Features analysis on Traditional Chinese Medicine syndromes in patients with diabetic peripheral neuropathy

Objective

To study the features of the distribution and differentiation of Traditional Chinese Medicine (TCM) syndromes in patients with diabetic peripheral neuropathy (DPN).

Methods

We collected clinical data on illness course, age, fasting blood glucose, saccharogenic hemoglobin, TCM syndromes, tongue, and pulse of 238 DPN patients. Differentiated main syndromes (Yin deficiency and exuberant heat, invasion of spleen by damp-heat, deficiency of both Qi and Yin, and deficiency of both Yin and Yang) and accompanying syndromes (blood stasis and phlegm-dampness) of diabetes were also recorded. The features of DPN syndromes were then analyzed.

Results

Among the four main syndromes of diabetes, deficiency of both Yin and Yang was the most common in the 238 DPN patients, of which 89%-96% had blood stasis.

Conclusion

The method of differentiating syndromes of diabetes can be applied to DPN patients. Deficiency of both Yin and Yang, often accompanied by blood stasis, is commonly seen.     

A quantification model of Traditional Chinese Medicine syndromes in children with idiopathic precocious puberty and early puberty

Objective

To establish a quantification model of Traditional Chinese Medicine (TCM) syndromes by sampling patients undergoing idiopathic precocious puberty (IPP) and early puberty.

Methods

A questionnaire for classifying and quantifying TCM syndromes was designed and administered. All the results were analyzed; the relationship between 3 types of syndrome and 47 symptoms were summated. Meanwhile, the frequency distribution of each symptom or sign was aggregated. Fuzzy mathematics was used to develop a quantification model of TCM syndromes.

Results

We found that precocious puberty had 3 types of syndrome, including hyperactivity of fire due to Yin deficiency (Syndrome I), depressed liver Qi transforming into fire (Syndrome II), and end retention of damp heat (Syndrome III). In the IPP group, Syndrome I was the most common principal syndrome (100%). Forty-six patients (43.81%) were diagnosed with Syndrome I accompanied by Syndrome II and 11 (10.48%) were diagnosed with Syndrome I accompanied by Syndrome III. In the early puberty group, Syndrome I was also the main syndrome (98.39%). The degrees of most symptoms were mild to moderate. Reddened tongue was the most common tongue manifestation (62.86% prevalence) in the IPP group. The most common pulse manifestations were slippery pulse, thread pulse, and taut pulse. The Asymptotic Normalization Coefficient (ANC) method was used to quantify the TCM syndromes in 167 cases. Diagnostic accuracy rate reached 91%, comparable to expert diagnosis.

Conclusion

We find that there are 3 types of syndrome in the IPP group and in the early puberty group. Syndrome I (hyperactivity of fire due to Yin deficiency) is the main syndrome in the two groups. ANC may be an appropriate for quantification model of TCM syndromes.     

Correlation between tobacco and alcohol use and Traditional Chinese Medicine constitutions: an analysis based on a sample from general population of China

Objective

To investigate the relationship between smoking and drinking and constitution types from Traditional Chinese Medicine (TCM) theory.

Methods

The Constitution in Chinese Medicine Questionnaire (CCMQ) was used. A sample of 8448 subjects from nine provinces and municipalities was chosen from the database of the TCM constitution and health status survey. Constituent ratio and correspondence analysis were used to find the relationship between smoking and drinking and TCM constitution.

Results

There was an association between smoking and drinking and the Gentleness, phlegm-dampness, and dampness-heat type constitutions. People that did not smoke tobacco or drink alcohol tended to have Yang-deficiency, Yin-deficiency, Qi-depression, Qi-deficiency, special diathesis, or blood-stasis type constitutions.

Conclusion

There was a significant correlation between tobacco and alcohol use and TCM constitutions. To improve patient health, more attention should be paid to tobacco and alcohol control.     

Screening and identification of potential biomarkers and establishment of the diagnostic serum proteomic model for the Traditional Chinese Medicine Syndromes of tuberculosis

Ethnopharmacological relevance

Chemotherapy is the mainstay of modern tuberculosis (TB) control. Traditional Chinese Medicine (TCM) can enhance the effect of anti-TB drug, promote the absorption of the foci in the lung and reduce drug toxicity. In TCM, the determination of treatment is based on ZHENG (also called TCM syndrome). To establish a diagnostic model by using proteomics technology in order to identify potential biomarkers for TCM syndromes of TB.

