柴松岩老师学术思想和临床经验继承及基于“二阳致病”学说辨治浆细胞性乳腺炎的应用研究
摘要
国家级名老中医柴松岩老师从事中医妇科临床60年,是全国著名的中医妇科临床专家,拥有深厚的理论积淀与实践经验。在长期的临床诊疗中,柴松岩老师中医妇科学术体系逐步形成,其学术思想鲜明,临床经验丰富,治疗效果独到。2008年至2012年间,我有幸跟随柴松岩老师,以传统方式继承学习老师的学术思想和临床经验,从跟师临诊中真切感受,从理论学习中深入思考从独立实践中反复磨练,学业上获益丰厚,思想上感触良多。本次研究是对老师学术思想和临床经验的整理与总结,是对中医学术传承中传统方式和现代思路结合的有益尝试。研究分为四个部分：第一部分柴松岩老师学术渊源；第二部分柴松岩老师学术思想和临床经验的整理与总结；第三部分柴松岩老师“二阳致病”学说的理论阐释与再认识；第四部分基于柴松岩老师“二阳致病”学说辨治浆细胞性乳腺炎的应用研究。
一、柴松岩老师的学术渊源
本节通过对老师重要生活经历和背景的回顾,探求老师取得学术成功的外部条件及内在原因。简要介绍了老师的学术特色及其形成的理论和实践渊源。在学术特色方面,以“肾之四最”、养护阴血”、“二阳致病”学说为代表的学术思想；从“顺应周期”、注重气化”、“运用五行”观点出发的论治法则；涉及月经病、妊娠病、妇科杂病的辨病思路；依据舌象、脉象、基础体温的认证技巧；以及气味平和、药少剂轻、价廉易得的用药风格。在学术渊源上,老师的学术发端于对中医经典《黄帝内经》的领悟；发扬于对中医各家学说的借鉴,如朱丹溪“阳常有余,阴常不足”的思想,《景岳全书》“经本阴血,何脏无之”的阴血观,《女科辑要》“肾生”、“肾足”、“肾衰”的阐释,以及《傅青主女科》辨治月经、妊娠诸病的经验等；历经现代医学教育的严格培训；禀受当代中医名家陈慎吾、刘奉五、蒲辅周、祁振华、姚正平等人的熏陶,逐步形成柴松岩老师独到的妇科学术思想和临床经验。
二、柴松岩老师学术思想和临床经验的整理与总结
本节对老师学术思想和临床经验的体系脉络进行梳理,将学习内容分门别类,以便把握知识结构,理清逻辑关系,从而提高学习效率。将学术思想分为辨证思想和论治法则两个部分,临床经验分为辨病思路、认证技巧和用药经验三个方面。力求以知识结构的认知,加强对老师学术内容的记忆,通过对逻辑关系的理解,提升对老师学术主旨的领悟。
1学术思想部分
1.1辨证思想
1.1.1肾之四最
肾之四最是柴老对肾气盛衰在妇科临床决定作用的高度概括。反映在辨证中重视肾气损伤的病理,在治疗中着重补益肾气的治疗,在生活中纠正耗损肾气的生活方式。尤其强调顺应肾气盛衰的阶段性规律,调整不同年龄段的治疗原则,既避免急功近利的激发动员,又灵活把握护顾肾气与运用肾气的辩证关系,是中医学“重肾思想”在妇科临床中的具体体现。在“四最”的论述中,明确了天癸不是肾气表现的全部,提出了绝经期后女性重新规划人生,保护肾气以获得高质量生活的指导原则。
1.1.2养护阴血
养护阴血反映了柴老妇科临床中以阴血为本的思想。阐释女性“阴常不足”的生理特点,在辨证中重视阴血不足的病理,在论治时注重滋养阴血的思路。论述养护阴血的具体方法,则从“经本阴血,何脏无之”的角度看待阴血与脏腑的关系,健运脏腑开阴血生化之源,并积极治疗直接损伤阴血的疾病,同时杜绝导致“阴血暗耗”的不良习惯,另以“水库论”蓄灌和疏浚的原理,取象比类的说明阴血、血海与月经来潮的关系,强调养护为先和因势利导的原则。
1.1.3二阳致病
柴松岩老师引《素问·阴阳别论》“二阳之病发心脾,有不得隐曲,女子不月……”的论述,结合历代观点和临床实践,发展提出了阳明热毒随经传入冲脉血海,损伤阴血,扰动血海,导致妇科月经失常的观点。在辨证中特别关注胃肠功能与排便情况,在治疗上重视调畅阳明的治法,临床应用屡获佳效。介绍了“二阳致病”学说在指导高泌乳素血症的辨证治疗中取得的临床进展。
1.2论治法则
1.2.1顺应周期
顺应周期是“天人合一”的思想在中医妇科临床中的具体应用。从自然规律论及人身生理,强调顺应天癸周期变化,维护或恢复女性正常的月经来潮。充分发挥传统中医技法的特长,又积极利用如基础体温、超声监测、激素测定等现代医学手段,提升妇科临床把握周期的能力。提出对“周期只能顺应而不可制造”的观点,以“借贷款”比喻“人工周期”治疗存在的隐患,遵循《素问·四气调神》中春、夏、秋、冬四气运动的规律,确立月经周期各阶段的治疗原则、具体用药及注意事项。
1.2.2注重气化
注重气化是柴老师最重要的论治法则之一。其理论根源是《黄帝内经》中对三焦气化的论述,不仅阐释了气化的概念、意义、状态、场所等问题,更是柴老师结合妇科临床实践,逐步提炼和完善而成。注重气化即是根据患者的生理需求、病理发展和药物性质,调整气化运动的方向和趋势,并通过健运脏腑功能来维持气化的长治久安,以恢复气化为临床追求的理想目标；另一方面老师特别强调在气化的调整过程中要珍视生理和关注平衡,避免急功近利的过度干预,把握治疗进退的分寸,所谓“临床医生不能作勇士”。
1.2.3运用五行
运用五行生化制克关系进行辨证论治,是老师指导妇科临床的重要论治法则。尤其以“补肺启肾”、“肝无所索”学说为代表的治法应用,理论阐释成熟指导临床治疗屡获佳绩。“补肺启肾”即在久病重病、肾气痿惰、生机难复之时,利用肺肾间的相生关系,补益肺气以促进肾气的恢复；而“肝无所索”学说的形成来自于柴松岩老师对前人理论的发展和自身临床经验的总结,揭示出肾水骤亏,肝木求索,阴血不济,致肝之相火妄动,急迫化火为逆的病机,对于妇科及其他专业的临床治疗均具有指导作用。
2临床经验部分
2.1辨病思路
