Discussion on Traditional Chinese Medicine Treatment of Liver-Depression-Spleen-Deficiency Type Insomnia Based on the State-Target Theory and the Regulation of Microbiome-Gut-Brain Axis

Insomnia has become an urgent clinical problem in modern society.Current research has found that the gut flora-gut-brain axis plays an important role in regulating insomnia.The state-target theory is a product of the combination of traditional Chinese medicine and modern molecular biology technology.This paper clarifies the correlation between the state-target theory,the intestinal flora-gut-brain axis,and liver-depression-spleen-deficiency insomnia.The use of traditional Chinese medicine to regulate the structure and abundance of intestinal flora was also explored,aiming to integrate traditional Chinese medicine with Western medicine for the prevention and treatment of liver-depression-spleen-deficiency insomnia.

A Clinical Study on the Treat ment of Chronic Pelvic Inflammation of Qi-stagnation with Blood Stasis Syndrome by Penyanqing Capsule (盆炎清胶囊)

Objective： To observe the clinical efficacy of Penyanqing Capsule （盆炎清胶囊, PYQC） in treating pelvic inflammation of Qi-stagnation with blood stasis syndrome. Methods： The randomized, single blinded, parallel positive drug controlled method was adopted, with 82 patients assigned into two groups by envelop method. The 42 patients in the treated group received PYQC 3 times a day, 4 capsules each time taken orally; the 40 patients in the control group were given orally Fuyankang tablets （妇炎康片, FYKT） 3 times a day, 6 tablets each time. The therapeutic course for both groups was 2 months, and 2 courses of treatment were given successively to observe the comprehensive effect, changes of symptoms and signs before and after treatment. The effects of PYQC on hemorrheological character in part of the patients and on the pathogenetic chlamydia and mycoplasma were also observed. Results： The total effective rate in the treated group was 83.3%, which was insignificantly different from that in the control group （77.5%, P〉0.05）. However, PYQC could significantly lower the hemorrheologic indexes in patients and showed definite influence on the pathogenetic chlamydia and mycoplasma. Conclusion： PYQC has good therapeutic effect in treating chronic pelvic inflammation of Qi-stagnation with blood stasis syndrome, and showed definite effect on chlamydia and mycoplasma.

Meta-analysis of Tonifying-Kindney and Soothing-Liver traditional Chinese medicine method in the treatment of polycystic ovary syndrome

Background:To systematically evaluate the clinical efficacy of Tonifying-Kindney and Soothing-Liver method in the treatment of polycystic ovary syndrome(PCOS).Methods:The literatures of randomized controlled trials(RCTs)on the treatment of PCOS with traditional Chinese medicine(TCM)published at home and abroad until March 2020 were retrieved,and RCTs on the treatment of PCOS with Tonifying-Kindney and Soothing-Liver method were collected.According to the systematic evaluation method of the Cochrane Collaboration Network,RevMan5.3 software was used to perform quality evaluation and data extraction for meta-analysis of tests that met the inclusion criteria.Results:A total of 30 eligible RCTs were included,including 2244 patients.Meta-analysis results show that the method of tonifying the kidney and Soothing-Liver has certain advantages in the treatment of PCOS.Compared with Western medicine alone group,tonifying the kidney and Soothing-Liver TCM method alone or combined with Western medicine could improve the total effective rate[OR=3.52,95%CI(2.67,4.63),I2=0%,P<0.00001].It is superior to the control group in improving ovulation rate[OR=2.01,95%CI(1.46,2.78),I2=0%,P<0.0001],pregnancy rate[OR=2.82,95%CI(2.28,3.49),I2=0%,P<0.00001],reducing LH[MD=-2.65,95%CI(-3.43,-1.88),I2=92%,P<0.00001]and ovarian stimulating hormone levels[MD=-0.52,95%CI(-0.85,-0.18),I2=94%,P=0.002].There was no statistical difference in reducing serum testosterone levels[SMD=-0.56,95%CI(-1.22,0.09),I2=96%,P=0.09]and improving TCM symptoms[MD=-0.09,95%CI(-4.75,4.56),I2=97%,P=0.97].Conclusion:The method of tonifying the kidney and Soothing-Liver has a certain effect in treating polycystic ovary syndrome,but the evidence is still very limited,and a large sample of high-quality randomized controlled studies is still needed in order to make a more rigorous evaluation.

