1.Exploring the Application of "Cleaning Spleen and Restoring Defensive Qi" Method in Treatment of Pancreatic Cancer based on Neutrophil Extracellular Traps Abnormal Accumulation
Chuanlong ZHANG ; Mengqi GAO ; Yi LI ; Xiaochen JIANG ; Songting SHOU ; Bo PANG ; Baojin HUA
Journal of Traditional Chinese Medicine 2025;66(1):30-33
The abnormal accumulation of neutrophil extracellular traps (NETs) can promote the initiation and progression of pancreatic cancer, which is considered a potential therapeutic target for this disease. The Miraculous Pivot·Inquiry About Statement (《灵枢·口问》) have recorded the concept of "defensive qi stagnation". Based on the recognition that the function of defensive qi is similar to the immune function of neutrophils, and combining traditional Chinese medicine theory with clinical practice, it is proposed that the abnormal accumulation of NETs may be a pathological product of "defensive qi stagnation", with the spleen being the critical site of pathology. Further exploring the application strategy of cleaning spleen and restoring defensive qi method in pancreatic cancer treatment, it is proposed to employ three approaches such as dredging method to eliminate spleen stagnation and inhibit pancreatic cancer proliferation, cleaning method to remove spleen dampness and suppress the inflammatory micro-environment, and tonifying method to strengthen Weiqi and to improve the immune microenvironment, which aims to provide new insights for the clinical treatment of pancreatic cancer with traditional Chinese medicine.
2.Development of Patient Self-Reported Core Outcome Set in Community Studies on Heat-Sensitive Moxibustion for Primary Hypertension
Jianyu YOU ; Shuqing LI ; Guihua DENG ; Xu ZHOU
Journal of Traditional Chinese Medicine 2025;66(1):34-41
ObjectiveTo establish the self-reported core outcome set (COS) for patients with an example of a community study on heat-sensitive moxibustion for primary hypertension (PH), to provide a reference for the selection of effectiveness evaluation indicators in community study on heat-sensitive moxibustion. MethodsA systematic literature search was conducted to collect outcomes used in randomized controlled trials and systematic review of heat-sensitive moxibustion for PH (Jan 2021), and additional outcomes were added through patient and expert questionnaires (Feb 2021) to create a pool of outcome entries. A multidisciplinary expert Delphi survey was conducted to screen outcomes applicable to patient self-reporting (Apr 2021), and the importance of outcome indicators was rated on a 5-Point Likert Scale. Finally, patient self-reported COS was determined through a consensus conference (June 2021). ResultsA pool of patient self-reported indicators in the community study of heat-sensitive moxibustion treatment for PH was generated by standardizing and combining the outcome indicators based on the results of the literature search and the questionnaire survey, which consisted of totally 100 measurement tools or contents, excluding 51 indicators or measurement tools required measurement by specialized physicians or hospital equipment, and 49 items were retained to enter the initial list of indicator entries. For the first round of Delphi survey, the mean score for expert familiarity was 0.819, the mean score for basis of judgment was 0.710, and the expert authority coefficient was 0.765, with a total of 21 indicator measurement tools or contents deleted (significance score ≤ 75 or coefficient of variation > 0.25), 28 retained, and 3 new expert-added indicator entries added. In the second round of Delphi survey, the average score for expert familiarity was 0.859, the average score for basis for judgment was 0.763, and the expert authority coefficient was 0.811, with a total of 11 indicator measurement tools or contents deleted and 20 retained involving 5 domains. Following an expert consensus meeting, 8 outcome indicators were finalized for inclusion in the patient self-reported COS, including 6 indicators of effectiveness evaluation such as quality-of-life scores, blood pressure, traditional Chinese medicine symptom scores, cost-benefit, cardiovascular and cerebrovascular events, and adverse reactions/events, and 2 indicators of factors influencing effectiveness such as sensation of heat-sensitive moxibustion, and adherence. ConclusionIn this study, we initially established a criteria for evaluating the effectiveness in the community study on heat-sensitive moxibustion by constructing patient self-reported COS in the community study on heat-sensitive moxibustion for PH, which can provide a scientific research paradigm for the subsequent development of the community study on heat-sensitive moxibustion.
