Evaluation of the Efficacy of Auricular Acupoint Pressure Patch Combined with Modified Huangqi Decoction in Treating Diabetic Nephropathy

Objective:To explore the efficacy of auricular acupoint pressure patch combined with modified Huangqi Decoction in treating diabetic nephropathy.Methods:60 patients with diabetic nephropathy treated in our hospital from January 2021 to December 2022 were selected for this study.The patients were randomly divided into two groups using the random number table method,with 30 patients in each group.Among them,the control group was treated with conventional Western medicine,while the experimental group was treated with auricular acupoint pressure patches combined with modified Huangqi Decoction.The patients’fasting blood glucose(FPG),2-hour postprandial blood glucose(2hPG),glycated hemoglobin(HbA1c),urinary protein quantification,urea nitrogen(BUN),serum creatinine(SCr),and other indicators were detected and recorded before and after treatment.Results:Before treatment,there was no statistically significant difference in the FPG,the 2hPG,and the HbA1c between the two groups of patients(P>0.05);after treatment,the FPG,the 2hPG,and the HbA1c of the patients in the experimental group were significantly lower than those in the control group(P<0.05).Before treatment,there was no statistically significant difference in the urinary protein quantification,the BUN,and the SCr between the two groups of patients(P>0.05);after treatment,the urinary protein quantification,BUN,and SCr of the patients in the experimental group were significantly lower than those in the control group(P<0.05).The experimental group showed better improvement in symptoms such as fatigue,backache,and frequency of nocturia(P<0.05).Conclusion:Auricular acupoint pressure patch combined with modified Huangqi Decoction effectively treats diabetic nephropathy and it helps control blood sugar and renal function indicators and improve clinical symptoms,therefore improving the patients’quality of life.

Huangqi Guizhi Wuwu Decoction for treating diabetic peripheral neuropathy：a meta-analysis of 16 randomized controlled trials

OBJECTIVE：This meta-analysis was performed to systematically assess the efficacy and safety of the Chinese herbal medicine Huangqi Guizhi Wuwu Decoction（HGWWD） for treating diabetic peripheral neuropathy.DATA SOURCES：Six electronic databases,including the Cochrane Library,MEDLINE database,Chinese Biomedical Database,Chinese National Knowledge Infrastructure Database,Chinese Science and Technique Journals Database,and the Wanfang Database,were search ed on the internet for randomized controlled trials published up until 1 December 2015.The search terms included ＂Chinese herbal medicine＂,＂diabetic peripheral neuropathy＂ and ＂randomized controlled trials＂ in Chinese and in English.DATA SELECTION：We included randomized controlled trials using HGWWD/modified HGWWD for the treatment group,without restriction for the control group.We assessed literature quality in accordance with the Cochrane Review Handbook.A random or a fixed effects model was used to analyze outcomes using Rev Man 5.2 software.OUTCOME MEASURES：The primary outcomes were changes in symptoms and nerve conduction velocities.The secondary outcomeswere fasting blood glucose and hemorheological indexes.RESULTS：Sixteen randomized controlled trials,with a total of 1,173 patients,were included.Meta-analysis revealed that the efficacy of HGWWD for diabetic peripheral neuropathy was significantly superior compared with the control treatment（i.e.,control group）（risk ratio = 0.36,95% confidence interval（CI）：0.29–0.46,Z =8.33,P 〈 0.00001） Compared with the control group,there was an increase in median motor nerve conduction velocity（mean difference（MD） = 3.46,95%CI：1.88–5.04,Z = 4.30,P 〈 0.01） and median sensory nerve conduction velocity（MD = 3.30,95%CI：2.04–4.56,Z = 5.14,P 〈 0.01）.There was also an increase in peroneal motor nerve conduction velocity（MD = 3.22,95%CI：2.45–3.98,Z = 8.21,P 〈 0.01） and peroneal sensory nerve conduction velocity（MD = 3.05,95%CI：2.01–4.09,Z = 5.75,P 〈 0.01） in the treatment groups.No significant difference in fasting blood glucose was found between the treatment groups and the control groups（MD =-0.12,95%CI：-0.42–0.19,Z = 0.76,P = 0.45）.Plasma viscosity was significantly decreased after treatment（MD =-0.11,95%CI：-0.21 to-0.02,Z = 2.30,P = 0.02）.No significant difference in fibrinogen was detectable（MD =-0.53,95%CI：-1.28–0.22,Z = 1.38,P = 0.17）.Four trials reported that treatment groups experienced no adverse reactions.Adverse events were not mentioned in the other 12 trials.No trial reported the incidence of complications,quality of life outcomes,or health economics.CONCLUSION：HGWWD treatment improves diabetic neurologic symptoms and ameliorates nerve conduction velocities.Our study suggests that HGWWD may have significant therapeutic efficacy for the treatment of diabetic peripheral neuropathy.However,the methodological quality of the randomized controlled trials was generally low.Larger and better-designed randomized controlled trials are required to more reliably assess the clinical effectiveness of HGWWD.

