Effects of Zhenren Yangzang Decoction Combined with Modified Shenling Baizhu Powder on Immune Function and Intestinal Microecology of Diarrhea Patients with Deficiency and Cold Syndrome

OBJECTIVE: To observe the effects of Zhenren Yangzang Decoction combined with modified Shenling Baizhu Powder on the immune function and intestinal microecology of diarrhea patients with deficiency and cold syndrome. METHODS: A total of 60 diarrhea patients with deficiency and cold syndrome were randomly divided into observation group and control group, with 30 cases in each group. The control group was treated with conventional western medicine. The observation group was given the treatment of Zhenren Yangzang Decoction combined with modified Shenling Baizhu Powder on the basis of the same treatment for 4 weeks. The clinical symptoms, fecal flora and immunoglobulin content of the 2 groups were observed and the clinical efficacy was evaluated. RESULTS: After treatment, the symptoms scores of fecal diarrhea, aversion to cold, cold limbs, loss of appetite, cold and painful waist and knee, abdominal fullness, abdominal distension and abdominal pain, and intestinal bacilli contents were significantly decreased(P < 0.05). The contents of lactobacillus, bifidus bacilli, IgG, IgM and IgA were significantly increased(P < 0.05), and the improvement of the above indexes in the observation group was significantly better than that in the control group(P < 0.05). The total effective rate after treatment in the observation group was 93.3%, which was significantly higher than 73.3% of the control group(P < 0.05). CONCLUSION: The treatment of diarrhea patients with deficiency and cold syndrome with Zhenren Yangzang Decoction and modified Shenling Baizhu Powder can effectively improve the intestinal micro-ecological environment, improve the immune function of patients and promote the rapid recovery of patients.

Effects of Shenling Baizhu powder on endoplasmic reticulum stress related signaling pathway in liver tissues of nonalcoholic fatty liver disease rats

Background:According to our previous studies,Shenling Baizhu powder has an excellent preventive and therapeutic effect on nonalcoholic fatty liver disease,but the prevention mechanism is still not clear.In this study,we intended to explore the effects of Shenling Baizhu powder on the endoplasmic reticulum stress related signaling pathway in nonalcoholic fatty liver disease rats’liver tissues.Methods:After 16 weeks,the levels of serum total cholesterol,triglyceride,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,alanine transaminase and aspartate transaminase were evaluated by an automatic biochemical analyzer,and the levels of serum free fatty acid and hepatic total cholesterol and triglyceride were evaluated by commercial kits.Then,histological changes of the liver were observed by hematoxylin and eosin and oil red-O staining.Protein expression related to the liver unfolded protein response signalling pathway was assessed using Western blot analysis.Results:The results showed that Shenling Baizhu powder supplementation reduced serum total cholesterol,triglyceride,free fatty acid,alanine transaminase,and aspartate transaminase(P<0.05 or P<0.01),as well as the levels of hepatic total cholesterol and triglyceride(P<0.01).Pathological examination showed that Shenling Baizhu powder improved hepatic steatosis and lipid accumulation.The results of biochemical parameters and histological changes indicated that Shenling Baizhu powder administration exerted protective effects against nonalcoholic fatty liver disease.In addition,Shenling Baizhu powder decreased the protein expression levels of binding immunoglobulin protein,activating transcription factor 6,phosphorylation of eukaryotic initiation factor 2 alpha,protein kinase RNA-like endoplasmic reticulum kinase and X-box binding protein 1s in the liver(P<0.05 or P<0.01).Conclusion:Shenling Baizhu powder can ameliorate high-fat diet-induced liver lipid metabolism disorder in nonalcoholic fatty liver disease rats.The mechanisms may be related to the inhibition of the expression of proteins related to unfolded protein response signaling pathways in endoplasmic reticulum stress.

