Ancient Chinese medical case records serve as crucial carriers for the inheritance of traditional Chinese medicine (TCM). However, current inheritance practices face significant challenges, including low levels of digitization, inadequate research methodologies, limited exploration of tacit knowledge, the absence of standardized efficacy evaluation systems, and insufficient interdisciplinary collaboration. This study conducts an in-depth analysis of the issues and underlying causes hindering the inheritance of ancient medical case records. It explores strategies for their preservation and digitization, innovations in research methodologies, approaches to uncovering tacit knowledge, the establishment of comprehensive efficacy evaluation systems, and the enhancement of interdisciplinary cooperation and resource sharing. These findings aim to provide a theoretical foundation for advancing the effective inheritance and innovative development of ancient Chinese medical case records.
The academic experience of distinguished veteran doctors of traditional Chinese medicine (TCM) embodies thousands of years of accumulated wisdom in TCM. Although currently receiving significant attention, its inheritance remains constrained by bottlenecks such as insufficient in-depth exploration, weak application and transformation, and high disciplinary barriers. To address these issues, this paper proposes a three-dimensional upgrade path: First, ‘digging deeper’: focusing on the explication of tacit knowledge and systematization of theoretical essence, thereby consolidating the foundation of inheritance through structuralization and standardization. Second, ‘advancing to a higher level’: promoting the evidence-based transformation of veteran doctors’ experience and the construction of clinical pathways, empowering breakthroughs in difficult and complicated diseases, precision intervention, and ‘preventive treatment’ practices, thus unlocking greater clinical value. Third, ‘branching wider’ deeply integrating cutting-edge tools such as artificial intelligence, big data, multi-omics, and evidence-based medicine to solve inheritance problems through cross-disciplinary synergy. The coordinated efforts of this three-dimensional upgrade path aim to drive a triple transition in the experience of distinguished veteran doctors: from ‘personal possession’ to ‘collective wisdom’, from ‘static preservation’ to ‘dynamic application’, and from ‘empirical medicine’ to a new paradigm ‘featuring both evidence-based and precision approaches’, thereby constructing a dynamically evolving public knowledge base and providing core momentum for the inheritance, innovation, and development of TCM.
In the theory of traditional Chinese medicine (TCM), the term ‘epidemic disease’ specifically refers to diseases that are highly contagious, epidemic, and cause severe harm, which is equivalent to the concept of infectious diseases in modern medicine. Determining the nature of an epidemic disease promptly is of great significance in its diagnosis and treatment. However, the specific classification of the nature of TCM epidemic diseases remains controversial to date. This paper first introduces three classification methods for the nature of epidemic diseases: the five epidemics classification, the four seasons-five zang organs-yin yang toxin classification, and the three-category classification of cold, warm, and mixed epidemics. It points out that the nature of epidemic diseases possesses both specificity and long-term stability. Subsequently, integrating these three mainstream classification methods, this paper proposes a six-category classification of cold and warm epidemics, where in cold epidemics are subdivided into narrow-sense cold epidemics, cold-dampness epidemics, and cool-dryness epidemics; and warm epidemics are subdivided into narrow-sense warm epidemics, dampness-heat epidemics, and warm-dryness epidemics. This six-category classification is then tentatively applied to define the nature of six common infectious diseases. It is proposed that defining the nature of an epidemic disease should not rigidly adhere to a fixed disease corresponding to a fixed nature. Instead, the nature should be defined based on the differences in various influencing factors such as season, geographical region, and the type of epidemic disease. This approach may better align with objective reality and could play a significant role in the scientific understanding and timely response to emerging and sudden infectious diseases.
On the basis of systematically sorting out the developmental origins of dampness pathogen theories from ancient to modern times, this paper identifies that a clear theoretical demarcation between endogenous and exogenous dampness took shape in the late Song and early Jin dynasties. Literatures prior to the Song dynasty mainly expounded dampness centered on exogenous dampness. During the Qin and Han dynasties, dampness-induced disorders were primarily attributed to humid climates and damp living environments. From the Three Kingdoms, Wei and Jin dynasties to the Song dynasty, dampness was generally categorized as an external pathogenic factor together with wind, cold, summer-heat and other pathogens. Influenced by Neo-Confucianism, physicians of the Song, Jin and Yuan dynasties focused on exploring internal pathogenic mechanisms of diseases. LIU Wansu elaborated thoroughly on the connotation, pathogenic characteristics and therapeutic principles of endogenous dampness. Subsequently, physicians including LI Dongyuan, LUO Zhiti and ZHU Danxi successively advanced the diagnostic and therapeutic theories as well as herbal prescription regimens for differentiated treatment of exogenous and endogenous dampness. Starting from concrete observations of illnesses triggered by long-term residence in damp terrain, traditional Chinese medicine (TCM) scholars gradually extended their research to interpret the pathogenetic connotations of endogenous dampness and applied relevant theories to clinical diagnosis and treatment, which gradually perfected the theoretical system of diseases induced by damp pathogens in TCM.
Exogenous febrile disease is a general term for a class of febrile diseases. In ancient Chinese medicine, ‘typhoid fever’ ‘warm disease’ ‘epidemic disease’ ‘seasonal disease’, etc. can be attributed to the category of ‘exogenous febrile disease’. The reconstruction of the ‘exogenous febrile disease of traditional Chinese medicine’ covers hot and difficult issues such as ‘unification of cold and temperature’ and ‘relationship between Chinese and Western medicine’. This paper discusses the reconstruction of exogenous febrile disease from five aspects: the category, etiology, core pathogenesis, key elements of reconstruction of syndrome differentiation and treatment system, and basic treatment principles and methods. It is concluded that the category of exogenous febrile disease should cover all kinds of acute febrile diseases. The original ‘six evils’ etiology theory is difficult to meet the clinical needs. The core pathogenesis of exogenous febrile disease can be summarized as ‘yang depression/deficiency of vital qi→qi-heat transmission/deficiency of vital qi→closed syndrome/deficiency of vital qi→removal of syndrome/deficiency of vital qi→collateral disease/deficiency of vital qi’. The key elements of the reconstruction of the discrimination system of exogenous febrile disease include ‘stage of disease, nature of disease and location of disease’. The basic treatment principles and methods are ‘eliminating evil method’ and ‘strengthening the body resistance method’, and should run through the whole course of the disease. The method of eliminating evil can be divided into giving the evil to the way out, directly resisting the disease, and giving the evil to the way out combined with the treatment of resisting the disease.
Shennong’s Classic of Materia Medica first documented the indication of Zanthoxylum bungeanum for ‘penetrating joints, removing deadened skin-flesh, alleviating cold-damp Bi pain’. This medicinal use, however, has gradually diminished with the passage of history, and its significance has faded into obscurity. This paper presents a comprehensive survey of the term’s meaning and the historical applications of Zanthoxylum bungeanum, with related treatments classified into Bi diseases and sores and ulcers. From unearthed bamboo and silk manuscripts to handed-down prescriptions, Zanthoxylum bungeanum has been extensively utilized as a principal remedy for Bi diseases, involving heart Bi, blood Bi, and Bi in the limbs and meridians. For the treatment of sores and ulcers, it is commonly used in surgical trauma, carbuncles and scabies. Not only does it have the effect of warming yang and dissipating cold, removing dampness and relieving impediment, but it also has the function of warming the blood, detoxification parasiticide and relieving itching. The applications of Zanthoxylum bungeanum for ‘penetrating joints, removing deadened skin-flesh, alleviating cold-damp Bi pain’ have been consistently seen over the generations, with both single and compound formulas proving effective, and the flexibility in formulating with pungent, warming and dredging herbs. It has been used in various forms such as pills, powders, ointments, medicinal liquors, and can be applied both internally and externally. Under the theme of changes in the efficacy of herbs, it is necessary to reassess the preservation and decay of therapeutic effects, and to discern the lost efficacy, which is akin to the pearl submerged in the depths of the ocean.
