Qi stagnation and qi deficiency are associated with depression in college students.

Objective: The current study aims to investigate the correlations between qi stagnation, qi deficiency, and depression levels among college students. Method: This study investigated 403 college students and measured their levels of depression, qi stagnation, and qi deficiency to analyze the relationship between these three variables. Pearson correlation and linear regression statistical techniques were utilized. Results: (1) On average, college students reported mild depressive symptoms; (2) college students manifested low levels of qi stagnation and qi deficiency. (3) There exists a strong positive correlation between qi stagnation and qi deficiency; (4) a moderate positive correlation is present between depression and both qi stagnation and qi deficiency among college students. All these results support the mechanism by which qi stagnation and qi deficiency contribute to depression in traditional Chinese medicine theory. Conclusion: Qi stagnation and qi deficiency are moderately associated with depression levels in college students. It is feasible to use traditional Chinese physical therapy for qi regulation to alleviate depressive symptoms among college students.

Identification of Biomarkers for Lung Adenocarcinoma With Qi Deficiency and Phlegm Dampness.

BACKGROUND: Qi deficiency and phlegm dampness (QPD) is one of the most common traditional Chinese medicine (TCM) syndromes in lung adenocarcinoma (LUAD). This study aimed to identify syndrome-specific biomarkers for LUAD with QPD syndrome. METHODS: Peripheral blood mononuclear cells (PBMCs) from LUAD patients with QPD, LUAD patients with non-QPD (N-QPD), and healthy control (H) were collected and analyzed with RNA-seq to identify differentially expressed genes (DEGs). The area under the receiver operator characteristic curve (AUC) of each DEG was calculated, and the top 10 highest AUC DEGs were validated by qRT-PCR. Logistic regression analysis was used to develop a diagnostic model evaluated with AUC. RESULTS: A total of 135 individuals were enrolled in this study (training set: 15 QPD, 15 N-QPD, 15 H; validation set: 30 QPD, 30 N-QPD, 30 H). A total of 1480 DEGs were identified between QPD and N-QPD. The qRT-PCR results showed that the expression of DDR2 was downregulated, and PPARG was upregulated, which was in line with the finding of the training set. We developed a diagnostic model with these two genes. The AUC of the diagnostic model in the training cohort and validation cohort was 0.891 and 0.777, respectively. CONCLUSIONS: We identified the two genes (DDR2 and PPARG) as syndrome-specific biomarkers for LUAD with QPD syndrome and developed a novel diagnostic model, which may help to improve the accuracy and sensibility of clinical diagnosis and provide a new target for natural drug treatment of LUAD.

Network pharmacology-based exploration of molecular mechanisms underlying therapeutic effects of Jianpi Huatan Quyu recipe on chronic heart failure with spleen Qi deficiency syndrome.

BACKGROUND: Chronic heart failure is a complex clinical syndrome. The Chinese herbal compound preparation Jianpi Huatan Quyu recipe has been used to treat chronic heart failure; however, the underlying molecular mechanism is still not clear. AIM: To identify the effective active ingredients of Jianpi Huatan Quyu recipe and explore its molecular mechanism in the treatment of chronic heart failure. METHODS: The effective active ingredients of eight herbs composing Jianpi Huatan Quyu recipe were identified using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform. The target genes of chronic heart failure were searched in the Genecards database. The target proteins of active ingredients were mapped to chronic heart failure target genes to obtain the common drug-disease targets, which were then used to construct a key chemical component-target network using Cytoscape 3.7.2 software. The protein-protein interaction network was constructed using the String database. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed through the Metascape database. Finally, our previously published relevant articles were searched to verify the results obtained via network pharmacology. RESULTS: A total of 227 effective active ingredients for Jianpi Huatan Quyu recipe were identified, of which quercetin, kaempferol, 7-methoxy-2-methyl isoflavone, formononetin, and isorhamnetin may be key active ingredients and involved in the therapeutic effects of TCM by acting on STAT3, MAPK3, AKT1, JUN, MAPK1, TP53, TNF, HSP90AA1, p65, MAPK8, MAPK14, IL6, EGFR, EDN1, FOS, and other proteins. The pathways identified by KEGG enrichment analysis include pathways in cancer, IL-17 signaling pathway, PI3K-Akt signaling pathway, HIF-1 signaling pathway, calcium signaling pathway, cAMP signaling pathway, NF-kappaB signaling pathway, AMPK signaling pathway, etc. Previous studies on Jianpi Huatan Quyu recipe suggested that this Chinese compound preparation can regulate the TNF-α, IL-6, MAPK, cAMP, and AMPK pathways to affect the mitochondrial structure of myocardial cells, oxidative stress, and energy metabolism, thus achieving the therapeutic effects on chronic heart failure. CONCLUSION: The Chinese medicine compound preparation Jianpi Huatan Quyu recipe exerts therapeutic effects on chronic heart failure possibly by influencing the mitochondrial structure of cardiomyocytes, oxidative stress, energy metabolism, and other processes. Future studies are warranted to investigate the role of the IL-17 signaling pathway, PI3K-Akt signaling pathway, HIF-1 signaling pathway, and other pathways in mediating the therapeutic effects of Jianpi Huatan Quyu recipe on chronic heart failure.

Mental fatigue mediates the relationship between qi deficiency and academic performance among fifth-grade students aged 10-13 years.

