The Follow-up Dynamic Observation Of The Prescriptions And The Law Of Prescriptions And Medicines Of Shegan Mahuang Decoction Based On The Theory Of Six Meridians And Eight Outlines

Objective:The primary goal of this research is to summarize the most common formula pattern progressions after taking She Gan Ma Huang Tang for treating various respiratory diseases.By analyzing years of extensive clinical data,we were also able to identify the common single herb modifications of She Gan Ma Huang Tang as well as their frequency and modifications.We have also identified the most common symptom presentations and respiratory disease diagnoses fitting the She Gan Ma Huang Tang patternMethods:This research compiled over 6725 clinical cases from the respiratory outpatient clinic of Dong Zhi Men Hospital in Beijing over the period of 6 years and 8 months.From these cases,443 patients were prescribed She Gan Ma Huang Tang.Out of the 443 patients,201 patients were prescribed She Gan Ma Huang Tang since the initial consultation.These 201 cases were compiled and analyzed according to the following information,including:Age,disease diagnosis,prescribed western medication,clinical symptom presentation,tongue and pulse diagnoses,prescribed formulas as well as the variants of the follow up formula progressions,modifications and symptom changes.This study compares the ratio of most common She Gan Ma Huang Tang modifications used for treating respiratory diseases.Therefore,this research also rates the percentage of the most commonly seen formula progressions of She Gan Ma Huang Tang.Lastly,this research summarizes the commonly seen diseases that correlate to She Gan Ma Huang Tang.Results:Within the 201 She Gan Ma Huang Tang clinical cases,126(62.7%)patients were female and 75(37.3%)were male.The most commonly affected age group was 41-60 with 97 cases(48.2%),making up for almost half of the patients,followed by patients between the ages of 61-90,which were the second highest age group with 54 cases(26.9%),39 cases(19.4%)in the 21-40 age group and 11 cases(5.5%)in the 1-20 age groupThe ten most common respiratory diseases treated with She Gan Ma Huang Tang in this research are:Asthma(60.2%),Cough(19.14%),COPD(12.4%),Bronchitis(6%),Allergic rhinitis(4.5%),Emphysema(3.5%),Upper respiratory tract infections(0.5%),Pulmonary heart disease(0.5%),Lung cancer(0.5%),and Laryngitis(0.5%).Since asthma made up 60%of the disease diagnoses,we have further separated it into different types of asthma,including Acute asthma(57.8%),stable phase asthma(36.4%),and Cough Variant Asthma(CVA)(5.8%).Most of the diseases were chronic(65%)and about a third of these diseases were acute(35%).The 11 most common symptoms addressed with She Gan Ma Huang Tang in this research are:Cough with phlegm(84%),throat rales(54%),panting(45%),viscous phlegm(27%),shortness of breath(21%),loose stools(21%),wheezing(19%),rhinorrhea(14%),throat itching(13%),sneezing(13%),and chest oppression(9%)Among the 201 patients who received She Gan Ma Huang Tang on the first consultation,there were 14 recurring modifications,namely:Shi gao(66%),Huang qin and Chai hu(57%).Dang gui(36%),Zhi gan cao(36%).Sang bai pi(8%)Fu ling(6%),Jie geng(4%),Dang shen(4%)Yi yi ren(3%),Xin yi(2%),Gan.jiang(1%),Chen pi(1%),and Bai shao(1%).From the 201 patients who received She Gan Ma Huang Tang,65 patients(32%)received a different formula as a progression of She Gan Ma Huang Tang.In total,36 formula pattern progressions were identified,among which 14 formula patterns presented more than once and 22 occurred once.The 14 most commonly observed formula pattern progression of She Gan Ma Huang Tang,in order of frequency,are:Ban Xia Hou Po Tang(18%),Xiao Chai Hu Tang(13%),Xiao Qing Long Jia Shi Gao Tang(13%),Yi Yi Jie Geng Bai Jiang San(11%),Gan Lu Xiao Du Dan(7%),Ma Xing Yi Gan Tang(7%),Ding Chuan Tang(6%),Gui Zhi Jia Hou Po Xing Zi Tang(5%),Wei Jing Tang(5%),Ma Xing Shi Gan Tang(5%),Hou Po Ma Huang Tang(4%),Liu Jun Zi Tang(2%),Ma Huang Fu Zi Xi Xin Tang(2%),Mai Men Dong Tang(2%).Among the total of She Gan Ma Huang Tang pattern progressions,26%were Chai hu group formula patterns and 17%were Gui zhi group formula patterns.22 formula pattern progressions were only observed once,including 11 Chai hu group and Gui zhi group formula patterns,including:Chai Hu Gui Zhi Tang Jia Shi Gao,Chai Hu Gui Zhi Gan Jiang Tang Jia Shi Gao,Da Chai Hu Tang Jia Shi Gao,Chai Po Tang modified,Liu Wei Chai Hu Tang Qu Ban Xia Jia Tian Hua Fen and Jie Geng,Si Ni San,Gui Zhi Tang,Gui Zhi Jia Jing Fang Tang,Gui Zhi Jia Ge Gen Tang,Gui Zhi Gan Cao Long Gu Mu Li