Traditional Chinese medicine prescriptions and herbs for the treatment of hypothyroidism:a narrative review

The increasing prevalence of hypothyroidism,which can cause endocrine dysfunction,abnormal neurological function,and cardiovascular and cerebrovascular injuries,poses serious health problems.Thyroid hormone supplementation constitutes the current main therapeutic method for hypothyroidism,yet it has many limitations and risks and is not suitable for everyone.Therefore,it is necessary to seek alternative and complementary treatment methods.It has been proven in practice that traditional Chinese medicine(TCM)possesses multi-channel comprehensive characteristics for the treatment of hypothyroidism and has more advantages than single thyroid hormone supplementation.Through a comprehensive examination of existing literature about TCM efficacy in addressing hypothyroidism,we have meticulously consolidated the most recent research findings on prescriptions and herbal substances employed in the treatment of this condition.Furthermore,we have explicated their respective functions in the management of hypothyroidism,thereby offering valuable perspectives and recommendations for the prospective utilization of natural remedies in its treatment.

China Association of Chinese Medicine Paper notice for seminar on clinical application of TCM classic prescriptions and herbs in the treatment of emotional diseases

Hosted by ChinaAssociation of Chinese Medicine,and organized by World Journal of Integrated traditional and western Medicine,seminar on clinical application of TCM classic prescriptions and herbs in the treatment of emotional diseaseis planned to be held in Yichang,Hubei province from June 22nd to 24th.

7576张含丹参-当归药对的门诊中药饮片处方回顾性分析

目的:了解江苏省中西医结合医院南部院区/南京市溧水区中医院(以下简称“该院”)含丹参-当归药对的门诊中药饮片处方情况,探究该药对的临床配伍应用规律,为该药对的合理使用提供参考。方法:采用回顾性分析方法,统计2020—2022年该院使用丹参-当归药对的7576张门诊中药饮片处方,对患者的性别、年龄、处方药味数、金额、疗程、涉及科室及病症、使用剂量、常用的配伍比例及配伍饮片等相关内容进行统计分析。结果:7576张含丹参-当归药对的门诊中药饮片处方中,女性患者处方数约为男性患者处方数的3.21倍(5776张vs.1800张),>30~40岁患者居多。单张处方的中药饮片味数多集中在16~20味,开具的疗程均<30 d。丹参的使用剂量为《中华人民共和国药典》规定的10~15 g的处方有6490张,占85.67%;当归的使用剂量为《中华人民共和国药典》规定的6~12 g的处方有6608张,占87.22%。处方数排序居前3位的科室依次为国医堂、妇科及脑病科,治疗的病证以冲任失调、心脾两虚及气滞血瘀证为主。单张处方中丹参用量大于等于当归用量,丹参与当归的配伍比例以1∶1为多,高频配伍饮片为茯苓、川芎、炒白芍。结论:基于处方用药分析,该院含丹参-当归药对的门诊中药饮片处方基本合理,为丹参-当归药对的使用剂量范围及配伍规律研究提供了数据支持,有利于促进临床合理用药。

A brief overview of traditional Chinese medicine prescription powered by artificial intelligence

Traditional Chinese medicine prescription is one of the treasures of traditional Chinese medicine(TCM).There are tens of thousands TCM prescriptions accumulated in the past thousands of years,corresponding to different diseases,symptoms and therapeutic goals.The correspondences are so complicated that there is an urgent need to leverage new technologies such as artificial intelligence(AI)to analyze,understand and utilize them effectively.In this paper,we present a brief overview of this direction,where current research progress on TCM prescription powered by AI is summarized.Our summarization focuses on three aspects,TCM prescription mining that aims at understanding the TCM prescription,TCM prescription or herb knowledge base construction that aims at extracting knowledge to support the TCM prescription-related study,and TCM prescription discovery that aims at utilizing AI technologies to further energize TCM.It is encouraging to see that steady progress in this direction has been made recently.Besides,a toy experiment on image-based TCM herb recognition by using convolutional neural networks is also conducted.It basically verifies that it is promising to use AI technologies to address challenging tasks in TCM.We also point out several research topics that could be cooperatively performed by researchers from the two disciplines.

