Pei Zhengxue Medical Essence Series

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Pei Zhengxue Medical Essence Series

Pei Zhengxue Medical Notes 2 by Pei Zhengxue, compiled by Cao Jingyu, Chen Guangyan, and Qi Li, China Press of Traditional Chinese Medicine

Pei Zhengxue and his disciple, the main compiler of this book, Cao Jingyu (Cao Jingyu graduated from the Department of Clinical Medicine at Lanzhou Medical College in June 1995 and is an associate professor at Gansu Health Vocational College. In 2013, he became a direct disciple of Professor Pei Zhengxue. He currently serves as the vice president of the Pei Zhengxue Institute of Traditional Chinese Medicine and has participated in the compilation of many works by Mr. Pei, serving as the chief editor of “Collection of Discussions on Pei Zhengxue’s Clinical Experience”).

Professor Pei Zhengxue’s calligraphy

September 2021: Professor Pei Zhengxue’s discipleship ceremony

December 2019: Professor Pei Zhengxue giving a lecture at Gansu University of Traditional Chinese Medicine

June 2018: Professor Pei Zhengxue teaching grassroots physicians

Introduction to Professor Pei Zhengxue

Pei Zhengxue, male, born in February 1938 in Wushan, Gansu Province, graduated from the Medical Department of Xi’an Medical University in 1961. He is a chief physician and professor, and a renowned expert in integrated traditional Chinese and Western medicine in China. Currently, he serves as a lifetime council member of the Chinese Association of Traditional Chinese Medicine, honorary president of the Gansu Provincial Society of Integrated Traditional Chinese and Western Medicine, doctoral supervisor at the China Academy of Traditional Chinese Medicine, doctoral supervisor at Gansu University of Traditional Chinese Medicine, national-level mentor for apprentices in traditional Chinese medicine, one of the 500 most famous senior TCM doctors nationwide, and among the first group of distinguished senior TCM doctors in Gansu Province (ranked first among the 27 initial distinguished senior TCM doctors). He is also the chief expert at the Gansu Provincial Academy of Medical Sciences Cancer Hospital, the chief expert at the Gansu Provincial Hospital of Traditional Chinese Medicine, the honorary president of the Tianshui City Hospital of Integrated Traditional Chinese and Western Medicine, and a member of the Gansu Provincial Museum of Literature and History. Since 1991, he has been receiving a special government allowance from the State Council. He previously served as the vice president of the Gansu Provincial Academy of Medical Sciences and the Gansu Provincial Cancer Hospital, a council member of the Chinese Society of Integrated Traditional Chinese and Western Medicine for its 2nd, 3rd, 4th, 5th, and 6th sessions, an advisor to the World Journal of Integrated Traditional Chinese and Western Medicine, and an editorial board member of the Chinese Journal of Integrated Traditional Chinese and Western Medicine for its 3rd, 4th, 5th, 6th, 7th, and 8th issues. He was also a member of the 6th, 7th, and 8th committees of the Gansu Provincial Political Consultative Conference.

Professor Pei Zhengxue has authored “Practical Internal Medicine of Integrated Traditional Chinese and Western Medicine,” “Commentary on Blood Disorders,” “New Compilation of Warm Disease Theory in Traditional Chinese Medicine,” “New Compilation of Formulas in Traditional Chinese Medicine,” “Diagnosis and Treatment of Hepatitis B,” “Collection of Pei Zhengxue’s Medical Experiences,” “Collection of Medical Cases and Conversations by Pei Zhengxue,” “Pei Zhengxue Medical Notes,” “Pharmacology and Clinical Applications of Rhubarb,” “Selected Medical Cases by Pei Shen,” “New Compilation of Warm Disease Theory,” “Integrated Treatment of Hypertension with Traditional Chinese and Western Medicine,” “Integrated Treatment of Diabetes with Traditional Chinese and Western Medicine,” “Integrated Treatment of Liver Diseases with Traditional Chinese and Western Medicine,” “Integrated Treatment of Gastric Pain with Traditional Chinese and Western Medicine,” “Beginner’s Guide to Medicine in Cursive Script,” “Second Edition of Practical Internal Medicine of Integrated Traditional Chinese and Western Medicine,” “Pei Zhengxue Medical Collection,” “Pei Zhengxue Health Weibo Q&A,” “Pei’s Practical Oncology of Integrated Traditional Chinese and Western Medicine,” “Pei Zhengxue’s Traditional Chinese Medicine,” “Pei Zhengxue Health Weibo Q&A,” “Collection of Pei Zhengxue’s Clinical Experiences in Integrated Traditional Chinese and Western Medicine” (a total of 10 volumes), and other 39 medical works. He is also passionate about literature, poetry, and calligraphy, having authored “The Great Wind Song,” “The Spring Breeze Song,” “Pei Zhengxue’s Collection of Novels and Essays,” “Pei Zhengxue’s Collection of Poems and Prose,” and other 11 literary works, totaling 50 published monographs. He has also published over 100 medical papers.

