1.Inheritance and Current Research Status of Major Spleen-Stomach Theories in Traditional Chinese Medicine
Ling HU ; Fengyun WANG ; Xudong TANG ; Beihua ZHANG ; Yunkai DAI ; Xu CHEN ; Shiqi LI
Journal of Traditional Chinese Medicine 2026;67(1):87-94
This paper systematically reviews the core concepts and lines of theoretical inheritance of major spleen-stomach theories in traditional Chinese medicine (TCM), including spleen deficiency theory, spleen-stomach damp-heat theory, and liver-spleen disharmony theory. It is found that these theories have all undergone a developmental trajectory characterized by classical foundation, refinement of therapeutic methods, systematization of pathogenesis, and modern innovation. The evolution of spleen-stomach theory has achieved a shift from a singular focus on tonifying the spleen to regulating dynamic middle-jiao (焦) balance, and from localized spleen-stomach regulation to the circular movement of qi involving all five zang organs. In terms of modern disease-syndrome integrative research, spleen deficiency syndrome is shown to be closely associated with impairment of the gastrointestinal mucosal barrier, metabolic disorders, and gene polymorphisms related to Helicobacter pylori-associated gastric diseases. Spleen-stomach damp-heat syndrome is closely linked to hyperactive energy metabolism, inflammatory cytokines, and abnormal expression of aquaporins. Liver-spleen disharmony syndrome is mainly associated with dysregulation of the brain-gut axis and microbiota-related metabolic disorders. It is proposed that future research on spleen-stomach diseases and syndromes should further elucidate their potential multidimensional differential biological characteristics, thereby promoting the modernization of the TCM discipline of spleen-stomach studies.
2.Current Status of Traditional Chinese Medicine Diagnosis and Treatment of Inflammatory Bowel Disease and the Research on Mechanism
Junxiang LI ; Hong SHEN ; Tangyou MAO ; Lei ZHU ; Jiaqi ZHANG ; Zhibin WANG ; Xudong TANG
Journal of Traditional Chinese Medicine 2026;67(1):103-110
In recent years, traditional Chinese medicine (TCM) has achieved significant progress in the treatment of inflammatory bowel disease (IBD). A comprehensive literature search was conducted covering the period from January 1, 2010, to December 30, 2024, across Chinese databases including China National Knowledge Infrastructure (CNKI), Wanfang Data, VIP China Science and Technology Journal Database, and the Chinese Biomedical Literature Service System, as well as international databases such as PubMed, Web of Science, and Embase. The clinical applications and mechanistic studies of TCM in IBD were systematically reviewed. The current status of TCM research on the etiology and pathogenesis of IBD, innovative clinical practices, and multimodal therapeutic approaches, including Chinese herbal formulas, single herbs or active compounds, acupuncture, herbal retention enema, and acupoint application, were summarized, together with their synergistic effects when combined with western medical treatments. The development and application of Chinese patent medicines for IBD are undergoing a profound transition from efficacy validation to mechanistic exploration. Mechanistic studies on the effects of TCM in IBD mainly focus on regulating gut microbiota homeostasis, repairing the intestinal mucosal barrier, and modulating intestinal immune balance. Furthermore, future research directions for TCM-based IBD management are proposed, including the establishment of TCM diagnostic and treatment models, expanding integrated applications of external and internal TCM therapies, innovating personalized treatment strategies, and advancing drug development. These efforts aim to provide insights for the standardized and precision-oriented development of TCM in the diagnosis and treatment of IBD.
3.Current Status and Strategies of Integrated Traditional Chinese and Western Medicine in the Treatment of Helicobacter pylori Infection
Xuezhi ZHANG ; Xia DING ; Zhen LIU ; Hui YE ; Xiaofen JIA ; Hong CHENG ; Zhenyu WU ; Xudong TANG
Journal of Traditional Chinese Medicine 2026;67(1):111-116
This paper systematically reviews the current status of integrated traditional Chinese and western medicine in the treatment of Helicobacter pylori (Hp) infection, as well as recent progress in clinical and basic research both in China and internationally. It summarizes the advantages of traditional Chinese medicine (TCM) in Hp infection management, including improving Hp eradication rates, enhancing antibiotic sensitivity, reducing antimicrobial resistance, decreasing drug-related adverse effects, and ameliorating gastric mucosal lesions. These advantages are particularly evident in patients who are intolerant to bismuth-containing regimens, those with refractory Hp infection, and individuals with precancerous gastric lesions. An integrated, whole-process management approach and individualized, staged comprehensive treatment strategies combining TCM and western medicine are proposed for Hp infection. Future prevention and control of Hp infection should adopt an integrative Chinese-western medical strategy, emphasizing prevention, strengthening primary care, implementing proactive long-term monitoring, optimizing screening strategies, and advancing the development of novel technologies and mechanistic studies of Chinese herbal interventions. These efforts aim to provide a theoretical basis and practical pathways for the establishment and improvement of Hp infection prevention and control systems.
