| Objective:Profenssor Ji Haiwang has undertaken the work of medical treatment, teaching and scientific research for30years. He is a person of good quality and excellent skills, with thousands of students. Profenssor Ji Haiwang is so kind-hearted that he makes up his mind to save people from diseases. He always cultivates his mind in daily life so that he is so broad-minded and tolerant with other people.He helps to treat miscellaneous diseases since he was young, especially rheumatism. He has accumulated rich clinical experience. He follows the ancient prescriptions and methods, but never rigidly adhere to the doctrine. On the contract, he uses both traditional and western medicine theories and methods while treating. He holds the view that disease and syndrome should be integrated properly, which is called "Integrated Chinese and Western Medicine". Also, he is very good at using the visceral syndrome differentiation to diagnose and treat diseases. He emphasizes the great significance of the function of the spleen and kidney during the occurrence and change of diseases as well as prognosis. Through combining the theory of TCM, he carries out actively the work of "Prevention Theory".Profenssor Ji Haiwang speaks highly of the idea of the visceral syndrome differentiation in Huang di’s Canon of Medicine. After years’of clinical experience and continuous summaries and creation, he forms his own academic thought that the treatment of the spleen and kidney which takes the spleen and kidney as key based on studying and inheriting ancient physician’s theories. He puts forward the view that viscera is meridian, and qi, blood, essence, body fluid are collaterals. Also, he thinks that the spleen and kidney play an important role in the activities of body. The function of them lies in the influence on qi, blood, essence and body fluid. For example, we can treat rheumatoid arthritis by treating kidney, treat digestive disorders and respiratory diseases by treating the spleen.Modern medicine considers gout as a kind of chronic disease caused by metabolic disorder of a group of purine. Its main clinical character is the excessive production of uric acid in the body or the reductive excretion of uric acid in the kidney, causing high concentration of uric acid in the blood and the formation of hyperuricemia, repeated attacks of acute gouty arthritis, gouty tophus, chronic gouty arthritis and joint deformity.Gout pertains to "BiZheng","TongFeng","LiJiebing" in traditional Chinese medicine (TCM). While diagnosing and treating the gout, attention must be paid to the influence of the function of the spleen and kidney to the pathogenic factors at all stages. Both selecting the prescription and applying the medicine are based on regulating the spleen and stomach and protecting kidney essence. Tonifying deficiency and reducing excess are reasonable and flexible. Profenssor Ji Haiwang thinks gout has a close relationship with the kidney and spleen. Phlegm stagnation, toxic heat, blood stasis, deficiency of healthy qi are the pathogenic factors of gout at different stages. The treatment of gout adopts the method of combination of disease and syndrome, that is to say, the combination of visceral syndrome differentiation with treatment of different phases. Gout can be divided into the following four phases:acute phase, intermittent phase, chronically stabilized phase and hyperuricemia. Profenssor Ji Haiwang considers that acute gouty arthritis pertains to toxic dampness heat syndrome.Exuberant pathogenic heat and stagnated phlegm are the key pathogenesis to it. Phlegm stagnation, toxic heat, blood stasis are important pathogenic factors. The therapeutic principle "relieving the secondary symptoms first in treating acute disease" means to attack pathogenic factor and protect healthy qi. By inducing fire to detoxicate poison and expelling dampness to smooth collaterals, he created the prescription named "Powder for Relieving Pain ",which has a satisfying effect on the treatment of acute gouty arthritis.The passage tries to learn and inherit the academic thought and experience on the whole and systematically studies the clinical experience on treating the gout. Through the comparative study among the experienced prescription "Powder for Relieving Pain" used to treat gouty arthritis, Chinese patent drug "Tong Feng Ding" and diclofenac sodium, we mean to provide experimental research data for professor to treat acute gouty arthritis by using "Powder for Relieving Pain"Method:We summary and study the academic origin and thought;collect150cases gouty patients treated by professor; do a statistical analysis about