最新刊期
卷 47 ， 期 5 ， 2024
- “最新研究发现，中医药在治疗脑小血管病方面具有独特优势，通过病络学说和玄府理论，将疾病分为三个阶段，为中医药防治提供新思路。”摘要：Cerebral small vessel disease (CSVD) is a slowly progressive cerebrovascular disease caused by structural and functional disorders of small vessels and vascular neural units in the brain, and CSVD imaging markers may be evidence as manifestations of brain aging. Clinically, the onset of CSVD is not limited to individuals in middle-to-old age. Young patients without typical vascular risk factors may also have imaging markers, such as enlarged perivascular space and white matter hyperintensity. The diagnosis and treatment of these cases must be approached seriously. Compared with Western medicine, traditional Chinese medicine (TCM) has an advantage in treating disorders related to emotions, sleep, and cognition in patients with CSVD. Regarding CSVD, there are commonalities between anatomical structures, physiological functions, pathogenic mechanisms, and xuanfu and collateral theories in TCM. We combined the xuanfu and abnormal collateral theory and classified CSVD into three clinical stages: early-stage, dysfunction in xuanfu and stagnation in the qi collaterals; middle-stage, endogenous toxins and damage to the blood vessels; and late-stage, kidney and marrow deficiency and toxins damaging the brain collaterals. Different treatment strategies, such as promoting qi circulation, calming the mind, and dredging collaterals in the early stage; dispelling pathogenic factors and promoting blood circulation in the middle stage; tonifying the kidney and replenishing the marrow and removing toxins from collaterals in the late stage, are applied at different stages to offer novel perspectives on TCM treatment for CSVD.关键词：cerebral small vessel disease;abnormal collateral theory;Xuanfu;syndrome differentiation and treatment;staged therapy
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发布时间：2024-06-03 - “最新研究发现，获得性脑淀粉样血管病与外毒、伏毒和浊毒等传播途径密切相关。王永炎院士提出的“毒损脑络”理论为中风病研究提供了新视角，揭示了其核心病机，为临床治疗和预防策略提供了新思路。”摘要：Acquired cerebral amyloid angiopathy, as a cerebrovascular disease discovered in recent years, mainly spreads through iatrogenic factors. This paper focuses on acquired cerebral amyloid angiopathy and delves into the new applications and profound implications of the " toxins damaging brain collaterals" theory proposed by academician WANG Yongyan in stroke research. Starting from the perspective of " toxins damaging brain collaterals", it comprehensively analyzes the causes and pathological mechanisms of acquired cerebral amyloid angiopathy, emphasizing the importance of external toxins, latent toxins, and turbid toxins in understanding the pathogenesis of the disease. It reveals that " toxins damaging brain collaterals" is the core mechanism of acquired cerebral amyloid angiopathy. On this basis, it proposes a new connotation of " toxins damaging brain collaterals" : first, " toxin" includes both internal and external toxins; second, the organic integration of " external wind theory" and " toxins damaging brain collaterals" guides the improvement of theoretical research, clinical treatment, and prevention strategies for stroke, and promotes a deeper understanding of the disease. This approach to understanding acquired cerebral amyloid angiopathy from the perspective of " toxins damaging brain collaterals" not only demonstrates the effective integration of traditional Chinese medicine theory and modern biomedical science, but also provides insights and references for the clinical diagnosis and treatment of the disease.关键词：toxins damaging brain collaterals;external toxins;acquired cerebral amyloid angiopathy;iatrogenic cerebral amyloid angiopathy;cerebral amyloid angiopathy
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发布时间：2024-06-03 - “最新研究显示，活血豁痰法在防治急性脑出血后脑积水方面具有显著疗效。中西医结合队列的临床总有效率、脑积水发生率、血肿缩小程度、死亡人数以及NIHSS评分、mRS评分和Barthel指数评分均优于西医队列。该研究为脑出血后脑积水的防治提供了新的解决方案。”摘要：ObjectiveWe aimed to evaluate the clinical efficacy of promoting blood circulation and eliminating phlegm method in preventing and treating patients with hydrocephalus after acute intracerebral hemorrhage.MethodsThis study included 139 patients with acute intracerebral hemorrhage who visited Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Guangyuan Hospital of Traditional Chinese Medicine, Affiliated Hospital of North Sichuan Medical College, Meishan Hospital of Traditional Chinese Medicine, and Xuyong Hospital of Traditional Chinese Medicine from September 2019 to June 2023. Patients who met the exposure factors of " using the method of promoting blood circulation and eliminating phlegm" were classified into the integrated Chinese and Western medicine cohort, while those who did not meet the exposure factors were classified into the Western medicine cohort. Clinical efficacy, incidence of hydrocephalus after intracerebral hemorrhage, sum of maximum distance between the anterior horn of the lateral ventricle and the head of the caudate nucleus (Huckman value), size of the hematoma, incidence of endpoint events, National Institutes of Health Stroke Scale (NIHSS) score, Modified Rankin Scale (mRS) score, and Barthel index score between two cohorts were compared.ResultsTotal clinical effective rates for patients with hydrocephalus in the two cohorts were 60.0% and 75.0%, respectively. The total effective rate of the integrated Chinese and Western medicine cohort was higher than that of the Western medicine cohort (P<0.05). After 28 days of treatment, the incidence of hydrocephalus in patients in the integrated Chinese and Western medicine cohort was lower than that of the Western medicine cohort, and the Huckman value decreased compared with the Western medicine cohort (P<0.05). Compared with 24 hours after onset, both cohorts showed a reduction in hematoma size after 