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

Table of Content

    30 September 2020, Volume 43 Issue 9 Previous Issue    Next Issue
    Theoretical Studies
    Theoretical discussion on “what” and “why” in traditional Chinese medicine*
    Jia Chunhua
    2020, 43 (9):  709-713.  doi: 10.3969/j.issn.1006-2157.2020.09.001
    Abstract ( 314 )   PDF (1270KB) ( 210 )   Save
    After analyzing the sentence “observe pulse and symptoms to infer their causes and then give treatment accordingly”, we believe that theoretical discussions in traditional Chinese medicine fall into two categories: discussions on what and discussions on why. By “observing pulse and symptoms”, we try to answer the question “what” a particular combination of pulse and symptoms is like. By “inferring their causes”, we try to answer the question “why” such pulse and symptoms appear. By giving treatment accordingly, we try to answer the question “how” to deal with them. The last question involves the relationship between pattern manifestations and prescriptions, which can be further reduced to “what” and “why” is the relationship. Therefore, the general principles of traditional Chinese medicine embodied in the above-mentioned sentence can be analyzed from the two angles of what and why. The study of “what” is descriptive research, which leads to descriptive theory. The study of “why” leads to interpretative theory of causality. However, the causality in traditional Chinese medicine is often based on inferring causes from results. Therefore, it is difficult to test and verify the “cause” derived from such analysis because it is not a factual “cause”, but a “cause” in terms of ontological commitment. The main reason why the interpretative theory of traditional Chinese medicine can guide clinical practice is that such interpretative theory is based on a large number of descriptive theories that have been tested and verified.
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    Confucianization of TCM and transformation of TCM physicians’ concepts of human body in the Ming Dynasty*
    Liu Peng
    2020, 43 (9):  714-717.  doi: 10.3969/j.issn.1006-2157.2020.09.002
    Abstract ( 207 )   PDF (1187KB) ( 115 )   Save
    Under the direct influence of Neo-Confucianism, it became the common pursuit of Confucianists and TCM doctors to understand the tai chi principle of the universe by exploring tai chi of the body. Therefore, in order to understand and explain the body from a Confucian perspective, physicians in the Ming Dynasty re-explored the origin of life by applying the cosmological model of Neo-Confucianism to life. As they re-explored and reconstructed the origin of human body, they sought evidence from perspectives of both medicine and culture.From the medical perspective, they borrowed the term “mingmen” (life gate), originally referring to “eyes”, from Huangdi Neijing (Huangdi’s Internal Classic), and the concept “the stirring qi of the kidney region”, which is regarded as fundamental to life from Nanjing (Classic of Difficult Issues). Through combination and transformation, mingmen began to refer to the stirring qi of the kidney region and became the new origin of life, thus forming the textual support from medical classics.In terms of culture, TCM physicians’ re-exploration of the origin of life in the Ming Dynasty were motivated directly by the pursuit of the ontology of the universe by Neo-Confucianism at that time. Drawing on Yi-ology, especially Zhou Dunyi’s new interpretation, they reshaped mingmen and the two kidneys in a metaphysical way, which gained the medical theory support from Confucianism that was widely acknowledged by the society. However, the transformation of the concepts of body by TCM doctors in the Ming Dynasty represented by the mingmen theory was more an analogy to Confucianism than any real breakthrough in and transcendence over the traditional system of pattern differentiation and treatment.
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    Discussion on the process of theorization of TCM based on “data feeding” model*
    Wu Hao, Wang Qian, Liu Hong, Yan Ran, You Fengming, Zheng Chuan
    2020, 43 (9):  718-722.  doi: 10.3969/j.issn.1006-2157.2020.09.003
    Abstract ( 179 )   PDF (1597KB) ( 73 )   Save
    This paper analyzes the theoretical characteristics of traditional Chinese medicine (TCM) by applying artificial intelligence “data feeding” to it. It is believed that the essence of the theorization of TCM is to construct the database of general “clinical information” based on the human brain as the material base and with materialist dialectics as the guiding principle to realize the digital decision-making process of “data feeding” in TCM. The conclusions are follows. Improvement in the volume and quality of the “data pool” is the most important motive force for TCM theorization. On the other hand, the decline of the “data pool” will lead to the stagnation of TCM development, and the present development of TCM should focus on the clinical practice of treating diseases. In addition, further development in the field of artificial intelligence is expected to deepen our understanding of TCM by providing a new historical context.
