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

Table of Content

    30 July 2020, Volume 43 Issue 7 Previous Issue    Next Issue
    COVID19
    Exploration of COVID-19 etiology from the perspective of traditional Chinese medicine based on abduction inference
    Chen Jie, Jia Chunhua
    2020, 43 (7):  533-538.  doi: 10.3969/j.issn.1006-2157.2020.07.001
    Abstract ( 297 )   PDF (1225KB) ( 116 )   Save
    As an emergent international public health event, it is crucial to determine the etiology of Coronavirus Disease 2019 (COVID-19). Etiological research has shown that COVID-19 is caused by SARS-CoV-2.Since there are no effective conventional therapies for COVID-19,the involvement of traditional Chinese medicine(TCM) in the treatment of COVID-19 in a timely and effective manner is in extremely urgent need. It is proposed in TCM to "identify the etiology and apply treatment based on pattern differentiation", which indicates that it's crucial to find the TCM etiology of COVID-19.Huangdi Neijing (Huangdi's Internal Classics) states that "All of five pestilences can spread from person to person. No matter in children or in adults, the symptoms are similar".At present, it is believed that the cause of COVID-19 is pestilential qi. This statement itself lacks necessary logical proof.This article analyzes and demonstrates why pestilential qi is deemed the cause of COVID-19 by abduction inference and best explanation.The hypothesis of pestilential qi through abduction inference and best explanation is thus powered by strong logic and can provide reference for the treatment of COVID-19.
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    COVID20
    Understanding COVID-19 from the perspective of traditional Chinese medicine
    Wang Xihong, Han Zhenyun, Xu Mengbai, Zhang Kaiwen, Chen Jiaxu
    2020, 43 (7):  539-543.  doi: 10.3969/j.issn.1006-2157.2020.07.002
    Abstract ( 487 )   PDF (1130KB) ( 133 )   Save
    Based on analysis of clinical manifestations of corona virus disease 2019 (COVID-19), statements from ancient books and published literature on pestilential diseases have been reviewed in this paper to sort out how traditional Chinese medicine interprets the pathogenic characteristics of COVID-19.This paper mainly expounds from five aspects: the concept and characteristics of pestilence, etiology and pathogenesis, pattern differentiation combined with tongue diagnosis, analysis of critical and severe cases, and considerations for treatment. From the perspective of traditional Chinese medicine, COVID-19 falls into the category of pestilential diseases. The basic pathogenesis of the disease is invasion of external pathogens leading to damage to the lung and spleen, and deficiency of the healthy qi. Most patients with underlying diseases tend to progress to critical and severe stages, which are related to the depletion of lung's source supply,the blockage of heart and spirit, ending up with internal blockage and external collapse.In addition, in the diagnosis and treatment of pestilence, tongue diagnosis should be highlighted as it can reflect the real-time progression of the disease. Pathogenic qi should be expelled in time, but purgation method should be applied based on pattern differentiation, and tonifying methods should be used with caution.
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    Qi Forum
    On the origin and correction of yuan qi theory in Huangdi Neijing*
    Shi Lingsheng, He Juan
    2020, 43 (7):  544-547.  doi: 10.3969/j.issn.1006-2157.2020.07.003
    Abstract ( 355 )   PDF (1127KB) ( 180 )   Save
    The theory of yuan qi was first put forward in Chunqiu Fanlu in the Western Han Dynasty,and considered as formed the early natural philosophy of Confucianism. However,in Huangdi Neijing (Huangdi's Internal Classics),except for the seven major treatises on yunqi theory in the Eastern Han Dynasty that were added in later generations,the character "yuan" in its text didn't have the equivalent philosophical connotation to the root theory yet. After the Eastern Han Dynasty,there was overlapping between "yuan qi" and "zhen qi" in the generative theory, so the widely-used word "yuan qi"was used to replace or integrate the concept of "zhen qi". Nevertheless,yuan qi and zhen qi have different philosophical origins. The yuan qi thought was rooted in Confucianism in the Western Han Dynasty,while the zhen qi thought originated from Taoism in the pre-Qin Dynasty. It is "zhen qi" rather than "yuan qi" that is the core concept of the root theory in Huangdi Neijing.
