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Immune checkpoint inhibitors （ICIs） have shown good efficacy in tumor treatment and have changed the landscape of tumor treatment. However， some patients treated with ICIs have not only failed to achieve the desired therapeutic effect， but also developed an atypical response pattern of abnormally accelerated tumor growth， namely hyperprogressive disease （HPD）. The pathogenesis of HPD is still unclear and it is difficult to diagnose， which poses a challenge for clinical identification and treatment decisions. Exploring the underlying mechanism of HPD is important to improve the effect of immunotherapy. Based on the theory of "Yang deficiency and toxic knot"， this paper discussed the mechanism of HPD in immunotherapy from the perspective of "spleen and kidney Yang deficiency and hefty toxic pathogens". It was concluded that the inactivation of p53 oncogene and immunosuppressive microenvironment were the manifestations of the deficiency of healthy qi in the body and declined yang in the spleen and kidney， serving as an important basis for the occurrence of HPD. Adverse reactions caused by ICIs belong to the category of "drug toxicity". The occurrence and development of murine double minute 2 （MDM2）/murine double minute 4 （MDM4） activation， epidermal growth factor receptor （EGFR） mutation， and tumor inflammatory microenvironment are the manifestations of the hyperactivity of pathogenic Qi， conflict of cancer toxicity and drug toxicity， and being hefty by virtue of deficiency， which can promote the abnormal proliferation of tumor cells， and they are the core pathogenic elements of HPD and are closely related to disease prognosis. In terms of treatment， under the guidance of the theory of "five views on differentiation and treatment" （time-space view， core view， symptom view， precision view， and disease-before-onset view）， which was summarized according to the clinical practice of this research team， this paper， taking the prevention and treatment of HPD as the entry point， formulated traditional Chinese medicine （TCM） compounds to reinforce healthy Qi and warm Yang and realize the dynamic management of the whole spatiotemporal cycle， and removed toxins and resisted cancer to realize the all-round systemic intervention of the specimen. Additionally， targets were enriched in the macro-clinical manifestations and microscopic pathological changes of HPD to improve the targeting of drug selection and the precision of prevention and treatment， giving full play to the unique therapeutic advantages of TCM， and providing new ideas for the clinical application of TCM in the prevention and treatment of HPD.
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The term ''panvascular'' refers to the human vascular system， which is a complex network of arteries， veins， and lymphatic vessels. Panvascular diseases refer to a group of vascular system diseases， with vascular atherosclerosis as the common pathological feature. The panvascular diseases in target organs such as the heart， brain， kidney， and limbs are caused by ischemia or bleeding， including arterial system diseases， venous system diseases， microcirculation system diseases， and Zangfu organ-blood vessel diseases. The concept of panvascular diseases integrates vascular lesions and target organ damage. In clinical practice， blood vessels in multiple regions are regarded as a large vascular unit system， and vascular lesions and the induced target organ damage are considered as a whole. Based on the holistic concept and the Zangxiang theory in traditional Chinese medicine （TCM）， the ''blood vessel-Zangfu organ-syndrome differentiation and treatment'' network is built， on the basis of which a pattern of vascular disease-Zangfu organ dysfunction-syndrome differentiation and treatment is applied to the TCM diagnosis and treatment of panvascular diseases. The theory of treating arterial system diseases from the heart， venous system diseases from the kidneys， and microvascular system diseases from the liver is proposed. According to the causes identified based on syndrome differentiation， this paper summarizes the methods of reinforcing Yang and activating blood （including warming Yang and activating blood， replenishing Qi and activating blood， replenishing Qi， nourishing Yin and activating blood， activating Yang and blood， dispersing cold and activating blood）， cooling blood and resolving stasis， tonifying kidney and promoting urination coupled with activating blood and dredging vessels， nourishing Yin and tonifying kidney coupled with activating blood and dredging vessels， and soothing liver and regulating Qi coupled with activating blood and dredging collaterals， as well as wind-extinguishing medicines， applied to the treatment of panvascular diseases， aiming to provide methods and ideas for the treatment of vascular diseases with TCM.
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Cancer-related fatigue (CRF) belongs to the category of "consumptive disease" in TCM, and its occurrence is based on "internal deficiency" of the body causing by the tumor. Its nature is intermingled deficiency and excess. Its pathogenesis is the deficiency of qi, blood, yin and yang and zang-fu viscera dysfunction caused by disorders of "rise and fall of middle qi" and kidney origin depletion. The theory of "treating overstrain syndrome with warming methods" originates from Huang Di Nei Jing, which proposes that warming methods are the basic methods of treating consumptive disease. Therefore, starting from the cause and pathogenesis of CRF, this article sorted out the theoretical origin of "treating overstrain syndrome with warming methods", and discussed the clinical application of warming methods for the treatment of CRF combining with modern clinical research, with the purpose to provide references for clinical practice.
