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.

Effectiveness of Xiaoyao capsule on sleep disorders and mood disturbance in patients in recovery from coronavirus disease 2019: a randomized controlled trial.

OBJECTIVE: To study the efficacy of Xiaoyao capsule in improving the clinical symptoms of sleep and mood disorders during recovery from coronavirus disease 2019 (COVID-19). METHODS: The study cohort comprised 200 patients with sleep and mood disorders during recovery from COVID-19. Patients were randomized into the control group and the experimental group in a 1:1 ratio by blocked randomization. The patients received either Xiaoyao capsule (experimental group) or a placebo Xiaoyao capsule (control group) for 2 weeks. The improvements in the Traditional Chinese Medicine (TCM) syndrome scales, total effective rates, and disappearance rates of irritability, anxiety, and poor sleep were compared between the two groups. RESULTS: The TCM syndrome pattern scales, total effective rates, and disappearance rates of irritability, anxiety, and poor sleep did not significantly differ between the experimental group versus the control group in the full analysis set and the per protocol set after 1 and 2 weeks of treatment ( > 0.05). CONCLUSIONS: Xiaoyao capsule do not significantly improve the clinical symptoms of sleep and mood disorders in patients in recovery from COVID-19.

Discussion on the Underlying Disease of Wei （卫）-Qi-Ying （营）-Blood Syndrome Differentiation System： Taking Epidemic Cerebrospinal Meningitis as an Example / 中医杂志

Epidemic cerebrospinal meningitis shows a high degree of consistency with the law of transmission among wei （卫）-qi-ying （营）-blood， in terms of the onset of the season， contagiousness， symptoms， pathogenesis， as well as characteristics of the transmission. It is proposed to use epidemic cerebrospinal meningitis as an example to explore the underlying disease of wei-qi-ying-blood syndrome differentiation system. Epidemic meningitis invades the brain from the upper respiratory tract along the nervous system， and its overall pathogenesis follows from entering the lung system （prodromal period） to entering the blood （bacteremia period， sepsis period） and then entering the brain （shock period）. According to the four-dimensional qualitative principle of epidemic pathogen tropism， it corresponds to disease of both wei and qi syndrome， then blazing of both qi and ying syndrome， and then heat blocking pericardium， exuberant heat stirring wind， and internal block and external collapse syndrome. This article explored the laws of transmission among wei-qi-ying-blood and its underlying diseases described in On Warm Heat （《温热论》）， and revealed the original appearance of the disease model under the laws of transmission among wei-qi-ying-blood to guide the clinical practice.

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.

Therapeutic Effect and Mechanism of Yiqi Huoxue Tongbian Prescription on Slow Transit Constipation in Rats / 中国实验方剂学杂志

ObjectiveTo explore the therapeutic effect and mechanism of Yiqi Huoxue Tongbian prescription on slow transit constipation （STC） in rats. MethodThe rat model of STC was established by gavage of loperamide hydrochloride. Rats were assigned into control， model， mosapride， low-， medium-， and high-dose （3.51， 7.02， and 14.04 g·kg-1， respectively） Yiqi Huoxue Tongbian prescription groups. The changes of general signs， fecal moisture content， and intestinal propulsion rate were measured after model establishment and drug administration. The colonic mucosal changes were observed by hematoxylin eosin staining. Enzyme-linked immunosorbent assay was employed to determine the content of substance P （SP） and vasoactive intestinal peptide （VIP） in the colon of rats in each group. The gray values of aquaporin （AQP） 3， AQP4， AQP8， and c-Kit in rat colon tissue were measured by immunohistochemistry and Western blot， and the changes of intestinal flora were detected by 16S rRNA high-throughput sequencing. ResultCompared with the model group， 10 days of treatment with Yiqi Huoxue Tongbian prescription increased the fecal moisture content and intestinal propulsion rate （P<0.01）. The medium- and high-dose Yiqi Huoxue Tongbian prescription groups and the mosapride group showed no obvious mucosal inflammation and neat arrangement of goblet cells with a large number in the colon tissue. Moreover， the three groups showed increased SP content （P<0.01） and decreased VIP content （P<0.01） in the serum. The medium- and high-dose Yiqi Huoxue Tongbian prescription groups showed down-regulated protein levels of AQP3， AQP4， and AQP8 （P<0.01） and up-regulated protein level of c-Kit （P<0.01）. The drug administration groups presented slightly increased observed species， Chao1， ACE， and Shannon， Simpson， and PD whole tree. The principal component analysis showed that the control group had a short distance with the high- and medium-dose Yiqi Huoxue Tongbian prescription groups， indicating that high- and medium-dose Yiqi Huoxue Tongbian prescription can recover the intestinal flora to that in the control group. ConclusionYiqi Huoxue Tongbian prescription can alleviate the defecation status of rats with slow transit constipation by down-regulating the expression of AQP3， AQP4， and AQP8 to reduce the absorption of water in the intestine， up-regulating the expression of c-Kit to increase the number and distribution of Cajal interstitial cells， and regulating the balance of flora in the colon tissue.

