TCM Syndrome Research Articles

Clinical effect of acupoint injection of salmon calcitonin in the treatment of senile osteoporosis

Objective To observe the clinical effect of acupoint injection of salmon calcitonin in the treatment of senile osteoporosis. Methods From February 2016 to July 2017, 136 elderly patients with osteoporosis admitted to Wenzhou Hospital of Traditional Chinese Medicine were included.The patients were randomly divided into two groups, with 68 cases in each group.The acupoint-injection group was given 50IU salmon calcitonin on day 1, day 2 100IU, one time per day, continuously used for 15 days for a course of treatment, and with an interval of 90 days, and repeat the course of treatment.The patients were given 0.9% sodium chloride diluted to 2mL, inject 0.5mL into bilateral Shenshu and Zusanli these two points.The intramuscular injection group was given the same dose of salmon calcitonin gluteus maximus injected intramuscularly.At the same time, both two groups were given calcium Erqi D tablets one tablet a day, alendronate once a week, each time 70mg fasting taken orally.The type Ⅰ collagen β-CTx, PINP, NBAP, femoral neck, femur trochanter, lumbar (L1-L4) lumbar BMD and osteoporosis symptom score before and after treatment were compared. Results After treatment, the NBAP and BMD of the two groups were significantly higher than those before treatment (all P<0.05), and the β-CTx, PINP and symptoms scores were lower than before treatment (P<0.05). After treatment, NBAP in the acupoint injection group was (32.36±3.03)μg/L, which was higher than (29.66±3.20)μg/L in the intramuscular injection group(t=10.477, P<0.05). The β-CTx and PINP in the acupoint injection group were decreased to (0.10±0.05)μg/L and (28.78±5.23)μg/L, which were significantly lower than those in the intramuscular injection group[β-CTx(0.20±0.05)μg/L, PINP(35.77±6.49)μg/L(t=5.983, 2.662, all P<0.05)]. After treatment, the BMD of the femoral neck, femur trochanter and lumbar vertebra (L1-L4) in the acupoint injection group were (0.690±0.032)g/m2, (0.620±0.010)g/m2 and (0.822±0.012)g/m2, respectively, which were higher than those in the intramuscular injection group[(0.652±0.012)g/m2, (0.572±0.022)g/m2 and (0.801±0.011)g/m2(t=5.055, 6.133, 1.956, all P<0.05)]. After treatment, the improvements of TCM syndromes such as weakness in the waist and knees, tinnitus and deafness, loss of appetite, release of teeth, relaxation of two feet, weak tongue, weak pulse in the acupoint injection group were better than those in the intramuscular injection group (all P<0.05). Conclusion The acupoint injection of salmon calcitonin at Zusanli and Shenshu points is more effective than the intramuscular injection in the treatment of senile osteoporosis.It can significantly increase the serum NBAP, decrease the serum β-CTx, PINP, improve the BMD and improve the patients' clinical symptoms, which means acupoint injection is a safe and effective way to treat senile osteoporosis. Key words: Osteoporosis; Acupuncture points; Shenshu; Tsusanli; Injections, intramuscular; Salmon calcitonin; Aged; Comparative study

The correlation between traditional Chinese medicine differentiation syndrome and gastrointestinal hormone in reflux esophagitis

Objective To provide evidence for TCM treatment according to syndrome differentiation by studying the correlation between TCM syndromes and serum gastrin (GAS), motilin (MTL), cholecystokinin (CCK) and vasoactive intestinal peptide (VIP) levels of reflux esophagitis (RE) patients. Methods A total of 120 eligible RE patients from Dongzhimen Hospital were differentiated with TCM syndromes, and blood samples were taken to test for GAS, MTL, CCK and VIP levels. Differences between the different TCM syndromes in terms of serum gastrointestinal hormones levels were analysed. Results The male patients had the most distribution of stagnation of heat in the liver and stomach syndrome, but the female patients had the most distribution of disharmony of the liver and stomach syndrome (χ2=27.994, Ps<0.001). The Grades A, B and C were mainly associated with the obstruction of phlegm syndrome, disharmony of the liver and stomach syndrome, and stagnation of heat in the liver and stomach syndrome respectively (χ2=9.951, P=0.007). For patients with the syndrome of stagnation of heat in the liver and stomach, the serum GAS level was significantly lower than the syndrome of disharmony of the liver and stomach, the syndrome of obstruction of phlegm, the syndrome of deficiency of the center and upward flow of qi, and mixture of cold and heat syndrome (P<0.01 or P<0.05). For patients with mixture of cold and heat and patients with deficiency of qi and stagnation of blood, there was a significant raise in serum CCK level, compared to the patients with stagnation of heat in the liver and stomach, patients with disharmony of the liver and stomach, or patients with deficiency of the center and upward flow of qi (P<0.01). Compared with the patients with disharmony of the liver and stomach and patients with the syndrome of obstruction of phlegm, the serum CCK level of patients with the syndrome of deficiency of the center and upward flow of qi rose significantly (P<0.01). Compared with the patients with the syndrome of stagnation of heat in the liver and stomach, the serum MTL levels of patients with obstruction of phlegm and patients with mixture of cold and heat rose significantly (P<0.01). There was a significant raise in serum MTL level of patients with the syndrome of mixture of cold and heat compared to patients with disharmony of the liver and stomach and patients with deficiency of the center and upward flow of qi (P<0.05). Conclusions The RE patients with mixture of cold and heat, and patients with deficiency of qi and stagnation of blood, and patients with deficiency of the center and upward flow of qi may be related to the rise in CCK levels. The patients with the syndrome of stagnation of heat in the liver and stomach are related to the decrease in GAS and MTL levels. Key words: Reflux esophagitis; Differentiation of TCM syndromes; Gastrointestinal hormone

