Serum protein profiles suggest a possible link between qi deficiency constitution and Pi-qi-deficiency syndrome of chronic superficial gastritis

Objective:To identify potential serum protein candidates involved in linking the traditional Chinese medicine(TCM)-defined qi deficiency constitution(QDC)to Pi-qi-deficiency syndrome(PQDS)of chronic superficial gastritis(CSG).Methods:Using participants with the TCM-defined balanced constitution as a control population,labelfree quantitative proteomics was adopted to identify differentially expressed proteins(DEPs)in serum samples from two case populations:case population 1(participants with QDC)and case population 2(patients with PQDS of CSG).The DEPs discovered in both case populations were analyzed to identify common DEPs as potential candidates for proteins involved in the link between QDC and PQDS.Based on Kyoto Encyclopedia of Genes and Genomes pathway(KEGG)and Gene Ontology(GO)enrichment analysis and analysis of proteineprotein interaction networks,we evaluated the possible functions of these potential serum candidates.Results:We discovered 24 and 28 proteins that were differentially expressed in case populations 1 and 2,respectively,compared with the control population.Hierarchical clustering analysis showed that the expression profile of DEPs of individuals from the same population clustered well,while those from different populations were segregated.Furthermore,GO analysis revealed the 10 DEPs that were common to both case populations to be mainly associated with negative regulation of cellular metabolic and immune system processes while KEGG analysis indicated these proteins to be associated with complement and coagulation cascades and peroxisome proliferator-activated receptor signaling.Notably,serum levels of C4b-binding protein beta chain,glycosylphosphatidylinositol-specific phospholipase D1 and MS-F1 light chain variable region proteins were notably higher in the two case populations compared with the control,particularly in the case of CSG with PQDS.Conclusion:The results presented here provide new insights into the molecular mechanisms underlying development of PQDS of CSG from QDC,and suggest candidate serum biomarkers for future application in integrative medicine.

Screening for blood leukocyte microRNA biomarkers responsible for association between qi deficiency constitution and Pi-qi-deficiency syndrome of chronic superficial gastritis

Objective:To screen for blood leukocyte microRNA(miRNA)biomarkers responsible for the association between the traditional Chinese medicine(TCM)qi deficiency constitution(QDC)and the Pi-qi-deficiency syndrome(PQDS)of chronic superficial gastritis(CSG).Methods:Peripheral blood leukocytes were separated from people of two TCM constitutions(balance and qi deficiency)and from CSG patients with PQDS.Total RNA was isolated from the leukocytes and subjected to subsequent high-throughput miRNA sequencing to identify the miRNAs that are specifically and highly expressed in persons of QDC and CSG patients with PQDS.In addition,the target genes of the associated miRNAs were predicted.Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway-based enrichment analyses of these target genes were performed to further evaluate the associated miRNA candidates as potential biomarkers responsible for the association between QDC and PQDS of CSG.Results:Compared with the control group with a balance constitution(P<.05,fold change>1.5 or<0.5),31 and 38 differentially expressed miRNAs were found in persons of QDC and CSG patients with PQDS,respectively.In particular,hsa-miR-145-5p and hsa-miR-146a-3p were highly expressed in both the persons of QDC and CSG patients with PQDS.GO analysis of the target genes of the two common miRNAs showed that they were mainly associated with functions related to synthesis and metabolism,such as cellular nitrogen compound metabolic processes,biosynthetic processes,cellular protein modification processes,and cellular component assembly.KEGG analysis identified the common pathways enriched among the target genes,including the Hippo signaling pathway and the transcriptional misregulation pathway.The common target genes of the two miRNAs seemed to be associated with the spliceosome pathway and the RNA degradation pathway.Conclusion:Hsa-miR-145-5p and hsa-miR-146a-3p may serve as candidate biomarkers responsible for the association between QDC and PQDS of CSG.

