TCM diagnosis and treatment theory of chronic complete occlusion of coronary artery based on etiology and pathogenesis

Chronic total occlusive disease of the coronary artery belongs to the category of"chest palsy"and"true heart pain"in traditional Chinese medicine.Its etiology has two aspects:deficiency of blood,blood stasis,qi stagnation,and phlegm.Failure can be caused by deficiency or disease.The pathogenesis of this disease is caused by obstruction of the heart pulse,and its pathogenesis can be transformed into each other.The theory of traditional Chinese medicine believes that the general rule is not painful.Therefore,the treatment of coronary CTO lesions should be based on the combination of Tong and Tong tonic.The chronic complete occlusive disease of the coronary artery can be treated through Xuanbi Tongyang,Huoxue Tongluo,and Aroma Wentong.Based on the Chinese medicine's understanding of the etiology and pathogenesis of coronary CTO lesions,it provides a basis for the diagnosis and treatment of traditional Chinese medicine,solves the problems of interventional medicine in western medicine,and gives play to the unique advantages of traditional Chinese medicine for clinical diagnosis and treatment.

Etiology and pathogenesis of corona virus disease 2019 on the view of Chinese medicine

Traditional Chinese Medicine has played an important role in the prevention and treatment of the Corona Virus Disease 2019 epidemic.But in views of different TCM scholars there are different opinions about disease name,characteristic of etiology,law of pathogenesis about this epidemic.Based on related literatures,this article overviews of the characteristics of TCM etiology,law of pathogenesis and methods of syndrome differentiation,hoping to find research method that fit in with TCM clinical practice.Prerequisite of treatment is identifying the cause.The clinical manifestations of patients are important to TCM,and the etiological attributes can be inferred from the clinical manifestations.SARS-CoV-2 belongs to exogenous etiological factors,but there are different opinions about its characteristics of six pathogenic factors.Cold,Dampness,Warm,Dry,Toxin,Summer-heat,Wind,are all involved.Thus,different understanding of the pathogenesis and the law of transmission is caused.Such as cold and dampness hurt Yang,furthermore,consumed of Qi;dampness and toxin infected from external environment,turbid dampness produced inside the body;dryness affecting lungs and consume of Yin;warm-heat-turbid-toxin affected lungs,stomach and intestine;and then produced phlegm stagnation or blood stasis,furthermore consumed Qi and Yin.Based on those differences,methods of syndrome differentiation in treatment of COVID-19 are diverse,which contain pattern differentiation of zang-fu organs,pattern differentiation of Wei-defence,Qi,Ying nutrients and blood;pattern differentiation by the eight principles,and pattern differentiation of six meridians.Because of SARS-CoV-2 can spread to the whole country or even the whole world in a short period of time,its pathogenic nature should be roughly the same.So studying the treatment of COVID-19 based on clinical cases,refining the similarities and differences in the clinical presentation of patients with different subtypes during the epidemic,clarification of the etiologic attribution and evolutionary patterns of disease mechanisms,developing a comprehensive understanding of COVID-19 in Chinese medicine is needed.Furthermore,getting a full understanding of COVID-19,and providing reference for the prevention and treatment of unknown infectious diseases.

Mechanism of sex hormone level in biological clock disorder induced acne and analysis of TCM Pathogenesis

Acne vulgaris is a common chronic inflammatory disease of pilosebaceous units. And sex hormone level disorder has became a hot research topic in the pathogenesis of acne. Studies show that the biological clock disorder can result in the disorder of sex hormone levels which causes or aggravates acne. Biological clock disorder coincides naturally with "sleep rhythm disorder" in Traditional Chinese Medicine(TCM). In this paper, we will discuss the modern medical mechanism of the biological clock disorder resulting in acne from the angle of sex hormones, and analyze the TCM pathogenesis of the disease caused by the disorder of the biological clock.

