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The tongue appearance of four types
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Objective
To investigate the correlation between simplified classification and laboratory indicators in patients with acute ischemic stroke, also provide accurate evidences for simplified classification and guide clinical interventions and treatment.
Methods
Two hundred patients with acute ischemic stroke were classified into four types according...
Similar publications
Objective:
We conducted a systematic review and meta-analysis to systematically evaluate the curative effect of Tongqiao Huoxue Decoction (TQHXD) combined with Western medicine treatment (WMT) on Ischemic Stroke (IS).
Methods:
Randomized controlled trials (RCTs) of TQHXD in the treatment of IS by computer retrieval of PubMed, Embase, Web of Scie...
Citations
... (2) The diagnostic criteria of stroke in TCM refer to "From clinical appearance to accurate management in acute ischemic stroke patients: With the guidance of innovative traditional Chinese medicine diagnosis" [20] . ...
Background
Dysarthria is one of the most common stroke complications. It seriously affects the patient’s ability to communicate with one another and their overall recovery. The priority therapeutic methods in treating dysarthria after stroke (DAS) are speech training, physical therapy, and traditional Chinese rehabilitation, but the overall outcomes are not optimal. This study combines proprioceptive neuromuscular facilitation (PNF) and traditional chinese medicine (TCM) theory to design a kaiyin xuanfei manipulation (KYXF), which may improve the physiological function of vocal organs and improve speech intelligibility. However, there is still a lack of high-quality, large-sample clinical studies. The objective of this study is to conduct a randomized controlled trial to evaluate KYXF's efficacy in the treatment of DAS.
Methods
Patients (N = 60) who meet the trial's inclusion criteria will be randomly divided into 2 groups in this prospective, single-blind, randomized controlled trial: speech training and speech training plus KYXF, with each group consisting of 30 patients. Both groups will undergo routine medical therapy, rehabilitation, and speech training. For 8 weeks, all treatments will be delivered 5 times per week. The Frenchay functional score will be used to evaluate all outcomes at baseline, week 4, week 8, and follow-up.
Discussion
This study will be the first prospective randomized controlled trial to evaluate the safety and preliminary efficacy of KYXF in patients with DAS. Furthermore, this trial is also expected to standardize and expand the clinical treatment of DAS using a combination of traditional chinese and western medicine.
Trial Registration
Chinese Clinical Trial Registry, identifier: ChiCTR2100050343. Registered on 26 August 2021.
... This study selected all the symptom characteristics collected from the literature and included them as the standard for surveying in the clinical investigation phase. The advantage of selecting all characteristics is that to not leave out on symptoms that were clinically present or were rarely present, but when present were a particular characteristic of a syndrome [30]. ...
Sensory disturbance is a common symptom of post-stroke. In traditional Chinese medicine (TCM), this symptom is classified as numbness (Ma Mu). While there have been many studies on the therapeutic effect of numbness in TCM, little research has been conducted on the characteristics of numbness. This study aimed to investigate the characteristics of numbness in patients with ischemic stroke in the early rehabilitation phase. This study consisted of two phases. Phase 1 investigated the characteristics of numbness based on medical literature; Phase 2 investigated the characteristics of numbness in patients with ischemic stroke in the early rehabilitation phase based on the cross-sectional study. Phase 1 identified 9 characteristics of numbness based on 11 medical /literature, including: S1 (feeling of heaviness in the affected area), S2 (feeling of tension in the affected area), S3 (sensation of crawling insects), S4 (numbness in a fixed position), S5 (increased numbness with movement), S6 (increased numbness when exposed to cold), S7 (increased numbness when exposed to moisture), S8 (decreased with warm compresses), S9 (decreased when pressed). Phase 2, a clinical survey of 67 patients, recorded 9 characteristics (S1 to S9). We found that there is a relationship between the degree of sensory disturbance according to Fugl-Meyer Assessment with S2 and S6, and obesity with S5. The study examined the characteristics of numbness in ischemic stroke patients in the early rehabilitation phase from the perspective of TCM. This study provided a basis for individualized diagnosis and treatment combining traditional and modern medicine.
