Exploring the Application Effect of Flipped Classroom Combined with Problem-Based Learning Teaching Method in Clinical Skills Teaching of Standardized Training for Resident Doctors of Traditional Chinese Medicine

Objective: To explore the application effect of flipped classroom combined with problem-based learning teaching method in clinical skills teaching of standardized training for resident doctors of traditional Chinese Medicine. Methods: The study used the experimental control method. The study lasted from September to November 2022. The subjects of this study were 49 students of standardized training for resident doctors of traditional Chinese Medicine from grades 2020, 2021 and 2022 of Dazhou integrated TCM & Western Medicine Hospital. They were randomly divided into experiment group (25) and control group (24). The experiment group adopted flipped classroom combined with problem-based learning teaching method, and the control group adopted traditional teaching method. The teaching content was 4 basic clinical skill projects, including four diagnoses of traditional Chinese Medicine, cardiopulmonary resuscitation, dressing change procedure, acupuncture and massage. The evaluation method was carried out by comparing the students’ performance and a self-designed questionnaire was used to investigate the students’ evaluation of the teaching method. Results: The test scores of total scores in the experimental group (90.12 ± 5.89) were all higher than those in the control group (81.47 ± 7.96) (t = 4.53, P P Conclusions: The teaching process of the flipped classroom combined with problem-based learning teaching method is conducive to improving the efficiency of classroom teaching, cultivating students’ self-learning ability, and enhancing students’ willingness to learn.

Study on prescription medication mode and mechanism of traditional Chinese medicine in the treatment of noncritical COVID-19 based on data mining

Background:As of 2023,coronavirus disease 2019(COVID-19)is still spreading globally.Therefore,we aim to integrate non-critical COVID-19 high-frequency and high-targeting Chinese medicines to provide a reference for clinical prescriptions to improve COVID-19-related symptoms.Materials and methods:The information on non-critical COVID-19 high-frequency Chinese medicines in the diagnosis and treatment of COVID-19 was obtained by the TCM inheritance support platform.Using network pharmacology and molecular docking technology,high-targeting Chinese medicines with good docking activity with COVID-19 receptors angiotensin-converting enzyme-II(ACE2),3CLpro and tyrosine-protein kinase receptor UFO(AXL)were obtained.A new prescription for non-critical COVID-19 was established by integrating high-frequency and high-targeting Chinese medicines.Rats with acute lung injury induced by lipopolysaccharide were used as the experimental model.The histopathological changes in the lungs of rats in each group were observed by hematoxylin-eosin staining.The lung coefficient of rats was measured.The levels of IL-6,TNF-α,and IL-1βin serum were detected by enzyme-linked immunosorbent assay.The mRNA and protein levels of ACE2 and AXL in lung tissue were detected by real-time quantitative polymerase chain reaction and western blot.Results:Through data mining,it was found that there were 39 high-frequency traditional Chinese medicines for non-critical COVID-19 in the diagnosis and treatment guidelines.According to network pharmacology and molecular docking,30 highly targeted traditional Chinese drugs for COVID-19 were found.The new prescriptions for non-critical COVID-19 were comprehensively obtained,including Glycyrrhizae Radix,Ephedra Herba,Amygdalus Communis Vas,Gypsum Fibrosum,Descurainiae Semen,Atractylodes Lancea,Scutellariae Radix,Amomum Tsao-Ko Crevostet,Forsythiae Fructus,Pogostemon cablin,Magnolia Officinalis.Compared with the LPS-induced lung injury model group,the medium dose of the new prescription group had significantly alleviated pathological changes in lung tissue,decreased lung coefficient,decreased contents of IL-6,TNF-αand IL-1β,and increased mRNA and protein expression of ACE2 and AXL(P<0.05).Conclusion:Based on data mining,network pharmacology and molecular docking technology,the new prescription for non-critical COVID-19 established by this method has an anti-inflammatory effect on rats with acute lung injury induced by lipopolysaccharide and can provide a reference for clinicians to alleviate the symptoms related to non-critical COVID-19.

Summary of Zhang Hongxing's Experience in Treating Refractory Angina Pectoris with Traditional Chinese Medicine

As a famous traditional Chinese medicine(TCM)expert in Shandong province and a famous veteran TCM expert in Dezhou city,Zhang Hongxing has been engaged in cardiovascular clinical work for more than 30 years.He has unique experience in the treatment of refractory angina pectoris.This paper comprehensively explains from the aspects of etiology and pathogenesis.His treatment is mostly based on syndrome differentiation,combined with the basic pharmacology of modem Chinese medicine to formulate prescriptions and drugs,and at the same time values the use of insect drugs.We hereby attach the clinical records,hoping to provide reference for clinical workers,which is conducive to the inheritance and development of famous Chinese medical academic experience.

