This study summarizes the clinical experience of professor LIAN Jianwei, a nationally renowned traditional Chinese medicine (TCM) practitioner, in treating chronic atrophic gastritis (CAG) with syndrome differentiatio...This study summarizes the clinical experience of professor LIAN Jianwei, a nationally renowned traditional Chinese medicine (TCM) practitioner, in treating chronic atrophic gastritis (CAG) with syndrome differentiation based on pulse-taking. Professor LIAN emphasizes the importance of pulse diagnosis in TCM clinical practice, focusing on the normal and variant aspects of pulse methods, and centers on the dynamic changes of the “Guan pulse” to accurately determine the functional status of the spleen and stomach based on pulse variations, thereby formulating personalized treatment plans. For patients with a slow and moderate pulse, spleen and stomach deficiency and dampness due to spleen deficiency are often identified, and treatment mainly focuses on strengthening the spleen, resolving dampness, and boosting Qi to aid transportation, usually with modifications of Shenling Baizhu San. When the left Guan pulse is string-like and the right Guan pulse is slow and moderate, it indicates liver depression and spleen deficiency, and Xiaoyao San is commonly used to soothe the liver, nourish the blood, and strengthen the spleen, harmonizing the liver and spleen. If the right Guan pulse is large and the left Guan pulse is string-like, it mostly belongs to liver and stomach Qi stagnation, and Bupleurum Liver-soothing powder is often used to soothe the liver, regulate Qi, and harmonize the stomach. A large and empty right Guan pulse suggests insufficiency of Central Qi, and Buzhong Yiqi Tang is commonly used to tonify Qi and soothe the liver. In terms of medication, professor LIAN pays attention to patients’ dietary habits and combines methods of eliminating dampness, promoting digestion, and activating blood circulation to improve symptoms and reverse atrophy.展开更多
OBJECTIVE： To show that the pulse diagnosis used in Traditional Chinese Medicine, combined with nonlinear dynamic analysis, can help identify car- diovascular diseases. METHODS： Recurrence quantification analysis （...OBJECTIVE： To show that the pulse diagnosis used in Traditional Chinese Medicine, combined with nonlinear dynamic analysis, can help identify car- diovascular diseases. METHODS： Recurrence quantification analysis （RQA） was used to study pulse morphological changes in 37 inpatients with coronary heart dis- ease （CHD） and 37 normal subjects （controls）. An in- dependent sample t-test detected significant differ- ences in RQA measures of their pulses. A support vector machine （SVM） classified the groups accord- ing to their RQA measures. Classic time-domain pa- rameters were used for comparison. RESULTS： RQA measures can be divided into two groups. One group of measures [ecurrence rate（RR）, determinism （DEL）, average diagonal line length （L）, maximum length of diagonal structures （Lmax）, Shannon entropy of the frequency distribu- tion of diagonal line lengths （ENTR）, laminarity （LAM）, average length of vertical structures （TT）, maximum length of vertical structures （Vmax）] showed significantly higher values for patients with CHD than for normal subjects （P〈0.0S）. The other measures （RR_std, L_std, Lmaxstd, TT_std, Vmax_std） showed significantly lower values for the CHD group than for normal subjects （P〈0.05）. SVM classification accuracy was higher with RQA measures： With RQA （16 parameters） accuracy was at 88.21%, and with RQA（12 parameters） accuracy was at 84.11%. In contrast, with classic time-do- main （15 parameters） accuracy was 75.73%, and with time-domain （7 parameters） accuracy was 74.7O%. CONCLUSION： Nonlinear dynamic methods such as RQA can be used to study functional and struc- tural changes in the pulse noninvasively. Pulse sig- nals of individuals with CHD have greater regulari- ty, determinism, and stability than normal subjects, and their pulse morphology displays less variabili- ty. RQA can distinguish the CHD pulse from the healthy pulse with an accuracy of 88.21%, thereby providing an early diagnosis of cardiovascular dis- eases such as CHD.展开更多
基金supported by the Zhejiang Science and Technology Program of TCM(No.2025ZF017)the Clinical Young-Talent Trainning Project in TCM under the Young Eagle Program of the China Association of Chinese Medicine(No.CYJH2024048).