Background: Health has effects on children's academic performance. Qi deficiency is generally used to assess an individual's health in the Chinese traditional medicine theory. This study explores the effects of qi deficiency on children's academic performance and examines whether mental fatigue mediates these effects. Methods: A total of 550 students aged 10-13 in fifth-grade were surveyed in a big primary school in Sichuan Province in November 2023 using paper-pencil-based questionnaires. Qi deficiency and mental fatigue were assessed, and exam scores in Chinese and Mathematics were recorded. Pearson's correlation and linear regression analyses were used to test the mediation model and hypotheses. Results: The fifth-grade students had mild qi deficiency (M = 2.09) and a mild state of mental fatigue (M = 2.38) on a five-point Likert scale. The average exam scores in Mathematics and Chinese were 70.07 and 74.44 points out of 100, respectively. Qi deficiency was associated with Mathematics scores (r = -0.37, p < 0.01) and Chinese scores (r = -0.30, p < 0.01), and mental fatigue (r = 0.47, p < 0.01). Furthermore, mental fatigue was associated with Mathematics scores (r = -0.46, p < 0.01) and Chinese scores (r = -0.34, p < 0.01). Linear regression analyses showed that qi deficiency significantly predicted Mathematics scores (ß = -0.26, p < 0.01), Chinese scores (ß = -0.19, p < 0.01), and mental fatigue (ß = 0.41, p < 0.01). When qi deficiency was controlled for, mental fatigue significantly predicted Mathematics scores (ß = -0.28, p < 0.01) and Chinese scores (ß = -0.17, p < 0.01). Conclusion: The mediation model and hypotheses were well supported, indicating that mental fatigue mediated the influence of qi deficiency on academic performance of fifth-grade students. Furthermore, the mediation effect of mental fatigue on Mathematics scores was a little stronger than that on Chinese scores.

Analysis of Gut Microbiota as a Diagnostic Biomarker for Lung Adenocarcinoma with Qi-Deficiency and Phlegm-Turbid Stagnation.

BACKGROUND: In lung adenocarcinoma (LUAD), Qi-deficiency and Phlegm-turbid stagnation (QP) are the most prevalent Traditional Chinese medicine (TCM) syndrome. METHODS: Herein, we collected 90 fecal samples (Healthy individual (H): 30; other syndrome (O): 30; QP: 30) and explored the composition and diversity of gut microbiota in LUAD patients with QP syndrome using 16s-rRNA sequencing. Then, we identified biomarkers for QP syndrome in LUAD patients with linear discriminant analysis (LDA) effect size (LEfSe) and applied logistic regression analysis to construct a diagnostic model evaluated with the area under the receiver operating characteristic curve (AUC) and validated with data from metagenomics. RESULTS: The α diversity and ß diversity revealed that the microbiota community structure in LUAD patients with QP syndrome was different from that with healthy individuals and LUAD patients with other syndromes. At the phylum level, the QP group had more abundance of Bacteroidetes and less Proteobacteria than the O group. At the genus level, the abundance of 4 genera (Bacteroides, Parabacteroides, Prevotella, and Flavonifractor) was different between the QP group and O group. Moreover, LEfSe indicated that those 4 genera might be the biomarkers for LUAD patients with QP syndrome. Then, we used those 4 genera to develop a diagnostic model. The AUC based on 16s-rRNA sequencing and metagenomics was 0.989 and 1, respectively. CONCLUSION: A diagnostic model was developed, which would be an available tool for the clinical diagnosis of LUAD with QP syndrome.

The influence of early diet quality on the mental health of college students: the mediation effects of height and qi-deficiency.

Background: In China, the prevalence of mental health issues among college students is a significant concern in society. This study aims to investigate the impact of early dietary quality on the psychological well-being of college students and elucidate the underlying mechanisms through which these effects occur, specifically focusing on height and qi-deficiency as mediators according to Chinese traditional medicine (CTM). Methods: A total of 655 college students were surveyed in October 2023 using paper-pencil-based questionnaires at four second-tier universities in Sichuan Province. The assessment included mental health, height, and qi-deficiency. Pearson's correlation and linear regression analyses were employed to examine the mediation model and test the hypotheses. Results: The college students exhibited acceptable levels of early diet quality (M = 3.72) and mental health (M = 3.63), while also presenting mild qi-deficiency symptoms (M = 2.25). Their average height was measured at 164.61 cm. Early diet quality demonstrated significant associations with mental health (r = 0.38, p < 0.01), height (r = 0.32, p < 0.01), and qi-deficiency (r = -0.32, p < 0.01). Mental health displayed correlations with height (r = 0.32, p < 0.01) and qi-deficiency (r = -0.49, p < 0.01). The results of linear regression analyses revealed significant associations between early diet quality and mental health (ß = 0.31, p < 0.01), height (ß = 0.21, p < 0.01), as well as qi-deficiency (ß = -0.26, p < 0.01). Furthermore, when early diet quality was included in the regression model, both height (ß = 0.21, p < 0.01) and qi-deficiency (ß = -0.35, p < 0.01) emerged as significant mediators in the relationship with mental health. Conclusion: The mediation model and hypotheses were strongly supported, demonstrating that early diet quality exerted an influence on the mental health of college students through two distinct pathways: height and qi-deficiency. Moreover, the mediating effect of qi-deficiency was found to be more pronounced than that of height in the relationship between early diet quality and mental health among college students.

Parallel needling technique for peripheral facial paralysis with qi deficiency and blood stasis: a randomized controlled trial. / å¹³è¡Œå¯¹åˆºæ³•æ²»ç–—æ°”è™šè¡€ç˜€åž‹å‘¨å›´æ€§é¢ç˜«ï¼šéšæœºå¯¹ç §è¯•éªŒ.

