| ObjectiveBy studying the relevant medical cases of gastroesophageal reflux disease(GERD)in the Ming and Qing Dynasties,this paper summarizes the development of GERD in the Ming and Qing dynasties,including the distribution range of disease names,the characteristics of symptoms,the use of Chinese medicine and acupoints in treatment,in order to provide some ideas and guidance for today's clinical diagnosis and treatment.This study also summarizes the clinical characteristics and treatment effects of patients with GERD in Changshu Area,and compares them with the Ming and Qing Dynasties.MethodsConsult the medical cases in the fifth edition of the Chinese Medical Code,select the medical cases belonging to the Ming and Qing Dynasties,plus other relevant medical cases and works that are not included in the Chinese Medical Code,read these medical records and works one by one,sort out the medical cases related to GERD according to the inclusion criteria stipulated in this study,and establish a database based on Microsoft Excel 2016.The name,symptoms,Chinese medicine and acupoint selection of GERD were statistically analyzed by using ancient and modern medical record cloud platform(V 2.3.8),including frequency statistics,cluster analysis,association analysis,complex network analysis and so on,and the results were analyzed and discussed.The data of patients with GERD who were admitted to the Department of Acupuncture and Moxibustion of Changshu Hospital of Traditional Chinese Medicine from June 2019 to December 2020 are sorted out,and the age and gender,clinical manifestations,syndrome differentiation,disease characteristics,and treatment effects are analyzed.Results1.General results of medical cases:this study included 133 medical cases and works in Ming and Qing dynasties,including 36 in Ming Dynasty,97 in Qing Dynasty and 513 cases of gastroesophageal reflux disease,including 277 typical cases and 236 atypical cases.2.Typical medical cases of gastroesophageal reflux disease:among the 277 cases of typical gastroesophageal reflux disease,there were 267 cases of traditional Chinese medicine,2 cases of acupuncture and moxibustion,2 cases of combination of acupuncture(or moxibustion)and Chinese medicine.There were 106 kinds of disease names with a total frequency of 233,385 symptoms with a total frequency of 1035,343 kinds of traditional Chinese medicine with a total frequency of 2576.The top ten traditional Chinese medicines were Fuling,Banxia,Chenpi,Gancao,Baizhu,Renshen,Baishao,Huanglian,Wuzhuyu,Ganjiang.Warm drugs were the most commonly used,accounting for 30.63%,followed by mild drugs and mild cold drugs.The most drugs entered the spleen,accounting for 52.62%,followed by the drugs entered the lung and stomach.There were 7 acupoints,involving 4 meridians and 4 specific acupoints,among which front-mu point is the most frequently used.3.Medical cases of atypical gastroesophageal reflux disease:among the 236 cases of atypical gastroesophageal reflux disease,there were 229 cases of traditional Chinese medicine,2 cases of acupuncture and moxibustion,3 cases of combination of acupuncture(or moxibustion)and Chinese medicine.There were 72 kinds of disease names with a total frequency of 190,386 symptoms with a total frequency of 852,392 kinds of traditional Chinese medicine with a total frequency of 2151.The top ten traditional Chinese medicines were are Fuling,Banxia,Gancao,Baishao,Chenpi,Xingren,Maidong,Renshen,Yujin,Guizhi.Warm drugs are the most,accounting for 24.73%,followed by mild drugs and mild cold drugs.The most drugs entered the lung,accounting for 48.02%,followed by the drugs entered the spleen and stomach.There are 7 acupoints,involving 2 meridians and 2 specific acupoints.Front-mu point is the most frequently used.4.Changshu Area:253 cases were included,of which 77.87%were typical symptoms,50.59%were heartburn,51.38%were atypical symptoms,21.09%were upper facial features,followed by stomach and esophagus,39.13%were spleen and stomach weakness,39.13%were qi deficiency,and 83.40%were qi deficiency.Tongue quality is mainly fat,big tongue,purple and dark tongue,and tongue coating is mainly less coating;Tongdu-Jiangni method for the treatment of the disease recovery rate is 66.41%.ConclusionFor the first time,this study systematically summarizes the medical cases of gastroesophageal reflux disease in the Ming and Qing dynasties,filles the gap in the research field of gastroesophageal reflux disease in the Ming and Qing dynasties,and enriches the content of traditional Chinese medicine in the diagnosis and treatment of gastroesophageal reflux disease.This is the first time to summarize the clinical characteristics and efficacy of patients with GERD in Changshu Area.The results show that during the Ming and Qing dynasties,gastroesophageal reflux disease had various names and extensive symptoms.The syndrome types were mainly spleen-stomach deficiency-cold syndrome and spleen-stomach qi deficiency syndrome.The basic prescriptions were Liujunzi decoction,Banxiaxiexin decoction,Zuojin decoction,Wendan decoction,Xiaoyao decoction,Shaoyaogancao decoction,Xuanfudaizhe decoction,Maimendong decoction and Jupizhuru decoction were commonly used prescriptions.The core medicine pair was Fuling-Banxia ternata.The meridian attributes of Chinese medicine were mainly spleen,lung and stomach meridians.Acupoints were mainly selected for body cadre acupoints,Ren meridian was often used,front-mu point and eight influential points were widely used,and local acupoints and meridian acupoints were mainly used in treatment.But acupuncture therapy had not been paid attention to and widely used.Point RN 12(zhang men)and Point LR 13(zhong wan)had good theoretical value in the treatment of gastroesophageal reflux disease and were worthy of further study.Patients with GERD in Changshu Area have weakness of the spleen and stomach as the most common syndrome and cause.Foreign body sensation in the throat is the most common atypical symptom.Diagnosis should pay attention to extraesophageal symptoms such as head,face,facial features and throat.Acupuncture has a good effect on this disease.The clinical characteristics of GERD are highly similar in ancient and modern times. |
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