| Professor LvWenpei has been engaging in clinical teaching about surgery of TCM for many years. During the time, she is the director of surgery in Beijing Chinese Medicine Hospital, the head of surgery and the postgraduate tutor. Now she is the advisor of the fifth of the country and the fourth of Beijing in TCM academic inheritance work. She makes continuous accumulation, development and innovation in the field of TCM theory and clinical practice. Furthermore, on the basis of Fang Zhixuan, Zhao Bingnan, Wang Yuzhang and other surgical authorities, she combines the surgical clinical features to pursue development, breakthrough and innovation, and gradually forms the scientific ideological system. From 2012 to 2015,I have the honor to learn from Professor Lv, and receive the careful guidance and all the knowledge of the teacher with the method of TCM inheritance learning follow teacher. Besides, the experience leaves a deep impression on me. I hope to preliminarily discuss the main academic thoughts of the teacher and specific method of surgery about TCM through the writing of the thesis.The content of the study is divided into three parts:I. Academic origin exploration of Professor Lv:through learning follow teacher, medical record settlement, literature research, classical theory discussion and other application of learning methods, I organize and summarize Lv’s growing experience in forming the academic thoughts, the academic inheritance origin and the main learning achievements.1. Learning in the formal university can make a solid foundation for the future clinical work. In the beginning of the work, Lv is lucky to meet the leading scholar in TCM, which cultivates her experience and academic system in learning follow teacher, and the Chinese and Western medicine integrated ideology majored in TCM.2. Professor Lv learns a lot from Fang Zhixuan. She plays an important role in the treatment of takayasu’s arteritis, the application characteristics of blood drug, and academic inheritance study of character extraction powder.3. Professor Lv learns from Wang Yuzhang, and as the academic successor, she not only plays a vital role in her academic thought formation, but summarizes Wang’s valuable clinical experience completely as well. Indeed, she makes summaries about the whole and partial differentiation characteristics of surgery of TCM, the application of spleen stomach theory in surgical diseases, and the flexible application of internal and external treatment.4. Professor lv makes clinical practices with Zhao Bingnan, and Zhao’s Yin and Yang syndrome differentiation system makes great influence on Lv, which emphasizes the recognition of Qi and blood at any time in pathologic progress as well as the whole and partial differentiation. Meanwhile, Zhao takes numerous prescriptions and makes great impact on clinical therapy.II. Academic thoughts and experience summaries of Professor Lv:make further discussions about Lv’s clinical dialectical features, ideology theory system, dialectical characteristics, and summary and application of prescription drug-used rule. On the basis of absorbing from others, Lv traces the origin and summarizes numerous clinical practices and experience, to form an outstanding characteristics in academic experience of surgical diseases. Besides, on the basis of syndrome-differentiation of Qi and blood, she forms a special dialectical academic thinking system.1. Focus on the combination of whole and parts, and disease identification and syndrome differentiation. When necessary, pay attention to western medical diagnostics and the application of therapies.2. Focus on the comprehension and application of surgical first distinguish Yin and Yang. Discuss yin and yang dialectics as the surgical general from morbidity situation, symptoms of local and systemic, prognostic judgment and other aspects.3. Discuss the application of QI and blood theory in peripheral vascular diseases. Make discussions about surrounding vascular disease pathogenesis, core idea of Qi and blood theory, and the skillful application of clinical Qi and blood theory.4. Be familiar with classics, learn the essence and combine the key ideas of Internal Classic, A Guide Toclinical Practice Withmedical Records, A Treatise on Blood Troubles with TCM’s surgical characteristics in application.Ⅳ Sketch Lv’s clinical treatment characteristics1. Clinical characteristics of ulcerations of the diabetic foot:Lv emphasizes the whole and partial differentiation of Qi and blood as the significant principle. Internal therapy contains dispersing, promoting and tonifying methods in harmony, and pays attention to the principle of strengthening spleen and stomach. External therapy focuses on ta stain, dusting power, paste elimination methods and the skillful application of debridement.2. TCM syndrome differentiation and treatment of DVT:Lv emphasizes that blood stasis resisted in venation is the basic pathogenesis. Stasis, wet and heat in mutual disease is the main pathological feature in the early stage, and blood stasis is throughout the disease all the time. For the disease, weakness is the origin, evil is the standard, and stasis is the change. The principle of Qi and blood stagnation should be paid attention to, and the main parts are due to spleen, kidney and lung.3. Clinical characteristics of lower limb lymphedema:according to the disease characteristics, Lv emphasizes that in dialectics, it should be focused on distinguishing muggy, Qi and blood, and parts. Meanwhile, pay attention to the vital effect of internal and external therapy.4. Clinical characteristics of breast disease:take smooth, regulate and strengthen as the general treatment due to the liver, spleen and kidney, and emphasize on dealing the relationship between supporting healthy aspects and eliminating pathogens, especially be good at taking Dangguihaoyao