Yin Deficiency Syndrome Research Articles

Characteristics of blood glucose excursions in type 2 diabetes mellitus patients with three different Traditional Chinese Medicine syndromes

ObjectiveTo explore the characteristics of blood glucose excursions of type 2 diabetes mellitus patients with three different Traditional Chinese Medicine (TCM) syndromes. MethodsOne hundred and nine patients with type 2 diabetes mellitus were recruited from the Department of Endocrinology and the Department of TCM of the Sixth People's Hospital affiliated to Shanghai Jiao Tong University. Subjects were divided into three groups according to TCM syndrome: intrinsic Damp (n = 42), Yin deficiency and internal Heat (n = 25), and Qi and Yin deficiency (n = 42). Subcutaneous interstitial glucose was monitored with a continuous glucose monitoring system for 3 consecutive days to investigate the glycemic profile in each group. Plasma C-peptide levels were measured, and an arginine test was taken in 10 patients randomly selected from each group. Glucose data and glycemic variability were analyzed to investigate the differences among the groups. The change in C-peptide levels and the results from arginine trial were used to evaluate β cell function. ResultsIndicators reflecting blood glucose level were the highest in subjects with Yin deficiency and internal Heat syndrome, and parameters reflecting glycemic variability were the lowest in those with Qi and Yin deficiency syndrome. The change in C-peptide levels showed that subjects with Qi and Yin deficiency syndrome had the best β cell function among the three groups; this was confirmed by the arginine trial. ConclusionPatients with Qi and Yin deficiency syndrome had a more stable blood glucose profile, as glycemic variability was higher in those with intrinsic Damp syndrome and those with Yin deficiency and internal Heat syndrome.

Hydrogen as fuel from biodiesel and diesel

To explore the characteristics of blood glucose excursions of type 2 diabetes mellitus patients with three different Traditional Chinese Medicine (TCM) syndromes.One hundred and nine patients with type 2 diabetes mellitus were recruited from the Department of Endocrinology and the Department of TCM of the Sixth People's Hospital affiliated to Shanghai Jiao Tong University. Subjects were divided into three groups according to TCM syndrome: intrinsic Damp (n = 42), Yin deficiency and internal Heat (n = 25), and Qi and Yin deficiency (n = 42). Subcutaneous interstitial glucose was monitored with a continuous glucose monitoring system for 3 consecutive days to investigate the glycemic profile in each group. Plasma C-peptide levels were measured, and an arginine test was taken in 10 patients randomly selected from each group. Glucose data and glycemic variability were analyzed to investigate the differences among the groups. The change in C-peptide levels and the results from arginine trial were used to evaluate β cell function.Indicators reflecting blood glucose level were the highest in subjects with Yin deficiency and internal Heat syndrome, and parameters reflecting glycemic variability were the lowest in those with Qi and Yin deficiency syndrome. The change in C-peptide levels showed that subjects with Qi and Yin deficiency syndrome had the best β cell function among the three groups; this was confirmed by the arginine trial.Patients with Qi and Yin deficiency syndrome had a more stable blood glucose profile, as glycemic variability was higher in those with intrinsic Damp syndrome and those with Yin deficiency and internal Heat syndrome.

Serum cytokine profiling analysis for zheng differentiation in chronic hepatitis B.

BackgroundLiver-gallbladder dampness-heat (LGDH) and liver kidney yin deficiency (LKYD) syndromes are Chinese medicine (CM) zhengs in chronic hepatitis B (CHB) patients. This study aims to investigate the changes in cytokines and their profiles accompanied by different biological responses in LGDH and LKYD in CHB.MethodsDuring 2010–2012, a total of 138 morning fasting venous blood samples were obtained from participants in Shuguang Hospital, Shanghai University of Traditional Chinese Medicine in Shanghai, China. First, serum samples from 20 health controls (HCs) and 40 CHB patients (20 LGDH, 20 LKYD) were collected to detect the profiles of cytokines by multiplex biometric ELISA-based immunoassay. Random forest (RF) with a fivefold cross-validation was used to analyze the significant cytokines. Then the significant cytokines were validated using serum samples from an independent cohort of 60 CHB patients (30 LGDH, 30 LKYD) and 18 HCs.ResultsThere were different profiles of cytokines in LGDH and LKYD. Twenty-three significantly differentially expressed cytokines were detected, among which three cytokines, interleukin (IL)-17, macrophage inflammatory protein (MIP)-1α, and MIP-1β, with the largest Gini scores were identified by RF, and further evaluated for their significant changes in serum levels. A receiver-operator characteristic analysis revealed that the logistic regression panel could differentiate LGDH from LKYD (P < 0.001; AUC = 0.827). A functional pathway analysis showed that cytokine–cytokine receptor interaction, cytosolic DNA-sensing pathway, and chemokine signaling pathway overlapped between LGDH and LKYD, whereas Toll-like receptor signaling pathway, intestinal immune network for IgA production, NOD-like receptor signaling pathway, and Jak-STAT signaling pathway were only enriched in LGDH.ConclusionsThere were characteristic cytokines profiles in LGDH and LKYD with different inflammatory and immune responses. IL-17, MIP-1α, and MIP-1β might be involved in the differentiation of LGDH and LKYD in CHB.Electronic supplementary materialThe online version of this article (doi:10.1186/s13020-015-0055-8) contains supplementary material, which is available to authorized users.