Clinical observation of Qiangdu-Nianwang decoction on patients with ankylosing spondylitis and TCM syndrom of kidney deficiency

Objective To explore clinical efficacy and safety of Qiangdu-Nianwang decoction on patients with ankylosing spondylitis (AS) and the TCM syndrome of kidney deficiency. Methods A total of 112 patients with AS who met the inclusion criteria weredivided into two groupsby random number table method, 56 cases in each group. The control group was treated with conventional therapy, while the study group was given Qiangdu-Nianwang decoction. The two groups were treated for 1 months continuously. TCM syndromes, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI) and Bath Ankylosing Spondylitis Metrology Index (BASMI) was scored before and after treatment. The ELISA method was used to detect serum CRP level. The wechsler method was used to detect ESR. Aand clinical efficacy was evaluated. Results The total effective rate of the study group was 96.4% (54/56) and the control group was 76.8% (43/56). The difference between the two groups was statistically significant (χ2=9.314, P=0.002). After treatment, the scores of rachialgia, hypnalgia and total pain in the study group waswere significantly lower than those in the control group (t=8.980, 4.675, 9.686, P<0.01). The score of BASDAI, BASFI, BASMI and TCM syndromes was were significantly lower than those of the control group (t=14.117, 4.312, 7.665, 9.213, P<0.01). After treatment, the levelof ESR and CRP in the two groups was were significantly lower than those before treatment (P<0.05), and the levels of ESR and CRP in the study group was were significantly lower than those in the control group (t=9.128, 9.588, P<0.01). Conclusions The Qiangdu-Nianwang decoction on patients with AS and kidney deficiency has a good efficacy and low adverse reactions, can reduce the clinicalsymptoms, improve limb functions, and it was worthy clinical application. Key words: Spondylitis, ankylosing; Pain; Pain measurement; Qiangdu-Nianwang decoction; Syndrome differentiation treatment; Kidney deficiency

Effect of Ronghuang Granule on serum FGF23, FGFRs and Klotho in non-dialysis patients with CKD-MBD and kidney deficiency and damp-heat syndrome

To observe the effect of Ronghuang granule on serum fibroblast growth factor 23 (FGF23), fibroblast growth factor receptor (FGFRs) and Klotho protein levels in non-dialysis patients with chronic kidney disease-mineral and bone disorder (CKD-MBD) and kidney deficiency and damp heat syndrome. Seventy non-dialysis CKD-MBD patients with kidney deficiency and dampness-heat syndrome were randomized into control group (n=35) and treatment group (n=35). All the patients were given routine treatment combined with traditional Chinese medicine retention enema, and the patients in the treatment group received additional Ronghuang granule treatment (3 times a day). After the 12-week treatments, the patients were examined for changes of TCM syndromes. Serum levels of Ca, P, parathyroid hormone (iPTH), FGF23, FGFRs and Klotho proteins were detected before and after treatment. These parameters were also examined in 20 healthy volunteers. Sixty-five patients completed the study, including 33 in the control group and 32 in the treatment group. The patients in the treatment group showed significantly better treatment responses than those in the control group (P &lt; 0.05 or 0.01). At 4, 8, and 12 weeks of treatment, the patients in the treatment group had significantly lowered scores of TCM syndromes compared with the score before treatment (P &lt; 0.05 or 0.01), while in the control group, significant reduction of the scores occurred only at 12 weeks (P &lt; 0.05); at each of the time points, the treatment group had significantly greater reductions in the score than the control group (P &lt; 0.01). Significant improvements in serum Ca, P and iPTH levels were observed at 4, 8, and 12 weeks in the treatment group (P &lt; 0.05) but only at 12 weeks in the control group (P &lt; 0.05). The patients in the control and treatment groups all showed elevated serum levels of FGF23, FGFRs and Klotho protein compared with the normal subjects (P &lt; 0.01); FGF23, FGFRs and Klotho levels were significantly reduced in the treatment group (P &lt; 0.05) but remained unchanged in the control group (P&gt;0.05), showing significant differences between the two groups. Ronghuang granule improves the clinical symptoms of non-dialysis CKD-MBD patients with kidney deficiency and dampness heat syndrome by reducing serum levels of FGF23, FGFRs and Klotho, improving calcium and phosphorus metabolism disorder, and inhibiting secondary hyperparathyroidism.

