2. Liver-Yang Excess

2. Liver-Yang Excess

According to traditional TCM theory, "liver-yang excess" represents the reverse pathological change of "liver-qi stagnation"—the former involves "excess energy but insufficient substance," while the latter involves "excess substance but insufficient energy." Domestic researchers have observed the autonomic nervous system function in patients with liver-yang excess, examining micro-level indicators such as changes in plasma cyclic nucleotides, red blood cell intracellular nucleotide content, plasma atrial natriuretic peptide levels, and whole-blood trace element variations. The results suggest that the neural–humoral regulation in cases of liver-yang excess is highly complex. First, this condition may primarily result from enhanced peripheral sympathetic–adrenal medulla activity: ① Autonomic nervous system dysfunction, with sympathetic overactivity accounting for 69.8%; ② Urinary CA, NE, E, and TMN levels reflecting peripheral sympathetic–adrenal medulla function all increase; ③ Central NE metabolite urinary MHPG levels decrease; ④ Plasma CAMP and CGMP levels rise, with CGMP increasing more prominently, leading to a declining CAMP/CGMP ratio; ⑤ Plasma T×B2, 6K---PGF levels rise, along with an increased ratio; ⑥ Red blood cell ATP, ADP, and NADP levels increase.

It is currently widely accepted that during sympathetic nervous system excitation, NE release increases, binding to β-receptors on cell membranes and activating adenylate cyclase (CAMP---ase), thereby raising intracellular CAMP levels and increasing plasma CAMP concentrations. Catecholamines can also bind to α-receptors, enhancing guanylate cyclase (CGMP---ase) activity and causing CGMP levels to rise. Prostaglandins (PG) can activate CAMP---ase activity in many tissues, increasing CAMP concentration and disrupting the balance of T×B2---6K---PGF12 levels, potentially affecting key steps in nucleotide metabolism. CA promotes metabolic processes and enhances energy mobilization. Increased energy metabolism may be an important manifestation of excessive sympathetic–adrenal medulla function.

