Clinical Nursing Intervention of Moxibustion on Abdominal Distension Symptoms in Heart Failure (Heart and Kidney Yang Deficiency and Blood Stasis Blocking Collaterals Syndrome)

Objective:To investigate the clinical nursing intervention effect of moxibustion on abdominal distension symptoms in heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome).Methods:62 patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)admitted to our hospital from February 2023 to February 2024 were selected and divided into the observation group(n=31)and the control group(n=31)by using the random numerical table method.The control group adopted conventional nursing interventions,and the observation group received the nursing program of the control group with the addition of moxibustion nursing interventions.The nursing effectiveness,quality of life scores,and nursing satisfaction were compared between the two groups.Results:The nursing effectiveness of the observation group was significantly higher than the control group(P<0.05);the quality of life score of the observation group was significantly higher than the control group(P<0.05);the nursing satisfaction of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:The use of moxibustion nursing intervention in patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)can effectively relieve the symptoms of abdominal distension,improve patients'quality of life,and increase nursing satisfaction,which has promotion and application values.

Transcriptomic and metabolomic analysis of the effects of Zhenwu decoction on kidney yang deficiency pattern in chronic kidney disease

Objective:To explore the kidney yang deficiency pattern(KYDP)in a chronic kidney disease(CKD)rat model and the mechanisms underlying the effects of Zhenwu decoction(ZWD)by conducting tran-scriptomic and metabolomic analyses.Methods:Adriamycin(ADR)combined with hydrocortisone(HC)was used to induce CKD with KYDP in rats.ADR was injected into the tail vein twice.HC was injected intramuscularly for 8 weeks.ZWD was administered by gavage for 8 weeks.The general condition was observed,24-h urine protein was detected,serum corticosterone,triiodothyronine,thyroxine,TSH,testosterone,cAMP,and cGMP levels were determined,and pathological analysis was conducted.Transcriptomic and metabolomic analyses were conducted to screen differentially expressed genes(DEGs),differentially expressed metabolites(DEMs),and differentially expressed pathways(DEPs).The core DEMs and DEGs were input to Metab-oanalyst 5.0 to identify the pathways affected by ZWD.Results:In the HC group,KYDP symptoms were observed.Compared with control group,the levels of 24-h urine protein,TSH,and cGMP significantly increased(all P<0.01),and corticosterone,triiodothyronine,thyroxine,and cAMP significantly decreased(all P<0.01)in the HC group.After ZWD intervention,the levels of above-mentioned indicators could be reversed to some extent.Pathological analysis in the HC group revealed kidney lesions.DEGs in the ZWD group were mainly associated with pathways such as nucleotide synthesis and endocrine pathways.In the ZWD group,differences in biosynthesis of unsat-urated fatty acids and butanoate metabolism were observed.The following pathways were significantly affected by ZWD:arachidonic acid metabolism,valine,leucine,and isoleucine biosynthesis,linoleic acid metabolism,and alpha-linolenic acid metabolism.Conclusion:ZWD can be used to treat KYDP in CKD through regulating arachidonic acid metabolism,valine,leucine,and isoleucine biosynthesis,linoleic acid metabolism,and alpha-linolenic acid metabolism.

Clinical observation on efficacy of compound of warming yang, descending turbidity and dredging collaterals in the treatment of diabetic kidney disease with Yin-Yang deficiency and blood stasis syndrome

