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

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

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

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

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

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

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

[Comparasion of Antis Egg-case Before and After Preparing in Reproducing Kidney-Yang Deficiency Model Rats]

OJECTIVE

To compare the effects of antis egg-case before and after preparing in reproducing kidney-Yang deficiency model rats,and to explore the best medicinal part of antis egg-case.

METHODS

Divide the rats into nine groups randomly: antis egg-case group, salt fried antis egg-case group, steamed antis egg-case group, eggs from antis egg-case group, eggs from salt fried antis egg-case group, eggs from steamed antis egg-case group, egg shell from antis egg-case group, egg shell from salt fried antis egg-case group, and egg shell from the steamed antis egg-case group. Make kidney-Yang deficient model by giving the rats hydrocortisone. Two weeks later, give the rats treatment for four weeks, compare the effects of antis egg-case by determining the contents of NO,TSH,T3,T4,EPI,NE,17-OH,CORT,T,E2,coefficient of thyroid, body temperature, coefficient of adrenal and kidney, weight and water intake.

RESULTS

Antis egg-case before and after preparing increased the contents of T3,T4,EPI,NE and T, increased weight, body temperature, coefficient of thyroid and adrenal, but reduced the contents of NO and E2,the coefficient of kidney and water intake were also decreased.

CONCLUSION

The medicinal materials came from different medicinal parts of antis egg-case before and after preparing can treat the symptoms of kidney-Yang in different degrees. The effects of antis egg-case to treat kidney-Yang deficient has been strengthened after preparing, salt fried antis egg-case and eggs from salt fried antis egg-case played the more important role.

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

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

[Study on the Distribution of Constitutions of Chinese Medicine in Patients with Osteonecrosis of Femoral Head]

OBJECTIVE

To observe the distribution of constitution types of Chinese medicine (CM) in patients with osteonecrosis of femoral head (ONFH).

METHODS

Totally 130 ONFH patients were recruited. Constitution types of CM were identified in all patients. Distribution features of constitution types of CM in ONFH patients were observed. The differences of distribution in gender, age, single or bilateral hips, course of disease, staging, cause, and region were also analyzed.

RESULTS

Seventy patients were of complicated constitutions, while 60 patients were of single constitution. Among the 60 single constitution cases, yang-deficiency constitution [18 (13.9%)], damp-heat constitution [10 (7.7%)], blood-stasis constitution [7 (5.4%)], and qi-deficiency constitution [7 (5.4%)] were mainly distributed. Of the complicated constitutions, yang-deficiency dominated constitution occupied the top ratio [30 (23.1%)], followed by blood-stasis dominated constitution [15 (11.5%)], damp-heat dominated constitution [9 (6.9%)]. By putting them together, yang-deficiency constitution occupied the top constitution of CM [48 (36.9%)], followed by blood-stasis constitution [ 22 (16.9%)] and damp-heat constitution [19 (14.6%)]. The aforesaid three constitutions accounted for 68.5% of the total. There were no statistical distribution differences in gender, age, single or bilateral hips, course of disease, staging, or cause.

CONCLUSION

Yang-deficiency constitution, damp-heat constitution, and blood-stasis constitution were liable constitutions of CM in ONFH patients.

[Effect of Morinda officinalis Root and Its Salt-Processing Product on Energy Metabolism in Rats with Yang Deficiency]

OBJECTIVE

To compare the effects of Morinda officinalis root and its salt-processing prodduct on rats with kidney yang deficiency from the viewpoint of energetic metabolism.

METHODS

The rat models for the kidney yang deficiency were established through the perfusion of methimazole. The models were treated with different dosages of Morinda officinalis root without woods and its salt-processing products extracts. The activity of liver glycogen,muscle glycogen,free fatty acid( NEFA),lipoprotein lipase( LPL),hepatic lipase( HL),liver and skeletal muscle Na+,K+ATPase,Ca2 +,Mg2 +ATPase,succinodehydrogenase( SDH) were measured by colormetric methods,and the coefficient of body fat were observed by weighing method.

RESULTS

Morinda officinalis root without woods and its saltprocessing products could improve the energetic metabolism of kidney yang deficiency of rats. The effects of salt-processing products were better than Morinda officinalis root without woods in the same dosage.

CONCLUSION

The effect of invigorating the kidney and strengthening yang of Morinda officinalis were correlated with energetic metabolism. The correct processing-products of Morinda officinalis root should be chosen with the suitable measurements in clinic.