4.Yttrium-90 selective internal radiation therapy on liver cancer: the past, the present, and the future
Jingqin MA ; Linhong ZHANG ; Minjie YANG ; Jiabin CAI ; Ying FANG ; Rong LIU ; Xudong QU ; Lingxiao LIU ; Zhiping YAN
Chinese Journal of Clinical Medicine 2025;32(1):3-8
Yttrium-90 selective internal radiation therapy (90Y-SIRT) is a treatment technique that delivers radioactive microspheres precisely to the arterial vascular bed of neoplasms, utilizing beta radiation to administer a high local dose of radiation to the neoplasm tissues. This technology has demonstrated significant efficacy in patients with unresectable pirmary liver cancers and liver metastases. This article systematically reviews the development history and clinical application status of 90Y-SIRT in the treatment of liver cancer, and looks forward to future development directions.
5.Advances in the diagnosis and treatment of hepatocellular carcinoma with bile duct tumor thrombus
Yuxiang GUO ; Maosen WANG ; Zhongyuan LIU ; Xudong ZHANG ; Pengfei MA ; Xiangkun WANG ; Renfeng LI
Journal of Clinical Hepatology 2025;41(2):359-364
Hepatocellular carcinoma (HCC) with biliary duct tumor thrombus (BDTT) is currently not common in clinical practice and is easily misdiagnosed, and previously, it was often considered an advanced stage of the disease with a poor prognosis, making its treatment challenging. However, in-depth studies in recent years have gradually deepened our understanding of this disease, leading to significant changes in diagnostic and treatment concepts. Currently, comprehensive treatment, mainly surgery, is used for treatment, but there is still controversy over the selection of clinical treatment strategies. This article provides a detailed discussion on surgical methods and prognosis, in order to provide a reference for clinical treatment options.
6.Individualized treatment and pharmaceutical care for breast cancer complicated with chronic kidney disease
Lu YU ; Xudong WU ; Ming ZHANG
China Pharmacy 2025;36(7):853-857
OBJECTIVE To provide a reference for individualized treatment and pharmaceutical care for patients with breast cancer complicated with chronic kidney disease (CKD). METHODS Clinical pharmacists participated in the anti-tumor treatment and pharmaceutical care for a breast cancer patient with CKD. Clinical pharmacists reviewed guidelines and literature to assist the clinical physician in formulating the initial neoadjuvant treatment plan (docetaxel+trastuzumab+paltuzumab) and provided monitoring recommendations for potential adverse drug reactions, such as vomiting, myelosuppression, renal impairment, cardiotoxicity. In response to the patient’s acute kidney injury after treatment, clinical pharmacists assisted the physician in analyzing the cause of the adverse reaction through causality assessment. Taking into account the patient’s preferences, docetaxel was substituted with paclitaxel (which did not require dose adjustment based on renal function). The clinical pharmacists collaborated with the physician to establish a postoperative targeted therapy regimen (trastuzumab+pertuzumab). Taking into account the patient’s positive estrogen receptor status, the clinical pharmacists recommended to initiate regular anastrozole administration after the completion of radiotherapy and undergo periodic bone density assessments. RESULTS The clinical physician accepted the suggestions from the clinical pharmacists. The patient successfully completed preoperative neoadjuvant chemotherapy and postoperative targeted therapy, and was discharged with medication (anastrozole). During the treatment process, the patient did not experience adverse reactions such as myelosuppression, cardiotoxicity, or the occurrence of osteoporosis. CONCLUSIONS Clinical pharmacists analyzed and adjusted the preoperative and postoperative antitumor treatment plans based on the patient’s renal function. They promptly assessed the correlation between antitumor drugs and acute kidney injury, and actively implemented comprehensive pharmaceutical care to ensure medication safety for breast cancer patients with CKD.
