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Respiratory diseases are common， frequently-occurring clinical diseases. As the prevalence rate is increasing year by year， they have become a problem that seriously affects public health. The diseases are mainly located in the lung by traditional Chinese medicine （TCM） syndrome differentiation. Lung governs Qi and controls breathing and is also an organ for the storage of phlegm. Clinically， phlegm and Qi are often used for the treatment. Banxia Houputang （BHT）， originated from Synopsis of the Golden Chamber （《金匮要略》）， was used to treat plum-stone Ai （globus hystericus） at first. It is composed of Rhizoma Pinelliae， Cortex Magnoliae Offcinalis， Poria， Rhizoma Zingiberis Recens， and Folium Perillae， and treats diseases with the core pathogensis of mutual obstruction of phlegm and Qi. BHT has the effects of moving Qi， dissipating mass， descending adverse Qi， and resolving phlegm， which basically correspond to the pathological characteristics of the lungs. Clinical studies have confirmed that modified BHT can be used either alone or in combination with western medicine to treat chronic pharyngitis， asthma， chronic obstructive pulmonary disease， pneumonia， obstructive sleep apnea， upper airway cough syndrome and other respiratory diseases， with significant effects. It effectively improves the symptoms and signs of the diseases and reduces the recurrence rate. Basic research has shown that BHT plays anti-inflammatory， anti-oxidative stress， anti-apoptotic， autophagy-regulating， and iron overload-regulating roles by regulating the targets in multiple pathways. This paper， by combing the relevant literature in recent years， conducted a systematic review on BHT from the three aspects of syndrome analysis， clinical treatment research and mechanism research， with a view to providing theoretical basis and reference for the mechanism research of BHT in treating respiratory diseases and for expanding its clinical application.
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Objective:To explore the effectiveness and safety of comprehensive treatment of type 2 diabetes mellitus (T2DM) based on syndrome differentiation and diet.Methods:Prospective clinical study. A total of 147 patients with T2DM from September 2021 to August 2022 who met the inclusion criteria were included in the self-controlled trial. On the basis of diet and exercise intervention, the subjects were treated and observed with comprehensive treatment based on syndrome differentiation for 120 days. The main outcome indicators including TCM symptom score, fasting blood glucose (FPG), 2 hPG, HbA1c , Fasting insulin (FINS), C-peptide(C-PR), and the secondary outcome indicators including blood lipid (TC, TG, HDL-C, LDL-C), blood pressure, and safety indicators were performed before and after treatment.Results:After treatment, the FPG of subjects decreased from (8.75±2.26) mmol/L to (7.05±1.23) mmol/L, 2 hPG decreased from (10.75±3.01) mmol/L to (7.07±0.78) mmol/L, HbA1c decreased from (6.82±1.47)% to (5.49±0.63)%, and FINS decreased from (15.4±9.33) μIU/ml to (8.82±7.28) μIU/ml, C-PR decreases from (1.95±0.91) nmol/L to (1.72±1.53) nmol/L, SBP decreased from (137.51±17.94) mmHg to (125.79±7.57) mmHg, DBP decreased from (82.85±9.65) mmHg to (77.54±6.21) mmHg,TG decreased from (1.57±1.04) mmol/L to (1.25±1.24) mmol/L, HDL-C increased from (1.48±0.41) mmol/L to (1.66±0.46)mmol/L. The above differences were statistically significant ( P<0.05). Conclusion:The comprehensive treatment of T2DM based on syndrome differentiation and diet can significantly reduce the blood glucose indicators including FPG, 2 hPG, HbA1c, FINS and C-PR, and benefit blood pressure and blood lipids with no adverse reactions.
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Traditional Chinese Medicine (TCM) has certain advantages in the treatment of precancerous lesions of gastric cancer (PLGC) based on the holistic concept and the thought of syndrome differentiation. Currently, it is generally divided into 6 kinds of syndromes: liver and stomach qi stagnation syndrome, liver and stomach heat stagnation syndrome, spleen and stomach weakness syndrome (including spleen and stomach qi deficiency syndrome with coldness), spleen and stomach damp heat syndrome, stomach yin deficiency syndrome and blood stasis in stomach collateral syndrome. Clinically, the doctor should treat PLGC patients according to different syndrome types by using Chinese medicine prescription, which could improve the gastric mucosal pathological state, gastroscopy and clinical symptoms, to rehibit the development of precancerous lesions, reduce the incidence rate of gastric cancer. In the future, the doctors shouldreach the consensus of treating PLGC with TCM diagnosis, and focus on the research of TCM compounds or monomers with obvious curative effect, increase the times of follow-up, and evaluate the long-term curative effect.
