最新刊期
卷 47 ， 期 1 ， 2024
- 摘要：This article delves into the insights of civilized mutual learning in the development of traditional Chinese medicine, emphasizing the importance of life science characteristics in the construction of this discipline. It also discusses the dynamic adjustment of the disciplinary system. Civilized mutual learning is an inevitable phenomenon in history. Researchers in traditional Chinese medicine should focus on the commonalities between Eastern and Western civilizations. They should adhere to the principles of traditional Chinese culture, preserve its creative nature, and be open to incorporating the achievements of science and humanities from both ancient and modern China and foreign countries.The construction of traditional Chinese medicine should accentuate its life science features, allowing the philosophy of Chinese civilization to play a guiding role in the preventive treatment of diseases. Furthermore, traditional Chinese medicine should be responsive to the impact of new findings in areas such as the information conservation law and quantum mechanics on the discipline′s development. It should also reinforce research on the quality and efficacy of Chinese medicinals and dynamically update the disciplinary system that fosters talent training.In conclusion, this article highlights the significance of civilized mutual learning in the development of traditional Chinese medicine. It proposes that the construction of the discipline should emphasize its life science characteristics and explores the dynamic adjustment and improvement of the disciplinary system. Through ongoing exploration and innovation, traditional Chinese medicine will contribute significantly to the global life science field.关键词：civilization exchange and mutual learning;traditional Chinese medicine;disciplinary construction
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发布时间：2024-05-20
Voice of Guidance
- 摘要：The disease-pattern combination is a diagnostic and treatment model that guides individualized treatment from the holistic view of traditional Chinese medicine (TCM). The construction of a comprehensive diagnosis and treatment plan that integrates " disease-core pathogenesis-key TCM patterns-series of prescriptions", is a highly consensus clinical diagnosis, treatment and research paradigm based on more than 30 years of research result and practical experience in the prevention and treatment of stroke with TCM, which covers the understanding of the core pathogenesis from the pathological characteristics of the disease, grasps the key TCM patterns and their change patterns that closely affect the prognosis, provides effective series of prescriptions, and achieves complete unity of theory, treatment, prescription and medication. This article mainly elaborates on the patterns differentiation thinking process of " disease-pathogenesis-syndrome-treatment" from the aspects of disease-syndrome correlation, patterns diagnosis, innovative pathogenesis, as well as systematic differentiation and treatment plan, early general treatment plan, Chinese and western medicine integration plan, etc. The key points of the newly released relevant expert consensus and guidelines are explained to improve the practical ability and diagnosis and treatment level of clinicians in the prevention and treatment of stroke with TCM.关键词：disease-pattern combination;stroke;diagnosis and treatment plan;guideline
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发布时间：2024-05-20
Expert Commentary
- 摘要：ObjectiveWe aimed to assess the serum levels of the glycolysis-related protein hypoxia-inducible factor-1α(HIF-1α) and cytokines in patients with relapsing-remitting multiple sclerosis(RRMS) before and after treatment with the traditional Chinese medicine Yishen Daluo Decoction, as well as their correlation with clinical parameters, and explore the immune regulatory mechanism of Yishen Daluo Decoction on multiple sclerosis.MethodsTwenty-eight patients with RRMS in remission recruited from May 2018 to January 2022 in the Multiple Sclerosis Clinic at Dongzhimen Hospital, Beijing University of Chinese Medicine were retrospectively included. Comparisons were made with paired samples from 13 of them before and after Yishen Daluo Decoction treatment. A total of 20 gender- and age-matched healthy controls(HCs) were also recruited. Clinical information was collected from all of the subjects, and the neurological impairments of RRMS patients were assessed with the Expanded Disability Status Scale(EDSS) score. ELISA and SP-X multiplex cytokine assays were used to measure the serum levels of HIF-1α and 10 cytokines(IL-1β, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-22, IFN-γ, and TNF-α), respectively. Spearman′s method was used to analyze the correlation between the serum levels of HIF-1α and cytokines, and the correlation between the serum levels of HIF-1α and cytokines and patients′ clinical indicators, including disease duration, the number of attacks, and the EDSS score.ResultsSerum HIF-1α, IL-4, IL-6, IL-8, IL-10, IL-12p70, IFN-γ, and TNF-α levels in the RRMS group were significantly higher than those in the HC group(P<0.05). Serum levels of HIF-1α, IL-4, IL-6, and IL-12p70 in the Yishen Daluo Decoction-pre group were significantly higher than those in the Yishen Daluo Decoction-post group(P<0.05). In addition, the serum HIF-1α level was positively correlated with IL-6(r=0.452, P=0.016) and TNF-α(r=0.524, P=0.004) levels in patients with RRMS. The IFN-γ level was negatively correlated with the EDSS score(r=-0.423, P=0.025), the IL-4 level was negatively correlated with disease duration(r=-0.385, P=0.043), and the TNF-α level was positively correlated with disease duration(r=0.397, P=0.037).ConclusionThe regulatory mechanism of Yishen Daluo Decoction on immune imbalance in RRMS may be related to its ability to reduce the serum levels of the glycolysis-related protein HIF-1α in RRMS patients. It is also related to the levels of various inflammatory cytokines.关键词：Yishen Daluo Decoction;multiple sclerosis;hypoxia-inducible factor-1α;glycolysis-related protein;cytokine