Clinical study of umbilical compress using anti-cancer Xiaogu formula in the management of malignant ascites

Objective To observe the clinical efficacy of umbilical compress with anti-cancer Xiaogu formula in managing malignant ascites. Methods A total of 56 patients with malignant ascites who met the inclusion criteria were randomized into 28 patients in the treatment group and 28 patients in the control group. The control group was treated with one type of diuretic, and the treatment group was given umbilical compress using Anti-Cancer Xiaogu formula and diuretics. Both groups were treated for 14 days. The changes of abdominal girth, 24 h urine volume, ascites efficacy, TCM syndrome scores, quality of life and adverse reactions were observed. Results The decrease in the maximum depth difference of the ascites in the treatment group was significantly greater than that of the control group (1.16 ± 1.29 vs. 0.00 ± 1.34, Z=-2.553). The difference was statistically significant (P 0.05). The response rate in the treatment group was 92.9% (26/28), while that of the control group was 89.3% (25/28).treatment group was 71.4%, while that of the control group was 35.7%. The difference was statistically significant (P<0.05). The increase in KPS in the treatment group was significantly higher than that of the control group. The difference was statistically significant (P<0.05). Conclusions Anti-cancer Xiaogu umbilical cord combined with diuretic can reduce the degree of malignant ascites, alleviate clinical symptoms, improve quality of life and decrease the occurrence of adverse reactions when used concomitantly with diuretics in the management of malignant ascites. Key words: Ascites; Malignant carcinoid syndrome; Administration on umbilicus; anti-cancer Xiaogu formula; Spironolactone; Quality of life; Drug-related side effects and adverse reactions

Semantic clustering fuzzy c means spectral model based comparative analysis of cardiac color ultrasound and electrocardiogram in patients with left ventricular heart failure and cardiomyopathy

To investigate the correlation between TCM syndrome element, syndrome distribution and cardiac color ultrasound, 90 patients are divided into five groups according to the syndrome type: syndrome of qi deficiency of heart and lung, deficiency of both qi and yin, syndrome of qi deficiency and blood stagnation, syndrome of water overflowing due to yang deficiency, and syndrome of yang deficiency of heart and kidney, to extract and analyze the distribution of CHF syndrome element. 18 healthy volunteers are enrolled as the normal control group to study the correlation between NYHA cardiac function grading and cardiac color ultrasound. The results show that the distribution of CHF syndrome element is as follows: root deficiency syndrome element in which disease location is dominated by heart (94.4%) and disease natures is dominated by qi deficiency (82.2%), and the superficial sthenia syndrome element dominated by the blood stagnation (70.0%). Conclusion: The CHF pathogenesis is characterized by deficient root and excessive superficiality, disease location is dominated by heart, and the symptom element of disease nature is rooted by qi deficiency and is marked by blood stagnation. Cardiac color ultrasound is an important examination method for CHF, its parameters have significant differences among the syndrome type groups, and it can be used as an important auxiliary means for CHF TCM syndrome differentiation. Different CHF syndrome types are significantly different in the levels, which can be used as important reference index for CHF TCM syndrome differentiation.

Flipping moxibustion of Hui medicine at acupoints in governor vessel combined with acupuncture for vascular dementia