Heart collateral disease encompasses cardiovascular diseases such as hypertension, coronary heart disease, and heart failure. Traditional Chinese medicine (TCM) methods of treatment have largely overlooked its constant spatiotemporal dynamic nature, and its diagnostic and therapeutic system remains to be improved. This paper integrates the spatiotemporal perspective with the theory of ‘three-dimensional stereoscopic network system’ to systematically analyze the spatiotemporal characteristics of heart collaterals, expounds the distinct temporal features and abnormalities in spatial structure during the progression of heart collateral disease, proposes ‘spatiotemporal unblocking of collaterals’ as the core treatment principle for heart collateral disease, and establishes specific methods of treatment: unblocking collaterals according to rhythmic temporal patterns and unblocking collaterals based on spatial sequence. Thus, it forms a spatiotemporal syndrome differentiation and treatment approach for heart collateral disease, providing theoretical guidance for its TCM diagnosis and treatment.
The first volume ‘Xuanfu theory’ of LIU Songyan’s Muke Jiejing is the first special chapter on LIU Wansu’s Xuanfu theory in ancient times. He created the ‘Sanjiao Xuanfu theory’, which takes Sanjiao as the framework, Zangfu as the core, Xuanfu as the channel, and qi, blood, water and fire as the raw materials, forming a syndrome differentiation and treatment system that combines both theory and method, bases on the whole and pays attention to the local area, providing a new idea for the diagnosis and treatment of ophthalmology. However, there is not enough attention to this in the field of traditional Chinese medicine, and there is no special article for in-depth study. This article systematically discusses the theoretical connotation and practical value of ‘Sanjiao Xuanfu theory’ from six aspects, including system construction, visual physiology, pathogenesis, treatment methods, prescription selection and medication, contraindications, in order to provide reference for the deepening of LIU Wansu’s Xuanfu theory and the clinical application of ophthalmology.
Objective: To observe the effect of moxibustion and moxa smoke on the airway inflammation in the asthmatic rats based on the p38MAPK/NLRP3/Caspase-1 signaling pathway. Methods: Seventy SD rats were randomly divided into seven groups: the blank group, the model group, the moxibustion group, the smokeless moxibustion group, the moxa smoke inhalation group, the cigarette smoke inhalation group and the dexamethasone group, with 10 rats in each group. The asthma model was induced in rats by intraperitoneal injection of ovalbumin (OVA) and aluminum hydroxide suspension for sensitization and atomization of OVA solution (excitation). The rats in the moxibustion group were treated with the gentle moxibustion on bilateral ‘Feishu’ (BL13), ‘Dazhui’ (GV14) and bilateral ‘Fengmen’ (BL12). In the smokeless moxibustion group, the generated moxa smoke was removed using a smoke exhaust machine during the moxibustion. The rats in the moxa smoke inhalation group and the cigarette smoke inhalation group were intervened with the moxa smoke and the cigarette smoke at the concentrations of 10 to 15 mg/m³, respectively. The rats in the above groups were intervened 30 min each time. The rats in the dexamethasone group were treated with the intraperitoneal injections of the dexamethasone sodium phosphate solution. The rats in the above groups were intervened once a day for 14 consecutive days. HE and PAS staining were used to assess pathological changes in lung tissues. ELISA was performed to measure the serum inflammatory factors, including the levels of interleukin (IL)-1β，IL-33，IL-13，inteferon γ (IFN）-γ. The water-soluble tetrazolium-1 (WST-1) method was employed to measure the activity of total superoxide dismutase (T-SOD), the colorimetric method was employed to detect the activity of glutathione peroxidase (GSH-Px) in the serum, and the thiobarbituric acid (TBA) method was employed to determine the level of malondialdehyde (MDA), Western Blot were used to detect the expression levels of phosphorylated p38 mitogen-activated protein kinase (p-p38MAPK), p38 mitogen-activated protein kinase, nuclear factor-κB p65 (NF-κB p65), NOD-like receptor protein 3 (NLRP3), apoptosis-associated speck-like protein (ASC), and Caspase-1 proteins in lung tissues. RT-qPCR was used to measure the expression levels of p38MAPK, NF-κB p65, NLRP3, ASC and Caspase-1 mRNA in lung tissues. Results: Compared with the model group, inflammatory cells infiltrated, goblet cells and mucus secretion were significantly decreased in the lung tissues of the moxibustion group rats, the smokeless moxibustion group rats and the dexamethasone group rats; the levels of serum IL-1β, IL-33, IL-13 and MDA were significantly decreased, while the levels of serum IFN-γ, T-SOD and GSH-Px were significantly increased (P<0.01); the protein expressions of p-p38MAPK, p38MAPK, NF-κB p65, NLRP3, ASC and Caspase-1 and the mRNA expressions of p38MAPK, NF-κB p65, NLRP3, ASC, and Caspase-1 in lung tissues were significantly down-regulated (P<0.01). Compared with the smokeless moxibustion group, the moxibustion group showed statistical significance (P<0.05). Conclusion: Moxibustion and moxa smoke may regulate the p38MAPK/NLRP3/Caspase-1 signaling pathway, thereby reducing the secretion of inflammatory cytokines IL-1β, IL-33, and IL-13, lowering MDA levels, enhancing the activity of T-SOD and GSH-Px, and inhibiting oxidative stress, ultimately ameliorating airway inflammation in asthma.
Objective: To investigate the therapeutic effects of tanshinone ⅡA (Tan ⅡA) on diabetic retinopathy (DR) and its mechanism of action. Methods：Forty C57BL/6J mice were randomly divided into control group, model group, Tan ⅡA low-dose group, and Tan ⅡA high-dose group, with 10 mice in each group. Diabetes models were induced by intraperitoneal injection of streptozotocin (STZ). Each treatment group was given Tan ⅡA at 50 or 100 mg/kg for 10 weeks of intervention. After 10 weeks of administration, fundus lesions were observed using a fundus angiography system; changes in histone H4K5 lactylation modification in mouse retinal tissues were observed by Western Blot; mRNA expression changes of vascular endothelial growth factor A (VEGFA), hypoxia-inducible factor-1α (HIF-1α), fibroblast growth factor 2 (FGF2), and vascular endothelial growth factor receptor 2 (VEGFR2) in mouse retinal tissues were observed by RT-qPCR. Human umbilical vein endothelial cells (HUVECs) were divided into control group, high-glucose group, Tan ⅡA low-dose group (Tan ⅡA-L group), and Tan ⅡA high-dose group (Tan ⅡA-H group). Each treatment group was given Tan ⅡA at 10 or 20 μmol/L and exposed to high glucose for 36 h. Changes in histone H4K5 lactylation modification in HUVECs were observed by Western Blot; mRNA expression changes of VEGFA, HIF-1α, FGF2, and VEGFR2 in HUVECs were observed by RT-qPCR; the enrichment of histone H4K5 lactylation modification at the VEGFA promoter region in HUVECs was observed by ChIP-qPCR. Results：Compared with the model group, after Tan ⅡA intervention, the number of vascular branch points was close to that of the control group, and no obvious strong fluorescence was observed, in the Tan ⅡA low-dose group and Tan ⅡA high-dose group (P<0.01); compared with the model group, after Tan IIA intervention, histone H4K5 lactylation modification was significantly reduced (P<0.01); compared with the model group, after Tan ⅡA intervention, the mRNA levels of VEGFA, HIF-1α, FGF2, and VEGFR2 in the Tan ⅡA high-dose group were significantly decreased (P<0.01); compared with the high-glucose group, after Tan ⅡA intervention, cell proliferation ability and tube formation ability were significantly decreased, in the Tan ⅡA-L group and Tan ⅡA-H group (P<0.01); compared with the high-glucose group, after Tan ⅡA intervention, the mRNA levels of VEGFA, HIF-1α, FGF2, and VEGFR2 in the Tan ⅡA-H group were significantly decreased (P<0.01); compared with the high-glucose group, Tan ⅡA significantly reduced the enrichment of histone H4K5 lactylation modification at the VEGFA promoter region in cells (P<0.01). Conclusion：Tan ⅡA may inhibit histone H4K5 lactylation modification, downregulate the transcriptional expression of VEGFA and related genes, and attenuate retinal angiogenesis as well as endothelial cell proliferation and tube formation in mice with DR.
