Spleen Qi Deficiency Syndrome Research Articles

Identifications of metabolic differences between Hedysari Radix Praeparata Cum Melle and Astragali Radix Praeparata Cum Melle for spleen-qi deficiency rats: A comparative study

Hedysari Radix Praeparata Cum Melle (HRPCM) and Astragali Radix Praeparata Cum Melle (ARPCM) are capable of improving spleen-qi deficiency (SQD) syndrome especially in the gastrointestinal dysfunction and decreased immunity in traditional Chinese medicine clinically. This study aims to compare and reveal the metabolic differences between HRPCM and ARPCM for SQD rats. Firstly, HRPCM (12.6 g/kg) and ARPCM (12.6 g/kg) were used to intervene SQD rats to further evaluate the effect. The results showed that HRPCM and ARPCM were able to improve the spleen pathology, increase the body weight, the rectal temperature, the spleen index, the thymus index, the levels of GAS and D-xylose in serum, and decrease the levels of IL-2, IL-6 and TNF-α in serum for SQD rats. Then, the studies of metabolic differences in serum and spleen were carried out using UPLC-Q-TOF-MS. The findings emphasized that HRPCM and ARPCM not only regulated metabolic profiling of serum and spleen in SQD rats, but also existed differences. HRPCM and ARPCM regulated metabolic pathways mainly including lipid metabolism, energy metabolism, amino acid metabolism, nucleotide metabolism, sugar metabolism and other types of metabolism for SQD rats. However, the metabolite profiles in SQD rats changed significantly, mainly involving abnormal glycine synthesis occurred in SQD rats. The expression trends of metabolites in HRPCM and ARPCM intervention for SQD rats were partly the same. Interestingly, there are similarities and differences in metabolic profiling between HRPCM and ARPCM for SQD rats. The differences were mainly in the synthesis of L-glutamine in amino acid metabolism.

Clinical effects of a traditional Chinese medicine nursing programme to intervene in gastric pain of the spleen and stomach with Qi deficiency.

Gastroparesis is a common digestive disorder characterized by delayed gastric emptying, which can lead to symptoms such as nausea, vomiting, abdominal pain, and poor appetite. Traditional Chinese medicine (TCM) has been used for centuries to treat gastrointestinal disorders, including gastroparesis. TCM theory suggests that spleen and stomach qi deficiency syndrome is one of the main pathogenic factors in gastroparesis. Nursing care plays an important role in the treatment of gastroparesis, and TCM nursing interventions have shown promising results in improving patient outcomes. However, there is limited research on the clinical effectiveness of TCM nursing interventions for gastroparesis with spleen stomach deficiency syndrome. This study aimed to evaluate the clinical effect of TCM nursing intervention in the treatment of gastroparesis with spleen stomach deficiency syndrome and to compare it with routine nursing interventions. To analyze the clinical effect of traditional Chinese medicine nursing intervention in the treatment of gastric paraplegia with spleen stomach deficiency syndrome. From January 2020 to July 2021, 80 patients with gastroparesis of spleen stomach qi deficiency type diagnosed in our hospital were selected for the study. The 80 patients were randomly divided into a control group and an experimental group, with 40 cases in each group. During the treatment period, the control group received routine nursing interventions, while the experimental group received traditional Chinese medicine nursing procedures. Compare the nursing effects of the two groups and observe the changes in traditional Chinese medicine symptom scores, pain levels, and sleep quality before and after treatment. After treatment, comparing the treatment effects of the two groups, the total effective rate of the experimental group was significantly higher than that of the control group, with statistical significance (P < 0.05). There was no statistically significant difference in the TCM symptom score, visual analogue scale (VAS) score, and Pittsburgh sleep quality index (PSQI) score between the two groups before treatment (P > 0.05). However, after treatment, the TCM syndrome scores, VAS scores, and PSQI scores of the experimental group were significantly lower than those of the control group, with a statistically significant difference (P < 0.05). In the clinical nursing intervention of patients with mild gastroparesis due to spleen and stomach qi deficiency, the traditional Chinese medicine nursing plan has good clinical application value and nursing effect, and has a good effect on improving patients' pain and sleep quality.

