RÉSUMÉ
Arrhythmia is an important disease among cardiovascular diseases. Malignant arrhythmias often occur clinically and are induced by abnormal ion channels， electrical activity disorders， myocardial fibrosis， inflammation， dysfunctional mitochondrial biogenesis， mitochondrial calcium overload， out-of-balance energy metabolism， oxidative stress， sympathetic hyperactivity， and other pathological cardiac remodeling， and they are the main causes of sudden cardiac death. In traditional Chinese medicine， arrhythmias are considered to be palpitations， which are commonly caused by deficiency of Qi and Yin. It is often manifested as a deficiency of the spleen and stomach， resulting in malfunction of the Qi mechanism， followed by a particularly severe decline in cardiac function. Shengmaisan is a representative formula for nourishing Qi and Yin， consisting of Ginseng Radix et Rhizoma， Ophiopogonis Radix， and Schisandrae Chinensis Fructus. In recent years， clinical studies have shown that Shengmaisan and its additions and subtractions are commonly used in the treatment of arrhythmias. In this article， the mechanisms of the active ingredients of Shengmaisan in the electrophysiology， biochemistry， structure， autonomic nervous system， and subcellular fraction of the heart are reviewed， and the multi-target， multi-system， and integrality of Shengmaisan in the treatment of arrhythmias of Qi and Yin deficiency are described. In addition， energy metabolism disorder is tightly juxtaposed with Qi and Yin deficiency syndrome. Mitochondria， as the center of myocardial energy metabolism， play a paramount role in cardiac remodeling， indicating that Shengmaisan will be a salient part of future research to ameliorate cardiac pathologic remodeling through energy metabolism of mitochondria， so as to provide a theoretical basis for the clinical treatment of these arrhythmias.
RÉSUMÉ
Objective To establish the diagnostic criteria of deficiency of Qi and Yin in IgA nephropathy by combining Delphi method with analytic hierarchy process.Methods After literature research,an item pool of Qi and yin deficiency syndrome was formed.Based on this item pool and expert discussion,an expert questionnaire was formed.Two rounds of Delphi method were used to conduct expert questionnaire survey,and then the weight value of the items was calculated by AHP.Finally,a diagnostic questionnaire of Qi and yin deficiency syndrome in IgA nephropathy was formed,which laid a foundation for the final formation of diagnostic criteria.Results Through Delphi and analytic hierarchy process,the following 12 items and their weights were finally obtained:①mental fatigue:13.1205%;②Weak waist and knees:7.8514%;③Dry mouth or throat:10.6984%;④Hand foot heart heat:8.985%;⑤Tinnitus:4.0495%;⑥Susceptible to cold:8.8027%;⑦Spontaneous or night sweat:9.4594%;⑧Yellow or red urine:4.7458%;⑨Pale red tongue:6.906%;⑩Fat tongue:7.159%;?Less moss or thin white moss:8.947%;?Weak or thin pulse:9.275%.Conclusion Through the combination of Delphi method and analytic hierarchy process,the qualitative analysis and quantitative evaluation of each item of Qi and yin deficiency syndrome in IgA nephropathy were carried out,and the best item and specific weight of Qi and yin deficiency syndrome in IgA nephropathy were obtained,providing a reference for the formation of future standards.
