Characteristics and demographic factors of traditional Chinese medicine constitution types among elderly individuals in China:A national multistage cluster random study Author links open overlay panel

Objective To reveal the distribution characteristics and demographic factors of traditional Chinese medicine(TCM)constitution among elderly individuals in China.Methods Elderly individuals from seven regions in China were selected as samples in this study using a multistage cluster random sampling method.The basic information questionnaire and Constitution in Chinese Medicine Questionnaire(Elderly Edition)were used.Descriptive statistical analysis,chi-squared tests,and binary logistic regression analysis were used.Results The single balanced constitution(BC)accounted for 23.9%.The results of the major TCM constitution types showed that BC(43.2%)accounted for the largest proportion and unbalanced constitutions ranged from 0.9%to 15.7%.East China region(odds ratio[OR]=2.097;95%confidence interval[CI],1.912 to 2.301),married status(OR=1.341;95%CI,1.235 to 1.457),and managers(OR=1.254;95%CI,1.044 to 1.505)were significantly associated with BC.Age>70 years was associated with qi-deficiency constitution and blood stasis constitution(BSC).Female sex was significantly associated with yang-deficiency constitution(OR=1.646;95%CI,1.52 to 1.782).Southwest region was significantly associated with phlegm-dampness constitution(OR=1.809;95%CI,1.569 to 2.086).North China region was significantly associated with inherited special constitution(OR=2.521;95%CI,1.569 to 4.05).South China region(OR=2.741;95%CI,1.997 to 1.3.763),Central China region(OR=8.889;95%CI,6.676 to 11.835),senior middle school education(OR=2.442;95%CI,1.932 to 3.088),and managers(OR=1.804;95%CI,1.21 to 2.69)were significantly associated with BSC.Conclusions This study defined the distribution characteristics and demographic factors of TCM constitution in the elderly population.Adjusting and improving unbalanced constitutions,which are correlated with diseases,can help promote healthy aging through the scientific management of these demographic factors.

Advances in TCM Research of Insulin Resistance

Insulin resistance (IR) refers to subnormal response to a certain amount of insulin and is the most characteristic phenomenon in non-insulin dependent diabetes mellitus (NIDDM). It is also an element of the pathogenic mechanism shared with obesity, systemic hypertension, abnormal lipid metabolism and atherosclerosis. In recent years, studies on its treatment with traditional Chinese medicine (TCM) have gradually been carried out and the following is a report of them.Mechanisms of Diabetic IR in TCM TermsAction of insulin antagonizing hormones in peripheral tissues is one of the causes of diabetic IR. Cyclic nucleosides cAMP and cGMP, important intracellular messengers, are considered to be the second messenger of insulin, and cAMP is related to the amount of insulin receptors. Early in 1980s, some authors investigated the relationship among the symptoms of diabetes and such hormones and cAMP/cGMP ratio. Although they did not give due attention to IR, their studies provided evidences for differentiation of symptoms and signs in IR typing.

A TCM Theoretical Study on the Etiology and Pathogenesis of Metabolic Syndrome

Metabolic syndrome is a morbid condition that is related to many kinds of dysbolism, and is a critical factor for cardiovascular disease, which involves abnormal glucose tolerance, abnormal blood lipid, hypertension, obesity, hyperuricemia, hypercoagulability of blood, hypoplasminogenemia and microalbuminous urine, and it may finally induce angina pectoris, myocardiac infarction, sudden death, cerebral ischemia, cerebral apoplexy and intermittent claudication. As a syndrome not recorded in the ancient Chinese medical literatures, it is now threatening the human health in modern society. Exploration of the TCM etiology and pathogenesis of the syndrome may help us to have a better understanding, and is of active significance for prevention and treatment of the disease.

PROF. KONG LINGXU'S EXPERIENCE IN TCM TREATMENT OF INSOMNIA

In over 30 years of clinical practice, Prof.Kong Lingxu has adopted a great multitude offormulae for treatment of insomnia, and curedmany severe and lingering cases with hisunique experience in the use of specific drugson the basis of syndrome-and disease-differentiations. The following are someexamples.

