• <tr id="yyy80"></tr>
  • <sup id="yyy80"></sup>
  • <tfoot id="yyy80"><noscript id="yyy80"></noscript></tfoot>
  • 99热精品在线国产_美女午夜性视频免费_国产精品国产高清国产av_av欧美777_自拍偷自拍亚洲精品老妇_亚洲熟女精品中文字幕_www日本黄色视频网_国产精品野战在线观看 ?

    Intra-set correlation analysis of medical records of thyroid cancer treated by traditional Chinese medicine Master ZHOU Zhongying

    2022-07-02 07:46:18XUZiyunZHUYoLUMingZHOUZhongying
    Digital Chinese Medicine 2022年2期
    關(guān)鍵詞:癭瘤沙參正宗

    XU Ziyun,ZHU Yo*,LU Ming,b,ZHOU Zhongying*

    a. The First Clinical Medical College,Nanjing University of Chinese Medicine,Nanjing,Jiangsu 210023,China

    b. Data Mining Center,Medchitec Co.,Ltd.,Nanjing,Jiangsu 210009,China

    ABSTRACT Objective Based on intra-set correlation analysis,this paper deconstructs the clinical medical records of traditional Chinese medicine (TCM) Master ZHOU Zhongying in treating thyroid cancer,and analyzes the experience in “mechanism-syndrome-medicine-prescription” for thyroid cancer.Methods Through Medcase data processing platform,based on Frequent Pattern (FP)-Growth enhanced correlation analysis algorithm,the medical records of Professor ZHOU Zhongying for the treatment of thyroid cancer from June 1,2001 to February 28,2015 were analyzed within the set.Results This study involved 43 medical records,43 patients,and 167 visits. After processing intra-set correlations,28 groups of highly correlated symptoms,21 groups of highly correlated tongue images,10 groups of highly correlated pulse conditions,28 groups of highly correlated pathogenesis,34 groups of highly correlated herbs,and 26 groups of highly correlated western medicine diagnosis were selected. Professor ZHOU Zhongying treats thyroid cancer according to syndrome differentiation. Symptoms with more association rules included neck swelling,neck pain,cough,and dry mouth; tongue images with more association rules included dark purple tongue,dark red tongue,and fissured tongue; pulse conditions with more association rules were wiry pulse,thready pulse,small pulse,and slippery pulse; the pathogenesis with more association rules was phlegm and blood stasis,damp-heat accumulation,and impairment of both Qi and Yin; herbs with more association rules were Chaihu (Bupleuri Radix),Zeqi (Sun Euphoribiae Herb),and Tiandong (Asparagi Radix); western medicine diagnosis with more association rules included thyroid cancer,insomnia,and chronic gastritis.Conclusion Thyroid cancer mostly presents as deficiency in origin and excess in manifestations. The basic pathogenesis is phlegm and blood stasis,damp-heat accumulation,and impairment of both Qi and Yin,which are closely related to liver,kidney,and spleen. Professor ZHOU Zhongying adopts both attack and supplement approaches as the general treatment principle,with a strong emphasis on regulating Qi and relieving depression,eliminating phlegm and resolving stagnation,eliminating dampness and turbidity,clearing fire and destroying poison,moistening dryness and softening hard mass,invigorating Qi and nourishing Yin,and paying attention to nourishing liver and kidney,invigorating spleen and stomach,while protecting the heart and lungs.

    Keywords Traditional Chinese medicine Master ZHOU Zhongying Thyroid cancer Empirical analysis Data mining Intra-set association Phlegm and blood stasis Damp-heat accumulation Combination of attack and supplement

    1 Introduction

    Thyroid carcinoma is the most common tumor disease of the endocrine system,and can be divided into papillary carcinoma,follicular carcinoma,and medullary carcinoma,according to the pathology,90% of which are papillary carcinoma and follicular carcinoma[1]. According to the International Agency for Research on Cancer,the incidence of thyroid cancer ranks eleventh in the world,with 586 202 new cases in 2020[2]. It is the fifth most common cancer in women[3]. Ancient physicians thought that emotional factors were the main etiology[4],while modern medicine views that its carcinogenic mechanism is related to mitogen-activated protein kinase (MAPK)pathway,phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/Akt/mTOR)pathway,or vascular endothelial growth factor (VEGF)[5].In terms of treatment,thyroid cancer is still mainly resected by surgery,but there are many complications after operation[1]. Traditional Chinese medicine (TCM) is effective in relieving postoperative adverse reactions and improving patients’ quality of life. Professor ZHOU Zhongying,a TCM Master,has profound attainments in Qihuang’s skills. His lofty medical ethics and superb medical skills have been widely recognized in the fields of Chinese medicine,both locally and abroad. Having more than 60 years of medical practice,he has accumulated rich and valuable experience in clinical medications,which is worth exploring and studying deeply. Therefore,through the Medcase data processing platform,a Frequent Pattern (FP) tree,constructed based on the FPGrowth enhanced correlation analysis algorithm,was used to make an intra-set correlation analysis on Professor ZHOU Zhongying’s clinical treatment of thyroid cancer,so as to better understand his clinical prescription ideas in the treatment of thyroid cancer.

    2 Data and methods

    2.1 Data source

    The original medical records of thyroid cancer cases treated by Professor ZHOU Zhongying from June 1,2001 to February 28,2015 were collected.

    2.2 Diagnostic criteria

    (i) Western medicine diagnosis: this study refers to the guidelines for diagnosis and treatment of differentiated thyroid cancer of Chinese Society of Clinical Oncology(CSCO),with pathologic diagnosis as the gold standard.Histopathological examination carried out on the specimens showed clear pathological report of thyroid cancer[1]. (ii) TCM diagnosis: the identified lump,diagnosed as “stone gall”,is described to be hard as stone,uneven,and immovable[4].

    2.3 Medical records selection criteria

    2.3.1 Inclusion criteria (i) Pathologic diagnosis following surgical operation was clearly “thyroid cancer”.(ii) TCM diagnosis accorded with “stone gall”. (iii) Complete medical records which included western medicine diagnosis,TCM diagnosis,clinical manifestations,tongue images,pulse condition,pathogenesis and/or treatment,medication,etc.

    2.3.2 Exclusion criteria (i) Medical records that were repeated,or contained uncertain information,or presented with unclear logical association. (ii) Patients with other diseases such as severe heart,brain,or kidney problems,which affect the diagnosis and treatment of thyroid cancer.

