Clinical Observation on Influence of Chinese Medicines for Promoting Blood Circulation to Remove Blood Stasis on FIB and DD in Plasma of Patients with Cerebral Thrombosis

Objective: to study the influence of Chinese medicines for promoting blood circulation to remove blood stasis on fibrinogen (FIB) and D-dimer (DD) in plasma of patients with cerebral thrombosis. Method: 73 inpatients with acute cerebral thrombosis were randomly divided into a control group of 34 cases and a treatment group of 39 cases. The content of FIB and DD in plasma was detected before treatment and on the 7th and 14th days after treatment. Result: FIB content in plasma after treatment was lower than that before treatment in the control group (P<0.01) and more remarkable in the treatment group (P<0.001). There was an obvious difference in DD content before and after treatment in both groups. DD content on the 7th and 14th days after treatment in the treatment group was obviously higher than that in the control group (P<0.01 and P<0.05 respectively). Conclusion: Chinese medicines for promoting blood circulation to remove blood stasis can reduce the FIB content in plasma of patients with cerebral thrombosis, raise the DD content in plasma, cause the peak of DD content appear earlier and obviously improve hypercoagulability of blood in patients with cerebral thrombosis.

Train of Thought about Treatment of High Blood Pressure with Integrative Traditional and Western Medicine

Based on the differ—ent theories,TCM andWestern medicine(WM)have their owndifferent understandingsabout the pathogenesisand treatment of highblood pressure(HBP).In TCM the balancesbetween blood-qi,vis—cera—bowel, and yin—yang are all highly

Meta Analysis of the Efficacy of Nonpharmaceutical Chinese Medicine Therapy in the Treatment of Obese Polycystic Ovary Syndrome

Objective:To systematically evaluate the effects of acupuncture,auricular point sticking,acupoint catgut embedding,cupping and other non-pharmaceutical Chinese medicine therapies on sex hormone as well as glucose and lipid metabolism in patients with obese polycystic ovary syndrome.Method:The databases such as China National Knowledge Infrastructure were searched by computer to collect the literature on the treatment of obese polycystic by non-pharmaceutical Chinese medicine therapy combined with western medicine or lifestyle change,and the literature quality of the included literature was evaluated,and finally the data were analyzed.A total of 15 randomized controlled trial(RCT)literature were included in this study,with a total of 1263 patients.Results:Non-pharmaceutical Chinese medicine therapy combined with metformin or lifestyle can reduce body mass index,insulin resistance index,fasting plasma insulin,fasting blood glucose,luteinizing hormone,ratio of luteinizing hormone to follicle stimulating hormone,testosterone,but it has no obvious advantage over follicle stimulating hormone(FSH).Conclusion:Compared with simple application of metformin or lifestyle change,traditional Chinese medicine non drug therapy combined with metformin or lifestyle change can better improve sex hormone and blood glucose metabolism in obese PCOS patients.

Effect on Life Span and Membrane Protein in Red Blood Cells by Integrated Medicine Therapy on Chronic Aplastic Anemia

Objective: To explore the mechanism ofintegrated traditional Chinese and Westernmedicine (TCM--WM ) therapy on chronicaplastic anemia (CAA). Methods: The RBClife span of 30 normal human subjects and 30patients with CAA were measured by sir labelled technique before and after TCM--WMtherapy. The morphology and distribution ofRBC membrane protein granules were observed by freeze fracture etching and transmission electron microscope. Results: The halflife of erythrocytes (RBC TI/2)was shortenedin CAA cases and there was a significant difference compared to healthy control (P <0. 01). After therapy, the RBC life span prolonged and approached the normal level. Before treatment, there existed abnormal in morphology, decrease in amount and uneven indistribution of protein granules in protoplasmicface (PF) and extracellular face (EF) of RBCmembrane. After treatment, the protein granules of RBC membrane was improved and approached to control. Conclusions: The morphology, amount, quality and distribution ofRBC membrane protein granule were closelyrelated to its life span. The therapeutic effectof TCM--WM was better than that of WMalone and it had a function both in stabilizingmembrane protein and extending the RBC lifespan.

