Cosmological Origins of the Obverse-Reverse Zang Fu Pairing in Chinese Medicine

Most of the rich philosophical and scientific concepts which nurtured the Chinese thought we know today, were developed during the troubled final end of the era before ours, from V to II centuries. After reading reputed sinologists’ work on the cosmological origin and subsequent evolution of the Chinese concept of parallelism-pairing in poetry, literature, mathematic and other disciplines and since it is a tradition that all branches of knowledge in China are based on the development of those initiatory thoughts, the author asked herself if such knowing on the cosmological genesis of the parallelism concept could also be applied to Chinese medicine, science that describes its coupled structures and functions in pairs, simply based on yinyang, matrix of all pairings. Therefore, this paper proposes to apply those foundations, to explain the pairing of dynamisms in medicine. This work starts out from the oracular inscriptions in ancient times, cosmological basis of these ideas and their applications to Chinese literature and from there translates this approach to the study of the pairings described by Chinese medicine, and thanks to which (qi xue) blood-energy circulation occurs in human beings. Organic and functional pairs described by Chinese medicine are the basic element to understand the concept of health and disease, and this paper is about the cosmological roots of those pairings, the cosmic resonance influence and the numerology influence in them, and the whole is illustrated both through the description of the (obverse-reverse) biao li pair, different from (inside-outside) nei wai, and the functional relationship between these two couples.

Herb-herb interaction in traditional Chinese medicine：a review of pharmacokinetics-based interaction in Herb-Pairs

"Herb-Pairs",also known as pair drugs,refers to a prescription consisted of two relatively fixed traditional Chinese medicine,is the most basic,most simple and most common form of medication prescription in traditional Chinese medicine compound compatibility.It is not a random combination of two herbs,nor is the simple accumulation of efficacy,but the simple and delicate experience of ancient Chinese medicine practitioners.As a bridge between single drug and prescriptions,it is the embodiment of the regular and dialectical connotation.Therefore,research on Herb-Pairs has always been the most basic and most important entry point for compound compatibility studies.However,the interaction between herbs and herbs is an effect with a downside as well as benefits.The beneficial herb-herb interaction in Herb-Pairs include mutual promotion,mutual enhancement,mutual restraint between two drugs and counteract toxicity of another drug.And the harmful herb-herb interaction in Herb-Pairs includes mutual inhibition and antagonism.Al of these interactions areby means of affecting the metabolism of components to play a therapeutic effect.Using the pharmacokinetic-pharmacodynamic(PK-PD)binding model,the combination of drug metabolism and pharmacodynamics can further elucidate the influence on effect caused by drug concentration and metabolism,which can help elucidate the mechanism of drug action.Consequently,in this review,the herb-herb interactions in terms of pharmacokinetic were summarized to elucidate rule of TCM compatibility.

Research on Herb Pairs of Classical Formulae of ZHANG ZhongJing Using Big Data Technology

