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主 办:北 京 中 医 药 大 学
ISSN 1006-2157 CN 11-3574/R

Table of Content

    15 May 2015, Volume 38 Issue 5 Previous Issue    Next Issue
    On complexity of original thinking mode in Traditional Chinese Medicine*
    GUO Gang, XU Li, ZHENG Yan-fei, BAI Ming-hua, YU Ruo-xi, WANG Qi
    2015, 38 (5):  239-298.  doi: 10.3969/j.issn.1006-2157.2015.05.001
    Abstract ( 469 )   Save
    The original thinking mode of Traditional Chinese Medicine is a holistic thinking modality, which makes use of analogy and numbers, integrates body-spirit unity and considers qi as monism. This thinking mode is characterized by holistic dynamics, ambiguity, nonlinearity, and uncertainty. However, with clinical practice as its objective criteria, complemented by logical thinking, it has turned into a relatively stable, abstract, and explanatory system.
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    Microscopic interpretation of TCM constitutional theory using intestinal microecology*
    HUANG Teng-jie, LI Ying-shuai, LUO Bin
    2015, 38 (5):  299-302.  doi: 10.3969/j.issn.1006-2157.2015.05.002
    Abstract ( 548 )   PDF (1076KB) ( 809 )   Save
    Modern microecology states that there are a lot of commensal bacteria on the surface and inside human body, and most of them reside in the human intestines. The microbiota, which colonize in the gut of the host, the host, and the environment, together constitute a unity of dynamic equilibrium. Intestinal microecology is mainly to explore the structure and function of gut microbiota in the bodies of healthy human beings, to discover the influence of the structural disorder of gut microbiota on human health, and to use its intervention to guide the host to live healthily. Human’s constitution in TCM theory is considered as an inherent characteristic, which is formed on the basis of the prenatal and postnatal development of human beings, and affects morphology, physiology and psychology. The human gut microbiota are involved in many physiological and pathological activities, and their changes could reflect the physiological and pathological state of the host, so the research method of using intestinal microecology to study TCM constitution could be of important significance in the individual treatment. The four basic principles and three scientific questions of TCM constitutional theory are strongly interrelated with the basic theory of intestinal microecology, and they could serve as mutual interpretation. Based on the study result of modern intestinal microecology, this paper attempts to combine TCM constitutional theory with intestinal microecology, and offers microscopic interpretation of the four basic principles and the three key scientific questions of TCM constitutional theory.
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    Analysis of tertiary collateral vessel in Huangdi’s Internal Classic
    LIU Bin,YOU Hai-yan
    2015, 38 (5):  303-305.  doi: 10.3969/j.issn.1006-2157.2015.05.003
    Abstract ( 616 )   PDF (1138KB) ( 1038 )   Save
    Tertiary collateral vessel (Sun Luo) is a component of meridian and collateral system. It belongs to vessel (Mai) in the five body constituents and is also a branch of collateral vessel. This article discusses the properties of tertiary collateral vessel after reviewing chapters and sections related to tertiary collateral vessel (Sun Luo) and tertiary vessel (Sun Mai) in Huangdi’s Internal Classic (Huang Di Nei Jing). It is found that tertiary collateral vessel is located at the level of flesh (musculature) in five body constituents. A large number of tertiary collateral vessels form a wide range of interconnection in flesh (musculature), integrate Qi with blood, and flow to other structure, with particularly close relationship with Xigu and skin. Tertiary collateral vessel takes part in the circulation of Qi and blood, receives the infusion of nutrient Qi in middle energizer (jiao), and is a key part of meridian and collateral system for receiving the essence of water and food. The initial findings of the research reveals the complexity of tertiary collateral vessel as well as its distinctiveness in the Qi and blood circulation in human body. It has potential practical value in the diagnosis and treatment of related diseases, as well as in the research of chronomedicine. It is also significant for research on hemorheology of meridian and collateral system through further discussion on the characteristics of the structure and flow of tertiary collateral vessel.