Traditional Chinese medicine Master XIONG Jibo’s medication experience in treating arthralgia syndrome through data mining

Objective This study aimed to examine and propagate the medication experience and group formula of traditional Chinese medicine(TCM)Master XIONG Jibo in diagnosing and treat-ing arthralgia syndrome(AS)through data mining.Methods Data of outpatient cases of Professor XIONG Jibo were collected from January 1,2014 to December 31,2018,along with cases recorded in A Real Famous Traditional Chinese Medicine Doctor:XIONG Jibo's Clinical Medical Record 1,which was published in December 2019.The five variables collected from the patients’data were TCM diagnostic information,TCM and western medicine diagnoses,syndrome,treatment,and prescription.A database was established for the collected data with Excel.Using the Python environment,a custom-ized modified natural language processing(NLP)model for the diagnosis and treatment of AS by Professor XIONG Jibo was established to preprocess the data and to analyze the word cloud.Frequency analysis,association rule analysis,cluster analysis,and visual analysis of AS cases were performed based on the Traditional Chinese Medicine Inheritance Computing Platform(V3.0)and RStudio(V4.0.3).Results A total of 610 medical records of Professor XIONG Jibo were collected from the case database.A total of 103 medical records were included after data screening criteria,which comprised 187 times(45 kinds)of prescriptions and 1506 times(125 kinds)of Chinese herbs.The main related meridians were the liver,spleen,and kidney meridians.The properties of Chinese herbs used most were mainly warm,flat,and cold,while the flavors of herbs were mainly bitter,pungent,and sweet.The main patterns of AS included the damp heat,phlegm stasis,and neck arthralgia.The most commonly used herbs for AS were Chuanniuxi(Cyathu-lae Radix),Huangbo(Phellodendri Chinensis Cortex),Cangzhu(Atractylodis Rhizoma),Qinjiao(Gentianae Macrophyllae Radix),Gancao(Glycyrrhizae Radix et Rhizoma),Huangqi(Astragali Radix),and Chuanxiong(Chuanxiong Rhizoma).The most common effect of the herbs was“promoting blood circulation and removing blood stasis”,followed by“supple-menting deficiency(Qi supplementing,blood supplementing,and Yang supplementing)”,and“dispelling wind and dampness”.The data were analyzed with the support≥15%and con-fidence=100%,and after de-duplication,five second-order association rules,39 third-order association rules,39 fourth-order association rules,and two fifth-order association rules were identified.The top-ranking association rules of each were“Cangzhu(Atractylodis Rhizoma)→Huangbo(Phellodendri Chinensis Cortex)”“Cangzhu(Atractylodis Rhizoma)+Chuanniuxi(Cyathulae Radix)→Huangbo(Phellodendri Chinensis Cortex)”“Chuanniuxi(Cyathulae Radix)+Danggui(Angelicae Sinensis Radix)+Gancao(Glycyrrhizae Radix et Rhizoma)→Qinjiao(Gentianae Macrophyllae Radix)”and“Chuanniuxi(Cyathulae Radix)+Danggui(Angelicae Sinensis Radix)+Gancao(Glycyrrhizae Radix et Rhizoma)+Huangbo(Phello-dendri Chinensis Cortex)→Qinjiao(Gentianae Macrophyllae Radix)”,respectively.Five clusters were obtained using cluster analysis of the top 30 herbs.The herbs were mainly dry-ing dampness,supplementing Qi,and promoting blood circulation.The main prescriptions of AS were Ermiao San(二妙散),Gegen Jianghuang San(葛根姜黄散),and Huangqi Chongteng Yin(黄芪虫藤饮).The herbs of core prescription included Cangzhu(Atractylodis Rhizoma),Chuanniuxi(Cyathulae Radix),Gancao(Glycyrrhizae Radix et Rhizoma),Huangbo(Phellodendri Chinensis Cortex),Mugua(Chaenomelis Fructus),Qinjiao(Gentianae Macro-phyllae Radix),Danggui(Angelicae Sinensis Radix),and Yiyiren(Coicis Semen).Conclusion Clearing heat and dampness,relieving collaterals and pain,and invigorating Qi and blood are the most commonly used therapies for the treatment of AS by Professor XIONG Jibo.Additionally,customized NLP model could improve the efficiency of data mining in TCM.