Clinical Study of Jiawei Huangqi Guizhi Wuwu Decoction (加味黄芪桂枝五物汤) in Preventing and Treating Peripheral Neuro-sensory Toxicity Caused by Oxaliplatin

Objective： To evaluate the efficacy of Jiawei Huangqi Guizhi Wuwu Decoction （加味黄芪桂枝五物汤, JHGWD） in treating neuro-sensory toxicity induced by oxaliplatin. Methods： A randomized controlled self-crossover trial was performed. Thirty-one patients were randomly divided into AB and BA groups. Patients in A cycle belonged to the treated group, who were treated with chemotherapy combined with oxaliplatin plus JHGWD. Patients in B cycle belonged to the control group and were treated with chemotherapy alone. The peripheral neuro-sensory toxicity was observed and analyzed. Results： The main neurotoxicity was cold-induced paresthesia after the use of oxaliplatin, which included hyperaesthesia, chill, anaesthesia in the extremities, electrified sensation, formication, foreign body sensation and pain that might be exacerbated by exposure to cold. Twenty patients （64.5 % ） suffered from neuro-sensory toxicity in the treated group and 27 cases （87.1% ） in the control group. Symptoms were more serious and lasted longer in the control group than those in the treated group （P〈0.01）. Conclusion： JHGWD could prevent and reduce the occurence and intensity of acute peripheral neuro-sensory toxicity caused by oxaliplatin.

Efficacy and safety of Huangqi Jianzhong decoction in the treatment of chronic atrophic gastritis:A meta-analysis

BACKGROUND Chronic atrophic gastritis is a persistent disorder of the digestive system where the gastric mucosa epithelium and glands undergo atrophy,leading to a decrease in their number and thinning of the gastric mucosa.It is worth noting that the prevalence of chronic atrophic gastritis is higher in China compared to the global average,and it is also considered a precancerous condition for gastric cancer.AIM To evaluate the efficacy of Huangqi Jianzhong decoction in treating chronic atrophic gastritis.Chronic atrophic gastritis is a persistent illness characterized by the progressive disappearance of healthy gastric glands due to repeated injury.Huangqi Jianzhong decoctions are widely used in China to treat chronic atrophic gastritis.However,there is limited scientific evidence regarding their efficacy in treating this illness.METHODS The present meta-analysis adhered to the PRISMA guidelines and used the Cochrane Collaboration methodology.We performed a comprehensive search for clinical trials investigating the use of Huangqi Jianzhong decoction in treating chronic atrophic gastritis published until January 2023.The risk of bias and the quality of the included studies were evaluated using the Cochrane Handbook guidelines.Finally,a meta-analysis was conducted using the RevMan 5.4 softRESULTS This study included a total of 13 articles,comprising 1269 samples.The meta-analysis was conducted on these 13 articles,yielding the following results:I2=0%,P=0.60,[RR=1.24,95%CI:1.18 to 1.30,P<0.00001].The forest plot analysis of the Helicobacter pylori clearance rate revealed I2=0%,P=0.36,[RR=1.20,95%CI:1.05 to 1.38,P=0.009].The forest plot of PG-I level showed I2=99%,P<0.00001,[MD=4.99,95%CI:-1.59 to 11.58,P=0.14].The forest plot of stomach pain demonstrated I2=54%,P=0.04,[MD=-0.63,95%CI:-0.68 to-0.58,P<0.00001].The forest plot of reflux indicated I2=82%,P=0.0009,[MD=-0.48,95%CI:-0.63 to-0.33,P<0.00001].The forest plot of recurrence rate exhibited I2=0%,P=0.92,[RR=0.15,95%CI:0.04 to 0.66,P=0.01].The forest plot of adverse reactions showed no heterogeneity in outcome data,[RR=1.07,95%CI:0.53 to 2.17,P=0.86].CONCLUSION This study demonstrated that Huangqi Jianzhong decoction improved various factors in adults with chronic atrophic gastritis.These factors included the total effective rate,Helicobacter pylori clearance rate,symptoms such as stomachache and acid reflux alleviation,and recurrence rates.

Potential Mechanism of Huangqi Guizhi Wuwu Decoction for Cervical Spondylosis treatment based on Network Pharmacology

