Therapeutic efficacy serves as the fundamental driving force for the sustainable development of traditional Chinese medicine (TCM). Syndrome differentiation and treatment is the prerequisite for TCM to exert its therapeutic effects, and syndromes are the core of both syndrome differentiation and clinical diagnosis and treatment. Therefore, evaluating the therapeutic effects of syndromes is one of the key points and difficulties in promoting the high-quality development of TCM. Prospective cohort studies represent one of the research design methods for evaluating the clinical therapeutic effects of TCM, offering unique advantages for evaluating the therapeutic effects of TCM syndromes dominated by syndrome differentiation and treatment. However, there are numerous methodological issues in practical research, and it is easy to confuse this design with randomized controlled trials. Therefore, this article explores the differences between the two research designs. By combining the practical application of prospective cohort studies in syndrome therapeutic research, we sort out the key links in the research process and provide suggestions, aiming to bring more inspiration to TCM syndrome therapeutic research.
The abundant unearthed medical documents on bamboo and silk from the Pre-Qin and Han dynasties provide precious materials for studying the development of early traditional Chinese medicine. Research on medicinal materials in these texts is of great significance for analyzing early perceptions of medicine, medical practices, and cultural connotations. This paper reviews and reflects on the current status of research on medicinal materials in bamboo and silk, proposing five future research directions: data mining, multidisciplinary research, medicinal literature comparison, relationship between medicinal materials and prescriptions, and modern application and value transformation. The aim is to expand research perspectives, and construct a three-dimensional, in-depth, and scientific research framework for medicinal materials in Pre-Qin and Han dynasties bamboo and silk manuscripts.
Multiple chronic conditions (MCCs) have become the new normal of endangering people’s health. Its complex, diverse and changeable characteristics have brought severe challenges to clinical diagnosis and treatment. Based on the holistic view, differentiation of pathogenesis, treatment and prevention of disease, TCM has unique advantages in the prevention and treatment of MCCs. The holistic view follows the unity of man and nature, society and their own integrity, and emphasizes the treatment method of ‘heterozygous treatment’ in view of the complex body state; Differentiation of pathogenesis and treatment, exploration of complex pathogenesis, and realization of ‘simultaneous treatment of different diseases’; Prevention is the priority of preventive treatment, which can regulate the body state and reduce the occurrence and recurrence of disease. Finally, some practical paths such as strengthening high-quality evidence-based research, building a digital management platform, and exploring a new model of health management are further proposed, in order to provide effective assistance for the diagnosis, treatment and management of MCCs.
In recent years, the incidence of psychiatric and neurological disorders has been on the rise, and the theory of Shen in traditional Chinese medicine (TCM) has regained extensive academic attention. As the cornerstone of the TCM theoretical system, Huangdi Neijing integrates profound philosophical connotations into its elaboration of Shen. This paper conducts a systematic and in-depth analysis of the descriptions related to Shen in Huangdi Neijing, and broadly categorizes Shen into three broad categories: the Shen of nature, the Shen of the human body, and the Shen of psyche. On this basis, it summarizes the Shen consciousness system, which uses the essence of the spleen and kidney as its material foundation, the Hun of the liver and the Po of the lung as its functional manifestation, and the Shen residing in the heart as its governing core. This paper further expounds the guiding role of this system in evaluating life status, revealing the rhythm of life, and guiding clinical diagnosis and treatment, and proposes a syndrome differentiation system with the core framework of ‘substance-Shen-appearance-brilliance’. This study aims to make concrete the profound and abstract concept of Shen, so as to better guide clinical syndrome differentiation and treatment, and promote in-depth research and discussion on the theory of Shen.
Jing, as one of the basic substances that constitutes and sustains life, its association with the attributes of yin and yang began in Huangdi Neijing. Yin-Jing and yang-Jing, two opposing and unified images in a whole, have not been clearly defined by medical practitioners throughout the ages, and the meanings symbolized by yin-Jing and yang-Jing have not been standardized. Through theoretical research and medical literature, the article discusses the classification, generation and transformation of Jing and its functional connotation, and explores the intrinsic connection between yin-yang theory and Jing, thus clarifying the definition and application of yin-Jing and yang-Jing, with a view to benefiting the relevant theoretical research and clinical practice.
ZHANG Zhongjing’s Jingui Yaolue advocated the principle of ‘deficiency-excess correspondence’, clarifying the dialectical relationship between deficiency of healthy qi and excess of pathogenic factors, which is particularly consistent with the pathogenesis and progression of malignant tumors. Based on this theory, this article discusses the therapeutic strategies for malignant tumors at the stage of excess syndrome, strengthening healthy qi and consolidating the root in the deficiency stage, and applying both attacking and tonifying methods in the stage of mixed deficiency and excess. In view of the marked depletion of healthy qi after modern radiotherapy and chemotherapy, the role of traditional Chinese medicine in regulating the spleen and stomach, restoring vitality, strengthening healthy qi, and eliminating pathogenic factors are discussed, and the clinical application of the principle of deficiency-excess correspondence in enhancing immunity and preventing recurrence is analyzed. Through the integration of classical theory and modern medicine, the unique advantages and practical value of the therapeutic principle of deficiency-excess correspondence in cancer treatment are highlighted.
Allergic purpura is a common vasculitis disease in childhood. Based on the ‘disease differentiation-constitution differentiation-syndrome differentiation’ diagnostic and therapeutic model, this article integrates disease, constitution, and syndrome in the management of allergic purpura in children, aiming to identify the patterns of disease evolution, clarify the characteristics of constitution, and determine syndrome-based treatment and prescriptions. It is concluded that the core pathogenesis of allergic purpura in children includes insecurity of the fundamental shield, inherent intolerance, invasion by external pathogens, and lingering difficulty in recovery. Treatment should be staged based on the comprehensive consideration of disease, constitution, and syndrome. In the acute stage, priority is given to ‘syndrome differentiation’, while on the basis of disease differentiation and constitution differentiation, adopting methods such as dispelling wind to stabilize the constitution, clearing heat to regulate the constitution, eliminating dampness to strengthen the constitution, supplementing qi to tonify the constitution, and nourishing yin to nurture the constitution. In the remission stage, priority is given to ‘constitution regulation’, while on the basis of syndrome differentiation and disease identification, carrying out constitutional care and protection to prevent recurrence.
To study and apply the theory of five evolutive phases and six climatic factors, one must first identify the year and its constant patterns of qi transformation. The standard configuration pattern of the five evolutive phases and six climatic factors is the foundation for mastering this system. In clinical practice, when examining patients’ constitution and condition through the lens of five evolutive phases and six climatic factors, key considerations include: the five evolutive phases and six climatic factors pattern at their birth year, the pattern at the time of consultation, and the pattern at the onset of their initial illness. These analyses involve both constants and variations, all grounded in a thorough understanding of the standard configuration pattern of the relevant year’s five evolutive phases and six climatic factors. For five evolutive phases, the annual qi movement should be primarily examined; for six climatic factors, dominant qi, guest qi, and their interaction are the focuses, with special attention to celestial control and terrestrial effect of the guest qi. The procedures for analyzing the standard configuration pattern for a patient’s innate constitution are as follows: ①Determine the heavenly stem by the last digit of the birth year, and the earthly branch by the birth year’s zodiac sign. ②The ten heavenly stems govern the five evolutive phases to determine the annual qi movement. ③The dominant qi remains unchanged yearly, cycling through six phases in sequence: wood, fire, fire, earth, metal and water. ④Twelve earthly branches mark the six guest qi phases to determine celestial control. The six guest qi follows the ‘one-two-three-one-two-three’ yin-yang sequence, rotating clockwise based on celestial control. ⑤Each of the year’s six phases features guest qi superimposed on dominant qi, forming their interaction. The same logic applies to analyzing any year’s standard configuration pattern. Accordingly, the core principle of applying five evolutive phases and six climatic factors in clinic is to observe manifestations to recognize qi; and to know the constants to comprehend change.
