1.Intervention Strategies for Heart Failure with Preserved Ejection Fraction Using Combined Classical Formulas Based on the Theory of "Disease of Both Blood and Water"
Yuzhi JIA ; Qingyong HE ; Jie WANG ; Xin ZHAO ; Ziyi WANG ; Dongmei LI ; Junqiao AN
Journal of Traditional Chinese Medicine 2026;67(4):370-374
Based on the theory of "disease of both blood and water" in Essentials from the Golden Cabinet (《金匮要略》), and in combination with the dynamic syndrome evolution of heart failure with preserved ejection fraction (HFpEF), this paper systematically clarifies the pathomechanism of HFpEF, characterized by yang deficiency as the root, blood stasis as the pivotal factor and water retention as the manifestation. Accordingly, the therapeutic principles have been proposed, which are warming yang and banking up original qi to consolidate the root, activating blood and unblocking collaterals to smooth the mechanism, and promoting urination and regulating pivot to remove the branch. On this basis, a compound formula structure of "one monarch, one minister and one assistant" is established, forming an integrated intervention strategy that synergistically combines the three methods of warming yang, activating blood, and promoting urination through combined classical formulas. Zhenwu Decoction (真武汤), which warms yang and dissolves rheum, is used to consolidate the root and directly target the source of yang deficiency, serving as the monarch; Guizhi Fuling Pills (桂枝茯苓丸), which activates blood, promotes urination and unblocks the pivot, assists in interrupting the binding of blood stasis and water retention, serving as the minister; Tingli Dazao Xiefei Decoction (葶苈大枣泻肺汤), which regulates qi, disperses retained fluids, and eliminates the manifestation, alleviates acute water-retention symptoms, serving as the assistant. This compound formula is warming without being drying, diuretic without being drastic, and dispels stasis without consuming blood, thereby achieving the therapeutic effects of warming yang, activating blood, and promoting urination.
2.Analysis of comparator selection strategies for pharmaceutical enterprises in the national reimbursement drug list access application
Qingwen WANG ; Qin AN ; Xiaoyan YUAN ; Yuzhi HAN ; Xi CHEN ; Hongyan WU
China Pharmacy 2026;37(8):985-990
OBJECTIVE To analyze the selection and rationales of comparators for pharmaceutical enterprises in their medical insurance access application, so as to provide a reference for promoting communication and consensus between enterprises and medical insurance authorities in this process. METHODS The application materials for drugs outside the catalogue that passed formal review published by the National Healthcare Security Administration from 2021 to 2025 were extracted, and then content analysis was used to systematically sort out relevant information of the declared drugs and comparators; the specific situations and rationales of pharmaceutical enterprises’ selection of comparators were analyzed. RESULTS A total of 1 341 declared drug documents were collected. Data analysis showed that 1 035 (77.18%) were submitted with positive comparators and 306 (22.82%) used blank comparators; 58 drugs (4.33%) took combination therapy as the reference, and 5 drugs (0.37%) referred to non-pharmacological (or non-single pharmacological) treatment regimens. Among competitive drugs declared by multiple enterprises, 50.00% of the enterprises submitted different comparators. A total of 4 basic conditions and 39 additional conditions were extracted as the rationales for selecting positive comparators. For blank comparators, 12 drug-related factors, 2 administrative factors, and 1 other factor were identified. More than 10% of the drugs did not state the rationale for comparator selection, and over 44% of drugs using blank comparators provided only one justification. CONCLUSIONS Pharmaceutical enterprises mainly select comparators based on their own interests in the medical insurance access application, and there are deficiencies in the adequacy and standardization of their selection basis and reasoning. It is recommended that enterprises follow the principled requirements of medical insurance authorities, and fully and normatively explain the reasons for selecting comparators in combination with the characteristics of their own products. Meanwhile, it is advisable to change the current open-ended statement form of selection reasons into a closed-ended answering mode, so as to highlight the priority of selection, standardize the declaration behavior of enterprises, and reduce communication divergences between the two parties.
