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@#[Objective] To construct a Nomogram model for the prediction of essential hypertension (EH) risks with the use of traditional Chinese medicine (TCM) syndrome elements principles in conjunction with cutting-edge biochemical detection technologies. [Methods] A case-control study was conducted, involving 301 patients with essential hypertension in the hypertensive group and 314 without in the control group. Comprehensive data, including the information on the four TCM diagnoses, general data, and blood biochemical indicators of participants in both groups, were collected separately for analysis. The differentiation principles of syndrome elements were used to discern the location and nature of hypertension. One-way analysis was carried out to screen for potential risk factors of the disease. Least absolute shrinkage and selection operator (LASSO) regression was used to identify factors that contribute significantly to the model, and eliminate possible collinearity problems. At last, multivariate logistic regression analysis was used to both screen and quantify independent risk factors essential for the prediction model. The “rms” package in the R Studio was used to construct the Nomogram model, creating line segments of varying lengths based on the contribution of each risk factor to aid in the prediction of risks of hypertension. For internal model validation, the Bootstrap program package was utilized to perform 1000 repetitions of sampling and generate calibration curves. [Results] The results of the multivariate logistic regression analysis revealed that the risk factors of EH included age, heart rate (HR), waist-to-hip ratio (WHR), uric acid (UA) levels, family medical history, sleep patterns (early awakening and light sleep), water intake, and psychological traits (depression and anger). Additionally, TCM syndrome elements such as phlegm, Yin deficiency, and Yang hyperactivity contributed to the risk of EH onset as well. TCM syndrome elements liver, spleen, and kidney were also considered the risk factors of EH. Next, the Nomogram model was constructed using the aforementioned 14 risk predictors, with an area under the curve (AUC) of 0.868 and a 95% confidence interval (CI) ranging from 0.840 to 0.895. The diagnostic sensitivity and specificity were found to be 80.7% and 85.0%, respectively. Internal validation confirmed the model’s robust predictive performance, with aconsistency index (C-index) of 0.879, underscoring the model’s strong predictive ability. [Conclusion] By integrating TCM syndrome elements, the Nomogram model has realized the objective, qualitative, and quantitative selection of early warning factors for developing EH, resulting in the creation of a more comprehensive and precise prediction model for EH risks.
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Colorectal cancer （CRC） is one of the refractory malignant tumors of the digestive system worldwide. With limitations， the available clinical therapies are usually suspended or show unsatisfactory effect. Therefore， it is urgent to find and develop new candidate drugs specifically targeting the cancer with ideal efficacy， low toxicity， and low cost， and the solutions can be found in traditional Chinese medicine （TCM） which has a long history. In TCM， sovereign， ministry， assistant， and guiding medicinals are selected based on the syndrome differentiation， and it has shown remarkable efficacy on CRC in recent years. In particular， Chinese medicinal compounds and monomers from Chinese medicinals which have been applied in clinical settings are advantageous in the treatment of CRCs， as they improve the quality of life， alleviate clinical symptoms and toxic and side effects of chemotherapy， and prolong the survival of patients. Therefore， we retrieved the English and Chinese articles with "CRC"， "TCM"， "compound" and "monomer" as keywords， and summarized the progress in the treatment of CRC with Chinese medicinal compounds and monomers from Chinese medicinals from four aspects of "replenishing Qi and invigorating spleen"， "clearing heat and removing toxin"， "nourishing liver and kidney"， and "tonifying Qi and nourishing blood". However， Chinese medicine features multiple components， multiple targets， and multiple pathways， and in-depth research should be carried out on the application of Chinese medicinal compounds and monomers from Chinese medicinals in the treatment of CRC， in an attempt to minimize the pain and side effects and maximize the therapeutic effect. This study is expected to provide new insight into the treatment of CRC and a reference for further research on the efficacy and mechanism of Chinese medicine.
