Effectiveness of Xiangsha Liujun pills on decreased digestive function in convalescent patients of coronavirus disease 2019: a randomized, double blind, placebo controlled clinical trial.

OBJECTIVE: To evaluate the effectiveness and safety of Xiangsha Liujun pills on the decreased digestive function in patients in the recovery phase of the Coronavirus disease 2019 (COVID-19). METHODS: A randomized, double blind, placebo controlled clinical trial was conducted. A total of 200 COVID-19 patients in the recovery phase were included in our study in Ezhou Hospital of Traditional Chinese Medicine. Totally 200 subjects were randomly divided into a treatment group (Xiangsha Liujun pills) and a control group (placebo), with 100 in each group. Subjects took Xiangsha Liujun pills or placebo orally three times a day for two weeks. Three visits were scheduled at week 0 (baseline), week 1 (the middle of the intervention) and week 2 (the end of the intervention) for each eligible patient. The total efficacy rates for improving the Traditional Chinese Medicine (TCM) symptoms (fatigue, poor appetite, abdominal distension and loose stools) and the disappearance rates of symptoms were observed and compared in the treatment and control groups. Adverse events were recorded during the study period. SAS 9.4 was used to analyze the data. RESULTS: A total of 200 patients were included in this study, among which 4 participants withdrew because the drugs did not work. Three patients were excluded for age. Before the treatment, there was no significant difference between the TCM symptoms scores of subjects. After 1 week of treatment, the full analysis set (FAS) showed that the efficacy rates for abdominal distension and loose stools in the treatment group were significantly higher than the control group ( 0.05). There were no significant differences in the efficacy rates for fatigue and poor appetite between the two groups (0.05). In addition, the disappearance rate of fatigue in the treatment group was significantly higher than the control group (0.05); there were no significant differences between the two groups after treatment in the rates of poor appetite, abdominal distension, and loose stools (>0.05). After 2 weeks of treatment, the efficacy rates for fatigue, poor appetite, abdominal distension, and loose stools in the treatment group were significantly higher than the control group (0.05). The disappearance rate of loose stools in the treatment group was significantly higher than the control group ( 0.05). However, there were no significant differences in the disappearance rates of fatigue, poor appetite, and abdominal distension between the two groups ( 0.05). No severe adverse events were reported by subjects during the study. CONCLUSIONS: This clinical study confirmed that Xiangsha Liujun pills can effectively improve the symptoms related to the decreased digestive function in COVID-19 convalescent patients.

Musculoskeletal ambulation disability symptom complex as a risk factor of incident bone fragility fracture.

OBJECTIVES: Influence of presenting musculoskeletal ambulation disability symptom complex (MADS) on occurrence of bone fragility fracture (BFF) is investigated with retrospective cohort study. METHODS: A total of 931 subjects joined in the study. Subjects were selected as bone fragility risk positive in the fracture assessment tool questionnaire. Their assumed risk factors were harvested from the medical records and X-ray pictures. They were followed up at least 8 years consecutively, and occurrence of incident BFF was set as primary endpoint. Each assumed risk factor including MADS was evaluated using Cox regression analysis. Subjects were divided into 2 groups according to presence of MADS (G-MADS and G-noMADS). Adjusted hazard ratios between the 2 groups was evaluated using Cox regression analysis. The statistical procedures were performed before and after propensity score matching (PSM) procedures in order to make parallel with assumed risk factors. RESULTS: Statistically significant risk factors within 5% were prevalent vertebral body fracture, disuse, MADS, cognitive disorder, hypertension, contracture, Parkinsonism, being female sex, hyperlipidemia, insomnia, T-score in the femoral neck ≤ -2.3, chronic kidney disease ≥ stage 2, chronic obstructive pulmonary diseases, glucocorticoid steroid administrated, and osteoarthritis in order of the adjusted hazard ratios (from highest to lowest). Adjusted hazard ratios between G-MADS and G-noMADS were 2.70 and 1.83 for before and after PSM, respectively. CONCLUSIONS: MADS demonstrated as a significant risk factor of BFF occurrence. In treating osteoporosis, fall risk should be aware of as well as bone fragility risk.

Protocol to study the effects of Traditional Chinese Medicine on patients with coronary heart disease showing phlegm-heat-stasis symptom pattern.

