Jianpi Fuzheng Decoction in the Treatment of Gastric Cancer-Related Fatigue

Objective:To observe the clinical effects of Jianpi Fuzheng Decoction in patients with gastric cancer and cancer-related fatigue(CRF).Methods:Using the random number table method as a reference,68 cases of gastric CRF were randomly divided into two groups.One group served as the control group and received basic treatment,while the other was the observation group.The observation group,in addition to the control group’s treatment,received Jianpi Fuzheng Decoction.The clinical treatment effectiveness,fatigue scores,immune function indicators,and treatment safety were compared between the two groups.Results:The total clinical treatment effectiveness of the observation group and the improvement in immune function indicators after treatment were higher than those of the control group.The fatigue score after treatment was lower in the observation group than in the control group(P<0.05).No serious adverse reactions occurred during the treatment in either group.Conclusion:Jianpi Fuzheng Decoction can enhance the clinical treatment effectiveness for gastric cancer patients with CRF.It facilitates the acceleration of fatigue symptom improvement and immune function enhancement.The medication’s safety is guaranteed,making it worthy of promotion.

Expression of phosphatase and tensin homolog deleted on chromosome ten in liver of athymic mice with hepatocellular carcinoma and the effect of Fuzheng Jiedu Decoction

AIM： To explore the expression of phosphatase and tensin homolog deleted on chromosome ten （PTEN） in liver of athymic mice with hepatocellular carcinoma （HCC） and the effect of Fuzheng Jiedu Decoction （FJD）. METHODS： Forty eight male BALB/c athymic mice models were built by Bel-7402 with an indirect method. After 24 h of postoperation, the 48 athymic mice were distributed randomly into 4 groups： A, B, C, D, each group had 12 athymic mice. Group A were were treated by intragastric administration with FT207 （Tegafur） for 4 wk. Group B, C and D were treated by intragastric administration with FJD （complex prescription of Chinese crude drug） that had been delegated into 3 kinds of density as the low, middle, and high for 4 wk. At last, athymic mice were put to death, live time, volume of tumors, exponent of tumors and the tumor metastasis in livers were observed; and PTEN was detected in hepatic tissue, latero-cancer tissue and cancer tissue by immunohistochemistry. RESULTS： Four weeks later, the total survival rate in treatment group （A ＋ B ＋ C） was 50% and higher than the control group （0%） treated by FT207, （P 〈 0.01）. The survival rate in group A, B, C was higher than in group D, and except group A with D, there was significant differentces （Fisher＇s Exact Test P = 0.05 or 0.01）. And no differences were observed between the treatment groups and the control group in volume of tumors and exponent of tumors （P 〉 0.05）. Tumor metastasis in livers of the treatment group was less than the controls （Fisher＇s Exact Test, P = 0.021）. The result of immunohistochemistry showed that the intensity of PTEN in latero-cancer tissue was the highest, and then the hepatic tissue, the lowest was cancer tissue （Kruskal- Wallis test, X^2 = 60.67, P = 0.000）. It also showed that the intensity of PTEN in treatment groups （A, B, C） was higher than the control group （D） （F = 5.90, P = 0.002 in hepatic tissue and F = 15.99, P = 0.000 in latero-cancer tissue and X^2 = 26.08, P = 0.000 in cancer tissue）, and group B is the highest in the treatment groups （P 〈 0.05, r = 0.01. respectively）. However, there was no significant statistic difference between group A and group C （P 〉 0.05）. CONCLUSION： FJD can prolong the survival time and decrease tumor metastasis in livers of these experimental mice. Mechanisms of FJD healing HCC may partially be explained by enhancing the expression of PTEN in liver.

Effect of Fuzheng Yiliu decoction combined with chemotherapy on patients with intermediate and late stage gastrointestinal cancer

