The paper introduces Professor ZHAO Hong's clinical experience and the thinking of diagnosis and treatment for gynecological diseases based on spleen-stomach theories of TCM and explore the effects of the dysfunction of spleen and stomach on gynecological diseases. In clinical practice, Professor ZHAO proposes the "theory" for protecting the spleen and stomach, and in consideration of the other organs; focuses on the "principle" for strengthening the spleen, harmonizing the stomach, promoting qi circulation, removing stagnation and mutually-regulating the body, qi and mind; and adopts the "methods" of integrating acupuncture with medication and specially uses the warming and resolving techniques. She attaches importance to "acupoints" on the detection, and the selection of fewer but more effective ones; and delivers the "needling techniques" for releasing the stagnation and obstruction and inducing muscle jumping and sensation transmission. Professor ZHAO Hong integrates acupuncture with medication in views of spleen and stomach theories of TCM for ovarian insufficiency, polycystic ovary syndrome, endometriosis, thin endometrium and dysfunctional uterine bleeding, which provides the references for the treatment of gynecological diseases.
Humans ; Female ; Acupuncture Therapy ; Spleen/physiopathology* ; Genital Diseases, Female/physiopathology* ; Stomach/physiopathology* ; Medicine, Chinese Traditional ; Acupuncture Points

OBJECTIVE: To observe the clinical efficacy of herb-spreading moxibustion as an adjuvant treatment for chemotherapy-induced nausea and vomiting (CINV) of spleen and stomach deficiency cold in gastric cancer. METHODS: Seventy-six patients with CINV of spleen and stomach deficiency cold in gastric cancer were randomly divided into an observation group (38 cases, 1 case was discontinued, 1 case dropped out) and a control group (38 cases, 1 case was discontinued). The patients in both groups were treated with cisplatin+tigio regimen chemotherapy, and were treated with basic anti-nausea drugs on the 1st to 3rd day of chemotherapy. The observation group was treated with herb-spreading moxibustion at Zhongwan (CV12) acupoint area (covering from Shangwan [CV13] to Shenque [CV8] of the conception vessel, and from both sides to the kidney meridian of foot-shaoyin). The herb was selected as Fuzi Lizhong decoction, once a day, about 50 min each time, with 3 consecutive days as one treatment course, with an interval of 1 day between each course, for a total of 3 treatment courses. The grading of nausea and vomiting degree in the two groups were recorded on the 1st, 3rd, 7th and 14th days of chemotherapy. Karnofsky performance status (KPS) score in the two groups was observed before treatment and on the 1st, 3rd, 7th and 14th days of chemotherapy. The TCM symptom grading and TCM syndrome score of the two groups before and after treatment were compared, and the clinical efficacy and safety of the two groups were evaluated. RESULTS: On the 7th and 14th days of chemotherapy, the grading of nausea degree in the observation group was lower than that in the control group (P<0.05). On the 3rd, 7th and 14th days of chemotherapy, the grading of vomiting degree in the observation group was lower than that in the control group (P<0.05, P<0.01). Compared before treatment, the KPS scores of the two groups on the 1st day of chemotherapy and the control group on the 7th day of chemotherapy were decreased (P<0.05, P<0.01), and the KPS scores of the observation group on the 7th day of chemotherapy and the two groups on the 14th day of chemotherapy were increased (P<0.01). On the 7th and 14th days of chemotherapy, the KPS scores of the observation group were higher than those of the control group (P<0.01). After treatment, the each item grading of TCM symptom in the two groups was better than that before treatment (P<0.01), except for loose stool, the each item grading of TCM symptom in the observation group was better than that in the control group (P<0.05, P<0.01). After treatment, the scores of TCM syndrome in the two groups were lower than those before treatment (P<0.01), and the score in the observation group was lower than that in the control group (P<0.01). The obvious effective rate of the observation group was 58.3% (21/36), which was higher than 24.3% (9/37) of the control group (P<0.01). No adverse events occurred in both groups. CONCLUSION Herb-spreading moxibustion as an adjuvant treatment for CINV of spleen and stomach deficiency cold in gastric cancer can effectively relieve nausea and vomiting, and improve the symptoms of TCM, and improve the quality of life of patients. The clinical efficacy is satisfactory and the safety is good.
Humans ; Moxibustion ; Male ; Female ; Middle Aged ; Stomach Neoplasms/drug therapy* ; Nausea/physiopathology* ; Vomiting/physiopathology* ; Aged ; Adult ; Acupuncture Points ; Antineoplastic Agents/therapeutic use* ; Drugs, Chinese Herbal/administration & dosage* ; Spleen/drug effects* ; Stomach/drug effects*

