Clinical study on microscopic syndrome differentiation and traditional Chinese medicine treatment for liver stomach disharmony in chronic gastritis

BACKGROUND Chronic gastritis(CG)is a common gastrointestinal disorder characterized by inflammation of the stomach lining.Liver-stomach disharmony(LSD)syndrome is believed to contribute to CG symptoms.AIM To evaluate the efficacy and safety of microcosmic syndrome differentiation and Chinese herbal medicine(CHM)treatment in patients with CG and LSD syndrome.METHODS Sixty-four patients with CG and LSD syndrome were randomly divided into two groups:The treatment group received CHM based on microcosmic syndrome differentiation and the control group received conventional Western medicine.The treatment course lasted 12 wk.The primary outcome was improvement in dyspeptic symptoms,measured using the Nepean Dyspepsia Index.The secondary outcomes included the improvement rate of endoscopic findings,histopathological findings,and microcosmic syndrome scores and the incidence of adverse events.RESULTS After 12 wk of treatment,the treatment group showed significantly greater improvement in dyspeptic symptoms than the control group(93.75%vs 65.63%,P<0.01).The treatment group also showed a significantly higher improvement rate in endoscopic findings than the control group(81.25%vs 53.13%,P<0.05).The improvement rates of histopathological findings and microcosmic syndrome scores were not significantly different between the two groups(P>0.05).No serious adverse events were observed in either group.CONCLUSION Microcosmic syndrome differentiation and CHM treatment can effectively improve dyspeptic symptoms and endoscopic findings in patients with CG and LSD syndrome and have a good safety profile.Further studies with larger sample sizes and longer follow-up periods are required to confirm the long-term efficacy and mechanism of action of this treatment.

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.

Clinical efficacy of Chinese herbal compound in the treatment of infertility with kidney deficiency:A meta-analysis

Objective:Based on the current evidence system to evaluate the effect of traditional Chinese medicine compound on the clinical efficacy of infertility patients with kidney deficiency.Methods:Search the China Knowledge Resources Database(CNKI),Chinese Science and Technology Journal Database(VIP),China Academic Journal Database(Wanfang),PubMed,EMBASE,Ovid.The included studies are randomized controlled trials.The experimental group is Chinese medicine compound or Chinese medicine compound combined with western medicine,and the control group is western medicine.Two reviewers independently extracted and evaluated the literature data according to the Cochrane manual standards,and used Rev Man5.3 software for data synthesis and Meta-analysis.Results:32 studies were selected,a total of 2715 cases of infertility patients.The clinical pregnancy rate of the experimental group and the control group[n=29,OR(95%CI)=2.47(2.07,2.96),P<0.00001],the clinical total effective rate[n=20,OR(95%CI)=3.77(2.83,5.03),P<0.00001],TCM syndrome score[n=14,MD(95%CI)=4.34(3.08,5.61),P<0.00001],ovulation rate[n=20,OR(95%CI)=2.21(1.85,2.63),P<0.00001],the occurrence rate of two-way BBT[n=11,OR(95%CI)=2.65(2.02,3.48),P<0.00001].The GRADE scoring results show that the level of evidence is low and very low.Conclusion:Traditional Chinese medicine compound can increase the clinical pregnancy rate and clinical total effective rate of infertility with kidney deficiency syndrome,improve the scores of Chinese medical syndromes,increase its ovulation rate and the occurrence rate of BBT bidirectional type,and confirm the clinical efficacy of Chinese medicine compound from the perspective of evidence-based medicine.

Can TCM Treatment be Performed on the Basis of Differential Diagnosis of the Diseases Instead of the Syndromes?

Great advances have been achieved in the integration of western and traditional Chinese medicine (TCM).More and more TCM physicians in their practice accept the term 'differential diagnosis of the diseases' instead of the syndromes since western medicine has been introduced into the TCM circle.