Mechanism of Shenling Baizhu powder in treating dextran sulfate sodium-induced colitis in rats

Objective: To investigate whether Shenling Baizhu powder can inhibit the inflammatory response of dextran sulfate sodium-induced colitis in rats by protecting the intestinal mucosal barrier. Methods: A total of 40 SD rats were randomly divided into normal control group (group A), dextran sulfate sodium model group (group B), middle-dose Shenling Baizhu powder group (group C), high-dose Shenling Baizhu powder group (group D) and sulfasalazine group (group E), with 8 rats in each group. In addition to group A, dextran sulfate sodium solution (40 g/L) was added to the drinking water of rats for free drinking. The treatment groups were also given the corresponding dose of Shenling Baizhu powder/sulfasalazine. Body weight, disease activity index(DAI), colon length and intestinal mucosal permeability were measured to evaluate the effect of Shenling Baizhu powder on colitis induced by dextran sulfate sodium. The content of interleukin-10(IL-10), interleukin-6(IL-6) and tumor necrosis factor(TNF-ɑ) in rat colonic homogenate were analyzed by using enzyme-linked immunosorbent assay. The protective effect of Shenling Baizhu powder on intestinal mucosa was discussed. Results: The levels of IL-6 and TNF-ɑ in group B were higher than those in group A (P<0.05), while IL-10 level of group B was lower than that of group A (P<0.05). The levels of TNF-ɑ in groups C, D and E were significantly lower than those in group B (P<0.01), and showed concentration dependence in groups C and D. The levels of IL-6 in groups D and E were significantly lower than those in group B (P<0.05). The levels of IL-10 in groups C, D and E were significantly higher than those in group B (P<0.01), and concentration dependence was observed in groups B and C. Conclusion: Shenling Baizhu powder can protect the intestinal mucosal barrier by regulating the function of cytokines such as IL-10, IL-6 and TNF-ɑ, which alleviate the inflammatory response in rats with dextran sulfate sodium-induced colitis.

Study on the mechanism of Shenling Baizhu Powder in the treatment of diarrhea-type irritable bowel syndrome based on network pharmacology and molecular docking

Objective:Explore the possible intervention mechanism of Shenling Baizhu Powder on IBS-D from network data through network pharmacology and molecular docking simulation technology.Methods:Establish a complete regulatory network of Shenling Baizhu powder on IBS-D after obtaining the active components and drug targets of Shenling Baizhu Powder on the TCMSP platform and obtaining the disease targets of IBS-D from GeneCards and OMIM databases.Then screen out the potential best target of Shenling Baizhu Powder in IBS-D intervention network combining with the PPI network constructed in the STRING database,and screen the potential core of compounds through the molecular docking simulation and comparison with pivecurium bromide.After that,the related gene ontology functions and pathways of Shenling Baizhu Powder in treating IBS-D will be obtained though gene ontology(GO)enrichment analysis through DAVID database and Kyoto encyclo-pedia of genes and genomes(KEGG)pathways enrichment analysis through Bioconductor database.Results:The number of IBS-D disease-related targets was 2,724.And there were 184 active compounds in Shenling Baizhusan,among which 175 could act on IBS-D.After screening,four potential best targets of PTGS2,ESR1,AR and MAPK14 were obtained,and four core compounds of quercetin,luteolin,kaempferol and isorhamnetin were obtained by molecular docking simulation.GO enrichment analysis results showed that there were 92 biological processes,18 cellular components and 21 molecular functions associated with shenling Baizhu Powder intervention IBS-D process.The results of KEGG pathway enrichment analysis showed that shenling Baizhu Powder had 172 pathways involved in the intervention of IBS-D.Conclusion:The intervention effect of Shenling Baizhu powder on IBS-D was better than pivecurium bromide in terms of the number of targets and the ease of binding to the targets.Its intervention process of IBS-D may be closely related to inflammation,cancer,endocrine disorders and other related reactions and pathways,among which quercetin,luteolin,kaempferol and isorrine are the most potential core compounds in the intervention network,and the four target proteins of PTGS2,ESR1,AR and MAPK14 are the potential best target options in the intervention network.

