In recent years, the diagnosis and treatment concepts for osteoarthritis have continued to evolve, with evidence-based medical research and both domestic and international guidelines being constantly updated. Against this backdrop, the project team adhered to evidence-based principles and conducted a systematic search and objective evaluation of the evidence related to the integrated diagnosis and treatment of osteoarthritis based on disease-pattern differentiation. Following in-depth expert panel discussions, revisions and updates were made to the traditional Chinese medicine syndrome classifications and treatment plans included in the 2021 edition of the Guidelines for Integrated Traditional Chinese Medicine Syndrome and Disease Diagnosis and Treatment of Osteoarthritis. This has resulted in a new edition of the guidelines, providing a foundation for the TCM-based diagnosis and treatment of osteoarthritis.

The theory of constitution soil is the core content of the ‘four theories of pathogenesis’ of traditional Chinese medicine (TCM) constitution. It refers to that different biased constitutions form the background and foundation for the occurrence of various diseases, individual constitutions share similar susceptibility to a class of diseases with common pathogenic mechanisms, that is, ‘constitution-disease symbiotic environment’ and ‘common soil’. This perspective emphasizes the ‘constitution-disease correlation’, moving beyond the traditional ‘disease-symptom’ correspondence framework and deepening the theoretical understanding of TCM disease etiology. This paper discusses the background of its concept from the ancient and modern Chinese medicine understanding of constitution soil theory and modern research evidence system. Explain its scientific connotation from the perspective of constitution soil determining the type of disease and constitution soil clarifying the mechanism of multimorbidity aggregation. The clinical significance is discussed from three aspects: expanding the new idea of the same prevention and treatment of different diseases, optimizing the diagnosis and treatment mode of comorbidities and leading the reform of medical concept. Studying the formation mechanism, biological characteristics and its influence on the occurrence and development of diseases is of far-reaching significance for expanding the theoretical system of TCM etiology, explaining the phenomenon of multimorbidity and guiding the prevention and treatment of chronic diseases.

In the theoretical system of traditional Chinese medicine, Jin, as a key tissue for limb movement, play an important role. However, at present, there are many disputes and differences in aspects such as the pathological mechanism and syndrome differentiation methods of Jin, which have seriously hindered the accurate diagnosis and treatment of bone and Jin diseases. In view of this, this article closely combines the records in relevant ancient Chinese medicine books and modern research results, and conducts in-depth and systematic discussions from multiple dimensions such as the essence, classification, physiological functions, and pathological changes of Jin. Taking various symptom manifestations of Jin diseases as the starting point and based on the characteristics of different parts where Jin diseases occur, it comprehensively summarizes the internal laws of mechanical transformation involved in Jin diseases, and then constructs an overall three-dimensional dynamic syndrome differentiation system for Jin diseases and further clarifies the corresponding intervention targets, aiming to provide references for the clinical diagnosis and treatment of Jin diseases.

Traditional Chinese medicine has significant advantages and profound theoretical foundations in preventing and treating insomnia. It emphasizes syndrome differentiation and integrated treatment modalities. These approaches urgently need to be further summarized and promoted. The drafting group of this consensus conducted the research based on the key research and development plan of the Ministry of Science and Technology of China, Research on New Traditional Chinese Medicine Diagnosis and Treatment Plans and Mechanisms for Chronic Insomnia. It adopted real-world research and cohort studies of renowned senior traditional Chinese medicine practitioners, using chronic insomnia as the research focus and clinical data from syndrome differentiation-guided treatment as evidence. From the perspective of ‘primordial qi, yin-yang, spirits of the five zang-organs’, the Consensus of Traditional Chinese Medicine Diagnosis and Treatment Experts on Chronic Insomnia in Adults was formulated based on ‘syndrome differentiation and integrated therapies’. This aims to provide more comprehensive and rational guidance for the clinical diagnosis and treatment of chronic insomnia, improve the quality of life of patients with insomnia, and contribute to the construction of a ‘Healthy China’.

Objective:To evaluate the efficacy and safety of artificial bear bile powder instead of bear bile powder in patients with acute conjunctivitis (syndrome of liver meridian heat).Methods:A block randomized, positive drug parallel-controlled, double-blind, double dummy, multi-center trials were designed for clinical study. A total of 160 patients with acute conjunctivitis (syndrome of liver meridian heat) collected from 10 hospitals from August 2021 to June 2022 were randomly separated into the treatment group (80 cases) who oral bear bile capsules containing artificial bear bile powder and the control group (80 cases) who oral bear bile capsules containing bear bile powder. After 5 days of treatment, the improvement of traditional Chinese medicine syndrome of liver meridian heat, the score of the main symptoms and signs of the disease, the score of the main symptoms of acute conjunctivitis (foreign body sensation, burning sensation, eye itching), the score of the main signs of acute conjunctivitis (palpebral conjunctiva, bulbar conjunctival injection), disappearance rate of the main symptoms and the signs of acute conjunctivitis respectively, the improvement of each individual symptom or sign and the adverse reactions were observed.Results: The ratio and 90% CI of the two groups of the main efficacy outcomes of syndrome of liver meridian heat were 1.00[0.914, 1.081]. And the ratio and 90% CI of the two groups of the score of the main symptoms and signs of acute conjunctivitis were 1.01[0.903, 1.107]. The results of secondary efficacy outcomes analysis showed that the main symptom score change (foreign body sensation, burning sensation, eye itching), the change of main sign score (palpebral conjunctival injection, bulbar conjunctival injection), the disappearance rate of the main symptoms, the disappearance rate of the main signs, the improvement of individual symptoms and signs, and C-reactive protein were no significant difference between the treatment group and the control group. The results of the analysis of the two subgroups of high and low doses were consistent with the overall trial. There were no serious adverse reactions were observed during the trial and no significant difference in the incidence of adverse events between the two groups.Conclusion: Artificial bear bile powder is clinically equivalent to bear bile powder in the treatment of acute conjunctivitis (syndrome of liver meridian fiery) with good safety and low incidence of adverse reactions. This study verifies the function of artificial bear bile powder to clear heat, calming liver and brightening eyes and the main indication marked by sore red swollen eyes is consistent with bear bile powder, which could be used as a substitute for bear bile powder.

