Effects of mind-body exercise on body constitution and circadian rhythm in people with suboptimal health status

BACKGROUND

Suboptimal health status (SHS) is a dynamic state in which people have not been diagnosed with a disease but tend to develop diseases. People with SHS are more prone to conditions such as cardiovascular disease and metabolic syndrome. Suitable interventions in people with SHS can prevent disease development. SHS is correlated with traditional Chinese medicine (TCM)-based constitutions, including Yang-Xu (yang deficiency), Yin-Xu (yin deficiency), and stasis types. The circadian rhythm is a potential biomarker of health and metabolism. Baduanjin exercise, a kind of mind-body exercise, has been regarded to adjust body constitution and metabolism, but few studies have evaluated the effects of Baduanjin exercise on body constitution and circadian rhythms. Therefore, this randomized controlled trial investigated the effects of Baduanjin exercise on body constitution and circadian rhythms in people with SHS.

METHODS

Seventy-six participants with SHS were divided into the Baduanjin exercise and control groups (watching a Baduanjin video), with the interventions lasting 12 weeks. The Body Constitution Questionnaire (BCQ), SHS Questionnaire-25 (SHSQ-25), and actigraphy for circadian rhythm measurement were conducted.

RESULTS

The scores of SHSQ-25, Yang-Xu, Yin-Xu, and BCQ stasis decreased significantly after 12 weeks in the Baduanjin exercise group, but not in the control group. Interdaily stability of the circadian rhythm increased significantly in the Baduanjin exercise group but not in the control group.

CONCLUSION

This is the first report of improved health status, modulated body constitution, and increased interdaily stability of the circadian rhythm in participants with SHS who practiced Baduanjin exercise.

Review on the systems biology research of Yin-deficiency-heat syndrome in traditional Chinese medicine

Traditional Chinese medicine (TCM) is a systematic medical method that has existed for more than 3,000 years. Unlike Western medicine, the disease diagnosis in TCM is carried out by inspection, auscultation, olfaction, interrogation, and palpation. The patient is then treated according to the disease and corresponding TCM syndrome. However, the development of Chinese medicine is stagnated, partially because it can be influenced by subjective factors, such as the experience and knowledge of TCM practitioners, and there is a lack of relevant biological research on TCM syndromes. Yin-deficiency-heat (YDH) syndrome in TCM is characterized by a series of pathological changes caused by the insufficiency of Yin-fluid, inability to moisturize, and the failure to suppress Yang. In recent years, systems biology research on TCM syndromes has gradually become the focus of TCM research, including syndrome differentiation and functional research using systems biology methodologies such as proteomics, transcriptomics, and metabolomics. This journal aims to publish a series of issues on the systems biology research of TCM syndromes that can provide biological indicators for the syndrome differentiation of YDH syndrome and can provide perspectives on the biological research of YDH syndrome.

[Clinical symptoms and distribution characteristics traditional Chinese medicine syndromes of pulmonary nodules]

A cross-sectional study method combined with two types of traditional Chinese medicine(TCM) syndrome differentiation methods was adopted to investigate the clinical symptoms and distribution characteristics of TCM syndromes in patients with pulmonary nodules from the perspectives of number, size, nature, and stability of pulmonary nodules by using the χ~2 test, systematic clustering and Apriori algorithm correlation analysis. The common clinical symptoms of pulmonary nodules were fatigue(77.35%) and irritability(75.40%), and 40 symptoms were clustered into 3 groups(digestive system symptoms, respiratory system symptoms, and emotional and systemic symptoms) and 8 major symptom categories. The proportion of cold and heat in complexity syndrome(63.43%) was higher based on cold-heat syndrome differentiation. The top two syndromes were Qi deficiency syndrome(88.03%) and Qi depression syndrome(83.17%) based on disease syndrome differentiation. Yang deficiency syndrome(60.52%) was more than Yin deficiency syndrome(50.16%). There were higher proportions of phlegm syndrome(78.67%) and Yang deficiency syndrome(69.33%) of so-litary pulmonary nodules in terms of the number of pulmonary nodules. In terms of size, the proportion of phlegm syndrome decreased as the mean diameter of pulmonary nodules increased, while the proportions of Yang deficiency syndrome and blood stasis syndrome increased. The distribution of Qi depression syndrome was more in those with mean diameter<10 mm(85.02%, P=0.044) and cold syndrome was more in those with mean diameter ≥10 mm(16.67%, P=0.024). In terms of the nature of pulmonary nodules, the proportions of Qi depression syndrome and heat syndrome decreased with the increase in solid components of pulmonary nodules, while the proportions of Yin deficiency syndrome and cold and heat in complexity syndrome increased. The blood stasis syndrome accounted for a higher proportion of pulmonary nodules with solid components. In terms of the stability of pulmonary nodules, dampness syndrome(72.97%), blood stasis syndrome(37.84%), and cold and heat in complexity syndrome(70.27%) accounted for higher proportions. In addition, patients with new nodules presented higher proportions in Qi inversion syndrome(52.00%, P=0.007) and cold and heat in complexity syndrome(66.00%, P=0.008). Meanwhile, 11 syndromes were associated and 4 common compound syndromes were obtained(Qi deficiency and depression syndrome, Qi depression and phlegm coagulation syndrome, Qi deficiency and phlegm coagulation syndrome, and Qi deficiency and dampness obstruction syndrome). Qi deficiency syndrome and Qi depression syndrome could be associated with other syndromes. The results show that the main clinical symptoms of pulmonary nodules are fatigue and irritability. The main TCM syndromes of pulmonary nodules are Qi deficiency syndrome, Qi depression syndrome, Yang deficiency syndrome, and cold and heat in complexity syndrome. The distribution of TCM syndromes is significantly correlated with the size of pulmonary nodules and the presence or absence of new nodules. The common compound syndromes are Qi deficiency and depression syndrome, Qi depression and phlegm coagulation syndrome, Qi deficiency and phlegm coagulation syndrome, and Qi deficiency and dampness obstruction syndrome.

1H NMR serum metabolomics and its endogenous network pharmacological analysis of gushudan on kidney-yang-deficiency-syndrome rats

The pharmacodynamics, ¹H NMR metabolomics and endogenous network pharmacology strategy approaches were integrated to investigate the preventive mechanism of Gushudan (GSD) on kidney-yang-deficiency-syndrome (KYDS) rats in this study. Firstly, the KYDS rat model was achieved by hydrocortisone induction, and the efficacy of GSD on KYDS model rats was assessed by the pharmacodynamic indicators. Next, the comprehensive untargeted serum metabolic profile of rats was obtained in ¹H NMR metabolomics study, 29 potential biomarkers closely associated with KYDS were identified, which were mainly involved in carbohydrate metabolism, amino acid metabolism and intestinal flora metabolism. In addition, the potential biomarkers-targets-pathways-disease metabolic network was further investigated for deeper understanding the preventive effects of GSD on KYDS rats and its mechanism, which was further obtained for the important targets related to biomarkers and diseases such as NOS3, PTGS2 and CXCL8, and important metabolic pathways such as glyoxylate and dicarboxylate metabolism, arginine and proline metabolism, and microbial metabolism in diverse environments. Finally, compared with our previous anti-osteoporosis study of GSD, it suggested that some similar metabolic pathways, which would provide some scientific reference of the existence of the kidney-bone axis under the traditional Chinese medicine (TCM) theory of "kidney dominates bone".

Integrated Systems Pharmacology, Urinary Metabonomics, and Quantitative Real-Time PCR Analysis to Uncover Targets and Metabolic Pathways of the You-Gui Pill in Treating Kidney-Yang Deficiency Syndrome

Kidney-yang deficiency syndrome (KYDS) is a metabolic disease caused by a neuro-endocrine disorder. The You-gui pill (YGP) is a classic traditional Chinese medicine (TCM) formula for the treatment of KYDS and has been widely used to warm and recuperate KYDS clinically for hundreds of years in China. However, it is unknown whetherthe corresponding targets and metabolic pathways can also be found via using metabonomics based on one platform (e.g., 1H NMR) to study different biological samples of KYDS. At the same time, relevant reports on further molecular verification (e.g., RT-qPCR analysis) of these targets associated with biomarkers and metabolic pathways have not yet, to our knowledge, been seen in KYDS's research. In the present study, a comprehensive strategy integrating systems pharmacology and 1H NMR-based urinary metabonomics analysis was proposed to identify the target proteins and metabolic pathways that YGP acts on KYDS. Thereafter, further validation of target proteins in kidney tissue was performed through quantitative real-time PCR analysis (RT-qPCR). Furthermore, biochemical parameters and histopathological analysis were studied. As a result, seven target proteins (L-serine dehydratase; phosphoenolpyruvate carboxykinase; spermidine synthase; tyrosyl-tRNA synthetase, glutamine synthetase; 3-hydroxyacyl-CoA dehydrogenase; glycine amidinotransferase) in YGP were discovered to play a therapeutic role in KYDS via affecting eight metabolic pathways (glycine, serine and threonine metabolism; butanoate metabolism; TCA cycle, etc.). Importantly, three target proteins (i.e., 3-hydroxyacyl-CoA dehydrogenase; glutamine synthetase; and glycine amidinotransferase) and two metabolic pathways (butanoate metabolism and dicarboxylate metabolism) related to KYDS, to our knowledge, had been newly discovered in our study. The mechanism of action mainly involved energy metabolism, oxidative stress, ammonia metabolism, amino acid metabolism, and fatty acid metabolism. In short, our study demonstrated that targets and metabolic pathways for the treatment of KYDS by YGP can be effectively found via combining with systems pharmacology and urinary metabonomics. In addition to this, common and specific targets and metabolic pathways of KYDS treated by YGP can be found effectively by integration with the analysis of different biological samples (e.g., serum, urine, feces, and tissue). It is; therefore, important that this laid the foundation for deeper mechanism research and drug-targeted therapy of KYDS in future.

End-to-End syndrome differentiation of Yin deficiency and Yang deficiency in traditional Chinese medicine

BACKGROUND AND OBJECTIVE

Yin and Yang, two concepts adapted from classical Chinese philosophy, play a diagnostic role in Traditional Chinese Medicine (TCM). The Yin and Yang in harmonious balance indicate health, whereas imbalances to either side indicate unhealthiness, which may result in diseases. Yin-yang disharmony is considered to be the cause of pathological changes. Syndrome differentiation of yin-yang is crucial to clinical diagnosis. It lays a foundation for subsequent medical judgments, including therapeutic methods, and formula, among many others. However, because of the complexities of the mechanisms and manifestations of disease, it is difficult to exactly point out which one, yin or yang, is disharmonious. There has been inadequate research conducted on syndrome differentiation of yin and yang from a computational perspective. In this study, we present a computational method, viz. an end-to-end syndrome differentiation of yin deficiency and yang deficiency.

