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Objective:To systematically evaluate the clinical efficacy of Yiqi Yangyin Huoxue method for the treatment of diabetic retinopathy (DR).Methods:Clinical research literature about Yiqi Yangyin Huoxue method for the treatment of DR was retrieved from China Biomedical Literature Database (CBM), VIP information Chinese Periodical Service Platform (VIP), China National Knowledge Infrastructure (CNKI), Wanfang data, Cochrane Library and PubMed database from the establishment of the databases to December 31, 2021. RevMan5.3 software was used for meta-analysis.Results:A total of 18 articles were included, with a total of 1 487 patients. The results of meta-analysis showed that Yiqi Yangyin Huoxue method for the treatment of DR had curative effect advantages in improving the total clinical effective rate [ RR=1.31, 95% CI (1.21,1.41), P<0.001], the vision [ MD=0.12, 95% CI (0.07, 0.17), P<0.001], the level of whole blood reduced viscosity low shear [ MD=-2.80, 95% CI (-3.76, -1.84), P<0.001], the level of whole blood reduced viscosity high shear [ MD=-0.69, 95% CI (-1.15, -0.24), P=0.003], and plasma viscosity [ MD=-0.31, 95% CI (-0.51, -0.12), P=0.002], decreasing serum vascular endothelial growth factor [ SMD=-1.04, 95% CI (-1.26, -0.81), P<0.001], increasing TCM symptom score [ MD=-3.79, 95% CI (-6.16,-1.42), P=0.002], reducing the level of tumor necrosis factor-α [ SMD=-2.53, 95% CI (-3.55, -1.50), P<0.001] which were better than that of pure Western medicine ( P<0.05). Conclusion:The application of Yiqi Yangyin Huoxue method for the treatment of DR can improve vision, hemorheology and TCM symptoms, improve the total clinical response rate, and reduce the levels of VEGF and TNF-α, with high clinical safety.
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The basic pathogenesis of diabetes is yin deficiency as the root and dry heat as the symptoms, both of which are reciprocal causation. The occurrence and development of this disease is closely related to pathogenic heat, and pathogenic heat has different degrees of deficiency and excess, and is often cemented with tangible pathogenic factors, such as dampness, phlegm and blood stasis. Clinical application of Traditional Chinese Medicine treatment of the eight methods of "clearing therapy" in the treatment of diabetes and its complications has often achieved significant efficacy, which is specifically divided into Qingxie method (clearing heat and purging fire method), for the syndrome of excessive heat in the viscera, and the representative prescriptions are Dahuang Huanglian Xiexin Decoction and Longdan Xiegan Decoction; Qingli method (clearing heat and draining dampness method), for the accumulation of damp heat in the spleen and stomach, gastrointestinal, block triple energizer, and the representative prescription is Gegen Qinlian Decoction; Qinghua method (clearing heat and resolving phlegm, removing blood stasis method) for the disease caused by phlegm, the course of the disease is lingering, complex and changeable, or caused by blood stasis. The disease is various, more serious, with more experience in clinical use of self-made prescriptions; Qingbu method (clearing heat and nourishing method) is for the patients with diabetes for a long time. The pathogenic heat hurts yin and consumes qi, and the representative prescriptions are Baihu Jia Renshen Decoction, Huanglian Ejiao Decoction, and Yu'nyu Decoction.
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Traditional Chinese Medicine (TCM) has its own unique features in the treatment of post-stroke depression (PSD). The kidney is the congenital foundation and is closely related to the brain. Kidney deficiency runs through the entire course of stroke. Liver regulates the normal operation of qi in the human body, which is closely related to depression syndrome. Kidney deficiency and liver depression affect each other. The treatment of PSD with the Bushen Shugan (tonifying the kidney and soothing the liver) method has achieved good efficacy in clinic. The method of tonifying kidney and soothing liver can not only reflect the holistic view of TCM and the association of viscera, but also coordinate the relationship between body and spirit. In the future, the development direction of PSD in TCM research should be to further strengthen the concept of co-regulation of body and spirit and integration of brain and viscera.
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This article aimed to explore the theoretical connotation and mechanism of clearing damp-heat method in the treatment of chronic kidney disease (CKD), provide theoretical support for clearing damp-heat method in the treatment of chronic kidney disease, and further explain the modern scientific connotation of "damp-heat impairing kidney". Modern Traditional Chinese Medicine (TCM) believes that damp-heat is an important pathogenesis of kidney damage. Clearing damp-heat method plays a key role in inhibiting CKD immune inflammatory response, improving oxidative stress and antagonizing renal fibrosis. The mechanism is mainly related to the regulation of TNF-α level, blocking NF-κB signaling pathway, inhibiting inflammatory cytokines, antagonizing TGF-β1 secretion and other pathways.