Analysis on the Effect of Yiqi Huoxue Decoction Combined with Neuromuscular Electrical Stimulation in Improving ICU-Acquired Debility in Mechanically Ventilated Patients

Objective:To investigate the effect of Yiqi Huoxue decoction combined with neuromuscular electrical stimulation on improving intensive care unit(ICU)acquired debility in mechanically ventilated patients.Methods:50 patients who were admitted to the ICU and received mechanical ventilation treatment in our hospital from June 2022 to June 2023 and were complicated with ICU-acquired neurasthenia were selected,and randomly grouped using the randomized envelope method into two groups:control group with 25 patients who received neuromuscular electrical stimulation alone;observation group with 25 patients who received the traditional Chinese medicine Yiqi Huoxue decoction.Comparison indexes:treatment efficiency,degree of emotional recovery(APACHEⅡscore),muscle strength status(MRC score),motor status(FAC rating),and self-care ability(BI index score).Results:The treatment efficiency of patients in the observation group patients was higher as compared to those in the control group(P<0.05).There was no significant difference in the comparison of the results of the scores(ratings)of each index between the two groups before treatment(P>0.05).After the treatment,the APACHEⅡscores of patients in the observation group were significantly lower as compared to those in the control group,while the MRC scores,FAC ratings,and BI index scores were higher in the observation group than those of the control group patients(P<0.05).Conclusion:The combined application of Yiqi Huoxue decoction and neuromuscular electrical stimulation in the treatment of patients with ICU-acquired neurasthenia complicated by mechanical ventilation significantly enhanced the clinical efficacy,the patient’s muscle strength,motor status,and ability of self-care.Hence,it has high application value and is worthy to be popularized.

Yiqi Huoxue Decoction attenuates ischemia/hypoxia-induced oxidative stress injury in H9c2 cardiomyocytes

Objective:Yiqi Huoxue Decoction (YQHX) has been widely used for clinical treatment of ischemic heart disease.While oxidative stress plays a key role in the pathogenesis of ischemic heart disease,the function and molecular mechanism underlying antioxidative protective effects of YQHX on H9c2 cardiomyocytes against ischemia/hypoxia (I/H) have yet to be well clarified.Methods:H9c2 cells were subjected to 12 h of hypoxia with serum-free conditions and then treated with or without YQHX (100-400 μg/mL).Cell viability was examined using a CCK-8 assay.Maleic dialdehyde (MDA) and superoxide dismutase (SOD) activity were detected using commercial kits.Intracellular reactive oxygen species (ROS) levels and mitochondrial membrane potential were measured using fluorescence microscopy and confocal laser-scanning microscopy,respectively.Ultrastructural details of mitochondria in H9c2 cells were observed using transmission electron microscopy.The antioxidative protective pathway was assessed by measuring mRNA and protein expression of Nrf2 and HO-1,as well as AMPK activation.Results:I/H injury gradually induced oxidative stress.Treatment with YQHX significantly increased cell viability and reversed I/H-induced oxidative stress,including reducing the production of oxidative stress products (ROS and MDA),increasing SOD levels,improving mitochondrial morphology,and increasing mitochondrial membrane potential.YQHX was also observed to increase I/H-induced expression of Nrf2 and HO-1,and the activation effects of YQHX were blocked by an AMPK inhibitor.In addition,HPLC analysis showed that YQHX contained two active antioxidative constituents (calycosin and ferulic acid).Conclusion:The results suggest that anti-oxidative effects exerted by YQHX in H9c2 cardiomyocytes may be linked to upregulation of the AMPK-mediated Nrf2/HO-1 pathway.

Effect of sitagliptin combined with Yiqi yangyin huoxue decoction on clinical efficacy and hemorheology in early diabetic nephropathy

