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Objective To screen items of the Clinical Aided Decision Scheme for Stroke Simultaneous Treatment of Disease,Pulse and Syndrome;To provide reference for the formulation and improvement of the scheme.Methods The Delphi method was used to distribute two rounds of questionnaires to 60 experts in cerebropathy or neurology across the country.Statistical analysis was performed on the questionnaire results of the scheme's items,including the disease names,etiology and pathogenesis,syndrome characteristics,rules and regulations,representative prescriptions,acupuncture and other therapies,and preventive care.Results Totally 42 and 50 valid questionnaires were collected.The experts reached the consensus for the importance of etiology and pathogenesis,rules and regulations,acupuncture and other therapies,and preventive care.In the section on syndrome characteristics,items with low relevance or causing ambiguity were removed.Items that were no longer used in modern times and different prescriptions with the same name were removed from the representative prescriptions.The names of syndromes,rules and regulations were unified.Conclusion The experts generally reached the consensus for the importance of the Clinical Aided Decision Scheme for Stroke Simultaneous Treatment of Disease,Pulse and Syndrome.However,there are still some limitations that require further study and discussion.
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As the overweight and obese population is growing， the incidence of obstructive sleep apnea is rising， and most of the cases are complicated with coronary heart disease and other cardiovascular diseases. The two diseases affect each other and seriously endanger the patients' health， becoming a major public health problem of global concern. It is of great clinical importance to explore the combination of Chinese and Western medicine in the prevention and treatment of coronary heart disease complicated with obstructive sleep apnea syndrome. Researchers have explored the relationship between the two based on traditional Chinese medicine（TCM） theory and found that the two diseases belong to the TCM disease categories of chest impediment and snoring， respectively， and their co-morbidity is associated with the abnormal physiological functions of the heart and lungs. The failure of the heart to govern blood leads to the generation of blood stasis， and that of the lung to govern Qi movement leads to the generation of phlegm. The accumulation of phlegm and blood stasis in the chest causes chest impediment and snoring due to obstruction of the airway. This paper discusses the internal linkage between the pathogenesis of coronary heart disease and obstructive sleep apnea syndrome in Chinese and Western medicine from the TCM theory of heart-lung correlation. Furthermore， this paper proposes the treatment principles of simultaneously treating the heart and lung and activating blood and resolving phlegm， aiming to provide a theoretical basis for the clinical prevention and treatment of coronary heart disease complicated with obstructive sleep apnea.
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Atherosclerosis(AS) is the key pathological basis of coronary heart disease(CHD), and lipid infiltration is a classical theory to explain the pathological mechanism of AS. The theory highlights that the occurrence and development of AS are closely related to abnormal lipid metabolism, with the essence of the pathological reaction caused by the invasion of lipids into arterial intima from plasma. Phlegm and blood stasis are physiologically homologous and subject to pathological co-existence. Phlegm-blood stasis correlation is the basic theory to explain the pathogenesis characteristics of CHD and has important guiding significance for revealing the mecha-nism of lipid infiltration of CHD. Phlegm is the pathological product of abnormal metabolism of Qi, blood, and body fluid, and a gene-ral summary of a series of abnormally expressed lipid substances. Among them, turbid phlegm invades the heart vessels, gradually accumulates, and condenses to achieve the qualitative change from "invisible pathogen" to "tangible pathogen", which corresponds to the mechanism of lipid migration and deposition in the intima of blood vessels, and is the starting factor of the disease. Blood stasis is the continuous development of phlegm, and it is a result of pathological states such as decreased blood fluidity, increased blood coagulation, and abnormal rheology. The fact that blood stasis caused by phlegm accords with the pathological process of "lipid abnormality-circulatory disturbance" and is the central link of the disease. Phlegm and blood stasis aggravate each other and lead to indissoluble cementation. The phlegm-blood stasis combination serves as common pathogen to trigger the disease, which is the inevitable outcome of the disease. Based on the phlegm-blood stasis correlation theory, the simultaneous treatment of phlegm and blood stasis is established. It is found that this therapy can simultaneously regulate blood lipid, reduce blood viscosity, and improve blood circulation, which can fundamentally cut off the biological material basis of the reciprocal transformation between phlegm and blood stasis, thus exerting a significant curative effect.
