Clinical Effect of Modified Gegen Qinlian Decoction Combined with Western Medicine on Children with Rotavirus Enteritis with Damp-Heat Syndrome

[Objectives] To explore the clinical effect of Modified Gegen Qinlian Decoction combined with western medicine on children with rotavirus enteritis with damp-heat syndrome and its influence on myocardial enzymes.

Effect of the Haoqinqingdan decoction on damp-heat syndrome in rats with influenza viral pneumonia

Objective: To investigate the effect of Chinese medicine prescription-Haoqinqingdan decoction on damp-heat syndrome in rats with influenza viral pneumonia and its influence on the immune function. Methods: A total of 48 Wistar rats were randomly divided into the normal control group, the damp-heat syndrome model group, the Haoqinqingdan decoction group (high, medium and low dose group) and the ribavirin group. The body temperature and weight of rats in each group were recorded after modeling. After treatment for 6 d, the concentration of T lymphocyte subgroup (CD3+ CD4+ , CD3+ CD8+ ) was determined by flow cytometry. The OD value of IFN毭/IL-4 was detected by double-antibody sandwich ELISA method, and its concentration was acquired through conversion. Results: After modeling, the temperature and weight of rats in each modeling group showed the increasing trend ( P<0.01). From the second day of treatment, there was significant difference in the body mass between groups, and the rat weight of the control group was higher than in the modeling group ( P<0.05 or 0.01). With the advances of treatment, only the temperature in the medium and high dose Haoqinqingdan decoction groups declined significantly ( P<0.05). After treatment, the CD4+ /CD8+ ratio of the damp-heat syndrome model group decreased more significantly compared with the control group. Elevated CD3+ CD8+ percentages and declined CD4+ /CD8+ ratios can be observed in the low dose group and ribavirin group ( P<0.05). Moreover, the CD3+ CD4+ percentage of ribavirin group was lower than in the control group ( P<0.05). After treatment, the IFN-毭 and IFN-毭/ IL-4 levels in the peripheral blood of rats in the dampheat syndrome group were obviously higher than in the control group ( P<0.05). Conclusions: Compared with ribavirin, the high dose Haoqinqingdan decoction can improve the ratio of T lymphocyte subgroup and Th1/Th2 cell balance more effectively.

The role of endothelial biomarkers in predicting damp-heat syndrome in diabetic kidney disease

Objective:To explore the role of endothelial biomarkers in predicting damp-heat syndrome in diabetic kidney disease(DKD).Methods:A total of 183 patients with DKD were divided into 3 groups:the early DKD group,established DKD group,and advanced DKD group.All patients were classified according to traditional Chinese medicine(TCM)syndrome type,and clinical indexes were collected for statistical analysis.Results:A total of 183 DKD patients were included in this study.Fibroblast growth factor 23(FGF23),chitinase-3-like protein 1(CHI3L1),endocan,tumor necrosis factor receptor 1(TNFR1),secretory leukocyte protease inhibitor(SLPI),and vascular endothelial growth factor A(VEGF-A)were increased in advanced DKD.FGF23,CHI3L1,endocan,SLPI,and TNFR1 showed a negative correlation with estimated glomerular filtration rate(eGFR),while they had a positive correlation with 24 h urine protein.After adjusting for age,gender,diabetes duration,body mass index(BMI),hemoglobin,glucose,uric acid,24 h urine protein,cholesterol,triglyceride,low-density lipoprotein,and hemoglobin A1c(HbA1c),the multiple regression analysis showed that FGF23,endocan,TNFR1,and SLPI significantly correlated with eGFR.Conclusions:FGF23,endocan,TNFR1,and SLPI are elevated in advanced DKD compared with early stage,and they may take part in the pathogenesis and progression of DKD.Our study provides useful biomarkers for predicting the appearance of damp-heat syndrome,including FGF23,endocan,TNFR1,and SLPI.