RÉSUMÉ
Objective:This study aims to investigate the effect of addition and subtraction treatment to Renshen Maidongsan on metabolism of glucose， lipid and pregnancy outcome when used to gestational diabetes mellitus （GDM） with deficiency of both Qi and Yin. Method:In this study， 108 patients with GDM were randomly divided into observation group with 54 cases and control group with 54 cases. Patients in control group took Yuquan wan orally， 6 g/time， 4 times/day ， and patients in observation group were prescribed addition and subtraction treatment to Renshen Maidongsan， 1 dose/day. The course of treatment for both groups was 4 weeks. Oral glucose tolerance test （OGTT） was performed before and after treatment. Fasting blood glucose （FBG） ， 1 h our plasma glucose （1 h PG）， 2 h our plasma glucose （2 h PG）， glycosylated hemoglobin （HbA1c） and other indicators were detected to record the pregnancy outcome. Also， the levels of total cholesterol （TC）， triglyceride （TG）， high density lipoprotein cholesterol （HDL-C）， low density lipoprotein cholesterol （LDL-C）， adiponectin， serum amyloid A （SAA）， tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>）， resistin， interleukin-1<italic>β</italic> （IL-1<italic>β</italic>） and interleukin-6 （IL-6） were detected before and after treatment. Then the safety evalution was carried out. Result:The levels of insulin resistance index （HOMA-IR）， FBG， 1 h PG， 2 h PG， HbA1c， TC， LDL-C， TG， IL-6， IL-1<italic>β</italic>， TNF-<italic>α</italic>， SAA， leptin and resistin in observation group were lower than the data checked in control group （<italic>P</italic><0.01）， and the levels of HOMA-<italic>β</italic>， insulin sensitivity index （InISI） and adiponectin were higher than the standards of from control group （<italic>P</italic><0.01）. Then the incidence of medical cesarean section， pregnancy induced hypertension， polyhydramnios， premature rupture of membranes， premature delivery and adverse pregnancy outcomes were lower than those in control group （<italic>P</italic><0.01）. Conclusion:Addition and subtraction treatment to Renshen Maidongsan can improve insulin sensitivity and islet <italic>β</italic>-cell function， regulate inflammatory factors and adipokines， improve insulin resistance （IR）， effectively regulate glucose and lipid metabolism， improve maternal and infant adverse pregnancy outcomes when used on patients with GDM and deficiency of Qi and Yin， and it was safe to use in clinic.
RÉSUMÉ
Objective:To discuss the clinical efficacy of Yixinshu capsule for viral myocarditis (VMC) with deficiency of Qi and Yin, and to investigate its antioxidant and anti-inflammatory effect. Method:One hundred and thirty-two patients were randomly divided into control group (66 cases) and observation group (66 cases) by random number table. Patients in two group got comprehensive treatment of Western medicine, i.e. intravenous drip of creatine phosphate injection for 14 days, 1 g/time, 1 time/day. Coenzyme Q10 capsule, 1 grain/time, 3 times/day after meals. Trimetazidine dihydrochloride tablets, 1 tablet/time, 3 times/day during meals. And critically ill patients got intravenous drip of dexamethasone sodium phosphate injection for 14 days, 10-20 mg/time, 1 time/day. The control group took Wenxin granules orally,One bag at a time,3 times/day. Patients in observation group additionally got Yixinshu capsule, 3 grains/time, 3 times/days. The courses of treatment were 8 weeks in both groups. The serum troponin I (cTnI) and creatine phosphokinase (CK-MB) were monitored, and after treatment, the recovery rates of cTnI, CK-MB were recorded. Before and after treatment, the electrocardiogram was observed and the recovery rate after treatment was recorded. Before and after treatment, the scores of deficiency of Qi and Yin were graded, and levels of creatine phosphokinase (CPK), hydroxybutyrate dehydrogenase (HBDH), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GSH-Px), interferon-γ (IFN-γ), interleukin-10 (IL-10), IL-17 and IL-35 were detected. Echocardiography, left ventricular ejection fraction (LVEF), cardiac index (CI), and maximum velocity values between early and late diastolic (E/A) were detected. Result:In the analysis of rank sum test, clinical efficacy in observation group was better than that in control group (Z=2.151, P<0.05). Recovery rates of cTnI, CK-MB and electrocardiogram in observation group were 82.26% (51/62), 90.32% (56/62) and 80.65% (50/62), higher than 65.00% (39/60), 73.33% (44/60) and 63.33% (38/60) in control group (P<0.05). Levels of serum cTnI, CK-MB, CPK, HBDH, LDH, AST, MDA, IFN-γ and IL-17 were lower than those in control group (P<0.01), while levels of LVEF, CI, E/A, SOD, GSH-Px, IL-10 and IL-35 were higher than those in control group (P<0.01). Conclusion:On the basis of comprehensive anti-infection treatment, Yixinshu capsule can additional protect myocardium by anti-inflammatory and antioxidant effect, reduce myocardial enzyme, promote the recovery of ECG and cardiac enzyme, improve cardiac function and improve the effect of clinical treatment.
