Academic Thoughts And Clinical Experiences Of Professor Zhang Jueren In Treating Geriatric Lung Diseases Which Multiple Zang Organs Are Deficient And Tri-jiao Is Obstructed By Phlegm And Blood Stasis In

ObjectiveThis study discusses the academic origin of Professor Zhang Jueren in treating geriatric diseases,arranges and excavates academic thoughts and clinical experiences of Professor Zhang Jueren in treating geriatric lung diseases in order to inherit as well as develop his thoughts and clinical experiences thoroughly and further.This study observes the clinical effect of Bushenyifeihuatanfang which is a experience prescription treating stable chronic obstructive pulmonary disease in elderly patients.It explores the mechanism of the treatment of Bushenyifeihuatanfang in order to provide theoretical basis of the application of Bushenyifeihuatanfang. Methods 1.To sum up the academic theory of TCM about geriatric diseases, explore the academic origin of Professor Zhang Jueren in treating geriatric diseases and geriatric lung diseases by studying TCM Classics and referring to modern medical theory. 2.To explore the mind-set of Professor Zhang Jueren about treatment based on syndrome differentiation,sum up academic thoughts and clinical experiences of Professor Zhang Jueren in treating geriatric lung diseases,summarize the characteristics of the syndrome,method,prescription and medicine by arranging and analyzing medical records,learning notes and experiences in the last three years. 3.Clinical researchUsing a randomized controlled method,65 cases of COPD patients in stable stage were randomly divided into the treatment group(32 cases),control group(33 cases).The control group was treated with Seretide.The treatment group was treated with Bushenyifeihuatanfang and Seretide.The symptom scores,CAT score of two groups were recorded respectively before and after treatment.We recorded how many patients to attack again in 1 year and how many patients to aggravate acutely needing to be hospitalized.The comprehensive effect of both groups was evaluated respectively.Pulmonary function,IL-6 and TNF-a were determined and recorded respectively before and after treatment.The treatment group was compared with the control group in every aspects,including the symptoms score,CAT score,the comprehensive effect,pulmonary function,TNF-a,IL-6 and so on. Results 1.The academic thoughts of Professor Zhang Jueren in treating geriatric diseases originate from TCM Classics of the jin,yuan, ming and qing dynasties. 2.The academic thoughts of Professor Zhang Jueren in treating geriatric lung diseases include the following points:We should emphasize on regulating and tonifying the lung,spleen and kidney when multiple zang organs are deficient;it should pay more attention to regulate qi movement when qi movement is in disorder;we should focus on resolving phlegm and dredging the channel when Tri-jiao is obstructed by phlegm and blood stasis. 3.Clinical experiences of Professor Zhang Jueren in treating geriatric lung diseasesProfessor Zhang proposed:It is a basic rule of treatment to emphasize on regulating and tonifying the lung,spleen and kidney when five zang organs are deficient and to take account of regulating qi movement and resolving phlegm and dredging the channel.Professor Zhang was good at using all kinds of ginseng.He was also good at using Chinese medicinal herbs such as loofah,tangerine pith to promote blood circulation and dredge the channel.He often used the Chinese medicinal herbs which can be eaten.He liked using couplet medicines commonly in order to increase the clinical efficacy and reduce the toxic side effects.He was good at treatment according to syndrome differentiation.He was adept at seizing the main contradiction and using incorporative classical prescriptions.Professor Zhang was strict in prescriptions.He seldom used medicinal herbs with toxic side effects.The dose of the drug was strictly controlled.Professor Zhang proposed:Deficiency of lung,spleen and kidney was the foundation of geriatric COPD,and phlegm and blood stasis which obstructed Tri-jiao was the standard.In slationary phaseare of geriatric COPD deficiency of lung, spleen and kidney was more obvious than the standard,so the basic rule of treatment was to strengthen the body resistance and take account of the standard. 4.Clinical researchAfter the treatment,the symptom score and CAT score of the treatment group were significantly decreased.The comprehensive effect index was significantly increased.The frequency of acute exacerbation in 1 year and the rate of hospitalization were reduced.The lung function was significantly improved.IL-6 and TNF-a concentrations decreased significantly. 5.The inheritance and innovation of the experiences of Professor ZhangProfessor Zhang Jueren thought multiple zang organs were deficient and Tri-jiao was obstructed by phlegm and blood stasis When old people suffered from lung diseases.This is a new academic point.The methods of tonifying the lung and kidney,regulating qi movement,resolving phlegm and dredging the channel have an effect on inflammatory reaction and airway remodeling of geriatric COPD.The author developments the clinical experiences of Professor Zhang.Because the time,local conditions and the patients were different,the tongue and coating on the tongue were different.Original prescriptions of Traditional Chinese Medicine were often united. Conclusion 1.The academic thoughts of Professor Zhang Jueren in treating geriatric diseases point out the essence of geriatric diseases.It provides a clear direction for the clinical treatment of geriatric diseases. 2.Professor Zhang Jueren reveals:Multiple zang organs are deficient and Tri-jiao is obstructed by phlegm and blood stasis in geriatric lung diseases.This is the basic pathomechanism of geriatric lung diseases.It is a basic rule of treatment to emphasize on regulating and tonifying the lung,spleen and kidney and to take account of regulating qi movement and resolving phlegm and dredging the channel.The thoughts have guiding significance for the prevention and treatment of geriatric lung diseases.3.The experiences are worthy of further popularization and application including "dialectical use of ginseng" "using Chinese medicinal herbs to promote blood circulation and dredge the channel" "using the Chinese medicinal herbs which can be eaten" "uniting original prescriptions of Traditional Chinese Medicine". 4.Clinical researchBushenyifeihuatanfang can relieve clinical symptoms, improve the life quality,reduce the frequency of acute exacerbation in 1 year and the rate of hospitalization.The therapeutic effect is obvious.Bushenyifeihuatanfang can decrease the level of IL-6 and TNF-a.Bushenyifeihuatanfang has an effect on inflammatory reaction and airway remodeling of geriatric COPD by reducing the expression of adhesion molecules and other cytokines,inhibiting the chemotaxis of inflammatory cells such as neutrophils and lymphocytes and inhibiting the proliferation of fibroblasts.5.The inheritance and innovation of the experiences of Professor ZhangThe academic thoughts of Professor Zhang in treating geriatric diseases broad our thinking how to cure cough,asthma,lung distension,pulmonary,pulmonary flaccidity etc.The methods of tonifying the lung and kidney,regulating qi movement,resolving phlegm and dredging the channel may have anti-inflammation and anti-fibrosis effects.The points of "tongue differentiation according to the different time,local conditions and patients" and "combining use of original prescriptions of TCM" need to be applied more.