列选了临床具有代表性的卵巢早衰、高泌乳素血症、多囊卵巢综合征、功能失调性子宫出血、先兆流产、盆腔炎等六种常见疾病,以及小儿性早熟、羊水过多、巨乳症等三种特殊疾病,从病因、病机、治疗特色等方面,对每种疾病特有的辨病规律进行概括,并结合典型病例加以说明。
2.2认证技巧
就舌象与辨证、脉象与辨证、基础体温与辨证三方面介绍老师的认证技巧。在舌象部分,以淡舌、嫩舌、黯舌、红舌、瘦舌、敛舌及腻苔剥、脱苔、无苔为例,分类说明舌象在妇科临床中的辨证意义。在脉象部分,重点就滑脉辨血海盈亏,尺脉动象辨肾气盛衰,记录了老师的脉诊经验。在基础体温部分,分别总结了基线偏低、基线偏高、单相和不典型双相对辨证的指导意义,阐述了顺应周期并择期而治的方法。
2.3用药经验
柴松岩老师临床用药经验丰富,她谙熟药性、选药灵活,在中医妇科临床上独树一帜。老师的用药经验是辨证思想和论治法则在临床中的具体反映,本节重点介绍了补肾药、理血药、调畅阳明药、疏肝药、妊娠禁忌药等老师常用特色药物,突出了老师对药物认识和特殊应用。
三、柴松岩老师“二阳致病”学说的理论阐释与再认识
“二阳致病”学说源自经典,形成于临床实践,提出了辨析阳明是把握妇科病机线索的观点,以“阳明热毒”导致冲任“血虚失养”的病机模式,解释了阳明与经脉冲任内在生理病理关联。本节应用经典研读中以经释经的方法,对二阳的功能进行了总结概括,参合《灵枢·决气》六气同源的整体观念,以“津”对“血”的劫夺完成了对“二阳致病”学说的经典释义。并从经脉联系、病机特点、继承方法、理论发展、医学进展、应用领域等角度对“二阳致病”学说进行了理论解读和再认识。
四、基于柴松岩老师“二阳致病”学说辨治浆细胞性乳腺炎的应用研究
通过对老师学术思想和临床经验的继承,特别是“二阳致病”学说的学习,在外科浆细胞性乳腺炎的辨治中开拓新的思路,从理论挖掘阐释到临床实践均实现了进展,此部分介绍了应用老师“二阳致病”学说调畅阳明思路,在跨专业临床治疗中开展试验研究的情况和心得。在一个前瞻性的临床对照试验中,以“二阳致病”学说指导临床治疗,与传统中医外科治法开展对照研究,结果显示,在证候积分、不良事件、女性激素、乳房形态、复发情况等评价方面,新治法均优于传统治法。“二阳致病”学说的跨专业应用为中医辨治浆细胞性乳腺炎提供了新的思路和治法,对“二阳致病”学说的理论理解亦在临床实践中得以深化,体现在中医辨证论治与现代医学进展的结合,形成了对“二阳”功能体系的认知。
Professor Yansong Chai, one of national famous doctors, is engaged in gynaecology for60years, who has experiences and traditional Chinese medicine prescriptions accumulation. I had honor to be mentored by Prof. Chai from2008to2012. With traditional methodology, I learned Prof. Chai academic thought and clinical experience. Now, I advanced so much and have some deep thoughts and feelings. This paper collected Prof. Chai's methodology and experience and attempted to combine the traditional Chinese medicine with the western medicine. The study is divided into four parts.
Part1. Origin of Prof. Chai academic thought
In this pare, I reviewed the background of Prof. Chai and tried to find out the character of her academic thoughts."The four characters of kidney","nourishing blood" and "Yang-ming Channel Pathogenic Theory" are three important parts of academic thought."Comply with the menstruation cycle","vital energy theory" and "five elements" are the three principles in clinical treatment. In emmeniopathy, pregnancy disease, gynaecology difficulty mixed diseases, we analyze the tongue and pulse condition and basal body temperature, combined with properties and tastes of herb to make our plan. Her academic resource from " Emperor's Canon of Medicine","Jing Yue Quan Shu","Nv Ke Ji Yao" and "Fu Qing Zhu Nv Ke" and from contemporary masters of traditional Chinese medicine, such as:Shenwu Chen, Fengwu Liu, Pufu Zhou, Zhenhua qi and Zhengping Yao. With many years experience, the Chai academic thought was born.
