最新刊期
卷 44 ， 期 12 ， 2021
- 关键词：TCM constitution;constitution separable theory;constitution disease correlation theory;constitution adjustable theory;nine-constitution medicine
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发布时间：2022-01-06
Voice of Guidance
- 摘要：Between the two parts of Huangdi Neijing(Huangdi's Internal Classic)i.e.Suwen(Fundamental Questions) and Lingshu (Spiritual Pivot), the former has attracted more attention than the latter from physicians in all dynasties.Taking the spleen as an example, the paper argues that the spleen in Huangdi Neijing is the pancreas anatomically based on the physiological and pathological phenomena of the spleen such as the anatomical relationship between the spleen and the stomach, lips as the window of the spleen, spleen storing nutrients, spleen disorder due to excessive heat, and paralysis of limbs due to spleen dysfunction as well as texts that demonstrated more emphasis on the stomach and less on the spleen in Huangdi Neijing. Furthermore, it expounds that in Lingshu the zang-fu system was built up based on empirical knowledge while in Suwen on the relationship, e. g. the spleen corresponds to earth in the five elements, the spleen does not dominate any specific season, and the spleen and stomach play a pivotal role in qi activity of the five zang organs.Such relations together with theories that attach more importance to the spleen than the stomach in Suwen are a result of the influence of ancient Chinese philosophy. The philosophy-oriented medical theory in Suwen is based on and complements the empirical knowledge in Lingshu.The empirical research methodology applied to the study of zang-fu theory in Lingshu warrants due attention in modern Chinese medicine.关键词：Suwen;Lingshu;organ manifestations;spleen;Stomach;zang-fu system
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发布时间：2022-01-06
Prestigious Forum
- 摘要：In Huangdi Neijing(Huangdi's Internal Classic), there are the theories of "spleen housing ideas" and "aromatics acting on the spleen" . Based on statistical analysis of case records about dementia in ancient dynasties, the present research discovers that prescriptions to treat dementia by regulating the spleen and stomach accounted for the most (29.72%), followed by those inducing resuscitation (21.62%). Among the 192 Chinese medicinal herbs in the prescriptions, the top ten most frequently used were Banxia(Pinellia Rhizome, Rhizoma Pinelliae), Gancao(Liquorice Root, Radix et Rhizoma Glycyrrhizae), Shichangpu (Grassleaf Sweetflag Rhizome, Rhizoma Acori Tatarinowii), Fuling (Indian Bread, Poria), Yujin(Turmeric Root Tuber, Radix Curcumae), Fushen (Indian Bread with Hostwood, Sclerotium Poriae Pararadicis), Yuanzhi (Thin-leaf Milkwort Root, Radix Polygalae), Danggui (Chinese Angelica, Radix Angelicae Sinensis), Zhizi (Cape Jasmine Fruit, Fructus Gardeniae), and Shengdi(Rehmannia Root, Radix Rehmanniae). Among them, Shichangpu, Yujin and Danggui fall into the category of aromatic herbs in ancient times. Therefore, the authors argue that in the clinical treatment of dementia, regulating the spleen and stomach and making good use of aromatic herbs may be key to improving the curative effect, which is also a good example of the integration of traditional Chinese medicine theory and clinical practice.关键词：dementia;Huangdi Neijing;spleen housing ideas;aromatics acting on the spleen;Changpu Yujin Tang Decoction
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发布时间：2022-01-06 - 摘要：The anatomical entity of spleen in TCM organ manifestation theory is the most controversial among those of the five zang organs. However, based on the illustrations of zang-fu organs and descriptions of the appearance and position of the organs in ancient books, and the relationship between the spleen and stomach in terms of their position and function, the present paper argues that the term spleen in traditional Chinese medicine denotes both spleen and pancreas. Also, spleen's function of storing blood provides the basis for the claim that "spleen dominates blood" in the organ manifestation theory. The fact that the pancreas located beneath the stomach secretes pancreatic juice to help digestion is the basis of the spleen's function of facilitating the flow of body fluid for the stomach, its control over transportation and transformation of food and drinks, and its correspondence to the mouth, muscles and limbs.Great importance has been attached to the spleen and stomach as the postnatal foundation