Prognostic significance of identification of traditional Chinese medicine syndromes in colorectal cancer

Background:Traditional Chinese medicine(TCM)syndrome is the basic unit of TCM treatment,which help clinicians assess the disease progression and treatment preoperative of tumor patients.However,the prognostic significance of TCM syndrome is still unclear.This study aims to detect the differences in overall survival between different TCM syndrome and further develop a new nomogram with TCM syndrome for predicting overall survival in colorectal cancer.Methods:A total of 324 patients with colorectal cancer were enrolled and categorized into three groups based on TCM syndrome:deficiency,excess,and deficiency-excess.The prognosis of colorectal cancer patients with different TCM syndromes was evaluated using Kaplan-Meier analysis and Cox regression analysis.Results:The proportion of advanced stage and lymph metastasis in the patients with deficiency syndrome was higher,and the overall survival was shorter than other syndromes.Meanwhile,the TCM syndrome(P<0.001),tumor invasion depth(P<0.001),lymph metastasis(P=0.018),organic metastasis(P=0.005)and tumor node metastasis(TNM)stage(P=0.029)were the independent prognostic factor.Then,a new nomogram with TCM syndrome was established and assessed.324 colorectal cancer patients were randomly divided into training(n=215)and validation cohorts(n=109).A nomogram incorporating preoperative TCM syndrome,gender,age,T,N,and M status was developed,which had good discrimination and calibration.Conclusion:Taken together,our results indicated that TCM syndrome could assess the prognosis of colorectal cancer.The nomogram incorporating TCM syndromes and tumor information is helpful for risk stratification and prognostic predictions in colorectal cancer preoperatively.

A cross-sectional study on traditional Chinese medicine syndromes distribution for chronic atrophic gastritis based on data mining

Background:Chronic atrophic gastritis(CAG)is a common digestive system disease characterized by reduced gastric mucosa inherent glands and often accompanied by intestinal metaplasia and dysplasia.Traditional Chinese medicine believes that syndrome elements dampness and blood stasis are closely related to the occurrence and development of CAG and promote the occurrence of precancerous lesions of gastric cancer.However,there is a lacking of more in-depth and detailed study on the above syndrome elements.This study aimed to made a quantitative description by cross-sectional study on the frequency of key syndrome elements dampness and blood stasis of CAG.Methods:201 CAG patients who met with inclusion criteria were divided into 4 groups including:only dampness group,only blood stasis group,none of dampness and blood stasis group,dampness and blood stasis group according to their four diagnostic information.The severities and levels of patients’clinical symptoms,pathological signs and patient-reported outcome scale used as evaluation indexes were collected.Data mining method of exploratory factor analysis was used for statistics.Results:The results suggested that the frequencies of dampness and blood stasis were reflected in the severity and levels of gastric symptoms,helicobacter pylori infection and the distribution and severity of dysplasia.And blood stasis played a more prominent role in promoting the progression of the CAG to cancer.Conclusion:Our results might provide a quantitative syndrome description for the traditional Chinese medicine differentiation in treating precancerous lesions of gastric cancer and preventing gastric cancer.

Characteristics and Correlation Analysis of Negative Emotions, Quality of Life, and Chinese Medicine Syndromes in Patients with Lung Cancer after Surgery: A Cross-sectional Study

Objective:The objective of the study was to observe and analyze the characteristics of negative emotions and quality of life(QoL)in patients with nonsmall cell lung cancer(NSCLC)from 1 to 3 months after surgery,and summarize their population characteristics after surgery.Materials and Methods:The consolidation rehabilitation period was defined as 1 to 3 months after surgery.The main observation indicators were the general Hospital Anxiety and Depression Scale,the European Organization for the Research and Treatment of Cancer Core QoL Questionnaire(EORTC QLQ-C30),and EORTC QLQ-Lung Cancer-13.The secondary observation indicators were peripheral blood cytokines and immune function indicators.Statistical methods such as one-way analysis of variance and logistic regression were used to analyze the characteristics of this part of the population.Results:Among patients who underwent lung surgery,the overall incidence of anxiety during consolidation recovery was 13.66%,and that of depression was 10.38%.The scores of fatigue,pain,dyspnea,insomnia,and loss of appetite were significantly higher than those of other symptoms(P=0.000).The presence of anxiety was associated with the site of surgery(P<0.05)and the presence of depression was associated with emotional functioning and dyspnea(P<0.05).Conclusions:The occurrence of negative emotions in the postoperative NSCLC population is related to gender,and the degree of emotions is negatively correlated with QoL and positively correlated with the degree of symptoms.The main relevant syndromes are the pulmonary and meridian categories.