Palmoplantar pustulosis (PPP) represents a challenging condition in the clinical management of dermatological disorders. Based on the theory ‘dampness injury afflicts the lower body first’ from Suwen·Taiyin Yangming Lun, and in combination with the anatomical characteristics and clinical manifestations of the disease’s predilection for the palms and soles, this article has re-examined the etiology, pathogenesis and treatment methods of PPP. Dampness pathogen was established as the pivotal etiological factor. The inherent descending tendency of dampness leads to stagnation in extremities, where it synergistically interacts with wind, heat, cold, and blood stasis pathogens, thereby generating diverse pathogenesis and differentiation patterns. During acute phases, the condition manifests as clustered deep-seated pustules on edematous erythematous bases with yellow viscous exudate, attributable to wind-cold-damp-heat entanglement. The combined use of Mahuang Lianqiao Chixiaodou Decoction and Yiyi Fuzi Baijiang Powder aimed to dispel external pathogens, clear internal dampness, and expel pus. In remission phases, characterized by xerotic fissures, hyperkeratosis, or scattered pustules due to yin deficiency with latent dampness, Wuling Powder combined with Qianyang Fengsui Pills was recommended to activate yang, resolve dampness, and guide floating fire back to its origin. This study provides novel theoretical foundations and practical references for traditional Chinese medicine management of this condition.

Objective:To observe the clinical efficacy of a self-formulated Huangjing Jiangya Decoction combined with Amlodipine besylate in the treatment of qi-deficiency type hypertension.Methods:A total of 96 patients with primary hypertension diagnosed as qi-deficiency syndrome were enrolled from the outpatient department of Beijing Sixth Hospital between May 2022 and November 2023. Patients were randomly divided into a control group and an observation group according to a random number table, with 48 cases in each group. The control group received Amlodipine besylate tablets, while the observation group was additionally treated with the self-formulated Huangjing Jiangya Decoction on the basis of the control treatment. Both groups were treated continuously for 8 weeks. Clinic blood pressure, home blood pressure, 24-hour ambulatory blood pressure, traditional Chinese medicine (TCM) symptom scores, laboratory indicators, generalized anxiety disorder-7 (GAD-7) scores, and Pittsburgh Sleep Quality Index (PSQI) scores were compared before and after treatment.Results: After treatment, compared with baseline, scores for dizziness, headache, shortness of breath, weak, fatigue, spontaneous sweating, reluctance to speak, and the total TCM syndrome score in the observation group were significantly reduced (P<0.01, P<0.05). Clinic and home systolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly reduced (P<0.01). Ambulatory blood pressure indices including daytime, nighttime, 24-hour SBP and DBP were significantly decreased (P<0.01, P<0.05). GAD-7 scores (P<0.05), PSQI scores (P<0.01), and homocysteine (Hcy) levels (P<0.01) were all significantly decreased after treatment. After treatment, the observation group showed significantly lower TCM syndrome scores and higher symptom efficacy rates than the control group (P<0.01). Clinic and home SBP and DBP were significantly lower than those of the control group (P<0.01, P<0.05). Daytime, nighttime, 24-hour SBP and DBP were also lower than those in the control group (P<0.01, P<0.05). No adverse reactions such as nausea or vomiting were observed during treatment, and no abnormal changes in liver or renal function were found.Conclusion: The self-formulated Huangjing Jiangya Decoction shows good therapeutic effects in patients with qi-deficiency type hypertension. It can effectively relieve anxiety and improve sleep quality, with good safety, and is worthy of clinical promotion.

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.

Uterine fibroids are benign tumors of the reproductive system that are more common in women of childbearing age, and traditional Chinese medicine has unique advantages in the treatment of uterine fibroids during the ‘window period’. Based on the theory of ‘qi, blood, and water’, the authors believe that the onset of uterine fibroids is based on qi deficiency, emphasizing the accumulation of pathological products such as qi stagnation, phlegm retention, and blood stasis, and attaching importance to the repeated retention of turbid pathogens in the body and the impairment of health qi; In treatment, priority should be given to distinguishing between urgency and non-urgency, emphasizing the use of medication at different stages, supplementing deficiency throughout the entire process, and supplemented with methods such as regulating qi circulation, promoting diuresis, and activating circulation to achieve the goal of restoring menstrual cycle, controlling uterine fibroid growth, and improving discomfort symptoms.

‘Jun Huo Yi Ming, Xiang Huo Yi Wei’ originates from the theory of five circuits and six qi, describing the qi transformation during the second and third of the six annual phases. Jun Huo represents the nascent yang qi at the spring equinox, with ‘Ming’ signifying life’s flourishing, while Xiang Huo supports it and must remain in its place (‘Yi Wei’) to prevent excessive heat. During the Jin and Yuan dynasties, this concept was integrated into viscera syndrome differentiation, shifting its focus to human physiology and pathology. LI Dongyuan and ZHU Danxi emphasized Xiang Huo as a pathological source (e.g., yin fire, yin deficiency fire), while strengthening Jun Huo’s role in mental cognition. Later, Ming scholars such as SUN Yikui, ZHANG Jingyue, and ZHAO Xianke reinterpreted Xiang Huo as the source of physiological warmth and associated Jun Huo with spirit, a transformation largely completed by ZHANG Jingyue. This conceptual reconstruction merged the ‘sovereign’ name with Xiang Huo’s warming function, establishing the concepts of life gate fire and true yang.