Visual Analysis of Knowledge Map of Constipation Treated by TCM Based on CiteSpace / 中国实验方剂学杂志

ObjectiveTo understand the current situation and hot spots of research on the treatment of constipation by traditional Chinese medicine （TCM） in China and foreign countries， and provide references and directions for future research. MethodIn this study， the data analysis software CiteSpace 5.8.R3C was used to conduct bibliometrics analysis of the relevant papers on the treatment of constipation by TCM from January 1， 2000 to December 31， 2021 in China National Knowledge Infrastructure （CNKI） and Web of Science core database. The visual display was carried out. ResultAfter retrieval， 2 133 papers were included in CNKI database and 224 papers were included in Web of Science core database. The statistical analysis showed that the overall annual publication volume in China and foreign countries was on the rise， but the publication volume in China had been declining for the past two consecutive years. The author co-occurrence analysis showed that the authors with the largest number of publications in China and foreign countries were LIU Chunqiang and CHUNGWAH CHENG， respectively. The institution co-occurrence analysis showed that the institutions with the largest number of publications in China and foreign countries were the Anorectal Department of Longhua Hospital Affiliated to Shanghai University of TCM and Beijing University of Chinese Medicine， respectively. The keyword analysis showed that research in this field in China and foreign countries mainly focused on TCM therapy， clinical research， etiology and pathogenesis， etc. ConclusionThe research on the treatment of constipation by TCM is mainly concentrated in China， but there is no closely-related scientific research team. The research in this field in China and foreign countries is still developing. With the continuous deepening of research， all research institutions should pay attention to interdisciplinary intersection， highlight technological innovation， and strive to achieve greater breakthroughs in this field.

Chinese herbal medicine reduces mortality in patients with severe and critical Coronavirus disease 2019: a retrospective cohort study / 医学前沿

This study aimed to evaluate the efficacy of Chinese herbal medicine (CHM) in patients with severe/critical coronavirus disease 2019 (COVID-19). In this retrospective study, data were collected from 662 patients with severe/critical COVID-19 who were admitted to a designated hospital to treat patients with severe COVID-19 in Wuhan before March 20, 2020. All patients were divided into an exposed group (CHM users) and a control group (non-users). After propensity score matching in a 1:1 ratio, 156 CHM users were matched by propensity score to 156 non-users. No significant differences in seven baseline clinical variables were found between the two groups of patients. All-cause mortality was reported in 13 CHM users who died and 36 non-users who died. After multivariate adjustment, the mortality risk of CHM users was reduced by 82.2% (odds ratio 0.178, 95% CI 0.076-0.418; P < 0.001) compared with the non-users. Secondly, age (odds ratio 1.053, 95% CI 1.023-1.084; P < 0.001) and the proportion of severe/critical patients (odds ratio 0.063, 95% CI 0.028-0.143; P < 0.001) were the risk factors of mortality. These results show that the use of CHM may reduce the mortality of patients with severe/critical COVID-19.

Research on the Effect of Chinese Herbal Meridian Deoppilant Compound on Vascular Endothelial Cell Dysfunction of Obese Patients / 中国中医药信息杂志

Objective To observe the effects of Chinese herbal meridian and vessel deoppilant compound on the dysfunction of endothelium-dependent dilation (EDD) of simple obesity patients, and explore its mechanism. Methods Sixty-five obese patients with dysfunction of EDD (denoted by FMD: flow mediated brachial artery vasodilatation rate) were found through the prehminary high-resolution vascular ultrasound check, and randomized into the therapy group (treated with Chinese herbal meridian and vessel deoppilant compound) and the control group. The therapy group took Xinxiang Shuluo 2# capsules three times a day, 3 gram each time, and the control group was given the same doses of starch capsules. The experiment lasted 12 weeks. Before and after the experiment, FMD and inner diameter of brachial arteries (DO) of all the patients were measured, and the changes of total cholesterol (TC) and trigiyceride (TG) in serum were compared. Results FMD of the therapy group was significantly higher than the control group (P

