Ntu Ⅰ: Kev Tshawb Fawb Txog Kev Tshawb Fawb Txog Kev Tshawb Fawb Txog Kev Siv Tshuaj Hauv Suav Teb Rau Kev Tiv Thaiv Ntawm Cov Kab Mob Neurotransmitter
Mar 04, 2022
Yog xav paub ntxiv:ali.ma@wecistanche.com
Xiting Zhang, Lin Li, Ting Chen, Zuoyan Sun, Weiwei Tang, Shuang Wang, Tianqi Wang, Yi Wang, 1 thiab Han Zhang
1 Lub Tsev Kawm Ntawv ntawm Cov Tshuaj Suav Tshuaj, Tianjin University of Traditional suav tshuaj, Tianjin 300193, Suav
2 Lub Chaw Haujlwm Tseem Ceeb ntawm Pharmacology ntawm Tsob Ntoo Suav Kho Mob Formulae, Tianjin University of Traditional suav tshuaj, Ministry of Education, Tianjin 300193, Suav
Qhov no yog ib tsab xov xwm qhib nkag tau muab faib raws li Creative Commons Attribution License, uas tso cai rau kev siv tsis txwv, kev faib tawm, thiab luam tawm hauv ib qho nruab nrab uas muab cov haujlwm qub raug suav hais tias yog.
Tonic tsoos suav tshuaj yog siv dav hauv kev kho mob thiab tau muab faib ua plaub yam tshuaj tseem ceeb, uas yog, Qi-supplementing, Blood-enriching, Yin-nourishing, thiab Yang-tonifying. Neurotransmitters ua lub luag haujlwm sib koom tes hauv lub paj hlwb,kev ua haujlwm visceral, thiab kev nyuaj siab teb. Te excitation los yog suppression ntawm lub hauv paus paj hlwb muaj feem xyuam rau ntau yam kab mob, xws li insomnia, kev nyuaj siab,Alzheimer's disease, Parkinson's disease, thiab perimenopausal syndrome. Cov pov thawj ntau ntxiv qhia tau hais tias suav tshuaj ntsuab tonic thiab nws cov khoom xyaw nquag tuaj yeem ncua qhov tshwm sim thiab kev loj hlob ntawm cov kab mob no los ntawm kev hloov cov tshuaj neurotransmitters thiab lawv cov receptors, suav nrog norepinephrine (NE), serotonin (5-HT), dopamine ( DA), acetylcholine (ACh), thiab ?-aminobutyric acid (GABA). Nyob rau hauv daim ntawv tshaj tawm tam sim no, kev tshawb fawb txog kev kho mob ntawm cov kab mob neurotransmitter cuam tshuam nrog rau kev siv tshuaj tonic suav tshuaj raug tshuaj xyuas.
Nyem rau cistanche cov txiaj ntsig thiab cov kev mob tshwm sim rau tus kab mob Parkinson
1 Kev Taw Qhia
Tonic tshuaj suav tshuaj ntsuab tuaj yeem pab txhawb kev noj qab haus huv ntawm cov kab mob los ntawm kev ntxiv rau lawv lub neej. Raws li kev tshawb fawb pharmacology niaj hnub, tshuaj tonic tuaj yeem ua tauetiv thaiv kab mobmuaj peev xwm, ntxiv dag zogkev kawm thiab kev nco muaj nuj nqi, thiab tswj kev ua haujlwm ntawm endocrine ntawm cov neeg mob uas muaj kab mob tsis zoo. Interestingly, muaj lwm yam txiaj ntsig zoo, xws liantiageing[1], antioxidant[2], thiab antistress [3] cuam tshuam. Raws li nws cov nyhuv, cov tshuaj tonic muab faib ua Qi-tonifying, Ntshav-tonifying, Yin-tonifying, thiab Yang-tonifying tshuaj. Qi-tonifying tshuaj tuaj yeem ua kom lub cev visceral-Qi los kho cov kab mob sib txawv ntawm visceral-Qi deficiency [4]. Piv txwv li, qhov no tej zaum yuav muaj xws li invigorating tus po thiab ntsws kom ua rau tus po thiab ntsws. Qi-tonifying tshuaj yog siv los kho cov tshuaj sawv cev, suav nrog Radix Ginseng, Acanthopanax senticosus, Rhodiola Rosea, Astragalus, thiab Licorice. Ntshav-tonifying tshuaj [5] tsom cov ntshav thiab lub plawv tsis zoo nrog cov tshuaj xws li Radix Paeonia Alba, Angelica Sinensis, Polygonum ntau lub rooj sib tham ntiv tes xoo, thiab Radix Rehmanniae.Yin-tonifying tshuaj[6] feem ntau yog siv los kho Yinfuid thiab kho cov kab mob sib txawv ntawm Yin deficiency nrog cov tshuaj xws li Lily, Glossy Privet Fruit, thiab Eclipta alba. Tsis tas li ntawd, Yang-tonifying cov tshuaj [7] tuaj yeem pab Yang los kho txhua yam kab mob Yang deficiency. Cov tshuaj no muaj peev xwm muaj qab zib, pungent, ntsev, thiab sov zog thiab feem ntau cuam tshuam rau lub raum channel. Cov tshuaj muaj xws li Psoralea corylifolia, Morinda Officinalis,Cistanche tubulosa, Folium Epimedii, thiab Fructus Alpinia oxyphylla (saib Table 1).