PURPOSE: Non-operative management (NOM) has been validated for blunt liver and splenic injuries. Literature on continuous intra-abdominal pressure (IAP) monitoring as a part of NOM remains to be equivocal. The study aimed to find any correlation between clinical parameters and IAP, and their effect on the NOM of patients with blunt liver and splenic injury. METHOD: A prospective cross-sectional study conducted at a level I trauma center from October 2018 to January 2020 including 174 patients who underwent NOM following blunt liver and splenic injuries. Hemodynamically unstable patients or those on ventilators were excluded, as well as patients who suffered significant head, spinal cord, and/or bladder injuries. The study predominantly included males (83.9%) with a mean age of 32.5 years. IAP was monitored continuously and the relation of IAP with various parameters, interventions, and outcomes were measured. Data were summarized as frequency (percentage) or mean ± SD or median (Q₁, Q₃) as indicated. χ² or Fisher's exact test was used for categorical variables, while for continuous variables parametric (independent t-test) or nonparametric tests (Wilcoxon rank sum test) were used as appropriate. Clinical and laboratory correlates of IAP < 12 with p < 0.200 in the univariable logistic regression analysis were included in the multivariable analysis. A p < 0.05 was used to indicate statistical significance. RESULTS: Intra-abdominal hypertension (IAH) was seen in 19.0% of the study population. IAH was strongly associated with a high injury severity score (p < 0.001), and other physiological parameters like respiratory rate (p < 0.001), change in abdominal girth (AG) (p < 0.001), and serum creatinine (p < 0.001). IAH along with the number of solid organs involved, respiratory rate, change in AG, and serum creatinine was associated with the intervention, either operative or non-operative (p = 0.001, p = 0.002, p < 0.001, p < 0.001, p = 0.013, respectively). On multivariable analysis, IAP (p = 0.006) and the mean change of AG (p = 0.004) were significantly associated with the need for intervention. CONCLUSION As a part of NOM, IAP should be monitored as a continuous vital. However, the decision for any intervention, either operative or non-operative cannot be guided by IAP values alone.
Humans ; Male ; Adult ; Female ; Wounds, Nonpenetrating/physiopathology* ; Spleen/injuries* ; Prospective Studies ; Cross-Sectional Studies ; Liver/injuries* ; Middle Aged ; Monitoring, Physiologic/methods* ; Pressure ; Abdominal Injuries/physiopathology* ; Intra-Abdominal Hypertension ; Young Adult

Neuropathic pain is a chronic condition caused by damage or dysfunction in the nervous system. While the spleen may influence neuropathic pain, its role has been poorly understood. This study demonstrates that the spleen plays a crucial role in regulating neuropathic pain through the bed nucleus of the stria terminalis (BNST) - paraventricular nucleus of the hypothalamus (PVN) neural circuit in a chronic constriction injury (CCI) mouse model. Splenectomy, splenic denervation, or splenic sympathectomy significantly increased the mechanical withdrawal threshold (MWT) and reduced macrophage infiltration in the dorsal root ganglia (DRG) of CCI mice. Pseudorabies virus injections into the spleen revealed connections to the BNST and PVN in the brain. Chemogenetic inhibition of the BNST-PVN circuit increased macrophage infiltration in the DRG and decreased the MWT; these effects were reversed by splenectomy, splenic denervation, or sympathectomy. These findings underscore the critical role of the spleen, regulated by the BNST-PVN circuit, in neuropathic pain.
Animals ; Neuralgia/pathology* ; Septal Nuclei/physiopathology* ; Male ; Spleen/physiopathology* ; Paraventricular Hypothalamic Nucleus/physiopathology* ; Mice, Inbred C57BL ; Splenectomy ; Mice ; Neural Pathways/physiopathology* ; Disease Models, Animal ; Ganglia, Spinal/physiopathology* ; Sympathectomy ; Macrophages