OBJECTIVES: To observe the clinical efficacy of the parallel needling technique for peripheral facial paralysis with qi deficiency and blood stasis. METHODS: Sixty-two patients with peripheral facial paralysis of qi deficiency and blood stasis were randomly assigned to a parallel needling group and a conventional acupuncture group, with 31 patients in each group. The conventional acupuncture group received needling at Yangbai (GB 14), Quanliao (SI 18), Jiache (ST 6), Dicang (ST 4), Yifeng (TE 17) on the affected side, Hegu (LI 4) on the healthy side, and bilateral Zusanli (ST 36), Sanyinjiao (SP 6), Xuehai (SP 10) and Qihai (CV 6) etc. The parallel needling group, in addition to the conventional acupuncture points, received parallel needling at three additional groups of acupoints, i.e. forehead wrinkle group, mid-face group, and corner of the mouth group. Both groups retained needles for 30 min, with one session every other day and a total of three sessions per week, lasting for four weeks. The House-Brackmann (H-B) facial nerve function grading, physical function (FDIP) and social function (FDIS) scores of facial disability index (FDI), TCM syndrome score before and after treatment were compared between the two groups, and the clinical efficacy was assessed. RESULTS: Compared with before treatment, after treatment, both groups showed improvements in H-B facial nerve function grading (P<0.05), FDIP total scores and sub-item scores were increased (P<0.05), FDIS total scores, sub-item scores, and TCM syndrome scores were decreased (P<0.05). After treatment, the parallel needling group showed the higher FDIP total score and eating sub-item score and lower FDIS total score and insomnia sub-item score compared with those in the conventional acupuncture group (P<0.05). The total effective rate was 90.3% (28/31) in the parallel needling group and 87.1% (27/31) in the conventional acupuncture group, with no statistically significant difference between the two groups (P>0.05). CONCLUSIONS: The parallel needling technique combined with conventional acupuncture, is as effective as conventional acupuncture alone in treating facial paralysis with qi deficiency and blood stasis. However, the parallel needling technique combined with conventional acupuncture shows advantages in the improvement of food intake and sleep quality.

UPLC-QTOF-MS based metabolomics unravels the modulatory effect of ginseng water extracts on rats with Qi-deficiency.

Ginseng is commonly used as a nutritional supplement and daily wellness product due to its ability to invigorate qi. As a result, individuals with Qi-deficiency often use ginseng as a health supplement. Ginsenosides and polysaccharides are the primary components of ginseng. However, the therapeutic effects and mechanisms of action of these components in Qi-deficiency remain unclear. This study aimed to determine the modulatory effects and mechanisms of ginseng water extract, ginsenosides, and ginseng polysaccharides in a rat model of Qi-deficiency using metabolomics and network analysis. The rat model of Qi-deficiency was established via swimming fatigue and a restricted diet. Oral administration of different ginseng water extracts for 30 days primarily alleviated oxidative stress and disrupted energy metabolism and immune response dysfunction caused by Qi-deficiency in rats. Ultra-high-performance liquid chromatography combined with quadrupole time-of-flight mass spectrometry (UPLC-QTOF-MS) was used for untargeted serum metabolomic analysis. Based on the analysis results, the active constituents of ginseng significantly reversed the changes in serum biomarkers related to Qi-deficiency in rats, particularly energy, amino acid, and unsaturated fatty acid metabolism. Furthermore, analysis of the metabolite-gene network suggested that the anti-Qi-deficiency effects of the ginseng components were mainly associated with toll-like receptor (TLR) signaling and inflammatory response. Additional verification revealed that treatment with the ginseng components effectively reduced the inflammatory response and activation of the myocardial TLR4/NF-κB pathway induced by Qi-deficiency, especially the ginseng water extracts. Therefore, ginseng could be an effective preventive measure against the progression of Qi-deficiency by regulating metabolic and inflammatory responses.

Clinical Study on the Effects of Yiweining Capsules Combined with Rebamipide Tablet in Treating Chronic Atrophic Gastritis with Spleen-stomach Qi Deficiency Syndrome / 中国中医药信息杂志

Objective To observe the clinical effects of Yiweining Capsules combined with rebamipide tablet in the treatment of spleen-stomach qi deficiency syndrome in chronic atrophic gastritis(CAG).Methods Totally 80 patients with CAG were divided into the study group and the control group by using the random number table method,with 40 cases in each group.Both groups were given rebamipide tablet,0.1 g/time,3 times a day,orally;on this basis,the study group added Yiweining Capsules 2 g/time,3 times a day,orally.Both groups were treated continuously for 12 weeks.The TCM efficacy,the efficacy of gastroscopy and the efficacy of histopathology in the two groups were observed.The TCM symptom score before and after treatment in two groups were observed.The adverse reactions were recorded.Results No cases fell off in both groups.The total effective rate was 92.5%(37/40)in the study group and 70.0%(28/40)in the control group,and the clinical efficacy of the study group was better than that of the control group(P<0.01).Compared with before treatment,the total TCM symptom scores in the two groups after treatment decreased(P<0.01);Compared with after treatment,the total scores of TCM symptom in the study group were lower than those in the control group(P<0.05,P<0.01).The total effective rate of gastroscopy in the study group(82.5%)was better than that in the control group(67.5%),with statistical significance(P<0.05).The overall efficacy rate of histopathdogy in the study group(87.5%)was better than that of the control group(70.0%),with statistical significance(P<0.01).There were no adverse reactions in both groups.Conclusion Yiweining Capsules combined with rebamipide tablet can effectively improve the clinical symptoms,gastroscopic manifestations and the degree of mucosal lesions in patients with CAG,with remarkable efficacy.