AIM: To investigate the therapeutic effects of Fuzheng Yiliu (strengthening the body resistance to inhibit tumor) decoction combined with chemotherapy on the patients with intermediate and late stage gastrointestinal cancer. METHODS: Sixty patients were randomly divided into treatment group (chemotherapy combined with Fuzheng Yiliu decoction) and control group (chemotherapy alone). Four indexes, including the tumor recent remission rate (RR), the change of main symptoms, the toxic and side effects caused by chemotherapy and the change of performance status, were observed in the patients. Peripheral blood contents of CD3+, CD4+, CD8+ cells, CD4+/CD8+ and soluble interleukin-2 receptor (sIL-2R) were tested before and after treatment and the values were compared with those of healthy peoples. RESULTS: The improving rate of main symptoms (69.6%) and performance status (56.7%) were significantly higher in the treatment group than in the control group (34.8%, 26.7%, P<0.05). The occurrence rates of grade II toxic and side-effects on both bone marrow (13.3%) and digestive tract (30%) were lower in the treatment group compared to the control group (36.7%, 63.3%, P<0.05). Before treatment, the proportion of CD3+, CD4+ and CD4+/CD8+ decreased and the proportion of CD8+ and SIL-2R raised markedly both in the control group and treatment group as compared to the healttiy people. After treatment, that increased of CD3+, CD4+, CD4+/CD8+ increased (62.25±10.01% vs 68.31±9.72%, 36.83±10.44% vs 42.6±9.62%, 1.24±0.65 vs l.66±0.85, P<0.05) and the values of CD8+ and sIL-2R decreased obviously (33.06±7.69% vs 29.24±6.25%, 588.23±216.86 U/mL vs 475.87±211.36 U/mL,P<0.05) in the treatment group, whereas these values were opposite in the control group (64.22±6.91% vs60.63±5.75%,35.62±7.49% vs31.53±5.53%, 32.95±8.28% vs 37.14±7.48%, 1.17±0.43 vs 0.94±0.43, 573.63±214.32 U/mL vs 692.17?21.33 U/mL, P<0.05). CONCLUSION: Fuzheng Yiliu decoction can enhance therapeutic effects of chemotherapy on malignant gastrointestinal tumor, and also reduce the toxic and side effects on bone marrow and digestive tract, thereby improving the quality of life and cellular immunity in patients with malignant gastrointestinal tumor.

“Qingfei Paidu Decoction”—A Possible Choice of Phytotherapy for Severe Acute Respiratory Infection Caused by Coronavirus Disease-19

This work is aimed to study the therapeutics and pharmacology of the treatment of severe acute respiratory infection caused by coronavirus disease-19 (COVID-19) with traditional Chinese medicine (TCM) “Qingfei Paidu Decoction”. We analyze the “Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia” (Version I to Version VII) made by China, “Clinical management of severe acute respiratory infection when novel coronavirus (2019-nCoV) infection is suspected—Interim guidance” made by World Health Organization (WHO), “Therapeutic Guidelines: Respiratory” published by Australia, and the origin of classical prescription of Qingfei Paidu Decoction: “Shanghan Lun (Treatise on Febrile Diseases)” and “Jinkui Yaolue (Synopsis of Golden Chamber)”. We search the dictionary of traditional Chinese medicine (Version II) manually. We search literatures from 2001 to 2020 on Wiley online library. We conduct a comparative study on the therapeutic options and indications among Qingfei Paidu Decoction, COVID-19 and chronic obstructive pulmonary disease (COPD). And we carry out pharmacological inquiry of Qingfei Paidu Decoction. The therapeutic options and indications of Qingfei Paidu Decoction in China, COVID-19 and COPD are considered to be basically consistent. Qingfei Paidu Decoction has a definite therapeutic effect on the symptoms, basic diseases and complications for COVID-19 and COPD. Qingfei Paidu Decoction is a possible choice of phytotherapy for severe acute respiratory infection caused by COVID-19.

Intervention and immune regulation of Fuzheng Xiaoying Decoction on experimental autoimmune thyroiditis model rats

