最新刊期
      卷 46 ， 期 1 ， 2023

        Voice of Guidance

      • WANG Yongyan
        Vol. 46, Issue 1, Pages: 1-4(2023) DOI: 10.3969/j.issn.1006-2157.2023.01.001
        摘要：Since the 1950 s, Chinese medicine has gone through many changes from the era of integration of Chinese and Western medicine for survival to the establishment of equality for both types of medicine for development. As the first graduate of Beijing University of Chinese Medicine, my seniors and I have devoted our lives to the construction of the traditional Chinese medicine (TCM) discipline, which is still a lucky generation of Chinese medicine practitioners. I wish to thank my alma mater that educated mastered TCM doctors by reviewing academic papers. I hope that future generations will make new contributions to the development of TCM.  
        关键词：inheritance;traditional Chinese medicine;development   
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        发布时间：2023-02-03

        Prestigious Forum

      • GUO Rongjuan
        Vol. 46, Issue 1, Pages: 5-11(2023) DOI: 10.3969/j.issn.1006-2157.2023.01.002
        摘要：The research on the etiology and pathogenesis of depression in traditional Chinese medicine is still incomplete, and the current treatment of "liver depression" does not fully reflect its pathogenesis and clinical symptoms. Here, under the guidance of the "deficient-qi induced stagnation" innovative pathomechanism theory proposed by the academician Wang Yongyan, we conducted an in-depth analysis of the pathogenesis of depression, before elaborating on it using "deficient-qi" as the root, "stagnation" as the symptom, "qi depression" as the first, "phlegm obstruction" as the gradual, and "blood stasis" as the focus. Our result highlight that "deficient-qi" and "stagnation" have the characteristics of mutual causation and vicious circle. These findings provide a theoretical basis for the treatment of depression by identifying the "mechanism" , and provides a new way of thinking for the prevention and treatment of depression in the context of traditional Chinese medicine.  
        关键词：depression;innovative pathogenesis;deficient-qi induced stagnation;deficiency of vital energy;qi, blood and body fluid   
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        Standards & Guidelines

      • China Association of Chinese Medicine Blood Disease Branch,Hematology Branch of Chinese Ethnic Medicine Association,Chinese Cancer Committee of Integrated Traditional and Western Medicine,Cancer Committee of Beijing Society of Integrated Traditional Chinese and Western Medicine
        Vol. 46, Issue 1, Pages: 12-17(2023) DOI: 10.3969/j.issn.1006-2157.2023.01.003
        关键词：cancer;cancer-related depression;diagnosis and treatment of traditional Chinese medicine   
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      • Panel of Clinical Guideline for Body Weight Management in TCM of China Association of Chinese Medicine,Obesity League of Guangdong Association of Acupuncture-Moxibustion
        Vol. 46, Issue 1, Pages: 18-24(2023) DOI: 10.3969/j.issn.1006-2157.2023.01.004
        关键词：obesity;overweight;weight management;internet weight management;expert consensus   
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        发布时间：2023-02-03

        COVID-19 Theme

      • ZHAO Chenxi,LU Hongrong
        Vol. 46, Issue 1, Pages: 25-31(2023) DOI: 10.3969/j.issn.1006-2157.2023.01.005
        摘要：ObjectiveTo explore the pathogenic characteristics, etiology, pathogenesis, and evolution of Corona Virus Disease 2019 (COVID-19), with the aim to provide a reference for the prevention, control, and treatment of epidemics.Methods(ⅰ)Data statistics. Using 15 studies that documented the cold and heat conditions of patients with COVID-19 on admission from January 2020 to June 2022, we counted the number and frequency of cases corresponding to the cold and heat types upon hospital admission. Based on 12 clinical reports on variant strains of COVID-19 before July 2022, we evaluated the etiological properties of different variants of COVID-19. (ⅱ)Literature research. By referring to the literature on the related theories of COVID-19, we discuss the pathogenic characteristics and evolution of COVID-19 from the aspects of clinical manifestations, principles and methods of treatment, prescriptions, and drugs.ResultsDamp pestilence epidemic toxin is the main etiological property of COVID-19 and its variant strains. Aversion to cold and fever can be seen in the early stage. Most patients showed low or moderate fever, while some present alternate attacks of cold and fever, or hiding fever. Some asymptomatic infected patients with COVID-19 had pulmonary inflammation manifestations. Pulmonary imaging may show multiple small patchy shadows and pulmonary interstitial changes, as well as altered laboratory indicators such as decreased leukocyte and lymphocyte counts. The mid-term clinical manifestations are mainly pulmonary system lesions and spleen and stomach system lesions. Patients with severe disease may showed dyspnea, mental disorder, acute respiratory distress syndrome (ARDS), acute kidney injury, liver function impairment, and other complications. Besides, some recovered patients displayed re-positive result in nucleic acid testing. In clinical practice, relieving superficies and clearing interior, eliminating dampness, and removing toxicity can achieve better efficacy.ConclusionThe pathogenesis of COVID-19 involves damp pestilence epidemic toxin entering from the mouth and nose, before remaining latent in the upper pleurodiaphragmatic spaces. In the early stage of the disease, the damp pestilence epidemic toxin may leave the upper pleurodiaphragmatic spaces. At this time, the patient showed symptoms of both superficies-syndrome and interior syndrome. In the middle stage, the damp pestilence epidemic toxin changes inward, affecting the lung and spleen, with damp blockage of the middle energizer serving as the core pathogenesis. In the severe stage, the toxin heats of damp pestilence epidemic might enter yingfen and xuefen. The symptoms of some patients' qi syndrome still exist, the damp pestilence epidemic toxin has entered into yingfen and xuefen, which manifests as intense heat in both qi and ying systems. In the recovery period, the main pathogenesis is the lack of vital qi with lingering remnant pathogen.  
