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By analysing the similarity between defense qi and leukocytes in terms of function， site of action， and circadian rhythm， it is proposed that in traditional Chinese medicine （TCM）， the pathogenesis of leukopenia is defense qi deficiency. By analyzing the relevant discussions on the generation and transmission of defense qi in TCM classics， it is believed that the original qi in lower jiao （焦） is the source of defense qi， while the water and grain qi in middle jiao enriches defense qi， and the upper jiao transmits and distributes defense qi to the whole body. Therefore， when treating leukopenia after chemotherapy with TCM， Guilu Erxian Gelatin （龟鹿二仙胶） and Yougui Pill （右归丸） are often used to tonify the kidney and supplement essence， and moxibustion at Guanyuan （CV 4） and Qihai （CV 6） is usually accompanied to replenish the original qi in lower jiao and enrich the source of defense qi. Guipi Decoction （归脾汤）， Buzhong Yiqi Decoction （补中益气汤）， Shenling Baizhu Powder （参苓白术散）， and Sijunzi Decoction （四君子汤） are often suggested to strengthen spleen and replenish qi， in combination with moxibustion at Zhongwan （CV 12） and Zusanli （ST 36） to transport the spleen and stomach in the middle jiao to enrich the defense qi. Modified Guizhi Decoction （桂枝汤） to harmonize nutrient and defensive aspects is often used， and moxibustion at Dazhui （GV 14） and Feishu （BL 13） or scraping is added to dredge the striae and interstice in the upper jiao and promote transmission and dissemination of the defense qi. Considering the whole process of generation and distribution of defense qi， it is suggested to choose the most appropriate treatment modality flexibly， and combine internal treatment with external treatment， in order to provide ideas for the treatment of leukopenia in tumour patients.
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There are an increasing number of patients suffering from coronavirus disease 2019 (COVID-19) in our country and overseas. After the outbreak, the state health administrative sections have updated steadily several editions of Diagnosis and Treatment of Novel Coronavirus Pneumonia. According to the change of exposition of traditional Chinese medicine (TCM) treatment in these editions and the characteristics of cases in clinic, COVID-19 corresponds to pestilence category of TCM, which also based on the ancient literatures from the seasonal-febrile-disease subject of TCM. The disease contributes to pestilential pathogen caused by specifically regional climate characteristics of Wuhan city. It is important for COVID-19 patients to eliminate pathogens as soon as possible, which should apply defense-qi-nutrient-blood diagnosis to different courses of disease. The TCM therapy should be established according to the different organs where the virus lives and characters. In order to control the epidemic at an early date, it is necessary to consider the local conditions and use the combination of traditional Chinese and western medicine to treat COVID -19 patients.
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Objective To explore the etiology, pathogenesis, syndrome differentiation and treatment for dengue fever according to the theory of traditional Chinese medicine ( TCM) . Methods A retrospective case analysis was carried out in 257 dengue fever patients admitted in 2013 by Guangdong Provincial Hospital of Traditional Chinese Medicine. The clinical data of pathogenic features, TCM symptoms and signs, and therapeutic regimen were collected and analyzed. Results Six commonly-seen TCM syndrome patterns for dengue fever were classified into disease involving both defensive system and Qi system, excessive heat in defensive system, summer-heat and dampness stagnating the middle-jiao or attacking the exterior, excessive heat in both Qi system and blood system, pathogenic factors lodging between diaphragm and pleura, and mixture of blood stasis and toxicity, and the corresponding prescriptions were Yinqiao Powder, Chaige Jieji Decoction, Xinjia Xiangru Decoction, Qingwen Baidu Decoction, Dayuan Decoction, Xijiao Dihuang Decoction, respectively. Conclusion The TCM syndrome patterns of dengue fever in Guangzhou area are characterized as excessive heat in Qi system, complicated with nutrient and blood system syndrome, and mostly are blended with dampness. Correspondingly, the therapeutic principles should be clearing heat and removing toxicity in Qi system with cold-cool herbs, and assisting with cooling blood to clear heat in Qi system and removing dampness.
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From around 1990, it has been suggested that our internal defense system is composed of two distinct elements ; local innate immunity principally arranged on surface areas to establish barriers against various pathogens, and systemic acquired immunity mainly seen in systemic compartments to survey and control internal damage and disorders. The former innate surface barrier is chiefly regulated via species-restricted CD 1 antigen-presenting molecules, through lipid/glycolipid antigens presented mainly by dendritic cells (DCs) and lacking antigen-specific memory through gene-rearrangements, while the latter acquired barrier is controlled by individually restricted MHC molecules and gains antigen-specific memory through gene-rearrangements. Surprisingly, it had been revealed more than 2,000 years before in the ancient Chinese medicine textbook, <i>Ko-tei-nai-kei</i>, that our defense system is also classified into two categories, named “defense-qi” and “nutritional-qi”, and shown that the former “defense-qi” is arranged at the surface of skin to control our sweat and interact with “muddy” substances, while the latter “nutritional-qi” is situated on and within blood vessels and produces purified nutrients from food, drink and other exogenous substances. In this review, based on our recent understanding of immunological progress and the modern concepts of immunity, the possible relationship between “defense-qi” and innate immunity as well as “nutritional-qi” and acquired immunity are discussed.
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Objective To investigate the serum high-mobility group box protein 1(HMGB1)level in sepsis patients with different syndrome patterns,and to explore the correlation of HMGB1 level with defense-Qi-nutrient-blood syndrome differentiation and Acute Physiological and Chronic Health Evaluation Ⅱ(APACHEⅡ)score.Methods Twenty-four sepsis patients were differentiated as Qi system syndrome(QS group,N=11)and nutrient-blood system syndrome(NB group,N=13).Eight healthy volunteers served as the normal control.APACHEⅡ score was evaluated,serum HMGB1 level was detected by Western blot method,and the correlation of HMGB1 level with defense-Qi-nutrient-blood syndrome differentiation and APACHEⅡ score was analyzed.Results APACHEⅡ score was higher in NB group than that in QS group,the difference being significant(P
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0.05),but was significant as compared with the blood syndrome(P0.05).Conclusion The syndromes of AIDS fever patients are complex,covering defense,Qi,nutrient,and blood phases as well as triple energizers,characterized as multiple fever types and different tongue and pulse conditions.During the syndrome differentiation of AIDS fever,the incidental and fundamental symptoms should be differentiated based on the synthetical analysis of four examinations.