[Correlation Research between Syndrome Elements of Chinese Medicine and KRAS, BRAF, NRAS Gene Mutations in Advanced Colorectal Cancer Patients]

Objective To study the correlation between syndrome elements of Chinese medicine (CM) and KRAS, BRAF, NRAS gene mutations in advanced colorectal cancer patients. Methods Syn- drome elements of CM, KRAS, BRAF, NRAS gene mutations (mutation " +" & wild type/non-mutation " --") were collected in 33 advanced colorectal cancer patients. The correlation between gene mutations and syndrome elements of CM was analyzed using binary Logistic regression. Results Wild type KRAS (KRAS-) was negatively correlated with Gan depression syndrome (P =0. 043, P <0. 05), while KRAS mutation (KRAS + ) was positively correlated with Gan depression syndrome (P =0. 043, P <0. 05). KRAS-and KRAS + had no significant relation with Pi deficiency, Fei deficiency, Shen deficiency, yang deficiency, yin deficiency, qi deficiency, blood deficiency, phlegm turbidity, qi stagnation, and blood sta- sis (P>0. 05). BRAF-and NRAS-had no significant relation with Gan stagnation, Pi deficiency, Fei defi- ciency, Shen deficiency, yang deficiency, yin deficiency, qi deficiency, blood deficiency, phlegm turbidi- ty, qi stagnation, and blood stasis (P >0. 05). Positive BRAF and NRAS were seldom found in this study, so they were not statistically analyzed. Conclusions There existed correlations between gene mutations and Gan stagnation. KRAS-was negatively correlated with Gan depression, while KRAS+ was positively correlated with Gan depression. Whether there exists mutation of BRAF or NRAS was not correlated with syndrome elements of CM.

[Serum Levels of Interleukin-17 and Tumor Necrosis Factor-α in Dermatomyositis Patients with Dif- ferent Syndrome Types of Chinese Medicine]

Objective To observe serum levels of interleukin-17 (IL-17) and tumor necrosis factor-α (TNF-α) in dermatomyositis (DM) patients with different syndrome types of Chinese medicine (CM). Methods Totally 68 dermatomyositis patients were recruited and grouped by syndrome typing of CM, i.e., heat-toxin flourishing syndrome (20 cases) , damp-heat accumulation syndrome (14 cases) , cold-dampness obstruction syndrome (12 cases) , Pi-Shen deficiency syndrome (12 cases) , Gan-Shen yin deficiency syndrome (10 cases). Meanwhile, 64 healthy volunteers were recruited as healthy con- trols. The levels of IL-17 and TNF-α in serum were detected in patient groups and the healthy group. Results Compared with the healthy control group, the serum IL-17 level increased in patients with heat-toxin flourishing syndrome, damp-heat accumulation syndrome, and cold-dampness obstruction syndrome (P <0. 01) ; the serum TNF-α level increased in DM patients with each syndrome (P <0. 01 , P < 0. 05). Compared with the heat-toxin flourishing syndrome group, the serum IL-17 level decreased in patients with cold-dampness obstruction syndrome, Pi-Shen deficiency syndrome, and Gan-Shen yin deficiency syndrome (P <0. 01) ; and the serum TNF-α level decreased in patients with Pi-Shen deficiency syndrome and Gan-Shen yin deficiency syndrome (P <0. 01). Compared with the dampheat accumulation syndrome group, the serum IL-17 level decreased in patients with cold-dampness obstruction syn- drome, Pi-Shen deficiency syndrome, and Gan-Shen yin deficiency syndrome (P <0. 01) , and the serum TNF-α level decreased in patients with Pi-Shen deficiency syndrome and Gan-Shen yin deficiency syndrome (P <0. 01). Compared with the cold-dampness obstruction syndrome group, the serum levels of IL-17 and TNF-α decreased in patients with Pi-Shen deficiency syndrome and Gan-Shen yin deficiency syndrome (P <0. 01 , P <0. 05). Conclusion Serum levels of IL-17 and TNF-α are different in DM patients with different syndrome types of CM.

[Laws of Syndrome Types of Chinese Medicine in Dyslipidemia Patients]

Objective To observe changing laws of syndrome types of Chinese medicine (CM) in dyslipidemia patients. Methods Totally 439 dyslipidemia patients were recruited. Their syndrome types of CM and blood lipids were.observed at the baseline (at the first visit) , 1st interview (at week 4), 2nd interview (at week 8), and 3rd interview (at week 12), respectively. Analyses of multilayer latent class analysis model were performed in the 4 interviews. Changes of syndrome types of CM were sum- marized as well. Results Asymptomatic patients accounted for 49. 7% of the total number (218/439) at the baseline. Among symptomatic patients, yin deficiency yang predominance syndrome occupied the top (28.2%, 124/439), and followed by sputum turbidity obstruction syndrome (13. 7%, 60/439). At 1st interview there were still 134 asymptomatic patients. Among symptomatic patients, yin deficiency yang predominance syndrome occupied the top (23. 5%, 103/439), and followed by sputum turbidity obstruc- tion syndrome (17. 3% , 76/439). And 70 patients were lost. At 2nd interview blood stasis phlegm stagna- tion syndrome (21. 4%, 79/369) and yin deficiency yang predominance syndrome (19. 5% , 72)369) were main syndrome types. And 64 patients were lost. At 3rd interview sputum turbidity obstruction syndrome (11. 8%, 36)305) and qi-yin deficiency syndrome (11. 1%, 34)305) were main syndrome types. And 50 patients were lost. Conclusions Syndrome types of CM in dyslipidemia patients showed changing and unstable state along with the prolongation of dyslipidemia. It was insufficient to take syndrome types of CM as main therapeutic indicators for clinical research on dyslipidemia.