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发布时间：2024-05-20 - 摘要：Migraine is a chronic episodic neurovascular disease with a distinct " episode-remission" feature. According to the theory of traditional Chinese medicine, migraine belongs to the class of diseases including " Toutong" and " Toufeng". Disorder of qi and blood, especially blood stasis due to qi deficiency, lie at the basis of migraine pathogenesis. The physiological function of the neurovascular unit is strongly related to qi and blood. Focusing on the neurovascular unit, this paper expounds the physiological basis of the theory of qi and blood from the perspective of microenvironment homeostatic disorder and the interaction of various cell components, and discusses the scientific connotation of the pathogenesis of qi and blood in migraine. Disordered homeostasis of the neurovascular unit is involved in the pathology of migraine and tallies with the pathogenesis of qi and blood in migraine, which is mainly reflected in dysfunction of astringing, defending, and transforming due to qi deficiency, as well as pathogenic toxin accumulation and blood stasis. The explanation based on homeostasis of the neurovascular unit due to qi and blood pathogenesis in migraine is helpful to understand the development of migraine integrally and to provide guidance for traditional Chinese medicine treatment and research of migraine from the theory of qi and blood.关键词：migraine;neurovascular unit;theory of qi and blood;pathogenesis;blood stasis due to qi deficiency
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发布时间：2024-05-20 -
The theoretical research on
Yi He rehabilitation in staging treatment of post-stroke hemiplegia AI导读摘要：Yi He Rehabilitation, which is based on traditional Chinese rehabilitation treatments and rehabilitation principles from modern medicine, is effective in staging treatment of post-stroke hemiplegia. This paper systematically discusses the origin and annotation of Yi and He from the perspectives of traditional Chinese medicine and modern medicine. The medicinal connection between Yi and the body and its function is related to unobstructed attunement. Based on the connotation of Yi and He, we believe that the pathogenesis of post-stroke hemiplegia is the comprehensive result of abnormal effects of Yi on the organism at the microscopic level and abnormal effects of He on function at the macroscopic level, featured as tense muscle movement and a pathological process of abnormal motion, including the disturbance of yang qi with body dysfunction, the disorder of spirit with sinews and vessels with diversion, and the variation of brain collateral with physical and mental inconsistency. By inducing relaxation and calmness, Yi He rehabilitation takes effect in staging treatment of post-stroke hemiplegia with characteristic mechanisms. First, by calming ascending yang and relaxing the disordered body in periods of relaxation, it can achieve the maintenance function of the kinematic chain peripherally with passive rehabilitation. Second, by calming the disordered spirit and relaxing the inhibited meridian sinews in spasmodic periods, it can reconstruct the neural plasticity of motor function centrally with assistive rehabilitation. Third, by calming damaged brain collateral and relaxing the impassable zang organs in the recovery period, it can close the central-peripheral-central loop of rehabilitation with active rehabilitation.关键词：Yi;He;stroke;hemiplegia;rehabilitation;relaxation;calmness- 584
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发布时间：2024-05-20
Special Theme: TCM Prevention and Treatment of Encephalopathy
- 摘要：The current framework of traditional Chinese medicine is regarded as a medical system that places the zang-fu viscera at its core, encompassing external pathways, physical aspects, orifices, manifestation(hua), and the seasonal influence. Treatment modalities, such as pharmaceuticals, acupuncture and stone-needle, and moxibustion, are considered specific clinical applications encapsulated within this theoretical system. However, a closer examination of the medical theories within Huangdi Neijing reveals that the early medical theories in the Huangdi Neijing were developed based on external treatments using acupuncture and moxibustion, as well as internal treatments with pharmaceuticals. These early theories differ from the emphasis on internal treatment of zang-fu organs advocated in subsequent periods. The primary body of medical theory in the Huangdi Neijing is rooted in somatological medicine, which was primarily formed through external treatments, including theories related to meridians, acupoints, acupuncture, and encompassing theories such as the theory of five body constituents, the theory of the transformation of exterior and interior diseases, the theory of nutrient qi and defensive qi, the theory of deficiency and excess pathogensis, and therapeutic method involving tonification and purgation. These theories exhibit certain differences from the later dominant zang-fu viscera medicine theories. The oversimplification of amalgamating these two systems′ theories has result mistakes in inherent conflicts within the theory itself and a detachment from clinical practice. Thus, there is a pressing need for differentiation and a return to the original sources to reestablish a more coherent theoretical foundation.关键词：Huangdi Neijing;medical system;needing stone;five body constituents;external treatment;nutrient qi and defense qi
