| The traditional Chinese medicine theory is profound. The first, I inherited and summed the system academic thought of Professor Zhuang Guokang by following the teacher more than three years:1. The dialectical features of Professor Zhuang Guokang:trial rash and cure by case. Skin characteristics lies in its visibility and specificity, dermatological lesions can be visually observed directly, and each has its own unique dermatological performance and features. "It will demonstrate on the outside in the various". Dermatology obvious outward manifestation reflects the changes of evil within the body.Surgical physicians who constantly explored in the long period of time, summarized successively the development of a medicine which is different with "look and smell" four diagnostic parameters mode, that is, identified disease syndrome, treatment the disease by main features of the different manifestations of skin lesions, supplement of tongue pulse. Thus, the ideological feature is treatment the characteristic rash on the rule of traditional Chinese medicine thought dermatology. Professor Zhuang Guokang inherited the profound understanding of the thinking of specialist such as Cheng Yan Ran, Zhu Renkang, Duan FuTing, and the implementation of the thoughts:treat the rash by case on clinical treatment.2. The legislative features of Professor Zhuang Guokang:The combinations method:Professor Zhuang Guokang established a lot of clinical dermatology treatment rule:(1) dispersing heat; (2) nourishing and moistening eliminate itching wind; (3) strengthening spleen and dehumidifier; (4) clearing heat; (5) aromatizing wet; (6) invigorating the blood; (7) cooling blood and activating blood circulation (cooling blood to stop bleeding); (8) nourishing Yin and promoting blood circulation; (9) nourishing blood and activating blood circulation; (10) huoxuetongluo and softening lump, loosening knot; (11) warming meridians and activating blood circulation; (12) liangxueqingying; (13) strong tranquilizing and removing the wind; (14) sour flavor astringing and strengthening superficial defence; (15) nourishing kidney and fire suppression; (16) warming yang and invigorating the kidney; (17) sweat pore resuscitation.When Professor Zhuang Guokang clinical diagnoses patients, he often seized the main contradiction disease syndromes, determined the appropriate treatment rules with flexible compatibility, to achieve good results. For example, the same intractable itching skin disease, Professor Zhuang Guokang would seize the main contradiction intractable pruritus, establishd the rule of strong effectious tranquilizing and removing the wind. To improve the drug efficacy, flexibility is essential to use its compatibility. For example, in the clinical treatment of intractable itching skin disease, we often diagnoses and treated the disease based on the rash color, shape, adopting the nourishing blood method by angelica, shudihuang; moisturizing dryness-syndrome by habitat, scrophulariaceae, polygonum system; activating blood circulation by salvia, dalbergia, angelica root, madder, triangular, curcuma; nourishing yin by aspartame, ophiopogon, dendrobium, polygonatum; cooling by habitat, tree peony bark, comfrey, raw sophora japonica; dissipating phlegm by radish seed, white mustard, sea pumice, sea clam shell; strengthening spleen by citrus, pinellia, poria, licorice; shugan and relieving qi depression by cyperus, radix, turmeric; clearing heat by rhizome, diffusa, folium; when it appeared in the limbs, we often plused millettia, shouwu rattan.3. The recipe features of Professor Zhuangguo Kang:(1) Experience of drug using:cooling:antelope horn, tortoiseshell, habitat, tree peony bark; comfrey, raw sophora japonica, rhizome; activating blood circulation: salvia, dalbergia, angelica root, madder, triangular, nourishing blood; nourishing: angelica, rehmannia, radix; nourishing Qi:sealwort, heterophylla, astragalus; nourishing yin:rehmanniae, scrophulariaceae, aspartame, ophiopogon, polygonatum, dendrobium; reducing fire:gypsum, gardenia; dampness:berberine, scutellaria, phellodendron, sophora; dehumidification:pingwei:citrus, magnolia, herb, licorice; dissipate phlegm:radish seed, mustard seed, sea pumice, sea clam shell; loosening knot:soil fritillaria, trichosanthes, seaweed, kelp, raw oysters; dredging collaterals: millettia, uncaria, lycopodii, homalomena; liangxueqingying:rehmannia dride rhizome, the root bark of the peony tree, red peony root, gypsum, common anemarrhena, scrophulariaceae, lophatherum gracile, honeysuckle, talc; detoxification:honeysuckle, chrysanthemum, bunge corydalis herb, dandelion, glabrous greenbrier rhizome, oldenlandia, folium isatidis; stopping perspiration: ephedra root, raw oysters, ebony, schisandra, astragalus, divaricate saposhnikovia, atractylodes; latent:calcined magnet, calcined ocher, dried plum, raw oysters, mother-of-pearl, ormer, arabia cowry shell; dispelling wind-evil:nepeta, wind, stir-baked fructus tribuli; dispersing heat: notopterygium, nepeta, divaricate saposhnikovia, angelica, arctium, skullcap.