Analysis on the Effect of Qingre Jiangzhuo Prescription on Overweight Subjects of Type 2 Diabetes Mellitus Patients / 中国中医药信息杂志

Objective To observe the efficacy of Qingre Jiangzhuo prescription in the treatment of overweight subjects of type 2 diabetes mellitus. Methods Two hundred and four cases were divided into 2 groups in a randomized, paralleled, contrast, prospective study. The control group was treated with metformin tablet and the trial group was treated with Qingre Jiangzhuo prescription. The efficacy and safety of the two groups were compared on HbAlc, FBG, P2BG, TC, TG, BMI and AE after 12 weeks. Results After treatment, all indexes of the trial group were markedly improved compared with before treatment (P 0.05). The rate of AE in the trial group was less than that in the control group. Conclusion Qingre Jiangzhuo prescription has curative effect on type 2 diabetes mellitus patients with better safety.

Effect of Kaiyuqingwei Decoction on Expression of Insulin Receptor and Insulin Receptor Substrate-1 in Islets of Type 2 Diabetic Rats / 中国中医药信息杂志

Objective To investigate the mechanism of Chinese herbal medicine compound (Kaiyuqingwei Decoction) improving islet cells function of type 2 diabetes. Methods The models of type 2 diabetic rats were established by feeding with high-fat-diet and injecting low dosage of streptozotocin (15 mg/kg BW). Rats were randomly divided into model group, Kaiyuqingwei group, and Rosiglitazone group and normal control was established, at the same time, fasting and post-glucose loading 2 hours blood glucose, serum fructosamine and basal insulin were determined. Euglycemic hyperinsulin clamp technique was adopted to evaluate insulin sensitivity of periphery tissues, and intravenous glucose tolerance test to evaluate islets function. Adopting immunohistochemistry stain (EnVision) and computer image analysis technique to determine the expression of insulin, insulin receptor and insulin receptor substrate-1 in islets. Results There were insulin resistance, dysfunction of islet cells and obvious increase of blood glusose in model rats. All these could be improved by Kaiyuqingwei Decoction and Rosiglitazone. Meanwhile, immunohistochemistry stain of islets demonstrated that Kaiyuqingwei Decoction could increase expression of IRc and IRS-1. Conclusion Kaiyuqingwei Decoction have a certain positive role in improving glucose metabolism of type 2 diabetic rats. The mechanism include two aspects, one is elevation of insulin sensitivity, another is amelioration of dysfunction of islet cells. One of the important mechanisms of amelioration of dysfunction in islet cells is amelioration of insulin signal transduction in pancreatic islets.

Effects of Luotong on the Morphological Changes of Retinal Microvessels in the Streptozotocin-induced Diabetic Rats / 中国中医药信息杂志

Objective To study the protective and therapeutic effect of Luotong on the retinal microvessel kinetic morphological changes during various stages of streptozotocin-induced diabetic rats. Methods The diabetic rat model was setup by a single intraperitoneal injection 65 mg/kg of streptozotocin. Diabetic model rats were randomly divided into diabetic model group (6, 9, 12 months subgroups), diabetic group protected with Luotong (6 months) from the onset of diabetic model (LT group)and diabetic group treated with Luotong (3, 6 months subgroups ) 6 months after the onset of diabetic model (LT1, 2 group). The eyeballs were removed at 6, 9 and 12 months, respectively. The whole mounts of retinal digestion were prepared and stained with PAS staining method. The light microscope and transmission electron microscope morphological observations were performed and the basilar membrane thickness of retinal capillaries were quantitatively analysed by LEICA-Q550IW computer image system. Results At 6 months, the retinal microvessel morphological changes of LT group were less severe than those of 6 month model group. At 9 months of the diabetic model rat, the retinal microvessel morphological changes were prominent. 3 months after Luotong therapy, the retinal microvessel changes were partly improved in comparison with 9 month model group but still aggravated gradually. At 12 months, the retinal microvessel morphological changes of diabetic model rats were very severe. 6 months after Luotong therapy, the retinal microvessel changes were significant mitigated compared with 12 month model group. The results of computer image analysis indicated the retinal capillary basilar membrane thickness in diabetic group protected or treated with Luotong were significant decreased in comparison with homeochronous model group (P

Differential expression of adiponectin in different Chinese medicine syndrome of central obesity and its correlation with obesity character / 中华中医药杂志

Objective:to observe the differential expression of adiponectin in different Chinese medicine syndrome of central obesity and its correlation with obesity character.Methods:To establish xu and shi syndrome of central obesity groups,with normal group as control.The metabolic symptoms and adiponectin expression will be tested and be used to study their correlation with obesity character.Results:The level of adiponectin,ratio of VA/SA,and fast insulin(FIns),HOMA-IR had signifi cantly difference between the xu and shi groups(P

