ACUPUNCTURE TREATMENT ON 40 CASES OF IRRITABLE COLON SYNDROME ACCORDING TO DIFFERENTIATION OF SYMPTOMS AND SIGNS

Irritable intestinal tract syndrome was classified and treated with acupuncture according to differentiation of symptoms and signs.Of the 40 cases treated,28 were cured,11 improved,and 6 ineffective.The total effective rate was 85％.The syndrome was classified into fourtypes:weakness of the spleen and stomach,disharmony of the liver spleen,Yang deficiency ofthe spleen and kidney,and retention of dampness and heat.There was no statistically significant difference in therapeutic effects among the four types of syndromes.However,the curative effect in theacupuncture group was better than that in the medication group,and the difference was of statisticalsignificance.

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.

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

Based on the concept of ＂precision medicine＂, this paper is to probe into the thinking innovation thought anddevelopment direction of ＂dialectical theory＂ of TCM, and to compare the development prospects of ＂syndromedifferentiation＂ and ＂genetic constitution＂. It points out that the dialectical concept of ＂syndrome differentiation andtreatment＂ is combined with the concept of high and new technology of ＂precision medicine＂ to further clarify thescientific connotation of traditional Chinese medicine.

HHO optimized support vector machine classifier for traditional Chinese medicine syndrome differentiation of diabetic retinopathy

AIM:To develop a classifier for traditional Chinese medicine(TCM)syndrome differentiation of diabetic retinopathy(DR),using optimized machine learning algorithms,which can provide the basis for TCM objective and intelligent syndrome differentiation.METHODS:Collated data on real-world DR cases were collected.A variety of machine learning methods were used to construct TCM syndrome classification model,and the best performance was selected as the basic model.Genetic Algorithm(GA)was used for feature selection to obtain the optimal feature combination.Harris Hawk Optimization(HHO)was used for parameter optimization,and a classification model based on feature selection and parameter optimization was constructed.The performance of the model was compared with other optimization algorithms.The models were evaluated with accuracy,precision,recall,and F1 score as indicators.RESULTS:Data on 970 cases that met screening requirements were collected.Support Vector Machine(SVM)was the best basic classification model.The accuracy rate of the model was 82.05%,the precision rate was 82.34%,the recall rate was 81.81%,and the F1 value was 81.76%.After GA screening,the optimal feature combination contained 37 feature values,which was consistent with TCM clinical practice.The model based on optimal combination and SVM(GA_SVM)had an accuracy improvement of 1.92%compared to the basic classifier.SVM model based on HHO and GA optimization(HHO_GA_SVM)had the best performance and convergence speed compared with other optimization algorithms.Compared with the basic classification model,the accuracy was improved by 3.51%.CONCLUSION:HHO and GA optimization can improve the model performance of SVM in TCM syndrome differentiation of DR.It provides a new method and research idea for TCM intelligent assisted syndrome differentiation.

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.

Research Progress on Integrated Chinese and Western Medicine Treatment of Tourette Syndrome in Children

Tourette syndrome is a common neuropsychiatric disorder that affects the physical and mental health of children.Early detection,diagnosis,and treatment are crucial to prevent serious impacts on the affected children,their families,and society.In recent years,there has been an increasing trend towards using a combination of methods in the clinical treatment of children with Tourette syndrome.This approach has achieved remarkable results,leading to a reduction in the rate of Tourette syndrome symptoms in children.In recent years,a combination of clinical methods has been used to treat children with Tourette syndrome,resulting in significant improvement in control rates.This article reviews the etiology of infantile Tourette syndrome and the progress made in Chinese and Western medicine treatments,providing a reference for further treatment of the condition.

TCM Stage Differentiation Treatment of Diabetic Gangrene——An Observation on Microcirculatory Changes

Microcirculatory changes and therapeutic effects in 39 non-insulin dependent diabetes mellitus (NIDDM) cases were evaluated. Under the same basic treatment in both groups, the treatment group (21 cases) was treated with TCM drugs according to its stages and compared with the control group (18 cases, treated with 654-2). The results showed that the microcirculatory cumulative scores were significantly decreased in both groups (P<0.05), but the decrease in the treatment group was more marked (P<0.05). In the treatment group, 15 cases were cured, 3 markedly effective, 2 effective and 1 ineffective; while in the control group, 13 cases were cured, 1 markedly effective and 4 ineffective. Statistically, there is no significant difference between the 2 groups (P>0.05) in therapeutic effects.

