中医学对自身免疫性肝炎的认识

自身免疫性肝炎在临床上的发病率逐年攀升,但现代医学仍没有针对AIH的特效药。目前泼尼松单一使用或加用硫唑嘌呤联合治疗方案的副作用较大,花费较高,且患者难以接受,所以探寻治疗AIH的方法仍是临床研究的重要任务。在临床实践中,我们发现,中医药在AIH的治疗中取得了较好的疗效,且相对来说副作用较小,花费较低,患者更易于接受。因此,本文就AIH目前的中医治疗情况进行整理和分析,以期为AIH的治疗提供新的思路与方法。

Correlation Between Granulomatous Mastitis and Autoimmune Function and the Immuneregulating Role of Traditional Chinese Medicine

Granulomatous mastitis(GM)is a benign granulomatous condition,and its pathogenesis may be related to autoimmune disorders.Cellular immunity,humoral immunity,immunoglobulins,and complement could all play a role in the disease process,showing certain clinical patterns.Corticosteroids can quickly control disease progression,and immunosuppressants can be used for complex and refractory GM cases.In traditional Chinese medicine(TCM),“healthy qi”is similar to immune system function.For GM with deficient healthy qi,TCM treatments such as internal and external herbal applications can help regulate immune function and shorten disease duration by staged and TCM treatment,regulating viscera,reinforcing healthy qi,and eliminating pathogenic factors.

In vitro screening of traditionally used medicinal plants in China against Enteroviruses

AIM： To search for new antiviral agents from traditional Chinese medicine, specifically anti-enterovirosuses agents. METHODS： The aqueous extracts （AE） of more than 100 traditionally used medicinal plants in China were evaluated for their in vitro anti-Coxsackie virus B3 activities with a MTT-based colorimetric assay. RESULTS： The test for AE of 16 plants exhibited anti- Coxsackie virus B3 activities at different magnitudes of potency. They can inhibit three steps （inactivation, adsorption and replication） during the infection. Among the 16 plants, Sargentodoxa cuneata （Oliv.） Rehd. et Wils., Sophora tonkinensis Gapnep., Paeonia veitchii Lynch, Spatholobus suberectus Dunn. and Cyrtorniurn fortunei J, sm. also have activity against other enterovirus, including Coxsackie virus 135, Polio virus I, Echo virus 9 and Echo virus 29. Cell cytotoxic assay demonstrated that all tested AE had CC50 values higher than their EC50 values. CONCLUSION： The sixteen traditionally used medicinal plants in China possessed antMral activity, and some of them merit further investigations.

Comparison of integrated Chinese and Western medicine with and without somatostatin supplement in the treatment of severe acute pancreatitis

AIM: To evaluate the therapeutic effect of the combined use of early short-term somatostatin and conventional integrated Chinese and Western medicine in treating severe acute pancreatitis. METHODS: Sixty patients with severe acute pancreatitis were divided at random into a somatostatin group and a basic treatment group. Both groups received integrated traditional Chinese and Western medicine without surgery. For patients in the somatostatin group, somatostatin was infused intravenously 250 μg/h for 72 h; other medications were the same as in the basic treatment group. In both groups, comparisons of therapeutic effectiveness were made in terms of morbidity of organic dysfunction and mortality rate, and severity of the disease according to serum levels of C-reaction protein, scores of acute physiology and chronic health evaluation (APACHE Ⅱ), and scores of Balthazar-CT. RESULTS: The indexes for C-reaction protein levels on the fourth and seventh clays, and APACHE II scores on the seventh day after treatment, were significantly improved in the somatostatin group than in the basic treatment group. The morbidity of organic dysfunction was lower in the somatostatin group than in the basic treatment group, although the difference was not statistically significant. There was no significant difference in mortality between the two groups. CONCLUSION: We conclude that combined traditional Chinese and Western medicines with an early short-term use of somatostatin can improve the condition of patients with severe acute pancreatitis.