Quantitative and Qualitative Investigation of Traditional Chinese Medicine Nursing Protocols for Type 2 Diabetes Mellitus

Objective:To analyze the implementation status of traditional Chinese medicine(TCM)nursing protocols for type 2 diabetes mellitus.Methods:Totally 420 hospitalized patients with type 2 diabetes mellitus were given TCM nursing protocols by syndrome differentiation.A quantitative and qualitative investigation was conducted to patients who received TCM nursing and nurses who performed TCM nursing techniques.Results:According to the self-evaluation outcomes of patients,TCM nursing protocols were effective to relieve polydipsia,polyuria,fatigue and other symptoms.Patients exhibited a high level of compliance with nursing techniques such as auricular point pressing,acupoint massage,Chinese herbal foot-bath and moxibustion.The interview showed that patients could benefit from the TCM nursing protocols,and nurses considered that application of TCM nursing protocols could enhance their awareness of TCM knowledge and practice skills.Conclusion:The application of TCM nursing protocols is effective to relieve clinical symptoms of type 2 diabetes mellitus.It can also improve the knowledge level and practice skills of nurses in TCM hospitals.

Long-term Effect of TCM Decoctions in Treatment of Nephrotic Syndrome

Fifty-seven cases of nephrotic syndrome were treated with TCM decoctions as accessory treatment for prednisone and cyclophosphamide, and the effects were observed in a follow-up period of 5-15 years. The long-term complete remission rate of 68.4% and recurrence rate of 26.3% in the treatment group were respectively higher and lower than those in the control group (P<0.01, and P<0.01). The results suggested that the TCM decoctions were very helpful in treating this condition.

Illustrative Consultation of Myelodysplastic Syndrome

Case History Ms Li, a staff member aged 18 years, was hospitalized on May 8, 1987. Case number: 42514. Chief complaint: The patient was hospitalized into the Department of Hematology of the Hospital due to general weakness over 10 months, which was exacerbated and accompanied by palpitation and short breath in recent 15 days. Once ten month ago when doing housework, the patient suddenly fell into unconsciousness, but came to in 15 minutes without any treatment. Since then, she had got general weakness accompanied by spontaneous perspiration and liability to cold. In recent 15 days, the patient suffered from exacerbated general weakness accompanied with palpitation worsened upon movement, sore-throat, pale complexion, lips and finger-nails, and anorexia. So she came to this hospital for treatment.

CLINICAL ANALYSIS ON THE TREATMENT OF HIV/AIDS BY TRADITIONAL CHINESE MEDICINE

From Jan.1991 to Dec.1995,we treatedwith TCM nearly one thousand confirmedHIV/AIDS patients in Muhimbili MedicalCenter,Tanzania.Of them,437 cases withcomplete data have been summarized

Prof. Zhou Xuewen's Experience in Treating Superior Mesenteric Artery Syndrome

Prof. Zhou Xuewen (周学文), a veteran TCM doctor,is an expert in treating miscellaneous internaldiseases. I have the honor to follow him and havebenefited from his teaching. The following is hisexperience in treating superior mesenteric arterysyndrome that I would like to introduce below.

敏感性皮肤的中医辨治初探

敏感性皮肤发生率较高,国内女性敏感性皮肤发生率在15.93%,男性为8.62%。本文分析了敏感性皮肤的中医病因病机及辨证论治,介绍了肺经风热、肝经湿热、脾虚湿蕴、肝郁血燥、阳虚水饮五型及相应治则、方药,中药湿敷、中药膏/油外用、中药提取物护肤品的应用及体针、放血治疗方案。认为本症可通过中医内服外治联合的方案,以取得促进皮肤屏障修复、降低神经血管高反应性、控制炎症反应、提高皮肤耐受性的效果。

