Basic philosophy of three essences theory in traditional Mongolian medicine

Traditional Mongolian medicine(TMM)integrates Tibetan and Chinese medicine with indigenous Mongolian practices,focusing on the balance of three core essences:Khii,Shar,and Badgan,derived from the Five Elements-earth,water,fire,wind,and space.These essences regulate both physical and psychological processes,and their imbalance,often caused by diet,behavior,or environment,leads to disease.TMM utilizes holistic diagnostic methods such as pulse diagnosis,visual inspection,and lifestyle evaluation to identify imbalances of three essences.Treatments include herbal remedies,dietary adjustments,behavior modification,and accessory therapies like moxibustion and massage to restore balance.This mini review examines the philosophical underpinnings,diagnostic techniques,and therapeutic strategies to Khii,Shar,and Badgan,highlighting their importance in both traditional and modern integrative healthcare.

学四诊之法 把结构之脉

为解决中药化学课程教学中,因中药化学成分结构复杂、结构鉴定难度大导致学生较难掌握的问题,借鉴中医“四诊”之法的整体观,构建“四诊法”教学。即在讲授中药化学成分结构鉴定内容时,借鉴“望、闻、问、切”四诊之法,综合分析其成分的来源与结构类型、性质与结构特点、波谱特征与结构取代情况之间的关系,培养学生综合理解和运用所学知识解决实际问题的能力。该法分析中药化学成分结构鉴定的相关信息,依照望、闻、问、切的次序,抽丝剥茧地解析出化合物结构,有助于学生理解中药化学成分结构鉴定的过程和意义。将此法应用于中药化学成分结构鉴定课程教学中,将中医整体观与现代科学研究结果有机结合,可解决教学重难点问题,有助于培养学生的中医药思维和科学思维。

Herbal traditional Chinese medicine and its evidence base in gastrointestinal disorders

Herbal traditional Chinese medicine(TCM) is used to treat several ailments, but its efficiency is poorly documented and hence debated, as opposed to modern medicine commonly providinge ffective therapies. The aim of this review article is to present a practical reference guide on the role of herbal TCM in managing gastrointestinal disorders, supported by systematic reviews and evidence based trials. A literature search using herbal TCM combined with terms for gastrointestinal disorders in Pub Med and the Cochrane database identified publications of herbal TCM trials. Results were analyzed for study type, inclusion criteria, and outcome parameters. Quality of placebo controlled, randomized, double-blind clinical trials was poor, mostly neglecting stringent evidence based diagnostic and therapeutic criteria. Accordingly, appropriate Cochrane reviews and meta-analyses were limited and failed to support valid, clinically relevant evidence based efficiency of herbal TCM in gastrointestinal diseases, including gastroesophageal reflux disease, gastric or duodenal ulcer, dyspepsia, irritable bowel syndrome, ulcerative colitis, and Crohn's disease. In conclusion, the use of herbal TCM to treat various diseases has an interesting philosophical background with a long history, but it received increasing skepticism due to the lack of evidence based efficiency as shown by high quality trials; this has now been summarized for gastrointestinal disorders, with TCM not recommended for most gastrointestinal diseases. Future studies should focus on placebo controlled, randomized, double-blind clinical trials, herbal product quality and standard criteria for diagnosis, treatment, outcome, and assessment of adverse herb reactions. This approach will provide figures of risk/benefit profiles that hopefully are positive for at least some treatment modalities of herbal TCM. Proponents of modern herbal TCM best face these promising challenges of pragmaticmodern medicine by bridging the gap between the two medicinal cultures.

