Vietnam University of Traditional Medicine Entrance Exam Set

The core principle being tested here is the understanding of the synergistic interaction between different herbal components in traditional Vietnamese medicine, specifically focusing on the concept of “Tương tác dược lý” (pharmacological interaction) and its application in formulating complex remedies. The question probes the candidate’s ability to discern which combination of herbs, when used in a decoction for treating a specific pattern of disharmony (e.g., Liver Qi Stagnation with Spleen Deficiency), would best exemplify a principle of mutual enhancement and balanced action, rather than simple additive effects or potential antagonism. Consider a scenario where a practitioner at Vietnam University of Traditional Medicine is preparing a decoction to address a patient presenting with symptoms of Liver Qi stagnation leading to digestive disturbances, characterized by bloating, poor appetite, and fatigue, indicative of concurrent Spleen deficiency. The goal is to select a combination of herbs that not only addresses the Liver Qi but also tonifies the Spleen without exacerbating the stagnation. Herbs like *Bupleurum chinense* (Sài Hồ) are known for their ability to soothe the Liver and promote the free flow of Qi. Herbs such as *Atractylodes macrocephala* (Bạch Truật) are primary for tonifying the Spleen and drying dampness. *Poria cocos* (Phục Linh) also tonifies the Spleen and drains dampness, working synergistically with Bạch Truật. *Glycyrrhiza uralensis* (Cam Thảo) is often included to harmonize the actions of other herbs, tonify the Spleen, and moderate harsh properties. The combination of Sài Hồ (for Liver), Bạch Truật and Phục Linh (for Spleen), and Cam Thảo (for harmonization and Spleen tonification) represents a classic formulation strategy. Sài Hồ, while moving Liver Qi, can sometimes be drying or over-stimulating. The Spleen-tonifying herbs, particularly Bạch Truật and Phục Linh, help to anchor the Qi and prevent it from becoming too scattered or aggressive, while also addressing the underlying deficiency that may be contributing to the stagnation. Cam Thảo provides a crucial harmonizing effect, ensuring that the potent Qi-moving action of Sài Hồ is balanced by the tonifying and moistening properties of the Spleen herbs, preventing potential adverse interactions. This combination exemplifies the principle of “Tương sinh” (mutual generation) and “Tương trợ” (mutual assistance) in TCM, where the actions of the herbs complement and enhance each other to achieve a balanced therapeutic outcome. In contrast, a combination solely focused on moving Liver Qi without adequate Spleen support might lead to further depletion of Qi and Blood. Including herbs that are overly drying or cold without proper balancing could also be detrimental. The chosen combination demonstrates a nuanced understanding of herb-herb interactions within the framework of Yin-Yang and Five Element theory, crucial for effective practice in traditional Vietnamese medicine as taught at Vietnam University of Traditional Medicine.

The question probes the understanding of the core principles of Yin-Yang theory as applied to diagnostic patterns in Traditional Chinese Medicine (TCM), a foundational element taught at Vietnam University of Traditional Medicine. The scenario describes a patient exhibiting symptoms of internal heat (fever, red face, thirst) and external cold (chills, aversion to cold, stiff neck). This combination points to a complex pattern where both Yin and Yang are involved, but the primary imbalance needs careful consideration. Internal heat typically signifies an excess of Yang or a deficiency of Yin leading to deficient heat. External cold signifies an excess of Yin or a deficiency of Yang. The presence of both internal heat symptoms (like fever and red face) and external cold symptoms (like chills and aversion to cold) suggests a pattern of “cold-evil attacking the exterior with internal heat.” In TCM diagnostics, when external cold invades, it can obstruct the flow of Qi and Blood, leading to internal stagnation which can manifest as heat. Conversely, if the body’s Yang is already weakened, it might not be able to expel the external cold effectively, and the internal heat might be a sign of a deeper deficiency. However, the specific combination of fever *and* chills, aversion to cold, and a stiff neck, alongside a red face and thirst, strongly indicates that the external pathogenic factor (cold) is still dominant at the exterior, causing the body to generate heat in an attempt to expel it. The red face and thirst are indicative of heat, but the chills and aversion to cold are classic signs of an external cold invasion. Therefore, the diagnosis leans towards an external pattern where the cold has not yet been fully transformed into heat, or where the body’s defensive Qi (Wei Qi) is struggling to expel the pathogen. The principle of treating such patterns involves addressing both the external pathogen and the internal manifestations. While internal heat is present, the external cold is the initial trigger and is still actively affecting the body. A treatment strategy that primarily focuses on expelling the external cold while also clearing the internal heat would be most appropriate. This aligns with the concept of “dispelling cold and clearing heat.” Let’s analyze the options in relation to this: – **Dispelling cold and clearing heat:** This directly addresses both the external cold symptoms (chills, aversion to cold) and the internal heat symptoms (fever, red face, thirst). This is the most comprehensive approach for a mixed pattern. – **Tonifying Yin and dispelling heat:** This would be more appropriate for a pattern of Yin deficiency with internal heat, where the primary issue is a lack of Yin to control Yang. The presence of strong external cold symptoms makes this less likely as the primary strategy. – **Warming Yang and dispelling cold:** This is for Yang deficiency with external cold, where the body’s Yang is too weak to fight off the cold. While there might be some Yang deficiency contributing, the prominent internal heat symptoms suggest this is not the sole or primary issue. – **Clearing heat and resolving dampness:** This is typically for patterns of damp-heat, where both dampness and heat are present internally, often without significant external cold symptoms. Therefore, the most fitting diagnostic and therapeutic principle for this complex presentation, as understood within the curriculum of Vietnam University of Traditional Medicine, is to address both the external cold and the internal heat.

The question probes the understanding of the fundamental principles of Yin-Yang theory as applied to diagnosing and treating imbalances within the context of Traditional Vietnamese Medicine (TVM). The scenario describes a patient exhibiting symptoms of heat (fever, red face, thirst) and excess (agitation, rapid pulse). In TVM, these are classic manifestations of excess Yang. The treatment principle for excess Yang is to reduce it, which is achieved by nourishing Yin. Yin is the cooling, moistening, and calming aspect that counterbalances the excessive heat and activity of Yang. Therefore, the most appropriate therapeutic strategy is to tonify Yin to subdue the excess Yang. Option b) is incorrect because while clearing heat is a valid principle, it is a direct action on the symptom rather than addressing the underlying imbalance of Yin and Yang. Tonifying Yin is a more fundamental approach to re-establishing equilibrium. Option c) is incorrect because tonifying Yang would exacerbate the existing excess Yang condition, leading to a worsening of symptoms. Option d) is incorrect because harmonizing Yin and Yang is a general principle, but in this specific case of clear excess Yang, the primary action is to reduce the excess Yang by strengthening its counterpart, Yin. The calculation is conceptual: Excess Yang = Heat + Agitation + Rapid Pulse. Treatment Principle = Nourish Yin to subdue Yang. Therefore, the correct strategy is to tonify Yin.