The constitution-based pathogenesis highlights the close correlation between disease occurrence and individual constitutional differences. As an extension, the theory of constitutional determination by fetal endowment further enriches its connotation by tracing the association between constitutional formation and pathogenic mechanisms back to the early stage of life. From the perspectives of conceptual proposition, scientific connotation, and clinical significance, this paper systematically explores the profound impacts of fetal endowment, excess or deficiency of fetal essence, and disturbance of fetal essence on fetal constitutional development and adult-onset diseases. Based on the theory of fetal origin of constitution, a prenatal ‘three-level prevention’ protocol is proposed, which aims to improve maternal health through constitution-based regulation and provide guidance for eugenics and superior child-rearing. It is emphasized that the theory of fetal origin of constitution serves as a key entry point for the ultra-early intervention of adult chronic diseases. Additionally, a full-life-cycle constitutional health management strategy, ranging from infancy to adulthood, as well as a unique strategy specifically for women, is put forward. Collectively, these findings hold significant clinical value and strategic importance for enhancing the quality of the birth population and realizing ultra-early prevention and control of adult chronic diseases.

Using textual research and conceptual metaphor analysis, this paper explores the core connotation of Bentun qi in Synopsis of Golden Chamber, a unique traditional Chinese medicine disease term whose naming reflects the cognitive mode of classification according to manifestation. By tracing the diachronic evolution of the Bentun concept from early classics onward, the historical relationship between Bentun and Bentun qi is revealed. Through analysis of the character tun, the piglet theory is philologically confirmed, while the porpoise theory of the Ming and Qing period is identified as a later derivative. Based on this, the source domain of Bentun qi is identified not as a piglet’s running posture but as its rapid and disordered breathing, which was mapped onto the pathological phenomenon of qi rushing upward. Through the metaphorical cognition of Bentun qi, a cognitive pathway for traditional Chinese medicine diseases, namely ‘metaphor discovery, retrospective exploration, and ancient-modern mutual verification’ is proposed, offering new perspectives for disease concept research in traditional Chinese medicine.

Traditional Chinese medicine (TCM) has a deep historical lineage, sustained by the differentiation of the ‘four properties and five flavors’, a method that has remained intact for centuries. The four properties (cold, heat, warmth and coolness) serve to adjust the excesses of yin and yang; the five flavors (sour, bitter, sweet, pungent and salty) act on the organs and exert therapeutic effects, forming the cornerstone of herbal pharmacology and the framework for TCM syndrome differentiation and treatment. The development of modern TCM, influenced by Western pharmacology, tends to focus on isolating chemical compounds and analyzing the molecular mechanisms of single ingredients, while overlooking the traditional principles of the holistic nature and compound synergy. While this method has proven highly effective in the precise treatment of specific diseases, the lack of a holistic approach makes it hard to demonstrate the synergistic effects of TCM formulas. As a result, the traditional theories of the ‘four properties and five flavors’ are diminishing, and the study and application of the overall pharmacology of TCM face significant challenges. This paper aims to trace the origins of the ‘four properties and five flavors’, discern the differences and similarities between traditional theories and modern science, analyze the current dilemmas in TCM development, and explore a path that combines heritage and innovation to open up a new prospect for the future development of TCM.

Huangdi Neijing is the inaugural classic masterpiece of traditional Chinese medicine (TCM), laying the theoretical foundation for the development of TCM, with its clinical principles still guiding medical practice to this day. The concept of ‘hyperactive fire consuming qi’ is an integral part of the theoretical system of the Huangdi Neijing and holds profound value for clinical research. Therefore, based on the research of predecessors, this paper collates and summarizes the origins and extensions of the ‘hyperactive fire consuming qi’ theory by organizing and generalizing the understanding and insights of numerous physicians from both ancient and modern times. The original meaning of ‘hyperactive fire consuming qi’ refers to the consumption of the body’s healthy qi by herbs and foods of the purely yang nature. In the inheritance and development by physicians of later generations, the majority consensus is that ‘hyperactive fire consuming qi’ involves the excessive yang energy eroding the body’s healthy qi. Building on this, the paper innovatively puts forward the new idea of ‘hyperactive fire consuming qi’, positing that it is the process by which pathogenic factors or substances with fire-heat characteristics injure the body’s healthy qi, characterized by a continuous accumulation and dynamic change from quantitative to qualitative transformation. The paper also provides separate discussions on ‘hyperactive fire’ and ‘consuming qi’, with the aim of offering significant guidance for future research, learning, and clinical application.

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.

Depression, characterized by persistent low mood and anhedonia, is a prevalent mental disorder. Traditional Chinese medicine classical prescriptions encapsulate the experiential wisdom of ancient physicians in diagnosing and treating illnesses. Recent research indicates promising prospects for classical prescriptions in the treatment of depression. The ‘different treatments for same disease’ theory, originating from the Huangdi Neijing, embodies a significant academic concept in traditional Chinese medicine. This paper explores the importance of classical prescriptions in the treatment of depression, starting from the perspective of this theory, and integrates specific applications of classical prescriptions in depression research, providing a theoretical basis and rationale for their clinical use in depression treatment.

Objective:To investigate the effect of multi-glycosides of Tripterygium wilfordii (GTW) on VDR/DDIT4/mTOR signaling pathway in diabetic kidney disease (DKD) rats.Methods:Thirty rats were randomly divided into normal group (n=6) and model group (n=24). The normal group was fed with normal diet, and the model group was established with high-fat and high-sugar feed and one-time intraperitoneal injection of streptozotocin (STZ). After the model was successfully established, the rats were randomly divided into model group, Daiwen group and GTW group, and gastric lavage was started from the 9th week. The rats in Daiwen group were gavaged with valsartan and GTW group were gavaged with GTW. After 6 weeks’ continuous gavage, serum albumin (ALB), alanine aminotransferase (ALT), urea nitrogen (BUN), creatinine (SCr), glucose (GLU), cholesterol (CHO), triglyceride (TG) and total 24 hour total urine protein (24 h-UTP) were detected. The expression levels of VDR, DDIT4, mTOR, phosphorylated mTOR (p-mTOR), autophagy gene unc-51-like kinase 1 (ULK1) mRNA and protein were detected by PCR and Western Blot, respectively.Results: Compared with the normal group, 24 h-UTP, BUN, SCr, ALT, CHO, TG and GLU in the model group were significantly increased (P<0.01), while ALB was significantly decreased (P<0.01), the expression of VDR, DDIT4, ULK1 protein and mRNA in renal tissue decreased significantly (P<0.01), while the expression of mTOR protein and mRNA increased significantly (P<0.01), and the expression of p-mTOR protein increased significantly (P<0.01), pathology of renal tissue was obviously damaged. Compared with the model group, 24 h-UTP, BUN, SCr, ALT, CHO, TG and GLU in Daiwen group and GTW group decreased significantly (P<0.01), while ALB increased significantly (P<0.01), the expression of VDR, DDIT4, ULK1 protein and mRNA in renal tissue increased significantly (P<0.01), while the expression of mTOR protein and mRNA decreased significantly (P<0.01), and the expression of p-mTOR protein decreased significantly (P<0.01), glomerular morphology was basically normal, mesangial cell proliferation and inflammatory cell infiltration were reduced.Conclusion: GTW can reduce 24 h-UTP, protect renal function, reduce blood lipid and improve renal pathological injury in DKD rats, and its mechanism may be related to its regulation of VDR/DDIT4/mTOR signaling pathway expression and improvement of autophagy.