METHODS

Unlike most previous studies on syndrome differentiation, which use structured datasets, this study takes unstructured texts in medical records as its inputs. It models syndrome differentiation as a task of text classification. This study experiments on two state-of-the-art end-to-end algorithms for text classification, i.e. a classic convolutional neural network (CNN) and fastText. These two systems take the n-grams of several types of tokens as their inputs, including characters, terms, and words.

RESULTS

When evaluated on a data set with 7326 modern medical records in TCM, it is observed that CNN and fastText generally give rise to comparable performances. The best accuracy rate of 92.55% comes from the system taking inputs as raw as n-grams of characters. It implies that one can build at least a moderate system for the differentiation of yin deficiency and yang deficiency even if he has no glossary or tokenizer at hand.

CONCLUSIONS

This study has demonstrated the feasibility of using end-to-end text classification algorithms to differentiate yin deficiency and yang deficiency on unstructured medical records.

Traditional Chinese Medicine syndrome elements of male infertility revealed by latent tree model analysis

OBJECTIVE

To explore the features of Traditional Chinese Medicine (TCM) syndromes in male infertility using computer-based analyses.

METHODS

Latent class analysis was used to analyze the TCM syndrome data from 813 patients with male infertility and establish a latent tree model.

RESULTS

A latent tree model with a Bayesian information criterion score of -11 263 was created. This model revealed that the characteristics of basic TCM syndromes in patients with male infertility were kidney Yang deficiency, kidney Qi deficiency, spleen Yang deficiency, liver Qi stagnation, Qi stagnation and blood stasis, and dump-heat; moreover, most patients with male infertility had complex syndromes (spleen-kidney Yang deficiency and liver Qi stagnation) rather than simple single syndromes.

CONCLUSION

The hidden tree model analysis revealed the objective and quantitative complex relationships between the TCM symptoms of male infertility, and obtained the quantification and objective evidence of TCM syndromes in male infertility.

Integrative metabolic and microbial profiling on patients with Spleen-yang-deficiency syndrome

Gut microbiota is recognized as an indispensable "metabolic organ" that plays crucial roles in maintaining human health or initiating diseases. Spleen-yang-deficiency syndrome (SYDS) is a common syndrome of Traditional Chinese Medicine (TCM) clinic. It is a complex phenotype reflecting the overall changes of metabolism which are mainly caused by digestive disorders. However, little is known about the changes of gut microbiota and metabolism in patients with SYDS, as well as the crosstalk between gut microbiota and host metabolism. In the current study, an integrative metabolic and microbial profiling was performed on plasma, urine and feces from recruited SYDS and healthy individuals by using a LC-QTOFMS-based metabolomic and 16 s rRNA sequencing approaches. Our results showed a potentially significant contribution of gut dysbiosis to the metabolic disorders in SYDS. By integrating the differential gut bacteria with the metabolites, the results revealed some active bacterium of norank_f_CFT112H7, f_lachnospiraceae and bacteroides were closely involved in host mucosal integrity, bile acid metabolism and polysaccharides decomposition. Therefore, our results indicated the probable involvement of gut microbiota in mediating the metabolic changes, which warrants a further investigation on the role of gut microbiota in modulating the pathogenesis of SYDS.

[Correlation between TCM syndrome types and clinical symptoms of benign prostatic hyperplasia with chronic prostatitis]

OBJECTIVE

To investigate the correlation between the syndrome types of traditional Chinese medicine (TCM) and clinical symptoms of benign prostatic hyperplasia (BPH) with chronic prostatitis (BPH-CP).

METHODS

We selected 150 cases of BPH-CP in this study and divided them into 7 TCM syndrome types. Using univariate and multivariate logistic regression analyses, we studied the correlation of each TCM syndrome type with the age, disease course, prostate volume, postvoid residual urine volume (PVR), prostate-specific antigen (PSA) level, maximum urinary flow rate (Qmax), and International Prostate Symptoms Score (IPSS).

RESULTS

Kidney-yin deficiency was correlated positively with the prostate volume but negatively with Qmax and IPSS; kidney-yang deficiency positively with the age and prostate volume but negatively with IPSS; the damp heat syndrome positively with the PSA level but negatively with the disease course, prostate volume and Qmax; the spleen-qi deficiency syndrome positively with the prostate volume but negatively with the disease course; liver-qi stagnation positively with the disease course but negatively with the age, prostate volume and PVR; the syndrome of qi stagnation and blood stasis positively with the disease course and IPSS but negatively with PVR; the syndrome of lung-heat and qi blockage positively with the age, Qmax and IPSS but negatively with the disease course.

CONCLUSIONS

The TCM syndrome types of BPH-CP are closely correlated to their clinical symptoms. The analysis of the clinical objective indexes of BPH-CP can provide some reliable evidence for accurate identification of the TCM syndrome type of the disease.

[Clinical study on depression differentiated as yang deficiency treated with the combined therapy of ginger-isolated moxibustion and western medicine]

OBJECTIVE

To compare the differences in the clinical efficacy on depression differentiated as yang deficiency between the combined therapy of ginger-isolated moxibustion and escitalopram and the simple application escitalopram.

METHODS

Eighty patients of depression differentiated as yang deficiency were randomized into an observation group and a control group, 40 cases in each one. In the control group, escitalopram was prescribed for oral administration, 10 mg a day, after each breakfast. In the observation group, on the basis of the treatment as the control group, the ginger-isolated moxibustion was supplemented at Dazhui (GV 14) and bilateral back-shu points of five zang organs[Xinshu (BL 15), Ganshu (BL 18), Pishu (BL 20), Feishu (BL 13) and Shenshu (BL 23)]. Moxibustion was used 5 times a week. Twenty times of moxibustion were taken as one session and totally 3 sessions were required (totally 84 days). After 3 sessions of treatment, the concentration of serum 5-hydroxytryptamine (5-HT) before and after treatment and clinical efficacy were observed in the two groups. After 3 sessions of treatment, escitalopram was taken continuously, 10 mg a day for 9 months in the two groups and the recurrent rate was observed in a half year after discontinuity of medication in the two groups.

RESULTS

The total effective rate was 97.5% (39/40) in the observation group and was 92.5% (37/40) in the control group. The total effective rate was similar between the two groups (both P>0.05). The curative and remarkably effective rate was 82.5% (33/40) in the observation group, better than 62.5% (25/40) in the control group (P<0.05). The serum 5-HT after treatment was increased as compared with that before treatment in the patients of the two groups (both P<0.05), but the diffe-rence was not significant statistically between the two groups (P>0.05). The recurrent rate of depression was 7.7% (3/39) in the observation group, lower than 27.0% (10/37) in the control group (P<0.05).

CONCLUSIONS

The combined therapy of ginger-isolated moxibustion and escitalopram achieves the better curative and remarkably effective rate as compared with the simple western medicine and it significantly reduces the recurrence of depression.

[Relationship between Life Habits and Constitution Types of Chinese Medicine in the Senile Living at Home in Beijing Downtown]

OBJECTIVE

To investigate the distribution of constitution types of Chinese medicine (CM) in the elderly living at home in Beijing downtown, and to explore its relationship with life habits.

METHODS

A total of 3894 senile more than 60 years old were enrolled in this study. Their constitution types of CM were typed using CM constitution questionnaire. Meanwhile, their demographic features, disease condition, diet habits, exercise habits, sleep habits, and so on were investigated. Multivariate Logistic regression analysis was used to evaluate the relationship between life habits and constitution types of CM.

RESULTS

The number of mild type constitution senile was 1111 (28.53%) and the number of biased constitutions 2783 (71.47%). Biased constitutions of the top three were qi deficiency constitution (662, 17.00%), yang deficiency constitution (445, 11.43%), and blood stasis constitution (363, 9.32%). Univariate analysis showed that different habits of diet, exercise, and sleep exist among the senile of different constitutions (P < 0.05). By taking mild type constitution, multivariate Logistic regression analysis (except demographic indices and chronic history) showed that significantly positive correlation existed between qi deficiency constitution and favor for hot food (OR = 1.349, P = 0.015), yang deficiency constitution and favor for hot food (OR = 2.448, P < 0.01), phlegm-wetness constitution and favor for barbecue food (OR = 2.144, P = 0.003), wet-heat constitution and favor for sweet food (OR = 1.355, P = 0.032), wet-heat constitution and favor for tea (OR = 1.359, P = 0.047), blood stasis constitution and favor for hot food (OR = 1.422, P = 0.017), and qi depression constitution and favor for hot food (OR = 1.446, P = 0.031). Regular exercise had negative correlation with qi deficiency constitution (OR = 0.397, P < 0.01), yang deficiency constitution (OR = 0.522, P < 0.01) , phlegm-wetness constitution (OR = 0.475, P < 0.01), wet-heat constitution (OR = 0.647, P = 0.015), blood stasis constitution (OR = 0.608, P = 0.001), qi depression constitution (OR = 0.541, P = 0.001), and special diathesis constitution (OR = 0.466, P < 0.01). Early sleep and rise habit had negative with phlegm-wetness constitution (OR = 0.414, P < 0.01), wet-heat constitution (OR = 0.536, P = 0.015), blood stasis constitution (OR = 0.515, P = 0.004), and special diathesis constitution (OR = 0.526, P = 0.039).

CONCLUSIONS

Different constitution types of CM might be highly related to specific life habits. Cultivating better life habits can improve biased constitutions of CM.

[Correlation between Signs of Living Body in Abdominal and Pelvic Cavities and Syndrome Typing of Chinese Medicine in Colorectal Cancer Patients]

OBJECTIVE

To explore the correlation between signs of living body in abdominal and pelvic cavities and syndrome typing of Chinese medicine (CM) in colorectal cancer patients.

METHODS

Totally 112 colorectal cancer patients undergoing open abdominal surgery or laporoscopic surgery were syndrome typed as five types, i.e., inner-accumulation of damp and heat, blockage of stasis and toxin, Pi-Shen yang deficiency, blood-qi deficiency, Gan-Shen yin deficiency. Signs of living body in abdominal and pelvic cavities were collected. The correlation between signs of living body in abdominal and pelvic cavities and syndrome typing of CM were analyzed.