The rationale behind the four major anti-COVID-19 principles of Chinese herbal medicine based on systems medicine

As the novel coronavirus disease 2019(COVID-19)and its variants continue to rage into the second year of a global pandemic,many success stories of applying Chinese herbal medicine(CHM)to treat COVID-19 patients continue to emerge from China and other part of the world.Herewith,from a systems medicine perspective,the authors analyze those experiences and categorize them into four major treatment principles:(1)focusing on eliminating toxins in the early stage of the disease,(2)tonifying deficiency of the body throughout the entire disease course,(3)treating the affected lung and intestine simultaneously based on visceral interactions,(4)cooling blood and removing blood stasis at the later stage,as well as interpret the rationale of these principles.This is helpful not only in reducing the complexity of promoting the CHM applications to enhance anti-COVID-19 efficacy,but also in ramping out the process of integrating traditional Chinese medicine with modern medical practices.

Chinese medicine compound Changtong oral liquid on postoperative intestinal adhesions

AIM: The aim of this study was to observe the effect of a Chinese medicine compound Changtong oral liquid (CT) on tissue plasminogen activity (t-PA), plasminogen activator inhibitor (PAI), TGF-β1 and hydroxyproline (OHP). METHODS: Two sets of animal experiments were performed in the present study. Forty New Zealand rabbits and 48 Sprague-Dawley (SD) rats were assigned randomly to one of the five groups: sham adhesion, adhesion with saline, adhesion with low dosage of the CT, adhesion with middle dosage of the CT and adhesion with high dosage of the CT. t-PA and PAI activity in plasma, OHP and TGF-β1 expression in adhesion were investigated. Analysis of variance was used to test differences among groups. RESULTS: CT treatment increased plasma t-PA activity in rabbits but decreased TGF-β1 activity in rats. The data were expressed from low to high dose respectively as follows: t-PA, 46.1±8.6 μkat/L, 59.6±10.1 μkat/L, 64.0±11.5 μkat/L; TGF-β1 28±7.23%, 31±3.05%, 30±4.04%. There were significant differences compared with saline-treated animals (t-PA 26.4±5.1 μkat/L, TGF-β1 54±5.51%). OHP content in cecum of rabbits from middle and high but not low dose of CT lowered significantly as compared with saline-treated rabbits, 0.3641±0.1373, 0.3348±0.0321, 0.2757±0.0497 mg/g vs 0.4183±0.0883 mg/g of protein, P>0.05, P<0.05, P<0.05 respectively. The rabbit plasma PAI activity and OHP content in abdominal wall had no difference in all groups. CONCLUSION: CT treatment significantly enhanced t-PA activity in rabbits, but decreased TGF-β1 content in rats, OHP content in cecum of rabbits, and failed to affect the activity of PAI and OHP content in abdominal wall in rabbits, compared with saline group. The result suggests that CT could effectively prevent adhesions without interfering wound healina.

Study on alantolactone-induced differentiation of mesenchymal stem cells intovascular cells

To promote efficient screening of active angiogenic drugs from traditional medicines, we constructed a humanembryonic kidney-293 cell model using vascular endothelial growth factor （VEGF） gene promoter as the drug target. Inthis model, VEGF gene promoter may regulate the expression of the luciferase reporter gene by responding to thestimulation of drug molecules. This cell model allows rapid and efficient screening of vascular-inducing activecomponents from several drug monomer molecules. Furthermore, we used rat bone marrow mesenchymal stem cells（rMSCs） to conduct a preliminary study on the activity of alantolactone. Using simvastatin as a positive control, weinvestigated the effects of alantolactone on the expression of vascular-related cell marker molecules such as VEGF andα-smooth muscle actin （α-SMA） in rMSCs. According to our results, 0.1, 1, 3 and 5 μM of alantolactone upregulated thetranscriptional luciferase gene activity of VEGF promoter, and a significant difference from that in the control group wasobserved. Among them, 3μM of alantolactone showed the better effect than that of 3 μM of simvastatin （P = 0.036） andother concentrations of alantolactone and simvastatin showed similar effects. Compared with that in the control group,rMSCs induced with 1μM alantolactone for 3 days showed a significant increase in the relative mRNA expressions ofVEGF and α-SMA genes. However, these effect of 5 μM alantolactone were weaker than those of 5 μM simvastatin （P 〈0.05）; rMSCs treated with 1 μM alantolactone for 3 days showed brighter green fluorescence （FITC marker） of α-SMAand VEGF in situ expression than that observed in the control group and similar fluorescence intensity than that ofsimvastatin group in an immunoradiometric assay. The above results demonstrate the reliability of the highly efficientsystem for screening of active drug molecules and confirmed the vascular induction function of alantolactone at the geneand protein levels.