Serum protein gamma-glutamyl hydrolase, Ig gamma-3 chain C region, and haptoglobin are associated with the syndromes of pulmonary tuberculosis in traditional Chinese medicine.

BackgroundTraditional Chinese Medicine (TCM) has been applied in treating tuberculosis (TB) based on the TCM syndromes with the effects of inhibiting Mycobacterium, strengthening the body immune system, and reducing the pulmonary toxicity. We used bioinformatic methods to study the clinical and pathological characteristics of pulmonary TB patients with TCM syndromes. Isobaric tags for relative and absolute quantification - coupled two dimensional liquid chromatography-tandem mass spectrometry (iTRAQ-2DLC-MS/MS) methods were applied to screen differentially expressed serum proteins.MethodsPulmonary TB cases were divided into four distinctive TCM syndromes: pulmonary Yin deficiency (PYD) syndrome, hyperactivity of fire due to Yin deficiency (HFYD) syndrome, deficiency of Qi and Yin (DQY) syndrome, and deficiency of Yin and Yang (DYY) syndrome. The serum samples from 214 pulmonary TB patients were collected, and the clinical and pathological data was analyzed by using iTRAQ-2DLC-MS/MS. Finally, the differentially expressed proteins were screened and tested by ELISA. Only 5 patients with DYY syndrome were recruited in 3 years, which were not enough for further research.ResultsThe DQY cases had higher erythrocyte sedimentation rate (ESR) compared to the PYD and HFYD cases (P = 0.0178). 94.44 % (12 PYD, 18 HFYD, and 4 DQY before anti-TB treatment) of 36 treated TB cases were transformed to PYD accompanied with the reduction of ESR and absorption of pulmonary lesions. A total of 39 differentially expressed proteins (ratios of >1.3 or <0.75) were found among the three TCM syndromes. Proteomic studies revealed that gamma-glutamyl hydrolase (GGH), Ig gamma-3 chain C region (IGHG3), and haptoglobin (HPT) were specifically over-expressed in PYD (P < 0.01), HFYD (P < 0.001), and DQY cases (P < 0.01), respectively. Furthermore, GGH was significantly higher in PYD cases compared to the HFYD and DQY cases (P < 0.01, P < 0.001, respectively), whereas IGHG3 was significantly higher in HFYD cases than PYD and DQY cases (P < 0.001, P < 0.01, respectively).ConclusionsThe results suggest that TCM syndromes are significantly correlated with the pulmonary lesions and ESR. GGH was associated with folate metabolism in PYD cases, IGHG3 was linked to the control of Mycobacterium infection in HFYD patients, and HPT was involved in hypoxia in DQY patients. The present study provides new biological basis to understand the pathological changes and proteomic differences of TB syndromes.Electronic supplementary materialThe online version of this article (doi:10.1186/s12906-015-0686-4) contains supplementary material, which is available to authorized users.

Mining analysis and experience summary for chronic atrophic gastritis cases treated by Professor LIU Feng-bin

