最新刊期
      卷 46 ， 期 2 ， 2023

        TCM Constitution

      • ZONG Yuhan,LI Lingru,YANG Fan,KONG Jingwei,ZHAO Haihong,CHEN Shunqi,WANG Ji
        Vol. 46, Issue 2, Pages: 149-153(2023) DOI: 10.3969/j.issn.1006-2157.2023.02.001
        摘要：The theory of "constitution-disease relation" is a key scientific problem in the study of constitution in traditional Chinese medicine. The theory states that different constitution types are closely related to the occurrence of some specific diseases. Based on the three theories of constitution-disease relation: the susceptibility theory, the transformation theory, and the soil theory, we expounds the internal relationship between phlegm-dampness constitution and asthma. It is believed that the specific physiological and pathological basis and the genetic susceptibility of phlegm-dampness constitution with obesity as the main external phenotype make this constitution type susceptible to asthma. Phlegm-dampness constitution is the soil of asthma. Moreover, individual differences in the phlegm-dampness constitution population affect the etiology and pathogenesis, the nature of the lesion, and prognosis of asthma. Therefore, both subjective symptoms and objective indicators may be benefited by regulating phlegm-dampness constitution in the diagnosis and treatment of obesity-related asthma clinically.  
        关键词：TCM constitution;constitution-disease relation;asthma;phlegm-dampness constitution   
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        发布时间：2023-03-07
      • WANG Jiemei,QIN Jingbo,XIE Zhiyan,QIAO Mengyuan,LUO Yuxi,XIA Bo,LIANG Yuqing,YANG Yan,WU Wenbin
        Vol. 46, Issue 2, Pages: 154-158(2023) DOI: 10.3969/j.issn.1006-2157.2023.02.002
        摘要：Dementia is the focus and difficulty of chronic disease prevention and management among the elderly. Constitution is the basis of disease development. People with the biased constitution are more likely to suffer from dementia than those with the normal constitution. In the context of China’s national policy of comprehensive healthcare, combined with physical identification based on traditional Chinese medicine (TCM) theory, a diagnosis and treatment model for constitution-disease-syndrome differentiation should be applied flexibly in the prevention and treatment of different stages of the disease, and personalized TCM constitution intervention programs are formulated to correct the biased constitution to prevent and treat dementia, in order to reduce morbidity and mortality. For healthy people, health maintenance is based on constitution differentiation. Patients with subject cognitive decline should adjust their constitution to prevent occurrence of the disease. For patients with mild cognitive impairment, it is recommended to adjust their constitution to prevent further development of the disease. When the disease develops to dementia, it is necessary to combine constitution adjustment and syndrome differentiation to prevent the disease from getting worse. In the dementia stage, treatment can be based on the primary and secondary relationships between constitution, disease, and syndrome. For those people with a weak constitution, constitution adjustment should be preceded by disease and syndrome differentiation; when the disease progresses rapidly, disease differentiation should be the main focus, supplemented with constitution and syndrome differentiation; when the disease is stable, the focus is on the combination of disease differentiation and syndrome differentiation, supplemented with constitution adjustment. This can serve as a theoretical basis to the prevention and treatment of dementia. TCM constitution will make contributions to national healthcare.  
        关键词：dementia;TCM constitution;comprehensive healthcare;constitution differentiation and treatment   
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        发布时间：2023-03-07
      • ZHANG Anqi,WAN Jinyi,YAO Haiqiang
        Vol. 46, Issue 2, Pages: 159-163(2023) DOI: 10.3969/j.issn.1006-2157.2023.02.003
        摘要：Phlegm-dampness constitution is formed by the stagnation and condensation of water and body fluid. It is a constitution type characterized by viscosity, stagnation, and turbidity, and is the common soil of various metabolic diseases. "Spleen being in charge of the defensive function" is a highly generalizing abstraction of the spleen’s function in preventing disease and removing pathogenic factors. Dysfunction of the spleen is an essential pathological factor in the metabolic disorder of phlegm-dampness constitution. However, its microscopic mechanism is still unclear. "Spleen being in charge of the defensive function" and intestinal mucosal immunity have homogenous academic connotations. From the perspective of intestinal mucosal immunity, a new scientific interpretation can be made for the theory of the "spleen being in charge of the defensive function" in traditional Chinese medicine (TCM). Phlegm-dampness constitution is associated with a low degree of chronic inflammation, which can further develop into insulin resistance and metabolic diseases. Intestinal mucosal immune dysfunction plays a crucial role in this pathogenic process. Based on the theory of "spleen being in charge of the defensive function" , the therapeutic method of replenishing qi and strengthening the spleen can be used to effectively regulate intestinal mucosal immunity and improve metabolic disorders, providing a new scientific basis and therapeutic strategy for the clinical management of phlegm-dampness constitution and the treatment of related diseases, which is beneficial to clinical practice.  