Applying TCM Constitution Theory to Infertility via Omics

Polycystic ovary syndrome(PCOS)has become a major international public health concern,affecting 5%–10%of women of reproductive age around the world[1].The prevalence of PCOS in China has increased significantly over the past ten years[2],which is partially attributed to rapid changes in lifestyle,including diet[3].Lifestyle modification has led to widespread obesity in China.

Scientific connotation of “treating different diseases with the same method” from the perspective of metabolic-immune dysregulation in inflammation-mediated carcinogenesis of digestive organs

Inflammation-mediated carcinogenesis develops in the context of chronic inflammation and is a significant cause of cancer within the digestive system.In the chronic inflammation microenvironment,the metabolic activity of tissue cells undergoes extensive changes,which interfere with the normal function of immune cells.Dysregulation of cell metabolism and immune function has been identified as a key factor contributing to inflammation-mediated carcinogenesis within the major digestive organs,such as the stomach,liver,and colorectum.This metabolic-immune imbalance also corresponds to traditional Chinese medicine(TCM)theories of“yin-yang disharmony”and“disharmony between Ying-nutrients and Wei-defense.”The metabolic-immune imbalance has also been regarded as the key factor supporting“treatment of different diseases with the same method”,in which the same approach is adopted in the treatment of different conditions.In the TCM treatment process,it is necessary to first identify TCM patterns and then apply the corresponding TCM to correct the dysregulated metabolic and immune function,thereby blocking the progression from inflammation to malignancy.Our study findings deepen the TCM understanding of metabolic-immune dysregulation and the relationship between metabolic-immune dysregulation,pattern identification,and treatment method.They also provide new insights for the treatment of inflammation-mediated carcinogenesis in major digestive organs and help us further explore the scientific connotation of the TCM strategy of“treating different diseases with the same method”.

A Multilayer Network Constructed for Herb and Prescription Efficacy Analysis

Chinese Medicine(CM)has been widely used as an important avenue for disease prevention and treatment in China especially in the form of CM prescriptions combining sets of herbs to address patients’symptoms and syndromes.However,the selection and compatibility of herbs are complex and abstract due to intrinsic relationships between herbal properties and their overall functions.Network analysis is applied to demonstrate the complex relationships between individual herbal efficacy and the overall function of CM prescriptions.To illustrate their connections and correlations,prescription function(PF),prescription herb(PH),and herbal efficacy(HE)intranetworks are proposed based on CM theory to identify relationships between herbs and prescriptions.These three networks are then connected by PF-PH and PH-HE interlayer networks adopting herb dosage to form a multidimensional heterogeneous network,a Prescription-Herb-Function Network(PHFN).The network is applied to 112 classic prescriptions from Treatise on Exogenous Febrile and Miscellaneous Diseases to illustrate the application of PHFN.The PHFN is constructed including 146 functions in PF intra network,89 herbs in the PH intra network,and 163 herbal efficacies in the HE intra network.The results show that herb pairs with synergistic actions have stronger relevance,such as licorice-cassia twig,licorice-Chinese date,fresh ginger-Chinese date,etc.The integration of dosage to the network helps to indicate the main herbs for cluster analysis and automatic formulation.PHFN also reveals the internal relationships between the functions of prescriptions and composed herbal efficacies.

Efficacy and Safety of Acupuncture in the Management of Cancer

Acupuncture, as a complementary therapy, has been used to manage the cancer associated symptoms of cancer patients. To identify the efficacy and safety of acupuncture in the management of cancer, this review critically analyses the relevant publications including both experimental and clinical studies. The majority of studies suggest that acupuncture effectively relieves some cancer related symptoms such as cancer pain, and some adverse effects caused by the cancer conventional treatments such as nausea, vomiting, neutropenia and xerostomia.

