3. Clinical Application of the Model

The clinical model of "Western diagnosis, TCM syndrome differentiation, TCM as the mainstay, Western medicine as the auxiliary" can be applied to any systemic internal medicine disease. Let us illustrate this with examples.

(1) Gastric Pain

This syndrome is a clinical manifestation caused by multiple diseases. If TCM syndrome differentiation and treatment are carried out without first clarifying the Western diagnosis, it will inevitably be difficult to grasp the core of the disease—resulting in ineffective medication at best, or misdiagnosis and mistreatment at worst. Sometimes, conditions such as pancreatitis and gastric perforation are mistaken for ordinary stomach ailments and treated accordingly, delaying proper treatment and even leading to unforeseen consequences. However, if "Western diagnosis" is performed before "TCM syndrome differentiation," not only can the aforementioned problems be avoided, but TCM can also be further developed through the integration of disease and syndrome. For the Western diagnosis of gastric pain, barium meal radiography, gastroscopy, and pathological biopsy should be used; if necessary, ultrasound can also be employed to rule out diseases of the liver, gallbladder, pancreas, and spleen, utilizing all available Western diagnostic tools to confirm the true cause of gastric pain. Common causes of gastric pain include peptic ulcer disease, chronic atrophic gastritis, chronic superficial gastritis, chronic hypertrophic gastritis, chronic pancreatitis, chronic cholecystitis, and chronic liver diseases. In addition, conditions such as gastric perforation, acute pancreatitis, and liver abscess can also cause severe abdominal pain; if left untreated, they can be life-threatening. Once the above diagnoses for gastric pain have been confirmed, "TCM syndrome differentiation" can be carried out with much greater accuracy. Peptic ulcer disease is often accompanied by heartburn, belching, bloating, loss of appetite, fatigue, and pallor, typically indicating spleen-stomach qi deficiency; commonly used prescriptions include Xiangsha Liujunzi Tang, Huangqi Jianzhong Tang, and Liangfu Wan. Chronic atrophic gastritis often presents with burning pain in the epigastric region and thick, greasy tongue coating, usually indicating damp-heat accumulation in the lower abdomen; commonly used prescriptions include Banxia Xiexin Tang, Huanglian Tang, and Huanglian Jiedu Tang. Biliary tract diseases are often accompanied by bitter taste in the mouth, dry throat, and pain radiating to the right flank, typically indicating pathogenic invasion of Shaoyang; commonly used prescriptions include Da and Xiao Chaihu Tang, Chaihu Shugan San, Biliary Stone Expulsion Decoction, Jinqiancao, Banzhilian, and Huzhang. Pancreatic diseases often cause pain radiating to the upper left abdomen, accompanied by low back pain, loose or hard stools, and in acute attacks, severe pain—even cold extremities and weak, almost absent pulse, indicative of yang deficiency; commonly used prescriptions include Chaihu Shugan San, Danshen Yin, Jinlingzi San, Da Jianzhong Tang, Sanhuang Xiexin Tang, and Wuwei Xiaodu Yin. For gastric perforation, if it is a chronic perforation, TCM also has Huoluo Xiaoling Dan and Taohong Siwu Tang with adjustments; if it is an acute perforation and conservative treatment fails, surgical intervention should be sought immediately.