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    Qualitative Research
    Interview skills in qualitative research on inheritance of illustrious senior traditional Chinese medicine practitioners: an analysis with examples*
    Yu He, Cui Lijun, Luo Changyong, Liu Tiegang, Mei Chencheng, Dong Fei, Gu Xiaohong
    2020, 43 (9):  723-728.  doi: 10.3969/j.issn.1006-2157.2020.09.004
    Abstract ( 193 )   PDF (1190KB) ( 132 )   Save
    In-depth interview is one of the most commonly used methods to collect data in qualitative research. The information obtained as raw data determines the outcome of qualitative research. Knowing the ways of effective implementation of interviews help to improve the quality of interview, enrich the materials for interview and guarantee the successful progress of the qualitative research. During the preparation for the interview, the researchers should clarify the purpose of the study, carry out pre-interviews, familiarize the background information of the interviewees, determine the time and place of interview, and dress properly. During the interview, they should pay attention to the interview skills of breaking the ice, questioning, making detailed inquiry and giving feedback. After the interview, they should sort out the data in time and determine whether a second interview or supplementary materials are needed. By illustrating the above points with specific examples of qualitative research on illustrious senior traditional Chinese medicine practitioners, this study provides ideas for carrying out efficient and high-quality interviews and reference for future qualitative research in Chinese medicine.
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    Textual Research
    History of clinical applications of charred Chinese medicinal herbs*
    Sun Ziwei, Zhang Yue, Kong Hui, Qu Huihua, Zhao Yan
    2020, 43 (9):  729-734.  doi: 10.3969/j.issn.1006-2157.2020.09.005
    Abstract ( 207 )   PDF (1278KB) ( 155 )   Save
    As a unique part of Chinese herbal medicine, charred Chinese medicinal herbs, or charred herbs for short, enjoyed a long history and abundant clinical applications. Charred herbs were firstly used by accident, and later more were used intentionally and systematically until finally a theory was formed, the whole process of which took a long time. As early as in the Qin and Han dynasties, the mystery of using charred herbs to cure diseases was unveiled in medical practice. The types and processing methods of charred herbs increased and improved over the later dynasties. It was widely used in internal medicine, external medicine, gynecology, and pediatrics, etc. Its curative effects were proven in clinical practice in the past and has been confirmed by more and more pharmacological researches now. Through a thorough review of ancient literature, it’s believed that the application of charred herbs was one of the pioneering medical practices of our ancestors and its vitality lies in its great efficacy. This paper provides literature basis and ideas for more profound research into charred herbs, on which further studies are warranted.
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    Supplement and corrections regarding TCM basic theory books in the Republic of China to Zhongguo Zhongyi Guji Zongmu*
    Zheng Jiahan, Yang Dongfang
    2020, 43 (9):  735-737.  doi: 10.3969/j.issn.1006-2157.2020.09.006
    Abstract ( 209 )   PDF (1238KB) ( 101 )   Save
    Zhongguo Zhongyi Guji Zongmu (General Catalogue of Ancient Books on Chinese Medicine), which recorded the collection information of TCM ancient books, has been indispensable to the research of traditional Chinese medicine. Based on literature review and comparison with the original book, this paper discovers that the catalogue failed to include three major works on basic TCM theory in the Republic of China (1912-1949), i.e. Shenglide Ranshao (Physiological Oxidation), Huabei Guoyi Xueyuan Shenglixue Jiangyi (Physiology Teaching Materials of North China Chinese Medicine College) and Binglixue Jiangyi (Pathology Teaching Materials). In addition, there are also several mistakes concerning the publication time, author and categories of 5 other works. With the addition and correction of the information of these books, Zhongguo Zhongyi Guji Zongmu can be further improved.