Comprehensive effects of traditional Chinese medicine treatment on heart failure and changes in B-type natriuretic peptide levels: A meta-analysis

BACKGROUND Heart failure(HF),a common cardiovascular condition,is characterized by significant morbidity and mortality.While traditional Chinese medicine(TCM)is often used as a complementary approach in HF management,systematic evalua-tions of its impact on clinical outcomes,TCM syndrome scores,and B-type natriuretic peptide(BNP)levels are lacking.This study fills this gap through a comprehensive analysis of randomized controlled trials(RCTs)focusing on TCM for HF treatment.It encompasses an assessment of methodological quality,a meta-analysis,and an evaluation of evidence quality based on established standards.The results offer crucial insights into the potential advantages and constraints of TCM in HF management.RCTs on TCM for HF treatment published since the establishment of the database were searched in four Chinese and English databases,including China National Knowledge Infrastructure,Wanfang,VIP Information Chinese Science and Technology Journal,and PubMed.Methodological quality was assessed for the included studies with the Cochrane risk-of-bias assessment tool,and the meta-analysis and publication bias assessment was performed with the RevMan5.3 software.Finally,the quality of evidence was rated according to the GRADE criteria.RESULTS A total of 1098 RCTs were initially retrieved.After screening,16 RCTs were finally included in our study,which were published between 2020 and 2023.These RCTs involved 1660 HF patients,including 832 in the TCM group[TCM combined with conventional Western medicine(CMW)treatment]and 828 in the CWM group(CWM treatment).The course of treatments varied from 1 wk to 3 months.TCM syndrome differentiation was analyzed in 11 of the included RCTs.In all included RCTs,outcome indicators included comprehensive clinical outcomes,TCM syndrome scores,and BNP levels.The meta-analysis results showed significant differences between the TCM and CWM groups in terms of comprehensive clinical outcomes[risk ratio=-0.54;95%confidence interval(CI)=-0.61,-0.47;P<0.00001],TCM syndrome scores[weighted mean difference(WMD)=-142.07;95%CI=-147.56,-136.57;P<0.00001],and BNP levels(WMD=-142.07;95%CI=-147.56,-136.57;P<0.00001).According to the GRADE criteria,RCTs where"TCM improves clinical comprehensive outcomes"were rated as low-quality evidence,and RCTs where"TCM reduces TCM syndrome scores"or"TCM decreases BNP levels"were rated as medium-quality evidence.CONCLUSION TCM combined with CWM treatment effectively improves comprehensive clinical outcomes and diminishes TCM syndrome scores and BNP levels in HF patients.Given the low and medium quality of the included RCTs,the application of these results should be cautious.

Serum metabolic profiling of traditional Chinese medicine syndromes in patients with diarrhea-predominant irritable bowel syndrome

Objective:The clinical symptoms of diarrhea-predominant irritable bowel syndrome(IBS-D)can be effectively improved by traditional Chinese medicine(TCM)treatment,based on the usage of specific therapies for different TCM syndromes.However,in the stage of diagnosis,the standard criteria for the classification of TCM syndrome were still deficient.Through serum metabolic profiling,this study aimed to explore potential biomarkers in IBS-D patients with different TCM syndromes,which can assist in diagnosis of the disease.Methods:Serum samples were collected from healthy controls(30 cases),IBS-D patients with LiverStagnation and Spleen-Deficiency syndrome(LSSD,30 cases),Yang Deficiency of Spleen and Kidney syndrome(YDSK,11 cases)and Damp Abundance due to Spleen-Deficiency syndrome(DASD,22 cases).Serum metabolic profiling was conducted by ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry.The potential biomarkers were screened by orthogonal partial least square-discriminate analysis,while metabolic pathways undergoing alterations were identified by pathway enrichment analysis in Metabo Analyst 4.0.Results:Overall,34 potential biomarkers were identified in LSSD group,36 in YDSK group and 31 in DASD group.And the 13 metabolites shared by three groups were determined as the potential biomarkers of IBS-D.Glycerophospholipid metabolism was disturbed significantly in IBS-D patients,which may play a role in IBS-D through inflammation.What’s more,three TCM syndromes have the specific potential biomarkers in glycerophospholipid metabolism.Conclusion:The serum metabolomics revealed that different TCM syndrome types in IBS-D may have different metabolic patterns during disease progression and glycerophospholipid metabolism was one of the pathways,whose metabolism was disturbed differently among three TCM syndromes in IBS-D.Therefore,the specific potential biomarkers in glycerophospholipid metabolism of three TCM syndromes in IBS-D can serve as the objective indicators,which can facilitate the TCM-syndrome objective classification of IBS-D.