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发布时间：2024-05-20 - 摘要：Dong qi, referring to beating beside the navel, was proposed for the first time by Nan Jing. " Beating above the navel" " beating below the navel", and " beating below the heart" in Shanghan Lun all belong to the category of Dong qi. The pathogenesis of Dong qi can be learned from Shanghan Lun. Yang deficiency of the heart, spleen, and kidney, with qi failing to transform body fluids, results in fluid retention. Fluid retention is the key etiological factor of Dong qi. Although there is an exterior pattern with Dong qi, the exterior-releasing and purgative method cannot be used for treatment, or the patient will be impaired of yang and exhausted of yin, fluid circulation will be disturbed, and so on. Reinforcing yang qi to drain water retention is the treatment principle of Dong qi. The coupled medicines of Fuling and Guizhi were commonly used by ZHANG Zhongjing to treat Dong qi. This reflects the treatment principle of strengthening the spleen and warming yang for transforming qi to circulate body fluids. ZHANG Bi, a physician from the Yuan Dynasty who learned from ZHANG Zhongjing, thought that the treatment of Dong qi was based on the method of cultivating earth to restrain water and taking into account the ascending, descending, entering, and exiting of qi of the liver, heart, lung, and kidney while tonifying the spleen, and then created Baoming Siqi Powder (Zhiqiao, Fuling, Fangkui, and Qianhu Powder) for the treatment of Dong qi, which is of great significance to the clinic.关键词：Dong qi beside the navel;Shanghan Lun;Baoming Siqi Powder;warm yang and transform qi to circulate body fluids;ascending and descending of qi movement
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发布时间：2024-05-20 - 摘要：The theory of " lung governing skin and hair" has always occupied an important position in the clinical practice of traditional Chinese medicine. However, in western medicine, the close correlation between the lungs and the skin in health and disease has not been established. The difference between these two medical views has triggered an urgent need for the scientific interpretation and clinical application of the theory of " lung governing skin and hair" in western medicine. Therefore, the purpose of this paper is to discuss the application of " lung governing skin and hair" in chinese medicine and the correlation between the lung and the skin in western medicine from the connotation and history of " lung governing skin and hair" in Chinese medicine. In addition, we will discuss the common pathologic biomarkers of lung and skin diseases in western medicine and the co-morbidities between lung and skin, with the aim to provide new ideas for the clinical diagnosis and treatment of lung and skin diseases and modern research, as well as providing a direction for the integration of the theory of " lung governing skin and hair" into the clinical practice of western medicine.关键词：Huangdi Neijing;lung governing skin and hair;traditional Chinese medicine;western medicine;marker
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发布时间：2024-05-20
Theoretical Studies
- 摘要：ObjectiveWe aimed to establish and evaluate a rat model of post-infectious irritable bowel syndrome (PI-IBS) with the pattern of liver depression and spleen deficiency coupled with dampness.MethodsFirst, 200 rats were randomly divided into the normal group, the infection group, the infection + stress group, the infection + stress + external dampness group, and the acetic acid + stress group (n = 40 rats per group) for eight weeks. The rats were treated with Trichinella spiralis infection, chronic restraint stress, an artificial high-humidity climate, and/or acetic acid enema. Weight growth rate, 24-hour food intake and water intake, and the fecal moisture percentage were recorded. The open field test and the sucrose consumption test were used to determine the behavioral characteristics of rats in each group. The abdominal withdrawal reflex (AWR) test was used to determine visceral sensitivity. The contents of 5-hydroxytryptamine (5-HT) and aquaporin 4 (AQP4) in colon tissue were detected by ELISA.ResultsCompared with the normal group, the weight growth rate of rats in the infection + stress + external dampness group and the acetic acid + stress group was lower from Week 1 to Week 8 of modeling. The 24-hour food intake of rats in the infection + stress + external dampness group and the infection + stress group was lower than that in the normal group from Week 2 to Week 8 of modeling. At the end of week 2 of modeling, the 24-hour water intake of rats in the infection + stress + external dampness group, the acetic acid + stress group, and the infection + stress