Objective:To observe the clinical efficacy of compound of owarming yang,descending turbidity and dredging collaterals in the treatment of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome.Methods:Seventy-six patients of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome were randomly divided into observation group and control group,thirty-eight cases in each group.The control group was given conventional western medicine treatment,while the observation group took compound of owarming yang,descending turbidity and dredging collaterals orally on the basis of conventional western medicine treatment.The course of treatment covered for one month.Before and after treatment,we observed the scores of traditional Chinese medicine symptoms,indicators of renal function[serum creatinine(Scr),blood urea nitrogen(BUN),microalbuminuria(MALB)],indicators of glucose metabolism[fasting plasma glucose(FPG),2-hour postprandial blood glucose(2hPG),glycosylated hemoglobin(HbAlc)],indicators of hemorheology[plasma viscosity(PV),platelet aggregation rate(PAR),fibrinogen(FIB)],Cystatin-C(Cys-C),C-reactive protein(CRP)in the two groups.Results:After treatment,the clinical effect of the observation group was significantly better than the control group(P<0.05).The scores of traditional Chinese medicine symptoms,indicators of renal function(Scr、BUN、UAER),indicators of glucose metabolism(FPG、2hPG、HbAlc),indicators of hemorheology(PV、PAR、FIB),Cys-C and CRP in the two groups were decreased significantly compared with those before treatment(P<0.05),and the decrease in the observation group was superior to that in the control group(P<0.05).Conclusion:Compound of warming yang,descending turbidity and dredging collaterals has remarkable efficacy in treating of diabetic kidney disease patients with yin-yang deficiency and blood stasis syndrome by alleviating clinical symptoms,glucose metabolism,renal function and microcirculatory disturbance,and the mechanism related to alleviation of microinflammation.

Brief Analysis of Treatment of Postpartum Body Pain by Professor Zhang Xiaofeng from the Viewpoint of “Liver Vital Deficiency and Yang Stagnation”

Postpartum body pain is a common gynecological disease in clinical setting.Its symptoms are complex and is difficult to treat.It is often treated in many ways but with poor results,which bring great pain to patients and their families.Professor Zhang Xiaofeng can effectively improve clinical treatment of this disease from the point of view of“liver vital deficiency and yang stagnation”.This paper mainly introduces the professional experience of Professor Zhang Xiaofeng in treating postpartum body pain.A clinical case was attached for reference as proof.

Proteomics analysis of IBS-D with spleen and kidney yang deficiency

Objective:To investigate the molecular mechanism underlying the development of diarrhea-predominant irritable bowel syndrome (IBS-D) with spleen and kidney yang deficiency (SKYD) using a proteomics approach.Methods:Male Sprague-Dawley rats (n =22) were divided into IBS-D (n =12) and normal control (n =10) groups.SKYD was then modeled in IBS-D rats by a combination of acetic acid enema,bondage,rectal dilation,tail stimulation,and Senna gavage.Colon tissue samples were subsequently collected and examined by Q Exactive mass spectrometry to identify differentially expressed proteins between the two groups.Results:The occurrence of SKYD/IBS-D was associated with ribosomal protein S23 (Rps23),protein phosphatase 2 catalytic subunit alpha (Pp2a),and growth factor receptor-bound protein 2 (Grb2),which are involved in the ribosome,neurotrophin signaling,and Janus kinase-signal transducer and activator of transcription (JAK-STAT) signaling pathways.Conclusion:These data suggest that SKYD/IBS-D pathophysiology likely involves inflammation,cell growth,apoptosis,stress granule formation,immune activation,loss of epithelial cell integrity,and visceral hypersensitivity.

Clinical Study of Acupotomy Trinity Lysis on Cervical Spondylotic Myelopathy with Liver and Kidney Deficiency Syndrome

Objective:To compare the therapeutic effects of acupotomy trinity lysis and traditional acupotomy on cervical spondylotic myelopathy.Methods:A total of 205 patients with cervical spondylotic myelopathy of liver and kidney deficiency syndrome were randomly divided into the experimental group(105 cases)and the control group(100 cases).The experimental group was relaxed with acupotomy in three positions:Heaven(tian),Human(ren)and Earth(di).Traditional acupotomy was used to relax Ashi acupoints of the affected vertebra in the control group.One treatment was conducted in one week,and the duration of one course of treatment was three weeks.The VAS,JOA score and NDI index were observed after treatment.Results:Before and after treatment,the total treatment efficiency of the treatment group was 95.23%,and that of the control group was 80.00%,there was significant difference between the two groups,P<0.05;Before operation,there was no significant difference in JOA score,NDI index score,and VAS score between the treatment group and the control group(P>0.05);there was no significant difference after 1 week(P>0.05),but there were significant differences between the two groups 2 weeks and 3 weeks after operation(P<0.05).Conclusion:Acupotomy trinity lysis is a safe,effective and economical treatment for cervical spondylotic myelopathy.