Review: The vital role of traditional Chinese medicine (TCM) in the prevention and treatment of COVID-19 and the etiology and pathogenic mechanism of COVID-19 based on TCM theory

"Yi"is defined in traditional Chinese medicine theory as the general pathological conditions of epidemics.Throughout thousands of years of history,TCM has been playing an essential role in preventing and treating epidemics in China.Showing significant efficacy against severe acute respiratory syndrome(SARS)in 2002 and 2003,a medical intervention involving TCM was applied at the beginning of the pandemic of the corona virus disease 2019(COVID-19),and has been found with good preventive and curative value in clinical practice.In this study,the etiology and pathogenic mechanism of COVID-19 was discussed on a TCM theory basis,and the clinically effective prevention and treatment methods/prescriptions were summarized.It is suggested that TCM has been playing a unique and vital role in preventing and treating COVID-19,and thus contributes greatly to public health.

Research on etiology and pathogenesis of cancer based on data mining under theguidance of Neijing theory

Etiology and pathogenesis are the causes and mechanisms of disease development and change. The unification and innovation of cancer pathogenesis is the key to the breakthrough of Chinese medicine. According to the related theory in Neijing, cancer in different parts of the body could be classified based on the five elements. Chinese mainland is divided into five parts： east, south, west, north and central section. Based on the annual data of China Cancer Center, we analyzed the data of 72 cancer registries covering 32 provinces and autonomous regions for consecutive 5 years. The results showed that the total incidence of the five regions in the mainland of China was statistically significant （F = 8.561, P 〈 0.01）; the east was the highest, the west was the lowest, and the south, middle and north were in the middle level. The incidence of tumors in different parts of the human body was statistically significant （F = 523.382, P 〈 0.01）. The incidence rate from high to low was lung, spleen, kidney, liver and heart. The heat is too much in China＇s eastern and the southern, and Qi is not too enough in the northwest. Five-Qi was imbalance. The pathogenesis of cancer is due to the two aspects, deficiency of five Zang-organs and abnormal seasonal climates. The viscera weakness for a long period and abnormal seasonal climates causes the body Yin and Yang disharmony, resulting in five zang organs dysfunction.

Rules and Characteristics of TCM Treatment Prescriptions for Patients with Decreased Ovarian Reserve

[Objectives]To analyze the characteristics and rules of traditional Chinese medicine(TCM)in the treatment of decreased ovarian reserve(DOR)in Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine.[Methods]A total of 107 patients with DOR in Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine were selected for sorting,and the usage,classification,nature,taste and meridian homing of the used drugs were statistically analyzed.[Results]A total of 107 patients were included in this stud and a total of 189 flavors of TCM are used.The total frequency of drugs was 4345 times,and a total of 535 prescriptions were issued.The top five frequency of drug use were 2261 times(50.04%)of Paeoniae Radix Alba(Cynanchum otophyllum Schneid.),2037 times(46.88%)of Corni Fructus(Cornus officinalis Sieb.et Zucc.),1818 times(41.84%)of Rehmanniae Radix Praeparata[Rehmannia glutinosa(Gaertn.)Libosch EX Fisch.et Mey.],1610 times(37.05%)of Guiban[Chinemys reevesii(Gray)],and 1303 times(29.99%)of Uncariae Ramulus Cum Uncis(Uncariar hynchophylla Miq.ex Havil.).Kidney deficiency syndrome accounted for the largest proportion at 51.40%,and the use frequency of tonic drugs accounted for the highest at 50.64%;heat-clearing drugs and qi and blood-boosting drugs separately accounted for 19.24%and 17.39%;the top 3 medicinal tastes are sweet(52.02%),pungent(20.71%)and bitter(20.32%);medicinal properties are ranked as warm(60.54%),cold(24.16%),hot(8.72%)and cool(6.49%);the main meridians are spleen,lung,liver,stomach and kidney.[Conclusions]The basic pathogenesis of DOR is deficiency of qi and blood,mainly due to dysfunction of the spleen,lung,liver,liver,stomach and other organs,and kidney deficiency and spleen deficiency are more common.

ACHIEVEMENTS IN THE TREATMENT OF HYPERLIPIDEMIA WITH TCM-WM

In recent ten years, TCM--WM re-searches on the etiology, pathogenesis,treatment and prevention of hyperlipidemiahave been extensively carried out in China,and considerable progress has been made.

