| In the history of biosciences, there were many knowledges about Constitution in ancient Eastern and Western. But those scattered knowledges, which were lack of academic schools, diagnostic criteria and clinical applications, did not formed systemlized theroies. After continued efforts of researchers, led by Wang Qi, the theoretical system of TCM constitution was constructed, the Constitution theory in traditional Chinese medicine was founded and the constitution academic school was authenticated by State Administration of Traditional Chinese Medicine from the late1970s to the present.The modern academic school research is still in its early stages and there is a lack of systematic research on TCM constitution school inheritance, development and application etc. So advantages of the TCM constitution can not be developed to a certain extent.Based on the background of constitution in Chinese Medicine School and the hypothesis--"correlation between prescription and constitution", the study was to investigate "prescription based on syndrome differentiation" by choosing yin deficiency constitution and yang deficiency constitution as the research object. The present study includes two parts, ie. the clinical study and the experimental study. The clinical part on the inheritance of professor Wang Qi and academic heirs--professor Ni Cheng was carried out to concise constitution school’s thoughts, write the TCM constitution academic history. the experimental part was to observe the interventions of Liuwei Dihuang pill on yin deficiency constitution participants and Guifu Dihuang pill on yang deficiency constitution participants and to explore the partial regulative mechanisms of traditional Chinese medicine formulas. As a result, the study aims to reveal the modern connotation of yang deficiency and yin deficiency constitution and demonstrate science principle of "correlation between prescription and constitution" and "prescription based on syndrome differentiation".The main contents are as follows:1The clinical studyMethods:In this study, yang deficiency constitution and yang syndrome, yin deficiency constitution and yin syndrome were differentiated.The academic thoughts of thesupervisor, prescription based on syndrome differentiation, were summarized by those methods such as literature researchs, clinic practices, medical record finishing and lectures of the supervisor. We selected two kinds of medical records,aversion to cold and night sweat, to summarize the clinical diagnosis and treatment strategy, prescription compatibility, application methods, the clinical experience and innovative thinking of the supervisor.With those measures adopted, we fully expect to develop the school of constitution in TCM.Results:①The study of traditional Chinese medicine formulas based on yang deficiency constitution for the therapy of the symptom of fearing of cold. Based on the theroy of "constitution being recoverable" romoted by Professor Wang Qi and "correlation between prescription and constitution" promoted by Professor Ni Cheng, this article summarizes Professor Ni Cheng’s academic experiences of prescription in accordance with constitution for treating the symptom of aversion to cold. These includes three aspects, which are correlation between aversion to cold with yang deficiency and the decline in health-related quality of life (HRQOL) of patients with it, the definition of yang deficiency constitution and yang deficiency syndrome of aversion to cold and the principle of prescription. Medical cases are also taken to illustrate some main points of individualized prescription that differentiation constitution should be combined with type of constitution and state of constitution differentiation and with disease and syndrome differentiation in diagnosis and treatment of aversion to cold.②The study of traditional Chinese medicine formulas based on yin deficiency constitution for the therapy of the symptom of night sweats. Based on the theroy of "constitution relating to disease" and "constitution being recoverable" promoted by Professor Wang Qi and "correlation between prescription and constitution" promoted by Professor Ni Cheng, this study summarizes Professor Ni Cheng’s clinical experience about the prevention and therapy of night sweat by traditional Chinese medicine. These includes three aspects, which are correlation between night sweat with yin deficiency consititution, the definition of yin deficiency constitution and yin deficiency syndrome of night sweat and the principle of prescription. Medical cases are also taken to illustrate some main points of individualized prescription that differentiation constitution should be combined with type of constitution and state of constitution differentiation and with disease and syndrome differentiation in diagnosis and treatment of night sweat.By summing up the inheritance of the above two kinds of disease diagnosis and treatment experience, inheritance characteristic way was continued in the constitution school of TCM. Those usually include the development of new discovery, the theory innovation and academic of thinking training. The academic thought of "prescription based on consititution differentiation" was also inherited and the change of the way of thinking for solving problem was promoted.2The experimental studyResearch1:Yin deficiency and Yang deficiency constitution intervention effects on constitution scoringMethods:Some25-40years old healthy subjects were recruited and divided into3groups according to their constitution type--heathy constitution, yang deficiency constitution and yin deficiency constitution. Then yang deficiency individuals were randomly divided into the control group of yang deficiency