Objective:To investigate the effect of Fuzheng Xiaoying Decoction on experimental autoimmune thyroiditis(EAT)model rats and explore its possible mechanism of immune regulation.Methods:Among the 40 female SD rats,10 were randomly selected as the blank group,and the rest were immunized with pig thyroglobulin and Freund's adjuvant combined with high iodine feeding to make the EAT model.After the model was established,they were randomly divided into three groups:the model group,the selenium yeast tablet group and the Fuzheng Xiaoying Decoction group,which were continuously gavaged for 2 months.The anti thyroid autoantibodies,thyroid function,IL-38 and Th17/Treg distribution were measured.The pathological changes of thyroid tissue were observed by HE staining.Results:Compared with the blank group,the levels of TPOAb and TGAb in the model group were significantly higher(P<0.05).Lymphocyte infiltration was seen in the thyroid tissue of the model group,and also the thyroid follicles were partially destroyed,the shape was irregular,and the colloid distribution was uneven,indicating that the modeling was successful.Compared with the model group,the levels of TPOAb and TGAb in the selenium yeast tablet group and the Fuzheng Xiaoying Decoction group decreased significantly(P<0.05).And the Fuzheng Xiaoying Decoction group had more significant improvement in thyroid follicle destruction and lymphocyte infiltration than the selenium yeast tablet group(P<0.05).Compared with the blank group,the levels of T3,T4,FT3 and FT4 in the model group increased,the level of IL-38 decreased,the proportion of Th17 increased,and the ratio of Th17/Treg increased(P<0.05).Compared with the model group,T4 level decreased,IL-38 level increased in the selenium yeast tablet group and the Fuzheng Xiaoying Decoction group(P<0.05).But there was no statistically significant difference in the reduction of Th17 proportion and Th17/Treg ratio between the above two groups and the model group(P>0.05).There was no significant difference in Treg ratio among the groups.Conclusion:Fuzheng Xiaoying Decoction can significantly reduce the level of anti thyroid autoantibodies in EAT rats by regulating the immunity of EAT rats,and improve the follicular destruction and lymphocyte infiltration of thyroid tissue in rats.

Discussion on the composing principle of "Qingfei Paidu Decoction"in the treatment of anti-COVID-19 from the theory of syndrome-differentiation of the six meridians in Treatise on Febrile Diseases

The coronavirus disease 2019(COVID-19)was a newly discovered infectious respiratory disease and characterized by wide prevalence,high incidence rate and fast progress and dangerous,which belonged to the category of"cold-wet plague"in TCM.The onset of COVID-19 was caused by pestilence,which mingled with seasonal cold-dampness and invaded the human body when external defensive qi was weak and then leaded to the accumulation of Yang qi.Different from exogenous pathogenic factors transmitted from the external to the internal or followed the transmission law of Wei,Qi,Ying and Xue,the nature of pestilence belonged to the category of pathogenic fire,spreading as soon as possible,from the external to the internal and from the upper and lower part of triple energizer,even to every part.At the very beginning,the pestilence attacked from the Taiyang meridian into the Yangming meridian quickly,or straight into the three Yang meridian,which was called"triple-yang combination of diseases".Manifestations of fever,aversion to cold and pain of body were conformed to the exterior syndrome of Taiyang,as well as manifestations of fullness and discomfort in chest,vomiting and spitting and diarrhea were conformed to the syndrome of half-interior-half-exterior;And symptoms manifested as high fever,faint,and abdominal fullness and constipation were conformed to the syndrome of Yangming;But sometimes,there was cold-dampness surrounding the exterior at the beginning along with intense interior pathogenic fire.Or at the beginning,the exterior factors invaded into three Yin meridians quickly while have not been eliminated,which may lead to the syndrome of inner blocking causing collapse or Jue exhaustion.The most typical syndrome of COVID-19 was triple-yang combination of diseases,which was often seen in mild,moderate and part of severe cases.Hence"Qingfei Paidu Decoction"was prescribed especially for this kind of syndrome.Its accurate efficacy has been proved by that mild cases converting to severe cases in the mobile cabin hospital have been effectively restrained and thus the progression of the disease has blocked.Composition analysis showed that Mahuang decoction with Maxing Shigan decoction was to relieve exterior Taiyang syndrome,Xiaochaihu decoction was for harmonizing half-superficies and half-interior Shaoyang syndrome,and large dose of gypsum was used to clear interior heat of the Yangming meridian,and Shegan Mahuang decoction and Xiaoqinglong plus gypsum decoction was for lowering the adverse qi and resolving fluid,and Wuling San was for warming the triple energizer and transforming qi and draining water."Qingfei Paidu Decoction"was an syncretic innovation of classical prescriptions from Treatise on Febrile Diseases,which was not made up of herbs but multiple concordant prescriptions helping to get twice the result with half the effort,so that the"cold-wet plague"can be quickly discharged.