To observe the difference for vascular dementia among flipping moxibustion of Hui medicine at acupoints in governor vessel combined with acupuncture, simple Hui medicine and simple acupuncture. A total of 120 patients with vascular dementia were randomly assigned into a combination group, a flipping moxibustion group and an acupuncture group, 40 cases in each one, with 2 patients dropping respectively. Flipping moxibustion was used at the acupoints of group A on Monday and at the acupoints of group B on Friday in the flipping moxibustion group. The acupoints of group A were Baihui (GV 20), Dazhui (GV 14), Shenzhu (GV 12), Zhiyang (GV 9), Jizhong (GV 6), Mingmen (GV 4), Yaoyangguan (GV 3), and the acupoints of group B were Fengfu (GV 16), Taodao (GV 13), Shendao (GV 11), Jinsuo (GV 8), Xuanshu (GV 5), Changqiang (GV 1). Acupuncture was used in the acupuncture group at the main acupoints of Baihui (GV 20), Sishencong (EX-HN 1), Neiguan (PC 6), Zusanli (ST 36), Taixi (KI 3) and Xuanzhong (GB 39), matched with the acupoints based on syndrome differentiation, 30 min a time, once a day, continuous 5 times a week. The above two methods were applied in the combination group. All the treaments were for 4 weeks. The indexes were observed before and after treatment, including syndrome differentiationof TCM scale for vascular dementia (SDSVD), simple mental state scale (MMSE), self-care ability of daily life scale (ADL). The clinical effects and safety were evaluated. After treatment, the total effective rate in the combination group was 89.5% (34/38); the rate in the flipping moxibustion group was 65.8% (25/38); the rate in the acupuncture group was 63.2% (24/38). The difference among groups was statistically significant (P<0.05). The effect in the combination group was better than those in the flipping moxibustion group and in the acupuncture group (both P<0.05). There was no statistically significant difference between the flipping moxibustion group and the acupuncture group (P>0.05). The SDSVD scores after treatment were lower and the MMSE and ADL scores after treatment were higher than those before treatment in the three groups (all P<0.01), with better results on the above three scores in the combination group than those in the other two groups (P<0.05, P<0.01), and the differences on the three scores between the flipping moxibustion group and the acupuncture group were not statiatically significant (all P>0.05). The treatment in the three groups was safe, without stastical significance (P>0.05). The effect of flipping moxibustion combined with acupuncture for vascular dementia is better than those of simple flipping moxibustion and simple acupuncture. The combination treatment achieves better effect on TCM syndrome, cognitive function and daily activity ability than the other two simple treatment.

Professor FANG Jianqiao's clinical experience in the treatment of primary cervical dystonia

Professor FANG Jianqiao's clinical experience in the treatment of primary cervical dystonia based on the syndrome differentiation of TCM was explored preliminarily. Based on the disease identification of western medicine and the syndrome differentiation of TCM, in combination with the differentiations of meridians and collaterals of acupuncture, Professor FANG proposes the three-dimensional system of diagnosis and treatment of acupuncture, named "disease differentiation, TCM syndrome differentiation and meridian differentiation". Regarding the diagnosis and treatment of primary cervical dystonia, the physical examination of nerve system, TCM syndrome differentiation and meridian differentiation are equally important. It is pointed out that the key pathogenesis of the disease is qi and blood obstruction and the malnutrition in the muscle regions of meridians. Hence, the treating principle is proposed as eliminating the exogenous pathogens, regulating qi and blood and unblocking the muscle regions of meridians. Professor FANG also stresses that the affected sites and the factors of dystonia should be considered in acupuncture treatment. The local points are mainly those adjacent to the responsible muscles with the motor disturbance in the neck region. "Xinshe" point (Extra) is taken as the empirical point. The distal points are selected in accordance with the three-dimensional system of diagnosis and treatment. At the same time, the percutaneous acupoint electric stimulation is applied to the starting and ending points or the conjunctive points of the affected muscles, acting on regulating qi, nourishing blood and promoting the circulation in meridians and collaterals.

Clinical characteristics of Yinhua Miyanling Pian users based on real world study

Clinical characteristics of Yinhua Miyanling Pian user group were analyzed based on real world hospital information system (HIS)database. The information was collected from the HIS in sixteen hospitals of grade Ⅲ-A. Normalizing the data and descriptive analysis was performed. Among the 5 312 cases, female patients(63.67%) were more than male patients (36.33%). The median age was 49 years old. The age of 18-65 accounted for 74.52%.The patient was admitted to the hospital's department of obstetrics and gynecology(28.71%) and urology(28.43%). The median single dose is 2 g, accounted for 49.55%. The median daily dose is 6 g. 88.80% of patients were treated for less than 7 d. The median hospitalization were 12 d, most were 7-14 d accounted for 41.70%. Most hospitalization expenses payment by medicare, accounted for 80.22%. The median hospitalization expenses was 12 211.47 RMB. Most patients with benign tumor(27.36%) and malignant tumor(15.56%), next is the obstruction of urinary tract(15.49%) and urinary calculi(10.52%). The most common syndromes were damp heat syndrome(32.46%), liver and kidney deficiency syndrome(15.33%) and splenasthenic fluid-retention syndrome(15.01%). Clinical use is combined with antibiotics, as well as traditional Chinese medicine heat clearing agents, tonic drugs and so on. Finally, 44.22% were cured and 51.05% were better. Most of the drug users were adults, and mostly were female. Most with the tumor, urinary tract obstruction or stones. TCM syndrome is mainly characterized by dampness and heat, deficiency of liver and kidney, and dampness of spleen. In clinical practice, it was mainly combined with Western medicines, and Chinese medicines were also a-vailable. And most are combined with antibiotics.The medication basically conforms to the drug instruction. Based on the results of the real world HIS，Yinhua Miyanling Pian could provide theidea and reference for regulating the medication in adolescent patients.