3.Clinical and Neuroelectrophysiological Features of Autoimmune Nodopathy
Hongfei TAI ; Xunyan HUANG ; Songtao NIU ; Bin CHEN ; Yuzhi SHI ; Xingao WANG ; Fan JIAN ; Hua PAN ; Zaiqiang ZHANG
JOURNAL OF RARE DISEASES 2026;5(2):191-199
To summarize the clinical characteristics, antibody spectrum and neuroelectrophysiological features of autoimmune nodopathy(AN), and to explore the phenotypic differences among different antibody-positive subgroups. The clinical and electrophysiological data of patients definitely diagnosed with AN in Beijing Tiantan Hospital, Capital Medical University, from October 2018 to January 2026 were retrospectively analyzed. A total of 33 patients with AN were included. Antibody examination results showed that, anti-neurofascin(NF)155 antibody was the most prevalent, detected in 17 patients(51.50%), followed by anti-contactin-1(CNTN1) antibody in 8 patients(24.24%). Anti-NF186 antibody(4 cases, 12.12%), anti-contactin-associated protein 1(Caspr1) antibody(2 cases, 6.06%) and dual-target antibody positivity(2 cases, 6.06%) were relatively uncommon. The main clinical manifestations of AN patients included symmetric distal paresthesia of the extremities(32 cases, 96.97%), limb weakness(31 cases, 93.93%) and sensory ataxia(25 cases, 75.76%). Different antibody-positive subgroups presented distinct phenotypic features: patients with positive anti-NF155 antibody had a relatively younger age of onset, chronic onset and a high incidence of tremor, which was dominated by immunoglobulin(Ig)G4 subclass antibodies; patients with positive anti-CNTN1 antibody had a relatively advanced age of onset, mostly presented with acute or subacute onset, and were prone to complicated nephrotic syndrome; patients with positive anti-NF186 antibody had relatively mild nerve conduction damage; patients with anti-Caspr1 antibody manifested acute or subacute onset, with relatively elevated cerebrospinal fluid protein level and 24-h intrathecal IgG synthesis rate. The prominent neuroelectrophysiological manifestations of AN included decreased motor and sensory nerve conduction velocities, prolonged distal latency, frequent non-compressive conduction block and abnormal temporal dispersion. Definite sensory nerve action potentials could not be elicited in more than half of the patients. Patients with AN show high heterogeneity in clinical and neuroelectrophysiological characteristics, and different antibody-positive subgroups correspond to specific clinical and neuroelectrophysiological phenotypes.
4.Clinical Application of Qili Qiangxin Capsules in Prevention and Treatment of Chronic Heart Failure: A Review
Dongmei LI ; Ziyi WANG ; Yuzhi JIA ; Xiaoping ZHENG ; Jia SUN ; Lei WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):306-313
This study systematically dissects the core pathogenesis of chronic heart failure (CHF) featured by internal deficiency and external excess,imbalance of Qi,blood,Yin,and Yang,and intermingling of phlegm,blood stasis,and fluid retention. According to the traditional Chinese medicine (TCM) therapeutic principles of simultaneously treating root cause and symptoms,regulating Yin and Yang,replenishing Qi and activating blood,and promoting urination to relieve edema,this article deeply explores the formula-syndrome correspondence of Qili Qiangxin (QLQX) capsules in the treatment of CHF,providing a solid theoretical basis for the multi-effect characteristics of this drug. CHF is a common critical cardiovascular disease in clinical practice,and its pathological process involves multiple links including myocardial injury,neurohumoral disturbance,and ventricular remodeling. Its TCM pathogenesis is complex and involves multiple Zang-Fu organs,making it difficult for a single therapeutic method to achieve comprehensive coverage. QLQX capsules,formulated based on classical TCM theory,perfectly matches the pathogenic characteristics of CHF. Modern pharmacological studies have confirmed that QLQX capsules possess definite cardiotonic,diuretic,and vasodilatory effects. The active ingredients of QLQX capsules can rapidly and effectively alleviate the core clinical symptoms such as chest tightness,shortness of breath,decreased exercise tolerance,limb edema,palpitations,and fatigue of CHF patients by enhancing myocardial contractility and coronary blood flow,improving renal water excretion function,dilating peripheral blood vessels,and reducing cardiac load,thereby significantly improving patients' quality of life. On the basis of analyzing the symptomatic