[Quantitative evaluation of the degrees of traditional Chinese medicine qualitative syndromes of osteoporosis]

OBJECTIVE

To establish a quantitative estimate model for diagnosing traditional Chinese medicine (TCM) syndromes of patients with osteoporosis.

METHODS

Symptoms and signs of osteoporosis and methodology related to syndrome research were collected by reviewing medical literature. The symptoms and sighs were quantitatively classified into three, two or one category according to a 100-mm visual analog scale. Fuzzy comprehensive evaluation model of TCM qualitative syndromes was performed based on analytic hierarchy process. Then "Hall for Workshop of Metasynthetic Engineering" expert symposium was held on subjects of syndrome quantification method and weight of evaluation indices in different levels for developing the analysis model of common syndromes. For clinical verification, the created models were applied to patients with osteoporosis for discriminating syndromes. Syndrome of each patient was also identified by 8 experts major in integrative medicine treating osteoporosis for comparing the coincidence rate using a self-made clinical questionnaire.

RESULTS

Through literature reviewing, symptoms and signs quantification and expert discussing, the authors formed estimate models of essence deficit, qi deficiency, yin deficiency, yang deficiency, and blood stasis. A total of 220 patients with osteoporosis were enrolled and filled the clinical questionnaire. All 8 experts completed and returned the questionnaire (1 760 cases), and 1 545 of them were filled in completely. Experts' opinion on syndrome differentiation was exactly coincidence to estimate model in 611 cases and almost coincidence in 639 cases. The total coincidence rate reached to 94.05%.

CONCLUSION

The estimate model for syndrome differentiation of osteoporosis has a high-coincidence rate with the fuzzy evaluation from experts, with good rationality and feasibility, and is worthy of promotion in the clinical study.

[Correlation between Chinese medicine syndromes and the NPHS1 gene and NPHS2 gene polymorphism as well as corticosteroid sensitivity in patients with minimal change disease]

OBJECTIVE

To explore the correlation between Chinese medicine (CM) syndromes and the NPHS1 gene and NPHS2 gene polymorphism as well as corticosteroid sensitivity in patients with minimal change disease (MCD).

METHODS

A total of 94 MCD patients were recruited, including 58 steroid-sensitive nephritic syndrome (SSNS) patients and 36 steroid-resistant nephritic syndrome (SRNS) patients. Genomic DNA was obtained from peripheral blood lymphocytes and sequence analysis of single nucleotide polymorphisms (SNPs) in the genes was performed.

RESULTS

(1) The SNPs of G349A-3 in NPHS1 gene was found in MCD, but the SNPs of G686A-5 and C695T-5 in NPHS2 gene were not discovered in MCD. (2) When comparing the frequency of genotype AA and allele A in NPHS1 gene (G349A-3), genotype AA and allele A were higher in the SRNS group than in the SSNS group (P < 0.05). (3) When compared with the SRNS group, qi yang deficiency syndrome had a higher incidence in the SSNS group, and yin deficiency syndrome and qi-yin deficiency syndrome had a less incidence in the SSNS, but with no statistical difference (P > 0.05). The rheumatism syndrome had a higher incidence in the SSNS group (P < 0.05). The blood stasis syndrome had a lower incidence in the SSNS with statistical difference (P < 0.05). (4) There was no statistical difference in the correlation between GG, AA, GA and CM syndromes (P > 0.05).

CONCLUSIONS

Homozygous mutations of AA and allele A in NPHS1 gene were correlated to SRNS patients of MCD. Rheumatism syndrome patients were prone to be sensitive to corticosteroids, while patients of blood stasis syndrome were prone to be insensitive to corticosteroids. We didn't discover the correlation between NPHS1 gene polymorphism and CM syndrome distribution.

[Clinical study of Jiangtang Xiaozhi Capsule in treating type 2 diabetes mellitus patients]

OBJECTIVE

To evaluate the efficacy and safety of Jiangtang Xiaozhi Capsule (JTXZC) in treating type 2 diabetes mellitus (T2DM) patients of qi-yin deficiency and inter-obstruction between phlegm and stasis.

METHODS

Adopting prospective, randomized, controlled trial design, 73 T2DM patients of qi-yin deficiency and inter-obstruction between phlegm and stasis syndrome, were randomly assigned to two groups, the pioglitazone tablet group (36 cases) and the JTXZC group (37 cases). The therapeutic course for all was 8 weeks. The body weight, height, body mass index (BMI), waistline (WC), hipline, waist-to-hip ratio (WHR), and scoring for Chinese medicine (CM) symptoms assessment were observed. The fasting blood glucose (FBG), 2-h postprandial blood glucose (PBG), glycated hemoglobin (HbA1c), plasma total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), plasma insulin (FINS) were detected. The HOMA-IR was also calculated. The safety indices such as liver and renal functions, adverse reactions were also observed.

RESULTS

The levels of HbA1c were lowered after treatment in the two groups after 8 weeks of treatment, showing statistical difference when compared with before treatment (-0.59% +/- 1.99% and -0.27% +/- 2.73%, P < 0.05). The PBG level also decreased with statistical difference (-1.71 +/- 2.52 mmol/L and -0.72 +/- 4.17 mmol/L, P < 0.05), but there was no statistical difference between the two groups. The body weight, BMI, TG obviously decreased (P < 0.05). The CM symptoms efficacy and CM symptom scoring were significantly reduced in the two groups (P < 0.01). Besides, better effects were shown in the JTXZC group (P < 0.05). No severe adverse event occurred in either group during the therapeutic course. There was no statistical difference in the incidence of adverse events (P > 0.05).

