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

Table of Content

    30 May 2020, Volume 43 Issue 5 Previous Issue    Next Issue
    COVID 2019 Forum
    Exploring the mechanism and treatment of lung-kidney impairment in novel coronavirus pneumonia by using the “lung-sanjiao moyuan-kidney” model theory*
    Dong Fei, Liu Hongliang, Gu Xiaohong
    2020, 43 (5):  357-362.  doi: 10.3969/j.issn.1006-2157.2020.05.001
    Abstract ( 444 )   PDF (911KB) ( 143 )   Save
    The novel coronavirus pneumonia is mainly characterized by involvement of pulmonary interstitial lesions. Among patients with increased expression of virus in the kidney, lung-kidney impairment tends to manifest from the early stage after onset. For patients with older age and underlying diseases, their lung and kidney seem to be both involved at later stages, which may then develop into multiple organ failure syndrome (MOFS). The “lung-sanjiao (triple energizer) moyuan (membrane source)-kidney” theory in traditional Chinese medicine (TCM) considers that lung mesenchyme and kidney mesangial membranes are the material basis for triple energizer membrane source to play its role, which is highly consistent with the pathogenesis theory of “[epidemic] pathogens lurking in the membrane source” proposed by Wu Youke in book titled On Epidemic Diseases (Wen Yi Lun). This paper articulates the model theory of “lung-triple energizer moyuan-kidney”, to reason how and why the treatment methods of “treating the upper, [middle] and lower jiao respectively (fen xiao shang xia)” by Ye Tianshi in the book titled On Warm & Heat Diseases (Wen Re Lun) are widely used and also effective in clinical practice. This model theory may serve as reference for the further application of the TCM classic theories in the treatment of emerging and emergent infectious diseases.
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    Traditional Chinese medical strategy in the management of the corona virus disease 2019 during recovery period*
    Yang Xianzhao, Du Hongbo, He Weili, Zhang Jingfeng, Liu Ning, Cui Jie, Chen Zhengguang, Du Yong, Ye Yong’an
    2020, 43 (5):  363-367.  doi: 10.3969/j.issn.1006-2157.2020.05.002
    Abstract ( 382 )   PDF (749KB) ( 94 )   Save
    It has been more than two months since the outbreak of Corona Virus Disease 2019 (COVID-19), and the overall epidemic situation is now under effective control with the number of cured discharged cases surpassing existing confirmed ones. Although the general condition of discharged patients has been improved to a certain extent, quite a number of them still have clinical symptoms and organ injury. Therefore, follow-up rehabilitation treatment for these patients is of great importance. Our team went to Wuhan, the center of epidemic regions, to assist clinical treatment using traditional Chinese medicine. From our experience, we found the course of the disease is relatively long, and that the problem of pulmonary fibrosis is more prominent during the recovery period. Most COVID-19 patients at the recovery stage tend to present with a complicated state of multiple patterns, characterized by dominant qi deficiency, increasing severity of blood stasis together with remaining excess of pathogens. Based on field observations, we hold that the qi deficiency and blood stasis is the core pathogenesis. Therefore, management of COVID-19 patients during the recovery period should target at pulmonary fibrosis as the key pathology by using qi-tonifying blood-activating treatment as the basic principle, combined with methods of clearing away the remaining pathogenic factors. Flexible medicinal modification could help patients recover better.
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    Commentary on the study designs of clinical trials using traditional Chinese medicine in the treatment of COVID-19: problems and suggestions*
    Wang Yuguang, Cheng Jinlian, Yan Shiyan
    2020, 43 (5):  368-372.  doi: 10.3969/j.issn.1006-2157.2020.05.003
    Abstract ( 338 )   PDF (769KB) ( 80 )   Save
    There has been no specific treatment for coronavirus disease 2019 (COVID-19). Quite a number of ongoing clinical trials are conducted to search for efficacious medicine against COVID-19. Meanwhile there are concerns about study design rigor,non-specific target and adequate oversight of these trials.This paper analyzed the problems observed in current COVID-19 clinical trials investigating the efficacy of traditional Chinese medicine (TCM) therapies and then offered suggestions for possible solutions. Design of COVID-19 clinical trials should be based on the nature of COVID-19 as an emergent and acute epidemic disease.Investigators should discern the TCM understanding of COVID-19 in terms of its pathogenic factors and mechanism, combining the stage characteristics of the course of acute infectious diseases, while following TCM general understanding of pestilential diseases. Multiple clinical study designs could be employed for different objective set at different stage of epidemic disease, including epidemiological study of TCM patterns, observational study, randomized controlled trials and case studies, etc. TCM should be properly positioned in playing its effective role in intervention with severe and critical cases and not limited to mild or common types only. Meanwhile, surveillance with unified deployment needs to be in place to ensure strong ethical grounds and rigorous scientific research attitude.
