| Professor Ling xiangLi has committed to the Chinese medicine clinical, teaching and scientific research work nearly 40 years.She has done quite a lot medical skills. This paper systematically collates and summaries the main academic thoughts of professor LingXiangLi, and discussed and summarized the clinical experience about treating diabetic gastroparesis(DGP) by using of the method of soothing liver and harmonizing stomach and regulating qi. Based on professor LingXiangLi experience in Shuganhewei tang treatment of diabetic gastroparesis of the type of disharmony between the Liver and the Stomach clinical curative effect observation, to further verify the tutor's academic point of view. Aims to teacher lifelong medical practice experience summary and refining, make the teacher's academic essence can be fully succeed, for providing a new method of combining traditional Chinese and western medicine treatment of diabetic gastroparesis and effective prescription, thus completes the famous old doctor of traditional Chinese medicine of the inheritance and development of the experience. This paper is divided into four parts.1. Academic thought origin of Professor LingXiangLi and general research situation of diabetic gastroparesisIntroduces the academic thoughts origin of Professor LingXiangLi; Systematic reviews of past dynasties literature of traditional Chinese medicine on diabetic gastroparesis of disease, the understanding of the etiology and pathogenesis, and summarizes the contemporary Chinese and western medicine treatment of diabetic gastroparesis, pointed out that at present not yet unified the etiology of diabetic gastroparesis, its pathological mechanism is not entirely clear, and modern medicine has no specific therapy,but Chinese medicine, has more obvious advantages in the treatment of diabetic gastroparesis. To further explore the understanding of the etiology and pathogenesis of traditional Chinese medicine on diabetic gastroparesis, based on the whole, from the use of traditional Chinese medicine syndrome differentiation and the local treatment of diabetic gastroparesis should be the future research direction; To seek new thinking and effective formula of effective cooperation of Chinese and western medicine in the treatment of DGP is one of the future research goal.2. The sorting and summary of Professor LingXiangLi academic thoughts and clinical experienceProfessor LingXiangLi has noble medical ethics,and medical skills.She carefully studies and classics book during the period of the long-term teaching and clinical practice, especially research thorough and thorough exposition some classics medicine book,such as HuangDi NeiJing and Shang Han Lun. Professor Ling does not laies particular stress on any theory,learns from others'advantage, melts the later medical academic points, and refers to the understanding of the modern medicine, and make western medicine and traditional chinese medicine compatibly, gradually formed its own unique academic style. Professor Ling's academic thought mainly includes:(1)Correlation of all four examination, searching for the primary cause of disease in treatment, Be good at graspping the thread of pathogenesis: emphasis on graspping the thread of pathogenesis on the basis of information collection, find out the primary symptom, good grasp pathogenesis main line and rule; (2) All applications and the west in the traditional Chinese medicine, combined disease and syndrome: advocating the idea of west is used by the doctor of traditional Chinese medicine and the root of traditional Chinese medicine, combined Chinese and western philosophy, promoting guided by the basic theory of traditional Chinese medicine, the combination of disease and syndrome.In treatment of complicated medical certificate of knotty process, the syndrome differentiation of traditional Chinese medicine combined with western medicine diagnosis of disease, and guides clinical evidence-based medicine. (3)If qi movement unobstructed, all ills will not produce:nothing that disorder of qi activity is the important factor of disease development, only to grasp the movement rule of the gas of the zang-fu organs, diagnosis of the disorder of qi activity, make the person qi movement unobstructed, disease will be recure.Focus on freeing movement of qi is smoothing the liver and regulating spleen and stomach, clinical toning qi movement mainly follows the two principle of homeopathy and contrarian therapy. (4) The focal point of strengthening and consolidating body resistance is regulating and nourishing the spleen and the kidney:The source of the treating disease from the root is the spleen and the kidney.We should pay attention to cultivate and supplement qi and blood, Yin and Yang of the spleen and the kidney, Integrate tonifying kidney and strengthening spleen on medication, regulating and treating the spleen and the kidney at the same time.The focal point of regulating the spleen and stomach is interdependence between ascending and descending, interdependence between drying and moistening, Attacking does not hurt the spleen and the stomach should be noticed. To cultivate and supplement the the birth of the kidney emphasizes Each other aid of Yin and Yang, tretment at the same time, but tonifying yin is the basis. (5) Be good at the harmonization method, searching for balance is the key point:cold and heat, tonification and purgation in combination, it was done in order to treat complicated syndrome and restore dynamic balance; The object of harmonizingYin and Yang is keeping Yin and Yang in balance, the key point of regulating zang-fu organs is searching balance; When Clinical treatment, you should treat Mitigatory and gently to avoid new unbalance. (6)Pay attention to the whole, comprehensive adjustment and treatment:holism concept runs through the physiology and pathology of TCM, syndrome differentiation and treatment etc. Only attaches great importance to the natural environment, social environment influence on disease formation and