Clinical Study on Effect of Chinese Herbal Medicine for Supplementing Kidney and Qi and Activating Blood Circulation in Treating Intrauterine Growth Retardation of Fetus

Objective: To explore the therapeutic effect and the possible working mechanism in using Chinese herbal medicine (CHM) for supplementing Kidney and Qi, and activating blood circulation in treating intrauterine growth retardation of fetus (IUGR). Methods: Fifty-five cases of IUGR were divided into two groups, 30 cases in the CHM group treated with CHM and the 25 in the control group treated with amino acids. The effect of CHM treatment was observed and compared with that of the control group, normal pregnancy group and non-treated IUGR group. Results: Body weight of the newborns in the CHM was markedly higher than that in the control group. Not only the maternal fundal height (FH) and the abdominal circumference (AC), but also the fetal growth parameters, including biparietal diameter, head circumference (HC), and femur length (FL) in the CHM group increased much faster than those in the control group. After CHM treatment, the maternal serum levels of estriol (E3) and human placental lactogen (hPL) approached to those in the normal pregnancy group, but the control group,in comparison with the normal pregnancy group, was significantly different. The umbilical venous plasma concentration of essential amino acids in both treated groups improved, but the improvement in the CHM group was more significant than that in the control group. No apparent adverse effect of CHM was observed in either mother or fetus.Conclusion: CHM for supplementing Kidney and Qi and activating blood circulation was more effective in improving placental function and enhancing amino acid transportation than amino acid

Metabolomic Profiling Reveals Distinct Patterns of Tricarboxylic Acid Disorders in Blood Stasis Syndrome Associated with Coronary Heart Disease

Objective： To investigate the underlying metabolomic profiling of coronary heart disease（CHD） with blood stasis syndrome（BSS）. Methods： CHD model was induced by a nameroid constrictor in Chinese miniature swine. Fifteen miniature swine were randomly divided into a model group（n=9） and a control group（n=6）, respectively according to arandom number table. After 4 weeks, plasma hemorheology was detected by automatic hemorheological analyzer, indices including hematocrit, plasma viscosity, blood viscosity, rigidity index and erythrocyte sedimentation rate; cardiac function was assessed by echocardiograph to detect left ventricular end-systolic diameter（LVED）, left ventricular end-diastolic diameter（LVEDd）, ejection fraction（EF）, fractional shortening（FS） and other indicators. Gas chromatography coupled with mass spectrometry（GC-MS） and bioinformatics were applied to analyze spectra of CHD plasma with BSS. Results： The results of hemorheology analysis showed significant changes in viscosity, with low shear whole blood viscosity being lower and plasma viscosity higher in the model group compared with the control group. Moreover, whole blood reduction viscosity at high shear rate and whole blood reduction viscosity at low shear rate increased significantly（P〈0.05）. The echocardiograph results demonstrated that cardiac EF and FS showed significant difference（P〈0.05）, with EF values being decreased to 50% or less. The GC-MS data showed that principal component analysis can clearly separate the animals with BSS from those in the control group. The enriched Kyoto Encyclopedia of Genes and Genomes biological pathways results suggested that the patterns involved were associated with dysfunction of energy metabolism including glucose and lipid disorders, especially in glycolysis/gluconeogenesis, galactose metabolism and adenosine-triphosphate-binding cassette transporters. Conclusion： Glucose metabolism and lipid metabolism disorders were the major contributors to the syndrome classification of CHD with BSS.

A Multicenter,Randomized,Double-blind Clinical Study on Wufuxinnaoqing Soft Capsule(五福心脑清胶囊) in Treatment of Chronic Stable Angina Patients with Blood Stasis Syndrome