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Ischemic stroke (IS) is a severe cerebrovascular disease with a high incidence, mortality, and disability rate. The first-line treatment for IS is the use of recombinant tissue plasminogen activator (r-tPA). Regrettably, numerous patients encounter delays in treatment due to the narrow therapeutic window and the associated risk of hemorrhage. Traditional Chinese medicine (TCM) has exhibited distinct advantages in preventing and treating IS. TCM enhances cerebral microcirculation, alleviates neurological disorders, regulates energy metabolism, mitigates inflammation, reduces oxidative stress injuries, and inhibits apoptosis, thereby mitigating brain damage and preventing IS recurrence. This article summarizes the etiology, pathogenesis, therapeutic strategies, and relationship with modern biology of IS from the perspective of TCM, describes the advantages of TCM in the treatment of IS, and further reviews the pharmacodynamic characteristics and advantages of TCM in the acute and recovery phases of IS as well as in post-stroke complications. Additionally, it offers valuable insights and references for the clinical application of TCM in IS prevention and treatment, as well as for the development of novel drugs.
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Da Qinjiaotang is a common classical prescription for the treatment of stroke. It originates from Collection of Writings on the Mechanism of Disease， Suitability of Qi， and the Safeguarding of Life as Discussed in the Basic Questions （《素问病机气宜保命集》） by physician LIU Wansu， and is composed of Gentianae Macrophyllae Radix， Glycyrrhizae Radix et Rhizoma， Chuanxiong Rhizoma， Angelicae Sinensis Radix， Paeoniae Radix Alba， Asari Radix et Rhizoma， Notopterygii Rhizoma et Radix， Saposhnikoviae Radix， Scutellariae Radix， Gypsum Fibrosum， Angelicae Dahuricae Radix， Atractylodis Macrocephalae Rhizoma， Rehmanniae Radix， Rehmanniae Radix Praeparata， Poria， and Angelicae Pubescentis Radix. Doctors of all dynasties have disputed the composition principle of the prescription and argued whether its treatment of stroke belongs to the theory of "internal wind" or "external wind". Through collating and analyzing ancient and modern literature related to the indications of Da Qinjiaotang， this paper was dedicated to the origin of syndrome differentiation and treatment of Da Qinjiaotang. According to LIU Wansu's original works， Da Qinjiaotang is a prescription for the treatment of "internal wind"， and in the prescription， wind medicinal herbs such as Gentianae Macrophyllae Radix， Notopterygii Rhizoma et Radix and Angelicae Pubescentis Radix removes stagnation， clears sweat pore， and makes qi and blood channels flow smoothly. However， later generations， affected by the idea of "external wind"， believe that this prescription is used for the treatment of "external wind". Ancient physicians gradually supplemented the symptoms of stroke， such as wry eye and mouth， hemibody pain and limb numbness， which were treated by Da Qinjiaotang， and Da Qinjiaotang was also applied to the treatment of other diseases， such as tendon dryness， convulsion and arthralgia. Modern doctors still explain the disease pathogenesis from the theory of "external wind" as deficiency in channels and collaterals and the entry of pathogenic wind， and the prescription has the effect of dispersing wind， clearing heat and nourishing and activating blood. In clinical practice， Da Qinjiaotang is mainly used to treat cerebrovascular diseases and peripheral facial paralysis in nervous system diseases， gouty arthritis and rheumatic arthritis in the rheumatic immune system and skin diseases. The above findings facilitate the research and development of Da Qinjiaotang.