Objective:To study the potential mechanism of Huangqi Guizhi Wuwu Decoction in the treatment of cervical spondylosis based on the network pharmacological method,and to provide a basis for clinical application and pharmacological research.Methods:TCMSP search was used to screen the main active compounds and related action targets of Huangqi Guizhi Wuwu Decoction,the standard names of action targets were obtained through the Uniprot database,and the"drug-target"interaction network was constructed by using Cytoscape3.6.1 software.The related targets of cervical spondylosis were obtained by searching GeneCards,OMIM,DisGeNET,and CTD databases,and the disease targets and drug targets were mapped by the Venny platform,and the intersection genes of them were the potential targets for drug treatment of this disease.Then,the intersection genes were input into the STRING database and Cytoscape 3.6.1 software,and the protein-protein interactions(PPI)network of"drug-disease intersection targets"was constructed,and we screened the core targets.Finally,GO biological function analysis and KEGG signaling pathway analysis of core targets were carried out through the DAVID database.Results:According to the screening conditions,74 effective compounds and 138 drug action targets of Huangqi Guizhi Wuwu Decoction were obtained,12179 genes related to cervical spondylosis were obtained,and the Venny platform analysis obtained 105 intersecting targets.With visual network processing by Cytoscape software,33 core targets were obtained by analyzing and calculating the core target degree values,which were JUN,PTGS2,NR3C1,TNF,IL6,TP53,EGFR,VEGFA,NOS3,IL1B,and so on.GO analysis showed that there were 133 items(P<0.05),involving adrenergic receptor activation,neurotransmitter receptor activation,nuclear receptor activation,catecholamine binding,etc.KEGG analysis obtained a total of 139 pathways(P<0.05),involving IL-17 signaling pathway,and tumor necrosis factor signaling pathway,relaxin signaling pathway,AGE-RAGE signaling pathway of diabetic complications,fluid shear stress,and atherosclerosis.Conclusion:the active components in Huangqi Guizhi Wuwu decoction may act on the core targets such as JUN,PTGS2,NR3C1,TNF,IL6,TP53,VEGFA through IL-17 signal pathway,tumor necrosis factor signal pathway,and AGE-RAGE signal pathway of diabetic complications,and exert their therapeutic effects.The research results can provide a basis for future basic and clinical research.

Application of Huangqi Guizhi Wuwu Decoction in Orthopaedics and Traumatology

The Huangqi Guizhi Wuwu Decoction(HQGZWWT)is composed of Huangqi(Astragali Radix),Shaoyao(Paeoniae Radix Alba),Guizhi(Cinnamomi Ramulus),Shengjiang(Zingiberis Rhizoma Recens),and Dazao(Jujubae Fructus)which has various pharmacological anti-inflammatory,analgesic,antioxidant,antitumor,lipid-lowering,and immunity-regulating activities.It has certain advantages in the treatment of orthopaedic diseases,such as cervical spondylosis,scapulohumeral periarthritis,lumbar disc herniation,knee osteoarthritis,rheumatoid arthritis,myofascial pain syndrome,etc.,with outstanding clinical efficacy,few adverse reactions,and high patient compliance.However,modern pharmacological researches on the whole prescription of HQGZWWT are insufficient and the therapeutic targets are not clear which needs further exploration.Besides,this prescription cannot treat ll orthopaedic diseases,so we should adhere to the thinking of four diagnostics in traditional Chinese medicine(TCM),select prescriptions based on syndrome differentiation,closely follow the pathogenesis,innovate and expand its scope of application,reflect the application advantages of this prescription in orthopaedics and traumatology and improve the total clinical efficiency.

黄芪补肾活血汤对芳香化酶抑制剂诱导骨质疏松模型小鼠破骨细胞活性的影响

背景:芳香化酶抑制剂尽管显著提高了激素受体阳性乳腺癌患者的临床获益,但其相关的不良事件——骨质疏松严重影响了患者的生活质量,黄芪补肾活血汤能有效预防芳香化酶抑制剂所致骨质疏松的发生,但是其作用机制尚不清楚。目的:探究黄芪补肾活血汤对芳香化酶抑制剂所致骨质疏松模型小鼠破骨细胞活性的影响及机制。方法:选取60只8周龄C57BL/6J雌性小鼠随机分为假手术组、模型组、黄芪补肾活血汤高、中、低剂量组、阳性对照组各10只,除假手术组外,其余组小鼠均切除双侧卵巢联合皮下注射来曲唑构建绝经后芳香化酶抑制剂所致骨质疏松模型,黄芪补肾活血汤高、中、低剂量组分别给予19.24,9.62,4.81 g/(kg·d)黄芪补肾活血汤进行灌胃(1次/d),阳性对照组给予阿仑膦酸钠5 mg/kg灌胃(1次/周)。给药3个月后,Micro-CT检测胫骨骨密度和骨微结构,对股骨进行苏木精-伊红染色、抗酒石酸酸性磷酸酶染色及免疫组化检测核因子κB受体活化因子配体、骨保护素蛋白表达,ELISA检测血清中Ⅰ型胶原交联羧基端肽、抗酒石酸酸性磷酸酶5b水平。结果与结论:①与假手术组相比,模型组小鼠骨密度显著下降、骨小梁形态疏松断裂、血清中Ⅰ型胶原交联羧基端肽、抗酒石酸酸性磷酸酶5b水平显著上升,表明芳香化酶抑制剂所致骨质疏松模型构建成功;②与模型组相比,黄芪补肾活血汤高、中、低剂量组和阳性对照组小鼠骨密度、骨微结构显著改善,骨小梁形态增粗致密,血清中Ⅰ型胶原交联羧基端肽、抗酒石酸酸性磷酸酶5b水平显著下降,破骨细胞数量减少,核因子κB受体活化因子配体蛋白表达下降,骨保护素蛋白表达升高。结果表明,黄芪补肾活血汤可能调控核因子κB受体活化因子配体/核因子κB受体活化因子/骨保护素信号通路抑制破骨细胞活性,改善骨小梁形态和骨微结构,提高骨密度,进而预防芳香化酶抑制剂所致骨质疏松模型的发生发展。

