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Evidence-based Complementary and... 2022According to Chinese constitutional theory, people can be divided into nine constitutions, which represent distinctive vulnerability to different diseases such as...
BACKGROUND
According to Chinese constitutional theory, people can be divided into nine constitutions, which represent distinctive vulnerability to different diseases such as metabolic syndrome, atherosclerosis, and immunity-related disease, and so forth in modern medicine, phlegm-dampness constitution (PDC) is one of the nine constitutions, which is susceptible to metabolic syndrome (MS) and atherosclerosis that associate with lipid metabolism and immunity dysregulation closely.
OBJECTIVES
In this study, we aimed to investigate the metabolic and immunity profiles of phlegm-damp constitution (PDC), including metabolites, lymphocytes distribution, and inflammatory cytokines.
METHODS
A total of 74 patients with PDC and 66 individuals with gentle constitution (GC) were enrolled in this study. We utilized biochemical methods to detect metabolic parameters, flow cytometry to survey T/B/NK/NKT lymphocyte subgroups distribution, and ELISA to assay inflammatory cytokines.
RESULTS
The subjects with PDC had higher GLU, AI TC, TG, and LDL-C and lower HDL-C levels. The immunity profile indicated that PDC subjects had higher percentage of WBCs, neutrophils, lymphocytes, B cells, and natural killer T cells compared with subjects with GC ( < 0.05). Serum levels of IL-10 decreased significantly in the subjects with phlegm-damp constitution, whereas IL-12 levels increased dramatically in the PDC group compared with the GC group (both < 0.05). Additionally, logistic regression identified four independent variables (GLU, TG, LDL-C, and lymphocytes) that were highly correlated with PDC ( < 0.05). The area under the curve of the receiver operating characteristic curve was 0.878, which indicated the data were reliable to distinguish the subjects with PDC from the ones with GC.
CONCLUSION
Phlegm-damp constitution was prone to hyperglycemia and hyperlipidemia syndrome, promoting the occurrence and progression of metabolic-related diseases. Interestingly, proinflammatory cells and cytokines were activated in the PDC group as well. Our findings could offer a profile of early screening indicators to identify high-risk patients of metabolic- and immunity-related diseases from Chinese constitution.
PubMed: 35154341
DOI: 10.1155/2022/3353549 -
Frontiers in Cardiovascular Medicine 2022In this study, we analyzed the metabonomics of intermingled phlegm and blood stasis (IPBS) and its three concurrent syndromes in patients with stable angina pectoris of...
OBJECTIVES
In this study, we analyzed the metabonomics of intermingled phlegm and blood stasis (IPBS) and its three concurrent syndromes in patients with stable angina pectoris of coronary heart disease.
METHODS
A total of 164 sera of separated outpatients from 12 national tradition Chinese medicine clinical research centers with IPBS or concurrent syndromes were collected for the study and assessed with LC-ESI-MS/MS (liquid chromatography-electrospray ionization tandem-mass spectrometry)-based metabolomics and multivariate statistical analysis.
RESULTS
Non-differential metabolites between IPBS and its separate syndrome combined with the top 100 most abundant metabolites in four groups were screened to reflect the essence of IPBS. Amino acid and its metabolomics and glycerol phospholipids were screened for common metabolites, and these metabolites were mainly enriched in valine, leucine, and isoleucine metabolism and glycerophospholipid metabolism. Principal component analysis revealed that the difference between IPBS and its separate concurrent syndromes was not distinct. Compared with IPBS, anserine, cytidine 5'-diphosphocholine, and 7,8-dihydro-L-biopterin separately significant increase in phlegm stasis and toxin (PST), phlegm stasis and Qi stagnation (PQS), and phlegm stasis and Qi deficiency (PQD). While these different metabolites were associated with histidine metabolism, beta-alanine metabolism, glycerophospholipid metabolism, and folate biosynthesis. Three accurate identification models were obtained to identify the difference between IPBS and its concurrent syndromes.
