Huang Lijuan Academic Thoughts And Clinical Experience And Clinical Research For The Treatment Of Coronary Restenosis After Interventional

Professor Huang-lijuan has engaged in medical work of traditional Chinese medicine for more than 40 years. She not only has deep academic attainments, but also has a lot of clinical experiences. It is a very meaningful research tasks that I inherited and learned from her for the academic thought and clinical experiences to use for the guiding clinical practice and carry forward her thought and the experiences.1.The origin of Huang-lijuan’s academic thoughtsProfessor Huang has taken great attention to the study on the classic treatise of traditional Chinese medicine, She systematically studied a lot of medical books, such as "Canon of Medicine", "treatise on febrile diseases", "golden chamber" and so on,which establish solid theoretical foundation. The theory of holistic concept, combination of disease differentiation and syndrome differentiation, attention to Spleen and Stomach have great influence on the formation of Professor Huang’s academic thoughts. She was diligent and studied hard. She learnd from several famous old doctors of tcm successively, such as Wang-weiLan, Ji-liang chen, Fang-heqian, Sun-boyang, and so on. She digested the theories of those famous doctors and made full use of their points in the long process of clinical practice. On the basis of previous research and In the theory of inheritance, She has formed own characteristics of theory. The patients of coronary PCI and artery coronary bypass grafting are increasing year by year, Professor Huang has made the focus on the restenosis after percutaneous coronary intervention in treatment of integrated traditional Chinese and western medicine in recent years. She proposes that deficiency of both qi and yin and obstruction of blood are the important pathogenesis of restenosis after percutaneous coronary intervention. The basic principle of treatment is to invigorate qi and replenish yin and promote blood circulation and remove blood stasis.2. Summarize and Research on Huang-lijuan’s academic thoughts and clinical experiences2.1 The summary of Huang-lijuan’s academic thoughts2.1.1 Holistic conceptProfessor Huang adhering to the Canon of Medicine overall concept theory, not only follow holistic dialectic concept of between human viscera allelopathy and interconnectedness, also from the "nature and humanity" the theory, insist on the principle of medication of follow person conditions,time conditions,and local conditions.2.1.2 Correlation of Five VisceraProfessor Huang believes the five viscera function activities is not isolated, but linked to each other, that is both the mutual information and interdependent relationship between five viscera. Physical contact each other in five viscera, in pathology will influence each other. Therefore, when treatment, except for the sick viscera of this treatment outside, still should be based on the relationship of Generation, Restriction, Subjugation and Reverse Restriction about the positions of five viscera, and to adjust the relationship between the five viscera.2.1.3 Combination of disease differentiation and syndrome differentiationProfessor Huang believes that traditional Chinese medicine diagnosis and treatment of diseases, both disease differentiation and syndrome differentiation, combination of disease and syndrome differentiation and combination. In addition, it takes western medicine diagnosis, and it puts emphasis on the principles of Chinese medicine diagnosis and treatment.2.1.4 Attention to Spleen and StomachProfessor Huang according to "spleen and stomach being the postnatal" this theory, clinical attention when the recuperation of spleen and stomach, not only from the spleen and stomach treatment of diseases, and in the treatment of any a kind of diseases are always pay attention to the spleen and stomach.2.1.5 Treatment based on Qi and blood, emphasizes the role of QiProfessor Huang is in the process of making clinical attention from the blood to treat the disease, often used for the double adjustable Qi and blood methods, such as replenishing Qi and blood, promoting Qi and activating blood, supplementing Qi and activating blood circulation, etc. On the process of Qi and blood homology, the teacher has paid more attention to the important role of Qi.2.2 The summary of Huang-lijuan’s clinical experiences2.2.1Disease of chest stuffiness and pains (Coronary heart disease)Professor Huang believes the pathogenesis is primary asthenia-secondary sthenia syndrome. "Primary Deficiency" includes the deficiency of Yin,Yang, qi and blood of heart and shortage of liver, kidney, spleen and lung; "Excessive Incidental" means qi stagnation, blood stasis, body fluid accumulates into phlegm and cold coagulation etc. The basic principle of treatment is to invigorate qi and replenish yin and promote blood circulation and remove blood stasis. So we should stick to emphasize the function in Coordination of Zang-fu and syndrome differentiation in the conception of wholism.2.2.2 Disease of Heart Failure (Heart Failure)Professor Huang believes the pathogenesis of Heart Failure is primary asthenia-secondary sthenia