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.

Research on the treatment based on syndrome differentiation of COVID-19 according to the theory of Guangwenyilun

COVID-19 is highly infectious and epidemic,which belongs to the"plague"disease of traditional Chinese medicine and seriously endangers the safety of human life.Based on the theory of Guangwenyilun combined with the treatment experience of COVID-19 in TCM,syndrome differentiation-based treatment and the clinical characteristic of COVID-19 is being deeply analysed.COVID-19 began because of the"epidemic pathogenic factors",and the pathogenesis is that the dampness and heat generated toxin which blocked the qi movement.The early onset of this disease is in the pleurodiaphragmatic interspace,and its transmission can be divided into sequential transmission and reverse transmission.Regardless of the direction of its transmission,grasping the transmission of"epidemic pathogenic factors"on the diagnosis and treatment combined with"five distinguishing thought,exterior and interior,accompanying symptoms"theory will be of great importance to help to improve the effect of treatment.At the same time,this clinical approach will also provide reference for the diagnosis and treatment of any possible new diseases.

Progress of traditional Chinese Medicine on ADHD Treatment Based on Syndrome Differentiation

Attention-Deficit Hyperactivity Disorder(ADHD)is a common neurodevelopmental disorder in childhood.Syndrome differentiation for ADHD in traditional Chinese medicine is complex without common uniform,it is important to propose unified standards.Based on the principle of syndrome differentiation,this article focused on the different names of different syndrome differentiation methods but the same essence,and summarized Chinese medicine compounds according to syndrome factors.By collecting relevant literature on ADHD treatment with Chinese herbal compound in recent years,ADHD is classified into 7 different syndrome types,and Chinese herbal compound is classified correspondingly for reference and selection of clinical treatment of ADHD.

Discussion on the thinking innovation of the “Treatment based on syndromedifferentiation” according to “Precision medical”

本文基于“精准医疗”的理念探析中医“辨证论治”思想的思维创新思路及发展方向,比较辨“证候”与辨“基因体质”两者优势互补的发展前景.指出将“辨证论治”的经典辨证理念与“精准医疗”的高新技术医学理念相结合,进一步阐明中医精准医疗的科学内涵.

Summary of Experience in Treating Hyperthyroidism with TCM Syndrome Differentiation

Syndrome differentiation is the characteristic and soul of Traditional Chinese Medicine (TCM), which has certain advantages in the treatment of hyperthyroidism. TCM mainly divides its syndrome differentiation into four types: exuberant liver fire type, yin deficiency and fire exuberant type, qi-yin deficiency type and phlegm stagnation type. This paper summarizes the treatment of hyperthyroidism by TCM syndrome differentiation, in order to provide some reference for the treatment of this disease.

Treatment of insomnia by differentiation of yang deficiency syndrome

Insomnia has become one of the common clinical diseases.In recent years,it has been found that patients with insomnia of Yang deficiency type are more and more common,and the trend of rejuvenation gradually appears,which seriously affects the normal progress of people's life,work and study.Clinical treatment through syndrome differentiation,mainly from the heart,spleen,kidney three viscera yang deficiency,on the basis of the warm yang method to add Qianzhen tranquilizing products,and pay attention to multiple organs as diseases,add moisture,blood The qi thing,while not forgetting the psychological counseling,adjusting the body and mind,and achieving a certain clinical effect,can provide ideas for the treatment of this disease.

The combination of disease and Zheng (syndrome) on the basic of differentiation of six channels:a new pattern of disease diagnosis and treatment of traditional Chinese medicine

传统中医形成于2000多年前并且一直发展至今,中医治疗疾病的角度有其特殊性.证是传统中医理论中的重要概念.证是对机体在疾病发展过程中某一阶段的病理概括.辨证论治是中医认识疾病和治疗疾病的基本原则,是中医学对疾病的一种特殊的研究和处理方法.在东汉时期,医圣张仲景在《伤寒杂病论》中提出了用六经辨证的方法去诊断和治疗疾病.他根据病人证的不同把疾病分成了六种疾病即六经病.根据张仲景的分类标准,六经病几乎可以包含所有的疾病.而且,六经病的传变是有规律的.因此,我们提出了一个新的假说:在六经辨证的基础上通过病证结合进行中医诊断及治疗,从而有利于我们更好地把握和理解疾病,使疾病的治疗更加方便、快捷、有效.