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    Theoretical Studies
    Characteristics and prospect analysis of network image thinking*
    Li Bing, Wang Yongyan, Wang Zhong
    2020, 43 (7):  548-552.  doi: 10.3969/j.issn.1006-2157.2020.07.004
    Abstract ( 268 )   PDF (1127KB) ( 77 )   Save
    The holistic, interrelated, systematic, and multivariate Network Image Thinking (NIT) of image thinking goes with the objective trend and reflects the inevitability of history.The concept of NIT was put forward to promote the in-depth research of TCM network pharmacology, illuminate the shift of thinking from entity to relational ontology, individual to group thinking, objective reality to virtual existence of NIT, and further analyze the NIT thinking characteristics of integrity and relevance, hierarchy, de-centeredness, modularity, dynamic, universality, individuality, and adjustability. With the guidance of NIT, there will be a broad prospect in the research of network pharmacology in the expression of prescription multi-targeted action, optimal design of prescriptions, the correlation research of prescriptions and patterns, which will manifest the guiding role of original thinking of TCM in modern research.
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    Questioning etiology and pathogenesis theory of traditional Chinese medicine: taking taiyang wind-stroke pattern and Guizhi Decoction in Shanghan Lun as an example*
    Jia Chunhua
    2020, 43 (7):  553-556.  doi: 10.3969/j.issn.1006-2157.2020.07.005
    Abstract ( 297 )   PDF (1124KB) ( 139 )   Save
    Back in the era relying on physical perception only, the internal changes of the body can only be perceived by inference through external observation and analysis of the cause through the effects, and expressed with metaphorical cognition. The etiology and pathogenesis theory of traditional Chinese medicine(TCM) is the product of such cognitive approach. This paper explored the origins of the theory that came from clinical practices and that cannot be perceived physically,with etiology and pathogenesis of TCM as the main line, and taiyang wind-stroke pattern and Guizhi Decoction (Cinnamon Twig Decoction, GZT) in Shanghan Lun (On Cold Damage) as an example.Metaphorical cognition is used to analyze taiyang wind-stroke pattern and GZT, including how cold damage was stated and what was the difference between the language used for the statement and the daily language used at that time; Why GZT has the effect of releasing the muscle and regulating the nutritive and defensive level; Why the etiology and pathogenesis theory works well, and what are the new findings from the etiology and pathogenesis theory. At last, it reveals the differences between the logical determination of propositions and the fact test,with the logical determination of the truth and falsity of conditional propositions and the verifiability of the etiology in TCM.
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    Analysis of “fuliang" disorder in Huangdi Neijing*
    Wang Renping, Zhang Qingxiang
    2020, 43 (7):  557-560.  doi: 10.3969/j.issn.1006-2157.2020.07.006
    Abstract ( 426 )   PDF (1127KB) ( 178 )   Save
    The term"fuliang"is an ancient disease name, and refers to epigastric and abdominal mass.It was first documented in four chapters of Huangdi Neijing(Huangdi's Internal Classic),including the chapters of Symptoms of Zangfu-Organs due to Attack of Pathogenic Factors and Muscles of the Meridians in Lingshu(Spiritual Pivot), and Discussion on Special Diseases and Discussion on the Abdominal Disorders in Suwen(Plain Questions).Through analysis of the name, etiology and pathogenesis of "fuliang" disorder in Huangdi Nejing, it was found that this disease has been present not only in ancient times.It is believed that "fuliang" is an umbrella term for abdominal abscess and swelling,mass below the heart, and edema below the navel, which are equivalent to abdominal tumors,masses and edema in modem medical terms."Fuliang" is caused by pathogenic qi accumulation leading to stagnation of qi and blood, which results in internal accumulation. Treatment should be given on the basis of correct analysis of pathogenesis.