    2.4 Data preprocessing

    In the research process of text entry and data mining for Professor ZHOU Zhongying’s medical records in the treatment of thyroid cancer,obvious non-research data noises were found due to typographical errors,the use of wrong or different characters in data sources (such as in the records of symptoms,diagnosis,pathogenesis,treatment,herbs,physical and chemical examinations),and the presence of wrong or missing information in records of examination units or doses. Hence,traceability pretreatment was carried out for the purpose of noise reduction and optimization.

    2.5 Data standardization

    After pretreatment,the whole data of medical record research database were standardized according to the different types of research and analysis algorithms. Standardization of Chinese medicine terms was done according to its subset item groups: item sets of symptoms,diagnosis,and pathogenesis were standardized with reference toInternal Medicine of Traditional Chinese Medicine[6],while herb items were standardized with reference toChinese Materia Medica[7]andChinese Pharmacopoeia(2020 edition)[8]. The process of data standardization was carried out according toStandardization Standard of Data Mining Research on Clinical Medical Records of Traditional Chinese Medicine[9].

    2.6 Data analysis

    The data analysis of this study was formatted and coded by XMiner V1.0,a subsystem of Medcase Ver5.2,which is an auxiliary platform for inheriting the experience of famous old Chinese medicine practitioners[10]. Based on FPGrowth algorithm for enhanced FP tree,the formatted medical record data were first constructed into an FP tree,then frequent items were recursively mined in the FP tree. The data weight was calculated according to the text characteristics of medical records,and appropriate adjustments were made to the Support and Confidence interval. Data analysis was performed with reference to theOperational Standard for Data Analysis of Data Mining Research on Clinical Medical Records of Traditional Chinese Medicine[11]. The specific algorithm principle is displayed in Figure 1.

    Figure 1 Principle of FP-Growth algorithm [10]

    3 Results

    3.1 Study baseline distribution

    In this study,43 patients with thyroid cancer met the inclusion criteria,with a total of 167 visits. Among them,there were 12 males,accounting for 27.91% of the total number,and 31 females,accounting for 72.09% of the total number (Table 1). The age range found in the study was 28 - 77 years old,and the average age of patients was(49.00 ± 13.66) years old (Table 2). A total of 198 kinds of clinical symptoms and 221 kinds of herbs were involved in this study.

    Table 1 Sex distribution of medical records of thyroid cancer treated by Professor ZHOU Zhongying

    Table 2 Age distribution of medical records of thyroid cancer treated by Professor ZHOU Zhongying

    3.2 Curative effect evaluation of medical records

    There were 43 medical cases in this study,among which 18 cases were first-time,single-visit medical records,and 25 cases were medical records of repeated visits; symptoms improvements observed at follow-up visits were recorded in 20 cases,and the rate of improvement for clinical symptoms was 80%. There were 16 long-term medical cases with more than three visits,and the improvement rate of clinical symptoms in all long-term medical cases was 100%.

    3.3 Intra-set association of clinical symptoms

    Of the association item set in the symptom sets,based on a Support interval greater than 0.040 0 and Confidence interval greater than 0.150 0,symptoms that generated more association rules were neck swelling (n= 4),neck pain (n= 1),cough (n= 6),dry mouth (n= 3),and poor sleep (n= 2) (Table 3 and Figure 2). Symptoms with high correlation to swollen neck were mainly cough,neck pain,dry mouth,and chest tightness; symptom with high correlation to neck pain was swollen neck; symptoms with high correlation to cough were mainly whitesputum,swollen neck,chest tightness,pectoralgia,phlegm,and dry mouth; symptoms with high correlation to dry mouth were mainly poor sleep,swollen neck,and cough; symptoms with high correlation to poor sleepwere the fear of cold and dry mouth. At present,thyroid cancer is mainly treated with thyroidectomy in western medicine,and patients selected for this study were no exception. Thyroidectomy could potentially damage the thyroid gland itself,the adjacent tissues and organs of neck. Therefore,in addition to neck swelling,symptoms of neck pain and cough are also evident. Depending on the different clinical classification and staging of thyroid cancer patients,treatment in western medicine may need to be supplemented by radiotherapy,targeted therapy and chemotherapy. However,these treatment methods attack and damage healthy parts of the body,causing a decrease in the immunity of patients,hence,it is easy to have symptoms of dry mouth,fear of cold,and poor sleep.

    Table 3 Association rules of item set in symptom sets(n = 167,Support > 0.040 0,Confidence > 0.150 0)

    Figure 2 Structure diagram of association sites in symptom sets (n = 167,Support > 0.040 0,Confidence > 0.150 0)

    3.4 Intra-set association of tongue images

    Of the association item set in the tongue image sets,based on the Support interval greater than 0.030 0 and Confidence interval greater than 0.100 0,tongue images that generated relatively more association rules were dark purple tongue (n= 4),red tongue (n= 1) ,dark red tongue (n= 4),and fissured tongue (n= 4)(Table 4 and Figure 3). Tongue images with high correlation to dark purple tongue included dark red tongue,yellow,thin,and greasy tongue coating,yellow greasy tongue coating,and fissured tongue; tongue images with high correlation to dark red tongue included greasy tongue coating,yellow greasy tongue coating,fissured tongue,and yellow,thin,and dark purple tongue; tongue images with high correlation to fissured tongue included dark red tongue,yellow,thin,and greasy tongue coating,yellow greasy tongue coating,and dark purple tongue.Dark purple tongue and dark red tongue reflect the pathogenesis of “blood stasis”; yellow greasy tongue coating,and yellow,thin,and greasy tongue coating reflect the pathogenesis of “dampness” and “heat”; fissured tongue reflects the pathogenesis of “Yin deficiency”. To sum up,the tongue images of thyroid cancer patients reflect the pathogenesis of blood stasis,dampness,heat,and Yin deficiency.

