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

Table of Content

    30 October 2020, Volume 43 Issue 10 Previous Issue    Next Issue
    Theoretical Studies
    On naming COVID-19 in traditional Chinese medicine*
    Liu Tiegang, Bai Chen, Liu Shaoyang, Long Chaojun, Hu Li, Zhao Yansong, Yu He, Gu Xiaohong
    2020, 43 (10):  797-803.  doi: 10.3969/j.issn.1006-2157.2020.10.001
    Abstract ( 546 )   PDF (1274KB) ( 290 )   Save
    Through review of national and regional Diagnosis and Treatment Plan of Corona Virus Disease 2019 (COVID-19) and related literature, this article analyzed the characteristics of COVID-19, and probed into its TCM nomenclature, combining the naming rules for pestilence in traditional Chinese medicine (TCM). The terms used for COVID-19 in TCM currently include pestilence, cold pestilence, cold-damp pestilence, cold-damp lung pestilence, damp pestilence, dampness-toxin pestilence, warm pestilence, damp-heat pestilence, lung pestilence, wind pestilence, winter pestilence, wind-warm and damp pestilence, wood pestilence, etc. COVID-19 can be generally referred to as “pestilence”in TCM; according to the nature of the symptoms and the characteristics of the pathogenesis, it can be named as “dampness-toxin pestilence” since symptoms of damp nature have maintained throughout the disease course with the pathogenesis of stasis and toxin obstruction; the name of “lung pestilence” according to disease location fails to reflect the lesion site of the disease; the name of “winter pestilence”, “wind pestilence” and “wind-warm and dampness pestilence” according to the time of onset, though in accordance with the definition of warm diseases, does not conform to the characteristics and pathological rules of the disease; according to the five elements motion and six climatic changes, it can be named as “wood pestilence”. At present, it is not suitable to name the disease only according to clinical characteristics, but with increased understanding of this disease, the nomenclature may be further improved.
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    On therapeutic characteristics of Shibing Lun and application of Lei’s moyuan-diffusing method
    Huang Ting, Ma Huimiao, Guo Yantong, Cheng Zhiqiang
    2020, 43 (10):  804-808.  doi: 10.3969/j.issn.1006-2157.2020.10.002
    Abstract ( 259 )   PDF (1228KB) ( 131 )   Save
    Shibing Lun (Treatise on Seasonal Diseases) is a monograph on seasonal diseases written by Lei Feng, a famous epidemiologist in the Qing Dynasty. The book recorded experiences of predecessors’ formulas combining with Lei’s own clinical experiences. This paper summarized the academic ideas and characteristics of the monograph, which are stressing therapeutic methods rather than formulas and adapting therapeutic methods according to changing pathogenesis. Furthermore, this paper also analyzed Lei’s moyuan-diffusing method which is based on Wu Youke’s principle of Dayuan Yin (Moyuan-Diffusing Decoction), and made a comparison between the two methods from three aspects, including background of preparation, the symptoms of different patterns, and the composition of prescriptions. It is found that this method is in alignment with the treatment methods used for Corona Virus Disease 2019 (COVID-19), which also proves that adjusting therapeutic methods according to pathogenesis is the key of the theory. Lei learned from the knowledge of the past without being bound by it, and used his own judgement in the treatment. His academic thought not only has far-reaching influences on shaping clinical thinking of doctors today, but can be used for reference in containing the prevalence of COVID-19. Moreover, many published articles have confirmed that moyuan theory is indeed enlightening in the treatment of COVID-19, which deserves further exploration.