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    Science & Technology Theme
    Research on the differentiation method of spleen deficiency leading to damp accumulation pattern in rats with ulcerative colitis*
    Jiao Wenchao, Luo Hui, Tang Jiayang, Wang Qing, Su Congping, Yu Xue, Liu Yan, Shi Bingjie, Wang Wei, Guo Shuzhen
    2020, 43 (9):  738-745.  doi: 10.3969/j.issn.1006-2157.2020.09.007
    Abstract ( 216 )   PDF (1502KB) ( 135 )   Save
    Objective To investigate the differentiation methods for the pattern of spleen deficiency leading to damp accumulation in ulcerative colitis (UC) rats from the perspectives of both the disease in Western medicine and the pattern in traditional Chinese medicine (TCM), and then establish desirable models for pharmacological evaluation of Chinese herbal medicine and basic researches in TCM pattern.Methods 40 SD rats were randomly divided into the control groups (studied for 4 weeks) and the model groups (8 weeks), 10 in each group. Immune induction together with coloclysis of 2,4, 6-trinitrobenzene sulfonic acid(TNBS) was used to induce ulcerative colitis. Macroscopic characteristics, grip strength, open field test, hair and other features of the rats were collected at multiple time points. The colon samples were taken on the 28th and 56th days after coloclysis and the pathological changes were analyzed using HE stained sections. The corresponding criteria for pattern differentiation of rats were established based on common clinical diagnostic criteria of ulcerative colitis.Results Three days after coloclysis, rats in the model groups manifested relatively lusterless and frizzy hair, anorexia, significant weight loss, diarrhea, bloody stool, and increased resistance against grasping but normal vitality, responsiveness, autonomous activity and general state. From the fourth day to the end of the second week, compared with the control group, no significant differences were observed in the model rats except loose and sticky stool. In the third and fourth weeks, the model rats excreted loose stools, ate less and showed decreased grip strength (P<0.05) and lusterless and frizzy hair. Compared with the control groups, they also showed decreased vitality, resistance against grasping and responsiveness and UC was diagnosed based on their colonic pathological test results. From the fifth week to the eighth week, all the parameters of the model rats returned to normal gradually.Conclusion During the third and fourth weeks after coloclysis, the model rats could meet the diagnostic criteria of ulcerative colitis with spleen deficiency leading to damp accumulation pattern.
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    Chinese Medicinal Pharmacology
    Preventive effects of Yiqi Jiedu Fang on acute testicular injury of mice induced by 2.0 Gy 60Co γ ray*
    Lu Xi, Li Panfei, Wang An, Wang Lei, Wang Yan, Shi Zhongyu, Gao Yushan, Hu Sumin
    2020, 43 (9):  746-753.  doi: 10.3969/j.issn.1006-2157.2020.09.008
    Abstract ( 182 )   PDF (3105KB) ( 92 )   Save
    Objective To observe the acute testicular injury in male Balb/c mice induced by 2.0 Gy 60Co γ rays and the preventive effect of Yiqi Jiedu Fang (Qi-boosting and Toxin-removing Decoction, YQJDF) administered before irradiation. Methods 200 male Balb/c mice were randomly divided into five groups: normal group, model group, positive drug group, and high- and low-dose YQJDF groups. Except for the normal group, the other mice were subjected to single-dose whole-body irradiation with 2.0 Gy 60Co γ rays. The mice in the intervention groups were given their corresponding drugs for 10 consecutive days before the irradiation, and at the same time the mice in the normal group and the model group were given deionized water. Mice tissues were collected 1 day before and on the 1st, 3rd, and 7th days after the irradiation, and the body weight, testicular parameters, morphological changes of the testis, and apoptosis of spermatogenic cells were measured. Results Compared with the normal group, there was no significant difference in the above mentioned parameters of mice between groups 1 day before the irradiation. However, 1 day after irradiation, mice in the model group had a decreased Johnsen score of testis and an increased apoptosis rate of spermatogenic cells. On the 3rd day after irradiation, the weight of mice in the model group and the positive drug group decreased, the Johnsen score of mice in the model group, the positive drug group and the high-dose YQJDF group decreased, and the apoptosis rate of spermatogenic cells in all groups subjected to irradiation increased. On the 7th day after irradiation, testicular parameters decreased in all the irradiated groups, testicular morphology and structure changed, Johnsen score decreased significantly, and the spermatogenic cell apoptosis rate increased further. Compared with the model group, on the 3rd and 7th day after the irradiation, the Johnsen score of all the intervention groups were notably higher, and the apoptosis rate of spermatogenic cells were significantly lower, and the testicular pathological changes were lighter. Conclusion 2.0 Gy 60Co γ ray can cause morphological and structural changes in mouse testis, and increase the apoptosis of spermatogenic cells, and in turn affect the spermatogenic function of mice. The preventive treatment with YQJDF before irradiation effectively reduced the above injuries.
