Yiwei Xiaoyu granules for treatment of chronic atrophic gastritis with deficiency syndrome of the spleen and stomach

BACKGROUND The Correa sequence,initiated by Helicobacter pylori(H.pylori),commonly progresses to gastric cancer through the stage of chronic atrophic gastritis(CAG).Although eradication of H.pylori only reduces the risk of gastric cancer,it does not eliminate the risk for neoplastic progression.Yiwei Xiaoyu granules(YWXY)are a commonly used composite preparation in Chinese clinics.However,the pursuit of excellence in clinical trials and the establishment of standardized animal experiments are still needed to contribute to full understanding and application of traditional Chinese medicine in the treatment of CAG.AIM To demonstrate the effectiveness of YWXY in patients with CAG and spleenstomach deficiency syndrome(DSSS),by alleviating histological scores,improving response rates for pathological lesions,and achieving clinical efficacy in relieving DSSS symptoms.METHODS We designed a double-blind,randomized,controlled trial.The study enrolled seventy-two H.pylori-negative patients(mean age,52.3 years;38 men)who were randomly allocated to either the treatment group or control group in a 1:1 ratio,and treated with 15 g YWXY or 0.36 g Weifuchun(WFC)tablet combined with the respective dummy for 24 wk.The pre-randomization phase resulted in the exclusion of 72 patients:50 participants did not meet the inclusion criteria,12 participants declined to participate,and 10 participants were excluded for various other reasons.Seven visits were conducted during the study,and histopathological examination with target endoscopic biopsy of narrow-band imaging was requested before the first and seventh visits.We also evaluated endoscopic performance scores,total symptom scores,serum pepsinogen and gastrin-17.RESULTS Six patients did not complete the trial procedures.Treatment with YWXY improved the Operative Link on Gastric Intestinal Metaplasia Assessment(OLGIM)stage,compared with WFC(P<0.05).YWXY provided better relief from symptoms of DSSS and better improvement in serum gastric function,compared with WFC(P<0.05).CONCLUSION YWXY compared with WFC significantly reduced the risk of mild or moderate atrophic disease,according to OLGIM stage,significantly relieved symptoms of DSSS,and improved serum gastric function.

Preventive and inhibitive effects of Yiwei Xiaoyu granules on the development and progression of spasmolytic polypeptideexpressing metaplasia lesions

BACKGROUND Spasmolytic polypeptide-expressing metaplasia(SPEM)is a potential preneoplastic lesion.AIM To elucidate the microRNA(miR)-7-mediated preventive and inhibitive effects of Yiwei Xiaoyu granules(YWXY)in SPEM lesions.METHODS Gastric mucosa biopsies were collected from chronic atrophic gastritis patients and healthy people with signed informed consent.YWXY was administered to the mice with induced SPEM by tamoxifen,and the gastric mucosa was harvested on the tenth day of the experiment.Then immunohistochemistry and immunofluorescence were performed to validate the SPEM,lesions and the potential mechanism was investigated.RNA transcripts were detected with reverse transcriptionquantitative polymerase chain reaction.RESULTS The expression of miR-7 was downregulated in the SPEM lesions,and expression of trefoil factor 2(TFF2)and clusterin was high in the human gastric mucosa.In vivo experiments showed that YWXY could inhibit the cell proliferation in the tamoxifen-induced SPEM lesions by regulating Ki67.Simultaneously,YWXY could restore the expression of miR-7 by regulating TFF2 by detection with immunofluorescence but not with reverse transcription-quantitative polymerase chain reaction,indicating its potential mechanism of targeting miR-7 by mediating TFF2.The expression of vascular endothelial growth factor-βand gastric intrinsic factor was restored within 3 d of YWXY administration for the SPEM lesions,speculating that the possible mechanism of YWXY is to inhibit the development and progression of SPEM by regulating vascular endothelial growth factor-βand gastric intrinsic factor.CONCLUSION miR-7 downregulation is an early event in SPEM through regulation of TFF2 in human gastric mucosa.YWXY is able to inhibit the cell proliferation and restore the expression of miR-7 by mediating TFF2 in the SPEM mouse model.

