南京中医药大学学报

The Four Characteristics of Classic Formula and Syndrome

HUANG Huang

2022, 38(8): 651-654. doi: 10.14148/j.issn.1672-0482.2022.0651

[Abstract](631) [FullText HTML] (237) [PDF 1712KB](74)

Abstract:
This study describes the four characteristics of the classic formula and syndrome, including authentic and reliable, objective and easy to learn, vivid and expressive, as well as intuitive and simple. The above four characteristics reflect the unique charm of the classic formula. In terms of the classic formula, it is not only the core technology of clinical practice in traditional Chinese medicine (TCM), but also the carrier of TCM mode of thinking, and the inheritance and innovation of TCM. Thus, it is vital to pay attention to the teaching and research of the classic formula and syndrome.

Comparison between the Diagnosis and Treatment Model in Differentiating Combined with Treating Diseases and Syndrome and the Theoretical System of Treatment According to Syndrome Differentiation

ZHAO Ming-fang

2022, 38(8): 655-665. doi: 10.14148/j.issn.1672-0482.2022.0655

[Abstract](210) [FullText HTML] (97) [PDF 1137KB](44)

Abstract:
The classical diagnosis and treatment model, which was established by the Treatise on Cold Damage and Miscellaneous Diseases, is a combination of differentiating and treating diseases and syndrome. Considering the essence of a disease is its etiology and pathogenesis, disease differentiation and treatment is the legislative prescription of medication treatment around the etiology of the disease. The syndrome, as the clinical manifestation of a disease, can appear singly or in diverse combination. Therefore, the differentiation and treatment of syndrome is the direct way targeted one or more syndromes with the application of formulas and medicines, while the differentiation combined with treatment of diseases and syndrome emphasizes the simultaneous treatment according to both syndrome differentiating and the disease differentiating. The theoretical system of treatment according to syndrome differentiation established by the modern Chinese medical community is essentially the treatment according to differentiating the etiology and pathogenesis. In the process of development of Chinese medicine, some problems have been gradually revealed. In view of this phenomenon, it is proposed that the development of Chinese medicine should return to the classics and inherit the essence by restoring the original meaning of syndrome, as well as advocating the spirit of differentiating combined with treating diseases and syndrome.

Evidence-Based Classic Formula Research on "Formula-Disease-Person" and Empirical Exploration of TCM Academics

LU Yan, HUANG Huang

2022, 38(8): 666-670. doi: 10.14148/j.issn.1672-0482.2022.0666

[Abstract](200) [FullText HTML] (60) [PDF 1058KB](39)

Abstract:
Evidence-based medicine is the only way for medical development, and the integration with evidence-based medicine is the urgent requirement for the development of traditional Chinese medicine (TCM). However, due to the unique academic characteristics of TCM, how to combine the TCM theories and practical experience with modern evidence-based research has become a difficult problem for the academic progress of TCM. Therefore, through regarding evidence-based research on the classic formula as a breakthrough, we explored the role and significance of combining TCM with evidence-based medicine in dealing with the relationship between syndrome differentiation and disease differentiation, in clarifying the efficacy, in treating new diseases and rare diseases, in the warning of adverse reactions, in the Chinese and western medicine interactions, in the empirical examination on the compatibility of medicines in prescriptions, as well as in the testing and optimization of traditional pharmaceutical methods. In conclusion, this study looks into the future of the evidence-based research on classic formula.

Explanation on the Pathogenesis of Coronary Heart Disease — Internal Wind Caused by Excessive Dampness

ZHANG Meng, DONG Qi-mei, SHEN Jian-ping, WANG Xin-dong

2022, 38(8): 671-675. doi: 10.14148/j.issn.1672-0482.2022.0671

[Abstract](182) [FullText HTML] (27) [PDF 1039KB](22)

Abstract:
The key pathogenesis of coronary heart disease is the replacement of yang position by yin pathogens such as phlegm and dampness due to the chest yang insufficiency. It is believed that the obstruction of chest yang caused by phlegm and dampness can lead to the internal wind inducing the latent pathogens like phlegm or dampness to replace the yang position and obstruct the qi movement in the chest. Thus, the pathogenesis — internal wind caused by excessive dampness is put forward. The treatment of coronary heart disease is based on the basic principle of treating both wind and dampness. The treatment methods of strengthening the spleen, soothing the liver, and warming the kidney can be used to eliminate the source of dampness. Besides, the treatments of drying the dampness, draining the dampness, and removing the dampness can be applied to expel the accumulated dampness. In addition, the treatments of calming, tranquilizing, and clearing can also be used to subdue yang and extinguish wind. On top of that, some medicines with the effects of extinguishing wind can be applied to remove the dampness and reinvigorate the chest yang. In conclusion, the above treatments can be adopted to develop the thinking of the Chinese medicine pathogenesis, as well as the prevention and treatment of coronary heart disease.