Part2. The academic thoughts and clinical experience of Prof. Chai
In this part, the Prof. Chai academic thoughts was divided into syndrome differentiation, therapy principle. In diagnosis and therapy principle part is included by three aspects.
Academic thoughts
The four characters of kidney is the important summarization of Prof. Chai academic thoughts, which reflect that the kidney damage is the main pathological mechanism in TCM and tonifying kidney is the core of therapy. She emphasizes that the treatment should be conformed to the natural period of kidney function and adjusted the therapy with the patients age.
Nourishing blood is based on "yin blood maintenance". It explain the women's physiological character:shortage of yin. When diagnosis is yin blood deficiency, this academic thought is used. It describes that we should avoid consuming yin blood."The reservoir theory" is explained the relationship between yin blood and menstruation.
Yang-ming Channel Pathogenic Theory
According to " Emperor's Canon of Medicine", Prof. Chai developed her thoughts that heat toxin produce form yang-ming channel which enter into xue-hai point of Chong channel and result in yin blood deficiency and irregular menstruation. In clinical, under this guidance we care about the dysfunction of stomach and intestine, for example fecal incontinence.
Diagnosis and therapy principle
Comply with the menstruation cycle is the specific use of "unity of human and nature", a concept of traditional Chinese medicine. Prof. Chai follow the period of tian kui to maintain the regular menstruation period. Utilizing the modern methods like basal body temperature, ultrasonic inspection and measurement and estrogen hormone, Prof. Chai take advantage of herb therapy. We determine the therapy principle, according to the different stage of the menstruation period and seasons change.
Vital energy theory is the other character of Prof. Chai principle. This part explains the definition, meaning, state and environment of vital energy theory. Physiological demand, pathological mechanism development and herb nature are the key factors to adjust the vital energy. Focus on physiology balance is the key to maintian the stability of vital energy.
