Research on the treatment based on syndrome differentiation of COVID-19 according to the theory of Guangwenyilun

COVID-19 is highly infectious and epidemic,which belongs to the"plague"disease of traditional Chinese medicine and seriously endangers the safety of human life.Based on the theory of Guangwenyilun combined with the treatment experience of COVID-19 in TCM,syndrome differentiation-based treatment and the clinical characteristic of COVID-19 is being deeply analysed.COVID-19 began because of the"epidemic pathogenic factors",and the pathogenesis is that the dampness and heat generated toxin which blocked the qi movement.The early onset of this disease is in the pleurodiaphragmatic interspace,and its transmission can be divided into sequential transmission and reverse transmission.Regardless of the direction of its transmission,grasping the transmission of"epidemic pathogenic factors"on the diagnosis and treatment combined with"five distinguishing thought,exterior and interior,accompanying symptoms"theory will be of great importance to help to improve the effect of treatment.At the same time,this clinical approach will also provide reference for the diagnosis and treatment of any possible new diseases.

Discussion on the thinking innovation of the “Treatment based on syndromedifferentiation” according to “Precision medical”

Based on the concept of ＂precision medicine＂, this paper is to probe into the thinking innovation thought anddevelopment direction of ＂dialectical theory＂ of TCM, and to compare the development prospects of ＂syndromedifferentiation＂ and ＂genetic constitution＂. It points out that the dialectical concept of ＂syndrome differentiation andtreatment＂ is combined with the concept of high and new technology of ＂precision medicine＂ to further clarify thescientific connotation of traditional Chinese medicine.

Progress of traditional Chinese Medicine on ADHD Treatment Based on Syndrome Differentiation

Attention-Deficit Hyperactivity Disorder(ADHD)is a common neurodevelopmental disorder in childhood.Syndrome differentiation for ADHD in traditional Chinese medicine is complex without common uniform,it is important to propose unified standards.Based on the principle of syndrome differentiation,this article focused on the different names of different syndrome differentiation methods but the same essence,and summarized Chinese medicine compounds according to syndrome factors.By collecting relevant literature on ADHD treatment with Chinese herbal compound in recent years,ADHD is classified into 7 different syndrome types,and Chinese herbal compound is classified correspondingly for reference and selection of clinical treatment of ADHD.

Analysis on the law of differentiating and treating insomnia by physicians based on cluster analysis of drug syndrome

Objective:To explore the general differentiation and treatment of insomnia by Professor Gao Ying through drug clustering and group correspondence analysis,and provide reference for clinical diagnosis and treatment.Methods:Collect retrospective case data from outpatient system,use SPSS20.0 software to perform frequency and cluster analysis on high-frequency symptoms and drug data,and perform corresponding analysis on the clustered drug syndrome groups.Results:A total of 349 consultations in 204 patients were included.Cluster analysis of 35 symptoms and 40 flavors with a frequency of more than 10%resulted in a corresponding relationship between 7 symptom groups,6 drug groups and 5 drug syndrome groups.The medicine symptom group has a high degree of matching;the doctors distinguish and tre at insomnia with calming,clearing heat,nourishing yin,liver,spleen,qi and phlegm as the core treatment,with consistent decoction,two to pill,lily ground Huang Tang,Lily Zhimu Decoction,Wendan Decoction,Sini San,Xiao Chai Hu Tang,Xiaoyao San,etc.are commonly used prescriptions;the physician's experience is to add or subtract Danshen and Zao Ren drink,which has a wide range of applicability to various insomnia syndrome.Conclusion:Based on the cluster analysis of drug symptoms and group correspondence analysis,it can reveal the pathogenesis,treatment and class information hidden in the data of drug symptoms,which can reflect the general law of physicians'syndrome differentiation and treatment of insomnia.This method has a reference for the exploration of TCM clinical experience significance;The results of this study can provide feedback to guide the clinical diagnosis and treatment of insomnia.