    Table 4 Association rules of item set in tongue image sets (n = 167,Support > 0.030 0,Confidence > 0.100 0)

    Figure 3 Structure diagram of association sites in tongue image sets (n = 167,Support > 0.030 0,Confidence > 0.100 0)

    3.5 Intra-set correlation of pulse conditions

    Of the association item set in the pulse condition sets,based on the Support interval greater than 0.030 0 and Confidence interval greater than 0.150 0,pulse conditions that generated relatively more association rules were wiry pulse (n= 3),thready pulse (n= 2),small pulse(n= 2),and slippery pulse (n= 3) (Table 5 and Figure 4).Wiry pulse was highly correlated to slippery pulse,thready pulse,and small pulse; thready pulse was highly correlated to slippery pulse and wiry pulse; small pulse was highly correlated to slippery pulse and wiry pulse;slippery pulse was highly correlated to thready pulse,small pulse,and wiry pulse. Wiry pulse is indicative ofpain,phlegm retention,deficiency-consumption,and decline in stomach Qi; thready pulse is indicative of deficiency in both Qi and blood,virtual strain,and dampness; small pulse could be indicative of either deficiency or excess; slippery pulse is indicative of phlegm retention,food stagnation,and excess heat. As seen,the pulse condition reflects that phlegm-dampness and deficiency are the main pathogenesis of thyroid cancer.

    Table 5 Association rules of item set in pulse condition sets (n = 167,Support > 0.030 0,Confidence > 0.150 0)

    Figure 4 Structure diagram of association sites in pulse sets (n = 167,Support > 0.030 0,Confidence > 0.150 0)

    3.6 Intra-set association of pathogenesis

    Of the association item set in the pathogenesis sets,based on the Support interval greater than 0.030 0 and Confidence interval greater than 0.140 0,pathogenesis that generated more association rules was phlegm and blood stasis (n= 4),damp-heat accumulation (n= 4),impairment of both Qi and Yin (n= 3),kidney deficiency and liver depression (n= 3),kidney deficiency and liver hyperactivity (n= 2),stagnation of liver Qi (n= 3),liver depression transforming into fire (n= 2),and poor heart Ying circulation (n= 2) (Table 6 and Figure 5). It can be seen that the pathogenesis of thyroid cancer is mostly phlegm and blood stasis,damp-heat accumulation,and impairment of both Qi and Yin. Phlegm and blood stasis binding,and internal accumulation of damp-heat are set as branch,while impairment of both Qi and Yin are considered as the root. Thyroid cancer always belongs to deficiency and excess,and the pathological viscera involved are mainly liver and kidney.

    Table 6 Association rules of item set in pathogenesis sets (n = 167,Support > 0.030 0,Confidence > 0.140 0)

    Table 6 Continued

    Figure 5 Structure diagram of association sites in pathogenesis sets (n = 167,Support > 0.030 0,Confidence > 0.140 0)

    3.7 Intra-set association of herbs

    Of the association item set in the herb sets,based on the Support interval greater than 0.300 0 and Confidence interval greater than 0.890 0,herbs that generated more association rules were Chaihu (Bupleuri Radix) (n= 1),Zeqi(Sun Euphorbia Herb) (n= 3),Tiandong (Asparagi Radix)(n= 4),Maozhuacao (Ranunculi Ternati Radix) (n= 4),Nanshashen (Adenophorae Radix) (n= 3),Beishashen(Glehniae Radix) (n= 3) (Table 7 and Figure 6). Interestingly,Chaihu (Bupleuri Radix),Zeqi (Sun Euphorbia Herb),Tiandong (Asparagi Radix),Maozhuacao(Ranunculi Ternati Radix),Nanshashen (Adenophorae Radix),Beishashen (Glehniae Radix),Shancigu(Pseudobulbus Pleiones Pseudobulbus),Baihuasheshecao (Hedyotis Diffusa),Biejia (Trionycis Carapax),Zhongjiefeng (Sarcandrae Herba),Xuanshen (Scrophulariae Radix),Xiangfu (Cyperi Rhizoma),Tiannanxing(Arisaematis Rhizoma),Maidong (Ophiopogonis Radix),Jiangcan (Bombyx Batryticatus),Yuzhizi (Akebiae Fructus) are all correlated to Xiakucao (Prunellae Spica),indicating that Xiakucao (Prunellae Spica) plays an important role in Professor ZHOU Zhongying’s treatment of thyroid cancer.

    Table 7 Association rules of item set in herb sets (n = 167,Support > 0.300 0,Confidence > 0.890 0)

    Table 7 Continued

    Figure 6 Structure diagram of association sites in herb sets (n = 167,Support > 0.300 0,Confidence > 0.890 0)

    3.8 Intra-set association of western medicine diagnosis

    Of the association item set in the western medicine diagnosis sets,based on the Support interval greater than 0.100 0 and Confidence interval greater than 0.100 0,western medicine diagnoses that generated more association rules were thyroid cancer (n= 7),insomnia(n= 4),chronic gastritis (n= 2),lipoma (n= 4),and reflux esophagitis (n= 4) (Table 8 and Figure 7). Chronic gastritis and reflux esophagitis both point towards the spleen and stomach,which shows that thyroid cancer is related to the spleen and stomach.

    Table 8 Association rules of item set in western medicine diagnosis sets (n = 167,Support > 0.100 0,Confidence > 0.100 0)

    Figure 7 Structure diagram of association sites in western medicine diagnosis sets (n = 167,Support > 0.100 0,Confidence > 0.100 0)

