Exploration of Modern Integrated Chinese and Western Medicine Model：from Target to State / 中医杂志

It is the current confusion encountered by integrated Chinese and Western medicine that how to find the breakthrough direction of integrating Chinese and Western medicine， from crossover to integration to innovation， and open up a new horizon of integrated Chinese and Western medicine. The progress of Chinese medicine lay in expanding the scope of diagnosis and treatment with the help of modern diagnostic and therapeutic equipments and developing “micro” identification， while the progress of Western medicine lay in looking at “macro” and developing systemic medicine and integrated medicine， both of which are in the direction of each other. The “state-target identification and treatment” may become an important way to build a modern diagnosis and treatment system of integrated Chinese and Western medicine， and the thinking mode of “from target to state” is a further refinement and development on the basis of the theoretical system of “state-target identification and treatment”， which provided a clearer solution for the current stage of the integrated Chinese and Western medicine model， and pointed out the important development direction for the future integrated Chinese and Western medicine. From the perspective of strategic level and diagnosis and treatment practice， it integrated the “target-state” thinking mode into the modern diagnosis and treatment model of the integrated Chinese and Western medicine， i.e.， “Western medicine as the basis and treating with Chinese medicine； Chinese medicine as the basis and treating with Western medicine”. On the one hand， Western medicine should strengthen the reference to the traditional theories and holism of Chinese medicine， and advocate a higher level of education on the integrated Chinese and Western medicine under the guidance of the traditional theories of Chinese medicine. On the other hand， the “from target to state” mode of thinking should be applied to guide the establishment of diagnostic and treatment strategies and clinical selection of medicines in clinical practice， so as to locate the target and adjust the body state in a gradual and orderly manner， and to provide practical methods for the modern clinical work of the integrated Chinese and Western medicines. Chinese and Western medicine systems can learn from each other， combine organically， give full play to their respective strengths， and form an internal law， so as to make breakthroughs and innovations in the integrated Chinese and Western medicine model.

Traditional Chinese Medicine Syndromes and Influencing Factors of Protein Energy Wasting in Chronic Kidney Disease Patients Undergoing Maintenance Hemodialysis：a Cross-sectional Study / 中医杂志

ObjectiveTo investigate the distribution of traditional Chinese medicine （TCM） syndrome types and influencing factors of protein-energy wasting （PEW） in chronic kidney disease （CKD） undergoing maintenance hemodialysis （MHD）. MethodsAccording to diagnostic criteria， 164 patients with MHD were divided into PEW group and non-PEW group. The clinical data of all patients were collected， including general information such as gender， age， height and weight， disease characteristics such as course， cormobidity， and haemodialysis duration， laboratory indicators such as blood routine， liver function， renal function， electrolyte， blood lipid， grip strength， and the four examinations. Logistic regression analysis was used to find the influencing factors of PEW by taking the clinical indicators with significant differences between the two groups （P＜0.05） as the independent variables， diagnosis of PEW as the dependent variable， and normal values as the reference. ResultsOut of 164 patients with MHD， there were 96 （58.5%） cases in PEW group and 68 cases （41.5%） in non-PEW group. Compared to the non-PEW group，PEW group had increased age， ratios of bedrest， deep vein preservation， edema， and low grip strength， percentages of comorbidities type 2 diabetes， cardiovascular and cerebrovascular diseases，infections and anemia， and levels of alanine aminotransferase and permine amin aminotransferase， as well as decreased body mass index， self-care ratio，internal arteriovenous fistula， red blood cell count， hemoglobin， serum total protein， serum albumin levels （P＜0.05）. The PEW group had significantly higher frequency of poor appetite and digestion， abdominal distension， fear of cold and preference of warmth， weak breathing and fatigue， poor appetite， oliguria， nausea and vomiting than non-PEW group （P＜0.05）. The incidence of both yin and yang deficiency syndrome and damp-turbidity syndrome were significantly higher in the PEW group than the non-PEW group， while that of liver-kidney yin deficiency syndrome and stirring of wind syndrome were lower （P＜0.05）. Logistic regression analysis showed that low BMI （＜22 kg/m2）， inability to take care of oneself， low grip strength，low serum albumin （＜38 g/L）， infection， older age， fear of cold and cold limbs，and poor appetite were the risk factors of PEW in patients undergoing MHD （P＜0.05）. ConclusionThe root syndrome of MHD-PEW patients is both yin and yang deficiency， concurrent with damp-turbidity syndrome. Low BMI， low serum albumin， infection and older age may be the influencing factors of PEW in patients undergoing MHD.

