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Objective To observe the effects of chemotherapy on nutritional status and quality of life in elderly patients aged 60 years and over with stage Ⅲ or Ⅳ non-small-cell lung cancer,who were unable to undergo molecular-targeted drug therapy according to genetic testing.Methods A total of 100 elderly patients with stage Ⅲ or Ⅳ non-small cell lung cancer were randomized into an observation group(n=50)and a control group(n=50).Patients in the observation group were treated with GP regimen(gemcitabine+ cisplatin),while patients in the control group were treated with TP regimen(paclitaxel+cisplatin).The scores of nutritionally relevant indicators and quality of life were compared between the two groups.Results After chemotherapy,the body weight,body mass index,plasma total protein,plasma albumin,and triglyceride concentrations were significantly lower in the GP regimen group than in the TP regimen group(P＜0.0001,P =0.0027,P =0.0305,P＜0.0001,P＜ 0.0001,respectively).The overall health status score,physical function,role function,and emotional function scores were higher in the GP group than in the TP group(P =0.0017,0.0044,0.0064,0.006,respectively) after chemotherapy.The scores of shortness of breath,insomnia,loss of appetite,constipation,and diarrhea were significantly lower in the GP group than in the TP group(P =0.0067,P ＜0.0001,P =0.0026,P =0.0066,P =0.0023).The clinical effective rate was significantly higher in GP regimen than in TP regimen(56.0％ vs 30.0％,x2 =6.90,P=0.009).The incidence of grade Ⅰ adverse reactions was higher in the observation group (54.0％,27/50 cases),and the incidences of grade Ⅱ,Ⅲ and Ⅳ adverse reactions were higher in the control group(36.0％,18/50 cases;24.0％,12/50 cases;and 24.0％,12/50 cases,respectively) (x2 =16.40,P =0.001).Conclusions The TP chemotherapy is more beneficial to patients' nutrition,while the GP chemotherapy can achieve both higher clinical efficacy and better quality of life.
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Analogy is to construct the theory of traditional Chinese medicine in clinical thinking method,which the proper use of this thinking is helpful to improve the clinical thinking of Chinese medicine,contributes to the development of disease differentiation and treatment ideas.This article tried to analyze the diagnosis and treatment of kidney diseases with Professor Zhu Zongyuan on the process,to explore the analogy on disease differentiation treatment guide.
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"Absorbing image "is an important method in establishing fundamental theoretical system of TCM.The term and concept of "nomenclature according to manifestations" is the starting point of theoretical thoughts and the results of scientific studies."Testing viscera via the state of internal organs" is a method of "understanding the interior from the exterior",which makes TCM surpass productivity level and practical tools of that time,finally aquire knowledge.The huge theoretical system of TCM is constructed on the basis of "classification according to manifestation",discovering unknown fields according to infinite knowledge.
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This article explores the TCM essence by extensive comparative study of eastern-western philosophy,science and technology history,medical science and so on,making deep-going comparative study on systems of TCM and western medicine by ontology and methodology.It shows that observation and classifi cation plays an important role in western medicine,and western medicine is an experience science that emphasizes on life regularity from the aspect of texture-function of human body.But in TCM,it is observation and mode reasoning plays an important role,and TCM is a theoretic science emphasizing on phenomenon-state of human body.
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The thought of "verification" in Inner Canon of Huangdi includes "verifying through comparison" and "verifying through result",which ensures the truth of medical experience,theoretical results and recognition of Chinese medicine.Therefore,"verification" is a important concept and category of verifying criterion of truth in theoretical system of TCM.
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The basic concept and category of"consciousness"from Inner Canon of Huangdi put forward to understanding the life motion and laws through analysis and inference in order to construct TCM theoretical system,which proposed the question of theory thoughts.There are two explanations about consciousness:1.Theory thoughts in method of experience and cognition,which means during the activity of observing and recognizing,organizing perceptual cognition with theoretical knowledge of ying-yang,five phases and so on to achieve purpose of identification;2.Explaining experiential facts with certain theories and creating some theoretical hypothesis,in order to achieve the purpose of rising experiential knowledge to theoretical knowledge.
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China ancients were good at the use of yunshu,they used mathematics method to study the life movement,explore the rule of disease,Those were the important scientific method and theoretical category of establishment of TCM theory system by Inner Canon of Huangdi.The yunshu thought in Inner Canon of Huangdi started from metric and developed to calculation,it contained the mathematical thought of shu and xing,and the trace of taking shu as image.
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In ancient times of China, thoughts of matter differentiation developed on basis of observation. It derived from primitive gather activities, its initial form was differentiation, then, formed into classification. As a scientific methods category, the development of thoughts of matter diffetentiation also had effect on traditional Chinese medicine. It effected and controlled that traditional Chinese medicine theory showed solicitude for sorts but not structural analysis. It directed theory of traditional Chinese medicine to obtain experience, combine knowledge and construct theory system in way of methodology.
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Observation is a necessary precondition of obtaining and constructing reliable knowledge,through which people can extract nature and low of things and lives from complex phenomenon.Therefore,widely and deeply observation is an important foundation and scienti c method category of forming TCM theoretical system.
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‘Body and spirit’ is a pair of category that indicates the relationship between body and spirit.The categogy of ‘body and spirit’ of Inner Canon of Huangdi shapes the theory of ‘somatic and spiritual harmony’.It makes the TCM grasp the relationship between body and spirit exactly,and introduce the cognitive method of ‘mind’ from pre-qin philosophy,master the method of discovering the essence of things from observing the phenomenon.Therefore,in the era of low productivity and limited technique,TCM can recognize the essence of life by study the vital phenomena of human body.