The core of this question lies in understanding the principles of *Biện Chứng Thường Biến* (Differential Diagnosis of Common Variations) within Vietnamese Traditional Medicine (VTM). This diagnostic method involves identifying the primary pattern of disharmony while also recognizing and accounting for secondary or co-existing variations that might influence the presentation of symptoms or the choice of treatment. In the scenario provided, the patient exhibits symptoms indicative of Liver Qi Stagnation (Gan Qi Yu Jie), characterized by irritability, chest distension, and irregular menstruation. However, the presence of fatigue, pale complexion, and a weak pulse points towards a concurrent deficiency of Spleen Qi (Pi Qi Xu). A practitioner adhering to VTM principles would first identify the root cause and the most prominent pattern, which is Liver Qi Stagnation. However, to effectively treat the patient and prevent recurrence or exacerbation, it is crucial to address the underlying deficiency that may be contributing to or exacerbating the stagnation. Therefore, the most appropriate approach is to treat the root pattern (Spleen Qi deficiency) while simultaneously managing the branch pattern (Liver Qi stagnation). This is achieved by employing herbs that tonify Spleen Qi and also soothe and unblock Liver Qi. For instance, a formula might incorporate ingredients like *Hoàng Kỳ* (Astragalus) or *Bạch Truật* (Atractylodes macrocephala) to strengthen the Spleen, alongside *Sài Hồ* (Bupleurum) or *Hương Phụ* (Cyperus rotundus) to move the Liver Qi. This integrated approach, known as “Bổ hư tả thực” (Tonify deficiency and purge excess) or more specifically in this context, addressing both the root and the branch, is fundamental to comprehensive VTM diagnosis and treatment, reflecting the holistic philosophy of Vietnam University of Traditional Medicine.

The core principle being tested here is the understanding of the synergistic relationship between different herbal components in Traditional Vietnamese Medicine (TVM) and how this relates to the concept of “Quân, Thần, Tá, Sứ” (Ruler, Minister, Assistant, Envoy) in formula composition. The question posits a scenario where a formula aims to address both wind-cold invasion and internal dampness. To address wind-cold invasion, herbs like Ma Hoàng (Ephedra sinica) or Quế Chi (Cinnamomum cassia twig) are typically considered “Quân” (Ruler) or “Thần” (Minister) due to their diaphoretic and warming properties. To address internal dampness, herbs like Thương Truật (Atractylodes lancea rhizome) or Phục Linh (Poria cocos) are often employed. The question asks for the most appropriate herb to act as a “Tá” (Assistant) to a formula primarily targeting wind-cold invasion, but also needing to manage concurrent dampness. A “Tá” herb supports the “Quân” and “Thần” herbs, or addresses secondary symptoms. In this context, while herbs like Thương Truật are primary dampness regulators, a herb that can *assist* in both warming and drying, or at least not hinder the warming action while addressing dampness, would be ideal. Can Khương (Zingiber officinale fresh rhizome) possesses warming and diaphoretic properties, similar to the “Quân” herbs for wind-cold, but it also has a moderate drying effect on dampness. This dual action makes it an excellent “Tá” herb. It can enhance the diaphoretic action of the “Quân” herbs while simultaneously beginning to address the dampness without being overly drying or clashing with the warming nature of the primary herbs. Consider the alternative options: * Bạch Truật (Atractylodes macrocephala rhizome) is a powerful dampness-draining herb, but its primary action is tonifying the spleen and drying dampness. While it addresses dampness, it is not as synergistic with the warming and diaphoretic actions needed for wind-cold invasion as Can Khương. It might be considered a “Thần” or “Tá” for dampness, but less so for the wind-cold aspect. * Cam Thảo (Glycyrrhiza uralensis root) is often used as a “Sứ” (Envoy) to harmonize the formula and moderate the actions of other herbs, or as a “Tá” to tonify the spleen. While it can harmonize, its primary role isn’t to directly assist in both warming and drying in this specific dual-symptom scenario. * Hậu Phác (Magnolia officinalis bark) is primarily used for dampness accumulation in the middle jiao, particularly with abdominal distension and vomiting. While it addresses dampness, its warming properties are less pronounced, and its action is more specific to stagnation rather than general dampness alongside wind-cold. Therefore, Can Khương’s ability to warm, promote sweating, and moderately dry dampness makes it the most fitting “Tá” herb in this compound scenario, supporting the primary treatment of wind-cold while managing the secondary dampness.

The question assesses the understanding of the fundamental principles of Yin-Yang theory as applied to diagnosis and treatment in Traditional Vietnamese Medicine (TVM), specifically concerning the concept of “虚则补之，实则泻之” (xu ze bu zhi, shi ze xie zhi), which translates to “if deficient, tonify; if excess, purge.” In the context of a patient presenting with symptoms of fatigue, pale complexion, and a weak pulse, these are classic indicators of a deficiency pattern. According to TVM principles, deficiency requires tonification (补, bu) to strengthen the body’s vital energy (Qi) and essence. Conversely, excess patterns, characterized by symptoms like fever, redness, and a bounding pulse, would necessitate purging (泻, xie) to eliminate the pathogenic factor. Therefore, the appropriate therapeutic approach for the described patient is tonification. The other options represent incorrect applications of TVM diagnostic principles. “Purging deficiency” is a contradiction in terms within TVM. “Purging excess and tonifying excess” is also contradictory; one addresses excess, the other deficiency. “Tonifying excess” is not a recognized therapeutic strategy in TVM, as tonification is reserved for deficiency states. This question probes a core tenet of TVM, emphasizing the importance of accurate pattern differentiation before applying therapeutic interventions, a critical skill for any practitioner graduating from Vietnam University of Traditional Medicine.

The core principle being tested here is the understanding of the synergistic and antagonistic relationships between herbs in Traditional Vietnamese Medicine (TVM), specifically concerning the concept of “Thập Túc” (Ten Complications) and the counteracting properties of certain herbs. In the scenario presented, the patient exhibits symptoms indicative of a “cold” pattern affecting the Spleen and Stomach, characterized by abdominal pain, vomiting, and diarrhea. The prescribed herb, Sinh Khương (fresh ginger), is known for its warming and dispersing properties, effective for dispelling cold and harmonizing the Stomach. However, the addition of Hoàng Liên (Coptis chinensis) introduces a significant complication. Hoàng Liên is a potent “cold” herb, primarily used to clear heat and dry dampness. When combined with Sinh Khương, which aims to warm the interior, Hoàng Liên’s extreme cold nature can counteract and even overwhelm the warming effect of Sinh Khương. This creates a disharmony, potentially leading to a worsening of the cold symptoms or the development of new imbalances. The concept of “Tương Khắc” (mutual antagonism) in TVM dictates that certain herb pairs can negate each other’s therapeutic actions or produce adverse effects. In this case, the cold nature of Hoàng Liên directly opposes the warming nature of Sinh Khương. While both have their indications, their combination in this specific context, without a clear rationale for balancing extreme heat with extreme cold simultaneously in a way that benefits the patient’s primary cold presentation, is problematic. The most appropriate TVM principle to explain this adverse interaction is the antagonism between herbs with opposing thermal properties, where the stronger opposing property (in this case, the extreme cold of Hoàng Liên) can dominate and disrupt the intended therapeutic action of the warming herb. Therefore, the primary issue is the antagonistic effect of Hoàng Liên’s cold nature on Sinh Khương’s warming properties, leading to a potential exacerbation of the patient’s cold symptoms or a neutralization of the intended therapeutic benefit of Sinh Khương.