28 days of treatment; compared with the Western medicine cohort, patients in the integrated Chinese and Western medicine cohort had reduced hematoma size (P<0.05). After 6 months of onset, the number of deaths in the integrated Chinese and Western medicine cohort decreased compared with the Western medicine cohort (P<0.05). Compared with 28 days of treatment, the NIHSS and mRS scores of the patients in both cohorts decreased after 6 months, while the Barthel index score increased; compared with the Western medicine cohort, patients in the integrated Chinese and Western medicine cohort showed a decrease in the NIHSS and mRS scores after both 28 days of treatment and 6 months, while the Barthel index score increased (P<0.05).ConclusionPromoting blood circulation and eliminating phlegm can effectively prevent and treat hydrocephalus after intracerebral hemorrhage and does not increase the risk of bleeding within 24 hours.关键词：hydrocephalus after intracerebral hemorrhage;promoting blood circulation and eliminating phlegm;Integrated Chinese and Western medicine;cohort study
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发布时间：2024-06-03 - “最新研究发现，"天麻－红景天"药对通过调控TNF-α/NF-κB，能提高低灌注－脑小血管病小鼠脑血流量，改善步态异常，减轻脑组织病理损伤，保护内皮细胞屏障的功能和结构，其机制可能与降低炎症因子表达有关。”摘要：ObjectiveWe aimed to investigate the mechanism of Tianma (tall gastrodia tuber)-Hongjingtian (rose root) medicinal pair in regulating tumor necrosis factor-α (TNF-α)/nuclear factor-κB (NF-κB) to protect the endothelial cell barrier in mice with hypoperfused-cerebral small vessel disease.MethodsSeventy male C57BL/6 mice were assigned to the sham operation group, model group, Tianma-Hongjingtian groupⅠ, Ⅱ, and Ⅲ (the mass ratio of Tianma to Hongjingtian were 1: 1, 2: 1, and 1: 2), with 14 mice in each group. A unilateral common carotid artery occlusion mouse model was established. The mice of each group were gavaged once at six hours after the surgery then once every 24 h thereafter. The doses of Tianma-Hongjingtian groupⅠ, Ⅱ, and Ⅲ were 1.30, 1.95, and 1.95 g/(kg·d), and the sham operation and model groups were administered with the same volume of saline. Cerebral blood flow detection and behavioral post and sampling were performed on the 3rd day (acute phase) and 7th day (subacute phase) of the experiment. Laser diffuse linear ratio imaging was used to observe changes in cerebral blood flow. A gait analyzer was used to evaluate motor coordination.Hematoxylin-eosin staining combined with light microscopy was used to observe pathological and morphological changes in brain tissue. Western blotting was used to detect the expression level of albumin. Immunofluorescence and Western blotting were used to detect the expression levels of tight junction proteins (Occludin and ZO-1). The expression levels of TNF-α, NF-κB, IL-β, and IL-6 were detected through RT-PCR and Western blotting.ResultsCompared with the sham operation group, cerebral blood flow was reduced on the 3rd day and 7th day in the model group(P<0.05); gait abnormalities of prolonged swing duration, reduced stride frequency, and reduced gait equilibrium (P<0.05) were observed; severe pathological damage was observed in brain tissues, with increased level of albumin expression, decreased protein expression levels of Occludin and ZO-1 (P<0.05); mRNA and protein expression levels of TNF-α, NF-κB, IL-β, and IL-6 increased (P<0.05). Compared with the model group, the cerebral blood flow of mice on the 3rd and 7th day in the three Tianma-Hongjingtian groups was elevated (P<0.05); swinging duration was shortened, step frequency increased, gait equilibrium was elevated (P<0.05); brain histopathological damage was reduced, albumin expression level decreased (P<0.05), and the expression levels of Occludin and ZO-1 proteins were elevated (P<0.05); the mRNA and protein expression levels of TNF-α, NF-κB, IL-β, and IL-6 were decreased (P<0.05). Among them, the combined efficacy was better on the 3rd day of Tianma-Hongjingtian group Ⅱ; the combined efficacy was better on the 7th day of Tianma-Hongjingtian groupⅢ.ConclusionTianma-Hongjingtian can increase cerebral blood flow, improve gait abnormalities, reduce pathological damage to brain tissue, and protecte the function and structure of the endothelial barrier in mice with hypoperfused cerebral small vessel disease, and the mechanism may be related to decreasing the expression of inflammatory factors.关键词：tall gastrodia tuber;rose root;cerebral small vessel disease;endothelial barrier;mice
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发布时间：2024-06-03
Special Theme: TCM Prevention and Treatment of Cerebrovascular Diseases
- “最新研究揭示跷脉理论发展与应用长期受滞的根本原因，为《黄帝内经》理论研究提供新视角。”摘要：Qiaomai is one of the eight extraordinary meridians, and its theory has long been marginalized in academic research on meridians. So its academic and practical value has not received sufficient attention. This article is based on the theory in Huangdi Neijing, combined with unearthed literature from the Pre-Qin period and the fusion of various medical schools reflected in the meridian theory system, to explore qiaomai′s name and essence. Our team believes that the formation of qiaomai is the result of the long-term exploration and application of somatic twisting daoyin in Central Plains medicine. The formation of qiaomai coincides with the practical process and therapeutic thinking of somatic twisting daoyin, which has gone through a transformation from directly treating sick tendons to treating sick qi by adjusting tendons. The name of qiaomai may originate from the meanings of various movements such as limb touching, stretching, and swinging in the somatic twisting technique. The primitive physiological function of qiaomai is to dominate human movement, and its physiological level should be located in the tendons of the human body. Qiaomai constantly intersected and was confused with the bladder meridian of foot-taiyang and the kidney meridian of foot-shaoyin after the integration of meridian theory and visceral medicine during the period of Huangdi Neijing, and the positioning and function of qiaomai gradually became blurred. This cognitive confusion has become the fundamental reason why the academic exploration and clinical application of qiaomai has been hindered for a long time. This also suggests that when studying various Pre-Qin medical theoretical systems in Huangdi Neijing, sufficient screening, analysis, and restoration should be carried out to ensure that theories from different sources are authentic.关键词：qiaomai;extraordinary meridians;Huangdi Neijing;somatic twisting daoyin;tendons
