Effects of TCM Nursing Based on Syndrome Differentiation on Pulmonary Function and Quality of Life in Patients with Acute Exacerbation of COPD

[Objectives] To investigate the effects of TCM nursing based on syndrome differentiation on pulmonary function and quality of life in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). [Methods] A total of 92 patients with AECOPD who came to Nanchong Chinese Medicine Hospital from March 2022 to February 2023 were selected for the study, and the intervention group (TCM nursing based on syndrome differentiation, 46 cases) and the conventional group (basic nursing, 46 cases) were selected for the study, and the pulmonary function and quality of life of the two groups were compared. [Results] Before nursing, there was no significant difference in levels of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and percentage of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) between the intervention group and conventional group ( P >0.05). After 3 months of nursing, the levels of FVC, FEV1 and FEV1/FVC in the intervention group were higher than those in the conventional group ( P <0.05). Before nursing, there was no significant difference in the scores of health, emotion and social functions between the two groups ( P >0.05). At three months of nursing, the scores of health, emotion, and social functions in the intervention group were higher than those in the conventional group ( P <0.05). [Conclusions] The implementation of TCM nursing based on syndrome differentiation in patients with AECOPD can effectively improve the pulmonary function and quality of life of patients, and has significant clinical implementation value.

Exploring the characteristics of inquiry and the correlation with TCM syndromes about the patients with cardiovascular disease

Objective:Inquiry occupies an important position in the Traditional Chinese Medicine(TCM)diagnostic methods.Observing the characteristics of inquiry symptoms and the correlation with TCM syndromes can determine the important guiding significance to build recognition model and diagnostic criteria of syndrome.Methods:In this study,we collected 3707 valid cases,analyzed the inquiry symptoms of patients with cardiovascular disease,then to explore the distribution of inquiry information and the correlation with TCM syndromes based on the methods,such as frequency analysis,expert score,and correlation analysis.Results:We found the symptoms of frequency analysis and expert symptom score all in the top 50,add up to 41.According to the results by correlation analysis,the correlation coefficient between each symptom and each syndrome are sorted from high to low,the same with the experts score to each inquiry symptom basing on its importance of in diagnosing each syndrome.Conclusion:Inquiry occupies an important effect in differentiation syndrome.This research could provide certain objective basis for establishment of TCM syndromes diagnostic criteria of cardiovascular disease,thus provide some ideas and methods for the research of establishing TCM syndrome identification model,then to provide a reference for the syndrome standardization and objectification.

Characteristic changes of intestinal flora and its correlation with clinical indexes in patients with Behcet's disease based on TCM syndromes

Objective: To analyze the characteristics of intestinal microflora in patients with Behcet's disease of damp heat syndrome by 16S rRNA technique and its correlation with clinical indexes;Methods: 49 patients with Behcet's disease were divided into Shire group (SR, n =19) and non-shire group (Non-SR, n = 30), and 43 healthy subjects were selected as control group. The basic information and laboratory test indexes of three groups were collected, and fecal samples were collected to detect the diversity and abundance of intestinal flora in each group by 16S rRNA. Results: Compared with Non-SR group, the incidence of ocular involvement was higher in SR group (P<0.05). At the same time, WBC, CRP, ESR and IgG in SR group were significantly higher than those in Non-SR group (P<0.05). The results of alpha diversity showed that the ace, Chao 1 and Shannon indexes of the SR group were significantly lower than those of the healthy group and the Non-SR group, while the Simpson index was significantly higher (P<0.05). Compared with the Non-SR group, the abundance of Actinobacteria phylum increased in the SR group (P<0.05);the level abundance of Collinsella, Intestinimonas and Enterobacteriaceae_ unclassified genus were increased, and the level abundance of Clostridiales_unclassified, Ruminococcaceae_UCG009, and Ruminococcus_gauvre auii_group genus were decreased (P<0.05). Pearson correlation analysis showed that Oscillospira abundance was positively correlated with WBC, CRP, ESR and IgG levels, while Eubacterium and Cetobacterium abundance were negatively correlated with WBC, CRP, ESR and IgG levels. Conclusion: The change of intestinal flora is involved in the pathogenesis of BD. At the same time, there are differences in intestinal flora in different types of BD patients. In addition, the specific flora in intestinal tract is closely related to the serum inflammation and immune indexes of BD.