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    Collation methods of ancient books by the Office of Revising Medical Books in the Northern Song Dynasty*
    WANG Li-yuan, ZENG Feng
    2015, 38 (5):  306-309.  doi: 10.3969/j.issn.1006-2157.2015.05.004
    Abstract ( 513 )   PDF (1145KB) ( 767 )   Save
    By analyzing the differences between the two editions of Important Formulas Worth a Thousand Gold Pieces (Qian Jin Yao Fang) as well as other medical literature edited by Song scholars, this thesis has summed up most of the collation methods used by Song scholars to edit Traditional Chinese Medicine(TCM) ancient literature. Those methods include: rectification, addition of missed content, deletion of repeated content and the rearrangement as well as the reordering of content. It can be said that Song scholars outpaced the methods used by Han and Tang scholar and they put more emphasis on the accuracy and intactness of the content as well as the consistency of the form. The efforts of Song scholars have promoted the enrichment of Chinese medicine theories and accuracy of the Chinese medicine academic framework. Their work has a profound and extensive influence on the development of Chinese medicine theories.
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    Evolution of TCM patterns from non-atrophic to atrophic gastritis*
    CHEN Run-hua, ZHANG Chang, SU Ze-qi, LI Pei-cai, DING Xia
    2015, 38 (5):  310-314.  doi: 10.3969/j.issn.1006-2157.2015.05.005
    Abstract ( 798 )   PDF (1099KB) ( 540 )   Save
    Objective To examine the evolution of TCM patterns from Non-atrophic gastritis (CSG) to atrophic gastritis (CAG). Methods We analyzed TCM patterns in 400 cases of chronic gastritis. χ2 test was used to compare the evolution of TCM patterns from CSG to CAG. Results There were nine essential pattern elements for chronic gastritis, namely, Qi deficiency, Qi stagnation, dampness, heat, Yin deficiency, Yang deficiency, blood stasis, food accumulation, and cold. Eight basic pattern categories for chronic gastritis were liver-stomach disharmony, liver-stomach constraint heat, spleen cold and stomach heat, retention of heat in the interior, spleen-stomach weakness (including Qi deficiency and yang deficiency), phlegm obstructing the stomach collaterals, food accumulation, and stomach-Yin deficiency, respectively. Chi-square test showed that CSG was closely related to Qi deficiency, Qi stagnation, heat, Yang deficiency, blood stasis, food accumulation and coldness while CAG was related to dampness, particularly to Yin deficiency. The correlation between nine essential pattern elements and Hp-positive CSG were: food accumulation > Heat > Yin deficiency; food accumulation > Qi stagnation > Yin deficiency; indigestion > coldness > Yin deficiency; food accumulation > dampness; blood stasis > dampness; Qi deficiency > Yin deficiency; Yang deficiency> Yin deficiency; blood stasis > Yin deficiency. Hp-positive CAG was just the opposite. Chi-square test also showed that stomach-Yin deficiency pattern was related to CAG and that CSG was related to other six basic pattern types except the pattern of heat retention in the interior. The correlation between the eight basic pattern categories and Hp-positive CSG were: food accumulation > liver-stomach constraint heat > stomach-Yin deficiency; food accumulation > pattern of spleen-stomach weakness > stomach-Yin deficiency; food accumulation > accumulation of damp-heat; stasis obstructing stomach collateral > pattern of heat retention in the interior; liver-stomach disharmony > stomach-Yin deficiency; stasis obstructing stomach collaterals > stomach-Yin deficiency. Hp-positive CAG was just the opposite. Conclusion Food accumulation is the earliest TCM pattern in chronic gastritis, thereafter dampness, heat, and blood stasis. Pattern of heat retention in the interior and deficiency of Healthy Qi is present throughout the development of chronic gastritis. In CSG stage, excess of pathogenic factors is often dominant. Sometimes, deficiency and excess patterns may coexist. In CAG stage, deficiency of Healthy Qi is dominant.