... 13e15 For example, the PDC has been implied to be the pathologic basis for the occurrence of metabolic syndrome, 16 and it is always related to higher blood pressure level, 17 cardiovascular disease, 18 body mass index, 19 and total cholesterol. 20 Individuals with the YADC tend to have a cold body and limbs owing to an insufficiency of yang qi, which fails to warm the body and easily leads to the gastrointestinal discomfort caused by cold food (typical cold intolerance). 21 People with the YIDC are susceptible to hypertension and diabetes. ...
Objective
To investigate whether the specific traditional Chinese medicine (TCM) constitution of individuals can be defined by certain biological indexes instead of answering the questionnaire, and to explore the possibility of discriminating nine TCM constitutions from each other simultaneously using biological indexes.
Methods
Blood and urine samples from 152 individuals with nine TCM constitutions were collected, and the related biological indexes were analyzed combining ANOVA, multiple comparison, discriminant analysis, and support vector machine.
Results
We found that 4 out of 24 blood routine indexes, 7 out of 10 urine routine indexes, and 12 out of 32 biochemical indexes showed differences among the constitutions. High-sensitivity C-reactive protein, apolipoprotein A1, and alkaline phosphatase were potential candidates for screening out individuals with unbalanced constitutions. Combining uric acid, high-density lipoprotein, apolipoprotein A1, creatine kinase, total protein, aspartate aminotransferase, total bile acid, dehydrogenase, sodium, and calcium levels had the potential to directly distinguish the nine TCM constitutions from each other. Among these indexes, the highest ratio of discriminant analysis between two constitutions was 95.5%, while the lowest was 66.1%.
Conclusion
Our results suggest that some biochemical and urine indexes are related to various TCM constitutions, and thus they have the potential to be used for TCM constitution classification.
... The evolution of syndromes in the acute phase of stroke is complex, and the phlegmheat syndrome is the primary syndrome in the acute phase of stroke (Wang and Xie, 2013). Additionally, the team of integrated Chinese and Western medicine in the Department of Neurology of Xuanwu Hospital has simplified the classification based on years of clinical experiences, dividing the syndrome into four types: phlegm-heat syndrome, phlegm-dampness syndrome, Yin deficiency syndrome, and Qi deficiency syndrome (Song et al., 2019a). Based on this, the treatment targeting the particular syndrome achieved good outcomes. ...
... Based on the syndrome characteristics of cerebrovascular disease, Professor Gao Li combined modern etiology with pathology and imaging examination in syndrome analysis. The team of Gao also simplified the TCM syndromes of AIS into four types, where the phlegm-heat syndrome is the most common (Song et al., 2019a). In addition to neurological deficits, AIS with phlegm-heat syndrome exhibits bad breath, thick tongue coating, sticky sputum, abdominal distension, dry or poor stools, etc. ...
As a life-threatening disease, stroke is the leading cause of death and also induces adult disability worldwide. To investigate the efficacy of the integrated traditional Chinese medicine (ITCM) on the therapeutic effects of acute ischemic stroke (AIS) patients, we enrolled 26 patients in the ITCM [Tanhuo decoction (THD) + Western medicine (WM)] group and 23 in the WM group. Thirty healthy people were also included in the healthy control (HC) group. ITCM achieved better functional outcomes than WM, including significant reduction of the phlegm-heat syndrome and neurological impairment, and improvement of ability. These facts were observed in different pretreatment gut enterotypes. In this paper, we collected the stool samples of all participants and analyzed the 16S rRNA sequence data of the gut microbiota. We identified two enterotypes (Type-A and Type-B) of the gut microbial community in AIS samples before treatment. Compared to Type-B, Type-A was characterized by a high proportion of Bacteroides, relatively high diversity, and severe functional damage. In the ITCM treatment group, we observed better clinical efficacy and positive alterations in microbial diversity and beneficial bacterial abundance, and the effect of approaching healthy people’s gut microbiota, regardless of gut enterotypes identified in pretreatment. Furthermore, we detected several gut microbiota as potential therapeutic targets of ITCM treatment by analyzing the correlations between bacterial abundance alterations and functional outcomes, where Dorea with the strongest correlation was known to produce anti-inflammatory metabolite and negatively linked to trimethylamine-N-oxide (TMAO), a biomarker of AIS. This study analyzed clinical and gut microbial data and revealed the possibility of a broad application independent of the enterotypes, as well as the therapeutic targets of the ITCM in treating AIS patients with phlegm-heat syndrome.