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ObjectiveTo explore the distribution and characteristics of traditional Chinese medicine （TCM） syndromes in patients with endometriosis （EMS）. MethodA cross-sectional survey was conducted to analyze the characteristics of TCM syndromes in 1 895 cases of EMS in hospitals of 19 provinces， autonomous regions， and municipalities. ResultAmong the 1 895 patients， Qistagnation and blood stasis syndrome accounted for the highest proportion， followed by Qi deficiency and blood stasis syndrome， cold coagulation and blood stasis syndrome， and kidney deficiency and blood stasis syndrome. The distribution of TCM syndrome types of patients with EMS in different regions， different treatment stages， and different disease types and with different therapeutic goals was different， and the differences were statistically significant. However， under different conditions， the Qi stagnation and blood stasis syndrome accounted for the highest proportion. Under the stratification of different regions， the cold coagulation and blood stasis syndrome in north China was relatively high， the kidney deficiency and blood stasis syndrome in south China was relatively high， and the combined phlegm and stasis syndrome was relatively high in southwest China. Different diagnosis and treatment goals corresponded to different clinical syndromes. With pelvic pain as the main manifestation， the proportion of cold coagulation and blood stasis syndrome was higher. The proportion of kidney deficiency and blood stasis syndrome was higher in married patients with infertility. Patients with the main diagnosis and treatment goals of controlling mass and inhibiting recurrence had a higher proportion of Qi deficiency and blood stasis syndrome. In different treatment stages， the proportion of Qi deficiency and blood stasis syndrome in postoperative patients and those with recurrent EMS was higher. Among different disease types， the Qi deficiency and blood stasis syndrome accounted for a higher proportion in patients with ovarian endometriosis （OEM）. The cold coagulation and blood stasis syndrome accounted for a higher proportion in patients with deep invasive endometriosis （DIE）. The kidney deficiency and blood stasis syndrome accounted for a higher proportion in patients with peritoneal EMS. There were significant differences in age， body mass index （BMI）， and course of disease among patients with different syndromes. Patients with Qi deficiency and blood stasis syndrome was relatively older， and their course of the disease was relatively long. Patients with combined phlegm and stasis syndrome had relatively high BMI. There was no significant difference in CA125 and CA199 levels among all syndrome types. ConclusionThe distribution of TCM syndromes of EMS has a certain regularity， and there are differences in regional distribution， therapeutic goals， treatment stages， and disease types（P<0.05）. However， the Qi stagnation and blood stasis syndrome accounts for a large proportion under different conditions， suggesting that Qi stagnation is the key link of EMS. In the early stage， the team took relieving depression and activating blood as the primary treatment， and created Huoxue Xiaoyi prescription， which was the core prescription for the treatment of EMS with Qi stagnation and blood stasis syndrome， achieving good clinical effect. At the same time， it is emphasized that EMS treatment should be integrated into the concept of chronic disease management and combined with health management. Through psychological counseling， cognitive behavior intervention， popular science lectures， and other methods， it is advised to adjust the emotion of patients with EMS， thereby increasing the curative effect. This study is expected to provide references for the clinical treatment of EMS.
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ObjectiveTo observe the clinical effect of Mahuang Xixin Fuzitang combined with acupuncture and moxibustion in the treatment of localized scleroderma. MethodA total of 95 patients with localized scleroderma treated in Wuhan No. 1 Hospital from September 2019 to October 2021 were assigned into a control group （47 patients） and an observation group （48 patients） by random number table method. The control group was treated with Centella triterpenes tablets and heparin sodium cream， and the observation group was additionally treated with Mahuang Xixin Fuzitang combined with acupuncture and moxibustion. Both groups were treated for 8 weeks， and the clinical effect was compared between groups. The traditional Chinese medicine（TCM） syndrome score （local skin sclerosis， loss of skin texture， darkening of skin pigment， scaly dry skin， etc.）， serum levels of soluble interleukin-2 receptor （sIL-2R） and tumor necrosis factor-alpha （TNF-α）， erythrocyte sedimentation rate （ESR）， and eosinophil count （EO） were compared between before and after treatment as well as between groups. Additionally， the adverse reactions were recorded. ResultThe observation group had higher total effective rate than the control group ［95.83% （46/48） vs. 82.98% （39/47）， χ2=4.166 4， P<0.05］. Before treatment， the TCM syndrome score， sIL-2R， TNF-α， ESR， and EO showed no significant differences between the two groups. The 8 weeks of treatment improved the TCM syndrome score， sIL-2R， TNF-α， ESR， and EO. Moreover， the observation group was superior to the control group in these indicators （P<0.05）. During the treatment， the observation group showed 1 case of abnormal liver function and 1 case of nausea and vomiting， and the control group had 1 case of nausea and vomiting， 1 case of abnormal renal function， and 1 case of abnormal liver function. The total adverse reactions of the observation group （4.17%） and the control group （6.38%） had no significant difference （χ2=0.233 9， P=0.062 86）. ConclusionMahuang Xixin Fuzitang combined with acupuncture and moxibustion is safe and effective in the treatment of localized scleroderma.
