Professor Tian Jinzhou 's Academic Thought And Clinical Experience

My mentor professor Tian Jinzhou is a famous geriatric neurology specialist, the first Changjiang Scholar among Chinese traditional medical, and also mentor of the 5th group academic experience of inheritance as Chinese traditional medicine old specialist in national wide. Engaged 40 years on clinic, medicine teaching and research, he has been working on research of geriatric neurology and developing his unique insight on diagnosis and treatment of Alzheimer’s disease, Parkinson’s disease, apoplexy, insomnia and cephalalgia.Through 3 years learning from mentor Prof. Tian, adopting recording clinical prescription, taking learning notes, writing down minutes of thinking, reading related ancient books, looking up document literature, questioning and disabusing, regular classes and oral or mental instructions etc., I comprehend, sort and summarize my mentor’s academic thoughts, clinical experiences and characteristic of diagnosis and treatment. In order to deeply study Prof. Tian’s academic idea, clinical experience and theoretical innovation, I trace his academic idea origin and theoretical basis, clear up succession of consanguineous academic with statistical approach, try to summarize a regularity of clinical prescription, conclude his treatment thoughts, and set forth his therapy theory on insomnia treatment complying with liver function.This study report consists of three parts.1. Academic thoughts origin:Exploring professor Tian Jinzhou academic thought formation of origin and basis, perusal of classic provided he thought foundation, teacher’s guide gave him direction of academic, overseas education expanded his view. Having a solid theoretical basis and clinical between Chinese and western medicine, further achieving mastery through a comprehensive study, Prof. Tian Jinzhou’s eventually form academic characteristics including Chinese and western medicine.2. The academic thoughts and clinical experience summary:Prof. Tian attaches great importance to the flexible use of the combination of Chinese and western medicine in academic, advocates combination of the syndrome differentiation of traditional Chinese medicine and targeted therapy of western medicine, combines differentiation of disease and syndrome differentiation, finds the joint from confliction between Chinese and western different medicine thoughts, carries forward the advantages of Chinese and western medicine. Inheritance and innovation, is an eternal subject for the development of traditional Chinese medicine. Traditional Chinese medicine (TCM) need to keep up with times, comply with the regulations, achieve innovation and development based on inheriting the essence. Whether insomnia treated from the liver or 3 stages of dementia and its change rule as steps, these theories demonstrate my mentor’s innovation based on inheritance. Mentor stressed treating the disease from its root, grasping principal contradiction, mastering the regular pattern of specimen transformation, to achieve well understood. Teacher thinks the kidney deficient encephala reduce is the origin of Neurodegenerative disorder, therefor invigorating the kidney and filling the marrow is important in the treatment. "Synthesis of the four diagnostic methods" is an important means to collect patient information, Prof. Tian especially pay attention to the change of the tongue and pulse condition, smartly combined with the clinical symptoms, comprehensive differentiation, reflect the TCM characteristic clinical diagnosis thinking.In each idea of disease treatment, it contains my mentor’s constantly deepening clinical thinking process. Through summarizing the clinical experience, it could further excavate my mentor’s academic concept. My mentor proposed differentiation strategy by stages to cure dementia, emphasizing reinforcing deficiency in plateau phase, reducing phlegm in fluctuation phase, and taking detoxification in worsening phase. Not only differentiation strategy but also taking dialectic approach among deficiency and excess, this reflects Prof. Tian’s overall understanding on the development process of dementia.Chronic insomnia is a common disease and frequently encountered disease in aged people. It is also very difficult to treat. Prof. Tian considers it is related to unhealthy liver. Because one’s peace is decided by his liver, one would be sleepless if his liver cannot take back his spirit. Making spirit going to peace, there are treatments of soothing the liver, removing heat from the liver and nourishing liver. It is important that being sophisticated and nimble in clinic, flexible treatment applied.It gets more and more attention that affection on the quality of patient’s life caused by high incidence of the non-motor symptoms of Parkinson’s disease. Intractable constipation is one of the most common of the non-motor symptoms. Mentor Tian considers this kind of disease root is deficiency of Yin and dryness-heat of intestine, so the fundamental of treatment is nourishing Yin and moistening intestine, the key of treatment is tonifying spleen and kidney, the auxiliary treatment is activating blood and breathing, the long term nursing and regulating are essential.My mentor Tian thinks the hydrocephalus is categorized as deficiency in essence but sufficient in appearance, spleen and kidney deficiency are principal, blood stasis and dampness retarded are appearances, the key of pathogenesis is obturation of brain caused by waterhead stasis, and treatment focuses on "tonify deficiency, removing stasis, alleviating water".The treatment of primary headache with traditional Chinese medicine has a great advantage. Prof. Tian puts forward that diagnosis is priority for treating headache, distinguish differences of meridians and collaterals then using different methods with stressing utilization of Ligusticum wallichii. This thinking way of diagnosis and treatment is a great help to clinical. Distinguishing the kind of meridians and collaterals could identify the location of sickness, confirm the nature of disease, and understand the property of pathopoiesia, so that providing guarantee for accurate and effective treatment. Ligusticum wallichii is mild taste and utilized as circulating and diffusing efficiencies. It is the medicine for circulation of blood and regulating vital energy, carrying out the energy to