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Depression syndromes(anxiety and depression), as typical psychological disorders, often coexist with and mutually influence coronary heart disease(CHD). They constitute a psycho-cardiology disease involving both the blood vessels of the heart and the spirit of the heart. Based on the theory of "coexistence of diseases and depression syndromes", it was proposed that CHD and depression syndromes coexisted independently and were causally related. The factors of depression syndromes go through the entire course of CHD and have different causal relationships at different stages, leading to a pathogenic process of "depression causing disease" or "disease causing depression". In the chronic latent period, phlegm predominates, with depression leading to the production of phlegm. Phlegm accumulation and Qi stagnation initiate a mutual damage process of psycho-cardiology, marking the onset of the disease. In the pathological development period, blood stasis becomes predominant. Depression leads to blood stasis, which further obstructs Qi circulation, accelerating disease progression. In the acute attack period, toxicity becomes crucial. Depression transforms into toxicity, damaging Qi and blood, disturbing the balance of the mind, and inducing a sudden and severe exacerbation of the disease. Based on this, the approach of treating phlegm and depression together, treating blood stasis and depression together, and treating toxicity and depression together by stages was established. Research has found that this approach can simultaneously improve organic damage and emotional disorders, and also has a regulating effect on micro-level syndrome indicators, achieving harmonization of psycho-cardiology in the treatment.
Subject(s)
Humans , Medicine, Chinese Traditional , Depression/diagnosis , Coronary Disease/diagnosis , Mucus , Syndrome , AnxietyABSTRACT
There is still a lack of effective strategies for the prevention and treatment of liver cancer, and a deep understanding of its pathogenesis may help to develop new treatment methods. Due to the abnormal changes of lipid metabolism in the development and progression of liver cancer, such process is closely associated with the "phlegm-turbidity" theory in traditional Chinese medicine (TCM). Starting from the changes of lipid metabolism in hepatocellular carcinoma microenvironment, this article discusses the association of the abnormal changes of lipid metabolism in tumor cells and immune cells with the "phlegm-turbidity" theory and the clinical efficacy of phlegm-eliminating therapies in clinical practice. Since the "phlegm-turbidity" theory in TCM plays an important role in the pathogenesis and pathological changes of liver cancer, the analysis of its theoretical connotation helps to clarify pathological mechanism, thereby providing a theoretical basis for the role of TCM in the prevention and treatment of liver cancer.
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Objective::To observe the clinical efficacy of Sanju Kechuan oral liquid on phlegm-turbid obstruction of lung syndrome of asthma at acute episode, in order to study its effect on pulmonary function and inflammatory factors. Method::One hundred and seventeen patients were randomly divided into control group (57 cases) and observation group (60 cases) by random number table. Patients in control group got budesonide suspension for inhalation by atomizer, 1-2 mg/time, 2 times/days. Patients who could not control were added with salmeterol xinafoate and fluticasone propionate powder for inhalation in every morning and evening, 50-250 μg/time. In addition to the therapy of control group, patients in observation group was added with Sanju Kechuan oral liquid, 20 mL/time, 3 times/days. The course of treatment was 7 days. And before and after treatment, the severity of asthma at acute episode and the phlegm-turbid obstruction of lung syndrome were scored. And 1-second forced expiratory volume (FEV1), diurnal variability of peak expiratory flow (PEF), fractional exhaled nitric oxide (FeNO), peripheral blood, percentage of sputum eosinophils (Eos) were recorded, and levels of interleukin-2 (IL-2), interferon-gamma (IFN-γ), IL-4, IL-5 and IL-17 were detected. Result::The clinical efficacy in observation group was better than that in control group (Z=1.916, P<0.05). Scores of severity of asthma at acute episode and phlegm-turbid obstruction of lung syndrome were lower than those in control group (P<0.01). And FEV1 was higher than that in control group (P<0.05), while PEF was lower than that in control group (P<0.05). Asthma control in observation group was better than that in control group (Z=2.231, P<0.01). And levels of FeNO, Eos in sputum, Eos in peripheral blood, IL-4, IL-5 and IL-17 were lower than those in control group (P<0.01), whereas levels of IL-2 and IFN-γ were higher than those in control group (P<0.01). Conclusion::In addition to the therapy of routine western medicine, Sanju Kechuan oral liquid can alleviate the severity of phlegm-turbid obstruction of lung syndrome of asthma at acute episode, improve the lung function, control the attack of asthma and inhibit the airway inflammation, with a better the clinical efficacy than pure western medicine treatment.