7.Development and Application of the Evidence Quality Rating Scale for Ancient Classical Prescriptions in Traditional Chinese Medicine
Juwen ZHANG ; Jianping LIU ; Xiangfei SU ; Wei WEI ; Xiaolan SU ; Xue FENG ; Fanya YU ; Xudong ZHANG ; Junhong YU ; Wei CHEN
Journal of Traditional Chinese Medicine 2025;66(8):804-810
ObjectiveTo develop the Evidence Grading Scale for Ancient classical prescriptions in Traditional Chinese medicine, assess its reliability and validity, and apply it in practice to provide multi-source evidence for clinical practice guidelines development. MethodsLiterature retrieval was conducted to extract and screen existing evaluation dimensions, then the initial items were summarized using thematic analysis. Experts in the clinical medicine, medical history and literature participated in the Delphi questionnaire survey to evaluate and refine the items. An expert consensus meeting was conducted to finalize the included items, refine the method for items evaluation and evidence grading. The evidence quality rating scale for ancient classical traditional Chinese medicine (TCM) prescriptions was then established and tested for reliability and validity. ResultsThrough literature review, extraction, screening and summarization, a total of 3 dimensions and 12 initial items were formed. Questionnaires were sent to 69 experts to evaluate the initial items, with a questionnaire response rate of 100% and an expert authority coefficient of 0.92. All 12 items were retained for they had importance scores above 4. The Evidence Grading Scale on Ancient classical prescriptions in Traditional Chinese medicine includes 3 dimensions with 12 items. The 3 dimensions includes ancient evidence, inheritance status, and modern application. Each dimension contains 4 items, and each item has a full score of 5 points. The evidence was rated as high-level, moderate-level, and low-level according to the final scores. The content validity index (CVI) of the 12 items was >0.9, the average CVI of the scale was 0.98, and the intraclass correlation coefficient (ICC) was 0.90. ConclusionThe Evidence Grading Scale on Ancient classical prescriptions in Traditional Chinese medicine has good reliability and validity, which is practical for use in the development of TCM clinical guidelines and can better support clinical decision-making.
8.Effect of Modified Gegen Qinlian Decoction (加味葛根芩连汤) on the Intestinal Mucus Barrier and Intestinal Stem Cell Proliferation and Differentiation in Ulcerative Colitis Model Mice
Jinke HUANG ; Jiaqi ZHANG ; Fengyun WANG ; Xudong TANG
Journal of Traditional Chinese Medicine 2025;66(9):941-947
ObjectiveTo explore the possible mechanism of Modified Gegen Qinlian Decoction (加味葛根芩连汤, MGQD) in the treatment of ulcerative colitis (UC) based on intestinal mucus barrier. MethodsThirty C57BL/6 mice were randomly divided into a control group, a model group and a MGQD group with 10 mice in each. Dextran Sulfate Sodium Salt (DSS) was used to construct the UC model in all groups except for the control group. Meanwhile, mice in the MGQD group were given 20 g/kg of MGQD decoction by gavage according to their body weight, while those in the control group and model group were given 0.2 ml/20 g of pure water by gavage, once a day for 7 consecutive days. On the day following the last gavage, the body weight, disease activity index (DAI) score, spleen weight, and colon length were compared. The pathological changes of the intestinal mucosal tissues were observed by HE staining; the protein expression levels of mucin 2 (MUC2) and leucine-rich repeat G protein-coupled receptor 5 (Lgr5) in the intestinal mucosal tissues were detected by immunofluorescence; the cuprocytes in the intestinal mucosal tissues were detected by AB/PAS staining; and the expression level of Ki67 in the intestinal mucosal tissues was detected by immunohistochemistry. ResultsHE staining showed that the colon mucosal tissue of the mice in the control group was intact. In the model group, the colon mucosal epithelial structure was severely damaged, with a large amount of inflammatory cell infiltration in the mucosal propria. In the MGQD group, the mucosal tissue structure was partially lost, with a small amount of inflammatory cell infiltration.The body weight and colon length of mice in the model group decreased significantly compared to those in the control group, while DAI scores and spleen weight increased, and the levels of MUC2, Ki67, Lgr5 proteins, and the number of goblet cells were significantly reduced (P<0.01). Compared to the model group, the MGQD group had increased body weight of mice, colon length, and decreased DAI scores and spleen weight; the levels of MUC2, Ki67, Lgr5 proteins, and the number of goblet cells were increased (P<0.05 or P<0.01). ConclusionMGQD has a favorable ameliorative effect on UC-related symptoms and pathological tissue damage, and its mechanism of action may be related to the restoration of the prolife-ration and differentiation of intestinal stem cells into goblet cells, thereby promoting the repair of the intestinal mucus barrier.
