| Background:Tutor Ke Weijun, a well-known blood disease specialist in combination of Chinese traditional and Western medicine, now is one of the fourth batch senior Chinese medicine experts for the academic work experience in heritance field. Tutor Ke has undertaken the medical work for more than 50 years, and has accumulated fundament knowledge and clinical experiences in the field of the treatment of blood diseases,so as to form his unique academic thoughts. She is good at the Chinese traditional and Western treatment of idiopathic thrombocytopenic purpura (ITP), aplastic anemia, al lergic purpura and many kinds of blood system diseases.ITP is an autoimmune disease. The primary symptoms are mucocutaneous hemorrhage or visceral hemorrhage, thrombocytopenia, the number of bone marrow megakaryocytes increases or keeps normal but with maturation block. Because its pathogenesis is still unknown, there isn't any specific medication in modern medicine, and there are some problems such as the effect is not ideal, the side effect is obvious and the price is expensive. The integrative treatment of Chinese traditional and Western medicine has accumulated lots of experience and possessed many advantages such as overall adjustment,reliable effect,little side effect and cheap prices.Tutor Ke has done in-depth and detailed research on the pathogeny of ITP and the Dialectical theory, finally achieving significant effect.At present, there is still a lack of overall and systematic conclusion about tutor Ke's academic thoughts and clinical experience,which are only staying on the organization and generalization level with certain subjective elements.Objective:Comprehensivly and systematically conclude senior expert Ke Weijun's academic thoughts and clinical experience.Content:Analyse tutor Ke's academic ideological origins; study and conclude tutor Ke Wei jun's clinical experience on the treatment of blood diseases; refine and sublimate her academic thougts;use modern information techniques to investigate Ke's speciality on the treatment of ITP,and conclude its medication regulation, so as to fatherly understand her academic thoughts and clinical experience.Method:The study includes three parts1.Academic ideological origins:By searching Chinese medicine books and analyzing famous senior Chinese medicine academic thoughts which greatly influence my tutor, explore tutor Ke's academic ideological origins.2. Comprehensive conclusion of Ke's academic thoughts and clinical experience:Conclude her academic thoughts from Ke's ideas including "differentiation of disease and symptoms and signs", "strengthening the body resistance and eliminating evil", "merely alleviate the symptoms of an illness and effect a permanent cure", "a balance of yin and yang", "enforcing spleen and nourishing kidney" and "activating blood circulation to dissipate blood stasis"; combine some cases, and separately discuss differential treatment rules and specific treatment and drugs's application in her clinical experience of the blood diseases.3. Clinical research:Apply Microsoft Excel 2007 to establish datasheet, use statistic methods to analyse Ke's cases which are responsive to her ITP treatment. Take single medication frequency and the emerging frequency of multidrugs as observation point, conclude Ke's medication rules; take a typical case's treatment as an example, analyse disease transformation rules and differentiation of symptoms and signs donor level to farther conclude the pathology of the disease. In the treatment of ITP, compare the difference of the symptoms between allergic purpura and ITP.Conclusion:1. Academic ideological origins:Ke Wei jun's academic ideological origins arise from Chinese medicine theory, clinical practice and scientific studies,and she is influenced by senior famous Chinese medicine as well.2. Comprehensive conclusion of Ke's academic thoughts and clinical experience:Ke's academic thoughts includes the following aspects:differentiating syndromes by traditional chinese medicine and western medicine; differentiate healthy energy from evils,combine strengthening the healthy energy and eliminating evil; master the rules of syndrome evolution, and there are priorities for temporary solution and permanent solution; take the balance of yin and yang as principal, "enforcing spleen and nourishing kidney" as basic,and carry "activating blood circulation to dissipate blood stasis" through blood trouble.Ke's primary clinical experiences include:ITP are mainly divided into the types of "bleeding due to blood-heat", "yin deficiency and blood heat", "deficiency of both vital energy and yin", "asdthenic splenonephro-yang", and all types have certain transformation rules, so there are some rules to obey in the treatment, with the self-refit aromatic Cornus Rhinoceri and Rehmanniae Decoction treatment, which is a quite effective method. As for aplastic anemia, she has brought out some academic thoughts such as "treatment on the spleen", "main point is the balance of yin and yang","together with removing blood stasis for promoting tissue regeneration","cure both old disease and new disease". As for allergic purpura,use purple pink sauce soup of erythema, and