Analysis of the Prescription Regularities of Proprietary Chinese Medicines for Insomnia Based on Data mining

Objective: To analyze the medication characteristics and regularities of proprietary Chinese medicines for the treatment of insomnia, and to provide new ideas for the clinical treatment of this disease and the research and development of proprietary Chinese medicines. Methods: The prescriptions of proprietary Chinese medicines for the treatment of insomnia were collected from“yaoZH” database, and then Excel 2016, and SPSS Modeler18.0 was employed for frequency statistics, correlation analysis and Apriori association rule. Analysis graphs were drawn using Cytoscape to summarize the patterns of medication use Results: A total of 152 prescriptions were finally screened, involving 336 Chinese herbal medicines, with a cumulative frequency of 1433. The top 5 drugs with the highest cumulative frequency were Danggui (3.07%), Fuling (2.86%), Wuweizi (2.86%), Shudihuang (2.58%) and Huangqi (2.37%). The first place of each order of the drug-drug association rule was Danggui→ Zhiyuanzhi, Chaosuanzaoren+ Danggui→ Fuling; the first place of each order of the drug-symptom association rule was Fuling → Insomnia, Fuling + Danggui → Insomnia. In addition, 152 Chinese patent medicines could treat a total of 66 TCM syndromes, and the top 5 syndromes with the highest treatment frequency were Qi and Blood Deficiency Syndrome (16.5%), Liver and Kidney Deficiency Syndrome (10.9%), Heart and Spleen Deficiency Syndrome (5.21%), Qi and Yin Deficiency Syndrome (4.73%), and Liver Yang Hyperactivity Syndrome (4.26%). Conclusion: The treatment of insomnia with proprietary Chinese medicines is focused on nourishing deficiency, and is particularly good at treating insomnia caused by deficiency of Qi and Blood, deficiency of Liver and Kidney or deficiency of Heart and Spleen, and its main treatment symptoms, apart from insomnia, are most often accompanied by palpitations, fatigue, dizziness and memory loss, which can provide a basis for the clinical treatment of insomnia and the development of proprietary Chinese medicines.

Comparative study on the gastrointestinal- and immune- regulation functions of Hedysari Radix Praeparata Cum Melle and Astragali Radix Praeparata cum Melle in rats with spleen-qi deficiency, based on fuzzy matter-element analysis

Context Hedysari Radix Praeparata Cum Melle (HRPCM) and Astragali Radix Praeparata Cum Melle (ARPCM) are used interchangeably in clinics to treat spleen-qi deficiency (SQD) symptom mainly including gastrointestinal dysfunction and decreased immunity, which has unknown differences in efficacy. Objective To investigate the differences between HRPCM and ARPCM on intervening gastrointestinal- and immune-function with SQD syndrome. Materials and methods After the SQD model was established, the Sprague–Dawley (SD) rats were randomly divided into nine groups (n = 10): normal; model; Bu-Zhong-Yi-Qi Pills; 18.9, 12.6 and 6.3 g/kg dose groups of HRPCM and ARPCM. Gastrointestinal function including d-xylose, gastrin, amylase vasoactive intestinal peptide, motilin, pepsin, H+/K+-ATPase, Na+/K+-ATPase, sodium-glucose cotransporter 1 (SGLT1), glucose transporter 2 (GLUT2) and immune function including spleen and thymus index, blood routine, interleukin (IL)-2, IL-6, interferon-γ (IFN-γ), tumour necrosis factor-α (TNF-α), immunoglobulin (Ig) M, IgA, IgG and delayed-type hypersensitivity (DTH) were detected. Finally, the efficacy differences were analysed comprehensively by the fuzzy matter-element method. Results In regulating immune, the doses differences in efficacy between HRPCM and ARPCM showed in the high-dose (18.9 g/kg), but there were no differences in the middle- and low- dose (12.6 and 6.3 g/kg); the efficacy differences were primarily reflected in levels of IL-6, IFN-γ, TNF-α and IgM in serum, and the mRNA expression of IL-6 and IFN-γ in the spleen. In regulating gastrointestinal, the efficacy differences were primarily reflected in the levels of D-xylose, MTL, and GAS in serum, and the mRNA and protein expression of SGLT1 and GLUT2 in jejunum and ileum. Discussion and conclusions HRPCM is more effective than ARPCM on regulating gastrointestinal function and immune function with SQD syndrome. Therefore, we propose that HRPCM should be mainly used to treat SQD syndrome in the future.

The Single-Nucleotide Polymorphism of miR-27a rs895819 and the Expression of miR-27a in Helicobacter pylori-Related Diseases and the Correlation with the Traditional Chinese Medicine Syndrome.

Aims The study aims to explore the effects of the single-nucleotide polymorphism of miR-27a and its expression in Helicobacter pylori (H. pylori)-related diseases and the relationship between gastric pathology and traditional Chinese medicine (TCM). Methods Subjects were classified into six histopathological groups and five TCM syndrome groups. All specimens underwent H. pylori detection through rapid urease test and methylene blue staining. Histopathological characteristics were observed by hematoxylin-eosin. The expression of miR-27a and its genotype were, respectively, detected by Quantitative Real-Time PCR and direct sequencing. Results H. pylori promoted the malignant evolution of gastric mucosa and were involved in the formation of TCM syndrome. In H. pylori-positive patients, the frequency of miR-27a CT genotype at the rs895819 locus and its expression in the gastric cancer group were higher than those in other pathological groups. TCM syndrome had a close relationship with histopathological changes, and patients with spleen-qi deficiency syndrome had a higher risk of gastric cancer than other syndromes, regardless of H. pylori infection. Conclusion The C allele at miR-27a rs895819 locus may be an oncogene in gastric cancer. High levels of miR-27a could play an important role in gastric malignant evolution, especially cancerization. There is a certain connection between TCM syndrome and pathological changes of the gastric mucosa to some extent, where patients with SQD syndrome had a higher risk of GC.