treatment of CHF with QLQX capsules,this study further expounds that the drug can intervene in ventricular remodeling through multiple pathways and targets,regulate the pathological mechanism of CHF,improve vascular endothelial function,mediate the activation of related signaling pathways,inhibit the transdifferentiation of cardiac fibroblasts,and regulate myocardial energy metabolism,thus delaying disease progression. QLQX capsules exert significant benefits in reducing composite cardiac events,improving New York Heart Association (NYHA) cardiac function classification,left ventricular ejection fraction (LVEF),6-minute walking distance (6MWD),and quality of life,demonstrating favorable clinical value. With the TCM pathogenesis of CHF as the guiding principle and modern pharmacology as the evidence,this study systematically clarifies the core advantage of QLQX capsules in treatment based on syndrome differentiation and multi-target synergy through the in-depth integration of TCM theory and modern pharmacology. It provides academic support with both theoretical depth and practical value for TCM intervention in CHF,and contributes TCM wisdom and schemes to the construction of a chronic disease management system with Chinese characteristics.
5.Clinical Application of Qili Qiangxin Capsules in Prevention and Treatment of Chronic Heart Failure: A Review
Dongmei LI ; Ziyi WANG ; Yuzhi JIA ; Xiaoping ZHENG ; Jia SUN ; Lei WANG
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(20):306-313
This study systematically dissects the core pathogenesis of chronic heart failure (CHF) featured by internal deficiency and external excess,imbalance of Qi,blood,Yin,and Yang,and intermingling of phlegm,blood stasis,and fluid retention. According to the traditional Chinese medicine (TCM) therapeutic principles of simultaneously treating root cause and symptoms,regulating Yin and Yang,replenishing Qi and activating blood,and promoting urination to relieve edema,this article deeply explores the formula-syndrome correspondence of Qili Qiangxin (QLQX) capsules in the treatment of CHF,providing a solid theoretical basis for the multi-effect characteristics of this drug. CHF is a common critical cardiovascular disease in clinical practice,and its pathological process involves multiple links including myocardial injury,neurohumoral disturbance,and ventricular remodeling. Its TCM pathogenesis is complex and involves multiple Zang-Fu organs,making it difficult for a single therapeutic method to achieve comprehensive coverage. QLQX capsules,formulated based on classical TCM theory,perfectly matches the pathogenic characteristics of CHF. Modern pharmacological studies have confirmed that QLQX capsules possess definite cardiotonic,diuretic,and vasodilatory effects. The active ingredients of QLQX capsules can rapidly and effectively alleviate the core clinical symptoms such as chest tightness,shortness of breath,decreased exercise tolerance,limb edema,palpitations,and fatigue of CHF patients by enhancing myocardial contractility and coronary blood flow,improving renal water excretion function,dilating peripheral blood vessels,and reducing cardiac load,thereby significantly improving patients' quality of life. On the basis of analyzing the symptomatic treatment of CHF with QLQX capsules,this study further expounds that the drug can intervene in ventricular remodeling through multiple pathways and targets,regulate the pathological mechanism of CHF,improve vascular endothelial function,mediate the activation of related signaling pathways,inhibit the transdifferentiation of cardiac fibroblasts,and regulate myocardial energy metabolism,thus delaying disease progression. QLQX capsules exert significant benefits in reducing composite cardiac events,improving New York Heart Association (NYHA) cardiac function classification,left ventricular ejection fraction (LVEF),6-minute walking distance (6MWD),and quality of life,demonstrating favorable clinical value. With the TCM pathogenesis of CHF as the guiding principle and modern pharmacology as the evidence,this study systematically clarifies the core advantage of QLQX capsules in treatment based on syndrome differentiation and multi-target synergy through the in-depth integration of TCM theory and modern pharmacology. It provides academic support with both theoretical depth and practical value for TCM intervention in CHF,and contributes TCM wisdom and schemes to the construction of a chronic disease management system with Chinese characteristics.
