After treatment 63 45.0 42 30.0 35 25.0 39 27.9 49 35.0 52 37\. 29 20.2 53 37.9 48 34.3 26 18.6 75 53.6 39 27.9 21 15.0 69 49.2 50 35.7

| > After treatment | > 63 | > 45.0 | > 42 | > 30.0 | > 35 | > 25.0 | > 39 | 27.9 | 49 | 35.0 | > 52 | 37. | > 29 | 20.2 | > 53 | 37.9 | > 48 | 34.3 | > 26 | > 18.6 | > 75 | 53.6 | > 39 | 27.9 | > 21 | 15.0 | > 69 | > 49.2 | > 50 | 35.7

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| > | | | | | > | | | > | | > 0.01 | | | | | > Household i | | | > Or | J A Clinical Efficacy Analysis of Treating 72 Cases of Stroke with Syndrome Differentiation and Repeated Use of Min Dang Gui in Gansu Provincial Hospital of Traditional Chinese Medicine, Department of Internal Medicine, Cardiology and Neurology Group Xia Yongchao Dou Youyi

Xu Wenke Tao Huizhen

Han Yan Jia Zhengzhong Research Guidance

Liao Zhifeng Ji Yan Yi Zhang Dinghua Zhang Xueping

Liao Bo Zao

Lu Fuhu Zhou Jie

From January 1984 to December 1986, our hospital’s Department of Internal Medicine, Cardiology and Neurology Group, based on summarizing our previous experience in treating stroke, repeatedly used Min Dang Gui, a local specialty of our province, to formulate proprietary prescriptions and implement syndrome differentiation-based treatment, successfully treating a total of 72 cases of stroke with satisfactory results. The summary report is as follows:

Clinical Data I. General Information: This group comprises 72 cases, including 44 males and 28 females. The youngest patient is 31 years old, the oldest is 84, with an average age of 56. The average length of hospital stay is 57 days. The time from onset to admission ranges from a minimum of 3 hours to a maximum of 9 months. Among all cases, 39 were admitted within 7 days of onset, 10 between 8 and 14 days, 5 between 15 and 29 days, 8 between 30 and 59 days, 6 between 60 and 119 days, and 4 over 180 days (including 2 cases over 180 days, 1 case over 210 days, and 1 case over 270 days).

II. Western Medical Diagnosis: 49 cases of cerebral thrombosis, 21 cases of cerebral hemorrhage, and 2 cases of cerebral embolism.

III. Traditional Chinese Medicine Syndrome Classification and Efficacy Evaluation Standards: Based on the "TCM Diagnostic and Efficacy Evaluation Standards for Stroke" formulated by the Internal Medicine Society of the All-China Association of Traditional Chinese Medicine (approved at the Tai’an Conference in June 1986). (Hereinafter referred to as the "Standards").

Treatment course: 1 to 2 courses (each course lasting 30 days).

IV. Syndrome Classification and Treatment: According to the "Standards," this group can be divided into five syndrome categories. Below is a description of the initial syndrome manifestations and the self-formulated treatment prescriptions:

(1) Qi Deficiency and Blood Stasis. Symptoms include hemiplegia, numbness on one side of the body, facial deviation, slurred speech, drooling, spontaneous sweating, shortness of breath and fatigue, palpitations and loose stools, swelling of the hands and feet, dark tongue body, thin white or greasy white tongue coating, and deep, fine, or wiry-fine pulse. Treatment: Tonify Qi and activate blood circulation. Self-formulated "Buddha’s Hand Qi-Tonifying and Blood-Activating Decoction," with the following prescription: Dang Gui 30–90 grams, Chuan Xiong 7–15 grams, Huang Qi 15–30 grams, Chi Shao 9 grams, Dan Shen 12 grams, Shui Zhi 9 grams, Gan Cao 5 grams. Adjustments: For excessive sweating, add 15 grams each of calcined Long Mu or 30 grams of floating wheat; for loose stools, add 30 grams of Shan Yao. There are 44 cases in this category in our group.

(2) Yin Deficiency and Wind Movement: Symptoms include hemiplegia, numbness on one side of the body, facial deviation, slurred speech, irritability and insomnia, dizziness and tinnitus, heat in the palms and soles, red or dark-red tongue body, little or no tongue coating, and fine-wiry or fine-wiry-rapid pulse. Treatment: Nourish Yin and extinguish Wind. Self-formulated "Buddha’s Hand Yin-Nourishing Decoction," with the following prescription: Dang Gui 30 grams, Chuan Xiong 7–9 grams, Shu Di 12 grams, Bai Shao 9–15 grams, Mai Dong 10–15 grams, Yuan Shen 12–15 grams, Ju Hua 9 grams, Gou Teng 9 grams, Ma Ren 15 grams, Gan Cao 5 grams, plus adjustments.