[Correlation between the Distribution of Chinese Medicine Syndromes and CD4 + T Lymphocyte Count in AIDS Patients in Xinjiang Region]

Objective To observe the correlation between the distribution of Chinese medicine (CM) syndromes and CD4 + T lymphocyte counts of acquired immune deficiency syndrome (AIDS) patients in Xin- jiang region. Methods Totally data (four diagnostic information of CM) of 787 HIV+ patients were collected and syndrome typed from 6 places with higher incidence of AIDS (Urumqi region, Aksu region, Turpan region, Yili region, Kashi region, and Bazhou region). CD4 + T lymphocyte counts were detected in AIDS patients with each syndrome. The correlations of CD4 + T lymphocyte counts and distributions of CM syndrome types were ana- lyzed. Results Qi-yin deficiency syndrome (QYDS) and qi deficiency and dampness resistance syndrome (QDDRS) were dominant in AIDS patients in Urumqi region and Aksu region. Gan stagnation qi stasis syn- drome (GSQSS) was more often seen in AIDS patients in Turpan region. QDDRS was more often seen in AIDS patients in Yili Region. Gan-Shen yin deficiency syndrome (GSYDS) was more often seen in AIDS patients in Kashi region. QYDS was more often seen in AIDS patients in Bazhou region. Fei-Shen yin deficiency syndrome (FSYDS) was more often seen in AIDS patients with CD4 T lymphocytes less than 200/μL. FSYDS and qi stag- nation phlegm coagulation syndrome (QSPCS) were more often seen in AIDS patients with CD4+ T lympho- cytes ranging 201 -350/μL. QDDRS and QYDS were more often seen in AIDS patients with CD4 + T lymphocytes ranging 351 -500/μL. Unconsolidated Fei-qi syndrome (UFQS) and Pi-qi deficiency syndrome (PQDS) were more often seen in AIDS patients with CD4+ T lymphocytes more than 501/μL (P <0. 05). Conclusions There existed different T-lymphocyte levels in AIDS patients with various syndrome types of CM in Xinjiang region, with certain correlation. Along with decreased CD4+T lymphocyte counts, AIDS patients' CM syndromes mani- fested a changing process from superficiality to interior syndrome, and from intermingled syndromes of defi- ciency and excess to deficiency syndrome.

[Correlation Analyses between Obesity/Overweight and Constitutions of Chinese Medicine/Cardio- vascular Risk Factors in Elderly Residents of a Community in Guangzhou]

Objective To analyze the correlation between obesity/overweight and constitutions of Chinese medicine (CM)/cardiovascular risk factors in elderly residents of Tianhe District Wushan Com- munity, Guangzhou City. Methods Recruited were 1 054 elderly residents (over 60 years), who had free health examinations in Tianhe District Wushan Community of Guangzhou City from October 2014 to September 2015. They were assigned to the obesity group (107 cases) , the overweight group (431 ca- ses) , and the normal weight group (516 cases) according to body mass index (BMI) by randomized sampling. Constitution types of CM were assessed using Classification and Judgment of Constitution Types of CM. Health files were filled in. General indices such as waist circumference, blood pressure, etc., and blood biochemical indicators such as fasting blood glucose, blood lipids, uric acid, blood creati- nine, etc. were detected. The correlation between constitution types of CM and obesity/overweight was analyzed using multivariate Logistic regression analysis. Results Among the 1 054 elderly residents, 75. 62% (797/1 054) of those were of biased constitution and 24. 38% (257/1 054) were of normal consti- tution. Phlegm dampness (247 cases, 23. 43%), yin deficiency (150 cases, 14. 23%), and qi deficiency (136 cases, 12. 90%) constitution were top 3 commonly seen biased constitution types. Multiple Logistic regression analysis showed that the risk of obese/overweight patients of phlegm dampness constitution was 61. 641 times (Cl: 24. 491 -155. 144) and 9. 393 times (Cl: 5. 910 -14. 929) that of subjects of nor- mal constitution respectively (P <0. 01) ; the risk of obese/overweight patients of dampness heat consti- tution was 21. 478 times (Cl: 6. 978 -66. 102) and 4. 505 times ( Cl: 2. 308 -8. 793) that of subjects of normal constitution respectively (P <0. 01) ; the risk of obese/overweight patients of qi deficiency consti- tution was 3.408 times ( Cl:1. 161 -10. 004) and 1. 655 times (Cl: 1. 062 -2. 580) that of subjects of nor- mal constitution respectively (P <0. 05). Compared with normal body weight senile, the incidences of ab- dominal obesity, hypertension, diabetes were obviously higher in obese/overweight senile (P <0. 01 , P < 0. 05). Their values of fasting blood glucose, triglyceride, high-density lipoprotein, and uric acid were ob- viously higher than those in normal body weight senile (P <0. 01). Conclusions Community obese/over- weighed elderly residents have the tendency of phlegm dampness, dampness heat, and qi deficiency constitutions. Compared with the normal body weight senile, they have higher risk of cardiovascular risk factors, and increased risks of suffering from hypertension, diabetes, and dyslipidemia.