Objective:To observe the effects of Tuina Huantiao (GB30) on rats with lumbar disc herniation (LDH) and its anti-inflammatory and analgesic effect mechanism. Methods: A total of 20 clean-grade male SD rats were randomly divided into four groups: sham operation group, blank group, Tuina group, and model group, with 5 rats in each group. The model group was prepared by exposing the L4 and L5 intervertebral foramina through an incision in the right spinal skin and muscle and implanting a sterile L-shaped stainless steel rod to induce LDH. After successful modeling, the rats were housed for three days. On the fourth day, the Tuina group received Tuina therapy at the right Huantiao (GB30) for 15 minutes using a custom-made rat restraint, while the model group was restrained without Tuina therapy. The sham operation group had their skin and muscle incised and then sutured without any further intervention, and the blank group received no intervention. The changes in paw withdrawal threshold (PWT) and paw withdrawal latency (PWL) were recorded in rats in each group 1 day before modelling and 4, 6, 8, 10, 13 and 17 days after surgery. After Tuina, HE staining was performed on the L4 and L5 intervertebral discs of each group to observe internal tissue changes. Protein expression levels of IL-1β, IL-18, NLRP3, ASC, and Caspase-1 in the L4 and L5 dorsal root ganglion (DRG) were detected using Western Blot analysis. Additionally, immunofluorescence (IF) was used to assess differences in NLRP3 activation levels in the L5 DRG across the groups. Results: On days 13 and 17 after post-surgery, the PWL and PWT in the Tuina group were significantly higher than the model group (P<0.05, P<0.01). Compared with the control group and the sham operation group, the model group and the Tuina group showed inflammatory cell invasion and degeneration in the lumbar intervertebral discs, Tuina was able to slow down degeneration and alleviate inflammation. Protein expression of IL-1β, IL-18, NLRP3, ASC and Caspase-1 was significantly lower in the Tuina group than in the model group (P<0.01, P<0.05). The fluorescence intensity of NLRP3 in the model group was obviously higher than that in the blank and sham operation groups. After Tuina intervention, the fluorescence intensity of NLRP3 decreased obviously. Conclusion: Tuina therapy can inhibit the activation of the NLRP3 inflammasome in the DRG of LDH model rats and reduce the protein expression levels of downstream IL-1β and IL-18, thereby alleviating pain behavior and inflammatory responses in LDH rats.
Objective:To establish various rat models of focal segmental glomerulosclerosis (FSGS) with doxorubicin to simulate typical human FSGS. Methods: A total of 48 SD rats were randomly divided into groups A-H, with six rats in each group. Rats in group A received a single tail vein injection of 0.9% sodium chloride solution. Rats in groups B, C and D were injected with 5, 6 and 7 mg/kg of doxorubicin, respectively. Rats in groups E, F and G received two doxorubicin injections with a 14‑day interval; the first dose was 4 mg/kg, and the second dose was 2, 3 and 4 mg/kg, respectively. Rats in group H underwent left nephrectomy, followed by doxorubicin injections at 3 mg/kg on days 7 and 14 post‑surgery. Urinary total protein (UTP), liver function, and renal function were measured. Renal histopathological changes were observed using hematoxylin‑eosin (HE), periodic acid‑Schiff (PAS), and Masson’s trichrome staining, and renal ultrastructural changes were evaluated by transmission electron microscopy. Results: Compared with group A, UTP was elevated in all model groups, with a more pronounced increase in the single‑injection groups. Liver and renal function were impaired in all model groups, with more severe impairment observed in the single‑injection groups. Histopathological staining and electron microscopy results showed that the severity of FSGS was increased in all model groups, with the single‑injection groups generally exhibiting greater severity than the two‑injection groups and group H. These changes were characterized by obvious glomerulosclerosis, tubular lumen deformation, interstitial fibrosis, and severe podocyte injury. Among all groups, group D showed the most severe changes, while group F and group H exhibited similar degrees of severity. Conclusion: The modeling methods used in group F and group H are suitable for inducing typical FSGS models.
Immunological non-responder (INR) is a clinical phenomenon of HIV/AIDS patients after receiving antiretroviral therapy, which is harmful and constitutes a difficult problem in the field of AIDS prevention and treatment. INR can be classified under the category of ‘deficiency syndrome’ in traditional Chinese medicine. Deficiency of vital energy and spleen damage are the key pathogenesis of INR. The main method of treating INR in traditional Chinese medicine is to supplement vital energy and restore spleen function by using traditional Chinese medicine such as tonifying the spleen and replenishing qi. Gut microbiota dysbiosis is an important characteristic of INR, which can participate in the occurrence and development of INR by inhibiting immune cell recovery and mediating abnormal immune activation. Moreover, gut microbiota disbiosis is related to the core pathology of spleen qi deficiency in INR. This article starts from the perspective of gut microbiota and preliminarily explores the possible mechanism of action of traditional Chinese medicine for strengthening the spleen and nourishing qi in treating INR by regulating gut microbiota, in order to provide new ideas for the treatment of INR with traditional Chinese medicine.
According to traditional Chinese medicine (TCM) body constitution believes that body constitution is formed by congenital inheritance and acquired factors with relatively stable and inherent characteristics, and it has susceptibility and tendency to certain pathogenic factors and diseases. Allergic body constitution is the most special kind of biased constitution among the nine kinds of constitution, which mainly includes allergic body constitution, congenital and genetic body constitution, and fetus transmission body constitution, etc.. Among them, allergic body constitution is greatly affected by the individual’s acquired lifestyle. Studies have shown that allergic individuals are susceptible to allergic diseases such as allergic rhinitis, allergic asthma, food allergy, etc.. Although the mechanism of its occurrence and development is still unclear, allergy is closely related to allergic diseases. Therefore, this article will combine the ancient Chinese medical texts and modern research to explore the innate endowment and acquired diet, exercise, emotion, sleep and other related influencing factors, and at the same time, combined with the idea of preventive treatment of future disease, in order to guide the allergic population to actively change the poor lifestyle, to provide a pathway or target for the allergic body constitution, which is of great significance for the prevention and treatment of allergic diseases.
This article presents a novel discussion and analysis of the medical concept of ‘circular movement of central qi’ proposed by the Qing dynasty physician HUANG Yuanyu, from the perspective of inner alchemy. Through a comprehensive examination of aspects such as ‘clarification of concepts’ ‘origin of inner alchemy’ ‘interpretation of inner alchemy’, this study elucidates how HUANG’s theories were profoundly influenced by the inner alchemy. By integrating Daoist principles into medicine and drawing upon alchemical discourse to explain pharmacology, HUANG Yuanyu constructed a dual-integrated medical and Daoist theoretical system inspired by the cultivation of inner alchemy, establishing himself as a master physician of his era.
From the ‘tonification of the five viscera’ recorded in Shennong Bencao Jing to the modern Pharmacopoeia description of ‘greatly tonifying primordial qi, restoring pulse, and consolidating collapse’, the medicinal efficacy of ginseng has undergone significant transformations. This study systematically investigates the historical evolution of ginseng’s efficacy by analyzing its botanical origin shifts, migration of geo-authentic production areas, and conceptual changes in pharmacological understanding. Key findings include: Multi-source confusion persisted in ginseng usage prior to the Ming dynasty, with the Compendium of Materia Medica first establishing Panax ginseng as the authentic species through systematic textual research; the geo-authentic production region shifted from the Taihang Mountains to the Changbai Mountains during the Ming dynasty due to the extinction of Shangdang ginseng; Debates on ginseng’s medicinal properties persisted throughout history, while its efficacy underwent three major theoretical reconstructions: initial focus on ‘tonifying the five viscera’ narrowed to ‘tonifying yang qi of the lung and spleen’, evolved into ‘tonifying primordial qi’ under the Yishui School’s gastric qi theory, and later expanded to ‘restoring yang and consolidating collapse’ through warm supplementation theory. This evolutionary process highlights the necessity of dynamically interpreting medicinal efficacy within specific theoretical frameworks to achieve precise clinical application.
Insect drugs have a unique application in the five-sense diseases of Shengji Zonglu. It has an upward tendency, and is adept in dissipating pathogens. It can also play a special disease-specific medicine. Insect drugs is rigorous in compatibility. Pairs of insect drugs can exert the therapeutic effect. In addition, insect drugs is often compatible with aromatic drugs. The use of some insect drugs has its own characteristics. Pheretima and Didan often take liquid from raw products; Bufonis Venenum is used in the form of floss prescription to reaches the site of the disease and control toxicity; Salt is often used to distinguish and treat diseases of teeth and ears, which can induce medicine into kidney. The special application of insect drugs in the diagnosis and treatment of five-sense diseases also can be seen in modern clinical practice. However, the varieties, forms of action of floss prescription, etc. in ancient medical books still need to be explored. By analyzing and summarizing the application characteristics of insect drugs in five-sense diseases in Shengji Zonglu, it can provide some inspiration and reference for the treatment of five-sense diseases with insect drugs.