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ObjectiveTo observe the clinical effect of Mahuang Xixin Fuzitang combined with acupuncture and moxibustion in the treatment of localized scleroderma. MethodA total of 95 patients with localized scleroderma treated in Wuhan No. 1 Hospital from September 2019 to October 2021 were assigned into a control group （47 patients） and an observation group （48 patients） by random number table method. The control group was treated with Centella triterpenes tablets and heparin sodium cream， and the observation group was additionally treated with Mahuang Xixin Fuzitang combined with acupuncture and moxibustion. Both groups were treated for 8 weeks， and the clinical effect was compared between groups. The traditional Chinese medicine（TCM） syndrome score （local skin sclerosis， loss of skin texture， darkening of skin pigment， scaly dry skin， etc.）， serum levels of soluble interleukin-2 receptor （sIL-2R） and tumor necrosis factor-alpha （TNF-α）， erythrocyte sedimentation rate （ESR）， and eosinophil count （EO） were compared between before and after treatment as well as between groups. Additionally， the adverse reactions were recorded. ResultThe observation group had higher total effective rate than the control group ［95.83% （46/48） vs. 82.98% （39/47）， χ2=4.166 4， P<0.05］. Before treatment， the TCM syndrome score， sIL-2R， TNF-α， ESR， and EO showed no significant differences between the two groups. The 8 weeks of treatment improved the TCM syndrome score， sIL-2R， TNF-α， ESR， and EO. Moreover， the observation group was superior to the control group in these indicators （P<0.05）. During the treatment， the observation group showed 1 case of abnormal liver function and 1 case of nausea and vomiting， and the control group had 1 case of nausea and vomiting， 1 case of abnormal renal function， and 1 case of abnormal liver function. The total adverse reactions of the observation group （4.17%） and the control group （6.38%） had no significant difference （χ2=0.233 9， P=0.062 86）. ConclusionMahuang Xixin Fuzitang combined with acupuncture and moxibustion is safe and effective in the treatment of localized scleroderma.
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The evaluation standard of LEAD animal model was established according to the understanding of the etiology and pathogenesis of diabetic lower extremity vascular disease based on Chinese and Western medicine. The consistency between the existing LEAD animal model and the clinical characteristics of traditional Chinese and Western medicine was analyzed and evaluated. The advantages and disadvantages of the existing model were compared,the application scope of different models was considered,and the possible improvement methods of the existing model were proposed,so as to provide impetus for the improvement of LEAD animal model.We should reflect more characteristics of traditional Chinese medicine syndromes in the process of model improvement and development,making the LEAD animal model to get closer to clinical features of traditional Chinese and Western medicine.