        关键词：TCM constitution;phlegm-dampness constitution;spleen being in charge of the defensive function;intestinal mucosal immunity;metabolic disorders   
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        发布时间：2023-03-07
      • JIANG Yuqi,LIU Qingwu,WANG Yaqi,HUANG Jieping,HUANG Chuhan,YANG Dingquan
        Vol. 46, Issue 2, Pages: 164-170(2023) DOI: 10.3969/j.issn.1006-2157.2023.02.004
        摘要：ObjectiveWe aimed to explore the correlation between androgen level and TCM constitution in patients with early-onset androgenetic alopecia (AGA).MethodsEarly-onset AGA patients who visited the Hair Medical Center of the China-Japan Friendship Hospital between November 2020 and April 2021 were selected. The clinical baseline data were collected, and the serum levels of testosterone (T), sex hormone binding globulin (SHBG), and dehydroepiandrosterone sulfate (DHEAS) were determined. The TCM constitution questionnaire was filled out, and TCM constitution identification was carried out. The patients who have effectively completed the TCM constitution questionnaire and serum test were divided into groups, first according to the main constitution, and then according to the composite constitution with the binary classification. The analysis of variance, nonparametric test, and multivariate linear regression analysis were used to analyze the correlation between androgen level and TCM constitution.Results220 patients with early-onset AGA were enrolled. Among them, 195 patients completed the questionnaire and underwent serum test. Among 195 patients in the main constitution, the top four were damp heat constitution (25.64%), balanced constitution (21.03%), qi stagnation constitution (16.41%) and yang deficiency constitution (11.28%). The total frequency of the composite constitution is 310 times, and the top four are damp heat constitution (22.58%), qi stagnation constitution (16.77%), balanced constitution (13.23%) and yang deficiency constitution (12.26%). In the main constitution grouping method, the serum SHBG level of patients with yang deficiency constitution was higher than that of patients with damp heat constitution (P<0.05). The serum DHEAS level of patients with phlegm dampness constitution, qi stagnation constitution and yang deficiency constitution were lower than those with damp heat constitution (P<0.05, P<0.01). The serum DHEAS level of patients with yin deficiency constitution and damp heat constitution were higher than those with balanced constitution (P<0.01). The serum DHEAS level of patients with qi stagnation constitution and yang deficiency constitution were lower than those with yin deficiency constitution (P<0.05, P<0.01). In the composite constitution grouping method, multivariate linear regression analysis showed that T was positively correlated with male and yang deficiency constitution. SHBG was negatively correlated with male, BMI, degree of AGA, and damp heat constitution; DHEAS was positively correlated with male, BMI, and damp heat constitution and negatively correlated with age, balanced constitution and phlegm dampness constitution.ConclusionThe serum levels of T, SHBG, and DHEAS in patients with early-onset AGA are related to the TCM constitution. Androgen plays a key role in many systemic diseases, and the study of TCM constitution can provide a new way to explain the correlation.This study suggests that we should pay attention to the recuperation of patients with different TCM constitutions, the comprehensive intervention of serum androgens and other endocrine hormones, and the possibility of subsequent complications of other systemic diseases with early-onset AGA.  
        关键词：androgenetic alopecia;TCM constitution;testosterone;sex hormone binding globulin;dehydroepiandrosterone sulfate   
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        发布时间：2023-03-07

        Theoretical Studies

      • LI Ming,DING Yanting,TAO Xiaohua
        Vol. 46, Issue 2, Pages: 171-175(2023) DOI: 10.3969/j.issn.1006-2157.2023.02.005
        摘要：Among the prescriptions recorded in the Treatise on Febrile and Miscellaneous Diseases, animal drugs are widely used. Their variety is high, their classification varies, and most of them are insect-based drugs, which are cheap and readily available. Most animal drugs are processed, for example by stir-frying or baking, before being used as medicine, and some are used directly. The five flavors of animal drugs are mainly salt and sweet, and the four natures is mainly coldness. Animal drugs such as Gadfly, Leech, and Woodlouse can break stagnancy and eliminate blood stasis, clear the channels, and move blood downward; animal drugs such as Turtle shell and Hive can reduce phlegm and eliminate stasis, relieve mass, and eliminate nodes; animal drugs such as Oyster can tranquilize the mind, nourish yin, and clear heat; animal drugs Donkey-hide glue, Egg, Pigskin, and Mutton can tonify the body and strengthen resistance; and animal drugs such as Honey, Pig bile, and Urine can reduce toxicity, correct the biased, and be used as corrigent. Animal drugs are mainly used in pill and powder form. Research of animal drugs can be of great significance for clinic treatment.  
        关键词：Treatise on Febrile and Miscellaneous Diseases;animal drugs;processing;efficacy   
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        发布时间：2023-03-07
      • ZHANG Xinyu,LI Mengfei,WANG Guiqing,CHEN Liya,JIANG Miao
        Vol. 46, Issue 2, Pages: 176-180(2023) DOI: 10.3969/j.issn.1006-2157.2023.02.006
        摘要：Blood depletion disease originates from Huangdi Neijing. The clinical symptoms are fullness and discomfort in the chest and hypochondrium, poor diet, hemoptysis, blood in the urine, blood in the stool, even in woman with amenorrhea. The Siwuzeigu Yiluru Pill can be used to treat blood depletion disease, although physicians of later generations had different opinions on the etiology, pathogenesis, treatment, and prescription of blood depletion disease. It was even believed that the cuttlefish bone in Siwuzeigu Yiluru Pill has astringent effects, while India madder root is used to promote blood circulation. However, astringent is contrary to the effect of promoting blood circulation, and difficult to grasp clinically, the classic prescription almost disappeared. Zhang Xichun, a famous physician of the Republic of China, inherited the spirit of Huangdi Neijing and integrated traditional Chinese medicine and Western medicine. He provided innovative research on blood depletion disease in his representative work Records of Tradition Chinese and Western Medicine in Combination, which can be roughly summarized into two points as new prescriptions for ancient diseases and new use of ancient herbal prescriptions. Our team attempted to sort the new prescriptions created by Zhang Xichun to treat blood depletion disease, including Lichong Decoction, Lichong Pill, Zisheng Decoction, Zisheng Tongmai Decoction, Liquan Decoction, Huayu Tongjing Powder, and Shiquan Yuzhen Decoction, from the perspective of new prescriptions for ancient diseases. He believed that stagnation of heart and spleen deficiency and blood stasis underlie the pathogenesis of blood depletion disease, and suggested that the most effective treatment would be to strengthen the vital energy and eliminate the pathogenic factor, while concurrently promoting digestion, removing blood stasis and removing stagnation, nourishing yin for reducing fire. However, we also aimed to discuss Zhang Xichun’s idea of removing the limitation of the contradictory efficacy of cuttlefish bone and India madder root in the new use of the ancient herbal prescription. We used the bidirectional regulating effect of the medicine to remove stagnation and astringency to treat diseases such as morbid vaginal discharge, metrorrhagia, difficulty and pain in micturition, hemafecia, and hematuria, which broadened the applicability of the ancient prescription. These points provide new ideas for the clinical treatment of gynecopathy and andrological disease, which broaden the applicability of the ancient prescription and have important guiding significance for clinical practice.  
