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

Table of Content

    30 October 2018, Volume 41 Issue 10 Previous Issue    Next Issue
    The triple burners and four qi paths
    Ma Ning
    2018, 41 (10):  797-802.  doi: 10.3969/j.issn.1006-2157.2018.10.001
    Abstract ( 493 )   PDF (9654KB) ( 202 )   Save
    The triple burners (Sanjiao) and the four qi paths (Sijie) are the major cavities and spaces in the human body. They are the most important spaces to accommodate and distribute the defensive qi (weiqi). Triple burners are body cavities: the upper burner (Shangjiao) is the mediastinum; the middle burner (Zhongjiao) is the peritoneal cavity; and the lower burner (Xiajiao) is the general term for the retro-peritoneal cavity. Consistent with modern anatomical nomenclature, Huangdi Neijing (Huangdi’s Internal Classic) named the retro-peritoneal cavity in two terms: lower burner (Xiajiao) and Sanjiao. Xiajiao referred to the perirectal space and Sanjiao referred to retro-peritoneal space. The retroperitoneal space is renamed as “retro-Sanjiao” in this article in order to differentiate the general term of Sanjiao when it refers to the three body cavities. The lower burner is the base of the generation, accumulation and distribution of the defensive qi. Four qi paths are the extension of the upper and lower burners. The abdominal qijie corresponds to extraperitoneal fascia, and the leg qijie refers to the anterior and posterior osteofascial sheathes. The pectoral qijie is equivalent to the endothoracic fascia, and the head qijie refers to retropharyngeal space and prevertebral space etc. Triple burners and meridians are the spaces and routes for the distribution and circulation of defensive qi. Once there is an obstruction in the four extremities, one of the four qi path will open and engage to relieve the pressure of defensive qi, and eventually will involve all of four qi paths. Therefore, it is necessary not only to stimulate the points related to four qi paths, but also has to resolve the obstruction in the body extremities in order to regain the normal circulation of the defensive qi.
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    A new interpretation of the exterior concept in traditional Chinese medicine*
    Hu Rong, Tian Yongyan, Li Jintian, Zhao Xiaoqiang, Zhao Zhiwei, Lian Fenhong
    2018, 41 (10):  803-807.  doi: 10.3969/j.issn.1006-2157.2018.10.002
    Abstract ( 478 )   PDF (3259KB) ( 287 )   Save
    With regard to “exterior”, it is generally considered that this entity refers to the muscle and surface of human body. In fact, according to the depth of human tissue and the connection with the outside world, the exterior can be further refined into “the surface of exterior”, “the lining of exterior”, “the surface of interior”. The skin, hair and muscle are in direct contact with the outside world. The outermost layer of the human body is “the surface of exterior”; the meridians, bones, and blood vessels is deeper than the surface of the exterior, and it is not directly connected with the outside world. So it is the human body “the lining of exterior”; human internal organs that communicate directly with the outside world are the “the surface of interior”. The defensive function of the “exterior” is the embodiment of the defensive qi (weiqi) function, and the function of the defensive qi depends on the “exterior” of the tangible entity. This “exterior” entity division can broaden the scope of application ofexterior-resolving method and wind-expelling medicinals, and enrich the theory of external treatment.
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    Development of granulomatous lobular mastitis from the perspective of “phlegm pathogen causing diseases” theory in traditional Chinese medicine*
    Liang Huan, Zhang Dongxiao, Sun Yujian, Fu Na, Xie Fang, Dong Hao, Wang Chun, Gao Qian, Huang Qiao, Zhao Wenjie
    2018, 41 (10):  808-811.  doi: 10.3969/j.issn.1006-2157.2018.10.003
    Abstract ( 468 )   PDF (1200KB) ( 299 )   Save
    This paper discusses the relationship with the manifestations of granulomatous lobular mastitis and phlegm dampness constitution in traditional Chinese medicine based on the “phlegm pathogen causing diseases” and features of phlegm pathogen. The clinical manifestations of granulomatous lobular mastitis are varied. Phlegm is involved in the whole process of granulomatous lobular mastitis. The authors conclude that granulomatous lobular mastitis is a mass disease caused mainly by phlegm affecting the skin. In clinical practice, diagnosis should be focused on phlegm, treating the kidney, spleen and liver. The combination of pattern diagnosis and constitution differentiation could ensure a better clinical efficacy. This paper could be used as references for the theory development and clinical treatment of granulomatous lobular mastitis.