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Animals , China , Diabetes Mellitus/drug therapy , Drugs, Chinese Herbal , Lower Extremity , Medicine , Medicine, Chinese TraditionalABSTRACT
Objective:To explore the distribution characteristics of traditional Chinese medicine （TCM） syndromes of abnormal uterine bleeding associated with ovulatory dysfunction （AUB-O）. Method:A clinical and epidemiological investigation was conducted in 6 688 patients with AUB-O from the provincial， municipal， and county/district hospitals in 29 provinces， autonomous regions， and municipalities across China to identify the distribution characteristics of their TCM syndromes. Result:The AUB-O patients nationwide were mainly differentiated into the kidney Qi deficiency syndrome （17.34%）， the spleen Qi deficiency syndrome （13.25%）， the Qi and blood deficiency syndrome （12.62%）， the Qi deficiency and blood stasis syndrome （8.45%）， and the kidney Yin deficiency syndrome （6.88%）. AUB-O resulted from Qi deficiency， Yin deficiency， and blood deficiency， often involving the kidney， spleen and liver. The analysis of the regional distribution of TCM syndromes in AUB-O patients revealed that kidney Qi deficiency， spleen Qi deficiency， and Qi and blood deficiency were the shared syndromes. However， due to regional discrepancy， the TCM syndrome varied widely from one geographic region to another. The kidney Qi deficiency syndrome was more frequently seen in North China， Northwest China， Southwest China， and East China， but less frequently in central China， Northeast China， and South China. The spleen Qi deficiency syndrome occurred most frequently in central China， while the East China had the highest frequency of Qi and blood deficiency syndrome. The spleen and kidney deficiency syndrome was mostly present in central China， North China， and Southwest China， the Qi deficiency （kidney deficiency） and blood stasis syndrome in Northwest China， South China， and North China， the kidney Yin deficiency syndrome in East China， Northwest China， and Northeast China， the deficiency-heat syndrome in Southwest China and East China， the kidney Yang deficiency syndrome in South China， the liver depression and blood heat syndrome in Northeast China， and the liver depression and spleen deficiency syndrome in central China. The diagnostic criteria for the kidney Qi deficiency， spleen Qi deficiency， Qi and blood deficiency， Qi deficiency and blood stasis， and kidney Yin deficiency syndromes were not significantly different from the previous ones. The distinctive symptoms for the kidney Qi deficiency syndrome were irregular vaginal bleeding， heavy menstrual flow， or shortened menstrual cycle， back soreness and pain， and forgetfulness， while those for the spleen Qi deficiency syndrome mainly included the shortened menstrual cycle， mental fatigue， lack of strength， poor appetite， loose stool， and white tongue coating. The Qi and blood deficiency syndrome were mainly manifested as the shortness of breath， laziness to speak， pale complexion， dizziness， and palpitation. The Qi deficiency and blood stasis syndrome were mainly judged by the scanty menstrual flow frequently or occasionally accompanied by blood clots， mental fatigue， lack of strength， and dark purple tongue. The ovulatory bleeding， dizziness， tinnitus， vexing heat in chest， palms and soles， and night sweat were the characteristic signs for the kidney Yin deficiency syndrome. Conclusion:There exist certain rules in the geographical distribution of TCM syndromes of AUB-O patients， which has provided a reference for the clinical treatment of AUB-O in accordance with the local conditions.
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Objective:To study the clinical effect of Qinghao Fuzheng Jiedu decoction on systemic lupus erythematous （SLE）. Method:A total of 109 SLE patients admitted to the Rheumatology and Immunology Department of Wuhan No. 1 Hospital from December 2019 to October 2020 were selected and divided into an observation group （55 cases） and a control group （54 cases） using the random number table. Two cases in the observation group dropped out， leaving a total sample of 53， and one case in the control group dropped out， with 53 cases finally included. Patients in the control group were treated with prednisone tablet and azathioprine. On this basis， those in the observation group further received Qinghao Fuzheng Jiedu decoction. The clinical efficacy， traditional Chinese medicine （TCM） syndrome score， TCM syndrome efficacy， immunoglobulin （Ig） G， IgA， IgM， and complements C3 and C4 of the two groups were compared. The conversion of positive antinuclear antibody （ANA） and anti-double-stranded deoxyribonucleic acid antibody （DS-DNA） titers to negative in two groups after treatment was analyzed. Result:The total clinical efficacy rate of the observation group was significantly higher than that of control group （92.45% vs 73.58%，<italic>χ<sup>2</sup></italic>=6.692，<italic>P</italic><0.05）. Before treatment， there were no significant differences in IgG， IgA， IgM， complements C3 and C4， and serum ANA and ds-DNA titers between two groups. After treatment， the levels of IgG， IgA， and IgM and serum ANA and ds-DNA titers in both groups obviously declined， whereas the levels of complements C3 and C4 rose （<italic>P</italic><0.05）. Besides， the levels of IgG， IgA， and IgM and serum ANA and ds-DNA titers in the observation group were lower than those in the control group， while the levels of complements C3 and C4 were higher （<italic>P</italic><0.05）. The negative rates of ANA and ds-DNA in observation group were significantly higher than those in control group （<italic>χ<sup>2</sup></italic>=8.040，<italic>P</italic><0.05）. TCM syndrome scores were decreased in both groups after treatment （<italic>P</italic><0.05）， and the score in observation group was lower than that in control group （<italic>P</italic><0.05）. In terms of TCM syndrome efficacy， the total effective rate of observation group was significantly increased as compared with that of the control group （94.34% vs 50.94%，<italic>χ<sup>2</sup></italic>=25.112，<italic>P</italic><0.05）. Conclusion:Qinghao Fuzheng Jiedu decoction is effective in treating SLE and has a certain clinical application value.
