Danggui Shaoyao powder improves hepatic lipid metabolism in atherosclerosis mice via PPARγ-LXRα-ABCA1 pathway regulation

Objective To observe the effects of Danggui Shaoyao powder(DSP)on hepatic lipid metabolism and further explore its mechanism of action by peroxisome proliferator-activated receptor(PPARγ)-liver X receptor(LXRα)-adenosine triphosphate(ATP)-binding cassette transporter A1(ABCA1)pathway regulation.Methods Eight C57BL/6J male mice were selected as the control group,and 24 ApoE^(−/−)male mice were randomly divided into the atherosclerosis model(AS)group,atorvastatin calcium(AC)group,and DSP group(n=8 each group).To establish an AS model,ApoE^(−/−)mice were fed a high-fat diet for 16 weeks.Pathologic changes in the aortic vasculature and liver were identified using Oil Red O staining.Triglyceride(TG),cholesterol(TC),and low-density lipoprotein cholesterol(LDL-C)levels were determined in the livers using a single-reagent GPO-PAP method.Fluorescence quantitative polymerase chain reaction and western blot were used to observe and evaluate the mRNA and protein expression of the PPARγ-LXRα-ABCA1 intermediates in the liver.Results After 16 weeks of a high-fat diet,ApoE−/−mice showed more Oil Red O staining in the aorta and liver compared to the CONT group.Compared to the AS group,the DSP and AC treatment reduced aortic plaque and hepatic lipid deposition to varying degrees.Furthermore,DSP significantly reduced the hepatic lipid area in ApoE^(−/−)mice(P<.001)and decreased the levels of TG,TC,and LDL-C in liver(P<.001,P=.027,P<.001,respectively).DSP also significantly increased the levels of PPARγ,LXRα,ABCA1,and ABCG1 mRNA expression,as well as the PPARγ,LXRα,ABCA1,and ABCG1 protein expression in liver.Conclusion DSP improved hepatic lipid metabolism via PPARγ-LXRα-ABCA1 pathway modulation for AS treatment.

Exploration of the potential mechanism of Danggui Shaoyao powder in the treatment of endometriosis based on bioinformatics

Background:Endometriosis is a hormone-and organ-dependent disease with unclear pathogenesis.Danggui Shaoyao powder(DSP)has been used for the treatment of endometriosis for many years and has been proven to be effective,but its underlying molecular mechanisms remain unclear.In this study,we explored the molecular targets and pathways of DSP in the treatment of endometriosis mainly from the perspective of network pharmacology,and provided some novel ideas for managing this disease.Methods:In the present study,we focused on the underlying mechanisms between DPS and endometriosis,via oral bioavailability screening,drug similarity assessment,target identification,network analysis,drug relocation,and molecular docking using network pharmacology.Results:By bioinformatics,54 active components of DSP were predicted from the 534 components provided by the TCMSP database.We then found 85 validated targets and 6059 predicted targets for herbal components,and 2241 targets for endometriosis.After mapping,there were 255 targets in common.After that,network analysis was performed to screen key networks and core targets.Ninetynine indirect targets were collected from 14 direct ones.GO and KEGG analyses identified 63 enriched functions and 10 pathways(P<.01).According to the disease target,dipyridamole could undergo drug repositioning for endometriosis(score?1).The mechanism of action of dipyridamole on endometriosis was compared with that of DSP.Finally,eight targets,namely,AR,ESR1,HMGCR,NOS2,NR3C1,PPARG,PTGES,and PTGS2,were validated by molecular docking,suggesting that the probable molecular mechanisms by which DSP treats endometriosis are through seven validated pathways:hsa05200,hsa04915,hsa01100,hsa00900,hsa04920,hsa01130,and hsa00590.Conclusion:In this study,we uncovered the mechanism by which DSP can treat endometriosis using a drugecomponentetarget interaction network.This approach can provide some novel ideas for the development of Chinese medicine and the clinical management of endometriosis.