(2) Chest Pain

Conditions such as coronary heart disease, pleurisy, pulmonary inflammation, lung cancer, pleural mesothelioma, intercostal neuralgia, chronic pancreatitis, liver diseases, heart valve disease, and arrhythmia can all cause chest pain. First, the cause of chest pain must be clarified through Western diagnosis, followed by TCM syndrome differentiation. Coronary heart disease falls under the TCM category of "chest obstruction," with treatment focusing on broadening the chest, regulating qi, and dispersing depression and activating yang; commonly used prescriptions include Gualou Xiebai Banxia Tang, combined with recent integrated Western and TCM research on coronary heart disease, incorporating blood-activating and stasis-resolving drugs such as Guanxin II and Guanxin Suhé Wan. Pleurisy falls under the TCM categories of "suspended fluid" and "chest constriction," with clinical options including Zao Tang, Da Xianxiong Tang (pill), and Xiao Xianxiong Tang; some patients may have pathogenic invasion of Shaoyang, in which case Xiao Chaihu and Da Chaihu Tang with adjustments can be used. Pulmonary infections vary widely, including lobar pneumonia, bronchial pneumonia, viral pneumonia, chronic bronchitis, emphysema, cor pulmonale, bronchial asthma, and bronchiectasis. All these types of pneumonia are collectively referred to in TCM as "real fire accumulating in the lungs" and "phlegm-heat cough," requiring selection from prescriptions such as Ma Xing Shi Gan Tang, Da Qinglong Tang, Xie Bai San, and Tingli Da Zao Xie Fei Tang; if necessary, Wuwei Xiaodu Yin can be added to enhance the Qingre Jiedu effect. Inflammation of the tracheal region is either wind-heat or wind-cold, with options including Sangju Yin, Jingfang Baidu San, Su Xing San, Ma Huang Tang, and Gui Zhi Tang with Houpu Xingzi Tang. Bronchial asthma falls under the TCM categories of "lung distension" and "phlegm-asthma," requiring selection from Ma Xing Shi Gan Tang, Xiao Qinglong Tang, Su Zi Jiang Qi Tang, and Houpu Ma Huang Tang. Emphysema is related to "kidneys unable to contain qi," and if combined with infection, it becomes "upper excess, lower deficiency," with prescriptions including Su Zi Jiang Qi Tang and Du Qi Wan. Bronchiectasis can be either wind-heat or wind-cold, also falling under lung distension; if there is hemoptysis, treatment should be based on "blood heat running wild" or "qi deficiency unable to control blood." Cor pulmonale falls under the TCM category of "fluid accumulation in the heart," with treatment focusing on draining phlegm and water, calming the spirit, and using prescriptions such as Ling Gui Zhu Gan Tang, Zhen Wu Tang, and Baizi Yang Xin Tang. Intercostal neuralgia is caused by qi stagnation and blood stasis in the Shaoyang region, requiring addition of qi-regulating and blood-activating herbs to Chaihu Shugan San, or use of Fuyuan Huoxue Tang, Taohong Siwu Tang, and Huoluo Xiaoling Dan with pangolin scales, soapberry spines, frankincense, and myrrh. Chronic pancreatitis should be attributed to liver qi stagnation and liver wood overacting on earth, with prescriptions such as Chaihu Shugan San, Xiaoyao San, and Da and Xiao Jianzhong Tang; for severe pain, add Yuanhusuo and Chuanlianzǐ. Liver diseases should focus on treating the liver, with emphasis on regulating liver function; TCM syndrome differentiation still mainly focuses on liver qi stagnation and liver wood overacting on earth, with choices including Chaihu Shugan San, Danzhi Xiaoyao San, and Qianggan Tang. Additionally, as mentioned earlier, for those with significant increases in turbidity in liver function tests, heavily use Huangqi, Danshen, and Shouwu; for those with significant increases in transaminases, heavily use Gongying, Baijiang, Bailuanshe She Cao, and Banzhilian. The former is due to decreased albumin, indicating "deficiency," hence the need for tonifying treatment; the latter is due to increased transaminases, indicating "excess," hence the need for Qingre Jiedu treatment. Heart valve and arrhythmia issues are often related to "water qi overwhelming the heart," "dampness hindering yang," "blood unable to nourish the heart," and "dual deficiency of qi and blood," requiring selection from Ling Gui Zhu Gan Tang, Zhen Wu Tang, Baizi Yang Xin Tang, Zhi Gan Cao Tang, and Sheng Mai San. Lung cancer and pleural mesothelioma require early consultation with Western specialists; if the opportunity for surgery is missed, Western chemotherapy and radiation therapy will be necessary, at which point TCM can be used in conjunction with Fuzheng Guben therapy to reduce the side effects of chemotherapy and radiation.

