Paleo-Tethyan Oceanic Crust Subduction in the Eastern Section of the East Kunlun Orogenic Belt:Geochronology and Petrogenesis of the Qushi'ang Granodiorite

The Qushi’ang granodiorite（QSG） is located at the central east of the ophiolitic melange belt in the East Kunlun Orogenic Belt（EKOB） in the northern margin of the Qinghai-Tibetan Plateau. LA-MC-ICP-MS zircon U–Pb dating suggests that the granodiorite and mafic microgranular enclaves（MMEs） crystallized 246.61±0.62 and 245.45±0.9 Ma ago, respectively. Granodiorite, porphyritic diorite, and MMEs are metaluminous and medium-K calk-alkaline series, with island-arc magma features, such as LILE enrichment and HFSE depletion. The porphyritic diorite has high Cr（13.50 ppm to 59.01 ppm）, Ni（228.53 ppm to 261.29 ppm）, and Mg~#（46–54）. Granodiorite and porphyritic diorite have similar mineral compositions and evolved major and trace elements contents, particularly Cr and Ni, both of which are significantly higher than that in granites of the same period. The crystallization age of MMEs is close to that of granodiorite, and their major and trace elements contents are in-between porphyritic diorite and granodiorite. The results suggest that the original mafic magma, which was the product of mantle melting by subduction process, intruded into the lower crust（Kuhai Rock Group）, resulting in the formation of granodiorite. Countinous intrusion of mafic magma into the unconsolidated granodiorite formed MMEs and porphyritic diorite. The granodiorite reformed by late-stage strike-slip faulting tectonic event indicates that the strike-slip fault of Middle Kunlun and the collision of the Bayanhar block with East Kunlun were later than 246 Ma. Therefore, the formation of the QSG not only indicates the critical period of evolution of East Kunlun but also represents the tectonic transition from oceanic crust subduction to slab breaking.

Exploration and Study of Jianpi Qushi Powder Combined with Standard Anti HP Quadruple Therapy in the Treatment of HP Infectious Gastritis of Spleen Deficiency and Dampness Stagnation Type

Objective: To explore the therapeutic effect of traditional Chinese medicine Jianpi Qushi powder combined with standard anti-HP quadruple therapy in the treatment of HP infectious gastritis with spleen deficiency and dampness stagnation. Methods: From January 2020 to December 2021, 223 patients with laboratory-confirmed HP infection who were admitted to the Outpatient and Inpatient Department of Internal Medicine in our hospital were selected as the research objects and randomly divided into two groups. 101 patients in the control group were given standard anti HP quadruple therapy;122 cases in the treatment group were given traditional Chinese medicine Jianpi Qushi powder combined with standard anti HP quadruple therapy. The two groups were rechecked carbon breath test after the designed course of treatment, and the curative effects of the two groups were compared. Results: 113 cases in the treatment group were cured by traditional Chinese medicine Jianpi Qushi powder combined with standard anti HP quadruple therapy, and the cure rate was 92.62%. 84 cases in the control group were cured by standard anti HP quadruple therapy, and the cure rate was 83.17%, χ2 = 4.7955, P = 0.0285, the difference was statistically significant (P < 0.05). Conclusion: Traditional Chinese medicine Jianpi Qushi powder combined with standard anti HP quadruple therapy in the treatment of HP infectious gastritis with spleen deficiency and dampness stagnation is one of the best treatment schemes for HP infection. The results of this study achieve the best clinical treatment effect, and provide a more valuable and reliable method for the treatment of gastropathy in clinical internal medicine, which is worthy of popularization and application.

Research Progress of Jianpi Qushi Powder Combined with Standard Anti Hp Quadruple Therapy in the Treatment of Hp Infectious Gastritis with Spleen Deficiency and Dampness Stagnation

Stomach Helicobacter pylori infection is one of the common gastric diseases. Helicobacter pylori infectious gastritis of spleen deficiency and dampness stagnation is a relatively intractable chronic disease. In recent years, traditional Chinese medicine methods have emerged one after another in the treatment of gastric Helicobacter pylori infection. By collecting references, the author reviewed the clinical characteristics of gastric Helicobacter pylori infection and the new progress of traditional Chinese medicine treatment.