CONCLUSION
Our study indicated that valine, leucine, and isoleucine metabolism and glycerophospholipid metabolism could represent the essence of IPBS; dysregulated metabolites were valuable in identifying PST from IPBS.
PubMed: 35647058
DOI: 10.3389/fcvm.2022.871142 -
Nan Fang Yi Ke Da Xue Xue Bao = Journal... Oct 2021To investigate the effect of dissipating phlegm and blood stasis simultaneously for protecting cardiac microvascular endothelial cells (CMECs) against high...
OBJECTIVE
To investigate the effect of dissipating phlegm and blood stasis simultaneously for protecting cardiac microvascular endothelial cells (CMECs) against high glucose-induced injury and the role of AGEs/RAGE axis in the underlying mechanism.
METHODS
The primary CMECs were isolated from rat heart by enzymatic digestion and identified by immunofluorescence assay. The CMECs exposed to 33 mmol/L glucose for 48 h were divided into model group (MC), resolving phlegm (RP) group, dissipating blood stasis (DBS) group, dissipating phlegm and blood stasis (RPDBS) group and ALT-711 group. After treatment with 10% drug-containing serum and ALT-711 for 48 h, the content of AGEs in the cells were measured with ELISA. The expressions of RAGE mRNA and protein were measured with real-time quantitative PCR, immunofluorescence assay and Western blotting; The activity of NADPH oxidase and ROS level were measured by cytochrome c reduction and fluorescent probe DHE.
RESULTS
High glucose exposure significantly increased the content of AGEs, RAGE expressions at the protein and mRNA levels, NADPH oxidase activity and ROS level in the CMECs ( < 0.01). These changes were significantly mitigated by treatments with RP, DBS, RPDBS and ALT-711 ( < 0.01), among which RPDBS caused the most significant decrements in AGEs content, RAGE expression and NADPH oxidase activity ( < 0.01, < 0.05). The reduction of ROS level in the RPDBS group was significantly greater than that in RP group ( < 0.01), but similar to that in DBS group ( > 0.05).
CONCLUSION
Dissipating phlegm and blood stasis simultaneously can be helpful for prevention and treatment of diabetic myocardial microangiopathy by suppressing the excessive activation of AGEs-RAGE signal axis and oxidative stress, thus protecting CMECs against high glucose-induced damage. Dissipating phlegm and blood stasis simultaneously is better than either of the therapy alone.
Topics: Animals; Diabetes Mellitus; Diabetic Angiopathies; Endothelial Cells; Glucose; Glycation End Products, Advanced; Myocardium; Oxidative Stress; Rats; Receptor for Advanced Glycation End Products
PubMed: 34755668
DOI: 10.12122/j.issn.1673-4254.2021.10.11 -
Nan Fang Yi Ke Da Xue Xue Bao = Journal... May 2020To observe the effect of traditional Chinese medicine for intervention of phlegm and blood stasis in regulating TGF-β1/Smad3 signaling and relieving nephropathy in...
OBJECTIVE
To observe the effect of traditional Chinese medicine for intervention of phlegm and blood stasis in regulating TGF-β1/Smad3 signaling and relieving nephropathy in diabetic rats.
METHODS
SD rats were divided into blank group (NC), diabetic model group (MC group), intervention of phlegm and blood stasis (RPDBS) group, phlegm-removing (RP) group and blood-removing (DBS) group. Diabetic models were established in all the rats except for those in the blank group. After 4 weeks of feeding, the rats in RPDBS group, RP group and DBS group were given corresponding drug intervention for 8 weeks. HE staining was used to observe the changes in renal histopathology. Western blotting and real-time fluorescence quantitative PCR were used to detect the expression levels of transforming growth factor-β1 (TGF-β1) and Smad3.