... Modern scholars of TCM also point out that blood stasis is the principal problem in the process of occurrence, development, and outcome of ischemic stroke Zhong et al., 2015;Sun et al., 2016;Chai and Zhang, 2018). Therefore, in the prevention Tsai et al., 2016;Song et al., 2019), treatment Hsu et al., 2019;Luo et al., 2019), and rehabilitation Zhao et al., 2018) of ischemic stroke, conventional treatment combined with drugs that promote blood circulation and remove blood stasis can be an effective intervention. ...
With the increase of the aging population, the high mortality and disability rates caused by ischemic stroke are some of the major problems facing the world, and they dramatically burden the society. Panax notoginseng (Burk) F. H. Chen, a traditional Chinese medicine, is commonly used for promoting blood circulation and removing blood stasis, and its main bioactive components are Panax notoginseng saponins (PNS). Therefore, we performed a meta-analysis on focal cerebral ischemia-reperfusion animal models established with middle cerebral artery occlusion (MCAO) surgery to evaluate the therapeutic effect of PNS. We systematically searched the reports of PNS in MCAO animal experiments in seven databases. We assessed the study quality using two literature quality evaluation criteria; evaluated the efficacy of PNS treatment based on the outcomes of the neurological deficit score (NDS), cerebral infarct volume (CIV), and biochemical indicators via a random/fixed-effects model; and performed a subgroup analysis utilizing ischemia duration, drug dosage, intervention time, and administration duration. We also compared the efficacy of PNS with positive control drugs or combination treatment. As a result, we selected 14 eligible studies from the 3,581 searched publications based on the predefined exclusion-inclusion criteria. PNS were significantly associated with reduced NDS, reduced CIV, and inhibited release of the inflammatory factors IL-1β and TNF-α in the focal MCAO rat models. The PNS combination therapy outperformed the PNS alone. In addition, ischemia time, drug dosage, intervention time, and administration duration in the rat models all had significant effects on the efficacy of PNS. Although more high-quality studies are needed to further determine the clinical efficacy and guiding parameters of PNS, our results also confirmed that PNS significantly relieves the focal cerebral ischemia-reperfusion in rat models. In the animal trials, it was suggested that an early intervention had significant efficacy with PNS alone or PNS combination treatment at a dosage lower than 25 mg/kg or 100–150 mg/kg for 4 days or longer. These findings further guide the therapeutic strategy for clinical cerebral ischemic stroke.
Ischemic stroke (IS) remains one of the leading causes of death and disability in humans. Unfortunately, none of the treatments effectively provide functional benefits to patients with IS, although many do so by targeting different aspects of the ischemic cascade response. The advantages of traditional Chinese medicine (TCM) in preventing and treating IS are obvious in terms of early treatment and global coordination. The efficacy of TCM and its bioactive constituents has been scientifically proven over the past decades. Based on clinical trials, this article provides a review of commonly used TCM patent medicines and herbal decoctions indicated for IS. In addition, this paper also reviews the mechanisms of bioactive constituents in TCM for the treatment of IS in recent years, both domestically and internationally. A comprehensive review of preclinical and clinical studies will hopefully provide new ideas to address the threat of IS.
