Chronic obstructive pulmonary disease （COPD）， as a chronic respiratory disease that can be prevented and intervened but cannot be completely cured， has increasing incidence and mortality rates year by year， often complicated by one or more comorbidities. However， there is currently no specific treatment available. Therefore， the healthcare issues related to COPD are urgent and prominent. Traditional Chinese medicine （TCM） delays the progression of COPD through multiple mechanisms， pathways， and targets. As a result， exploring the pathogenesis of COPD and identifying TCM treatment approaches and effective prescriptions are key issues that urgently need to be addressed in clinical practice. In TCM， COPD is categorized into syndromes such as "cough"， "asthma"， and "lung distension". It is believed that the deficiency in the origin runs through the entire disease. When external pathogens invade， Qi becomes disordered， and phlegm and blood stasis begin to accumulate， leading to an excess condition in the manifestation. Modern medicine research on the pathogenesis of COPD mainly involves aspects such as inflammatory response， oxidative stress， autophagy imbalance， and aging. Studies have found that Chinese medicine monomers， single herbs， and compound prescriptions can improve COPD by inhibiting inflammation， reducing oxidative damage， correcting autophagy， and delaying aging. However， there is no study that intuitively organizes the various pathogenesis mechanisms of COPD and their interrelationships. At the same time， research on the therapeutic effects of TCM on COPD primarily focuses on exploring a single mechanism or pathway， without integrating multiple mechanisms， pathways， and targets. Additionally， there are very few studies that summarize the corresponding relationships between the various pathogenesis mechanisms of COPD and the regulatory effects and signaling pathways of Chinese medicine. This study， for the first time， combines the latest literature in China and abroad to explain the various pathogenesis mechanisms of COPD and their interrelationships using a combination of graphs， text， and tables. It also outlines the signaling pathways， targets， and mechanisms of Chinese medicine monomers， single herbs， and compound prescriptions in regulating COPD， in order to provide new ideas and strategies for the in-depth research and systematic treatment of COPD with TCM.

Idiopathic pulmonary fibrosis （IPF） can be classified as pulmonary collateral disease，and its pathogenesis is mainly characterized by the loss of Qi meridian nourishment，the loss of Yin meridian nourishment，and the formation of blood stasis in the blood vessels. Qi Yin deficiency is the pathological basis that runs through IPF，and obstruction of meridians and collaterals is a key element in the development of the disease. The dysfunction of "spleen being in charge of the defensive function" is closely related to the formation of the pathological pattern of "lung deficiency and collateral stasis" in IPF. The term "spleen being in charge of the defensive function" originated from the Yellow Emperor's Inner Canon. If the spleen is healthy，the Qi will be filled with vitality. Positive energy is stored inside，evil cannot be dried up. Its concept is quite similar to the immune defense function in modern medicine. If the principle of "spleen being in charge of the defensive function" is lost，the key structure and function of the IPF alveolar epithelial barrier may be abnormal，and it can interact with various innate immune cells to promote inflammation and fibrosis processes. Therefore，this article explains the imbalance of immune homeostasis in IPF alveolar epithelium from two aspects：the barrier function of alveolar epithelial cells（AECs） and their interaction with innate immune cells. And based on the theory of "spleen being in charge of the defensive function"，using traditional Chinese medicine for strengthening the spleen and nourishing Qi to treat IPF from the perspective of the spleen. This not only strengthens the scientific connotation of "spleen being in charge of the defensive function" in the pathogenesis of IPF，but also provides new research directions and ideas for its future clinical prevention and treatment.

