ABSTRACT
Bipolar disorder (BD) is a serious chronic emotional disorder with a high suicide rate and a common psychiatric disease. Traditional Chinese medicine (TCM) treatment based on syndrome differentiation of BD has unique advantages and good safety, which is expected to become a breakthrough in the treatment. Based on Expert Consensus on TCM Syndrome Differentiation Criteria for Bipolar Disorder by Professor Yin Dongqing and Professor Jia Hongxiao, this study collated the treatment protocols of BD with various syndrome types according to Meta-analysis of the existing literature in the database and evaluated the evidence level according to the evidence evaluation standard issued by the US Agency for Healthcare Research and Quality (AHRQ). (1) Depression attack. ① Liver depression and spleen deficiency syndrome: Xiaoyaosan pills or Shugan Jieyu capsules, ② Phlegm dampness and spleen stagnation syndrome: Wendantang modified with Tianwang Buxindan, ③ Heart and spleen deficiency syndrome: Jiuwei Zhenxin Granules or DANG's Ganmai Dazhaotang, ④ Fire heat and internal depression syndrome: Danzhi Xiaoyaosan Granules or Chaihu Longgu Mulitang, ⑤ Liver and kidney deficiency syndrome: JIANG's Buganshen Decoction. (2) Mania episode. ① Heart and liver fire hyperactivity syndrome: Zhengan Ningshen Formula, ② Phlegm heat harassing spirit syndrome: Huatan Xiehuo Dingshen decoction, Lianzhi Tongqiao Anshen decoction, Qingshen Dingkuang decoction or Qingshen Xingnao decoction, ③ Liver and gallbladder dampness-heat syndrome: Longdan Xiegantang. (3) Other syndrome types. ① Liver qi stagnation syndrome: modified Tongqiao Huoxue decoction, Shengyang Yiwei Acupuncture, ② Deficiency of kidney yang syndrome: Jingui Shenqitang, ③ Phlegm accumulation and blood stasis syndrome: modified Tongqiao Huoxue decoction, ④ Qi and Yin deficiency, stagnation of blood stasis syndrome: Xinnaoxin pills, ⑤ Syndrome of blood deficiency generating wind and fire heat harassing spirit: Fangji Dihuangtang.
ABSTRACT
Bipolar disorder (BD) is considered to be mainly related to qi, phlegm, fire and deficiency. Binding constraint of liver qi is the initial cause, while phlegm and qi interact obstruction as well as phlegm and fire interact binding is the key pathogenesis of the transformation between depression and mania, and deficiency of both qi and yin is the main reason of the protracted course of disease. In clinical practice, BD is divided into binding constraint of liver qi pattern, phlegm and qi interact obstruction pattern, phlegm and fire interact binding pattern, and deficiency of both qi and yin pattern, which can be treated with Jinyu Shugan Powder (金玉疏肝散), Kaiyu Wendan Decoction (开郁温胆汤), Qingxin Huatan Decoction (清心化痰汤), and Baihe Shengmai Beverage (百合生脉饮) in their modifications respectively; moreover, Guanye Jinsitao (Herba Hyperici Perforati) is usually used to rectify qi, relieve phlegm and clear heat. It is also suggested to put focus on the prevention and treatment of qi, phlegm and heat simultaneously, and modify the medicinals flexibly in accordance with the pathogenesis evolution and the abnormal exuberance.
ABSTRACT
More and more evidence shows that there is a close relationship between the inflammatory state and coronary heart disease. Inflammatory state triggers the damage of vascular endothelium in the early stage of coronary heart disease and ultimately mediates the formation of atherosclerotic plaque. The mechanism of occurrence and development of heart disease is of great significance. Phlegm is a pathological product formed by the subtle imbalance of the spleen and stomach in the transportation and transformation of water and grain. It is the general summary of a series of abnormally accumulated inflammatory substances, such as low density lipoprotein, inflammatory cells, and inflammatory factors. The nature of Phlegm determines the invasiveness and turbidity of Phlegm. Phlegm invades the meridians, causing damage to the meridians and gradually accumulating, which eventually causes the local meridian damage to aggravate. This process is similar to the persistent damage of the vascular endothelium caused by inflammation. Phlegm blocks the meridians, affects the operation of Qi and blood, causes Qi stagnation and blood stasis, and finally forms the outcome of heart and blood stasis. This process is similar to the mechanism of atherosclerotic plaques formed by continuous inflammatory damage. Heart blood stasis, depression and heat, heat toxin endogenous, forming the syndrome of heat toxin stasis, which is similar to the process of atherosclerotic plaque rupture and thrombosis causing acute cardiovascular events.The formation of Phlegm is rooted in the deficiency of spleen. Based on the ''phlegm,stasis,toxin'' theory, spleen deficiency is the intrinsic pathogenesis of the inflammatory state of coronary heart disease, and the invasion of phlegm, blood stasis of heart, heat and blood stasis are the evolution of inflammatory damage of coronary heart disease. Traditional Chinese medicine differentiation and treatment is based on strengthening the spleen and nourishing Qi to treat the root and removing phlegm and blood stasis, and clearing heat and detoxifying to treat symptoms. The related Chinese medicine compounds, Chinese patent medicines, and single Chinese medicines can reduce the inflammatory indicators of coronary heart disease, thereby improving the prognosis of coronary heart disease.
ABSTRACT
Autophagy, a mechanism of cell self-protection and self-renewal, is associated with the occurrence and development of lung cancer. Favorable autophagy can slow down the progression of lung cancer, while unfavorable autophagy can promote the progression. Therefore, regulating the level of autophagy is of great significance in the treatment of lung cancer. Healthy Qi deficiency and pathogenic Qi stagnation is an extension of the theory of deficiency and Qi stagnation proposed by the Academician WANG Yongyan. It refers to the pathological process that the abnormal body fluid metabolism caused by Qi deficiency of lung, spleen, and kidney results in phlegm and blood stasis. Lung cancer has the root cause of Qi deficiency of lung, spleen, and kidney and the syndrome of phlegm and blood stasis. The autophagy in lung cancer is interconnected with healthy Qi deficiency and pathogenic Qi stagnation. The Qi deficiency of lung, spleen, and kidney is the key factor for the weakening of favorable autophagy in lung cancer, which inhibits the apoptosis of tumor cells and leads to the accumulation of harmful substances. Phlegm and blood stasis is a direct factor enhancing the unfavorable autophagy in lung cancer, which promotes the autophagic death of normal cells, weakens the immunosuppressive effect of immune cells on tumor cells, and leads to the proliferation and migration of tumor cells. The combination of healthy Qi deficiency and pathogenic Qi stagnation results in the development of autophagy in an unfavorable direction and finally leads to the continuous progression of lung cancer. Therefore, the traditional Chinese medicine (TCM) treatment of lung cancer should follow the principle of reinforcing healthy Qi and expelling pathogenic Qi, removing phlegm and resolving stasis, so as to enhance favorable autophagy while inhibiting unfavorable autophagy. Such therapy can inhibit the proliferation and migration of tumor cells and promote the remission of lung cancer. According to the existing literature, Chinese medicine monomers are mainly used to treat lung cancer by regulating autophagy. The Chinese medicine intervention of autophagy in lung cancer mainly aims to promote the activation of autophagy. This may be because the favorable autophagy weakening caused by the Qi deficiency of lung, spleen, and kidney is the fundamental reason for the development of lung cancer.