Correlation between Different Chinese Medicine Syndromes and Changes in Microcirculation in Septic Shock Patients

Objective： To investigate the correlation between different Chinese medicine （CM） syndromes and variations in microcirculation in septic shock patients. Methods： seventy Septic shock patients were divided into four groups： heat damaging qi-yin group （HDQY, 23 cases）; yin exhaustion and yang collapse group （YEYC, 26 cases）; excessive heat in Fu organ group （EHFO, 10 cases）; and heat damaging nutrient-blood group （HDNB, 11 cases）. Sublingual microcirculation parameters were observed by sidestream dark-field （SDF） imaging and scored by Acute Physiology and Chronic Health Evaluation Ⅱ （APACHE Ⅱ） and the Sequential Organ Failure Assessment （SOFA）, and parameters of microcirculation perfusion variations and prognoses were analyzed. Results： Compared with those with qi-yin heat damage, perfused vessel density （PVD） in other groups decreased dramatically （P〈0.05）, and APACHE H scores increased significantly （P〈0.05）. In addition, the recovery time was prolonged substantially （P〈0.05）, and the mixed venous oxygen saturation （SVO2） decreased （P〈0.05）. Blood lactic acid increased significantly （P〈0.05）, and the mixed SVO2 decreased （P〈0.05）, in the YEYC group. Compared with the thermal injury camp blood group, sublingual microcirculation parameter variations showed no obvious difference in the YEYC and EHFO groups （P〉0.05）. There were significant positive correlations between CM syndromes and APACHE Ⅱ scoring in different groups （r=0.512, P〈0.05）. There were negative correlations between PVD and APACHE Ⅱ scoring （r=-0.378, P=0.043）, the proportion of perfused vessels （PPV） and APACHE g scoring （r=0.472, P=0.008）, as well as between the microvascular flow index （MFI） and APACHE Ⅱ scoring （r=-0.424, P=0.023） in different patients. Conclusion： Sublingual microcirculation may serve as a clinical diagnostic parameter of the patient condition, as well as being a prognostic indicator.

Circulating Levels of Inflammatory Cytokines in Patients with Psoriasis Vulgaris of Different Chinese Medicine Syndromes

Objective： To investigate whether the serum levels of inflammation-related cytokines might be different between the healthy individuals and the psoriatic patients diagnosed of three varied Chinese medicine （CM） syndromes [blood-stasis syndrome （BSS）, blood-dryness syndrome （BDS） and wind-heat syndrome （WHS）]. Methods： A total of 62 psoriatic patients were recruited and assigned to 3 groups according to their CM syndromes, including 27 patients of BSS, 21 of BDS and 14 of WHS. Another 20 sex- and age- matched healthy subjects were enrolled into the control group. Serum concentrations of multiple cytokines, including monocyte chemotactic protein-1 （MCP-1）, macrophage inflammatory protein-1α （MIP-1α）, soluble CD40 ligand （SCD40L）, tumor necrosis factor-α （TNF-α）, epidermal growth factor （EGF）, interleukin-8 （IL-8）, interleukin-17 （IL-17）, interferon γ inducible protein-10 （IP-10） and vascular endothelial growth factor （VEGF）, were measured by a multiplexed flow cytometric assay. Results： The circulating levels of MIP-1α, TNF-α, IL-8, and IP-10 were significantly increased in the psoriatic patients compared with the healthy controls （P〈0.01）. Male and female patients tended to have higher serum levels of MCP-1 and IP-10, respectively （P〈0.05）. Interestingly, compared with the control group, 6 out of the 9 cytokines （MCP-1, MIP-1α, TNF-α, EGF, IL-8 and IP-10） were substantially increased in the BSS group （P〈0.05 or P〈0.01）, whereas only MIP-1α and IL-8 levels were elevated in the BDS group （P〈0.05 or P〈0.01） concurrent with lowered concentrations of SCD40L and IL-17 （P〈0.05）. In the WHS group, MIP-1α was the only cytokine whose level was evidently increased （P〈0.01）, in contrast to IL-17 which was decreased as compared with the control （P〈0.05）. The psoriatic patients overall owned higher levels of MIP-1 a and IL-8 in the circulation which were comparable among the 3 groups of CM syndromes （P〈0.01）. In contrast, TNF-α level of the BSS group was the highest among the three （P〈0.01）, followed by the BDS and the WHS groups. Conclusions： The expression profiles of cytokines in the circulation might not be necessarily identical for psoriatic patients with different CM syndromes. Accordingly, the serum concentrations of certain cytokines could potentially be used as the ancillary indices for the clinical classification of psoriatic CM syndromes.