Research progress on the correlation between TCM syndromes of coronary heart disease and blood biochemical indexes

The researches on the correlation between TCM syndromes of coronary heart disease and blood biochemical indexes from Jan.2011 to Jul.2020 were reviewed,in order to explore the association of different TCM syndromes of coronary heart disease with blood biochemical indexes,such as blood lipid metabolism,inflammatory factors,coagulation-fibrinolysis system,blood rheology and vascular endothelial function,which was hoped to provide a guidance on the clinical combined application of TCM syndrome differentiation and biochemical indexes of coronary heart disease,so as to promote the objectification and standardization of TCM syndrome differentiation.

Relationship between Traditional Chinese Medicine Syndrome Type and Coronary Arteriography of Acute Coronary Syndrome

Objective: To explore the relationship of Traditional Chinese Medicine (TCM) Syndrome type and coronary arteriography (CAG) with respect to the number and degree of stenosed branches of coronary artery (CA) and ACC/AHA stage of acute coronary syndrome (ACS), to provide an objective evidence for TCM Syndrome typing on ACS Methods: Ninety patients of ACS with their TCM Syndrome typing and CAG successfully conducted were enrolled in this study. They were classified into 3 Syndrome types, the blood stasis type (type I ), the phlegm stagnant with blood stasis type (type II ),and the endogenous collateral Wind type (type III) The scores of the number and severity of the stenosis branch of CA and ACC/AHA lesion stage in different Syndrome types were calculated respectively and analysed statistically by Ridit analysis. Results: The number of stenosed branches increased gradually with the Syndrome type changing from I -II-III, compared the type III with the other two types(P<0. 01). The severity of stenosis in type I and II were similar, but that of Type III, much aggravated was significantly different from that in the former two (P<0. 01) . The ACC/AHA stage of coronary lesion tended to be more complex as the Syndrome type changed, patients of TCM type I and II had mostly lesion of stage A or Bl , while lesion in majority of patients of type III belonged to stage B2 or C, comparison between the three types showed significant difference (P<0.01). Conclusion: Most ACS patients of TCM Syndrome type III with tri-branch, severe stenosed coronary arteries, belong to the complex ACC/AHA stage of B2 and C.

Exploring the biological mechanism of qi deficiency syndrome with chronic obstructive pulmonary disease(COPD)based on integrated pharmacology

Objective:To explore the potential biological mechanism of chronic obstructive pulmonary disease(COPD)qi deficiency syndrome,we used the integrated pharmacology network computing platform and carried out experimental verification.Methods:Using an integrated pharmacology strategy to analyze the potential biological targets of COPD qi deficiency syndrome.Based on the established qi deficiency syndrome rat model of COPD,the biological targets of lung and skeletal muscle were detected by electron microscopy,adenosine triphosphate(ATP)content assays,and western blotting.Results:According to the integrated pharmacological results,it was found that the locations of cell components related to COPD qi deficiency syndrome were mainly mitochondria.Electron microscopy results using lung tissue showed that mitochondria in the lipopolysaccharide(LPS group)and pulmonary instillation of LPS combined with cigarette smoke(LPStCS group)were swollen,deformed,and fragmented,with disappearing or broken crista.Results also showed that the total content of ATP in the lung and skeletal muscle of both groups was significantly lower than that in the control group at the 12th week(P<.05).At the 12th week,the expression of dynamin-related protein 1(DRP1)and mitofusin 1(MFN1)protein was significantly difference than that of the control group(P<.05).At the 10th and 14th weeks,changes in fission and fusion proteins in mitochondria of the lung and skeletal muscle were further detected.There was also a significant difference in the expression between the two groups compared to that in the control group at the 10th week and 14th week(P<.05).Conclusion:These findings suggest that the changes in mitochondrial morphology and ATP content and the unbalanced expression of DRP1 and MFN1 might be the key mechanisms underlying qi deficiency syndrome in rats with COPD.