Objective To analyze various herbal combinations in Treatise on Exogenous Febrile Diseases(Shang Han Lun,《伤寒论》)and Synopsis of Prescriptions of the Golden Chamber(Jin Gui Yao Lve,《金匮要略》),seeking to identify fundamental rules dictating the selection of herbal combinations through probability models and big data technology.Methods A total of 252 formulae were collected from Treatise on Exogenous Febrile Diseases(Shang Han Lun,《伤寒论》)and Synopsis of Prescriptions of the Golden Chamber(Jin Gui Yao Lve,《金匮要略》)by ZHANG Zhong-Jing.Formulae were then preprocessed with all herb names standardized.The concepts of candidate herb pair and candidate herb pair probability were proposed to analyze the rules of combinations in classical formulae based on probability statistics.MapReduce parallel computing framework of distributed big data technology was adopted to analyze large data samples combined with inverted index algorithm.Results The results showed that the core herbs were Glycyrrhizae Radix Rhizoma(Gan Cao,甘草),Cinnamomi Ramulus(Gui Zhi,桂枝),Zingiberis Rhizoma Recens(Sheng Jiang,生姜),Jujubae Fructus(Da Zao,大枣),Paeoniae Radix Alba(Bai Shao,白芍),etc.43 high-frequency pairs co-occurring 10 times or above were extracted,and 35 of these combinations were recognized as traditional herb pairs,such as Cinnamomi Ramulus(Gui Zhi,桂枝)-Glycyrrhizae Radix Rhizoma(Gan Cao,甘草),Zingiberis Rhizoma Recens(Sheng Jiang,生姜)-Jujubae Fructus(Da Zao,大枣),and Cinnamomi Ramulus(Gui Zhi,桂枝)-Ginseng Radix Et Rhizoma(Ren Shen,人参).The other 8 pairs of combinations,such as Paeoniae Radix Alba(Bai Shao,白芍)-Zingiberis Rhizoma Recens(Sheng Jiang,生姜),Paeoniae Radix Alba(Bai Shao,白芍)-Jujubae Fructus(Da Zao,大枣),and Zingiberis Rhizoma Recens(Sheng Jiang,生姜)-Ginseng Radix Et Rhizoma(Ren Shen,人参),were not defined traditionally,but in connection with commonly used herbs.Classical formulae took the core herbs as principles,focusing on tonifying deficiency,strengthening the spleen and the stomach,strengthening the healthy Qi,and eliminating pathogenic factors.The compatibility pattern of properties involved was mainly acrid and sweet,which reflected the compatibility laws of benefiting Qi and tonifying Yang,replenishing Qi and nourishing blood,etc.Conclusions The research of classical formulae provides common understanding of some basic rules that have been adopted to tackle common illnesses/diseases using herbal medicine.The results help to reinforce theoretical understanding and development of traditional Chinese medicine(TCM),and revealing the hidden rules of combination in TCM data.Analyzing wider data samples of various herbal combinations through computation and big data technology can further optimize the use of TCM.

The Pairing of Heart and Small Intestine Xin Xiao Chang Xiang Biao Li 心 小 肠 相 表 里

This paper investigates the reasoning, based on both Chinese and Western medical data, which will lead to an understanding of the relation of the heart and small intestine, organs which Chinese Medicine, in the Fire energy phase, link both functionally and anatomically. The direct relationship between the liver and the gall bladder and between the kidneys and the bladder is recognised and accepted in both Chinese and Western Medicine. This is not the case with the pairings which in Eastern morphophisiology are formed by the heart and small intestine and the lungs and large intestine. These pairings are not recognised in Western Medicine. The writer in her dual capacity of Doctor of Western Medicine and acupuncturist is investigating the reasons why in Chinese Medicine the heart and small intestine and their meridians form a relation which couples them. For this the comparative method was used between data from Western anatomy which demonstrate the interorganic and functional relation between the small intestine and the heart and the Chinese energy dynamic of the corresponding zangfu and jingluo. Biomedicine which does not relate the heart with the small intestine brings in the materiality of its anatomic descriptions which are valuable for the interpretation of Oriental Medicine. This interrelation between the two organs and their meridians are well explicated in Chinese Medicine whose traditional concepts in this respect are corroborated by Western anatomical descriptions which, nevertheless, do not admit the functional-organic coupling of the heart and small intestine.

Research Progress of Herb Pair Rhizoma Coptidis-Fructus Evodiae

The herb pair is the basic form of compatibility and application of traditional Chinese medicine.Herb pairs have the advantages of simple structure,clear compatibility and effective characteristics,and are suitable for scientific research.Rhizoma Coptidis-Fructus Evodiae is a relatively fixed combination of two herbs commonly used in clinical Chinese medicine.Chinese medicine uses it to treat various diseases caused by damp-heat accumulation in the liver and gallbladder,and spleen and stomach.The two medicines in the herb pair are opposite in nature but complement each other,and can achieve a great effect based on simple combination.Modern research shows that the herb pair has a wide range of pharmacological effects and good anti-tumor,analgesic,bacteriostatic and anti-inflammatory activity,and show good curative effects on stress ulcers,functional dyspepsia,chronic colitis,etc.This paper reviewed the research progress on the herb pair of Rhizoma Coptidis-Fructus Evodiae.