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    Textual Research
    Value of research on text variance in different versions of Qian Jin Yao Fang*
    Fan Lu, Zeng Feng
    2020, 43 (5):  377-380.  doi: 10.3969/j.issn.1006-2157.2020.05.005
    Abstract ( 324 )   PDF (670KB) ( 161 )   Save
    This thesis explores the text variances in three different versions of Qian Jin Yao Fang (Important Formulas Worth a Thousand Gold Pieces) in terms of the following four aspects: medical principle, therapeutic method, prescription and medicinals. Based on that, the disciplinary differences are analyzed, and concluded that historical medical literature has the characteristic of being complex, and the contents have a certain degree of uncertainty. The text variances in academic thoughts among the three versions of Qian Jin Yao Fang have provided solid evidence for tracing the development history, distinguishing between right and wrong, and sorting the ambiguous issues that have existed for a long time. Therefore, the text variances in different versions of Qian Jin Yao Fang could serve as the pointcut for research of the book in a deeper level, which will not only provide advice for clinical practice, but also provide reference for further research on the academic and thinking development history of TCM.
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    Study on citations of Chinese medical literatures related to Shang Han Lun and Jingui Yaolue in Euibangyoochui
    Huang Yinghua, Liang Yongxuan
    2020, 43 (5):  381-385.  doi: 10.3969/j.issn.1006-2157.2020.05.006
    Abstract ( 305 )   PDF (756KB) ( 50 )   Save
    Euibangyoochui (Yi Fang Lei Ju) is a large-scale medical book compiled by the government of Chosun Dynasty in 1445 AD. It quotes 152 kinds of Chinese medical classics and one kind of Koryo’s medical work. Based on the categories of literature related to Shang Han Lun (Treatise on Cold Damage) and Jingui Yaolue (Synopsis of Golden Chamber) listed in General Catalog for Chinese Medical Classical in China and Grand Dictionary of Chinese Medical Classics, this paper attempts to explore the citations of medical literatures related to these two books in Euibangyoochui. First, the general information about the book, such as author and its written time, are determined; then it is comprehensively analyzed combined with other materials. Finally, the relevant quotations in Euibangyoochui are compared to those in Xin Bian Jin Gui Fang Lun, which is the existing earliest version of the base copy of Zhang Zhongjing by Deng Zhen in Yuan Dynasty. Thus the citations of 16 kinds of medical literatures related to Shang Han Lun and one book related to Jingui Yaolue are analyzed and evaluated.
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    Chinese Medicinal Pharmacology
    Protective effect and mechanism of Wuzi Yanzong Pill in rat sertoli cells under heat stress*
    Liu Sijia, Chen Yucai, Hu Suqin, Li Chunrui, Guo Jian
    2020, 43 (5):  386-392.  doi: 10.3969/j.issn.1006-2157.2020.05.007
    Abstract ( 321 )   PDF (6581KB) ( 78 )   Save
    Objective To explore the pharmacological mechanism of Wuzi Yanzong Pill in the treatment of male spermatogenic dysfunction by network pharmacology in rat sertoli cells. Methods Targets of anti-spermatogenic dysfunction in Wuzi Yanzong Pill were screened and the biological function and signal pathway were analyzed by online database. The heat stress model was constructed with rat sertoli cells to detect changes in the production of reactive oxygen species (ROS) and the expression of Hsp70. Results The results of network pharmacology showed that Wuzi Yanzong Pill mainly improved male spermatogenesis dysfunction by regulating ROS level and extracellular stimulus response etc. The ROS fluorescence probe results showed that, compared with the blank group, the ROS production was significantly increased in the model group, and significantly decreased in the Wuzi Yanzong Pill group. Western blot results showed that the expression of Hsp70 in Wuzi Yanzong Pill group was higher than that in the blank group and lower than that in the model group. Conclusion Wuzi Yanzong Pill seems to protect rat sertoli cells under heat stress by reducing ROS production and Hsp70 expression.