Five elements is the bridge between different organs. Among these relationship, the "nourishing lung to develop kidney" is an important principle. When patients with serious disease and aeipathia, we will use this principle. This principle uses the the relationship between lung and kidney to support these "Losing nourishing liver" explains when the kidney is shortage or damaged, the liver will dysfunction.
Clinical experience
Differentiation of disease
The diseases differentiation illustrates the method and thinking way about gynaecology. It takes examples of classic gynaecology diseases like:premature ovarian failure, hyperprolactinemia, Stein-Leventhal syndrome, dysfunctional uterine bleeding, threatened abortion, pelvic inflammation and special disease, such as sexual precocity, hydramnios and breast hypertrophy.
Diagnosis skills
Referring tongue condition, Prof. Chai conclude12types of tongue conditions, according to the shape, quality, colour and fur of tongue. Referring pulse condition, the change records of slippery pulse and Chi point of pulse tracking the Prof. Chai's experience. Referring basal body temperature, this index has several conditions like low baseline, high baseline, uniphasic basal temperature, biphasic basal temperature. Different condition has different meaning for treatment.
Therapy principle
Prof. Chai has rich experience in herb therapy. Her experience reflects her dialectical thinking and diagnosis and therapy Policy. This part illustrate the herb therapy policy on nourishing kidney, invigorating blood circulation, clear Yang-ming channel and pregnancy caution, which take examples of some special herb prescription and some special application.
Part3. Theory Recognition of "Yang-ming Channel Pathogenic Theory"
"Yang-ming Channel Pathogenic Theory" is showned the relationship between Yang-ming Channel and Chong-Ren Channel, which toxic heat from Yang-ming Channel, entered into Chong and Ren Channel to damage Yin-blood."Understanding canon with canon" through "Emperor's Canon of Medicine", the competition which "Jing" is to "Blood" explains the "Yang-ming Channel Pathogenic Theory". This part explains the theory from aspect of connections of meridians, disease pathology, theory heritage, theory development and theory application.
Part4. Research of diagnosis and heal plasma cell mastitis by "Yang-ming Channel Pathogenic Theory"