    4 Discussion

    4.1 Etiology and pathogenesis of thyroid cancer

    The number of female patients in this study is more than twice that of male patients,which coincides with the latest epidemiological investigation[12]. In terms of physiological characteristics,the thyroid gland located in the neck is closely related to Ren,liver,and kidney meridians. In TCM,women are born of liver blood; their“Tiangui” (a kind of essence) is formed by the kidneys,and their fetuses are governed by the Ren meridian. As such,the menstruation,pregnancy,and lactation phase of women are intimately associated with Ren meridian,liver,and kidney. In addition,General Records of Holy Universal Relief·Doors to Goiters and Tumors(Sheng Ji Zong Lu·Ying Liu Men,《圣濟(jì)總錄 · 癭瘤門》)[13]says that “This disease is more commonplace amongst women,because it is the women who experience more melancholy than men”. From the psychological point of view,women worry more easily than men,hence in terms of gender distribution,thyroid cancer is more likely to occur in women. TCM classifies thyroid cancer as “goiter disease”,which is similar to “stone goiter”. Professor ZHOU Zhongying perceives that pathogenesis is an important entry point to understanding diseases. According to the results of data mining,phlegm and blood stasis as well as impairment of both Qi and Yin are the most common pathogenesis of thyroid cancer. Although thyroidectomy has a good curative effect on thyroid cancer,there is a saying in theComplete Book of Ulcer Medicine(Yang Yi Da Quan,《瘍醫(yī)大全》)[14]that goes,“In any sores,fractures,injuries,falls,and internal damage,there will definitely be blood stasis,hence blood stasis is one of the basic pathogenesis of thyroid cancer”.General Records of Holy Universal Relief[13]records that “It is because of the intake of sandy water which enters the pulse together with Qi,and which then stays under the neck that goiter is formed,and also because of inhabiting on the mountains that goiter results”,thus emphasizing that the occurrence of goiter is related to geographical region and diet,and that its development does not occur within a day,but over a longer period of time. In TCM,long-term diseases tend to have the characteristics of phlegm and dampness,hence phlegm is also an important pathogenesis of thyroid cancer.Surgical Authentic·Goiter and Tumor Theory(Wai Ke Zheng Zong·Ying Liu Lun,《外科正宗 ·癭瘤論》)[15]also states that goiter is caused by blood stasis,turbid Qi,and phlegm stagnation in the five internal organs. Following a long period of time,phlegm and blood stasis combines and stagnates within the body,giving rise to heat. LIU Hejian also pointed out that any disease of dampness pathogenesis mostly arises from heat[16]. Thus,it can be seen that dampness and heat mutually encourage the increase in each other. Phlegm and blood stasis are tangible,while heat is intangible. Intangible heat adheres to the tangible phlegm and blood stasis,and because phlegm and dampness are sticky in nature,it becomes difficult for blood stasis to dissipate quickly; phlegm,blood stasis,and heat stick together,hindering the movement of Qi,blood,and body fluids.Thyroid cancer presents as a syndrome of deficiency in origin and excess in manifestations,in which phlegm,blood stasis,heat,and other excess pathogens stagnate and cause obstruction within the body for a long time,and the body is in a state of weakness with deficiency in Qi,blood,and body fluids. Moreover,most patients with thyroid cancer give priority to western medicine surgery,radiotherapy,and chemotherapy; these treatment methods provide fast and effective results,but they invade too much,and cause evident damage to Qi and Yin,and as such,patients develop dry mouth,poor sleep,and fatigue. From the perspective of visceral syndrome differentiation,thyroid cancer is closely related to liver and kidney. From the perspective of meridian distribution,the liver meridian (also known as Foot Jueyin Meridian)travels along the throat posteriorly,and then enters the nasopharyngeal cavity,the spleen meridian (also known as Foot Taiyin Meridian) goes above the diaphragm,travels alongside the esophagus,connects with the root of the tongue,and spreads over the lower surface of the tongue,and the kidney meridian (also known as Foot Shaoyin Meridian) enters the lungs,goes along the throat,and travels alongside the root of the tongue[17]. As such,the liver,spleen,and kidney meridians all pass near the thyroid gland,and are closely related to it. From the perspective of Professor ZHOU Zhongying’s pathogenesis syndrome differentiation[18],thyroid cancer involves dampness,depression,blood stasis,phlegm,deficiency,and toxin,all of which often occur in tandem to other pathogenesis,such as the co-existence of blood stasis and heat,phlegm and blood stasis,and deficiency and excess.To sum up the above,thyroid cancer is mostly due to deficiency and excess,and its basic pathogenesis is phlegm and blood stasis,and impairment of both Qi and Yin,and is closely related to the liver,spleen,and kidney.

    4.2 Prescription and medicine laws

    In Professor ZHOU Zhongying’s treatment of thyroid cancer,the commonly used herbs can be grouped into two types: herbs that eliminate pathogenic factors,and herbs that strengthen the body. Taking reference to Professor ZHOU Zhongying’s ten methods of treating tumors[19],herb-pairs eliminating pathogenic factors can be used to regulate Qi and relieve depression [such as Chaihu(Bupleuri Radix) + Xiakucao (Prunellae Spica),Xiangfu(Cyperi Rhizoma) + Xiakucao (Prunellae Spica)],eliminate phlegm and resolve stagnation [Tiannanxing (Arisaematis Rhizoma) + Xiakucao (Prunellae Spica),Shancigu (Pseudobulbus Pleiones Pseudobulbus) + Xiakucao (Prunellae Spica),Shancigu (Pseudobulbus Pleiones Pseudobulbus) + Jiangcan (Bombyx Batryticatus)],eliminate dampness and turbidity [Zeqi (Sun Euphorbia Herb) + Xiakucao (Prunellae Spica),Zeqi (Sun Euphorbia Herb) + Jiangcan (Bombyx Batryticatus),Zeqi(Sun Euphorbia Herb) + Biejia (Trionycis Carapax)],clear fire and destroy poison [Baihuasheshecao (Hedyotis Diffusa) + Xuanshen (Scrophulariae Radix),Baihuasheshecao (Hedyotis Diffusa) + Xiakucao (Prunellae Spica),Baihuasheshecao (Hedyotis Diffusa) + Jiangcan (Bombyx Batryticatus)]; herb-pairs that strengthen the body are mainly used to invigorate Qi and nourish Yin [Nanshashen (Adenophorae Radix) + Xiakucao (Prunellae Spica),Nanshashen (Adenophorae Radix) + Maidong(Ophiopogonis Radix),Nanshashen (Adenophorae Radix) + Beishashen (Glehniae Radix),Beishashen(Glehniae Radix) + Xiakucao (Prunellae Spica),Beishashen (Glehniae Radix) + Maidong (Ophiopogonis Radix),Beishashen (Glehniae Radix) + Jiangcan (Bombyx Batryticatus)]. The results of many experimental studies and clinical studies showed that the Chinese herbal medicines much frequently used by Professor ZHOU Zhongying possess anti-thyroid cancer effect[19-22]. For example,Xiakucao (Prunellae Spica) exhibited multi-component,multi-target,and multi-pathway benefits in the treatment of thyroid cancer,with serine/threonine protein kinase 1 (AKT1),vascular endothelial growth factor A (VEGFA),caspase-3 (CASP3),and MYC being the important therapeutic targets[20]. Maozhuacao (Ranunculi Ternati Radix),through improving the immune function of the body,increases the killing rate of NK cells to tumor cells,and induces the production of tumor necrosis factor to treat immune-mediated tumor diseases[21].JI et al.[22]have shown that Zhimu (Anemarrhe Naerhizoma) has an inhibitory effect on colorectal tumors.The ethanol extract of Yuzhizi (Akebiae Fructus) has antitumor effect on H22cell transplanted tumor in mice[23].

