The Inheritance And Development Of Zhongjing Heat-clearing Method In Records Of Traditional Chinese And Western Medicine In Combination

1 Research purposesTo summarize the characteristic of Zhang Xichun heat-clearing method in prescription and clinical application,and conclude the inheritance and development of Zhong Jing theory of heat-clearing method in Yixue Zhongzhong Canxi Lu(Records of Traditional Chinese and Modern Western Medicine in Combination,hereinafter referred to as Canxi Lu)by collating the relevant content in Shanhan Zabing Lun(Treatise on Exogenous Febrile and Miscellaneous Diseases)and Canxi Lu.2 Research methodsUsing methods of comparative analysis and induction throughout the comparative study of the chapters and sections,prescriptions and medicines of Canxi Lu and Shanhan Zabing Lun,summarized the inheritance and development of Zhongjing theory of heat-clearing method in Canxi Lu.2.1 Classification1.Classification criteria: Refer to the classification of prescriptions in textbook pharmacology of traditional Chinese medical formulae,the study divided the heat-clearing prescriptions into 9 categories,including clearing heat from qi system,clearing ying system and cooling blood,clearing heat and detoxifying,clearing qi and blood,clearing heat from zang and fu organs,clearing away deficiency-heat,clearing away summer-heat,clearing heat and promoting diuresis and clearing heat and resolving phlegm,and established classification criteria.2 Prescription inclusion criteria:(1)The prescriptions that were considered to fit the classification criterion according to Canxi Lu;(2)The prescriptions that were not discussed in Canxi Lu yet were considered to fit the classification criterion according to physicians of different dynasties or the content of Dictionary of Chinese Medicine Prescriptions;(3)The prescriptions that were debatable yet were considered to fit the classification criterion according to pharmacology of traditional Chinese medical formulae;(4)The prescription shall be included into corresponding classification once it fits one of the above.3.Prescription exclusion criteria:(1)The prescriptions without dosages;(2)The prescriptions that were cited from others;(3)The specific prescriptions that were changed from set prescriptions with symptoms and the prescriptions that were not considered as set prescriptions.4.Chapters and sections inclusion criteria: Same as the prescription inclusion criteria.2.2 Statistical methodsUse Excel software to record and count the frequency of Chinese medicines in each category.In order to facilitate reading,it is stipulated that in the output data results,the horizontal coordinate group ? 25 should always be kept,and the data with the lowest frequency is eliminated when the number of medicines exceeds 25.3 Research results1.Clearing heat from qi system:(1)Chapters and sections comparison: Shanhan Zabing Lun has 21 related clauses while Canxi Lu has 34 sections.Canxi Lu discussed clauses No.34,154,155,176,219 and 350 in Shanhan Lun;it put forward the idea that the exogenous and epidemic febrile diseases were different in the beginning yet unified in the end;the treatment for scarlatina reflects the combination of disease and syndrome.(2)Prescriptions comparison: Shanhan Zabing Lun has 11 related prescriptions while Canxi Lu has 17.Canxi Lu has expanded many prescriptions based on Zhongjing Baihu Decoction,Baihu plus Ginseng Decoction and Gardeniae and Sojae Praeparati Decoction,and has 2 prescriptions combined with western medicine.(3)Medicine comparison: Zhongjing commonly used gardenia and gypsum,while Zhang X C commonly used gypsum,anemarrhena and atractylodes.In Canxi Lu,forsythia and cicada were often used as leading medicines and the characteristic of western medicine Aspirin was discussed.Canxi Lu proposed that herbs pungent in flavor and cool in property were more suitable for Yangming syndrome,supplemented and expanded the efficacy of gypsum and used ginseng to help gypsum to clear away heat and benefit yin;it also attached importance to leaving heat a way out.2.Clearing ying system and cooling blood: There is no such prescription in Shanhan Zabing Lun,but the use of rehmannia glutinosa in Fangji Dihuang Decoction is the ancestor of Clearing-ying and cooling-blood prescriptions;Canxi Lu has Xianxiao Jigen Decoction,and usually uses rehmannia glutinosa to clear the heat of the blood.3.Clearing heat and detoxifying:(1)Chapters and sections comparison: Shanhan Zabing Lun has 5 related clauses while Canxi Lu has 24 sections.Canxi Lu discussed the treatment of yang toxinosis and pulmonary abscess,supplemented the treatment of plague and cholera,emphasized that heart should be protected from heat in infectious diseases and discussed intestinal ulcers in the combination of disease and syndrome.(2)Prescriptions comparison: Shanhan Zabing Lun has 4 related prescriptions while Canxi Lu has 15.Canxi Lu pointed out that Campanulaceae was not suitable for pulmonary abscess and herbs pungent in flavor and warm in property were not suitable for yang toxinosis;it also supplemented the therapy with prescriptions for cholera,venereal disease and ophthalmic diseases.