Network pharmacology-based exploration of molecular mechanisms underlying therapeutic effects of Jianpi Huatan Quyu recipe on chronic heart failure with spleen Qi deficiency syndrome

BACKGROUND Chronic heart failure is a complex clinical syndrome.The Chinese herbal compound preparation Jianpi Huatan Quyu recipe has been used to treat chronic heart failure;however,the underlying molecular mechanism is still not clear.AIM To identify the effective active ingredients of Jianpi Huatan Quyu recipe and explore its molecular mechanism in the treatment of chronic heart failure.METHODS The effective active ingredients of eight herbs composing Jianpi Huatan Quyu recipe were identified using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform.The target genes of chronic heart failure were searched in the Genecards database.The target proteins of active ingredients were mapped to chronic heart failure target genes to obtain the common drugdisease targets,which were then used to construct a key chemical componenttarget network using Cytoscape 3.7.2 software.The protein-protein interaction network was constructed using the String database.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed through the Metascape database.Finally,our previously published relevant articles were searched to verify the results obtained via network pharmacology.RESULTS A total of 227 effective active ingredients for Jianpi Huatan Quyu recipe were identified,of which quercetin,kaempferol,7-methoxy-2-methyl isoflavone,formononetin,and isorhamnetin may be key active ingredients and involved in the therapeutic effects of TCM by acting on STAT3,MAPK3,AKT1,JUN,MAPK1,TP53,TNF,HSP90AA1,p65,MAPK8,MAPK14,IL6,EGFR,EDN1,FOS,and other proteins.The pathways identified by KEGG enrichment analysis include pathways in cancer,IL-17 signaling pathway,PI3K-Akt signaling pathway,HIF-1 signaling pathway,calcium signaling pathway,cAMP signaling pathway,NF-kappaB signaling pathway,AMPK signaling pathway,etc.Previous studies on Jianpi Huatan Quyu recipe suggested that this Chinese compound preparation can regulate the TNF-α,IL-6,MAPK,cAMP,and AMPK pathways to affect the mitochondrial structure of myocardial cells,oxidative stress,and energy metabolism,thus achieving the therapeutic effects on chronic heart failure.CONCLUSION The Chinese medicine compound preparation Jianpi Huatan Quyu recipe exerts therapeutic effects on chronic heart failure possibly by influencing the mitochondrial structure of cardiomyocytes,oxidative stress,energy metabolism,and other processes.Future studies are warranted to investigate the role of the IL-17 signaling pathway,PI3K-Akt signaling pathway,HIF-1 signaling pathway,and other pathways in mediating the therapeutic effects of Jianpi Huatan Quyu recipe on chronic heart failure.

Mechanism of Huatan Sanjie Fang in improving goiter in Graves'disease mice based on the Hippo signaling pathway

Objective:To explore the mechanism of Huatan Sanjie Fang(HTSJ)in regulating goiter in Graves'disease(GD)mice by detecting key factors of the Hippo signaling pathway.Methods:A mouse model of GD was established by injecting Ad-TSHR289 adenovirus into the bilateral quadriceps femoris of female mice.Successful mouse models were then randomly divided into a model group,methimazole(MMI)group,and HTSJ group,and fed with deionized water,MMI(4.5 mg/kg per day),and HTSJ(35.10 g/kg per day),respectively,for 10 weeks.Histopathological changes of the thyroid gland were subsequently observed by hematoxylin-eosin staining.Radioimmunoassay was used to detect serum total thyroxine(T4)and thyrotrophin-receptor antibody(TRAb)levels.The relative expression of mRNA of Mst1,YAP,and TAZ were detected by quantitative real-time polymerase chain reaction,while the protein expression of Mst1,YAP,TAZ,pMst1,and pYAP were detected by western blot.Results:After 10 weeks of drug intervention,goiter and other pathological changes in the HTSJ group significantly improved compared with the model group,and the levels of serum T4 and TRAb significantly decreased(P=.002,P<.001,respectively).Decreased mRNA expression of Mst1,YAP,and TAZ,the key factors of the Hippo signaling transduction pathway,was also observed(P=.002,P=.022,P<.001,respectively).In contrast,protein expression of Mst1(P=.046),pMst1(P=.026),and p YAP(P=.004)increased,while protein expression of YAP and TAZ decreased(P=.041,P<.001,respectively).Conclusion:HTSJ can effectively improve goiter in GD mice through the Hippo signaling pathway.