Clinical study on the treatment of bronchiectasis in remission period by embedding thread combined with Jianpi Qushi Huayu plaster

Objective:To explore the clinical effect of embedding thread combined with Jianpi Qushi Huayu ointment in the treatment of bronchiectasis in remission period,and to observe the effect on the level of inflammatory cytokines.Methods:150 patients with bronchiectasis in remission period were divided into three groups(50 cases in each group),western medicine group(treated with salmeterol fluticasone and low dose erythromycin),combined group(treated with Jianpi Qushi Huayu plaster),observation group(treated with western medicine+Jianpi Qushi Huayu plaster+embedding thread),and the clinical treatment of the three groups were compared.Result:before and after treatment,the improvement of TCM syndrome score,the improvement of pulmonary ventilation index,the improvement of inflammatory cytokines,and the change of adverse reactions.Results:the treatment efficiency of the observation group and the combination group was significantly higher than that of the western medicine group P The peak level of expiratory flow velocity,the maximum expiratory flow,the forced expiratory volume in one second and the ratio of forced expiratory volume in one second to vital capacity in the observation group and the combined group were significantly better than those in the western medicine group and the pre-treatment level(P<0.05),and the improvement in the observation group was better than that in the combined group After treatment,the expression of IL-13,IL-10 and IL-4 in the combined group was significantly better than that in the western medicine group and before treatment(P<0.05),and the improvement in the observation group was better than that in the combined group;there was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusion:catgut embedding combined with Jianpi Qushi Huayu ointment can significantly alleviate the related clinical symptoms and signs,effectively control the further aggravation of the disease,improve the lung function of patients,regulate the level of inflammatory cytokines to reduce the degree of inflammatory reaction,and do not significantly aggravate the adverse reactions of drugs.

Mechanic study of Qushi Kaiyu decoction on non-alcoholic fatty liver disease model rats based on the inhibition of TLR4/NF-ĸB pathway

Background:The objective of this research was to examine the impact of the Chinese herbal formula Qushi Kaiyu(QSKY)on rats with non-alcoholic fatty liver disease(NAFLD)and its inhibitory effect on the TLR4/NF-ĸB pathway.Methods:NAFLD model rats was constructed through high-fat diet.Meanwhile,rats were treated with QSKY(6.4 g/kg)by gavage.The therapeutic effect of QSKY on NAFLD was assessed by testing body weight change,the liver index,lipid concentrations in blood,and antioxidant and inflammatory levels;assessing liver function;and performing pathological staining including hematoxylin-eosin and Oil Red O.The protein levels of key factors in the TLR4/NF-ĸB pathway(TLR4,MyD88,p65 and IKB)in rat liver tissue were determined using western blotting in order to explore the mechanism responsible for the therapeutic effects of QSKY in rats with NAFLD.Results:QSKY significantly reduced the liver index and body weight value;reduced triglyceride,cholesterol,alanine aminotransferase,and aspartate aminotransferase levels in NAFLD rats;improved the pathological changes,such as ballooning degeneration,fat accumulation,necrosis,and inflammation;elevated GSH-Px and superoxide dismutase activities and lowered malondialdehyde levels,indicating that QSKY enhanced the antioxidant capacity;and reduced inflammatory cytokine(IL-6,IL-1β,and TNF-α)levels.Western blotting results showed that QSKY significantly reduced TLR4,MyD88,and decreased the phosphorylation of IKB and p65 protein levels in the livers of rats with NAFLD.Conclusions:QSKY showed therapeutic effects on NAFLD and can alleviate oxidative stress and inflammation.This mechanism may be related to an improvement in TLR4/NF-ĸB pathway.

Qushi Huayu Decoction (祛湿化瘀方) Inhibits Protein and Gene Expression of Cathepsin B in HepG2 Cells Induced by Free Fatty Acids