Acute glomerulonephritis belongs to the categories of ‘acute kidney wind’ and ‘wind edema’ in the theoretical system of traditional Chinese medicine (TCM). TCM master PI Chiheng professor proposed that this disease is mainly caused by Shaoyin kidney deficiency, with external pathogens attacking the surface and dampness, turbidity, heat and toxin as the branch manifestations based on the pathological characteristics of ‘deficiency of the foundation and excess of the substance’. Its pathogenesis can be included in the six meridian syndrome differentiation system. On the basis of the theory of ‘all six meridians have exterior syndrome’ proposed by the Qing dynasty physician KE Qin, professor PI innovatively constructed a diagnostic and therapeutic framework for acute glomerulonephritis based on the six meridian exterior syndrome. Based on the clinical characteristics of this disease, the syndrome system is classified into six types: Taiyang surface syndrome combined with Shaoyin kidney deficiency, Shaoyang surface syndrome combined with Shaoyin kidney deficiency, Yangming surface syndrome combined with Shaoyin kidney deficiency, Shaoyin surface syndrome combined with dampness turbidity heat toxin, Taiyin Shaoyin combined disease combined with dampness turbidity internal accumulation, and Jueyin surface syndrome combined with lung spleen kidney deficiency. Corresponding treatment principles and methods have been established, forming a unique syndrome differentiation and treatment plan, providing new ideas for enriching the TCM diagnosis and treatment system of acute glomerulonephritis.
The thought of ‘harmony and flexibility’ is a unique academic philosophy of Yanjing XIAOs’ gynecology. Professor XIAO Chengcong, the TCM master, perfectly interpreted this philosophy in treating diminished ovarian reserve (DOR), and believed that DOR is caused by the deficiency of the kidney and the imbalance of chong meridian, which should be treated with ‘benefiting kidney and regulating chong meridian’. The article analyzes in depth how the idea ‘harmony and flexibility’ is embodied in the pathogenesis and treatment principles advocated by professor XIAO, with a view to understanding and passing on the thought of ‘harmony and flexibility’ more deeply, and providing ideas for the clinical diagnosis and treatment of DOR.
TCM master HONG Guangxiang has rich experience in the treatment of asthma and remarkable curative effect. This paper tries to analyze HONG Guangxiang’s experience in the treatment of asthma from the perspective of the theory of ‘Sanjiao qi transformation’. The upper jiao is lost in dispersing, the middle jiao is lost in recharge, the lower jiao is lost in warming, and the Sanjiao qi transformation is lost in division, resulting in defensive qi deficiency, qi-yang deficiency, and phlegm and blood stasis interwined. ‘Qi yang weakness is the main internal cause of asthma attack’, ‘phlegm and blood stasis in the lung is the root cause of asthma attack’ ‘invasion by the six exogenous pathogens is the main inducement of asthma attack’ proposed by professor HONG, which are closely related to the transformation functions of Sanjiao. Sanjiao governs various qi, and the strength of primordial qi and pectoral qi and asthma allergic constitution are also related to the function of Sanjiao transformation. Therefore, in the formulation and medication, regulating the Sanjiao qi transformation by warming the lung and dispersing cold, benefiting qi and warming yang, resolving phlegm and removing blood stasis and other methods, which embodies the idea of ‘treating lung not far from warming’.
Based on the yin-yang syndrome differentiation of the eight principles, TCM master HONG Guangxiang believed that the main pathogenesis of bronchial asthma was yin-yang imbalance, that is ‘yang being often insufficient and yin being often surplus’, which belongs to the syndrome of deficiency in essence and excess in substance, and its internal cause was the weakness of qi and yang, the persistent root was phlegm, blood stasis and yin, and the inducement was exogenous wind-cold and yin. It was pointed out that warming method was the key to treat bronchial asthma, and the treatment focused on warming yang to protect yang, warming phlegm and removing blood stasis, warming yang to dispel cold to eliminate yin, When qi and yang are warmed, they circulate, when phlegm, blood stasis, cold, and yin pathogens are warmed, they dissipate, emphasizing the importance of ‘whole-course warming method to treat asthma’, and flexibly using warming method to support yang recovering yin and yin calming down, yin is at peace and yang is compact.
Based on the theory of ‘extreme cold generating dryness’, this paper analyzes the role of cold pathogen in the pathogenesis of Sjögren syndrome associated interstitial lung disease (SS-ILD). As a yin pathogen, cold tends to damage the yang qi of the lung and spleen, leading to dysfunctional qi transformation and impaired fluid distribution, thereby generating dryness. This results in the failure of the lung to be moistened, ultimately contributing to the development of SS-ILD. Accordingly, warming yang is established as the fundamental therapeutic principle for SS-ILD in clinical practice. By warming yang to promote qi transformation and regenerate fluids, as well as warming the middle energizer and strengthening the spleen to distribute fluids, supplemented with nourishing yin, activating blood circulation, and unblocking collaterals, yang qi can be restored, and the circulation of fluids and blood normalized, thereby resolving dryness. Guided by the pathogenesis perspective of ‘extreme cold generating dryness’ and in line with the pathophysiological characteristics of the lung, this study aims to explore the correlation between cold pathogen and SS-ILD, with the goal of providing new insights for the syndrome differentiation, treatment, and further research of this disease in clinical practice.
Based on the pathological mechanism and clinical manifestations of severe asthma, this paper holds that ‘deficiency qi retention and stagnation’ is a summary of the pathogenesis characteristics of severe asthma. ‘Deficiency qi’ is the root cause of the disease, mainly involving deficiency of the lung and kidney, while ‘retention and stagnation’ is the secondary cause, attributed to latent wind and retained phlegm. The core pathogenesis is the retention and stagnation of wind and phlegm and deficiency of the lung and kidney, which runs through the entire course of severe asthma. Deficiency of the lung and kidney is the root cause, while the intermingling of wind and phlegm is the secondary cause, presenting a mixed pattern of deficiency and excess. During the acute phase, the latent pathogenic factors are triggered by external pathogens, causing the retention and stagnation of pathogenic factors to float up, with wind and phlegm attacking and obstructing the airways, leading to airway spasm. During the remission phase, the root cause of deficiency becomes apparent, with the lung and kidney deficiency, and the lingering of pathogenic factors due to deficiency. Wind and phlegm pathogenic factors continue to hide in the lung collateral. The clinical treatment advocates the principle of tonifying deficiency and promoting circulation throughout the entire course. During the acute phase, the focus is on the secondary excess symptoms, with the main goal of improving current symptoms, emphasizing the promotion of circulation. On the basis of dispelling wind, resolving phlegm, relieving spasm and asthma, tonifying the lung and kidney is also emphasized to strengthen the body’s resistance against pathogenic factors. During the remission phase, the focus is on the root cause of deficiency, with the main goal of preventing acute attacks. Emphasis is placed on the application of methods for tonifying the lung and kidney and eliminating wind and clearing up phlegm, integrating elimination within tonification. Adhering to the core pathogenesis, the dynamic evolution relationship among latent wind, old phlegm, and organ deficiency is emphasized. Medication is flexibly adjusted based on the evolution of the pathogenesis and the degree of predominance to achieve the management goals of alleviating current symptoms and reducing future risks.
