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ObjectiveTo explore the clinical experience and characteristics of treating phlegm syndrome with Erchen Decoction （二陈汤） by ZHU Zhenheng， a famous doctor in Jin-Yuan Dynasty， and provide ideas for treating various diseases from phlegm in clinical practice. MethodsThis study comprehensively collected the medical cases and discussions of Erchen Decoction in treating phlegm syndrome in ZHU Zhenheng's six types of medical works. With the help of qualitative grounded theory method， pathogenesis and treatment were coded by Nvivo 11， and finally the pathogenesis and treatment system of ZHU Zhenheng using Erchen Decoction in the treatment of phlegm syndrome was constructed. ResultsA total of 48 medical case reports of ZHU Zhenheng using Erchen Decoction to treat phlegm were collected， having 52 discussions about Erchen Decoction， and involving 38 miscellaneous internal diseases such as vomiting， fullness， and stroke， six gynecological diseases， four pediatric diseases and four surgical diseases. According to the pathogenesis， ZHU Zhenheng mainly used Erchen Decoction in modifications to treat the tangible phlegm such as damp phlegm （28）， cold phlegm （17）， hot phlegm （17）， wind phlegm （15）， food phlegm （13）， phlegm stasis （7）， and phlegm-rheum （3）， as well as invisible phlegm such as latent phlegm mainly composed of qi phlegm （27）， and deficiency phlegm （15）. Seven methods are suggested to treat corresponding syndromes based on the different pathogenesis， which are fortifying the spleen and reinforcing healthy qi （28）， warming the center and dissipating cold （15）， nourishing blood and supplementing yin （10）， rectifying qi and relieving constraint （34）， raising the clear and directing the turbid downward （11）， dispelling wind and eliminating dampness （39）， and discharging heat and moving stagnation （17）. ConclusionZHU Zhenheng widely uses Erchen Decoction dissolving phlegm， draining phlegm and dispelling phlegm methods to treat internal， surgical， gynecological and pediatric diseases caused by tangible phlegm such as damp phlegm， qi phlegm， cold phlegm， hot phlegm， wind phlegm， deficiency phlegm and invisible phlegm.
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Objective:To investigate the efficacy of Yanghe Pingchuan Decoction in the treatment of chronic obstructive pulmonary disease (COPD) with syndrome of kidney deficiency and phlegm in the acute exacerbation stage.Methods:A total of 86 patients meeting the standard with acute exacerbation of COPD who were admitted to Haikou Hospital of TCM from May 2019 to July 2021 were selected and divided into an observation group and a control group by random number table method, with 43 cases in each group. The patients in the control group were treated with conventional Western medicine, and the patients in the experimental group were treated with Yanghe Pingchuan Decoction on the basis of the treatment in the control group. Both groups took 14 days of treatment. Scoring of TCM symptom of both groups before and after treatment was conducted. The serum levels of CRP, TNF-α and IL-6 were detected by ELISA, and the ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC) and the percentage of FEV1 to predicted value (FEV1%) were detected by automatic pulmonary function tester. Clinical efficacy was evaluated.Results:The observed total effective rate was 90.70% (39/43) in the observation group, which was significantly higher than 72.09% (31/43) in the control group, with statistical significance ( χ2=4.91, P<0.05). After treatment, the symptom scores of cough and expectoration, wheezing, shortness of breath, poor appetite, sweating and cold limbs in the observation group were significantly lower than those in the control group ( t values were 10.21, 11.30, 15.77, 13.87, 8.73, respectively, all Ps<0.01); the levels of CRP and TNF-α，IL-6 in the observation group were significantly lower than those in the control group ( t values were 22.43, 18.21, 20.90, respectively, all Ps<0.01); the levels of FEV1/FVC (62.58±5.23 vs. 58.47±11.61, t=2.12), FEV1 (63.79±1.47 vs. 60.17±10.94, t=2.15) in the observation group were significantly higher than those in the control group ( P<0.05). Conclusion:Yanghe Pingchuan Decoction can effectively improve the pulmonary function of patients with acute exacerbation of COPD, relieve clinical symptoms, reduce the levels of serum CRP, TNF-α and IL-6, and improve the efficacy.