Effect of Xiaoyu Zhixue Tablet (消瘀止血片) on Expression ofPlatelet Membrane Glycoproteins in Patients withHemorrhagic Thrombopathy

Objective: To observe the effect of Xiaoyu Zhixue tablet (消瘀止血片,XYZXT) on the expression of platelet membrane glycoproteins in patients with hemorrhagic thrombopathy, and to explore its possible mechanism. Methods: The total of 148 patients with hemorrhagic thrombopathy were randomly divided into two groups, the traditional Chinese medicicne (TCM) group (n=98) treated with XYZXT and the Western medicine (WM) group (n=50) treated with adrenosin, vitamins C, K and P, both for 6 months. The therapeutic effect and the recovery rate of platelet aggregation in the two groups were observed. And platelet membrane glycoprotein (GP) Ⅰb/Ⅸ, GPⅡb/Ⅲa complexes, GPⅠb, GPⅡb, GP Ⅲa and P-selectin were analyzed by flow cytometry in both groups before and after treatment and also in 34 normal healthy subjects. Results: The total effective rate of hemostasis was 89. 8% in TCM group and 54. 0% in the WM group (x2=45.83, P<0.01), and the recovery rate of platelet aggregation was 72.4% and 4.0% respectively (x2=62.06, P<0.01). The fluorescence intensity of GP Ⅰ b/Ⅸ, GPⅡb/Ⅲa complexes, GPⅠb, GPⅢa and P-selectin were lower in both groups before treatment than those in the healthy subjects. Expression of above-mentioned marks was elevated in TCM group after 6 months' therapy, which was insignificantly different as compared with the healthy subjects (P>0.05) and higher than those in the WM group (P<0.05). Conclusion: One of the mechanisms in treating hemorrhagic thrombopathy with XYZXT is that it could regulate the expression of GP Ⅰb/Ⅸ, GPⅡ b/Ⅲa complexes, GPⅠb, GPⅢa and P-selectin at the level of receptor protein.

Xiaoyu Jiangzhi capsule protects against heart failure via Ca^(2+)/CaMKII signaling pathways in mice

Objective: Heart failure(HF), a worldwide health condition, is the result of many cardiovascular diseases.The traditional Chinese medicine(TCM) Xiaoyu Jiangzhi capsule(XYC) has long been in use in China to treat hyperlipidemia and inhibit platelet aggregation. This study explores the effects of XYC on heart failure(HF) and its detailed mechanisms.Methods: Isoproterenol(ISO, 30 mg/kg) was injected intraperitoneally for 7 days to copy a HF model of 10-12 weeks old, 20-30 g male mice. We then compared the CON(control) group, ISO(HF model)group, MET(metoprolol) group, and XYC group. Cardiac systolic function and left wall thickness were evaluated by echocardiograph. Using western blot analysis, we detected the proteins of calmodulin dependent protein kinase Ⅱ(Ca MKII) and sarco/endoplasmic reticulum Ca^(2+)-ATPase(Serca). Furthermore, ts A201 cells were cultured and the human CaV1.2 calcium channel current(hCaV1.2) were detected by patch clamp experiments.Results: XYC reduced HF, inhibiting the protein expression of Ca MKII, but Serca did not change significantly. Moreover, XYC inhibited the peak amplitude of the hCaV1.2 current, depolarizing shifted the activation curve 27.6 mV, and shifted the inactivation curve toward a positive potential 17.6 mV. The fraction recovered from inaction was reduced in XYC group compared with that in CON group.Conclusion: XYC could inhibit ISO-induced HF by reducing the Ca^(2+)/Ca MKII signaling pathway in mice.