Analysis on the law of differentiating and treating insomnia by physicians based on cluster analysis of drug syndrome

Objective:To explore the general differentiation and treatment of insomnia by Professor Gao Ying through drug clustering and group correspondence analysis,and provide reference for clinical diagnosis and treatment.Methods:Collect retrospective case data from outpatient system,use SPSS20.0 software to perform frequency and cluster analysis on high-frequency symptoms and drug data,and perform corresponding analysis on the clustered drug syndrome groups.Results:A total of 349 consultations in 204 patients were included.Cluster analysis of 35 symptoms and 40 flavors with a frequency of more than 10%resulted in a corresponding relationship between 7 symptom groups,6 drug groups and 5 drug syndrome groups.The medicine symptom group has a high degree of matching;the doctors distinguish and tre at insomnia with calming,clearing heat,nourishing yin,liver,spleen,qi and phlegm as the core treatment,with consistent decoction,two to pill,lily ground Huang Tang,Lily Zhimu Decoction,Wendan Decoction,Sini San,Xiao Chai Hu Tang,Xiaoyao San,etc.are commonly used prescriptions;the physician's experience is to add or subtract Danshen and Zao Ren drink,which has a wide range of applicability to various insomnia syndrome.Conclusion:Based on the cluster analysis of drug symptoms and group correspondence analysis,it can reveal the pathogenesis,treatment and class information hidden in the data of drug symptoms,which can reflect the general law of physicians'syndrome differentiation and treatment of insomnia.This method has a reference for the exploration of TCM clinical experience significance;The results of this study can provide feedback to guide the clinical diagnosis and treatment of insomnia.

Application of Stone Needle Therapy Based on Blood Stasis Theory in the Treatment of 36 Cases of Knee Osteoarthritis in Early and Middle Stage

Objective:To evaluate the clinical efficacy of stone needle therapy based on blood stasis theory for different traditional Chinese medicine(TCM)syndrome types of patients with knee osteoarthritis in early and middle stage.Methods:Totally 36 patients with knee osteoarthritis were enrolled in the orthopaedic ward between March 2016 and December 2017,and diagnosed as qi stagnation and blood stasis syndrome,cold dampness and stasis syndrome,or phlegm and stasis syndrome according to TCM syndrome differentiation.After treatment,stone needle was used for ironing on the different meridian acupoints according to different syndrome.The efficacy of patients with the above three syndromes was respectively evaluated,and the visual analogue scale(VAS)score and western ontario and mcMaster universities arthritis Index(WOMAC)score of the three groups were calculated before treatment,2 weeks,and 4 weeks after treatment.Results:The effective rates of the three groups were 86.67%,81.82%,and 80.00%,respectively.After 2 weeks and 4 weeks of treatment,the VAS and WOMAC scores of the three groups decreased significantly compared to treatment before(P<0.05).Conclusion:Stone needle therapy for ironing on the acupoints around the knee joint has a good therapeutic effect on knee osteoarthritis of different syndrome types,which is worthy of further application.

Some Problems of Warm Acupuncture in the Treatment of Knee Osteoarthritis

Knee osteoarthritis(KOA)is a chronic derivative joint issue that mainly damages the artistic cartilage and leads to pain,swelling,and stiffness around the joint,which is commomly worldwide.With the aging of society and the increment in obesity rate,the incidence of KOA increases sharply,which seriously effects the quality of human life.Before,how to take effective treatment methods is very important.Severe ways to treat the disease include non-steroidal drugs,local injections,surgery,and cell and gene therapies.However,each therapy has certain defections,such as gastrotestinal tract irritation,cardiovascular safety,or high medical costs for patients.Traditional Chinese medicine has a long history in treating KOA,reported by acupuncture,massage,internal administration of traditional Chinese medicine,and external use of traditional Chinese medicine.In clinical practice,patients can be treated from the root agreement to different etiology,and patients can be treated agreement to different syndrome types by syndrome difference to achieve effect.Studies have shown that warm acupuncture is effect in treating KOA.It has two kinds of treatment methods:acupuncture and moxibustion at the same time.It has fewer side effects and is more acceptable to patients.However,there are still some problems in the basic research and clinical application of warm acupuncture and moxibustion in treating KOA.This paper discussed the existing problems from the followingfive aspects:lack of unified synthesis difference and treatment system,problems in clinical research,weak basic research,problems in the study of moxibustion,and lack of the best treatment program recognized by the academic community.Meanwhile,the selection of acupoints,the relationship between acupuncture depth and anatomy should be further studied in order to offer research ideas for the healthy development of the treatment of KOA with warming acupuncture and moxibustion in the future.

Research progress of diabetes treatment guided by Traditional Chinese Medicine constitutional types

Diabetes and its complications seriously affect patients’life quality,and have a major impact on individuals,families,health systems,and national economies.Traditional Chinese Medicine constitution refers to the inherent characteristics of a relatively comprehensive and stable form,structure,physiological function,and psychological state formed under the combined effects of innate endowments and acquired in the course of an individual’s life.Many studies have shown that the constitution type is closely related to the incidence of diabetes,especially in the process of disease prevention and treatment.This article reviews the correlation of diabetes and its chronic complications with constitution types to provide theoretical basis for the treatment of diabetes based on syndrome differentiation.