Therapeutic Effect of Shenling Baizhu Powder on Primary Nephrotic Syndrome Featuring Damp Abundance Due to Splenic Asthenia

[Objectives]To observe the clinical efficacy of Shenling Baizhu Powder in the treatment of primary nephrotic syndrome(PNS)featuring damp abundance due to splenic asthenia.[Methods]40 patients with PNS were randomly divided into treatment group(n=19)and control group(n=21).In the treatment group and the control group,methylprednisolone tablets were taken orally and cytoxan(CTX)was given intravenously for treatment;in the treatment group,based on oral administration of methylprednisolone tablets and intravenous drip of cytoxan(CTX),oral administration of traditional Chinese medicine(addition and subtraction of Shenling Baizhu Powder)was added.Urine routine,24-hour urinary protein,renal function and serum albumin were re-examined after 4 weeks of treatment.[Results]The total effective rate of the treatment group was significantly higher than that of the control group(89.47%vs 61.90%,P<0.05).After treatment,both groups could effectively reduce the levels of 24-hour urinary protein(P<0.05),serum creatinine(P<0.05)and urea nitrogen(P<0.05),and increase the level of serum albumin(P<0.05),but the degree of improvement in the treatment group was significantly higher than that in the control group(P<0.05),and the difference was statistically significant(P<0.05).[Conclusions]Methylprednisolone combined with addition and subtraction of Shenling Baizhu Powder could effectively reduce urinary protein,improve edema symptoms,shorten the course of hormone use and reduce adverse reactions in the treatment of PNS featuring damp abundance due to splenic asthenia.

Clinical observation of Shenling Baizhu Powder combined with triamcinolone acetonide in treating macular edema induced by retinal vein occlusion

Objective:to observe the clinical effica-cy of Shenling Baizhu Powder(SLBZP)combined with a subconjunctival injection of triamcinolone acetonide(TA)in treating macular edema(ME)induced by retinal vein occlusion(RVO).Method:there were 62 patients(62 eyes)with ME induced by RVO that were selected and divided into two groups in accordance with the ran-dom number table.Each group had 31 eyes.Group one,the control group,was treated with a single subconjunc-tival injection of TA;group two,the observation group,was treated with a single subconjunctival injection of TA(20 mg/0.5 mL)per eye and one month of SLBZP.To evaluate the clinical efficacy,both groups were checked(3×)with the best corrected-visual acuity(BCVA),cen-ter macular thickness(CMT),and intraocular pressure(IOP).The checks were before treatment,one month af-ter injection,and three months after injection.Results:there were 26 eyes(83.87%)in the observation group,and 17 eyes(54.84%)in the control group in which the BCVA was significantly improved.The ME obviously de-creased in 27 eyes(87.10%)the observation group and in 19 eyes(61.29%)the control group.The clinical effica-cy of the observation group was significantly better than that of the control group(P<0.05).Conclusion:as one method to treat ME induced by RVO,SLBZP combined with subconjunctival injection of TA is significantly more effective than a single subconjunctival injection of TA.Besides,the SLBZP had less side-effects.Based on the above,this method deserves in-depth research.

Analysis on the Clinical Effect of Shenling Baizhu San Combined with Routine Treatment on Bacterial Pneumonia in Children

[Objectives]To explore the effect of Shenling Baizhu San combined with routine treatment on the clinical efficacy,gastrointestinal function protection,inflammatory response and immune function of children with bacterial pneumonia.[Methods]From July 2017 to January 2018,80 children with bacterial pneumonia were randomly selected and divided into observation group and control group with 40 cases in each group.The control group was treated with conventional Western medicine,while the observation group was treated with Shenling Baizhu San on the basis of conventional treatment,with a period of 10 d.Then,we compared the clinical efficacy,incidence of gastrointestinal symptoms,WBC,CRP,CD4+and CD8+levels between the two groups.[Results]The clinical efficacy of the observation group was better than that of the control group(P<0.05).After treatment,the levels of WBC and CRP in the two groups decreased,especially in the observation group(P<0.05).After treatment,the level of CD4+in both groups increased significantly,while the level of CD8+decreased significantly,and the level of CD4+in the observation group was significantly higher than that in the control group after treatment.The incidence of gastrointestinal symptoms in the observation group was significantly lower than that in the control group(P<0.01).[Conclusions]Shenling Baizhu San can obviously improve the clinical effect of bacterial pneumonia in children and has the protective effect of gastrointestinal tract,and its mechanism may be related to its anti-inflammatory and immunomodulatory effects.

