| 1．Reasearch Objectives:The classical prescriptions have always enjoyed the fame for its effectiveness and efficiency. The Chief Physician Zhu Jiangui from the Department Of Gerontology has been working on clinical medicine for over 30 years and is an expert in treating all kinds of difficult and complicated disease. The study aims to uncover the prescription compound guidelines and application disciplines in treating all kinds of common illness and complicated diseases with the approaches of classical prescription and symptom by Dr. Zhu Jiangui and enhance the dialectic thoughts patterns, applying modern medical statistics, distilling the data, obtaining the relative data in the prescriptions used by Dr. Zhu Jiangui, and combining with the analyse and exploration of the clinical cases.2．Research Method:The thesis, designed with the theory of "the Correspondence of Prescription and Symptoms" , discussing the common classical prescription applied by Dr. Zhu Jiangui in clinical medicine, i.e., Ganmaidazao Soup, Suanzaoren Soup, Shenqi Pellets, Sini Powder; Shaoyaogancao Soup, Xiaochaihu Soup, Banxiaxiexin Soup, Huanglian' ejiao Soup, trying to uncover the relation between the prescriptions (illness-prescription-medicine-symptom), with the aid of crosstab and obtain the frequency of medicine application in the classical prescription and the law of symptom distribution of the classical prescriptions. The thesis reveals the clinical dialectic law in applying the classical prescription by Dr. Zhu Jiangui, with the results of data mining as the clinical reference, which is presented with figures and tables, and the aid of case analysis.3．Results:①Ganmaidazao Soup (128 times) : grasping "viscera weak and dry" as the main cause of the disease, loss of Yin and blood, no moistening of the viscera, inner stir of the Wuzhi fire, which leads to the fire of heart and liver, and being unable to stay calm. The cause of the disease lies in the hurt of mind and emotion. The results of the data shows that the prescription always treats the symptom of heart-throb, fever and sweating, red tongue, Mai deep and weak, which shows that the inner essence of Yin weakness and the symptom is basically consistent. The application frequency of Fuxiaomai and Dazao in the prescription is the same as 127 times, which ranks the first and Shenggancao is 120 times, which ranks the second. The prescription treats the dryness of viscera most frequently as 26 times; insomnia, 22 times, which ranks the second; sweating, 20 times, which ranks the third. The prescription is also used by Dr. Zhu in treating menopause patient with tidal fever and sweating quiet often. The menopause symptom is always accompanied by dryness of viscera, and the experts of clinical medicine always treats the disease with Zhibodihuangwan, Baihedihuangwan and Zhizichi Soup; for insomnia, the prescription is always applied with Suanzairen Soup.②Suanzaoren Soup (118 times) : the best choice for weakness and insomnia. Dr. Zhu treats most of the insomnia patients with this prescription. According to the result of the data mining, symptoms such as insomnia, sweating, heart throbbing, red tongue, dreamfulness and weak pulse are very common. The symptom of the insufficiency of Yin blood of heart and liver has certain relationship with the description of "weak, fatigue and annoyance leading to insomnia" . In the prescription, Suanzaoren is applied for 117 times; Zhimu, 107 times; Fuling, 101 times. The application frequency of these three herbs ranks the top, while the application of Shenggancao (67 times) and Chuanqiong (36 times) ranks the bottom. This does not mean that the effect of the medicine is neglected in the prescription. Dr. Zhu prescribes Chuanqiong by its effects as pungent, ascending, and dispelling the pathogenic factors, which leads to heal headache. It is used for curing insomnia for 61 times, which ranks the first. In curing the insomnia patient with defecate and disgest disorders, experts always compose the prescription with Xiaochengqi Soup, and Pingwei Powder. It is used for headache and dizziness respectively for 9 times, which ranks the second. The herb is always applied with Tianmagouteng Soup and Shaoyaogancai Soup, in which Chuanqiong is not omitted, but with heavy dose. The herb is used for curing dryness of viscera for 7 times, which ranks the third, and is used with Ganmaidazao Soup. To cure annoyance, it is used with Zhizichi Soup, Ganmaidazao and Sini Powder. To cure dryness in mouth, the prescription is used with Xiaochaihu Soup and Liuweidihuang Pills with alteration. To grasp the word "Weakness" and break through the word "sleep" , the doctor can well apply the prescription.