Summarize Professor Ding Yi-jiang’s Academic Thoughts, Clinical Experiences And Observe The Clinical Curative Effect Of Warming Yang For Relaxing Bowels Granules On Spleen-kidney Yang Deficiency Type Constipation

Ding Yi-jiang, an aged TCM doctor, is the ninth inheritor of Dings hemorrhoid department, a professor and PhD supervisors of Nan Jing University of Traditional Chinese Medicine, and the fifth group of the old Chinese medicine expert academic experience inheritance tutor, enjoying the special allowance of the State Council. He is the incumbent vice president of Nanjing Hospital of Chinese Traditional Medicine and the director of the Chinese Medicine Anorectal Specialist Medical Center. Professor Ding has engaged in clinical, teaching, scientific researching regarding to Chinese anorectal section for nearly 40 years. He is a doctor of great attainment and experienced in refractory anorectal diseases including circular mixed hemorrhoid, complex high anal fistula, functional constipation, inflammatory bowel disease and colorectal cancer.Objective:Theoretical research:explore the origin of Ding Yi-jiang’s academic thoughts and its formation. Systematize and summarize Professor Ding’s academic thoughts to inherit and develop it deeply, so that there are qualified successors of Chinese anorectal section. Clinical research:To observe the clinical curative effect of warming yang for relaxing bowels granules on spleen-kidney Yang deficiency type constipation.Methods:Theoretical research:Collect the clinical data of Professor Ding comprehensively by reviewing the history of Dings hemorrhoid department and the process of medicine study and experience of Professor Ding, combining with learnnings, typical medical cases and operations of refractory diseases from Professor Ding. Study the thesis and works written by Professor Ding, search relevant background literatures widely, explore and summarize the academic thoughts and clinical experience from Professor Ding, and make it a thesis. Clinical research:Collecting 60 patients of spleen-kidney Yang deficiency type constipation were divided into study group with 30 cases and control group with 30 cases randomly. Study group were given warming yang for relaxing bowels granules for 4 weeks and control group were given Prucalopride Succinate Tablets for 4 weeks. The parameters were calculated, such as chronic constipation severity scale, TCM symptoms scale and quality of life questionnaire scale before and after treatment.Results:Theoretical researchrThe origin of Ding Yi-jiang’s academic thoughts has been summarized in the following three aspects:The first is from the literatures of successive dynasties such as Huangdi Neijing, Treatise on Febrile Diseases, Three-character Medical Verses, Complete Works of Zhang Jingyue, Orthodox Manual of External Diseases,etc. The second is from family heritage. It’s a family devoted to acamedic context for ten generations for more than 300 years. Professor Ding was influenced by bis family since he was a child. He learned basic theories of TCM from his father and read the classic medical books of TCM by heart. The third is from hard clinical practice for years. Ding Yi-jiang was graduated from Nanjing Medical University in 1970. He worked in general surgery department in Jiangpu People’s Hospital for 10 years since then. Until 1979 he was tranfered to anorectal section in Nanjing Hospital of TCM, working with Professor Ding Ze-min (his father). He lays emphasis on combination of theories of TCM and morden medicine and clinical practice. Therefore he develops his own unique academic thoughts. Some refractory anorectal diseases including circular mixed hemorrhoid, complex high anal fistula, functional constipation, inflammatory bowel disease and colorectal maliganant tumor are all his superiorities. The Ding Yi-jiang’s academic thoughts has been summarized in the following five aspects:The first is combining differentiation of symptoms and diseases, optimizing therapeutic schemes. Professor Ding considers that we must abide by the principle that combining differentiation of symptoms with differentiation of diseases when dealing with anorectal diseases, which means we need to diagnose diseases with modern medical technologies and formulate individual treatment plans according to theory of differentiation of symptoms and signs of traditional Chinese medicine. The second is the best in each other if using both acupuncture and Chinese herbal medicine. Professor Ding often treats the patients with constipation who manifest as the Yang deficiency of spleen and kidney with acupuncture which using back-shu points and front-mu points combination to anabiosis yang qi and promote intestinal peristalsis, besides on the basis of Chinese herbal medicine treatment. The third is taking minimally invasive treatment as the first choice to protect the patient’s anus meticulously. During the long-term medical clinical practice, Professor Ding established the clinical concept that "protecting the anus meticulously", against excessive treatment. He emphasized that "treating the hemorrhoids with symptoms only while exairesis every seen hemorrhoid". Professor Ding uses segmental dentate ligation and skin bridge suture and suspension to make the internal hemorroids ligation points be not in the same horizontal plane and retain perianal skin sufficiently. Meanwhile He performed suspension to protect function and morphology of anal and avoid stricture of anus, which often happened after a circular mixed hemorrhoid surgery. The fourth is focusing on modern technologies. Professor Ding is very concerned with developments within the professional field at home and abroad. He is willing to accept and generalize it whatever is a new theory or a new technology. Professor Ding takes the lead in carrying out some examinations such as trans-rectal ultrasonography, trans-rectal three-dimensional ultrasonography and MRI to increase the accuracy of preoperative examination of complex high anal fistula. He also firstly adopted the biofeedback to treat with functional constipation, which has achieved great effect. The fifth is initiating multidisciplinary cooperation. Professor Ding set up the diagnosis afid treatment center of functional pelvic floor diseases and adopted the multidisciplinary consultation cooperation mode. The center includes different departments of doctors, for instance, anorectal surgeons, acupuncture doctors, psychotherapists, functional examination technicians, biofeedback therapists and specialist nurses. All of them treat pelvic floor diseases under the concept of holism instruction. We summarized Professor Ding’s clinical experiencein anorectal diseases such as circular mixed hemorrhoid, high perianal abscess, complex high anal fistula, functional constipation with Yang deficiency and UC. Clinical research:The curing rate and total effective rate were 13% and 90% respectively in study group, which were 7% and 60% respectively in control group. The curing rate and total effective rate in study group were significantly higher than that in control group(.P<0.05). Chronic constipation severity scale, TCM symptoms scale and quality of life questionnaire scale after treatment in study group were significantly lower than that in control group(P<0.05).Conclusions:Ding Yi-jiang is an experienced Chinese anorectal doctor, who has a great reputation around the country. Now we summarize Professor Ding’s academic thoughts and clinical experience to inherit and develop them deeply and provide new thoughts and methods for clinical practice. Warming yang for relaxing bowels granules is a safe and effective treatment for spleen-kidney Yang deficiency type constipation.