Traditional Chinese medicine for prevention and treatment of hepatocarcinoma: From bench to bedside

Traditional Chinese medicine(TCM) has played a positive role in the management of hepatocarcinoma. Hepatocarcinoma patients may present Qi-stagnation, damp-heat, blood stasis, Qi-deficiency, Yin-deficiency and other TCM syndromes(Zheng). Modern treatments such as surgery, transarterial chemoembolization(TACE) and high intensity focus ultrasound treatment would influence the manifestation of TCM syndromes. Herbs with traditional efficacy of tonifying Qi, blood and Yin, soothing liver-Qi stagnation, clearing heat and detoxifying and dissolving stasis, have been demonstrated to be potent to prevent hepatocarcinogenesis. TCM has been widely used in all aspects of integrative therapy in hepatocarcinoma, including surgical resection, liver transplantation, TACE, local ablative therapies and even as monotherapy for middle-advanced stage hepatocarcinoma. Clinical practices have confirmed that TCM is effective to alleviate clinical symptoms, improve quality of life and immune function, prevent recurrence and metastasis, delay tumor progression, and prolong survival time in hepatocarcinoma patients. The effective mechanism of TCM against hepatocarcinoma is related to inducing apoptosis, autophagy, anoikis and cell senescence, arresting cell cycle, regulating immune function, inhibiting metastasis and angiogenesis, reversing drug resistance and enhancing effects of chemotherapy. Along with the progress of research in this field, TCM will contribute more to the prevention and treatment of hepatocarcinoma.

The Psychosomatic Traits of“People with the Five Elements in Traditional Chinese Medicine”:A Qualitative Study

Objective To identify the representative attributes of the five elements of a person with a qualitative methodology and provide the basis for the clinical diagnosis and treatment of“people with the five elements in traditional Chinese medicine(TCM).”Methods Data collected from the literature review,two sessions of brainstorming of experts with related experience in“people with the five elements in TCM”from October 2020 to December 2020,and six rounds of in-depth interviews with 30 participants who had various attributes of the five elements from March 2021 to October 2021 were analyzed.Triangulation was used in this study,and theming and synthesizing were used to analyze the data.Results A total of 31 experts and 30 interviewees participated in this study.The median age of the experts and interviewees were 48.0 and 38.5 years,respectively;51.66%and 54.8%of experts and interviewees,respectively,were men.The descriptors of facial diagrams of“people with the five elements in TCM”were complexion,shape,distribution state of facial bones,convergence trend of facial muscles,and facial expression.A theoretical model of“people with the five elements in TCM”was shaped based on these findings.Conclusion The study suggests a possibility for bridging the gap between personality and bodily state,identifying an avenue for personality research from the perspective of TCM.

Simultaneous quantification of five major active components in capsules of the traditional Chinese medicine 'Shu-Jin-Zhi-Tong' by high performance liquid chromatography

A simple and reliable high performance liquid chromatography （HPLC） method has been developed for the simultaneous quantification of five major bioactive components in ＇Shu-Jin- Zhi-Tong＇ capsules （SJZTC）, for the purposes of quality control of this commonly prescribed traditional Chinese medicine. Under the optimum conditions, excellent separation was achieved, and the assay was fully validated in terms of linearity, precision, repeatability, stability and accuracy. The validated method was applied successfully to the determination of the five compounds in SJZTC samples from different production batches. The HPLC method can be used as a valid analytical method to evaluate the intrinsic quality of SJZTC.

Treatment and exploration of integrated traditional Chinese and Western medicine for hypertension

At present,hypertension has the phenomenon of increasing incidence and advancing age of onset.It can be complicated by various cardiovascular and cerebrovascular diseases and has a poor prognosis.Its pathogenesis is related to vascular endothelial injury and its mediated inflammation,blood flow,changes in mechanical force,and vascular remodeling.Vascular biomechanical changes are the early and critical pathogenic factors of this disease.Mechanosensitive ion channels and their proteins affect the pathological process of hypertension by improving cell membrane tension,regulating vascular tension and contractility,and participating in vascular biomechanical changes such as vascular remodeling.However,the drugs currently used to treat high blood pressure only slow the progression of the disease.Therefore,it is necessary to find and study effective medicines to treat hypertension.At present,modern medical methods do not have targeted treatment measures.Traditional Chinese medicine plays a significant role in treating this disease based on the principle of“treatment according to the syndrome”.Traditional Chinese medicine regulates the mechanical force of blood flow and maintains blood pressure balance in patients with hypertension.There are many kinds of Chinese patent medicines used to treat hypertension with good curative effects.