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Acupuncture for Benign prostatic hyperplasia (BPH) pays attention to the syndrome differentiation theory, but also emphasizes the differentiation of the meridians, to obtain the better effective. At present, the clinical treatment of BPH is mainly based on deep acupuncture with filiform needle, electroacupuncture, warm acupuncture and moxibustion and comprehensive treatment of acupuncture and moxibustion, especially the comprehensive treatment of warm acupuncture combined with needle, Traditional Chinese Medicine and western medicine. Acupuncture treatment of BPH can reduce the prostate volume of patients, improve their lower urinary tract symptoms, improve their quality of life, without sever adverse events. BPH patients are often accompanied by emotional problems. It is suggested that acupuncture "treating spirit" should be further developed in clinical treatment to promote the application of acupuncture in the treatment of this disease.
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The pathogenesis of tic disorder in children is closely related to the dysfunction of the internal organs, especially the lung, spleen and liver. The main causes of tic disorder caused by visceral disorders are as follows: lung guard is the main cause of the disease, liver wind is the key to the pathogenesis and spleen deficiency and wind phlegm are the pathological basis. At the same time, the lung, liver, and spleen are mutually restrictive and affect each other. The main manifestations are that if the lung is affected by evil, the wood will punish the gold; if the spleen is insufficiency and the liver is hyperactive, the earth deficiency will be leading to over-restriction by wood. Based on the understanding of the related theories about viscera's disease and viscera's generation, we pay attention to distinguish the etiology and pathogenesis of the viscera, and we treat tic disorders based on syndrome differentiation of lung, liver and spleen with curative effect.
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The theory of generation and restriction among five elements， as one of the basic theories in traditional Chinese medicine （TCM）， reveals that treating disease should focus on the root. Since its first record in Huangdi's Internal Classic （Huang Di Nei Jing）， this theory has been covered in many chapters of Synopsis of the Golden Chamber （Jin Gui Yao Lue） and further developed by physicians of later generations， allowing it to serve as a guide for clinical treatment of various diseases. Diabetic nephropathy （DN） is one of the most common complications of diabetes and also a main risk factor for death and disability by virtue of the long-term disease course and complex symptoms. At present， no specific drug is available in western medicine. Considering the close relationship of its complicated etiology and pathogenesis with the five zang organs， DN treatment should focus not only on the kidney， but also other zang organs. Guided by the theory of generation and restriction among five elements， this article believes that DN mainly results from kidney deficiency combined with spleen deficiency and its dysfunction in regulating the water passage. In addition， the exuberance of heart fire and the failure of liver to govern the free flow of Qi are also responsible for the occurrence of DN. Clinically， the therapeutic methods proposed based on theory of generation and restriction among five elements are recommended for DN treatment after the differentiation of actual manifestations into specific syndromes. Specifically， the method of replenishing Huo to nourish Tu is applicable to DN patients with spleen and kidney yang deficiency， the method of nourishing Shui to moisten Mu to those with liver and kidney yin deficiency， the method of mutual generation between Jin and Shui to those with lung and kidney yin deficiency， the method of banking up Tu to generate Jin to those with lung and spleen Qi deficiency， the method of purging the heart and tonifying the kidney to those with non-interaction between heart and kidney， and the method of banking up Tu to control Shui to those with spleen deficiency and fluid retention. Such timely and effective interventions are conducive to delaying the development of DN to end-stage renal disease （ESRD） and improving the clinical outcomes. This article discusses the application of the theory of generation and restriction among five elements in TCM to DN treatment， aiming to provide a theoretical basis for the future application of such new diagnosis and treatment ideas.
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This paper discusses the rational use of traditional Chinese medicine based on chemical composition, body state and biological effect. The essence and connotations of traditional Chinese medicine are explained by modern scientific theory and technical means, and the mechanism of traditional Chinese medicine in the treatment of diseases is defined in modern medicine language, which is conducive to promoting rational and safe clinical use of drugs. Based on the chemical composition of traditional Chinese medicine,the selected genuine medicinal materials were collected and processed in a standardized way, and then used in the combination with other traditional Chinese medicines, with the aim to improve the efficacy of traditional Chinese medicine in clinical indications, increase the advantages, eliminate the disadvantages, and adapt to flexible and safe clinical drug demands. Based on the body state elements, clinical diagnosis and treatment shall be patient-centered, and doctors shall distinguish the differences of pathogenesis, symptoms and diseases, and consider the drug contraindications of special groups. According to the " dose-effect-toxicity" relationship, doctors shall select the appropriate dosage form, control the drug dosage, balance the benefits and risks of drugs, and carry out appropriate medical treatment. Based on the biological effect elements and the regulatory mechanism of traditional Chinese medicine on the target and pathway of disease, traditional Chinese medicine shall strengthen the precise positioning, provide accurate treatment; evaluate the safety of traditional Chinese medicine combination, explore the adverse reaction mechanism, strengthen the clinical safety monitoring of traditional Chinese medicine, and guide the clinical rational use of drugs, in the expectation of ensuring the safe use of traditional Chinese medicine and maximize the clinical efficacy of traditional Chinese medicine.