Traditional Chinese medicine treatment of immune-related pneumonia caused by PD-1/PD-L1 inhibitors

With the wide application of immunotherapy drug PD-1/PD-L1 inhibitor in China and the continuous clinical research,a major problem that we have to face is the immune-related pneumonia caused by PD-1/PD-L1.At present,western medicine mainly treated it by hormone therapy,which may cause side effects,such as obesity,osteoporosis and osteonecrosis for hormone therapy by long-term,and increase the patients'pain.Under the guidance of the theory of syndrome differentiation,traditional Chinese medicine(TCM)advocates the methods of expelling wind and clearing away cold,resolving phlegm and relieving asthma,relieving heat from lung,and invigorating the spleen and tonifying the kidney,etc.Exact differentiation of symptoms and rational usage of drugs can play an important role in the early prevention and treatment of immune-related pneumonia,reflecting the important role of TCM in the prevention and treatment of side effects of new drugs.In order to provide an effective clinical reference for clinicians in the practice of using PD-1/PD-L1,this paper systematically reviewed the use of TCM in the treatment of immune-related pneumonia induced by PD-1/PD-L1 inhibitors.

Research Status of Traditional Chinese Medicine Constitution Theory in Insomnia

With the development of modern bio-psycho-social medical model and traditional Chinese medicine(TCM)constitution theory,we gradually realize that the exploration of the constitution characteristics of insomnia is of great significance for the reveal of the origin of insomnia and the innovation of its treatment and nursing methods.This paper focused on the analysis of the investigation of TCM constitution classification of insomnia and the application of TCM constitution theory in the treatmentand nursing of insomnia.Moreover,the research prospect of insomnia in TCM constitution was discussed.The purpose is to provide theoretical basis for the treatment and nursing of patients with insomnia based on analysis of constitution differentiationin the future,and to better serve the clinic.

Based on the Four Segments and Treatment by Syndrome Differentiation to Lower the Mortality of Sepsis

Lowering the mortality of sepsis has become an important issue in the international critical care medicine because of its unacceptably high incidence. In 2004 and 2008,there were no essential breakthroughs in international guidelines for the management of severe sepsis

Traditional Chinese medicine combined with low-dose glucocorticoid for treating nephrotic syndrome: A case report

Nephrotic syndrome(NS)is a common refractory clinical disease that can develop into end-stage renal disease(ESRD)if cannot be controlled.At present,in Western medicine,glucocorticoid or immunosuppressant drugs with heavy dose and long course are used for the therapy of NS.There are still few reports on the combined treatment of traditional Chinese medicine and low-dose glucocorticoid for NS.Here,we reported a case of a 48-year-old man diagnosed with NS,accompanied by severe pulmonary infection,abundant proteinuria,and pleural effusion.Integrated traditional Chinese and Western medicine was used as the therapeutic regimen of this patient.Traditional Chinese medicine(TCM)mainly focused on invigorating spleen and kidney,promoting blood circulation,removing blood stasis and promoting diuresis,and Chinese patent medicines or TCM immunosuppressants were given to consolidate the treatment.In Western medicine,small dose and short course glucocorticoids combined with symptomatic treatment were adopted.Delightfully,proteinuria subsided after 5 months treatment with integrated TCM and Western medicine and all laboratory reports were negative after 10 months,which has been normal so far(July 2019).This case report indicates that the combination of TCM and low-dose glucocorticoid is effective in curing NS,with low recurrence rate and few side effects.

论基于“病、证、征结合”方剂的主治表述

目前对方剂主治的规范性研究较少,通过对方剂主治源流的梳理并分析《方剂学》教材中方剂主治描述中存在的问题,提出“病、证、征结合”3个层次的方剂主治描述规范,从而有利于临证依法用方、规范教材和规范方剂的科学研究。