syndrome. "Primary Deficiency" primary includes the deficiency of qi, Yin and Yang. "Excessive Incidental" means blood stasis, body fluid accumulates into phlegm and cold coagulation. The clinical manifestations includes deficiency accompanied with excess. The location of this disease is in heart. However, it also can affect the lung, spleen, kidney and liver in the development of heart failure. The basic principle of treatment is to supply qi to warm yang and activate blood and promote diuresis. we should supply deficiency and dispelling pathogenic factor. At the same time we should protect yin and body fluid. Moreover, we must pay attention to the discipline of pathogenesis of heart failure, but also attach importance to their characteristics of the pathogenesis itself, we should attention to the combination of identified diseases and syndromes.2.2.3 Disease of twist (Hypertension)Professor Huang believes the disease almost related with emotional maladjustment, improper diet, internal injury and deficiency and loss, etc. It is caused by disorder of Yin and Yang of Zang-fu, disharmony between qi and blood, abnormal lifting of qi, endogenous wind and fire, obstruction of phlegm and stasis. The location of this disease is in liver and kidney and related with heart and spleen. The characteristics is the primary asthenia-secondary sthenia syndrome. The deficiency includes liver and kidney. The Excessive means wind, fire, phlegm, qi, stasis. The common syndromes include syndrome of hyperactivity of liver yang, syndrome of obstruction by sputum and wet, syndrome of deficiency of kidney essence, syndrome of liver qi stagnation. We should treat it with etiology and pathogenesis, Zang-fu and syndrome differentiation.2.2.4 Disease of palpitation (Arrhythmia)Professor Huang believes the disease belongs to the primary asthenia-secondary sthenia syndrome. The location of this disease is in heart and related with spleen, lung, kidney and liver closely. Those organs affect each other. She almost uses the pulse-activating powder as the basic prescription to treat it and symptoms to add and subtract according to Zang-fu differentiation. She also emphasizes the function of promoting blood circulation and removing blood stasis and tranquilization in treatment. She will choose the drugs according to the frequent and slow arrhythmia and disease differentiation.2.2.5 Disease of cloud blood (Ayperlipidemia)Professor Huang believes that deficiency of spleen, turbid phlegm and blood stasis are the important factors which made the disease happened. The pathogenesis of it is deficiency of spleen and blood stasis and body fluid accumulates into phlegm is its excessive incidental factors. She thinks that strengthening spleen and removing damp and turbid is the foundation of the treatment. She chooses the basic prescription composed of Poria, Atractylodes, Raw barley, Alisma, Dioscorea collettii, Typha orientalis, Curcuma, Rhubarb and Purslane, and so on to symptom to add and subtract. She advices the patients to control diets and do some proper sports so that they can receive a satisfactory results of losing weight and lipid-lowering.2.2.6 DiabetesThe disease the basic pathogenesis thought the professor Huang is Yin deficiency for this, hot and dry for mark. Abnormal function of spleen and stomach, blood stasis also is the important pathogenesis. Treatment mainly for nourish Yin clear heat, invigorating spleen and removing dampness, activating blood circulation and eliminating stasis.2.2.7 CardiomyopathyProfessor Huang think the pathogenesis of hypertrophic cardiomyopathy is Qi deficiency, turbid phlegm, and blood stasis block. Treatment mainly for deficiencing origin and excessing in superficiality, promoting blood circulation and removing blood stasis,reducing phlegm and resolving masses. The pathogenesis of healthy atmosphere for expansionary cardiomyopathy is Qi deficiency, turbid phlegm, and blood stasis block. Treatment for strengthening healthy Qi and eliminate pathogens, strengthening healthy Qi to carry out the principle from beginning to end.2.2.8 Apoplexy sequelaProfessor Huang think the disease pathogenesis is deficiency origin and excess in superficiality. Deficiency origin contains liver and kidney deficiency and Qi-blood shortage,the wind phlegm and blood stasis for excess in superficiality. Treatment principle is strengthening healthy Qi and eliminate pathogens. Strengthening healthy Qi to replenishing Qi,blood, kidney, liver, spleen to given priority to, eliminate pathogens to promoting blood circulation and removing blood stasis, dry wet and eliminating phlegm,relieving spasm by subduing liver-wind primarily.2.2.9 Menopausal syndromeThe pathogenesis of this disease that professor Huang mainly is the balance of Yin and Yang kidney disorders, lead to heart, liver and spleen the function disorder. When treatment to the kidney Qi, adjust the balance of Yin and Yang kidney is given priority to, even give attention to nourishing heart, soothing liver, invigorating spleen.2.2.10 Motor neuron diseaseProfessor Huang thinks that the disease pathogenesis focus in the liver, spleen and kidney deficiency, and can also nourish because lung injury, damp and hot dip