基于BOPPPS线上线下混合式案例教学模式的中医诊断学教学探索

在分析中医院校中医诊断学课程定位及当前教学中存在的突出问题后,作者基于BOPPPS教学模型,创新性地将线上线下教学与案例教学相融合,采取课前线上线下教学、课中线下教学、课后线上师生交流和线下学生深入实践探寻问题相结合的模式,对提高学生学习积极性和学习效果进行探索。经初步实践证实,该教学模式能够激发学生的学习积极性与主动性,进一步提高学生的主体意识和自学能力,提高其四诊技能的综合运用能力和临床思辨能力,有效提高教学质量。因此,在中医诊断学课程教学中,基于BOPPPS教学模型的线上线下混合式案例教学模式为改善当前传统教学模式的不足提供了一种新的思路,值得研究及推广。

腰椎管狭窄症中西医结合诊疗指南(2023年)

腰椎管狭窄症是导致腰腿痛常见的原因之一。目前尚缺乏中西医结合治疗腰椎管狭窄症的循证指南,为规范中西医结合诊治腰椎管狭窄症,本指南严格遵循国内外指南制订的相关指导原则,成立了多学科工作组,采用GRADE方法进行证据质量和推荐强度分级,最终形成了关于中西医结合治疗腰椎管狭窄症的推荐意见,旨在规范临床实践。本指南适用于各种程度的腰椎管狭窄症患者。

中医寒湿证素对膝骨关节炎患者临床症状的影响研究

目的探索中医寒湿证素与膝骨关节炎临床症状之间的关系。方法采用横断面研究设计,研究对象来自课题组前期风寒湿研究队列中2015年3月至2015年11月在上海中医药大学附属曙光医院关节科门诊就诊的膝骨关节炎患者110例,其中女性87例,平均年龄为(60.67±6.01)岁,平均体质量指数(BMI)为(23.79±2.88)kg/m^(2)。依据《证素辨证学》的证素诊断标准,判别符合寒、湿证素诊断的患者;采用西安大略麦克马斯特大学骨关节炎指数(WOMAC)评估临床症状;分别比较寒组与非寒组、湿组与非湿组、寒+湿组与非(寒+湿)组的组间WOMAC评分;运用多元回归分析探讨寒证素、湿证素及寒+湿证素与WOMAC评分的相关性。结果与证素诊断不成立的患者相比,证素诊断成立(寒证素、湿证素、寒+湿证素)的患者在WOMAC评分上均显著增高(P<0.05)。回归分析揭示,在校正性别、年龄、BMI及病程后,寒证素均对WOMAC得分产生显著正向影响(疼痛:β=4.582,t=2.879,P=0.005;僵硬:β=1.558,t=1.994,P=0.049;功能:β=15.324,t=3.146,P=0.002;总分:β=21.464,t=3.302,P=0.001)。湿证素仅对WOMAC的功能和总分产生显著影响(功能:β=10.942,t=2.016,P=0.046;总分:β=14.950,t=2.056,P=0.042)。当寒湿证素同时存在时,其对所有WOMAC得分的影响均显著(疼痛:β=3.750,t=2.357,P=0.020;僵硬:β=2.229,t=2.953,P=0.004;功能:β=14.146,t=2.923,P=0.004;总分:β=20.125,t=3.120,P=0.002)。结论中医寒、湿证素与KOA患者的临床症状有显著关联,提示对中医寒湿证素的防治将对KOA防治有积极意义。