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Objective: To discuss the efficacy of Erzhu Erchentang on major cardiovascular risk factors caused by type 2 diabetes mellitus (T2DM)with phlegm turbidity and blood stasis syndrome, and its anti-inflammatory effect. Method: One hundred and forty-two patients were randomly divided into control group and observation group by random number table. Patients in control group got insulin or oral hypoglycemic drugs for controlling blood sugar, aspirin enteric-coated tablets, 100 mg/time, 1 time/day, telmisartan tablets, 40 mg/time, 1 time/day, atorvastatin, 10 mg/time, 1 time/day, and non-drug interventions. In addition to the therapy of control group, patients in observation group were also given modified Erzhu Erchentang, 1 dose/day, 5 times/week. The course of treatment was 24 weeks. And a 24-week follow-up was recorded. And levels of fasting blood glucose (FPG), 2 h postprandial blood glucose (2 hPG), glycosylated hemoglobin (HbA1c), systolic blood pressure (SBP), diastolic blood pressure (DBP), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HLD-C) and low-density lipoprotein (LDL-C) were detected. And the occurrence of major cardiovascular events, cerebrovascular events and peripheral vascular events were recorded. Before and after treatment, levels of body mass index (BMI), carotid intima-media thickness (IMT), framingham risk (FRS) and waist-hip ratio (WHR) were assessed. And procalcitonin (PCT), homocysteine (Hcy), hypersensitive C-reactive protein (hs-CRP), cystatin C (CysC) and matrix metalloproteinase-9 (MMP-9) were measured. Result: After treatment, levels of 2 hPG, HbA1c, SBP, DBP, TC, TG, LDL-C, IMT and BMI in observation group were lower than those in control group (PPχ2=4.775, Pχ2=5.639, PZ=2.165, PPConclusion: In addition to the comprehensive therapy of conventional western medicine, modified Erzhu Erchentang can increase the reduce serum inflammatory factors and control the high risk factors of cardiovascular disease of patients with T2DM, so as to reduce the major cardiovascular events.
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Objective To analyze the distribution of traditional Chinese medicine(TCM)syndromes in patients with acute pulmonary embolism(APE)and to summarize the medication rule,so as to supply evidence for the clinical diagnosis and treatment of APE. Methods A retrospective study was carried out in the APE inpatients admitted in the First Affiliated Hospital of Guangzhou University of Chinese Medicine in recent 4 years. The general data, clinical manifestations at the attack of APE, TCM syndromes, treatment and prognosis of the included patients were input into the database for the analysis of TCM syndrome distribution and medication rule. Results A total of 139 cases of APE patients were included into the study. The main manifestations at admission were dominated by dyspnea and chest pain, pale or darkish red tongue, string pulse and deep pulse. TCM syndromes were divided into three types, phlegm turbidity syndrome, blood stasis syndrome and yang collapse syndrome. The blood stasis syndrome accounted for the largest proportion and then came the phlegm turbidity syndrome. In various age groups,the 3 syndrome types accounted the highest proportion in the age group of 51-70 years old, and accounted higher proportion in the age group over 71 years old. Blood stasis syndrome was frequently seen in the age group below 30 years old. Xuefu Zhuyu Decoction and Tao Hong Siwu Decoction were frequently used for the treatment of blood stasis syndrome, Gualou Xiebai Banxia Decoction and Wendan Decoction were often used for the phlegm turbidity syndrome, and Shenfu Injection was often used for yang collapse syndrome. Conclusion APE occurs in various clinical departments, and phlegm turbidity syndrome, blood stasis syndrome and yang collapse syndrome are the main syndrome patterns of APE. Blood stasis syndrome accounts the largest proportion in clinic. Therefore, Xuefu Zhuyu Decoction and Tao Hong Siwu Decoction, Gualou Xiebai Banxia Decoction and Wendan Decoction should be used as the indicated recipes for APE to activate blood and remove stasis, strengthen spleen and resolve phlegm.