because ancient Chinese people felt and understood thoroughly that food exerts great influence over life and health and decides over life or death to some extent. The primary zang organ in charge of absorbing the essence of food and drinks turned from stomach into spleen. In addition to such change in the function, the original belief that the stomach was more important than the spleen was changed into the belief that the spleen was the more important one between the two, which led to the the change in the anatomical entity of spleen from the pancreas below the stomach into the spleen over the stomach to ensure the correspondence between their position in anatomy and importance.This, however, resulted in the confusion in the understanding of spleen's anatomical entity in later generations.关键词：spleen;theory of organ manifestation;pancreas;metaphor;Stomach
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发布时间：2022-01-06 - 摘要：Vessels, in traditional Chinese medicine, are the channels through which qi and blood run.Vessel diseases refer to a series of diseases caused by excess pathogens such as phlegm turbidity and blood stasis that retain and accumulate in the vessels, resulting in impeded flow of qi and blood as well as change in the structure or even obstruction of vessels, which leads to qi and blood nourishment deprivation of corresponding zang-fu organs. "Integration of essence from the skin-hair and the vessels" is an important prerequisite for normal movement of qi and blood in the vessels to nourish the zang-fu organs and orifices of the head. "Disharmony of the skin-hair and the vessels" , however, is the initial stage of the occurrence and development of vessel diseases.This paper explores the two from the following perspectives. Firstly, based on relevant discussion in Huangdi Neijing (Huangdi's Internal Classic), the present research expands the theoretical connotation of "integration of essence from the skin-hair and the vessels" to include "circulation of nutrients and defence qi, body fluids harmonization, and body fluids and blood infiltration and transformation" by arguing that the integration occurs not only at skin-hair level but also in instriae, muscle, and triple energizer.Secondly, combining "integration of essence from the skin-hair and the vessels" and the theory of "sweat pore" , the paper proves that normal functioning of the sweat pore is an important basis for "integration of essence from the skin-hair and the vessels" . Lastly, the present study discusses the pathogenesis of vessel diseases with the phlegm and blood stasis pattern caused by "disharmony of the skin-hair and the vessels" from phlegm turbidity to phlegm binding and to phlegm stasis, which provides new ideas for inheriting and developing the theory of vessel diseases in traditional Chinese medicine.关键词：vessel diseases;atherosclerosis;integration of essence from the skin-hair and the vessels;phlegm turbidity and blood stasis;nutrient and defense;sweat pore
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发布时间：2022-01-06 - 摘要：Through Records of Chinese Medicine with Reference to Western Medicine, Zhang Xichun's profound and unique pharmacological theory based on the correspondence between nature, human and herbs was explored. Such correspondence is mainly reflected in the following aspects: relationship between the nature, flavor, ascending and descending property of the medicinals and those of the five zang organs; relationship between the five zang organs and the five elements; texture and appearance of herbs; factors influencing the production of the medicinals; processing of the herbs; characteristics of the living environment and growth of the medicinals; and location of the medicinals in its source.It was also expanded thanks to knowledge of chemistry and electromagnetics as well as observation of natural phenomena and inference from therapeutic effects. The present elaboration of Zhang's correspondence theory in his book may provide reference for studying the theory of Chinese medicine, appreciating its wise ways of thinking, guiding clinical pattern differentiation and treatment, and improving curative effect.关键词：Zhang Xichun;correspondence pharmacology;image thinking
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发布时间：2022-01-06
Theoretical Studies