Clinical observation of sinew-regulating and bone-setting manipulation combined with Xiaoyu Jiegu Powder in treating knee osteoarthritis

Objective:To evaluate the clinical efficacy of sinew-regulating and bone-setting manipulation(SRBSM)combined with Xiaoyu Jiegu Powder(XYJGP)in treating knee osteoarthritis(KOA).Methods:Sixty patients were randomly divided into treatment group(30 cases)and control group(30 cases).The treatment group was treated with SRBSM combined with XYJGP and the control group was given intermediate frequency electrotherapy and XYJGP.Visual Analogue Scale(VAS).The Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC),Flexion range of motion of the knee joint,and surface electromyography(sEMG)were used to evaluate and compare the patients'knee function before and after treatment.The efficacy was observed with diagnosis and efficacy standards of TCM.Results:After treatment,compared with the same group before treatment,muscle fatigue and muscle tension decreased,pain was reduced,range of motion of the knee joint was increased,and motor function was improved(P<0.05).The improvement degree of the treatment group was better than that of the control group(P<0.05).The total effective rate of the treatment group was 96.6%(29/30),higher than that of the control group(80.0%),P<0.05.Conclusion:SRBSM combined with XYJGP can effectively reduce the pain of KOA patients,improve the range of motion of the joints,and improve the quality of life of the patients,and its curative effect is better than that of intermediate frequency electrotherapy combined with XYJGP.

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。

凉血消瘀方在糖尿病视网膜病变患者中的应用

目的探讨凉血消瘀方在糖尿病视网膜病变(diabetes retinopathy,DR)患者中的应用。方法采用随机数字表法将本院2021年2月—2022年2月收治的80例DR患者分为对照组(羟苯磺酸钙治疗)和试验组(羟苯磺酸钙+凉血消瘀方治疗),各40例;比较两组患者临床治疗效果,对比两组治疗前后中医证候积分和最佳矫正视力(best corrected visual acuity,BCVA),血糖、血脂水平和视网膜病变改善情况。结果治疗后,试验组总有效率高于对照组(P<0.05);治疗后,试验组中医证候积分均低于治疗前和对照组(P<0.05);两组BCVA均升高(P<0.05),且试验组均高于对照组(P<0.05);治疗后,两组空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(2 h postprandial blood glucose,2 h PBG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、甘油三酯(triglycerides,TG)、总胆固醇(total cholesterol,TC)和低密度脂蛋白(low-density lipoprotein,LDL)水平均降低(P<0.05),且试验组均低于对照组(P<0.05);两组高密度脂蛋白(high density lipoprotein,HDL)均升高(P<0.05),且试验组高于对照组(P<0.05);治疗后,两组血管瘤、出血斑及黄斑厚度均降低(P<0.05),且试验组均低于对照组(P<0.05)。结论对DR患者给予凉血消瘀方效果显著,可降低中医证候积分,提高视力,改善血糖、血脂水平,还可改善视网膜病变情况。

消瘀泄浊饮中活性成分鉴定以及HPLC法测定其中5种关键成分

目的利用高效液相色谱联合质谱技术鉴定消瘀泄浊饮中的活性成分,并利用HPLC法测定毛蕊异黄酮葡萄糖苷、大黄素、芦荟大黄素、杯苋甾酮、苦杏仁苷这5种成分的含量。方法采用液质联用技术测定消瘀泄浊饮中的生物活性成分,色谱柱:Waters HSS T3(100 mm×2.1 mm,1.8μm),流动相为0.1%甲酸-水溶液→0.1%甲酸-乙腈-异丙醇,梯度洗脱;流速:0.3 mL/min;柱温:40℃。高分辨质谱:鞘气40 Arb;辅助气10 Arb;离子喷雾电压3000 V/-2800 V;温度350℃;离子传输管温度320℃;扫描模式为Full-scan MS2模式。采用Progenesis QI进行基线过滤、峰识别、积分、保留时间校正、峰对齐,对比公共数据库和实验室自建数据库后得到消瘀泄浊饮中的生物活性成分。选择Sharpsil-U C_(18)色谱柱;流动相为甲醇→超纯水;梯度洗脱;流速:1.0 mL/min;柱温:30℃;进样量:10μL;检测波长:210 nm(苦杏仁苷、杯苋甾酮),260 nm(毛蕊异黄酮葡萄糖苷、大黄素、芦荟大黄素)。结果从消瘀泄浊饮中共找到276种生物活性成分,其中负离子模式下找到119种,正离子模式下找到157种。选择毛蕊异黄酮葡萄糖苷、大黄素、芦荟大黄素、杯苋甾酮、苦杏仁苷为消瘀泄浊饮的指标成分。各成分均能有效检出,分离度良好,阴性无干扰;5种成分在测定的进样浓度范围内与峰面积线性关系良好;平均加样回收率为99.94%~101.07%;RSD为0.78%~2.27%。结论液质联用技术可以有效鉴定消瘀泄浊饮中的生物活性成分,所建立的HPLC法稳定性好,特异性强,可以为消瘀泄浊饮的质量控制和评价提供参考依据。

