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[Study on correlation of insulin resistance with TCM syndrome type and activity of fibrinolytic system in patients with coronary arterial disease].

OBJECTIVE: To study the correlation of insulin resistance (IR) with TCM syndrome type and activity of fibrinolytic system in patients with coronary arterial disease (CAD). METHODS: One hundred and twelve CAD patients were classified according to TCM Syndrome into 4 types, the Xin-blood stasis (XBS) type, the phelgm blocking Xin-channel (PBXC) type, the Qi-insufficiency with blood stasis (QIBS) type and the both Qi-Yin deficiency (QYD) type. Patients' fasting blood glucose (FBG), fasting blood insulin (FIns) were measured, the insulin sensitive index (ISI) calculated. Data were compared between various types, also with those obtained from 30 healthy persons in the control group respectively. Moreover, activity of tissue plasminogen activator (t-PA) and content of plasminogen activator inhibitor-1 (PAI-1) were determined in 90 patients selected from the 112 to conduct linear correlation analysis of IR with t-PA activity and PAI-1 content. RESULTS: FBG and FIns levels in the CAD patients were higher than those in the healthy control significantly (P < 0.01); ISI in the 4 syndrome type of CAD patients were all lower than that in the control (P < 0.01). IR existed in all the 4 types, but the level in the XBS type and the PBXC type was more severe than in the other two types. Correlation analysis showed that IR was correlated with t-PA activity and PAI-1 content (P < 0.01). CONCLUSION: IR often exists in CAD patients, the severity of IR varies in patients of different TCM syndrome types, and IR is correlated with the abnormality of fibrinolytic system activity.

Adult↗

[Relationship of plasma endotoxin level with TCM deficiency/excess syndrome and grading/staging of pathologic change of liver in patients with chronic hepatitis].

OBJECTIVE: To explore the relationship of plasma endotoxin level with TCM deficiency/excess Syndrome and the grading/staging of pathologic change of liver in patients with chronic hepatitis B (CHB). METHODS: Plasma level of endotoxin (ET) was determined using chromogenic limulus amebocyte lysate (LAL) assay in 75 patients with chronic hepatitis B (30 of excess dominance, 45 of deficiency dominance) and also in 15 healthy subjects for control. Moreover, pathological examination on liver biopsy of 20 patients was conducted. RESULTS: (1) ET level increased in all CHB patients, and the increment was higher in patients of excess dominance than that in patients of deficiency dominance, showing significant difference (P < 0.01). (2) Correlation between ET level and liver pathological grading/staging was shown in CHB patients. CONCLUSION: Plasma level of ET could be taken as one of the criteria of TCM microcosmic diagnosis in differentiating deficiency/excess syndrome. (2) Endotoxemia plays an important role in pathologic process of liver injury.

Adolescent↗

[Study on relationship between TCM Syndrome types (Xin-qi and Xin-yang deficiency) and contents of cytokines (tumor necrosis factor-alpha and interleukins) in patients with congestive heart failure].

OBJECTIVE: To explore the relationship between TCM Syndromes types, Xin-qi deficiency (XQD) and Xin-yang deficiency (XYD), and contents of cytokines, including tumor necrosis factor alpha (TNF-alpha), interleukin-6 (IL-6), IL-1beta and IL-10 in patients with congestive heart failure (CHF). METHODS: Sixty-seven CHF in-patients with Xin-qi deficiency or Xin-yang deficiency syndrome were enrolled, their NYHA (New York Heart Association) cardiac function was assessed, ejection fraction (EF) and E peak/A peak (E/A) ratio were determined by Doppler ultrasonic echocardiograph, and serum TNF-alpha, II-6, IL-1beta and IL-10 were measured by double antibody sandwich ELISA assay. RESULTS: The cardiac function grading in patients of XQD was mostly of I and II grade, while that in patients of XYD was mostly of III and IV grade (by Ridit analysis, P<0.01). The E/A and EF values were higher in patients of XQD than those in patients of XYD (P<0.01). Levels of TNF-alpha, IL-6 and IL-1beta were higher and IL-10 was lower in patients of XYD than those in patients of XQD (P<0.05 or P<0.01) respectively. CONCLUSION: TNF-alpha, IL-6, IL-1beta and IL-10 probably play an important role in the development process of XQD to XYD, and could be taken as the microcosmic indexes for differentiation of the two syndromes.

Aged↗

[Effect of liuwei dihuang pill on erythrocyte aldose reductase activity in early diabetic nephropathy patients].