Effect of Qingjin Huatan Decoction on transferrin and Iron regulatory protein in COPD rats

Objective:To explore the mechanism of Qingjin Huatan Decoction in regulating iron metabolism by regulating inflammatory factors in the inflammatory environment of chronic obstructive pulmonary disease.Methods:The COPD model was prepared by tracheal drops of lipopolysaccharide(LPS)combined with smoke.40 rats were randomly divided into normal group,COPD group,roxithromycin western medicine group and Qingjin Huatan Decoction traditional Chinese medicine group(n=10).Post-molding drug administration intervention,Qingjin Huatan Decoction Chinese medicine group was given 14.62 g/kg(Qingjin Huatan Decoction),roxithromycin western medicine group was given 0.01575 g/kg(roxithromycin),COPD group and normal group were given normal saline 10 mL/kg,twice a day.The expressions of Hepcidin,IL-1β,IL-10 and TGF-β1 in serum of rats in each group were detected by ELISA.WesternBlot and qRT-PCR were used to detect the expression of TF and IREB2 protein and mRNA in lung tissues of each group.Results:Compared with the normal group,the contents of serum Hepcidin and IL-10 in COPD group were significantly decreased(P<0.01),while the contents of serum IL-1βand TGF-β1 were significantly increased(P<0.01,P<0.05).Compared with COPD group,the contents of serum Hepcidin and IL-10 were significantly increased in the two drug groups(P<0.01),while the contents of serum IL-1βand TGF-β1 were significantly decreased in the two drug groups(P<0.05).Compared with normal group,TF mRNA and protein expression in COPD group were increased(P<0.01),while IREB2 mRNA and protein expression were decreased(P<0.01).Compared with COPD group,TF mRNA and protein expressions in lung tissues of the two-drug group were decreased(P<0.01,P<0.05),while IREB2 mRNA and protein expressions were increased(P<0.01).Conclusion:Iron metabolism is related to inflammation.Qingjin Huatan Decoction can regulate iron metabolism in inflammatory environment to treat COPD.

Clinical efficacy of angina pectoris after pci in patients with coronary heart disease complicated with type 2 diabetes by Yiqi Yangyin and Huatan Tongluo recipe

Objective:To evaluate the clinical efficacy of Yiqi Yangyin and Huatan Tongluo Recipe in improving the symptoms of angina pectoris and cardiac function in patients with coronary heart disease complicated with type 2 diabetes after PCI.Methods Sixty-two patients with coronary heart disease complicated with type 2 diabetes after PCI were randomly divided into treatment group and control group,with 31 patients in each group.Both groups were treated with western medicine.The treatment group added Yiqi Yangyin and Huayu Tongluo Recipe granules.The changes of metabolic equivalent(METs),angina symptoms,TCM symptoms,BNP,hypersensitive C-reactive protein(hs-CRP),Interleukin-6(IL-6),Tumor necrosis factor-(TNF-α)and left ventricular ejection fraction(LVEF)were analyzed after 1 course of treatment and Corrected TIMI Frame Count(CTFC)after six month.Results The improvement of METS and LVEF in the treatment group was better than that in the control group(P<0.05);the improvement of BNP,hs-CRP,IL-6,TNF-αand CTFC in the treatment group was better than that in the control group;the curative effect of angina pectoris in the treatment group was better than that in the control group;the effective rate of TCM syndrome improvement in the treatment group was better than that in the control group.Conclusion Yiqi Yangyin and Huatan Tongluo Recipe can effectively alleviate angina pectoris symptoms in patients with coronary heart disease complicated with type 2 diabetes after PCI,suggesting cardiac function,inhibiting inflammatory response,and improving microcirculation disturbance.

A Meta-analysis on the Treatment of Insulin Resistance in Polycystic Ovary Syndrome by Bushen Huatan Recipe

Objective:To systematically evaluate the efficacy and safety of Bushen Huatan recipe compared with metformin in the treatment of insulin resistance in polycystic ovary syndrome(PCOS).Methods Researches were reviewed by searching the China National Knowledge Infrastructure(CNKI),VIP network,WanFang database,SinoMed,Cochrane Library,Web of Science,PubMed and Embase up to December 8,2019.We retrieved the RCTs of Bushen Huatan recipe and metformin in the treatment of insulin resistance in polycystic ovary syndrome and applied Revman5.3 software for meta analysis.Results A total of 5 RCTs were included,with a total of 285 PCOS patients.The results showed:①There was no significant difference between the two groups in LH[WMD=-2.68,95%CI(-6.21,0.84),P=0.14]、FSH(WMD=0.36,95%CI(-0.59,1.32),P=0.45]、LH/FSH(WMD=-0.29,95%CI(-1.06,0.48),P=0.46)、fasting blood glucose(FPG)[WMD=0.05,95%CI(-0.18,0.28),P=0.67]、fasting insulin(FINS)[WMD=-0.91,95%CI(-15.28,13.46),P=0.9].②TCM syndrome score:Bushen Huatan recipe group[WMD=-3.10,95%CI(-5.39,-0.81),P=0.008]was better than metformin group;③Total clinical effective rate:Bushen Huatan recipe group[RR=1.50,95%CI(1.18,1.92),P=0.001]was better than metformin group.Conclusion Bushen Huatan recipe has the same effect as metformin in improving the sex hormones and glucose metabolism of patients with PCOS complicated with insulin resistance,and can effectively improve the clinical symptoms of patients,reduce TCM syndrome score,and improve the total therapeutic efficiency.