CONCLUSIONS

JTXZC showed similar therapeutic effects to pioglitazone. They both could effectively im- prove clinical symptoms with no severe adverse reaction.

[Study of the correlation between the colorectal cancer Chinese medicine syndrome types and (excision repair cross-complementing 1, ERCC1) gene polymorphisms]

OBJECTIVE

To explore the correlation between excision repair cross-complementing 1 (ERCC1) C8092A and C19007T gene polymorphisms and different Chinese medicine (CM) syndrome types of colorectal cancer (CC).

METHODS

Ninety-nine patients with CC were syndrome typed as dampness-heat accumulation syndrome, qi stagnation with blood stasis syndrome, Pi-Shen yang deficiency syndrome, and Gan-Shen yin deficiency syndrome. The gene polymorphisms of excision repair cross-complementing 1 (ERCC1) C8092A and C19007T in different CM syndrome types of CC were examined by polymorphisms chain reaction amplification and direct sequencing, and analyzed statistically.

RESULTS

The frequencies of C8092A genotype and allele in different CM syndrome types had no statistical difference (P > 0.05). The frequencies of C19007T genotype and allele in different CM syndrome types had statistical difference (P < 0.05). Of them, there was no statistical difference in the frequencies between dampness-heat accumulation syndrome and qi stagnation with blood stasis syndrome, or between Pi-Shen yang deficiency syndrome and Gan-Shen yin deficiency syndrome (P > 0.05). There was statistical difference between dampness-heat accumulation syndrome and Pi-Shen yang deficiency syndrome as well as Gan-Shen yin deficiency syndrome (P < 0.05). There was statistical difference between qi stagnation with blood stasis syndrome and Pi-Shen yang deficiency syndrome as well as Gan-Shen yin deficiency syndrome (P < 0.05).

CONCLUSION

ERCC1 C19007T gene polymorphisms might be associated with CM syndrome types of CC, which needed to be further studied.

[The occurrence of cardiovascular events of coronary heart disease inpatients and study on Chinese medicine syndrome distribution laws]

OBJECTIVE

To explore the correlation between Chinese medicine (CM) syndrome elements and follow-up cardiovascular events in coronary heart disease (CHD) inpatients, thus providing the clinical evidence for CM syndrome typing.

METHODS

Adopting prospective design and method of principal component and Logistic regression analysis, we studied the distribution laws of CM syndrome elements in 1 005 CHD inpatients according to the follow-up cardiovascular events.

RESULTS

The dominant CM syndrome elements in CHD patients were blood stasis, qi deficiency, turbid phlegm, and yin deficiency. After 1-year follow-up, 66 CHD patients suffered from acute cardiovascular events. The analysis results demonstrated that the second principal component composed of qi deficiency and yin deficiency with statistical significance in Logistic regression (P = 0.036).

CONCLUSIONS

Blood stasis, qi deficiency, turbid phlegm, and yin deficiency were main syndrome elements of CHD inpatients. Qi deficiency and yin deficiency might be relevant CM syndrome elements of the CHD inpatients who suffered from acute cardiovascular events in the 1-year follow-up.

[Study on the Chinese medical syndrome distribution of ulcerative colitis]

OBJECTIVE

To study on the Chinese medicine (CM) syndrome distribution of ulcerative colitis (UC) and the distribution of CM syndrome types at different staging periods.

METHODS

From March 2007 to April 2010, 110 UC out- or inpatients at the Department of Digestive Diseases of Guangzhou Municipal Hospital of Traditional Chinese Medicine were recruited. The patients' symptoms were calculated. The systematic clustering was used. The symptom was taken as the variable in the clustering. The syndrome types were confirmed according to the clustering results. The syndrome typing was performed and its results were analyzed.