Effects of endoscope combined with drug therapy on the hemorrhage of esophageal varicose veins in cirrhosis

Objective To observe the clinical effect of endoscope combined with drug therapy in the treatment of hemorrhage of esophageal and gastric varices in patients with cirrhosis, thus to provide reference for clinical diagnosis and treatment. Methods From January 2017 to January 2018, 58 liver cirrhosis patients with ruptured esophageal gastric varices bleeding in Tongji Huangzhou Hospital of Huazhong University of Science and Technology were selected and divided into two groups by random number table method, with 29 cases in each group.The control group was treated with somatostatin alone.The observation group was treated with somatostatin combined with endoscopic therapy.The clinical efficacy of the two groups was compared, and the clinical indicators and the changes of indices of TCM syndromes before and after treatment were compared between the two groups. Results The total effective rate of the observation group was 89.8%, which was higher than 79.3% of the control group, and the difference was statistically significant(χ2=9.75, P<0.01). After treatment, the pain, abdominal distention, poor appetite, nausea, weakness of the body tired, depression, boredom, loose stool and other syndromes index scores of two groups were improved obviously, the improvements in the observation group was better than those in the control group, and the differences were statistically significant(t=8.847, 9.470, 7.833, 8.120, 9.029, 8.120, 9.029, all P<0.05). After treatment, the white blood cells, platelets of the two groups were increased, the spleen length to diameter, thickness of spleen, portal venous trunk, spleen vein diameter of the two groups were reduced, the improvements in the observation group was better than those in the control group, and the differences were statistically significant(t=8.934, 8.923, 8.933, 9.463, 9.478, 9.463, all P<0.05). Conclusion Endoscope combined with drugs in the treatment of cirrhotic esophageal variceal hemorrhage has significant clinical efficacy, and can effectively improve the patients' TCM syndrome score and clinical indicators. Key words: Endoscopy; Somatostatin; Liver cirrhosis; Esophageal and gastric varices; Hemorrhage

Clinical efficacy of modified cistanche decoction combined with lactulose oral liquid in the treatment of constipated irritable bowel syndrome and its impact on quality of life

Objective To investigate the clinical efficacy of modified cistanche decoction combined with lactulose oral liquid in the treatment of patients with constipation-type irritable bowel syndrome, and to observe its effect on improving the quality of life of patients. Methods From June 2013 to June 2016, the clinical diagnosis and treatment of 76 patients with constipation-predominant irritable bowel syndrome in the People's Hospital of Qingyuan County were retrospectively analyzed.Among them, lactulose oral liquid was used in the control group.On the basis of the control group, cistanche soup was given in the treatment group, the control group and the treatment group had 38 cases.The clinical effects, adverse reactions were analyzed, and before and after treatment, TCM syndrome score and quality of life score were recorded. Results After treatment, the TCM syndrome scores of the treatment group were significantly lower than those of the control group (t=2.87, 3.17, 2.68, 3.75, 4.27, 3.83, 5.02, 4.40, 2.48, P=0.00, 0.00, 0.00, 0.00, 0.00, 0.00, 0.00, 0.00, 0.01), the quality of life dimensions scores of the treatment group were significantly higher than those of the control group (t=3.10, 3.44, 3.36, 3.58, 4.51, 3.32, 2.95, 2.89, P=0.00, 0.00, 0.00, 0.00, 0.00, 0.00, 0.00, 0.00). However, after treatment, the scores of TCM syndromes in both two groups were significantly lower than those before treatment (control group: t=4.28, 5.11, 4.07, 6.38, 5.06, 2.11, 7.32, 4.38, 20.22, P=0.00, 0.00, 0.00, 0.00, 0.00, 0.00, 0.04, 0.00, 0.00; treatment group: t=7.81, 9.86, 7.68, 13.76, 9.31, 6.57, 14.639.62, 7.36, P=0.00, 0.00, 0.00, 0.00). The scores of all dimensions of life quality were significantly higher than those before treatment (control group: t=2.85, 3.59, 2.58, 2.60, 4.01, 4.88, 3.05, 2.36, P=0.00, 0.00, 0.01, 0.01, 0.00, 0.00, 0.00, 0.02; treatment group: t=5.57, 6.72, 6.60, 6.40, 7.74, 7.63, 5.84, 6.30, P=0.00, 0.00, 0.00, 0.00, 0.00, 0.00, 0.00, 0.00). The total effective rate of the treatment group was 86.84%, which was significantly higher than 65.79% of the control group(χ2=7.13, P=0.02). There were no significant adverse reactions during treatment. Conclusion Cistanche decoction combined with lactulose oral solution for constipation-irritable bowel syndrome patients has significant effect, and can help to improve the quality of life of patients. Key words: Irritable bowel syndrome; Quality of life; Cistanche; Lactulose