[Features of Syndrome Patterns of Chinese Medicine in Elderly AIDS Patients in Guangxi Zhuang Autonomous Region]

Objective To observe the features of syndrome patterns of Chinese medicine (CM) in elderly human immunodeficiency virus/acquired immune deficiency syndrome ( HIV/AIDS) patients in Guangxi Zhuang Autonomous Region. Methods According to a case-control study, a clinical question- naire was designated in elderly HIV/AIDS patients older than 50 years and healthy examinees with age and sex match. Their syndrome information of CM were collected from designated medical institutions in Guangxi Zhuang Autonomous Region from October 2013 to April 2014. Analyses of syndrome factors were conducted using WF-I[A Diagnosis and Treatment System of Traditional Chinese Medicine (Auxilia- ry). The disease location of CM and nature of diseases were compared between elderly HIV/AIDS patients and the controls. The features of syndrome patterns of CM in elderly HIV/AIDS patients were summarized. Results A total of 417 elderly HIV/AIDS patients and 362 examinees were enrolled. In elderly patients with HIV/AIDS, established syndrome factors of disease nature were qi deficiency, yang deficiency, yin deficiency, blood deficiency, dampness, and phlegm , and established syndrome factors of disease loca- tion included Shen, Fei, Pi, and Gan. There were statistical differences in established syndrome factors of disease location or nature between elderly patients with HIV/AIDS and the controls (P <0. 05). Conclu- sions Elderly HIV/AIDS patients were characterized by deficiency of qi, yang, yin, and blood in Shen, Fei, Pi, and Gan, as well as endogenous production of pathogenic factors such as dampness and phlegm. Intermingled deficiency and excess was dominated in elderly HIV/AIDS patients, and mainly man- ifested as deficiency syndrome.

[Correlation Study on Syndrome Types of Chinese Medicine in Dysfunctional Uterine Bleeding Patients and Serum Sex Hormones]

Objective To observe the correlation between serum sex hormone levels and different syndrome types of Chinese medicine (CM) in dysfunctional uterine bleeding (DUB) patients. Methods Totally 532 DUB patients were classified into 10 different syndrome types according to syndrome typing theories of CM, including Gan-depression transforming heat syndrome, Shen deficiency blood sta- sis syndrome, Shen-yin deficiency syndrome, Pi-Shen deficiency syndrome, qi and yin deficiency syndrome, qi and blood deficiency syndrome, Pi deficiency syndrome, qi stagnation blood stasis syndrome, damp-heat syndrome, yin deficiency blood heat syndrome. Besides, 6 serum levels of sex hormone were measured including follicular stimulating hormone (FSH) , luteinizing hormone (LH) , estradiol (E₂) , progesterone (P) , testerone (T) , and prolactin (PRL) in patients with different syndrome types. Correlation study between syndrome types and sex hormones were performed using Logistic regression analysis. Results The distributions of DUB in CM were sequenced from high to low as uterine bleeding, menostaxis, preceded menstrual cycle, intermenstrual bleeding, and menorrhagia. The distributions of syndrome types were sequenced from high to low as yin deficiency blood heat syndrome, qi and blood deficiency syndrome, qi stagnation blood stasis syndrome, Shen-yin deficiency syndrome, Pi-Shen deficiency syndrome, Gan-depression transforming heat syndrome, Pi deficiency syndrome, Shen deficiency blood stasis syndrome, qi and yin deficiency syndrome, damp-heat syndrome. PRL level was positively correlated with Gan-depression transforming heat syndrome in the ratio of 1. 117 (P <0. 05). FSH level was positively correlated with Shen-yin deficiency syndrome in the ratio of 1. 327 (P <0. 05). LH level was positively correlated with Pi-Shen deficiency syndrome in the ratio of 1.342 (P <0.05). Conclusions DUB patients with various syndrome types of CM had different levels of sex hormones, with certain-laws manifested. Positive correlation existed between PRL level and Gan-depression transforming heat syn- drome, FSH level and Shen-yin deficiency syndrome, LH level and Pi-Shen deficiency syndrome.

[Thinking on Treatment of Severe Aplastic Anemia by Detoxication, Blood Activating, and Yin Nourishing Method]

Chinese medicine therapy has advantages in treating aplastic anemia (AA) in depart- ments of Chinese medicine (CM) blood diseases. But there is no unified syndrome typing standard of CM for severe AA. Heat-toxin induced yin deficiency syndrome is one of severe AA syndrome types com- monly seen in authors' long-term clinical practice. This syndrome type has the features of asthenia in ori- gin and asthenia in superficiality. Therefore, authors put forward that detoxication, blood activating, and yin nourishing (DBAYN) method, taking detoxication as superficiality and Shen supplementing as origin. Meanwhile, blood activating and stasis removing was assisted. Detoxication aimed to eliminating evils and purifying blood, blood activating aimed to getting rid of evils and generating new blood, and yin nour- ishing aimed to strengthening vital qi and nourishing blood. Classical recipes such as Xijiao Dihuang De- coction and Erzhi Pill could be modified. This theory was of great significance in complementing and per- fecting CM theoretical systems of AA, which provided beneficial ideas and methods for clinical treatment of severe AA.

[Syndrome Features of Chinese Medicine in Hyperlipidemia Patients of Han, Uyghur, Kazakh Na- tionalities in Xinjiang Uyghur Autonomous Region]