OBJECTIVE: To describe a protocol to assess the effects of Traditional Chinese Medicine (TCM) on patients with coronary heart disease (CHD) showing symptoms of phlegm-heat-stasis symptom pattern. METHODS: This is a single-blind randomized controlled trial that will be conducted in the First Teaching Hospital of Tianjin University of TCM and 60 patients with CHD showing phlegm-heat-stasis symptom pattern will be included. Patients will be randomly divided into either a treatment group (Qingre Huatan formulae + Western Medicine) or to a control group (conventional Western Medicine only) for 7-14 d. Primary patient outcomes will be vascular endothelial function and quality of life. Measurement data will be expressed as mean ± standard deviation using t-test analysis or repeated-measure variance analysis. Enumeration data will be expressed by cases and percentages, using χ2 analysis, and rank sum test will be used for ranked data. RESULTS: This study further verified the effectiveness and safety of Qingre Huatan formulae for the phlegm-heat-stasis syndrome pattern of CHD on the basis of previous studies on the characteristics of syndromes and medication rules. DISCUSSION: Phlegm-heat-stasis symptom pattern has become a common manifestation in CHD. Standardized Western medications together with TCM have been extensively used in China and have developed into a comprehensive treatment model. Our trial will help formulate recommendations for symptom maintenance and provide clinical evidence for the application of TCM for patients with CHD showing phlegm-heat-stasis symptom pattern.

Xuanbai Chengqi decoction plus Western Medicine in treatment of severe pneumonia with symptom pattern of phlegm-heat obstructing lung: a Meta-analysis.

OBJECTIVE: To evaluate the effectiveness and safety of Xuanbai Chengqi decoction (, XBCQD) plus Western Medicine (WM) in treatment of severe pneumonia with symptom pattern of phlegm-heat obstructing lung. METHODS: Randomized controlled trials (RCTs) investigating the effect of XBCQD on severe pneumonia with symptom pattern of phlegm-heat obstructing lung, were included in this study. Seven electronic databases were searched up to March 2019. Meta-analysis was conducted by Review Manager 5.3 software. Risk ratio (RR) and mean difference (MD) with 95% confidence interval (CI) were used as effect estimation. RESULTS: Eleven RCTs were included, involving 992 participants. Meta-analysis showed that XBCQD combined with WM achieved better effectiveness than WM alone in terms of total effective rate [RR = 1.23, 95%CI (1.16, 1.30)], clinical pulmonary infection score [CPIS, MD = -2.02, 95%CI (-2.42, -1.63)], acute physiology and chronic health evaluation Ⅱ [APACHEⅡ, MD = -6.81, 95% CI (-8.26, 5.37)], mechanical ventilation time [MD = -101.41, 95%CI (-140.47, -62.34)], and lactic acid content in arterial blood [MD = -2.41, 95%CI (-2.64, -2.18)]. CONCLUSION: XBCQD combined with WM had better benefit than WM alone to the patients of severe pneumonia with the symptom pattern of phlegm-heat obstructing lung. However, due to low quality of the included studies, more rigorously designed studies were required to further evaluate the effectiveness and safety of XBCQD in the treatment of severe pneumonia with symptom pattern of phlegm-heat obstructing lung.

Kampo Ｍedicine and Its Treatment in 10 Cases Suspected to be Orthostatic Dysregulation / 日本東洋医学雑誌

Orthostatic dysregulation is also a social problem as a disease of puberty today, and its treatment has at­tracted attention. Ten cases suspected to be orthostatic dysregulation based on diagnostic criteria of Society of Pediatric Psychology were diagnosed and treated with Kampo medicine, and all improvements were made. After analyzing 10 cases, Symptom­complex resulting from blood stagnation (血証), Disorders of the body's water metabolism (水毒), Psychosomatic factors (心身症的要因) were found as a background to cause orthostatic dysregulation. In these backgrounds, kamishoyosan, unkeito, and tokishakuyakusan were prescribed for symptom-­complex resulting from blood stagnation. Goreisangokumibinroto and ryokeijutsukanto were prescribed for disorders of the body's water metabolism. Saikokeishito and saibokuto were prescribed for the psychosomatic factors. Therapeutic effect of modern medical treatment is insufficient. It is considered that medical diagnosis and treatment with Kampo medicine is very effective.

