Meta-analysis of the curative efficacy of Duhuo Jisheng Decoction combined with western medicine on knee osteoarthritis

Objective:To evaluate the efficacy and safety of Duhuo Jisheng Decoction combined with western medicine in the treatment of knee osteoarthritis.Methods:The databases of CNKI,VIP,CBM,WANFANG DATA and PubMed were electronically to collect randomized controlled trials(RCTs)of the treatment of knee osteoarthritis with Duhuo Jisheng Decoction combined with western medicine.After literature was strictly screened and the study quality was evaluated according to relevant procedures,the Meta analysis was performed by RevMan5.3 software.Resluts:A total of 15 RCTs were included.The result of meta-analysis showed that:compared with the western medicine alone,Duhuo Jisheng Tang combined with western medicine could significantly improve the efficacy(RR=1.25,95%CI(1.18,1.32),p<0.00001),the posttreatment pain visual analogue scale scores(MD=-0.85,95%CI(-1.00,-0.71),p<0.00001)、the western ontario and mcmaster universities arthritis index scores(MD=-7.76,95%CI(-10.37,-5.15),p<0.00001)and matrix metalloproteinase3(MD=-11.72,95%CI(-17.39,-6.05),p<0.0001)were lower in treatment group compared to control group.There was no statistical difference in the incidence of adverse reactions between the 2groups.Conclusions:The current evidence shows that Duhuo Jisheng Decoction combined with western medicine can further improve the clinical efficacy for knee osteoarthritis.

Meta-analysis of clinical efficacy of Duhuo Jisheng Decoction in the treatment of lumbar intervertebral disc herniation

Objective:To explore the clinical effect of Duhuo Jisheng Decoction in the treatment of lumbar disc herniation.Methods:CNKI,VIP,Wan Fang Data,Pubmed,Cochrane Library,Medline Complete and Embase databases were searched by computer.The randomized controlled trial(RCT)of Duhuo Jisheng Decoction combined with western medicine in the treatment of lumbar intervertebral disc herniation was studied.The searching time was from the establishment of the database to July 20,2019.Data were extracted and analyzed by Revman 5.3 software.Results:Twenty-four literatures involving 1980 patients were included.Meta-analysis showed that the total effective rate of Duhuo Jisheng Decoction group was significantly higher(OR=5.26,95%CI(4.13,6.69),Z=13.47,P<0.00001)and the incidence of adverse reactions was significantly lower(OR=0.45,95%CI(0.23,0.87),Z=2.36,P=0.00001)than that of Western medicine group.02).Conclusion:Duhuo Jisheng Decoction is effective and safe in the treatment of lumbar intervertebral disc herniation.However,the literature included in this study is limited,and the quality of the literature is low.It is necessary to carry out in-depth verification of high-quality,large-sample RCT.

Mechanism of Duhuo Jisheng Decoction based on bioinformatics and network pharmacology in treating osteoporosis of kidney Yin deficiency

Objective:To study the active ingredients,target and mechanism of Duhuo JiSheng Decoction for the treatment of osteoporosis by bioinformatics analysis and network pharmacology.Methods:The gene expression profile of GSE56116 was acquired through the NCBI GEO database,and the software R was used for differential analysis.The Chinese medicine system pharmacology technology platform(TCMSP)was used to retrieve the chemical components,target genes of Duhuo,Fangfeng,Xixin,and Sangjisheng.The differential genes acquired from GSE56116 were intersected and analyzed by GO enrichment analysis and KEGG pathway to study the mechanism of Duhuo JiSheng Decoction.Results:A total of 33 active ingredients and 9 differential genes of Duhuo JiSheng Decoction for the treatment of Shengyin deficiency osteoporosis were screened.GO function enrichment analysis focuses on the regulation of intracellular signal transduction,calcium-mediated signaling,and steroid hormone mediated signaling.KEGG analysis showed that it was mainly concentrated in signal pathways such as P53 signal pathway,TNF signal pathway,and IL-17 signal pathway.Conclusion:Through bioinformatics and network pharmacological analysis,Duhuo JiShenng Decoction may exert therapeutic effects by acting on AR,IGFBP3,and FOS target genes.