TCM master CHEN Lao proposed the theory of ‘mutual impairment of body and spirit’, emphasizing that ‘dampness-heat, toxin and stasis, and imbalance of yin and yang’ is the pathogenesis of anal fistula. The team adopted the surgical method of ‘minimizing bodily damage while preserving the body’ to protect both the physical form and spirit, and used internal therapy of ‘harmonizing yin and yang’ to strengthen healthy qi and eliminate pathogenic factors after surgery. The balance between radical cure of anal fistula and protection of anal morphology and function is achieved through the trinity external treatment (i.e., ‘high-position shaping with thread-drawing, low-position incision for unobstructed drainage, and intermittent skin bridge preservation to protect form’) combined with the three-stage post-operative internal treatment system. This paper summarizes the clinical experience of TCM master CHEN Minfan in treating anal fistula based on the concept of ‘integration of body and spirit, harmonization of yin and yang’. A clinical case is presented for clinical reference.
Traditional Chinese medicine (TCM) has significant advantages in the prevention and treatment of chronic renal failure (CRF). Professor ZHAO Jinxi’s team has proposed the ‘harmonizing the stomach and dispersing turbidity’ treatment method for the diagnosis and treatment of CRF based on long-term clinical practice. The team proposes believes that kidney deficiency and the formation of ‘micro-zhengjia’ are the root causes of CRF, while the accumulation of turbid fluids and weakened stomach qi are key manifestations that need urgent resolution. The treatment concept is proposed as ‘protecting the stomach qi also protects the kidney essence, and dispersing turbidity also preserves the kidney essence’. The eight methods for harmonizing the stomach include strengthening the spleen and supplementing qi, regulating qi and relieving depression, transforming phlegm and removing dampness, aromatic transformation of dampness, unblocking yang and transforming fluid, nourishing yin and soothing the liver, warming the middle and dispelling cold, and stopping vomiting and descending rebellious qi. The four methods for dispersing turbidity include clearing heat, warming yang, draining dampness, and detoxifying. Harmonizing the stomach and dispersing turbidity method is both an innovation and inheritance of TCM classics and the ‘micro-zhengjia’ theory, aiming to guide clinical practice, improve efficacy, and refine the TCM treatment system for kidney disease.
The treatment of benign essential blepharospasm (BEB) is difficult and prone to recur. This paper summarized professor GAO Jiansheng’s experience in treating BEB from Jueyin, the core pathogenesis of BEB is the mixture of cold and heat due to the weakness of liver yang. The weakness of liver yang is the basis of the disease, and cold-heat complex is the key to the disease. The middle stage of the disease is accompanied by spleen deficiency. The late stage of the disease is accompanied by internal stirring of liver wind. GAO Jiansheng clinical treatment advocates warming the liver and regulating the middle as the basic treatment, using the prescription Wumei Pills. In the early stage, the formula focuses on regulating cold and heat, harmonizing yin and yang. In the middle stage, it is equipped with chinese medicine to benefit qi and strengthen the spleen. And in the late stage, it is equipped with Chinese medicine to dredge the meridians and relieve spasms.
The root cause of allergic rhinitis lies in exposure to cold, excessive consumption of cold foods, and damp-cold environments. The core pathogenesis involves excessive internal cold-dampness that damages the yang qi of the lungs, spleen, and kidneys, leading to cold-fluid retention in the lungs, spleen deficiency with dampness accumulation, and kidney yang deficiency. If cold-dampness persists, the body becomes susceptible to pathogenic wind-cold-dampness, resulting in recurrent and chronic conditions. Treatment combines the Gan Zhi auricular point therapy with herbal decoctions. The herbal formula is based on Xiaoqinglong Decoction combined with Fuzi Lizhong Decoction. During acute phase, treatment should address both symptoms and root causes: warm the lungs to dispel cold and resolve fluid retention, combined with auricular points Hai Zi Chou+Si Wu Wei+Yin Mao+Chen Si+Xiao Li Ji+Bing Xin Hua Shui. During stable phase, focus on consolidating root treatment: warm yang, strengthen the spleen, and eliminate dampness, using auricular points Hai Zi Chou+Yin Mao+Chen Si+Xiao Li Ji+Shen You positions. This integrated internal-external approach allows flexible modification based on acute and stable phase presentations while addressing both manifestations and root causes. Emphasis on lifestyle adjustments to eradicate the root cause of the disease has achieved satisfactory clinical efficacy.
To explore novel therapeutic approaches for chondromalacia patella and to inherit the Zen acupuncture method, founded by professor WANG Guocai, a renowned veteran practitioner of traditional Chinese medicine, this study, based on the pathogenesis of impaired circulation of qi and blood in chondromalacia patella, applied Zen acupuncture method, which is characterized by high-frequency vibration and strong stimulation intensity, at Neixiyan (EX-LE5), Dubi (ST35), and Binzhong (empirically effective acupoint). The treatment aims to stimulate acupoint effects, dredge the meridians, promote blood circulation, and relieve pain, with an emphasis on guiding qi through intention. Through mechanistic analysis from three aspects, namely postural advantage, acupoint effects, and needling characteristics, combined with clinical case observations, this study preliminarily demonstrates the safety and efficacy of Zen acupuncture method in the treatment of chondromalacia patella. The results suggest that Zen acupuncture method can effectively alleviate knee pain associated with chondromalacia patella. However, due to the limited clinical sample size and lack of objective evidence, further clinical trials with larger sample sizes are needed to validate these findings.
Osteoporosis (OP) is a common bone metabolic disease. Although its exact etiology remains unclear, its core pathological mechanism lies in the imbalance between osteogenesis and osteoclasis caused by abnormal differentiation of bone marrow mesenchymal stem cells. Traditional Chinese Medicine has demonstrated unique advantages in the treatment of OP, considering this disease to fall within the categories of ‘bone flaccidity’ ‘bone impediment’ and ‘low back pain’, and emphasizing that insufficiency of kidney essence is the core cause of the disease, among which kidney-deficiency OP is the major syndrome type. Based on the theory of ‘marrow lesions preceding bone lesions’ proposed by professor WANG Haibin, and integrating the ‘qi-blood theory’ of SHIs’ traumatology as well as the therapeutic concept of YUANs’ Shengmai Chenggu Capsules, Yisui Qianggu Formula has formed a unique syndrome differentiation and treatment system through the integration and optimization of extensive clinical application. Starting from the origin and core idea of the theory that pathological changes in the marrow precede those in bone, this study focuses on the formulation principle of Yisui Qianggu Formula developed on this basis and its approach to modification in clinical practice.
Microvascular angina (MVA) is a common disease of the cardiovascular system characterized by angina-like chest pain. Modern medical practitioners mostly treat it from the theory of ‘phlegm stasis’, and the treatment is more generalized and not as detailed as it should be. Based on the theory of ‘phlegm stasis’, this article systematically elaborates the role of phlegm and stasis interconnection as the core mechanism in the development of MVA, advocates to accurately grasp the changes of phlegm and stasis in the course of dynamic changes, and proposes to take phlegm and stasis co-adjustment as the outline, and to fine-tune the dialectic for the characteristic clinical manifestations; and to flexibly utilize phlegm-eliminating and stasis-eliminating methods, and supplement with the medicines of inducing meridian to enhance the efficacy of the treatment; at the same time, it carefully clarifies the body’s cold and heat, deficiency and excess, and identifies the disease location and condition, constructing a diagnosis and treatment decision-making system that adjusts with the syndrome, aiming to provide ideas for precise and efficient clinical diagnosis and treatment of MVA with phlegm and blood stasis intertwining syndrome.
Insomnia with kidney not being able to store zhi is a subtype of insomnia in the five-spirit subtyping diagnostic method for insomnia in Chinese medicine, characterized by early awakening from sleep as its direct clinical symptom. The disease is located in the kidney, and its core pathology is the deficiency of kidney essence, qi, yin and yang, which leads to the restlessness of kidney zhi and subsequent insomnia. Treatment should be centered on tonifying the kidneys and calming zhi. Professor ZHANG Xingping has achieved good results in treating insomnia with kidney not being able to store zhi based on the method of tonifying the kidneys and calming zhi, by applying modified Bushen Anzhi Formula. This prescription uses tonic drugs such as Radix Rehmanniae Preparata, Rhizoma Dioscoreae, Fructus Corni, etc. to tonify the kidney, supplemented by Radix Polygalae and Poria to soothe the nerves, so as to tonify the kidney, replenish vital energy and calm the zhi, thereby achieving the purpose of treating insomnia with kidney not being able to store zhi.
Syndrome research, as the core link in the syndrome differentiation and treatment system of traditional Chinese medicine (TCM), is of great significance for guiding clinical practice and improving therapeutic effects. In recent years, with the in-depth development of research on TCM syndromes of pancreatic cancer, many experts and scholars have achieved certain results in this field. However, current research on TCM syndromes of pancreatic cancer still faces many challenges and problems. This paper aims to comprehensively analyze the current status of TCM syndrome research on pancreatic cancer from three aspects: the distribution pattern of pancreatic cancer syndromes, the correlation between syndromes and modern biomarkers, and the dilemmas encountered in syndrome research. Combined with the clinical practice experience of our team, we put forward future research directions and prospects, so as to provide references and insights for subsequent syndrome research.