OBJECTIVE: To observe the inhibitory effect of Liuwei Dihuang Pill (LDP) on erythrocyte aldose reductase (EAR) activity in early diabetic nephropathy (DN) patients and to explore the clinical significance of applying LDP in prevention and treatment of DN as an inhibitor of aldose reductase. METHODS: Seventy-two patients diagnosed as early DN with TCM Syndrome of both Qi-yin deficiency were randomly divided into the control group (31 patients) treated by conventional therapy (orally taken Gliquidone or injection of insulin) and the treated group (41 patients) treated by conventional therapy plus LDP for 3 months as one therapeutic course. Changes of symptoms, physical signs, fasting blood glucose (FBG), blood glucose 2 hrs post breakfast (2hPBG), blood total cholesterol (TC), triglyceride (TG), EAR activity, urinary albumin excretion rate (UAER), blood and urinary beta2-microglobulin (beta2-MG) in patients before and after treatment were observed. RESULTS: LDP could improve the symptoms and signs of patients with DN, it could significantly inhibit EAR activity, to make it significantly lower than that in the control group (P < 0.05), and the levels of UAER, beta2-MG in blood and urine in the treated group after treatment were obviously lower than those in the control group (P < 0.05), and LDP showed no apparent effect on blood glucose, lipids and mean arterial pressure (P < 0.05). CONCLUSION: LDP could obviously inhibit the activity of EAR in patients with early DN, improve various indexes of DN, so as to be helpful for its treatment.

Adult↗

[Epidemic survey on TCM syndrome typing and preliminary discussion on TCM etiology and pathogenesis of fatty liver].

OBJECTIVE: To investigate the common TCM syndrome types of fatty liver by way of epidemic questionnaire, their occurrence ratio, and the correlation between various syndrome types and objective indexes. METHODS: A total of national wide 503 subjects with fatty liver were enrolled, the TCM syndromes, body mass index (BMI), abdominal perimeter/hip circumference, liver function, blood lipids, B ultrasonic examination and CT in them were observed and recorded. RESULTS: In the 46 symptoms investigated in total, the first ten symptoms in order of appearing rate were lassitude, obese, oral dryness, vertigo, hypochondriac distending pain, soreness and pain in loin, spiritlessness, oral bitterness, aching and weakness in knee and abdominal distention. The mostly appeared tongue figures were pale and corpulent or pale dim tongue proper, white greasy or yellow greasy tongue coating, and the mostly appeared pulse figures were taut, taut-thin and taut slippery. Statistical cluster analysis showed that syndromes of fatty liver could be typed into 4 TCM types, the asthenia Pi-Shen with Gan-stagnation type, the asthenia Pi-Shen type, the asthenia Pi with phlegm-heat type and the unclassified type. Among them the asthenia Pi-Shen with Gan-stagnation type was the commonest one, which accounted to 62.32%. CONCLUSION: The mostly appeared syndrome type of fatty liver was asthenia Pi-Shen with Gan-stagnation type. The TCM pathogenesis of fatty liver was deficiency of origin, mainly deficiency of Shen, involving Pi, with excess superficiality, the turbid-phlegm and blood stasis.

Adolescent↗

[Clinical observation on chronic obstructive pulmonary disease of acute aggravating stage treated with activating blood circulation to remove blood stasis recipe].

OBJECTIVE: To investigate the clinical efficiency of activating blood circulation to remove blood stasis recipe (ARR) in treatment of patients with chronic obstructive pulmonary disease (COPD) of acute aggravating stage. METHODS: Adopting the prospective randomized controlled method, sixty patients with COPD of acute aggravating stage were divided into two groups. Patients in the treated group (n = 32) was subdivided into four subtypes, Phlegm-Heat accumulation in Fei type, Phlegm-Dampness accumulation in Fei type, Fei-Shen Yin deficiency type and Fei-Pi Qi deficiency type. They were treated with ARR with modification according to their Syndrome type. Patients in the control group (n = 28) were treated with conventional western medicine. The therapeutic course of the two groups was 2 weeks. Changes of indexes including hemorrheological indexes (blood viscosity) and pulmonary function (FEV1, FEV1/FVE%) were observed before and after treatment. RESULTS: The total effective rate was 90.6% in the treated group, while it was 67.9% in the control group. The symptom score and pulmonary function in the two groups were significantly different after treatment (P < 0.01, P < 0.05). In addition, the effect of ameliorating whole blood viscosity in the treated group was better than that in the control group, showing significant difference (P < 0.05). CONCLUSION: Both therapies can improve clinical symptom in patients, but it was showed the effect in those treated with conventional western medicine plus ARR was better than in those treated with conventional western medicine alone.

