| ObjectiveThis research is to collate the teacher Wang’s academic thought of the spleen and stomach disease, "Dealing with the five zang-organs is treating the spleen and the stomach", and clinical treatment experience of comprehensive systematically and comprehensively. A data mining study on the use of medication for the treatment of peptic ulcer.In order to summarize, inherit and sublimation of the teacher’s theory of the spleen and stomach disease, and provide some experience for clinical syndrome differentiation and treatment of spleen and stomach disease.MethodThe study is mainly based on taking the inspiration in teacher Wang’s learning, the division of clinical records, teacher’s teaching materials, teacher’s published papers and published works and other heirs of the teacher’s clinical experience and academic thinking summary of the paper. Reference to the different views of different doctors, research progress of peptic ulcer in Chinese and Western Medicine, the teacher academic’s origin, academic thoughts and application, unique herbal prescription characteristics and digestive ulcer medication rule.Part one, research progress of peptic ulcer in Chinese and Western medicine. Using literature review method, analyzed from study on the pathogenesis and treatment of peptic ulcer with Western medicine, traditional Chinese medicine on the etiology and pathogenesis of peptic ulcer, differentiation and treatment, resear-ch status of the effect of traditional Chinese medicine on Helicobacter pylori and research status of traditional Chinese medicine to improve the quality of ulcer healing. Part two, academic origin. Summarized the origin of the theory of spleen and stomach that the teacher follows is in that time into three stage. Finding the origin of the teacher’s academic thoughts by the teacher’s mainly academic ideas for analysis. Part three, summarized academic thought of "Dealing with the five zang-organs is treating the spleen and the stomach"and medication characteristics and experience in diagnosis and treatment of spleen and stomach diseases. Using the method of literature analysis and research, combined with Chinese traditional classical theories from the spleen and stomach is satisfied of the correlation of five viscera, emphasis on diet, stool, the constitution of the spleen and stomach syndrome differentiation , medical treatment concept-"dealing with the five zang-organs is treating the spleen and the stomach". Nourishing spleen and kidney, eliminating drug regimen supplementation and concept and the unique characteristics of teacher prescription. Part four, study on the treatment of peptic ulcer. Based on auxiliary system of traditional Chinese medicine Inheritance(VI.1), collected 120 prescriptions of the treatment of peptic ulcer. Establishing the medical record template for clinical diagnosis and treatment of peptic ulcer, input drug information, the formation of the treatment of peptic ulcer medical records prescription database. Using "prescription analysis", "statistical report", which are in data analysis module in software. Unsupervised data mining method based on association rules and complex system entropy clustering. Analysis of new prescription from the single herb medicine on frequency, many kinds of medicine, three aspects and prescription rule.ResultThrough the study of teacher’s academic origin,<Nei jing> has established the idea "spleen transport, stomach and the main receiving", "people lived with stomach Qi","people lived with food as a fundamental".< Treatise on Fevrile Diseases) has created the thinking method of syndrome differentiation has laid a solid theoretical foundation for the academic thought of the teacher. Li’s spleen-stomach theory, Qian’s child spleen-stomach theory, Wang’s yin theory, Ye’s wei-yin theory, Liao’s "Sweet cool, moist, nourishing yin" to treat spleen yin deficiency, and Wu’s "sweet, nature, nourishing yin". All of this provides a profound theoretical basis for clinical diagnosis and treatment of stomach disease of teacher;Xue’s "the spleen and stomach", Zhang’s "an adjustable internal organs of spleen and stomach", Luo Tianyi was attached importance to each organ of spleen and Professor Deng Tietao has proposed "doctrine of the correlation of five viscera", have has provided conclusive experience teacher’s "five internal organs to cure stomach view".