扶正化浊汤联合甲状腺片治疗对甲状腺结节大小及疗效的影响

目的探讨扶正化浊汤治疗甲状腺结节(TN)对结节大小的影响。方法TN患者106例,随机均分为观察组和对照组,对照组给予左甲状腺素钠片常规治疗,观察组在对照组基础上同时增加扶正化浊汤治疗;于治疗前、治疗3个月时,对2组患者进行中医主症评分,采用彩色多普勒超声仪记录2组患者结节数目、最大直径、结节体积、血流阻力指数(RI)及搏动指数(PI),同时采集患者外周静脉血4 mL,检测促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离四碘甲腺原氨酸(FT4)及血管内皮生长因子(VEGF)水平,治疗3个月后评估2组患者的西医疗效,记录2组治疗期间恶心、呕吐、皮疹及口干等不良反应发生情况。结果治疗后3个月,2组中医主症评分均较治疗前下降,且观察组低于对照组(P<0.05);与对照组比较,2组TN患者治疗3个月后结节数目减少、结节最大直径和结节体积均降低,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后3个月,观察组TSH低于对照组,FT 3、FT 4高于对照组(P<0.05);治疗3个月后,观察组VEGF、RI、PI低于对照组(P<0.05);观察组西医疗效和中医证候疗效中的临床痊愈和总有效率均高于对照组,差异有统计学意义(P<0.05);比较观察组与对照组不良反应发生率比较,差异无统计学意义(P>0.05)。结论扶正化浊汤治疗TN疗效显著,可有效减轻患者症状,减小结节数目及大小,调节甲状腺功能,改善血流状况,降低VEGF表达,且安全性高。

通络扶正汤对脑卒中后遗症患者血清Wnt3a、Wnt5a表达量及神经功能影响分析

【目的】分析通络扶正汤(由胆南星、法半夏、桃仁、天麻、全蝎、红花、地龙等中药组成)对脑卒中后遗症患者神经功能及血清分泌型糖蛋白(Wnt)3a、Wnt5a表达量的影响。【方法】采用回顾性研究方法,根据治疗方案的不同将146例脑卒中后遗症风痰瘀阻证患者分为观察组和对照组,每组各73例。对照组给予常规西药及康复治疗,观察组在对照组的基础上给予通络扶正汤治疗,疗程为3周。观察2组患者治疗前后美国国立卫生研究院卒中量表(NIHSS)评分、Berg平衡量表(BBS)评分、Fugl-Meyer量表(FMA)评分、Holden步行功能分级(FAC)、躯干屈伸肌群表面肌电均方根值(RMS)及血清Wnt3a、Wnt5a表达量的变化情况,并比较2组患者的临床疗效和不良反应发生率。【结果】(1)治疗3周后,观察组的总有效率为95.89%(70/73),对照组为79.45%(58/73),组间比较,观察组的疗效明显优于对照组(P<0.01)。(2)治疗后,2组患者的NIHSS评分均较治疗前明显降低(P<0.05),BBS、FMA评分均较治疗前明显升高(P<0.05),且观察组对NIHSS评分的降低幅度及对BBS、FMA评分的升高幅度均明显优于对照组(P<0.01)。(3)治疗后,2组患者的FAC分级均较治疗前改善(P<0.05),且观察组对FAC分级的改善作用明显优于对照组(P<0.05)。(4)治疗后,2组患者的竖脊肌、腹直肌表面肌电RMS值均较治疗前明显升高(P<0.05),且观察组对竖脊肌、腹直肌表面肌电RMS值的升高幅度均明显优于对照组(P<0.01)。(5)治疗后,2组患者的血清Wnt3a、Wnt5a表达量均较治疗前明显升高(P<0.05),且观察组对血清Wnt3a、Wnt5a表达量的升高幅度均明显优于对照组(P<0.01)。(6)观察组的不良反应发生率为4.11%(3/73),对照组为6.85%(5/73),组间比较,差异无统计学意义(P>0.05)。【结论】通络扶正汤可有效减轻脑卒中后遗症患者神经功能受损程度及运动障碍,提高平衡能力及治疗效果,增强躯干屈伸肌群肌力,上调血清Wnt3a、Wnt5a表达量,且不良反应发生率低,具有较高的安全性。