        关键词：blood depletion disease;Records of Tradition Chinese and Western Medicine in Combination;Zhang Xichun;new prescriptions for ancient diseases;new use of ancient herbal prescriptions   
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        发布时间：2023-03-07
      • YANG Deshuang,HUANG Li,YAO Ruiqi,GUO Shuzhen
        Vol. 46, Issue 2, Pages: 181-185(2023) DOI: 10.3969/j.issn.1006-2157.2023.02.007
        摘要：Diabetic cardiomyopathy (DCM) is one of the complications of diabetes. According to traditional Chinese medicine (TCM), the pathogenesis of DCM is likely that, due to the overeating and the deficiency of spleen’s transport and transformation functions, water and grain are stuck in the middle jiao. The "sugar poison" is generated. The "sugar poison" enters the pulse, travels with the pulse, and accumulates in the heart. The blood stagnation becomes the blood stasis, the blood stasis produces heat and then turns into poison over time, and then blood stasis and poison intersect together. The blood stasis and the poison are confined in the heart for a long time, the poison damages the heart’s veins, defeats the vital qi of the heart, and then damages its function and body. According to Western medicine, blood stasis and poison in TCM are caused by accumulation of abnormal metabolic substances in the body. Based on the classical theory of TCM, combined with modern clinical and basic research, our team systematically expounds the etiology and pathogenesis of DCM from the perspective of blood stasis and poison. And our team proposes that according to the degree of blood stasis and poison, the prescriptions for removing turbidity and detoxification, promoting blood circulation and removing blood stasis could put forward from the whole and local perspectives. According to the spatio-temporal node of blood stasis and poison in the DCM and treat it by stages according to the nodes, so as to provide some experience for basic and clinical research.  
        关键词：diabetic cardiomyopathy;blood stasis and poison;etiology;pathogenesis;whole;local   
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        发布时间：2023-03-07
      • WANG Yuhan,LIU Fuming
        Vol. 46, Issue 2, Pages: 186-190(2023) DOI: 10.3969/j.issn.1006-2157.2023.02.008
        摘要：Atherosclerosis (AS) is one of the typical diseases in arteriosclerosis and is characterized by the accumulation of rich yellow atheromatous lipids in the affected vessels starting from the intima and gradually forming lesions. Considering the pathogenesis differentiation and treatment of early AS, we propose the theory of "Channel Injury" , which starts with treatment of the main location. This core of this theory is the mutual causality of "turbidity reversal will damage the pulse pathway, and the disharmony between nutrient qi and defensive qi will damage the pulse pathway" . The correlation between the mechanical regulation of hemodynamic shear stress by endothelial cells and the theory of "Channel Injury" are extended from the medical molecular mechanism and pathogenesis of early AS. Based on the core view that "turbidity reversal with damage the pulse pathway, and the disharmony between nutrient qi and defensive qi will damage the pulse pathway" , the prevention and treatment measures are based on the method of "restoring the pulse and helping the righteousness" and the principle of "healing from its qi" . As the pulse pathway is self-damaging, the treatment still needs to heal the pulse as the basis. The aim is to detect clinical symptoms in the early stage of AS, and improve the accuracy of Chinese medicine in its prevention and treatment.  
        关键词：Channel Injury;atherosclerosis;hemodynamic shear stress;recovering the channel and healing qi   
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        发布时间：2023-03-07
      • WANG Guibin,PANG Bo,PIAO Bingkui
        Vol. 46, Issue 2, Pages: 191-195(2023) DOI: 10.3969/j.issn.1006-2157.2023.02.009
        摘要：Ancient and modern doctors often take "warmth of labor" as an important rule for the treatment of asthenia, but their understanding is different, the solution of "warming" is especially controversial. On the basis of tracing the source of words, combined with medical theory and clinical thinking, we searched the relevant records of labor syndrome in ancient books and documents and further examined the connotation of "warmth of labor" , the meaning of "warming" should cover three aspects: warming is nourishing, focusing on the restoration of genuine qi; warming is softness, paying attention to the relaxation of governance; and warming is the meaning of transformation, focusing on the cultivation of vitality. These three aspects are in fact one. They all aim at cultivating, transforming, and generating the essence of life, which can be used for reference.  