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    Effect of Haizao Yuhu Decoction and its recipe removing antagonistic medicinal combination on the thyroid hormone level and tissue morphology in rats with goiter*
    Lyu Yanmin, Xiu Linlin, Liu Haiyan, Zhang Jingxuan, Li Na, Zhang Chen, Xu Wan, Chen Feng, Wang Xin, Ge Chaoran, Chen Shaohong, Zhong Gansheng
    2020, 43 (5):  393-401.  doi: 10.3969/j.issn.1006-2157.2020.05.008
    Abstract ( 323 )   PDF (1496KB) ( 75 )   Save
    Objective To comparative the thyroid hormone level and histopathological changes of the thyroid tissue in PTU-induced goiter rats treated with Haizao Yuhu Decoction and its recipe minus antagonistic medicinal combination, and to explore whether eliminating antagonistic medicinal combination in Haizao Yuhu Decoction can affect the therapeutic effect. Methods The rats were randomly divided into the blank group, model group, positive drug group (euthyrox),Haizao Yuhu Decoction group,Haizao Yuhu Decoction minus Glycyrrhizae group, Haizao Yuhu Decoction minus Sargassum group, and Haizao Yuhu Decoction minus Sargassum and Glycyrrhizae group. The rat model of goiter was induced with propylthiouracil. Each group was fed with the corresponding drug or decoction. The concentration of serum related indicators was detected, including the thyroid coefficient, thyroid hormone level and its synthesis, transport and regulation. Under light microscope, pathological changes of thyroid tissue in rats were observed, and nucleic number and follicular area in sections were counted. Results Like the positive drug, Haizao Yuhu Decoction was consistent with the positive drug of euthyrox in maintaining thyroid functions and recovering the pathological damage of thyroid tissue in PTU-induced goiter rats. Comparing the thyroid hormone related indicators,the degree of recovery was listed: Haizao Yuhu Decoction group>Haizao Yuhu Decoction minus Glycyrrhizae group>Haizao Yuhu Decoction minus Sargassum group>Haizao Yuhu Decoction minus Sargassum and Glycyrrhizae group. Comparing the histopathological changes of the thyroid tissues, the alleviating degree was listed: Haizao Yuhu Decoction group>Haizao Yuhu Decoction minus Sargassum and Glycyrrhizae group>Haizao Yuhu Decoction minus Sargassum group>Haizao Yuhu Decoction minus Glycyrrhizae group. Conclusion The therapeutic effect of Haizao Yuhu Decoction in regulating thyroid hormone level and improving histopathological changes in goiter rats seems to be better than its recipe minus antagonistic medicinal combination, and the Haizao Yuhu Decoction minus Sargassum and Glycyrrhizae tends to have the least effect.
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    Treatment of nonalcoholic steatohepatitis by regulating the methylation level of TLR4 gene with Xiaoyao San*
    Xu Huichao, Gao Yan, Chen Hao, Hao Jianheng, Liu Jinfang, Liu Yang, Miao Yuchuan
    2020, 43 (5):  402-407.  doi: 10.3969/j.issn.1006-2157.2020.05.009
    Abstract ( 298 )   PDF (1762KB) ( 57 )   Save
    Objective To explore the new mechanism of changes in TLR4 gene methylation levels in the treatment of liver stagnation and spleen deficiency pattern in non-alcoholic steatohepatitis (NASH) in rats with Xiaoyao San (Xiaoyao Powder). Methods 30 male SD rats were randomly divided into blank group, model group and Xiaoyao San group (n=10). Rats in the blank group were given normal diet for 28 weeks. followed by injection of normal saline for 4 weeks. In the model group and Xiaoyao San group, liver stagnation and spleen deficiency pattern model was established by feeding the rats with a high-fat and high-sugar diet with stimulations of chronic stress and irregular diets for 28 weeks In the last 4 weeks, the model group and Xiaoyao San group were injected with normal saline and Xiaoyao San solution respectively. At the end of 28 weeks, urine was collected from the three groups, and the liver and hippocampus tissues were taken to make pathological sections. The corresponding indicators were detected by real-time fluorescence quantitative PCR (qPCR), enzyme-linked immunosorbent assay (ELISA), and hydrogen sulfite sequencing PCR (BSP), etc. Results Compared with the model group, the symptoms of liver stagnation and spleen deficiency pattern were significantly alleviated with a decreased pattern score in the Xiaoyao San group. The numbers of fat vacuoles and infiltration degree of inflammatory cells in liver cells were significantly reduced. The TLR4 mRNA content in liver tissues was decreased, while the methylation level of TLR4 gene was increased (P<0.05). Conclusion Xiaoyao San may up-regulate the TLR4 gene methylation level and down-regulate the TLR4 mRNA expression in rats with liver stagnation and spleen deficiency pattern in non-alcoholic steatohepatitis, thus improving the degree of liver steatosis and alleviating inflammation and other symptoms. This seems to be the new mechanism for the treatment of such condition with Xiaoyao San.
