| Objective:To arrange and summarize the academic origin, academic theory and clinical experience of mentor Chen Zhaoding chief physician. Provide information in order to succeeding traditional Chinese medicine pediatric diagnosis and medication characteristics. According to Chen Zhaoding’s theory of regulating qi and blood, by clinical observation of Purple mixture treatment for Infectious Mononucleos is by EB virous infection in children, prove mentor’s academic theory and clinical value.Methods:Explore mentor’s academic origin and theory from his career in medicine experience, studying origins, various ancient and modern theory, etc. From the academic point of view, etiology and pathogenesis, TCM drugs using based on syndrome differentiation, treatment characteristics and other aspects, analysis, collate and summarize instructor’s characteristics of academic thought, his feature of clinical experience and medication. Prospective randomized controlled study on the clinical efficacy, the affection on viral replication and immune in application of regulating blood treatment for children with Infectious Mononucleosis.Results:Chen Zhaoding teacher had formatted his own understanding theory of qi and blood in children by many years of his own clinical experience, succeeded Wang Pengfei’s view point of focus on Qi and Blood, based on the thoughts of various periods ancients and the knowledge of modern pharmacological and pathology study. The academic theory which focuses on Qi and Blood emphasizes Blood and Qi regulating is fundamental to maintain human health. The academic theory which focuses on Qi and Blood emphasizes Blood and Qi regulating is fundamental to maintain human health. Disorder of Qi and Blood is the key of disease emergence and development. For the pathophysiological characteristics, children are more prone to have blood disorders. The heat, wet, sputum, dyspeptic retention, weak and shock are all common disease causes of Qi and Blood disorders in children. "The liver being liable to excess "is the cause of chaos of Qi and Blood in children, and also be the pathological basis of convulsion and bleeding and heat stasis, qi and blood stasis " are the pathological basis, Pathological outcome can be qi and blood stasis, formation of dampness and phlegm or collaterals breaking and blood overflow. They can take extensive damage to the organs and meridians, and be filled to the awakened muscle, resulting in lingering disease and poor prognosis. Treatment of children with blood disorders should be clearing heat and adjusting liver, activating spleen-energy and regulating qi, activating blood circulation to dissipate blood stasis.Summary experience of tutor at the spleen and stomach disease.①Experience for digestive ulcer:pathogenesis is weakness of the spleen and stomach, blood and qi disorders, qi stagnation and blood stasis. Activating blood circulation to dissipate blood stasis, regulating qi to alleviate pain, invigorating spleen and harmonizing stomach can be seemd as the basic rule of treatment. Take Qingdai, Zicao, Ruxiang and Baiji as the basic medication, and pay attention to the use of endoscopy and other modern means of improve the level of diagnosis and pathogenesis awareness.②Experience on the chronic gastritis:heat and humid are the common causes, the main pathogenesis is damp-heat congestion at middle energizer, gastric qi blocking, functional activity of QI being not smooth, Damp-heat Blocking Collaterals, collaterals stagnation, qi stagnation and blood stasis. Gastroscope and HP infection studies showed relationship between the disease and the damp heat syndrome and gastrointestinal stasis. Drug treatment, taking Qingdai, Zicao and Four Incense as a representative, in order to promote blood circulation throughout the clinical experience.③The infant jaundice experience:The common causes of infant jaundice are dyspeptic retention and damp-heat, blood stasis. Hepatobiliary collaterals stasis is the key pathogenesis. Doctors should pay attention on therapy qi and blood, dredging collaterals. Commonly used Qingdai, Zicao,Ruxiang, Yujin, Sanleng, Ezhu for promoting blood circulation and removing blood stasis. Weilingxian, Lulutong, chaenomelis, Shenjincao and fasciculus vascularis luffae can be used to resolve dampness and dredging collaterals.④The PICA:It was thought to be infestation of stomach heat. Stomach heat accelerates digestion bulimia, compulsive eating foreign body. If ingestion of foreign bodies for long time, the foreign bodies will change into toxicant and block meridian. Qi and blood loss free, stagnate and stasis. Treatment use Qingdai, Guanzhong, mung bean, alumbre powder for heat-clearing and detoxicating, Jianqu, Caokou, Sharen, hawthorn, etc for invigorating spleen and stomach and to restore the spleen and stomach regulating blood circulation, while focusing on cleaning liver and blood, helping blood and qi to be recovery.⑤The gastric bezoar:Teacher thought the disease is caused from deficiency, dysfunction of the spleen in transport, pathogenic factor and Qi stagnation. Phlegm, food, Qi, blood and other factors formed the main causes. Treatment of these visible pathogens should pay attention to qi stagnation and blood stasis. Using medicine of promoting qi, purging stagnation and disperse blood seasis to dispelling phlegm damp and other visible pathogens may take effective. Commonly used Sanleng, Ezhu to broke collaterals, casual blood stasis in order to achieve the purpose of regulating qi and blood.Also summarizes Chen’s experience at other disease.①Lung abscess:The disease is mainly caused by exogenous stasis indissoluble, or exogenous pathogenic factor plus phlegm heat retention. The heat transfer to the inner, and lung are burned, qi loss of descending and sputum formed from saliva. Phlegm heat block pulmonary collateral, due to blood stasis. Blood stasis and phlegm heat expand, then the blood streak and meat rot, formed pyogenic carbuncle. If carbuncle persisted long time, it will hurt the Qi and yin, and then lead to deficiency of healthy qi. Treatment are heat-clearing and detoxifying, promoting blood circulation and removing blood stasis, detumescence and discharging pus. Through the efficacy of pharmacological studies revealed common medicine like Qingdai, Zicao, Ruxiang, Hanshuishi, Yazao powder (abscess powder) with blood circulation, anti-inflammatory, antibacterial and other aspects of the role.