基于化学成分与药理作用评价当归-黄芪药对配方颗粒汤剂与传统汤剂的差异

目的评价当归-黄芪药对配方颗粒汤剂(DGD)与传统汤剂在化学成分和药理效应方面的差异,为合理应用该配方颗粒提供参考。方法以原料来源批次统一和不统一2种对比方式,设不同样品组,采用高效液相色谱(HPLC)法建立特征图谱,从特征图谱相似度、成分种类、指标成分含量、共有峰面积等角度对化学成分进行评价;采用失血性血虚模型小鼠评价药效。结果①DGD特征图谱与传统汤剂相似度较高(相似度>0.87);②共有色谱峰数目不一致,传统汤剂-自购饮片和传统汤剂-A厂饮片共有色谱峰各12个,A厂DGD共有色谱峰15个,B厂DGD共有色谱峰10个;③A厂DGD中阿魏酸、毛蕊异黄酮苷含量高于传统汤剂(P<0.05);B厂DGD与传统汤剂阿魏酸含量差异无统计学意义,但毛蕊异黄酮苷含量较传统汤剂低(P<0.05);④DGD共有峰面积总和与传统汤剂相比,自购传统汤剂、A厂传统汤剂及A厂配方颗粒、B厂配方颗粒中各成分含量相对比值分别为1.00、0.96、2.14、0.60;⑤DGD及传统汤剂均能明显促进失血性贫血模型小鼠血红蛋白(Hb)、红细胞(RBC)恢复(P<0.01);与模型对照组比较,除B厂DGD组外均差异有统计学意义(P<0.05);A厂DGD与传统汤剂差异无统计学意义,B厂DGD与传统汤剂差异有统计学意义(P<0.01)。结论无论原料来源批次是否一致,DGD与传统汤剂在化学成分上均存在一定差异;在药理作用上,来源于同一批次饮片制备的DGD与传统汤剂对改善失血性贫血药效相当,来源于不同批次饮片制备的DGD与传统汤剂在药效上存在一定差异;不同来源批次的饮片和不同制备工艺造成不同厂家配方颗粒存在质量差异,说明国家统一配方颗粒质量标准及制定相关过程规范具有必要性与紧迫性。

中药单味药、药对及复方治疗睡眠障碍的研究进展

睡眠是人类不可或缺的生理活动,约占人生中1/3的时间。人体需要借助适当的睡眠来完成身体机能及大脑认知学习的恢复等关键生理功能。近年来,睡眠障碍的发病率呈上升趋势,西医治疗睡眠障碍虽取得一定疗效,但仍存在诸多问题,而中药以其不良反应小、疗效显著的优势受到广泛关注。对中药单味药、药对、复方治疗睡眠障碍的研究进展和作用机制进行归纳总结,以期为中药防治睡眠障碍的临床应用研究提供参考。

中药葛根防治糖尿病的作用机制和研究进展

糖尿病患病率高且并发症多,严重影响各种疾病的预后。在治疗上,降糖西药不良反应较多,限制临床治疗。中医药对于防治糖尿病经验丰富,可通过多靶点多通路降低患者血糖。中药葛根作为辛凉解表药,有清热、生津、止渴之效,药理学研究其具有抗氧化应激反应、减少炎症因子积聚、增强胰岛素敏感性、减少胰岛素抵抗等作用。葛根治疗糖尿病的主要活性成分为葛根素,临床研究表明以葛根素、葛根药对、葛根类方辨证论治各种糖尿病患者,疗效显著。近年来研究发现葛根素、葛根药对及葛根类方可以通过多靶点、多通路抑制氧化应激反应、调节体内炎症因子水平、减少AGEs的形成与累积、抑制胰岛β细胞凋亡、增加胰岛素敏感性、减少胰岛素抵抗等多种途径达到降低血糖,控制并改善各种并发症。文章旨在通过梳理相关文献,从葛根素、葛根药对、葛根类方3个方面总结归纳中药葛根防治糖尿病的作用机制和研究进展。

基于组分中药理论的薏苡仁-知母药对治疗糖尿病患者的配伍特点

药对是源于中医传统经方或验方,依据中药配伍原则,能长期应用并指导临床实践的两味药物相对固定的配伍形式,具有协同增效或配伍减毒的作用。薏苡仁-知母为典型的清热滋阴药对,二者相辅相成,治疗阴虚热盛型糖尿病患者效果显著。其成分知母皂苷、知母多糖、芒果苷、薏苡仁多糖等对糖尿病均有较好的干预作用。现从中医理论及现代药理学研究等层面探究薏苡仁-知母药对治疗糖尿病的配伍特点,剖析主要活性成分的降糖作用和作用机制,为治疗糖尿病的新药研究提供理论基础。

