2024 Vol. 40, No. 1

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Exploring the Generation and Academic Significance of the Nineteen New Pathogenic Factors Based on Zhou Zhongying's Academic Idea of "Identifying the Core Pathogenesis"
LIU Ke, XIE Pengfei, GUAN Huifang, LI Qingwei, LI Xiuyang, YU Xiaotong, TONG Xiaolin
2024, 40(1): 1-5. doi: 10.14148/j.issn.1672-0482.2024.0001
Abstract:
This article explores the application of Professor Zhou Zhongying's "focus on the core pathogenesis" concept in the context of epidemic hemorrhagic fever and examines how Academician Tong Xiaolin has inherited and developed Professor Zhou's experiences. Influenced by Professor Zhou Zhongying's academic thoughts and considering the contemporary context, Academician Tong Xiaolin, drawing on years of clinical experience, has proposed a new set of Nineteen Pathogenic Factors. Building upon the foundation of the Nineteen Pathogenic Factors in the The Yellow Emperor's Inner Classic, this new framework enriches and expands the understanding of disease location, etiology and pathogenesis, disease classification, and pays attention to a comprehensive understanding of diseases. It emphasizes that the process of seeking the underlying mechanisms should be approached from three aspects: dynamic, state, and condition, rather than solely focusing on the immediate clinical manifestations. This comprehensive approach to understanding disease development offers a fresh perspective and contributes to the application of traditional Chinese Medicine in the diagnosis and treatment of modern diseases.
Syndromes and Treatment of Shang Qi from Essentials from the Golden Cabinet
LIU Mingjia, MA Yong
2024, 40(1): 6-12. doi: 10.14148/j.issn.1672-0482.2024.0006
Abstract:
The term "shang qi" first appeared in The Yellow Emperor's Inner Classic, and Essentials from the Golden Cabinet made a systematic discussion on the syndromes and treatment of "shang qi", but later generations of physicians did not have a deep and unified understanding of the meaning of "shang qi". By combining the relevant provisions of The Yellow Emperor's Inner Classic and Essentials from the Golden Cabinet, referring to medical texts and combining with clinical reality, the author believes that the "shang gi" in Essentials from the Golden Cabinet has dual meanings of disease name and syndrome. As a disease, it is a symptom of "qi rush" that occurs in the lungs, often causing cough or accompanying cough and wheezing. The pathogenesis of "shang qi" can be divided into cold, heat, deficiency and excess. Essentials from the Golden Cabinet focuses on the differentiation and treatment of the four syndromes of "shang gi": cold fluid stagnation of the lungs, fluid heat stagnation of the lungs, deficiency heat invasion of the lungs, and phlegm turbidity obstruction of the lungs, attaching importance to both the pathogenesis and the correspondence between medication and syndrome. Therefore, the understanding of the treatment of classic prescriptions should be based on syndrome differentiation and mutual reference between formulas and syndromes, in order to integrate the principles, methods, and medicines of classic prescriptions.
Analysis of the System Construction and Differentiation and Treatment Model of "Common Medicines for Various Diseases"
JI Wenda, MA Jun, XIAO Zheng, BAI Min, YANG Xiaoyi, LI Yingcun
2024, 40(1): 13-17. doi: 10.14148/j.issn.1672-0482.2024.0013
Abstract:
The "common medicines for various diseases" in the preface of Collective Commentaries on the Classic of Materia Medica has been highly praised by medical practitioners for its unique "disease-medicine" outline and clinical practicality, and has continued to be included and developed in later works on materia medica and prescriptions, laying the foundation for the research and development of "specialized prescriptions for specialized diseases" and "specialized medicines for specialized diseases". Tao Hongjing used "the root of major diseases" in Shen Nong's Classic of the Materia Medica as the basic framework, referred to the prescriptions and medicines in Treatise on Cold Damage and Miscellaneous Diseases, and expanded his own and other medical experience to create the "common medicines for various diseases" system, relating and summarizing the representative diseases and main therapeutic effects of medicines, and creating a "disease-medicine" outline system. The construction of the "common medicines for various diseases" system has opened up the precedent of "specialized prescriptions for specialized diseases" and "specialized medicines for specialized diseases", providing new prescription ideas for clinical differentiation and treatment.