Objective： To confirm the efficacy and safety of Wufuxinnaoqing Soft Capsule （五福心脑清胶囊, WSC） in the treatment of chronic stable angina （blood stasis syndrome）. Methods： A multicenter, randomized, double-blind, placebo-controlled trial with superiority test was designed. A total of 240 patients with chronic stable angina （blood stasis syndrome） from multiple centers were randomly and equally assigned to the treatment group and the control group. Based on standard treatment of Western medicine, the treatment group was given WSC, while the control group was given WSC mimetic, both for 12 weeks. Observed indicators included the efficacy in angina, the efficacy in Chinese medicine syndrome, the withdrawal or reduce rate of nitroglycerin and routine safety indices. Results： After 12-week treatment, the significant effective rate and total effective rate of the treatment group were significantly better than those of the control group （23.5% vs. 9.2%, 64.7% vs. 30.8%）, respectively, with statistically significant difference （P〈0.01）. After 12-week treatment, the decreased points and the decreased rate of angina symptom score in the treatment group were better than in the control group （5.1±4.2 points vs. 2.8± 3.5 points, 44.9% ±37.2% vs. 25.4%±30.7%） respectively, with significant difference （P〈0.01）. After 12-week treatment, the significant effective rate and total effective rate of the treatment group were better than the control group （respectively, 30.3% vs. 15.0%, 67.2% vs. 45.0%, P〈0.01）. After 8- or 12-week treatment, the decreased points and the decreased rate of Chinese medicine syndrome score in the treatment group were better than the control group （P〈0.05 or P〈0.01）. After 12-week treatment, nitroglycerin withdrawal rate and the withdrawal or reduce rate in treatment group were better than the control group （P〈0.01）. On safety evaluation, the incidence of adverse events （7.563% vs. 7.500%） and the incidence of cardiovascular events （0.840% vs. 0.000%） in the treatment group were similar with the control group, and the difference was not statistically significant （P〉0.05）. Couch=SlOB： In treatment of chronic stable angina （blood stasis syndrome）, WSC can reduce angina attacks and consumption of nitroglycerin, decrease angina severity degree, effectively relieve the blood stasis syndromes, such as chest pain, chest tightness, palpitations, dark purple tongue and other symptoms. Besides, adverse events and cardiovascular adverse events in the treatment group and the control group showed no difference. All shows that the drug is safe and effective. [This study was registered in Chinese Clinical Trial Registry （ChiCTR）, with registration number： ChiCTR-TRC-14005158.]

Long-Term Follow-Up of Chinese Herbal Medicines Combined with Conventional Treatment in Patients with Acute Coronary Syndrome after Percutaneous Coronary Intervention: A Multicenter Randomized Controlled Trial

Objective： To evaluate the prognosis effect of Chinese herbal medicines（CHMs） for benefiting qi and activating blood circulation adjunctive to conventional treatment in patients with acute coronary syndrome（ACS） after percutaneous coronary intervention（PCI）. Methods： A total of 702 patients with ACS who underwent PCI were enrolled and randomly assigned to receive conventional treatment plus CHMs for benefiting qi and activating blood circulation（treatment group, 351 cases） or conventional treatment alone（control group, 351 cases） for 6 months. Six months later, all patients received conventional treatment alone. Follow-ups were scheduled at 6th, 12 th, 18 th, 24 th month after enrollment in April 2008, and the final follow-up visit was during September 2011 and November 2011. The primary endpoint was the composite of cardiac death, nonfatal myocardial infarction or revascularization（PCI or coronary artery bypass grafting）; and the secondary endpoint was the composite of re-admission for ACS, congestive heart failure, nonfatal stroke or other thrombus events. Results： A total of 621（88.59%） patients completed 35.4±3.8 months follow-up, while 80（11.41%） patients withdrew from the trial（41 in the treatment group and 39 in the control group）. The incidence of primary endpoint was 5.7%（20 patients） in the treatment group versus 10.86%（38 patients） in the control group [relative risk（RR）： 0.53; 95% confidence interval（CI）： 0.30, 0.88; P=0.013; absolute risk reduction（ARR）： –0.052, 95% CI： –0.06, 0.01]. The incidence of secondary endpoint was 5.98%（21 patients） in the treatment group versus 10.28%（36 patients） in control group（RR： 0.58, 95% CI： 0.33, 0.97, P=0.037; ARR： –0.043, 95% CI： 0.06, 0.01）. Most of the primary and secondary endpoints were occurred in 18 months（84.50% in the treatment group versus 78.10% in the control group）. Conclusion： CHMs for benefiting qi and activating blood circulation adjunctive to conventional treatment improved clinical outcomes for patients with ACS after PCI in long-term follow-up.

Relationship between Two Blood Stasis Syndromes and Inflammatory Factors in Patients with Acute Coronary Syndrome

Objective： To investigate the relationship between inflammatory factors and two Chinese medicine（CM） syndrome types of qi stagnation and blood stasis（QSBS） and qi deficiency and blood stasis（QDBS） in patients with acute coronary syndrome（ACS）. Methods： Sixty subjects with ACS, whose pathogenesis changes belongs to qi disturbance blood stasis syndrome, were divided into 2 groups： 30 in the QSBS group and 30 in the QDBS group. The comparative analysis on them was carried out through comparing general information, coronary angiography and inflammatory factors including intracellular adhesion molecule-1（ICAM-1）, chitinase-3-like protein 1（YKL-40） and lipoprotein-associated phospholipase A2（Lp-PLA2）. Results： Compared with the QSBS group, Lp-PLA2 and YKL-40 levels in the QDBS group showed no-significant difference（P〉0.05）; ICAM-1 was significantly higher in the QDBS group than in the QSBS group in the pathological processes of qi disturbance and blood stasis syndrome of ACS（P〈0.05）. Conclusion： Inflammatory factor ICAM-1 may be an objective basis for syndrome typing of QSBS and QDBS, which provides a research direction for standardization research of CM syndrome types.