Research Progress on Material Basis,Pharmacological Effect and Clinical Application of Danggui Shaoyao Powder

The research of modern pharmacology displays that main material basis of Danggui Shaoyao Powder exerting efficacy includes ligustilide,paeoniflorin,poria acid,ferulic acid,ligustrazine and so on,and its efficacy is mainly realized by regulating neural receptor-ligand interaction,cytokine release,and TNF-αinflammatory pathway.Systematic study of metabonomics,serum pharmacochemistry and network pharmacology of Danggui Shaoyao Powder sufficiently clarifies its potential pharmacodynamic mechanism,and it could provide scientific theoretical basis for its clinical application.In this paper,by systemically analyzing material basis of Danggui Shaoyao Powder,and exploring its complex pharmacological mechanism and clinical application in vivo,it could comprehensively understand the clinical value of Danggui Shaoyao Powder,so as to provide beneficial reference for further development of the material basis,quality control and classical prescription of Danggui Shaoyao Powder.

A Medical Case of Acne Vulgaris Treated with Danggui Shaoyao Powder Combined with Sini Powder

Acne vulgaris is a chronic inflammatory skin disease damaging face,and the incidence of acne vulgaris is increasing year by year in China.Acne falls into the category of pimple in traditional Chinese medicine,and there are many dialectical understandings of acne in modern traditional Chinese medicine.Dr.He Aijuan has a unique diagnosis and treatment thinking in treating acne vulgaris(liver stagnation and spleen deficiency type)with traditional Chinese medicine in her clinical work for many years.Her application of Danggui Shaoyao Powder combined with Sini Powder has a remarkable effect in the clinical treatment process,so a clinical medical case is selected for discussion.

Protocol for evaluating the effects of Danggui Shaoyao Powder in the treatment of DPN with qi deficiency and blood stasis pattern based on routine therapy:a randomized controlled trial

Background:Diabetic peripheral neuropathy(DPN)has high incidence.At present,the treatment for DPN mainly focuses on controlling of blood sugar,nourishment of nerves and symptomatic treatment of pain which face some limitations,such as poor effects and adverse reactions of drugs and so on.Traditional Chinese Medicine(TCM)has certain curative effect in the prevention and treatment of DPN.Danggui Shaoyao powder,one of the famous classic prescriptions in TCM,has been often used clinically in the treatment of DPN in China,which without any relevant evidence-based medical research data.The protocol was designed to evaluate the effects of Danggui Shaoyao Powder in the treatment of DPN with qi deficiency and blood stasis pattern based on routine therapy.Methods:This protocol is designed as a three-arms parallel-group,outcome-assessor blinded RCT.303 Patients with DPN,from outpatient and inpatient departments of four clinical centers in China,will be randomly allocated into 3 groups(routine group,treatment group and control group).The course of treatment was designed as 1 month and followed up for 3 months.The TCSS scale,TCM syndrome scale,nerve conduction function,serum indexes will be tested to provide more clinical evidences for the effect of Danggui Shaoyao Powder on prevention and treatment of DPN.Finally,we will make statistics and analyse the data to draw a conclusion.Discussion:Danggui Shaoyao Powder is the ideal drug which is an agent acting on multiple targets related to DPN’s pathogenesis.We hope to find more clinical evidences for the effect of Danggui Shaoyao Powder on prevention and treatment of DPN through this RCT experiment.

Effect of Danggui Shaoyao San with Huangqi on adriamycin-induced nephrotic syndrome in rats

Objective:To determine the therapeutic effect of Danggui Shaoyao San with Huangqi on rats with nephrotic syndrome(NS)was discussed,and the scientific connotation of TCM treatment principle was elaborated,so as to provide experimental basis for its clinical application.Methods:The NS rat model was established by iv administration of adriamycin;The rats were divided into model group,Danggui Shaoyao San group,Danggui Shaoyao San with Huangqi group,Huangqi group and positive drug group,with 10 rats in control group;The best dosage ratio of Danggui Shaoyao San and Huangqi was screened by Excel;24 h urine protein was measured by BCA method;The electrolyte level was detected by automatic biochemical analyzer;In serum Urea nitrogen(BUN),Creatinine(SCr),Total cholesterol(TC),Triglyceride(TG),Total protein(TP),Albumin(ALB),Immunoglobulin M(Ig-M)and Immunoglobulin G(Ig-G)were detected by the kit;hematoxylin-eosin staining was used to observe the renal morphology;The Total water content(TBW),Extracellular water content(ECF)and Intracellular water content(ICF)were measured by experimental animal body composition analyzer.Results:Compared with the model group,the urine protein in the modified Astragalus group of Danggui Shaoyao Powder was significantly decreased(P<0.01);Urine electrolytes were significantly decreased and serum electrolytes were significantly increased(P<0.01);Serum BUN,SCR,TC and TG were significantly decreased(P<0.01),while TP,ALB,TBW and ICF were significantly increased(P<0.01);The levels of Ig-M and Ig-G were significantly increased(P<0.01),TBW and ICF were significantly increased,and ECF was significantly decreased(P<0.01);Histopathology showed that the pathological changes of renal tissue were obviously alleviated;The improvement of each index was better than that of Danggui Shaoyao San group and Huangqi group.Conclusion:Danggui Shaoyao San with Huangqi group can significantly improve the edema,proteinuria,blood lipid and immune function of NS rats,and the effect is better than that of Danggui Shaoyao San group and Huangqi group.It has the best therapeutic effect on NS,which indicates that Huangqi plays a key synergistic effect on Danggui Shaoyao San,which verifies the scientific connotation of"Yiqi Huoxue Lishui"in the treatment of NS.