Clinical Observation on Quality of Life in Coronary Artery Bypass Grafting Patients Treated According to Syndrome Differentiation of TCM

Objective: To evaluate the clinical effect and quality of life (QOL) in coronary artery bypass grafting (CABG) patients treated according to syndrome differentiation of TCM. Methods: Eighty-two CABG patients were allocated in the control group (n = 39) treated with conventional method of western medicine, and the TCM-treated group (n

HOW TO MASTER THE DIFFERENTIATION OF SYNDROMES AND THE SELECTION OF ACUPOINTS QUICKLY

Differentiation of syndromes can be done by three steps:First to differentiate thenature of disease,second to differentiate the location of disease,third to analyse comprehensively thenature and location of disease.Depend on complete differentiation of syndromes,the acupoints are selected.Three cases are analysed to explain how to dominate preceding contents.

Comparing the effectiveness of pattern differentiation treatment and fixed formula treatment for perimenopausal syndrome with Chinese herbal medicine:A study protocol

Objective:To further understand and compare the effectiveness of pattern differentiation treatment and fixed prescription treatment in perimenopausal syndrome.Methods:The study will be conducted in the Hong Kong Federation of Trade Unions Workers'Medical Clinics,Hong Kong Baptist University Chinese Medicine Clinic cum Training and Research Centre(Hong Kong,China).One hundred Chinese women,aged 45-55 years,will be recruited.The participants will be randomized into 2 groups.The intervention group will be administered medication,based on pattern differentiation,by qualified traditional Chinese medicine(TCM)practitioners.After each evaluation,TCM practitioners will evaluate and revise the prescription,based on the participants'patterns.The control group will be given the standard formula,i.e.,the Erxian decoction,which contains 6 herbs.The treatment period and the follow-up period will be 8 weeks each.The primary assessment outcome measure will be the Kupperman Index,and the secondary outcome measure will be the Menopause-specific Quality of Life Questionnaire score.Conclusion:Pattern-differentiated treatment is the basic principle of TCM to understand and treat diseases.The study will show the pattern-differentiated treatment is effectiveness than the fixed prescription.

Study on the Correlation between Syndrome Differentiation of Malignant Pleural Effusion Treated by External Treatment of Traditional Chinese Medicine and Immunohistochemistry of Biopsy Tissue Based on Medical Video-assisted Thoracoscope

Objective:Guided by the theory of syndrome differentiation of yin and yang in traditional Chinese medicine surgery,through visual observation of internal medicine thoracoscope,comprehensive observation of pleural cavity and immunohistochemistry of biopsy tissue,to classify malignant pleural effusion according to syndrome differentiation,and to explore the scientific nature of its theory.Methods:From March 1,2014 to February 28,2015,40 cases of malignant pleural effusion were treated in Beijing Chaoyang Hospital affiliated to Capital Medical University.According to the proposed TCM diagnostic criteria for yin and yang syndrome differentiation,and collect age,gender,course of disease,clinical symptoms,tumor primary focus,histomorphological manifestations and immunohistochemical results and other related information,and carry out statistical data processing.Results:The positive syndrome was mainly metastatic lung adenocarcinoma,which accounted for the majority of all MPE cases,up to 75%.The immunohistochemical results of biopsy tissues were mainly CEA and TTF-1 positive;While pleural effusion caused by pleural mesothelioma was the main type of yin syndrome,and the results of immunohistochemistry combined with biopsy were mainly positive for D2-40,Calretinin,WT-1 and CK5/6.Conclusion:TCM syndrome differentiation of MPE based on internal thoracoscopy combined with biopsy immunohistochemical results has sufficient theoretical basis and certain scientific nature,and further clinical research is needed to verify its effectiveness and practicability in the future.

Treatment of nutcracker syndrome with spermatic vein ligation and iliac vein anastomosis:Case report of three cases

Three patients with nutcracker syndrome(NCS) were enrolled in the study.Their clinical symptoms mainly included proteinuria and serious varicocele.Color Doppler ultrasound and computed tomography showed that the patients had constricted abdominal aortas,reduced superior mesenteric artery angles,and thinned left renal veins.Patients then underwent left spermatic vein ligation and iliac vein anastomosis.They were checked tliree months after their operation,and results showed that their sperms were improved and their proteinuria disappeared. The color Doppler ultrasound showed new cycle pathways.NCS clinical manifestations are complicated,and need combination diagnosis of symptoms and auxiliary examination to detennine surgical indications.Ligation of spermatic vein and vein anastomosis can be used to treat NCS.

