Phlegm Stasis Research Articles

Huaxian Formula Prevents the Progression of Radiation-Induced Pulmonary Fibrosis by Inhibiting the Pro-Fibrotic Effects of Macrophages

Ethnopharmacological relevanceThe Huaxian formula (HXF), a traditional Chinese medicine (TCM) remedy, specifically targets the pathological factors of "heat toxicity" and "phlegm stasis" induced by radiation in radiation-induced pulmonary fibrosis (RIPF). It works by clearing heat and invigorating the blood, addressing these key factors in the development of RIPF. Aim of the studyThe HXF has demonstrated potential in preventing RIPF, although its underlying mechanisms remain unclear. This study aims to investigate the efficacy, molecular targets, and mechanisms of action of HXF. Materials and methodsThe major constituents of the HXF were identified by ultra performance liquid chromatography and tandem mass spectrometry (UPLC-MS). C57BL/6j mice were divided into four groups: control (Ctrl), HXF alone (HXF), 17Gy-irradiation alone (IR), and irradiation plus HXF (IR + HXF). Lung damage and fibrosis were assessed by histopathological staining, and the flow cytometry and immunohistochemistry (IHC) were used to detect the macrophages phenotype of lung tissues in vivo at 16 weeks post-irradiation. Transcriptomic sequencing and bioinformatics analyses identified key genes modulated by HXF. In vitro assays included flow cytometry, western bolt, and quantitative PCR (qPCR) explored the impact of HXF on macrophage polarization and fibrotic activity, while co-culture experiments of the macrophage conditional medium and mouse embryo fibroblast NIH/3T3 investigated macrophage-fibroblast interactions. Results20 major constituents of HXF were identified. And the in vivo results revealed significant lung damage and fibrosis in the IR group, which were notably mitigated in the IR + HXF group. And HXF has been shown to significantly inhibit the infiltration of M2-type macrophages in lung tissues. Transcriptomic analysis identified differentially expressed genes (DEGs) such as Arg1, Mmp10, and Fgf23. Bioinformatics enrichment analysis indicated that these DEGs are involved in pathways related to the inhibition of extracellular matrix formation and inflammation. In vitro, HXF-containing serum reduced M2-type macrophage polarization and decreased the secretion of Arginase1 and TGFβ1. Conditioned medium from HXF-treated macrophages suppressed fibroblast activation. ConclusionHXF's preventive effects on RIPF involve multiple targets and mechanisms, including the modulation of Arg1, Mmp10, and Fgf23 expression. By inhibiting the pro-fibrotic capacity of macrophages, HXF suppresses fibroblast activation and collagen production, thereby alleviating lung fibrosis. These findings underscore the potential of HXF as a preventive strategy in managing RIPF.

The Influencing Factors and Traditional Chinese Medicine Syndrome Characteristics of Depression/Anxiety in Patients with Coronary Heart Disease: A Cross-sectional Study

Abstract Objective: The objective of the study was to investigate the situation of depression/anxiety in patients with coronary heart disease (CHD) at different stages of the disease and to analyze the influencing factors and the evolution characteristics of traditional Chinese medicine (TCM) syndromes. Materials and Methods: From October 2016 to April 2018, a cross-sectional survey was conducted at 48 clinical research centers in 23 provinces, cities, and autonomous regions across China. A total of 11383 cases were collected by outpatient or inpatient cases, including healthy individuals (n = 1754), low-risk individuals (n = 2339), metabolic syndrome (n = 1475), stable CHD (n = 3366), acute coronary syndrome (n = 704), perioperative intervention treatment (n = 753), and heart failure (n = 992). Survey demographic data, lifestyle habits, disease and health status, TCM symptoms and signs, and other information were collected. Results: The prevalence rates of depression/anxiety in surveyed patients with CHD were 35.7% and 21.0%, respectively, and were higher than those in patients with metabolic syndrome (18.8% and 10.3%, respectively), low-risk individuals (11.7% and 7.5%), and healthy individuals (9.7% and 5.7%, respectively). The significant risk factors for CHD combined with depression analyzed by the generalized linear mixed model included age (odds ratio [OR] = 0.019), gender (OR = 0.632), hypertension (OR = 0.306), course of CHD (OR = 0.022), stent placement (OR = −0.284), heart function level (OR = −4.151/−3.336/−2.118), and phlegm stasis syndrome score (OR = 0.129). The significant risk factors for CHD combined with anxiety included gender (OR = 0.581), heart function level (OR = −1.856), and phlegm stasis syndrome score (OR = 0.094). Factor analysis was conducted on the symptoms and signs of patients with CHD combined with depression/anxiety, and 16 common factors were obtained with cumulative contribution rates of 62.83% and 66.13%, respectively. Disease syndromes included liver and kidney deficiency syndrome, liver stagnation and discomfort syndrome, Qi deficiency syndrome, liver meridian fire heat syndrome, kidney deficiency syndrome, phlegm dampness syndrome, heart and gallbladder Qi deficiency syndrome, blood stasis syndrome, lung Qi inversion syndrome, Yang deficiency syndrome, and three symptoms named diseases, including chest tightness, chest pain, insomnia, and head discomfort. Conclusions: Through cross-sectional design, the data obtained in this study revealed the actual situation of CHD patients with anxiety or depression at different stages. The influencing factors of CHD patients with depression or anxiety were analyzed through the collected cross-sectional information and further revealed the syndromic characteristics of CHD patients with depression or anxiety at different stages from the perspective of TCM syndromes. The data obtained provide a practical basis for further understanding the clinical characteristics of bicardiac diseases and for proposing treatment strategies in stages.