Phenotypic genomics of traditional Chinese medicine (TCM) is a novel disciplinary concept that integrates the holistic view and the individualized diagnosis and treatment concepts of TCM as well as the modern multi-omics technologies in the background of precision medicine. Based on the concept of TCM phenotypic genomics, this paper reviews the characteristic changes of different TCM syndromes in type 2 diabetes mellitus from three levels: macroscopic phenotypes, mesoscopic phenotypes, and microscopic phenotypes. The research shows that TCM phenotypic genomics provides a new approach to revealing the biological basis of TCM syndromes in type 2 diabetes mellitus and achieving precise syndrome-based treatment. However, there are still limitations, such as a relative lack of macroscopic phenotype studies and a shortage of prospective cohort studies with TCM characteristics. Future efforts should focus on the application of standardized TCM technologies, multi-dimensional data association analysis, and the construction of large-scale cohorts to promote in-depth research on the characteristics of TCM syndromes in type 2 diabetes mellitus.
In the study of traditional Chinese medicine constitution, clinical epidemiological methods have been widely applied, mainly focusing on constitution classification, constitution-disease correlation, and intervention for modulating constitution. This article summarized the application of clinical epidemiological methods in the study of traditional Chinese medicine constitution, with a special focus on cross-sectional studies, randomized controlled trials, case-control studies, and cohort studies. By analyzing the current application status of these methods, the aim is to provide guidance for researchers in designing and conducting epidemiological studies in traditional Chinese medicine constitution, thus improving the quality of research. Additionally, this article discussed the challenges and shortcomings of clinical epidemiological methods in the study of traditional Chinese medicine constitution, as well as the innovative research methods and development trends, in order to provide direction for future research.
The safety and efficacy of traditional Chinese medicine (TCM) depend on the stability and controllability of its quality, and a controllable quality evaluation standard is an important strategy for the modernization and internationalization of TCM. TCMs for activating blood circulation and resolving stasis possess complex chemical compositions. Evaluation based on a single component is insufficient to comprehensively reflect their overall efficacy and quality. In contrast, bioactivity-based assay can assess the efficacy and safety of such medicines from the perspective of holistic biological effects, and have gradually become an important approach for TCM quality evaluation. This paper reviews the current status and limitations of quality evaluation of blood-activating and stasis-resolving TCMs, focusing on the bioactivity determination methods and their methodological validation employed in quality assessment. Furthermore, it discusses the application value and prospects of bioactivity assays in improving quality standards and investigating pharmacodynamic substances of these TCMs. This review provides a reference for optimizing the quality evaluation system, promoting rational clinical application, and facilitating the TCM modernization.
Insomnia is a common sleep disorder. At present, the diagnosis of insomnia in clinical practice is mostly based on the evaluation of the patient’s chief complaint and assessment scales, which can objectively evaluate sleep quality and the abnormal mood, fatigue, reduce quality of life, and cognitive impairment caused by insomnia. Both Pittsburgh sleep quality index (PSQI) and Athens insomnia scale can evaluate the sleep quality of insomnia patients, and the PSQI is the most common scale used in clinical diagnosis and treatment. Spiegel sleep questionnaire and insomnia severity index can grade the severity of insomnia. Dysfunctional beliefs and attitudes on sleep and Glasgow sleep effort scale can assess patients’ irrational sleep cognition. When the mood is abnormal, self-rating anxiety scale and Hamilton anxiety scale can be added to evaluate anxiety, self-rating depression scale and Hamilton depression scale to evaluate depression. Flinders fatigue scale, fatigue severity scale, fatigue scale-14 are commonly used to evaluate fatigue conditions. The quality of life of patients can be evaluated according to the characteristics of the population and the severity of complications. Montreal cognitive assessment and mini-mental state examiniation can evaluate general cognitive function, while auditory verbal memorize mainly evaluates memory. According to the specific conditions of insomnia patients, reasonable selection of assessment scales can provide reference for clinical diagnosis and treatment.
This article reviews the effect of acupuncture on the molecular biological mechanism of cervical spondylosis (CS). Due to its high morbidity and increasing prevalence in younger populations, CS has become a disease that highly affects the quality of life. Acupuncture is the most recognized among many therapies because of its convenience, effectiveness and inexpensiveness. With the deepening of research, it has been found that acupuncture may have the following mechanisms in the treatment of cervical spondylosis: ①Regulating pro-inflammatory factors, such as IL-1, IL-6, TNF-α, PGE2, etc., and inducing JAK-STAT, NF-κB/IκB/IKK and other signaling pathways to reduce inflammatory response. Regulating anti-inflammatory factors, such as TGF-β1, NO, etc., and affect the JAK-STAT/SOCS pathway to produce anti-inflammatory effects. ②Regulating the expression of apoptotic factors, such as Bcl-2, Bax, Caspase-3, Caspase-8, Caspase-9, etc. ③Regulating the expression of autophagy factors, such as Beclin1, LC3, etc. In summary, this article sorts out the molecular biology studies existing in China on acupuncture in the treatment of CS, in order to provide more evidence and thoughts for acupuncture in the treatment of CS.
HUANG Yuanyu is a representative figure of the gasification school. He is proficient in the five-yun and six-qi theory and is skilled at explaining the pathogenesis through gasification. In Sisheng Xinyuan, he has a special discussion on the six qi. Besides, HUANG Yuanyu also has a unique understanding of the theory of the ministerial fire. He believes that although the monarch fire and the ministerial fire are different in form and name, they are actually of the same origin. When ascending, it is the monarch fire, and when descending, it is the ministerial fire. They move up and down. HUANG Yuanyu is good at explaining physiology and pathology through the ministerial fire. Based on HUANG Yuanyu’s theory of the six meridians’ gasification and the theory of ministerial fire, this article proposes the viewpoint that ‘ministerial fire circulates around six qi’: ministerial fire rises in Jueyin Fengmu, long in Shaoyin Junhuo, pivot down to Shaoyang Xianghuo and Taiyin Shitu, down in Yangming Zaojin, hidden in the Taiyang Hanshui. Any disorder of the six qi will lead to the ministerial fire leaving its position. The treatment methods and corresponding prescriptions created by HUANG Yuanyu for the six qi provide us with therapeutic ideas through making ministerial fire back to six qi for supporting healthy qi.
This paper analyzes the relationship between the River Map, the eight trigrams, and the internal organs and Chinese materia medica properties and flavors. It then derives the correspondence between the internal organs and Chinese materia medica properties and flavors based on the River Map. The River Map numbers occupy the directions with yin and yang and the five elements. Properties and flavors also have yin and yang and five element attributes. The River Map is heaven, one and six are water, two and seven are fire, three and eight are wood, and four and nine are metal. Four and nine are the greater yang, three and eight are the lesser yang, two and seven are the lesser yin, and one and six are the greater yin. The trigrams correspond to the nine celestial mansions, four in the palace of the West, three in the palace of the Fire, eight in the palace of the East, and two in the palace of the Wind. Seven in the palace of the Water, six in the palace of the Mountain, and one in the palace of the Earth. This is the pre-heavenly nine palace diagram. The sun is hot, nine is very hot. The lesser yang is warm, eight is slightly warm. The lesser yin is cool, two is slightly cool. The greater yin is cold, one is very cold. Therefore, it can be known that gan is very hot, yue is hot, li is warm, zhen is slightly warm, xun is slightly cool, kan is cool, geng is cold, and kun is very cold. Therefore, zhen and xun, which are slightly warm, are the balanced qi. This qi is also according to the ‘five flavors corresponding to the five zang organs theory’ of Huangdi Neijing. It will classify the human body parts and herbal properties and flavors according to the theory of correspondence and summarize the relationship table, which can provide ideas for clinical prescription and drug selection.
Stroke is a common and frequently occurring disease with high mortality and disability rate, posing great harm to families and society. LI Shizhen’s Compendium of Materia Medica systematically documents extensive therapeutic protocols for stroke, encompassing both narrow-sense stroke (equivalent to stroke in modern) and broad-sense stroke (diseases caused by pathogenic wind invasion). Each disease and syndrome is elaborated through multiple articles, often accompanied by medical case records, with detailed discussions on stroke symptoms, treatment methods, Chinese herbs and herbal formulae, and administration methods. The Compendium of Materia Medica systematically records diagnostic principles, therapeutic strategies, and herbal applications for stroke, retaining critical guidance for modern clinical practice. Therefore, an analysis and summary are conducted.
