Traditional Chinese Medicine Syndromes in Depressive Episodes of Bipolar Disorder Based on Cluster Analysis and Bayesian Network：A Cross-sectional Study / 中医杂志

ObjectiveTo explore the elements， distribution and characteristics of traditional Chinese medicine （TCM） syndromes in depressive episodes of bipolar disorder （BD）. MethodsBasic information， along with the four examination information， the Hamilton Depression Scale and Young Mania Rating Scale scores， were collected from 293 outpatients with BD at Beijing Anding Hospital， Capital Medical University. The four examination information with an occurrence rate greater than 12% were retained. The R language “dist” function was used to calculate the distances between samples using the Euclidean distance method. The hierarchical clustering of the four examination information was performed using the “hclust” function and the squared Euclidean distance method. A team of five researchers was formed to determine the nature and location of the essential elements of TCM syndrome in BD based on the clustering results. The PC algorithm was used to construct a Bayesian network model of the essential elements. The working group combined the essential elements of TCM syndromes in the Bayesian network according to the reference model results， and then extracted common TCM syndromes. The score of each patient based on the essential elements was matched with the common TCM syndromes to determine the syndrome type of each patient. The working group then performs conformity and revision based on this， obtaining the final distribution of TCM syndromes for the patients. ResultsThere were 77 common TCM symptoms in BD with a frequency greater than 12%. The top 15 symptoms with higher frequencies were slippery pulse， mental fatigue and lack of strength， wiry pulse， excessive rumination， preference for solitude， vexation， agitation and irritability， dry mouth， palpitations， profuse dreaming， unwarranted worries， chest oppression， thin white coating， amnesia， frequent sighing， and poor appetite. TCM syndrome elements of BD can be grouped into 11 categories. The nature of disease-related essential elements included fire， qi deficiency， blood deficiency， qi counterflow， yin deficiency， dampness， heat， fire from constraint， and phlegm. The location of disease-related essential elements included heart， liver， spleen， stomach， kidney， bladder channel， and gallbladder. By constructing a Bayesian network model and considering the opinions from the experts， six common syndromes of BD were identified， among which the highest proportion was heart-stomach heat accumulation， accounting for 27.99% （82 cases）， followed by heart-spleen deficiency （55 cases， 18.77%）， non-interaction between the heart and the kidney （49 cases， 16.72%）， liver constraint and blood deficiency （42 cases， 14.33%）， heart qi deficiency （37 cases， 12.63%）， and damp-heat in the liver and gallbladder （28 cases， 9.56%）. ConclusionsThe nature of disease-related elements of BD are predominantly fire and heat， while the location of disease-related essential elements are primarily associated with the heart， liver， and spleen. The most common TCM syndromes are heart-stomach heat accumulation and heart-spleen deficiency.

Therapy of replenishing and regulating for manic episode in bipolar disorder: study protocol for a prospective, double-blind, randomized controlled trial.

Bipolar disorder (BD) is a chronic and recurrent disorder characterized by biphasic mood episodes of mania or hypomania and depression. It affects more than 1% of the global population and is a leading cause of disability in young people. Currently available treatments for BD are still fairly limited in terms of efficacy, with high rates of non-adherence, non-response, and undesirable side effects. Traditional Chinese medicine (TCM) has a long history and rich experience in stabilizing mania and improving quality of life. Aiming at rebalancing and in BD, therapy of replenishing and regulating (RYRY therapy) has been in clinical use for years in China. The present prospective, double-blind, randomized controlled trial is designed to investigate the efficacy and safety of RYRY therapy for bipolar mania and its possible mechanism from the point of regulating gut microbiota and anti-inflammation. A total of 60 eligible participants will be recruited from Beijing Anding Hospital. They will be randomized to either the study group or the control group in a ratio of 1∶1. Participants allocated to the study group will receive RYRY granule, while placebo granule will be applied in the control group. Participants in both groups will be prescribed conventional therapy for manic episode in BD. Four scheduled visits will be conducted over 4 weeks. Outcome measurements include Young Mania Rating Scale, TCM Symptom Pattern Rating Scale, Treatment Emergent Symptom Scale, levels of C-reactive protein, interleukin-6 and tumor necrosis factor-α and the gut microbial community profile of stool samples. Safety outcomes and adverse events will also be recorded. In this study, we set a number of scientific and objective assessments to evaluate the efficacy of RYRY therapy and study into its possible mechanism, hopefully offering clinicians an alternative approach to BD.

Research Progress in the Treatment of Taucette Syndrone by Traditional Chinese Medicine / 中国药师

The pathogenesis of tourette syndrome is not clear yet, and the clinical manifestations are diverse. With modern medi-cal treatment, adverse reactions occur frequently in clinics. Based on syndrome differentiation, TCM treatment can well control the clinical symptoms of children, and achieve better results without obvious adverse reactions. TCM treatment has unique advantages. In the paper, the etiology and pathogenesis, and the classification of the disease were discussed, so as to systematically explore TCM treatment of the disease and provide reference for TCM treatment of the disease.

