| Background:Chen Quan is a famous Traditional Chinese Medicine expert in Shandong Province,engaged in clinical medicine for more than forty years.He has rich experiences in the treatment of internal?surgical?gynecological and pediatric diseases,especially in treating chronic kidney diseases. He has unique experiences in refractory nephropathy syndrome?Chronic Renal Failure in early and medium stage. As an academic heir of Chen Quan, it is an obligation and responsibility to sum up the teacher's academic thoughts and clinical experiences,and thus improve our clinical experiences, and it is also a good way to inherit and develop Traditional Chinese Medicine.Objectives:To sum up the academic thoughts and the clinical experiences in treating Chronic Kidney Diseases(CKD) of Chen Quan.Carry out the clinical research of the clinical efficacy of the teacher's experience in treating Henoch-Schonlein purpura(HSP) by Fengduqingjie decotion, and to observe the effect of C3, IgA and other indicators of the decotion, and further summarize the clinical experience of the teacher in the treatment of HSP.Methods:1.By the way of learning form the teacther in clinic, collecting teachers'medical records, summaring the the stydy notes, reading teacher' writings, listening to teacher lectures and reading the classic books of traditional Chinese medicine, to sum the teachers'academic thoughts and the clinical experiences in treating Chronic Kidney Diseases(CKD) and refining. On the basis of the summary of teachers'academic thoughts and experience, by randomized controlled trials, to observe the clinical effects of treating HSP and HSPN by Fengduqingjie decotion, focus on the teacher's experience in treating HSP.2.To observe the clinical effects of treating HSP of Fengduqingjie decotion by randomized controlled trials?By means of random number table,60 HSP patients were divided into Fengduqingjie decotion treatment group and western medicine group,each group include 30 cases,after two weeks of treatment,to observe rash subsided time, IgA, C3 and the number of cases of renal injury before and after treatment. By means of random number table,60 HSPN patients were also divided into two groups of TCM group and western medicine group,after three month of treatment,to observe red blood cell count and protein level in urine, changes of IgA and C3.Results:1.Teacher's academic thoughts were based on inner Canon of Huangdi and Shanghan Zabing Lun,influnced by famouse doctors in past dynasties and his teacher Yao Ziyang,Yuan Zhengyao,Zhu Liangchun and so on,and form his own characteristics.The teacher's academic thoughts include:"advocating neutralization, regulating yin and yang", "According to law of Zhongjing, skilled in using classical prescriptions", "preventing and the diseases early","corresponding between man and universe, responding to the circumstances","making good use of insect drugs,curing serious illness", "paying attention to exogenous, strengthening body resistance and eliminating evil".2.The experiences in treating CKD of Chen Quan:(1)The pathogeny and pathogenesis:the pathogenetic of CKD is Dificiency in Spleen and Kindey,Dampness and blood stasis in the vessel, The Dificiency in Spleen and Kindey is the foundation of CKD occurrence,and the Dampness and blood stasis is the pathological features of CKD,and the occurrence of CKD is often induced by the outer cvil qi.The inner and outer evil Qi often influences each other,thus CKD becomes lingering.3.The principle and method of treatment:(1)The main treatment method is strengthening body resistance to eliminate pathogenic factors,the principle is strengthening the spleen and kidney, eliminating the dampness and blood stasis at the same time,and considering the imbalance of Yin and Yang.(2) Specifically, the deficiency syndrome is divided into five types:Qi-dificiency in spleen and kidney, Yang-dificiency in spleen and kidney,Qi and Yin dificiency in spleen and kidney, Yin and Yang dificiency in spleen and kidney,Yin-dificiency in the liver and kidney, Qi-difficiency in lung. Removing the evil elements of stamness and blood stasis are applied during the whole course of treatment, the excess in superficiality syndrome is divided into such types:Damp in middle-jiao, damp heat in middle-jiao, damp heat in lower-jiao, blood stasis in kidney collaterals, blood heat and stasis, yin deficiency and blood stasis, Qi deficiency and blood stasis. Pay attention to get rid of exopathy,such as wind cold, wind heat, toxic heat, damp and other exogenous pharyngeal node.(3)Combining the diseases and the symdromes, the macro symdromes and the micro symdromes.(4) Summarize the teacher'clinical experience of using traditional Chinese medicine such asJiangca?Chantui?Huangqi?Dilong?Shuizhi?Gejie?Lurong?Dahuang.(5) Arranged the teacher's experience prescription:Huazhuo Gushen decotion, Shenlikang capsule, Yan Shuai Shenbao capsule and Fengduqingjie decotion.3. The teacher's clinical experience in the treatment of Henoch-Schonlein purpura: Pay attention to the affection of wind evil in the morbidity of HSP.The basic pathogenesis is that the wind and the dampness,heat evil damaged blood collaterals, or kidney collateral by meridian.The therapy is according to the three types:wind and heat injurd the skin,Yin-deficiency and inner heat, wind and dampness and heat injured the kidney collaterals,on the basis of using Fengduqingjie decotion. The therapeutic effect is better than western medicine group.4. Clinical research results:The levels of serum IgA in patients with HSP and HSPN were increased, and the level of C3 were not significantly changed. For patients with HSP, the skin rash subsided time in the treatment group was significantly shorter than that in the control group, serum IgA level and renal damage were significantly lower than the control group (P<0.05). For patients with Henoch-Schonlein purpura nephritis, the time of skin rash subsided, urine red blood cells and urine protein level, serum IgA levels were significantly lower than those in the control group (P<0.05).Conclusion:During the long time of clinical practice,Chen Quan formed the academic thoughts of: "advocating neutralization, regulating yin and yang", "According to law of Zhongjing, skilledin using classical prescriptions", "preventing and the diseases early","corresponding between man and universe, responding to the circumstances","making good use of insect drugs,curing serious illness", "paying attention to exogenous, strengthening body resistance and eliminating evil".In the treatment of CKD, he thinks that the pathogenetic of CKD is Dificiency in Spleen and Kindey,Dampness and blood stasis in the vessel.As to the treatment,the principle is strengthening the spleen and kidney,eliminating the dampness and blood stasis at the same time,and eliminating the outer evil Qi.He pay attention to the effect of wind evil in the morbidity of HSP, The basic pathogenesis is that the wind and the dampness,heat evil damaged blood collaterals, or kidney collateral by meridian.The therapy is according to the four types:wind and heat injurd the skin,Yin-deficiency and inner heat,wind and dampness and heat injured the kidney collaterals,on the basis of using Fengduqingjie decotion. The experimental results show that through the application of Fengduqingjie decotion,the clinical symptoms of HSP and HSPN can be improved obviously,and it also can shorten the course of disease and reduce the occurrence of renal damage and the level of IgA, which has the function of regulating the body's immune system. |
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