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    Effects of Louqin Zhisou Youhua Fang on improving antibiotic permeability through Pseudomonas aeruginosa biofilm by correcting inflammatory immune imbalance*
    Li Jie, Wu Tong, Yu Ziyang, Liu Liting, Huang Mingming, Zhao Cuiyun, Meng Zixia, Peng Guiying
    2020, 43 (9):  754-761.  doi: 10.3969/j.issn.1006-2157.2020.09.009
    Abstract ( 164 )   PDF (2036KB) ( 98 )   Save
    Objective To explore the immune protective effects of Louqin Zhisou Youhua Fang (Snakegourd-fruit Scutellaria-root Cough-stopping Formula with Modifications, LQZSYHF) on infection with Pseudomonas aeruginosa. Methods The effects of LQZSYHF on improving the penetration of levofloxacin through the PA mature biofilm (BF) were studied via in vitro experiment. Its effects on regulating inflammatory immune imbalance were explored through observing the levels of TNF-α and IFN-γ in the lung tissues of PA-infected rats via in vivo experiment. Results In vitro, both LQZSYHF and ambroxol assisted levofloxacin in penetrating PA mature biofilms. In vivo, both the Western drug and Chinese herbal medicine significantly promoted the elimination of lung bacteria and reduced the pathological damage to lung tissue. TNF-α level in lung tissue was significantly reduced and IFN-γ level was greatly increased in the Chinese herbal medicine (CHM) group compared with the model group (P<0.001). TNF-α level in lung tissue was greatly significantly reduced (P<0.001) and IFN-γ level was slightly increased without statistical significance in the Western drug (WG) group compared with the model group. TNF-α level in lung tissue was significantly reduced and IFN-γ level was greatly increased in the CHM group compared with WD group (P <0.001). Conclusion LQZSYHF can help antibiotics pass through mature biofilms in vitro. Its mechanism might be that it can correct the immune imbalance in PA-infected rats, by which it accelerates the elimination of lung bacteria and reduces lung pathological damage, thereby reducing inflammatory response, and it enhances body resistance against PA biofilm infection, thereby indirectly eliminating bacteria. Compared with ambroxol, its advantages may lie in improving immunity, and its underlying mechanism warrants further study.