Huangqi Guizhi Wuwu Decoction suppresses inflammation and bone destruction in collagen-induced arthritis mice

Objective: Rheumatoid arthritis(RA) is a chronic inflammatory and destructive arthritis, characterized by inflammatory infiltration and bone destruction. Huangqi Guizhi Wuwu Decoction(HGWD) is traditional Chinese medicine, which has been applied in the treatment of RA in clinical. The aim of this study was to investigate the therapeutic effect of HGWD on collagen-induced arthritis(CIA) mouse model.Methods: DBA/1J female mice were used to establish the collagen-induced arthritis(CIA) model. HGWD was administered intragastrically once a day for four weeks starting on the 22nd day after the first immunization. The body weight, hind paw thickness and clinical score were measured every five days. Gait analysis, histopathological staining, enzyme-linked immunosorbent assay(ELISA), ultrasound imaging and micro-computed tomography imaging were performed to determine the effects of HGWD treatment on inflammation and bone structure in this model. Moreover, Real-time PCR and Western blot analysis were used to detect inflammatory factors m RNA and protein levels after HGWD intervention in RAW264.7 cells.Results: HGWD attenuated symptoms of arthritis, suppressed inflammatory synovium area and the serum levels of inflammatory factors, inhibited joint space enlargement in the knee and ankle joints,reduced numbers of osteoclasts, protected bone destruction, as well as improved motor function.HGWD decreased the expression of m RNA for inflammatory factors and the protein expression levels of p-NF-ΚB and IL-17.Conclusion: These results suggested that HGWD suppresses inflammation, attenuates bone erosion and maintains motor function in collagen-induced arthritis mice.

Protective effect of modified Huangqi Chifeng decoction(加味黄芪赤风汤)on immunoglobulin A nephropathy through toll-like receptor 4/myeloid differentiation factor 88/nuclear factor-kappa B signaling pathway

OBJECTIVE:To examine the nephroprotective mechanism of modified Huangqi Chifeng decoction(加味黄芪赤风汤,MHCD)in immunoglobulin A nephropathy(IgAN)rats.METHODS:To establish the IgAN rat model,the bovine serum albumin,lipopolysaccharide,and carbon tetrachloride 4 method was employed.The rats were then randomly assigned to the control,model,telmisartan,and high-,medium-,and low-dose MHCD groups,and were administered the respective treatments via intragastric administration for 8 weeks.The levels of 24-h urinary protein,serum creatinine(CRE),and blood urea nitrogen(BUN)were measured in each group.Pathological alterations were detected.IgA deposition was visualized through the use of immunofluorescence staining.The ultrastructure of the kidney was observed using a transmission electron microscope.The expression levels of interleukin-6(IL-6),monocyte chemoattractant protein-1(MCP-1),and transforming growth factor-β1(TGF-β1)were examined by immunohistochemistry and quantitative polymerase chain reaction.Levels of toll-like receptor 4(TLR4),myeloid differentiation factor 88(MyD88),and nuclear factor-kappa B(NF-κB)P65,were examined by immunohistochemistry,Western blotting,and quantitative polymerase chain reaction.RESULTS:The 24-h urine protein level in each group increased significantly at week 6,and worsen from then on.But this process can be reversed by treatments of telmisartan,and high-,medium-,and low-dose of MHCD,and these treatments did not affect renal function.Telmisartan,and high-,and medium-dose of MHCD reduced IgA deposition.Renal histopathology demonstrated the protective effect of high-,medium-,and low-dose of MHCD against kidney injury.The expression levels of MCP-1,IL-6,and TGF-β1 in kidney tissues were downregulated by low,medium and high doses of MHCD treatment.Additionally,treatment of low,medium and high doses of MHCD decreased the protein and mRNA levels of TLR4,MyD88,and NF-κB.CONCLUSIONS:MHCD exerted nephroprotective effects on IgAN rats,and MHCD regulated the expressions of key targets in TLR4/MyD88/NF-κB signaling pathway,thereby alleviating renal inflammation by inhibiting MCP-1,IL-6 expressions,and ameliorating renal fibrosis by inhibiting TGF-β1 expression.