Fetal epilepsy is a distinctive clinical subtype of pediatric epilepsy that is particularly challenging to treat. To date, there is still no systematic understanding of this condition within the field of traditional Chinese medicine (TCM) pediatrics. The author previously proposed that its fundamental pathogenesis is characterized by ‘heterogeneous congenital endowment with failure of essence to transform into qi’ and developed a corresponding therapeutic strategy. In recent years, our understanding of fetal-onset epilepsy has been further refined. Building upon previous work, this article further elaborates on the historical development, definition, etiology, disease localization, core pathogenesis, and therapeutic principles of fetal-onset epilepsy. From the etiological perspective, congenital abnormal endowment (primarily genetic abnormalities) constitutes the principal cause, whereas perinatal complications, infections, vaccinations, and other factors serve as triggering events. Regarding disease localization, fetal-onset epilepsy originates in the kidney, while its clinical manifestations involve all five zang organs and continue to evolve with age. In terms of pathogenesis, the fundamental mechanism may lie in a state of heterogeneous congenital endowment, resulting in an extremely deficient constitutional state of ‘subtle yin and subtle yang’. Heterogeneous congenital endowment represents the latent disease state of fetal-onset epilepsy, whereas the ultimate clinical trajectory is determined by this constitution of subtle yin and subtle yang. This constitutional state represents a pathological condition even more deficient than the physiological state of ‘immature yin and immature yang’ in children, reflecting an extreme insufficiency of both yin and yang. Clinically, deficiency syndromes predominate, whereas excess syndromes are relatively uncommon. Therefore, treatment should primarily focus on reinforcing the body’s vital qi, supplemented by the elimination of pathogenic factors. Therapeutically, tonifying the kidney and strengthening the primordial foundation serves as the cornerstone, with adjunctive strategies including strengthening the spleen, nourishing the blood, softening the liver, directing rebellious qi downward, and extinguishing endogenous wind. Established therapeutic approaches include tonifying the kidney and extinguishing wind, calming the liver while reinforcing the kidney, replenishing qi and nourishing yin, and dispelling wind while diffusing lung qi. At last, this article presents a representative clinical case to promote further research in this field.
‘Deficiency cause, cold accumulation, qi stagnation’ is derived from essentials from the Jingui Yaolue·Furen Zabing Maizheng Bingzhi, which pioneers the differentiation and treatment of female diseases based on syndrome differentiation, exerting a profound influence on later generations. By simplifying the complex classical theories, this paper explores the causes and mechanisms of endometriosis-associated infertility from perspective ‘deficiency cause, cold accumulation, qi stagnation’. It is believed that obstruction of yang qi, accumulation of yin cold, and dysfunction of the viscera is the key of the disease, while cold damage and malfunction of the triple energizer leading to qi stagnation, phlegm-dampness, and blood stasis intertwining are the external manifestations of the disease. The general principles of treatment should be to support the healthy energy, warm yang, dissipate pathological conditions, and eliminate turbid pathogens, followed by utilizing prescriptions flexibly to treat endometriosis-associated infertility in order to achieve a balance of yin and yang, regulate menstruation, and promoting fertility.
Based on the ‘five spirit viscera theory’ of Huangdi Neijing, this paper proposes the ‘Chinese medicine insomnia five spirit typing diagnosis method’, which establishes the location of the five viscera based on the direct symptoms of the patients with insomnia, this diagnostic method recognizes that the core pathogenesis of insomnia is that the five spirit (soul, spirit, mind, prana, and will) are not resting in the five organs (liver, heart, spleen, lungs, and kidneys), and the treatment should be based on the method of ‘harmonization of the five organs and resting of the five spirit’ as the outline, so as to make the five spirit resting in the five organs, then the insomnia can be restored, and the use of pairs of medicines in the light of this method of treatment has yielded good results. Among them, Cu Chaihu-Baishao, Longdan-Huangqin, Hehuanhua-Hehuanpi, Zhenzhumu-Longchi can regulate the liver and tranquilize the soul; Longyanrou-Suanzaoren, Danshen-Danggui, Fushen-Dangshen, Huanglian-Banxia can reassure the mind; Dangshen-Huangqi, Lianzi-Yizhiren can transport the spleen and store the will; Longgu-Muli, Baihe-Shengdihuang, Banxia-Chenpi can tranquilize the lungs and regulate the vitality; Shanyurou-Fuling, Yuanzhi-Fuling can replenish the kidneys and tranquilize the will.
Pruritic dermatoses are common dermatological disorders characterized by recurrent episodes of severe itching. Persistent scratching often leads to a vicious itch-scratch-itch cycle, severely impairing patients’ quality of life. Professor JIN Qifeng, a nationally renowned veteran doctor of traditional Chinese medicine with over 60 years of clinical experience, applied the principles of internal medicine to the treatment of external diseases. He believed that pruritic dermatoses were closely associated with exuberance of heart and liver fire, and advocated the therapeutic principle of ‘clearing the heart and purging the liver’ to relieve pruritus. His self-formulated Qinzao Ningyang Decoction demonstrated remarkable efficacy and embodied the principle of ‘treating different diseases with the same therapeutic method’. Professor JIN’s prescriptions were distinctive: he favored Paridis Rhizoma for calming the liver, sedating the mind, and relieving itching, and skillfully employed medicinals derived from insects and other animals to expel wind and unblock the collaterals for stubborn itch. Integrating external therapies with emotional regulation, he treated both the root cause and the manifestations, achieving notable clinical outcomes.
Professor MA Ruijie has been engaged in clinical practice, teaching, and scientific research in acupuncture for more than 20 years and has accumulated extensive clinical experience in the diagnosis and treatment of hemifacial spasm. This article summarizes her clinical experience in treating hemifacial spasm from three aspects: The syndrome differentiation approach, therapeutic characteristics, and representative clinical cases. Professor MA believes that the treatment of hemifacial spasm should be guided by the theory of meridian sinews, with acupoint selection and needling based on meridian sinew differentiation. She emphasizes differentiating the involved meridian sinews to explore deficiency and excess, attaches importance to individualized treatment according to disease, symptoms, and patient characteristics, regulates the spirit and qi with the Qiao vessels as the guiding principle, promotes collateral dredging with qi and blood as the framework, and flexibly applies the combined use of acupuncture and herbal medicine. Her diagnostic and therapeutic approach reflects the therapeutic characteristics of integrating syndrome differentiation with meridian sinew differentiation and combining acupuncture with Chinese herbal medicine, which may provide a reference for the clinical treatment of hemifacial spasm.
Frailty syndrome, characterized by reduced physiological reserve and increased vulnerability, poses a major global public health challenge. From a traditional Chinese medicine (TCM) health-management perspective, this study integrates macro-, meso-, and micro-level state parameters to enable precise identification and dynamic classification of frailty-related states. A risk early-warning model incorporating common risk factors is then developed to improve early detection of high-risk individuals and sharpen intervention targeting. Finally, an individualized closed-loop TCM health-management model centered on dynamic monitoring and follow-up is proposed. Together, these components form an integrated ‘state identification- early warning- management’ framework, providing a theoretical basis and technical pathway for precision prevention of frailty.
Exploring the key elements affecting the evolution of syndromes is beneficial for optimizing the research design of syndromes and enhancing the understanding the law of syndrome patterns. Based on the ‘three-dimensional seven essentials’ diagnostic rule in traditional Chinese medicine, this paper proposes that ‘overall review, mutual reference between Chinese and Western medicine’ and ‘combination of disease and syndrome, and unity of the dynamic and the static’ are the fundamental principles for exploring the key elements affecting the evolution of syndromes, and horizontally analyzes the influence of different aspects (including Chinese and Western medicine) and dimensions (covering diseases, patterns and syndromes) on the diagnosis and syndromes of diseases. Through discussion, we found that the elements affecting the evolution of syndromes comprise uncontrollable ones (age, physical constitution, personal life history, individual personality, medical history, complicated diseases, etc.) and adjustable ones (pathological products-induced disease causes, individual pathological states, intervention and treatment measures, disease transmission, functional axis abnormalities, etc.). The paper suggests that during clinical research, attention should be paid to balance uncontrollable elements and take adjustable factors as the starting point to explore the essence of the evolution of syndromes.