Clinical efficacy and gene chip expression analysis of Shenzhu Guanxin recipe granules in patients with intermediate coronary lesions.

To evaluate the clinical efficacy and safety of Shenzhu Guanxin recipe granules (, SGR) in treating patients with intermediate coronary lesions (ICL), and to investigate the potential mechanism though a transcriptome sequencing approach. ICL patients with Qi deficiency and phlegm stasis were adopted and randomly assigned to a case group or a control by random number generator in a 1:1 randomization ratio to evaluate the clinical efficacy. There was no significant difference between the two groups in coronary computed tomography angiography related indexes in the two groups before and after intervention. Through the gene chip expression analysis, it is finally concluded that there are 355 differential mRNAs (190 up-regulated genes and 165 down regulated genes) when compared the SGR group and placebo group. Through protein-protein interaction network analysis of differentially expressed genes, 10 hub genes were finally obtained: CACNA2D2, CACNA2D3, DNAJC6, FGF12, SGSM2, CACNA1G, LRP6, KIF25, OXTR, UPB1. SGR combined with Western Medicine can be safely used to treat ICL patients with Qi deficiency and phlegm stasis. The possible mechanism of action and relevant gene loci and pathway were proposed.

Associations of traditional Chinese medicine body constitution and all-cause mortality in patients with type 2 diabetes mellitus: a prospective cohort study of a Taiwanese medical center.

The objective of this study was to investigate associations between baseline body constitutions (BCs) in traditional Chinese Medicine (TCM) and all-cause mortality in Chinese individuals with type 2 diabetes. A total of 887 individuals with type 2 diabetes who were enrolled in managed care in 2010 were included. These individuals were followed up until 2015, and their mortality status was determined through the use of Taiwan National Death Datasets. At baseline, BC status of participants, including Yin deficiency, Yang deficiency, and phlegm stasis, was assessed using a well-developed Body Constitutions Questionnaire. Hazard ratios (HR) were calculated using a multivariate Cox proportional hazards model. During 6807.2 person-years of follow-up of 887 participants, with an average follow-up period of 7.7 years, a total of 190 individuals died, resulting in an incidence density of 0.0279 person-years. Yin deficiency was associated with all-cause mortality (HR, 95% CI: 1.39, 1.02-1.90). This study indicates that individuals diagnosed with Yin deficiency in TCM, characterized by symptoms such as thirst, reduced urine volume, hard stool, and hot flushes, had a 39% higher risk of all-cause mortality. The findings may provide information for TCM practitioners on tailoring treatment plans for persons with type 2 diabetes. No conclusive statements can be made on the basis of the preliminary data presented here. Controlled prospective studies are warranted.

从痰瘀论治慢性阻塞性肺疾病的 临床应用进展

从痰瘀论治慢性阻塞性肺疾病的 临床应用进展

Analysis of traditional Chinese medicine syndrome types and frequency changes of CD8+ and CD25+ T cells in metabolic-related fatty liver disease.