(3) Lower Abdominal Pain

Gynecological pelvic inflammatory disease, uterine fibroids, dysmenorrhea, cystitis, bladder and urinary tract stones, bladder cancer, colonic inflammation (both non-specific and specific), and appendicitis can all cause varying degrees and natures of lower abdominal pain. First, modern medical physicochemical examinations and other diagnostic methods should be used to confirm the disease causing lower abdominal pain, followed by TCM syndrome differentiation.

Gynecological pelvic inflammatory disease, whether it is adnexitis or more widespread pelvic inflammation, is mostly classified in TCM as "damp-heat descending," and if the pain is severe, it is considered "lower-jiao blood stasis." Options include Simiao San, Wandai Tang, Qingdai Tang, Gui Zhi Fu Ling Wan, Dang Gui Shao Yao Tang, and Taohong Siwu Tang; if necessary, add Baihua She She Cao, Banzhilian, Gongying, and Baijiang as Qingre Jiedu herbs. Uterine fibroids should have treatment principles determined based on the size and location indicated by ultrasound; generally, if the diameter is within 2 cm,

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For fibroids, traditional Chinese medicine can be used to disperse them; however, if the fibroids are too large or located at the cervical os, it is advisable to promptly switch to Western medical gynecological surgery. In treating uterine fibroids with TCM, the principle follows the theory in the "Jin Gui" section on "women with pre-existing conditions," primarily using Guizhi Fuling Wan combined with Danggui Shaoyao San as the main formula, with appropriate additions of Sanleng, Ezhushi, Ruxiang, and Moyao, among others. This approach falls under the "tong yin tong yong" method, which means using blood-activating herbs to treat excessive uterine bleeding. Aside from abdominal pain during menstruation, the primary symptom of uterine fibroids is usually menorrhagia. The differentiation of dysmenorrhea still belongs to "lower-jiao blood stasis," and the treatment principle is to activate blood circulation and remove stasis. One can choose among Shao Fu Zhu Yu Tang, Xue Fu Zhu Yu Tang, Tao Hong Si Wu Tang, and Guizhi Fuling Wan. Bladder inflammation (including non-specific urinary tract infections) presents with bladder irritation symptoms such as frequent urination, urgency, and dysuria. Traditional Chinese medicine holds that "damp-heat accumulates in the bladder," so formulas like Ba Zheng San, Long Dan Xie Gan Tang, Gan Lu Xiao Du Yin, and Si Miao San are available for selection. For those with significant lower abdominal pain, Jin Ling Zi San and Shi Xiao San can be added. Colitis includes dysentery and ulcerative colitis. Traditionally, TCM treats dysentery as "damp-heat accumulating in the large intestine" and employs the "clearing heat and draining dampness" method, choosing from formulas such as Xiang Lian Wan, Shao Yao Tang, Lian Li Tang, Ge Gen Qin Lian Tang, Zhi Shi Dao Zhi Wan, and Bai Tou Weng Tang. If diagnosed as amoebic dysentery, Yadan Zi and Ku Shen can be heavily used within the aforementioned formulas. Ulcerative colitis is often considered by TCM as "Taiyin deficiency diarrhea," requiring kidney-tonifying, spleen-strengthening, and heat-clearing, dampness-draining therapies. Options include Lizhong Tang, Fuzi Lizhong Tang, Lian Li Tang, Wu Mei Wan, and He Li Le San. Appendicitis was historically called "intestinal abscess." The "Jin Ji Yao Lue" records two highly effective prescriptions: Da Huang Mu Dan Pi Tang and Yi Yi Fu Zi Bai Jiang San. Later generations have also proposed other effective drugs for appendicitis, such as Hong Teng, Xia Ku Cao, Bai Hua She She Cao, Ban Zhi Lian, and Zhu Ye Jiao, all of which can be selected for use. Urinary tract stones (including bladder stones) generally fall under the TCM categories of "shi lin" and "xue lin," with pathogenesis also involving "damp-heat descending." Treatment should focus on clearing heat and draining dampness, with options including Shi Wei San, Yu Lin San, Xiao Shi San, Ba Zheng San, and Xiao Ji Yin Zi. Bladder cancer requires early diagnosis and early Western surgical treatment; patients who miss the opportunity for surgery can undergo Western chemotherapy (including systemic chemotherapy and local bladder instillation) and radiotherapy. Traditional Chinese medicine can provide supportive treatment through tonifying and consolidating methods to reduce the side effects of chemotherapy and radiotherapy.