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    Chinese Medicinal Pharmacology
    Effects of Zigui Yichong Formula on ovarian oxidative damage in rats with diminished ovarian reserve and its mechanism*
    Lu Xingxing, Ren Doudou, Xu Huazhou, Song Cuimiao, Zhang Yu, Fan Lijie, Ma Huirong
    2020, 43 (7):  561-568.  doi: 10.3969/j.issn.1006-2157.2020.07.007
    Abstract ( 231 )   PDF (3071KB) ( 81 )   Save
    Objective To investigate the effects of Zigui Yichong Formula(Gui-nourishing and Chong-benefiting Formula, ZGYCF) on ovarian oxidative damage in rats with diminished ovarian reserve (DOR) and its mechanism. Methods The rat models of DOR were established by administering intraperitoneal injection of cyclophosphamide. 30 rats with successful modeling were randomly divided into model group, high-dose ZGYCF group (28 g/kg), and low-dose ZGYCF group (7g/kg) (n=10 in each group). 10 rats with regular estrous cycle were set as the normal control group. The rats were treated with corresponding drugs except those in the normal group for 28 days and all were sacrificed before estrous cycle. Then the levels of serum estradiol(E2), anti-mullerian hormone(AMH), follicle stimulating hormone (FSH) and luteinizing hormone (LH) were determined.The morphological changes of ovarian tissue were observed with HE staining.Theactivity of superoxide dismutase(SOD),glutathione peroxidase(GSH-Px), catalase(CAT)and the content of malonicdialdehyde(MDA) were determined.The protein expression of p53,p21 and Nrf2 in ovarian tissue were detected with immunochemistry technology and Western Blot assay. Results Compared with the normal group,the levels of E2,AMH were decreased and the levels of FSH and LH were increased (P<0.05);the number of follicles in the ovarian tissue was decreased,the number of atresia follicles was increased and the number of granulosa cells was decreased;the activity of SOD,GSH-Px,CAT was decreased and the content of MDA was increased(P<0.05);the protein expression of p53,p21 and Nrf2 in ovarian tissue was increased (P<0.05) in the model group.Compared with the model group,the levels of E2,AMH were increased and the levels of FSH,LH were decreased (P<0.05); the number of atresia follicles was decreased and the number of granulosa cells was increased;the activity of SOD,GSH-Px,CAT was increased and the content of MDA was decreased(P<0.05); the protein expression of p53,p21 and Nrf2 in ovarian tissue was decreased (P<0.05) in high-dose ZGYCF group and low-dose ZGYCF group. Conclusion Zigui Yichong decoction can improve the ovarian reserve function of DOR rats,reduce ovarian oxidative damage and protein expression of p53, p21 and Nrf2 in ovarian tissue.
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    Effects of gardenia essential oil aromatherapy on exercise capacity and anxiety in dual transgenic mouse model of Alzheimer's disease*
    Chen Ziwei, Zhang Qian, He Fang, Zhang Ce, Gu Ruoxi, Zhao Keqin, Wang Xu, Tan Yan
    2020, 43 (7):  569-574.  doi: 10.3969/j.issn.1006-2157.2020.07.008
    Abstract ( 409 )   PDF (1153KB) ( 170 )   Save
    Objective To observe the effects of gardenia essential oil aroma therapy on the exercise capacity and anxiety of dual transgenic model of Alzheimer's disease(APP/PS1)mice. Methods The mice were divided into three groups: normal group (6 litter mate wild type mice, male), model group and aroma group (5 APP/PS1 mice in each group, male).Aroma intervention was performed once every 4 days, 2-3 μL of gardenia essential oil each time for 2 hours only to aroma group.No intervention was administered in the normal and model groups. The body weight was measured after 180 days; the fat and muscle content were measured with a fat meter; rotating rod was used to detect exercise endurance; open field test was used to detect activity, exploration ability and anxiety; two-photon fluorescence microscopy was used to detect capillary blood flow velocity in the hind limbs. Results Compared with the normal group, the body weight and fat content of the mice in the model group were significantly increased (P<0.01 and P<0.05);the movement distance in the center of the open field and the capillary blood flow velocity in hind limbs of the mice in the model group were significantly decreased(P<0.05 and P<0.05). Compared with the model group, the body weight of the mice in the aroma group was significantly decreased (P<0.05), the movement distance and time in the center of the open field in the aroma group were significantly decreased(P<0.05 and P<0.05).After aroma intervention, the fat content tended to decrease; the exercise endurance and capillary blood flow velocity in hind limbs tended to increase.Conclusions Gardenia essential oil aromatherapy can reduce the body weight and anxiety of APP/PS1 mice, and increase their exploration ability, and it tends to inhibit fat gain, increase exercise endurance and blood flow in APP/PS1 mice. Aromatherapy could be considered as adjuvant therapy to improve early symptoms of AD.