Research progress on the etiology and pathogenesis of adolescent idiopathic scoliosis

Etiology of adolescent idiopathic scoliosis(AIS),a complicated three-dimensional spinal deformity with early-onset,receives continuous attention but remains unclear.To gain an insight into AIS pathogenesis,this review searched PubMed database up to June 2019,using key words or medical subject headings terms including"adolescent idiopathic scoliosis,""scoliosis,""pathogenesis,""etiology,""genetics,""mesenchymal stem cells,"and their combinations,summarized existing literatures and categorized the theories or hypothesis into nine aspects.These aspects include bone marrow mesenchymal stem cell studies,genetic studies,tissue analysis,spine biomechanics measurements,neurologic analysis,hormone studies,biochemical analysis,environmental factor analysis,and lifestyle explorations.These categories could be a guidance for further etiology or treatment researches to gain inspiration.

Budd-Chiari syndrome:Etiology,pathogenesis and diagnosis

Budd-Chiari syndrome is a congestive hepatopathy caused by blockage of hepatic veins. This syndrome occurs in 1/100 000 in the general population. Hypercoagulable state could be identified in 75% of the patients; more than one etiologic factor may play a role in 25% of the patients. Primary myeloproliferative diseases are the leading cause of the disease. Two of the hepatic veins must be blocked for clinically evident disease. Liver congestion and hypoxic damage of hepatocytes eventually result in predominantly centrilobular fibrosis. Doppler ultrasonography of the liver should be the initial diagnostic procedure. Hepatic venography is the reference procedure if required. Additionally liver biopsy may be helpful for differential diagnosis. The prognosis of the chronic form is acceptable compared to other chronic liver diseases.

Acute pancreatitis:Etiology and common pathogenesis

Acute pancreatitis is an inflammatory disease of the pancreas.The etiology and pathogenesis of acute pancreatitis have been intensively investigated for centuries worldwide.Many causes of acute pancreatitis have been discovered,but the pathogenetic theories are controversial.The most common cause of acute pancreatitis is gallstone impacting the distal common bile-pancreatic duct.The majority ofinvestigators accept that the main factors for acute billiary pancreatitis are pancreatic hyperstimulation and bile-pancreatic duct obstruction which increase pancreatic duct pressure and active trypsin reflux.Acute pancreatitis occurs when intracellular protective mechanisms to prevent trypsinogen activation or reduce trypsin activity are overwhelmed.However,little is known about the other acute pancreatitis.We hypothesize that acute biliary pancreatitis and other causes of acute pancreatitis possess a common pathogenesis.Pancreatic hyperstimulation and pancreatic duct obstruction increase pancreatic duct pressure,active trypsin reflux,and subsequent unregulated activation of trypsin within pancreatic acinar cells.Enzyme activation within the pancreas leads to auto-digestion of the gland and local inflammation.Once the hypothesis is confirmed,traditional therapeutic strategies against acute pancreatitis may be improved.Decompression of pancreatic duct pressure should be advocated in the treatment of acute pancreatitits which may greatly improve its outcome.

Traditional Chinese Medicine etiology and pathogenesis of acquired immune deficiency syndrome in simian immunodeficiency virus-infected Chinese rhesus macaques

OBJECTIVE： To investigate the traditional Chinese Medicine （TCM） etiology and pathogenesis of ac- quired immune deficiency syndrome （AIDS） by 18-month observation of Chinese rhesus macaques infected with simian immunodeficiency virus （SIV） mac239. METHODS： Thirty-five healthy Chinese rhesus ma- caques were divided into a model group （n=30） and a control group （n=5）. The model was estab- lished by inoculating monkeys intravenously with SIVmac239. Changes in TCM symptoms after SIV in- fection within 18 months were then observed and recorded. Routine blood tests, SIV viral load, T-lym-phocyte subsets, plasma triiodothyronine （T3）, tet- raiodothyronine （14）, adrenocorticotropic hormone （ACTH） and cortisol （Cor） were tested periodically during the experiment. RESULTS： During the acute infection period of SIV, model monkeys temporarily showed clinical symp- toms such as diarrhea, dysphoria and slight weight loss. Decrease percentages of CD4~ T-lymphocytes were observed but levels of T3, 14, Cot, and ACTH were relatively unchanged. Monkeys in the model group during the early and middle periods of infec- tion showed no obvious symptoms, except few monkeys exhibited transient diarrhea and reduced food intake. All variables at this stage showed nor- mal fluctuations. In the middle period model group monkeys showed chronic and persistent diarrhea, weight loss, reduced food intake and low levels of 13 and Cot. In the late period, symptoms including emaciation, weight loss, listlessness, crouching in corners and low levels of T3appeared. CONCLUSION： The results suggest that the rhesus monkey SIWSAIDS model can be applied to re- search on TCM etiology and pathogenesis of AIDS. According to this model, the etiology of disease is the SIV virus. The pathogenesis manifests as the in- vasion of SIV virus, incubation of the virus, balance between virus and healthy ＂Qi＂, damage to spleen and kidney as the disease progressed, exhaustion of vitality and finally the failure of five zang and six fu organs.