<Neijing> has discussed about the related of disease and location of disease, and Gao Jinting’s surgery thought-"part of syndrome differentiation", concise and effective guidance teacher by dampness, the residence of the upper, middle and lower eczema. It also has proposed "preventive treatment of disease" theory and Li zhongzi was advocated the "spleen was acquired of the kidney is the innate" theory, as teacher will adjust the nourishing spleen and kidney, eliminating supplementation throughout in health care, anti senility to cure diseases for the core concept of health.In part three showed that teacher’s physiological and pathological views in treatment of spleen and stomach disease, "Five evil are all through to spleen and stomach" which is based on link to spleen, stomach and correlation of five zang-organs. Pay attention to "security organs regulating spleen and stomach". Teacher advocates clinical on treating spleen and stomach disease must focus on the heart, lung, liver, kidney, it’s more important to keep spleen balance, advocated the spleen and stomach, appropriate cure liver first;sparse spleen and stomach, should discharge lung first tonifying the spleen, and vibration of the heart and kidney. Teacher pay attention to the physiological function and pathological changes of the spleen and stomach, and the idea can be used no more than spleen and stomach disease. But can be widely used in the treatment of other diseases of the system. For example, "according to the site and viscera to treat different eczema". If wet is in upper, for treatment of lung first, wet dispersing qi; if wet is in middle, mainly controlling the liver and spleen, regulating qi, dampness; if wet is in lower part, cure kidney. Gas to help the spleen dampness is the concrete application of the academic thought.The teacher is advocating Zhongjing, Dongyuan, and learning from Dunhuang medicine and old Dunhuang prescriptions, formed unique characteristics of drug use, combined with their own clinical experience summary, and created a series of effective prescription for the treatment of spleen and stomach diseases. The teacher has created several prescriptions which can represented his unique ideas, such as Wenzhong Yukui decoction, Yangyin Yukui decoction, Shugan Yukui, Sanhan Yukui decoction.And the unique prescription, such as Shuganhewei decoction can smooth qi, treatment of gas troesophageal reflux disease with the method of reducing the stomach and descending the stomach, Huayu Xiaopi decoction in the treatment of spleen and stomach, treatment of chronic atrophic gastritis with qi and blood stasis, acid liver treatment of peptic ulcer, Wenzhong Yukui decoction can warm up the spleen and stomach. Moreover, the teacher also advocated the concept of health preserving which the key is to nourishing spleen and kidney, supplementation and elimination. Make it as a guide and created Dunhuang Shishi Dabao capsule, which is learning from"The Dunhuang Grottoes note". Using accurate and precise combination, highlighting the spleen and kidney nourishing, eliminating supplementation on delaying senescence effect.In part four, based on association rules and the research of teacher in the treatment of peptic ulcer medication rule of entropy clustering shows that the frequency of drug used in the treatment of 120 prescriptions of peptic ulcer. From high to low are Cuttlebone 117, Bulbus Fritillariae thunbergii 110, Zhigancao 97, Astragalus 83, Radix Paeoniae Alba,82, Cassia twig 70, Dandelion 69, Poria, 59,Rhizoma Coptidis 52, Rhodiola 51, Evodia rutaecarpa 49. Teacher in the treatment of peptic ulcer commonly used in three categories of drugs. The first class of drugs are warm tonic drugs (Huang Qi, White peony root, tuckahoe, Cassia twig, Rhodiola rosea, Wu Zhuyu),58.54% of the frequency of the top 11. The commonly used doses of each drug are Huangqi 15～25g,12～15g, Radix Paeoniae Alba Guizhi 6--12g,15～30g, Fuling Rhodiola 15g, Wu Zhuyu 10g. Second kinds of drugs is to neutralize stomach acid(Cuttlebone, Zhejiang Fritillaria),27.05% of the frequency of the top 11. The commonly used doses of each drug are Cuttlebone30～50g, Zhejiang Fritillaria 12g. The third is to clearing heat and clearing damp (Dandelion, Goldthread),14.41% of the frequency of the top 11. The commonly used doses of each drug are Dandelion 10～ 12g, Goldthread 3～5g. The nature of hot in all drugs frequency accounted for 54.01%, while cold frequency accounted for 30.46%. Warm drugs use frequency are far greater than the cold drugs. In the five kinds of situation, sugariness frequency for 34.18%, bitter frequency accounted for 26.73%,pungent frequency accounted for 21.46% which are far more than the sour, salty, astringent drug. Cumulative frequency was 88.90%, which of the spleen and stomach channel accounted for 42.16%, liver channel occupies 16.87%, lung channel occupies 14.27%, heart channel occupies 9.12%, kidney channel occupies 6.48%. There are three main types of commonly used drugs:the cold temperature compatibility (Dandelion Guizhi, Dandelion cuttlebone, Fritillaria thunbergii Guizhi frequency etc.) accounted for 47.08%;warm compatibility (Guizhi-cuttlebone, Rhodiola-Guizhi, Guizhi-Evodia rutaecarpa) frequency accounted for 35.34%.The bitter cold compatibility (Zhejiang fritillary-Dandelion, Dandelion, dandelion-Rhodiola lactiflora) frequency was 17.68%. It’s shows that the results of drug data mining fully reflected the teacher’s understanding of the etiology and pathogenesis, treatment methods, drug selection and compatibility.The teacher considered that the disease in the stomach, and is closely related to liver and spleen. The pathogenesis is weak(spleen and stomach