In traditional Chinese medicine (TCM), ischemic stroke belongs to the category of "apoplexy". Brain orifices confused by phlegm is one of the core pathogeneses of apoplexy, and phlegm is an essential pathological factor; however, its modern biological basis remains unclear. As the most lipid-rich organ in the human body, lipids play a pivotal role in maintaining its structure and function. Intracerebral lipid metabolism disorders, such as dysregulation of cholesteraol and phospholipids, may occur in the acute phase of ischemic stroke and can further induce neuroinflammation. From the perspective of TCM, post-stroke phlegm obstructs the clear orifices, leading to obstruction of the clear orifices and dysfunction of the mind. Although these two perspectives differ, they share an intrinsic connection. Our team believes that after stroke, the three pathological factors of phlegm, heat, and blood stasis interact with each other: phlegm can aggravate heat and promote blood stasi; phlegm, heat, and blood stasis block the cerebral collaterals and cloud the clear orifices, which jointly drive the occurrence and development of the spirit orifices confused by phlegm. The disorder of lipid metabolism in the brain induces the formation of lipid droplets in the brain, and the abnormal lipid metabolism drives neuroinflammation, lipid accumulation and inflammatory chemotaxis to stimulate the formation of microthrombosis. Therefore, this paper proposes the pathological mechanism of the spirit orifices confused by phlegm in ischemic stroke, which includes not only lipid metabolism disorder in the brain after ischemic stroke, but also neuroinflammation and microthrombosis driven by such cerebral lipid metabolic disturbance. The purpose of this article is to provide a modern perspective for brain orifices confused by phlegm, and lay a foundation for clinical practice and theoretical innovation of ischemic stroke from the perspective of clearing heat and resolving phlegm.

PM_2.5-induced lung injury has emerged as a major public health concern. Western medicine currently lacks targeted curative approaches, whereas existing research in traditional Chinese medicine (TCM) has focused primarily on localized pathological mechanisms of the lung, with insufficient attention paid to the holistic perspective of meridian-qi-blood circulation. The classical theory of "lung failure in dispersion and descent" is limited to describing abnormalities in the rhythmic flow of qi, thus failing to encompass the complex pathological state of this disease. Consequently, drawing on the qi pathway theory and considering the composite pathogenic characteristics of PM_2.5, which encompasses wind, cold, dampness, turbidity, and toxicity, this paper systematically elucidates the core pathogenesis of PM_2.5-induced lung injury as "obstruction of the thoracic qi pathway by turbid toxins." This disruption leads to impaired pivoting movement of qi dynamics, subsequently inducing metabolic disorders of qi, blood, and body fluids, as well as lung-collateral damage. The disease progression evolves through three distinct stages: "qi pathway obstruction-pivoting dysfunction-systemic involvement." Jingfang Baidu Powder, through its precisely balanced composition of sovereign, minister, assistant, and envoy herbs, establishes a comprehensive therapeutic system aimed at "unblocking the pathway and restoring pivoting movement of qi." This offers a novel theoretical framework for the TCM-based diagnosis and treatment of PM_2.5-related lung diseases, while also expanding the modern application of classical formulations.

Traditional Chinese medicine (TCM) syndrome is an integral and essential component of TCM theory, and goes beyond philosophic concepts. This article reviews the concept of TCM syndromes and summarizes research findings on the biologic foundation of syndromes. In addition, insight is provided into the promotion of standardization of syndrome classification by enforcing uniformity of TCM terminology, applying standardized diagnostic criteria and operating procedures to minimize subjective effects. Also incorporating interdisciplinary approaches such as data mining and structure modeling, as well as integrating findings on biomarker research are discussed. Consideration is made of the fundamental TCM aspects of syndrome elements, symptoms, phenotypic features, as well as diseases, to form an integral process in the diagnostic path. We believe that better understanding of the biologic basis of the TCM syndrome and standardization of syndrome classification will improve diagnosis, which in turn will enhance therapeutic efficacy and disease prognosis.