Study on the regulation of brain-gut peptide by Shenling Baizhu San in functional diarrhea rats

Objective:To explore the therapeutic mechanism of Shenling Baizhu San (SLBZS) on functional diarrhea (FDr) by studying the brain-gut axis and related neuropeptides.Methods:Sixty male Wistar rats were randomly divided into the control group,model group,SLBZS-treated group and Montmorillonite Powder-treated group (MP-treated group) (n =15/group).Rats received gavage after the establishment of functional diarrhea.An equal volume of SLBZS solution and Montmorillonite Powder (MP) solution was administered to the SLBZS-treated group and MP-treated group,respectively,and an equal volume of distilled water was administered to the control group and the model group.The chemical components and targets related to SLBZS were identified from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and Traditional Chinese Medicine Integrated Database (TCMID).The effective chemical components were screened based on oral bioavailability (OB) and drug like-index (DL),and their biological functions were analyzed by GlueGO.Based on this screening,the expression of Cholecystokinin (CCK) and Ghrelin in the hypothalamus of rats was detected by real-time PCR (RT-PCR) and western blotting.Results:In this study,72 effective components and 190 core targets of SLBZS were screened.SLBZS may regulate smooth muscle contraction,energy metabolism and other biological processes.The results of RT-PCR showed that in the model group,the expression of CCK mRNA (P =.001) and Ghrelin mRNA (P =.000) increased significantly.Compared with the model group,CCK mRNA (P =.007) and Ghrelin mRNA (P =.001) levels in SLBZS-treated rats were decreased significantly.The results of western blotting showed that in the model group,the protein expression of CCK (P =.001) and Ghrelin (P =.000) increased significantly.The protein levels of CCK (P =.001) and Ghrelin (P =.005) in the SLBZS-treated group were decreased significantly compared with the model group.Conclusion:SLBZS improved functional diarrhea by regulating the brain-gut axis.Changes in the expressions of brain-gut peptide,CCK and Ghrelin might explain the pathogenesis of functional diarrhea related to brain-gut peptide and gastrointestinal hormone.

Treatment of rotaviral gastroenteritis with Qiwei Baizhu powder

AIM To observe the effects of Qiwei Baizhu Powder ( QWBZP) on rotaviral gastroenteritis in children and in animal models.``METHODS Enrolled patients were divided into two groups, and one group was treated with oral rehydration solution(ORS) and the other treated with oral liquid of QWBZP. Neonate mice were orally infected with 50 μLrotavirus suspension (4 × l0s PFU/mL) and treated with ORS or oral liquid of QWBZP, respectively.``RESULTS Eighty-three cases of rotaviral gastroenteritis treated with QWBZP revealed a better efficacy than that treated with ORS (x2 - 10.8T, P<0.05). The contents of sodium and glucose as well as number of patients with positive human rotavirus antigen in stool in QWBZP group were all less than that in ORS group. In animal models,QWBZP was found effective in treating rotavirus gastroenteritis in neonate NIH mice, as compared with control groups. In QWBZP group, the mortality of infected mice was decreased by 73.3%, the body weight of infected mice was increased, the contents of sodium and glucose as well as number of mice with positive rotavirus antigen in feces were significantly reduced, and the pathological changes such as damage of small intestinal mucosa and villi were also obviously alleviated.``CONCLUSION QWBZP has effects on improving the absorptive function of small intestine, shortening the duration of diarrhea and rotavirus shedding from stool and alleviating the pathological changes of small intestine induced by rotavirus.