Clinical study of self-made Wenyang-Huoxue Decoction combined with gestrinone capsules in the treatment of adenomyosis dysmenorrhea / 国际中医中药杂志

Objective:To evaluate the efficacy of self-made Wenyang-Huoxue Decoction combined with gestrinone capsule in the treatment of adenomyosis dysmenorrhea. Methods:A total of 88 patients with adenomyosis dysmenorrhea who met the inclusion criteria in Datong Traditional Chinese Medicine Hospital from January 2016 to December 2018 were enrolled and divided into two groups according to random number table method, 44 cases in each group. The control group was treated with conventional western medicine and the study group was treated with self-made Wenyang-Huoxue Decoction on the basis of the control group. Two groups were treated continuously for 6 months. The TCM syndrome score and dysmenorrhea score were performed before and after treatment. The vaginal ultrasound was used to detect and calculate uterine volume, Nottingham Health Poofite (NHP) was used to evaluate the quality of life. The ELISA was used to detect serum carbohydrate antigen 125 (CA125), TNF-α and IL-8 levels. The clinical efficacy was evaluated. Results:The total effective rate of the study group was 93.2% (41/44) and that of the control group was 72.7% (32/44), where the difference between the two groups was statistically significant ( χ2=6.510, P<0.01). After treatment, the TCM syndrome score, dysmenorrhea score and uterine volume of the study group were significantly lower than those in the control group ( t values were 7.956, 4.959 and 4.235, respectively, all Ps<0.01); the scores of pain, energy, emotion, sleep, social activity and physical activity were significantly lower than those in the control group ( t values were 8.592, 9.341, 6.652, 13.597, 4.085, 7.858, respectively, all Ps<0.01). After treatment, serum CA125 (33.02 ± 5.11 IU/ml vs. 46.22 ± 6.51 IU/ml, t=10.580), TNF-α (41.13 ± 5.03 pg/ml vs. 55.50 ± 6.15 pg/ml, t=11.997) and IL-8 (38.02 ± 5.50 pg/ml vs. 49.42 ± 6.51 pg/ml, t=8.873) in the study group were significantly lower than those in the control group ( P<0.01). Conclusions:Self-made Wenyang-Huoxue Decoction combined with gestrinone capsule can reduce the levels of serum CA125, TNF-α and IL-8 in patients with adenomyosis dysmenorrhea, and improve the clinical symptoms, and the quality of life.

Current situation and existing problems of acupuncture for primary hypertension / 中国针灸

<p><b>OBJECTIVE</b>To analyze the present situation and existing problems of acupuncture for primary hypertension (PH) based on clinical research literature in recent 20 years.</p><p><b>METHODS</b>The clinical research literature regarding acupuncture for PH were searched from China National Knowledge Infrastructure (CNKI), VIP data network (VIP) and database from 1997 through 2016; a total of 218 papers met the inclusive criteria. Microsoft Excel and Apriori algorithm of SPSS Clementine software were applied to analyze the data.</p><p><b>RESULTS</b>The main acupoints of acupuncture for PH were Taichong (LR 3), Quchi (LI 11), Zusanli (ST 36) and Hegu (LI 4), but its support degree was only 12.21%. 127 papers were randomized controlled trials, accounting for 58.26%. 158 papers had clear diagnostic criteria, accounting for 72.48%. 138 papers had clear efficacy evaluation criteria, accounting for 63.30%. Only 5.05% of the papers were classified as high-quality literature by using Jadad scale.</p><p><b>CONCLUSION</b>In recent 20 years, some rules existed in acupoint selection for PH, but the support degree was low so it could not accurately guide clinical treatment. Although the clinical literature quality of acupuncture for PH was gradually increasing, the proportion of high-quality literature was low, therefore modern medical research model and foreign similar research should be followed to design a more rigorous trial protocol. As a result, the quality of clinical research is increased to provide reference for future clinical treatment.</p>

