Differentiating and Treating Gynecological Diseases based on the Theory of Collateral Diseases

The collateral disease theory is a unique component of the theoretical system of traditional Chinese medicine(TCM),which is currently applied to all kinds of diseases related to the collaterals.With the in-depth study of collaterals theory by many practitioners,its advantages in differentiating and treating gynecological diseases are gradually embodied.Based on the theory of collaterals disease,we discussed the pathogenesis,syndrome differentiation and treatment of gynecological diseases,concluded that the deficient collaterals under nourishment and the stagnant and blocked uterine collateral are the important pathogenesis of gynecological illness.Then we pointed out that invigorating the spleen and tonifying the kidney,and unblocking collateral and dissipating stasis are important treatment methods.We discussed the application of collateral disease theory in Tianjin HA's gynecology,and provided certain theoretical basis and clinical reference for the treatment of gynecologic diseases.

Application of Preventive Treatment Theory in the Treatment of Pelvic Inflammatory Disease

With a history of more than two thousand years, the theory of preventative treatment has been closely followed by the development of modern medical theories on the basis of inheritance by medical experts in the past dynasties, which has been constantly improved and enriched, and deeply applied in the prevention and treatment of serious and multiple diseases. It has achieved great benefits. For women with gynecological diseases, pelvic inflammatory disease patients accounted for a large proportion. Due to the lack of specificity in diagnosis and treatment, the condition is lingering and difficult to cure, so it seriously reduces the quality of life of women, thus affecting the harmony of family and society. From the perspective of prevention, according to the characteristics of each stage of the disease, this paper put forward substantive prevention suggestions and targeted treatment methods, ensuring preventing before disease, preventing progress after disease, and preventing reoccurring after recovery. It has important practical significance for the prevention and treatment of pelvic inflammatory diseases, as well as the development and inheritance of traditional Chinese medicine.

UPLC-QTOF/MS结合网络药理学探讨诃子与草乌配伍“异病同治”类风湿性关节炎和痛风性关节炎作用机制

目的:探讨诃子与草乌配伍“异病同治”类风湿性关节炎(RA)和痛风性关节炎(GA)的作用机制。方法:采用数据挖掘技术找出治疗“图赖”病的核心药物组合(诃子-草乌),并使用超高效液相色谱-四极杆飞行时间质谱法(UPLC-QTOF/MS)检测大鼠灌胃诃子与草乌配伍药物后的入血成分;运用PubChem、Swiss Target Prediction、GeneCards、OMIM、DisGeNET、Metascape等多个数据库检索诃子与草乌化学成分对应靶点、RA和GA的疾病靶点,以及代谢通路等信息,利用Cytoscape3.8.2软件构建成分-靶点-通路-疾病网络,并利用分子对接方法证实诃子与草乌的主要成分与关键靶点之间的高亲合力。结果:诃子与草乌入血成分相应靶点与RA靶点交集后得到323个交集靶点、与GA靶点交集后得到24个交集靶点,两者共有靶点24个,主要有肿瘤坏死因子(TNF)、肿瘤蛋白p53(TP53)、基质金属蛋白酶-9(MMP-9)、前列腺素内过氧化物合酶2(PTGS2)和信号转导和转录激活因子3(STAT3),与十八碳四烯酸、绢酸、5-(3-羟基-4-乙酰氧基-1-丁基)-2,2'-联噻吩、灵芝酸H等有紧密联系,涉及通路有TNF信号通路、破骨细胞分化通路、癌症通路等。分子对接结果显示灵芝酸H和TNF、5-(3-羟基-4-乙酰氧基-1-丁基)-2,2'-联噻吩和MMP-9有强烈对接活性。结论:蒙古族药诃子与草乌配伍治疗RA和GA具有多靶点效应,可能通过炎症反应的调节、细胞对生物刺激的反应、对细菌源分子的反应、磷酸盐代谢的正调控和对激素的反应等通路发挥“异病同治”作用。

