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Zhongguo Zhong Yao Za Zhi = Zhongguo... Aug 2023According to the traditional Chinese medicine(TCM) theory, coronary heart disease(CHD) is mainly caused by heart vessel obstruction due to Qi stagnation, blood stasis,... (Review)
Review
According to the traditional Chinese medicine(TCM) theory, coronary heart disease(CHD) is mainly caused by heart vessel obstruction due to Qi stagnation, blood stasis, and phlegm turbidity. Chest impediment with combined phlegm and stasis is a common syndrome of CHD, with the manifestations of chest tightness, chest pain, and asthma. Lymphatic system is one of the important immune systems in the human body and has a close relationship with the Qi and blood movement in TCM. The dysfunction of the lymphatic system may lead to metabolism disorders, the generation of dampness pathogen which turns into sticky and difficult-to-dissolve phlegm turbidity. Moreover, it can affect blood circulation and coagulation, causing slow blood flow, increased blood viscosity, and microcirculation disorders. Alterations in lymphatic hydrodynamics may affect the interaction between blood circulation and the lymphatic system. A variety of small molecule drugs and TCM can treat cardiovascular diseases by targeting the lymphatic system. This review discusses the role of the lymphatic system in CHD based on the theory of combined phlegm and stasis, involving the influences of mechanical factors on lymphatic function and the effects and pharmacological mechanisms of TCM and chemicals that target lymphocyte function and lymphatic circulation. By expounding the development process of combined phlegm and stasis in CHD from the lymphatic system, this paper aims to provide new ideas for deciphering pharmacological mechanisms of TCM for resolving phlegm and stasis.
Topics: Humans; Coronary Disease; Medicine, Chinese Traditional; Mucus; Lymphatic System; Heart
PubMed: 37802774
DOI: 10.19540/j.cnki.cjcmm.20230427.601 -
Complementary Therapies in Medicine Aug 2014A series of case-control studies have been conducted to investigate the association between blood lipid and phlegm turbidity syndrome of angina pectoris, but produced... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
A series of case-control studies have been conducted to investigate the association between blood lipid and phlegm turbidity syndrome of angina pectoris, but produced inconsistent results.
OBJECTIVE
We performed a meta-analysis to determine the association between blood lipid and phlegm turbidity syndrome of angina pectoris more precisely.
METHODS
Manual screening as well as screening of the China National Knowledge Infrastructure (CNKI), Chinese Journal full-text database (VIP), Wanfang database (WF), ScienceDirect, Pubmed, the Cochrane Library, and Embase were carried out for relevant literature. The formula was translated to calculate the pooled mean value and standard deviation value. The "Newcastle-Ottawa Quality Assessment Scale: Case-Control Studies" (NOS) was taken to assess the quality of the included studies. The Revman 5.2.6 software provided by "The Cochrane Collaboration" was used to analyze the collected data. The subgroup analysis was established according to the sample size proportion between the test group and the control group. Sensitivity analysis was constructed by using two different effect models. Besides, a funnel plot was created to analyze potential publication bias.
RESULTS
No statistically meaningful difference existed between the test group and control group of total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C) in non-Qi and yin deficiency syndrome (QYDS) and non-Yang deficiency syndrome (YDS) subgroup, whereas the two biotic indicators in the test group were higher than the non-phlegm syndrome group in other subgroups. Triglyceride (TG) in phlegm syndrome group showed superior to non-phlegm syndrome group in the rest subgroups except for the non-CCS (Cold coagulating syndrome)-non-YDS subgroup. High-density lipoprotein-cholesterol (HDL-C) levels of the phlegm group were lower than that of the non-phlegm group in all subgroups.
CONCLUSION
When comparing with Traditional Chinese Medicine (TCM) syndromes of asthenia nature, such as YDS, QYDS, and heart qi deficiency syndrome), the levels of TG, TC, and LDL-C were higher in phlegm turbidity syndrome. However, for sthenia syndromes such as Qi stagnation syndrome (QSS), heart blood stasis syndrome (HBSS), and CCS, there was no obvious difference. Furthermore, HDL-C levels in the phlegm turbidity group were lower than those of the non-phlegm group. Nevertheless, these results should be confirmed with further studies.