Systemic syndrome differentiation pulse science is a development and innovation of traditional Chinese pulse diagnosis under the guidance of systems science. It constructs a systematic pulse manifestation analysis system through five dimensions: position, rate, form, movement, and quality. Based on this system, the integration with the eight principles differentiation and qi-blood-body fluids syndrome differentiation is explored. This integration enables more precise characterization of the disease properties of exterior-interior, cold-heat, deficiency-excess, and yin-yang. Moreover, it reveals the etiology, pathogenesis, and transmission patterns of diseases through the dynamic changes of pulse pattern elements. The systemic syndrome differentiation pulse science pulse manifestation analysis system, combined with various traditional Chinese medicine diagnostic methods, provides a more standardized and precise basis for clinical pulse diagnosis and constructs a new approach for clinical diagnosis and treatment.

Based on the concepts of ‘preventive treatment of disease’ and ‘preventing the progression of existing disease’, traditional Chinese medicine (TCM) therapy demonstrates unique advantages in delaying the progression of heart failure (HF). Guided by the ‘opening-closing-pivoting’ theory of the Huangdi Neijing, and combining the qi transformation functions of the six meridians with the pathological evolution laws of HF, this paper proposes a staged treatment strategy. In the early stage, dysfunction of Taiyang and Shaoyang predominates; treatment focuses on harmonizing Ying (nutrient) and Wei (defensive) and pivoting the qi mechanism, using modified Guizhi Decoction combined with Bupleurum-based formulas. The middle stage centers on the mutual impairment of Taiyin and Shaoyin; treatment focuses on warming and transporting the Middle Jiao and unblocking yang to promote diuresis, utilizing modified Lingguizhugan Decoction combined with Zhenwu Decoction. In the late stage, due to the exhaustion of the Shaoyin pivot and the failure of the Jueyin closing function, there is a significant risk of yin-yang separation. Treatment aims to restore yang to rescue the patient from collapse and astringe yin to prevent desertion; the primary prescription is modified Sini Decoction, supplemented with heavy settlers to anchor floating yang. By adhering to the therapeutic principle of ‘appropriate opening and closing, and rhythmic pivoting’, this approach highlights the advantages of TCM in holistic regulation and staged individualized treatment.

Objective:To qualitatively analyze the chemical constituents in Renqing Mangjue using ultra-performance liquid chromatography-quadrupole time-of-flight tandem mass spectrometry (UPLC-Q-TOF MS).Methods:The analysis was performed on an Agilent ZOBRAX SB-C₁₈ column (4.6 mm×250 mm, 5 μm) using a gradient elution with a mobile phase of 0.1% formic acid aqueous solution (A) and 0.1% formic acid acetonitrile solution (B). Compounds were identified based on retention time, accurate relative molecular mass, and mass spectrometry fragment ions, utilizing a self-constructed database and comparison with standard substances and published literature.Results: A total of 166 compounds were identified from Renqing Mangjue, including 53 flavonoids, 32 phenolic acids, 17 alkaloids, 22 terpenoids, 13 anthraquinones, and 29 other compounds. Among these, 19 of which were accurately identified by comparison with standard substances.Conclusion: The study successfully achieved rapid and comprehensive characterization and identification of the chemical constituents in Renqing Mangjue, providing valuable theoretical support for the exploration of its active substances and the establishment of quality control measures.

Polycystic ovary syndrome (PCOS) is a common gynaecological endocrine disorder that seriously affects the reproductive function of women in their childbearing years. TCM master XIAO Chengzong has been practicing medicine for dozens of years, inheriting the harmony ideology academic thinking of Yanjing XIAOs’ medicine, innovation and development, and believes that PCOS is based on renal deficiency, with pathological factors involving phlegm-dampness, blood stasis, etc., and renal deficiency, phlegm and blood stasis as the main pathogenesis, and proposes that the true period of biochemistry should be grasped and yin-yang transformations should be complied with. The main treatment is to tonify the kidney, dispel blood stasis and resolve phlegm, focusing on the internal guarding of Yuan Zhen, and promoting follicular growth, development and maturation through the harmonisation of yin and yang; in the period of true chance, attention is paid to the ‘spirit of mobility’, and the medicines used in the formulas and medications should include medicines that activate the blood and help mobilisation, so as to facilitate the exchange of yin and yang and to transform yin into yang.

Chinese philosophy is the philosophy of life, and Chinese medicine is the study of life following the nature and ‘the way of life’. Under the guidance of the principle of ‘the way of life’, Xin’an doctors have gradually formed medical cases that comply with the principle of life, the qi of life, the use of life, the effect of life, and the virtue of life. Xin’an doctors pay attention to the understanding of human physiology and pathology to guide its diagnosis and treatment and health practice, and pay attention to the protection and mobilization of human life in clinical medicine; According to the actual situation of the disease, flexible use of medicine, acupuncture, external treatment and other methods; In the process of medicine, the heart should be treated first to improve the effectiveness of life. The concept of the virtues of life will be implemented in clinical treatment and prevention of health care, and eventually form the ‘way of life’ Xin’an medicine medical case.