ObjectiveTo assess the therapeutic effectiveness and safety of the traditional Chinese medicine compound Shenlong decoction in addressing the symptoms of pulmonary deficiency and stasis in patients with idiopathic pulmonary fibrosis （IPF）. MethodsSixty eligible patients with lung deficiency and collateral stasis syndrome of IPF were randomly assigned to the observation （30 patients） and control groups （30 patients）. All patients underwent standard Western medical therapy. Additionally，the observation group received Shenlong decoction granules，while the control group received a placebo. Both treatments were packaged in four doses of 10.5 g each，taken twice daily for three months. The indexes of the patients during the treatment cycle were observed，and the main indexes include traditional Chinese medicine （TCM） syndrome scores and 6 min walk test （6MWT）. The secondary indexes include pulmonary function test ［actual value/expected value of total lung volume （TLC%），actual value/expected value of vital capacity（FVC%），actual/predicted diffusing capacity of the lung for carbon monoxide（DLCO%），actual/predicted forced expiratory volume in one second （FEV₁%），and FEV₁/ forced vital capacity （FVC）］，blood gas analysis ［arterial blood diathesis partial pressure of oxygen （PaO₂），partial pressure of carbon dioxide （PaCO₂），and arterial oxygen saturation （SaO₂）］，serum inflammatory factors ［transforming growth factor-β₁ （TGF-β₁），interleukin-4 （IL-4），interleukin-13 （IL-13），interleukin-12 （IL-12），and gamma-interferon （IFN-γ）］，and quality of survival evaluation ［St George's Respiratory Questionnaire （SGRQ） score］. The patients' clinical manifestations were determined at the end of the treatment， and the occurrence of adverse events was recorded. ResultsA total of 53 patients completed the study，comprising 27 in the control group and 26 in the observation group. Upon completion of the treatment period，the control group achieved a total effective rate of 33.33% （9/27），whereas the observation group demonstrated a total effective rate of 53.85% （14/26），which was statistically superior to the control group （χ²=4.034，P<0.05）. After the treatment，the TCM syndrome scores，6MWT，DLCO%，FEV₁%，PaO₂，PaCO₂，TGF-β₁，IL-4，IL-13，IL-12，and IFN-γ in the two groups were all significantly improved （P<0.01）. Compared with those in the control group after treatment at the same period，the TCM syndrome scores，6MWT，PaO₂，and PaCO₂ were significantly improved in the observation group after 60 days and 90 days of medication （P<0.01）. Three months after the end of medication，the SGRQ score in the observation group showed significant improvement when compared to that in the control group （P<0.05），and no severe adverse events were reported during the follow-up period. ConclusionCompound Shenlong decoction can alleviate clinical symptoms such as shortness of breath and wheezing in patients with lung deficiency and collateral stasis syndrome of IPF，enhance exercise tolerance，improve the quality of life，and have certain potential advantages in improving pulmonary function.

ObjectiveTo assess the therapeutic effectiveness and safety of the traditional Chinese medicine compound Shenlong decoction in addressing the symptoms of pulmonary deficiency and stasis in patients with idiopathic pulmonary fibrosis （IPF）. MethodsSixty eligible patients with lung deficiency and collateral stasis syndrome of IPF were randomly assigned to the observation （30 patients） and control groups （30 patients）. All patients underwent standard Western medical therapy. Additionally，the observation group received Shenlong decoction granules，while the control group received a placebo. Both treatments were packaged in four doses of 10.5 g each，taken twice daily for three months. The indexes of the patients during the treatment cycle were observed，and the main indexes include traditional Chinese medicine （TCM） syndrome scores and 6 min walk test （6MWT）. The secondary indexes include pulmonary function test ［actual value/expected value of total lung volume （TLC%），actual value/expected value of vital capacity（FVC%），actual/predicted diffusing capacity of the lung for carbon monoxide（DLCO%），actual/predicted forced expiratory volume in one second （FEV₁%），and FEV₁/ forced vital capacity （FVC）］，blood gas analysis ［arterial blood diathesis partial pressure of oxygen （PaO₂），partial pressure of carbon dioxide （PaCO₂），and arterial oxygen saturation （SaO₂）］，serum inflammatory factors ［transforming growth factor-β₁ （TGF-β₁），interleukin-4 （IL-4），interleukin-13 （IL-13），interleukin-12 （IL-12），and gamma-interferon （IFN-γ）］，and quality of survival evaluation ［St George's Respiratory Questionnaire （SGRQ） score］. The patients' clinical manifestations were determined at the end of the treatment， and the occurrence of adverse events was recorded. ResultsA total of 53 patients completed the study，comprising 27 in the control group and 26 in the observation group. Upon completion of the treatment period，the control group achieved a total effective rate of 33.33% （9/27），whereas the observation group demonstrated a total effective rate of 53.85% （14/26），which was statistically superior to the control group （χ²=4.034，P<0.05）. After the treatment，the TCM syndrome scores，6MWT，DLCO%，FEV₁%，PaO₂，PaCO₂，TGF-β₁，IL-4，IL-13，IL-12，and IFN-γ in the two groups were all significantly improved （P<0.01）. Compared with those in the control group after treatment at the same period，the TCM syndrome scores，6MWT，PaO₂，and PaCO₂ were significantly improved in the observation group after 60 days and 90 days of medication （P<0.01）. Three months after the end of medication，the SGRQ score in the observation group showed significant improvement when compared to that in the control group （P<0.05），and no severe adverse events were reported during the follow-up period. ConclusionCompound Shenlong decoction can alleviate clinical symptoms such as shortness of breath and wheezing in patients with lung deficiency and collateral stasis syndrome of IPF，enhance exercise tolerance，improve the quality of life，and have certain potential advantages in improving pulmonary function.