A Systematic Review and Meta-analysis for Duhuo Jisheng Decoction Combined with Manipulation in Treatment of Lumbar Disc Herniation

Objective:To systematically evaluate the efficacy and safety of Duhuo Jisheng decoction combined with manipulation in the treatment of lumbar disc herniation.Method:We systematically searched 8 databases at home and abroad.Literature quality of the included studies was evaluated by the bias risk assessment tool of Cochrane collaboration network,and the Meta-analysis was performed by RevMan 5.3 software.Result:A total of 427 related literature were retrieved,and 12 studies were eventually included,involving 1153 patients.All studies were in Chinese.Meta-analysis results showed that the total effective rate of Duhuo Jisheng decoction combined with manipulation in the treatment of LDH was better than that of the control group(RR=1.23,95%CI[1.17,1.29],P<0.00001).Subgroup analysis showed that Duhuo Jisheng decoction combined with manipulation had a more significant effect than conventional treatment(RR=1.34,95%CI[1.20,1.50],P<0.00001),nonsteroidal anti-inflammatory drugs(RR=1.24,95%CI[1.12,1.37],P<0.0001),and Yaotongning capsules(RR=1.19,95%CI[1.10,1.29],P<0.0001).It has obvious advantages in improving VAS scores(MD=-1.19,95%CI-1.19[-1.87,-0.51],P=0.0006),but it has no obvious advantages in improving JOA scores(MD=2.6595%CI[0.06,5.24],P=0.05).In terms of safety,Duhuo Jisheng decoction combined with manipulation treatment reported fewer adverse events.Conclusion:The Duhuo Jisheng decoction combined with manipulation treatment can effectively relieve the clinical symptoms of patients with lumbar disc herniation,with obvious clinical efficacy,and fewer adverse events.But in view of the limitations of clinical studies,there are some limitations in this study,and more studies with high quality of evidence are needed to further confirm its efficacy and safety.

A meta-analysis of Duhuo Jisheng decoction combined with non-operative therapy on lumbar disc herniation

Objective:To systematically evaluate the cllinical efficacy of Duhuo Jisheng decoction(DHJSD)combined with non-surgical therapy on lumbar disc herniation(LDH).Methods:China Science and Technology Journal Database(VIP),Chinese National Knowledge Infrastructure(CNKI),WanFang Data,PubMed were searched and eligible randomized controlled clinical trials(RCTs)were included.Two reviewers evaluated the quality of the included RCTs and extracted data independently.Then,data analysis was performed with RevMetn 4.2 software.Results:A total of 18 RCTs were enrolled,including 1682 patients.Meta-analysis results showed that the overall response rate of DHJSD combined with non-operative therapy group(treatment group)in the treatment of LDH was better than that of the non-operative therapy group(control group)[OR=4.29,95%CI(3.19,5.76),P<0.001].JOA score of the treatment group was significantly higher than that of control group[OR=3.96,95%CI(3.4,4.52),P<0.001].VAS score was dramatically lower in the treatment group than the control group[OR=-1.58,95%CI(-1.97,-1.18),P<0.001].Conclusion:The clinical efficacy of DHJSD combined with non-surgical therapy is better than that of non-surgical therapy alone.However,due to the low quality of the included literatures,large-scale and high-quality RCTs are still needed for further confirmation.

Effects of fumigation and washing with Shujin Huoluo decoction combined with Duhuo Parasitic decoction on TIMP-1 and PON1 levels in KOA patients