Clinical Practice of Danzhi Xiaoyao Powder

Damaged by excess of seven emotions always result in failure of liver-energy to convey and disperse, disorder of movement of qi, damaged viscera function as well as disorder of qi and blood, thus triggering various diseases. Danzhi Xiaoyao powder has the effect of clearing heat and relieving liver depression, strengthening the spleen and qi blood, and is the main treatment of liver depression and heat, as well as the spleen-qi deficiency syndrome, as one of the classic medical prescriptions commonly used in clinical practice, in the past few years, the clinical application range of Danzhi Xiaoyao powder has been continuously expanded, and the efficacy is remarkable. Here are five typical medical cases regarding the analysis of the essence of Danzhi Xiaoyao powder, experiencing the subtlety of the homotherapy for heteropathy so as to give a reference for clinical prescriptions.

한의학 이론 연구를 위한 새로운 방법: 네트워크 약리학을 활용한 약물중심 접근법

The scientific understanding of Korean medicine theory remains largely unknown, since there is a lack of proper methods to investigate its complex and unique characteristics. Here, we introduce a drug-centered approach, a novel method to investigate Korean medicine theory by analyzing the mechanisms of herbal medicines. This method can be effectively conducted by employing network pharmacology that can analyze the systems-level mechanisms of herbal medicines on a large scale. Firstly, we introduce the method of network pharmacology that are applied to analyze the mechanisms of herbal medicines in a step-by-step manner. Then, we show how the drug-centered approach employing network pharmacology can be applied to investigate Korean medicine theory by describing studies that identify the biological correlates of the cold-hot nature of herbs, spleen qi deficiency syndrome, or Sasang constitution. Finally, we discuss the limitations and future directions of the proposed approach in two aspects: The methods of network pharmacology for a drug-centered approach and the process of inferring Korean medicine theory through it. We believe that a drug-centered approach employing network pharmacology will provide an advanced scientific understanding of Korean medicine theory and contribute to its development by generating biologically plausible hypothesis.

ASSOCIATION BETWEEN THE VISCERA SYNDROMES ACCORDING TO TRADITIONAL MEDICINE AND THE CLINICAL SYMPTOMS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Background: Diabetes mellitus (DM) has become a common disease worldwide. The treatment with Traditional medicine (TM) depends on the clinical form as well as the specific viscera syndrome. According to the strategy of developing TM from 2014 to 2023 of the World Health Organization, the safe and effective use of TM in the national health system needs to be focused and strengthened. Objectives: To investigate the viscera syndromes according to TM and the association with the clinical symptoms in patients with type 2 DM. Materials and Method: A cross-sectional study was carried out in 97 patients with type 2 DM at Hue University of Medicine and Pharmacy Hospital and Hue Central Hospital from 07/2019 to 03/2020. Results: Mean of age was 66.1 ± 11.3. The proportion of patients with the viscera syndromes was 91.8%, in which 30.9% Kidney-Yin deficiency syndrome, 25.8% Spleen-Qi deficiency syndrome, 17.5% Kiney-Yin and Yang deficiency syndrome, 17.5% Liver-Yin deficiency syndrome, 16.5% Liver-Blood deficiency syndrome, 13.4% Lung-Dryness syndrome, 4.1% Stomach-Heat syndrome and 2.1% Stomach-Yin deficiency syndrome. There was association between TM viscera syndromes and the clinical symptoms of type 2 DM according to Western medicine (p &lt; 0.05). Conclusion: The syndromes of high rate are Kidney-Yin syndrome and Spleen-Qi deficiency syndrome. The syndromes of low rate are Stomach-Heat syndrome and Stomach-Yin deficiency syndrome. The viscera syndromes are significantly associated with the Western medicine symptoms. Key words: Frequency, type 2 diabetes mellitus, viscera syndrome, traditional medicine.

Material Basis of the Difference between Hedysari Radix and Honey-Processed Hedysari Radix in Buzhong Yiqi.