Materials and methods

The surface-enhanced laser desorption ionization time of flight mass spectrometer (SELDI–TOF MS) combined with weak cation exchange (WCX) magnetic beads was used to screen serum samples from 71 cases of deficiency of lung yin syndrome (DLYS), 64 cases of fire (yang) excess yin deficiency syndrome (FEYDS) and 45 cases of deficiency of both qi and yin syndrome (DQYS). A classification model was established by Biomarker Pattern Software (BPS). Candidate protein biomarkers were purified by reverse phase-high performance liquid chromatograph (RP-HPLC), identified by MALDI–TOF MS, LC–MS/MS and validated by ProteinChip Immunoassays.

Results

A total of 74 discriminating m/z peaks (P<0.001) among three TCM syndromes of TB were detected. A diagnostic model for the TCM syndrome of TB based on the five biomarkers (3961.7, 4679.7, 5646.4, 8891.2 and 9416.7 m/z) was established which could discriminate DLYS, FEYDS and DQYS patients with an accuracy of 74.0%, 72.5%, and 96.7%, respectively. The candidate biomarker with m/z of 9416.7 was identified as a fragment of apolipoprotein C-III (apoC-III) by MALDI–TOF-MS and LC–MS/MS.

Conclusion

The TCM syndrome diagnostic model of TB could successfully distinguish the three TCM syndromes of TB patients. This provided a biological basis for the determination of treatment based on different TCM syndromes of TB. ApoC-III was identified as a potential biomarker for TCM syndromes of TB and revealed the biochemical basis and pathogenesis of TCM syndromes in TB.     

Traditional Chinese Medicine syndrome patterns and Qi-regulating,chest-relaxing and blood-activating therapy on cardiac syndrome X

Objective

To master the syndrome patterns characteristics and explore the effective therapy methods of Traditional Chinese Medicine (TCM) for cardiac syndrome X (CSX).

Methods

The TCM syndrome characteristics were mastered and the TCM intervention programs were determined by clinical investigations for TCM syndrome patterns characteristics of CSX patients. Then, the clinical efficacy studies on TCM intervention for CSX were carried out through randomized controlled trials.

Results

CSX is a clinical syndrome with the main manifestations of chest pain and chest stuffiness, and Qi stagnation, phlegm retention and blood stasis are the basic symptoms of CSX. As a result, the Qi-regulating, chest-relaxing and blood-activating therapy integrated with some Western Medicines was adopted for treatment. The effect of Qi-regulating, chest-relaxing and blood-activating therapy can reduce the frequency and degree of angina, improve the symptoms and exercise the tolerance of patients, inhibit the inflammatory response of vascular walls and protect the function of vascular endothelial cells, which is better than that of the simple and conventional Western Medicine alone.

Conclusion

A good effect was achieved in the integration of Chinese and Western Medicines for CSX. The therapy is worthy to be applied further in clinical practice. On the other hand, more long-term and randomised controlled studies with large samples are still required to further determine the clinical efficacy and safety of the therapy.     

Applied research on serum protein fingerprints for prediction of Qi deficiency syndrome and phlegm and blood stasis in patients with non-small cell lung cancer

Objective

This study screened serum tumor biomarkers by surface enhanced laser desorption/ionization time-of-flight mass spectrometry (SELDI-TOF-MS) to establish a subset which could be used for the prediction of Qi deficiency syndrome and phlegm and blood stasis in patients with non-small cell lung cancer; and as diagnostic model of Chinese medicine.

Methods

Serum samples from 63 lung cancer patients with Qi deficiency syndrome and phlegm and blood stasis, and 28 lung cancer patients with non-Qi deficiency syndrome and phlegm and blood stasis were analyzed using SELDI-TOF-MS with a PBS II-C protein chip reader. Protein profiles were generated using immobilized metal affinity capture (IMAC3) protein chips. Differentially-expressed proteins were screened. Protein peak clustering and classification analyses were performed using Biomarker Wizard and Biomarker Pattern software packages, respectively.

Results

A total of 268 effective protein peaks were detected in the 1,000–10,000 Da molecular range for the 15 serum proteins screened (P<0.05). The decision tree model was M 2284.97, with a sensitivity of 96.2% and a specificity of 66.7%.

