The hypoglossal vein of 200 patients with tumor was investigated and compared with non-tumor patients with similar gender and age. It was found that the hypoglossal vein of the former was obviously abnormal than that of the latter. Among them, the hypoglossal vein abnormalities of digestive system, internal organs and facial tumors are particularly significant; There is no significant difference in abnormal sublingual pulse between benign and malignant tumors.
2. A case-control study on hypoglossal vein abnormality in diabetic patients.
Initially, 89 patients with diabetes were investigated for hypoglossal veins, and the abnormal rate of hypoglossal veins was 56%. Later, a case-control study found that the score of hypoglossal vein abnormality was higher than that of diabetic patients, and some factors that might cause hypoglossal vein abnormality were studied. It was found that the abnormal score of hypoglossal vein was related to the patient's age and accompanying vascular diseases.
Blood Stasis Syndrome of Type 32 Diabetes Mellitus and Therapeutic Observation of Drugs for Supplementing Qi and Promoting Blood Circulation in Preventing Vascular Lesions
Source: journal of traditional chinese medicine,1989; 30(6):2 1
Among 76 cases of type 2 diabetes, 52% showed blood stasis syndrome. In order to evaluate the preventive effect of traditional Chinese medicine, they were randomly divided into treatment group and control group, with 30 cases in each group. In the treatment group, hyperlipidemia and arteriosclerosis index were significantly improved after 3-6 months of oral hypoglycemic drugs plus Chinese medicine for invigorating qi and promoting blood circulation. The control group was only treated with oral hypoglycemic agents, and other indexes were not significantly improved except cholesterol. The author thinks that after the blood sugar is basically controlled, supplementing qi and activating blood circulation drugs are especially suitable for diabetes mellitus complicated with lipid metabolism disorder, and it is speculated that supplementing qi and activating blood circulation drugs can prevent vascular lesions in type 2 diabetes mellitus.
Clinical application and research progress of warming kidney and supporting yang method
Recent clinical application of the method of warming and tonifying kidney yang: 1. In endocrine system diseases, it is found that drugs of warming and tonifying kidney yang can act on three axes to regulate its dysfunction. (1) acts on the hypothalamus-pituitary-adrenal cortex axis: (2) acts on the hypothalamus-pituitary-gonad axis: (3) acts on the hypothalamus-pituitary-thyroid axis: (2) acts on hematopoietic and skeletal system diseases: (1) aplastic anemia: (2) proliferative arthritis: (3). Recent experimental study on drugs for warming and tonifying kidney yang: first, improving energy metabolism; Similar to endocrine hormones: 3. Effects on cardiovascular system: 4. Effect on hematopoietic system: 5. Effect on urinary system: 6. Research on immunity.
4. Prevention and treatment of bronchial asthma by tonifying kidney and observation of endocrine immunity.
It is preliminarily confirmed that tonifying kidney can make asthma get long-term curative effect, and it is found that the urine 17 hydroxy corticosteroid (hereinafter referred to as urine 17 hydroxy) value of most asthma patients is low, suggesting that asthma patients may have mild or potential adrenal cortex dysfunction. In the further AGTH2 day intravenous drip test (hereinafter referred to as AGTH test), it was found that more than half of asthma patients with kidney-yang deficiency had a delayed response to AGTH test, while asthma patients without kidney deficiency had a normal response to AGTH test. Therefore, it is considered that asthma does have endocrine changes, and the degree of expression is different due to different TCM syndromes.
5. Clinical application and research progress of some antiasthmatic prescriptions.
First, asthma prescription bronchial asthma is divided into attack and remission. During the attack, the general treatment is asthma, which is mostly caused by exogenous factors or phlegm, and it is divided into cold and heat. Cold asthma is generally caused by wind-cold external bundle, while heat asthma is generally caused by warm pathogen invading the lung. Syndrome differentiation is based on whether there is fever, chills, thirst, phlegm color, defecation and tongue quality. Allergic asthma is mostly cold asthma at first, but it can also become hot after a long time; Infectious asthma (or allergic asthma with infection) is mostly heat asthma; Children with asthma are mostly hot asthma; Those who take adrenocortical hormone for a long time also belong to heat asthma. People with cold and asthma can use Xiaoqinglong Decoction and Shegan Mahuang Decoction. Maxing Shigan Decoction and Dingchuan Decoction are commonly used by patients with heat asthma. Clinically, the persistent state of asthma is often manifested as a mixture of cold and heat or a change from cold to heat. The representative prescription for treatment is Daqinglong Decoction. Physicians in ancient and modern times have always attached importance to resolving phlegm and relieving asthma when treating asthma. Commonly used prescriptions include Sang Zi Baozao Decoction, Sanzi Yangqin Decoction, Guizhi Houpu Almond Decoction and Perilla Jiang Qi Decoction.