3.Effect of Shenlong Dingji Formula (参龙定悸方) on the Quality of Life in Patients with Paroxysmal Atrial Fibrillation of Qi-Yin Deficiency and Phlegm-Stasis Obstructing Collaterals Syndrome
Liang MA ; Baofu WANG ; Yukun DING ; Xian WANG
Journal of Traditional Chinese Medicine 2025;66(1):42-49
ObjectiveTo explore the effectiveness and safety of Shenlong Dingji Formula (参龙定悸方) on the quality of life in patients with paroxysmal atrial fibrillation (PAF) of qi-yin deficiency and phlegm-stasis obstructing collaterals syndrome. MethodsA total of 60 patients with PAF of qi-yin deficiency and phlegm-stasis obstructing collaterals syndrome were recruited and randomly divided into a treatment group and a control group, with 30 patients in each group. The control group received standard western medicine treatment, while the treatment group was additionally given Shenlong Dingji Formula orally, one dose per day. Both groups were treated for 4 weeks. The primary outcome measure is the Atrial Fibrillation Effect on Quality of Life (AFEQT) score including scores of four dimensions,i.e. atrial fibrillation-related symptoms, treatment concerns, daily activities, and treatment satisfaction. The secondary outcome measures included the frequency and duration of symptomatic atrial fibrillation episodes and traditional Chinese medicine (TCM) syndrome scores covering symptoms such as palpitations, chest tightness, fatigue, shortness of breath, reluctance to speak, spontaneous sweating, stabbing pain, and insomnia. These indicators were assessed at baseline (before treatment), after 2-week of treatment, after 4-week of treatment, and 4 weeks after the end of treatment (follow-up). Additionally, safety indicators before and after treatment and adverse events occurring during the trial were recorded to evaluate safety. ResultsA total of 56 patients completed the study, with 28 in each group. Primary outcome indicators: 1) the treatment group showed significant improvement in the total score of the AFEQT scale, with significantly higher total scores after 2-week treatment, 4-week treatment, and follow-up compared to the previous time point (P<0.05). In the control group, the AFEQT score significantly increased only after 4-week treatment compared to baseline (P<0.05). In the treatment group, the AFEQT scores after 2-week, 4-week treatment, and during follow-up were all higher than those of the control group at the corresponding time points (P<0.01). 2) In the treatment group, there was no statistically significant difference in the AFEQT treatment satisfaction dimension score during follow-up compared to that after 4-week treatment (P>0.05). However, the scores for all other dimensions at each time point were higher than those at the previous time point (P<0.05). In the control group, the scores for the atrial fibrillation-related symptom dimension were higher after 2-week and 4-week treatment than those of the previous time points (P<0.05). For the treatment satisfaction dimension, significant increases were observed only after 2-week and 4-week treatment compared to baseline (P<0.05). Secondary outcome indicators: 1) In the treatment group, the frequency and duration of symptomatic atrial fibrillation episodes decreased significantly at each time point compared to the previous time point (P<0.05), except for the duration of trial fibrillation at follow-up. In the control group, the frequency of episodes decreased significantly at all time points compared to baseline (P<0.05), while the duration of trial fibrillation showed a significant reduction at follow-up compared to those after 2-week treatment (P<0.05). 2) In the treatment group, TCM syndrome scores significantly reduced after 2-week treatment, 4-week treatment, and during follow-up compared to the previous time point and baseline (P<0.05). In the control group, significant reductions were observed only after 4-week after treatment and during follow-up (P<0.05). The TCM syndrome scores in the treatment group were lower than those in the control group at the same time points (P<0.01). No adverse events occurred during the trial in either group, and safety indicators showed no significant changes after treatment. ConclusionShenlong Dingji Formula effectively improves the quality of life, alleviates TCM syndromes, and reduces the frequency and duration of symptomatic atrial fibrillation in patients with PAF of qi-yin deficiency and phlegm-stasis obstructing collaterals syndrome, and demonstrates good safety.