鱼酱排毒合剂对急性鼻窦炎大鼠NF-κB通路的影响

目的研究鱼酱排毒合剂对急性鼻窦炎大鼠核转录因子-κB(NF-κB)通路相关蛋白表达的影响。方法采用单侧鼻腔接种金黄色葡萄球菌建立大鼠急性鼻窦炎模型,根据急性鼻窦炎评分表评估造模结果。将成模大鼠分为正常组、模型组、鱼酱组(予鱼酱排毒合剂)和阿莫西林组(予阿莫西林克拉维酸分散片),各组给予相应药物治疗7 d。治疗结束后测定各组大鼠鼻腔分泌物的pH值;HE染色观察鼻黏膜组织病理学改变;ELISA检测鼻腔灌洗液及鼻黏膜上清液中肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)水平;Western blotting检测NF-κB信号通路相关蛋白表达水平。结果急性鼻窦炎大鼠炎症模型成功建立。与模型组相比,鱼酱组和阿莫西林组大鼠鼻腔分泌p H值显著降低(P<0.01),鼻黏膜病理损伤明显改善,鼻腔灌洗液和鼻黏膜组织上清液中TNF-α、IL-1β、IL-6水平明显降低(P<0.01),NF-κB相关蛋白表达水平显著下降(P<0.01)。结论鱼酱排毒合剂可通过调节急性鼻窦炎大鼠NF-κB相关信号蛋白的表达,从而改善大鼠急性鼻窦炎症状。

参芪扶正汤治疗桥本氏甲状腺炎合并甲状腺功能减退临床疗效及相关机制研究

[目的]探讨参芪扶正汤治疗桥本氏甲状腺炎(HT)合并甲状腺功能减退的临床疗效,初步分析其治疗机制。[方法]选择秦皇岛市中医医院2020年1月—2023年1月收治的HT患者110例,按照随机数字表法分为观察组和对照组,每组55例,两组均口服左甲状腺素钠片,在此基础上,对照组口服亚硒酸钠片,观察组口服中药参芪扶正汤,疗程12周。比较两组治疗前后中医证候评分、甲状腺体积和峡部厚度、游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)、促甲状腺素(TSH)、甲状腺球蛋白抗体(TGAb)、甲状腺过氧化物酶抗体(TPOAb),长链非编码RNA人母系表达基因3(lncRNA MEG3)、微小RNA-17(miR-17)、辅助性T淋巴细胞亚群17(Th17)、调节性T细胞(Treg)含量、Th17/Treg值,并比较两组治疗总有效率。[结果]治疗后观察组中医证候评分低于对照组(P<0.05),甲状腺体积和峡部厚度均低于对照组(P<0.05);血清FT3、FT4水平高于对照组(P<0.05),TSH、TGAb、TPOAb水平低于对照组(P<0.05);观察组Th17、Th17/Treg、miR-17低于对照组(P<0.05),Treg、lncRNA MEG3高于对照组(P<0.05);治疗总有效率高于对照组(P<0.05)。[结论]参芪扶正汤可以改善中医证候和甲状腺功能,调节甲状腺自身抗体,减小甲状腺体积,治疗HT合并甲状腺功能减退效果显著,其机制可能与调节血清lncRNA MEG3、miR-17有关。

扶正逐瘀汤治疗脓毒症合并多重耐药菌感染菌血症的临床疗效以及机制研究

目的采用网络药理学方法结合临床回顾性分析,探讨扶正逐瘀汤治疗脓毒症合并多重耐药菌感染菌血症的作用机制。方法回顾性队列研究方法分析2019年1月至2022年12月广西中医药大学第一附属医院仙葫院区重症医学科(ICU)的68例明确诊断脓毒症菌血症患者,并且药敏试验为多重耐药菌,根据是否使用扶正逐瘀汤分为观察组和对照组,观察组为菌血症多重耐药菌感染并使用扶正逐瘀汤的患者,对照组为菌血症多重耐药菌感染未使用扶正逐瘀汤的患者。所有的患者均进行了常规治疗。利用中药系统药理学数据库与分析平台(TCMSP)、Uniprot数据库检索扶正逐瘀汤的主要活性成分和作用靶点,利用OMIM和GeneCards数据库分别检索脓毒症、菌血症、多重耐药菌的靶点,绘制韦恩图。使用Cytoscape3.10.1软件、STRING数据库、DAVID数据库构建蛋白相互作用网络、基因本体(GO)和京都基因与基因组百科全书(KEGG)富集分析。结果治疗后两组SOFA评分、APACHEⅡ评分明显降低,且观察组明显低于对照组,差异具有统计学意义(P<0.001),观察组WBC计数、CRP水平、中医症候评分、症候疗效判定明显优于对照组,且差异具有统计学意义(P<0.05)。结论在治疗脓毒症菌血症多重耐药菌感染患者治疗中,加用扶正逐瘀汤的临床治疗效果明显优于常规治疗,且扶正逐瘀汤可以通过多组分、多靶点抑制常见多重耐药菌,值得推广应用。