Clinical observation of Guipi Decoction Combined with non steroidal drugs on sleep in elderly patients with acute traumatic pain and Qi deficiency constitutionabortion

Objective:To explore the effect of Guipi Decoction Combined with non steroidal anti-inflammatory drugs on sleep time of elderly patients with traumatic pain and Qi deficiency constitution during hospitalization.Methods:A total of 52 elderly patients hospitalized in the orthopedic(trauma)ward of the Second Affiliated Hospital of Zhejiang Chinese Medical University from November 2020 to may 2021 were randomly divided into control group and treatment group.Patients in the control group were treated with loxoprofen sodium tablets immediately after admission,and placebo was added to loxoprofen sodium tablets from the second day of admission;The patients in the treatment group were treated with loxoprofen sodium tablets after admission.Guipi Decoction was added on the basis of loxoprofen sodium tablets from the second day of admission.Before and after admission,all patients used the TCM constitution classification judgment table to evaluate the score of qi deficiency and VAS;From the first day to the fourth day after admission,the bracelet was worn to monitor the sleep time(total sleep time,deep sleep time,light sleep time and awakening times)every night.The patients were scored by VAS after taking drugs every morning.Results:Finally 25 patients in the control group and 24 patients in the treatment group completed the experiment.There was no significant difference in gender,age,fracture location,chronic medical history VAS score and TCM Qi deficiency constitution score,between two groups at admission(P>0.05).At the time of discharge,the score of qi deficiency constitution in the treatment group was 33.724±12.634;The TCM Qi deficiency constitution score of the control group was 42.25±15.912,and there was significant difference between the two groups(P<0.05);and there was significant difference in VAS score between the two groups at discharge(P<0.05).There were significant differences in total sleep time,light sleep time,deep sleep time and night awakening times between the two groups on the second,third and fourth day of admission(P<0.05).Conclusion:1.Guipi Decoction can significantly improve the sleep time of patients with Qi deficiency acute traumatic pain.2.Guipi Decoction can not only improve the constitution of patients with Qi deficiency bias,but also improve the VAS score at discharge.

A Study on the Law of Birth and Formation of Yang-Deficiency Constitution Based on the Theory of Five Movement and Six Qi

Objective:To explore the law of birth and yang deficiency constitution based on the theory of five movements and six qi,as well as to provide a new way to better realize the prevention of yang deficiency constitution.Methods:The data of TCM quality table and luck data were collected via questionnaires.According to the data of from the TCM quality table,the respondents were divided into yang deficiency constitution group and non-yang deficiency group.According to the luck data,the distributions of gestational age were compared between the two groups.Results:A total of 175 questionnaires were collected,of which 89 were non-yang deficiency constitution and 86 were yang deficiency constitution.The proportion of Ding year(15.1%)in the yang deficiency group was significantly higher than that in non-yang deficiency group(5.6%),in which the difference was statistically significant(P<0.05).Conclusion:The possibility of yang deficiency constitution is higher.

Analysis of Constitutional Factors in Patients with Gallstone Disease

Objective: To summarize the common constitutional types in patients with gallstone disease and analyze influencing factors. Research Hypothesis: Qi stagnation constitution may be a potential predisposing constitution for gallstone disease, whereas the Balanced Constitution and Yin deficiency constitution have a lower tendency towards the development of the disease;gallstone disease is more prevalent among young men engaged in mental labor. Methods: A retrospective study was conducted on 180 patients with gallstone disease who were hospitalized in the Department of Hepatobiliary Surgery, First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine (TCM), from July 2017 to July 2023. Additionally, 180 healthy individuals undergoing physical examinations at the Health Examination Center of the same hospital were selected as the normal control group. Both groups underwent general condition surveys, TCM constitution scales, Eysenck Personality Questionnaires, Brief Coping Styles Questionnaires, and Social Support Rating Scales to determine risk factors and common types. Results: Independent variables such as gender, Qi stagnation constitution, Balanced Constitution, negative coping scores, positive coping scores, and stressful life events were included in the model. The OR values for Balanced Constitution, gender, positive coping style, and overall social support were all less than 1, and the maximum value of the 95% confidence interval was also less than 1. After selecting the intercept into the model and analyzing the standardized regression coefficients, it was found that negative coping scores had a significant impact on the model, while stressful life events showed extremely high relevance to the study. Compared with the normal group, the frequency of Qi stagnation constitution in the study group significantly increased, with a significant difference (P χ2 = 11.109, P = 0.0009, indicating a significant difference (P χ2 = 4.0890, P = 0.0432, indicating a significant difference (P 0.05). However, when comparing mental workers with physical workers within the patient group, the frequency of Qi stagnation constitution in mental workers was significantly higher, with χ2 = 6.8467, P = 0.012, indicating a significant difference (P Conclusion: Qi stagnation constitution is a potential predisposing constitution for gallstone disease, whereas the tendency to develop the disease is relatively low for Balanced Constitution and Yin deficiency constitution. Gallstone disease is more commonly found in young male mental workers.

