Study On The Regularization Of Chinese Medical Syndrome Differentiation And The Development Rule Of Chinese Medical Syndromes Of Chronical Renal Failure

Source of the problem: This research was put forward and done all by the teacher and the master themselves.Objective: CRF is a clinical syndrome which happens at the end of some primary and secondary renal diseases. It is one of the most important diseases which threaten the people's health and lives because of its vicious prognosis. For economic and technologic reasons dialysis and kidney-transplanting are used not as generally as the other therapies. Rapid progress has been made in the Traditional Chinese Medicine therapies on CRF recent years. At the present time the curative effect of TCM on CRF still can not turn up trumps but it is sure that TCM therapies can ease up the state of CRF and prolong the lives of patients. There are still many shortcoming need to improve in the clinical practice and scientific research .Study on regularizing TCM syndromes has become one of the most important problems in TCM research with the proceeding of transferring from traditional medicine which based on personal experience to the modern medicine and the modernization of TCM. Though modernization of TCM and objectifying Chinese Medical Syndrome differentiation is still in argue, a lot of studies on that are now kept on and deepened. But as a whole, the methodology of study adopted is not idealin recent decades. For instance, methods like literature studying, consultation to experts and cases studying are broadly taken. And the results of studies are not authorized and therefore can not be popularly used in clinical practice because the identifications and the criterions of identification of CRF made by doctors are various. As a result, it seems that the research of CRF is out of order and then the development of fundamental and clinical research of TCM therapies against CRF is stagnant.Different clinical syndromes can be caused or influenced as a result of the change of body state by factors such as pathogeny, age, sex, constitution, prescription, season and environment, etc. The effects of the factors on patients are various so the factors should be taken into account when differentiating syndrome and planning treatment. The clinical syndrome and its development are more complex and more multiple in recent years because of the broadly using of hormone and diuretic and the popularization of dialysis and kidney-transplanting. Furthermore, systematic rule of syndrome's development and that of identification and treatment of CRF should be sum up and it is essential to cognize the pathogeny, the pathogenic mechanism, the influential factors, occurring, development stages at the point of view of TCM clearly and objectively. In addition, to identify the TCM syndromes according to data get from laboratory testing with modern technologic methods and then improve the degree of objectivity is one of the important problems domestic and overseas doctors actively probing into all through .At present, many laboratory indexes have been put forward aiming to realize objective TCM diagnosis. But some of those have little pertinence with CRF. The data were get only from where the patients and the researcher were in and the blind rule was rarely used in those studies. So the popularity and the objectivity of the results of the studies need to be improve. There is no doctor who has realized objective diagnosis with those laboratory indexesand proved it to be true as yet. Therefore, it is not certain that if those study can do good to TCM diagnosis. In addition,- the cases were not selected and dealt with by a unified normative diagnose criterion and statistic method as study objective and statistic the numbers were not enough. These factors also brought on localization and difference of study results.The sample number of epidemiology study is more than that of general clinical study and it has a characteristic of universality and equipoise. So the bias brought by regions, environment, constitution, complication and the subjective factor of researchers can be avoided. In addition, it can do good to study the relation between CRF syndromes and the factors which will help us to adjust measures to patients, seasons and local conditions when treating CRF.Method: Therefore, our study gave up the methods of studying literature, case reporting, treating with special prescriptions and medicines and adopt the authorized criterion of identification. Directed by the theory and method of identification of TCM, we used the methods of population-control study and cross-sectional study in modern epidemiology for reference. 312 patients' and 40 healthy people's clinical data since 1993 were collected from six hospitals in Guangzhou, Guangdong province; Guilin, liuzhou, Guangxi Chuang Municipality and Changsha, Yongzhou, Dong'an, Hunan province. Objective clinical data that may be used in identification can be selected out to dispose with analysis of variance and discriminant analysis in turn and then discriminant functions of each type of syndrome can be worked out. It is a attempt to regularize the criterion of identification and make it an objective one so we can identify and treat CRF more reasonable. We also analyzed the data to help to clarify the development rule of Chinese Medical syndromes of CRF. First, we divided the courses of each patient into various phases according to the Chinese Medical clinic data. Second, judge thepattern of each phase on the basis of authorized criterion. At last, analyze the change of the patterns.Content: The study includes four parts. First the author introduced the Chinese Medical theory and clinic practice on CRF. Second, the discussion on modernization of TCM is introduced. Third, he discussed the regularization of the identifying patterns according to symptoms and signs. The last chapter is the study on development rule of syndrome of Traditional Chinese Medicine of Chronical Renal Failure.Results: Three laboratory indexes were put forward to identify the patterns of TCM syndrome:CO2CP> 24 hour urine and Na+. In addition to the Deficiency of Liver-yin and Kidney-yin type, the other four patterns' discriminant functions have been worked out to help to identify TCM patterns of CRF as a assistant diagnostic measure and a validity check. But their veracity and practicability are still need to be proved in clinical practice because the problem was only a primary study and was restricted by conditions such as outlay and time offered. In the last chapter the development rule of TCM syndrome is clarified : the Deficiency of Splenic and Renal Qi pattern has a tendency to change into the Deficiency of Splenic and Renal Yang pattern or the Deficiency of both Qi and Yin pattern and at last into the Deficiency of both Yin and Yang pattern. Those who are in the Deficiency of Liver and Renal Yin pattern often change into the Deficiency of both Qi and Yin pattern and into the Deficiency of both Yin and Yang pattern as the end. We can prevent and treat CRF with TCM therapies according to this rule.