消瘀泄浊饮对糖尿病肾病小鼠肾脏足细胞凋亡及HIF1α表达的调控作用

[目的]探讨消瘀泄浊饮对糖尿病肾病(diabetic kidney disease,DKD)小鼠肾脏足细胞凋亡的保护作用及对低氧诱导因子1α(hypoxia inducible factor 1 alpha,HIF1α)的影响。[方法]选用6只db/m小鼠为阴性对照组,18只db/db小鼠随机分为DKD模型组、低剂量消瘀泄浊饮组、高剂量消瘀泄浊饮组,每组6只。灌胃12周后,检测尿液中尿蛋白、β_(2)-微球蛋白(β_(2)-microglobulin,β_(2)-MG)、尿白蛋白/肌酐(albumin/creatinine ratio,Acr)、尿β_(2)-微球蛋白/肌酐(β_(2)-microglobulin/creatinine ratio,β_(2)-MG/Ucr)及血清甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC)、白蛋白(albumin,Alb)、尿素氮(blood urea nitrogen,BUN)、血肌酐(serum creatinine,Scr)的水平。分离肾组织,光镜及电镜下观察肾组织病理变化;组织匀浆后用实时聚合酶链式反应(Real-time polymerase chain reaction,RT-PCR)法检测HIF1α、nephrin mRNA水平。[结果]与阴性对照组比较,DKD模型组小鼠的尿蛋白、尿β_(2)-MG、Acr、β_(2)-MG/Ucr,血清TG、TC、BUN、Scr水平升高(P<0.01),血清Alb下降(P<0.01);肾小球体积增大,毛细血管袢呈分叶状,系膜细胞及基质增生,间质炎症及纤维化程度加重,足突融合增加,基底膜增厚,足细胞凋亡增加;肾组织HIF1αmRNA表达升高(P<0.01),nephrin mRNA表达下降(P<0.01)。与DKD模型组比较,高、低剂量消瘀泄浊饮组的尿蛋白、尿β_(2)-MG、Acr、β_(2)-MG/Ucr,血清TG、TC、BUN、Scr水平下降(P<0.01),血清Alb水平升高(P<0.01);肾小球、肾间质、足突病变明显改善,足细胞凋亡减少;肾组织HIF1αmRNA表达下降(P<0.01),nephrin mRNA表达升高(P<0.01)。高、低剂量消瘀泄浊饮组间尿蛋白、β_(2)-MG、Acr、β_(2)-MG/Ucr,血清TG、TC、BUN、Scr、Alb水平和肾组织HIF1α、nephrin mRNA表达差异无统计学意义(P>0.05)。[结论]消瘀泄浊饮能改善DKD小鼠尿蛋白、肾功能及肾脏结构病变、足细胞凋亡等指标,其可能通过调节HIF1α表达发挥作用。