Discussion on the Function of Building a New Method of Syndrome Differentiation and Treatment by Thinking of Imagine——the Function of Syndrome Differentiation and Treatment by Wu Shen Zang / 世界科学技术-中医药现代化

Psychiatric disorders with the chief feature of psychiatric symptoms are different from body diseases, traditional syndrome differentiation and treatment of Zang and Fu based on somatic symptoms is not adapted to the psychiatric clinical practice, so the new method of syndrome differentiation and treatment should be established. The new method must be guided by the methodology of Chinese Medicine (CM) . Thinking of imagine is the core of CM, and formation of the CM theory and syndrome differentiation and treatment of clinical course also reflect this thinking model.The new method of syndrome differentiation and treatment based on psychiatric symptoms must be guided by the methodology of thinking of imagine, so this paper discussed the significance in establishing the new method of syndrome differentiation and treatment based on psychiatric symptoms from the methodology of thinking of imagine, and this paper perhaps provided an idea for the establishment of syndrome differentiation and treatment of psychiatric disorders.

Emotional and neurobehavioural status in chronic pain patients.

OBJECTIVE: To investigate the emotional and neurobehavioural status of patients suffering from chronic pain. METHODS: Fifteen male patients with chronic lower back pain and 15 healthy control subjects were studied for approximately six months. Pain was measured using a visual analogue scale. The WHO Neurobehavioral Core Test Battery (NCTB) was used to assess neurobehavioural effects of environmental and occupational exposures. RESULTS: Visual analogue scale results demonstrated a modest range of reported pain (mean [± SD] 62.0 ± 10.8) in chronic pain patients, whereas control subjects reported no measurable pain. With the NCTB, it was found that scores of negative mood state, including anger-hostility, depression-dejection, fatigue-inertia and tension-anxiety in pain patients were significantly higher than scores in the control subjects. By contrast, scores of positive mood state (vigour-activity) in chronic pain patients were lower than those in the control group. The NCTB scores of the Santa Ana Dexterity and Pursuit Aiming II tests in chronic lower back pain patients were lower than those of the control group. Scores for other NCTB subtests, including the Digit Span, Benton Visual Retention and Digit Symbol tests, were not significantly different compared with controls. Assuntos Emoções , Transtornos das Habilidades Motoras/etiologia , Dor/complicações , Dor/psicologia , Tempo de Reação/fisiologia , Adulto , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Dor/diagnóstico , Medição da Dor , Estimulação Luminosa , Retenção Psicológica/fisiologia , Inquéritos e Questionários

Self-reference Effect and Insight in Schizophrenia Patients / 中国临床心理学杂志

Objective:To investigate the relationship between insight and self of schizophrenia patients by paradigm of self-reference effect(SRE).Methods:16 schizophrenia patients with insight, 16 schizophrenia patients without insight and 16 normal controls matched with age and education degree were measured by SRE, and the results were analyzed.Results:SRE was shown in normal controls, and R performance on Self task was better than on other two tasks(P0.05).This means that SRE was not demonstrated in schizophrenia patients.There were significant differences between patients without insight and normal controls in R performance(P0.05).Conclusion:The profile of the results indicates that self-disturbance is shown in schizophrenia.There is no obviously correlation between insight and self-reference effect in schizophrenia patients.

Discussion on schizophrenia from the liver in TCM / 中华中医药杂志

Schizophrenia is roughly equivalent to insanity in TCM.Premorbid personality traits of schizophrenia are similar to the characteristic of stagnation of liver in TCM.The stagnation of liver-qi is a usually cause and main differentiation type of schizophrenia.Early location of this disease is toward to the liver.The stagnant qi of the liver turns into fire,up to brain to interfere the activity of mind,then leads the disease into the acute phase;Stagnation of the liver-qi and the heart-fire affect other organs and lead the disease to its chronic phase:The change of solar term or dramatic disturbances of climate change often leads liver yang to interfere the mind,resulting in recurrence or relapses of schizophrenia.We should pay attention to rule of liver in the treatment,rehabilitation,prevention of recurrence in schizophrenia.When treating schizophrenia,we need pay attention to soothing liver,without inhibiting the sthenic liver-energy;suppressing the hyperactive liver by calming the liver and removing heat from the liver.Soothing liver and strengthening spleen,dispersing liver-qi and regulating stomach are the common treatment.For preventing degeneration,while nourishing liver and kidney,clearing heat and calming the mind should be used at same time;while nourishing liver yin,wind-dispersing,eliminating phlegm,clearing-stasis should be used at same time.Cleaning liver heat,nourishing yin,activating blood and detoxification should be paid attention to when preventing and treating the side effects caused by antipsychotic drugs.