Objective To observe distribution laws and features of syndrome types of Chinese medicine (CM) in hyperlipidemia patients of Han, Uyghur, Kazakh nationalities in Xinjiang Uyghur Auton- omous Region. Methods Using cluster random sampling, 1 410 hyperlipidemia patients (18 -70 years old ) were recruited from Urumqi, Turpan, Altay, Ili, Aksu, Hetian in Xinjiang Uyghur Autonomous Re- gion. The general condition, susceptible factors, classification of blood lipids, complications, syndromes of CM, tongue figure, etc. clinical data were investigated using self-formulated Epidemiological Investiga- tion Questionnaire on Susceptible Factors in Different Nationalities of Hyperlipemia Patients in Xinjiang (abbreviated as Questionnaire thereafter). Factor analysis and cluster analysis were performed. Results Cronbach's coefficient for the 54 syndrome items in Questionnaire was 0.891, Kaiser-Meyer-Olkin (KMO) 0. 897, Sig <0.05 in Bartlett's sphericity test. Seventeen common factors were obtained using principal component analysis (PCA). Totally 54 common symptoms of hyperlipidemia were screened, which were then divided into 17 groups with 1 -6 symptoms in each group. F4 (soreness and weakness of waist and knees, sour pain in joints and muscles, body numbness, heavy body sensation, cold limbs), F5 (frequent and clear nocturia, dysuria,-dribble of urine, frequent urination at night), F10 (thirsty, no desire for water, tastelessness, hydroadipsia) , F12 (a white complexion with puffiness, hid- ing fever, hypoactive sexual desire) , and F17 (enuresis) were merged as Shen yang deficiency (SYD) ; F2 (fatigue, drowsiness, depression, spiritlessness, fatigue and disinclination to talk) and F15 (poor ap- petite) were merged as Pi-qi deficiency (PQD) ; F3 (dry mouth and dry pharynx, thirsty, propensity for water, bitter mouth, greasy mouth, stingy mouth, irritability and upset) and F16 (dark red tongue proper, greasy tongue fur) were merged as damp-heat trapped in Pi (DHTP). Results of cluster analysis showed that Pi-Shen deficiency (PSD) was most often seen in hyperlipidemia, and main syndrome types were sequenced from high to low as Pi-Shen deficiency type (46. 2%, 652/1 410) , blockage of cardiac vessels type ( 31. 1% , 438/1 410 ), phlegm and blood stasis internal resistance type ( 13. 3% , 187/1 410), Pi-deficiency induced damp abundance type (8. 3%, 123/1 410), Gan-Shen yin deficiency type (0. 7%, 10/1 410). Conclusions Deficiency syndrome was dominant in hyperlipidemia patients of Xinjiang Uyghur Autonomous Region. Phlegm turbidity, damp heat, and etc. were often complicated. The complex situation was manifested to be involved in multiple organs, qi-blood-fluid mixed disease.

[Distribution Laws of PCOS Syndrome Types and Features of Sex Hormone Levels and Glucose Metabolism]

OBJECTIVE

To analyze distribution laws of polycystic ovary syndrome PCOS) syndrome types and features of sex hormone levels and glucose metabolism, providing evidence for clinical syndrome typing, diagnosis and treatment.

METHODS

Totally 237 PCOS patient were recruited. Their basic information and clinical data were collected and syndrome typed as Shen yin deficiency type, Shen yang deficiency type, Gan depression type, phlegm dampness type, blood stasis type. Data were analyzed by using SPSS21. 0 Software package. Basic features, hormone levels, and glucose metabolism were observed in patients with different syndrome types.

RESULTS

(1) The laws of syndrome distribution: Shen yin deficiency type in 46 cases (19. 41%), Shen yang deficiency type in 61 cases (25. 74%), Gan depression type in 48 cases (20. 25%), phlegm dampness type in 46 cases (19. 41%), blood stasis type in 36 cases (15.19%). (2) The levels of sex hormones: Compared with patients with Shen yin deficiency type, luteinizing hormone (LH) was higher in patients with Shen yang deficiency type (P <0. 01 , P <0. 05) ; LH was lower in patients with Gan depression type and phlegm dampness type (P <0. 01 , P <0. 05) ; follicle stimulating hormone (FSH) was lower in patients with phlegm dampness type (P <0.05); LH/FSH ratio was higher in patients with Shen yang deficiency type (P <0. 01); testosterone (T) level was lower in patients with Gan depression type and blood stasis type (P <0. 05, P <0. 01) ; prolactin (PRL) level was higher in patients with blood stasis type and phlegm dampness type (P <0. 05, P <0. 01). Compared with patients with Shen yang deficiency type, LH level and LH/FSH ratio were lower in patients with Gan depression type, phlegm dampness type, and blood stasis type (P <0. 01) ; FSH was lower in patients with phlegm dampness type (P<0.05); T was also lower in patients with Gan depression type and blood stasis type (P <0.05, P < 0.01); PRL was higher in patients with Gan depression type and phlegm dampness type (P <0.01, P < 0. 05). Compared with patients with Gan depression type, PRL was lower in patients with phlegm dampness type and blood stasis type (P <0. 01). Ddehydroepiandrosterone sulfate (DHEAS) level was the lowest in patients with blood stasis type (P <0. 05, P <0. 01). There was no statistical difference in estradiol (E₂) among all groups (P>0.05). (3) The characteristics of glucose metabolism: Compared with patients with phlegm dampness type, fasting insulin (FINS), 2 h insulin (INS 2 h) , 3 h insulin (INS 3 h) , insulin/glucose (I/G), homeostatic model for insulin resistance (HOMA-IR) were lower in patients with Shen yin deficiency type, Shen yang deficiency type, Gan depression type, blood stasis type (P <0. 01) ; islet β-cell function index (HOMA-β) was lower in patients with Shen yang deficiency type, Gan depression type, blood stasis type (all P <0. 01); 2 h glucose (GLU 2 h) was lower in patients with Shen yin deficiency type, Shen yang deficiency type, blood stasis type (P <0. 05, P <0. 01); 3 h glucose (GLU 3 h) was lower in patients with Shen yin deficiency type (P <0. 05). Compared with patients with Gan depression type, INS 2 h and GLU 2 h were also lower patients with Shen yin deficiency type (P <0. 05, P <0. 01).

CONCLUSIONS

There exists certain distribution laws of syndrome types in PCOS patients. Besides, different syndrome types had certain relevance with sex hormone and glucose metabolism features.

