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Go through the academic thought and clinical experience and treatment of allergic purpura clinical research

Author: AnJunYing
Tutor: ZhouYaoTing
School: Beijing University of Traditional Chinese Medicine
Course: Chinese medical science
Keywords: Professor Zhou Yaoting academic ideological clinical experience of allergic purpura Zhou Yaoting experience square
CLC: R249.2
Type: Master's thesis
Year: 2011
Downloads: 36
Quote: 0
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Abstract


The academic thoughts and experiences of famous veteran Chinese medicine doctors are precious wealth of Traditional Chinese Medicine (TCM). Inheritance, mining and spreading of these thoughts and experiences is an important way for the development and innovation of TCM. The study aims to summary and research the academic thoughts and clinical experiences of Professor Zhou Yaoting, the study of clinical experiences of Professor Zhou to anaphylactoid purpura is a major subject too.The thesis is mainly divided into the following three parts.First part is about the academic origins of Professor Zhou. Professor Zhou’s clinical style has been formed based on experience of treating pharyngitis by modern physicians Qi Zhenhua, treating asthma by Zhou Muxin, treating diarrhea by Yang Yinong. Professor Zhou is acquainted with many classical books of TCM, especially with books on warm diseases. He has studied "exogenous hot theory" by Ye Tianshi, "warm diseases identification" by Wu Jutong. He is good at treating most fever diseases, breath system diseases and other diseases with warm diseases theory. He is also good at treating diseases of internal medicine, surgery, gynecology, pediatrics. He gives more prominence to inspection in treating pediatric diseases. Through the learning process and clinical experience, Professor Zhou has formed his personal opinions and his own systems of discrimination diagnosis and treatment, at the same time, professor Zhou has done his best to the development and the innovation of TCM. Professor Zhou pays more attentions on both teaching, studying and clinical experience. As a professor he has taught warm disease theory and pedology for many years. He knows how to combine teaching, studying and clinical treating and do best in teaching and clinical treating.It’s important to identify inner-outer properties in respiratory disease syndrome. For treating long-term fever and respiratory disease, professor Zhou thinks Ye Tianshi’s WeiQiYingXue syndrome and Wu Jutong’s SanJiao syndromes should be followed. It should be paid more attention to Yin medicines for treating ShiZuMoYuan fever. Professor Zhou has brought forward two concepts about macula that has significance to the treatment of macula. Professor Zhou has his own method for treating anaphylactoid purpura, he thinks the treatment is mainly by clearing heat and toxin, cooling blood, secondly by dispelling wind and damp.Second part is about the summary of professional thoughts and clinical experience. Academic thoughts:Professor Zhou is good at treating most fever disease with warm disease theory. He thinks that clinical treatment must combine WeiQiYingXue syndrome with Sanjiao syndrome for knowing about the disease completely. The warm disease theory can also be used in many other disease, such as icterus, macula, ruffian, abdomen bulge, spirit confusion delirious speech, hyperkinesias, etc. Summary of clinical experience:Professor Zhou is good at treating many kinds of diseases, the popular kinds of diseases are selected to be studied and summaried such as breath system diseases, fever over a long period of time, Macula, nutritional anemia, too more-red-cells disease、stomachache, diarrhea, comprehensive disease of menopause, eczema, urticaria, acne and some other diseases.The third part is about the clinical study on anaphylactoid purpura. This scheme employs a prospective, randomized, single blind clinical trial method.70 cases suited for the diagnosis criteria for the anaphylactoid purpura were selected into this study. The treatment group and control group both have 35 cases. The treatment group uses the professor Zhou’s prescription for anaphylactoid purpura, and the control group uses Xijiao Dihuang Decoction. The treatment for the two groups has all proceeded for 12 weeks. After the end of treatment, there is a period of a month for checking the recurrence. Evaluation of patients’efficacy with the diseases and the TCM syndrome is done using score-summation method. The conclusions are as follows:(1) Single cause of susceptibility and chronic pharyngitis accounts for the total cases of 47.14%, nearly half of all; Cases of more than one cause accounts for 19. Cases with susceptibility and allergic constitution accounts for 10, it’s the most and accounts for 14.29%. You can see that the susceptibility and the chronic pharyngitis are the main causes of anaphylactoid purpura, and allergy is also one of the important causes. Through clinical observation it’s found that infection, pharyngitis and allergy are not only the main causes of anaphylactoid purpura, but also the main causes of recurrent for the disease. So it’s important for treatment and prevention of the disease, prevention recurrent of the disease and improving the curative effect to actively prevent allergy, to adjust the body, to effectively control the infection and treat pharyngitis.(2) After the treatment, there is obvious difference (the probability less than 0.05) about syndromes scores between the two groups that means the treatment group is superior to control group in abating and banishing the syndromes. The results for the two groups are as follows:the effective rate of treatment group is 94.3%, and it’s 68.6% for control group, the cure rate of treatment group is 60%, and it’s 17.1% for the control group. The effective rates and the cure rates of the two groups are all obviously different in statistics which means that the treatment group is superior to control group. According to clinical characteristic, anaphylactoid purpura belongs to YangBan which isn’t same to that caused by heat and poison. Professor Zhou found that the treatment using Xijiao Dihuang decoction, HuaBan decoction is ineffective. Based on the traditional prescription of Xijiao Dihuang decoction, the power for clearing heat and poison, promoting blood circulation and removing blood stasis is strengthenen and companied with medicine for removing damp and wind in Professor Zhou’s prescription. The duration and degree of the disease have no relation with the clinical efficacy which means that if dialectical treatment is right and the medicine is fit, then the effect can be expected.