Clinical Observation on the Effect of Zengse Pill (增色丸) in Treating Patients with Vitiligo of Qi-stagnancy and Blood-stasis Syndrome Type

Objective： To observe the clinical efficacy of Zengse Pill （增色丸, ZSP） on patients with vitiligo of qi-stagnancy and blood-stasis syndrome type （V-QB）, and to preliminarily explore its mechanism of action. Methods： Sixty-five V-QB patients, with their diagnosis confirmed by clinical examination, were randomized by digital table method into two groups, with 31 patients in the control group and 34 in the treatment group. Cobamamide （2 tablets） was administered orally to all patients, and Psoralea tincture （a self-formulated preparation） was applied externally thrice a day. In addition, for patients in the treatment group, ZSP was given orally, at 5 pills per dose, 3 times every day. The therapeutic course for both groups was 3 months. Patients were re-examined every half-month, and changes in the skin lesions were observed and recorded. The levels of lymphocyte subsets, serum immune globulin, and complement C3 and C4 in patients were determined before and after the therapeutic course and compared with the corresponding indexes determined in 21 healthy subjects, Results： The total effective rate in the treatment group was 82.4%, which was markedly higher than that in the control group （54.8%）, showing a significant difference （P〈O.05）. After treatment, CD4^＋ percentage, CD4^＋/CD8^＋ratio, and blood levels of C3 and C4 increased, while CD8^＋ percentage decreased in the treatment group （P〈0.05 or P〈0.01）. All these indexes remained unchanged in the control group, and the respective comparisons between groups showed significant differences （P〈0.01）. Conclusion： ZSP has a definite clinical effect on the treatment of V-QB but with no evident adverse reactions, and it can increase the CD4^＋ percentage, CD4^＋/CD8^＋ ratio, and the levels of serum C3 and C4, thus regulating the immunity of the organism, which might be one of its mechanisms of action.

Traditional Chinese Medicines alleviated myocardial ischemia by regulating Qi and promoting blood circulation

OBJECTIVE:To investigate the efficacy of Chinese medicines on Qi stagnation and blood stasis in rats with myocardial ischemia.METHODS:Fifty male Wistar rats were randomly divided into five groups(n=10)as follows:(a)sham operation(Sham),(b)myocardial ischemia(Model),(c)treatment that regulates Qi(Qi),(d)treatment that promotes blood circulation(Blood),(e)treatment that both regulates Qi and promotes blood circulation(QB).The rat model was established via activities restriction for 6 h followed by tail clamp stimulation for 5 mins every day for 7 d and occlusion left coronary anterior descending artery.Afterwards rats were treated with medicines that regulate Qi and/or promote blood circulation via gavage for 14 d.Behavioral parameters were evaluated using open field and elevated plus-maze tests.The tongue color and sublingual vein were visually examined.Blood flow perfusion of tongue and auricle were detected using PIMⅡ.The mesenteric microcirculation was examined via capillaroscopy,and hemodynamics was assessed using a polygraph system.Serum homocysteine(Hcy),creatine kinase isoenzyme(CKMB)levels and endothelin-1(ET-1)were measured.Hematoxylin and eosin staining and transmission electron microscopy were employed to detect the myocardial morphology and ultrastructure,respectively.RESULTS:Compared with findings in Sham group,rats in model group had coarse hair,dark mucosa of the lips and claw,low activity,and increased anxiety.Compared with findings in Model group,rats in the three treatment groups exhibited a lighter tongue color without an extended and varicose sublingual vein.There were significant increases of auricle blood flow perfusion in the Qi group and tongue bottom blood flow perfusion in the QB group.Compared with findings in Model rats,rats in Blood group exhibited improved mesenteric microcirculation associated with increased mesenteric blood flow and a larger arteriole diameter.Moreover,compared with findings in Model rats,Qi and QB rats exhibited increased left ventricular±dp/dtmax,decreased serum CKMB,Hcy,ET-1 levels,and reduced myocardial ultrastructural damage.CONCLUSION:Myocardial ischemia damage was suppressed by Traditional Chinese Medicines that regulate Qi and promote blood circulation.