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This study was aimed to investigate potential biomarkers in different traditional Chinese medicine (TCM) syndromes of angina pectoris of coronary heart disease (CHD) by using metabolomic technology,and to explore the objective law of different TCM syndromes of CHD.Endogenous metabolites in serum and urine from the healthy group,and patients with DHD angina pectoris patients of the syndrome of Qi deficiency and blood stasis,as well as the syndrome of Qi deficiency,blood stasis and phlegm turbidity were detected by the liquid chromatography-mass spectrometry (LC-MS).Metabolic profiles were analyzed by the principal component analysis (PCA) and the orthogonal partial least squares discriminant analysis (OPLS-DA).The results showed that in PCA,the healthy group,Qi deficiency and blood stasis group,as well as the Qi deficiency,blood stasis and phlegm turbidity group can be obviously distinguished.Potential biomarkers in the Qi deficiency and blood stasis syndrome contained aspartyl methionine and cysteine sulfinic acid.Potential biomarkers in the Qi deficiency,blood stasis and phlegm turbidity syndrome contained hippuric acid,amino glucose,fructosamine and triglyceride.The objective performance of Qi deficiency syndrome was the absence of biotin,lysyl tyrosine,phosphatidylglycerol and glycocholic acid.It was concluded that through the new metabolomic technology,different endogenous metabolites in the syndrome of Qi deficiency and blood stasis,as well as the syndrome of Qi deficiency,blood stasis and phlegm turbidity of patients with DHD angina pectoris were detected.It provided ideas for the clinical practice of prevention,diagnosis and treatment of different TCM syndromes.
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Objective To observe the real-time and short-term therapeutic efficacies of fire-needle acupuncture and warm needling in treating cervical vertigo due to upward disturbance of phlegm-turbidity, and compare the two treatment methods. Method Eighty-four patients with cervical vertigo due to upward disturbance of phlegm-turbidity were randomized into a fire-needle acupuncture group and a warm needling group, 42 cases in each group. The two groups received treatment once a day, respectively for 10 sessions. The symptoms, functions and total score were evaluated by adopting the modified Cervical Vertigo Symptoms and Functions Assessment Scale before the second treatment session and after 10 treatment sessions; the therapeutic efficacy was evaluated based on the traditional Chinese medicine symptoms scale. Result The scores after 10 treatment sessions were significantly different from that before treatment in the two groups (P<0.05);before the 2nd treatment session, the improvements of the symptoms and total scores in the fire-needle acupuncture group were more significant than that in the warm needling group (P<0.05);after 10 sessions, there were significant differences in comparing the symptoms, functions and total scores between the two groups (P<0.05);the clinical control rate was 26.2%and total effective rate was 95.2%in the fire-needle acupuncture group, versus 9.5%and 90.5%in the warm needling group, and there was a significant difference in comparing the therapeutic efficacy between the two groups. Conclusion Fire-needle acupuncture and warm needling both are effective in treating cervical vertigo due to upward disturbance of phlegm-turbidity, while fire-needle acupuncture can improve the vertigo symptoms in a real-time manner, and its short-term therapeutic efficacy is also superior to that of warm needling.
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Objective:To observe the relationship between coronary heart disease(CHD)patterns and coronary lesion,and between the syndrome of spleen deficience with/or phlegm turbidity(SP)and coronary lesion.Methods:Traditional Chinese medicine(TCM)patterns and syndromes of 81 patients with CHD confirmed by coronary angiography(CAG)were differentiated.And the relationship between CHD patterns and coronary lesion,and between SP syndrome and coronary lesion were analyzed.The extent of coronary lesion was reflected by the affected branches and degree of arterial constriction based on CAG.Results:In 81 cases,the average affected branches amount in the group of blood stasis pattern was the most;arterial constriction degree in the group of cold-accumulation pattern was the most severe;the coronary lesion of cases in the qi-stagnation pattern group and yin-deficiency pattern group were slighter;but there was not significant difference among the CHD patterns groups.In 81 cases,there was significant difference between the SP syndrome group(38 cases)and the non-SP syndrome group(43 cases)in both affected branch distribution and arterial constriction degree.It manifested that the left circumflex artery(LCX)and right coronary artery(RCA)was easier to be affected and their constriction was more severe in the SP syndrome group.Conclusion:There was relationship between different CHD patterns and coronary lesion;coronary lesion and the clinical symptom of SP syndrome may exist the relationship of cause and effect.
