Summary Of The Academic Experience Of Professor Yang Zhen And The Clinical Research On Treatment Of Infant Cytomegalovirus Hepatitis

Objecticve:The inherittance of the academic experience from senior Chinese physician is an important approach to develop and innovate TCM career. Professor Yang who is the famous liver specialist, engaged in TCM clinical work more than 50 years, is a man full of love and skillfulness. He is good at treating incurable diseases, especially liver diseases. In the long clinical diagnosis and treatment process, he gradually formed the academic theoretical system by himself, which is full of special insights, rich in clinical experience and effectiveness. Fortunately, I am an inheritor of Prof. Yang, and I benefit a lot from Mr. Yang in both individual thought and academic knowledge.The purpose of the research is to explore the academic origin, dig and summarize Prof. Yang’s academic thought, in ordet to comfirm the system of his academic thoughts in clinical practice. Based on the ministerial fire theory, the application of Liangxuejiedu methods and Yangyinsanjie methods to cure infant cytomegalovirus hepatitis enrichs and develops a new effective measures of TCM for infant cytomegalovirus hepatitis.Methods:1 Learning with teacher:to seize every opportunity to learn from Prof. Yang, such as outpatient clinic, ward round, academic conference and teaching. To seek advice from Prof. Yang at any time and disscuss the related academic ideas and clinical application. To take notes, especially diagnosis methods and clinical medicine, in order to analyze the principle of medication experience and syndrome differentiation.2 Studying the literature:To study the literature systematically, and read the supervisor’s articles, lecture notes and the paper published by other inheritors. To study the four classics of TCM and the ancient books of TCM recommended by Prof. Yang. At the same time, to read the newly research achievements published on magazines and books in order to explore the origins of Prof. Yang’s academic thinking and understand his academic thought deeply.3 Practice and exploration:To sum up the academic thinking and cinical experience after systematic exploration and thinking of the supervisor’s academic thinking. To combine it with pediatrics into practice. Through repeated practices and optimistical exploration, the theory is improved and the achivement of study is tested, and theunderstanding of supervisor’s academic thoughts is deepened.Contents:1 Research on the academic origins of Prof. YangTo explore the origins of the supervisor’s academic theory by studying the academic origins of liver diseases and ministerial fire theory.1.1 The academic origins of liver diseases theoryThe main academic achievement of supervisor’s clinical practice more than half a century is the theory of liver disease. Through the study of ancient academic work, "Huangdi’s Internal Classic" laid a good foundation for forming and developing the theory of liver disease, and the "Treatise on Cold Damage Disease" provided the standard for clinical diagnosis and treatment. The four scholars in Jin-yuan dynasty enriched and developed the theory of liver disease. The theory of epidemic febirile disease, qi activity in the dynasties of Ming and Qing, and the modern theory of syndrome differentiation also had a great influence on supervisor’s liver theory. In addition, Prof. Yang learned the true skill and genuine knowledge with Wang Xinwu, Ma Ruiting and Wu Xueqiao, Who are experts in this field. Above all, through combination these theories with his own clinical experientce, Prof. Yang formed his own unique theoretical system of liver disease.1.2 The academic origins of ministerial fire theory"Ministerial Fire" first appeared in "Huangdi’s Internal Classic", which explains the characteristics of Yun Qi, and then later generations used it to express the pathology and physiology characteristics of human being, which led to the new recognition of ministerial fire theory. In the period of Song Jinyuan, Liu Hejian first put forward the theory of life gate fire, and Zhu Danxi elaborated on the ministerial fire theory in details inculuding the physiological function and the nature and abnormal aspects of ministerial fire. Zhang Jiebing proposed that ministerial fire came from the gate of life, and Zang and Fu all produced fire. Besides, Li Shizhen thought highly of the theory of life gate fire and classified it into prosperous fire and failling fire. All those theories have great influences on supervisor’s theory, especially Zhu Danxi’s.2 Research on Prof. Yang’s academic thinking and medication feature2.1 Research of Prof. Yang’s academic thinkingIn this part, Prof. Yang’s academic thinking system was summarized and categarized into academic point of view and prescription and medication in oder to make it more convenient to study and build up knowledge system. By