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Objective: To observe the clinical efficacy of tuina at head and abdomen for headache due to phlegm turbidity. Methods:A total of 56 patients with headache due to phlegm turbidity were randomized into a tuina group and a Chinese medicine group by the random number table, with 28 cases in each group. The tuina group was treated mainly with tuina at the head and abdomen, while the Chinese medicine group was treated with oral administration of Ban Xia Bai Zhu Tian Ma Tang(Pinellia, Atractylodes Macrocephala and GastrodiaDecoction). The course of treatment was 30 d. The scores of headache index, traditional Chinese medicine syndrome scale, and the therapeutic efficacy were observed. Results:There were 2 dropouts in each group during treatment. The total effective rate was 92.3％ in the tuina group, significantly higher than 76.9％ in the Chinese medicine group (P<0.05). The scores of headache index and traditional Chinese medicine syndrome scale in both groups decreased after treatment (bothP<0.05), and scores in the tuina group were lower than those in the Chinese medicine group (bothP<0.05). Conclusion:Tuina mainly at head and abdomen is effective in treating headache due to phlegm turbidity, and has a better effect than Ban Xia Bai Zhu Tian Ma Tang (Pinellia, Atractylodes Macrocephala and GastrodiaDecoction).
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Objective To observe the clinical efficacy of modified Sanzi Yangqin Decoction for the treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS). Methods Totally 80 cases of OSAHS patients were randomly divided into treatment group and control group, with 40 cases in each group. Both groups received intervention of diet and life. The control group was given vitamin C, 100 mg each time, 3 times a day orally. Treatment group was given modified Sanzi Yangqin Decoction, 1 dosage per day, twice a day, orally, for 14 d. The scores of TCM symptoms, sleep apnea (AHI), lowest oxygen saturation (LSaO2) and longest apnea were observed before and after treatment. Results The overall effective rate of TCM syndrome was 90% (36/40) in the treatment group and 65% (26/40) in the control group, with statistical significance (P<0.05). Compared with before treatment, there was statistical significance in the scores of TCM symptoms, AHI, LSaO2, and longest apnea (P<0.05,P<0.01). After the treatment, compared with the control group, there was statistical significance in the scores of TCM symptoms, AHI, and LSaO2 in the treatment group (P<0.05,P<0.01). Conclusion Modified Sanzi Yangqin Decoction can effectively treat OSAHS and improve the life quality of patients.
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Objective To evaluate the effect of Eight Section Brocade on the lipid metabolism of people with mild dyslipidemia and phlegm dampness constitutionin communities.MethodsA total of 121 residents from the maple street community health service center and TCM outpatients in theXuhui district of Shanghai. Residents were randomizedly into intervention group with 61 residents and control group with 60 by the random number table method. Residents of control group received health education intervention daily, while residents of intervention group practiced Eight Section Brocade besides the education, All the residents continued their intervention until the 24thweek, and the index of blood lipid were evaluated.ResultsThe levels of serum TC 4.15 (2.06, 2.06) mmol/Lvs. 5.34 (3.18, 3.18) mmol/L,Z=-2.113; TG 1.55 (0.39, 0.39) mmol/Lvs. 1.77(0.38, 0.38) mmol/L,Z=-1.289; LDL-C 2.20 (0.42, 0.42) mmol/Lvs.2.50 (0.87, 0.87) mmol/L,Z=-1.237 of intervention group were significantly lower than those of the control group (P<0.05). The total effective rate of intervention group was significantly higher than the control group (91.8%vs. 76.7%;χ2=4.155,P=0.042). Conclusion The Eight Section Brocade with health education can significantly improve the community residents of lipid metabolism in Dampness-phlegmconstitution.
