Meta-analysis of Tonifying-Kindney and Soothing-Liver traditional Chinese medicine method in the treatment of polycystic ovary syndrome

Background:To systematically evaluate the clinical efficacy of Tonifying-Kindney and Soothing-Liver method in the treatment of polycystic ovary syndrome(PCOS).Methods:The literatures of randomized controlled trials(RCTs)on the treatment of PCOS with traditional Chinese medicine(TCM)published at home and abroad until March 2020 were retrieved,and RCTs on the treatment of PCOS with Tonifying-Kindney and Soothing-Liver method were collected.According to the systematic evaluation method of the Cochrane Collaboration Network,RevMan5.3 software was used to perform quality evaluation and data extraction for meta-analysis of tests that met the inclusion criteria.Results:A total of 30 eligible RCTs were included,including 2244 patients.Meta-analysis results show that the method of tonifying the kidney and Soothing-Liver has certain advantages in the treatment of PCOS.Compared with Western medicine alone group,tonifying the kidney and Soothing-Liver TCM method alone or combined with Western medicine could improve the total effective rate[OR=3.52,95%CI(2.67,4.63),I2=0%,P<0.00001].It is superior to the control group in improving ovulation rate[OR=2.01,95%CI(1.46,2.78),I2=0%,P<0.0001],pregnancy rate[OR=2.82,95%CI(2.28,3.49),I2=0%,P<0.00001],reducing LH[MD=-2.65,95%CI(-3.43,-1.88),I2=92%,P<0.00001]and ovarian stimulating hormone levels[MD=-0.52,95%CI(-0.85,-0.18),I2=94%,P=0.002].There was no statistical difference in reducing serum testosterone levels[SMD=-0.56,95%CI(-1.22,0.09),I2=96%,P=0.09]and improving TCM symptoms[MD=-0.09,95%CI(-4.75,4.56),I2=97%,P=0.97].Conclusion:The method of tonifying the kidney and Soothing-Liver has a certain effect in treating polycystic ovary syndrome,but the evidence is still very limited,and a large sample of high-quality randomized controlled studies is still needed in order to make a more rigorous evaluation.

龙胆泻肝颗粒的保肝利胆作用研究

目的研究龙胆泻肝颗粒的保肝利胆作用。方法观察不同剂量的龙胆泻肝颗粒对CCl4引起的小鼠实验性肝损伤和大鼠胆汁分泌作用。结果龙胆泻肝颗粒(2·40、4·80、9·60g/kg,ig)可使实验性肝损伤小鼠血清中升高的ALT、ALP值显著降低,改善CCl4引起的动物肝细胞浆疏松化和气球样变,以及肝细胞的脂肪变性和肝细胞坏死。龙胆泻肝颗粒(2·70、5·40g/kg)十二指肠给药可明显增加大鼠的胆汁分泌量,在给药30min已很显著,60min时作用更强。结论龙胆泻肝颗粒对小鼠实验性肝损伤有明显的保护作用,对大鼠具有显著的利胆作用。

茵陈蒿汤醇提与水提部位利胆保肝药效研究

目的筛选茵陈蒿汤利胆、保肝退黄的药效部位。方法将64只大鼠随机分成正常对照组、模型对照组及醇提和水提部位低、中、高剂量组,每组8只。除正常对照组外,其余各组于实验第1、4、7、10日给予α-萘异硫氰酸酯(ANIT)80 mg/kg灌胃造模。醇提和水提部位低、中、高剂量组每日分别给予茵陈蒿汤75%乙醇提取物和其药渣的水提取物0.040 5、0.081、0.162 g/10 g(折合成原药材计)灌胃,正常对照组和模型对照组灌胃给予生理盐水,连续12 d。末次给药后1 h胆总管插管收集胆汁,记录每只大鼠2、4、6 h的胆汁量;胆汁收集结束后,颈动脉取血,检测总胆红素(TBIL)、碱性磷酸酶(ALP)、谷氨酸氨基转移酶(ALT)、总胆汁酸(TBA)。结果与模型对照组比较,醇提及水提部位中剂量组胆汁分泌量均显著增加(P<0.01或P<0.05),血清TBIL、ALP、ALT、TBA均显著降低(P<0.01或P<0.05);醇提部位高剂量组TBIL、ALT、TBA显著下降(P<0.01);水提部位高剂量组TBIL、ALT也显著下降(P<0.05)。结论茵陈蒿汤醇提部位及水提部位均具有一定的利胆保肝退黄作用。