the syndrome, fundamental prescription, and the usage of the gypsum; discuss the clinical experience about the differentiation treatment of gout at different phases. According to the clinical research of the experienced prescription "Powder for Relieving Pain" in treating toxic dampness heat syndrome of professor.We adopt a random, open, contrasted method. We divide the patients into three groups as follows:the "Powder for Relieving Pain" group, the Tong Feng Ding group, the diclofenac sodium group. We analysis the joint index, TCM syndrome and criterion of test in the three groups and evaluate the safety.Results:The syndrome differentiation and treatment research of gout shows that deficiency of spleen and dampness retention are the main syndromes in the high uric acid hematic period(83.3%);toxic dampness heat pathogenesis is the main syndrome in the acute period(80.7%); yin deficiency and blood stasis are the main syndromes in the intermittent period(57.1%); deficiency of spleen and kidney and phlegm stasis are the main syndromes in the chronic period(56.3%). It’s better to treat the disease by strengthening the spleen and clearing away the dampness in the high uric acid hematic period without symptoms. In this period, strengthening the spleen and clearing away the dampness is the fundamental prescription(65.6%). In the acute period, Xi Tong Powder is the fundamental prescription(60%), but it’s better to clear away heat to remove toxin and dispel dampness to smooth the collaterals. In the intermittent period, the decoction of removing toxin and eliminating stasis is the fundamental prescription(60%), but it’s better to nourish and tonify liver and kidney, activate the blood to smooth the collaterals. In the chronic period, NO.2gout is the fundamental prescription(65%), but it’s better to benefit kidney and strengthen the spleen, and activate blood to remove phlegm. Gesso is frequently used in the acute period(86.5%) and the dosage is from50g to70g.(80%), p<0.05.The clinical research shows that "Powder for Relieving Pain" has a significant effect in alleviating joint pain, reducing joint swelling and pain. There is no statistical differences (p>0.05) compared with the diclofenac sodium group. And it’s superior to the Tong Feng Ding group (p<0.05). The total effectiveness rate of TCM is95.2%. Thus, it’s clear that "Powder for Relieving Pain" is superior to the control group (p<0.01) in reducing the quantitative score of the TCM syndrome."Powder for Relieving Pain" can effectively reduce the inflammatory index (ERS, CRP). There is no statistical differences (p<0.05) compared with the diclofenac sodium group. And it’s superior to the Tong Feng Ding group (p<0.05). The level of UA doesn’t decrease obviously. There is no side effect in the treatment group.Conclusion:Profenssor Ji Haiwang speaks highly of the visceral syndrome differentiation and his academic thought focus on spleen and kidney treatment. Spleen deficiency, toxic dampness heat, yin deficiency and blood stasis, spleen and kidney deficiency and phlegm stasis are the typical syndromes in treating the gout. Strengthening spleen to remove dampness,"Powder for Relieving Pain", the decoction of removing toxin and eliminating stasis, NO.2gout pill are the typical prescriptions used to treat gout in different phases. The high dosage of gypsum is also the characteristic in treating acute gouty arthritis.Professor’s experienced prescription "Powder for Relieving Pain" has almost the same effect with the control group in alleviating joint pain and reducing joint swelling and pain. Its apparent advantages are improving fever, bitter and dry mouth and it can reduce the inflammation index blood sedimentation (ERS), C-reactive protein (CRP). There is no adverse reaction and side effect. On the contrary, it’s safe and effective. It’s predicted that this prescription may have the function of anti-inflammatary, immune-inhibition action, analgesic action and the effective improvement of the microcirculation of the inflammatory tissue. The mechanism needed to be studied and discussed further.Although we have made progress in treating gout through the treatment of spleen and kidney, it still should be improved in reducing the uric acid level in order to prevent fluctuation of the uric acid level and recurrence. TCM dosage forms still need to be improved. The author thinks that we may get an ideal effect if the disease is treated through the treatment of liver, spleen and kidney. Researchers should make a further study to treat gout through the treatment of liver, spleen and kidney. |
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