Traditional Chinese medicine syndrome types and syndrome elements of nonalcoholic fatty liver disease / 临床肝胆病杂志

ObjectiveTo investigate the distribution of traditional Chinese medicine (TCM) syndrome types and syndrome elements of nonalcoholic fatty liver disease (NAFLD). MethodsRelated databases (CNKI, Wanfang Dota, and VIP)were searched for articles on the syndrome differentiation of NAFLD published up to July 2020. Two investigators independently performed literature screening and collection and summarization of syndrome types based on the inclusion and exclusion criteria, and an Excel 2010 database was established after the standardization of syndrome names, re-decomposition of syndrome types, and extraction of syndrome elements. The data were imported into SPSS 25.0 statistical software for the analysis of frequency distribution. ResultsA total of 45 qualified articles were collected, with a total of 8703 cases reported. A total of 14 syndrome types were obtained after standardization, and 10 syndrome elements reflecting the nature of disease and 4 syndrome elements of disease location were obtained after the syndrome types were disassembled. Stagnation of liver Qi and spleen deficiency syndrome (26.47%) and damp-heat accumulation syndrome (22.16%) were the most common syndrome types, followed by stagnation of phlegm dampness, intermingled phlegm and blood stasis, and stagnation of liver Qi and Qi stagnation. Dampness (23.75%), Qi stagnation (19.82%), Qi deficiency (17.12%), phlegm (15.43%), and heat (12.13%) were the most common syndrome elements reflecting the nature of disease, followed by stasis, Yin deficiency, and Yang deficiency, while fire and cold were relatively uncommon. Qi stagnation and Qi deficiency (26.63%), dampness and heat (22.30%), phlegm and dampness (16.17%), and phlegm and stasis (12.19%) were the most common combinations of syndrome elements. The liver and the spleen were the most common syndrome elements of disease location, accounting for 90.95% of the constituent ratio, and the combination of the liver and the spleen with the same disease accounted for 54.01%. The combination of one, two, three, or four syndrome elements was observed, and the combination of two syndrome elements accounted for 76.03%. ConclusionStagnation of liver Qi and spleen deficiency are the basic pathogeneses of NAFLD, and liver, spleen, dampness, Qi stagnation, Qi deficiency, phlegm, and heat are common syndrome elements. Dampness, phlegm, and heat are important factors for the development and progression of this disease.

Performance of controlled attenuation parameter measured by FibroScan in the diagnosis of nonalcoholic fatty liver disease and its association with traditional Chinese medicine syndrome types / 临床肝胆病杂志

Objective To investigate the application value of controlled attenuation parameter (CAP) of hepatocyte steatosis measured by FibroScan in the diagnosis and traditional Chinese medicine (TCM) syndrome differentiation of nonalcoholic fatty liver disease (NAFLD). Methods A retrospective analysis was performed for related data of 364 patients with NAFLD who attended The First Affiliated Hospital of Henan University of Traditional Chinese Medicine from January 2017 to December 2019, including basic information (age, sex, and body mass index [BMI]), CAP measured by FibroScan, ultrasound findings of the liver, gallbladder, spleen, and pancreas, liver function parameters, and blood lipid parameters. TCM syndrome differentiation was performed based on the information obtained by four diagnostic methods, and then the patients were divided into liver depression and spleen deficiency group, damp turbidity and stagnation group, damp-heat accumulation group, intermingled phlegm and blood stasis group, and spleen-kidney deficiency group. The association of CAP, color Doppler ultrasound findings, liver function parameters, blood lipid parameters, and BMI with TCM syndrome was analyzed. A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the least significant difference t -test was used for further comparison between two groups; the Kruskal-Wallis H rank sum test with multiple sets of independent samples was used for comparison of non-normally distributed continuous data between multiple groups and further comparison between two groups. The chi-square test or Kruskal-Wallis H rank sum test was used for comparison of categorical data between multiple groups and further comparison between two groups. A Spearman's rank correlation analysis was used to investigate the correlation between CAP and ultrasound grading. Results Among the 364 patients with NAFLD, 169 had the syndrome of liver depression and spleen deficiency, 71 had the syndrome of damp turbidity and stagnation, 60 had the syndrome of damp-heat accumulation, 41 had the syndrome of intermingled phlegm and blood stasis, and 23 had the syndrome of spleen-kidney deficiency. There was a significant difference in CAP value between the different syndrome types ( F =14.839, P < 0.001), and further comparison between two groups showed that the spleen-kidney deficiency group and the intermingled phlegm and blood stasis group had a significantly higher CAP value than the liver depression and spleen deficiency group, the damp turbidity and stagnation group, and the damp-heat accumulation group (all P < 0.05). There was a significant difference in ultrasound grading between the different syndrome types ( χ 2 =22.947, P < 0.001); the liver depression and spleen deficiency group mainly had a mild grade (40.2%), the damp turbidity and stagnation group and the damp-heat accumulation group mainly had a moderate grade (53.5% and 53.3%, respectively), and the intermingled phlegm and blood stasis group and the spleen-kidney deficiency group mainly had a severe grade (68.3% and 43.5%, respectively). CAP was positively correlated with the severity of fatty liver ( r =0.431, P < 0.001). The spleen-kidney deficiency group and the intermingled phlegm and blood stasis group had significantly higher levels of alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, and BMI than the other three groups (all P < 0.001). Conclusion Association is observed between CAP and the TCM syndrome types of NAFLD, and patients with the syndrome of spleen-kidney deficiency and the syndrome of intermingled phlegm and blood stasis have a higher CAP value than those with the other syndrome types. CAP has similar efficiency to color Doppler ultrasound in the diagnosis of NAFLD.