[Differentiation Study of Chinese Medical Syndrome Typing for Diarrhea-predominant Irritable Bowel Syndrome Based on Information of Four Chinese Medical Diagnostic Methods and Brain-gut Peptides]

OBJECTIVE

To establish discriminant functions of diarrhea-predominant irritable bowel syndrome (IBS-D) by studying it from quantitative diagnosis angle, hoping to reduce interference of subjective factors in diagnosing and differentially diagnosing Chinese medical syndromes of IBS-D.

METHODS

A Chinese medical clinical epidemiological survey was carried out in 439 IBS-D patients using Clinical Information Collection Table of IBS. Initial syndromes were obtained by cluster analysis. They were analyzed using step-by-step discrimination by taking information of four Chinese medical diagnostic methods and serum brain-gut peptides (BGP) as variables.

RESULTS

Clustering results were Gan stagnation Pi deficiency syndrome (GSPDS), Pi-Wei weakness syndrome (PWWS), Gan stagnation qi stasis syndrome (GSQSS), Pi-Shen yang deficiency syndrome (PSYDS), Pi-Wei damp-heat syndrome (PWDHS), cold-damp disturbing Pi syndrome (CDDPS). Of them, GSPDS was mostly often seen with effective percentage of 34. 2%, while CDDPS was the least often seen with effective percentage of 5.5%. A total of 5 discriminant functions for GSPDS, PWWS, GSQSS, PSYDS, and PWDHS were obtained by step-by-step dis- crimination method. The retrospective misjudgment rate was 4.1% (16/390), while the cross-validation misjudgment rate was 15.4% (60/390).

CONCLUSION

The establishment of discriminant functions is of value in objectively diagnosing and differentially diagnosing Chinese medical syndromes of IBS-D.

[Treatment of Chronic Heart Failure Patients with Qi-Yang Deficiency and Blood Stasis Resistance Syndrome by Xnmallong Injection: a Multi-center Randomized Control Study]

OBJECTIVE

To evaluate the efficacy and safety of Xinmailong Injection (XI) in treatment of chronic heart failure (CHF) patients with qi-yang deficiency and blood stasis resistance syndrome (QY-DBSRS).

METHODS

Totally 238 CHF patients with QYDBSRS were assigned to the treatment group (118 cases) and the control group (120 cases) by randomized, double-blind, placebo parallel controlled method. Patients in the treatment group received routine therapy and XI (100 mg/2 mL, by dripping at 5 mg/kg, twice per day for 5 consecutive days), while those in the control group received routine therapy and XI mimetic agent (100 mg/2 mL, by dripping at 5 mg/kg, twice per day for 5 consecutive days). The heart function classification of New York Heart Association (NYHA), 6-min walking distance, left ventricular ejection fraction (LVEF), scores for Chinese medical symptoms were observed before and after treatment, and safety assessed.

RESULTS

Totally 235 patients actually entered full analysis set (FAS), including 120 cases in the control group and 115 cases in the treatment group. The total effective rate of heart function, 6-min walking distance and increased post-pre-treatment distance in the experimental group were superior to those of the control group with statistical difference (all P < 0.05). Compared with the control group, increased value of post-pre-treatment LVEF, the total effective rate of Chinese medical syndrome efficacy, scores for Chinese medical symptoms and decreased post-pre-treatment value of Chinese medical syndrome scores were obviously improved (all P < 0.05). There was no significant difference in the incidence of adverse events between the two groups (P > 0.05).

CONCLUSIONS

XI could improve the heart function of CHF patients, improve Chinese medical symptoms, elevate exercise tolerance, and improve LVEF. It had no obvious toxic and side effects.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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

[Relation between Chinese Medical Constitutions and Chemotherapy-induced Leucopenia in Breast Cancer Patients: a Clinical Study]

OBJECTIVE

To analyze the relationship between Chinese medical constitutions and chemotherapy-induced leucopenia (CIL) of primary breast cancer patients.

METHODS

Totally 306 breast cancer patients undergoing adjunctive chemotherapy for the 1st time, and effective 291 breast cancer patients were recruited in this study.Nine Basic Constitutional Scale was used before first chemotherapy. Chinese medical constitutions were classified and quantitatively scored. The highest grading for any item of adverse reactions in each case during the whole chemotherapy course was recorded after chemotherapy. Data were statistically analyzed using SPSS16.0.

RESULTS

There was no significant difference in CIL between different chemotherapy regimens and various Chinese medical constitutions of breast cancer patients (P > 0.05). Yang deficiency constitution is one risk factor for CIL. The higher the score of yang deficiency constitution, the more severe the CIL.

CONCLUSIONS

Yang deficiency constitution was correlated with the degree of CIL. The higher the score of yang deficiency constitution, the greater the risk of III-IV grade CIL in breast cancer patients.