李曰庆治疗生殖器疱疹药对浅析

生殖器疱疹是常见的性传播疾病之一,也是男科的常见病和多发病,由于缺乏特效药物,容易反复发作,治疗较为棘手。中医学将该病归属于“热疮”“阴疮”的范畴,认识较早,治疗方法丰富。李曰庆教授认为生殖器疱疹的病机当根据其发病特点分期而辨,发作期多实证,以湿热淫毒壅遏肌肤多见;潜伏期多虚实夹杂,正虚邪恋,以肾阳不足、气阴两虚为著。李曰庆教授对该病的辨治经验丰富,见解有独到之处,强调辨证与辨病相结合,中医与西医相结合,男女同诊,内外兼治,身心同调,疗效确切,现对其治疗思路及常用药对做一浅析,以供同道相互借鉴。

基于超图理论的中医方剂网络药对挖掘方法

随着复杂网络研究的深入发展,利用复杂网络理论对中药药方数据进行建模分析已成为研究中药配伍规律的重要方法之一。然而,传统的“药-药”网络结构只基于“点-边”关系,无法体现方剂和中药之间的高阶交互关系,从而影响药对挖掘的准确率和效果。针对该问题,提出了一种基于超图的方药超网络建模方法来刻画方剂与中药之间的高阶关联关系,以方剂为超边、方剂中的中药为节点构建方药超网络,对比传统“药-药”网络和方药超网络的统计特性发现,方药超网络节点超度分布更加符合幂律分布特征,具有小世界和无标度特性,证明了方药超网络建模方法具有合理性和可行性;基于方药超网络提出一种融合多因素的双权重度中心性指标(double weight degree centrality,DWDC)挖掘方剂中的常见中药,引入超边属性对节点特性的影响,以网络的脆弱性和鲁棒性为依据,通过各算法之间的对比实验,验证所提出方法能够更有效筛选出方剂超网络中的常见中药;再将DWDC指标推广到二阶常见药对挖掘,提出高阶指标H-DWDC,基于真实数据集的实验结果表明,该方法能够有效地从海量数据中挖掘出常见药对。

国医大师雷忠义运用角药治疗心衰经验探析

心衰是多种心脏疾病发展的终末阶段,是目前心血管常见疾病之一。雷忠义国医大师认为心衰的病机为气虚阳微,血瘀水停,角药是方剂的基本单位,相互配伍,可起到相辅相成、相互制约、减毒增效的作用。雷大师临证常用角药治疗心血管疾病,本文通过论述雷忠义国医大师运用黄芪-人参-制附子、茯苓-桂枝-白术、鹿角胶-龟甲-前胡、玉竹-淫羊藿-制附子、丹参-三七-陈皮、泽兰-益母草-茯苓、葶苈子-小叶萆薢-北五加皮、赤芍-车前子-泽泻八组角药治疗心衰的组成功效、配伍要点、适应症、随证加减等,探析雷大师临证运用角药治疗心衰之经验,以指导专科诊疗,从而提升疗效。

夏小军教授运用对药治疗原发免疫性血小板减少症拾萃

原发免疫性血小板减少症(ITP),是一种获得性自身免疫性疾病,以孤立性外周血血小板计数减少为特点。临床表现为血小板数目减少,伴或不伴皮肤黏膜出血。西医治疗ITP多运用糖皮质激素、促血小板生成药物及脾切除等,能在短时间内改善患者的临床症状,但存在不良反应大、易复发、远期疗效差等弊端。既往已有大量研究表明,中医药治疗ITP具有增效减毒、提高患者生活质量等优势。ITP归属于中医学“紫斑”“血证”“葡萄疫”等范畴,夏小军教授临床辨治以清热凉血止血、健脾益气滋阴为主,佐以活血化瘀,且善于运用对药,如墓头回—紫草凉血活血、仙鹤草—阿胶止血补血、水牛角—生地黄清热养血、黄芪—益母草补血活血、牡丹皮—地骨皮养阴活血、白茅根—赤芍凉血散血等。以对组方,方中有方,是其用药的特色,灵活应用,收到较好疗效。

