Effectiveness of Peng's Shengjing recipe on male asthenospermia caused by kidney yang deficiency: A randomized pilot study.

OBJECTIVES: To examined the efficacy and safety of Peng's Shengjing recipe in treating asthenospermia with deficiency and failure of kidney yang. The traditional Chinese medicine (TCM) Peng's Shengjing recipe might have benefits in treating male asthenospermia. METHODS: This randomized, positive drug-controlled, single-blind pilot study enrolled outpatients from the Third Department of Traditional Chinese Medicine Surgery, Shanghai University of Traditional Chinese Medicine, Shanghai, China, between April 2020 and September 2020. A total of 99 participants were randomized to Shengjing recipe (n=50) and Xuanju capsule (n=49). They were treated for 12 weeks. The primary endpoint was routine semen examinations, including the percentage of sperm motility rated grade A, A+B, and A+B+C, and the clinical effective rate. The secondary endpoints were the levels of gonadotropins. RESULTS: The A grade sperms (18.9% versus [vs.] 13.9%, p=0.030) and A+B grade sperms (42.9% vs. 32.7%, p<0.001) were higher in the Shengjing recipe group than the Xuanju capsule group. The effective rates were 68% and 53.1% in the Shengjing recipe and Xuanju capsule groups (p=0.128). No safety signals were observed. CONCLUSION: Peng's Shengjing recipe improves the quality of sperms and is effective in treating clinical asthenospermia of deficiency of kidney yang. The treatment was well tolerated, without obvious hepatorenal toxicity.Chinese Clinical Research Registry No.: ChiCTR2000030845.

Efficacy and safety of Linggui Zhugan decoction in the treatment of chronic heart failure with Yang deficiency: A protocol for systematic review and meta-analysis.

BACKGROUND: Chronic heart failure (CHF) is an advanced stage of various heart diseases and has become a major global health problem. In 2018, the Chinese guideline for the diagnosis and treatment of HF suggested adding traditional Chinese medicine (TCM) as an adjunct to the treatment of CHF, but also pointed out the need for more convincing clinical evidences. Linggui Zhugan decoction (LGZGD) is one of the widely used TCM for CHF treatment, especially for patients with Yang deficiency. Given that treatment based on syndrome differentiation is an important principle in TCM, we provide a protocol to systematically evaluate efficacy and safety of LGZGD for CHF with Yang deficiency. METHODS: We will search the following electronic databases from inception to April 30, 2021, including PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure, VIP Information Database, Chinese Biomedical Literature Database (CBM), and Wanfang Database. Randomized controlled trials (RCT) examining the LGZGD on CHF patients with Yang deficiency will be included. Study selection, data extraction and quality assessment will be conducted by 2 researchers, respectively. The primary outcome measures will be n-terminal brain natriuretic peptide and left ventricular ejection fraction. The risk of bias will be evaluated by the Cochrane Collaboration tool. We will use the fixed-effects model or random-effects model of RevMan V.5.3 based on the results of heterogeneity assessment. The evidence quality of results will be assessed by Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. RESULTS: It will provide the results about efficacy and safety of LGZGD in the treatment of CHF with Yang deficiency by various comprehensive assessments. CONCLUSIONS: This study will provide reliable evidences about the efficacy and safety of LGZGD in the treatment of CHF with Yang deficiency. ETHICS AND DISSEMINATION: Ethical approval is not necessary for this study because the data extracted does not involve any individual privacy. We plan to presented the results of this review in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD 42019140797.

Association between dry eye and traditional Chinese medicine body constitutions: A Taiwanese adults study.

ABSTRACT: In the theory of traditional Chinese medicine (TCM), except for the balanced constitution, other constitutions are unbalanced and may lead to susceptibility to certain diseases. This study made the first efforts to explore the relationship between TCM constitutions and the dry eye condition.This cross-sectional study collected information from 2760 subjects aged 30 to 70 years who had participated in a questionnaire survey conducted by Taiwan Biobank (TWB) in 2012 to 2017. The questionnaire included questions on basic demographic characteristics, chronic diseases, depression, blood lipid levels, lifestyles, and drug allergies, as well as a TCM constitution scale developed by a research team of TCM constitution and syndrome at China Medical University College of Chinese Medicine.Unadjusted and stratified multiple logistic regression analyses were performed to explore the relationships between TCM constitutions and dry eye. The analysis revealed that subjects falling into the constitution category of Yang deficiency, Yin deficiency, or Phlegm stasis were more likely to develop dry eyes (crude odds ratio [OR] = 1.741, 95% confidence interval [CI] = 1.361-2.227; crude OR = 2.4821, 95% CI = 1.968-3.131; and crude OR = 2.082, 95% CI = 1.597-2.714, respectively). After adjusting for important risk factors (demographic characteristics, chronic diseases, blood lipid levels, lifestyles, depression, and drug allergies), subjects with an unbalanced constitution were 1.6 to 2.5 times more likely to develop dry eye than those with a balanced constitution.These results confirm a high correlation of TCM constitution with dry eye. Considering that the current treatment outcome is not fully satisfactory to the patients with dry eyes, integration of TCM and Western medicine may be an alternative treatment option. Individualized treatments and lifestyle recommended should be provided to patients with different TCM constitutions to alleviate dry eye symptoms.