Professor WU Lianzhong's experience in the treatment of oculomotor nerve palsy with acupuncture based on the interactions of twelve muscle regions and opposing needling theory

It was to introduce professor WU Lianzhong's experience in the treatment of oculomotor nerve palsy with acupuncture based on the interactions of twelve muscle regions and opposing needling theory. In the treatment, the TCM syndrome differentiation is taken as the general principle, the theory of the interactions of twelve muscle regions and opposing needling as the specific feature. The contrary needling is used at Hanyan (GB 4) and Juliao (ST 3) on the healthy side. The meridian-collateral and the exterior-interior differentiations are adopted to identify the syndromes. At the early stage of the disease, the treating principle focuses on expelling wind, eliminating cold and promoting the circulations of meridians and collaterals. The shallow needling, less acupoints and gentle stimulation are required. At the middle and late stage, the treating principle concentrates on strengthening the antipathogenic qi and harmonizing qi and blood. The deep needling, the multiple acupoints and the strong stimulation are applied. Additionally, the four-needling technique at Fengchi (GB 20), the multiple shallow needling at the eyelid margin, the opposing needling and the quantity of needling sensation are used in combination, which were developed by professor WU. With those comprehensivemethods, the symptoms of oculomotor nerve palsy are relieved and the significant clinical therapeutic effects achieved.

Procalcitonin impact analysis, respiratory function and blood gas analysis on Xiaoqinglong decoction combined with non-invasive ventilation in treatment of AECOPD patients

To observe the effect of Xiaoqinglong decoction combined with noninvasive ventilation on procalcitonin (PCT), blood gas analysis and respiratory functions in acute exacerbation of chronic obstructive pulmonary disease in the elderly (AECOPD), and investigate its correlation and clinical significance. Eighty-four elderly AECOPD patients with respiratory failure in our hospital from January 2015 to October 2017, were randomly divided into control group and observation group, 42 cases in each group. The control group received western medicine combined with noninvasive ventilator therapy, and the patients in observation group additionally received Xiaoqinglong decoction on the basis of the treatment in control group. Both groups were treated for 2 weeks. The clinical effects of two groups were observed and their PCT, blood gas analysis outcomes [arterial oxygen partial pressure (PaO₂), arterial partial pressure of carbon dioxide (PaCO₂), respiratory function, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC], TCM syndrome score and other indexes and adverse reactions were compared before and after treatment. The total efficiency was 95.24% (40/42) in observation group, higher than 76.19% (32/42) in control group, with statistically significant difference (P<0.05). There were no statistically significant differences in PCT, PaO₂, PaCO₂, FVC, FEV1/FVC, FEV1, and TCM syndrome scores between two groups before treatment. But after treatment, PCT and PaCO₂ levels in the observation group were lower and PaO₂, FVC, FEV1/FVC, FEV1 levels was higher than those in the control group (P<0.05); TCM syndrome scores were lower than those in the control group (P<0.05); both groups had no obvious adverse reactions. The results showed that Xiaoqinglong decoction combined with noninvasive ventilator could significantly reduce the procalcitonin level, effectively improve the respiratory function and blood gas analysis indexes, and significantly reduce the clinical symptoms in AECOPD patients, so it is worthy of promotion.

Clinical effect of Shenqi-Tongmai decoction in stable angina pectoris patients with Qi-deficiency-blood-stasis syndrome and the influence on levels of serum associated adhesion factors