Efficacy of Jianpi Bushen Huatan Recipe in the treatment of obese polycystic ovarian syndrome:A meta-analysis

Objective:To evaluate the effects of Jianpi Bushen Huatan Recipe on sex hormone levels、blood lipid and blood glucose levels in the treatment of obese poly-cystic ovarian syndrome(PCOS).Methods:Data bases including the CNKI、Vip、Wanfang were searched.Studies about randomized controlled trials(RCT)of the effectiveness of Jianpi Bushen Huatan Recipe Combined with Metformin in the Treatment of obese PCOS were included.Rev Man 5.3 software was used for meta analysis.Results:A total of 11 studies were enrolled.Meta-analysis showed that Jianpi Bushen Huatan Recipe Combined with Metformin significantly improved the clinical total effective rate of patien ts(RR=1.32,95%CI(1.20,1.45),P<0.00001);reduced the body mass index(BMI)(SMD=-0.92,95%CI(-1.13,-0.72),P<0.00001),luteinizing hormone(LH)(SMD=-1.00,95%CI(-1.37,-0.62),P<0.00001),LH/FSH(SMD=-1.03,95%CI(-1.34,-0.71),P<0.00001),insulin resistant index(HOMA-IR)(SMD=-0.59,95%CI(-0.79,-0.40),P<0.00001),fasting insulin(FIN)(SMD=-0.77,95%CI(-1.19,-0.35),P=0.0003),total cholesterol(TC)(SMD=-0.63,95%CI(-0.88,-0.38),P<0.00001),triglycerides(TG)(SMD=-0.60,95%CI(-0.83,-0.36),P<0.00001),highdensity lipoprotein(HDL)(SMD=-0.41,95%CI(-0.51,-0.32),P<0.00001).However,there was no statistically significant in waist-to-hip ratio(WHR),follicle stimulating hormone(FSH),fasting blood sugar(FBS)and low density lipoprotein(LDL).Conclusions:Jianpi Bushen Huatan Recipe Combined with Metformin in the treatment of obese PCOS has an advantage in improving the sex hormone level,blood lipid and blood glucose level,and is superior to metformin alone.

Yiqi Yangyin and Huatan Quyu granule can improve skeletal muscle energy metabolism in a type 2 diabetic rat model by promoting the AMPK/SIRT/PGC-1α signalling pathway

Objective:To investigate how Yiqi Yangyin and Huatan Quyu granule (YYHO) improves skeletal muscle insulin resistance in a type 2 diabetic rat model and to discover whether the molecular mechanism is related to the promotion of the AMPK/SIRT/PGC-1α signalling pathway.Methods:Rats were randomly divided into 4 groups:the normal group,the model group,the YYHQ granule group,and the pioglitazone group.The type 2 diabetic rat model was established by feeding a high-fat diet for 5 weeks along with a single intraperitoneal injection of 30 mg/kg streptozotocin (STZ).After modelling successfully,the appropriate drug was intragastrically administered to diabetic rats for 2 weeks,once per day.The YYHQ granule group was given a dose of 4.8 g/kg body weight per day,the pioglitazone group was given a dose of 1.35 mg/kg body weight per day.The doses for both groups were equivalent to the clinical equivalent dose based on a previous study.Other groups were gavaged with the same amount of saline water.Body weight,food intake,water intake,urine volume and grip strength were recorded weekly.The fasting blood glucose(FBG) was determined weekly using blood glucose test strips.The related glucose and lipid metabolism indexes,e.g.,fasting insulin (Fins),glycated haemoglobin (GHb),HOMA-IR,ISI,triglycerides (TG),total cholesterol (TC),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C) and free fatty acid (FFA),were determined using biochemical method.The mRNA expression levels of adenosine monophosphate-activated protein kinase (AMPK),peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PGC-1α),carnitine palmitoyl transterase-1 (CPT-1),Sirtuin 1 (SIRT1),and Sirtuin 3 (SIRT3) were assessed using quantitative real-time PCR (qRT-PCR).The protein expression levels of creatine kinase (CK),Ca2+ ATPase,α-Actin,AMPK,PGC-1α and CPT-1 were determined using enzyme-linked immunosorbent assay method (ELISA).Results:Body weight decreased significantly (P <.01),food intake,water intake and urine volume increased significantly (P <.01),and grip strength decreased significantly (P <.01) in the model group compared with the normal group.The levels of FBG,Fins,GHb and HOMA-IR increased significantly (P <.01),and the ISI decreased significantly (P <.01) in the model group.The levels of TG,TC,LDL-C and FFA increased significantly (P <.05 or P <.01),and the level of HDL-C decreased significantly (P <.05) in the model group.These changes were reversed after treatment with YYHQ granule or pioglitazone.Compared with the model group,the YYHQ granule and pioglitazone groups significantly improve body weight,water intake and urine volume (P <.05 or P <.01),however,both treatments had no significant effect on food intake (P >.05).The levels of FBG,Fins,GHb,HOMA-IR and ISI were improved significantly (P <.01) and the levels of TG,TC and LDL-C were improved significantly (P <.05 or P <.01),however,both treatments had no significant effect on the levels of HDL-C and FFA (P >.05).Further results indicated that YYHQ granule significantly decreased the mRNA expression of AMPK,PGC-1α,CPT-1,SIRT1 and SIRT3 in skeletal muscle (P <.01) and the pioglitazone group showed similar effects;moreover,the protein expression levels of CK,Ca2+ATPase,α-Actin,AMPK,PGC-1α and CPT-1 in skeletal muscle significantly decreased (P <.01),however,pioglitazone had no significant effect on CK and α-Actin (P >.05).Conclusion:The possible molecular mechanism of YYHQ granule improving skeletal muscle insulin resistance in a type 2 diabetic rat model may be related to the stimulation of energy metabolism in skeletal muscle via the AMPK/SIRT/PGC-1α signalling pathway.