文摘This study summarizes the clinical experience of professor LIAN Jianwei, a nationally renowned traditional Chinese medicine (TCM) practitioner, in treating chronic atrophic gastritis (CAG) with syndrome differentiation based on pulse-taking. Professor LIAN emphasizes the importance of pulse diagnosis in TCM clinical practice, focusing on the normal and variant aspects of pulse methods, and centers on the dynamic changes of the “Guan pulse” to accurately determine the functional status of the spleen and stomach based on pulse variations, thereby formulating personalized treatment plans. For patients with a slow and moderate pulse, spleen and stomach deficiency and dampness due to spleen deficiency are often identified, and treatment mainly focuses on strengthening the spleen, resolving dampness, and boosting Qi to aid transportation, usually with modifications of Shenling Baizhu San. When the left Guan pulse is string-like and the right Guan pulse is slow and moderate, it indicates liver depression and spleen deficiency, and Xiaoyao San is commonly used to soothe the liver, nourish the blood, and strengthen the spleen, harmonizing the liver and spleen. If the right Guan pulse is large and the left Guan pulse is string-like, it mostly belongs to liver and stomach Qi stagnation, and Bupleurum Liver-soothing powder is often used to soothe the liver, regulate Qi, and harmonize the stomach. A large and empty right Guan pulse suggests insufficiency of Central Qi, and Buzhong Yiqi Tang is commonly used to tonify Qi and soothe the liver. In terms of medication, professor LIAN pays attention to patients’ dietary habits and combines methods of eliminating dampness, promoting digestion, and activating blood circulation to improve symptoms and reverse atrophy.
基金Supported by Innovation Program of Shanghai Municipal Education Commission(No.11YZ71)the 3rd Shanghai Leading Academic Discipline Project(No.S30302)the National Natural Science Foundation of China(No. 81173199)
文摘OBJECTIVE： To show that the pulse diagnosis used in Traditional Chinese Medicine, combined with nonlinear dynamic analysis, can help identify car- diovascular diseases. METHODS： Recurrence quantification analysis （RQA） was used to study pulse morphological changes in 37 inpatients with coronary heart dis- ease （CHD） and 37 normal subjects （controls）. An in- dependent sample t-test detected significant differ- ences in RQA measures of their pulses. A support vector machine （SVM） classified the groups accord- ing to their RQA measures. Classic time-domain pa- rameters were used for comparison. RESULTS： RQA measures can be divided into two groups. One group of measures [ecurrence rate（RR）, determinism （DEL）, average diagonal line length （L）, maximum length of diagonal structures （Lmax）, Shannon entropy of the frequency distribu- tion of diagonal line lengths （ENTR）, laminarity （LAM）, average length of vertical structures （TT）, maximum length of vertical structures （Vmax）] showed significantly higher values for patients with CHD than for normal subjects （P〈0.0S）. The other measures （RR_std, L_std, Lmaxstd, TT_std, Vmax_std） showed significantly lower values for the CHD group than for normal subjects （P〈0.05）. SVM classification accuracy was higher with RQA measures： With RQA （16 parameters） accuracy was at 88.21%, and with RQA（12 parameters） accuracy was at 84.11%. In contrast, with classic time-do- main （15 parameters） accuracy was 75.73%, and with time-domain （7 parameters） accuracy was 74.7O%. CONCLUSION： Nonlinear dynamic methods such as RQA can be used to study functional and struc- tural changes in the pulse noninvasively. Pulse sig- nals of individuals with CHD have greater regulari- ty, determinism, and stability than normal subjects, and their pulse morphology displays less variabili- ty. RQA can distinguish the CHD pulse from the healthy pulse with an accuracy of 88.21%, thereby providing an early diagnosis of cardiovascular dis- eases such as CHD.