RESULTS
The structure and arrangement of the glomeruli and renal tubules improved significantly in the treatment groups in comparison with those in the MC group. The expression levels of TGF-β1, Smad3 and p-Smad3 were significantly downregulated at both the protein and mRNA levels in the treatment groups ( < 0.05), and the down-regulation was more obvious in RPDBS group than in RP group and DBS group ( < 0.05).
CONCLUSIONS
Intervention of phlegm and blood stasis may inhibit the activation of TGF-β1/Smad3 signaling pathway and delay diabetic nephropathy and fibrosis to protect the renal function in diabetic rats.
Topics: Animals; Diabetes Mellitus, Experimental; Diabetic Nephropathies; Kidney; Rats; Rats, Sprague-Dawley; Signal Transduction; Smad3 Protein; Transforming Growth Factor beta1
PubMed: 32897204
DOI: 10.12122/j.issn.1673-4254.2020.05.15 -
Zhongguo Zhen Jiu = Chinese Acupuncture... Sep 2021From the perspective of academic history, the background and evolution of "Fenglong (ST 40) for phlegm" were systematically summarized. As a result, it was found that in...
From the perspective of academic history, the background and evolution of "Fenglong (ST 40) for phlegm" were systematically summarized. As a result, it was found that in the early period, Fenglong (ST 40) was used for "tangible phlegm" of respiratory tract, but in the later generations, due to the comprehensive effects of various factors, the phlegm treated by Fenglong (ST 40) was generalized. In modern clinical practice of acupuncture and moxibustion, Fenglong (ST 40) is widely used for phlegm-related diseases. In addition, the knowledge content represented by "Fenglong (ST 40) for phlegm" showed evolution and change in academic heritage of previous dynasties. It is necessary for modern acupuncture researchers to systematically sort out, test and discriminate the habitual knowledge in combination with the background of traditional Chinese medicine, so as to promote the contemporary inheritance and application of traditional acupuncture theory and knowledge.
Topics: Acupuncture Points; Acupuncture Therapy; Moxibustion; Mucus; Respiratory System
PubMed: 34491655
DOI: 10.13703/j.0255-2930.20210104-k0001 -
The Journal of International Medical... Aug 2020This study aimed to evaluate the effect of clearing heat and resolving phlegm for acute exacerbation of chronic obstructive pulmonary disease with the syndrome of...
OBJECTIVE
This study aimed to evaluate the effect of clearing heat and resolving phlegm for acute exacerbation of chronic obstructive pulmonary disease with the syndrome of phlegm-heat obstruction of the lung.
METHODS
This was a real-world retrospective cohort study of inpatients at our institution from 1 January 2015 to 31 December 2017. The patients were divided into two groups according to whether they received oral traditional Chinese medicine (TCM) for clearing heat and resolving phlegm or routine treatment (controls). Efficacy and safety indicators were analyzed. Propensity score matching was used to control for confounding factors.
RESULTS
Among 488 patients, 164 (82 pairs) were successfully matched. The changes in neutrophils (%) and C-reactive protein levels were more significant in the TCM group than in the control group. The duration of fever was significantly shorter in the TCM group than in the control group.
CONCLUSIONS
The therapy of clearing heat and resolving phlegm might effectively control the inflammatory reaction of acute exacerbation of chronic obstructive pulmonary disease in patients with the syndrome of phlegm-heat obstruction of the lung, especially for those with fever. Nevertheless, large-scale and prospective studies are required to provide a higher quality of evidence.
Topics: Drugs, Chinese Herbal; Hot Temperature; Humans; Lung; Medicine, Chinese Traditional; Prospective Studies; Pulmonary Disease, Chronic Obstructive; Retrospective Studies
PubMed: 32814490
DOI: 10.1177/0300060520945502 -
Frontiers in Endocrinology 2022Metabolic syndrome (MS) is a group of complex medical conditions that can lead to serious cardiovascular and cerebrovascular diseases. According to the theory of...