[Further Exploration on the Essence of Yin Deficiency Caused Fire Hyperactivity Syndrome in Precocious Puberty Children Patients]

In this paper 200 girls with precocious puberty or advanced puberty were clinically sur- veyed, and the literatures of traditional Chinese medicine (TCM) for treating precocious puberty in previ- ous 33 years were retrospectively analyzed. By conjecturing syndromes from symptoms and identifying syndrome types from efficacies of TCM drugs, authors proved that Gan yin deficiency syndrome occupies the same important position as Shen yin deficiency syndrome, or even more important position in syn- drome based treatment of precocious puberty children patients with yin deficiency caused fire hyperactivity syndrome. Therefore, Gan yin deficiency syndrome cannot be neglected in treating precocious puberty pa- tients. Authors further suggested that yin deficiency caused fire hyperactivity syndrome in precocious pu- berty should be exactly described as Gan-Shen yin deficiency caused fire hyperactivity syndrome.

Establishment and evaluation of a mouse model of bronchial asthma with Yin deficiency syndrome

OBJECTIVE

To establish and evaluate a mouse model of bronchial asthma with Yin deficiency syndrome.

METHODS

The mouse model of bronchial asthma with Yin deficiency syndrome was established by the treatment with injecting ovalbumin (OVA) two times to sensitize, inhaling OVA 14 times to stimulate, and using thyroxin through lavage during late stimulation. This model was evaluated through body weight, asthmatic behaviors, respiratory function, autonomous activity, lung pathology, and pulmonary fluid clearance.

RESULTS

OVA combined with thyroxin was an appropriate method to induce the mouse model with increased food and water intake, autonomous activity, asthmatic behaviors score, and respiratory rate, decreased body weight, tidal volume, and wet/dry ratio of lung, and changed with pathology of lung tissue. The changes of the above mentioned parameters indicated that the model was the bronchial asthma with Yin deficiency syndrome.

CONCLUSION

The OVA combined with thyroxin is a good pattern to establish a mouse model of bronchial asthma with Yin deficiency syndrome successfully, which can highly simulate the clinical symptoms of this disease.

[Recurrence of Cerebral Infarction Associated Aspirin Resistance or Chinese Medical Constitutions: a Correlation Study]

OBJECTIVE

To explore the correlation between the recurrence of cerebral infarction and aspirin resistance (AR)/Chinese medical (CM) constitutions.

METHODS

Totally 413 cerebral infarction patients took Aspirin Enteric-coated Tablet (100 mg per day) while receiving routine therapy, 5 days at least in a week. They were followed-up for 12 months. Aspirin sensitivity (AS) was determined using turbidimetry. CM constitutions among patients with different AS were compared. Ratios of AR patients and AS patients of different CM constitutions in cerebral infarction recurrent patients were compared. Platelet membrane glycoproteins (GP) II b HPA-3 gene polymorphism was detected by polymerase chain reaction (PCR) method. Correlation between recurrence of cerebral infarction and AR, bb genotypes, CM constitutions times AS were analyzed by Logistic regression.

RESULTS

Totally 11 patients dropped out, 101 (25.12%)with recurrent cerebral infarction and 301 (74.88%) without recurrent cerebral infarction. There were 152 (37.81%) AR patients and 250 (62.19%) AS patients. AR accounted for 26.6% (80/ 301) and AS accounted for 73.4% (221/301) in non-recurrent cerebral infarction patients. AR accounted for 71.3% (72/101) and AS accounted for 28.7% (29/101) in recurrent cerebral infarction patients. There was statistical difference in AR and AS ratios (χ2 = 64.287, P = 0.000). The proportion of yin deficiency constitution (YDC) was the largest [28.3% (43/152)] in AR patients. The proportion of blood stasis constitution (BSC) was the largest [23.6% (59/250)] in AS patients. There was statistical difference in CM constitutions between AR patients and AS patients (χ2 = 21.574, P < 0.01). The former 4 recurrent rates occurred in AR patients of YDC, BSC, damp-phlegm constitution (DPC), qi deficiency constitution (QDC). YDC occupied the first place [22.4% (34/152)]. The former 4 recurrent rates occurred in AS patients of BSC, QDC, DPC, damp-heat constitution (DHC). BSC occupied the first place [3.2% (2/250)]. Compared with non-recurrent cerebral infarction patients and AS patients, bb gene occurred most often, but aa gene and ab gene occurred obviously lesser in non-recurrent cerebral infarction patients and AR patients (χ2 = 20.171, χ2 = 55.139, P < 0.01). AR and bb gene were positively correlated with recurrent cerebral infarction (OR = 18.423, P = 0.000; OR = 1.304, P = 0.028). Body constitutions interacted with AS (OR = 0.707, P = 0.000).

CONCLUSIONS

Recurrent cerebral infarction was closely related to AR and constitutional types. The recurrence rate was higher in AR patients of YDC. GP I b HPA-3 bb genotype might be a risk factor for AR and recurrent cerebral infarction.

[Relation between Chinese Medical Constitutions of Female Patients with Late-onset Acne: an Epidemiological Investigation]

OBJECTIVE

To explore the correlation between syndrome types of late-onset acne female patients and constitutions of Chinese medicine (CM).

METHODS

A questionnaire was performed in 365 late-onset acne female patients and 135 healthy subjects (as the control) using Professor WANG Qi's. methods and Standards for Chinese Medical Constitutions Classification.