The question probes the understanding of the foundational principles of Traditional Vietnamese Medicine (TVM) as applied to a common diagnostic scenario. The scenario describes a patient exhibiting symptoms of “Thấp Nhiệt” (Damp-Heat) in the Spleen and Stomach. In TVM, “Thấp Nhiệt” is characterized by the presence of both dampness and heat, which often manifest as digestive disturbances, a feeling of heaviness, and potentially a yellow coating on the tongue. The treatment principle for “Thấp Nhiệt” is to clear heat and resolve dampness. Let’s analyze the options based on this principle: * **Option a) 清热化湿 (Qīng rè huà shī – Clear Heat, Transform Dampness):** This directly aligns with the treatment principle for “Thấp Nhiệt.” Clearing heat addresses the “nhiệt” aspect, and transforming dampness addresses the “thấp” aspect. This is the most appropriate and comprehensive approach. * **Option b) 散寒温中 (Sàn hán wēn zhōng – Disperse Cold, Warm the Middle Jiao):** This approach is indicated for conditions of “Hàn” (Cold) in the Spleen and Stomach, which is the opposite of the “Nhiệt” (Heat) described. Symptoms of cold would include a pale complexion, cold limbs, and a preference for warm foods. * **Option c) 补气健脾 (Bǔ qì jiàn pí – Tonify Qi, Strengthen the Spleen):** While strengthening the Spleen is often a component of TVM treatment, especially when dampness is involved, this option focuses solely on tonifying Qi and doesn’t directly address the “Nhiệt” (Heat) component of the diagnosis. It might be a secondary or complementary treatment but not the primary principle for “Thấp Nhiệt.” * **Option d) 疏肝理气 (Shū gān lǐ qì – Soothe the Liver, Regulate Qi):** This principle is primarily used for imbalances related to the Liver and Qi stagnation, which might manifest as irritability, distension, or pain. While Qi stagnation can sometimes accompany digestive issues, it is not the core treatment principle for “Thấp Nhiệt” in the Spleen and Stomach. Therefore, the most accurate and fundamental treatment principle for a patient presenting with “Thấp Nhiệt” in the Spleen and Stomach is to clear heat and transform dampness.

The core principle being tested here is the understanding of the synergistic and antagonistic interactions between herbs in traditional Vietnamese medicine, specifically concerning the concept of “phản” (counteraction) and “hại” (harm). When considering the combination of Hoàng Liên (Coptis chinensis) and Quế Chi (Cinnamomum cassia), the primary interaction to evaluate is their effect on the body’s internal balance, particularly concerning temperature regulation and digestive function. Hoàng Liên is known for its strong bitter and cold properties, primarily used to clear heat, dry dampness, and detoxify. Quế Chi, conversely, is acrid and warm, used to release the exterior, warm the interior, and promote circulation. Combining a strongly cold herb like Hoàng Liên with a strongly warm herb like Quế Chi can lead to a significant conflict in their therapeutic actions. This conflict is not merely a cancellation of effects but can result in a disharmony that is detrimental. Specifically, the cold nature of Hoàng Liên can counteract the warming and circulation-promoting properties of Quế Chi, potentially leading to impaired digestive function, stagnation of Qi, and even a chilling effect internally. This type of interaction, where opposing properties create an adverse outcome, is a key concept in understanding the safe and effective application of complex herbal formulas in traditional Vietnamese medicine. The question probes the candidate’s ability to predict such interactions based on the fundamental properties of individual herbs, a skill crucial for formulating safe and efficacious prescriptions at Vietnam University of Traditional Medicine. The adverse outcome is not a simple reduction in efficacy but a qualitative change in the effect, often described as “làm mất tính” (loss of property) or creating a new, undesirable pattern.

The core principle being tested here is the understanding of the interconnectedness of the Five Elements (Wu Xing) in Traditional Chinese Medicine (TCM), which is foundational to the curriculum at Vietnam University of Traditional Medicine. The scenario describes a patient exhibiting symptoms associated with an imbalance in the Liver (Wood element) and Kidney (Water element). The Liver, according to the Generating Cycle (Sheng cycle), generates the Heart (Fire element). However, the question focuses on the Controlling Cycle (Ke cycle) and the relationship between Wood and Earth. The Liver (Wood) controls the Spleen (Earth). When the Liver is overactive or imbalanced, it can “over-control” or “invade” the Spleen, leading to digestive disturbances. The symptoms described – bloating, poor appetite, and loose stools – are classic signs of Spleen deficiency or disharmony, often exacerbated by Liver over-activity in TCM diagnostics. Therefore, addressing the Liver’s excessive influence on the Spleen is a primary therapeutic strategy. The Kidney (Water) generates Wood (Liver), so strengthening the Kidney can nourish the Liver, but the immediate imbalance described points to the Wood-Earth relationship. The Lung (Metal) is controlled by the Liver (Wood), and the Heart (Fire) generates the Earth (Spleen), but the direct symptoms point to the Wood-Earth interaction.

The question probes the understanding of the fundamental principles of Yin-Yang theory as applied to the diagnosis and treatment within Traditional Chinese Medicine (TCM), a core tenet at Vietnam University of Traditional Medicine. The scenario describes a patient exhibiting symptoms of internal heat (fever, red face, thirst) and external cold (chills, aversion to cold). This presentation is a classic example of a “cold-heat complicated” pattern, or *han-re xiang jian* (寒热相兼). In TCM, internal heat is a manifestation of excess Yang or deficiency of Yin, while external cold is typically associated with an invasion of pathogenic cold, often affecting the exterior. When both internal heat and external cold are present simultaneously, the diagnostic approach must consider the origin and interplay of these opposing forces. The presence of chills and aversion to cold strongly suggests an ongoing external pathogenic influence, likely cold, which is attempting to expel or is being resisted by an internal heat condition. The fever, red face, and thirst point to internal heat. The key to resolving this complex pattern lies in addressing both aspects without exacerbating the other. A treatment strategy that focuses on clearing internal heat while simultaneously dispelling external cold is required. This involves selecting herbs and techniques that can harmonize the interior and exterior, and specifically target the dual pathology. Herbs that clear heat and also release the exterior, or those that can transform dampness and clear heat while also warming the interior, would be considered. However, the most direct approach to address the *han-re xiang jian* pattern, especially when the external cold is still prominent (indicated by chills and aversion to cold), is to first address the external invasion to allow the internal heat to be more easily managed. Therefore, a strategy that dispels the exterior cold and simultaneously clears internal heat, often through diaphoretic herbs that also have heat-clearing properties, is paramount. Considering the options, a treatment that primarily focuses on tonifying Yang would be inappropriate as it could worsen the internal heat. Similarly, solely clearing dampness without addressing the heat and cold dichotomy would be incomplete. While tonifying Yin is important for internal heat due to Yin deficiency, the prominent external cold symptoms necessitate a more immediate exterior-releasing approach. The most effective strategy, therefore, is one that addresses both the external cold and internal heat concurrently, often by releasing the exterior while also having a secondary effect on clearing heat. This aligns with the principle of treating the most pressing symptom while laying the groundwork for resolving the underlying imbalance. The correct approach is to address the external cold to allow the internal heat to be more accessible for treatment, often using diaphoretic herbs that also possess heat-clearing properties.