The combination of disease and Zheng (syndrome) on the basic of differentiation of six channels:a new pattern of disease diagnosis and treatment of traditional Chinese medicine

Traditional Chinese medicine(TCM)was formed two thousand years ago,and developed in the following centuries.TCM has a unique way of looking at health and illness.Zheng(syndrome)is the basic unit and key term in TCM theory.Zheng is the pathological generalization of a certain stage in the development of disease.Treatment based on syndrome differentiation and disease differentiation of TCM is the basic principle to know and treat diseases,and a kind of special method to study diseases in TCM.In Han Dynasty(200 AD),doctor Zhang Zhongjing proposed Liujing Bianzheng(the differential diagnosis in accordance with the theory of six channels)to diagnose and treat diseases in Treatise on Febrile and Miscellaneous Diseases.In other words,he divided diseases into six channels diseases based on patient's Zhengs.Six channels diseases almost include all of the disease according to his classification standards.In addition,there are development rules in the progress of six channels diseases.Therefore,we hypothesized that combination of six channels disease and Zheng on the basic of differentiation of six channels is a new pattern of diagnosis and treatment diseases in TCM,which is beneficial to the understanding of a certain disease and makes disease treatment more convenient,fast and effective.

Treatment of insomnia by differentiation of yang deficiency syndrome

Insomnia has become one of the common clinical diseases.In recent years,it has been found that patients with insomnia of Yang deficiency type are more and more common,and the trend of rejuvenation gradually appears,which seriously affects the normal progress of people's life,work and study.Clinical treatment through syndrome differentiation,mainly from the heart,spleen,kidney three viscera yang deficiency,on the basis of the warm yang method to add Qianzhen tranquilizing products,and pay attention to multiple organs as diseases,add moisture,blood The qi thing,while not forgetting the psychological counseling,adjusting the body and mind,and achieving a certain clinical effect,can provide ideas for the treatment of this disease.

基于《黄帝内经》病证结合思想探讨疾病循证病机-证治体系研究模式

深度挖掘《黄帝内经》病证结合思想,《黄帝内经》首开辨病论治之先河,在此基础上,又将辨病与脏腑辨证、病因辨证、经络辨证及六经辨证有机结合,开启了病证结合思想的萌芽,为后世病机、证候、治则治法理论的发展奠定了坚实的理论基础。基于病机、证候、治法、方药之间的内在联系性与统一性,提出病证结合是循证病机-证治体系的立论基础,循证病机-证治体系以疾病为研究基础,以病机为核心要素,以临床疗效为评价标准,“基于疗效,评价病机”是构建疾病循证病机-证治体系的关键。在疾病循证病机-证治体系的构建过程中,借鉴循证医学系统评价的方法,通过“以方测证、验证病机”的方式,为循证病机-证治体系的构建提供思路。

Traditional Chinese medicine combined with low-dose glucocorticoid for treating nephrotic syndrome: A case report

Nephrotic syndrome(NS)is a common refractory clinical disease that can develop into end-stage renal disease(ESRD)if cannot be controlled.At present,in Western medicine,glucocorticoid or immunosuppressant drugs with heavy dose and long course are used for the therapy of NS.There are still few reports on the combined treatment of traditional Chinese medicine and low-dose glucocorticoid for NS.Here,we reported a case of a 48-year-old man diagnosed with NS,accompanied by severe pulmonary infection,abundant proteinuria,and pleural effusion.Integrated traditional Chinese and Western medicine was used as the therapeutic regimen of this patient.Traditional Chinese medicine(TCM)mainly focused on invigorating spleen and kidney,promoting blood circulation,removing blood stasis and promoting diuresis,and Chinese patent medicines or TCM immunosuppressants were given to consolidate the treatment.In Western medicine,small dose and short course glucocorticoids combined with symptomatic treatment were adopted.Delightfully,proteinuria subsided after 5 months treatment with integrated TCM and Western medicine and all laboratory reports were negative after 10 months,which has been normal so far(July 2019).This case report indicates that the combination of TCM and low-dose glucocorticoid is effective in curing NS,with low recurrence rate and few side effects.