severe patients combined with Ephedra forsythia Chixiaodou method to get better effect. Regarding myeloproliferative disorders, hematologic malignancy, she has brought out a combination of Chinese medicine and western medicine. Chinese medicine focuses on trengthening the body resistance, combined with eliminating evil, which can decrease toxic side effect of western medicine and improve patients'life quality. Otherwise, tutor Ke usually adopts typical prescriptions to cure modern blood diseases. such as fried Rhizoma Imperatae Oujie for the evidence of acute hemorrhage, Rhubarb worm pill for polycythemia vera, small Pinellia Poria soup for the evidence of ausea and vomiting,which are often effective.Ke Weijun' s application of insect-drugs in treatment of blood diseases also have its property. Besides blood diseases, Ke also has good treatment performance for Behcet syndrome, acute apoplexy and other diseases.3. Clinical research part:3.1 By analyzing the drug frequency, conclude Ke Weijun's 16 kinds core medication for the ITP treatment, and form basic prescript ion as follow:Buffalo horn, Rehmannia, white peony root, Dan, Selaginella, Polygonum,37 powder, tortoise shell powder, antelope horn powder, Angelica, Astragalus, Ligustrum, Eclipta, Cynomorium, psoralen, raw licorice.3.2 Through the analysis of the function classification of core medication and tropism of taste, conclude the basic principals of Ke's ITP treatment: removing pathogenic heat from blood, supplementing qi and nourishing yin, tonifying spleen and kidney,activating blood circulation and stop bleeding.3.3 By analyzing the core medication,Ke's academic thoughts of ITP's etiology and pathogenesis are verified:This disease is located in the spleen and kidney, and the pathogenesis is deficiency and excess exsisting at the same time. The deficiency includes deficiency of yin and deficiency of both Qi and yin (the deficiency of spleen Qi and kidney yin).asdthenic splenonephro-yang (deficiency of Qi); excess includes pyretic toxicity and blood stasis. Deficiency of both spleen and kidney is inner cause, pyretic toxicity is outer cause, and the obstruction of collaterals by blood stasis is the result of pathological changes.3.4 Through the analysis of prescription of typical cases, show the evolution rules of ITP's patterns of syndrome summarized by Ke:the pattern of syndromes transform like this:syndrome of bleeding due to blood-heat; hemopyretic bleeding→syndrome of yin deficiency and blood heat→syndrome of deficiency of both vital energy and yin→syndrome of insufficiency of both the spleen and the kidney.3.5Through the analysis of prescription of typical cases, discover Ke's medication features:the treatment usually begins with eliminating pathogenic heat from the blood;removing pathogenic heat from blood, nourishing yin and suppressing sthenic yang; when the patient is making good progress, benefitvital energy and calm blood,make up the spleen and kidney, promote blood circulation by removing blood stasis.4. Put forward new sights:Purpura is found in both ITP and allergic purpura, but the etiology and pathogeneis, and also the treatment, have some different characteristics. So far the comparation and analysis for their different characteristics are very lacking in the public documents, in some cases the clinical treatment for these two diseases are confused. In this paper,I have generalized the syndrome differentiation and treatment's differences between idiopathic thrombocy-topenic purpura and purpura by analyzing Ke's treatment. The resemblances are the inner cause are all spleen and kidney deficiency, and the outer causes all have feeling the heat toxin,heat forced blood,deficiency-excess complication, and obstruction of collaterals by blood stasis is the result of pathological changes, so the treatment all mainly focused on removing pathogenic heat from blood for eliminating the pathogenic factors, and build up one's resistance to disease on the law of enforcing spleen and nourishing kidney, activating blood circulation to dissipate blood stasis through the disease. The differences are the allergic purpura has exogenous evil which focused on wind, heat, dampness, especially the wind-syndrome and dampness,so the treatment should induce mild diaphoresis and thoroughly evil, eliminate dampness and heat. As a result, it provides directions for different syndrome differentiation and treatment of Purpura disease. Significance:This research more comprehensivly summarizes expert Ke Weijun's academic thoughts and clinical experience in the treatment of blood diseases, and enable people enhance and glorify it. It has provides more comprehensive treatment pathways for Chinese medicine on Purpura disease,and will relieve pain and improve quality of life of patients. Background:Tutor Ke Weijun, a well-known blood disease specialist in combination of Chinese traditional and Western medicine, now is one of the fourth batch senior Chinese medicine experts for the academic work experience in heritance field. She is good at the Chinese traditional and Western treatment of idiopathic thrombocytopenic purpura (ITP), aplastic anemia, allergic purpura and many kinds of blood