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"Human body" and "natural environment" is a pair of ancient,important philosophical categories in Chinese philosophy.Ancient Chinese philosophy produced and developed on the basis of "debate on human and nature".Especially in the Pre-qin and Han dynasty,"human body" and "natural environment" is the center subject of philosophic discussion,which also permeated into the fi elds of life science,and became the most important categories in theoretical system of traditional Chinese medicine.This subject had signifi cant effect on formation of theoretical system of traditional Chinese medicine and theory of "adaptation of human body to natural environment".
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The category of five elements had consummated in the Spring and Autumn and the Warring States Periods.The five elements emerged from the observation of the various groups of dynamic processes,functions and characteristics in the natural world.It thoughts that the five elements are mutual united and supplementary.The category of five elements brings a new thinking mode into the theory of TCM,establishes a theory of man,as a microcosm,is connected with the macrocosm which is on the basis of five orientations,five kinds of elements and five organs.It makes integer conception,which regards five viscera as a center and considers human physiological and pathological activities from multiple factors and multiple levels,follow through the TCM theory.
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Yin-yang in ancient Chinese philosophy originally meant two kinds of qi,yin was cold and yang was warm.Its extended meaning originated from Yizhuan was two aspects opposite to each other during the whole world.In Inner Canon of Huangdi, the category of yin-yang was more than generalization of the law of the unity of opposites in nature,the basic principles of yin-yang were further revealed,which was the major content of the yin-yang theory of TCM.Thinking pattern of physicians through the ages had been effected by the yin-yang theory for more than two thousand years,which made TCM theory has a dialectical thinking mode.Therefore,a theoretical system of medicine with the property of dialectical logic was set up.
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Qi was a basic concept of material existence in Chinese ancient philosophy.Qi was the flowing and microscopic existence in pre-qin dynasty,which was different from liquid and solid.Qi was the important conception of the flowing and microscopic existence in Inner Canon of Huangdi,which constructed the medical theory and explained the nature,human body,physiology and pathology.Thus,it made the TCM theory belong to materialistic epistemology.Qi explained the existence of life material which could not be cognized at that time,this made TCM theory do not need to study what material was,but to study what the changes of material were,then promoted the progress of medical science.
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The art of warm disease of TCM not only has abundant clinical experience,but also has a profound theoretical thinking,and it starts with its unique concept category and logical system,and riches and enriches,updates and develops on the basic of this,and goes along the road of independent development,has a distinct characteristics.This paper preliminarily studies on wei qi ying and xue of the art of warm disease of TCM from meaning,development of history,nature and action,et al.And it provides references of ideas and methodologies for the development and innovation of the art of warm disease of TCM.
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Views of "Integrated whole of heaven,earth and man","Derive the theory of the human body from natural environment" and "Xing-ming Ying-yin" combined with medical practice were origins of traditional Chinese medicine theory.On the premise of ensuring internal coordination of the whole theory in accordance with the logic of proposition,physicians kept on enriching connotation,validating hypothesis and using the theories in practice,made traditional Chinese medicine theory has scientific conformation of medical model of "environment-body and spirit",logic system of "dialectical-analogize" and subject character of "manifestation-state ".
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Traditional Chinese medicine is not much of a experience fact delineation and record on human body vital movement,disease process and disease therapeutics,but a theory explanation on experience fact though making observed medical phenomenon come down to general law and principle;a dialectic-analogy logic system formed by applying logical thinking law of Chinese people to tidy up medical experience knowledge;a theory medical science formed by a concept-category system organized by a series of different decks of theory categories,which has highly self-support nature in interior of theory whole and logic consistency between propositions.
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What kind of science is TCM? How to develop TCM that consistent with its inherent rule? To solve this problem,we should establish dimension research area of TCM,set up science of "theory study of TCM",evolve dimension research of TCM.We can gather a body of scholars of TCM that not only master TCM theory but also possess knowledge structure in terms of philosophy,logic,science philosophy and science epistemology et al,formation academic society,carry out research,discussion and argument.So to make clear that what kind of science is TCM,what are its theoretical structure,essential characteristic and developing rule,which aspect of biotic phenomenon,research method and thought does it study.In that way to recognize investigative aim of TCM science,establish rationality belief of science community of TCM,so as to accelerate us to choice TCM research thought that accord with its own inherent rule,advance clinical therapeutic effect and develop foundational theory of TCM.
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How did Inner Canon of Huangdi(Huangdi Nei Jing) get the numerous thinking quintessences of Dao,Fa,Ru,Mo,Ming,Yin-yang,Nong and Bing etc to establish the TCM theory system? In the middle and end stages of the Warring States Period,the Ji Town School established by government official of Qi state marshaled numerous schools of Dao,Fa,Ru,Mo,Ming,Yin-yang,Nong and Bing etc,developed face to face academic communication,a hundred schools of thought contend,brought about the naissance of Huang Lao Neodoxy,which adopted the numerous thinking quintessence.It established the integration view of "heaven,earth and human",developed the thought style of understanding human rules according to the order of nature,and influenced numerous thoughts at that time and settled as the tradition thought style of the Chinese nation.Huangdi(Huangdi Nei Jing) brought the integration view of "heaven,earth and human" into the theory framework,to draw the the thought style of understanding human rules according to the order of nature,found the academic essence of TCM.
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Determinacy is the aim that human search during the course ofrecognition.But with the development ofscience, human discover that indeterminacy is the essence ofthe world.The contingency and randomness ofbiomutation indicate that there are many indeterminacy during the course oflife movement and changes ofdiseases.In ancient, the Chinese people grasped the movement and change rules ofobjective objects by mode reasoning under the condition ofindeterminacy and diversity.They applied the mode reasoning into TCM to study the multivariate life state ofhuman body, and to grasp the movement and change rules oflife and diseases.