Application method of clinical guide medical records

1. Overall grasp, case analysis Although the text of the cases in the Guide to Clinical Medical Records is brief, it is not difficult to have an overall grasp of Ye's dialectical legislation and the law of prescription and drug selection for specific diseases if the similar types can be comprehensively analyzed in detail. Statistical analysis is also an important method to grasp Ye's academic experience as a whole. Some people have made a statistical analysis of the drugs in the medical records of clinical guidelines, and found that the drugs with the highest frequency of use are Poria, Ginseng, Radix Paeoniae Alba, Angelica sinensis and so on. And most of them are tonics, which shows that Ye attaches importance to the academic thought of consolidating the foundation and tonifying the deficiency. Ye's case is simple, but unique. Through the analysis of its cases, it is helpful to grasp the interest and mystery of its dialectical medication. For example, in Biography, Zhu said that "the cause of asthma syndrome is lung and deficiency is kidney", which is a high summary of the pathogenesis of asthma syndrome. The Treatise on Epidemic Febrile Diseases says that "the evil of oral and nasal inhalation first dries up in the lungs ...", which is considered as an innovative conclusion on the cause and spread of epidemic febrile diseases.

2. Pay attention to comments and extract the essence. Each door of Clinical Guide Medical Records is accompanied by comments from its owners, such as Hua Jinyun, Shao Xinfu, Zou Zijiu, Yao and Hua. These comments emphasize the characteristics of diagnosis and treatment, or discuss the methods of syndrome differentiation and treatment, which are quite pertinent and of great reference significance. For example, after the book "Vertigo Gate" was published, Hua said: "People who suffer from vertigo are not exogenous evil, but the wind of the liver and gallbladder blows on their ears, and they may even faint and fall. ..... If the fire is very serious, Mr. Wang uses antelope, gardenia, forsythia, pollen, radix scrophulariae, radix rehmanniae, cortex moutan, and mulberry leaves to clear the heat of the collaterals, which should be treated from the gallbladder first. If there is too much phlegm, it is necessary to manage Yangming and eliminate phlegm, such as bamboo juice, ginger juice, calamus, dried tangerine peel and Erchen decoction. Deficiency in the middle is combined with ginseng, and so is Fuling drink in Taiwan. Deficiency must be treated from the liver, tonifying the kidney and nourishing the liver, nourishing yin and suppressing yang, and treating the town. " In a short comment, the law of syndrome differentiation, treatment and medication of Ye's treatment of vertigo was clearly revealed in an orderly and orderly manner. In addition, Xu Ling's explanation of the fetus is also of great reference value. Xu Ling made a comprehensive and detailed study of 2424 medical records in the book, and wrote more than 260 critical opinions, more than 3600 comments and more than 80 behind-the-scenes comments, which highly affirmed and evaluated Ye's clinical experience and the essence of academic innovation, and also bluntly criticized and corrected his shortcomings or mistakes.

3. Verify the clinic and draw inferences. To truly grasp the essence of the Ye case, we must combine specific cases, practice in person, draw inferences from others and explore its essence. Pain syndrome is a common clinical disease, among which stomach pain and hypochondriac pain are the most common. Among 67 cases of stomachache and hypochondriac pain in Clinical Guide Medical Records, 37 cases were chronic pain entering collaterals. Ye believes that all pain syndromes begin with qi injuring meridians, and should be based on treating qi and regulating qi; Long-term illness is blood damage to collaterals, and treating blood and promoting blood circulation should be the first step. The treatment of collateral diseases commonly used by insects with leaves makes "blood not stagnate, but qi and blood spread", which is obviously more developed than the general method of regulating qi and promoting blood circulation, and also provides new basis and methods for the treatment of various chronic diseases. Zhang Cigong, a famous doctor in later generations, mainly treated rheumatoid arthritis with insect drugs, and Yuntieqiao treated extremely hot convulsions with Jiejing powder and calming the liver and calming the wind, all of which could not be said to have nothing to do with Ye's thought. Modern Chinese medicine has regarded the method of promoting blood circulation and dredging collaterals as an important therapeutic principle, which has been widely used in clinical departments and has always achieved satisfactory results. The theories in Clinical Guide to Medical Records, such as three strategies of dredging and supplementing strange meridians, treating deficiency and attaching importance to spleen and stomach, are all summaries of clinical experience.