| Objective:The objective of this dissertation is to analyze the specific indications of the clinical applications of Chailing Decoction according to the clinically valid medical records of Professor Huang Huang,and to elaborate and discuss the formula presentations of Chailing Decoction based on this clinical evidence mainly with the recordation of the original lines of Chailing Decoction,and secondly with Xiao Chaihu Decoction and Wuling San.Hereon to enhance the clinical efficacies and the safety of the formula’s application,and to explicit the indications of the clinical applications of Chailing Decoction,to provide reference for future clinical research.Methods:(1)Research documentation sources:Through the research on the recordation of the documentation on the clinical indications of Chailing Decoction,only those documentation of Chailing Decoction’s medicine compostition similarity more than and equallly to 50%to this study are included and collected.At the same time,the data of 289 clinically valid medical records from Professor Huang Huang were statistically analyzed as research object.(2)Collection and entry of medical records:The total of 650 medical records of the clinical application of Chailing Decoction from Professor Huang Huang in between January 2004 and July 2021 were collected and arranged.In order to ensure the objectivity of the analysis results,this study only conducted statistics and analysis on effective medical records and formulated a strict inclusion and exclusion criteria for effective medical records,and a total of 289 effective medical records were passed through the screening at last.(3)The data analysis system was used for statistical analysis:The research project such as the indication’s recordation of Xiao Chaihu Decoction and Wuling San’s original lines from Treatise on Cold Damage and Miscellaneous Disease,as well as the documentation and the clinical experiences’ recordation of the doctors from past dynasties,and effective medical records of Professor Huang Huang were arranged and summarized,and the frequencies classify statistic were performed again in this study.The methods used for the statistical analysis of IBM SPSS Statistics 25.0 in this study as below:(a)Cluster Analysis:The indications of Chailing Decoction,clinical syndrome and the analysis on medicine application of Chailing Decoction which containing combined medicinal herbs were obtained.(b)Binary Logistic Regression Analysis:The clinical data were mined to obtain the influencing factors of increasing the risk of the disease from the gender,age and common symptoms of the patients.Results:(1)The applicable body constitution of Chailing Decoction.Female patients were most suitable for this formula.The age of the patients was 50.59±16.78-year-old in male and 50.95 ±14.55 in female.The height was 168.05±17.61cm for male and 159.98±4.8cm for female.The body weight was 65.65±13.64kg for male and 56.08±7.96kg for female.The body mass index(BMI)was 23.14±3.1 in males which indicating that the body mass was normal or overweight,while was 21.91±2.8 in female which indicating that the body mass was normal.The other body’s constitution’s characteristics of patients includes the tongue’s indication,such as the tongue are red,dull,teeth-print,pale and swollen;the tongue coatings are greasy,white,thin,thick and yellow.The body shape of patient is medium,thin,fat and muscular.The facial complexion are yellow,red,dull and colored patches.The pulse is slippery and rapid.The lips are red and dull.For the abdominal examination,the abdominal signs which seen often are soft abdomen muscles and the stomach comes with the vibration water sounds when pressing on it.(2)The applicable symptoms of Chailing Decoction.The list of symptoms in this dissertation are as follow:thirsty,poor sleep,loose stools,fatigue,poor appetite,fear of cold,to drink,dry stools,easy to sweat out,upper abdominal distention,dizzy,difficult urination,be susceptible to cold,diarrhea,dreaminess and cough.Through the study and contrastive analysis of the clinical application of Chailing Decoction among the Treatise on Cold Damage and Miscellaneous Disease,the documentation and the clinical experiences’ recordation of the doctors from past dynasties,and effective medical records of Professor Huang Huang,it shown there are similarities and differences.The similarities in between are thirst/dry mouth,aversion to cold/protect against cold,diarrhea/loose stool,easy to sweat/sweat/spontaneous perspiration/night sweat and hard glomus/fullness in[below]the heart/distention in epigastrium,the rest symptoms could be treated as the peculiarity of the clinical application of "only one sign[means that]this is[the pattern]" of Xiao Chaihu Decoction,as well as corporate with the application of Wuling San which able to treat the symptom which is related to dampness.