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Objective:To analyze the general situation and traditional Chinese medicine (TCM) syndrome characteristics in patients with coronavirus disease-2019（COVID-19） in Anhui province, and to provide a basis for clinical diagnosis and treatment. Method:The 144 cases of COVID-19 patients in Anhui province were collected from designated hospitals by means of multi-center cross-sectional epidemiological survey. The TCM syndrome information collection table of patients with novel coronavirus pneumonia was created to collect the general data, etiology and pathogenesis, pulse and signs, syndrome type and frequency statistics of the patients, and then summarize and analyze the main symptoms and syndrome distribution characteristics of patients with novel coronavirus pneumonia. Result:The mean age of 144 patients with COVID-19 infection was （43.54±15.91） years old, and the number of males was larger than the number of females (9/7). The age distribution and gender difference of the patients were statistically significant (P<0.05). 36.11%（52/144） of the patients had a history of travel/residence in Wuhan/Hubei province, and 63.89% (92/144) of the patients had a history of close contact with the confirmed patients. The main clinical manifestations included fever, cough, diarrhea, fatigue and poor tolerance. Light red tongue and red tongue were dominant in tongue quality, with mainly greasy coating, slippery pulse, rapid pulse and soft pulse were the main types of pulse. The main types of syndrome differentiation were the common type (76.38%, 110/144), most of which were demonstrated as dampness obstructing the lung and spleen (56.25%, 81/144). There was no significant difference in gender composition and age distribution between two groups. Conclusion:The pathogenesis of COVID-19 patients in Anhui province is closely related to the lung and spleen, and the dampness caused by pathogen of the epidemic virus is the main pathological factor of disease, which is in line with characteristics of dampness epidemic in TCM, also can see concurrently "heat, poison, stasis" for a characteristic.
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Objective: To investigate the correlation between Ras homolog gene family member A (RhoA) gene in Wnt/PCP signaling pathway and acute exacerbation chronic obstructive pulmonary disease (AECOPD) traditional Chinese medicine(TCM)syndrome, attempting to provide an objective standard for the diagnosis of AECOPD TCM syndrome. Method: The 100 AECOPD patients were collected and divided into 5 groups:phlegm turbid obstructing lung syndrome,, phlegm-heat obstructing lung syndrome, syndrome of orifices confused by phlegm, deficiency of pulmonary and renal Qi, and edema due to yang deficiency, with 20 people in each group. 15 normal people were selected as a normal control group. All patients received fasting hemospasia, using a kit to extract blood total RibonucleicA(RNA) according to instructions. Real-time quantitative polymerase chain reaction (Real-time PCR) was adopted to detect the mRNA expression of RhoA gene in blood of patients with AECOPD TCM syndrome, and to explore the correlation. Result: There was no difference between phlegm-heat obstructing lung syndrome group and syndrome of orifices confused by phlegm group. The mRNA expression of RhoA gene in phlegm turbid obstructing lung syndrome group, phlegm-heat obstructing lung syndrome group, syndrome of orifices confused by phlegm group, deficiency of pulmonary and renal Qi group, and edema due to Yang deficiency group were significantly higher than that in normal group (PConclusion: The significant difference in mRNA relative expression of RhoA gene in Wnt/PCP signaling pathway among the five AECOPD TCM syndrome groups may provide some objective diagnostic criteria for AECOPD TCM syndromes and reveal their disease severity.
