Therapeutic effect in patients with coronary heart disease based on information analysis from Traditional Chinese Medicine four diagnostic methods

OBJECTIVE： To study information gained by Tradi- tional Chinese Medicine（TCM） four diagnostic methods and characteristics of syndrome develop- ment before and after treatment in patients with coronary heart disease, and to probe into assess- ment indexes of therapeutic effects with distinctive TCM features. METHODS： Information from the four diagnostic methods before and after treatment in 100 patients with coronary heart disease was collected using the TCM interrogation scale, a pulse condition in- strument, a tongue-face diagnosis instrument, anda voice diagnosis information collection system. Changes in the four diagnostic method results from before and after treatment were analyzed with frequency analysis and t-test methods. RESULTS： Before treatment, deficiency syndrome complicated with hyperactivity of pathogenic fac- tors was most common. After treatment, deficiency syndrome was most common. This change from complex syndromes to single syndromes indicates disease and syndrome alleviation. Frequencies of symptoms gained by interrogation after treatment for syndrome of deficiency of heart-Qi, syndrome of deficiency of heart-Yin, and turbid phlegm syn- drome were all less severe than those before treat- ment. Parameters of face color, color on all sub-re- gions of tongue, color of tongue fur, septic and greasy fur, and lip color after treatment all had sig- nificant changes. After treatment, part of the voice diagnosis parameters in the deficiency of heart-Yin and turbid phlegm syndromes had significant changes, but no significant changes were found in the deficiency of heart-Qi syndrome. CONCLUSION： Use of the TCM four diagnostic methods can provide an effective basis forTCM syn- drome diagnosis, observation of development of state of illness, and evaluation of clinical therapeu- tic effects.     

Application of Systems Biology Technology in Research of Traditional Chinese Medicine

Systems biology is an emerging science of the 21st century and its method and design of study resemble those of traditional Chinese medicine （TCM）. Adopting systems biology technology will help to understand TCM Syndromes and modernize Chinese herbal medicine. The technology platforms of systems biology, especially proteomics can provide useful tools for exploring essence of TCM syndromes and understanding principle of herbal formulation. Moreover, compared with methods of molecular biology, such as genomics and proteomics, metabolomics provide more direct, rapid, concise and effective methods for study of kidney disease especially in the case of prevention and treatment with TCM.     

谢晶日教授中药内服与外洗治疗小儿疝气经验

小儿疝气多是指腹股沟疝,临床主要表现为腹股沟或阴囊肿块、啼哭、坠胀感,站立、哭闹时肿块增大,平卧时肿块变小或消失。对于本病的治疗西医多以外科手术为主,对小儿伤害较大。谢晶日教授系黑龙江中医药大学附属第一医院肝脾胃病科主任,博士生导师,从事临床、教学与科研30余载,擅长运用中药治疗内科、儿科各类疑难杂病,现以小儿疝气1例分析谢师治疗小儿疝气的辨证特点和用药规律。     

《外科正宗》中医外科护理特色探析

探讨明代医学家陈实功在中医外科护理方面的特色,主张整体护理、辨证施护、无菌操作、药刀结合、引流通畅、器械研发等。     

沈敏鹤从三焦辨治肿瘤临床经验

沈敏鹤主任医师系国家级名老中医吴良村教授的学术继承人,从事中西医结合肿瘤内科临床工作二十余载,擅长中西医结合治疗各种常见恶性肿瘤,尤其对从三焦辨治肿瘤见解独到。笔者有幸随师侍诊,获益匪浅,现将沈师从三焦辨治肿瘤的临床经验总结介绍如下。     

Effects of Chinese herbs in children with Henoch-Schonlein purpura nephritis：a randomized controlled trial