The ‘Six Principles’ was first recorded in Biographies of Bian Que and Cang Gong in Records of the Grand Historian. The exposition not only used medical matters as a metaphor for state governance but also conformed to medical principles, hence being widely quoted in medical works of later generations. Through transcription and evolution over successive dynasties, the ‘Six Principles’ was attributed to both Bianque and Canggong. It evolved from a medical discourse on prognostic judgment into a moral code of conduct for patients seeking medical treatment, and thus became the seed and an important carrier of the development of ancient doctor-patient ethics. Its interpretations and content changed alongside the development of medical practices in ancient China, reflecting the characteristics of the medical ecology of each dynasty. This paper clarifies the historical evolution of the ‘Six Principles’, interprets the rich historical information embedded in its emergence and evolution and explores, the inspirations from a critical inheritance perspective.

Objective:To develop and validate a diagnostic scale for polycystic ovary syndrome (PCOS) based on traditional Chinese medicine (TCM) syndrome elements, addressing the lack of standardization in clinical pattern differentiation.Methods:A multicenter cross-sectional study enrolled 448 PCOS patients from seven tertiary hospitals nationwide. An item pool was constructed using literature and theoretical frameworks, followed by item selection and model optimization via logistic regression, ROC curves, and Youden indices.Results: The scale established 10 core syndrome elements and developed a quantitative diagnostic model. Validation demonstrated an overall accuracy >75%, AUC ranging from 0.81 to 0.91, with sensitivity and specificity both >70%. Split-half reliability was 0.74, Cronbach’s alpha coefficient was 0.87, and factor analysis extracted three common factors (cumulative contribution rate 51.48%), consistent with the theoretical framework.Conclusion: Based on the ‘New Theory of Chong and Ren Vessels’ and the pathogenesis of ‘Kidney Deficiency with Chong Vessel Rebellion’, this study constructs a dynamic PCOS pattern differentiation model integrating ‘symptoms-pattern elements-patterns’. It provides a scientifically practical diagnostic tool for standardizing TCM pattern differentiation.

By examining the extant medical literature on Bianque’s medicine, this study aims to elucidate the academic discourse, theoretical value, and practical significance of Bianque’s medicine utilization of Shushu in the construction of his medical system. Through an analysis of the relationship between the concept of ‘Shou Shu’ and Shushu, this study outlines the fundamental aspects and underlying connections of the techniques employed in Bianque’s medicine, including pulse-taking, observation of complexion, voice-diagnosis and morphometric diagnosis. It is noted that the medical techniques of pulse-taking, observation of complexion, voice-diagnosis and morphometric diagnosis of the Bianque’s school are based on the physiological foundation of blood vessel. Their primary purpose is to clarify the nature of blood and qi, with Shushu as the fundamental structure and defining feature. The notion of ‘shrewd in Shou Shu’ provides an accurate description of the concept and theory of Shushu in the quantitative diagnosis and treatment system of Bianque’s medicine. Understanding this concept and feature is a fundamental prerequisite for the paradigm shift, inheritance innovation of Chinese medicine.

Chronic kidney disease (CKD) is one of the critical public health issues in the world. ‘Kidney deficiency’ refers to the insufficiency of renal yin, yang, essence and qi, while ‘collateral stoppage’ refers to the blockage of collateral in the kidney. The fundamental cause of CKD is the deficiency of healthy qi or the insufficiency of renal yin, yang, essence and qi. The internal factors of the progression of CKD are the micro masses embezzling the renal collateral or the turbid toxin accumulation. In brief, ‘kidney deficiency’ is the basic reason of ‘collateral stoppage’ formation, which is the key factor exacerbating ‘kidney deficiency’. Therefore, this article discussed the pathogenesis and differentiation and treatment of CKD from ‘kidney deficiency’ and ‘collateral stoppage’. The core pathogenesis of CKD is summarized as ‘kidney deficiency and collateral stoppage’. On this basis, it is further proposed that spleen and kidney are critical in the treatment of ‘deficiency’, with the aim of balancing and protecting yin and yang, and collateral dredges are crucial in the treatment of ‘stoppage’, with the aim of annihilating or eliminating micro masses and turbid toxin. It is hoped that this article could have value of reference for the theoretical development and clinical treatment of CKD in traditional Chinese medicine.

Aromatic drug is fragrant, pungent and warm, and good at regulating women’s qi and blood, so it is widely used in the field of gynecology in the Northern Song dynasty. In the treatment of different gynecological disease such as menstrual disease, leukorrheal disease and reproductive-obstetrical disease, Shengji Zonglu is reasonably selected in combination with the respective characteristics of aromatic drug such as Gui, Xiongqiong, Muxiang and Aiye. In addition, the book increases the efficacy of aromatic drug by the special treatment of raw and processed dual-use, and fire-avoiding preparation, or the clever use of aromatic drug pair of Xiongqiong, or the assistance of wine. It also makes up for the disadvantages of aromatic drug in consuming qi and damaging yin by regulating the dosage of aromatic drug, or combining with the products of benefiting qi and nourishing blood, so that aromatic drug can better play the functions of activating blood and dredging meridians, ascending and stopping collapse, removing dampness and turbidity.