Effect of Huangqi Xiaoke Recipe combined with alprostadil on qi and yin deficiency type diabetic nephropathy and its effect on vascular endothelium and oxidative stress

Objective: To observe the clinical efficacy of Huangqi Xiaoke Decoction combined with alprostadil on qi and yin deficiency type diabetic nephropathy (DN) and its effect on vascular endothelium and oxidative stress. Methods: A total of 72 patients with qi and yin deficiency type DN who were admitted to the diabetes specialist ward and outpatient department of Baoan District Hospital of Shenzhen from January 2017 to July 2018 were enrolled. The patients were divided into the control group and the observation group according to the random number method. 36 cases in each group. Both groups were treated with conventional treatments such as hypoglycemic, hypotensive, lipid-lowering and anti-platelet aggregation. The control group was treated with alprostadil on the basis of conventional treatment. The observation group was given orally on the basis of the control group. Both groups were treated once a day for a total of 4 weeks. Compare the clinical syndrome scores and clinical efficacy of the two groups before and after treatment;fasting blood glucose (FPG), glycosylated hemoglobin (HbA1C), blood lipids (TC, TG, LDL, HDL), serum creatinine (SCr), blood urea nitrogen (BUN Endothelin-1 (ET-1), nitric oxide (NO), von Willebrand factor (vWF);glutathione peroxidase (GSH-Px), superoxide disproportionation The level of enzyme (SOD), malondialdehyde (MDA). Results:The total effective rate of TCM syndromes in observation group was 94.44%, which was significantly different from 72.22% in the control group. The scores of TCM syndromes in the observation group were significantly lower than those in the control group;Compared with the control group, the HDL-C of the observation group did not change much, there was no statistical difference;FBG, HbA1C, SCr, BUN, TC, TG, LDL-C, ET-1, vWF, MDA Significantly decreased, NO, GSH-Px, SOD increased significantly, with significant difference. Conclusion: Huangqi Xiaoke Decoction combined with alprostadil in the treatment of qi and yin deficiency type DN has significant curative effect, which can not only lower blood sugar, regulate blood lipids, improve renal function and clinical symptoms, but also inhibit oxidative stress and protect endothelial function.

黄芪建中汤合暖胃汤治疗患儿脾胃虚寒型急性肠胃炎

目的观察黄芪建中汤合暖胃汤治疗脾胃虚寒型急性肠胃炎患儿的疗效。方法选取2021年2月-2023年5月医院收治的74例脾胃虚寒型急性肠胃炎患儿,以随机数字表法分为研究组与对照组,各37例。2组均接受对症治疗,对照组在此基础上采用奥美拉唑肠溶胶囊治疗,研究组在对照组的基础上接受黄芪建中汤合暖胃汤治疗。2组均治疗14 d。对比2组中医证候评分、病症恢复时间、临床疗效、炎症反应、胃肠激素及不良反应。结果治疗后,2组主症评分、次症评分、总评分明显降低(P<0.05),且研究组降低更为明显(P<0.05)。研究组发热、腹痛、呕吐、腹泻等病症恢复时间短于对照组(P<0.05)。研究组总有效率高于对照组(P<0.05)。治疗后,2组白细胞介素-17(IL-17)、基质金属蛋白酶-3(MMP-3)、中性粒细胞与淋巴细胞比值(NLR)水平明显降低(P<0.05),且研究组降低更为明显(P<0.05)。治疗后,2组胃泌素(GSA)水平明显降低(P<0.05),且研究组降低更为明显(P<0.05)。治疗后,2组胃动力素(MTL)水平明显升高(P<0.05),且研究组升高更为明显(P<0.05)。2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论黄芪建中汤合暖胃汤治疗脾胃虚寒型急性肠胃炎患儿疗效确切,可改善患儿临床症状与胃肠功能,促进患儿康复,减轻炎症反应,且安全可靠。

黄芪建中汤干预胃溃疡的药理实验及分子生物学作用机制

目的:基于生物信息学分析黄芪建中汤治疗胃溃疡(GU)的作用机制,并结合动物实验进一步验证。方法:在中药系统药理学数据库与分析平台(TCMSP)、成分靶点预测数据库(Swiss Target Prediction)中收集黄芪建中汤的活性成分和作用靶点;利用基因数据库(GeneCards)、药物数据库(Drug Bank)等提取GU疾病靶点;在Cytoscape 3.7.2软件中获取黄芪建中汤防治GU的“活性成分-潜在治疗靶点”图,借助STRING和DAVID数据库依次获取蛋白质-蛋白质相互作用(PPI)网络、基因本体(GO)和基因组百科全书(KEGG)富集分析;并通过分子对接和动物实验验证黄芪建中汤防治GU的可能机制。结果:黄芪建中汤治疗GU有131个潜在靶点,其中核心靶点为磷脂酰肌醇-4,5-二磷酸3-激酶催化亚基α(PIK3CA)、蛋白激酶B1(AKT1)等,KEGG分析提示磷脂酰肌醇3-激酶/蛋白激酶B(PI3K/AKT)等信号通路发挥着重要作用。分子对接提示核心靶点与核心成分对接良好。动物实验显示,与正常组比较,模型组溃疡指数增高、胃组织出现炎性浸润,白细胞介素-6(IL-6)、白细胞介素-1β(IL-β)、肿瘤坏死因子-α(TNF-α)表达显著升高(P<0.01),胃组织PI3K、磷酸化蛋白激酶B(p-AKT)蛋白表达显著降低(P<0.01);与模型组比较,给药组大鼠胃损伤明显减轻,IL-6、IL-β、TNF-α表达显著下调(P<0.01),PI3K、p-AKT蛋白表达显著上调(P<0.01)。结论:黄芪建中汤对GU的干预作用具有多途径、多靶点的特性,可能是通过激活PI3K/AKT信号通路来加速胃黏膜修复,并降低炎症而减轻胃损伤。