Effects of Zhoufei Pingchuan Capsules on Th17/Treg Balance and Related Inflammatory Factors in Peripheral Blood of Patients with Stable Chronic Obstructive Pulmonary Disease with Lung-kidney Qi Deficiency Syndrome / 中国中医药信息杂志

Objective To investigate the effects of Zhoufei Pingchuan Capsules on the balance of peripheral blood helper T lymphocyte 17 cell/regulatory T lymphocyte cell(Th17/Treg)and related inflammatory factors in peripheral blood of patients with stable chronic obstructive pulmonary disease(COPD)with lung-kidney qi deficiency syndrome.Methods Totally 40 COPD patients were randomly divided into the study group and the control group,with 20 cases in each group.Another 20 cases were in the healthy group.The control group was given tiotropium bromide powder inhalation,18 μg/time,1 time/d,inhalation;on the basis of the control group,the study group was given Zhoufei Pingchuan Capsules,3 pills/time,3 times/d,orally.All patients were treated for 8 weeks.The healthy group was not given any intervention.Forced expiratory volume in one second(FEV1),FEV1/forced vital capacity(FEV1/FVC),maximum mid-expiratory flow(MMEF),carbon monoxide diffusing capacity/alveolar ventilation(DLCO/VA),arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),COPD assessment test(CAT)score,Th17/Treg ratio,cytokines interleukin(IL)-17,IL-22,IL-10,and transforming growth factor-β1(TGF-β1)were compared before and after treatment.Results Compared with before treatment,the lung function indexes(FEV1,FEV1/FVC,MMEF,DLCO/VA),blood gas indexes(PaO2,PaCO2)and CAT score in the study group after treatment were significantly improved(P<0.05).After treatment,the mean values of MMEF,DLCO/VA,PaCO2 and CAT score in the study group were better than those in the control group(P<0.05).Compared with before treatment,the levels of Th17,IL-17 and IL-22 in the study group were significantly lower,and the levels of Treg,IL-10 and TGF-β1 were significantly higher(P<0.05).After treatment,there were significant differences in Th17,Treg,IL-17,IL-22,IL-10 and TGF-β1 among the three groups(P<0.01).Further pairwise comparison showed that Th17 ranked in the order of high and low was control group>study group>healthy group,Treg in the order of high and low was healthy group>study group>control group,the levels of IL-17 and IL-22 in the order of high and low were control group>study group>healthy group,and the levels of IL-10 and TGF-β1 in the order of high and low were healthy group>study group>control group,with statistical significance(P<0.05).Conclusion Zhoufei Pingchuan Capsules can improve the lung function,arterial blood gas and symptom score of patients with lung-kidney qi deficiency syndrome in stable stage of COPD.Its mechanism may be related to regulating the balance of Th17/Treg,down-regulating the levels of Th17,IL-17 and IL-22,and up-regulating the levels of Treg,IL-10 and TGF-β1,in order to reduce airway inflammation and regulate immune homeostasis.

Effect of Atractylenolide Ⅰ on Lung Injury in Rats with Recurrent Respiratory Tract Infection of Lung and Spleen Qi Deficiency by Regulating the PI3K/Akt/mTOR Signaling Pathway / 中药新药与临床药理

Objective To investigate the effect of atractylenolideⅠon lung injury in rats with recurrent respiratory tract infection(RRTI)of lung and spleen qi deficiency by regulating phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin(PI3K/Akt/mTOR)pathway.Methods Eighty-four rats were randomly separated into a control group,a model group,a low-dose atractylenolideⅠgroup,a high-dose atractylenolideⅠgroup,a positive drug group,an insulin-like growth factor-1(IGF-1)group,and a high-dose atractylenolide Ⅰ+IGF-1 group,with 12 rats in each group.Except for the control group,the RRTI rat model of lung and spleen qi deficiency was constructed using a combination of fatigue,dietary disorders,and fumigation method with shavings and tobacco among rats in other groups.After the model is successfully copied,the model was administered once a day for 6 weeks.Animal lung function instrument was applied to detect the changes of peak expiratory flow(PEF),forced expiratory volume in first second(FEV1),forced vital capacity(FVC)in rats.The changes of wet/dry mass ratio of lungs in rats were detected.HE staining was applied to detect pathological changes of lung tissue in rats of each group.ELISA was applied to detect the levels of interleukin(IL)-6,tumor necrosis factor-α(TNF-α),malondialdehyde(MDA)and the activity of superoxide dismutase(SOD)in rat lung tissue.Western Blot was applied to determine the protein expressions of p-PI3K,p-Akt,and p-mTOR in rat lung tissue.Results Compared with the control group,rats in the model group showed a decrease in PEF,FEV1 and FVC(P＜0.01)and an increase in the wet/dry mass ratio of lungs(P＜0.01).The alveolar septa in lung tissues had become larger.Pulmonary interstitial edema and a large amount of inflammatory cell infiltration were found.The levels of IL-6,TNF-α and MDA in lung tissue increased(P＜0.01),and the SOD activity decreased(P＜0.01).The protein expressions of p-PI3K,p-Akt,and p-mTOR in lung tissue increased(P＜0.01).Compared with the model group,rats in the low-,high-dose atractylenolideⅠgroups,and positive drug group showed an increase in PEF,FEV1,and FVC,and a decrease in the wet/dry mass ratio of lungs(P＜0.01).Pathologic damage in lung tissue was alleviated.The levels of IL-6,TNF-α,MDA decreased and SOD activity in lung tissue increased(P＜0.01).The protein expressions of p-PI3K,p-Akt,and p-mTOR in lung tissue decreased(P＜0.01),while the corresponding indicators in the IGF-1 group showed opposite trends(P＜0.01).Compared with the high-dose group of atractylenolide I,rats in the high-dose atractylenolide I+IGF-1 group showed a decrease in PEF,FEV1 and FVC,and an increase in the wet/dry mass ratio of lungs(P＜0.01).Pathologic damage in lung tissue was increased.The levels of IL-6,TNF-α,MDA increased and the SOD activity in lung tissue decreased(P＜0.01).The protein expressions of p-PI3K,p-Akt,and p-mTOR in lung tissue increased(P＜0.05,P＜0.01).Conclusion AtractylenolideⅠmay improve lung injury in RRTI rats of lung and spleen qi deficiency by inhibiting the PI3K/Akt/mTOR pathway.