deep understanding and consideration, I summed up the academic thinking for four parts, which were "Uphold ministerial fire theory, Appreciate the method of Ziyin Yangye, Advocate smoothing the liver and regulating qi, Lay emphasis on finding a way for evil", standing for the essence of Prof. Yang’s theory.2.1.1 Academic reviews of Prof. Yang① Uphold ministerial fire theory:Ministerial fire theory is the most characteristic part of supervisor’s academic thought, which was completed by deeply understanding the ancient physicians’ theories, and combining with clinical practices. It had been innovated and perfected based on the thought of Zhu Danxi. Prof. Yang proposed that ministerial fire came from the gate of life and be preserved in five Zang, especially in liver and kidney. The characteristic of normal ministerial fire is perpetual motion, which could warm the skin, hair and Zang-Fu, and be dominated by the heart fire. It has close connection to yin of liver and kidney and is the motive power of body organism. Under the guidance of the theory, Prof. Yang sorted the abnormal ministerial fire into six kinds, which are stagnant heat, blood heat, dampness heat, heat stasis, deficiency of yin and weakness of ministerial fire. At the same time, the six corresponding therapies are clearing away and dispersing the stagnant heat, clearing the blood heat away, dissipating dampness, climinating stasis, moistening dryness and treating deficiency with tonification. As summarize and analyse the point of view of ministerial fire theory through observing the pathology and physiology of pediatric diseases. He concluded that abnormal emotional, improper diet, febrile diseases, drug toxic and activeness of ministerial fire of pregnant women could lead to abnormal ministerial fire, and we could treat these diseases from this aspect.② Appreciate the methods of Ziyin Yangye:It reflects the fundamental thought of liver yin and liver body in clinical practic. Appreciating the theory of Zhu Danxi that "Yang often being in excess, Yin often being deficient", he proposed that yin-liquid is the basic substances to constitute the human body. So in the differentiation, pay attention to liver-yin and liver blood, in order to soften and nourish liver in treatment by the means of raising liver blood deficiency and nourishing liver-yin, kidney water, lung-yin, spleen-yin, as well as tonifying qi and yin and ZiYing-XiFeng. At the same time, the key points of treatment are being not too warm and dry, and when soothing the liver, be cautious to use bitter and cold herbs to expel heat. Besides, prevention is more important than treatment.③ Advocate smoothing the liver and regulating qi:The primary reason of diseases is the disordering of qi activity. As it said in "Su Wen Ju Tong Lun", all illness are born in the qi, and "liver takes charge of catharsis". On the other hand, treating diseases by soothing the liver is the key. Prof. Yang sticks out smooting the liver and regulating qi activty, while at the same time, Zang-Fu relationship and Qi-blood-liquid-fluid pattern blend into the smoothing, which forms a particular differentiation.④ Lay emphasis on finding a way for evil:Five Zang and six Fu organs are the center of human body, constituting a whole organic entity combined with the five sense organs and the nine orifices and all the limbs and bones. Smoothing the five Zang and six Fu’s function is of importance so that the organic entity could reach the balance of yin and yang, and smoothing is a convenient way to give a way to evil.2.1.2 Research on Prof. Yang’s medication featureProf. Yang has rich clinical experience on medication with deep understanding of medicines and fiexible application. This part introduced the principle of differentiation treatment and medication methods. Supervisor is good at using classic prescription of herbs of flowers, guiding drug and Ji Neijin. All of these reflected the supervisor’s deep understanding and flexible application of medicines.2.2 Summary of the clinical experience of Prof. YangIn this part, I collated summed up the clinical experience of common diseases such as liver diseases, miscellaneous diseases and pediatric diseases, in order to deeply and completely understand the essence of academic thinking.2.2.1 The clinical experience about liver diseases and miscellaneous diseases of Prof. YangIn this section, I collated and studied the clinical experience of five common liver diseases, such as viral hepatitis type B, liver cirrhosis, fatty liver, depression and acne. The rule of differentiation of different disease was summarized which reflected the major academic thought, particularly the differentiation experience of the viral hepatitis type B and liver cirrhosisl.2.2.2 Treatment experience of pediatric of Prof. YangProf. Yang has accumulated rich experience in the field of pediatrics. In this part, Ⅰ summarized the treatment experience