weakness), exogenous evil(damp heat, qi stagnation, blood stasis, etc.). Therefore, reduce acid, reduce heat and dampness, promoting qi to activate blood are the mainly treatment. Because the cold sore is most common in specific clinical disease (spleen deficiency), the teacher thoughts that treatment should be warm, so the highest frequency is warm tonic, almost 58.54%. And these drugs are commonly used in large doses. Statistical analysis of the four and five flavor frequency, it shows that the important in warming middle-Jiao and tonifying deficiency is warming and tonic, and it’s aims to promote the digestion of the spleen and stomach, and adding spice drugs to prevent the digestion of the spleen and stomach.The Cuttle-bone and Zhejiang fritillary are the top two in all three types of drug frequency in acid neutralizing drugs. And the maximum dose of cuttle-bone is 30-50g.The drug combination of mining also shows the teacher use Wubeisan (Cuttlefish bone, Zhejiang Fritillaria) to reduce acid and relieve pain in treatment of peptic ulcer. All of this shows the idea,the occurrence of this disease is closely related to the excessive secretion of gastric acid and the view of "no acid no ulcer", the treatment should stop acid secretion.Combined with the analysis of the results showed that the teacher in drugs choosing would rather to direct the spleen and stomach at first in the disease treatment. And combine adjusted lung, arrived in liver and warm heart, kidney at the same time. Pay attention to"dealing with the five zang-organs is treating the spleen and the stomach"in order to improve the curative effect. In addition to that sweet-warm compatibility is the highest drug compatibility (up to 35.34%), compatibility of cold and warm frequency is also very high (up to 47.08%). The teacher thoughts that the cause of the disease is long, easy to relapse and so on, so, it’s better to use cold and warm drugs in cold-heat complicated syndrome. But the teacher pay more attention to the sweet-warm compatibility in certificate. Can not use cold medicine in pure in order to take care of the spleen and stomach. In clinical treatment, the highest frequency are Dandelion and Goldthread in common cold medicine. The drug dosage is small, Dandelion 10g, Goldthread 3～5g. And it use with warm medicines in the same time such as Dandelion and Cassia twig, Dandelion and Rhodiola, Dandelion and Evodia rutaecarpa, Coptis and Cassia twig etc. In drug compatibility, the frequency of sweet-warm +cold medicine is 82.42% and it’s higher than cold medicine (17.58%).All of this present the teacher’s idea of keeping warm and protecting the spleen and stomach. Teacher believes that the occurrence of spleen stomach disease (including peptic ulcer), in addition to the weakness of spleen and stomach, also has a relationship with the spleen and stomach of obstruction of qi and movements abnormal. Long duration of the disease can lead to chronic illness into body inside and make blood stasis. Therefore, the treatment of qi and blood circulation is essential. Teacher used qi and blood circulation drugs in common such as Fructus aurantii, Rhizoma Cyperi, Rhizoma Nardostachyos, Pseudo-ginseng, Ligusticum wallichii and Angelica sinensis with invigorating spleen and clearing heat drugs can have good curative effects.ConclusionThe theory of the spleen and stomach that the teacher follows is deep and reliable, the academic thoughts of teacher in treating spleen and stomach disease is clear. Teacher’s clinical evidence advocate on treatment of spleen and stomach disease are as follows:The physiological view of correlation of five stomach absorption and lifting. The pathology view ofthe five internal organs’pain will final going to spleen and stomach". The dialectical view of pay attention to diet taste, stool and body constitution in spleen stomach disease. The medical treatment concept of "dealing with the five zang-organs is treating the spleen and the stomach". The medication regimen of nourishing spleen and kidney, supplementation and elimination. Advocating Zhongjing, Dong yuan, from Dunhuang and drug group of prescription compatibility improving effect characteristics. All of this formed a unique academic system of the spleen and stomach disease. The drug treatment chooses of peptic ulcer disease is link closely with stomach and closely related with the liver and spleen. And the pathogenesis is asthenia in origin and asthenia in superficiality,the incidence is closely related to the excessive secretion of gastric acid. Reduce acid, clear heat andeliminate dampness and promoting qi to activate blood as the main treatment method. And pay attention to the idea of "dealing with the five zang-organs is treating the spleen and the stomach" to improve curative effects. Teacher thinks it should pay more attention in warming middle-Jiao and tonifying deficiency when treating the disease, avoid to cast pure cold medicine and take care of the spleen and stomach qi. |
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