Cov kev tshawb pom tsis ntev los no qhia tau hais tias cov tshuaj suav tshuaj suav tshuaj suav tshuaj tuaj yeem hloov kho cov tshuaj neurotransmitters [8], txhim kho insomnia, siv tshuaj tiv thaiv kev ntxhov siab, ncua kev txhim kho cov kab mob neurodegenerative, thiab txhim kho cov tsos mob ntawm cov poj niam. Hauv daim ntawv no, kev tshawb fawb txog kev nce qib raug tshuaj xyuas (saib Table 2).
2. Cov txheej txheem
Peb tshawb PubMed siv cov lus tseem ceeb hauv qab no: Cov kab mob ntsig txog (Kev nyuaj siab / Alzheimer'sdisease / Parkinson's disease / Perimenopausal syndrome / pw tsaug zog mob) THIAB Neurotransmitters (5-HT, DA, NE, ACh, GABA) THIAB Tonic tshuaj suav tshuaj ( Cov tshuaj sawv cev ntawm Qi supplementing, Blood-enriching, Yin-nourishing, thiab Yang-tonifying). Peb txwv peb qhov kev tshawb nrhiav rau kev kawm tsuas yog luam tawm ua lus Askiv los ntawm PubMed. Peb kuj tau tshawb nrhiav CNKI rau Suav cov lus nrog tib lo lus tseem ceeb. Lub sijhawm peb tshawb nrhiav tsis muaj kev txwv (txog tam sim no). Zuag qhia tag nrho, peb pom 155 tsab xov xwm nyob rau hauv ob lub databases, ntawm cov uas 70 tau luam tawm ua lus Askiv thiab 85 tau luam tawm nyob rau hauv Suav. 18 kab lus raug tshem tawm rau kev rov ua dua hauv cov ntsiab lus. Raws li kev piav qhia ntawm cov ntsiab lus xws li Qi, ntshav, Yin, Yang, thiab cov khoom siv zoo ntawm cov tshuaj suav tshuaj tonic, thaum kawg peb pom 33 hom ntawv Suav thiab 44 hom ntawv Askiv.
Raws li Suav Materia Medica thiab Clinical common tshuaj, peb xaiv cov tshuaj sawv cev hauv qab no ntawm cov tshuaj suav tshuaj tonic. (1) Qi-supplementing: Radix Ginseng, Acanthopanax senticosus, Rhodiola Rosea, Astragalus, thiab Licorice; (2) Cov ntshav ua kom zoo: Radix Paeonia Alba, Angelica Sinensis, Polygonum multiform ntiv tes xoo, thiab Radix Rehmanniae; (3) Yin-nourishing: Lily, Glossy privet txiv hmab txiv ntoo, thiab Eclipta alba; (4) Yang-tonifying: Psoralea corylifolia, Morinda Officinalis,Cistanche tubulosa, Folium Epimedii, thiab Fructus Alpinia oxyphylla.