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Humans , Contraindications, Drug , Drug Dosage Calculations , Drugs, Chinese Herbal/therapeutic use , Medicine, Chinese Traditional , Practice Patterns, Physicians'ABSTRACT
Objective@#To observe the curative effect of TCM syndrome differentiation and treatment for novel coronavirus pneumonia (novel coronavirus pneumonia, NCP) patients and the preventive effect for Chinese medical staff.@*Methods@#A total of 62 NCP suspected patients admitted in 2020 were treated with TCM syndrome differentiation and treatment, as well as our hospital medical staff with No.1-4 hospital prescription.@*Results@#After taking traditional Chinese medicine, 16 out of 25 NCP suspected patients with phlegm heat stagnating lung syndrome were discharged to home for isolation observation, 4 patients hospitalized for observation, and 5 patients confirmed with NCP. For 15 patients with phlegm dampness accumulating lung syndrome, 7 patients were discharged to home for isolation observation, 3 patients were hospitalized for observation and 5 patients have been confirmed. For 18 patients with spleen stomach disharmony syndrome, 15 patients were discharged to home for isolation observation, 1 patient was hospitalized for observation and 2 patients have been confirmed. For 4 patients with Qi deficiency and dampness stagnation syndrome were discharged to home for isolation observation, 1 patient was hospitalized for observation, and two have been confirmed. The duration of taking traditional Chinese medicine was 1 to 20 days from admission to be discharged. The doctors and nurses who took the prescription of TCM for 12 to 15 days have been prevented from NCP infection.@*Conclusions@#The clinical effect and the preventive effect of TCM syndrome differentiation and treatment for NCP have been proved to be satisfactory. TCM can go into the primary hospital for treatment and prevention on NCP.
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At present, viral myocarditis is still an important problem to be solved in clinical practice. Traditional Chinese medicine (TCM) has unique advantages in the treatment of this disease. However, there is still a lack of relevant clinical practice guidelines to standardize and guide the diagnosis and treatment of this disease by TCM. Within the framework of relevant laws, regulations and technical guidance documents, International Clinical Practice Guideline of Traditional Chinese Medicine·Viral Myocarditis was developed by consensus of experts through the classification of evidences and recommendation of opinions based on relevant clinical research evidences at home and abroad in recent years. This guideline introduces the diagnosis, etiology, pathogenesis, syndrome differentiation and treatment, acupuncture treatment, prevention and rehabilitation of viral myocarditis. And it will provide guidance for clinicians of TCM and integrated Chinese and western medicine engaged in the prevention and treatment of viral myocarditis.
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Objective@#To observe the curative effect of TCM syndrome differentiation and treatment for novel coronavirus pneumonia (novel coronavirus pneumonia, NCP) patients and the preventive effect for Chinese medical staff.@*Methods@#A total of 62 NCP suspected patients admitted in 2020 were treated with TCM syndrome differentiation and treatment, as well as our hospital medical staff with No.1-4 hospital prescription.@*Results@#After taking traditional Chinese medicine, 16 out of 25 NCP suspected patients with phlegm heat stagnating lung syndrome were discharged to home for isolation observation, 4 patients hospitalized for observation, and 5 patients confirmed with NCP. For 15 patients with phlegm dampness accumulating lung syndrome, 7 patients were discharged to home for isolation observation, 3 patients were hospitalized for observation and 5 patients have been confirmed. For 18 patients with spleen stomach disharmony syndrome, 15 patients were discharged to home for isolation observation, 1 patient was hospitalized for observation and 2 patients have been confirmed. For 4 patients with Qi deficiency and dampness stagnation syndrome were discharged to home for isolation observation, 1 patient was hospitalized for observation, and two have been confirmed. The duration of taking traditional Chinese medicine was 1 to 20 days from admission to be discharged. The doctors and nurses who took the prescription of TCM for 12 to 15 days have been prevented from NCP infection.@*Conclusions@#The clinical effect and the preventive effect of TCM syndrome differentiation and treatment for NCP have been proved to be satisfactory. TCM can go into the primary hospital for treatment and prevention on NCP.
