Objective To evaluate the effects of Xue Ji's time-based tonic therapy on nutritional status and diaphragm thickness in stable chronic obstructive pulmonary disease(COPD)patients with lung-kidney deficiency syndrome.Methods Eighty eligible patients were treated at the First Affiliated Hospital of Guangzhou University of Chinese Medicine(Chongqing Hospital/Beibei District Hospital of Traditional Chinese Medicine)between January 1 and October 1,2024.The patients were randomly divided into trial group and control group by random number table method,40 cases in each group.The control group was treated with Salmeterol-Fluticasone Propionate(Seretide)plus Xue Ji's time-based tonic therapy.The trial group was treated with Xue Ji's time-based tonic therapy on the basis of treatment for the control group.The trial group took Buzhong Yiqi Pills at 7-9 AM and Liuwei Dihuang Pills at 5-7 PM daily for 3 months.The changes in body mass,BMI,nutritional markers(hemoglobin,albumin,total protein),accessory respiratory muscle use score,diaphragm thickness[TDI(end-inspiration),TDE(end-expiration),TDImax(maximal inspiration)],diaphragm thickening rate(TF index),TCM syndrome scores,mMRC dyspnea scale,and CAT scores,and the clinical efficacy was compared between the two groups.Results(1)A total of 5 cases fell off during the study,and a total of 75 patients were finally included,including 38 in the trial group and 37 in the control group.(2)After 3 months of treatment,the total effective rate of the trial group was 86.84％(33/38),and that of the control group was 72.97％(27/37).The intergroup comparison(by chi-square test)showed that the curative effect of the trial group was significantly superior to that of the control group(P＜0.05).(3)In terms of nutritional status,the body mass,BMI,hemoglobin,albumin,total protein and other nutritional indexes of the two groups were improved compared with those before treatment(P＜0.05),and the improvement of the trial group was significantly superior to that of the control group(P＜0.05 or P＜0.01).(4)In terms of diaphragm function,after treatment,the diaphragm thickness(TDI,TDE and TDImax)and diaphragm thickening rate(TF index)in the two groups were significantly higher than those before treatment(P＜0.05),and the increase in the trial group was significantly superior to that in the control group(P＜0.05 or P＜0.01).(5)In terms of each score,after treatment,the scores of TCM syndromes,auxiliary respiratory muscle use,mMRC and CAT in the two groups were significantly lower than those before treatment(P＜0.05 or P＜0.01),and the decrease in the trial group was significantly superior to that in the control group(P＜0.05 or P＜0.01).Conclusion Xue Ji's time-based tonic therapy combined with Seretide significantly improves symptoms(cough,expectoration,dyspnea),nutritional status and diaphragm function,and increases diaphgram thickness in stable COPD with lung-kidney deficiency,demonstrating higher clinical value than western treatment alone.

Traditional right ventricular pacing is non-physiological pacing, can lead to ventricular electrical and mechanical dyssynchmnization, which increases the risk of heart failure and atrial fibrillation. His-Purkinje system pacing is the hot research of physiological pacing method. The high thresholds and difficult implantation of his bundle pacing limits its application and popularization. In recent years, domestic scholars have proposed left bundle branch area pacing. Many studies have confirmed the safety and feasibility of left bundle branch area pacing. Left bundle branch pacing transmit down the conduction system, which can effectively achieve ventricular electrical and mechanical synchrony, At the same time, it also has many others advantages, such as good and stable electrical parameters, significantly improved cardiac function, and pacing across blocked parts. It will become the main development direction of physiological pacing in the future. This article aims to review the origin, standard and classification, advantages and limitations of left bundle branch area pacing.