OBJECTIVE： To research the curative effect of Chi- nese herbs for clearing away heat, promoting diure- sis, nourishing the kidney, and consolidating es- sence in children with Henoch-Schonlein purpura nephritis（HSPN） with internal accumulation of damp-toxin using randomized controlled observa- tions on large samples. To seek the mechanism of the therapy and its scope of indications. METHODS： Overall, 186 children with HSPN were randomly divided into two groups： treatment group（n=126） treated with Chinese herbs for clear- ing heat and promoting diuresis and a control group（n=60） treated with Western Medicine. The treatment was carried out for three courses of 4 weeks each. We recorded changes in patient urine routines, 24 h urinary protein, blood-coagulating series, immunoglobulin and T-cell subgroups, and improvements in main symptoms. We evaluated the alleviation of clinical symptoms and the im- provement of proteinuria, hematuria, and other lab-oratory test results. Finally, we analyzed the patient population suitable for this therapy according to the relationship between the grouping of patient body weight and curative effect. RESULTS： Damp-heat syndrome improved in the treatment group, with a significant difference in to- tal effective rate after a 4-week treatment（χ2= 13.5220, P=0.0002） and in curative rate after a 12-week treatment（χ2=6.3410, P=0.0118）, com- pared to those in the control group.The curative ef- fect in the treatment group was greater than that in the control group but there was no statistical dif- ference between the two groups. The curative ef- fect after a 4-week treatment of patients in the treatment group weighing 30 kg or less based on Traditional Chinese Medicine（TCM） signs and uri- nary protein was significantly greater than that in the control group. However, there was no statistical difference in the curative effect on urinary red cells and various indexes after a 12-week treatment be- tween the two groups. CONCLUSION： Therapy for clearing away heat, pro- moting diuresis, nourishing the kidney, and consoli- dating essence using TCM is effective in children with HSPN from internal accumulation of damp-toxin. The therapy is especially suitable for patients weighing 30 kg or less. The curative effect may be related to the improvement of immune function and blood-coagulation.     

Spleen-Yang-deficiency patients with polycystic ovary syndrome have higher levels of visfatin

OBJECTIVE： To study serum visfatin levels in wom- en with polycystic ovary syndrome（PCOS） grouped by Traditional Chinese Medicine（TCM） patterns. To study the correlations of serum visfatin levels with homeostatic model assessment insulin resis- tance（HOMA-IR）, fasting plasma glucose（FPG）, fasting insulin（FINS）, body mass index（BMI）, tes- tosterone（T）, total cholesterol（TC）, and triglycer- ides（TG）. METHODS： Two hundred and twelve PCOS pa- tients were placed into the following TCM pattern subgroups： Kidney-Yang deficiency（KYD） group, Spleen-Yang deficiency（SYD） group, stagnant Liv- er-Qi transforming into heat（SLQTH） group, and Kidney-Yin deficiency（KYIND） group. The correla- tions between serum visfatin levels and HOMA-IR, FPG, FINS, BMI,T,TC, andTG were analyzed.RESULTS： Of all patients with PCOS, there were 82 in the KYD group（38.6%）, 67 in the SYD group（31.6%）, 37 in the SLQTH group（17.5%）, and 26 in the KYIND group（12.3%）. Visfatin levels in all PCOS subgroups were higher than those in the control group（P0.01 or P0.05）. Among these subgroups, the visfatin levels in the SYD group were significantly higher than those in the other three TCM pattern groups（P0.05）. There were no statistical differences among the remaining three pattern groups. The levels of BMI, FINS, HOMA-IR, T, and TG were significantly higher in all sub- groups than those in the control group（P0.05）. There were no significant differences in FPG and TC between all PCOS subgroups and the control group（P0.05）. The SYD group had higher levels of FINS and HOMA-IR compared with the KYD, SLQTH, and KYIND groups（P0.05）. In all sub- groups, after controlling for BMI, TG, TC, and age, visfatin was positively correlated with FINS（r= 0.197, P=0.015） and HOMA-IR（r=0.173, P=0.033）, and was not correlated with T. CONCLUSION： KYD and SYD patterns are most common in PCOS patients. Increased visfatin is a common pathophysiologic manifestation in PCOS patients. The SYD group had the highest levels of visfatin, and visfatin was positively correlated with FINS and HOMA-IR.     

Effect of polypeptide 2B1 on condition of dampness pattern in rats in terms of Traditional Chinese Medicine

OBJECTIVE： This study investigated how polypeptide 2B1 is involved in regulating and governing dampness in rat models with dampness pattern defined in terms of Traditional Chinese Medicine. METHODS： We randomly divided 48 SPF 10-week-old male Sprague-Dawley （SD） rats into a normal group, normal ＋ Aristolochic acid I （AA-I） for 5 min group, normal ＋ AA-I for 60 min group, dampness pattern group （DS-Group）, dampness pattern ＋ AA-I for 5 rain tern ＋ AA-I for 60 min group, and dampness pat- group. Groups were then treated accordingly. We took out the lung, stom- ach, liver, spleen, kidney, large intestine, and small intestine tissues to detect gene and protein expres- sion of organic anion transporter polypeptide 2B1 （OATP2B1）. RESULTS= Gene expression of OATP2B1 in spleen, kidney, and small intestine of rats with dampness pattern was lower than that in normal rats （P〈0.05）. The gene expressions of OATP2B1 in liver, stomach, large intestine, and small intestine were lower than that in control rats at different time points after being stimulated by AA-I （P〈0.05）. CONCLUSION There is coordination among multiple viscera in handling the condition of dampness, and the mechanism underlying the action may rely on regulating the expression of OATP2B1.     