田理教授基于证素辨证治疗变应性鼻炎临床药对撷菁

文章介绍了田理教授基于变应性鼻炎(Allergic Rhinitis, AR)的基本证素“虚、风、热、瘀、湿”常用的13组药对以及其在临床中应用的经验。从“虚”辨治的黄芪-党参、女贞子-墨旱莲、附子-干姜/肉桂/熟地黄、山药-薏苡仁/莲子4组药对,从“风”辨治的荆芥-蒲公英/防风、桑叶-菊花2组药对;从“热”辨治的柴胡-黄芩、桑白皮-地骨皮2组药对;从“瘀”辨治的丹皮-茜草、川芎-当归、桃仁-红花3组药对;从“湿”辨治的茯苓-白术、茵陈-滑石2组药对;以期为AR提供新的治疗思路。

福州苍霞洲李氏中医儿科学术流派论治小儿高热特色

发热病因病机复杂,临证以外感热病多见。小儿发热严重会对患儿的神经发育造成难以修复的损伤,影响语言沟通及自主行动能力。现代医学主要采取物理降温、抗病毒、抗感染等方法治疗该病,但长期应用上述方法会使患儿神经发育受损,影响患儿的记忆和学习能力,对智力的影响有可能持续到成年,故其临床应用有限。中医药在治疗小儿高热方面有丰富的临证经验。文章通过整理福州李氏中医儿科历史书籍,主要探讨福州李氏中医儿科学术流派论治小儿高热的经验。福州李氏儿科流派始于清末,一脉相承,近百年已传六代,是福州中医儿科学的主要组成部分,也是福建儿科流派最为重要的分支之一。福州李氏儿科学术流派针药结合,继承并创新,弥补不足,结合现代技术及地域特点,在长期与小儿高热的抗争中凝练出独具特色的小儿高热用药经验和诊疗技术:重外感,以疏为要截病邪,以清为要通腑热,以下为要。治高热时善用药对荆芥、薄荷、豆豉;黄连、连翘、栀子;大黄、石膏、瓜蒌等。李氏流派医家尤为重视内外兼治,擅长运用小儿飞针特色治法,临床中疗效颇丰,为流派的积淀、继承、发扬奠定了坚实的基础,也为同道提供了一定借鉴。

基于“阴阳交感”及临床药理探讨“黄连-肉桂”对失眠的治疗

药物配伍是中医的魂之所在,用药如用兵,善用方者,必善药之配伍,执简驭繁。失眠皆因阳盛阴衰,阴阳失交所致,而临床上心肾不交型失眠尤为多见。黄连,味苦性寒,有泻火之功,当属阴药;肉桂,味辛甘、性大热,有补火助阳、引火归元之功,当属阳药。“黄连-肉桂”配伍,交通心肾阴阳二气,可治阴阳失调、心肾不交所致失眠之症。“黄连-肉桂”联用效果更显著,一种可能是由于两药联用后会使有效成分的溶出率更高,还有一种可能是会增多或抑制相关蛋白的表达。通过探讨“黄连-肉桂”所体现的阴阳交感的中医思想,不仅可以为治疗阴阳失调提供新的思路,也可以通过现代药理研究预测出治疗失眠的新机制,并通过实验进行药效验证,为中西医结合治疗失眠打开新思路。

辨治儿童肥胖常用药对拾撷

总结张雪荣教授运用药对治疗儿童肥胖的经验。张教授认为儿童肥胖的病位主要在脾,常涉及肝肾,基本病机为脾虚湿盛,并兼有肝郁或肾阳虚,致痰湿瘀血内生留滞于肌肉腠理发为肥胖,属于本虚标实。治疗应当健脾利湿,并辅以疏肝、补肾阳,化痰活血。常用药对有荷叶与泽泻、茯苓与白术、柴胡与香橼、丹参与川芎、茯神与合欢皮、土茯苓与威灵仙。药对配伍得当,疗效明显。附验案1则以佐证。