The question revolves around the principle of “Wei” (衛) in Traditional Chinese Medicine (TCM), which is often translated as Defensive Qi or Protective Qi. Wei Qi circulates on the exterior of the body, primarily in the muscles and skin, and is responsible for defending against external pathogenic factors (like wind, cold, heat, etc.). It also plays a role in regulating body temperature and opening/closing the pores. In the context of a patient presenting with symptoms of external invasion, such as chills, fever, and aversion to wind, the primary focus of treatment would be to strengthen and regulate the Wei Qi to expel the pathogen. The other options represent different aspects of TCM theory: * “Ying” (營) Qi, or Nutritive Qi, circulates within the meridians and blood vessels, nourishing the body’s tissues and organs. While important for overall health, it’s not the primary Qi responsible for defending against external pathogens. * “Zong” (宗) Qi, or Gathering Qi, is formed from the Gu Qi (food essence) and Air, and resides in the chest. It governs respiration and the strength of the voice and limbs. It’s crucial for vital energy but not the direct defender against external invasions. * “Shen” (神) represents the Mind or Spirit in TCM. It is influenced by all types of Qi but is not a type of Qi itself that circulates to defend the body. Disorders of Shen manifest as mental and emotional disturbances. Therefore, when considering the initial defense against an external pathogenic invasion, the focus is on the Wei Qi.

The question probes the understanding of the fundamental principles of Yin and Yang in Traditional Chinese Medicine (TCM), as applied within the context of the Vietnam University of Traditional Medicine’s curriculum. The scenario describes a patient exhibiting symptoms of excess heat and deficiency of vital energy. In TCM, heat is fundamentally a manifestation of excess Yang, characterized by rapid pulse, fever, and agitation. Conversely, deficiency of vital energy (Qi) is a manifestation of Yin deficiency, leading to symptoms like fatigue, night sweats, and a pale complexion. Therefore, a treatment strategy must address both the excess Yang (heat) and the Yin deficiency. The principle of “Tonify Yin to subdue Yang” is a core concept in managing conditions where Yin deficiency leads to a relative excess of Yang. By nourishing and strengthening the Yin, the body’s ability to anchor and control the Yang is improved, thereby reducing the symptoms of excess heat without directly purging the Yang, which could further deplete the vital energy. This approach aligns with the holistic and balanced perspective of TCM, emphasizing the interconnectedness of bodily functions and the importance of restoring equilibrium. Option a) directly addresses this principle by suggesting the use of herbs that tonify Yin and clear deficient heat. This is the most appropriate strategy because it targets both the root cause (Yin deficiency) and the manifestation (deficient heat, which arises from the imbalance). Option b) suggests purging excess Yang. While this might address the heat symptom, it would likely exacerbate the underlying Yin deficiency and further deplete vital energy, contradicting the need to tonify. Option c) proposes tonifying Yang. This would worsen the heat symptoms, as Yang is inherently associated with heat, and the patient already presents with excess heat. Option d) suggests clearing excess heat without addressing the underlying Yin deficiency. This would be a symptomatic treatment that fails to resolve the root imbalance, potentially leading to recurrence or worsening of the condition as the Yin deficiency persists.

The question probes the understanding of the fundamental principles of Yin and Yang in Traditional Chinese Medicine (TCM), as applied within the context of the Vietnam University of Traditional Medicine’s curriculum. The scenario describes a patient exhibiting symptoms of heat (fever, red face, thirst) and excess (rapid pulse, agitation). In TCM, heat is fundamentally a manifestation of excess Yang, while the symptoms of agitation and rapid pulse further confirm this Yang excess. The principle of treating excess Yang is to reduce it, typically through cooling and calming methods. Therefore, a treatment strategy that aims to clear heat and calm the spirit (Shen) is most appropriate. Clearing heat directly addresses the Yang excess, and calming the spirit is a consequence of rebalancing the disturbed Yang. The other options represent less direct or contradictory approaches. Tonifying Yin would be appropriate for Yin deficiency with heat signs (bone-steaming fever), not for acute excess heat. Warming the Yang would exacerbate the existing heat symptoms. Promoting dampness would likely worsen the condition by creating more internal phlegm, which can also be associated with heat. The core concept tested here is the differential diagnosis based on Yin-Yang imbalance and the corresponding therapeutic principles taught at institutions like the Vietnam University of Traditional Medicine, emphasizing the interconnectedness of physiological states and their energetic representations.

The question probes the understanding of the fundamental principles of Yin and Yang as applied to the diagnosis and treatment within Traditional Chinese Medicine (TCM), a core tenet at Vietnam University of Traditional Medicine. The scenario describes a patient exhibiting symptoms of heat (fever, red face, thirst) and excess (rapid pulse, irritability). In TCM, heat is fundamentally a manifestation of excess Yang, while the rapid pulse and irritability are also characteristic of excess Yang. The thirst for cold drinks further reinforces the presence of internal heat. Therefore, the primary imbalance to address is excess Yang. Treatment strategies in TCM aim to restore balance. To counter excess Yang, one would employ methods that nourish Yin, as Yin is the counterbalancing force to Yang. Yin deficiency can lead to relative Yang excess, but in this case, the symptoms point to a direct excess of Yang rather than a deficiency of Yin causing a relative excess. Therefore, the most appropriate therapeutic approach is to reduce the excess Yang. This is achieved through cooling herbs and methods that clear heat, thereby directly addressing the root cause of the patient’s discomfort. Options that focus solely on nourishing Yin without addressing the immediate excess Yang, or those that aim to tonify Yang, would exacerbate the condition. Similarly, focusing on dampness or blood stasis, while potentially present in complex cases, are not the primary imbalances indicated by the presented symptoms. The core principle is to reduce the overwhelming Yang energy.