IV. Research on the Heart

The heart is one of the five zang organs. The "Plain Questions" states: "The heart is the sovereign organ, where divine spirit originates"; the "Spiritual Pivot" says: "The heart is the master of the five zang and six fu organs," and "When the heart beats, all five zang organs tremble." The "Spiritual Pivot" further notes: "What constitutes the divine spirit... When divine spirit resides in the heart, soul and spirit are fully present, thus forming a human being." The heart's primary functions can be summarized as two: first, serving as the master of the five zang and six fu organs; second, being the source of divine spirit. In recent years, experimental research in this area has been relatively limited, with most studies relying on existing experimental evidence for reference and explanation. Foreign researchers have conducted systematic studies on the mechanism of placebo effects, discovering that placebos produce different effects depending on linguistic induction. Under these circumstances, subcutaneous atropine injection can increase secretions, saline can activate adrenal cortical function, while placebos may reduce serum lipoproteins and peripheral eosinophil counts. These experiments demonstrate that cognitive and conscious activities governed by the cerebral cortex can alter the normal functions of various organs, causing typical drug responses to behave abnormally. Thinking and consciousness fall under the TCM concept of "shen," which is governed by the heart, thus validating the TCM theory that "the heart is the master of the five zang and six fu organs." Soviet renowned physiologist Bekov and his colleagues believed that countless interoceptors exist throughout the body's organs and tissues, playing an indispensable role in maintaining homeostasis—for example, muscle receptors are crucial for coordination during movement, while gastrointestinal receptors regulate digestive organ activity. All these receptors function via sympathetic and parasympathetic pathways, controlled by the central nervous system. The central nervous system, in turn, falls under the TCM concept of "the heart governs divine spirit." Many studies have been conducted on the functions of the hypothalamus, brainstem, and autonomic nervous system. When the hypothalamus is stimulated, numerous functions across different organs undergo noticeable changes, including body temperature, respiration, heartbeat, sleep, sugar and fat metabolism, and endocrine functions. It has now been proven that the anterior and medial parts of the hypothalamus—including the suprachiasmatic nucleus, preoptic area, and gray tubercle region—control parasympathetic activity; stimulating these areas enhances parasympathetic function, resulting in slower heart rate, vasodilation, and increased smooth muscle tone. Conversely, the posterior and lateral parts of the hypothalamus control sympathetic activity; stimulating these areas boosts sympathetic function, leading to pupil dilation, piloerection, faster heartbeat, increased blood pressure, and deeper, faster breathing. Modern psychology views emotions and feelings as a form of reaction to real-life situations: when reality aligns with the body's needs, emotions and feelings typically manifest as joy, satisfaction, and love; when reality does not meet the body's needs, dissatisfaction, pain, fear, hatred, and anger arise. The former are positive emotions and feelings, while the latter are negative. Positive emotions and feelings enhance organ function, whereas negative ones inhibit it. Thus, people generally consider mood (emotions and feelings) to be a critical factor influencing the normal functioning of various bodily systems. Mood can be regulated through personal cultivation and moral orientation, so the directing role of the cerebral cortex extends to regulating various body departments. These emotional and feeling-based moods, along with cultivation and moral orientation, all fall under the TCM concept of "the heart governs divine spirit," impacting various body systems under the broader notion of "the heart is the master of the five zang and six fu organs." In summary, most of the heart's functions in TCM overlap with modern neuroscience; however, from the perspective of "the heart governs blood circulation," it also shares similarities with the modern heart. Domestic researchers have used C×Z---Ⅰ type ultrasonic cardiovascular diagnostic equipment to conduct preliminary observations on left ventricular systolic and diastolic function in individuals with heart qi deficiency, heart yin deficiency, and blood stasis. They found that in cases of heart qi deficiency, the mean value of the mitral valve–interventricular septum distance (EPSS) increases, while the mitral valve amplitude (CHE), cardiac output (SV), average left ventricular posterior wall contraction speed (MPMVS), average left ventricular posterior wall diastolic speed (MPWVD), ventricular wall thickening rate (ΔT%), EF slope (MVV), and the ratio of rapid filling phase left ventricular posterior wall motion total amplitude (R) to total left ventricular posterior wall motion amplitude (RPWE) all decrease. In cases of heart yin deficiency, besides the increased EPSS mean value, the diastolic function indicator MVV also decreases significantly. Comparing heart yin deficiency with heart qi deficiency, aside from the common reduction in EPSS mean value, other indicators show reductions in heart qi deficiency but not in heart yin deficiency, with statistically significant differences between the two. For blood stasis, the SV and MPWVD mean values decrease, as do CHE and ΔT%; meanwhile, the MVV and R/PWE mean values decline, while the EPSS mean value increases. These experimental studies demonstrate that heart qi deficiency, heart yin deficiency, and blood stasis in TCM are all closely related to cardiac contractile function, while also highlighting their shared and distinct essential aspects in terms of cardiac function, thereby providing a material basis for understanding the traditional pathogenesis of heart qi deficiency, heart yin deficiency, and blood stasis in TCM. Additionally, some researchers have observed the cardiac contraction time interval (STI) in coronary heart disease patients with heart qi deficiency, finding that in these patients, the electromechanical contraction time (QS2) is prolonged, the left ventricular ejection time (LVET) is shortened, the pre-ejection period (PEP) is extended, and the PEP/LVET ratio increases, indicating a close relationship between heart qi deficiency and left ventricular function. They use the PEP/LVET ratio—the most sensitive and reliable indicator of left ventricular function—as a standard, setting the upper limit of normal at 0.37; any value exceeding this threshold is considered abnormal left ventricular function. Statistical results show that the abnormal rate among coronary heart disease patients with heart qi deficiency is 94.7%, while for those with both heart qi and yin deficiency it is 91.7%; no abnormalities were found among other coronary heart disease patients. Furthermore, myocardial imaging has confirmed left ventricular dysfunction in patients with heart qi deficiency. Other studies have examined the left ventricular contraction time interval in 95 patients with different syndrome classifications, concluding that cardiac dysfunction, reduced cardiac output, and inadequate systemic blood perfusion are the pathological foundations of heart qi deficiency.

V. Research on the Lung

The lung is the "canopy" of the five zang and six fu organs. The lung governs qi, controls respiration, interacts with the skin and hair, and is internally connected to the large intestine. Based on the above discussion, the TCM lung possesses both the modern medical lung's meaning and functions that modern medicine lacks. Beyond respiratory function, concepts such as "the lung governs qi," "the lung interacts with the skin and hair," and "the lung is internally connected to the large intestine" are all core components of TCM organology. In recent years, researchers have conducted several experimental studies to explore the essence of these concepts, though the results remain preliminary, they nonetheless indicate that the TCM lung's functions are grounded in material reality.