This study aimed to observe and analyze the changes in traditional Chinese medicine (TCM) syndrome types and CD8+ and CD25+T cell frequencies of metabolic-related fatty liver disease. For this purpose, 100 patients with metabolic-related fatty liver disease and their TCM syndrome types who were screened for medical treatment were collected. Flow cytometry was used to detect the changes in the frequency of CD8+ and CD25+T cells in the peripheral blood of patients, as well as liver function, fasting blood glucose, and lipid index. The frequency differences of CD8+ and CD25+T cells in patients with different syndrome types were compared. To use partial correlation analysis to determine the correlation between CD8+, CD25+T cell frequencies and TCM syndrome types in patients. Results showed that a total of 30 cases of liver stagnation and spleen deficiency syndrome, 25 cases of phlegm turbidity internal obstruction syndrome, 20 cases of dampness heat stasis syndrome, and 25 cases of phlegm stasis mutual accumulation syndrome were included in the 100 MAFLD patients. There was statistical significance (P<0.01) in the comparison of ALT, AST, GGT, TC, TG, HDL-C, LDL-C, FPG, HOMA-IR, CD8+CD25+, CD8+CD25-, CD8-CD25+, and CD8-CD25- among patients with different TCM syndrome types. There is a positive correlation between TCM syndrome types and patients' CD8+CD25+, CD8+CD25-, and CD8-CD25+, while there is a negative correlation between them (P<0.05). From the chord diagram, the relationship between CD8+CD25+ and TCM syndrome types is the closest. The ROC curve was used to analyze and determine that the relevant standard for CD8+CD25+ in liver depression and spleen deficiency syndrome is <4.90%; The relevant standard for phlegm turbidity internal obstruction syndrome is 4.90%~7.88%; Damp heat stasis syndrome is 7.88%~8.20%; The syndrome of phlegm and blood stasis accumulation is more than 8.20%. The TCM syndrome types of metabolic-related fatty liver disease will vary with the frequency of CD8+ and CD25+T cells. In conclusion, TCM syndrome types are closely related to the severity of the patient's condition and immune function, providing a new perspective and means for understanding the pathogenesis of metabolic-related fatty liver disease and evaluating the condition.

Therapeutic effects of Naohuan Dan combined with idebenone in treating mild cognitive impairment with kidney deficiency and phlegm stasis: A retrospective study

Abstract Background Naohuan Dan is a prescription used to treat dementia. This study aims to assess the effectiveness and safety of Naohuan Dan combined with idebenone in treating mild cognitive impairment (MCI) with kidney deficiency and phlegm stasis. Materials and methods This retrospective, observational clinical trial enrolled 64 MCI patients treated in the Sun Yat-sen Memorial Hospital, Zhongshan University, from May 1, 2019, to April 30, 2022. The 32 patients in the treatment group received Naohuan Dan combined with idebenone, whereas the 32 patients in the control group were treated with idebenone alone. The observation lasted for 12 weeks. The primary outcomes were the Mini-Mental State Examination (MMSE) score and clinical efficacy, whereas secondary outcomes included the Montreal Cognitive Assessment (MCS) score, the activities of daily living (ADL) score, the Geriatric Depression Scale (GDS) score, the traditional Chinese medicine (TCM) syndrome score, and changes in serum markers. Neuron-specific enolase (NSE), interleukin 8 (IL-8), and tumor necrosis factor α (TNF-α) were taken as the serological indicators for evaluating cognitive function. Adverse events in both groups were recorded during the treatment period. Results The treatment group demonstrated higher MMSE scores and clinical efficacy than the control group, specifically in the scores of spatial orientation, attention and calculation, and language proficiency in the MMSE scale. The treatment group outperformed the control group in MCS, ADLs, GDS, and TCM syndrome scores. Furthermore, the treatment group was superior to the control group in recovering the levels of NSE, IL-8, and TNF-α. In addition, the treatment group had lower incidence of adverse reactions such as nausea and poor appetite than the control group. Conclusions The 12-week treatment with Naohuan Dan combined with idebenone significantly improved the cognitive function and daily life abilities, lowered the depression levels, and reduced the occurrence of adverse events among patients with MCI. These findings offer valuable insights into the efficacy of integrating TCM with Western medicine in the clinical management of MCI. (ClinicalTrials.gov ID: NCT05931029; https://clinicaltrials.gov/study/NCT05931029?cond=Naohuan%20Dan&amp;rank=1)

Retracted: Observation on the Efficacy of Moxibustion Combined with Ear Acupoint Pressing Beans in Treating Patients with Phlegm Stasis Syndrome Vertigo.