To summarize Professor LIU Feng-bin's clinical experience and theoretical thoughts on chronic atrophic gastritis (CAG), the study group designed a retrospective study on his case series and expert interview. First of all, the data of CAG patients treated in the First Affiliated Hospital of Guangzhou University of Chinese Medicine between 2009 and 2013, e. g. herbs, diseases, syndrome type, prescription amount and number of herbs, was collected and processed. The statistical description and binary logistic regression were used to determined the syndrome type, initial basic remedy and modification. During the statistics, a complete and sub-group analysis was performed simultaneously. After the expert interview, the syndrome type and medication were finalized. As a result, a total of 228 CAG patients aged at (50.30 ± 10.18) were collected, including 151 males (66.23%). Of them, the TCM diagnosis and syndrome type were extracted from the information of 157 patients, including 115 cases with gastric stuffiness, 23 cases with gastric pain, 19 missing cases, 2 cases with spleen-stomach weakness syndrome, 57 cases with spleen deficiency and dampness-heat syndrome, 18 cases with spleen-stomach disharmony syndrome, 23 cases with syndrome of liver depression syndrome, 21 cases with liver qi invading stomach syndrome and 26 qi and yin deficiency syndrome, respectively. All of the 228 patients used totally 104 herbs, while the subgroups with 157 patients used 94 herbs. The most frequently used 15 herbs used in each groups were analyzed to determine the initial basic remedy and modification. Subsequently, based on the information of the sub-groups with 157 patients, with the syndrome type as the dependent variable, the logistic regression analysis was made on the most frequently used 32 herbs, in order to determined the modification in herbs for different syndrome types. After experts reviewed and modified, they believed the main causes of CAG were dietary irregularities, moodiness and weak constitution; the pathogenesis of CAG was spleen deficiency with qi stagnation, heat depression and blood stasis in the stomach meridian. The above six syndrome types and 12 herbs were determined, including Pseudostellariae Radix, Poria, Atractylodismacrocephalae Rhizoma, Glycyrrhizae Radix et Rhizoma, Fritillariae Thunbergii Bulbus, Sepiae Endoconcha, Arecae Pericarpium, Aurantii Fructus, Perillae Caulis, Herba Hedyotis Diffusae, Scutellariae Barbatae Herba, Curcumae Rhizoma. This study summarized Professor LIU Feng-bin's clinical experience and theoretical thoughts of chronic atrophic gastritis based on clinical practice data and expert interview, with a rigorous design and good scientificity and practicability.

Effect of acupoint application therapy on life quality of hypertensive patients with yin deficiency and yang excess syndrome

Objective To discuss the effect of acupoint application therapy in improving life quality of hypertensive patients with yin deficiency and yang excess syndrome. Methods Based on the inclusive and exclude criteria, a total of 80 hypertensive patients were chosen by convenient sampling method and divided into trial group and control group via random number table on average. The patients of trial group received general treatment and acupoint application therapy including 3 courses and 4 weeks for each course, and the patients of control group only received general treatment. The life quality was evaluated before the intervention and after all courses finished. Results After 12 weeks of the intervention, the scores of the role physical (RP), general health, vitality and mental health of trial group were (83.75±15.56), (60.20±9.71), (87.00±4.50) and (90.40±6.77), respectively, which were improved compared with that of the control group and before the intervention of trial group (P<0.05). Conclusions Acupoint application therapy can improve the physiological function and vitality of hypertensive patients with yin deficiency and yang excess syndrome, and also promote their mental health and general health. It is an effective approach to improve the life quality of hypertensive patients. Key words: Hypertension; Life quality; Acupoint application therapy; Yin deficiency and yang excess syndrome

Effect of yangxinkang tablets on chronic heart failure: A multi-center randomized double-blind placebo-controlled trial.

To investigate the safety and efficacy of yangxinkang tablets in patients with chronic heart failure (CHF) and syndrome of qi and yin deficiency, blood stasis, and water retention. In a double-blinded, randomized, placebo-controlled, multicenter clinical trail, 228 patients with CHF New York Heart Association (NYHA) class II or III in stage C were assigned by randomized block method to two groups in a 1:1 ratio to undergo either conventional Western treatment or conventional treatment plus yangxinkang tablets for 4 weeks. The outcome measure were effect of cardiac function, Chinese medicine (CM) syndromes, scores of symptoms, signs, and quality of life measured by Minnesota Living with heart failure questionnaire (MLHFQ) before and after the treatment. Totally 112 patients were analyzed in the treatment group and 109 in the control group. They were comparable in NYHA functional class, basic parameters and primary diseases before treatment. Cardiac function and CM syndromes were greatly ameliorated in both groups after treatment. Total effective rates of cardiac function and CM syndrome in the treatment group were significantly higher than those in the control group (P<0.05). Total symptom score and sign score in the treatment group decreased significantly after treatment (P<0.01), which were significantly lower than those in the control group (P<0.05). There were statistically significant differences in post-treatment scores of gasp, cough with phlegm, pulmonary rales and jugular vein engorgement between the two groups (P<0.05 or P<0.01). Three MLHFQ scores decreased significantly in both groups after treatment (P<0.01). Post-treatment total scale score and physical subscale score in the treatment group and the reduction of them showed statistically significant differences (P<0.05) as compared with the control group. There was no significant difference between the two groups in emotional subscale score and the reduction after treatment (P>0.05). There was no obvious adverse reaction in either group noted during the study. Yangxinkang tablets were safe and efficacious in improving cardiac function, CM syndromes, symptoms, signs, and quality of life in patients with CHF class II or III in stage C on the base of conventional treatment.