Expression of PYCARD Gene Transcript Variant mRNA in Peripheral Blood Mononuclear Cells of Primary Gout Patients with Different Chinese Medicine Syndromes

Objective： To study the expression level and role of apoptosis-associated speck-like protein containing a caspase recruitment domain （PYCARD） gene transcript variant mRNA in peripheral blood mononuclear cells （PBMCs） of primary gout （PG） patients with different Chinese medicine （CM） syndromes. Methods： The expressions of PYCARD gene transcript variant mRNA and interleukin-1β （IL-1β） mRNA in PBMCs were investigated in 96 PG patients with acute phase （APPG, 44 cases） and non-acute phase （NAPPG, 52 cases） and 30 healthy controls （HCs） by reverse transcription-polymerase chain reaction （PCR） and/or real-time quantitative PCR. PYCARD and nuclear factor-κB （p50） [NF-κB （p50）] protein was detected by Western blot in PBMCs respectively. IL-1β, IL-4 and IL-10 protein levels in plasma of HCs and PG patients were measured by enzyme-linked immuno sorbent assay. Results： The main CM syndromes in APPG patients were obstruction of dampness and heat syndrome （ODHS, 36.36%） and intermingled phlegm-blood stasis syndrome （IPBSS, 27.27%）, while in NAPPG patients were Pi （Spleen）-deficiency induced dampness syndrome （PDIDS, 40.38%） and qi-blood deficiency syndrome （QBDS, 26.92%）. It showed statistical significances of the expressions of PYCARD gene and its transcript variant mRNA, the protein of PYCARD and NF-κB （p50） and the plasma IL-1β, IL-4 and IL-10 in APPG, NAPPG, ODHS, IPBSS, PDIDS and QBDS groups, compared with the HC group respectively （P〈0.05 or P〈0.01）. There were also significant differences of mRNA expressions of PYCARD-1 and PYCARD-2 as well as protein expressions of IL-1β, IL-4 and IL-10 among the 4 CM syndromes groups （P〈0.05 or P〈0.01）. Correlation analysis showed positive correlation between the mRNA expressions of PYCARD-1 gene transcript variant and IL-1β in APPG patients （r=0.3088, P=0.0183）. Conclusion： PYCARD gene and its transcript variant may play a critical and regulative role in the inflammatory response of PG patients with different phases and CM syndromes.

Analysis on the Chinese Medicine Syndromes and Demographic Characteristics of Patients with Influenza-Like IIlness in Clinics of China

Objective： To investigate Chinese medicine （CM） patterns and epidemiological characters of patients with influenza-like illness （ILI） syndromes in clinics in China. Methods： A prospective multi-center observational epidemiology survey on the clinical CM patterns of ILI and its prevalence was conducted from September 2009 to April 2010. A unified survey questionnaire was developed for data collection of ILI symptoms and CM pattems. Totally 45 hospitals from 22 provinces, municipality cities and autonomous regions of China participated this study. The collected data were input by EPI-data v3.1 and analyzed by SPSS 18.0, which included descriptive analysis and Chi-square test for group comparison. Results： A total of 5,967 ILI patients were included in the study. The proportion of the 18-34 aged group （56.2%） was the largest; students （41.0%） were more than other occupations. Majority of the patients had the wind-heat invading Lung （Fei） syndrome （76%）, while in Southwest China mainly wind-heat invading Lung syndrome and wind-cold tightening the exterior syndrome occurred. The typical symptoms of ILI were ranked as fatigue （80.9%）, cough （72.2%）, sore throat （67.2%）, muscular soreness （67.1%）, headache （65.4%）, aversion to cold （60.1%）, thirst （55.1%） and nasal obstruction （48.1%）. Conclusions： The ILl patients in clinics were mainly teenagers and young adults. In regard to CM syndrome, wind-heat invading Lung syndrome prevailed in all regions except the Southwest China. The characteristics of CM syndrome of ILl patients may be relevant to age and region distribution.