Objective To investigate the effect of Shenqi-Tongmai decoction in Stable Angina pectoris Patients with Qi-deficiency-blood-stasis syndrome and the influence on serum associated adhesion factors. Methods A total of 110 patients with stable angina pectoris treated in the department of cardiology of traditional Chinese medicine hospital of Xinle city from Feb. 2015 to Feb. 2017 were divided into 2 groups according to the number random table method, with 55 in each group. All the patients were given the standardized treatment with western medicine, and the treatment group were aditionally treated with the Shenqi-Tongmai decoction. All the patients were treated for a course of 4 weeks. The TCM syndrome score, Seattle angina questionnaire (SAQ) score, electrocardiographic examination index and serum soluble intercellular adhesion molecule 1 (sICAM-1), soluble vascular cell adhesion molecule 1 (sVCAM-1) level of the two groups before and after treatment were compared, and the clinical curative effect of the two groups was compared. Results The TCM syndrome score (7.1 ± 2.2 vs. 11.4 ± 3.0, t=8.590), serum sICAM-1 (227.69 ± 42.81 ng/ml vs. 275.33 ± 48.62 ng/ml, t=5.454) level, serum sVCAM-1 (272.04 ± 39.87 ng/ml vs. 296.58 ± 42.60 ng/ml, t=3.127) level and lead ecg ST segment down number (2.7 ± 0.6 vs. 3.2 ± 0.6, t=4.067), T wave of low lead numbers (1.7 ± 0.3 vs. 2.1 ± 0.3, t=6.807), numbers of T wave inversion lead (1.7 ± 0.3 vs. 2.1 ± 0.2, t=9.908) of the treatment group were significantly lower than those of the control group (P<0.01). The SAQ scores (76.8 ± 10.5 vs. 67.4 ± 10.1, t=4.805) was higher than that of the control group (P<0.01). The curative effect of angina pectoris and electrocardiogram of the treatment group were 91.0% (50/55) and 92.7% (51/55), and the control group were 76.4% (42/55) and 78.2% (43/55). The difference was statistically significant between the two groups (χ2=4.251, 4.681, P<0.05). Conclusions Traditional Chinese medicine Shenqi-Tongmai decoction can effectively improve the SAQ scores and TCM syndrome score and electrocardiogram examination index, improve the clinical curative effect in the treatment of Stable Angina pectoris based on the western medicine (Qi-deficiency-blood-stasis syndrome) and its mechanism may be related to improving of the serum levels of sICAM 1, sVCAM 1. Key words: Angina, stable; Qi-deficiency blood stasis; Shenqi-Tongmai decoction; Soluble intercellular adhesion molecule-1; Soluble vascular cell adhesion molecule-1

Discussion on traditional Chinese medicine treatment models of depression named "three phases, five internal organs and ten syndromes"

Based on the inheritance, the research group summarized the transmissive pathogenesis of depression in three typical stages, formulating the stepward treatment units which included Chinese medicine, acupuncture and TCM characterized psychotherapy, and formed a sequential treatment plan that balanced the principle of strengthening healthy Qi to eliminate pathogens, active and passive treatment, physical therapy and psychotherapy. Based on the retrospective analyses, ten typical clinical have been formed, constituting the pattern differentiation of Three Phases, Five internal organs and Ten syndromes for depression, which sysmatically showed the TCM syndrome differentiation. This work promoted the experiences and methods of treating depression by Chinese medicine. Key words: Depression; Traditional Chinese medicine; Three phases, Five internal organs and Ten syndromes; Staging syndrome differentiation; Spirits of five Zang viscera

Establishment of grading model of knee osteoarthritis based on clinical research system

The factors influencing the grade of knee osteoarthritis were screened by ordered Logistic regression analysis. The classification model of knee osteoarthritis was established, which provided tool for the evaluation of clinical classification of knee osteoarthritis. A total of 753 cases of knee osteoarthritis from Wangjing Hospital, China Academy of Chinese Medical Sciences were treated with single factor and multivariate Logistic regression analysis from September 18, 2014 to April 26, 2016. The model formula was constructed and evaluated. In this study, it was found that 13 factors associated with knee osteoarthritis grading. Old age, obesity, long course of disease, recurrence, lower limb deformity, quadriceps muscle atrophy, WOMAC index, TCM syndrome score, VAS score and grading degree were positively correlated. One knee pain, limited pain range, knee activity and grading degree were negatively correlated. The knee osteoarthritis grading model was constructed and the evaluation test was effective(Training set AUC=0.860, test set AUC=0.879). In this study, a classification model of knee osteoarthritis was established which has a good ability to predict the classification of knee osteoarthritis under preliminary evaluation.

The efficacy and safety of Jiedu Tongluo granules for treating post-stroke depression with qi deficiency and blood stasis syndrome: study protocol for a randomized controlled trial