Professor Liu Guobin used traditional Chinese medicine to cure a case of primary erythema limb pain

Primary erythema limb pain is a very rare disease,and its pathogenesis is not clear.Usually,the pain symptoms of patients exist for a long time,which seriously affect the daily life of patients and increase the economic burden of patients.Professor Liu Guobin,who has been engaged in the diagnosis and treatment of peripheral vascular diseases for nearly 30 years,believes that heat-toxin and blood stasis collaterals are closely related to the disease,and emphasizes the principle of heat-toxin and evil qi causing the disease.It is emphasized that clearing heat and detoxification,promoting blood circulation and dispersing blood stasis are the main treatment principles.This paper selects a typical case to describe Professor Liu's clinical experience in the treatment of primary erythema limb pain by oral and external use of traditional Chinese medicine,so as to provide an effective method of traditional Chinese medicine for the treatment of primary erythema limb pain.

Humanistic Spirit Contained in Traditional Chinese Medicine should Be Valued

Medicine is a science studying human's health and diseases as well as the regularity between them. Its research subject is human, who possess natural attribute, psychological attribute and social attribute. Therefore, medicine is bound to possess humanistic attribute. Rooted in Chinese traditional culture, Traditional Chinese Medicine contains abundant humanistic thoughts, for instance, pursuing the unity of human and nature, advocating the vital importance of life, sticking to the virtue of "medicine being humane art", abiding by the principle of "Benevolence prior to interest", complying with the medical rule of "Respecting peers". These are the very concrete reflections of medical humanistic spirit. In this article we aim to explore the humanistic thoughts contained in Traditional Chinese Medicine, and try to inherit and carry forward the spirit to better relieve the tensions between doctors and patients and improve the quality of medical services.

Validity and reliability of the evaluation tool of TCM confidence in students with TCM learning experience

Objective:This study aimed to design an evaluation scale of traditional Chinese medicine(TCM)confidence and then evaluate its validity and reliability.Methods:Three parallel samples with TCM learning experience were included in this current study.Randomly selected 500 nursing students were included factor analysis and reliability and validity analyses.After 4 weeks,200 nursing students were recruited to retest the reliability.The evaluation tool of TCM confidence included 6 dimensions and 25 entries.Results:Cronbach's a coefficient of the evaluation scale was 0.95 and that of the 6 observed aspects were higher than 0.90,and splithalf reliability was 0.81.For the retest reliability,Cronbach's a coefficient of the evaluation scale was 0.93 and that of the 6 examined aspects was all over 0.80.The index of content validity Scale Content Validity Index(S-CVI)was 0.92 and Item Content Validity Index(I-CVI)was 0.83–1.00.Conclusions:Observed results may indicate that the designed tool can be used to assess the TCM confidence level of students with TCM studied experience and also can evaluate results of TCM education during studying TCM lectures.

East to west:research progress in traditional Chinese medicine for antiaging strategies

Delaying the onset of aging is considered an important tool for dealing with the global crisis of the aging population.Accordingly,several antiaging studies have been conducted using strategies of modern medicine and traditional Chinese medicine(TCM).In this review,we summarize the current state of antiaging research related to both modern medicine and TCM and provide suggestions for further research.Various theories related to the aging process have been proposed,including the free radical theory,mitochondrial DNA damage theory,telomere theory,cross-linking theory,and intestinal flora theory,and a number of antiaging chemical treatments have been developed using modern medicine.These theories and achievements have resulted in major advancements in antiaging research.TCM is based on practical experience and has a long history with unique advantages in antiaging research.Some antiaging practices such as moderate diet consumption,acupuncture,Tai Chi(a traditional Chinese martial art that can relax the nerves to slow down the aging process),and Wuqin Xi(a traditional Chinese exercise to strengthen the body)have been adopted to maintain health.Several TCMs and prescriptions,particularly those related to medicine food homology,have been used in antiaging treatment,and their antiaging properties have been demonstrated to be effective based on pharmacological experiments and clinical applications.