        关键词：warmth of labor;Huangdi Neijing;connotation;asthenia;traditional Chinese medicine   
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        发布时间：2023-03-07

        Experimentmental Studies

      • MA Jizheng,ZHU Jiajie,SONG Dechao,WANG Dongfang,FENG Shuo,LIU Shaoneng,TAO Xiaping
        Vol. 46, Issue 2, Pages: 196-206(2023) DOI: 10.3969/j.issn.1006-2157.2023.02.010
        摘要：ObjectiveWe aimed to investigate the molecular mechanisms underlying the effects of Jianpi Shengqing Decoction (JPSQ, a compound prescription for invigorating spleen and upbearing the clear) on lipid metabolism in a rat model of non-alcoholic fatty liver disease (NAFLD). We focused on the farnesoid X receptor (FXR)/small heterodimer protein (SHP)/sterol regulatory element binding protein 1c (SREBP-1c) and FXR/apolipoprotein CⅡ (ApoCⅡ) pathways.MethodsAccording to the random number table method, forty-eight Sprague-Dawley rats were divided into the blank group, the model group, the JPSQ high-dose group, the JPSQ medium-dose group, the JPSQ low-dose group, and the obeticholic acid group (n=8 rats per group). The rats in the blank group were fed normally, and the other rats were fed a high-fat diet for 12 weeks to establish the NAFLD model. The blank and model groups were given saline; the high-, medium-, and low- dose groups were administered 15.2, 7.6, and 3.8 g/kg JPSQ, respectively; the obeticholic acid group was given 10.0 mg/kg, once daily for 4 weeks. Body weight and Lee’s index were recorded. The serum levels of TC, TG, LDL, and HDL were measured using immunoenzymatic assays, and the inflammation, steatosis, and ballooning degeneration of liver tissue were observed and scored under the microscope. The protein expression levels of FXR, SHP, SREBP-1c, and ApoCⅡ in liver were detected by immunohistochemistry (IHC), and the mRNA levels were determined by RT-PCR.ResultsThe body weight, Lee’s index, and serum TC levels were lower in the JPSQ high-, medium-, and low- dose groups than in the model group (P<0.05, P<0.01). The inflammation scores in the JPSQ high-, medium-, and low- dose groups were lower than in the model group (P<0.01). The steatosis scores in the JPSQ medium- and low- dose groups were lower than in the model group (P<0.05, P<0.01), and the ballooning degeneration scores in the JPSQ medium-dose group were lower than in the model group (P<0.01). IHC result showed that the protein expression levels of FXR were higher in the JPSQ high-dose and obeticholic acid groups than in the model group (P<0.05). Levels of SHP and ApoCⅡwere lower in the model group than that in the blank group (P<0.05), but no significant differences were seen in the JPSQ high-, medium-, low- dose and obeticholic acid groups compared with the model group. SREBP-1c levels were lower in the JPSQ medium-dose and obeticholic acid groups than in the model group (P<0.05, P<0.01). RT-PCR result showed that the FXR mRNA levels were higher in the JPSQ medium-dose group than in the model group (P<0.05). The SHP mRNA levels were higher in the JPSQ high-dose group than in the model group (P<0.05). The SREBP-1c mRNA levels were lower in the JPSQ medium-dose and obeticholic acid groups than in the model group (P<0.01).ConclusionJianpi Shengqing Decoction may play a role in the treatment of NAFLD by regulating lipid metabolism through the FXR/SHP/SREBP-1c signaling pathway. It promoted the decomposition of TC and TG, and improved the state of steatosis of liver tissue and reduced inflammatory tissue damage in model rats.  
        关键词：Jianpi Shengqing Decoction;non-alcoholic fatty liver disease;lipid metabolism;farnesoid X receptor;Yiqi Congming Decoction;Pingwei Powder;rats   
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        发布时间：2023-03-07
      • LIU Mengrui,HAO Yanzhi,ZUO Qianqian,CHEN Jing,YU Zhifang,DUAN Mei,LIANG Xiao,SONG Cuimiao,DU Huilan
        Vol. 46, Issue 2, Pages: 207-214(2023) DOI: 10.3969/j.issn.1006-2157.2023.02.011
        摘要：ObjectiveThe potential of Bushen Tiaojing Recipe to improve the 2-cell embryonic development of mice with repeated controlled ovarian stimulation (COS) was studied by observing the relationship between tricarboxylic acid cycle (TCA) enzymes and epigenetic modifications during the embryonic zygotic genome activation period (ZGA).MethodsFemale mice with a normal estrous cycle were divided into the normal group, the model group, the kidney tonifying low dose group, and the kidney tonifying high dose group (n=25 mice per group). Except for the normal group, COS models were established in other groups. Mice in the model group and the treatment groups were treated with repeated controlled ovarian stimulation. Mice in these three groups were given distilled water, low dose Bushen Tiaojing Recipe (25.6 g/kg), or high dose Bushen Tiaojing Recipe (51.2 g/kg) by gavage at 9: 00 am every day for 10 consecutive days. On the 11th day, 10 IU of pregnant horse serum gonadotropin (PMSG) was intraperitoneally injected at 16: 00 pm, on the 13th day, 10 IU of human chorionic gonadotropin (hCG) was intraperitoneally injected at 16: 00 pm. Mice in the normal group were injected with 0.1 mL of normal saline. There were 3 consecutive cydes with an internal of 4 days between every two cycles. After the third intraperitoneal injection, the mice were immediately caged with male mice of the same strain. In the morning of the next day, the female mice with vaginal plug or sperm on the vaginal smear were considered as pregnant. The pregnant mice were killed 44-46 h after the last intracperitoneal injection of hCG. The two-cell embryos were taken out under an inverted microscope for morphological observations and counted. The protein expression levels of pyruvate dehydrogenase (PDH), citrate synthase (CS), isocitrate dehydrogenase (IDH3A), and sex determination region Y box protein 2 (SOX2) and the levels of acetylated histone 3 lysine 9 (H3K9ac) in two-cell embryos were detected by immunofluorescence. The mRNA expression levels of PDH, CS, IDH3A, and SOX2 in two-cell embryos were detected by RT-PCR.ResultsCompared with the normal group, the number of two-cell embryos was increased in the model group (P<0.05), the morphology was obviously disrupted, and the development was poor. The mRNA and protein expression levels of PDH, CS, IDH3A, and SOX2 were decreased (P<0.05), while the protein expression level of H3K9ac was increased (P<0.05). Compared with the model group, there was no significant difference in the number of two-cell embryos obtained in the kidney tonifying low and high dose groups (P>0.05), with complete morphological development and fewer fragments. The mRNA and protein expression levels of PDH, CS, IDH3A, and SOX2 were increased (P<0.05), while the protein expression level of H3K9ac was decreased (P<0.05).ConclusionBushen Tiaojing Recipe can (i) affect the epigenetic modifications of two-cell embryos of repeated COS mice in ZGA and (ii) improve the embryonic developmental potential. It is speculated that its mechanism of action may be related to the influence of TCA enzymes.  