Association of gene mutations in the pre-C, C, and basic core promoter regions of hepatitis B virus with traditional Chinese medicine syndrome types / 临床肝胆病杂志

ObjectiveTo investigate the association of gene mutations in the pre-C, C, and basic core promoter (BCP) regions of hepatitis B virus (HBV) with traditional Chinese medicine (TCM) syndrome types in patients with chronic hepatitis B (CHB). MethodsA retrospective analysis was performed for the clinical data of CHB patients who were diagnosed and treated at the outpatient service and ward of Spleen, Stomach, and Hepatobiliary Department, The First Affiliated Hospital of Henan University of Chinese Medicine, from November 2014 to June 2018. Related clinical data were collected and recorded, including general information, HBV serological markers, HBV gene mutations, and information obtained by four TCM diagnostic methods. Syndrome differentiation and typing were performed for each patient with reference to the criteria for TCM syndrome differentiation of viral hepatitis, and the association of gene mutation in the pre-C, C, and BCP regions of HBV with TCM syndrome types was analyzed. The chi-square test was used for comparison of categorical data between groups, and the Kruskal-Wallis H test was used for comparison of continuous data between multiple or two groups. ResultsA total of 235 patients with CHB were enrolled, among whom 101 had internal retention of damp-heat, 88 had stagnation of liver Qi and spleen deficiency, 17 had blood stasis obstructing the collaterals, 19 had liver-kidney Yin deficiency, and 10 had spleen-kidney Yang deficiency. There were significant differences in sex, age, and course of disease between the patients with different TCM syndrome types (χ2=17.389, H=173.280, H=86.520, all P＜0.01), and there was a significant difference in age between the CHB patients with gene mutations in the pre-C, C and BCP regions of HBV (H=30.150, P＜0.001). There was a significant difference in the distribution of TCM syndrome types between the CHB patients with gene mutations in the pre-C, C and BCP regions of HBV (χ2=58.117, P＜0.001), and internal retention of damp-heat and stagnation of liver Qi and spleen deficiency were major TCM syndrome types accounting for 80.43%. The patients with internal retention of damp-heat tended to have A1762T and G1764A mutations, and those with stagnation of liver Qi and spleen deficiency tended to have G1896A, A1762T, and G1764A mutations; G1764A mutation was often observed in the patients with blood stasis obstructing the collaterals or liver-kidney Yin deficiency, and I97L mutation was often observed in the patients with spleen-kidney Yang deficiency. ConclusionGene mutations in the pre-C, C, and BCP regions of HBV are associated with TCM syndrome types in CHB patients, and internal retention of damp-heat and stagnation of liver Qi and spleen deficiency are the most common TCM syndrome types. I97L mutation is often observed in patients with spleen-kidney Yang deficiency.

Metabonomics and traditional Chinese medicine syndrome of nonalcoholic fatty liver disease / 临床肝胆病杂志

The incidence rate of nonalcoholic fatty liver disease (NAFLD) is increasing year by year and NAFLD has become one of the most common liver diseases in the world. Metabolomics follows the research thoughts of genomics and proteomics and conducts a quantitative analysis of all metabolites in organisms to explore the association between metabolites and physiological and pathological changes, which provides a new way for studying the traditional Chinese medicine diagnosis and treatment of NAFLD. This article summarizes the research advances in metabolomics and traditional Chinese medicine syndromes in NAFLD, so as to provide new thoughts and methods for further exploration of NAFLD.

