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Gastroesophageal reflux disease （GERD） is a frequently and commonly occurring disease in clinic. In recent decades， with the development in pathophysiology and drug researches， modern medicine has achieved remarkable progress and results in diagnosis and treatment. However， the treatments for non-erosive reflux disease， refractory gastroesophageal reflux disease， proton pump inhibitor resistance， overlap of disease symptoms， and extraesophageal symptoms are limited and ineffective. Traditional Chinese medicine （TCM） was widely used in clinical practice， which has been proved effective in relieving symptoms and improving the quality of life. Sponsored by China Association of Chinese Medicine （CACM） and undertaken by the Spleen and Stomach Disease Branch of CACM， "the 12th Youth Salon of Clinical Predominance Disease Series （GERD）" invited 18 authoritative digestive experts of TCM and western medicine to discuss "the difficulties of clinical diagnosis and treatment of GERD and TCM advantages". The focus issues such as modern medical diagnosis and treatment achievements and contributions， improvement and maintenance of symptoms， response to overlapping disease symptoms， reduction and withdrawal of acid suppressors， and treatment of extra-esophageal symptoms were discussed in depth. TCM and western medicine exchanged and complemented each other's strengths， combing the difficulties of modern medical diagnosis and treatment， which clarified the positioning and advantages of TCM and provided guidance for clinical and scientific research.
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Depression is a mental illness characterized by persistent negative feelings， which has seriously threatened people's health. In recent years， neuronal autophagy， an important stress response， has also been regarded as a hypothesis for the pathogenesis of depression. Relevant studies have shown that either insufficient or excessive autophagy triggers neuronal damage， and activated or inhibited neuronal autophagy can be observed in animal models of depression. Therefore， neuronal autophagy may be a double-edged sword involved in the pathogenesis of depression. It is believed in traditional Chinese medicine （TCM） that the occurrence of this disease is closely related to liver depression and spleen deficiency. Chinese medicine regulates the neuronal autophagy via multiple ways. The TCM monomers that regulate neuron autophagy are capable of protecting nerves or penetrating the blood-brain barrier. TCM compounds designed for soothing liver or invigorating spleen have been proved effective against this disease， demonstrating that the core pathogenesis of depression lies in liver depression and spleen deficiency. The regulatory effects of TCM on neuronal autophagy in depression models might result from its action on multiple targets， multiple pathways， and multiple systems. This paper discussed the limitations in current research based on the involvement of neuronal autophagy in depression and its treatments， in order to provide ideas for later similar research and that concerning TCM treatment of depression.
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The tumor incidence goes up with every passing year. Chemotherapy， as one of the main treatment methods， is faced with a major challenge of drug resistance in clinical practice. Tumor-associated macrophages （TAMs） are the key factors inducing chemotherapy resistance of tumors. TAMs are inflammatory cells with the largest number in the tumor microenvironment， which are widely distributed in such epithelial tissues as large intestine and stomach in the immune environment and closely associated with multiple common cancers like breast cancer and colorectal cancer. TAMs can be divided into two phenotypes， with M2-polarized TAMs into the tumor-promoting phenotype that affects the oncogenesis and progression and promotes drug resistance via immune escape， angiogenesis and other ways. At the same time， the frequently utilized chemotherapeutic agents will increase the recruitment of TAMs and trigger the secretion of cytokines， leading to the excessive polarization of macrophages to M2 type， followed by tumor drug resistance. The molecular mechanism of chemotherapy resistance is complex， which is becoming an urgent problem in the field of chemotherapy. Traditional Chinese medicine （TCM） has exhibited unique advantages in resisting tumor drug resistance. It has been proved efficient and safe in improving tumor microenvironment and regulating TAMs by acting on multiple targets via multiple ways， thus adjusting tumor progression and improving drug resistance. Based on related articles published in recent years， this paper reviewed the drug resistance-promoting effect of TAMs via regulating the immune microenvironment and interacting with tumor stem cells and the driving effect of chemotherapeutic agents on drug resistance to figure out the role of TAMs in chemotherapy resistance. Besides， it summarized the mechanisms of TCM in regulating related cytokines， proteins， activity， and the polarization direction of TAMs to expound the effective components of TCM in the intervention of drug resistance. The aim of this paper was to provide reference for further research on the biological mechanism of chemotherapy resistance and its targeted intervention with TCM.