Aged↗

[Exploration on the basic framework of standard for macrocosmic diagnosis of syndrome].

Starting from the thinking characteristics of TCM in the holistic approach of syndrome and process of syndrome differentiation, the problems in the criteria of syndrome diagnosis was analyzed, combining with the outcome of investigation on macrocosmic diagnosis of syndrome carried on twice by expert group nationwide in China, a concept for designing basic framework of standard for macrocosmic diagnosis of syndrome was advocated in this study. In order to recognize and master fully the standard, the following items would be the contents of the framework: give a standardized term of each syndrome; the basic clinical features of a syndrome; the qualitative parameters which could be used to distinguish the nature of a syndrome, and indexes to be used to judge the affected location of a syndrome during identifying process for a syndrome; the order of pertinent indexes with their given score, and the threshold for quantitative diagnosis. It is considered that the above framework defined the sufficient criteria which is constructed on the bases of the approaches with integrated qualitative and quantitative methods. It may enable the syndrome differentiation to access the real world of a patient to be used appropriately this framework.

Diagnosis, Differential↗

An analysis of the long-term therapeutic effect of the integrated therapy of traditional Chinese medicine and radiotherapy on abdominal malignant tumor.

To observe the long-term therapeutic effect of the integrated therapy of radiotherapy and Chinese herbal drugs for treatment of abdominal malignant tumor and explore the applied value of differential treatment during radiotherapy. Sixty cases of abdominal malignant tumor with hyperactivity of fire due to yin deficiency or deficiency of both qi and blood were randomly divided into an integrated treatment group of 30 cases and a control group of 30 cases. The integrated treatment group was treated by combination of radiotherapy and Chinese herbal drugs and the control group by simple radiotherapy. The results shows that in the integrated treatment group, the score of physical state was 23.17 +/- 7.18, score of psychological quality 21.23 +/- 4.53 and total score of living quality 44.40 +/- 11.22, and survival rate for three years was 67.55%, which were significantly superior to those of the control group (P < 0.01). It is then concluded that differential treatment of TCM could play a valuable role in treating abdominal malignant tumor during radiotherapy, which can improve the long-term living quality and prolong the survival time of the patients.

Abdominal Neoplasms↗

[Relationship of the A1166C polymorphism of ATI R gene with TCM syndrome and efficacy of Chinese hypotensor in patients with essential hypertension].

OBJECTIVE: To investigate the polymorphic distribution of the A1166C, the angiotensin II type I receptor (AT1R) gene, in the Chinese people with essential hypertension (EH), and to study the relationship of A1166C with the TCM syndrome types and the efficacy of hypotensor. METHODS: Blood pressure (BP), body weight index (BWI), fasting blood glucose (FBG), cholesterol (Ch), concentration of triglyceride, levels of serum plasma Ang II , endothelin (ET) and calcitonin-gene related peptide (CGRP) in 206 patients with EH and 86 health subjects of Chinese nationality were determined. DNA of peripheral white blood cells were extracted by salting out method and the polymorphism of AT1R gene A1166C was assessed by PCR and limited enzymatic segmentation. The 206 EH patients were differentiated into different types according to TCM syndrome differentiation, and the gene distribution appeared in each TCM syndromes was compared. Qingxin Capsule (QC) or captopril was used respectively to treat 34 and 32 patients with hypertension of Yin-deficiency and excessive Yang type to observe the relationship between the hypotensive effect of treatment and the distribution of gene types. RESULTS: (1) No significant difference was found in BWI, FBG, blood lipid or serum related hormones, only the difference in systolic and diastolic pressure was shown between the hypertension group and the control group. (2) The rate of AT1R AC plus CC gene type in EH patients was 0.126, which was significantly higher than that in the normal control group (0.047, P < 0.01). The frequency of C allele distribution was obviously higher than that in the normal control group (0.068 vs 0.023, P<0.05). No significant difference was found in AT1R gene types or frequency of allele distribution between different sexes (male and female). (3) Analysis on relationship between gene types and clinical phenotype showed that no significant difference was found in systolic pressure, diastolic pressure, blood glucose, blood lipid, plasma Ang II, ET, or CGRP between patients with AA gene type and with AA plus CC gene type by t test (P > 0.05). (4) Analysis on relationship between gene type and TCM syndrome type showed that the distribution of AA gene type and AA plus CC type was insignificantly different in patients with various TCM syndrome types. (5) Analysis on relationship between gene type and hypotensive effect of treatments showed that both QC and captopril were effective to patients with hypertension of different gene types. The hypotensive effect of either was similar in spite of what gene types the patients with. CONCLUSION: A1166C gene type is related to EH in the Chinese, C allele might a susceptible gene to hypertension, while TCM syndrome type of EH patients might not be related to whether C allele was borne. The hypotensive effect of QC or captopril was not related to whether C1166 allele was borne. No significant difference of blood pressure, blood glucose, blood lipid, plasma Ang II, ET, or CGRP in patients with different gene types, which suggested the effect of gene types on hypertension might not be by path of glucose or lipid metabolism, ET, CGRP or plasma Ang II system.