4.Horticultural Therapy Combined with Intradermal Needling for Patients with Generalized Anxiety Disorder of Liver Depression Transforming into Fire Syndrome Under Transcranial Magnetic Stimulation and Psychological Therapy:Clinical Observation of 60 Cases
Wanyun ZHANG ; Jiayi YAN ; Qingyi QIU ; Yumei PENG ; Xiaoling ZHONG ; Jinwen ZHANG ; Rundong TANG ; Miao WU ; Dan HU ; Guang SU
Journal of Traditional Chinese Medicine 2025;66(1):50-58
ObjectiveTo observe the clinical effectiveness of horticultural therapy involving the planting of Chinese medicinal herbs (mint and lily potted plants) combined with intradermal needling therapy for generalized anxiety disorder (GAD) of liver depression transforming into fire syndrome under transcranial magnetic stimulation and basic psychological therapy, and to explore the possible mechanisms of action. MethodsA total of 180 patients with GAD of liver depression transforming into fire syndrome were randomly divided into three groups, horticultural therapy group, intradermal needling group, and horticultural therapy+intradermal needling group, with 60 patients in each. All groups received basic treatment including basic psychological therapy and transcranial magnetic stimulation. The horticultural therapy group received horticultural therapy in addition to the basic treatment; the intradermal needling group received intradermal needling therapy once a week for 8 weeks in addition to the basic treatment; the horticultural therapy+intradermal needling group received both horticultural therapy and intradermal needling therapy, following the same procedures and duration. Hamilton Anxiety Rating Scale (HAMA), Self-Rating Anxiety Scale (SAS), and Pittsburgh Sleep Quality Index (PSQI) scores were assessed at baseline and after 2, 4, 6, and 8 weeks of treatment. Serum levels of adrenocorticotropic hormone (ACTH) and corticosterone (CORT) were measured before treatment and after 8 weeks of treatment. Motor-evoked potential (MEP) baseline levels were recorded before treatment, and MEP amplitude ratios were compared after 1 week and 8 weeks of treatment. Clinical effectiveness and safety were evaluated after 8 weeks of treatment. Pearson correlation analysis was used to examine the relationships between serum ACTH and CORT levels, MEP amplitude, and anxiety. ResultsIn the horticultural therapy group and intradermal needling group, HAMA, SAS and PSQI scores after 4, 6, and 8 weeks treatment were lower than baseline scores (P<0.05). In the horticultural therapy+intradermal needling group, these scores showed a significant decline starting after 2 weeks treatment and continuing through 8 weeks after treatment (P<0.05). The HAMA, SAS, and PSQI scores in the horticultural therapy+intradermal needling group were significantly lower than those in the other two groups after 2, 4, 6, and 8 weeks treatment (P<0.05). After 8 weeks of treatment, serum CORT and ACTH levels in the horticultural therapy+intradermal needling group were significantly lower than baseline levels (P<0.05) and were also lower than those in the horticultural therapy group and intradermal needling group at the same time point (P<0.01). When comparing the level after 8 weeks treatment to that after 1 week treatment, under PAS10 stimulation, the MEP amplitude ratio in the intradermal needling group decreased at 30 minutes, while in the horticultural therapy+intradermal needling group, the MEP amplitude ratio decreased at all time points (P<0.05 or P<0.001); under PAS25 stimulation, the MEP amplitude ratio in the horticultural therapy group increased at 20 minutes, and in the intradermal needle group at 10 minutes (P<0.05). In the horticultural therapy+intradermal needling group, the MEP amplitude ratio increased significantly at all time points after treatment (P<0.001). The cure rate in the horticultural therapy+intradermal needling group (74.14%, 43/58) was significantly higher than that in the horticultural therapy group (30.00%, 18/60) and the intradermal needling group (48.28%, 28/58, P<0.05). Correlation analysis revealed that serum ACTH and CORT levels were positively correlated with HAMA scores (r = 0.488, P<0.01; r = 0.428, P<0.01). Following PAS10 intervention, the MEP amplitude ratio was positively correlated with HAMA scores (r = 0.458, P<0.01), whereas after PAS25 intervention, the MEP amplitude ratio was negatively correlated with HAMA scores (r = -0.562, P<0.01). ConclusionHorticultural therapy combined with intradermal needling treatment, under transcranial magnetic stimulation and basic psychological therapy, demonstrates significant clinical effectiveness in patients with GAD of liver depression transforming into fire syndrome. Its mechanism of action may be related to the regulation of hyperactivation of the hypothalamic-pituitary-adrenal (HPA) axis and the reduction of cortical excitability.
