最新刊期
      卷 45 ， 期 6 ， 2022

        Expert Commentary

      • Hongfang LIU
        Vol. 45, Issue 6, Pages: 541-545(2022) DOI: 10.3969/j.issn.1006-2157.2022.06.001
        摘要：With the continuous penetration and integration of traditional Chinese medicine (TCM) with Western medicine, the TCM diagnosis and treatment mode has gradually changed from a thinking mode based on syndrome differentiation and treatment to a thinking mode based on the combination of the di-sease and syndrome. However, it is unclear how the disease-syndrome combination model can be applied to disease to improve its efficacy. This article introduces the contention of the two thinking modes of "syndrome dominating disease" and "disease dominating syndrome" in the combination of the disease and syndrome and analyzes the application characteristics of these two modes and the advantages of using the "disease dominating syndrome" thinking mode in the treatment of diabetic kidney disease (DKD). Then, it introduces the process of diagnosing and treating DKD with the thinking mode of "disease dominating syndrome" in clinical practice. That is, first recognize the disease; establish the DKD pathogenesis of essence depletion and the collateral impediment. Second, determine the "syndrome" of DKD by recognizing the disease. Finally, treatment according to the syndrome by the legislation of the disease target and syndrome target. The thinking mode of "disease dominating syndrome" provides a new idea for the more effective clinical treatment of DKD.  
        关键词：diabetic kidney disease;disease dominating syndrome;essence depletion and collateral impediment;clinical practice   
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        发布时间：2022-07-11
      • Juan HE
        Vol. 45, Issue 6, Pages: 546-550(2022) DOI: 10.3969/j.issn.1006-2157.2022.06.002
        摘要：There are two modes of meridian circulation in Huangdi Neijing: the centripetal (upward) mode and the 12-meridian circulatory flow mode. The latter is generally regarded as the basic meridian circulation mode in later acupuncture theories. However, this paper argues that these two modes, whose coexistence in Huangdi Neijing is mainly due to the difference in clinical practice experience and ancient philosophical thoughts, are interdependent and complementary in the life system. The genuine qi circulating in the meridians mainly follows upward mode, while the nutrient qi (valley qi) mainly follows 12-meridian circulatory flow mode. The paper concludes that the upward mode plays a more important role in clinical practice.  
        关键词：meridian circulation;centripetal circulation;12-meridian circulation;Huangdi Neijing   
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        发布时间：2022-07-11