Warming yang method in traditional Chinese medicine for depression: A protocol for systematic review and meta-analysis.

BACKGROUND: Depression is a chronic psychological disease with low emotion, interest, cognition, thinking and disorder of physiological function, even numbness, or hallucination, delusion and other psychotic symptoms. Traditonal Chinese medicine plays an important role in the treatment of mental diseases in China and East Asia. The aim of this study is to assess the efficacy and safety of warming yang method in traditional Chinese medicine for depression. METHODS: We search the following databases: PubMed, the Cochrane Library, Chinese Science and Technique Journals Database, Chinese Biomedical Literature Database, Excerpt Medica Database, MEDLINE, Chinese National Knowledge Infrastructure Database, and the Wanfang Database. Other sources will also be searched like Google Scholar and gray literatures. All databases mentioned above are searched from the start date to November 2020. Randomised controlled trials will be included which recruiting depression participants to assess the efficacy and safety of warming yang method in traditional Chinese medicines against controls (placebo or other therapeutic agents). Primary outcomes will include the reduction ratio of Hamilton Depression Rating Scale and security index. Secondary outcomes include the Yang deficiency improves. Two authors will independently scan the searched articles, extract the data from attached articles and import them into Endnote X8 and use Microsoft Excel 2013 to manage data and information. We will assess the risk of bias by Cochrane tool of risk of bias. Disagreements will be resolved by consensus or the participation of a third party. All analysis will be performed based on the Cochrane Handbook for Systematic Reviews of Interventions. The meta-analysis in this review will use RevMan 5.3 software. RESULTS: The study is aim to evaluate the efficacy and safety of warming yang method in traditional Chinese medicine for depression. CONCLUSION: This study of the meta-analysis could provide evidence for clinicians and help patients to make a better choice. INPLASY REGISTRATION NUMBER: INPLASY2020110129.

A multi-center, randomized, double-blind, placebo-parallel controlled trial for the efficacy and safety of shenfuqiangxin pills in the treatment of chronic heart failure (Heart-Kidney yang deficiency syndrome).

BACKGROUND: Heart failure (HF) is the final stage of various cardiac diseases with poor prognosis. The integrated traditional Chinese medicine (TCM) and western medicine therapy has been considered as a prospective therapeutic strategy for chronic heart failure (CHF). There have been small clinical trials and experimental studies to demonstrate the efficacy of Shenfu Qiangxin Pills (SFQX) for treating CHF, however, there is still a lack of further high-quality trial. This paper describes the protocol for the clinical assessment of SFQX in CHF (heart-kidney Yang deficiency syndrome) patients. METHODS: A randomized, double-blind, parallel-group, placebo-controlled, multi-center trial will assess the efficacy and safety of SFQX in the treatment of CHF. 352 patients with CHF (heart-kidney Yang deficiency syndrome) from 22 hospitals in China will be enrolled. Besides their standardized western medicine, patients will be randomized to receive treatment of either SFQX or placebo for 12 weeks. The primary outcome is the plasma N-terminal pro-B-type natriuretic peptide levels, which will be measured uniformly by the central laboratory. The secondary outcomes include composite endpoint events (hospitalization due to worsening HF, all-cause mortality, other serious cardiovascular events), echocardiography indicators, grades of the New York Heart Association (NYHA) functional classification, the 6-minute walk test (6MWT) results, Minnesota Living With Heart Failure Questionnaire and TCM syndrome scores. DISCUSSION: The integrated TCM and western medicine therapy has developed into a treatment model in China. The rigorous design of the trial will assure an objective and scientific assessment of the efficacy and safety of SFQX in the treatment of CHF. TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR2000028777 (registered on January 3, 2020).

Therapeutic Effect of Ershen Pill () Extract on Pi (Spleen)-Shen (Kidney) Yang Deficiency-Induced Diarrhea in Rat Model.

OBJECTIVE: To investigate whether Ershen Pill (ESP, ) could alleviate the symptom of Pi (Spleen)-Shen (Kidney) yang deficiency (PSYD)-induced diarrhea in rat model and explore its anti-diarrhea mechanism. METHODS: Seventy-five Sprague-Dawley rats were divided into 5 groups by a random number table, including control, positive, model, low-dose (LD) and high-dose (HD) ESP groups, 15 rats in each group. All the rats, except those in the control group, were developed PSYD induced-diarrhea based on its pathology and etiology. The rats in positive, LD and HD ESP groups were treated with Shenling Baizhu Pill (), LD (1.05 g/kg) or HD (3.50 g/kg) ESP petroleum ether extract once a day for 2 weeks, respectively. Body weight change and diarrhea index were measured. The histology scores of the kidney were evaluated via hematoxylin and eosin (HE) staining. Aquaporin-3 (AQP3) expression in the colon was analyzed by immunofluorescence, quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and Western blot, respectively. RESULTS: Compared with the model group, oral administration of LD and HD ESP prevented body weight loss and inhibited diarrhea after 2-week treatment (P<0.05). Kidney deterioration was impeded, and the histology score in LD and HD ESP groups were 8.2 and 10.5, respectively, which were both higher than those in the model group (P<0.05). In addition, ESP treatment alleviated rat colitis, and HD ESP significantly improved the AQP3 positive staining intensity in the colon tissue compared with the model group. The result from Western blot revealed that AQP3 protein synthesis in colon tissue of LD and HD ESP groups increased by 2.1- and 5.9-fold compared with the model group (P<0.05). qRT-PCR result showed that AQP3 gene expression in the HD ESP group was also up-regulated by 2.5-fold normalized to the model group (P<0.05). CONCLUSION: ESP extract effectively alleviates the symptoms of PSYD and relieves PSYD-induced diarrhea by improving AQP3 synthesis in the colon.

