| ObjectiveThis study summarizes Professor Yao Naili’s basic understanding,diagnosis and treatment ideas,treatment experience and medication characteristics in the diagnosis and treatment of chronic gastritis with Insomnia Based on the theory of "stomach discord is restless",and inherits and develops the academic experience of famous and old Chinese medicine.At the same time,the clinical efficacy of Jianpi Tiaogan Anshen Decoction in treating chronic gastritis with insomnia of liver depression and spleen deficiency type was observed to verify the effectiveness and repeatability of the experience of famous and old Chinese medicine.Explore the potential of traditional Chinese medicine in treating chronic gastritis with insomnia,in order to improve its clinical efficacyMethodsThrough collecting and sorting out Professor Yao Naili’s cases of chronic gastritis with insomnia,learning from his teacher and personal guidance from Professor Yao Naili,the basic understanding,diagnosis and treatment ideas,treatment experience and medication characteristics of Professor Yao Naili’s clinical experience in the diagnosis and treatment of chronic gastritis with insomnia of liver depression and spleen deficiency type were preliminarily understood.Meanwhile,a prospective self-control study was conducted in 60 patients with chronic gastritis and insomnia of liver depression and spleen deficiency type.Jianpi Tiaogan Anshen Decoction was used as the basic prescription for 8 weeks,followed up for 4 weeks.The main symptoms of chronic gastritis were recorded before treatment,4 weeks after treatment,8 weeks after treatment and at the time of follow-up.The Pittsburgh Sleep Quality Index(PSQI)score was recorded.Hamilton Anxiety Scale(HAMA)score and Hamilton Depression Scale(HAMD)score were recorded before treatment,8 weeks after treatment and 8 weeks after follow-up,respectively,and related safety indicators were recorded before treatment and 8 weeks after treatment.SPSS 24.0 statistical software was used for data analysis to evaluate the clinical efficacy and safety of Jianpi Tiaogan Anshen DecoctionResultsProfessor Yao Naili’s clinical experience in the diagnosis and treatment of chronic gastritis with insomnia is summarized for the first time based on the theory of "stomach discord is restless".Professor Yao Naili believed that the disease was caused by exogenous pathogens,dietary fatigue,emotional failure and physical weakness"Weakness of spleen and stomach,disorder of liver,disorder of ascending and descending,disorder of yin and yang,disturbance of mind"was the basic pathogenesis of the disease.Weakness of spleen and stomach,unfavorable transport and transformation were the basis of the disease.Damp and heat,food accumulation,phlegm turbidity and blood stasis were the important pathological factors,disorder of liver,disorder of ascending and descending and descending.For the basic pathological changes,the key pathogenesis lies in the weakness of spleen and stomach,the disorder of yin and yang,and the disturbance of mind and mind.From the basic pathogenesis,Professor Yao Naili established the basic principles of invigorating the spleen and stomach,regulating the liver and tranquilizing the spirit.The treatment proceeded from five aspects:invigorating the spleen and stomach to fix its root,regulating its movement to dispel its pathogens,ventilating the ascending and descending phase,intersecting Yin and Yang to calm its spirit,and regulating the whole body to help it heal.Professor Yao Naili pointed out that we should accurately grasp the basic pathogenesis of the disease,combine differentiation of diseases with differentiation of symptoms and signs,macro-differentiation with microcosmic differentiation of symptoms and signs,and attach importance to tongue and veins in differentiation of symptoms and signs.Professor Yao Naili is cautious about protecting the spleen and stomach,using the mediation mechanism of ascending and descending,adding or subtracting the pathogenesis with syndrome,and skilled in compatibility and making good use of the right medicineBased on Jianpi Tiaogan Anshen Decoction,the total score of symptoms of chronic gastritis was decreased in 4 weeks,8 weeks and follow-up compared with baseline before treatment(P<0.01).Compared with baseline before treatment,the total score of symptoms of chronic gastritis was decreased after 8 weeks of treatment(P<0.01)Compared with baseline before treatment,the scores of symptoms of chronic gastritis were decreased after 8 weeks of treatment.The difference was statistically significant(P<0.05).In terms of PSQI score,compared with baseline before treatment,the total PSQI score decreased at 4 weeks,8 weeks and follow-up(P<0.01).Compared with baseline before treatment,the scores of PSQI components decreased after 8 weeks of treatment,and the difference was statistically significant(P<0.01).Compared with the baseline before treatment,the total scores of HAMA and HAMD decreased at 8 weeks of treatment and follow-up,and the difference was statistically significant(P<0.01).In the evaluation of TCM symptoms of chronic gastritis,14 cases were cured after 8 weeks of treatment,accounting for 23.33%,27 cases were markedly effective,accounting for 45.00%,14 cases were effective,accounting for 23.33%,55 cases were effective,the total effective rate was 91.67%.In the evaluation of sleep quality,8 cases were cured after 8 weeks of treatment,accounting for 13.33%,18 cases were markedly effective,accounting for 30.00%,25 cases were effective,accounting for 41.67%,51 cases were effective,the total effective rate was 85.00%.ConclusionProfessor Yao Naili,based on the theory of "stomach discord is restless",has distinctive characteristics in basic understanding,diagnosis and treatment,treatment experience,medication and nursing of chronic gastritis.It has been proved that Jianpi Tiaogan Anshen Decoction is effective and safe in treating chronic gastritis with insomnia of liver depression and spleen deficiency type. |
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