Second, the commonly used prescriptions for tonifying kidney are Liuwei Dihuang Pill, Fugui Bawei Pill, Gui You Pill, Zuogui Pill and Shen Ge Powder. Prescriptions for invigorating kidney and lung, such as Shen Ge Powder and Ginseng and Walnut Decoction, are generally used in the remission stage of asthma, but in recent years, they have also been reported to be used in the rescue of patients with asthma.
Three, effective Chinese herbal medicines and unilateral Chinese herbal medicines have been reported to treat bronchial asthma, such as Datura flower, ginseng, pepper, earthworm, Sophora flavescens and so on. Datura flower contains scopolamine and atropine, which mainly antagonizes acetylcholine, thus reducing tracheal secretion and relieving bronchial smooth muscle spasm, and can be made into inhalants. Hot ginseng mainly contains scopolamine. Scopolamine and scopolamine have antihistamine effects of dilating bronchi and inhibiting saliva secretion. The preparation is hot ginseng extract tablets. Zanthoxylum bungeanum preparation, including Zanthoxylum bungeanum powder and Zanthoxylum bungeanum oil, has rapid antiasthmatic effect. Guangdilong has a good spasmolytic effect on bronchial smooth muscle, and its antiasthmatic component is succinic acid, which has been made into earthworm injection and can be applied to clinic through intramuscular injection. Clinical verification shows that Sophora flavescens decoction is effective for patients with bronchial asthma and asthmatic bronchitis, and the total effective rate of instant asthma relief is 86.5%. It is reported that besides earthworm, there are stiff silkworm, cicada, centipede, trogopterus dung, pangolin, ground beetle, leech and so on. It is believed that this kind of drugs can dispel wind and relieve spasm, promote blood circulation and remove blood stasis, and dredge airway congestion, which has a significant effect on relieving bronchospasm.
6. Discussion on the clinical characteristics and risk factors of blood stasis syndrome of diabetes.
Through the clinical observation of 170 patients with type II diabetes, the incidence of blood stasis syndrome is 6 1.77%. The clinical characteristics of blood stasis syndrome in diabetes are as follows: (1) The factors reflecting the universality of blood stasis syndrome are: purple and dark tongue, blood stasis in tongue and blood stasis in sublingual collaterals; (2) The factors that reflect the characteristics (personality) of blood stasis syndrome of diabetes are the formation, bleeding and proliferation of retinal hemangioma. Headache, chest pain, limb pain or numbness are common symptoms of blood stasis syndrome. The analysis shows that when the body mass index increases, the prevalence of patients with coronary heart disease, cerebrovascular disease, retinopathy, hyperlipidemia and blood stasis syndrome in traditional Chinese medicine increases. It is suggested that the main cause of diabetic complications is qi and blood.
7. Clinical analysis of treating nephrotic syndrome with integrated traditional Chinese and western medicine.
Origin: journal of traditional chinese medicine, 199 1, 4 issues, 34 pages.
In order to explore the treatment of nephrotic syndrome with integrated traditional Chinese and western medicine, improve the remission rate and reduce the recurrence rate, the author used the method of tonifying kidney and promoting blood circulation combined with adrenocortical hormone to treat 3 cases of nephrotic syndrome (including refractory nephrotic syndrome 13 cases), and achieved good results, with complete remission 14 cases (normal urine routine, negative urine protein, disappearance of symptoms and signs, and recovery of renal function). Among them, 10 cases were followed up for more than 1 year after hormone withdrawal, and 4 cases were followed up for more than 3 months, all of which remained in complete remission and no signs of recurrence were found. The remaining 8 patients with primary nephrotic syndrome had a decrease in hormone maintenance dose after treatment, among which 4 patients were unable to maintain the original dose of 20 mg, and the maintenance dose was changed to 10 mg after treatment, and 4 patients were below 20 mg. The average maintenance dose of hormone in 5 cases of secondary nephrotic syndrome also decreased from 65438±05mg to 65438±00mg. It is recommended to treat nephrotic syndrome with kidney-tonifying drugs combined with glucocorticoid, advocate early use of nourishing yin and reducing gunpowder, and alleviate the symptoms of "yin deficiency and excessive fire" caused by hormones. When the hormone drops to the maintenance level, add kidney-warming drugs until the hormone is removed, and then consolidate the treatment for 3 months, which is conducive to encouraging the yang of the kidney and turning the opening and closing function into normal. The persistent recurrence of the disease is related to damp heat, and the treatment of damp heat is very important to alleviate the disease. Of the 8 patients with primary nephrotic syndrome who continued to take hormones, 6 were damp-heat type or damp-heat syndrome. Nephrotic syndrome is often accompanied by hypercoagulability. In this paper, drugs for promoting blood circulation and removing blood stasis are also selected for treatment.
8. Three cases of allergic sub-septicemia were treated by removing hormones by tonifying kidney.
Origin: journal of traditional chinese medicine, 1984, No.4, 4 1.