Scars, yellow and greasy tongue coating, and wiry-rapid pulse. The syndrome belongs to Liver Depression Transforming into Heat. For Yang Deficiency and Water Overflow, use Modified Hepatitis B (Type) No. 4: Dang Shen 10 grams, Bai Zhu 10 grams, Fu Ling 12 grams, Gan Cao 6 grams, Ban Xia 6 grams, Dan Shen 30 grams, Huang Qi 30 grams, Chen Pi 6 grams, Cang Zhu 6 grams, Hou Pu 6 grams, Zhu Ling 10 grams, Ze Xie 10 grams, Gui Zhi 10 grams, Gan Jiang 6 grams, Fu Pian 6 grams, Chai Hu 10 grams, Ban Lan Gen 10 grams. Decocted in water, take one dose daily; after 20 doses, ascites disappears, abdominal distension alleviates, gum bleeding stops, and the patient’s mental state and appetite both improve significantly compared with before. Platelet count rises to 120,000 per cubic millimeter, jaundice index drops to 6 units, TFT+ +, TTT6 units, ZnT12 units, total plasma protein 2.8 grams per deciliter, globulin 3.4 grams per deciliter, electrophoresis r-globulin 20%, HBeAg(-), HBSAg 1:256, anti-HBe(+), HBV---DNA-P(+), After removing Gan Jiang and Fu Pian and continuing for another 20 doses, the condition improves further. Prescribe No. 3 granules for 40 days, and all symptoms disappear. Except for the liver, which can still be palpated 2 centimeters below the xiphoid process, there are no other abnormalities. Laboratory tests: HBSAg (one), HBeA anti-HBe(+), HB V-DNA-P(-), Total plasma protein 7.1 grams per deciliter, albumin 3.8 grams per deciliter, globulin 3.3 grams per deciliter, liver function—except for TFT+ —all other indicators are within normal range. The patient’s physical strength, mental state, and appetite are all good, and they can return to work normally. VI. Discussion

This study, comparing 429 cases of chronic hepatitis B treated with TCM syndrome differentiation versus Western medicine Hepatobiliary Recovery, demonstrates that TCM syndrome differentiation therapy is more effective than Western medicine in treating chronic hepatitis B, with statistically significant or highly significant differences in all test indicators. TCM syndrome differentiation not only shows obvious effects in eliminating hepatitis B symptoms (see Table 1) and improving liver function (see Table 2)—with an overall effective rate of around 87.5%—but also has a more pronounced effect in turning HBsAg negative (turning negative rate 39.9%), e antigen negative (turning negative rate 68.51%), and HBV---DNA---P negative (turning negative rate 56.43%). This indicates that TCM syndrome differentiation treatment for chronic hepatitis B is not merely symptomatic therapy; in essence, it treats hepatitis B at its root, fully embodying the TCM academic principle of “internal factors manifest externally” and the TCM spirit of “treating disease by addressing its root.” Chronic hepatitis B is diagnosed based on microscopic test indicators combined with hepatosplenomegaly and disease course, whereas TCM syndrome differentiation primarily focuses on another…

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From several perspectives [------]{.underline} starting with the patient's subjective symptoms, pulse condition, and tongue color—these macroscopic aspects—the same "chronic active hepatitis B" can manifest as different patterns: initial qi-yin deficiency, pathogenic factors invading Shaoyang, qi stagnation and blood stasis, or yang deficiency with water overflow. Patients with initial qi-yin deficiency generally have relatively good compensatory function of the body, with mild subjective symptoms; their primary formula, Hepatitis B No. 1, consists of herbs that tonify qi and nourish yin while clearing heat and detoxifying. Patients with pathogenic factors invading Shaoyang typically present with recent aggravation or recurrence; their primary formula, Hepatitis B No. 2, is composed of herbs that soothe the liver and harmonize the Shaoyang channel, along with clearing heat and detoxifying. Patients with qi stagnation and blood stasis often exhibit significant hepatosplenomegaly, marked liver pain, and severe liver function impairment; their primary formula, Hepatitis B No. 3, includes herbs that regulate qi and blood, nourish yin and soften the liver, and clear heat and detoxify. Patients with yang deficiency and water overflow are mostly in the stage of cirrhosis or early cirrhosis, with obvious physical weakness and prominent signs of portal hypertension; their primary formula, Hepatitis B No. 4, comprises herbs that tonify the middle jiao and benefit qi, warm yang, and promote diuresis. Clearing heat and detoxifying is a crucial therapeutic principle for chronic active hepatitis B. Herbs such as Polygonum cuspidatum, wild chrysanthemum, Artemisia capillaris, Isatis indigotica, and Solanum nigrum, which have heat-clearing and detoxifying properties, are used in patients positive for hepatitis B antigens (surface antigen, e antigen), and while improving symptoms, the surface antigen titer often decreases or even turns negative, and the e antigen frequently becomes negative as well. For patients with elevated SGPT levels, these herbs can also help bring them down. "Tonifying qi and nourishing yin" is another major therapeutic principle for chronic active hepatitis B. Herbs like Codonopsis pilosula, Atractylodes macrocephala, Astragalus membranaceus, Chinese yam, Salvia miltiorrhiza, Rehmannia glutinosa, and Paeonia lactiflora are used in patients with abnormal flocculation and turbidity tests; not only do subjective symptoms show marked improvement, but laboratory indicators also gradually improve. Traditional Chinese Medicine holds that elevated GPT levels and positivity for hepatitis B antigens are both caused by pathogenic factors, judged from the heat pattern seen in acute hepatitis B—this pathogenic factor is considered to be heat-toxin, hence the use of heat-clearing and detoxifying methods. Abnormalities in albumin and globulin, such as decreased albumin and increased globulin, fall under the category of deficiency syndromes. The Inner Canon states: "When there is deficiency, one should tonify," thus the approach of tonifying qi and nourishing yin. "Clearing heat and detoxifying" is "expelling pathogenic factors," while "tonifying qi and nourishing yin" is "supporting vital energy." In treating chronic active hepatitis B, "expelling pathogenic factors" and "supporting vital energy" should complement each other to achieve synergistic effects.