薄荷素油对家兔Oddi括约肌收缩性的影响

背景:薄荷素油具有直接松弛消化道平滑肌、利胆等作用。Oddi括约肌作为消化道平滑肌的一部分,具有自主收缩和舒张运动功能,对胆汁排出具有重要意义。目的:探讨薄荷素油对家兔Oddi括约肌收缩性的影响。方法:20只家兔随机分为实验组和对照组,分别向Oddi括约肌处喷洒5 m L薄荷素油溶液或0.9%Na Cl溶液,动态监测Oddi括约肌收缩和压力变化。结果:实验组喷洒薄荷素油溶液后,Oddi括约肌基础压[(10.600±1.712)mm Hg对(17.500±1.581)mm Hg,P<0.01]、收缩频率[(6.700±0.823)次/min对(9.000±1.247)次/min,P<0.01]和运动指数[(50.400±10.068)mm Hg·次/min对(67.500±19.021)mm Hg·次/min,P<0.01]较基线值显著降低,收缩幅度则无明显变化[(7.500±1.080)mm Hg对(7.400±1.264)mm Hg,P>0.05];对照组喷洒0.9%Na Cl溶液前后上述各项指标差异均无统计学意义(P>0.05)。结论:薄荷素油可能通过抑制Oddi括约肌收缩、降低Oddi括约肌基础压而降低胆汁排出阻力,从而发挥利胆、预防胆固醇结石形成的作用。

残黄片对α-奈异硫氰酸酯致大鼠黄疸模型的退黄作用

目的观察残黄片对α-萘异硫氰酸酯所致大鼠黄疸模型的退黄作用。方法将48只SD大鼠随机分为6组:正常对照组、α-萘异硫氰酸酯模型对照组、茵栀黄颗粒阳性药物组、残黄片低、中、高(0.175、0.350、0.700mg·kg^(-1))剂量组。各给药组连续给药7d,最后1次给药后1h,按75mg·kg^(-1)体质量灌服α-萘异硫氰酸酯诱发大鼠黄疸模型,正常对照组给等量大豆油,48h后大鼠股静脉取血,测定血清总胆红素、胆固醇和总胆汁酸含量;72h后,腹主动脉取血,检测血清丙二醛含量和超氧化物歧化酶活性,同时肝脏组织切片,观察病理学改变。结果与正常对照组比较,模型组大鼠血清总胆红素含量及丙二醇含量明显升高(P<0.01),超氧化物歧化酶活性明显降低(P<0.01),残黄片能明显对抗这种改变;肝脏组织病理学检查证实,残黄片能减轻中毒大鼠肝细胞损伤程度。结论残黄片退黄作用肯定,初步研究结果提示其作用机制与改善胆汁代谢过程和抗自由基氧化损伤有关。

益苷颗粒剂对大鼠利胆作用的研究

目的观察不同剂量益苷颗粒对正常大鼠胆汁流量的影响。方法将正常大鼠随机分为空白对照组、阳性对照组、中药益苷颗粒剂大、中、小剂量组,做十二指肠插管给药,胆管插管收集胆汁;分段收集胆汁,比较给药前后流量的变化,分析药物对胆汁流量的影响,并测定用药前后胆汁中胆红素含量。结果中药益苷颗粒剂能使正常大鼠胆汁流量增加,且与剂量正相关。结论中药益苷颗粒剂具有利胆和促进胆红素排泄的作用。

灵五颗粒利胆作用的实验研究

目的实验观察灵五颗粒对健康Wistar大鼠的利胆效果。方法 40只Wistar大鼠随机分为生理氯化钠溶液组、阳性药熊去氧胆酸对照（0.63 g/kg）组、灵五颗粒低、中、高（1.75、3.5、7.0 g/kg）剂量组,每组8只。麻醉状态下手术暴露胆总管,插入导管,引流胆汁,给药前30 min收集记录各组胆汁流量。采用十二指肠方法给药,分别在给药后0~30、30~60、60~90 min收集记录各组胆汁量,并分析胆汁中胆红素、胆固醇、总胆汁酸的含量。结果灵五颗粒各剂量组给药后,各时间段上的胆汁流量均比生理氯化钠溶液组明显增加,尤其在60 min时胆汁量最多,持续至90 min仍有明显的增加,优于阳性对照药组。熊去氧胆酸组和灵五颗粒高、中、低剂量组,在给药后各时间均能增加胆汁中的总胆红素、胆固醇的含量,降低总胆汁酸的含量,与生理氯化钠溶液组相比,具有非常显著性差异。结论灵五颗粒对大鼠确有较强的利胆作用,并能明显增加排出的胆汁中胆红素、胆固醇含量,降低总胆汁酸的含量。