中医专业影像诊断学教学大纲修订的初步探索

随着医学影像学的迅速发展,其在临床应用中的地位越来越重要。为了适应中医现代化的发展需求及当前医学教育趋势,中医影像诊断学教学大纲的修订十分必要且重要。首都医科大学附属北京中医医院放射科对影像诊断学教学大纲进行全面细致的梳理及修订,总结了一些经验及方法。首先明确中医学五年制专业学生为培养对象,针对其特点,对教学大纲的修订既要守正,也要创新;其次保证教学内容全面覆盖,并适当增加影像学的新进展,跟上时代发展的步伐;然后充分突出学生的主体地位,融合翻转课堂、问题及病例驱动等多种教学方法,以岗位胜任力为导向,培养学生知识、能力及素质全面发展,塑造中医新型人才;最后,引入形成性评价,全面且详细地评估教学效果。

基于多方位综合素质培养的研究生教育模式探索与实践—以湖南中医药大学中医诊断研究所为例

医学研究生是医学研究的重要力量,同时也是培养高层次创新医学人才的重要储备。医学教育的根本任务是加强医学相关学科的建设布局和支持力度,培养高层次的、具有国际视野的复合型医学人才。在此背景下,探索如何提升中医学术型研究生的综合素质是高层次医学创新型人才培养的关键课题。文章以湖南中医药大学中医诊断研究所为例,在培养中医诊断学学术型研究生过程中,通过实验室结合可共享数字化学术资源为主的开放式共享平台,联合产学研合作、学科竞赛及人文素质教育的培养模式,探讨了提升中医诊断学学术型研究生综合素质的可行性,旨在为该教育模式的推广提供依据和参考。

基于批数据过采样的中医临床记录四诊描述抽取方法

中医临床记录四诊描述抽取对中医临床辨证论治的提质增效具有重要的应用价值,然而该任务尚有待探索,类别分布不均衡是该任务面临的关键挑战之一。该文围绕中医临床记录四诊描述抽取任务展开研究,首先构建了中医临床四诊描述抽取语料库;然后基于无标注的中医临床记录微调通用预训练语言模型实现该模型的领域适应;最后利用小规模标注数据,采用批数据过采样算法,完成中医临床记录四诊描述抽取模型的训练。实验结果表明,该文提出的抽取方法的总体性能均优于对比方法,并且与对比方法的最优结果相比,该文方法将少见类别的抽取性能F1值平均提升了2.13%。

课程思政元素融入中医诊断学教学的探索

中医诊断学作为中医学相关专业的主干课程,是联系基础理论与临床各科的桥梁。因其自身重思辨、知识面以及广与各科联系密切的学科特点,具有进行课程思政的多种优势。结合中医诊断学学科特点,选取立德树人、文化自信、思辨能力、中医养生观等结合点,通过线上线下相结合、典型病例法、模拟病人法等方法,进行课程思政与中医诊断学教学的有机融合。

五结合一回归教学模式在中医诊断学中的应用

依据中医诊断学课程特点,对接新时代中医药高等教育要求,课程组积极构建“五结合一回归”教学模式,将理论教学与实践教学相结合,线下教学与线上教学相结合,第一课堂与第二课堂相结合,课程思政与思政课程相结合,过程性与终结性考核相结合,授课回归中医经典,强化中医思维培养,实现了知识、能力、素质、情感态度与价值的融合式发展,为中医药传承创新人才培养提供了新思路。

2023年中医诊断学研究进展

2023年,中医诊法理论研究主要集中在望诊和脉诊领域,致力于将诊法理论与临床病证紧密结合,并扩展到舌诊、面诊、鼻诊和手诊等领域,结合现代影像学技术,提高了诊断的灵活性和准确性。多维辨证体系构建为现代医学所需,结合现代技术在心血管病、咳嗽、疫病等方面得到应用,开辟了中西医结合新途径。证候辨证研究通过横向数据揭示证候分布的规律性,旨在规范研究,客观反映病因、病机及病情发展趋势。动物模型成为验证中医理论和探索新治疗方法的关键,在线粒体功能、能量代谢、免疫调节和炎症反应等方面,揭示了证候的生物学基础,分析及揭示了代谢物、基因表达、细胞因子等标志物及肠道菌群变化与证候形成的相关关系。传统中医诊断技术与大数据分析、机器学习和传感器技术结合,在舌诊、面诊、脉诊等领域取得进展,显著提高了诊断方法的精准度和客观性,应用高通量影像组学参数分析、注意力机制模型和电子鼻技术,提升了中医诊断的标准化和科学性,也为远程医疗和个性化诊疗创造了新的可能性。

