Objective To observe the clinical efficacy of soothing the liver and invigorating the spleen in the treatment of subthreshold depression of liver depression and spleen deficiency. Methods The method of random, controlled and double-blind was conducted. 100 cases of subthreshold depression with liver depression and spleen deficiency syndrome were randomly divided into control group and treatment group, 50 cases in each group. After excluding the falling off cases, 47 cases were in the control group and 48 cases were in the treatment group. The patients in the treatment group were treated with Jie-you-kai-yu recipe, while the patients in the control group were given placebos. After 12 weeks of treatment and 1 year of follow-up, the clinical efficacy, Hamilton Depression Scale and TCM Syndrome Scale were observed, and the safety was evaluated.Results After 12 weeks of treatment, the results of Hamilton Depression Scale showed that: in the control group, 2 cases were clinically controlled, 4 cases had significant progress, 12 cases had progress, 29 cases were ineffective, 18 cases were effective, and the total effective rate was 38.30%; in the treatment group, 12 cases were clinically controlled, 11 cases were significant progress, 15 cases were progress, 10 cases were ineffective, 38 cases were effective, and the total effective rate was 79.16%. Generalized linear analysis, Wald chi square =18.383, P<0.001, showed that the clinical efficacy of the treatment group was better than that of the control group. After 12 weeks of treatment, TCM syndrome scale evaluation results showed that: in the control group, there was 0 case which were clinically controlled, 4 cases of significant progress, 10 cases of progress, 33 cases of ineffective, 14 cases of effective, and the total effective rate was 29.79%; in the treatment group of 48 cases, 20 cases of clinical control, 14 cases of significant progress, 10 cases of progress, 4 cases of no effect, the total effective rate was 91.67%. According to the generalized linear analysis, Wald chi square = 44.861, P<0.001, indicating that the therapeutic effect of the treatment group was better than that of the control group. After 12 months of follow-up, 12 cases in the control group were transformed into depression, with the conversion rate of 25.53%, and 6 cases in the treatment group were transformed into depression, with the conversion rate of 12.50%. No serious adverse reactions occurred during the treatment.Conclusions The method of soothing the liver and invigorating the spleen has a definite effect on subthreshold depression of liver depression and spleen deficiency, and can prevent it from developing into depression.

Objective To analyze the clinical characteristics of patients with renal dysfunctions induced by Xing nao jing Injection in the real world, and to explore the relavant risk factors for renal dysfunction caused by Xing nao jing Injection. Methods Based on HIS database of 39 Grade A hospitals constructed by TCM Clinical Basic Medicine Research of China Academy of Traditional Chinese Medicine, medical records of 53,075 in patients who had used Xing nao jing Injection at least once from January 1998 to December 2016 were extracted. 553 patients with renal dysfunctions were included. A retrospective nest-control study design, SOMTE sampling and Logistic regression were used to analyze the characteristic factors of patients with abnormal renal functions after Xing Nao jing Injection. A total of 65 influencing factors were included in the analysis, including age, gender, course of treatment, length of hospital stay, single dose, combined disease and combined medication. Results Among the 553 patients with renal dysfunctions after Xing nao jing Injection, the most frequent complication was cerebral infarction (9,370 cases, 17.87%). The highest frequency of combined drug use was mannitol 26,537 cases, accounting for 48.53%, followed by insulin 20,340 cases. SMOTE sampling with binary logistic regression analysis were used for 23 variables, includingage between 18 and 75 years of age, gender, male, duration, hospitalization days more than 7 days, or combined with pulmonary infections, fracture, diseases such as diabetes, brain related diseases, or a combination of ammonia bromine rope, sodium bicarbonate, olathe, lidocaine, adr mentioned, naloxone, phenobarbital, insulin, promethazine, panxitoraetc, Sammy, diazepam and other drugs. These variables may be related to renal dysfunctions after Xing nao jing Injection. Conclusions Through the analysis of the clinical characteristics of patients with abnormal renal functions caused by Xing nao jing Injection in the real world, when the clinical use of Xing nao jing Injection and the above-mentioned factors exist at the same time, it is necessary to strengthen observation to prevent potential abnormal renal functions, so as to ensure the safety of medication.