The Clinical Relevance of Serum NDKA, NMDA, PARK7, and UFDP Levels with Phlegm-Heat Syndrome and Treatment Efficacy Evaluation of Traditional Chinese Medicine in Acute Ischemic Stroke.

According to the methods of Patient-Reported Outcome (PRO) based on the patient reports internationally and referring to U.S. Food and Drug Administration (FDA) guide, some scholars developed this PRO of stroke which is consistent with China's national conditions, and using it the feel of stroke patients was introduced into the clinical efficacy evaluation system of stoke. “Ischemic Stroke TCM Syndrome Factor Diagnostic Scale (ISTSFDS)” and “Ischemic Stroke TCM Syndrome Factor Evaluation Scale (ISTSFES)” were by “Major State Basic Research Development Program of China (973 Program) (number 2003CB517102).” ISTSFDS can help to classify and diagnose the CM syndrome reasonably and objectively with application of syndrome factors. Six syndrome factors, internal-wind syndrome, internal-fire syndrome, phlegm-dampness syndrome, blood-stasis syndrome, qi-deficiency syndrome, and yin-deficiency syndrome, were included in ISTSFDS and ISTSFES. TCM syndrome factor was considered to be present if the score was greater than or equal to 10 according to ISTSFDS. In our study, patients with phlegm-heat syndrome were recruited, who met the diagnosis of both “phlegm-dampness” and “internal-fire” according to ISTSFDS. ISTSFES was used to assess the syndrome severity; in our study it was used to assess the severity of phlegm-heat syndrome (phlegm-heat syndrome scores = phlegm-dampness syndrome scores + internal-fire syndrome scores).

Urinary metabolite profiling offers potential for differentiation of liver-kidney yin deficiency and dampness-heat internal smoldering syndromes in posthepatitis B cirrhosis patients.

Zheng is the basic theory and essence of traditional Chinese medicine (TCM) in diagnosing diseases. However, there are no biological evidences to support TCM Zheng differentiation. In this study we elucidated the biological alteration of cirrhosis with TCM “Liver-Kidney Yin Deficiency (YX)” or “Dampness-Heat Internal Smoldering (SR)” Zheng and the potential of urine metabonomics in TCM Zheng differentiation. Differential metabolites contributing to the intergroup variation between healthy controls and liver cirrhosis patients were investigated, respectively, and mainly participated in energy metabolism, gut microbiota metabolism, oxidative stress, and bile acid metabolism. Three metabolites, aconitate, citrate, and 2-pentendioate, altered significantly in YX Zheng only, representing the abnormal energy metabolism. Contrarily, hippurate and 4-pyridinecarboxylate altered significantly in SR Zheng only, representing the abnormalities of gut microbiota metabolism. Moreover, there were significant differences between two TCM Zhengs in three metabolites, glycoursodeoxycholate, cortolone-3-glucuronide, and L-aspartyl-4-phosphate, among all differential metabolites. Metabonomic profiling, as a powerful approach, provides support to the understanding of biological mechanisms of TCM Zheng stratification. The altered urinary metabolites constitute a panel of reliable biological evidence for TCM Zheng differentiation in patients with posthepatitis B cirrhosis and may be used for the potential biomarkers of TCM Zheng stratification.

Preliminary study on relationship of disease-syndrome-symptom of ovulatory disorder infertility based on factor analysis

In this study, the clinical data of 240 cases of data acquisition on ovulation in patients with anovulatory infertility. Using the method of factor analysis, summed up the distribution situation of various syndromes and the relationship of disease-syndrome-symptom. From the study we found that polycystic ocary syndrome > premature ovarian failure > corpus luteum insufficiency > luteinized unruptured follicle syndrome > hyperprolactinemia > anovulatory dysfunctional uterine bleeding. Using the factor analysis method, the syndromes of anovulatory infertility were divided into six types and the distribution proportion of them is: kidney Yang deficiency and blood stasis > kidney Yang deficiency > kidney Yin deficiency and blood stasis > kidney Yin deficiency and liver Qi stagnation syndrome > kidney Yang deficiency and phlegm dampness stagnation > kidney Yin deficiency. By means of statistics, the traditional Chinese medicine (TCM) symptoms as abdomen pain before menstrual onset, obfuscation colour, cold lower abdomen, insomnia, fatigue, eyes dark, face dark or ring lip dark, before and after menstruation breast swelling, chest tightness, irritable insomnia, depression and lower abdomen pain during menstruation etc contribute high degree in the process. Polycystic ovary syndrome and premature are the main causes of ovulatory disorder infertility and the disease incidence rate assumed the tendency which rose year by year. The treatment of the disease of kidney yang deficiency syndrome scales biggest the disease degree of contribution. Blood stasis is the important factor in the process of pathogenesis evolution. In the study of disease distribution, we found that symptom distribution trend roughly the same and the same symptom severity in different diseases with different, which provides experience for the theory-different diseases with the same therapeutic method. These conclusions provide guidance and reference evidences for clinic practice.