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    Effects of Shenling Baizhu San on the protein expression of NF-κB p65 and the serum level of related inflammatory cytokines in the colon tissue of rats with ulcerative colitis due to dampness retention and spleen deficiency*
    LI Zi-hui, WANG Jian, CAI Rong-lin, SUN Juan, YE Ming-gang
    2015, 38 (5):  315-317.  doi: 10.3969/j.issn.1006-2157.2015.05.006
    Abstract ( 480 )   PDF (1082KB) ( 679 )   Save
    Objective To investigate the effects of Shenlin Baizhu San (Ginseng, Poria and Atractylodes Macrocephalae Powder) on the protein expression of NF-κB p65 in the colon tissue of rats with ulcerative colitis due to dampness retention and spleen deficiency, as well as the related inflammatory cytokines. Methods 48 Wistar rats were divided into four groups: normal group, model group, sulfasalazine group, and Shenlin Baizhu San group, with 12 rats in each group. The model rats were induced by environment and diet intervention combined with composite trinitrobenzene sulfonic acid and ethanol in enema. The protein expression of NF-κB p65 in the colon tissue of rats were detected with immunohistochemistry methods. Levels of IL-6,IL-8, and TNF-α were measured with ELISA. Results The protein expression of NF-κB p65 and the serum level of IL-6,IL-8, and TNF-α in the model rats were significantly higher than those in normal group (P<0.05). The protein expression of NF-κB p65 and the serum level of IL-6, IL-8, and TNF-α in Shenlin Baizhu San and sulfasalazine groups significantly decreased, and the difference was significant compared with model group (P<0.05). The difference between Shenlin Baizhu San and sulfasalazine groups showed no statistical significance (P>0.05). Conclusion Shenlin Baizhu San could significantly improve the protein expression of NF-κB p65 and the serum level of IL-6,IL-8, and TNF-α in the colon tissue of rats with ulcerative colitis, which could promote the repair of the intestinal mucosa.
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    Protective effects of total saponrins in Panax Notoginseng on high glucose-induced injury in cultured rat retinal capillary endothelial cells(RRCECs)*
    QIAO Yuan, DUAN Hui-hui, HUANG Jian-mei, TANG Min-ke
    2015, 38 (5):  318-322.  doi: 10.3969/j.issn.1006-2157.2015.05.007
    Abstract ( 477 )   PDF (1148KB) ( 597 )   Save
    Objective To observe the effects of total saponins of Panax Notoginseng (PNS) protection and expression of intercellular adhesion molecules-1 (ICAM-1) in cultured rat retinal capillary endothelial cells (RRCECs) induced with high-concentration glucose. Methods Endothelial cells obtained from rat retinas were cultured in vitro, and the cells were identified using immunofluorescence. RRCECs were randomly divided into five groups: normal group, high glucose group, high glucose+20 mg/L PNS group, high glucose+50 mg/L PNS group, and high glucose+100 mg/L PNS group. Cell viability was measured with MTT method while cell number was detected with Trypan blue assay. The protein expression of ICAM-1 in RRCECs was measured by using Western blotting. Results According to MTT assay, the cell viability in high glucose+PNS (50 mg/L, 100 mg/L) groups were promoted after an action time of 48 hours and 72 hours (P<0.01). According to Trypan blue assay, after 48 hours and 72 hours, the cell number in high glucose+PNS (100 mg/L) group was increased (P<0.01); after 48 hours, the cell number in high glucose+PNS (50 mg/L) group was increased (P<0.05). After an action time of 72 hours, the expression of ICAM-1 in all high glucose+PNS groups were detected by using Western blotting. The result showed that the expression of ICAM-1 in RRCECs decreased with the rise of PNS concentration under high glucose condition (P<0.01). Conclusion PNS could protect RRCECs from damage caused by high glucose, and inhibit the expression of ICAM-1. Relation between protective effects of PNS and regulation of ICAM-1 expression in cultured RRCECs merits further study.
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    Effects of astragalus and puerarin injections on the expression of GRP78 in KKAy mice with diabetic nephropathy*
    ZHANG Zhi-hui, LI Shu-yu, WANG Yan-fei, ZHANG Da, WU Ying, GAO Yu-shan, ZHANG Shu-jing, JIA De-xian, WANG Qian
    2015, 38 (5):  323-326.  doi: 10.3969/j.issn.1006-2157.2015.05.008
    Abstract ( 423 )   PDF (1144KB) ( 435 )   Save
    Objective To observe the effects of astragalus and puerarin injections on the expression of 78-kD glucose-regulated protein (GRP78) in KKAy mice with diabetic nephropathy. Methods Male KKAy mice were randomly divided into model group and treatment group, and C57BL/6J mice were used as normal control group. The mice in treatment group were given intraperitoneal astragalus injection and puerarin injection from the 12th week. The mice were sacrificed in the 16th week. The blood serum was collected for detecting the levels of fasting blood glucose, urea, creatinine, triglycerides, and total cholesterol. The kidneys were removed and the renal pathological changes were observed. The expression of GRP78 in the renal tissues was examined using immunohistochemical staining. Results Blood biochemical tests in mice showed that, compared with normal mice, the levels of fasting blood glucose, urea, creatinine, total cholesterol and triglycerides increased significantly in model group (P<0.01). Compared with model group, the levels of fasting blood glucose, urea and the creatinine decreased markedly in treatment group (P<0.05 or P<0.01). Under morphological observation, vacuoles were discovered in the cytoplasm of renal tubular epithelial cells in model group. After treatment, the structure of glomerular and tubular were intact, and there were no apparent pathological changes. Immunohistochemistry showed that the expression of GRP78 protein in treatment group was significantly lower than model group (P<0.01). Conclusion Astragalus injection and puerarin injection used together can reduce the degree of endoplasmic reticulum stress and protect the function of kidney through inhibiting the expression of GRP78 to certain extent.
