Professor Fengjie He’s Experience in Treating Polycystic Ovary Syndrome of Kidney Asthenia and Liver Depression

Polycystic ovary syndrome is a common reproductive endocrine metabolic disease in clinic. Professor Fengjie He has accumulated rich clinical experience in the process of diagnosis and treatment of the disease. He believes that the key to the pathogenesis of the disease is the dysfunction of the reproductive axis of “kidney - Tiangui - Chongren – uterus,” which is based on kidney deficiency and involves the liver and spleen. Clinically, patients with kidney deficiency and liver depression are common. The treatment takes tonifying the kidney and regulating the menstrual cycle as the main method, and the clinical effect is very effective.

Efficacy of Bushen Huatan Decoction combined with Baduanjin in the treatment of polycystic ovary syndrome with insulin resistance (IR-PCOS), kidney deficiency and phlegm dampness: study protocol for a randomized controlled trial

Background Polycystic ovary syndrome (PCOS) is a common reproductive endocrine disease in women. Insulin resistance (IR) has emerged as a central contributor to the pathogenesis of this disease. According to traditional Chinese medicine (TCM), kidney deficiency is the main syndrome of PCOS. The deficiency of the kidney cannot vaporize water-dampness, and the retention of water-dampness accumulates into phlegm dampness stagnation, resulting in visceral dysfunction and metabolic disorder. TCM involving syndrome differentiation and treatment is widely used to adjust women’s menstrual cycles. Our patented formula Bushen Huatan Decoction (BSHTD) has been proven to be effective in the clinical treatment of IR-PCOS. Baduanjin also plays an important role in improving metabolic syndrome through lifestyle intervention. This study investigates the clinical efficacy of Bushen Huatan Decoction combined with Baduanjin in IR-PCOS, to form a specific TCM-behaviour intervention plan in the treatment of IR-PCOS. Methods/design This is a randomized controlled trial involving 190 participants diagnosed with IR-PCOS. All participants will be randomly allocated into 5 groups: group A will receive metformin; group B, BSHTD; group C, Baduanjin; group D, BSHTD combined with metformin; and group E, BSHTD combined with Baduanjin. One course of treatment lasts 3 months, a total of two courses. The primary outcomes are changes in the homeostatic model assessment of insulin resistance (HOMA-IR) and improvements in the oral glucose tolerance test (OGTT) and insulin-releasing test (INS). The secondary outcomes are improvements in the menstrual cycle, ovulation rate, clinical pregnancy rate, basic serum sex hormone levels, free androgen index (FAI), Ferriman-Gallwey scores, body mass index (BMI) and TCM syndrome scores. The related observation indexes will be collected at baseline, during the process of treatment and at the 6-month follow-up. Simultaneously, close monitoring of possible adverse events will be performed throughout the trial process. Discussion This trial will investigate the efficacy of the comprehensive intervention program of Bushen Huatan Decoction combined with Baduanjin on the adjustment of the menstrual cycle, improvement of insulin resistance and correction of glucose metabolism disorder in IR-PCOS patients. It is expected to form an alternative treatment of TCM-behaviour intervention therapy for IR-PCOS and promote the Chinese fitness Qigong Baduanjin in the application of lifestyle diseases. Trial registration Chinese Clinical Trial Registry ChiCTR2100043415. Registered on 15 February 2021.

Specification and DNA Barcoding of Thai Traditional Remedy for Chronic Kidney Disease: Pikad Tri-phol-sa-mut-than

The Pikad Tri-phol-sa-mut-than (TS) remedy, a Thai traditional medicine, is officially recorded in Tamra Paetsart Sonkrau Chabub Anurak for its capabilities in treating kidney deficiency. TS remedy is composed of three fruit species—Aegle marmelos (L.) Corrêa., Coriandrum sativum L., and Morinda citrifolia L.—in an equal part by weight. The quality of the raw material is one of the essential factors that can affect the effectiveness and safety of treatment by herbal remedy. The pharmacognostic evaluation and DNA barcode of the three fruit species and TS remedy were performed in this study to authenticate them from contamination, and to provide the scientific database for further uses. Macroscopic and microscopic examination, chemical profile by TLC, and DNA barcoding were employed to positively identify the raw materials bought from the herbal market, especially the powder form. Consequently, the outcomes of this investigation can be used to develop an essential and effective tool for the authentication of crude drugs and herbal remedies.