Professor Pei Zhengxue has received one world-class award, one national-level award, and multiple provincial and ministerial-level awards for scientific and technological progress. In 1994, he was named a “National Advanced Worker in Integrated Traditional Chinese and Western Medicine,” and in 2000, he was awarded the title of “Outstanding Contributor to Integrated Traditional Chinese and Western Medicine Nationwide.” In 2009 and 2014, he received the “Achievement Award for the Development of Traditional Chinese Medicine” from the Chinese Association of Traditional Chinese Medicine twice. In 2014, he was consecutively elected as a “Good Person of China” and a “Good Person of Lanzhou,” as well as a model of morality and dedication in Gansu Province. In 2015, he was honored as one of the “Ten Prideful Sons of Gansu.” In addition, he has received more than 20 other prestigious honors. In 2018, he was listed as one of the 60 “Pioneers of Integrated Traditional Chinese and Western Medicine in China.” His biography has been included in “Contemporary World Celebrities Biographies,” “Contemporary Famous TCM Doctors,” “Great Dictionary of Famous Chinese Doctors,” “Great Dictionary of Chinese Celebrities,” and the foreign-language edition of “Cambridge World Who’s Who.”

After the publication of “Commentary on Blood Disorders,” compiled by Professor Pei Zhengxue, it gained significant influence in Japan. In May 1985, Professor Tan Eiichi, president of Shizuoka Medical University in Japan, traveled specially to Lanzhou to seek advice on issues related to the book. The specialized prescription for treating leukemia formulated by him was officially named the “Lanzhou Formula” at the National Hematology Conference in 1974. This formula has completely cured numerous patients with acute monocytic leukemia (M5) and acute lymphocytic leukemia (L2), among others. Later, this formula was developed into an in-house preparation—Pei’s Blood-Nourishing Granules—which has been widely used in the prevention and treatment of blood diseases, malignant tumors, and side effects of radiotherapy and chemotherapy, achieving excellent clinical results and creating tremendous social value. Furthermore, based on his experience in treating other systemic diseases, after years of clinical practice, he refined and improved these formulas to create more than 20 types of traditional Chinese medicine preparations, including Pei’s Gallbladder and Pancreas Granules, Pei’s Gynecological Inflammation Granules, Pei’s Heat-Clearing and Fire-Extinguishing Granules, Pei’s Wind-Dissipating and Dampness-Removing Capsules, Pei’s Hepatitis B Elimination Granules, and Pei’s Hepatitis B Recovery Granules, all of which have shown remarkable clinical efficacy and greatly benefited countless patients.

In the early 1990s, at the request of Minister Chen Minzhang of the Ministry of Health, Professor Pei organized 21 experts in integrated traditional Chinese and Western medicine from the Northwest region to write China’s first monumental work on internal medicine in integrated traditional Chinese and Western medicine, “Practical Internal Medicine of Integrated Traditional Chinese and Western Medicine.” After its publication, the book won the “International Gold Award for Outstanding Contribution” at the Third World Congress of Traditional Medicine, and Professor Pei himself was honored as one of the “Top 100 Stars of Ethnic Medicine Worldwide.” As the chief editor of the book, Professor Pei was invited to Las Vegas, USA, in April 1996 to receive the award and deliver lectures in several American cities.