BACKGROUND Early diabetic nephropathy(DN)is a complication of diabetes mellitus.It mainly affects kidney microvessels and glomerular function,and its timely and effective treatment is critical for early DN.However,the effects of treatments comprising simple Western medicine are not optimal.With the promotion and implementation of integrated Chinese and western medicine treatments,remarkable results have been achieved for many diseases.To this end,we explored the clinical efficacy of integrated traditional Chinese and western medicines for the treatment of early DN.AIM To investigate the effect of sitagliptin tablets combined with Yiqi yangyin huoxue decoction on clinical efficacy and hemorheology in patients with early DN.METHODS Through a retrospective analysis,123 patients with early DN were admitted to the endocrinology clinic of the Changzhou NO.7 People’s Hospital from January 2021 to October 2022 and were selected as study subjects.After rigorous screening,100 patients with early DN were enrolled.The control group(CG,n=50)and the observation group(OG,n=50)were divided according to the treatment method.The CG were treated with sitagliptin,and the OG were treated with sitagliptin plus the Yiqi yangyin huoxue decoction.Both groups were treated for 3 mo.For both groups,the baseline data and clinical efficacy were compared,and changes in blood glucose levels,lipid levels,renal function,and hematological indicators before(T0)and after(T1)treatment were assessed.RESULTS The total effective rate for the OG was 94.00%and that of the CG was 80.00%(P<0.05).After treatment(T1),the levels of fasting blood glucose,2 h postprandial glucose,total cholesterol,triacylglycerol,and low-density lipoprotein cholesterol in OG patients were obviously lower than those in the CG(P<0.05),and cystatin C,homocysteine,urinary microalbumin,and blood creatinine values in OG patients were also obviously lower than those in the CG(P<0.05);erythrocyte deposition,plasma viscosity,whole blood high shear viscosity,and whole blood low shear viscosity were markedly lower in OG patients than in the CG(P<0.05).CONCLUSION Sitagliptin combined with Yiqi yangyin huoxue decoction has a remarkable effect when used to treat patients with early DN.Further,it is helpful in improving hemorheological indices and controlling disease progression.

Yiqi Huoxue Decoction modifies the expression of myocardial cytoskeleton-associated proteins by regulating the AMPK signaling pathway in H9c2 cells exposed to hypoxic conditions

Background:In myocardial ischemia,hypoxia leads to destruction of the cytoskeleton,and especially the imbalance of microtubule polymerization-depolymerization,which seriously affects the structure and function of cardiomyocytes.We previously showed that a Yiqi Huoxue Decoction (YQHX) improves mitochondrial function and decreases anti-oxidative effects in hypoxia-induced H9c2 cell injury.Therefore,in this study we investigated whether YQHX protects against hypoxia-induced damage by decreasing damage to the cardiac cytoskeleton.Methods:After reaching 70%-80% confluence,H9c2 cells were synchronized in serum-free Dulbecco's Modified Eagle Medium for 6 hours,then divided into control,model,and YQHX (100,200,400 μg/mL) groups,which were then grown in a hypoxic atmosphere for 12 hours.Cardiac cell viability was assessed using an xCELLigence system.The levels of lactate dehydrogenase,maleic dialdehyde,and superoxide dismutase in H9c2 cell supernatants were measured.Hoechst 33258 staining was employed to observe cardiac cell apoptosis.Confocal microscopy,immunofluorescence,and western blot analysis were performed to evaluate the protective effects of the YQHX against hypoxia-induced injury in the H9c2 cell line.Results:Cells that were pretreated with YQHX were more able to maintain their microtubule structure in the early stages of hypoxia and had better myocardial fitness in response to hypoxia compared with cells that were not pretreated.However,hypoxia-induced upregulation of α-tubulin and β-tubulin expression antagonized the protective effect of YQHX (100 μg/mL).In addition,YQHX (100 μg/mL) treatment significantly upregulated MAP4 protein expression (P =.003) and downregulated p-AMPKα protein expression (P <.001) compared with the model group.Conclusion:The results indicate that YQHX plays a role in protecting against oxidative stress injury and apoptosis in H9c2 cells.Notably,our results suggested that the YQHX could mitigate the damage to the cardiac cytoskeleton and the dysregulation of AMPK-related protein signaling pathways that are induced by hypoxia.

Serum proteomic approach in patients with Qi deficiency and blood stasis syndrome in coronary heart disease:to explore therapeutic mechanism of Yiqi Huoxue decoction

OBJECTIVE To explore the curative effect and mechanism of Yiqi Huoxue decoction in the treatment of coronary heart disease with Qi deficiency and blood stasis syndrome.METHODS The patients with coronary heart disease of Qi deficiency and blood stasis syndrome were treated with Yiqi Huoxue decoction for 3 months,and the changes of cardiac function were observed.61 serum samples(including 29 cases of disease group and 32 cases of Yiqi Huoxue expression group)were analyzed by non labeled proteomics.The disease group was used as the control group,and the protein with expression level difference of more than 1.2 folds(P<0.05)was screened.The molecular function,biological pathway and protein interaction of the different proteins were analyzed by bioinformatics,so as to identify the molecular and biological pathway of Yiqi Huoxue decoction in the treatment of coronary heart disease with Qi deficiency and blood stasis syndrome.RESULTS Clinical treatment found that Yiqi Huoxue decoction can improve TCM syndrome score and left ventricular ejection fraction,regulate blood glucose and blood lipid levels,prolong thrombin time,and improve heart function.The results of proteomic quantitative analysis showed that there were 69 proteins with different expression levels in the disease group.Bioinformatics analysis results showed that Yiqi Huoxue decoction may regulate ApoA1,alpha-2 and other proteins to act on HDL assembly,platelet degradation,PI3K Akt signaling pathway,and then play a therapeutic role in coronary heart disease with Qi deficiency and blood stasis syndrome.CONCLUSION Yiqi Huoxue decoction can effectively improved the heart function decline caused by Qi deficiency and blood stasis syndrome of coronary heart disease.It mainly act on energy metabolism and platelet activation pathway by activating HDL assembly and platelet degradation signal pathway proteins.This study can provide reference for the follow-up treatment mechanism of Qi deficiency and blood stasis syndrome of coronary heart disease.