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    Characteristics of herb and formula used for amenorrhea in the book of Prescription Worth Thousand Gold: data mining and analysis*
    Bai Yu, Wu Xiaodan, Hong Fang, Zhang Lin, Yang Yong
    2018, 41 (10):  812-815.  doi: 10.3969/j.issn.1006-2157.2018.10.004
    Abstract ( 398 )   PDF (1220KB) ( 272 )   Save
    Prescription worth thousand gold (Beiji Qianjin Yaofang) contains numerous data of pattern, medicinals, and formulae. This paper summarizes how Chinese medicinals are used in 30 formulae in the chapter of amenorrhea by using data mining and literature analysis. The key mechanism of amenorrhea is accumulation of static blood with pathogens of cold, heat, phlegm or qi stagnation. Qi and blood deficiency is often combined as well. The symptoms are amenorrhea, abdominal qi stagnation or masses, abdominal pain and abnormal leucorrhea. Treatment method used is breaking and expelling blood stasis mainly. The following treatment methods may also be combined depending on the manifestations: warming meridians to dissipate coldness, resolving and dissipating masses and binds, clearing pathogenic heat, expelling phlegm and draining water, tonifying qi and blood. Preparing and administering methods corded in the book are of guidance in clinical practice.
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    On evolution of meridian theory in Tongren Shuxue Zhenjiu Tujing (Illustrated Manual of Acupuncture Points of the Bronze Figure)*
    Liu Jintao, Chen Zijie, Wang Weiguang, Wang Huiru, Li Menglin, Chen Jingwen, Liang Yan, Zhai Shuangqing
    2018, 41 (10):  816-820.  doi: 10.3969/j.issn.1006-2157.2018.10.005
    Abstract ( 440 )   PDF (1180KB) ( 411 )   Save
    The concept and historical evolution of meridian theory in the Song Dynasty and dynasties before Song are clarified. After investigating the chapters of meridian theory in Tongren Shuxue Zhenjiu Tujing (Illustrated Manual of Acupuncture Points of the Bronze Figure) and comparing them with those in Huangdi Neijing (the Yellow Emperor’s Internal Classic), Nanjing (Classic of Difficult Issues) and some other works, The evolution of meridian theory in Tongren Shuxue Zhenjiu Tujing is summed up as follows: Nutrient qi transforms into blood qi running in the meridian to moisten the whole body. The naming methods of the meridians changes from zang (fu) hands (feet) vessels to hands (feet) zang (fu) meridians. The theory of shidong and suoshengbing in Nanjing is inherited and developed, and pulse-taking methods on renying and qikou acupoints in Huangdi Neijing are developed to present the concept of conception vessel (CV) being the sea of yin vessels. The related concepts and origins of some problems of meridian theory before the Song Dynasty are clarified, which is helpful for us to grasp deeply the development characteristics of meridian theory.