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    Interpretation of “pills” in the line “the doctor purged it with pills”*
    Song Qiumeng, Liu Ning, Jia Chunhua
    2020, 43 (10):  809-813.  doi: 10.3969/j.issn.1006-2157.2020.10.003
    Abstract ( 199 )   PDF (1223KB) ( 205 )   Save
    Regarding the meaning of the line “the doctor purged it with pills” in Shang Han Lun (Treatise on Cold Damage Diseases), there have been various speculations since ancient time, but no detailed interpretation could be traced. Based on the original text and its context, this article attempted to analyze the nature, action, and composition of “pills” combined with previous annotations. It is deduced that those “pills” might be a class of purgatives that contain violent and even toxic drugs with pungent properties, and their indication is possibly constipation caused by unresolved exterior pathogenic factors entering the exterior of the body. Based on such deduction, two classical medical books of Wai Tai Mi Yao (Arcane Essentials from the Imperial Library) and Qian Jin Yao Fang (Important Formulas Worth a Thousand Gold Pieces) are searched to find corresponding prescriptions, namely, Shenshi Kuaichi Pill, Gujin Luyan Xuming Pill and Kuaichi Pill.
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    TCM Pharmacovigilance
    Study of contraindications in traditional Chinese medicine: pearls for safety evaluation of traditional Chinese medicinals*
    Liao Xing, Hu Ruixue, Chen Wei, Hu Jing, Zhao Hui, Xu Haiyu, Wang Yongyan
    2020, 43 (10):  814-824.  doi: 10.3969/j.issn.1006-2157.2020.10.004
    Abstract ( 214 )   PDF (1363KB) ( 100 )   Save
    The study of contraindications in traditional Chinese medicine (TCM) aims to improve the efficacy and reduce risks in the diagnosis and treatment in clinical practice. Therefore, contraindication is the essential part to study in traditional Chinese medicine. A firm grasp of contraindications in TCM can help prevent known and unknown risks in clinical practice. TCM practitioners should learn about contraindications, which can promote rational use of Chinese medicines, regulate the behavior of clinicians, improve the effects of medical treatment, and reduce adverse events or adverse reactions. The idea of this paper comes from the book Contraindications in Traditional Chinese medicinals, from which commentary is made to summarize pearls for the safety evaluation of traditional Chinese medicinals. The purpose of this paper is to put forward the notion that TCM contraindications should be taken into consideration throughout the clinical practice of TCM. There are contraindication rules and regulations to follow in the general principle of diagnosis and treatment. We should not ignore them when we are engaged in clinical practice and scientific research of traditional Chinese medicine. Based on the contraindication theory of TCM, two practical and urgent problems need to be solved at present, which are to improve the existing leaflets of traditional Chinese patent medicine and to establish the contraindication database of traditional chinese medicinals in the hospital prescription information system.
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    Textual Research
    Understanding the “eight extraordinary meridians system” in the Case Records as a Guide to Clinical Practice based on the theory of “six compartments of yin and yang”*
    Chen Xu, Jia Bo
    2020, 43 (10):  825-829.  doi: 10.3969/j.issn.1006-2157.2020.10.005
    Abstract ( 193 )   PDF (1168KB) ( 198 )   Save
    The pattern identification of the eight extraordinary meridians reflected in the book titled Lin Zheng Zhi Nan Yi An (Case Records as a Guide to Clinical Practice) includes the theories of “six compartments of yin and yang”, “triple jiao” and “branch, root and center of six qi” in Huangdi Neijing, align with Ye Tianshi’s theory of “defense-qi-construction and blood” and “triple jiao”. The common route of Taichong meridians is from the bottom to the top, or from the root of Shaoyin through Yangming to the top of Guangming, crossing three jiao and three compartments, supplied with defense, qi, nutrient and blood by all the meridians. The essential qi is thus vaporized upwards to the brain. The defensive qi of all zang-organs in the triple jiao diverges into two pathways: one outside the vessels, or defensive qi goes out of triple jiao and flows into six fu organs; the other infusing into the vessels and converge at the extra meridians. The extra meridians are similar to lakes and rivers. They echo with the solitary organ of triple jiao. Interiorly, extra meridians unite the defense, qi, nutrient and blood, govern the three yin and three yang meridians to harmonize yin and yang, harmonize the essential qi and unite six qi; whereas exteriorly, triple jiao governs the defense, qi, fluids and humor, so as to balance heat and cold as well as yin and yang. When extra meridians and triple jiao are harmonious interiorly and exteriorly, yin-yang balance is achieved. By establishing the extra meridian system of Ye Tianshi, it can be used as reference to help us understand the physiology and pathology of traditional Chinese medicine, as well as predict, prevent, diagnosis and treatment of diseases.