正交试验法结合主成分分析优选消瘀凝胶膏提取工艺

目的优选消瘀凝胶膏的提取工艺。方法以挥发油含量为评价指标,以加水量、浸泡时间、提取时间为影响因素,采用L_(9)(3^(4))正交试验法优选挥发油提取工艺,并验证。以干膏得率及积雪草苷、木犀草素、黄芩苷含量为评价指标,以主成分综合得分为综合指标,以乙醇体积分数、溶剂用量、提取次数为考察因素,采用L_(9)(3^(4))正交试验法优选非挥发性成分提取工艺,并验证。结果挥发油最佳提取工艺为加10倍量水,浸泡1.0 h,提取6 h;25 g药材(荆芥、乳香、没药及当归)挥发油含量为1.6 mL。非挥发性成分最佳提取工艺为,以10倍量60%乙醇为溶剂,提取3次,每次1 h。验证试验中平均综合评分为125.36分,RSD为0.49%(n=3)。结论优选工艺稳定可行,最大限度保留了可能有效成分,为新药开发奠定了基础。

HPLC法同时测定消瘀凝胶贴膏中7种成分的含量

目的建立HPLC法同时测定消瘀凝胶贴膏中羟基积雪草苷、毛蕊花糖苷、木犀草素、黄芩苷、三七皂苷R1、人参皂苷Rg1、人参皂苷Re的含量。方法分析采用Shimsen C 18色谱柱(4.6 mm×150 mm,5μm),流动相乙腈-0.2%磷酸(含2 mmol/Lβ-环糊精),梯度洗脱;体积流量1 mL/min;柱温30℃;检测波长205、280、310 nm。结果7种成分在各自范围内线性关系良好(r≥0.9995),平均加样回收率97.25%~100.90%,RSD 1.85%~2.60%。结论该方法准确稳定,重复性好,可用于消瘀凝胶贴膏的质量控制。

Effect of Xiaoyu Zhixue Tablet(消瘀止血片) on the Expression of Platelet Membrane Glycoprotein Ⅰb/Ⅸ/Ⅴ Complex in Patients with Chronic Renal Failure

Objective： To investigate the effect of Xiaoyu Zhixue Tablet （消瘀止血片, XYZXT） on the expression of platelet membrane glycoprotein （GP） Ⅰ b/Ⅸ/Ⅴ complex and GP Ⅰ b α in patients with chronic renal failure （CRF） in early metaphase. Methods： Fifty-one patients with CRF in early metaphase （treated group） were treated with XYZXT, 3 months as the course of treatment for 2 courses. The previous therapies remained unchanged. Flow cytometry was used to assess the expression of platelet GP Ⅰb/Ⅸ/Ⅴ complex and GP Ⅰb α in patients with CRF, and turbidity method was used to determine the platelet maximum aggregation rate （MAR）, meanwhile the renal function was measured. The final data were compared with those before the treatment, and with those in the normal control group （31 healthy subjects）. Results： Compared with the normal control group, expressions of GP Ⅰ b/Ⅸ/Ⅴ complex and GPⅠb α, and platelet MAR in CRF patients were significantly lower （P=0.007,P=0.001,P=0.009） before the treatment; after the treatment with XYZXT, the above indexes in CRF patients were remarkably increased （P=0.033,P=0.026, P=0.045）, but still lower than those in the normal control group, however, it was not statistically significant. Conclusion： （1） The expression of GP Ⅰ b/Ⅸ/Ⅴ complex in CRF patients of early metaphase was decreased, which lead to platelet aggregation dysfunction. This might be one of the reasons for the hemorrhagic trend in CRF. （2） XYZXT was able to upgrade expressions of GP Ⅰb/Ⅸ/Ⅴ complex and GPⅠb α in CRF patients, improve platelet function and clown-regulate platelet activation in patients with CRF.