Efficacy of Pidan Jianqing decoction in treatment of type 2 diabetes with spleen deficiency and damp-heat syndrome

Introduction:This study aimed to assess the clinical efficacy of Pidan Jianqing decoction in the treatment of type 2 diabetes.Methods:A total of 72 patients with type 2 diabetes differentiated as spleen deficiency with damp-heat syndrome were randomly assigned to a treatment group(n=35)or control group(n=32).Patients in the control group received diet and exercise guidance and medication in the form of 0.5 g metformin hydrochloride tablets,while patients in the treatment group received Pidan Jianqing decoction in addition to the treatment given to the control group.Efficacy was evaluated after 8 weeks of treatment.Results:Efficacy was 91.4%in the treatment group versus 68.8%in the control group,which was a statistically significant difference(P<0.05).Significant group differences were also noted in the number of patients with improvement in symptoms such as dry mouth and polydipsia,frequency of urination and polyuria,abdominal distention and loss of appetite,fatigue and weakness,and sticky stools(all P<0.05),with greater improvement in the treatment group compared to the control group.The fasting blood glucose(FBG)and 2 h postprandial blood glucose levels significantly improved in both groups after treatment(P<0.05);however,there was no significant difference in glycated hemoglobin levels before and after treatment in both groups.Conclusion:Pidan Jianqing decoction can lower blood glucose levels and improve symptoms in patients with type 2 diabetes.

Clinicopathological features and expression of regulatory mechanism of the Wnt signaling pathway in colorectal sessile serrated adenomas/polyps with different syndrome types

BACKGROUND Colorectal cancer(CRC)is the third most common cancer worldwide,with the fourth highest mortality among all cancers.Reportedly,in addition to adenomas,serrated polyps,which account for 15%-30%of CRCs,can also develop into CRCs through the serrated pathway.Sessile serrated adenomas/polyps(SSAs/Ps),a type of serrated polyps,are easily misdiagnosed during endoscopy.AIM To observe the difference in the Wnt signaling pathway expression in SSAs/Ps patients with different syndrome types.METHODS From January 2021 to December 2021,patients with SSAs/Ps were recruited from the Endoscopy Room of Shanghai Traditional Chinese Medicine-Integrated Hospital,affiliated with Shanghai University of Traditional Chinese Medicine.Thirty cases each of large intestine damp-heat(Da-Chang-Shi-Re,DCSR)syndrome and spleen-stomach weakness(Pi-Wei-Xu-Ruo)syndrome were reported.Baseline comparison of the general data,typical tongue coating,colonoscopy findings,and hematoxylin and eosin findings was performed in each group.The expression of the Wnt pathway-related proteins,namelyβ-catenin,adenomatous polyposis coli,and mutated in colorectal cancer,were analyzed using immunohistochemistry.RESULTS Significant differences were observed with respect to the SSAs/Ps size between the two groups of patients with different syndrome types(P=0.001).The other aspects did not differ between the two groups.The Wnt signaling pathway was activated in patients with SSAs/Ps belonging to both groups,which was manifested asβ-catenin protein translocation into the nucleus.However,SSAs/Ps patients with DCSR syndrome had more nucleation,higherβ-catenin expression,and negative regulatory factor(adenomatous polyposis coli and mutated in colorectal cancer)expression(P<0.0001)than SSA/P patients with Pi-Wei-Xu-Ruo syndrome.In addition,the SSA/P size was linearly correlated with the related protein expression.CONCLUSION Patients with DCSR syndrome had a more obvious Wnt signaling pathway activation and a higher risk of carcinogenesis.A high-quality colonoscopic diagnosis was essential.The thorough assessment of clinical diseases can be improved by combining the diseases of Western medicine with the syndromes of traditional Chinese medicine.

Logistic Regression Analysis of Damp-Heat and Cold Damp Impeding Syndrome of Rheumatoid Arthritis:A Perspective in Chinese Medicine