Er Shen Wan extract reduces diarrhea and regulates AQP 4 and NHE 3 in a rat model of spleen-kidney Yang deficiency-induced diarrhea.

INTRODUCTION: Er Shen Wan (ESW), a traditional Chinese medicinal formula comprised of Psoraleae Fructus (Babchi seeds, from Psoralea corylifolia Linn.) and Myristicae Semen (Nutmeg, from Myristica fragrans Houtt.), is widely used to treat spleen-kidney Yang deficiency (SKYD)-induced diarrhea. Previous studies have demonstrated preliminarily that the petroleum ether extract of ESW (ESWP) exhibits significant anti-diarrheal activity. The present study aimed to evaluate the anti-diarrhea activity of ESWP and to explore the underlying mechanisms with respect to fluid metabolism in a rat model of SKYD-induced diarrhea. MATERIALS AND METHODS: A high-performance liquid chromatography-diode array detector (HPLC-DAD) approach was developed and validated for qualitative and quantitative analyses of the main constituents of ESWP. SKYD model rats were established and treated with an effective dose (3.5?g/kg) of the extract for two weeks. Anti-diarrheal activity and stool properties were observed. After the experiment, the appearance and histology of the intestines were evaluated. Serum levels of neuropeptide Y (NPY) and vasoactive intestinal peptide (VIP) were also determined. Furthermore, to characterize the regulation of aquaporin-4 (AQP 4) and Na+/H+ exchanger isoform 3 (NHE 3) in the colon, quantitative real-time RT-PCR (qRT-PCR), immunohistochemistry (IHC) and Western blotting (WB) were employed to detect mRNA and protein expression levels. RESULTS: In the rat models, oral ESWP administration significantly reduced the diarrhea score and the number and weight of wet stools. Jejunal and ileac histological damage was impeded, and the histology score decreased. Serum VIP levels were significantly decreased, in contrast to NPY levels. In addition, AQP 4 and NHE 3 expression levels increased significantly. CONCLUSIONS: These results showed that ESWP's anti-diarrheal effect might at least partially involve the regulation of hormones intimately involved in maintaining fluid and electrolyte levels, as well as by increasing AQP 4 and NHE 3 expression levels and enhancing the absorption of Na+ and water.

The Analysis of Constitutions of Traditional Chinese Medicine in Relation to Cerebral Infarction in a Chinese Sample.

OBJECTIVE: To investigate the relationships between the constitutions of Traditional Chinese Medicine (TCM) and patients with cerebral infarction (CI) in a Chinese sample. METHODS: A total of 3748 participants with complete data were available for data analysis. All study subjects underwent complete clinical baseline characteristics' evaluation, including a physical examination and response to a structured, nurse-assisted, self-administrated questionnaire. A population of 2010 neutral participants were used as the control group. Multiple variable regression (MLR) were employed to estimate the relationship between constitutions of TCM and the outcome. DESIGN: A cross-sectional study was conducted to evaluate the association of body constitution of TCM and CI. SETTINGS/LOCATION: Communications and healthcare centers in Shanghai. SUBJECTS: A total of 3748 participants with complete data were available for data analysis. OUTCOME MEASURES: All study subjects underwent complete clinical baseline characteristics' evaluation, including a physical examination and response to a structured, nurse-assisted, self-administrated questionnaire. A population of 2010 neutral participants were used as the control group. MLR were employed to estimate the relationship between constitutions of TCM and the outcome. RESULT: The prevalence of CI was 2.84% and 4.66% in neutral participants and yang-deficient participants (p = 0.012), respectively. Univariate analysis demonstrated a positive correlation between yang deficiency and CI. After adjustment for relevant potential confounding factors, the MLR detected significant associations between yang deficiency and CI (odds ratio = 1.44, p = 0.093). CONCLUSION: A yang-deficient constitution was significantly and independently associated with CI. A higher prevalence of CI was found in yang-deficient participants as compared with neutral participants.

[Effects of acupoint catgut embedding combined with auricular point pressure on menopausal syndrome of liver-kidney deficiency type and estradiol].