To evaluate the clinical efficacy and safety of Shugan Jieyu Capsules,Jieyu Pills and Xiaoyao Pills in the treatment of liver-stagnation and spleen-deficiency depression by the network Meta-analysis( NMA),so as to provide evidence-based clinical practice. Chinese databases,including CNKI,VIP,Wan Fang Data,CBM as well as English databases including the Cochrane Library,PubMed,EMbase and Web of Science were retrieved from inception to October 30,2018,to collect randomized controlled trials( RCTs) about clinical study of the three kinds of Chinese patent medicines. The quality and bias risk of the included studies were assessed by 5. 1 standard in Cochrane Handbook,ADDIS software was applied in the statistical analysis,and the result were compared by NMA. A total of 37 studies involving 3 105 patients were included. The results of NMA showed that the adjuvant therapy with the three kinds of traditional Chinese patent medicines could improve the clinical efficacy. Jieyu Pills had the most significant effect( OR = 4. 59,95%CI[1. 94,12. 71],P<0. 05). In HAMD,Shugan Jieyu Capsules( MD = 3. 22,95%CI[2. 07,4. 39],P< 0. 05) and Xiaoyao Pills( MD= 2. 23,95%CI[0. 41,4. 03],P<0. 05) can effectively reduce the depression scale indicators. In the incidence of adverse reactions,the three kinds of Chinese patent medicines can reduce the incidence of adverse reactions. The three kinds of Chinese patent medicines can be combined with auxiliary Western medicine to treat liver-stagnation and spleen-deficiency depression,with complementary advantages in action mechanisms. In the clinical efficacy and safety,the Chinese patent medicines had good clinical manifestations. Although this study showed that Jieyu Pills may be the referred medicine for depression,this conclusion is still immature and needs to be further verified by high-quality RCTs studies,and the application shall be selective based on specific characteristics in clinic.
Depression/drug therapy* ; Drugs, Chinese Herbal/therapeutic use* ; Humans ; Liver/physiopathology* ; Medicine, Chinese Traditional ; Network Meta-Analysis ; Nonprescription Drugs/therapeutic use* ; Randomized Controlled Trials as Topic ; Spleen/physiopathology*

OBJECTIVETo compare the difference in the clinical efficacy on infantile food accumulation treated with centripetal tuina therapy at spleen meridian site of different location.

METHODSSixty cases of infantile food accumulation were randomized into a palmar thumb surface group and a radial margin group, 30 cases in each one. In the palmar thumb surface group, the spleen meridian was stimulated with the pushing technique centripetally on the palmar side of the thumb. In the radial margin group, the spleen meridian was stimulated with the pushing, technique centripetally along the radial margin of the thumb. The traditional tuina techniques, such as tuisanguan, yun neibagua were combined in the two groups. The treatment was given once a day, 6 times a week, 12 treatments as one session. After the 1 session of treatment, the main symptom scores before and after treatment were compared in the patients of the two groups, the improvements in the accompanied symptoms were observed, such as appetite, defecation and tongue coating; and the efficacy was evaluated in the two groups.

RESULTSThe total effective rates were 93.3% (28/30) and 90.0% (27/30) in the palmar thumb surface group and the radial margin group respectively and the difference was not significant statistically in comparison of the two groups (P > 0.05). After treatment, the main symptom score was improved significantly in the two groups, indicating the significant difference as compared with that before treatment (both P < 0.05). The improvement in foul breathing in the palmar thumb surface group was better than that in the radial margin group (P < 0.05).

CONCLUSIONBetween the two kinds of pushing techniques at spleen meridian site, pushing on the palmar surface of the thumb and pushing along the radial margin, there is no difference in the total efficacy on infantile food accumulation. Regarding the improvement in foul breathing, the effect in the palmar thumb surface group is better than that in the radial margin group.

Acupuncture Points ; Child ; Child, Preschool ; Defecation ; Female ; Humans ; Infant ; Intestinal Diseases ; physiopathology ; therapy ; Male ; Massage ; Meridians ; Spleen ; physiopathology ; Treatment Outcome

OBJECTIVETo explore the efficacy on obesity of spleen deficiency and damp blockage pattern and hyperlipemia treated with warm needling therapy and auricular acupuncture and the effect mechanism of the combined treatment.