(2) Binding Integrative Theory:Under the guidance of the idea of Binding Integrative Theory, Professor Zhuang Guokang treated skin diseases by western medicine conbined with traditional Chinese medicine for decades, he has done extensive, in-depth research. We have accumulated considerable valuable clinical experience in clinical Bianzheng Differential treatment based on the combination of pathogenesis characteristics and function of traditional Chinese medicine itself, the application of pharmacological research, selection of traditional Chinese medicine with clear therapeutic effect, such as the medicine which are commonly used for erythema scaly(anti-tumor medicine):bittersweet herb, duchesnea, solanum nigrum, oldenlandia, menispermi, barbed skullcap herb, lobelia; painful swelling(anti-infection medicine):dent amaranth, patrinia, lithospermum, indigowoad leaf, indigowoad root, equisetum, nutgrass galingale rhizome, honeysuckle; fungal skin disease(anti-fungal medicine):cinnamon,sealwort, cloves, wrinkled gianthyssop herb, fortune’s eupatorium herb, costusroot, alum, borneol, nutgall; photochemical treatment (increased photosensitization medicine):angelica, psoralen, doubleteeth angelica root, giant knotweed rhizome, swordlike atractylodes rhizome and so on.(3) Empirical prescriptions:strong effectious tranquilizing soup, nourishing and dehumidification soup, Xuanfu resuscitation, cooling blood soup, cooling Xiaofeng scattered cooling Xiaofeng powder, aromatic dissipating dampness soup, activating blood circulation soup, restraining and strengthening surface soup. 4. Many experiences in treatment of common dermatology diseases:(1) As for the treatment of eczema, the first thing was nourishing yin and dehumidification; (2) Some experiences in the treatment of psoriasis:cooling blood detoxification, cooling blood, nourishing yin and activating blood; resuscitation Xuanfu appropriate cooperated with some anti-tumor medicine. (3) Refractory itching of the skin--wind-dispersing with heavy and sedative herb. Theory:Intractable itching was usually accompanied by emotional changes, mind dystrophy, liver catharsis failure-treatment by pinggan wind, tranquil mind; heart fire, the fire was inflammation-the rule was tranquiling; core prescription:calcined magnet, calcined ocher, raw keel, raw oysters, mother-of-pearl, abalone, erosaria each 30g (the application of five or more prescription drugs are considered core). (4) treatment of pigmentation disorders such as vitiligo by the method of "complement color to color":black sesame, male black beans, mulberry, polygonum multiflorum, rehmannia, desertliving cistanche herb, etc; chloasma:. atractylodes, poria alba, angelica, white beans, white peony, common bletilla tuber, white silkworm, cynanchum stauntoni, mustard Seed, ampelopsis, bittersweet herb, giant typhonium tuber and so on.(5) Common treatment rule of Professor Zhuang Guokang:The methods of dehumidify included the method of nourishing yin, strengthening spleen, water removal, clearing heat, aromatization, warming yang and so on, while the cooling blood methods included cooling and promoting blood circulation, QinYin method, cooling blood to stop bleeding, promoting blood circulation, clearing heat and nourishing yin activating blood, nourishing and activating blood and Tongluo Huoxue Huayu method, softening lump method and so on. The heat-clearing therapy comprised detoxification, clearing the wind, clearing lung, pouring stomach and purging heat et al. Furthermore,there were other internal treatments such as wind-dispersing with heavy and sedative herb method, Xuanfu resuscitation, raising blood dryness, sour flavor astringing and strengthening superficial defence, removing wind and relieving itching, nourishing kidney and fire suppression method, nourishing liver and kidney. As for the external therapy, there were whitening and improving eyesight, alleviate itching blood heat and dampness, blood stasis, heat and toxin wet etc.. Prof.Zhuang used the drug in the treatment always corresponding specific conditions.(6) Drugs experience of Professor Zhuang Guokang to treat pruritus:As for the clinical diagnosis, Prof.Zhuang thought that the proper rule was critical to improve clinical curative effect of the premise, and lule should based on appropriate syndrome. Differentiation of symptoms and signs manifested the difference of the etiology and pathogenesis of disease. Prof.Zhuang established the methods of treatment based on the specific etiology, which focused on the combined application of treatment, often received a good effect by the rule "very flexible method combined with compound medicine".The Second:clinical reseachWe established the system with a large database of old patient medical records nearly 10 years, standardized outpatient diagnostic disease name. A total