RESULTS

Red colorectal canals or mass were dominated in colorectal cancer patients with inner-accumulation of damp and heat syndrome. Dark purple colorectal canals or mass were dominated in colorectal cancer patients with blockage of stasis and toxin syndrome. Reddish colorectal canals or mass were dominated in colorectal cancer patients with blood-qi deficiency syndrome. Pale colorectal canals or mass were dominated in colorectal cancer patients with Pi-Shen yang deficiency syndrome. Whitish or red-white stripes were dominated in colorectal cancer patients with Gan-Shen yin deficiency syndrome. Dropsy colorectal canal was associated with Pi-Shen yang deficiency syndrome. Intracavitary effusion was often seen in colorectal cancer patients with inner-accumulation of damp and heat syndrome. The effusion was yellowish in less amount. Intracavitary adhesion was often seen in colorectal cancer patients with blockage of stasis and toxin syndrome. There was no correlation between the maximum diameter of mass or each syndrome type of CM.

CONCLUSION

There existed correlation between signs of living body in abdominal and pelvic cavities and syndrome typing of CM, which could be taken as one of references for syndrome typing of colorectal cancer patients.

[Distribution characteristics of basic syndromes of chronic functional constipation and its related factors analysis]

OBJECTIVE

To explore the distribution characteristics of basic syndromes and its related factors in patients with chronic functional constipation (CFC).

METHODS

The complete data of 538 patients with CFC were collected and initial database was established with Epidata 3. 0. TCM syndrome typing was performed. The distribution characteristics of basic syndromes were analyzed using SPSS 17. 0 Software. The univariate and multivariate Logistic regression analyses were performed with SPSS 17. 0 Software to determine basic syndrome related factors such as age, engaged professionals, sleep quality, depression, mental stress, interpersonal relations, work fatigue, stimulating beverage, exercise conditions, Western medicine type of constipation, and so on.

RESULTS

The TCM syndrome frequency of CFC patients was sequenced from high to low as qi deficiency syndrome (380 cases, 70.6%), qi stagnation syndrome (337 cases, 62.6%), blood deficiency syndrome (234 cases, 43.5%), yin deficiency syndrome (220 cases, 40.9%), yang deficiency syndrome (197 cases, 36.6%), and others(58 cases, 10. 8%) . Most patients were complicated with complex syndromes, and the most common complex syndromes were qi deficiency complicated qi stagnation syndrome (275 cases, 51.1%) and qi deficiency complicated blood deficiency syndrome (222 cases, 41.3%). Aging, work fatigue, and exercise conditions were main related factors for qi deficiency syndrome (P <0. 01, P <0. 05). Poor emotional (depression and anxiety tendencies), mental stress, interpersonal relations, defecation barriers constipation were main related factors for qi stagnation syndrome (P <0.01). Sleep quality and poor emotional (depression and anxiety tendencies) were main related factors for blood deficiency syndrome (P <0. 01, P < 0.05). Stimulating beverages were main related factor for yin deficiency syndrome (P <0.05). Engaged in mental work and slow transit constipation were main related factors for yang deficiency syndrome (P < 0. 01, P <0. 05).

CONCLUSIONS

CFC is featured as complex syndromes. The most common complex syndromes were qi deficiency complicated qi stagnation syndrome and qi deficiency complicated blood deficiency syndrome. Basic syndrome related factors such as age, engaged professionals, sleep quality, poor emotional (depression and anxiety tendencies), mental stress, interpersonal relations, work fatigue, stimulating beverage, exercise conditions, Western medicine type of constipation were associated with the distribution of CFC syndromes.

[Expert survey for Chinese medicine syndrome characteristics of different clinical types of coronary artery disease based on the Delphi method]

OBJECTIVE

To carry out expert survey for traditional Chinese medicine (TCM) syndrome characteristics of different clinical types of coronary artery disease (CAD).

METHODS

By using Delphi method, we carried out two rounds of nationwide expert surveys for modern TCM characteristics of syndrome elements and syndrome types of CAD.

RESULTS

Based on expert consensus, qi deficiency, blood stasis, phlegm turbidity, qi deficiency blood stasis, and intermingled phlegm and blood stasis are common TCM syndromes for different clinical types of CAD. Of them, qi stagnation, blood stasis, phlegm turbidity, heat accumulation, cold coagulation, yang deficiency, deficiency of both qi and yang were more often seen in patients with unstable angina than in those with stable angina. Qi deficiency, yin deficiency, and deficiency of both qi and yin were less seen. We could see more excess syndrome and less deficiency syndrome (such as qi deficiency, yin deficiency, etc.) in acute ST-segment elevation myocardial infarction (STEMI) than acute non-ST-segment elevation myocardial infarction (NSTEMI). Qi deficiency, blood stasis, water retention, yang deficiency, phlegm turbidity, yin deficiency, Xin-qi deficiency, and qi deficiency blood stasis induced water retention are the most common TCM syndrome types of CAD heart failure (HF). Blood deficiency, yin deficiency, heat accumulation, deficiency of both Xin and Pi, deficiency of both qi and blood, deficiency of both qi and yin, yin deficiency and fire hyperactivity were more often seen in CAD arrhythmias.

CONCLUSIONS

TCM syndrome distributions of different clinical types of CAD have common laws and individual characteristics. Results based on the expert consensus supplied evidence and support for clinical diagnosis and treatment of CAD.

Features analysis on Traditional Chinese Medicine syndromes in patients with diabetic peripheral neuropathy

OBJECTIVE

To study the features of the distribution and differentiation of Traditional Chinese Medicine (TCM) syndromes in patients with diabetic peripheral neuropathy (DPN).

METHODS

We collected clinical data on illness course, age, fasting blood glucose, saccharogenic hemoglobin, TCM syndromes, tongue, and pulse of 238 DPN patients. Differentiated main syndromes (Yin deficiency and exuberant heat, invasion of spleen by damp-heat, deficiency of both Qi and Yin, and deficiency of both Yin and Yang) and accompanying syndromes (blood stasis and phlegm-dampness) of diabetes were also recorded. The features of DPN syndromes were then analyzed.

RESULTS

Among the fourmain syndromes of diabetes, deficiency of both Yin and Yang was the most common in the 238DPN patients, of which 89%-96 had blood stasis.

CONCLUSION

The method of differentiating syndromes of diabetes can be applied to DPN patients. Deficiency of both Yin and Yang, often accompanied by blood stasis, is commonly seen.

[Chinese medical syndromes of rheumatoid arthritis: a clinical literature study]

OBJECTIVE

To explore the distribution features of Chinese medical syndromes of rheumatoid arthritis (RA) by literature retrieval.

METHODS

Pertinent articles on treating RA by syndrome differentiation were retrieved from China National Knowledge Infrastructure Databases (CNKI), VIP Chinese Biomedical Journal Database, Guizhou Digital Library, and Duxiu Chinese Academic Periodicals full papers database from January 2000 to December 2011.

RESULTS

A total of 33 documents were recruited covering 4 233 cases. Damp-heat blocking collaterals syndrome occupied the top in the occurrence frequency (20 times, 60.61%), followed by deficiency of Gan and Shen syndrome (18 times, 54.55%), intermingled phlegm and blood-stasis syndrome (17 times, 51.52%), wind-cold-damp impediment syndrome (15 times, 45.45%), cold-damp blocking collaterals syndrome (14 times, 42.42%), wind-damp-heat impediment and deficiency of qi and blood syndrome (10 times, 30.30%), and intermingled cold and heat syndrome (9 times, 27.27%). According to the case number of patients, it was sequenced as damp-heat blocking collaterals syndrome syndrome (768 cases, 18.14%), wind-damp-heat impediment syndrome(666 cases, 15.73%), wind-cold-damp impediment syndrome(584 cases, 13.80%), cold-damp blocking collaterals syndrome syndrome (517 cases, 12.21%), intermingled cold and heat syndrome (415 cases, 9.80%), intermingled phlegm and blood-stasis syndrome (364 cases, 8.60%), deficiency of Gan and Shen syndrome (235 cases, 5.55%),asthenia of healthy energy due to lingering arthralgia syndrome (223 cases, 5.27%). The case numbers of remaining syndromes did not exceed 5%.

CONCLUSION

Damp-heat blocking collaterals syndrome was the main syndrome in RA patients, followed by wind-cold-damp impediment syndrome,wind-damp-heat impediment syndrome,cold-damp blocking collaterals syndrome,intermingled phlegm and blood-stasis syndrome, and deficiency of Gan and Shen syndrome.

[Research on syndrome distribution features, etiologies, and pathogeneses of Japanese encephalitis]

OBJECTIVE

To explore Chinese medical syndrome distribution features of Japanese encephalitis (JE), and to analyze its correlation between syndromes and features of etiologies and pathogeneses.

METHODS

Recruited were 277 patients with confirmative diagnosis of JE from Wuhan Medical Treatment Center, Children's Hospital Affiliated to Chongqing Medical University, Fifth People's Hospital of Guiyang City, Hangzhou Sixth People's Hospital, and Chengdu Hospital of Infectious Diseases between July to September 2012. Chinese medical syndrome distribution features were summarized from their general materials and detailed records of clinical data, including medical history, symptoms and signs, tongue fur, and pulse figures.The frequency of symptoms and signs was calculated according to mild, ordinary, severe, extreme severe degrees. The distribution of Chinese medical syndromes was summarized. And its correlation between syndromes and features of etiologies and pathogeneses were analyzed.

RESULTS

After clustering analysis, Chinese medical syndromes of JE could be categorized as four groups: toxicity accumulation in Fei and Wei syndrome (TAFWS), brain collateral impaired by poison syndrome (BCIPS), depression of toxicity in the pericardium syndrome (DTPS), exhaustion of yin and yang syndrome (EYYS). BCIPS and DTPS were dominated, accounting for 74.0% (205 cases). The main causes covered evil of summer heat [accounting for 92.42% (256/277 cases)], heat [accounting for 87.73% (243/277 cases)], and toxin [accounting for 99.64% (276/277 cases)].

CONCLUSIONS

The four Chinese medical syndrome types of JE met Chinese medical clinical features of encephalitis. It is induced by infestation of dampness-heat, resulting in toxicity accumulation in Fei and Wei, brain collateral impaired by poison, depression of toxicity in the pericardium. Yin fluid and blood is exhausted as time goes by. Qi and yin are impaired to form intermingled deficiency and excess, and finally causing exhaustion of yin and yang.

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

OBJECTIVE

To study the correlation between various complications of chronic heart failure (CHF) patients and Chinese medical syndromes, thus indicating distribution laws of Chinese medical syndromes in various complications of CHF patients.