宫颈高危型人乳头瘤病毒感染患者中医体质类型分布研究

目的:分析宫颈高危型人乳头瘤病毒(high risk human papilloma virus,HR-HPV)感染患者中医体质类型分布特点,为中医药调理体质防治宫颈HR-HPV感染提供依据。方法:选择2019年1月至2020年12月就诊于河南中医药大学第一附属医院妇科门诊及体检中心的420例宫颈HR-HPV感染者作为观察组,选择420例同时段宫颈HR-HPV检测阴性者为对照组。分析两组中医体质类型分布情况、观察组不同年龄段中医体质类型分布情况、观察组不同HR-HPV基因型别中医体质类型。结果:观察组中医体质分布依次为:痰湿质(30.50%)>湿热质(19.00%)>平和质(15.50%)>阳虚质(14.80%)>气虚质(10.00%)>阴虚质(5.90%)>瘀血质(2.70%)>气郁质(1.70%);对照组中医体质分布依次为:平和质(73.30%)>湿热质(8.40%)>阴虚质(5.70%)>痰湿质(4.50%)>气虚质(4.30%)>阳虚质/瘀血质(1.80%)>气郁质(0.20%)。两组中医体质类型比较,差异具有统计学意义(P<0.05),其中,痰湿质、湿热质、阳虚质、气虚质,两组间比较,差异具有统计学意义(P<0.001)。观察组体质类型居前三位的是痰湿质、湿热质、阳虚质,占全部体质类型的64.30%。对照组平和质324例,占比73.50%,观察组平和质81例,占比15.50%,两组间比较,差异具有统计学意义(P<0.001)。观察组中,痰湿质、阳虚质、阴虚质主要见于46~55岁,湿热质、气虚质、气郁质主要见于36~45岁,组间比较差异具有统计学意义(P<0.05)。两组宫颈HR-HPV16、18型和非16、18型中医体质比较,差异无统计学意义(P>0.05)。结论:痰湿质、湿热质、阳虚质为宫颈HR-HPV感染人群的易感体质;痰湿质、湿热质、阳虚质与年龄具有相关性,痰湿质多见于36~45岁,湿热质、阳虚质多见于46~55岁,HR-HPV基因型别与中医体质类型之间无明显相关性。

岭南地区亚健康人群睡眠状况与中医体质类型的相关性研究

【目的】探究岭南地区亚健康人群睡眠状况与中医体质类型的相关性。【方法】选取2022年5月~2023年5月于深圳市宝安区中医院治未病中心就诊的688例在深圳市居住5年以上,无严重心血管疾病,经亚健康人群评定量表评定为亚健康的人群为研究对象,采用匹兹堡睡眠质量指数(PSQI)量表、中医体质评定量表对其进行问卷调查,并将其睡眠状况与中医体质类型进行多元线性回归分析。【结果】(1)调查问卷发放回收情况:共发放688份问卷,其中,失访19份,回收669份,剔除无效问卷29份,最终共纳入有效问卷640份。(2)不同睡眠状况人群的PSQI量表评分情况:根据PSQI量表得分情况将人群分为睡眠优组(PSQI总分<8分)350例和睡眠差组(PSQI总分≥8分)290例,组间比较,睡眠优组的入睡时间、睡眠时间、睡眠障碍得分以及总分均明显低于睡眠差组(P<0.05或P<0.01)。(3)不同睡眠状况人群的中医体质类别分布情况:睡眠优者多表现为平和质(86.86%),睡眠差者多表现为偏颇体质(79.64%)。睡眠差人群中,偏颇体质排前3位的分别是湿热质(15.52%)、痰湿质(13.79%)以及气郁质(13.10%)。(4)多元线性回归分析结果显示,入睡时间与痰湿质、气郁质呈正相关(P<0.01),与平和质呈负相关(P<0.05);睡眠效率与湿热质、特禀质呈正相关(P<0.05或P<0.01),与平和质呈负相关(P<0.05);睡眠障碍与气郁质、阴虚质呈正相关(P<0.01);催眠药物与阴虚质呈正相关(P<0.01);日间功能障碍与痰湿质呈正相关(P<0.05)。【结论】岭南地区亚健康人群睡眠状况与其中医体质类型具有一定相关性,湿热质、痰湿质、气郁质、阴虚质、平和质、特禀质是影响睡眠状况主要的6种中医体质类别;结合中医体质辨识指导亚健康人群通过改善其体质从而达到未病先防的目的是很有意义的。

