Many disease of emotions of clinical deal with (one)

YeFang Nanjing university of Chinese medicine GuoYi master ZhouZhongYing famous doctors studio

China's traditional Chinese medicine to

        As a clinical doctor, will meet every day such a challenge: many patients in many diseases coexist (this paper called "disease of emotions") problem, whether diagnosis, treatment and prognosis of illness or judgment, especially specific choice drug choice, are very complex.

        For example, I have recently in the outpatient service has a ZhangXing patient: two years ago has been diagnosed as "hypertension, cerebral infarction, diabetes, chronic viral hepatitis c, glaucoma, etc", usually eat decompression, oral glucose-lowering drugs, in order to QiuZhi chronic hepatitis c and toss nanjing, Shanghai, hangzhou and other places, a doctor gave a by "always Fried add sedum sarmentosum" prescription, take up to now, the illness is still, aminotransferase, blood sugar, blood fat always anomaly, blood pressure fluctuation is differ. Patients helplessly asked: "I this kind of situation actually is to see which section of an expert to good?"

        The patient, at least from two years ago to now is in the "disease of emotions" condition, and, in a few years, may also have more syndrome appear, such as high blood pressure or diabetic kidney disease, coronary heart disease, multiple cerebral infarction, hepatitis c liver cirrhosis, stomach disease, cervical spondylosis, prostatitis, cataract, etc. In the process, each disease may need some kind of drug therapy, different drug interactions and very complex. In fact, we just opened a hospital medical records, especially in elderly patients, including community care, unit medical report, many people in the "sick of emotions/disease coexist/serious illness" state. Then, actually to give these patients a how traditional Chinese and western medicine treatment of comprehensive plan, in order to obtain the maximum comprehensive curative effect?

        What is a "disease of emotions"

        "Disease of culture" of the "disease" is mainly refers to western medicine disease "disease", it is to point to a variety of diseases coexist, so "disease of emotions" and could be called "disease coexist" or "sick".

        1. "disease of emotions" does not equal to "complexity disease"

        Complexity disease refers to heart disease, cancer, diabetes, obesity, mental disorders, etc., these chronic non-communicable disease poses a serious threat to human health, and the disease pathogenesis complex, the multiple genes and environmental factors in influence. Complexity disease as the population ages, complexity disease to health, economic and social influence more and more out.

        Previously, people have eagerly looking forward to the progress of human genome project will answer all kinds of complex diseases problem, hope can take genome information based on disease prevention measures, to the newborn undertake the disease susceptibility gene identification, in early screening to the risk, and then the environmental factor, the life style intervention implementation, looking forward to when unfortunate sicken, can gene diagnosis and gene therapy. But in fact, so far medical science in complexity disease etiology study progress of far does not meet the expectations of the people.

        2. "disease of emotions" does not equal to "multiple organ failure"

        Multiple organ failure often "in the critical or chronic severe disease the end, its treatment purpose is more than to keep life is the most important. The most" disease of emotions "patients may not immediately have life risk, but many diseases exist at the same time, including several diseases may need to start now and long-term give corresponding effective treatment, and some diseases do not need to use immediately, but also some fundamental is no cure, in addition, many time still need to use drug to disease patients. These set patients in one of a number of diseases, comprehensive treatment plan can't be to several diseases different scheme of simple superposition, otherwise, not only cause patients a daily need to take a lot of different drugs, but also because of the interaction between drug bring hard to predict adverse reactions and the high cost of medical treatment charge!

        "Disease of emotions" bad ending

        Clinical face many disease of culture condition, most of the clinical doctor give solutions often biased, lack of overall consideration setting indiidualized comprehensive prevention and control scheme. Especially a lot of specialized subject doctor, treats perspective is very easy to only based on my professional involved a disease, and for other diseases will need to patients in addition to the corresponding specialized subject to QiuZhi.

        The front heave ZhangXing patients, because of chronic hepatitis c infectious, likely to liver cirrhosis and liver cancer poor prognosis is particularly worry, so two years mainly in and more infectious disease, liver disease QiuZhi families. Many find western medicine liver disease experts were told "in c with high blood pressure and diabetes situation can't use interferon and ribavirin scheme, so there is no western medicine can treat", patients had to change QiuZhi in TCM liver disease experts, and the front TCM liver disease experts based on chronic hepatitis, the use of drug inertia thinking, draw the zhang by "always Fried add sedum sarmentosum" prescription. In fact, this patient two years hypertension and fasting plasma glucose and all not to obtain the very good control, but in terms of from traditional Chinese medicine, not only with Yin deficiency, more hot and humid intrinsic, phlegm and blood stasis resistance complex complex pathogenesis of existence, just use always Fried to nourish the liver and kidney is difficult to deal with the actual condition of patients.