RESULTS

Their CM constitutions were sequenced as damp-heat constitution, yin-deficiency constitution, balanced constitution, yang-deficiency constitution, blood-stasis constitution, qi-stagnation constitution, qi-deficiency constitution, phlegm-damp constitution, inherited special constitution, with statistical difference when compared with those of the control group ( χ2 = 85.206, P < 0.01). In the 365 female late-onset acne patients, 114 (31.23%) were with Chongren imbalance syndrome, 108 (29.59%) were with blood stasis or coagulated phlegm syndrome, 83 (22.74%) were with dampness heat syndrome, and 60 (16.44%) were with wind heat syndrome. There was statistical difference in CM constitution distributions among different CM syndrome types (χ2 = 105.671, P < 0.01). The distribution of CM medical constitutions was different between the two groups. Biased constitutions were often seen in the patient group, while balanced constitution was often seen in the control group. Binary Logistic regression analysis indicated that influencing factors covered sweet food, light diet, roasted food, coffee, stress, work pressure, and family pressure. Of them light diet was one protective factor, while the rest were adverse factors.

CONCLUSION

The etiology and syndrome types of female late-onset acne female patients were associated with CM constitution.

[Multi-center randomized control study on the effects of syndrome differentiated traditional Chinese medicine therapy on CKD 1-2 with chronic nephritis proteinuria]

OBJECTIVE

To determine the effects of Syndrome Differentiated Chinese Medicine (TCM) Therapy on (CKD) 1-2 stage chronic kidney disease with proteinuria.

METHODS

A prospective randomized control study was undertaken in 11 centers. A total of 396 chronic nephritis patients were divided into a treatment group (n=297) and a control group (n=99). Their TCM syndrome was classified as "Qi and Yin Deficiency of spleen and kidney" or "Qi and Yang Deficiency of spleen and kidney", with accompanying syndromes showing as "water and dampness", "damp-heat", and "blood stasis". Patients in the treatment group took a dose of Chinese medicine daily in response to their syndromes, while the controls took 50 mg/d losartan. The course of treatment was 24 weeks. Changes of 24-hour urinary protein excretion and glomerular filtration rate (eGFR) before and after treatments (4, 8, 12, 16, 20, 24 weeks), as well as clinical efficacy (after 4, 16, 24 weeks treatments) were measured.

RESULTS

361 patients were included in the final program participants comply analysis (PPS). Patients in the treatment group showed gradual decreased 24-hour urinary protein excretion, whereas the controls remained unchanged. Significant differences in 24-hour urinary protein excretion appeared between the experimental and control group at week 20 and 24 (P<0.05). eGFR decreased in all of the patients after treatments (P=0.0014). At three follow-up points, patients in the treatment group had higher eGFR than the controls, but without statistical significance (P>0.05). Significant differences in clinical remission rate, marked effect rate and total effective rate were observed between the treatment and control groups at week 24 (P<0.001).

CONCLUSION

Syndrome differentiated TCM therapy can reduce the level of proteinuria in CKD 1-2 nephritis patients, promoting clinical effectiveness and protecting renal functions.

[An establishment of theoretical structure of PRO questionnaire in treating chronic liver disease by Chinese medicine]

By reviewing research contents of patient-reported outcome (PRO) and discussing Chinese medicine (CM) theories related to chronic liver disease (CLD), we have followed international PRO questionnaire development specification, combined CM theories such as uniformed spirit and body, correspondence between human and the universe, yin in property and yang in function of Gan, and seven emotions, and constructed theoretical structure of PRO questionnaire of treating CLD, including four major areas as physiology, psychology, independence, and society and nature. Of them, the physiological field contained six aspects such as blood deficiency, yin deficiency, bleeding, disorder of qi movement, improper transformation and transportation of Pi-Wei, and abnormal biliary excretion. The psychological field contained two aspects: Gan-related emotions and general disease related emotions. The independence field contained two aspects: daily life and study and work. The field of society and nature contains three aspects: social relations, social environment, and natural adaptability.

[Correlation study on Chinese medical syndrome types of chronic hepatitis B patients and HLA-DR13 gene, BCP mutation, and T-lymphocyte subsets]

OBJECTIVE

To explore the correlation between the HLA-DR13, basic core promoter (BCP), changes of T lymphocyte subset and clinical Chinese medical syndromes of chronic hepatitis B (CHB).

METHODS

Totally 102 CHB patients were syndrome typed as Gan depression Pi deficiency syndrome (GDPDS), Pi-Shen yang deficiency syndrome (PSYDS), Gan-gallbladder dampness heat syndrome (GGDHS), Gan-Shen yin deficiency syndrome (GSYDS), and static blood blocking collaterals syndrome (SBBCS). Besides, 30 healthy subjects were recruited as the normal control group. The blood HBV-DNA level and HLA-DR13 gene were detected with real time fluorescent PCR. The expression of CD4+ and CD8+ in T lymphocytes was detected using flow cytometry. The mutation of serum A1762T/G1764A was detected using PCR sequencing. Hepatitis Be antigen (HBeAg) was detected with ELISA, and correlation between various Chinese medical syndrome types and objective indicators were analyzed.

RESULTS

There was no statistical difference in HBV-DNA quantitative results among various syndrome types (P > 0.05). HBeAg positive rate was higher in GDPDS than in other syndrome types (P < 0.05). It was sequenced as GDPDS > GSYDS > SBBCS > GGDHS > PSYDS. Compared with the normal control group, percentages of CD3+ and CD3+ CD4+ were lower in PSYDS (P < 0.05). The ratio of CD3+ CD4+/CD3+ CD8 was lower in GGDHS and PSYDS than in the normal control group (P < 0.05). There was no statistical difference in the CD3+ CD8+ percentage among various syndrome types (P > 0.05). The quantitation of HLA-DR13 gene was lower in GDPDS and GSYDS than in the normal control group (P < 0.05). The positive rate of BCP mutation was higher in GSYDS than in other syndrome types (P < 0.05).

CONCLUSION

Co-detection results of HLA-DR13 and BCP could be used as reference indices of Chinese medical syndrome typing of CHB.