Correlation between Characteristics of Coronary Plaque and Chinese Medicine Syndromes of Coronary Heart Disease:A Cross-Sectional Study Analysed by Intravascular Ultrasound

Objective:To analyse the correlation between the characteristics of coronary plaque in coronary heart disease(CHD)patients with phlegm-blood stasis syndrome(PBS)and blood stasis syndrome(BSS).Methods:Patients were divided into different groups based on Chinese medicine(CM)syndrome differentiation.The baseline demographics and clinical variables were collected from the medical records.Additionally,the characteristics of plaque and pathological manifestations in coronary artery were evaluated intravascular ultrasound(IVUS).Results:A total of 213 CHD patients were enrolled in two groups:184 were diagnosed with PBS and the remaining 29 were diagnosed with BSS.There were no significant differences in age,body mases index,proportions of patients with high blood pressure,diabetes mellitus,smoking,hyperlipidemia,history of coronary artery bypass graft and percutaneous coronary intervention,medications,index from cardiac ultrasound image,blood lipids and C-reactive protein between the two groups(P>0.05),except gender,weight and proportions of OVUS observed target vessels(P<0.05 or P<0.01).More adverse events such as acute myocardial infarction(P=0.003)and unstable angina(P=0.048)were observed in BSS.Additionally,dissection,thrombus and coronary artery ectasia were significantly increased in BSS(P<0.05 or P<0.01).In contrast,PBS had more patients with stable angina and chronic total occlusion with significantly higher SYNTAX(synergy between percutaneous coronary intervention with Taxus and coronary artery bypass surgery)scores(P<0.05 or P<0.01).Moreover,dense-calcium was significantly elevated in PBS(P<0.01).Conclusions:Coronary plaque characteristics were correlated with different CM syndromes.Patients with PBS were associated with a higher degree of calcified plaque and severe coronary artery stenosis,indicating poor clinical prognosis but with a low probability of acute coronary events.On contrast,the degree of calcified plaque in patients with BSS remained relatively low,and plaque was more vulnerable,resulting in the possibility of the occurrence of acute coronary events remaining high.

Correlations among Persistent Viral Infection,Heart Function and Chinese Medicine Syndromes in Dilated Cardiomyopathy Patients

Objective：To investigate the correlations among persistent viral infection,heart function and Chinese medicine（CM） difined-syndromes in patients with dilated cardiomyopathy（DCM）.Methods：Fifty patients with DCM in the First Affiliated Hospital of Zhejiang Chinese Medical University from October 2009 to December 2011 were selected as the research subjects,and 30 healthy people were simultaneously selected as the normal control group to detect persistent viral infections after admission.The CM syndrome type and grade of heart function were then evaluated.The expression level of Coxsackie adenovirus receptor（CAR） was detected using the flow cytometry（FCM） technique,coxsackie virus RNA（CVB-RNA） using reverse transcription polymerase chain reaction（RTPCR）,and the plasma brain natriuretic peptide（BNP） level with a Triage meter plus diagnosis instrument.Finally,the parameters such as left ventricular end diastolic diameter（LVEDd） and left ventricular ejection fraction（LVEF） were measured by ultrasonic cardiogram.Person correlation analysis was used for measured data,Spearman correlation analysis for rating data,and the Chi-square test for numerical data.Results：CVB-RNA was positive in 22 patients（44%） with DCM,while only 6 cases（20%） were CVB-RNA-positive in the normal control group,with a significant difference between the two groups（P〈0.01）.The expression level of CAR was significantly elevated in the DCM group compared with the normal control group（P〈0.01）.In CVB-RNA-positive patients（22 cases）,the expression level of CAR was significantly higher than in CVB-RNA-negative patients（28 cases;P〈0.01）.In the DCM patients,there was a positive correlation between the CAR expression and the BNP level（r=0.34,P〈0.05）,while no significant difference was found between the CAR expression and the LVEF and LVEDd（r=-0.32,0.30,P〉0.05）.There was no clear correlation between virus infection and the CM syndrome types in DCM patients（r=-0.22,P〉0.05）.According to the sequence of syndrome types：phlegm → qi deficiency → blood stasis → hydroretention with asthenic yang（from low to high）,a positive correlation was existed between the BNP levels and CM syndrome types（r=0.139,P〈0.05）.Conclusion：The expression of CAR on the surface of white cells could be used to detect persistent viral infection.The expression level of CAR and heart function in DCM patients were highly correlated.The expression level of BNP may serve as an objective index for differentiating CM syndromes for patients with DCM.