五脏系统疾病中医诊疗思维训练虚拟仿真实验教学的研究与实践

中医临床思维是中医学专业本科生最应着重培养的基本能力。但以往由于各种条件限制,学生接触的临床真实病例和病种有限,同时学生难以对一个完整诊疗周期内的病人进行持续实践操作。基于以上原因,我们开发了“五脏系统疾病中医诊疗思维训练虚拟仿真”实验教学系统,将真实的临床案例数字化、虚拟化,构建高度仿真的虚拟实训环境和实训对象,帮助受训者形成正确的中医临床思维方式方法,提高了中医实践教学的质量和水平。

从“岭南罗氏妇科诊法”谈中医药的文化传承与学术传播

“岭南罗氏妇科诊法”为广东省、广州市的非物质文化遗产项目(简称非遗项目),具有文化属性与学术属性。“岭南罗氏妇科诊法”源于岭南罗氏妇科流派,带有岭南文化的基因与岭南医学的印记。中医药非遗项目与中医流派的文化传承与学术传播各有侧重。非遗项目由文化部门组织评定,其传播主要面向公众,以外展型传播为主;而流派是由中医药管理部门评定,其传播则以行业内为主,外展为辅。中医流派的文化传承与学术传播,既要在中医理论方面深入发掘,又要以理论指导临床,提高疗效;流派团队建设尤需注重学科文化传承,可通过工作站建设等形式,在行业内进行学术传播,让更多的从业者了解和掌握流派的学术经验,从而使民众获益。与中医流派相比,中医药非遗项目的文化属性更为突出,非遗传承人不仅要传承技艺,更需要在社会层面进行文化与技艺推广,让民众了解中医药非遗项目,自觉以中医药保健防病。中医药非遗项目与学术流派的传播均应坚定文化自信,充分利用信息化、网络化技术,多层次、多维度传播中医药文化。

中医诊断装备辅助体质辨识的文献研究

目的:通过文献研究中医诊断装备对体质辨识“治未病”的辅助作用。方法:对2002年1月至2023年7月文献进行统计研究,导入Note Express中建立文献数据库,将符合纳入标准的有效文献录入Excel 2019表格,建立中医体质辨识文献数据库。依据红外仪、舌诊仪、脉诊仪和面诊仪研究归纳总结。结果:不同体质类型的不同部位温度情况、舌象特征、脉象指标、脉象特征、面象指标各不相同,且存在显著差异(P<0.05),可借助红外仪、舌诊仪、脉诊仪和面诊仪收集受检者相应的生理数据进行分析,从而辅助体质辨识。结论:利用中医检测装备可以降低体质辨识时由于医生主观判断所造成的偏差,能有效促进体质辨识系统化、规范化,从而提供更加精准的养生治疗建议。

基于中西医临床病症特点的肠易激综合征动物模型评价

肠易激综合征(IBS)是一种以慢性或者反复性腹痛同时伴随着排便异常或排便习惯变化为特点的功能性胃肠道疾病。目前IBS动物模型吻合度较高的为多因素联合的病症结合模型,但此类模型多为中药灌胃合并某证型,多因素造模方法在IBS复杂的病因病机方面也存在一定的局限性。而更完善的动物模型可以有助于临床研究和筛选治疗药物。构建更加符合中西医临床病症特点的动物模型尤为重要。基于IBS的中西医临床病症特点,对现有的IBS模型进行归纳分析,评价动物模型和临床的吻合度,分析其优缺点。完善动物模型评价标准,结合中医优势联系各建模方法的相互作用,结合环境、遗传、生活方式等因素,是未来IBS动物模型的发展方向。