Objective： To investigate a method for quantitative differential diagnosis of damp-heat and cold-damp impeding syndrome of rheumatoid arthritis （RA） in Chinese medicine （CM）. Methods： Laboratory parameters were collected from 306 patients with RA. The clinical symptoms and laboratory parameters were compared between patients with these two syndromes （158 with RA of damp-heat impeding syndrome, and 148 with RA of cold-damp impeding syndrome）, and a regression equation was established to facilitate discrimination of the two RA syndromes. Results： There were significant differences in disease activity score in 28 joints [DAS28 （4）], erythrocyte sedimentation rate （ESR）, white blood cell count （WBC）, C-reactive protein （CRP）, platelet count （PLT）, albumin （ALB） and globulin （GLB） between the two syndrome of RA （P〈0.05）. Logistic regression analysis showed that the parameters ESR, WBC, CRP, joint pyrexia, joint cold, thirst, sweating, aversion to wind and cold, and cold extremities were statistically useful to discriminate damp-heat from cold-damp impeding syndrome. The regression equation was as follows： P=1/{1＋exp[-（3.0-0.021X1-0.196X2-0.163X3- 1.559X4＋1.504X5-0.927X6-1.039X7＋1.070X8＋1.330X9）]}. The independent variables X1-X9 were ESR, WBC, CRP, hot joint, cold joint, thirst, sweating, aversion to wind and cold, and cold limbs. A P value 〉 0.5 signified cold-damp impeding syndrome, and a P value 〈 0.5 signified damp-heat impeding syndrome. The accuracy was 90.2%. Conclusion： The regression equation may be useful for discriminating damp-heat from cold-damp impeding syndrome of RA.

Objective Tongue Inspection on 142 Liver Cancer Patients with Damp-Heat Syndrome

Objective： To establish the diagnosis evidence of objective tongue inspection for liver cancer （LC） patients with damp-heat syndrome （DHS） by dynamically observing their tongue figures using modern tongue image analytic apparatus, and to explore the effect of intervention on the tongue figures. Methods： Tongue figures were collected from 142 LC patients with DHS by tongue image analytic apparatus. Red （R）, green （G） and blue （B） values were analyzed. The r and g values were calculated requesting r=R/（R＋G＋B）, g=G/（R＋G＋B）, and b=l-r-g, and scored in combination with Chinese medical symptoms scale. The tongue figure and correlated scores were collected from 59 of them 3 days after transcatheter arterial chemoembolization intervention. Results： The range of objective tongue inspection of LC patients with DHS was as follows： as for tongue fur, 0.360〈r〈0.402 and 0.280〈g〈0.322; as for tongue proper, 0.404〈r〈0.470 and 0.243〈g〈0.301. The tongue figures and the average scores of quality of life, DHS, poor appetite, aggravated pain, decreased sleep quality and aggravated fever were obviously changed in the 59 LC patients with DHS after intervention, showing statistical difference when compared with before intervention （P〈0.05 or P〈0.01）. Conclusion： The range of objective tongue inspection of LC patients with DHS could be known by collecting and analyzing objective indicator of tongue figures, thus laying foundation for further studies with analysis of correlation between intervention and Chinese medicine based on tongue figures.

中医证候量表研制方法概述

辨证论治是中医的精髓,但长期以来证候的客观化、标准化在一定程度上成为中医理论体系继承和发展的桎梏。借鉴现代医学、心理学的量表制订方法,根据中医辨证的特色和思维规律,研制出符合中医基本理论和临床实际的中医证候量表,逐渐成为中医临床诊治的一个量化评价的重要手段。本文基于目前中医证候量表研究的成果,阐述中医量表研制的具体方法,并且提出在中医证候量表研制过程中需注意的关键问题。

《医门■要》主要内容的统计分析

对《医门■要》的作者进行了初探,介绍该书结构并对该书所论病证(症)、方剂学、脉学内容进行了统计分析;提出该书具有丰厚的医学理论和临床经验,是研究滇南医学的重要著作。

沈舒文教授基于“三维六纲”辨治慢性萎缩性胃炎经验

慢性萎缩性胃炎(CAG)是临床常见病、多发病,具有起病隐匿、病因多端、病理变化复杂、病程长、治疗效果欠佳、迁延难愈等特点。沈舒文教授基于多年临床经验,提出了“三维六纲”的辨治方法,将虚实、寒热、滞逆六纲贯穿于证候病理结构的病因、病性及病势三个维度,执简驭繁,认为脾胃虚弱是CAG病机之根本,气机郁滞是CAG发生、发展之关键,认为“通降胃气,胃降脾自升”为治疗关键,并强调时时顾护胃气,活用益气养阴,补虚调滞;清泻湿热,开化气机;消散痰瘀,促食纳谷等治法,在临床应用中卓有成效。本文介绍沈舒文教授基于“三维六纲”辨治慢性萎缩性胃炎经验,并附医案1则加以佐证,以飧同道。