[This retracts the article DOI: 10.1155/2022/4295423.].

Visual analysis of research on traditional Chinese medicine treatment of Alzheimer's disease in recent ten years

This study employed bibliometrics tools to review the studies of traditional Chinese medicine(TCM) treatment of Alzheimer's disease(AD) in recent ten years, aiming to explore the research status, hotspots, and future trends in this field at home and abroad. The relevant literature published from January 1, 2012 to August 15, 2022 was retrieved from Web of Science and CNKI. CiteSpace 6.1R2 and VOSviewer 1.6.15 were used for the visual analysis of authors, countries, institutions, keywords, journals, etc. A total of 2 254 Chinese articles and 545 English articles were included. The annual number of articles published showed a rising trend with fluctuations. The country with the largest number of relevant articles published and the largest centrality was China. SUN Guo-jie and WANG Qi were the authors publishing the most Chinese articles and English articles, respectively. Hubei University of Chinese Medicine and Beijing University of Chinese Medicine published the most articles in Chinese and English, respectively. Journal of Ethnopharmacology and Neuroscience Letters published the articles with the highest cited frequency and the highest centrality. According to the keywords, the research on TCM treatment of AD mainly focused on the mechanism of action and treatment methods. Metabolomics, intestinal flora, oxidative stress, tau hyperphosphorylation, β-amyloid(Aβ), inflammatory cytokines, and autophagy were the focuses of the research on mechanism of action. Acupuncture, clinical effect, kidney deficiency and phlegm stasis, and dredging governor vessel to revitalize mind were the hotspots of clinical research. This research field is still in the stage of exploration and development. Exchanges and cooperation among institutions should be encouraged to carry out more high-quality basic research on TCM treatment of AD, obtain high-level evidence, and clarify the pathogenesis and prescription mechanism.

Explanation of the Connotation of Lei Zhongyi's Theory System of Chest Obstruction and Phlegm Stasis in Coronary Heart Disease

According to Lei Zhongyi, most patients with coronary heart disease are middle-aged and elderly, with deficiency of Qi, deficiency of Qi and Blood, deficiency of Yin and Yang, deficiency of Qi to transport Blood, stagnation of Blood, imbalance of Qi, stagnation of Qi and Blood, invasion of Cold, stagnation of Cold and Blood, internal growth of Phlegm, mutual obstruction of Phlegm and Stasis, internal gathering of Heat and Poison, stagnation of Heat and Blood. The disease is characterized by deficiency of the root and the symptoms, with a mixture of deficiency and reality. The deficiencies include Qi deficiency, Qi-Yin deficiency and Yin-Yang deficiency, while the symptoms include blood stasis, cold clotting, phlegm stagnation, Qi stagnation and heat toxicity. Lei Zhongyi has devoted himself to the study of activating blood stasis and using the method of activating blood stasis to treat angina pectoris in coronary heart disease with remarkable results. Based on clinical observations, he proposed the theory of mutual integration of phlegm and blood stasis in the treatment of chest paralysis and heart pain. The theory of phlegm and stasis of blood is often combined, and the two are both pathological products and causative factors that intertwine and play a very important role in the development of coronary heart disease.

Traditional Chinese medicine body constitution predicts new-onset diabetic albuminuria in patients with type 2 diabetes: Taichung diabetic body constitution prospective cohort study

This prospective cohort study explored whether body constitution (BC) independently predicts new-onset albuminuria in persons with type 2 diabetes mellitus (T2DM) enrolled in the diabetes care management program (DCMP) of a medical center, providing evidence of integrating traditional Chinese medicine into DCMP for improving care quality. Persons with T2DM (n = 426) originally without albuminuria enrolled in DCMP were recruited in 2010 and were then followed up to 2015 for detecting new-onset albuminuria. The participants received urinalysis and blood test annually. Albuminuria was determined by an elevated urinary albumin/creatinine ratio (≥ 30 µg/mg), and poor glucose control was defined as Glycosylated hemoglobin above or equal to 7%. BC type (Yin deficiency, Yang deficiency, and phlegm stasis) was assessed using a well-validated body constitution questionnaire at baseline. Risk factors for albuminuria (sociodemographic factors, diabetes history, lifestyle behaviors, lipid profile, blood pressure, and kidney function) were also recorded. Hazard ratios (HR) of albuminuria for BC were estimated using multivariate Cox proportional hazards model. During the 4-year follow-up period, albuminuria occurred in 30.5% of participants (n = 130). The HR indicated that Yin deficiency was significantly associated with an increased risk of new-onset albuminuria in persons with T2DM and good glucose control after adjustment for other risk factors (HR = 2.09; 95% confidence interval = 1.05-4.17, P = .04), but not in those with poor glucose control. In persons with T2DM and poor glucose control, phlegm stasis was also significantly associated with a higher risk of albuminuria (2.26; 1.03-4.94, P = .04) after multivariate adjustment, but not in those with good glucose control. In addition to already-known risk factors, BC is an independent and significant factor associated with new-onset albuminuria in persons with T2DM. Our results imply Yin deficiency and phlegm stasis interacting with glucose control status may affect new-onset albuminuria in persons with T2DM.