Conclusion

SELDI-TOF-MS techniques, combined with a decision tree model, can help identify serum proteomic biomarkers related to Qi deficiency syndrome and phlegm and blood stasis in lung cancer patients; and the predictive model can be used to discriminate between Chinese medicine diagnostic models of disease.     

Capillary blood flow in patients with dysmenorrhea treated with acupuncture

Objective

To observe capillary blood flow at acupoints during acupuncture treatment of primary dysmenorrhea and gain new insights into its analgesic mechanism.

Methods

Patients with primary dysmenorrhea were enrolled and randomly assigned to a treatment or control group. Subjects' symptoms were differentiated into various Traditional Chinese Medicine (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 to compare the change in the vasomotor amplitude and perfusion of the capillaries in Hegu (LI 4) before and during the treatment. Each subject was required to finish the period pain symptoms observation form, verbal rating scales, numerical rating scale, pain rating index, face rating scale, Zung self-rating depression scale, Zung self-rating anxiety scale, and numerical rating scale before and after treatments.

Results

After 10 sessions, the symptom scores, pain index (PI), and visual analog scale (VAS) decreased significantly in treatment group. The volume of blood flow in Hegu (LI 4) declined slightly. No significant evidence supported that needling caused capillary contraction, but the capillary vasomotor amplitude at Hegu (LI 4) increased remarkably.

Conclusion

Acupuncture can increase the capillary blood flow, thus promoting the flow of Qi and blood in terms of TCM theory, which facilitates pain relief.     

Relative specificity of acupuncture reinforcing and reducing methods

Objective

To probe the effects of acupuncture reinforcing and reducing methods on the human body.

Methods

Studied acupuncture reinforcing and reducing actions in the ancient literature, based on modern clinical and experimental studies, in combination with experience of acupuncture teaching and clinical treatment.

Results

The key to the generation of reinforcing and reducing actions is not the acupuncture reinforcing and reducing methods themselves, but instead the functional state of the patient during the acupuncture. When reinforcing and reducing methods act on the human body, a reinforcing-reducing effect is produced through regulation of Qi, indicating that the production of the reinforcing-reducing effect requires a certain condition. Specifically, acupuncture does not produce the reinforcing-reducing effect under all conditions, but can produce a reinforcing effect in patients with deficiency syndrome and a reducing effect in patients with excess syndrome.

Conclusion

Reinforcing and reducing methods each have therapeutic effects on both deficiency syndrome and excess syndrome, but a reinforcing method should be selected first for deficiency syndrome and a reducing method should be selected first for excess syndrome.     

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

Objective

To study serum visfatin levels in women 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 resistance (HOMA-IR), fasting plasma glucose (FPG), fasting insulin (FINS), body mass index (BMI), testosterone (T), total cholesterol (TC), and triglycerides (TG).

Methods

Two hundred and twelve PCOS patients were placed into the following TCM pattern subgroups: Kidney-Yang deficiency (KYD) group, Spleen-Yang deficiency (SYD) group, stagnant Liver-Qi transforming into heat (SLQTH) group, and Kidney-Yin deficiency (KYIND) group. The correlations between serum visfatin levels and HOMA-IR, FPG, FINS, BMI, T, TC, and TG 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 (P<0.01 or P<0.05). Among these subgroups, the visfatin levels in the SYD group were significantly higher than those in the other three TCM pattern groups (P<0.05). 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 subgroups than those in the control group (P<0.05). There were no significant differences in FPG and TC between all PCOS subgroups and the control group (P>0.05). The SYD group had higher levels of FINS and HOMA-IR compared with the KYD, SLQTH, and KYIND groups (P<0.05). In all subgroups, 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.     

Discrimination of type 2 diabetes mellitus corresponding to different traditional Chinese medicine syndromes based on plasma fatty acid profiles and chemometric methods

Aims of the study

Traditional Chinese medicine (TCM) has a long history and particular advantages in the diagnosis and treatment of type 2 diabetes mellitus (T2DM). Syndrome differentiation is the foundation and essence of TCM theories. The aims of the study are to discriminate T2DM corresponding to different syndromes (Qi-deficiency, Qi and Yin-deficiency and Damp heat) and discover syndrome-related biomarkers using metabolomics technology.

