Etiology and pathogenesis of corona virus disease 2019 on the view of Chinese medicine

Traditional Chinese Medicine has played an important role in the prevention and treatment of the Corona Virus Disease 2019 epidemic.But in views of different TCM scholars there are different opinions about disease name,characteristic of etiology,law of pathogenesis about this epidemic.Based on related literatures,this article overviews of the characteristics of TCM etiology,law of pathogenesis and methods of syndrome differentiation,hoping to find research method that fit in with TCM clinical practice.Prerequisite of treatment is identifying the cause.The clinical manifestations of patients are important to TCM,and the etiological attributes can be inferred from the clinical manifestations.SARS-CoV-2 belongs to exogenous etiological factors,but there are different opinions about its characteristics of six pathogenic factors.Cold,Dampness,Warm,Dry,Toxin,Summer-heat,Wind,are all involved.Thus,different understanding of the pathogenesis and the law of transmission is caused.Such as cold and dampness hurt Yang,furthermore,consumed of Qi;dampness and toxin infected from external environment,turbid dampness produced inside the body;dryness affecting lungs and consume of Yin;warm-heat-turbid-toxin affected lungs,stomach and intestine;and then produced phlegm stagnation or blood stasis,furthermore consumed Qi and Yin.Based on those differences,methods of syndrome differentiation in treatment of COVID-19 are diverse,which contain pattern differentiation of zang-fu organs,pattern differentiation of Wei-defence,Qi,Ying nutrients and blood;pattern differentiation by the eight principles,and pattern differentiation of six meridians.Because of SARS-CoV-2 can spread to the whole country or even the whole world in a short period of time,its pathogenic nature should be roughly the same.So studying the treatment of COVID-19 based on clinical cases,refining the similarities and differences in the clinical presentation of patients with different subtypes during the epidemic,clarification of the etiologic attribution and evolutionary patterns of disease mechanisms,developing a comprehensive understanding of COVID-19 in Chinese medicine is needed.Furthermore,getting a full understanding of COVID-19,and providing reference for the prevention and treatment of unknown infectious diseases.

TCM diagnosis and treatment theory of chronic complete occlusion of coronary artery based on etiology and pathogenesis

Chronic total occlusive disease of the coronary artery belongs to the category of"chest palsy"and"true heart pain"in traditional Chinese medicine.Its etiology has two aspects:deficiency of blood,blood stasis,qi stagnation,and phlegm.Failure can be caused by deficiency or disease.The pathogenesis of this disease is caused by obstruction of the heart pulse,and its pathogenesis can be transformed into each other.The theory of traditional Chinese medicine believes that the general rule is not painful.Therefore,the treatment of coronary CTO lesions should be based on the combination of Tong and Tong tonic.The chronic complete occlusive disease of the coronary artery can be treated through Xuanbi Tongyang,Huoxue Tongluo,and Aroma Wentong.Based on the Chinese medicine's understanding of the etiology and pathogenesis of coronary CTO lesions,it provides a basis for the diagnosis and treatment of traditional Chinese medicine,solves the problems of interventional medicine in western medicine,and gives play to the unique advantages of traditional Chinese medicine for clinical diagnosis and treatment.

Research on etiology and pathogenesis of cancer based on data mining under theguidance of Neijing theory

Etiology and pathogenesis are the causes and mechanisms of disease development and change. The unification and innovation of cancer pathogenesis is the key to the breakthrough of Chinese medicine. According to the related theory in Neijing, cancer in different parts of the body could be classified based on the five elements. Chinese mainland is divided into five parts： east, south, west, north and central section. Based on the annual data of China Cancer Center, we analyzed the data of 72 cancer registries covering 32 provinces and autonomous regions for consecutive 5 years. The results showed that the total incidence of the five regions in the mainland of China was statistically significant （F = 8.561, P 〈 0.01）; the east was the highest, the west was the lowest, and the south, middle and north were in the middle level. The incidence of tumors in different parts of the human body was statistically significant （F = 523.382, P 〈 0.01）. The incidence rate from high to low was lung, spleen, kidney, liver and heart. The heat is too much in China＇s eastern and the southern, and Qi is not too enough in the northwest. Five-Qi was imbalance. The pathogenesis of cancer is due to the two aspects, deficiency of five Zang-organs and abnormal seasonal climates. The viscera weakness for a long period and abnormal seasonal climates causes the body Yin and Yang disharmony, resulting in five zang organs dysfunction.