Clinical Study on Acupoint Application of Jianpi Powder Combined with Chinese Medicine Decoction in Chronic Atrophic Gastritis

Background To investigate the clinical effects of acupoint application with Jianpi Powder combined with Chinese herbal decoction in chronic atrophic gastritis (CAG).Methods: 140 patients with CAG of spleen deficiency and phlegm stasis type from January 2018 to January 2020 were selected and divided into control and observation groups, with 70 cases in each group. The patients in control group was given Chinese medicine decoction, and those in the observation group was given acupoint application of Jianpi Powder combined with Chinese medicine decoction. The clinical efficacy, the levels of gastrograph index and inflammatory factors, life quality and the occurrence of adverse effects were compared.Results: After treatment, the total effective rate of the observation group was obviously higher than that of the control group. The amplitudes of the pre-prandial and postprandial electrogastrograms were obviously higher, and those in the observation group were obviously higher compared with the control group. Interleukin-8 (IL-8), interleukin-11 (IL-11), and tumor necrosis factor (TNF-α) were decreased than those before treatment, and those in the observation group was lower. The scores of physical function, health status, social function, and mental health were obviously higher than those before treatment, with the significantly increase in patients of the observation group . There was no significant difference in the incidence of adverse effects.Conclusion: Acupoint application of Jianpi Powder with traditional Chinese medicine decoction has a significant effect on patients with CAG, with clinical symptoms improvement, inflammation reduction, and the recovery of gastric motility promotion.

Levonorgestrel intrauterine devices improve body constitution deviations in the perspective of traditional Chinese medicine and quality of life in patients with chronic pelvic pain and heavy menstrual bleeding

ObjectiveThis study aimed to investigate whether the use of levonorgestrel intrauterine devices (LNG-IUD) in the perspective of traditional Chinese medicine (TCM) can improve the body constitution deviations and quality of life (QoL) in patients with chronic pelvic pain (CPP) and heavy menstrual bleeding (HMB). Materials and methodsTo understand the TCM body constitution differences between patients, patients with CPP from a gynecology clinic were first compared to a healthy control group from the Academia Sinica Taiwan Biobank (TWB). Patients with CPP were also compared with patients with pelvic diseases from the TWB. Patients with CPP and HMB, some who under LNG-IUD treatment, underwent tests for physical consistency. After 6–8 months, the TCM body constitution and QoL of patients who received LNG-IUD treatment were reanalyzed. The questionnaires used included the Self-Assessment Chart of Menstrual Bleeding, the Taiwanese version of the Pictorial Blood Loss Assessment Chart, the TCM Body Constitution Questionnaire, the 6-point Behavior Rating Scale, and the Taiwanese version of the Short Form-36 Health Survey. All data were analyzed using Wilcoxon's signed-rank test in SAS 9.4 software. ResultsIn total, 2932 healthy women and 724 women with pelvic diseases were present in the TWB project. Moreover, 376 patients with CPP were admitted to a gynecology clinic, of whom 42 received LNG-IUD treatment. After LNG-IUD treatment, the primary endpoint was regarded as an improvement in Yang-Xu (lack of energy), Yin-Xu (lack of material), and phlegm stasis (accumulation of pathological products). These findings indicated an improvement in menstrual blood loss, pelvic pain, physical functioning, physical problems, body pain, general health, and emotional problems (p < 0.05). ConclusionLNG-IUD treatment improves body constitution deviations in TCM and QoL in patients with CPP and HMB. Our results provide a valuable reference for the use of modern medicine and TCM in treating CPP and HMB.

Different traditional Chinese medicine constitution is associated with dietary and lifestyle behaviors among adults in Taiwan.