5.Nuangong Tiaojing Decoction (暖宫调经汤) Combined with Ginger Moxibustion at Baliao (八髎) Acupoints for Patients with Premature Ovarian Failure of Yang-Deficiency Uterus-Coldeness Syndrome:65 Cases Clinical Observation
Yuqiong MENG ; Qiang GAO ; Tingting ZHAI ; Zhihong YANG
Journal of Traditional Chinese Medicine 2025;66(1):59-64
ObjectiveTo explore the clinical effectivess of Nuangong Tiaojing Decoction (暖宫调经汤) combined with ginger moxibustion at Baliao acupoints (Eight Bone-Holes) for treating premature ovarian failure (POF) of yang-deficiency uterus-coldeness syndrome, based on conventional western medical treatment. MethodsA total of 130 patients diagnosed with POF of yang-deficiency uterus-coldeness syndrome were divided into a treatment group and a control group, with 65 cases in each group, based on patient preference. The control group received conventional western medicine treatment, while the treatment group was additionally given Nuangong Tiaojing Decoction orally one dose per day and underwent ginger moxibustion at Baliao points once daily. Both groups were treated for three months. Before and after treatment, ovarian function indicators, including ovarian volume, follicle count, ovarian peak systolic velocity (PSV), and endometrial thickness were assessed, and serum sex hormone levels including progesterone (P), estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL), and testosterone (T), as well as anti-Müllerian hormone (AMH) levels were also measured. Additionally, traditional Chinese medicine (TCM) syndrome scores were evaluated, covering symptoms such as reduced libido, lumbosacral pain, fear of cold with cold extremities, fatigue, dull complexion, lower abdominal distension and pain, pale tongue, and deep and rough pulse. After treatment, clinical effectiveness and safety were determined. ResultsCompared with the pre-treatment levels within group, both groups showed significant increases in ovarian volume, follicle count, PSV, endometrial thickness, and levels of P, E2, and AMH after treatment, while the levels of FSH, LH, PRL, and T, as well as scores of lumbosacral pain, reduced libido, dull complexion, deep and rough pulse, and total TCM syndrome scores significantly reduced after treatment. Furthermore, the treatment group exhibited higher ovarian volume, follicle count, PSV, endometrial thickness, and levels of P, E2, and AMH compared to the control group, while FSH, LH, PRL, T levels, and all symptom scores, as well as total TCM syndrome scores, were significantly lower in the treatment group than in the control group (P<0.05 or P<0.01). The clinical effectiveness in treatment group was 96.92% (63/65), significantly higher than 81.54% (53/65) in control group (P<0.05). The incidence of adverse reactions in the treatment group was 26.15% (17/65), while in the control group it was 32.31% (21/65), with no statistically significant difference (P>0.05). ConclusionOn the basis of conventional western medicine treament, Nuangong Tiaojing Decoction combined with ginger moxibustion at Baliao acupoints for patients with POF of yang-deficiency uterus-coldeness syndrome can significantly improve ovarian function and clinical symptoms, regulate hormone levels, and thereby enhance clinical effectiveness.