Research progress on the etiology and pathogenesis of adolescent idiopathic scoliosis

Etiology of adolescent idiopathic scoliosis(AIS),a complicated three-dimensional spinal deformity with early-onset,receives continuous attention but remains unclear.To gain an insight into AIS pathogenesis,this review searched PubMed database up to June 2019,using key words or medical subject headings terms including"adolescent idiopathic scoliosis,""scoliosis,""pathogenesis,""etiology,""genetics,""mesenchymal stem cells,"and their combinations,summarized existing literatures and categorized the theories or hypothesis into nine aspects.These aspects include bone marrow mesenchymal stem cell studies,genetic studies,tissue analysis,spine biomechanics measurements,neurologic analysis,hormone studies,biochemical analysis,environmental factor analysis,and lifestyle explorations.These categories could be a guidance for further etiology or treatment researches to gain inspiration.

Budd-Chiari syndrome:Etiology,pathogenesis and diagnosis

Budd-Chiari syndrome is a congestive hepatopathy caused by blockage of hepatic veins. This syndrome occurs in 1/100 000 in the general population. Hypercoagulable state could be identified in 75% of the patients; more than one etiologic factor may play a role in 25% of the patients. Primary myeloproliferative diseases are the leading cause of the disease. Two of the hepatic veins must be blocked for clinically evident disease. Liver congestion and hypoxic damage of hepatocytes eventually result in predominantly centrilobular fibrosis. Doppler ultrasonography of the liver should be the initial diagnostic procedure. Hepatic venography is the reference procedure if required. Additionally liver biopsy may be helpful for differential diagnosis. The prognosis of the chronic form is acceptable compared to other chronic liver diseases.

Acute pancreatitis:Etiology and common pathogenesis

Acute pancreatitis is an inflammatory disease of the pancreas.The etiology and pathogenesis of acute pancreatitis have been intensively investigated for centuries worldwide.Many causes of acute pancreatitis have been discovered,but the pathogenetic theories are controversial.The most common cause of acute pancreatitis is gallstone impacting the distal common bile-pancreatic duct.The majority ofinvestigators accept that the main factors for acute billiary pancreatitis are pancreatic hyperstimulation and bile-pancreatic duct obstruction which increase pancreatic duct pressure and active trypsin reflux.Acute pancreatitis occurs when intracellular protective mechanisms to prevent trypsinogen activation or reduce trypsin activity are overwhelmed.However,little is known about the other acute pancreatitis.We hypothesize that acute biliary pancreatitis and other causes of acute pancreatitis possess a common pathogenesis.Pancreatic hyperstimulation and pancreatic duct obstruction increase pancreatic duct pressure,active trypsin reflux,and subsequent unregulated activation of trypsin within pancreatic acinar cells.Enzyme activation within the pancreas leads to auto-digestion of the gland and local inflammation.Once the hypothesis is confirmed,traditional therapeutic strategies against acute pancreatitis may be improved.Decompression of pancreatic duct pressure should be advocated in the treatment of acute pancreatitits which may greatly improve its outcome.

Traditional Chinese Medicine etiology and pathogenesis of acquired immune deficiency syndrome in simian immunodeficiency virus-infected Chinese rhesus macaques

