Effect of Tanreqing Injection(痰热清注射液)on Treatment of Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Chinese Medicine Syndrome of Retention of Phlegm and Heat in Fei(肺)

Objective：To explore the effect of Tanreqing Injection（痰热清注射液,TRQI） on the treatment of acute exacerbation of chronic obstructive pulmonary disease（AECOPD） with Chinese medicine syndrome of retention of phlegm and heat in Fei（痰热阻肺证,RPHF）.Methods：In a prospective randomized controlled clinical trial,90 patients with AECOPD of RPHF syndrome were randomly assigned to 3 groups,TRQI and controls A and B,each with 30 cases.The TRQI group was administered with the intravenous injections of 20 mL TRQI once a day and conventional Western medicine treatment.Control group A was administered with the intravenous injection of 15 mg ambroxol hydrochloride twice a day and conventional Western medicine treatment,and control group B was administered with conventional Western medicine treatment only.The treatments were administered for 10 days.Chinese medical symptoms and signs were scored,and plasma concentrations of interleukin（IL）-8 and neutrophil elastase（NE） were recorded.Results：（1） The Chinese medical symptoms （cough,sputum amount,expectoration,dyspnea and fever） and signs（tongue and pulse） improved significantly in the TRQI group（P〈0.05 or P〈0.01）,and improvements in cough,sputum amount and expectoration were better in the TRQI group than control group B（P〈0.05）;there was no significant difference between the TRQI group and control group A（P〉0.05）.The sign of tongue was also improved significantly in the TRQI group （P〈0.05）.（2） The overall effects in the TRQI group and control group A were significantly better than in control group B（P〈0.05）,with no significant differences between the TRQI group and control group A（P〉0.05）.There was no significant difference in the total effective rate among the three groups（P〉0.05）.（3） After treatment, the plasma concentrations of IL-8 and NE decreased in the TRQI group and control group A（P〈0.05）,and the concentration of IL-8 in control group B decreased（P〈0.05）.The difference in IL-8 was greater in the TRQI group than in control group A and B before and after treatment,and the change in NE was greater in control group A than in the TRQI group and control group B,but there was no statistical significance among the three groups with regards to the change in IL-8 or NE（P〉0.05）.Conclusion：TRQI could improved the Chinese medical signs and symptoms in the patients with AECOPD,possibly because of the decreasing plasma levels of IL-8 and NE which could improve response to airway inflammation and mucus hypersecretion.

Research Progress on Prevention and Treatment of Glucolipid Metabolic Disease with Integrated Traditional Chinese and Western Medicine

Hyperlipidemia, type 2 diabetes mellitus, nonalcoholic fatty liver and many other metabolic disorder are frequently co-existing in patients. In addition, these diseases are closely related in pathophysiological settings. However, increasing of the disease incidence, lacking of comprehensive prevention and control measurements against the key pathology point concomitant occurrence with the pattem of the single disease, single target therapy, that is leading therapeutic strategy for these metabolic disorders in the setting of Western medicine （WM）. On the basis of the combination of the advantages of integrated Chinese medicine （CM） and WM, with unified understanding of such diseases, the new concept of glucolipid metabolic disease （GLMD） is introduced. In this new concept, disorders in glucose and lipid metabolism are recognized as the key trigger and major driving force for the progress of GLMD. The key points of pathology included dysfunction of neuronal-endocrine-immune system,insulin resistance, oxidative stress, inflammation and intestinal flora imbalance. In the core pathogenic perspective of CM, it can be explained as ＂Gan （Liver） Shi Shu Xie＂ （dysfunction of Gan in metabolism and emotion regulation） that will lead to the occurence/production of endogenous dampness and phlegm, blood stasis and turbid. This leads to the new concept of ＂Liver-based regulatory system for metabolic homeostasis＂ to be introduced further. The comprehensive prevention and control strategy ＂Tiao Gan Qi Shu Hua Zhuo＂ （modulating Gan, trigging key metabolic system to resolve pathogenic factors such as phlegm retention and dampness）. Its representative formula Fufang Zhenzhu Tiaozhi Capsule （复方贞术调脂胶囊） is innovated under such rationales. Comment for some commonly-used CM GLMD therapeutic drugs was presented. High-level evidence-based and epidemiological and mechanism studies should be carded out to further interpret and explain of the scientific connotation of GLMD.

Traditional Chinese Medicine syndrome patterns and Qi-regulating,chest-relaxing and blood-activating therapy on cardiac syndrome X

OBJECTIVE:To master the syndrome patterns characteristics and explore the effective therapy methods ofTraditional Chinese Medicine(TCM) for cardiac syndrome X(CSX).METHODS:The TCM syndrome characteristics were mastered and the TCM intervention programs were determined by clinical investigations for TCM syndrome patterns characteristics of CSX patients.Then,the clinical efficacy studies on TCM intervention for CSX were carried out through randomized controlled trials.RESULTS:CSX is a clinical syndrome with the main manifestations of chest pain and chest stuffiness,and Qi stagnation,phlegm retention and blood stasis are the basic symptoms of CSX.As a result,the Qi-regulating,chest-relaxing and blood-activating therapy integrated with some Western Medicines was adopted for treatment.The effect of Qi-regulating,chest-relaxing and blood-activating therapy can reduce the frequency and degree of angina,improve the symptoms and exercise the tolerance of patients,inhibit the inflammatory response of vascular walls and protect the function of vascular endothelial cells,which is better than that of the simple and conventionalWestern Medicine alone.CONCLUSION:A good effect was achieved in the integration of Chinese and Western Medicines for CSX.The therapy is worthy to be applied further in clinical practice.On the other hand,more long-term and randomised controlled studies with large samples are still required to further determine the clinical efficacy and safety of the therapy.