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Objective: To investigate the clinical efficacy of Yaotongning Capsule in relieving osteoporotic bone pain in the elderly. Methods: A total of 120 patients with pain VAS score between 3 and 8 in the department of orthopedics and traumatology, Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from September 2018 to December 2019, in accordance with the diagnostic criteria of senile osteoporosis, were randomly divided into control group (60 cases) and treatment group (60 cases). The control the group was treated with oral Calcium Carbonate and Vitamin D3, 0.6 g, once a day; The treatment group was treated with Yaotongning Capsule on the basis of control group, four capsules each time, 0.5 h before sleeping every night, with 10 mL yellow wine mixed with a small amount of warm boiled water. The dosage of other anti-osteoporosis drugs should not be changed. The drug was administered continuously for 2 weeks. The patients were followed up for 0, 3, 7 and 14 d, respectively, with a time window of ± 1 d. After treatment, according to the changes of visual analogue scale (VAS) score in each visit period, the curative effect was evaluated according to the improvement of pain degree. Serum pain media levels were tested between two groups before and after treatment. Results: The total effective rate of 60 patients in the treatment group was 91.7%. The total effective rate of 60 patients in the control group was 23.3%, which was significantly lower than that in the treatment group, and the difference between the two groups was statistically significant. The scores of pain before and after treatment in the observation group were lower than those in the control group (P < 0.01). After 14 d of treatment, the levels of PGE2, SP and 5-HT did not change significantly in the control group, but decreased significantly in the treatment group (P < 0.01). Conclusion: The results of this study show that Yaotongning Capsule has a rapid onset and significant effect in relieving bone pain of senile osteoporosis.
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Taking peroral dermatitis as an example, this article discussed difficulties in diagnosis and treatment and treatment ideas of TCM dermatology, and pointed out the importance of syndrome differentiation of the six meridians and pulse diagnosis.
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Gastric polyps are frequently occurring diseases of the digestive system, which are easy to recur. Some of the polyps are prone to canceration. Western medicine is currently under endoscope surgery. Although the curative effect is exact, the recurrence rate is high. Professor ZENG Bin-fang, after years of clinical research and experience, concludes that the basic pathogenesis of gastric polyps is deficiency of spleen and stomach, spleen qi deficiency and qi deficiency through the disease, and they are also important reasons for its recurrence. Accordingly, invigorating the spleen, invigorating qi and activating blood circulation, regulating qi and reducing phlegm dampness, and strengthening the body resistance to eliminate pathogenic factors are proposed to treat gastric polyps. In addition, the Yiqi Sanjie Decoction was created, with good clinical efficacy. But for gastric polyps of d＞ 0.5 cm, it is still recommended to take gastroscopic treatment before taking TCM treatment, which can shorten the course of TCM, relieve the physical and mental burden of patients, and prevent patients from interrupting treatment because they can not take TCM for a long time, to affect the curative efficacy.
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Objective To analyze the death cases of the oncology inpatients of the First Hospital of Hunan University of Chinese Medicine (hereinafter referred to as "this hospital") during 2007-2016; To provide the basis for the prevention and treatment of cancer, prognosis improvement and rational allocation of TCM health resources. Methods The death cases of the oncology inpatients from 2007 to 2016 were analyzed by retrospective medical history method from the aspects of causes of death, hospitalization costs and survival time. Results There were 830 death cases of the oncology inpatients in the hospital during 2007-2016, with 548 males and 282 females, and the mortality rate decreased year by year. The average hospitalization costs for patients was 39 630.86 yuan, of which TCM treatment cost 6206.98 yuan (15.66%). Patients with colon cancer had the highest proportion of TCM treatment costs (20.10%), followed by lung cancer, breast cancer, and liver cancer. The top five causes of death were lung cancer, liver cancer, breast cancer, colon cancer, and rectal cancer. The sex ratio of patients who died of lung cancer was 1.61:1. The average survival time of male patients was 446.3 days, which was far lower than the 738.3 days of female patients. The cancers with long-term survival periods were cervical cancer, breast cancer, and rectal cancer. The cancers with shorter survival periods were pancreatic cancer, liver cancer, and lung cancer. Conclusion The structure of death causes of the oncology inpatients in the hospital has a certain degree of representation. The prevention and control of lung cancer, especially male lung cancer should be strengthened; TCM health resources and prevention should be utilized rationally; the prognosis of patients with liver cancer should be improved, to improve the overall survival and quality of life of patients with breast cancer or cervical cancer, which is important for the prevention and treatment of malignant tumor.