Objective： To study the experimental efficacy of Qushi Huayu Decoction （祛湿化瘀方,QHD） on protein and gene expression of cathepsin B （ctsb） in HepG2 cells induced by free fatty acids （FFAs）.Methods： The model of HepG2 steatosis and tumor necrosis factor-α （TNF-α） secretion was induced by long-chain FFAs.HepG2 cells were divided into 4 groups： control group （group C）,model group （group M）,low-dose QHD group （group L） and high-dose QHD group （group H ）.Long-chain FFAs were added to groups M,L and H.The 10% blank-control serum was added to group C and M,while 5% and 10% QHD-containing sera were added to group L and H,respectively.The levels of serum TNF-α and cellular triglyceride （TG） were detected.Cellular p-IκB and ctsb expression were detected using Western blot and PCR.The expression and distribution of ctsb were observed by immunofluorescence.Results： After incubating with FFA for 24 h,TG deposition in HepG2,TNF-α content in cell supernatant,the protein expression of cellular ctsb and P-IκB,as well as mRNA expression of ctsb increased markedly in group M compared with group C （P〈0.05,P〈0.01）.Compared with group M,TG deposition,the expression of cellular ctsb,P-IκB and ctsb mRNA in groups L and H,as well as TNF-α content in group H,decreased significantly （P〈0.05）.Cell immunochemical fluorescence studies showed that ctsb was released from lysosomes and distributed in the cytoplasm extensively and diffusedly after being stimulated with FFA.In this study,these above-mentioned changes were inhibited markedly in groups L and H.Conclusion： QHD might have a direct inhibitory effect on the ctsb target in the FFA-ctsb-TNFα pathway of hepatic lipotoxicity.

Clinical observation of Qushi Xiezhuo formula in reducing monosodium urate crystal deposition in patients with axial spondyloarthritis

OBJECTIVE: To investigate effect of Qushi Xiezhuo formula (QSXZF) on axial spondyloarthritis (AxSpA) with a high incidence of monosodium serum urate (MSU) crystal deposition.METHODS: In this prospective cohort study, 62 Ax- SpA patients diagnosed with MSU crystal deposition from October 2012 to July 2015 were recruited for follow-up observation for 1 year after discharge from the hospital. Patients were divided into a case group with QSXZF treatment and a control group without any interventions. X-ray and dual-energy computed tomography were used to assess structural damage in the pelvis and sacroiliac joint and the volume of the MSU crystals. The Wilcoxon rank-sum test and Fisher's exact test were used to compare the proportion and distribution between the groups. RESULTS: A decrease in C-reactive protein (CRP) level, relief from back pain, and an increase in MSU crystal depositions were found in control patients. Compared with the control group, QSXZF reduced CRP levels and back pain to a greater extent, as well as reduced erythrocyte sedimentation rate levels, serum uric acid levels, Ankylosing Spondylitis Disease Activity Score, morning stiffness and MSU crystal deposition. CONCLUSION: QSXZF can lower progress of radiogrphaic grade at sacroiliac joint in AxSpA/AS patients with MSU crystal deposition by decreasing the inflammation response and reducing the serum uric acid and volume of MSU crystal deposition in sacroiliac joint. The above process may be attributed to the relieving the Qi-movement disturbance in the body, and eliminating turbidity and dampness by QSXZF.

Reliability of online near-infrared spectroscopy analysis of the ex-traction process of Huatan Qushi decoction for phlegm-dampness constitution

OBJECTIVE: To establish a quantitative model for the online analysis of hesperidin content in the extraction process of Huatan Qushi decoction for individuals with phlegm-dampness constitution by using near-infrared(NIR) spectroscopy and partial least squares(PLS) methods.METHODS: The reference content of hesperidin, an effective ingredient of Huatan Qushi decoction,was determined using high-performance liquid chromatography(HPLC). The modeling band was selected using synergy interval PLS(Si PLS) algorithms, and a PLS model demonstrating the relationship between NIR predictive values and HPLC reference values was established. The optimal modeling route was selected through global optimization of process trace parameters.RESULTS: The root mean square error of cross-validation was 9.8410. The coefficients of determination of the calibration set and prediction set were0.9860(R2 cal) and 0.9458(R_(cal)~2), respectively. The residual predictive deviation was 3.0115. The parameters demonstrated high predictive capability and reliability. The band was selected via the Si PLS method. There were seven latent variables.CONCLUSION: This study provides a favorable comprehensive evaluation method for variable selection and quality control of the Traditional Chinese Medicine extraction process.

