| Objective:Based on the idea of "Integration of Tao and Shu",this study adopts the multiple integration methods of grounded theory,data mining and case series research to supplement each other,and obtains the information of Professor Peng Jianzhong at two levels of Tao and Shu and refines the key points of inheritance to avoid the decline of inheritance.In addition,this research provides methodological paradigm for the study of experience inheritance of illustrious senior traditional Chinese medicine practitioners,so that the essence of traditional Chinese medicine may be fully inherited.Methods:1 We interviewed with Professor Peng Jianzhong himself,his disciples and patients to obtain interview data,and applied the grounded theory method to dig deep into the invisible non-digital information of Professor Peng Jianzhong,such as values,mode of thinking,cultural spirit,speculative methods,etc.,and then formed genera and core genera,constructed Professor Peng Jianzhong’s experience inheritance model from the perspective of "Integration of Tao and Shu" and obtained the key points of inheritance.2 The method of data mining was used to analyze the idea of prescription.We mainly used Gephi software and R software to analyze the frequency statistics,association rules and complex network visualization of the prescriptions of chronic kidney disease collected in Professor Peng Jianzhong’ outpatient clinic in order to understand the correlation rules both among the nature,flavor and channel tropism of Chinese medicine and among Chinese medicine,and understand Professor Peng Jianzhong’s medication ideas of treatment in different stages of chronic kidney disease.3 We used the method of case series study to collect the changes of indicators such as glomerular filtration rate,creatinine,urea nitrogen,uric acid,24-hour urinary protein,urine occult blood,liver function,etc.and the TCM symptom improvement of patients with chronic kidney disease who were treated by Professor Peng Jianzhong.The curative effect was evaluated by comparing the patients themselves before and after treatment.Results:1 Research based on grounded theoryThis study interviewed Professor Peng Jianzhong twice;interviewed 7 people of Peng Jianzhong’s disciples and students,each person once,and obtained 7 interview materials;interviewed 20 patients,each person once,and obtained 20 interview materials;a total of 29 transcribed materials were obtained,totaling more than 160,000 words,with 1554 initial codes,forming 53 subcategories and 9 categories,which can be dominated by two core categories,namely excellent cultural spirit and academic inheritance and development.On this basis,the experience inheritance model of Professor Peng Jianzhong based on"Integration of Tao and Shu" was constructed,and the following inheritance points were obtained:(1)Thoughts and actions:cultural spirits:perseverance,humility and open-minded,embracing responsibility with courage,seeking truth from facts,benevolence,diligence,indifferent to fame and fortune,peace of mind,simple life,contentment.Ideological and moral character:to be a person,he honors the teachers and esteems truth,instructs and influences disciples and students by his word and deed,takes care of colleagues;as for his family,he loves and cares for his family;as for patients,he treats patients as relatives,selfless dedication and noble medical ethics;as for medical stills,he is well versed in medical skills and familiar with classics and theories,integrates the knowledge and applies flexibly;as for medical cause,he has a good knowledge of both traditional Chinese medicine and western medicine,and spares no effort to carry forward the cause of traditional Chinese medicine.Concept of money:he attaches importance to technology and dedication,not eagers for money.Concept of cause:he is committed to the inheritance and development of the cause of traditional Chinese medicine.Concept of career:benevolence,he puts patients at the first place.Outlook on life:contentment,tenacity and optimism.