characteristics, and the coordination and balance between human zang-fu, and the relation of local affection and the zang-fu organs.To make a diagnosis and give treatment from the whole, you can manifest the advantages of traditional Chinese medicine and improve the clinical curative effect. (7) The features of clinical medication:Professor Ling attaches great importance to the processing and the dosage of drugs; Likes use the medicine pair and medicine teams; Advocates use carefully the partial medicine of drug properties and taste, avoid attacking and tonifying hardly, for the purpose of peace, the prescription ingredients is simple and insipid, the dose is light; When using classic ancient prescription,she is good at seizing the core pathogenesis, studies its method without its ingredients.At the same time, according to many years clinical experience and research results, Professor Ling has created some new prescription:Tangtong Ying,Shuganahewei tang, Qishu Tang, Zhendi Tang etc, those have achieved good clinical effect.3. The professor Ling XiangLi clinical experience and research of treating diabetic gastroparesis LingXiangLi professor have original ideas of diabetes and its complications, malignant tumors and its reaction after radiation or chemotherapy treating, spleen and stomach disease, neurasthenia and menoxenia. This paper only summaried comprehensively and discussed deeply Professor Ling XiangLi clinical experience of treating diabetic gastroparesis. (1)Understanding of etiology and pathogenesis about DGP:Professor Ling think that diabetes gastroparesis have the special law of occurrence and development besides diabetes common regularity of disease, and it was summed up basically has the following three points:First, the basic pathogenesis of diabetes and its complications is the weakness of the viscera of spleen and stomach, liver, kidney.Spleen(stomach) deficiency, liver depression and kidney deficiency are the internal causes and results of DGP occurrence and development; Second, disorder of the Qi movement is always the important link of diabetic gastroparesis; Third, liver dysfunction is the important factor,and liver-stomach disharmony is the core of DGP pathogenesis. (2) Professor Ling s TCM thinking of syndrome differentiation of DGP: ? Attaching great importance to identify the Zang-fu organs qi movement.You should recognize the specific situation of Qi activity disorder on clinic, and the emphasis of treatment is regulating Qi activity. ? Pay attention to deficiency and excess of the disease, attack rule of DGP is deficiency and excess reciprocal causation, and is the syndrome of intermingled deficiency and excess which was resulted from deficiency. Therefore, identifing clearly the situation of disease deficiency and excess and treating together, should be emphasized clinically. Vhen syndrome differentiation, to grasp the primary symptom, pay attention to accompanied symptom, refer to pulse and tongue. (3)Thinking of the treatment of DGP:Professor ling especially puts forward the importance of overall adjustment and Qi activity balance, keeping core pathogenesis on treatment, paying attention to equilibrate the overall, principle of treatment of regulating Qi activity should be do throughout the treatment process of DGP, and to create the traditional Chinese medicine compound Shuganhewei Tang which was applied to clinical. (4) To analysis of the composition, sent medicine ideas characteristics, and the function of drug and modern pharmacological research, at the same time, to summarize and subtract the rule of Ingredients to add and subtract. (5) Typical medical record:Excerpting a part of DGP typical medical record during clinic treatment following my tutor. Then finishing and analyzing these typical medical records in order to further explain tutor's academic point of view.4. Clinical research of Shuganhewei tang for treating the type of disharmony between the Liver and the Stomach diabetic gastroparesisObjective:By observing the clinical effect of Shuganhewei Tang which was on the basis of the methods about soothing liver and harmonizing stomach and regulating qi for treating the type of disharmony between the Liver and the Stomach DGP, make verification of academic point of view of treating DGP of the instructors, to search the effective methods for treating DGP to provide a theoretical basis. Methods:58 patients Conforming to the diagnostic criteria of DGP were randomly divided into treatment group and control group, each group of 29 cases. On the basis of the diabetes treatment, treatment group was given Shuganhewei Tang, control group was given domperidone, it is one period of treatment for 4 weeks. After a period of treatment, the clinical symptoms and signs scores before and after the treatment, plasma motilin, serum gastrin, surface electrogastrogram, blood sugar, glycosylated hemoglobin, blood lipids were observed, and follow-up after drug withdrawal in 2 months. Results:Treatment group given by Shuganhewi Tang is better than control group given by domperidone in improving clinical symptoms, increasing gastric electrical amplitude after the meal, adjusting the level of plasma MOT (P< 0.05), and the level of 2hPG, TG, TC of treatment group after treatment decreased significantly (P< 0.05); The total effective rate of treatment group was 96.43%, and the total effective rate of control group was 81.48%, the difference is significant (P< 0.05); The number of cases of recurrence of treatment group were obviously lower than control group. Conclusion:Shuganhewei Tang can significantly improve the clinical symptoms of the type of disharmony between the Liver and the Stomach DGP patients, significantly promote gastric emptying after a me,al, effectively reduce the level of MOT,2hPG and blood lipid.The comprehensive curative effect of treatment ground is superior to the control ground, and the recurrence rate is low. So Shuganhewei Tang is the effective prescription for the treatment of diabetic gastroparesis. |
PDF Full Text Request