②The edema disease (acute glomerulonephritis):Treated from Qi and blood, the water metabolism need gasification, qi could push the water transition. Only blood and qi had been smooth, then the metabolism can be normal. If diseases stagnate at triple energizer, gasification and the cannel function can be broken, then make the edema. Treatment must pay attention to regulating qi and blood, " Qi pushes water forward" to relive the water swelling. He often uses Qingdai, Zicao, Hanshuishi, Ruxiang, Weilingxian, Honghua, etc medicine for Iremoving heat and dampness, promoting blood circulation.③The sty:Chen treated the sty from the liver, advocated clear liver meridian therapy, promoting blood circulation, relieving rheumatism node, and regulating qi and blood, reducing the repeated episodes focus on clearing stomach Xiaoshi Daozhi, reached Fu Huo, regulating qi, blood and attaching the purpose of recovery.④The Tourette syndrome:Treating can emphasize to liver heat phlegm fire, which lead to disharmony of Qi and blood, and injured liver by instigate wind and brokered venues. Take the following as the treatment principle:Clearing liver hear and dampness, promoting blood circulation, extinguishing wind to stop startled, regulating Yin and Yang, pay attention to differentiate using medication by local symptoms at the same time.Mentor Chen’s clinical prescription, the Purple mixture, which follows the manner of "treating different diseases with the same method", has achieved good effect in treatment of nearly 20 kinds of diseases including to digestive system, Nervous system, Respiratory system, Urinary system, the blood system and skin. The main symptoms are pain, bleeding, irritability, fever swelling, phlegm blocking, and skin and mucous membrane abnormal. The main syndromes of diseases carbuncle swollen and bleeding disorders. The core syndrome type is "blood and heat stasis, qi and blood stasis" The core ideas are "clearing away heat and removing blood stasis", "regulating qi and blood". The main medicine is Qingdai, Zicao, Ruxiang, Hanshuishi.A prospective randomized controlled study which using the traditional Chinese medicine to treat mononucleosis in children caused by EB virus infection displayed that regulating qi and blood, to show the application of theories, using the purple soup, according to differentiation characteristics the disease in different stages, adopting disperse detoxification, smooth blood circulation, stagnation dispersing and meridian dredging recipe for treatment principle, and take addition and subtraction medication, obtained the total efficiency of 97.1% efficacy. The results show the application of the group of Chinese medicine treatment can effectively improve the fever, angina, tonsil liver and lymph node enlargement and other clinical symptoms and signs caused by EB viruses. It can reduce the peripheral blood lymphocytes of anomalies, for inhibit virus DNA, may also increase the number of NK cells. The research suggested that the group traditional Chinese medicine is possible promote immune restoration through antiviral and immune regulation. And in the two aspects it can control EB infection caused by the human body injury. Conclusion:Teacher Chen succeeded Wang Pengfei’s traditional Chinese medicine on Qi blood theory, combined with his own years of clinical experience, as well as the understanding of ancient, modern pathological and pharmacological research, formed himself awareness and treatment characteristics in children with blood disorders. He thought that children have the more prone to disorder of Qi and blood, because of the physiological and pathological characteristics of children, "heat wet phlegm food and deficiency" are causes of infantile disorder of Qi and blood, qi stagnation and blood stasis are common causes, but also spread rapidly, changing it to the pathological basis, in clinical for different diseases, should judge for and understand of disease, the disorder of Qi and blood.By clearing away heat and eliminating pathogen, activating collaterals means, using blue soup as the basis, for treatment of "Regulating Qi and blood". And restore the normal flow of Qi and blood, promote the body’s rehabilitation. Tutorial theory and clinical experience on Qi blood has better curative effect. It is Worthy of inheriting and further study. Objective:Through prospective randomized controlled observation of traditional Chinese medicine treatment of children infectious mononucleosis caused by EB virus infection in clinical curative effect and DNA virus and immune cells and antibodies effects, further confirmed the efficacy of method in the treatment of EB virus acute infection, which by regulating qi and blood for the purpose, with clear toxic heat, smooth blood circulation, and removing obstruction in the channel. And take effort to explore its possible mechanism of action.Methods:The object of study are all hospitalized children, from the Traditional, Chinese Medicine ward of Beijing Children’s Hospital Department, during 2008 June-2010 March, in consistent with reference to" the Zhufutang, practical pediatrics" 7 edition, acute EB viral infection diagnosis standard and inclusion, exclusion criteria in 69 children, taken randomly divided into Chinese medicine group and Western medicine group. The doctor of traditional Chinese medicine group make Chinese medicine decoction, according to syndrome differentiation. Children in this group take traditional Chinese medicine prescriptions, one daily dose, decoct with water, 2 times a day,<20kg:100ml/time;≥20kg:200ml/time. The western medicine group takes Gnciclovir:10mg/kg/d, intravenous infusion, two times a day. The period for treatment of two groups is 2 weeks. Treatment observation including fever, angina, lymphadenopathy and hepatosplenomegaly, tongue, pulse condition, clinical symptoms and signs, at the same time before and after the treatment in the determination of blood routine (abnormal lymphocyte percentage), T cell subsets, immunoglobulin, B ultrasound observation of cervical lymph nodes, abdominal B ultrasound to understand liver spleen and abdominal lymph nodes, EB virus antibody, DNA virus load, liver function, electrocardiogram. Take statistical analysis subsequently.Results:①The treatment group total effective rate was 97.1%, higher than 94.3% in the control group, but the two group total effectiveness compared no significant differences statistically.