Warm needling moxibustion versus electroacupuncture for simple obesity due to yang deficiency of the spleen and kidney: a controlled clinical trial

Objective: To compare the therapeutic efficacy between warm needling moxibustion and electroacupuncture (EA) in the treatment of simple obesity due to yang deficiency of the spleen and kidney. Methods: Seventy patients with simple obesity due to yang deficiency of the spleen and kidney were randomly divided into a warm needling moxibustion group and an EA group, with 35 subjects in each group. Same major acupoints were selected for the two groups, including Shuifen (CV 9), Guanyuan (CV 4), Daheng (SP 15), Shuidao (ST 28), Shousanli (LI 10), Zusanli (ST 36), Sanyinjiao (SP 6) and Taixi (KI 3). The warm needling moxibustion group received warm needling moxibustion, while the EA group received EA treatment. The interventions were performed once every other day, with 15 treatments as one course. The therapeutic efficacy, body weight and body mass index (BMI) were then observed and compared. Results: The total effective rate in the warm needling moxibustion group was 85.7% versus 77.1% in the EA group, and the between-group difference was statistically significant (P<0.05). The warm needling moxibustion was remarkably superior to the EA in weight loss and lowering BMI, both with statistical significance (P<0.05, P<0.01). At the three-month follow-up, the body weight and BMI further decreased in the warm needling moxibustion group (both P<0.05), and the levels were lower than those in the EA group (P<0.05, P<0.01). Conclusion: Warm needling moxibustion can produce reliable and consistent efficacy in the treatment of simple obesity due to yang deficiency of the spleen and kidney. Compared with EA, warm needling moxibustion shows advantage in both short-term and long-term efficacies, and thus is worth promotion in clinical practice.

Therapeutic observation of 'warming-unblocking needling technique'for knee osteoarthritis due to deficiency of liver and kidney

Objective:To compare the clinical efficacy between'warming-unblocking needling technique7 and reinforcing method by twirling in treating knee osteoarthritis(KOA)due to deficiency of liver and kidney.Methods:A total of 72 patients with KOA were divided into a warming-unblocking group and a reinforcing group by complete randomized method,with 36 cases in each group.Xuehai(SP 10),Heding(EX-LE 2),Liangqiu(ST 34);Neixiyan(EX-LE 4),Xizhong(Extra),Dubi(ST 35),Yinlingquan(SP 9),Zusanli(ST 36)and Yanglingquan(GB 34)were the main points in both groups.Taichong(LR 3),Taixi(Kl 3)and Sanyinjiao(SP 6)were the combined points.'Warming-unblocking needling technique'was applied in the warming-unblocking group,and reinforcing method by twirling was applied in the reinforcing group.The treatments were performed once a day,10 times as a treatment course,at a 2-day interval between two courses,for 3 courses in total.The scores of Western Ontario and McMaster Universities osteoarthritis index(WOMAC)in the two groups were observed before and after the treatment,and the clinical efficacy was compared.Results:After treatment,the total effective rate was 94.3%in the warming-unblocking group and 87.9%in the reinforcing group,and the difference between the two groups was statistically significant(P<0.05).The component scores of pain,stiffness and daily activities in WOMAC and total WOMAC scores in both groups decreased after treatment(all P<0.01).The component and total WOMAC scores in the warming-unblocking group were lower than those in the reinforcing group(P<0.05 or P<0.01).Conclusion:'Warming-unblocking needling technique' has significant efficacy than reinforcing method by twirling in treating KOA due to deficiency of liver and kidney.It can significantly improve pain,stiffness and daily functional activities of patients.