Objective To compare the changes of chemical components of Hedysari Radix (HR) before and after honey-processing, and to explore the material basis of the difference between HR and honey-processed Hedysari Radix (HPHR) in Buzhong Yiqi. Methods Different compounds in aqueous extracts of HR and HPHR were analysed by UPLC-MS. A rat model of spleen qi deficiency was established. The rats were treated with different doses of water extracts of HR or HPHR, and pathological differences in spleen tissue, serum levels of D-xylose, gastrin (GAS) and amylase (AMS) interleukin-2 (IL)-2 and tumour necrosis factor-α (TNF-α), as well as spleen and thymus indices, were used as indicators. Differences in the efficacy of HR and HPHR in Buzhong Yiqi were studied. Results The research showed that compared with the blank group, the spleen tissue of rats in the model group showed spleen tissue damage, which mainly manifested as unclear boundaries between red pulp and white pulp, irregular spleen morphology and irregular arrangement, and the structure of white pulp destruction, less lymphocytes, the number of germinal centers decreased or atrophied. Compared with the model group, the middle and high dose groups of HR and HPHR had protective effects on spleen tissue of spleen-qi deficiency rats, and HPHR had a stronger effect; compared with those in the model group, rats in each treatment group showed remarkably higher serum D-xylose, GAS and AMS levels and thymus and spleen indices, and remarkably lower serum IL-2 and TNF-α levels, among which HPHR group showed better regulation effect than HR group. A total of 16 differential compounds were found in the aqueous extracts of HR and HPHR, of which 10 compounds in HPHR were up regulated, while 6 compounds were down regulated compare to HR. Conclusion The results indicated that both HR and HPHR can improve spleen qi deficiency syndrome of rats, the pharmacodynamic effect of the latter was better than the former. Differences in components of HR and HPHR potentially leading to variations in efficacy.

Study on syndrome differentiation of ancient arthralgia syndrome and drug use rules based on latent structure model

In this study, the ancient doctors' concentrated prescriptions for arthralgia syndrome were collected and Lantern 3.2 software was used to construct and analyze the latent structure model of ancient arthralgia syndrome. A total of 10 syndrome types of ancient arthralgia syndrome were obtained, namely, cold-coagulation meridian syndrome(partial Yang deficiency), cold-dampness obstruction syndrome(cold weight), damp-heat obstruction syndrome, liver and kidney deficiency syndrome, essence deficiency syndrome, phlegm and blood stasis syndrome, spleen and stomach Qi deficiency syndrome, dampness evil accumulation syndrome, arthralgia meridian syndrome, cold-dampness binding lung syndrome, meridian obstruction syndrome, and wind-cold-dampness arthralgia syndrome(both wind-cold and dampness). This syndrome differentiation method further strengthened the thought on eight-class syndrome differentiation, and showed the characteristics of different syndrome differentiation types of the core drugs in the latent structure model, which was mainly reflected in paying attention to removing blood stasis and eliminating phlegm with use of pungent taste products having dispersing effect, emphasizing the effect of nourishing Yin and generating marrow to supplement congenital deficiency, invigorating spleen and replenishing Qi to regulate the spleen and stomach functions, nourishing vital energy and expelling evil. In addition, Python 3.7 software was used to mine the frequent item sets and association rules for the frequently used drugs for ancient arthralgia syndrome. The drug compatibility law is characterized by making good use of blood-nourishing drugs. Blood-activating drugs are often compatible with cold-dispelling drugs, liver and kidney tonifying drugs, and wind-dampness-dispelling drugs, following the compatibility principle of dispelling wind and dispelling cold as well as tonifying liver and kidney. The induction of syndrome differentiation types of ancient arthralgia syndrome and the discussion on the characteristics of drug use and compatibility law provide a new way for clinical syndrome differentiation and treatment, with certain reference value for the research and development of new Chinese patent medicines.

Network Pharmacology to Uncover the Biological Basis of Spleen Qi Deficiency Syndrome and Herbal Treatment.

Spleen qi deficiency (SQD) syndrome is one of the basic traditional Chinese medicine (TCM) syndromes related to various diseases including chronic inflammation and hypertension and guides the use of many herbal formulae. However, the biological basis of SQD syndrome has not been clearly elucidated due to the lack of appropriate methodologies. Here, we propose a network pharmacology strategy integrating computational, clinical, and experimental investigation to study the biological basis of SQD syndrome. From computational aspects, we used a powerful disease gene prediction algorithm to predict the SQD syndrome biomolecular network which is significantly enriched in biological functions including immune regulation, oxidative stress, and lipid metabolism. From clinical aspects, SQD syndrome is involved in both the local and holistic disorders, that is, the digestive diseases and the whole body's dysfunctions. We, respectively, investigate SQD syndrome-related digestive diseases including chronic gastritis and irritable bowel syndrome and the whole body's dysfunctions such as chronic fatigue syndrome and hypertension. We found innate immune and oxidative stress modules of SQD syndrome biomolecular network dysfunction in chronic gastritis patients and irritable bowel syndrome patients. Lymphocyte modules were downregulated in chronic fatigue syndrome patients and hypertension patients. From experimental aspects, network pharmacology analysis suggested that targets of Radix Astragali and other four herbs commonly used for SQD syndrome are significantly enriched in the SQD syndrome biomolecular network. Experiments further validated that Radix Astragali ingredients promoted immune modules such as macrophage proliferation and lymphocyte proliferation. These findings indicate that the biological basis of SQD syndrome is closely related to insufficient immune response including decreased macrophage activity and reduced lymphocyte proliferation. This study not only demonstrates the potential biological basis of SQD syndrome but also provides a novel strategy for exploring relevant molecular mechanisms of disease-syndrome-herb from the network pharmacology perspective.