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OBJECTIVE:To observe the clinical efficacy of strengthening spleen,reducing phlegm and stasis-dispelling recipe combined with atorvastatin calcium tablet for hyperlipidemia of phlegm-turbidity accumualtion.METHODS:In prospective study,80 patients with hyperlipidemia of phlegm-turbidity accumulation received traditional Chinese medicine combine with atorvastatin calcium tablet(therapy group) or atorvastatin calcium tablet alone(control group) with each group of 40 cases.Both groups were given oral dose of atorvastatin calcium tablet 10 mg before supper for 8 weeks.Therapy group were additionally given strengthening spleen,reducing phlegm and stasis-dispelling recipe.The levels of serum,TC,TG,HDL-C,LDL-C were observed.RESULTS:Total response rate of therapy group was 92.5%,which was better than control group of 85%.The improvements of TC,TG,LDL-C and HDL-C in therapy group were superior to control group.The improvement of clinical symptom in therapy group was better than control group according to the score of dizziness,sleepiness,chest tightness and palpitation,abdominal distention.Adverse drug reaction had not observed in both groups.CONCLUSION:Traditional Chinese medicine combine with atorvastatin calcium tablet has better effect than atorvastatin calcium tablet alone.2 groups show similar safety of drug use.
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Objective To study the relations among phlegm turbidity, blood stasis syndromes, Interleukin-6 (IL-6) and highly sensitive C-reactive protein (hs-CRP) in simple hypertension patients and those complicated with abnormal blood fat and/or diabetes.Methods Totally 319 cases of hypertension collected were divided into the group with simple hypertension (simple group, 98 cases) and the group with hypertension complicated with abnormal blood fat and/or diabetes (complicated group, 221 cases). The patients were classified according to the 4 different syndromes, i.e., phlegm turbidity, blood stasis, phlegm turbidity plus blood stasis, and not phlegm turbidity not blood stasis. ELISA was used to measure serum IL-6 content, and latex enhancement immune turbidimetry was applied to determine hs-CRP content.Results The contents of IL-6 and hs-CRP of the two groups were not significantly different. The content of hs-CRP of both groups in the 4 syndromes was not significantly different. In the simple group, the content of IL-6 in the 4 syndromes was not significantly different either. In the complicated group, the content of IL-6 in the syndrome of phlegm turbidity plus blood stasis was significantly higher than in other syndromes (P
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Objective To study the effect of Zhimaikang Granules (Granules for lipid abnormality) on atherosclerosis of hyperlipidemia patients of phlegm turbidity retention type.Methods Totally 120 hyperlipidemia patients were randomized into treatment group and control group, 60 cases in each. The treatment group was administered Zhimaikang Granules, each time 1 bag, twice a day. The control group was given Simvastatin Tablets, oral taking before sleeping. Both groups were treated for 45 days. Changes of superoxide dismutase (SOD), malondialdehyde (MDA), and nitric oxide (NO) were observed.Results After treatment, activity of NO and SOD were significantly higher than before in both groups (P0.05).Conclusion Zhimaikang Granules was proved to enhance the activity of antioxidase, promote anti-free radical reactions, inhibit lipid peroxidation and protect endothelial cells in atherosclerosis patients.
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Objective To observe effect of Liqiao Yizhi Decoction (Decoction for inducing resuscitation to improve cognition) on mild cognitive impairment (MCI). Methods Treatment group (32 cases) was treated with Liqiao Yizhi Decoction,and the control group was treated by Piracetam. Memory,congnition and related scores of both groups were observed. Results Both groups were improved in the scores of cognition,memory and behavioral ability of MCI patients (P