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    Effects of Danzhi Xiaoyao San on morphological changes of encephalic regions in the anxiety model rats*
    MA Xiang-feng, TANG Qi-sheng, ZHAO Rui-zhen, DONG Ning, WANG Rao
    2015, 38 (5):  327-331.  doi: 10.3969/j.issn.1006-2157.2015.05.009
    Abstract ( 385 )   PDF (1104KB) ( 371 )   Save
    Objective To observe the morphological changes in hippocampus and amygdaloid nucleus of rat model exposed to natural enemies and water drinking conflict, when administered with Danzhi Xiaoyao San (Cortex Moutan and Furctus Gardeniae Free Wanderer Powder) which has liver-soothing, heat-clearing and spleen-tonifying effects. Methods Evaluated by the open-field test, the male Wistar rats were randomly divided into four groups: normal group, model group, traditional Chinese herbal medicine group, and western medicine group, with 8 rats in each group. Rats in the model group, traditional Chinese herbal medicine group and western medicine group were exposed to natural enemies and water drinking conflict to establish anxiety model. From the 15th day on, rats in the normal group and model group were offered distilled water, and the rats in the western medicine group started on buspirone hydrochloride, while the rats in the traditional Chinese herbal medicine group were given Danzhi Xiaoyao San using intragastric administration. All the above intervention lasted for 7 consecutive days. Light microscope was used to observe the morphological changes in the hippocampus and amygdaloid nucleus. Results Somas of the neurons of the hippocampus and amygdaloid nucleus were relatively large and round in rats of normal group, and their brain cells lined up in an orderly concentrated manner. In the rats of model group, there was karyopyknosis of a large number of neurons, which were hyperchromatic and deformed; the cells were loosely arranged without patterns and there was increased space between the cells. Such feature was particularly prominent in the CA2 and CA3 regions of the hippocampus. Compared with the model group, cells in the traditional Chinese herbal medicine group and western medicine group appeared significantly better and the cell layout was relatively in order. Conclusion The Chinese herbal medicine, Danzhi Xiaoyao San, the key liver-soothing, heat-clearing and spleen-tonifying formula, may repair the encephalic region injury related to the rat’s Papez circuit and also facilitate the recovery.
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    Protective effects of qi-tonifying toxin-removing Chinese medicinals against acute radiation injury*
    GAO Ming-ze, XU Wen-hui, WANG Tian-qi, MA Jie, LI Feng, HU Su-min
    2015, 38 (5):  332-338.  doi: 10.3969/j.issn.1006-2157.2015.05.010
    Abstract ( 402 )   PDF (1179KB) ( 759 )   Save
    Objective Qi-tonifying toxin-removing Chinese medicinals can tonify qi and remove toxin. This research studied its protective effects against acute radiation injury in mice. Methods There were six groups, including blank group, model group, high dose group of qi-tonifying toxin-removing Chinese medicinals, low dose group of qi-tonifying toxin-removing Chinese medicinals, amifostine group, and anduolin group. All of the above groups were administered for 14 days. At day 14 after drug administration, all groups of mice, except the blank group, were given 4 Gy 60Co gamma ray for total body irradiation to induce acute radiation injury. At day 3,7, and 14 after irradiation, the mice’s white blood cell count, thymus index, spleen index, spleen pathological section, the ratio of CD4+/CD8+ T lymphocyte of peripheral blood, SOD activity and MDA content of liver were examined respectively. Results After gamma ray irradiation in the model group, a significant reduction in white blood cell count were detected. Immune organ index of model group mice decreased significantly. There were also significant pathological changes in the spleen, and marked increase of CD4+/CD8+ ratio, indicating impaired immunity. SOD activity decreased while MDA content increased significantly. At day 7 after irradiation, SOD activity and MDA content returned to normal level; At day 14 after irradiation, the spleen index returned to normal level. Compared with the model group, the spleen pathological changes of treatment groups were less severe. At day 3 after irradiation, the activity of SOD in liver of low dose group was significantly enhanced (p<0.01); hepatic MDA content significantly decreased (p<0.05). At day 7 after irradiation, the spleen index in low dose group and high dose group mice significantly increased (p<0.05), and the ratio of CD4+/CD8+ T lymphocyte in peripheral blood of low dose group significantly reduced (p<0.05); At day 14 after irradiation, thymus index of low dose group significantly increased (p<0.05). Conclusion Low dose of formula has protective effects against sublethal doses of gamma ray induced acute radiation injury in mice.