group was lower than that in the normal group. The fecal moisture percentage of rats in the infection + stress + external dampness group was higher than that in the normal group at the end of Week 1, 6, and 8 (P<0.05). At the end of Week 4 of modeling, the total distance in the open field test in the infection + stress + external dampness group and the acetic acid + stress group was shorter than that in the normal group. The sugar preference rate in the infection + stress + external dampness group was lower than that in the normal group at the end of 1, 4, and 8 weeks and lower than that in the acetic acid + stress group at the end of Week 4 and 8 (P<0.05). The AWR scores of rats in the infection + stress + external dampness group were higher than those in the normal group after week 1 at 60 and 80 mmHg(1 mmHg≈0.133 kPa), after Week 4 at 40, 60, and 80 mmHg, and after Week 6 and 8 at 20, 40, and 80 mmHg (P<0.05). At the end of Week 2 and 4, a large number of inflammatory cells were infiltrated in the colonic mucosa of the intervention groups, and the inflammation score was higher than that of the normal group (P<0.05). At the end of weeks 6 and 8, the inflammatory cell infiltration in the intestinal mucosa of the intervention groups was not obvious, and the colonic mucosa returned to normal. At the end of weeks 6 and 8, the 5-HT content was higher in the infection + stress group, the infection + stress + external dampness group, and the acetic acid + stress group than in the normal group (P<0.05). After Week 4, the AQP4 content was lower in the infection + stress + external dampness group and the acetic acid + stress group than that in the normal group (P < 0.05). After week 6, compared to the normal group, the AQP4 content was lower in all groups except for the acetic acid + stress group, and the AQP4 content in the infection + stress + external dampness group was lower than that in the acetic acid + stress group. After week 8, only in the infection + stress + external dampness group the AQP4 content was lower than in the normal group (P<0.05).ConclusionThe combination of Trichinella spiralis infection, chronic restraint stress, and an artificial high-humidity climate can be used to prepare a relatively stable and reliable rat model of PI-IBS with the pattern of liver depression and spleen deficiency with dampness.关键词：post-infectious irritable bowel syndrome;pattern of liver depression and spleen deficiency with dampness;combination of disease and syndrome;model;rats
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发布时间：2024-05-20 - 摘要：ObjectiveWe aimed to explore the mechanism by which Bushen Yangjing Soup improves elderly infertility based on oocyte mitochondrion.MethodsC57BL/6J mice were used, including 15 young females (6-8 weeks old), 45 elderly females (10 months old), and ten young males (6-8 weeks old). The female 6-8-week-old young mice were assigned to the young group, and the female 10-month-old elderly mice were randomly divided into the model group, the dehydroepiandrosterone (DHEA) group, and the Bushen Yangjing Soup group. Mice in the DHEA and Bushen Yangjing Soup groups were given DHEA [11.26 mg/(kg·d)] and Bushen Yangjing Soup [11.41 g/(kg·d)]. Mice in the other groups were given normal saline. After 45 days, oocytes were collected, the number of oocytes and the proportion of mature oocytes were recorded, and in vitro fertilization (IVF) was carried out, followed by calculation of the successful fertilization rate. Real-time PCR was used to determine the copy number of mitochondrial DNA in oocytes, mito-tracker green was used to observe the distribution of mitochondria, and the mitochondrial membrane potential (MMP) of oocytes was determined using the JC-1 kit. The mRNA and protein levels of mitofusin 2 (Mfn2) in oocytes were determined by real-time PCR and Western blotting, respectively.ResultsCompared with the young group, the number of oocytes, the proportion of mature oocytes, and the IVF rate were significantly reduced (P<0.01), the copy number of mitochondrial DNA in oocytes was decreased, the rate of abnormal mitochondrial distribution was increased, the MMP was decreased (P<0.01), and the mRNA and protein levels of Mfn2 were decreased (P<0.01) in the elderly model mice. Compared with the elderly model group, the number of oocytes, the proportion of mature oocytes, and the IVF rate were significantly increased (P<0.05), the copy number of mitochondrial DNA in oocytes was increased (P<0.05), the rate of abnormal mitochondrial distribution was decreased, the MMP was increased (P<0.05), and the mRNA and protein levels of Mfn2 were increased (P<0.01) in the Bushen Yangjing Soup group.Compared with the DHEA group, the number of oocytes, the proportion of mature oocytes, and the IVF rate were increased, the copy number of mitochondrial DNA in oocytes was increased, the rate of abnormal mitochondrial distribution was decreased, the MMP was increased, the mRNA and protein levels of Mfn2 were increased in the Bushen Yangjing Soup group, and there was a significant difference in the number of oocytes and the expression of Mfn2 protein (P<0.05).ConclusionBushen Yangjing Soup may improve the quantity, distribution, and function of oocyte mitochondria by increasing the mRNA and protein levels of Mfn2, thereby improving oocyte quality. This is one of the possible mechanisms for clinical application of Bushen Yangjing Soup to improve ovarian function and treat elderly infertility.关键词：elderly infertility;oocyte;Mitochondrion;mitofusin 2;Bushen Yangjing Soup;mice