Efficacy of Thunder-Fire Moxibustion In Treating Ankylosing Spondylitis of Kidney Deficiency And Governor Meridian Cold And Its Influence On Bone Metabolism：Study Protocol For A Randomized Controlled Trial

Background: Ankylosing spondylitis(AS) is a common chronic inflammatory spondyloarthropathy,.It is considered in Traditional Chinese Medicine(TCM) that the pathogenesis of AS is mainly due to Yang deficiency of kidney governor meridian and internal prosperity of cold evil. Thunder-fire moxibustion is a kind of moxibustions and characterized in abundance in drug composition, high heat radiation and strong penetration. Thunder-fire moxibustion on spinal segment of governor meridian in treating AS seems compatible with the main pathogenesis of kidney deficiency and governor meridian cold. The Trial aims to explore the efficacy of thunder-fire moxibustion in patients with AS of kidney deficiency and governor meridian cold and its influence on bone metabolism, through a prospective randomized trial. Methods: Sixty patients with AS of kidney deficiency and governor meridian cold will be recruited and randomly assigned to the treatment group （thunder-fire moxibustion three times a week plus basic treatment）and the control group (basic treatment) at the Center of TCM of Beijing Luhe Hospital Affiliated to Capital Medical University (Beijing, China), Each patient will be treated for 4 weeks.Primary outcome indexes will include efficacy of TCM syndrome,Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI),with observation once respectively prior to the treatment, 2 weeks post to the treatment, and at the end of the treatment. Secondary outcome indexes will include tumor necrosis factor-α(TNF-α) and receptor activator of nuclear factor-κ B ligand(RANKL), which will be determined once respectively before and after treatment.Side effects during the treatments will be recorded and analyzed as well. Inter-group comparison and analysis will be performed based on intention-to-treat set and per-protocol set. Discussion: This prospective randomized trial will help verify the efficacy of thunder-fire moxibustion in treating AS of kidney deficiency and governor meridian cold, discuss preliminarily its mechanism in treating this disease, and provide high-quality evidences for scientific researches on clinical treatment with thunder-fire moxibustion against AS. Trial registration: Chinese Clinical Trial Registry, ChiCTR2100044227 . Registered on 12 March 2021.

Effectiveness of Modified Buzhong Yiqi Decoction In Treating Myasthenia Gravis: Study Protocol For A Series Of N-of-1 Trials

Background: Myasthenia gravis (MG) is an acquired autoimmune disease with high heterogeneity. The disease is chronic, relapsing repeatedly and progressive with acute exacerbation occasionally. Although the treatment of MG has developed, it is still unsatisfactory and has some unexpected side effects. Traditional Chinese medicine(TCM) has shown great potential in MG treatment, including relief of muscle weakness syndrome, improvement of patient’s quality of life and reduction of side effects of western medicine. The purpose of this study is to evaluate the effectiveness of Modified Buzhong Yiqi Decoction (MBYD) as an add-on therapy for MG through a small series of N-of-1 trials.Methods: Single-centre, randomized, double-blind, 3 crossover N-of-1 trials will be conducted to enroll 12 adult patients with MG diagnosed as spleen-stomach deficiency syndrome or spleen-kidney deficiency syndrome in TCM. Each N-of-1 trial has 3 cycles of two 4-week periods containing the MBYD period and placebo period. The wash-out interval of 1-week is prior to switching each period. Primary outcome: Quantitative Myasthenia Gravis (QMG). Secondary outcomes: the following scales: myasthenia gravis composite (MGC), myasthenia gravis activities of daily living profile (MG-ADL), myasthenia gravis quality of life (MG-QOL); the level of CD4+FoxP3+Treg cells and cytokines (IL-4, IL-17A, INF-γ, TGF-β) in the peripheral blood; the alterations of the composition of gut microbiota; reduction of the side effects of western medicine. Discussion: Paired t tests or Wilcoxon signed rank tests will be used to analyse this trials’ data and the results we arrived at will be interpreted cautiously. We assumed that this study would reveal that MBYD is effective for MG and provide robust evidence of the efficacy of TCM to treat MG. Trial registration: Chinese Clinical Trial Register, ID: ChiCTR2000040477, registration on 29 November 2020, http://www.chictr.org.cn/showprojen.aspx?proj=64688.

Treating Diabetes from Cold

Diabetes refers to the disease with the main symptom of “three more and less.” Traditional Chinese medicine (TCM) regards Yin deficiency and dryness heat as the basic pathogenesis, and mostly adopts the method of clearing away heat, nourishing yin and generating fluid. The author thinks that the deficiency of Yuanyang in Zang Fu organs, the lack of stimulation and promotion, the metabolic disorder of body fluid, the loss of moistening of Zang Fu organs, and the onset of diabetes. Body fluid metabolism is closely related to the spleen and kidney. Deficiency of Yang Qi is the root of thirst, stagnation of body fluid and Qi is the pathogenesis, and thirst is the final result.

A Case of the Therapeutic Effect of Nangan-jeon on Refractory Functional Dyspepsia Caused by “Liver-Kidney Deficiency Cold”

Objective: This study explored the clinical usefulness of Nangan-jeon decoction to treat refractory functional dyspepsia.Methods: A 61-year-old female had been suffering from severe functional dyspepsia for about 40 years, but the dyspeptic symptoms rapidly improved after taking Nangan-jeon decoction. The clinical outcome was assessed by the numerical rating scale (NRS) and the self-reporting method.Result: After there was no improvement from various herbal treatments in a department of a Korean college hospital, the patient moved to the author’s clinic. She had been diagnosed with the pattern identification of “liver-kidney deficiency cold” and prescribed with Nangan-jeon decoction. This herbal drug rapidly improved her dyspeptic symptoms, from NRS 10 to NRS 2 (after 3 weeks) and NRS 1 (after 7 weeks).Conclusion: This case report is the first to present the potential of Nangan-jeon decoction to improve refractory functional dyspepsia.