Etiology, pathogenesis, and diagnosis of neovascular glaucoma

Neovascular glaucoma is defined as iris and/or anterior chamber angle neovascularization associated with increased intraocular pressure. It is a secondary glaucoma that is most frequently caused by severe retinal ischemia. The most common diseases responsible for the development of neovascular glaucoma are diabetic retinopathy, ischemic central retinal vein occlusion,and ocular ischemic syndrome. Uncommon causes include ocular radiation, ocular tumors, uveitis and other miscellaneous conditions. Vascular endothelial growth factor is an important and likely predominant agent involved in the pathogenesis of intraocular neovascularization and neovascular glaucoma. The evolution of clinical and histopathological changes from predisposing conditions to the occurrence of rubeosis iridis and neovascular glaucoma is divided into four stages: prerubeosis, preglaucoma, open angle glaucoma, and angle-closure glaucoma.

Current trends in acute pancreatitis:Diagnostic and therapeutic challenges

Acute pancreatitis(AP)is an inflammatory disease of the pancreas,which can progress to severe AP,with a high risk of death.It is one of the most complicated and clinically challenging of all disorders affecting the abdomen.The main causes of AP are gallstone migration and alcohol abuse.Other causes are uncommon,controversial and insufficiently explained.The disease is primarily characterized by inappropriate activation of trypsinogen,infiltration of inflammatory cells,and destruction of secretory cells.According to the revised Atlanta classification,severity of the disease is categorized into three levels:Mild,moderately severe and severe,depending upon organ failure and local as well as systemic complications.Various methods have been used for predicting the severity of AP and its outcome,such as clinical evaluation,imaging evaluation and testing of various biochemical markers.However,AP is a very complex disease and despite the fact that there are of several clinical,biochemical and imaging criteria for assessment of severity of AP,it is not an easy task to predict its subsequent course.Therefore,there are existing controversies regarding diagnostic and therapeutic modalities,their effectiveness and complications in the treatment of AP.The main reason being the fact,that the pathophysiologic mechanisms of AP have not been fully elucidated and need to be studied further.In this editorial article,we discuss the efficacy of the existing diagnostic and therapeutic modalities,complications and treatment failure in the management of AP.

Diagnosis and Treatment Protocol for COVID-19(Trial Version 7) Traditional Chinese medicine(TCM) treatment

The COVID-19 belongs to plague in TCM with the etiology of epidemic factor exposure.Different regions can refer to the following plans for syndrome differentiation and treatment,according to the disease,local climate characteristics and different constitutions.Prescriptions which exceed maximum dose according to pharmacopoeia should be used under the guidance of a physician.

从“阳化气,阴成形”探讨慢性咳嗽之因机证治

慢性咳嗽是以咳嗽为主症或唯一症状、病程持续8周以上的呼吸系统疾病。慢性咳嗽病因复杂,病程较长,病势缠绵,且极易复发。西医诊断该病过程繁琐,治疗手段有限,而中医药以整体观念和辨证论治思想为指导,在缓解临床症状、预防疾病复发方面具有独特优势。该文以“阳化气,阴成形”为抓手,分析阴阳在慢性咳嗽因机证治全周期的重要意义,认为慢性咳嗽之病机关键为“阳化气,阴成形”功能失衡,以肺之气血失和、阴阳虚损为本,阳化而气行不畅、周流有碍,阴变而凝结停滞、壅塞肺络为标。治疗上,需要补肺、脾、肾阴阳之不足,泄气滞、水湿、痰饮、瘀血、热毒之有余,以恢复“阳化气,阴成形”之平衡。具体用药方面,主张以偏纠偏,以药物气味之偏性纠正人体阴阳之偏颇。另附典型医案二例,加以验证说明,以期为中医药防治慢性咳嗽提供新的诊疗思路和方法。