Animal experiment is a key link in the scientific research of traditional Chinese medicine,and the syndrome animal model is an important research object in the animal experiment of traditional Chinese medicine.Good reproducibility,repeatability,specificity,safety,convenience and economy are the basic requirements of animal model.In recent years,with the continuous development of animal experimental studies on lung diseases,the animal model construction and evaluation methods of related syndromes have been improved to a certain extent.However,in terms of model evaluation,problems such as more subjective descriptions,less accurate quantification,more macro representations,less microscopic evidence,more disease-related indicators,less syndrome-related indicators,and lack of primary and secondary stratification of indicators continue to be prominent.Therefore,based on the literature review method,the author systematically reviewed the current research progress of lung disease syndrome models,and proposed that strengthening the research on the four-diagnosis manifestations and reaction characteristics of model animals,standardization of modeling interventions,four-diagnosis information collection tool and the objective evaluation study,and the TCM syndrome model evaluation scale study might be feasible approaches for future model optimization.In order to provide new ideas and methods for the study of the syndrome model of lung disease in the future.

The aging disease associated with type 2 diabetes mellitus(T2DM)is a hot research topic in the field of diabetes at present.Sarcopenia has become the third major complication of T2DM after microvascular and macrovascular diseases,which could lead to the occurrence and development of various adverse events such as fracture,disability,and dysfunction.The spleen belongs to the earth,is in the middle jiao,governs transportation and transformation,and governs muscle.The functional activities of the spleen manifesting in normal transformation and transportation,the distribution of cereal essence,and the nourishment of muscles are necessary for normal physiological functions to be exerted.Recent studies have shown that skeletal muscle cell ferroptosis plays an important role in the pathogenesis of T2DM sarcopenia.Based on the theory of"spleen governing transportation and transportation and governing muscle",this study explores the pathogenesis of T2DM sarcopenia from the perspectives of the pathogenesis of"dysfunction of spleen in transportation,deficiency of cereal essence,obstruction of dampness and turbidity,and muscle dystrophy"in traditional Chinese medicine and the pathological mechanism of"skeletal muscle cell ferroptosis"in modern medicine.It summarizes the principles of traditional Chinese medicine prevention and treatment for T2DM sarcopenia based on the spleen,to provide theoretical support for enriching the theoretical connotation of spleen visceral state,as well as basic research and clinical trials on the prevention and treatment of T2DM sarcopenia with traditional Chinese medicine.

Idiopathic pulmonary fibrosis(IPF)is a progressive and inflammatory interstitial lung disease,clinically divided into stable and acute exacerbation periods of idiopathic pulmonary fibrosis(AE-IPF),which faces great difficulties in prevention and treatment,increasing the health and life burden of patients.At present,the diagnostic methods of AE-IPF are relatively limited,while biomarkers are safe,simple and specific,which are of great significance for the diagnosis and treatment of AE-IPF.Based on the theoretical connotation of AE-IPF(lung heat and collateral obstruction syndrome),this paper explores the application value of combining AE-IPF lung heat stagnation syndrome and biomarkers,explains the pathogenesis of AE-IPF lung heat stagnation syndrome at the molecular level,and analyzes the guiding role of combining syndromes and biomarkers in the clinical application of traditional Chinese medicine for AE-IPF lung heat stagnation syndrome.