METHODS

Chinese medical syndrome typing was performed in 630 CHF patients by cross-sectional study of the demographic data, history of present diseases, related information on Chinese medical four diagnostic methods, and the distribution of complications. Logistic regression analysis was used to determine the correlation of various complications of CHF patients and Chinese medical syndromes.

RESULTS

In this study, recruited were common complications such as hypertension, diabetes, arrhythmia, hyperlipemia, and cerebral vascular accident, and so on. Main syndromes were sequenced as qi deficiency syndrome, blood stasis syndrome, water retention syndrome, yin deficiency syndrome, phlegm turbid syndrome, yang deficiency syndrome. Results of Logistic regression analysis indicated that correlation existed between common complications and Chinese medical syndromes. In CHF complicated hypertension patients, Logistic regression analysis showed qi deficiency syndrome and yang deficiency syndrome were negatively correlated with hypertension (P < 0.05). In CHF complicated diabetes patients, Logistic regression analysis showed phlegm turbid syndrome and water retention syndrome were positively correlated with diabetes (P < 0.05). In CHF complicated arrhythmia patients, there was no statistical difference in the distribution of each syndrome (P > 0.05). In CHF complicated hyperlipemia patients, Logistic regression analysis showed qi deficiency syndrome and water retention syndrome were negatively correlated with hyperlipemia (P < 0.05), while blood stasis syndrome, yin deficiency syndrome, and phlegm turbid syndrome were positively correlated with hyperlipemia (P < 0.01). In CHF complicated cerebral vascular accident patients, Logistic regression analysis showed qi deficiency syndrome and yang deficiency syndrome were negatively correlated with cerebral vascular accident (P < 0.01, P < 0.05).

CONCLUSIONS

There existed certain correlations between complications of CHF and the distribution of main Chinese medical syndromes. It could be used as guidance for treating CHF and its various complications by Chinese medicine and pharmacy.

[Analysis of clinical features of traditional Chinese medicine symptoms and syndromes of 220 patients with chronic aplastic anemia]

OBJECTIVE

To study Chinese medicine (CM) syndrome types of chronic aplastic anemia (CAA) patients and the distribution laws of typical CM symptoms in different genders.

METHODS

From June 2002 to June 2012, 220 CAA outpatients/inpatients at Department of Hematology, Zhejiang Chinese Medical Hospital were recruited. Patients' symptoms and signs, as well as four diagnostic information at the first onset were collected. CM syndrome differentiation was performed. The syndrome types and typical symptoms were analyzed.

RESULTS

(1) In the 220 CAA patients, there were 121 cases of Shen yang deficiency syndrome (55.0%), 18 of Shen yin deficiency syndrome type (8.18%), 81 cases of Shen yin-yang deficiency syndrome (36.82%). (2) The distribution of typical symptoms: fatigue and shortness of breath (77.12% males and 73.53% females), pale complexion (64.41% males and 57.84% females), low temperature of four limbs (12.71% males and 26.47% females), spontaneous perspiration and night sweating (32.20% males and 26.47% females), dry mouth and throat (6.78% males and 6.86% females), feverish feelings in palms and soles (14.41% males and 20.59% females), loose stool (6.78% males and 2.94% females), petechiae and ecchymosis (42.37% males and 43.14% females).

CONCLUSIONS

Shen yang deficiency syndrome was most often seen in CAA patients at the initial diagnosis, followed by Shen yin-yang deficiency syndrome. Shen yin deficiency syndrome was the least seen. In CM symptoms, fatigue and shortness of breath were most common seen, followed by pale complexion, skin petechia and ecchymosis.

[Cluster analysis on TCM syndrome characteristics of chronic hepatitis B]

OBJECTIVE

To explore the characteristics of Chinese medicine (CM) syndromes of chronic hepatitis B (CHB) in Sichuan area, thus providing referential evidence for objective research of CHB.

METHODS

According to the CRF chart, 1 064 CHB patients' four diagnostic information from 8 clinical units were recorded in Sichuan region using cross-sectional method. The laws of CHB syndrome characteristics were explored using the K-means clustering analysis method.

RESULTS

Based on the K-means cluster analysis, we found 8 categories that fulfill the clinical practice combined professional knowledge with experts' opinions. They were Pi-Wei dampness heat (326 cases, 30.6%), Gan and gallbladder dampness heat (193 cases, 18.1%), Gan and Pi dampness heat (158 cases, 14.8%), Gan depression and Pi deficiency (92 cases, 8.6%), Gan depression transforming into heat (89 cases, 8.4%), Pi deficiency with dampness encumbrance (74 cases, 7.0%), dampness-heat combined with yin deficiency of Gan and Shen (73 cases, 6.9%), yang deficiency mingled with blood stasis (59 cases, 5.5%).

CONCLUSION

The results of cluster analysis showed Pi-Wei dampness heat, Gan and gallbladder dampness heat, Gan and Pi dampness heat, Gan depression and Pi deficiency, Gan depression transforming into heat, Pi deficiency with dampness encumbrance, dampness-heat combined with yin deficiency of Gan and Shen, yang deficiency mingled with blood stasis were mainly syndromes of CHB patients in Sichuan area.

[Preliminary study on features of syndrome distribution and cluster analysis for AIDS patients with pulmonary infection]

OBJECTIVE

To investigate Chinese medical features of acquired immunodeficiency syndrome (AIDS) patients with pulmonary infection.

METHODS

Using cluster analysis method, Chinese medical syndromes of 196 AIDS patients with pulmonary infection were analyzed. The distribution features of each syndrome type were analyzed according to the severity and CD4+ numerical analysis.

RESULTS

Basic Chinese medical syndrome types could be summed up as three kinds: exterior invasion of wind heat and phlegm heat obstructing Fei syndrome (61 cases, 31.1%), Fei-Pi deficiency and Fei stagnation of phlegm syndrome (64 cases, 32.7%), Fei-Shen deficiency and yin deficiency induced inner heat syndrome (71 cases, 36.2%). There was statistical difference in the severity degree and the distribution of CD4 among the three syndrome types (P < 0.05).

CONCLUSIONS

AIDS patients with pulmonary infection involve Fei, Shen, and Pi. The pathogenic factors were related to "wind", "heat", "phlegm", and "xu". The Chinese medical syndrome distribution was closely correlated with patients' immunity.

[Observation of serum protein fingerprinting in primary liver cancer patients of different Chinese medical syndromes before and after interventional treatment]

OBJECTIVE

To explore changes of serum protein fingerprinting in primary liver cancer (PLC) patients of different Chinese medical syndromes before and after interventional treatment detected by surface enhanced laser desorption ionization time of flight mass spectrometry (SELDI-TOF-MS).

METHODS

Totally 154 PLC patients were assigned to 5 groups, i.e., Gan depression syndrome (GDS, 37 cases), Pi deficiency syndrome (PDS, 45 cases), dampness heat syndrome (DHS, 18 cases), blood stasis syndrome (BSS, 28 cases), yin deficiency syndrome (YDS, 26 cases). The mass spectra of serum proteins was analyzed by using SELDI-TOF-MS. Then the correlation between Chinese medical syndrome types and the mass spectra of serum proteins was explored before and after interventional treatment.

RESULTS

Compared with the healthy control group, the expression of serum proteins peak was down-regulated in GDS with M/Z being 6 589 and 4 182 Da, in DHS with M/Z being 5 710 Da, in YDS with M/ Z being 6 992 Da, while it was up-regulated in PDS with M/Z being 5 816 Da and in BSS with M/Z being 4 297 Da, showing statistical difference (P < 0.01). Compared with before intervention, the expression of serum proteins peak was down-regulated in GDS with M/Z being 6 589 and 4 182 Da, in PDS with M/Z being 5 816 Da, in DHS with M/Z being 5 710 Da in BSS with M/Z being 4 297 Da, while it was up-regulated in YDS with M/Z being 6 992 Da, showing statistical difference (P < 0.05, P < 0.01).

CONCLUSION

There was statistical difference in changes of serum protein fingerprinting in PLC patients of different Chinese medical syndromes before and after interventional treatment.

[Comparative analysis of clinical indicators of gout patients of different syndrome types and its significance]

OBJECTIVE

To understand the difference in clinical indicators of gout patients of different Chinese medical syndromes and its clinical significance.

METHODS

Form November 2011 to December 2012, syndrome typed were 257 male gout in-/outpatients from Affiliated Hospital of Chuanbei Medical College. Another 50 healthy male subjects were recruited as the control. Their clinical and laboratory data were collected. All were excluded from infections and other inflammatory diseases.

RESULTS

Four syndrome types existed in gout patients, i.e., intermingled phlegm-stasis blood syndrome (IPSBS), obstruction of dampness and heat syndrome (ODHS), Pi-deficiency induced dampness syndrome (PDIDS), qi-blood deficiency syndrome (QBDS). Of them, 53 acute phase gout patients suffered from IPSBS, 41 from ODHS, 25 from QBDS, and 17 from PDIDS; 41 non-acute phase gout patients suffered from QBDS, 40 from PDIDS, 24 from ODHS, and 16 from IPSBS. Statistical analysis of clinical data showed that, when compared with the normal control group, there was statistical difference in blood routines (WBC, GR, LY, MO) and blood biochemical indices (UA, Ur, Cr, ALT, AST, ALB, GLOB, TG, HDL-C, VLDL-C, apoA, apoB100) of gout patients of different syndromes (P < 0.05, P < 0.01). There was also statistical difference or correlation among different syndromes (P < 0.05).

CONCLUSIONS

In the acute phase gout patients, IPSBS and ODHS were dominated, while in the non-acute phase gout patients, QBDS and PDIDS were often seen. In patients of IPSBS and ODHS, inflammation and immune response were more obvious, indicating that better efficacy might be achieved by clearing heat and removing blood stasis associated anti-inflammatory and immune regulation therapies. In patients of QBDS and PDIDS, impaired renal functions were more significant, indicating that better efficacy might be achieved by invigorating Pi and tonifying Shen dominated treatment.

[Latent structure model evaluation of syndrome elements and features in 826 hypertriglyceridemia patients]

OBJECTIVE

To evaluate main Chinese medical syndrome elements and features of hypertriglyceridemia patients.

METHODS

Using latent structure model (LSM) method, the latent structure diagram of 826 hypertriglyceridemia patients were established. Hypertriglyceridemia syndrome elements and features were interpreted by using latent probability, conditional probability, mutual information, and cumulative information coverage to quantify symptoms/syndromes data,as well as using manual interpretation methods.