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    Inter-textual interpretation style of Huangdi Neijing*
    Lai Xueyu, Wang Yulin, Yang Mingming
    2020, 43 (10):  830-833.  doi: 10.3969/j.issn.1006-2157.2020.10.006
    Abstract ( 151 )   PDF (1218KB) ( 67 )   Save
    In Huangdi Neijing (Huangdi’s Internal Classics), There exists the phenomenon that the preceding part and the latter part explain each other. This inter-textual interpretation style can be roughly divided into four categories. From the perspective of the chapter relationship, it can be divided into two categories: the whole chapter or part of the chapter being the interpretation of the other chapter. From the perspective of the text relationship, it can be divided into another two categories: within one chapter, the latter part explain the preceding part; the text and its interpretation text are indistinguishable within the text. Studying the interpretation style of Huangdi Neijing could help us develop intuitive understanding of the original text and a deeper understanding of its connotation. In this process, we can also find the phenomenon of extra and missed characters in Huangdi Neijing, which is helpful for providing a new approach to the collation and edition of the classics.
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    Chinese Medicinal Pharmacology
    Effects of Compound Zhebei Extract (CZBE) on the expression of apoptotic protein and xenograft tumors of human colon cancer oxaliplatin-resistant cells (HCT-116/L-OHP) in nude mice: an experimental study*
    Lyu Peng, Dong Qing, Liu Yu, Li Ruibai, Fan Qiuyue, Chen Xinyi, Hou Li
    2020, 43 (10):  834-840.  doi: 10.3969/j.issn.1006-2157.2020.10.007
    Abstract ( 216 )   PDF (2225KB) ( 97 )   Save
    Objective To observe the inhibitory effect of Compound Zhebei Extract(CZBE) on HCT-116/L-OHP transplanted tumors in nude mice and the expression of apoptotic proteins related to transplanted tumors. Methods HCT-116/L-OHP cells were inoculated into the axilla of BALB/c nude mice to establish L-OHP-resistant transplantation model of colon cancer. After the successful establishment of the model, the transplanted mice were divided into five groups: control group, L-OHP group (3 mg/kg), high-dose CZBE (10 g/kg) combined with L-OHP group, mid-dose CZBE (5 g/kg) combined with L-OHP group, and low-dose CZBE (2.5 g/kg) combined with L-OHP group. Method of administration: CZBE, intragastric administration, once a day; L-OHP, 3 mg/kg, intraperitoneal injection, once every other day for 2 consecutive weeks. At the end of the experiment, the mice were sacrificed and weighed, and then the tumors were removed completely and weighed to calculate the tumor inhibition rate. The tumors were sliced and photographed. Then the effects of CZBE on apoptotic protein expression of HCT-116/L-OHP transplanted tumors were analyzed by using ImageProPlus 7.0 and SPSS21 software. Results CZBE combined with L-OHP could effectively inhibit the growth of HCT-116/L-OHP transplanted tumors in nude mice. The inhibition rate of high-dose CZBE combined with L-OHP group was 45.031%, which was significantly different from that of L-OHP group (P<0.05). The inhibition rate of mid-dose CZBE combined with L-OHP group was 37.669%. The inhibition rate of low-dose CZBE combined with L-OHP group was 32.147%. The inhibition rate of L-OHP group was 27.239% in the positive control group, and the survival time of transplanted nude mice was prolonged. Compared with L-OHP group, IOD/Area of Bcl-2 cells in low-dose CZBE combined with L-OHP group decreased(P<0.05), while IOD/Area of Bcl-2 cells in mid-dose and high-dose CZBE combined with L-OHP group decreased significantly (P<0.01). IOD/Area values of Bax in mid-dose CZBE combined with L-OHP group increased (P<0.05), while IOD/Area values of Bax in high-dose CZBE combined with L-OHP group increased significantly (P<0.01). Conclusion CZBE combined with L-OHP can improve the tumor inhibition rate of L-OHP-resistant human colon cancer cell lines and prolong the survival time of Oxaliplatin-resistant nude mice. The mechanism may be to reverse multidrug resistance and promote apoptosis of tumor cells by regulating Bax/Bcl-2 apoptotic pathway.