The Effect of Yiqi Huoxue Formula （益气活血方） in the Treatment of Chronic Pulmonary Heart Disease and Heart Failure with Qi Deficiency and Blood Stasis Pattern of 58 Cases： A Randomized Controlled Trial / 中医杂志

ObjectiveTo explore the effectiveness and safety of Yiqi Huoxue Formula （益气活血方， YHF） in the adjuvant treatment of chronic pulmonary heart disease （CPHD） and heart failure （HF）with qi deficiency and blood stasis pattern. MethodsOne hundred and twenty patients with CPHD and HF with qi deficiency and blood stasis pattern were allocated randomly into treatment group and control group， with 60 case in each group. The control group was given conventional basic western medicine， while the treatment group was given oral administration of YHF granules in addition， one dose per day. The treatment course for both groups was 8 weeks. The TCM symptom scores， Minnesota Life Quality Scale （MLHF-Q） scores， echocardiographic indicators including right ventricular end-diastolic diameter （RVEDD）， left ventricular end-diastolic diameter （LVEDD）， left atrial end-diastolic diameter （LAEDD） and pulmonary artery mean pressure （PAMP）， six-minute walking distance （6MWD）， and plasma N-terminal pro-B-type natriuretic peptide （NT-ProBNP） level were compared between the groups. The effectiveness regarding cardiac function and TCM syndromes were compared between the two groups after treatment， and the occurrence of adverse events was observed. ResultsWith two drop-outs both in the treatment group and control group， and 58 cases in each group were included in the outcome analysis. The total effective rate regarding cardiac function and TCM syndromes in the treatment group were 91.38% （53/58） and 96.55% （56/58）， respectively， significantly higher than the corresponding 70.69% （41/58） and 48.27% （28/58） in the control group （P＜0.05）. After treatment， the TCM symptom scores and RVEDD level were significantly reduced in the treatment group， and MLHF-Q score， plasma NT-ProBNP level and PAMP level decreased significantly， while 6MWD increased in both groups （P＜0.01）. Compared to those in the control group， the TCM symptom scores， MLHF-Q score， plasma NT-ProBNP level and PAMP level significantly decreased， while 6MWD increased in the treatment group （P＜0.01）. There were no obvious abnormalities in the blood， urine， stool routine and liver and kidney function indicators in both groups. One adverse reaction each occurred in both groups， and there was no statistically significant difference in the incidence rates（P＞0.05）. ConclusionYHF combined with conventional western medicine can significantly improve the clinical efficacy， improve the clinical symptoms and cardiac function， increase the quality of life and exercise tolerance， and is relatively safe.

Exploring Traditional Chinese Medicine Pattern Identification and Treatment of Malignant Tumors Based on “Regulating Qi with Changes” / 中医杂志

It is believed that qi changes throughout the whole process of malignant tumors. Tumour formation is induced by qi constraint in the early stage， qi sinking is the core disease mechanism after tumour surgery， qi counterflow is an important disease mechanism for nausea and vomiting related symptoms in chemotherapy stage， and qi deficiency is the main pathology in recurrence and metastasis stage. It is proposed that the therapeutic principle of “regulating qi with changes” discussed in Miraculous Pivot-Wei Qi Disorder （《灵枢·卫气失常》） should be implemented in traditional Chinese medicine （TCM） pattern identification and treatment of malignant tumours， modifying the treatment with changes， and regulating qi with corresponding methods： for qi constraint， it should soothe to eliminate the tumour by the method of rectifying qi to resolve constraint， with treatment as Shugan Jianpi Formula （疏肝健脾方）； for qi sinking， it should raise to lift up postoperative viscera by the method of boosting qi to raise sinking， with treatment as Shengxian Decoction （升陷汤） from Records of Chinese Medicine with Reference to Western Medicine （《医学衷中参西录》）； for qi counterflow， the method of moving qi and direct counterflow downward will be used to dissipate the accumulated medicinal toxicity， and patients with retention of medicinal toxicity in the middle jiao and ascending counterflow of stomach qi treated by Xuanfu Daizhe Decoction （旋覆代赭汤） from On Cold Damage （《伤寒论》）， patients with middle yang deficiency and turbid ying failing to descend treated by Wuzhuyu Decoction （吴茱萸汤） from On Cold Damage （《伤寒论》） ； for qi deficiency， it should tonify to prevent the tumor toxin from spreading by the method of boosting qi to resolve toxins， treated by Fuzheng Jiedu Formula （扶正解毒方）.

Effects of Bimin Formula （鼻敏方） on the Nasal Mucosa TMEM16A/NF-κB/MUC5AC Signaling Pathway in a Rat Model of Allergic Rhinitis with Lung-Spleen Qi Deficiency / 中医杂志