Objective To observe the efficacy of Qingre Lishi Formula combined with loxoprofen sodium tablets in the treatment of acute gouty arthritis with dampness-heat stasis syndrome and its effects on cytokines. Methods Ninety-two patients with acute gouty arthritis with dampness-heat stasis syndrome were randomly assigned to the treatment group (n=46) and the control group (n=46). The control group was treated with loxoprofen sodium tablets, and the treatment group was treated with modified Qingre Lishi Formula in addition to Western medicine in the control group. The scores of TCM syndromes, clinical effects, pain scores, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), leukocyte (WBC), uric acid (UA), interleukin-1 β (IL-1 β), interleukin-18 (IL-18) and interleukin-37 (IL-37) were observed, and the adverse reactions were recorded by visual analogue score (VAS). Results The TCM syndrome scores of the two groups were significantly lower after treatment than before treatment (P< 0.05). The TCM syndrome scores were significantly lower in the treatment group than in the control group (P< 0.05). There were significant differences between the two groups before and after treatment (P< 0.05). Among the 46 cases in the treatment group, 12 cases were clinically cured, 25 cases were markedly effective, 6 cases were effective and 3 cases were ineffective with the overall effective rate of 93.48%. Among the 46 cases in the control group, 9 cases were clinically cured, 23 cases were markedly effective, 8 cases were effective and 6 cases were ineffective with the overall effective rate of 86.96%. The rank sum test showed that there was no significant difference in the curative effect between the two groups (P>0.05). The scores of ESR, CRP, WBC, UA, IL-1 β, IL-18 and VAS were significantly lower in the two groups after treatment than before treatment, and the scores were significantly lower in the treatment group than in the control group, and there were significant differences between the two groups before and after treatment. The total incidence of adverse reactions was 2.17% in the treatment group and 6.52% in the control group. Conclusions Qingre Lishi Formula can effectively reduce inflammatory reactions, improve symptoms and has good safety in the treatment of acute gouty arthritis with dampness-heat and blood stasis syndrome.

Objective To observe the clinical efficacy of modified Danggui Liu Huang Decoction combined with guasha(scraping) therapy in the treatment of recurrent suppurative tonsillitis in children. Methods Ninety children with recurrent suppurative tonsillitis were assigned to the treatment group and control group according to the parallel control method, with 45 cases in each group. The control group was treated with routine symptomatic treatment of Western medicine, and the treatment group was treated with modified Danggui Liu Huang Decoction combined with guasha(scraping)therapy once a week for 4 weeks. The short-term clinical effects of the two groups were observed, such as the disappearance time of clinical symptoms and signs, and the long-term clinical efficacy of repeated attacks of tonsillitis in 6 months before and after treatment were also observed. Results In the treatment group, 20 cases were cured, 22 cases were effective, and 3 cases were ineffective, with a total effective rate of 93.33%; in the control group, 19 cases were cured, 21 cases were effective, 5 cases were ineffective, with a total effective rate of 88.89%.The short-term curative effect of the treatment group was similar to that of the control group, according to the rank sum test, Z = 0.549, P= 0.768, P> 0.05. After treatment, the fever abatement time, pharyngalgia relief time and purulent secretion disappearance time were less than those before treatment in each group (P<0.05). Meanwhile, the fever abatement time, pharyngalgia relief time and purulent secretion disappearance time were significantly shorter in the treatment group than in the control group, and the difference was statistically significant (P< 0.05), indicating the treatment group was superior to the control group. The frequency of recurrent attacks in the treatment group was lower than that before treatment (P< 0.05), but there was no significant difference in the control group after 6 months of treatment (P> 0.05). After 6 months of treatment, the frequency of recurrent attacks was significantly lower in the treatment group than in the control group, and the difference was statistically significant (P< 0.05).After treatment, 8 cases were clinically cured, 13 cases were markedly effective, 18 cases were effective and 6 cases were ineffective, with the total effective rate of 86.67% in the treatment group; while in the control group, 2 cases were clinically cured, 9 cases were markedly effective, 18 cases were effective, 16 cases were ineffective and 29 cases were total effective, with the total effective rate of 64.44%. The long-term effect was betterin the treatment group than in the control group according to rank sum test, Z= -2.866, P= 0.004, P< 0.05. Conclusions Modified Danggui Liu Huang Decoction combined with guasha(scraping) therapy has a good clinical effect in the treatment of recurrent suppurative tonsillitis in children.