Treatment of Chronic Bronchitis with Modified Ma Xing Shi Gan Tang and Er Chen Tang

Chronic bronchitis is a disease commonly seen in theclinic. The authors have treated 78 cases of the disease with modified Ma Xing Shi Gan Tang (麻杏石甘汤Decoction of Ephedra, Armeniacae Amarum,Glycyrrhizae and Gypsum Fibrosum) plus Er ChenTang (二陈汤Two Old Drugs Decoction). The results were satisfactory and reported as follows.

Application of Thermal Science to Tongue Inspection in Traditional Chinese Medicine

The study on Traditional Chinese Medicine (TCM)by the technology and method of thermal science is a new cut in point in interdisciplinary science, and its purpose is to study the tongue inspection in TCM from the view of the bio heat transfer theory. In this paper human tongues were studied with the infrared thermal imaging technology. And the characteristic relationship between temperature distribution and age, tongue color as well as infrared thermal tongue image concerning the characteristic of viscera was analyzed by the experimental data,which confirms that the change in temperature distribution in different positions of the tongue is related to the diseases of different internal organs of the body. From a series of invasive experiments in animals, the blood perfusion rate was measured with the equipment of CBI 8000 Doppler Blood Flow Meter and MP 100 Physiologic Research System for the first time and the characteristic relationship curve between the temperature on the surface of the tongue and the blood perfusion rate was obtained. From the experiments the temperature on the surface of the tongue reflects objectively the tongue color which is influenced by the blood perfusion rate. This will help to develop some new cognition in the theory of TCM.

Research on Herb Pairs of Classical Formulae of ZHANG ZhongJing Using Big Data Technology

Objective To analyze various herbal combinations in Treatise on Exogenous Febrile Diseases(Shang Han Lun,《伤寒论》)and Synopsis of Prescriptions of the Golden Chamber(Jin Gui Yao Lve,《金匮要略》),seeking to identify fundamental rules dictating the selection of herbal combinations through probability models and big data technology.Methods A total of 252 formulae were collected from Treatise on Exogenous Febrile Diseases(Shang Han Lun,《伤寒论》)and Synopsis of Prescriptions of the Golden Chamber(Jin Gui Yao Lve,《金匮要略》)by ZHANG Zhong-Jing.Formulae were then preprocessed with all herb names standardized.The concepts of candidate herb pair and candidate herb pair probability were proposed to analyze the rules of combinations in classical formulae based on probability statistics.MapReduce parallel computing framework of distributed big data technology was adopted to analyze large data samples combined with inverted index algorithm.Results The results showed that the core herbs were Glycyrrhizae Radix Rhizoma(Gan Cao,甘草),Cinnamomi Ramulus(Gui Zhi,桂枝),Zingiberis Rhizoma Recens(Sheng Jiang,生姜),Jujubae Fructus(Da Zao,大枣),Paeoniae Radix Alba(Bai Shao,白芍),etc.43 high-frequency pairs co-occurring 10 times or above were extracted,and 35 of these combinations were recognized as traditional herb pairs,such as Cinnamomi Ramulus(Gui Zhi,桂枝)-Glycyrrhizae Radix Rhizoma(Gan Cao,甘草),Zingiberis Rhizoma Recens(Sheng Jiang,生姜)-Jujubae Fructus(Da Zao,大枣),and Cinnamomi Ramulus(Gui Zhi,桂枝)-Ginseng Radix Et Rhizoma(Ren Shen,人参).The other 8 pairs of combinations,such as Paeoniae Radix Alba(Bai Shao,白芍)-Zingiberis Rhizoma Recens(Sheng Jiang,生姜),Paeoniae Radix Alba(Bai Shao,白芍)-Jujubae Fructus(Da Zao,大枣),and Zingiberis Rhizoma Recens(Sheng Jiang,生姜)-Ginseng Radix Et Rhizoma(Ren Shen,人参),were not defined traditionally,but in connection with commonly used herbs.Classical formulae took the core herbs as principles,focusing on tonifying deficiency,strengthening the spleen and the stomach,strengthening the healthy Qi,and eliminating pathogenic factors.The compatibility pattern of properties involved was mainly acrid and sweet,which reflected the compatibility laws of benefiting Qi and tonifying Yang,replenishing Qi and nourishing blood,etc.Conclusions The research of classical formulae provides common understanding of some basic rules that have been adopted to tackle common illnesses/diseases using herbal medicine.The results help to reinforce theoretical understanding and development of traditional Chinese medicine(TCM),and revealing the hidden rules of combination in TCM data.Analyzing wider data samples of various herbal combinations through computation and big data technology can further optimize the use of TCM.