Application of Stone Needle Therapy Based on Blood Stasis Theory in the Treatment of 36 Cases of Knee Osteoarthritis in Early and Middle Stage

Objective:To evaluate the clinical efficacy of stone needle therapy based on blood stasis theory for different traditional Chinese medicine(TCM)syndrome types of patients with knee osteoarthritis in early and middle stage.Methods:Totally 36 patients with knee osteoarthritis were enrolled in the orthopaedic ward between March 2016 and December 2017,and diagnosed as qi stagnation and blood stasis syndrome,cold dampness and stasis syndrome,or phlegm and stasis syndrome according to TCM syndrome differentiation.After treatment,stone needle was used for ironing on the different meridian acupoints according to different syndrome.The efficacy of patients with the above three syndromes was respectively evaluated,and the visual analogue scale(VAS)score and western ontario and mcMaster universities arthritis Index(WOMAC)score of the three groups were calculated before treatment,2 weeks,and 4 weeks after treatment.Results:The effective rates of the three groups were 86.67%,81.82%,and 80.00%,respectively.After 2 weeks and 4 weeks of treatment,the VAS and WOMAC scores of the three groups decreased significantly compared to treatment before(P<0.05).Conclusion:Stone needle therapy for ironing on the acupoints around the knee joint has a good therapeutic effect on knee osteoarthritis of different syndrome types,which is worthy of further application.

Based on the Four Segments and Treatment by Syndrome Differentiation to Lower the Mortality of Sepsis

Lowering the mortality of sepsis has become an important issue in the international critical care medicine because of its unacceptably high incidence. In 2004 and 2008,there were no essential breakthroughs in international guidelines for the management of severe sepsis

辨证取穴利咽针刺联合呼吸-吞咽协调训练治疗脑梗死后吞咽功能障碍的疗效分析

目的:探讨辨证取穴利咽针刺联合呼吸-吞咽协调训练治疗脑梗死后吞咽功能障碍的疗效以及对舌肌力、舌骨喉复合体动度以及营养状态的影响。方法:根据随机数字表法将80例脑梗死后吞咽功能障碍患者分为两组,对照组(40例)采用呼吸-吞咽协调训练治疗,观察组(40例)采用辨证取穴利咽针刺联合呼吸-吞咽协调训练治疗,两组均治疗4周。观察两组治疗疗效,吞咽功能、舌肌力、舌骨喉复合体动度以及营养状态。结果:观察组总有效率高于对照组,差异具有统计学意义(P<0.05)。两组治疗后标准吞咽功能评定(SSA)、吞咽造影检查(VFSS)误吸评分与VFSS吞咽障碍评分均较治疗前明显降低,差异具有统计学意义(P<0.05),舌压峰值、舌压平均值、舌压持续时间、舌骨上移、舌骨前移、甲状软骨上移、甲状软骨前移、血清白蛋白(ALB)与前白蛋白(PA)水平均较治疗前明显增高,差异具有统计学意义(P<0.05)。观察组治疗后SSA、VFSS误吸评分与VFSS吞咽障碍评分低于对照组,差异具有统计学意义(P<0.05),舌压峰值、舌压平均值、舌压持续时间、舌骨上移、舌骨前移、甲状软骨上移、甲状软骨前移及血清ALB、PA水平高于对照组,差异具有统计学意义(P<0.05)。结论:辨证取穴利咽针刺联合呼吸-吞咽协调训练可改善脑梗死后吞咽功能障碍患者吞咽功能,提高舌肌力与舌骨喉复合体动度,改善营养状态。

基于时-邪-体-法四维体系探讨疫病辨证方法

在对疫病的辨证认识上,各个时期的中医学家存在不同的观点。由于历史上不同时期发生疫病的种类不同以及人们对疫病的认识角度和深度的不同,在面对新的疫病流行时进行快速有效的辨证论治仍存在一定困难。笔者通过分析几个重要历史时期中医学家对疫病的辨证论治方法,总结出“时-邪-体-法”的四维辨证方法,提出在对疫病辨证论治时应全面评估“时-邪-体-法”四个维度,从而得出立体性、特异性的防治方案。以期对当前疫病的防治工作起到一定的积极作用。