Regulatory mechanism of hormones of the pituitary-target gland axes in kidney-Yang deficiency based on a support vector machine model

OBJECTIVE:To study the development mechanism of kidney-Yang deficiency through the establishment of support vector machine models of relevant hormones of the pituitary-target gland axes in rats with kidney-Yang deficiency syndrome.METHODS:The kidney-Yang deficiency rat model was created by intramuscular injection of hydrocortisone,and contents of the hormones of the pituita- ry-thyroid axis:thyroid stimulating hormone(TSH),3,3',5-triiodothyronine(T_3) and thyroxine(T_4);hormones of the pituitary-adrenal gland axis:adrenocorticotropic hormone(ACTH) and Cortisol(CORT);and hormones of the pituitary-gonadal axis:luteinizing hormone(LH),follicle-stimulating hormone(FSH),and testosterone(T),were determined in the early,middle,and advanced stages.Ten support vector regression(SVR) models of the hormones were established to analyze the mutual relationships among the hormones of the three axes.RESULTS:The feedback control action of the pituitary-adrenal axis began to lose efficacy from the middle stage of kidney-Kong deficiency.The contents all hormones of the three pituitary-target gland axes decreased in the advanced stage.Relative errors of the jackknife test of the SVR models all were less than 10%.CONCLUSION:Imbalances in mutual regulation among the hormones of the pituitary-target gland axes,especially loss of effectiveness of the pituitary-adrenal axis,is one pathogenesis of kidney-Yang deficiency.The SVR model can accurately reflect the complicated non-linear relationships among pituitary-target gland axes in rats with of kidney-Yang deficiency.

The Effect of Hormones of the Hypothalamic-pituitary-target Gland Axes in a Kidney-Yang Deficiency Syndrome Model

Kidney-yang deficiency syndrome(KYDS)is a diagnostic pattern in the traditional Chinese medicine.Studies have shown that KYDS is related to the functional disorder of hormones of the hypothalamic-pituitary-target gland axes.The standard procedure used to mimic KYDS is the injection of a high dose of exogenous glucocorticoid(hydrocortisone and corticosterone).Such a model showed symptoms such as exhaustion,body twists,cold limbs,lying crowded together,decreased rectal temperature,sexual dysfunction,decreased reaction speed,reduced spontaneous activity,hair loss,loss of appetite,and weight loss.Moreover,the model manifested an imbalance in mutual control among the hormones of the pituitary-target gland axes,including adrenocorticotrophic hormone,CORT,CRH,thyroid-stimulating hormone,triiodothyronine,thyroxine,T,E2,follicle-stimulating hormone,luteinizing hormone,and 17-OHCS.

Effect of Huqian Wan on liver-Yin and kidney-Yin deficiency patterns in patients with knee osteoarthritis

OBJECTIVE: To observe the curative effect of Huqian Wan on liver and kidney-Yin deficiency knee osteoarthritis(KOA).METHODS: One hundred patients were randomly divided into a treatment(50 patients) and control group(50 patients). In the treatment group, patients orally took the Chinese medicine Huqian Wan. Control group patients orally took Votalin, 75 mg, once a day, for 8 weeks. The visual analog scale(VAS), Western Ontario and Mc Master University Osteoarthritis Index(WOMAC), and Medical Outcomes Study Short Form 36-Item Health Survey(SF36) were used to evaluate the curative effect before treatment and after 8 and 16 weeks of treatment.RESULTS: VAS and WOMAC scores significantly decreased and SF 36 scores significantly increased after treatment in both groups compared with before treatment(P < 0.05). There were significant differences in VAS, WOMAC, and SF 36 score changes between the two groups at week 16(P < 0.05).There was a significant increase in VAS and WOMAC scores in the control groups(P < 0.05) between weeks 8 and 16, but no significant difference was found in the treatment group(P > 0.05).CONCLUSION: Huqian Wan could effectively improve the clinical symptoms and quality of life in patients with KOA. It could also have a better and longer lasting curative effect without obvious adverse events compared with Votalin.