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    Effects of shenzhiling oral liquid on learning, memory and synaptic structure of APPswe/PSldE9 mice*
    Wu Yiqiong, Chen Fang, Sheng Ning, Ren Ying, Yang Jinduo, Wang Pengwen
    2018, 41 (10):  821-827.  doi: 10.3969/j.issn.1006-2157.2018.10.006
    Abstract ( 394 )   PDF (1950KB) ( 165 )   Save
    Objective To observe the effects of shenzhiling (SZL) oral liquid on learning, memory and synaptic structure of APPswe/PSldE9 mice. Methods Seventy-five APPswe/PSldE9 mice were randomly divided into model group, donepezil group(0.92 mg/(kg·d)), high-dose SZL (50 g/(kg·d)) group, mid-dose SZL (25 g/(kg·d)) group, and low-dose(12.5 g/(kg·d)) SZL groups (n=15 in each group). 15 C57/BL6J mice were used as the normal control group. For the model and normal group, mice were administered oral gavage of distilled water while the interventional groups received corresponding medicine for three months. Learning and memory was evaluated by using Morris water maze test, and the ultrastructure of the synapses were observed with transmission electron microscope. Results Compared with the normal group, mice in the model group had a longer escape latency and swimming distance (P<0.01); reduced times across the platform and stay in the target platform quadrant (P<0.01). After SZL treatment, escape latency was reduced and the swimming distances was shorter (P<0.05); times across the platform and stay in the target platform quadrant were increased, especially in the mid-dose and low-dose groups (P<0.01). The ultrastructure of the synapses was improved in the SZL groups than that in the model group, especially in the mid-dose and lowdose groups. Conclusion SZL oral liquid could improve learning and memory ability, and improve ultrastructure of the synapses in APPswe/PSldE9 mice. This may be one of the important mechanisms of improving cognitive function.
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    Effects of Chaibei Zhixian decoction on the expressions of P-gp in intractable epileptic rats*
    Zheng Xiangchun, Liu Jinmin
    2018, 41 (10):  828-834.  doi: 10.3969/j.issn.1006-2157.2018.10.007
    Abstract ( 359 )   PDF (2364KB) ( 194 )   Save
    Objective By investigating the effects of Chaibei Zhixian (Radix Bupleuri and Bulbus Fritillariae Thunbergii anti-epilepsy, CBZX) decoction, a Chinese herbal compound, on the expression and distribution of multidrug resistance protein (P-glycoprotein, P-gp) in intractable epileptic rats, to explore the possible molecular pathogenesis mechanism of intractable epilepsy. Methods 80 Wistar rats were intraperitoneally injected lithium chloride-pilocarpine hydrochloride to establish intractable epilepsy model, and 12 rats at the same week age were used as the normal control. 59 rats were selected as successful model and randomly divided into model group (n=14), CBZX group (n=15; 8.1 g/kg intragastric gavage), and carbamazepine(CBZ) group (n=15; 36 mg/kg intragastric gavage) and combination treatment group (n=15; CBZX plus CBZ intragastric gavage). The average duration of seizures and the Racine's grade of epileptic seizure were evaluated after 2 weeks’ intervention. Immunohistochemical method and Western blotting assay were used to compare the expression and distribution of P-gp in the hippocampus and cerebral cortex of the rats. Results Compared with the normal group, the expression of P-gp increased significantly in all epileptic groups (P<0.05). Conclusion CBZX decoction combined with carbamazepine is superior to using single therapy. The Chinese herbal compound CBZX decoction seems to show some effects in inhibiting P-gp drug transporters.
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    Analyzing chemical composition of Mongolian compound Xieriga-4 in vivo and in vitro*
    Bai Feng, Dong Yu, Li Binxin, Zhao Hailong, Zhang Tianming
    2018, 41 (10):  835-841.  doi: 10.3969/j.issn.1006-2157.2018.10.008
    Abstract ( 365 )   PDF (3308KB) ( 170 )   Save
    Objective To establish the in vitro and in vivo HPLC profiles of Mongolian drug compound Xieriga-4, and assign and identify its chemical composition in vitro and in vivo. Methods To take SD rats and intragastrically administer a certain amount of Mongolian medicine compound Xieriga-4 to prepare in vivo serum and metabolic urine, and measure with HPLC. comparing the effective components in drug-containing serum and urine, an in vitro and in vivo HPLC profile of Mongolian drug compound Xieriga-4 was established. Results The in vitro HPLC profiles of Mongolian medicine compound Xieriga-4 were analyzed, and a total of 53 peaks were found. There were 35 blood components after in vivo administration of Mongolian Medicine Compound Xieriga-4, and 25 blood components were directly injected into the blood. The other 10 were considered new metabolites. Peaks 7, 9, 12, 14, 15, 17, 26, 27, 30, 33, 51, 53 originated from turmeric, Peaks 18 and 19 came from Cork; the peaks 1, 2, 3, 10, and 16 from lice; the peaks 8, 18, 31, and 32 from earthworms. Four incoming chemical constituents were identified through in vitro and in vivo chemical composition comparisons. Three of them were identical to those in metabolism and it was assumed that they may act as prototype components and be excreted. Conclusion Blood components and metabolites may be effective components of compound effects. This article speculates that the composition of blood components of the compound into the blood to speculate the mechanism of its treatment, in order to provide further evidence to explore the mechanism of Mongolian medicine compound Xieriga-4 treatment of diseases.
