Research On TCM Ancient Books And Knowledge Acquisition Schemes For Postpartum Hemorrhage

Postpartum hemorrhage is abnormal vaginal bleeding that occurs during the puerperium,which seriously threatens the life of the puerpera and affects postpartum recovery.In recent years,the popularity of cesarean section surgery and the opening of the second-birth policy,the change of the living environment,personal life concepts,and living habits of the puerpera have significantly increased the incidence of postpartum hemorrhage.The urgent clinical needs put forward new requirements for research on traditional Chinese medicine(TCM)obstetrics and gynecologyIn ancient TCM books postpartum hemorrhage was named as "postpartum lochia",postpartum blood collapse","postpartum bleeding",etc.,which means there is a solid foundation for literature research.To understand postpartum hemorrhage from the perspective of TCM,explore the clinical treatment advantages of TCM,it's necessary to summarize its origins and academic thoughts.In addition,since the knowledge of postpartum hemorrhage exists in a large amount of ancient books,how to efficiently acquire the specialized knowledge from them is also a methodological problem which need to solve urgentlyThis dissertation's topic is research on ancient books and knowledge acquisition methods for postpartum hemorrhage.The first part of the study first determines the connotation and extension of postpartum hemorrhage in the context of TCM,by going through 102 ancient books which are selected according to catalog books,dictionaries,synopses,and modern experts'reading experience in gynecology to conduct bibliographic screening.Then,it analyzes the evolution of names for the disease,causes and pathogenesis,diagnosis,and theories,methods,prescriptions and medicines in the order of dynasties.Based on the results of tutorial team research,the second part refines three-dimensional integration" method to acquire knowledge,which integrates ancient books,doctors,and knowledge.The author adopts the method of expert interview to collect expert opinions on the "three-dimensional integration",further complements and improves the "three-dimensional integration" framework model,demonstrates and determines the levels of knowledge elements,adapts to the actual situation,makes it more operable,and forms a complete scheme for knowledge acquisition of ancient books.Finally,taking postpartum hemorrhage literature as an example,this paper makes an exploratory study on the acquisition of postpartum hemorrhage ancient literature knowledge,which provides a set of knowledge acquisition scheme for the undergraduate teaching,clinical and continuing education of traditional Chinese medicine ancient books,and effectively improves the learning and utilization efficiency of traditional Chinese medicine ancient literature knowledge.The postpartum diseases from pre-Qin to Qin and Han Dynasties were collectively referred to as "Ru Yu Ji",and sprout records were found related to postpartum hemorrhage.Inner Canon of Yellow Emperor first mentioned the postpartum disease"Ru Zi Bing Re".The book creatively put forward a comprehensive diagnosis and prognosis judgment of women's diseases through looking,listening and pulse-taking,and pioneered the theory of extraordinary meridians in situations of childbirth and pregnancy.According to the physiological characteristics of postpartum bleeding and blood trauma,Jingui Yaolue proposed that spasm,depression,and astrction are common postpartum diseases.During the Wei,Jin,Southern and Northern Dynasties,related records of"postpartum hemorrhage" diseases were mostly presented as indications of certain prescription.Mai Jing edited by Jin Wangshuhe laid the foundation for obstetric pulse diagnosis.It systematically proposed to predict the prognosis from the surface,temperature,size,and speed of the puerpera's pulse for the first time.The book also put forward if the pulse was big then the illness became worse,while if it was small the patient was safe.During this period,at least over 20 drugs were recorded for the treatment of postpartum diseases.In this period,there was no direct record of"postpartum hemorrhage",but in practice,the bud of the diagnosis and treatment of"postpartum hemorrhage" formed.During the Sui and Tang Dynasties,Jing Xiao Chan Bao and Zhu Bing Yuan Hou Lun began to focus on the names of postpartum hemorrhage