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Objective To investigate the clinical efficacy of acupoint catgut embedding in treating breast cystic hyperplasia of blood stasis-phlegm pattern.Methods One hundred and three patients with breast cystic hyperplasia of blood stasis-phlegm pattern were randomly allocated to a treatment group of 53 cases and a control group of 50 cases. The treatment group received acupoint catgut embedding and the control group took Rupi Sanjie granules. The symptom/sign scores and the qi stagnation transformation score were recorded and sex hormone levels were measured in the two groups before and after 12 weeks of treatment. The clinical therapeutic effects were compared between the two groups.Results The cure rate and the total efficacy rate were 50.9% and 92.5%, respectively, in the treatment group and 46.0% and 90.0%, respectively, in the control group. There were no statistically significant differences in the cure rate and the total efficacy rate between the two groups (P>0.05). There were statistically significant post-treatment differences in the symptom/sign scores (pain, mass hardness, mass range, mass size and accompanying symptoms scores) between the two groups (P<0.05). At the three-month and six-month follow-ups, there were statistically significant differences in the pain, mass range and accompanying symptoms scores as compared with at the end of treatment in the treatment group, and between the treatment and control groups (P<0.05). There was a statistically significant pre-/post-treatment difference in the qi stagnation transformation score in the two groups (P<0.01,P<0.05). There was a statistically significant difference in the qi stagnation transformation score at the three-month and six-month follow-ups compared with at the end of treatment in the treatment group (P<0.05). There was a statistically significant difference in the qi stagnation transformation score between the treatment and control groups at the end of treatment and at the three-month and six-month follow-ups (P<0.05). There was a statistically significant pre-/post-treatment difference in the E2 content in the two groups (P<0.05). There were statistically significant pre-/post-treatment differences in the P and PRL contents in the treatment groups (P<0.05).Conclusion Acupoint catgut embedding is an effective way to treat breast cystic hyperplasia of blood stasis-phlegm pattern.
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Phlegm syndrome, as the main syndrome of coronary heart diseases, not only its clinical signs and symptoms are clear, but also related with gene polymorphism, plasma metabolomics, genomics protein metabolism and urine metabolomics indicators, especially the close connection between serum lipids and phlegm syndrome in coronary heart diseases. The further research on the connection can be used as the references for the syndrome diagnosis and clinical treatment guidance, and provide solid foundation for TCM syndromes toward internationalization. This article pointed out that the treatment of coronary heart diseases should retain Chinese characteristics, focus on the basis of the phlegm syndrome, and pay attention to control lipid levels, in order to improve the clinical efficacy, and look forward to making progress in in-depth study on efficacy evaluation system of phlegm syndrome in coronary heart diseases.
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ObjectiveTo observe the effect of auricular point sticking plus acupressure on blood pressure and lipid in hypertension patients with a dampness-phlegm constitution.MethodThe eligible subjects were randomized into antreatment group of 38 cases and a control group of 40 cases. The control group was intervened by conventional medication, while thetreatment group was additionally intervened by auricular point sticking plus acupressure. Before and after intervention, the blood pressure and lipid levels [total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL)] were detected. ResultAfter intervention, the blood pressure, TC and TG levels were decreased in thetreatmentgroup (P0.05).ConclusionAuricular point sticking plus acupressure can somehow improve the blood pressure, TC and TG of hypertension patients with a dampness-phlegm constitution.
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Metabolic syndrome (MS) is a complex polygenic inheritance disease, caused by the accumulative effect of multiple genes and some environmental factors. Insulin resistance is the pathophysiologic foundation of MS. From the viewpoint of TCM, phlegm is the basic pathological factor of MS. In different periods and different symptoms of the disease, phlegm can be found during the whole disease course. Genes as an important component of the innate factors, play an important role in the formation of phlegm syndrome. Researches on correlation between susceptibility genes and phlegm syndrome in MS are important to enrich the connotation of phlegm syndrome and improve the level of diagnosis and treatment for this disease.
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[Objective] Have a research on therapeutic methods of phlegm syndrome of Li Ziyi in Qing dynasty, to sum up his therapeutic experience of such syndrome.[Methods]Analysis on the related states and cases on the base of researches on the contents of “Approaches of phlegmatic scrofula ”which was written by Mr. Li, elaborating his characteristics in treating such syndrome. [Results] Mr. Li considered that phlegm syndrome can be classified into milder phlegm and scrofula according to its level of the patient ’s condition and therapeutic effect. He also believed that several aspects should be taken into consideration through the therapeutic process:treat by internal combing with external treatment ,pay attention to seven emotions and smoothen the temper, emphasize nursing care and obey to the contraindication strictly. [Conclusion]There are features in Mr. Li ’s view on phlegm and his treating method of phlegm syndrome. His treating method has a good therapeutic effect and it is worth popularizing.