Exploring medication rules in Chinese randomized controlled trials of type 2 diabetes based on data mining technology

Background:To systematically summarize and categorize the Chinese herbal medicine in the domestic traditional Chinese medicine(TCM)literature on type 2 diabetes mellitus(T2DM),in this paper,we mine traditional Chinese medicine data for relationships and provide for future practitioners and researchers.Methods:Taking randomized controlled trials on the treatment of T2DM in TCM as the research theme,we searched for full-text literature in three major clinical databases,including CNKI,Wan Fang,and VIP,published between 1990 and 2020.We then conducted frequency statistics,cluster analysis,association rules extraction,and principal component analysis based on a corpus of medical academic words extracted from 1116 research articles.Results:The most frequently used is Astragali Radix,and the most commonly used two-herb combination in T2DM treatment consisted of Coptidis Rhizoma and Moutan Cortex.Moutan Cortex,Alismatis Rhizoma,and Dioscoreae Rhizoma were the most frequently used three-herb combination.We found a“lung”and“liver”and“kidney”model and confirmed the value of classical meridian tropism theory and pattern identification.The treatment is mainly to fill deficiency and clear heat and consider water infiltration,dampness,blood circulation,and silt.Conclusion:This study provides an in-depth perspective on the TCM medication rules for T2DM and offers practitioners and researchers valuable information about the current status and frontier trends of TCM research on T2DM in terms of diagnosis and treatment.

Give Full Play the Role of Traditional Chinese Medicine to Prevent and Treat Severe Acute Respiratory Syndrome with Integrative Chinese and Western Medicine Approach

Member of Political Bureau of Central Committee of CPC, Vice Premier of State Council concurrently Minister of Health, General Command of National Protecting and Treating Severe Acute Respiratory Syndrome ( SARS) Headquarters Vice premier WU Yi cordially met the well-known TCM specialists, and held a symposium with them. Sixteen specialists including WANG Yong-yan, CHEN Ke-ji, LI Fu-ren, JIAO Shu-de, HE Pu-ren, LIU

Treatment of Irritable Bowel Syndrome by Oral Administration of Chinese Medicines and Retention-Enema——A Report of 50 Cases

Irritable bowel syndrome (IBS), a common disease of intestinal dysfunction, is also called emotional enteritis, mucous enteritis, irritable colon and so on1. It is often lingering with a long disease course and is easy to recur. The author has in recent years treated 50 cases of the disease by oral administration of Chinese medicines and retention-enema, with satisfactory results reported as follows.

Summary and correlation analysis of TCM syndromes in 159 elderly patients with acute myeloid leukemia

Objective:To investigate the characteristics of TCM syndromes in elderly patients with acute myeloid leukemia(AML)at the onset,and to analyze the main syndrome types and their correlation with age,percentage of bone marrow blasts,and genetic prognostic stratification.Methods:A retrospective analysis was performed on 159 AML patients aged over 60 years who were diagnosed and treated in our hospital,and the clinical data were collected and analyzed statistically.Results:In 159 elderly AML patients,the main clinical symptoms were fatigue,poor appetite,conscious fever,and various hemorrhages.The main syndromes were Ying(42.01%),Wei(31.25%),Essential(14.81%)and Blood(11.69%);the syndromes are divided into Qi and Yin deficiency(32.70%),Qi and blood deficiency(30.19%),true Yin deficiency(28.03%)and Qi heat and blood(8.81%).The age difference between the two groups was statistically significant(P<0.001),and the multiple comparison results showed that the age of the Qi-blood deficiency group was younger than the true-Yin deficiency group and the Qi-Yin deficiency group;the percentage of bone marrow blasts was statistically significant in the three groups at the initial diagnosis(P<0.05),multiple comparison results showed that the percentage of bone marrow blasts in the true Yin deficiency group was higher than that in the Qi-blood deficiency group and the Qi-Yin deficiency group;the genetic prognostic stratification of the three groups was statistically significant(P<0.05),multiple comparisons.The results showed that the genetic prognosis of the true Yin deficiency group was poorer than that of the Qi and blood deficiency group and the Qi and Yin deficiency group.Conclusion:The most common clinical symptoms of elderly AML patients are fatigue,the disease is located in the bone marrow,and the disease is Ying,Wei,essence,and blood.With the increase in the patient's age,the TCM syndrome types tend to be more insufficiency of true Yin and deficiency of both Qi and Yin,and the prognosis of patients with insufficiency of true Yin is poor.It provides a directional scientific basis for the treatment of senile AML with integrated traditional Chinese and Western medicine.