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As one of the diseases with high incidence in China， cancer seriously endangers human health. The scientific research and clinical practice of traditional Chinese medicine （TCM） in the prevention and treatment of tumors during the Sixth Five-Year Plan period and the 13th Five-Year Plan period show that TCM has certain advantages in preventing and treating postoperative metastasis and recurrence， prolonging survival period， alleviating adverse reactions， and improving the quality of life of patients with advanced tumors. However， innovation of the TCM theoretical thinking and realization of the TCM full-cycle management are needed urgently， which limits the improvement of clinical efficacy. Malignant tumor is a truly representative of major difficult diseases. The simple mode of syndrome differentiation and treatment cannot meet the clinical needs， and thus the triple mode of disease， syndrome and symptom differentiation and treatment emerged， and has received widespread attention. However， since malignant tumors have their own characteristics of occurrence， development and evolvement， it is urgent to establish a new system of TCM differentiation and treatment for special diseases to adapt to the law of modern disease development. Therefore， on the basis of the triple mode， this paper innovatively proposed a new system of cancer prevention and treatment based on five views on differentiation and treatment in TCM， forming a new paradigm of whole-cycle， whole-chain and all-directional integrated Chinese and western medicine prevention and treatment of tumors. Specifically， time-space view： On the basis of the holistic concept and combined with the complex characteristics of different pathological types， lesion location， disease course and treatment stages of malignant tumors， the dynamic and systematic participation of TCM in the whole process of tumor treatment was brought into play from the time and space dimensions. Core view： The core pathogenesis was summarized based on the combination of disease and syndrome， and its key role in guiding differentiation and treatment of malignant tumors was emphasized. Additionally， the pathogenesis characteristics and evolvement rules of various cancer types in different stages were paid attention. Symptom view： The symptoms were ameliorated and the quality of life was improved. The current obvious contradictions of patients were solved to enhance the humanistic nature of treatment. Precision view： In combination of modern medical concepts， TCM constitutions and laboratory indicators， TCM advantages were enriched and emphasized for precise clinical positioning. Disease-before-onset view： As prevention is more important than treatment， precaution was focused on in each stage of tumors. The five views had different emphases and were interrelated， covering new understandings of the existing TCM prevention and treatment system of malignant tumors. In addition， new ideas and concepts have been introduced on the basis of the original TCM theory， which provided new strategies for the comprehensive prevention and treatment of tumors.
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Postmenopausal osteoporosis （PMOP） is a systemic disease characterized by increased bone fragility caused by insufficient estrogen secretion in women after menopause，resulting in decreased bone mass and damage to the microstructure of bone tissues. The main clinical manifestations are low back pain，osteoporotic fractures，spinal deformities，and multiple organ dysfunction. PMOP directly leads to high morbidity， high mortality， and a decline in the quality of life. In addition to miss diagnosis， it is often not treated in time. In recent years， significant progress has been made in the research on factors related to the pathogenesis of PMOP. Based on the previous findings in recent years，this article described three major pathogenesis of PMOP， including intestinal flora imbalance，oxidative stress，and abnormal differentiation of bone marrow mesenchymal stem cells （BMMSCs）， and analyzed the current status of PMOP treatment， such as syndrome differentiation and treatment，acupuncture and moxibustion，exercise therapy， and external treatment in traditional Chinese medicine （TCM）， and basic measures，drug intervention，and physical therapy in western medicine. Among them，drug intervention in western medicine treatment is generally divided into bone resorption inhibitors，bone formation promoters，and other mechanism drugs according to the mechanism of action. This article summarized the specific methods and effects or mechanisms of TCM and western medicine in the clinical treatment of PMOP，which is expected to provide a reference for formulating reasonable health management models and drug treatments in the future.
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Atopic dermatitis （AD） is a chronic， recurrent and inflammatory skin disease. Modern medical research suggests that AD is related to immune function， genes， skin barrier and other factors， while the specific etiology and pathogenesis remains unclear. The disease has a long course and is prone to reoccur， which seriously affects people’s production and life. Steroids， antihistamines and immunosuppressants are commonly used western medicines for the treatment of AD， which， however， will cause adverse reactions after long-term application. Traditional Chinese medicine （TCM） has a long history， good therapeutic effect and rich clinical experience in the prevention and treatment of AD， and the research on the treatment of AD with TCM has been intensifying. Centering on the theory of TCM， we systematically summarized the research progress related to AD， discussed the etiology and pathogenesis of AD， and summarized the TCM syndrome differentiation of AD from the aspects of eight principles， etiology， Qi-blood-body fluid， zang-fu organs， six meridians， defense-Qi-nutrient-blood and triple energizer. According to the etiology and pathogenesis of AD， we proposed the therapeutic regimens corresponding to the type and stage of the disease. Considering the research progress achieved in the recent years in the prevention and treatment of AD by TCM and the modern pharmacological research on Chinese medicinal materials， we reviewed the classic famous prescriptions， self-made prescriptions and Chinese patent medicines， and expounded the mechanisms of single Chinese medicinal materials in the treatment of AD at the molecular level. The TCM external therapies such as wet compress， medicated bath， gel and ointment are safe and effective. Acupuncture and moxibustion play a role in the prevention and treatment of AD， which is worthy of promotion in clinical practice， and the syndrome differentiation methods of Qi-blood-body fluid and triple energizer are novel in the treatment of this disease. TCM， characterized by diverse therapeutic methods and good clinical efficacy， is worthy of promotion in the treatment of AD， which will contribute to the development of TCM in China.