预防刺参腐皮综合征复方中药的筛选及体内药效评价

为开发防治刺参腐皮综合征的复方中药,从14种中药中筛选出对灿烂弧菌(Vibrio splendidus)有明显抑制作用的单味中药,并通过正交实验确定最佳抗菌复方FF-Z(诃子﹕五倍子﹕穿心莲﹕川芎=15 g﹕2 g﹕10 g﹕5 g)。在饲料中分别添加10、20、30和40 g/kg的复方FF-Z作为试验组,不含复方FF-Z的饲料为对照组,并以含恩诺沙星粉20 g/kg的饲料为药物对照组,连续投喂刺参10d,继而用终浓度为10^(7) CFU/mL的灿烂弧菌进行浸浴攻毒,以观察预防保护效果。结果显示,灿烂弧菌对复方FF-Z极敏感,抑菌圈直径可达(23.10±0.62)mm,最小抑菌浓度(MIC)和最小杀菌浓度(MBC)值分别为7.81和15.63 mg/mL;与阴性对照组相比,复方FF-Z各剂量组刺参的SOD、ACP和AKP活性显著提高,且优于药物对照组。在灿烂弧菌感染后,复方FF-Z各剂量组处理的刺参发病时间比阳性对照组推迟2d,其中复方FF-Z 20 g/kg组、FF-Z 30 g/kg组和FF-Z 40 g/kg组刺参的20d发病率分别为22.08%、22.14%和14.58%,显著低于阳性对照组的84.45%。组织病理学观察结果表明,添加30 g/kg复方FF-Z的饲料能够有效减轻灿烂弧菌入侵引起的刺参组织炎症反应,从而起到保护作用。研究证明,复方FF-Z能够显著提高刺参的免疫和抗病力,对灿烂弧菌引起的腐皮综合征具有良好的预防保护效果,能延缓该病的发病进程并降低发病率。

基于溶藻弧菌感染的虾苗细菌性玻化症(BVS)及其防控中药筛选和药效学评价

为了筛选可用于防治虾苗细菌性玻化症(bacterial vitrified syndrome,BVS)的中药复方,本研究首先通过牛津杯法和二倍稀释法进行体外抑菌实验,从50种中药中筛选出对BVS致病菌溶藻弧菌(Vibrio alginolyticus)和副溶血弧菌(V.parahaemolyticus)具有良好抑菌效果的中药。然后,以不同浓度的溶藻弧菌浸浴感染虾苗,建立BVS病理模型;再通过体内药效学实验从死亡率、组织病理学和超微组织病理学角度比较不同中药复方对于患BVS虾苗的防治效果。体外抑菌实验结果显示,五味子(Schisandrae chinensis fructus)、马鞭草(Verbenae herba)、乌梅(Mume fructus)等中药对溶藻弧菌的抑菌圈直径可达12 mm以上;诃子(Chebulae fructus)、五味子、牡丹皮(Moutan cortex)等中药对副溶血弧菌的抑菌圈直径可达13mm以上。五倍子(Gallachinensis)、诃子、五味子、丁香(Caryophylliflos)对溶藻弧菌和副溶血弧菌的最小抑菌浓度(MIC)均≤12.5mg/mL,最小杀菌浓度(MBC)均≤50 mg/mL。结合香附(Cyperi rhizoma)、栀子(Gardeniae fructus)2味中药组成3种中药复方,处方1、处方2和处方3;以5×10^(4) CFU/mL的溶藻弧菌感染虾苗成功建立BVS病理模型,在此基础上采用药物治疗患病虾苗7d,各组死亡率由低至高依次为空白对照组、处方1组、20%氟苯尼考粉对照组、处方3组、处方2组和阳性对照组。处方1组虾苗死亡率显著低于阳性对照组(P<0.05);处方2组、处方3组和20%氟苯尼考对照组虾苗死亡率低于阳性对照组,但差异不显著(P>0.05)。由此可见,处方1可显著降低患病虾苗死亡率。组织病理学和超微组织病理学研究显示,相比于其他感染组,处方1组虾苗肝胰腺病变程度明显较轻,肠道结构较为完整;虾苗肝小管上皮细胞的细胞膜、细胞核正常,线粒体、内质网丰富且基本正常。表明口服处方1可对患病虾苗的肝胰腺和肠道组织起到良好的保护作用,并优于处方2、处方3和20%氟苯尼考粉。综上所述,处方1(诃子30 g、五味子20 g、香附20 g)对溶藻弧菌感染的虾苗保护和治疗效果良好。本研究结果可为研制防控虾苗BVS专用中药提供依据,助力对虾养殖绿色高质量发展。