As the core carrier of the theoretical system of traditional Chinese medicine (TCM), TCM language possesses distinct cultural characteristics and unique expressive features. Its generality and abstract nature make it crucial for contemporary interpretation of TCM theories. The development of TCM language is not only the foundation and prerequisite for disciplinary construction but also a vital component in the inheritance and innovation of TCM culture. In the current era advocating for the inheritance and innovative development of TCM, it is imperative to systematically understand the characteristics and patterns of TCM language and focus on key issues in its research and development. Language research can serve as an entry point to delve into the essence of traditional scholarship, clarify disciplinary development trajectories, thereby providing theoretical support and practical guidance for advancing the modernization of TCM.
The development of consumptive disorders is associated with deficiencies in qi, blood, yin, and yang of the zang-fu organs, leading to yin and fluid depletion and failure of the eyes to be nourished and moistened. Mitochondria, as the center of cellular energy metabolism, may become dysfunctional with age, which may trigger a vicious cycle of ocular surface inflammation and oxidative stress, worsening dry eye symptoms. Drawing inspiration from the theory of ‘strengthening the middle jiao for consumptive disorders’ outlined in the Synopsis of Golden Chamber, this study integrates traditional Chinese medicine principles with modern medical insights into the role of mitochondrial dysfunction in dry eye. By elucidating the interconnection between ‘consumptive disorders-mitochondrial dysfunction-dry eye’, this work aims to explore the identical pathogenesis mechanisms of traditional Chinese and Western medicine, offering a novel direction for advancing dry eye treatment.
Diabetes and cardiovascular disease comorbidity is highly prevalent worldwide. Currently, the prevention and treatment of this comorbidity with traditional Chinese medicine (TCM) lacks high-quality clinical evidence, an evaluation system for therapeutic effects, and a digitalized and individualized management model, which has become a major bottleneck restricting the development of TCM. In response to the characteristics of this comorbidity, exploring TCM prevention and treatment plans based on the concept of ‘toxins damaging collaterals and panvascular diseases’ and digitalized management models, through interdisciplinary integration and collaboration, can form an integrated TCM prevention and treatment system of ‘theoretical guidance-evidence based optimization-comprehensive evaluation-intelligent management’, which will promote the leapfrog development of TCM.
Cerebral small vessel disease (CSVD) is a series of common clinical, imaging and pathological syndromes caused by the body’s lesions involving intracranial small/micro arteries, capillaries, small/micro veins, etc.. At present, there is still a lack of consensus on the diagnosis and treatment of CSVD with integrated Chinese and Western medicine. Hunan Academy of Chinese Medicine, Xiangya Hospital of Central South University in association with Encephalopathy Branch of Hunan Provincial Association of Chinese Medicine & Integrated Chinese and Western Medicine, Geriatric Branch of China Medical Association of Minorities has jointly established the consensus formulation group for the diagnosis and treatment of CSVD with integrated Chinese and Western medicine. The formulation group was formed to systematically retrieve relevant evidence on the diagnosis and treatment of CSVD. We have reached a consensus on the diagnosis and treatment program of integrated Chinese and Western medicine for CSVD through the Delphi method. This expert consensus provided a systematic recommendation for the diagnosis, treatment, efficacy evaluation, and prevention and nursing care of CSVD through the integrated Chinese and Western medicine, and supply a basis for the development of clinical diagnosis and treatment plans and pathway for CSVD at first time.
Abdominal Henoch-Schönlein purpura is one of the main types of allergic purpura, which is most common in children. The Guidelines for Traditional Chinese Medicine Diagnosis and Treatment of Abdominal Henoch-Schönlein Purpura in Children was established by the China Association of Chinese Medicine and led by Beijing Children’s Hospital, Capital Medical University. Based on the principle of evidence-based medicine and literature research, the opinions of clinical experts in pediatrics of traditional Chinese medicine in China were collected to jointly formulate this guideline. The content of the guideline includes definition, diagnosis, key points of syndrome differentiation, treatment, prevention and nursing, in order to provide standardized treatment strategies and methods of traditional Chinese medicine for pediatric clinical practice and promote the academic development of this disease.
Tubeimoside Ⅰ(TBMS1), a triterpenoid saponin extracted from the traditional Chinese medicine Bolbostemmatis Rhizoma, possesses a variety of pharmacological effects, including anti-inflammatory, anticancer, antioxidant, and immunomodulatory activities, etc.. As an anticancer agent, TBMS1 has demonstrated antitumor activity in various types of cancer, with mechanisms of action that include inhibiting tumor cell proliferation, suppressing invasion and migration, inducing apoptosis and autophagy in tumor cells, cell cycle arrest, reversing drug resistance, and immune modulation, among others. This review summarizes the current understanding of the anticancer mechanisms of TBMS1, providing research ideas and a theoretical basis for its clinical application in cancer treatment.
Malignant tumor is a major disease that threatens human life and health. Traditional Chinese medicine has attracted much attention in the field of malignant tumor prevention and treatment because of its multi-target, multi-pathway effects and fewer adverse reactions. Warming-yang detoxifying Chinese medicinals have the effects of warming the middle, dispelling cold, as well as anti-tumor and detoxifying properties. Modern experimental studies have found that its various active ingredients can play an anti-tumor role by inducing tumor cell apoptosis, inhibiting tumor cell proliferation, inhibiting tumor angiogenesis, regulating body immunity, and reversing tumor cell resistance. This article systematically reviews domestic and international literature to summarize the mechanism characteristics of warming-yang detoxifying Chinese medicinals in anti-tumor therapy, aiming to provide new insights for tumor prevention, treatment and new drug development.
Compound Fresh Bamboo Drainage Liquid has the effect of clearing heat and dissolving phlegm and relieving cough. Clinically, it is often used to treat phlegm, fever and cough, and sputum yellow viscosity. However, at present, there is little basic research on its pharmacological mechanism and medicinal substances, and the quality control is not comprehensive. Based on the research progress concerning the chemical composition and pharmacological effects of Compound Fresh Bamboo Drainage Liquid, this paper employs the quality marker (Q-Marker) theory to conduct a predictive analysis of its Q-Markers from five perspectives. The results showed that (+)-Lyoniresinol 9’-O-glucoside, guaiacol, vanillin, vanillic acid, alpha-terpineol, decanoylacetaldehyde, baicalein, acacetin, platycodin D, oleanic acid, DL-menthol, alpha-farnesene, 6-gingerol can be used as Q-Marker of Compound Fresh Bamboo Drainage Liquid, which provides reference for the improvement of the quality standard of compound fresh bamboo drainage and the establishment of the whole process quality traceability system.
Idiopathic membranous nephropathy (IMN) is the common cause of nephrotic syndrome, with approximately one-third of patients progressing slowly to end-stage renal disease. At present, IMN treatment includes supportive therapy, immunosuppressive therapy, and research-based targeted therapy, but their clinical application is often limited by frequent adverse reactions, high recurrence rates, and substantial economic costs. Based on the understanding of IMN by modern physicians, this review constructs the pathogenesis network of ‘deficiency-dampness-wind-blood stasis’ with ‘deficiency-centered, dampness as manifestation, wind as change, blood stasis as damage’, classifies traditional Chinese medicine compounds with ‘tonifying and replenishing spleen and kidney, strengthening healthy qi and removing dampness, distributing the body fluid and blood stasis, dispelling wind and dredging collaterals’, and summarizes their clinical efficacy and experimental mechanism, in order to provide ideas and references for the treatment of IMN with traditional Chinese medicine.