Objective:To study the effect of fumigation and washing with Shujin Huoluo Decoction combined with Duhuo Parasitic Decoction on Metalloproteinase inhibitor-1(TIMP-1)and Oxyphosphatase 1,PON1)level.Methods:A total of 100 KOA patients,59 males and 41 females,were selected for diagnosis and treatment in our hospital from November 2018 to November 2019.The patients were divided into the control group and the combined group with 50 patients each according to a completely random method.The control group was treated with Duhuo Parasitic Decoction and the combined group was treated with Duhuo Parasitic Decoction and Shujinhuoluo decoction.Detection of TIMP-1,PON1,Matrix metalloproteinase-3(MMP-3),C-reactive protease(CRP),Tumor necrosis factor-alpha(TNF-α)and Superoxide dismutase(SOD)levels.WOMAC score,Lysholm score,and VAS score were evaluated.Results:The levels of TIMP-1 and PON1 in the combined group were higher than those in the control group after treatment,and the levels of MMP-3 were lower than those in control group(P<0.05).The WOMAC score and VAS score of the combined group were lower than those of the control group,and the Lysholm score was higher than that of control group(P<0.05).The levels of CRP and TNF-αin the combined group were lower than those in the control group,and the SOD levels were higher than those in control group(P<0.05).The total effective rate of the combined group was higher than the total effective rate of control group(P<0.05).Conclusion:The combination of fumigation and washing with Shujin Huoluo Decoction and Duhuo Parasitic Decoction has a significant effect on the treatment of KOA patients.It improves the levels of TIMP-1 and PON1,improves the knee function of patients and pain.

Intervention effect and mechanism of Jisheng Shenqi Decoction plus Panax notoginseng and Bionjia on CCl4-induced hepatic fibrosis rat model

Objective:To investigate the intervention effect and specific mechanism of Jisheng Shenqi Decoction plus Panax notoginseng and Turmeric on carbon tetrachloride(CCl4)-induced liver fibrosis in rats.Methods:SPF SD rats were randomly divided into control group,model group,and Chinese medicine treatment(low,medium and high dose)groups.The model group and Chinese medicine treatment group were given intraperitoneal injection of 40%CCl4 olive oil solution twice a week.A rat model of liver fibrosis was replicated by the method for 8 weeks.After successful modeling,each drug-administered group was gavaged with corresponding drugs,and the control group and model group were gavaged with equal volume of distilled water,once a day,for 4 weeks.After the last intragastric administration,HE staining and Masson staining were used to observe the pathological morphology of liver tissue,and liver function(ALT,AST)was detected;ELISA method was used to determine transforming growth factorβ(TGF-β),angiotensin II(Ang-Ⅱ),chitinase 3-like protein 1(CHI3L1),interleukin-1(IL-1),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)content;The expression levels of type I,type III collagen(Col-Ⅰ,Col-Ⅲ)and TGF-βmRNA were determined by RT-PCR.Results:①HE and Masson staining showed that a large number of liver cells in the model group were inflamed and necrotic,the collagen fibers in the liver tissue were extensively proliferated,the fibrous septa were interconnected,and the pseudolobules were formed.Compared with the model group,the levels of ALT,AST,TGF-β,Ang-Ⅱ,CHI3L1,IL-1,IL-6 and TNF-αin the traditional Chinese medicine treatment group were decreased,while the levels of Col-Ⅰ,Col-ⅢThe expressions ofⅢand TGF-βmRNA were decreased,and the effect was most obvious in the middle and high dose groups of traditional Chinese medicine(P<0.01).Conclusion:Jisheng Shenqi Decoction combined with Panax notoginseng and Biejia can significantly improve liver fibrosis induced by CCl4 in rats,and its mechanism may be related to the down-regulation of angiotensin-converting enzyme(ACE)-angiotensin II(Ang-II)-angiotensin II receptor 1(AT1R)signaling pathway related gene expression,reducing the level of related cytokines,promoting the degradation of extracellular matrix and so on.