Comparative observation of the efficacy on facial spasm among different therapies / 中国针灸

<p><b>OBJECTIVE</b>To compare the differences in the clinical efficacy on facial spasm among auricular acupuncture, acupuncture and western medication.</p><p><b>METHODS</b>Ninety cases of facial spasm were randomized into an auricular acupuncture group, an acupuncture group and a western medication group, 30 cases in each one. In the auricular acupuncture group, yan (LO), shenmen (TF), xin (CO), gan (CO), pi (CO), pizhixia (AT), chuiqian (LO), and zhen (AT) were selected. In the acupuncture group, Baihui (GV 20), Fengchi (GB 20), Sibai (ST 2), Xiaguan (ST 7), Chengqi (ST 1), Hegu (LI 4), Taichong (LR 3) and Zusanli (ST 36) were selected. The needling therapy was given once a day in these two groups and 5 treatments as one session. There were 2 days at intervals. Totally two sessions were required. In the western medication group, carbamazepine tablets were prescribed for oral administration, 0.1 g each time, three times a day, for 7 days as one session, and totally 2 sessions were required. The facial spasmodic intensity was observed before and after treatment in the three groups. The effects were compared among the three groups.</p><p><b>RESULTS</b>After treatment, the facial spasmodic intensity was reduced as compared with that before treatment in all of the three groups (all<0.05). The result in the auricular acupuncture group was better than the other two groups (both<0.05). The result in the acupuncture group was better than that in the western medication group (<0.05). The total effective rates were 93.3% (28/30), 80.0% (24/30) and 53.3% (16/30) in the three groups separately. The efficacy in the auricular acupuncture group was better than either the acupuncture group or the western medication group (both<0.05). The result in the acupuncture group was better than that in the western medication group (<0.05). The efficacy in the cases with the diseases duration less than 6 months was significantly better than that in the cases with the diseases duration over 6 months (all<0.05). What's more, the efficacy of the auricular acupuncture group were the best.</p><p><b>CONCLUSIONS</b>The auricular acupuncture is quite optimal in the treatment of facial spasm. Its efficacy is better than that of routine acupuncture and carbamazepine. The efficacy is especially better in the cases with the diseases duration less than 6 months.</p>

Advances in Basic Science and Clinical Studies on Peppermint Oil in Treatment of Irritable Bowel Syndrome / 胃肠病学

Irritable bowel syndrome (IBS)is a commonly seen digestive system disease,and its pathogenesis is not fully clarified.The treatment of IBS includes change of life style and diet habit,medicine and psychotherapy,yet the therapeutic efficacy is not satisfactory.Studies have shown that peppermint oil is an effective drug for IBS,which can ameliorate symptoms of IBS and raise the patients'quality of life.This article reviewed the advances in basic science and clinical studies on peppermint oil in treatment of IBS.

Effects of dietary leucine supplementation on the hepatic mitochondrial biogenesis and energy metabolism in normal birth weight and intrauterine growth-retarded weanling piglets