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ObjectiveBased on the medical cases of Qi and blood co-treatment of traditional Chinese medicine（TCM） masters， to discover the syndrome and treatment rules and medication experience of Qi and blood co-treatment through data mining. MethodFrom December 1999 to November 2020， the Qi and blood treatment cases of TCM masters were retrieved from China National Knowledge Infrastructure （CNKI）. Frequency statistics， association rules， cluster analysis and other methods were used for data mining. ResultThe analysis of 591 medical cases of 57 national medical master found that blood stasis， Qi deficiency， Qi stagnation， blood deficiency and phlegm were the most common syndromes. The tongue was reddish， pale or dark， the moss was white or thin， and the pulse was thin， stringy， heavy and slippery. In the treatment of Qi and blood， the disease in the early stage is mostly in Qi and blood itself. At this time， the emphasis should be on regulating Qi and blood， or tonic or attack or both. At the same time， attention should be paid to invigorating the spleen， soothing the liver and tonifying the kidney. Core drugs include Danggui Buxuetang， Buyang Huanwutang， Huangqi Guizhi Wuwutang， Taohong Siwutang， Si Junzitang， Linggui Zhugantang， Xiaoyaosan， Danggui Shaoyaosan and other chemical cut. ConclusionWhen treating Qi and blood together， Chinese medical masters attach great importance to the relationship between Qi and blood and the development stage of diseases， and emphasize the precision and dynamic differentiation of treatment. Their theories and experience of diagnosis and treatment are worthy of clinical application and promotion.
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Patients with radioactive enteritis generally have certain intestinal microecological imbalance. Traditional Chinese Medicine (TCM) has showed good advantage in regulating intestinal microbial flora. In clinical practice, patients are treated based on syndrome differentiation of heat toxin damaging collaterals, cold-heat mixed syndrome, spleen deficiency and dampness stagnation, spleen and kidney yang deficiency, yin deficiency and body fluid deficiency. The Baitouweng Decoction, Wumei Pill, Sijunzi Decoction are the common prescriptions. TCM can promote the balance of intestinal microecology and treat digestive diseases such as radioactive enteritis, by improving the abundance of intestinal flora, inhibiting the level of inflammatory cytokines, and playing the role of probiotics and immune regulation.
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This paper reviews the Traditional Chinese Medicine (TCM) diagnosis and treatments for Coronavirus Disease 2019 (COVID-19) and the theories of different experts in TCM. The pathogenesis of COVID-19 involves dampness, toxin, heat, cold, blood stasis and deficiency. Dampness and poison were the core pathological factors. The treatment is based on the situation of patients in different regions and different stages of the disease, and focuses on dampness and toxin, with the purpose of eliminating evil and consolidating the foundation. Oral TCM prescriptions such as Qingfei-Paidu Decoction, Qingfei-Touxie-Fuzheng Decoction, Lianhua-Qingwen capsule (granule) show good curative effect. TCM non drug therapies, such as acupuncture, moxibustion, acupoint application, ear acupuncture, traditional exercises, etc., are mostly aimed at light, ordinary and convalescent patients, which can improve symptoms. However, high-quality TCM research is still needed.
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OBJECTIVE：To provide referenc e for the construction and software development of knowledge base for rational use of TCM decoction pieces. METHODS ：By reviewing the literatures on rational drug use software and TCM decoction pieces in recent years ，the clinical characteristics of rational drug use of TCM decoction pieces as well as the characteristics and shortcomings of existing rational drug use software in the detection of rational drug use of TCM decoction pieces were analyzed ， and the core contents and difficulties in the construction of knowledge base of rational drug use software of TCM decoction pieces were summarized. RESULTS & CONCLUSIONS ：Clinical application of TCM decoction pieces was mainly based on “syndrome differentiation”，which reflected the unity of dialectics ，treatment，prescription selection and medication. Therefore ，the consideration of the rationality of clinical use of TCM decoction pieces could not blindly imitate the evaluation method of chemical medicine. Current rational drug use software was not based on the theoretical system of traditional Chinese medicine ，and it was not comprehensive and mature in the aspect of rational drug use review of TCM decoction pieces ，and lacks the knowledge base that could meet the requirements of rational use of TCM decoction pieces. Therefore ，it is necessary to construct a set of knowledge base which can meet the evaluation requirements of “consistency of principle ，method and prescription use ”of TCM decoction pieces under the guidance of TCM theoretical system. Its contents include that patient information collection ，construction of knowledge base related to diseases and syndromes ，selection of processed products of TCM dec oction pieces ，addition andsubtraction of clinical symptoms ，selection taboo of varieties of TCM decoction pieces ， compatibility taboo ， combined application of Chinese patent medicine or chemical medicine ， dosage of TCM decoction pieces ， total dosage and tastquantity of each prescription ， special de coction drugs ， medication methods and administration frequency ，etc. There are still some difficulties in the development of rational drug use software of TCM decoction pieces ，such as the construction of disease and syndrome related knowledge base and the difficulty in judging the rationality of clinical symptom addition and subtraction.