桂枝加葛根汤联合当归芍药散治疗良性位置性眩晕的效果

目的 探讨桂枝加葛根汤联合当归芍药散治疗良性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的效果。方法 选取2021年2月-2023年8月收治的80例老年后半规管BPPV痰瘀互阻证患者,按照掷硬币法分为2组,对照组(n=40)采取常规西药治疗,观察组(n=40)另用桂枝加葛根汤联合当归芍药散治疗,比较2组疗效。结果 治疗7 d、14 d后,观察组中医证候积分较对照组低(P<0.05)。14 d治疗后,观察组眩晕评分、血液流变学指标、血清同型半胱氨酸(homocysteine,Hcy)水平均优于对照组(P<0.05)。治疗后,观察组脑血流动力学较对照组优(P<0.05)。2组在治疗期间均未出现头痛、乏力不良反应。结论 对老年后半规管BPPV痰瘀互阻证患者采取桂枝加葛根汤联合当归芍药散治疗,可明显减轻患者眩晕症状和中医证候积分,改善其血液流变学和脑血流动力学,值得推广。

当归芍药散与布洛芬口崩片治疗原发性痛经气滞血瘀证的疗效比较

目的 比较当归芍药散与布洛芬口崩片治疗原发性痛经气滞血瘀证的临床疗效。方法 前瞻性选取2020年1月—2023年12月琼海市中医院收治的原发性痛经气滞血瘀证患者144例作为研究对象,采用随机数字表法分为西药治疗组和中药治疗组,各72例。西药治疗组患者接受布洛芬口崩片治疗,中药治疗组患者接受当归芍药散治疗。2组患者均连续治疗3个月经周期。比较2组临床疗效,治疗前后痛经程度评分、血清学指标[前列腺素F_(2)α(PGF_(2)α)、前列腺素E_(2)(PGE_(2))]。结果 中药治疗组患者治疗总有效率为93.06%,高于西药治疗组的77.78%(χ^(2)=6.746,P=0.009)。治疗3个月经周期后,2组患者痛经程度评分低于治疗前,且中药治疗组低于西药治疗组(P<0.01);2组患者血清PGF_(2)α水平低于治疗前,血清PGE_(2)水平高于治疗前,且中药治疗组低/高于西药治疗组(P<0.05或P<0.01)。结论 采用布洛芬口崩片及当归芍药散治疗原发性痛经气滞血瘀证均能通过降低PGF_(2)α、提高PGE_(2)水平而减轻痛经程度,但当归芍药散的效果更佳。

经方治疗良性前列腺增生症的研究进展

正气不足、瘀血留结、水饮停留为良性前列腺增生症(benign prostate hyperplasia,BPH)发病的主要病机。正气不足为BPH发病之根本,以金匮肾气丸、真武汤化生肾气、温阳利水;瘀血留结是BPH发病的关键病机,以桂枝茯苓丸、抵当汤以化瘀消瘢、利窍通便;水饮停留为BPH最为紧急之症,治以五苓散、当归芍药散以化气利水,解标症之急。

当归芍药散在妇产科临床中的应用

当归芍药散出自《金匮要略》,由三味“血分药”和三味“水分药”组成,共奏肝脾调和、气血水同调之功。血虚为主者,三味水药量宜小,血滞者三味血药量宜大,湿盛浮肿者,三味水药应重用,以达药专力宏之效;水酒同煎,取其宣通药势。临床用于妇人腹痛、子肿、月经不调、更年期综合征等妇产科疾病,有良好效果。