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    Effects and mechanism of ginsenoside Rg3 combined with tumstatin 19 peptide on apoptosis of HepG2 cells in liver cancer*
    Yi Tonghui, Wu Yanmin, Liu Rui, Zhang Chunjing, Yao Shujuan, Shi Yan, Li Shuyan
    2020, 43 (7):  575-582.  doi: 10.3969/j.issn.1006-2157.2020.07.009
    Abstract ( 238 )   PDF (1771KB) ( 83 )   Save
    Objective To study the effects and mechanism of ginsenoside Rg3 combined with tumstatin 19 peptide on apoptosis of liver cancer HepG2 cells. Methods The two-level factorial-analysis design was used in the experiment with factor A of ginsenoside Rg3 with two levels of 0 mg/L and 40mg/L, and factor B of tumstatin 19 peptide with two levels of 0 mg/L and 200 mg/L. The proliferation of HepG2 cells was measured by using the CCK-8 kit.Hoechst33342 staining was used to detect the morphological changes of the apoptosis of HepG2 cells.The apoptosis rates of HepG2 cells were detected with flow cytometry.The cell membrane potential change of HepG2 cells was measured by fluorescence probe JC-1.The expression ofphosphatase and tensin homology deleted on chromosometen(PTEN), phosphated phosphatidylinositol phosph atidylinositol 3-kinase (p-PI3K) and p-Akt was evaluated by using Western blot assay.The activities of caspase-3 and caspase-9 were measured with the Caspase-activity assay kit. Results Ginsenoside Rg3,tumstatin 19 peptide and the combined therapyhad in hibitory effect on the proliferation of HepG2 cells.Ginsenoside Rg3,tumstatin 19 peptide had a positive synergistic effect.The IC50 of Rg3 was 45.06 mg/L, and that of 19 peptide was 214.03mg/L. Results of Hoechst33342 staining showed that changes of apoptosis in combined therapy was more evident.The results of flow cytometry were consistent with Hoechst33342 staining, and the apoptosis rate was the highest in combined therapy. Fluorescence probe JC-1 showed that combined therapy emitted the strongest green fluorescence. The combined therapy was more significant in up-regulating the expression of PTEN protein and down-regulating the expression of p-PI3K and p-Akt protein.The activities of caspase-3 and caspase-9 enzyme were significantly increased in combined therapy(P<0.001). Conclusion Ginsenoside Rg3 and tumstatin 19 peptide can inhibit proliferation and induce apoptosis of HepG2 cells.They manifest a positive synergistic effect.The synergistic effect might be achieved through the PTEN/PI3K/Akt signaling pathway.