OBJECTIVE: To observe the efficacy differences between acupoint catgut embedding combined with auricular point pressure with beans and nilestriol on menopausal syndrome of liver-kidney deficiency type, and to explore their effects on estradiol (E2). METHODS: Sixty patients with menopausal syndrome of liver-kidney deficiency type were randomly divided into an acupoint stimulation group and a medication group, 30 cases in each group. The patients in the acupoint stimulation group were treated by acupoint catgut embedding at Taixi (KI 3), Sanyinjiao (SP 6), Shenshu (BL 23), Ganshu (BL 18) and Taichong (LR 3), combined with auricular point pressure at Gan (CO12), Shen (CO10), Neifenmi (CO18), Shenmen (TF4), Pizhixia (AT4); the treatment was given once a week for consecutive four weeks. The patients in the medication group were treated with oral administration of nilestriol, 1 mg, once a day, combined with oral administration of oryzanol, 20 mg, three times per day for consecutive four weeks. The clinical symptom score was compared between the two groups before and after treatment as well as in follow-up visit. The level of E2 was obserced before and after treatment, and the clinical effect was compared. RESULTS: (1) Compared before treatment, the clinical symptom score in the two groups was significantly reduced after treatment and in follow-up visit (all P<0.05); In follow-up visit, the clinical symptom score in the acupoint stimulation group was significantly lower than that in the medication group (P<0.05). The different value before treatment and at follow-up in the acupoint stimulation group was better than that in the medication group (P<0.05). (2) Compared before treatment, the level of E2 in the two groups were increased after treatment (both P<0.05); compared before and after treatment, the difference in the treatment group was significantly higher than that in the medication group (P<0.05). (3) After treatment, the total effective rate was 93.33% (28/30) in the acupoint stimulation group, which was similar to 90.00% (27/30) in the medication group (P>0.05). CONCLUSIONS: Compared with nilestriol, acupoint catgut embedding combined with auricular point pressure with beans could better improve clinical symptoms for patients with menopausal syndrome of liver-kidney deficiency type, and increased the level of E2.

[Efficacy and safety of traditional Chinese medicine combined with sildenafil in the treatment of ED in Chinese men： A real-world study].

OBJECTIVE: To make a real-world study on the efficacy and safety of traditional Chinese medicine (TCM) combined with sildenafil in the treatment of erectile dysfunction (ED) that failed to respond to TCM medication. METHODS: This study included 1 038 ED patients with the International Index of Erectile Function-5 (IIEF-5) scores ≤21 and improvement <30% after 4 weeks of TCM medication, differentially diagnosed with kidney-yang or kidney-yin deficiency syndrome. We administered TCM combined with sildenafil (Viagra, Pfizer Pharmaceutical Co., Ltd) at 100 mg 1 hour before sexual intercourse. After 2 and 4 weeks of medication, we recorded the scores in IIEF-5, erection hardness, Sexual Encounter Profile question 2 (SEP-2: whether vaginal penetration is successful), SEP-3 (whether sexual intercourse is successful), and TCM Syndromes Scale as well as the indexes of routine blood, urine, liver function, and renal function of the patients, and compared them with those obtained before treatment. RESULTS: No serious adverse reactions were observed in any of the patients. Compared with the baseline, the patients achieved significantly increased IIEF-5 scores after 2 and 4 weeks of medication (15.01 ± 2.25 vs 16.96 ± 2.55 and 19.41 ± 2.82, P <0.05), penileelectionhardness remarkably improved at 4 weeks (3.36% vs 44.58%, P<0.05), and the positive answers to SEP-2 and SEP-3 both markedly increased at 2 (38.11% vs 90.49%, P<0.05; 22.01% vs 63.77% , P<0.05) and 4 weeks (38.11% vs 96.95% , P<0.05; 22.01% vs 89.73%, P<0.05). CONCLUSIONS: TCM combined with sildenafil is safe and effective in the treatment of ED in Chinese men, which can significantly improve the IIEF-5 score and erection hardness of the patients.

[A correlation research on Chinese medical syndromes of chronic heart failure and various complications].

OBJECTIVE: To study the correlation between various complications of chronic heart failure (CHF) patients and Chinese medical syndromes, thus indicating distribution laws of Chinese medical syndromes in various complications of CHF patients. METHODS: Chinese medical syndrome typing was performed in 630 CHF patients by cross-sectional study of the demographic data, history of present diseases, related information on Chinese medical four diagnostic methods, and the distribution of complications. Logistic regression analysis was used to determine the correlation of various complications of CHF patients and Chinese medical syndromes. RESULTS: In this study, recruited were common complications such as hypertension, diabetes, arrhythmia, hyperlipemia, and cerebral vascular accident, and so on. Main syndromes were sequenced as qi deficiency syndrome, blood stasis syndrome, water retention syndrome, yin deficiency syndrome, phlegm turbid syndrome, yang deficiency syndrome. Results of Logistic regression analysis indicated that correlation existed between common complications and Chinese medical syndromes. In CHF complicated hypertension patients, Logistic regression analysis showed qi deficiency syndrome and yang deficiency syndrome were negatively correlated with hypertension (P < 0.05). In CHF complicated diabetes patients, Logistic regression analysis showed phlegm turbid syndrome and water retention syndrome were positively correlated with diabetes (P < 0.05). In CHF complicated arrhythmia patients, there was no statistical difference in the distribution of each syndrome (P > 0.05). In CHF complicated hyperlipemia patients, Logistic regression analysis showed qi deficiency syndrome and water retention syndrome were negatively correlated with hyperlipemia (P < 0.05), while blood stasis syndrome, yin deficiency syndrome, and phlegm turbid syndrome were positively correlated with hyperlipemia (P < 0.01). In CHF complicated cerebral vascular accident patients, Logistic regression analysis showed qi deficiency syndrome and yang deficiency syndrome were negatively correlated with cerebral vascular accident (P < 0.01, P < 0.05). CONCLUSIONS: There existed certain correlations between complications of CHF and the distribution of main Chinese medical syndromes. It could be used as guidance for treating CHF and its various complications by Chinese medicine and pharmacy.