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    Clinical Studies
    Analysis of TCM prescriptions for chronic heart failure in recent 20 years*
    Shi Jun, Wang Xing, Zhao Huihui, Wang Wei
    2020, 43 (10):  841-848.  doi: 10.3969/j.issn.1006-2157.2020.10.008
    Abstract ( 159 )   PDF (1187KB) ( 84 )   Save
    Objective To explore the characteristics of TCM prescriptions for chronic heart failure (CHF) in the recent 20 years. Methods After screening, 206 formulae were collected, involving 210 medicinal herbs. After data standardization of all included prescriptions, a database of formulae for chronic heart failure was established using Microsoft Excel software. SPSS 17.0 and clementine 12.0 software were used on Windows 7 platform for descriptive analysis and association analysis (Apriori algorithm). Results Statistics showed that qi deficiency was the most commonly seen pattern element of CHF, appearing 158 times in the database of prescriptions, followed by blood stasis (142 times), water and fluid retention (86), yin deficiency (75), phlegm turbidity (68) and yang deficiency (63). The CHF affected zang-fu organs were mainly heart, kidney and lung. The top 10 medicinal herbs frequently prescribed for CHF were Huangqi (Astragalus Root, Radix Astragali) (170), Danshen (Danshen Root, Radix et Rhizoma Salviae Miltiorrhizae) (140), Fuling (Poria, Poria) (128), Fuzi (Monkshood, Radix Aconiti) (108), Baizhu (White Atractylodes Rhizome, Rhizoma Atractylodis Macrocephalae) (104), Tinglizi (Pepperweed Seed, Semen Descurainiae seu Lepidii) (86), Guizhi (Cinnamon Twig, Ramulus Cinnamomi) (84), Gancao (Licorice Root, Radix et Rhizoma Glycyrrhizae) (78), Renshen (Ginseng, Radix et Rhizoma Ginseng) (76) and Zexie (Water Plantain Rhizome, Rhizoma Alismatis) (66). Association analysis identified the medicinal herbs and their combinations that were highly correlated with qi deficiency, blood stasis, water and fluid retention, yin deficiency and phlegm turbidity. Further analysis of pairs of highly correlated medicinal herbs demonstrated that CHF treatment incorporated methods of boosting qi, invigorating blood, promoting urination, dissolving phlegm and warming yang, which complemented each other and treated the root and branch simultaneously. Conclusion During the onset, progression and prognosis of CHF, its TCM pattern is in constant change. Its pathogenesis is the root in deficiency with the branch in excess, i.e. the root is heart yang qi (and sometimes yin) deficiency while the branch is blood stasis, water dampness and phlegm rheum. In addition, through analysis, we found a high correlation between pattern elements and medicinal herbs used in treatment. Commonly used herbal combinations were mainly conducive to boosting qi, invigorating blood, promoting urination, nourishing yin, dissolving phlegm and warming yang. Clinically, the physician should, on the basis of thorough understanding of the relation between pathogenic factors and healthy qi, treat the branch in acute cases, and treat the root or the root and the branch simultaneously in mild cases.