宁心汤治疗气阴两虚型永久性心房颤动患者新型冠状病毒感染后的临床疗效观察

目的评价宁心汤治疗气阴两虚型永久性心房颤动(房颤)患者新型冠状病毒(新冠病毒)感染后的临床疗效.方法收集2023年2月至8月在中国中医科学院广安门医院南区门诊就诊的120例新冠病毒感染气阴两虚型永久性房颤患者作为研究对象.将患者按随机数字表法分为对照组和治疗组,每组60例,最后每组各有1例脱落,余59例.治疗组给予宁心汤(药物组成:桂枝15 g,酒萸肉15 g,生地黄15 g,红景天15 g,人参6g,桑寄生10 g,黄连3g,丹参12 g,川芎10 g,麦冬12 g,醋五味子6g)免煎颗粒水冲服,每日2次;对照组给予辅酶Q1010 mg,每日3次,两组均连续治疗4周.观察两组治疗前后胸痛、头晕、乏力、倦怠懒言、心悸、胸闷气短、失眠、多梦等中医证候的改善情况,以及心率变异性(HRV)和心率减速力指标的变化.结果治疗组在改善胸痛、乏力、心悸、胸闷气短方面均有明显疗效,在倦怠懒言、失眠、多梦方面有所改善,在改善头晕方面无明显疗效.对照组在改善心悸方面有明显疗效,胸痛、胸闷气短方面有所改善,其余方面均无明显疗效.治疗组在改善胸痛、乏力、倦怠懒言、胸闷气短、失眠、多梦方面的有效率均明显高于对照组[胸痛:95.45%(42/44)比78.57%(33/42),乏力:83.67%(41/49)比31.25%(15/48),倦怠懒言:73.91%(34/46)比12.77%(6/47),胸闷气短:88.89%(48/54)比63.64%(35/55),失眠:78.43%(40/51)比12.24%(6/49),多梦:76.09%(35/46)比43.75%(21/48),均P<0.05].两组治疗后RR间期的标准差(SDNN)、相邻RR间期差值的均方根(RMSSD)、RR间期平均值的标准差(SDANN)、相邻RR间期差值>50 ms占总RR间期数的百分比(PNN50)均较治疗前明显升高,且治疗组治疗后RMSSD、SDANN、PNN50均明显高于对照组[RMSSD(ms):28.96±3.59比24.34±2.66,SDANN(ms):108.55±11.80比100.44±13.58,PNN50:7%(6%,7%)比5%(5%,6%),均P<0.05],两组治疗前后心率减速力比较差异均无统计学意义.结论宁心汤对改善气阴两虚型永久性房颤患者新冠病毒感染后中医证候及心率变异性均有良好效果.