Applicability of Zipfs Law in Traditional Chinese Medicine Prescriptions

Objective Traditional Chinese medicine(TCM)prescriptions have been used to cure diseases in China for thousands of years,in which many TCM herbs have no definite common quantity.Some key TCM herbs are commonly used and thus deserve in-depth investigations based on a more acceptable classification method.This study analyzes whether TCM prescriptions follow Zipf's law and attempts to obtain the thresholds of key TCM herbs based on the application of Zipfs law;Methods A total of 84,418 TCM prescriptions were collected and standardized.We tested whether Zipf's law and Zipfs distribution fit the Chinese herb distributions.A linear fitting experiment was performed to verify the relationship between the frequency distribution and frequency of TCM herbs.Results The distribution of TCM herbs in TCM prescriptions conformed to Zipf's law.Accordingly,the thresholds were obtained for the key TCM herbs.Conclusion The distribution of TCM herbs in TCM prescriptions follows Zipfs law.

Research ideas and strategies on the dose-effect relationship of traditional Chinese medicine prescriptions and herbs

We discuss here the complexity of the doses of traditional Chinese medicine(TCM) prescriptions and herbs from different viewpoints,including the heterogeneity of drug quality,the flexibility of prescriptions,and the diversity of drug effects.Then,the corresponding research ideas and strategies are proposed.We can reveal the actual situation of clinical doses based on in-depth "real-world study" of the safety and effectiveness of TCM prescriptions,create an analytical method for dose-effect relationships in accordance with the features of TCM,and reveal the correlated regular nature of the effectiveness and dosage of TCM prescriptions and herbs.

旋覆代赭汤及其拆方对反流性食管炎模型大鼠COX-2表达的影响

目的观察旋覆代赭汤及其拆方对反流性食管炎(RE)模型大鼠环氧合酶-2(COX-2)表达的影响。方法将90只Wistar大鼠留取10只为正常对照组(正常组),其余80只行"食管十二指肠端侧吻合术"后,随机分为6组,即模型组、旋覆代赭汤全方组(全方组)、辛开中药治疗组(辛开组)、甘补中药治疗组(甘补组)、咸降中药治疗(咸降组)、西药对照组(西药组),连续给药21天后,观察各组大鼠食管黏膜COX-2的表达情况。结果与正常组比较,模型组、辛开组、甘补组差异有统计学意义(P<0.05);与模型组比较,除辛开组外,其他各用药组差异有统计学意义(P<0.05);与西药组比较,辛开组差异有统计学意义(P<0.05);与全方组比较,辛开组、甘补组差异有统计学意义(P<0.05);与辛开组比较,甘补组、咸降组差异有统计学意义(P<0.05);与甘补组比较,咸降组差异有统计学意义(P<0.05)。结论旋覆代赭汤全方组、咸降中药治疗组药物可抑制细胞中的环氧合酶-2表达,逆转模型大鼠食管黏膜组织形态学病变,且作用优于辛开组、甘补组药物。

9对“对药”和非“对药”间多分子体系紫外-可见光谱分析

目的 :探讨常用中药的组合——“对药”和非“对药”间 ,在化学成分、分子结构、构型、构象方面的相似性差异。方法 :(1 )按中药多分子体系的脂溶性差异 ,分为石油醚、氯仿、乙酸乙脂、乙醇和水的溶出性成分集合 ,然后进行“对药”与非“对药”的对比分析 ;(2 )用紫外 -可见光光度计测定吸收光谱曲线。结果 :分析2 2 5份样品 ,约 1 30 0个数据 ,9对“对药”中有 6对分别显示 :紫外 -可见光吸收光谱峰的分布区域重叠较大 ;相同波峰数和相同波谷数较多 ;组合后吸收光谱曲线下面积增加趋势较大。结论 :提示化学成分相近 ,分子结构或构型、构象相似是中药 (植物药 )组方配伍的原则之一。