        关键词：Bushen Tiaojing Recipe;two-cell embryos;tricarboxylic acid cycle enzymes;epigenetic modification;embryonic developmental potential;mice   
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        发布时间：2023-03-07
      • WU Jing,TIAN Weiyi,CAI Kun,LI Yaofeng,YANG Shasha
        Vol. 46, Issue 2, Pages: 215-223(2023) DOI: 10.3969/j.issn.1006-2157.2023.02.012
        摘要：ObjectiveTo explore the mechanism of Dajianzhong Decoction in treating visceral pain and depression associated with diarrhea irritable bowel syndrome.MethodsChronic unpredictable stimulation and dextran sodium sulfate were used to establish a rat model with visceral pain and depression associated with diarrhea irritable bowel syndrome. The rats were randomly divided into normal group, model group, Dajianzhong Decoction group [10.8 g/(kg·d)] , and fluoxetine group [0.01 g/(kg·d)] . After 14 days of treatment, the depression level of the rats in each group was evaluated by forced swimming, the intestinal pain sensitivity of the rats in each group was evaluated by abdominal wall withdrawal reaction (AWR), the interleukin (IL)- 1β, tumor necrosis factor-α (TNF-α), IL-10, and IL-4 expression in the anterior cingulate cortex (ACC) of the rats in each group were detected by enzyme linked immunosorbent assay. Western blotting was used to detect the expression of myelin sheath lipoprotein (PLP), myelin oligodendrocyte glycoprotein (MOG), myelin basic protein (MBP), microtubule associated protein 1 light chain 3-Ⅱ(LC3-Ⅱ), p62, Beclin-1, microglial cell (MG)-associated protein Arg1, and inducible nitric oxide synthase (iNOS). The coexpression of autophagy related protein LC3-Ⅱ and MG calcium binding adaptor molecule 1 (Iba1) in the ACC region was observed by the immunofluorescence double labeling method .ResultsCompared with the normal rats, the model rats showed shorter forced swimming times (P<0.01), and increased immobility times (P<0.01). The AWR fraction increased under pressures of 20, 40, and 60 mmHg. The protein levels of PLP, MOG, and MBP in the anterior cingulate cortex decreased (P<0.01), and iNOS protein increased (P<0.01). The proinflammatory factors TNF-α and IL-1β increased significantly (P<0.01). We observed an increasing trend in the levels of the anti-inflammatory factors IL-10 and IL-4; LC3-Ⅱ and Beclin-1 protein decreased significantly (P<0.01); p62 protein increased (P<0.01); and the number of cells that were positive for LC3-Ⅱ and Iba1 decreased (P<0.01). Compared with the model group, the immobility time and AWR scores under various pressures in the Dajianzhong Decoction group decreased (P<0.01). In the Dajianzhong Decoction group, the protein levels of PLP, MOG, MBP in the anterior cingulate cortex increased (P<0.01); Arg1 protein increased (P<0.01); iNOS protein decreased (P<0.01); TNF-α and IL-1β decreased (P<0.01); IL-10 and IL-4 increased (P<0.01); LC3-Ⅱ and Beclin-1 protein increased (P<0.01); p62 protein decreased (P<0.01); and LC3-Ⅱ, Iba1 positive cells increased significantly (P<0.01). There was no significant difference in the above indices between the fluoxetine group and the Dajianzhong Decoction group.ConclusionThe mechanism of Dajianzhong Decoction in treating visceral pain and depression associated with diarrhea irritable bowel syndrome may involve promoting autophagy to regulate microglia to clear myelin sheath fragments.  
        关键词：diarrhea irritable bowel syndrome;depression;autophagy;microglia;Dajianzhong Decoction;rats   
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        发布时间：2023-03-07
      • LIU Jiapeng,FENG Jing,CHE Yu’e,ZHANG Xiaofeng,LIU Yumeng,WANG Qian,LI Shuyu
        Vol. 46, Issue 2, Pages: 224-231(2023) DOI: 10.3969/j.issn.1006-2157.2023.02.013
        摘要：ObjectiveTo investigate the effects of Shenqi Wan on renal damage in Zucker diabetic fatty (ZDF) rats and the underlying mechanisms.MethodsTwenty 8-week-old male ZDF rats were given 5C08 high-fat fodder for four weeks to induce diabetes. ZDF rats were randomly divided into the model group and the Shenqi Wan group. Seven male Zucker lean rats of the same age were used as the control group. Rats in the Shenqi Wan group were given Shenqi Wan decoction (8.12 g/kg). Rats in the model group and the control group were given the same amount of normal saline. Rats were continuously administered for 4 weeks. The general condition of rats was observed regularly. The fasting blood glucose (FBG) and 24-hour urinary microalbumin (24 h U-mAlb) levels were measured. Renal tissue was stained and morphology was observed. The ultra-microstructure was observed by transmission electron microscopy. The mRNA levels of GRP78, Beclin-1, and LC3 in rat renal tissue were examined by real-time PCR and the protein levels were examined by Western blotting.ResultsCompared with the model group, rats in the Shenqi Wan group showed improved fur gloss, more weight increase(P<0.05); both FBG and 24 h U-mAlb levels were decreased (P<0.05). The kidneys of rats in the model group showed dilated glomerular capillaries, irregularly thickened basement membranes, widened mesangial areas, and segmental sclerosis; renal tubular atrophy and renal interstitial fibrous tissue were also observed in these kidneys. These pathological changes were alleviated in the Shenqi Wan group. Compared with the model group, both gene and protein levels of GRP78 were decreased (P<0.05) in the Shenqi Wan group; the protein level of Beclin-1 was decreased (P<0.05); and the protein level of LC3 was increased (P<0.05).ConclusionShenqi Wan may alleviate renal damage in ZDF rats with type 2 diabetes mellitus and delay the progression of diabetic kidney disease by reducing endoplasmic reticulum stress and enhancing autophagy.  