Neurological disorders impose a mounting burden, spatiotemporal heterogeneity between lesion and function, phenotypes dependent on high-dimensional signals, and non-uniform evidence standards constrain precise subtyping and individualized decisions under conventional care. Artificial intelligence (AI) opens methodological and engineering avenues for integrating traditional Chinese medicine (TCM): multimodal fusion of imaging, speech and gait, wearable physiological signals, and clinical text to drive objectification of syndrome differentiation, risk stratification, prognosis and efficacy evaluation, and closed-loop individualized interventions; taking the knowledge of ‘syndrome-treatment-formula’ as the core, it relies on knowledge graphs, causal reasoning and graph learning to realize interpretable decision support. In terms of clinical translation, it promotes the coordinated progress of data standardization and governance, external validation, real-world research, privacy protection and edge deployment. This review synthesizes progress and key challenges across TCM neurology, and proposes a fusion paradigm centered on computable TCM priors to build verifiable, transferable intelligent diagnostic-therapeutic systems that strengthen the evidential basis and accessibility of TCM in neurological care.
Quantifying acupuncture manipulation is pivotal for the modernization and standardization of acupuncture practice. This study synthesizes research progress over the past decade on the quantification of acupuncture techniques and their dose-effect relationships, with a focus on core manipulations such as lifting-thrusting and twirling-rotating. Key parameters, including needle insertion depth, manipulation frequency, needle retention time, and treatment interval, were statistically analyzed to evaluate their influence on therapeutic outcomes and to elucidate the correlation between acupuncture manipulation and clinical efficacy. Analysis reveals that, within defined limits, greater insertion depth, higher manipulation frequency, and prolonged retention time are each positively correlated with clinical efficacy. These findings elucidate the dose-effect relationship between manipulation parameters and therapeutic outcomes, offering theoretical insights for optimizing clinical practice and providing a quantitative framework for future research on acupuncture techniques.
Intestinal flora is involved in nutrient absorption, immunity, and metabolism of the human body through intestinal barrier immunity, secretion of metabolites, and so on, which are intimately related to the development of diseases. Intestinal flora is also one of the substance vectors and centers where moxibustion acts on the organism. By systematically searching and combing the Chinese and English databases in the past 10 years, this study found that moxibustion could play a curative role in multiple systemic diseases by regulating the intestinal flora, and its mechanism may be related to the modulation of flora diversity, the suppression of inflammatory factors, the activation of intestinal mucosal immunity, the ‘brain-intestinal axis’, and the ‘lung-intestinal axis’, among other things. This paper sums up the progress of research on the mechanism of moxibustion regulating intestinal flora in treating diseases from different systems, intending to provide the thoughts and information for the study of the mechanism of moxibustion in preventing and treating the diseases in respective systems.
Cancer has become a significant global health challenge, with its incidence and mortality rates continuously increasing. Traditional treatment methods are fraught with numerous limitations, prompting the search for new therapeutic strategies. In recent years, the gut microbiota and health have become the focus of attention, especially its relationship with cancer. Imbalances in the gut microbiota are associated with various types of cancer, influencing tumor progression through pathways such as inflammation induction, immune modulation, and metabolic alterations. Traditional Chinese medicine (TCM), primarily administered orally, interacts with the gut microbiota and demonstrates potential anti-tumor benefits. TCM components and compound formulas can modulate the composition of the microbiota, increase beneficial bacteria, reduce pathogenic bacteria, and affect metabolites, thereby enhancing immune function and barrier integrity. Although research on the anti-tumor effects of TCM through the modulation of the gut microbiota is still in its infancy, with technological advancements and in-depth studies, it is expected that the underlying mechanisms will be unveiled. Therefore, understanding the relationship between the gut microbiota and cancer, as well as the regulatory mechanisms of TCM, can provide new strategies for the prevention and treatment of cancer in the future.
Objective: To investigate the therapeutic effect of shikonin on psoriasis. This study examined its impact on keratinocyte viability and cell cycle under psoriatic pathological conditions through in vitro experiments, and explored the potential underlying mechanisms. Methods: The CCK-8 assay was used to evaluate the effects of shikonin at concentrations of 0, 1, 3, 5, 10, 20, 40, and 80 μmol/L on the growth of keratinocytes. Flow cytometry was employed to analyze cell cycle distribution and apoptosis rate. Western Blot was used to detect the protein expression levels of PI3K, AKT, phosphorylated AKT (P-AKT), and mTOR. Results: Shikonin effectively inhibited IL-17-induced proliferation of HaCaT cells (P<0.01). At a concentration of 10 μmol/L, shikonin arrested the cell cycle of HaCaT cells at the G0/G1 phase. It also downregulated the expression of AKT, P-AKT, and mTOR proteins (P<0.05, P<0.01). Conclusion: Shikonin exhibits therapeutic potential in an in vitro model of psoriasis, and its mechanism of action may be related to the regulation of the PI3K/AKT/mTOR signaling pathway.
Objective: To investigate the effects of Xiaoyao Powder on histamine receptors in gastrointestinal tissue (H1R, H2R, H3R, H4R) in depression rats with liver depression and spleen deficiency syndrome. Methods: Seventy-two male SD rats were randomly divided into six groups (n=12): normal, model, Fluoxetine, and Xiaoyao Powder high-, medium-, and low-dose groups. Except for the normal group, all groups underwent a 42-day chronic unpredictable mild stress protocol. During modeling, drug groups received intragastric administration of drugs at corresponding doses (adjusted by body weight), while the normal and model groups received equal volumes of normal saline, once daily. Gastrointestinal motility was assessed via carbon powder propulsion. Pathological changes in gastric and colonic tissues were evaluated using HE staining. RT-qPCR and Western Blot were performed to quantify mRNA and protein expression of H1R, H2R, H3R and H4R in gastric and colonic tissues. Results: Compared with the normal group, the model group exhibited significantly reduced gastric emptying and intestinal propulsion rates (P<0.01), pathological necrosis of epithelial cells, glandular atrophy, and inflammatory infiltration in gastric and colonic tissues, gastric H1R, H2R, H4R mRNA and protein levels were downregulated (P<0.01), while colonic H1R, H3R mRNA and protein were downregulated (P<0.01, P<0.05), and H2R, H4R mRNA and protein were upregulated (P<0.01). Compared with the model group, gastric emptying and intestinal propulsion rates were increased (P<0.01), the gastrointestinal motility, gland atrophy and inflammatory cell infiltration in gastrointestinal tissues of rats in the high-, medium- and low-dose Xiaoyao Powder groups were all improved. In gastric tissues, the mRNA and protein expressions of H4R were significantly up-regulated in the high-dose Xiaoyao Powder group (P<0.01); the mRNA and protein expressions of H2R were markedly down-regulated, while those of H4R were remarkably elevated in the medium-dose group (P<0.01, P<0.05); the mRNA and protein levels of H1R, H2R, H3R and H4R were significantly increased in the low-dose group (P<0.01, P<0.05). In colonic tissues, the mRNA and protein expressions of H2R and H4R were significantly down-regulated (P<0.01), whereas H3R was markedly increased in the high-dose group (P<0.01); the mRNA and protein levels of H1R were significantly up-regulated and H3R were notably reduced in the medium-dose group (P<0.01, P<0.05); the mRNA and protein expressions of H1R and H3R were markedly elevated, while H2R and H4R were significantly decreased in the low-dose group (P<0.01, P<0.05). Conclusion: Xiaoyao Powder exerts therapeutic effects on rats with depression of liver stagnation and spleen deficiency syndrome, and its underlying mechanism may be related to regulating the expression levels of gastrointestinal histamine receptors H1R, H2R, H3R and H4R. Among all doses, low-dose Xiaoyao Powder achieves a more balanced regulatory effect on gastrointestinal histamine receptors.