影响阳虚体质因素的Logistic回归分析

目的:研究影响阳虚体质的主要因素。方法:采用横断面调查,收集上海中医药大学附属岳阳中西医结合医院治未病中心2020年9月至2021年11月中医体质调查数据。中医体质调查采用中医体质辨识软件V3.0实施,运用多因素Logistic回归模型分析筛选影响阳虚体质的主要因素。结果:共纳入811例研究对象,其中阳虚质211例(26.0%)。多因素Logistic回归分析结果显示,相对女性,男性阳虚质比例降低,差异具有统计学意义[OR=0.55,95%CI(0.37~0.81),P=0.002];相对年龄<50岁,年龄≥50岁者阳虚质比例较高,差异具有统计学意义[OR=1.83,95%CI(1.26~2.65),P=0.001];体质量超重、肥胖人群阳虚质比例高于体质量正常及偏低人群,差异具有统计学意义[OR=0.59,95%CI(0.38~0.91),P=0.018];高脂血症患者阳虚质比例高于血脂正常人群,差异具有统计学意义[OR=0.63,95%CI(0.44~0.90),P=0.011];脂肪性肝病患者阳虚质比例高于正常人群,差异具有统计学意义[OR=0.56,95%CI(0.37~0.87),P=0.010];功能性胃肠病阳虚质比例高于正常人群,差异具有统计学意义[OR=1.77,95%CI(1.05~2.99),P=0.032]。结论:年龄、性别、超重/肥胖、功能性胃肠病、脂肪性肝病、高脂血症是影响阳虚质的主要因素。

基于体质可调论治糖尿病大血管病变

糖尿病大血管病变为糖尿病后期的严重并发症,具有较高的致残致死率,早期干预可达既病防变目的,对于改善患者生活质量、节约医疗资源意义深远。中医体质学说认为人的体质不仅禀赋于先天,亦可通过外在手段干预而改变。糖尿病大血管病变的好发体质类型主要集中在阴虚质、气虚质、痰湿质与血瘀质。以中医治未病思想为指导,从体质可调出发,列举验案2则,为糖尿病大血管病变的高危体质类型制定出中医药、饮食、运动等具体体质调节方案,及早纠正体质偏颇,以期为临床防治糖尿病大血管病变提供参考。

959例子宫内膜异位症患者中医体质分布特点

【目的】探讨959例子宫内膜异位症(EMs)患者的中医体质分布特点。【方法】选取2019年1月至2019年11月就诊于中国中医科学院广安门医院、首都医科大学附属北京妇产医院、北京医院、北京中医药大学东方医院、首都医科大学附属友谊医院、首都医科大学附属复兴医院的EMs患者959例,记录患者的一般情况,进行中医体质辨识,分析其中医体质分布情况、兼夹体质的关联关系以及与年龄、合并痛经的关系。【结果】(1)EMs患者的体质分布占比由多到少依次为阳虚质65.1%(624/959)、气郁质58.4%(560/959)、气虚质52.8%(506/959)、血瘀质44.2%(424/959)、痰湿质42.5%(408/959)、湿热质41.9%(402/959)、阴虚质39.6%(380/959)、平和质26.8%(257/959)、特禀质16.6%(159/959);患者中单一体质者较少,占比为20.2%(194/959),兼夹体质者居多,占比为79.8%(765/959)。(2)基于Apriori算法的关联规则挖掘结果发现相关规则33条,气虚质-阳虚质、血瘀质-阳虚质、血瘀质-气郁质是其中置信度较高的关联规则。(3)与35岁及以下患者相比,35岁以上患者中血瘀质所占比例较大(P<0.05);与无痛经患者相比,合并痛经患者各偏颇体质占比均增加、平和体质占比减少(P<0.05或P<0.01)。【结论】阳虚质、气郁质、气虚质、血瘀质是EMs患者的高发体质类型,EMs患者中医体质兼夹现象普遍存在,较单一偏颇体质更为常见;从温阳、解郁、益气、活血角度管理EMs,及时纠正偏颇体质,防止疾病进展,可有效发挥中医体质调理的“治未病”效果。