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Humanos , Medicina Tradicional Chinesa , Doença das Coronárias , Muco , Aterosclerose , LipídeosRESUMO
Chronic obstructive pulmonary disease (COPD) is characterized by excess in nature and deficiency in superficiality. For COPD patients, the deficiency of lung and kidney is the basis for production of the latent toxin, and repeated exogenous infection is the main factor for the latent toxin to enter the lung. The key pathogenesis of stable COPD is the entry of latent toxin into the lung and the injury of lung and collaterals. Therefore, tonifying lung and kidney, removing toxins and dredging collaterals are the core treatment methods for COPD in stable period. Bufei Decoction is with good efficacy in the treatment of COPD in stable period, which can not only tonify lung and kidney to consolidate, but also dredging collaterals to remove toxins. Based on the pathogenesis of "latent toxin entering lung", the relevant mechanisms of Bufei Decoction in treating stable COPD were further understood and explored, in order to benefit clinical practice.
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Wumei Pill is a classic insect repellent prescription, which is used for ascaris lumbricoides and diarrhea. It is considered to be a representative prescription for the treatment of simultaneous occurrence of cold and heat syndromes. Its prescription is mainly composed of sour drugs ( Mume Fructus and bitter wine) and pungent drugs ( Aconiti Lateralis Radix Praeparataaconite, Cinnamomi Ramulus, Sichuan pepper, Angelicae Sinensis Radix, Zingiberis Rhizoma, and Asari Radix et Rhizoma), supplemented by bitter drugs ( Coptidis Rhizoma and Phellodendri Chinensis Cortex) and sweet drugs ( Ginseng Radix et Rhizoma and honey). From the point of view of "Tang-Ye-Jing-Fa Map", the role of liver is to disperse, whose deficiency leads to limb syncope, and excess leads to the full of hypochondrium and abdominal pain. The pungent herbs can tonify the liver-deficiency, the sour herbs can dispel the liver-excess, and sweet herbs can relive them both. The role of spleen is to moderate, whose deficiency leads to fatigue and weakness, and excess leads to the vomiting and diarrhea. The sweet herbs can tonify the spleen-deficiency, the pungent herbs can dispel the spleen-excess, and bitter herbs can relive them both. Therefore, the function of Wumei Pills is located in the liver and spleen, giving consideration to the heart and lung. It is used for the deficiency and excess mixed syndrome of liver and spleen, which is mainly characterized by chest and flank abdominal pain, limb chills, diarrhea, muscle and pulse contracture and the symptoms of the parts along the liver meridian. It is commonly used in the treatment of ascaris, diarrhea, impotence, depression. At the same time, it can also be used for the treatment of diseases about heart and lung, and cough, anxiety and other diseases.
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The high morbidity and fatality rates of cardiovascular and cerebrovascular diseases seriously harm human health，greatly affect the quality of life and increase the burden of disease. Thus， more and more attention has been paid to the relationship between heart and brain. "Simultaneous treatment of heart and brain" is the continuous deepening and development of the theory of "simultaneous treatment of different diseases" in traditional Chinese medicine （TCM）， and exploring the relationship between heart and brain as well as the current situation of Chinese medicine treatment has important clinical significance for the establishment of integrated traditional Chinese and western medicine diagnosis and treatment programs of cardiovascular and cerebrovascular diseases. Through a systematic theoretical tracing of the "simultaneous treatment of heart and brain"，the authors held that cardiovascular and cerebrovascular diseases had the same origin，and that heart and brain took blood as the material basis and governed mind jointly. They also expounded the modern biological relationship of the simultaneous treatment of heart and brain. In other words，the pathogenic factors of cardiovascular and cerebrovascular diseases were the same， with complicated comorbidities， and the disorders of neurohumoral reflex and endocrine system and immune system regulation could affect each other's function. Additionally，the present situation of clinical application of Chinese medicine for simultaneous treatment of heart and brain and its intervention effect on cardiovascular and cerebrovascular diseases were discussed. It was found that these Chinese medicines could protect cardiovascular and cerebrovascular diseases through multi-target，multi-pathway and multi-link regulation. Combined with the existing problems in the current research，the authors thought and looked forward to the practical strategies of treating cardiovascular and cerebrovascular diseases with Chinese medicine by paying attention to key groups，focusing on dominant diseases，giving full play to the value of Chinese medicine，and scientifically explaining the connotation of simultaneous treatment of heart and brain， in order to provide ideas and reference for the follow-up transformation application research and better guidance of clinical practice.