Yiqi Huoxue Decoction in the treatment of Qi and yin deficiency and stasis type diabetic nephropathy in stageⅢ and its effect on VEGF and TGF-β1

Objective:To observe the efficacy of Yiqi Huoxue Decoction in the treatment of patients with diabetic nephropathy(DN)stageⅢwith qi and yin deficiency and stasis and its effects on vascular endothelial growth factor(VEGF)and transforming growth factor-β(TGF-β1).Methods:Sixty patients with stage DN of Qi-yin deficiency and stasis type DN who were treated in the Endocrinology Department of the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine from September 2018 to December 2019 were selected as the research subjects.The remainder method was used to divide them into 30 cases in the observation group and 30 cases in the control group.Patients in both groups were referred to the guidelines and expert consensus for general treatment of DN(hypogl-ycemic,antihypertensive,lipid-lowering,etc.).The control group was given pancreatic kallikrein enteric-coated tablets orally once,120U,3 times a day,and the observation group was given The traditional Chinese medicine Yiqi Huoxue Decoction was taken orally,one dose daily,twice a day in the morning and evening;the two groups intervened continuously for 8 weeks.Detect blood FPG,PBG,HbA1c,β2-MG,BUN,SCr,VEGF,TGF-β1,and urine mALB and UACR levels before and after treatment,and calculate eGFR before and after treatment in both groups;observe changes in TCM syndrome scores in the two groups,Compare its clinical efficacy.Results:After 8 weeks of treatment,the total clinical effective rate of patients in the observation group was 93.3%,which was significantly different from the control group of 76.6%(P<0.05);the TCM syndrome scores in the observation group were significantly lower than those before treatment and in the control group(P<0.05);The levels of FPG,HbA1c,PPG,mALB,β2-MG,UACR,VEGF,and TGF-β1 in the observation group were significantly lower than those in the control group,with significant differences(P<0.05).The levels of SCr and BUN in the observation group were significantly lower.Compared with before treatment,eGFR increased,but there was no signi-ficant difference(P>0.05).Conclusion:Yiqi Huoxue Decoction for the treatment of patients with DN typeⅢqi-yin deficiency and stasis type,not only helps to lower blood sugar levels,improve TCM syndromes,but also can reduce early renal damage,reduce urine albumin,and delay kidney function It may be further worsened and has better safety.The mechanism may be related to reducing the levels of VEGF and TGF-β1,thereby delaying the fibrosis of tubulointerstitial scar and inhibi-ting glomerular capillary sclerosis.

Efficacy and safety of Yiqi Huoxue Jiedu decoction for the treatment of advanced epithelial ovarian cancer patients: a double-blind randomized controlled clinical trial

OBJECTIVE:To further evaluate the complementary effect of Yiqi Huoxue Jiedu decoction(YHJD)on patients with advanced epithelial ovarian cancer(EOC).METHODS:All 330 enrolled participants diagnosed with stageⅢc EOC were randomly divided into two groups that received YHJD or a placebo.The primary end point was health-related quality of life(HRQL)measured by the functional assessment of cancer therapy-ovary cancer(FACT-O)questionnaire.The secondary end point was progression-free survival(PFS).RESULTS:A total of 299 participants completed the trial with 153 and 146 in YHJD and control groups,respectively.After 6 months of treatment,YHJD increased physical wellbeing(PWB),functional wellbeing(FWB),additional concerns(AC),and the trial outcome index(TOI)(P<0.05)by various degrees compared with the baseline.YHJD also had notable advantages over the placebo at 3 and 6 months in terms of PWB,FWB,AC(P<0.05),and TOI(P<0.01).In addition,YHJD had a significant advantage in terms of PFS compared with the placebo(21 vs18 months,P<0.05).No adverse events were reported.CONCLUSION:YHJD is an effective and safe choice as a complementary therapy to improve HRQL and prolong PFS of stageⅢc EOC patients.