- 摘要：ObjectiveTo compare the efficacy of integrated Chinese and Western medicine treatment and that of Western medicine treatment alone for severe cases of COVID-19, identify the risk predictors affecting the prognosis of patients with severe COVID-19, evaluate the significance of traditional Chinese medicine in the treatment of severe cases of COVID-19 and provide reference for clinical diagnosis and treatment.MethodsExplainable machine learning was used to retrospectively analyze the clinical treatment process of 1 055 cases of severe COVID-19 admitted to the main hospital area, Optical Valley branch and Sino-French New City branch of Tongji Hospital in Wuhan.The cases were divided into integrated Chinese and Western medicine-Chinese herbal medicine(CW-CHM) group, integrated Chinese and Western medicine-Chinese patent medicine (CW-CPM) group and Western medicine (WM) group according to the treatment plan they followed.The WM group received such conventional treatment as antiviral treatment, oxygen support and symptomatic therapy based on the diagnosis and treatment protocol of novel coronavirus pneumonia, while the CW-CHM group and CW-CPM group were treated with herbal decoction and Chinese patent medicine combined with herbal decoction respectively in addition to the conventional treatment given to the WM group.Clinical efficacy indicators of the three groups were observed and compared, including total length of hospitalization, rate of cases that turned critical, intubation mortality, and laboratory-related indicators.ResultsIntubation mortality for patients with low A/G ratio, low white blood cell count and low lymphocyte count in the CHM group and CW-CPM group were significantly reduced compared with that in the WM group. The intubatione mortality rate and the rate of cases that turned critical in the CW-CHM group and CW-CPM group were lower than those in the WM group. The total hospitalization days of CW-CHM group and WM group were fewer than those of CW-CHM group.ConclusionThe addition of Chinese medicine decoction or Chinese medicine decoction+ Chinese patent medicine to conventional WM treatment for severe COVID-19 cases may reduce the intubation mortality and improve the prognosis of the patients by improving their immune function.关键词：COVID-19;severe cases;integrated traditional Chinese and western medicine;Chinese patent medicine;machine learning
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发布时间：2022-01-06
COVID-19 Theme
- 摘要：ObjectiveTo study the characteristics of traditional Chinese medicine (TCM) pattern elements and the distribution of pattern types of post-hepatitis B cirrhosis (PHBC).MethodsA retrospective study of 572 PHBC patients was carried out to collect their TCM symptoms, signs, tongue manifestations and pulse conditions by using self-designed Clinical Questionnaire of TCM Patterns of PHBC. Based on factor analysis and cluster analysis, the characteristics of TCM pattern factors and the distribution of pattern types of PHBC were discussed.ResultsThe factor analysis of the 83 symptoms in the questionnaire showed that the KMO value was 0.843 and Bartlett's ball type test result was P<0.001. A total of 16 common factors were extracted and 66 significant symptoms were identified. The pattern factors indicating disease location (positional factors) were liver, spleen and kidney and those indicating disease property (pathological factors) were blood stasis, qi deficiency, qi stagnation, yin deficiency, yang deficiency, dampness heat, dampness and water retention. From these factors, seven pattern types were identified: dampness heat accumulation (DHA) pattern, liver and kidney yin deficiency (LKYD) pattern, blood stasis blocking collaterals (BSBC) pattern, spleen and kidney yang deficiency (SKYD) pattern, spleen qi deficiency(SQD) pattern, liver qi stagnation (LQS) pattern, and dampness retention (DR) pattern. Cluster analysis was used to explore the distribution of pattern types of this disease. It was discovered that patients with BSBC pattern accounted for 26.92% of the total cases, those of DHA pattern 16.96%, DR pattern 14.86%, SKYD pattern 12.41%, LKYD pattern 11.71%, LQS pattern 10.66%, and SQD pattern 6.47%.ConclusionThe basic TCM pattern types of PHBC may fall into seven categories: dampness heat accumulation pattern, liver and kidney yin deficiency pattern, blood stasis blocking collaterals pattern, spleen and kidney yang deficiency pattern, spleen qi deficiency pattern, liver qi stagnation pattern, and dampness retention pattern. In terms of distribution of pattern types and pathological characteristics, blood stasis blocking collaterals pattern was one of the most common TCM pattern types of PHBC.关键词：post-hepatitis B cirrhosis;TCM pattern elements;TCM pattern;factor analysis;cluster analysis