The World Health Organization states prevention of chronic diseases should be based on good lifestyle behaviors and healthy diets as they can reduce the risk of chronic diseases by 80%. The theory of traditional Chinese medicine constitution (TCMC) emphasizes the congenital differences of TCMC stem from the genes of parents, while acquired differences in TCMC are caused by factors as living environments, lifestyle behaviors, and dietary habits. From the perspective of preventive medicine, this study explores the correlation between dietary habits and lifestyle behaviors as potential risk factors for different types of TCMC—balanced constitution, Yang deficiency, Yin deficiency, and Phlegm stasis. Research data were collected from 2760 subjects aged 30 to 70 years participating in a survey conducted by Taiwan Biobank in 2012 to 2017. The survey included basic demographic characteristics, lifestyle behaviors, and dietary habits along with a Body Constitution Questionnaire. Compared to men, women were 3 to 4 times more likely to develop Yang-deficiency, Yin-deficiency, and Phlegm stasis. Variables that affected TCMC were smoking, midnight snack consumption, consumption of gravy-soaked or lard-soaked rice/noodles, deep-fried soybean products, bread spread, pickled vegetables as side dishes for the main course of a meal, and the dietary habit of vegetables or fruits instead of high-fat desserts. Poor dietary habits and lifestyle behaviors are the cause of unbalanced TCMCs. Understanding the specific TCMC of individual can provide useful information and predictions to maintain physical health and achieve early disease prevention to meet the goal of preventive medicine.

Traditional Chinese medicine Master XIONG Jibo’s medication experience in treating arthralgia syndrome through data mining

ObjectiveThis study aimed to examine and propagate the medication experience and group formula of traditional Chinese medicine (TCM) Master XIONG Jibo in diagnosing and treating arthralgia syndrome (AS) through data mining. MethodsData of outpatient cases of Professor XIONG Jibo were collected from January 1, 2014 to December 31, 2018, along with cases recorded in A Real Famous Traditional Chinese Medicine Doctor: XIONG Jibo's Clinical Medical Record 1, which was published in December 2019. The five variables collected from the patients’ data were TCM diagnostic information, TCM and western medicine diagnoses, syndrome, treatment, and prescription. A database was established for the collected data with Excel. Using the Python environment, a customized modified natural language processing (NLP) model for the diagnosis and treatment of AS by Professor XIONG Jibo was established to preprocess the data and to analyze the word cloud. Frequency analysis, association rule analysis, cluster analysis, and visual analysis of AS cases were performed based on the Traditional Chinese Medicine Inheritance Computing Platform (V3.0) and RStudio (V4.0.3). ResultsA total of 610 medical records of Professor XIONG Jibo were collected from the case database. A total of 103 medical records were included after data screening criteria, which comprised 187 times (45 kinds) of prescriptions and 1 506 times (125 kinds) of Chinese herbs. The main related meridians were the liver, spleen, and kidney meridians. The properties of Chinese herbs used most were mainly warm, flat, and cold, while the flavors of herbs were mainly bitter, pungent, and sweet. The main patterns of AS included the damp heat, phlegm stasis, and neck arthralgia. The most commonly used herbs for AS were Chuanniuxi (Cyathulae Radix), Huangbo (Phellodendri Chinensis Cortex), Cangzhu (Atractylodis Rhizoma), Qinjiao (Gentianae Macrophyllae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Huangqi (Astragali Radix), and Chuanxiong (Chuanxiong Rhizoma). The most common effect of the herbs was “promoting blood circulation and removing blood stasis”, followed by “supplementing deficiency (Qi supplementing, blood supplementing, and Yang supplementing)”, and “dispelling wind and dampness”. The data were analyzed with the support ≥ 15% and confidence = 100%, and after de-duplication, five second-order association rules, 39 third-order association rules, 39 fourth-order association rules, and two fifth-order association rules were identified. The top-ranking association rules of each were “Cangzhu (Atractylodis Rhizoma) → Huangbo (Phellodendri Chinensis Cortex)” “Cangzhu (Atractylodis Rhizoma) + Chuanniuxi (Cyathulae Radix) → Huangbo (Phellodendri Chinensis Cortex)” “Chuanniuxi (Cyathulae Radix) + Danggui (Angelicae Sinensis Radix) + Gancao (Glycyrrhizae Radix et Rhizoma) → Qinjiao (Gentianae Macrophyllae Radix)” and “Chuanniuxi (Cyathulae Radix) + Danggui (Angelicae Sinensis Radix) +Gancao (Glycyrrhizae Radix et Rhizoma) + Huangbo (Phellodendri Chinensis Cortex) → Qinjiao (Gentianae Macrophyllae Radix)”, respectively. Five clusters were obtained using cluster analysis of the top 30 herbs. The herbs were mainly drying dampness, supplementing Qi, and promoting blood circulation. The main prescriptions of AS were Ermiao San (二妙散), Gegen Jianghuang San (葛根姜黄散), and Huangqi Chongteng Yin (黄芪虫藤饮). The herbs of core prescription included Cangzhu (Atractylodis Rhizoma), Chuanniuxi (Cyathulae Radix), Gancao (Glycyrrhizae Radix et Rhizoma), Huangbo (Phellodendri Chinensis Cortex), Mugua (Chaenomelis Fructus), Qinjiao (Gentianae Macrophyllae Radix), Danggui (Angelicae Sinensis Radix), and Yiyiren (Coicis Semen). ConclusionClearing heat and dampness, relieving collaterals and pain, and invigorating Qi and blood are the most commonly used therapies for the treatment of AS by Professor XIONG Jibo. Additionally, customized NLP model could improve the efficiency of data mining in TCM.