METHODSOne hundred and ten patients of obesity of spleen deficiency and damp blockage pattern and hyperlipemia were randomized into an observation group and a control group, 55 cases in each one. Additionally, a healthy group (52 cases) was set up as the control. In the control group, the warm needling therapy was applied to Taibai (SP 3), Chongyang (ST 42), Yinlingquan (SP 9), Zusanli (ST 36), etc., once every two days. In the observation group, on the basic treatment as the control group, the auricular acupuncture was applied to Pi (CO₁₃), Wei (CO₄), Fei (CO₁₄), Shen (CO₁₀), etc., once every 2 to 3 days. The efficacy was evaluated after 3-month, treatment in the two groups. The observation was conducted on the obesity outcomes [body mass, obesity degree (A), body mass index (BMI), body fat percentage (F%)], blood-lipoids indicators [such as serum total cholesterol (TC), triacylglycerol (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C)], fat-islet endocrine axis outcomes [such as fasting plasma glucose (FPG) , fasting leptin (FLP), fasting insulin (FINS), insulin sensitivity index (ISI), insulin resistance index (Homa-IR) and insulin β cell function index (Homa-β)], as well as autonomic nerve function index (Y) before and after treatment in the patients of the two groups. The efficacy was assessed in the two groups.

RESULTSThe total effective rate was 96.4% (53/55) in the observation group, better than 87.3% (48/55, P < 0.01) in the control group. For the improvements of the obesity indices, the differences were not significant between the two groups (all P > 0.05). Before treatment, the levels of TC, TG, LDL-C, FLP, FPG, FINS and Homa-IR in the two groups were all significantly higher than those in the healthy group (all P < 0.01), and the levels of HDL, ISI, Homa-β and Y were significantly lower than those in the healthy group (all P < 0.01). After treatment, except Homa-β, the other indices were all improved significantly (all P < 0.01). The results in the observation group were better than those in the control group (all P < 0.01).

CONCLUSIONThe patients of obesity of spleen deficiency and damp blockage pattern and hyperlipemia have the disturbances of lipid metabolism, "fat-islet endocrinal axis" function and automatic nerve function. The combined treatment of warm needling therapy and auricular acupuncture or simple warm needling therapy present the effects of weight reducing and lipid reducing. The effect of the combined treatment is better than simple warm needling therapy. The efficacy mechanism is probably relevant to the positive regulation of blood glucose, lipid metabolism, fat-islet endocrinal axis and automatic nerve function.

Acupuncture Points ; Acupuncture Therapy ; Acupuncture, Ear ; Adolescent ; Adult ; Blood Glucose ; Female ; Humans ; Hyperlipidemias ; metabolism ; physiopathology ; therapy ; Lipids ; blood ; Male ; Middle Aged ; Obesity ; metabolism ; therapy ; Spleen ; physiopathology ; Treatment Outcome ; Triglycerides ; blood ; Young Adult

OBJECTIVETo compare the characteristics of esophageal gastric varices in portal hypertension patients with and without spontaneous shunts.

METHODSClinical data of 118 patients with esophageal gastric varices undergoing portal vein computed tomographic angiography (CTA) and gastroscopy between January 2012 and August 2015 was retrospectively reviewed.

RESULTSPortal vein CTA results showed that spleno-renal or gastro-renal shunts were detected in 24 out of 118 cases. The average portal vein diameters (PVD) of patients with and without spontaneous shunt were (12.48±2.79) mm and (13.58±3.46) mm, respectively (P>0.05). The average area of gastric veins in patients with spontaneous shunt was significantly larger than that of patients without shunt [294.00 (0.00~2400.00) mm2 vs. 26.00 (0.00~1620.00) mm2, respectively, (P<0.001]. Compared with patients without spontaneous shunt, the location of esophageal varices was lower and the degree was less serious in patients with spontaneous shunt (P<0.05). No matter with history of uppergastrointestinal bleeding, the average area of gastric veins in patients with spontaneous shunt was significantly larger than that of patients without shunt (P<0.05). For patients having no history of splenectomy, the average portal vein diameter (PVD) in those with spontaneous shunt was significantly smaller than that in those without shunt (P<0.05).

CONCLUSIONThe portal vein diameter of patients without splenectomy and with spontaneous shunts is shorter and their esophageal varices are less serious; the gastric veins are large and wriggly in patients with spontaneous shunts.

