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ObjectiveTo investigate the clinical efficacy and possible mechanism of Erzhi Tiangui prescription on repeated implantation failure （RIF） of kidney deficiency syndrome. MethodSeventy patients with RIF of kidney deficiency syndrome who underwent natural cycle frozen-thawed embryo transfer （FET） in the Reproductive and Genetic Center of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine were enrolled and randomly divided into a treatment group （35 cases） and a control group （35 cases）. Patients in the treatment group took oral Erzhi Tiangui prescription from the third day of each menstrual cycle two months before the FET cycle and continued to take it until the day of transplantation from the third day of the menstrual cycle in the month of transplantation. Those in the control group did not accept traditional Chinese medicine （TCM）. In addition，10 patients who successfully achieved clinical pregnancy after the first natural cycle FET were screened from the reproductive medical record bank of this hospital and assigned to the normal group. Peripheral blood samples of patients in the three groups on the day of embryo transfer were collected from the specimen bank of the Reproductive and Genetic Center. Serum soluble programmed death molecule-1 （sPD-1），soluble programmed death molecule-ligand 1 （sPD-L1），transforming growth factor-β （TGF-β），interleukin-17 （IL-17）， and interleukin-10 （IL-10） levels were measured by enzyme-linked immunosorbent assay （ELISA）. The changes in kidney deficiency syndrome scores， the final biochemical pregnancy rates， clinical pregnancy rates， and embryo implantation rates of the treatment group and the control group before and after treatment were observed. ResultCompared with the normal group，the model group showed increased serum levels of sPD-1 and IL-17（r=0.347，P<0.05），decreased levels of IL-10 and TGF-β （P<0.01），and non-significant change in sPD-L1 level. Serum sPD-1 was positively correlated with IL-17 （P<0.05） and negatively correlated with IL-10（r=-0.521，P<0.01） and TGF-β（r=-0.457，P<0.01） in RIF patients with kidney deficiency syndrome. After TCM treatment，compared with the control group， the treatment group showed improved TCM syndrome score （P<0.05） and increased clinical pregnancy rate and embryo transfer rate（P<0.05），but there was no statistically significant difference in the biochemical pregnancy rate between the two groups. ConclusionAbnormal expression of sPD-1 in patients with RIF of kidney deficiency syndrome breaks the balance of T helper 17 （Th17）/regulatory T cell （Treg），which is not conducive to embryo implantation and pregnancy maintenance. Erzhi Tiangui prescription，a TCM for tonifying the kidney，can significantly improve the symptoms of kidney deficiency in patients with RIF of kidney deficiency syndrome，reduce the concentrations of sPD-1 and IL-17 in the peripheral serum，increase the levels of TGF-β and IL-10，regulate the peripheral Th17/Treg immune balance，and increase the implantation rate and clinical pregnancy rate，which has a high clinical value.
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Objective:To observe the clinical efficacy of the modified Buzhong Yiqitang combined with Erxian decoction in treating stress urinary incontinence （SUI） of perimenopausal women due to spleen and kidney Qi deficiency. Method:One hundred and six patients were randomly divided into a control group （52 cases） and an observation group（54 cases）. Patients in both groups received lifestyle intervention and pelvic floor muscle training （PFMT）. On this basis， patients in the observation group were further treated with the modified Buzhong Yiqitang combined with Erxian decoction， 1 bag/day， while those in the control group were provided with Suoquan pills， 6 g/time， 2 times/day， for eight weeks. Following the international consultation on incontinence questionnaire-short form （ICIQ-SF） scoring before and after treatment， the urodynamic parameters such as maximum urinary flow rate （Q<sub>max</sub>）， maximum urethral closure pressure （MUCP）， residual urine volume （RUV）， abdominal pressure leakage point pressure （ALPP）， and bladder capacity （BC） were measured. The number of incontinence episodes per 24 h， the degree of urinary incontinence， the amount of 1 h urine leakage， and the spleen and kidney Qi deficiency syndrome score were recorded