3. Kev sib raug zoo ntawm Qi, Ntshav, Yin, Yang, thiab Neurotransmitters
Yin thiab Yang yog ob yam khoom hauv tib neeg lub cev zoo sib xws thiab lawv cov cim ua haujlwm [9]. Yang hais txog kev sov siab, kev zoo siab, kev txhawb zog, thiab lwm yam, thaum Yin hais txog kev txhawb nqa, moistening, inhibiting, thiab lwm yam. Yin thiab Yang sawv tawm tsam ib leeg, tuaj yeem hloov mus rau ib leeg, thiab tso siab rau ib leeg los ntawm kev ua haujlwm hauv kev sib npaug. Kev ua haujlwm hauv kev sib npaug txhais tau hais tias Yin thiab Yang muaj qhov sib npaug ntawm kev loj hlob thiab kev poob qis thiab tswj kom muaj kev sib npaug ntawm kev hloov pauv ntawm kev loj hlob thiab poob [10]. Yog tias ob sab yuav txo qis lossis tsis txaus, sab nraud yuav raug txo lossis tsis muaj zog [11]
Qi yog lub zog hloov maj mam uas tsim los ntawm tib neeg lub cev thiab txhawb nqa kev ua neej [12]. Ntshav yog ib qho khoom noj khoom haus uas khiav hauv cov hlab ntsha thiab ncig thoob plaws lub cev. Nws yog ib qho ntawm cov khoom tseem ceeb uas suav nrog tib neeg lub cev thiab txhawb nqa kev ua neej nyob. Qi thiab ntshav tuaj yeem hloov mus rau ib leeg; uas yog, Qi tuaj yeem tsim cov ntshav, thiab rov ua dua. Ntshav tsis txaus yuav ua rau Qi tsis txaus thiab tuaj yeem ua rau lub hlwb poob qis, tsis nco qab, insomnia, chim siab, tsis muaj peev xwm, thiab lwm yam tsos mob [13].
Los ntawm cov khoom ntawm Yin thiab Yang, peb tuaj yeem txiav txim siab tias Qi muaj cov khoom ntawm Yang, nquag thiab sov, thaum cov ntshav muaj cov khoom ntawm Yin, zoo li qub thiab moistening. Lawv vam khom rau ib leeg los txhawb thiab txhawb kev ua neej [14].
Kev sib txuas ntawm Qi, ntshav, Yin thiab Yang yog tiav los ntawm meridians [15]. Meridians yog cov channel uas Qi thiab ntshav txuas rau hauv nruab nrog cev, qhov chaw ntawm lub cev, thiab lub cev. Nws ua haujlwm raws li kev tswj hwm ntawm tib neeg lub cev ua haujlwm los ntawm kev thauj Qi thiab ntshav mus rau tag nrho lub cev thiab txhawb cov ntaub so ntswg thiab kabmob. Lub caij no, meridians muaj qhov zoo sib xws ntawm lub cev ua haujlwm rau lub paj hlwb. Meridian, neuroendocrine neurotransmitters, thiab receptors yog sib txuas zoo. Nws tau lees paub tias cov paj hlwb, cov hlwb mast, calcium, adrenergic neurotransmitters, thiab lwm yam tshuaj muaj feem xyuam rau kev tswj hwm meridian. Raws li Chang et al. [16], lub hauv paus ntawm kev ua haujlwm meridian yog qhov ua kom muaj zog nrog kev koom tes ntawm cerebral cortex thiab ntau tus kws tshawb fawb tau tshawb pom tias muaj qhov tshwm sim ntawm neurotransmitter enrichments nyob rau hauv meridian sensing cheeb tsam.
Piv txwv li, nyob rau hauv txoj kev tshawb no ntawm meridian acupuncture cov ntsiab lus, Omura [17] pom tias feem ntau cov ntsiab lus muaj enriched neurotransmitters thiab cov tshuaj hormones, xws li acetylcholine, norepinephrine, adrenocorticotropic hormone, 5-HT, thiab ?- GABA. Thaum lub sij hawm txoj kev tshawb fawb ntawm cov teeb liab conduction nyob rau hauv acupuncture, Liu cov kev tshawb fawb pab pawg pom tau hais tias acupuncture tso cai rau meridians tso norepinephrine, epinephrine, thiab lwm yam catecholamines raws ntawm daim tawv nqaij thiab hais tias lawv cov ntsiab lus yog ntau dua li tsis-acupuncture meridians [18, 19]. Qhov tsis muaj zog ntawm Qi, Ntshav, Yin, thiab Yang tuaj yeem cuam tshuam rau neurotransmitters los ntawm meridians.