constitution and the intervention group of yang deficiency constitution.yin deficiency were randomly divided into the control group of yin deficiency constitution and the intervention group of deficiency constitution.There were a total of5groups and each group at least10cases. Participants in the intervention group of yin deficiency constitution andyang deficiency constitution were daily take Liuwei Dihuang pill and Guifu Dihuang pill respectively,6grams each time,2times a day. The process take90days. The rest3groups did not take medicines. After treatment,theconsititution score of each group were compared. We used constitution scoring to observe the the intervention effects of Liuwei Dihuang pill and Guifu Dihuang pill on the constitutions of yin deficiency and yang deficiency.Results:After the administration,the constitution scoring data showed that Liuwei Dihuang pill treatment significantly decreased the constitution score in yin deficiency participants group, and Guifu Dihuang pill treatment also significantly decreased the constitution score in yang deficiency participants group (P<0.01)Conclustion:Liuwei Dihuang Pill can be used to regulating yin deficiency constitution and Guifu Dihuang Pill can be used to regulating yang deficiency constitution. Both are able to obviously improve subjective symptoms of yang deficiency constitution and yin deficiency constitution subjects.Research2:Yin deficiency and Yang deficiency constitution intervention effects onThl,Th2,Thl7cells subsetsMethods:Some25-40years old healthy subjects were recruited and divided into3groups according to their constitution type--heathy constitution, yang deficiency constitution and yin deficiency constitution. Then yang deficiency individuals were randomly divided into the control group of yang deficiency constitution and the intervention group of yang deficiency constitution.yin deficiency were randomly divided into the control group of yin deficiency constitution and the intervention group of deficiency constitution.There were a total of5groups and each group at least10cases. Participants in the intervention group of yin deficiency constitution andyang deficiency constitution were daily take Liuwei Dihuang pill and Guifu Dihuang pill respectively,6grams each time,2times a day. The process take90days. The rest3groups did not take medicines. After90days treatments, vein blood was drawn. We futher investigated the interventions of Liuwei Dihuang pill and Guifu Dihuang pill on the serum levels of Th1Th2、Th17for the constitutions of yin deficiency and yang deficiency by measuring the levels of Thl, Th2, and Th17in vitro, the serum contents of Thl-related cytokines including IL-2, INF-y and TNF-a, and the serum levels of Th2, Th17-related cytokines including IL-4, IL-6, IL-10and IL-17A, respectively.Results:Our data showed that:①Compared with the normal group, the Thl/Th2index was significantly decreased in both yin deficiency and yang deficiency groups, respectively, but Th1(%), Th17(%), Th2(%) had no statistically significant difference; Guifu Dihuang pill treatment had an obvious tread to increase the indexes of Th1(%) and Thl/Th2in yang deficiency group, and decrease the index of Th2(%),but not obvious for Thl7(%); Liuwei Dihuang pill treatment had an obvious tread to increase the indexes of Th1(%) in yin deficiency group, but not obvious for Th2(%),Th1/Th2, and Th17(%).②Compared with the normal group, the levels of IL-2, INF-y, and TNF-a were significantly decreased in yang deficiency control group, the level of IL-2, INF-y was also significantly decreased in yin deficiency control group, and the levels of TNF-a had an obvious tread to decrease in yin deficiency control group; Guifu Dihuang pill treatment significantly increased the contents of IL-2, TNF-a and INF-y in yang deficiency participants; Liuwei Dihuang pill treatment significantly increased the contents of TNF-α and INF-γ in yin deficiency participants Liuwei Dihuang pill treatment had an obvious tread to increase the contents of IL-2in yin deficiency participants, but there was no statistically significant difference.③Compared with the normal group, the levels of IL-4, IL-6, IL-10and IL-17A were significantly decreased in yang deficiency control group, the levels of IL-4and IL-17A were significantly decreased in yin deficiency control group but not obvious for the levels of IL-6and IL-10; compared with the yang deficiency control group, Guifu Dihuang pill treatment significantly increase the content of IL-4, IL-6, IL-10, and had obvious tread to increase the contents of IL-17A; compared with the yin deficiency control group, Liuwei Dihuang pill treatment significantly increased the content of IL-4, IL-6, IL-17A, and had obvious tread to increase the contents of IL-10, but there was no statistically significant difference.Conclustion:Our results indicated that compared with the normal group, the Thl/Th2index, serum IL-2,INF-γ, TNF-α, IL-4,IL-6,IL-10, and IL-17A in both yin deficiency and yang deficiency control groups had decreased. Compared with yang deficiency control group, the Thl/Th2index, serum IL-2,INF-γ, TNF-α, IL-4,IL-6,IL-10, and IL-17A in both yin deficiency control groups had increased. It showed that there were Thl type cytokine secretion differences between yang deficiency constitution and yin deficiency constitution. Guifu Dihuang pill treatment significantly increase the content of IL-2, INF-γ, TNF-α, IL-4, IL-6, IL-10of yang deficiency participants. Liuwei Dihuang pill treatment significantly increase the content of INF-γ, TNF-α, IL-4, IL-6, IL-10, IL-17A of yin deficiency participants.These may be the causes of correcting yin deficiency and yang deficiency constitution, restoring Th cell