Based on learning Prof. Chai's academic thoughts and clinical experience, especially "Yang-ming Channel Pathogenic Theory", I made combination with Prof. Chai's theory and modern thoughts. With the new combination, a prospective clinical experiment is proceeded, which showed better efforts than traditional way in whole efforts, adverse effort, estrogen hormone, shape of breast and recurrences. The prospective clinical controlled trials of "Yang-ming Channel Pathogenic Theory" bring us the new idea and new therapy. Meanwhile the application also deepen the understanding for this theory, which deepen the cognition of Yang-ming channel system.
一、柴松岩老师的学术渊源
本节通过对老师重要生活经历和背景的回顾,探求老师取得学术成功的外部条件及内在原因。简要介绍了老师的学术特色及其形成的理论和实践渊源。在学术特色方面,以“肾之四最”、养护阴血”、“二阳致病”学说为代表的学术思想；从“顺应周期”、注重气化”、“运用五行”观点出发的论治法则；涉及月经病、妊娠病、妇科杂病的辨病思路；依据舌象、脉象、基础体温的认证技巧；以及气味平和、药少剂轻、价廉易得的用药风格。在学术渊源上,老师的学术发端于对中医经典《黄帝内经》的领悟；发扬于对中医各家学说的借鉴,如朱丹溪“阳常有余,阴常不足”的思想,《景岳全书》“经本阴血,何脏无之”的阴血观,《女科辑要》“肾生”、“肾足”、“肾衰”的阐释,以及《傅青主女科》辨治月经、妊娠诸病的经验等；历经现代医学教育的严格培训；禀受当代中医名家陈慎吾、刘奉五、蒲辅周、祁振华、姚正平等人的熏陶,逐步形成柴松岩老师独到的妇科学术思想和临床经验。
二、柴松岩老师学术思想和临床经验的整理与总结
本节对老师学术思想和临床经验的体系脉络进行梳理,将学习内容分门别类,以便把握知识结构,理清逻辑关系,从而提高学习效率。将学术思想分为辨证思想和论治法则两个部分,临床经验分为辨病思路、认证技巧和用药经验三个方面。力求以知识结构的认知,加强对老师学术内容的记忆,通过对逻辑关系的理解,提升对老师学术主旨的领悟。
1学术思想部分
1.1辨证思想
1.1.1肾之四最
肾之四最是柴老对肾气盛衰在妇科临床决定作用的高度概括。反映在辨证中重视肾气损伤的病理,在治疗中着重补益肾气的治疗,在生活中纠正耗损肾气的生活方式。尤其强调顺应肾气盛衰的阶段性规律,调整不同年龄段的治疗原则,既避免急功近利的激发动员,又灵活把握护顾肾气与运用肾气的辩证关系,是中医学“重肾思想”在妇科临床中的具体体现。在“四最”的论述中,明确了天癸不是肾气表现的全部,提出了绝经期后女性重新规划人生,保护肾气以获得高质量生活的指导原则。
1.1.2养护阴血
养护阴血反映了柴老妇科临床中以阴血为本的思想。阐释女性“阴常不足”的生理特点,在辨证中重视阴血不足的病理,在论治时注重滋养阴血的思路。论述养护阴血的具体方法,则从“经本阴血,何脏无之”的角度看待阴血与脏腑的关系,健运脏腑开阴血生化之源,并积极治疗直接损伤阴血的疾病,同时杜绝导致“阴血暗耗”的不良习惯,另以“水库论”蓄灌和疏浚的原理,取象比类的说明阴血、血海与月经来潮的关系,强调养护为先和因势利导的原则。
1.1.3二阳致病
柴松岩老师引《素问·阴阳别论》“二阳之病发心脾,有不得隐曲,女子不月……”的论述,结合历代观点和临床实践,发展提出了阳明热毒随经传入冲脉血海,损伤阴血,扰动血海,导致妇科月经失常的观点。在辨证中特别关注胃肠功能与排便情况,在治疗上重视调畅阳明的治法,临床应用屡获佳效。介绍了“二阳致病”学说在指导高泌乳素血症的辨证治疗中取得的临床进展。
1.2论治法则
1.2.1顺应周期
顺应周期是“天人合一”的思想在中医妇科临床中的具体应用。从自然规律论及人身生理,强调顺应天癸周期变化,维护或恢复女性正常的月经来潮。充分发挥传统中医技法的特长,又积极利用如基础体温、超声监测、激素测定等现代医学手段,提升妇科临床把握周期的能力。提出对“周期只能顺应而不可制造”的观点,以“借贷款”比喻“人工周期”治疗存在的隐患,遵循《素问·四气调神》中春、夏、秋、冬四气运动的规律,确立月经周期各阶段的治疗原则、具体用药及注意事项。
1.2.2注重气化
注重气化是柴老师最重要的论治法则之一。其理论根源是《黄帝内经》中对三焦气化的论述,不仅阐释了气化的概念、意义、状态、场所等问题,更是柴老师结合妇科临床实践,逐步提炼和完善而成。注重气化即是根据患者的生理需求、病理发展和药物性质,调整气化运动的方向和趋势,并通过健运脏腑功能来维持气化的长治久安,以恢复气化为临床追求的理想目标；另一方面老师特别强调在气化的调整过程中要珍视生理和关注平衡,避免急功近利的过度干预,把握治疗进退的分寸,所谓“临床医生不能作勇士”。
1.2.3运用五行
运用五行生化制克关系进行辨证论治,是老师指导妇科临床的重要论治法则。尤其以“补肺启肾”、“肝无所索”学说为代表的治法应用,理论阐释成熟指导临床治疗屡获佳绩。“补肺启肾”即在久病重病、肾气痿惰、生机难复之时,利用肺肾间的相生关系,补益肺气以促进肾气的恢复；而“肝无所索”学说的形成来自于柴松岩老师对前人理论的发展和自身临床经验的总结,揭示出肾水骤亏,肝木求索,阴血不济,致肝之相火妄动,急迫化火为逆的病机,对于妇科及其他专业的临床治疗均具有指导作用。
2临床经验部分
2.1辨病思路
列选了临床具有代表性的卵巢早衰、高泌乳素血症、多囊卵巢综合征、功能失调性子宫出血、先兆流产、盆腔炎等六种常见疾病,以及小儿性早熟、羊水过多、巨乳症等三种特殊疾病,从病因、病机、治疗特色等方面,对每种疾病特有的辨病规律进行概括,并结合典型病例加以说明。
2.2认证技巧