[Effects and mechanisms of Qifu decoction ameliorating renal tubulointerstitial fibrosis through inhibiting ERK1/2 signaling pathway in unilateral ureteral obstruction rats with yang deficiency].

OBJECTIVE: To demonstrate the effects and mechanisms of Qifu decoction( QFD) on renal interstitial fibrosis (RIF) in model rats with yang-deficiency syndrome. METHOD: The rats were randomly divided into 3 groups, the Sham group (Group A), the Model group (Group B), the Qifu decoction group (Group C) and the Enalapril group (Group D). The RIF model was established by adenine administrated and unilateral ureteral obstruction (UUO) of the left ureter. After the model was successfully established, the rats in Group C and D were administrated with QFD or the Enalapril suspension,while the rats in Group A and B were administrated with distilled water. All rats were administrated for 3 weeks. Before administration and at the end of week 1, 2 and 3, the rats were weighted, and 24 h urinary protein excretion (Upro), urinary ß2-microglobulin (Uß2-MG) and urinary N-acetyl-D-glucosaminidase (NAG) were examined, respectively. All rats were killed after administration for 3 weeks. Blood and renal tissues were collected, renal morphology and tubulointerstitial morphology were evaluated, respectively. Serum cyclic adenosine monophosphate (cAMP), cyclic guanosine monophosphate (cGMP), blood urea nitrogen (BUN), serum creatinine (Scr) and uric acid (UA) were detected, respectively. The protein expressions of E-cadherin, α-smooth muscle actin(α-SMA), transforming growth factor-ß1 (TGF-ß1), onnective tissue growth factor (CTGF) extracellular signal-regulated protein kinase 1/2(ERK1/2) and phosphorylated-ERK1/2 (p-ERK1/2) in kidney were evaluated, respectively. RESULT: QFD ameliorated serum cAMP level and the rate of cAMP/cGMP, attenuated urinary ß2-MG level, NAG level and renal tubulointerstitial fibrosis, increased E-cadherin protein expression, and reduced α-SMA, TGF-ß1, CTGF and p-ERK1/2 protein expressions in the kidney. However, QFD had no influence on renal function in vivo. In addition, these effects were better than those of the model rats treated by Enalapril. CONCLUSION: QFD could alleviate yang-deficiency parameters, as well as urinary ß2-MG level and NAG level in model rats induced by adenine administration and UUO. Moreover, QFD could improve EMT and RIF by up-regulating E-cadherin protein expression, and down-regulating α-SMA, TGF-ß1, CTGF and p-ERK1/2 protein expressions, the key molecular in ERK1/2 signaling pathway.

Bone marrow angiogenesis in patients presenting with differential Chinese medicine syndrome: correlation with the clinico-pathological features of aplastic anemia.

OBJECTIVE: To explore differences in bone marrow angiogenesis seen in aplastic anemia (AA) patients presenting with differential Chinese medicine (CM) syndrome, and to correlate these differences with clinical pathology. METHODS: Thirty-five patients were enrolled, including 18 with "yang deficiency syndrome" and 17 with "yin deficiency syndrome." Bone marrow biopsies and serum were collected. Microvessel density (MVD) and positive expression of vascular endothelial-derived growth factor (VEGF) were detected by immunohistochemisty. Hypoxia inducible factor -1α (HIF-1α), and VEGF expression were assayed by enzyme-linked immunoabsorbent assay (ELISA), serum lactate dehydrogenase (LDH) was tested by enzyme method and liquid chip technology was used to detected the expression of interleukin (IL)-2, IL-4, IL-6, IL-10, interferon (IFN)-γ and tumor necrosis factor (TNF)-α. RESULTS: Counts for leukocytes, absolute neutrophils and platelets in "yin deficiency syndrome" were lower than those found in "yang deficiency syndrome" (P<0.05). MVD and VEGF expression, and the positive rate of CD34 and VEGF in bone marrow were lower in AA, especially in "yin deficiency syndrome" (P<0.01 or P<0.05). "Yin deficiency syndrome" displayed decreased VEGF and LDH expression, and enhanced expression of HIF-1α as compared to "yang deficiency syndrome" (P<0.05). Levels of IL-4 and IL-6 were higher in AA (P<0.01), but IL-10 was decreased (P<0.05). High TNF-α expression was seen in "yang deficiency syndrome" and IFN-γ expression was decreased in "yin deficiency syndrome" as compared with normals (P <0.01 and P<0.05, respectively). CONCLUSION: AA patients have lower MVD than normals, especially in "yin deficiency syndrome." MVD might differentially correlate to disease severity, and could be dependent on bone marrow or serum VEGF expression and LDH. Additionally, IL-2, IL-10, IL-4 and IFN-γ were negatively associated while IL-6 and TNF-α were positively associated with MVD.