A Landscape of Metabonomics for Intermingled Phlegm and Blood Stasis and Its Concurrent Syndromes in Stable Angina Pectoris of Coronary Heart Disease.

ObjectivesIn this study, we analyzed the metabonomics of intermingled phlegm and blood stasis (IPBS) and its three concurrent syndromes in patients with stable angina pectoris of coronary heart disease.MethodsA total of 164 sera of separated outpatients from 12 national tradition Chinese medicine clinical research centers with IPBS or concurrent syndromes were collected for the study and assessed with LC-ESI-MS/MS (liquid chromatography—electrospray ionization tandem—mass spectrometry)-based metabolomics and multivariate statistical analysis.ResultsNon-differential metabolites between IPBS and its separate syndrome combined with the top 100 most abundant metabolites in four groups were screened to reflect the essence of IPBS. Amino acid and its metabolomics and glycerol phospholipids were screened for common metabolites, and these metabolites were mainly enriched in valine, leucine, and isoleucine metabolism and glycerophospholipid metabolism. Principal component analysis revealed that the difference between IPBS and its separate concurrent syndromes was not distinct. Compared with IPBS, anserine, cytidine 5′-diphosphocholine, and 7,8-dihydro-L-biopterin separately significant increase in phlegm stasis and toxin (PST), phlegm stasis and Qi stagnation (PQS), and phlegm stasis and Qi deficiency (PQD). While these different metabolites were associated with histidine metabolism, beta-alanine metabolism, glycerophospholipid metabolism, and folate biosynthesis. Three accurate identification models were obtained to identify the difference between IPBS and its concurrent syndromes.ConclusionOur study indicated that valine, leucine, and isoleucine metabolism and glycerophospholipid metabolism could represent the essence of IPBS; dysregulated metabolites were valuable in identifying PST from IPBS.

Observation on the Efficacy of Moxibustion Combined with Ear Acupoint Pressing Beans in Treating Patients with Phlegm Stasis Syndrome Vertigo.

Objective The aim of this study is to investigate the efficacy of moxibustion combined with an ear acupoint pressing bean in the treatment of patients with phlegm stasis syndrome vertigo. Methods 60 patients with vertigo identified as phlegm stasis syndrome who were hospitalized in our department from May 2020 to May 2021 were selected and divided into a control group and a treatment group of 30 cases each according to the random number method. The control group was treated with conventional treatment and care, and the treatment group was treated with moxibustion combined with ear acupressing beans on top of the conventional group. The treatment effects, the dizziness disorder inventory (DHI), Pittsburgh sleep quality index (PSQI), Hamilton anxiety score (HAMA), TCM symptom score, and blood flow parameters (left vertebral artery flow velocity (LVA), right vertebral artery flow velocity (RVA), and basilar artery flow velocity (BA)) of the two groups were compared with each other during and after the treatment. Results After implementation, the treatment efficiency of the treatment group was higher than that of the control group, and the treatment group had lower PSQI, HAMA, and DHI scores as well as TCM symptom scores such as vertigo, head heavy as a wrap, chest tightness, and nausea and vomiting than the control group (P < 0.05). In addition, LVA, RVA, and BA were all higher in the treatment group than in the control group after treatment (P < 0.05). Conclusion Moxibustion combined with ear acupoint pressing bean treatment can clearly improve patients' sleep quality, psychological state, relieve patients' various symptoms caused by vertigo, improve blood flow parameters, and have better efficacy in the treatment of phlegm stasis syndrome vertigo.