        关键词：Corona Virus Disease 2019;damp pestilence epidemic toxin;cause of disease;pathogenesis;hidden pathogen   
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        Theoretical Studies

      • CHEN Jiena,LI Yuan,DING Xia
        Vol. 46, Issue 1, Pages: 32-36(2023) DOI: 10.3969/j.issn.1006-2157.2023.01.006
        摘要：In traditional Chinese medicine (TCM), the academic perspectives that "the occurrence of various diseases may result from internal damage to the spleen and stomach" and that "those who are good at treating diseases, regulate the spleen and stomach well" have been endowed with guiding significance to understand the occurrence, development, and prognosis of tumors. Western medicine has the view that the hallmarks of cancer depend not only on the characteristics of tumor cells themselves, but are also closely related to the microenvironment where tumor cells are located and the imbalanced immune macroenvironment. In TCM, the main pathogenesis of tumors is defined as a "weakness of the spleen and stomach, and accumulation of cancer toxins" . "Weakness of the spleen and stomach" is the internal basis for the formation of the tumor immune macroenvironment, and the "accumulation of cancer toxins" is an important condition for the formation of the tumor immune microenvironment; the two mutually promote the occurrence and development of tumors. Based on the theory that "the spleen acts as the guard of the body" and "the vigorous spleen is able to resist invasion of pathogens, " TCM has achieved remarkable clinical efficacy with the treatment of "invigorating spleen and attacking poison" in the prevention and treatment of tumors. This emphasizes the unique advantages of the "spleen and stomach" in tumor immune regulation. Thus, based on the theory of spleen and stomach in TCM, we explore the scientific connotation of spleen and stomach function in the tumor immune microenvironment and the organism immune macroenvironment, so as to promote the theoretical integration and development of integrated Chinese and Western medicines in tumor occurrence, development, prevention, and treatment.  
        关键词：spleen and stomach;tumor;immune microenvironment;traditional Chinese medicine   
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      • HOU Jianchen,YANG Feng,FU Xing,ZHOU Ranran,LUO Yamin,LI Qianqian,LI Ran,ZHANG Yao,GE Fei,TAO Xiaohua
        Vol. 46, Issue 1, Pages: 37-41(2023) DOI: 10.3969/j.issn.1006-2157.2023.01.007
        摘要：ObjectiveTo analyze the characteristics of symptoms in Shanghan Lun (Treatise on Cold Damage) and construct a symptom classification system.MethodsUsing the method of knowledge element indexing, the knowledge elements of symptom in the provisions of Shanghan Lun were extracted and separated to the semantic level. Then the symptoms were encoded and classified step by step using the grounded theory method to construct a three-level framework for further analysis.ResultsA total of 510 knowledge elements of symptom and 1 361 semantics of symptom were extracted. The symptoms in Shanghan Lun were classified into 8 categories: systemic symptoms, symptoms of the abdomen and epigastrium, symptoms of the genitals and anus, mental symptoms, symptoms of the head, face and five sense organs, symptoms of the limbs, symptoms of the chest and hypochondrium, and symptoms of the neck, back and waist.ConclusionAlthough the symptom classification system of Shanghan Lun formed by the grounded theory is similar to the existing symptom classification in traditional Chinese medicine, the systemic symptoms, symptoms of the abdomen and epigastrium and mental symptoms seem to be quite different from those formed in the later generations, which displays the distinct value of this book.  
        关键词：Shanghan Lun;symptom classification;knowledge element indexing;grounded theory   
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      • QIN Jin,YANG Rui,ZONG Xingyu,ZHAO Peng
        Vol. 46, Issue 1, Pages: 42-46(2023) DOI: 10.3969/j.issn.1006-2157.2023.01.008
        摘要：Exploring the etiology and pathogenesis of hypertension based on the heart as the foundation of life is an organic combination of traditional Chinese medicine (TCM) syndrome differentiation and treatment and current Western Medical understanding. This combination elaborates on the "treatment of symptoms and root causes" of TCM, which has certain guiding and enlightening significance for the effective control and treatment of hypertension and its complications. Starting from the modern clinical understanding of the definition of blood pressure, combined with the theoretical understanding of the heart dominating the blood and the spirit, we discuss the basic conditions, influencing factors, organ damage, and other aspects of the formation of hypertension. Focusing on the importance of the heart as the foundation of life for the prevention and treatment of hypertension, we highlight the necessity that it should be used as a basic treatment rule. In consideration of this, we propose corresponding syndrome and treatment strategies from the aspects of spirit, blood, heart-qi, and blood vessels, among others. On this basis, combined with multiple dimensions such as yin-yang, five elements and constitution, both symptoms and root causes should be treated, and the solution should be changed according to the situation, so as to more effectively solve the challenges of "elevated blood pressure" and "difficult to achieve quick result " associated with hypertension. This is not only of great significance for the "prevention" and "seeking the root of disease" in TCM, but is also an innovative development of the organic combination of TCM and Western medicine theory, which can provide a certain reference value for inherit TCM and learn from Western medicine to develop TCM.  