Hepatoprotective Activity of Yigan Mingmu Oral Liquid against Isoniazid/Rifampicin-Induced Liver Injuries in Rats

Background: To explore the hepatoprotective effect of Yigan mingmu oral liquid (YGMM) on isoniazid-rifampicin induced liver injury in rats. Methods: Total 38 SD rats were randomly divided into 6 groups including control group, model group, silymarin positive control group, and three YGMM treatment groups. Model group was administered intragastrically with INH (100 mg/kg) and RIF (100 mg/kg) for 14 days. Silymarin group and YGMM treatment groups were administered intragastrically with silymarin (100 mg/kg) and different doses of YGMM (1, 2.5, 5 mg/kg) 2 hours before INH and RIF administration from day 4 to day 14.?Results: Rats were sacrificed 16 hours after the last day treatment to determine the activities of serum alanine transaminase (ALT), aspartate transaminase (AST) and alkaline phosphatase (ALP), as well as total bilirubin (TB) content. Oxidative stress was evaluated by measuring total superoxide dismutase (T-SOD) and malondialdehyde (MDA) levels. Histopathological changes in liver tissues were observed under an optical microscope by using hematoxylin and eosin staining. The mice?in model groups showed significantly (p < 0.05) increased levels in AST, ALT, ALP, TB and MDA compared to their control groups;and showed significantly (p < 0.05) decreased level in T-SOD. These changes were significantly (p < 0.05) reversed by the YGMM treatments in a dose-dependent manner. Hepatic pathological changes were attenuated or even reversed by silymarin or YGMM treatments. Conclusions: YGMM has a good hepatoprotective activity on isoniazid-rifampicin induced liver injuries in rats.

Progress in diagnosis and treatment of small cell lung cancer with integrated traditional Chinese and Western medicine

Lung cancer is one of the most common major diseases that seriously threaten human health,lung cancer includes small cell lung cancer(SCLC)and non-small cell lung cancer(NSCLC).Although patients with SCLC account for about 20%of the total number of patients with lung cancer,the mortality rate is much higher than that of patients with NSCLC.Integrated traditional Chinese and Western medicine has obvious advantages in the treatment of patients with SCLC.According to the relevant literature reports on the treatment of SCLC in recent years,this article will summarize the research progress of integrated traditional Chinese and western medicine in the treatmentof SCLC from the aspects of traditional Chinese medicine(TCM)combined with surgery,chemotherapy,radiotherapy,and molecular targeted therapy.

CLINICAL AND EXPERIMENTAL STUDIES OF CHRONIC GASTRITIS PATIENTS WITH QI-DEFIClENCY OF SPLEEN

We have studied the syndrome characteris-tics of chronic gastritis with Oi-deficiency ofSpleen through observations on the effects ofdrugs that invigorate the Spleen and replenish thevital energy 健脾益气药 and on 4 indicators.The preliminary results are as follows.CLINICAL INVESTIGATIONClinical DataIn this series,the 41 patients were confirmedby gastroscopy and pathology to be chronicgastritis,some of them complicated by ulcers ofthe stomach or duodenal bulb.26 cases weremale and 15 cases female;the age ranged

CLINICAL AND EXPERIMENTAL STUDIES ON THE TREATMENT OF NUMBNESS AND PAIN IN THE LIMBS WITH RAMULUS CINNAMOMI

Most numbness and pain in the limbs iscaused by invasion of pathogenic wind,cold anddampness into the deficient body,blocking themeridians of the limbs with stagnation of Qi orblood,and diffusion of impeded body fluids.Ramulus Cinnamomi has the property of warm-

