1.Construction of a Three-dimensional Syndrome Differentiation System for Pulmonary Nodules under the Perspective of Qi, Blood and Fluids
Longfei ZHANG ; Hengzhou LAI ; Xi FU ; Fang LI ; Xueke LI ; Chuan ZHENG ; Fengming YOU ; Yifeng REN
Journal of Traditional Chinese Medicine 2024;65(2):144-148
Based on the theory of qi, blood and fluids, and taking into account of the pathogenesis evolution process from constraint to phlegm, stasis and then mass in pulmonary nodules, an attempt has been made to construct a three-dimensional differentiation system for pulmonary nodules from the dimensions of time and space. The temporal progression of the early, middle, and late stages of pulmonary nodules reflects the pathological changes from constraint to phlegm and then stasis in the metabolism disorders of qi, blood and fluid. The spatial structures such as size, density, and morphology of pulmonary nodules reflect the pathological states of the duration, severity, and primary and secondary conditions of qi, blood and fluid metabolism disorders. Based on the temporal progression, the therapeutic principles have been proposed, which are dispelling pathogenic factors and promoting the use of beneficial factors to interrupt the growth momentum in the early stage, removing turbidity and dispersing phlegm to reduce the degree of nodules in the middle stage, and dispersing nodulation and eliminating abnormalities in the late stage. Based on the spatial structures, the suggested therapeutic methods are using wind herbs, employing multiple approaches to treat phlegm, and promoting blood circulation to resolve stasis, so as to provide theoretical reference for the systematic diagnosis and treatment of pulmonary nodules in traditional Chinese medicine.
2.Pathophysiological Evolution and Syndrome-Based Stratified Treatment of Qi Deficiency with Stagnation in Chemotherapy-Induced Myelosuppression
Jing LONG ; Hengzhou LAI ; Wenbo HUANG ; Feng YU ; Yifang JIANG ; Zhuoling DAI ; Chong XIAO ; Fengming YOU
Journal of Traditional Chinese Medicine 2025;66(11):1109-1113
The concept of "qi deficiency with stagnation" refers to a pathological state characterized by the depletion of primordial qi, impaired qi transformation, and the development of internal stagnation. Under the cyclic chemotherapy regimen in oncology, chemotherapy-induced myelosuppression follows a progressive pathological course from qi deficiency to increasing stagnation. This sequential evolution from mild to severe myelosuppression closely aligns with the dynamic syndrome differentiation and treatment framework of "qi deficiency with stagnation". "Qi deficiency" reflects the gradual depletion of qi, blood, and essence, while "stagnation" refers to the accumulation of phlegm, turbid dampness, and blood stasis. These two components interact reciprocally, forming a vicious cycle where deficiency leads to stagnation, and stagnation further damages the healthy qi. In the early stage of mild myelosuppression, chemotoxicity begins to accumulate in the bone marrow, leading to qi consumption, blood deficiency, yin injury, and the gradual formation of turbid phlegm and damp stagnation. In the advanced stage of severe myelosuppression, the accumulation of toxicity causes qi sinking, exhaustion of essence, and marrow depletion, along with blood stasis obstructing the collaterals. Treatment strategies should be based on syndrome differentiation, with an emphasis on assessing the severity of the condition, balancing deficiency and excess, and achieving both symptomatic relief and root cause resolution.