ObjectiveTo explore the possible mechanism of Bimin Formula （鼻敏方） in treating lung-spleen qi deficiency syndrome of allergic rhinitis （AR） with high mucin secretion. MethodsThirty-four SD rats were randomly divided into a blank group （8 rats）， a model group （8 rats）， a low-dose Bimin Formula group （8 rats）， and a high-dose Bimin Formula group （10 rats）. Except for the blank group， the other groups were subjected to AR lung-spleen qi deficiency rat models induced by smoking， gavage of Ginkgo biloba leaf extract， and ovalbumin. After modeling， rats in the low- and high-dose Bimin Formula groups were given Bimin Formula concentrate （concentration of 2.16 g/ml） by gavage at doses of 1.08 g/100 g and 2.16 g/100 g， respectively， while rats in the model group were given 0.5 ml/100 g of normal saline by gavage， once daily for 28 days； the blank group was not intervened. Behavioral assessments were performed after intervention. ELISA was used to detect the levels of peripheral blood total immunoglobulin E （IgE）. HE staining was used to observe the pathological changes of nasal mucosa epithelium in rats， while immunohistochemistry was used to detect the expression of transmembrane protein 16A （TMEM16A） and mucin 5AC （MUC5AC） protein in nasal mucosa. Western Blot was used to detect the expression of nuclear factor kappa B （NF-κB） protein， and RT-PCR was used to detect the expression of TMEM16A， MUC5AC， and NF-κB mRNA in nasal mucosa. ResultsHE staining showed that the nasal mucosa epithelial cell structure in the blank group was intact without shedding， swelling， or necrosis； the nasal mucosa epithelial tissue of rats in the model group was thickened and partially shed， with infiltration of eosinophils and lymphocytes visible； the pathological changes in nasal mucosa tissue of rats in the high- and low-dose Bimin Formulagroups were improved， and more improvement was showen in the high-dose group. Compared with those in the blank group， the behavioral scores and peripheral blood total IgE levels of rats in the model group significantly increased， as well as the expression of TMEM16A， MUC5AC， and NF-κB proteins and mRNA in nasal mucosa （P＜0.05 or P＜0.01）. Compared with those in the model group， the behavioral scores and peripheral blood total IgE levels of rats in the high-dose Bimin Formula group decreased， and the expression of TMEM16A， MUC5AC， and NF-κB proteins and mRNA in nasal mucosaalso decreased （P＜0.05 or P＜0.01）； the behavioral scores and peripheral blood total IgE levels of rats in the low-dose Bimin Formula group were reduced， and the expression of TMEM16A and MUC5AC proteins and mRNA in nasal mucosa， as well as the expression of NF-κB protein decreased （P＜0.05 or P＜0.01）， but the difference in NF-κB mRNA expression was not statistically significant （P＞0.05）. Compared with the low-dose Bimin Formula group， the expression of NF-κB protein in the high-dose group decreased （P＜0.01）. ConclusionBimin Formula may improve the symptoms and high mucus secretion of AR lung-spleen qi deficiency by regulating the TMEM16A/NF-κB/MUC5AC signaling pathway in nasalmucosa.

Bushen Huoxue Formula （补肾活血方） Combined with Conventional Western Medicine for 129 Patients of Heart Failure with Mid-range Ejection Fraction with Syndrome of Qi Deficiency and Blood Stasis：A Randomized Controlled Trial / 中医杂志

ObjectiveTo evaluate the clinical effectiveness of Bushen Huoxue Formula （补肾活血方） in the treatment of heart failure with mid-range ejection fraction. MethodsA total of 277 patients of heart failure with mid-range ejection fraction with syndrome of qi deficiency and blood stasis were randomly divided into the treatment group （139 cases） and the control group （138 cases）. The control group was given conventional western medicine， and the treatment group was given Bushen Huoxue Formula on the basis of the control group. Both groups were treated for 8 weeks. Left ventricular ejection fraction （LVEF）， N-terminal B-type natriuretic peptide （NT-pro BNP） level， cardiac function grade， Minnesota heart failure quality of life score， anxiety score， depression score， and the major incidence of cardiovascular adverse events and re-hospitalization rate after 6-month treatment were compared between the two groups before and after treatment. ResultsThere were 10 withdrawals in the treatment group and 6 withdrawals in the control group， so 129 cases in the treatment group and 132 cases in the control group completed the trial. After treatment， LVEF increased and NT-pro BNP level decreased in both groups （P＜0.05）； compared with those in the control group， LVEF increased and NT-pro BNP level decreased in the treatment group （P＜0.05）. The total rate of graded improvement of cardiac function in the treatment group （97.67%， 126/129 cases） was higher than that in the control group （84.09%， 111/132 cases） （P＜0.05）. After treatment， the Minnesota heart failure quality of life score， anxiety score， and depression score were lower in both groups （P＜0.05）， and the above scores in the treatment group were lower than those in the control group （P＜0.05）. After 6-month treatment， there was no death event in both groups， and there was no significant difference in the major incidence of cardiovascular adverse events between the treatment group （25.58%， 33/129 cases） and the control group （33.33%， 44/132 cases） （P＞0.05）. The rate of re-hospitalization in treatment group （14.73%， 19/129 cases） was lower than that in control group （30.30%， 40/132 cases） （P＜0.05）. ConclusionBushen Huoxue Formula can increase LVEF， reduce NT-pro BNP， improve quality of life， improve anxiety and depression， and reduce the rate of re-hospitalization in patients of heart failure with mid-range ejection fraction with syndrome of qi deficiency and blood stasis.

The Effects of Huqi Zhengxiao Formula （槲芪癥消方） on the Survival Rate and Quality of Life of Patients of Stage Ⅲ Hepatitis B-Associated Primary Liver Cancer with Syndrome of Healthy Qi Deficiency， Toxic Stasis Accumulation After Transcatheter Arterial Chemoembolisation Treatment / 中医杂志