Meta-analysis of single-group rate of the distribution of traditional Chinese medicine syndromes in 2 139 patients with coronavirus disease 2019

To systematically evaluate the incidence of coronavirus disease 2019 (COVID-19) syndrome in traditional Chinese medicine (TCM), and to provide a basis for the standard of COVID-19 syndrome differentiation. CNKI, China Medical Journal Network, PubMed and Embase databases were searched by computer, and TCM syndrome data of COVID-19 cross-sectional surveys and case series were collected from the establishment of the database to March 31st in 2020. Two researchers independently screened the literature, extracted relevant data such as TCM syndromes, and evaluated the quality of the literature according to the quality assessment tool recommended by the JBI Evidence-Based Health Care Center. Stata 14.0 software was used to perform a single-group Meta-analysis of TCM syndromes. Thirteen cross-sectional studies and 5 case series studies were included, with a total of 2 139 patients. The analysis of the cross-sectional studies showed that the risk bias was higher in the identification, control and accuracy of the confounding factors, and the description of the reliability and validity of the outcome indicators was unclear. The analysis of the case series studies showed that the overall risk bias was small, but there was a lack of a comprehensive description of the assessment when selecting patients. A total of 33 TCM syndromes of COVID-19 were sorted out by combining the TCM syndromes with the same disease position and pathogenic syndrome in the included 18 literatures, and there were 10 types of TCM syndromes of which the number of occurrences was ≥ 50, the incidence rate was ≥ 10%, and had statistical significance [indicated that 95% confidence interval (95%CI) didn't cross the meaningless line 0], including cold dampness syndrome (469 cases, incidence rate was 28.2%, 95%CI was 5.9%-50.6%), damp heat syndrome (247 cases, incidence rate was 32.1%, 95%CI was 10.7%-53.6%), epidemic closed lung syndrome (228 cases, incidence rate was 28.9%, 95%CI was 12.5%-45.2%), pulmonary and spleen Qi deficiency syndrome (202 cases, incidence rate was 22.1%, 95%CI was 9.5%-34.7%), dampness stagnation lung syndrome (180 cases, incidence rate was 41.2%, 95%CI was 18.4%-64.1%), dampness obstructing lung and spleen syndrome (81 cases, incidence rate was 56.3%, 95%CI was 48.1%-64.4%), evil heat syndrome lung syndrome (76 cases, incidence rate was 31.1%, 95%CI was 25.3%-36.9%), dampness-blocking lung and stomach syndrome (70 cases, incidence rate was 13.4%, 95%CI was 10.4%-16.3%), heat poisoning lung closure syndrome (55 cases, incidence rate was 16.9%, 95%CI was 8.3%-25.5%), and Qi-Yin deficiency syndrome (53 cases, incidence rate was 13.7%, 95%CI was 2.7%-24.8%). Subgroup analysis showed that there were 6 types of TCM syndromes that met the above conditions in cross-sectional studies, namely cold and damp lung syndrome (200 cases, incidence rate was 20.9%, 95%CI was 12.6%-29.2%), damp heat syndrome (221 cases, incidence rate was 41.8%, 95%CI was 9.4%-74.2%), dampness-disease lung syndrome (120 cases, incidence rate was 41.4%, 95%CI was 8.6%-74.3%), lung and spleen Qi deficiency syndrome (115 cases, incidence rate was 19.2%, 95%CI was 6.8%-31.7%), heat-fever lung syndrome (76 cases, incidence rate was 31.1%, 95%CI was 25.3%-36.9%) and Qi-Yin deficiency syndrome (53 cases, incidence rate was 13.7%, 95%CI was 2.7%-24.8%). There were 3 kinds of TCM syndromes in case series studies, which were virus closed lung syndrome (133 cases, incidence rate was 44.0%, 95%CI was 24.5%-63.4%), lung and spleen Qi deficiency syndrome (87 cases, incidence rate was 38.7%, 95%CI was 32.3%-45.0%), and dampness and depression lung syndrome (60 cases, incidence rate was 40.6%, 95%CI was 29.3%-52.0%). The TCM syndromes of COVID-19 syndrome were widely distributed and complex. The main TCM syndromes were cold dampness syndrome, damp heat syndrome, epidemic closed lung syndrome, pulmonary and spleen Qi deficiency syndrome, dampness stagnation lung syndrome, dampness obstructing lung and spleen syndrome, evil heat syndrome lung syndrome, dampness-blocking lung and stomach syndrome, heat poisoning lung closure syndrome, Qi-Yin deficiency syndrome, which can provide reference for the standard of TCM syndrome differentiation of COVID-19.