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    Application and reflection of single-case randomized controlled trial in efficacy evaluation of traditional Chinese medicine*
    Jing Hanguang, Meng Qinggang
    2018, 41 (10):  842-847.  doi: 10.3969/j.issn.1006-2157.2018.10.009
    Abstract ( 336 )   PDF (1426KB) ( 317 )   Save
    Objective To explore suitable clinical research methods for traditional Chinese medicine by comparing the advantages and disadvantages of the three clinical methods in traditional Chinese medicine, including single-case randomized controlled trial (n-of-1), randomized controlled trial (RCT), and real world study (RWS). Methods Relevant literature including latest guideline at home and abroad were searched to compare and contrast for analysis. Results Traditional Chinese medicine is featured by individualized treatment. N-of-1 trial seems to align with scientific and TCM rationale in clinical diagnosis and treatment. Conclusion N-of-1 trial is a scientifically refined case study in TCM. Systematic evaluation of data obtained could facilitate scientific evaluation of efficacy and validation of individualized treatment. Its application has great prospective in TCM clinical studies.
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    Development and evaluation of the TCM pattern element diagnostic scale for type 2 diabetes mellitus*
    Zhao Lingyan, Bi Lifu, Chen Jianxin, Zhao Huihui, Yang Yi, Zhang Yajun, Zhang Xingguang, Wang Wei
    2018, 41 (10):  848-853.  doi: 10.3969/j.issn.1006-2157.2018.10.010
    Abstract ( 381 )   PDF (1224KB) ( 298 )   Save
    Objective To establish a diagnostic scale of TCM pattern elements of type 2 diabetes mellitus(T2DM) by introducing the scale development method into the diagnosis of TCM patterns and to explore the standardization of TCM pattern by developing relevant scale. Methods Data obtained with TCM four diagnostic methods was collected from 249 qualified patients with T2DM in five grade 3 and first-class hospitals around the country by using a multi-center clinical epidemiology survey. Pattern differentiation was centrally made after all the information was collected. The entry pool of four TCM diagnostic methods of each pattern was initially identified on the basis of literature research. Correlation coefficient, stepwise regression and factor analysis methods were jointly used to do entry screening on the data of 179 samples. Logistic regression was conducted to do entry assignment, and ROC curve was used to determine the diagnostic threshold to establish the diagnosis scale of T2DM TCM pattern elements. 70 samples were used to do reliability and validity evaluation of the scale. Results There were nine pattern elements in T2DM Diagnostic Scale of TCM patterns, namely, pattern of qi deficiency, yin deficiency, internal dampness, dryness-heat, yang deficiency, blood stasis, liquid depletion, phlegm turbidity and qi stagnation, whose diagnostic threshold were: 11 points, 9 points, 8 points, 13 points, 8 points, 10 points, 12 points, 7 points and 4 points respectively. The split-half reliability of the scale was 0.878, and its Cronbach’sα was 0.844. Three common factors were extracted with factor analysis. The cumulative variance contribution rate was 69.123% and the correlation coefficient of the score of each pattern element to the total score was 0.471-0.794. Conclusions There are nine pattern elements in the diagnostic scale of T2DM TCM factors, which is of good reliability and validity, and can be used for clinical or research pattern diagnosis. It provides new ideas and methods for the study of TCM pattern standardization.