Objective:To explore the possible mechanism of Jiedu Quyu Ziyin Prescription (JP) in antagonizing hippocampal neuron damage in prednisone-induced MRL/lpr lupus mice from the perspective of the gut-brain axis.Methods:Thirty-two female MRL/lpr mice were divided into four groups: control group, Prednisone acetate (PA) model group, PA+JP group, and PA+Memantine hydrochloride (MH) group, with eight mice in each group. The degree of hippocampal neuron damage in mice was analyzed by inducing long-term potentiation (LTP) in vivo, and the relative value of population spike (PS) amplitude after high-frequency stimulation (HFS) was used as an indicator to observe LTP induction. The Morris water maze test was used to assess learning and memory performance in each group. The gut microbiota of colonic feces from each group was analyzed using 16S rRNA gene sequencing. Pathological changes in hippocampal neurons were observed using HE staining.Results: Compared with the model group, the relative PS amplitude in the JP group was significantly increased (P<0.01), the escape latency was significantly shortened on days 4 and 5 (P<0.01), and the pathological changes in hippocampal neurons were significantly improved. 16S rRNA gene sequencing of colonic feces showed that the relative abundances of Bacteroidota, Odoribacter, and Rikenellaceae_RC9_gut_group were significantly increased in the model group compared with the control group, while the relative abundances of Firmicutes and Dubosiella were significantly decreased. These changes in gut microbiota were significantly improved after treatment with JP and MH. Functional prediction of the gut microbiota genes revealed upregulation in pathways related to cognitive dysfunction such as Parkinson’s disease and downregulation in pathways related to cognitive improvement such as taurine and hypotaurine metabolism. Treatment with JP downregulated the expression of gut microbiota genes in pathways related to cognitive dysfunction and upregulated their expression in pathways related to cognitive improvement.Conclusion: Jiedu Quyu Ziyin Prescription improves hormone-induced hippocampal neuron LTP damage through the gut-brain axis, thereby exerting both synergistic and detoxifying effects in the treatment of systemic lupus erythematosus.

This article summarizes the clinical experience in applying the Jingshun Decoction to treat heart failure based on the five-dimensional differentiation and treatment theory. Jingshun Decoction originally recorded as the Taiyang Sitian formula in CHEN Wuze’s treatise on the Sanyin Jiyi Bingzheng Fanglun, this paper details the application of Jingshun Decoction for heart failure with a cold-dampness Yunqi pathogenesis from five dimensions: Yunqi spatio-temporal patterns, disease-syndrome-formula correspondence, human constitution, disease pharmacology, and drug potency. The Yunqi spatio-temporal dimension incorporates analysis of the Sitian Zaiquan, host-guest qi, the opening-closing-pivoting temporal phases, and Yunqi-targeted/herb-paired medicine. The disease-syndrome dimension integrates considerations of pathogenesis, syndrome elements, formula-syndrome correspondence, and herb-syndrome correspondence. The human constitution dimension combines assessments of Yunqi-conferred constitutional predisposition and TCM constitutional types. The disease pharmacology dimension reconciles traditional herbal functions with modern pharmacological actions. The drug potency dimension synthesizes factors of dosage, therapeutic efficacy, and preparation methods. Guided by a holistic disease-view, treatment-view, and preventive-view rooted in the heaven-human unity concept, by applying Yunqi formulas within this five-dimensional framework, the clinical goal of ‘clarifying the five dimensions to comprehensively achieve fivefold therapeutic efficacy’ is pursued.

Objective:To observe the clinical effect of Kangxian Yixin Prescription in the treatment of dilated cardiomyopathy (DCM) with qi deficiency and blood stasis syndrome based on the real world.Methods:A total of 664 patients with DCM were included from June 2010 to October 2021 at Henan Provincial Hospital of Traditional Chinese Medicine and divided into the Western medicine conventional treatment group (group A) and the Kangxian Yixin Prescription group (group B). The course of treatment was 6 months, followed up at 6 months and 12 months. Traditional Chinese medicine syndrome score, cardiac function grade, left ventricular end-diastolic inner diameter (LVEDD), left ventricular ejection fraction (LVEF), left ventricular short axis shortening rate (LVFS), and safety indexes were compared between the two groups before and after treatment, and the clinical efficacy, clinical cure rate, left ventricular reverse remodeling condition and safety were evaluated.Results: Compared with before treatment, TCM syndrome scores in both groups decreased at 6 and 12 months (P<0.05), and the decrease in group B was more significant than that in group A (P<0.05). LVEDD was significantly decreased in both groups (P<0.05), LVEF and LVFS were significantly increased (P<0.05), and the improvement of group B was more significant than that of group A (P<0.05). The total effective rate of cardiac function improvement in group B was higher than that in group A (P<0.01, P<0.05). The proportion of normal heart structure and function and reverse left ventricular remodeling in group B were both higher than those in group A. The occurrence of adverse reactions in the group B was lower than that in the group A (P<0.05).Conclusion: Kangxian Yixin Prescription can effectively improve clinical symptoms, improve heart function, and reverse ventricular remodeling in patients with DCM in qi deficiency and blood stasis syndrome.

This article introduces professor LAI Xinsheng’s clinical experience in treating breast hyperplasia using the Tongyuan therapy, which is based on the principle of staged treatment based on syndrome differentiation and combining acupuncture and herbal medicine. Mammary gland hyperplasia, also known as abnormal breast structure, falls within the scope of traditional Chinese medicine’s ‘breast fibroid’ ‘breast nut’ and ‘breast knot’. Professor LAI considers that the mammary gland hyperplasia is characterized by liver depression, spleen and kidney deficiency, and disharmony between penetrating vessel and conception vessel, which manifests as qi stagnation, blood stasis, phlegm coagulation, etc., and locally produces pathological products of qi, blood, phlegm, dampness and blood stasis. The treatment is based on the characteristics of breast filling before menstruation and relieving after menstruation. Treatment follows a staged approach based on the characteristics of breast fullness before menstruation followed by alleviation afterward. During the premenstrual period treatment focuses on soothing liver qi stagnation, promoting blood circulation to remove stasis while also softening liver to disperse stagnation; during post-menstrual period emphasis shifts to strengthening spleen function for nourishing qi and blood replenishment along with regulating liver-kidney functions to harmonize penetrating vessel and conception vessel, additionally addressing dampness-phlegm transformation while dispersing hardness are essential aspects. Furthermore, combination of acupuncture and medicine and staging treatment based on syndrome differentiation aim for both stage-specific differentiation as well as holistic management.

By examining the knowledge construction of traditional Chinese medicine (TCM) etiology theories through the methodology of knowledge archaeology, it can be discerned that the origins of TCM etiology theories trace back to the pre-Qin period, with the early etiology theories centered on ‘direct causes’. Following the Sui and Tang dynasties, ‘inferred causes’ gradually emerged and became the mainstream of etiology theories during the Ming and Qing dynasties. The modern reconstruction of TCM etiology theories under the ideology of syndrome differentiation and treatment involves, on the one hand, the integration of etiology theories from various dynasties, particularly by taking ‘inferred causes’ as the primary focus of modern TCM etiology, and on the other hand, the interpretation and absorption of some etiological knowledge from modern medicine, thereby enriching the theoretical connotations of TCM etiology.