RÉSUMÉ
Based on our research team's clinical and basic research results of traditional Chinese medicine (TCM) in the prevention and treatment of ischemic stroke, and combined with TCM syndrome standard manifestations of this disease, wind, phlegm, fire, deficiency and blood stasis, this paper points out definitely that the basic pathogenesis of ischemic stroke is blood stasis caused by deficiency of both Qi and Yin. The pathogenic characteristics are deficiency in origin and excess in superficiality, and the wind, fire, phlegm, deficiency and blood stasis are related one another resulting in this disease; it is established that the basic syndrome types of this disease are deficiency of both Qi and Yin and static blood blocking the collaterals, and the therapeutic regime is a recipe including the TCM ingredients having the actions of nourishing yin, tonifying Qi and improving blood circulation (Yangyin Yiqi Huoxue) and according to the patient's individual variation of syndrome differentiation, the ingredients in the recipe can be added or subtracted. In this report, a new system of treatment for ischemic stroke based on syndrome differentiation is proposed.
RÉSUMÉ
[Purpose] To summarize SHEN Yiping's clinical experience and academic views about treatment of elderly acute myeloid leukemia(AML) patients with traditional Chinese medicine(TCM).[Method] By means of learning form Professor SHEN in the clinic,collect cases and analyze them,and then conclude his clinical thought and dialectical methods,further summarize his clinical experience and academic views.[Result] Professor SHEN Yiping believes that these patients have deficiency of the lung,spleen and kidney,easily form the unhealthy environmental influences with shapes such as phlegm,damoeness,blood stasis,meeting with invaded by the invasion,causing the results of the happening of the disease.The functions of Zang-fu are damaged after chemotherapy,with the presentation of deficiency of qi and yin.Professor SHEN thinks that the treatment should be tonifying lung,spleen and kidney,dispelling the pathological products such as phlegm,dampness,blood stasis,eliminating the invasion at the same time.For those patients who are in remission,we should use the therapy of purging fire and maintaining yin,in order to remove leukemia residual of lesions thoroughly.Professor SHEN uses the anticancer drugs which could clear away heat and toxic frequently in order to depress the proliferation of the leukemia cells.[Conclusion]Professor SHEN is well-versed in the learning of both TCM and modern medicine,abundant clinical experience and rigorous dialectical methods,skilled in using TCM to treat elderly AML patients.He also has peculiar methods for the treatment of patients with recurrence of leukemia.His clinical experience and academic thoughts are worth learning and communication for us.
RÉSUMÉ
Objective:To observe the clinical efficacy and safety of compound hypoglycemic Yuye oral liquor combined with metfo-ma and glimepiride in the treatment of type 2 diabetes mellitus ( deficiency of both Qi and Yin) . Methods:Totally 80 type 2 diabetes mellitus patients were randomly divided into the treatment group and the control group with 40 each, both groups were treated with met-formin hydrochloride tablets and glimepiride tablets, the treatment group was given compound hypoglycemic Yuye oral liquor additional-ly, and the treatment duration was 12 weeks. At the end of the treatment, fasting plasma glucose( FPG) , postprandial 2 hours plasma glucose(2hPG), hemoglobin A1c(HbA1c)and traditional Chinese medicine (TCM ) syndrome in the two groups were compared. Re-sults:In both groups, FPG, 2hPG and HbAlc were decreased after the treatment, and the decrease in the treatment group was more notable than that in the control group with statistically significant difference (P<0. 05 or P<0. 01). As for TCM syndrome, the score in the treatment group was lower than that in the control group with statistically significant difference (P<0. 01). The clinical efficien-cy in the treatment group was 47. 5%, that was 22. 5% in the control group, and the difference between the two groups was statistically significant (P<0. 05). Conclusion:Compound hypoglycemic Yuyeoral liquor can reduce the blood glucose in type 2 diabetes mellitus patients( deficiency of Qi and Yin) , and the improvement of clinical symptom is striking with good safety and clinical application value.
RÉSUMÉ
Objective]To observe the clinical effect of Shenmai Injection on chronic kidney disease(CKD) in V stage and the sustainable dialysis patients accompanied with both deficiency type of Qi and Yin.[Method] Choose 120 cases of such disease, randomly select 60 cases as control group with routine treatment;make another 60 cases as treatment group, added with Shenmai Injection. Both were treated for 4w, after that, compare their syndrome integral and score of both deficiency of Qi and Yin, blood pressure and hemoglobin indexes. [Result] In treatment group, the syndrome integral was much less than before, the blood pressure was increased a lot, so did the hemoglobin, the difference had statistical meaning. But there's no marked difference on control group. The comparison of them showed difference of statistical meaning. [Conclusion] Shenmai Injection can markedly relieve the syndrome of both deficiency of Qi and Yin, improve the blood pressure and hemoglobin in dialysis, and improve patients' dialysis quality.