system diseases.ITP is an autoimmune disease. The primary symptoms are mucocutaneous hemorrhage or visceral hemorrhage, thrombocytopenia, the number of bone marrow megakaryocytes increases or keeps normal but with maturation block. Because its pathogenesis is still unknown, there isn't any specific medication in modern medicine, and there are some problems such as the effect is not ideal, the side effect is obvious and the price is expensive. The integrative treatment of Chinese traditional and Western medicine has accumulated lots of experience and possessed many advantages such as overall adjustment,reliable effect, little side effect and cheap prices.Tutor Ke has done in-depth and detailed research on the pathogeny of ITP and the Dialectical theory, finally achieving significant effect.Objective:Conclude senior expert Ke Weijun's academic thoughts and clinical experience on ITP.Content:Take advantage of modern information techniques to investigate Ke's speciality on the treatment of ITP, and conclude its medication regulation, so as to fatherly understand her academic thoughts and clinical experience.Method:Apply Microsoft Excel 2007 to establish datasheet, use statistic methods to analyse Ke's cases which are responsive to her ITP treatment. Take single medication frequency and the emerging frequency of multidrugs as observation point, conclude Ke's medication rules; take a typical case's treatment as an example, analyse disease transformation rules and differentiation of symptoms and signs donor level to farther conclude the pathology of the disease. In the treatment of ITP, compare the difference of the symptoms between allergic purpura and ITP.Conclusion:1. By analyzing the drug frequency,conclude Ke Weijun's 16 kinds core medication for the ITP treatment, and form basic prescription as follow:Buffalo horn, Rehmannia, white peony root, Dan, Selaginella, Polygonum,37 powder, tortoise shell powder, antelope horn powder, Angelica, Astragalus, Ligustrum, Eclipta, Cynomorium, psoralen, raw licorice.2. Through the analysis of the function classification of core medication and tropism of taste, conclude the basic principals of Ke's ITP treatment: removing pathogenic heat from blood,supplementing qi and nourishing yin, tonifying spleen and kidney, activating blood circulation and stop bleeding.3. By analyzing the core medication, Ke's academic thoughts of ITP's etiology and pathogenesis are verified:This disease is located in the spleen and kidney,and the pathogenesis is deficiency and excess exsisting at the same time. The deficiency includes deficiency of yin and deficiency of both Qi and yin (the deficiency of spleen Qi and kidney yin). asdthenic splenonephro-yang(deficiency of Qi);excess includes pyretic toxicity and blood stasis. Deficiency of both spleen and kidney is inner cause, pyretic toxicity is outer cause, and the obstruction of collaterals by blood stasis is the result of pathological changes.4. Through the analysis of prescription of typical cases, show the evolution rules of ITP's patterns of syndrome summarized by Ke:the pattern of syndromes transform like this:syndrome of bleeding due to blood-heat; hemopyretic bleeding→syndrome of yin deficiency and blood heat→syndrome of deficiency of both vital energy and yin→syndrome of insufficiency of both the spleen and the kidney.5. Through the analysis of prescription of typical cases, discover Ke's medication features:the treatment usually begins with eliminating pathogenic heat from the blood; removing pathogenic heat from blood, nourishing yin and suppressing sthenic yang; when the patient is making good progress, benefit vital energy and calm blood, make up the spleen and kidney, promote blood circulation by removing blood stasis.6. In this paper,I have generalized the syndrome differentiation and treatment's differences between idiopathic thrombocytopenic purpura and purpura by analyzing Ke's treatment. The resemblances are the inner cause are all spleen and kidney deficiency, and the outer causes all have feeling the heat toxin, heat forced blood, deficiency-excess complication, and obstruction of collaterals by blood stasis is the result of pathological changes,so the treatment all mainly focused on removing pathogenic heat from blood for eliminating the pathogenic factors, and build up one's resistance to disease on the law of enforcing spleen and nourishing kidney, activating blood circulation to dissipate blood stasis through the disease. The differences are the allergic purpura has exogenous evil which focused on wind, heat, dampness, especially the wind-syndrome and dampness, so the treatment should induce mild diaphoresis and thoroughly evil, eliminate dampness and heat. As a result, it provides directions for different syndrome differentiation and treatment of Purpura disease.Significance:This research summarizes expert Ke Weijun's academic thoughts and clinical experience in the treatment of ITP, and enable people enhance and glorify it. It has provides more comprehensive treatment pathways for Chinese medicine on Purpura disease, and will rel ieve pain and improve quality of life of patients. |
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