RESULTS

The accumulative information coverage rate reaching 95% was taken as the judgment standard for major syndrome elements. In the 826 hypertriglyceridemia patients, moderate and severe symptoms/syndromes (with the latent probability being 35% and 60% respectively) were dominant. The syndrome elements mainly included qi deficiency, qi stagnation,fire heat, stasis blood, yin deficiency, and yang deficiency. The main targets were dominated in Xin, Gan, and Shen.

CONCLUSION

LSM based syndrome element evaluation method could quantify the association degree of each variable (syndrome element; Chinese medical symptoms) and the occurrence probability.

[Analysis of associated rules between Chinese medical syndrome typing features of epigastric pain and endoscopic features]

OBJECTIVE

To explore Chinese medical syndrome typing features of epigastric pain and its association with gastroscopic manifestations.

METHODS

Using associated rules data mining method, an analysis study was performed in 234 patients with epigastric pain by combining holistic Chinese medical syndrome typing and results of gastroscopic examinations.

RESULTS

Pi-Wei deficiency cold syndrome (PWDCS) was associated with pale gastric mucosa, or superficial ulcers accompained with unobvious redness and swelling. Inversed Gan-qi invading Wei syndrome (IGIWS) was associated with bile regurgitation. Damp-heat stagnating in the middle jiao syndrome (DSMJS) was associated with obvious redness and swollen mucosa, or ulcers accompanied with yellow and white fur. Wei-yin exhaustion syndrome (WYES) was associated with coarse mucosa and exposed blood vessels, or rare mucus. Retention of blood stasis in Wei syndrome was associated with bulged swelling and erosion. Indigestion impairing Wei syndrome (IIWS) was associated with retention of water and food, or more mucus attached. The endoscopic manifestations of PWDCS and DSMJS occurred most frequently, while PWDCS and IGIWS ranked the first place in macroscopic Chinese medical syndrome typing.

CONCLUSIONS

The manifestations of endoscopic features were closely associated with Chinese medical syndrome typing. The syndrome typing features of epigastric pain could be objectively and further grasped by summarizing syndrome typing laws using modern devices such as gastroscopic examinations, thus improving the accuracy of clinical syndrome typing.

[Study on correlation between neuropsychological features and Chinese medical syndrome types in patients with Wilson's disease]

OBJECTIVE

To explore the correlation between neuropsychological features and Chinese medical syndrome types in Wilson's disease (WD) patients, thus providing evidence for early intervention by syndrome typing.

METHODS

Totally 96 WD patients were assigned to Gan-Dan damp-heat syndrome (GDDHS, 31 cases), Gan-Shen yin deficiency syndrome (GSYDS, 47 cases), and qi-blood deficiency syndrome (QBDS, 18 cases) by syndrome typing. Three items of neuropsychological testing were performed in them, i.e., Raven's standard progressive matrices (R'SPM), Stroop color-word test (CWT), trail making test (TMT). The correlations between the integrals of Chinese medical syndrome types and results of the 3 tests were analyzed.

RESULTS

(1) There was statistical difference in the total scores of R'SPM, the word interference time of CWT, and interference effects of TMT among the 3 syndrome types (P <0.01, P <0.05). There was statistical difference in the total scores of R'SPM and the word interference time of CWT in patients of QBDS, when compared with those of GDDHS and GSYDS (P <0.05). There was statistical difference in interference effects of TMT in patients of GDDHS, when compared with those of QBDS and GSYDS (P <0.05). (2) The integrals of the 3 syndrome types were negatively correlated with the total scores of R'SPM (P <0.01). The integral of GDDHS was significantly positively correlated with the interference effects of TMT (P <0.01). The integral of GSYDS was significantly positively correlated with TMT-B time consumption and interference effects of TMT (P <0. 05). The integral of QBDS was significantly positively correlated with the word interference time of CWT (P <0.05).

CONCLUSIONS

There was correlation between neuropsychological changes of WD patients and Chinese medical syndrome types. The severity of asthenia syndrome was sequenced from high to low as QBDS > GSYDS > GDDHS. The severity of asthenia was higher than that of asthenia.

[Research on the application role of yin-yang consumption theory in evaluating the inflammatory immune state and prognosis of patients with abdominal surgical]

OBJECTIVE

To study the differences of the inflammation immune state, severity, and prognosis of patients with abdominal surgical critical illness between yin consumption and yang consumption, to clarify the clinical application of yin-yang consumption theory in evaluating their inflammatory immune state, pathological severity, and prognosis.

METHODS

One hundred and forty-five patients with abdominal surgical critical illness were recruited from Surgical Intensive Care Unit, Tianjin Nankai Hospital from January 2007 to March 2010. According to syndrome typing, all patients were assigned to yang deficiency group (82 cases) and yin deficiency group (63 cases). The patient's vital signs were measured, including body temperature, pulse, respiration, mean arterial pressure (MAP), and so on. The acute physiology and chronic health evaluation II (APACHE II) score was performed. The patients' white blood cell (WBC) count, C-reactive protein (CRP), human leukocyte antigen DR-site (HLA-DR), as well as regulatory T lymphocytes (Treg) were determined. The CU length of stay, the total hospitalization time, the hospitalization cost, and the mortality, were also statistically recorded.

RESULTS

There was no statistical difference in gender, age, or primary disease between the two groups (P > 0.05) . The APACHE U score, the number of organ dysfunction, MAP, HLA-DR, the ICU length of stay, the total hospitalization time, and the hospitalization cost were significantly higher in yang deficiency group than in yin deficiency group (P < 0.05). But the body temperature, heart rate, respiration, WBC count, CRP, and Treg were significantly lower in yang deficiency group than in yin deficiency group (P < 0.05). There was no statistical difference in the mortality between the two groups (P > 0.05).

CONCLUSIONS

In the domain of abdominal surgical critical diseases, the differences in yang consumption and yin consumption of primary disease could help judge the severity of patient's condition and immunodissonance. Yin-yang consumption theory had stronger application value in assistant diagnosis and treatment.

[Exploring the pathogenesis and therapy of liver cancer from "damp-heat insidious pathogen" to "cancer toxin"]

From a macro-level analysis of the attributes and pathogenic features of HBV, the main pathogenic factor for chronic liver diseases including viral hepatitis, cirrhosis, and liver cancer, the concept of damp-heat insidious pathogen was obtained, according to which, in-depth discussions were undertaken. Adopting syndrome typing of Wei (defense), qi (vital energy), Ying (nutrients), and blood, the pathogens leading to different syndromes as well as new products such as pathological "sputum", "stasis" in the disease process were understood, and then, the pathological "sputum" and "stasis", as the hub, playing a role in chronic lesions of the liver collateral were explained. Finally the pathological "sputum" and "stasis" blend and form cancer toxin. Through a comprehensive understanding of the development of chronic liver diseases, it is clear that damp-heat insidious pathogen, as its initiating factor, always exists in the whole process. We summed up heat clearing, dampness resolving, and detoxification was the principle for treating chronic liver disease.

[Comparative proteomics analysis of the ileum of Pi-Yang deficiency model rats]

OBJECTIVE

Based on proteomics technology, Pi-yang deficiency syndrome (PYDS) correlated differential proteins were screened, thus providing powerful experiment reliance for exploring the essence of PYDS.

METHODS

Totally 36 SD rats of SPF grade were randomly divided into the normal control group (n = 16) and the PYDS group (n = 20). The PYDS model rats were induced by improper diet, overstrain, and administration of yang impairing bitter cold herbs. The total proteins of the ileum were separated and extracted from rats in the PYDS group and the normal control group. The differential protein dots were identified using Delyder 2D 6.5 image analysis software by two-dimensional gel electrophoresis (2-DE) technology. The finger print map of corresponding peptide qualities was obtained by applying MALDI TOF/TOF. The differential proteins were identified using Mascot search library.

RESULTS

Judged by statistics and fuzzy mathematics, Pi-yang deficiency rat model was successfully established. Eight proteins with differential expressions involving cell skeleton, energy metabolism, and signal transduction, and so on were obtained. Of them, there were 4 up-regulated proteins, i.e., desmin, cytokeratin8 (CK8), pyruvate kinase (PK), and ezrin. Four down-regulated proteins were glyceraldehyde-3-phosphate dehydrogenase (GAPDH), cytokeratin19 (CK19), cytokeratin1 (CK1), and actin.

CONCLUSION

The pathogenesis of PYDS might be slowed energy metabolism rate, reduced energy production, changed structure of ileal villin, and weakened absorbing and digestive functions.

[The Chinese medicine syndrome features of ulcerative colitis by using fluorescence intensity of auto fluorescence imaging]

OBJECTIVE

To study the Chinese medicine (CM) syndrome features of ulcerative colitis (UC) by using fluorescence intensity (the ratio of green to red, G/R ratio) of auto fluorescence imaging, thus providing objective evidences for the CM syndrome typing of UC.

METHODS

Totally 49 patients were recruited. They were typed as Dachang damp-heat syndrome (19 cases), Pi-Wei qi deficiency syndrome (30 cases), and the healthy control group (21 cases) on the bases of mucosal morphology of white light endoscopy (WLE) and the G/R ratio of AFI.

RESULTS

Compared with the healthy control group (1.227 +/- 0.137), the G/R ratio in Dachang damp-heat syndrome (0.915 +/- 0.114) and Pi-Wei qi deficiency syndrome (1.147 +/- 0.137) decreased with statistical difference (P < 0.05, P < 0.01). Of them, it was lower in Dachang damp-heat syndrome group (P < 0.01). The case number was mainly dominated in moderate endoscopic index (EI) (11 cases) and severe EI (5 cases) in Dachang damp-heat syndrome group. The case number was mainly dominated in the remission phase (17 cases) and mild EI (7 cases) in Pi-Wei qi deficiency syndrome group. The G/R ratio of the remission phase was higher than that of the active phase (1.220 vs. 0.963, P < 0.01). There was statistical difference in the G/R ratio of the mild EI (1.044), the moderate EI (0.967), and the severe EI (0.830) (P < 0.01).

CONCLUSIONS

The inflammation degree of Dachang damp-heat syndrome was more severe than that of Pi-Wei qi deficiency syndrome. AFI could better reflect the inflammation degree of UC.

[Study on the regional features of Chinese medicine etiology and pathogenesis of AIDS]

OBJECTIVE

To analyze the differences in the Chinese medicine (CM) etiology and pathogenesis of AIDS.