Traditional Chinese medicine for prevention and treatment of hepatocarcinoma: From bench to bedside

Traditional Chinese medicine(TCM) has played a positive role in the management of hepatocarcinoma. Hepatocarcinoma patients may present Qi-stagnation, damp-heat, blood stasis, Qi-deficiency, Yin-deficiency and other TCM syndromes(Zheng). Modern treatments such as surgery, transarterial chemoembolization(TACE) and high intensity focus ultrasound treatment would influence the manifestation of TCM syndromes. Herbs with traditional efficacy of tonifying Qi, blood and Yin, soothing liver-Qi stagnation, clearing heat and detoxifying and dissolving stasis, have been demonstrated to be potent to prevent hepatocarcinogenesis. TCM has been widely used in all aspects of integrative therapy in hepatocarcinoma, including surgical resection, liver transplantation, TACE, local ablative therapies and even as monotherapy for middle-advanced stage hepatocarcinoma. Clinical practices have confirmed that TCM is effective to alleviate clinical symptoms, improve quality of life and immune function, prevent recurrence and metastasis, delay tumor progression, and prolong survival time in hepatocarcinoma patients. The effective mechanism of TCM against hepatocarcinoma is related to inducing apoptosis, autophagy, anoikis and cell senescence, arresting cell cycle, regulating immune function, inhibiting metastasis and angiogenesis, reversing drug resistance and enhancing effects of chemotherapy. Along with the progress of research in this field, TCM will contribute more to the prevention and treatment of hepatocarcinoma.

Diagnosis and treatment of acute pulmonary inflammation in critically ill patients: The role of inflammatory biomarkers

Pneumonia and acute respiratory distress syndrome are common and important causes of respiratory failure in the intensive care unit with a significant impact on morbidity, mortality and health care utilization despite early antimicrobial therapy and lung protective mechanical ventilation. Both clinical entities are characterized by acute pulmonary inflammation in response to direct or indirect lung injury. Adjunct anti-inflammatory treatment with corticosteroids is increasingly used, although the evidence for benefit is limited. The treatment decisions are based on radiographic, clinical and physiological variables without regards to inflammatory state. Current evidence suggests a role of biomarkers for the assessment of severity, and distinguishing sub-phenotypes (hyperinflammatory versus hypo-inflammatory) with important prognostic and therapeutic implications. Although many inflammatory biomarkers have been studied the most common and of interest are C-reactive protein, procalcitonin, and pro-inflammatory cytokines including interleukin 6. While extensively studied as prognostic tools (prognostic enrichment), limited data are available for the role of biomarkers in determining appropriate initiation, timing and dosing of adjunct anti-inflammatory treatment (predictive enrichment)

A handy review of carpal tunnel syndrome:From anatomy to diagnosis and treatment

Carpal tunnel syndrome(CTS) is the most commonly diagnosed disabling condition of the upper extremities. It is the most commonly known and prevalent type of peripheral entrapment neuropathy that accounts for about 90% of all entrapment neuropathies. This review aims to provide an outline of CTS by considering anat-omy, pathophysiology, clinical manifestation, diagnostic modalities and management of this common condition, with an emphasis on the diagnostic imaging evaluation.

Self reported adherence to antiretroviral treatment and correlates in Hunan province,the Peoples Republic of China

Aims:This study aimed to describe the adherence level to antiretroviral therapy and its associated factors among people living with HIV in Hunan province,China.Methods:Across-sectional survey study was done at two major HIV treatment sites within Hunan province in China from July 2011 to Oct 2012 through face-to-face interviews.Adherence measures were captured using a 30-day visual analog scale(VAS).Results:A total of 418 participants consented and completed the questionnaires with the mean age being 38 years old.Based on VAS,28%of the participants had lower than 90%ART adherence level.The main reasons for missing drugs were;forgetting,being away from home,being busy and feeling worse after taking drugs.Logistic regression results showed that drug use(B=0.68,OR=2.11),time on ART(B=0.31,OR=0.72)and side effects(B=0.64,OR=1.82)were significantly associated with adherence to ART.Conclusion:Patients on ARVs in Hunan province are faced with adherence challenges notably drug abuse,drug regime scheduling challenges at the initial stages of therapy and drug side effects.It is therefore necessary to institute specific adherence interventions that target those who abuse drugs,ART naïve patients,and those experiencing side effects in order to achieve optimal ART adherence.