中医辨证治疗方案对老年社区获得性肺炎出院后患者生存质量和疗效满意度的评价研究

背景社区获得性肺炎(CAP)为常见的感染性疾病之一,尤其在老年患者中,其临床症状不典型,易出现严重并发症,缺乏有效的治疗措施,常预后不良。目的探究中医辨证治疗方案对老年CAP出院(1周内)患者的生存质量及其疗效满意度情况。方法本研究为多中心、随机双盲安慰剂临床研究。选取河南中医药大学第一附属医院、河南省胸科医院、河南省人民医院、郑州市中医院、郑州人民医院5家医院呼吸科2018年4月—2020年1月病房收治的老年CAP出院后患者为研究对象,采用中央随机入组模式将患者分为试验组和对照组。试验组患者经中医辨证后给予相应中药颗粒剂进行治疗,气虚痰湿证给予补肺健脾化痰方,气阴虚痰热证给予益气养阴清肺方。对照组则给予与中药颗粒外观、重量、颜色、气味基本一致的安慰剂。治疗疗程为2个月,随访至治疗开始后6个月。比较两组患者治疗前、治疗1个月、治疗2个月、随访3个月、随访6个月的生存质量[采用中文版生存质量评分量表(SF-36)评价]和疗效满意度[采用肺炎患者疗效满意度问卷(ESQ-CAP)评价]。结果纳入120例患者中,脱落8例,最终纳入符合方案集的病例112例,其中试验组54例、对照组58例。治疗前两组性别、年龄、出院后时间、中医辨证分型、CUBR-65评分、基础疾病比较,差异无统计学意义(P>0.05)。组别对SF-36生理机能领域评分(F组间=5.057,P组间=0.027)、一般健康状况领域评分(F组间=7.286,P组间=0.008)、情感职能领域评分(F组间=6.858,P组间=0.010)主效应显著。组间比较:治疗2个月、随访3个月、随访6个月,试验组SF-36生理机能领域评分高于对照组(P<0.05);治疗1、2个月和随访3、6个月,试验组SF-36一般健康状况领域、情感职能领域评分高于对照组(P<0.05);随访3、6个月,试验组SF-36精神健康领域评分高于对照组(P<0.05)。组别对ESQ-CAP日常生活与能力领域评分(F组间=16.218,P组间<0.001)、方便领域评分(F组间=25.013,P组间<0.001)及ESQ-CAP总分(F组间=13.843,P组间<0.001)主效应显著。治疗2个月和随访3、6个月,试验组ESQ-CAP日常生活与能力领域评分高于对照组(P<0.05)。治疗1、2个月和随访3、6个月,试验组ESQ-CAP方便领域评分及ESQ-CAP总分高于对照组(P<0.05)。随访3个月,试验组ESQ-CAP总体疗效领域评分高于对照组(P<0.05)。结论中医辨证治疗方案对于老年CAP出院后患者的生存质量和疗效满意度具有较好的改善作用。

2型糖尿病合并多代谢紊乱态靶综合治验1例——仝小林院士教学查房实录

以广安门医院内分泌科中2型糖尿病合并多代谢紊乱案患者为例,邀请仝小林院士进行教学查房,对早中期2型糖尿病合并多代谢紊乱的中医认识、疾病发展与转归、诊疗要点进行阐述。仝小林院士强调肥胖是脾瘅的基石、分类-分期-分证辨治糖尿病、糖肝共治2型糖尿病合并代谢相关脂肪性肝病;治疗上注重运用靶方靶药,关注有效剂量,预防果态,防治脉损,态靶辨治,提高临床疗效。

中重度宫腔粘连应用中医临床决策系统效果分析

[目的]探讨中医临床决策系统在治疗中重度宫腔粘连(intrauterine adhesion,IUA)中的应用及效果。[方法]采用随机对照试验进行前瞻性研究,选择2022年1月至12月在杭州市某三级甲等中医院行宫腔镜下子宫粘连松解术的中重度IUA患者,根据是否通过中医优势病种临床决策系统进行辨证论治分为对照组(51例)、决策系统组(53例)、临床医师组(54例),比较3组患者治疗前后月经量改善、美国生育协会(American Fertility Society,AFS)评分、子宫内膜厚度、子宫内膜血流参数、中医伴随症候疗效。[结果]治疗后3组患者月经量比较,决策系统组、临床医师组较对照组均有显著改善,差异有统计学意义(P<0.05),决策系统组与临床医师组差异无统计学意义(P>0.05)。治疗后3组患者宫腔AFS评分比较,决策系统组、临床医师组较对照组显著下降(P<0.01),决策系统组与临床医师组差异无统计学意义(P>0.05)。治疗后3组患者子宫内膜厚度显著增加,子宫内膜血流参数显著下降,差异有统计学意义(P<0.01),但治疗前后组间差异均无统计学意义(P>0.05)。治疗后3组患者中医伴随症候疗效比较,临床医师组较对照组、决策系统组明显改善,差异有统计学意义(P<0.05),对照组与决策系统组差异无统计学意义(P>0.05)。[结论]中医临床决策系统用于中重度IUA的治疗可显著改善患者月经量,降低术后AFS评分,防止粘连再发生。

复发性流产辨治经验

复发性流产(RSA)是一种临床较为常见的妇产科疾病,易导致反复性妊娠失败,常规西医治疗效果欠佳,使女性生殖健康受到严重损害的同时,亦对其家庭幸福稳定造成不良影响。随着临床对中医治疗RSA相关研究的逐渐增加,RSA病因复杂,临证时在进行查诊的同时需结合“不治已病治未病”的理念进行辨证论治,以减少RSA的发生。此文旨在从RSA病因病机、辨证论治等角度探讨中医治疗RSA临证思路及临床经验,以期为改善患者预后提供依据。