独活寄生汤调控PI3K/Akt/mTOR信号通路介导细胞焦亡对膝骨关节炎模型兔的影响

探究独活寄生汤防治膝骨关节炎(KOA)的可能作用机制。40只SPF级新西兰大兔采用SPSS 26.0软件随机分为空白组、模型组、独活寄生汤低剂量组、独活寄生汤高剂量组、独活寄生汤高剂量+磷脂酰肌醇3-激酶(PI3K)/蛋白激酶B(Akt)/哺乳动物雷帕霉素靶蛋白(mTOR)信号通路激活剂组(独活寄生汤高剂量+740Y-P组),每组8只。除空白组外,其余各组大兔采用木瓜蛋白酶膝关节腔注射+膝关节强迫屈曲位法构建KOA模型。造模完成后次日,空白组与模型组予以10 mL·kg^(-1)生理盐水灌胃,独活寄生汤低、高剂量组分别予以8.8、35.2 g·kg^(-1)独活寄生汤灌胃,独活寄生汤高剂量+740Y-P组予以35.2 g·kg^(-1)独活寄生汤灌胃+耳缘静脉注射0.15μmol·kg^(-1)740Y-P,各组均持续给药4周。造模及干预完成后对各组大兔进行行为学观察,干预完成后对各组大兔膝关节行影像学观察,取材后肉眼观察各组大兔膝关节软骨大体形态变化、苏木素-伊红(HE)染色对软骨组织行病理学观察,同时上述观察结果分别通过Lequesne MG评分、Kellgren-Lawrence(K-L)分级、Pelletier评分及Mankin评分进行量化评估,ELISA法检测软骨组织白细胞介素-1β(IL-1β)、白细胞介素-18(IL-18)、基质金属蛋白酶13(MMP13)含量,real-time RT-PCR法检测软骨组织PI3K、Akt、mTOR、Nod样受体蛋白3(NLRP3)、半胱氨酸蛋白酶1(caspase-1)、焦孔素D(GSDMD)mRNA表达,Western blot法检测软骨组织PI3K、Akt、mTOR、NLRP3、caspase-1、GSDMD蛋白表达。结果显示,与空白组比较,模型组膝关节退变明显;Lequesne MG评分、K-L分级、Pelletier评分及Mankin评分升高;软骨组织中IL-1β、IL-18、MMP13含量升高,PI3K、Akt、mTOR磷酸化激活且mRNA表达升高,NLRP3、caspase-1、GSDMD蛋白及mRNA表达升高。与模型组比较,独活寄生汤低、高剂量组上述指标皆逆转,且独活寄生汤高剂量组上述指标下降程度高于独活寄生汤低剂量组。与独活寄生汤高剂量组比较,独活寄生汤高剂量+740Y-P组膝关节退变改善程度下降;Lequesne MG评分、K-L分级、Pelletier评分及Mankin评分升高;软骨组织中IL-1β、IL-18、MMP13含量升高,P13K、Akt、mTOR磷酸化激活且mRNA表达升高,NLRP3、caspase-1、GSDMD蛋白及mRNA表达升高。综上所述,独活寄生汤干预KOA疗效肯定、安全,其机制可能与抑制软骨组织PI3K/Akt/mTOR信号通路介导的细胞焦亡,从而改善膝关节骨性结构、炎症反应及软骨基质降解有关。