Variation of islet?-cell secretary function on Type 2 diabetic patients with long-term treatment based on syndrome differentiation / 中华中医药杂志

Objective:To explore variation of HOMA2-%B,HbA1C,present symptoms and TCM compatibility on T2DM patients with long-term treatment based on syndrome differentiation.Methods:It is a retrospective study in view of actual TCM treatment.All patients who were fi t for standards have been treated with TCM based on syndrome differentiation.Their treatment courses are all more than 6 months.Observational statistical data is measured on every 3 months.Results:① Index number of islet ?-cell secretary function(HOMA2-%B)of patients treated with TCM have been improving than those before preliminary diagnosis on 9 months/21 months(P

New Discussion of Pi-dan / 中华中医药杂志

Pi-dan is a signifi cant conception,which comes from Inner Canon of Huangdi.From the vivid description of Pi-dan in Inner Canon of Huangdi,we consider that the formation and process of Pi-dan is equivalent to metabolic syndrome.They are have the same etiological factor:obesity,the same pathogenesis:abdominal fullness and interior heat,and they can result in diabetes,hypertension,hyperlipidemia,fat liver,gout and a series of severity vascular complication.The theory of Pi-dan exactly points out that obesity the original cause of metabolic syndrome,and suggests that early prevention and treatment for obesity is an important method to prevention metabolic syndrome and its complications.The main pathogenesis of Pi-dan is abdominal fullness and interior heat,and the main therapeutic methods are Xiaogaojiangzhuo,Kaiyuqingre,and Huoxuetongluo.

Basic biology research on different types of syndrome of obese type 2 diabetes / 中华中医药杂志

Objective:Combining with modern medical research progress in a number of target selections,to explore basic biology of different types of syndrome of obese type 2 diabetes.Methods:To research abnormal metabolic status from three levels of anthropometry,blood metabolism and fat factors.Results:The resistin secretion in phlegm-heat syndrome group was significant higher than that in the endogenous heat due to yin deficiency syndrome group,suggesting that resistin could be used as evidence to distinguish phlegm-heat syndrome and endogenous heat due to yin defi ciency syndrome.There was no signifi cant difference of the levels of leptin,IL-6,E-selectin,TNF-?,GLP-1,body mass index,waist-hip ratio,sugar metabolism in the target fasting blood glucose,glycosylated hemoglobin insulin,C-peptide levels,lipid metabolism in the target cholesterol,triglyceride,low-density lipoprotein,very low density lipoprotein,three renal urinary albumin excretion rate in urine,sugar protein and ?2-microglobulin,blood pressure,hematocrit,fibrinogen,C-reactive protein between the phlegm-heat syndrome group and endogenous heat due to yin deficiency syndrome group,but there was marked change tendency.Conclusion:There were differences of different types of syndrome of type 2 diabetes in basic biology from the aspect of spleen heat,and evidence of the possible differences need further study.

A discussion on preventive treatment of pre-diabetes mellitus in traditional Chinese medicine / 中华中医药杂志

Pre-disease is a condition in which characteristic symptoms are not prominent.That is to say pre-disease is lack of key proof to be diagnosed as a disease,but has common symptoms as well as signs.It is said in Inner Canon of Huangdi that "prefer prevention to treatment",which needs doctors to find unusual symptoms in early stage of diseases then take positive preventive measures to help patients regain health.Diabetes mellitus(DM) is one of the life style-related diseases which associated with unhealthy habits of human beings.Pre-diabetes mellitus mainly refers to impaired glucose tolerance(IGT).With the help of modern medical technology,doctors and patients should focus on pre-diabetes by combining TCM treatment based on syndrome differentiation and health care,in order to stop DM at early stage.

Study on the clinical characteristics of severe acute respiratory syndrome(SARS )in elderly patients / 中华老年医学杂志

ObjectiveTo elucidate the clinical characteristics and the outcome of SARS in elderly pat ients. Methods Clinical data of 66 elderly patients(≥60 years) with SARS were analysed and compared with that of 238 younger adult SARS patients(18-59 years) in the sa me period. Results Sixty-six out of 304 patients(21 7%) with SARS were more than 60 years. Th e mortality rate of SARS in elderly patients was 22 7%. Underlying disease,lon ger course of disease,dyspneic respiration,severe type of SARS,and higher mor tality were more prevalent in elderly patients than those in the younger adult S ARS patients(P