黄芪桂枝五物汤治疗乳腺癌化疗后手足麻木的效果

目的:探讨乳腺癌化疗后手足麻木采用黄芪桂枝五物汤治疗的效果。方法:选取2018年1月—2022年12月南通市第三人民医院收治的乳腺癌化疗后手足麻木患者110例作为研究对象,按照双色球法随机分为两组,各55例。对照组采用常规西药治疗,观察组采用黄芪桂枝五物汤治疗。比较两组手足麻木消退时间、治疗效果、关节活动度。结果:观察组手足麻木消退时间短于对照组,差异有统计学意义(P<0.001)。观察组治疗总有效率高于对照组,差异有统计学意义(P=0.019)。治疗前,两组关节前屈、外展、后伸、内收角度比较,差异无统计学意义(P>0.05);治疗后,两组关节前屈、外展、后伸、内收角度大于治疗前,且观察组大于对照组,差异有统计学意义(P<0.05)。结论:黄芪桂枝五物汤治疗乳腺癌化疗后手足麻木的效果显著,可有效改善患者肢体功能,缓解手足麻木症状。

黄芪竹叶汤配合益气生津丸治疗2型糖尿病气阴两虚证患者的临床观察

目的观察黄芪竹叶汤配合益气生津片治疗2型糖尿病气阴两虚证的临床效果。方法选取2020年1月—2022年1月期间河南省安阳市中医院收治的2型糖尿病(T2DM)患者90例作为研究对象,按随机数字表法分为对照组和治疗组,每组各45例。两组患者均给予常规西药治疗,对照组采用黄芪竹叶汤,治疗组在对照组基础上加用益气生津丸治疗,均连续治疗3个月。观察比较两组患者临床疗效、不良反应发生率,治疗前后中医证候积分、血糖指标[空腹血糖(Fasting plasma glucose,FPG),糖化血红蛋白(Glycosylated hemoglobin,HbA1c),空腹胰岛素(Fasting insulin,FINS)]及血清炎性因子[C-反应蛋白(C-reactive protein,CRP)、白细胞介素-1β(Interleukin-1β,IL-1β)、白细胞介素-6(Interleukin-6,IL-6)]水平。结果治疗后治疗组总有效率91.11%(41/45)明显高于对照组75.55%(34/45),差异有统计学意义(P<0.05)。治疗后两组患者中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且治疗组各主症及各次症积分均低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血糖指标FPG、FINS、HbA1c均较治疗前降低,差异有统计学意义(P<0.05);且治疗组FPG、FINS、HbA1c均低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清炎性因子水平CRP、IL-6、IL-1β均较治疗前降低,差异有统计学意义(P<0.05);且治疗组CRP、IL-6、IL-1β均低于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论黄芪竹叶汤配合益气生津丸是治疗2型糖尿病有效且安全的方案,能明显控制患者血糖,减轻炎症反应。

黄芪阳和汤调控PI3K/AKT/NF-κB信号通路促进糖尿病足溃疡大鼠创面愈合

目的基于磷脂酰肌醇3-激酶(PI3K)/蛋白激酶B(AKT)/核因子-κB(NF-κB)信号通路探究黄芪阳和汤对糖尿病足溃疡(DFU)大鼠创面愈合的影响。方法构建DFU大鼠模型,将建模成功的48只大鼠随机分为模型组,黄芪阳和汤低(8.5 g/kg)、高(17 g/kg)剂量组,黄芪阳和汤高剂量(17 g/kg)+LY294002(PI3K/AKT通路抑制剂,0.3 mg/kg)组;每组12只;另取12只大鼠为对照组。各组大鼠给予对应药物干预,连续4周。第14、28天给药后,观察大鼠一般状态及创面变化,计算创面愈合率,检测大鼠空腹血糖(FBG)水平和大鼠创面周围组织经皮氧分压(TcpO2);酶联免疫吸附试验检测大鼠血清血管内皮生长因子(VEGF)、缺氧诱导因子-1α(HIF-1α)、C反应蛋白(CRP)、白细胞介素(IL)-6水平;苏木素-伊红染色观察大鼠创面组织病理学变化;免疫组织化学染色测定大鼠创面组织微血管密度;蛋白免疫印迹法检测大鼠创面组织中PI3K、磷酸化PI3K(p-PI3K)、AKT、磷酸化AKT(p-AKT)、NF-κB p65、磷酸化NF-κB p65(p-NF-κB p65)、NF-κB抑制蛋白α(IκB-α)蛋白表达。结果对照组大鼠毛色光滑,饮食、饮水、排泄均正常,较活跃,创面愈合快,创面组织炎症反应较轻,新生血管较多,肉芽组织中成纤维细胞及胶原基质丰富;模型组大鼠毛色暗淡无光泽,活动减少,且出现多饮、多食、多尿症状,创面颜色较深,且周围组织出现水肿、溃疡,创面组织可见大量炎性细胞浸润,伴组织坏死、渗出,新生血管及成纤维细胞较少,创面愈合率、创面周围组织TcpO2、血清VEGF、HIF-1α、创面组织微血管密度、p-PI3K、p-AKT、IκB-α蛋白表达水平降低,FBG、血清CRP、IL-6、创面组织p-NF-κB p65蛋白表达升高(P<0.05);与模型组相比,黄芪阳和汤低、高剂量组大鼠状态逐渐改善,创面组织病变程度依次减轻,创面愈合率、创面周围组织TcpO2、血清VEGF、HIF-1α、创面组织微血管密度、p-PI3K、p-AKT、IκB-α蛋白表达水平依次升高,FBG、血清CRP、IL-6、创面组织p-NF-κB p65蛋白表达依次降低(P<0.05);LY294002能部分逆转高剂量黄芪阳和汤对DFU大鼠的治疗作用(P<0.05)。结论黄芪阳和汤能调控PI3K/AKT/NF-κB信号通路,抑制DFU大鼠炎症反应,促进血管新生,从而促进创面愈合。