    Professor ZHOU Zhongying mainly prefers to use compound prescriptions,and classic prescriptions often involved in his treatment of thyroid cancer are Chaihu Shugan Powder (柴胡疏肝散) and Shashen Maidong Decoction (沙參麥冬湯). Professor ZHOU Zhongying’s prescription also incorporates the consideration of anti-cancer drugs in modern medicine. Professor ZHOU Zhongying uses medical knowledge from the past for the present,and from the West for the East. He knows how to frequently change,and applies both attack and supplement approaches. He emphasizes regulating Qi to relieve depression,eliminating phlegm and resolving stagnation,eliminating dampness and removing turbidity,clearing fire and destroying poison,moistening dryness and softening hard mass,invigorating Qi and nourishing Yin,while paying attention to nourishing the liver and kidney,invigorating the spleen and stomach,and taking into account the heart and lungs.

    5 Conclusion

    Professor ZHOU Zhongying treats thyroid cancer according to syndrome differentiation. The symptoms with more association rules included neck swelling,neck pain,cough and dry mouth; tongue images with more association rules included dark purple tongue,dark red tongue,and fissured tongue; pulse conditions that produced more association rules were wiry pulse,thready pulse,small pulse,and slippery pulse; the pathogenesis that produced more association rules were phlegm and blood stasis,damp-heat accumulation,and impairment of both Qi and Yin; herbs that produces more association rules were Chaihu (Bupleuri Radix),Zeqi (Sun Euphorbia Herb),and Tiandong (Asparagi Radix); western medicine diagnosis with more association rules included thyroid cancer,insomnia,and chronic gastritis. Thyroid cancer mostly presents with deficiency in origin and excess in manifestations,and its basic pathogenesis is phlegm and blood stasis,damp-heat accumulation,and impairment of Qi and Yin,and is closely related to the liver,kidney,and spleen. Professor ZHOU Zhongying uses both attack and supplement approaches as the general principle,with an emphasis on regulating Qi and relieving depression,eliminating phlegm and resolving stagnation,eliminating dampness and turbidity,clearing fire and destroying poison,moistening dryness and softening hard mass,invigorating Qi and nourishing Yin,while paying attention to nourishing the liver and kidney,invigorating the spleen and stomach,and taking into account the heart and lungs. Through data mining of the medical records by Professor ZHOU Zhongying in the treatment of thyroid cancer,this paper provides reference for the clinical prescription of Chinese medicine in the treatment of thyroid cancer,in terms of providing an in-depth analysis of master-level clinical experience and a summary of thyroid cancer-related knowledge.

    Fundings

    Six Talent Peak Projects in Jiangsu Province (RJFW-40),Jiangsu Province “333 High-level Talent Training Project”(2018III-0121),Technology Innovation Fund of Science and Technology Enterprises in Jiangsu Province (BC2015 022),Representative Project of Intangible Cultural Heritage in Pukou District,Nanjing (PKIX-4),and The Construction and Application of Thyroid Disease Differentiation and Treatment Rule Mining and Clinical Decision Support System by Traditional Chinese Medicine Master ZHOU Zhongying (012071003583).

    Competing interests

    The authors declare no conflict of interest.