and Erqu as the important drugs in curing nodules of breast. The two drugs both enter the blood, and play a role in nourishing and activating blood, as well as regulating liver and removing blood stasis.5. Clinical characteristics:take Lv’s eliminating tumors as the example, analyze that pathogenic character of Qi, phlegm, and stasis majors in Qi depression in the early stage. While in the middle and late period, it majors in the form of blood stasis and phlegm stasis. Features of the disease are the origin and astheniain superficiality, intermingled deficiency and exxcess. Furthermore, the main causal factors are Qi depression, blood stasis and phlegm stasis.6. Clinical characteristics of Artery inflammation:on the basis of combining Fang zhixuan’sexperience, the teacher considers that the disease is mainly divided into deficient cold and deficient heat. Take harmonizing Qi and blood as the main therapy principle, combine the movement and peace, regulate Qi activity, then combine reinforcement and elimination when necessary.7. Characteristic analysis of tumor diagnosis:Lv considers that the relative balance state of regulating yin and yang, making up the deficiency, purging the more and recovering yin and yang os the basic principle of treating tumor. The teacher comes up with the idea of "coexist with disease" for patients with chronic diseases. Through the harmonic method, the whole state of human body environment can be improved, and the Qi and blood can reach the state of dynamic balance again.8. Clinical characteristics of chronic urticaria:Lv considers that the disease can cure from "blood" theory and always grasp "blood", then distinguish the differences between Qi and blood, yin and yang, deficiency and excess, which has significant clinical effect.9. Summary of common painkillers in surgery of TCM:"pain" in surgery should be in accordance with the differences in disease location, property, duration, attack features and inducing factors to identify the cause and make flexible use.10. Dialectical features of Qi and blood in perimenopausal period:during this period, Chong and Ren function is reducing. If Qi and blood, yin and yang lose balance in the organism, diseases will come into being. In surgery, breast disease, thyroid disease and vascular disease are very common. Lv considers that most of them are because of strong diarrhea or weak kidney energy. Therefore, hepatorenal homology and Qi and blood regulation are the common therapeutic schemes.IV.TakeLv’s method of regulating Qi and blood to treat ASO, conduct comparison study of clinical cases, and assess the advantages and characteristics of this method in clinic. ObjectiveAccording to the clinical effects, symptoms and signs, as well as the improvement of objective specialized index in observation and application of Lv’s regulating Qi and blood prescription to treat ASO, and discuss the treatment mechanism and advantages of Qi and blood in ASO.Research method1.Select from January,2013 to July,2015, and take clinic that accords with the study’s diagnostic criteria and 109 inpatients as the research objective. Then make random allocation with case number of 2:1. Furthermore, there are 74 observational cases in the treatment group, and 35 in the control group.2.The treatment group applies Lv’s regulating Qi and blood prescription, and chooses granule formulations. One dose a day, and take warm in twice. The treatment is 3 months. The treatment group applies TaohongSiwu Decoction granule formulations. One dose a day, and take warm in twice. The treatment is 3 months.3.Conduct therapeutic evaluation, specialized index(arterial ultrasonic Doppler, ankle brachial and toes PPG), and security index observation.4. Statistical method:apply SPSS 18.0 to carry on statistical analysis, the measurement date will adopt average x±s, the enumerationdata will adopt case number, the comparison between different time points and baseline will adopt pair t test or rank sum test, and the comparison between before and after treatment will adopt double independent-samples t test or double independent-samples chi-square test or rank sum test. Homogeneity test of variances will be carried on before chi-squared test and t test, if the variable transformation still cannot conform to homogeneity, then nonparametric rank sum test will be adopted.Consequences1.Whole medical effect evaluation:in 74 cases of treatment group,3 are cured,25 are obvious,36 are effective,5 are invalid, and the total effective rate is 93.2%; in 35 cases of the control group,1 is cured,10 are obvious,17 are efficient,7 are invalid, and the total effective rate is 80%.2.Score improvement in specialized clinical symptoms:after the treatment, the specialized symptom scores of two groups are both improved. After one month’s treatment, score improvement of treatment group is better than the control group in the skin cools, aches, limp intermittently, skin temperature decreases, skin color appears abnormal. After three months’treatment, TCM syndrome scoring is improved better than the control group (P<0.05) in skin cools, aches, limb numbness, limp intermittently, rest pain, skin temperature decreases, skin color appears abnormal.3.Assessment of specialized index:after one month’s ABI test, ABI of the treatment group is improved (p<0.05), Assessment of specialized index:after three month’s ABI test, ABI of the treatment group is improved (p<0.05). Assessment of specialized index:after one month’s PPG test, ABI of the treatment group is improved (p<0.05)ConclusionThe application of regulating Qi and blood method in the treatment of arteriosclerosis obliterans can improve clinical effects, especially in aspects of skin cools, aches, limb numbness, limp intermittently, rest pain, skin temperature decreases, and skin color appears abnormal.
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