中医辨证治疗方案对老年社区获得性肺炎出院后患者生存质量和疗效满意度的评价研究

背景社区获得性肺炎(CAP)为常见的感染性疾病之一,尤其在老年患者中,其临床症状不典型,易出现严重并发症,缺乏有效的治疗措施,常预后不良。目的探究中医辨证治疗方案对老年CAP出院(1周内)患者的生存质量及其疗效满意度情况。方法本研究为多中心、随机双盲安慰剂临床研究。选取河南中医药大学第一附属医院、河南省胸科医院、河南省人民医院、郑州市中医院、郑州人民医院5家医院呼吸科2018年4月—2020年1月病房收治的老年CAP出院后患者为研究对象,采用中央随机入组模式将患者分为试验组和对照组。试验组患者经中医辨证后给予相应中药颗粒剂进行治疗,气虚痰湿证给予补肺健脾化痰方,气阴虚痰热证给予益气养阴清肺方。对照组则给予与中药颗粒外观、重量、颜色、气味基本一致的安慰剂。治疗疗程为2个月,随访至治疗开始后6个月。比较两组患者治疗前、治疗1个月、治疗2个月、随访3个月、随访6个月的生存质量[采用中文版生存质量评分量表(SF-36)评价]和疗效满意度[采用肺炎患者疗效满意度问卷(ESQ-CAP)评价]。结果纳入120例患者中,脱落8例,最终纳入符合方案集的病例112例,其中试验组54例、对照组58例。治疗前两组性别、年龄、出院后时间、中医辨证分型、CUBR-65评分、基础疾病比较,差异无统计学意义(P>0.05)。组别对SF-36生理机能领域评分(F组间=5.057,P组间=0.027)、一般健康状况领域评分(F组间=7.286,P组间=0.008)、情感职能领域评分(F组间=6.858,P组间=0.010)主效应显著。组间比较:治疗2个月、随访3个月、随访6个月,试验组SF-36生理机能领域评分高于对照组(P<0.05);治疗1、2个月和随访3、6个月,试验组SF-36一般健康状况领域、情感职能领域评分高于对照组(P<0.05);随访3、6个月,试验组SF-36精神健康领域评分高于对照组(P<0.05)。组别对ESQ-CAP日常生活与能力领域评分(F组间=16.218,P组间<0.001)、方便领域评分(F组间=25.013,P组间<0.001)及ESQ-CAP总分(F组间=13.843,P组间<0.001)主效应显著。治疗2个月和随访3、6个月,试验组ESQ-CAP日常生活与能力领域评分高于对照组(P<0.05)。治疗1、2个月和随访3、6个月,试验组ESQ-CAP方便领域评分及ESQ-CAP总分高于对照组(P<0.05)。随访3个月,试验组ESQ-CAP总体疗效领域评分高于对照组(P<0.05)。结论中医辨证治疗方案对于老年CAP出院后患者的生存质量和疗效满意度具有较好的改善作用。

论基于“病、证、征结合”方剂的主治表述

目前对方剂主治的规范性研究较少,通过对方剂主治源流的梳理并分析《方剂学》教材中方剂主治描述中存在的问题,提出“病、证、征结合”3个层次的方剂主治描述规范,从而有利于临证依法用方、规范教材和规范方剂的科学研究。

甲状腺功能亢进症的态靶辨治策略

借鉴现代甲状腺功能亢进症的生理病理等医学认识,结合甲状腺功能亢进症的临床诊疗特征等,基于传统中医思维,以态靶辨治理论为指导,重新认识甲状腺功能亢进症,构建现代中医诊疗体系。根据甲亢(瘿气)的疾病发展演变态势,可概括为郁、火、虚三个阶段,治疗以态靶结合,态下分证,随病机变化施以疏肝散郁,或清泄火热,或益气养阴等,重视靶方靶药与现代药理研究的结合应用,精准用药。