[Features of anovulatory infertility patients of gan-yin deficiency syndrome: a primary exploration]

OBJECTIVE

To explore the laws of anovulatory infertility patients of Gan-yin deficiency syndrome (GYDS), and to analyze the correlation between GYDS and partial sex hormones and metabolic parameters.

METHODS

Recruited were 103 anovulatory infertility patients, including 48 of GYDS and 55 of non-GYDS. At the same time, 20 healthy pluripara at the child-bearing period were recruited as the control group. The body mass index (BMI) and waist to hip ratio (WHR) were measured. Serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone (T), prolactin (PRL), estradiol (E2), sex hormone binding globulin (SHBG), fasting blood glucose (FBG), fasting insulin (FINS), total cholesterol (TC), triglyceride (TG), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), and leptin were detected. The inter-group difference of the above indices was compared between the two groups.

RESULTS

Levels of BMI, FINS, HOMA-IRI, leptin, TC, TG, LDL-C, T, PRL, and LH were higher in the GYDS group and the non-GDS group than in the control group (P < 0.01, P < 0.05), while SHBG was lower in the GYDS group and the non-GYDS group than in the control group (P < 0.01). Only the PRL level was higher in the GYDS group than in the non-GYDS group (P < 0.01).

CONCLUSIONS

Gan-yin deficiency is a predominant manifestation in anovulatory infertility patients. Partial disorder of some sex hormones and metabolic derangement might be common pathological factors for anovulatory infertility, while increased PRL levels was dominant in GYDS.

[A literature review on Chinese medicine syndrome and syndrome elements of chronic fatigue syndrome]

OBJECTIVE

To research the distribution characteristics of Chinese medicine (CM) syndrome and syndrome elements of chronic fatigue syndrome (CFS) by analyzing literature in recent 20 years.

METHODS

Relevant literature on treating CFS by syndrome differentiation of CM at home were retrieved by computer and manual ways. Database were established by using EpiData 3.1 to conduct frequency analysis of syndrome and syndrome elements.

RESULTS

The most common clinical syndromes were Xin-Pi deficiency syndrome, Gan stagnation Pi deficiency syndrome, Gan-Shen yin deficiency syndrome, Gan qi stagnation syndrome, and Pi-Wei qi deficiency syndrome. Disease locations were sequenced as Pi, Gan, Shen, and Xin. The clinical pathogenesis of CFS was characterized by deficiency of vital energy, complicated with intermingled excess and deficiency. Asthenia of healthy energy was mainly manifested as qi deficiency, blood deficiency, and yin deficiency, while excess of sthenia was mainly manifested as qi stagnation, phlegm dampness, and static blood.

CONCLUSIONS

Research of CM syndrome starting from syndrome elements can better unify and standardize clinical syndrome differentiation. Results of literature analysis can provide reference for further studies.

[Correspondence analysis of chinese medical constitution features in different ages population]

OBJECTIVE

To explore the distribution features of Chinese medical constitutions in different ages population, thus providing scientific evidence of constitution process theory.

METHODS

Recruited were 21 948 cases from a survey of Chinese medical constitutions and health conditions in 9 provinces or municipalities across China (including Jiangsu, Anhui, Gansu, Qinghai, Fujian, Beijing, Jilin, Jiangxi, and Henan) from Dec 2005 to Jan 2007. The body constitution type of individual was diagnosed using discriminant analysis on the basis of Chinese medical constitution questionnaire. By using correspondence analysis, the correlation between the general population, genders, ages, and Chinese medical constitution types was studied.

RESULTS

Constitutions of yin-deficiency type, wetness-heat type, qi-depression type, and special diathesis type often occurred in the population ranging 15 -24 years old. Gentleness type mostly occurred in the population ranging 25 -44 years old. During this time period, phlegm-wetness type and wetness-heat type were liable to occur in males, while blood-stasis type was liable to occur in females. Qi-deficiency type and yang-deficiency type were most often seen in those older than 45 years. Phlegm-wetness type and blood-stasis type body constitution were also liable to occur in those older than 45 years.

CONCLUSIONS

The distribution features were different in different Chinese medical constitutions. Different constitution types exist in different genders. Different constitution types exist different ages population.

[Effect of Qiju Dihuang Pill on serum levels of IFN-gamma and IL-4 in pregnant women of Gan-Shen yin deficiency syndrome]

OBJECTIVE

To observe the effect of Qiju Dihuang Pill (QDP) on changes of Chinese medical syndrome types in pregnant women of Gan-Shen yin deficiency syndrome (GSYDS), and to explore the correlation between imbalanced cytokine levels and GSYDS.

METHODS

This was a random controlled trail. A total of 163 pregnant women of GSYDS at 12 -16 gestational weeks were randomly allocated into the experimental group (86 cases) and the control group (77 cases). Patients in the experimental group took QDP for 2 -4 weeks. Changes of Chinese medical syndrome types and serum interferon-gamma (IFN-gamma) and interleukin-4 (IL-4) levels were observed and compared between the two groups before and after treatment.

RESULTS

(1) Totally 41 patients (47.7%) in the experimental group were transformed to normal Chinese medical syndrome type. In the same period of the follow-ups, 9 patients (11.7%) in the control group were transformed to normal Chinese medical syndrome type, showing statistical difference (P < 0.05). (2) In the experimental group, the serum level of IFN-gamma and the ratio of IFN-gamma/IL-4 in the peripheral blood were obviously lower after treatment than before treatment (P < 0.01), and obviously lower than those in the control group (P < 0.01). The level of IL-4 after treatment in the experimental group was higher than that before treatment, and also higher than that in the control group, but with no statistical difference.