        关键词：Shenqi Wan;type 2 diabetes mellitus;diabetic kidney disease;endoplasmic reticulum stress;autophagy;GRP78;Zucker diabetic fatty rats   
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      • SUN Song,CHAI Limin,FENG Guiyu,LI Dongyang,ZHANG Pingxin,LIU Wei,ZHANG Yingkai
        Vol. 46, Issue 2, Pages: 232-241(2023) DOI: 10.3969/j.issn.1006-2157.2023.02.014
        摘要：ObjectiveTo investigate the mechanism underlying the regulatory effects of freeze-dried powder of aqueous extract of Lonicera japonica Thunb. on the migration of rat T lymphocytes in a coculture system.MethodsTranswell was used to establish a coculture system of rat peripheral blood T lymphocytes and rat synovial cell line RSC-364 cells, and interleukin-1β (25 μg/L) was used to induce the inflammatory injury model of cells. The freeze-dried powder of aqueous extract of Lonicera japonica Thunb. (100 and 250 mg/L) was used as the intervention measure, and interleukin-1β inhibitor (25 μg/L) was used as the positive control. The components of aqueous extract of Lonicera japonica Thunb. were analyzed by high-performance liquid chromatography-electro spray ionization/mass spectrometry (HPLC-ESI/MS). HE staining was used to observe the morphological changes of synovial cells. The change of lymphocyte migration index was determined by real-time cellular analysis(RTCA). The percentage changes of CD3+ CD4+ T cells and CD3+ CD8+ T cells were detected by flow cytometry, and the concentrations of sVCAM-1 and sICAM-1 in the coculture system were detected by ELISA.ResultsThe result of HPLC-ESI/MS analysis showed that the main components of freeze-dried powder of aqueous extract of Lonicera japonica Thunb. were caffeic acid and rutin, etc. After the intervention of freeze-dried powder of aqueous extract of Lonicera japonica Thunb., HE staining showed that the number of synovial cells was decreased and the cell morphology had changed to varying degrees; the cells were round, the cytoplasm was deeply stained, and the nucleus was relatively distinct. Compared with the model group, the migration index of T lymphocytes in the aqueous extract of Lonicera japonica Thunb. low-dose group at 48 h and the aqueous extract of Lonicera japonica Thunb. high-dose group at 24 and 48 h measured by RTCA decreased (P<0.05, P<0.01). Compared with the model group, the percentage of CD3+ CD4+ T cells in the aqueous extract of Lonicera japonica Thunb. low-dose and high-dose groups decreased at 24 and 48 h (P<0.01), and the percentage of CD3+ CD8+ T cells in the aqueous extract of Lonicera japonica Thunb. high-dose group decreased at 48 h (P<0.01). Compared with the model group, ELISA result showed that the concentrations of cytokines sVCAM-1 and sICAM-1 in the aqueous extract of Lonicera japonica Thunb. low-dose and high-dose groups in the coculture system decreased at 24 and 48 h (P<0.01).ConclusionThe freeze-dried powder of aqueous extract of Lonicera japonica Thunb. can reduce the contents of sICAM-1 and sVCAM-1, inhibit the migration of lymphocytes to synovial cells, inhibit the migration and infiltration of CD4+ T and CD8+ T cells to reduce inflammation, alleviate the inflammatory proliferation of synovial cells, slow down and block the disease development process of rheumatoid arthritis, so as to alleviate inflammation.  
        关键词：freeze-dried powder of aqueous extract of Lonicera japonica Thunb.;lymphocyte;migration;coculture system;rheumatoid arthritis   
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        Clinical Studies

      • MENG Han,WANG Hongwu
        Vol. 46, Issue 2, Pages: 242-246(2023) DOI: 10.3969/j.issn.1006-2157.2023.02.015
        摘要：Kenang theory is an important theory of the combination of phlegm and static blood, which has been continuously developed and perfected through the clinical practice of doctors of all ages. In recent years, people have paid more attention to pulmonary nodules, a common and frequently occurring respiratory disease. In the present paper, we discuss the pathogenesis and treatment of pulmonary nodules based on Kenang theory.Traditional Chinese medicine theory holds that pulmonary nodules are often found deep in the lungs, and the pathogenic factor is hard to remove. Pulmonary nodules are difficult to treat. Regulating qi, transforming phlegm, and circulating blood are the basic treatment principles, and these therapeutics need to be applied comprehensively for a long time.  
        关键词：Kenang;pulmonary nodules;combination of phlegm and static blood;transforming phlegm and circulating blood;regulating qi   
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      • QU Yiwei,MA Dufang,WU Tao,WANG Yong
        Vol. 46, Issue 2, Pages: 247-251(2023) DOI: 10.3969/j.issn.1006-2157.2023.02.016
        摘要：Sunluo refers to the terminal structural branches of the meridian system, which is equivalent to the microvessels in Western medicine and are closely related to the heart. "Eliminate peculiar pathogen and circulate Yingwei" is a classical theory about Sunluo in Huangdi Neijing, which has important guiding significance for the prevention and treatment of myocardial fibrosis (MF) with traditional Chinese medicine. Referring to the physiological function of Sunluo’s "eliminate peculiar pathogen and circulate Yingwei, " this paper is based on the belief that MF is caused by a peculiar pathogen invading Sunluo and blocking Yingwei, which leads to internal resistance of blood stasis, which further affects the biochemical function of Yingwei, leads to the imbalance of body fluid and blood, and finally leads to water stagnation. With the mutual formation of stasis and water, the collaterals accumulate for a long time, which eventually leads to collaterals block. According to Western medicine, the renin-angiotensin-aldosterone system can interfere with cardiac microvessels, which not only damages vascular endothelial cells and leads to blood stasis and extravasation of water, but also causes vascular endothelial cells and immune cells to act abnormally on fibroblasts and promote fibroblasts to synthesize collagen protein, leading to excessive deposition of extracellular matrix and eventually leading to MF. Treatment is mainly based on promoting blood circulation and diuresis, as well as nourishing Sunluo, reconciling Yingwei, and treating the root, aiming at making Yingwei flow, blood vessels smooth, yin and yang interlinked to restore coronary microcirculation homeostasis, so as to prevent and treat MF.  