Background
Acute cerebral infarction, characterized by a rapid onset and high fatality rate, presents a significant global challenge in terms of timely and effective treatment. In recent years, research focusing on the combined approach of traditional Chinese medicine (TCM) and Western medicine has demonstrated promising results in improving therapeutic outcomes in patients with acute cerebral infarction.
Diagnosis
This study adhered to the latest edition of Internal Medicine of Traditional Chinese Medicine, published by the China Press of Traditional Chinese Medicine, as a reference. It selects eight commonly encountered TCM syndrome differentiations for accurate diagnosis.
Methods
This study included 151 patients admitted to the hospital between 2019 and 2022 with acute cerebral infarction. Data on various diagnostic indicators were meticulously collected and subjected to single-factor analysis.
Results
Among the multiple factors analyzed, those exhibiting a significance level of P < 0.05 included blood pressure, uric acid, glucose level, triglyceride level, total cholesterol level, homocysteine level, duration of disease, and cerebral infarction site. Subsequently, a binary logistic regression analysis was performed to assess the impact of these factors on different TCM syndrome types.
Conclusion
The findings of this study indicate that Wind Phlegm Obstruction syndrome, triglyceride levels, location of cerebral infarction, uric acid levels, and disease duration significantly influence the development and progression of acute cerebral infarction. Additionally, blood pressure and cerebral infarction site were found to have a statistically significant impact on the Wind Yang Disturbance syndrome. Uric acid level and blood pressure were also identified as statistically significant factors. Moreover, total cholesterol and homocysteine levels were found to significantly affect phlegm stasis-blocking collateral syndrome. The insights gained from this study will contribute to the advancement of integrated treatment approaches, combining traditional Chinese and Western medicine, for acute cerebral infarction. Furthermore, these findings can serve as a valuable reference for the general population in terms of preventive measures against this condition.
Objective: To explore the characteristics of plasma metabolites, feces gut microbiota and the crosstalk between gut microbiota and host metabolism in patients with acute ischemic stroke and phlegm-heat pattern (AIS-PHP). Methods: The metabolic and microbiome profiles of 20 AIS-PHP patients and 20 healthy controls (HCs) were analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS)-based metabolomics and 16s rDNA sequencing, respectively. The covariation between LC-MS/MS-based metabolite data and 16s rDNA sequence data was presented. Results: Distinct alterations in the plasma metabolic phenotype of AIS-PHP patients were found, in which 16 metabolites differed significantly between the AIS-PHP patients and the HCs. These metabolites represented 17 different metabolic pathways, including amino acid metabolism, lipid metabolism, and nucleotide metabolism. Additionally, significant alterations of gut microbiota composition and taxon were revealed at the phylum level between the AIS-PHP patients and the HCs. In AIS-PHP, Bacteroidetes, Firmicutes, and Proteobacteria dominated. Moreover, some microbes that differed between the 2 groups manifested a sole association with certain metabolites, such as the connection between Bacteroides and inosine and between Lachnospiraceae_unclassified and hypoxanthine. Conclusion: The present study preliminarily investigated the metabolomic and gut microbiome characteristics of AIS-PHP patient indicators. The link between metabolic and microbial dysbiosis in AIS-PHP sheds new light on the function of gut microbiota and associated metabolomics in the pathogenesis of the disease.
In integrative cardiovascular Chinese medicine, the brain is considered the sea of marrow, because it is a major communication base for the control of gray and white matter that comprise the brain and other marrow found in centers throughout the body, all of which sustain the physiological functions of the body. Neurological disorders involve the brain, kidneys, liver, Qi and shen. Biochemical factors in neurological and psycho-emotional disorders include folate deficiencies, dopamine deficiency, serotonin deficiency, glutamate deficiency. Genetic determinants in disease susceptibility include MTHFR gene, ASGPR gene, PGE2 gene, alpha-1 antitrypsin gene, PSEN1 gene, PSEN2 gene, APP gene, APOE gene. Genetic determinants in disease progression include NOTCH3 gene and MTHFR gene.