癌痛消方中活血化淤药对大鼠移植性肝癌细胞中Fas、FasL及Caspase-3蛋白表达的影响

目的探讨癌痛消方中使用的大剂量活血化淤药物对肝癌细胞凋亡因子的影响,进一步明确其在抗肿瘤方面的作用机制。方法将40只Walker-256移植性肝癌大鼠模型随机分为4组,即癌痛消全方组、活血化淤药组、非活血化淤药组及模型组,于造模后第8天给药,连续用药14 d后停药24 h,处死大鼠,并取出适量肿瘤组织行流式细胞JC-1染色法检测,并取出适量瘤块行免疫组化法检测其中Fas、FasL、Caspase-3蛋白的表达情况。结果肝癌细胞线粒体膜电位下降的细胞比值(JC-1+%)在活血化淤药组中为(22.34±1.94)%,与癌痛消全方组、非活血化淤组两两比较,差异均显著(P=0.000),与模型组比较,差异无统计学意义(P=0.093)。Fas、FasL和Caspase-3蛋白在活血化淤药组的表达情况与模型组比较,差异无统计学意义(P=0.835、P=0.584和P=0.820);与癌痛消全方组和非活血化淤药组两两比较,差异均有统计学意义(P<0.01或P<0.05)。三者蛋白表达情况与细胞凋亡检测结果相一致。结论单独使用癌痛消方中大剂量活血化淤药不能明显影响Fas、FasL和Caspase-3蛋白在肝癌细胞中的表达,不能明显干扰细胞凋亡网络信号从而促进肝癌细胞的凋亡,有必要与其他具有抗肿瘤作用药物联合使用。

Discovery of Regularities in the Use of Herbs in Chinese Medicine Prescriptions

Chinese medicine （CM） is a discipline with its own distinct methodologies and philosophical principles. The main method of treatment in CM is to use herbal prescriptions. Typically, a number of herbs are combined to form a formula and different formulae are prescribed for different patients. Regularities in the mixture of herbs in the prescriptions are important for both clinical treatment and novel patent medicine development. In this study, we analyze CM formula data using latent tree （LT） models. Interesting regularities are discovered. Those regularities are of interest to students of CM as well as pharmaceutical companies that manufacture medicine using Chinese herbs.

基于中医传承计算平台探索含“白芍-甘草”药对的成方制剂的组方证治规律

目的分析含有“白芍-甘草”药对的成方制剂,得到其药物组成及主治疾病的核心组合和用药规律,为“白芍-甘草”药对的临床辨证应用及新药研发提供参考。方法收集并整理《中华人民共和国药典:2020年版一部》和《中华人民共和国卫生部药品标准·中药成方制剂》中收录的组成中含有“白芍-甘草”药对的成方制剂,提取其处方组成、主治中医疾病、中医证候,录入中医传承计算平台(V3.0),统计用药频次、四气五味、归经及二者剂量比例;运用Apriori算法及关联规则对所治高频疾病的遣方核心组合进行统计分析(支持度设置为15%-50%)。结果共提取出184首含“白芍-甘草”药对的成方制剂,涉及组成药物319味,其性味以苦、甘居多,归脾肝肺经,主治中医证候为气血两虚、肝胃不和、肝郁脾虚等;常用药材组合19种(频次≥30),其中核心药材组合包括白芍-甘草-当归、白芍-甘草-白术、白芍-甘草-茯苓、白芍-甘草-当归-白术等,其中白芍-甘草最常见的剂量比例为1∶1。结论通过中医传承计算平台分析了含“白芍-甘草”药对的成方制剂,反映了其组方配伍特点及用药规律,为该药对的临床应用及后续开发提供研究思路。

中医概念“方”“药”初义求真——以简帛“方”“药”用法为中心

“方”“药”是中医学重要的基础概念。古代“方”的得名原由,中医界有普遍的误解;古代的“方”与当今的“方剂”概念的关系,也未能真正理顺。古代“药”的初义与当今的“中药”概念也并不等同。单药方属药还是属方(方剂),在当今方剂学研究中存在较大认识偏差。通过对简帛及早期医药文献、文史文献中的相关用例进行梳理、分析,以上问题可以得出较为清晰的答案,从而有助于理解古代医药文献、阐明中医学术中的某些疑难点。