We treated 3 patients with allergic sub-septicemia who had been dependent on adrenocortical hormone for a long time. After taking a large dose of Radix Rehmanniae as the main treatment, 2 cases were cured, and recurred after stopping taking the drug for half a year 1 case.
9. Macroscopic and microscopic study on blood stasis syndrome of diabetes.
Origin: journal of traditional chinese medicine, 1997, 4 issues, 233 pages.
Clinical epidemiological investigation method was used in macro research, and molecular markers related to hemorheology and thrombosis were used in micro research. The blood stasis syndrome of diabetes mellitus was deeply studied, and it was suggested that the pathological and microscopic blood stasis syndrome of diabetes mellitus should be paid attention to.
10, prevention and treatment of urinary calculi with traditional Chinese and western medicine and its research progress
According to its different syndromes, urinary calculi often belong to the categories of stranguria, blood syndrome and low back pain in traditional Chinese medicine. The treatment is mainly "stranguria", mainly Wuling powder and Bazheng powder. Urinary stones have a certain natural excretion rate, which is related to the size of stones.
1. Heat-clearing and dampness-removing method: Liu applied the heat-clearing and dampness-removing and stranguria-removing formula composed of Lysimachia christinae, Plantaginis, Pyrrosia, Alisma orientalis, Magnolia officinalis, Fructus Aurantii and Talc to treat 37 cases. Deng used Lysimachia christinae, Lygodium japonicum, Malva, Dianthus chinensis, Polygonum aviculare, Plantago asiatica, Alisma orientalis, Talcum, Smilax China, Radix Cyathulae and so on. Treatment of stones with secondary hydronephrosis (maximum transverse diameter > 0.5cm). Animal experiments have found that heat-clearing and diuretic drugs can increase urine flow and enhance ureteral peristalsis, and Lysimachia christinae, Dianthus, Plantago asiatica, Poria, Alisma orientalis and Akebia manshuriensis have obvious diuretic effects.
Second, the method of promoting blood circulation and removing blood stasis: This method is a treatment method for local congestion, edema, inflammation and adhesion caused by stones stimulating the ureteral wall for a long time. Rhizoma Sparganii, Rhizoma Curcumae, Squama Manis, Gleditsia sinensis, Radix Cyathulae, japonica rice, Pericarpium Citri Reticulatae Viride, Fructus Aurantii, etc. 98 cases of urolithiasis with a transverse diameter of 0.6 ~ 0.8 cm were treated. Animal experiments have confirmed that the prescription of promoting blood circulation and removing blood stasis has no obvious diuretic effect, but can promote ureteral peristalsis. From this point of view, the effect of the prescription for promoting blood circulation and removing blood stasis is not the result of diuresis, but the result of pushing stones down due to the enhanced peristalsis of ureter. These effects are beneficial to the discharge of stones with long incarceration time and large transverse diameter.
Third, the method of tonifying kidney, warming kidney and benefiting water: For a long time, ureteral calculi often cause hydronephrosis, affecting renal function, and the stone removal rate will be significantly reduced. Such patients may show some signs of kidney deficiency. Deng's method of tonifying kidney is the main method, and Radix Dipsaci, Herba Taxilli, Fructus Ligustri Lucidi, Ecliptae Herba, Radix Rehmanniae, Semen Cuscutae, Fructus Psoraleae, Herba Epimedii, Radix Morindae Officinalis, Cistanchis Herba and Semen Juglandis are added for calculus complicated with hydronephrosis. Results: The stone removal rate was 1. 1%. Animal experiments show that the method of warming kidney and promoting diuresis does not increase the renal blood flow of the dog model of ureteral incomplete hydronephrosis, but can significantly increase the pressure in the renal pelvis and accelerate the frequency of ureteral peristalsis.
Fourth, the "general attack" stone removal method: in a short period of time, comprehensive use of traditional Chinese and western medicine, acupuncture and other methods to speed up the stone removal, known as the "general attack" stone removal method. Zunyi Medical College uses plenty of drinking water, diuretics, spasmolytics, electroacupuncture, exercise and Chinese medicines (Herba Lysimachiae Christinae, Folium Pyrrosiae, Semen Plantaginis, Caulis Akebiae, Herba Dianthi, Herba Polygoni Avicularis, Fructus Gardeniae, talc, Radix Glycyrrhizae and Radix et Rhizoma Rhei) to treat ureteral calculi. The stone clearance rate was 58.3% and 13.3%. The mechanism of "general attack" is that after drinking a lot of water and using diuretics, the urine volume will increase exponentially, thus washing away stones.
5. Comprehensive treatment, etc. For stones with large transverse diameter, or when stones cannot be removed by other treatment methods, comprehensive measures such as traditional Chinese medicine combined with magnetized water, ultrasound, electromagnetic plate, body slapping, gymnastics and massage can be adopted to improve the stone removal rate.