related diseases.According to Zhu Bing Yuan Hou Lun,the causes and pathogenesis of blood avalanche are exogenous cold pathogen,deficiency damage and blood stasis.For the first time,it was put forward in Bei Ji Qian Jin Yao Fang that the endless lochia is closely related to the postpartum time,and it emphasized the two major accompanying symptoms of abdominal pain and cold,and clarified part of the connotation of the endless lochia,which is of pioneering significance.There were more than 30 prescriptions for postpartum hemorrhage in this period,but no special discussion was found.In addition,Ma Jixing's Annotation and Research on Ancient Medical Books Unearthed in China records that most of the obstetric prescriptions used in Dunhuang unearthed papers are single prescriptions and single drugs,involving Zao Xin Tu and paeony.In Song,Jin and Yuan Dynasties,the number of names of postpartum haemorrhagic diseases increased significantly.At this time,it was recorded that the causes of postpartum lochia were deficiency damage,blood stasis and cold evil.The etiology and pathogenesis of postpartum hemorrhage increased the factors of improper diet,emotion and medicine.Fu Ke Mi Lan Quan Shu can better reflect gynecology postpartum hemorrhage diagnosis and treatment ideas.It is suggested to record four prescriptions of Dang Gui Jian Zhong Decoction,Du Sheng powder,Ze Lan Decoction and Rui Lian powder on the 7th day of postpartum.And obedience to prenatal,parturient,postpartum physiological state to adjust and protect,timely correct the abnormal state of maternal blood circulation,prevent postpartum hemorrhage.According to Wei Sheng Jia Bao Chan Ke Bei Yao metrorrhagia and leakage are the clinical manifestations of the further development of postpartum lochia.Kun Yuan Shi Bao and Nv Ke Ji Yin Yao Yu Wan Jin Fang of Zheng's gynaecology advocate that Qi and blood should be greatly replenished after childbirth.The Tongzhi formula of Siwu Decoction for postpartum hemorrhage was introduced to form a complete treatment plan with Siwu Decoction as the main treatment idea and means.Combing the works of Zhang Yuan,Li Dongyuan.Luo Tianyi,Liu Hejian,etc.,sorting out three ideas of differentiation and treatment after production.After childbirth,we need to support Rong Wei and regulate blood gas.Those with strong evil spirits need to attack.After childbirth,it is better to replenish qi and blood.More than 30 prescription drugs were collected.During this period,the literature of postpartum hemorrhage has developed rapidly,and the concept of disease has included the concept of "examining causes and treating".Outstanding progress is to introduce postpartum hemorrhage into the concept of emergency,and bring it into the emergency treatment system.This means that the treatment of postpartum hemorrhage disease can be clearly differentiated according to the urgency.During this period,the works began to show obvious school characteristics,which had the function of connecting the past and the futureIn Ming Dynasty,postpartum hemorrhage was further developed to be distinguished by the amount and potential of hemorrhage.Nomenclature is diversified.and the meaning of critical illness is clear in nomenclature.At this stage,the pathogenesis of lochia,blood collapse,Chong and Ren,Zang Fu organs,etiology and pathogenesis were developed.From the perspective of etiology and pathogenesis,it was realized that mismatch between pre pregnancy,parturient and postnatal care was closely related to the occurrence and development of postpartum diseases.The academic thought mainly inherits the system of Chen Ziming's Fu Ren Da Quan Liang Fang in Song Dynasty and Zhu Danxi's "postpartum tonifying qi and blood" theory.The innovation is mainly manifested in the theoretical innovation of the combination of dialectical thinking and physique identification in Jing Yue Quan Shu · Fu Ren Gui by Zhang Jingyue,the innovation of Zhao Xianke's thinking of syndrome differentiation and treatment of blood syndrome from the true and false of yin and Yang,and the innovation of Xue Ji's theory of syndrome differentiation of viscera in postpartum hemorrhage.In Ming Dynasty,Si Wu Decoction and Sheng Hua Decoction were commonly used as prescription systems for postpartum hemorrhage.The postpartum drug contraindications increased 14 kinds of drugs,such as San Ling,zedoary turmeric,safflower,Sumu,Niu Xi,etc.,and the heat clearing