The Combined Use of Tonification and Purgation in Treatment of Fatty Liver

Fatty liver is a disease caused by excessive accumulation of fat in the liver due to long-term ort repeated affection of various causative factors'When the pathogenic factor prevails,the qi is sure to be deficient',Therefore,deficiency of the vital-qicontributes greatly to the occurrence of fatty liver.For many years,the author has concentrated ont the treatment of fatty liver with the tonificatioin method,or tonification followed by purgation,or the combination of tonificaytioin with purgation,so as to effectively prevent the liver from being injured by harmful substances ,and to benefit the recovery of fatty liver.The following is a report of his experience in treatment of fatty liver with the combined use of tonification and purgation.

SARS-CoV-2 Infected Cases with Untraceable Epidemic Origin:Its Values,Identification and TCM Treatment in Preventing Recurrence

During the outbreak of coronavirus disease 2019(COVID-19),the identification of a SARS-CoV-2 infected case with untraceable epidemic origin has three values:(1)the region has community transmission of the virus;(2)a certain portion of population in the community is getting immunized and more individuals have already been immunized;(3)an unpredictable future risk exists for regions where there are no infected cases with untraceable epidemic origin.Minimizing or avoiding the aggregation infection through individuals with no clinical symptoms is crucial and possible as its occurrence is mainly attributed to the local environment as opposed to the super spreader with or without clinical symptoms.As infected cases are not necessarily positive with gene test by definition,proper application of gene test is crucial in the identification of asymptomatic cases.In the early stage of an outbreak of infectious disease,gene test can be used to identify asymptomatic cases but it should not be used to exclude cases with typical clinical symptoms and signs.In the middle or late stages of an outbreak gene test should be applied in evaluation of infection rate of the population of a region,in addition to be used in spreader identification and isolation.Although asymptomatic cases are attributed to the overwhelming effect of personalized defense against pathogens,they are still a source of infection.Asymptomatic cases are considered to be Qi deficiency and with lingering toxicity in traditional Chinese medicine(TCM).Treatment in such cases,typically,involves therapy focused on replenishing the Qi,tonifying the lung,clearing the fever,and detoxification in order to return to a normal health condition.The recommended Chinese medicines include Qing Fei Pai Du Decoction,Yi Qi Qu Du Decoction,Xuan Fei Bai Du Granule,Lian Hua Qing Wen Capsule(Granule),and Jin Hua Qing Gan Granule,etc.

A DOUBLE BLIND OBSERVATION FOR THERAPEUTIC EFFECTS OF THE TONG LUO KAI BI TABLETS ON RHEUMATOID ARTHRITIS

The therapeutic effects of the Tong Luo Kai Bi Tablets [symbol: see text] in 120 patients with rheumatoid arthritis were observed in this clinical trial by the randomized double blind method. Both the observed group and the control group each had 60 patients. In the observed group treated with the Tong Luo Kai Bi Tablets, 1 case (1.7%) was cured clinically, 27 cases (45.0%) improved markedly, 26 cases (43.3%) improved, with a total effective rate of 90.0%. In the control group treated with Rheumatic Semen Strychni Tablets [symbol: see text], no case was cured, 16 cases (26.7%) improved markedly, 33 cases (55.0%) improved, with a total effective rate of 81.7%. Statistical data showed the Tong Luo Kai Bi Tablets had much better therapeutic effectiveness clinically than the Rheumatic Semen Strychni Tablets (P

CLINICAL OBSERVATION ON 96 CASES OF PRIMARY DYSMENORRHEA TREATED BY MEDICINE-SEPARATED MOXIBUSTION AND INVESTIGATION ON ITS MECHANISMS