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Meridians include (Qi) channels and blood (vessels). In Duyi Suibi, ZHOU Xue-hai of qing Dynasty named the terminal of Qi channel as"fine collateral of Qi" and the terminal of blood vessel as"fine collateral of blood". Qi channels of the heart cover extensive regulating mechanisms including cardiac pacing and conducting system. Blood vessels of the heart cover circulation system of coronary artery. Cardiac Qi channels and blood vessels are coordinated mutually, and Ying and Wei run together, to jointly maintain normal functions of the heart. Abnormal Yingwei caused by various pathogenic factors leads to occurrence of arrhythmia. Based on the Yingwei theory of vessel-collateral theory, this paper puts forward treatment based on syndrome differentiation of arrhythmia guided by therapeutic principle of"regulating Yingwei in case of heart damage" (Nanjing·14thNan) as well as addresses both symptoms and root causes by prescriptions for regulating Wei, Qi, Ying and blood through sufficiently considering modern pathogenic factors and pathogenic characteristics, in order to provide beneficial reference for clinical diagnosis and treatment.
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Cancerous fever is one of the common symptoms of advanced malignant tumors,which seriously affects the quality of life and survival of patients. At present,the clinical research on the treatment of cancerous fever by traditional Chinese medicine is limited,and there is a lack of research on the medication rules from multiple dimensions of disease-symptom-syndrome. The treatment of cancerous fever has not made substantial progress. In this study,we collected the literature on treatment of cancerous fever in Chinese medicine,and concluded that common syndrome types include Yin deficiency type,Qi deficiency type,Yang deficiency type,blood stasis type,damp-heat accumulation type,toxic heat flourishing type and liver meridian stagnated heat type. Two hundreds and fifty-seven prescriptions for Chinese medicine and 249 flavors for single medicine were extracted. The analysis of the drug composition of the drug found that the cancerous fever treatment was mainly based on heat-clearing drugs and deficiency-nourishing drugs. Apriori association analysis of the drug found that the second and third related drugs were mainly Rehmanniae Radix,Moutan Cortex,Artemisiae Annuae Herba,Trionycis Carapax and Anemarrhenae Rhizoma. The top five gray correlation degrees were Psoraleae Fructus,Bupleuri Radix,Hordei Fructus Germinatus,Scutellariae Radix and Massa Medicata Fermentata. And seven new prescriptions were evolved. The results showed that the treatment of cancerous fever can be started from the disease-symptom-syndrome,nourishing Yin and clearing heat is an important method for " disease differentiation and treatment". The combination of Bupleuri Radix and Scutellariae Radix is the embodiment of " symptom differentiation and treatment". The new prescriptions conform to the idea of " syndrome differentiation and treatment" of traditional Chinese medicine can provide reference for clinical medication. The grey screening method combined with multivariate analysis method was used to analyze the prescription rules of Chinese medicine in the treatment of cancer fever,which followed the black box structure of traditional Chinese medicine,made the potential rule of prescriptions explicit,broadened its thinking of Chinese medicine treatment,and made up for the deficiency of traditional analysis methods.
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Humans , Drugs, Chinese Herbal , Therapeutic Uses , Fever , Drug Therapy , Medicine, Chinese Traditional , Meridians , Multivariate Analysis , Neoplasms , Drug Therapy , Quality of LifeABSTRACT
"Only one syndrome is evident for disease", a clinical guiding ideology in the Treatise on Febrile Diseases proposed by Zhang Zhongjing, has caused widespread controversy among physicians over the ages. The core lies in the divergence of the understanding of "one syndrome". The reason is that although many physicians sum up experience on the basis of their clinical experience, the premise of the clinical environment is ignored when interpreting the connotation. On the one hand, "only one syndrome is evident for disease" emphasizes the flexibility of grasping the main symptoms clinically. On the other hand, it emphasizes the evidence sufficiency of "one syndrome" as the basis for diagnosis. Generally speaking, specific symptoms are higher evidence as a basis for diagnosis. However, because of the clinical complexity, the symptoms with lower specificity, less targeting and lower evidence strength in common cases may become the key points of the final prescription selection in specific cases sometimes, increasing the strength of evidence and becoming the only important factor in determining the overall situation. In addition to the objective clinical conditions, some subjective factors such as clinical level and academic quality of the physicians are also important factors that affect the clinical application of "only one syndrome is evident for disease". Therefore, it is necessary to not only pay attention to the clinical objective conditions, but also try to improve the physicians' clinical level, appreciate the "only one syndrome is evident for disease" thought in the clinical environment, which is the key to solve this problem.