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发布时间：2024-06-03 -
Metaphorical analysis of the functional characteristics of the decoction based on
Jingui Yuhan Jing AI导读“在中医药剂型研究领域，专家通过《金匮玉函经》分析古代医家对汤剂功用特性的认识，建立了基于“水隐喻”的汤剂作用阐释体系，为剂型认识研究开辟新方向。”摘要：The relationship between dosage form and efficacy is an important aspect of traditional Chinese medicine pharmacy research. However, there is a lack of systematic analysis of how ancient physicians understood the functional characteristics of decoction. By analyzing the advantages and effects of using decoction in the Jingui Yuhan Jing, it can be observed that ancient people′s understanding of the therapeutic effect of decoction did not solely stem from medical practice, but also understood and elaborated on the function of decoction through the characteristics of water. This article starts with a discussion on the application of decoction in Jingui Yuhan Jing and uses metaphorical cognitive theory to analyze how ancient physicians understood and constructed the cleansing, opening, guiding, dispersing, nourishing, and moisturizing effects of decoction in the aspects of water cleanliness, connectivity, fluidity, impact, and moisturizing. This has formed a relatively complete set of explanations on the functional characteristics of decoction based on the " water metaphor". This has affected the widespread application of decoction and selection of solvents and has developed a new thinking system for the understanding and research of ancient dosage forms.关键词：Jingui Yuhan Jing;water;decoction;metaphorical cognition- 87
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发布时间：2024-06-03 - “在中医领域，叶天士建立了完善的伏气温病治疗体系，为临床治疗新型冠状病毒感染等疾病提供新思路。”摘要：YE Tianshi possessed a comprehensive theoretical system and extensive therapeutic experience in the treatment of warm disease caused by latent pathogenic qi, all of which was recorded in his medical records. YE Tianshi elucidated the characteristics of the pathogenesis of the three types of warm disease caused by latent pathogenic qi, namely spring warmth, summer heat, and winter warmth, and explained the pathogenesis of latent pathogenic qi from the perspective of vital qi and pathogen, and pointed out that the weakness of vital qi and the pathogenic qi led to the concealment of pathogenic qi, and that the struggle between vital qi and pathogen led to the onset of latent pathogenic qi. In the treatment, YE Tianshi emphasized the importance of clearly identifying the level of qi and blood in the internal organs where the latent pathogenic qi is located, and focused on the syndrome differentiation of weifen, qifen, yingfen, and xuefen, and combined with the syndrome differentiation of zang-fu viscera, the principle and method of treatment and medication law of warm disease caused by latent pathogenic qi were formulated. Although warm disease caused by latent pathogenic qi is a heat syndrome, YE Tianshi also attached importance to the deficiency and excess of yang qi, pointed out that latent pathogenic qi had the possibility of transforming into cold syndrome, and discussed the rules of medication for cold latent pathogenic qi in the spleen, kidney, and eight extraordinary meridians. YE Tianshi′s treatment of warm disease caused by latent pathogenic qi not only emphasizes the nourishment of yin, but also emphasizes clearing qi and blood, and the circulation of qi in order to clear and penetrate the evil qi; he also pays attention to the sanjiao transmission of the latent pathogenic evil. The study of the law of YE Tianshi′s differentiation and treatment of warm disease caused by latent pathogenic qi may provide ideas for the clinical treatment of COVID-19, as well as diseases in various disciplines.关键词：Ye Tianshi;warm disease caused by latent pathogenic qi;syndrome differentiation of weifen, qifen, yingfen, and xuefen
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发布时间：2024-06-03 - “在心肌纤维化治疗领域，专家提出以扶阳抑阴为原则，采用温阳、通阳等治法，为临床治疗提供新思路。”摘要：Myocardial fibrosis is a common pathological manifestation of various heart diseases, with hidden onset and the possibility of evolving into irreversible heart failure. Currently, there is still insufficient diagnosis and treatment of myocardial fibrosis. Traditional Chinese medicine can regulate myocardial fibrosis at multiple levels, targets, and pathways, and has significant advantages in treating myocardial fibrosis. Its underlying mechanisms are worth further exploration. The theory of " yang generating qi, yin constituting the body" in Huangdi Neijing embodies the meaning of yin and yang, containing a profound outlook on life and disease. Pathological changes in the initial, progressive, and final stages of myocardial fibrosis conform to the yin-yang theory of " yang generating qi, yin constituting the body". Insufficient yang generating qi and excessive yin constituting the body constitutes the core pathogenesis of myocardial fibrosis. This article proposes a treatment approach for myocardial fibrosis by tonifying yang and abating yin. The treatment of warming yang, unblocking yang, removing blood stasis, resolving phlegm, detoxifying, and promoting diuresis is applied to broaden the clinical treatment approach for myocardial fibrosis.关键词：myocardial fibrosis;yang generating qi;yin constituting the body;method of tonifying yang and abating yin