Objective To observe the clinical efficacy of Facility-balance rehabilitation on spastic hemiplegia after ischemic stroke. Methods A total of 171 patients with spastic hemiplegia after ischemic stroke were randomly assigned to the intervention group (n=114) and control group (n=57) according to the proportion of 2∶1 in the central random system. Brunnstrum rating was used to evaluate and compare the efficacy. Results The efficacies of the two therapies were analyzed by generalized estimation equation. Main results of left upper limb were listed as follows: ① results of inter group comparison: Wald χ²=5.244, P<0.05; ② comparison results of repeated measurement time: Wald χ²=44.313, P<0.05. Main results of right upper limb: ① results of inter group comparison: Wald χ²=9.563, P<0.05; ② comparison results of repeated measurement time: Wald χ²=44.313, P<0.05. No serious adverse events were found. Conclusions The two rehabilitation techniques can effectively improve the limb function of patients, and Facility-balance rehabilitation technology is more helpful to promote the upper limb separation movement of patients with ischemic stroke, which is safe and has no side effects.

Objective To observe the efficacy of the treatment of diabetic gastroparesis (DGP) assisted by hot compressing with silkworm excrement and to investigate the role of infrared thermal imaging in its efficacy evaluation. Methods One hundred and two patients with DGP were assigned to the control group (n=55) and treatment group (n=55). In the treatment group, 3 cases were abscessed, and 52 cases were observedwith an abscission rate of 5.45%.In the control group, 5 cases were abscessed and 50 cases were observed with an abscission rate of 9.09%.Both groups received Western conventional treatment of diabetes. The treatment group received hot compressing with silkworm excrement, while the control group received hot compressing with a hot water bag. Both groups were examined by gastric emptying rate testing, infrared thermal imaging when they participated in the project at 2 weeks and 4 weeks. The absolute temperature(T) and relative temperature(ΔT) of the stomach cavity region, Zhongwan acupoint, abdominal region, the left and right Zusanli acupoints of the 102 patients were measured. The differences in T, ΔT and gastric emptying rate of the two groups were compared. Results Compared with before treatment, the gastric emptying rate was significantly improved after treatment and during follow-up (P<0.05).Repeated measurement analysis of variance showed that:As for the T₃,△T₁,△T₄, the interaction between groups and observation time was statistically significant (P＜0.05).Compared with the control group, △T₃ was lower in the treatment group than in the control group, and the difference was statistically significant (P<0.05).Conclusions The treatment of DGP by hot compressing with silkworm excrement can improve the gastric emptying rate of patients with DGP. Meanwhile, the relative temperature of abdomen region appears to increase in the infrared thermal imaging. Infrared thermal imaging can assess the clinical efficacy of DGP.