(3)Medicine comparison: Zhongjing commonly used licorice,while Zhang X C commonly used licorice,Brucea javanica,borax and honeysuckle.Zhang X C was good at clearing intestinal heat with Brucea javanica and detoxifying with licorice and panax notoginseng;meanwhile,he observed and discussed western medicines for cholera,venereal disease and ophthalmic diseases.4.Clearing qi and blood: There is no such prescription in Shanhan Zabing Lun.Canxi Lu has Qingzhen Decoction as presentative;it cleared the heat from qi system in imitation of Zhongjing's Baihu Decoction.5.Clearing heat from zang and fu organs:(1)Chapters and sections comparison: Shanhan Zabing Lun has 12 related clauses while Canxi Lu has 28 sections.Canxi Lu discussed clauses No.63,162,371 and 373 in Shanhan Lun and clauses No.17,46 in Jingui Yaolue chapter 17;it supplemented the treatment of pulmonary heat,dysentery,jaundice,hematemesis and epistaxis;the treatment for pulmonary tuberculosis reflects the combination of disease and syndrome.(2)Prescriptions comparison: Shanhan Zabing Lun has 9 related prescriptions while Canxi Lu has 22.Canxi Lu discussed and developed Zhongjing Maxing Ganshi Decoction,Radix Pulsatillae Decoction,Xiaoshi Fanshi Powder and Xiexin Decoction.(3)Medicine comparison: Zhongjing commonly used Radix Scutellariae,Rhizoma Coptidis and licorice,while Zhang X C commonly used licorice,Chinese herbaceous peony,Fructus Arctii,Radix Scrophulariae and cinnabaris.Canxi Lu discussed the characteristic of western medicine Pepsinum Saccharatum and Kalium Bromatum,and the using of Radix Pulsatillae and melanterite in Zhongjing's prescriptions;it assessed the curative effect of western medicines for the treatment of dysentery and jaundice and proposed that herbs pungent in flavor and cool in property were more suitable for epidemic febrile diseases.6.Clearing away deficiency-heat:(1)Chapters and sections comparison: Shanhan Zabing Lun has 9 related clauses while Canxi Lu has 7 sections.Canxi Lu discussed clauses No.303 and 310 in Shanhan Lun.(2)Prescriptions and medicine comparison: Shanhan Zabing Lun has 8 related prescriptions while Canxi Lu has 3.Canxi Lu discussed Zhongjing Huanglian Ejiao Decoction,based on which it developed prescriptions for Shaoyin heat transformation syndrome.7.Clearing away summer-heat:(1)Chapters and sections comparison: Shanhan Zabing Lun has only 1 related clause while Canxi Lu has 4 sections.Canxi Lu discussed and developed 3 syndromes,including summer-heat without dampness or with dryness,summer-heat along with diarrhea and consumption of yin,and latent summer-heat.(2)Prescriptions and medicine comparison: Baihu plus Ginseng Decoction is representative in Shanhan Zabing Lun,and the representative prescriptions in Canxi Lu are Jiawei Tianshui Powder and Jiawei Yiyuan Powder.Zhong Jing used ginseng to increase body fluid,while Zhang X C used yam.The latter also used Zhongjing Baihu Decoction or a large dose of gypsum in the treatment for latent summerheat.8.Clearing heat and promoting diuresis:(1)Chapters and sections comparison: Shanhan Zabing Lun has 14 related clauses while Canxi Lu has 12 sections.Canxi Lu discussed clause No.223 and clauses about jaundice in Shanhan Lun,and developed the treatment for stanguria and ascite;it pointed out that Western medicine usually gave same treatments for five different types of sranguria,obviously less effective than traditional Chinese medicine.(2)Prescriptions comparison: Shanhan Zabing Lun has 10 related prescriptions while Canxi Lu has 9.Canxi Lu discussed and developed Zhongjing Zhuling Decoction,Yinchen Hao Decoction,Zhizi Baipi Decoction and Mahuang Lianyao Chixiao Dou Decoction.(3)Medicine comparison: Zhongjing commonly used talc,while Zhang X C commonly used talc,licorice and Chinese herbaceous peony.9.Clearing heat and resolving phlegm:(1)Chapters and sections comparison: Shanhan Zabing Lun has only 1 related clause while Canxi Lu has 8 related sections.Canxi Lu discussed clause No.138 in Shanhan Lun and supplemented this content with abnormal mental illness caused by phlegm-heat.(2)Prescriptions and medicine comparison: The representative prescription in Shanhan Zabing Lun is Xiaoxian Xiong Decoction while Longhao Litan Decoction and Dangxiong Decoction are representative in Canxi Lu.In this section,Zhang X C commonly used ocher and mirabilite;His Dangxiong Decoction was developed on the basis of Xiaoxian Xiong Decoction.4 Research conclusions1.The theory of heat-clearing method in Canxi Lu inherited from Zhongjing and was inclusive in the debatable theory of exogenous and epidemic febrile diseases and proposed the perspective that two diseases were different in the beginning yet unified in the end.It believed that some of Zhongjing's heat-clearing decoctions were also prescriptions for epidemic febrile diseases,pointed out that herbs pungent in flavor and cool in property were more suitable for heat syndromes,and supplemented the application of heat-clearing method in the treatment of exogenous and epidemic febrile diseases.2.Canxi Lu inherited Zhongjing's ideology and emphasized that heat should have a way out,believing that heat can be cleared from the lungs,anatomy and waterways,good at using lead-out medicines for deep heat.It also paid attention to making good use of the situation and pointed out that adjusting the yin and yang in accordance with the status of disease could relieve the heat from sweat,which means diaphoretic prescriptions are not always necessary.3.Canxi Lu revised and developed part of Zhongjing's prescripts,greatly expanding the original scope of application,and proposed that the ancient prescriptions must be adapted to the current use.The discussion of heat toxin and epidemic toxin also made up for the deficiency of Zhong Jing's theory of heat-clearing method.4.Canxi Lu also developed Zhongjing heat-clearing method on the reference of Western medicine theory,and set a precedent for the application of Western medicine in heat-clearing method with the guidance of traditional Chinese medicine theory,which improved the effectiveness and provided new ideas for the combination of traditional Chinese and modern medicine.