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Blockage type of rheumatoid arthritis clinical research for Zhou Naiyu academic thinking and clinical experience and Bi Yu Kang I,Treatment of late alpine

Author: ZhangQin
Tutor: ZhouNaiYu
School: Beijing University of Traditional Chinese Medicine
Course: Chinese medical science
Keywords: Zhou Naiyu academic thought clinical experience rheumatoid arthritis alpine Blockage of type Bi Yu Kang I side Tripterygium
CLC: R259
Type: Master's thesis
Year: 2011
Downloads: 34
Quote: 0
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Abstract


Background:Prof. Zhou Naiyu (1939-), female, was birth in Liaoyang of Liaoning province.After graduated from the traditional Chinese medicine (TCM) of inner Mongolia medical college in 1964, she worked in Beijing TCM hospital. She was taught impediment disease by famous TCM expert Prof. Wang Dajing. She was senior doctor, chief of the department of TCM rheumatology, committee of China society of integrated traditional Chinese and western medicine of rheumatic association, director of Beijing association of Chinese medicine association and chairman of rheumatic association. And she was evaluated as national TCM expert academic inheritance in 2003. Prof. Zhou Naiyu has been engaged in clinical, scientific research and education for over 50 years. She has studied hard of the classic of traditional medicine and accumulated plenty of clinical experience, simultaneously she has deep knowledge of theory. Her academic thought has made outstanding contribution of the development of TCM rheumatism field.Impediment disease (Rheumatism) is a group of diseases caused by nutrient-defense disharmony and invasion of wind, cold, dampness, heat pathogen or long time deficiency of the healthy qi, phlegm turbidity, static blood, toxic heat in body, struggle between the healthy qi and pathogenic qi on the meridian, skin, blood vessel,sinew and bone, even disharmony of qi and blood in the viscera and bowels, deficiency with dryness on the meridian involving muscles, sinews, bones and joints, manifested by local pain, swelling, soreness, numbness, heaviness, deformities, stiffness, limited activity, even involve viscera, also referring to arthralgia. It contains rheumatoid arthritis (RA),ankylosing spondylitis (AS), osteoarthritis (OA), gout, sjogren’ s syndrome (SS),systemic lupus erythematosus (SLE),all of them belong to connective tissue diseases. In initial stages of impediment disease, it locates in skin, in advanced stages it damages sinew, bone, viscera, even all the body. It is a chronic disease, mostly progressive or irregular onset in clinical which is deficiency of the healthy qi and excessiveness of the pathogenic qi. It is systematic disease which serious hazard health when advanced may damage viscera. Traditional Chinese Medicine (TCM) has a long history in treating impediment disease. The results of many clinical studies confirm the therapy of Chinese medicines are significant effective.Objective:(1) National TCM expert academic inheritance of Prof. Zhou NaiYu has been engaged in clinical almost 50 years, she has accumulated a lot of clinical experience, which has significant effective in clinical practice. Her academic thought has been prestigious in rheumatism field of our country. The paper is objective to systematic summary her clinical experience and passes on her academic thought, appreciates her academic thought essence, unceasingly inherites her accumulation and clinical experience. We combines with clinical practice in department of rheumatology of Beijing hospital of traditional Chinese medicine, deeply implement, further summaries and refining her academic thought in clinical practice. We constantly carry forward her academic thought, actively explore for TCM rheumatism development innovation.(2) To observe the therapeutic effect and safety of Bi Yu Kang formula I (BYKI) in pattern of dampness-cold obstructing the collaterals of intermediate and advanced RA patients which is a experienced prescription according to Prof. Zhou Naiyu’s clinical experience. To constantly develop her academic thought and clinical experience. It may provide more effective medicine for RA patients.Methods:(1) First, we systematic analyzed the content of impediment disease in classics of traditional medicine, such as Huang Di Nei Jing(Huangdi’s Canon of Medicine), Shang Han Lun(Treatise on Cold-induced and Miscellaneous Diseases) and Jin Kui Yao Lue (Synopsis of Prescriptions of the Golden Chamber) and researched the development of diagnosis and treatments of impediment disease from Han dynasty to Qing dynasty. We summarized the influence of classics of traditional medicine and ancient doctors in Prof. Zhou Naiyu’s theory. We compared with the theory of impediment disease in various modern famous experts such as Prof. Zhu Liangchun, Prof. Jiao Shude, Prof. Wang Weilan, Prof. Xie Haizhou et al, and summed up to the same and different of academic theory between her and others. Finally, we thorough understood her inheritance of history and theory origin, and researched the academic thought of Prof. Shi Jinmo and Prof. Wang Dajing and analyzed inheritance and improvement of the theory from her teacher.Combined with clinical practice, we systematically summarized the impediment disease academic thought of Prof. Zhou Naiyu about the principles, methods,formulas and medicinal and the clinical experiences of treating rheumatism which contain rheumatoid arthritis(RA), ankylosing spondylitis(AS), sjogren’s syndrome(SS), gout, osteoarthritis(OA), psoriatic arthritis(PsA)et al. and other internal and nervous system diseases which have progressive muscular dystrophy, Parkinson’s disease, depression and anxiety et al.