BACKGROUND/OBJECTIVES: The study was conducted to evaluate the effects of dietary leucine supplementation on mitochondrial biogenesis and energy metabolism in the liver of normal birth weight (NBW) and intrauterine growth-retarded (IUGR) weanling piglets. MATERIALS/METHODS: A total of sixteen pairs of NBW and IUGR piglets from sixteen sows were selected according to their birth weight. At postnatal day 14, all piglets were weaned and fed either a control diet or a leucine-supplemented diet for 21 d. Thereafter, a 2 × 2 factorial experimental design was used. Each treatment consisted of eight replications with one piglet per replication. RESULTS: Compared with NBW piglets, IUGR piglets had a decreased (P < 0.05) hepatic adenosine triphosphate (ATP) content. Also, IUGR piglets exhibited reductions (P < 0.05) in the activities of hepatic mitochondrial pyruvate dehydrogenase (PDH), citrate synthase (CS), α-ketoglutarate dehydrogenase (α-KGDH), malate dehydrogenase (MDH), and complexes I and V, along with decreases (P < 0.05) in the concentration of mitochondrial DNA (mtDNA) and the protein expression of hepatic peroxisome proliferator-activated receptor-γ coactivator 1α (PGC-1α). Dietary leucine supplementation increased (P < 0.05) the content of ATP, and the activities of CS, α-KGDH, MDH, and complex V in the liver of piglets. Furthermore, compared to those fed a control diet, piglets given a leucine-supplemented diet exhibited increases (P < 0.05) in the mtDNA content and in the mRNA expressions of sirtuin 1, PGC-1α, nuclear respiratory factor 1, mitochondrial transcription factor A, and ATP synthase, H+ transporting, mitochondrial F1 complex, β polypeptide in liver. CONCLUSIONS: Dietary leucine supplementation may exert beneficial effects on mitochondrial biogenesis and energy metabolism in NBW and IUGR weanling piglets.

Correlation between positive reaction point of auricular points and stroke / 中国针灸

<p><b>OBJECTIVE</b>To explore the auricular point specificity of the electric determination in stroke so as to provide the evidence for the objective study on the auricular point diagnosis in stroke.</p><p><b>METHODS</b>Thirty patients of stroke were selected in an observation group; 30 patients of non-stroke internal medicine disorder were in a control group A; 30 persons of healthy examination were in a control group B. In the observation group.and the control group A, beside the conventional treatment, acupuncture was applied to all the cases. In the observation group, Jianyu (LI 15), Quchi (LI 11), Shousanili (LI 10), Hegu (LI 4), Waiguan (TE 5), Liangqiu (ST 34), Zusanli (ST 36), Sanyinjiao (SP 6) and Taichong (LR 3) were selected on the affected side. In the control group A, Yin-tang (GV 29), Baihui (GV 20), Sishencong (EX-HN 1), Fengfu (GV 16), Dazhui (GV 14), Fengchi (GB 20), Tianzhu (BL 10), Jiaji (EX-B 2) C4-C7 were selected. Acupuncture was given once a day in the two groups. The; treatment of one week made one session, and continuously 2 sessions were required. In the control group B, the convention physical examination was provided without any medication and acupuncture involved. The CLRH-A auricular point detector was used to detect the entire auricular point area in the subjects and the positive reaction sites of auricular points in the subjects of each group before and after treatment separately. The auricular point positive detecting score and positive point frequency were observed in the subjects.</p><p><b>RESULTS</b>Before treatment, the auricular points detecting score in the observation group was obviously higher than that in the control group A and control group B (both P<0. 05). The difference in the score between the control groups was not significant in' comparison (P>0. 05). In two weeks of treatment, the auricular points detecting score in the observation group was reduced apparently (P<0. 05). The difference was not significant before and after treatment in either the control grolip A or the control group B (both P>0.05). In the observation group, the first 15 points with high frequencies of positive reaction were naogan (AT3,4i), pizhixia (AT4), e (AT1), xin (CO15), gan (CO12), nie (AT2), zhen (AT3), shen (CO10), jiaogan (AH6a), pi (CO13) shenmen (TF4), wei (CO4), neifenmi (CO18), shenshangxian (TG2p) and erjian (HX6,7i). The differences were significant in the frequencies of positive reaction at 9 auricular points as compared with the control group A and the control group B respectively, named naogan (AT3,4i), pizhixia (AT4), e (AT1), xin (CO15), gan (CO12), nie (AT2), zhen (AT3), shen (CO10) and jiaogan (AH6a) (all P <0. 05).</p><p><b>CONCLUSION</b>The pathological degree of positive reaction about auricular points in stroke patients is higher than those in the patients of non-stroke internal medicine disease and the healthy people. It is verified that the auricular diagnostic method is specific in stroke. naogan (AT3,4i), pizhixia (AT4), e (AT1), xin (C15), gan (GO12), nie (AT2), zhen (AT3), shen (CO10) and jiaogan (AH6a) are correlative with stroke.</p>