Effects of Bushen Yiqi Huoxue Decoction in Treatment of Patients with Diminished Ovarian Reserve:A Randomized Controlled Trial

Objective:To explore the therapeutic effect of Bushen Yiqi Huoxue Decoction BYHD)in patients with diminished ovarian reserve(DOR).Methods:A total of 180 patients with DOR diagnosed from December2013 to December 2014 were equally assigned into progynova and duphaston(E+D)group,Zuogui Pill group and BYHD group with 60 cases in each by computerized randomization.Patients received E+D,Zuogui Pill or BYHD for 12 months,respectively.Follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E_(2)),anti-Mullerian hormone(AMH),antral follicle count(AFC),ovarian volume,endometrial thickness,and the resistance indices(Rls)of ovarian arteries and uterine arteries were observed before and after treatment.Results:Nine women(4 from the E+D group,3 from the Zuogui Pill group,and 2 from the BYHD group)withdrew from the study.After 6 months,Zuogui Pill and BYHD significantly decreased FSH and LH and increased endometrial thickness and AMH(all P<0.01),BYHD also resulted in E2 elevation(P<0.05),ovary enlargement(P<0.05),AFC increase(P<0.01),and RI of ovarian arteries decrease(P<0.05).After 12 months,further improvements were observed in the Zuogui Pill and BYHD groups(all P<0.01),but BYHD showed better outcomes,with lower FSH,larger ovaries and a thicker endometrium compared with the Zuogui Pill group(all P<0.01).However,E+D only significantly increased endometrial thickness(P<0.01)and no significant improvements were observed in the RI of uterine arteries in the three groups.Conclusions:BYHD had a favorable therapeutic effect in patients with DOR by rebalancing hormone levels,promoting ovulation,and repairing the thin endometrium.The combination of tonifying Shen(Kidney),benefiting qi and activating blood circulation may be a promising therapeutic strategy for DOR.

Multiple Pharmacological Actions of Yiqi Huatan Decoction(益气化痰方) in A Model of Depression in Rats

Objective： To investigate the influence of Yiqi Huatan Decoction （益气化痰方, YHD） on a model of depression in rats under different pathological conditions. Methods： Thirty-two male SD rats were randomly divided into 4 groups of 8： normal, model, YHD, and maprotiline. The model group, YHD group and maprotiline group used separate feeding and rats were exposed to chronic and unpredictable stress to build the depression model. From day 2, the YHD group and maprotiline group were respectively given YHD （7 g/kg） and maprotiline （10 mg/kg） by gastrogavage once daily. The normal and model groups were given the same volume of drinking water. The medication duration were 21 days. At the end of the experiment, the serum levels of copper and zinc were determined by atomic absorption spectroscopy, plasma concentrations of adrenocorticotropic hormone （ACTH） and cortisol （COR） were detected by radioimmunoassay, and levels of norepinephrine （NE）, dopamine （DA）, and 5-hydroxytryptamine （5-HT） in the hypothalamus were analysed by high performance liquid chromatography-eletricochemistry. Results： Compared with the content of copper and zinc in the serum of rats in the normal group, serum copper levels in model rats were significantly increased and zinc content was significantly reduced （both P〈0.05）. Plasma concentrations of ACTH and COR in the model group were significantly increased compared with those in the normal group （P〈0.05, P〈0.01）. The contents of NE, DA, and 5-HT in the hypothalamus of rats in the model group were significantly reduced compared with those of the normal group （P〈0.05 or P〈0.01）. Compared with those in the model group, the serum copper content and plasma concentrations of ACTH and COR were significantly decreased （all P〈0.05）; meanwhile, serum zinc content and hypothalamic contents of NE, DA, and 5-HT were significantly increased in rats of the YHD group （all P〈0.05）. The same effects were also shown in the maprotiline group except for 5-HT （all P〈0.05）. Conclusion： The pharmacological actions of YHD for depression might be related to improving trace-element anomalies, reversing endocrine dysfunction, and modulating the disorders of monoaminergic neurotransmitters.

益气活血通络方对脊髓型颈椎病模型大鼠miR-126a-5p及VEGF信号通路的影响

目的探讨益气活血通络方对脊髓型颈椎病模型大鼠微小RNA-126a-5p(miR-126a-5p)及血管内皮生长因子(VEGF)信号通路的影响。方法30只健康雄性SD大鼠按照随机数字表法均分为假手术组、模型组和中药组。模型组、中药组均制备脊髓型颈椎病模型。中药组给予益气活血通络方灌胃,假手术组、模型组给予生理盐水灌胃,均为12周。各组干预结束后进行大鼠行为学测试,测定机械性刺激阈值和热刺激回缩时间。处死大鼠,HE染色观察各组椎间盘软骨终板结构的差异。TUNEL染色观察大鼠椎间盘纤维环细胞变化。实时荧光定量聚合酶链式反应检测大鼠椎间盘纤维环组织miR-126a-5p和VEGF mRNA。采用Western blot法检测大鼠椎间盘纤维环组织VEGF蛋白表达。结果与假手术组比较,模型组大鼠椎间盘血管芽数目减少,大鼠椎间盘纤维环细胞破坏明显、大量凋亡且细胞密度降低;模型组和中药组机械性刺激阈值降低,热刺激回缩时间缩短,miR-126a-5p水平降低,VEGF mRNA和蛋白表达水平升高(P<0.05)。与模型组比较,中药组大鼠椎间盘血管芽数目增加,大鼠椎间盘纤维环细胞破坏减轻,大鼠椎间盘纤维环细胞凋亡减少且细胞密度增加,机械性刺激阈值升高,热刺激回缩时间延长,miR-126a-5p水平增加,VEGF mRNA和蛋白表达水平降低(P<0.05)。结论益气活血通络方治疗脊髓型颈椎病的机制可能与上调miR-126a-5p、下调VEGF表达有关。