Inter-observer Reliability of Indicators and Decision of Pattern Identification Using Diagnostic Flowchart with Traditional Korean Medicine

Objective： To evaluate the consistency of patterns and pattern identification（PI）, and the improvement in the diagnosis of blood stasis after the standard operating procedures（SOPs） were enhanced by using a diagnostic flowchart. Methods： A total of 358 subjects who were admitted by the Jaseng Hospital of Korean Medicine between June 2013 and December 2014 were included in the study. Each patient was independently diagnosed by two experts from the same department. In 2014, the SOPs included the use of a diagnostic flowchart for each indicator. Inter-observer consistency was assessed by simple percent agreement and by the kappa and AC1 statistics. Results： The improvements in inter-observer agreement for the indicators（for al patients） and PI were greater in 2014 than in 2013. In 2013, the j-value measure of agreement between the two experts ranged from ＂poor＂（κ=–0.051） to ＂good＂（κ=0.968）. The AC1 measure of agreement between the experts was generally high for the indicators and ranged from –0.010 to 0.978. In most cases, agreement was considerably lower when it was assessed by the j-values compared with the AC1 values. In 2014, the j-value measure of agreement on the indicators（for the subjects） general y ranged from poor to good, with the values ranging from –0.007 to 0.994. Moreover, the AC1 measure of agreement between the experts was general y high for al of the indicators and ranged from ＂moderate＂（AC1=0.408） to ＂excel ent＂（AC1=0.996）. Conclusions： In four examinations, there was moderate agreement between the clinicians on the PI indicators of blood stasis. To improve clinician consistency（e.g., in the diagnostic criteria used）, it is necessary to analyse the reasons for inconsistency and to improve clinician training.（Trial registration No. KCT0000916）

Effect of Wenhua Juanbi Recipe(温化蠲痹方) on Expression of Receptor Activator of Nuclear Factor Kappa B Ligand,Osteoprotegerin,and Tumor Necrosis Factor Receptor Superfamily Member 14 in Rats with Collagen-Induced Arthritis

Objective： To study the effect of Wenhua Juanbi Recipe（温化蠲痹方, WJR） on expression of receptor activator of nuclear factor kappa B ligand（RANKL）, osteoprotegerin（OPG）, and tumor necrosis factor receptor superfamily member 14（TNFRSF14, also known as LIGHT） in rats with collagen-induced arthritis（CIA）. Methods： CIA rats were generated by subcutaneous injection of bovine collagen type-Ⅱ at the tail base. Sixty CIA rats were randomly assigned（10 animals/group） to： model, methotrexate（MTX）-treated（0.78 mg/kg body weight）, and WJR-treated（22.9 g/kg） groups. Healthy normal rats（n=10） were used as the normal control. Treatments or saline were administered once daily by oral gavage. Rats were sacrificed at day 28 post-treatment and knee synovium and peripheral blood serum were collected. Toe swelling degree and expression of RANKL, OPG, and LIGHT were determined by Western blot and immunohistochemistry. Results： Compared with the normal group, toe swelling degree was significantly increased in the model group（P〈0.01）. After treatment, toe swelling degree decreased significantly in the WJR and MTX groups compared with the model group（P〈0.01）. Compared with the normal group, expression of RANKL and LIGHT were significantly increased and OPG significantly decreased in peripheral blood and synovium of the model group（P〈0.01）. Conversely, RANKL and LIGHT expression were significantly reduced and OPG increased in the WJR and MTX groups compared with the model group（P〈0.01）. No statistically significant difference existed between WJR and MTX groups. Conclusion： WJR likely acts by reducing RANKL expression and increasing OPG expression, thus inhibiting RANKL/RANK interaction and reducing LIGHT expression, thereby inhibiting osteoclast formation/activation to block bone erosion.