中医药防治冠心病的蛋白质组学研究进展

冠心病是临床常见的心血管疾病,危险因素多,发病率高,病死率高,其症状反复发作,严重影响患者的身心健康。中医药可通过“双心治疗”缓解冠心病患者的症状及焦虑情绪。冠心病属中医“胸痹心痛”范围,其发病机制复杂,临床证型多,包括心脉瘀阻证、痰浊闭阻证、气滞心胸证、寒凝心脉证、痰瘀互结证、气阴两虚证、心肾阴虚证及心肾阳虚证。针对不同证型,治疗方剂众多,但作用机制尚不明确。蛋白质组学技术是一种识别蛋白质和研究蛋白质表征的技术,能够全面认识疾病的发生发展,可用于探究具有诊断价值的生物标志物、研究不同中医证候的蛋白质差异、推断中医药治疗冠心病的作用机制。

Whether Syndrome Differentiation Affects Treatment Result:Study Protocol of MaZiRenWan(麻子仁丸)for Functional Constipation in A Randomized Controlled Trial

Background: Syndrome is one of the most important concepts in Chinese medicine(CM) theory. However, it was not well accounted in most of randomized controlled trials(RCTs). Objective: To determine whether CM syndrome differentiation affects the treatment results, functional constipation(FC) was selected as a target disease, and MaZiRenWan(麻子仁丸, MZRW), a classic CM formula commonly used for constipation with excessive heat syndrome, was selected for study. Methods: It is an 18-week prospective double-blinded, doubledummy RCT, including 2-week run-in, 8-week treatment and 8-week post treatment follow-up. A total of 120 FC patients diagnosed as excessive heat syndrome will be recruited from the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine and the Baokang Affiliated Hospital of Tianjin University of Traditional Chinese Medicine. Patients will be randomly allocated into fixed MZRW(f_MZRW) granule group, modified MZRW(m_MZRW) granule group or bisacodyl group. For m_MZRW group, no more than two herbal granules can be added according to the syndrome differentiation for individual participants. The primary end point is the mean of complete spontaneous bowel movements(CSBMs) per week during the treatment period. Secondary end points include mean of CSBMs per week during follow-up, stool form, global symptom improvement, constipation and constipation-related symptoms assessment, CM syndrome change, and reported adverse events. Discussion: This trial is designed to evaluate the effectiveness of these three interventions for FC patients with the CM syndrome of excessive heat, and to determine the change of CM syndrome and the progress of disease during the treatment course. The results are important to explore whether syndrome differentiation is important for the therapeutic effect of a formula on a disease.

中药复方保健产品人体试验评价体系构建的要点探讨

中药复方保健产品种类众多,但缺乏人体试验指导原则与技术规范。现有的评价技术规范不能体现中医药的优势和特色。基于中药复方保健产品的特点与优势、人体试食试验实施的总结与思考,对中药复方保健产品人体试验的试验设计、伦理审查、受试人群、对照设置、样本量规定、功能及安全性等评价要点进行探讨,为建立中药复方保健产品人体评价体系提供参考。

从中医辨证分型探讨中药复方防治阿尔茨海默病

阿尔茨海默病(Alzheimer’s disease,AD)是一种不可逆的神经退行性疾病,其致病因素多、病理机制复杂。现临床用于治疗AD的西药多针对单一靶点,且副作用较大。中药复方具有多成分、多靶点、多途径、多系统、多环节的治疗特点。中医通过辨证分型采用不同中药复方防治AD是研发防治AD新药的一种有效途径。根据中医辨证分型可将中药治疗AD复方分为补肾填髓类、补血养心类、健脾益气类、疏肝解郁类、活血祛瘀类、化痰开窍类及清热解毒类。该文整理近年来治疗AD的相关中药复方,从临床研究、现代药理研究两方面系统阐述其防治AD的研究,为寻找AD防治药物的提供思路。