自拟补气消瘀方用于子宫腺肌病GnRHa治疗对患者中医证候、血清CA199、CA125的影响

目的:探究自拟补气消瘀方用于子宫腺肌病(AM)患者促性腺激素释放激素类似物(GnRHa)治疗对中医证候、血清糖类抗原199(CA199)、糖类抗原125(CA125)的影响。方法:按随机数字表法将2020年1月~2022年12月泰州市中医院收治的78例AM患者分成对照组(39例)和治疗组(39例)。对照组予以GnRHa治疗,在此基础上治疗组予以自拟补气消瘀方治疗,时长为3个月。比较两组疗效、中医证候积分、血清指标(CA199、CA125)、临床康复指标[子宫体积、经期疼痛程度(VAS)、月经失血图(PBAC)、COX痛经症状量表(CMSS)]、用药安全性和复发率的差异。结果:治疗后,治疗组的总有效率高于对照组(P<0.05);两组经期/前小腹痛、行经不规律、经量异常、次证总分均低于同组治疗前,且治疗组低于对照组(P<0.05);两组CA199、CA125水平均低于同组治疗前,且治疗组低于对照组(P<0.05);两组子宫体积、VAS、PBAC、CMSS(持续时间、严重程度)评分均低于同组治疗前,且治疗组低于对照组(P<0.05);治疗组的不良反应发生率低于对照组(P<0.05);随访6个月后,治疗组的复发率低于对照组(P<0.05)。结论:自拟补气消瘀方辅助GnRHa治疗AM的疗效显著,能有效改善中医证候及痛经相关积分,降低血清CA199、CA125水平,缩小子宫体积,减少不良反应发生及疾病复发。

浮针联合自制消瘀膏治疗寒湿凝滞型冻结肩35例疗效观察

目的:观察浮针联合自制消瘀膏治疗寒湿凝滞型冻结肩35例的临床疗效。方法:回顾性分析寒湿凝滞型冻结肩的患者67名,按照治疗方法将其分为对照组与观察组,对照组给予浮针治疗,观察组给予浮针加自制消瘀膏外敷;分别记录两组治疗前及治疗后3个月、6个月、1年的疼痛视觉模拟评分(VAS)、肩关节功能评分(CMS)及治疗后总有效率。结果:两组治疗前后的疗效指标相比均有统计学差异(P<0.05);观察组治疗后6个月、1年的疗效指标与对照组比较具有明显的统计学差异(P<0.05)。观察组的治疗总有效率高于对照组。结论:对于寒湿凝滞型冻结肩患者,浮针联合消瘀膏外敷能大大提高患者的远期疗效,值得临床推广。

疏肝消瘰丸治疗肉芽肿性乳腺炎肿块期肝郁痰凝证的临床研究

目的研究分析疏肝消瘰丸治疗肉芽肿性乳腺炎(GLM)肿块期肝郁痰凝证的临床效果。方法选取2021年12月至2022年12月湖南中医药大学第一附属医院收治的60例GLM肿块期肝郁痰凝证患者,采用简单随机法分为对照组与观察组,各30例。两种均给予常规治疗,对照组加用甲泼尼龙,观察组加用疏肝消瘰丸。治疗12周后,对比两组临床疗效、临床证候积分、疼痛程度、肿块大小及不良反应发生情况。结果治疗后,两组临床证候积分较治疗前显著降低,且观察组临床证候积分较对照组更低,P<0.05;两组VAS评分均较治疗前显著降低,P<0.01,但治疗后两组间VAS评分对比,P>0.05;两组体表肿块直径均较治疗前缩小,且与对照组相比,观察组肿块直径缩小更显著,P<0.01。治疗12周后,观察组总有效率高于对照组,P<0.05。两组不良反应对比,P>0.05。结论对GLM肿块期肝郁痰凝证患者采用疏肝消瘰丸治疗效果显著,可改善患者临床症状,缩小肿块,减轻疼痛,且不增加不良反应。

程晓昱临床论治心悸特色经验拾萃

心悸作为心血管临床的常见疾病,拥有庞大的患病人群,症状轻者多表现为心慌、胸闷,严重者心慌持续不能自止,可合并多种症状,甚至危及生命,严重影响了患者正常的工作与生活,对人的身体及心理健康产生难以评估的消极作用。程晓昱教授通过分析心悸患者的病因病机,结合自身临床经验,在合理正确辨证治疗的同时体现出“心肝同治”“调理脾胃”“内外结合”的治疗特色。文章介绍了程晓昱教授临床治疗心悸的经验及特色,并附临床病案一则。