Efficacy and safety of Qingfei Huatan formula in the treatment of acute exacerbation of chronic obstructive pulmonary disease:A multi-centre,randomised,double-blind,placebo-controlled trial

Background Chronic obstructive pulmonary disease(COPD),a common respiratory disease,can be effectively treated by traditional Chinese medicine(TCM).Qingfei Huatan,a TCM formula,has been reported to effectively alleviate the clinical symptoms of COPD patients.However,there is a lack of multi-centre,randomised,double-blind,controlled clinical trials documenting the clinical efficacy and safety of this formula in the treatment of acute exacerbation of COPD(AECOPD).Objective This study evaluated the efficacy and safety of Qingfei Huatan formula in the treatment of AECOPD,thereby providing high-quality clinical evidence.Design,setting,participants and interventions A total of 276 patients with AECOPD were included in this multi-centre,randomised,double-blind,placebo-controlled trial and were randomised into treatment and control groups at a ratio of 1:1.Patients in the treatment and control groups took Qingfei Huatan granules or simulated Qingfei Huatan granules twice a day,for 14 days,in addition to Western medicine treatment.All patients were followed up for 3 months.Main outcome measures The primary outcome was time taken to symptom stabilisation.The secondary outcomes included duration of antibiotic use,clinical symptom and sign score,TCM syndrome score,dyspnoea score,and quality of life(QOL)score.Meanwhile,the safety of the formula was assessed through routine urine and stool tests,electrocardiograms,liver and kidney function tests,and the observation of adverse events throughout the trial.Results The time taken for effective stabilisation(P<0.05)and obvious stabilisation(P<0.01),and the duration of antibiotic use(P<0.05)were significantly shorter in the treatment group than in the control group.On days 6,9,12 and 14 of treatment,clinical symptom and sign score decreased in both groups,particularly in the treatment group(P<0.01).On days 9,12 and 14 of treatment,the TCM syndrome scores of both groups were reduced(P<0.01),with more significant reductions in the treatment group.At 3 months after the end of treatment,the treatment group continued to have lower clinical symptom and sign score and TCM syndrome score than the control group(P<0.01).On days 6,9,12 and 14 of treatment,dyspnoea and QOL scores were markedly reduced in the two groups(P<0.05 and P<0.01,respectively),especially in the treatment group.At 3 months after the end of treatment,dyspnoea and QOL scores were lower in the treatment group than those in the control group(P<0.01).No serious adverse events were observed in either group.Conclusion The Qingfei Huatan formula can effectively shorten the duration of AECOPD and antibiotic use,significantly relieve clinical symptoms,and increase QOL for AECOPD patients,with a favourable safety profile.These results suggest that this formula can be used as a complementary treatment for AECOPD patients.

化痰消瘀汤联合炔雌醇环丙孕酮片治疗多囊卵巢综合征患者的临床疗效及对其妊娠的影响

目的 观察化痰消瘀汤联合炔雌醇环丙孕酮治疗多囊卵巢综合征(Polycystic ovarian syndrome,PCOS)患者的疗效及对其妊娠的影响。方法 选取2020年6月—2021年6月期间山东省枣庄市妇幼保健院生殖医学中心及妇科就诊的PCOS患者80例,采用随机数字表法分为对照组和观察组,每组各40例。对照组予炔雌醇环丙孕酮治疗,观察组在对照组基础上加用化痰消瘀汤治疗。两组患者均治疗3个月。观察比较两组患者治疗前后中医证候积分、血清激素[促黄体生成素(Luteinizing hormone,LH)、促卵泡生成素(Follicle stimulating hormone,FSH)、睾酮(Testosterone,T)、雌二醇(Estradiol,E_(2))]水平、卵巢体积、卵泡数目、子宫内膜厚度(Endometrial thickness,EM)、阻力指数(Resistance Index,RI)、螺旋动脉搏动指数(Spiral artery pulsatilityindex,PI),并比较两组患者妊娠结局。结果 治疗后两组患者中医证候积分均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组中医证候积分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清激素E_(2)、LH及T水平均较治疗前明显降低,FSH水平较治疗前升高,差异有统计学意义(P<0.05);且观察组血清激素E_(2)、LH及T水平均明显低于对照组,FSH水平明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者卵巢体积及卵泡数目均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组卵巢体积及卵泡数目均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者EM值均较治疗前升高,PI、RI值均较治疗前降低,差异有统计学意义(P<0.05);且观察组EM值明显高于对照组,PI、RI值均明显低于对照组,差异有统计学意义(P<0.05)。治疗后观察组妊娠率71.05%(27/38)、排卵率89.47%(34/38)及生产率57.59%(22/38)明显高于对照组51.36%(19/37)、75.68%(28/37)、24.32%(9/37),且早期流产率13.16%(5/38)明显低于对照组27.02%(10/37),差异有统计学意义(P<0.05)。结论 化痰消瘀汤的应用能进一步有效减轻PCOS患者临床症状,改善其卵巢异常状态,改变机体多囊性,调节激素水平和子宫容受性,有利于促进患者排卵及妊娠,提高妊娠率。