独活寄生汤含药血清细胞外囊泡对类风湿关节炎滑膜成纤维细胞的影响

背景:独活寄生汤是治疗类风湿关节炎的经典方剂,但具体作用机制尚不清楚,细胞外囊泡具有细胞间通讯及传递信号的强大功能,可能是该方剂发挥作用的信号载体。目的:探讨独活寄生汤含药血清细胞外囊泡对类风湿关节炎滑膜成纤维细胞增殖、迁移、侵袭及凋亡的影响。方法:肿瘤坏死因子α体外诱导构建类风湿关节炎滑膜成纤维细胞模型,实验分为5组:正常组、模型组、独活寄生汤含药血清组、独活寄生汤含药血清细胞外囊泡组、生理盐水血清细胞外囊泡组。采用CCK-8法筛选独活寄生汤含药血清及独活寄生汤含药血清细胞外囊泡作用的最佳浓度及时间;ELISA检测细胞上清炎症因子水平;划痕实验检测细胞迁移能力;Transwell实验检测细胞侵袭能力及迁移能力;Hoechst染色检测细胞凋亡情况;qRT-PCR及Western blot检测细胞凋亡相关基因及蛋白表达。结果与结论:(1)独活寄生汤含药血清作用的最佳体积分数为10%,独活寄生汤含药血清细胞外囊泡作用的最佳质量浓度为10 ng/mL,二者作用的最佳时间均为24 h;(2)与模型组相比,独活寄生汤含药血清、独活寄生汤含药血清细胞外囊泡及生理盐水血清细胞外囊泡均能抑制类风湿关节炎滑膜成纤维细胞的炎症因子表达(P<0.05)、划痕愈合(P<0.05)、迁移及侵袭(P<0.05),且独活寄生汤含药血清细胞外囊泡的抑制作用更为突出(P<0.05);(3)独活寄生汤含药血清及独活寄生汤含药血清细胞外囊泡均可促进类风湿关节炎滑膜成纤维细胞的凋亡;(4)与模型组相比,独活寄生汤含药血清、独活寄生汤含药血清细胞外囊泡及生理盐水血清细胞外囊泡均可增加促凋亡因子Caspase-3、Caspase-9、Bax表达(P<0.05),降低抑凋亡因子Bcl-2表达(P<0.05),且独活寄生汤含药血清细胞外囊泡对凋亡相关因子的调节作用更显著。上述实验结果表明独活寄生汤含药血清细胞外囊泡可以抑制类风湿关节炎滑膜成纤维细胞的过度增殖、迁移、侵袭并促进其凋亡。

基于“肝肾同源”理论防治乳腺癌内分泌治疗相关性骨质疏松症的思路探讨

乳腺癌内分泌治疗主要用于乳腺癌患者的术前新辅助治疗、术后辅助治疗和晚期乳腺癌的解救治疗。骨质疏松症是乳腺癌内分泌治疗的常见不良反应,严重影响患者的生活质量。肝肾同源与骨质疏松症的病因病机及治则密切相关。乳腺癌内分泌治疗相关性骨质疏松症的发病与肝肾的关系最为密切,其病机特点为本虚标实,本虚为肝肾不足,标实为瘀血阻络。补益肝肾的中医药干预可用于乳腺癌患者的不同内分泌治疗阶段。在术前新辅助治疗阶段,中医药干预应重在攻癌,与新辅助治疗协同发挥抗癌功效,辅以扶正,减少不良反应的发生率,可选用六味地黄丸加减治疗。在术后辅助治疗阶段,中医药干预应重在扶正,帮助患者恢复身体机能,预防骨质疏松症,可选用独活寄生汤、左归丸等加减治疗。在晚期解救治疗阶段,治疗以扶正为主要方向,用药除选用补益肝肾、强筋壮骨、行气活血止痛等方药外,还可增加血肉有情之品,以增强补益肝肾之效果。

归脾汤化裁方现代临床应用及作用机制研究进展

归脾汤首见于宋代医家严用和之《济生方》,可用于治疗心脾两虚及脾不统血等诸证,至今仍被广泛应用于临床,具有较好的临床疗效。本文从临床应用及作用机制两个方面对其现代研究进行了梳理归纳,阐述总结了归脾汤在临床治疗神经精神系统、循环系统、消化系统、肿瘤癌症、妇科及儿科等多种病种中的应用,总结其对于不同病种的治疗效果,为临床治疗提供更多案例参考。同时,本文进一步总结了归脾汤改善相关病种的作用机制,阐述其具有改善血管内皮功能、抗炎抗氧化、调控下丘脑-垂体-肾上腺轴、调节肠道菌群及脂质代谢、调节心脏标志物及改善血细胞和改善骨髓功能等相关机制作用,以期为临床应用和现代药理学研究提供更多参考依据。