This article takes the difficult problem of the varying numbers of Qi Heng Fu organs in the theory of traditional Chinese medicine organs as the starting point, and interprets it from the perspective of genetics. It proposes that the ‘gallbladder’ of Qi Heng Fu organs is the male reproductive organ, which stores essence and qi, and is a place for seed cultivation. It further extends to play the overall function of the circulation of Yang qi throughout the body, mainly responsible for the rise, development, and pivot of yang qi throughout the body. Therefore, the gallbladder of Qi Heng Fu organs is a summary of the function of yang qi throughout the body, and based on this, puts forward the viewpoint that ‘men are born with gallbladder’, corresponding to the theory that ‘women are born with liver first’. This not only provides some enlightenment for the treatment of male diseases, but also makes the theory of Qi Heng Fu organs more comprehensive, and also makes the theory of traditional Chinese medicine’s hidden phenomena more perfect.
Objective:To observe the effects of different doses of Astragalus combined with Qigui Luotong Xianrong Decoction on lung function, lung tissue pathology and the transforming growth factor β1 (TGF-β1)/Smads signaling pathway in a rat model of idiopathic pulmonary fibrosis (IPF), aiming to screen for the optimal dosage of Astragalus combined with Qigui Luotong Xianrong Decoction for the treatment of IPF, and to provide an experimental basis for clinical medication. Methods: Forty-eight SPF male SD rats were randomized into sham, IPF model, 120 g, 60 g and 30 g of Astragalus combined with Qigui Luotong Xianrong Decoction groups, and pirfenidone groups, 8 in each group. IPF was induced by intratracheal bleomycin. Treatments were administered by oral gavage for 28 days starting 24 h post-surgery. Pulmonary function, lung index, histopathology (HE and Masson’s trichrome with Szapiel/Ashcroft scoring), hydroxyproline content, and EMT markers (α-SMA, vimentin) and TGF-β1/Smad pathway components were analyzed by immunohistochemistry, Western blot, and qRT-PCR. Results: Compared with the model group, the rats in the Astragalus combined with Qigui Luotong Xianrong Decoction groups at 120 g, 60 g, and 30 g showed an increase in the distance moved in an open field (P<0.01); the PEF and MV of lung tissue were significantly increased (P<0.01), and F was significantly decreased (P<0.01); the Szapiel and Ashcroft scores of lung tissue, the protein expression of α-SMA and Vimentin, the expression of TGF-β1, Smad2, Smad3 protein and gene were all significantly reduced (P<0.05, P<0.01), the protein and gene expressions of Smad7 was significantly increased (P<0.05, P<0.01), the efficacy of the Qigui Luotong Xianrong Decoction containing 120 g of Astragalus was comparable to that of the positive control drug pirfenidone but superior to those containing 60 g or 30 g of Astragalus. Conclusion: Qigui Luotong Xianrong Decoction attenuates IPF-associated locomotor dysfunction and impaired pulmonary ventilation by inhibiting EMT through TGF-β1/Smad pathway modulation. The 120 g Astragalus-containing formulation exhibited superior efficacy, implicating qi deficiency as a pivotal pathogenic contributor to IPF in traditional Chinese medicine theory.
Objective:To investigate the therapeutic efficacy of different modified formulations of Erchen Decoction in reversing cisplatin resistance in nude mice with lung cancer, and to explore the regularity of medication formulation. Methods: Erchen Decoction was used as the basic formula, modified and cut it into 4 prescriptions. Construct a cisplatin resistant A549 lung cancer nude mouse model, with seven groups including positive group, negative group, blank control group, and intervention groups of prescription one, two, three, and four. Dynamically measure the body mass, tumor volume, and tumor mass of nude mice, and calculate the tumor inhibition rate; TUNEL/DAPI staining method was used to evaluate the apoptosis rate of tumor cells. Results: The body mass and tumor bearing volume of each group of nude mice increased with the prolongation of experimental time, showing a time-dependent positive correlation. The final mass and volume of tumors in each intervention group were significantly lower than those in the negative and blank control groups (P<0.05), while the final mass and volume of tumors in intervention groups 1, 2, and 3 were higher than those in intervention group 4 (P<0.05). The tumor inhibition rates of intervention groups 1, 2, 3, and 4 increased sequentially, all higher than the negative control group (P<0.05); There was a statistical difference between the intervention group of prescription 1, 2, and 3 and the intervention group of prescription four (P<0.05). The apoptosis rate of tumor cells in intervention groups 1, 2, 3, and 4 increased sequentially (P<0.05); The apoptosis rate of each group was higher than that of the negative and blank control groups (P<0.05). Conclusion: Different modifications of Erchen Decoction have the effect of reversing cisplatin resistance, and when combined with cisplatin, it can effectively promote tumor inhibition and apoptosis of tumor cells. In the diagnosis and treatment of lung cancer drug resistance in TCM, ‘phlegm’‘deficiency’‘stasis’ and ‘toxin’ serve as pathological factors, with ‘drying dampness and resolving phlegm’‘tonifying qi and nourishing yin’‘activating blood and resolving stasis’ and ‘clearing heat and detoxifying’ as fundamental therapeutic approaches. The formulation of prescriptions is based on phlegm-resolving herbs, with supportive, blood-activating, and detoxifying ingredients synergistically combined.
Objective:To explore the distribution patterns of common syndromes in sepsis based on clinical investigations and expert questionnaires, providing a basis for establishing diagnostic criteria for traditional Chinese medicine syndromes in sepsis. Methods: Clinical data of sepsis patients admitted to the ICU of 8 hospitals nationwide from May 2021 to August 2022 were collected, and establish a clinical investigation database; Preliminary exploration was performed using descriptive statistics, cluster analysis, and latent structure analysis. Based on clinical investigation, expert questionnaires were conducted using the Delphi method to further clarify common symptoms of sepsis. Results: A total of 1 100 clinical survey forms were distributed, and 1 082 valid clinical survey forms were collected, with a recovery rate of 98.36%; Based on descriptive statistics and cluster analysis, eight syndromes were inferred, namely yin deficiency and internal heat syndrome, intense exuberant heat toxin syndrome, Yangming fu-organ excess syndrome, blood stasis and toxin obstruction (damage) syndrome, phlegm heat obstructing the lungs syndrome, qi and blood deficiency syndrome, yin exhaustion and yang deficiency syndrome, and lung qi deficiency syndrome; The latent structure analysis identified 9 syndromes, namely intense exuberant heat toxin syndrome, yin exhaustion and yang deficiency syndrome, phlegm heat obstructing the lungs syndrome, damp heat accumulation syndrome, blood stasis and toxin obstruction (damage) syndrome, lung qi deficiency syndrome, qi and blood deficiency syndrome, yin deficiency and internal heat syndrome, and Yangming fu-organ excess syndrome. A total of 30 expert questionnaires were collected, with an expert positivity coefficient of 93.7%, an expert authority coefficient of 0.94, an expert coordination coefficient of 0.19, a mean≥4.0, a coefficient of variation≤2.0, and a full score ratio≥30%. The syndromes included phlegm heat obstructing the lungs, blood stasis and toxin obstruction (damage) syndrome, intense exuberant heat toxin syndrome, yin exhaustion and yang deficiency, Yangming fu-organ excess syndrome, lung qi deficiency, yin deficiency and internal heat, and qi and blood deficiency. Based on the principles of establishing common syndromes, eight common syndromes were ultimately obtained: phlegm heat obstructing the lungs syndrome, intense exuberant heat toxin syndrome, Yangming fu-organ excess syndrome, blood stasis toxin obstructing (damaging) collaterals syndrome, lung qi deficiency syndrome, yin deficiency and internal heat syndrome, qi and blood deficiency syndrome, and yin exhaustion and yang deficiency syndrome. Conclusion: The common syndromes of sepsis are 2 categories and 8 syndromes. These can provide a basis for the establishment of clinical syndrome differentiation standards and diagnostic criteria.
Objective:To explore the traditional Chinese medicine (TCM) syndromes and clinical characteristics of brain glioma, and to provide a basis for TCM syndrome differentiation and treatment of brain glioma. Methods: Data from 123 brain glioma patients admitted to the Department of Traditional Chinese Medicine, Beijing Tiantan Hospital, Capital Medical University, from 2020 to 2023 were collected. Descriptive statistics were used to analyze general data, tumor type, location, and grade. Clinical symptoms were analyzed through factor analysis and cluster analysis. Results: Among the 123 glioma patients, there were 77 male patients (62.60%) and 46 females patients (37.40%). Of these, 107 patients (86.99%) underwent surgery, while 16 patients (13.01%) did not. The five most common symptoms were insomnia, limb weakness, unsteady gait, slurred speech, and lethargy. Most patients had a pale red tongue, thin white coating and thready pulse. Based on factor and cluster analysis combined with clinical experience, TCM syndrome differentiation of brain glioma can be categorized into hyperactivity of liver yang pattern, blood stasis induced water retention pattern, qi deficiency with blood stasis pattern, kidney deficiency with blood stasis pattern four types. Conclusion: The TCM syndrome types for brain glioma can be classified as hyperactivity of liver yang pattern, blood stasis induced water retention pattern, qi deficiency with phlegm and blood stasis pattern, kidney deficiency with blood stasis pattern. In clinical practice, treatment should be based on the disease stage of the patient, integrating syndrome differentiation and disease differentiation.
