Professor Pang He 's Academic Thought And Clinical Experience And Clinical Study On The Treatment Of ASO (Non - Ulcer) By Yiqi Huoxue Decoction

[objective] Professor Pang He is the doctoral tutor of Beijing University of Chinese Medicine, chief physician, the guidance of the fifth batch of national famous old TCM experts, engaged in traditional Chinese medicine clinical work for more than 30 years, He is knowledgeable, experienced, and good at Chinese medicine treatment of internal diseases and peripheral vascular disease. The academic thought and clinical experience of professor PANG in treating peripheral vascular disease and other internal medical diseases is a very valuable asset. To summarize, organize, inherit and develop the academic thought and clinical experience comprehensively and systematically is one of the purposes of this study. Another purpose of this paper is to study the clinical effect of Yiqi Huoxue Quzhuo Jiedu (benefiting qi for activating blood circulation, eliminating turbid and removing toxicity) therapy in treating arteriosclerosis obliterans (without collapse), and to study professor Pang’s academic thought and clinical experience in treating this disease, and in order to master the basic methods of clinical research.[Methods and contents] The clinical thought of syndrome differentiation and treatment, medication thinking and experience of professor Pang were analyzed by clinical practice, writing notes, collecting typical clinical medical records and writing the feelings and experiences (diary) of learning with professor Pang; The academic thoughts of professor Pang was summarized by collecting his papers and books, audio and video data and text lectures; In order to complete the summary and arrangement of academic thought origin and clinical experience of professor Pang, the ancient books and the academic thoughts of famous old Chinese medicine experts which influence the formation of his academic thought were researched; The academic thought and clinical experience of professor Pang was applied to the author’s clinical practice. The clinical research of this paper was carried out to study the clinical effect of Yiqi Huoxue Quzhuo Jiedu therapy in treating arteriosclerosis obliterans (without collapse) by professor Pang He, and finally, the clinical efficacy before and after treatment were analyzed.[Results] The paper was divided into three parts. Including overview of origin of professor Pang He’s academic thought, summary of professor Pang He’s academic thought and clinical experience, as well as the clinical research of Yiqi Huoxue Quzhuo Jiedu therapy in treating arteriosclerosis obliterans (without collapse) by professor Pang.The first part:the origin of academic thought of professor Pang HeThe academic thought of professor Pang He mainly comes from two aspects. Firstly, the academic thoughts from Liu Du-zhou, Su Bao-gang, Cheng Shi-de, Zhao Shao-qin and other prominent TCM doctors. To learn their academic characteristics of classic study, pursuit of perfection, perfect the theory and flexible application, holism, and attaches great importance to the compatibility, and learn their academic ideas and experiences of using classical prescriptions in treating other internal medical diseases. Secondly, the academic thoughts from Inner Canon of Yellow Emperor, Treatise on Cold Pathogenic Diseases, Synopsis of Golden Chamber, Golden Mirror of Medicine, Orthodox Manual of External Diseases, and combined with clinical study.The second part:Professor Pang He’s academic thought and clinical experience(A) Academic ThoughtProfessor Pang thinks that the main pathogenesis of chronic lower extremity arterial ischemic disease is’vital qi deficiency, blood stasis, and turbidity pathogen (phlegm, dampness, heat, turbid) blocking collaterals’. He emphasis that vital qi deficiency is the basis of the pathogenesis of this disease and local blood stasis is throughout the disease process; in understanding the pathogenesis of innovation and development of this disease, the doctors should pay attention to the role of turbidity pathogen in the occurrence and development of the disease.On the syndrome differentiation of peripheral vascular diseases, professor Pang hold that although the limbs local lesions are obvious, its clinical manifestations is related to the imbalance of qi and blood of zang-fu viscera, therefore, the clinical treatment