        关键词：myocardial fibrosis;Sunluo;eliminate peculiar pathogen;circulate Yingwei;blood stasis and water stagnation;activating blood and diuretic water   
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      • ZHANG Wenhan,WU Zhenqi
        Vol. 46, Issue 2, Pages: 252-256(2023) DOI: 10.3969/j.issn.1006-2157.2023.02.017
        摘要：Children’s visceral organs are fragile, and their morphology and physiological functions are not yet full. As a delicate organ, the lung is most vulnerable to evil. The lung suits dampness but is unaccustomed to dryness and is therefore susceptible to disease caused by dryness evil. In the pathogenesis of mycoplasma pneumoniae pneumonia (MPP) in children, dry cough is the main clinical symptom, which is consistent with the pathogenesis of lung injury caused by dryness evil. MPP in children is caused by dryness evil, and can be divided into two pathological states, namely, deficiency and obstruction of fluid, according to the depth of the disease and the degree of injury to fluid. Based on this, the theory of "flowing fluid to moisten dryness" is proposed. In this theory, moistening is applied to maintain the flow of fluid, so that the meridians can be opened, fluid can be transported, and the organs can be irrigated and nourished. Our team believe that dryness evil injuring the lung fluid and the obstruction of fluid are fundamental factors in the development of MPP in children. External dryness evil attacking the body, internal dryness evil burning the fluid, and evil becoming poisonous over time are key to the de-velopment of MMP. Treatment should consider the physiological and pathological characteristics of the children and be performed under the guidance of the theory of "flowing fluid to moisten dryness, " including applying the moistening method to moisten the lung, nourish the fluid, and dispel the evil. This should be performed in combination with the tonic method, clearing method, and lowering method. By combining multiple method, the lung fluid will be full, the evil will be removed, and the body will become healthy.  
        关键词：flowing fluid to moisten dryness;mycoplasma pneumoniae pneumonia;pediatrics;dryness evil;moistening method   
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      • QIAO Chenxi,ZHAO Jian,HU Shuaihang,ZHOU Tong,HOU Wei
        Vol. 46, Issue 2, Pages: 257-262(2023) DOI: 10.3969/j.issn.1006-2157.2023.02.018
        摘要：The theory of traditional Chinese medicine believes that children’s shaoyang constitution affects the evolution of disease. "Shaoyang dominating bone" highly summarizes the pathogenesis of bone disease, and children’s bone tumor presents typical shaoyang pathogenesis characteristics in many aspects. Therefore, this paper combined the theory of "shaoyang dominating bone" with shaoyang as the pivot, shaoyang meridians circulation, the gallbladder having the nature of stiff, shaoyang’s qi being fire in nature and manifested as yang, corresponding to a high incidence in joints, bone marrow, soft tissue, or a wide range in children’s bone tumor, explained the mechanism of shaoyang effects bone strength, cold or heat syndrome, pathological type and metastasis, and elucidated the guiding significance of shaoyang in the pathogenesis of children bone tumor preliminarily.  
        关键词：shaoyang;children;bone tumor;shaoyang dominating bone   
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      • LI Qiuye,JIANG Haiyang,CHEN Wei,WANG Shuai,HE Fanyu,WANG Fengrong
        Vol. 46, Issue 2, Pages: 263-268(2023) DOI: 10.3969/j.issn.1006-2157.2023.02.019
        摘要：ObjectiveWe aimed to explore the correlation between depression in patients with unstable angina pectoris after coronary revascularization and the levels of platelet (PLT), total lymphocyte count (TLC), platelet-lmphocyte ratio (PLR), and total bilirubin (TBIL) and specific TCM syndromes.MethodsAltogether 87 patients with unstable angina pectoris after coronary revascularization from November 2020 to July 2021 were selected. Laboratory examination was conducted after admission, including PLT, TLC, and TBIL values. The PLR was obtained by calculating the ratio of PLT and TLC. On the same day, the patient's Hamilton Depression Scale (HAMD) score was collected. Patients with a score between 8 and 24 were included in the depression group (42 cases); patients with a score below 8 were included in the control group (45 cases). Bivariate Spearman correlation analysis was conducted to investigate the relationship between each laboratory examination indices (PLT, TLC, TBIL, and PLR) and depression. Then, depression was taken as a dependent variable and each above laboratory examination index was taken as an independent variable to conduct binary Logistic regression analysis to determine the influencing factors. TCM syndromes (qi stagnation and blood stasis syndrome, qi stagnation and phlegm stagnation syndrome, and syndrome of qi depression transforming into fire) were classified by assigning values of 1 and 0, and Spearman correlation analysis was conducted. Then, the subjects were divided into compliance and non-compliance subgroups according to different TCM syndromes, and the independent sample t-test was conducted for laboratory examination indices with statistical significance in Spearman correlation analysis.ResultsPLT (r=0.312, P=0.003) and PLR (r=0.486, P<0.001) were positively correlated with the occurrence of depression, while TLC (r=-0.296, P=0.005) and TBIL (r=-0.424, P<0.001) were negatively correlated with the occurrence of depression. PLT was positively correlated with the occurrence of qi stagnation and blood stasis syndrome (r=0.354, P=0.001), and TLC (r=-0.229, P=0.033) and PLR (r=0.293, P = 0.006) were negatively or positively correlated with the occurrence of syndrome of qi depression transforming into fire, respectively.ConclusionPLR is an independent risk factor for depression in patients with unstable angina pectoris after coronary revascularization, and TBIL is a protective factor. High levels of PLT are closely related to the occurrence of qi stagnation and blood stasis syndrome, and high levels of TLC and PLR are related to the occurrence of syndrome of qi depression transforming into fire.  
        关键词：angina pectoris after coronary revascularization;depression;platelet-lymphocyte ratio;traditional Chinese medicine syndrome: correlation   
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      • MA Huilan,GUO Yanfen,LU Kunbin,DAI Yamei,LUO Yujie,WU Fangzhen,CHEN Yuyu,ZHAO Yushan,WANG Zhengyang,CHEN Shanni,ZHAO Zhongwen
        Vol. 46, Issue 2, Pages: 269-272(2023) DOI: 10.3969/j.issn.1006-2157.2023.02.020
        摘要：Postpartum arthralgia belongs to the category of "arthralgia syndrome" in traditional Chinese medicine, in which clinical syndromes are mostly characterized by "multiple deficiency and much blood stasis" after childbirth. Treatment method includes tonifying deficiency and reducing excess. Xuanfu and collaterals are not only all over the body, but also subtle and difficult to observe. They interact with each other and connect the internal and external body. They are not only the functional channels for transporting qi, blood, and body fluids, but also key disease sites for the invasion of external evils, phlegm and blood stasis, and other evils. Therefore, based on the theoretical system of "Xuanfu-collaterals" , in the present paper we clarify the physiological functions of unblocked Xuanfu, vigorous collaterals, recuperated nutrient blood and defensive qi, and healthy internal organs. It is proposed that the impermanence of opening and closing of the Xuanfu, the impermanence of the collaterals, and the disharmony of the nutrient blood and defensive qi are the basic pathogenesis of postpartum paralysis. Clinically, treatment is based on opening the Xuanfu and relieving the blood stasis, tonifying deficiency and dredging collaterals, and reconciling nutrient blood and defensive qi. This study provides new ideas for understanding and treating postpartum paralysis at the microstructure level of traditional Chinese medicine.  