6.Effects of Shenfuhuang Formula (参附黄配方) on Potential Targets of Action in the Brain Tissue of Sepsis Model Mice:Transcriptomics-Based Exploration
Yuchen WANG ; Xuerui WANG ; Xiaolong XU ; Jingxia ZHAO ; Jiabo WANG ; Yuan GAO ; Weijun KONG ; Qingquan LIU
Journal of Traditional Chinese Medicine 2025;66(1):65-70
ObjectiveTo investigate the possible mechanism of Shenfuhuang Formula (参附黄配方) in prevention and treatment of epsis-associated encephalopathy from the perspective of brain genomics. MethodsC57BL/6 mice were randomly divided into sham surgery group, sepsis group, and Shenfuhuang group, with 20 mice in each group. The sepsis group and Shenfuhuang group were induced to develop sepsis by cecal ligation and puncture (CLP) procedure. At 4 hours after modelling, Shenfuhuang group were gavaged with 2.5 g/(kg·d) of Shenfuhuang Formula, 0.5 ml each time, at 12 hours intervals, for a total of 4 times after modelling. Sepsis group and sham surgery group were given 0.5 ml of purified water orally. At 48 hours after modeling, the transcriptome sequencing was used to explore the differential gene expression in the effects of Shenfuhuang Formula on the brain regions of septic mice, and real-time PCR and ELISA were later used to further validate the differential gene and proteins expression. ResultsA total of 4605 genes were differentially expressed in Shenfuhuang group compared with sepsis group, of which 2353 genes were up-regulated and 2252 genes were down-regulated. According to the results of previous publications, six key genes were screened, including serine/threonine-protein kinase (Nek1), myelin-associated glycoprotein (Mag), endothelial cell-specific tyrosine kinase receptor (Tek), a disintegrin and metalloproteinase with thrombospondin motifs 20 (Adamts20), lymphocyte antigen 86 (Ly86), and E3 ubiquitin-protein ligase (Traip). Further genetic and protein validation revealed that, compared to the sham surgery group, the mRNA levels and corresponding protein levels of Nek1, Mag, Tek, Adamts20, Ly86, and Traip in the brain tissue of septic mice significantly reduced (P<0.05). In comparison to the sepsis group, Shenfuhuang group showed significantly increased mRNA levels and corresponding protein levels of Nek1, Mag, Tek, Adamts20, Ly86, and Traip (P<0.05). ConclusionThe potential therapeutic targets of Shenfuhuang Formula for treating sepsis-associated encephalopathy may be related to the Nek1, Mag, Tek, Adamts20, Ly86, and Traip genes and their encoded proteins.
7.The Effect of Modified Ditan Decoction (涤痰汤) on Cognitive Function and Resting-State Functional Magnetic Resonance Imaging of the Brain in Chronic Intermittent Hypoxia Model Rats
Naijie CHEN ; Xiaoting WANG ; Fengsheng XU ; Shuanghong SHEN ; Zuanfang LI ; Qin CHEN ; Jin CHEN ; Runhua WU
Journal of Traditional Chinese Medicine 2025;66(1):71-78
ObjectiveTo explore the effect of modified Ditan Decoction (涤痰汤) on chronic intermittent hypoxia cognitive function and the potential function mechanism. MethodsTwenty-four Sprague-Dawley (SD) rats were randomly divided into a normal group, a model group, and a modified Ditan Decoction group, with eight rats in each group. Rats in the modified Ditan Decoction group were administered the decoction by gavage at 14.8 ml/(kg·d), while the normal group and the model group received the same dose of normal saline. Thirty minutes after daily gavage, the rats in all three groups were placed in an intermittent hypoxia chamber. The oxygen concentration for the model group and the modified Ditan Decoction group was adjusted daily for 8 hours using a computer program to establish the model, while the normal group was exposed to the same airflow rate of ambient air. The intervention was continued for 12 weeks to establish a chronic intermittent hypoxia rat model. The Y-maze test was used to evaluate spatial working memory in the rats. Resting-state functional magnetic resonance imaging (rs-fMRI) was performed to detect whole-brain regional homogeneity (ReHo) and seed-based functional connectivity (FC). Brain regions showing significant differences in rs-fMRI were selected for further analysis. Immunofluorescence was used to detect β-amyloid (Aβ) deposition and the number of ionized calcium-binding adapter molecule 1 (IBA1)-positive microglial cells. Immunohistochemistry was employed to assess the expression of synaptophysin (SYP), the excitatory synapse marker vesicular glutamate transporter 1 (Vglut1), and the inhibitory synapse marker vesicular γ-aminobutyric acid transporter (VGAT). ResultsCompared with the normal group, the model group showed a reduced spontaneous alternation rate in the Y-maze test. The smoothed Z-score standardized regional homogeneity (SzReHo) value in the left entorhinal cortex significantly increased, and the FC value from this seed point to the left basal forebrain significantly reduced. Additionally, the model group exhibited significantly higher Aβ fluorescence intensity and Iba1 positivity in the left entorhinal cortex, decreased expression of SYP, Vglut1, and VGAT, along with an increased Vglut1/VGAT ratio (P<0.05 or P<0.01). Compared to the model group, the modified Ditan Decoction group demonstrated an increased spontaneous alternation rate, a significantly reduced SzReHo value in the left entorhinal cortex, and a significantly increased FC value from this region to the left basal forebrain. Furthermore, this group showed significantly lower Aβ fluorescence intensity and Iba1 positivity in the left entorhinal cortex, increased levels of SYP, Vglut1, and VGAT, and a decreased Vglut1/VGAT ratio (P<0.05 or P<0.01). ConclusionModified Ditan Decoction can reconstruct the projection from the left basal forebrain to the entorhinal cortex in chronic intermittent hypoxia, thereby reducing Aβ aggregation and excessive microglial activation in the left entorhinal cortex. This process improves the excitation/inhibition imbalance caused by synaptic remodeling, ultimately enhancing cognitive function in rats of chronic intermittent hypoxia.