补肾化痰活血方治疗多囊卵巢综合征合并胰岛素抵抗不孕症的临床研究

[目的]观察补肾化痰活血方治疗多囊卵巢综合征合并胰岛素抵抗(PCOS-IR)不孕症的临床疗效。[方法]将62例肾虚痰瘀型PCOS-IR不孕症患者随机分为治疗Ⅰ组和治疗Ⅱ组,每组各31例。两组均给予基础干预,治疗Ⅰ组给予二甲双胍,治疗Ⅱ组给予补肾化痰活血方,治疗及随访周期均为3个月。统计两组的妊娠及排卵情况,比较两组治疗前后身体质量指数(BMI)、中医证候积分、糖代谢指标[空腹血糖(FBG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)]、性激素水平[睾酮(T)、促黄体生成素(LH)、促卵泡刺激素(FSH)、LH/FSH、雌二醇(E2)、催乳素(PRL)]、着床期(排卵后6~9 d)子宫内膜三维超声参数[厚度、分型、容积、血管化指数(VI)、血流指数(FI)、血管化-血流指数(VFI)]和不良反应。[结果]与治疗前比较,治疗后两组的BMI、中医证候积分、FINS、HOMA-IR、LH、LH/FSH水平均降低(P<0.01或P<0.05),且治疗Ⅱ组的中医证候积分降低显著(P<0.01)。与治疗Ⅰ组比较,治疗Ⅱ组的周期排卵率较高,但比较后差异无统计学意义(P>0.05),着床期子宫内膜血流参数VI、VFI水平较高(P<0.05)。治疗结束及随访后,治疗Ⅱ组的临床妊娠率分别为61.54%(16/26)和73.08%(19/26),明显高于治疗Ⅰ组对应时间节点的妊娠率[33.33%(8/24)和41.67%(10/24)],差异有统计学意义(P<0.05),且胚胎停育率更低(P<0.05)。治疗Ⅱ组的不良反应率显著低于治疗Ⅰ组(15.38%vs 41.67%,P<0.05)。[结论]补肾化痰活血方治疗肾虚痰瘀型PCOS-IR不孕症临床效果良好,能够改善胰岛素抵抗及肥胖体征,调节内分泌紊乱,显著增加着床期子宫内膜血流灌注,提高临床妊娠率并改善妊娠结局,且不良反应小,值得推广应用。

益气活血汤治疗不稳定型心绞痛老年患者的疗效及对其血流动力学和心电图的影响

目的探究益气活血汤对不稳定型心绞痛(Unstable angina pectoris,UAP)老年患者的疗效及对其血流动力学和心电图的影响。方法选取2019年5月-2022年6月期间大连市友谊医院老年医学中心老年病科收治的92例UAP老年患者,按随机数字表法分为对照组和观察组,每组各46例。对照组给予常规治疗,观察组在对照组基础上给予益气活血汤治疗,均持续治疗4周。观察比较两组患者临床疗效、心电图改善情况,治疗前后血脂[总胆固醇(Total cholesterol,TC)、甘油三酯(Triglyceride,TG)、高密度脂蛋白胆固醇(High density lipoprotein cholesterol,HDL-C)、低密度脂蛋白胆固醇(Low density lipoprotein cholesterol,LDL-C)]水平、血流动力学(全血还原黏度、纤维蛋白原、红细胞聚集指数、血浆黏度)指标及不良反应发生情况。结果治疗后观察组临床总有效率91.30%(42/46)明显高于对照组73.91%(34/46),差异有统计学意义(P<0.05)。治疗后两组患者血脂TC、TG、LDL-C水平均较治疗前降低,HDL-C水平较治疗前升高,差异有统计学意义(P<0.05);且观察组TC、TG、LDL-C水平均明显低于对照组,HDL-C水平明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者全血还原黏度、红细胞聚集指数、纤维蛋白原、血浆黏度均较治疗前降低,差异有统计学意义(P<0.05);且观察组血流动力学指标明显低于对照组,差异有统计学意义(P<0.05)。治疗后观察组心电图改善总有效率86.96%(40/46)明显高于对照组67.39%(31/46),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)。结论益气活血汤治疗老年UAP的疗效显著,可有效改善患者血流动力学指标和心电图情况。