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发布时间：2024-05-20 - 摘要：ObjectiveTo study the effects of Guizhi Shaoyao Zhimu Decoction on factors related to bone destruction and bone protection in rats with collagen-induced arthritis (CIA) based on osteoprotegerin (OPG)/receptor activator of NF-κB ligand (RANKL)/receptor activator of NF-κB (RANK) signaling pathway.MethodsAccording to the body weight, 60 female Wistar rats were randomly divided into the following six groups: the normal group, the model group, the Triperygium wilfordii multiglucoside group (0.01 g/kg), the Guizhi Shaoyao Zhimu Decoction low-dose group (8.6 g/kg), the Guizhi Shaoyao Zhimu Decoction medium-dose group (17.2 g/kg), and the Guizhi Shaoyao Zhimu Decoction high-dose group (34.4 g/kg) (n=10 rats per group). The rats in all groups except for the normal group were given 100 μg bovine type Ⅱ collagen on the 1st and 8th days to establish the CIA model, and was injected into the left foot sole and tail root of the rats. After the successful modeling, the rats were treated by gavage for 4 weeks. The general state, body weight, and arthritis index (AI) score of rats were recorded, and the contents of RANKL and OPG in rat serum were determined by enzyme-linked immunosorbent assay. The mRNA and protein expressions of RANKL, RANK, and OPG in the ankle joint were determined through real-time PCR and Western blotting, respectively.ResultsCompared with the normal group, the general state of the model group was poor, the toe swelling was obvious, the AI score was increased, the serum RANKL content was increased, the serum OPG content was decreased, and the mRNA and protein expressions of RANKL and RANK in the ankle joint were increased (P<0.05). Compared with the model group, the degree of toe swelling and the AI score of rats in the Guizhi Shaoyao Zhimu Decoction low-, medium-, and high-dose groups were decreased, the serum RANKL content was decreased, the serum OPG content was increased, the mRNA and protein expressions of RANKL and RANK in the ankle joint were decreased, the mRNA and protein expressions of OPG were increased, and the RANKL/OPG ratio of the ankle joint was decreased(P<0.05).ConclusionGuizhi Shaoyao Zhimu Decoction can improve the destruction of joint bone in CIA rats, and its mechanism of action may be related to reducing RANKL level, reducing RANKL/OPG ratio, and regulating bone balance.关键词：Guizhi Shaoyao Zhimu Decoction;OPG/RANKL/RANK signaling pathway;collagen-induced arthritis;bone metabolism;bone balance;rats
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发布时间：2024-05-20 - 摘要：ObjectiveTo study the intervention effect of Jianpi Zhidong Decoction on the expressions of Cx43 and Cx30 in the cortex, corpus striatum, hypothalamus, and hippocampus of tic disorder mice.MethodsAccording to the random number table method, 60 male ICR mice were divided into the blank control group(n=15) and modeling group(n=45). The mice in the modeling group were intraperitoneally injected with iminodipropanitrile(350 mg/kg, once a day for 7 days) to establish a tic disorder model, and the mice in the blank control group were intraperitoneally injected with equal volume of normal saline. The stereotyped behavior score was calculated to evaluate the success of modeling. According to the random number table method, the mice in the modeling group were divided into the model group, tiapride group(29.5 mg/kg) and Jianpi Zhidong Decoction group(17.8 g/kg), with 15 mice in each group. The drug was administered by gavage for 4 weeks. After administration, stereotyped behavior score was calculated. The positive protein expression, protein expression, and mRNA expression of Cx43 and Cx30 in the cortex, corpus striatum, hypothalamus and hippocampus were determined by immunohistochemistry, Western blotting and real-time PCR.ResultsCompared with the blank control group, the stereotyped behavior score of mice in the model group was increased(P<0.05). Compared with the model group, the stereotyped behavior scores of mice in the tiapride group and the Jianpi Zhidong Decoction group were decreased(P<0.05). Compared with the blank control group, the average optical densities of Cx43 in the cortex, corpus striatum, hypothalamus, and hippocampus of mice in model group were decreased(P<0.05). Compared with the model group, the average optical densities of Cx43 in the cortex and hippocampus in the tiapride group were increased, and the average optical densities of Cx43 in the cortex, corpus striatum, and hippocampus in the Jianpi Zhidong Decoction group were increased(P<0.05). Compared with the tiapride group, the average optical density of Cx43 in the cortex in the Jianpi Zhidong Decoction group was increased(P<0.05). Compared with the blank control group, the average optical densities of Cx30 in the cortex, corpus striatum, hypothalamus, and hippocampus of mice in model group were decreased(P<0.05). Compared with the model group, the average optical densities of Cx30 in the corpus striatum and hypothalamus in the tiapride group were increased, and the average optical densities of Cx30 in the cortex, corpus striatum, and hippocampus in the Jianpi Zhidong Decoction group were increased(P<0.05). Compared with the tiapride group, the average optical density of Cx30 in the hippocampus in the Jianpi Zhidong Decoction group was