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

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

[Effect of yougui formula granule on ovarian granulosa cells gene expression profiles in IVF patients of shen yang deficiency syndrome]

OBJECTIVE

To observe the effect of Yougui Formula Granule (YFG) on ovarian granulosa cells gene expression profiles in in vitro fertilization-embryo transfer (IVF-ET) patients of Shen yang deficiency syndrome (SYDS) from the viewpoint of genomics.

METHODS

Totally 72 infertility patients undergoing IVF-ET were randomly assigned to the treatment group and the control group according to random digit table, 36 in each group. Patients in the treatment group took YFG combined gonadotropin (Gn), while those in the control group took placebos combined Gn. All medication lasted for 3 menstrual cycles before IVF. With high-throughput gene sequencing technology, gene expression profiles of ovarian granulosa cells in the two groups were analyzed to explore the difference by gene ontology (GO) enrichment analysis and kyoto encyclopedia of genes and genomes (KEGG) pathway analysis.

RESULTS

Ovarian granulosa cell gene expression profiles from the follicular fluid showed, when compared with the control group, 391 differential genes were found in the syndrome-control group, 153 down-regulated and 238 upregulated. Enrichment of differentially expressed cellular location and molecular function of genes involved cell proliferation and apoptosis associated cyclin, protein ubiquitination, construction of microtubules and microfilament, mitochondrial function and energy-related factors, regulatory factors for hormone synthesis. Participated pathways involved energy metabolism pathway and transforming growth factor-β (TGF-β) signaling pathway.

CONCLUSIONS

There existed significant difference in gene expression profiles of ovarian granulosa cells between the treatment group and the control group. Differentially expressed genes involved in biological processes correlates with Shen yang deficiency induced proliferation of germ cells, confused apoptosis, and hindered process during which mitochondria produced energy.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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

[A correlation study between diarrhea-predominant irritable bowel syndrome complicated functional dyspepsia patients of Gan-stagnation Pi-deficiency syndrome and gastrointestinal hormones]

OBJECTIVE

To investigate the correlation between the pathogeneses of diarrhea-pre- dominant irritable bowel syndrome (D-IBS) complicated functional dyspepsia (FD) patients of Gan-stagnation Pi-deficiency Syndrome (GSPDS) and symptoms, psychological states, and gastrointestinal hormones.

METHODS

A total of 111 patients with confirmed D-IBS complicated FD of GSPDS were recruited as the treated group by using Rome III standard and Chinese medical syndrome standard. And 30 healthy volunteers were recruited as the control group. The general condition, scoring for digestive symptoms, and the distribution of GSPDS subtype of all subjects were recorded by a questionnaire, and assessed by Symptom Checklist (SCL-90; a software for psychological test developed by Beijing Huicheng Adult Cor- poration). Meanwhile, plasma levels of 5-hydroxytryptamine (5-HT), somatostatin (SS), vasoactive intestinal peptide (VIP), endothelin (ET), interleukin 10 (IL-10), and interleukin 12 (IL-12) were measured in all subjects.

RESULTS

(1) The subtype of D-IBS complicated FD of GSPDS was dominant in Pi-qi deficiency type (51/111,45.9%),Pi yang deficiency type (34/111,30.6%), and GSPDS. There was no statistical difference in the scoring of digestive symptoms among the 3 subtypes (P >0.05). (2) Compared with the control group, the anxiety factor score and the total score significantly increased in all three subtypes of D-IBS complicated FD of GSPDS, and the depression score of Pi yang deficiency type and Gan-depression type also significantly increased (P <0.05, P <0.01); the depression score of Gan-depression type was significantly higher than that of the Pi-qi deficiency type (P <0.01). Plasma 5-HT levels were obviously lower in D-IBS complicated FD patients of GSPDS accompanied with anxiety or depression than in those with no obvious psychological abnormalities, and VIP and IL-10 levels were significantly lower than those in the control group (P <0.05). Plasma VIP levels were also obviously lower in D-IBS complicated FD patients of GSPDS accompanied with anxiety or depression than in those with no obvious psychological abnormalities (P <0.01), and SS levels were significantly lower than those in the control group (P <0.05). There was no statistical difference in plasma ET or IL-12 levels in each patient group, when compared with the control group (P >0.05). (3) Compared with the.control group, plasma 5-HT levels significantly increased, plasma VIP and IL-10 levels significantly decreased in ach subtype of D-IBS complicated FD patients of GSPDS (P <0.05, P <0.01), and no significant change of SS, ET, or IL-12 occurred (P >0.05). Besides, plasma 5-HT levels were significantly higher in Gan-depression type than in Pi yang deficiency type, VIP levels were lower in Gan-depression type than in Pi-qi deficiency type (all P <0.05).