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Objective To explore the rule of traditional Chinese medicine (TCM) syndrome differentiation of coronavirus disease 2019 (COVID-19) patients. Methods The symptoms of 756 cases with COVID-19 in Guanggu Branch of Maternity and Child Healthcare Hospital of Hubei Province were collected by cross sectional survey. The incidence rates of the symptoms were recorded by frequency method at different courses of the disease: prodromal stage (onset), middle stage (7-30 days), and later stage (>30 days). The common symptoms (incidence rate>5.0%) were analyzed by systematic clustering. With expert experience, the rule of TCM syndrome differentiation of COVID-19 patients was summarized. Results Fever (52.25%, 395 cases), cough (43.25%, 327 cases), asthenia (27.25%, 206 cases), chest distress (26.72%, 202 cases), asthma (17.59%, 133 cases) and expectoration (5.03%, 38 cases) were the most common symptoms in the prodromal stage (756 cases) of the disease, which were clustered into one category except expectoration, indicating the pathogenesis of both lung and body surface suppressed by dampness. In the middle stage (383 cases), the 19 common symptoms including greasy fur (64.49%, 247 cases), yellow fur (43.86%, 168 cases), thick fur (40.21%, 154 cases), cough (34.73%, 133 cases), red tongue (32.38%, 124 cases), poor stool (25.85%, 99 cases), asthma (25.33%, 97 cases), asthenia (25.07%, 96 cases), poor appetite (23.76%, 91 cases), bitterness of mouth (14.36%, 55 cases), dry fur (12.01%, 46 cases), purple tongue (12.01%, 46 cases), perspiration (11.49%, 44 cases), constipation (10.18%, 39 cases), white phlegm (8.62%, 33 cases), insomnia (7.31%, 28 cases), nausea (7.05%, 27 cases), diarrhea (6.79%, 26 cases) and yellow phlegm (6.27%, 24 cases), were clustered into three groups, indicating the pathogenesis of damp-heat accumulation, obstruction of lung and spleen by dampness, and dryness due to dampness-heat. In the later stage (373 cases), the 13 common symptoms including greasy fur (50.94%, 190 cases), asthenia (39.41%, 147 cases), cough (37.80%, 141 cases), red tongue (33.78%, 126 cases), asthma (32.17%, 120 cases), perspiration (23.86%, 89 cases), dry mouth (22.79%, 85 cases), poor appetite (20.11%, 75 cases), poor stool (19.30%, 72 cases), bitterness of mouth (15.01%, 56 cases), white phlegm (10.72%, 40 cases), palpitation (8.31%, 31 cases) and little fur (8.04%, 30 cases), were clustered into two groups, indicating the pathogenesis of deficiency of Qi and Yin with residual dampness, and deficiency of lung Qi and spleen Qi with residual dampness. Conclusion The TCM syndromes of COVID-19 patients in different stages have its own typical characteristics, with a regular change from exterior to interior, from dampness to dampness-heat and from excess to deficiency..