Objective: To study the compounds of Ephedra equisetina Bunge. stems and their anti-asthmatic activities. Methods: The compounds were separated and purified on the basis of a variety of column chromatography techniques and preparative HPLC. Their structures were identified by mass spectrometry and nuclear magnetic resonance spectroscopy, anti-asthmatic activity were assessed through bioassays. Results: Thirty-seven compounds were isolated from Ephedra equisetina stems and identified as 7-O-methylherbacetin-3-α-rhamnoside (1), kaempferol (2), kaempferol-3-O-a-L-rhamnoside (3), kaempferol-3-O-(6''-acetyl)-β-glucopyranoside (4), kaempferol-3-O-(3-acetyl)-β-glucopyranoside (5), rhamnazin-3-O-β-D-glucopyranoside (6), isorhamnetin-3-O-(6''-acetyl)-β-D-glucopyranoside (7), 8-methoxyl-kaempferol-7-O-rhamnoside (8), kaempferide-3-O-β-D-glucoside (9), ephedroside C (10), kaempferol-3-O-a-L-(4''E-p-coumaroyl)-rhamnoside (11), limocitrin-3-O-β-D-glucoside (12), tamarixetin-3-O-β-D-glucopyranoside (13), isorhamnetin-3-O-β-D-glucopyranoside (14), sexangularetin-3-O-β-D-glucopyranoside (15), ephedroside B (16), kaempferol-3-O-(4''-cis-p-coumaroyl)-α-rhamnopyranoside (17), kaempferol-8-O-β-D-glucopyranoside(18), (+)-catechin (19), (-)-epicatechin (20), (-)-epiafzelechin (21), (-)-catechin (22), syringaresinol (23), magnolin (24), eudesmin (25), lirioresinol B dimethyl ether (26), lirioresinol A (27), epimagnolin (28), salicifoliol (29), eplignan A (30), yunnanensin A (31), secoisolariciresinol (32), lyoniresinol (33), 4-O-methylcedrusin (34), ceplignan (35), spicatolignan (36), 5, 5'-dimethoxy-7-oxolariciresinol (37). Conclusion: Among them, compounds 1-22 were isolated from Ephedra equisetina for the first time. The results of the anti-asthma activities showed that compounds 2, 17, 22, 23, 26, 28, 30, 34-36 may possess potential anti-asthmatic activities.
Objective: To investigate the clinical characteristics and distribution pattern of traditional Chinese medicine (TCM) evidence patterns of systemic lupus erythematosus (SLE) complicated with dyslipidemia. Methods: A total of 428 patients with SLE treated at The Second Affiliated Hospital of Zhejiang Chinese Medical University from September 2021 to December 2023 were included. They were divided into a normal lipid group and a dyslipidemia group (214 cases in each group). The clinical characteristics, distribution patterns of TCM syndrome, and their relationship with dyslipidemia were retrospectively analyzed. Results: SLE patients with dyslipidemia more frequently showed symptoms including hypothermia and cold limb, decreased appetite, loose stool, fatigue, edema, proteinuria, foamy urine, abdominal distension, heavy body, thin putty and thick greasy, and astringent pulse (P<0.01, P<0.05). Additionally, their complement C3 was lower (P<0.01) while the hemoglobin level and SLEDAI score were higher (P<0.05, P<0.01). Multivariate analysis identified low complement C3, high SLEDAI score, cold limbs, loose stool, foamy urine, edema were independent risk factors for SLE complicated with dyslipidemia (P<0.01, P<0.05). TCM syndrome distribution differed significantly between the two groups (P<0.05). The SLE group was primarily characterized by syndrome of yin deficiency and internal heat (83/214, 38.79%), while the SLE combined with dyslipidemia group mainly showed yang deficiency and dampness pathogen syndrome (81/214, 37.85%). Conclusion: SLE patients with yang deficiency and dampness pathogen syndrome are more prone to dyslipidemia. The risk of dyslipidemia increases in SLE patients who present with low complement C3, high SLEDAI score, hypothermia and cold limb, loose stool, foamy urine, and edema, which can guide clinical prevention and treatment of the disease.
Objective: To explore the clinical common syndromes and their distribution patterns in patients with non-small cell lung cancer (NSCLC), providing references for traditional Chinese medicine diagnosis and treatment, and laying the foundation for the establishment of diagnostic criteria for NSCLC syndromes. Methods: Based on clinical data of 2 016 NSCLC patients combined with 27 expert consultation questionnaires, descriptive statistics, cluster analysis, latent structure models, and chi-square tests were used to identify common syndromes and their distribution differences across different TNM stages, treatment modalities, and pathological types. Results: The common syndromes of NSCLC included eight types: lung-qi deficiency syndrome, lung-dryness due to yin deficiency syndrome, lung-qi and yin deficiency syndrome, lung-spleen qi deficiency syndrome, lung-kidney qi deficiency syndrome, phlegm-damp obstructing lung syndrome, phlegm-heat obstructing lung syndrome, and lung collateral stasis syndrome. Some common syndromes showed distribution differences across different TNM stages, treatment modalities, and pathological types (P<0.01, P<0.05). Conclusion: Patients with NSCLC mainly manifest five deficiency syndromes and three excess syndromes in clinical practice. The distribution of these syndromes varies across different TNM stages and treatment modalities. Elucidating such distribution patterns facilitates the synergistic application of integrated traditional Chinese and Western medicine.
Objective: To analyze the efficacy of Yifei-Sanjie Pills combined with epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) in the treatment of advanced non-small cell lung cancer (NSCLC) based on real-world data. Methods: Clinical data of patients with advanced NSCLC treated with EGFR-TKI combined with Yifei-Sanjie Pills at the First Affiliated Hospital of Guangzhou University of Chinese Medicine from September 2019 to April 2023 were retrospectively analyzed. Overall survival (OS) was taken as the primary endpoint of the study. The Kaplan-Meier method was used to draw survival curves to explore the survival benefit of patients, and the COX proportional hazards model was constructed to explore the influencing factors of OS. Results: A total of 177 patients were included. As of the last follow-up on 2023-11-12, 58 patients met a death event, and the mOS for the whole cohort was 54 months (95%CI[41, 84]. Significant differences in survival curves were observed among different mutations of EGFR (P=0.011) and across different generations of EGFR-TKI (P=0.032). COX analyses suggested that the age (HR=1.03, 95%CI[1.01, 1.06], P=0.009), EGFR L858R mutation (HR=3.43, 95%CI[1.50, 7.82], P=0.003), and combination of 2nd-generation EGFR-TKI (HR=2.55, 95%CI[1.08, 6.02], P=0.032) were associated with poorer prognosis, but potential confounding factors need to be considered. Conclusion: The combination therapy of Yifei-Sanjie Pills with EGFR-TKIs demonstrated survival benefits in advanced NSCLC, further enhancing the therapeutic efficacy of EGFR-TKIs.
Objective: Based on the theories of traditional Chinese medicine (TCM), this study aims to innovate a new design paradigm for intelligent TCM design systems, and construct an intelligent TCM design system driven by the ‘syndrome element+medicinal property combination mode’. The system is expected to provide scientific support for revealing TCM compatibility rules, facilitating new drug development, and formulating dietary therapy products. Methods: First, based on classic TCM works and relevant literature, standardized classification of syndrome elements for common diseases was conducted and a corresponding database was established. Knowledge bases were then constructed using data annotation, entity relationship extraction, and data mining techniques. Next, the basic properties and compatibility rules of TCMs in the knowledge bases were integrated to build the medicinal property combination modes suitable for different syndrome elements, with the establishment of corresponding entity relationships. Finally, programming was performed to design and test the intelligent TCM system. Results: This study proposed a novel design of ‘syndrome element+medicinal property combination mode’ and successfully constructed an intelligent TCM system based on this design. The system encompasses core data including 3 037 common syndromes, 41 syndrome elements, 605 TCMs, and 1 582 medicinal property combination relationships. The matching accuracy of the medicinal property combination mode reaches 90%, which aligns with the core requirements of TCM theories and provides insights for other new compounds. Conclusion: The ‘syndrome element+medicinal property combination mode’ design model can provide reference and support for the development and design of TCM analysis and formulation systems. The intelligent TCM design system based on this design model is expected to realize the compatibility of other new materials through the medicinal property combination mode, thereby achieving innovations in drug compatibility.