        关键词：foundation of life;hypertension;treatment of symptoms and signs;inherit TCM and learn from Western medicine   
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        发布时间：2023-02-03
      • ZHAO Yibo,WEI Fengqin
        Vol. 46, Issue 1, Pages: 47-51(2023) DOI: 10.3969/j.issn.1006-2157.2023.01.009
        摘要：In order to more clearly and stereoscopically discuss the movement characteristics of kidney qi responding to winter, this paper will be based on a literature review focusing on solar terms in winter, we examine the changes of the movement state of kidney qi from the perspective of the rise and fall of qi, with the aim to clearly and stereoscopically discuss the movement characteristics of kidney qi responding to winter. It is proposed that the essence of the theory of "kidney corresponding with winter" is that the kidney qi and the winter qi are in constant correspondence, that is, the rise and fall of the kidney qi responding to winter should be at the same time and position. This is mainly manifested in the changes of its corresponding qi mechanism laws: the primary, secondary, turning and spatial positions of the rise and fall of the kidney qi change with the winter qi. Therefore, the theory of "kidney corresponding with winter" should be applied to guide the clinical practice, with particular emphasis on adjusting measures to the time; this is important to grasp the dynamic changes of kidney qi at any time, such as the ascending and descending, primary and secondary, and the ascending and descending transition and spatial position. Through further research on the theory of "kidney corresponding with winter" at the solar terms level, the physiological qi mechanistic characteristics of kidney qi corresponding to winter are clarified more clearly and stereoscopically, and the application content of syndrome differentiation and treatment of kidney qi disease according to time is further clarified. This research will aid the theory of "kidney corresponding with winter" to guide the treatment of clinical related diseases more specifically and accurately.  
        关键词：kidney corresponding with winter;kidney qi;qi movement;primary and secondary;turning point;position   
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      • LI Yansong,LYU Cuixia
        Vol. 46, Issue 1, Pages: 52-56(2023) DOI: 10.3969/j.issn.1006-2157.2023.01.010
        摘要：The manic pulse is an important component of the ancient pulse method. Although it does not belong to the traditional 28 pulses, it often appears in the classic medical books and has unique clinical value. After Huangdi Neijing, the pulse descriptions of manic pulse rarely appear in the medical literature and classics, and its meaning is unclear. This article reviews the historical documents and the understanding of modern physicians, and conducts an induction and deduction to rediscover the connotation, derivation and clinical application significance of the manic pulse. From the aspects of diagnostic indications, formation mechanism, clinical significance, and identification of common concurrent pulses, the manic pulse was differentiated and discussed, and the following conclusion were drawn. The manic pulse is a type of pulse potential, which is opposite to the tranquil pulse, and is defined as not soft, unstable, and unsteady. The manic pulse is a composite pulse condition formed by the combination of various elements including increased blood flow rate, unstable pulse wave strength and speed. The manic pulse is often accompanied by an increased pulse rate, a rapid pulse, but the manic pulse is not necessarily frequent and fast, and even a slow and manic pulse. The main disease of the manic pulse can be divided into two groups: usually a floating manic pulse represents diseases of the hand meridians and the beginning of the fever, while a deep manic pulse represents qi stagnation. The deficiency and excess should be identified based on the strength and weakness when the pulse is pressed heavily. The appearance of a manic pulse means that the disease is at an important node of development, the change and struggle between vital qi and the pathogen, which is especially worthy of attention.  
        关键词：manic pulse;origin;pulse potential;clinical significance   
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        Experimental Studies

      • DENG Di,MA Luyao,LIU Tianyi,ZHOU Na,LIU Menghua,YANG Mingrui,QIU Zonglin,HAO Yu
        Vol. 46, Issue 1, Pages: 57-64(2023) DOI: 10.3969/j.issn.1006-2157.2023.01.011
        摘要：ObjectiveWe aimed to explore the anti-inflammatory molecular mechanism of Xijiao Dihuang Decoction combined with Yinqiao Powder(XDY) in macrophages infected with influenza virus.MethodsGenes related to human macrophages infected by influenza virus PR8 were screened by the gene chip published in the GEO database.The intersection of the active components of XDY and the related differential genes of human macrophages infected by influenza virus PR8 was input into the STRING database to obtain the interaction relationship between target proteins.The core target was obtained according to the degree of protein interaction.The protein-protein interaction network was visualized with Cytoscape 3.7.2 software, and topology analysis was performed.The Metascape database was used for Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analysis.Macrophages J774A.1 were divided into the normal group, the model group(influenza virus PR8 infection), and the XDY group(PR8 + 162.5 mg/L XDY) and treated for 24 h. The mRNA levels of Toll-like receptor 4(TLR4), myeloid differentiation factor 88(MyD88), TNF receptor-associated factor 6(TRAF6), tumor necrosis factor-α(TNF-α), and interleukin-6(IL-6) were detected by real-time PCR; nuclear factor-κB(NF-κB) translocation was detected by immunofluorescence; and the levels of TNF-α and IL-6 in the supernatant were detected by ELISA.ResultsIn total, 104 common targets were obtained by analyzing the intersection of the differentially expressed genes in the PR8 and XDY groups.Pathway enrichment analysis showed that the effects of XDY on influenza may be mediated by the TLR4/NF-κB pathway.PCR result showed that compared with the model group, the mRNA levels of TLR4, MyD88, TRAF6, TNF-α, and IL-6 were lower in the XDY group(P<0.01).Immunofluorescence result showed that compared with the model group, the nuclear localization of NF-κB in the XDY group was decreased, and the nuclear-cytoplasmic ratio was also decreased(P<0.01).ELISA result showed that compared with the model group, the levels of TNF-α and IL-6 in the supernatant in the XDY group were decreased(P<0.01).ConclusionXijiao Dihuang Decoction combined with Yinqiao Powder can regulate the TLR4/NF-κB pathway to reduce the inflammatory response in macrophages infected with influenza virus.  