Capillary blood flow in patients with dysmenorrhea treated with acupuncture

OBJECTIVE; To observe capillary blood flow at acu- points during acupuncture treatment of primary dysmenorrhea and gain new insights into its anal- gesic mechanism. METHODS： Patients with primary dysmenorrhea were enrolled and randomly assigned to a treat- ment or control group. Subjects＇ symptoms were differentiated into various Traditional Chinese Medi- cine （TCM） syndromes and treated for 10 sessions with puncturing acupuncture or self-pressing right-hand Hegu （LI 4）, adding other acupoints based on syndrome. Laser speckle was used tocompare the change in the vasomotor amplitude and perfusion of the capillaries in Hegu （LI 4） be- fore and during the treatment. Each subject was re- quired to finish the period pain symptoms observa- tion form, verbal rating scales, numerical rating scale, pain rating index, face rating scale, Zung self-rating depression scale, Zung self-rating anxi- ety scale, and numerical rating scale before and af- ter treatments. RESULTS： After 10 sessions, the symptom scores, pain index （PI）, and visual analog scale （VAS） de- creased significantly in treatment group. The vol- ume of blood flow in Hegu （LI 4） declined slightly. No significant evidence supported that needling caused capillary contraction, but the capillary vaso- motor amplitude at Hegu （LI 4） increased remark- ably. CONCLUSION： Acupuncture can increase the capil- lary blood flow, thus promoting the flow of Qi and blood in terms of TCM theory, which facilitates pain relief.     

Safety and efficacy of Danqipiantan capsule for treatment of stroke： a systematic review

OBJECTIVE： To evaluate the efficacy and safety of Danqipiantan capsule （DPC） for the treatment of stroke. METHODS： PubMed, China Science And Technolo- gy Journal Database, Wanfang Database, Chinese periodicals in the China National Knowledge Infra- structure, and the General Hospital of Tianjin Medi- cal University＇s Library were searched until July 2012. Randomized controlled trials （RCTs） and ob- servational studies that reported the use of DPC for treatment of stroke were selected. RESULTS： Eleven articles that included 12 RCTs, and 2 articles that included 3 observational studies were identified. A total of 2590 patients participat- ed in the studies. We found that there was a signifi-cant statistical difference between DPC treatment groups and the control groups in terms of the effec- tive rate [risk ratio （RR）, 1.14; 95% confidence inter- vals （CI）, 1.04, 1.25; P=0.01], FugI-Meyer Assessment Scale [weighted mean difference （WMD）, 9.77; 95% CI （4.84, 14.70）; P=0.00], Barthel Index [WMD=6.40; 95% CI （3.15, 9.65）], and mean flow velocity [WMD= 5.79; 95% CI （1.64, 9.94）]. There were no significant differences for The National Institutes of Health Stroke Scale [WMD=0.60; 95% CI （ - 1.09, 2.29）], vi- sual field defects [left visual field： WMD= - 203.10; 95% CI （ - 424.41, 18.21）; right visual field： WMD= - 172.60; 95% CI （ - 409.29, 64.09）] or the functional independence measure [WMD= - 7.90; 95% CI （ - 16.64, 0.84）]. Seven articles that included eight RCTs reported the safety of DPC treatment. Two ar- ticles that included three observational studies also reported beneficial effects for DPC. Because the Chinese studies were of poor methodological quali- ty, and most of the sample sizes were small, our analysis was likely affected by bias. CONCLUSION： DPC has a beneficial effect and is relatively safe when used for the treatment of stroke.     

Effects of Jianpi herbal suppository on hemorheology and CD62p in patients with ulcerative colitis

OBJECTIVE： To compare the effects of a Chinese herbal suppository （Jianpi suppository） and West- ern Medicine （mesalazine） on hemorheology and CD62p in patients with ulcerative colitis （UC）. METHODS： In a randomized trial, 120 mild to moderate UC patients were randomly divided into two equal groups. The Jianpi suppository group used Chinese herbal suppository rectally, while the me- salazine group was treated with mesalazine tablets orally. Two 15-day courses of treatment were car- ried out in both groups. Changes in the hemorheology and CD62p indices in patients were observed. RESULTS： The hemorheology and CD62p indices in the Jianpi suppository group decreased significantly more than those of the mesalazine group. CONCLUSION： Jianpi suppository is effective in improving the hypercoagulability of UC patients, and therefore may be worth using in clinical practice.     