Objective To explore the biological basis of different diseases with the same syndrome for pulmonary related comorbidities(pulmonary hypertension,obstructive sleep apnea syndrome,chronic obstructive pulmonary disease,lung cancer)in idiopathic pulmonary fibrosis(IPF)through genomic bioinformatics analysis.Methods GSE110147,GSE113439,GSE135917,GSE106986 and GSE118370 datasets were downloaded as research subjects.The differential genes between each disease group and the control group were screened.Cytoscape 3.10.0 software was used for topology analysis to screen core genes.OmicShare was used to perform GO and KEGG pathway enrichment analyses on core genes.Results A total of 23 core genes related to IPF was obtained.GO enrichment analysis showed that core genes were mainly enriched in biological processes such as cellular process,metabolic process,biological regulation/biological process,developmental process,localization,response to stimulus,immune system process and signaling;in cellular components such as cellular anatomical entity and protein-containing complex;in molecular functions such as binding,catalytic activity,structural molecule activity,molecular adaptor activity,molecular function regulator and transcription regulator activity.KEGG pathway enrichment analysis showed that core genes were mainly enriched in ribosome biogenesis in eukaryotes,AGE-RAGE signaling pathway in diabetic complications,Th17 cell differentiation,JAK-STAT signaling pathway,RNA polymerase,neutrophil extracellular trap formation.Conclusion Using genomic bioinformatics analysis to explore the core genes and signaling pathways of pulmonary related comorbidities in IPF can reveal the mechanism of different diseases with the same syndrome for pulmonary related comorbidities in IPF to a certain extent.

Bitter taste is one of the important contents in the theory of"Five tastes"in traditional Chinese medicine(TCM).It has the functions of"releasing,dryness and firmness"and plays an important role in the treatment of respiratory diseases.Bitter taste receptors(T2Rs)is a kind of G-protein-coupled receptors,studies have shown that it can act on human airway smooth muscle,relax smooth muscle and dilate bronchus,and play a vital role in the treatment of bronchial asthma and chronic obstructive pulmonary disease.It can also inhibit the inflammatory reaction and reduce the damage of lung tissue by reducing the release of inflammatory factors and promoting the apoptosis of inflammatory cells.The therapeutic mechanism of bitter Chinese herbs action may depend on the effect of T2Rs,the effects of bitter Chinese herbs such as"lowering qi","releasing heat","eliminating dampness"are quite consistent with the cognitions of western medicine that bitter taste receptors could"relaxe bronchus","reduce airway resistance","inhibits inflammatory factors"and"reduces mucus secretion".Based on the understanding of bitter taste in TCM theory and modern research,this study aims to discuss the effect of bitter Chinese herbs depend on T2Rs as the starting point,so as to provide a new research direction for clinical treatment of pulmonary diseases such as bronchial asthma and chronic obstructive pulmonary disease.

Type 2 Diabetes Mellitus(T2DM)is a chronic metabolic disease characterized by disorders of insulin and glucose.As a disease closely related to our daily diet,the molecular mechanism of its pathogenesis is still unclear.Sweet taste receptors are a kind of G protein-coupled receptors with 7 times transmembrane.Although the research on the pathogenesis of T2DM has been gradually deepened,there are few studies on the mechanism of sweet taste damage in the state of disease.Therefore,in-depth study of the pathological mechanism of T2DM sweet taste receptor damage is of great significance to further understand the molecular characteristics of sweet taste receptors and explore new targets of traditional Chinese medicine in the treatment of T2DM.In this paper,the biological characteristics of sweet taste receptors,signal transduction mechanism of sweet taste receptors,sweet taste receptors and T2DM,sweet taste receptors and"spleen is sweet"are reviewed in order to provide the latest opinions for the targeted prevention and treatment of this kind of diseases by traditional Chinese medicine and the elucidation of related pathological mechanism.