        关键词：Xijiao Dihuang Decoction combined with Yinqiao Powder;influenza virus;network pharmacology;macrophages;TLR4/NF-κB pathway   
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      • ZHANG Chao,JIA Xiufeng,HUANG Wanling,ZHOU Yong,TANG Qi,CHEN Gang
        Vol. 46, Issue 1, Pages: 65-76(2023) DOI: 10.3969/j.issn.1006-2157.2023.01.012
        摘要：ObjectiveTo explore the possible mechanism of Shouwu Pill in delaying brain aging.MethodsFifty male SPF SD rats were randomly divided into the normal group, model group, vitamin E group, Shouwu Pill group, and double dose Shouwu Pill group. Except the normal group, the other four groups were used to generate aging models with D-galactose (120 mg/kg). Simultaneously, Shouwu Pill was used to intervene the Shouwu Pill group and double dose Shouwu Pill group (1.08, 2.16 g/kg), while the vitamin E group (0.018 g/kg) was given vitamin E by gavage. After 6 weeks of modeling, six mice per group were randomly selected for 16S rRNA sequencing to analyze the changes in intestinal flora diversity and species richness, and to detect the hippocampus β-galactosidase activity. Hematoxylin and eosin (HE) staining were used to observe the pathological changes of jejunum tissue, and the content of trimethylamine oxide (TMAO) in serum and hippocampus of rats in each group was detected by enzyme-linked immunosorbent assay (ELISA).ResultsCompared to the normal group, the β-galactosidase activity increased in the hippocampus of the model group(P<0.01). Compared to the model group, the β-galactosidase activity decreased in the hippocampus of the Shouwu Pill group and double dose Shouwu Pill group(P<0.01). Compared to the model group, the striated border of the ileum in the Shouwu Pill group and double dose Shouwu Pills group was neat, and the shedding of mucosal epithelial cells was reduced. Compared to the normal group, the model group showed a decreased Chao1 index, Faith index, and Observed_ otus (P<0.05, P<0.01). Compared to the model group, the Chao1 index, Faith index, Observed_ otus, and Shannon index (P<0.05, P<0.01) increased in the Shouwu Pill group, and the Chao1 index and Shannon index in the double dose group increased (P<0.05). Beta diversity analysis of intestinal flora demonstrated that each group of samples could be significantly distinguished. At the phyla level, compared to the normal group, the abundance of Bacteroides and Actinomycetes in the model group decreased (P<0.01), while the abundance of Proteus and Cyanobacteria in the model group increased (P<0.01). Compared to the model group, the ratio of relative abundance of Firmicutes and Bacteroides in the Shouwu Pill group and double dose Shouwu Pill group decreased, the abundance of Actinomycetes increased (P<0.01), and the abundance of Cyanobacteria decreased (P<0.01). At the genus level, compared to the normal group, the relative abundance of Prevotella, Lactobacillus, Vibrio, Bacteroides, and Para Prevotella in the model group decreased (P<0.01). Compared to the model group, after the intervention of Shouwu Pill, the relative abundance of Prevotella, Lactobacillus, Vibrio, Bacteroides, Para Prevotella, Brautzia, and Para Prevotella increased (P<0.01). Compared to the normal group, the content of TMAO in the serum and hippocampus of the model group was significantly increased (P<0.01). Compared to the model group, the content of TMAO in the serum and hippocampus in the Shouwu Pill group and double dose Shouwu Pill group were significantly decreased (P<0.01). Spearman correlation analysis showed that Prevotella, Lactobacillus, Parapre votella, and Brautzia were negatively correlated with serum TMAO.ConclusionShouwu Pill can reduce the β-galactosidase activity in the hippocampus of aging rats treated with D-galactose. Moreover, the β-galactosidase activity can improve the pathological morphology of the jejunum, which may delay brain aging by regulating intestinal flora and reducing the production of TMAO.  
        关键词：brain aging;Shouwu Pill;pathological morphology;intestinal flora;trimethylamine oxide;rats   
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      • FAN Fangxin,ZHU Haoru,QIAN Meng,SHI Tuo,ZHU Sitai,XIE Ming
        Vol. 46, Issue 1, Pages: 77-86(2023) DOI: 10.3969/j.issn.1006-2157.2023.01.013
        摘要：ObjectiveTo investigate skeletal muscle injury and its mechanism in a rat model of spleen deficiency syndrome.MethodsMale Wistar rats(SPF/VAF) were randomly divided into control group and model group according to body weight. The "improper diet combined with exhaustive swimming" method was used to duplicate the rat model with spleen deficiency syndrome. The control group was fed normally. We regularly recorded the appearance, body weight, dietary intake, and excrement water content of the two groups of rats. At the end of Week 2, 3, and 4, the swimming exhaustion time, grip strength, urine D-xylose excretion rate, spleen index, thymus index, and gastrocnemius wet weight were measured, and the gastrocnemius was subjected to pathological examination by HE staining. Besides, at the end of Week 2, 3, and 4, we used enzyme-linked immunoassay to determine the levels of motilin, gastrin, interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) in serum, and the levels of citrate synthase, Ca2+ -ATPase, IL-1β, IL-6, and TNF-α in the gastrocnemius. At the end of Week 4, immunohistochemistry method was used to measure the positive expression of IL-1β, IL-6, and TNF-α, and immunofluorescence was used to detect the cells that were positive for cysteine aspartate proteolytic enzyme 3 (cleaved-caspase 3) in the gastrocnemius.ResultsCompared to the control group, the body weight, dietary intake, swimming exhaustion time, grip strength, gastrocnemius wet weight, and urine D-xylose excretion rate in the model group were significantly decreased from Week 2 to 4 (P<0.05, P<0.01), while excrement water content increased (P<0.01). Serum gastrin in the model group was also significantly decreased at Week 3 and 4 (P<0.05, P<0.01). Besides, the gastrocnemius wet weight to body weight ratio and serum IL-6 of the rats in the model group were increased at Week 2 (P<0.05, P<0.01). At the end of Week 4, the gastrocnemius wet weight to body weight ratio, spleen index, thymus index, citrate synthase and Ca2+ -ATPase in the gastrocnemius, the levels of gastrin, IL-1β, and TNF-α in the serum of the model group decreased significantly (P<0.01); and the levels of cleaved-caspase 3, IL-1β, IL-6, and TNF-α in the gastrocnemius increased significantly (P<0.01).ConclusionThe spleen deficiency syndrome rat model induced by "improper diet combined with exhaustive swimming" method in accordance with the appearance of traditional Chinese medicine syndrome of spleen deficiency and related laboratory indexes. The muscle strength and atrophy of the gastrocnemius was decreased with the modeling time. The systemic immune function of the model rats decreased, while the protein expression of systemic and gastrocnemius inflammatory factors increased. We presume that the skeletal muscle damage involves mitochondrial injury and apoptosis in the spleen deficiency syndrome rat model but is related to inflammatory mechanism.  