Topics: Adult; Aged; Aged, 80 and over; Angina Pectoris; Cholesterol; Female; Humans; Male; Medicine, Chinese Traditional; Middle Aged; Triglycerides
PubMed: 25146084
DOI: 10.1016/j.ctim.2014.05.008 -
Zhongguo Zhong Yao Za Zhi = Zhongguo... Jan 2016Coronary heart disease (CHD) with pathological characteristics of atherosclerotic coronary artery and myocardial ischemia is more likely to cause phlegm and blood... (Review)
Review
Coronary heart disease (CHD) with pathological characteristics of atherosclerotic coronary artery and myocardial ischemia is more likely to cause phlegm and blood stasis. The current study showed high morbidity and severity of phlegm and blood stasis syndrome in CHD, which has attracted increasing attention. This paper introduced the knowledge of traditional Chinese medicine (TCM) about the CHD with phlegm and blood stasis syndrome. On the basis of modern medical studies, we found a close relationship between phlegm and blood stasis syndrome and blood fat, hemorheology, oxygen free radical, blood coagulation function, inflammation, sugar metabolism and other related gene expression changes. We reviewed TCM therapies and prescriptions and found that TCM therapies achieved a good clinical effect through the understanding of etiology and pathogenesis and differentiation in organs. Besides, phlegm and blood stasis removing prescription relieved the objective indicators, which would have a good development prospects.
Topics: Animals; Coronary Disease; Drugs, Chinese Herbal; Hemorheology; Humans; Lipid Metabolism; Lipids; Medicine, Chinese Traditional; Mucus
PubMed: 28845636
DOI: 10.4268/cjcmm20160107 -
Bulletin of the History of Medicine 2023Phlegm figures as a major cause and consequence of disease in late imperial Chinese medicine. Curiously, however, when we go back to the classics, the very notion of...
Phlegm figures as a major cause and consequence of disease in late imperial Chinese medicine. Curiously, however, when we go back to the classics, the very notion of phlegm is entirely absent. The rise of phlegm is one of the fundamental transformations in the history of Chinese medicine. This article suggests that the little-known Yuan dynasty treatise On the Art of Nourishing Life (1338), which is notable for extending Chinese phlegm theory in unprecedented ways, was pivotal for this transformation. Noting a strong resemblance of the innovations of this treatise with Galenic medical theories, this article argues that they were inspired by an encounter with the Galenic medical tradition. It submits that these novel ideas radically altered preexisting Chinese understandings of the body's materiality and the nature of disease, and calls for closer attention to the transcultural movements of theories and concepts in the historiography of Chinese and global medicine.
Topics: Medicine, Chinese Traditional; Historiography
PubMed: 38588245
DOI: 10.1353/bhm.2023.a905729 -
Journal of Healthcare Engineering 2020In the nonmedical sputum monitoring system, a practical solution for phlegm stagnation care of patients was proposed. Through the camera, the video images of patients'...
In the nonmedical sputum monitoring system, a practical solution for phlegm stagnation care of patients was proposed. Through the camera, the video images of patients' laryngeal area were obtained in real time. After processing and analysis on these video frame images, the throat movement area was found out. A three-frame differential method was used to detect the throat moving targets. Anomalies were identified according to the information of moving targets and the proposed algorithm. Warning on the abnormal situation can help nursing personnel to deal with sputum blocking problem more effectively. To monitor the patients' situation in real time, this paper proposed a VDS algorithm, which extracted the speed characteristics of moving objects and combined with the DTW algorithm and SVM algorithm for sequence image classification. Phlegm stagnation symptoms of patients were identified timely for further medical care. In order to evaluate the effectiveness, our method was compared with the DTW, SVM, CTM, and HMM methods. The experimental results showed that this method had a higher recognition rate and was more practical in a nonmedical monitoring system.
Topics: Algorithms; Deglutition Disorders; Female; Humans; Image Processing, Computer-Assisted; Male; Sputum; Video Recording
PubMed: 32399167
DOI: 10.1155/2020/8714070 -
Journal of Traditional Chinese Medicine... Aug 2023To evaluate the clinical efficacy of Traditional Chinese Medicine prescriptions for resolving phlegm in the treatment of angina pectoris of phlegm-stasis coronary heart... (Meta-Analysis)
Meta-Analysis
Effect of Traditional Chinese Medicine combined with Western Medicine on blood lipid levels and inflammatory factors in patients with angina pectoris in coronary heart disease identified as intermingled phlegm and blood stasis syndrome: a network Meta-analysis.
OBJECTIVE
To evaluate the clinical efficacy of Traditional Chinese Medicine prescriptions for resolving phlegm in the treatment of angina pectoris of phlegm-stasis coronary heart disease by a network Meta-analysis.
METHODS
Randomized controlled trials (RCTs) on clinical efficacy of CHD angina pectoris with interaction of phlegm and blood stasis were searched in PubMed, Springer, the Cochrane Library and Chinese-language databases China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang Data from their inception to December 2021. Literature was screened and literature bias risk was assessed by RevMan5.4 software. The overall response rate, the duration of angina attack, the levels of serum lipids such as total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), and high density lipoprotein cholesterol (HDL-C), and expression of hypersensitive C-reactive protein (hs-CRP) were selected as outcome indicators for network Meta-analysis and mapped using Stata15.1 software.