中药治疗早期股骨头坏死的组方规律和研究进展

目的:探讨近12年来中药治疗早期股骨头坏死的用药组方规律,并综述目前相关中药治疗早期股骨头坏死的国内外研究进展,为临床应用中药治疗早期股骨头坏死和进一步的实验研究提供参考。方法:检索2010年1月1日至2022年10月15日中国期刊全文数据库(CNKI)、万方数据知识服务平台(Wangfang Data)、维普中文期刊服务平台(VIP)和PubMed收录的关于中药治疗早期股骨头坏死的临床研究文献,提取中药处方,建立中药处方数据库,运用Microsoft Excel 2010、SPSS Statistics 19和SPSS Modeler 15.0,采用描述性分析、聚类分析和关联规则分析等数据挖掘方法进行分析。结果:在42条中药处方中共出现了166种中药,总频次为591次;得到5个有效聚类群,其中当归和牛膝各为一个聚类,甘草、黄芪、川芎、红花、熟地黄、丹参、骨碎补、杜仲和续断为一个聚类,鹿角胶、乳香、白芍、鸡血藤和淫羊藿为一个聚类,其余20味药物为一个聚类;得到10个高价值中药组合,分别为乳香-没药、鸡血藤-威灵仙、白芍-柴胡、鸡血藤-威灵仙-白芍、鸡血藤-生地黄-桂枝、鹿角胶-菟丝子-赤芍、补骨脂-菟丝子-桂枝、乳香-没药-补骨脂、乳香-没药-淫羊藿和乳香-没药-鹿角胶。结论:近10年来中药治疗早期股骨头坏死主要选用补虚药和活血化瘀药,高价值对症治疗中药组合较多,且均符合早期股骨头坏死的常见症状,同时一些单味中药值得进一步的基础研究。

Multistage analysis method for detection of effective herb prescription from clinical data

Determining effective traditional Chinese medicine （TCM） treatments for specific disease conditions or particular patient groups is a difficult issue that necessitates investigation because of the complicated personalized manifestations in real-world patients and the individualized combination therapies prescribed in clinical settings. In this study, a multistage analysis method that integrates propensity case matching, complex network analysis, and herb set enrichment analysis was proposed to identify effective herb prescriptions for particular diseases （e.g., insomnia）. First, propensity case matching was applied to match clinical cases. Then, core network extraction and herb set enrichment were combined to detect core effective herb prescriptions. Effectiveness-based mutual information was used to detect strong herb symptom relationships. This method was applied on a TCM clinical data set with 955 patients collected from well-designed observational studies. Results revealed that groups of herb prescriptions with higher effectiveness rates （76.9% vs. 42.8% for matched samples; 94.2% vs. 84.9% for all samples） compared with the original prescriptions were found. Particular patient groups with symptom manifestations were also identified to help investigate the indications of the effective herb prescriptions.

中药外洗癣病方联合复方酮康唑软膏治疗手足癣临床观察

目的:观察中药外洗癣病方联合复方酮康唑软膏治疗手足癣的疗效。方法:132例分为两组,对照组61例用复方酮康唑软膏治疗,观察组71例用中药外洗癣病方及复方酮康唑软膏治疗。结果:总有效率观察组高于对照组(P<0.05)。治疗14d后临床症状积分观察组低于对照组(P<0.05)。治疗后1个月、3个月复发率观察组均低于对照组(P<0.05)。不良反应发生率观察组与对照组比较差异无统计学意义(P>0.05)。结论:中药外洗癣病方联合复方酮康唑软膏治疗手足癣有良好疗效,且不增加不良反应。

《清宫医案集成》中熏洗方运用初探

[目的]探究《清宫医案集成》中熏洗方治疗疾病的特殊性和有效性,为现代临床外治法提供参考。[方法]以《清宫医案集成》中117首熏洗方为研究对象,运用Excel软件,对清宫熏洗方的组成、剂量、药性、功效进行整理统计,并结合该书中的相关医案及按语,对熏洗方在清宫中的特色运用进行系统整理。[结果]《清宫医案集成》中的117首宫廷熏洗方在遣方用药上展现出种类繁多、质量上乘,方简药精、效专力宏,随证加减、用药灵活,治病为先、不拘药量,善用风药、不避毒药等多种特色;且另有受众广泛、方式独特、器具考究、药液制备过程细致等其他优势。[结论]《清宫医案集成》中的熏洗方颇具宫廷特色及优势,对其运用展开探索能够获得独特的见解和启示,有助于发扬宫廷用药特色,促进中医药外治疗法的发展,具有较高的研究价值。