8.The Effect of Qishao Tongbi Capsule (芪芍通痹胶囊) on the Wnt/β-catenin Pathway in a Rat Model of Intervertebral Disc Degeneration
Yumen XUE ; Xilin XU ; Wei HAN ; Jiaben XU ; Wenting XU ; Zelin LIU ; Xiaofeng ZHANG
Journal of Traditional Chinese Medicine 2025;66(1):79-88
ObjectiveTo explore the possible mechanism of Qishao Tongbi Capsule (芪芍通痹胶囊, QTC) in the treatment of intervertebral disc degeneration (IDD). MethodsSeventy-five rats were randomly divided into control group, model group, low-dose QTC group, high-dose QTC group, high-dose QTC +agonist group, with 15 rats in each group. Except for the control group, all other groups were subjected to a fibrous ring puncture to prepare an IDD model. After modeling, rats in low-dose QTC group and high-dose QTC group were given QTC at doses of 0.2 and 0.8 g/(kg·d) by gavage, respectively. Rats in high-dose QTC+ agonist group was given QTC at 0.8 g/(kg·d) and SKL2001 solution at 10 mg/(kg·d) by gavage. The control group and model group were given 10 ml/(kg·d) distilled water by gavage. All treatments were given once a day for 4 consecutive weeks. After treatment, X-ray and magnetic resonance imaging (MRI) were used to detect IDD degree. Hematoxylin-eosin (HE) staining and Safranin O-Fast Green staining were used to observe the morphological changes of the intervertebral disc tissue. Immunohistochemical staining was performed to examine the levels of proteoglycan, type Ⅱ collagen (COL Ⅱ), and matrix metalloproteinase-3 (MMP-3) in the intervertebral disc tissue. Western blotting was used to detect the extracellular matrix (ECM)-related proteins (proteoglycan, COL Ⅱ, MMP-3, MMP-9, MMP-13), aging-related proteins (P53, P21, P16), apoptosis related proteins, including B-cell lymphoma/leukemia 2 (BCL-2), BCL-2 related X protein (BAX), Cleaved Caspase-3, and Wnt/β-catenin pathway related proteins such as Wnt3a, glycogen synthase kinase-3β (GSK-3β) and β-catenin in the intervertebral disc nucleus pulposus (NP) tissue. Reverse Transcription Quantitative Polymerase Chain Reaction (RT-qPCR) was used to assess the mRNA expression of Wnt3a, GSK-3β, and β-catenin in intervertebral disc tissue. ResultsCompared with the model group, rats in the low-dose QTC group and high-dose QTC group exhibited improved DHI, decreased Pfirmann grading, and alleviated IDD. The structural integrity of the NP and annulus fibrosus increased, and the number of the NP increased. The levels of proteoglycan, COL Ⅱ, BCL-2 and GSK-3β increased, while the levels of MMP-3, MMP-9, MMP-13, P53, P21, P16, BAX, Cleaved Caspase-3, Wnt3a and β-catenin protein decreased. The mRNA expression of Wnt3a and β-catenin mRNA decreased, while GSK-3β mRNA expression increased (P<0.05). Compared with the low-dose QTC group, the high-dose QTC group showed further improvements in DHI, decrease in Pfirrmann grading (P<0.05), and greater alleviation of IDD. The structural integrity of NP and annulus fibrosus was further enhanced, and the number of NP cells further increased. The levels of proteoglycan, COL Ⅱ, BCL-2 and GSK-3β were higher, while the levels of MMP-3, MMP-9, MMP-13, P53, P21, P16, BAX, Cleaved Caspase-3, Wnt3a and β-catenin were lower. The mRNA expression of Wnt3a and β-catenin decreased, while GSK-3β mRNA expression increased (P<0.05). Compared with the high-dose QTC group, the high-dose QTC +agonist group showed a decrease of DHI, an increase of Pfirmann grading (P<0.05), significant aggravation of IDD, reduction in structural integrity of the NP and annulus fibrosus, a decrease of NP cell count, lower levels of proteoglycan, COL Ⅱ, BCL-2 and GSK-3β, and higher levels of MMP-3, MMP-9, MMP-13, P53, P21, P16, BAX and Cleaved Caspase-3. Additionally, GSK-3β mRNA expression decreased (P<0.05). ConclusionQTC can inhibit NP cell aging, apoptosis, and ECM degradation in IDD rats, and its therapeutic effect may be mediated through the inhibition of the Wnt/β-catenin pathway.