        COVID-19 Theme

      • Shenzhen Traditional Chinese Medicine Quality Control Center for Pre-disease Treatment,Infectious Diseases Professional Committee of Shenzhen Association of Traditional Chinese Medicine
        Vol. 45, Issue 6, Pages: 551-554(2022) DOI: 10.3969/j.issn.1006-2157.2022.06.023
        关键词：COVID-19;preventive treatment of disease;winter and spring;consensus;non-drug treatment   
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        发布时间：2022-07-11
      • Yuan WANG,Donghui HUANG,Huixian WANG,Cuiling FENG,Zishao ZHONG,Junxiang CAI,Dongping XIE,Lin SONG,Minyong WEN,Tonghan WANG,Zhongde ZHANG
        Vol. 45, Issue 6, Pages: 555-562(2022) DOI: 10.3969/j.issn.1006-2157.2022.06.004
        摘要：ObjectiveTo observe the effects of traditional Chinese medicine (TCM) dialectical treatment combined with Western medicine on the outcome and various indicators of severe and critical COVID-19 patients to comprehensively evaluate the treatment’s clinical efficacy and safety.MethodsFrom February to March 2020, patients with severe and critical COVID-19 who were admitted to Hubei Provincial Hospital of Integrated Chinese & Western Medicine and managed by the Guangdong TCM Medical Team were selected as the study subjects. They were divided randomly into the experimental group and the control group in a ratio of 2∶1. The control group was given the basic treatment of Western medicine according to the Western medicine treatment plan issued by the National Health Commission. Along with the basic Western medicine treatment, the experimental group added TCM dialectical treatment that included Chinese herbal decoction and proprietary Chinese medicine for stagnant pathogens trapped in the Shaoyang syndrome, stagnant pathogens trapped in the Moyuan syndrome, dampness-heat obstructing lung syndrome, epidemic toxin-blocking lung, qi-yin deficiency syndrome, the dual blaze of qi and nutrient syndrome, and internal blocking and external detachment syndrome, we observed the outcome, nucleic acid negative time, the total score of the syndrome as well as the change in the laboratory index in the two groups before and after treatment.ResultsThe total efficiency and nucleic acid negative conversion rate of the experimental group were higher than those in the control group, and the difference between the two groups was significant (P<0.05). However, there was no obvious difference in the 28-d fatality rate and nucleic acid negative time between the two groups (P>0.05). The two groups showed a downward trend in TCM scores after treatment, and the decline was more pronounced in the experimental group than in the control group (P<0.05). The two groups showed a downward trend after treatment with C-reactive protein, serum amyloid A protein (SAA), and interleukin-6 (IL-6), but SAA and IL-6 in the experimental group were more reduced than in the control group (P<0.05). White blood cells (WBC), lymphocytes (LYM), T lymphocytes, and natural killer cells (NK) of the experimental group, and WBC and T lymphocytes of the control group showed an upward trend after treatment. WBC, LYM, T lymphocytes, and NK of the experimental group also increased more significantly than in the control group (P<0.05). Lactic acid (Lac) of both groups decreased after treatment, but Lac of the experimental group decreased more significantly than that of the control group (P<0.05). PaO2/FiO2 of the experimental group increased after treatment (P<0.05).ConclusionTCM dialectical treatment combined with Western medical treatment can regulate the immune function of severe and critical COVID-19 patients, inhibit their inflammatory response, improve tissue hypoxia and hypoperfusion, effectively alleviate symptoms, and thus improve the clinical efficacy.  
        关键词：COVID-19;severe patients;critical patients;integration of traditional and Western medicine;clinical study   
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        发布时间：2022-07-11
      • Lin MA,Xiaowei MAN,Qianhong WANG,Pei XUE
        Vol. 45, Issue 6, Pages: 563-570(2022) DOI: 10.3969/j.issn.1006-2157.2022.06.005
        摘要：ObjectiveTo analyze the changes in the recognition of traditional Chinese medicine (TCM) among residents before and after the outbreak of COVID-19 and TCM influencing factors to provide a reference for promoting the popularization of TCM.MethodsAn online questionnaire survey was conducted among residents in mainland China to examine changes in knowledge, trust, and attitudes toward the development prospect of TCM before and after the outbreak of COVID-19 and to analyze the relevant influencing factors.ResultsA total of 3, 067 questionnaires were returned, with 2, 975 valid questionnaires and a valid response rate of 97.00%. After the outbreak of COVID-19, the percentage of residents who had at least "know some" of TCM increased from 47.97% to 59.36%; the percentage of those who had at least "trust to some extent" in TCM increased from 65.44% to 71.29%, and the percentage of those who had at least "modest optimism" about the development prospect of TCM increased from 68.94% to 77.01%. Age, education, residence, basic medical insurance for urban and rural residents and whether to choose TCM were the influencing factors for positive changes in residents’ recognition, age and education were the influencing factors for positive changes in residents’ trust, and age, gender, residence and profession were the influencing factors for positive changes in residents’ development prospect attitudes toward TCM after the outbreak of COVID-19 (P<0.05).ConclusionThe overall recognition of TCM among residents has increased since the outbreak of COVID-19, but there is still a need to adopt multiple means of publicity to promote the popularization of TCM knowledge and enhance the recognition of TCM in residents.  
        关键词：residents;TCM recognition;COVID-19;influencing factors   
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        发布时间：2022-07-11

        Theoretical Studies

      • Liwei LIU,Yizhi DONG,Yukun LI,Yumao JIANG,Qiang LI,Yipin FAN,Dameng YU
        Vol. 45, Issue 6, Pages: 571-577(2022) DOI: 10.3969/j.issn.1006-2157.2022.06.011
        摘要：Pills were an important dosage form in ancient China in the critical period of transformation and upgrading of traditional dosage forms. It is important to understand the history of ancient pharmaceuticals and realize the modernization of bolus by combing history and summarizing the development law of bolus. The theory of pills has been summarized three times and gradually established the core theory of pills’ slow release. The scientific connotation of pills’ slow release is closely related to their dosage form and excipients. Excipients show the characteristics of being varied and reduced. Traditional pill formulation also evolved into the honey pill, water pill, water honey pill, concentrated pill, paste pill, and wax pill as the supplement. The two are facing the situation of elimination. The modernization of pills must be based on modern means of preparation; the comprehensive analysis of compound preparations from the aspects of the drug release system, drug carrier, and pharmacodynamic components; and the construction of new pills. The aim is to maintain the characteristics of the sustained release of pills and realize time-controlled drug delivery. In the aspect of traditional supplementary materials, we should focus on the scientific interpretation of traditional supplementary materials such as caramel, glutinous rice, and beeswax as well as dig deep into the characteristics and inherit the essence.  
        关键词：traditional Chinese medicine pills;historical evolution;scientific connotation;traditional materials;pill theory;secondary development   
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        发布时间：2022-07-11