清肺排毒汤对重症肺炎的影响

目的观察清肺排毒汤对重症肺炎(SAP)患者中医证候积分、氧合状态及炎性细胞因子水平的影响。方法选取2020年8月—2023年7月南昌市洪都中医院收治的70例SAP患者,随机分为对照组(35例)和观察组(35例),其中对照组采用西药常规治疗,观察组在对照组基础上采用清肺排毒汤治疗。比较2组患者临床疗效、中医证候积分、氧合状态、炎性因子水平及治疗期间不良反应情况。结果治疗后,观察组总有效率高于对照组(P<0.05);观察组各项中医证候积分、炎性因子水平均低于对照组(P<0.05);观察组PaO_(2)、SaO_(2)、PaO_(2)/FiO_(2)水平均高于对照组(P<0.05);2组患者治疗期间不良反应总发生率差异无统计学意义(P>0.05)。结论清肺排毒汤治疗SAP患者能提升治疗效果,降低中医证候积分,改善临床症状和氧合状态,减轻炎症反应,且具有一定安全性。

扶正解毒汤对结直肠癌患者的作用效果

目的研究扶正解毒汤对结直肠癌患者的作用效果。方法选取2020年1月至2022年10月河南中医药大学第三附属医院收治的96例结直肠癌患者,根据简单随机分组法分为化疗组(48例)和扶正解毒组(48例)。化疗组接受FOLFOX4化疗方案治疗,扶正解毒组在化疗组的基础上接受扶正解毒汤治疗,两组均治疗18周。统计两组治疗18周后的临床疗效,比较两组治疗前和治疗18周后中医证候积分、功能状态、肿瘤标志物、磷脂酰肌醇3酶-丝苏氨酸蛋白激酶(PI3K-Akt)信号通路、肠道菌群、生活质量。结果治疗18周后,扶正解毒组疾病控制率及总缓解率(68.75%、54.17%)高于化疗组(47.92%、31.25%)(P<0.05)。治疗18周后扶正解毒组主症、次症评分与治疗前比较降低,且低于化疗组(P<0.05);与治疗前比较,两组功能状态评分、乳酸杆菌、双歧杆菌数量及未来展望评分升高,且扶正解毒组高于化疗组(P<0.05);与治疗前比较两组血清癌胚抗原、糖类抗原199、外周血PI3K mRNA、Akt mRNA水平、肠球菌、大肠杆菌数量及排尿便问题、体重下降评分降低,且扶正解毒组低于化疗组(P<0.05)。结论扶正解毒汤联合FOLFOX4化疗方案可改善结直肠癌患者中医证候、功能状态,降低肿瘤标志物水平,调节PI3K-Akt信号通路、肠道菌群,提高患者生活质量,具有较好的治疗效果。

扶正消瘿汤联合左甲状腺素钠片治疗桥本甲状腺炎疗效及对血清炎症因子的影响

目的:观察扶正消瘿汤联合左甲状腺素钠片治疗桥本甲状腺炎(HT)的疗效及对血清炎症因子的影响。方法:选取90例HT患者,按随机数字表法分为观察组及对照组各45例。对照组服用左甲状腺素钠片治疗,观察组在对照组基础上加用扶正消瘿汤。比较2组临床疗效及不良反应发生情况,比较2组治疗前后中医证候积分、甲状腺体积、实验室检查指标[白细胞介素-6(IL-6)、白细胞介素-12(IL-12)、肿瘤坏死因子-α(TNF-α)、游离三/四碘甲状腺原氨酸(FT_(3)/FT_(4))、促甲状腺激素(TSH)、过氧化物酶抗体(TPOAb)、球蛋白抗体(TGAb)]值的变化。结果:治疗后,2组中医证候积分均较治疗前下降(P<0.05),观察组中医证候积分低于对照组(P<0.05)。观察组临床疗效总有效率为93.33%,对照组临床总有效率为75.56%,2组临床疗效比较,差异有统计学意义(P<0.05)。治疗后,2组甲状腺体积均较治疗前缩小(P<0.05),观察组甲状腺体积小于对照组(P<0.05)。治疗后,2组IL-6、IL-12、TNF-α、TSH、TPOAb、TGAb水平均较治疗前下降(P<0.05),FT_(3)、FT_(4)水平均较治疗前上升(P<0.05);观察组IL-6、IL-12、TNF-α、TSH、TPOAb、TGAb水平均低于对照组(P<0.05),FT_(3)、FT_(4)水平均高于对照组(P<0.05)。治疗期间,2组患者出现不良反应经休息后,均自行恢复。结论:扶正消瘿汤联合左甲状腺素钠片治疗HT能有效提高临床疗效,抑制血清炎症因子水平,降低炎症反应,缓解临床症状。