6.Animal Models of Carotid Vulnerable Plaques Based on Clinical Disease and Syndrome Characteristics of Traditional Chinese and Western Medicine
Yuzhi JIA ; Qingyong HE ; Ziyi WANG ; Suwen CHEN ; Hui ZHANG ; Jing GAO ; Peihao WANG ; Junqiao AN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(22):235-240
The rupture of carotid vulnerable plaques is the core pathological basis for major cardiovascular and cerebrovascular events. However, the insufficient alignment between existing animal models and the clinical disease and syndrome characteristics of traditional Chinese and western medicine has limited research progress. In this study, biomedical databases in China and abroad were systematically searched, and the modeling mechanisms and evaluation systems of carotid vulnerable plaque animal models were systematically assessed based on diagnostic criteria of both traditional Chinese and western medicine. Analysis of the clinical correspondence indicated that existing animal models can be categorized into four types: simple high-fat diet, surgical induction combined with high-fat feeding, genetic engineering combined with high-fat feeding, and drug induction combined with high-fat feeding. Among these, the compound strategy of surgical induction combined with high-fat feeding has become the current mainstream approach, showing good concordance with western medicine. The study found that the double balloon injury rabbit model and the ApoE-/- mouse carotid artery tandem constriction combined with high-fat feeding model demonstrated a high degree of clinical correspondence with both traditional Chinese and western medicine in terms of vulnerable plaque imaging and pathological features. Nevertheless, existing models still face significant technical limitations in faithfully simulating plaque pathology and in translating findings to clinical applications. To address these challenges, integrating complex comorbidity mechanism construction, multimodal dynamic mechanism monitoring, and collaborative evaluation systems of traditional Chinese and western medicine could enable the development of highly concordant carotid vulnerable plaque disease-syndrome combination animal models. Such models would provide a reproducible experimental platform for targeted drug development to regulate plaque stability and for individualized precision treatment, as well as a theoretical basis for innovation in clinical diagnostic and therapeutic strategies.
7.Effect of Bushen Huoxue Granule (补肾活血颗粒) on Dopamine Homeostasis and ERK/CREB/VMAT2 Signaling Pathways in the Striatum in Parkinson's Disease Model Mice
Hehao SUN ; Yingfan CHEN ; Peng WANG ; Xiaohan GENG ; Yuzhi ZHANG ; Qian ZHANG ; Min LI ; Shaodan LI ; Minghui YANG
Journal of Traditional Chinese Medicine 2025;66(23):2484-2493
ObjectiveTo investigate the possible mechanism of Bushen Huoxue Granule (补肾活血颗粒, BHG) in treating Parkinson's disease (PD) from the perspecitve of dopamine (DA) homeostasis. MethodsSeventy-two mice were randomly divided into blank group, model group, madopar group and BHG low-, medium- and high-dose groups, with 12 mice in each group. Except for the blank group, all mice were administered intraperitoneal injections of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) for 7 consecutive days to induce a PD model. On the day following the injection, BHG low-, medium- and high-dose groups were administered BHG at doses of 1.25, 2.5, and 5.0 mg/(g·d) by oral gavage, respectively, while the madopar group received madopar tablets at dose of 0.093 8 mg/(g·d) by oral gavage. The blank group and the model group were given 0.2 ml/10 g of distilled water by gavage. All treatments were given once daily for 14 days. Open field test, pole climbing test and grip test were used to evaluate the behavior of mice in each