circulate blood, evacuating liver-wind from blood, leading other medicines going to brain to treat nidus. So Ligusticum wallichii is the chief medicine for treatment of headache. Prof. Tian often uses Ligusticum wallichii to treat various of headache based on syndrome differentiation of signs. It gets outstanding curative effect.Hidrosis is also an appearance of autonomic nerve dysfunction of the Parkinson. Prof. Tian utilizes the decoction made of Chinese angelica and six yellow ingredients flexibly to treat Hidrosis caused by Parkinson. It expands the original decoction prescription’s scope of application, not only the clinical curative effect is outstanding but concentrating on the main points of Hidrosis treatment.According to morbidity characteristics and clinical manifestations of Multiple System Atrophy, Chinese medicine categorizes them as "megrim", "faint", "tremble" and "exhausting". Nature of this disease is mainly root deficiency in liver, kidney and spleen, or mixed with blood stasis and dampness retarded of symptoms. The treatment to this disease should focus on the root deficiency amending to strengthen autoimmunity, or concurrently to treat the appearances of symptoms. Prof. Tian is good at clinic with using medicine made from insects to remove cold and get main and collateral channels connecting. Through increasing and decreasing dosage of each component in medication, it will restore the body’s normal function to regulate body itself.Vertigo is the clinical common disease, categorized as peripheral vertigo and central vertigo and other causes of vertigo. Prof. Tian puts forward the "ascertaining cause of vertigo before treatment", should first confirm the cause of vertigo, curing to the pathogenesis, forecast prognosis. Vertigo is mainly root deficiency related to liver, kidney and spleen, so stress "treating vertigo should be with taking good care of liver and kidney". Adjusting liver should be soothing the liver, removing heat from liver, calming the liver, nourishing liver and suppressing hyperactive liver. Most important thing of maintaining kidney is reinforcing kidney to replenish essence, nursing Yin to benefit marrow. "Treating vertigo should take different options according to acute stage and catabasis", remitting symptom is main way during acute stage, and give consideration to tonify deficiency of liver and kidney during catabasis.3. Clinical researchInsomnia is a clinical common disease. Modern medicine could treat its symptoms, but is difficult to treat the root cause of trouble, cannot adjust insomnia symptom in fundamental. Taking medicine in long term to treat insomnia will certainly harm cognitive function, but it will relapse if ceasing taking. Chinese traditional medicine has advantages of etiology targeted, integral regulation, and less toxic and side effect, etc. So, more and more insomnia patients volunteer to take traditional medicine. Selecting 60 cases of insomnia patient whom cured by Prof. Tian in Brain III Division of Dongzhimen hospital from November 2012 to April 2015 as study objects, observing its clinical therapeutic effect, and syndrome statistics and drug statistics, by deep analysis of statistical results, summarize the experiences of Prof. Tian from the liver treatment of insomnia.4. Conclusion clinical research:4.1 Appling with the theory of insomnia treated from the liver, patients’ symptoms of insomnia, anxiety, depression are improved significantly.4.2 Through this project research, traditional Chinese medicine (TCM) is the best choice to treat primary insomnia patients.4.3 Jin-zhou Tian thinks the etiology and pathogenesis of insomnia are, location of disease is mainly in liver, relate to heart, spleen and kidney; phlegm, heat, depression, blood stasis, deficiency are pathogenic factors; nature of this disease is always belong to unbalance of Yin and Yang, and miss-adjustment Qi and blood.4.4 Basic prescription of treating insomnia by Prof. Tian consists of 12 core components, fried jujube kernel, fructus schisandrae, tuber fleeceflower stem, salvia miltiorrhiza, rhizoma coptidis, radix bupleuri vinegar, notoginseng, bitter orange, radix rehmanniae, radix paeoniae alba, nacre mother of pearl and licorice.4.5 Basic rule of treating insomnia by Prof. Tian is, clearing heat and soothing nerves, regulating vital energy and promoting blood flow, nourishing the blood and tranquilization.4.6 Prof. Tian treats insomnia usually based on syndrome differentiation, with disease differentiation, rationally use herbal medicine that having targeting effecting. But he stresses the foundation of treatment is syndrome differentiation, cannot put the cart before the horse.4.7 The usage of tonify deficiency medicine ranks in first position in total amount of medicine, hematinic and yin-nourishing herbs are primary medicine among them. Yin-nourishing and soothe nerves prescription is mainly used in the usage of tranquilizer. It sufficiently reflects that yin blood insufficiency is pathological basis of deficiency type insomnia.4.8 Stressing usage of seed of wild jujube is characteristic of Prof. Tian’s treatment of insomnia, and the trend is better by quantity increasing.4.9 By learning and summarizing the practices of Prof. Tian to treat insomnia, my experience is as follows:4.9.1 A lot of neurasthenia patients with insomnia often accompany the stomach enrages disaccord symptoms, the so-called "stomach problem resulting in disturbed". Meanwhile relieving liver for smooth Qi, it should also regulate spleen and stomach to achieve requiem sleeping effect.4.9.2 For recurrent insomnia after drug withdrawal, to the first visit and recurrence diagnosis of insomnia patients, it remains to be further observed for a long time to find appropriate and effective treatment schedule.4.9.3 To extend the experience of Prof. Tian’s insomnia treatment complying with liver function, by pathogenesis deduction and clinical practices observation of Parkinson’s merger insomnia, it is found that sleeping improvement could be achieved through nourishing liver and blood, nourishing yin for suppressing hyperactive yang. But there are differences in the same disease, on the basis of soothing the liver, removing heat from the liver and nourishing liver, scorpio, tortoise plastron, trionyx sinensis shell should be used as calming liver wind medicine throughout the treatment from beginning to the end.