The effect of alternating current stimulation on the esophageal motility of rabbits / 中华消化内镜杂志

Objective To observe the effect of electrical stimulation on the movement of rabbits esophagus, and to promote effective esophageal peristalsis and determine the best electrical pacing parameters. Methods After anesthesia, 24 healthy rabbits underwent open surgery and the lower esophagus was exposed. The esophagus was stimulated with the multi-channel signal generator, and the changes of esophagus pressure and the length of esophageal contraction with high resolution manometry were recorded. (1) The effects on contraction pressure of esophagus body and lower esophageal sphincter (LES) after single site electrical stimulation under different parameters were observed. The stimulation modes utilized were electric current 3 mA, 5 mA and 8 mA, frequency 5 Hz, 10 Hz and 20 Hz, pulsewidth 0. 25 ms, 25 ms and 50 ms, waveform of single phase and double phase. (2) The esophagus was sequentially stimulated. The stimulation mode utilized was electric current 5 mA, frequency 20 Hz, pulsewidth 25 ms, stimulation duration 3 s, single phase square wave. Results At electrical stimulation on the esophagus body and LES, contraction delay was 13. 00±1. 54 ms and 12. 00±0. 73 ms respectively. The contraction pressure of esophageal body was significantly positively related tothe electric current (R=0. 968, P<0. 01), the pulse width(R=0. 971, P<0. 01), and the frequency (R =0. 947, P <0. 01). The length of contraction in 10 Hz group was shorter than that of the 20 Hz group(1. 33±0. 06 cm VS 1. 80±0. 00 cm, P<0. 05). The contraction pressure of LES was also significantly positively related to the electric current(R=0. 965, P<0. 01),the pulse width (R=0. 973, P<0. 01), and the frequency (R=0. 842, P<0. 01). The pressure of lower esophageal sphincter of single phase square wave was greater than that of the double phase square group (P<0. 05). Under the same parameters, the contraction pressure of LES group was lower than that of the esophageal body group (27. 33±1. 15 mmHg VS 104. 00±6. 00 mmHg, P<0. 05). Esophageal sequential contraction was induced by multi-points sequential electrical stimulation. Conclusion Single point electric stimulation can cause esophageal contraction immediately without obvious delay. Within a certain range, the esophageal contraction pressure is positively correlated with electric current, frequency and pulse width. The contraction pressure of single square phase wave is greater than that of the double square phase wave. The contraction pressure of esophageal body is greater than that of LES after electric stimulation. Multi-points sequential electrical stimulation can promote sequential movement of esophagus.

Optimization of technology conditions from Ermiao Wan decoction by semi-bionic extraction method / 中国中药杂志

<p><b>OBJECTIVE</b>To optimize the technology of Ermiao Wan decoction by SBE with uniform design.</p><p><b>METHOD</b>Uniform design was used to optimize the efficient processing conditions of the SBE for Ermiao Wan decoction according to the content of the berberine, total alkaloids, volatile oil and the yield of the total extract.</p><p><b>RESULT</b>The extract condition for Ermiao Wan decoction was set up as follow: the pH value of the water was 6.00, 6.50 and 8.7, respectively,and the extract times were 2, 1 and 1 h,respectively.</p><p><b>CONCLUSION</b>The optimized extraction condition of the SBE for Ermiao Wan decoction is reasonable.</p>

Total parenteral nutrition and somatostatin in the treatment of acute pancreatitis / 肠外与肠内营养

Objectives:To investigate the effects of total parenteral nutrition (TPN) and somatostatin in the treatment of acute pancreatits. Methods: Patients were divided into two groups. Group A was patients treated from 1990 to 1994 with traditional non operative methods. Group B was patients treated from 1995 to 2000 with traditional methods plus both TPN and somatostatin. Results: In group B, morbidity, mortality and hospital stay were improved when compared with group A. The serum albumin concentration was below the normal at the beginning and was not different between the two groups. After the treatment of 15 days,the serum albumin concentration of group B was increased significantly and it remained almost the same in group A. Conclusions: Somatostatin and TPN can significantly improve the treatment effects of acute pancreatitis.