9.Syndrome Differentiation and Treatment of Atrial Fibrillation based on the Holistic View of "Spleen-Vessels-Heart-Spirit"
Yihang DU ; Chenglin DUAN ; Xueping ZHU ; Meng LYU ; Jiafan CHEN ; Yi WEI ; Yuanhui HU
Journal of Traditional Chinese Medicine 2025;66(1):89-92
Based on the holistic view of "spleen-vessels-heart-spirit" system, this article explores the pathogenesis and progression of atrial fibrillation. It is proposed that the onset of atrial fibrillation is due to failure of the spleen to transport and disharmony of blood vessels; phlegm and blood stasis obstructing the collaterals and damage to the heart structure are the basis of its pathogenesis; the unclear mind and disorder of body and spirit are the causes of its progression. Based on the characteristics of pathological changes in different stages of the disease, it is proposed that early treatment should focus on restoring the middle jiao, clearing and promoting blood vessels, using modified Yigong Powder (异功散); during the progression of the disease, treatment should remove blood stasis and phlegm, nourish heart and protect the pulse, using self-prescribed modified Mengshi Tongmai Decoction (礞石通脉汤); meanwhile, calming mind and stabilizing palpitations, and regulating spirit should be sequentially incorporated, with self-prescribed Jiazao Ningmai Decoction (甲枣宁脉汤) or Shenying Dingji Decoction (参英定悸汤) and modified as appropriate. Clinical treatment should focus on the whole disease course of atrial fibrillation, implementing stage-based treatments to enable early intervention and holistic regulation.
10.Treatment of Sjögren's Syndrome of Yin-Deficiency and Heat-Toxin Type based on the Theory of Exuberance of Shaoyang Ministerial Fire Accumulating to Heat Toxin
Wei LIU ; Qingyun YUE ; Meijiao ZHOU
Journal of Traditional Chinese Medicine 2025;66(1):93-97
This article aimed to summarize the clinical experience of treating sjögren's syndrome of yin-deficiency and heat-toxin type based on the theory of exuberance of shaoyang ministerial fire accumulating to heat toxin. It is believed that sjögren's syndrome of yin-deficiency and heat-toxin type is attributed to dysfunction of shaoyang gallbladder, disruption in the circulation of sanjiao, stagnation of qi leading to fire, and prolonged accumulation of toxins causing damage. The core disease mechanism involves shaoyang dysfunction, hyperactivity of ministerial fire, and accumulation of heat toxins. In clinical practice, the therapeutic principles focus on regulating shaoyang, stabilizing and subduing ministerial fire, enriching yin and resolving toxins. For shaoyang dysfunction with internal stagnation of heat toxins, treatment should aim to unblock shaoyang, clear fire and expel toxins, using modified Sangchai Decoction (桑柴饮); for shaoyang transformation into fire with symptoms of wood (the gallbladder) disease, the approach involves soothing and regulating gallbladder, clearing heat and resolving toxins, using modified Chaihu Shaoyao Decoction (柴胡芍药汤); for disordered ministerial fire with excessive heat toxins, the strategy is to rescue the sovereign fire and stabilize the ministerial fire, employing modified Xinshen Liangjiao Decoction (心肾两交汤); for unregulated ministerial fire with disordered distribution, treatment focuses on increasing body fluids and nourishing yin, stabilizing the ministerial fire, using modified Buyin Decoction (补阴汤).

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