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    TCM analysis of tongue characteristics in 3,211 patients with metabolic syndrome based on multicenter database*
    Zhu Xiaoyun, Tang Yang, Zhu Lili, Feng Lei, Liu Ximing
    2020, 43 (10):  849-858.  doi: 10.3969/j.issn.1006-2157.2020.10.009
    Abstract ( 179 )   PDF (1215KB) ( 84 )   Save
    Objective To analyze the characteristics of tongue in patients with metabolic syndrome (MS) and provide evidence and support for the correlation between TCM pattern differentiation based on tongue characteristic and basis of human biology. Methods Data of MS patients’ tongue images and their physical and chemical examination results were extracted from MS clinical epidemiological investigation database. SPSS17.0 software was used for descriptive statistical analysis and stepwise logistic regression of the data. Results 3,211 MS patients were included in the study with a male-to-female ratio of 1.06∶1. The number of patients with abnormal levels of blood lipids, blood pressure (BP) and fasting plasma glucose (FPG) was the largest (1,050), accounting for 32.70%. The number of those with abnormal levels of blood lipids and BP and normal levels of FPG came next (1,010), accounting for 31.45%, followed by the number of cases with abnormal levels of FPG and BP and normal levels of blood lipids (719), accounting for 22.39%. The average age of the patients was 53.86±10.33 with the majority aged from 40 to 69. The age distribution of men is younger than that of women. The most frequently observed abnormal tongue shapes were enlarged tongue (32.4%), cracked tongue (14.2%) and teeth-marked tongue (11.0%). In terms of tongue color, red tongue (38.2%) was the most frequently encountered, followed by pale tongue (17.0%) and light purple tongue (15.1%). Varicose sublingual vein cyanosis (14.4%) was also seen at a high frequency. The colors of tongue coatings were mainly yellow and white, accounting for 53.9% and 46.0% respectively. Most of the tongue coatings were thin (37.6%), greasy (36.8%) or thick (25.4%). Logistic regression showed that increase in blood pressure was significantly related to enlarged tongue, red and crimson tongue, stasis macules and spots on the tongue, varicose sublingual vein cyanosis and thin tongue coating, etc. Abnormal levels of blood lipids were significantly correlated with light purple tongue, varicose sublingual vein cyanosis, greasy tongue coating, thick tongue coating and glossy tongue coating. Increase in fasting blood glucose was positively related to pale tongue. However, there was a negative correlation between blood glucose and varicose sublingual vein cyanosis, moist tongue coating and glossy tongue coating. Meanwhile, there was a close relationship between changes in tongue image and patients’ physical and chemical examination results. Deep tongue color, stasis macules and spots on the tongue and varicose sublingual vein cyanosis were related to significant increase in blood viscosity. Conclusion Tongue images of MS patients of different types demonstrate different characteristics. Most of them present excess pattern with blood stasis featuring deep tongue color, stasis macules and spots on the tongue and varicose sublingual vein cyanosis. There is consistency and correlation between tongue image and pathogenic factors, physical and chemical examination results and hemorheological parameters of patients with MS, which reflects the influence of multiple factors on MS. The present findings can provide Objective basis for clinical diagnosis and treatment of MS.
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    Establishing the new system of traditional Chinese medical diagnosis and treatment of psoriasis vulgaris based on expert survey using the Delphi method*
    Liu Aimin, Li Weiling, Chen Hongxiang, Yan Xiaoning, Zhao Wei, Zhang Buxin, Wang Xiaoli, Xu Shengdong
    2020, 43 (10):  859-864.  doi: 10.3969/j.issn.1006-2157.2020.10.010
    Abstract ( 155 )   PDF (1233KB) ( 81 )   Save
    Objective To establish a new system of traditional Chinese medical diagnosis and treatment of psoriasis vulgaris according to experts’ opinions and to form a broad consensus of pattern types, pattern diagnosis essentials, treatment methods and prescriptions for psoriasis vulgaris. Methods Delphi method was used to gather experts’ opinion. Three rounds of questionnaires were distributed among 23 experts, and the questionnaires were collected, entered and analyzed. Results According to the statistical results of experts’ scoring, five types of patterns were identified in the following order: blood-heat patterns (wind-heat toxin, accumulated heat entering blood, heat constrained in the liver meridian, damp-heat in the blood), blood-dryness patterns (yin-blood consumed by heat, blood deficiency and dryness-heat, qi-blood deficiency and stasis and heat retention), blood stasis patterns (blood-heat and blood stasis, yin deficiency and stasis and heat retention), external cold and internal heat pattern, yang deficiency and external cold, skin stasis heat), a total of 11 sub-types, and the corresponding symptoms, treatment methods and prescriptions. Conclusion This study furthers the establishment of the new system of traditional Chinese medical diagnosis and treatment of psoriasis vulgaris, which could be helpful for clinical application.