METHODS

A cross-sectional investigation study of AIDS patients and non-infected people was carried out in Henan, Guangdong and Xinjiang provinces respectively by questionnaire of clinical epidemiology and analyzed with frequencies of symptoms and signs combined with syndrome factors. The distribution differences of syndrome factors in the 3 provinces were compared.

RESULTS

Totally 321 cases were investigated in the 3 provinces. As for the syndrome factors of AIDS, qi deficiency, blood deficiency, yin deficiency, yang deficiency, dampness evil, phlegm, qi stagnation, essence deficiency, and so on were dominated in the 3 provinces, but with their own features. For example, the scores of dampness evil were higher in Guangdong Province. Yin deficiency was dominated in Xinjiang Province. The scores of Henan Province were generally higher. As for the location of syndrome factors, Shen, Fei, Pi, and Gan were dominated in the 3 provinces. The score of Pi was the highest in Guangdong Province, while the score of Shen was the highest in Henan and Xinjiang provinces.

CONCLUSIONS

AIDS has regional features in the nature and the syndrome factors of location in different provinces. It is necessary to take into consideration the regional factors when analyzing the pathogenesis of AIDS.

[Analyzing Chinese medicine syndromes of hematotoxicity reaction induced by highly active antiretroviral therapy]

OBJECTIVE

To investigate the main features of Chinese medicine (CM) syndromes and differences of hematotoxicity reaction induced by highly active antiretroviral therapy.

METHODS

The information of CM four diagnostic methods was collected by cross-sectional study. Their syndrome features were summed up and their differences were analyzed.

RESULTS

Of the 216 patients, the main syndromes were qi-blood deficiency syndrome (142 cases, accounting for 65.7%) and Pi-Shen yang deficiency syndrome (74 cases, accounting for 34.3%). The score of qi-blood deficiency syndrome was obviously lower than that of Pi-Shen yang deficiency syndrome (P < 0.05). The count of CD4+ T cells was higher in qi-blood deficiency syndrome than in Pi-Shen yang deficiency syndrome. There was no statistical difference in the serum viral load between the two groups (P > 0.05). The quality of life was higher in qi-blood deficiency syndrome than in Pi-Shen yang deficiency syndrome, but with no statistical difference (P > 0.05).

CONCLUSIONS

Qi-blood deficiency syndrome and Pi-Shen yang deficiency syndrome were main syndromes of hematotoxicity reaction induced by HAART. The pathogenic condition of qi-blood deficiency syndrome patients was milder. There was no obvious difference in the quality of life, CD4+ T cells, and the viral loads between two syndromes.

[Literature study on the syndrome diagnosis and classification of coronary artery disease]

To investigate the application of diagnosis methods for coronary artery disease (CAD) and the status quo of its syndrome typing. The literature content analysis was used in this study. The frequency statistics was performed by comprehensively collecting CAD (thoracic obstruction) syndrome typing correlated literatures, designing content analysis tables, extracting information such as typing methods, typing elements, and syndrome typing, and so on. Results showed that blood stasis, yin deficiency, qi deficiency, yang deficiency, phlegm turbidity, and other syndrome elements extensively exist in literatures concerning CAD syndrome typing. Modem doctors prefer to use syndrome typing of qi, blood, jinye, and eight principles in syndrome typing of CAD more frequently. The asthenia in origin and asthenia in superficiality has been widely recognized as the basic syndrome of CAD.

[Clinical investigation of Chinese medicine syndromes in two hundred girls of advanced puberty]

OBJECTIVE To analyze the Chinese medicine (CM) syndrome typing features for girls with advanced puberty.

METHODS

The CM symptoms of girls with advanced puberty in the Department of CM, Children's Hospital of Fudan University from March 2008 to March 2011 were recruited and statistically analyzed. The CM syndrome typing features were summed up.

RESULTS

Yin deficiency induced fire hyperactivity syndrome (174 cases, accounting for 87.0%) occupied the highest ratio in the main syndrome diagnosis, followed by Gan depression transforming into fire syndrome (25 cases, accounting for 12.5%) and the endoretention of damp heat syndrome (1 case, accounting for 0.5%). The mean rank of the 3 syndrome types was sequenced from yin deficiency induced fire hyperactivity syndrome (462.87), Gan depression transforming into fire syndrome (287.22), and the endoretention of damp heat syndrome (146.91). Of them 149 (accounting for 74.5%) girls were diagnosed with both yin deficiency induced fire hyperactivity syndrome and Gan depression transforming into fire syndrome. Yin deficiency induced fire hyperactivity syndrome accompanied with Gan depression transforming into fire syndrome was the most often seen (88 cases, accounting for 44.0%), followed by Gan depression transforming into fire syndrome accompanied with yin deficiency induced fire hyperactivity syndrome (46 cases, accounting for 23.0%).

CONCLUSIONS

Yin deficiency induced fire hyperactivity syndrome and Gan depression transforming into fire syndrome were the leading patterns of CM syndrome typing for girls with advanced puberty. It must not neglect their combinations in clinical syndrome typing.

[Clinical epidemiologic investigation on Chinese medicine syndrome laws in patients with chronic heart failure]

OBJECTIVE

To study the distribution laws of Chinese medicine syndromes in patients with chronic heart failure (CHF) by clinical epidemiologic investigation.

METHODS

512 CHF patients were studied, including 168 items of symptoms and 48 items of tongue and pulse pictures. A database of Chinese medicine syndromes was established, and 9 disease nature elements and 5 disease location elements were extracted. Frequency analysis was performed on all symptoms, tongue and pulse pictures. The variables with frequency constituent ratio less than 10.0% were deleted. Then the features of clinical epidemiology, syndrome patterns, syndrome elements, main symptoms, as well as tongue and pulse pictures were analyzed.

RESULTS

(1) The disease nature elements of CHF covered qi deficiency, yin deficiency, and yang deficiency (categorized as the essential deficiency), as well as blood stasis, turbid phlegm, and the retained fluid (categorized to the superficiality excess). Among them, frequencies of qi deficiency and blood stasis (both more than 85.0%) were the highest. The disease location elements of CHF were ordered in frequency as Xin (97.9%), Pi (88.1%), followed by Shen (43.0%), Fei (30. 1%), and Gan (7.0%). (2) In the distribution of syndrome patterns in CHF patients, qi deficiency phlegm-stasis syndrome was the most (59.2%), followed by qi-yin deficiency with phlegm-stasis intermingle syndrome (20.3%), Xin-yang decline with phlegm-stasis obstruction syndrome (7.0%), and yang-deficiency with water overflowing syndrome (5.5%). (3) Patients with heart function grade II, III, and IV mainly manifested as qi-deficiency with phlegm-stasis syndrome. Besides, qi-yin deficiency with phlegm-stasis intermingle syndrome could be often seen in those with grade III. And Xin-yang decline with phlegm-stasis obstruction syndrome and yang-deficiency with water overflowing syndrome could often be seen in those with grade IV.

CONCLUSIONS

The pathogenesis of CHF is essential deficiency and superficiality excess. The essentiality consists of qi deficiency, yin deficiency, and yang deficiency, and the superficiality consists of blood stasis, turbid phlegm, and retained fluid. The disease was located at the five zang-organs, mainly dominated at Xin and Pi, and associated with Fei, Shen, and Gan. Qi deficiency phlegm-stasis syndrome was dominated in Chinese medicine syndrome patterns. Along with the aggravation of CHF, Chinese medicine syndrome pattern shows certain development laws.

[Correlation between essential elements of Chinese medicine syndrome and the lung function in patients with acute aggravating chronic obstructive pulmonary disease]

OBJECTIVE

To study the correlation between essential elements of Chinese medicine syndrome (EECMS) and the lung function in patients with acute aggravating chronic obstructive pulmonary disease (AACOPD).

METHODS

Adopting clinical epidemiological method, the Chinese medicine syndrome of 199 AACOPD patients with various grades of the lung function was differentiated, and EECMS in them were picked up, summarized and analyzed statistically.

RESULTS

Along with the deteriorating of the lung ventilation, the EECMS of disease-position was progressed correspondingly, i.e. in patients with lung function of grade I, disease was positioned mainly on Fei (88.89%); in patients of grade II, on Fei-Shen (25.97%), Fei-Pi (9.09%), and Fei-Gan (3.90%); in those of grade III, on Fei-Shen (51.32%), Fei-Pi (7.89%), Fei-Pi-Shen (19.74%), and Fei-Pi-Shen-Xin (2.63%); in those of grade IV: on Fei-Shen (56.76%), Fei-Pi-Shen (27.03%). The EECMS of disease-property was also progressed, that for excessive syndromes were disposed as: grade I - II, phlegm (23.76%); grade III: phlegm-heat (30.26%), phlegm-stasis (15.79%), and phlegm-retention (9.21%); grade IV: phlegm-stasis (24.32%), phlegm-heat-stasis (29.73%), phlegm-retention-stasis (2.70%); and for deficiency syndromes were arranged as qi-deficiency --> qi-yin deficiency --> qi-yang deficiency --> qi-yin-yang deficiency.

CONCLUSION

The lung function could be taken as the objective and quantitative index for the progression of Chinese medicine syndromes in patients with AACOPD.

[Analysis of Chinese syndrome features and combination laws of 2029 patients with coronary heart disease angina]

OBJECTIVE

To explore the element distribution features and syndrome combination laws of coronary heart disease angina.

METHODS

The syndrome database of 2 029 patients with coronary heart disease angina was established to study the syndrome elements and syndrome combination laws.

RESULTS

(1) The syndrome element distribution of coronary heart disease angina was featured as: blood stasis > qi deficiency > phlegm turbid > yin deficiency > phlegm turbid with more warm property > yang deficiency > stagnant qi > phlegm turbid with more cold > cold coagulation. Of them, qi deficiency and blood stasis were the main two syndrome elements, and phlegm turbid with more warm and yin deficiency also occupied important positions. (2) Syndrome combination laws of coronary heart disease angina: three elements syndrome and two elements syndrome were dominant. The combination of sthenia syndrome element and asthenia syndrome element was the most important combination laws. Qi deficiency and blood stasis was the main combination form.

CONCLUSIONS

Qi deficiency, yin deficiency, phlegm turbid, and blood stasis form four key links of its pathogenesis, in which, qi deficiency and blood stasis was the most basic pathogenesis. The syndrome element combination had some laws.

[Basic pathogenesis of asthenia of healthy energy and blood stasis in liver cirrhosis studied by serum proteomics]

OBJECTIVE

To study the basic pathogenesis of "asthenia of healthy energy and blood stasis" in liver cirrhosis studied by Chinese syndromes and serum proteomics.