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    Effect of medicated serum of NaotaifangⅡ on microglia polarization induced by LPS*
    Zhang Xiuli, Lei Chang, Liu Yang, Ge Jinwen, Meng Pan, Zhang Junyu, Ren Yongzhen, Zi Dong, Zhu Wei
    2020, 43 (5):  408-413.  doi: 10.3969/j.issn.1006-2157.2020.05.010
    Abstract ( 326 )   PDF (977KB) ( 45 )   Save
    Objective To investigate the influence of medicated serum of Naotaifang Ⅱ on the morphology, M1/M2 polarization markers and inflammatory factors of HAPI cells induced by LPS. Methods The inflammation model of HAPI cell was induced by LPS. The cultured cells were divided into: blank group, model group, Naotaifang Ⅱ group, and minocycline group. Morphology and quantity of microglia were observed by High Content Imaging System. mRNA expression of M1-type markers (MCH II, iNOS, MCP-1, CD11b) and M2-type markers (Arg1, Mrc1, Ym1), pro-inflammatory factors (IL-1β, IL-6, IL-12, TNF-α) and anti-inflammatory factors (IL-4, IL-10, TNF-β) was detected by qRT-PCR. Results Compared with the blank group, in the model group, microglia cell body became larger while showing multipolarization or amoeba type with coarser and shorter synapse; the mRNA level of M1 markers and pro-inflammatory increased significantly (P< 0.01); moreover, the expression of M2 marker Mrc1 and anti-inflammatory factors IL-4 and TNF-β decreased dramatically (P<0.01). Compared with the model group, in NaotaifangⅡgroup, the cell swelling recovered, the synapses became longer, and the microglia increased. Besides, in NaotaifangⅡgroup, the mRNA expression of M1 markers MHCⅡ, iNOS and CD11b and the pro-inflammatory factors were significantly decreased (P<0.01), and the mRNA expression of M2 markers and anti-inflammatory factors were significantly increased (P<0.01). Compared with the minocycline group, the Naotaifang Ⅱ group showed no significant advantage in reducing the expression of M1 markers (P>0.05), while better effect on lowering the expression of pro-inflammatory factors IL-6, IL-12 and TNF-α (P<0.01) except IL-β. Besides, NaotaifangⅡcould better increase mRNA expression of M2 markers Mrc1, Ym1 and anti-inflammatory factors IL-4, TGF-β compared with the minocycline group. Conclusion Naotaifang seems to inhibit M1 polarization, promote M2 polarization by regulating cell morphology, M1/M2 markers and inflammatory factors. It could possibly enhance M2 markers and anti-inflammatory factors better than minocycline.
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    Early Warning of Chinese Materia Medica
    Early warning on safety risks of Danshen preparation in the treatment of breast cancer*
    Wang Xiao, Lin Zhijian, Zhang Bing, Wang Yu, Mao Qiuyue, Jiang Zhuoxi
    2020, 43 (5):  414-422.  doi: 10.3969/j.issn.1006-2157.2020.05.011
    Abstract ( 322 )   PDF (3823KB) ( 51 )   Save
    Objective To explore the safety risk of Danshen (danshen root, Radix et Rhizoma Salviae Miltiorrhizae) preparation in the treatment of breast cancer. Methods Bioinformatics technology was used to screen and analyze the gene chip GSE85871 in the GEO database. The intervention effect of main chemical components of the Danshen preparation on the differentially expressed genes of human breast cancer cells MCF7 was analyzed with the GO function and the KEGG pathway, combined with the literature mining method to sort out the adverse reactions/events of Danshen preparation. Results When Danshen preparation interferes with the MCF7 cells, it could regulate genes such as nerve ligand signal pathway, thyroid pathway, immune regulation, and the expression of CHRM2. The abnormality of this pathway would cause abnormal neurological receptor function, hypothalamic dysfunction (thyroid), and respiratory function (asthma). Conclusion With the approaches of bioinformatics and literature mining, thisarticle explores the early warning of the potential safety risk of Danshen preparation in the adjuvant treatment of breast cancer. In the treatment of breast cancer with Danshen preparation, more attention should be paid to monitor the patient’s neurological, thyroid and respiratory functions. Thus, this article attempts to provide ideas for further study of the safety issue of TCM preparation.