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DENG Tie-tao is a national TCM doctor and Ruangan Decoction is one of his empirical formulae for liver cirrhosis. It includes functions of tonifying spleen and nourishing liver, reinforcing kidney, enriching blood and invigorating the circulation of blood, manifesting the theory of correlation of five zang, which focuses on entirety but also the sick part.The Ruangan Decoction displays some methods as nourishing,smoothing and regulating the liver, which provides simple and effective methods for TCM treatment of liver cirrhosis.
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The pathogenesis of edema disease is related to the Qi activity.However,in the past the understanding of edema disease is mostly centered on the theory of viscera,and it is less discussed from the perspective of Qi activity.This paper explores the edema disease from the perspective of Qi activity.The relationship can be summarized as "Water metabolism depend on the movement of Qi",so the treatment of edema disease should be paid attention to the Qi activity.In the case of digestive diseases,cirrhosis ascites is a common edema disease.This article analyzes the cirrhosis ascites as an example.
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[Objective] Exploretreatment of simultaneous upper and lower diseases focusing on spleen and stomachin specific therapy of malignant tumors. [Methods]Through hackling origin of history,analyse clinical manifestations of cancer patients in viscera,limbs,guan orifices and so on.Combined with typical case,we explore concrete treatment method of treatment focusing on spleen and stomachand diet taboo and suitable. [Results]Patients with malignant tumor mostly perform simultaneous upper and lower diseasesin end-stage of disease or accepting modern medical treament frequently. According to therapeutic thoughts of paying attention to the spleen and stomach of past dynasty medical practitioners and strategic treatment methods oftreatment focusing on spleen and stomachof YE Tianshi,we proposed it should supplement the middle at first in therapy of cancer.Eliminating pathogenic factors and regulating should not damage the spleen and stomach.And we advocate using insect drug timely and appropriately to attack pathogenic qi.[Conclusions]TCM pays attention to regulating the function of the spleen and stomach in the whole treatment of cancer.
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Severe traumatic brain injury is a common clinical emergency, which is often combined with pulmonary contusion syndrome, and the treatment will be more difficult. This article started from the integration of traditional Chinese and Western medicine, and adoptedHuoxue Tongfu therapy by targeting the key pathogenesis qi stagnation and blood stasis of the disease, which achieved satisfactory efficay.
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Subacute thyroiditis is a common type of thyroid pain disease. Severe symptoms include fever and severe pains in the thyroid gland. Throughout many years of clinical experience, the author found that TCM treatment for subacute thyroiditis is effective, with less adverse reactions. This article reported two cases of subacute thyroiditis treated recently.
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Palmer-foot hyperhidrosis is one kind of focal hyperhidrosis, with symptoms of sweating hands or feet. Some people even have sweat dripping off their hands or feet. This article studied the views of TCM on palmer-foot hyperhidrosis, expounded the pathological and physiological relationship between palmer-foot hyperhidrosis and spleen and stomach, and proposed that clinical treatment should be based on the syndrome differentiation and treatment of spleen and stomach, which can achieve certain efficacy.
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Traditional Chinese medicine has advantages in treating chronic glomerulonephritis. According to the articles in recent years, the therapeutic methods of TCM include not only syndrome differentiation, but also symptomatic treatment, modification of the chief prescriptions, Chinese traditional patent medicine, single Chinese herb, and combined internal and external treatment, which all have achieved some remarkable effects. However, the majority of articles were about personal experience and clinical observation which lack experimental study on the therapeutic mechanism. Therefore, the results of relative researches should be under objective evaluation. A large number of experimental researches on the therapeutic mechanism and standardized clinical observation need to be carried out in the future.
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Objective] To explore the clinical experience of Professor Zhang Juan on Elderly Diabetic Constipation and hope to provide a new perspective for future study about Chinese medicine treatment of Diabetes Mellitus(DM).[Method] Reviewed 103 cases from Sep. 2014 till now who were older than 65,diagnosed with DM and had constipation as primary symptom. Analyzed and summarized the syndrome differentiation and treatment of the cases. [Results] According to the etiology and pathogenesis of Elderly Diabetic Constipation ,Professor Zhang deems that its pathogenesis takes place in two stages:one is spleen deficiency,the other is kidney deficiency and proposes the therapy of“treat the middle-jiao if others are not working”,“nourish the natal qi with post-natal qi”,“combine disease,syndrome and symptom”and“treat in stages”.[Conclusion] The treatment on Elderly Diabetic Constipation raised by Professor Zhang is effective and her clinical experience has important clinical value .