METHODS

The information of four methods of examinations and serum samples were collected from 44 cases of male cirrhotic patients and 17 cases of healthy male volunteers. The different syndrome groups were summarized according to syndrome differentiation and frequency analysis using the patient's information of four methods of examinations. The serum proteins were isolated by magnetic beads and detected by matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF-MS). The proteins expressed differently between cirrhotic patients of different syndrome types and healthy volunteers were analyzed by statistical analysis software (product of Bruker Corporation ClinProTools 2.1 software). The diagnosis model was established by QC algorithm.

RESULTS

The liver cirrhosis syndrome with the appearance frequency of more than 30% was sequenced from high to low as fatigue, listlessness, spider telangiectasia, liver palms, anorexia, bleeding from the nose, the gum or the subcutaneous tissue, the abdominal distention, shortness of breath while moving, dim facial complexion, pricking pain of the flank, weak waist and knees, dull pain in the flank, burning sensation of five centers, or low fever, hectic fever, and night sweat. The cases belonging to Child-Pugh A in the seventeen patients of the Pi-qi asthenia syndrome group accounted for 64.7%. The cases belonging to Child-Pugh C in the twelve patients of the Gan-Shen yin deficiency syndrome group accounted for 66.7%. The cases belonging to Child-Pugh A were similar to the cases belonging to Child-Pugh C in the fifteen patients of the blood stasis syndrome group, being more than 40%. Such syndromes as spider telangiectasia, liver palms, shortness of breath while moving, burning sensation of five centers, or low fever, hectic fever, and night sweat, varicose vein of the abdominal wall, and edema of lower extremities appeared more frequently in Child-Pugh C than in Child-Pugh A (all P < 0.05). The characteristic protein expression peak with mass-to-charge ratio of 4642.81, 4963.91, 5247.8, 5805.95, 6305.27, and 12447.7 in the Pi-qi asthenia syndrome diagnosis model were chosen. The former five peaks could be found in Child-Pugh A and Child-Pugh C. The protein expression peak with mass-to-charge ratio of 9 290. 3 was the characteristic protein expression peak in the Gan-Shen yin deficiency syndrome diagnosis model. The protein expression peak with mass-to-charge ratio of 9290.06 and 7 768. 29 were down-regulated in the Gan-Shen yin deficiency syndrome group compared with the other two syndromes groups. The protein expression peaks 9290.3 and 7768.29 were included in the diagnosis model of hepatitis B cirrhosis. They did not appear in Child-Pugh A, while they were gradually down-regulated in Child-Pugh B and Child-Pugh C. Of the other seventeen protein expression peaks in patients of the Gan-Shen yin deficiency syndrome, eight expressed in Child-Pugh A. The protein expression peaks 4964.55 and 5806.83 that expressed both in Child-Pugh A and Child-Pugh C constituted the characteristic protein peaks of the hepatitis B cirrhosis blood stasis diagnosis model. The diagnosis model of the Pi-qi asthenia syndrome was established with the sensitivity of 100% and the specificity of 82.35%. The diagnosis model of the Gan-Shen yin deficiency syndrome was established with the sensitivity of 100% and the specificity of 94.12%. The diagnosis model of the blood stasis syndrome was established with the sensitivity of 100% and the specificity of 100%.

CONCLUSIONS

Asthenia of healthy energy and blood stasis was the basic pathogenesis during the whole process of liver cirrhosis. Asthenia of healthy energy covers Pi-qi asthenia and Gan-Shen yin deficiency. Gan-Shen yin deficiency was obvious in the compensation stage of liver cirrhosis, but it has manifested in this stage. So early treatment was necessary.

[Correlation between serum thyroid hormone and dopamine levels and Chinese medicine syndrome types]

OBJECTIVE

To analyze the correlation between changes of thyroid hormone (TH), dopamine (DA) and Chinese medicine syndrome types by detecting contents of serum TH and DA in insomnia, thus to explore objective indices of Chinese medicine syndrome types.

METHODS

Insomnia patients were assigned to four Chinese medicine syndrome types groups, covering depressed Gan transforming into fire, internal disturbance by phlegm-heat, excessive fire due to yin deficiency, and Xin-Pi deficiency. One healthy control group was set up. Each group consisted of 30 patients or subjects. Serum DA content was determined using spectrophotofluorometry. Serum levels of 3,5,3'-triiodothyronine (T3) and tetraiodothyronine (T4) were detected using radioimmunoassay (RIA).

RESULTS

The serum levels of DA and TH showed difference among groups at various levels. The serum DA level was sequenced from high to low as the control group > the depressed Gan transforming into fire group > the excessive fire due to yin deficiency group > the internal disturbance by phlegm-heat group > the Xin-Pi deficiency group. The serum TH level was sequenced from high to low as the excessive fire due to yin deficiency group > the depressed Gan transforming into fire group > the internal disturbance by phlegm-heat group > the control group > the Xin-Pi deficiency group.

CONCLUSIONS

Serum DA levels in insomnia patients were in line with the disease course and the dynamic change from sthenia to asthenia in Chinese syndrome types. Serum DA levels, as one of pathological factors constituting the sthenia syndrome or the asthenia syndrome, may be taken as an objective indicator in Chinese medicine syndrome typing.

[Differential gene expressions in kidney Yang deficiency in individuals with sub-health status]

OBJECTIVE

To study the gene expression profiles in kidney Yang deficiency in individuals with sub-health status.

METHODS

The subjects identified to have Kidney-yang deficiency and sub-health status were enrolled in this study with healthy subjects as the normal control. Using gene chip technique and MAS software, the gene expression profiles in kidney Yang deficiency in the subjects with sub-health status were analyzed.

RESULTS

Characteristic profiles of the differentially expressed genes were found between the kidney Yang deficiency group and normal control group. Among the total of 75 differentially expressed genes, 22 were up-regulated (with a ratio greater than 2) and 53 were down-regulated (with a ratio less than 0.5) in kidney Yang deficiency group.

CONCLUSION

Gene chip technique allows rapid and high-throughput screening for gene expression in kidney Yang deficiency and sub-health status, and a initial evidence of kidney Yang deficiency-related genes has been obtained.

[Study on Chinese medical syndrome identification in patients with post-hepatitis cirrhosis by soft independent modelling of class analogy]

OBJECTIVE

To explore the feasibility of Chinese medical syndrome identification in patients with post-hepatitis cirrhosis (PHC) by soft independent modeling of class analogy (SIMCA).

METHODS

After variants were normalized, SIMCA was used to analyze clinical symptoms, physical signs, and biological parameters in 268 PHC patients, and the obtained distance of SIMCA was used to identify the syndromes of PHC. Some incorrect reasons were then tested by Mann-Whitney test.

RESULTS

The recognition rates of 5 Chinese medical syndromes (Gan depression and Pi deficiency syndrome, Gan-Shen yin-deficiency syndrome, Pi-Shen yang-deficiency syndrome, inner accumulation of dampness-heat syndrome, and stasis-heat accumulation syndrome) were 72.9% in the nearest class, and 17.91% in the sub-near class, as well as the total recognition rate was 90.3%. The highest recognition rate (95.24%) presented in the recognition on Gan-Shen yin-deficiency syndrome. Among some vital symptom variants of nearest class, significant difference could be found between identified and un-identified syndromes (P < 0.05).

CONCLUSION

Identification of Chinese medical syndromes by SIMCA has rather higher goodness-of-fit with clinical practice, to set up a SIMCA depended syndrome identifying system could offer a useful reference for Chinese medical syndrome identification.

[Mathematical analysis of characteristics of glucocorticoid-induced yang deficiency or yin deficiency syndrome in animal models based on information entropy theory]

OBJECTIVE

Based on information entropy theory, this study analyzes the experimental indicators of glucocorticoid-induced traditional Chinese medicine yang deficiency or yin deficiency syndrome in animal models, thus laying the foundation of defining and interpreting the model state.

METHODS

Data of biochemical indicators from 24 groups of animal models with different modeling conditions (type of modeling agent, dosage of modeling agent and modeling time) were collected. Information gain values for three study objects (type of modeling agent, dosage of modeling agent and modeling time) were calculated respectively after standardization, and then characteristics of yang deficiency or yin deficiency syndrome models were interpreted with these values and ranking map.

RESULTS

Greatest information gain values of most indicators were got when the study object was the type of modeling agent, which is the most important factor in the differentiation of model state. With this study object, triglyceride (TG), total cholesterol (TC), total protein (TP), albumin (ALB), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and corticosteroid (CS) got larger information gain values than testosterone (T), lactic dehydrogenase (LDH), and cyclic adenosine monophosphate (cAMP). This indicated that the former seven indicators may be significantly different between the two animal models induced by hydrocortisone and dexamethasone, respectively. In the study of the modeling time, AST may be affected more than others. In the study of the dosage of modeling agent, TC and ALB may be affected more in the model of hydrocortisone and no indicators were significantly affected by the dosage of modeling agent in the dexamethasone model.

CONCLUSION

Mathematical method based on information entropy theory allows researchers to analyze experimental data in several experiments at the same time and to interpret the trend and stability of indicators. Based on this study and by analyzing the impacts of different modeling conditions on the indicators, elucidations of the characteristics of glucocorticoid-induced yang deficiency or yin deficiency syndrome in animal models and some biochemical indicators for model comparison are in need.

[Study on the relation between Pi-deficiency pattern and metabolic syndrome in patients with polycystic ovarian syndrome]

OBJECTIVE

To evaluate the relation between Pi-deficiency syndrome (PDS) pattern and metabolic syndrome (MS) in patients with polycystic ovarian syndrome (PCOS), for exploring their internal pathologic mechanism.

METHODS

Among the 102 PCOS patients, 22 complicated with MS (PCOS-MS) and 80 not complicated with MS (PCOS-NMS), the Chinese medicine syndrome pattern was differentiated as PDS in 50 patients and non-PDS in 52. The clinical data, in terms of fasting blood glucose (FBG), fasting insulin (FINS), waistline, body weight (BW), stature, blood pressure (BP), etc. was collected and compared and the relation between data was analyzed.

RESULTS

Levels of FINS and homeostasis model of assessment for insulin resistence index (HOMA-IR), in PCOS-MS patients were significantly higher than those in PCOS-NMS patients, also higher in patients of PDS pattern than those of non-PDS pattern (P < 0.01); the occurrences of MS and PDS were highly positively correlated with levels of FINS and HOMA-IR (P < 0.01); incidence of MS in patients of PDS pattern was significantly higher than those in patients of non-PDS pattern (P < 0.05); presenting of PDS was positively related with the existence of MS (P < 0.05), but in case of the FINS or HOMA-IR factor being controlled, statistical meaning of the relativity between them turned to insignificant (P > 0.05).