group. Immunohistochemistry was used to detect the expression of tyrosine hydroxylase (TH) in striatum. Nissl staining was used to detect the activity of striatal neurons. The contents of DA and 3,4-dihydroxyphenylacetic acid (DOPAC) in striatum were detected by ultra performance liquid chromatography tandem mass spectrometry. The number and volume of synaptic vesicles were observed by transmission electron microscope. The expression of vesicular monoamine transporter 2 (VMAT2) in striatum was detected by immunofluorescence. Western Blot was used to detect the expression of extracellular signal-regulated kinase (ERK), phosphorylated ERK (p-ERK), cAMP response element-binding protein (CREB), phosphorylated CREB (p-CREB) and VMAT2 in striatum. ResultsCompared to the blank group, mice in the model group showed a significant decline in total distance and average speed in the open field test, along with an increase in total resting time; in the pole test, both the time required for the mice to turn completely downward (T-turn) and the total time taken to reach the bottom of the pole (T-total) were prolonged; forelimb grip strength was reduced; in the striatum, the mean optical density of TH, the average fluorescence intensity of VMAT2 protein, and DA content all decreased, while the number of striatal neurons was reduced, and the DOPAC/DA ratio was elevated; the levels of p-ERK/ERK, p-CREB/CREB, and VMAT2 in the striatum significantly decreased (P<0.01); transmission electron microscopy revealed that both the number and volume of synaptic vesicles in striatal neurons were markedly reduced. Compared to the model group, mice in the madopar group and BHG low-, medium- and high-dose groups showed significant improvements in all the above indicators (P<0.05 or P<0.01). Compared to madopar group, the BHG high-dose group exhibited increased DA content and elevated p-CREB/CREB ratio in the striatum (P<0.05). Compared to the BHG low-dose group, the BHG high-dose group showed increased total distance and mean velocity, decreased total resting time, T-turn, and T-total, as well as enhanced forelimb grip strength; moreover, the average fluorescence intensity of VMAT2 protein, DA content, p-ERK/ERK, p-CREB/CREB, and VMAT2 levels in the striatum were all significantly elevated (P<0.05 or P<0.01). ConclusionBHG may restore DA homeostasis and alleviate the damage of dopaminergic neurons by regulating ERK/CREB/VMAT2 signaling pathway.
8.Dual attributes of tonifying drugs in Shen Nong Ben Cao Jing: replenishing deficiency and expelling pathogens
Yuzhi HUO ; Cheng LUO ; Mengfan YANG ; Ying DENG ; Fei WANG
International Journal of Traditional Chinese Medicine 2025;47(9):1195-1201
Tonifying herbs described in the Shen Nong Ben Cao Jing frequently possess well-defined efficacy in dispelling pathogenic factors, including eliminating pathogenic factors, eliminating severe wind-disorders, dispelling Bi syndrome, removing blood stasis and resolving hard masses, facilitating urination and defecation, relieving chills and fever, promoting digestion, regulating and smoothing qi movement, treating carbuncles and deep-rooted ulcers, killing the :three worms: (parasites), draining pus and alleviating pain, and treating bone fractures and traumatic injuries. These effects correspond to a broad spectrum of conditions, encompassing immune, digestive, and respiratory system disorders, as well as tumors. These effects are closely related to the taste and compatibility of drugs, and are supported by modern pharmacological studies (such as anti-inflammatory, anti-tumor, immune regulation, etc.). This study could provide a novel perspective for the rational clinical application of tonifying herbs and establish a foundation for in-depth research into the multi-efficacy mechanisms of Chinese materia medica.