Some Problems of Warm Acupuncture in the Treatment of Knee Osteoarthritis

Knee osteoarthritis(KOA)is a chronic derivative joint issue that mainly damages the artistic cartilage and leads to pain,swelling,and stiffness around the joint,which is commomly worldwide.With the aging of society and the increment in obesity rate,the incidence of KOA increases sharply,which seriously effects the quality of human life.Before,how to take effective treatment methods is very important.Severe ways to treat the disease include non-steroidal drugs,local injections,surgery,and cell and gene therapies.However,each therapy has certain defections,such as gastrotestinal tract irritation,cardiovascular safety,or high medical costs for patients.Traditional Chinese medicine has a long history in treating KOA,reported by acupuncture,massage,internal administration of traditional Chinese medicine,and external use of traditional Chinese medicine.In clinical practice,patients can be treated from the root agreement to different etiology,and patients can be treated agreement to different syndrome types by syndrome difference to achieve effect.Studies have shown that warm acupuncture is effect in treating KOA.It has two kinds of treatment methods:acupuncture and moxibustion at the same time.It has fewer side effects and is more acceptable to patients.However,there are still some problems in the basic research and clinical application of warm acupuncture and moxibustion in treating KOA.This paper discussed the existing problems from the followingfive aspects:lack of unified synthesis difference and treatment system,problems in clinical research,weak basic research,problems in the study of moxibustion,and lack of the best treatment program recognized by the academic community.Meanwhile,the selection of acupoints,the relationship between acupuncture depth and anatomy should be further studied in order to offer research ideas for the healthy development of the treatment of KOA with warming acupuncture and moxibustion in the future.

复发性流产辨治经验

复发性流产(RSA)是一种临床较为常见的妇产科疾病,易导致反复性妊娠失败,常规西医治疗效果欠佳,使女性生殖健康受到严重损害的同时,亦对其家庭幸福稳定造成不良影响。随着临床对中医治疗RSA相关研究的逐渐增加,RSA病因复杂,临证时在进行查诊的同时需结合“不治已病治未病”的理念进行辨证论治,以减少RSA的发生。此文旨在从RSA病因病机、辨证论治等角度探讨中医治疗RSA临证思路及临床经验,以期为改善患者预后提供依据。

2型糖尿病合并多代谢紊乱态靶综合治验1例——仝小林院士教学查房实录

以广安门医院内分泌科中2型糖尿病合并多代谢紊乱案患者为例,邀请仝小林院士进行教学查房,对早中期2型糖尿病合并多代谢紊乱的中医认识、疾病发展与转归、诊疗要点进行阐述。仝小林院士强调肥胖是脾瘅的基石、分类-分期-分证辨治糖尿病、糖肝共治2型糖尿病合并代谢相关脂肪性肝病;治疗上注重运用靶方靶药,关注有效剂量,预防果态,防治脉损,态靶辨治,提高临床疗效。

基于真实世界数据的青春期异常子宫出血用药规律研究

目的:通过对女童青春期异常子宫出血患儿临床实际诊疗病例资料进行数据挖掘分析其中药治疗的用药规律。方法:基于医院信息管理系统提取2020年1月至2022年12月首都医科大学附属北京儿童医院女童青春期异常子宫出血患儿的病历数据,分为止血期和调理期2个阶段,总结归纳其辨治规律。结果:纳入止血期663例患儿,1020例病历;调理期796例患儿,2047例病历。止血期涉及中药169味,排名前5位为侧柏炭、牡丹皮、小蓟、麸炒椿皮和白芍,性味以寒、苦药为最多,归经以肝经为最多,功效以止血、补虚类药物为最多;调理期涉及中药232味,排名前5位为当归、酒女贞子、炙淫羊藿、黄芪和生地黄,性味以温、甘药最多,归经以肝、肾经为最多,功效以补虚类为最多。聚类分析分别获得4类和5类核心药物组合。结论:真实世界临床数据显示肾阴亏虚、血热内扰为青春期异常子宫出血常见证型,治则先以止血为主,待崩漏缓解后,重在调补脾肾以复旧,组方注重止血、补虚、收涩和清热等药物的配伍应用。

基于态靶辨治理论诊疗慢性阻塞性肺疾病

慢性阻塞性肺疾病是常见的呼吸系统气道慢性病,严重影响患者的生活质量。传统的中医辨证论治体系存在对疾病的发生发展规律认识不足,对检查化验指标改善欠佳的问题。仝小林院士经过多年的临床实践,提出“态靶辨治”的现代中医诊疗体系,并将其用于慢性疾病临床诊疗过程中。基于此,以“态靶辨治”理论为指导,结合临床经验与现代药理学研究成果,将慢性阻塞性肺疾病发病过程分为“痰、阻、瘀、衰”四态(四期),每态下进行分证,并结合治疗靶点,确定各阶段相应的靶方靶药,构建慢性阻塞性肺疾病的态靶辨治体系,为提高该病的中医治疗效果提供新的路径。