基于网络药理学探讨加味当归芍药散对子宫内膜异位症痛经的作用机制及实验验证

目的:基于网络药理学探讨加味当归芍药散治疗子宫内膜异位症(EMs)痛经的作用机制。方法:利用中药系统药理学数据库与分析平台(TCMSP)、人类孟德尔遗传在线数据库(OMIM)、人类基因数据库(GeneCards)、人类疾病相关基因与突变位点信息数据库(DisGeNET)、疗效靶点数据库(TTD)等数据库分析组方活性成分及潜在作用靶点,构建加味当归芍药散活性成分-EMs痛经靶点网络,并对核心靶点进行基因本体(GO)及京都基因与基因组百科全书(KEGG)通路富集分析,应用分子对接vina(Autodock vina)软件对组方潜在活性成分及核心靶点进行分子对接,并采用实时荧光定量逆转录聚合酶链反应(RT-qPCR)及蛋白免疫印记法初步验证组方对EMs小鼠模型子宫内膜预测靶点mRNA及相关蛋白表达的影响。结果:组方筛选出活性成分86个,其治疗EMs痛经对应的交集靶点共64个,其中度值较高的靶点包括表皮生长因子受体(EGFR)、肿瘤抑制基因p53(TP53)、前列腺素内过氧化物合酶2(PTGS2)、血管内皮生长因子A(VEGFA)、丝氨酸/苏氨酸蛋白激酶1(AKT1)、白细胞介素6(IL-6)、基序趋化因子配体8(CXCL8)、基质金属蛋白酶9(MMP9)等。GO功能富集分析共得到1990个条目,KEGG通路分析涉及雌激素、黏着斑等127条通络。分子对接结果显示,组方核心成分槲皮素与VEGFA、AKT1、低氧诱导因子1A(HIF1A)等关键靶点具有良好的结合力。验证实验显示,加味当归芍药散可显著下调EMs小鼠模型VEGFA、CXCL8、TP53等mRNA及MMP9、环氧合酶-2(COX-2)蛋白表达水平。结论:加味当归芍药散的核心成分可调控EMs痛经的多个靶点,其作用机制可能和调控细胞侵袭、雌激素、免疫、炎症反应等信号通路相关。

瓜石汤联合当归芍药散对多囊卵巢综合征合并胰岛素抵抗小鼠的影响

目的:探讨瓜石汤联合当归芍药散对多囊卵巢综合征联合胰岛素抵抗(PCOS-IR)小鼠模型性激素和内膜炎症介质的影响。方法:用来曲唑和高脂饮食构建PCOS-IR模型小鼠,观察小鼠动情周期变化及检测小鼠空腹血糖、空腹胰岛素评价模型成功是否。将小鼠随机分为对照组、模型组、中药组,中药组造模成功后给予瓜石汤联合当归芍药散中药方灌胃,对照组及模型组给予等体积纯净水。干预21 d后用酶联免疫吸附试验(ELISA)法测定血清卵泡刺激素(FSH)、促黄体生成素(LH)、总睾酮(T)水平,检测内膜组织肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)的水平。结果:造模后对照组小鼠动情周期正常,模型组小鼠动情周期紊乱,多数位于动情间期;对照组小鼠胰岛素抵抗指数(HOMA-IR)均小于2.69,而模型组均大于2.69。给药21 d后,中药组小鼠血清LH、T、LH/FSH较模型组低(P<0.05),内膜组织TNF-α、IL-1β、IL-6 mRNA和蛋白表达水平较模型组低(P<0.05)。结论:瓜石汤联合当归芍药散能改善PCOS-IR小鼠血清激素水平,降低内膜炎症介质水平,改善内膜炎症。