七味白术散治疗老年肺炎肺脾气虚证的疗效及对胃肠功能的影响

目的 观察七味白术散对老年肺炎肺脾气虚证的疗效及对胃肠功能的影响。方法 将60例老年肺炎肺脾气虚证患者按照随机数字表法分为2组,对照组30例予常规基础治疗,治疗组30例在对照组治疗基础上予七味白术散加减治疗。2组均治疗2周。比较2组治疗前后中医证候评分、外周血炎症因子[白细胞介素6(IL-6)、白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)]水平、胃肠功能指标(腹内压、肠鸣音次数)及肠道菌群情况,并统计2组疗效及安全性。结果 治疗组总有效率93.33%(28/30),对照组总有效率73.33%(22/30),治疗组临床疗效优于对照组(P<0.05)。2组治疗后中医证候各项评分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后IL-6、WBC、CRP、PCT水平均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后腹内压均较本组治疗前降低(P<0.05),肠鸣音次数均增加(P<0.05),且治疗组治疗后腹内压低于对照组(P<0.05),肠鸣音次数高于对照组(P<0.05)。2组治疗后肠道乳酸杆菌、双歧杆菌菌落数均较本组治疗前增加(P<0.05),肠球菌、肠杆菌菌落数均降低(P<0.05),且治疗组治疗后乳酸杆菌、双歧杆菌菌落数均高于对照组(P<0.05),肠球菌、肠杆菌菌落数均低于对照组(P<0.05)。2组治疗期间未出现肝肾功能异常。结论 七味白术散治疗老年肺炎肺脾气虚证疗效显著,可有效降低炎症因子水平,调节肠道菌群,改善胃肠功能,安全性高。

基于文献及计量学方法研究脾阴学说古今发展及参苓白术散滋补脾阴作用阐释

脾乃后天之本、气血生化之源,脾之阳气为脾脏功能的发挥提供了“动力”,而脾阴则提供了“物质基础”。脾阴学说成说较晚、论说较少,基于文献研究系统梳理了脾阴理论内涵及历史发展源流,认为“辅运化”“主滋养”和“和胃阳”是脾阴主要的生理功能;脾阴理论的发展主要经历了《黄帝内经》构建脏腑阴阳理论体系、《伤寒论》初识脾阴方证、“丹溪学派”首开滋阴法先河、缪希雍系统建立脾阴理论体系、吴澄引申“芳香甘平”治法5个历史时期。此外,通过文献计量学Citespace分析脾阴学说现代整体发展应用情况,对比古今常用11个滋补脾阴类中药复方发现:现代研究中对脾阴学说的认识主要传承自唐容川、叶天士、吴澄、李东垣、缪希雍、张锡纯几位医家;其理论主要应用在消渴(糖尿病)、泄泻、便秘、肉痿等疾病治疗中;用药偏以甘淡,兼顾养胃阴为特色;局方参苓白术散成方早,充分体现了“甘淡”补脾之滋补脾阴用药的基本法则,具有健脾气、滋脾阴、渗脾湿之功效,全方升降相因、散收并用、补行兼施,尤宜于脾气阴虚夹湿的患者,乃滋补脾阴理论应用的基础方。

参苓白术散联合穴位贴敷治疗腹泻型肠易激综合征疗效观察

目的 本研究旨在评估参苓白术散结合穴位贴敷疗法在腹泻型肠易激综合征(irritable bowel syndrome with diarrhea,IBS-D)治疗中的临床效果。方法 选取2022年5月-2023年8月期间就诊于安徽中医药大学第二附属医院脾胃病科门诊与住院部的肠易激综合征腹泻型的患者88例,采用随机数字表法分组为对照组与研究组,各44例。在控制日常饮食与适量运动的前提下,对照组采用盐酸洛哌丁胺治疗,而研究组则应用参苓白术散与穴位贴敷的联合疗法。经过为期28 d的治疗周期,对2组腹泻型肠易激综合征患者的治疗效果进行全面评估。结果 研究组的临床治疗效果在总有效率上明显优于对照组,差异具有统计学意义(P<0.05),其腹胀、排便频率、性状及腹痛程度的改善情况均优于对照组(P<0.05)。经过治疗周期后,2组的血清5-羟色胺(5-HT)以及神经肽Y(NPY)指标均呈现下降趋势,差异具有统计学意义(P<0.05)。在不良反应方面,2组无统计学差异(P>0.05)。对2组中治疗有效的患者进行随访,研究组复发率4.76%(2/42)低于对照组20.00%(7/35)(P<0.05)。结论 参苓白术散联合穴位贴敷治疗腹泻型肠易激综合征具有显著疗效,在改善临床症状和实验室指标方面具有明显优势,且复发率低。