RESULTS

There were 64 main symptoms in UC patients, including diarrhea, mushy stool, watery stool, abdominal pain, and bloody stool. Seventy cases belonged to the active period and 40 to the remission period. The UC syndrome types were sequenced from high to low as the dampness-heat of Dachang syndrome, Pi-Wei qi deficiency syndrome, Gan depression and Pi deficiency syndrome, Pi-Shen yang deficiency syndrome, blood stasis in the intestinal collaterals syndrome, yin and blood deficiency syndrome. There was statistical difference in the case number among different syndrome types (P < 0.05). In the active period, dominated were the dampness-heat of Dachang syndrome (28 cases, 25.5%), Gan depression and Pi deficiency syndrome (14 cases, 12.7%), and blood stasis in the intestinal collaterals syndrome (10 cases, 9.0%). In the remission period, dominated were Pi-Wei qi deficiency syndrome (18 cases, 16.4%) and Pi-Shen yang deficiency syndrome (10 cases, 9.0%), showing statistical difference (P<0.05). The typical symptoms of patients of the dampness-heat of Dachang syndrome were sequenced from high to low as yellow tongue fur (31 cases, 28.1%), tenesmus (26 cases, 23.6%), mucopurulent bloody stool (25 cases, 227%), diarrhea (24 cases, 21.8%), anal burning (24 cases, 21.8%), watery stool (21 cases, 19.0%), abdominal pain (19 cases, 17.2%), red tongue (19 cases, 17.2%), and greasy tongue fur (19 cases, 17.2%). The typical symptoms of patients of Pi-Wei qi deficiency syndrome were sequenced from high to low as tastelessness (25 cases, 22.7%), fine pulse (25 cases, 22.7%), pink tongue (22 cases, 20.0%), eructation (21 cases, 19.1%), hypodynamia (21 cases, 19.1%), loss of appetite (20 cases, 18.2%), and white tongue fur (20 cases, 18.2%). The typical symptoms of patients of Pi-Shen yang deficiency syndrome were sequenced from high to low as abdominal pain (17 cases, 15. 5%), preference for warmth (17 cases, 15. 5%), diarrhea (16 cases, 14.5%), aggravation while encountering cold (15 cases, 13.6%), white tongue fur (15 cases, 13.6%), pale white tongue (14 cases, 12.7%). The typical symptoms of patients of Gan depression and Pi deficiency syndrome were sequenced from high to low as emotions inducing (18 cases, 16.4%), eructation (16 cases, 14.5%), white tongue coating (16 cases, 14.5%), dry stool before loose stool (15 cases, 13.6%), frequent break wind (15 cases, 13.6%), and frequent sigh (15 cases, 13.6%). The typical symptoms of patients of blood stasis in the intestinal collaterals syndrome were sequenced from high to low as abdominal pain (12 cases, 10.9%), sting (12 cases, 10.9%), soreness of the waist (12 cases, 10.9%), dark red tongue with petechiae (12 cases, 10.9%), thick fur (12 cases, 10.9%). There was statistical difference in the symptom ratio among each syndrome types (P<0.05). There was no statistical difference in other symptoms except yin and blood deficiency syndrome (P>0.05).

CONCLUSIONS

The dampness-heat of Dachang syndrome, Gan depression and Pi deficiency syndrome, and blood stasis in the intestinal collaterals syndrome were dominated in the UC active period. Pi-Wei qi deficiency syndrome and Pi-Shen yang deficiency syndrome were dominated in the remission period.

[Effects of acupoint heat-sensitization moxibustion on the gastrin and motilin in chronic diarrhea patients of Pi-Shen deficiency syndrome]

OBJECTIVE

To observe the therapeutic efficacy of acupoint heat-sensitization moxibustion on chronic diarrhea patients as well as its effects on the levels of gastrointestinal neurotic mediators such as serum gastrin (GAS) and plasma motilin (MTL).

METHODS

Sixty chronic diarrhea patients of Pi-Shen deficiency syndrome were randomly assigned to Group A (30 cases, treated with acupoint heat-sensitization moxibustion, once daily) and Group B (30 cases, treated with Changtai Oral Liquid, 10 mL each time, three times daily). The therapeutic course was 4 weeks. Another 20 healthy volunteers were recruited as the health control group. The levels of serum GAS and plasma MTL were detected using radioimmunoassay before and after treatment. The cured rate, the markedly effective case, the effective case, the ineffective case, and the total effective rate were calculated by the end of the treatment.

RESULTS

Before treatment the serum GAS level was lower and the plasma MTL level higher in the two patient groups than in the health control group with statistical difference (P<0.05). There was no statistical difference in the symptom integral between the two patient groups and the health control group (P>0.05). After treatment the serum GAS level increased, the plasma MTL level and the symptom integral decreased in the two patient groups, showing statistical difference when compared with the same group before treatment (P<0.05, P<0.01). After treatment the symptom integral was lower in the treatment group than in the control group with statistical difference (P<0.05). There was no statistical difference in the GAS and MTL levels between the two patient groups (P>0.05). The total effective rate for clinical symptoms was significantly higher in Group A than in Group B with statistical difference (93.3% vs 73.3%, P<0.05).

CONCLUSIONS

The therapy of acupoint heat-sensitization moxibustion was effective for chronic diarrhea patients of Pi-Shen deficiency syndrome. It could regulate the levels of serum GAS and plasma MTL and improve the patients' clinical symptoms.

Liuwei Dihuang decoction facilitates the induction of long-term potentiation (LTP) in senescence accelerated mouse/prone 8 (SAMP8) hippocampal slices by inhibiting voltage-dependent calcium channels (VDCCs) and promoting N-methyl-d-aspartate receptor (NMDA) receptors

ETHNOPHARMACOLOGICAL RELEVANCE

Liuwei Dihuang decoction (LW) is a typical traditional Chinese medicine (TCM) prescription and consists of six herbs including Rehmannia glutinosa Libosch. (family: Scrophulariaceae), Cornus officinalis Sieb. (family: Cornaceae), Dioscorea opposite Thunb. (family: Dioscoreaceae), Alisma orientale (G. Samuelsson) Juz (family: Alismataceae), Poria cocos (Schw.)Wolf (family: Polyporaceae) and Paeonia suffruticosa Andrews (family: Paeoniaceae). It has long been used clinically in treatment of many kinds of diseases with the sign of Yin insufficiency of kidney.