中医治未病“五辨”理论发微

中医治未病“五辨”理论乃上海市浦东新区卫生健康委员会十余年“治未病”工作积淀,“五辨”理论乃治未病的核心特征,即在“辨证”理论指导下进行“辨体、辨症、辨病、辨变”。辨证论治,总体指导,辨明轻重缓急、真假主次;辨体论治,首辨体质,再辨男女、长幼、习性;辨症论治,注重宏观、中观、微观之三观并重;辨病论治,参合古今、辨明标本先后及病程新久;辨变论治,明辨病位、病性、病势之变。并附验案1则。

Text Mining of Rheumatoid Arthritis and Diabetes Mellitus to Understand the Mechanisms of Chinese Medicine in Different Diseases with Same Treatment

Objective： To identify the commonalities between rheumatoid arthritis （RA） and diabetes mellitus （DM） to understand the mechanisms of Chinese medicine （CM） in different diseases with the same treatment. Methods： A text mining approach was adopted to analyze the commonalities between RA and DM according to CM and biological elements. The major commonalities were subsequently verified in RA and DM rat models, in which herbal formula for the treatment of both RA and DM identified via text mining was used as the intervention. Results： Similarities were identified between RA and DM regarding the CM approach used for diagnosis and treatment, as well as the networks of biological activities affected by each disease, including the involvement of adhesion molecules, oxidative stress, cytokines, T-lymphocytes, apoptosis, and inflammation. The Ramulus Cinnamomi-Radix Paeoniae Alba-Rhizoma Anemarrhenae is an herbal combination used to treat RA and DM. This formula demonstrated similar effects on oxidative stress and inflammation in rats with collagen-induced arthritis, which supports the text mining results regarding the commonalities between RA and DM. Conclusion： Commonalities between the biological activities involved in RA and DM were identified through text mining, and both RA and DM might be responsive to the same intervention at a specific stage.

Network pharmacology unveils spleen-fortifying effect of Codonopsis Radix on different gastric diseases based on theory of “same treatment for different diseases” in traditional Chinese medicine

Objective: "Same treatment for different diseases" is a unique treatment strategy under the guidance of traditional Chinese medicine(TCM) theory.Codonopsis Radix(Codonopsis pilosula,Dangshen in Chinese)with spleen-fortifying effect was employed to understand the strategy of "Same treatment for different diseases",based on its common mechanism in the treatment of gastric diseases including gastric ulcer,gastritis and gastric cancer via network pharmacology research.Methods:Network pharmacology research methods were used to analyze the interaction network and potential mechanisms of Dangshen in treating gastric ulcer,gastritis and gastric cancer.The active components and their target proteins of Dangshen were integrated from TCMSP,BATMAN-TCM databases.The targets of gastric ulcer,gastritis and gastric cancer were collected through GeneCards,PubMed,TDD and DisGeNET Database.Through screening,the key components and the key targets of Dangshen in treating gastric ulcer,gastritis and gastric cancer were obtained.After KEGG pathway analysis and GO analysis,the important pathways and biological processes were analyzed.Results:Through data and literature mining,the common and specific pharmaceutical effects and mechanism of Dangshen were summarized in these three gastric lesions.It was shown that Dangshen mainly acted on gastric ulcer,gastritis and gastric cancer through the overall regulation of the PI3K-AkT signaling pathway.With the development of the disease,it will gradually increase the control of inflammation through TNF,NF-κB and other inflammation-related signaling pathways to reduce inflammatory damage.For tumorigenesis,it pays more attention to inhibiting the ErbB signaling pathways to reduce the proliferation and migration of tumor cells.In addition,Dangshen's regulation of HIF-1 signaling pathway may also be beneficial for the treatment of gastric ulcer,gastritis and gastric cancer.Conclusion:Dangshen achieves spleen-fortifying effect on gastric diseases including gastric ulcer,gastritis and gastric cancer through multiple targets in multiple pathways,especially PI3K-AKT pathway and HIF-1 pathway.It could provide a scientific basis for understanding the strategy of "Same treatment for different diseases" in traditional Chinese medicine.