七味白术散加味治疗肝硬化腹泻临床观察

目的:观察七味白术散加味治疗肝硬化腹泻的临床疗效。方法:选取确诊的96例肝硬化腹泻患者,随机分为两组各48例。两组均予肝硬化西医常规治疗,对照组在此基础上予双歧杆菌四联活菌口服,治疗组予七味白术散加味治疗,疗程均为2周,比较两组临床疗效以及肠道sIgA水平变化、肠道菌群的改善情况。结果:治疗组总有效率为95.83%,对照组总有效率81.25%,两组比较差异有统计学意义(P﹤0.05);治疗后,治疗组患者的ALT、AST、TBIL改善程度明显优于对照组(P﹤0.05);治疗组肠道sIgA水平、肠道菌群改善水平均明显优于对照组(P﹤0.05)。结论:七味白术散加味治疗肝硬化腹泻疗效较好,可改善患者肝功能水平及肠道有益菌群生长,增加患者肠道sIgA水平。

参苓白术散联合EGFR-TKIs靶向治疗非小细胞肺癌临床观察

目的 参苓白术散联合人表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIs)靶向治疗非小细胞肺癌(NSCLC)的临床效果。方法 将患者随机分为对照组(29例)和联合组(30例)。对照组采用EGFR-TKIs靶向治疗,联合组在对照组基础上予口服参苓白术散。治疗9周,比较2组临床疗效、中医证候积分、免疫功能指标及不良反应发生率。结果 联合组临床疗效优于对照组(P<0.05)。治疗后,2组中医证候积分下降,联合组偏低(P<0.05);2组CD4^(+)、CD4^(+)/CD8^(+)比率升高,联合组偏高(P<0.05),CD8^(+)水平则降低,联合组偏低(P<0.05)。联合组不良反应总发生率低于对照组(P<0.05)。结论 参苓白术散联合EGFR-TKIs靶向治疗NSCLC疗效显著,可改善免疫功能,减轻不良反应。

基于免疫-炎症轴的化斑汤合参苓白术散预防放疗放射性肺损伤的临床效果

目的探讨化斑汤合参苓白术散对癌症放疗放射性肺损伤(RILI)的预防效果及对免疫-炎症轴的影响。方法将2021年1月—2023年1月收治的120例癌症放疗患者均分研究组和对照组。2组均持续放疗6周,放疗期间研究组予化斑汤合参苓白术散治疗,对照组予中药安慰剂治疗。比较2组放疗效果、RILI发生率,以及放疗前后血清炎性因子[白细胞介素-6(IL-6)、转化生长因子-β(TGF-β)、肿瘤坏死因子-α(TNF-α)],免疫指标(CD3+、CD4+、CD4+/CD8+)水平,肺功能指标[肺总量(TLC)、用力肺活量(FVC)],血浆外泌体miR-17-5p、miR-7-5p水平。结果研究组放疗总有效率[91.67%(55/60)]高于对照组[78.33%(47/60)],RILI发生率低于对照组(P<0.05);研究组放疗3周、6周后血清TNF-α、TGF-β、IL-6及血浆外泌体miR-17-5p、miR-7-5p水平低于对照组,CD3+、CD4+、CD4+/CD8+及TLC、FVC水平高于对照组(P<0.05)。结论化斑汤合参苓白术散对癌症放疗RILI有良好的预防效果,并可减轻炎症反应,改善免疫功能、肺功能,降低RILI发生率,其作用机制可能与抑制miR-17-5p、miR-7-5p表达有关。