肺宁排毒汤联合常规治疗对肺炎支原体大叶性肺炎患者的临床疗效

目的考察肺宁排毒汤联合常规治疗对肺炎支原体大叶性肺炎患者的临床疗效。方法90例患者随机分为对照组和观察组,每组45例,对照组给予常规治疗,观察组在对照组基础上加用肺宁排毒汤,疗程2周。检测临床疗效、中医证候评分、炎症指标(WBC、N、CRP、ESR、PCT)、炎性细胞因子(TNF-α、IL-6、IL-8)、凝血指标(PLT、TT、PT、APTT、Fib、D-D)、肺部影像学积分、不良反应发生率变化。结果观察组总有效率高于对照组(P<0.05)。治疗后,2组中医证候评分、炎症指标、炎性细胞因子、PLT、肺部影像学积分降低(P<0.05),以观察组更明显(P<0.05);观察组TT、PT、APTT延长(P<0.05),Fib、D-D降低(P<0.05),并比对照组更明显(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)。结论肺宁排毒汤联合常规治疗可安全有效地缓解肺炎支原体大叶性肺炎患者临床症状,改善炎症反应和凝血功能。

扶正安中汤联合索拉非尼在中晚期肝癌患者的临床观察

目的:探讨扶正安中汤联合索拉非尼(SOR)治疗肝动脉插管化疗栓塞术(TACE)后中晚期肝细胞癌(HCC)患者的临床效果。方法:选取2021年1至12月亳州市中医院肿瘤科收治的TACE后的中晚期HCC患者100例作为研究对象,用简单随机化分组方法分为对照组和观察组,每组50例。对照组采用SOR治疗,观察组采用SOR联合扶正安中汤治疗,持续治疗3个疗程后予以疗效评估,随访1年;比较2组治疗前后中医证候积分、肝功能、肾功能、肿瘤标志物及炎症介质水平指标;统计1年患者生存情况及用药安全性。结果:对照组和观察组疾病控制率分别为24.00%和56.00%(P<0.05)。治疗后,2组患者中医证候积分、血清指标谷草转氨酶(GOT)、谷丙转氨酶(GPT)、白蛋白(ALB)、总胆红素(TB)较治疗前下降,且对照组高于观察组(均P<0.05);2组患者血清肌酐(Cr)、尿素氮(BUN)较治疗前升高,且对照组低于观察组,但差异无统计学意义(P>0.05)。1年随访期间对照组和观察组生存率分别为24.00%和42.00%,组间差异显著(χ~2=8.72,P=0.0018)。2组血清恶性肿瘤特异性生长因子(TSGF)、血清甲胎蛋白(AFP)、血管内皮生长因子(VEGF)、肿瘤坏死因子-α(TNF-α)及白细胞介素-6(IL-6)水平较治疗前下降,且对照组高于观察组(P<0.05)。结论:扶正安中汤联合SOR是治疗TACE后中晚期HCC患者的有效方案。相对于单独使用SOR治疗,能有效调节血清肿瘤标志物及炎症介质水平,且不增加药物治疗风险。

扶正透邪解毒化瘀方对多重耐药铜绿假单胞菌肺炎老年大鼠炎症损伤的影响

目的探讨扶正透邪解毒化瘀方对多重耐药铜绿假单胞菌(MDRPA)肺炎老年大鼠不同时相炎症损伤的影响。方法将老年SD大鼠分为空白组、模型组、西药组、中药组、中药提前给药组、中西医结合治疗组,除空白组外使用经口气管插管法进行MDRPA肺炎造模,观察各组大鼠死亡保护率、生命延长率;在感染后不同时间点取大鼠血清及肺组织标本,应用ELISA试剂盒测定血清肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)水平,光镜下观察肺组织支气管、肺泡等结构;在感染后第3日取肺组织标本,电镜下观察各组肺组织超微结构。结果中药提前给药组和中西医结合治疗组可提高死亡保护率和生命延长率。中西医结合治疗组可明显降低MDRPA肺炎老年大鼠血清中促炎因子TNF-α水平,升高抑炎因子IL-10水平,其作用强度明显优于西药组,且可明显减少肺组织炎症细胞浸润和充血水肿,明显减轻肺泡结构的破坏。中药提前给药组可在炎症反应早期升高血清抑炎因子IL-10水平,降低促炎因子TNF-α水平。结论扶正透邪解毒化瘀方对老年MDRPA肺炎大鼠有着较高的死亡保护率和生命延长率,与头孢他啶联合治疗可纠正MDRPA感染后紊乱的炎症状态,减轻炎症损伤。中药提前给药可对MDRPA感染后造成的炎症损伤起到保护与治疗作用,对维持机体免疫稳态具有重要意义。