Association of APOE polymorphisms and insulin resistance with TCM syndromes in type 2 diabetes patients with macroangiopathy.

To investigate the association between apolipo-protein E (APOE) polymorphisms and insulin resistance and Traditional Chinese Medicine (TCM) syndromes in type 2 diabetes mellitus (T2DM) with macroangiopathy, 60 patients with T2DM macroangiopathy were enrolled and divided into three groups: dryness-heat due to deficiency of yin, Qi-Yin deficiency, and Yin-Yang deficiency, according to the TCM syndromes, with a control group of 20 healthy individuals. APOE genotype analysis was performed with polymerase chain reaction amplification and restriction fragment length polymorphism, and the results showed that the proportion of the ε4/4 and ε3/4 genotypes and frequencies of the ε4 and ε3 alleles were higher in the Qi-Yin deficiency group (P<0.05). Among the T2DM macroangiopathy patients, the E4 group had the largest number of cases, as well as a significantly longer disease course compared to the E2 group (P<0.05). The insulin resistance index (IRI), insulin action index and body mass index (BMI) of patients in the Yin-Yang deficiency group were significantly different from those of patients with dryness-heat due to deficiency of yin and Qi-Yin deficiency. Furthermore, correlation analysis of the BMI and IRI of patients in the Yin-Yang deficiency group revealed a correlation coefficient r=0.696 (P<0.01) and a typical correlation between them. In conclusion, the Qi-Yin deficiency in T2DM patients with macroangiopathy is associated with the APOE E4 and E3 genotypes. Thus, the APOE gene polymorphism can, to some degree, reflect the TCM syndrome types of T2DM patients with macroangiopathy. Insulin resistance plays an important role in the occurrence of T2DM macroangiopathy and is closely associated with the Yin-Yang deficiency according to the TCM differentiating types.

La moxibustión en el tratamiento de la infertilidad femenina asociada a la insuficiencia de Yang de riñón / Moxibustion in the treatment of feminine infertility associated to Yang insuffiency of kidney

Fundamento: La infertilidad femenina constituye un problema de salud por su alta incidencia, limitaciones diagnósticas y terapéuticas e implicaciones económicas y psicológicas. Objetivo: Determinar el efecto de la moxibustión en el tratamiento de la infertilidad femenina asociada a la Insuficiencia de Yang de riñón. Método: Se realizó un estudio fase II, abierto, multicéntrico, prospectivo y secuencial. La muestra estuvo formada por 62 mujeres infértiles, que acudieron a la consulta en el Policlínico Carlos J Finlay creada para esta investigación, remitidas por especialistas en Ginecología y Obstetricia de toda la provincia, desde enero de 2007 a abril de 2008, que cumplieron con los criterios de diagnóstico e inclusión. El tratamiento fue diario, con moxibustión indirecta con moxas pure sobre los puntos R7, BL23, DU4, REN6 durante seis ciclos de 15 días, se descansó al final de cada ciclo una semana. Resultados: El 24,2 por ciento de los pacientes logró un embarazo y el 58,1 por ciento ovuló. Los síntomas con mejor respuesta al tratamiento fueron frío en el útero, sensación de pesadez y frío en región lumbar y rodillas y aversión al frío, con frío en el cuerpo y las extremidades. La mala evolución se relacionó directamente con la edad superior a 35 años, más de dos hijos, hijos con antecedentes de deficiencia energética de Riñón, antecedentes familiares de infertilidad, precedentes dos o más hermanos, hábitos tóxicos alcohol, café, tabaco, signos físicos de senilidad prematura, enfermedades crónicas y bajo peso. La asociación de cinco o más representaron un signo de mal pronóstico. Conclusiones: Más de la octava parte de los casos estudiados presentaron una buena evolución al tratamiento.