    猜你喜歡
    癭瘤沙參正宗
    癭瘤的啟示
    癭瘤的啟示
    前線(2021年11期)2021-11-30 04:52:54
    肺熱肺燥 喝點(diǎn)冰糖沙參粥
    認(rèn)準(zhǔn)這個(gè)“壹”,才是正宗的昌盛“海南壹號(hào)”
    ‘Fourand More
    關(guān)于南沙參的品種問題
    《我的英雄學(xué)院》——這就是正宗的《少年Jump》!
    沙參麥冬湯緩解老慢支
    特別健康(2018年4期)2018-07-03 00:38:16
    櫻桃癭瘤頭蚜的生物學(xué)特性及防治措施初步研究
    最正宗的,就是最好吃的?
    都市麗人(2015年4期)2015-03-20 13:33:26
    欧美日本视频| 在线观看66精品国产| 色哟哟哟哟哟哟| 婷婷六月久久综合丁香| 国产精品av久久久久免费| 国产色视频综合| 国产精品 欧美亚洲| 中文字幕精品免费在线观看视频| 午夜福利在线在线| 欧美黑人欧美精品刺激| 人成视频在线观看免费观看| 成人国语在线视频| 中出人妻视频一区二区| 女人被狂操c到高潮| 三级毛片av免费| 亚洲成av人片免费观看| 亚洲第一欧美日韩一区二区三区| 国产成人精品久久二区二区免费| 在线观看66精品国产| 久久亚洲精品不卡| 99国产精品一区二区蜜桃av| 少妇的丰满在线观看| 国产亚洲精品av在线| 欧美一区二区精品小视频在线| 国产极品粉嫩免费观看在线| 一级毛片女人18水好多| 日韩中文字幕欧美一区二区| 国产私拍福利视频在线观看| 国产精品久久视频播放| 亚洲avbb在线观看| 在线十欧美十亚洲十日本专区| 欧美日本亚洲视频在线播放| 免费高清在线观看日韩| 三级毛片av免费| 看片在线看免费视频| 黄色 视频免费看| 亚洲第一青青草原| 国产成人影院久久av| 欧美国产日韩亚洲一区| 国产精品一区二区精品视频观看| 久久亚洲精品不卡| 亚洲精华国产精华精| 亚洲国产中文字幕在线视频| 免费无遮挡裸体视频| 国产又爽黄色视频| 狠狠狠狠99中文字幕| www国产在线视频色| 亚洲专区字幕在线| 精品久久久久久,| 成在线人永久免费视频| 夜夜夜夜夜久久久久| 黑人操中国人逼视频| 成人国产一区最新在线观看| 淫秽高清视频在线观看| 亚洲欧美激情综合另类| 中文字幕av电影在线播放| 一进一出抽搐gif免费好疼| 久久精品影院6| 国产亚洲av嫩草精品影院| 制服人妻中文乱码| 欧美三级亚洲精品| 国产精品二区激情视频| 18禁裸乳无遮挡免费网站照片 | 精品第一国产精品| 久久久久久免费高清国产稀缺| 国产一卡二卡三卡精品| 91国产中文字幕| 成人18禁高潮啪啪吃奶动态图| 一级a爱视频在线免费观看| 在线观看一区二区三区| 精品久久久久久久末码| 成人18禁高潮啪啪吃奶动态图| 国产乱人伦免费视频| 成人av一区二区三区在线看| 欧美又色又爽又黄视频| 国产精品影院久久| 啦啦啦免费观看视频1| 久久久国产成人精品二区| 观看免费一级毛片| 亚洲国产高清在线一区二区三 | 成年女人毛片免费观看观看9| 好看av亚洲va欧美ⅴa在| av中文乱码字幕在线| 丝袜美腿诱惑在线| 欧美成人免费av一区二区三区| 日韩精品中文字幕看吧| 少妇被粗大的猛进出69影院| 国产精华一区二区三区| 日韩大尺度精品在线看网址| 国产爱豆传媒在线观看 | 美女 人体艺术 gogo| 国产成人精品久久二区二区免费| 村上凉子中文字幕在线| 一个人观看的视频www高清免费观看 | 黄色 视频免费看| 国产午夜精品久久久久久| 可以在线观看的亚洲视频| 国产成人精品久久二区二区免费| 亚洲成人精品中文字幕电影| 欧美zozozo另类| www.熟女人妻精品国产| 国产99白浆流出| 国产三级黄色录像| 免费在线观看亚洲国产| 日本熟妇午夜| 国产高清激情床上av| 久久精品成人免费网站| 日韩大尺度精品在线看网址| 午夜免费成人在线视频| av视频在线观看入口| 法律面前人人平等表现在哪些方面| 黄色成人免费大全| 88av欧美| 热99re8久久精品国产| 久久精品亚洲精品国产色婷小说| 亚洲国产精品999在线| 成人午夜高清在线视频 | 哪里可以看免费的av片| 亚洲人成伊人成综合网2020| 久久精品亚洲精品国产色婷小说| 嫩草影视91久久| 免费高清在线观看日韩| 一卡2卡三卡四卡精品乱码亚洲| 女性被躁到高潮视频| 男人舔女人的私密视频| 国产又色又爽无遮挡免费看| 国产精品久久久久久人妻精品电影| 天天一区二区日本电影三级| 91国产中文字幕| 女人高潮潮喷娇喘18禁视频| 国产精品亚洲一级av第二区| 日韩一卡2卡3卡4卡2021年| 成人午夜高清在线视频 | 俺也久久电影网| 成人亚洲精品一区在线观看| 深夜精品福利| 久久国产精品男人的天堂亚洲| 身体一侧抽搐| 欧美性长视频在线观看| 人人澡人人妻人| 国产aⅴ精品一区二区三区波| bbb黄色大片| 欧美zozozo另类| 日韩三级视频一区二区三区| 精品乱码久久久久久99久播| 婷婷精品国产亚洲av在线| 亚洲一区中文字幕在线| 成人精品一区二区免费| 最近最新中文字幕大全电影3 | 久久久久久久久免费视频了| 欧美日韩亚洲国产一区二区在线观看| 日本一区二区免费在线视频| av超薄肉色丝袜交足视频| 色综合站精品国产| 黄片小视频在线播放| 美女免费视频网站| 国产男靠女视频免费网站| 午夜视频精品福利| 精品少妇一区二区三区视频日本电影| 在线国产一区二区在线| 久久久久久久久免费视频了| 国产又黄又爽又无遮挡在线| 精品午夜福利视频在线观看一区| 三级毛片av免费| 亚洲aⅴ乱码一区二区在线播放 | 国产又色又爽无遮挡免费看| 此物有八面人人有两片| 日韩中文字幕欧美一区二区| 又黄又爽又免费观看的视频| 亚洲自偷自拍图片 自拍| 又黄又粗又硬又大视频| 啦啦啦观看免费观看视频高清| 久久久久精品国产欧美久久久| 久久久国产成人精品二区| xxxwww97欧美| 日本在线视频免费播放| 日日爽夜夜爽网站| 在线播放国产精品三级| 成人18禁在线播放| 欧美国产日韩亚洲一区| 成人午夜高清在线视频 | xxxwww97欧美| 精品欧美国产一区二区三| www.www免费av| 久久久久九九精品影院| 国产高清有码在线观看视频 | www.