Regulatory effects of stage-treatment with established Chinese herbal formulas on inflammatory mediators in pediatric asthma

OBJECTIVE： To explore the regulatory effects of es- tablished Chinese herbal formulas on inflammatory mediators released during asthma attacks, and to elucidate the molecular mechanism of Traditional Chinese Medicine in the treatment of asthma. METHODS： Seventy-five asthmatic children were randomly divided into a Chinese medication group （45 cases） and a Western medication control group （30 cases）. Patients in the Chinese medication group were treated with a series of established Chi- nese herbal formulas, whereas the Western medica- tion control group received a leukotriene receptor antagonist and a bronchial relaxant. Real-time PCR was used to determine the mRNA expression levels of interleukin （IL）-4, cysteinyl leukotriene receptor 1 （CysLTR1）, and interferon （IFN）-γ in peripheralblood mononuclear cells before and after treat- ment. Enzyme-linked immunosorbent assay was used to measure the peripheral blood levels of IL-4, leukotriene （LTE）-4, and INF-γ before and after treat- ment. RESULTS： After treatment, the mRNA expression levels of 11-4 and CysLTR1 were down-regulated （P〈 0.01） and the mRNA expression levels of IFN-γ were up-regulated （P〈0.05） in the Chinese medication and Western medication groups; no significant dif- ference was found between the two groups. In the Chinese medication group, IL-4 blood level was de- creased and it was significantly different from that in the Western medication group （P〈0.05）; there was also a significant increase in IFN-γ blood levels after treatment with Chinese medica- tion （P〈0.05）. There were no significant differenc- es in LTE-4 blood levels between the two groups before and after treatment （P〉0.05）. CONCLUSION： Chinese medication has a regulato- ry effect on leukotriene receptor gene expression and the imbalance of Th1/Th2 immune cells dur- ing asthma attacks in pediatric patients.     

陈旻从肝论治女性甲状腺癌术后验案2则

陈旻主任系上海中医药大学附属市中医医院肿瘤科主任医师,上海中医药大学硕士研究生导师,全国名老中医夏翔教授学术继承人;从事临床工作20余载,善于治疗甲状腺恶性肿瘤,经验丰富,屡获佳效。笔者有幸侍诊于侧,受益匪浅,现结合验案2则将其有关经验介绍如下。     

吴银根运用膏方治疗支气管哮喘经验

吴银根教授系上海市名中医、世界中医联合会呼吸病专业委员会副主任委员、中国中西医结合学会呼吸病专业委员会主任委员;主攻中医内科学,尤其擅长中医防治支气管哮喘、急慢性支气管炎、支气管扩张咯血、慢性阻塞性肺疾病、间质性肺炎、慢性咳嗽、肺源性心脏病、肿瘤术后调理、肺肾虚证调理,以及各种疑难杂症的中医治疗。 吴银根老师长期致力于中医药治疗肺系疾病的临床研究工作,学验俱丰。     

徐振晔“以通为用”治疗晚期恶性肿瘤经验

徐振哗教授从事肿瘤临床工作三十余年,经验丰富;认为晚期恶性肿瘤患者正气明显衰退,治疗当“以通为用”。笔者跟师临诊,获益良多,现将其“以通为用”治疗晚期恶性肿瘤的临床经验总结介绍如下。     

从体质辨证调神治疗痹证验案4则

颈、肩及腰腿疼痛等属于中医学＂痹证＂范畴。通常认为,本病多由风、寒、湿及瘀血阻滞经络所致。南京中医药大学黄煌教授认为本病与情志改变关系密切,故在体质学说的指导下,创立体质辨证方药,从调神治疗痹证,其思维新颖,视角独特,临床疗效显著。     

虞坚尔辨治小儿疾病验案举隅

虞坚尔教授系上海中医药大学博士研究生导师、上海市中医药研究院中医儿科研究所所长,享受国务院特殊津贴专家,从事中医儿科临床、教学、科研工作近30载,临床经验丰富,尤其擅长治疗小儿肺系、肾系疾病。笔者有幸随师抄方,收益颇多。兹将虞老师治疗小儿疾病验案4则总结介绍如下,以飨同道。     

黄建平辨治胆石症、胆囊炎经验

黄建平教授系上海中医药大学附属曙光医院普外科主任医师,上海市中西医结合外科学会委员,主要从事中西医结合肝胆疾病的临床与研究工作,擅长治疗各类肝胆胰疾病。笔者有幸师从黄建平教授,获益匪浅，兹将老师辨治胆石症、胆囊炎的经验整理如下。