余国珮“燥湿为纲”临床诊治特色初探

清代新安医家余国珮集前贤诸家之长结合自身临床经验首倡"燥湿为纲"理论,以"燥湿"二字对疾病的病因病机、诊断要点、辨证用药进行了系统而详细的阐述,并将其理论应用于内外各科病症的治疗,疗效甚佳。余国珮"燥湿为纲"理论为一套理法方药完备的临床思想,独具临床特色,极大地丰富和发展了中医学有关燥湿二气的病因病机和辨证论治理论体系,兹对其"燥湿为纲"理法方药思想进行探讨和总结,以期指导临床相关疾病的诊治。

刘英锋论“六经提纲”活用之法

针对《伤寒论》困惑古今的“六经提纲”意义之争,刘英锋教授秉承先师姚荷生伤寒学疾病分类的学术思想,提出基于正确认定六经生理实质与各经病证常变分类的基础上,对六经提纲分别进行大义解析,以求准确理解条文本义,并剖析各经疑惑所在,建立既知守常之法又懂通变之例的辩证思维观念,对太阳、厥阴二经的变证进行示范性重点举例论述,达到举一反三的目的,以期拓展辨证视野,丰富诊治思路,发挥并拓展六经提纲在指导临床辨证中的实际作用。

《伤寒论》“胃家实”探讨

“阳明之为病,胃家实是也”作为“阳明病篇”提纲证,其解读历来存在争议,争议点主要围绕“胃家”的代指及“实”字的含义两点展开。由于“胃家实”作为提纲证统摄“阳明病篇”全篇,是准确把握阳明病证之机要与理解“阳明病篇”立法处方的切入点,因此有必要对“胃家实”的概念进行考据并结合临床情况阐发其实践应用。该文从训诂学及中医经典理论角度出发,结合临床阐释“阳明之为病,胃家实是也”的内涵,并由此展开针对“阳明病篇”第179~181条的讨论,概括总结“阳明病篇”的方证主治以及主要的治法思路,以期对经方之理论研究及临床应用作有益探讨。

胡希恕六经辨证理论体系浅解少阳病提纲及临证体会

著名经方家胡希恕先生和其弟子首都国医名师冯世纶教授的研究指出:中医有两大理论体系--以《伤寒论》为代表的经方医学理论体系和以《黄帝内经》为代表的医经理论体系,即六经辨证体系与脏腑辨证体系。胡老为研究《伤寒论》倾注了毕生心血,他发展经方六经辨证体系理论,有独特见解,取得了世人瞩目的成就。此文依据胡老和冯老的理论体系,浅析《伤寒论》中第96条、第97条、第263条等关于少阳病提纲的条文。由于少阳病临证涉及面非常广泛,所以根据上述提纲来指导临床判断少阳病、治疗典型和常见的少阳病,将咳嗽、胸闷心悸、慢性鼻炎、慢性咽喉炎、梅核气、消化不良、慢性胃痛、慢性头晕头痛、睡眠障碍、焦虑抑郁、更年期潮热等呼吸系统、心脑血管系统、消化系统、眼耳鼻喉五官科以及妇科病症等多系统诸多病症联系起来,并阐述临床应用心得,理论指导临证实践,从而提高临床疗效。

张山雷《疡科纲要》治痈疡学术思想再认识

张山雷是中国近代著名中医教育家、著作家、中医药学家,中西医汇通重要代表人物之一。《疡科纲要》是张山雷在继承嘉定黄墙痒科之学并结合自己多年实践之结晶于兰溪所著中医外科学经典教材,书中充分反映了先生在外疡的辨证和治疗上,提倡外证内治、首重“阴阳辨证”“贵消畏托”“反对一方套治”等学术思想,同时其还开创中西医药物联用方法治疗外科疾病的独特理论见解,在当时有标识新论之意,并至今仍对我们后人在中医痈疡治疗和临床实践上有着启迪和指导作用。

Assessment of Clinical Effect of Therapy Combining Disease with Syndrome on Rheumatoid Arthritis