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    Difference of intestinal ion transport function in rats with pattern of dampness retention due to spleen deficiency and analysis of coix seed's effects*
    Han Xiaochun, Lyu Jiajian, Gu Liangzhen, Tian Shen, Yang Zhe, Zhang Lu, Guo Liangqing, Zhao Haijun, Wang Shijun
    2020, 43 (7):  583-591.  doi: 10.3969/j.issn.1006-2157.2020.07.010
    Abstract ( 225 )   PDF (2023KB) ( 82 )   Save
    Objective To explore the changes of ion transport function in rats with pattern of dampness retention due to spleen deficiency (DRSD) and the mechanism of coix seed (Yiyiren, Semen Coicis) on strengthening the spleen and draining dampness. Methods The animal model of DRSD was established by swimming-induced labor combined with specific feedstuff. The model rats were randomly divided into 6 groups (n=10). These rats except those in the model group were orally administered with coix decoction (6.25 g/kg), coix oil (287.5 mg/kg), coix polysaccharide (911.3 mg/kg), coix protein (281.3 mg/kg), and coix starch (1 798.1 mg/kg) by intragastric gavage once daily. Another 10 normal rats were taken as the control group. After 14 days of intervention, the small intestine samples were collected and the gene expression of rat intestine was detected by using Agilent's whole genome expression microarray. After screening the differential genes expression (DEGs) of ion transport between model group and control group, principal component analysis (PCA) and cluster analysis were carried out for the differential genes of each group. The PCA loading and scores were also analyzed. Results There were 38 DEGs in ion transport between model rats and control rats. Bi-plot analysis of PCA on the DEGs showed that the model group was farthest from the control group, which was consistent with the clustering results of samples. After treatment with different components of coix seed, the result of each treatment group was between the model group and the control group. The analysis of DEGs showed the top 10 genes were Atox1, Slc5a4, Slc40a1, Slc5a1, Slc11a2, Cftr, Fxyd5, Cacna1i, Kcnj13 and Atp5d, and most of them were in the same category in cluster analysis. Conclusion There are apparent changes of ion transport gene in intestinal epithelial cells of DRSD rats. Different components of coix seed, especially the oil and the protein components, have strong effects on ion transport function. Solute carrier (Slc) family is the main target of spleen-strengthening and dampness-draining effects. Besides, Atox1 and Cftr also play a significant role in these effects.
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    Effects of triptolide on IFN-γ and IL-17A expression in collagen-induced arthritic rats*
    Ma Junfu, Meng Qingliang, Zheng Fuzeng, Gu Huimin, Hou Xiujuan, Zhu Yuelan
    2020, 43 (7):  592-598.  doi: 10.3969/j.issn.1006-2157.2020.07.011
    Abstract ( 223 )   PDF (1162KB) ( 73 )   Save
    Objective To study the effect of triptolide on IFN-γ and IL-17A expression in collagen-induced arthritis (CIA) rats. Methods 50 female Wistar rats were randomly divided into 5 groups (n=10 in each group): the normal group, model group, methotrexate (MTX) group and Tripterygium wilfordii glycosides tablet (TGT) group and triptolide (TPL) group. CIA rat model was established in all groups except the normal group. The normal group was fed routinely, while other groups were given by gavage with distilled water, MTX (1.78mg/kg), TGT (20mg/kg) and TPL (4mg/kg) respectively once a day for 4 weeks after CIA model was established. The weight, arthritis index (AI), foot swelling drainage volume of each groups were evaluated once a week. At week 4, ELISA assay was used to detect the IFN-γ and IL-17A levels in the peripheral blood of rats. RT-qPCR assay was used to detect the relative expression levels of IFN-γ mRNA and IL-17A mRNA in the rat knee joint. Results Compared with normal group the weight loss in each interventional group (MTX, TGT and TPL) at baseline(P< 0.05), and the AI value and the drainage volume of both feet were significantly increased (P< 0.05). After intervention, the swelling of the foot of the group reduced and AI value decreased continously. There was no significant difference in the AI and the double feet swelling drainage volume at the same time among drug-treated groups (P> 0.05). The IFN-γ and IL-17A levels in peripheral blood of model group and administration group were significantly higher compared to normal group (P< 0.05), and the level of each administration group was significantly lower than that in model group (P< 0.05).There was no significant difference between MTX, TGT and TPL group of it (P> 0.05). The IFN-γ mRNA and IL-17A mRNA relative expression of model group was significantly higher than that in normal group (P< 0.05), and the relative expression of mRNA were decreased after treatment. Except for MTX group, there was no significant difference between the other administration groups and the model group of the relative mRNA expression (P> 0.05). Conclusion Triptolide can relieve the joint swelling of CIA rats, reduce AI value and the expression of IFN-γ and IL-17A in the peripheral blood of CIA rats.