独活寄生汤联合几丁糖对寒湿痹阻型膝骨关节炎的临床疗效

目的 观察独活寄生汤联合几丁糖治疗寒湿痹阻型膝骨关节炎的临床效果。方法 选取2023年1月至8月黑龙江中医药大学附属第一医院门诊的60例膝骨关节炎患者,采用随机数字表法将其分为观察组和对照组,各30例。观察组采用独活寄生汤(加水煎煮,200 ml/剂,1剂/d,早晚两次温服,连续服用3周)联合几丁糖注射液(2 ml/次,1次/周,共3周)治疗,对照组口服洛索洛芬钠片(120 mg/次,3次/d)联合几丁糖注射液(2 ml/次,1次/周,共3周)治疗。评价两组临床疗效。比较两组治疗前后中医症状评分、西安大略和麦克马斯特大学骨关节炎指数评分(WOMAC评分)、视觉模拟评分法(VAS)评分,血清白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)的水平和血清环氧合酶(COX-2)和前列腺素(PGE2)的改善情况,并对两组患者于治疗后六周进行电话追踪和随访观察复发率。结果 观察组临床疗效优于对照组,差异有统计学意义(P<0.05)。治疗后,两组VAS评分低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组WOMAC评分较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组IL-1、TNF-α水平较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后两组血清COX-2、PGE2降低,且观察组低于对照组,差异有统计学意义(P<0.05)。两组复发率比较,差异无统计学意义(P>0.05)。结论 独活寄生汤联合几丁糖对寒湿痹阻型膝骨关节炎有显著疗效,并且能恢复膝关节功能,提高生活质量。

寒湿阻滞型腰痛大鼠模型构建及独活寄生汤干预效果的实验研究

目的构建大鼠寒湿阻滞型腰痛动物模型,评估独活寄生汤对该模型的干预效果。方法24只雄性SD大鼠适应性喂养7 d后,随机分为空白组、模型组和独活寄生汤组。空白组仅腹腔注射戊巴比妥钠麻醉,模型组、独活寄生汤组在腹腔注射戊巴比妥钠麻醉下行“腰椎后柱结构部分切除术”,并在寒湿环境下饲养6周。造模2周后,空白组、模型组予等体积蒸馏水灌胃,独活寄生汤组予独活寄生汤18.6 g/(kg·d)灌胃,均连续灌胃4周。比较各组大鼠一般情况、自发性疼痛行为学评分和神经功能评分,CT三维成像评估脊柱生理曲度形态改变情况,椎间盘组织病理切片评估椎间盘髓核病变程度。结果造模后1周,与空白组比较,模型组、独活寄生汤组开始出现少动、皮毛无光泽、嗜睡蜷缩、反应迟钝、大便稀溏表现,体质量减轻(P<0.05),自发性疼痛行为学评分和神经功能评分升高(P<0.05);给药后3周,与模型组比较,独活寄生汤组疼痛行为学评分和神经功能评分降低(P<0.05)。给药后4周,与模型组比较,独活寄生汤组大鼠脊柱CT三维成像形态退变不明显,椎间盘组织病理切片显示,独活寄生汤组椎间盘髓核病变不明显。结论“腰椎后柱结构部分切除术+寒湿环境饲养”可成功构建SD大鼠寒湿阻滞型腰痛动物模型,独活寄生汤对该模型有较好的干预效果。

独活寄生汤治疗骨质疏松症患者的临床效果研究

目的分析独活寄生汤治疗骨质疏松症患者的临床效果。方法选择60例骨质疏松症患者,按随机数字表法分为研究组和对照组,各30例。对照组采取碳酸钙D3片治疗,研究组在对照组基础上增加独活寄生汤治疗。对比两组治疗后临床疗效、疼痛评分、骨代谢与骨密度指标及日常生活能力。结果研究组的治疗总有效率93.33%明显高于对照组的73.33%(P<0.05)。治疗7、21、35 d,研究组疼痛评分均明显低于对照组(P<0.05)。治疗后,研究组的腰椎骨密度(0.84±0.09)g/cm2明显高于对照组的(0.76±0.07)g/cm2,Ⅰ型胶原羧基端肽β特殊序列(0.21±0.03)ng/ml和Ⅰ型胶原氨基末端肽(60.42±2.10)ng/ml明显低于对照组的(0.25±0.07)、(62.54±3.11)ng/ml(P<0.05)。治疗21 d、35 d及3个月,研究组日常生活能力评分均明显高于对照组(P<0.05)。结论独活寄生汤应用于骨质疏松症治疗中可提高临床疗效和日常生活能力,减轻疼痛负担,改善骨密度。