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发布时间：2024-06-03
Theoretical Studies
- “在医学研究领域，科研团队成功建立了原发性高血压合并膝骨关节炎肝肾亏虚证大鼠模型，并通过一系列检测和观察，证实了模型符合中西医临床病证特点，能表征肝肾亏虚证的主要症状，具有膝关节软骨及软骨下骨典型的组织病理改变，能维持稳定的收缩压和舒张压高血压范围。这一研究成果为揭示中医药优势病种的病证本质、疗效机制及研发创新型中药新药提供了有效的实验载体。”摘要：ObjectiveTo establish the animal model of comorbidity of knee osteoarthritis (KOA) and hypertension with pattern of liver and kidney deficiency and evaluate its characteristics of comorbidity and pattern.MethodsWistar-Kyoto (WKY) rats and spontaneously hypertensive rats (SHR) were assigned to the WKY control group (control group), hypertension combined with KOA sham-operation group (sham-operation group), hypertension combined with KOA group (model group), hypertension combined with KOA and liver-kidney deficiency pattern group (LKD group). The animal model of KOA combined with hypertension was prepared by anterior cruciate ligament transection (ACLT) in spontaneously hypertensive rats. ACLT combined with intramuscular injection of hydrocortisone was performed to prepare an animal model of KOA with liver-kidney deficiency (LKD) pattern type, combined with hypertension. Then, the related indexes of LKD syndrome were detected in turn, including the contents of thyroid stimulating hormone (TSH), testosterone (T), corticosterone (CORT), adrenocorticotropic hormone (ACTH) in serum, and enzyme activities of alanine transaminase (ALT), aspartate transaminase (AST), and alkaline phosphatase (ALP) in serum, the mass ratio of liver, kidney, spleen, thymus to the brain, body weight, anal temperature, activity situation, and emotion. Systolic blood pressure, diastolic blood pressure, and other blood pressure-related indices were also detected. The levels of serum tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β), plantar mechanical pain sensitivity threshold, weight difference score of both hind limbs, hind limb joint swelling, and quadruped gait parameters were also measured. Furthermore, hematoxylin-eosin, safranine-fast green, and Masson staining were performed to observe pathological changes, cartilage degeneration, and bone destruction of the knee joint, and the microstructure parameters of the tibia were detected by Micro-CT imaging.ResultsCompared to the model group, the contents of serum TSH, ACTH, T, CORT and the mass ratio of the kidney, spleen, and thymus to the brain in the LKD group decreased(P<0.05). Compared to the control group, the systolic blood pressure and diastolic blood pressure of the other three groups increased significantly (P<0.05). Compared to the sham-operation group, serum TNF-α and IL-1β levels increased, plantar mechanical pain threshold decreased, weight difference score of both hind limbs and joint swelling of the affected limb increased(P<0.05), and gait parameters (e.g., gait length and standing time of the affected limbs) became abnormal in the model and LKD groups. Simultaneously, the cartilage surface defect of the rat knee joint was severe, the arrangement of the surface chondrocytes was altered, the cartilage layer became thinner, the muscle fibers increased, and the cartilage ossification was severe. Furthermore, the relative volume, thickness, and number of trabeculae of the knee joint decreased significantly (P<0.05).ConclusionThe rat model established in this study is consistent with the clinical characteristics of integrated traditional Chinese and Western medicine in patients with comorbidities of hypertension and KOA with liver and kidney deficiency pattern. This rat model can characterize the typical symptoms of liver and kidney deficiency pattern. It has typical pathological changes in knee cartilage and subchondral bone tissues and can maintain a stable range of high systolic and diastolic blood pressure. It also explore the scientific connotation of simultaneous treatment of different diseases in traditional Chinese medicine, revealing the therapeutic mechanism and developing new drugs.关键词：liver and kidney deficiency pattern;knee osteoarthritis;hypertension;combination of disease and pattern;rat comorbidity model
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发布时间：2024-06-03 - “最新研究发现，葛花解酒涤脂汤能有效改善酒精性肝病小鼠肝脏能量代谢异常，为治疗酒精性肝病提供新思路。”摘要：ObjectiveTo detect the level of related indexes of energy metabolism in liver tissue of alcoholic liver disease (ALD) mice, and to explore the intervention effect of Gehua Jiejiu Dizhi Decoction.MethodsForty male C57BL/6J mice were randomly divided into the normal control group, the model group, the Gehua Jiejiu Dizhi Decoction high-dose group (4.94 g/kg), the Gehua Jiejiu Dizhi Decoction low-dose group (2.47 g/kg), and the resveratrol group (0.40 g/kg), with 8 mice in each group. Except the normal control group, the mice in other groups were fed with Lieber-DeCarli control liquid diet for five days, followed by Lieber-DeCarli alcohol liquid diet for ten days, and on the 16th day, the mice were given 31.5% alcohol solution through gavage to establish the ALD model. From the second day after modeling, the rats in the intervention groups were given the corresponding drugs by gavage once a day for nine consecutive days. Hematoxylin and eosin staining and oil red O staining were used to observe the liver steatosis in liver tissue. The activities of Na+ K+ -ATPase and Ca2+ Mg2+ -ATPase, and the contents of succinate dehydrogenase (SDH) and hepatic glycogen in liver tissue were detected using spectrophotometry. The contents of ATP, ADP, AMP, the