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Objective: To collect the clinical symptoms of novel coronavirus pneumonia, explore and analyze the clauses and prescriptions related to the clinical symptoms of 2019 novel coronavirus pneumonia in “Treatise on differentiation and treatment of epidemic febrile disease”, in order to provide a reference for clinical treatments of the disease. Methods: Searching literature from the databases CNKI and PubMed by entering “novel coronavirus” (in Chinese) and “2019 Novel Coronavirus” as key words, classifying typical symptoms depending on their reported frequencies of occurrence, comparing with related pathogenesis in “Treatise on differentiation and treatment of epidemic febrile disease”, and analyzing clauses and prescriptions combined with the sixth version of “New coronavirus pneumonia diagnosis and treatment scheme”. Results: We optimized 20 literatures published in Chinese or English for the review, in which, a total of 647 clinical cases were reported. Based on that, 28 typical symptoms were summarized, including respiratory symptoms, such as fever and cough; Gastrointestinal symptoms, such as poor appetite, nausea, vomiting, diarrhea; Other symptoms, such as myalgia, fatigue, and so forth. Among them, fever (558 cases), cough (395 cases), and fatigue (257 cases) were the top three clinical symptoms. By analysis, we optimized 15 clauses, 18 prescriptions, and 46 traditional Chinese medicines from “Treatise on differentiation and treatment of epidemic febrile disease”, including two clauses in the upper energizer, nine in the middle energizer, and four in the lower energizer; A total of seven prescriptions for treating dampness-heat, five for cold-dampness, and six for warm-heat diseases; as well as Chinese medicines Pinellia ternata (mentioned for six times), Cinnamomi Ramulus (five times), Tetrapanacis Medulla (five times), Poria cocos (four times), Talcum (four times), Coptis chinensis (four times) and Coicis Semen (four times), etc. P. ternata, Cinnamomi Ramulus, C. chinensis, Scutellaria baicalensis, and Zingiberis Rhizoma were selected to treat dampness-heat diseases, in order to “pungency opening and bitter discharging”; P. cocos, Tetrapanacis Medulla, Talcum, and Coicis Semen were selected for “eliminating dampness with bland medicinal”; Almond, Amomum kravanh, and Magnolia officinalis were used to “regulating qi movement”; Anemarrhenae Rhizoma, Gypsum Fibrosum, and Forsythiae Fructus were used to treat warm-hot diseases for “purging fire and removing toxin”. The formula of Sanren Decoction, Yiyizhuye Powder can be used for people in the stage of medical observation period; Sanren Decoction, Yiyizhuye Powder, Xingrenyiyi Decoction, Wuling Powder, Baihujiaguizhi Decoction, and Lingjiangzhugui Decoction for treating mild cases; Huangqin Huashi Tang, Xingren Huashi Decoction, and Fulingpi Decoction for severe cases; Jiaomei Decoction, Jianweiwumei Pill, Sini Decoction, and Taohua Porridge for critical patients, and Maidong Maren Decoction, Wuzhi Yin, and Niuru Yin for convalescents. Conclusion: The prescriptions of “Treatise on differentiation and treatment of epidemic febrile disease” can provide reference for the clinical treatments of 2019 novel coronavirus pneumonia.
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Objective: To evaluate the efficacy and safety of the combination therapy of Compound Danshen Dropping Pills and conventional chemical drugs in the treatment of the angina by Meta-analysis. Methods: Databases including CNKI, WanFang, CBM, VIP, PubMed, and Cochrane Library were searched to collect qualified researches, and the quality of articles was evaluated according to Cochrane Handbook. Meta-analysis including subgroup analysis was performed by using Stata 13.1 and RevMan 5.3 software. All these methods were used to systematically evaluate the safety and clinical efficacy of Compound Danshen Dropping Pills in the treatment of angina pectoris under two circumstances (with or without syndrome differentiation). Results: A total of 39 studies involving 3 941 patients were studied, including 1 991 patients in the experimental group and 1 950 in the control group. The results of Meta analysis showed that: the clinical efficacy [RR = 1.24, 95%CI (1.20, 1.28), P < 0.000 01], ECG efficacy [RR = 1.29, 95%CI (1.21, 1.37), P < 0.000 01], angina attack frequency [WMD = -1.82, 95%CI (-3.28, -0.36), P = 0.01], duration of angina attack [WMD = -2.09, 95%CI (-2.67, -1.50), P < 0.000 01], hs-CRP [WMD = -2.63, 95%CI (-4.39, -0.86), P = 0.003], ET [WMD = -16.22, 95%CI (-19.37, -13.06), P < 0.000 01], platelet aggregation [WMD=-7.46, 95%CI (-11.15, -3.78), P < 0.000 1], GMP-140 [WMD=-5.64, 95%CI (-6.88, -4.39), P < 0.000 01] and fibrinogen [WMD = -0.73, 95%CI (-1.00, -0.46), P < 0.000 01] of routine western medicine treatment combine with Compound Danshen Dripping Pills group had significant difference compared with the control group; In terms of clinical efficacy, the combination effect of dialectical medication group and non dialectical medication group had no significant difference (P = 0.55, I2 = 0). A total of 15 studies described adverse reactions, with 43 cases in the experimental group and 65 cases in the control group. There was no significant publication bias on funnel plot and Egger's test. Conclusion: It is safe and effective to use Compound Danshen Dropping Pills in patients with coronary heart disease and angina, which can further improve the clinical effect compared with the simple routine treatment. There is no significant difference between the therapeutic effect of Compound Danshen Dropping Pills and that of non-syndrome differentiation. However, these conclusions still need to be verified with more high-quality and large-sample literature.