Materials and methods

Plasma fatty acid profiles of 85 clinical samples were established by high performance liquid chromatography (HPLC). Moreover, some of the lipid parameters, including total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL) and low-density lipoprotein (LDL), were obtained through clinical testing methods. Orthogonal signal correction-partial least squares (OSC-PLS) and uncorrelated linear discriminant analysis (ULDA) were employed to establish two-class models for three different syndromes.

Results

Compared with the plasma fatty acid profiles of healthy controls, the characteristic fatty acids of three TCM syndromes were discovered (p<0.01). Totally, the plasma fatty acids of T2DM were up-regulated, while significant differences existed in different syndromes. Results of ULDA indicate that the three TCM syndromes could be effectively separated by the plasma fatty acid profiles and the syndrome-related biomarkers were also screened.

Conclusions

The fact that three TCM syndromes can be separated indicates certain metabolic differences in different TCM syndromes of T2DM really exist and such differences can be manifested by fatty acids and lipid parameters. The results benefit modern biological interpretation of the three TCM syndromes and in a sense the diagnosis and treatment of diabetes.     

Clinical efficacy and safety of Traditional Chinese Medicine combined with Western Medicine in patients with diabetic acute ischemic stroke

Objective

To observe the clinical efficacy and safety of Traditional Chinese Medicine (TCM) combined with Western Medicine (WM) in patients with diabetic acute ischemic stroke.

Methods

Ninety patients with diabetic acute ischemic stroke were randomly divided into a treatment group and a control group. The 45 patients in the treatment group were given standardized treatment with TCM combined with WM. They received corresponding oral Chinese decoctions three times daily, according to their TCM syndromes, along with basic western medical treatment. The 45 patients in the control group were given non-standardized treatment with TCM combined with WM. They received an oral Chinese decoction for promotion of blood circulation to inhibit hemostasis, regardless of their TCM syndromes, along with basic western medical treatment. The treatments lasted for 4 weeks. Scores were evaluated on the National Institutes of Health Stroke Scale (NIHSS) score, activity of daily life (ADL) scores, and TCM symptoms before treatment and 2 and 4 weeks after treatment.

Results

Analysis of variance for repeated measurements showed that there were significant differences in NIHSS and ADL score before and after treatment in both groups (P<0.05). There were also significant differences between the scores at 2 and 4 weeks after treatment. There were significant differences in TCM syndrome scores before and after treatment in both groups (P<0.05). There were also significant differences between the scores at 2 and 4 weeks after treatment. The χ² test showed no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05).

Conclusion

Standardized treatment was superior to non-standardized treatment for clinical efficacy of TCM combined with WM in patients with diabetic acute ischemic stroke, and the superiority was more obvious in improving neural dysfunction, ADL score, and TCM symptoms. The adverse reactions were similar in the two treatment groups.     

Mechanism research on combination of decoction for reinforcing lung Qi and argon helium lancet in treatment of non-small cell lung cancer

Objective

To observe the effect of decoction for reinforcing lung Qi on T-lymphocytic function, interleukin-2 (IL-2) and tumor necrosis factor-α (TNF-α) in peripheral blood of patients with non-small cell lung cancer after operation with argon helium lancet in order to explore its mechanism.

Methods

A total of 76 patients suffering from non-small cell lung cancer without surgical indication were randomly divided into a treatment group treated with decoction for reinforcing lung Qi and argon helium lancet and a control group treated with argon helium lancet only to observe lymphocytic proliferation, detect the percentage of positive cells in the T-lymphocyte CD₂₈ with flow cytometry and detect the expression of IL-2 and TNF-α in peripheral blood with enzyme linked immunosorbent assay.

Results

Proliferation of T-lymphocytes and expression of CD₂₈, IL-2 and TNF-α in peripheral blood after treatment in the treatment group were more obviously strengthened than those before treatment and those in the control group (all P<0.05).

Conclusion

The mechanism of using decoction for reinforcing lung Qi and argon helium lancet to treat lung cancer may be realized through promoting T-lymphocytic proliferation, up-regulating expression of CD₂₈, IL-2 and TNF-α, and activating T-cells.     

Clinical and pathological analysis on Traditional Chinese Medicine syndromes in children with immunoglobulin A nephropathy

Objective

To evaluate the common Traditional Chinese Medicine (TCM) syndromes and analyze their relationship to clinical and pathological manifestations in children with IgA nephropathy.