AMP/ATP value, total adenosine pool (TAN) content, and energy charge (EC) in liver tissue were detected by reversed phase high performance liquid chromatography method. The mRNA expressions of NAD dependent deacetylase Sirtuin-1 (SIRT1) and AMP-activated protein kinase (AMPK) α2 in liver tissue were detected by real-time PCR. The protein expressions of SIRT1, AMPKα2, and AMPKβ1 in liver tissue were detected by Western blotting.ResultsCompared with the normal control group, the model group mice showed significant hepatic steatosis, significantly decreased Ca2+ Mg2+ -ATPase activity and SDH content in liver tissue, significantly increased hepatic glycogen content, significantly decreased EC and AMP/ATP value, significantly increased ATP, ADP, AMP, and TAN content, significantly decreased mRNA expressions of SIRT1 and AMPKα2, significantly increased protein expression of AMPKβ1 (P<0.05). Compared with the model group, the Gehua Jiejiu Dizhi Decoction high- and low-dose groups significantly reduced liver tissue steatosis, and the activity of Na+ K+ -ATPase in liver tissue was significantly reduced, the EC and the mRNA expressions of SIRT1 and AMPKα2 were increased (P<0.05); the activity of Ca2+ Mg2+ -ATPase, SDH and ATP contents were increased in the Gehua Jiejiu Dizhi Decoction low-dose group (P<0.05); the AMP/ATP value was increased in the Gehua Jiejiu Dizhi Decoction high-dose group (P<0.05); and the protein expression of SIRT1 was increased in the the Gehua Jiejiu Dizhi Decoction high- and low-dose groups and the resveratrol group(P<0.05); the protein expression of AMPKα2 in the Gehua Jiejiu Dizhi Decoction low-dose group and the resveratrol group was increased (P<0.05). Compared with the Gehua Jiejiu Dizhi Decoction high-dose group, the Gehua Jiejiu Dizhi Decoction low-dose group and the resveratrol group showed a significant increase in ATP, TAN contents, and EC in liver tissue, while the AMP/ATP value decreased (P<0.05); mRNA expressionin of AMPKα2 in the Gehua Jiejiu Dizhi Decoction low-dose group was decreased (P<0.05); and the protein expressions of SIRT1 and AMPKα2 in the resveratrol group were increased (P<0.05). Compared with the Gehua Jiejiu Dizhi Decoction low-dose group, the protein expression of AMPKβ1 was decreased in the resveratrol group (P<0.05).ConclusionThe changes of energy metabolism caused by chronic alcohol intake may be related to the occurrence of ALD, and the intervention of Gehua Jiejiu Dizhi Decoction can improve the abnormal energy metabolism in the liver of ALD mice.关键词：Alcoholic liver disease;Gehua Jiejiu Dizhi Decoction;energy metabolism;SIRT1;AMPK;mice
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发布时间：2024-06-03
Experimental Studies
- “在高甘油三酯血症相关性急性胰腺炎治疗领域，中医典籍提供了独特视角。专家通过梳理“膏－浊－热毒”病机演变，为临床治疗提供新启发。”摘要：Hypertriglyceridemia-associated acute pancreatitis is an inflammatory disorder of exocrine pancreas caused by metabolism disturbances of triglyceride-rich lipoproteins. Currently, hypertriglyceridemia-associated acute pancreatitis is characterized by an escalating incidence rate, a tendency for more severe cases, and a lack of therapeutic drugs. Traditional Chinese medicine has distinct advantages in treating this disease, but its theoretical framework has not yet been established. Hypertriglyceridemia-associated acute pancreatitis manifests itself as a febrile disease, aberrant accumulation of fat and turbidity may stem from dietary imbalances and visceral dysfunction in ordinary individuals. The prolonged accumulation of fat and turbidity can transform into turbid pathogen, subsequently engendering heat, constituting a pivotal pathogenic factor. Throughout the progression of the disease, the fiery pathogen consumes the fat and turbidity, resulting in the generation of toxic heat, which is a crucial mechanism in the exacerbation of the disease severity. Thus, this article posits therapeutic principles aimed at averting the transformation of fat and turbidity into turbid pathogen and counteracting toxic heat in this disease. This article reviews two key theories from traditional Chinese medicine classics relevant to hypertriglyceridemia-associated acute pancreatitis: the theory of fat-turbidity associated with hypertriglyceridemia and the febrile disease related to acute pancreatitis. Combining these traditional theories with modern research on the mechanisms that intensify hypertriglyceridemia-associated acute pancreatitis and the corresponding targets of traditional Chinese medicine, it suggests that the pathogenesis of " fat-turbidity-toxic heat" serves as the theoretical basis of traditional Chinese medicine for the aggravated severity of hypertriglyceridemia-associated acute pancreatitis. The article aims to offer new insights for the treatment of hypertriglyceridemia-associated acute pancreatitis.关键词：hypertriglyceridemia-associated acute pancreatitis;fat-turbidity-toxic heat;free fatty acids;multiple organ dysfunction syndrome