Three Cases of Treating Diseases with Tiaozhong Yiqi Decoction

This paper introduced three cases of treating diseases with Tiaozhong Yiqi Decoction.Tiaozhong Yiqi Decoction,first proposed in Treatise on the Spleen and Stomach written by Li Gao,is an effective prescription for treating the syndrome of dampness stagnancy due to spleen deficiency.The authors sorted out the treatment of some difficult and complicated diseases with this prescription and the curative effect is remarkable.Tiaozhong Yiqi Decoction is evolved from Buzhong Yiqi Decoction by removing ATRACTYLODIS MACROCEPHALAE RHIZOMA and ANGELICAE SINENSIS RADIX,and adding ATRACTYLODIS RHIZOMA and AUCKLANDIAE RADIX.It uses ASTRAGALI RADIX,GINSENG RADIX ET RHIZOMA,and GLYCYRRHIZAE RADIX ET RHIZOMA to benefit qi and invigorate spleen,so as to treat the deficiency of spleen;it uses BUPLEURI RADIX and CIMICIFUGAE RHIZOMA to raise the clear yang;it also uses ATRACTYLODIS RHIZOMA,CITRI RETICULATAE PERICARPIUM,and AUCKLANDIAE RADIX to harmonize the middle to dispel the dampness.In this paper,the case of tinnitus and deafness belongs to the syndrome of dampness stagnancy due to spleen deficiency,dampness obstruction due to qi block,and dampness accumulation affecting clear orifices.The case of red vaginal discharge belongs to the syndrome of sunken spleen qi due to spleen deficiency and sunken yin fire.The case of cough belongs to the spleen deficiency combined with earth not engendering metal.All cases were treated with Tiaozhong Yiqi Decoction,fully proving the mechanism of the same treatment for different diseases.Only by identifying disease causes and syndromes,may it be able to obtain remarkable curative effect.

Understanding the individual with Alzheimer’s disease: Can socioemotional selectivity theory guide us?

Individuals often get lost behind the diagnosis of Alzheimer’s disease (AD) while widespread differences between these patients are morecommon than similarities. Socioemotional Selectivity Theory (SST) suggests that as we age our goals change from future-oriented (acquiringnew information) to present-oriented (enhancing the emotional, especially positive, meaning of encounters). The goal of the current article is to examine whether the principles of SST might also apply for people with AD. Some aspects of SST are found especially in the early stages of AD when awareness is often intact and cognitive impairment is relatively limited. This review has clinical significance for the treatment of AD because it focuses on what is important to the individual rather than treating patients as a homogenous group. It also highlights the importance of social networks and emphasizes the role of the proxy in AD care. Lastly, it suggests that if those with AD (like the healthy elderly) have a positivity bias then positive emotional stimuli/wording/instructions could usefully be employed in their daily treatment. I suggest that SST may be a useful starting point when attempting to address what matters to individuals with AD and conclude by providing a few suggestions for future studies.

部分嵌套式设计在中医药“同病异治”疗效评价中的应用及方法学探索

目的本研究针对中医学同病异治、辨证论治的特征,引入部分嵌套式设计。方法部分嵌套式设计以复杂干预对照标准化治疗,中医组按“证型-治法-方药”分割为多个子集(存在嵌套结构),对照组采用标准化西医治疗(无嵌套结构);并以一项溃疡性结肠炎“同病异治”数据为例,套用该设计类型并采用多水平模型分析。结果部分嵌套式设计符合“同病异治”诊疗特征并满足循证评价的设计要求,通过多水平模型可实现类似数据结构的分析。结论利用部分嵌套式设计能实现对“同病异治”整体效果的评价,可为中医药临床疗效评价提供方法学参考。