中医药在糖尿病合并勃起功能障碍治疗中的应用及思考

随着糖尿病的发病趋于年轻化,糖尿病性勃起功能障碍(diabetic mellitus erectile dysfunction,DMED)发病率逐渐较高,现代医学治疗存在一定的局限性,部分患者可能出现一定的不良反应,这影响DMED的治疗。中医药治疗DMED可以有效缓解患者症状,降低现有药物不良反应,辅助降糖。现代医家多采用辨证论治,分型组方,运用单味药、药对、中药提取物、经方验方、中成药进行个体化治疗。现通过概述中药的多种组方思路,总结其优势,并对中医药治疗DMED的现状进行思考与总结,为中医药治疗DMED得到更好的发挥。

经方药对在子宫内膜异位症治疗中的应用及规律探析

目的挖掘经方药对在子宫内膜异位症(EMs)治疗中的应用及规律。方法收集2018年1月1日至2022年12月31日在北京中医药大学第三附属医院妇科就诊的EMs患者的结构化电子病历信息,纳入使用含经方药对处方干预的数据资料,构建数据库。梳理经方中药,并统计频次、药性、药味、归经及功效,明确高频中药。通过IBM SPSS Modeler 18.0对EMs用药进行Apriori关联规则分析。采用IBM SPSS Statistics 26对高频药物进行聚类分析和因子分析。结果共纳入EMs患者376例,896张中医处方,涉及292味中药,总使用频次14703次,其中经方中药79味,累计频次为7571次,占51.49%。获得高频中药30味,以活血化瘀药、补虚药、清热药、理气药居多,包括麦芽、牡丹皮、当归、熟地黄等,药性以温、寒、平为主,药味以苦、辛、甘为多,归经主入肝、脾经。共产生2441条有效的关联规则,其中对药81条。聚类分析将高频中药分为6类,因子分析产生6个公因子。最终预测形成一个潜在处方,由20味中药组成,包括肾气丸、温经汤、当归芍药散和薏苡附子败酱散4首经方的主要药味。结论中医药治疗EMs以补虚化瘀为主,常选用活血化瘀、温阳补虚、理气化痰类中药,体现了EMs阳虚瘀结的病理特点。经方药对在EMs治疗中较常应用,结合临床也产生了一些新的药对,并预测形成1个用治EMs的可能处方,为中医药治疗EMs遣方用药提供了依据和参考。

基于多标记学习的中医药方功能预测研究

中医是西方医学之外,一门独立的医学体系。经过几千年的发展,中医领域已经积累了大量成熟的医药方剂,如何从这些中医药方中提取出有意义且潜在有用的知识,是目前机器学习及数据挖掘领域所关注的诸多热点应用问题之一。论文考虑采用多标记学习技术建立中医药方与药方功能间的映射关系,从而开发相对精确的中医药方功能预测模型。通过多种多标记学习算法在超过一千个成熟的中医药方上的建模结果显示:多标记学习技术有能力相对精确地根据中医药方预测其功能。

基于药对探讨中药复方配伍规律的思考

复方的配伍规律是中药方剂理论的核心问题。近年来,药对配伍研究已成为继拆方试验和正交试验之后方剂配伍规律研究的又一重点取向。从复方中特定两味药的配伍形式——药对出发,阐述药对理论的历史渊源、药对的组成方式(包括四气配对、五味配对、归经配对、引经配对、毒性配对、升降浮沉配对、七情相合配对等),以及药对在复方配伍规律研究中的作用。通过以上研究表明,从药效物质基础、作用机制、临床配伍应用等方面对药对的配伍展开系统而深入的研究,不仅对于理解药对配伍理论具有重要意义,而且对于复方配伍规律的研究具有重要价值。