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This study was aimed to observe the effect of Sang-Ji (SJ) mixture in the treatment of Toll-like receptor 4 (TLR-4) expression on peripheral blood monocytes (PBMCs) in hypertensive patients. A total of 60 cases of hyper-tensive cases with overabundant liver-fire and phlegm syndrome were randomly divided into the treatment group and the control group with 30 cases in each group. Both groups received Felodipine and/or Benazapril treat-ment. The treatment group was added with SJ mixture. The observation duration was 28 days. The detection was made on indicators such as blood pressure , traditional Chinese medicine ( TCM ) syndrome scores and TLR-4 ex-pression on PBMCs before and after treatment. The results showed that after treatment, the blood pressure, TCM syndrome scores and TLR-4 expression on PBMCs of both groups decreased compared with that of the pretreat-ment . Changes on TCM syndrome scores and TLR-4 expression of the treatment group were more significant than that of the control group ( P < 0 . 05 ) . It was concluded that SJ mixture improved clinical symptoms in pa-tients with overabundant liver-fire and phlegm syndrome , decreased TLR-4 expression on PBMCs , in order to inhibit the immune response to a certain extent .
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[Objective] To conclude and inherit Professor Pan Zhimin clinical academic experience. [Methods]Through long-term copy with patient rounds , outpatient parties , the teaching methods of face-to-face , after clinical y reading a large number of cases to generalize the characteristics pathogenesis, and treatment of phlegm syndrome. [Results] Professor Pan Zhimin concluded that the formation and development of phlegm turbidity, have close relation with wet resistance, blood stasis and qi stagnation, which always concurr or interact with each other.Based on the method of dampness-transforming, water-disinhibiting, eliminating phlegm and blood stasis, and using the theory ofwu-ji, Professor Pan Zhimin always obtained good effects in the treatments. [Conclusion] Professor Pan Zhimin always grabs for the treatment of phlegm syndrome and wet resistance, blood stasis and qi stagnation, and for the disease and the onset of the chain of relationships,she is good at prescribing formula. Therefore the treating method has clinical value.
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Objective] In order to guide the treatment based on syndrome differentiation and to provide theory and thinking method for further research , the article researched the experience in treating phlegm syndrome of Pro.Wu Weikang,a prominent physician of Longjiang medical school,and discussed the four treatments of phlegm syndrome. [ Methods] The article researched experience in treatment of phlegm syndrome mainly from four aspects: ①searching for the primary cause of disease in treatment; ②harmonizing method with warm medicine; ③treat qi before phlegm; ④synchronic treating phlegm and blood stasis. [Results] Pro.Wu Weikang maintained that strange and chronic diseases are accompanied with phlegm. Thus he advocated that searching for the primary cause of disease in treatment,the treatment with mild medicine,the priority over qi treatment and the simultaneous treatment of both phlegm and stasis. These principles are widely used in clinic and highly effective. [Conclusion]The experience in prescription component of the treatment of phlegm syndrome not only has a high scientific content ,but also has significant guidance of clinical practice.
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Objective To explore the clinical efficacy of the Yiling-Qutan Decoction on treating Sub-health and the mechanism of traditional Chinese medicine.Methods 219 cases of Sub-health and belonging to dampness-phlegm syndrome and were collected and treated with Yiling-Qutan Decoction for 1 month.The effective rate of syndrome of traditional Chinese medicine and state of Sub-health,syndrome score of traditional Chinese medicine and sub-health status score were observed.Results The effective rate of syndrome of traditional Chinese medicine:7 patients were cured,35 cases were significantly effective,171 cases were effective and 6 cases were unfruitful.The improvement of syndrome score of and Sub-health status were also significantly better (P＜0.01).Conclusion It was effective to treat sub-health with Yiling-Qutan Decoction.