Application of the Yang-Warming Method for Treatment of Diabetes

Warming yang is one of the most important therapeutic methods for treating diseases. In Peaceful Holy Benevolent Prescriptions (太平圣惠方 a collection of more than ten thousand formulas) written by Dr. Wang Huaiyin (王怀隐) et al in the Song Dynasty in 992 AD, more than one hundred formulas for treating diabetes are all complied with the principles of supplementing qi and nourishing yin. Dr. Liu Hejian (刘河间) in the period of Jin and Yuan Dynasty advocated that it should be treated with the principles of clearing away pathogenic heat and fire, and supplementing qi and nourishing yin. Dr. Huang Kunzai (黄坤载) in the Qing Dynasty held that diabetes should be treated by supplementing qi and nourishing yin.

STUDIES ON THE LUMINESCENCE OF CHANNELS IN RATS AND ITS LAW OF CHANGES WITH“SYNDROMES”AND TREATMENT OF ACUPUNCTURE AND MOXIBUSTION

We previously reported the discovery of 14 channels in the human body,which possessed thebiophysical property of high emission of light.In this study we found the same property on theRen and Du channels in healthy rats.Additionally,we discovered that the luminance of the relat-ed channels in rat models with different“syndromes”varied greatly.For instance,a markedlylow luminance appeared on the Du channel in animals with experimental syndrome of Yang defi-ciency induced by hydrocortisone;while in animals with experimental syndrome of blood deft-ciency caused by bleeding,an apparently low luminance occurred on the Ren channel.The inten-sity of the emitted light on Du and Ren channels increased after acupuncture treatment,but notsignificantly.This phenomenon conforms to the theory in traditional Chinese medicine that theDu channel is the“sea of Yang channels”,while the Ren channel is the“sea of Yin channels”.

Meta-analysis on Efficacy of Yiqi Huoxue Chinese Drugs in the Treatment of Coronary Heart Disease after Coronary Revascularization

[Objectives] To make a systematic evaluation on the therapeutic efficacy and safety of Yiqi Huoxue traditional Chinese drugs combined with western medicine in treatment of coronary heart disease( CHD) after coronary revascularization. [Methods] The literatures were retrieved from China Knowledge Infrastructure( CNKI),Chinese science and technology journal full-text database( VIP database,VIP),Wanfang Data,the Chinese biomedical Database,Pub Med,Embase,and the Cochrane Library. The retrieval time was set to the creation of the database to January 2017. The randomized controlled trial( RCT) was conducted on the comparison between Yiqi Huoxue Chinese drugs combined with western medicine and the western medicine alone in the treatment of CHD after coronary revascularization. The literature information was extracted and the methodological quality of the included literature was evaluated according to the bias risk assessment tool developed by the Cochrane Collaboration. Meta-analysis was performed with the aid of Rev Man 5. 3 software. Coronary artery restenosis rate,angina pectoris treatment efficiency,left ventricular ejection fraction( LVEF),left ventricular end-diastolic volume( LVEDV),B-type natriuretic peptide( BNP),6-minute walk test( 6 MWT),and adverse reactions were analyzed. [Results] A total of 29 articles were included,a total of2 518 patients,the literature quality was low. Meta-analysis results showed that compared with the treatment by western medicine alone,Yiqi Huoxue Chinese drugs combined with western medicine could further reduce coronary restenosis rate[RR = 0. 45,95% CI( 0. 34,0. 60),P <0. 000 01],improve the angina pectoris treatment efficiency[RR = 1. 13,95% CI( 1. 05,1. 21),P = 0. 000 5],raise LVEF[WMD = 4. 25,95% CI( 3. 46,5. 04),P < 0. 000 01],reduce LVEDV[WMD =-10. 41,95% CI(-17. 88,-2. 95),P = 0. 006],decrease the plasma BNP level[WMD =-32. 32,95% CI(-44. 92,-19. 72),P < 0. 000 01],and increase 6 MWT distance(WMD = 62. 25,95% CI( 21. 71,102. 78),P = 0. 003)[Conclusions]Yiqi Huoxue Chinese drugs combined with western medicine can alleviate the symptoms of angina pectoris,reduce the rate of coronary restenosis,improve heart function and improve exercise capacity,thereby improving clinical efficacy in patients with CHD after coronary revascularization.