        Chinese Medicinal Pharmacology

      • Zhiqiang HUANG,Jianjun ZHANG,Danping ZHAO,Xue ZHOU,Chun WANG,Yan CHEN,Liang CHEN,Jun DU,Hongyue LIU,Guoyuan LI,Linyuan WANG
        Vol. 45, Issue 6, Pages: 578-586(2022) DOI: 10.3969/j.issn.1006-2157.2022.06.022
        摘要：ObjectiveTo verify and reveal the mechanism of traditional Chinese medicine (TCM) of Gouqi Juhua Fang (GJ Fang) on asthenopia, this experiment studied the nourishing effect of GJ Fang by establishing the yin deficiency of the liver and kidney pattern model.MethodsAccording to body weight, 50 male Kunming mice were randomly divided into five groups (each n=10): normal group, model group, Qiju Dihuang Pill (QD Pill) group (3.0 g/kg), low-dose GJ Fang group (65.7 mg/kg), and high-dose GJ Fang group (131.4 mg/kg). Each morning, the intervention groups were administered corresponding medicine by gavage, and the normal group and model group were administered the same amount of distilled water by gavage, for 14 days. Each afternoon, the model group and each intervention group were given levothyroxine sodium solution (150 μg/kg) by gavage, and then the tail was clipped about 3 cm from the tip for 5 minutes, for 14 days. The general state of the mice was observed every day, and all mice were weighed on the 1st, 7th, and 14th day. On the 14th day, the temperature tropism was detected. On the 15th day, all mice were sacrificed, and the samples were collected. The thymus index was calculated; the cyclic nucleotides, thyroid hormones, sex hormones, liver function, and immune factors in serum were detected; the energy metabolism enzyme activities and oxidation levels in the liver tissue were also determined.ResultsCompared with the normal group, the model group showed symptoms of deficiency and heat such as weight loss, dry and hard stools, yellow urine, increased voluntary activities, irritability, active reactions, and the desire to be close to the cold environment. The symptoms both improved to a certain extent in the QD Pill group and GJ Fang group. Compared with the model group, the low- and high-dose GJ Fang group showed the following: The bodyweight of the mice was increased (P<0.05); the contents of cAMP, cGMP, cAMP/cGMP, E2/T, T4, and ALT were decreased (P<0.05); the thymus index was increased (P<0.05); and the levels of T3 and IL-2 increased (P<0.05). In addition, the contents of MDA and the activities of Na+ -K+ -ATPase and Ca2+ -Mg2+ -ATPase decreased(P<0.05) in the liver.ConclusionGJ Fang and QD Pill both can improve internal heat and endocrine hormone disorders in yin deficiency, reduce the rate of energy metabolism, enhance the immunity and antioxidant factors level, and comprehensively relieve the state of yin deficiency in the liver and kidney, thus relieving asthenopia. Because of the safe formula and clear active ingredients, GJ Fang has the potential to be developed into a safe, stable, controllable, and pattern-differentiated product for asthenopia.  
        关键词：Gouqi Juhua Fang;Qiju Dihuang Pill;asthenopia;yin deficiency of liver and kidney;pattern model;mice   
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        发布时间：2022-07-11