excessive, vacuity wind stirring internally, and has unclear blood of pathological factors. The treatment of strengthening healthy Qi and eliminate pathogens pay attention to the spleen and stomach Qi, nourishing kidney pulp, even give attention to treatment of phlegm dampness, hot and humid, blood stasis, wen evil, stagnant, etc.3.The clinical study of professor Huang-lijuan in the treatment of restenosis after percutaneous coronary intervention3.1 The study of professor Huang’s medication rules on the treatment of restenosis after percutaneous coronary interventionAccording to the proportion results of the six common TCM syndromes of coronary heart disease and restenosis after percutaneous coronary intervention 107 patients that Teacher Huang treated them with syndrome differentiation, it shows that the syndrome of deficiency of both qi and yin and obstruction of blood in heart is the most common syndrome, syndrome of dysfunction of spleen in transport, syndrome of phlegm and blood stasis, syndrome of deficiency of kidney-yang, syndrome of cold fluid and stasis, syndrome of impeded flow of liver-qi and syndrome of qi stagnation and blood stasis as the follow. The third is syndrome of deficiency of qi both of heart and lung, syndrome of heart blood stasis and epidemic heat and blood stasis syndrome. Teacher Huang differentiates and treats the coronary heart disease and restenosis after percutaneous coronary intervention patients with the common drugs which mainly includes supplementing qi, nourishing yin, warming yang, promoting qi, activating blood, tranquilization, dissipating dampness, clearing away heat, Fu-unblocking and phlegm-resolving drugs, etc. Her common therapeutic methods includes supplementing qi, nourishing yin, promoting qi, activating blood and tranquilization. The total drugs are 113 kinds and the top 15 were Astragalus, Poria, Radix pseudostell, Atractylodes, Liriope, Schisandra, Lily, Peony root, Citrus aurtantium, Bergamot, Salvia, Curcuma, Rhizoma corydalis, Milettia reticulate and Spine date seed. She uses the pulse-activating powder and decoction for removing blood stasis to add or subtract to treat the syndrome of deficiency of both qi and yin and syndrome of obstruction of blood in heart. She uses the ease power to add or subtract to treat the syndrome of impeded flow of liver-qi and syndrome of qi stagnation and blood stasis. She uses the decoction of Trichosanthes, Allium and Pinellia to add or subtract to treat the syndrome of dysfunction of spleen in transport and syndrome of phlegm and blood stasis. She uses the Zhenwu decoction to add or subtract to treat syndrome of deficiency of kidney-yang, syndrome of cold fluid and stasis. She uses the pulse-activating powder and supplement lung decoction to add or subtract to treat syndrome of syndrome of deficiency of qi both of heart and lung, syndrome of heart blood stasis. She therapy the epidemic heat and blood stasis syndrome with the self-made prescription.To analysize the statistical materials 32 patients which had been treated by the coronary angiography or coronary artery CTA in 6 months before and after treatment, the results showed the main symptom integral and condition of complication integral all declined significantly before the treatment (P<0.05), who were treated effective by teacher Huang. Chest pain, chest tightness, shortness of breath, fatigue, heart palpitations and chest flank pain symptoms all had been improved obviously. The results showed that 32 patients’s narrow degree is no more aggravating after treatment and it has not appear new restenosis.3.2 Clinical study on reinforcing qi and nourishing yin and promote blood to restore luo in the treatment of resterosis after percutaneous coronary interventionObjective:To explore the clinical effectiveness of reinforcing qi and nourishing yin and promote blood to restore luo in the treatment of resterosis after percutaneous coronary intervention. Methods:60 cornary heart disease patients who had accepted PCI treatment and occurred restenosis were randomly divided into 2 groups.The patients in the control group (30 cases) received conventional western medicine treatment, the treatment group (30 cases) received conventional western medicine treatment plus Chinese tranditional medicine for reinforcing qi and nourishing yin and promote blood to restore luo. The follow-up underwent for 6 months.The changes of clinical symptoms and blood lipid, coronary angiography or coronary artery CTA were observed.Results:The patients’clinical symptoms in the treatment group were improved, such as chest pain, chest tightness, shortness of breath, fatigue, dry mouth and so on (P<0.05). The situation of red tongue with little fur is improved (P<0.05). The results of the treatment group are much better than that of the control group. According to the results of coronary angiography or coronary artery CTA, the patients’s narrow degree in the treatment group is no more aggravating after treatment and it has not appear new restenosis.The degree of restenosis of 2 patients were lower. It is found that the Chinese herb group can regulating the level of CHOL、TG、HDL-C、LDL-C (P<0.05), the treatment group are improved more in CHOL、TG、LDL-C