儿童青少年近视与中医体质类型相关性研究的Meta分析

目的 通过Meta分析探讨儿童青少年近视与中医体质类型的相关性。方法 检索PubMed、Web of Science、Elsevier、中国知网、万方、维普、中国生物医学文献数据库中关于儿童青少年近视与中医体质类型相关性研究的文献,检索时间为建库至2023年7月1日。对文献按照纳入标准与排除标准进行筛选和数据提取,采用纽卡斯尔-渥太华量表(NOS)对文献质量进行评分,RevMan 5.4软件进行统计分析。结果 (1)一般情况:共纳入5项研究,包括20,829例受试者,其中近视患者9,050例,非近视者11,779例。近视儿童青少年的体质占比前4位的类型分别为平和质(33.50%)、阳虚质(22.02%)、气虚质(14.69%)、阴虚质(9.19%)。(2)平和质:病例组平和质体质类型人数占比低于对照组,差异有统计学意义[OR=0.480,95%CI(0.270,0.850),Z=2.530,P=0.010)]。(3)气虚质:病例组气虚质体质类型人数占比高于对照组,差异有统计学意义[OR=2.010,95%CI(1.140,3.560),Z=2.400,P=0.020)]。(4)阳虚质和阴虚质:2组阳虚质和阴虚质体质类型人数占比,差异无统计学意义(P>0.05)。(5)其他体质:其他5种体质在近视的儿童青少年中占比较少,从高到低依次为湿热质(6.80%)、气郁质(5.48%)、痰湿质(5.26%)、特禀质(2.11%)、血瘀质(1.51%)。病例组中,湿热质[OR=0.870,95%CI(0.790,0.970),Z=2.620,P=0.009)]、气郁质[OR=0.830,95%CI(0.740,0.930),Z=3.170,P=0.002)]、血瘀质[OR=0.770,95%CI(0.620,0.950),Z=2.390,P=0.020)]体质类型人数占比高于对照组,差异均有统计学意义;而2组特禀质、痰湿质体质类型人数占比,差异无统计学意义(P>0.05)。结论 气虚质、阴虚质、阳虚质是儿童青少年近视患者的主要偏颇体质类型,并且气虚质可能是其发生近视的主要体质危险因素。

高血压患者体质类型与认知障碍相关性研究

目的:探讨高血压伴认知障碍(CI)患者的体质分布情况及CI的影响因素。方法:纳入3799例高血压患者,分为CI组和无认知障碍(NCI)组,记录两组患者一般资料(年龄、性别、文化程度、婚姻状态、工作类型、烟酒史等)、实验室指标(空腹血糖、血脂、血肌酐等)水平、量表[简易智力状态检查量表(MMSE)、匹兹堡睡眠质量指数量表(PSQI)、中医体质类型量表]评分等信息。以体质类型为主要监测指标,分析高血压伴CI患者体质类型分布状况。结果:3799例高血压患者中有506例(13.32%)被纳入CI组。CI组患者年龄、年龄大于60岁人群比例、女性比例、文化程度在初中以下人群比例、工作类型以体力劳动为主人群比例、3级高血压人群比例、有睡眠障碍人群比例、高血压病程、血肌酐水平显著高于NCI组(P<0.05);汉族人群比例、吸烟人群比例、饮酒人群比例、体质量指数(BMI)及甘油三酯、胆固醇、低密度脂蛋白(LDL)水平低于NCI组(P<0.05)。CI组气虚质患者人数最多,NCI组平和质患者人数最多。偏颇质高血压患者的定向、记忆、计算、回忆、命名、阅读、执行、书写认知功能比平和质高血压患者更差(P<0.05)。Logistic回归分析显示,体质类型是CI发病的影响因素,气虚质、气郁质与CI发生相关。年龄大于60岁、文化程度低、汉族以外的其他民族、存在睡眠障碍、LDL水平低与CI发生有关。结论:不同中医体质的高血压患者CI发病倾向不同,气虚质、气郁质与CI发生相关,此类体质者应从“体病相关”理论出发,采取相应预防措施。