Objective:To investigate the distribution characteristics and influencing factors of traditional Chinese medicine (TCM) syndromes in patients with psoriasis vulgaris of blood-heat syndrome complicated by sleep disturbances (SDs). Methods: A total of 140 psoriasis vulgaris of blood-heat syndrome complicated by SDs patients were included and their basic information, traditional Chinese medicine syndrome data, as well as Psoriasis area and severity index (PASI), Pittsburgh sleep quality index (PSQI), insomnia severity index (ISI), pruritus visual analog scale (VAS), Hamilton anxiety scale (HAMA), and dermatology life quality index (DLQI) scores were collected. Cluster analysis was conducted to summarize the syndrome types of this disease and the differences in basic information and scores among each type were then compared to analyze the distribution characteristics. Logistic regression analysis was used to identify the influencing factors of syndrome types. Results: The disease could be categorized into four types: ‘blood heat with exuberant heart fire’, ‘blood heat with liver fire disturbing heart’, ‘blood heat with deficiency of heart and spleen’, ‘blood heat with heart kidney disruption’. There were statistically significant differences in age, PASI, PSQI, ISI, and HAMA scores among patients of these types (P<0.01). Multiple comparisons indicated that ‘blood heat with exuberant heart fire’ patients age was lower than ‘blood heat with heart kidney disruption’ (P<0.01), PSQI, ISI, HAMA scores in ‘blood heat with liver fire disturbing heart’ patients were higher than that in ‘blood heat with exuberant heart fire’ (P<0.01), PASI scores in ‘blood heat with deficiency of heart and spleen’ patients were lower than that in ‘blood heat with liver fire disturbing heart’ and ‘blood heat with exuberant heart fire’ (P<0.01, P<0.05). Taking ‘blood heat with exuberant heart fire’ as a reference, an increase in HAMA and PSQI scores could elevate the risk of developing ‘blood heat with liver fire disturbing heart’ syndrome (P<0.01). The increased HAMA score appeared to be a risk factor of ‘blood heat with deficiency of heart and spleen’ (P<0.01), whereas the increased PASI score and BMI served as its protective factors (P<0.05). Advancing age and elevated HAMA scores could increase the risk of ‘blood heat with heart kidney disruption’ syndrome (P<0.01). Conclusion: This disease can be classified into four distinct syndrome types, the crucial influencing factors for TCM syndromes are age, BMI and scores of HAMA, PSQI and PASI.
Objective:To construct a risk prediction model for aromatase inhibitor associated bone loss (AIBL) in hormone receptor-positive (HR+) breast cancer patients. Methods: A total of 113 breast cancer patients receiving aromatase inhibitor therapy were enrolled. The information of traditional Chinese medicine (TCM) symptoms and laboratory indexes were collected in breast cancer patients treated with aromatase inhibitors (AIs). Univariate analysis was performed to identify AIBL risk factors, followed by the development and comparison of Logistic regression and XGBoost prediction models. Results: Duration of breast cancer, duration of aromatase inhibitor treatment, Major Osteoporotic Fracture index, Hip Fracture index, prolactin, osteocalcin, shortness of breath and fatigue were independent risk factors for AIBL (P<0.01, P<0.05). The XGBoost model demonstrated superior performance (AUC=0.755, sensitivity=0.773, specificity=0.667) compared to the Logistic model (AUC=0.737, sensitivity=0.941, specificity=0.529). Conclusion: Both Logistic regression and XGBoost models effectively predicted AIBL risk, with the XGBoost model showing better screening performance, providing a reference for early clinical intervention.
Objective:To analyze the correlation between the characteristic parameters of tongue diagnosis and the imaging histological indexes of peripheral fat of coronary artery in patients with coronary heart disease with phlegm and stasis, and to provide a basis for the objective diagnosis of coronary heart disease. Methods: Sixty patients with coronary artery disease with phlegm and stasis syndrome in the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine were collected and compared with 30 patients with coronary artery disease without phlegm and stasis syndrome. The tongue images of the two groups of patients were collected, and the quantitative features (RGB, HSV, Lab, HIS) and qualitative features (coating texture, degree of fluid moistening and dryness, and sublingual collaterals) of the Chinese medicine tongue images were extracted. Meanwhile, 3D-slicer software was used to extract the imaging histological indexes of peri-coronary adipose tissue. Independent samples t-test, Mann-Whitney U-test, and Chi-square test were used for between-group comparisons; LASSO regression was used to screen for independent risk factors of peri-coronary adipose tissue; and Spearman correlation analyses were performed to analyse the correlation between the tongue characteristic parameters and peri-coronary adipose tissue imaging histological indexes. Receiver operating characteristics (ROC) curves were analysed to determine the predictive value of peri-coronary adipose tissue imaging metrics for coronary heart disease with phlegm and stasis syndrome. Results: The independent samples t-test screened out 43 tongue features of coronary heart disease phlegm and stasis syndrome: R value, S value (HSV), V value and L value of the tip of the tongue, R value, S value (HSV), V value and I value of the right side of the body of the tongue, V value, I value and S value (HIS) of the left side of the body of the tongue, S value (HSV), I value and V value of the tongue root, S value (HSV), V value and I value of the right side of the tongue moss, V value of the middle part of the moss, as well as thick tongue coating, greasy tongue coating, dry tongue coating, yellow greasy tongue coating, thick greasy tongue coating and purple-black network of blood vessels under the tongue (P<0.05). LASSO regression screened seven independent risk factors for coronary heart disease with phlegm and stasis interconnections: firstorder-Mean, firstorder-90Percentile, glcm-Inverse Variance, glrlm-Low Gray Level Run Emphasis, glrlm-High Gray Level Run Emphasis, glrlm-Run Entropy, glszm-Small Area Low Gray Level Emphasis. Correlation analysis of tongue diagnostic parameters with peri-coronary adipose tissue radiomics: Seventy-two positive correlations versus 57 negative correlations (|r|>0.3, P<0.05). Seven coronary peripheral adipose tissue imaging metrics had predictive value for the diagnosis of coronary heart disease with phlegm and stasis. Conclusion: The more complex and uneven the peri-coronary fat texture of patients with coronary artery disease with phlegm stasis syndrome, the purpler and darker the tongue texture, and the more yellowish and thick and greasy the tongue coating, and the peri-coronary adipose tissue imaging parameters have predictive value for coronary artery disease with phlegm stasis syndrome.
Objective:To investigate the differences in the types and relative contents of metabolites in the rhizomes of Ligusticum chuanxiong Hort. from different production areas. The aim was to provide theoretical reference and scientific basis for the construction of quality evaluation system of Ligusticum chuanxiong Hort.. Methods: This study used liquid chromatography-mass spectrometry (LC-MS) technology and high-sensitivity SCIEXQTRAP® 6500+mass spectrometry platform for class targeted metabolomics research, combined with principal component analysis, hierarchical clustering analysis, KEGG annotation, and enrichment analysis methods for multivariate statistical analysis of metabolites. Results: 1 260 metabolites were detected in the rhizomes of Chuanxiong, mainly including amino acids and their derivatives, lipids, organic acids and their derivatives, sugars and their derivatives, etc. totaling 21 classes; There were 26 phenolic acid components such as ferulic acid and caffeic acid etc, 9 lactones such as ligustilide, senkyunolide A, and neoisoimperatorin, 10 alkaloids such as ligustilide and 6 alcohols and polyols such as chlorogenic acid and isochlorogenic acid A in Ligusticum chuanxiong rhizomes with active ingredients greater than 1×105.Relative content heat map of effective components in chuanxiong rhizomes from different production areas on phenolic acids, alkaloids, lactones and alcohols and polyols. The metabolites with high relative abundance of ferulic acid, ligustilide, senkyunolide A, and neoisoimperatorin showed no significant differences, other pharmacodynamic components were significantly different. There were significant differences in the number of upregulated and downregulated metabolites. The pathways with more enriched differential metabolites were different. Conclusion: The relative content of metabolites in rhizomes of Ligusticum chuanxiong Hort. from different production areas was different.