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Chronic atrophic gastritis, which is the precancerous lesions of gastric cancer, has no good effect in west-ern medicine treatment. However, traditional Chinese medicine (TCM) has achieved certain effect in recent years. This article mainly discussed from aspects of etiology and pathogenesis, syndrome differentiation, therapies and for-mulas, acupuncture treatment, famous doctors’experiences, and integrative medicine treatment. The research pro-gress was summarized on TCM treatment and integrative medicine of this disease in recent 5 years.
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ObjectiveTo investigate the therapeutic effects of advanced lung adenocarcinoma treated with TCM treatment based on syndrome differentiation combined with Gefitinib.MethodsAll cases were recruited from adenocarcinoma of lung patients in Hunan Province Cancer Hospital from February 2008 to February 2010.These 56 adenocarcinoma of lung patients were randomly divided into a treatment group (30cases) and a control group (26 cases).The control group was treated with Gefitinib,250 mg/d,until the disease getting progress or the patient showing intolerable untoward reaction; while the treatment group was treated with TCM syndrome differentiation based on the control group.ResultsAfter the treatment,the total therapeutic effects was 90.00％ in the treatment group than 65.38％ in the control group (x2=5.40,P＜0.05); symptoms score in both group decreased after the treatment,comparing with the same group before the treatment,with the difference was statistical significance (tthe treatment group=9.2446,tthe control group=2.7778,both P＜0.01) ;non-progressive survival rate of half year,1year and 2year was 66.67％,50.00％ and 30.00％ respectively,and survival rate of lyear and 2yenr was 73.33％ and 46.67％ respectively,in the treatment group,while non-progressive survival rate of half year,lyear and 2year was 38.46％,23.08％ and 7.69％ respectively,and survival rate of 1year and 2year was 46.15％ and 19.23％ respectively,in the control group,showing statistical difference between the two groups (x2 value was 4.46、4.31、5.44、4.31、5.27,P value was 0.03、0.04、0.02、0.04、0.02,all P＜0.05 ) ; the effective power of KPS was 76.67％ and 46.15％ in the treatment and the control group respectively,showing statistical difference(x2=6.24,P＜0.05) ; both groups were absent of such side effects of hematology,heart,liver and kidney toxicity,and interstitial pneumonia,but the incidence rate of Ⅱ ～ Ⅲ degree rash and diarrhea was significantly decreased in the treatment group,comparing with the control group(x2=4.49、4.37,P＜0.05 ).ConclusionThe therapy of TCM treatment based on syndrome differentiation combined with Gefitinib can improve living quality,control aggravation of disease,prolong life span and enhance survival rate of the patients with advanced lung adenocarcinoma.
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Objective To investigate the therapeutic effects of treating chloasma with Huoxue Xiaoban Decoction.Methods A total of 80 cases were randomly recruited into a control group and a treatment group, 40 cases in each group. The treatment group was treated with Huoxue Xiaoban Decoction, while the control group was treated with high dose of Vitamin C. After both groups were treated for a therapeutic course of four weeks, the therapeutic effects were compared between them. Results The total effective rate was 85.0% and 47.5% in the treatment group ands the control group respectively, showing significant difference between the two group (χ2= 12.26, P＜0.01 ) . Conclusion Huoxue Xiaoban Decoction was effective in treating chloasma.
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Objective To explore the rule for treating salpingemphraxis infertility with TCM . Methods A comprehensive analysis was made based on relative literatures and self clinical experience. Results TCM had experienced a relatively big progress in treating salpingemphraxis infertility from etiology, treatment based on syndrome differentiation,combined therapy of syndrome differentiation and disease differentiation, specific formula for specific disease, acupuncture,massage, paste of Chinese medicine, and lab researches. Conclusion TCM had sound clinical effects in treating salpingemphraxis infertility.
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In broad definition,diseases caused by exogenous pathogenic factors involve with respiratory system,digestive system,urinary system,and nervous system;While concerned with internal medicine of respiration,they are common cold,upper respiratory tract infection,acute tracheitis and bronchitis.Clinically,we call diseases that caused by external pathogens,showing symptoms of respiratory system in general,as FeiXi Waigan Bing(lung system diseases caused by external pathogens).In curing these diseases,we integrated traditional Chinese and western medicine and got satisfactory clinical effect.This demonstrated the advantages and features of Traditional Chinese medicine in curing lung system diseases caused by external pathogens.