Six, Chinese medicine "dissolving stone" method: the precipitation of salts in urine is related to the pH value of urine. It has been reported that ebony was added to Paishi decoction to eat raw walnut kernel acidified urine to promote the dissolution of magnesium ammonium phosphate, and tangerine peel, cowherb seed and cyathula root were added to Ji Fang Huangqi decoction to adjust the pH to 6.5 ~ 7.0 to treat uric acid stones, and calcium oxalate stones were treated with yellow horn powder wine or rice vinegar.
7. Prevention of urinary calculi: The recurrence rate of urinary calculi after lithotomy or operation is high, and preventing recurrence of urinary calculi is of great significance to consolidate the curative effect. Some people use Rhizoma Atractylodis, Radix Astragali, Cortex Phellodendri, Semen Vaccariae, Talcum, Radix Cyathulae, Semen Plantaginis and Herba Lysimachiae to prevent stones from recurring. Animal experiments have proved that the decoction and magnetized water composed of Semen Plantaginis, Herba Lysimachiae Christinae, Spora Lygodii, Talcum, Pumice, Fishbone, Carapax Trionycis, Rhizoma Atractylodis, and Semen Militaris can prevent the formation of stones. The preventive effect of Chinese medicine combined with magnetized water is more obvious.
Based on the above data, it can be seen that the methods of clearing heat and promoting diuresis, promoting blood circulation and removing blood stasis, tonifying kidney, warming kidney and promoting diuresis in traditional Chinese medicine have certain curative effect on urinary calculi. Clinical application should be analyzed according to the size, location, residence time and renal function. Generally speaking, clearing heat and promoting diuresis is suitable for the treatment of early and small stones, promoting blood circulation and removing blood stasis can be used for the treatment of stones with long retention time and large transverse diameter, warming kidney and promoting diuresis is beneficial to the treatment of patients with incarcerated stones and hydronephrosis, and the "general attack" method can accelerate the discharge of stones, but it is not suitable for the elderly, the weak and the renal insufficiency. Comprehensive treatment can improve the stone clearance rate.
1 1, blood stasis syndrome and deficiency syndrome of diabetes.
170 patients with blood stasis syndrome and deficiency syndrome of type 2 diabetes mellitus were observed clinically. The results show that the incidence of blood stasis syndrome is 665438 0.77%, and the incidence of deficiency syndrome is 79.465438 0%. When accompanied by qi deficiency, heart deficiency and liver and kidney deficiency, the prevalence of blood stasis syndrome increases. This paper also discusses the relationship between blood stasis syndrome, deficiency syndrome and diabetic vascular disease. It is suggested that the fundamental cause of blood stasis syndrome of diabetes lies in qi deficiency; Deficiency of viscera will not only affect the generation of qi, but also lead to vascular diseases and aggravate the formation of blood stasis.
12. Preliminary study on the relationship between TCM syndrome differentiation of chronic nephritis and renal biopsy pathology.
Source: Journal of Integrated Traditional Chinese and Western Medicine,1983; 3( 1):25
Through the comparative observation of TCM syndrome differentiation and renal biopsy pathology in 43 cases of chronic nephritis, it is shown that different syndromes of chronic nephritis have different material basis. This paper also puts forward some suggestions on the classification method of chronic nephritis with integrated traditional Chinese and western medicine. (1) Spleen and kidney deficiency: pale or (white) yellow complexion, edema of lower limbs or whole body, cold limbs, pale and fat tongue, teeth marks on the side, often accompanied by hypoproteinemia, decreased plasma immunoglobulin IgG, massive loss of urine protein, mild or inconspicuous hematuria under microscope, normal blood pressure, normal or moderate damage to renal function, and also accompanied by cardiac function. Renal biopsy pathology, membranous type, membranous hyperplasia type, mesangial sclerosis type and mesangial hyperplasia type can also be seen in this type. (2) Yin deficiency of liver and kidney: dizziness, vexation and insomnia, high or increased blood pressure, often accompanied by damp heat, easy infection, sore throat, red blood cells in routine urine, persistent proteinuria, normal or abnormal renal function, greasy tongue coating, which are common in mesangial proliferative nephritis, and IgA nephropathy often belongs to this category. (3) Spleen deficiency type: soreness of waist and knees, mental fatigue, mild edema or no edema, less urine protein or hematuria under microscope, normal renal function, and nephritis type is more common. Pathologically, all types can be seen, mostly minimal lesion type, focal nephritis and mesangial proliferative nephritis. (4) Kidney-yang descending type: dull and sallow complexion, petechiae on the skin of lips and tongue, scanty urine, edema of limbs, loss of appetite, decreased renal function, nitrogen in blood and rapid pulse. Clinically, it can enter the stage of renal decompensation, which may be more common in membranous proliferative nephritis, membranous nephropathy, mesangial sclerosis, mesangial proliferative nephritis with focal crescent formation. Because there are not many cases in this group, and patients with microalbuminuria and uremia are not selected as the objects of renal biopsy, we can only discuss the pathological relationship between TCM syndrome differentiation of chronic nephritis and renal biopsy.