独活桂辛方对腰椎间盘突出症(肝肾亏虚证)患者疼痛及腰椎功能的影响

目的观察独活桂辛方联合针刺、布洛芬缓释胶囊治疗腰椎间盘突出症(肝肾亏虚证)的临床疗效。方法将85例患者随机分为两组,观察组43例,予以独活桂辛方联合针刺、布洛芬缓释胶囊口服,对照组42例,予以针刺联合布洛芬缓释胶囊口服。疗程3周。结果观察组总有效率为92.68%,高于对照组的78.05%(P<0.05)。治疗后及随访时,两组患者中医症状积分、视觉模拟量表(VAS)评分、Roland-Morris功能障碍调查表(RMDQ)均较治疗前明显降低(P<0.05),观察组下降更明显(P<0.05);两组患者日本骨科协会腰椎(JOA)评分均较治疗前明显升高(P<0.05),观察组升高更明显(P<0.05)。治疗后,两组患者血清白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)水平均较治疗前明显下降,观察组下降更明显(P<0.05)。结论独活桂辛方联合针刺、布洛芬缓释胶囊可减轻腰椎间盘突出症(肝肾亏虚证)患者腰腿疼痛症状,降低血清IL-1β、IL-6、h-CRP水平,改善腰椎功能。

独活寄生汤结合温针灸治疗腰椎间盘突出症的疗效观察

目的:观察独活寄生汤结合温针灸治疗腰椎间盘突出症(LDH)的临床疗效。方法:选取2021年1月—2022年12月南昌市洪都中医院微创骨科收治的48例LDH为研究对象,随机分为观察组和对照组,各24例。对照组仅用独活寄生汤治疗,观察组则在对照组的基础上施以温针灸,比较2组临床治疗效果、疼痛[视觉模拟评分法(VAS)]及功能障碍[日本骨科协会评估治疗分数(JOA)]改善情况。结果:观察组总有效率为91.67%,优于对照组的79.17%(P<0.05)。治疗后,2组VAS评分、JOA评分均较治疗前有明显改善(P<0.05),且观察组较对照组改善更明显(P<0.05)。结论:独活寄生汤结合温针灸治疗LDH患者,可明显缓解其腰腿麻木、疼痛症状,可在临床治疗过程中应用推广。

独活寄生汤内服联合中药外洗治疗类风湿关节炎肝肾亏虚证的疗效观察

目的 探讨独活寄生汤内服联合中药外洗治疗类风湿关节炎肝肾亏虚证的临床疗效。方法 选取2019年12月—2022年12月南京中医药大学徐州附属医院收治的86例类风湿关节炎肝肾亏虚证患者,依照随机数表法分为观察组和对照组各43例。观察组予甲氨蝶呤+硫酸羟氯喹,并配合独活寄生汤+中药外洗治疗,对照组予甲氨蝶呤+硫酸羟氯喹治疗。比较两组患者临床疗效、简化疾病活动指数(SDAI)、临床疾病活动指数(CDAI)、红细胞沉降率(ESR)、C反应蛋白(CRP)及白细胞介素-6(IL-6)等指标。结果 观察组总有效率高于对照组(P<0.05)。治疗后,两组CDAI评分和SDAI评分均较本组治疗前下降(P<0.05),且观察组下降水平高于对照组(P<0.05)。治疗后,两组ESR、CRP、IL-6水平均较本组治疗前降低(P<0.05),且观察组低于对照组(P<0.05)。结论 独活寄生汤内服联合中药外洗治疗类风湿关节炎肝肾亏虚证,改善患者临床症状,疗效确切,并且能够减少炎症因子释放,安全可靠。