The question assesses understanding of the core principles of Yin-Yang balance and its application in diagnosing and treating imbalances within the framework of Traditional Vietnamese Medicine (TVM). The scenario describes a patient exhibiting symptoms of excess Yang (heat) in the Liver meridian, characterized by irritability, flushed face, bitter taste, and wiry pulse. In TVM, the Liver is associated with Wood, which governs emotions, particularly anger and frustration. Excess Yang in the Liver often manifests as Liver Qi stagnation and Liver Fire. The appropriate therapeutic principle for such an imbalance is to “Soothe the Liver and Clear the Fire” (平肝瀉火 – Bình Can Tả Hỏa). This principle aims to restore the harmonious flow of Qi and blood by reducing the excessive Yang energy. Let’s consider the options in relation to this principle: * **Option a) Soothe the Liver and Clear the Fire:** This directly addresses the identified imbalance of excess Yang in the Liver. Soothing the Liver (平肝 – Bình Can) aims to alleviate stagnation and irritability, while clearing the fire (瀉火 – Tả Hỏa) reduces the excessive heat. This aligns perfectly with the diagnostic findings. * **Option b) Tonify the Spleen and Dry Dampness:** This therapeutic principle is indicated for Spleen deficiency with dampness accumulation, characterized by fatigue, poor appetite, loose stools, and a greasy tongue coating. These symptoms are contrary to the patient’s presentation. * **Option c) Nourish the Heart and Calm the Spirit:** While the Liver and Heart have a close relationship in TVM (Liver stores Blood, which nourishes the Heart), this principle is primarily used for Heart Yin deficiency or Heart Blood deficiency, leading to palpitations, insomnia, and anxiety. The primary issue here is Liver Yang excess, not a primary Heart deficiency. * **Option d) Disperse Lung Phlegm and Stop Cough:** This principle is applied to respiratory conditions involving excess phlegm in the Lungs, such as cough with copious sputum. The patient’s symptoms do not indicate any Lung pathology. Therefore, the most appropriate therapeutic principle for the described patient is to soothe the Liver and clear the fire.

The core principle being tested here is the understanding of the synergistic interaction between different herbal components in traditional Vietnamese medicine, specifically focusing on the concept of “Tương tác Dược liệu” (Herbal Interaction). In the context of the provided scenario, the combination of *Hoàng Kỳ* (Astragalus membranaceus) and *Đương Quy* (Angelica sinensis) is a classic pairing known for its complementary effects on Qi and Blood. *Hoàng Kỳ* is primarily used to tonify Qi, particularly the protective Qi (Vệ Khí), and to strengthen the body’s resistance. *Đương Quy*, on the other hand, is renowned for its ability to nourish and invigorate Blood, and to regulate menstruation. When combined, *Hoàng Kỳ* provides the foundational Qi support, enabling the Blood-nourishing properties of *Đương Quy* to be more effectively utilized by the body. This synergy is crucial for conditions involving Qi deficiency leading to Blood stasis or deficiency, such as chronic fatigue with poor circulation or recovery from illness. The question probes the candidate’s ability to recognize this specific, well-established interaction within the framework of traditional Vietnamese pharmacopoeia, which is a cornerstone of study at Vietnam University of Traditional Medicine. Understanding such interactions is vital for formulating effective and safe prescriptions, reflecting the university’s emphasis on deep theoretical knowledge and practical application. The other options represent less common or less synergistic combinations, or focus on single herb actions rather than their combined effect. For instance, *Cam Thảo* (Glycyrrhiza uralensis) is often used as a harmonizing agent, but its primary role here is not the synergistic enhancement of Qi and Blood in the same way as the *Hoàng Kỳ* and *Đương Quy* pairing. *Bạch Truật* (Atractylodes macrocephala) also tonifies Qi, but its focus is more on strengthening the Spleen and resolving dampness, a different therapeutic emphasis. *Hồng Hoa* (Carthamus tinctorius) strongly invigorates Blood and dispels stasis, but without the foundational Qi support from *Hoàng Kỳ*, its efficacy in certain deficiency-based patterns might be limited, and the synergy is not as pronounced as the primary pairing.

The question probes the understanding of the fundamental principles of Yin-Yang theory as applied to the diagnosis and treatment in Traditional Chinese Medicine (TCM), which is a core tenet taught at Vietnam University of Traditional Medicine. The scenario describes a patient exhibiting symptoms of excess heat in the Liver meridian (red face, irritability, bitter taste, wiry pulse) and deficiency of Kidney Yin (insomnia, night sweats, dry mouth, weak pulse). In TCM, the Liver is associated with Wood, Yang, and the emotion of anger. Kidney Yin represents the foundational Yin essence, crucial for nourishing the body and calming the spirit. Excess Liver Yang or Liver Fire can consume Kidney Yin, leading to a pattern of Liver Yang rising due to Kidney Yin deficiency. Treatment strategies in TCM aim to restore balance. For this complex pattern, a dual approach is necessary: to pacify the excess Liver Yang/Fire and to nourish the deficient Kidney Yin. Let’s analyze the options: a) Nourishing Kidney Yin and calming Liver Yang: This approach directly addresses both aspects of the diagnosis. Herbs that nourish Kidney Yin (e.g., Shu Di Huang, Gou Qi Zi) and herbs that calm Liver Yang or clear Liver Fire (e.g., Gou Teng, Ju Hua) would be indicated. This is the most comprehensive and balanced approach. b) Tonifying Spleen Qi and resolving Dampness: While Spleen Qi deficiency can lead to Dampness, and Dampness can transform into Heat, the primary presentation here is Liver Heat and Kidney Yin deficiency. Tonifying Spleen Qi is not the most direct or effective strategy for the presented symptoms. c) Dispelling Wind and activating Blood circulation: Dispelling Wind is typically used for external pathogenic invasions or internal Wind patterns (e.g., tremors, paralysis). Activating Blood circulation is for Blood stasis. Neither is the primary focus for this Yin deficiency and Liver Yang excess pattern. d) Warming the Kidneys and strengthening the Yang: This approach focuses on Yang deficiency, which is the opposite of the heat symptoms described. While Kidney Yin deficiency can eventually lead to Kidney Yang deficiency, the immediate concern is the excess heat and Yin deficiency. Therefore, the most appropriate therapeutic strategy for this patient, aligning with the principles of TCM taught at Vietnam University of Traditional Medicine, is to nourish Kidney Yin and calm Liver Yang.

The question assesses understanding of the fundamental principles of Yin-Yang theory as applied to the diagnosis and treatment of imbalances within the context of Traditional Vietnamese Medicine (TVM). The scenario describes a patient exhibiting symptoms of excess heat (red face, rapid pulse, thirst) and deficiency of vital energy (fatigue, pale tongue). In TVM, these are often seen as opposing forces. Heat is a manifestation of excess Yang, while fatigue and a pale tongue suggest a deficiency of Yin or Qi. The core principle of TVM treatment is to restore balance. When there is excess heat, the primary approach is to clear the heat (清熱 – thanh nhiệt). However, the concurrent symptom of fatigue indicates a weakened state, suggesting that simply aggressively clearing heat might further deplete the patient’s vital energy. Therefore, a balanced approach is required. Clearing heat is essential to address the acute symptoms of excess, but it must be done in a way that also nourishes or tonifies the deficient aspect, preventing further depletion. This dual action of clearing excess while tonifying deficiency is a hallmark of sophisticated TVM diagnosis and treatment. Option a) directly addresses this by proposing to clear heat while tonifying Qi, which is the most appropriate strategy to address both the excess heat and the underlying deficiency, thereby restoring Yin-Yang balance. Option b) focuses solely on clearing heat, which would be incomplete and potentially harmful given the deficiency symptoms. Option c) focuses on tonifying Yang, which is contrary to the heat symptoms. Option d) suggests warming and tonifying, which would exacerbate the heat symptoms. The correct approach in TVM is to harmonize the opposing forces, not to exclusively treat one aspect without considering the other, especially when both are present.