13, Clinical Application of Rehmannia glutinosa
Source: Journal of Integrated Traditional Chinese and Western Medicine,1983; 3( 1):25
In animal experiments, our hospital found that some Chinese herbs for tonifying kidney can make thymus atrophy like hormones, so it is considered that they have adrenocortical hormone-like effects. Radix Rehmanniae and Radix Rehmanniae Preparata alone have similar effects. This paper focuses on increasing the dose of Rehmannia glutinosa (30g~90g per day) to explore whether the large dose of Rehmannia glutinosa really has adrenocortical hormone-like or hormone-like immunosuppression in clinic, and now it is discussed through cases.
14 clinical observation on 20 cases of chronic severe aplastic anemia
Source: Journal of Integrated Traditional Chinese and Western Medicine,1988; 8(6):
Abstract: Chronic severe aplastic anemia (hereinafter referred to as severe aplastic anemia) has high mortality and poor treatment effect. Androgen alone and splenectomy are not ideal. 20 cases of severe aplastic anemia were treated with combination of traditional Chinese and western medicine, and good results were achieved. The cure rate and remission rate reach 65%, and the effective rate reaches 90%. The treatment of aplastic anemia should emphasize comprehensive treatment. For some patients who may have immune mechanism or intramedullary hemolysis, high-dose glucocorticoid should be added for short-term application, and patients who fail after splenectomy should continue to receive comprehensive treatment. Early treatment and continuous treatment are the key to improve the curative effect of chronic severe aplastic anemia. The curative effect of aplastic anemia in this group is related to the length of the course of disease before treatment. Early treatment of integrated traditional Chinese and western medicine is an important factor to improve the curative effect. The treatment principle of traditional Chinese medicine should be tonifying kidney and filling marrow, warming or nourishing kidney according to the advantages and disadvantages of yin and yang, properly helping to replenish qi and blood, promoting blood circulation and stopping bleeding. Epimedium 15 ~ 30g Psoralea corylifolia 10g Cistanche deserticola 10g Antlers 10g Cynomorium songaricum 10g, etc. Cuscuta 30g Ligustrum lucidum 10g Lycium barbarum 12g Rehmannia glutinosa 12g Mulberry 12g Ophiopogon japonicus 10g Polygonatum sibiricum, etc. Codonopsis pilosula 15g Astragalus membranaceus 15g Angelica sinensis 10g Ejiao 10g, etc. Among them, 3 cases were added with human fetal dry powder, and 3g was put into capsules every day for swallowing. Chuanxiong rhizome 10g salvia miltiorrhiza 15 ~ 30g madder 15 ~ 30g Eclipta prostrata 10g agrimony 30g is used as a medicine for promoting blood circulation and stopping bleeding. Among them, 3 cases were added with Sanqi 15g steamed chicken. All patients took medicine continuously. After remission, reduce the dosage appropriately or take 1 post every other day to maintain stability.
15 and Wenyang tablets to prevent seasonal attack of bronchial asthma and its mechanism.
In this paper, Wenyang tablets are used to prevent seasonal asthma attacks. The effective rate in the treatment group was 63.5 ~ 75.0%, and that in the control group was 65,438 08.5 ~ 22.2% (P < 0.065438 0.05). Immunological study found that Wenyang tablet could inhibit the seasonal increase of serum IgE and improve the function of T cells. The correlation between Ts and serum IgE before and after treatment was observed synchronously. It was found that the difference between IgE and Ts in Wenyang tablet group was negatively correlated (r=-0.44 1, P < 0.05), but there was no obvious linear correlation in control group. It is suggested that Wenyang tablet may play a preventive role through immunomodulation.
Clinical significance of determination of plasma α -granule membrane protein 16 and 140 in primary glomerular disease with blood stasis syndrome
Source: journal of traditional chinese medicine, China,1996; 1(4):22
In this study, the plasma concentration of α -granule membrane protein 140(GMP- 140) was measured in 53 patients with primary glomerular disease (PGD) with or without blood stasis syndrome, and the relationship between hyperlipidemia and hypertension and GMP- 140 was observed. The results showed that the plasma GMP- 140 concentration of PGD patients was significantly higher than that of the control group (P < 0.0 1), and the platelet was highly activated, and the blood stasis syndrome group was significantly higher than that of the non-blood stasis syndrome group (P < 0.0 1), and the qi deficiency syndrome group was higher than that of the non-qi deficiency group (P < 0.05), indicating GMP-. Hyperlipidemia and hypertension are closely related to the abnormal increase of GMP- 140, which is an important factor of PGD hypercoagulability and blood stasis tendency.