AIM OF THE STUDY

Our previous pharmacological studies demonstrated that LW possesses effect of ameliorating the decline of the learning and memory in senescence accelerated mouse/prone 8 (SAMP8), but the mechanism has not been well established. LW-containing serum (LWCS) is used in the current study to elucidate the possible mechanisms.

MATERIALS AND METHODS

6-month-old SAMP8 was used in this study to investigate the effect of LWCS on the induction of long-term potentiation (LTP). Primary cultured hippocampal neurons were used in this study to investigate the effects of LWCS on [Ca(2+)](i), I(Ca) and N-Methyl-d-aspartate (NMDA)-evoked currents. [Ca(2+)](i) was imaged using Fluo-3 and whole-cell patch recordings were applied to study the I(Ca) and NMDA-evoked currents.

RESULTS

We find that LWCS facilitates the induction of LTP in hippocampal slices of 6-month-old SAMP8. In primary cultured hippocampal neurons, LWCS increases intracellular [Ca(2+)](i), the I(Ca) is suppressed by LWCS, and NMDA-evoked currents are promoted.

CONCLUSION

These results indicate that LW improves the synaptic plasticity by inhibiting voltage-dependent calciumchannels (VDCCs) and promoting the function of NMDA receptors. This improvement might be one of the mechanisms contributing to cognitive improvement effect of LW.

[Study on the correlation between stroke of qi deficiency syndrome and the neurological impairment degree and its long-term prognosis]

OBJECTIVE

To explore the correlation between stroke of qi deficiency syndrome (QDS) and the neurological impairment degree, and to study its correlation between QDS and its long-term prognosis.

METHODS

Recruited were 706 stroke patients with complete clinical information including diagnostic scale scoring of elements such as wind, fire, phlegm, blood stasis, qi deficiency, and yin deficiency, scoring of The National Institutes of Health Stroke Scale (NIHSS) within 72 h from attack, on the 7th, 14th, 28th, and 90th day after attack, and Barthel index (BI) scoring on the 90th day. They were assigned to the QDS group (330 cases) and the non-QDS group (376 cases). The NIHSS scores at different time points were compared between the two groups using analysis of variance of repeated measure data. The correlation between each syndrome element and the long-term prognosis of stroke was studied using Logistic regression analysis.

RESULTS

Higher NIHSS score was found in patients of QDS than those of non-QDS at each time point (P < 0.01). Statistical difference existed in NIHSS score between the two groups at each time point (P < 0.01, P < 0.05). Besides, NIHSS score decreased gradually as time went by. The occurrence frequencies of blood stasis syndrome and phlegm syndrome were higher at each time point. On the 90th day after attack, 427 patients with BI > or = 95 (accounting for 60%) had favorable prognosis, while 279 with BI < 95 (accounting for 40%) had unfavorable prognosis. QDS at each time point was negatively correlated with the 90th-day BI, with the B value being -0.496, -0.714, -0.867, -0.567, and -0.764, respectively.

CONCLUSIONS

Stroke patients of QDS had more severe neurological impairment than those of non-QDS. Stroke patients of acute-stage QDS was closely correlated with unfavorable prognosis on the 90th day after attack. Early actively invigorating healthy qi plays an important role in improving the long-term prognosis of stroke patients.

[Study on the quantization diagnostic method for immunoglobulin A nephropathy of qi-yin deficiency syndrome]

OBJECTIVE

To study the method for establishing a quantization diagnostic standard for immunoglobulin A (IgA) nephropathy of qi-yin deficiency syndrome (QYDS).

METHODS

1,016 patients with primary IgA nephropathy were recruited in this study. They were randomly assigned to the training sample group (344 cases of QYDS and 456 cases of non-QYDS) and the testing sample group (77 cases of QYDS and 139 cases of non-QYDS) using SPSS software. On the basis of epidemiological survey, the typing standards for QYDS and common clinical symptoms were taken as candidate correlated factors. The correlated factors were selected using binary Logistic stepwise regression. The correlated factors were scored using conditional probability conversion method. The threshold value of the quantization diagnostics was determined using maximum likelihood method. The receiver operating characteristic (ROC) curve was drawn to calculate the area under curve (AUC), sensitivity, specificity, and accuracy rating. The retrospective and prospective tests were performed on the established quantization diagnostic standard for QYDS.

RESULTS

The quantization diagnosis threshold value of IgA nephropathy of QYDS was 12 points. The sensitivity, specificity, and accuracy rating of the quantization diagnostic standard were 75.3%, 68.0%, and 71.1% in the retrospective test, as well as 60.4%, 84.4%, and 69.0% in the prospective tests. The AUC was 0.80 and 0.78 respectively.

CONCLUSIONS

It was a feasible method to set up a quantization diagnostic standard for IgA nephropathy of QYDS by taking the occurrence frequency of symptoms. But this method failed to cover the strength information of symptoms.

[Therapeutic efficacy of modified zigui decoction in treatment of polycystic ovary syndrome of gan-shen yin deficiency syndrome]

OBJECTIVE

To study the therapeutic efficacy of Modified Zigui Decoction (MZD) in treatment of polycystic ovary syndrome of Gan-Shen yin deficiency syndrome.