Intervention Program for the Preventive Treatment of Pediatric Asthma

ZHAO Xia, WANG You-peng, QIN Yan-hong, CHEN Jian, XUE Zheng, WANG Meng-qing, WAN Li-sheng, SUN Li-ping, WU Li-qun, WU Zhen-qi, LI Xin-min, YU Shun, TIAN Man, ZHANG Bao-qing, ZHAO Yun, ZHAO Qiong, HE Li, WANG Xiao-xiao, SONG Gui-hua, YAN Yong-bin, CUI Xia, YANG Yan, LI Wei-wei, LI Lan, ZHANG Xue-rong, CHEN Zhu, SUN Xiang-juan, XU Ling, ZHANG Pei, LIU Ying, MING Xi, LI Dan, LI Min

2022, 38(8): 676-686. doi: 10.14148/j.issn.1672-0482.2022.0676

[Abstract](348) [FullText HTML] (73) [PDF 1230KB](26)

Abstract:
Based on the completion of literature search, evaluation, and summary, the Intervention Program for the Preventive Treatment of Pediatric Asthma is developed through intra-group consultation with experts, expert validation meeting, expert steering group review, as well as opinion solicitation from external experts and online users, which proposes the terminology and definition of the intervention program for the preventive treatment of pediatric asthma. In addition, this document also clarifies the epidemiology, etiology and pathogenesis, screening, diagnosis, staging, constitution differentiation, intervention program, and follow-up monitoring. On top of that, the proposed protocol aims to standardize the intervention measures for the preventive treatment of pediatric asthma via providing clinicians with strategies and methods for standardizing the preventive treatments of disease in pediatrics, combined with improving the technical standardization and scientific research of the preventive treatments of disease in pediatrics. Thus, it can be used as a vital reference for the technical standardization and quality evaluation of the preventive treatment of diseases in departments of traditional Chinese medicine, pediatrics, child healthcare, pneumology, as well as centers for preventive treatment of disease.

Clinical Efficacy and Mechanism of Lichang Beverage in the Treatment of Diarrhea-Type Irritable Bowel Syndrome with Liver Depression and Spleen Deficiency

YIN De-fei, WEI Xiu-nan, LIU Jia-hui, CHENG Yan, LIU Tong, CHI Li-li

2022, 38(8): 687-695. doi: 10.14148/j.issn.1672-0482.2022.0687

[Abstract](203) [FullText HTML] (49) [PDF 3254KB](30)