当归芍药散古今源流及临床应用机制

目的:系统梳理有关当归芍药散的古今文献,了解当归芍药散的历史沿革和临床应用概况,为当归芍药散的现代临床应用及研究提供理论基础。方法:在《中华医典》数据库中以“当归芍药散”为关键词搜索有关条目及古代书籍,在国家知识基础设施数据库(CNKI)及PubMed数据库中以“当归芍药散”“DangGui ShaoYao San(DSS)”为主题词进行检索,并依据纳入和排除标准筛选,最终总结出当归芍药散的历史沿革与临床研究。结果:古代文献最终纳入111条目,共50部医籍,当归芍药散首载于《金匮要略》,其药物组成、基原、剂量、煎服方法大致延续了仲景书中的记载,书中并未记载当归芍药散的炮制方法、服药反应及禁忌证,但是后世医家及学者对当归芍药散的单个药物进行了考证和探讨,处方配伍比例当为3∶16∶8∶4∶4∶8,方中药物为生品,主治腹痛;现代文献纳入38篇文献,该方具有镇痛抗炎、调节激素水平、降低血脂程度、改善血流状态、提高免疫的功用,主要用于慢性盆腔炎、痛经、黄褐斑、糖尿病肾病等疾病。结论:当归芍药散的组成、基原、剂量、煎煮及服用方法基本上与《金匮要略》保持一致,该方主要适用证型有5型,疾病有10余种。临床治疗上,探究其临床应用机制,扩宽了当归芍药散的应用范围,为经方当归芍药散的开发与应用提供了参考。

当归芍药散治疗慢性盆腔炎的临床研究及实验研究进展

慢性盆腔炎(CPID)是女性常见的慢性炎症性疾病,具有病程长、易复发的特点。当归芍药散出自《金匮要略》,为治疗“妇人腹中诸疾痛”的常用方,现代常用于治疗CPID,并取得较好疗效。该文对近10年来当归芍药散治疗CPID的临床研究和实验研究方面的文献进行总结分析,探讨当归芍药散治疗CPID的临床疗效及其作用机制。临床研究方面,应用当归芍药散治疗CPID多使用原方加减用药,或单独使用,或联合抗生素及中医外治法;与单独应用西药相比,当归芍药散联合西药可明显改善炎症指标及免疫功能指标、缓解疼痛等临床症状与体征,且未增加不良反应。实验研究方面,当归芍药散可通过降低内皮细胞的黏附、调节细胞外基质的降解、改善炎性因子水平、下调核因子κB(NF-κB)通路相关蛋白表达等对CPID发挥治疗作用。

基于转录组学探讨当归芍药散对db/db小鼠肾脏保护作用的潜在机制

目的基于转录组学和实验验证探究当归芍药散对db/db糖尿病肾病小鼠肾脏的保护机制。方法25只8周龄造模成功的db/db小鼠按体质量随机均分为模型组(20 mL/kg蒸馏水)、达格列净组(1.3 mg/kg)、当归芍药散低剂量组(8.39 g/kg)、当归芍药散中剂量组(16.77 g/kg)、当归芍药散高剂量组(33.54 g/kg),每组5只;另选5只同龄db/m小鼠作为空白组(20 mL/kg蒸馏水)。每组灌胃1次/d,连续6周。给药结束后,检测各组小鼠体质量、空腹血糖(fasting blood glucose,FBG)、口服糖耐量试验(oral glucose tolerance test,OGTT)的曲线下面积(area under thecurve,AUC);采用全自动生化分析仪检测尿白蛋白肌酐比值(urea albumin creatinine ratio,UACR)、甘油三酯(triglyceride,TG)、总胆固醇(total cholesterol,TC);采用肌酐比色法检测血肌酐(serum creatinine,Scr);采用尿素比色法检测小鼠血尿素氮(blood urea nitrogen,BUN);采用HE染色观察肾脏组织病理形态;采用转录组学芯片技术检测小鼠肾组织差异基因,并对当归芍药散中剂量组差异基因进行KEGG富集分析;采用RT-PCR法检测表达量TPM>10的核心基因在肾脏组织中的mRNA表达水平。结果与空白组比较,模型组小鼠体质量、OGTT-AUC、FBG、UACR、Scr、BUN、TG、TC显著升高(P<0.01)。与模型组相比,达格列净组、当归芍药散各剂量组小鼠体质量、OGTT-AUC、FBG、UACR、Scr、BUN、TG、TC均降低(P<0.05,P<0.01)。与空白组相比,模型组共筛选出1129个差异基因,其中上调差异基因337个、下调差异基因792个。与模型组相比,当归芍药散共筛选出271个差异基因,其中上调差异基因195个、下调差异基因76个。空白组、模型组、当归芍药散中剂量组三组差异共表达基因57个,其中TPM>10的核心基因共12个,包括Gsta2、Cyp4a12a、Slc8a1、Abcc4、Cpeb4、Serpina1b、Npl、Aacs、Kap、Slc5a10、Tmem252、Ifi27l2a。12个核心基因的mRNA表达水平与转录组测序趋势相同。与模型组比较,当归芍药散中剂量组小鼠Gsta2、Abcc4、Slc8a1、NPL mRNA表达水平升高(P<0.05,P<0.01),Slc5a10、Tmem252 mRNA表达水平下降(P<0.05)。当归芍药散中剂量组差异基因富集于药物代谢-细胞色素P450、谷胱甘肽代谢、活性氧等相关通路。结论当归芍药散具有改善糖尿病肾病预后的作用,其机制可能与调控Gsta2、Slc5a10、Abcc4、Slc8a1、Tmem252、Npl等基因表达,调控细胞色素P450、谷胱甘肽代谢、活性氧等信号通路相关。