CONCLUSIONS

Gan stagnation and Pi deficiency were dominant in D-IBS complicated FD patients of GSPDS. Psychological abnormalities, increased plasma 5-HT levels, and decreased plasma VIP levels were closely correlated with Gan stagnation subtype, which provided some reference for looking for objective indicators of Chinese medical syndromes in treating D-IBS complicated FD patients of GSPDS.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

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

[Short-course kidney-invigorating therapy improves near-term semen quality in asthenozoospermic men with kidney deficiency]

OBJECTIVE

To evaluate the effect of short-course kidney-invigorating therapy on near-term semen quality in asthenozoospermic men with kidney deficiency.

METHODS

Based on the differential types in traditional Chinese medicine, 121 asthenozoospermia patients received at our clinic of andrology were divided into groups A (kidney-yin deficiency), B (kidney-yang deficiency) and C (spleen and kidney deficiency), and treated with Yougui Decoction plus Wuziyanzong Pills, Jinkuishenqi Pills plus Wuziyanzong Pills, and Shizi Decoction plus Liujunzi Decoction, respectively, all given once daily for 4 weeks. Sperm parameters of the patients were analyzed with the computer-assisted sperm analysis system before and after treatment and compared among the three groups.

RESULTS

The baseline sperm concentrations in groups A, B and C ([70.4 +/- 38.6], [73.5 +/- 40.2] and [56.0 +/-34.4] x 10(6)/ml) showed no significant differences from those after medication ([74.4 +/- 32.6], [67.0 +/- 30.8] and [58.6 +/- 24.6] x 10(6)/ml) (P > 0.05). The percentages of grade a sperm in the three groups were (12.9 +/- 5.3)%, (13.7 +/- 7.7)% and (12.9 +/- 6.4)% respectively after treatment, significantly higher than (9.9 +/- 6.7)%, (9.3 +/- 5.4)% and (9.0 +/- 6.8)% before treatment (P < 0.05), and so were the percentages of grade a + b sperm ([37.4 +/- 10.2 ]%, [35.7 +/- 13.7]% and [35.9 +/- 12.3]% after treatment versus [29.6 +/- 13.2]%, [27.5 +/- 10.4]% and [28.3 +/- 12.1]% before treatment, P < 0.05). All the three groups showed significantly increased sperm motility after treatment ([53.8 +/- 10.5]%, [52.6 +/- 15.2]% and [51.1 +/- 13.1]%) as compared with the baseline levels ([44.3 +/- 14.0]%, [43.5 +/- 15.0]% and [42.4 +/- 14.9]%) (P < 0.05). The cure rate and total effectiveness rate were significantly higher in group B than in A (P < 0.05), but had no significant differences between either A and C or B and C (P > 0.05).

CONCLUSION

Short-course kidney-invigorating therapy can significantly improve near-term semen quality in asthenozoospermic men with kidney asthenia, especially in those with kidney-yang deficiency, and it has no obvious adverse effects.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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

[Clinical observation on combination of compound xuanju capsule and clomiphene citrate in treating ovulatory dysfunctional infertility patients of Shen-yang deficiency]

OBJECTIVE

To explore the therapeutic efficacy of combination of Compound Xuanju Capsule (CXC) and clomiphene citrate (CC) for ovulatory dysfunctional infertility (001) patients of Shen-yang deficiency syndrome (SYDS).

METHODS

Totally 87 001 patients of SYDS were randomly assigned to 2 groups, the treatment group (44 cases, treated with CXC and CC) and the control group (43 cases, treated with CC alone). The post-treatment clinical symptoms, the cervical mucus, the endometrial thickness, the quality of follicles, the ovulation, and the pregnancy rate, and so on were observed.

RESULTS

In aspect of improving the patients' SYDS, the effective rate was 86.4% (38/44) in the treatment group and 25.6% (11/43) in the control group. It was better in the treatment group (P < 0.01). After treatment better effects on the cervical mucus, the endometrial thickness, and the pregnancy rate were obtained in the treatment group, showing statistical difference when compared with the control group (P < 0.05). There was no statistical difference in the rate of ovulation and mature follicular numbers between the two groups (P > 0.05).

CONCLUSION

CXC combined CC could ameliorate hypoestrinemia-like effects on the endometrium, increase the endometrial thickness, and be favorable to the pregnancy in treating ODI patients of SYDS.

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

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

OBJECTIVE

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

METHODS

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

RESULTS

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

CONCLUSION

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