中药复方治疗肥胖症疗效的随机对照试验Meta分析

目的系统评价中药复方治疗肥胖症的有效性和安全性。方法计算机检索中国知网(CNKI)、维普中文期刊服务平台(VIP)、万方数据知识服务平台(WanFang Data)、中国生物医学文献服务平台(CBM)、PubMed、Cochrane、AMED、CINAHL、ClinicalTrials、Embase、Informit、ProQuest、SciFinder、Scopus、Web of Science等中英文数据库中收录的中药复方治疗肥胖症的相关文献(随机对照试验),文献发表时间为建库至2022年7月30日。采用Cochrane系统偏倚风险工具评估文献质量,借助RevMan5.4软件进行Meta分析。结果①最终纳入25篇文献,涉及2472例肥胖症患者,其中中药复方组1255例、对照组1217例。②与对照组相比,中药复方组能更好地降低肥胖症患者的体质量[MD=-3.05,95%CI(-4.64,-1.46)]和体质量指数[MD=-1.19,95%CI(-1.55,-0.82)],差异有统计学意义(P<0.05)。③进一步分析,与安慰剂比较,中药复方降低肥胖症患者体质量[MD=-3.22,95%CI(-5.78,-0.66)]及体质量指数[MD=-1.02,95%CI(-1.73,-0.31)]的作用更为显著;与生活方式干预比较,中药复方降低肥胖症患者体质量[MD=-3.91,95%CI(-5.49,-2.32)]及体质量指数[MD=-1.52,95%CI(-1.99,-1.05)]的作用更为显著;与西药比较,中药复方降低肥胖症患者体质量[MD=-2.89,95%CI(-6.47,0.69)]及体质量指数[MD=-1.18,95%CI(-1.68,-0.68)]的作用更为显著。以上差异均有统计学意义(P<0.05)。④亚组分析发现,与自拟方相比,经方对肥胖症具有更好的疗效[经方亚组体质量MD=-4.74,95%CI(-5.11,-4.36);自拟方亚组体质量MD=-2.19,95%CI(-4.63,0.25)];与辨病论治相比,辨证论治肥胖症疗效更佳[辨证论治亚组体质量MD=-4.99,95%CI(-7.13,-2.85);辨病论治亚组体质量MD=-1.21,95%CI(-4.12,1.69)]。以上差异均有统计学意义(P<0.05)。⑤纳入的25篇文献均未报道严重不良反应。结论中药复方是治疗肥胖症的有效方法,安全性良好,比较理想的应用模式为基于经方和辨证论治的处方用药。

全国名老中医何嘉琳膏方治疗围绝经期综合征经验举隅

[目的]总结全国名老中医何嘉琳教授运用膏方诊治围绝经期综合征的临床特色经验。[方法]分析二则临床典型医案,总结何教授应用膏方诊治围绝经期综合征的辨证思路与遣方特色。[结果]何教授认为,围绝经期综合征以脏腑阴阳失调、功能减退和气血虚弱为主要病机特点,临证主张调脏腑、理阴阳、益气血等对症治疗,同时注重心理疏导,强调身心同调。文中所附医案分别属于绝经前期肝肾阴虚型和绝经后期心肾不交型,何教授分别治以调补肝肾和交通心肾,兼顾调理脏腑阴阳气血,辨证论治,终得良效。[结论]何教授运用膏方治疗围绝经期综合征,从调脏腑、理阴阳、益气血入手,辨证细腻准确,方大效宏,临床效果显著,值得临床借鉴。