Application of RRLC-QTOF-MS-based metabonomics and UPE for investigating Spleen-Qi deficiency syndrome with Panax ginseng treatment

Ethnopharmacological relevanceSpleen-Qi deficiency is a syndrome of traditional Chinese medicine. Panax ginseng (ginseng) is well known as the key herb for replenishing Qi and tonifying Spleen. However, the pathogenesis of Spleen-Qi deficiency syndrome and therapeutic mechanism of ginseng on Spleen-Qi deficiency constitution have not yet been entirely elucidated. Aim of the studyThe aim of this work was to investigate the pathogenesis of Spleen-Qi deficiency syndrome and therapeutic mechanism of ginseng on Spleen-Qi deficiency constitution. Materials and methodsThe urinary metabonomics was investigated before and after ginseng treatment in Spleen-Qi deficiency subjects by rapid resolution liquid chromatography coupled with quadrupole-time-of-flight mass spectrometry (RRLC-QTOF-MS). The spectra of metabolites were analyzed by principal component analysis (PCA) and the score showed significant difference among the three different groups. The serum biochemical parameters creatine kinases (CK), lactate dehydrogenase (LDH), interferon-γ (INF-γ), Interleukin-4 (IL-4), superoxide dismutase (SOD) and malondialdehyde (MDA) were determined by assay kits. In addition, ultraweak photon emission (UPE) intensity was measured at dazhui point in each subject. ResultsAccording to the orthogonal partial least-squares discriminant analysis (OPLS-DA) results and biochemistry databases searching, 15 potential biomarkers were identified to be involved in Spleen-Qi deficiency syndrome and ginseng influenced Spleen-Qi deficiency. The metabonomics and biological experiment data indicated that metabolism pathways were corresponding to energy metabolism, amino acid, carbohydrate, lipid and pyrimidine metabolisms, oxidative stress urea cycle, and intestinal flora metabolism. And the UPE intensity decreased significantly after the treatment. ConclusionsGinseng could promote the related metabolisms in Spleen-Qi deficiency constitution and the metabolites and UPE intensity may be useful as potential biomarkers for diagnosing and monitoring for Spleen-Qi deficiency syndrome.

Real-world study on syndrome distribution and medication characteristics of colonic malignant tumors

In order to explore the characteristics of traditional Chinese medicine(TCM) syndromes and medications in patients with colonic malignant tumors in China, the clinical data of patients with colonic malignant tumors from the information system of 33 Grade-A tertiary hospitals in China from 2001 to 2016 were extracted and a descriptive analysis was conducted on their disease characteristics, syndrome distribution, drug characteristics and treatment status. A total of 22 691 patients with colonic malignancies nationwide were included in the analysis, with male to female ratio of 1.59∶1, median age of 62 years, susceptible age of 50-79 years. Postoperative patients with colonic malignant tumors accounted for 47.10%, and patients with liver metastases reached 36.02%. Among the 520 patients with colonic malignant tumors, the top three TCM syndromes were: spleen deficiency syndrome(21%), Qi and Yin deficiency syndrome(17%) and liver and stomach disharmony syndrome(15%). The most frequently used Western medicine for patients with colonic malignant tumors was anti-metabolite cytotoxicity(61.23%), most frequently used in combination with platinum-based cytotoxic drugs(support degree 42.40%).The top three Western medicines were oxaliplatin(42.26%), leucovorin injection(38.58%) and dexamethasone(34.67%). The most frequently used traditional Chinese medicine type was heat-clearing and detoxifying drugs(39.59%), most frequently used in combination with Qi replenishing and body resistance strengthening drugs(support degree 12.72%). The top three traditional Chinese medicines were compound Kushen Injection(14.62%), Shenqi Fuzheng Injection(10.18%) and Aidi Injection(6.48%). This study shows that spleen and Qi deficiency may be the dominant syndrome of colonic malignant tumor, and chemotherapy is one of the main treatment methods. Traditional Chinese medicine has shown unique advantages in alleviating the toxic and side effects of chemotherapy and preventing recurrence and metastasis, so integrated TCM and Western medicine can significantly improve the clinical efficacy.

