ABSTRACT
Stroke is one of the most common cerebrovascular diseases， including hemorrhagic stroke and ischemic stroke. From a modern medical perspective， stroke is caused by cerebrovascular damage or embolism leading to impaired blood circulation. From the traditional Chinese medicine （TCM） perspective， the pathogenesis of this disease is mainly due to the disorder of Qi and blood， which ascend to the brain， causing either blood extravasation or blockage of brain collaterals. Stasis is a pathological factor that runs throughout the entire course of stroke， and the method of promoting blood circulation and resolving stasis has been a core treatment for stroke for a long time. Hirudo， as a traditional insect drug， has shown good effects in promoting blood circulation and resolving stasis. Modern pharmacological research has confirmed that Hirudo contains anticoagulant components， which provide significant advantages in dissolving thrombi in ischemic stroke and facilitating hematoma absorption in hemorrhagic stroke. Hirudo and its related preparations have been proven to exert an anti-stroke effect through anticoagulation， anti-thrombosis， and protection of vascular endothelium. As a result， they have been widely used in the treatment of stroke. This article explored the theoretical basis and research status of using Hirudo for treating stroke based on its main active components and hemostatic properties and summarized the current research status of commonly used Hirudo-based formulations and preparations， aiming to provide references for the involvement of Hirudo in stroke treatment.
ABSTRACT
This study preliminarily discussed the TCM syndrome types of myasthenia gravis (or flaccidity) and its treatments and prescriptions through consensus method,providing evidence and level revision of the recommended expert consensus of myasthenia gravis in TCM clinical practice guideline.Literatures over TCM syndrome types,symptoms,therapeutic regime,medication and acupuncture were involved in the syndrome analysis of myasthenia gravis through literature retrieval.The common clinical syndromes were outputted by mentioned rate.Ten first-rate hospitals were finally included,such as The Affiliated Hospital of Changchun University of Traditional Chinese Medicine,Dongfang Hospital of Beijing University of Chinese Medicine,Guangdong Province Traditional Chinese Medical Hospital and Affiliated Hospital of Anhui University of Traditional Chinese Medicine.Twelve experts in aggregate were confirmed to participate in the discussion for the identification of the TCM syndrome types,treatments and prescriptions of myasthenia gravis.As a result,five TCM syndrome types,such as syndrome of spleen and stomach qi deficiency,syndrome of spleen-kidney deficiency,deficiency syndrome of both qi and yin,syndrome of deficiency and sinking of qi,were confirmed;while five therapeutic regimes were approved,including reinforcement of qi,tonification of spleen and stomach,tonification of spleen and kidney qi,tonification of qi and yin,the supplement of qi and restoration of yang for ascending qi collapse.In addition,five prescriptions were supported by the experts,such as Bu Zhong Yi Qi (BZYQ) decoction,BZYQ decoction combined with You Gui pills,BZYQ decoction combined with Sheng Mai powders and Sheng Xian decoction.In conclusion,the expert consensus method for the screen of TCM syndrome types of myasthenia gravis embodied the conception of literature research based on the clinical practice combined with the scientific methods in conformity with the current research approaches to TCM syndrome types.