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    Clinical features of Lingnan academic school in the treatment approaches to exogenous diseases*
    Sun Yan, Cai Yihang, Wang Yuanyuan, Zhang Zhongde
    2020, 43 (10):  865-869.  doi: 10.3969/j.issn.1006-2157.2020.10.011
    Abstract ( 138 )   PDF (1219KB) ( 65 )   Save
    As an important branch of traditional Chinese medicine, Lingnan academic school has unique styles in the treatment of diseases caused by exogenous pathogenic factors. By using textual research methods, this paper analyzes geographical characteristics and body constitution in Lingnan area. The external factors (high temperature and high humidity, irregular seasonal climates and residual Yangqi) shape the unique constitutional characteristics of “yang qi floating exteriorly with yin qi closing interiorly”. Taking these factors into consideration, local practitioners have developed the unique treatment approaches and preferences, such as frequent and flexible use of dampness-drying and center-warming medicines at low doses, rare use of diaphoretic and purgation medicines and emphasis on“homology of medicine and food”. The representative clinicians were Liu Shichang and Zhen Mengchu etc.
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    Prevention and treatment of chloasma from the perspective of “preventive treatment of disease” in traditional Chinese medicine*
    Yang Xueyuan, Cai Wanling, Yan Xiaoning
    2020, 43 (10):  870-875.  doi: 10.3969/j.issn.1006-2157.2020.10.012
    Abstract ( 173 )   PDF (1174KB) ( 128 )   Save
    Chloasma has always been a difficult-to-treat disease in the medical and cosmetic community due to its refractory and disfiguring nature. Various treatment methods used in the treatment of chloasma have turned out to be ineffective, which highlights the importance of prevention and management. The etiology and pathogenesis of chloasma should be taken into account throughout the entire treatment process under the principle of “preventive treatment of disease” in traditional Chinese medicine. Early intervention in the occurrence, development, and prognosis of chloasma is beneficial to support the healthy qi, reduce the incidence and improve the curative rate. Specifically speaking, before the onset of disease, adjustment should be made to keep regular hours of daily life, strengthen the physique, avoiding overstrain, and removing triggers etc. Five-phase musical intervention on the basis of constitutional identification can also be offered to prevent the disease from occurring. After the onset of disease, comprehensive therapies should be adopted to prevent the disease from progression; during recovery period, proactive management to consolidate the treatment effects to cure the disease and avoid relapses.
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    Acupuncture & Moxibustion
    Clinical significance of the statement “the use of all needling methods must be based on shen” as guidance for acupuncture practice*
    Chang Yu, Ma Tieming
    2020, 43 (10):  876-880.  doi: 10.3969/j.issn.1006-2157.2020.10.013
    Abstract ( 185 )   PDF (1227KB) ( 131 )   Save
    The line “all needling methods must be based on shen (spirit or vitality) originates from the chapter entitled Ben Shen in Lingshu (Miraculous Pivot). This statement indicates that basis of shen plays vital role in acupuncture therapy. Treating the shen of the patients is the perquisite key to the effectiveness of acupuncture treatment and this thought should be maintained in the acupuncture clinical practice. By reviewing, analyzing and interpreting all relevant literature by ancient practitioners, this paper offers a summary of the meaning of this statement. During acupuncture therapy, acupuncturists should maintain their own shen and treat patients in an intensive focused state. Meanwhile, patients should also calm down and nurse their internal shen to properly respond to acupuncture intervention and achieve desired effectiveness. These two aspects need to be coordinated to arrive at the goal of treating both physique and mind. From the perspective of rationale, methods and techniques of treating shen, this paper elaborates on how to apply acupuncture on the basis of treating shen by giving details on how to evaluate, regulate, maintain and calm shen, Serving reference to the improvement of acupuncture effectiveness.
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