升阳泻湿法治疗非酒精性脂肪性肝病初探

非酒精性脂肪性肝病是目前的多发病,为多因素所致,严重影响公共健康,目前对于该病的证治报道较多。该病的临床表现多数不典型,病机证候复杂,笔者汲取李东垣理论思想中升发脾之清气,以及黄元御理论思想中泻湿疏木的治法,把二者进行优化组合,拟定了升阳化湿,培土疏木为治疗大法运用于临床,立足于“湿”,分为“湿浊内蕴”和“脾虚湿困”2个证型,驭繁就简,取得了理想的临床疗效。

宫颈高危型人乳头瘤病毒感染的中医证候特征研究

【目的】探究宫颈高危型人乳头瘤病毒(HR-HPV)感染者中医证候特征,为临床辨证论治提供参考。【方法】收集2020年9月至2022年10月于天津中医药大学第二附属医院妇科就诊行HPV检测确诊为宫颈HR-HPV感染者进行中医证候调查,总结其病位、病性特点及证型分布。【结果】宫颈HR-HPV感染者的临床特征主要以阴道分泌物异常为主,占63.40%。病位证素为胞宫、脾、肝、肾、经络、胃、心神、心,其中以胞宫、脾、肝最多见,分别占67.00%、58.80%和55.80%。病性证素为湿、热、气滞、血瘀、气虚、阳虚、阴虚、痰、寒,其中以湿、热、气滞、血瘀最多见,分别占66.40%、56.60%、36.00%和31.80%。各年龄段病位证素均以胞宫为主,病性证素均以湿、热为主。双病位证素以胞宫-脾最常见,三病位证素以胞宫-脾-肝最常见。双病性证素以湿-热最常见,三病性证素以湿-热-血瘀最常见。根据聚类分析结果,结合临床实际,发现宫颈HR-HPV感染者的主要证型分布为湿热瘀阻、肝郁气滞、心肾不交、脾胃阳虚。【结论】宫颈HR-HPV感染者的中医病位证素主要在胞宫,兼脾、肝、肾多脏腑合病;病性证素以湿、热为主,呈现虚实错杂的特点;中医证型主要是湿热瘀阻、肝郁气滞、心肾不交、脾胃阳虚。

基于孟德尔随机化探讨原发性甲状腺功能减退症与肠易激综合征的因果关系及相关病机

目的:采用孟德尔随机化(MR)方法探究原发性甲状腺功能减退症与肠易激综合征(IBS)的因果关系,并分析二者中医病机特点。方法:利用全基因组关联研究(GWAS)数据进行MR分析,以原发性甲状腺功能减退症为暴露因素,以IBS为结局变量。采用方差反加权法(IVW)作为主要研究指标,同时采用MREgger、加权中位数法、加权模式法等方法保证MR结果的可靠性;进行异质性检验、敏感性分析、多效性分析保证研究结果的稳定性。结果:原发性甲状腺功能减退症对IBS有因果关系,IVW(OR=1.08,95%CI为1.01~1.16,P=0.02)。IBS对原发性甲状腺功能减退症有因果关系,IVW(OR=1.11,95%CI为1.03~1.20,P=0.006)。结论:原发性甲状腺功能减退症可以增加IBS的患病风险,IBS亦可增加原发性甲状腺功能减退症的患病风险。肝郁脾虚、肾阳亏虚是两者互为因果关系及共病的主要中医病机。

温阳扶正方联合PD-1免疫治疗影响阳虚型肝癌微环境的临床研究

目的探讨温阳扶正方联合PD-1免疫治疗影响阳虚型肝癌微环境的临床疗效。方法选取复旦大学附属中山医院青浦分院2021年10月至2023年7月的阳虚型原发性肝癌行PD-1免疫治疗的住院患者80例为研究对象,按照随机数字表法将其分为对照组(予PD-1免疫治疗)和中药组(予PD-1免疫治疗联合用温阳扶正方治疗),对两组患者的中医疗效、中医证候积分、主症评分、行为能力状况、免疫功能指标及血清中标志物水平进行对比。结果中药组的总有效率为72.50%,明显高于对照组的50.00%(P<0.05);两组患者治疗后中医证候积分明显低于治疗前(P<0.05),且中药组治疗后中医证候积分明显低于对照组(P<0.05);两组患者治疗后主症右胁胀痛、畏寒、乏力、纳差、便溏、舌质淡或淡暗、苔白腻评分明显低于治疗前(P<0.05),且中药组治疗后主症右胁胀痛、畏寒、乏力、纳差、便溏、舌质淡或淡暗、苔白腻评分明显低于对照组(P<0.05);两组患者治疗后Karnofsky得分明显高于治疗前(P<0.05),且中药组治疗后Karnofsky得分明显高于对照组(P<0.05);两组患者治疗后的CD4^(+)T细胞、CD4^(+)/CD8^(+)明显高于治疗前(P<0.05),且中药组治疗后CD4^(+)T细胞、CD4^(+)/CD8^(+)明显高于对照组(P<0.05);两组患者治疗后血清中的bFGF、VEGF、TGF-β1、AFP水平明显低于治疗前(P<0.05),且中药组治疗后bFGF、VEGF、TGF-β1、AFP水平明显低于对照组(P<0.05)。结论温阳扶正方联合PD-1免疫治疗阳虚型肝癌疗效显著,有利于改善免疫功能和抑制肿瘤标志物的释放,具有良好的参考、推广及借鉴价值。