(4) Flank Pain

Hepatitis, liver cancer, liver abscess, hepatic hemangioma, fatty liver, cholecystitis, gallstones, gallbladder cancer, pancreatic diseases, and others can all cause flank pain. Once these diagnoses are confirmed, TCM syndrome differentiation should be performed. For hepatitis, TCM syndrome differentiation has been discussed previously: treating based on "liver qi stagnation" and "liver wood overpowers earth" often yields good results. For severe pain, Jin Ling Zi San, Ruxiang, Moyao, and Qing Chen Pi can be added. Hepatic hemangiomas are associated with liver qi stagnation and qi stagnation with blood stasis, so choices include Xiaoyao San, Xiao Chai Hu, and Chai Hu Shu Gan San, with long-term use of blood-activating and stasis-removing herbs such as Ruxiang, Moyao, Shui Zhi, Tu Bie Chong, Han San Qi, Sanleng, and Ezhushi, which can shrink the hemangioma and eliminate pain in the liver region. Fatty liver is mostly due to liver qi stagnation, with relatively few cases involving blood stasis. The disease resides in the qi level, so treatment focuses on regulating qi and soothing the liver, using Chai Hu Shu Gan San with Mu Xiang, Fo Shou, Qing Chen Pi, Mu Gua, Huang Qi, and Dan Shen. Cholecystitis and gallstones often cause each other; their pathogenesis both involves damp-heat accumulation in the liver and gallbladder—acute cases involve Shaoyang, while chronic cases involve Jueyin. For Shaoyang patterns, one can adjust formulas such as Xiao Chai Hu, Da Chai Hu, San Huang Xie Xin, and Dan Shen Yin, adding or subtracting ingredients as needed. For damp-heat-heavy cases, add Hu Zhang, Jin Qian Cao, Ban Zhi Lian, Bai Hua She She Cao, and Zao Xiu; for severe pain, add Yuan Hu, Chuan Lian Zi, Ruxiang, and Moyao. For Jueyin patterns, one can adjust formulas such as Nuan Gan Jian, Si Ni San, and Shu Gan San, adding or subtracting ingredients as needed. For jaundice, add Xiao Shi Fan Shi San; for severe pain, increase the dosage of Zhi Shi and Mu Xiang, and also add Jin Ling Zi and Yuan Hu. For damp-heat-combined cases, add Jin Qian Cao and Hu Zhang. Liver abscesses were historically called "liver boils," with symptoms of internal heat-toxin accumulation in the liver. Treatment should focus on soothing the liver, clearing fire, and detoxifying, with formulas such as Da Chai Hu, Long Dan Xie Gan, and Dang Gui Long Hui Wan being adjusted accordingly, adding Er Hua, Lian Qiao, Gong Ying, Bai Jiang, Bai Hua She She Cao, Ban Zhi Lian, and Xia Ku Cao. Once liver cancer or gallbladder cancer is confirmed, a specialist consultation with Western medicine should be sought to strive for early surgery. If surgery is no longer an option, TCM treatment can be tried. Most cases involve damp-heat accumulation in the liver and gallbladder, so treatment focuses on soothing the liver and relieving pain, clearing heat and draining dampness. Formulas remain similar to Da Xiao Chai Hu Tang, Chai Hu Shu Gan San, and Gallbladder Stone Removal Soup, with additional emphasis on Bai Hua She She Cao, Ban Zhi Lian, Hu Zhang, Zao Xiu, Gong Ying, and Bai Jiang for clearing heat and detoxifying. Chronic pancreatitis has been discussed previously; in the acute phase, besides severe flank and epigastric pain, there is also a feeling of fullness and pain from the heart down to the lower abdomen. Most cases fall under the TCM category of "large chest obstruction," requiring treatment that addresses the root cause. Options include Da Chai Hu, Da Xian Xiong, Da Cheng Qi, and Gallbladder Stone Removal Soup.