基于网络药理学和分子对接技术探讨扶正解毒方治疗社区获得性肺炎的作用机制

目的基于网络药理学和分子对接技术探讨扶正解毒方治疗社区获得性肺炎(CAP)可能的作用机制。方法应用TCMSP、UniPort数据库筛选扶正解毒方的药物活性成分及相对应的靶点蛋白;应用GeneCards、OMIM和Disgent数据库中检索出CAP相关靶基因。应用Metascape数据库进行GO富集分析和KEGG通路富集分析;最后通过CB-Dock对网络中度值较高的药物成分与核心作用靶点进行分子对接验证。结果筛选得到扶正解毒方治疗CAP重要活性成分215个,核心靶点113个,确定扶正解毒方治疗CAP的主要通路,分子对接中活性成分与靶点具有较为稳定的结合活性。结论扶正解毒方具有多因素协同调控的作用特点,这为进一步阐明扶正解毒方治疗CAP的作用机制提供了科学思路与依据。

清肺排毒汤联合甲泼尼龙治疗免疫检查点抑制剂相关性肺炎患者临床观察

[目的]探讨清肺排毒汤联合甲泼尼龙治疗临床2~4级免疫检查点抑制剂相关性肺炎(CIP)患者的有效性及安全性。[方法]将30例免疫检查点抑制剂所致免疫性肺炎的恶性实体瘤患者以随机数字表法随机分为两组,对照组给予甲泼尼龙治疗;联合组给予清肺排毒汤联合甲泼尼龙治疗,比较两组患者治疗前后的临床-影像-生理(CRP)评分、影像学疗效评价、卡式功能状态(KPS)评分、中医证候积分。[结果]治疗后,两组的CRP评分均下降,联合组比对照组下降明显(P<0.05);两组的影像学表现均改善,联合组有效率为86.7%,对照组为66.7%,但两组比较差异无统计学意义(P>0.05);两组的KPS评分均升高,联合组比对照组升高明显(P<0.05);两组中医证候积分均减少,联合组比对照组减少明显(P<0.05)。[结论]清肺排毒汤联合甲泼尼龙可改善CIP患者的临床症状,提高生活质量,且疗效优于单独使用甲泼尼龙治疗。

清肺排毒汤联合西医治疗新型冠状病毒肺炎临床疗效的Meta分析

目的:系统评价清肺排毒汤治疗新型冠状病毒肺炎(COVID-19)的临床疗效与安全性。方法:检索中国知网、万方、维普、Pubmed、Embase、Cochrane Library等数据库,检索时间截至2022年4月20日,筛选有关清肺排毒汤联合西医治疗COVID-19的临床疗效研究。采用Cochrane偏倚风险评价工具对纳入的研究进行风险评估及质量评价,提取相关数据,采用State17.0软件进行Meta分析,Begg’s检验分析发表偏倚。结果:最终纳入6篇临床疗效研究共602例患者,其中实验组采用清肺排毒汤联合西医治疗295例,对照组单纯西医治疗307例。Meta分析结果显示,实验组在提高临床有效率[RR=1.17,95%CI(1.09,1.26),P<0.0001]、CT好转情况[RR=1.20,95%CI(1.10,1.30),P<0.0001],降低不良反应[RR=0.73,95%CI(0.60,0.90),P=0.002],缩短核酸转阴时间[WMD=-6.56,95%CI(-10.37,-2.75),P=0.0007]、住院天数[WMD=-4.75,95%CI(-6.26,-3.25),P<0.00001]等方面的作用优于对照组。结论:清肺排毒汤联合西医常规疗法可有效改善COVID-19临床症状,具有一定的疗效和安全性,但仍需大量高质量研究证实疗效。