increased(P<0.05). Compared with the blank control group, the protein expressions of Cx43 in the cortex, corpus striatum, and hippocampus of mice in the model group were decreased(P<0.05). Compared with the model group, the protein expression of Cx43 in the cortex in the tiapride group was increased, and the protein expressions of Cx43 in the cortex, corpus striatum, and hippocampus in the Jianpi Zhidong Decoction group were increased(P<0.05). Compared with the blank control group, the protein expressions of Cx30 in the cortex and hippocampus of mice in the model group were decreased(P<0.05). Compared with the model group, the protein expressions of Cx30 in the cortex and hippocampus in the tiapride group and the Jianpi Zhidong Decoction group were increased(P<0.05). Compared with the blank control group, the mRNA expressions of Cx43 in the cortex, corpus striatum and hippocampus in the model group were decreased(P<0.05). Compared with the model group, the mRNA expressions of Cx43 in the cortex, corpus striatum, and hippocampus in the tiapride group and the Jianpi Zhidong Decoction group were increased(P<0.05). Compared with the blank control group, the mRNA expressions of Cx30 in the cortex and hippocampus in the model group were decreased(P<0.01). Compared with the model group, the mRNA expressions of Cx30 in the cortex and hippocampus in the tiapride group and the Jianpi Zhidong Decoction group were increased(P<0.05).ConclusionThe decreased expression of Cx43 and Cx30 in the cortex, corpus striatum, hypothalamus, and hippocampus may be involved in the occurrence of stereotyped behavior in tic disorder mice. The intervention mechanism of Jianpi Zhidong Decoction may be related to the increased expression of Cx43 and Cx30 in various brain regions.关键词：Jianpi Zhidong Decoction;tic disorder;Cx43;Cx30;spleen governing muscle;mice
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发布时间：2024-05-20
Experimental Studies
- 摘要：Atherosclerosis is classified as " vessel bi" in traditional Chinese medicine, and cold evil is one of its important causes. Cold, having the properties of coagulation, stagnation, and contraction, tends to narrow the diameter of blood vessels and slow down blood flow, which can promote the pathophysiological process of atherosclerosis. At present, the etiological theory of vessel bi caused by cold evil has not been fully elaborated. Based on the explanations of " evening" in " pathogenic cold affecting in the evening", such as " ying", " end of year", " end of day", and " time of yang decline and yin exuberance", this paper proposes the viewpoint that the cold evil tends to affect ying-blood and cause vessel bi, and discusses its pathogenesis. From the perspective of the external environment, cold evil affecting the vessel is conditional, often occurring in winter and in the middle of the night. From the perspective of internal environment, the cold evil affects the vessel in a process which can be manifested in three stages: cold injury, cold stagnation, and cold congelation. The strength of yang qi is the factor that determine whether the cold evil can cause disease. Exploring the etiology and pathogenesis of atherosclerosis from the perspective of " pathogenic cold affecting in the evening" provides a new idea for further elucidating the pathogenesis of the disease and expanding its clinical treatment.关键词：atherosclerosis;pathogenic cold affecting in the evening;cold evil
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发布时间：2024-05-20 - 摘要：ObjectiveWe aimed to investigate the relationship between microscopic pattern of blood stasis and renal pathological grade and related physical and chemical indexes in children with Henoch-Schönlein purpura nephritis (HSPN).MethodsWe conducted a retrospective analysis of 800 HSPN children from the medical records of the First Affiliated Hospital of Henan University of Chinese Medicine. Laboratory indicators (blood routine test, urine routine test, coagulation test, liver function) and renal pathological indicators of them were collected. According to the severity of renal pathological microscopic lesions, the microscopic pattern of blood stasis was divided into three types, including choroidal discord, dead blood coagulation and intracarenal disease accumulation.The classification of renal microscopic pattern of blood stasis and the correlation between laboratory indexes and renal pathological index were analyzed by Spearman grade correlation and binary Logistic regression analysis.Results(i) There was no statistical difference of the distribution of the renal microscopic pattern of blood stasis in the different traditional Chinese medicine patterns. (ii) There were significant differences in the contents or the grade of albumin and fibrinogen in the HSPN children with different microscopic pattern of blood stasis(all P<0.05). (iii) The maximum area under the receiver operating characteristic (ROC) curve between fibrinogen and intracarenal disease accumulation was 0.594 (95%CI from 0.540 to 0.633, P<0.001); sensitivity was 0.447, specificity was 0.725; the best threshold on the ROC curve of 0.172 was 3.755 g/L. (iv) There were positive correlations between the content of fibrinogen, ISKDC grade and Bohle A grade respectively with the scores of intracarenal disease accumulation type (r=0.176, r=0.315, r=0.656; all P<0.001). (v) There were positive correlations between the content of fibrinogen, ISKDC grade and Bohle A grade respectively with the renal microscopic pattern of blood stasis (r=0.157, r=0.377, r=0.429; all P<0.001).ConclusionThe microscopic renal pattern of blood stasis can not only reflect the severity of renal blood stasis, but also reflect the severity and long-term prognosis of renal diseases. Albumin and urinary protein grade can reflect the early stage of the microscopic renal pattern of the blood stasis (choroidal discord). The content of fibrinogen increases with the aggravation of renal microscopic pattern of blood stasis, reflecting the end-stage of HSPN, which has the correlation with the formation and severity of related indexes. Fibrinogen can be used as a laboratory indicator to assist in the diagnosis of irreversible lesionsin the renal pathology of HSPN children.