(3)The applicable diseases of Chailing Decoction.The list of diseases is as follow:recuperation after cancer surgery,Lung Cancer and Sjogren’s Syndrome.According to Binary Logistic Regression Analysis,the influencing factors of increasing the risk of recuperation after cancer surgery are the age and symptom of thirsty.For Lung Cancer,the influencing factor of increasing the risk are the gender,age and symptom of cough.For Sjogren’s Syndrome,the influencing factors of increasing the risk is the symptom of thirsty.Besides,Chailing Decoction is also could uses for constitution’s conditioning for the malignant tumor patients.(4)Syndrome distribution of Chailing Decoction:(a)Cause of disease:The physiological function of Spleen and Stomach is low,contention in between right and evil.(b)Pathomechanism:Pivot’s mechanism of Lesser Yang is inhibited,vacuity and debilitated of Right Qi,insecurity of the defensive exterior and metabolic dysfunction of fluid.(c)The main location of viscera is Spleen(Stomach),involved Lung(Large Intestines),Heart(Small Intestine)and Liver(Gallbladder).(d)Throughout the cluster spectrum diagram of the statistical result obtained from the method of Cluster Analysis of SPSS 25.0 for the above symptoms,they were systematically combined and classified,and nine clinical syndromes were obtained,they are fecal and urine,head and,face and five offices,sleep,whole body’s symptoms,abdominal,gastrointestinal tract,heat and cold of the body,condition of sweating,and chest and rib-side.(5)Main formula’s regularity:The formula regularity which commonly applied during clinical practice of Professor Huang Huang is the original formula combination of Chailing Decoction,which includes Xiao Chaihu Decoction and Wuling San.He seldom adds or subtract medicinal herbs from the prescription,but only adjusted the dosage of the medicinal herbs accordingly to the symptoms of patient.(6)Medicinal herb’s application regularity:The commonly used medicinal herb which is needed to added in to or subtracted from the original formula prescription of Chailing Decoction according to the numerous clinical symptoms by Professor Huang Huang,they are Fangfeng,Jingjie,Baishao,Houpo,Lianqiao,Danggui,Chuanxiong,Suye,Sugeng and Zhike,the addition of the above medicinal herbs into the Chailing Decoction’s formula combination have created four formulas,they are Shaoyao Gancao Decoction,Guizhi Decoction,Huangqin Decoction and Banxia Houpo Decoction.According to the result of the Cluster Analysis shown,there are eleven medicinal herb pairs for the Chailing Decoction with additional herbs,and there are five medicinal herb’s combinations composed of three medicinal herbs respectively.(7)Dosage regularity:The dosage of medicinal herbs which arranged from the effective medical records of Chailing Decoction are Chaihu 5-30g,Huangqin 5-25g,Jiang Banxia 5-15g,Ganjiang 5-10g or Shengjiang 10-20g,Zhuling 10-40g,Fuling 10-40g,Zexie 10-60g,Hongzao 10-40g,Guizhi 5-35g or Rougui 5-15g,Dangshen 10-20g or Sheng Shaishen 5-15g,Sheng Gancao 5-15g or Zhi Gancao 5-15g,Sheng Baizhu 10-30g or Cangzhu 10-30g.Conclusion:(1)Throughout the inductive and analyzation of the data of the research on the 289 effective cases of Professor Huang Huang,the three aspects such as the applicable body constitution,the attending symptom and the attending disease of Chailing Decoction are confirmed and inductive for the first time.Besides,the cause of disease,pathomechanism,the nature pattern of disease and the location of viscera involved are summarized by the statistical analysis system,as well as the influencing factors of increasing the risk of the applicable diseases.The results above have created certain clinical value and reference significance on the clinical application experiences of Chailing Decoction of Professor Huang Huang which has analyzed and concluded.(2)The original lines of Xiao Chaihu Decoction,Wuling San and Chailing Decoction are discussed in this study,and the indications of the clinical application of the differentiation of Chailing Decoction presentations,the herb pairs and the additional herbs in Chailing Decoction are discussed as well.(3)The academic thoughts of Professor Huang Huang on the clinical application of Chailing Decoction are as follow:(a)Attaching great importance on the clinical "primary symptom",blend in with the classical original lines.(b)Emphasize the correlation of all four examinations and let clinical diagnosis to be more objective.(c)Strengthen the attention of abdominal diagnosis,to consolidate the diagnosis of palpation.(d)Applying the combination formula skillfully,with clinical indications as the gold standard.(e)Take reasonable diet as the key principle,pay attention to the qualities of life of patients.(4)The characteristic of formula presentation of Jingfang:(a)The integrity of formula presentation.(b)The systematicness of formula presentation.(c)The typicality of formula presentation.(d)The heritability of formula presentation. |
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