Glue drug originated from the application of ‘glue’ in ancient production and life. It can be divided into three categories: animal glue drug, plant glue drug and mineral glue drug. Moreover, its preparation technology has drawn mutual references with Taoist alchemy. During clinical treatment, through the processing and reasonable compatibility of glue drug, the multiple properties of glue drug, such as tenacity, lubricity and viscosity, are skillfully used to make it play a role in surgery, orthopedics, internal medicine, gynecology, pediatrics and andrology. In addition, glue drug can also be used as excipients for dosage forms such as pills and ointments, which broadens the administration routes for treating diseases in both internal and external medicine.
Objective: To explore the clinical application of the ‘form-qi-shen’ integration theory based on lumbar and back myofascial inflammation and provide theoretical support for systematic Chinese medicine diagnosis and treatment. Methods: A database of 361 patients with lumbar and back myofascial inflammation was established. Descriptive statistics and association rule analysis were performed using R software to investigate the clinical relevance of form, qi and shen. Results: The majority of patients were aged between 30 and 69 years. Common comorbidities included insomnia, anxiety, and constipation, indicating that physical symptoms coexisted with emotional and mental issues. The highest incidence was observed during the periods of the Fifth qi, Jueyin Wind-Wood, Fourth Yun, and Taiyin Damp Earth, suggesting a close relationship between the disease and the changes in the five movements and six qi. Association rule analysis showed that poor emotional state was more likely to be accompanied by poor sleep, irritability, dizziness, and fatigue, reflecting the mutual influence of form, qi and shen in the disease process. Conclusion: Addressing the patient’s physical, emotional, and mental state is crucial for improving treatment outcomes. Seasonal and climatic changes significantly impact the disease, highlighting the dynamic interaction of form, qi and shen in pathological states.
This article explores the internal elements necessary for establishing empirical disciplines such as traditional Chinese medicine (TCM) as scientific disciplines. From the three dimensions of science, health, and civilization, and integrating the literature on the history of science, the nature of science, and the characteristics of TCM, it is found that: it is possible to introduce Qi ontology into the modern scientific paradigm and establish the Chinese scientific paradigm, i.e., Qi-based scientific paradigm. One can define the research object of TCM as the whole process of regulating internal Qi and producing therapeutic effects by TCM therapies. The scientific existence and researchability of the research object of TCM give rise to the universal scientific hypothesis based on Qi ontology, and hence, the universal hypotheses of TCM, acupuncture and medical Qigong are proposed. If they pass the test of repeatability, uncertainty, and predictability together with empirical evidence, the hypotheses are upgraded to universal theories, and it can be considered then that the scientific disciplines of TCM, acupuncture, and medical Qigong have been established.
The YUs’ Orthopedics School in Longyan, Fujian originated in the late Qing Dynasty, possessing a profound foundation and a unique inheritance lineage. Historically, injuries caused by labor were frequent in the Longyan area, and there were abundant resources of traditional Chinese medicine. Against this backdrop, the YU family became an important representative of the orthopedics schools. Passed down through several generations, the predecessors have accumulated sophisticated experiences in tendon-regulating, reduction manipulation and the application of characteristic medications for orthopedic injuries. Particularly remarkable is that the YUs’ School has formed a systematic academic thought in the treatment of bi disease. Under the guidance of the academic thought that ‘the bi disease is attributed to the liver and kidneys’, remarkable curative effects have been achieved through external treatments, medications and so on. Sorting out its inheritance lineage and the overview of academic thoughts on bi-syndrome is of great significance for in-depth exploration of traditional orthopedic medicine and inheritance and promotion of the characteristic diagnosis and treatment wisdom of the YUs’ School.
The research conducted on meridian literature unearthed from Han tombs. It compares the theories of the twelve meridians in Huangdi Neijing with the meridian literature found in bamboo and silk manuscripts, as well as the meridian lines depicted on lacquered human figures from the Tianhui Han Tomb. The comparison focuses on three aspects: the distribution of yang meridians on the exterior, the distribution of yin meridians on the interior, and the convergence of yang meridians at the head. The study finds that the latter (bamboo and silk manuscript meridian theories) provide a better explanation for certain passages in Huangdi Neijing, such as the theory of the Suwen · Yinyang Lihe Lun and Lingshu · Weiqi Xing. Based on this, it suggests that the meridian records in the bamboo and silk manuscripts should be viewed from a theoretical perspective, and emphasizes the supplementary role of the meridian depictions on lacquered human figures in the meridian theory found in bamboo and silk manuscripts.
In view of the greatest controversy over the original meaning of ‘the disease of the two yang organs originates from the heart and spleen. There is an inability to have sexual intercourse, and in women, there is amenorrhea’ in Plain Questions · Chapter on Yin-Yang Distinction throughout history, this paper aims to restore the original meaning of the scripture through collation and annotation. By comparing the annotations of medical scholars in successive dynasties, referring to both ancient and modern literature, and cross-referring to the context within the same language environment, and comprehensively applying the theoretical research methods of traditional Chinese medicine literature, this paper explores the origin and discerns the right from the wrong. The research shows that ‘the disease of the two yang organs’ refers to the disease of the Yangming meridian; ‘the heart and spleen’ remain in their original form; ‘inability to have sexual intercourse’ refers to impotence; ‘inability to have sexual intercourse’ and ‘amenorrhea in women’ are in a parallel relationship, both belonging to the diseases caused by the Yangming meridian disease or related zang-fu organs. The original meaning of the scripture should be interpreted as: ‘the disease of the Yangming meridian is caused by the damage to the heart and spleen, manifested as impotence in men and amenorrhea in women.’ Later medical scholars’ association with kidney wind (wind-stroke in the kidney), bone exhaustion, and wind-consumption is the result of the expansion and extension of the scripture, which is unrelated to the original meaning of the classic text.
Objective: To investigate the effects of the treatment frequency of warm needle transmucosal method on the clinical efficacy of knee osteoarthritis (KOA) and on musculoskeletal ultrasound. Methods: Seventy-eight patients with KOA who met the criteria in the Department of Acupuncture-Moxibustion of Third Affiliated Hospital of Henan University of TCM from December 2022 to December 2023 were randomly divided into the group of 5 times per week (39 cases, 3 cases of shedding) and the group of 3 times per week (39 cases, 2 cases of shedding and 1 case of exclusion). Both groups were treated with warm-needle translucency moxibustion, given the same acupoints and maneuvers, 5 times per week in the 5 times per week group and 3 times per week in the 3 times per week group, and both groups were treated continuously for 4 weeks. Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) and visual analogue score (VAS) of pain were observed in the two groups before treatment and after 2 and 4 weeks of treatment; the musculoskeletal ultrasound scores were compared before treatment and after 4 weeks of treatment, and the clinical efficacy and safety of the two groups were evaluated after 4 weeks of treatment. Results: Compared to the group of 3 times per week, the group of 5 times per week showed significantly lower WOMAC scores, VAS scores, synovial thickness (P<0.05), and reduced joint effusion after treatment (P<0.05). Conclusion: The clinical effect of 5 times per week of warm acupuncture and moxibustion treatment for KOA is better than 3 times per week, which is worth to be promoted in the clinic, and the safety is better.