(3) The recurrence rate (treatment group 5.7%, control group 28.6%) means that the treatment group is farely better than the control group in long-period effect and controlling the disease recurrence.The clinical research expresses that Professor Zhou’s prescription for anaphylactoid purpura is fairly effective and safe in clinic. It can raise the effective rate and clinical cure rate and reduce the recurrent rate. So Professor Zhou’s prescription for anaphylactoid purpura has an extensively market prospect, and is worthy of further research and extension. There is no record about anaphylactoid purpura in the TCM books, but there are some document about similar diseases such as "purpura wind" , "grape disease" , "spot" that have the same clinical characteristics. Most of the diseases are associated with infection. The patients usually have fever, sore throat, upper respiratory tract infection and general malaise before 1-3 weeks. The skin purpura is almost in lower limbs and buttocks. The skin purpura almost has symmetric distribution and occurs in batches. The serious patient may have purpura in upper limbs and trunk. Purpura has characteristics of varying size, red-purple, outstanding the skin. The disease may be accompanied by urticaria, angioedema, and bullae for severer with hemorrhagic necrosis. In the course of the disease, joint pain, abdominal pain, hematuria, proteinuria and purpura nephritis may occur.At present, medicines with antihistamine diphenhydramine are often used in Western Medicine on anaphylactoid purpura treatment. Most medicines such as Diphenhydramine, Astemizole are invalid. Hormones and other immune inhibitor haven’t good effects. In addition to allergy, there are many other pathogenic factors which increased the complexity of the disease, so there is no better treatment in Western Medicine.Most modern TCM doctors think that TCM syndrome of anaphylactoid purpura is always around wind, damp, heat, blood stasis, poison, deficiency. Syndrome differentiation is from simple to complex, from coarse to fine. Syndrome differentiation type generally has the following:heat impairing collaterals, excessive heat forcing blood, heat resistance, hyperactivity of fire due to Yin deficiency, Qi not controlling blood, blood stasis, deficiency of Qi and Yin, deficiency of the liver and kidney. In clinical view, the type of excessive heat forcing blood has a large proportion.This study is on the immanent rule for treating anaphylactoid purpura by summarizing and analyzing professor Zhou’s clinical efficacy in the treatment of the disease. Professor Zhou treats the disease by dispelling wind and removing dampness, cooling blood detoxification, promoting blood circulation and removing blood stasis.This scheme employs a prospective, randomized, single blind clinical trial method.70 cases suited for the diagnosis criteria for the anaphylactoid purpura were selected into this study. The treatment group and control group both have 35 cases. The treatment group uses the professor Zhou’s prescription for anaphylactoid purpura, and the control group uses Xijiao Dihuang Decoction. The treatment for the two groups has all proceeded for 12 weeks. After the end of treatment, there is a period of a month for checking the recurrence. Evaluation of patients’efficacy with the diseases and the TCM syndrome is done using score-summation method. The conclusions are as follows:(1) Single cause of susceptibility and chronic pharyngitis accounts for the total cases of 47.14%, nearly half of all; Cases of more than one cause accounts for 19. Cases with susceptibility and allergic constitution accounts for 10, it’s the most and accounts for 14.29%. You can see that the susceptibility and the chronic pharyngitis are the main causes of anaphylactoid purpura, and allergy is also one of the important causes. Through clinical observation it’s found that infection, pharyngitis and allergy are not only the main causes of anaphylactoid purpura, but also the main causes of recurrent for the disease. So it’s important for treatment and prevention of the disease, prevention recurrent of the disease and improving the curative effect to actively prevent allergy, to adjust the body, to effectively control the infection and treat pharyngitis.(2) After the treatment, there is obvious difference (the probability less than 0.05) about syndromes scores between the two groups that means the treatment group is superior to control group in abating and banishing the syndromes. The results for the two groups are as follows:the effective rate of treatment group is 94.3%, and it’s 68.6% for control group, the cure rate of treatment group is 60%, and it’s 17.1% for the control group. The effective rates and the cure rates of the two groups are all obviously different in statistics which means that the treatment group is superior to control group. According to clinical characteristic, anaphylactoid purpura belongs to YangBan which isn’t same to that caused by heat and poison. Professor Zhou found that the treatment using Xijiao Dihuang decoction, HuaBan decoction is ineffective. Based on the traditional prescription of Xijiao Dihuang decoction, the power for clearing heat and poison, promoting blood circulation and removing blood stasis is strengthenen and companied with medicine for removing damp and wind in Professor Zhou’s prescription. The duration and degree of the disease have no relation with the clinical efficacy which means that if dialectical treatment is right and the medicine is fit, then the effect can be expected.(3) The recurrence rate (treatment group 5.7%, control group 28.6%) means that the treatment group is farely better than the control group in long-period effect and controlling the disease recurrence.The clinical research expresses that Professor Zhou’s prescription for anaphylactoid purpura is fairly effective and safe in clinic. It can raise the effective rate and clinical cure rate and reduce the recurrent rate. So Professor Zhou’s prescription for anaphylactoid purpura has an extensively market prospect, and is worthy of further research and extension.

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