Objective To explore the neuroprotective mechanism of Yinao Jieyu Compound on damaged brain tissues in rats with post-stroke depression(PSD). Methods SD rats were assigned to the normal control group, sham operation group,stroke group, PSD group, Western medicine group and traditional Chinese medicine group.The focal cerebral ischemia model induced by MCAO and the PSD rat model of focal cerebral ischemia combined with orphan and restraint stress were used.From the beginning of the model to the end of the experiment, each group was intragastrically administered once a day.The expressions of TLR2, TLR4 and NF-κB protein in hippocampus were observed by the Western Blot method at the 2nd,4th and 6th weeks.After gavage, HE staining was used to observe the pathological changes in the hippocampal CA3 area.Results At the 4th week, the differences in the expressions of TLR2 and TLR4 proteins in the hippocampus of each group were statistically significant(P<0.01).The expressions of TLR2 and TLR4 in the PSD group were significantly higher than those in the normal group, sham operation group, stroke group, Western medicine group and traditional Chinese medicine group(P<0.05 or P<0.01). At 2, 4, 6 weeks, the differences in the expression of NF-κB protein in the hippocampus of each group were statistically significant(P<0.05 or P<0.01).The expression of NF-κB was higher in the PSD group than in the normal group, sham operation group, Western medicine group and traditional Chinese medicine group(P<0.05 or P<0.01). Compared with the normal group, the PSD group had irregular cell morphology, incomplete structure, darker staining, sparse and disordered arrangement, fewer cell layers, and significantly reduced cell numbers.Compared with the PSD group, the hippocampal CA3 cells of the Western medicine group and the traditional Chinese medicine group had more regular cell morphology, complete and clear structure, relatively orderly arrangement, more cell layers and increased numbers.Conclusions Yinao Jieyu Compound may treat PSD by reducing the expressions of TLR2, TLR4 and NF-κB protein to reduce the immune inflammatory response and repair nerve cells in hippocampus.

Objective To evaluate the quality of methodology and the reliability of its outcome indicators in systematic reviews of traditional Chinese medicine in the treatment of metabolic syndrome. Methods A few English and Chinese electronic databases including PubMed,CochraneLibrary, Web of Science, CNKI, VIP,CBM and Wanfang were retrieved electronically to screen out the systematic reviews of traditional Chinese medicine treatment for metabolic syndrome from inception to March 2020 that met the inclusion criteria. The method ological quality of the included systematic reviews was evaluated by using the AMSTAR 2 tool,and the quality of the outcome indicators of the included systematic reviews was further graded according to the GRADE system. Results A total of 17 systematic reviews were included, including 15 meta-analyses. The AMSTAR2 evaluation showed that all systematic evaluation was very low. The findings of GRADE evaluation showed that there were 2 high quality indicators,8 intermediate quality indicators,19 low-level quality indicators and 60 extremely low-level quality indicators. Conclusions The available evidence shows that the overall methodological quality of the systematic reviews for the treatment of metabolic syndrome is low, and the reliability of the outcome indicators is low. Therefore, the clinical should be cautious in using the conclusions of the systematic reviews, and high-quality research needs to be carried out in futurein order to obtain high-quality clinical evidence and provide guidelines for the treatment and management of metabolic syndrome.

Line 28 in Treatise on Febrile Diseases is one of the most controversial lines. There are four different opinions on the removal and retention of Guizhi(Ramulus Cinnamomi) and Shaoyao(Radix Paeoniae Alba seu Rubra) in the prescription used in this article. There are mainly 4 kinds of interpretations. Firstly, the original text means the removal of Guizhi. Secondly, the original text means removal of Shaoyao. Thirdly, the original text means reduction of Guizhi. Finally, the original text means both are reserved. With reference to the provisions before and after Line 28, and from the perspective of pathogenesis, this article holds that the original text should be “removal of Guizhi”, due to the inhibited Taiyang meridians, which is caused by fluid retention. The exterior syndrome is actually caused by the inhibited Taiyang meridians and treatment should not be retention of the fluid. So, there is no need to use Guizhi to relieve the exterior. Therefore, the prescription used in this article should be removal of Guizhi plus Fuling Baizhu decoction.