Clinical efficacy and safety of Guipi decoction combined with escitalopram oxalate tablets in patients with depression

BACKGROUND Depression is a widespread mental health condition that requires effective treatment.In the treatment of depression,traditional Chinese medicine(TCM)offers obvious advantages,fewer adverse reactions,and a lower recurrence rate.AIM To evaluate the clinical benefits of Guipi decoction combined with escitalopram oxalate tablets for individuals with depression.METHODS In total,80 patients diagnosed as having depression were enrolled in the study and divided into either an experimental group or a control group.All of the patients were orally administered escitalopram oxalate tablets.Additionally,the experimental group received Jiajian Guipi decoction and reduced Governor vessel fumigation over 4 wk.TCM syndrome scores,Hamilton depression rating scale(HAM-D)scores,self-rating depression scale(SDS)scores,and Pittsburgh sleep quality index scores were measured for the two groups and compared before and after the treatment.The two groups were monitored for any adverse reactions.RESULTS After 4 wk of treatment,both groups exhibited a significant reduction in TCM syndrome scores compared with their pre-treatment scores(P<0.05).However,the experimental group exhibited significantly lower TCM syndrome scores than the control group(P<0.05).Similarly,the post-treatment SDS and HAM-D-24 scores were significantly lower in both groups than the pre-treatment scores(P<0.05),with the experimental group exhibiting lower scores than the control group(P<0.05).The total treatment efficiency was significantly better in the experimental group(97.14%)than in the control group(77.78%)(P<0.05).Furthermore,after 4 wk of treatment,the Pittsburgh sleep quality index scores for both groups were significantly lower than those before the treatment(P<0.05),with the experimental group exhibiting lower scores than the control group(P<0.05).The incidence of adverse reactions was significantly lower in the experimental group than in the control group(P<0.05).CONCLUSION The combination of Guipi decoction and escitalopram oxalate tablets was found to be an effective and safe treatment for depression.This combination could reduce TCM syndrome scores,improve depressive symptoms,and enhance sleep quality.

Traditional Chinese Medicine Pattern Classification and Herbal Medicine for COVID-19: A Comparative Study of Data from Different Sources

Background: Traditional Chinese medicine(TCM) plays a crucial role in the prevention and control of coronavirus disease 2019(COVID-19). Objective: The study aimed to reveal the distribution characteristics of COVID-19 TCM syndrome types and syndrome elements and the law of TCM treatment and medication. Methods: The TCM diagnosis and treatment protocol for COVID-19 and clinical research data were obtained through network retrieval, and Revman 5.3 and SPSS 23.0 were employed to analyze the composition of TCM syndromes and the situation of TCMs in meta and frequency. Results: The top three TCM syndromes of COVID-19 included damp-heat accumulation in the lung pattern, damp abundance due to spleen deficiency, and epidemic toxin invading the lung pattern, while the syndrome elements were dampness, heat, and toxin. Gypsum fibrosum, Pogostemonis herba, and Armeniacae semen were identified as the commonly used drugs. Different syndrome elements were identified at lung disease location: Forsythiae fructus, Glycyrrhizae radix, and Armeniacae semen can be used for “wind;” Glycyrrhizae radix, Armeniacae semen, and Scutellariae radix can be used for “Heat;” Armeniacae semen, Sheng Gypsum fibrosum, and Ephedrae herba can be used for “Toxin;” Ephedrae herba, Armeniacae semen, and Atractylodis rhizome can be used for “Damp;” Magnoliae officinalis Cortex, Ephedrae herba, and Zingiberis Rhizoma recens can be used for “cold;” and Armeniacae semen, Gypsum fibrosum, Ephedrae herba, and Lepidii/Descurainiae semen can be used for “epidemic.” Conclusion: The establishment of a treatment scheme based on the classification of disease syndrome elements should be considered for sudden infectious diseases, such as COVID-19. Pogostemonis herba, Armeniacae semen, Gypsum fibrosum, and Glycyrrhizae radix should be considered as effective drugs from TCM for the treatment of COVID-19.