4. Kev sib raug zoo ntawm Tonic Traditional suav tshuaj thiab Neurotransmitter ntsig txog kab mob
4.1. Kev nyuaj siab.
Kev nyuaj siab yog txhais raws li kev puas siab puas ntsws uas tshwm sim los ntawm psychomotor retardation, xws li kev xav qeeb, nrog rau kev tsis txaus siab thiab kev pib. Cov kev tshawb fawb tsis ntev los no tau pom tias qhov tsis txaus ntawm cov neurotransmitters hauv qab no cuam tshuam nrog qhov pib ntawm kev nyuaj siab: 5-HT, DA, NE, Ach, thiab GABA [20]. Qhov tseem ceeb, feem ntau cov tshuaj tiv thaiv kev ntxhov siab tawm dag zog los ntawm kev nce qib ntawm cov neurotransmitters nyob ntawm synapses.
Kev nyuaj siab yog nyob rau hauv qeb ntawm "melancholia" hauv Suav Tshuaj. Melancholia yog ib hom tshuaj suav tshuaj uas tshwm sim los ntawm kev tsis xis nyob thiab Qi-stagnation [21]. Suav tshuaj muaj kev paub dav dav hauv kev tiv thaiv thiab kho kev nyuaj siab. Piv txwv li, cov tshuaj no ua rau lub siab, tus po, lub raum, thiab lub plawv, tab sis kuj ua rau lub siab ntsiag to thiab. Txawm li cas los xij, kev sib xyaw ntawm cov tshuaj no nrog kev ua haujlwm antidepressant yog ib qho kev txhawj xeeb thoob plaws.
Tus qauv mob hnyav tsis paub txog kev ntxhov siab (CMUS) yog ib txoj hauv kev zoo tshaj plaws rau kev kawm kev nyuaj siab [22]. Nws yog feem ntau siv rau kev tshuaj ntsuam xyuas ntawm cov tshuaj tiv thaiv kev ntxhov siab thiab cov kab mob pathophysiology ntawm kev nyuaj siab.
Cov kev sim ua luam dej yuam kev (FST) thiab qhov ntsuas qhov kev ncua (TST) yog cov qauv tsim zoo rau kev kawm kev nyuaj siab hauv cov tsiaj [23, 24]. Nyob rau hauv lub frontal cortex thiab hippocampus, FST tau soj ntsuam los qhia qhov txo qis hauv 5-HT qib nrog kev hloov me ntsis hauv 5-HIAA qib, ua rau muaj kev nce siab hauv 5-HIAA/{ {6}}HT ratio [25].
4.2. Alzheimer's Disease (AD)
Alzheimer's disease (AD) yog ib qho kab mob tsis txaus ntseeg thiab ua rau cov kab mob neurodegenerative uas cuam tshuam rau lub paj hlwb. Nws yog tus cwj pwm los ntawm kev dementia thiab suav nrog kev tsis nco qab, aphasia, thiab kev ua haujlwm tsis zoo. NE, DA, 5-HT, thiab cholinergic transmitter ACh yog cov neurotransmitters tseem ceeb hauv lub hlwb. Ntawm lawv, choline acetyltransferase (ChAT) yog ib qho tseem ceeb enzyme nyob rau hauv lub synthesis ntawm Ach [26], thiab AchE yog ib qho tseem ceeb enzyme nyob rau hauv degradation ntawm ACh. Kev kho mob Acetylcholinesterase inhibitor (AChEI) yog ib txoj hauv kev siv ntau zaus hauv kev kho AD [27]. Ob qho CAT thiab AchE cov dej num muaj kev sib raug zoo nrog ACH cov ntsiab lus hauv lub hlwb. Lawv tswj hwm qhov sib npaug ntawm ACH thiab ua lub luag haujlwm tseem ceeb hauv kev tswj hwm kev txawj ntse. Kev txo qis hauv cov neurotransmitters tuaj yeem ua rau muaj kev ntxhov siab senile. Tshwj xeeb tshaj yog, cov kev tshawb fawb qhia tau hais tias NE modulates cortex los ntawm axons thiab muaj kev cuam tshuam dav rau kev xav, kev txawj ntse, thiab kev txav mus los [28]. DA tau pom tias txo qis oxidative kev nyuaj siab, ua kom cov ntshav ntws mus rau lub hlwb, thiab koom tes nrog NE los tswj lub cev excitability. Tsis tas li ntawd, 5-HT modulates central cholinergic paj hlwb kev ua si los ntawm kev tswj cov kev tso tawm ntawm Ach nyob rau hauv lub hlwb cov ntaub so ntswg, uas yog ib qho tseem ceeb neurotransmitter rau kev sib haum xeeb txawj ntse. Qhov txo qis ntawm Ach cov ntsiab lus tau pom zoo kom muaj feem cuam tshuam nrog qhov mob hnyav ntawm cov tsos mob ntawm AD [29].
