Study On The Ancient And Modern Principle Of Syndrome Differentiation Of Treatment Of Forgetfulness From Phlegm And Blood Stasis

Objectives:1.Reviewing the literature on forgetfulness in ancient medical texts,and summarize the understanding of ancient doctors on the concept,etiology and treatment ideas of forgetfulness.Compiling and analyze the causes of phlegm and stasis and the relationship between phlegm and stasis,and combining the modern medical research to explore the importance of phlegm stasis in the onset and development of forgetfulness,and sorting through the literature on the treatment of forgetfulness from the phlegm-stasis theory by doctors of all generations.The focus is on the collation of theories on the etiology and pathogenesis of phlegm and stasis leading to forgetfulness,and the summary of the treatment of forgetfulness from the phlegm-stasis theory.2.Collecting the medical cases related to the treatment of forgetfulness from phlegm and blood stasis by modern and contemporary medical practitioners from ancient and modern Chinese medical texts,as well as from the more authoritative literature databases in China.Classifying and organizing the collected medical cases so as to present an objective and realistic view of the medical practitioners in each historical period.Using statistical analysis,data mining and other methods to analyse medical cases,for exploring the rules and experiences of medical doctors in treating forgetfulness based on the theory of phlegm and stasis.In anticipation of enriching the theories related to the treatment of forgetfulness in Chinese medicine,providing ideas and directions for experimental research on forgetfulness,and providing references for clinical treatment and research by this study.Methods:1.Data collection: Based on the resources of the ancient literature included in the Chinese Medical Code.Using the keywords just as "forgetfulness",and so on,to collecting ancient texts on forgetfulness,classifying and organizing these literature.Secondly,using "phlegm" "stasis" and "phlegm-stasis" as keywords,to searching the ancient literature about phlegm and stasis theory,and collating theories on the production of phlegm and stasis,the relationship between phlegm and stasis.Finally,using the keywords "forgetfulness" "mild cognitive impairment(MCI)" and "phlegm" or "stasis" or "phlegm-stasis" to collect literature on the treatment of forgetfulness from phlegm-stasis theory.2.Statistical analysis: Collecting and collating ancient and modern medical cases on the treatment of forgetfulness from phlegm-stasis theory based on the Chinese Medical Code,the ancient and modern medical case cloud platform,the classical medical texts in the library of Yunnan University of Traditional Chinese Medicine,and electronic databases include the China Knowledge Network,the Wanfang database,the Wipu Chinese Journal Service Platform,etc.Excel was used to build a medical case database,which was imported into the Ancient and Modern Medical Case Cloud Platform.The platform’s application frequency statistics and data mining functions were used to analyse the chronological distribution of medical cases,patient gender,age distribution,symptom distribution and the application of prescriptions and medicines.3.Theoretical overviews: To sum up the etiology and pathogenesis of forgetfulness and its corresponding treatment methods by synthesizing and classifying the literature and combining it with the basic theories of Chinese medicine.Summarizing the factors which affecting the production of phlegm and stasis,and the pathogenic characteristics of phlegm and stasis,the relationship between phlegm and stasis.Analysing the mechanisms and treatments of forgetfulness caused by phlegm and stasis.Summarize the treatment patterns of ancient and modern medical doctors in treating forgetfulness from phlegm-stasis theory,by the results of the statistical analysis,Results:1.The term "forgetfulness" is first found in the "Pulse Classic",before that the ancient doctors also called "Xiwang" "Shanwang" "Haowang" "Douwang" and so on.Forgetfulness can be triggered by the six excesses,the seven emotions,diet,fault of therapist,and the transmission of other diseases.The pathogenesis of forgetfulness is asthenia in origin and asthenia in superficiality,the root is the deficiency of Zang-fu and qi-blood,the branch is phlegm and stasis.The heart,kidneys and brain are the main disease locations.The main treatments for forgetfulness are herbal medicine(single herbs or herbal compound)and acupuncture.Single herbs such as Acorus calamus,Yuan Zhi,Ginseng,Fu Shen and Huang Lian are common.Most of the Chinese compound formulas are for nourishing the heart,tonifying kidney,tonifying spleen,regulating flow of qi and resolving phlegm,with some of the stasis-clearing and heat-clearing agents.Acupuncture points are mostly selected from the Heart and Kidney channels,the Ren and Du channels and the urinary bladder channel of foot-taiyang.2.The production of phlegm and stasis is related to factors such as native endowment,dietary habits,emotional and internal trauma,six climatic factors due to exopathy,trauma and fall,diet and labour and rest,and prolonged illness and old age.Phlegm and stasis is formed by deficiency of zang-fu organ,abnormalities in Qi transformation and abnormal transformation of jing,blood and body fluid.Phlegm and stasis are the pathological products of abnormal flow of fluid and blood.Phlegm and stasis have similar causes and pathogenic characteristics,and they can be mutually causal and transform each other.Modern