function point of balance and improving the body constitution.Research3:Yin deficiency and Yang deficiency constitution intervention effects ona the neuroendocrine immune systemMethods:Some25-40years old healthy subjects were recruited and divided into3groups according to their constitution type--heathy constitution, yang deficiency constitution and yin deficiency constitution. Then yang deficiency individuals were randomly divided into the control group of yang deficiency constitution and the intervention group of yang deficiency constitution.yin deficiency were randomly divided into the control group of yin deficiency constitution and the intervention group of deficiency constitution.There were a total of5groups and each group at least10cases. Participants in the intervention group of yin deficiency constitution and yang deficiency constitution were daily take Liuwei Dihuang pill and Guifu Dihuang pill respectively,6grams each time,2times a day. The process take90days. The rest3groups did not take medicines. After90days treatments, vein blood was drawn. We futher investigated the interventions of Liuwei Dihuang pill and Guifu Dihuang pill on the constitutions of yin deficiency and yang deficiency via the neuroendocrine immune system, such as the plasma levels of norepinephrine, dopamine and epinephrine,5-hydroxytryptamine and adreno-cortico-tropic-hormone, the contents of serum cortisol, IgA, IgG, and IgM, etc.ResultsrOur data showed that:①Compared with the normal group, the contents of serum cortisol and plasma ACTH significantly decreased in yand deficiency group, but not obvious for plasma5-HT; the contents of plasma ACTH significantly decreased, and the contents of cortisol and plasma5-HT had an obvious tread to decrease in yin deficiency group, but there was no statistically significant difference. Compared with the yang deficiency control group, Guifu Dihuang pill treatment increased the content of plasma5-HT, serum cortisol and plasma ACTH, but there was no statistically significant difference. Compared with the yin deficiency control group, Liuwei Dihuang pill treatment increased the content of plasma5-HT, serum cortisol and plasma ACTH, but there was no statistically significant difference.②Compared with the normal group, the content of norepinephrine had an obvious tread to increase in yang deficiency group, and the contents of both norepinephrine and dopamine had an obvious tread to increase in yin deficiency group, but there was no statistically significant difference. Guifu Dihuang pill treatment had an obvious tendency to decrease the level of norepinephrine, but not obvious for the contents of dopamineand epinephrine. Liuwei Dihuang pill treatment had an obvious tread to decrease the level of dopamine in yin deficiency group, but not obvious for the contents of norepinephrine and epinephrine.③Compared with the normal group, the levels of serum of IgA, IgG, and IgM in both yang deficiency group and yin deficiency group had no obvious significant change. Bot Guifu Dihuang pill treatment and Liuwei Dihuang pill treatment had no obvious effect in yang deficiency group and yin deficiency group.Conclustion:The research demonstrated that, the decrease of serum Cor and plasma ACTH content decreased in both yang deficiency and yin deficiency constitution. It suggests that the hypothalamic pituitary adrenal axis function decline.Although more subjective symptoms of participants were improved by the intervention of Guifu Dihuang pill and Liuwei Dihuang Pill, serum Cor and plasma ACTH content compared with control group did not change.It perhaps was related to less time of intervention and or poor compliance of subjects.In summary, the findings of the study and the main conclusions are as follows:①The hypothesis--"correlation between prescription and constitution" refer to that different individuals have different responses and adaptability of the application of prescription. The hypothesis is based on types and state of the body constitution and reflects the characteristics of traditional Chinese medical of prescription based on constitution differentiation.②The Th1/Th2index, serum IL-2,INF-γ, TNF-α, IL-4,IL-6,IL-10, and IL-17A in both yin deficiency and yang deficiency had decreased, for Thl, Th2cell subsets was inhibited. There was a tendency to shifting Th2lymphocyte subsets. In addition, the contents of plasma ACTH and serum cortisol also decreased in both yin deficiency and yang deficiency groups, which indicated the dysfunction of the hypothalamic-pituitary-adrenal axis. Compared with yang deficiency, the Thl/Th2index, serum IL-2,INF-γ, TNF-α, IL-4,IL-6,IL-10, and IL-17Ain yin deficiency groups had increased. It showed that there were Thl type cytokine secretion differences between yang deficiency constitution and yin deficiency constitution. This provides a partial explanation for the internal heat performance of yin deficiency constitution. Compared with yin deficiency, the Th1/Th2index, serum IL-2,INF-γ, TNF-α, IL-4,IL-6,IL-10, and IL-17A in yang deficiency groups had decreased. It showed that there were insufficient secretion of Thl type cytokine in yang deficiency constitution. This provides a partial explanation for intolerance to cold performance of yang deficiency constitution.Guifu Dihuang pill treatment significantly increase the content of IL-2, INF-γ, TNF-α, IL-4, IL-6, IL-10of yang deficiency participants. Liuwei Dihuang pill treatment significantly increase the content of INF-γ, TNF-α, IL-4, IL-6, IL-10, IL-17A of yin deficiency participants.These may be the causes of correcting yin deficiency and yang deficiency constitution and improve the body constitution. |
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