than the control group(P<0.05). Conclusion:The principle of reinforcing qi and nourishing yin and promote blood to restore luo can improve the patients’clinical symptoms and blood lipid. There is the trend that it can prevent restenosis. Coronary artery disease is the effect of human health and the causes of death of one of the most important disease. At present, percutaneous coronary intervention technology rapid development, has become the important treatment method of vascular reconstruction coronary heart disease. However, after coronary stent placement, there are still happen again the possibility of narrow, the impact of the intervention of the long-term outcome. How to prevent the complications of cardiology after interventional treatment such as restenosis has become the current research field faced one of the important topics.1. The study of professor Huang’s medication rules on the treatment of restenosis after percutaneous coronary interventionAccording to the proportion results of the six common TCM syndromes of restenosis after percutaneous coronary intervention 107 patients that professor Huang treated them with syndrome differentiation, it shows that the syndrome of deficiency of both qi and yin and obstruction of blood in heart is the most common syndrome, syndrome of dysfunction of spleen in transport, syndrome of phlegm and blood stasis, syndrome of deficiency of kidney-yang, syndrome of cold fluid and stasis, syndrome of impeded flow of liver-qi and syndrome of qi stagnation and blood stasis as the follow. The third is syndrome of deficiency of qi both of heart and lung, syndrome of heart blood stasis and epidemic heat and blood stasis syndrome. Teacher Huang differentiates and treats the coronary heart disease and restenosis after percutaneous coronary intervention patients with the common drugs which mainly includes supplementing qi, nourishing yin, warming yang, promoting qi, activating blood, tranquilization, dissipating dampness, clearing away heat, Fu-unblocking and phlegm-resolving drugs, etc. Her common therapeutic methods includes supplementing qi, nourishing yin, promoting qi, activating blood and tranquilization. The total drugs are 113 kinds and the top 15 were Astragalus, Poria, Radix pseudostell, Atractylodes, Liriope, Schisandra, Lily, Peony root, Citrus aurtantium, Bergamot, Salvia, Curcuma, Rhizoma corydalis, Milettia reticulate and Spine date seed. She uses the pulse-activating powder and decoction for removing blood stasis to add or subtract to treat the syndrome of deficiency of both qi and yin and syndrome of obstruction of blood in heart. She uses the ease power to add or subtract to treat the syndrome of impeded flow of liver-qi and syndrome of qi stagnation and blood stasis. She uses the decoction of Trichosanthes, Allium and Pinellia to add or subtract to treat the syndrome of dysfunction of spleen in transport and syndrome of phlegm and blood stasis. She uses the Zhenwu decoction to add or subtract to treat syndrome of deficiency of kidney-yang, syndrome of cold fluid and stasis. She uses the pulse-activating powder and supplement lung decoction to add or subtract to treat syndrome of syndrome of deficiency of qi both of heart and lung, syndrome of heart blood stasis. She therapy the epidemic heat and blood stasis syndrome with the self-made prescription.2. Clinical study on reinforcing qi and nourishing yin and promote blood to restore luo in the treatment of resterosis after percutaneous coronary interventionObjective:To explore the clinical effectiveness of reinforcing qi and nourishing yin and promote blood to restore luo in the treatment of resterosis after percutaneous coronary intervention. Methods:60 cornary heart disease patients who had accepted PCI treatment and occurred restenosis were randomly divided into 2 groups.The patients in the control group (30 cases) received conventional western medicine treatment, the treatment group (30 cases) received conventional western medicine treatment plus Chinese tranditional medicine for reinforcing qi and nourishing yin and promote blood to restore luo. The follow-up underwent for 6 months.The changes of clinical symptoms and blood lipid, coronary angiography or coronary artery CTA were observed.Results:The patients’clinical symptoms in the treatment group were improved, such as chest pain, chest tightness, shortness of breath, fatigue, dry mouth and so on (P<0.05). The situation of red tongue with little fur is improved (P<0.05). The results of the treatment group are much better than that of the control group. According to the results of coronary angiography or coronary artery CTA, the patients’s narrow degree in the treatment group is no more aggravating after treatment and it has not appear new restenosis.The degree of restenosis of 2 patients were lower. It is found that the Chinese herb group can regulating the level of CHOL、TG、HDL-C、LDL-C (P<0.05), the treatment group are improved more in CHOL、TG、LDL-C than the control group(P<0.05). Conclusion:The principle of reinforcing qi and nourishing yin and promote blood to restore luo can improve the patients’clinical symptoms and blood lipid. There is the trend that it can prevent restenosis.