9.Characterization of Animal Models of Type 2 Diabetes Mellitus with Hypertension Based on Clinical Symptoms in Traditional Chinese and Western Medicine
Ziyi WANG ; Xingyu FAN ; Yuzhi JIA ; Qingyong HE
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(7):230-236
Type 2 diabetes mellitus (T2DM) and hypertension are common and frequent chronic non-communicable diseases, which often coexist in clinical practice, resulting in a large number of cardiovascular events and deaths, and their case fatality rate far exceeds that of other factors such as dyslipidemia and obesity. Based on the diagnostic standards, guidelines, and animal model evaluation methods of T2DM with hypertension at home and abroad, this study summarized, evaluated, and analyzed the characteristics of the existing animal models of T2DM with hypertension based on the clinical symptoms in traditional Chinese and Western medicine. The animal models showing high fitting degrees with the clinical symptoms in Western medicine are mainly established by injection of streptozocin (STZ) in SHR rats in the surgical induction and chemical induction methods and feeding a high-fat and high-salt diet combined with STZ injection in SD rats in the dietary induction methods. The models showcasing high fitting degrees with the clinical symptoms in traditional Chinese medicine (TCM) are mainly established by the surgical induction method. Considering the fitting degrees and the advantages and disadvantages, the ideal modeling method for T2DM with hypertension is the two-kidney, one clip (2K1C) method (a surgical induction method) combined with feeding a high-fat and high-sugar diet and STZ injection. However, the available models lack the characteristics of TCM and the evaluation indicators have poor specificity. This study found that there are few animal models of T2DM with hypertension considering the characteristics of both disease and syndrome, which may be related to the identification and attribution of TCM syndromes in animal macroscopic information. In view of this problem, it is suggested that the evaluation criteria should be established and improved for the animal models combining disease and syndrome, which can help to evaluate the fitting degree of the pathological characteristics of different syndromes in the animal models of T2DM with hypertension. In this way, ideal animal models of T2DM with hypertension can be established to simulate the disease occurrence and development in the human body. The animal models are expected to provide an ideal approach for the further research on the pathogenesis of T2DM and its prevention and treatment with TCM, which is of great significance for the treatment and prevention of T2DM with hypertension and the prognosis of its complications. At the same time, breakthroughs in the basic syndrome models of comorbidities are expected to lay a foundation for the leapfrog development of TCM research.
10.Characterization of Animal Models of Type 2 Diabetes Mellitus with Hypertension Based on Clinical Symptoms in Traditional Chinese and Western Medicine
Ziyi WANG ; Xingyu FAN ; Yuzhi JIA ; Qingyong HE
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(7):230-236
Type 2 diabetes mellitus (T2DM) and hypertension are common and frequent chronic non-communicable diseases, which often coexist in clinical practice, resulting in a large number of cardiovascular events and deaths, and their case fatality rate far exceeds that of other factors such as dyslipidemia and obesity. Based on the diagnostic standards, guidelines, and animal model evaluation methods of T2DM with hypertension at home and abroad, this study summarized, evaluated, and analyzed the characteristics of the existing animal models of T2DM with hypertension based on the clinical symptoms in traditional Chinese and Western medicine. The animal models showing high fitting degrees with the clinical symptoms in Western medicine are mainly established by injection of streptozocin (STZ) in SHR rats in the surgical induction and chemical induction methods and feeding a high-fat and high-salt diet combined with STZ injection in SD rats in the dietary induction methods. The models showcasing high fitting degrees with the clinical symptoms in traditional Chinese medicine (TCM) are mainly established by the surgical induction method. Considering the fitting degrees and the advantages and disadvantages, the ideal modeling method for T2DM with hypertension is the two-kidney, one clip (2K1C) method (a surgical induction method) combined with feeding a high-fat and high-sugar diet and STZ injection. However, the available models lack the characteristics of TCM and the evaluation indicators have poor specificity. This study found that there are few animal models of T2DM with hypertension considering the characteristics of both disease and syndrome, which may be related to the identification and attribution of TCM syndromes in animal macroscopic information. In view of this problem, it is suggested that the evaluation criteria should be established and improved for the animal models combining disease and syndrome, which can help to evaluate the fitting degree of the pathological characteristics of different syndromes in the animal models of T2DM with hypertension. In this way, ideal animal models of T2DM with hypertension can be established to simulate the disease occurrence and development in the human body. The animal models are expected to provide an ideal approach for the further research on the pathogenesis of T2DM and its prevention and treatment with TCM, which is of great significance for the treatment and prevention of T2DM with hypertension and the prognosis of its complications. At the same time, breakthroughs in the basic syndrome models of comorbidities are expected to lay a foundation for the leapfrog development of TCM research.

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