补肾化痰活血方治疗多囊卵巢综合征合并胰岛素抵抗不孕症的临床研究

[目的]观察补肾化痰活血方治疗多囊卵巢综合征合并胰岛素抵抗(PCOS-IR)不孕症的临床疗效。[方法]将62例肾虚痰瘀型PCOS-IR不孕症患者随机分为治疗Ⅰ组和治疗Ⅱ组,每组各31例。两组均给予基础干预,治疗Ⅰ组给予二甲双胍,治疗Ⅱ组给予补肾化痰活血方,治疗及随访周期均为3个月。统计两组的妊娠及排卵情况,比较两组治疗前后身体质量指数(BMI)、中医证候积分、糖代谢指标[空腹血糖(FBG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)]、性激素水平[睾酮(T)、促黄体生成素(LH)、促卵泡刺激素(FSH)、LH/FSH、雌二醇(E2)、催乳素(PRL)]、着床期(排卵后6~9 d)子宫内膜三维超声参数[厚度、分型、容积、血管化指数(VI)、血流指数(FI)、血管化-血流指数(VFI)]和不良反应。[结果]与治疗前比较,治疗后两组的BMI、中医证候积分、FINS、HOMA-IR、LH、LH/FSH水平均降低(P<0.01或P<0.05),且治疗Ⅱ组的中医证候积分降低显著(P<0.01)。与治疗Ⅰ组比较,治疗Ⅱ组的周期排卵率较高,但比较后差异无统计学意义(P>0.05),着床期子宫内膜血流参数VI、VFI水平较高(P<0.05)。治疗结束及随访后,治疗Ⅱ组的临床妊娠率分别为61.54%(16/26)和73.08%(19/26),明显高于治疗Ⅰ组对应时间节点的妊娠率[33.33%(8/24)和41.67%(10/24)],差异有统计学意义(P<0.05),且胚胎停育率更低(P<0.05)。治疗Ⅱ组的不良反应率显著低于治疗Ⅰ组(15.38%vs 41.67%,P<0.05)。[结论]补肾化痰活血方治疗肾虚痰瘀型PCOS-IR不孕症临床效果良好,能够改善胰岛素抵抗及肥胖体征,调节内分泌紊乱,显著增加着床期子宫内膜血流灌注,提高临床妊娠率并改善妊娠结局,且不良反应小,值得推广应用。

基于BDNF通路探讨化痰通络汤治疗卒中后认知功能障碍的研究

目的 观察化痰通络汤治疗卒中后认知功能障碍(PSCI)痰瘀阻络证的临床疗效及其对患者血清脑源性神经营养因子(BDNF)通路相关因子的影响。方法 收集符合纳入标准的患者60例,随机分为对照组和治疗组各30例。对照组予基础治疗和尼莫地平治疗,治疗组在对照组治疗基础上加服化痰通络汤,2组疗程均为4周。治疗前后比较2组简易精神状态评价量表(MMSE)、中医证候积分及血清BDNF、核转录因子κB(NF-κB)、B淋巴细胞瘤-2(Bcl-2)、Bcl-2相关X蛋白(Bax)水平变化,治疗后评估2组患者中医临床疗效,治疗期间观察2组患者不良反应发生情况。结果 治疗后,2组患者MMSE评分显著增加,中医证候积分总积分明显降低(P<0.01),治疗组优于对照组(P<0.01);2组患者血清BDNF、NF-κB、Bcl-2水平明显升高(P<0.05,P<0.01),Bax水平明显下降(P<0.01),治疗组优于对照组(P<0.01)。结论 化痰通络汤能够改善痰瘀阻络型PSCI患者临床症状,安全有效,其疗效机制可能与调控BDNF通路,抑制神经细胞凋亡有关。