就舌象与辨证、脉象与辨证、基础体温与辨证三方面介绍老师的认证技巧。在舌象部分,以淡舌、嫩舌、黯舌、红舌、瘦舌、敛舌及腻苔剥、脱苔、无苔为例,分类说明舌象在妇科临床中的辨证意义。在脉象部分,重点就滑脉辨血海盈亏,尺脉动象辨肾气盛衰,记录了老师的脉诊经验。在基础体温部分,分别总结了基线偏低、基线偏高、单相和不典型双相对辨证的指导意义,阐述了顺应周期并择期而治的方法。
2.3用药经验
柴松岩老师临床用药经验丰富,她谙熟药性、选药灵活,在中医妇科临床上独树一帜。老师的用药经验是辨证思想和论治法则在临床中的具体反映,本节重点介绍了补肾药、理血药、调畅阳明药、疏肝药、妊娠禁忌药等老师常用特色药物,突出了老师对药物认识和特殊应用。
三、柴松岩老师“二阳致病”学说的理论阐释与再认识
“二阳致病”学说源自经典,形成于临床实践,提出了辨析阳明是把握妇科病机线索的观点,以“阳明热毒”导致冲任“血虚失养”的病机模式,解释了阳明与经脉冲任内在生理病理关联。本节应用经典研读中以经释经的方法,对二阳的功能进行了总结概括,参合《灵枢·决气》六气同源的整体观念,以“津”对“血”的劫夺完成了对“二阳致病”学说的经典释义。并从经脉联系、病机特点、继承方法、理论发展、医学进展、应用领域等角度对“二阳致病”学说进行了理论解读和再认识。
四、基于柴松岩老师“二阳致病”学说辨治浆细胞性乳腺炎的应用研究
通过对老师学术思想和临床经验的继承,特别是“二阳致病”学说的学习,在外科浆细胞性乳腺炎的辨治中开拓新的思路,从理论挖掘阐释到临床实践均实现了进展,此部分介绍了应用老师“二阳致病”学说调畅阳明思路,在跨专业临床治疗中开展试验研究的情况和心得。在一个前瞻性的临床对照试验中,以“二阳致病”学说指导临床治疗,与传统中医外科治法开展对照研究,结果显示,在证候积分、不良事件、女性激素、乳房形态、复发情况等评价方面,新治法均优于传统治法。“二阳致病”学说的跨专业应用为中医辨治浆细胞性乳腺炎提供了新的思路和治法,对“二阳致病”学说的理论理解亦在临床实践中得以深化,体现在中医辨证论治与现代医学进展的结合,形成了对“二阳”功能体系的认知。
Professor Yansong Chai, one of national famous doctors, is engaged in gynaecology for60years, who has experiences and traditional Chinese medicine prescriptions accumulation. I had honor to be mentored by Prof. Chai from2008to2012. With traditional methodology, I learned Prof. Chai academic thought and clinical experience. Now, I advanced so much and have some deep thoughts and feelings. This paper collected Prof. Chai's methodology and experience and attempted to combine the traditional Chinese medicine with the western medicine. The study is divided into four parts.
Part1. Origin of Prof. Chai academic thought
In this pare, I reviewed the background of Prof. Chai and tried to find out the character of her academic thoughts."The four characters of kidney","nourishing blood" and "Yang-ming Channel Pathogenic Theory" are three important parts of academic thought."Comply with the menstruation cycle","vital energy theory" and "five elements" are the three principles in clinical treatment. In emmeniopathy, pregnancy disease, gynaecology difficulty mixed diseases, we analyze the tongue and pulse condition and basal body temperature, combined with properties and tastes of herb to make our plan. Her academic resource from " Emperor's Canon of Medicine","Jing Yue Quan Shu","Nv Ke Ji Yao" and "Fu Qing Zhu Nv Ke" and from contemporary masters of traditional Chinese medicine, such as:Shenwu Chen, Fengwu Liu, Pufu Zhou, Zhenhua qi and Zhengping Yao. With many years experience, the Chai academic thought was born.
Part2. The academic thoughts and clinical experience of Prof. Chai
In this part, the Prof. Chai academic thoughts was divided into syndrome differentiation, therapy principle. In diagnosis and therapy principle part is included by three aspects.