Objective： To observe the effectiveness and safety of a therapy combining disease with syndrome on rheumatoid arthritis. Methods： Eighty patients with rheumatoid arthritis belonging to syndrome of damp-heat obstruction were randomly divided into a treatment group and a control group according to stratified blocked randomization method.Forty cases in the control group orally took Loxoprofen Sodium Tablet and Leifumite Tablet and the other 40 cases in the treatment group orally took a Chinese medicine for 12 weeks as a course of treatment. ACR therapeutic effect was used as the standard for evaluating the total therapeutic effect. Results： After l 2 weeks of treatment, there was a statistical difference （P〈0.01） in the improvement of VAS score, morning stiffness time, number of swelling joints, index of swelling joints, number of joints with tenderness, index of joints with tenderness, average grip strength of both hands, DSA28 score, HAQ, patient＇s assessment, physician＇s assessment, ESR, CRP and RF in both groups. The improvement of morning stiffness time, number of swelling joints, index of swelling joints, grip strength, HAQ and patient＇s assessment in the treatment group was much better than that in the control groups with statistical difference （P〈0.05）. ACR20, ACR50 and ACR70 was 27.5% （11/40）, 37.5% （15/40） and 22.5% （9/40） respectively in the treatment group and 40% （16/40）, 27.5% （11/42） and 10.0% （4/40） respectively in the control group with statistical difference （P〈0.05） in the superiority of the treatment group over the control group. The incidence of adverse reaction in the control group was higher than that in the treatment group （P〈0.05）. Conclusion： Definite therapeutic effect and high safety can be achieved in using the therapy combining disease with syndrome to treat rheumatoid arthritis belonging to syndrome of damp-heat obstruction.

Potential Mechanism and Application of Strengthening the Spleen, Clearing Heat and Dampness in Treatment of Gastroesophageal Reflux Disease

Gastroesophageal reflux disease(GERD)is one of refractory digestive disease in clinic characterized by high prevalence,complex and recurrent symptoms.Traditional Chinese medicine(TCM)has a significant effect on the treatment of GERD.Spleen deficiency and damp-heat syndrome becomes one of the main syndrome patterns of GERD adapting with the changes of modern lifestyle.Although the therapy of strengthening the spleen,clearing heat and dampness is widely used in treatment of GERD,further studies still need to be conducted.The article comprehensively analyses the theoretical basis,mechanism and clinical efficacy of the therapy in order to provide more ideas for clinical treatment.

伤寒学术流派划分及代表性流派发展脉络探微

伤寒流派,可定义为伤寒学派之下因研究对象、研究方法、核心学术问题认知不同,从而形成的有特色、有传承、有创新、有代表性医著的医家群体。历代医家从不同角度对《伤寒论》进行研究,其医著或研究的对象各有侧重(如证候、辨证、治法、经方、文献、医案等),或研究的方法各不相同(如注解、发挥、重订等),或对某些关键学术问题看法不一(如伤寒概念、寒温关系、三纲鼎立、错简重订等),这些医家在继承前人学说的同时,多有突破创新,从而形成不同特色的“流派”。其中,影响力较大、有一定特色、有代表性著作、传承脉络清晰的伤寒流派有重订派、增补派、证候派、广义伤寒派、八纲派、气化派等。

少阳病提纲证的病机及治疗探析

文章对少阳病提纲证的病机特点进行了剖析,并对主证进行了归纳,阐述了其与少阳病柴胡证的区别;同时对其治疗禁忌、治疗原则和方法进行了梳理,丰富了少阳病提纲证的治疗内容。

内窥镜诊治臂丛神经血管受压征入路的解剖学研究

目的探讨用内窥镜诊治臂丛神经血管受压征的可行性，寻找到达第１肋骨前中斜角肌止点的最佳入路。方法取陈旧尸体２０具４０侧，新鲜尸体１５具３０侧。在锁骨下距胸锁关节４ｃｍ处作１ｃｍ长的皮肤横切口，测量自入路点到达第１肋骨前、中斜角肌止点的距离，解剖肋锁间隙的组织结构及入路的毗邻关系。结果自皮肤至第１肋骨的入路中无血管神经通过，内窥镜自锁骨下静脉、动脉，臂丛神经下干与第１肋骨之间间隙可顺利到达前、中斜角肌止点。结论该手术入路是内窥镜到达前、中斜角肌在第１肋骨止点的最佳入路。