黄芪下瘀血汤合方对四氯化碳诱导肝纤维化小鼠的干预作用及机制

目的基于NOD样受体热蛋白结构域相关蛋白3(NLRP3)/含半胱氨酸的天冬氨酸蛋白水解酶-1(Caspase-1)/白细胞介素-1β(IL-1β)通路探讨黄芪汤和下瘀血汤合方(黄芪下瘀血汤)对四氯化碳诱导肝纤维化小鼠的干预作用及其可能机制。方法取6周龄C57BL/6小鼠75只,随机选择15只作为正常组,其余小鼠腹腔注射15%四氯化碳橄榄油溶液(2 mL/kg体重,每周3次)造模。1周后,将造模小鼠随机分为模型组、黄芪汤组、下瘀血汤组和黄芪下瘀血汤组,每组15只。各用药组继续予四氯化碳造模的同时,每天给予相应药物进行灌胃,正常组和模型组灌胃等剂量双蒸水,连续灌胃5周。6周末处死各组小鼠,检测血清丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6)水平,HE染色和天狼猩红染色观察肝组织炎症和胶原沉积情况,试剂盒检测肝组织中超氧化物歧化酶(SOD)、丙二醛(MDA)、羟脯氨酸(Hyp)含量,Western blot法检测肝组织中胶原增生标志物层连蛋白(FN)、I型胶原(Col I)、α-平滑肌肌动蛋白(α-SMA)以及NLRP3、Caspase-1、IL-1β蛋白表达情况。结果黄芪汤、下瘀血汤、黄芪下瘀血汤均可明显降低肝纤维化模型小鼠肝功能和血清炎性细胞因子水平,上调肝组织SOD活性,降低MDA、Hyp含量,改善肝组织炎性损伤和胶原沉积,下调肝组织FN、Col I和α-SMA蛋白表达水平,且黄芪下瘀血汤较单用黄芪汤和下瘀血汤组有进一步增强的作用,尤其以肝组织胶原沉积和Hyp更为显著,差异均有统计学意义(P均<0.05)。黄芪下瘀血汤可下调肝组织NLRP3、Caspase-1和IL-1β蛋白表达水平。结论黄芪下瘀血汤可有效改善四氯化碳诱导的肝纤维化小鼠的肝功能,减轻肝组织炎症,减少胶原纤维沉积,且防治肝纤维化的作用强于黄芪汤和下瘀血汤,其机制可能与调控NLRP3/Caspase-1/IL-1β通路、抑制炎症及氧化应激反应有关。

加减黄芪健脾汤治疗脾胃虚弱型慢性结肠炎反复发作性腹泻的临床研究

目的探讨加减黄芪健脾汤治疗脾胃虚弱型慢性结肠炎反复发作性腹泻的临床效果。方法选取2020年12月至2022年8月在大连市中心医院中医内科接受治疗的60例慢性结肠炎患者作为研究对象,采用随机数字表法将其分为治疗组和对照组,每组各30例。治疗组给予加减黄芪健脾汤治疗,对照组给予枯草杆菌二联活菌肠溶胶囊治疗。分别于治疗前及治疗后2、4、8周记录血中T淋巴细胞亚群(CD3^(+)、CD4^(+))的水平及中医症状积分,并比较两组的临床疗效和停药1个月后复发率。结果治疗组患者治疗后2、4、8周的血中T淋巴细胞亚群(CD3^(+)、CD4^(+))水平高于对照组,差异有统计学意义(P<0.05);治疗组患者治疗后2、4、8周的临床症状总积分低于对照组,差异有统计学意义(P<0.05);治疗组患者治疗总有效率高于对照组,差异有统计学意义(P<0.05);治疗组患者停药1个月后的复发率低于对照组,差异有统计学意义(P<0.05)。结论加减黄芪健脾汤治疗脾胃虚弱型慢性结肠炎反复发作性腹泻具有显著疗效,能改善患者的临床症状,还可以提高患者的免疫功能。