OBJECTIVE： To investigate the traditional Chinese Medicine （TCM） etiology and pathogenesis of ac- quired immune deficiency syndrome （AIDS） by 18-month observation of Chinese rhesus macaques infected with simian immunodeficiency virus （SIV） mac239. METHODS： Thirty-five healthy Chinese rhesus ma- caques were divided into a model group （n=30） and a control group （n=5）. The model was estab- lished by inoculating monkeys intravenously with SIVmac239. Changes in TCM symptoms after SIV in- fection within 18 months were then observed and recorded. Routine blood tests, SIV viral load, T-lym-phocyte subsets, plasma triiodothyronine （T3）, tet- raiodothyronine （14）, adrenocorticotropic hormone （ACTH） and cortisol （Cor） were tested periodically during the experiment. RESULTS： During the acute infection period of SIV, model monkeys temporarily showed clinical symp- toms such as diarrhea, dysphoria and slight weight loss. Decrease percentages of CD4~ T-lymphocytes were observed but levels of T3, 14, Cot, and ACTH were relatively unchanged. Monkeys in the model group during the early and middle periods of infec- tion showed no obvious symptoms, except few monkeys exhibited transient diarrhea and reduced food intake. All variables at this stage showed nor- mal fluctuations. In the middle period model group monkeys showed chronic and persistent diarrhea, weight loss, reduced food intake and low levels of 13 and Cot. In the late period, symptoms including emaciation, weight loss, listlessness, crouching in corners and low levels of T3appeared. CONCLUSION： The results suggest that the rhesus monkey SIWSAIDS model can be applied to re- search on TCM etiology and pathogenesis of AIDS. According to this model, the etiology of disease is the SIV virus. The pathogenesis manifests as the in- vasion of SIV virus, incubation of the virus, balance between virus and healthy ＂Qi＂, damage to spleen and kidney as the disease progressed, exhaustion of vitality and finally the failure of five zang and six fu organs.

Etiology, pathogenesis, and diagnosis of neovascular glaucoma

Neovascular glaucoma is defined as iris and/or anterior chamber angle neovascularization associated with increased intraocular pressure. It is a secondary glaucoma that is most frequently caused by severe retinal ischemia. The most common diseases responsible for the development of neovascular glaucoma are diabetic retinopathy, ischemic central retinal vein occlusion,and ocular ischemic syndrome. Uncommon causes include ocular radiation, ocular tumors, uveitis and other miscellaneous conditions. Vascular endothelial growth factor is an important and likely predominant agent involved in the pathogenesis of intraocular neovascularization and neovascular glaucoma. The evolution of clinical and histopathological changes from predisposing conditions to the occurrence of rubeosis iridis and neovascular glaucoma is divided into four stages: prerubeosis, preglaucoma, open angle glaucoma, and angle-closure glaucoma.

Current trends in acute pancreatitis:Diagnostic and therapeutic challenges

Acute pancreatitis(AP)is an inflammatory disease of the pancreas,which can progress to severe AP,with a high risk of death.It is one of the most complicated and clinically challenging of all disorders affecting the abdomen.The main causes of AP are gallstone migration and alcohol abuse.Other causes are uncommon,controversial and insufficiently explained.The disease is primarily characterized by inappropriate activation of trypsinogen,infiltration of inflammatory cells,and destruction of secretory cells.According to the revised Atlanta classification,severity of the disease is categorized into three levels:Mild,moderately severe and severe,depending upon organ failure and local as well as systemic complications.Various methods have been used for predicting the severity of AP and its outcome,such as clinical evaluation,imaging evaluation and testing of various biochemical markers.However,AP is a very complex disease and despite the fact that there are of several clinical,biochemical and imaging criteria for assessment of severity of AP,it is not an easy task to predict its subsequent course.Therefore,there are existing controversies regarding diagnostic and therapeutic modalities,their effectiveness and complications in the treatment of AP.The main reason being the fact,that the pathophysiologic mechanisms of AP have not been fully elucidated and need to be studied further.In this editorial article,we discuss the efficacy of the existing diagnostic and therapeutic modalities,complications and treatment failure in the management of AP.

Mechanism of sex hormone level in biological clock disorder induced acne and analysis of TCM Pathogenesis

Acne vulgaris is a common chronic inflammatory disease of pilosebaceous units. And sex hormone level disorder has became a hot research topic in the pathogenesis of acne. Studies show that the biological clock disorder can result in the disorder of sex hormone levels which causes or aggravates acne. Biological clock disorder coincides naturally with "sleep rhythm disorder" in Traditional Chinese Medicine(TCM). In this paper, we will discuss the modern medical mechanism of the biological clock disorder resulting in acne from the angle of sex hormones, and analyze the TCM pathogenesis of the disease caused by the disorder of the biological clock.