should be combined with integral and local syndrome differentiation.In the treatment of peripheral vascular disease, professor Pang argue that the pathogenesis of this disease is characterized by deficiency in root cause and excess in manifestation, deficiency in root cause lead to excess in manifestation, so the treatment should pay attention to regulate the function of zang-fu viscera, treating both manifestation and root cause of disease, strengthen vital qi and eliminate pathogenic factor. He also applied ’harmonizing’ method to the treatment of peripheral vascular disease, regulating yin and yang and harmonizing qi and blood. In the treatment of blood stasis for long time, professor Pang proposed ’replenishing blood to dissipate stasis’ academic idea, he thought that the sufficient of yin and blood is an important condition for normal blood circulation, so replenishing blood is conducive to activating blood circulation.(B) Clinical Experience1 Chronic venous insufficiency (CVI):Professor Pang believes that the basic pathogenesis of this disease is blood stasis due to qi deficiency, and dampness-stasis-turbid pathogen blocking collaterals, it can be divided into three kinds of syndromes:blood stasis due to qi deficiency, dampness, stasis, turbid pathogen blocking collaterals, damp-heat and amassing poison. According to different syndrome types, the TCM prescriptions such as modified Huangqi Guizhi Wuwu Decoction, Danggui Shaoyao Powder, Wuling Powder, Ermiao Powder, Wuwei Xiaodu Drink were used to treat this disease.2 Stasis dermatitis:This disease can be divided into four syndromes, professor Pang believes that the basic pathogenesis of this disease is wind and dryness due to blood deficiency and damp-turbidity amassing poison. The modified Yangxue Qufeng Zhiyang Decoction can be used to treat this disease.3 Raynaud’s syndrome:Professor Pang believes that the pathogenesis of this disease is blood stasis blocking channels which caused by innate deficiency of yang in the body, cold pathogen invading superficies or liver depression and qi stagnation. The treatment should pay attention to promoting blood circulation for removing blood stasis. Modified Huangqi Guizhi Wuwu Decoction can be used to treat this disease.4 Chest painful impediment:Professor Pang believes that the pathogenesis of chest painful impediment is yang debility and yin excessiveness, yang qi blockage; deficiency of yang qi is the key factor of this disease. The treatment should pay attention to warmly dredging yang qi and dispelling cold pathogen, Modified Gualou Xiebai Decoction can be used to treat this disease.5 Arthralgia:Professor Pang believes that the internal cause of arthralgia is loss of control due to deficient vital qi and the external cause is pathogenic qi invading. The treatment should pay attention to both strengthening vital qi and eliminate pathogenic factor. The patients of the department of peripheral vascular are mainly blood bi and painful bi, Modified Huangqi Guizhi Wuwu Decoction and Modified Guizhi Decoction combined with Mahuang Fuzi Xixin Decoction can be used to treat this disease respectively.6 Vertigo:Professor Pang believes that although considered complex etiology, the pathogenesis of vertigo is nothing more than deficiency and excess. The deficiency and excess may affect each other. Vertigo caused by phlegm and fluid retention can be treated with Zexie Decoction combined with Danggui Shaoyao Powder. Vertigo caused by hypertension can be treated with Modified Wucao Decoction.7 Insomnia:Although many causes of insomnia, professor Pang believes that changes in pathogenesis are yin-yang disharmony, liver depression disturbing heart, and inferior spirit restless. This disease can be divided into syndrome of phlegm-heat attacking heart, disharmony between heart and kidney, deficient heat attacking internally, and yin-yang disharmony. Rhizoma Pinelliae and Spica Prunellae can be used to regulating liver and nourishing blood, tranquilizing by calming heart, and coordinating yin and yang.8 Menopathy:Professor Pang believes that the pathogenesis of menopathy is complex, disease manifestations are varied, nature of this disease is intermingled cold and heat, deficiency and excess, its key pathogenesis is deficient cold of thoroughfare and conception channels and static blood in lateral lower abdomen. The treatment should warming channel and nourishing blood, coordinating