Simulation Study on Color Matching of Traditional Chinese Medicine Compound Placebo Based on Neural Network Optimization Model
LI Hang, LI Shengqiang, ZHOU Enli, WANG Tuanjie, ZHANG Chenfeng, ZHANG Xin, XIAO Wei, WANG Zhenzhong
2024, 40(1): 18-25. doi: 10.14148/j.issn.1672-0482.2024.0018
Abstract:
  OBJECTIVE  To predict the amount of colorants used in the preparation of placebo of Chinese medicine by constructing particle swarm optimization-back propagation neural network PSO-BPNN compound granules, and to provide a new idea for the simulation of placebo color of Chinese medicine compound granules.  METHODS  The BP neural network was used to establish the model of sample color parameters L, a*, b* and pigment mass fraction. The global search ability of particle swarm optimization algorithm was used to optimize the weight and bias of BP neural network to prevent the local minimum value of the model. The linear reduction weight coefficient method and the introduction of mutation operator were used to improve the global optimization ability of particle swarm optimization algorithm. The color comprehensive evaluation index (ΔE) was used as the objective evaluation standard to verify the test results.  RESULTS  The training results show that the fitting accuracy of the improved PSO-BP neural network was up to 98.31%. The prediction results show that the prediction error of the improved PSO-BP neural network was the smallest, and the mean absolute percentage error (MAPE), root mean square error (RMSE) and mean color difference (ΔE) were 0.411 5, 2.164 6 and 2.56, respectively. The verification samples of three kinds of particles were prepared for verification. The ΔE of the verification sample and the model drug were 1.73, 2.63 and 4.11, respectively. The color difference between the two groups and the model drug was small by visual evaluation.  CONCLUSION  The BP neural network based on the improved particle swarm optimization algorithm can simulate the prediction of the amount of colorants used in the preparation of Chinese medicine compound granules, and can be used as a recommended optimization model for placebo color matching research.
Study on the Effect of Moslae Herba Oil on the Percutaneous Absorption of Active Ingredient of Evodia Rutaecarpa in vitro
LI Qiujuan, LIANG Yafang, SHU Juan, JIA Congling, LIU Chanchan, WU Qinan
2024, 40(1): 26-36. doi: 10.14148/j.issn.1672-0482.2024.0026
Abstract:
  OBJECTIVE  To investigate whether Moslae herba oil has penetration enhancing effect on the active components of Evodia rutaecarpa and its ability to promote transdermal absorption.  METHODS  In vitro transdermal experiments were performed using the diffusion pool and the isolated skin of rats. Using various components of Evodia rutaecarpa as indicators, HPLC was determined to calculate the umulative penetration amount of each component. Changes in the skin and cuticle layers were observed by HE staining, immunohistochemical staining, and ATR-FTIR. GC-MS was used to measure Moslae herba oil components after administration.  RESULTS  Moslae herba oil showed the penetration-enhancing effect on various components in Evodia rutaecarpa. Compared with the postive drug nitrogenone, the cumulative penetration amounts of hyperoside, evodiamine and rutaecarpine were greater. In addition, the sesquiterpene composition and thymol in the Moslae herba oil were more likely to be stored in the skin, which could disturb the lipid structure of the cuticle layer and promote the penetration of drugs.  CONCLUSION  The results provide reference for the selection of transdermal absorption agent.