of 8820 database consultation times,226 diagnostics were included. It was the first time to mining data of experience and application search of the method of wind-dispersing with heavy and sedative herb for intractable itching dermatosis from large databases. Wind-dispersing with heavy and sedative herb method was the experience treatment method of Prof. Zhuang GuoKang to treat intractable pruritus, and was effective by the long-term clinical observation. But it was difficult to collect useful information completely by the traditional case summary, so we lack large data. This study established the large data of empirical treatment of Prof. Zhuang GuoKang, and strengthened the "evidence" concept, introduced the "evidence-based" ideas, and formed a series of data analysis, summed the experience of Prof. Zhuang GuoKang by the method of people-oriented, man-machine integration.Not only could we find the overall treatment characteristics and explicit knowledge of wind-dispersing with heavy and sedative herb method of Prof. Zhuang guoKang for intractable itching dermatosis, but also we provided a basis for further deep mining analysis to ensure the results of vinegar soak with high-level evidence, reliability and repeatability and stability.The Third:heritage and development1. Warming yang in dermatology applications:In the course with Professor Zhuang Guokang, we used the resuscitation method of Xuanfu inspired prescription, accompanied by differentiation aconite, used FUZHI and achieved good results.Skin diseases were generated in the outermost layer of the skin, also common in head and face. Characteristic performance was red rash, swelling, heat, itching majority. Simple rash syndrome was heat, fire, treated by cooling detoxify drugs. If the patients themselves were yang deficiency, the essence of the performance rash was virtual fire inflammation or virtual fire on the outside, the drugs may took a short-term effect, but in the long term, the results were often becoming worse. So on the basis of dissipating phlegm to remove mass, accompanied by radix aconiti praeparata suppressing liver yang, warming yang, the patients with dermatology diseases such as acne, particularly cystic acne, chiselling folliculitis, often received unexpected results.2. Accordance with GCP norms randomized, controlled further study, the effect of the experience of treating tinea by Zhu Renkang, Mr. Zhuang Guokang was objectively verified.In seventies of last century, the old famous Chinese medicine experts in skin surgery, Zhuangguo Kang, Xu Xian exploited vinegar soak (it is now used in our hospital), based on the research of effective experience soak-vinegar soak for tinea by old TCM expert Zhu Renkang (main drugs:nepeta 18g, divaricate saposhnikovia 18g, safflower 18g, cortex lycii 18g, honey locust thorns 30g, hydnocarpus 30g, alum 18g, etc.). It was made from extraction of soaked acetate of the mashed drug, addin benzoic acid. By clinical observation of using improved vinegar soak to treat tinea, fungal suppression test and scanning electron microscopy and so on, the vinegar sterilization, antibacterial effect was confirmed, the short and long term effects to treat keratotic tinea were good. However, because of not in accordance with GCP standards and lack of strictly controlled clinical observation compared with topical antifungal modern medicine, the efficacy and safety of vinegar soak for keratotic tinea was difficult to obtain domestic and international recognition. After following Professor Zhuangguo Kang three years, we completed the task-the clinical efficacy studies of vinegar soak to treat keratotic tinea. In a multi-centers, randomized, and positive drug parallel comparison trial.142 patients (aged from 18 to 65 years) with hyperkeratotic type of tinea manus or tinea pedis were enrolled from Guang-an-men hospitals. They were randomly assigned to vinegar soak group or 1% terbinafine hydrochloride cream group to receive 4 weeks treatment. The symptoms were observed every week and two months after discontinuation to judge therapeutic effect, and data analysis were judged after the whole treatment. We evaluated the clinical efficacy and safety of vinegar soak in treating hyperkeratotic type of tinea manus and tinea pedis due to blood deficiency and wind-dryness, this meidicine’s effect in improving single symptom of hyperkeratotic type of tinea manus and tinea pedis (Including lesion area, scale, erythema, apule, cornification, fissure, itch and pain).The results are in the vinegar soak group, the total efficiency is 96.49%. In the control group, the total efficiency is 85.46%. Compared vinegar soak with control group, the efficiency of the difference was statistically significant (P<0.05). As to the improvement of single symptoms, the function of vinegar soak was better than the control group in the improvement of papules, cornification, scales, itch. |
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