Revision and validation of the“Constitution in Chinese Medicine Questionnaire(Elderly Edition)”based on the Delphi process

Objective:This study aimed to revise the Constitution in Chinese Medicine Questionnaire(Elderly Edition)(CCMQ-EE),as well as evaluate its reliability and validity.The objective was to provide a more accurate Chinese medicine constitution identification tool for geriatric health management and help further research on the relationship between geriatric diseases and constitution type,etc.Methods:The Delphi method and a cross-sectional survey of the elderly population were used.From April to October 2021,experts in different fields were invited to participate in the questionnaire,and items were revised through the experts'ratings and feedback.From December 2021 to February 2022,the revised CCMQ-EE was validated in the elderly population.Results:The coefficients of variation of rationality and importance scores decreased to less than 0.25 in the third round of Delphi.The Kendall coordination coefficients of rationality and importance in the third round were 0.15 and 0.17(P=.031 and P=.007,respectively).The revised CCMQ-EE was established with 34 items.The factor loadings of subscales were between 0.39 and 0.92,and the fitting effects of other subscales were acceptable,except for the inherited special constitution.The Cronbach alpha and test-retest reliability coefficients of each subscale ranged from 0.65 to 0.83,and 0.66 to 0.96,respectively.The composite reliability and average variance extraction were between 0.66 and 0.84,and between 0.32 and 0.57,respectively.The reliability and validity of the revised CCMQ-EE were acceptable or satisfactory.Conclusion:The revised CCMQ-EE was developed through a three-round Delphi process and internal team discussion.After the verification in the elderly in Beijing area,its measurement performance was good.The updated questionnaire can probably replace the initial version to better promote health management and help healthy aging by identifying the constitution type of the elderly.

Efficacy of the method of tonifying Qi,resolving phlegm and eliminating stasis in thetreatment of AECOPD:A meta analysis

Objective:To systematically evaluate the efficacy and safety of the method of tonifying qi,resolving phlegm and eliminating stasis in the treatment of acute exacerbation of chronic obstructive pulmonary disease.Methods:Search the China Knowledge Network(CNKI),VIP Chinese Science and Technology Journal Database(VIP),Wanfang Data Knowledge Service Platform,China Biomedical Literature Database(CBM),PubMed,Embase,Cochrane Library,and select the databases that meet the requirements for tonifying qi,resolving phlegm and eliminating stasis.The stasis method in the treatment of AECOPD was included in the standard literature,and RevMan 5.4 software was used for statistical analysis.Results:A total of 10 articles were included,with a total of 854 patients,435 in the treatment group and 419 in the control group.Systematic analysis shows that the method of tonifying qi,resolving phlegm and eliminating stasis combined with conventional Western medicine treatment of AECOPD is significantly different in total clinical effective rate than conventional Western medicine treatment alone[OR=3.98,95%CI(2.23,7.11),P<0.00001];In terms of lung function,FEV1/FVC[MD=6.08,95%CI(5.01,7.15),P<0.00001],FEV1[MD=0.07,95%CI(0.01,0.13),P=0.02],FEV1%[MD=4.56,95%CI(3.09,6.02),P<0.00001]is significantly higher than the control group;arterial oxygen partial pressure(PaO_(2))[MD=18.47,95%CI(16.77,20.16),P<0.00001]Significant improvement compared to the control group;arterial partial pressure of carbon dioxide(PaCO_(2))[MD=-7.48,95%CI(-8.7,-6.26),P<0.00001]was significantly lower than the control group.Conclusion:The current evidence shows that the method of tonifying qi,resolving phlegm and eliminating stasis combined with conventional Western medicine treatment of chronic obstructive pulmonary disease in acute exacerbations can improve clinical efficacy and improve the quality of life of patients.