Characteristic Chromatogram and Index Component Contents of Substance Benchmark of Classic Formula Qingwei Power
CAO Jienan, LI Si, SHENG Hua
2024, 40(1): 37-46. doi: 10.14148/j.issn.1672-0482.2024.0037
Abstract:
  OBJECTIVE  To establish an HPLC characteristic spectrum and content determination method for the reference material of the classic formula Qingwei Powder, and control its quality to ensure subsequent preparation.  METHODS  Following ancient books and combining with the investigation of the previous preparation process, 15 batches of Qingwei Powder material standards were prepared. HPLC was used to establish the material standard feature map, and the similarity was calculated using the Chinese medicine chromatographic fingerprint similarity evaluation system (2012 version); seven indicator components from five medicinal herbs were used as the reference content determination indicators for Qingwei Powder, and an HPLC content determination method was established for 15 batches of samples.  RESULTS  The similarity of the characteristic spectra was≥0.975; 13 common peaks were calibrated; and 7 common peaks were identified for chemical composition, including catalpol (peak 1), ferulic acid (peak 5), isoferulic acid (peak 6), berberine hydrochloride (peak 7), palmatine hydrochloride (peak 8), paeonol (peak 12), and ligustilide (peak 13). Two sets of indicator component content determination methods have been established. Firstly, the contents of catalpol, ferulic acid, isoferulic acid, and paeonol were determined, and the four component contents were specified to be 1.48-2.76、0.14-0.26、0.48-0.90、1.72-3.19 mg·g-1, respectively; secondly, the contents of coptisine hydrochloride, palmatine hydrochloride, and berberine hydrochloride was determined, and it was specified that the content of the three components should be 0.65-1.21、0.57-1.07、1.86-3.45 mg·g-1, respectively.  CONCLUSION  A quality control method for the reference material of Qingwei Powder has been established through the characteristic spectrum and content determination method. This method is simple and reliable, providing a basis and foundation for subsequent quality control and formulation development.
Research on Water Extraction Process of Flos Lonicerae-Fructus Forsythuae Based on Network Pharmacology and Design Space
CUI Ting, LI Meizhou, GAN Lifan, LIN Jiaming, LIANG Lijin, HUANG Xingpeng, ZHANG Zhipeng
2024, 40(1): 47-60. doi: 10.14148/j.issn.1672-0482.2024.0047
Abstract:
  OBJECTIVE  To optimize the water extraction process of Flos Lonicerae-Fructus Forsythuae and determine the range of water extraction process parameters.  METHODS  The active components were screened by network pharmacology, and the indicator ingredients were determined in combination with the quality markers under the relevant terms of Chinese Pharmacopoeia 2020 edition and the literature. Take extraction yield and the extraction rate of the indicative component as the critical quality attributes of the water extraction process to screen critical process parameters. The mathematical model was established by Box-Behnken experimental design to investigate the interaction between CQAs and CPPs and build the design space of the water extraction process of Flos Lonicerae-Fructus Forsythuae.  RESULTS  The extraction percentages of phenolic acids, forsythoside A and forsythin were screened as the index components; specifications of medicinal slices, extraction time and water addition were the key process parameters. Based on the establishment and optimization of the design space, the optimum water extraction process was obtained as follows: the medicinal slice of Lian-Qiao was broken into 0.8-1.2 cm, adding 12 times the amount of water in the first and extract for 30-50 min, 10 times the amount of water in the second and extract for 25-30 min.  CONCLUSION  The verification results show that the measured value obtained by using the design space method to optimize the water extraction process is close to the predicted value, indicating that the method is stable and reliable, which can provide ideas for its further process development and quality control for the couple medicines of Flos Lonicerae-Fructus Forsythuae.