Objective:To analyze the demographic characteristics, antiretroviral treatment status, and TCM syndrome characteristics of AIDS hospitalized patients in Shangcai County, Henan Province based on the real world.Methods:Hospitalization information of AIDS patients admitted for the first time from January 2011 to November 2017 in Traditional Chinese Medicine Hospital of Shangcai County was extracted to construct a database with traceability verification. Frequency and rate analyses were performed using SPSS 25.0 and Excel 2023, and chi-square tests were used for intergroup comparisons.Results: In the real-world setting, paid blood donation was the main route of infection for AIDS hospitalized patients in Shangcai County, Henan Province. HIV antibody testing was positive in 89.3% (5 329/5 970) of AIDS hospitalized patients between 2000-2010. Among AIDS hospitalized patients, 17.7% (1 077/6 095) had hypertension, 17.4% (1 063/6 095) had hepatitis, and opportunistic infections were common with pulmonary infections accounting for 4.1% (248/6 095). HAART adherence was maintained in 70.9% (4 124/5 816) of AIDS hospitalized patients, with 58.3% (2 403/4 124) using the second-line HAART regimen at that time. CD4⁺ T cell counts <200 cells/mm³ accounted for 32.1% (1 074/3 343). Common current symptoms included fatigue, poor appetite, dizziness, and heaviness in the limbs. Lymphadenopathy and skin lesions (papules, herpes) were common physical signs. Tongue colors were commonly pale-red, red, and pale-white. Tongue coatings were commonly thin, greasy, and thick, with white and yellow being common coating colors. Pulse patterns were commonly thin, deep, and taut. The most common TCM syndrome type was deficiency of qi, blood, yin, and yang. There was a correlation between TCM syndrome types and CD4⁺ T cell counts. When CD4⁺ T cell counts >350 cells/mm³, the syndrome was primarily excess-type; when ≤200 cells/mm³, it was primarily deficiency-type.Conclusion: The study provides the data support for TCM treatment of AIDS, optimization of clinical treatment pathways, and development of targeted prevention and control strategies.

Objective:To explore the temporal distribution pattern of the maximum daily average blood pressure in hypertensive patients based on the theory of meridian flow, and to provide corresponding theoretical basis and diagnostic and treatment ideas for the prevention and treatment of hypertension.Methods:A retrospective collection was conducted on patients who underwent 24-hour dynamic blood pressure monitoring at Xiyuan Hospital of China Academy of Chinese Medical Sciences from January 1, 2023 to December 31, 2023. A total of 1 642 valid cases were screened and stratified by age, gender, hypertension level, and comorbidities. The dynamic blood pressure data of each stratified patient were analyzed using t-tests and χ² tests, and the distribution of the maximum daily average blood pressure and corresponding meridians in each stratified patient was summarized.Results: The maximum average arterial pressure throughout the day was higher in the youth group (P<0.01). The age of the male group was lower (P<0.01). The maximum average arterial pressure throughout the day was higher in the hypertensive grade 3 group (P<0.01). The average arterial pressure throughout the day was higher in the hypertension combined with kidney disease group (P<0.01). The maximum daily average blood pressure of hypertensive patients mainly occurs during the Chen and You periods.Conclusion: Severe hypertension is more common in young male patients. Patients with primary hypertension and concomitant encephalopathy or kidney disease are more likely to experience high blood pressure. Hypertensive patients mainly experience maximum blood pressure during the Chen and You periods. During the Chen period, the Yangming meridian point is selected to select traditional Chinese medicine that belongs to the Yangming meridian; Taking the Shaoyin meridian acupoint and selecting traditional Chinese medicine that belongs to the Shaoyin meridian during the You period, the treatment of hypertension is more effective according to the Chen and You periods.

This study pioneers a three-dimensional tuoyue body qi mechanism model in Huangdi Neijing based on the scientific framework of temperament-calendar integration: ①Spatial dimension establishes a dynamic exterior-interior structure of the ‘body shell (tuo)-zang fu (yue)’, where zang organs distribute nutritive blood via meridians and defensive fluids via the triple energizer pathway to the body shell, realizing ‘yue-dynamic drives tuo-response’ synergy. ②Temporal dimension reveals defensive qi’s rhythmic expansion-contraction within the body shell synchronized with temperament-calendar cycles (day-night/four seasons/lunar phases), laying the foundation for ‘heaven-human correspondence’. ③Qi-transformation dimension deciphers the dynamic mechanism of the collaborative zang-organ system distributing nutritive-defensive qi, blood, and qi to the body shell, alongside the functional division between ‘nutritive-defensive qi and blood’. The model operationalizes theories such as ‘opening-closing-pivoting’, demonstrating the temperament-calendar origin of ‘heaven-human correspondence’. Clinically, qi disorders are attributed to ‘yue-dysfunction causing tuo-dysregulation’, exemplified by Wuling Powder syndrome and Shengyu Decoction syndrome. This model systematically integrates classical qi theory, providing mechanistic insights for ‘regulating zang-organs to treat the body’.

Chronic heart failure (CHF) is the end-stage manifestation of various cardiovascular diseases, characterized by high prevalence, frequent rehospitalization, and elevated mortality rates, making it a significant public health issue. Buyang Huanwu Decoction, derived from Yilin Gaicuo, is a classic herbal formula for treating CHF, known for its effects in replenishing qi, promoting blood circulation, and removing meridian obstructions. This article systematically reviews and analyzes clinical studies and mechanisms of Buyang Huanwu Decoction in treating CHF by searching Chinese and English databases. Clinical research indicates that Buyang Huanwu Decoction combined with conventional Western medicine significantly improves clinical symptoms, cardiac function, TCM syndrome scores, and quality of life in CHF patients, with good safety and minimal adverse reactions. Mechanistic studies focus on its roles in inhibiting the neuroendocrine system, delaying myocardial remodeling, reducing apoptosis, alleviating immune-inflammatory responses, improving myocardial energy metabolism, regulating calcium cycling dysfunction, mitigating endoplasmic reticulum stress, and modulating gut microbiota. This article summarizes the research progress on Buyang Huanwu Decoction in treating CHF, highlights existing limitations, and provides suggestions for future research and clinical applications.