化瘀祛湿方对miR⁃21靶向Skp2介导早期膝骨关节炎软骨细胞自噬的影响

目的:研究miR‑21‑5p介导Skp2对膝OA软骨细胞自噬影响,探讨化瘀祛湿方对膝OA软骨细胞的保护作用。方法:(1)取全膝关节置换术的人体膝OA软骨组织,采用FISH单染试验检测miR‑21‑5p表达和定位,免疫荧光检测Skp2表达,TUNEL染色试验检测膝OA细胞凋亡,Western blot法检测Bax、Bcl‑2、Beclin1、CARM1、LC3Ⅱ/Ⅰ和Skp2相对表达量;(2)取SD大鼠36只,按随机数字法分为正常对照组、假手术组、模型组、模型+空载组、模型+miR‑21‑5p干扰组、模型+化瘀祛湿方组6组,每组6只;采用石蜡切片阿利新蓝染色观察软骨形态结构,qPCR、Western blot法检测各组软骨组织Beclin1、CARM1、LC3Ⅱ/Ⅰ、Skp2相对表达量,免疫组化检测Skp2的IOD/Area值。结果:FISH检测显示miR‑21‑5p在人体膝OA软骨组织中高表达,免疫荧光检测表明Skp2在人体膝OA软骨组织中低表达;TUNEL检测发现,人体膝OA软骨组织凋亡显著增加;Western blot法检测显示,与正常对照组相比,人体膝OA软骨组织中Bax、CARM1相对表达量较正常组显著升高,而Bcl‑2、LC3Ⅱ/Ⅰ、Skp2相对表达量明显降低,Beclin1相对表达量稍降低(P<0.05)。动物实验显示,采用miR‑21‑5p干扰处理后,Beclin1、CARM1、LC3Ⅱ/Ⅰ表达显著下降,Skp2稍降低;免疫组化检测发现Skp2 IOD/Area值与正常对照组相比,模型组IOD/Area值显著降低(P<0.05);与模型组相比,模型+化瘀祛湿方组IOD/Area值显著升高(P<0.05);石蜡切片阿利新蓝染色显示与假手术照组相比,模型+空载组、模型+miR‑21‑5p干扰组蓝色变浅,但模型组蓝色变深,模型+化瘀祛湿组蓝色较为明显。结论:miR‑21‑5p可负向调控Skp2,介导膝OA软骨细胞自噬,加速OA发展;化瘀祛湿方可能通过抑制miR‑21‑5p,提高Skp2表达,起到延缓膝OA退变的作用。

分消走泄法对代谢综合征患者代谢、应激、炎症状态的影响

目的探讨国医大师路志正“分消走泄法”治疗代谢综合征的临床疗效及对患者代谢、应激、炎症状态的影响。方法收集我院2018年3月-2020年4月湿热型代谢综合征患者200例,并随机分为对照组(盐酸吡格列酮)和试验组(祛湿降浊方),比较2组患者的疗效、治疗前后的中医症状评分、代谢相关指标[三酰甘油(triglyceride,TG)、总胆固醇(total cholesterol,TC)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、谷丙转氨酶(alanine transaminase,ALT)、谷草转氨酶(glutamic oxaloacetic transaminase,AST)、空腹血糖(fasting blood glucose,FBG)、尿酸(uric acid,UA)]、应激和炎症相关指标[谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-Px)、总抗氧化能力(total antioxidant capacity,T-AOC)、髓过氧化物酶(myeloperoxidase,MPO)、丙二醛(malondialdehyde,MDA)、白介素-6(interleukin-6,IL-6)、人单核细胞趋化蛋白-1(monocyte chemotactic protein-1,MCP-1)、脂联素(adiponectin,ADP)、脂蛋白(lipoprotein,LP)]。结果与对照组比较,试验组的总有效率明显增高(P<0.05)。治疗前,2组的主症评分、次症评分、中医症状总分、代谢、应激、炎症相关指标差异无统计学意义(P>0.05);治疗后,与对照组比较,试验组主症评分、次症评分、中医症状总分、TG、TC、ALT、FBG、UA、MPO、MDA、IL-6、MCP-1、LP均降低(P<0.05),HDL-C、GSH-Px、T-AOC、ADP均增高(P<0.05)。结论路志正“分消走泄法”可用于治疗MS,可明显改善湿热型MS患者的症状、代谢、应激、炎症状态,值得临床推广。