ObjectiveTo observe the effects of Huqi Zhengxiao Formula （槲芪癥消方） on the survival rate and quality of life of patients with stage Ⅲ hepatitis B-associated primary liver cancer （PLC） with syndrome of healthy qi deficiency and toxic stasis accumulation after transcatheter arterial chemoembolisation （TACE） treatment. MethodsOne hundred and twenty-six patients with stage Ⅲ hepatitis B-associated PLC who were identified as syndrome of healthy qi deficiency and toxic stasis accumulation after TACE treatment were selected， and were randomly assigned to 63 cases each of the treatment group and the control group in a ratio of 1∶1 by using the random number table method； the control group was given symptomatic supportive treatments with western internal medicine， and the treatment group was given the addition of Huqi Zhengxiao Formula on the basis of the control group. All patients were treated for a period of 48 weeks， and were followed up at weeks 4， 8， 12， 24， 36， and 48 of the treatment process. The primary effectiveness index was the 1-year survival rate， and the secondary effectiveness index was the Karnofsky score and the traditional Chinese medicine （TCM） syndrome score. Survival analysis was performed using the Kaplan-meier method， and Log-rank test was used to compare the differences between the survival curves of each group. ResultsSix withdrawals in the treatment group and seven withdrawals in the control group， and finally 57 patients in the test group and 56 patients in the control group were included in the statistical analysis. The 1-year survival rate of patients in the treatment group was 56.1% （32/57）， which was higher than that of 33.9% （19/56） in the control group （P = 0.033）. The mean survival time was （275.30±15.50） days in the treatment group， higher than （227.16±17.11） days in the control group （P = 0.039）. Thirty-two patients in the treatment group and 19 patients in the control group completed the Karnofsky score and TCM symptom score at each time point. At weeks 4， 8， 12 and 36， the difference in the Karnofsky score between the two groups was not statistically significant （P＞0.05）； at weeks 24 and 48， the Karnofsky score in the treatment group was higher than that in the control group at the same time point （P＜0.05）； analysis of variance of repeated measurements found that the downward trend of the Karnofsky score in the treatment group was slower than that in the control group （F = 4.47， P = 0.037）. The difference between the TCM symptom scores of the two groups at each follow-up observation point was not statistically significant （P＞0.05）； there was a tendency for the TCM symptom scores of the two groups to increase， but the ANOVA of repeated measurements found that the difference between the two groups was not statistically significant either （F = 0.31， P = 0.58）. Concusion The oral administration of Huqi Zhengxiao Formula can improve the survival rate， prolong the survival time， and improve the quality of life of patients with stage Ⅲ hepatitis B-associated PLC with syndrome of healthy qi deficiency and toxic stasis accumulations after TACE treatment.

Astragali Radix-Curcumae Rhizoma Inhibits Metastasis of Lewis Lung Cancer in Mice via C5a/NETs Pathway / 中国实验方剂学杂志

ObjectiveTo explore the mechanisms of Astragali Radix-Curcumae Rhizoma （HQ-EZ） in alleviating hypercoagulability and inhibiting tumor growth and metastasis by modulating the formation of neutrophil extracellular traps （NETs） via the complement component 5a （C5a）/C5a receptor （C5aR） pathway. MethodForty male C57BL/6 mice were randomized into four groups： Blank， model， HQ-EZ （8.2 g·kg-1）， and PMX53 （1 mg·kg-1）. The mouse model of Lewis lung cancer was established in other three groups except the blank group. Mice were administrated with corresponding drugs from day 3 after modeling. Specifically， the HQ-EZ decoction was administrated for 14 consecutive days， while intraperitoneal injection of PMX53 was implemented on days 3， 6， 9， 12， and 15. Mouse body weight and tumor diameter were measured every two days. On the next day of the last administration， lung microCT was performed to observe the tumor metastasis in vivo. Blood samples were collected from the eyeball after anesthetization， and tumor and lungs were collected after the mice were sacrificed. Tumor weight was measured to calculate the tumor growth inhibitory rate. Enzyme-linked immunosorbent assay was employed to measure the levels of C5a， neutrophil elastase （NE）， citrullinated histone-H3 （Cit-H3）， myeloperoxidase （MPO）， matrix metallopeptidase-9 （MMP-9）， NETs， von Willebrand Factor （vWF）， tissue factor （TF）， and P-selectin in the serum and tumor tissue. Terminal-deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling was conducted to assess apoptosis in the tumor tissue. Hematoxylin-eosin staining was conducted to observe lung metastasis， and immunofluorescence （IF） was employed to observe the expression of NETs in the tumor tissue. Western blot was employed to determine the protein levels of C5aR， MPO， and Cit-H3 in the tumor tissue. ResultCompared with the blank group， the model group had nodules in the lung， increased areas with low X-ray transmittance， appearance of nodular foci and multiple hemorrhagic foci in the lungs， and darkening lung color. Furthermore， the modeling elevated the serum levels of C5a， NETs and related proteins， vWF， TF， and P-selectin （P<0.01）. Compared with the model group， HQ-EZ and PMX53 reduced the lung metastases， areas with low X-ray transmittance， and nodules in the lungs and lightened the lung color. Compared with the model group， the two drug intervention groups showed flat tumor growth curves， decreased tumor weight （P<0.01）， increased apoptosis of tumor cells （P<0.01）， lowered levels of C5a， NETs and related proteins， vWF， TF， and P-selectin both in the serum and tumor tissue （P<0.05）， and down-regulated protein levels of C5aR， MPO， and Cit-H3 （P<0.05）. ConclusionHQ-EZ inhibited the expression of NETs by suppressing the C5a/C5aR pathway， thereby alleviating hypercoagulability and inhibiting tumor growth and metastasis.

Clinical Efficacy of Modified Yigongsan Combined with Multi-enzyme Tablets and Bifidobacterium Triple Live Powder in Treatment of Infantile Anorexia with Spleen-Stomach Qi Deficiency Syndrome / 中国实验方剂学杂志