BACKGROUND
Metabolic syndrome (MS) is a group of complex medical conditions that can lead to serious cardiovascular and cerebrovascular diseases. According to the theory of traditional Chinese medicine (TCM), MS can be divided into two main subtypes termed 'phlegm-dampness syndrome' (TSZE) and 'qi-yin deficiency syndrome' (QYLX). At present, the research into intestinal microbiota of different TCM syndromes of MS and its association with clinical manifestation is lacking.
MATERIALS AND METHODS
Using 16S rRNA sequencing, we performed a cross-sectional analysis of human gut microbiota between two different TCM syndromes (QYLX and TSZE, n=60) of MS, and their differences with healthy participants (n=30).
RESULTS
We found that the QYLX and TSZE groups differ from the healthy control group in the overall gut microbiota composition, and some specific microbial taxa and functional pathways. Moreover, significantly differentially abundant taxa and distinct BMI-correlated taxa were observed between QYLX and TSZE groups, suggesting the potential contribution of gut microbiota to the distinction between the two TCM syndromes. The predicted functional profiles also showed considerable differences, especially pathways related to amino acid metabolism and lipopolysaccharide synthesis.
CONCLUSION
Our study highlights the gut microbiota's contribution to the differentiation between two TCM syndromes of MS and may provide the rationale for adopting different microbiota-directed treatment strategies for different TCM syndromes of MS in the future.
Topics: Humans; Yin Deficiency; Gastrointestinal Microbiome; Metabolic Syndrome; Qi; Cross-Sectional Studies; RNA, Ribosomal, 16S
PubMed: 36440222
DOI: 10.3389/fendo.2022.1063579 -
Journal of Traditional Chinese Medicine... Oct 2021To describe a protocol to assess the effects of Traditional Chinese Medicine (TCM) on patients with coronary heart disease (CHD) showing symptoms of phlegm-heat-stasis...
OBJECTIVE
To describe a protocol to assess the effects of Traditional Chinese Medicine (TCM) on patients with coronary heart disease (CHD) showing symptoms of phlegm-heat-stasis symptom pattern.
METHODS
This is a single-blind randomized controlled trial that will be conducted in the First Teaching Hospital of Tianjin University of TCM and 60 patients with CHD showing phlegm-heat-stasis symptom pattern will be included. Patients will be randomly divided into either a treatment group (Qingre Huatan formulae + Western Medicine) or to a control group (conventional Western Medicine only) for 7-14 d. Primary patient outcomes will be vascular endothelial function and quality of life. Measurement data will be expressed as mean ± standard deviation using t-test analysis or repeated-measure variance analysis. Enumeration data will be expressed by cases and percentages, using χ2 analysis, and rank sum test will be used for ranked data.
RESULTS
This study further verified the effectiveness and safety of Qingre Huatan formulae for the phlegm-heat-stasis syndrome pattern of CHD on the basis of previous studies on the characteristics of syndromes and medication rules.
DISCUSSION
Phlegm-heat-stasis symptom pattern has become a common manifestation in CHD. Standardized Western medications together with TCM have been extensively used in China and have developed into a comprehensive treatment model. Our trial will help formulate recommendations for symptom maintenance and provide clinical evidence for the application of TCM for patients with CHD showing phlegm-heat-stasis symptom pattern.
Topics: Coronary Disease; Hot Temperature; Humans; Medicine, Chinese Traditional; Quality of Life; Randomized Controlled Trials as Topic; Single-Blind Method
PubMed: 34708642
DOI: 10.19852/j.cnki.jtcm.2021.05.016 -
Contrast Media & Molecular Imaging 2022This research was aimed to explore the application of high-resolution computed tomography (HRCT) based on intelligent iterative reconstruction technique in the early...
Artificial Intelligence Algorithm-Based High-Resolution Computed Tomography Image in the Treatment of Children with Bronchiolitis Obliterans by Traditional Chinese Medicine Method of Resolving Phlegm and Removing Blood Stasis.