益气活血汤联合乌司他丁治疗脓毒症心肌病的单中心随机对照研究

目的:分析益气活血汤联合乌司他丁治疗脓毒症心肌病(SC)的效果。方法:选择2022年1月—2024年3月廉江市人民医院收治的60例SC患者作为研究对象,依照随机数字表法分两组,各30例。对照组予以常规治疗,研究组在对照组基础上予以益气活血汤联合乌司他丁治疗。比较两组治疗效果、心功能指标[左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、心脏指数(CI)]、心肌损伤指标[心肌肌钙蛋白I(cTnI)、N-末端B型利钠肽前体(NT-proBNP)、肌酸肌酶同工酶(CK-MB)]、急性生理与慢性健康状况Ⅱ(APACHEⅡ)评分、炎症因子水平[白细胞介素-6(IL-6)、白细胞介素-10(IL-10)]及患者转归情况。结果:研究组治疗总有效率高于对照组(P<0.05)。治疗1 d后,两组心肌损伤指标、心功能指标、APACHEⅡ评分、IL-6、IL-10比较,差异均无统计学意义(P>0.05);治疗7、10 d后,研究组LVEF、CI均高于对照组,LVEDD、cTnI、NT-proBNP、CK-MB、IL-6、IL-10均低于对照组(P<0.05);治疗10 d后,研究组APACHEⅡ评分低于对照组(P<0.05)。结论:益气活血汤联合乌司他丁治疗效果显著,可改善患者心肌损伤、心功能指标及炎症因子水平,降低死亡率,并缩短住院时间。

基于网络药理学探讨益气化痰活血方治疗甲状腺功能减退症的作用机制

目的:基于网络药理学探讨益气化痰活血方治疗甲状腺功能减退症的作用机制。方法:采用中药系统药理学数据库与分析平台(TCMSP)、化学专业数据库、本草组鉴平台筛选出益气化痰活血方的活性成分,利用Swiss Target Prediction数据库预测活性成分的潜在靶点。利用Gene Cards数据库、Dis Ge NET数据库和在线人类孟德尔遗传数据库(OMIM)检索甲状腺功能减退症的相关靶点。利用STRING数据库对药物与疾病交集靶点进行蛋白质-蛋白质相互作用网络构建,获得益气化痰活血方治疗甲状腺功能减退症的关键靶点。利用Metascape对关键靶点进行京都基因与基因组百科全书(KEGG)信号通路与基因本体论(GO)功能富集分析。结果:得到药效成分46个、药物靶点266个、甲状腺功能减退症靶点1 294个,最终获得关键靶点69个、KEGG通路2条。益气化痰活血方治疗甲状腺功能减退症主要成分为槲皮素、β-谷甾醇、山柰酚等,关键靶点为白细胞介素(Interleukin,IL)-6、IL-10、肿瘤坏死因子(Tumor Necrosis Factor,TNF)、丝氨酸/苏氨酸蛋白激酶(Akt Serine/Threonine Kinase,Akt)、血管内皮生长因子A(Vascular Endothelial Growth Factor A,VEGFA),关键的信号通路可能包括磷脂酰肌醇3激酶-蛋白激酶B(Phosphatidylinositol 3-kinase-Akt,PI3K-Akt)信号通路、晚期糖基化终末产物-糖基化终末产物受体(AGE-RAGE)信号通路等。结论:本研究初步揭示了益气化痰活血方多成分、多靶点、多途径治疗甲状腺功能减退症的机制,为益气化痰活血方的临床开发利用提供了依据。

健脾益气活血汤治疗2型糖尿病合并骨质疏松的疗效

目的探讨健脾益气活血汤治疗2型糖尿病(type 2 diabetes mellitus,T2DM)合并骨质疏松的疗效。方法选取100例河北省沧州中西医结合医院收治的T2DM合并骨质疏松患者,分为对照组(50例)和研究组(50例),分组方法为随机数字表法,选例时间设置在2022年1月—2022年10月。对照组接受常规西医方案治疗,研究组在对照组的基础上接受健脾益气活血汤治疗,两组患者连续治疗6个月。比较两组治疗后临床疗效,治疗前后骨代谢指标、腰椎、双髋部骨密度、疼痛程度、中医症状积分以及血糖指标。结果治疗后,研究组总有效率高于对照组;治疗后与治疗前比较,两组血清总Ⅰ型胶原氨基端延长肽(peptide of type I collagen,PINP)、β胶原降解产物(β-collagen degradation product,β-CTX)、I型胶原C末端肽(C-terminal peptide of type I collagen,CTX-1)、空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(2 h postprandial blood glucose,2 h PG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)水平、视觉模拟评分法(visual analogue scale,VAS)评分及各项中医症状积分降低,两组间治疗后相比,研究组更低;治疗后与治疗前比较,两组血清碱性磷酸酶(alkaline phosphatase,ALP)、护骨素(osteoprotegerin,OPG)及腰椎、双髋部骨密度水平升高,两组间治疗后相比,研究组水平更高,数据存在较显著的差异(P<0.05)。结论健脾益气活血汤治疗T2DM合并骨质疏松患者有助于缓解其临床症状,优化骨代谢指标,增加腰椎、双髋部骨密度,减轻疼痛,改善血糖指标,疗效显著。