Drawing on his more than sixty years of clinical experience, Professor Pei has distilled the essence of integrated traditional Chinese and Western medicine into sixteen characters: “Western diagnosis, Chinese differentiation, Chinese medicine as the mainstay, Western medicine as the auxiliary.” This principle immediately garnered widespread attention from the national community of traditional Chinese and Western medicine and has since guided the development of integrated traditional Chinese and Western medicine in China.

Professor Pei is particularly skilled in clinical practice, with unique expertise in oncology, hematologic diseases, connective tissue diseases, liver diseases, cardiovascular diseases, and gastrointestinal diseases, enjoying a high reputation throughout the Northwest region and even nationwide.

Preface\Table of Contents\2007---2010\2007

“Learn until old age, live until old age,

At the age of seventy, still diligent and hardworking.

No need for you or me to judge what’s good,

Just believe that reading can prolong life.”

May 25, 2007: Research Progress on Chronic Hepatitis C

Chronic hepatitis C (commonly referred to as hepatitis C) is an infectious disease caused by the hepatitis C virus (HCV). Its main routes of transmission are blood transfusions and the use of blood products. A characteristic of this disease is few symptoms and poor prognosis, with about 50% of cases becoming chronic. It is now believed that the proportion of chronic cases is even higher, possibly exceeding 70%.

Individual differences in response to interferon (IFN) therapy for HCV are related to viral load and host susceptibility. Since the introduction of long-acting interferon in 1969, there have been some promising developments in the treatment of this disease. The proposal of a pegylated interferon combined with ribavirin regimen has enabled hepatitis C patients to receive individualized treatment based on their genetic type. For genotype I, using Pegasys 180 μg combined with ribavirin 1000–1200 mg for 48 weeks can significantly improve sustained virological response; whereas genotypes II and III only require 24 weeks to achieve satisfactory response.

It is now widely recognized that pegylated interferon combined with ribavirin is the “gold standard” for treating hepatitis C. The dosage of ribavirin must be maintained at an adequate level. The initial dose of ribavirin is usually positively correlated with the response, and a higher initial dose can often improve the sustained virological response (SVR) in patients with genotype I. Regarding genotypes, hepatitis C is divided into three types: I, II, and III. Type I is considered difficult to treat, with high viral load and body weight over 85 kg; types II and III are relatively easier to treat. Type II can further be subdivided into four subtypes—A, B, C, and D—with decreasing difficulty in treatment.

August 27, 2007: More on Diabetes

The incidence of diabetes is increasing year by year. According to statistics from June 2006, over the past 20 years, the number of diabetes patients worldwide has increased from 30 million to 230 million, an increase of about sevenfold. China has approximately 40 million diabetes patients, second only to India.

Currently, all medications used to treat diabetes have certain side effects, as follows:

① Insulin secretagogues: Whether it’s repaglinide or sulfonylurea drugs that stimulate insulin secretion, they can both cause hypoglycemia.

② Biguanides: Lactic acidosis is the most common side effect of phenformin. Metformin also has side effects, but they are much milder, occurring in only 3 out of 100,000 cases; however, when it does occur, it can lead to a mortality rate of 50%. This situation is most pronounced in patients with heart and lung dysfunction or renal insufficiency.

③ Alpha-glucosidase inhibitors: Including acarbose and voglibose. Acarbose is a biosynthesized pseudo-oligosaccharide. Its structure is very similar to oligosaccharides, so it can competitively bind to alpha-glucosidase, hence the name alpha-glucosidase inhibitor. Glucose formation relies entirely on alpha-glucosidase, so acarbose can inhibit glucose formation, preventing it from entering the bloodstream and thus treating diabetes. However, acarbose can cause bloating, intestinal rumbling, frequent flatulence, and even diarrhea and abdominal pain. Therefore, it is advisable to start with a low dose, such as 25 mg initially, gradually increasing to 50 mg.