CONCLUSIONS

These results indicated that there was imbalanced IFN-gamma/IL-4 ratio in the peripheral blood of pregnant women of GSYDS. QDP might play a role in immunoregulation by affecting the IFN-gamma level.

Evaluation of symptom, clinical chemistry and metabolomics profiles during Rehmannia six formula (R6) treatment: an integrated and personalized data analysis approach

ETHNOPHARMACOLOGICAL RELEVANCE

Rehmannia Six Formula (R6, Chinese name is Liu Wei Di Huang Wan) is one of the most important classic Chinese medicine formula used to treat metabolic disorders related to aging. It was first reported in the Chinese medicine book titled 'Xiao Er Yao Zheng Zhi Jue by Qian Yi' (Chinese Song dynasty: 1035-1117). In modern times it is therefore often used to treat diabetes, pre-diabetes, fatigue and people with metabolic syndrome. The aim of this study is to measure changes in symptoms, clinical parameters and serum metabolite profiles during R6 treatment of human subjects with features of metabolic syndrome.

MATERIALS AND METHODS

Symptoms, clinical parameters and serum metabolites were measured before and after 4 and 8 weeks of R6 treatment. Nonlinear Principal Component Analysis was applied for the first time to conduct an integrated analysis of the three data sets. Correlation structures were compared before treatment and after 4 and 8 weeks of treatment. Additionally, a State Space Grid approach was used to study personalized changes in symptom profiles.

RESULTS

The symptoms 'hectic fever' and 'spontaneous sweating' were found to be most relieved during R6 treatment. Most of the symptoms were less correlated with other variables after 8 weeks of R6 treatment. LDL-C, total cholesterol, systolic blood pressure and waist size were found to decrease during R6 treatment. Additionally, 10 of the 15 measured phosphatidylcholines were found to decrease. Personalized symptom profiles as described by Chinese medical terms show that most Yin deficiencies are addressed first by R6 treatment. However, in subjects with reduced or less Yin deficiency but which do have a substantial Qi deficiency a reduction of Qi deficiency is subsequently observed.

CONCLUSIONS

R6 treatment was shown to improve the lipid profile indicating a reduction of cardiovascular risk. Additionally, the changes observed in correlation structure indicate a different angle of looking at treatment effects. Less strong correlations between symptoms and metabolites suggest a healthier situation after R6 treatment. A State Space Grid analysis showed that the effect of R6 was different for the Yin deficiency subjects and the Qi deficiency subjects. The observed decrease of Yin deficiency related symptoms is in agreement with the use of R6 in Chinese medicine to nourish Yin. Observing individual differences in treatment effects is therefore an essential step in the development of personalized medicine.

[The distribution of Chinese medicine syndrome types in primary liver cancer and their differences of the survival time: a clinical study]

OBJECTIVE

To explore the distribution of Chinese medicine (CM) syndrome types in primary liver cancer (PLC) and their differences of the survival time.

METHODS

From May 2007 to March 2009, recruited were 151 PLC inpatients at Department of Tumor, Guangdong Provincial Hospital of Traditional Chinese Medicine. Their survival time were statistically calculated. Patients' average survival time and median survival time were calculated using Kaplan-Meier method. The Log-rank test was used to analyze their differences of survival time among different CM syndrome types.

RESULTS

The proportion of CM syndrome types in PLC patients were ranked from high to low as follows: mutual accumulation of dampness and blood stasis syndrome [MADBSS, 43.0% (65/151)], Gan-stagnation Pi-deficiency syndrome [GSPDS, 34.4% (52/151)], qi stagnation blood stasis syndrome [QSBSS, 9.3% (14/151)], retention of damp-heat syndrome [RDHS, 8.6%(13/151)], and Gan-Shen yin deficiency syndrome [GSYDS, 4.6% (7/ 151)]. The median survival time of different CM syndrome types were ranked from longer to shorter as follows: GSPDS (14.77 months), QSBSS (6.13 months), RDHS (5.27 months), MADBSS (4.78 months), and GSYDS (0.80 months). The mean survival times were ranked from longer to shorter as follows: GSPDS (12.40 months), QSBSS (8.84 months), MADBSS (6.99 months), RDHS (7.08 months), and GSYDS (0.72 months). There was statistical difference in the difference of the survival time among different CM syndrome types (P < 0.05).

CONCLUSIONS

GSPDS and MADBSS were the most common CM syndrome types in PLC patients. There was difference in the survival time between GSPDS and MADBSS/between RDHS and GSYDS. There was difference in the survival time between MADBSS and GSYDS. Patients of GSPDS might get the best prognosis, while patients of GSYDS might get the poorest prognosis.

[Exploration of academic thoughts on treating myelodysplastic syndrome with combination of disease and syndrome by Prof. Ma Rou]

The diagnosis and treatment pattern using combination of disease and syndrome, fully developing the advantages of both traditional Chinese medicine (TCM) and Western medicine (WM) and being widely used clinically, has been constructed in the long history of TCM. Prof. MA Rou, as a hematology specialist of integrative medicine (IM), uses modern medical equipment to diagnose diseases and takes traditional Chinese medical methods to treat diseases. He is loyal to TCM sciences and refers to the advantages of WM. He holds the essence of MDS lies in toxic stasis according to its pathogenic features. He detoxifies and removes stasis using Qinghuang Powder. Meanwhile, according to patients' clinical manifestations, he summarized two common syndrome types, Pi-Shen yang deficiency syndrome and Gan-Shen yin deficiency syndrome. Better efficacy could be achieved by combining Chinese herbs for tonifying Pi-Shen. In recent years the application of Qinghuang Powder won some achievements in clinical study and experimental study, thus providing scientific reliance for Prof. MA Rou's academic thought on treating MDS.