益气通窍活血汤联合丁苯酞氯化钠注射液治疗老年急性脑梗死的临床研究

目的:观察益气通窍活血汤联合丁苯酞氯化钠注射液对老年急性脑梗死(ACI)患者的临床疗效,并观察该治疗方案对患者血管内皮功能和氧化应激的影响。方法:将河北以岭医院2020年8月—2022年8月收治的80例ACI患者以随机数字表法分为两组,对照组40例给予丁苯酞氯化钠注射液治疗,观察组40例给予益气通窍活血汤联合丁苯酞氯化钠注射液治疗。两组以1周为1个疗程,治疗2个疗程。比较两组疗效、中医证候积分、血管内皮功能及氧化应激水平变化。结果:观察组总有效率优于对照组(P<0.05);两组治疗后中医主症与次症评分、NIHSS评分均降低(P<0.05),观察组低于对照组(P<0.05);两组治疗后ADL评分、Fugl-Meyer评分均提高(P<0.05),观察组高于对照组(P<0.05);两组治疗后血清内皮素-1(ET-1)水平均降低,一氧化氮(NO)水平均提高,观察组ET-1水平低于对照组,NO水平高于对照组(P<0.05);两组治疗后髓过氧化物酶(MPO)水平均降低,超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)水平均提高(P<0.05),观察组MPO水平低于对照组,SOD、GSH-Px水平高于对照组(P<0.05)。结论:益气通窍活血汤联合丁苯酞氯化钠注射液治疗老年ACI可减轻患者临床症状,更好地恢复患者神经功能、生活自理能力及运动能力,减轻血管内皮损伤,纠正氧化应激状态,疗效显著,可供临床参考。

益气活血化痰汤治疗慢阻肺并呼吸衰竭临床观察

目的探讨益气活血化痰汤治疗慢性阻塞性肺疾病(简称慢阻肺)并呼吸衰竭的效果。方法选取2020年1月—2022年9月就诊于灌云县中医院中医内科的慢阻肺并呼吸衰竭患者64例。按治疗方法分入研究组与对照组,每组32例。对照组采取常规西药治疗方案,研究组在该方案基础上增加益气活血化痰汤。对2组中医证候积分、肺功能以及免疫功能指标予以比较。结果治疗后研究组主症与次症积分均低于对照组(P<0.05);研究组FVC、FEV_(1)以及FEV_(1)/FVC均大于对照组(P<0.05);研究组治疗后CD_(3)^(+)与CD_(4)^(+)以及CD_(4)^(+)/CD_8^(+)均高于对照组(P<0.05)。结论慢阻肺并呼吸衰竭治疗中增加益气活血化痰汤,可明显改善肺功能以及免疫功能,缓解症状与体征。

补阳还五汤对失神经肌萎缩大鼠自噬调控作用的实验研究

目的:探究补阳还五汤对失神经肌萎缩大鼠自噬的调控作用,阐明益气活血法对失神经肌萎缩的保护机制。方法:制备神经夹伤大鼠模型,实验分假手术组、模型组、弥可保组、补阳还五汤、补阳还五汤+LY294002,每组8只;各组大鼠每日灌胃给药,第18天取胫前肌计算湿重比并进行形态学观察,Western-blot检测胫前肌PI3K/PKB/mTOR(磷脂酰肌醇3-激酶/蛋白激酶/B/雷帕霉素靶蛋白)信号通路蛋白。结果:模型组大鼠胫前肌湿重比显著降低(P<0.05),而补阳还五汤组和弥可保组胫前肌湿重比显著提高(P<0.05),补阳还五汤+LY294002组胫前肌湿重比下降。形态学观察发现:模型组肌纤维横截面积减少,形态不规则,肌纤维结构紊乱,结缔组织增生较多,肌纤维明显萎缩变性。补阳还五汤组胶原纤维增生明显减少(P<0.05),形态较规则。补阳还五汤+LY294002组肌萎缩加重,胶原纤维明显增多。补阳还五汤组、弥可保组p-PI3K、p-PKB、mTOR蛋白相对表达量与模型组相比显著增加(P<0.05)。Atg5,Becline-1蛋白相对表达量显著降低(P<0.05);补阳还五汤+LY294002组p-PI3K、p-PKB、mTOR蛋白表达降低而Atg5,Becline-1蛋白表达升高。结论:益气活血法代表方——补阳还五汤可通过PI3K/PKB/mTOR通路抑制自噬-溶酶体系统过度激活,发挥失神经肌萎缩的保护作用。