drugs Scutellaria,Coptis,gardenia,phellodendron,etc.compared with the predecessors.The careful use of the prescriptions for Da Cheng Qi Decoction and Wu Ling powder enriched the content of the contraindications of postpartum bleeding.In the Qing Dynasty',Fu Ke Bing Jian provided a more accurate summary of the definition of postpartum lochia for the first time,it was believed that lochia lasted for more than seven days and lasted for a long time.Compared with the former,it added the names of "lochia gravis in the first month after childbirth" and "post partum gonorrhea".Compared with the previous generation,the pathogenesis of the disease was increased.The viscera theory complements the concept of postpartum Qi and blood,and the pathogenesis of liver catharsis and kidney occlusion.Tai Chan Xin Shu puts forward that diet,emotion and sexual injury are the important etiology and pathogenesis of postpartum hemorrhage.The innovation of ancient bleeding books in Qing Dynasty is mainly manifested in five aspects:the innovation of Blood Stasis Theory;the innovation of Qi,blood,water and fire theory;the innovative application of Qi Jing theory in postpartum;the innovation of clinical application of integrated traditional Chinese and Western medicine and the emergence of a large number of original new prescriptions.The theory of Si Wu Decoction and Sheng Hua Decoction in the treatment of postpartum hemorrhage has been further developed.Sheng Hua decoction has become a commonly used prescription in obstetrics and one of the frequently selected prescriptions for postpartum hemorrhage since the Qing DynastyThe second part mainly focuses on the research of knowledge acquisition and thinking methods of TCM.Based on the literature research on postpartum hemorrhage,this part firstly figures out two commonly used knowledge acquisition methods mentioned in modern and ancient times which are "personal experience of doctors" and"official medical education";and then it illustrates research based on expert interview on the "three-dimensional integration" knowledge acquisition method proposed by the team of the author's tutor.To acquire the ancient TCM knowledge in an orderly manner,the author's mentor team refers to the thinking mode of human brain,and proposes a "three-dimensional integration" model.Using the concepts of knowledge elements and knowledge systems,the author designed a questionnaire for interviews with method experts,clinical experts,and literature experts,which included questions on the importance of the "three-dimensional integration" in knowledge acquisition,the weight relationship,and the importance and the role of the 23 knowledge elements in the three knowledge systems Through in-depth research,the "three-dimensional integration" knowledge acquisition data model was comprehensively supplemented and improved in a comprehensive and systematic manner.At the same time,metadata empowerment and knowledge push expert in-depth interviews are organized to provide expert opinion basis for data model building.The in-depth interview opinions include suggestions on the weight of knowledge body and knowledge element;suggestions on the time and space of ancient books in different historical time and different disciplines in the data model;suggestions on the quantification of user opinions,etc.At the end of the paper,combined with the study of the ancient books and literature of postpartum hemorrhage,and three different ways of knowledge acquisition,the ancient books and literature of postpartum hemorrhage are classified and counted,and four clinical thinking paths are sorted out.For postpartum hemorrhage,knowledge acquisition path for ancient books,doctors and disease knowledge;postpartum hemorrhage diagnosis thinking path;postpartum hemorrhage treatment path of thinking;post natal care thinking path.Finally,combined with the experience of 25 famous gynecologists in modern times,69 kinds of recommended bibliographies related to postpartum hemorrhage were sorted out.The purpose of clinical literature research of traditional Chinese medicine is to "learn from the past".It is an important goal of clinical literature research that we put our heart on combining the rich experience of ancient doctors with the current clinical problems,providding theoretical basis for clinical obstetrics of traditional Chinese medicine,and seeking the further development of obstetrics.