基于NGF/PI3K/TRPV1信号通路探究参苓白术散对腹泻型肠易激综合征小鼠的干预机制

目的研究基于神经生长因子/磷脂酰肌醇3-激酶/瞬时受体电位香草酸受体1(NGF/PI3K/TRPV1)信号通路探究参苓白术散对腹泻型肠易激综合征小鼠的干预机制。方法选取40只SPF级SD雄性大鼠,其中空白组10只,模型组13只、研究1组7只、研究2组9只。对照组、模型组只进行生理盐水灌胃,不做其他任何处理。研究1组给予匹维溴铵片20mg/kg水溶液进行灌胃,研究2组给予参苓白术散4g/kg进行灌胃。评估Bristol评分情况;分析脾脏系数、胸腺系数情况;检测IgA、IgG、IgM、IL-1β、IL-6、TNF-α表达水平及NGF/PI3K/TRPV1蛋白表达情况。结果相比于空白组,模型组、研究1组、研究2组Bristol评分、脾脏系数、胸腺系数、IgA、IgG、IgM、IL-1β、IL-6、TNF-α水平及NGF、PI3K、TRPV1蛋白表达均上升(P<0.05);相比于模型组、研究1组,研究2组Bristol评分、脾脏系数、胸腺系数、IgA、IgG、IgM、IL-1β、IL-6、TNF-α水平及NGF、PI3K、TRPV1蛋白表达均下降(P<0.05)。结论参苓白术散抑制NGF/PI3K/TRPV1通路,改善大鼠胃肠功能及大便状态,减轻炎症反应,提高免疫功能稳态情况,干预效果显著。

HPLC法测定参苓白术散中三种成分的含量

目的:建立参苓白术散中苍术酮、白术内酯Ⅰ和甘草苷的定量检测方法。方法:采用HPLC法,以C_(18)色谱柱(5μm,4.6 mm×250 mm),乙腈作为流动相A,测定了参苓白术散中苍术酮、白术内酯Ⅰ、甘草苷的含量。结果:苍术酮在0.0082~0.1308 mg/mL浓度范围内线性关系良好,平均加样回收率97.8%(RSD=0.7%,n=6);白术内酯Ⅰ在0.0016~0.0256 mg/mL浓度范围内线性关系良好,平均加样回收率103.4%(RSD=1.8%,n=6);甘草苷在0.0153~0.2444 mg/mL浓度范围内线性关系良好,平均加样回收率104.2%(RSD=0.5%,n=6)。结论:本研究成功建立了参苓白术散中苍术酮、白术内酯I和甘草苷的检测方法,且方法专属性强,精密度、重复性良好。

基于Meta和网络药理学分析参苓白术散治疗糖尿病肥胖的作用机制

目的:采用文献荟萃分析法(Meta)评估参苓白术散对糖尿病型肥胖的治疗作用,再结合网络药理学和动物实验方法分析参苓白术散治疗糖尿病肥胖的作用机制。方法:纳入国内外相关文献,以身体质量指数(BMI)、糖化血红蛋白(HbA1c)、餐后2 h血糖(2 h PG)、空腹血糖(FBG)、胰岛素抵抗指数(Homa-IR)、腰臀比作为结局指标,评估参苓白术散对糖尿病型肥胖的治疗作用。从GEO数据库中下载糖尿病肥胖的相关基因,在中药系统药理学数据库与分析平台(TCMSP)、中医药综合数据库(TCMID)和中药分子机制生物信息学分析工具(BATMAN-TCM)中下载参苓白术散的作用靶点,对两者的交集靶点进行蛋白质-蛋白质相互作用分析,再根据拓扑分析筛选出核心靶点蛋白质;制备糖尿病肥胖小鼠的模型,分组后进行参苓白术散的灌胃治疗,2周后测量各组小鼠体质量、血糖、Lee's指数,采用苏木精-伊红(HE)染色法分析各组小鼠的脂肪细胞体积变化,测量小鼠血清中的胆固醇、三酰甘油及核心靶点蛋白质的浓度。结果:共纳入9篇文献,数据完整,未发现发表偏倚,评估为low risk。患者服用参苓白术散后,BMI、HbA1c、2 h PG、Homa-IR和腰臀比均得到明显改善;参苓白术散-糖尿病肥胖的交集靶点共59个,核心靶点为载脂蛋白E(APO-E)、胰岛素生长因子-1(IGF-1)、纤溶酶原激活物抑制物-1(PAI-1),参苓白术散主要通过影响细胞对油酸的反应(GO:0071400)、转化生长因子β1生产的正调控(GO:0032914)和纤溶酶原激活的负调控(GO:0010757)等生物学功能,影响不饱和脂肪酸的生物合成(hsa01040)、脂肪酸代谢(hsa01212)等信号通路来治疗糖尿病肥胖;动物实验结果表明,经过参苓白术散灌胃治疗后的小鼠血糖变化不显著,体质量和Lee's指数呈现明显下降趋势,脂肪细胞直径明显缩小,胆固醇、三酰甘油浓度及APO-E、IGF-1、PAI-1水平均呈现下调趋势。结论:结合Meta分析和动物实验的结果,参苓白术散对糖尿病肥胖具有明显的治疗作用,其作用机制可能与影响不饱和脂肪酸、脂肪酸的合成,减少糖和脂肪的转化,纠正机体能量代谢失衡,调控自噬促进脂肪组织的分解有关。