Give Full Play the Role of Traditional Chinese Medicine to Prevent and Treat Severe Acute Respiratory Syndrome with Integrative Chinese and Western Medicine Approach

Member of Political Bureau of Central Committee of CPC, Vice Premier of State Council concurrently Minister of Health, General Command of National Protecting and Treating Severe Acute Respiratory Syndrome ( SARS) Headquarters Vice premier WU Yi cordially met the well-known TCM specialists, and held a symposium with them. Sixteen specialists including WANG Yong-yan, CHEN Ke-ji, LI Fu-ren, JIAO Shu-de, HE Pu-ren, LIU

Potential Mechanism and Application of Strengthening the Spleen, Clearing Heat and Dampness in Treatment of Gastroesophageal Reflux Disease

Gastroesophageal reflux disease(GERD)is one of refractory digestive disease in clinic characterized by high prevalence,complex and recurrent symptoms.Traditional Chinese medicine(TCM)has a significant effect on the treatment of GERD.Spleen deficiency and damp-heat syndrome becomes one of the main syndrome patterns of GERD adapting with the changes of modern lifestyle.Although the therapy of strengthening the spleen,clearing heat and dampness is widely used in treatment of GERD,further studies still need to be conducted.The article comprehensively analyses the theoretical basis,mechanism and clinical efficacy of the therapy in order to provide more ideas for clinical treatment.

Research progress of traditional Chinese medicine nursing for pelvic inflammatory disease sequelae

Pelvic inflammatory disease refers to a group of female genital tr act on infec tious disease, mainly including endometritis, tubal phlogistic, oviduct ovarian abscess, if not 廿mely tr eatment of the disease is easy to become chr onic, now called pelvic inflammatory disease sequelae, clinical manifestations in chronic pelvic pain, recurrent pelvic inflammatory disease, affect women's physical and mental health. TCM nursing based on the basic theory of TCM, apply the overall view, the nursing method of syndrome differentiation, the traditional Chinese medicine nursing technique is widely used in the disease, such as traditional Chinese medicine enema, Chinese medicine external treatment, moxibustion, ear acupuncture point buries a seed, methods of modern nursing, has the characteristics of simple and cheap effect, can reduce the swelling fights, promoting blood circulation to remove blood stasis, relieve the pelvic congestion, promote drainage in abdominal and pelvic cavity and the absorption of bag piece, adjust the viscera function, obvious effect and has unique advantages, further prove the uniqueness of TCM nursing and safety, provide the basis for clinical treatment.

基于治未病理论灸药同治对实体恶性肿瘤化疗患者骨髓抑制的预防作用

目的:基于治未病理论探讨灸药同治对实体恶性肿瘤化疗患者骨髓抑制的预防作用。方法:选取2019年1月至2022年1月于武汉科技大学附属武汉亚心总医院接受治疗的实体恶性肿瘤化疗患者120例作为研究对象,采用随机数字表法分为对照组和观察组,每组60例。对照组常规接受化疗,观察组化疗前连续3 d给予灸药同治(艾灸+加味八珍汤)。比较治疗前、化疗后7 d 2组患者中医证候积分、血常规[血红蛋白(Hb)、白细胞计数(WBC)、血小板计数(PLT)、中性粒细胞计数(NEUT)]、生命质量[卡诺夫斯凯计分(KPS)、中国癌症患者生命质量(QOL_(2))调查问卷],比较化疗后7 d 2组患者骨髓抑制情况[发生率、严重程度、重组人粒细胞集落刺激因子(rhG-CSF)使用情况]。结果:化疗后7 d,2组患者中医证候积分升高,但观察组低于对照组(P<0.05);Hb、WBC、PLT、NEUT、KPS评分及QOL_(2)评分降低,但观察组高于对照组(均P<0.05);观察组骨髓抑制发生率、rhG-CSF使用率低于对照组,0、Ⅰ度比例高于对照组(均P<0.05)。结论:基于治未病理论,灸药同治能够改善实体恶性肿瘤化疗患者临床症状及血常规,提高患者生命质量,减少骨髓抑制的发生。