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    Experimental study on the effect of Qishen Yiqi Dripping Pill on myocardial ischemia-reperfusion injury via PI3K/AKT signaling pathway*
    He Guixin, Xiao Ting, Qin Weibin, Mo Xiaoyun, Lin Lin, Ren Jiayi, Shen Yongyan, Yu Liyan, Feng Yufei, Zheng Guokun
    2020, 43 (9):  762-768.  doi: 10.3969/j.issn.1006-2157.2020.09.010
    Abstract ( 208 )   PDF (1311KB) ( 111 )   Save
    Objective To observe the protective effect of Qishen Yiqi (Astragalus Root and Danshen Root Qi-boosting) Dripping Pills (QSYQDP) on myocardial ischemia-reperfusion injury and its correlation with the activity of PI3K/AKT pathway. Methods Models of myocardial ischemia-reperfusion injury were established by ligating the left anterior descending branch of coronary artery in miniature pigs. Sixty healthy Bama miniature pigs were randomly divided into 6 groups (n=10): sham-operated group, model group, low-dose QSYQDP group (0.125 g/kg), mid-dose QSYQDP group (0.25 g/kg), high-dose QSYQDP group (0.3 g/kg), and QSYQDP plus wortmannin group. QSYQDP plus wortmannin group was given 20 mg/g PI3K/AKT signaling pathway blocker wortmannin and QSYQDP 300 kg/L via gavage. All the groups were treated continuously for 4 weeks. The levels of serum CK, CK-MB, AST, CRP and cTnT were detected by ELISA, and the levels of p-AKT and AKT were assessed by Western blotting. During the treatment, the second lead ECG was continuously monitored, and the frequency of ventricular fibrillation and the amplitude of ST segment elevation were recorded. Results ECG results showed that the incidences of ventricular fibrillation in the QSYQDP groups were significantly lower than that in the model group (P<0.05). Levels of CK, CK-MB and cTnT in the model group and low-dose QSYQDP group were significantly higher than those in the sham-operated group (P<0.05). Compared with the model group, the contents of AST, cTnT and CRP in the low-, mid- and high-dose QSYQDP groups were significantly lower. The cTnT and CRP levels in the high-dose QSYQDP group were lower than those in the low-dose QSYQDP group with statistically significant difference (P<0.05). Compared with the model group, the expression levels of p-AKT in the low-, mid- and high-dose QSYQDP groups increased (P<0.05), but there was no significant change in total AKT protein levels in any group (P>0.05). Conclusion QSYQDP can improve in a dose-dependant manner the cardiac function, reduce the incidence of ventricular fibrillation and activate the PI3K/AKT signaling pathway in miniature pigs with myocardial ischemia, so as to reduce the myocardial ischemia-reperfusion injury and protect cardiomyocytes.
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    Chinese Herbal Preparation
    Study on change in color and contents of three common ginsenosides of Hongshen steamed for different durations*
    Qu Wenjia, Jia Tianying, Wang Haili, Xin Jieping, Wang Min, Bai Yuying, Xu Wenjuan, Li Xiangri
    2020, 43 (9):  769-775.  doi: 10.3969/j.issn.1006-2157.2020.09.011
    Abstract ( 180 )   PDF (1742KB) ( 139 )   Save
    Objective To investigate the change in color and contents of three commonly seen ginsenosides Rg1, Re and Rb1 of Hongshen (Red Ginseng, Radix et Rhizoma Ginseng Rubra) at different steaming durations and provide reference for revising the standard for determination of ginsenosides in Pharmacopoeia of the People’s Republic of China (hereinafter referred to as the Chinese Pharmacopoeia). Methods Renshen (Ginseng, Radix et Rhizoma Ginseng) and Hongshen (steamed for different durations) were grounded into powder, the color of which were measured with colorimeter. The contents of ginsenosides Rg1, Re and Rb1 in the samples were determined with the method listed in the part of content determination of Hongshen in the Chinese Pharmacopoeia (ChP2015). The results were analyzed with SPSS 20.0 software. Results The results showed that with the increase in steaming time, the color luminance value L and the total color difference value E of Hongshen powder decreased gradually, while the chromaticity values a and b increased gradually. Meanwhile, the contents of ginsenosides Rg1 and Re demonstrated no significant change. However, the content of ginsenoside Rb1 increased gradually and there was significant difference in this regard between Hongshen steamed for 2 hours and Renshen (P<0.05). Conclusion As the steaming time increases, the color of Hongshen powder deepened gradually and the content of ginsenoside Rb1 increased significantly. Therefore, it is suggested to raise the content standard of ginsenoside Rb1 in Hongshen in Chinese Pharmacopoeia.