自偷自拍.com| 日本成人三级电影网站| 日本成人三级电影网站| 亚洲国产高清在线一区二区三 | www日本黄色视频网| 韩国精品一区二区三区| 欧美三级亚洲精品| 又紧又爽又黄一区二区| 变态另类成人亚洲欧美熟女| 亚洲午夜精品一区,二区,三区| 国产熟女xx| 99国产精品99久久久久| 国产高清videossex| 1024手机看黄色片| 成人欧美大片| 午夜日韩欧美国产| xxx96com| 精品国内亚洲2022精品成人| 国产成人一区二区三区免费视频网站| 一级作爱视频免费观看| 一个人观看的视频www高清免费观看 | 欧美大码av| 成人三级做爰电影| 两人在一起打扑克的视频| 午夜免费激情av| 日韩高清综合在线| 亚洲aⅴ乱码一区二区在线播放 | 国产精品av久久久久免费| 亚洲成人久久爱视频| 淫妇啪啪啪对白视频| 黄色成人免费大全| 搡老岳熟女国产| 91麻豆精品激情在线观看国产| 午夜福利一区二区在线看| 久久国产乱子伦精品免费另类| 欧美又色又爽又黄视频| 日韩精品青青久久久久久| 亚洲av成人不卡在线观看播放网| 欧美日本亚洲视频在线播放| 久久国产精品男人的天堂亚洲| 日本 av在线| 97人妻精品一区二区三区麻豆 | 欧美激情 高清一区二区三区| 久久中文看片网| 日韩三级视频一区二区三区| 成在线人永久免费视频| av超薄肉色丝袜交足视频| 视频在线观看一区二区三区| 一边摸一边抽搐一进一小说| 满18在线观看网站| 国产精品久久久久久人妻精品电影| 日韩大码丰满熟妇| 1024视频免费在线观看| 人成视频在线观看免费观看| 免费看十八禁软件| 午夜免费激情av| 午夜精品久久久久久毛片777| 国产国语露脸激情在线看| av福利片在线| 成年免费大片在线观看| 精品日产1卡2卡| 色综合欧美亚洲国产小说| 亚洲第一电影网av| 精品国内亚洲2022精品成人| 亚洲中文日韩欧美视频| 超碰成人久久| 欧美日韩瑟瑟在线播放| 久久久久国产精品人妻aⅴ院| www日本在线高清视频| 在线观看免费视频日本深夜| 欧美亚洲日本最大视频资源| 999久久久国产精品视频| 美女午夜性视频免费| 岛国视频午夜一区免费看| 欧美性猛交黑人性爽| 两个人视频免费观看高清| 成人手机av| 中出人妻视频一区二区| 久久精品亚洲精品国产色婷小说| 在线观看www视频免费| 亚洲 国产 在线| 国产精品久久久久久精品电影 | 国产视频内射| 很黄的视频免费| 精品久久久久久久人妻蜜臀av| 777久久人妻少妇嫩草av网站| 亚洲第一av免费看| 听说在线观看完整版免费高清| 久99久视频精品免费| 夜夜躁狠狠躁天天躁| 国产亚洲精品久久久久久毛片| 精华霜和精华液先用哪个| 91成年电影在线观看| 可以在线观看的亚洲视频| 国产精品一区二区免费欧美| 国产亚洲精品久久久久久毛片| 国产精品久久久人人做人人爽| 男女视频在线观看网站免费 | 久久久国产成人免费| 丰满人妻熟妇乱又伦精品不卡| 久久久久国产精品人妻aⅴ院| 伊人久久大香线蕉亚洲五| 久久久久久久午夜电影| 十八禁人妻一区二区| 99热这里只有精品一区 | 97人妻精品一区二区三区麻豆 | 中文字幕精品亚洲无线码一区 | 午夜两性在线视频| 丰满的人妻完整版| 亚洲国产欧美一区二区综合| 欧美黄色淫秽网站| 99精品在免费线老司机午夜| 色哟哟哟哟哟哟| 在线免费观看的www视频| 成人午夜高清在线视频 | 婷婷精品国产亚洲av在线| 亚洲一码二码三码区别大吗| 国产精品亚洲av一区麻豆| 搡老熟女国产l中国老女人| 亚洲国产毛片av蜜桃av| 丝袜美腿诱惑在线| bbb黄色大片| 国产精品国产高清国产av| 国产不卡一卡二| 国产高清有码在线观看视频 | av超薄肉色丝袜交足视频| 婷婷丁香在线五月| 亚洲av五月六月丁香网| 日韩精品免费视频一区二区三区| 色播亚洲综合网| 日韩欧美国产在线观看| 午夜两性在线视频| 国产欧美日韩精品亚洲av| 麻豆成人午夜福利视频| 一区二区三区国产精品乱码| 国内少妇人妻偷人精品xxx网站 | 不卡av一区二区三区| av中文乱码字幕在线| 国产一区二区三区在线臀色熟女| 两人在一起打扑克的视频| 香蕉久久夜色| 久久精品夜夜夜夜夜久久蜜豆 | or卡值多少钱| av片东京热男人的天堂| 欧美精品亚洲一区二区| 中文字幕人妻丝袜一区二区| 午夜激情福利司机影院| 两性午夜刺激爽爽歪歪视频在线观看 | 精品卡一卡二卡四卡免费| 国产野战对白在线观看| 日本免费a在线| 日本三级黄在线观看| 一二三四在线观看免费中文在| 久久中文看片网| 在线观看免费午夜福利视频| 好看av亚洲va欧美ⅴa在| 国产野战对白在线观看| 久久久久久久精品吃奶| 久久国产精品人妻蜜桃| 免费在线观看影片大全网站| 久久久久久大精品| 色综合欧美亚洲国产小说| 动漫黄色视频在线观看| 国产一区二区激情短视频| 久久精品国产99精品国产亚洲性色| 少妇熟女aⅴ在线视频| 色综合亚洲欧美另类图片| 香蕉国产在线看| 久久 成人 亚洲| 婷婷精品国产亚洲av在线| 免费人成视频x8x8入口观看| 欧美一级a爱片免费观看看 | 欧美一区二区精品小视频在线| 国产一区二区三区在线臀色熟女| 最新在线观看一区二区三区| 国产免费男女视频| 国产精品免费一区二区三区在线| 丝袜人妻中文字幕| 成人一区二区视频在线观看| 国产精品久久久av美女十八| 麻豆av在线久日| 91老司机精品| 村上凉子中文字幕在线| 免费观看人在逋| 中文在线观看免费www的网站 | 少妇粗大呻吟视频| 琪琪午夜伦伦电影理论片6080| 美女 人体艺术 gogo| 亚洲午夜精品一区,二区,三区| 亚洲久久久国产精品| 久99久视频精品免费| 久久精品亚洲精品国产色婷小说| 久久婷婷人人爽人人干人人爱| 俺也久久电影网| 99国产精品99久久久久| 美女大奶头视频| 久久精品91无色码中文字幕| netflix在线观看网站| 国产野战对白在线观看| 男女视频在线观看网站免费 | 正在播放国产对白刺激| 男人舔女人的私密视频| av免费在线观看网站| 亚洲久久久国产精品| 成年免费大片在线观看| 变态另类成人亚洲欧美熟女| 国产亚洲欧美在线一区二区| 欧美中文综合在线视频| 欧美日韩黄片免| 欧美性猛交╳xxx乱大交人| 久久久久国产一级毛片高清牌| 国产精品1区2区在线观看.