关键词：Henoch-Schönlein purpura nephritis;pathological grade;coagulation index;blood stasis;fibrinogen
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发布时间：2024-05-20 - 摘要：ObjectiveWe aimed to observe the effect of the traditional Chinese medicine(TCM)-based " tertiary hospital-community integrated" treatment program in patients with diabetic kidney disease.MethodsA total of 126 patients from the Jiangtai and Cuigezhuang Communities in Chaoyang District were randomly divided into the experimental group and the control group(n=63 patients per group). In the experimental group, the " tertiary hospital-community integrated" treatment program was implemented(including TCM differentiated health preservation, chronic disease management, comprehensive diagnosis and treatment program of integrated Chinese and Western medicine), while in the control group, the existing chronic disease diagnosis, treatment, and management program in the community was implemented(including chronic disease management with regular follow-ups, diagnosis and treatment program of Western medicine). The observation period was 6 months, with 3 months as a course of treatment. The 24 h urine total protein level(24 hUTP), the serum level of creatinine(Scr), and the estimated glomerular filtration rate(eGFR) were compared between the two groups, as well as the effective rates of 24 hUTP, Scr, and eGFR, the rate of achieving standard glucose levels and normal lipid metabolism, including low-density lipoprotein-cholesterol (LDL-C), triglyceride(TG), and glycosylated hemoglobin (GHB), the level of patients′ self-management, and the medical service in utilization.ResultsThere were 120 patients included for analysis(60 in the experimental group and 60 in the control group). The difference in 24 hUTP was significantly different(P<0.05), while Scr and eGFR were not statistically different between the experimental and control groups after 3 months of treatment. The differences in 24 hUTP, Scr, and eGFR were statistically significant after 6 months(P<0.05). After 6 months of treatment in both groups, the effective rates of 24 hUTP, Scr, and eGFR were higher in the experimental group than in the control group(78.3%, 48.3%, and 50.0% in the experimental group and 35.0%, 18.3%, and 15.0% in the control group, respectively)(P<0.05); after 6 months, the LDL-C, TG, and GHB qualified rates were higher in the experimental group than in the control group(75.0%, 83.3%, and 71.7% in the experimental group and 56.7%, 63.3%, and 46.7% in the control group, respectively; P<0.05); comparing the self-management levels of the two groups after 3 and 6 months of treatment, the total self-management score and the total self-efficacy score were both higher in the experimental group than in the control group(P<0.05); comparing the time of hospitalization and hospitalization costs of the two groups 6 months after enrollment, the time of hospitalization and hospitalization costs were lower in the experimental group(P<0.05).ConclusionThe " tertiary hospital-community integrated" TCM-based treatment program improves renal function, glucose and lipid metabolism, and patients′ self-management; it can reduce the economic burden of families, save medical resources, and improve the utilization of medical services.关键词：diabetic kidney disease;TCM syndrome differentiation;TCM health preservation;chronic disease management;integration of management and treatment;integration;randomized control trial
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发布时间：2024-05-20
Clinical Studies
- 摘要：ObjectiveBy observing the effects of " three methods and three points" tuina technique on the expression of interleukin-17F(IL-17F), interleukin-17 receptor C(IL-17RC), activator 1 of nuclear transcription factor-κB(Act1), tumour necrosis factor receptor-associated factor 6(TRAF6) and M1 microglial cell expression in the spinal dorsal horn of rats with mild chronic compressive injury(minor CCI) model, we explored the immediate analgesic mechanism of tuina on peripheral neuropathic pain(pNP).MethodsThirty-six SD rats were divided into the sham group, the model group and the tuina group according to the random number method, twelve rats in each group, and the minor CCI model was replicated by ligating the right sciatic nerve. The rats in the tuina group were subjected to pointing, plucking and kneading at the BL37, BL57 and GB34 points on the affected side using a tuina simulator, while the sham group and the model group were only grasped and restrained, and were intervened for one time. The mechanical pain test and cold plate test were used to evaluate the response of rats to mechanical stimulation and cold stimulation