METHODS

66 polycystic ovary syndrome patients of Gan-Shen yin deficiency syndrome were randomly assigned to the MZD group (Group A) and the Westem medicine group (Group B), 33 patients in each. Patients in Group A orally took MZD, while those in Group B orally took Diane-35. Their menstrual cycle rate, basal body temperature (BBT), the ovarian size, the number of follicles, and changes of endocrine hormones were observed before treatment, the first menstrual cycle, and the sixth menstrual cycle after treatment.

RESULTS

(1) The normal rate of one menstrual cycle after stopping taking medicine was 57.58% in Group A and 63.64% in Group B. There was no statistical difference between the two groups (P>0.05). The normal rate of six menstrual cycles after stopping taking medicine was 45. 45% in Group A and 21.21% in Group B. The former was superior to the latter, showing statistical difference (P<0.05). (2) The biphasic BBT rates of one menstrual cycle after stopping taking medicine were somewhat elevated in the two groups, better than before treatment respectively (P<0.01). But there was no statistical difference between the two groups (P>0.05). The biphasic BBT rate of six menstrual cycles after stopping taking medicine was 45.45% in Group A and 18.18% in Group B. The former was superior to the latter, showing statistical difference (P<0.05). (3) The bilateral ovarian volume of one menstrual cycle after stopping taking medicine was obviously reduced in both groups (P<0.01). The bilateral ovarian volume of six menstrual cycles after stopping taking medicine was still more reduced than before treatment in Group A (P<0.01), while it returned to the size of before treatment in Group B (P>0.05). (4) The number of follicles of one menstrual cycle after stopping taking medicine was obviously reduced in both groups (P<0.01). The number of follicles of six menstrual cycles after stopping taking medicine was still reduced in Group A (P<0.01), while it returned to the number before treatment in Group B (P>0.05). (5) The luteinizing hormone (LH), testosterone (T), LH/FSH ratio of one menstrual cycle after stopping taking medicine were obviously reduced in both groups (P<0.01). They were still more reduced six menstrual cycles after stopping taking medicine than before treatment in Group A (P<0.01), while they returned to the levels of before treatment in Group B (P>0.05).

CONCLUSIONS

MZD could effectively treat patients with polycystic ovary syndrome of Gan-Shen yin deficiency syndrome. Besides, its long-term efficacy was more stable and lasting.

[Correlation between Chinese medicine syndrome types of polycystic ovary syndrome and ovulation induction effect]

OBJECTIVE

To study the correlation between Chinese medicine syndrome types of polycystic ovary syndrome (PCOS) and ovulation induction effect, and its clinical significance.

METHODS

Eighty patients with clinically confirmed PCOS were syndrome differentiated as four types, i.e., Shen-yin deficiency syndrome (21 cases), Shen-yang deficiency syndrome (18 cases), phlegm-dampness accumulation syndrome (19 cases), and Gan-stagnancy transformed heat syndrome (22 cases). They all took 100 mg clomiphene as the ovulation induction for 5 successive days. Results of ovulation in all patients were analyzed and compared.

RESULTS

Ovulation induction and the conception rate were sequenced from high to low as follows: Shen-yang deficiency syndrome (66.7%, 22.2%), Gan-stagnancy transformed heat syndrome (59.1%, 18.2%), Shen-yin deficiency syndrome (28.6%, 9.5%), and phlegm-dampness accumulation syndrome (26.3%, 5.3%). Significant difference was shown in ovulation induction results when compared Shen-yang deficiency syndrome with Shen-yin deficiency syndrome and phlegm-dampness accumulation syndrome (P<0.05) as well as when compared Ganstagnancy transformed heat syndrome with Shen-yin deficiency syndrome and phlegm-dampness accumulation syndrome (P<0.05). Significant difference was shown in the conception rate between Shen-yang deficiency syndrome and phlegm-dampness accumulation syndrome (P<0.05).

CONCLUSION

The effects of ovulation induction in patients of phlegm-dampness accumulation syndrome and of Shen-yin deficiency syndrome were poorer than those in patients of Shen-yang deficiency syndrome and Gan-stagnancy transformed heat syndrome, which indicated the reproduction endocrine abnormality or the metabolism abnormality degree of the former two syndrome types were more server than the latter two syndrome types.

[A study of traditional Chinese medicine syndromes correlated to neurologic function or to coagulation function in patients with acute cerebral infarction]

OBJECTIVE

To investigate the correlations between traditional Chinese medicine (TCM) syndrome elements and neurologic function and between them and coagulation function in patients with acute cerebral infarction (ACI).

METHODS

Two hundred and twenty-three patients with ACI were enrolled. The syndromes of this disease were scored according to Stroke Diagnostic Criteria for Differentiation of Syndromes. Neurologic function deficit score (NDS) was scored according to stroke scale of the National Institutes of Health (NIHSS). The prothrombin time (PT), activated partial thromboplastin time (APTT) and fibrinogen (FIB) contents were detected. The correlations between TCM syndrome elements and NDS and between them and coagulation function were investigated.