彭清华教授治疗围绝经期干眼经验

围绝经期女性是干眼的好发人群,其发生与性激素水平失调密切相关。围绝经期干眼的发病率逐年升高,其临床表现为眼睛干涩、有异物感、灼热感、容易疲乏等,严重影响患者的生活质量。彭清华教授认为围绝经期干眼以肾虚为本,肾阴阳失衡是病机关键。其证型包括肾阴不足、水不涵木,肾阳虚衰、脾失温煦,以及肝经郁热、气机壅滞,在临床上采用补益肝肾、上病下取,温阳益气、阴中求阳,清肝解郁、身心同调为法,辅以针刺眼周穴位攒竹、睛明、承泣及体穴三阴交、养老、合谷等联合密蒙花颗粒剂中药熏蒸仪熏蒸治疗,临床疗效显著。

方朝晖教授从肾论治多囊卵巢综合征临床经验

多囊卵巢综合征(PCOS)是常见的内分泌紊乱性疾病,常伴有痤疮、多毛、肥胖、不孕等临床症状,严重影响患者生活,近年来其发病率不断升高。现代医学的治疗方案主要为口服孕激素类药物,严重者可进行手术治疗。中医药治疗PCOS治愈率高,兼顾整体治疗,预后良好,不良反应少,可明显改善患者生活质量,具有独特的优势。方朝晖教授躬耕临床数十年,治疗经验丰富,将PCOS病因病机总结为脾肾阳虚、肝肾不足。脾肾阳虚则水液气化无力,水湿痰浊内生,瘀阻胞宫,肝肾不足则疏泄失常,气滞不畅,导致卵泡发育受阻、排卵障碍,进而引发PCOS。治疗上,方朝晖教授强调针药结合、辨证论治,随法选方选穴,搭配穴位埋线疗法,改善患者临床症状,疗效颇丰。

陈意教授“以和统之”理论治疗不寐临床经验探讨

[目的]总结陈意教授“以和统之”理论指导下治疗不寐的临证经验。[方法]通过师承学习、整理归纳相关文献及陈意教授的论述与案例,详细阐述对不寐病因病机的认识,探讨基于“以和统之”理论的独特辨治思路和经验,并举以医案验证。[结果]陈意教授认为不寐的发生是由于脏腑阴阳失衡、气血失和,提出以和法统摄八法,采取分而治之的策略,并强调养、疏、清、宁,形成了独特的安神助眠治疗特色。所附医案为值绝经前后的不寐患者,以阴阳失衡、阴不敛阳而致阴虚火旺为主病机,予滋阴降火、宁心安神治法,进一步调和气血,恢复脏腑功能,达到“阴平阳秘”的状态,“致中和”、人安寐。[结论]陈意教授以“以和统之”理论治疗不寐,疗效显著,值得学习与推广。

姜莉云教授基于“阳主阴从”观论治功能性消化不良临证经验

功能性消化不良属中医“胃痞”范畴,姜莉云教授临证以阴阳为纲,立足阳主阴从观,认为功能性消化不良患者多以脾肾阳虚为发病基础,湿困脾土、气运不畅为该疾病的诱发及加重因素。擅以扶阳大法施治,每获良效,具体诊疗思路为扶助元阳,温补脾阳;燥湿健脾,脾旺土厚;暖肝顺气,气运得畅。