        关键词：spleen deficiency syndrome;rats;gastrocnemius injury;mitochondrial enzyme;apoptosis;inflammation mechanism   
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        TCM Constitutions

      • WANG Xueke,LI Tianxing,LI Lingru
        Vol. 46, Issue 1, Pages: 87-92(2023) DOI: 10.3969/j.issn.1006-2157.2023.01.014
        摘要：Based on the diagnosis and treatment thought of "constitution identification-disease identification-syndrome differentiation" , we have systematically analyzed the physiological and pathological characteristics, common pathogenesis and syndromes of qi-deficiency constitution. The result highlight that qi has a series of functions, including transportation, defense, qi transformation, lifting, promotion, and nutrition. In the event that the qi deficiency constitution is not properly regulated, six major types of pathogenesis can commonly occur; these include abnormal spleen and stomach transport and transformation, muscle surface instability, clearing yang without rising, qi depression, large intestine conduction failure, and heart and spleen loss. This may be accompanied by various syndromes, such as endogenous dampness, phlegm block qi stagnation, dampness overflowing, food stagnation, external deficiency and spontaneous sweating, external deficiency and blood paralysis, rheumatism, damp-heat suppressing yang, yin-fire flaming up, qi-jin injury, middle qi sinking, spleen deficiency sinking, atmospheric sin-king, constipation due to qi deficiency, and deficiency of both qi and blood. Further, based on the idea of systemic disease (syndrome) and body system prescription (medicine) and taking the common pathogenesis of qi-deficiency constitution as the key link, we reanalyzed 14 related prescriptions with the formula pattern of "body-disease-syndrome" to systematically expound the qi-deficiency constitution. We provide a summary of the commonalities and individual laws of related prescriptions, the commonly used body-regulating drugs for qi-deficiency constitution, and the commonly used additions and subtractions for diseases and syndromes. This work serves to provide a clearer overall picture of prescription selection and medication for common pathogenesis of qi-deficiency constitution, which will improve the flexibility of prescribing drugs.  
        关键词：qi-deficiency constitution;constitution-disease-syndrome;formula pattern;prescription   
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      • ZHAO Xinyuan,ZHU Yanbo,LI Yuqiong,LONG Liqun,CHEN Pipi
        Vol. 46, Issue 1, Pages: 93-99(2023) DOI: 10.3969/j.issn.1006-2157.2023.01.015
        摘要：ObjectiveA holistic and comprehensive analysis of traditional Chinese medicine (TCM) constitutions health states was conducted to explore the impact of different concurrently clamped constitution histories on health-related quality of life (HRQOL).MethodsUsing the convenient sampling method, the Constitution in Chinese Medicine Questionnaire-41 entry short version, the Chinese verison of SF-36, and other tools were used to measure the unpaid blood donor population aged 18 to 60 years old, and the fuzzy set qualitative comparative analysis was used to explore configuration of the TCM constitution that affected HRQOL.ResultsThe mean age of the 2 254 study subjects included in the analysis was (30.72±9.78) years. The percentage of gentleness constitution was 35.71%, and 33.81% had a combination of more than 3 types biased constitutions. Three categories of TCM constitution groupings negatively influenced HRQOL in the physiological domain. First, non-gentleness constitution, qi-deficiency constitution, yang-deficiency constitution, phlegm-wetness constitution, and blood-stasis constitution were the core conditions; second, non-gentleness constitution, qi-deficiency constitution, phlegm-wetness constitution, blood-stasis constitution and special diathesis constitution were the core conditions; and third, all eight biased constitutions were present as core conditions. Three categories of TCM constitution groupings negatively influenced HRQOL in the psychological domain. First, non-gentleness constitution, qi-deficiency constitution, phlegm-wetness constitution, blood-stasis constitution, and qi-depression constitution were the core conditions; second, non-gentleness constitution, qi-deficiency constitution, yin-deficiency constitution, wetness-heat constitution, and qi-depression constitution were the core conditions; and third, all eight biased constitutions occurred as core conditions.ConclusionThe fuzzyset qualitative comparative analysis method with a configuration perspective revealed the effect of TCM constitution on HRQOL as a multi-component combination of concurrent mechanisms. The diversity of concurrently clamped constitution and the complexity of its relationship with HRQOL were fully analyzed, and this results provide a reference direction for researchers to dig deeper into the intervention pathways of TCM constitution conditioning to enhance quality of life.  