Abstract:
OBJECTIVE To observe the clinical efficacy of Lichang beverage in the treatment of diarrhea-type irritable bowel syndrome (IBS-D) based on the bacteria-brain-intestine axis and its effects on serum brain-gut peptide and intestinal flora, and to explore the possible mechanism of efficacy. METHODS A total of 66 IBS-D patients with liver depression and spleen deficiency were randomly divided into the Chinese medicine group (44 patients) and the western medicine group (22 patients) in a 2 ∶ 1 ratio. In the Chinese medicine group, Lichang beverage was given orally. However, the patients in the western medicine group were administrated with Bifico combination with Dicetel. The treatment course lasted four weeks. Besides, the changes in the IBS-SSS scores of both groups were evaluated before treatment, as well as after two weeks and four weeks of treatment. The changes in the traditional Chinese medicine (TCM) syndrome scores of both groups were observed before and after treatment. In addition, the expression levels of serum brain-gut peptide indexes [substance P (SP) and serotonin (5-HT)] and the composition of intestinal flora were measured. RESULTS The IBS-SSS scores of both groups were reduced significantly after two weeks and four weeks of treatment (P < 0.01), but the results in the Chinese medicine group were better than those in the western medicine group (P < 0.01). After four weeks of treatment, the total TCM syndrome scores of both groups were reduced significantly (P < 0.01), while the results in the Chinese medicine group were better than those in the western medicine group (P < 0.01). In addition, the clinical healing rate and total effective rate of the Chinese medicine group were higher than those of the western medicine group (P < 0.05, P < 0.01). After treatment, the serum SP level in both groups were reduced significantly (P < 0.05), and the serum 5-HT level in the Chinese medicine group were reduced notably (P < 0.01), but there was no significant difference between the two groups (P>0.05). The α diversity analysis indicated that the richness of intestinal flora in both groups decreased to different degrees after treatment (P < 0. 05, P < 0.01), and the diversity of flora in the western medicine group was reduced compared with that before (P < 0. 05), while there was no significant difference in the Chinese medicine group (P>0. 05). The PCoA analysis showed that the composition of microbial community in both groups changed significantly (P < 0. 05), and there were significant differences between groups (P < 0.01). Among them, the biomarkers with significant advantages after treatment in the Chinese medicine group were Clostridium_sensu_stricto_1 and Bacteroides_plebeius. However, the Biomarkers with significant advantages after treatment in the western medicine group were ruminococcus_gnavus_group. The functional prediction of the flora suggested that the main pathway of IBS-D treatment by Lichang beverage was glucose metabolism-related. Besides, no drug-related adverse reactions were observed in either group during the treatment course. CONCLUSION The efficacy of Chinese herbal medicine compound — Lichang beverage in treating IBS-D with liver depression and spleen deficiency is accurate and safe. Its mechanism may be related to the regulation of serum brain-gut peptide level, adjustment of intestinal flora structure, correction of flora imbalance, and regulation of glucose metabolism-related flora.

Clinical Study of Acupuncture Therapy as An Auxiliary Treatment for Guillain-Barre Syndrome

HUANG Jian-fu, LIU Jian-hao, WANG Bo, WANG Tian-lei, XU Qiong

2022, 38(8): 696-702. doi: 10.14148/j.issn.1672-0482.2022.0696

[Abstract](114) [FullText HTML] (15) [PDF 2815KB](12)

Abstract:
OBJECTIVE To observe the clinical efficacy of acupuncture therapy in the auxiliary treatment of Guillain-Barre syndrome (GBS). METHODS A total of 169 patients with GBS admitted to Sanya TCM Hospital from February 2019 to October 2021 were studied, and were divided into control group (83 cases) and observation group (86 cases) by random number table method. There were 50 cases in the western medicine control group, 50 cases in the western medicine observation group, 33 cases in the Chinese medicine control group, and 36 cases in the Chinese medicine observation group. The control group was treated with conventional western or Chinese medicine therapies, while the observation group was given acupuncture-auxiliary treatment based on the therapies in the control group. The treatment course lasted four weeks. In addition, we compared the muscle strength of the limbs, nerve function [motor nerve conduction velocity (MCV), sensory nerve conduction velocity (SCV)], traditional Chinese medicine (TCM) syndrome scores, clinical efficacy, serum inflammatory factors [interleukin-10 (IL-10), interleukin-18 (IL-18)] levels, as well as safety indexes in the control group and the observation group before and after treatment. RESULTS After treatment, the muscle strength of the of limbs was significantly increased in the western and Chinese medicine observation groups (P < 0.05, P < 0.01), whose results were better than those in the control group (P < 0.05). Besides, the MCV and SCV of the median nerve and tibial nerve were significantly increased in the western and Chinese medicine observation groups (P < 0.05), whose results were also better than those in the control group (P < 0.05). In addition, TCM syndrome scores were significantly reduced in the western and Chinese medicine observation groups compared to pre-treatment results and lower than those in the control group (P < 0.05). The total effective rates of treatment in the western and Chinese medicine observation groups were significantly increased than those in the control group (P < 0.05). on top of that, the IL-10 levels in the western and Chinese medicine observation groups were significantly increased (P < 0.01) and higher than those in the control group (P < 0.05), while IL-18 levels were significantly reduced (P < 0.01) and lower than those in the control group (P < 0.05). There were no notable complications in all groups. CONCLUSION Acupuncture auxiliary therapy can significantly optimize the clinical efficacy of western and Chinese medicine treatment. Besides, it can improve patients' muscle strength and neurological function, mitigate clinical syndromes, and restore patients' serum inflammatory factor levels.