        Science & Technology Theme

      • Hongpeng LYU,Tianfang WANG,Jing ZHANG,Xiuyan WU,Haotian XIE,Yingying YANG,Peiwen XUE,Yuwen CHE,Pengpeng HAN,Yujie WANG,Yimian ZHANG
        Vol. 45, Issue 6, Pages: 587-593(2022) DOI: 10.3969/j.issn.1006-2157.2022.06.007
        摘要：ObjectiveTo explore the correlation between facial San Ting and Cattell’s 16 Personality Factor Questionnaire (16PF)factors of undergraduates and graduates at Beijing University of Chinese Medicine (BUCM). San Ting is a Chinese term meaning the three parts of a human face, from upper to lower.MethodsThe MARS industrial camera was used to collect the facial images, and the 16 PF was used to evaluate the personality of college students recruited by BUCM. Facial San Ting features were measured by the software FaceDiag. Pearson correlation analysis was used to explore the correlation between each indicator of facial San Ting and 16PF. Multiple linear regression analysis was used to explore the correlation between 16PF and facial San Ting, with 16PF as the dependent variable. The index of facial San Ting with significant correlation was incorporated into the multiple linear regression model to predict the 16PF factors, and age and sex were controlled.ResultsA total of 904 students were recruited. There was a significant positive correlation between the Zhong Ting area ratio and sensitivity factor score and a significant negative correlation between the Zhong Ting area ratio and the emotional and calm alertness factor score. There was a significant positive correlation between the Zhong Ting height ratio and the factor score of warmth and a negative correlation between the factor score of emotional/calm alertness and the width of Shang Ting/width of Zhong Ting. Moreover, the width of Shang Ting and Xia Ting ratio was positively correlated with the sensitivity and creative ability factor. There was a significant positive correlation between the width of Shang Ting/width of Zhong Ting and reasoning and vigilance.ConclusionThe features of facial San Ting are correlated with 16PF to some extent, providing a basis for the enrichment and development of TCM inspection and constitution identification.  
        关键词：TCM inspection;San Ting;facial morphology;Cattell’s 16 Personality Factor Questionnaire;integration of the body and spirit;constitution identification   
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        发布时间：2022-07-11
      • Qinjun YANG,Zhenhao HE,You SHI,Jie ZHU,Yating GAO,Jiabing TONG,Mengyao SHI,Huanzhang DING,Di WU,Dengdi SUN,Zegeng LI,Mingxiang HAN
        Vol. 45, Issue 6, Pages: 594-602(2022) DOI: 10.3969/j.issn.1006-2157.2022.06.008
        摘要：ObjectiveTo study the rules of symptoms, patterns, and medicines of medical records of lung distention treated by Xin’an doctors through data mining methods, and to explore the characteristics of Xin’an doctors in the treatment of lung distention.MethodsMedical records related to the treatment of lung distention by Xin’an doctors were collected and sorted from the medical books of Xin’an. After the standardized processing of various information, mathematical models such as frequency analysis, topology analysis, Louvain clustering, and factor analysis were used to conduct data mining research on symptoms, patterns, and prescriptions.ResultsWe included 361 medical records and counted 272 traditional Chinese medicines in total. Among them, 35 were core medicines, including Poria, Radix Glycyrrhizae, Semen Armeniacae Amarum, Semen Coicis, Rhizoma Pinelliae, Radix Ginseng, Rhizoma Atractylodis Macrocephalae, and Fructus Schisandrae Chinensis. In the lung distention, clinical practice of Xin’an doctors, tonic medicines (30.14%) were used most, followed by expectorant cough suppressants and anti-asthmatic medicines (22.81%). The pattern of phlegm and dampness accumulating in the lung (30.19%) was the most commonly observed, and the patterns of deficiency were mainly lung qi deficiency (22.44%), spleen qi deficiency (21.05%), and kidney qi deficiency (17.45%). Semen Armeniacae Amarum, Poria, Semen Coicis, Rhizoma Pinelliae, and Exocarpium Citri Grandis were the core prescription medicines for the pattern of phlegm and dampness accumulating in the lung. Poria, Radix Glycyrrhizae, Radix Ginseng, Rhizoma Atractylodis Macrocephalae, Semen Armeniacae Amarum, and Pericarpium Citri Reticulatae were the core prescription medicines of the lung qi deficiency pattern. Poria, Radix Ginseng, Radix Glycyrrhizae, Rhizoma Atractylodis Macrocephalae, Pericarpium Citri Reticulatae, and Rhizoma Pinelliae were the core prescription medicines of the spleen qi deficiency pattern. Poria, Rhizoma Dioscoreae, Radix Rehmanniae Preparata, Fructus Corni, and Fructus Schisandrae Chinensis were the core prescription medicines of the kidney qi deficiency pattern. Furthermore, 10 common factors were extracted by factor analysis. The disease’s main locations were the lung, spleen, and kidney. Water dampness, phlegm, and blood stasis were the main pathological factors.ConclusionLung distention is a disease whose pathogenesis is the root deficiency with the branch in excess. The deficiency of the lung, spleen, and kidney are the root, while the pathological factors of phlegm, blood stasis, and heat are its branch. In Xin’an doctors’ clinical practice, they preferred to use Poria, Semen Coicis, Radix Ginseng, and Rhizoma Atractylodis Macrocephalae to treat lung distention. While eliminating phlegm, clearing the lung, relieving cough, and relieving asthma were used to correct the obvious and superficial pathological factors of lung distention, these were often combined with medicines for tonifying the lung and kidney as well as strengthening the spleen to benefit the root cause.  
        关键词：lung distention;Xin’an doctors;symptoms;patterns;medicines;data mining;Poria cocos;pattern of phlegm-dampness accumulation of lung   
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        发布时间：2022-07-11