从“阳化气,阴成形”探讨慢性咳嗽之因机证治

慢性咳嗽是以咳嗽为主症或唯一症状、病程持续8周以上的呼吸系统疾病。慢性咳嗽病因复杂,病程较长,病势缠绵,且极易复发。西医诊断该病过程繁琐,治疗手段有限,而中医药以整体观念和辨证论治思想为指导,在缓解临床症状、预防疾病复发方面具有独特优势。该文以“阳化气,阴成形”为抓手,分析阴阳在慢性咳嗽因机证治全周期的重要意义,认为慢性咳嗽之病机关键为“阳化气,阴成形”功能失衡,以肺之气血失和、阴阳虚损为本,阳化而气行不畅、周流有碍,阴变而凝结停滞、壅塞肺络为标。治疗上,需要补肺、脾、肾阴阳之不足,泄气滞、水湿、痰饮、瘀血、热毒之有余,以恢复“阳化气,阴成形”之平衡。具体用药方面,主张以偏纠偏,以药物气味之偏性纠正人体阴阳之偏颇。另附典型医案二例,加以验证说明,以期为中医药防治慢性咳嗽提供新的诊疗思路和方法。

慢性萎缩性胃炎的中医辨治思路与对策

慢性萎缩性胃炎(CAG)是临床上公认的胃癌前疾病,中医药治疗CAG具有明显的优势及鲜明的特色。从CAG病因病机等方面的研究入手,对中医药治疗CAG提出治本独取阳明,补虚泻实,顾护脾胃,升降气机,调气和血,祛瘀通络,祛邪解毒,甘平凉润,和胃护络的辨治思路与对策,以期进一步提高中医药治疗CAG的临床疗效。

基于“肝心和合”理论的动脉粥样硬化性疾病病机演变

动脉粥样硬化性疾病对人类的生命和健康造成了威胁,在生物-心理-社会医学的模式下,基于中医古籍挖掘与整理,结合现代医学理论及实验进展,以中医基础理论为指导,提出基于“肝心和合”理论的AS性疾病病机演变全过程,即预病状态→已病状态→病复状态。系统阐释在AS性疾病中“心”与“肝”状态失衡是导致疾病进展或骤变的主要因素,“郁-痰-瘀-毒-虚”的病理特点,并逐一对病理特点进行中西医的发病机制诠释,五者在疾病中不仅可以单一存在,而且可以相互兼见,相互作用,相互影响,其中是“郁”是“痰-瘀-毒-虚”进一步病变的基础。以肝郁心虚、心脉遏滞;肝心失司、心脉瘀阻;肝心失和、瘀毒虚互结等中医内涵揭示AS性疾病的发病机制,为中西医结合诊疗提供新思路和新方法。

雄激素性脱发的病因及发病机制研究进展

雄激素性脱发(AGA)是一种常见的脱发性疾病,发病机制复杂。目前对于AGA的机制研究仍聚焦于机体对雄激素的过度反应及遗传因素的影响。另外,毛发生长周期、头皮的血液流变学以及生活习惯在AGA的发病中也起到重要作用。本文对AGA病因及其发病机制进展作一综述,旨在为相关的治疗研究提供理论依据。

张德英从痰论治痤疮验案举隅

[目的]总结张德英教授从痰证角度治疗痤疮的特色及经验。[方法]通过跟随张教授门诊临证学习,整理张教授治疗痤疮的病案,选取三则典型验案,结合中医经典理论,分析、总结张教授对痰证理论的独到见解及临床经验。[结果]张教授从当今人们的体质状况及痤疮发病特点出发,指出痤疮的病因病机为痰热或痰火上犯头面胸等处,局部肉腐而发病。根据痰浊生于中焦脾胃,为土家实邪,在治疗上可以通过泻土降浊、繁木制土、化土生金的方法达到化痰的目的,再加以清热药物,从而清化上焦痰热之邪,使痤疮得以治愈。同时需注意到五行相互关系,痰浊太盛则易克伐肾水而致肾虚,在治疗上祛痰降浊为先,痰浊去除后再补益肾水方可有效,甚或有些患者不需补肾,而肾自慢慢恢复。[结论]张教授对痰证理论认识独特,指出痤疮病机多为痰火或痰热郁于肌表,肉腐而成。治疗当以清化痰热为主。痰为土家之邪,化痰之法除泻土之外,根据五行理论,还有繁木制土、生金消土之法,其临床疗效显著,值得临床推广应用。