Screening and identification of potential biomarkers and establishment of the diagnostic serum proteomic model for the Traditional Chinese Medicine Syndromes of tuberculosis

Ethnopharmacological relevanceChemotherapy is the mainstay of modern tuberculosis (TB) control. Traditional Chinese Medicine (TCM) can enhance the effect of anti-TB drug, promote the absorption of the foci in the lung and reduce drug toxicity. In TCM, the determination of treatment is based on ZHENG (also called TCM syndrome). To establish a diagnostic model by using proteomics technology in order to identify potential biomarkers for TCM syndromes of TB. Materials and methodsThe surface-enhanced laser desorption ionization time of flight mass spectrometer (SELDI–TOF MS) combined with weak cation exchange (WCX) magnetic beads was used to screen serum samples from 71 cases of deficiency of lung yin syndrome (DLYS), 64 cases of fire (yang) excess yin deficiency syndrome (FEYDS) and 45 cases of deficiency of both qi and yin syndrome (DQYS). A classification model was established by Biomarker Pattern Software (BPS). Candidate protein biomarkers were purified by reverse phase-high performance liquid chromatograph (RP-HPLC), identified by MALDI–TOF MS, LC–MS/MS and validated by ProteinChip Immunoassays. ResultsA total of 74 discriminating m/z peaks (P<0.001) among three TCM syndromes of TB were detected. A diagnostic model for the TCM syndrome of TB based on the five biomarkers (3961.7, 4679.7, 5646.4, 8891.2 and 9416.7 m/z) was established which could discriminate DLYS, FEYDS and DQYS patients with an accuracy of 74.0%, 72.5%, and 96.7%, respectively. The candidate biomarker with m/z of 9416.7 was identified as a fragment of apolipoprotein C-III (apoC-III) by MALDI–TOF-MS and LC–MS/MS. ConclusionThe TCM syndrome diagnostic model of TB could successfully distinguish the three TCM syndromes of TB patients. This provided a biological basis for the determination of treatment based on different TCM syndromes of TB. ApoC-III was identified as a potential biomarker for TCM syndromes of TB and revealed the biochemical basis and pathogenesis of TCM syndromes in TB.

The association between blood lipid and phlegm turbidity syndrome of angina pectoris: A systematic review and meta-analysis

A series of case-control studies have been conducted to investigate the association between blood lipid and phlegm turbidity syndrome of angina pectoris, but produced inconsistent results. We performed a meta-analysis to determine the association between blood lipid and phlegm turbidity syndrome of angina pectoris more precisely. Manual screening as well as screening of the China National Knowledge Infrastructure (CNKI), Chinese Journal full-text database (VIP), Wanfang database (WF), ScienceDirect, Pubmed, the Cochrane Library, and Embase were carried out for relevant literature. The formula was translated to calculate the pooled mean value and standard deviation value. The "Newcastle-Ottawa Quality Assessment Scale: Case-Control Studies" (NOS) was taken to assess the quality of the included studies. The Revman 5.2.6 software provided by "The Cochrane Collaboration" was used to analyze the collected data. The subgroup analysis was established according to the sample size proportion between the test group and the control group. Sensitivity analysis was constructed by using two different effect models. Besides, a funnel plot was created to analyze potential publication bias. No statistically meaningful difference existed between the test group and control group of total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C) in non-Qi and yin deficiency syndrome (QYDS) and non-Yang deficiency syndrome (YDS) subgroup, whereas the two biotic indicators in the test group were higher than the non-phlegm syndrome group in other subgroups. Triglyceride (TG) in phlegm syndrome group showed superior to non-phlegm syndrome group in the rest subgroups except for the non-CCS (Cold coagulating syndrome)-non-YDS subgroup. High-density lipoprotein-cholesterol (HDL-C) levels of the phlegm group were lower than that of the non-phlegm group in all subgroups. When comparing with Traditional Chinese Medicine (TCM) syndromes of asthenia nature, such as YDS, QYDS, and heart qi deficiency syndrome), the levels of TG, TC, and LDL-C were higher in phlegm turbidity syndrome. However, for sthenia syndromes such as Qi stagnation syndrome (QSS), heart blood stasis syndrome (HBSS), and CCS, there was no obvious difference. Furthermore, HDL-C levels in the phlegm turbidity group were lower than those of the non-phlegm group. Nevertheless, these results should be confirmed with further studies.