        Acupuncture & Moxibustion

      • Xian WU,Xiaoge SONG,Man LU,Shuai XIA,Zeyu SHE,Mengya LU,Shuang DING,Xiang SHANG,Kai GENG,Xiuhua LIN,Yonghui YANG
        Vol. 45, Issue 6, Pages: 603-611(2022) DOI: 10.3969/j.issn.1006-2157.2022.06.009
        摘要：ObjectiveTo observe the effect of acupotomy on the lncRNA/miRNA/NF-κB pathway of knee cartilage in rabbits with knee osteoarthritis (KOA) and explore the mechanism of the cartilage-protective effect of acupotomy on KOA.MethodsNew Zealand rabbits were randomly divided into control, model, and acupotomy groups, with nine rabbits in each group. The rabbit model of KOA was established by the Videman fixation method , and the acupotomy group was given acupotomy intervention once weekly for 3 weeks after modeling. Cartilage tissue of the knee joint was sampled, pathological changes in cartilage tissue were observed using hematoxylin and eosin (HE) staining, and cartilage tissue damage was observed by scanning electron microscopy. RT-qPCR was used to determine the expressions of long non-coding RNA-small nucleolar RNA host gene 1 (lncRNA-SNHG1), long non-coding RNA-activated by transforming growth factor β (lncRNA-ATB), miR-16-5p and miR-223-3p, and mRNA expressions of cyclooxygenase 2 (COX-2), inducible nitric oxide synthase (iNOS), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), nuclear factor κB p65 (NF-κB p65) and nuclear factor inhibitor protein κB (IκBα); immunoblotting (WB) analysis was used for the protein expressions of NF-κB p65, phosphorylated NF-κB p65 (p-NF-κB p65), IκBα, phosphorylated IκBα (p-IκBα), COX-2, and iNOS. Moreover, protein expressions of IL-6 and TNF-α were determined using ELISA. Correlation analysis was done for lncRNA-SNHG1/miR-16-5p and lncRNA-ATB/miR-223-3p.ResultsPathological and scanning electron microscopic examination showed that there was significant damage to the cartilage tissue in KOA rabbits. Compared with the control group, the mRNA expression levels of NF-κB p65, IκBα, COX-2, iNOS, IL-6, and TNF-α as well as the expression levels of lncRNA-ATB and miR-16-5p were higher (P<0.01). The lncRNA-SNHG1 and miR-223-3p expression levels were lower in the knee cartilage tissue of the model group (P<0.01). The protein expression levels of p-NF-κB p65/NF-κB p65, p-IκBα/IκBα, COX-2, iNOS, IL-6, and TNF-α were higher in the model group (P<0.01). Compared with the model group, the mRNA expression levels of IκBα, COX-2, iNOS, IL-6 (P<0.01), TNF-α, NF-κB p65 (P<0.05), lncRNA-ATB, and miR-16-5p expression levels were lower (P<0.01). Moreover, lncRNA-SNHG1, miR-223-3p expression levels were higher (P<0.01) in the knee cartilage tissue of the acupotomy group. The protein expression levels of p-NF-κB p65/NF-κB p65, p-IκBα/IκBα, COX-2, iNOS, and IL-6, TNF-α were lower in the acupotomy group (P<0.01). Negative correlations of expression levels were observed between lncRNA-SNHG1 and miR-16-5p and between lncRNA-ATB and miR-223-3p (P<0.01).ConclusionThe effect of acupotomy therapy to protect knee cartilage in KOA rabbits may be related to the regulation of lncRNA-SNHG1/miR-16-5p and lncRNA-ATB/miR-223-3p pathways, which jointly inhibit the NF-κB signaling pathway.  
        关键词：acupotomy;knee osteoarthritis;lncRNA;NF-κB;SNHG1;miR-16-5p;ATB;miR-223-3p;rabbits   
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        发布时间：2022-07-11