Methods

Forty five children diagnosed as having primary IgA nephropathy by renal biopsy for the first time were enrolled in this trial, and their TCM syndromes were evaluated and the distribution of TCM syndromes was observed. All the sick children were growed? according to clinical manifestations and pathological damages, and the differences in TCM syndromes were compared between the groups.

Results

The first 5 TCM symptoms were common cold, hyperhidrosis, red dry throat, dark yellow urine and lassitude. In the acute nephritis group, edema and aching pain in loin and knees were significant (P=0.021 and P=0.000). In the severe pathological damage group, edema was obvious (P= 0.004), and 24 h urinary protein was positively correlated with edema (P=0.015) while negatively with common cold (P=0,007). The score of mesangial cell proliferation was correlated with edema, red dry throat and common cold (P=0.006, 0.013 and 0.029 respectively). The score of segmental pathological change was positively correlated with edema (P=0.039).

Conclusion

Common cold, hyperhidrosis, red dry throat, dark yellow urine, lassitude and other symptoms of qi deficiency of the spleen and lung mainly seen in children with IgA nephropathy may bear a close relationship to clinical manifestations and pathological damages.     

Analysis of TCM syndrome elements and relevant factors for senile diabetes

Objective

To explore the laws governing the distribution of TCM syndrome elements (SEs) of senile diabetes (SD) and their relationship to relevant factors.

Method

An investigation of patients who met the inclusion criteria was conducted by trained doctors, using case report forms. All related data were collected, including body mass index (BMI =body weight [kg]/height² [m]), glycated hemoglobin, illness course, complications, symptoms, and tongue and pulse manifestation. The SEs of each patient were judged by three qualified associate chief physicians independently.

Result

The main SEs of SD are Yin deficiency, Qi deficiency, blood stasis, and phlegm turbidity. Yin deficiency, Qi deficiency, blood stasis, and phlegm turbidity are most commonly seen among 4-SE combinations. Yang deficiency is typically related to illness course and BMI, phlegm turbidity to hypertension and hyperlipidemia, excessive heat to diabetic microangiopathy, and blood stasis to illness course and diabetic macroangiopathy.

Conclusion

SD pathogenesis has a deficiency in origin and excess in superficiality. Deficiency syndrome mainly manifests as deficiency of both Qi and Yin, and concurrently in Yang deficiency. Excess syndrome is characterized by blood stasis and phlegm turbidity. SE analysis provides a basis for the prevention and treatment of SD with Traditional Chinese Medicine (TCM) and lays the foundation for objectively evaluating multicentric clinical research for SD in TCM.     

Toxicity and clinical reasonable application of Taoren (Semen Persicae) based on ancient and modern literature research

Objective

To probe the toxicity and relative application theory of the commonly-used traditional Chinese herbal drug Taoren (Semen Persicae), and set up a correct attitude and principle and method to use Taoren (Semen Persicae) for treating the syndrome of stagnation of blood stasis and others in TCM clinic.

Methods

In this study, we analyzed and probed the ancient and modern literature research about Taoren (Semen Persicae), and summarized the realization of its toxicity and application contraindications in ancient herbals and the research assertion of its processing, drug-nature, pharmacologic actions, adverse reaction, and clinical reasonable application in modern literature.

Results

We found that some TCM doctors were worried about the effect of Taoren (Semen Persicae)‘s disintegrating blood stasis to impair body's healthy Qi and its toxicity, and were not good at using this herb. And some patients were afraid of its toxic and side-effect not to take it. In the ancient and modern literatures some proper hates of Taoren (Semen Persicae) existed, and the toxicity component was also clear-cut, and the applications of Taoren (Semen Persicae) were in many fields especially the gynecological and traumatological diseases. The key root of toxicity generation and unreasonable application of Taoren (Semen Persicae) lies in taking without syndrome differentiation or using with overdosage.

Conclusion

Under the precondition of correct processing, treatment based on syndrome differentiation, and taking the dosage stipulated by laws to apply Taoren (Semen Persicae) should be quite safe. The ancient and modern literature records and researches about Taoren (Semen Persicae) provide the determinate reference for understanding Taoren (Semen Persicae)‘s efficacy and drug-nature (toxicity) more objectively and also for further correctly clinic recognition and research on Taoren (Semen Persicae).