Angiography ; Esophageal and Gastric Varices ; physiopathology ; Gastroscopy ; Humans ; Hypertension, Portal ; physiopathology ; Portal Vein ; pathology ; Retrospective Studies ; Spleen ; Tomography, X-Ray Computed

OBJECTIVETo investigate the effects of iron overload on apoptosis and function of splenic CD8+ T cells in mice.

METHODSForty C57BL/6 mice were randomly divided into control groups, Iron overload (IO), IO+NAC and IO+DFX groups. The iron overload model was established by intraperitoneal injection of iron dextran, and saline was injected as the control. The levels of intracellular reactive oxygen species (ROS) and labile iron pool (LIP) were analyzed by measuring the mean fluorescence intensity (MFI) of 2-7 dichlorofluorescein (DCF) or calcein. The ratio of CD8+ T cells and the levels of IFN-γ, TNF-α, Granzyme-B, and perforin in CD8+ T cells were detected by flow cytometry. The CD8+ T cell apoptosis was determined by flow cytometry with Annexin V/PI double staining. Real-time PCR was used to detect the expression of IFN-γ, TNF-α, Granzyme-B, perforin, BCL-2, and bax at mRNA level in CD8+ T cells.

RESULTSIron overload was found by spleen iron staining and flow cytometry. The level of intracellular ROS in iron overload (IO) groups was higher than that of the control groups (P<0.01). The percentage of CD8+ T cells in spleen from mice with IO was lower than that in control groups (P<0.05). The expression of IFN-γ and Granzyme-B in CD8+ T cells in IO group were lower than that in control group, the expression of IFN-γ and Granzyme-B at mRNA level in CD8+ T cells was lower than that of control group (P<0.05). CD8+ T cell apoptosis in iron overload group was significantly higher than that in control groups (P<0.01); the expression of BCL-2 at mRNA level was lower than that in control group, but the expression of BAX at mRNA level was higher than that in control group (P<0.05). These effects could be reversed after treating iron-overloaded mice with DFX or NAC.

CONCLUSIONIron overload can inhibit the ratio of CD8+ T cells of splenic cells in mice, decrease the expression of IFN-γ, Granzyme-B, increase the apoptosis of CD3+ CD8+/CD8-. These effects may be regulated through increasing the intracellular ROS level, and can be partially reversed after treating iron-overloaded mice with DFX or NAC.

Animals ; Apoptosis ; CD8-Positive T-Lymphocytes ; cytology ; pathology ; Granzymes ; metabolism ; Interferon-gamma ; metabolism ; Iron ; metabolism ; Iron Overload ; physiopathology ; Mice ; Mice, Inbred C57BL ; Perforin ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Random Allocation ; Reactive Oxygen Species ; metabolism ; Spleen ; cytology ; Tumor Necrosis Factor-alpha ; metabolism ; bcl-2-Associated X Protein ; metabolism

The function of the spleen in tumor development has been investigated for years. The relationship of the spleen with hepatocellular carcinoma (HCC), a huge health burden worldwide, however, remains unknown. The present study aimed to examine the effect of splenectomy on the development of HCC and the possible mechanism. Mouse hepatic carcinoma lines H22 and Hepa1-6 as well as BALB/c and C57 mice were used to establish orthotopic and metastatic mouse models of liver cancer. Mice were divided into four groups, including control group, splenectomy control group (S group), tumor group (T group) and tumor plus splenectomy group (T+S group). Tumor growth, metastases and overall survival were assessed at determined time points. Meanwhile, myeloid-derived suppressor cells (MDSCs) were isolated from the peripheral blood (PB), the spleen and liver tumors, and then measured by flow cytometery. It was found that liver cancer led to splenomegaly, and increased the percentage of MDSCs in the PB and spleen in the mouse models. Splenectomy inhibited the growth and progression of liver cancer and prolonged the overall survival time of orthotopic and metastatic models, which was accompanied by decreased proportion of MDSCs in the PB and tumors of liver cancer-bearing mouse. It was suggested that splenectomy could be considered an adjuvant therapy to treat liver cancer.
Animals ; Carcinoma, Hepatocellular ; physiopathology ; surgery ; Cell Line, Tumor ; Flow Cytometry ; Humans ; Liver Neoplasms ; physiopathology ; surgery ; Mice ; Myeloid-Derived Suppressor Cells ; pathology ; Neoplasms, Experimental ; physiopathology ; surgery ; Spleen ; physiopathology ; surgery ; Splenectomy ; methods