中医体质与强直性脊柱炎患者发病因素的相关性研究

【目的】研究中医体质与强直性脊柱炎(ankylosing spondylitis,AS)患者发病因素的相关性。【方法】选取2019年8月至2020年9月就诊于西安市第五医院(即陕西省中西医结合医院)的100例强直性脊柱炎患者及其家系成员作为研究对象。采用中华中医药学会颁布的《中医体质分类与判定》中的准则对研究对象进行体质判定,通过问卷调查和临床调查的方式收集强直性脊柱炎患者及其家系成员的社会人口学、生活习惯、临床症状、中医体质等情况,调查强直性脊柱炎患者的疾病诱发因素;采用二进制逻辑回归模型,分析强直性脊柱炎患者中医体质类型与发病因素的相关性。【结果】(1)100例强直性脊柱炎患者中,以偏颇体质居多,其分布频率由高到低依次为阳虚质、气虚质、湿热质,分别占33.00%、14.00%、18.00%。(2)强直性脊柱炎患者的Ⅰ、Ⅱ、Ⅲ级亲属的患病率分别为56.25%、40.00%、25.00%;在人类白细胞抗原B27(HLA-B27)阳性率方面,强直性脊柱炎患者的HLA-B27均为阳性,而其Ⅰ、Ⅱ、Ⅲ级亲属的HLA-B27阳性率分别为44.31%、30.67%、15.63%。(3)回归分析结果显示,强直性脊柱炎患者的病程与气虚质、骶髂关节炎级别与气郁质、年龄与血瘀质呈显著相关性(P<0.05或P<0.01)。表明强直性脊柱炎患者的病程和年龄是影响体质的重要因素,其中病程与气虚关系密切,年龄与血瘀关系密切。【结论】强直性脊柱炎为高度遗传的自身免疫性疾病,其发病与HLA-B27相关;阳气亏欠是强直性脊柱炎最基本的体质特点,而湿热质是强直性脊柱炎疾病进展过程(尤其是疾病活动期)的主要体质类型,且随病程的延长会加剧病情和气虚表现。

基于中医临床思维模式构建的“六维辨识”体系要略

中医学是认识人体生理状态和疾病过程的医学,既有一般思维方法的普适性,又有东方文化思维的特殊性。该文从中医临床思维模式构建的必要性出发,回归中医哲学体系,重新审视、剖析疾病本质思维规律的重要性,提出涵盖辨病、辨证、辨症、辨机、辨体、辨气的中医临证“六维辨识”思维理念。“六维辨识”思维指导下的中医临床诊疗立足于整体大局观,倡导辨病与辨证相结合;辨症基于主症,可明晰疾病病机转化、病势进退、病证演变;辨机要求临证之际应注重病机演变,据证施治,依症加减;辨体需根据患者体质,结合疾病之病因、病位、病性、病势,详细参辨;辨气应依据机体正气盛衰、邪气强弱来综合考虑,做到因人、因时、因地制宜。“六维辨识”旨在阐释辨病要素、识证参法、据症化裁、机态辨识的内在机理,有助于临证对疾病、病机、证候、治疗的全面把握,可为疾病的准确治疗提供理论基础。

基于“阳化气,阴成形”辨治肺结节经验

“阳化气,阴成形”理论认为,肺结节基本病机为阳化气不足致气化失司、气机失调,阴成形太过致水液失调、痰瘀互结;治疗原则为温阳抑阴、固本培元。“阳化气,阴成形”理论对中医论治肺结节具有良好的指导意义。

超重/肥胖患者中医体质特征及与人体成分分析的相关性研究

【目的】研究上海地区超重/肥胖患者的中医体质特征及其与人体成分分析的相关性。【方法】对2020年8月至2022年12月至上海市第十人民医院内分泌科针灸埋线专病门诊就诊的有完整中医体质和人体成分检测的患者数据进行分析,根据体质量指数(body mass index,BMI)情况将患者分为正常体质量组(BMI<24 kg/m2)、超重组(24 kg/m2≤BMI<28 kg/m2)和肥胖症组(BMI≥28 kg/m2),分析3组患者的中医体质分布特征,并采用多元回归分析探讨中医体质与人体成分的关系。【结果】(1)共纳入315例患者,其中正常体质量43例,超重85例,肥胖症187例。(2)正常体质量人群体质分布比例从高到低依次为脾虚>肝郁>湿热>阳虚>阴虚,超重人群体质分布比例从高到低依次为脾虚>肝郁>湿热>阳虚>阴虚,肥胖症人群体质分布比例从高到低依次为脾虚>阳虚>湿热>肝郁>阴虚,超重/肥胖症组体质分布比例从高到低依次为脾虚>湿热>阳虚>肝郁>阴虚。正常体质量人群与超重/肥胖症人群的中医体质分布情况比较,差异无统计学意义(P>0.05);正常体质量和超重/肥胖症患者均以单一体质较多,兼夹体质少见,组间比较,差异无统计学意义(P>0.05)。(3)多元回归分析结果显示:所有患者基础代谢均与阳虚质呈正相关,与湿热质呈负相关,差异均有统计学意义(P<0.01),即阳虚质分数上升1分,基础代谢增加0.54 kcal;湿热质分数下降1分,基础代谢减少1.005 kcal。【结论】在上海地区,肥胖可能是体质改变的主要阶段;肥胖症患者体质除脾虚外,阳虚、湿热、肝郁的占比也较高。在中医体质与人体成分关系方面,基础代谢与阳虚质呈正相关,与湿热质呈负相关,故阳虚质和湿热质患者要注意自身基础代谢水平对疾病发展的影响。