Effects of electroacupuncture at "Zusanli"(ST36) on ultrastructure and mitochondrial dynamics of skeletal muscle in rats with spleen qi deficiency syndrome

To observe the effects of electroacupuncture (EA) at "Zusanli" (ST36) on the ultrastructure and mitochondrial dynamics of skeletal muscle tissue in spleen qi deficiency rats, so as to explore the partial action mechanism of EA at ST36 for spleen deficiency syndrome. Twenty-four male SD rats were randomly divided into 4 groups: normal group, model group, ST36 group and non-acupoint group (n＝6 in each group). The model of spleen qi deficiency syndrome was established by improper diet and exhaustive swimming. EA (2 Hz/15 Hz, 0.5 mA) was applied to bilateral ST36 in the ST36 group and non-acupoint in the non-acupoint group for 20 min, once daily for 7 days. The colorimetric method was used to detect the ATP content in skeletal muscle tissue. The ultrastructure changes of skeletal muscle tissue were observed by transmission electron microscopy. The expression levels of optic atrophy 1 (Opa1) and dynamin-related protein 1 (Drp1) mRNA and proteins in the skeletal muscle tissue were determined by fluorescence quantitative real-time PCR and Western blot, respectively. The ATP content in skeletal muscle tissue of model group was significantly lower than that in the normal group (P<0.05), while significantly higher in the ST36 group than that in the model group and non-acupoint group (P<0.05). Transmission electron microscopy showed that a large number of muscle fibers that were ruptured, damaged, and disorganized; moreover, many vacuoles with different sizes, and abnormally shaped or swollen mitochondria were observed in the model group. ST36 treatment improved the disor-dered fiber arrangement, and reduced the population of damaged mitochondria; thus, fused and elongated mitochondria were readily observed. Compared with the model group, there were no obvious improvements in the non-acupoint group. Compared with the normal group, the expression levels of Opa1 and Drp1 mRNAs and proteins in the skeletal muscle tissue were significantly lower in the model group (P<0.05). After the treatment, the expression levels of Opa1 and Drp1 mRNAs and proteins were up-regulated in the ST36 group (P<0.05), and the expression of Drp1 protein was up-regulated in the non-acupoint group (P<0.05)．. EA at ST36 can correct the imbalance of mitochondrial fission and fusion in skeletal muscle of rats with spleen qi deficiency, thereby improving the damage of mitochondrial structure and function, and leading to an increase of energy metabolism.

Chinmedomics facilitated quality-marker discovery of Sijunzi decoction to treat spleen qi deficiency syndrome.

Sijunzi decoction (SJZD) is a Chinese classical formula to treat spleen qi deficiency syndrome (SQDS) and has been widely used for thousands of years. However, the quality control (QC) standards of SJZD are insufficient. Chinmedomics has been designed to discover and verify bioactive compounds of a variety of formula rapidly. In this study, we used Chinmedomics to evaluate the SJZD's efficacy against SQDS to discover the potential quality-markers (q-markers) for QC. A total of 56 compounds in SJZD were characterized in vitro, and 23 compounds were discovered in vivo. A total of 58 biomarkers were related to SQDS, and SJZD can adjust a large proportion of marker metabolites to normal level and then regulate the metabolic profile to the health status. A total of 10 constituents were absorbed as effective ingredients that were associated with overall efficacy. We preliminarily determined malonyl-ginsenoside Rb2 and ginsenoside Ro as the q-markers of ginseng; dehydrotumulosic acid and dihydroxy lanostene-triene-21-acid as the q-markers of poria; glycyrrhizic acid, isoglabrolide, and glycyrrhetnic acid as the q-markers of licorice; and 2-atractylenolide as the q-marker of macrocephala. According to the discovery of the SJZD q-markers, we can establish the quality standard that is related to efficacy.

Changes in Heart Rate Variability in Patients with Spleen-Qi Deficiency Syndrome

Many functional diseases are related to dysautonomia, and heart rate variability has been used to assess dysautonomia. However, heart rate variability has not been studied in Spleen-Qi deficiency syndrome (SQDS). Healthy volunteers (n = 37) and patients with SQDS (n = 67), recruited from the Clinic of the State University of Ecatepec Valley were included in the study. Outcome measures were average heart rate, standard deviation of the normal-to-normal heartbeat intervals, low frequency (LF), high frequency (HF) power, and the LF/HF ratio. Also, intestinal peristalsis, gastrointestinal symptoms (GSs), fatigue, and level of attention were measured. Standard deviation of the normal-to-normal heartbeat intervals (17 ± 2.3%) and HF (14 ± 3.1%) were lower in SQDS patients (17 ± 1.3%) than in healthy volunteers. SQDS patients had higher heart rate, LF power, LF/HF ratio, and fatigue scores (9.6 ± 1.12%, 16 ± 2.1%, 22 ± 3.8%, and 21 ± 4.1%). The fatigue correlated positively with the LF/HF ratio and negatively with HF power. The SQDS group had lower concentration performance (16.2 ± 1.9%) in the d2 test. The intestinal peristalsis showed a reduction (15 ± 1.3%) as compared with control. GS score and peristalsis correlated negatively with HF. Our results suggest that the pathology of SDQS could be associated with a low vagal tone which causes a decrease in peristalsis, increased fatigue, reduced attention, and appearance of GSs.