(5) Dizziness

Hypertension, cerebral arteriosclerosis, hypotension, anemia, ear-origin dizziness, neurasthenia, menopausal syndrome, intracranial tumors, and other conditions can all cause dizziness. First, confirm the Western medical diagnosis, then perform TCM syndrome differentiation, which greatly improves the accuracy of diagnosis. Hypertension is usually due to yin deficiency and yang excess, with yang excess generating wind. Treatment should focus on nourishing yin and subduing yang, calming the liver and extinguishing wind. Options include Qi Ju Di Huang Tang, Zhen Gan Xi Feng Tang, and Jian Ling Tang, with adjustments made as needed. Some cases of hypertension with yang excess show no obvious symptoms, so Zhen Wu Tang and Ling Gui Shu Gan Tang can be used instead. Cerebral arteriosclerosis is mostly due to blood stasis, so treatment should focus on activating blood circulation and removing stasis—this is what is known as "treat wind by first activating blood; once blood flows, wind naturally dissipates." Options include Xue Fu Zhu Yu Tang, Guan Xin II Hao, and Tao Hong Si Wu Tang. Hypotension is mostly due to heart-spleen deficiency or middle qi collapse, so treatment should focus on nourishing blood, strengthening the heart, and replenishing middle qi. Options include Gui Pi Tang, Bu Zhong Yi Qi Tang, and Sheng Mai San. Most cases of anemia are due to heart-spleen deficiency, heart-kidney disharmony, or qi failing to control blood. In recent years, many formulas have been developed to treat anemia, but most follow the same principles. The most commonly used formulas include Gui Pi Tang, Bu Zhong Yi Qi Tang, Liu Wei Di Huang Tang, and Xiang Sha Liu Jun Zi Tang. Based on the specific condition, choose a formula and add Tu Si Zi, Nu Zhen Zi, Gou Qi Zi, He Shou Wu, and Xian He Cao for better results. Ear-origin dizziness is mostly due to "water qi overwhelming the heart," "dampness trapping the heart's yang," "phlegm obscuring the heart's orifices," or "blood deficiency generating wind." Treatment should focus on clearing the heart, eliminating phlegm, calming the mind, promoting water metabolism, and warming yang to transform phlegm. Options include Ling Gui Shu Gan Tang, Zhen Wu Tang, Wu Ling San, and Xuan Fu Dai Zhe Tang. Neurasthenia and menopausal syndrome allow for more flexible TCM syndrome differentiation, with several types: "heart-spleen deficiency," "heart-kidney disharmony," "excessive fire," "water not nourishing wood," "yin deficiency and yang excess," "blood deficiency generating wind," "internal liver wind," and "floating yang." Options include Gui Pi Tang, Tian Wang Bu Xin Dan, Bai Zi Yang Xin Tang, Xue Fu Zhu Yu Tang, Gan Mai Da Zao Tang, Chai Hu Jia Long Gu Mu Li Tang, and Yi Gan Tang.

(“Research on the Integration of Traditional Chinese and Western Medicine,” March 1996)

Modern Research on the Concept of Zang-Xiang in Traditional Chinese Medicine

Pei Zhengxue

The theory of zang-xiang is an important component throughout the entire system of traditional Chinese medicine, and understanding zang-xiang is a required course for studying TCM. Modern research on the concept of zang-xiang is also an important avenue for integrating traditional Chinese and Western medicine. Over the past several decades, efforts to integrate the two systems have yielded numerous results, initially forming important points of convergence between the two medical traditions in terms of basic theory. It is precisely these points of convergence that have enabled TCM and Western medicine to develop a common language in academic discourse. As these points of convergence continue to increase and research on each one deepens, the two medical traditions will eventually further merge, at which point TCM will embark on a path toward comprehensive modernization.