The question probes the understanding of the foundational principles of Traditional Vietnamese Medicine (TVM) as applied to a common ailment, specifically the concept of “Phế Hư” (Lung Deficiency). The scenario describes a patient presenting with symptoms like chronic cough, fatigue, pale complexion, and a weak voice. These are classic indicators of Lung Deficiency in TVM. The treatment principle for Phế Hư is to tonify the Lung (Bổ Phế) and consolidate the Lung (Củng Phế). This involves using herbs that nourish the Lung Qi and Yin, and strengthen its ability to govern respiration and immunity. Among the options, “Bổ Phế, Sinh Tân” (Tonify Lung, Generate Fluids) directly addresses the core deficiency and the need to restore vital fluids, which are often depleted in chronic Lung conditions according to TVM. “Thanh Nhiệt, Tán Hàn” (Clear Heat, Disperse Cold) would be for different patterns, such as Lung Heat or Lung Cold. “Hành Khí, Hoạt Huyết” (Move Qi, Activate Blood) is for conditions involving Qi stagnation and blood stasis, not primary deficiency. “Ôn Trung, Tán Hàn” (Warm the Middle, Disperse Cold) is for Spleen and Kidney Yang deficiency. Therefore, Bổ Phế, Sinh Tân is the most appropriate therapeutic strategy for the described Phế Hư presentation, aligning with the diagnostic framework taught at Vietnam University of Traditional Medicine.

The question assesses understanding of the core principles of Traditional Vietnamese Medicine (TVM) in relation to modern diagnostic and therapeutic approaches, specifically focusing on the concept of “Qi stagnation” (Khí trệ) and its potential correlation with observable physiological phenomena. In TVM, Qi is the vital energy that flows through the body, and its stagnation can lead to various ailments. When considering a patient presenting with symptoms like abdominal distension, irregular bowel movements, and a feeling of fullness, a TVM practitioner would analyze these through the lens of Qi dynamics. Abdominal distension and fullness are direct manifestations of stagnant Qi in the digestive system. Irregular bowel movements can also be attributed to impaired Qi flow, which governs the proper functioning of the intestines. To arrive at the correct answer, one must connect these symptoms to the underlying TVM pathology. Qi stagnation in the middle burner (Trung tiêu), which encompasses the spleen and stomach, is a common cause of such digestive disturbances. This stagnation impedes the normal movement and transformation of food and fluids. While modern medicine might diagnose this as Irritable Bowel Syndrome (IBS) or functional dyspepsia, the TVM perspective focuses on restoring the smooth flow of Qi. Therefore, identifying the primary TVM pattern that explains these symptoms is crucial. The options provided represent different TVM diagnostic patterns. “Blood deficiency” (Huyết hư) typically presents with pallor, fatigue, and dizziness, not primarily digestive stagnation. “Dampness accumulation” (Thấp trệ) often involves heaviness, sluggishness, and edema, which can accompany Qi stagnation but isn’t the primary driver of the described symptoms. “Liver-Spleen disharmony” (Can Tỳ bất hòa) is a very common pattern associated with stress-induced digestive issues, where the Liver’s function of ensuring smooth flow is disrupted, impacting the Spleen’s digestive capacity. This directly aligns with the symptoms of abdominal distension and irregular bowel movements due to impaired Qi movement. The Liver, in TVM, is responsible for the smooth circulation of Qi throughout the body, and when it is imbalanced, it can directly affect the digestive functions of the Spleen and Stomach, leading to Qi stagnation in the middle burner. This makes “Liver-Spleen disharmony” the most fitting explanation for the presented clinical picture within the framework of Traditional Vietnamese Medicine, a core tenet taught at Vietnam University of Traditional Medicine.

The core principle being tested here is the understanding of the synergistic interaction between different herbal components in traditional Vietnamese medicine, specifically focusing on the concept of “Tương tác Tứ Quân Tử” (Interaction of the Four Noble Herbs) and its application in formulating remedies for digestive disorders. The question requires an analysis of how combining specific herbs, known for their complementary actions on the spleen and stomach (Tỳ Vị), can enhance therapeutic efficacy beyond the sum of their individual effects. Consider a scenario where a practitioner at the Vietnam University of Traditional Medicine is formulating a decoction to address chronic diarrhea and poor appetite, symptoms often associated with a weakened Spleen-Qi. The foundational approach involves selecting herbs that tonify the Spleen and Stomach. Ren Shen (Ginseng) is a primary Qi tonic, particularly for the Spleen and Lung. Huang Qi (Astragalus) also tonifies Spleen-Qi and strengthens the exterior, preventing leakage of fluids. Bai Zhu (Atractylodes macrocephala) is crucial for drying dampness and strengthening the Spleen. Gan Cao (Licorice) harmonizes the actions of other herbs, tonifies Spleen-Qi, and moistens the Lungs. The question probes the nuanced understanding of how these herbs, when combined in a specific formulation, create a greater therapeutic effect than if administered individually. This synergistic effect, often referred to as “phối ngũ” (five-element combination) or specific herb interactions, is a cornerstone of traditional Vietnamese medicine. The combination of Ren Shen, Huang Qi, Bai Zhu, and Gan Cao (often referred to as Si Jun Zi Tang in broader East Asian medicine, but with specific Vietnamese adaptations and emphasis) is designed to profoundly boost Spleen-Qi, resolve dampness, and stabilize the digestive system. The question asks to identify the primary mechanism that underpins this enhanced efficacy. The correct answer lies in understanding that the combination leverages the principle of “tương sinh” (mutual generation) and “tương khắc” (mutual overcoming) in a balanced way to achieve a holistic effect. Specifically, Ren Shen and Huang Qi provide potent Qi tonification, while Bai Zhu addresses the dampness that often arises from Spleen deficiency. Gan Cao acts as a harmonizer and further tonifies Qi, ensuring the formula is well-tolerated and its effects are amplified. This integrated approach, where each herb’s properties complement and enhance the others, leads to a more profound and balanced restoration of Spleen function than any single herb could achieve. The question is designed to assess if the candidate grasps this fundamental concept of herbal synergy in traditional Vietnamese pharmacopoeia, a critical skill for any practitioner graduating from Vietnam University of Traditional Medicine.