养阴益气活血方治疗原发性干燥综合征患者的临床效果

目的探究养阴益气活血方治疗原发性干燥综合征患者的临床效果。方法选取2021年5月至2022年5月收治的100例原发性干燥综合征患者为研究对象,依据不同治疗方式将其分为对照组和观察组,各50例。对照组给予硫酸羟氯喹片治疗,观察组在对照组基础上联合养阴益气活血方治疗。比较两组的治疗效果。结果治疗后,观察组的焦虑自评量表(SAS)、抑郁自评量表(SDS)评分均低于对照组(P<0.05)。治疗后,观察组的社会关系、躯体、环境、心理维度评分均明显高于对照组(P<0.05)。治疗后,观察组的匹兹堡睡眠质量指数量表(PSQI)评分低于对照组(P<0.05)。治疗后,观察组的降钙素原(PCT)、超敏C反应蛋白(hs-CRP)、白细胞介素-18(IL-18)及白细胞介素-6(IL-6)水平均低于对照组(P<0.05)。治疗后,观察组的欧洲抗风湿联盟干燥综合征疾病活动度指数(ESSDAI)评分低于对照组(P<0.05)。观察组的治疗总有效率高于对照组(P<0.05)。结论养阴益气活血方治疗原发性干燥综合征的效果显著,可改善患者的心理状态、生活质量、睡眠质量、血清炎症因子水平及疾病活动度。

通腑益气活血汤配合肺泡灌洗治疗肺炎脓毒症的疗效及对患者T淋巴细胞亚群、线粒体损伤指数的影响

目的观察通腑益气活血汤配合纤支镜肺泡灌洗治疗肺炎脓毒症的疗效,并探讨其对患者T淋巴细胞亚群、线粒体损伤指数的影响。方法选取2020年1月至2023年1月河南省第二人民医院收治的92例肺炎脓毒症患者作为研究对象,按随机数表法分为观察组和对照组各46例。对照组患者予以纤支镜肺泡灌洗治疗,观察组患者予以通腑益气活血汤配合纤支镜肺泡灌洗治疗,均治疗2周。比较两组患者治疗2周后的疗效,及治疗前、治疗1周后、治疗2周后的中医证候积分、血气指标[经皮血氧饱和度(SpO_(2))、动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、肺功能[第1 s用力呼吸容积(FEV_(1))、FEV_(1)/用力肺活量(FVC)、第1秒用力呼气容积占预计值百分比(FEV_(1)%)]、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+))、线粒体损伤指数(CD3^(+)MDI、CD4^(+)MDI、CD8^(+)MDI)、临床肺部感染评分(CPIS)、Murray肺损伤评分(MLIS)及急性生理与慢性健康量表(APACHEⅡ)评分;随访2个月,统计两组患者的生存情况及CPIS、MLIS、APACHEⅡ评分。结果观察组患者的治疗总有效率为91.30%,明显高于对照组的76.09%,差异有统计学意义(P<0.05);治疗2周后,观察组患者的主症、次症积分及总积分明显低于对照组,差异均有统计学意义(P<0.05);治疗2周后,观察组患者的FEV_(1)、FEV_(1)%、FEV_(1)/FVC、PaO_(2)及SpO_(2)明显高于对照组,PaCO_(2)明显低于对照组,差异均有统计学意义(P<0.05);治疗2周,观察组患者的CD3^(+)、CD4^(+)明显高于对照组,CD8^(+)、CD3^(+)MDI、CD4^(+)MDI、CD8^(+)MDI明显低于对照组,差异均有统计学意义(P<0.05);治疗2周后,观察组患者的MLIS、CPIS及APACHEⅡ评分明显低于对照组,差异均有统计学意义(P<0.05);随访2个月,观察组患者的生存率为95.95%,略高于对照组的89.13%,但差异无统计学意义(P>0.05),而观察组患者的MLIS、CPIS及APACHEⅡ评分明显低于对照组,差异均有统计学意义(P<0.05)。结论通腑益气活血汤配合纤支镜肺泡灌洗应用于肺炎脓毒症,可有效调节患者的血气与免疫功能,缓解临床症状,减轻肺损伤、改善肺功能,临床应用效果显著。