(2) In the study, we observed 71 cases outpatients in 2010-2011 years in the Capital medical university affiliated Beijing hospital of traditional Chinese medicine. Treatment group have 36 cases.Control group have 35 cases. Treatment group:We applied the clinical efficacy formula B YK I in treating pattern of dampness-cold obstructing the collaterals of intermediate and advanced RA patients. Control group:tripteryginum wilfordiipolyglycoside TWP 60mg/day.The pre and post treatment 2 weeks,4weeks,6weeks,8weeks of the morning stiffness time,28 tender joint count,28 swollen joint count, average power of grip,pain and fatigue score, assessment of doctor and patients, assessment of health assessment questionnaire (HAQ), and traditional Chinese symptoms evaluation were measured and recorded, respectively.Conclusion:(1) The academic thought of Prof. Zhou Naiyu is original on the yang qi theory of (Huangdi’s) Internal Classic. Her pays more attention on visceral pattern identification. She emphasis the constitution of the internal differentiation of pathogenic factors, and claims that reinforce the healthy qi and eliminate the pathogenic factors, adjust visceral functions. When analysising the cause and mechanism of disease, her emphasizes the external causes are cold-dampness, dampness-heat, dampness toxin, the internal cause are yin-yang disharmony in viscera. In the mechanism of disease, wind-cold-dampness is tip, spleen-kidney yang deficiency is root. It has cold-heat complex and deficiency-excess complex. In the therapy, her applies theory of holism, and combines with pattern identification of visceral and six-meridian, regulates qi and blood, resolve phlegm expel stasis, relax sinews and activate collaterals, disease and pattern identification differentiation. She is good at classics of traditional medicine, lives classical formula, special studies "Treatise on Cold Damage Diseases" and "Synopsis of Prescriptions of the Golden Chamber". She further researches theory and application in therapy of impediment disease. She expertly uses Chaihujialonggumuli decoction, Chaihuguizhi decoction, Simi decoction, Zhenwu decoction, Fengyin decoction, Baihu decoction, Yanghe decoction, Yiyifuzibaijiang powder in clinical practice often has surprising effect. In long-term clinical practice, she initiates "Bi Yukang", "Tong Fengping decoction", "Jianpiyiqitongyang decoction" et al, these decoctions have significant effect. In medicine, she respectes yang-tonifying medicinal, skilles in insect drugs, compatibility and craftsmanship.(2) "BYKI" applied in treating pattern of dampness-cold obstructing the collaterals of intermediate and advanced RA patients. After treatment 8 weeks, Total efficiency of traditional Chinese symptoms evaluation was 91.7%, ACR20% improvement rate was 91.7%.Control group was 91.4%.1. Traditional Chinese symptoms evaluation result:When treatment 2 weeks 3 cases had marked effect(8.3%),21 cases were effective(58.3%),12 no effect(33.3%); When treatment 4 weeks 5 cases had marked effect(13.9%),25 cases were effective(69.4%),6 no effect(16.7%); When treatment 6 weeks 6 cases had marked effect(16.7%),25 cases were effective(69.4%),5 no effect(13.9%).When treatment 8 weeks cases had marked effect(19.4%),26 cases were effective(72.2%),3 no effect(8.3%).Traditional Chinese symptoms evaluation after 2 weeks treatment compared with integral t test P< 0.05, There was significant difference between them. 2 Clinical symptoms and signs of change:2 weeks after treatment compare with pre treatment, morning stiffness time, tender joint count, swollen joint count, average power of grip,pain and fatigue score, assessment of doctor and patients, compared with integral t test P< 0.05, There was significant difference between them.3 assessment of health assessment questionnaire (HAQ):2 weeks after treatment compare with pre treatment, the HAQ of patients, compared with integral t test P< 0.05, There was significant difference between them.4. Laboratory changes:2 weeks after treatment compare with pre treatment, erythrocyte sedimemtation (ESR), C-reactive protein (CRP) compared with integral t test P< 0.05, There was significant difference between them.5. ACR20%:Treatment group:After 2 weeks, it had marked effect 23cases, total effective rate was63.9%; After 4 weeks, it had marked effect 30cases, total effective rate was83.3%; After 6 weeks, it had marked effect 31cases, total effective rate was86.1%; After 8 weeks, it had marked effect 33cases, total effective rate was91.7%.Control group:After 2 weeks, it had marked effect 30cases, total effective rate was85.7%; After 4 weeks, it had marked effect 31cases, total effective rate was88.6%; After 6 weeks, it had marked effect 32cases, total effective rate was91.4%; After 8 weeks, it had marked effect 32cases, total effective rate was91.4%.6. Safety observation:In all group, the blood routine、liver and kidney function of patients were in the normal range, it didn’t have abnormal changes. Treatment group: 1case has medication nausea.1case has skin tickle.Control group:6cases have medication nausea.5cases have abdominal pain.3cases have skin tickle.8cases have lack of white blood cells.8cases have damage to liver fuction.No cases quite it.Conclusion:Prof. Zhou Naiyu has praised the theory of warm yang, and put emphasis on reinforcing the healthy qi and