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    Correlation analysis of tongue manifestations and FibroScan value in 108 patients with post-hepatitic cirrhosis*
    Dou Zhili,Wu Xiuyan, Wang Tianfang, Xue Xiaolin, Zhao Lihong, Li Xin, Li Ning
    2018, 41 (10):  854-858.  doi: 10.3969/j.issn.1006-2157.2018.10.011
    Abstract ( 395 )   PDF (1256KB) ( 227 )   Save
    Objective To investigate the correlation of tongue manifestations and FibroScan value in patients with post-hepatitic cirrhosis and provide Objective evaluation of illness severity and pathogenesis. Methods The clinical information extraction table of hepatitis cirrhosis was used to collect the general information of the patient's condition, the FS value of the tongue image and etc. The data were inputted into Excel, and grouped according to whether there was any tongue picture or not. SPSS 20.0 software was used to analyze the clinical information of patients with descriptive statistical analysis, including t test, chi-square test, and rank sum test. Results In 108 patients with post-hepatitic cirrhosis, the minimum value of FS was 4.10 kPa and the maximum value was 75.00 kPa. The mean value was (24.07±18.43) kPa; compensatoed stage (16.18±10. 06) kPa, decompensated stage (38. 03±21). There was significant difference between the two stages (P<0.05). FS of the crimson tongue was highest in the color of tongue. In tongue shape, Fs of thin tongue was higher than other tongues. In tongue coating, dry and yellow coating were higher than others. Among all the groups, only the bulgy tongue group, the cracked tongue group and the dry fur group had significant differences (P<0.05), but there was no significant difference between other groups. Conclusion FS value appears to ke higher in the patients with thin tongue, fissured tongue and dry coating. It shows that the higher the FS value of heat syndrome, yin deficiency, blood deficiency and injury, the more serious the condition of liver cirrhosis is when the above three tongue signs appear in the patients with hepatitis and liver cirrhosis. This indicates that FS value has a certain correlation with tongue changes.
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    Study on the correlation between TCM constitution and sleep quality of 308 patients with primary insomnia*
    Pei Qinghua, Li Xia, Xu Jing, Qu Miao, Tang Qisheng
    2018, 41 (10):  859-862.  doi: 10.3969/j.issn.1006-2157.2018.10.012
    Abstract ( 440 )   PDF (1157KB) ( 556 )   Save
    Objective To study the distribution of TCM constitution in patients with primary insomnia, and the correlation between TCM constitution and sleep quality. Methods Cross-sectional survey was used. The Pittsburgh sleep quality index (PSQI) and the Chinese Medical Constitution Scale were evaluated, and the data were collected to analyze the patients’ constitution distribution, sleep quality and the association between the constitution and the sleeping quality. Results A total of 308 cases (104 male & 204 female) were observed; the youngest was 20 years old, the oldest was 75 years old, with an average age of (46.32±16.23) years old. There were 162 cases of single constitution and 146 cases of combined constitution. The mean score of PSQI was (12.65±3.04). Symptoms of insomnia include poor sleep quality, shorter sleep time and longer time to falling asleep. The main symptoms were difficulty of falling asleep. Secondary symptoms of each constitution were as follows: early awakening in the phlegm dampness and yang deficiency constitutions; profuse dreaming in the blood stasis constitution; easy awakening in the yin deficiency constitution; shallow sleeping in the qi stagnation constitution, qi deficiency constitution, damp heat constitution and special constitution. Secondary symptoms of combined constitution were profuse dreaming. Conclusion The most common constitution in insomniacs were qi deficiency constitution, yin deficiency constitution and phlegm dampness constitution; and three kinds of combined constitution were qi deficiency and yang deficiency constitution, qi deficiency and yin deficiency constitution, yang deficiency and phlegm dampness constitution. There was no difference in the sleep quality between the single and combined constitutions, and the main symptom was difficulty in falling asleep. The secondary symptoms were correlated with the constitution of TCM.