CONCLUSIONS

PCOS patients of PDS pattern are the high-risk population of MS, which might be related with the insulin resistance. So, early treatment of PCOS, especially on patients of PDS pattern, is of important significance for preventing the complication, as MS, of the disease.

Traditional Chinese medicine in diagnosis and treatment of fibromyalgia syndrome

Fibromyalgia Syndrome (FS) is known for the difficulties arising from classification. The accompanying pain in skeletal muscles, myofascial peri-articular structures and a number of polymorphic symptoms cannot be separated into complexes of symptoms. The application of principles of Traditional Chinese Medicine (TCM) helps in analyzing the symptoms of FS to detect a leading syndrome and thereby establish an individual therapy. Medical histories and objective examinations of 25 patients with FS and 22 patients with vertebrogenic pain syndromes were analyzed according to TCM. A questionnaire was used to determine the leading constitutional type according to the 5-elements-theory. Analyses of the results showed that 83% of patients with FS were of constitutional type of the element earth. The following syndromes were found to be important in FS: 1) liver-Qi-stagnation, 2) Yin and blood deficiency of the liver, 3) Yang-weakness of the spleen and kidney, 4) Yin-weakness of the kidney. Applying TCM for FS allows for separating a group of symptoms and thus individual therapy. The determination of the constitutional type according to the 5-elements-theory may be used for a better understanding of the disharmony pattern.

[Relationship between body fat and beta-cell function in obesity women of PI-deficiency with phlegm-dampness type and QI-stagnancy with phlegm-blocking type]

OBJECTIVE

To analyze the relationship between body fat and beta-cell function in obesity women of Pi-deficiency with phlegm-dampness type (PDPD) and qi-stagnancy with phlegm-blocking type (QSPB).

METHODS

Sixty women, who had normal blood glucose level and without family history of diabetes, were enrolled. They were classified into non-obesity group and obesity group depending on their body mass index (BMI), and subjects of obesity group were differentiated into the PDPD type and QSPB type according to Chinese medicine syndrome differentiation. The body fat was detected using double energy X-ray absorptiometry, and the beta-cell function was assessed by measuring the acute insulin response (AIR), the under insulin curve area (AUCins), the under glucose curve area (AUCglu), and their ratio (AUCins/AUCglu), through intravenous glucose tolerance test (IVGTT).

RESULTS

BMI, body fat and waist circumference (Wf) were higher in obesity subjects than those in non-obesity subjects, but showed no significant difference between the two obesity types. Comparisons between obesity women of different types showed that the fat content of trunk and total body, the ratio of trunk fat/total mass, AIR, AUCins, and AUCins/AUCglu were all higher in QSPB than those in PDPD. AIR, AUCins, AUCins/AUCglu showed good correlation with BMI, Wf, trunk fat and total body fat contents. Multiple linear regression analysis demonstrated the increasing of trunk fat content was an influencing factor of AIR.

CONCLUSION

Obesity women of QSPB type possess higher body fat (especially the trunk fat) content and insulin resistance with high acute insulin response, so clinical intervention should dominantly pay attention to subjects with QSPB type of obesity.

[Relationship between Chinese medicine syndrome type and mRNA expressions of IL-10, IL-18 and Fas in peripheral blood mononuclear cells in patients with systemic lupus erythematosus]

OBJECTIVE

To explore the mRNA expressions of IL-10, IL-18 and Fas in peripheral blood mononuclear cells (PBMCs) in systemic lupus erythematosus (SLE) patients of various Chinese medicine syndrome types in order to seek the objective indices for syndrome differentiation of SLE.

METHODS

SLE patients were sorted into various syndrome types by Chinese medicine syndrome differentiation. In them, patients with the 4 often encountered types were selected, i.e. the qi-xue excessive heat type (Group A, 12 patients), the Pi-Shen yang-deficiency type (Group B, 19 patients), the qi-yin deficiency with blood stasis type (Group C, 23 patients), and the qi stagnation and blood stasis with gan stagnation type (Group D, 28 patients). The mRNA expressions of IL-10, IL-18 and Fas in PBMCs were detected by SYBR Green I real time PCR.

RESULTS

The mRNA expressions of IL-10, IL-18 and Fas in PBMC of all SLE patients (0.40 +/- 0.53, 1.41 +/- 1.93 and 0.33 +/- 0.70) were significantly higher than those in the normal control group (0.07 +/- 0.11, 0.24 +/- 0.25, 0.08 +/- 0.21, P<0.01, P<0.05), their levels in different syndrome types decreased in order of type A-->B-->C-->D. The levels of the three indices in patients of type A and B were obviously higher than those in patients of type C and D (P<0.01), while no significant difference was found between type A and B (P>0.05), and between type C and D (P>0.05).

CONCLUSION

The mRNA expressions of IL-10, IL-18 and Fas in PBMCs could be taken as the objective indices for reference in syndrome differentiation of SLE.

[Epidemiologic study on basic TCM syndrome in the subhealth population in the Zhengzhou area]

OBJECTIVE

To study the distribution characteristics of clinical manifestation and TCM basic syndromes in the subhealth population.

METHODS

The investigation list for basic syndrome of subhealth used in the study was formulated through retrieving a large amount of literatures, referring to principles of epidemiology, computer science, mathematics and international metrics, and according to the standard denoting figure of GR/T 1.1-2000 and ZY/T001.1-94. The data obtained were analyzed by the statistical methods like multiple factor analysis and cluster analysis to explore the distribution of main symptoms and syndromes in the subhealth condition.

RESULTS

The analysis of data from 2,133 lists showed that in the Zhengzhou area, the main clinical symptoms presented in the subhealth population were aversion to cold, fatigue, spontaneous perspiration, poor memory, bad-temper, short breath, palpitation, etc.; with the syndrome key elements of deficiency, dampness, phlegm, stagnancy, stasis, qi-stagnation, and body fluid loss; the dysfunction of zang-fu organs was mainly observed in Xin, Pi, Shen, Gan, Dan, Wei, Fei, etc.; and the most commonly encountered basic syndromes were Xin-Pi deficiency, Xin-Shen deficiency, Gan-qi stagnation, Pi insufficiency with dampness stagnation, phlegm-qi cementation, Shen-yin deficiency, Shen-yang deficiency, qi insufficiency, Gan-stagnancy transforming to fire, damp-heat accumulation, etc.

CONCLUSION

The clinical manifestation of the subhealth population in the Zhengzhou area is characterized by a syndrome composed of a certain main symptom with some other accompanied symptoms, the distribution of the basic syndrome is mainly dominated by the deficiency syndrome.

[Establishment and analysis of serum two-dimensional gel electrophoresis profiles of myasthenia gravis patients with spleen and kidney deficiency syndrome]

OBJECTIVE

The purpose of this study was to establish two-dimensional gel electrophoresis (2-DE) profiles of serum of myasthenia gravis patients, and to identify the differential proteomic expressions between normal persons and myasthenia gravis patients with spleen and kidney deficiency syndrome.

METHODS

Samples of serum protein were extracted by repeated freeze-thaw method and separated by two-dimensional electrophoresis. Differential proteomic expressions between the myasthenia gravis patients and the normal control persons were identified by two-dimensional polyacrylamide gel electrophoresis, silver staining, image-master 2-DE software analysis, peptide mass fingerprinting based on matrix assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS), BioWorks and NCBI software database searching.

RESULTS

The two-dimensional polyacrylamide gel electrophoresis profiles of serum proteins were successfully established by 2-DE. Twenty-one of the significant differential proteins were selected and identified by MALDI-TOF-MS. Eight of them were finally identified.

CONCLUSIONS

The 2-DE profiles of serum proteins were established and the differential proteomic expressions were identified by proteome technique in our study. This can be an experimental basis for further research of the pathogenesis and treatment of myasthenia gravis.

[Establishment of a quantitative mathematical model of Shen-deficiency syndrome based on whole-genome transcriptional profiles]

OBJECTIVE

To establish a quantitative mathematical model of Shen-deficiency syndrome of TCM by utilizing whole-genome transcriptional profiles.

METHODS

The 4, 10, 18, 24 months old SD rats were used, 24-months aged rats intervened by Epimedium Flavonoids (EF) were adopted in the experiment. Rats' hypothalamus, pituitary, adrenal, lymphocytes, bone, liver, and kidney, and spleen were taken for determining whole-genome mRNA expression with gene chip, and a quantitative nerve network model was established by utilizing the gene expression profile of different aged rats, then the model was used to evaluate the effects of EF on Shen-deficiency syndrome.

RESULTS

Totally 199 genes showing age-dependent characteristics were screened out from the 7 kinds of tissue, most of them were neuro-endocrine immune related genes. Evaluation based on the mathematical model showed the age of hypothalamus, pituitary, adrenal, liver, kidney, bone, and spleen in the 24-months rats after EF intervention was 12.64, 10.87, 8.10, 12.70, 11.93, 13.14, and 10.13 months, respectively.

CONCLUSION

A quantitative mathematical model can be established based on the gene expression profile, it is suitable for estimating the efficacy of Shen-tonifying drugs. EF can make the gene expression of elder close to the young state, suggesting that EF has action in improving Shen-deficiency syndrome and delaying senescence.

[Effect of Penqiangyan Granule on the immune function of patients with chronic pelvic inflammatory disease of blood-stasis and Shen-deficiency syndrome type]

OBJECTIVE

To explore the effect of Penqiangyan Granule (PG) on the immunity of patients with chronic pelvic inflammatory disease (CPID) of blood stasis and Shen-deficiency syndrome (BSSDS) type.

METHODS

Sixty patients were randomly assigned to two groups: the treatment group treated with PG and the control group with Penyanjing Granule, 30 cases in each group. The treatment course was 4 weeks for both groups. The clinical efficacy, plasma levels of CD4 and CD8, and the serum levels of tumor necrosis factor-alpha (TNF-alpha) and interleukin-2 (IL-2) were measured before and after treatment.

RESULTS

After treatment, the total effective rate in the treatment group and the control group was 96.7% and 63.3% respectively with significant difference between groups (P < 0.05); in the treatment group the plasma CD4, CD4/CD8 and serum IL-2 increased obviously, while the plasma CD8 and serum TNF-alpha decreased markedly (P < 0.05), all were significantly different with those in the control group (P < 0.05).

CONCLUSION

PG can improve the immune function and alleviate inflammation in CPID patients of BSSDS type.