孙桂芝病证结合辨证在肿瘤治疗中的应用

病证结合是孙桂芝教授治疗肿瘤病学术思想的重要组成部分,把辨证与辨病有机地结合起来,进行综合诊治,既照顾到整体,又注意到局部;辨证为先还是辨病为先在临床诊疗中要根据实际情况而定,二者互补。特别是现代科学技术的发展弥补了中医诊疗方面的不足,辨病治疗成为中医治疗学的重要部分。孙桂芝教授临证始终强调辨证与辨病紧密相连,中西手段并用,诊断疾病现代仪器和中医四诊联合,治疗上病证相参结合,攻补兼施,标本兼治,既要兼顾全局,也要重视细节。

基于隐结构模型结合关联规则研究冠心病稳定型心绞痛中医证候特征

目的探讨冠心病稳定型心绞痛中医证候的分布及特征,为今后冠心病稳定型心绞痛的辨证论治提供客观可靠的依据。方法计算机检索中国期刊全文数据库(CNKI)、万方(WanFang)、维普(VIP)等数据库内自建库以来至2022年1月的名老中医治疗冠心病稳定型心绞痛的医案及临床经验,采用孔明灯Lantern5.0软件,应用爬山法(LTM-EAST)算法建立症状隐结构模型并进行综合聚类分析;采用SPSS Modeler 15.1软件,用Apriori算法,对中医证素进行关联规则分析并绘制复杂网络图。结果①纳入的206例医案共涉及24个中医证候,其中频次较高(>5%)的分别为心血瘀阻证、痰瘀互结证、气滞血瘀证、痰湿阻滞证、气虚血瘀证、心阳虚证、气阴两虚证。②将共计121个症状作为显变量,应用LTM-EAST算法构建结构模型,得出30个隐变量,对得出的30个隐变量进行综合聚类,共得出9个综合聚类模型即9个中医证候,分别为气滞血瘀证、心血瘀阻证、气虚血瘀证、心阳虚证、气阴两虚证、痰瘀互结证、痰湿内阻证、痰热内闭证、心肾阳虚证。③对24个中医证候提取的17个证素进行关联规则分析,推导出7个中医证候,分别为心血瘀阻证、心阳虚衰证、痰瘀互结证、气阴两虚证、阳虚血瘀证、气虚血瘀证、气滞血瘀证。结论综合归纳,最终得出6个中医常见证候,分别为:气滞血瘀证、心血瘀阻证、气虚血瘀证、心阳虚证、气阴两虚证、痰瘀互结证。

慢性阻塞性肺疾病急性加重期中医证型结构方程分析

目的为慢性阻塞性肺疾病急性加重期(Acute Exacerbation of Chronic Obstructive Pulmonary Disease,AECOPD)临床辨证诊断和证型的量化标准提供参考依据。方法通过临床调研,应用先进的数理统计方法结构方程对AECOPD中医证候进行系统的研究。收集病例资料100例,数据分析软件选择R语言,首先经过探索性分析,利用最大方差旋转方法,提取出五个共因子,归纳为F1至F5,依据中医理论进行证型辨证命名。结果通过结构方程初步揭示了AECOPD的疾病的五个常见的证型:风寒证、肾虚证、脾虚证、阴虚证、痰湿证,同时分析出了五大常见证型的辨证要点。AECOPD结构方程中各因子与临床证型间存在着较好的对应关系。结论AECOPD的基础证型是风寒、肾虚、脾虚、阴虚、痰湿证等。