Objective:To analyse volatile oil composition and determination of four lignans in Magnoliae Flos, and to distinguish different origin in chemical composition. Methods: Analysis of the chemical constituents of different origin using gas chromatography-mass spectrometry (GC-MS) and high performance liquid chromatography(HPLC), principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA) were used to find the different components of the volatile oils of different basidiomata. Results: There were some differences in the types and relative contents of the volatile oils of different origin Magnoliae Flos; the volatile oil contents of Magnolia biondii Pamp. and Magnolia denudata Desr. were generally higher than those of Magnolia sprengeri Pamp.; the relative content of L(-)-camphor could be used as a basis for distinguishing the volatile oils of different Magnoliae Flos, with Magnolia biondii Pamp.>Magnolia denudata Desr.>Magnolia sprengeri Pamp.; only the magnolia content of Magnolia biondii Pamp. complied with the ChinesePharmacopoeia (2020) standard. Conclusion: This study clarifies the differences in chemical composition and content of different origins of Magnoliae Flos, and provides analytical methods and theoretical basis for the quality control and origin identification of different origins of Magnoliae Flos.
Objective:To observe the effects of terahertz waves moxibustion on the repair of skin barrier function and local inflammatory response in psoriasis mice. Methods: Sixty SPF-grade BALB/c male mice were divided into a blank group, a model group, a positive drug group, a terahertz waves 10 min group, a terahertz waves 20 min group, and a terahertz waves 30 min group, with 10 mice in each group. The backs of mice in each group were shaved, and except for the blank group, apply imiquimod cream for external modeling while receiving corresponding treatment methods for intervention. To observe and record the thickness, scale, and erythema of mouse skin lesions daily, and score the severity index (PASI). A water and oil pen was used to measure the local water content of the skin. After the intervention, pathological slices of the mouse skin were taken and Baker score was assessed. Immunohistochemistry was used to detect the positive expression of occludin, claudin-1 and proliferating cell nuclear antigen (PCNA) in the mouse skin tissue. ELISA was used to detect IL-1β and TNF-α protein content in the mouse skin tissue. Results: The skin color of the blank group was uniform, without scales or erythema; The back skin of the model group mice showed significant thickening, accompanied by a large amount of scales covering them; Compared with the blank group, the PASI score and Baker score of the model group mice were significantly increased (P<0.01), while the water content, occludin and claudin-1 expression of the back skin tissue of the mice were significantly decreased (P<0.01). The expression of PCNA, IL-1β and TNF-α protein content were significantly increased (P<0.01); After treatment with positive drugs and terahertz waves moxibustion for 20 and 30 minutes, the symptoms of thickening and scale coverage of the back skin of mice were significantly alleviated, and the PASI and Baker scores were significantly decreased (P<0.01). The skin tissue water content, occludin and claudin-1 expression were significantly up regulated (P<0.01, P<0.05), and the expression levels of PCNA, IL-1β and TNF-α proteins were significantly decreased (P<0.01). Conclusion: Terahertz waves moxibustion has the effect of reducing local symptoms in psoriasis mice, and its mechanism is closely related to repairing the skin barrier and inhibiting inflammatory response.
Objective:To investigate the pharmacodynamics and preliminary mechanisms of Morus alba L. (Sangzhi) alkaloids (SZ-A) on retinal vascular proliferation. Methods: An oxygen-induced retinopathy (OIR) model was established in C57BL/6J mouse pups, which were divided into the OIR model group, SZ-A low-dose (SZ-A-L), medium-dose (SZ-A-M), and high-dose (SZ-A-H) groups, and a positive control (bevacizumab) group. All groups received consecutive treatment for 5 days. Retinal vascular proliferation was assessed by GS-IB4 and HE staining. The mRNA and protein expression of VEGF was detected by q-PCR and immunohistochemistry, and Occludin protein expression by immunofluorescence. Network pharmacology was used to screen targets of SZ-A against vascular proliferation. q-PCR was used for detection, EGLN1 protein expression was detected by immunofluorescence, and EphA2, PI3K, and Akt protein levels were detected by Western Blot. Results: Compared with the OIR group, the SZ-A groups showed significant reductions in the area of retinal neovascularization, avascular area, and the number of vascular endothelial cell nuclei breaking through the inner limiting membrane, along with decreased VEGF expression and a trend toward increased Occludin expression. Network pharmacology identified PRKCA, SPHK1, STAT1, EphA2, ABL1, TGFB2, WARS1, EGLN1, and TGFBR2 as key targets. Molecular experiments confirmed that SZ-A reduced the protein expression levels of EGLN1, EphA2, PI3K, and Akt. Conclusion: SZ-A significantly inhibits retinal vascular proliferation by regulating key proteins including EphA2, EGLN1, VEGF, PI3K, and Akt, providing potential therapeutic targets for related ocular diseases.
Objective:To investigate the potential action mechanism of DING’s Wulianmei Ointment (CJC) in the treatment of postoperative wound of anal fistula by gene sequencing technology. Methods: Ten C57BL/6J mice were randomly divided into model group and CJC group. The postoperative wound was induced by dextran sulfate sodium combined with stainless steel wire. After the model was successfully established, the two groups were treated with normal saline, normal saline+CJC, respectively. After 11 days, samples were taken for HE staining to observe the pathological changes of granulation tissue and transcriptome analysis of related targets. Results: Compared with the model group, the muscle fibers and inflammatory cells were obviously reduced in the CJC group, the structure of the CJC group was well defined, and new capillaries were observed. The results of transcriptome analysis showed that PI3K-Akt signaling pathway and NOD receptor/TNF/IL-17 signaling pathway were the potential mechanisms of CJC in the treatment of postoperative wound. Conclusion: CJC can treat the postoperative wound of anal fistula by activating the pro-repair axis and inhibiting the inflammation-related pathways.
The traditional Chinese medicine (TCM) Jingxue and Zangxiang system is a regulatory network channel system formed by the vacuum zero-point energy field and the human body and even the general physical object. As a medium system that communicates the metaphysical Tao and the object with certain specific shapes, it is worthy of attention containing the key concepts and modern physics principle related to negative entropy, chaos fractal and fluctuation. The paper can match the existence of TCM system with the ambiguity and polysemy of the concept of qi and gasification in Chinese culture. At the same time, it also applies to the multi-perspective and multi-dimensional description and interpretation given by TCM clinical practice and modern scientific researches and therefore undoubtedly can be regarded as an enlightening exploration and beneficial attempt.
Tumor metastasis is the ultimate and fatal manifestation of malignant tumors. Neutrophil extracellular traps (NETs) are newly discovered extracellular network effectors released by activated neutrophils and composed of DNA fibers, histones and antibacterial proteins. Although NETs were initially viewed as a highly conserved pathogen defense mechanism, there is increasing evidence that NETs are a double-edged sword, playing an extremely important role in tumor metastasis. Blockage of blood stasis and retention of toxic pathogens are the core pathogenesis of malignant progression of tumors in traditional Chinese medicine (TCM), which is consistent with the modern pathological mechanism of NETs inducing thrombosis, adhering to and protecting circulating tumor cells, promoting the formation of pre-metastatic niches, and awakening dormant tumor cells to trigger tumor metastasis. Therefore, based on NETs, this paper discusses the scientific connotation of TCM pathogenesis theory of tumor metastasis due to blood stasis and toxic pathogen, in order to provide new ideas for TCM to interfere with the NETs formation or promote the NETs’ degradation to prevent and treat tumor metastasis.
This article summarizes the characteristics of YANG Qingshan’s Tuina manipulation (hereinafter referred to as YANG’s manipulation) by reviewing relevant literature and interviewing disciples of YANG Qingshan, actively exploring the inheritance and development strategies of YANG’s manipulation. YANG’s manipulation primarily focuses on deep kneading manipulation, forming its own systematic approach that emphasizes anatomical zoning treatment. Its manipulation primarily involves centripetal treatment, paying attention to the operational path. At the same time, it utilizes comfortable medium for operation, tailoring techniques according to the disease, individual, and symptoms. Furthermore, it also focuses on the practitioner’s coordination of breathing and other aspects of operation. However, there is insufficient collation and exploration of YANG’s manipulation’s theoretical system, a lack of specific operational standards, inadequate training of relevant talents, and insufficient external promotion. Therefore, it is necessary to establish a studio of renowned YANG’s Tuina masters, combining modern science and technology to systematically collate, explore, and promote YANG’s manipulation. Relevant research should be conducted on the biomechanics and metabolomics of YANG’s manipulation, talents should be cultivated, and active promotion should be undertaken to inherit and develop the technique. By adhering to the principles while innovating, we can benefit the people.