17, determination of platelet α -granule membrane protein and endothelin in patients with blood stasis syndrome
Source: China Journal of Traditional Chinese Medicine Information,1997; 4( 12):3
In this paper, platelet α -granule membrane protein (GMP- 140) and endothelin (et) were used as indicators of platelet activation and endothelial cell dysfunction. The observed diseases were cardiovascular disease, renal disease and type II diabetes. The results showed that the plasma GMP- 14 and ET in the three disease groups were significantly higher than those in the normal control group (P
18, the relationship between blood stasis syndrome and platelet activation
Source: journal of traditional chinese medicine, China,1996; 1(4):22
162 patients with vascular diseases or diseases prone to thrombosis, cardiovascular diseases prone to blood stasis syndrome based on TCM syndrome differentiation, type 2 diabetes and nephropathy were tested, and GMP- 140 was selected as the index to understand the significance of platelet activation in blood stasis syndrome. The GMP- 140 value of patients with blood stasis syndrome is significantly higher than that of patients without blood stasis syndrome, suggesting that patients with blood stasis syndrome have higher platelet activation state. In patients with renal diseases, platelet activation has a certain relationship with the progress of renal diseases, especially patients with qi deficiency and blood stasis syndrome.
19, some views on the integration of traditional Chinese and western medicine
Source: China Journal of Traditional Chinese Medicine Information,1997; 4( 12):3
1. Take the road of integrated traditional Chinese and western medicine with power and security; 2.3. On modernization of traditional Chinese medicine and integration of traditional Chinese and western medicine.
20. Significance of determination of plasma endothelin α granule membrane protein 140 in patients with kidney disease and blood stasis syndrome.
Abstract: The levels of plasma endothelin (ET) and platelet α granule membrane protein 140(GMP- 140) were measured in 52 patients with primary glomerular disease (PGD) with blood stasis syndrome and non-blood stasis syndrome. The results showed that the plasma levels of ET and GMP 140 in PGD patients were significantly higher than those in the control group (P < 0.05 ~ 0.00 1), especially in patients with renal failure. PGD blood stasis syndrome group is divided into two levels: non-blood stasis syndrome group > control group; ET was positively correlated with GMP 140. Above all, the abnormal increase of ET and GMP 140 reflecting the degree of platelet activation is not only closely related to the hypercoagulability in glomerulus and the occurrence and development of renal diseases, but also one of the important pathological bases of blood stasis syndrome in renal diseases.
2 1, microscopic syndrome differentiation of chronic nephritis
In this paper, the relationship between renal biopsy pathology and syndrome differentiation in 85 cases of chronic nephritis was observed, and the correlation between yin deficiency nephritis and biopsy pathology was emphatically discussed. It is considered that there is a certain relationship between TCM syndrome differentiation and clinical classification of nephritis. Nephritis type is mostly yin deficiency of liver and kidney, and nephropathy type is mostly yang deficiency of spleen and kidney. There is also a certain relationship between TCM syndrome differentiation and pathological types. Syndrome differentiation of proliferative nephritis is mostly liver-kidney yin deficiency, which is significantly different from other types of nephritis (P
22. Clinical significance of platelet activation in blood stasis syndrome of diabetes.
The plasma small granule membrane protein-140 (GMP- 140) was measured in 4 1 case of type Ⅱ diabetes mellitus and compared with 20 normal controls. Among 4 1 patients, 17 cases were in accordance with blood stasis syndrome, and 24 cases were not. Patients with vascular diseases 16 cases. It has been confirmed that platelet activation does exist in NIDDM patients, and it is significant in diabetic blood stasis group and vascular complications group. It shows that the occurrence of blood stasis syndrome in diabetes mellitus is closely related to platelet activation, and the abnormal increase of GMP- 140 level is a sensitive laboratory index to reflect blood stasis syndrome.
23. Blood stasis syndrome and prethrombotic state of type 2 diabetes.
Non-insulin-dependent diabetes mellitus (NIDDM, hereinafter referred to as DMⅱ) has a slow onset and is more common in middle-aged and elderly people. DM Ⅱ belongs to the category of "quenching thirst" in TCM. Common clinical symptoms are dull tongue, ecchymosis, purple swelling of sublingual collaterals, fingernails, or patients complaining of numbness and pain in limbs, thirst but not drinking much water, all of which are clinical manifestations of blood stasis syndrome. The research progress of modern medicine on prethrombotic state shows that there are changes in vascular endothelial cells, platelets, blood anticoagulation, coagulation, fibrinolysis system and other related factors in DM ⅱ patients, or pathological state caused by changes in hemorheology, which is beneficial to the process of thrombosis.