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    Clinical Studies
    Further discussion on the observation,pathogenesis,prevention and treatment of premonitory symptoms of strokeWang
    Wang Yongyan, Zou Yihuai, Xie Yingzhen
    2020, 43 (5):  423-426.  doi: 10.3969/j.issn.1006-2157.2020.05.012
    Abstract ( 317 )   PDF (632KB) ( 82 )   Save
    In order to reduce the morbidity and recurrence rate of stroke, the statement of "to record the clinical manifestations of patient before the occurrence of disease” in the second volume of Wang Qingren's Yi Lin Gai Cuo (Correction of Errors in Medical Works) was reviewed. Based on that, more attention should be paid to the observation of symptoms of stroke aura. By observing Xiang (external signs), the disease can be detected and pattern differentiated. The pathogenesis mainly involves depleted yuan qi, resulting in stagnation of deficient qi, which would be induced to internal wind. The mainly medicinals include Puhuang (cattail pollen, Pollen Typhae), Tianma (tall gastrodis tuber, Rhizoma Gastrodiae) and Foshou (finger citron fruit, Fructus Citri Sarcodactylis), etc. Besides, a prescription for secondary prevention of stroke is put forward.
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    Distribution characteristics of TCM patterns in stable coronary heart disease with dyslipidemia*
    Fang Ge, Ren Qi, Wang Bin, Zhou Xiaowen, Li Xiantao
    2020, 43 (5):  427-431.  doi: 10.3969/j.issn.1006-2157.2020.05.013
    Abstract ( 276 )   PDF (826KB) ( 52 )   Save
    Objective To explore the distribution characteristics of TCM patterns of stable coronary heart disease with abnormal lipid metabolism. Methods Through clinical epidemiological investigation, the distribution characteristics of TCM patterns of stable coronary heart disease with dyslipidemia were analyzed with the multivariate statistical method. Results The principal component analysis of patterns in patients with stable coronary heart disease and abnormal lipid metabolism was carried out. The principal component with eigenvalue greater than 1 was selected, and its cumulative contribution rate was 61.81%. In the factor analysis, 10 common factors were extracted and clustered into four characteristic groups under cluster analysis. Conclusion By frequency analysis, principal component analysis, factor analysis and cluster analysis, the distribution of TCM patterns of stable coronary heart disease with abnormal lipid metabolism can be classified into four types. Most of them are a mixture of deficiency and excess, with deficiency of yin or both qi and yin, and excess including blood stasis and phlegm-dampness, mainly involving the heart, spleen and kidney. This study could provide relevant references for improving TCM pattern differentiation, treatment and clinical efficacy.
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    Pathogenic laterality of left- and right-sided colon cancer based on “Left Blood and Right Qi” Theory*
    Lin Xiaoli, Tan Weihan, Zhu Fengyi, Liang Dan, Yan Ran, You Fengming
    2020, 43 (5):  432-435.  doi: 10.3969/j.issn.1006-2157.2020.05.014
    Abstract ( 323 )   PDF (686KB) ( 70 )   Save
    There exist significant differences in epidemiology, molecular biology, histology, genetics and pathological features between left-sided and right-sided colon carcinoma, so the treatment and prognosis differ too. In Huangdi Neijing (Huangdi’s Internal Classic), a theory of “Left-Blood and Right-Qi” states that the left side of the body pertains to blood, and its disorders are mostly related to blood deficiency or blood stasis; while the right side pertains to qi, and its disorders are mostly related to qi deficiency or qi stagnation. Based on that theory, in this paper the pathogenic difference between left-sided and right-sided colon cancer is explored, and suggestion of formula selection is put forward accordingly, Thus providing theoretical evidence for more accurate pattern differentiation of colon cancer.
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    Treatment of acne from perspective of qi deficiency constitution*
    Yang Yang, Ma Yuexiang
    2020, 43 (5):  436-440.  doi: 10.3969/j.issn.1006-2157.2020.05.015
    Abstract ( 374 )   PDF (787KB) ( 97 )   Save
    In recent years, with the acceleration of life pace and the improvement of living standards, the incidence of acne has increased year by year, with an increasingly more complicated pathogenesis. From the perspective of body constitution, modern medical practitioners have combined the differentiation of constitution, disease and pattern to explore a new approach in its diagnosis and treatment. Studies revealed that in patients with acne, the proportion of qi deficiency constitution had gradually increased. Thus, in this study, in order to improve the efficacy of treatment of patients with qi deficiency constitution, pattern differentiation for patients with acne was explored, as well as the theories on qi deficiency constitution. On basis of that, the survey results of qi deficiency constitution, and the experience of diagnosing and treating acne from the perspective of qi deficiency constitution were summarized. Thus, it was concluded that there were important clinical basis and therapeutic advantages to treat acne from the perspective of qi deficiency constitution.
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