针刺联合息风化痰通络颗粒对急性脑梗死溶栓患者的影响及机制研究

目的:评估针刺联合息风化痰通络颗粒对急性脑梗死(ACI)后溶栓患者的疗效,探讨其作用机制。方法:纳入ACI溶栓患者178例,按随机数字表法分为观察组和对照组各89例,最终164例完成研究,观察组81例,对照组83例。对照组接受常规治疗,观察组在对照组的基础上加用针刺联合息风化痰通络颗粒治疗,两组均治疗2周。评估比较两组的临床疗效、美国国立卫生研究院卒中量表(NIHSS)评分、日常生活活动能力量表(ADL)评分、血清炎症因子水平、氧化应激因子水平以及脑血流动力学。结果:治疗后,两组ADL评分、白细胞介素-10(IL-10)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、过氧化氢酶(CAT)水平均较治疗前升高(P<0.05),NIHSS评分、白细胞介素-1β(IL-1β)、超敏C反应蛋白(hs-CRP)、丙二醛(MDA)水平较治疗前降低(P<0.05),观察组NIHSS评分、IL-1β、IL-10、hs-CRP、MDA水平低于对照组(P<0.05),ADL评分、SOD、GSH-Px、CAT水平高于对照组(P<0.05)。两组脑血流动力学指标均较治疗前改善,且观察组改善情况优于对照组(P<0.05)。观察组治疗总有效率95.06%,对照组84.34%,两组疗效比较,差异有统计学意义(P<0.05)。结论:针刺联合息风化痰通络颗粒能够促进ACI溶栓患者脑血流动力学恢复,改善缺血再灌注损伤的神经功能,其作用机制可能与减轻炎症反应、抑制氧化应激反应有关。

化痰息风通络汤联合依达拉奉右莰醇治疗脑梗死临床疗效分析

目的:探讨化痰息风通络汤联合依达拉奉右莰醇治疗急性脑梗死(ACI)的疗效。方法:选取2021年1月—2023年3月无锡市中医医院和宿迁市中医院收治的205例ACI患者,按照随机数表法分为对照组(102例)和试验组(103例)。试验组和对照组患者因自然失访分别脱落2例和3例,两组纳入最终研究的分别为101例和99例。对照组给予依达拉奉右莰醇注射用浓溶液,试验组在对照组基础上加用化痰息风通络汤。两组患者疗程均为10 d。比较两组患者神经功能、自理功能、临床疗效、血液流变学指标、肝肾功能、神经元特异性烯醇化酶(NSE)及药物安全性。结果:治疗后,试验组美国国立卫生研究院卒中量表(NIHSS)、改良Rankin量表(mRS)评分、血浆黏度、全血高切黏度、全血低切黏度、NSE评分低于治疗前(P<0.05),且低于对照组(P<0.05),Barthel指数(BI)评分高于治疗前(P<0.05)且高于对照组(P<0.05);试验组总有效率高于对照组(P<0.05);两组安全性结果比较差异无统计学意义(P>0.05)。结论:化痰息风通络汤联合依达拉奉右莰醇治疗ACI可增强治疗效果,改善患者神经功能,增强自理能力,改善血液流变学及脑神经损伤,且安全性良好。

基于网络药理学探讨益气化痰活血方治疗甲状腺功能减退症的作用机制

目的:基于网络药理学探讨益气化痰活血方治疗甲状腺功能减退症的作用机制。方法:采用中药系统药理学数据库与分析平台(TCMSP)、化学专业数据库、本草组鉴平台筛选出益气化痰活血方的活性成分,利用Swiss Target Prediction数据库预测活性成分的潜在靶点。利用Gene Cards数据库、Dis Ge NET数据库和在线人类孟德尔遗传数据库(OMIM)检索甲状腺功能减退症的相关靶点。利用STRING数据库对药物与疾病交集靶点进行蛋白质-蛋白质相互作用网络构建,获得益气化痰活血方治疗甲状腺功能减退症的关键靶点。利用Metascape对关键靶点进行京都基因与基因组百科全书(KEGG)信号通路与基因本体论(GO)功能富集分析。结果:得到药效成分46个、药物靶点266个、甲状腺功能减退症靶点1 294个,最终获得关键靶点69个、KEGG通路2条。益气化痰活血方治疗甲状腺功能减退症主要成分为槲皮素、β-谷甾醇、山柰酚等,关键靶点为白细胞介素(Interleukin,IL)-6、IL-10、肿瘤坏死因子(Tumor Necrosis Factor,TNF)、丝氨酸/苏氨酸蛋白激酶(Akt Serine/Threonine Kinase,Akt)、血管内皮生长因子A(Vascular Endothelial Growth Factor A,VEGFA),关键的信号通路可能包括磷脂酰肌醇3激酶-蛋白激酶B(Phosphatidylinositol 3-kinase-Akt,PI3K-Akt)信号通路、晚期糖基化终末产物-糖基化终末产物受体(AGE-RAGE)信号通路等。结论:本研究初步揭示了益气化痰活血方多成分、多靶点、多途径治疗甲状腺功能减退症的机制,为益气化痰活血方的临床开发利用提供了依据。