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    Clinical Studies
    Effects of eye acupuncture combined with external application of warm Chinese herbs on post-stroke shoulder-hand syndrome: a parallel randomized controlled trial of 356 cases*
    Shao Yan, Ju Qingbo, Liu Jianping, Kang Jian, Cui Cong, An Taijian, Xu Hui, Gao Chen, Zhao Xia, Wang Pengqin
    2020, 43 (7):  599-605.  doi: 10.3969/j.issn.1006-2157.2020.07.012
    Abstract ( 201 )   PDF (1219KB) ( 90 )   Save
    Objective To observe the effects of eye acupuncture combined with external application of warm Chinese herbs on pain relief in patients with post-stroke shoulder-hand syndrome (SHS) at stage I. Methods A total of 356 SHS participants at stage I were assigned randomly to external warm application group (n=120), eye-acupuncture therapy combined with external warm application (combination therapy) group (n=122), and rehabilitation control group (n=114). The rehabilitation group received usual care while the external warm application group adds external application of warm Chinese herbs. The combination therapy group combined with extra eye acupuncture points on upper and lower jiao areas, heart and kidney. The treatment duration was all 4 weeks in three groups. Visual analogue scale (VAS) score, activities of daily livings (ADL) scale, Fugl-meyer scale and TCM syndrome scores were used to evaluate the pain and mobility of the affected upper limbs, daily living activities and efficacy of syndrome treatment in TCM. Safety was also evaluated in all groups to characterize the efficacy and safety profile of this combination technique. Results VAS scores were significantly reduced in all three groups after treatment when compared with before treatment (P<0.05). The combination therapy group had the most significant score reduction compared with external warm application group and rehabilitation group respectively (P<0.05). Shoulder pain relief was also significantly different among the three groups (P<0.05). Fugl-Meyer and ACL scores increased in all groups after treatment when compared with before treatment (P<0.05). The combination group had the most significant increase with marked difference from those in the external warm application therapy or rehabilitation alone. TCM syndrome scores were also reduced in all three groups after treatment (P<0.05),with the combination group having the most significant reduction of scores in comparison to the external warm application group and rehabilitation group. Conclusion Eye-acupuncture combined with external application of warm Chinese herbs could significantly relieve the pain of shoulder hand syndrome after stroke (pattern of phlegm and stasis obstructing the collaterals) at stage I. This combination therapy can significantly improve the mobility of affected should joint and restore the function of upper limbs without any side effects.
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    Analysis of outcomes used in RCTs of traditional Chinese medicine on stable angina pectoris in the past 3 years*
    Li Huimin, Xiong Xingjiang, Zhao Hui, Hu Ruixue, Shang Hongcai, Yang Wei, Liao Xing
    2020, 43 (7):  606-616.  doi: 10.3969/j.issn.1006-2157.2020.07.013
    Abstract ( 264 )   PDF (2064KB) ( 155 )   Save
    Objective To evaluate the outcomes used in randomized controlled trials (RCTs) of traditional Chinese medicine (TCM) in the treatment of stable angina pectoris, and to provide a basis for the study of the core outcome set of TCM in the treatment of stable angina pectoris. Methods We searched RCTs of TCM in the treatment of stable angina pectoris in the databases of PubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP from January 2016 to August 2019. Two reviewers independently screened all the records, extracted the data and evaluated the risk of bias for the included trials. A qualitative analysis was conducted to describe the outcomes of the included studies. Results 6349 papers were searched and screened. 24 papers (3 English papers) were included in the final analysis. Outcomes used in these 24 studies were mainly divided into six categories, namely clinical efficacy of angina pectoris, electrocardiogram (ECG), Quality of life (QoL) scale, blood biochemistry panel, safety profiles (including adverse reactions and adverse events), and other parameters. Blood biochemical parameters topped the list, followed by angina pectoris. 14 of the 24 studies used TCM syndrome scores as an indicator of outcome. Conclusion There are existing problems in the outcomes used in RCTs of TCM treatment of stable angina pectoris. We should establish core outcome set for TCM studies on the basis of combining the international standardized core outcome set with the characteristics and laws of diagnosis and treatment of traditional Chinese medicine.
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