Tang Jia Fu Ling,Gui Zhi Fu Ling Wan.There were 11 other observed formula pattern progressions,including:Ding Chuan Tang,Ze Qi Tang Jia Shi Gao,Xuan Fu Dai Zhe Tang Qu Gan Cao modified,Tao He Cheng Qi Tang,Zhi Zhu Tang Jia Fu Ling,Pai Nong San Jia Bai Mao Gen and Gan Cao,Pai Nong Tang,Zhi Zi Chi Tang Jia Jie Geng,Xing Ren and Shi Gao,Chi Xiao Dou Dang Gui San,Suan Zao Ren Tang,Xue Fu Zhu Yu Tang.This research summarized the 14 most common She Gan Ma Huang Tang formula progressions,including 4 formula patterns observed in over 10%of the cases,and 7 formula patterns occurring in 5%to 9%of the cases.Since every modification of a formula pattern changes its syndrome differentiation,this research analyzed the 4 most frequent formula pattern progressions.The most frequently seen She Gan Ma Huang Tang formula progression was Ban Xia Hou Po Tang,which was used by itself in 40%of the cases,and was used in combination with Xiao Chai Hu Tang in 40%of the cases.Its most common single herb modifications were adding Jie geng(26.7%),Shi gao(26.7%)and Xing ren(20%).The second most common progression of She Gan Ma Huang Tang was Xiao Chai Hu Tang which was used by itself in 17%of the cases,and was combined with Ban Xia Hou Po Tang in 63.6%of the cases.Its most common modifications were adding Shi gao(54%),Jie geng(45%),Xing ren(36%),and Dang gui(18%).The third most common progression of She Gan Ma Huang Tang was Xiao Qing Long Jia Shi Gao Tang which was used by itself in 27%of the cases,and was only combined with Ban Xia Hou Po Tang once(9.1%).Its most common modifications were adding Chai hu,Huang qin and Dang gui,all occurring in 45.5%of the cases.The fourth most common progression of She Gan Ma Huang Tang was Yi Yi Jie Geng Bai Jiang San.It was most often combined with Wei Jing Tang(55.6%),Ma Xing Yi Gan Tang(44.4%)and Xiao Chai Hu Tang(22.2%).Its most common modifications were adding Sang bai pi(44.4%),Chai hu(33.3%),Huang qin(33.3%),Ban xia(33.3%),and Lu gen(33.3%).Conclusion:In conclusion,36 formula pattern progressions were observed following the use of She Gan Ma Huang Tang,correlating a specific list of symptoms and respiratory diseases.Nevertheless,within these 36 formula patterns,there are 14 formula patterns which presented more than once,among which 4 formula patterns presented in over 10%of the cases,and 7 formula patterns which presented between 5%to 9%of cases.Within the 4 most commonly seen formula pattern progressions,Ban Xia Hou Po Tang pattern is the most significant progression of She Gan Ma Huang Tang pattern,clinically demonstrating a progression from a Tai yang Tai yin Yang ming concurrent syndrome to a Tai yang Tai yin concurrent syndrome still affecting the chest with respiratory symptoms.This evolution demonstrates that once the She Gan Ma Huang Tang pattern and the Yang ming syndrome affecting the upper have resolved,the pattern most commonly evolves to Ban Xia Hou Po Tang pattern.The second most commonly seen formula pattern progression is Xiao Chai Hu Tang plus Shi gao(54%)and Jie geng(45%).This formula progression evolves from a Tai yang Tai yin Yang ming concurrent syndrome to a Shao yang Yang ming concurrent syndrome.Xiao Chai Hu Tang Jia Shi Gao Jie Geng also treats dry cough,throat pain,chest oppression and shortness of breath,so it is a logical progression of She Gan Ma Huang Tang.Additionally,Ban Xia Hou Po Tang was added in 63.6%of the Xiao Chai Hu Tang cases.presenting as a three Yang Tai yin concurrent syndrome with similar symptoms.The third most commonly seen formula pattern progression is Xiao Qing Long Jia Shi Gao Tang pattern.In this progression,the two formulas share a large amount of medicinals with the same Tai yang Tai yin Yang ming concurrent syndrome presentation,both addressing cough with phlegm,wheezing,panting,and chest oppression.The fourth most commonly seen formula pattern progression is Yi Yi Jie Geng Bai Jiang San which correlates to a Yang ming syndrome,addressing damp heat stasis in the interior associated with She Gan Ma Huang Tang,and is often paired with Wei Jing Tang(55.6%),Ma Xing Shi Gan Tang(44.4%)and Xiao Chai Hu Tang(22.2%).Additionally,26%of She Gan Ma Huang Tang formula progressions were Chai hu group formula patterns and 17%were Gui zhi group formula patterns,suggesting a progression to Shao yang and Tai yang Zhong feng syndromes.Clinically,this research has identified the most common formula pattern progressions after the use of She Gan Ma Huang Tang in the goal of improving the clarity and speed of identifying the natural and common treatment progressions in respiratory diseases.