Bone marrow angiogenesis in patients presenting with differential Chinese medicine syndrome: Correlation with the clinico-pathological features of aplastic anemia

To explore differences in bone marrow angiogenesis seen in aplastic anemia (AA) patients presenting with differential Chinese medicine (CM) syndrome, and to correlate these differences with clinical pathology. Thirty-five patients were enrolled, including 18 with "yang deficiency syndrome" and 17 with "yin deficiency syndrome." Bone marrow biopsies and serum were collected. Microvessel density (MVD) and positive expression of vascular endothelial-derived growth factor (VEGF) were detected by immunohistochemisty. Hypoxia inducible factor -1α (HIF-1α), and VEGF expression were assayed by enzyme-linked immunoabsorbent assay (ELISA), serum lactate dehydrogenase (LDH) was tested by enzyme method and liquid chip technology was used to detected the expression of interleukin (IL)-2, IL-4, IL-6, IL-10, interferon (IFN)-γ and tumor necrosis factor (TNF)-α. Counts for leukocytes, absolute neutrophils and platelets in "yin deficiency syndrome" were lower than those found in "yang deficiency syndrome" (P<0.05). MVD and VEGF expression, and the positive rate of CD34 and VEGF in bone marrow were lower in AA, especially in "yin deficiency syndrome" (P<0.01 or P<0.05). "Yin deficiency syndrome" displayed decreased VEGF and LDH expression, and enhanced expression of HIF-1α as compared to "yang deficiency syndrome" (P<0.05). Levels of IL-4 and IL-6 were higher in AA (P<0.01), but IL-10 was decreased (P<0.05). High TNF-α expression was seen in "yang deficiency syndrome" and IFN-γ expression was decreased in "yin deficiency syndrome" as compared with normals (P <0.01 and P<0.05, respectively). AA patients have lower MVD than normals, especially in "yin deficiency syndrome." MVD might differentially correlate to disease severity, and could be dependent on bone marrow or serum VEGF expression and LDH. Additionally, IL-2, IL-10, IL-4 and IFN-γ were negatively associated while IL-6 and TNF-α were positively associated with MVD.

Effect of Qingxuan Granule () on blood pressure variability of hypertensive patients with and without obstructive sleep apnea.

To observe the effect of Qingxuan Granule () on blood pressure variability of hypertensive patients with and without obstructive sleep apnea (OSA). This study was a stratified, randomized, doubled-blind, placebo-controlled clinical trial. Ninety mild and moderate hypertensive patients with yin deficiency and yang hyperactivity syndrome were enrolled. Each patient received portable sleep monitoring for OSA diagnosis and 24-h ambulatory blood pressure monitoring (ABPM) for blood pressure diagnosis. According to the OSA diagnosis, the hypertensive patients were assigned to two subgroups, one with OSA (group A), the other without OSA (group B); and in each subgroup, the patients were randomly assigned to the treatment group (group A1 or group B1) and control group (group A2 or group B2). All of the patients were treated by Amlodpine Besylate, in addition, Qingxuan Granule was given to the treatment group (group A1 or group B1), and placebo was given to the control group (group A2 or group B2), respectively. After a 2-month treatment, each patient received portable sleep monitoring and 24-h ABPM again, the difference (D-value) of the blood pressure, and OSA index between pre-treatment and post-treatment were analyzed by covariance analysis in a generalized linear model. In this model, D-value was accepted as dependent variable Y, which was affected by treatment method (considered as factor a), the base level of all indices before treatment (considered as factor b), and OSA condition (considered as factor c). The following indices declined more in total treatment groups (groups A1+B1) than in total control groups (groups A2+B2, P a<0.05): 24-h systolic blood pressure (SBP) standard deviation (SD), daytime SBP SD, night time SBP SD, 24-h diastolic blood pressure (DBP) SD, 24-h DBP coefficient variation (CV), daytime DBP SD, night time DBP SD, and heart rate; the following indices declined less in the patients with OSA than those without OSA (P a<0.05): night time SBP, 24-h SBP SD, daytime SBP SD, night time SBP SD, 24-h DBP SD, 24-h DBP CV, daytime DBP SD, night time DBP SD, night time DBP CV, and heart rate; and the following indices increased less in the patients with OSA than those without OSA (P b<0.05): night time SBP fall rate, night time DBP fall rate. No significant difference was found in OSA' indices after taking Qingxuan Granule (P>0.05), with the exception that hypopnea index decreased and hypopnea improved (P<0.05). For hypertensive patients, Qingxuan Granule could improve the blood pressure variability, and this effect could be weakened by OSA; also Qingxuan Granule could improve hypopnea in OSA patients.