Evaluation of Renal Impairment in Patients with Diabetic Kidney Disease by Integrated Chinese and Western Medicine

Objective:To investigate the factors related to renal impairment in patients with diabetic kidney disease(DKD)from the perspective of integrated Chinese and Western medicine.Methods:Totally 492 patients with DKD in 8 Chinese hospitals from October 2017 to July 2019 were included.According to Kidney Disease Improving Global Outcomes(KDIGO)staging guidelines,patients were divided into a chronic kidney disease(CKD)1-3 group and a CKD 4-5 group.Clinical data were collected,and logistic regression was used to analyze the factors related to different CKD stages in DKD patients.Results:Demographically,male was a factor related to increased CKD staging in patients with DKD(OR=3.100,P=0.002).In clinical characteristics,course of diabetes>60 months(OR=3.562,P=0.010),anemia(OR=4.176,P<0.001),hyperuricemia(OR=3.352,P<0.001),massive albuminuria(OR=4.058,P=0.002),atherosclerosis(OR=2.153,P=0.007)and blood deficiency syndrome(OR=1.945,P=0.020)were factors related to increased CKD staging in patients with DKD.Conclusion:Male,course of diabetes>60 months,anemia,hyperuricemia,massive proteinuria,atherosclerosis,and blood deficiency syndrome might indicate more severe degree of renal function damage in patients with DKD.(Registration No.NCT03865914).

Immediate effects of scalp acupuncture with twirling reinforcing manipulation on hemiplegia following acute ischemic stroke: a hidden association study

Data mining has the potential to provide information for improving clinical acupuncture strategies by uncovering hidden rules between acupuncture manipulation and therapeutic effects in a data set. In this study, we performed acupuncture on 30 patients with hemiplegia due to acute ischemic stroke. All participants were pre-screened to ensure that they exhibited immediate responses to acupuncture. We used a twirling reinforcing acupuncture manipulation at the specific lines between the bilateral Baihui（GV20） and Taiyang（EX-HN5）. We collected neurologic deficit score, simplified Fugl-Meyer assessment score, muscle strength of the proximal and distal hemiplegic limbs, ratio of the maximal H-reflex to the maximal M-wave（Hmax/Mmax）, muscle tension at baseline and immediately after treatment, and the syndromes of traditional Chinese medicine at baseline. We then conducted data mining using an association algorithm and an artificial neural network backpropagation algorithm. We found that the twirling reinforcing manipulation had no obvious therapeutic difference in traditional Chinese medicine syndromes of ＂Deficiency and Excess＂. The change in the muscle strength of the upper distal and lower proximal limbs was one of the main factors affecting the immediate change in Fugl-Meyer scores. Additionally, we found a positive correlation between the muscle tension change of the upper limb and Hmax/Mmax immediate change, and both positive and negative correlations existed between the muscle tension change of the lower limb and immediate Hmax/Mmax change. Additionally, when the difference value of muscle tension for the upper and lower limbs was 〉 0 or 〈 0, the difference value of Hmax/Mmax was correspondingly positive or negative, indicating the scalp acupuncture has a bidirectional effect on muscle tension in hemiplegic limbs. Therefore, acupuncture with twirling reinforcing manipulation has distinct effects on acute ischemic stroke patients with different symptoms or stages of disease. Improved muscle tension in the upper and lower limbs, reflected by the variation in the Hmax/Mmax ratio, is crucial for recovery of motor function from hemiplegia.

Characteristics of Traditional Chinese Medicine Syndrome in Patients with Coronary Heart Disease at Different Disease Stages

Coronary atherosclerotic heart disease(CHD)has a high incidence,disability rate,and mortality rate,which severely affect people’s health,work,and life.Based on its clinical manifestations,traditional Chinese medicine(TCM)has classified CHD as“chest impediment”and“heart pain”for the treatment.The course of CHD is protracted,and the pathogenesis is complex and changeable.Moreover,different disease stages have different syndrome characteristics.Thus,this article aimed to summarize the classification and distribution characteristics of the TCM syndrome in various stages of CHD,such as before and after percutaneous coronary intervention therapy,disease progression,age,and complications,to provide references for the TCM clinical diagnosis and treatment of CHD.