(2)Theory and practice:theory mainly refers to the theory and thinking of traditional Chinese medicine,and practice mainly refers to clinical diagnosis,treatment and prescription.With the thinking method of learning from masters and treatment based on syndrome differentiation,Professor Peng Jianzhong summed up the five pathogenesis,four treatments and the corresponding core prescriptions for the treatment of chronic kidney disease.The characteristics of the treatment of chronic kidney disease:the use of drugs has its origin,pursuing the maximization of curative effect,using drugs in different dimensions,reasonably explaining the toxicity of traditional Chinese medicine,collecting the advantages of many theories,be clear with the treating principle,prescription in accordance with the principle and be flexible with the use of drugs.2 Data mining(1)In the prescription,the most frequent occurrence is the cooling blood and expelling blood stasis drug group:radix paeoniae rubra(Chishao),parched flos sophorae(Chaohuaihua),radix salviae miltiorrhizae(Danshen),radix rubiae(Qiancao);followed by benefiting qi and nourishing elements drug group:radix astragali(Shenghuangqi),eucommia bark(Shengduzhong);then is the dispelling pathogenic wind and removing dampness drug group:herba schizonepetae(Jingjie),saposhnikovia divaricate(Fangfeng).These drugs are mainly bitter,sweet and pungent in flavor,and the nature of them are almost the same while no medicine which is hot in nature appeared.The drugs belong in turn to the meridians of liver,lung and kidney.(2)The results of association rules between the diagnosis of chronic kidney disease and drugs suggest that there are three groups of drugs in both glomerulonephritis and renal insufficiency:charred schizonepeta(Jingjietan),radix rubiae(Qiancao),radix salviae miltiorrhizae(Danshen),radix sanguisorbae(Shengdiyu),radix paeoniae rubra(Chishao),parched flos sophorae(Chaohuaihua);herba schizonepetae(JIngjie),radix angelicae pubescens(Duhuo),angelica dahurica(Baizhi),saposhnikovia divaricate(Fangfeng);radix astragali(Huangqi),eucommia bark(Shengduzhong),radix dipsaci(Xuduan),herba taxilli(Sangjisheng).In addition,flos lonicerae(Jinyinhua),fructus forsythia(Lianqiao),herba taraxaci(Pugongying),rhizoma smilacis glabrae(Tufuling),rhizoma dioscoreae septemlobae(Mianbixie),herba hedyotis diffusae(Baihuasheshecao),rhizoma phragmitis(Lugen)and rhizoma imperatae(Baimaogen)are closely related to glomerulonephritis,while indian bread peel(Fulingpi),exocarpium benincasae(Dongguapi),and semen lepidii/semen descurainiae(Tinglizi)are closely related to renal insufficiency.3 Case series studyThe chronic kidney disease prescription could significantly improve the renal function of CKD patients,and the levels of serum creatinine,urea nitrogen and uric acid decreased significantly after treatment(P<0.01),the eGFR results increased after treatment(P<0.05);24-hour protein quantity and urine protein quality decreased significantly compared with those before treatment,and serum albumin increased significantly(P<0.05),which showed the prescription could improve the symptoms of urinary protein and edema.Urinary occult blood was significantly lower than that before treatment(P<0.05).There was no significant difference in AST and ALT between before and after treatment,and no liver function injury was found,so it is safe to use the drugs.The symptoms of the patients were significantly improved,and the symptoms of shortness of breath,thirst,yellow urine and dizziness were significantly alleviated after treatment as compared with those before treatment(P<0.001).There were also significant differences in fatigue,sore waist and knees,dry mouth and thirst,hand and foot heat,nausea,dry stool and skin itching compared with those before treatment(P<0.05).The research shows that under the guidance of the idea of treating same disease with the same treatment,the chronic kidney disease group has a significant clinical effect at least in the short term.Conclusion:1 The multiple integration methods of grounded theory,data mining and case series research can relatively comprehensively summarize the inheritance content of "Tao and Shu"of Professor Peng Jianzhong,and provide methodological paradigm for the study of experience inheritance of illustrious senior traditional Chinese medicine practitioners,so that the essence of traditional Chinese medicine may be fully inherited.2 Professor Peng Jianzhong clinically adopts the critical method of disease differentiation and treatment,combined with consideration methods of symptom seeking,microscopic syndrome differentiation,etc.,and through the profound understanding of the essence of diseases in traditional Chinese medicine,finally achieves the syndrome-based treatment under the guidance of the treating same disease with the same method.This method can significantly improve the indicators and symptoms of chronic kidney disease patients.These two parts are mutually verified with the results of grounded theory. |
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