Heterogeneity in progression of prodromal features in Parkinson's disease.

BACKGROUND: In the pre-diagnostic phase of Parkinson's disease (PD), a range of motor and non-motor symptoms can occur. However, there is considerable variability in their onset and currently little information exists on the pattern of progression of clinical features before diagnosis. METHODS: We analysed data from a survey amongst patients with PD from 11 European countries by the European Parkinson's Disease Association. They completed questions on first occurrence of 21 pre-diagnostic features. A principal component analysis (PCA) with varimax rotation was performed to determine the co-occurrence of these features. FINDINGS: 1467 patients were included. Changes in movement were the most commonly reported features up to 4 years before diagnosis. However, at five or more years before diagnosis loss of sense of smell, sleep problems, fatigue and other non-motor features had been experienced most frequently. PCA of pre-diagnostic features' duration revealed three factors with eigenvalues over Kaiser's criterion of 1: a) a neuropsychiatric factor comprised of anxiety, depression, apathy, stress, and sleep problems; b) an axial factor defined by difficulty eating and/or swallowing problems, freezing, and falls/balance problems; and c) a motor factor with additional non-motor features. Bladder/bowel problems and tremor had low factor loadings on all components. However, in those with disease duration less than 5 years the autonomic features were associated with the axial factor and tremor loaded on both the motor and psychiatric symptom factors. INTERPRETATION: The identified symptom complexes in the pre-diagnostic stage of PD may be reflective of a shared pattern of pathological disease progression.

Guidance value of QT dispersion and JT dispersion for identification of coronary heart disease with blood stasis syndrome type／ / 心血管康复医学杂志

To explore the guidance value of QT dispersion (QTd) and JT dispersion (JTd) for identifica‐tion of coronary heart disease (CHD) with blood stasis syndrome type .Methods : A total of 246 CHD patients of our hospital were divided into blood stasis block group (n＝71) ,Tanbixinyang group (TBXY group ,n＝42) ,liver and renal Yin deficiency group (LRYD group ,n＝44) ,Qi and Yin deficiency group (QYD group ,n＝45) and cardiac and renal Yang deficiency group (CRYD group ,n＝35) according to four diagnostic methods of Traditional Chinese Medicine (TCM).The QTd ,corrected QTd (QTcd) ,JTd and corrected JTd (JTcd) were observed in all groups , and their predictive value for blood stasis block were analyzed .Results : Compared with TBXY ,LRYD ,QYD and CRYD group ,there were significant rise in levels of QTd [ (72. 21 ± 16.48) ms ,(50.89 ± 12.77) ms ,(49. 17 ± 7.91) ms ,(62. 54 ± 12.80) msvs.(82.30 ± 19.05) ms] ,QTcd [(73.82 ± 18. 72) ms ,(51.41 ± 12.81) ms ,(51. 12 ± 9.73) ms ,(62.48 ± 13.35) msvs .(87. 75 ± 20. 72) ms] ,JTd [ (74. 54 ± 16.83) ms ,(52.18 ± 12. 68) ms ,(51. 50 ± 10. 78) ms ,(64.75 ± 12. 30) msvs.(89.43 ± 24.40 ) ms] and JTcd [ (75.14 ± 21. 05 ) ms ,(54. 93 ± 11.41 ) ms , (52.90 ± 10. 03) ms ,(65.26 ± 12. 72) msvs.(91. 98 ± 24. 22) ms] in blood stasis block group , P＝0. 001 all.Area under curve (AUC) of QTd ,QTcd ,JTd ,JTcd predicting CHD with blood stasis block was 0. 832 ,0. 861 ,0.856 and 0.854 respectively ,and optimal cutoff point was 70.77ms ,69.83ms ,77. 80ms and 77.51ms respectively .Conclu‐sion : QTd and JTd levels on ECG in CHD patients with blood stasis block type are significantly higher than other syndrome types , so they possess certain guidance value for CHD syndrome typing .

Traditional Chinese Medicine symptom patterns in patients with colorectal carcinoma.