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Vertigo is common in the clinic. On the basis of experience in clinical treatments, this article proposed new concepts in etiology and pathogenesis of vertigo, emphasized exogenous factors, blood stasis and so on in the incidence of vertigo, and put forward new TCM syndrome types of vertigo and clinical medication, which has achieved positive efficacy in clinic.
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Combined with circular motion thoughts, this article believed that kidney-yang deficiency, dysfunction of the spleen in transport and stagnation of hepatic qi are the pathogenesis of IgA nephropathy. The general principles of treatment should be warming and recuperating the kidney-yang, invigorating spleen and relieving the depressed liver, but its development is a dynamic process.
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[Objective]To research professor ZHANG's clinical experience in treatment of metrorrhagia. [Methods] By following professor ZHANG diagnosis long time, it summarizes ZHANG's experience of Chinese medicine treatment on uterine bleeding and academics from the etiology and pathogenesis.[Results] ZHANG thinks that the pathogenesis of metrorrhagia, both cold and heat, will cause Chong Ren imbalance, so the method to reconstruct the menstrual cycle as the fundamental purpose, comprehensive use of TCM and western medicine adjuvant hormonal therapy. In the acute hemorrhage, the use of clearing heat and bleeding, liver-spleen -harmonizing remission with artificial cycle therapy according to syndrome differentiation and treatment of hemorrhage, clarifying the source and rectifying the primary on the basis of syndrome making a better clinical effect during the remission. [Conclusion] Professor ZHANG's treatment of uterine bleeding experience, unique, has a strong clinical significance, with learning and promotion of application value.
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[Object]To]explore the academic view and clinical experience of Professor MIN 's treatment based on syndrome differentiation in psoriatic arthritis. [Methods] Through the study with MIN, organising clinical medical case, discussing Professor MIN 's academic view and clinical experience in psoriatic arthritis from the etiology and pathogenesis, treatment based on syndrome differentiation, principles and methods,summing up prescription, and stating a classic case as an evidence. [Results] Professor MIN summarizes the pathogenesis of psoriatic arthritis as"dampness","stasis" and"weakness". The exogenous wind, cold, dampness and heat evils, left in the muscle and joints,leading to qi stagnation and blood stasis, meridian discord and active barrier, ultimately to liver and kidney deficiency. Professor MIN also suggests that the treatment of psoriatic arthritis should grasp the principle of sixteen words"Detect Early, Treat Simultaneously,Intervene Early, Make Confidence".[Conclusion] MIN Zhongsheng's treatment based on syndrome differentiation in psoriatic arthritisis is clinically effective and has the value of popularization and application.
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Objective To explore suitable pre-processing methods for the TCM clinical data based on prospective study on insomnia treated by syndrome differentiation. Methods Based on the TCM shared clinical and research information platform and by using man-machine combination method, data cleaning rules, physician review, rule revision, procedural import and batch processing were used to conduct pre-processing for data in prospective study on insomniac treated by syndrome differentiation of 8 TCM doctors. Results Totally 27534 rules for symptoms data of individual treatment of insomnia were made and 1036 rules for diagnostic data, 842 rules for therapeutic ways, 540 rules for formula data, 3785 rules for data of Chinese materia medica. Conclusion Different kinds of terminology concepts were normalized at different levels, at the same time, characteristics of individualized treatment based on syndrome differentiation were reserved. Appropriate pre-processing methods can be used in the reaserch of individualization and standardization of TCM syndrome differentiation clinical data and can provide support for data mining.
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Based on the records of ancient medical books, this article analyzed the etiology and pathogenesis of primary bile reflux gastritis. Combined with the clinical diagnosis and treatment experience and thinking, this article explained from various aspects of the principle, method, formula, and medicine, and divided the treatment into three steps, with a purpose to provide references for clinical treatment.
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Objective]To introduce professor YU Jingmao’s experience in treament of children with adenoid vegetation. [Methods]To select 3 effective cases of adenoid vegetation diseases, clarify professor YU Jingmao’s features of treatment based on syndrome differentiation, stage therapy and drug characteristics, and then analyze and expound the clinical experiences of professor Yu Jingmao. [Result]Professor YU Jingmao in infantile adenoid vegetation body therapy, treats in three stages:the early cure dispelling wind pathogens to clear heat reducing swelling;medium-term plans to raise Yin and moisture lung, promoting blood circulation to remove blood stasis;late to invigorate qi for consolidating superficies, nourish yin to clear away heat,often obtains better effect. [Conclussion]Professor YU Jingmao’s dialectical claim of in treatment of adenoid vegetation,stage therapeutics,purgation-tonifying and cultivste vital qi are worth learning.