BackgroundPost-stroke depression (PSD) is the most common psychiatric complication after a stroke. The most frequently used antidepressants are selective serotonin receptor inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), however, these exhibit a series of side effects. Traditional Chinese medicine has been used to treat PSD with few side effects. The aim of this study is to evaluate the efficacy and safety of Jiedu Tongluo granules for treating PSD with qi deficiency and blood stasis syndrome.MethodsThe planned study is a double-blind, randomized, placebo-controlled pilot trial. Eighty participants will be randomly assigned to receive either treatment or placebo. The treatment group will receive Jiedu Tongluo granules (JDTLG) with conventional treatment, and the placebo group will receive placebo with conventional treatment for 8 weeks. The primary outcome is the effectiveness of JDTLG on depression after 8 weeks treatment, which is defined as a decrease of 50% or more in 17-item Hamilton Depression Scale (HAMD-17) score or clinical recovery (score < 7). Secondary outcomes are improvement in neurological function, degree of independence, activities of daily living, and TCM syndrome at each visit, which will be measured with National Institute of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), Barthel Index (BI) and TCM scale, respectively. Interleukin (IL)-6, IL-8, and small-molecule metabolites will be monitored to explore the mechanism of action of JDTLG on PSD. Safety measures include vital signs, results of electrocardiography, laboratory index (full blood count, kidney and liver function tests) and adverse events.DiscussionThe purpose of this trial is to evaluate the therapeutic effects and safety of JDTLG in individuals with PSD with concomitant qi deficiency and blood stasis syndrome. If successful, the outcome of this trial will provide a viable treatment option for PSD patients.Trial registrationClinicalTrials.gov ID: NCT03147053. Registered on 27 April 2017.

Integrated Modules Analysis to Explore the Molecular Mechanisms of Phlegm-Stasis Cementation Syndrome with Ischemic Heart Disease.

Background: Ischemic heart disease (IHD) has been the leading cause of death for several decades globally, IHD patients usually hold the symptoms of phlegm-stasis cementation syndrome (PSCS) as significant complications. However, the underlying molecular mechanisms of PSCS complicated with IHD have not yet been fully elucidated.Materials and Methods: Network medicine methods were utilized to elucidate the underlying molecular mechanisms of IHD phenotypes. Firstly, high-quality IHD-associated genes from both human curated disease-gene association database and biomedical literatures were integrated. Secondly, the IHD disease modules were obtained by dissecting the protein-protein interaction (PPI) topological modules in the String V9.1 database and the mapping of IHD-associated genes to the PPI topological modules. After that, molecular functional analyses (e.g., Gene Ontology and pathway enrichment analyses) for these IHD disease modules were conducted. Finally, the PSCS syndrome modules were identified by mapping the PSCS related symptom-genes to the IHD disease modules, which were further validated by both pharmacological and physiological evidences derived from published literatures.Results: The total of 1,056 high-quality IHD-associated genes were integrated and evaluated. In addition, eight IHD disease modules (the PPI sub-networks significantly relevant to IHD) were identified, in which two disease modules were relevant to PSCS syndrome (i.e., two PSCS syndrome modules). These two modules had enriched pathways on Toll-like receptor signaling pathway (hsa04620) and Renin-angiotensin system (hsa04614), with the molecular functions of angiotensin maturation (GO:0002003) and response to bacterium (GO:0009617), which had been validated by classical Chinese herbal formulas-related targets, IHD-related drug targets, and the phenotype features derived from human phenotype ontology (HPO) and published biomedical literatures.Conclusion: A network medicine-based approach was proposed to identify the underlying molecular modules of PSCS complicated with IHD, which could be used for interpreting the pharmacological mechanisms of well-established Chinese herbal formulas (e.g., Tao Hong Si Wu Tang, Dan Shen Yin, Hunag Lian Wen Dan Tang and Gua Lou Xie Bai Ban Xia Tang). In addition, these results delivered novel understandings of the molecular network mechanisms of IHD phenotype subtypes with PSCS complications, which would be both insightful for IHD precision medicine and the integration of disease and TCM syndrome diagnoses.

Clinical efficacy of invigorating qi, nourishing yin, and promoting blood circulation in treatment of type 2 diabetes mellitus

Objective: This study aims to investigate the clinical efficacy of invigorating qi, nourishing yin, and promoting blood circulation in the treatment of type 2 diabetes mellitus. Methods: Sixty-six patients with type 2 diabetes mellitus admitted to our hospital from February 2015 to January 2017 were recruited in this study. Odd-even method was used to divide the patients into two groups. Patients in the control group (n=33) were given with conventional treatment for type 2 diabetes mellitus, and those in the observation group (n=33) were administered with a conventional scheme involving invigorating qi, nourishing yin, and promoting blood circulation. The TCM syndrome efficacy and the levels of TC, FBG, and FINS were compared between the two groups. Results: Compared with the control group (72.73%), the observation group showed significantly improved TCM syndrome (96.97%) (P<0.05) and significantly increased levels of TC, FBG, and FINS (P<0.05). Conclusion: Treating patients with type 2 diabetes mellitus by invigorating qi, nourishing yin, and promoting blood circulation can ensure TCM syndrome efficacy and increase the levels of TC, FBG, and FINS levels, thereby improving the treatment outcomes.

在校女大学生月经病中医证治特征研究进展

在校女大学生月经病中医证治特征研究进展