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。

基于网络药理学与分子对接技术探讨半夏厚朴汤“异病同治”胃食管反流病和慢性咽炎的作用机制

目的 基于中医学“异病同治”理论,运用网络药理学与分子对接技术探究半夏厚朴汤治疗胃食管反流病(GERD)和慢性咽炎的作用机制。方法 通过中药系统药理学数据库与分析平台、本草组鉴数据库、中医药百科全书数据库检索半夏厚朴汤活性成分及潜在靶点;通过GeneCards、TTD和OMIM数据库获得GERD和慢性咽炎相关靶点;通过Venny平台筛选药物与两种疾病的共同靶点;通过Cytoscape 3.9.1软件构建“药物-活性成分-共同靶点-疾病”网络,以展示其交互作用关系;通过STRING平台构建共同靶点PPI网络;通过Metascape平台对共同靶点进行GO功能及KEGG通路富集分析;运用Schr9dinger Suite对关键靶点和所有活性成分进行分子对接,验证潜在作用靶点与药物成分的结合能力,并筛选出主要活性成分。结果 共筛选半夏厚朴汤活性成分46个,得到药物靶点223个,共获得GERD疾病靶点2 170个,慢性咽炎疾病靶点402个,筛选得到疾病与药物共有靶点59个;其中核心靶点涉及IL-6、TNF、AKT1、IL-1β、VEGFA等;GO分析显示,共有靶点主要参与细胞群增殖的负调控、细胞转运的正向调控、炎症应答等生物过程;KEGG富集结果显示,共有靶点与癌症通路、JAK-STAT、NF-κB等信号通路相关。分子对接结果显示,核心蛋白与大多数活性成分存在结合位点,其中槲皮素、(+)-儿茶素、刺槐苷B、黄芩苷、鞣花酸等成分与核心靶点结合较为稳定,可推测为“异病同治”主要成分。结论 半夏厚朴汤可通过多成分、多靶点、多通路抑制细胞凋亡、减少炎症反应以及调节免疫等发挥对GERD和慢性咽炎的“异病同治”作用。

基于“玄府气液”理论治疗慢性难愈性溃疡

慢性难愈性溃疡是“虚”“瘀”两种致病因素相互交织、相互作用的结果,“虚”“瘀”贯穿疾病发展的始终。而“玄府开阖失司,气液代谢失调”是本病迁延难治的病机关键。刘丽芳教授综合运用煨脓生肌、阳和通玄、托里消毒诸法开玄府、调气液,令玄府开阖有司,气液代谢调和,临床疗效满意,附验案一则加以阐明。

中医治未病与前馈控制理论在精准预防结石复发中的应用研究

目的:探讨中医“治未病”结合前馈控制理论在精准预防结石复发中的临床效果与现代理念。方法:根据入组标准纳入草酸钙结石患者100例,随机分为对照组和观察组,每组50例。两组患者均接受常规结石预防指导,参考《中国泌尿外科和男科疾病诊断治疗指南》制定结石预防方案,按食物草酸含量制定统一的含草酸饮食限制食谱。观察组在对照组的基础上增加定期检测尿液结晶,定期监测晨尿结晶的种类、数量和结晶大小,制定含草酸饮食个体化预防食谱。根据尿结晶测定值定期修改食谱,尿结晶正常者可维持上月饮食量,如果超标则减少10%的含草酸饮食量。在开始随访和随访12个月后,比较两组复发情况,进行最大尿结晶直径尿液结晶检测、B超检查和焦虑评分情绪评估。结果:全部病例随访1年,观察组无结石复发,对照组5例复发,观察组预防成功率是100%,高于对照组的89.13%,差异有统计学意义(P<0.05)。观察组最大尿结晶直径随访后明显减小,对照组尿结晶直径随访前后无变化,且观察组最大尿结晶直径小于对照组,差异有统计学意义(P<0.05)。随访12个月后,两组焦虑评分均低于随访前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论:中医“治未病”结合前馈控制理论制定的含草酸饮食限制食谱的个性化预防方案,可有效预防结石术后复发。