RESULTS
Totally, 26 RCTs were included, involving 2098 participants. There were 6 TCM formulas with the effects of dispelling phlegm and removing blood stasis. Taking conventional Western Medicine as the common intervention measures, the results showed that the overall response improvement rate from high to low was displayed as modified Xiaoxianxiong decoction (, MXD), Danlou tablet (, DT), modified Gualou Xiebai Banxia decoction (, MGXBD), modified Wendan decoction (, MWD), modified Zhishi Xiebai Guizhi decoction (, MZXGD), and modified Erchen decoction (, MED). The sequence of angina attack duration improvement from high to low was MZXGD, MGXBD, DT, MWD, MXD. The sequence of TC improvement from high to low was MZXGD, MED, DT, and MGXBD. Sequence of improving TG from high to low was MED, MZXGD, MGXBD, and DT. For LDL-C improvement, the effect from good to poor was MZXGD, MGXBD, DT, and MED. With regard to HDL-C improvement, the effect was ranked as MED, MZXGD, MGXBD, and DT from good to poor. hs-CRP expression from high to low was MZXGD, MXD, MED, MWD, and MGXBD.
CONCLUSION
TCM formula with the effects of dispelling phlegm and removing blood stasis combined with conventional Western Medicine has obvious advantages in treating CHD angina pectoris with interaction of phlegm and blood stasis. MZXGD has great potential in increasing the overall response rate, reducing Duration of angina attack improving blood lipids, and reducing inflammatory factors. However, due to the limitations of extant studies, the conclusions of this study need to be confirmed by numerous reasonably-designed RCTs.
Topics: Humans; Medicine, Chinese Traditional; Cholesterol, LDL; Network Meta-Analysis; C-Reactive Protein; Drugs, Chinese Herbal; Angina Pectoris; Coronary Disease; Lipids; Triglycerides
PubMed: 37454248
DOI: 10.19852/j.cnki.jtcm.20230506.001 -
Chinese Journal of Integrative Medicine Jan 2014Studying the essence of a syndrome has been a key challenge in the field of Chinese medicine. Until now, due to limitations of the methods available, the progress... (Review)
Review
Studying the essence of a syndrome has been a key challenge in the field of Chinese medicine. Until now, due to limitations of the methods available, the progress towards understanding such complicated systems has been slow. Metabonomics encompasses the dynamics, composition and analysis of metabolites, enabling the observation of changes in the metabolic network of the human body associated with disease. Being from the point of view of the whole organism, metabonomics provides an opportunity to study the essence of a syndrome to an unprecedented level. Phlegm and blood stasis syndrome is the main syndrome associated with coronary heart disease (CHD), which bring difficulties in clinical treatment due to difficulties associated with differentiation of symptoms and signs. The fundamental differences of material between the two also need to be interpreted. The authors consider that we can use the method of combining a disease (in this case CHD) with associated syndromes (phlegm and blood stasis syndrome) to select patients with phlegm and blood stasis syndrome of CHD, and utilize metabonomics to explore the essence of the syndrome by difference analysis of metabolite spectra. Meanwhile, we can study the syndrome in CM, observe the change regularity of metabolism spectra after the treatment of corresponding and non-corresponding prescription and syndrome, in order to validate the material fundament in the progress of syndrome formation and their differences. This will not only have great significance in enhancing the ability to identify syndrome of phlegm and blood stasis in CHD and to establish the clinical curative criteria, but will also offer a new approach of studying the essence for a syndrome using metabonomics.
Topics: Coronary Disease; Drug Prescriptions; Humans; Medicine, Chinese Traditional; Metabolomics; Syndrome
PubMed: 23207746
DOI: 10.1007/s11655-012-1182-z -
Journal of Ovarian Research Jul 2023Cangfu Daotan Wan (CFDTW) has been widely used for polycystic ovary syndrome (PCOS) patients in the type of stagnation of phlegm and dampness. In this study, we aimed to...
BACKGROUND/AIM
Cangfu Daotan Wan (CFDTW) has been widely used for polycystic ovary syndrome (PCOS) patients in the type of stagnation of phlegm and dampness. In this study, we aimed to evaluate the mechanism underlying the therapeutic effect of CFDTW on PCOS with phlegm-dampness syndrome (PDS).