This research was aimed to explore the application of high-resolution computed tomography (HRCT) based on intelligent iterative reconstruction technique in the early diagnosis and treatment of bronchiolitis obliterans (BO) in children and to explore the efficacy of traditional Chinese medicine (TCM) in resolving phlegm and removing blood stasis. Sixty pediatric patients with BO were selected as the study subjects and diagnosed by HRCT scanning, and the scanned images were processed by iterative reconstruction technique. The patients were treated with TCM therapy of resolving phlegm and removing blood stasis alone (group A), HRCT-guided TCM therapy of resolving phlegm and removing blood stasis (group B), and iterative reconstruction HRCT-guided TCM therapy of resolving phlegm and removing blood stasis (group C). The results showed that the lung HRCT image after iterative reconstruction was closer to the original image than that after filtered back projection reconstruction, and the edge of the image after filtered back projection reconstruction was more blurred and the noise was higher. The image obtained by iterative reconstruction technique was smoother and clearer, and the image stability after iterative reconstruction was higher. The treatment results showed that the proportion of moderate and severe obstruction in group C was 5.18%, which was significantly lower than that in group A (18.75%) and group B (11.29%), and group B was significantly lower than that in group A (18.75%) ( < 0.05). The proportion of clinical effect in group C after treatment was 70.18%, significantly higher than that in group A (55.5%) and group B (63.34%), and that in group B was significantly higher than that in group A (55.5%) ( < 0.05). In summary, the lung HRCT after iterative reconstruction can more clearly and intuitively show the lesion site, which has a key role in guiding the early diagnosis and treatment planning of BO; the HRCT image based on iterative reconstruction technique combined with TCM treatment of removing blood stasis and resolving phlegm has a better therapeutic effect on children, with a high application value.
Topics: Algorithms; Artificial Intelligence; Bronchiolitis Obliterans; Child; Humans; Medicine, Chinese Traditional; Tomography, X-Ray Computed
PubMed: 35685664
DOI: 10.1155/2022/8952791 -
Chest Nov 2023Airway mucus plugs are frequently identified on CT scans of patients with COPD with a smoking history without mucus-related symptoms (ie, cough, phlegm [silent mucus...
BACKGROUND
Airway mucus plugs are frequently identified on CT scans of patients with COPD with a smoking history without mucus-related symptoms (ie, cough, phlegm [silent mucus plugs]).
RESEARCH QUESTION
In patients with COPD, what are the risk and protective factors associated with silent airway mucus plugs? Are silent mucus plugs associated with functional, structural, and clinical measures of disease?
STUDY DESIGN AND METHODS
We identified mucus plugs on chest CT scans of participants with COPD from the COPDGene study. The mucus plug score was defined as the number of pulmonary segments with mucus plugs, ranging from 0 to 18, and categorized into three groups (0, 1-2, and ≥ 3). We determined risk and protective factors for silent mucus plugs and the associations of silent mucus plugs with measures of disease severity using multivariable linear and logistic regression models.
RESULTS
Of 4,363 participants with COPD, 1,739 had no cough or phlegm. Among the 1,739 participants, 627 (36%) had airway mucus plugs identified on CT scan. Risk factors of silent mucus plugs (compared with symptomatic mucus plugs) were older age (OR, 1.02), female sex (OR, 1.40), and Black race (OR, 1.93) (all P values < .01). Among those without cough or phlegm, silent mucus plugs (vs absence of mucus plugs) were associated with worse 6-min walk distance, worse resting arterial oxygen saturation, worse FEV % predicted, greater emphysema, thicker airway walls, and higher odds of severe exacerbation in the past year in adjusted models.
INTERPRETATION
Mucus plugs are common in patients with COPD without mucus-related symptoms. Silent mucus plugs are associated with worse functional, structural, and clinical measures of disease. CT scan-identified mucus plugs can complement the evaluation of patients with COPD.
PubMed: 38013161
DOI: 10.1016/j.chest.2023.11.033