RESULTS

Two hundred and twenty-three patients with ACI were divided into six syndromes: wind syndrome (n=147, 65.92%), fire syndrome ( n=100, 44.84%), tan syndrome (n=123, 55.16%), blood stasis syndrome (n=78, 34.98%), deficiency of qi syndrome (n=31, 13.90%), and yin deficiency causing hyperactivity of yang syndrome (n=25, 11.21%). The wind, tan and fire syndromes were the main syndrome elements related to ACI. The scores of wind, fire, tan and deficiency of qi syndromes were positively related to NDS (r₁=0.207, P₁=0.002; r₂=0.284, P₂=0.000; r₃=0.245, P₃=0.000; r₄=0.152, P₄=0.023). The score of deficiency of qi syndrome was negatively correlated with PT (r=-0.170, P=0.011); and the scores of tan, blood stasis, and deficiency of qi syndromes were negatively correlated with APTT (r₁=-0.182, P₁=0.006; r₂=-0.148, P₂=0.027; r₃=-0.211, P₃=0.001).Other syndromes were not correlated to NDS or coagulation factors.

CONCLUSION

The neurologic function deficiency due to ACI is more likely influenced by wind, tan, and fire syndromes; deficiency of qi syndrome also has some effects. The syndromes of tan, blood stasis, and deficiency of qi are closely correlated with coagulation function, and their scores may reflect the clotting function in patients with ACI.

[Characteristics of gene expression of adrenal cortical steroid synthetase and its regulatory factor in mice with H22 liver cancer of different patterns]

OBJECTIVE

To study the characteristics of gene expression of adrenal cortical steroid synthetase and its regulatory factor in mice with H22 liver cancer of different patterns.

METHODS

Syndromes revealed in mice with H22 tumor were differentiated by quantified four diagnostic methods and syndrome differentiation, and mice with commonly encountered patterns (A: evil-toxin accumulation pattern, B: qi-deficiency pattern, C: yang-qi deficiency pattern and D: qi-yin-yang deficiency pattern) were screened out for subjecting to the study. Two batches of GeneChip Mouse Exon 1.0 ST Array detection were performed in the selected mice for detecting the gene expressions of adrenal cortical steroid synthetase and its regulatory factor, with the analysis performed put stress on the differential expressions in mice of various syndrome patterns.

RESULTS

Data obtained from the two batches detection showed well repeatability, in which similar genes of high or low expression emerged. The adrenal cortical steroid synthetase genes, such as Cyp11a1, Star, Cyp11b2, Cyp21a1, Hsd3b and Hsd17b were highly expressed, with few difference among the four patterns. However, Cyp11a1 was down-regulated and Cyp1b2 up-regulated in all patterns; Hsd3b1 and Cyp21a1 down-regulated in pattern A and B, but up-regulated in pattern C and D. As for the expressions of the relative regulatory factors, Cyb5b and Wnt4 were down-regulated but Fdx1, Fdxr, Hsd11b1, Por, Agt and Nr 0b1 were up-regulated in all patterns; Nr5al down-regulated in pattern A but up-regulated in other three patterns; Nr4al and Nr4a2 up-regulated in pattern A and down-regulated in the others.

CONCLUSIONS

The adrenal cortical steroid synthetase genes are rather conservative and stable in mice bearing H22 liver cancer, part of the expression might be correlated to the condition of disease and essence of syndromes, embodying the differences among different patterns in the same disease.

[Study on application of SELDI protein chip technique in diagnosis of systemic lupus erythematosus of yin deficiency caused internal heat syndrome]

OBJECTIVE

To investigate the application of surface-enhanced laser desorption ionization time-of-flight mass spectrometry (SELDI) protein chip in diagnosis and Chinese medicie syndrome type researching of systemic lupus erythematosus (SLE).

METHODS

Eighteen female SLE patients of mild/moderate degree with yin-deficiency caused internal heat syndrome (YDHS) were enrolled in the treatment group, and 15 women healthy volunteers was set up as the control group. Using SELDI method, the pre-, mid- and post-treatment peripheral blood mononuclear cell (PBMC) protein fingerprint of them was created respectively, which was then managed to screen out the markers by using ZUCI-PDAS package for establishing a diagnosis model.

RESULTS

Study was completed in 15 cases of the treatment group with 2 cases dropped out and 1 case lost. Before treatment, 44 protein peaks in the treatment group were found significantly different to those in the control group (P<0.01), and the sensitivity and specificity of the created models, 10542 Da m/z and 2554 Da m/z, reached 100%. After a 12-week treatment, 30 peaks were found significantly different between the two groups (P<0.01), and the sensitivity of 3365, 7104, 3882 and 6796 Da m/z created peak models was 100%, its specificity being 93.33%. Comparing the 35 samples (pre-, mid- and post-treatment) got from the treatment group with the 15 samples from the control group, significant difference was found in 55 peaks (P<0.01), the sensitivity and specificity of the 7103, 3882, 7143 Da m/z created peak models was 100% and 91.43% respectively.

CONCLUSION

Significant differences of PBMC protein expression patterns were found between SLE patients of YDHS and healthy persons at times of before, during and after treatment, suggesting that SELDI may be used as a new method to create the diagnosis model, and its application in effecter protein screening, activity scoring and Chinese medicine syndrome type researching are expectable and waiting for further study in depth.