②The treatment group is shorter than the control group in their time to defervescence, duration of pharyngeal hyperemia, swelling of the tonsils duration, lymphadenopathy, and hepatomegaly duration. Compared to the control group, using the independent sample t test, it has statistically significant difference. It is shorter than control group in sore throat stay, but the difference was not significant.③After14 days treatment, the positive cases of peripheral blood hetero-lymphocyte was statistically significantly reduced compared than before treatment both in treatment group and the control group.2 weeks after treatment in treatment group of 3 cases of abnormal lymphocyte positive cases,15 cases of the control group, two groups compare, x 2=10.36023, P<0.05, with statistically significant. The prompt of elimination of the abnormal lymphcyte in traditional Chinese medicine group was better than those of control group.④After14 day’s treatment, the treatment group and the control group AST, ALT and AST were markedly improved than those before treatment, with statistically significant difference. AST, ALT in treatment group after treatment decreased significantly than the control group, but statistically with no significant differences. It ws description that two kinds of therapy have a certain action on liver function recovery of this disease. But traditional Chinese medicine group was better than the control group.⑤The immunoglobulin IgA, IgM had decreased after treatment than before both in the treatment group and control group, and there was significant difference between before and after treatment, IgG, IgE after treatment were also lower than before treatment, but the difference was not statistically significant. The differences between the treatment group with the control group were not statistically significant. In two groups after the treatment, CD3+, CD8+ than before treatment was significantly decreased, CD4+, CD4+ / CD8+, B cells increased significantly compared with those before treatment, the two groups before and after treatment were statistically significant difference. But there had no significant difference after treatment between two groups. The treatment group NK cells after treatment than before treatment also increased significantly, and higher than that of the control group, before and after treatment and compared between groups were statistically difference. The tips of immune function of the two groups after treatment has recovered, the Chinese medicine group is superior to control group in NK cell recovery.⑥After a treatment for 2 weeks the two set of EB virus DNA positive cases were significantly reduced, with statistically significant difference between the treatment group before and after treatment, EB DNA virus were negative, while the control group, there are still 3 positive cases, but two groups had no significant difference.⑦The group using Treatment of traditional Chinese medicine, had no obvious side effects, The control group appeared 3 cases of leukopenia, and 1 treated patient with abnormal liver function in exacerbations, consideratly associated with Ganciclovir. Discontinuation for10 days, the liver function returned to normal. Traditional Chinese medicine group is prompt more safety than the control group.Conclusion:Infectious mononucleosis in children is most commonly caused by EB virus infection disease, through this prospective randomized controlled observation on the traditional Chinese medicine for treating, further confirmed that traditional Chinese medicine in the treatment of EB virus infection is effective. The therapy obedience the disease cause and pathogenesis that exogenous toxic heat combined with phlegm and blood stasis, leading to the accumulation of dispersed sputum nuclear masses, even organs function. The therapy made according to Chen Zhaoding teacher’s academic thought of regulating qi and blood. The prescription, based on Purple mixture, was his frequently used prescription for harmonic qi and blood, according to the syndrome differentiation characteristic on disease different staging, using disperse detoxification, smooth blood circulation, removing obstruction in the channel therapeutic principles by medication, obtained the total efficiency of 97.1% efficacy, further confirmed Chen’s persistent on pathogenesis and the clinical experience using the same method treating different diseases in this application of Purple mixture.This study displayed Chinese medicine is not only used for the clinical symptoms caused by EB virus and signs improved, it can also promote the abnormalities lymphocytes to subsided in peripheral blood, inhibiting the viral DNA, while enhancing the NK cell number. It suggesting that the group medicine may be mediated by antiviral and immune regulation, promotion immune restoration in two aspects to control EB infection caused by the human body injury, to explore the Chinese medicine treatment of EB virus infection mechanism provides the basis. But the study sample number is little, lack of follow-up, experimental observation on immune system is simple, not on the prescription of pharmacological and toxicological study, therefore, the observation and research should be more in-depth and extensive. |
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