eliminating the pathogenic factors. And she has paid attention to differentiation of syndromes. In clinical practice, she has unique academic thought, very clinical experiences, and cures many patients.Prof. Zhou NaiYu has formed an experienced prescription BYK I benefits to pattern of dampness-cold obstructing the collaterals of intermediate and advanced RA patients. BYK I is an effective prescription that treats the patients of intermediate and advanced RA patients. No obviously adverse reaction or side-toxic effects were revealed. Its clinical curative effect is distinct. Using Chinese medicine could reduce the amount of western medicine and side effects, patients could cooperate with long course of treatment, which is an effective agent in treatment. Objective:To observe the therapeutic effect and safety of Bi Yu Kang formula I (BYK I) in pattern of dampness-cold obstructing the collaterals of intermediate and advanced RA patients which is a experienced prescription according to Prof. Zhou Naiyu ’s clinical experience. To constantly develop her academic thought and clinical experience. It may provide more effective medicine for RA patients.Methods:In the study, we observed 71 cases outpatients in 2010-2011 years in the Capital medical university affiliated Beijing hospital of traditional Chinese medicine. Treatment group have 36 cases.Control group have 35 cases. Treatment group:We applied the clinical efficacy formula BYK I in treating pattern of dampness-cold obstructing the collaterals of intermediate and advanced RA patients. Control group:tripteryginum wilfordiipolyglycoside TWP 60mg/day.The pre and post treatment 2 weeks,4weeks,6weeks,8weeks of the morning stiffness time,28 tender joint count,28 swollen joint count, average power of grip,pain and fatigue score, assessment of doctor and patients, assessment of health assessment questionnaire (HAQ), and traditional Chinese symptoms evaluation were measured and recorded, respectively.Coulution:"BYKI" applied in treating pattern of dampness-cold obstructing the collaterals of intermediate and advanced RA patients. After treatment 8 weeks, Total efficiency of traditional Chinese symptoms evaluation was 95%, ACR20% improvement rate was 93%. "BYKI" applied in treating pattern of dampness-cold obstructing the collaterals of intermediate and advanced RA patients. After treatment 8 weeks, Total efficiency of traditional Chinese symptoms evaluation was 91.7%, ACR20% improvement rate was 91.7%.Control group was 91.4%.1. Traditional Chinese symptoms evaluation result:When treatment 2 weeks 3 cases had marked effect(8.3%),21 cases were effective(58.3%),12 no effect(33.3%); When treatment 4 weeks 5 cases had marked effect(13.9%),25 cases were effective(69.4%),6 no effect(16.7%); When treatment 6 weeks 6 cases had marked effect(16.7%),25 cases were effective(69.4%),5 no effect(13.9%).When treatment 8 weeks cases had marked effect(19.4%),26 cases were effective(72.2%),3 no effect(8.3%).Traditional Chinese symptoms evaluation after 2 weeks treatment compared with integral t test P< 0.05, There was significant difference between them.3 Clinical symptoms and signs of change: 2 weeks after treatment compare with pre treatment, morning stiffness time, tender joint count, swollen joint count, average power of grip,pain and fatigue score, assessment of doctor and patients, compared with integral t test P< 0.05, There was significant difference between them.3 assessment of health assessment questionnaire (HAQ):2 weeks after treatment compare with pre treatment, the HAQ of patients, compared with integral t test P< 0.05, There was significant difference between them.4. Laboratory changes:2 weeks after treatment compare with pre treatment, erythrocyte sedimemtation (ESR), C-reactive protein (CRP) compared with integral t test P< 0.05, There was significant difference between them.5. ACR20%:Treatment group: After 2 weeks, it had marked effect 23cases, total effective rate was63.9%; After 4 weeks, it had marked effect 30cases, total effective rate was83.3%; After 6 weeks, it had marked effect 31cases, total effective rate was86.1%; After 8 weeks, it had marked effect 33cases, total effective rate was91.7%.Control group:After 2 weeks, it had marked effect 30cases, total effective rate was85.7%; After 4 weeks, it had marked effect 31cases, total effective rate was88.6%; After 6 weeks, it had marked effect 32cases, total effective rate was91.4%; After 8 weeks, it had marked effect 32cases, total effective rate was91.4%.6. Safety observation:In all group, the blood routine. liver and kidney function of patients were in the normal range, it didn’t have abnormal changes. Treatment group: lcase has medication nausea.lease has skin tickle.Control group:6cases have medication nausea.5cases have abdominal pain.3cases have skin tickle.8cases have lack of white blood cells.8cases have damage to liver fuction.No cases quite it.Conclusion:Conclusion:Prof. Zhou NaiYu has formed an experienced prescription BYK I benefits to pattern of dampness-cold obstructing the collaterals of intermediate and advanced RA patients. BYK I is an effective prescription that treats the patients of intermediate and advanced RA patients. No obviously adverse reaction or side-toxic effects were revealed. Its clinical curative effect is distinct. Using Chinese medicine could reduce the amount of western medicine and side effects, patients could cooperate with long course of treatment, which is an effective agent in treatment.

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