Analysis of treatment strategies of traditional Chinese medicine for COVID-19 in tropical regions based on the pathogens of dampness and heat

Objective:To summarize the treatment strategies of Traditional Chinese Medicine(TCM)for COVID-19 in tropical regions based on the pathogens of dampness and heat.Methods:For heat pathogen,analyzing heat in the superficies,lung and Yang Ming based on the different locations.Based on the progress of the disease,analyzing the stage of toxin and Qi deficiency induced by heat.For dampness pathogen,analyzing endogenous and external dampness based on the different locations.Analyzing dampness pathogen's special disease location—Moyuan and special symptom of dry cough with less sputum caused by sticky and stagnant characteristic of dampness.Results:The treatment strategies for heat and dampness pathogen were summarized.Conclusion:In the tropics,the pathogens of dampness and heat occur frequently and clinical treatments need to be dialectical.

Clinical effect of enriching qi, activating blood circulation, clearing away dampness and heat combined with western medicine in the treatment of idiopathic membranous nephropathy: A meta-analysis

Objective:To systemically review the efficacy and safety about the method of enriching qi,activating blood circulation,clearing away dampness and heat combined with western medicine in the therapy of patients with idiopathy membranous nephropathy(IMN).Methods:We collected the randomized controlled trials(RCTs)of enriching qi,activating blood circulation,clearing away dampness and heat for the treatment of IMN from Pub Med,The Cochrane Library,Medline,China National Knowledge Infrastructure(CNKI),China Biology Medicine disc(CBM),Wanfang Data and Wiper Databases.Bias of risk of retrieval literature was evaluated according to Cochrane Collaboration standard,and Review Manager 5.3 software was used for statistical analysis.Results:Fourteen trials(836 participants)were included in the meta-analysis.This kind of traditional Chinese method combined with western medicine in the treatment of IMN exerted statistical differences in reducing 24-hour urinary protein[WMD=-0.97,95%CI(-1.30,-0.65),Z=5.86(P<0.00001)]and elevating serum albumin[WMD=3.83,95%CI(2.10,5.57),Z=4.33,P<0.0001],lowering serum cholesterol[WMD=-0.82,95%CI(-1.08,-0.56),Z=6.18,P<0.00001],triglycerides[WMD=-0.39,95%CI(-0.67,-0.11),Z=2.77,P=0.006]and reducing the risk of adverse events[OR=0.29,95%CI[0.16,0.50],Z=4.35,P<0.0001]in the patients with IMN as compared with controls.However,there was no statistically significant difference between the method and controls when combining all trials in serum creatinine[WMD=-5.52,95%CI(-18.06,7.03),Z=0.86,P=0.39],when combining all trials in urea nitrogen[WMD=-0.90,95%CI(-2.22,0.41),Z=1.35,P=0.18].Conclusion:The method of enriching qi,activating blood circulation,clearing away dampness and heat combined with western medicine exerts certain advantages and better safety in treating patients with IMN.However,for the inferiority of the included studies,the conclusion still needs high-quality and large-sample prospective randomized controlled trials to verify.

Study on the Characteristics of Gut Microbiota in Chronic Hepatitis B(CHB)Patients with Damp Heat Syndrome and Liver Depression and Spleen Deficiency Syndrome

Objective:This study was designed to explore the characteristics of gut microbiota in CHB patients with two most common traditional Chinese medicine(TCM)Syndromes—damp heat syndrome and liver depression and spleen deficiency syndrome.Methods:According to the diagnostic criteria of Western medicine,TCM and screening exclusion criteria,65 cases of CHB with damp heat syndrome and 28 cases of CHB with liver depression and spleen deficiency syndrome were finally included in the study.All the basic information was gathered and the fresh fecal samples were collected for 16S rDNA sequencing.16S rDNA of gut microbiota was sequenced using Illumina hiseq 2,500 high-throughput sequencing platform.Based on the optimized sequence,Operational Taxonomic Units(OTU)clustering analysis and taxonomic annotation were carried out.Results:The difference in relative abundance of gut microbiota was significant between damp heat syndrome and liver depression and spleen deficiency syndrome in CHB patients.Cyanobacteria was only found in damp heat syndrome.The relative abundance of Erysipelotrichia and Subdoligranulum were higher in liver depression and spleen deficiency syndrome,while the relative abundance of Rhodospirillales,Alphaproteobacteria and Lachnospira were higher in the damp heat syndrome.LDA Effect Size(LEfSe)analysis showed that Lachnospira,Olsenella and Subdoligranulum had significant difference in species among the two TCM syndromes.Conclusion:The different characteristics of gut microbiota in the two TCM syndromes of CHB patients may play an important role in syndrome formation of TCM,which provides a new field of vision for the accurate diagnosis and treatment of TCM.