③Shenqi Pellets (89 times) : The result of the data showthat the symptoms such as dimand dark color of the tongue, deep and thin pulse, being afraid of coldness, edema of legs and waist ache are very common, which matches the description of the symptoms in the prescription as "weakness and fatigue, waist ache, pain in the lower abdomen, trouble in urination, cure it mainly with Baweishenqi Pellets" . In the prescription, three herbs, i.e., Shanyurou, Shanyao, and Shudi, which invigorate the body is used more frequently than the three purgatives, i.e., Danpi, Zexie and Fuling. What' s more, the prescription is the first choice for curing insufficiency of Kidney Yang. After analysis, we can find out that Dr. Zhu applies this prescription with the consideration to nourish Yin Blood of Liver and Kidney, and slowly invigorate the Yuanyang in Kidney. Fuzi is applied with high frequency in this prescription of 87 times, for its nature of extreme pungency and hot, which passes 12 Jing, runs but not stays, and warms the Yuanyang in Kidney. The result of the data show that Cinnamon is used for 61 times, while the usage of cassia twig is 27 times, which ranks the bottom. The former is good at leading the fire to Yuan and the latter is good at dispelling coldness, rheumatism or numbness. Dr. Zhu often replaces the cassia twig with cinnamon in applying the prescription of Shenqi Pellets. The prescription is used to cure hydropsy as an internal medicine disease for 32 times, which ranks the first; sweating and waist ache respectively for 8 times, which ranks the second. In curing hydropsy, the prescription is often applied with Wupi Soup, Wuling Powder, Mahuang Soup, Sini Powder. Weakness of Yang and sweating is often cured with Ganmaidazao Soup, Zhibodihuang Pills or Oyster Powder; Lumbar illness andosteoporosis is cured with Shaoyaogancao Soup and Huoluoxiaoling Pellets. The symptoms is caused by weakness in Kidney Yang, and the symptoms such as weakness of Yang, being afraid of coldness is obvious below the waist, which is the key dialectic point of the prescription. In grasping the key points, the application range of the prescription is expanded.④Sini Powder (62 times) : The application frequency of Shaoyao is 61 times, 1 time more than the application of Chaihu of 60 times in this prescription. The reason why the two herbs share similar application frequency is that Shaoyao treats the weakness in blood, and Chaihu treats the insufficiency in Qi and the two herbs adjust Qi and blood; the application frequency of Shenggancao is 56 times, 4 times more than Chaochishi of 51 times. With the composition of Shaoyao and gaocao will relieve the pain of the liver. Chishi is good at descending. With the application of the four herbs, the effects can be ascending, descending, internal and external, which release the pathogen, and release the stagnated qi, stagnation of yang, and eliminate the symptoms. The result of the data show that red tongue, yellow tongue fur or coating of the tongue, bad appetite, fullness of the stomach are all symptoms in the disorder of the stomach and intestine and the whole digestion system. They have certain relationship with stagnation in the liver, and the disorder of intestine. It is important to recuperate the qi in grasping the prescription. The prescription has the effect of ascending and descending, opening and closing, connecting to yang, and dredging the stagnation. It is the first choice for curing heat syncope and the key prescription in dredging liver, invigorating spleen and reconciling the stomach in internal medicine nowadays. If the qi in liver remain stagnant, the qi system all over the body will be in disorder, which is the key factor in causing the disease. If we can refer to the prescription but not keep on it, we can expand the application domain by adjusting the dosage.⑤Shaoyaogancao Soup (55 times) : The result of the data show that the symptoms such as headache, waist ache, clonus of the legs, sleep disorder are very common. The pains is the most obvious symptom for the prescription. The prescription is applied for headache for 27 times, waist ache for 10 times, which rank respectively the first and the second. With the co-application of shaoyao and gancao, the sour and sweet will convert to yin, relieving the pain in liver. In the prescription, the application frequency of the two herbs are similar, i.e., shaoyao for 53 times and gancao for 51 times. The experts mostly use raw gancao and large dose of shaoyao. Shaoyaogancao Soup is sour and sweat, which aims to relieve aches. The prescription is effective in relieving aches for the aches caused by lack of maintaining of the jinmai or acute convulsion of stomach. Grasping the dialectic points of loss and weakness of yin blood, lack of maintenance of jinmai, the treatment aims to nourish the blood and relieve liver, and stop aches. ⑥Xiaochaihu Soup (42 times) : The result of the data show that the bitterness in the mouth, bad appetite, taut pulse which matches the description in the prescription as "cold and heat, distending, indifferent, bad appetite, annoyed and easy to vomit" , and "bitterness in mouth, dryness in throat, dizziness, dim, thin and yellow tongue fur, taut pulse" . Red tongue, thin and yellow tongue fur or sticky coating of the tongue, dizziness and insomnia can be looked on as caused by disorder of the shaoyang crux, stagnation of gallbladder and lots of phlegm. The match of prescription, medicine and symptoms shows the reasoning of the treatment. The application frequencies of the herbs in this prescription are similar as 40 times. It is used to curing dizziness for 9 times, which ranks the first; insomnia for 8 times, which ranks the second; fever and headache, respectively for 4 times, which ranks the third. To cure dizziness, experts always apply the prescription with Tianmagouteng Soup; for insomnia, with Suanzaoren Soup; for tinnitus, with Qijudihuang Pills; fever, with Sanren Soup, Shengjiang Powder or Qinghaobiejia Soup. Though