Decision Tree-Based Body Constitution Diagnosis System for Traditional Chinese Medicine.

This study aimed to establish a method for fast and accurate determination of body constitution types from the body constitution questionnaire (BCQ) by employing a decision tree model. The model was trained for 4 classes, namely, Yin-Xu, Yang-Xu, Phlegm and Blood Stasis, and Normal, and it achieved 67% accuracy for the testing dataset. The model also reduced the required number of BCQ questions from 44 to 3–6, depending on the responses. Lastly, we developed the Traditional Chinese Medicine (TCM) body constitution online diagnosis system using our model to collect data digitally and use it more practically and efficiently. This system can assist doctors to improve the diagnosis and treatment in TCM practice.

Analysis on the Experience of Mishi Xiaoyu Decoction in Treating Gout of Spleen Deficiency and Phlegm Stasis

Gout is called arthralgia syndrome in traditional Chinese medicine, and its symptoms are often discomfort such as redness, swelling, heat, pain, acid distension, activity disorder and so on. Doctors have different understanding of its etiology and pathogenesis. In his long-term clinical practice, Dr. Xiao Yang concluded that the etiology and pathogenesis of gout was "spleen deficiency, phlegm and blood stasis". Based on this, Mishi Xiaoyu Jiangzhuo decoction was designed to treat gout, mainly to reduce the symptoms of acute gout and prolong the interval. Reduce the frequency of acute attacks. In clinical practice, the prescription has different emphasis according to different stages of gout, age of patients, deficiency of vital qi, etc., such as pain relief in acute stage, recuperation of spleen, stomach, liver and kidney function during intermission, strengthening spleen and replenishing qi and reducing turbidity in young people, and removing blood stasis and reducing turbidity in middle-aged and elderly people, probably because young people do not decline, phlegm turbidity is heavy, blood stasis is light, fatigue is damaged in middle-aged and elderly people, and long-term illness leads to phlegm and blood stasis. In the treatment, we should also take into account the physiological status of spleen and stomach, liver and kidney deficiency, plus take care of the spleen and stomach, protect Yin fluid drugs, the following from the clinical treatment of medical records to provide ideas for the clinical application of traditional Chinese medicine in the treatment of gout.

Correlation between TCM Syndromes and Type 2 Diabetic Comorbidities Based on Fully Connected Neural Network Prediction Model.

Objective To predict the major comorbidities of type 2 diabetes based on the distribution characteristics of syndromes, and to explore the relationship between TCM syndromes and comorbidities of type 2 diabetes. Methods Based on the electronic medical record data of 3413 outpatient visits from 995 type 2 diabetes patients with comorbidities, descriptive statistical methods were used to analyze the basic characteristics of the population, the distribution characteristics of comorbidities, and TCM syndromes. A neural network model for the prediction of type 2 diabetic comorbidities based on TCM syndromes was constructed. Results Patients with TCM syndrome of blood amassment in the lower jiao were diagnosed with renal insufficiency with 95% test sensitivity. The patients with spleen deficiency combined with ascending counterflow of stomach qi and cold-damp patterns were diagnosed with gastrointestinal lesions with 92% sensitivity. The patients with TCM syndrome group of spleen heat and exuberance of heart fire were diagnosed as type 2 diabetes complicated with hypertension with a sensitivity of 91%. In addition, the prediction accuracy of combined neuropathy, heart disease, liver disease, and lipid metabolism disorder reached 70∼90% in TCM syndrome groups. Conclusion The fully connected neural network model study showed that syndrome characteristics are highly correlated with type 2 diabetes comorbidities. Syndrome location is commonly in the heart, spleen, stomach, lower jiao, meridians, etc., while syndrome pattern manifests in states of deficiency, heat, phlegm, and blood stasis. The different combinations of disease location and disease pattern reflect the syndrome characteristics of different comorbidities forming the characteristic syndrome group of each comorbidity. Major comorbidities could be predicted with a high degree of accuracy through TCM syndromes. Findings from this study may have further implementations to assist with the diagnosis, treatment, and prevention of diabetic comorbidities at an early stage.