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Cognitive impairment secondary to cardiovascular disease is a common complication in the elderly population， which seriously threatens the health of patients and affects the long-term quality of life. Cardiovascular diseases can lead to vascular endothelial injury， cerebral hypoperfusion， and brain lesions， and then cause cognitive impairment. Cardiovascular risk factors also increase the risk of secondary cognitive impairment in patients. It is particularly important to seek for early diagnosis and traditional Chinese medicine （TCM） and western medicine prevention and treatment. Based on the "holistic concept"， TCM puts forward the theory of "the connection of heart and brain". The heart and brain are connected and both are in charge of mental activities. Heart injury affects the brain， resulting in abnormal consciousness， which is considered to be the pathogenesis of cognitive impairment secondary to cardiovascular disease in TCM. Later generations of doctors propose the theory of "simultaneous treatment of the heart and the brain" on the basis of "treating different diseases with the same treatment" and "the connection of heart and brain". The theory contains two meanings. One is that different diseases can be treated by the same method because of the same etiology and pathogenesis. The other is the coexistence of different diseases and the treatment should be targeted to the same risk factors. This paper systematically discussed the TCM pathogenesis of cognitive impairment secondary to cardiovascular disease and the prevention and treatment strategy of "simultaneous treatment of the heart and the brain". In this paper， the deficiency of qi and blood was the foundation， and the interaction of blood stasis and poison and the obstruction of the pulse and the loss of the body were the key factors. Activating blood， detoxifying arteries， and connecting the orifices were the main treatment method for the disease. This paper is expected to enrich the connotation of "simultaneous treatment of the heart and the brain"， and provide new ideas for the prevention and treatment of cognitive impairment secondary to the cardiovascular disease with TCM.
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Unstable carotid plaque is an independent risk factor for serious cerebrovascular events including stroke， making it considered as an intervention target for the primary and secondary prevention of cardiovascular diseases. Professor ZHU Liang-chun is a national distinguished master of traditional Chinese medicine （TCM） who is adept at treating difficult miscellaneous diseases with insects. He believes that the unstable carotid plaque falls into the category of “vessel impediment” in TCM according to the disease location and characteristics. The core pathogenesis of unstable carotid plaque lies in asthenia in origin and sthenia in superficiality， with spleen-kidney deficiency as the root cause and combined phlegm and blood stasis as the manifestations. He has pointed out that both phlegm and blood stasis should be emphasized in the treatment. In addition to the commonly used herbs for strengthening spleen， removing stasis， and resolving phlegm， the insects with strong effects of searching wind and dredging collateral can be added as appropriate to strengthen the power of removing stasis and dredging collateral. According to the pathogenesis of this disease， he develops the Qutan Tongluo Wenbanfang， which has been confirmed by modern pharmacological research to be efficient in resisting inflammation， regulating endothelial cell functions， lowering lipids， adjusting metabolism， and improving blood circulation， thereby ameliorating the related biological processes of atherosclerosis， suppressing atherosclerosis， and stabilizing plaques. As proved by clinical practice， Qutan Tongluo Wenbanfang helps to reduce blood lipids and reduce the area of unstable carotid plaque， indicating that it deserves clinical promotion.
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Objective:To observe the effects of addition and subtraction therapy of Danggui Shaoyaosan combined with Huaihuasan on ulcerative colitis (UC) with syndrome of dampness-heat in large intestine during active stage, and the effects on brain-gut petide neurotransmitter and inflammatory cytokines. Method:A total of 130 cases were included and randomly divided into control group and observation group, 65 cases in each group. In the control group, the patients received oral administration of mesalazine enteric-coated tablets, 1.0 g/time and 3 times/days. Severe patients received prednisone acetate tablets (0.75 mg·kg-1·d-1) in several times by oral administration. Based on the treatment in control group, patients in observation group also received addition and subtraction therapy of Danggui Shaoyaosan combined with Huaihuasan, 1 dose/day. Both groups were treated for 4 weeks. Symptom scores, Mayo scores, colonic mucosa scores and Inflammatory Bowel Disease Questionnaire (IBDQ) scores were assessed before and after treatment. Patients in remission stage were followed up for 6 months to record the recurrence. Before and after treatment, vasoactive intestinal peptide (VIP), substance P (SP), somatostatin (SS), interleukin-1 (IL-1), IL-6, IL-4 and IL-10 were detected. Result:After 4 weeks of treatment, the clinical remission rate was 93.22%in the observation group, better than 80.7%in the control group (χ2=4.035,PPPPχ2=4.509,PPPPPPConclusion:On the basis of conventional western medicine treatment, addition and subtraction therapy of Danggui Shaoyaosan combined with Huaihuasan in the treatment of UC (dampness-heat in large intestine) during active stage can control the disease activity in a short term, promote restoration of the colonic mucosa. And delay the recurrence in a long term, reduce the recurrence rate, regulate ghrelin neurotransmitters and pro-and anti-inflammatory cytokines levels.