程晓昱从本虚痰瘀论治冠心病经验

冠心病全称冠状动脉性心脏病(Coronary Heart Disease,CHD)为临床常见心血管疾病,是指因冠状动脉粥样硬化引起冠脉血管狭窄而导致的心肌供血障碍的疾病,若狭窄逐步加重,可导致心肌梗死和各种心律失常改变,病情发展严重后可导致心力衰竭等,直接危急人类生命。如何改善临床症状、延缓疾病进展为目前治疗的重难点。程晓昱教授对CHD的病机及治疗有着独特见解,认为CHD病机为本虚标实,脾肾亏虚为本,痰瘀互结为标,本虚痰瘀在发病中占有重要地位,故治疗时注重化痰祛瘀,通痹培本,同时强调身心同治、中西结合、因时制宜,兼以中医特色外治法,在临床上取得了很好的疗效,也为疾病的治疗提供了新的思路。

程晓昱治疗冠心病合并焦虑抑郁状态经验

随着人们生活方式的改变和社会老龄化速度的加快,冠心病合并焦虑抑郁状态的患病率逐年提升。冠心病和焦虑抑郁状态严重影响患者健康,给家庭和社会带来沉重负担,且两种疾病之间具有密切的联系。因此,如何有效干预该病的发生、发展已成为临床亟待解决的重要问题之一。程晓昱教授在临床诊治该病中重视“双心治疗”“心肝同治”“心胃同治”“内外并举”“衷中参西”等。作者重在介绍程教授对冠心病合并焦虑抑郁状态病因病机的认识、临床经验与学术思想,并附一则临床验案。

程晓昱从心肝脾论治冠心病合并抑郁症经验浅析

随着医学技术的发展,现代医学对“双心疾病”(心理心脏病)已经有了一个较为广泛的认知,通过对国内外的冠状动脉粥样硬化性心脏病(冠心病)和抑郁症的相关研究中发现,冠心病患者中抑郁症发病率高于普通人群,二者的合并病现已成为临床较为常见的双心疾病。中医学强调“形神一体”,在治疗冠心病合并抑郁症方面有着独特优势。文章从心肝脾三脏的“生克制化”关系、心肝脾共同维持气血生成运行、“神魂意相合”等理论出发,以“气血津液理论”、“形神一体观”、“藏象理论”为支撑,探讨冠心病合并抑郁症的发病机理,并浅析了程晓昱教授治疗该合并病的治疗原则以及方药运用。

清热消瘀方熏洗对混合痔术后患者疼痛程度、创面愈合及肛门功能的影响

目的研究清热消瘀方熏洗对混合痔术后患者疼痛程度、创面愈合及肛门功能的影响。方法2020年1月—2022年6月东台市人民医院收治的混合痔术后患者90例,分为对照组与试验组,各45例,方法为随机数字表法。对照组予以甘霖洗剂治疗,试验组予以清热消瘀方熏洗治疗,两组均治疗2周。比较两组治疗2周后疗效,治疗前、治疗2周后症状积分、凝血功能,不同时间点肛门功能,治疗期间并发症发生情况。结果治疗2周后,与对照组的总有效率(80.00%,36/45)比较,试验组总有效率更高[95.56%(43/45),P<0.05]。治疗2周后两组疼痛、水肿、出血症状评分降低,且试验组更低(P<0.05)。治疗前、治疗1周后、治疗2周后,两组肛管静息压呈降低趋势,且试验组更低(P<0.05);肛管最大收缩压呈升高趋势升高,且试验组更高(P<0.05)。治疗前、治疗2周后两组活化部分凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶时间(thrombin time,TT)以及凝血酶原时间(or prothrombin time,PT)比较,差异无统计学意义(P>0.05)。治疗过程中,与对照组并发症发生率17.78%(8/45)比较,试验组并发症发生率更低[4.44%(2/45),P<0.05]。结论清热消瘀方熏洗治疗混合痔术后患者疗效确切,可改善患者疼痛、水肿、出血等临床症状,提高肛门功能,促进创面愈合,可降低术后并发症的发生。