参苓白术散联合运动干预对糖尿病合并肌少症患者的效果评价

目的探讨给予老年2型糖尿病(T2DM)合并肌少症患者参苓白术散联合运动干预的有效性、安全性和经济性。方法140例老年T2DM合并肌少症患者随机分为对照组和干预组,每组70例。对照组给予常规诊疗方案,干预组在常规诊疗方案基础上增加参苓白术散联合运动干预,2组患者均干预3个月,比较两种方案的有效性、经济性和安全性。结果2组患者均顺利完成了随访,干预前,2组基线比较差异无统计学意义(P<0.05)。干预后,干预组糖化血红蛋白低于对照组(t=2.279,P=0.024);握力高于对照组(t=-2.205,P=0.029);6 m步速高于对照组(t=-2.638,P=0.009);随访周期内,干预组未发生运动损伤,药品不良反应发生率低于对照组(χ^(2)=0.061,P=0.805),骨折发生率低于对照组(χ^(2)=2.786,P=0.095),跌倒发生率低于对照组(χ^(2)=5.079,P=0.024);干预组成本低于对照组,效果优于对照组,为绝对优势方案,敏感性分析与成本效果分析结果一致。结论给予老年T2DM合并肌少症患者参苓白术散联合运动干预安全性较好,可降低糖化血红蛋白、提高握力和6 m步速,降低跌倒不良事件发生率;与常规诊疗方案相比,成本低、效果好,具有经济性。

参苓白术散联合肠内营养改善危重症患者营养状态和预后的研究

目的分析参苓白术散联合肠内营养改善危重症患者营养状态和预后的研究。方法纳入2020年1月—2022年8月医院收治的危重症患者60例,分为对照组和观察组,各30例,方法为随机数字表法。对照组给予标准肠内营养支持及安慰剂治疗,观察组给予标准肠内营养支持及参苓白术散治疗,两组均治疗至转出重症加强护理病房。比较两组治疗情况,治疗前、治疗后营养状态、炎症反应指标、血液流变学及预后。结果观察组呼吸机带机时间、重症加强护理病房住院时间短于对照组,肠内营养不耐受发生率低于对照组[3.33%(1/30)vs 26.67%(8/30),P<0.05]。与治疗前比较,治疗后,两组血清血红蛋白(serum hemoglobin,HGB)、前白蛋白(prealbumin,PA)、白蛋白(albumin,ALB)水平均升高,且观察组更高(P<0.05);两组全血白细胞总数(blood white blood cell count,WBC)、中性粒细胞百分比(neutrophil percentage,NEU%),急性生理功能与慢性健康评分(Acute Physiology and Chronic Health Evaluation,APACHEⅡ)得分,血清C反应蛋白(C-reactive protein,CRP)、降钙素原(procalcitonin,PCT)水平,全血高切、低切黏度、血浆黏度均降低,且观察组更低(P<0.05)。结论参苓白术散可降低危重症患者肠内营养的不耐受,改善患者营养状态,进而抑制机体炎症反应及血液黏度增加,促进患者康复,改善其预后。