Objective To analyze the medication regularity of traditional Chinese medicine in the treatment of cerebral palsy, so as to guide clinical medication. Methods The databases of CNKI, Wanfang medical network, PubMed, Web of science and Cochrane library were searched to screen the clinical research articles on the treatment of cerebral palsy by oral and external use of traditional Chinese medicine. The statistics were made on the frequency of use, efficacy, property, taste and meridian tropism of internal and external use of traditional Chinese medicine, and the cluster analysis and correlation analysis were conducted on high-frequency traditional Chinese medicine. Results Two hundred and five research articles were included, involving 206 prescriptions. There were two kinds of usage: oral and external. There were 79 formulas for oral administration, and Sijunzi Decoction appeared most frequently. A total of 147 traditional Chinese medicines were included in the statistics, and Danggui (Angelica sinensis), Huagnqi(Astragalus membranaceus), Fulin(Poria cocos), Yizhiren(Fructus Alpiniae Oxyphyllae) and Chuanxiong(Rhizoma Chuanxiong) were used frequently. There were 126 prescriptions for external use, and 108 herbs were included in the statistics. The most frequently used herbs were Shenjincao(Herba Lycopodii), Tougucao(Herba Vaccinii Urophylli), Danggui(Angelica sinensis), Honghua(Flos Carthami) and Niuxi (Radix Achyranthis Bidentatae). The most frequently-used internal herbs were tonifying drugs, accounting for 24.5%, and The most frequently-used external Chinese medicine were wind-and dampness-dispelling drugs, accounting for 21.3%.The most commonly used Chinese herbal medicines for internal and external use were warm in nature, accounting for 42.9% and 46.3% respectively. The drugs with a higher frequency in oral Chinese medicine were sweet, pungent and bitter in taste, while the drugs with a higher frequency in external Chinese medicine were pungent, bitter and sweet. Both the internal and external use of traditional Chinese medicine were mainly for the liver, kidney and spleen meridians. Through correlation analysis and cluster analysis of high-frequency drugs,10 pairs of high-frequency drug combinations can be obtained from high-frequency oral Chinese medicine and 10 pairs of high-frequency drug combinations can be obtained from high-frequency external Chinese medicine. Both high frequency oral and external Chinese medicine can form three clustering formulas. Conclusions In the treatment of cerebral palsy with traditional Chinese medicine, tonifying deficiency, expelling wind and dampness and relieving exterior syndrome drugs are mainly used for internal use, while dispelling wind-dampness, tonifying deficiency and promoting blood circulation and removing blood stasis drugs are mainly used for external use. The results of high frequency correlation analysis and cluster analysis can provide some reference and guidance for clinical medication.

Objective To explore the medication rules for the treatment of insomnia from phlegm in order to guide the clinical use. Methods The data of famous prescriptions and medical records in the database of Chinese Medical Code were searched, and the information of prescriptions for the treatment of phlegm patterns of insomnia was collected. The frequency statistics of the commonly used traditional Chinese medicine was counted. The rule of treatment group was analyzed based on association rules. The majorprescriptions were extracted based on cluster analysis and factor analysis. Results Among the 91 prescriptions, a total of 133 traditional Chinese medicines were counted, and 20 medicines with frequency≥13 were found, of which the frequency of Banxia (RhizomaPinelliae) was the highest, as high as 60 times. Medicinals used for the treatment of phlegm syndrome insomnia were mainly warm in nature,295 times. Sweet taste is the main traditional Chinese medicine in the treatment of phlegm syndrome insomnia. There were 84 times of sour taste and only 42 times of salty medicine. Among the commonly used traditional Chinese medicines for treating insomnia of phlegm syndrome, the frequency of the Spleen and Stomach Meridian was the highest (496 times). Factor analysis was carried out on the traditional Chinese medicine with the frequency ≥20 in 91 prescriptions. Seven common factors were screened by factor coefficient, and 14 groups of drug combinations for treating insomnia with phlegm syndrome were obtained by association rule analysis. The tree diagram of cluster analysis was generated by cluster analysis, and four groups of clustering results were extracted according to clinical practice. The treatment of phlegm syndrome insomnia was based on regulating qi, resolving phlegm and calming the mind as the basic treatment principles, and the drugs are mainly sweet and warm drugs, pungent and bitter to regulate qi movements, Wendan Decoction and Anshen Dingzhi Pills are the two main prescriptions, according to the changes of clinical condition, a better clinical effect can be obtained by adding or removing medicinals based on the syndrome. Conclusions Through the analysis of the prescription and medication rules of treating insomnia from phlegm in Chinese Medical Code, it can provide references for clinical treatment of insomnia from phlegm.