Objective： To observe the therapeutic effect of medicine-separated moxibustion for primary dysmenorrhea and its influence on plasma hormone level. Methods. Ninety-six patients suffering from primary dysmenorrhea were randomly and evenly divided into trealment group treated with medicine-separated moxibustion of Shenque （神阙 CV 8, 3-5 cones every time, beginning 1 week before onset of menstruation and stopping on the 3^rd day after onset, with 10 sessions being a therapeutic oourse, 3 courses all together）, and control group treated with oral administration of Yueyueshu （月月舒 menstruation-smoothing granule, 10 g/time, b.i.d, 3 courses altogether）. Menses prostaglandin E2（PGF2α） and plasma oxytocin （OT） during menstruation were determined by radioimmunoassay. Results; After the treatment, of the two 48 cases in treatment and control groups, 18 and 5 were cured, 24 and 9 had marked improvement in their symptoms, 6 and 26 had improvement, 0 and 8 failed in the treatment, with the total effective rates being 100. 096 and 83.3% respectively, the therapeutic effect of treatment group was markedly superior to that of control group （P〈0.05）. After the treatment, the contents of menses PGF2α in treatment group and plasma OT in both groups were significantly lower than those of pre-treatment （ P〈 0.01 ）. The therapeutic effect of moxibustion was significant- ly better than that of medication in lowering plasma OT. Conclusion： Medicine-separated moxibustion works well in treating primary dysmenorrhea, and moxibustion induced decrease of menses PGF2α and plasma OT may contribute to its effect in relieving dysmenorrhea.

Whole process control and precision therapy in lung cancer

Lung cancer is one of the most common malignant tumors in the world. Non-small cell lung cancer （NSCLC） accounts for approximately 80% of lung cancer cases, and approximately 75% of patients are diagnosed in the middle and late stages. The treatment methods mainly include surgery, chemotherapy, radiotherapy, molecular targeted therapy, traditional Chinese medicine therapy, and immune therapy. We summarize the current status of lung cancer-related treatment options and targets.

Personal Experience in TCM Treatment of Reflux Esophagitis

Reflux esophagitis falls into the category of reflux gastroesophagopathy. It is characterized by inflammation, erosion, ulcer formation and fibrosis of the esophageal mucous membrane due to reflux of the content of the stomach and duodenum into the esophagus.

Treatment of A Case of Spontaneous Rupture of Achille's Tendon

Mr. Guo, 51 years old, paid his first visit on November 7, 2001. The patient felt sudden pain in the right Achille's tendon in June 1999 with no apparent predisposing factors. Several months later he palpated a small pitting in the middle of the right Achille's tendon, which expanded gradually in size. In June 2000, two thirds of the tendon was diagnosed to be ruptured in a local hospital. Ten days later the tendon was ruptured completely when he felt sudden severe pain, numbness and distention, and he was unable to raise the heel. The lesion was healed three months later after being treated with a plaster model, but it was partially ruptured again 6 months later. Though the ruptured tendon was healed again with the help of a plaster model, he still suffered from local swelling and pain, which was aggravated during movement and made him difficult in walking, squatting down and standing up. During the examination, the right heel was found hyperemic and swollen with ecchymosis and tenderness. The tongue proper was dark red and the pulse thready and rapid. The condition was due to depletion and deficiency of liver-qi, stagnant blood with dampheat obstructing the collaterals. The principle of nourishing the liver and soothing the tendon was adopted, assisted by invigorating blood circulation and removing blood stasis, clearing heat and transforming dampness.

A brief history of human constitutionology

Human constitutionology studies human itself, which was proposed by Dr. Kuang. The study on human constitution in Chinese medicine has ever increased since the late 1970s. This review on the development of human constitutionology in Chinese Traditional Medicine （TCM） and western medicine is expected to give people with a different background to understand the establishment of this new subject, and its significance in promoting modernization of TCM and multi-disciplinary collaboration in human study and as an individualized model guiding the re-orientation of modern madicine.