        关键词：traditional Chinese medicine constitutions;qualitative comparative analyses;health-related quality of life;composite constitution type   
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        Clinical Studies

      • ZHANG Xueping,ZHANG Jiale,JI Chenyang,BAI Xinghua
        Vol. 46, Issue 1, Pages: 100-105(2023) DOI: 10.3969/j.issn.1006-2157.2023.01.016
        摘要：The governor vessel belongs to one of the Eight Extra-Meridians, which plays a leading role in the meridian system. The governor vessel can regulate the growth and development of the human body and the normal operation of the viscera and meridians of the whole body. Based on the "spine-related diseases" "back-shu function band" and neural related theory, the governor vessel is closely related to the back-shu point and EX-B2, and plays an important role in affecting viscera organs. By analyzing the circulation, physiological function, and correlation of the dorsal segment of the governor vessel and the back-shu point and EX-B2, combined with the relevant understanding of the nervous system of western medicine, we propose the existence of a "Broad Governor Vessel" zone. We believe that the governor vessel and its two sides, the back-shu point and EX-B2, are associated by channel qi, and are closely related to the viscera. From the perspective of the "Broad Governor Vessel, " pathological changes such as tenderness reaction, nodule, and temperature change in the acupoint area at different spinal segments in the dorsal segment of the governor vessel can reflect different visceral diseases and further assist in the clinical diagnosis of corresponding visceral diseases. The application of different spinal segments in the dorsal segment of the governor vessel, including the correction of spinal parenchyma lesions, acupoint stimulation, and other method, can treat the corresponding visceral diseases. The proposition of a "Broad Governor Vessel" summarizes the function of the dorsal segment of the governor vessel and extends the theory, which may allow further exploration of the application of clinical diagnosis and treatment to the visceral diseases.  
        关键词：Broad Governor Vessel;governor vessel;diagnosis and treatment thinking;clinical application;origin   
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        发布时间：2023-02-03
      • ZHANG Chaoyang,FENG Xinran,YAN Kang,LYU Tianyi,WANG Ruoshui,LIU Meng,ZHAO Xirui,WEI Yulong
        Vol. 46, Issue 1, Pages: 106-109(2023) DOI: 10.3969/j.issn.1006-2157.2023.01.017
        摘要：Under the traditional Chinese medicine (TCM) system, cognitive dysfunction can be categorized as a "mind" disease. The main pathogenesis of cognitive dysfunction is the lack of nourishment in the brain, the most important principle of which is the regulation of the movement of qi and blood. In the TCM system, pectoral qi generated by breath could flow to the brain and elixir field in the lower abdomen to nourish the mind and original qi simultaneously and promote the flow of essence qi originated from the liver and kidney. Connected by the movement of qi, the meridians can be coupled in a ring, so the sufficient essence, blood, and qi can be continuously supplied to the brain and all over the body. Our previous research found that abdominal breathing training has a benign regulatory effect on the viscera, qi, and blood functions of the human body, and has a positive trend of promoting and regulating the operation of zang-fu qi and blood. Additionally, as an active training therapy, it is beneficial to enhance the activity of the cerebral cortex motor center, improve the excitation of nerve cells, and improve the blood flow of the brain. Starting from the theory of qi, blood, and meridians in TCM, and by considering the latest research progress in related fields, we discuss the improvement gained from abdominal breathing training on brain cognitive function. Our work opens up new research ideas for improving cognitive ability and preventing and treating cognitive impairment.  
        关键词：abdominal breathing;cognitive function;Qi and blood;meridian;brain   
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      • SONG Wei,ZHANG Zhongyi,LING Guihua,RAO Xiangshu,ZHUO Xingwei,XIAO Min,CHEN Mingling,SHEN Tao
        Vol. 46, Issue 1, Pages: 110-114(2023) DOI: 10.3969/j.issn.1006-2157.2023.01.018
        摘要：Dryness and dampness reflect the change of climate in nature. For the human body, they can refer to the rise and fall of body fluid in two states. They seem to be opposite and mutually controlled, but in fact they are related, coexist and can be transformed into each other. Clinically, the color and position of ichthyosis scales show the skin lesions characteristic of "extreme dryness similar to wet and extreme wet similar to dryness" , meaning that "dryness and dampness coming from the same source" . The symptoms and signs of ichthyosis can reflect the combination of dryness and dampness, which means "dryness and dampness causing same disease" . According to the theory of "dryness and dampness from the same source causing same disease" , the core pathogenesis of ichthyosis is considered to be external dryness and internal dampness, or dampness depression and dryness production, or dryness blocking and dampness obstruction, or dryness and dampness interaction. For the treatment of ichthyosis, if the yin is simply raised, the evil of dampness would be more, and the excessive use of warm or dry natured herbs would aggravate yin deficiency, since they complement each other. Therefore, the only choice for treatment is the combination of nourishing yin and drying dampness. Interior dampness should be treated by strengthening the spleen, regulating qi, and mediating middle energizer to remove the evil of dampness, while exterior dryness by opening the sweat pore (xuanfu), nourishing yin and dispersing body fluid to moisten dryness. Based on the theory of "dryness and dampness from the same source causing same disease" , we found the combination of Runfu Decoction and Huacai Yigong Powder is effective in the treatment of ichthyosis.  
        关键词：ichthyosis;mutual root of yin and yang;dryness and dampness from the same source causing same disease;moisturizing and drying together;strengthening spleen and nourishing yin   
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        发布时间：2023-02-03
      • CHENG Zengyu,XU Haodong,LI Da,PANG Fengtao,JIANG Wen,TANG Xiaopo
        Vol. 46, Issue 1, Pages: 115-119(2023) DOI: 10.3969/j.issn.1006-2157.2023.01.019
        摘要：Fatigue is a common symptom of rheumatoid arthritis (RA). Patients with RA feel physically and mentally exhausted, presenting with an "overwhelming" discomfort, which is difficult to relieve by rest and seriously affects the quality of life. However, the clinical attention to RA is relatively low and the treatment effect is insufficient. Under the guidance of holism and pattern differentiation and treatment, traditional Chinese medicine pays attention to the subjective symptoms of patients, which can effectively improve the fatigue symptom of RA patients while reducing disease activity. Clinical observation has shown that the mutual entanglement of damp, heat and stasis is key to the pathogenesis of RA-related fatigue. In contrast to deficiency syndrome differentiation and treatment of fatigue, we explain the connotations of dampness, heat and stasis and their pathogenesis in RA-related fatigue. By conducting an in-depth analysis of the relationship between the three and the pathogenesis of mutual adhesion, we conclude that the mutual adhesion of dampness, heat and stasis is the core pathogenesis of RA-related fatigue. Considering these key points, the clinical treatment method of clearing heat, and removing dampness, and promoting blood circulation and qi was established. Clinical physician could modify decoction based on syndrome differentiation according to the characteristics of the damp, heat or blood stasis, and the severity of the disease. These provide ideas for the diagnosis and treatment of clinical RA-related fatigue.  