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发布时间：2022-01-06
Science & Technology Theme
- 摘要：ObjectiveTo investigate the mechanism of the effects of Shuizhi (Leech, Hirudo)- Wugong (Centipede, Scolopendra) medicinal pair on improving diabetic erectile dysfunction (DIED) by detecting the key factors of PI3K/AKT/mTOR signaling pathways.MethodsDIED was induced by streptozotocin (STZ) in male SD rats. After 8 weeks, the model was validated with apomorphine (APO). The rats were divided into the model group, tadalafil group and Shuizhi-Wugong (S-W) pair group. They were treated with deionized water, tadalafil (0.5 mg/kg) and Shuizhiand Wugong granules (0.3 g/kg) respectively for 8 weeks by gavage. After treatment, blood glucose level was measured, erectile function was evaluated, and hormone releasing levels of serum testosterone (T), luteinizing hormone (LH) and follicle stimulating hormone (FSH) were detected by chemiluminescence. Western blot and RT-qPCR were used to detect the expression of protein and mRNA of PI3K, AKT, and mTOR. HE staining was used for pathological analysis of penile tissue.ResultsAfter 8 weeks of intervention, the number of erections of the rats in the S-W pair group increased significantly (P<0.05), compared with the tadalafil group. The testosterone level of the rats in the S-W pair group was significantly higher than that of the model group (P<0.05), but there was no significant difference between the tadalafil group and model group (P > 0.05). The protein phosphorylation and mRNA expression levels of PI3K, AKT and mTOR in the model group were significantly lower than those in the blank control group (P<0.05). After intragastric administration of Shuizhi-Wugong, the protein phosphorylation and mRNA expression levels of PI3K, AKT and mTOR in the S-W pair group were significantly higher than those in the model group (P<0.05), but there was no significant difference between the tadalafil group and the model group (P>0.05).ConclusionShuizhi-Wugong pair can inhibit the apoptosis of smooth muscle cells of penis and improve erectile function by activating PI3K / AKT / mTOR signaling pathways.关键词：diabetic erectile dysfunction;Shuizhi;Wugong;PI3K/AKT/mTOR signaling pathways;rats
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发布时间：2022-01-06
Chinese Medicinal Pharmacology
- 摘要："Body, qi and spirit" is one of the theories of traditional Chinese medicine (TCM) in understanding the human body, which is an important embodiment of image thinking. The three constitute the human body, and they are interrelated. Against the background of comprehensive treatment of malignant tumor, the present paper explores the leading role of the theory in the comprehensive treatment of malignant tumor from the three perspectives of body, qi and spirit. It is argued that the treatment of the body is the core, which is targeted at the tangible tumor; the treatment of qi is the basis, which aims at the intangible function; and the treatment of spirit is the key, which addresses the psychological and emotional problems.In this way, the TCM way of thinking in the clinical context under the influence of the essence of Chinese culture and TCM image thinking can be integrated into Western clinical diagnosis and treatment, so as to provide new ideas for the treatment of malignant tumor.关键词：body, qi and spirit;malignant tumor;image thinking
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发布时间：2022-01-06 - 摘要：Current research shows that there is high incidence of depression and anxiety in patients with chronic heart failure, which is closely related to adverse outcomes such as the risk of cardiovascular events, readmission rate for those with heart failure and increased mortality. The main mechanism may lie in their physiological and pathological relationship and potential interaction. The purpose of this paper is to explore the relationship between chronic heart failure and depression and anxiety based on related theories such as "heart controls the mental activity" in traditional Chinese medicine (TCM) and "cardiac-psychological medicine" in Western medicine (WM). By reviewing systematically the current TCM and WM schemes and means of treating heart failure combined with depression and anxiety based on cardiac-psychological medicine, we can deepen our understanding of its pathogenesis, explore the strengths and weaknesses of TCM in preventing and treating such diseases, thus laying a foundation for the further development of TCM diagnosis and treatment of cardiac-psychological diseases.关键词：chronic heart failure;depression;anxiety;traditional Chinese medicine therapy;cardiac-psychological medicine
