Theoretical Research On The Application Of Coix Seed By Zhongjing Based On "removing Qi And Eliminating Dampness, Relieving Arthralgia And Eliminating Carbuncle"

Research purpose:Part Ⅰ:Taking the Zhongjing’s Coix recipes as the starting point,clarify the original appearance of the Zhongjing’s original intent of the Coix recipes,sort out the evolution and inheritance of later generations of commentators,and summarize the clinical application of the Coix recipes from related medical reports in ancient and modern times.PartⅡ:On the basis of the previous article,analyze the treatment methods,compatibility,selection of medicines,and dosage formulations of the Zhongjing’s Coix recipes,combined with Zhongjing’s understanding of dampness,carbuncle,and arthralgia,summarize Zhongjing’s methods and rules for using Coix and its implications for later generations.Part Ⅲ:A preliminary modern interpretation of the effect of Coix Seed in "moving qi and dispelling dampness,relieving arthralgia and carbuncle".Research method:Part Ⅰ is a textual research on the original intent of the Coix recipes and subsequent research on the rheology.The specific methods include:①Edition revision:compare the Yuan Dengzhen manuscripts and Ming Hongwu manuscripts.For those with major differences,verify the correctness and error.②Problem analysis:Analyze the rheology of Zhongjing’s interpretation by later commentators for clarification.③Difficult problem analysis:Analyze the evolution of the interpretation of Zhongjing’s original text by later commentators,in order to trace the flow and clear the source.Moreover,combine the results of the textual research,answer questions related to the clauses and prescriptions.④Medical records collation:Use tools such as the Chinese Medical Dictionary and CNKI to systematically collect the ancient and modern medical records of Coix and carry out quantitative data analysis and collation.Part Ⅱ discusses Zhongjing’s methods and laws of using Coix from the three aspects of inheritance,development and later application.The specific methods include:①Literature research:sort out the knowledge of Coix that the ancestors had mastered before the Zhongjing period through literature review.②Theoretical discussion:By analyzing Zhongjing’s understanding of water,dampness,phlegm,drinking,and fog,and the attachment of carbuncle and paralysis,summarize Zhongjing’s experience on using Coix Seed.The main research methods for Part Ⅲ are proteomics detection and bioinformatics analysis.Research results:The main results of part Ⅰ include:①The dosage of Maxing yigan Decoction should be based on Wu Qian’s origin,not a "light dose";In essence,it’s not converted to heat syndrome;the prescription should be used for dispelling cold and removing dampness,of which coix plays a key role,and this decoction contains Zhongjing unique treatment on removing dampness,activating Qi to remove dampness",which has not been inherited by the modern doctors.②"Xiong Bi Huan Ji" in Yiyi Fuzi Powder should be understood as "the relieve and relapse of the chest pain".The core of this disease is "dampness blocking".Coix has the power to Activating Qi to remove dampness blocking".Yiyi Fuzi Powder is a prescription for daily use.rather than acute onset of chest pain.③Coix Fuzi Baijiang Powder is used for long-standing carbuncle pus disease,for which the patients display the damp and heat evil.The whole prescription is to clear away heat and remove dampness and eliminate carbuncle.Coix is used to reduce dampness and eliminate carbuncle.Aconite helps Zhenyang to remove dampness,not to eliminate cold."Urination now" is not written incorrectly,but Baijiang’s effect of turning pus into water.Later,the original prescription was gradually incorrectly interpreted as to eliminate cold and dampness.④Qianjin Weijing Decoction is an original prescription of Zhongjing,rather than "Qianjin";The term "fanman" refers to the fullness of the chest and thighs,which is the result of hot and depression,rather than an emotional symptom;the term "xiong zhong jia cuo" may be visceral changes;the word "gua" specifically refers to the Muskmelon,not white gourd,during the Zhongjing period,so it should be used Muskmelon seeds instead of white gourd seeds.The variants of this prescription and the class prescriptions also show that the coix seed plays an important role in removing dampness and purging pus in the prescription.