I. Research on the Kidneys

The kidneys are the foundation of innate constitution, the source of yuan yin and yuan yang, and the basis for the yin and yang of all five viscera and six bowels. Throughout history, physicians have placed great importance on the changes and transformations of kidney yin and kidney yang, considering them crucial factors related to human health, development, growth, aging, disease, and even death. In the 1950s, Shanghai First Medical College was the first to use kidney-tonifying and yang-strengthening methods to treat six different diseases—bronchial asthma, functional uterine bleeding, and others—that, from a Western medical perspective, appeared completely unrelated—and achieved satisfactory results^①^. This revealed the essence of the traditional TCM principle of "treating different diseases with the same method." From this starting point, extensive research gradually began on the nature of the kidneys, discovering that patients with kidney yang deficiency generally had lower than normal levels of 17-hydroxycorticosteroids in their 24-hour urine, indicating a connection between the concept of kidney yang deficiency and modern medical adrenal cortex function. Subsequently, three-tiered testing methods were adopted—plasma cortisol diurnal rhythm measurement reflecting hypothalamic function, ACTH stimulation test reflecting pituitary function, and ACTH stimulation test reflecting adrenal cortex function—to comprehensively observe the functional status of the hypothalamus-pituitary-adrenal cortex axis. Through these tests on healthy individuals with kidney yin deficiency versus kidney yang deficiency, it was proven that patients with kidney yang deficiency exhibited dysfunction in the hypothalamus-pituitary-adrenal cortex axis, thus confirming that "kidney yang deficiency syndrome" has a material basis. After repeated experiments by scholars both domestically and internationally, a consistent view emerged: the TCM kidney is closely related to the modern endocrine system. Since the 1980s, the Shanghai First Medical College Institute of Integrated Traditional Chinese and Western Medicine has expanded its research to include thyroid and sex gland axis functions^②^, finding that in patients with chronic bronchitis, those with kidney yang deficiency showed normalized T levels. Additionally, a complete set of sex gland axis tests was conducted on male patients with kidney yang deficiency and sexual dysfunction^③^, revealing that patients with kidney yang deficiency had varying degrees of sex gland axis dysfunction, whereas those without kidney yang deficiency symptoms generally had normal sex gland axis function. Furthermore, sex gland axis functions were measured in elderly individuals averaging 69 years old^④^, finding that their changes were very similar to those of kidney yang deficiency patients, suggesting that the appearance of kidney yang deficiency syndrome is positively correlated with aging, with the key underlying mechanism being dysfunction in hypothalamic regulation. Thus, the exploration of the essence of kidney yang deficiency has gained more precise meaning. Guided by these theories, domestic scholars have widely used kidney-tonifying and yang-strengthening medicines to treat aging, and experimental studies have demonstrated that such medicines can enhance T-cell immune function in the elderly. At the same time, they also have a clear anti-aging effect on the sex gland axis, thereby confirming the correctness of the notion that "the aging clock is the hypothalamus." The Shanghai First Medical College Institute of Integrated Traditional Chinese and Western Medicine, following the traditional asthma treatment principle of "treat the lungs in emergencies, treat the kidneys in routine cases," formulated a kidney-tonifying and yang-warming tablet and conducted preventive kidney-tonifying treatment during the remission phase for seven batches totaling 419 asthma patients^⑤^, achieving an efficacy rate of 63.4%–75.0%, while the non-kidney-tonifying control group only achieved an efficacy rate of 14%–22.2%. Building on these results, endocrinological research was conducted, revealing that even asthma patients without clinical manifestations of kidney yang deficiency still had potential changes in the adrenal cortex axis similar to those seen in kidney yang deficiency patients. The yang-warming tablets could adjust adrenal cortex function at the microscopic level and improve asthma attacks at the macroscopic level. Additionally, the tablets also regulate the immune system and the neuroendocrine system, which may be another reason for preventing asthma attacks. Traditional Chinese medicine believes that "the kidneys store essence" and "the kidneys govern reproduction," with the kidneys storing essence in men and housing the fetus in women, indicating a close relationship between the kidneys and male and female reproductive functions. The Shanghai First Medical University Obstetrics and Gynecology Hospital treated polycystic ovary syndrome caused by ovarian dysfunction leading to ovulation disorders using a kidney-tonifying and phlegm-resolving method^⑥^, achieving an efficacy rate of 82.7%. To further explore the mechanism, a complete set of ovarian function tests was conducted on nine patients (vaginal smear eosinophil count, urine FSH bioassay, LRH stimulation test), proving that the true cause of these nine cases of ovarian dysfunction was hypothalamic dysfunction. Subsequently, nine more patients underwent dynamic hormone level measurements, further confirming that the effect of kidney-yang-strengthening medications is a comprehensive action across multiple levels—hypothalamus, pituitary, and ovaries—rather than a single effect. The Shanghai First Medical University Huashan Hospital treated 100 patients with obstructive hydronephrosis caused by ureteral stones using a yang-warming and diuretic method^⑦^, achieving a cure rate of 71%. Simultaneously, a hydronephrosis animal model was used to prove that yang-warming and diuretic medicines can increase pressure within the renal pelvis and significantly enhance peristaltic waves, whereas simple diuretics have no such effect. By measuring CAMP and norepinephrine (NA) levels in hydronephrotic kidney tissue and healthy kidney tissue separately using the animal hydronephrosis model, and then administering yang-warming and diuretic medicines, it was found that the hydronephrotic kidney had significantly higher CAMP and NA levels than the healthy kidney, with P<0.001, proving that yang-warming and diuretic medicines can influence the renal pelvis through catecholamines, stimulating activity in the renal pelvis and ureters, thereby achieving a diuretic effect. This shows that yang-warming and yang-strengthening medicines, in addition to enhancing hypothalamic, pituitary, and target gland functions, also have a clear regulatory effect on the autonomic nervous system. The Shanghai Endocrine Research Institute observed the patterns of sex hormone changes in several diseases most commonly associated with kidney yang deficiency—diabetes, coronary heart disease, sick sinus syndrome, and hypertension^⑧^—and found that the common pattern among male patients with these diseases was elevated E2, increased E2/T ratio, and a positive correlation with kidney yang deficiency. Phillips once suggested that an elevated E2/T ratio might be a risk factor for cardiovascular disease, but no corrective measures were found. After adopting kidney-tonifying therapy, symptoms of kidney deficiency improved, sex hormone changes were corrected, and specific symptoms unique to each disease also improved: blood pressure decreased in hypertension, blood sugar decreased in diabetes, chest pain lessened in coronary heart disease, and heart rate increased in sick sinus syndrome. In recent years, further research has been conducted on the relationship between sex hormone changes in female patients with diabetes, coronary heart disease, and hypertension and kidney deficiency, observing through saliva sex hormone measurements that women of childbearing age with these three diseases had varying degrees of ovarian function decline, manifested as reduced E2 and E2/T ratio—exactly the opposite of male patients. After applying the same kidney-tonifying and qi-replenishing methods as for men, the above situation also improved. This indicates that kidney deficiency is a common manifestation of hormonal imbalance in both men and women; on the other hand, it shows that as long as the kidney-tonifying and qi-replenishing methods focus on the diagnostic characteristics of kidney deficiency, they can effectively regulate hormonal imbalances in both sexes. This demonstrates that kidney-tonifying and qi-replenishing methods have a clear bidirectional regulatory effect on hormonal imbalances in men and women.

II. Research on the Spleen

The spleen is the foundation of postnatal constitution, governing middle qi and overseeing transformation and transportation, serving as the source of qi and blood production. Like the kidneys, it is crucial for human growth, development, health, and aging. The theories and doctrines concerning the spleen are an important part of the fundamental theories of TCM. In recent years, experimental research methods have been used to study the essence of the spleen, yielding promising initial results. Overall, the TCM "spleen" has the following three aspects of significance.