| 露出奶头的视频| 日本在线视频免费播放| 天天躁夜夜躁狠狠躁躁| 精品免费久久久久久久清纯| 国产成人av激情在线播放| 国产三级在线视频| 99久久无色码亚洲精品果冻| 高潮久久久久久久久久久不卡| 精品电影一区二区在线| 亚洲一码二码三码区别大吗| 国产99久久九九免费精品| 神马国产精品三级电影在线观看 | or卡值多少钱| 老司机福利观看| 精品一区二区三区视频在线观看免费| 99国产综合亚洲精品| 国产久久久一区二区三区| 日韩欧美 国产精品| 最近最新中文字幕大全免费视频| 国产精品 欧美亚洲| 午夜福利高清视频| 日本 欧美在线| 成人一区二区视频在线观看| 欧美在线黄色| 给我免费播放毛片高清在线观看| 中亚洲国语对白在线视频| 成人手机av| 成人国产综合亚洲| 长腿黑丝高跟| 老司机福利观看| 成人国产一区最新在线观看| 精品久久久久久久末码| 午夜日韩欧美国产| 国产精品,欧美在线| 成人国语在线视频| 不卡一级毛片| 午夜亚洲福利在线播放| 人妻丰满熟妇av一区二区三区| 波多野结衣av一区二区av| 黄片大片在线免费观看| www日本在线高清视频| 成人免费观看视频高清| 国产人伦9x9x在线观看| 欧美日本亚洲视频在线播放| 一区二区三区精品91| 欧美绝顶高潮抽搐喷水| 长腿黑丝高跟| 亚洲男人的天堂狠狠| 国产高清视频在线播放一区| 亚洲精华国产精华精| 好看av亚洲va欧美ⅴa在| 宅男免费午夜| 人妻久久中文字幕网| 午夜免费成人在线视频| 嫁个100分男人电影在线观看| 757午夜福利合集在线观看| 亚洲av美国av| 亚洲av电影不卡..在线观看| 成人av一区二区三区在线看| 最近最新免费中文字幕在线| 搡老熟女国产l中国老女人| 国产精品一区二区三区四区久久 | 欧美绝顶高潮抽搐喷水| 中文字幕人妻丝袜一区二区| 一卡2卡三卡四卡精品乱码亚洲| 亚洲全国av大片| tocl精华| 欧美日韩精品网址| 国产精品自产拍在线观看55亚洲| 亚洲欧美日韩高清在线视频| 亚洲片人在线观看| 亚洲一区高清亚洲精品| 久久久久久免费高清国产稀缺| 久久亚洲真实| 国产1区2区3区精品| 国产91精品成人一区二区三区| 色综合欧美亚洲国产小说| 日韩免费av在线播放| 欧美成人一区二区免费高清观看 | 男女之事视频高清在线观看| 黄色毛片三级朝国网站| 日韩欧美三级三区| 欧美日韩亚洲国产一区二区在线观看| 自线自在国产av| 禁无遮挡网站| 麻豆成人av在线观看| 人成视频在线观看免费观看| 老司机深夜福利视频在线观看| 露出奶头的视频| 人妻丰满熟妇av一区二区三区| 男女做爰动态图高潮gif福利片| 亚洲成a人片在线一区二区| 在线观看www视频免费| 夜夜爽天天搞| 美国免费a级毛片| 亚洲av美国av| 国内久久婷婷六月综合欲色啪| 午夜免费成人在线视频| 男人操女人黄网站| 一级a爱视频在线免费观看| 听说在线观看完整版免费高清| 亚洲欧美日韩高清在线视频| 91麻豆精品激情在线观看国产| 色综合欧美亚洲国产小说| 此物有八面人人有两片| 久久精品成人免费网站| 免费无遮挡裸体视频| 国产亚洲精品久久久久5区| 国产1区2区3区精品| 国产精品二区激情视频| 午夜久久久在线观看| 啦啦啦免费观看视频1| 亚洲成a人片在线一区二区| 午夜视频精品福利| 香蕉国产在线看| 国产99白浆流出| 精品久久久久久久末码| 亚洲一区中文字幕在线| 亚洲精品中文字幕一二三四区| 中文资源天堂在线| 久久久久久国产a免费观看| 两个人看的免费小视频| 男女做爰动态图高潮gif福利片| 亚洲欧美精品综合久久99| 日本五十路高清| 日韩一卡2卡3卡4卡2021年| 悠悠久久av| 真人一进一出gif抽搐免费| 久久香蕉精品热| 在线观看午夜福利视频| 亚洲专区国产一区二区| 亚洲av第一区精品v没综合| 欧美 亚洲 国产 日韩一| 51午夜福利影视在线观看| 国产熟女xx| 亚洲精品粉嫩美女一区| 看免费av毛片| 精品乱码久久久久久99久播| 欧美国产日韩亚洲一区| 久久精品夜夜夜夜夜久久蜜豆 | www国产在线视频色| 国产精品久久久久久亚洲av鲁大| 无人区码免费观看不卡| 国产爱豆传媒在线观看 | 好男人在线观看高清免费视频 | 人成视频在线观看免费观看| 不卡av一区二区三区| 国产伦人伦偷精品视频| 国产免费男女视频| 搡老妇女老女人老熟妇| 熟妇人妻久久中文字幕3abv| av在线天堂中文字幕| 韩国av一区二区三区四区| 久久久久久大精品| 精品卡一卡二卡四卡免费| av有码第一页| 成人精品一区二区免费| 国产一区二区三区在线臀色熟女| 中文资源天堂在线| 国内毛片毛片毛片毛片毛片| 在线国产一区二区在线| 日韩视频一区二区在线观看| 搡老熟女国产l中国老女人| 制服丝袜大香蕉在线| 免费在线观看视频国产中文字幕亚洲| 91av网站免费观看| 亚洲国产精品合色在线| 国产成人精品无人区| 成年版毛片免费区| 精品久久久久久久末码| 久热爱精品视频在线9| 久久久久九九精品影院| 亚洲电影在线观看av| 欧美日韩一级在线毛片| 亚洲 国产 在线| av片东京热男人的天堂| 国产不卡一卡二| 午夜久久久久精精品| 亚洲久久久国产精品| 久久 成人 亚洲| 国产精品精品国产色婷婷| 欧美 亚洲 国产 日韩一| 亚洲aⅴ乱码一区二区在线播放 | www日本在线高清视频| 一个人观看的视频www高清免费观看 | 国产精品亚洲一级av第二区| 日韩大码丰满熟妇| 身体一侧抽搐| 无人区码免费观看不卡| 久久久国产欧美日韩av| 美女扒开内裤让男人捅视频| 国产精品久久久人人做人人爽| 国产aⅴ精品一区二区三区波| 日本精品一区二区三区蜜桃| 免费观看精品视频网站| 午夜福利免费观看在线| 国产伦在线观看视频一区| 国产成人精品久久二区二区91| 成人国产综合亚洲| 久久精品91无色码中文字幕| 不卡一级毛片| 日韩一卡2卡3卡4卡2021年| 精华霜和精华液先用哪个| √禁漫天堂资源中文www| 国产成年人精品一区二区| 波多野结衣巨乳人妻| 搡老妇女老女人老熟妇| 免费无遮挡裸体视频| 禁无遮挡网站| 精品电影一区二区在线| 欧美丝袜亚洲另类 | 琪琪午夜伦伦电影理论片6080| netflix在线观看网站| 最近最新中文字幕大全免费视频| 变态另类成人亚洲欧美熟女| 国产精品久久视频播放| 色哟哟哟哟哟哟|