TREATMENT OF 50 CASES OF SENILE DEMENTIA BY ACUPUNCTURE COMBINED WITH INHALATION OF HERBAL DRUGS AND OXYGEN

Clinical DataCase selection: 100 cases who met thediagnostic criteria of senile dementiaformulated by American Association ofPsychiatry in Handbook of Diagnosis andStatistics (DSM-Ⅲ-R, 3rd revised edition)

INFLUENCE OF DIFFERENT NEEDLE-RETAINING DURATION ON CEREBRAL HEMODYNAMICS OF CEREBRAL PARALYSIS CHILDREN

Objective: To investigate the effects of different needle-retaining duration on cerebral hemodynamics in cerebral paralysis (CP) children. Methods: A total of 20 cases of CP children were subjected into this study. Changes of systolic peak value (Vs), blood flow velocity at the end-diastolic phase (Ved), mean velocity (Vm), pulsation index (PI) and resistance index (RI) of the cerebral hemodynamics before and after performing JIN’s Three-Needling Therapy with the needles retained for 30 min (group A) and 5 min (group B) were observed by using transcranial Doppler ultrasonography (TCD). Results: After acupuncture, the blood flow in the middle cerebral artery (MCA), anterior cerebral artery (ACA) and posterior cerebral artery (PCA) was accelerated, and the resistance of blood vessels decreased. The effect of needle-retaining-30 min was better than that of needle-retaining-5 min. Conclusion: In treating cerebral paralysis by using JIN’s Three-Needling Therapy, sufficient stimulation provided by needle remaining is an important factor for achieving satisfactory therapeutic effects.

CLINICAL STUDY ON TREATMENT OF SENILE STROKE PATIENTS BY ACUPUNCTURE PLUS CHINESE MEDICINAL HERBS

Objective: To observe the therapeutic effect of acupuncture therapy plus Chinese medicinal herbs in the treatment of 38 cases of senile patients with hemiplegia. Methods: A total of 69 senile stroke patients were randomly divided into treatment group (n=38, accepting acupuncture plus herbal medicine treatment) and control group (n=31, accepting herbal medicine treatment only). Principal acupoints used were Baihui(GV 20), Jiquan(HT 1), Jianyu(LI 15), Quchi (LI 11), Zhongwan(RN 12), Siqiang (Extra acupoint) and Zusanli(ST 36),combined with other acupoints according to the symptoms. These acupoints were punctured with filiform needles and stimulated with uniform reinforcing reducing method, once everyday except Sundays, with 30 sessions being a therapeutic course. Chinese medicinal herbs used were Huangqi (Radix Astragali,黄芪)30 g, Dangshen (Radix Codonopsis Pilosulae,党参)30 g, Danshen (Radix Salviae Miltiorrhizae, 丹参)30 g, Chishao (Radix Paeoniae Rubra,赤芍)30 g, Chuanxiong (Rhizoma Ligustici Chuanxiong,川芎)10 g,Dilong (Lumbricus,地龙)10 g, Niuxi (Radix Achyranthis Bidentatae,牛膝)15 g, Jixueteng (Caulis Spatholobi,鸡血藤)30 g and Gancao (Radix Glycyrrhizae, 甘草)6 g which were decocted in water to be taken one dose everyday (in the morning and evening), continuously for 60 days, with 30 days being a therapeutic course. Results: After treatment, in treatment and control groups, of the 38 and 31 cases, 18 (47.37%) and 8 (25.81%) experienced remarkable improvement, 18 (47.37%) and 18 (58.06%) were effective, and 2 (5.26%) and 5 (16.13%) had no significant changes, with the total effective rates being 94.74% and 83.87% respectively. Simultaneously, indexes of blood rheology as whole blood ratio high shear viscosity (WBRHSV), whole blood ratio low shear viscosity (WBRLSV), plasma ratio viscosity (PRV), hematacrit (HCT) and fibrinogen (Fib) were remarkably reduced in comparison with pre treatment, meaning improvement of the microcirculation (P<0.05-0.01). Conclusion: The results display that acupuncture plus herbal medicine treatment has a better therapeutic effect than that of simple medicinal herb treatment for senile hemiplegia, and both treatments can improve patients’ blood rheology.