OBJECTIVE: To observe the symptom patterns (or syndromes) according to Traditional Chinese Medicine (TCM) theory in patients with various stages of colorectal cancer, and to observe the dynamic evolution process of these TCM patterns. METHODS: A prospective and cross-sectional questionnaire-based investigation was performed. Clinical data on TCM symptom patterns in patients with colorectal cancer in the perioperative period (210 cases) and adjuvant treatment period (160 cases) were collected. EPIData 3.1 together with frequency statistics and cluster analyses were performed to identify the TCM patterns based on symptom characteristics in patients with colorectal cancer, and to assess the dynamic changes in these patterns. RESULTS: In the perioperative period, from the first day of perioperative care to postoperative days 3, 7, and 10, the TCM pattern showed a process of dynamic change from blood deficiency to deficiency of both Qi and Yin and the pattern of dampness and hot accumulative knotting. In the adjuvant treatment period, the TCM pattern changed from Qi deficiency and Yin deficiency inner-heat with dampness to a deficiency pattern, primarily including Yin deficiency of the liver and kidney, deficiency of Qi and blood, and spleen deficiency. CONCLUSION: Our study confirmed that variations in the dynamic evolution of TCM symptom patterns exist in patients with colorectal cancer during different treatment periods. This information is of great value in the individualized management of colorectal cancer.

The study on regularity of TCM diagnoses and treatment of the endoscope for the early phrase of colorectal cancer / 国际中医中药杂志

Objective To investigate the regularity of TCM diagnoses and treatment of the endoscope for the early phrase of colorectal cancer. Methods A total of 114 patients diagnosed with colorectal cancer were treated with endoscopy and herbal nursingfrom January 2013 to March 2016. The syndromes, herbs and channel tropism were analyzed to explore the regularity of TCM diagnoses and treatment of the endoscope for the early phrase of colorectal cancer. Results The common syndromes were spleen and kidney deficiency, liver and kidney Yin deficiency, Qi deficiency and blood stasis. There were 18 categories Chinese medicine. The most commonly medicine showed the function of promoting blood circulation, removing blood stasis, regulating Qi. The drugs mostly belonged to the liver, spleen, stomach, kidney meridian. Conclusions Most patients were spleen deficiency and kidney deficiency, and the disease's nature focusd on Qi and bood, with the pathogenesis characteristics of deficiency-excess complication. So the basic treatment mainly tonify the spleen and kidney, regulate Qi, promote blood circulation, and clearing heat and dampness.

Traditional Chinese Medicine symptom pattern analysis for Parkinson's disease.

OBJECTIVE: To use the theory of Traditional Chinese Medicine to identify the major symptom patterns of Parkinson's disease. METHODS: Journal databases were searched for relevant articles in the last 30 years. Articles were reviewed for symptom patterns of Parkinson's disease and analyzed using frequency analysis, cluster analysis, and other methods of data extraction. RESULTS: The analyses indicated that the most frequent symptom patterns of Parkinson's disease are Yin deficiency of kidney and liver, deficiency of Qi and blood, phlegm heat and wind stirring, blood stasis and wind stirring, and deficiency of Yin and Yang. CONCLUSION: Taken together, the analyses identified the primary symptom patterns of Parkinson's disease as Yin deficiency of kidney and liver, deficiency of Qi and blood, phlegm heat and wind stirring, and blood stasis and wind stirring.

The development of the knee osteoarthritis TCM syndrome evaluation scale as the Patient-Reported Outcome / 国际中医中药杂志

Objective To develop the knee osteoarthritis (KOA) TCM syndrome evaluation scale. Methods Resrarch team collected subjective symptoms from all kinds of syndrome types of KOA and classified the subjective symptoms, which formed the first version of item pool containing 24 subjective symptoms. Expert questionnaires were conducted to calculate the weight coefficient of items, and formed the item pool of the Knee Osteoarthritis TCM Syndrome Evaluation Scale. According to the patient's attention to the 11 items, the items were weighted.Results The Knee Osteoarthritis TCM Syndrome Evaluation Scale contained 11 items, including pain, swelling and stiffness with different weighted scores.Conclusions The Knee Osteoarthritis TCM Syndrome Evaluation Scale were introduced to assess the KOA outcomes on the basis of TCM syndromes. It showed the characteristic of TCM and TCM syndrome.It could provide an objective and standardized measurement for TCM treating KOA.

Biological Basis for the Clustering of Symptoms.