Antihypertensive Agents↗

[Effect of shensong yangxin capsule on ventricular premature beat and cardiovascular autonomic nervous function in patients with coronary heart disease].

OBJECTIVE: To observe the clinical efficacy of shensong yangxin capsule (SYC) on ventricular premature beat (VPB) differentiated in TCM as palpitation of Qi-yin deficiency syndrome or Xin collateral stagnation syndrome, and cardiovascular autonomic nervous function in patients with coronary heart disease (CHD). METHODS: The randomized, double-blind, parallel contrast method was adopted, patients were randomly assigned by 3:1 ratio into two groups. One hundred and sixty-five patients in SYC treated group and 56 in the control group (treated with Xinlvning tablet), and the therapeutic course for both groups was 4 weeks. RESULTS: The clinical efficacy on VPB and in improving TCM syndromes was better in SYC group than that in the control group (P < 0.01). After treatment, the heart rate variability (HRV) and QT dispersion in the two groups were improved in a certain degree. The changes of SDNN, SDANN, SDNN Index and PNN50 in the two groups were significantly different (P < 0.05, P < 0.01), the efficacy in the treated group was superior to that in the control group. CONCLUSION: SYC has definite effect on VPB and TCM Syndromes, it can obviously meliorate the activity of cardiovascular autonomic nervous system in the patients with CHD.

Adult↗

[Relation between traditional Chinese medicine differentiation of syndromes and HBV antigen, HBV DNA in serum and liver tissues and pathological changes in chronic hepatitis B].

TCM differentiation of syndrome in 131 cases of chronic hepatitis B has been studied with molecular-biological and immuno-histological techniques. The results showed that 94.6% cases of Gan-Yu Pi-Xu (stagnancy in the liver leading to diminished function of the spleen) type belonged to chronic persistent hepatitis (CPH), whose coincidence rate of pathology of the liver biopsies with CPH was 69.2%; the positive rate of HBeAg and/or HBV DNA in sera was 61.5%, and the positive rates of HBsAg and HBV DNA in liver tissues were 69.2% (of which 44.4% appeared diffuse pattern morphologically) and 33.3% respectively. 75.5% cases of Gan-Shen Yin-Xu (deficiency of Yin of the liver and kidney) type belonged to chronic active hepatitis (CAH) and 88.5% of the cases were pathologically described as CAH, the positive rates of HBeAg and/or HBV DNA in serum and HBsAg in liver tissues were all 80.8%, among which the diffuse pattern of HBsAg accounted for 85.7%, which was higher than that in Gan-Yu Pi-Xu type (P less than 0.05), the positive rates of HBcAg and HBV DNA in liver tissues were 34.6% (of which 55.6% appeared cytoplasmic pattern) and 63.2% respectively, which was higher than that in Gan-Yu Pi-Xu type (P less than 0.05). 75.0% cases of Qi-Zhi Xue-Yu (stagnation of vital energy and stasis of blood) type belonged to CAH with early state cirrhosis, its pathological changes in liver tissues were obvious, replication levels of HBV corresponded to the cases of Gan-Yu.Pi-Xu type.

Adult↗

A clinical study on the treatment of urinary infection with Zishen Tongli Jiaonang.

OBJECTIVE: To observe the therapeutic effects of Zishen Tongli Jiaonang (capsules for nourishing the kidney and promoting urination) for treatment of urinary infection. METHOD: The treatment group with a control group were randomly set up. 120 patients in the control group were given antibiotics according to drug sensitive tests for orally taking or intravenous drip, while 136 patients in the treatment group were additionally given the capsules on the basis of the above-mentioned treatment. One course of treatment lasted 2 weeks. Statistical analysis on the therapeutic effects was conducted after a two-course treatment. The recurrence rates of the two groups were compared one year later. RESULTS: The total remission rates were respectively 96.3% in the treatment group and 81.7% in the control group (P<0.05). The recurrence rates one year later were respectively 4.4% in the treatment group and 30.0% in the control group (P<0.01). CONCLUSION: The capsules show good effects for urinary infection, especially in the long-term effect.

Adolescent↗