④ Insulin sensitizers: These are different from insulin secretagogues. Thiazolidinediones (TZDs, such as rosiglitazone and pioglitazone) work by stimulating peroxisome proliferator-activated receptors (PPAR), increasing insulin sensitivity in peripheral tissues and organs, thereby improving insulin resistance. There was once a first-generation product called troglitazone, but due to severe liver reactions, the U.S. FDA announced its withdrawal from the market in 2000. Although the second-generation products rosiglitazone and pioglitazone have not been found to cause liver toxicity, they still have the side effect of edema (angioedema), so patients with heart and kidney dysfunction should avoid them.

⑤ Insulin: The side effect of insulin is hypoglycemia, which can occur frequently if used improperly. Therefore, in 2007, the American Medical Association classified this drug as the most likely to cause problems worldwide.

August 31, 2007: The Drawbacks of Medical Abortion

It is well known that medical abortion can easily lead to premature ovarian failure. Now, a clinical study conducted by the University of California in the United States has found that medical abortion has no other drawbacks, including any adverse effects on subsequent pregnancies. The study selected 2,710 women who had undergone medical abortion and 9,104 women who had undergone surgical induced abortion, comparing their rates of ectopic pregnancy, spontaneous abortion, preterm birth, and low-birth-weight infants, and found no significant differences between the two groups.

August 31, 2007: Diagnostic Tests for Hemolytic Anemia

① Mean corpuscular volume (MCV) > 95 fL.

② Elevated lactate dehydrogenase (LDH).

③ Increased reticulocyte count.

④ Increased indirect bilirubin (IBIL).

September 2, 2007: Non-Alcoholic Fatty Liver Disease

Fatty liver is divided into alcoholic fatty liver disease (AFLD) and non-alcoholic fatty liver disease (NAFLD). The former requires alcohol consumption as a prerequisite for diagnosis and is relatively easy to diagnose; the latter’s diagnosis has guidelines issued at the Asia-Pacific Medical Liver Disease Conference, with the following key points:

① For men, fatty liver with ethanol content less than 20 g/day; for women, less than 10 g/day, is considered non-alcoholic fatty liver disease.

② Exclude fatty liver caused by various types of viral hepatitis, including immune-related liver diseases.

③ Fatty liver associated with obesity and metabolic disorders falls into this category.

September 3, 2007: Clinical Application of 16-Slice CT

The 16-slice spiral CT produced by General Electric in the United States has the following advantages in clinical application: ① Fast speed—only 0.3 seconds to scan one slice, compared to 5 seconds for ordinary CT. ② Ability to perform three-dimensional imaging. ③ No artifacts. ④ Clear and non-invasive cardiovascular imaging, which can replace cardiac catheterization.

September 3, 2007: Talking About Epilepsy

This disease is common and frequently occurs, with 70% of patients experiencing a long period of remission after the first seizure following treatment. Carbamazepine is considered the drug of choice for treating epilepsy today. At the end of the 20th century, several new drugs for treating epilepsy emerged, such as tiagabine and gabapentin, but after more than ten years of clinical observation, their efficacy was still inferior to carbamazepine.

In addition to treating epilepsy, carbamazepine can also relieve pain, combat depression, and treat diabetes insipidus, making it suitable for various neuralgias (such as trigeminal neuralgia and herpes zoster pain) as well as depression and schizophrenia. The dosage is 0.1–0.2 g, three times a day, taken orally, starting with a small dose and gradually increasing to 1.2–1.6 g/day. Side effects include blurred vision, double vision, nystagmus, urinary retention, water intoxication (hyponatremia), rash, behavioral disorders in children, and lupus syndrome; common adverse reactions include arrhythmia, bone marrow suppression, and mental disorders.

September 3, 2007: Diagnosis and Differential Diagnosis of Crohn’s Disease (CD)

This disease should be differentiated from intestinal tuberculosis and malignant lymphoma.

1. Intestinal Tuberculosis (ITB) Both CD and ITB affect the ileum. CD can also involve the rectum, with anastomotic lesions accounting for about 77% of cases. The largest diameter of mesenteric lymph nodes in CD is 1 cm; in ITB, lymph nodes can reach up to 20 cm in diameter, accompanied by epithelial granulomas and caseous necrosis. The inflammatory local lesions in CD are more obvious than those in ITB.