OBJECTIVES: Identification of biologic pathways of symptom clusters is necessary to develop precision therapies for distressing symptoms. This review examined extant literature evaluating relationships between biomarkers and symptom clusters in cancer survivors. DATA SOURCES: PubMed, CINAHL, Web of Science and Cochrane Library were searched using terms "biological markers" or "biomarkers" and "symptom cluster" or "symptom complex" or "multiple symptoms." CONCLUSION: Biomarkers related to inflammation (eg, cytokines) were the most studied and showed the most significant relationships with clusters of symptoms. This review suggests that clustering of symptoms related to cancer or cancer therapy is linked to immune/inflammatory pathways. IMPLICATIONS FOR NURSING PRACTICE: Understanding the etiology of symptom clusters may guide future nursing interventions for symptom management.

A clinical study of Maxing-Shigan decoction combined with salmeterol/fluticasone inhalation for acute exacerbation of chronic obstructive pulmonary disease / 国际中医中药杂志

Objective To evaluate the therapeutic effect of Maxing-Shigan decoction combined with salmeterol/fluticasone inhalation for acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods A total of 86 patients with acute exacerbation of COPD were enrolled and randomly divided into a salmeterol/fluticasone group (41 patients) and a combined treatment group (45 patients). The salmeterol/fluticasone group was treated by salmeterol/fluticasone inhalation, and the combined treatment group by Maxing-Shigan decoction combined with salmeterol/fluticasone inhalation. Serum C-reactive protein (CRP) was detected by a immunonephelometric assay, and Toll-like receptor 9 (TLR9) in hemocytes was detected by flow cytometry. The score of the syndromes in traditional Chinese medicine (TCM), such as cough, sputum, gasping and shortness of breath, as well as pulmonary function and therapeutic effect were evaluateds. Results After the treatment, the serum C-reactive protein in the combined treatment group was significantly lower than that in the salmeterol/fluticasone group (4.3 ± 1.2 mg/L vs. 8.4 ± 2.5 mg/L;t=5.417, P<0.01), and the TLR9 expression was significantly higher (1.9 ± 0.7 vs. 1.6 ± 0.4;t=3.418, P<0.05). The scores of the syndromes in TCM, such as cough (1.7 ± 0.6 vs. 3.8 ± 1.1;t=2.859, P<0.05), sputum (1.6 ± 0.4 vs. 3.9 ± 1.2;t=3.027, P<0.05), gasping (1.2 ± 0.5 vs. 3.4 ± 1.3;t=3.416, P<0.05) and shortness of breath (1.5 ± 0.7 vs. 3.7 ± 1.6;t=3.468, P<0.05) in the combined treatment group were significantly lower than those in the salmeterol/fluticasone group. The forced expiratory volume in first second (75.4 ± 5.8 L vs. 62.8 ± 6.9 L;t=3.526, P<0.05) and the percentage of forced expiratory volume in first second to forced vital capacity (85.7%± 10.3%vs. 71.9%± 15.4%;t=5.648, P<0.01) in the combined treatment group were significantly higher than those in the salmeterol/fluticasone group. The time to symptoms alleviated (3.4 ± 0.7 d vs. 5.6 ± 1.2 d; t=3.256, P<0.05) and the use dose was (1.8 ± 0.2) ×103μg vs. (5.3 ± 0.4)×103μg, and use times of salmeterol/fluticasone (7.4 ± 1.3 vs. 16.5 ± 3.4;t=4.574, P<0.05) in the combined treatment group were significantly decreased than those in the salmeterol/fluticasone group. The total effective rate in in the combined treatment group were significantly decreased than those in the salmeterol/fluticasone group (84.4% vs. 73.2%; χ2=4.519, P<0.05). Conclusion Maxing-Shigan decoction combined with salmeterol/fluticasone inhalation can improve the pulmonary function in patients with acute exacerbation of COPD, its effiency is suppior to salmeterol/fluticasone inhalation alone.

