To Explore The Rule And Experience Of Professor Fu Si 's Treatment Of Reflux Esophagitis By Cluster Analysis

As one common disease with gradually increasing morbidity in recent years, the reflux esophagitis (RE) refers to the inflammatory lesion of esophageal mucosa due to regurgitation of contents in stomach or duodenum into the esophagus. Its classical symptoms include regurgitation and heartburn. The esophageal stenosis, bleeding, punching and Barrett esophagus, etc. shall occur simultaneously for serious condition. Its pathogenesis mainly includes abnormal anti-regurgitation protective structure and function of esophagus, abnormal clearance function of esophagus and reduced defense capability of esophageal mucosa. People still argue about whether the helicobacter pylori (H.pylori) can result in RE or not in recent years. The western medicine treatments mainly include acid resistance, acid suppression, gastrointestinal motility promotion and operation. Although the symptom can be relieved rapidly, it is easy to recur with more side effects. The dialectical treatment of traditional Chinese medicines mainly treats this disease by the means of relieving liver and reinforcing spleen and harmonizing stomach and calming the adverse-rising energy with lower recurrence rate and fewer side effects. However, the unified differentiation and typing and guiding pharmacy standard is lacked at present. Therefore, it has real clinical significance to research its differentiation and typing and medicine compatibility.187 out-patient patients with confirmed RE are collected by this research. The treatment is carried out by applying the unified dialectical treatment, and the cluster analysis is carried out for its clinical medicines. The differentiation and typing and medicine compatibility rules of RE are discussed.ObjectiveThe clinical medication rules and differentiation and typing applied by Professor Fu Si to treat RE are researched. The guidance is put forward against clinical treatment of RE.MethodsThe clinical cases collected by this research are prescriptions of dialectical treatment of traditional Chinese medicines for first diagnosis of 187 RE patients treated by Professor Fu Si between September 2014 and January 2016 at the expert outpatient clinic of China-Japan Friendship Hospital of Ministry of Health. The name, gender, age and traditional Chinese medicine name are input in Excel and introduced into IBM SPSS Statistics 22.0. The high-frequency drugs frequently used by Professor Fu Si are screened by the means of frequency analysis, classified as per the traditional Chinese medicine classification method of Science of Chinese Medicine and analyzed by the means of cluster analysis.ResultsThere are 128 female patients and 59 male patients in 187 RE patients, which account for 68.45% and 31.55% respectively. The youngest and eldest ages are 22 and 82 respectively with the average age of 52.78±14.38. The categories of traditional Chinese medicines with higher frequencies are deficiency reinforcing drug, dampness resolving drug, digestive drug, qi regulating drug and heat clearing drug respectively.45 kinds of screened high-frequency traditional Chinese medicines are divided into 11 categories by the cluster analysis:(1) the lily, albizia flower, angelica sinensis and purple ganoderma lucidum mainly focus on nourishing the blood and tranquilization; (2) the burnt malt, burnt medicated leaven and burnt coke hawthorn mainly focus on activating appetite and gastrointestinal motility; (3) the radix ophiopogonis, asparagus fern, radix glehniae, dendrobe and dried rehamnnia root mainly focus on clearing heat and nourishing yin; (4) the corydalis yanhusuo, white peony root and prepared radix licorice mainly focus on promoting qi circulation, regulating liver and relieving pain; (5) the felwort, coptidis rhizome, cuttle bone and calcined concha arcae mainly focus on diminishing inflammation and making acid; (6) the cinnamon, dried ginger and rhizoma pinellinae praeparata mainly focus on warming stomach and calming the adverse-rising energy; (7) the poria cocos, raw seed of Job’s tears, yam, fried hyacinth bean, fructus amomi, fortune eupatorium herb and atractylodes mainly focus on invigorating spleen and eliminating dampness; (8) the pericarpium citri reticulatae viride and pericarpium citri reticulatae mainly focus on soothing liver and regulating vital energy; (9) the radix scutellariae and dandelion mainly focus on clearing heat and detoxicating; (10) the caulis bambusae in taeniam and inula flower mainly focus on calming the adverse-rising energy and preventing vomiting; (11) the costustoot, prepared rhizoma cyperi with vinegar, pogostemon cablin, burnt semen arecae, dried semen raphani, round cardamom fruit, ginger magnolia bark, fructus aurantii immaturus, radix codonopsis and dried atractylodes macrocephala koidz mainly focus on soothing liver and strengthening spleen and removing mass and eliminating flatulence. The differentiation and typing is divided into 4 categories, namely, the deficient-cold in spleen and stomach, depressed liver and deficient spleen, dampness-heat of liver and gallbladder as well as deficiency of qi and blood. They can be treated by the addition and subtraction treatment of Fuzilizhong decoction combined with the addition and subtraction treatment of Gegenqinlian decoction, the addition and subtraction treatment of Jiawei Sanxiang decoction, the addition and subtraction treatment of Longdanxiegan decoction and the addition and subtraction treatment of Shenlingbaizhu decoction respectively.ConclusionProfessor Fu Si focuses on regulating and reinforcing spleen and stomach to treat RE. Meanwhile, he pay attention to regulating vital energy flow and resolving dampness and removing accumulation and relieving dyspepsia so as to warm the stomach, calm the adverse-rising energy, make acid, relieve pain and achieve the balanced Yin -Yang and Qi-blood of organism with very good clinical effect.