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发布时间：2024-06-03 - “最新研究发现，中医药治疗肠系膜淋巴结炎具有独特优势，通过温阳和中、燥湿行气、化痰散结之法，结合脑-肠轴相关理论，可取得明显临床疗效。”摘要：Mesenteric lymphadenitis(ML) is a common digestive system disease in pediatrics. It is a common cause of acute abdominal pain in children, which is characterised by recurrent attacks. If not treated properly with protracted duration, children′s growth and development will be affected. Western medicine focuses on relieving pain and resisting inflammation, traditional Chinese medicine(TCM)has unique advantages in the treatment of ML. HUANG Yuanyu′s " earth pivot four organs and whole qi circulating" is a theory about the circulation of qi in the body, which emphasizes in particular the importance of the middle-jiao. The spleen and stomach in middle-jiao is the core of the ascending and descending of qi in this theoretical system. The qi of spleen and stomach rises on the left to form the heart and liver, and falls on the right to form the lungs and kidneys. This process, just like a ring, is in an infinite loop. The brain-gut axis is a collective term for the complex information exchange network between the digestive system and the nervous system, which has some similarities with the theory of " earth pivot four organs and whole qi circulating". The etiology and pathogenesis of ML are consistent with the viewpiont of yang deficiency and yin excessiveness, and dampness obstructs the middle-jiao, causing the middle-jiao losing its vitality, resulting in stagnation of qi circulating in this theory. At the same time, the occurrence and development of ML is also regulated by the brain-gut axis. Therefore, the main pattern of this disease is spleen deficiency and dampness obstruction. Liver-spleen qi stagnation and spleen-kidney yang deficiency are common causes, too. Based on the theory of " earth pivot four organs and whole qi circulating", significant clinical effects can be achieved in the treatment of ML by warming yang and regulating middle-jiao, drying dampness and activating qi, dissipating phlegm and resolving masses, combined with the theory of the brain-gut axis.关键词：earth pivot four organs and whole qi circulating;Huang Yuanyu;mesenteric lymphadenitis;warming middle jiao, drying dampness, and activating qi
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发布时间：2024-06-03 - “最新研究揭示了溃疡性结肠炎活动期大肠湿热证患者的代谢组学特征，通过非靶代谢组学技术检测血清样本，筛选出显著差异的代谢产物，并利用KEGG数据库和MetaboAnalyst软件进行通路分析，发现主要涉及色氨酸代谢、鞘脂代谢、甘油磷脂代谢和嘧啶代谢等通路异常，为中医药辨证治疗提供了科学依据。”摘要：ObjectiveTo obtain the metabolomics characteristics of patients in the active stage of ulcerative colitis (UC) with syndrome of dampness-heat in large intestine through non-target metabolomics technology, and to provide a basis for promoting the theoretical system of traditional Chinese medicine (TCM) syndrome differentiation of disease syndrome combination and micro-macro combinations.MethodsNon-target metabolomics technology was used to detect the serum samples from 159 patients in the active stage of UC (81 cases with syndrome of dampness-heat in large intestine and 78 cases with syndrome of non-dampness-heat in large intestine) and 30 healthy volunteers. The orthogonal partial sample least squares discriminant analysis model was constructed to screen metabolites with significant changes among groups. The variable importance in projection≥1, P<0.05, and fold change (FC)>1.20 or FC<0.83 were used as the criteria for the screening of differential metabolites. The Kyoto Encyclopedia of Genes and Genomes (KEGG) was used to annotate differential metabolites, and MetaboAnalyst software was used for pathway analysis.ResultsBetween patients in active stage of UC with syndrome of dampness-heat in large intestine and syndrome of non-dampness-heat in large intestine, a total of 99 differential metabolites were screened in the positive ion mode, of which 48 were upregulated and 51 were downregulated. In the negative ion mode, a total of 38 differential metabolites were screened, of which 19 were upregulated and 19 were downregulated. The KEGG enrichment analysis showed that there were 21 metabolic pathways, and the pathway analysis showed that there were mainly four metabolic pathways involved in tryptophan metabolism, sphingolipid metabolism, glycerophospholipid metabolism, and pyrimidine metabolism.ConclusionPatients in the active stage of UC with syndrome of dampness-heat in large intestine have abnormal metabolic pathways, which can provide a basis for TCM syndrome differentiation and treatment for UC with syndrome of dampness-heat in large intestine.关键词：ulcerative colitis;syndrome of dampness-heat in large intestine;metabolomics;modernization of traditional Chinese medicine
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发布时间：2024-06-03
Clinical Studies
- “最新研究发现，中性粒细胞胞外诱捕网(NET)在哮喘发病中扮演重要角色，过度蓄积可能加重病情。基于中医体质学原理，探讨了NET在哮喘发病中的作用，为哮喘治疗提供了新思路。”摘要：Bronchial asthma (asthma) is a common clinical respiratory disease mediated by multiple cells and components, and neutrophils, as one of the classic innate immune cells, play an important role in the pathogenesis of asthma. In the inflammatory state, neutrophils release neutrophils extracellular trap(NET) into the periphery through the NETosis procedure. Although NET is a beneficial antibacterial defense structure, its excessive accumulation can trigger different response mechanisms that can also adversely affect the lungs and exacerbate asthma. Based on the basic principles of traditional Chinese medicine constitution, exploring the important role of NET in the pathogenesis of asthma, it holds that the life process theory body-spirit composition theory, endowment inheritance theory, and environmental constraint theory are related to the gradual formation of NET and different stimuli affect the heterogeneity of NET, thereby mediating different biological effects during the onset of asthma. Targeting NET and/or its components may become a new treatment strategy on asthma.关键词：traditional Chinese medicine constitution;bronchial asthma;neutrophils;neutrophil extracellular traps
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发布时间：2024-06-03
TCM Constitutions