METHODS
In silico analysis was adopted to identify CFDTW potential targets and the downstream pathways in the treatment of PCOS. Expression of PKP3 was examined in the ovarian granulosa cells from PCOS patients with PDS and rat PCOS models induced by dehydroepiandrosterone (DHEA). PKP3/ERCC1 was overexpressed or underexpressed or combined with CFDTW treatment in ovarian granulosa cells to assay the effect of CFDTW on ovarian granulosa cell functions via the PKP3/MAPK/ERCC1 axis.
RESULTS
Clinical samples and ovarian granulosa cells of rat models were characterized by hypomethylated PKP3 promoter and upregulated PKP3 expression. CFDTW reduced PKP3 expression by enhancing the methylation of PKP3 promoter, leading to proliferation of ovarian granulosa cells, increasing S and G2/M phase-arrested cells, and arresting their apoptosis. PKP3 augmented ERCC1 expression by activating the MAPK pathway. In addition, CFDTW facilitated the proliferation of ovarian granulosa cells and repressed their apoptosis by regulating PKP3/MAPK/ERCC1 axis.
CONCLUSION
Taken together, this study illuminates how CFDTW confers therapeutic effects on PCOS patients with PDS, which may offer a novel theranostic marker in PCOS.
Topics: Animals; Female; Humans; Rats; Apoptosis; DNA-Binding Proteins; Drugs, Chinese Herbal; Endonucleases; Granulosa Cells; Plakophilins; Polycystic Ovary Syndrome
PubMed: 37420272
DOI: 10.1186/s13048-023-01200-7 -
Zhongguo Zhong Yao Za Zhi = Zhongguo... Aug 2022The present study analyzed the effect of Citri Reticulatae Pericarpium on endogenous metabolites in spleen deficiency and phlegm dampness syndrome by metabolomics, and...
The present study analyzed the effect of Citri Reticulatae Pericarpium on endogenous metabolites in spleen deficiency and phlegm dampness syndrome by metabolomics, and explored the underlying mechanism of Citri Reticulatae Pericarpium in the treatment of spleen deficiency and phlegm dampness syndrome.The model of spleen deficiency and phlegm dampness syndrome was induced in rats by the multi-factor modeling method.The intervention effects of Citri Reticulatae Pericarpium on rats with spleen deficiency and phlegm dampness syndrome were preliminarily evaluated by observing the pathological changes of rat liver tissues and measuring the plasma content of pathological and biochemical indexes such as triglyceride(TG), total cholesterol(TC), low-density lipoprotein cholesterol(LDL-C), and high-density lipoprotein cholesterol(HDL-C).Immunohistochemistry was used to detect the expression of AQP2 in the kidney, AQP3 in the colon, and AQP5 in the submandibular gland, and the effect of Citri Reticulatae Pericarpium on aquaporin expression in rats with spleen deficiency and phlegm dampness syndrome was evaluated.Furthermore, UHPLC-ESI-MS/MS was used to analyze the metabolic profiles of rat plasma samples.Multiple methods, such as principal component analysis(PCA) and orthogonal partial least squares discriminant analysis(OPLS-DA) were used for pattern recognition.Differential metabolites were screened out by t-test and variable importance in projection(VIP), followed by pathway analysis based on MetaboAnalyst 5.0.As revealed by experimental results, Citri Reticulatae Pericarpium could improve the pathological changes of liver tissues, increase the levels of HDL-C in the plasma, reduce the levels of TC, TG, and LDL-C, and enhance the expression of AQP2 in the kidney, AQP3 in the colon, and AQP5 in the submandibular gland of rats with spleen deficiency and phlegm dampness syndrome.In addition, 87 differential metabolites of spleen deficiency and phlegm dampness syndrome were screened out by UHPLC-ESI-MS/MS(the levels of 39 metabolites increased significantly and the levels of 48 metabolites decreased significantly), with the representatives of glycine, L-isoleucine, N-acetyl-L-tyrosine, xanthine, hypoxanthine, and trigonelline.The differential metabolites were mainly enriched in the pathways of steroid hormone biosynthesis, linoleic acid metabolism, and purine metabolism.This study distinguished and revealed the characteristic metabolic pattern of spleen deficiency and phlegm dampness syndrome by metabolomics.The preliminary construction of the OPLS-DA model provides an objective basis for the differentiation of spleen deficiency and phlegm dampness syndrome in traditional Chinese medi-cine(TCM), as well as ideas and methods for exploring the biological basis of TCM syndrome from the molecular level and the overall level.
Topics: Animals; Aquaporin 2; Cholesterol, LDL; Citrus; Drugs, Chinese Herbal; Metabolomics; Rats; Spleen; Tandem Mass Spectrometry
PubMed: 36046904
DOI: 10.19540/j.cnki.cjcmm.20220218.701