A Data Mining-Based Analysis of Core Herbs on Different Patterns (Zheng) of Non-Small Cell Lung Cancer

Objective. To explore the role of Chinese prescriptions in non-small cell lung cancer (NSCLC) and provide references for the application of herbs and prescriptions. Methods. Randomized and quasirandomized controlled clinical trials on Chinese herbal medicine in the treatment of NSCLC were collected from seven databases to establish a database of prescriptions on NSCLC. Data-mining analyses were performed by RStudio (v4.0.3) software. Results. A total of 970 prescriptions were obtained from 945 included studies, involving 7 syndromes and 428 herbs. The main patterns of NSCLC included qi deficiency pattern, yin deficiency pattern, blood deficiency pattern, kidney deficiency pattern, heat toxin pattern, phlegm-dampness pattern, and blood stasis pattern. High-frequency herbs on NSCLC were Astragali Radix (Huangqi), Atractylodis Macrocephalae Rhizome (Baizhu), Glycyrrhizae Radix Rhizome (Gancao), Poria (Fuling), Ophiopogonis Radix (Maidong), Hedyotidis Diffusae Herba (Baihuasheshecao), Codonopsis Radix (Dangshen), and Glehniae Radix (Beishashen). The properties of the herbs were mainly cold, warm, and mild. The flavors of the herbs were mainly sweet, bitter, and pungent. The main meridian tropisms were Lung Meridian of Hand-Taiyin, Spleen Meridian of Foot-Taiyin, and Stomach Meridian of Foot-Yangming. Conclusion. Applying clearing and tonifying method by targeting the lung and spleen was the most frequently used therapy in the treatment of NSCLC. This study offered a glimpse of unique views of traditional Chinese medicine on NSCLC and may benefit the treatment of NSCLC.

APPLICATION OF CHEN YUANGAO IN THE TREATMENT OF SOFT TISSUE INJURY OF FOOTBALL PLAYERS

ABSTRACT The treatment of soft tissue injury in football players generally includes physical therapy, anti-inflammatory and analgesic drug treatment, surgical treatment and early rest immobilization. Western medicine treatment of soft tissue injury can quickly heal the wound and relieve pain in a short time. The treatment of traditional Chinese medicine is based on the whole and must seek the root of the disease. It is believed that the occurrence of certain diseases is related to Qi, blood, liver and kidney deficiency, so we should pay attention to the overall adjustment during treatment of symptoms. In view of this, this study analyzed the effect of Chen Yuan ointment, from traditional Chinese medicine, in the treatment of soft tissue injury. Sixty-eight football players who completed ankle ligament reconstruction were divided into four groups according to the type of operation and whether Chen Yuangao-assisted rehabilitation was used or not. The results showed that the Ankle Hindfoot Function Score and the visual analog scale (VAS) score of patients in the fibula brevis tendon reconstruction Chen Yuan ointment group were 98.3 and 0.3, respectively, at the last follow-up, which were better than those in other groups, and had lower pain scores. This result shows that Chen Yuangao has a certain effect in the treatment of soft tissue injury, which can provide a research idea for the rapid rehabilitation of football players.

Development of a Computerized Adaptive Test for Quantifying Chinese Medicine Syndrome of Myasthenia Gravis on Basis of Multidimensional Item Response Theory

Background. Making comprehensive management of myasthenia gravis (MG) is a challenge in clinical practice due to heterogeneity and multiple comorbidities among patients. Aim. To develop an end-to-end instrument for individualized assessment of MG in the perspective of Chinese medicine (TCM) with the application of multidisciplinary quantification approaches. Methods. A self-administrated questionnaire was developed integrating typical symptoms of MG and spleen-kidney deficiency syndrome on basis of the conceptual framework of TCM. With data collected in a multicenter cross-sectional study, confirmatory factor analysis together with multidimensional item response theory (MIRT) was used for evaluating the psychometric property of the questionnaire. A computerized adaptive test was developed based on the MIRT model, and scores of syndrome factors were calculated in simulation. A logistics regression model was also estimated for evaluating the consistency between the quantitative result and the clinical diagnosis of syndrome from clinical practitioners. Result. With 337 patients enrolled and assessed, the 14-item questionnaire was evaluated to be with adequate validity and reliability (Cronbach’s alpha indices = 0.87, AIC = 195.827, BIC = 348.631, CFI = 0.921, RMR = 0.006, GFI = 0.954, RMSEA = 0.048, and χ2/df = 1.782). With adequate factor loadings of symptoms on related syndrome factor, the instrument was evaluated with preliminary interpretation and was suitable for evaluating patients with moderate severity of the spleen and kidney deficiency syndrome. Conclusion. Setting typical symptoms of MG together with systemic discomforts in a computerized adaptive test on the basis of MIRT, this study proposed an innovative research paradigm for quantifying individual condition in the perspective of TCM with application of interdisciplinary approaches.