火针联合黄芪桂枝五物汤加减治疗脊髓损伤恢复期的临床效果

目的 观察火针联合黄芪桂枝五物汤加减治疗脊髓损伤恢复期的临床效果。方法 选取2021年12月至2023年10月于广西壮族自治区桂林市中医医院康复医学科及老年病科治疗90例脊髓损伤恢复期患者,按照随机数字表法将其分成火针组、中药组、联合组,每组30例。三组均给予常规基础康复训练,火针组增加火针治疗,中药组增加黄芪桂枝五物汤治疗,联合组增加火针联合口服黄芪桂枝五物汤,三组均持续治疗8周。分别于治疗前后进行美国脊柱损伤协会(ASIA)感觉功能评分量表、ASIA运动功能评定量表、日常生活活动能力评定。结果 治疗后,三组ASIA感觉功能评分量表中轻触觉、ASIA感觉功能评分量表中针刺觉、ASIA运动功能评定量表、改良Barthel指数评分高于治疗前,且联合组高于火针组、中药组(P<0.05)。结论 火针联合黄芪桂枝五物汤能显著改善脊髓损伤恢复期患者的感觉功能、运动功能,以及日常生活活动能力。

金银花黄芪汤联合中药熏洗对肛瘘术后患者肛门功能及炎症因子的影响

目的探讨金银花黄芪汤联合中药熏洗对肛瘘术后患者肛门功能及炎症因子的影响。方法选择如皋市中医院肛肠外科2020年5月—2021年6月经肛瘘切除术治疗的肛瘘患者162例的病例资料,按随机对照临床研究原则,分对照组(81例)和治疗组(81例),两组均予以肛瘘切除术治疗。术后对照组采用术后温水熏洗疗法;治疗组采用金银花黄芪汤联合中药熏洗治疗,治疗前后观察并记录视觉模拟(visual analog scale,VAS)评分、大便失禁严重程度(fecal incontinence severity index,FISI)、渗液程度积分,测定肛门功能指标,治疗后采血测定血清白细胞介素族(interleukin,IL)及β内啡肽(β-endorphin,β-EP)含量,同时对比临床疗效和并发症状况。结果与手术前比较,两组患者治疗后VAS评分、FISI评分、渗液程度积分降低,治疗后肛管最大收缩压(anal maximum contraction pressure,AMCP)、肛管最长收缩时间(anal longest contraction time,ALCT)升高,直肠静息压(rectal resting pressure,RRP)、肛管静息压(anal resting pressure,ARP)降低,治疗后血清IL-4、IL-6、IL-10以及β-EP含量升高(P<0.05);与对照组比较,治疗组治疗后VAS评分、FISI、渗液程度积分较低,ALCT较低,RRP、ARP较高,血清IL-4、IL-6、IL-10以及β-EP含量较低(P<0.05);对照组创口愈合时间和住院时间(22.16±3.21)d、(20.04±2.69)d与治疗组(17.25±2.69)d、(15.92±2.34)d,差异有统计学意义(P<0.05);对照组有效率为72.84%(59/81),治疗组有效率为90.12%(73/81),治疗组高于对照组(P<0.05)。结论金银花黄芪汤联合中药熏洗对肛瘘术后患者疗效显著,较好的保护患者肛门功能,降低疼痛应激及炎症反应,值得在临床上推广应用。

加味黄芪桂枝五物汤口服联合当归四逆汤熏洗佐治糖尿病周围神经病变临床评价

目的探讨加味黄芪桂枝五物汤口服联合当归四逆汤熏洗佐治糖尿病周围神经病变(DPN)的临床疗效。方法选取医院2022年7月至2023年11月收诊的DPN患者86例,根据治疗方法的不同分为对照组(41例)和观察组(45例)。两组患者均常规控制血糖、增强免疫及营养神经,观察组患者在此基础上加用加味黄芪桂枝五物汤口服联合当归四逆汤熏洗。两组均以14 d为1疗程,治疗3个疗程。结果观察组总有效率为93.33%,显著高于对照组的78.05%(P<0.05)。治疗后,两组患者的中医证候主症评分、次症评分及总评分均显著降低(P<0.05);多伦多临床评分系统评分均显著降低(P<0.05);腓总神经与正中神经的感觉神经传导速率和运动神经传导速率均显著加快(P<0.05);血清基质金属蛋白酶9、NOD样受体热蛋白结构域3炎性小体水平均显著降低,血清超氧化物歧化酶水平均显著升高(P<0.05);血清丙二醛水平均显著降低(P<0.05);且观察组各指标均显著优于对照组(P<0.05)。两组患者不良反应发生率相当(11.11%比7.32%,P>0.05)。结论加味黄芪桂枝五物汤口服联合当归四逆汤熏洗佐治DPN,可改善患者临床症状,提高神经传导速率,减轻炎性反应与氧化应激反应。