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发布时间：2022-01-06 - 摘要：ObjectiveTo evaluate the clinical efficacy of Yiqi Bushen Huazhuo Fang (Qi-reinforcing, Kidney-tonifying and Turbidity-resolving Formula) in the treatment of myasthenia gravis patients with pattern of spleen and kidney deficiency, and to study the patients' reduction and discontinuation of Western medication.MethodsBy means of data collection, followup phone call and electronic questionnaire, the medical records of patients with myasthenia gravis who were treated in the outpatient department of Dongfang Hospital of Beijing University of Chinese Medicine from June 2015 to June 2018 were reviewed. A total of 96 cases were included. The treatment process was divided by four time points: PointⅠ (the first outpatient visit), PointⅡ(oral intake of Western medicine reduced to half of the original dose), Point Ⅲ (reaching the Minimal Manifestation Status (MMS) of the disease in Western medicine for 3 months or more), and Point Ⅳ (reaching the best state since the onset). Patients were evaluated with the myasthenia gravis complex scale, TCM symptom scale, quality of life scale, Hamilton Anxiety Scale and Hamilton Depression Scale at the above four time points, and the time taken to reach the third and fourth points was calculated. For patients who failed to reach Point Ⅲ and Point Ⅳ, their scores were calculated according to the scale scores before treatment, 12 months, 18 months and 24 months after treatment.ResultsThe scores of the 96 patients at the four points decreased from one point to the next, and the effective rate were over 98%. Among the 96 patients, 45 patients who took bromopyrimidine reached MMS in terms of Western medicine and the best state. Among the 29 patients who took bromopyrimidine and prednisone acetate, 22 reached MMS and the best state. Among the 6 patients who took bromopyrimidine and tacrolimus, 2 reached MMS and the best state. Among the 16 patients who took bromopyrimidine, prednisone acetate and tacrolimus, 5 reached MMS and the best state.ConclusionYiqi Bushen Huazhuo Fang can relieve patients' clinical symptoms of myasthenia gravis, reduce and discontinue their use of Western medicine, and improve their clinical manifestations, TCM patterns, quality of life and anxiety and depression.关键词：myasthenia gravis;pattern of spleen and kidney deficiency;Yiqi Bushen Huazhuo Fang;retrospective study;clinical efficacy;reduction and discontinuation of Western medication
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发布时间：2022-01-06
Clinical Studies
- 摘要：Objectives TakingPeking University as an example, this paper aims to analyze the challenges and provide suggestions for the development of pharmaceutical preparation for medical institutions, especially for traditional Chinese herbal preparations of hospitals affiliated to universities.MethodsAfter interview outlines were designed and purposive sampling were used, in-depth semi-structured interviews were conducted with administrators from pharmacy departments of the four affiliated hospitals of Peking University. Based on relevant documents on institutional administration and pharmaceutical formulations from different hospitals, a thematic framework was established for analysis.ResultsTraditional Chinese herbal preparations made by university-affiliated hospitals could meet clinical needs, highlight hospital characteristics and improve research capacities. Nevertheless, there exist challenges such as increasing cost, limited clinical application and special examination and approval of Chinese herbal medicine.ConclusionPossible solutions to the problems may include coordinating development of herbal preparations, seeking large-scale manufacturing, increasing transfer of the preparations based on their characteristics, and strengthening research, development and application of traditional Chinese herbal preparations.关键词：hospitals affliated to universities;pharmaceutical preparation for medical institutions;traditional Chinese herbal preparations;solutions
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发布时间：2022-01-06
Chinese Herbal Preparation
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