1.Ⅱ type diabetes with blood stasis syndrome and its clinical significance
Blood stasis is a unique theory of traditional Chinese medicine, and the occurrence of diabetes is related to blood stasis. Dream Taoism's "Three Fingers Zen, Quenching thirst from pulse differentiation" says: "Quenching thirst is mainly based on thirst, while judging qi and blood, blood is also thirsty."
The name of quenching thirst was first seen in Neijing. Zhang Zhongjing's synopsis of the golden chamber in the Eastern Han Dynasty devoted himself to quenching thirst. In the book On Blood Syndrome and Blood Stasis written by Rong Chuan in the Qing Dynasty, the relationship between blood stasis and thirst was elaborated in detail. "Blood stasis in the body is thirsty, so qi and blood can't be separated. There is blood stasis in it, qi can't pass through, and water and body fluid can't be transported up, so I am thirsty." Shenshi Zun Sheng Xiao Ke Men (Volume 17) establishes Jin Sheng Yin by promoting blood circulation and moistening dryness. This prescription is composed of Radix Asparagi, Radix Ophiopogonis, Fructus Schisandrae Chinensis, Fructus Trichosanthis, Radix Rehmanniae, Radix Rehmanniae Preparata, Trichosanthis Radix, Radix Angelicae Sinensis, Radix Glycyrrhizae and Radix Angelicae Sinensis, and it is still used in clinical prescriptions.
As for the pathological mechanism of blood stasis in this disease, Zhu believes that yin deficiency and dryness-heat eventually lead to the failure of both qi and blood, and blood stasis is the standard of this disease, which leads to the weakness of qi deficiency and blood circulation, which is called "qi deficiency and accumulation of dirt"; On the other hand, diabetes is difficult to recover, and long-term illness will also lead to blood vessels losing blood circulation and blood stasis.
"Blood circulation" is related to "blood" and "pulse". Modern research on the essence of blood stasis can be divided into: blood stasis is blood stasis; Dirty blood is blood stasis; The blood separated from menstruation is blood stasis; Long-term illness entering the collaterals is blood stasis. It is suggested that the local factors causing blood stasis are basically consistent with Vir Chow's view on the three major factors of thrombosis, namely blood composition, blood flow state, blood vessel wall and other pathological changes. Blood stasis is the manifestation of some local and specific morphological changes at the overall level of the body.
2. Diabetes prethrombotic state and blood stasis syndrome
The whole blood viscosity, plasma viscosity and fibrinogen in diabetic patients were higher than those in normal control group, and the latter two increased statistically (P
Hyperplatelet function, enhanced coagulation function and hypercoagulability may be risk factors for vascular complications in patients with type 2 diabetes. In the process of coagulation and anticoagulation, the level of F Ⅳ-VWF in NIDDM plasma is positively correlated with the course of disease. As far as the morphology of red blood cells and platelets is concerned, the erythrocyte deformability (RCD) of patients with poor fasting blood glucose control (FBG) is significantly reduced. If FBG is well controlled, RCD will be close to normal; The increase of platelet volume and surface glycoproteins GPIB, GP, Ⅱ b/Ⅲ a was positively correlated with glycosylated hemoglobin HBAlc.
3. Diabetes complications and treatment of promoting blood circulation and removing blood stasis
Because blood stasis is the main cause of diabetic complications, and blood stasis syndrome is a syndrome of type II diabetes, the method of nourishing yin, benefiting qi and tonifying kidney is often used in clinic. On the basis of syndrome differentiation and treatment, the treatment of DM ⅱ should focus on the root cause, supplemented by promoting blood circulation and removing blood stasis, or treating both the symptoms and root causes, and preventing and treating vascular complications in DM ⅱ patients early. Under the treatment background of diet control and dosage of hypoglycemic drugs, the prescriptions of drugs for invigorating qi and promoting blood circulation are: Radix Astragali, Radix Pseudostellariae, Semen Cuscutae, Radix Scrophulariae, Rhizoma Anemarrhenae, Radix Angelicae Sinensis, etc. Diabetes is based on yin deficiency and dryness-heat, involving yin and yang, qi and blood for a long time.
Diabetic nephropathy was treated by tonifying kidney and promoting blood circulation. Prescriptions: Radix Aconiti Lateralis Preparata, Rhizoma Zingiberis Preparata, Fructus Corni, Radix Astragali, Rhizoma Dioscoreae, Radix Angelicae Sinensis, Radix Salviae Miltiorrhizae, Herba Leonuri, Fructus Schisandrae Chinensis, Semen Euryales, Polygoni Multiflori Radix, Semen Phaseoli, Fructus Lycii, Polyporus, and aged pumpkin. With diet control and hypoglycemic drugs, it is considered that diabetic nephropathy is accompanied by diabetic edema, spleen and kidney are involved, and the condition is entangled.
Treatment of diabetic retinopathy in patients with type Ⅱ diabetes mellitus.