This paper explores the theoretical connotation of YE Tianshi’s concept of ‘excess dampness weakens yang’ and identifies the pathological evolution process of internal and external dampness convergence, impaired yang function; alternating damp-heat, stagnated yang; and dampness invading the Tri-Jiao, leading to kidney yang deficiency, eventually entering the collaterals. This process aligns closely with the occurrence and progression of renal edema. Based on the characteristics of this pathogenesis, it is proposed that the primary treatment for renal edema should focus on draining dampness and promoting yang through mild diuresis, without rigidly adhering to the principle of ‘yang activation does not require warmth’. When appropriate, warming methods should be employed alongside strategies to strengthen the spleen and kidney. Additionally, methods such as diffusing and eliminating method, descending turbidity, and resolving stasis are recommended to clear pathogenic factors, while warming the kidney, promoting meridian circulation, and emphasizing constitution to protect vital qi and the body’s yang. This approach aims to provide new insights for the treatment of renal edema with traditional Chinese medicine.
Insomnia is a common clinical condition. Based on the theories in the Huangdi Neijing, CHAO Yuanfang was the first to propose that ‘yang dose not enter yin’ constitutes the fundamental pathogenesis of insomnia. By synthesizing the contents of Lingshu · Weiqi Xing, Lingshu · Dahuo Lun, and Lingshu · Yingwei Shenghui, this paper explores the circulation patterns of Wei qi and their correlation with the mechanism of ‘yang dose not enter yin’. From the perspective of the three yin and three yang meridians, the study posits that ‘yang dose not enter yin’ signifies the inability of Wei qi to transition from its circulation in the Taiyang, Shaoyang, and Yangming meridians to the Shaoyin, Taiyin, and Jueyin meridians. Furthermore, during the transition of Wei qi from the three yang to the three yin, Yangming facilitates the exit from the three yang through its ‘closing’ function, while Shaoyin assists the entry into the three yin via its ‘pivot’ function.
Objective:To investigate the clinical efficacy of the Yiqi Huoxue Jiedu formula as maintenance therapy in patients with advanced ovarian cancer. Methods: Sixty patients with advanced ovarian cancer from September 2022 to September 2023 in Guang’anmen Hospital of China Academy of Chinese Medical Sciences were randomly assigned to either the treatment group or the control group, 30 cases in each group. The treatment group received the Yiqi Huoxue Jiedu formula as the fundamental therapy with modifications based on syndrome differentiation, while the control group was treated with PARP inhibitors. Treatment was administered for at least 6 months or until disease progression. Progression-free survival, quality of life scales, and safety profiles in both groups were evaluated. Results: Up to and including October 24, 2024, the median progression-free survival (mPFS) for the treatment group was 20.133 months (95%CI[16.228, 24.039]), and the mPFS for the control group was 16.033 months (95%CI[5.184, 26.883]). Relative to the control group, the treatment group showed significantly increased scores in physical condition, social/family condition, emotional state, functional status, and total score at the final follow-up (P<0.01, P<0.05). No differences in adverse reactions were noted between the two groups. Conclusion: The Yiqi Huoxue Jiedu Formula demonstrates comparable clinical efficacy to PARP inhibitors in the maintenance therapy of advanced ovarian cancer, while additionally improving patients’ quality of life.
Objective: To evaluate the clinical efficacy of Chaihu Qinggan Decoction (CHQGT) in the treatment of granulomatous lobular mastitis (GLM) at the mass stage with liver merdian heat stagnation type. Methods: GLM patients from the First Hospital of Hunan University of Chinese Medicine from December 2021 to October 2022 were randomly assigned to either a Chinese medicine group and a steroid group, 20 cases in each group. The Chinese medicine group received CHQGT, while the steroid group was treated with Prednisolone. The expression levels of various parameters, including blood routine, liver and kidney function, interleukin (IL)-18, granulomatous lobular mastitis disease activity index (GMDAI), miR-451a, and miR-5571-3p, were compared between the two groups before and after treatment. Results: Levels of white blood cell (WBC), neutrophil (N), neutrophil lymphocyte ratio (NLR), C-reactive protein (CRP), IL-18, GMDAI, miR-451a, and miR-5571-3p were significantly reduced in both the Chinese medicine and steroid groups compared to pre-treatment values (P<0.05, P<0.01). In the steroid group, levels of ALT and AST were elevated compared to the Chinese herbal group (P<0.05). Correlation analysis showed that GMDAI was highly correlated with WBC and N, and strongly correlated with CRP, NLR, and miR-5571-3p. Conclusion: Both CHQGT and prednisolone exhibit comparable clinical efficacy in treating GLM at the mass stage with liver meridian heat stagnation type, but the Chinese herbal treatment demonstrates a lower incidence of liver damage. Parameters such as WBC, N, CRP, NLR, and miR-5571-3p may assist clinicians in evaluating the severity of inflammation in GLM patients.
Objective:To observe the effects of Tenghuang Jiangu Capsule on the anti-inflammatory cytokine secretion and Treg cell differentiation in postmenopausal osteoporosis (PMOP) patients with kidney deficiency and blood stasis. Methods: A total of sixty PMOP patients with kidney deficiency and blood stasis were selected and randomly divided into the control group and the observation group by the number-drawing method, with 30 cases in each group. The control group was treated with Calcium Carbonate D3 Granules, Calcitriol Capsules, Risedronate Sodium Tablets, and Salmon Calcitonin for Injection, while the observation group received the same treatment plus Tenghuang Jiangu Capsules, the course of treatment is 6 months. The visual analogue scale (VAS), total scores of traditional Chinese medicine syndrome (TCM syndrome scores), bone density T value, peripheral blood calcium, blood phosphorus, anti-inflammatory cytokine transforming growth factor-β (TGF-β), interleukin (IL)-10, and IL-33 levels, and Treg cell marker molecule forkhead box protein P3 (Foxp3) levels were compared between the two groups before and after treatment. Resuts: After treatment, VAS scores and TCM syndrome scores showed a significant decrease compared with the baseline levels between the two groups (P<0.01), TGF-β, IL-10, IL-33 levels, and Foxp3 levels showed a significant increase compared with the baseline levels (P<0.01). Bone density T value and blood calcium (Ca) level of the observation group showed a significant increase compared with those before treatment (P<0.05, P<0.01), the blood phosphorus (P) level was significantly decreased compared with that before treatment (P<0.01). Moreover, the VAS score, TCM syndrome scores, and blood phosphorus level of the observation group were significantly lower than those of the control group (P<0.01, P<0.05), the levels of TGF-β and Foxp3 were significantly higher than those of the control group (P<0.01). Conclusion: Tenghuang Jiangu Capsule combined with western medicine can effectively relieve the bone pain in PMOP patients with kidney deficiency and blood stasis, and its mechanism may be related to the excessive secretion of anti-inflammatory cytokine caused by the enhanced differentiation of Treg cells.
Objective:To explore the clinical efficacy and safety of Yiqi Huoxue Jieyu Formula in treating post-stroke depression (PSD) with qi deficiency with blood stasis and liver depression syndrome. Methods: From December 2017 to July 2024, 510 patients with PSD of qi deficiency with blood stasis and liver depression syndrome were collected from the Department of Neurology and Department of Internal Medicine of Traditional Chinese Medicine of the First Affiliated Hospital of Zhejiang Chinese Medical University and the Second Affiliated Hospital of Zhejiang Chinese Medical University. According to the randomized numerical table method, they were divided into the Western medicine control group, the Chinese medicine treatment group, and combination of Chinese and Western medicines group, with 170 patients per group, and the total course of treatment was 8 weeks. The differences of Hamilton depression scale (HAMD) scores, traditional Chinese medicine (TCM) evidence points, National Institutes of Health stroke scale (NIHSS) scores, Barthel index (BI) scores and adverse reactions were compared among the three groups, and the clinical efficacy and safety were analyzed. Results: Compared with before treatment, three groups’ HAMD scores, TCM syndrome points and NIHSS scores were significantly decreased after 4, 8 weeks of treatment (P<0.05), and BI scores were significantly increased (P<0.05). Compared with the Chinese medicine treatment group and the Western medicine control group, the improvement of each index after treatment in the combination of Chinese and Western medicines group was more obvious (P<0.05), and the clinical efficacy of the combination of Chinese and Western medicines group was better than that of the Chinese medicine treatment group and the Western medicine control group (P<0.05). There were no serious adverse reactions in the three groups during the treatment. Conclusion: Clinical effects of Yiqi Huoxue Jieyu Formula in treating PSD with qi deficiency with blood stasis and liver depression syndrome are remarkable. It can effectively improve the neurological impairment of patients and improve the quality of life, it has no obvious adverse reactions, it is an effective prescription for the treatment of PSD.