白头翁汤合益脾祛湿理肠汤加减对大肠湿热型溃疡性结肠炎患者的临床疗效

目的:探讨大肠湿热型溃疡性结肠炎(UC)患者给予白头翁汤合益脾祛湿理肠汤加减的临床疗效。方法:选取2022年3月—2023年2月江西中医药大学附属医院收治的大肠湿热型UC患者共计86例,以随机数字表法分成研究组(43例)与对照组(43例),对照组给予白头翁汤治疗,研究组给予白头翁汤合益脾祛湿理肠汤加减治疗,两组均治疗6周。比较两组临床疗效、肠黏膜屏障功能、炎症因子水平及不良反应。结果:研究组治疗总有效率(90.70%)较对照组(74.42%)更高,差异有统计学意义(P<0.05);两组治疗后D-乳酸(D-LA)、内毒素(BT)、二胺氧化酶(DAO)水平均降低,研究组均较对照组更低,差异均有统计学意义(P<0.05);两组治疗后白细胞介素-17(IL-17)、白细胞介素-23(IL-23)水平均降低,研究组均较对照组更低,差异均有统计学意义(P<0.05);研究组不良反应发生率(6.98%)与对照组(2.33%)比较差异无统计学意义(P>0.05)。结论:大肠湿热型UC患者给予白头翁汤合益脾祛湿理肠汤加减治疗,能够提升临床效果,改善患者肠黏膜屏障功能、炎症因子水平,安全性较高。

健脾祛湿解毒方治疗宫颈高危型HPV感染的临床疗效

目的:观察健脾祛湿解毒方治疗宫颈高危型人乳头瘤病毒(HR-HPV)感染的临床疗效。方法:选取符合纳入标准的68例脾虚湿热型宫颈HR-HPV感染患者,依据随机数字表随机分为观察组和对照组,每组各34例。对照组给予重组人干扰素α2b阴道泡腾片治疗,观察组在对照组用药的基础上口服健脾祛湿解毒方,3个月为1个疗程,共治疗2个疗程。比较两组HR-HPV转阴率、临床有效率以及治疗前后中医证候积分变化情况。结果:观察组HR-HPV转阴23例,对照组HR-HPV转阴14例,观察组HR-HPV转阴率显著高于对照组(P<0.05)。治疗后,两组中医证候积分均较治疗前降低,且观察组明显低于对照组(P<0.01)。观察组总有效率91.18%(31/34),对照组总有效率70.59%(24/34),观察组明显优于对照组(P<0.05)。结论:健脾祛湿解毒方联合重组人干扰素α2b阴道泡腾片能明显改善脾虚湿热型宫颈高危HR-HPV感染患者的中医临床证候,有效清除持续感染的HR-HPV,临床疗效较好。

健脾祛湿和络方治疗特发性膜性肾病内涵探讨

从多维论治角度结合部分健脾祛湿和络方的研究进展,阐释健脾祛湿和络方有效治疗特发性膜性肾病(IMN)的中医学内涵。IMN以脾虚证、肾虚证为核心证候,健脾祛湿和络方立方以调理脾胃为基础,脾肾同治。从肺肾相关、肠肾相关、肺与大肠相表里等理论看,健脾祛湿和络方亦体现出了脾肺同治、肠肾同治、肠肺同治的中医学内涵,脾、肺、肠、肾相结合的多维论治是健脾祛湿和络方取效之根本。

桂定坤运用益气养阴活血祛湿法治疗尿酸性肾病的经验

尿酸性肾病是以大量尿酸盐结晶沉积为特征,最终导致肾脏结构和功能损伤的一类慢性疾病,临床以高尿酸血症、小管间质性肾炎及肾纤维化为主要特征。中医学认为,尿酸性肾病归属“痹证”“水肿”“腰痛”等范畴,该病以脾肾气虚为本,水湿、痰浊、瘀血为标,同时与饮食密切相关。文章介绍桂定坤主任医师运用益气养阴活血祛湿法治疗尿酸性肾病的相关经验。桂定坤主任认为,该病多因患者禀赋不足,肾元亏虚,加之饮食劳倦、外邪侵袭等影响,导致脾肾俱虚,运化失常,水湿停聚,日久则气血津液运行不畅,易郁久化热,耗气伤阴,进而形成痰浊、瘀血,痹阻于经络、关节等处,发为尿酸性肾病。因此治疗时应抓住气阴两虚、血瘀湿滞的关键病机,注重益气活血。临床遣方用药时,在辨清缓急、分期论治的基础上,需针对疾病各阶段兼证不同灵活运用中医辨证论治等方法,标本兼顾的同时又有侧重。重用黄芪益气健脾,配伍黄精滋阴护肾,狗脊补肾强腰,当归养血活血,虎杖清热利湿。另外嘱患者注意预防调摄,低嘌呤饮食,多饮水,促进尿酸排泄。临床运用上述方法能有效降低血尿酸,延缓患者肾功能虚衰进展,改善症状。另附医案二则,以阐述益气养阴活血祛湿法治疗尿酸性肾病的临床经验。