Effects of Tuoli Xiaodusan on Ischemia-Reperfusion Injury of Rat Skin Flaps by Regulating NF-κB Signaling Pathway
CHEN Hao, ZHANG Tianqi, MA Xiao, FU Qiuyue, ZHANG Shan, YAN Su, CHEN Gang
2024, 40(1): 61-67. doi: 10.14148/j.issn.1672-0482.2024.0061
Abstract:
  OBJECTIVE  To explore the effect of Tuoli Xiaodusan (MDX) on ischemia-reperfusion injury of rat skin flaps and its potential mechanism.  METHODS  Rats were randomly divided into sham operation group (Sham group), Model group, MDX high-dose group (MDX-H group) and MDX low-dose group (MDX-L group), with 10 rats in each group. After the rat back skin flap model was successfully constructed, the drug was administered by gavage immediately, once a day for 14 consecutive days. The changes of rat skin flaps in each group after surgery were observed, and the survival rate of rat skin flaps in each group was measured on the 14th day after surgery; the histopathological changes of rat skin flaps were observed by HE staining; the protein expression of p-p65 and p-IκBα in the rat skin flap tissue was detected by Western blot; ELISA method was used to detect the expression of TNF-α, IL-1β, and IL-6 cytokines; Ki67 and CD31 immunohistochemical staining were used to observe epidermal basal layer cell proliferation and vascular regeneration.  RESULTS  Compared with Model group, MDX-H group and MDX-L group had a small amount of edema and inflammatory fluid exudation after surgery, and the scab removal time was advanced; the ischemic necrosis of the skin flap was significantly improved, the area of skin flap necrosis was significantly decreased, and the survival rate of rat skin flaps was significantly increased (P < 0.01). In addition, MDX could significantly improve the pathological morphology of ischemia-reperfusion injury in rat back skin flaps, reduce the expression of p-p65 and p-IκBα proteins (P < 0.001), and decrease the levels of TNF-α, IL-1β, IL-6 inflammatory factor levels (P < 0.05, P < 0.01, P < 0.001, P < 0.000 1). The differences in Ki67 and CD31 also suggested that treatment with MDX accelerate re-epithelialization and blood vessel formation after ischemic flap injury.  CONCLUSION  MDX plays a role in improving ischemia-reperfusion injury of skin flaps by regulating the NF-κB signaling pathway and accelerating epithelialization and angiogenesis.
Research on the Protective Effects and Mechanisms of Cycloartenol, the Effective Component of Pinellia Ternata, on Myocardial Ischemia-Reperfusion Injury in Mice
LIANG Yating, JIANG Yaning, SUN Yongning
2024, 40(1): 68-77. doi: 10.14148/j.issn.1672-0482.2024.0068
Abstract:
  OBJECTIVE  To explore the effects and mechanisms of cycloartenol on myocardial ischemia-reperfusion injury in mice.  METHODS  In vitro experiments, primary cardiomyocytes were extracted from 1-3 days SD mice. The hypoxia/reoxygenation model was established by incubating cells in a hypoxic culture box for 3 hours followed by reoxygenation in a normal culture box for 3 hours. The primary cardiomyocytes were divided into Control group, H/R group, low-dose (3 μmol·L-1) and high-dose (10 μmol·L-1) cycloartenol groups, and SB203580 group. CCK-8 was used to detect cell viability, the apoptosis rate was detected by flow cytometry, and Western blot was used to detect the expression levels of p38 MAPK and p-p38 MAPK in each group. In an in vivo experiment, 7-week-old male C57BL/6J mice were randomly divided into a Control group, an I/R group, and three doses of cycloartenol (0.2, 0.5, 1.0 mg·kg-1) groups. The mice were continuously administered for seven days before the surgery. The model was prepared by ligation of the left anterior descending coronary artery (LAD) for 30 minutes, followed by reperfusion for 24 hours to induce myocardial ischemia-reperfusion injury. Left ventricular ejection fraction (LVEF), cardiac output (CO), left ventricular fractional shortening (LVFS) of each group of mice were detected by small animal ultrasound. TTC staining was used to detect the changes of ischemic infarct size in each group. The changes of myocardial tissue in each group were observed by HE staining. The expression levels of p38 MAPK, p-p38 MAPK, IL-6 and TNF-α in myocardial tissue of mice were detected by Western blot. Serum levels of creatine kinase isoenzyme (CK-MB), lactate dehydrogenase (LDH), cardiac troponin I (cTnI), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) were measured using ELISA kits.  RESULTS  In vitro experiments demonstrated that compared with the H/R group, both the cycloartenol and SB203580 pretreatment groups showed a significant increase in myocardial cell viability and the apoptosis rate decrease, which can downregulate the protein expression level of p-p38 MAPK and decrease the ratio of p-p38 MAPK/p38 MAPK(P < 0.05). In vivo experiments confirmed that compared with the I/R group, cycloartenol pretreatment significantly improved LVEF, LVFS, and CO values (P < 0.05), reduce myocardial ischemic infarct size, thereby enhancing myocardial function. The protein expression level of p-p38 MAPK in myocardial tissue was down-regulated, the ratio of p-p38 MAPK/p38 MAPK was decreased, and the expression levels of IL-6 and TNF-α were decreased. Additionally, cycloartenol pretreatment reduced the levels of CK-MB, LDH, cTnI, IL-6, and TNF-α in mouse serum (P < 0.05).  CONCLUSION  Pre-treatment with cycloartenol can protect mouse cardiac function and alleviate myocardial ischemia-reperfusion injury. Its mechanism of action may be related to the inhibition of p38 MAPK phosphorylation, reducing inflammatory reactions.