        Chinese Medicinal Chemistry

      • Dan WANG,Miao QI,Hedi ZHAO,Han CHEN,Yanmin WANG,Yani JIANG,Yanan LAN,Jingjuan WANG
        Vol. 45, Issue 6, Pages: 612-620(2022) DOI: 10.3969/j.issn.1006-2157.2022.06.021
        摘要：ObjectiveTo use the high-performance liquid chromatography (HPLC) method and desorption electrospray ionization-mass spectrometry imaging (DESI-MSI) method to study the dynamic accumulation and distribution of secondary metabolites of Coptis chinensis in different growth years.MethodsUsing the samples of one-, three-, and five-year Coptis chinensis as the research object, the HPLC method was used to determine the contents of seven index components (jatrorrhizine hydrochloride, columbamine, epiberberine, coptisine hydrochloride, palmatine hydrochloride, berberine hydrochloride, and magnoflorine) as the secondary metabolites of Coptis chinensis. Further, the distribution of seven index components in the one-, three- and five-year Coptis chinensis slices were qualitatively analyzed by using the DESI-MSI method.ResultsThe HPLC result showed that the contents of berberine hydrochloride and palmatine hydrochloride, jatrorrhizine hydrochloride, columbamine, and magnoflorine in five-year Coptis chinensis were the highest; coptisine hydrochloride and epiberberine reached the highest level in 3-year Coptis chinensis, while the contents of magnoflorine and jatrorrhizine hydrochloride were the lowest in three-year Coptis chinensis; and berberine hydrochloride, palmatine hydrochloride, columbamine, epiberberine, and coptisine hydrochloride were the lowest in one-year Coptis chinensis. The hydrochloride of each alkaloid was dissociated in the process of mass spectrometry and appeared in the prototype form. The result obtained by the DESI-MSI method show that berberine and epiberberine were concentrated in the whole-slices section, the distribution area of the one-year sample was the smallest, and the distribution areas of the three- and five-year samples were similar. Jatrorrhizine and columbamine were distributed in the phloem and pith, and the five-year sample distribution area was the largest; palmatine and coptisine were distributed in the phloem and pith, and the one-year sample distribution area was the smallest. Magnoflorine was only distributed in the wood, and the distribution areas in the one-, three-, and five-year Coptis chinensis were similar.ConclusionThe accumulation of secondary metabolites in the one-year samples was the least, indicating that the first year is the main stage of the growth and development of Coptis chinensis. The accumulation of secondary metabolites of three-year samples was higher than those of the one-year sample, indicating that the following one to two years are the main stage for the accumulation of secondary metabolites of Coptis chinensis. The five-year plant sample had the highest content of total components, and berberine accumulated the most, which is consistent with the market usage rules of Coptis chinensis being cultivated for at least five years.  
        关键词：Coptis chinensis;growth years;secondary metabolites;alkaloids;desorption electrospray ionization-mass spectrometry imaging;high-performance liquid chromatography   
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        Clinical Studies