当归芍药散对大鼠盆腔炎性疾病后遗症模型的药效机制

目的探究当归芍药散治疗大鼠盆腔炎性疾病后遗症(SPID)模型的药效机制。方法以70只雌性SPF级SD大鼠为研究对象,采用机械损伤+混合菌液接种法建立大鼠SPID模型。将大鼠随机分成空白对照组、假手术组、模型组、当归芍药散高、中、低剂量组、妇科千金胶囊组,每组10只。给药20 d后在镜下对各组大鼠子宫形态学变化进行观察;用比色法测定大鼠血清超氧化物歧化酶(SOD)活性及丙二醛(MDA)的含量;ELISA法测定大鼠血清中炎性细胞因子白介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、白介素-4(IL-4)、白介素-10(IL-10)的含量。结果光学显微镜观察显示,当归芍药散高、中剂量组可以降低大鼠子宫内膜的炎症细胞浸润,促进病变上皮细胞增生修复,与空白组比较,模型组大鼠子宫病理学阳性评分升高;与模型组相比,当归芍药散高、中剂量组大鼠子宫病理学评分均降低;与空白组比较,模型组大鼠血清MDA、IL-1β、TNF-α含量增加,SOD、IL-4、IL-10含量下降(P<0.05)。与模型组相比,当归芍药散高、中剂量组、妇科千金胶囊组大鼠血清中MDA的含量均降低,各给药组大鼠SOD活力均增加(P<0.05),当归芍药散高、低剂量组大鼠血清IL-1β、TNF-α含量下降,各给药组大鼠血清IL-4、IL-10含量升高(P<0.05)。结论当归芍药散能调节体内氧化应激系统平衡及免疫系统中抗炎因子和促炎因子的水平,有效遏制炎症进展,对人体免疫功能有调节作用,促进炎症组织的修复。

2000-2023年当归芍药散研究热点及趋势的可视化分析

目的探讨2000—2023年当归芍药散相关文献的研究状况及趋势。方法检索中国知网(CNKI)、维普中文科技期刊数据库(VIP)、万方数据库、中国生物医学文献数据库(SinoMed)4个数据库中收录的当归芍药散相关研究文献,时间设置为2000年1月1日—2023年12月20日。采用文献管理软件NoteExpress合并文献去重,运用CiteSpace6.1.R6软件对文献进行图谱解读分析。结果共纳入文献1163篇,2000—2023年发文量呈波动增长趋势。此类文献发文量最多的期刊是《中国实验方剂学杂志》(39篇),发文量最多的作者是许钒(19篇),发文量最多的机构是河南中医药大学(10篇)、江西中医药大学(10篇)。高频关键词包括“临床应用”“慢性盆腔炎”“中医药疗法”等,聚类分析共生成11个标签。结论当归芍药散的研究热点涵盖临床应用、文献考证及作用机制等方面,通过网络药理学与分子对接技术探索其作用机制和作用靶点是研究趋势。

当归芍药散临床运用举隅

目的通过赵曼丽教授应用当归芍药散的临床验案举隅,分析当归芍药散的病机及方证特点,扩大当归芍药散的临床应用范围,拓展临床诊疗思路。方法分析当归芍药散的方药组成及证治,结合验案阐述其临床运用的症状、体征特点及病机要点。结果临床病机为肝脾不调或血水互结,兼见面色萎黄或有黄褐斑、脐周压痛或有条索状物、腹主动脉搏动明显、心下部有振水音等症状或体征者皆可应用当归芍药散,疗效显著。结论抓住病机,方证结合,是确保临床疗效的关键。