A Randomized Double-Blind Controlled Clinical Study of Bushen Yuyin Tiaochong Decoction in the Treatment of Diminished Ovarian Reserve Infertility with Kidney-Yin Deficiency
XU Ling, PENG Xuemei, DENG Lei, HU Jianju
2024, 40(1): 78-82. doi: 10.14148/j.issn.1672-0482.2024.0078
Abstract:
  OBJECTIVE  To evaluate the clinical effect of Bushen Yuyin Tiaochong Decoction in the treatment of diminished ovarian reserve (DOR) infertility with kidney-yin deficiency.  METHODS  60 DOR infertility patients with kidney-yin deficiency from the gynecology outpatient department of the Second Affiliated Hospital of Jiangxi University of Chinese Medicine from October 2020 to April 2023 were selected and divided into the placebo group and the kidney-tonifying group using the random number table method, with 30 cases in each group. Patients in both groups were given oral treatment with dehydroepiandrosterone (DHEA). The placebo group was additionally given placebo. The Bushen Yuyin group was additionally given Bushen Yuyin Tiaochong Decoction. The treatment course for both groups was 3 months. Changes in TCM syndrome scores and reproductive life quality scores were observed before and after treatment. Changes in serum follicle-stimulating hormone (FSH), anti-Mullerian hormone (AMH) and estradiol (E2) levels in patients were detected by ELISA. The occurrence of adverse reactions during treatment was observed, and the pregnancy rates of the two groups of patients after treatment were recorded.  RESULTS  After treatment, the total TCM syndrome scores of patients in the Bushen Yuyin group were significantly reduced (P < 0.01), which was better than that of the placebo group (P < 0.01); the reproductive life quality scores of patients in both groups were significantly increased (P < 0.05, P < 0.01), the Bushen Yuyin group was better than the placebo group (P < 0.05); the number of AFC in the Bushen Yuyin group was significantly increased (P < 0.01), which was better than the control group (P < 0.01); the serum AMH levels of patients in both groups were significantly increased (P < 0.05, P < 0.01), and the Bushen Yuyin group was higher than that of the placebo group (P < 0.01); the serum E2 level of patients in both groups was significantly decreased (P < 0.05, P < 0.01), the Bushen Yuyin group was lower than the placebo group (P < 0.01); the serum FSH level of patients in Bushen Yuyin group was significantly decreased (P < 0.01), which was better than that of the placebo group (P < 0.01); the total pregnancy rate of the Bushen Yuyin group was better than that of the placebo group (P < 0.05); no significant adverse reactions were observed in both groups during the treatment period.  CONCLUSION  Bushen Yuyin Tiaochong Decoction can significantly improve the pregnancy rate of DOR infertile patients, enhance ovarian function while reducing TCM syndrome scores, improve the quality of reproductive life, and is highly safe.