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Objective::Through data mining analysis of Chinese patent medicine prescription containing Aconiti Lateralis Radix Praeparata (CPMCA) in a hospital, the characteristic rules of clinical medication of this kind of Chinese patent medicine were analyzed from the perspective of traditional Chinese medicine (TCM) syndrome differentiation and treatment, and the application prospect of data mining in TCM prescription analysis was explored. Method::CPMCA in the hospital outpatient clinics from November 2017 to October 2018 was conducted. The clinical application of this kind of Chinese patent medicine was retrospectively analyzed from the aspects of basic situation of patients, TCM diseases, TCM syndromes and so on. The clinical application of CPMCA was reviewed and analyzed. Three kinds of data mining algorithms in Microsoft SQL Server Analysis Services 2012 were used to analyze the characteristics of prescription medication. Result::A total of 8 kinds of Chinese patent medicines containing Aconiti Lateralis Radix Praeparata were used in a hospital, and most of them were used by patients under 14 years old, among them, the dosage of Xiaoer Feike granules was the largest. The TCM diseases were mostly cough, cold and asthma, while the TCM syndromes were mostly cold-heat complicated syndrome, wind-phlegm syndrome and external contraction of wind evil. The CPMCA for nourishing and warming kidney-Yang included Jingui Shenqiwan, Longlu capsules, Wangbi capsules and Guifu Dihuang pills. The TCM diseases were mostly arthralgia syndrome, vertigo, and consumptive disease, meanwhile, the syndromes were mainly deficiency of liver and kidney, kidney deficiency and blood stasis, and deficiency of spleen and kidney. Decision tree analysis showed that the CPMCA had the characteristics of age distribution, among which TCM diseases and syndromes were the main decision points. According to the age, sex, diagnosis of Chinese and western medicine, and TCM syndromes of this type of prescription, the CPMCA were divided into 10 categories by cluster analysis. Correlation analysis showed that the combination of Xiaoer Feike granules was the most common, but the correlation was not high. And Jingui Shenqiwan, Qili Qiangxin capsules, Longlu capsules and Wangbi capsules had their own strong associated medication. Conclusion::The application of data mining algorithm in multi-factor analysis of clinical prescription is close to the clinical dialectical treatment thinking of TCM. Combined with the basic statistics, it can be seen that the CPMCA in a hospital is consistent with the characteristics of TCM syndrome differentiation and treatment.
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Objective To analyze the clinical features of patients with dengue fever (DF) accompanied by platelet count (PLT) reduction and their characteristics of traditional Chinese medicine (TCM) syndrome differentiation and treatment. Methods The clinical data of 1 570 patients with confirmed diagnosis of DF collected from the Information Management System (HIS) of the Second Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine (TCM) from January 2013 to December 2017 were retrospective analyzed. According to the patients accompanied by platelet (PLT) reduction or not, they were divided into DF accompanied by PLT reduction group (1 211 cases) and non-PLT reduction group (359 cases); according to whether the cooling blood and dissipating blood stasis TCM (composed of red peony, peony bark, rehmannia root, salvia miltiorrhiza, rhinoceros horn, etc.) was used or not in TCM syndrome differentiation prescription, they were divided into cooling blood and dissipating blood stasis group (492 cases) and non-cooling blood and dissipating blood stasis group (719 cases). The differences in clinical characteristics, laboratory indicators, TCM syndrome differentiation and prescription characteristics in DF accompanied by PLT reduction group and non-PLT reduction group were compared and analyzed; the differences in changes of white cell counts (WBC) and PLT levels before and after treatment between cooling blood and dissipating blood stasis group and non-cooling blood and dissipate blood stasis group were compared and analyzed. Results The proportions of rash, hemorrhage, WBC reduction and aspartate transaminase (AST) elevation in DF accompanied by PLT reduction group were significantly higher than those in non-PLT reduction group [rash: 61.4% (744/1 211) vs. 14.8% (53/359), hemorrhage: 7.3% (89/1 211) vs. 1.1% (4/359), WBC reduction: 88.2% (1 068/1 211) vs. 60.4% (217/359), AST increased: 41.0% (497/1 211) vs. 29.5% (106/359)]; the PLT and WBC in the DF accompanied by PLT reduction group were significantly lower than those in the non-PLT reduction group [PLT (×109/L): 74.2±27.5 vs. 166.6±42.8, WBC (×109/L): 2.1±1.6 vs. 6.4±3.7, both P < 0.05], and AST in the DF accompanied by PLT reduction group were significantly higher than those in the non-PLT reduction group (U/L: 69.6±34.1 vs. 52.6±26.1, P < 0.05). The common syndrome of TCM syndrome differentiation in DF accompanied by PLT reduction group and non-PLT reduction group was mainly