⑤It can be seen from the medical records that Zhongjing’s Coix recipes has been well inherited and used in later generations.The indications continue to expand,and many developments and changes have also occurred in the inheritance,such as Ma Xing Yi Gan Decoction with a large number of heat-clearing and dampness-removing products to treat damp and heat syndrome,increasing the dosage of aconite in Yiyi Fuzi Baijiang Powder to treat cold and dampness Yang deficiency syndrome and so on.The main results of part Ⅱ include:①The existing effects of coix seed in the Zhongjing period can be basically summarized as relaxation of muscles,eliminating dampness,replenishing qi,avoiding miasma and assisting pregnancy.②Zhongjing’s understanding of dampness is inherently united.The dampness is heavy and turbid,stagnating,and staying still.③Zhongjing uses the "moving qi" effect of Coix Seed in the "Shennong’s Herbal Classic of Materia Medica "to eliminate dampness,and exerts its function to "moving qi,dispelling dampness,relieving numbness and eliminating carbuncle".These are zhongjing’s unique developments and contributions.Zhongjing’s experience in the use of coix can be summarized as:moving qi to dispel dampness,moving to cure calmness,and to treat dampness obstruction and stagnation of arthralgia and carbuncle,which highlights the compatibility of slightly cold but also warm,the treatment method reflects the purpose of replenishing deficiency through the treatment of actual evils.④Zhongjing’s experience on using of coix is reflected in the later generations of herbal works,such as the treatment of coix in lung carbuncle,rheumatism,chest pain,hemoptysis,etc."The main results of part Ⅲ include:①The serum proteomics test found that the expression of a total of 66 proteins was significantly increased or decreased between the Coix Seed medication group and the control group.②Some of these proteins may play a role in rheumatoid arthritis,coronary heart disease,ulcerative colitis,sepsis,hepatic abscess,acute appendicitis and other infectious diseases by controlling inflammation and M2 type macrophages.Which means,Coix seed has the function of "Relieving Biblism and Eliminating Carbuncle".③There are also some proteins that can play a role in regulating blood lipids,which may be the performance of Coix Seed’s damp-removing effect;the improvement of Alzheimer’s disease and other diseases may be related to removing dampness and reducing phlegm.At the same time,this study found that Coix Seed can down-regulate the expression 10 tumor-promoting genes and up-regulate 1 tumor suppressor gene,which are consistent with the theoretical understanding of the close relationship between dampness and tumors in traditional Chinese medicine,and also in line with the actual situation of Coixen used in clinical tumor treatment.However,the sample size of this study is small,and it is only for preliminary exploration,and more studies are needed for verification in the future.Conclusion:This study is based on the research of the original intent of the four Coix recipes and the rheological combing.The part of the understanding that is not exactly the same as the existing understanding may be closer to the original intent of Zhongjing.Zhongjing’s experience on using coix seed was extracted from the four prescription,thus to make some tacit knowledge in the "Synopsis of Golden Chamber" explicit.This study uses the research method of Zhongjing’s original intention substitution and rheological combing to obtain the above-mentioned ancient Chinese documents,returning to the original meaning of Zhongjing based on empirical research,instead of deducing Zhongjing’s meaning based on clinical findings or later medical experts.This is also the main feature and innovation of this research.The innovations and shortcomings of this research:①Combining longitudinal research and horizontal research.Longitudinal research is to analyze ancient Chinese documents,historical annotators and modern medical records together.Horizontal research is to explore the commonalities between the four prescriptions and tap their inner connections.The former is the basis of the latter,while the latter is the deepening and extension of the former.②It connects the pathophysiological viewpoints in the "The Inner Classic of the Yellow Emperor" and Zhongjing’s medicine,so that Zhongjing’s valuable clinical experience contained in "Synopsis of Golden Chamber" can be refined.③The analysis of the effects of Coix seed on proteomics changes is based on the combination of TCM theories.Organically integrate traditional Chinese medicine theories with modern interpretations to guide further exploration.