before and after treatment. The levels of estradiol （E<sub>2</sub>）， follicle stimulating hormone （FSH）， pituitary adenylate cyclase activating peptide （PACAP）， and vasoactive intestinal peptide （VIP） were measured before and after treatment. Result:The ICIQ-SF sub-scores of the urinary incontinence frequency， severity， and impact on quality of life as well as the total score in the observation group were all lower than those in the control group （<italic>P</italic><0.01）. Q<sub>max</sub>， MUCP， ALPP and BC in the observation group were elevated in contrast to those in control group （<italic>P</italic><0.01）， while the RUV declined （<italic>P</italic><0.01）. Compared with the control group， the observation group exhibited a decreased number of incontinence episodes per 24 h， milder degree of urinary incontinence， reduced amount of 1 h urine leakage， and lower spleen and kidney Qi deficiency syndrome score （<italic>P</italic><0.01）. The E<sub>2</sub>， PACAP， and VIP in the observation group were up-regulated as compared with those in the control group （<italic>P</italic><0.01）， whereas the FSH was down-regulated （<italic>P</italic><0.01）. The cure and effective rates of the observation group were （29/50） 58.00% and （47/50）94.00%， respectively， significantly better than （18/48）37.50% and （38/48）79.17% of the control group （<italic>χ</italic><sup>2</sup>=4.124， <italic>χ</italic><sup>2</sup>=4.683， <italic>P</italic><0.05）. Conclusion:On the basis of the lifestyle intervention and PFMT， the modified Buzhong Yiqitang combined with Erxian decoction obviously alleviates urinary incontinence， adjusts sex hormones， PACAP and VIP， ameliorates urodynamic parameters， and enhances the quality of life of patients with SUI due to spleen and kidney Qi deficiency. The resulting cure and effective rates are superior to those of the positive control.
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Objective::To observe the clinical efficacy of dialectical therapy of Bufeitang combined with Shengesan and Fujiu application on chronic obstructive pulmonary disease (COPD) and lung-kidney Qi deficiency syndrome, and its effect on inflammatory damage and airway remodeling. Method::One hundred and thirty-four patients were randomly divided into control group (66 cases) and observation group (68 cases) by random number table. Patients in control group got spiriva by powder inhaler, 1 grain/time, 1 time/day, and salmeterol xinafoate and fluticasone propionate powder for inhalation for spray as appropriate, 1 suction/time, 1-2 times/days, for a continued 12 months. In addition to the therapy of control group, patients in observation group were also given Fujiu application at two-tailed acupoints of Feiyu, Piyu and Shenyu for the first day of the every San Fu and San Jiu, and dialectical therapy of Bufeitang combined with Shengesan were given at the first day of San Fu and San Jiu for 2 months. The course of treatment was 12 months. Before and after treatment, FEV1% of self-assessment questionnaire of patients with COPD (CAT), 6-min walking distance, St George's respiratory questionnaire (SGRQ), severity of dyspnea (mMRC) and index of BODE were assessed. And levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), matrix metalloproteinase-9 (MMP-9) and matrix metalloproteinase inhibitor-1 (TIMP-1) were detected. Result::After treatment, scores of CAT, the total score of SGRQ, scoring of each dimension and index of BODE in observation group were all lower than that in control group (P<0.01), while FEV1% was higher than that in control group (P<0.01). And 6-min walking distance was more than that in control group (P<0.01), and the numbers of acute exacerbations were less than that in control group (P<0.01). The severity of dyspnea was lighter than that in control group (Z=2.047, P<0.05). And levels of MMP-9, TNF-α, IL-6 and ratio of MMP-9/TIMP-1 were lower than those in control group (P<0.01), whereas the level of TIMP-1 was higher than that in control group (P<0.01). Conclusion::Dialectical therapy of Bufei decoction combined with Shenge powder and Fujiu application can alleviate the current symptoms of dyspnea, improve exercise tolerance, quality of life and pulmonary function, reduce the number of acute exacerbations, relieve inflammation damage and airway remodeling. The comprehensive clinical efficacy is better than that of conventional western medicine.