ObjectiveTo observe the clinical efficacy of modified Yigongsan combined with multi-enzyme tablets and bifidobacterium triple live powder on infantile anorexia with spleen-stomach Qi deficiency syndrome. MethodA total of 112 infantile patients anorexia with spleen-stomach Qi deficiency syndrome treated at Hebei Provincial Hospital of Traditional Chinese Medicine from January 2022 to June 2023 were enrolled and divided into a control group and an observation group， with 56 cases in each group， according to a random number table. Children in the control group were treated with multi-enzyme tablets and Bifidobacterium triple live powder， while those in the observation group were treated with modified Yigongsan in addition to the treatment in the control group. During the study， one case dropped out in the control group and two cases dropped out in the observation group. The clinical efficacy of the two groups of children was compared， including changes in traditional Chinese medicine （TCM） syndrome scores （main symptoms， secondary symptoms， tongue， and pulse）， time to restore normal food intake， and increase in body weight. Changes in calcium， iron， zinc levels， hemoglobin， and albumin levels before and after treatment， as well as changes in gastrointestinal hormones such as gastrin and motilin， vasoactive intestinal peptide， somatostatin， neuropeptide Y， orexin， and leptin， were observed. The occurrence of adverse reactions in the two groups of children during the study was also recorded. ResultThe total effective rate of children in the control group after treatment was 85.19% （46/54）， while that in the observation group was 98.15% （53/54） （χ2 =5.939， P<0.05）. Compared with the control group， the time for food intake to return to normal in the observation group was shorter， and the increase in body weight was greater （P<0.05）. Compared with the results before treatment， the TCM syndrome scores （main symptoms， secondary symptoms， tongue， and pulse） in both groups of children significantly decreased， while the levels of calcium， iron， zinc， hemoglobin， albumin， gastrin， motilin， neuropeptide Y， and orexin increased， and the levels of vasoactive intestinal peptide， somatostatin， and leptin decreased （P< 0.01）. Compared with the control group after treatment， the improvement in the above indicators in the observation group was more significant （P<0.01）. The incidence of adverse reactions in the two groups of children during the treatment period was similar， and the difference was not statistically significant. ConclusionModified Yigongsan combined with multi-enzyme tablets and Bifidobacterium triple live powder is highly effective in treating infantile anorexia （spleen-stomach Qi deficiency syndrome）. After treatment， symptoms of the children were improved，appetite and food intake increased， gastrointestinal function was improved， body weight increased， and adverse reactions were few， indicating that the treatment was safe and reliable.

Based on the theory of "Qi Pulse Constant Communication", the treatment of diabetic peripheral neuropathy by invigorating qi and activating blood was discussed / 国际中医中药杂志

Diabetic peripheral neuropathy (DPN) is the common chronic complication of diabetes, which can lead to foot ulcers, gangrene, and amputation in severe cases, seriously affecting their quality of life. DPN belongs to the category of "arthralgia", "hemorrhoids" and other categories of TCM, and the main pathogenesis is the deficiency of qi and blood, yin and yang, and the obstruction of the meridians by phlegm and stasis. Clinically, DPN is more common with qi deficiency and blood stasis syndrome. Based on the theory of "qi meridian constant communication" in the Huang Di Nei Jing, this article proposed that for patients with DPN with qi deficiency and blood stasis syndrome, the treatment should be based on the principle of "invigorating qi and activating blood circulation, dissolving stasis and arthralgia", so that the patients' qi meridian can be accessible, delay the disease progression, and provide reference for the TCM treatment of DPN.

Clinical Observation on Qigui Tongluo Oral Liquid Combined with Moxibustion for the Treatment of Chronic Fatigue Syndrome of Qi Deficiency and Blood Stasis Type Based on Qi-Collateral Theory / 广州中医药大学学报

Objective To observe the clinical efficacy of Qigui Tongluo Oral Liquid(a hospital preparation developed by Guangdong Second Traditional Chinese Medicine Hospital and being composed of Astragali Radix,Angelicae Sinensis Radix,Notoginseng Radix et Rhizoma,Paeoniae Radix Rubra,Achyranthis Bidentatae Radix,Spatholobi Caulis,Salviae Miltiorrhizae Radix et Rhizoma,Pheretima,etc.)combined with moxibustion for the treatment of chronic fatigue syndrome(CFS)of qi deficiency and blood stasis type on the basis of qi-collateral theory.Methods A retrospective study was conducted in 60 CFS patients with qi deficiency and blood stasis type.The patients were divided into an observation group and a control group,with 30 patients in each group according to the therapy.The control group was treated with mild moxibustion on Shenque(CV8)point with moxa sticks,and the observation group was treated with Qigui Tongluo Oral Liquid on the basis of treatment for the control group.The course of treatment lasted for 4 weeks.The changes of traditional Chinese medicine(TCM)syndrome scores,Fatigue Scale-14(FS-14)scores,serum immunoglobulin IgA,IgM,IgG levels,and cortisol(COR)level in the two groups were observed before and after the treatment.After treatment,the clinical efficacy and safety of the two groups were evaluated.Results(1)After 4 weeks of treatment,the total effective rate of the observation group was 96.67%(29/30),and that of the control group was 80.00%(24/30).The intergroup comparison showed that the clinical efficacy of the observation group was significantly superior to that of the control group(P＜0.05).(2)After treatment,the TCM syndrome scores and FS-14 scores of patients in the two groups were significantly decreased compared with those before treatment(P＜0.01),and the effect on decreasing TCM syndrome scores and FS-14 scores in the observation group was significantly superior to that in the control group(P＜0.01).(3)After treatment,the serum IgA and IgG levels of the two groups as well as the serum IgM and COR levels of the observation group were significantly increased compared with those before treatment(P＜0.01),and the effect of the observation group on increasing serum IgA,IgM,IgG,and COR levels was significantly superior to that of the control group(P＜0.05 or P＜0.01).(4)During the treatment,there were no significant adverse reactions occurring in the two groups.Conclusion Healthy-qi deficiency and collateral obstruction contribute to the core pathogenesis of CFS.Based on the TCM qi-collateral theory and following the therapeutic principle of replenishing deficiency and unblocking collaterals,Qigui Tongluo Oral Liquid combined with moxibustion for the treatment of CFS patients with qi deficiency and blood stasis type can achieve certain efficacy.The combined therapy could significantly alleviate the clinical symptoms,improve the immunity level,and regulate the neuro-endocrine-immune(NEI)network of the patients.