Background: The feminine infertility constitutes a health problem because of its high incidence, diagnostic and therapeutic limitations and economic and psychological implications. Objective: To determine the effect of the moxibustion in the treatment of feminine infertility associated to Yang insufficiency of kidney. Method: A phase II, open, multicentric, prospective and sequential study was carried out. The sample was constituted by 62 barren women that came to the consultation at Carlos J Finlay Polyclinic created for this investigation, remitted by specialists in Gynecology and Obstetrics of the whole province, from January 2007 to April 2008 that fulfilled the diagnosis and inclusion criteria. It was a daily treatment, with indirect moxibustion with moxas pure on the points R7, BL23, DU4, REN6 during six cycles of 15 days, rested at the end of each cycle one week. Results: The 24,2 percent of the patients achieved a pregnancy and 58,1 percent ovulated. The symptoms with better response to the treatment were cold in the uterus, sensation of heaviness and cold in lumbar region and knees and aversion to the cold, with cold in the body and extremities. The bad evolution was related directly with the age over 35 years, more than two children, children with antecedents of energy deficiency of kidney, family antecedents of infertility, precedent two or more brothers, toxic habits alcohol, coffee, tobacco, physical signs of premature senility, chronic diseases and under weight. The association of five or more represented a sign of bad prognosis. Conclusions: More than the eighth part of the studied cases presented a good evolution to the treatment.

La moxibustión en el tratamiento de la infertilidad femenina asociada a la insuficiencia de Yang de riñón / Moxibustion in the treatment of feminine infertility associated to Yang insuffiency of kidney

Fundamento: La infertilidad femenina constituye un problema de salud por su alta incidencia, limitaciones diagnósticas y terapéuticas e implicaciones económicas y psicológicas. Objetivo: Determinar el efecto de la moxibustión en el tratamiento de la infertilidad femenina asociada a la Insuficiencia de Yang de riñón. Método: Se realizó un estudio fase II, abierto, multicéntrico, prospectivo y secuencial. La muestra estuvo formada por 62 mujeres infértiles, que acudieron a la consulta en el Policlínico Carlos J Finlay creada para esta investigación, remitidas por especialistas en Ginecología y Obstetricia de toda la provincia, desde enero de 2007 a abril de 2008, que cumplieron con los criterios de diagnóstico e inclusión. El tratamiento fue diario, con moxibustión indirecta con moxas pure sobre los puntos R7, BL23, DU4, REN6 durante seis ciclos de 15 días, se descansó al final de cada ciclo una semana. Resultados: El 24,2 por ciento de los pacientes logró un embarazo y el 58,1 por ciento ovuló. Los síntomas con mejor respuesta al tratamiento fueron frío en el útero, sensación de pesadez y frío en región lumbar y rodillas y aversión al frío, con frío en el cuerpo y las extremidades. La mala evolución se relacionó directamente con la edad superior a 35 años, más de dos hijos, hijos con antecedentes de deficiencia energética de Riñón, antecedentes familiares de infertilidad, precedentes dos o más hermanos, hábitos tóxicos alcohol, café, tabaco, signos físicos de senilidad prematura, enfermedades crónicas y bajo peso. La asociación de cinco o más representaron un signo de mal pronóstico. Conclusiones: Más de la octava parte de los casos estudiados presentaron una buena evolución al tratamiento(AU)

Background: The feminine infertility constitutes a health problem because of its high incidence, diagnostic and therapeutic limitations and economic and psychological implications. Objective: To determine the effect of the moxibustion in the treatment of feminine infertility associated to Yang insufficiency of kidney. Method: A phase II, open, multicentric, prospective and sequential study was carried out. The sample was constituted by 62 barren women that came to the consultation at Carlos J Finlay Polyclinic created for this investigation, remitted by specialists in Gynecology and Obstetrics of the whole province, from January 2007 to April 2008 that fulfilled the diagnosis and inclusion criteria. It was a daily treatment, with indirect moxibustion with moxas pure on the points R7, BL23, DU4, REN6 during six cycles of 15 days, rested at the end of each cycle one week. Results: The 24,2 percent of the patients achieved a pregnancy and 58,1 percent ovulated. The symptoms with better response to the treatment were cold in the uterus, sensation of heaviness and cold in lumbar region and knees and aversion to the cold, with cold in the body and extremities. The bad evolution was related directly with the age over 35 years, more than two children, children with antecedents of energy deficiency of kidney, family antecedents of infertility, precedent two or more brothers, toxic habits alcohol, coffee, tobacco, physical signs of premature senility, chronic diseases and under weight. The association of five or more represented a sign of bad prognosis. Conclusions: More than the eighth part of the studied cases presented a good evolution to the treatment(AU)

[Observation on therapeutic effect of moxibustion at Shenque (CV 8) combined with electroacupuncture on gonarthritis of type of accumulation of pathogenic cold due to yang deficiency].