        Such, because most doctors can stand on the professional this specialized subject Angle consider illness and choose medicine, face different specialists give different treatment, patients I it is difficult to distinguish and judgment has a variety of diseases in their respective primary and secondary, weight and priorities, after several kind of disease corresponding experts many kinds of Suggestions after, many patients is already "overwhelmed", "opinions", "not know what to do!

        In May 2007, the British medical journal Chinese version "published an article" disease concurrent multiple challenge: the time has come - focus on growing vulnerable people demand "paper, high attention the disease; Emotions the clinical significant problems, puts forward the bad ending include: patients quality of life is reduced, and the mental depression, hospitalization days increase, the length of time is longer, the postoperative complications increase, medical expenses and increased mortality. The domestic situation in fact to worse some.

        In the face of "disease of emotions", there is no ready-made medical model can be used. Often, people pay special attention to a kind of disease of the complexity of the etiology, disease from evolution to treatment. Such as home and abroad have many common complex diseases have related guidelines, but many guidelines on domestic clinical guidance value and are far from satisfactory. The reason lies in a single disease itself has considerable complexity, such as high blood pressure, diabetes, chronic liver disease complexity disease itself has many treatment options are available, but different choice the long-term prognosis of patients is not the same, and when clinical doctors face is "much more disease of emotions/disease coexist/serious illness", its comprehensive treatment of choice is undoubtedly more complex.

        Deal with "disease of emotions" state the basic train of thought

        The doctor of traditional Chinese medicine culture of disease state of know early, such as "joint disease", "and disease" and so on. ZhangZhongJing in synopsis of the zang-fu organs and meridians · successively disease vein card "article" is: "husband disease problems, try to pawn disease," cure the disease, he is after for the chronic illness ". One of the "problems" refers to JiJiu is not easy to cure disease, relative "pawn disease" is concerned, it is an, "he disease" means new hair disease, many system recently feel the pericardium and hair of acute disease. But these with a number of disease state of culture has certain distinction, the latter often is "problems", also is a variety of chronic illness coexist, to the predecessor and no ready-made experience for reference.

        We believe that in the clinical face "disease of emotions/disease coexist/serious illness" complexity in establishing treatment strategies, actually contains two kinds of medical therapy of traditional Chinese and western medicine the reasonable selection and scientific applications. Whether the doctor of traditional Chinese medicine or western medicine, as a doctor, the first requirement of patients condition and prognosis and comprehensive treatment plan to have general and comprehensive grasp.

        First of all, from the western medicine is concerned, you want to know whether the patient suffering from some kind of disease of what stage respectively? Every disease at the present stage of their respective condition and prognosis? These diseases in pathogenesis between above what common, individual character, have significant or potential relevance. Which one or several diseases which affect patients is long-term prognosis, which one or several diseases which may at any time or in the near future will have serious adverse events, the possibility of the occurrence have how old? How to prevent? Whether each disease must be lifelong treatment, can maximum limit refining medicine? The primary and secondary drug? A drug can cure more or more disease a cure?

        Secondly, from the doctor of traditional Chinese medicine is concerned, the content of the need to think in addition to the professor cheng the train of thought of the reference, the core is to be based on the overall view, dynamic evolution of traditional Chinese medicine syndrome differentiation and treatment of view thought, using traditional Chinese medicine compound many targets action characteristic advantage, "huangdi neijing" the specimen theory ", "keep the pathogenesis, the company of" and "drain its flesh, make its tone is amounted to, and send peace" and "fluctuation into loss from which the" and so on all can effectively guide clinical pattern identification and treatment. GuoYi master ZhouZhongYing professor clinical good governance difficult persistent ailment, facing the patients "disease of emotions" state, still adopt the "careful card for machine", to recognize these emotions disease usually for the performance of the composite pathogenesis, a variety of pathogenesis and clamp, composite material, pathogenesis between each other more can transform, such as hot and humid cause blood stasis, blood stasis thermal injury Yin, phlegm and blood stagnation, pathogenesis based on differentiation of symptoms and signs, complex method combination, with the card cubic, at any time use, patients and obtain good treatment effect.

        Third, as a doctor, but also in the clear, western medicine for different diseases and the same disease different stages, or different treatment goals have different advantages and disadvantages, how to flexible choice of traditional Chinese medicine and western medicine, western medicine there is internal medicine, surgery, radiation and chemotherapy intervention, the don't, there are traditional Chinese medicine medicine, a decoction of medicinal ingredients, acupuncture and moxibustion, massage, psychological comfort of points, etc. For example, old age hypertension, diabetes, coronary heart disease, chronic liver disease and so on the many kinds of disease in microcirculation, promoting blood circulation to remove blood stasis removing method is many chronic difficult disease common one of effective value method, it is "different disease pathogenesis" bring objective basis, reduce the disease state of emotions the choice of the difficulty of the drug.