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    Dynamic variation of main active ingredients and phytohormones in Glycyrrhiza uralensis*
    XIANG Yu, LIU Chun-sheng, LIU Yong, LIU Ying, ZANG Yi-mei, QIAO Jing
    2015, 38 (5):  339-343.  doi: 10.3969/j.issn.1006-2157.2015.05.011
    Abstract ( 423 )   PDF (1277KB) ( 578 )   Save
    Objective To study the dynamic variation of main active ingredients and phytohormones in Glycyrrhiza uralensis. Methods The levels of major active ingredieats(glycyrrhizic acid, liquiritin, liquiritigenin, isoliquiritigenin) and phytohormones, including gibberellic acid(GA3), abscisic acid(ABA), jasmonic acid(JA), indole-3-acetic acid(IAA), and salicylic acid(SA) in Glycyrrhiza uralensis grown from latter part of April to latter part of October were measured. The dynamic variation feature was summarized by analyzing trends of those data. Results The levels of glycyrrhizic acid and liquiritigenin increased along with plant growth. The level of liquiritin increased firstly then decreased while isoliquiritigenin decreased at first then increased afterwards. Both of them reached to a turning point on August 26th. When it came to phytohormones, the content of GA3 was significantly influenced by the plant growth, while ABA showed a trend of plateau. SA and JA both reached the peak on August 26th. Conclusion The main active ingredients were constantly accumulated with plant growth, but its content did not necessarily keep a rising trend. The content of endogenous hormonal ingredients was greatly influenced by time and environment. Further analysis of the results was helpful to implement the chemical regulation in medical research and production. It could also provide certain reference basis for improving the medical quality of Glycyrrhiza uralensis.
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    Quality representation and correlation analysis of the characteristic spectrum of Rougui based on drug system*
    HUANG Ya-ting , PAN Ting, WEN Jing, TANG Xue-yang, SUN Ya-shu, CHI Lei, PENG Ping, SHI Ren-bing
    2015, 38 (5):  344-350.  doi: 10.3969/j.issn.1006-2157.2015.05.012
    Abstract ( 498 )   PDF (1286KB) ( 636 )   Save
    Objective To establish quality representation and correlation analysis method for analyzing the characteristic spectrum of Rougui (Cinnamomum cassia Presl.) based on drug system, evaluating the quality of Rougui decocting pieces comprehensively. Methods HPLC-PDA method was adopted to establish the characteristic spectrum of Rougui decocting pieces, and seven characteristic peaks were screened. The qualitative relevance was presented with the relative retention time characterization. Simultaneously, six main effective index components (protocatechuic acid, epicatechin, coumarin, cinnamic alcohol, cinnamic acid, and cinnamaldehyde) were measured, and characterization contents of the main phenols and the main phenylpropanoids were presented, whose quantitative relevance was represented with correlation analysis. Results Using batch 13 as reference standards, based on the qualitative representation model and correlation analysis, seven characteristic peaks of Rougui decocting pieces were detected to have two characteristic peaks of phenols and five characteristic peaks of phenylpropanoids; the seven characteristic peaks were found in 15 batches of Rougui decocting pieces chromatograms . Based on the quantitative representation model and correlation analysis, the overall amount of effective index components in batch 14 were higher than those in batch 13; the levels of components in batch 4, 6, 8, and 10 were highly related to batch 13. Comprehensive evaluation result showed that the quality of batch 14, 13, 4, 6, 8, and 10 were comparatively higher. Conclusion Quality representation was carried out on the basis of the qualitative characterization. This method could evaluate Rougui pieces’ quality comprehensively, provide a basis for the screening of resources, for controlling the quality of pharmaceutical raw materials, and for the related application, and also provide a new methodology for quality evaluation of Chinese materia medica
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    ACTH and GC levels in patients with hepatitis cirrhosis at two stages and their correlation with TCM pattern elements*
    ZHAO Feng-run , ZHAO Li-hong , WANG Tian-fang, XUE Xiao-lin, WU Xiu-yan , LI Yong-gang, LI Ning , WANG Si-ying , YANG Hui-yin , JIANG Yu-yong, LIU YAN-ling , CHEN Sheng-duo , ZHANG Qiu-yun , LI Xiu-hui , MAO De-wen , ZHANG Chang , LIU Wen