健脾祛湿食疗联合门冬胰岛素治疗儿童1型糖尿病痰湿体质的价值

目的探讨健脾祛湿食疗联合门冬胰岛素治疗儿童1型糖尿病痰湿体质的价值。方法选择2021年7月—2023年7月淄博市妇幼保健院接收的98例儿童1型糖尿病痰湿体质患儿为研究对象,按治疗方法的不同分为两组,各49例,对照组采取门冬胰岛素治疗,观察组采取健脾祛湿食疗联合门冬胰岛素治疗,比较两组治疗效果、血糖水平(空腹血糖、餐后2 h血糖、糖化血红蛋白)、血脂水平(总胆固醇、甘油三酯)。结果观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,观察组血糖水平低于对照组,差异有统计学意义(P均<0.05)。治疗后,观察组血脂水平低于对照组,差异有统计学意义(P均<0.05)。结论1型糖尿病痰湿体质患儿采取健脾祛湿食疗联合门冬胰岛素治疗可进一步控制血糖水平,消退不良症状,调节血脂水平。

祛湿通脉法治疗类风湿关节炎的研究与应用概况

基于类风湿关节炎患者“风湿瘀阻,筋伤骨损”的病机特点,提出“祛风除湿,通利血脉,畅通经络,健脾补肾,强筋壮骨”的治法,简称“祛湿通脉法”。在“祛湿通脉法”治疗原则的指导下,可根据正邪虚实,选用经验方如昆断益母方、南续益母颗粒、三藤舒筋方以及经方如桂枝芍药知母汤、黄芪桂枝五物汤、半夏泻心汤等进行随症加减的中药治疗,并可配合膏方、外治法、功能锻炼等,从而构建具有中医药优势的类风湿关节炎防治体系。该课题组所开展的系列临床和实验研究结果表明,“祛湿通脉法”治疗类风湿关节炎具有增效减毒的作用,是发挥中医药优势以防治类风湿关节炎的理论创新。

通痹祛湿活血汤对血虚风燥型银屑病患者症状积分及血清因子的影响

目的探讨通痹祛湿活血汤对血虚风燥型银屑病患者的症状积分及血清因子的影响。方法选取2021年1月—2023年6月同济大学附属东方医院胶州医院收治的94例血虚风燥型银屑病患者,随机数表法分为两组,每组47例。对照组采取常规西药治疗,观察组在对照组基础上加上通痹祛湿活血汤治疗,两组均治疗12周。比较两组症状积分、病症改善情况、血清因子、临床疗效。结果治疗12周后,观察组主症、次症总积分低于对照组(P<0.05)。治疗12周后,观察组的皮损角质层含水量高于对照组,PASI评分低于对照组,关节疼痛/肿胀个数少于对照组(P<0.05)。治疗12周后,观察组白细胞介素-6(IL-6)、C反应蛋白(CRP)、骨桥蛋白(OPN)水平低于对照组(P<0.05)。治疗12周后,观察组总有效率高于对照组(P<0.05)。结论在常规西药基础上采用通痹祛湿活血汤治疗血虚风燥型银屑病,可以促进皮损、关节疼痛等症状的恢复,减少炎性物质,提升临床效果。