A quantification model of Traditional Chinese Medicine syndromes in children with idiopathic precocious puberty and early puberty

ObjectiveTo establish a quantification model of Traditional Chinese Medicine (TCM) syndromes by sampling patients undergoing idiopathic precocious puberty (IPP) and early puberty. MethodsA questionnaire for classifying and quantifying TCM syndromes was designed and administered. All the results were analyzed; the relationship between 3 types of syndrome and 47 symptoms were summated. Meanwhile, the frequency distribution of each symptom or sign was aggregated. Fuzzy mathematics was used to develop a quantification model of TCM syndromes. ResultsWe found that precocious puberty had 3 types of syndrome, including hyperactivity of fire due to Yin deficiency (Syndrome I), depressed liver Qi transforming into fire (Syndrome II), and end retention of damp heat (Syndrome III). In the IPP group, Syndrome I was the most common principal syndrome (100%). Forty-six patients (43.81%) were diagnosed with Syndrome I accompanied by Syndrome II and 11 (10.48%) were diagnosed with Syndrome I accompanied by Syndrome III. In the early puberty group, Syndrome I was also the main syndrome (98.39%). The degrees of most symptoms were mild to moderate. Reddened tongue was the most common tongue manifestation (62.86% prevalence) in the IPP group. The most common pulse manifestations were slippery pulse, thread pulse, and taut pulse. The Asymptotic Normalization Coefficient (ANC) method was used to quantify the TCM syndromes in 167 cases. Diagnostic accuracy rate reached 91%, comparable to expert diagnosis. ConclusionWe find that there are 3 types of syndrome in the IPP group and in the early puberty group. Syndrome I (hyperactivity of fire due to Yin deficiency) is the main syndrome in the two groups. ANC may be an appropriate for quantification model of TCM syndromes.

GW24-e2982 Research on T. C. M Syndromes Discipline of Congestive Heart Failure Based on Literature Analysis and Retrospective Analysis of Clinical Cases

ObjectivesTo discuss the characteristics of TCM syndrome factors and distribution discipline of congestive heart failure, and provide basis for the establishment of diagnosis criteria on essential syndromes.Methods1) Based on databases...

Establish proposal of diagnosis and treatment of traditional Chinese medicine in AIDS patients with recurrent oral ulcerations

The pathogenesis of acquired immune deficiency syndrome-associated recurrent oral ulcerations (AIDS-ROU) remained obscure and these was no specific treatment for it. Syndrome differentiation in traditional Chinese medicine (TCM) focus on integral regulation and has an advantage of the disease that etiology and pathogenesis remain obscure. A draft of Chinese medicine diagnosis and treatment standard procedure for AIDS-ROU was established by literature retrieval and peer review. Two questionnaires were carried out to investigate the confirmation and advice of in-group specialist to key points of the draft including diagnosis, treatment and nursing. Then the procedures were revised accordingly. The preliminary results showed the recovery rate of complete questionnaires in the 1st survey was 96%. Specialists confirmed more on outline, case history and physical examinations, syndrome differentiation of hyperactivity of fire due to Yin deficiency syndrome (HFYDS), treatment of heat accumulated in heart and spleen syndrome (HAHSS) and HFYDS, treatment of western medicine and nursing. They held different opinions on incidence, treatment of deficiency of spleen-QI and stomach-QI syndrome (DSSS) and criterion of therapeutical evaluation. Cronbach coefficient alpha (CCA) was 0.998 and split-half reliability R was 0.91. Recovery rate of complete questionnaires in 2nd survey was 100%. Specialists confirmed more on outline, etiology and pathogenesis, case history and physical examination, auxiliary examination, diagnostic criteria, syndrome differentiation and treatment of HAHSS and HFYDS. They held different opinions on syndrome differentiation and treatment of intermingled cold and heat syndrome and DSSS, nursing and the other therapies. CCA was 0.428 and split-half reliability R was 0.96. Coefficient of variations of the 2nd survey were less than those of the 1st survey, which mean coordination was improved. Each single item in two surveys contributed less difference in overall results according to weight coefficients. A new revision of the procedure was preliminarily established according to results of two surveys. Experts'activeness, concentration and coordination were good in two surveys. They had reached consensus in key points of the draft including diagnosis, treatment and nursing on the whole.