穴位贴敷联合中药雾化吸入护理在老年慢性阻塞性肺疾病急性加重期患者中的应用效果

目的:探讨穴位贴敷联合中药雾化吸入护理在老年慢性阻塞性肺疾病急性加重期患者中的应用效果。方法:选取2021年6月~2023年6月北京朝阳医院收治的老年慢性阻塞性肺疾病急性加重期患者100例为研究对象,根据随机数表法分为研究组和对照组,各50例。研究采用穴位贴敷联合中药雾化吸入护理,对照组采用常规护理,比较两组中医症候积分、肺功能指标、炎症反应、免疫功能及生存质量。结果:研究组干预后咳嗽、喘息气短、咳痰、肺湿啰音中医症候积分低于对照组(P<0.05);研究组治疗有效率高于对照组(P<0.05);研究组干预后呼气峰值体积流量(PEF)、用力呼气容积/用力肺活量(FEV1/FVC)、用力呼气容积占预计值百分比(FEV1%pred)、用力肺活量占预计值百分比(FVC%pre)高于对照组(P<0.05);研究组干预后基质金属蛋白酶-9(MMP-9)、白介素-4(IL-4)、肿瘤坏死因子-α(TNF-α)低于对照组,CD4+/CD8+高于对照组(P<0.05)。结论:穴位贴敷联合中药雾化吸入护理可以改善患者临床症状,降低炎症反应,提高患者免疫功能及肺功能,提高临床治疗效果。

基于《伤寒论》的六经辨证体系中医辨证模型推荐处方与临床医生处方结果的Kappa一致性分析

目的分析基于《伤寒论》的六经辨证体系中医辨证模型推荐处方与临床医生处方结果的一致性。方法纳入门诊患者共747例,医生通过四诊的采集得出治疗处方,再以手机终端录入采集的相关症状、体征后得到系统推荐处方。利用Kappa一致性检验来评价基于《伤寒论》的六经辨证体系中医辨证模型推荐处方与临床医生处方结果的一致性。结果基于《伤寒论》的六经辨证体系中医辨证模型推荐处方与临床医生处方的结果具有高度一致性,差异具有统计学意义(Kappa=0.71,P<0.001)。结论基于《伤寒论》的六经辨证体系中医辨证模型推荐处方与临床医生处方结果具有一致性,可辅助临床医生处方。

不同辨证体系中类风湿关节炎中医病机研究进展

类风湿关节炎属于一种以周围关节骨质损害为主要特征的自身免疫性疾病。中医学对其曾多以病因角度辨证,且多从风、寒、湿、热论治,其他辨证体系涉及较少。近年来,类风湿关节炎病机的相关研究得到广泛重视,其辨证体系和角度的探索也得到进一步拓展。该文对近年发表的有关中医治疗类风湿关节炎的文献进行梳理总结,从脏腑理论、气血津液理论及络病理论共三种辨证体系论述其论治研究进展。期望通过该文的归纳、分类与总结,为今后类风湿关节炎的病机研究和证型分类提供参考和思路。

中医护理模式对亚健康患者的影响

目的分析基于中医体质辨识学说的中医护理模式对亚健康患者的影响。方法本研究为随机对照试验。前瞻性选取2021年4月至2023年4月连云港市中医院治未病中心收治的100例处于亚健康状态患者作为研究对象。采用随机数字表法,将患者分为对照组(50例)和观察组(50例)。对照组男29例,女21例;年龄(40.20±2.01)岁;疲劳症状持续时间(6.45±1.43)个月。观察组男31例,女19例;年龄(39.98±2.40)岁;疲劳症状持续时间(6.37±1.40)个月。对照组采用常规护理,观察组在对照组基础上采用基于中医体质辨识学说的中医护理模式。两组均连续干预30 d。比较两组干预前后中医症候积分、生活质量[欧洲五维生存质量量表(EQ-5D)]。采用独立样本t检验、配对t检验和χ^(2)检验。结果干预后,观察组中医症候积分中的体倦乏力、神疲懒言、口淡不渴、食少纳呆评分均低于对照组[(1.01±0.30)分比(1.25±0.69)分、(1.43±0.22)分比(1.66±0.59)分、(1.00±0.35)分比(1.29±0.46)分、(0.73±0.22)分比(1.04±0.41)分](均P<0.05)。观察组EQ-5D中的行动能力、自我管理能力、活动能力、疼痛或不适、焦虑或抑郁评分均高于对照组[(2.01±0.64)分比(1.78±0.14)分、(1.95±0.43)分比(1.72±0.34)分、(1.82±0.26)分比(1.67±0.27)分、(2.01±0.27)分比(1.90±0.12)分、(1.92±0.14)分比(1.78±0.30)分](均P<0.05)。结论基于中医体质辨识学说的中医护理模式可改善亚健康患者中医症候积分,提高生活质量。