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Objective To observe the clinical efficacy of SHAO's five-needle therapy in treating active ulcerative colitis. Method By following a randomized controlled design, 57 patients with active ulcerative colitis were divided into a lung-intestine simultaneous treatment group of 28 cases and an intestine treatment group of 29 cases. The lung-intestine simultaneous treatment group was intervened by SHAO's five-needle therapy plus medications including oral administration of mesalazine, sulfasalazine suppositories via rectal insertion and Ge Gen Qin Lian decoction via enema; the intestine treatment group was intervened by medications. The two groups were both treated successively for4 weeks. The Sutherland Disease Activity Index (Sutherland DAI) was observed in the two groups and the release rate was also assessed; the main clinical symptom and sign scores of the two groups were recorded before and after treatment. Result The Sutherland DAI score dropped after treatment in both groups (P<0.05), and the between-group difference was statistically significant (P<0.05); the scores of abdominal pain, diarrhea and stool mixed with pus and blood declined after treatment in both groups (P<0.05), and the between-group differences were statistically significant (P<0.05); the lung-intestine simultaneous treatment group was superior to the intestine treatment group comparing plus medications the therapeutic efficacy regarding the symptoms and signs (P<0.05). Conclusion SHAO's five-needle therapy can rapidly release the clinical symptoms and body signs of active ulcerative colitis and enhance the clinical efficacy.
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To establish mathematical model of Xin’an Wang’s internal medicine for treating epigastric pain through the data mining technique, and provide a more sufficient scientific basis for systematically discussing the rule of traditional Chinese medicines in treating epigastric pain. From the “Wang Zhongqi case” and “Wang Renzhi case”, outpatient medical records of Professor Letao Wang and Professor Jian Wang were used to select 310 cases of medical records in the diagnosis and treatment of epigastric pain according to inclusion criteria. Then we extracted the information of prescription, symptoms and signs, and established “information database of Xin’an Wang’s medical cases of internal medicine for treating epigastric pain”. Using frequency analysis, calculation of high-frequency drugs, and application of IBM Modeler 14.1 by SPSS Apriori algorithm for correlation analysis to extract the core prescription and then establish the mathematical model of Wang’s doctors treating epigastric pain. Wang’s doctors in Xin’an often treat the stomach and spleen with the same treatment of liver and spleen. Wang’s physician treated epigastric pain with both liver and spleen. Wang’s physician assisted the spleen with Tongyang method, or relieved phlegm, dredged liver and Qi to Tongyang, or Xinwen Sanhan to Tongyang, or Jianpi Huashi to Tongyang, or Huoxue Xingqi to Tongyang and Huoxue Sanjie method and Huoxue Huayu method.
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BACKGROUND: Displacement of dental implants into the maxillary sinus is rare, but it primarily occurs in patients with severe pneumatization of the maxillary sinus and/or deficiency of the alveolar process. Some complications such as the infection of the paranasal sinuses and formation of the oroantral fistula can be followed by the displacement of a dental implant. Therefore, the displaced implant has to be removed immediately with surgical intervention show and another plan for rehabilitation should be considered. MAIN BODY: The conventional procedure for the removal of a displaced implant from the maxillary sinus involves sinus bone grafting and new implant placement performed in two or more steps with a significant time gap in between. Simplification of these surgical procedures can decrease the treatment duration and patient discomfort. CONCLUSIONS: In this review, we discuss the anatomical characteristics of the maxillary sinus and the complications associated with implant displacement into the sinus.