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Objective: To observe the efficacy of Gushen Dingchuan pills combined with routine western medicine in treating stable chronic obstructive pulmonary disease (COPD) patients with syndrome of lung and kidney Qi yin deficiency, and investigate its effect on serum levels of S100 calcium binding protein A8/A9 complex (S100A8/A9), nuclear factor (NF) -κB, tumor necrosis factor (TNF) -α, interleukin (IL) -8 and IL-1β. Method:One hundred and ten stable chronic COPD patients were selected and randomly divided into control group (55 cases) and treatment group (55 cases) by the random number table. Cases of control group received routine therapy by reference to the Guidelines for Diagnosis and Treatment for Chronic Obstructive Pulmonary Disease (2013 Revision). In addition to the therapy of control group, cases of treatment group were orally given Gushen Dingchuan pills(1.5-2.0 g/time, tid). Both groups were treated for 12 weeks. Lung function, scores of symptoms of lung and kidney Qi Yin deficiency, life quality St. George's respiratory questionnaire (SGRQ) score, and the efficacy were compared between both groups. Serum levels of S100A8/A9, NF-κB, TNF-α, IL-8 and IL-1β were detected for two groups. Result:After treatment, FEV1% and FEV1/FVC of treatment group were obviously higher, while score of symptoms of lung and kidney Qi deficiency were lower than control group (Pχ2=4.777, PPκB of treatment group were obviously lower than those of control group (Pα, IL-8, IL-1β of treatment group were remarkably lower than control group after treatment (PConclusion:Gushen Dingchuan pills combined with western medicine can treat stable chronic COPD patients with syndrome of lung and kidney Qi Yin deficiency by improving lung function, alleviating symptoms of lung and kidney Qi deficiency, increasing life quality and efficacy and decreasing levels of S100A8/A9 and NF-κB inflammatory factors.
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Objective: To observe the effect of Shoutaiwan and Shaoyao Gancao Tang on recurrent spontaneous abortion due to spleen and kidney Qi deficiency. Method: Totally 80 eligible patients were randomly divided into the control group and the treatment group, with 90 cases in each group. The control group was treated with lymphocyte immune; the Shoutaiwan and Shaoyao Gancao Tang combined with lymphocyte immune was applied in the treatment group. Coagulation function[the part plasminogen activator inhibitor-1 (PAI-1), fibrinogen (FIB), type plasminogen activator (t-PA), prothrombin time (PT), D-dimer (D-D) and tissue factor (TF), fibrin peptide A (FPA), fibrinogen (Fig), Plasminase-antifibrinolytic complex (PAP), glycoprotein platelet particle-140 (GMP-140), thrombin-antithrombin complex (TAT)], serum closed antibody (CD3+,CD4+,CD8+,CD4+/CD8+), inflammatory factor interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), Interleukin-1β (IL-1β), interleukin-10 (IL-10)]were scored after the treatment. The rates of birth and adverse reactions in each group were compared. The traditional Chinese medicine(TCM) syndrome differentiation of abortion spleen and kidney Qi deficiency was scored. Result: 5 cases were lost during the study period. The term delivery rate was 92.0%in the treatment group, which was higher than 73.6%in control group (PP+, CD4+, CD4+/CD8+), inflammatory factors (IFN-γ,TNF-α,IL-1β) and TCM syndrome scores were significantly lower in the treatment group than that in control group (P+), inflammatory factors IL-10 were significantly increased compared with the control group (PPConclusion: Shoutaiwan and Shaoyao Gancao Tang have a remarkable effect on recurrent spontaneous abortion case by spleen and kidney Yang deficiency.