Academic thoughts
The four characters of kidney is the important summarization of Prof. Chai academic thoughts, which reflect that the kidney damage is the main pathological mechanism in TCM and tonifying kidney is the core of therapy. She emphasizes that the treatment should be conformed to the natural period of kidney function and adjusted the therapy with the patients age.
Nourishing blood is based on "yin blood maintenance". It explain the women's physiological character:shortage of yin. When diagnosis is yin blood deficiency, this academic thought is used. It describes that we should avoid consuming yin blood."The reservoir theory" is explained the relationship between yin blood and menstruation.
Yang-ming Channel Pathogenic Theory
According to " Emperor's Canon of Medicine", Prof. Chai developed her thoughts that heat toxin produce form yang-ming channel which enter into xue-hai point of Chong channel and result in yin blood deficiency and irregular menstruation. In clinical, under this guidance we care about the dysfunction of stomach and intestine, for example fecal incontinence.
Diagnosis and therapy principle
Comply with the menstruation cycle is the specific use of "unity of human and nature", a concept of traditional Chinese medicine. Prof. Chai follow the period of tian kui to maintain the regular menstruation period. Utilizing the modern methods like basal body temperature, ultrasonic inspection and measurement and estrogen hormone, Prof. Chai take advantage of herb therapy. We determine the therapy principle, according to the different stage of the menstruation period and seasons change.
Vital energy theory is the other character of Prof. Chai principle. This part explains the definition, meaning, state and environment of vital energy theory. Physiological demand, pathological mechanism development and herb nature are the key factors to adjust the vital energy. Focus on physiology balance is the key to maintian the stability of vital energy.
Five elements is the bridge between different organs. Among these relationship, the "nourishing lung to develop kidney" is an important principle. When patients with serious disease and aeipathia, we will use this principle. This principle uses the the relationship between lung and kidney to support these "Losing nourishing liver" explains when the kidney is shortage or damaged, the liver will dysfunction.
Clinical experience
Differentiation of disease
The diseases differentiation illustrates the method and thinking way about gynaecology. It takes examples of classic gynaecology diseases like:premature ovarian failure, hyperprolactinemia, Stein-Leventhal syndrome, dysfunctional uterine bleeding, threatened abortion, pelvic inflammation and special disease, such as sexual precocity, hydramnios and breast hypertrophy.
Diagnosis skills
Referring tongue condition, Prof. Chai conclude12types of tongue conditions, according to the shape, quality, colour and fur of tongue. Referring pulse condition, the change records of slippery pulse and Chi point of pulse tracking the Prof. Chai's experience. Referring basal body temperature, this index has several conditions like low baseline, high baseline, uniphasic basal temperature, biphasic basal temperature. Different condition has different meaning for treatment.
Therapy principle
Prof. Chai has rich experience in herb therapy. Her experience reflects her dialectical thinking and diagnosis and therapy Policy. This part illustrate the herb therapy policy on nourishing kidney, invigorating blood circulation, clear Yang-ming channel and pregnancy caution, which take examples of some special herb prescription and some special application.
Part3. Theory Recognition of "Yang-ming Channel Pathogenic Theory"
"Yang-ming Channel Pathogenic Theory" is showned the relationship between Yang-ming Channel and Chong-Ren Channel, which toxic heat from Yang-ming Channel, entered into Chong and Ren Channel to damage Yin-blood."Understanding canon with canon" through "Emperor's Canon of Medicine", the competition which "Jing" is to "Blood" explains the "Yang-ming Channel Pathogenic Theory". This part explains the theory from aspect of connections of meridians, disease pathology, theory heritage, theory development and theory application.
Part4. Research of diagnosis and heal plasma cell mastitis by "Yang-ming Channel Pathogenic Theory"
Based on learning Prof. Chai's academic thoughts and clinical experience, especially "Yang-ming Channel Pathogenic Theory", I made combination with Prof. Chai's theory and modern thoughts. With the new combination, a prospective clinical experiment is proceeded, which showed better efforts than traditional way in whole efforts, adverse effort, estrogen hormone, shape of breast and recurrences. The prospective clinical controlled trials of "Yang-ming Channel Pathogenic Theory" bring us the new idea and new therapy. Meanwhile the application also deepen the understanding for this theory, which deepen the cognition of Yang-ming channel system.
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