Efficacy and safety of Hou Gu Mi Xi in patients with spleen qi deficiency syndrome who underwent radical gastrectomy for gastric cancer: protocol for a multicenter, randomized, double-blind, placebo-controlled trial

BackgroundSpleen qi deficiency (SQD), a syndrome based on traditional Chinese medicine (TCM) theory, is common in patients after radical gastrectomy. SQD manifests with chronic gastrointestinal disorders and systemic symptoms and is challenging to manage. Hou Gu Mi Xi (HGMX) is a dietary TCM formula for SQD. This study aims to evaluate the efficacy and safety of HGMX in patients with SQD who have undergone radical gastrectomy for gastric cancer.Methods and designThis study is a multicenter, randomized, double-blind, placebo-controlled trial. One hundred thirty patients with SQD who have undergone radical gastrectomy for gastric cancer will be assigned to receive either HGMX or placebo for 2 years. The main outcome will be changes in SQD symptoms assessed by the Spleen Qi Deficiency Symptoms Grading and Quantifying Scale. The secondary outcomes will be changes in quality of life assessed by the Short Form 36 scale, performance status as assessed by the Eastern Cooperative Oncology Group Performance Status scale, body weight, and body mass index. Progression-free survival will also be assessed as a secondary outcome. Adverse events (AEs), severe AEs, and study withdrawal due to AEs will be recorded to evaluate the safety of HGMX.DiscussionThe results of this trial will provide initial evidence for the use of HGMX as an alternative and complementary intervention to manage chronic postoperative complications in patients who have undergone radical gastrectomy for gastric cancer.Trial registrationClinicalTrials.gov, NCT03025152. Registered on 17 January 2017.

Systematic Biology Basis of Constitution and Essence of Traditional Chinese Medicine Syndromes in Spleen Qi Deficiency of Chronic Atrophic Gastritis

Chronic Atrophic Gastritis (CAG) is a common digestive disease without specific treatment. Traditional Chinese Medicine could achieve significant effects for treatment of CAG. CAG could be divided into different syndromes according to the syndrome differentiation, which has not been widely accepted in western medicine. Our aim is to provide evidence for the existence of syndrome differentiation through comprehensive analysis, combining immunomics techniques with electronic gastroscopy, pathological examination and symptom scores evaluation. According to comparing the changes pre- and after treatment both in spleen qi deficiency and damp-heat syndrome groups, our research try to verify that treatment of TCM works only when the therapies match the corresponding syndromes; or there could be little or no effects through treatment. Clinical Trial Registry: It was registered in the Chinese Clinical Trial Registry (ChiCTR-TRC-14004088). Funding: The trial is financially supported by Natural Science Foundation of China. Declaration of Interests: The authors declare that no conflict of interest exists. Ethical Approval Statement: The study was conducted in compliance with the Declaration of Helsinki and the requirements of clinical trials by the Drug Administration Law of the People's Republic of China. The protocol and informed consent were reviewed and approved by the Beijing University of Chinese Medicine Clinical Trials and Biomedical Ethics Committee (No. 2013-06-20).

MUC1 and MUC5AC Acting on Helicobacter pylori-Related Deficiency and Solid Syndrome of Spleen and Stomach.

To investigate the relationship of MUC1, MUC5AC, and the syndrome of spleen and stomach, 109 subjects (34 peptic ulcer (PU), 62 chronic gastritis (CG), and 13 healthy volunteers (CON)) were included. All the subjects included were surveyed with questionnaire to classify them into damp-heat syndrome of spleen and stomach (DHSS), spleen-qi deficiency syndrome (SQD), and CON, examined by gastric endoscope, and biopsied. Rapid urease and methylene blue staining (MBS) were performed on every subject to diagnose for Helicobacter pylori (Hp) infection, and both were defined as Hp-positive. Hematoxylin and eosin (HE) staining was performed on every specimen to explore the histomorphology, inflammatory degree, and inflammatory activity of different groups; then Elivision™ plus kit was used to test the expression of MUC1 and MUC5AC. All the results of digital images were reviewed by two experts blindly. The inflammatory degree with Hp infection was higher than those uninfected or CON, but no significant difference was found between DHSS and SQD. And the expressions of MUC5AC with positive Hp was higher than those with negative Hp or CON regardless of the deficiency and solid syndrome of spleen-stomach but not for MUC1. We speculate that the deficiency and solid syndrome of spleen-stomach is a condition like Tai Ji symbol of dynamic equilibrium, showing the higher expression of MUC5AC but no change of MUC1 in the circumstance of Hp infection.