      • Cong SUN,Guohua DAI,Wulin GAO,Hui GUAN,Lili REN,Runmin LI,Xin LIU,Jue LI,Zepeng ZHAO,Haoran FU
        Vol. 45, Issue 6, Pages: 621-629(2022) DOI: 10.3969/j.issn.1006-2157.2022.06.012
        摘要：ObjectiveThe random forest and Logistic regression method were used to analyze the prognostic factors of cardiogenic death in patients with chronic heart failure complicated by atrial fibrillation.MethodsUsing the method of the cohort study, we selected patients with chronic heart failure complicated by atrial fibrillation in six traditional Chinese medicine (TCM) hospitals in Shandong Province (Affiliated Hospital of Shandong University of TCM, Weifang Hospital of TCM, Rizhao Hospital of TCM, Zibo Hospital of TCM, Qingdao Hospital of TCM, and Jinan Hospital of TCM) as the research object. We collected a total of 72 original data samples during hospitalization, including baseline data, complications, TCM pattern factors, cardiac color Doppler ultrasound, laboratory examination, and Chinese and Western medicinal treatment. After discharge, we followed up with the patients every six months to obtain the incidence of cardiac death. According to the occurrence of cardiac death, the included cases were divided into the endpoint group and the non-endpoint group. The statistically significant variables between the groups were selected by single factor analysis and successively included in the random forest model. The variable set with the smallest estimation error rate outside the bag was taken as the pre-treatment factor of cardiac death, and the importance of prognostic factors was ranked according to the reduction in the average Gini index. Multivariate logistic regression was further used to analyze the nature of prognostic factors.ResultsA total of 723 cases were included in the study, including 99 cases of cardiogenic death; 25 of 72 variables were screened out by single-factor analysis.Results of the stepwise random forest model showed that when the number of included variables was 11, estimation error rate outside the bag of the model was the smallest. Finally, the top 11 variables of the mean Gini index reduction were selected as the prognostic factors of cardiac death. Cardiac function grading, aortic valve stenosis, anticoagulant drugs, Yiqi TCM injection, heart rate, bilirubin, diastolic pressure, yang deficiency pattern, peripheral vascular disease, hypolipidemia drugs, and NT-ProBNP were ranked from high to low. Multivariate Logistic regression analysis showed that factors such as increased cardiac function grading (OR=2.204) combined with aortic stenosis (OR=12.852), increased heart rate (OR=1.008), increased bilirubin (OR=1.025), as well as increased diastolic blood pressure (OR=1.029) combined with peripheral vascular disease (OR=8.751) and an increase of NT-ProBNP (OR=1.922), were risk factors for cardiac death in Western medicine. Taking anticoagulants (OR=0.437) and hypolipidemics (OR=0.366) were both protective factors for cardiac death in Western medicine. The yang deficiency pattern (OR=1.127) was a TCM risk factor for cardiogenic death in patients, while the use of Yiqi TCM injections (OR=0.261) was a TCM protective factor of cardiogenic death in patients.ConclusionCardiac function grading, aortic valve stenosis, anticoagulants, Yiqi TCM injection, heart rate, bilirubin, diastolic pressure, yang deficiency pattern, peripheral vascular disease, hypolipidemics, and NT-ProBNP are prognostic factors of cardiogenic death in patients with chronic heart failure complicated by atrial fibrillation. The data analysis method combined with random forest and Logistic regression can realize complementary advantages and is suitable for high-dimensional and complex prognostic factor analysis of Chinese and Western medicine, which has clinical promotion value.  
        关键词：random forest;Logistic regression analysis;chronic heart failure;atrial fibrillation;prognostic factors;yang deficiency pattern;tonifying qi   
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      • Yang LI,Yuruo SUN,Jingsi FU,Yanting LI,Juan JIAO
        Vol. 45, Issue 6, Pages: 630-636(2022) DOI: 10.3969/j.issn.1006-2157.2022.06.013
        摘要：ObjectiveTo investigate the distribution of traditional Chinese medicine (TCM) patterns of fibromyalgia syndrome (FMS) and compare the demographic characteristics and the severity of patients with different TCM patterns.MethodsUsing a cross-sectional survey, TCM patterns were divided into the cold dampness obstruction pattern, liver qi stagnation pattern, qi-blood stagnation pattern, liver-gall bladder damp-heat pattern, deficiency of liver and kidney pattern, deficiency of liver blood pattern, and combination patterns (two patterns involved at the same time). By administering the "FMS TCM Pattern Questionnaire" , we investigated the TCM pattern distribution of FMS patients and compared their demographic characteristics. Then, five internationally recognized evaluation scales of FMS were used to assess the severity of the condition, including the Visual Analogue Scale, Revised Fibromyalgia Impact Questionnaire, Pittsburgh Sleep Quality Index, Multidimensional Fatigue Inventory, Beck Depression Inventory, and Perceived Stress Scale.ResultsA total of 165 patients’ clinical information was collected; 97 FMS patients had a single TCM pattern, including 27 cases of the deficiency of liver and kidney pattern (16.4%), 25 cases of the liver qi stagnation pattern (15.2%), 17 cases of the qi-blood stagnation stasis pattern (10.3%), 14 cases of liver-gallbladder damp-heat pattern (8.5%), 7 cases of the cold dampness obstruction pattern (4.2%), and 7 cases of the liver blood deficiency pattern (4.2%). Moreover, there were 34 cases of the combined liver qi stagnation pattern with liver blood deficiency pattern (20.6%) and 34 cases of other combined patterns (20.6%). Patients with different patterns had differences in gender, age, smoking, education level, and income. Patients with the liver blood deficiency pattern had a relatively long course of the disease. Patients with the liver qi stagnation pattern had a relatively high degree of depression. Finally, patients with the cold dampness obstruction pattern had a relatively mild overall condition.ConclusionIn the distribution of FMS patterns, excess pattern and pattern of intermingled deficiency and excess are major, while deficiency pattern is only a small part. The excessive pathogens mainly include qi stagnation, blood stasis, and cold dampness, while the vital qi deficiency mainly includes blood deficiency and yin deficiency. The yang deficiency is relatively rare, and the pathological changes of viscera are mainly in the liver. Thus, TCM pattern typing may be related to demographic characteristics and the severity of disease.  
        关键词：fibromyalgia syndrome;TCM pattern;demographic characteristics;cross-sectional survey;clinical research;liver qi stagnation pattern;liver blood deficiency pattern   
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      • Hua LIU,Xianqing REN,Hang SU,Shuang XU,Ying DING
        Vol. 45, Issue 6, Pages: 637-640(2022) DOI: 10.3969/j.issn.1006-2157.2022.06.014
        摘要：The pathogenesis characteristics of Henoch-Schönlein purpura (HSP) in children align with the theoretical connotation of "kidney responding to winter." In winter, yin qi is excessive, while yang qi is deficient. Humans respond to nature. When yang qi is hidden in the kidney, there is insufficient yang qi of the defensive exterior. Thus, it is easy for the kidney to be attacked by the pathogenic qi of the human body, which leads to the occurrence of HSP. The theory can be expounded from many angles, such as the correspondence between nature and man, a latent pathogen being triggered by the attack of pathogenic qi, the damage of collaterals, and the depression of Xuanfu. An effective way to reduce the incidence of HSP is to comply with the kidney being the dominator of storing essence and avoid other pathogenic qi attacking the kidney. After the onset of the disease, the way to prevent the transmission of pathogens is to eliminate the external pathogens that damage yang qi, remove internal pathogens that damage the kidney, and restore the function of the kidney as the dominator of storing essence. The way to prevent recurrence after remission is to nourish the kidney and consolidate defensive qi by taking into account other viscera. Prevention and treatment can be carried out according to the characteristics of pathogenesis in different periods, such as the disease-free period, deficiency of defensive qi and pathogenic qi attacking period, excessive pathogenic qi in the interior period, and positive deficiency of vital qi and pathogenic qi lingering in the period.  
        关键词：Henoch-Schönlein purpura in children;kidney responding to winter;humans respond to nature;prevention and treatment   
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      • Pengfei WEI,Shuangyuan HU,Yi ZHANG,Bin LI
        Vol. 45, Issue 6, Pages: 641-644(2022) DOI: 10.3969/j.issn.1006-2157.2022.06.016
        摘要：The theory of spleen "like or dislike tonifying and purgative" comes from Huangdi Neijing. "Dislike" is the pathological state of the spleen, and "like" is the physiological state of the spleen. Dampness accumulates in the spleen, which is "dislike" for the spleen, and the "dislike" of the spleen should be relieved by drying dampness with herbal medicines with bitter flavor. Deficiency of spleen-yin can easily cause the spleen to lose its tempering nature and lose its "like" . In the treatment, herbal medicines with sweet flavor should be used to calm the spleen and restore the "like" of the spleen. Ulcerative colitis is based on spleen deficiency, and dampness is a common pathological factor. When the spleen is deficient, internal dampness is generated, and the dampness is contained in the intestines and internal organs, which turn into heat, resulting in damp-heat poisonous evil, which burns the fatty ligaments and can lead to ulcerative colitis; damp-heat and toxin, which are not resolved, deplete the spleen yin, or using too many medicines with bitter flavor that damage the spleen-yin, and excessive thinking damages the spleen-yin, cause the spleen to lose its "like" , the blood vessels and muscles are not nourished by qi and blood, then the ulcerative colitis will not be heal for a long time, and the disease will be lingering. It is often the co-existence of damp-heat and spleen-yin deficiency in the late stage of ulcerative colitis, so the treatment should be clearing heat and drying dampness and removing toxin and protect yin, not forgetting dampness and yin, moistening dryness and nourishing yin together, in order to resolve the toxic evil of ulcerative colitis. Restoring the gentle nature of the spleen, allows the qi and blood to moisten the large intestine and ulcers can be healed.  
        关键词：ulcerative colitis;like or dislike tonifying and purgative;dampness;spleen-yin deficiency;Liangxue Qushi Buyin Yiqi Pill   
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        Texture Research