        关键词：postpartum arthralgia;Xuanfu;Collaterals;nutrient blood and defensive qi   
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        Chinese Medicinal Chemistry

      • LI Yan,YANG Fan,SUN Meng,LI Xiang,TU Guangzhong,JIANG Yanyan,LIU Bin
        Vol. 46, Issue 2, Pages: 273-280(2023) DOI: 10.3969/j.issn.1006-2157.2023.02.021
        摘要：ObjectiveTo study the reference substance of angoroside C using mass balance method and quantitative nuclear magnetic resonance method .MethodsThe structure was confirmed by ultraviolet-visible spectrometry, infrared spectrum, mass spectrometry, and nuclear magnetic resonance. The purity was checked by thin layer chromatography and high pressure chromatography. The moisture content, residual solvent, and ignition residue in the sample were determined, and the uniformity and stability were checked. The mass balance method was used to determine the value of angoroside C, and the uncertainty was calculated. The content of angoroside C was further determined by quantitative nuclear magnetic resonance method, and the assignment result were verified.ResultsThe certification result of the mass balance method was 94.04%, and the expanded uncertainty was 0.088%. The result of quantitative nuclear magnetic resonance method was 94.06%.ConclusionThe certification result of angeloside C using the mass balance method and the quantitative nuclear magnetic resonance method were basically consistent. The two method corroborate each other, which can better ensure the accuracy of the certification of angoroside C, and lay a foundation for the research and development of its reference substance.  
        关键词：angoroside C;reference substance;certification;mass balance method;quantitative nuclear magnetic resonance method   
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        Chinese Medicinal Resources

      • LIAN Tianci,WEI Shengli,FENG Ziwei,YU Fang,ZHAO Ting,LIU Fang,TIAN Wencang,LIU Fengbo,ZHANG Yuan
        Vol. 46, Issue 2, Pages: 281-288(2023) DOI: 10.3969/j.issn.1006-2157.2023.02.022
        摘要：ObjectiveWe aimed to determine and analyze the flavonoid contents in Astragali Radix from different habitats, so as to provide an experimental basis for the accurate origin identification of Astragali Radix from Zizhou.MethodsThe root segments of Astragalus membranaceus (Fisch.) Bge.var. mongholicus (Bge.) Hsiao from Zizhou County of Shaanxi Province, Hunyuan County of Shanxi Province, Inner Mongolia Province, and Gansu Province, were used as experimental materials. High-performance liquid chromatography photo-diode array (HPLC-PDA) was used to determine the main flavonoid contents in Astragali Radix. Based on the flavonoid content data of Astragali Radix from 0.7 to 1.0 cm in diameter, the quality difference markers of Astragali Radix from Zizhou and other habitats were screened and a discrimination model was constructed by principal component analysis (PCA), orthogonal partial least squares discriminant analysis (OPLS-DA), cluster analysis, and Fisher discriminant analysis.ResultsThe main flavonoid contents in Astragali Radix from different habitats were obtained. PCA can be used to preliminarily distinguish between Zizhou Astragali Radix and other habitats based on the flavonoid contents. OPLS-DA revealed four quality difference markers of Astragali Radix from Zizhou and other habitats. The accuracy of cluster analysis of Astragali Radix from different habitats based on the quality difference markers was 88.9%. The total discrimination rate of Astragali Radix from different habitats was 94.4% by the discrimination model based on the ratio of astrapterocarpan glucoside to isomucronulatol glucoside and the sum of the contents of four flavonoid glycosides.ConclusionThe method to identify Astragali Radix from different production areas based on flavonoid contents is feasible.  
        关键词：Astragali Radix from Zizhou;production areas;flavonoid   
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        Acupuncture Moxibustion and Tuina

      • ZHOU Kelin,GUO Sheng,WEI Peidong,LIU Jiang
        Vol. 46, Issue 2, Pages: 289-293(2023) DOI: 10.3969/j.issn.1006-2157.2023.02.023
        摘要：Professor DONG Jianhua is a well-known traditional Chinese medicine expert in China. He put forward unblocking and purging theory in the treatment of spleen and stomach diseases. Unblocking and purging theory played not only a guiding role in the drug treatment of spleen and stomach diseases in later generations, but also an important role in the treatment of spleen and stomach diseases by zangfu tuina. Under the guidance of unblocking and purging theory on spleen and stomach diseases, zangfu tuina techniques are combined with the patient's different pattern, using vibrating manipulation, circular rubbing manipulation, kneading manipulation , pushing manipulation and other tuina manipulations to circulate qi and resolve stagnation, circulate blood and transform stasis, eliminate phlegm and dampness, warm yang and dissipate cold, soothe the liver and harmonize the stomach, ascend the nutrients and descend the turbid, tonify qi and blood, regulate yin and yang, and finally restore the normal physiological function of spleen and stomach qi movement, thereby treating spleen and stomach diseases. In addition, treatment based on unblocking and purging theory in guiding zangfu tuina also has a good clinical effects on other zangfu diseases caused by dysfunction of the spleen and stomach.  
        关键词：unblocking and purging theory;zangfu tuina;spleen and stomach diseases;clinical application   
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