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    Meta-analysis of effectiveness of traditional Chinese medicine in the treatment of oligospermia and asthenospermia*
    Li Boyi, Wang Qi, Zhu Bin, Yang Peiying, Dong Yang, Yan Ji, Zheng Yanfei
    2018, 41 (10):  863-872.  doi: 10.3969/j.issn.1006-2157.2018.10.013
    Abstract ( 507 )   PDF (2976KB) ( 222 )   Save
    Objective To evaluate the effectiveness of traditional Chinese medicine in the treatment of oligospermia and asthenospermia. Methods Randomized controlled trials (RCTs) were retrieved from CNKI, Wanfang database, VIP, CBM, PubMed, Cochrane library, EMbase, Web of Knowledge. The date of publication was January 2004 to March 2017. RCTs about traditional Chinese medicine in the treatment of oligospermia and asthenospermia were included. Treatment group received traditional Chinese medicine, while the control group was treated with Western medicine. The quality of included studies was evaluated and performed by using the statistical software STATA12.0. Results A total of 44 RCTs involving 4779 patients were included. Meta-analysis showed that total effective rate [RR=1.15, 95%CI (1.07-1.23), P=1.00], semen volume [MD=0.57, 95%CI (0.44-0.70), P<0.000 01], sperm density [MD=0.82, 95%CI (0.73-0.91), P<0.000 01], percentage of class A sperm [MD=0.72, 95%CI (0.60-0.84), P<0.000 01], percentage of class A + B sperm [MD=0.85, 95%CI (0.74-0.96), P<0.000 01]. Conclusion Traditional Chinese medicine was superior to Western medicine in improving semen volume, sperm density, percentage of class A sperm, percentage of class A + B sperm, and total effective rate.
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    Meta-analysis of the efficacy and safety of compound Zaofan Pills alone or combined with Western medicine in the treatment of blood diseases*
    Zhang Zhichun, Zhang Xiaobo, Ding Hao, Jia Mengran, Wang Chong, Chen Xinyi, Tian Shaodan
    2018, 41 (10):  873-880.  doi: 10.3969/j.issn.1006-2157.2018.10.014
    Abstract ( 393 )   PDF (3298KB) ( 385 )   Save
    Objective To evaluate the efficacy and safety of compound Zaofan pills alone or combined with Western medicine in the treatment of blood diseases. Methods The researchers retrieved the seven authoritative databases commonly used, and searched published randomized controlled clinical trials on compound Zaofan pills alone or combined with Western medicine in the treatment of blood diseases from the establishment of the library to January 2018, and carried out data extraction and quality evaluation, and then the Review Manager 5.3 software was used for Meta analysis. Results Finally, 15 qualified clinical studies were included, among which 11 were aplastic anemia, 3 were myelodysplasia syndromes, and 1 was immune thrombocytopenia. Meta-analysis showed that: ①The overall efficacy evaluation showed that the compound Zaofan pills alone or combined with Western medicine was superior to Western medicine alone (P<0.000 01). ②The efficacy of compound Zaofan pills alone or combined with Western medicine in the treatment of aplastic anemia was better than that of Western medicine alone (P<0.000 01).③The efficacy of compound Zaofan pills alone or combined with Western medicine in the treatment of myelodysplastic syndrome was better than that of Western medicine alone (P=0.002).④Six studies reported treatment-related adverse reactions, mainly mild gastrointestinal reaction and mild liver function damage, but all of them occurred in the combined treatment group, so it could not be determined as the result of compound Zaofan pills. Conclusion Compound Zaofan pills alone or combined with Western medicine seems to be more effective than Western medicine alone in the treatment of aplastic anemia and myelodysplastic syndrome with safety.
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