疏肝利胆排石为主治疗胆囊切除术后综合征的临床观察

为寻求降低胆囊切除术后综合征（ｐｏｓｔｃｈｏｌｅｃｙｓｔｅｃｔｏｍｙｓｙｎｄｒｏｍｅ，ＰＣＳ），尤其是有胆道残留或再发结石的ＰＣＳ发病率及再手术率的中医药治疗方法，以具有疏肝利胆、清热祛湿、理气通腑、消石化瘀作用的中药方剂治疗了ＰＣＳ３５例（其中有术后胆道残留、再发结石者３２例），并与以西药常规治疗的对照组３７例作对照观察。结果两组近期疗效相仿（Ｐ＞０．０５）；但远期追踪观察，中药组３年内再发作率２２．８６％，对照组３年内再发作率８６．４９％，差异有显著性（Ｐ＜０．０１）。提示：中医疏肝利胆、清热祛湿、理气通腑、消石化瘀法对大多数有胆道内原因的胆囊切除术后综合征切中病机。

Effect of soothing-liver and nourishing-heart acupuncture on early selective serotonin reuptake inhibitor treatment onset for depressive disorder and related indicators of neuroimmunology:a randomized controlled clinical trial

OBJECTIVE:To observe the effect of soothing-liver and nourishing-heart acupuncture on selective serotonin reuptake inhibitor(SSRIs) treatment effect onset in patients with depressive disorder and related indicators of neuroimmunology.METHODS:Overall,126 patients with depressive disorder were randomly divided into a medicine and acupuncture-medicine group using a random number table.Patients were treated for 6 consecutive weeks.The two groups were evaluated by the Montgomery-Asberg Depression Rating Scale(MADRS) and Side Effects Rating Scale(SERS) to assess the effect of the soothing-liver and nourishing-heart acupuncture method on early onset of SSRI treatment effect.Changes in serum 5-hydroxytryptamine(5-HT) and inflammatory cytokines before and after treatment were recorded and compared between the medicine group and the acupuncture-medicine group.RESULTS:The acupuncture-medicine group had significantly lower MADRS scores at weeks 1,2,4,and 6 after treatment compared with the medicine group(P < 0.01).The acupuncture group had significantly lower SERS scores at weeks 1,2,4,and 6 after treatment compared with the medicine group(P < 0.01).At 6 weeks after treatment,serum 5-HT in the acupuncture-medicine group was significantly higher compared with the medicine group(P <0.01).lnterleukin-6(IL-6) in the acupuncture-medicine group was significantly lower than that in the medicine group(P < 0.01),whereas there was no significant difference in IL-1(3 between the groups(P > 0.05).Anti-inflammatory cytokines IL-4 and IL-10 were significantly higher in the acupuncture-medicine group compared with the medicine group(P < 0.01,P < 0.05,respectively).CONCLUSION:The soothing-liver and nourishing-heart acupuncture method can effectively accelerate the onset of SSRI effects when treating depressive disorder and can significantly reduce the adverse reactions of SSRIs.Moreover,acupuncture can enhance serum 5-HT and regulate the balance of pro-inflammatory cytokines and anti-inflammatory cytokines.

中药利胆排石汤治疗胆结石56例临床分析

目的探讨中药利胆排石汤治疗胆结石的临床疗效。方法选择2010年9月至2012年9月期间的胆结石患者56例,随机分为研究组和对照组各28例。研究组采用中药利胆排石汤治疗,对照组采用鹅去氧胆酸治疗,对两组的临床治疗效果进行比较。结果经过3个疗程的治疗,研究组28例患者中,治愈19例,显效7例,无效2例,总有效率为92.9%;对照组28例患者中,治愈8例,显效13例,无效7例,总有效率为75.0%。两组总有效率比较,差异有统计学意义(P<0.05)。两组腹泻、肝脏不良反应发生率比较,差异有统计学意义(P<0.05)。结论利胆排石汤治疗胆结石针对性强,疗效好,不良反应较小。