Nyob rau lub sijhawm tsis ntev los no, cov tshuaj niaj hnub tseem tsis tau tsim kev tiv thaiv thiab kho rau AD. Los ntawm qhov sib txawv, cov tshuaj suav tshuaj muaj qhov tshwj xeeb zoo vim tias nws muaj kev cuam tshuam los ntawm ntau lub hom phiaj thiab txoj hauv kev. Nws tuav lub tswv yim tias AD belongs rau qeb ntawm dementia. Txawm hais tias lub hauv paus pathogenesis yog cov tsos mob tshwm sim los ntawm asthenia, lub raum vacuity thiab pob txha depletion yog lub hauv paus ntawm tus kab mob [30]. Hauv qhov no, cov tshuaj suav tshuaj suav tshuaj tonic tuaj yeem pab txhim kho AD cov tsos mob. Ntau cov ntawv ceeb toom los ntawm kev sim ntawm tes thiab tsiaj txhu pom tias ?-amyloid (A?) yog cov protein tseem ceeb hauv cov neeg mob AD. Te A? fragment peptide 1–42 (A? 1–42) induced neuronal puas thiab apoptosis ntawm oxidative kev nyuaj siab nyob rau hauv vitro [31, 32]. Ib? 25–35 pom zoo ib yam li thaum ntxov neurotropic thiab lig neurotoxic kev ua ub no li A? [33]. Yog li ntawd, A? 1–42 thiab A? 25-35 feem ntau yog siv los ua qauv qauv.
4.3. Parkinson's Disease (PD).
Parkinson's disease (PD) yog lwm hom kab mob neurodegenerative uas muaj feem cuam tshuam los ntawm kev txav mus los. Nws yog ib qho nyuaj thiab tsis to taub pathogenesis, nrog rau cov tsos mob tshwm sim los ntawm tremor, slowness ntawm txav, thiab postural instability tshwm sim los ntawm ntau yam. Qhov kev hloov pauv tseem ceeb tshaj plaws ntawm tus kab mob yog qhov txo qis hauv DA qib hauv lub hlwb. Tyrosine hydroxylase (TH) yog tus nqi-limiting enzyme lub luag hauj lwm rau catalyzing hloov ntawm cov amino acid L-tyrosine rau L-3, 4-dihydroxyphenylalanine (L-DOPA) [34]. L DOPA yog ib qho precursor rau neurotransmitter DA. DA tau muab faib ua cov metabolites los ntawm pawg enzymes-monoamine oxidase (MAO) thiab catechol-O-methyl transferase (COMT). Cov khoom kawg ntawm DA metabolism yog DOPAC thiab HVA, ob qho tib si tuaj yeem siv los ua qhov taw qhia rau kev hloov pauv ntawm DA cov ntsiab lus hauv lub hlwb [35].
Cov tshuaj suav tshuaj suav suav txhais tau tias PD yog ib pawg ntawm cov kab mob, xws li tuag tes tuag taw agitans, cov kab mob tseem ceeb uas cuam tshuam nrog lub siab thiab lub raum. Yog li ntawd, kev siv cov tshuaj suav tshuaj ntsuab tuaj yeem pab txhim kho thiab ncua cov tsos mob ntawm tus kab mob.
4.4. Kev pw tsaug zog.
Insomnia yog ib qho teeb meem pw tsaug zog uas pw tsaug zog zoo tsis tuaj yeem ua tau raws li tus neeg xav tau ntawm lub cev, ua rau qaug zog, tsis muaj kev saib xyuas, thiab kev lag luam hauv lub hlwb. Kev pw tsaug zog ntev ntev yuav ua rau muaj kev phom sij rau tib neeg lub cev thiab lub siab lub ntsws thiab tuaj yeem ua rau ntau lub cev tsis ua haujlwm thiab lub cev tsis muaj zog uas cuam tshuam nrog kev kub siab, ntshav qab zib, thiab lwm yam kev puas hlwb. Kev ua haujlwm tsis zoo ntawm cov neurotransmitters xws li 5-HT thiab DA muaj kev sib txuas nrog insomnia. Raws li kev tshawb xav ntawm cov tshuaj suav tshuaj, palpitations, tsis nco qab, insomnia, thiab nkees feem ntau yog deficiency syndromes. Nws yog ib advisable mus tonify lub paj hlwb thiab tranquilize lub siab los ntawm tonifying tsoos suav tshuaj ntsuab tshuaj.