      • Cheng LIU,Sichao ZHANG
        Vol. 45, Issue 6, Pages: 645-648(2022) DOI: 10.3969/j.issn.1006-2157.2022.06.015
        摘要：Treatise on Differentiation and Treatment of Epidemic Febrile Disease, a monograph on warm diseases with a theory, methods, prescription, and medicine, is focused on the treatment of fever and yin injury by the TCM doctors of later generation, but ignored the treatment of yang injury. In this paper, by sorting, summarizing, and analyzing the book, we conclude that the main etiology and pathogenesis of lower energizer(Jiao) deficiency-cold syndrome is that cold and dampness impair yang and damage yin and yang; prolonged illness impairs yang; and medicine inadvertently impairs yang. Furthermore, Jutong’s treatment of deficiency-cold symptoms in the lower Jiao is guided by the pungent and sweet method of transforming Yang. Commonly used method include the method of warm and protection, methods of warm and purgation, methods of warm and smooth, and retrograde treatment. The method of warm and protection is effective in building up the middle and tonifying the lower jiao, warming and tonifying the ductus, and tonifying the qi and blood as well as yin and yang. The method of warm and purgation is effective in applying astringent products to the astringent lower Jiao yang. The method of warm and smooth is effective in applying lightly permeating products to benefit dampness and bitter and pungent products to move qi. The pungent, warm, and aromatic products are used to disperse the qi, penetrate the meridians, and move the qi to invigorate the channels to tonify the deficient yang. The treatise is of great significance for the contemporary treatment of deficient cold in the lower Jiao in miscellaneous diseases of external and internal injuries.  
        关键词：Wu Jutong;Differentiation and Treatment of Epidemic Febrile Disease;lower energizer;deficiency-cold syndrome;warming yang therapy   
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