An Empirical Case of Chinese Medicine in the Treatment of Idiopathic Edema

Idiopathic edema is a common,challenging,and complicated clinical condition with no recognized cause that is easy to prolong and repeat.Professor Li has a lot of expertise treating this condition.This condition is associated with a yang shortage in the spleen and kidneys,as well as a mutual accumulation of water and blood stasis.Zhenwu Decoction and Guizhi Fuling tablet are added to the prescription.Ms.Li’s clinical experience in the treatment of idiopathic edema is being shared with the fellow.

An introduction of the experience in treating Ventricular premature beat with stasis heat

Ventricular premature beat,a kind of arrhythmia,is one of common diseases which not only decreases the quality of life but also has the danger of death.The pathogenesis in Traditional Chinese Medicine is that the injury of heart and kidney is the essence and the block of solid evil such as phlegm and blood stasis is the manifestation.The teacher,Li Yuan,has worked in clinic for decades and considered that the important pathogenesis of the VP beat is“heat transformed from Yang”,which cannot be ignored as it is on the influence of diverse factors and can be observed in different symptoms and different treatment states of the disease.

Herbal medicine prescribing patterns from contemporary famous old TCM doctors for treating coronary heart disease: an analysis based on data mining

To analyze the herbal medicine prescribing patterns of contemporary famous old traditional Chinese medicine doctors in treating coronary heart disease,based on data mining technology,so as to provide useful insights into the clinical practice.Methods:Databases,including Medline(January 1966 to December 2019),Wanfang(January 1982 to December 2019),VIP Database(January 1989 to December 2019),CNKI(January 1979 to December 2019),CBMdisc(January 1978 to December 2019),and Classic Case Collection from Contemporary Famous Old Traditional Chinese Medicine Doctors were searched,and 224 eligible studies involving 416 patients were entered into the case study database after data processing.Frequency analysis and association rule analysis were used to investigate the prescribing patterns of contemporary famous old traditional Chinese medicine doctors in treating coronary heart disease.Results:In total 290 kinds of Chinese herbal drugs and 19 core drugs were used in the cases studied.The most commonly used categories were“Qi-Tonifying Drugs”,“Blood-Activating Drugs”,and“Phlegm-Eliminating Drugs”.The association rule analysis identified 14 commonly used herbal pairs,19 three-drug combinations,and 1 four-drug combination.Conclusion:Contemporary famous old traditional Chinese medicine doctors considered warming heart yang as an extremely important approach to treat coronary heart disease based on Zhang Zhongjing’s treatment for chest painful obstruction caused by“Inactivity of Chest Yang”(blockade of phlegm turbidity).Both symptoms and root causes were addressed in the formulas prescribed by these doctors.“Tonifying Qi,Nourishing Yin,Activating Blood,and Eliminating Phlegm”were the most commonly used therapeutic methods for patients with coronary heart disease.

Zhou Lamei's Experience in Treating Gout

Chief physician Zhou Lamei performs diagnosis and treatment according to syndrome differentiation,and proposes the method of combining internal treatment with external treatment of traditional Chinese medicine and paying attention to the adjustment of eating habits and lifestyle,which has certain advantages in relieving acute attack,reducing uric acid,reducing gout complications caused by disease development and reducing adverse reactions of western medicine,and is of great significance to the treatment of gout onset and hyperuricemia control.

张婷婷治疗子宫腺肌症痛证经验

子宫腺肌症的发病率逐年上升,其治疗是临床的难点。张婷婷教授治疗子宫腺肌症痛证,根据“瘀阻于内,不通则痛”的基本病机,口服汤剂采用“柴芍方”以疏肝行气、活血止痛;“红藤方”以清热凉血、散瘀止痛;“清瘀温通方”以寒温并用、化瘀止痛;“扶正祛瘀方”以益气扶正、祛瘀止痛。张婷婷临证还结合灌肠、足浴的方法,内外合治,长期管理患者,效果显著。

原发性干燥综合征合并血细胞减少中医诊治研究进展

原发性干燥综合征(pSS)是一种慢性炎症性自身免疫病,除累及外分泌腺之外,还可累及多器官、系统,其中以血液系统受累最为常见,多表现为一系或多系血细胞减少。目前对于pSS合并血细胞减少缺乏统一公认的治疗方案,西医治疗多以糖皮质激素、免疫抑制剂为主,而中医药治疗本病具有较好疗效。通过总结pSS合并血细胞减少的中医诊治经验,并对相关研究进行综述后发现,现代医家认为pSS核心病机为气阴亏虚,久之则产生热、毒、瘀等多种病理产物,相互影响,导致全身气血津液失常,引起血细胞减少。本病病位多责之于肝、脾、肾,治以滋阴、益气、养血之法,辅以清热解毒、化瘀通络之法,并根据其合并血细胞减少类型的不同以及是否使用糖皮质激素用药各有侧重。中医药治疗本病较西药治疗能够更好地改善血细胞水平且不良事件发生率更低,具有一定优势。