    2015, 38 (5):  351-355.  doi: 10.3969/j.issn.1006-2157.2015.05.013
    Abstract ( 489 )   PDF (1097KB) ( 651 )   Save
    Objective To compare the levels of serum adrencortical hormone (Adrenocorticotropic hormone, ACTH), and glucocorticoid (Glucocorticoid, GC) between patients of hepatitis cirrhosis at compensated and decompensated stages, and to evaluate their correlation with common TCM pattern elements. Methods Using a unified “hepatitis cirrhosis clinical information collection list”, which is formulated by this team, we conducted a national multi-center cross-sectional epidemiological survey, to collect the general condition of patients, their symptoms and other information. We also collected their blood samples for standardized laboratory tests. Previously published consensus and guidelines on diagnosis and treatment of hepatic cirrhosis were reviewed. With reference to literature review of clinical investigation, and finally we came up with a“common pattern element identification standard for hepatitis cirrhosis” after two rounds of expert consensus verification process. According to this standard, we can analyze the pattern elements and compare the differences between serum ACTH and GC levels during compensated and decompensated stages, as well as those between the pattern elements of blood stasis, yin deficiency, damp heat, qi stagnation, Qi deficiency, Yang deficiency, and water retention. ResultsCompared with patients at compensated stage, ACTH and GC levels in patients at decompensated stage were elevated, with significant difference in GC levels (P<0.05). In patients at decompensated stage, levels of ACTH in patients with Yang deficiency group was significantly lower than those in groups without it (P<0.05); In patients with blood stasis at decompensated stage, the level of ACTH was significantly higher than those in groups without it (P<0.05), but GC was higher than that of the other groups (P<0.05) in terms of pattern elements (except water retention). Conclusion ACTH and GC levels in patients with hepatitis cirrhosis could reflect the severity of disease, and may suggest a certain correlation with TCM pattern elements of class of common diseases.
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    Clinical research on pattern characteristics features of cough with a cold feeling of sensation in the back: a clinical survey*
    LIN Bin, SHI Li-qing, MA Jian-ling, XI Ning, LUO Qiu, CHEN Yong-tai, WANG Qian
    2015, 38 (5):  356-360.  doi: 10.3969/j.issn.1006-2157.2015.05.014
    Abstract ( 592 )   PDF (1099KB) ( 802 )   Save
    Objective To observe clinical manifestations and TCM pattern features of cough with a cold sensation in the back (back cold), and to discuss and analyze its etiology and pathogenesis, in the hope of providing evidence for the treatment of cough. Methods Cases with cough as a chief complaint accompanied by a cold sensation in the back were selected. We analyzed the general information, underlying respiratory diseases, clinical characteristics of and relevant factors for cough with a cold sensation in the back, and summarized the onset characteristics, etiology, pathogenesis, and TCM patterns. Results Cough with a cold sensation in the back was common in clinical practice. Moreover, a cold sensation in the back was closely related to cough. Common pathological elements included dampness-heat, yang deficiency, retention of phlegm and morbid fluid, and pathogenic wind, etc. The pattern identification of TCM showed that spleen-stomach dampness-heat pattern accounted for 22.8% of all cases; dampness-heat pattern complicated with lung yang deficiency, 21.3%; lung yang deficiency, 17.3%; and yang deficiency of the lung and spleen, 12.7% respectively, etc. Conclusion A cold sensation in the back often accompanies cough, closely related to seasons, climate changes and etc. This symptom of varying degrees could be present in people of different ages and with different respiratory diseases. Most commonly-seen TCM patterns are retention of dampness-heat in the spleen and stomach and yang deficiency of the lung. Pathogenic dampness and heat may hinder qi movement. Moreover, the lung-spleen yang is deficient, and defensive yang fails to distribute. Consequently, the lung fails to spread and depurate. This is probably its main disease mechanism.
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