Effect of methotrexate combined with Sanhuang Yilong decoction on serum and synovial fluid aquaporin levels in rheumatoid arthritis dampness-heat blockage syndrome

OBJECTIVE:To study the effect of methotrexate(MTX) combined with Sanhuang Yilong decoction(SYD) on aquaporin(AQP) expression,and to explore the role of AQPs in the pathogenesis of rheumatoid arthritis(RA).METHODS:A total of 118 dampness-heat blockage type RA patients who were hospitalized in the General Chengdu Military Hospital between January2014 and December 2016 were selected as subjects in this study(30 patient of these patients with knee joint effusion were assigned to the RA synovial fluid group).For the pre-treatment controlgroups,30 healthy volunteers were recruited as the healthy control group and 30 osteoarthritis(OA) patients with knee joint effusion were included as OA synovial fluid control group.The RA dampnessheat blockage syndrome treatment groups were divided into 45 cases in the combined group and 45 cases in the MTX group.The combined group received MTX combined with SYD treatment while the MTX group received MTX alone.AQP1,AQP2 and AQP3 expressions were detected in the serum and synovial fluid.RESULTS:AQP1 had the highest expression,followed by AQP3,and AQP2.The serum levels of AQP1,AQP2 and AQP3 were all significantly lower than those in the healthy volunteers(P < 0.05),while the synovial fluid AQP1,AQP2 and AQP3 expression in the RA group were comparable to these in the OA groups(P > 0.05).After treatment for2 weeks,serum AQP1,AQP2,AQP3 were significantly increased and erythrocyte sedimentation rate,C-reactive protein,disease activity score of 28 joints were decreased in the combined group(P < 0.05).CONCLUSION:Abnormal expression of AQPs inhibits water metabolism in RA dampness-heat blockage syndrome,so liquid is accumulated at the joint,which may play an important role in the pathogenesis of RA.MTX combined with SYD for the treatment of RA can effectively increase AQP expression.

Formulation Mechanism of Mailuo Shutong Pills in the Treatment of Varicocele

Varicocele is a common disease in male urology clinic,mainly manifested as testicular pendent distension discomfort,scrotal moisture,less weak semen and other symptoms.There is no specific drug in clinical treatment of modern medicine and traditional Chinese medicine.Mailuo Shutong Pills was created by TANG Zuxuan,a Chinese medical master,for the treatment of damp and heat stasis type thrombotic superficial phlebitis and other vascular diseases.In clinical application,it was found to have a good clinical effect on the treatment of symptoms caused by varicose vein.This paper analyzed the formulation mechanism of Mailuo Shutong Pills in the treatment of varicocele from the perspective of traditional Chinese and western medicine,and provides theoretical basis for clinical application.

Interleukin-12 and interferon-γacting on damp-heat of spleen-stomach syndrome triggered by helicobacter pylori

OBJECTIVE: To investigate the expression of and interleukin-12(IL-12) and interferon-γ(IFN-γ) in relation to the pathology of damp-heat of spleen-stomach syndrome(DHSS) induced by Helicobacter pylori(H. pylori) infection.METHODS: In total, 114 individual gastric mucosal specimens including 83 DHSS, 19 spleen-qi deficiency syndrome(SQD) and 12 from healthy volunteers(CON) were collected by gastroscopy. To explore the relationship between the two syndromes and H. pylori infection, individual samples were tested using rapid urease and methylene blue tests. Hematoxylin and eosin stained sections were examined to grade for the degree of inflammation and inflammatory activity, and expression of IL-12 and IFN-γ was investigated by immunohistochemistry.RESULTS: Statistically significant differences in the degree of inflammation and inflammatory activity were observed between the groups of specimens:DHSS, SQD and CON(P < 0.05). Additionally, greater intestinal metaplasia(IM) and dysplasia were observed in the DHSS group, especially those with H.pylori infection. Expression of both IFN-γ and IL-12 was higher in DHSS samples infected with H. pylori than in uninfected samples and in the CON(P <0.05) but not in the SQD(P > 0.05) groups. Intriguingly, in gastric specimens exhibiting IM and dysplasia, IL-12 translocated from the nucleus into the cytoplasm.CONCLUSION: Our findings suggest that IL-12 and IFN-γ are involved in DHSS pathology, but not in SQD, acting as healthy-Qi. DHSS is not just the consequence of those two cytokines but results from the cross-talk between a number of cytokines and/or other proteins, which may warrant further investigation in DHSS patients infected with H. pylori.