OBJECTIVE: To evaluate the effect of moxibustion at Shenque (CV 8) combined with electroacupuncture on gonarthritis of type of accumulation of pathogenic cold due to yang deficiency. METHODS: The single-blind, randomized and controlled design method was adopted, and 60 cases (104 knees) were divided into an observation group (34 cases, 54 knees) and a control group (30 cases, 50 knees). The observation group were treated with moxibustion at Shenque (CV 8) and local electroacupuncture at Dubi (ST 35), Neixiyan (EX-LE 5), Yanglingquan (GB 34) and Ashi points, and the control group were treated with sham moxibustion at Shenque (CV 8) and local electroacupuncture at the above points. The treatment was given once each day in the two groups and 10 sessions constituted one course. After treatment of one course and at following-up one month later, their therapeutic effects were compared. RESULTS: After treatment, for the pain-killing effect, 42 knees were clinically cured, 11 knees were markedly effective and 1 knee was effective and for the comprehensive therapeutic effect, 37 knees were excellent, 16 knees were good, and 1 knee was OK in the observation group; and for the pain-killing effect, 13 knees were clinically cured, 35 knees were markedly effective and 2 knees were effective and for the comprehensive effect, 9 knees were excellent, 40 knees were good and 2 knees were OK in the control group, with very significant differences between the two groups (P<0.01), the observation group being better than the control group. At the following-up one month later, there was no significant difference in the pain-killing effect (P>0.05) and a very significant difference (P<0.01) in the comprehensive effect between the two groups. CONCLUSION: Moxibustion at Shenque (CV 8) combined with electroacupuncture at local points has a better clinical effect on gonarthritis of type of accumulation of pathogenic cold due to yang deficiency, which is better than that of sham moxibustion at Shenque (CV 8) combined with electroacupuncture at local points.

[A randomized controlled trial of Yiqi Pingchuan Granule in treating acute attack of bronchial spasm due to asthma of qi deficiency and cold syndrome].

OBJECTIVE: To evaluate the safety and efficacy of Yiqi Pingchuan Granule in treating acute attack of asthma due to qi deficiency and cold syndrome. METHODS: A randomized controlled trial was conducted. A total of 80 patients with an acute attack of asthma were included. They were allocated into two groups randomly in a ratio of three to one. Sixty patients in the treatment group received Yiqi Pingchuan Granule and 20 patients in the control group received Ruyi Dingchuan Pill. Patients in both groups were treated for 7 days. RESULTS: There were no significant differences in traditional Chinese medicine syndrome, clinical symptoms and lung function between the two groups (P>0.05). After treatment, the forced expiratory volume in 1 second was increased in the treatment group (P<0.05), and the peak expiratory flow was accelerated in the control group (P<0.05). No significant side effects were noted in both groups. CONCLUSION: Yiqi Pingchuan Granule is safe and effective in treating acute attack of asthma due to qi deficiency and cold syndrome.

[Preliminary study on differential expressed genes in T lymphocyte of chronic obstructive pulmonary disease patients with Fei-qi deficiency syndrome].

OBJECTIVE: To study T lymphocyte related genes with differential expression in patients with chronic obstructive pulmonary disease (COPD) of Fei-qi deficiency (FQD) syndrome type by gene chips. METHODS: Lymphocytes in peripheral blood were isolated by Ficoll technique from blood samples collected from COPD patients of FQD syndrome type, Fei-yin deficiency (FYD) syndrome type, and also from healthy subjects for control. They were sorted and purified by flow cytometry, and the different expressed genes were screened from them by gene chip technique. RESULTS: There were 15 genes with high differential expression between patients of FQD type and those of FYD syndrome type, and between patients of FQD type and healthy subjects. CONCLUSION: Gene chip technique could be used for studying the gene expression profiles of TCM syndrome, and the T-lymphocyte related genes with differential expression in COPD patients with FQD were screened preliminarily.

Effect of Weikangfu granule on the physiopathologic figure of precancerosis of gastric mucosa in patients of chronic gastritis with Pi-deficiency syndrome.

OBJECTIVE: To study the physiopathologic basis of Weikangfu Granule (WKFG) in treating precancerosis of gastric mucosa in patients of chronic gastritis with Pi-deficiency syndrome (CG-PDS). METHODS: One hundred and fifteen patients of CG-PDS who suffered from intestinal metaplasia (IM) and atypical hyperplasia (ATHP) of gastric mucosa, were divided into two groups. The treated group (n = 61) was treated by WKFG with its ingredients modified according to the syndrome type of patients. The control group (n = 54) was treated with Weishu granule. The histopathological and subcellular ultrastructural changes were detected by optical microscope, screening electronic microscope, transmission electronic microscope and histochemical staining; the nuclear and mitochondrial ultrastructure of gastric mucosa were analyzed with energy dispersion X-ray analyser and image analysis system. And the changes of cAMP, lipid peroxide (LPO), superoxide dismutase (SOD) before and after treatment in the treated group were measured and compared with those of the health control group consisting of 15 volunteers. RESULTS: The symptomatic and pathological therapeutic effect in the treated group were significantly superior to those in the control group (P < 0.05). The contents of Zn, Cu, cAMP, SOD and (3)H-TdR LCT in gastric mucosa of the treated group before treatment were all lower than those of the healthy control group, yet all these indexes markedly increased after treatment, while serum LPO level, which increased before treatment was lowered after treatment. All the changes showed statistical significance (P < 0.05 or P < 0.01). CONCLUSION: WKFG can reverse IM and ATHP in patients of CG-PDS, and the effect may be realized by way of increasing the level of Zn, Cu, cAMP and SOD in gastric mucosa, promoting cell differentiation, enhancing cellular immunity and reducing oxygen free radicals and lipid peroxidation.