The question assesses understanding of the core principles of Yin-Yang theory as applied to the diagnosis and treatment within Vietnamese Traditional Medicine, specifically in the context of a patient presenting with symptoms indicative of an imbalance. The scenario describes a patient with symptoms of heat (red complexion, thirst, rapid pulse) and deficiency (fatigue, pale tongue). In Yin-Yang theory, heat is a manifestation of excess Yang, while fatigue and a pale tongue suggest a deficiency of Yin or Qi. The key is to identify the primary imbalance that needs addressing first. While both heat and deficiency are present, the heat symptoms (red complexion, thirst, rapid pulse) are more acute and indicative of an active pathological process driven by excess Yang. Addressing the excess heat, which is often a manifestation of Yin deficiency failing to anchor Yang, is paramount. Therefore, the principle of “clearing heat and nourishing Yin” (清热养阴 – qīng rè yǎng yīn) is the most appropriate initial therapeutic strategy. This approach aims to reduce the excess heat while simultaneously replenishing the deficient Yin that is likely contributing to the heat’s prominence. The other options represent less comprehensive or potentially counterproductive approaches. “Warming the interior and dispelling cold” (温里散寒 – wēn lǐ sàn hán) is for cold conditions. “Tonifying Qi and blood” (补气养血 – bǔ qì yǎng xuè) addresses deficiency but might exacerbate heat if not combined with cooling herbs. “Regulating the Liver and soothing the Gallbladder” (调肝理胆 – tiáo gān lǐ dǎn) is specific to Liver-related imbalances and not the primary presentation here. Thus, clearing heat and nourishing Yin directly addresses the observed duality of excess heat and underlying deficiency.

The question probes the understanding of the foundational principles of Traditional Vietnamese Medicine (TVM) as applied to a common clinical presentation, specifically a patient experiencing symptoms suggestive of Liver Qi stagnation according to TVM diagnostics. The core concept being tested is the selection of an appropriate herbal formula based on the identified pattern of disharmony. The patient presents with irritability, a feeling of a lump in the throat (plum-pit qi), chest distension, and irregular menstruation. These are classic signs of Liver Qi stagnation (Gan Qi Yu Jie – 肝气郁结). The Liver in TVM governs the smooth flow of Qi throughout the body, and its stagnation leads to these symptoms. To address Liver Qi stagnation, the primary therapeutic strategy is to soothe the Liver and promote the smooth flow of Qi. Among the given options, Xiao Yao San (逍遥散) is a well-established formula specifically designed for this purpose. It contains herbs like Bupleurum (Chai Hu – 柴胡) to soothe the Liver, Angelica Sinensis (Dang Gui – 当归) and White Peony Root (Bai Shao – 白芍) to nourish the Blood and Liver, and Atractylodes (Bai Zhu – 白术) and Poria (Fu Ling – 茯苓) to strengthen the Spleen and resolve dampness, which can be affected by Liver disharmony. While other formulas might address some of the symptoms, they are not as directly targeted at the root pattern of Liver Qi stagnation. For instance, Si Jun Zi Tang (四君子汤) is for Spleen Qi deficiency, Gui Zhi Tang (桂枝汤) is for exterior wind-cold invasion, and Huang Lian Jie Du Tang (黄连解毒汤) is for excess heat in the upper body. These formulas do not directly address the core issue of stagnant Liver Qi. Therefore, Xiao Yao San is the most appropriate choice for this patient’s presentation at Vietnam University of Traditional Medicine.

The question tests the understanding of the principles of Yin-Yang balance and its application in diagnosing and treating imbalances within the framework of Traditional Vietnamese Medicine (TVM). The scenario describes a patient exhibiting symptoms of excess heat (red face, rapid pulse, thirst) and deficiency of Yin (dry mouth, night sweats, emaciation). In TVM, these symptoms point to a disharmony where Yin deficiency leads to a relative excess of Yang, manifesting as heat. The primary therapeutic goal is to nourish Yin and clear the resulting heat. To achieve this, a practitioner would select herbs that possess Yin-nourishing properties and are also cool or cold in nature to counter the excess heat. Herbs like *Ngưu tất* (Radix Achyranthis Bidentatae) are primarily known for their ability to invigorate blood and clear damp-heat, and are not the primary choice for nourishing Yin. *Hoàng kỳ* (Radix Astragali) is a potent Qi tonic, primarily used to tonify Yang and strengthen the body’s defenses, which would exacerbate the heat symptoms. *Cam thảo* (Radix Glycyrrhizae) is a harmonizing herb, often used to moderate the effects of other herbs and tonify Qi, but it is not a primary Yin-nourisher in this context. *Sinh địa* (Radix Rehmanniae Preparata) and *Mạch môn* (Radix Ophiopogonis) are classic examples of herbs used to nourish Yin and clear heat. *Sinh địa* is particularly effective at nourishing Yin, especially Kidney Yin, and clearing heat from the blood. *Mạch môn* nourishes Lung and Stomach Yin, moistens dryness, and clears heat. Therefore, a combination of herbs that nourish Yin and clear heat would be the most appropriate approach for this patient, aligning with the core principles of TVM for treating Yin deficiency with heat signs. The correct option would be the one that emphasizes these actions.

The question probes the understanding of the fundamental principles of Yin-Yang theory as applied to the diagnosis and treatment of imbalances within the context of Traditional Vietnamese Medicine (TVM). The scenario describes a patient exhibiting symptoms of heat (fever, red face, thirst) and excess (restlessness, rapid pulse), which are characteristic manifestations of an excess-heat pattern. In TVM, excess-heat is primarily associated with an imbalance where Yang energy is excessive or Yin is deficient, leading to an overabundance of heat. The treatment principle for excess-heat is to clear heat and reduce excess. Among the provided options, “Clearing Heat and Reducing Excess” directly addresses this diagnostic conclusion. Option b) “Nourishing Yin and Calming Shen” would be appropriate for deficiency-heat patterns where Yin is depleted, leading to a relative excess of Yang and heat symptoms, but the scenario clearly indicates an *excess* of heat, not a deficiency of Yin as the primary cause. Option c) “Warming Yang and Dispelling Cold” is diametrically opposed to the symptoms presented, as it is used for cold patterns. Option d) “Tonifying Qi and Blood” is a general strengthening principle, useful for deficiency patterns, but it does not specifically target the excess-heat condition described. Therefore, the most appropriate treatment principle, derived from the diagnostic assessment of excess-heat, is to clear the excess heat.