Chong and Conception Vessels, Modified Wenjing Decoction can be used to treat this disease based on syndrome differentiation.9 Climacteric syndrome:Professor Pang believes that kidney deficiency and exhaustion of tian gui is the pathogenesis of climacteric syndrome. The syndrome of yin deficiency of liver and kidney, and failure of liver to convey and disperse can be treated with Liuwei Dihuang Pills combined with Danzhi Xiaoyao Powder to nourishing yin and clearing liver, dispersing stagnated liver qi for relieving qi stagnation. The syndrome of blood deficiency of heart and liver, malnutrition of five zang viscera can be treated with Ganmai Dazao Decoction combined with Baihe Dihuang Decoction and Zhupida Pills to tranquilizing by nourishing the heart. The syndrome of liver depression and qi stagnation, intermin-gled phlegm and blood stasis can be treated with Banxia Houpu Decoction and Ganmai Dazao Decoction combined with Siwu Decoction to dispersing stagnated liver for regulating qi-flowing, dissipating phlegm and resolving masses.10 Allergic rhinitis:Professor Pang believes that the pathogenesis of this disease is mostly invading nose by external cold and internal heat, Maxing Shigan Decoction can be used to clearing lung-heat and free the nasal orifices. If the disease sequential transmission along channel, stagnant pathogen of Shaoyang, Maxing Shigan Decoction combined with Xiaochaihu Decoction can be used to clearing lung-heat and free the nasal orifices, reconciling shaoyang. If the disease is transforming to collaterals, obstruction of the orifices by blood stasis, the method of activating blood and free the nasal orifices can be used to promoting blood circulation for removing blood stasis.The third part:clinical effect of Yiqi Huoxue Quzhuo Jiedu therapy in treating arteriosclerosis obliterans (without collapse) by professor Pang He1 BackgroundArteriosclerosis obliterans (ASO), a common clinical peripheral vascular disease, is a limb ischemia syndrome with pathological basis of medium-sized lower extremity arterial stenosis or occlusion and thrombosis. It seriously endanger the health of patients, affecting normal life, with high incidence and high morbidity. Conventional treatment of Western medicine has some limitations in clinical application while Chinese medicine for treating lower limb arteriosclerosis has a good advantage. How to make better use of Chinese medicine treatment of ASO, especially the prevention of ASO (without collapse), is worth further study and summary. After years of clinical practice and basic research, professor Pang He believes that the main pathogenesis of ASO is’vital qi deficiency, blood stasis, and turbidity pathogen (phlegm, dampness, heat, turbid) blocking collaterals’. He used the basic principle of Yiqi Huoxue Quzhuo Jiedu in treating ASO (without collapse) patients, with good results, and accumulated a wealth of clinical experience.2 ObjectiveThrough the clinical observation of Yiqi Huoxue Quzhuo Jiedu therapy in treating arteriosclerosis obliterans (without collapse), to study professor Pang He’s clinical efficacy in treating this disease.3 MethodAccording to the inclusion criteria,55 patients with arteriosclerosis obliterans (without collapse) were selected. Clinical intervention of Yiqi Huoxue Quzhuo Jiedu therapy according to professor Pang was performed. The treatment course was 28d, for three courses. The clinical symptoms and signs (pain, numbness, cold sensation, intermittent claudication) score, and ankle-brachial index (ABI) before and after treatment for 28d,56d,84d were observed, and its safety was evaluated.4 ResultsIntervention of Yiqi Huoxue Quzhuo Jiedu therapy in treating arteriosclerosis obliterans (without collapse) 55 cases by Professor Pang He, the results of clinical cure were 8 cases (14.5%), excellence were 27 cases (49.1%), effective were 15 cases (27.3%), ineffective were 5 cases (9.1%), the total clinical efficiency was 90.91%. After treatment, the clinical symptoms and signs of pain, numbness, coldness, intermittent claudication of patients were improved (P<0.05). After treatment, the ankle-brachial index (ABI) was significantly increased (P<0.05) than before.5 ConclusionsApplication of Yiqi Huoxue Quzhuo Jiedu therapy in treating arteriosclerosis obliterans (without collapse) have better clinical efficacy. It can improve the symptoms, signs, and ABI of ASO patients.