Eucommia Folium Extracts Alleviate Nonalcoholic Fatty Liver Disease in vivo and in vitro Based on the Network Pharmacology Study

CAI Dan-hong, ZHOU Chang-wei, ZHANG Zhao-feng, ZHAO Ye, BIAN Yao-yao, XUE Mei, LI Yu, LIU Xiao-li, ZHANG Liang

2022, 38(8): 703-716. doi: 10.14148/j.issn.1672-0482.2022.0703

[Abstract](308) [FullText HTML] (104) [PDF 6886KB](45)

Abstract:
OBJECTIVE To explore the active ingredients, targets and possible mechanism of ELE alleviating NAFLD based on the method of network pharmacology. METHODS The components in ELE were found in CNKI, Wanfang, TCMSP and Pubmed database. The components targets were found in TCMSP and swisstarget prediction database. NAFLD targets were found in genecard database and drugbank database. PPI network was established to analyze the interaction among targets by String 11.0 database. Compounds-targets-pathways network was established by the software of Cytoscape. Go and KEGG analysis were carried by david database. In addition the key targets were verified by cell and animals experiments. RESULTS The network of ELE against NAFLD contains 9 compounds and 35 targets. The targets related to lipid metabolism are PPARα and CPT-1A, and the signaling pathways mainly related to lipid metabolism are insulin resistance and AMPK signaling pathway. In vivo and in vitro experiments indicated that ELE could enhance lipid oxidation and improve NAFLD by activating AMPKα and enhancing the expression of PPARα and CPT-1A. CONCLUSION ELE can enhance lipid metabolism and improve NAFLD mainly related to AMPK signaling pathway.

Combination of Danshen and Renshen Regulates MDSCs to Remodel the Immune Microenvironment of Melanoma

YANG Ge-jun, ZOU Jue-yao, ZHAO Han, CHEN Qiong, HE Yong, LU Yin, CHEN Wen-xing

2022, 38(8): 717-726. doi: 10.14148/j.issn.1672-0482.2022.0717

[Abstract](197) [FullText HTML] (20) [PDF 6135KB](17)

Abstract:
OBJECTIVE To observe the effect of the combination of Danshen and Renshen on the immune microenvironment of mouse melanoma cell line B16F10 in vivo and in vitro and its mechanism of inhibiting B16F10 blood metastasis. METHODS T-lymphocyte-B16F10 co-culture system was constructed in vitro. Flow cytometry was used to detect whether the combination of Danshen and Renshen could enhance the killing ability of T-lymphocytes against B16F10 in vitro. The model of B16F10 mouse tail vein blood metastasis was established. The inhibitory effect of the combination of Danshen and Renshen on B16F10 lung metastasis was observed by in vivo imaging and HE pathological staining. In addition, flow cytometry, immunohistochemistry and immunofluorescence techniques were used to detect the number of CD4⁺, CD8⁺T cells and MDSCs in tumor-bearing mice, and qPCR was used to detect the mRNA expression level related to the proliferation of MDSCs. RESULTS The combination of Danshen and Renshen could enhance the killing ability of T lymphocytes against tumor cells in vitro, and effectively inhibit B16F10 lung metastasis in mice, and enhance CD4⁺and CD8⁺T cell infiltration, which in turn suppressed the number of MDSCs in metastases by inhibiting the mRNA expression of MDSCs proliferation-related cytokines. CONCLUSION The combination of Danshen and Renshen can inhibit tumor metastasis by regulating MDSCs to reshape the immune microenvironment of melanoma. This study lays a foundation for the clinical application of the combination of Danshen and Renshen against tumor metastasis.