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Objective To observe relationship between the phlegm and adhesion molecule and further explore the functions of the phlegm in the metastatic potential of the tumors. Methods Examin the expression difference of ICAM-1,E-cad,MMP-9 of gastric cancer by enzyme linked immunosorbent assay between the phlegm-stamp type and non-phlegm-stamp type,then reducing phlegm by chinese medicine treatment and comparing theirs expression variation.Results The expressions of ICAM-1,E-cad, MMP-9 were obviouslv different between the phlegm group and non-phlegm group[(403.6±99.7)μg/L,(9.08±1.69)mg/L,(465.0±96.64)μg/L &(319.9±81.4)μg/L,(7.56±1.15)mg/L,(228.1±43.79)μg/L].After using xiao-tan-san-jie recipes,the expressions of ICAM-1 and E-cad of the phlegm group were obviously lower than before(P<0.05);the expression of MMP-9 was also falling down,but the difference was not significative.Conclusion There is a correlation between the phlegm and adhesion molecule, which could take action in tumor metastams by affecting adhesion molecule expression.
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Recently, many Chinese doctors have treated metabolic syndrome from pathogenic phlegm, dampness, stasis and heat, which not only meets the theory of TCM, but also has achieved good clinical effects, besides the method has been confirmed by animal experiments..
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OBJECTIVE:To observe the clinical efficacy of Yiqi tongmai decoction for coronary artery disease and angina pectoris and its intervention effect on patients'serum lipid level.METHODS: A total of 96 patients with coronary artery disease and angina pectoris were randomly assigned to two groups: 48(trial group) were treated with Yiqi tongmai decoction one dose daily for 4 weeks,and another 48(control group) with Guan-Xin-Ⅱ Decoction one dose daily for 4 weeks.RESULTS:The efficacy in angina pectoris and EKG in the trial group showed a significantly better improvement than in control group(P
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Objective To research photoelectric facial blood flow volume characteristic of premature coronary heart disease of heart blood stasis syndrome (HBSS) and phlegm syndrome (PS), and its relation with NO and ET. Methods Patients of premature coronary heart disease of HBSS (36 cases) and PS (35 cases) were selected, with 31 health people as control. The parameter of photoelectric facial blood flow volume was detected with GD-3 photoelectric blood stream plethysm (PBSP) of the facial color-diagnosis. NO was determined by nitrate reductase method and ET was determined by RIA. Results Hb, He, Hf, Hb/Tab and Hf/Hb of HBSS decreased obviously compared with the control (P
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This paper elucidates the diagnosis and treatment of phlegm syndrome in Jing-Yue Complete Works(Jing Yue Quan Shu from pathogenesis,syndrome differentiation,principle and method of treatment,recipe,medicines,diet and rest,which are used for reference in the modern clinical diagnosis and treatment of traditional Chinese medicine.The diagnosis and treatment of phlegm syndrome in Jing-Yue Complete Works(Jing Yue Quan Shu) is widely used in internal medicine,surgery,gynecology and pediatrics,etc.Based on the point of emphasizing yin-yang in person,Zhang Jingyue supposed that the diagnosis and treatment of phlegm syndrome should focus on spleen and kidney,strengthening the body resistance,treating symptoms in acute condition,choosing recipe and medicines according to the position and character of phlegm,diet and rest.
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One hundred and twenty cases of restenosis after percutaneous transluminal coronary angioplasty (PTCA) were subjected to TCM syndrome analysis.PTCA and support implantation were performed by routine method. The standard of TCM syndrome differentiation is subordinated to Professor Deng Tietao. The results showed that 78 cases (65%) were differentiated as Qi deficiency with phlegm-blood stasis, 13(11%) as yin deficiency with phlegm-blood stasis and 29 (24%)as phlegm-blood stagnation. It is indicated that Qi deficiency with phlegm-blood stasis is the main syndrome and reinforcing Qi dissipating phlegm and activating blood-flow may be a reasonable way of preventing and treating restenosis.