- “在恶性肿瘤治疗领域，本团队基于国医大师周仲瑛“癌毒”理论，提出扶阳消阴辨治新策略，强调整体调和，动态用药，可显著提升患者生活质量和远期生存率。”摘要：Malignancies are a difficult to treat disease in clinical practice. At present, there are many cases of differentiation and treatment based on qi and yin deficiency, the coagulation of phlegm, blood stasis and cancer toxin, there are few theories on the treatment of yang deficiency and yin excessiveness, as well as the coagulation of cold and dampness. On the basis of inheriting the cancer toxin theory of Chinese medicine master ZHOU Zhongying, combined with the theory of promoting yang and our own practice, we believe that malignancy is caused by yang deficiency as the foundation, cold dampness, phlegm-turbidity stagnation and toxin transformation as the manifestation, and the key pathogenesis can be summarized as yang deficiency and yin binding. Based on this, it is proposed to differentiate and treat malignancies from promoting yang and eliminating yin. The method of promoting yang and eliminating yin is people-oriented, with harmony as the value, based on the whole, with a focus on adjusting harmony, constantly promoting yang and timely eliminating yin. The specific differentiation and treatment strategies are as follows: in the early stages of malignancy, it is important to seize the opportunity to warm and dredge, or eliminate yin; malignancy is already present, balancing deficiency and excess, supplementing, eliminating, and harmonizing appropriately; after malignancy surgery, it is important to strengthen the foundation and regulate the spleen and kidney, and strengthen both congenital and acquired constitution; treating the zang-fu organs accordingly, elevating and lowering, and conforming to the physiology of the organs. Unlike simple malignancy treatment and detoxification, promoting yang and eliminating yin is a method of examining symptoms and identifying etiology and pathogenesis. It involves macroscopic regulation of yin and yang, dynamic management of medication, and orderly treatment, which can significantly improve the quality of life of patients and increase long-term survival rates. Exploring the theory and strategy of promoting yang and eliminating yin in the differentiation and treatment of malignancy can provide new ideas and references for the clinical differentiation and treatment of malignancies.关键词：malignancy;promoting yang and eliminating yin;yang deficiency;harmonization;cancer toxin
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发布时间：2024-06-03 - “最新研究揭示了高危骨髓增生异常综合征(HR-MDS)患者的临床生存特征，为临床预后评估提供了重要参考。通过分析200例患者的临床资料，发现高危与极高危、血红蛋白(Hb)水平、血小板(PLT)计数以及骨髓增生异常综合征转白血病(MDS-AML)状态对无进展生存期(PFS)有显著影响。研究还发现，接受含砷中药复方联合去甲基化药物(HMAs)治疗的患者，PLT计数≥50×10^9/L和化疗疗程≥5个与PFS延长显著相关；而接受含砷中药复方联合雄激素治疗的患者，Hb≥80 g/L、PLT计数≥50×10^9/L和非MDS-AML状态与PFS延长显著相关。这一发现为HR-MDS患者的个体化治疗提供了科学依据。”摘要：ObjectiveTo investigate the clinical characteristics of survival in patients with high-risk myelodysplastic syndromes (HR-MDS) and provide a reference for the clinical prognosis of patients with HR-MDS.MethodsGeneral data, blood routine test, bone marrow smear with histopathology, cytogenetics, and other clinical data of 200 patients diagnosed with HR-MDS at Xiyuan Hospital of China Academy of Chinese Medical Sciences, during the period of January 2016-September 2022, were retrospectively analyzed. The included patients were categorized into the arsenic-containing herbal combination combined with demethylating agents (HMAs) treatment group and the arsenic-containing Chinese medicine compound combined with androgen treatment group. The influence of clinical indices on the survival characteristics of each group was analyzed.ResultsComparison of the impact of clinical indicators on survival in 200 patients with HR-MDS who were treated with arsenic-containing herbal compounds in combination with HMAs or androgens showed that high-risk vs. very high-risk (P = 0.018), hemoglobin (Hb) <80 g/L vs. Hb ≥80 g/L (P = 0.035), platelet (PLT) counts <50 × 109 L-1 vs. PLT counts ≥50 × 109 L-1 (P < 0.001), and the difference in median progression-free survival (PFS) time between myelodysplastic syndromes converted to leukemia (MDS-AML) and non-MDS-AML (P = 0.003) were statistically significant. Comparison of survival effects of clinical indicators in 68 patients with HR-MDS who were treated with arsenic-containing Chinese medicine compound combined with HMAs showed that the difference in median PFS between PLT count < 50 × 109 L-1 and PLT count ≥50 × 109 L-1 (P < 0.001) and the difference in median PFS between <5 and ≥5 courses of chemotherapy (P = 0.018) were statistically significant. Comparison of survival effects of clinical indicators in 132 patients with HR-MDS who were treated with arsenic-containing Chinese medicine compound combined with androgens showed that Hb <80 g/L and Hg ≥80 g/L (P = 0.028), PLT count <50 × 109 L-1 and PLT count ≥50 × 109 L-1 (P = 0.002), and the mean differences in PFS between MDS-AML and non-MDS-AML (P = 0.024) were statistically significant.ConclusionThe clinical characteristics of long-surviving patients treated with arsenic-containing herbal combination in combination with HMAs included PLT counts ≥50 × 109 L-1 and ≥5 courses of chemotherapy. The clinical characteristics of long-surviving patients treated with arsenic-containing herbal combination in combination with androgens included Hg ≥80 g/L, PLT count ≥50 × 109 L-1, and non-MDS-AML.关键词：high-risk myelodysplastic syndrome;blood diseases;survival analysis;arsenic-containing herbal combination;androgen;overall survival;progression-free survival
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发布时间：2024-06-03
Hematology and Oncology