The Repellent Effect of Tea Tree Oil Microcapsules Emulsion on Leeches

LIU Yi-jing, HU Jing-lu, DU Li-na

2022, 38(8): 727-734. doi: 10.14148/j.issn.1672-0482.2022.0727

[Abstract](93) [FullText HTML] (9) [PDF 2179KB](4)

Abstract:
OBJECTIVE To prepare tea tree oil into microcapsules emulsion, evaluate its repellent effects on leeches and clarify the repellent mechanisms. METHODS Tea tree oil aqueous solution was prepared with Tween 20 as solubilizer. Span 80 was used as the emulsifier to prepare tea oil emulsion. Gelatin and sodium alginate were used by complex coacervation method to prepare tea tree oil microcapsules. The particle size, morphology and the binding mode of microcapsules were characterized. The tea tree oil microcapsules emulsion was obtained by dispersing the microcapsules into the tea tree oil emulsion. The filter-paper ring method and the repellent test in water were used to evaluate the repellent effects and time of the tea tree oil microcapsules emulsion, tea oil aqueous solution, blank microcapsules emulsion and the positive drugs on leeches. The activities of acetylcholinesterase (AchE), glutathione S-transferase (GST) and carboxylesterase (CarE) activities in vivo were measured to clarify the repellent mechanisms of tea tree oil microcapsules emulsion on leeches. RESULTS The optimal ratio of gelatin and sodium alginate with high coacervation yield was obtained. The microcapsules with uniform particle size, uneven size and high encapsulation efficiency were successfully prepared. According to the orthogonal design, the optimal formulation was obtained, and the tea tree oil microcapsules emulsion was uniformly dispersed and stable. The microcapsules emulsion could effectively repel leeches and prolong the repelling time. It was clarified that tea tree oil microcapsules emulsion played a repellent role by increasing AchE activity and inhibiting GST and CarE activities in vivo. CONCLUSION The prepared tea tree oil microcapsules emulsion can avoid the volatilization of tea tree oil, which can prolong the repelling time. In summary, this study provides a new idea for the development of natural essential oil as the repellents with broad market prospects.

Treatment of Premature Ovarian Insufficiency from the Perspective of "the Two-Yang Disease Developing in the Heart and Spleen" Theory

GUO Qian, MA Wei-rong, TAN Yong

2022, 38(8): 735-738. doi: 10.14148/j.issn.1672-0482.2022.0735

[Abstract](148) [FullText HTML] (16) [PDF 1014KB](14)

Abstract:
Based on the theory of "the two-yang disease developing in the heart and spleen" from the Huangdi's Canon of Medicine, Professor Tan Yong believes that amenorrhea caused by the premature ovarian insufficiency is closely related to the yangming meridians, heart, and spleen. The key to the pathogenesis lies in the two-yang disease, especially the foot yangming stomach meridian is the main cause. Besides, there are some accompanied syndromes such as the heart and spleen deficiency, as well as qi constraint in the heart, liver, and spleen. Thus, the syndrome differentiation and treatment should be based on the yangming meridians, heart, and spleen. For example, the treatments of tonifying the yangming meridians to regulate the stomach and intestines can be applied. In addition, the treatments of reinforcing qi and nourishing blood to replenish the heart and spleen can be used clinically. On top of that, the treatments of strengthening the spleen and soothing the liver to clearing the heart heat and claming the mind can also be put into clinical practice. In conclusion, the above treatments can all be used to improve ovarian function and mitigate clinical symptoms.

Exploration of Treatment Strategies with Integrated Traditional Chinese and Western Medicine for Crohn's Disease under the Background of Biological Agents

SHEN Hong, ZHU Lei, ZHANG Lu

2022, 38(8): 739-742. doi: 10.14148/j.issn.1672-0482.2022.0739

[Abstract](124) [FullText HTML] (42) [PDF 1034KB](15)

Abstract:
Crohn' s disease (CD) is a chronic, progressive and disabling disease, which seriously affects the quality of life of patients. In recent years, with the continuous listing of biological agents in China, the treatment of CD has entered the era of biological agents, which has brought about continuous upgrading of treatment goals and changes in treatment strategies. Integrated traditional Chinese and western medicine has provided optimized treatment methods for CD patients, so how to make use of the advantages of integrated traditional Chinese and western medicine in the background of biological agents is a importent clinical issue. This article elaborates the treatment strategy for CD under the background of biological agents. Clinically, according to the different clinical manifestations of CD, it can be treated from different perspectives of "Li", "Yang", "Yong", "Luo" and "Lao", from the prevention and treatment of infection, anti-fibrosis, reduction of complications, and improvement of malnutrition In order to adapt to the change of treatment goals and improve clinical efficacy.

2022 Vol. 38, No. 8

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