平肝祛湿同治法对中青年高血压患者中医证候、不良事件及预后相关指标的影响

目的探讨平肝祛湿同治法对中青年社区高血压患者中医证候、不良事件及预后相关指标的影响。方法选取中青年高血压患者132例,随机分为2组,剔除病例后,最终每组各64例纳入研究。对照组采用厄贝沙坦片治疗,观察组在对照组基础上加用平肝祛湿同治法治疗,均连续治疗2个月。比较2组血压、疗效、中医证候积分、安全性、不良事件、预后相关指标。结果观察组中医和西医总有效率(96.88%、92.19%)均高于对照组(82.52%、78.13%),差异均有统计学意义(P=0.005,P=0.025);治疗1、2个月后观察组血压、证候积分、醛固酮、血浆肾素活性、血浆血管紧张素Ⅱ、内皮素-1均低于对照组,一氧化氮高于对照组,差异均有统计学意义(均P<0.05);2组不良反应发生率比较,差异无统计学意义(P>0.05);观察组治疗期间不良事件发生率(1.56%)与对照组(10.94%)比较,差异无统计学意义(P>0.05)。结论平肝祛湿同治法治疗中青年高血压患者能进一步改善患者症状,提高血压控制效果,促进预后改善。

理脾祛湿方治疗脾虚湿盛型腹泻型肠易激综合征的临床观察

【目的】观察理脾祛湿方治疗脾虚湿盛型腹泻型肠易激综合征(IBS-D)的临床疗效。【方法】将70例脾虚湿盛型IBS-D患者随机分为观察组和对照组,每组各35例。对照组给予马来酸曲美布汀片口服治疗,观察组给予理脾祛湿方治疗,连续治疗4周。观察2组患者治疗前后中医证候积分、肠易激综合征严重程度量表(IBS-SSS)评分、汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分、肠易激综合征生活质量量表(IBS-QOL)评分及血清白细胞介素6(IL-6)水平变化情况,并评价2组患者的中医证候疗效和安全性。【结果】(1)脱落情况方面:治疗过程中,观察组自行退出1例,脱落(因故未按疗程治疗)3例,失访1例;对照组自行退出3例,失访2例。最终2组各有30例患者完成全部疗程的治疗。(2)中医证候疗效方面:治疗4周后,观察组的总有效率为93.93%(28/30),对照组为80.00%(24/30),组间比较,观察组的中医证候疗效明显优于对照组(P<0.05)。(3)量表评分方面:治疗后,2组患者的中医证候积分、IBS-SSS评分、HAMA评分、HAMD评分和IBS-QOL评分均较治疗前明显下降(P<0.05),且观察组的下降幅度均明显优于对照组(P<0.05)。(4)血清炎症因子水平方面:治疗后,2组患者血清IL-6水平均较治疗前下降(P<0.05),且观察组的下降幅度明显优于对照组,差异有统计学意义(P<0.05)。(5)安全性方面:治疗过程中,2组患者均无明显不良反应发生,具有较高的安全性。【结论】理脾祛湿方治疗脾虚湿盛型IBS-D患者临床疗效确切,可显著缓解患者肠道症状,降低患者肠道炎症反应,改善患者焦虑、抑郁情绪,提高患者生活质量。

祛湿化瘀汤加减联合中药封包外敷对下肢深静脉血栓形成患者的效果

目的回顾性探讨祛湿化瘀汤加减联合中药封包外敷治疗下肢深静脉血栓形成(DVT)时对患者静脉通畅效果、凝血功能、复发率的影响。方法选取医院2021年7月至2022年8月收治的下肢DVT患者病历资料,根据治疗方案将68例患者分为两组,各34例。两组均接受常规治疗,对照组接受中药封包外敷,研究组接受中药封包外敷联合祛湿化瘀汤内服。对比两组静脉通畅效果、血液流变学[高切全血黏度(H-WBV)、血浆黏度(PV)、红细胞比容(HCT)]、凝血功能[纤维蛋白原(Fib)、活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)]、血清纤溶酶原激活物抑制剂1(serpine1)、血管性血友病因子(vWF)、Kruppel样转录因子(KLF2)水平及1 a复发率。结果研究组疗效优于对照组(P<0.05);治疗1、2周后,研究组H-WBV、PV、HCT、Fib、serpine1、vWF低于对照组,PT、APTT、KLF2高于对照组(P<0.05);研究组1 a复发率低于对照组(P<0.05)。结论祛湿化瘀汤联合中药封包外敷治疗下肢DVT效果显著,可能通过调节serpine1、vWF、KLF2等因子表达,改善凝血功能、血液流变学,防治血栓形成,降低复发率。