there is a saying as "typhoid and stroke, used with Chaihu. With one of the symptom, the prescription can be given. " , clinically the symptoms do not show altogether. This means that in analysing the disease, the main symptoms should be identified. Identifying the main symptoms means that in curing the disease, we should focus on one or two main symptoms which reflects the symptoms described in the record and influence other symptoms and these main symptoms is the key factors for using the prescription. Xiaochaihu Soup attacks the pathogens and invigorates the body with coldness and heat, having the effects of pacifying shaoyang, dredging sanjiao, adjusting ascending and descending, connecting internal and external. It is the first choice for reconciliation method and the most commonly used prescription.⑦Banxiaxiexin Soup (22 times) : The result of the data show that the symptoms such as nausea, acid reflux, heartburn is more frequent, which are mainly caused by stomach obstruction and reflux of qi, phlegm, damp and indigestion , disorder of the ascending and descending of stomach and spleen, stagnation of coldness and heat under the heart. So, the result shown matches the description in the prescription and the analysis of the appearance of the tongue is the key point of the treatment. The application frequencies of Banxia, huanglian, huangchen and ginger are similar as 20 times, which ranks the top 4; dazao, 17 times; shenggancao, 16 times; dangshen, 12 times, which ranks the bottom. The experts do not change the dosage of the herbs in the prescription in curing the stagnation under heart and the discordance of the coldness and heat. The prescription is used to cure stomachache for 12 times, which ranks the first; fullness in stomache, 7 times, which ranks the second; insomnia, 3 times, which ranks the third. The prescription applies cold and warm herbs to cure the patient who can not endure coldness and warmness, since the patients is weak in stomach and spleen, fullness in stomach, discordance of ascending and descending in stomach which leads to the inability to ascend the clear and descend the turbid and the stagnation of cold and warm qi under the heart. With the co-effect of shen, cao and zao, the prescription is able to eliminate the fullness and strengthen the stomach, curing the fullness in stomach. It is an important prescription in curing the discordance of coldness and heat.⑧Huanglian' ejiao Soup ( 19 times ) : treats insomnia (heat conversion of shaoyin) caused by insufficient of Shenshui, sthenic heart fire. The result of the data mining show that the symptoms of yellow tongue fur, insomnia, red tongue, deep or thin pulse, annoyance, tinnitus is very common, which matches the description of "Shaoyin disease for over two or three days, annoyed, unable to lie down, cure with Huanglian' ejiao Soup" . Heat conversion of shaoyin, and failure of water and fire will lead to insomnia while tinnitus is always caused by weakness of kidney and annoyance of liver. The herbs are used for about 18 times in the prescription. It is used to cure insomnia for 17 times, which ranks the first; ringing in the brain and hypochondria, 1 time, which ranks the second. The result above shows that the prescription is mostly applied to cure insomnia. In curing this kind of patient, Dr. Zhu applies the prescription with Jiaotai Pellets, Zhizichi Soup and Suanzaoren Soup; if the patient is windy, Pingwei Powder, Wendan Soup and Sini Powder is also used. Insomnia is connected with various kind of physical, psychological and pathological factors, among which the disorder of stomach is the closest one. The doctor should give careful analysis before prescription. The key point is the symptoms of heat conversion of shaoyin and the law of nourishing yin and dispel the heat should remain unchanged. 4．Conclusion:Classical prescription, as it is named, each has its corresponding symptoms. The most important is that each prescription has its unique theoretical construction and its theory based, the approaches, the prescriptions and medicine are combined as a whole. With the accurate analysis in clinical medicine, the corresponding of prescription and symptoms can be one prescription for multi-symptom, i.e., the concept different disease, same treatment.Traditional Chinese Medicine does not cure the illness without targets, but analyses the cause of the disease and obtain the prescription which matches the symptoms for the patient according to the symptoms of the patient. It does not use a single herb for a single illness, which represents the concepts of "sourcing the cause before curing the disease" in Chinese Medicine. In article 16 of the book The Theory of Injuries by Coldness, "analyse the pulse, understand the cause and cure according to the symptom" , and Article 317 "If the symptoms match the description, then use the prescription. " , we can found the concept of prescription-symptoms is very explicit. The match of symptom and prescription is a characteristic in the theory of Zhang Zhongjing. If we take it as an guideline and comprehend it by analogy, expand the relative connotation of the prescription-symptom content, we can really understand the core of the classical prescription and expand the application domain of the classic prescription. |
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