Adherence to pharmacological and non-pharmacological treatment of frail hypertensive patients

Objective To investigate the relationship between frailty syndrome （FS） and adherence to pharmacological and non-pharmacological treatment for hypertension. Methods The study included 100 patients diagnosed with hypertension and treated with one or more hypotensive drugs. Results Frail patients obtained low scores （4.1 ± 2.0） for adherence to pharmaceutical treatment of hypertension, while non-frail patients obtained moderate scores （6.1 ± 2.1）. Non-frail patients had higher scores in two out of four domains of the Health Behavior Inventory （HBI）： positive mental attitudes （3.6 ± 0.4 vs. 3.2 ± 0.5; P = 0.006） and health practices （3.6 ± 0.5 vs. 3.2 ± 0.5; P 〈 0.03）; as well as higher global scores （HBI raw score）： 83.3 ±10.6 vs. 77.3 ± 9.5; P 〈 0.03. Multiple regression analysis showed that frailty syndrome （FS） was a statistically significant independent determinant of worse adherence to pharmacological treatment （β= -0.27; P 〈 0.001） and health behaviors （β = -0.10; P = 0.036）. Education was a statistically significant independent determinant of better adherence to pharmacological treatment （β = 0.82; P = 0.012）, while net income positively affected health behaviors as measured by the HBI （β = 0.39; P = 0.046）. Conclusions FS is a significant independent factor contributing to worse adherence to pharmacological and non-pharmacological treatment of hypertension. Better education significantly improves patients＇ adherence to the prescribed pharmacological treatment, while a good financial standing evidenced by high net income is a determinant of better adherence to health-related behaviors recommended in hypertension treatment.

The Distribution Pattern of Traditional Chinese Medicine Syndromes in Patients with Hyperlipidemia

Objective: Hyperlipidemia is a representative nutritional metabolic disease in clinic, which is easy to induce atherosclerotic cardiovascular and cerebrovascular diseases, with complex classification. Traditional Chinese Medicine (TCM) syndrome aims to reflect the characteristics of diseases and is the basic principle of TCM treatment of diseases. This study aimed to summarize the distribution pattern of TCM syndromes in patients with hyperlipidemia. Methods: The frequency, characteristics and distribution of all TCM syndromes of 1012 patients with hyperlipidemia were analyzed. Results: The main disease types determined by frequency of 1012 patients included hypertriglyceridemia combined with hypo high-density lipoprotein cholesterolemia (19.76%), hypo high-density lipoprotein cholesterolemia (18.58%), hypercholesterolemia (16.50%), mixed hyperlipidemia (16.40%), and hypertriglyceridemia (15.12%). The distribution of TCM syndromes, in order of frequency, was as follows: Qi-deficiency and blood stasis syndrome (23.52%), liver depression and spleen deficiency (9.88%), syndrome of qi stagnation and blood stasis (9.29%), phlegm stasis syndrome (7.41%), and syndrome of yang deficiency of spleen and kidney (6.92%). Conclusion: Qi-deficiency and blood stasis syndrome and liver depression and spleen deficiency are the most common TCM syndromes in patients with hyperlipidemia.

Therapeutic alternatives for the treatment of type 1 hepatorenal syndrome: A Delphi technique-based consensus

AIM To propose several alternatives treatment of type 1 hepatorenal syndrome(HRS-1) what is the most severe expression of circulatory dysfunction on patients with portal hypertension.METHODS A group of eleven gastroenterologists and nephrologists performed a structured analysis of available literature.Each expert was designated to review and answer a question.They generated draft statements for evaluation by all the experts.Additional input was obtained from medical community.In order to reach consensus,a modified three-round Delphi technique method was used.According to United States Preventive Services Task Force criteria,the quality of the evidence and level of recommendation supporting each statement was graded.RESULTS Nine questions were formulated.The available evidence was evaluated considering its quality,number of patients included in the studies and the consistency of its results.The generated questions were answered by the expert panel with a high level of agreement.Thus,a therapeutic algorithm was generated.The role of terlipressin and norepinephrine was confirmed as the pharmacologic treatment of choice.On the other hand the use of the combination of octreotide,midodrine and albumin without vasoconstrictors was discouraged.The role of several other options was also evaluated and the available evidence was explored and discussed.Liver transplantation is considered the definitive treatment for HRS-1.The present consensus is an important effort that intends to organize the available strategies based on the available evidence in the literature,the quality of the evidence and the benefits,adverse effects and availability of the therapeutic tools described.CONCLUSION Based on the available evidence the expert panel was able to discriminate the most appropriate therapeutic alternatives for the treatment of HRS-1.

Treatment of oral ulcer based on TCM syndrome differentiation

Oral ulcer is a kind of ulcerative injury that occurs in the oral mucosa and is very common in clinic.In severe case,it can affect the quality of life of the patients.Western medicine treatment of oral ulcer is often prone to relapse,while the effect of traditional Chinese medicine treatment is remarkable.