孙克伟教授辨证论治肝病的经验探析

孙克伟教授在长期临床诊治中总结发现,多种肝病殊途同归,提出“补脾土,疏肝解郁”“逐湿邪,热无所依”“补先天,解毒袪邪”“调气血,瘀滞得化”“温脾阳,截断逆挽”的学术经验,临床应用效果显著。该文将从以上五法探析孙克伟教授辨证论治肝病经验,旨在为肝病中医诊疗提供参考和借鉴。

朱永康治疗分化型甲状腺癌术后并发症的经验

介绍朱永康教授治疗分化型甲状腺癌(DTC)术后并发症的临床经验。认为DTC术后的中医治疗分为早期和远期两个阶段,早期重在治“虚”,远期治疗除缓解其他治疗带来的毒副作用外,将“伏邪”理论引入治疗中,同时注重既病防变、已病防传和病愈防复。并附验案1则。

谢德聪治疗妇科痛证临证经验

妇科痛证发生在少腹,以胞宫为中心,为厥阴、少阴、冲任二脉循行部位,责之“不通则痛,不荣则痛”,病因多端,虚实错杂,属于妇科疑难杂症。谢德聪认为治疗妇科痛证,注重病机,明辨虚实,临证重视调肝,养血柔肝,理气止痛,调理冲任。并遵月经生理特点与气血阴阳消长转化分期调治,经前治实,经后补虚,临床疗效显著。其诊疗思路和用药经验颇具特色,有重要的借鉴意义。

国医大师夏桂成论中医女性生殖节律理论的“节”和“律”

分述女性生命中五种节律(昼夜节律、周节律、月节律、年节律、生命节律)特征以及夏桂成教授基于生殖节律理论治疗妇科临床疾病的经验。昼夜节律是生命节律的基本单位,白天活动振奋阳气,夜间安睡静养阴血是最基本的养生准则。七为少阳数,女性的经期常持续7天,阴分充足“锦丝带”(像锦缎一样的阴道分泌物)也可达7天,更有助成孕。月经周期节律上应月下应潮,夏教授提出了经典的四期月经周期节律学说,后为了更好地描述阴阳变化,又将经典的四期分为七期,以更好地指导临床。并附验案1则。

浙派中医治疗痛经经验整理

[目的]总结1911年前浙派中医治疗痛经的经验,探究其特色。[方法]对浙派中医古籍文献中有关痛经的论述、病案等进行摘录整理,总结痛经病机及治疗特色。[结果]浙派中医治疗痛经以“气血失调”为主要病机,提倡以寒热虚实为纲的气血辨证法,从月经有无先后失期、经血色量如何、痛在经行前后三方面进行辨证。文献所记载的痛经证型共8种,分别为血气虚证、血虚有滞证、血虚有寒证、血虚有热证、冲任不足证、肝气郁滞证、气滞血瘀证、寒凝血瘀证,以“温通清化、调和血气”为治则。浙派中医发扬命门学说,擅用温药,记载痛经要药10味,分别为凌霄花、白芍、马鞭草、玄胡、京三棱、鹿角、阳起石、白头翁根、莲房、荷叶。[结论]浙派中医治疗痛经从“气血”立论,“温补”“清化”以治本,“调畅气血”为根本,以辨证论治、治病求本为宗。

吕晓东论治肺结节经验撷菁

总结吕晓东教授运用中医药治疗肺结节的临床经验和学术思想。吕晓东教授基于阳化气,阴成形的两个基本生理功能观,考察肺结节的发生、发展的病理环节,认为肺结节形成之机理复杂,病因纷繁,为阴分邪气积聚为肺,但病性基础变化总体以阳虚为关键,病理以气滞痰瘀胶着于肺络为核心。在肺络病的指导原则下,运用扶阳抑阴、通补肺络的手段,恢复阳主阴从,一气周流,肺络调和的生理状态,从而调复肺脏的异常功能状态、消弭肺结节的病理改变,恢复身心健康的目的,临床每获良效,具有推广应用的价值。