- “最新研究发现，电针刺激特定穴位能有效改善帕金森病模型小鼠的运动功能障碍，减少PD标志物α-syn的异常聚集，增加酪氨酸羟化酶表达量，其机制可能与调控炎症小体相关通路NLRP3、Caspase-1、IL-1β表达有关。”摘要：ObjectiveTo explore the effects of electroacupuncture on motor function in Parkinson′s disease(PD) model mice and NLRP3 inflammasome-related proteins in the midbrain substantia nigra (SN).MethodsC57BL/6 mice were assigned to three groups according to the random number table method : control group, model group, and electroacupuncture (EA) group, 12 mice per group. The PD model was reproduced by intragastric administration of rotenone solution 10 mg/(kg·d). EA group was administered at the three selected points, " Fengfu" (GV16), " Taichong" (LR3), and " Zusanli" (ST36), with a treatment cycle of 2 weeks. The control and model groups took the same time synchronous fixation operation for the control variable. Behavioral scores and open field tests were used to detect the exercise ability of mice in each group. Tyrosine hydroxylase (TH) and α-synuclein (α-syn) in the midbrain SN of mice in all groups were measured with an immunohistochemistry test. NLRP3 and cysteinyl aspartate specific proteinase-1 (Caspase-1) protein expression levels in the midbrain SN of mice in the three groups were measured using Western blotting, and interleukin-1β (IL-1β) content was determined with an enzyme-linked immunosorbent assay.ResultsCompared to the control group, the behavioral scores of the mice in the model group were higher (P<0.01). Compared to the model group, the behavioral scores of the mice in the EA group were lower (P<0.01). Compared to the control group, the time ratio of the relative rest state of the mice in the model group (<100 mm/s) increased significantly (P<0.01), while the time ratio of the slow motion (100~200 mm/s) and time ratio of the fast motion (>200 mm/s) state decreased significantly (P<0.01). Compared to the model group, the time ratio spent in the relative rest state of mice in the EA group decreased significantly (P<0.01), while the time ratio of the slow motion state and time ratio of the fast motion state and movement rate increased significantly (P<0.01). Compared to the control group, the TH expression level decreased in the SN in the model group (P<0.01), while α-syn increased (P<0.01). Compared to the model group, the TH expression level in the EA group increased (P<0.05), while α-syn decreased (P<0.05). Compared to the control group, the protein expressions of NLRP3 and Caspase-1 in the SN of the model group increased (P<0.01); compared to the model group, the expressions of NLRP3 and Caspase-1 in the SN of the midbrain of mice decreased after EA treatment (P<0.01). Compared to the control group, IL-1β in the SN of the mouse midbrain increased in the model group (P<0.01). Compared to the model group, IL-1β decreased in the EA group (P<0.05).ConclusionThis experiment shows that stimulation of EA in " Fengfu", " Taichong", and " Zusanli" can effectively reduce abnormal aggregation of the PD marker α-syn, increase TH expression, and enhance the motor dysfunction of PD model mice. The molecular mechanism is related to the regulation of the expression of NLRP3, Caspase-1, and IL-1β of inflammasome-related pathways.关键词：Parkinson′s disease;electroacupuncture;motor dysfunction;Fengfu (GV16);Taichong (LR3);Zusanli (ST36);mice
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发布时间：2024-06-03
Acupuncture Moxibustion and Tuina
- “江苏省中医院针灸康复科利用咳喘停穴位贴敷治疗支气管哮喘患者，通过多种算法构建疗效预测模型，准确率超过70%，筛选出烟酒嗜好、过敏病史等5个重要影响因素。研究表明，穴位贴敷对哮喘控制水平改善作用明显，对气道炎症改善作用有限。”摘要：ObjectiveWe aimed to investigate the feasibility and method of constructing a traditional Chinese medicine (TCM) curative effect prediction model based on the data of Kechuanting acupoint plastering therapy in the treatment of bronchial asthma(asthma).MethodsData from the Chronic Disease Management Research Platform of 303 patients with asthma who were treated with Kechuanting acupoint plastering therapy for 6 weeks in the Department of Acupuncture and Rehabilitation of Jiangsu Hospital of Traditional Chinese Medicine from June to August 2018 to 2021 were selected. We used Phyton 3.10 for statistical analysis. After data preprocessing, the influencing factors were used to build models by Logistic regression, support vector machine, K-means clustering algorithm, Bayes algorithm, random forest method and Light gradient boosting machine(LightGBM) respectively, with the improvement of asthma control test score(ACT), forced expiratory volume in one second (FEV1) and exhaled nitric oxide (FeNO) as the outcome indicators. Then, the models were compared and analyzed. Subsequently, the superior model was used to establish the efficacy prediction model and verify its stability to obtain the accuracy rate and eliminate the relatively important factors.ResultsThe accuracy rate of the Kechuanting acupoint plastering therapy curative effect prediction model established by the LightGBM model was more than 70%. Five important factors were selected, including allergic history, tabacco and alcohol abuse, plastering duration, ACT before treatment, and FeNO before treatment. According to the classification analysis and the relationship between the important factors and the outcome indicators, Kechuanting acupoint plastering therapy significantly improved the ACT of patients with no history of allergy, no tabacco and alcohol abuse, and poor ACT: 5-15 points (P<0.05). Furthermore, Kechuanting acupoint plastering therapy improved FeNO more significantly in patients with more than 3 years of treatment than those with no more than 3 years (P<0.05). However, Kechuanting acupoint plastering therapy only improved FeNO in a few patients with poor asthma control levels (P<0.05) and severe airway inflammation (FeNO > 50×10-9) (P > 0.05).ConclusionAcupoint plastering application has a significant effect on improving the control level of asthma, but its effect on improving airway inflammation is limited. It is feasible to use data from the chronic disease management research platform to construct the prediction model. After optimization and testing, the predictive model established based on the data of this study may provide an effective evaluation tool for targeted clinical treatment.关键词：bronchial asthma;Kechuanting;plaster applied to point;efficacy predication;LightGBM model
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发布时间：2024-06-03
Information and Statistics
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