桂枝茯苓丸化裁异病同治血瘀型功能性肛门直肠痛经验

目的总结运用桂枝茯苓丸化裁治疗血瘀型功能性肛门直肠痛的诊疗思路。方法通过研究古籍、搜集整理文献、整理验方,结合现代医家研究,从病因病机、用药特点等方面,分析总结运用桂枝茯苓丸化裁治疗血瘀型功能性肛门直肠痛的诊疗思路,并列举验案加以佐证。结果功能性肛门直肠痛始于气机升降功能的紊乱,血瘀是该病最终趋势,活血化瘀是中医辨治功能性肛门直肠痛的核心方法。结论桂枝茯苓丸在临床中多用于治疗妇科相关疾病,以异病同治创新性地将其引入血瘀型功能性肛门直肠痛的治疗中,临证经验提示疗效显著,为功能性肛门直肠痛的临床诊治提供了新的思路。

基于络病学说浅析广泛性焦虑障碍发病与治疗

广泛性焦虑障碍(GAD)在临床中越来越常见,患者除心理上持久而过度的紧张担心外,还伴随一系列躯体化症状。本文将络病学说引入广泛性焦虑障碍,从络脉网状结构与广泛性焦虑障碍症状分布、络病病机与广泛性焦虑障碍病变特点、络病证治与广泛性焦虑障碍治疗三个方面说明两者之间的相似性和关联性。基于络病学说总结出“瘀”“滞”“虚”“损”为该病病机演变的关键,气滞血瘀为初始状态,日久则向络虚不荣、络脉损伤阶段转化,呈现虚实夹杂的病理状态。因此,根据以上核心病机,治疗上应注重行滞通络法和补虚通络法的应用。

基于经筋理论探讨触诊对颈痛分期诊疗的意义

颈痛属于中医学“经筋病”的范畴。经筋理论与颈痛的生理病理关系紧密,并且对颈痛的诊疗具有指导意义。触诊是颈痛诊断和分期治疗的重要环节,根据经筋病理产物出现的部位不同,可以明确病变经筋;根据不同的病理变化会出现不同的指下触感,可以对颈痛进行分期,进行有针对性的治疗,从而达到精确施治、提高临床疗效的目的。同时,触诊为颈痛的诊疗提供了一定的规范化、客观化的参考。

从气血同治探讨慢性气道疾病的异病同治

支气管哮喘和慢性阻塞性肺疾病(简称慢阻肺)同属慢性气道炎症疾病,在病机和治法上有一定的相似性,其都可通过调节气血以恢复肺气宣肃,行使正常生理功能。针对肺的生理功能和气血的关系,探讨支气管哮喘和慢阻肺的共同病机:支气管哮喘的基本病机是痰伏于肺,外邪引动,痰气互结,肺失宣降,并可兼有瘀血阻络之象;慢阻肺的病机以久病肺虚为本,加之痰浊、水饮、瘀血等病理产物,使得肺失宣降,本虚标实的病机随病程持续进展;进而从气血同治角度探讨支气管哮喘和慢阻肺2种慢性气道疾病的异病同治,得出“气血同治,畅通气道”的治疗理念。结合成药的应用,分析以此病机为指导的丹龙口服液组方特点和功效主治,为丹龙口服液异病同治2种气道疾病提供理论依据。

医护人员对中医“治未病”视角下健康管理的认知情况

为探究中医“治未病”视角下医护人员的健康管理工作状况,该文对中医“治未病”理念和健康管理概念进行深入分析,总结其具体应用情况,提出医护人员健康管理中推进中医“治未病”理念的方法,以此为强化其健康管理工作质量提供指导意见。

雷忠义国医大师基于“痰瘀毒风虚”理论分期论治冠心病经验探析

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唐明教授运用牛膝木瓜汤异病同治验案举隅

中医认为,自然界气候变化是导致人易发病的一大规律。运气学说是探究气候变化对人体影响的理论。牛膝木瓜汤是陈无择依“岁金太过之年,燥气偏盛,肝木受邪”之法所创,乃16首运气方之一。作者通过分析唐明教授医案三则,以分析牛膝木瓜汤的病因病机,探讨中医“异病同治”的特点;通过临床应用探索,深刻理解“辨天、辨地、辨人”在中医治疗中的重要性。