化痰通遂汤联合督脉三针对脑卒中后吞咽障碍患者脂质过氧化及血清NPAS4、PARK7的影响

目的探讨化痰通遂汤联合督脉三针对脑卒中后吞咽障碍对患者脂质过氧化及血清NPAS4、PARK7的影响。方法研究将前瞻性选取2020年3月—2022年4月在医院诊疗的86例脑卒中后吞咽障碍患者为受试对象,根据数字表法将其分成试验组与对照组,各43例,对照组予以化痰通遂汤治疗,试验组予以化痰通遂汤治疗的同时采用督脉三针治疗,密切观察并对比两组研究对象的疗效,治疗前后的氧化应激和脂质过氧化指标,血清NPAS4、PARK7水平,NIHSS评分、FMA评分、SSA评分及SIS评分。结果应用化痰通遂汤联合督脉三针治疗后的试验组疗效明显高于单纯应用化痰通遂汤治疗的对照组(P<0.05);治疗后两组患者的SOD、iso-PGs指标较治疗前均上升(P<0.05),且试验组SOD指标高于对照组(P<0.05),但试验组iso-PGs指标较治疗前无明显差异(P>0.05),且试验组低于对照组(P<0.05),MDA指标治疗较治疗前显著下降(P<0.05),且试验组低于对照组(P<0.05);治疗前两组的NIHSS评分、SSA评分、FMA评分及SIS评分均无显著性差异(P>0.05),治疗后试验组患者的FMA评分及SIS评分均显著高于对照组(P<0.05),而NIHSS评分、SSA评分显著低于对照组(P<0.05);治疗前两组血清NPAS4、PARK7水平较治疗前均无显著性差异(P>0.05),且试验组患者血清NPAS4、PARK7水平均显著低于对照组(P<0.05)。结论应用化痰通遂汤联合督脉三针治疗脑卒中后吞咽障碍,效果极佳,联用能够改善氧化应激以及脂质过氧化指标,降低血清NPAS4、PARK7水平,提高患者生存水平,安全可靠,临床应用前景较为宽阔。

息风化痰通络颗粒对急性脑梗死患者脂代谢、血液流变学指标及神经功能的影响

目的观察息风化痰通络颗粒对急性脑梗死患者脂代谢、血液流变学指标及神经功能的影响。方法80例急性脑梗死患者按随机数字表法分为观察组与对照组各40例,对照组采用常规治疗,观察组在对照组基础上予息风化痰通络颗粒治疗。记录并对比分析两组间脂代谢指标[总胆固醇(TC)甘油三酯(TAG)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C)]、血液流变学指标[全血高切黏度(HSV)、血小板黏附率(PAdR)及红细胞比容(HCT)]、脑血流灌注[大脑中动脉舒张末期血流速度(EDV)、收缩期峰值流速(PSV)及平均血流速度(Vm)]、美国国立卫生研究院卒中量表(NIHSS)评分等。结果治疗后,两组TC、TAG、HDL-C及LDL-C均较治疗前改善(P<0.05),且观察组明显优于对照组(P<0.05);治疗后,两组HSV、PAdR、HCT均较治疗前降低(P<0.05),且观察组明显低于对照组(P<0.05);治疗后,两组EDVPSV及Vm均较治疗前升高(P<0.05),且观察组明显高于对照组(P<0.05);治疗后,两组NIHSS评分均较治疗前降低(P<0.05),且观察组明显低于对照组(P<0.05)。结论息风化痰通络颗粒可改善急性脑梗死患者脂代谢,改善血液流变学指标,增加脑血流灌注,促进神经功能恢复。

熄风化痰止眩汤联合悬灸治疗风痰上扰型后循环缺血性眩晕的临床研究

目的探讨熄风化痰止眩汤联合悬灸对风痰上扰型后循环缺血性眩晕患者的治疗效果。方法选取2020年5月-2023年5月江阴市中医院脑病科中医收治的81例风痰上扰型后循环缺血性眩晕患者作为研究对象,按随机数表法分为3组,各27例。其中中药组患者服用熄风化痰止眩汤,悬灸组患者采用悬灸治疗,联合组患者采用熄风化痰止眩汤及悬灸联合治疗。各组治疗周期为4周,比较2组患者的临床疗效、眩晕症状评分[Berg平衡表(BBS)评分、眩晕评估评分量表(DARS)]、脑血流速度[椎基底动脉(BA)、左椎动脉(LVA)和右椎动脉(RVA)]、中医症状积分。结果3组患者治疗后的各指标均优于治疗前。联合组的总有效率为92.60%(25/27),中药组为70.37%(19/27),悬灸组为74.07%(20/27),联合组的疗效明显优于中药组和悬灸组,差异有统计学意义(P<0.05)。联合组的BBS评分明显高于中药组和悬灸组,而DARS评分显著低于中药组和悬灸组(P<0.05);联合组BA、LVA、RVA明显高于中药组和悬灸组(P<0.05);中医症状积分在联合组明显低于中药组和悬灸组(P<0.05)。结论熄风化痰止眩汤联合悬灸治疗风痰上扰型后循环缺血性眩晕患者,可显著提高治疗效果,改善患者后循环血流和眩晕症状,具有明显优势。