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Objective To study the relationship between traditional Chinese medicine (TCM)syndrome differentiation of multiple myeloma(MM)and laboratory indexes of MM,thus to supply evidence for the syndrome differentiation of MM. Methods A total of 59 MM patients were enrolled in the study. TCM syndrome differentiation was performed. And we also collected the laboratory indexes of serum protein electrophoresis (SPE),immunofixation electrophoresis (IFE),blood urea nitrogen (BUN),creatinine (CREA),serum beta 2 microglobulin,serum calcium(Ca),hemoglobin(Hb),Bence Jones protein,flow cytometric-immunophenotyping(FCM) and bone marrow cytology. The differences of the laboratory indexes in various syndrome types of MM were analyzed. Results No significant differences were found in myeloma cell morphology, M protein content, IFE typing results, Bence Jones protein positive rate and the concentration of Ca of various syndrome types of MM (P >0.05). However,the concentrations of BUN,CREA,serum beta 2 microsglobulin,Hb,and the positive rates of CD19- and CD56+ were significantly different in various syndrome types of MM (P < 0.05 or P < 0.01). Moreover,Hb,BUN,CREA,and serum beta 2 microspheres were significantly correlated with each other(P<0.05 or P < 0.01). Conclusion Hb, BUN, CREA, blood beta 2 microglobulin and FCM detection can be sued for the auxiliary diagnosis of syndrome types of MM, and for preliminary demonstration of illness severity and prognosis. The results will provide the basis for the treatment of MM with traditional Chinese medicine and western medicine.
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Objective To explore the correlation of traditional Chinese medicine (TCM) syndrome types of hypertension with carotid artery intima-media thickness (IMT) and plasma lipoprotein-associated phospholipase A2 (Lp-PLA2),so as to provide a TCM therapy for early prevention and treatment of hypertension and its complications in clinic.Methods We collected a total of 170 cases of hypertension patients,55 with kidney-essence insufficiency syndrome,50 with ascendant hyperactivity of liver yang syndrome,and 65 with phlegm-damp retention in middle energizer syndrome.IMT was measured by the carotid Doppler ultrasound,and plasma Lp-PLA2 expression was examined by enzyme-linked immunosorbent assay.And then the differences of IMT and Lp-PLA2 expression among the three groups were compared and analyzed.Results There were significant differences of carotid artery IMT and Lp-PLA2 among the three groups(P＜ 0.01),and the number of patients with carotid atherosclerosis and the expression level of Lp-PLA2 in the group of phlegm-damp retention in middle energizer syndrome were higher than those intheothertwogroups(P＜0.01).Conclusion Differentiation treatment based on phlegm may be more conducive to the prevention and treatment of hypertension and its complications.
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In order to understand the characteristics of traditional Chinese medicine（TCM） syndrome types, the typical symptoms of different patients and the analysis of professor MA's medication characteristics of the treatment for infertility patients were analyzed. Totally 40 cases of infertile women treated in Xiyuan hospital and TCM out-patient department of China Academy of Chinese Medical Sciences in the past five years were randomly selected to classify their symptoms, signs and the four diagnostic situations in the first diagnosis, summarize syndromes and typical symptoms and analyze the characteristics of medication with Ma. Randomly selected nearly five years in 40 cases of infertile women with China Academy of Chinese Medical Sciences Xiyuan hospital and Chinese medicine out-patient department treatment, first diagnosed by symptoms, signs and the four diagnostic situation. According to the results, kidney yang deficiency： 10 cases (25%), kidney yin deficiency： 6 cases (15%), phlegm dampness： 3 cases (7.5%), liver qi stagnation： 3 cases (7.5%), blood stasis in the uterus： 7 cases (17.5%), deficiency of kidney yin deficiency and phlegm dampness： 1 cases (2.5%), kidney yin deficiency syndrome of liver qi stagnation： 2 cases (accounted for 5%), deficiency of kidney yang deficiency syndrome of liver qi stagnation： 1 cases (2.5%), phlegm dampness syndrome of liver qi stagnation：1 cases (2.5%), kidney yin deficiency syndrome, blood stasis and stagnation in the uterus 2 cases (accounted for 5%), liver qi stagnation syndrome and blood stasis in the uterus 2 cases (accounted for 5%), deficiency of kidney yang deficiency syndrome of liver qi stagnation syndrome and blood stasis in the uterus, 1 cases (2.5%). Typical symptoms were dominated by backache, pain and cold in the lower abdomen, followed by thirst, dry throat, more menstrual blood clots, more petechial hemorrhages at tongue, dysphoria, premenstrual breast pain, irritability, chest distress and greasy in mouth, leucorrhea, semiliquid stool or coprostasis. 40 cases of infertility patients showed obvious curative effect after the treatment of professor Ma's medication.