after immediate intervention. The protein expression of IL-17F and TRAF6 in the spinal dorsal horn of rats in each group was detected by Western blotting. The mRNA expression of IL-17F, IL-17RC, Act1 and TRAF6 in the spinal dorsal horn of rats in each group was detected by real-time PCR. The average fluorescence intensity of M1 microglia in the spinal dorsal horn of rats in each group was detected by immunofluorescence.ResultsBehavioral results showed that before intervention, compared with the sham group, paw mechanical withdraw threshold(PMWT) decreased and cold sensitivity threshold(CST) increased in the model group and the tuina group; after tuina intervention, PMWT in the tuina group was increased, and CST was decreased compared with the model group; after intervention, PMWT in the tuina group was increased, while CST was decreased(P<0.05). RT-PCR results showed that compared with the sham group, mRNA expression levels of IL-17F, IL-17RC, TRAF6 and Act1 in the spinal dorsal horn of the model group were increased; compared with model group, the mRNA expression levels of above indexes in the tuina group were decreased(P<0.05). Western boltting results showed that compared with the sham group, the expression levels of IL-17F and TRAF6 protein in the spinal dorsal horn of the model group were increased; compared with the model group, the expression levels of IL-17F and TRAF6 protein in the tuina group decreased(P<0.05). Immunofluorescence results showed that the mean fluorescence intensity of CD40 in the spinal dorsal horn of model group was enhanced compared with the sham group; compared with the model group, the mean fluorescence intensity of CD40 in the tuina group was decreased(P<0.05).ConclusionThe " three methods and three points" tuina technique can produce immediate analgesia by inhibiting the expression of IL-17F, IL-17RC, Act1, TRAF6 and the activation of M1 microglia in the dorsal horn of the spinal cord after one intervention.关键词：tuina;microglia;BL37;BL57;GB34;rats
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发布时间：2024-05-20 - 摘要：ObjectiveTo evaluate the mechanism of governor vessel electroacupuncture in rats with post-stroke limb spasm by observing the changes of glutathione antioxidant system-related factors.MethodsA total of 60 SD rats were randomly divided into the normal group (n=12), sham operation group (n=12) and modeling group (n=36). The middle cerebral artery obstruction model was prepared by thread approach method in the modeling group, and 24 rats with successful modeling were randomly divided into the model group and the electroacupuncture group, with 12 rats in each group. At the 3rd day after modeling, the electroacupuncture group was treated with electroacupuncture at three acupoints of the governor vessel, namely, " Dazhui" (GV14), " Jizhong" (GV6) and " Houhui" (anteromedial of the transverse process of the sixth lumbar vertebra), for 30 min each time, once a day for 7 days. The neurological function of rats was assessed by Zea Longa neurological deficit score. The muscle tension of rats was detected by modified Ashworth dystonia rating and electrophysiological tracing method. The brain tissue water content was measured by the dry-wet weight method. The volume of cerebral infarction of rats was measured by the TTC staining method. The contents of glutathione(GSH), catalase(CAT), oxidized glutathione(GSSG), superoxide dismutase(SOD), and malondialdehyde(MDA) in the cortex of rats were detected by colorimetry. The protein and mRNA expressions of glutathione reductase(GR), glutamate cysteine ligase(GCL)C, GCLM, and glutathione peroxidase 4(GPX4) in the cortex of rats were measured by Western blotting and real-time PCR, respectively.ResultsCompared with rats in the normal and sham operation groups, the Zea Longa neurological deficit score, modified Ashworth dystonia rating, the volume of cerebral infarction, brain tissue water content, and GSSG and MDA contents in cortex were increased in the model group, the tension signal value and the proteins and mRNA expressions of GR, GCLC, GCLM, and GPX4 in cortex were decreased, and the contents of GSH, CAT, and SOD in cortex were decreased(P<0.05). Compared with the model group, the Zea Longa neurological deficit score, modified Ashworth dystonia rating, the volume of cerebral infarction, brain tissue water content, and GSSG and MDA contents in cortex were decreased in the electroacupuncture group, the tension signal value and the proteins and mRNA expressions of GR, GCLC, GCLM, and GPX4 in cortex were increased, and the contents of GSH, CAT, and SOD in cortex were increased(P<0.05).ConclusionGovernor vessel electroacupuncture can improve the severity of post-stroke limb spasm in rats, and its mechanism may be related to the regulation of glutathione antioxidant system in cerebral cortex.关键词：stroke;limb spasm;governor vessel;electroacupuncture;glutathione antioxidant system;oxidative stress;rats
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发布时间：2024-05-20
Acupuncture Moxibustion and Tuina
- 关键词：Henoch-Schönlein purpura nephritis;children;integrated traditional Chinese and western medicine;guidelines
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发布时间：2024-05-20 - 关键词：malignant tumor;traditional Chinese medicine maintenance treatment;expert consensus
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发布时间：2024-05-20
Standards & Guidelines
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