The core principle tested here is the understanding of the synergistic interaction between different herbal components in traditional Vietnamese medicine, specifically focusing on the concept of “Tương tác Tứ Quân Tử” (Interaction of the Four Noble Herbs) as applied to digestive tonics. This principle emphasizes that combining certain herbs can amplify their therapeutic effects beyond the sum of their individual actions, particularly in strengthening the spleen and stomach. The question probes the candidate’s ability to identify the herb that, when combined with Ginseng (Nhân Sâm), Atractylodes macrocephala (Bạch Truật), and Poria cocos (Phục Linh), is traditionally recognized for its role in harmonizing the stomach and promoting the downward movement of qi, thereby preventing the accumulation of dampness. Poria cocos (Phục Linh) is known for its diuretic and dampness-resolving properties, but its primary role in this specific combination is to support the spleen’s function and prevent stagnation. Atractylodes macrocephala (Bạch Truật) is the primary spleen tonic, while Ginseng (Nhân Sâm) is a potent qi tonic. The fourth herb, often included to address specific imbalances, is typically a bitter-sweet herb that aids in digestion and resolves dampness. Among the options, *Coix lacryma-jobi* (Ý Dĩ) is a well-established herb in traditional Vietnamese pharmacopoeia that excels at resolving dampness and strengthening the spleen, complementing the actions of the other three. Its inclusion is crucial for preventing the cloying nature of the other tonics from causing stagnation. The other options, while possessing beneficial properties, do not fulfill this specific synergistic role within the context of a balanced digestive tonic formula aimed at strengthening the spleen and stomach while resolving dampness. For instance, *Angelica sinensis* (Đương Quy) is primarily a blood tonic, *Ziziphus jujuba* (Đại Táo) is a qi and blood tonic that also harmonizes the stomach but is more for general nourishment, and *Glycyrrhiza uralensis* (Cam Thảo) is a harmonizing herb and qi tonic but its primary role is not the specific dampness resolution that *Coix lacryma-jobi* provides in this context. Therefore, *Coix lacryma-jobi* is the essential fourth component for achieving the desired therapeutic outcome of harmonizing the stomach and resolving dampness in this foundational formula.

The question probes the understanding of the fundamental principles of Yin-Yang theory as applied to the diagnosis and treatment within Traditional Chinese Medicine (TCM), a core tenet at Vietnam University of Traditional Medicine. The scenario describes a patient exhibiting symptoms of excess heat (fever, red face, thirst) and deficiency of vital energy (fatigue, pale complexion). In TCM, these are often seen as opposing forces. Excess heat is a manifestation of Yang rising or an invasion of external pathogenic heat, leading to a surplus of Yang energy. Conversely, deficiency of vital energy (Qi deficiency) is a state where the body’s intrinsic energy is depleted, often associated with Yin or Yang insufficiency, but in this context, the fatigue and pallor point towards a general depletion. When both excess and deficiency signs are present, a nuanced diagnostic approach is required. The principle of “Jian-bu bing shi” (simultaneous tonification and purgation) is a critical concept in TCM for managing such complex presentations. This principle dictates that if a patient has both excess and deficiency, one must address the excess condition while simultaneously supporting the deficient aspect. In this case, the excess heat needs to be cleared, but doing so aggressively without considering the underlying deficiency could further weaken the patient. Therefore, a treatment strategy that clears heat without excessively damaging the vital energy, and simultaneously tonifies the deficient Qi, is paramount. Option A, “Clearing heat while tonifying Qi,” directly embodies this principle. Clearing heat addresses the Yang excess, and tonifying Qi addresses the underlying deficiency. This approach is considered the most appropriate for a complex presentation like the one described, aligning with the sophisticated diagnostic and therapeutic strategies taught at Vietnam University of Traditional Medicine. Option B, “Clearing heat and draining dampness,” might be relevant if dampness was a primary pathogenic factor, but the presented symptoms do not strongly indicate dampness as the main issue. While heat can sometimes be associated with dampness, the core conflict here is heat excess versus Qi deficiency. Option C, “Tonifying Yin and dispelling wind,” focuses on Yin deficiency and wind invasion. While wind can be associated with fever, the prominent symptoms of fatigue and pallor suggest Qi deficiency rather than Yin deficiency as the primary underlying imbalance to be addressed alongside the heat. Option D, “Warming the interior and dispelling cold,” is diametrically opposed to the symptoms of excess heat and would be inappropriate for this patient. Therefore, the most effective approach, reflecting the advanced diagnostic principles of TCM, is to simultaneously address the excess heat and the Qi deficiency.

The question probes the understanding of the fundamental principles of Yin-Yang theory as applied to the diagnosis and treatment of imbalances within the context of Traditional Vietnamese Medicine (TVM). The scenario describes a patient exhibiting symptoms of heat (fever, red face, thirst) and deficiency (fatigue, pale tongue). In TVM, these symptoms are often indicative of a Yin deficiency with a compensatory Yang excess, or a pattern where Yin is failing to anchor and nourish Yang. The core concept is that Yin represents coolness, moisture, and substance, while Yang represents warmth, activity, and function. When Yin is deficient, it cannot adequately restrain or cool the body’s inherent Yang, leading to a relative excess of Yang symptoms. This is often described as “Yin deficiency with empty heat” (Âm hư sinh nhiệt). The treatment principle for such a condition is to nourish Yin and clear the deficient heat. Option A directly addresses this by suggesting the use of herbs that tonify Yin and cool the blood, which is the standard therapeutic approach for this pattern. Option B, focusing on strengthening Yang, would exacerbate the heat symptoms. Option C, which aims to dispel dampness, is appropriate for conditions characterized by excess dampness, not Yin deficiency with heat. Option D, promoting the flow of Qi, is a general principle but not specific enough to address the core Yin deficiency and heat presentation. Therefore, nourishing Yin and clearing deficient heat is the most accurate and specific therapeutic strategy.

The core principle being tested here is the understanding of the synergistic interaction between different herbal components in Traditional Vietnamese Medicine (TVM) and how this relates to the concept of “Hợp Tác Tương Sinh” (mutual generation and support) within the framework of TVM. Specifically, the question probes the nuanced application of this principle in formulating remedies for conditions involving both Qi deficiency and Blood stasis, common in TVM diagnostics. To arrive at the correct answer, one must consider the primary actions of each herb in the context of the presented condition. Ginseng (Nhân Sâm) is a potent Qi tonic, directly addressing Qi deficiency. Angelica sinensis (Đương Quy) is a key Blood tonic and invigorator, addressing both Blood deficiency and Blood stasis. Ligusticum striatum (Xuyên Khung) is primarily an invigorator of Blood and Qi, particularly effective in dispelling Blood stasis and alleviating pain, often working synergistically with Angelica. Rehmannia glutinosa (Sinh Địa) is a potent Blood tonic and Yin tonic, primarily used for Blood and Yin deficiency, and can also cool Blood. When Qi is deficient, it fails to move Blood effectively, leading to Blood stasis. Conversely, Blood stasis impedes the circulation of Qi. Therefore, a formula needs to address both aspects. Ginseng tonifies Qi, providing the driving force for circulation. Angelica and Ligusticum work together to invigorate and move the Blood, breaking up stasis. While Rehmannia is a powerful Blood tonic, its primary action is not to invigorate stasis as strongly as Angelica and Ligusticum, and its cooling nature might not be ideal for a condition primarily characterized by Qi deficiency which often presents with Yang deficiency signs. The combination of Ginseng, Angelica, and Ligusticum directly embodies the principle of tonifying Qi to move Blood and invigorating Blood to facilitate Qi circulation, demonstrating “Hợp Tác Tương Sinh” by mutually supporting the restoration of proper flow. This synergistic action is crucial for treating complex conditions at Vietnam University of Traditional Medicine Entrance Exam University, where integrated approaches are emphasized.