慢性萎缩性胃炎的中医辨治思路与对策

慢性萎缩性胃炎(CAG)是临床上公认的胃癌前疾病,中医药治疗CAG具有明显的优势及鲜明的特色。从CAG病因病机等方面的研究入手,对中医药治疗CAG提出治本独取阳明,补虚泻实,顾护脾胃,升降气机,调气和血,祛瘀通络,祛邪解毒,甘平凉润,和胃护络的辨治思路与对策,以期进一步提高中医药治疗CAG的临床疗效。

基于“肝心和合”理论的动脉粥样硬化性疾病病机演变

动脉粥样硬化性疾病对人类的生命和健康造成了威胁,在生物-心理-社会医学的模式下,基于中医古籍挖掘与整理,结合现代医学理论及实验进展,以中医基础理论为指导,提出基于“肝心和合”理论的AS性疾病病机演变全过程,即预病状态→已病状态→病复状态。系统阐释在AS性疾病中“心”与“肝”状态失衡是导致疾病进展或骤变的主要因素,“郁-痰-瘀-毒-虚”的病理特点,并逐一对病理特点进行中西医的发病机制诠释,五者在疾病中不仅可以单一存在,而且可以相互兼见,相互作用,相互影响,其中是“郁”是“痰-瘀-毒-虚”进一步病变的基础。以肝郁心虚、心脉遏滞;肝心失司、心脉瘀阻;肝心失和、瘀毒虚互结等中医内涵揭示AS性疾病的发病机制,为中西医结合诊疗提供新思路和新方法。

国医大师周仲瑛融贯古今创建病机理论新体系学术思想述要

概述了国医大师周仲瑛教授以创建中医病机理论新体系为核心学术思想的探索历程、学术意义,对其理论内涵进行解读。作为中医高等教育教材建设的开拓者,周仲瑛教授创建了中医内科脏腑辨证纲要,坚持不懈开展病机理论创新研究,取得丰硕的学术成果,充实、发展了中医理论学术体系。在对外感热病和内伤急难症临床诊疗过程中,系统创建了瘀热论、癌毒论等病机新理论,据此立法用药能够提高临床疗效,感悟出辨识病机是辨证论治的关键环节。周仲瑛教授晚年以整体观为指引,提出“病机十三条”,构建了中医病机辨证新体系,突出复合病机、病机要素因果链对临床复杂性病证的指导价值,形成以“审证求机,活化辨证”思想为灵魂的理论。该理论突破了从单一病机或固定证型辨证论治的僵化思维,以整体观思想重构了中医理论框架,是现代中医学的一次重大学术创新。

雄激素性脱发的病因及发病机制研究进展

雄激素性脱发(AGA)是一种常见的脱发性疾病,发病机制复杂。目前对于AGA的机制研究仍聚焦于机体对雄激素的过度反应及遗传因素的影响。另外,毛发生长周期、头皮的血液流变学以及生活习惯在AGA的发病中也起到重要作用。本文对AGA病因及其发病机制进展作一综述,旨在为相关的治疗研究提供理论依据。

中医辨证治疗妊娠期高血压疾病3例

妊娠期高血压疾病为妊娠期特有疾病,发病率较高,发病机制复杂。其治疗目的和原则是防止子痫,降低母婴严重并发症的发生。本研究回顾了3例中医辨证治疗妊娠期高血压疾病的临床医案,通过临床应用中医药辨证施治以祛邪消因,恢复机体平衡,使妊娠得以正常运行,验证了中医中药辨证施治妊娠期高血压疾病的有效性和可行性,分析了其中的治疗机制,为妊娠期高血压疾病的临床治疗提供了新的思路和方法。