中医治疗弱精子症的进展概述

弱精子症是临床常见的男性不育症,由多项因素共同导致。中医对弱精子症的病因病机有充分认识,且理论清晰,可采用分型施治、五脏分治、经络论治等多种方法治疗,对有明确病因以及无明确病因的弱精子症均有良好的治疗效果。上述治疗方法的实施涉及到对弱精子症患者证候类型的认知、特定药物的选择、针刺技术的使用等多项内容,总体呈现出方法多、疗效优的特点,对提高弱精子症的总体疗效、拓展弱精子症的认知深度发挥了积极的作用。本文即从中医对弱精子症的诊断与治疗进行简单总结。

霍乱证治考析

霍乱以临床特征得名。历代医家出于“司外揣内”“审证求因”等中医思维习惯,对于表现为“挥霍缭乱”特点的病症,多归为“霍乱”范畴进行论述。文章考察历代中医相关文献,发现霍乱有真霍乱、类霍乱之分,病因病机有寒热之辨、干湿之别以及亡阴损阳之变,论治又有温中散寒燥湿、清热化湿解暑、回阳固脱、理气解郁诸法,不乏化瘀以助回阳、解毒理血辟秽等治疗创见,对于诊治现代临床常见的急性胃肠炎、功能性胃肠病、肠梗阻、糖尿病酮症酸中毒、心肾功能衰竭以及应激性吐泻皆有重要的借鉴意义,学者切莫忽视。

基于“久病入络”理论探讨“从虚而始,因虚致瘀,瘀痹骨络”的激素性股骨头坏死核心病机观

激素性股骨头坏死(Steroid-induced osteonecrosis of femoral head, SONFH)是骨科常见疾病,随着激素应用率提升其发病率也逐年增加。随着“久病入络”理论的研究不断深入,特此提出“从虚而始,因虚致瘀,瘀痹骨络”为激素性股骨头坏死发病病机,强调药邪是SONFH的致病因素,肝脾肾三脏亏虚是SONFH发病基础,脏腑亏虚,功能减退,血行涩滞导致SONFH进展,瘀血痹阻骨络是SONFH的病机关键,以期建立“从虚而始,因虚致瘀,瘀痹骨络”的特色辨治体系,为中医药治疗SONFH提供理论基础。

基于“心受气于脾”论治类风湿关节炎累及心脏病变

类风湿关节炎累及心脏病变属于复合病证,根据其发病过程与临床表现,可归属于中医学“脏痹-心痹”。心痹为痹证日久缠绵不愈,复感风、寒、湿邪,向内传入于心所致。该文基于“心受气于脾”理论探讨其病因、病机与治疗。通过梳理古代文献,发现类风湿关节炎累及心脏病变的病因为脾气不足,卫阳不固,外感风、寒、湿邪气侵入机体,瘀血顽痰阻滞发为心痹。其病机为脾气不足,营卫虚弱;脾阳不足,痰浊内生;脾失健运,痰瘀互结。现代研究表明,细胞免疫失调、血脂异常以及血凝与类风湿关节炎合并心脏病变关系密切,这与中医病机一致。在治疗时选用补益卫阳,和营通痹;温阳散寒,化痰逐饮;益气活血,健脾祛痰之法,代表方剂分别为黄芪桂枝五物汤、苓桂术甘汤、赤茯苓汤。该文提出“心受气于脾”理论,为临床治疗类风湿关节炎累及心脏病变提供思路与指导。

基于痰瘀互结探讨慢性阻塞性肺疾病气道重塑

慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)的病理基础是气道的重塑,基于痰瘀相关理论,认为久病肺虚,痰气、瘀血阻塞气道,是慢性阻塞性肺疾病气道重构的基本病机,文章中医学痰瘀互结相关理论对COPD气道重塑病因病机、治疗等方面进行阐述。