基于PPAR-γ/SFRP5信号通路探究三期辨证中药复方对骨质疏松大鼠破骨细胞增殖分化的作用机制

目的 基于过氧化物酶体增殖物激活受体-γ/分泌型卷曲相关蛋白5(PPAR-γ/SFRP5)信号通路探究三期辨证中药复方对骨质疏松大鼠破骨细胞增殖分化的影响。方法 制备骨质疏松大鼠模型,原代分离骨质疏松模型大鼠破骨细胞并培养。取细胞分为对照组(1~6周均用不含任何药物的培养基培养)、一期组(1~2周用含增液汤合益骨汤培养基培养,3~6周用不含任何药物的培养基培养)、二期组(1~2周培养同一期组,3~4周用含归脾汤合益骨汤的培养基培养,5~6周用不含任何药物的培养基培养)和三期组(1~4周培养同二期组,5~6周用含独活寄生汤合益骨汤培养基培养),另取细胞分为sh-PPAR-γ组(细胞中转染pSilencer-shPPAR-γ质粒)、sh-NTC组(细胞中转染pSilencer-non-target control质粒)、sh-SFRP5组(细胞中转染SFRP5-shRNA质粒)、sh-NC组(细胞中转染NC-shRNA质粒)、三期+sh-PPAR-γ组(细胞培养于含增液汤合益骨汤、归脾汤合益骨汤、独活寄生汤合益骨汤的培养基中,同时转染pSilencer-non-target control质粒)、三期+sh-SFRP5组(细胞培养同三期+sh-PPAR-γ组,同时转染SFRP5-shRNA质粒)、三期+sh-PPAR-γ+sh-SFRP5组(细胞培养同三期+sh-PPAR-γ组,同时转染pSilencer-shPPAR-γ质粒和SFRP5-shRNA质粒),TRAP染色检测各组破骨细胞数量,MTT法检测细胞增殖能力,流式细胞术检测细胞凋亡率,Western blot法检测细胞中PPAR-γ、SFRP5、果蝇无翅基因(Wnt)、β-连环蛋白(β-catenin)蛋白表达情况。结果 与对照组比较,一期组、二期组和三期组破骨细胞数量、细胞增殖能力(吸光度值)和细胞中PPAR-γ、SFRP5蛋白表达量均明显降低(P均<0.05),细胞凋亡率和细胞中Wnt、β-catenin蛋白表达量均明显增高(P均<0.05);三期组破骨细胞数量、细胞增殖能力(吸光度值)和细胞中PPAR-γ、SFRP5蛋白表达量均明显低于一期组、二期组(P均<0.05),细胞凋亡率和细胞中Wnt、β-catenin蛋白表达量均明显高于一期组、二期组(P均<0.05)。与对照组比较,sh-PPAR-γ组、sh-SFRP5组破骨细胞数量、细胞增殖能力(吸光度值)和细胞中PPAR-γ、SFRP5蛋白表达量均明显降低(P均<0.05),细胞凋亡率和细胞中Wnt、β-catenin蛋白表达量均明显增高(P均<0.05)。与三期组比较,三期+sh-PPAR-γ组,三期+sh-SFRP5组、三期+sh-PPAR-γ+sh-SFRP5组破骨细胞数量、细胞增殖能力(吸光度值)和细胞中PPAR-γ、SFRP5蛋白表达量均明显降低(P均<0.05),细胞凋亡率和细胞中Wnt、β-catenin蛋白表达量均明显增高(P均<0.05);与三期+sh-PPAR-γ组和三期+sh-SFRP5组比较,三期+sh-PPAR-γ+sh-SFRP5组破骨细胞数量、细胞增殖能力(吸光度值)和细胞中PPAR-γ、SFRP5蛋白表达量更低(P均<0.05),细胞凋亡率和细胞中Wnt、β-catenin蛋白表达量均更高(P均<0.05)。结论 三期辨证中药复方可抑制骨质疏松大鼠破骨细胞增殖分化,机制与抑制PPAR-γ/SFRP5信号通路调节Wnt/β-catenin信号通路有关。