Tianma Gouteng Yin as Adjunctive Treatment for Essential Hypertension: A Systematic Review of Randomized Controlled Trials

Background. Tianma Gouteng Yin (TGY) is widely used for essential hypertension (EH) as adjunctive treatment. Many randomized clinical trials (RCTs) of TGY for EH have been published. However, it has not been evaluated to justify their clinical use and recommendation based on TCM zheng classification. Objectives. To assess the current clinical evidence of TGY as adjunctive treatment for EH with liver yang hyperactivity syndrome (LYHS) and liver-kidney yin deficiency syndrome (LKYDS). Search Strategy. 7 electronic databases were searched until November 20, 2012. Inclusion Criteria. RCTs testing TGY combined with antihypertensive drugs versus antihypertensive drugs were included. Data Extraction and Analyses. Study selection, data extraction, quality assessment, and data analyses were conducted according to the Cochrane standards. Results. 22 RCTs were included. Methodological quality was generally low. Except diuretics treatment group, blood pressure was improved in the other 5 subgroups; zheng was improved in angiotensin converting enzyme inhibitors (ACEIs), calcium channel blockers (CCBs), and “CCB + ACEI” treatment groups. The safety of TGY is still uncertain. Conclusions. No confirmed conclusion about the effectiveness and safety of TGY as adjunctive treatment for EH with LYHS and LKYDS could be made. More rigorous trials are needed to confirm the results.

Circulating miR-583 and miR-663 Refer to ZHENG Differentiation in Chronic Hepatitis B.

Traditional Chinese medicine (TCM) ZHENG as the key pathological principle is to understand the human homeostasis and guide TCM treatment. Here, circulating microRNAs (miRNAs) were utilized to differentiate between ZHENGs including liver-gallbladder dampness-heat syndrome (LGDHS) and liver-kidney yin deficiency syndrome (LKYDS) in chronic hepatitis B (CHB). Sera samples of CHB patients with LGDHS (n = 35), LKYDS (n = 24), and healthy controls (Ctrls, n = 21) were analyzed by microarray and real-time RT-PCR. Receiver-operator characteristic (ROC) curves were established to evaluate the levels of serum miRNA for discriminating LGDHS and LKYDS. The target genes of miRNAs were predicted by TargetScan. Gene Ontology (GO) and pathways were analyzed using DAVID tool. The results showed that 22 miRNAs were differentially expressed between LGDHS and LKYDS (fold change >2.0 and P < 0.01). Circulating miR-583 and miR-663 were significantly higher (P < 0.001) in CHB patients with LGDHS than those with LKYDS and Ctrls. ROC curve analysis revealed that miR-583 and miR-663 were sensitive and specific enough to distinguish LGDHS from LKYDS. Pathway enrichment analysis indicated that 354 putative targets for miR-583 and 68 putative targets for miR-663 were mainly involved in Axon guidance, Neurotrophin, and MAPK signaling pathway. miR-583 and miR-663 may be potential markers for ZHENG differentiation in CHB.

The Correlation of Traditional Chinese Medicine Deficiency Syndromes, Cancer Related Fatigue, and Quality of Life in Breast Cancer Patients

BackgroundTo evaluate the correlation between the different traditional chinese medicine (TCM) deficiency syndromes, cancer related fatigue (CRF), and quality of life (QoL) in breast cancer patients. Patients and methodsNinety-five breast cancer patients were categorized into different qi (氣 qì), blood (血 xuè), yin (陰 yin), and yang (陽 yáng) TCM deficiency syndrome groups (DSGs). We used the ICD-10 for diagnosing CRF. The QoL was assessed by the WHO-BREF and Short Form Health Survey (SF12) questionnaires. The major outcome was to compare the QoL scores between the different TCM DSGs. The second outcome was the intergroup analysis between the CRF and different TCM DSGs in breast cancer patients. ResultsThe patients with qi deficiency (氣虛 qì xu) had a higher correlation with CRF (p=0.001) and poorer QoL both in the WHO-BREF and SF12 survey (p<0.001), whereas the patients with yin deficiency (陰虛 yin xu) had poorer QoL in the psychological (p=0.02) and social aspects (p=0.04). The qi deficiency (氣虛 qì xu) syndrome was closely associated with yin deficiency syndrome (陰虛 yin xu). (p=0.03). ConclusionOur study confirmed the concept of Qi-deficiency (氣虛 qì xu) in TCM was associated with CRF as identified in cancer care in western medicine. The breast cancer patients with qi deficiency (氣虛 qì xu) have poorer QoL. Treatment of CRF and improving QoL by supplying qi (氣 qì) may warrant further investigation.