[Analysis of Chinese medicine syndrome pattern in patients with type 2 diabetes mellitus and its relationship with diabetic chronic complications]

OBJECTIVE

To analyze the Chinese medicine (CM) syndrome pattern of patients with type 2 diabetes mellitus (DM2) and the relationship of CM patterns with the different blood glucose levels controlled and the incidences of diabetic chronic complications.

METHODS

CM syndromes in 557 DM2 patients were sorted into 7 patterns, A: the Fei-Wei yin-deficiency with exuberant heat pattern; B: the Pi-qi deficiency pattern; C: the Shen-qi deficiency pattern; D: the Pi-Shen qi-deficiency pattern; E: the Gan-Shen yin-deficiency pattern; F: the both qi-yin deficiency pattern; and G: the both yin-yang deficiency pattern, the concurrent or accompanied excessive syndromes were not taken as the indication for sorting. The blood glucose level, duration of illness and incidence of diabetic chronic complications in patients of different patterns were compared.

RESULTS

The CM syndrome patterns commonly encountered in mostly of the 557 patients was pattern F (in 264 patients, accounting for 47.4%); the next was pattern C (95 patients, 17.1%) and E (92 patients, 16.5%). The concurrent syndromes appeared in most patients was blood stasis (501 patients, 89.9%), Gan-qi stagnation was the second (225 patients, 40.4%), and the portion of damp-heat syndrome was also rather large (180 patients, 32.3%). The duration of diabetes mellitus for patients with various patterns was significantly different (P < 0.01), the longest appeared in patients of pattern G, followed by pattern D, C, F, and E in sequence, and patients of pattern A and B had a rather shorter duration. Level of fasting blood glucose was rather higher in patients of pattern A, C, D, F, and G than in those of pattern B and E. Level of glycosylated hemoglobin in patients of pattern G was the highest and in pattern A the second, while in pattern B and E was rather lower. Incidences of diabetic chronic complications, including diabetic peripheral neuropathy, diabetic retinopathy, diabetic nephropathy, cerebral infarction, and atherosclerosis in patients of pattern A and B were lower than in those of other 5 patterns (P < 0.05); but the highest incidence of multiple chronic complications revealed in pattern D and G, and that of coronary heart disease revealed in pattern C and G, all showed significant different as compared with other patterns (P < 0.01).

CONCLUSION

The most commonly encountered CM syndrome patterns in DM2 patients of early stage are pattern A and B; and those of middle stage are pattern C, D, E and F, various diabetic chronic complications may reveal in this stage; pattern G could be found in patients accompanied with multiple chronic complications and with uncontrolled blood glucose for a long time.

[Observation on therapeutic effect of "reducing south and reinforcing north" needling method on hypertension of type of yang-hyperactivity due to yin-deficiency]

OBJECTIVE

To observe therapeutic effect of "reducing south and reinforcing north" needling method on hypertension of type of yang-hyperactivity due to yin-deficiency,

METHODS

Ninety cases of hypertension were randomly divided into a treatment group (n=59) treated with "reducing south and reinforcing north" needling method, and a control group (n=31) treated with capoten and aspirin. Their therapeutic effects on symptoms and blood pressure were compared.

RESULTS

The total effective rate was 93.2% in the treatment group and 77.4% in the control group, the treatment group being better than the control group (P<0.05). After treatment, systolic pressure and diastolic pressure in the two groups decreased (P<0.05), but with no significant difference between the two groups in the therapeutic effect of reducing blood pressure (P>0.05).

CONCLUSION

"Reducing south and reinforcing north" needling method and oral administration of capoten and aspirin have similar effect in reducing blood pressure, and the treatment group is better than the control group in improving symptoms.

A survey comparing TCM diagnosis, health status and medical diagnosis in women undergoing assisted reproduction

INTRODUCTION

For many women, undergoing assisted reproductive technology can be a difficult experience, and can result in changes in physical and emotional health and wellbeing. Recent research has suggested that acupuncture may be helpful for women undergoing assisted reproductive technology. To date, there is no information describing the traditional Chinese medicine (TCM) syndromes seen in women undergoing assisted reproductive technology, or relationships between TCM and Western medicine diagnoses.

OBJECTIVE

To examine the health status of women undergoing assisted reproductive technology from both Western and Chinese medicine perspectives.

METHODS

One hundred and eighty women were included in the study. All underwent a TCM diagnosis, 177 (98.3%) completed the quality of life questionnaire SF36. Information about Western medicine diagnosis was collected from case notes and was available for 176 (97.7%) women.

RESULTS

Women in the trial reported poorer health on several domains of the SF36 compared with the South Australian population. The most common TCM diagnosis was 'Kidney Yang deficiency', diagnosed for 53.9% of patients. A TCM diagnosis of Qi or 'Blood stagnation' was associated with poorer quality of life on the mental health, emotional role function and social function domains of the SF36. No associations were found between TCM diagnosis and physical or general health components of the SF36.

CONCLUSIONS

Associations between TCM and reproductive health diagnoses were demonstrated. Emotional health and wellbeing is an important aspect of patient care that needs to be addressed in clinical practice and research studies, as the findings suggest that this aspect of their health is often poorer during assisted reproductive technology.

Expression of bcl-2 oncogene in gastric precancerous lesions and its correlation with syndromes in traditional Chinese medicine

AIM: To observe the protein and mRNA expression of bcl-2 oncogene in gastric precancerous lesions (GPL) and to analyze its correlation with syndromes in traditional Chinese medicine (TCM).