Analysis on the Distribution Pattern of TCM Syndrome Types in Primary Ovarian Insufficiency Sleep Disorders
FENG Xiaoling, YAO Ruiting, HAN Xinyu, JIA Ziqian
2024, 40(1): 83-89. doi: 10.14148/j.issn.1672-0482.2024.0083
Abstract:
  OBJECTIVE  To explore the distribution pattern of traditional Chinese medicine (TCM) syndrome types of primary ovarian insufficiency (POI) sleep disorders and the differences in the distribution of sleep quality index among different syndrome types, in order to provide a basis for syndrome differentiation treatment and prevention of POI associated with sleep disorders.  METHODS  600 POI patients who met the inclusion criteria were collected for epidemiological investigation, and 405 patients who met the diagnosis of sleep disorders were selected as the research group. The patients' general information, TCM four diagnosis and sex hormone level information were collected, and the Pittsburgh sleep quality index (PSQI) scale was used to evaluate patients' sleep conditions, and analyze the characteristics and influencing factors of TCM syndrome types of POI associated with sleep disorders.  RESULTS  The main TCM syndrome types of POI accompanied by sleep disorders were heart and kidney disharmony syndrome (41.98%), spleen and kidney yang deficiency syndrome (22.22%), kidney deficiency and liver stagnation syndrome (20.99%), and kidney deficiency and blood stasis syndrome (14. 81%). The heart and kidney disharmony syndrome had the longest sleep latency and shortest sleep time, relied more on hypnotic drugs, and had the highest PSQI total score; the heart and kidney disharmony syndrome and kidney deficiency and liver stagnation syndrome had the worst sleep quality; the spleen kidney yang deficiency syndrome had the highest daytime dysfunction score. There was no significant difference in FSH levels among different TCM syndrome types; the distribution of E2 values from low to high was: heart and kidney disharmony syndrome, kidney deficiency and liver stagnation syndrome, spleen and kidney yang deficiency syndrome, and kidney deficiency and blood stasis syndrome, and there were significant differences among multiple groups (P < 0.05).  CONCLUSION  The main TCM syndrome types of patients with POI and sleep disorders are heart and kidney disharmony syndrome, spleen and kidney yang deficiency syndrome, kidney deficiency and liver stagnation syndrome, and kidney deficiency and blood stasis syndrome. Among them, the most common TCM syndrome type with the worst sleep quality is heart and kidney disharmony syndrome, which may be closely related to estrogen E2 levels.
Professor Wang Canhui's Experience in Differentiation and Treatment of Pulmonary Nodules
WAN Jinsheng, LIU Tao
2024, 40(1): 90-93. doi: 10.14148/j.issn.1672-0482.2024.0090
Abstract:
This article summarizes Professor Wang Canhui's experience in treating pulmonary nodules. It believes that qi deficiency is the root cause of pulmonary nodules, and phlegm and blood stasis are the symptoms; emphasizes the important role of emotional factors; summarizes the etiology as deficiency, depression, phlegm, stasis, and toxin, and the basic pathogenesis is lung qi deficiency, with phlegm and stasis accumulation. The treatment should focus on replenishing qi and clearing the lungs, activating blood circulation and dissipating knots. Meanwhile, attention should be paid to the smooth flow of qi movement, and good use of empirical medicinal pairs to achieve the purpose of strengthening healthy qi, dispelling pathogen and dispersing nodules.
Research Progress on Dendrobii Officinalis Caulis as Medicinal and Edible Traditional Chinese Medicine
HU Yang, ZHAO Mian, QIU Yuxuan, YE Debao, LIU Yangqing, ZHANG Chaofeng, WANG Haibo, CHENG Jianming
2024, 40(1): 94-108. doi: 10.14148/j.issn.1672-0482.2024.0094
Abstract:
Tiepishihu (Dendrobii officinalis Caulis) is a medicinal and food source herbal medicine with the effect of benefiting stomach and promoting fluid, nourishing Yin and clearing heat. It has rich chemical components and pharmacological activities, with anti-inflammatory, anti-bacterial, anti-oxidation, anti-tumor, immunomodulatory, blood press regulation, hypoglycemic effects. It is not only used as medicinal food and health care products, but also widely used in medicine, such as Shihu Yeguang Wan, Compound fresh dendrobium granules and other drugs, with high medicinal and economic value. This paper summarized the resource distribution, chemical composition, pharmacological activities, and medicine and food of Dendrobii officinalis Caulis, and analyzed its application status, laying a theoretical foundation for the sustainable development, medicinal and food homologous development and comprehensive utilization of Dendrobii officinalis Caulis.