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    Clinical Studies
    Relationship between insomnia and kidney in Huangdi Neijing*
    Tian Dong, Xi Chongcheng, Liao Shuqin, Huang Junwei, Shi Yanhao, Liu Jintao, Zhang Ning, Wang Weiguang, Chen Zijie, Zhai Shuangqing
    2020, 43 (9):  776-779.  doi: 10.3969/j.issn.1006-2157.2020.09.012
    Abstract ( 270 )   PDF (1191KB) ( 96 )   Save
    Although no such disease name as “不寐” (literally, insomnia) was mentioned in Huangdi Neijing (Huangdi’s Internal Classic, hereinafter referred to as Neijing), discussions on related symptoms like “目不暝” (literally, inability to close one’s eyes) and “卧不安” (literally, restless sleep) were recorded in Neijing. Based on an analysis of the discussion related to insomnia in Neijing, it is believed that the direct cause of insomnia is that phlegm-fluid retention disturbs the stomach, which in turn leads to restless sleep. The root cause of phlegm-fluid retention, however, lies in two functions of the kidney. First, the kidney controls qi transformation, whose normal function causes no phlegm-fluid retention. Second, as the kidney stores essence, whose abundance places the five zang organs in peace without phlegm-fluid retention and keeps essence and spirit in the interior resulting in sound sleep. This approach to explaining the reasons for and mechanism of insomnia in terms of the functions of the kidney not only complements the theoretical discussion of the relationship between insomnia and kidney but also provides guidance and suggestions for the treatment of insomnia based on pattern differentiation.
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    Application of the therapy of promoting the flow of yang in tumor treatment*
    Hu Shuaihang, Tian Peiyu, Zhang Xiaogang, Hou Wei
    2020, 43 (9):  780-784.  doi: 10.3969/j.issn.1006-2157.2020.09.013
    Abstract ( 213 )   PDF (1256KB) ( 143 )   Save
    The term tongyang (promoting the flow of yang) was clearly recorded in Wenre Lun (Treatise on Warm-Heat Diseases), and its theoretical essence can be traced back to many prescriptions recorded in Huangdi Neijing (Huangdi’s Internal Classic) and Shanghan Lun (Treatise on Cold Damage). Since the ancient time, tongyang has been employed as a major therapy in TCM pattern differentiation and treatment. Used to treat constrained yang qi, it was effective for static-blood obstruction and phlegm-fluid retention. As tumors have unique etiology and pathogenesis, the tongyang therapy for treating tumors should take into account not only the status of yin and yang in the body but also tumor’s properties of yin in the interior and yang in the exterior. This article discusses the application of the theory that tongyang does not refer to warming only in tumor treatment from the perspective of warming and supplementing prenatal and postnatal yang qi and dredging the channels for free flow of yang qi.
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    Preliminary analysis of the meaning of “excessive dampness causing sluggishness”
    Jia Zhixin
    2020, 43 (9):  785-788.  doi: 10.3969/j.issn.1006-2157.2020.09.014
    Abstract ( 237 )   PDF (1255KB) ( 200 )   Save
    Based on literature review, clinical practice and theoretical research, it is concluded that “湿胜则濡” (literally, excessive dampness causing sluggishness) is more likely to be the original text in Huangdi Neijing (Huangdi’s Internal Classic) than “湿胜则濡泻” (literally, excessive dampness causing diarrhea). At the same time, since both “湿” and “濡” can mean literally sluggishness and slowness, dampness is soggy and stagnant in nature, and it’s treated by promoting the flow of qi, it is concluded that “湿胜则濡” means “pathogenic stagnation leads to the pattern of stagnation”. By analogy, it is explained that “湿” (literally, dampness) denotes the concept of pattern while qi stagnation is its root cause. Therefore, dampness cannot be regarded as the pathological product of abnormal metabolism of body fluid because it may easily lead to misunderstandings like “dampness is yin in nature and moves downward”, “dampness is often treated with warming method” and “dampness must be treated by promoting urination”, which may cause excessive use of medicinal herbs warm in nature or diuretics, leading to consumption of qi and damage to fluid. It is proposed that “dampness should not be treated with unjustifiably nourishing yin”. Therefore, it is of great clinical significance to understand the underlying meaning of “湿胜则濡”.
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    Expert guidance on psychosomatic treatment of mixed anxiety and depressive disorder under pandemic-induced stress
    Expert Group of Psychosomatic Medicine Branch, China Association of Chinese Medicine
    2020, 43 (9):  789-792.  doi: 10.3969/j.issn.1006-2157.2020.09.015
    Abstract ( 169 )   PDF (1173KB) ( 113 )   Save
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