        关键词：damp, heat and stasis;rheumatoid arthritis;Fatigue;pathogenesis   
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        发布时间：2023-02-03
      • LI Yuhan,LIU Zheng,LI Yixuan,WANG Yingrui,LIU Guoyan,WANG Hongjie
        Vol. 46, Issue 1, Pages: 120-124(2023) DOI: 10.3969/j.issn.1006-2157.2023.01.020
        摘要：Lymphedema belongs to the category of "foot wind" and "elephantiasis" in traditional Chinese medicine, which is mostly dampness and evil stasis in the initial stage, qi stagnation and blood stasis for a long time, followed by phlegm and dampness accumulation. Xuanfu and collaterals, as the microstructure of running qi, blood, and body fluid described in traditional Chinese medicine, are widely involved in the pathological process of lymphedema, such as the obstruction of qi, stagnation of qi, mutual knot of phlegm and blood stasis, and fire and heat. This process is consistent with the process of lymphedema described in Western medicine, that is, lymphatic reflux disturbance, inflammatory reaction, fat hyperplasia, and interstitial fibrosis. Lymphedema is difficult to heal, this paper aims to combine the microstructure of Xuanfu-collaterals with the overall concept of traditional Chinese medicine to treat lymphedema from the perspective of opening Xuanfu and dredging collaterals, and this work will serve to provide a new direction for the treatment of lymphedema in traditional Chinese medicine.  
        关键词：lymphedema;Xuanfu;Collaterals;etiology;pathogenesis;opening Xuanfu and dredging collaterals   
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        发布时间：2023-02-03

        Acupuncture Moxibustion and Tuina

      • HAO Xiaowan,TU Jianfeng,WANG Liqiong,YU Fangting,LIN Lulu,LI Hongping,SHI Guangxia,LIU Cunzhi
        Vol. 46, Issue 1, Pages: 125-131(2023) DOI: 10.3969/j.issn.1006-2157.2023.01.021
        摘要：ObjectiveTo investigate whether there is sex difference in the acupuncture treatment of knee osteoarthritis.MethodsA secondary analysis of data from a multicenter randomized controlled trial was performed. A total of 442 patients with knee osteoarthritis were randomly divided into the acupuncture group (n=145), electroacupuncture group (n=151), and sham acupuncture group (n=146). For the acupuncture group, obligatory acupoints were selected, including ST35, EX-LE4, LV8, GB33, and ashi points, with three matching acupoints along the channel, and the electroacupuncture instrument was connected without any current. The same acupoints were selected for the electroacupuncture group, but the 2/100 Hz dilatational wave was connected. For the sham acupuncture group, eight shallow points that were unrelated to any channel or acupoint were selected, and the electroacupuncture instrument was not connected to a current. For all groups, the intervention lasted 30 min per session, three times a week, for eight weeks in total. The Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and the Numerical Rating Scale (NRS) were used for assessment before and after treatment. An effective acupuncture response was defined as a decrease of at least 6 points in the functional index of WOMAC and a decrease of at least 2 points in the NRS.ResultsIn the acupuncture group, the effective response rate was 58.8% and 59.6% for males and females, respectively (P > 0.05). In the electroacupuncture group, the effective response rate was 62.5% and 59.7% for males and females, respectively (P > 0.05). In the sham acupuncture group, the effective response rate was 52.5% and 45.3% for males and females, respectively (P > 0.05).ConclusionThe efficacy of acupuncture in the treatment of knee osteoarthritis is probably unrelated to sex, and the incidence of adverse events seems to be very low regardless of sex, suggesting that acupuncture, as a non-drug therapy, tends is effective and safe.  