METHODS: Sixty-seven patients with GPL confirmed by gastroscopy and pathology were studied, including 39 cases of moderate gastric mucosal dysplasia, 19 cases of severe gastric mucosa dysplasia, 9 cases of incomplete colon metaplasia. In syndrome differentiation of TCM, 17 cases belonged to the syndrome of qi and yin deficiency of the spleen and stomach complicated by qi stagnation, 21 cases belonged to the syndrome of qi and yin deficiency of the spleen and stomach complicated by stomach heat, 29 cases belonged to the syndrome of qi and yin deficiency of the spleen and stomach complicated by blood stasis. Protein and mRNA expression of bcl-2 oncogene were detected by labeled streptavidin biotin (LSAB) immunohist-ochemistry and in situ hybridization respectively.

RESULTS: Abnormal expression of protein and mRNA on bcl-2 oncogene was found in GPL, which increased gradually with the course of lesions. In moderate and severe gastric mucosal dysplasia and incomplete colon metaplasia, there was no difference in the expression of bcl-2 oncogene (P>0.05). In different accompanying syndromes, the expression of protein and mRNA on bcl-2 oncogene increased gradually in the following order: deficiency of both qi and yin of the spleen and stomach accompanying qi stagnation → stomach heat → blood stasis. In GPL, compared with accompanying blood stasis, there was an obvious difference in the expression of bcl-2 oncogene between the syndrome of qi and yin deficiency of the spleen and stomach and accompanying stomach heat, so did accompanying qi stagnation (the level of protein: χ² = 8.45, P<0.05; the level of mRNA: χ² = 7.35, P<0.05).

CONCLUSION: Apoptosis-associated bcl-2 oncogene is abnormally expressed in GPL, which correlates with different accompanying syndromes in TCM.

[Comparative analysis on results of treadmill test in patients of coronary heart disease caused angina pectoris with Qi-Yin deficiency syndrome with or without accompanied phlegm and blood stasis syndrome]

OBJECTIVE

To explore the objective special features and role of various indexes of treadmill exercise test (TET) in patients of coronary heart disease (CHD) caused angina pectoris with Qi-Yin deficiency syndrome (QYD) with or without accompanied phlegm and blood stasis syndrome (PBS), to provide references for preventing and treating CHD in clinical practice.

METHODS

One hundred and one patients, whose diagnosis measured to the diagnostic standard and the inclusion criteria of angina pectoris and CHD, were classified according to their TCM syndrome type to two groups, the QYD without PBS group (49 cases) and the QYD with PBS group (52 cases). TET was conducted on all the patients. The relative parameters were measured and compared.

RESULTS

As compared with the QYD without PBS group, in the QYD with PBS group, (1) the TET positive rate was higher; (2) total exercise time was lesser; (3) the maximal metabolic equivalent (Max MET) was lower; (4) the average depression of ST segment at the exercise endpoint of test (mV) was higher; (5) the time of ST segment depressed for 0.1mV (min) was longer; (6) the metabolic equivalent during ST-segment depressed by 0.1mV was shorter; and (7) the change of QRS wave time-limit before and immediately after TET was more evident. Moreover, in the testing time more patients revealed angina episode after exercise, and less patients had their heart rate reached the requirement in the QYD with PBS group than those in the QYD without PBS group. Comparison between the two groups in all the above-mentioned indices showed significant difference respectively (P < 0.01 or P < 0.05).

CONCLUSION

Patients with CHD caused angina pectoris of QYD with PBS are worse in the tolerance for exercise and severer in pathological change of coronary artery than those in those without PBS, they belong to the severe phase of TCM syndrome.

[Effect of radix Rehmanniae preparata on the expression of c-fos and NGF in hippocampi and learning and memory in rats with damaged thalamic arcuate nucleus]

OBJECTIVE

To study the effect of Radix Rehmanniae Preparata (RRP) on improving the function of learning and memory.

METHOD

With injured thalamic arcuate nucleus rats induced by MSG, the improving function of RRP on learning and memory was observed by step down task and Morris water maze task, and the expression of c-fos and NGF in hippocampi was observed by immunohistochemical means.

RESULT

RRP could decrease the times of mistakes and prolong the incubation period in step down task, shorten the incubation period of seeking the platform, and improve the rate through the platform position in Morris water maze task. RRP could also increase the expression of hippocampal NGF, c-fos.

CONCLUSION

RRP could improve the function of learning and memory of MSG rats, and its mechanism may by related with the increase of the expression of hippocampal c-fos and NGF.

[Preliminary study on differentiation of syndromes during HDT -6 degrees bed rest with traditional chinese medicine]

Differentiation of syndromes during 21 d HDT -6 degrees bed rest was made in 15 healthy young men. The results indicated that the subjects showed mainly deficiency of kidney-Yin, deficiency of Yin and hyperactivity of Yang, insufficiency of spleen-Qi and blood stasis in various degrees during the bed rest. The syndromes were most serious on the 3rd day, and then deficiency of kidney and deficiency of Yin and hyperactivity of Yang became mild gradually but insufficiency of spleen-Qi and blood stasis remained the same. The pulse condition was normal through the bed rest period