加味独活寄生合剂对膝骨关节炎小鼠血清IL-6、IL-1β、TNF-α及滑膜炎症的影响

目的探讨加味独活寄生合剂对膝骨关节炎小鼠血清白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)及滑膜炎症的影响,初步判定加味独活寄生合剂治疗膝骨关节炎的最佳剂量。方法将36只C57/BL6j小鼠随机分为空白组、模型组、西药对照组及中药低、中、高剂量组,除空白组外均通过膝关节注射木瓜蛋白酶溶液建立膝骨关节炎模型,空白组、模型组予生理盐水灌胃,西药对照组予双醋瑞因胶囊溶液灌胃,中药低、中、高剂量组分别按照6.28、12.56、25.12 g/kg剂量灌胃加味独活寄生合剂。连续灌胃8周后,各组小鼠进行改良Lequesen MG量表评分,ELISA测定各组小鼠血清中IL-6、IL-1β、TNF-α含量;HE染色及Masson染色观察膝关节滑膜组织结构形态及纤维组织增生情况。结果与空白组相比,模型组改良Lequesen MG量表评分显著升高(P<0.01),血清炎症因子含量明显升高(P<0.01),HE染色可见滑膜组织丰富的血管增生及大量炎性细胞浸润等滑膜炎症表现,Masson染色可见大量胶原纤维增生;西药对照组、中药低剂量组改良Lequesen MG量表评分较模型组显著降低(P<0.01),血清炎症因子含量均明显降低(P<0.01),HE染色见滑膜炎症改善,Masson染色见胶原纤维增生减轻;中药中、高剂量组较西药对照组和中药低剂量组改良Leque⁃sen MG量表评分显著降低(P<0.01),血清炎症因子含量明显降低(P<0.01);HE染色示滑膜炎症明显好转,Masson染色见胶原纤维增生明显减轻。结论加味独活寄生合剂可降低膝骨关节炎小鼠血清IL-6、IL-1β、TNF-α含量,改善膝关节滑膜炎症;12.56 g/kg剂量的加味独活寄生合剂对膝骨关节炎小鼠病情改善最明显。

从“络病-风药”理论探讨独活寄生汤治疗类风湿关节炎

类风湿关节炎(RA)属中医“痹病”范畴,其发生、发展、转归与络病密切相关。本文通过分析类风湿关节炎微小血管新生的病理状态与络脉生理和络病病机特点,以络脉为其邪伏、邪发、邪伤及邪阻之所展开论述,可认为“络病”是其病理基础,络虚是其根本病机,风挟寒湿之邪内侵络脉为发病关键。基于“络病”理论和“风药”理论相关认识,从独活寄生汤为治风之剂视角认识其治疗类风湿关节炎的作用,并提出病变早期络脉郁滞、风药先行,中期络脉瘀塞、健脾化瘀,晚期络脉空虚、风引入肾,探讨独活寄生汤在病变不同时期风药与他药的组方原理,丰富独活寄生汤的组方配伍理论,扩展独活寄生汤的临床指导意义,为其临床应用提供参考。

独活寄生汤治疗痹症研究进展

独活寄生汤是唐代著名医家孙思邈《备急千金要方》中治疗风寒湿痹的经典名方,其临床应用广泛且疗效较好。药理学研究已证实独活寄生汤不仅可以抗炎镇痛、调节免疫、干预氧化应激、促进骨代谢,在抗阿尔茨海默病、抗肿瘤、扩张血管,改善循环等方面也具有明显疗效。古代医家多用该方治疗痹证日久,肝肾两虚,气血不足,正虚邪实者。现代医家已将该方广泛用于治疗类风湿性关节炎、膝骨关节炎、腰椎间盘突出症、骨质疏松、骨折、腰背痛、神经根型颈椎病等骨伤科疾病。同时有研究表明,独活寄生汤联合针灸、手法、艾灸、中药熏洗等,疗效更为显著。随着现代医学技术和中西医结合的发展,后世医家的不断探究,独活寄生汤治疗痹症的地位和发展进程不断受到认可和推进。多项实验研究已证实,独活寄生汤的药理作用和治疗痹症的临床效果。现从药理作用及该方在痹症中的临床应用对近十年独活寄生汤相关37篇文献进行梳理,研究探讨独活寄生汤的应用,为临床应用提供更为科学的参考。