of pediatric diseases, such as sexual precocity, viral myocarditis, hand-foot-mouth disease, drug induced liver injury.based on ministerial fire theory and theory of warm diseases which best reflected different differentiation methods.3 Clinical research on infant cytomegalovirus hepatitis through ministerial fire theoryThe exploration on the treatment on infant cytomegalovirus hepatitis by ministerial fire theory opened up a new chapter by inheriting the academic thinking and clinical experience of Prof. Yang, especially the theory of ministerial fire.3.1 Objective:To observe the clinical efficacy of the treatment for infant cytomegalovirus hepatitis in the method of ministerial fire theory, and to evaluate the validity and superiority, to deepen understangding the theory in practice, to verify the effect of academic experience inheritance,and to provide practical TCM methods and evidence for infant cytomegalovirus hepatitis.3.2 Methods:92 cases of infant cytomegalovirus hepatitis were collected and then were divided into treatment group and control group by the table of random number. The two groups were all treated by western medicine, while the treatment group was added with herbs of Liangxuejiedu and Yangyinsanjie, and for both the period was 21 days. The efficacy, symptom score, biochemical indexes and inflammatory indicators were evaluated after 2 and3 weeks treatment respectively for both groups.3.3 Results:① 85 cases have beeb collected, in which 43 were in the treatment group, and 42 in the control group.② To compare the clinical effects of two patient groups. In the treatment group,18 cases (41.8%) were cured,17 cases (39.5%) with obvious effect,6 cases (14%) with effect, and the other 2 cases (4.65%) with noneffect. The total effective rate was 95.34% with 41 cases. In the control group,10 cases (23.8%) was cured,12 cases (28.57%) with obvious effect,8 cases (19.05%) with effect, and 12 cases (28.57%) with noneffect. The total effective rate was 71.43% with 30 cases. The total effec of the two groups tested by Ridit test were statistically significant (P<0.05), and the treatment group was significantly better than the control group.③ Effects of the symptom score of two groups tested by Ridit test were statistically significant (P<0.01), and the treatment group was better than the control group. Effects of the symptom score of two groups after 2 and 3 weeks treatment were statistically significant (P<0.01), and the treatment group was better than the control group in symptom improvement.④ After treatment, the serum TBIL, DBIL, ALT, AST, ALP, GGT and TBA in both groups were significantly improved with significant difference in statistics (P<0.05) compared to before, indicating that the liver function were improved in both groups after treatment. After 2 and 3 weeks’ treatment, the difference of TBIL, DBIL and ALT, AST of the treatment group and control group was statistically significant (P<0.05), indicating that the treatment group is better than the control group. However, ALP of the two groups had non-significance (P>0.05) after 2 and 3 weeks’ treatment. On the other hand, TBA of the two groups had non-significance (P>0.05) after 2 weeks, while after 3 weeks there were significance statistically (p<0.05), indicating that treatment group was better than the control group. Additionally, there were no significance (P>0.05) between the two groups in the case of CMV-DNA after 2 and 3 weeks’ treatment.⑤ The level of IL-6 and TNF-a before treatment were higher than the level after treatment in both groups, and it was statistically significant (P<0.05) between the two groups.⑥ Follow-up results indicated that the prognosis of treatment group was better than the control group (P<0.05). 3.4 Conclusions:① Ministerial fire theory, especially the heat-stasis ministerial fire theory, combined with the western medicine treatment, which was applied in treatment of infant cytomegalovirus hepatitis, had advantageous effect and improved prognosis as well.② Liangxuejiedu and yangyinsanje can treat jaundice, protect liver, lower transaminase, and decrease the Inflammatory substances.③ Liangxuejiedu and yangyinsanje as TCM treatment methods may be the commonly used methods in treating infant cytomegalovirus hepatitis.Research Achievement:Through three years’s learning and researching in-depth on the articles and papers of Prof. Yang, the academic thinking and clinical experience were deeply understood and systematically summarized. The core of academic thinking, "Think highly of ministerial fire theory, Appreciate the methods of Ziyin Yangye, Advocate smoothing the liver and regulating qi, Lay emphasis on finding a way for evil", was proposed. Useful exploration was conducted by applying the academic thinking and clinical experience with expected good result. thus the aim of good inheritance and development was achieved, and academic levels were greatly improved.