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Objective To investigate the effect of Bushen Digui Decoction in treatment of chronic nephritis proteinuria of spleen kidney qi deficiency.Methods 100 patients with chronic nephritis of spleen kidney qi deficiency were randomly divided into two groups,and each group had 50 cases.The control group was given lotensin,while the study group was given Bushen Digui Decoction.The relationship between proteinuria,kidney function improving and TCM clinical signs in the two groups were observed.Results The effective rate of study group was 76.0％,which was significantly higher than that of the control group 62.0％ (P ＜ 0.05).The effective rate of the study group according to the TCM criteria was 82.0％,which was significantly higher than that of the control group 52.0％ (P ＜0.01).24h urinary protein in the control group before treatment was (1.89 ±0.87) g,after treatment for six months was (1.45 ±0.63)g,those of the study group was (1.90 ±0.86)g,(1.01 ±0.58)g.24h urine protein in beth two groups after treatment was decreased,and the difference was statistically significant (P ＜ 0.05).After treatment,the low back pain,shortness of breath,fatigue,edema,loose stools diarrhea,frequent urination,or nocturia range of TCM symptom score improvement of the study group were significantly better than control group (P ＜ 0.05),while TCM main symptoms before and after treatment showed no improvement in the control group.Before and after the treatment,the study group and the control group in the total protein content,kidney function markers (SCr,BUN,Alb and CCr content) had no significant differences (P ＞ 0.05).Conclusion Bushen Digui Decoction can significantly improve patients' kidney function and reduce proteinuria remission in patients with low back pain,shortness of breath,fatigue,swelling,loose stools diarrhea,frequent urination,or nocturia many other symptoms.
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Two brothers with nocturnal enuresis, aged 8 and 7 years, were brought to our clinic. They had had nocturnal enuresis since early childhood, necessitating the use of disposable diapers every night. Their past histories were unremarkable, and a family history revealed that their father had experienced the same disorder until he was 12 years of age. On physical examination, we noted hypertonic abdominal muscles and high sensitivity to tickling in the 8-year-old boy, and no remarkable finding in the 7-year-old boy. Initially, the elder brother was treated with saikokeishito extract ; the younger brother, with kakkonto extract. Because these extracts were ineffective, rokumigan extract was later added. The combination therapies cured the nocturnal enuresis in both the children. The fact that these patients were brothers and that their father had the same disorder as a child indicates that the cause of nocturnal enuresis observed in the parent and the siblings might be related to “kidney qi deficiency”.
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EnuresisABSTRACT
Objective To analyse the distribution and evolution law of TCM syndrome for elderly hypertension (EH), to provide evidence for syndrome standardization study. Methods Case history of 2 029 EH patients during recent ten years were investigated in the way of epidemiology. The main and complicated syndrome types were studied. Results The main syndrome types of EH were yin deficiency of liver and kidney (40.0%), kidney qi deficiency (28.4%), hyperactivity of liver-yang (9.7%), excessive accumulation of phlegm-dampness (7.4%), collateral obstruction by blood stasis (6.6%), phlegm and blood stasis (5.7%), liver-fire hyperactivity (1.1%). The complicated syndrome types were liver-fire hyperactivity (26.5%), excessive accumulation of phlegm-dampness (9.6%), collateral obstruction by blood stasis (7.2%), phlegm and blood stasis (5.5%), kidney yin deficiency (3.7%). Conclusion The distribution of EH TCM syndrome is mainly about deficiency syndromes, in which kidney qi deficiency syndrome is very common, and mostly complicated with phlegm and blood.
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Objective:To reveal the characteristics of pulse condition of kidney qi deficiency and kidney yin deficiency syndrome,investigate the correlation between syndrome and pulse condition,and provide objective evidence for syndrome differentiation and traditional Chinese diagnosis.Methods:40 cases of kidney qi deficiency,35 cases of kidney yin deficiency and 25 people of control group were involved into the study.We used DY-SS-1 detective system of pulse condition,which had three probes and was designed according to traditional Chinese medical theories,to examine,record and analyze the messages of Cun,Guan and Chi of two hands.Results:Comparative analysis of pulse condition and syndrome differentiation showed a conclusion that the accurate diagnosis of sufferers was 68% while of controls was 88%,there was signif icant difference between them(P
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Objective: To explore the feasible methods for item selection of TCM syndrome scale.Methods:Elderly hypertension with syndrome of kidney qi deficiency was selected as example.The symptoms and signs of elderly hypertension patients were statistically analyzed with clinical epidemiological investigation on the basis of discussion among focus group and expert consultation.Six selection methods were used,such as correlation coefficient method,dispersion tendency method,factor analysis method,etc.Results:18 Items were selected in the end and constituted the preliminary scale of kidney qi deficiency of elderly hypertension.Conclusion:Only if combine subjective and objective selection methods,use kinds of proper statistical methods and master the scale of preserving items,can we acquire good reliability and validity of scale.