        关键词：knee osteoarthritis;acupuncture;response rate;sex   
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      • YOU Mingcan,CHEN Xinwang,YOU Yanwen,HAO Li
        Vol. 46, Issue 1, Pages: 132-140(2023) DOI: 10.3969/j.issn.1006-2157.2023.01.022
        摘要：ObjectiveWe aimed to investigate the effects of electroacupuncture on learning and memory and on the NOD-like receptor protein 3(NLRP3)/cysteine-aspartic proteases-1 (caspase-1) pathway in a mouse model of Alzheimer’s disease (AD) induced by Aβ25-35.MethodsThirty 2-month-old male C57BL/6 mice were divided into control, model, and electroacupuncture groups according to the principle of random assignment, with ten mice per group. The AD mouse model was induced by stereotaxic injection of Aβ25-35 into the bilateral lateral ventricles. The interventions were conducted in the control group (intralateral ventricular injection of sterile saline), model group (intralateral ventricular injection of Aβ25-35), and electroacupuncture group (intralateral ventricular injection of Aβ25-35 and electroacupuncture of GV20 and GV14) respectively. Aβ25-35 and saline were injected into each lateral ventricle at 3 μL. One dose of injection was given and seven days later electroacupuncture was administered. Treatment was carried out for 2 sessions and 6 days per session(1 session of 15 min once per day) with 1 day of rest in between, for a total of 13 days. The Morris water maze, Y-maze, and open field experiments were performed to evaluate the learning and memory abilities of the mice in each group. The expression levels of the inflammatory factors interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in the hippocampus of each group were measured by enzyme linked immunosorbent assay (ELISA). The mRNA levels of NLRP3, caspase-1, and IL-1β in the hippocampus of mice were analyzed by real-time PCR. The protein expression of NLRP3, caspase-1, and IL-1β was investigated with Western blotting.ResultsCompared to the control group, the mice in the model group had a prolonged escape latency on Day 4 and 5 of the Morris water maze (P<0.05) and a reduced number of platform crossings and percentage of time spent in the target quadrant (P<0.05). The spontaneous alternation accuracy of the mice in the Y-maze was significantly reduced (P<0.05). Mice in the open field test had a remarkably lower number of grooming incidents (P<0.05) and spent more time in the central area (P<0.05). The expression of inflammatory factors IL-1β and TNF-α was elevated in the hippocampal tissue of the model group by ELISA (P<0.05). The mRNA and protein expression of NLRP3, Caspase-1 and IL-1β were upregulated in the model group (P<0.05). Compared to the model group, the mice in the electroacupuncture group had a shorter escape latency on Day 5 of the Morris water maze (P<0.05), an increased number of platform crossings and percentage of time spent in the target quadrant (P<0.05), improved accuracy of spontaneous alternation in the Y-maze (P<0.05), a higher number of grooming incidents in the open field (P<0.05), and a shorter time spent in the central area (P<0.05). The expression of IL-1β and TNF-α was reduced in the hippocampal tissue of the electroacupuncture group(P<0.05). The mRNA and protein expression of NLRP3, Caspase-1, and IL-1β were all downregulated in the electroacupuncture group (P<0.05).ConclusionElectroacupuncture at the GV20 and GV14 acupuncture points enhanced learning and memory in the Aβ25-35-induced AD mouse model, which may be related to the alleviation of hippocampal inflammatory responses by electroacupuncture via the NLRP3/caspase-1 pathway.  
        关键词：electroacupuncture;Alzheimer’s disease;learning and memory;NOD-like receptor protein 3/cysteine-aspartic proteases-1;inflammatory response;mice   
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      • CAO Lingxiu,REN Lu
        Vol. 46, Issue 1, Pages: 141-148(2023) DOI: 10.3969/j.issn.1006-2157.2023.01.023
        摘要：ObjectiveBy estabtishing depression with kidney yang deficiency syndrome model rats, to explore the effect of warming kidney for dredging governor channel acupuncture method on warming kidney and regulating spirit, and reveal the mechanism underlying the warming kidney for dredging governor channel acupuncture method.MethodsThe rats were randomly divided into the normal group, model group, warm needle group, inhibitor group, and warm needle combined with inhibitor group, with six rats per group. Except for the normal group, the other groups were given a hydrocortisone hormone injection (intramuscular injection, 25 mg/kg) combined with chronic unpredictable mild stimulation for modeling. Acupuncture and moxibustion were used in the warm needle group and warm needle combined with inhibitor group. The rats in the warm needle combined with inhibitor group and inhibitor group were orally treated with ESI-09 (cAMP-RAF1 signal pathway inhibitor) at a dose of 10 mg/kg 24 h before being sacrificed. Before and after modeling and intervention, the general conditions of rats were observed, and forced swimming and water maze tests were used to observe the behavioral changes in rats. The levels of brain-derived neurotrophic factor (BDNF), 5-hydroxytryptophan (5-HT), dopamine (DA), and norepinephrine (NE) were determined by ELISA. Western blotting was used to detect the expression of cAMP, RAS-related protein 1 (RAP1), and RAF1 proteins in the cAMP-RAF1 signal pathway.ResultsAfter intervention, compared with the normal group, the body weights of the model group, warm needle group, inhibitor group, and warm needle combined with inhibitor group were decreased (P<0.01), as were the anal temperatures of the model group and inhibitor group (P<0.01). Compared with the model group, the body weight and anal temperature of the inhibitor group were decreased (P<0.05, P<0.01), while those of the warm needle group and warm needle combined with inhibitor group were increased (P<0.05, P<0.01). After intervention, compared with the normal group, the forced swimming immobility time of the model group, the inhibitor group and the warm needle combined with inhibitor group was prolonged (P<0.01), and there was no significant difference in the forced swimming immobility time of the warm needle group. Compared with the model group, the forced swimming immobility time of the inhibitor group was prolonged (P<0.01), and the forced swimming immobility time of the warm needle group and warm needle combined with inhibitor group was shortened (P<0.05, P<0.01). After intervention, compared with the normal group, the platform latency, shuttle times of the platform area, and the platform quadrant time ratio of the model group, warm needle group, inhibitor group and warm needle combined with inhibitor group were all decreased (P<0.01). Compared with the model group, the platform latency, shuttle times of the platform area, and the platform quadrant time ratio of the inhibitor group were decreased (P<0.01), but were increased in the warm needle group and warm needle combined with inhibitor group (P<0.01). The contents of BDNF, 5-HT, DA, and NE, and the protein expressions of cAMP, RAP1, and RAF1 in the hippocampus of the model group were lower than those of the normal group (P<0.01), but those were higher in the warm needle group compared with the model group (P<0.01).ConclusionWarming kidney for dredging governor channel acupuncture may restore hippocampal function by regulating the cAMP-RAF1 signal pathway, thus improving depression-like behavior in rats.  
        关键词：depression;kidney yang deficiency;acupuncture and moxibustion;cAMP-RAF1 signal pathway;rats   
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