GABA yog qhov tseem ceeb inhibitory neurotransmitter hauv CNS thiab yog qhov tseem ceeb rau kev kho kom haum xeeb tag nrho ntawm neuronal excitation thiab inhibition [36]. Lub hom phiaj molecular ntawm cov nroj tsuag tshuaj nrog sedative-hypnotic kev ua ub no koom nrog benzodiazepine site ntawm GABAA (GABAA-BZD) receptor. GABAergic neurotransmission ua lub luag haujlwm tseem ceeb hauv kev tswj kev pw tsaug zog, thiab BZD khi qhov chaw ntawm GABAA receptor yog lub hom phiaj rau feem ntau sedative-hypnotics [37]. BZD cov neeg ua haujlwm, xws li diazepam, tuaj yeem txhawb nqa lub peev xwm ntawm GABA los ua kom muaj qhov sib txawv ntawm daim nyias nyias los ntawm kev tso cai rau Cl- influx.
4.5. Perimenopausal Syndrome.
Cov kab mob perimenopausal yog ib qho ntawm cov tsos mob uas tshwm sim los ntawm kev ua haujlwm tsis zoo los ntawm kev ua haujlwm ntawm zes qe menyuam thiab qhov txo qis ntawm cov tshuaj estrogen hauv cov poj niam thaum lub sij hawm thiab nyob ib puag ncig cov poj niam. Lub zes qe menyuam ua haujlwm tsis zoo, qhov tsis txaus ntseeg ntawm hypothalamus pituitary-gonadal axis, kev tsis sib haum xeeb ntawm kev sib deev hormone secretion, thiab kev ua haujlwm ntawm lub paj hlwb tsis zoo hauv cov poj niam perimenopausal tuaj yeem cuam tshuam rau NE, DA, thiab 5-HT qib hauv hypothalamus [38]. Qhov no, nyob rau hauv lem, yuav ua rau kub flashes, tawm hws, chim siab, insomnia, thiab lwm yam tsos mob. NE thiab DA yog ob lub neurotransmitters nrog kev ua haujlwm dav hauv lub hlwb thiab tuaj yeem tswj hwm kev ua haujlwm ntawm ntau lub paj hlwb thiab kho qhov ua siab ntev ntawm nruab nrab thiab peripheral sympathetic qab haus huv. Raws li ib qho tseem ceeb neurotransmitter nyob rau hauv lub hlwb txo qis 5-HT theem tuaj yeem txo cov impulses tso tawm los ntawm lub cev kub tswj chaw, yog li pab tswj cov zaus thiab amplitude ntawm kub fashes tus sawv cev ntawm menopausal syndrome (MPS). MPS tuaj yeem txhim kho rau qee qhov ntawm kev hloov kho thiab kev cuam tshuam ntawm cov lus hais saum toj no cov kab mob neuroendocrine. Kev tshem tawm ob sab ntawm zes qe menyuam ntawm poj niam nas yog txoj hauv kev tseem ceeb siv rau kev simulation ntawm MPS. Piv txwv li, cov kev tshawb fawb tau pom tias qib ntawm DA, NE, 5-HT, thiab 5-HIAA hauv hypothalamus tau nce ntau hauv cov nas ovariectomized piv nrog cov nas hauv pawg tswj hwm [39–41].
Los ntawm txoj kev xav ntawm cov tshuaj suav tshuaj suav tshuaj, perimenopausal syndrome yog tus cwj pwm los ntawm lub raum tsis zoo, txawm hais tias kev ua haujlwm tsis zoo ntawm daim siab, spleen, thiab lub plawv kuj tshwm sim [42]. Tshwj xeeb tshaj yog, txoj kev xav ntawm kev sib txawv ntawm kev sib txawv yog ib qho tseem ceeb ntawm cov tshuaj suav tshuaj. Raws li qhov kev xav no, tsis yog tsuas yog cov xwm txheej ntawm lub raum tseem ceeb tab sis kuj yog qhov xwm txheej ntawm plaub lub cev tseem ceeb hauv kev ua ke nrog cov xwm txheej ntawm tsib lub hauv nruab nrog cev yog qhov tseem ceeb vim qhov no qhia qhov nyuaj ntawm kev hloov pauv pathological. Cov tshuaj rau tonifying deficiency tau pom tias ua tau zoo nyob rau hauv kev kho mob ntawm perimenopausal syndrome.