In the period of retinal hemorrhage, cooling blood to stop bleeding, nourishing yin and benefiting qi are the main methods. Liguben Zhixue Decoction consists of Radix Astragali, Rhizoma Dioscoreae, Rhizoma Atractylodis, Fructus Ligustri Lucidi, Eclipta prostrata, Radix Salviae Miltiorrhizae, Herba Lycopi, Carthami Flos and Radix Curcumae.
Peripheral neuropathy is particularly common in DM ⅱ patients, who feel numbness or pain in their limbs, or tingling or burning pain. Zhu Zhu's main prescription is Siteng Yixian Decoction, and the prescription is Spatholobus suberectus, Caulis Piperis, Caulis Trachelospermi and Radix Clematidis. Has good clinical curative effect. Zhu et al. used 3 parts of rhubarb, 2 parts of peach kernel and 5 parts of leech as raw materials, combined with syndrome differentiation and treatment, and cooperated with traditional Chinese medicine such as benefiting qi and nourishing yin to treat hyperlipidemia of type II diabetes. Clinical and experimental studies show that Tongyuling can significantly improve hyperlipidemia, and has obvious lipid-lowering effect on cholesterol, triglyceride and β lipoprotein, especially triglyceride, and it is considered that Tongyuling is suitable for blood stasis syndrome.
4. Guide medication according to modern pharmacological effects.
4. 1 Drugs affecting T×A2 and PGI2, Wang Shuoren's experiments in vitro confirmed that 1) Radix Glehniae has a bidirectional regulation effect on arachidonic acid metabolism, inhibiting the synthesis of T×A2 and promoting the synthesis of PGI2; 2) Codonopsis pilosula, Astragalus membranaceus and Angelica sinensis mainly inhibit the synthesis of T×A2 in a certain dose range, but have little effect on the synthesis of PGI2; 3) The synthesis of T×A2 such as Salvia miltiorrhiza, Paeonia lactiflora, Ligusticum chuanxiong and Angelica sinensis was also inhibited. At the same time, it also inhibits the synthesis of PGIz. Neobreviscapine (soluble sodium salt and calcium salt of 4 '- hydroxy -7-0 glucoside) has different effects on arachidonic acid metabolism of platelet leukocytes and endothelial cells, and inhibits the production of platelet T×B2 and endothelial cells 6-eto-PGF 12, but has no effect on the production of leukocyte T×B2. However, calcium ionophores stimulate the production of LTB4. Neobreviscapine has antithrombotic effect in vivo. Traditional Chinese medicine interferes with the metabolism of T×B2 and PGI2 _ 2 in vivo to improve vascular diseases and blood stasis syndrome.
4.2 Competitive antagonists of platelet activating factor
Piper kadsurae ketone extracted from Piper kadsurae, a commonly used drug for expelling wind and dredging collaterals, has the functions of "dredging meridians, harmonizing blood vessels, regulating qi, expelling wind and removing dampness", and has attracted worldwide attention as a competitive antagonist of platelet activating factor (PAF).
4.3 thrombin inhibitors
Hirudin, secreted by the head gland of leech, is the strongest thrombin inhibitor at present, which inhibits the combination of thrombin and platelets and makes thrombin free from platelets.
4.4 Fibrinolytic enzyme analogues
Pollen Typhae can promote blood circulation and is often used to treat type II diabetes. A fibrinolytic enzyme, Pollen Typhae Fibrinolytic Enzyme (TPF), was purified from the water extract of Pollen Typhae, which may belong to a serine protease with fibrinolytic activity. After the degradation of human fibrinogen (Fg) by TPF, X, Y and E fragments produced by the degradation of Fg by blood fibrinolytic enzyme can be seen, but no product equivalent to D fragment was found. The degradation of fibrinogen by TPF is not completely equivalent to the degradation of fibrinolytic enzyme in blood.
In a word, the fasting or postprandial blood sugar of DM ⅱ patients is higher than normal, and the metabolism of lipid and protein is disordered. Glycosylation of proteoglycan changes the visible components of blood, platelets and red blood cells. Among adult middle-aged and elderly patients, vascular diseases are particularly prominent.
24. Study on the relationship between blood stasis syndrome of diabetes mellitus and molecular markers of prethrombotic state.
In this paper, plasma α -granule membrane protein (GMP- 140), endothelin (ET), tissue plasminogen activator (T-PA), plasminogen activator and plasminogen activator inhibitor (PAI-I) were used as molecular markers of prethrombotic state to explore the relationship between blood stasis syndrome of diabetes mellitus and platelet activation and endothelial cell dysfunction. Fibrinolytic changes and so on. The results showed that there were platelet activation, endothelial cell injury and fibrinolytic enzyme changes in diabetic patients, especially those with blood stasis syndrome. It is suggested that CMP- 140 and ET can be used as important objective indicators to reflect the blood stasis syndrome of diabetes, and also can show the pathophysiological basis of the blood stasis syndrome of diabetes.