9.Application Value of Organoid Technology in the Research of Traditional Chinese Medicine for the Prevention and Treatment of Digestive System Diseases
Yongtian WEN ; Xiangxue MA ; Beihua ZHANG ; Fengyun WANG ; Xudong TANG
Journal of Traditional Chinese Medicine 2025;66(14):1433-1438
Organoid technology, a rapidly advancing three-dimensional (3D) cell culture platform, can closely mimic the microarchitecture and functions of human digestive organs, effectively overcoming the limitations of conventional two-dimensional cell models and animal experiments. By systematically summarizing the distinctive strengths of organoid technology in simulating digestive physiological and pathological states, constructing digestive system disease models, enabling high-throughput drug screening, and facilitating personalized treatment, this review explored the potential applications of organoids in identifying active components of traditional Chinese medicine (TCM) formulas, evaluating in vitro pharmacokinetics and toxicological parameters, and investigating multi-target synergistic mechanisms. By integrating cutting-edge engineering technologies, organoids are expected to provide a more scientific research platform for TCM, accelerate the modernization of its mechanistic studies, and enhance its scientific value and global impact.
10.Influence of Gene Mutation on the Effectiveness of Arsenic-Containing Herbal Compound Formula in Treatment of Myelodysplastic Syndromes of Different TCM Patterns
Zichun WANG ; Zhuo CHEN ; Dexiu WANG ; Haiyan XIAO ; Weiyi LIU ; Ruibai LI ; Chi LIU ; Fengmei WANG ; Shanshan ZHANG ; Mingjing WANG ; Liu LI ; Xiaoqing GUO ; Hongzhi WANG ; Xudong TANG
Journal of Traditional Chinese Medicine 2025;66(14):1463-1472
ObjectiveTo observe the effect of gene mutation on the effectiveness of arsenic-containing Chinese herbal compound formulas in the treatment of myelodysplastic syndromes (MDS) of different traditional Chinese medicine (TCM) patterns, so as to provide the basis for the clinical application. MethodsClinical data of 442 MDS patients who were treated with arsenic-containing herbal compound formulas were retrospectively collected, including the baseline demographic and clinical characteristics of the patients. Based on the TCM four examinations, the patients were divided into the spleen-kidney deficiency group as well as the qi-yin deficiency group, and according to the results of the next-generation sequencing (NGS) test, they were divided into the group with and without gene mutation respectively. The influence of gene mutation on the clinical effectiveness of patients with different TCM patterns was analyzed, the baseline demographic and clinical characteristics of the patients with different outcomes of the two TCM patterns were compared, and multivariate Logistic regression analysis was conducted on the influencing factors of the effective rate of MDS patients with gene mutation. ResultsA total of 190 cases were included in the spleen-kidney deficiency group (119 cases with gene mutation) and 43 cases in the qi-yin deficiency group (23 cases with gene mutation). No statistically significant differences were noted in effectiveness assessment, total effective rate, and total response rate between the spleen-kidney deficiency group and the qi-yin deficiency group (P>0.05). In the spleen-kidney deficiency group, the total effective rate of MDS with gene mutation was 65.55% (78/119), which was lower than 80.28% (57/71) of MDS without gene mutation, with statistical significance (P = 0.033), while no statistical differences in effectiveness assessment and total response rate were noted (P>0.05). In the qi-yin deficiency group, no statistical differences were observed in effectiveness assessment, total effective rate, and total response rate of the patients in with or without gene mutation (P>0.05). In the spleen-kidney deficiency group with gene mutation, the rate of complex karyotype (P = 0.031) and the mutation rate of CBL gene (P = 0.032) in the ineffective population were higher than those in the effective population, while the mutation rate of DDX41 gene in the effective population was higher than that in the ineffective population (P = 0.033). No statistically significant differences were found in other gene mutations, age, gender distribution, number of gene mutations, bone marrow hyperplasia degree, blast cell range, reticular fiber tissue proliferation or not, and prognosis of chromosomal abnormalities between the effective and ineffective populations (P>0.05). In the qi-yin deficiency group with gene mutation, no statistically significant differences were found in various items between populations with different outcomes (P>0.05). Multivariate Logistic regression analysis showed that complex karyotype, CBL mutation, and DDX41 mutation were independently associated with the effective rate of MDS with spleen-kidney deficiency and gene mutation (P<0.05). DDX41 mutation was an independent protective factor in the spleen-kidney deficiency group (OR>1), while complex karyotype and CBL mutation were independent risk factors (OR<1). ConclusionThe arsenic-containing TCM compound formulas exhibited better effectiveness in MDS with spleen-kidney deficiency pattern without mutation; and in MDS with spleen-kidney deficiency pattern without complex karyotypes, CBL mutation, and with DDX41 mutations. Furthermore, DDX41 mutation was an independent protective factor in the spleen-kidney deficiency group, while complex karyotype and CBL mutation were independent risk factors. In MDS with qi-yin deficiency pattern, gene mutation-related factors showed no significant impact on the effectiveness of arsenic-containing TCM compound formulas.

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