姜桂二陈汤治疗慢性阻塞性肺疾病稳定期(寒痰阻肺型)的临床研究

目的 探讨姜桂二陈汤对慢性阻塞性肺疾病稳定期(寒痰阻肺型)患者的临床疗效。方法 选取2020年1月—2022年12月北京中医药大学房山医院肺病科诊治的慢性阻塞性肺疾病稳定期(寒痰阻肺型)患者100例,随机分为观察组和对照组。对照组患者给予以规范西医治疗,观察组在规范西医治疗同时加用姜桂二陈汤,比较两组患者临床疗效、中医症状评分、肺功能及BODE指数。结果 两组患者疗效相比观察组较优(P<0.05);治疗后,两组患者中医症状评分均明显降低,两组相比观察组较低(P<0.05);治疗后,两组患者6 min步行距离(6MWTD)较治疗前升高,且观察组高于对照组;治疗后,两组患者肺功能水平明显提高,两组相比观察组较高;BODE指数较治疗前降低,且观察组低于对照组(P<0.05)。结论 姜桂二陈汤治疗慢性阻塞性肺疾病(寒痰阻肺型),可提高患者临床疗效,缓解患者临床症状,可改善患者肺功能及肺气肿程度,增强患者运动耐量,从而改善患者预后。

类风湿关节炎患者中医证型特点与Th17/Treg平衡和疾病活动度的关系

目的:探讨类风湿关节炎(RA)患者中医证型特点及与辅助性T细胞17(Th17)/调节性T细胞(Treg)平衡和疾病活动度的关系。方法:以2022年3月~2024年2月217例RA患者作为病例组,并选取同期健康体检志愿者100名为对照组,比较两组Th17细胞、Treg细胞、Th17/Treg及其相关因子[白细胞介素-17(IL-17)、IL-23]水平。依据中医证型将患者分为湿热痹阻证(108例)、寒湿痹阻证(43例)、痰瘀痹阻证(35例)、肝肾亏虚证(31例),比较各组患者临床特征分布情况、Th17/Treg及其相关因子、28个疾病活动度(DAS28)。结果:病例组Th17细胞、Th17/Treg及其相关因子水平高于对照组,Treg细胞低于对照组(P<0.05)。4种中医证型RA患者关节肿胀数、关节压痛数计病程存在显著差异(P<0.05);4种中医证型RA患者Treg、Th17细胞水平、Th17/Treg、IL-17、IL-23及DAS28水平存在显著差异(P<0.05)。4种证型RA患者DAS28评分等级差异具有统计学意义(P<0.05);其中湿热痹阻证、寒湿痹阻证RA患者高疾病活动度占比最高,痰瘀痹阻证、肝肾亏虚证RA患者中疾病活动度占比最高。结论:不同中医证型的RA患者外周血存在Th17/Treg细胞失衡,同时Th17/Treg细胞相关因子也表达异常;不同的中医证型患者间活动度存在明显的差异;RA患者的中医证型与Th17/Treg平衡和疾病活动度有关。

中医药治疗糖尿病肾脏病的现状及研究进展

糖尿病肾脏病(DKD)是糖尿病常见的微血管并发症之一,威胁着人类的生命健康。对中医、西医在DKD的发病机理及治疗方面的研究进展进行总结,发现中医和西医在DKD治疗中各有利弊,但中西药联合治疗能明显提高DKD的治疗效果,并能有效干预肾实质病变,延缓病情发展。