王自敏教授分期分型辨治IgA肾病经验

[目的]总结王自敏教授分期分型辨治IgA肾病的经验。[方法]通过跟师学习,收集病案,总结探讨王老治疗IgA肾病的经验,并附医案一则。[结果]王老认为,IgA肾病属本虚标实、虚实夹杂之病,病位主要在肾,与肝、脾、肺密切相关,病因分为内因和外因,两者合而为病,并认为本病核心病机为“湿、热、瘀、虚”,将本病分为急性发作期和慢性持续期,急性发作期分为风热袭肺型、心火亢盛型、湿浊犯脾型和下焦湿热型,慢性持续期分为阴虚火旺型、气阴两虚型、脾肾亏虚型以及瘀毒阻络型。王老针对不同证型,分别给予银翘散、导赤散、小蓟饮子、知柏地黄丸合二至丸、黄芪地黄汤、六君子汤合右归丸、自拟黄槐温胆汤合血府逐瘀汤等加减治疗。王老指出,本病治疗以扶正祛邪、攻补兼施为治则,主张中西医结合,并善用药对精准治疗。所附医案首诊时辨为阴虚火旺型,治以滋阴降火、清热凉血,予知柏地黄丸合二至丸加减,后随证加减,疗效甚佳。[结论]王老分期分型治疗IgA肾病经验丰富,提出本病核心病机为“湿、热、瘀、虚”,对治疗本病有较高的指导意义。

基于网络药理学和分子对接探究莪术-三棱药对治疗前列腺癌的作用机制

目的探究莪术-三棱药对治疗前列腺癌(prostate cancer,PCa)的药物活性成分、核心靶点及分子机制。方法基于HERB和PubChem数据库获取莪术-三棱的药物活性成分和作用靶点,利用Genecards、OMIM、PhamGkb、TTD、DrugBank数据库获取PCa疾病靶点,药物靶点和疾病靶点取交集得到共同靶点。采用Cytoscape 3.9.0软件构建莪术-三棱活性成分与PCa靶点网络,将交集靶点导入String数据库构建蛋白-蛋白相互作用网络(protein-protein interaction network,PPI),对潜在靶点进行基因本体(gene gontology,GO)功能富集分析和京都基因与基因组百科全书(Kyoto Encyclopedia of Genes and Genomes,KEGG)通路富集分析,最后利用AutoDockTools 1.5.7等软件对核心靶点和药物关键活性成分进行分子对接验证。结果共筛选得到72种药物活性成分和760个有效活性成分靶点,PCa疾病相关靶点13001个,交集靶点为659个。药物关键核心成分为莪术双环烯酮、无患子皂苷B、花椒麻素、(2s)-3',4'-亚甲二氧基-5,7-二甲氧基黄酮、芹菜素、天人菊内酯、山奈酚、三棱酸、脱甲氧姜黄素以及5,7,2',3'-四羟基黄酮。PPI网络分析得到SRC、TP53、MAPK3、MAPK1、STAT3、HSP90AA1、AKT1、PIK3R1、RHOA、GRB2核心靶点。GO和KEGG富集分析显示,莪术-三棱治疗PCa主要涉及细胞增殖、凋亡、迁移和信号转导等信号通路。分子对接结果显示核心靶点与活性成分之间存在较强的结合力。结论本研究揭示了莪术-三棱抗PCa的关键活性成分及其与潜在靶点的相互作用,凸显了其多成分、多靶点相互作用的特性,为深入研究莪术-三棱治疗PCa提供了有价值的参考。

黄芩-黄连药对及其活性成分治疗糖尿病肾病的作用机制研究进展

糖尿病肾病(DN)是糖尿病最常见的并发症之一,中医认为湿热内蕴是DN的关键病机,治法应以“清湿热”为主。黄芩-黄连药对是清湿热法的代表药对,现代研究表明该药对及其主要活性成分对DN具有治疗作用。梳理近年来黄芩-黄连药对及其主要活性成分的相关文献,从调节糖脂代谢紊乱、减少肾脏细胞凋亡、缓解肾脏炎症和纤维化、调节肠道微生物和调控基因转录等方面进行综述,为黄芩-黄连药对的临床运用和研发提供系统的理论依据。