从气虚体质探讨脾肾与IgA肾病肠道菌群紊乱的关系

IgA肾病是目前全球范围内最常见的原发性肾小球疾病之一,近年来,相关研究表明该病与肠道菌群有关,Gd-IgA1的产生为该病的主要致病因素。肠道菌群与肠道黏膜免疫相关,肠道菌群紊乱可通过影响肠道黏膜免疫,导致Gd-IgA1产生增多。气虚体质与IgA肾病肠道菌群紊乱有一定关系,脾肾不足可诱导人体逐渐形成气虚质,气虚质对风邪、湿邪具有一定的易感性,导致邪气阻于肠道引起菌群紊乱。因此在治疗上,可从脾肾入手调整IgA肾病患者气虚体质,兼疏风利湿,调整肠道菌群,以达到治疗疾病、延缓病情进展的目的。该研究可为IgA肾病的临床治疗提供新思路。

糖尿病肾病与气虚体质的相关性研究进展

糖尿病肾病作为糖尿病的主要并发症,严重威胁患者健康。相关文献表明,气虚体质是发生糖尿病肾病的重要体质类型。文章综合分析近十年来的理论研究、实验研究、临床研究,探讨气虚体质与糖尿病肾病的相关性。研究发现,气虚质由于元气不足表现为生理功能低下,与糖尿病肾病的高发病率和进展密切相关。气虚体质的形成与先天禀赋、后天因素如年龄、饮食、劳逸、情志等密切相关。在中医学中,气虚体质通过影响肺、脾、肾功能可能促进病理产物如痰湿、瘀血的形成,加剧糖尿病肾病病程。在治疗策略上,文章归纳了中医治疗糖尿病肾病的多种方法,包括方药、针灸、食疗等,强调调整和增强机体元气,采用益气健脾、补肾固精、活血化瘀的治疗原则,以调和气血,改善症状,延缓疾病进展。实验研究进一步揭示了气虚体质与糖尿病肾病易感性的生物学联系,为中医治疗方法提供了科学依据。此外,文章还讨论了不同病程阶段糖尿病肾病患者的体质类型差异,以及地域、年龄、生活习惯等因素对体质分布的影响。最后,文章提出了未来的研究方向,包括扩大样本量、深入研究气虚体质的生理生化指标、利用现代科学技术探索气虚体质与糖尿病肾病的内在机制,以及开展更多中医治疗方法的临床研究。这些研究将为糖尿病肾病的预防和治疗提供更为精准的策略。

中医治疗乳腺癌术后康复期临证经验

乳腺癌是女性最常见的恶性肿瘤,发病率较高。中医药可通过辨证论治,减轻放化疗对乳腺癌术后恢复的毒副作用,提高机体免疫力,提高患者生存质量,在防止术后肿瘤复发转移等方面有着不可替代的优势。牛阳教授认为,正虚邪实是乳腺癌术后的基本病机,扶正培本祛邪是乳腺癌术后的基本治疗原则,阴虚质、热毒质、血瘀质是乳腺癌术后常见的三大体质。因此,在乳腺癌术后康复期的整个治疗过程中,应以扶正培本为基础,加强对阴虚质、热毒质、血瘀质三大体质的辨证调治。