Relevance research on university students’ mental fatigue and TCM syndrome / 国际中医中药杂志

Objective To investigate and analyze TCM syndrome characteristics, impact factors and internal relationship among the factors of mental fatigue of university students. A preliminary understanding of mental fatigue situation of university students and prevent diseases was acquired in advance. Methods 100 students were randomly selected in Beijing University of Chinese Medicine, of whom 40 were undergraduate students and 60 were post-graduate students. Mental fatigue questionnaire was used to investigate mental fatigue situation for students, and TCM constitution scale was applied to collect TCM syndromes. A body energy survey was also conducted. Results In undergraduate and post-graduate students, the mental fatigue rate was relatively higher, both of them were over 50%of the total numbers, 57.5%(23/40)、61.7%(37/60) respectively. For the fatigue levels distribution in these two groups, the ratios of slight mental fatigue (undergraduate:52.5%;post-graduate:56.67%) were both higher than those of severe mental fatigue (undergraduate:5%;post-graduate:5%). In the undergraduate group, the top three biased constitutions among mental fatigue students were yang deficiency (7 out of 23:30.43%), qi deficiency (3 out of 23:13.04%) and dampness-heat (3 out of 23:13.04%). In the post-graduate group, the top three biased constitutions were yang deficiency (11 out of 37:29.73%), qi deficiency (6 out of 37: 16.22%) and dampness-heat (5 out of 37: 13.51%). Conclusion It is easier for university students with biased constitution to suffer from mental fatigue, mostly with yang deficiency, qi deficiency and dampness-heat constitution.

Physical performance and cognitive functions in community-dwelling older people at risk of Musculoskeletal Ambulation Disorder Symptom Complex (MADS) - the Nakagawa study - / 体力科学

<p>This study examined whether physical and cognitive function was independently associated with risk of Musculoskeletal Ambulation Disorder Symptom Complex (MADS) in community-dwelling older people. We examined 640 older people (315 men, 325 women; 65–89 years). We assessed physical performance by one-leg standing with eyes open, timed up and go (TUG), muscle strength, muscle power, and gait speed. Cognition was assessed using Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), and Trail-Making Tests (TMT) A and B. We divided participants by physical function into “MADS” (one-leg standing < 15s or TUG ≥ 11s) and “non-MADS”, and identified cognitive impairment if MMSE was < 27 and CDR ≥ 0.5. We also grouped by sex and age (younger-old: 65–74 years and older-old: 75–89 years), and controlled for age, Body Mass Index, education and steps. Physical and cognitive function was significantly worse in the MADS groups. The younger-old men had poorer muscle strength, muscle power and TMT-A. The younger-old women had poorer muscle power, gait speed, MMSE and TMT-B. Older-old men had poorer muscle strength, and older-old women poorer gait speed (P < 0.05). The MADS groups also had significantly higher adjusted odds ratio (OR) for cognitive impairment (younger-old men: OR: 4.62; 95% confidence interval [CI]: 1.08–19.8; younger-old women: OR: 6.09; 95% CI: 1.03–35.9; P < 0.05). This study suggested that poorer physical and cognitive function was significantly associated with the risk of MADS, and these associations may be differ with sex and age.</p>

Study on TCM syndromes of Type 2 diabetic encephalopathy by data mining / 国际中医中药杂志

Objective To explore characteristics of the elements of syndrome, the disease position and the relationship between chemical indicators and TCM syndromes of type 2 diabetic encephalopathy. Methods 2 501 cases of type 2 diabetes clinical data were collected from Guang'anmen Hospital of China Academy of Chinese Medical Sciences, Beijing University of Chinese Medicine, Dongzhimen Hospital, Dongfang Hospital, etc. in nearly 3 years, among which, 342 cases were type 2 diabetic encephalopathy. The original clinical data were double entried in epidata by two people, establishment forms in excel, factor analysis and Bayesian networks were used as data mining research methods. Results 20 elements which characteristic root more than 1 were derived by factor analysis, 68.4% were covered. Of all 20 elements, five factors belong to Yin, five factors belong to blood stasis; lassitude, shortness of breath, stool frequency were appeared when fasting glucose abnormalities; lassitude, hemiplegia were appeared when 2-hour postprandial blood glucose abnormalities;lassitude, feverish palms and soles, stool frequency, more nocturnal enuresis when glycated hemoglobin abnormalities by Bayesian networks. Conclusion The Elements of the syndrome of type 2 diabetes encephalopathy were deficiency of Yin and blood stasis; and the main positions for diabetic patients were liver, spleen and kidney. Patients with impaired fasting glucose were Qi deficiency; Patients with impaired 2-hour postprandial glucose were Qi deficiency or pathogenic wind attacking collaterals; Patients with abnormal hemoglobin were Qi deficiency and Yin deficiency.