温阳化痰贴对哮喘患儿调控因子TLR4/NF-κB影响研究

目的研究温阳化痰贴对哮喘患儿调控因子Toll样受体4(TLR4)/核转录因子-κB(NF-κB)的影响。方法选取2020年10月至2021年6月北京市昌平区中西医结合医院儿科门诊治疗的小儿哮喘缓解期患儿100例,随机分为对照组51例、治疗组49例,对照组给予西医常规治疗,治疗组西医治疗联合应用温阳化痰贴贴敷。结果治疗组的调控因子TLR4、NF-κB及肺功能FEF25、FEF50、FEF75较对照组明显改善,差异有统计学意义(P<0.05)。结论应用温阳化痰穴贴联合西药治疗小儿哮喘可以调节机体免疫调控因子,从而直接或间接调节细胞、体液免疫功能,提高机体抵抗力,使疾病快速恢复。

慢性支气管炎急性期患者的常规药物结合自拟宣肺化痰汤治疗作用

目的分析急性期慢性支气管炎患者的常规药物结合自拟宣肺化痰汤治疗作用。方法回顾性选取江苏省句容市中医院于2021年6月—2023年2月收治的76例慢性支气管炎急性期患者的临床资料,依照用药方案不同分为对照组(常规药物)、观察组(常规药物结合自拟宣肺化痰汤),各38例。比较两组临床疗效、肺功能、血气指标、炎性因子水平、不良反应发生率。结果观察组治疗总有效率为97.37%(37/38),高于对照组的76.32%(29/38),差异有统计学意义(χ^(2)=7.369,P<0.05)。用药前,两组肺功能、血气指标以及炎性因子水平比较,差异无统计学意义(P均>0.05)。用药后,观察组用力肺活量、第1秒用力呼气量、氧分压、二氧化碳分压、白细胞介素-10、超敏C反应蛋白均优于对照组,差异有统计学意义(P均<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论慢性支气管炎急性期患者,采用常规药物+自拟宣肺化痰汤治疗的效果更好,可改善肺功能及血气指标,减轻炎症反应,且安全性高。

清肺化痰汤治疗痰热郁肺证老年晚期非小细胞肺癌患者的临床疗效及对其生活质量、血清癌胚抗原、神经元特异性烯醇化酶、细胞角质素片段抗原水平的影响

目的探讨清肺化痰汤治疗痰热郁肺证老年晚期非小细胞肺癌患者的临床疗效及对其生活质量、血清癌胚抗原(Carcinoembryonic antigen,CEA)、神经元特异性烯醇化酶(Neuron specific enolase,NSE)、细胞角质素片段抗原(Cytokeratin 19 fragment antigen21-1,CYRAF21-1)水平的影响。方法选取2019年7月—2020年10月期间在东南大学医学院附属南京同仁医院接受治疗的非小细胞肺癌患者80例,采用随机数字表法分为对照组和观察组,每组各40例。对照组采用DP化疗方案治疗,观察组在对照组基础上联合清肺化痰汤治疗,每个疗程为21 d,连续治疗4个疗程。观察比较两组患者临床疗效、不良反应情况,治疗前后痰热郁肺证证候积分(咳嗽,咳痰、咯痰黄稠,气喘或气急,喉中痰鸣,发热,口渴)、血清肿瘤标记物(CEA、NSE、CYRAF21-1)、生命质量量表(QOL-38)评分改善情况。结果治疗后观察组总缓解率62.5%(25/40)、临床获益率85.0%(34/40)均明显高于对照组总缓解率40.0%(16/40)、临床获益率65.0%(26/40),差异有统计学意义(P<0.05)。治疗后两组患者咳嗽、咳痰、咯痰黄稠、气喘或气急、喉中痰鸣、发热、口渴评分均较治疗前降低,差异有统计学意义(P<0.01);且观察组痰热郁肺证证候积分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清CEA、NSE及CYRAF21-1水平均较治疗前明显降低,差异有统计学意义(P<0.01);且观察组血清CEA、NSE及CYRAF21-1水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者身体状况、情绪状况、功能状况、肺癌相关症状、社会/家庭状况评分均较治疗前明显降低,总体健康状况评分较治疗前明显升高,差异有统计学意义(P<0.01);且观察组QOL-38评分改善情况明显优于对照组,差异有统计学意义(P<0.05)。治疗期间,观察组不良反应发生率明显低于对照组,差异有统计学意义(P<0.05)。结论清肺化痰汤治疗痰热郁肺证老年晚期非小细胞肺癌疗效显著,能够有效降低血清CEA、NSE及CYRAF21-1水平,缓解临床症状,减轻化疗药物不良反应,提高患者生活质量。