当归芍药散介导氧化-炎症通路在老年痴呆大鼠模型神经损伤保护中的机制探究

目的:探讨当归芍药散介导氧化-炎症通路在老年痴呆大鼠模型神经损伤保护中的机制。方法:72只大鼠随机分成对照组、模型组、当归芍药散低剂量组(12g/kg)、当归芍药散中剂量组(24g/kg)、当归芍药散高剂量组(36g/kg)和尼莫地平组(20mg/kg),每组12只。除对照组外,其余组大鼠均复制老年痴呆模型。建模成功后,当归芍药散不同剂量组和尼莫地平组分别灌胃不同剂量当归芍药散、尼莫地平。其余组灌胃等剂量的生理盐水,连续灌胃4周。Morris水迷宫实验检测空间学习记忆能力。高效液相色谱-电化学检测法海马组织间液去甲肾上腺素(NE)、多巴胺(DA)、5-羟色胺(5-HT)和5-羟吲哚乙酸(5-hydroxyindole acetic acid, 5-HIAA)水平。Longa法评估各组大鼠神经功能缺陷。酶联免疫吸附检测脑组织白介素1β(IL-1β)、白介素10(IL-10)、肿瘤坏死因子α(TNF-α)、超氧岐化酶(SOD)、丙二醛(MDA)、谷胱甘肽过氧化物(GSH-Px)。结果:模型组逃避潜伏期均短于对照组(P<0.05)。与模型组相比,当归芍药散不同剂量组和尼莫地平组逃避潜伏期均下降(P<0.05)。与对照组相比,模型组大鼠的神经功能缺损评分以及脑组织中TNF-α、IL-1β、IL-6水平升高(P<0.05)。当归芍药不同剂量组和尼莫地平组神经功能缺损评分以及脑组织中TNF-α、IL-1β、IL-6水平低于模型组(P<0.05)。模型组大鼠海马组织间液NE、DA、5-HT、5-HIAA水平以及脑组织SOD和GSH-Px含量均低于对照组,脑组织MDA含量高于对照组(P<0.05)。与模型组相比,当归芍药散不同剂量组和尼莫地平组大鼠海马组织间液NE、DA、5-HT、5-HIAA水平以及脑组织SOD和GSH-Px含量均升高,脑组织MDA含量降低(P<0.05)。与对照组相比,Nrf2表达下降,TLR4和NF-κB表达升高(P<0.05)。与模型组相比,当归芍药散不同剂量组和尼莫地平组Nrf2表达升高,TLR4和NF-κB表达下降(P<0.05)。结论:当归芍药散通过Nrf2/TLR4/NF-κB信号通路发挥降低氧化应激反应、抗炎作用对老年痴呆大鼠神经损伤起到保护作用。

当归芍药散治疗非酒精性脂肪性肝病作用机制研究现状

随着人们生活水平的提高和饮食习惯的改变,非酒精性脂肪性肝病(NAFLD)逐渐成为世界上最常见的慢性肝病之一。其发病率呈逐年上升的趋势,因其发病机制较为复杂,尚不明确,目前未有特效的治疗药物,因此,寻找安全、高效、经济的NAFLD治疗药物迫在眉睫。与具有快速降脂作用的西药相比,中药因其具有多靶点、多通道作用机制等独特优势,在NAFLD的治疗中越来越受到关注。NAFLD的中医病机为肝脾失调、痰瘀互结。当归芍药散源于《金匮要略》,具有调和肝脾、祛湿消痰、活血化瘀之效,与该病病机相契合。当归芍药散已被证明通过调节各种途径来治疗NAFLD,包括改善肠道菌群、抗氧化应激、调节肠肝轴、减轻炎症反应等。中药因其具有多靶点、多通道作用机制对治疗NAFLD有独特优势,而当归芍药散药物组成多样,药理作用复杂,难以了解调控NAFLD的具体机制,目前缺少当归芍药散的临床试验研究,组成药物的剂量与配比问题无明确规定,当归芍药散诱导的肝毒性和肾毒性也需进一步探讨。因此,文章通过检索与整理相关文献,对当归芍药散治疗NAFLD的作用机制和实验数据及临床研究结果进行归纳和分析,总结了当归芍药散治疗NAFLD的优势与不足,为今后中医药进一步开展包括当归芍药散在内的深入实验研究及后续临床运用和推广提供思路和展望。