The lung cancer is one of the most common malignant tumors in clinical practice. The prognosis of the lung cancer patients with malignant pleural effusion (MPE) is often poor. “Metal-water generation” is also known as “Mutual Generation between the Lung and Kidney” and “Lung and Kidney Homogeny”. The lung and kidney are closely related as they are both involved in breathing, coordination of fluid distribution and metabolism and they are connected by meridians. Deficiency of the lung and kidney is an important pathogenic factor of MPE in the lung cancer. Clinical treatment often aggravates the deficiency of the lung and kidney. The treatment of lung cancer MPE emphasizes the treatment of both the lung and kidney. The theory of metal-water generating can guide the prescription and medication of lung cancer MPE, which is expounded in combination with the typical clinical records.

Epilepsy is a commondisease which is difficult to cure. It seriously threats lives and affects daily living.The theory of wu-shenzang is a high generalization of the relationship between fivespiritsand the five-zangorgans, which embodies the core theory of TCM on Holistic Thinking. We can adjust the abnormal spirits to restore the function of the five-zang organs and vice versa. The pathogenesis ofepilepsy is complicated, butwehavefoundthatitisrelatedtothistheory in TCM. Based on the unique theory, we proposed the “syndrome differentiation system of five spirits -five-zang organs -fiveepilepsies”tomatch the characteristics of spirits and the five-zang organ lesions with those of epileptic seizures. This system can help restore the balance of yin and yang to get better treatment for epilepsy. This paper could provide a new idea for treating epilepsy in TCM.

Postoperative ileus (POI) is a syndrome that fails to effectively transmit gastrointestinal contents due to changes in gastrointestinal motility after an abdominal or non- abdominal surgery. The main clinical manifestations are nausea, vomiting, abdominal distension and delayed exhaust and defecation.In traditional Chinese medicine, disharmony of the spleen and stomach is the basic pathogenesis of POI in abdominal surgery, and Chong Ren deficiency is the main pathogenesis. Accordingly, as for its clinical treatment, the harmonizing method is suggested.If the Middle Qi is harmonious, the upper and lower parts of the body will be unblocked, the spleen (qi) will ascend and the stomach qi will descend, and the Bowel Qi will be unblocked. Chong and Ren will be hurt in patients with POI after a gynecological abdominal surgery, which is the syndrome of both deficiency and excess, in which deficiency is embodied in deficiency of Chong Ren's Qi and blood; excess is the medal blade cutting the uterus, which hurts Chong and Ren, leading to blood stasis. As for the treatment, we should pay attention to the pathological essence of deficiency and excess, and adopt the methods of removing blood stasis and promoting the spleen and stomach to promote the recovery of gastrointestinal and Chong Ren functions.

Tourette's syndrome (TS) is a common complex neuropsychiatric disorder in children. In recent years, its incidence rate is high. It is found that traditional Chinese medicine has better effect on this disease. The spleen and stomach weakness is the basis of the disease, emotional changes are an important trigger of the disease, liver wind internal movement is the core of the syndrome of the disease, and restless spirit is the manifestation of the disease. In the process of treatment of this disease, the tips and roots are treated simultaneously. If the symptoms are urgent, the symptoms will be treated, and if the disease is relieved, the method of recovering meridians should be paid attention to. The methods of invigorating the spleen and stomach, regulating Ying and Wei, pacifying the liver, clearing the heart and tranquilizing mind run through the whole process, and the methods of soothing the liver and relieving depression, communicating the heart and kidney are also used. Commonly used prescriptions are Shanwu Decoction, Guizhi plus Longgu Oyster Decoction and so on. This paper introduces the experience of treating Tourette's syndrome in children by stages in accordance with the clinical records.

Raynaud's syndrome is a vascular disorder affecting distal extremities, with arteriole spasms and blood-flow restrictions usually triggered by cold temperatures or emotional stress. The syndrome differentiation of TCM for Raynaud's syndrome is mostly yang deficiency and cold stagnation, often treated with the method of warming the meridians, dissipating cold and unblocking the meridian. In this case, based on the close relationship between qi deficiency and yang deficiency, the treatment is mainly set on tonifying qi, and also activating blood. Modified Yupingfeng Powder was prescribed to warm and dissipate cold. Qi and blood was simultaneously emphasized to achieve the good effects.