medical research has found that the incidence of phlegm-stasis forgetfulness is on the rise,and that phlegm-stasis is a high-risk factor and an important pathological syndrome in the development of forgetfulness.In ancient medical texts,the theory that phlegm causes forgetfulness was first discussed in the Eastern Jin Dynasty,according to generations of medical doctors,phlegm causes forgetfulness is associated with disharmony between heart and kidney,emotional and internal trauma,and liver depression and qi stagnation.The theory of blood stasis causing forgetfulness was first published in “Huangdi Neijing”,and many medical doctors have believed that blood stasis causing forgetfulness is related to traumatic injury,emotional and internal injuries,qi stagnation and yang deficiency.The theory that interaction of phlegm and stasis cause forgetfulness is mostly found in the Qing Dynasty.The main mechanisms of phlegm and stasis leading to forgetfulness are qi deficiency and interaction of phlegm and stasis,qi stagnation and interaction of phlegm and stasis,Yang deficiency and interaction of phlegm and stasis,and interaction of phlegm and stasis conversion into heat and toxic pathogens leading to forgetfulness.3.A total of 231 medical cases were collected,divided into a small number of ancient and recent medical cases,and a large number of modern medical cases.The majority of patients in the cases were men aged 60-79.In addition to the symptom of forgetfulness,the common symptoms in forgetfulness include dizziness,dullness,insomnia,poor appetite,headache and fatigue.In terms of Chinese medicine applications,the most frequently used type of medicine is warm,flat and slightly cold in nature,sweet,pungent and bitter in taste,and the channel tropism is classified as belonging to the liver,heart and spleen channels.The most frequently used medicines are Acorus calamus,Yuan Zhi,Chuan Xiong,Poria,Radix Angelicae Sinensis,Salviae Sinensis,Pericarpium Citri Reticulatae,Glycyrrhiza glabra,Atractylodes macrocephala,Peach kernel.according to their effects,they are mainly classified as blood invigorating and blood stasis relieving herbs,tonifying deficiency herbs,phlegm relieving herbs and qi regulating herbs.The most commonly used categories of herbs are the phlegm-transforming herbs,tonifying deficiency and blood invigorating herbs.Through correlation rule analysis and combined with clinical application and efficacy assessment,obtained that the commonly used herb pairs were Yuan Zhi-Acorus calamus,Atractylodes-Poria,Radix Paeoniae-Chuanxiong,Yu Jin-Acorus calamus,Safflower-Chuanxiong,Safflower-Tao Ren,Danshen-Acorus calamus,Radix Paeoniae-Tao Ren.Tao Ren-Chuanxiong,By the analysis of the complex network of drugs,the core herbs used in the ancient and modern treatment of forgetfulness from phlegm and stasis theory are Acorus calamus,Yuan Zhi,Fu Ling,Atractylodes macrocephala,Chuan Xiong,Angelica sinensis,Dan Shen,Yu Jin,Chen Pi and Radix Paeoniae.Conclusions:1.The basic pathogenesis of forgetfulness is the deficiency of qi,blood,yin and yang in the internal organs and the blockage of the brain by phlegm and stasis.Phlegm and stasis are important etiological factors in the development of forgetfulness.The production of phlegm and stasis is associated with deficiencies in the function of the internal organs,abnormalities in qi and blood,and malfunction in the metabolism of essence,blood and fluid.Phlegm and stasis are associated with a variety of risk factors for the development of forgetfulness,and phlegm and stasis are important pathological factors contributing to the occurrence and development of forgetfulness.2.The mechanism of phlegm and stasis causing forgetfulness is closely related to the deficiency of qi and blood,and the deficiency of the heart,spleen and kidney.When phlegm and stasis are produced,they block the orifices of the mind,the interaction of phlegm and stasis conversion into heat and toxic pathogens leading to damage the orifices of the brain,which is an important etiological factor in the development of forgetfulness.Therefore,in treating forgetfulness caused by phlegm and blood stasis,attention must be paid to harmonizing Qi and Blood,tonifying the deficiencies of the Heart,Spleen and Kidney,and flexibly using methods to resolve phlegm and invigorate Blood,supplemented by methods to clear heat and detoxify the brain when necessary.3.The features of the ancient and modern medical treatment of forgetfulness from the phlegm-stasis theory can be summarized as follows: dispelling phlegm and resolving stasis,tonifying the deficiency and strengthening the body resistance,at the same time promoting the flow of qi and expelling stagnation,clearing heat and cooling the blood to nourish it.In the treatment of forgetfulness is must reating both manifestation and root,tonification and purgation in combinnation.4.Forgetfulness is a key symptom of MCI and is an early and major symptom of diseases such as Alzheimer’s disease,cerebral atherosclerosis and neurasthenia.Traditional Chinese medicine can provide guidance and expand ideas for the diagnosis and treatment of forgetfulness.By exploring the different understanding of the causes and mechanisms of forgetfulness by ancient and modern medical doctors,we can summarise their treatment experiences and use them as a basis for early intervention with Chinese medicine,which may be useful in slowing down the progression of forgetfulness and even reversing its course.The experiences of ancient and modern doctors are of great value in the diagnosis and treatment of forgetfulness.