The Luo Xuanfu, as the microscopic structural unit of the collateral meridian system, forms a three-dimensional network with the Xuanfu (pores) and collaterals, whose core function is to regulate qi-blood transformation and essence distribution through the ‘gathering-dispersing and opening-closing’ dual axis mechanism. Building on previous physiological studies, this research further elucidates its pathological characteristics: Luo Xuanfu stagnation serves as the initiating factor for diseases, while ‘defects in gathering-dispersing’ and ‘dy-sregulation of opening-closing’ constitute critical progression stages. The former manifests as qi-blood mutual transformation disorders, while the latter leads to essence distribution imbalances. These two pathological processes reciprocally reinforce each other, forming a vicious cycle that drives disease pathogenesis. In response, this study proposes a novel therapeutic framework centered on ‘opening and activating the Luo Xuanfu’, with two core strategies: ‘regulating qi and harmonizing form’ and ‘promoting dispersion and unblocking’ (pathway clearance). Complementary therapies: including tonifying deficiency and removing stagnation, eliminating dampness and promoting water transformation, heat-clearing and fire-purging, eliminating phlegm and clearing up turbid, and activating blood and removing toxin, are tailored to specific pathogenic products. Additionally, insect ant based therapies are employed to improve microcirculation. Through the synergistic application of these three therapeutic approaches that act in a targeted manner on the Luo-Xuanfu, we break through the cognitive limitation that the traditional Xuanfu merely governs the circulation of qi and body fluids, resolve the inherent contradictions of simple unblocking therapy, such as ‘deficiency of nourishment after unblocking’ and ‘subsequent tissue damage after unblocking’, and establish a microscopic regulatory mechanism for form-qi transformation as well as a dual-axis treatment system based on ‘gathering-dispersing and opening-closing’, thereby providing innovative insights for the clinical management of complex refractory diseases.

Objective:To explore the association between chronic disease comorbidity patterns and the consumption of medicinal plants among Chinese older adults.Methods:The data originated from the 2018 cross-sectional survey of the ‘Chinese Longitudinal Healthy Longevity Survey’. The study sample comprised 15 442 elderly aged 65 and above from 23 provinces (autonomous regions, municipalities) who completed questionnaires on the consumption of medicinal plants, self-reported diseases, and other surveys. SPSS 26.0 software was utilized for analysis of variance, chi-square tests, and multifactorial Logistic regression analysis.Results: The average age of the enrolled elderly was (85.60±11.61) years, with 83.7% (12 920/15 442) occasionally or regularly consuming medicinal plants. In the single chronic disease comorbidity pattern, the rate of comorbidity of two or more chronic diseases was 53.4%. In the complex chronic disease comorbidity pattern, the prevalence rates for the simple comorbidity group, mild and severe complex comorbidity groups were 10.2% (1 576/15 442), 39.3% (6 068/15 442), and 17.2% (2 659/15 442), respectively. After adjusting for confounding factors, in the single chronic disease comorbidity pattern, the presence of two or more chronic diseases was positively correlated with occasional or regular consumption of medicinal plants (OR=1.45, 95%CI[1.30, 1.61], P<0.001). In the complex chronic disease comorbidity pattern, compared to the relatively healthy group, the simple comorbidity group, mild, and severe complex comorbidity groups all showed a positive correlation with occasional or regular medicinal plant consumption, with the odds increases of 32%, 34%, and 56%, respectively (P<0.01, P<0.001). Subgroup analyses showed that within both the single and complex chronic disease comorbidity patterns, the frequency of medicinal plant consumption was significantly higher among males, those aged 65-80, and those with adequate access to medical services compared to females, those aged >80, and those without adequate access to medical services (P<0.001).Conclusion: The comorbidity patterns and numbers of chronic diseases in the Chinese elderly population are closely associated with occasional or regular consumption of medicinal plants.

AIDS osteoporosis is a common complication affecting the quality of life of HIV infected patients. Modern medicine believes that its pathogenesis is related to multiple factors such as the direct effect of HIV, antiviral drugs, chronic inflammation, and intestinal flora disorder. In traditional Chinese medicine (TCM), it is classified as ‘bone weakness’. The pathogenesis is ‘kidney deficiency’ and ‘blood stasis’ as the core, and the treatment is mainly to invigorate the kidney and spleen, promote blood circulation and strengthen bone. Based on the review of the understanding of TCM and Western medicine and the existing treatment plan, this paper points out the deficiencies in the current research in the aspects of pathogenesis interpretation, clinical design, drug development, and so on. In the future, it is proposed that multi-dimensional systematic research should be carried out from the theoretical, clinical, experimental and new drug development, so as to construct and improve the diagnosis and treatment system of AIDS osteoporosis with TCM.

Hepatic fibrosis (HF) is a key pathological stage in the progression of various chronic liver diseases to cirrhosis and liver cancer, posing a serious threat to human health. Currently, there is a lack of effective clinical treatment. This article firstly discusses the liver-gut axis, a bidirectional regulatory network between the gut and its microbiota and the liver, and its relationship with the occurrence and development of HF. Secondly, intestinal barrier damage, intestinal flora imbalance, and bile acid metabolism disorders, as manifestations of liver-gut axis dysfunction, are important mechanisms exacerbating HF. In addition, traditional Chinese medicine, with its unique advantages of targeting multiple pathways, shows significant potential in preventing and treating HF by regulating the homeostasis of the liver-gut axis. This article provides a review of research progress on how traditional Chinese medicine inhibits HF by regulating liver-gut axis homeostasis, such as repairing the intestinal barrier, regulating the abundance and diversity of intestinal flora, and improving bile acid metabolism.