Wei-Qi syndrome [425 cases (35.1%) and 147 cases (40.9%) respectively]; Yinqiao powder was the main TCM prescription in the two groups [132 cases (10.9%) and 46 cases (12.8%) respectively]. In the comparisons between the cooling blood and dissipate blood stasis group and non-cooling blood and dissipate blood stasis group, there were no statistically significant differences in the proportion of combining use of drugs for increasing WBC and PLT and the levels of WBC and PLT after treatment (all P > 0.05). After treatment, the WBC, PLT levels and the proportions of above indexes returned to normal in the cooling blood and dissipate blood stasis group were significantly higher than those in the non- cooling blood and dissipate blood stasis group [WBC(×109/L): 4.5±3.1 vs. 3.2±2.4, proportion of WBC returned to normal: 42.7% (210/492) vs. 33.1% (238/719); PLT (×109/L): 85.9±26.2 vs. 79.3±24.8, proportion of PLT returned to normal: 41.1% (202/492) vs. 27.5% (198/719), all P < 0.05]. Conclusions The symptoms of skin rash and bleeding are more common in patients with DF accompanied by PLT reduction. The syndrome differentiation of TCM for this disease is mostly based on the combined disorders of Wei (defence) and Qi, both Qi and blood burning and blood stasis associated with toxin. Cooling blood and dissipating blood stasis may help the recovery of WBC and PLT in these patients, which is of great significance in reducing severity of dengue fever (such as bleeding).
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Objective To prospectively survey the well-known experts of critical care and endocrine secretion to summarize their experience in treating diabetes mellitus complicated by sepsis for the purpose of providing guidance of theory and practice in making treatment schemes of traditional Chinese medicine for such disease.Methods The questionnaires were designed and submitted to the experts.The statistic analysis was undertook to investigate the rules.Results A total of 30 questionnaires were released and 28 were retrieved.The experts generally believed that eight-principle syndrome differentiation was the most useful method in the syndrome differentiation and treatment of this disease.The heat,stasis and toxin were usually acted as the main pathogenic factors while damp and phlegm commonly act as secondary pathogenic factors.They thought that weak body resistance under the invading of evil was the key mechanisms in the deterioration of the disease and they chose clearing heat,activating blood and detoxication as 3 core treatment principles.Conclusions The summarized opinions from the experts should be act as important reference in treating this disease,but its effectiveness and possibility for further generalization need to be validated in the clinical practice.
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[Objective] For six consecutive years, we investigated 83 cases of the effect of acupuncture therapy on children with night terrors.[Subjects and Methods] The number of subjects was 83 (38 boys and 45 girls, mean age: 2.2 ± 2.8 years old). Acupuncture therapy for infants was defined as pattern identification/syndrome differentiation and treatment. The acupuncture therapy used spoon needles and moxibustion; skin stimulation was applied to the acupuncture point. Infant needles in the Daishi style and moxibustion of the incense stick were used as a method to approach the hole. Therapeutic effect was judged by a self-written evaluation form certified by the Japan Society of Pediatric Acupuncture. One major item, "sleep disorder (broad sense of night terrors)," three minor items ('night terror' in a narrower sense), 'difficulty in falling asleep,' 'nocturnal awakening,' number of nocturnal awakenings at night, and satisfaction with acupuncture therapy in infants were investigated. Evaluations were made at the time of the first treatment and before the fifth treatment. In the statistical analysis, the change in the score of the evaluation slip and the number of partial awakenings were tested by the Wilcoxon signed-rank-sum test. The level of significance was set at 5%.[Results] Significant improvement was observed in the score for the major item, minor items, and number of partial awakenings. The degree of satisfaction was 90.4%.[Conclusion] It was suggested that acupuncture therapy in infants is effective for ameliorating symptoms of "sleep disorder."
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Professor CUI Xue-jiao considers that the root of prostate cancer is qi weakness and internal organs failure; the TCM pathogenesis of prostate cancer is seven emotions wounds and improper diet; the focus of prostate cancer is stasis blocking and poison collecting in lower energizer. Professor CUI attaches great importance to the method of purging therapy, emphasizes the part and the whole, strengthening body resistance to dispel pathogenic factors, and choosing different medicine based on different stages. Therapy mainly includes promoting qi and activating blood, resolving stasis and softening hardness, clearing heat and removing toxicity, strengthening healthy energy and soothing the liver, with good efficacy.