Pulsed cold plasma-induced blood coagulation and its pilot application in stanching bleeding during rat hepatectomy

This paper presents plasma-induced blood coagulation and its pilot application in rat hepatectomy by using a home-made pulsed cold plasma jet. Experiments were conducted on blood coagulation in vitro, the influence of plasma on tissue in vivo, and the pilot application of rat hepatectomy. Experimental results show that the cold plasma can lead to rapid blood coagulation. Compared with the control sample, the plasma-induced agglomerated layer of blood is thicker and denser, and is mostly composed of broken platelets. When the surface of the liver was treated by plasma, the influence of the plasma can penetrate into the liver to a depth of about 500 μm. During the rat hepatectomy, cold plasma was proved to be effective for stanching bleeding on incision. No obvious bleeding was found in the abdominal cavities of all six rats 48 h after the hepatectomy. This implies that cold plasma can be an effective modality to control bleeding during surgical operation.

Hemostasis Efficacy and Mechanism of Cold Atmospheric Air Plasma

The capacity of a cold atmospheric-pressure air plasma (CAAP) device for advanced first aid is presented. Using swine as an animal model, two trials: 1) a large, curved cut in hindquarters area and 2) amputation of a front leg, were performed. Cold atmospheric-pressure air plasma effluent, which carries reactive oxygen species (ROS) atomic oxygen (OI), is applied for wound treatments. Swift hemostasis of the wounds by the CAAP treatment was demonstrated. The pressure applied by a finger on the cut arteries in trial 1 and the tourniquet applied in trial 2 could be removed immediately after the treatment and there was no re-bleed in both cases. CAAP hemostasis mechanism was explored via in-vitro tests. The tests on sodium citrate mixed blood-droplet samples show that 1) the heat delivered by the CAAP has no impact on the observed clot formation, 2) plasma effluent activates platelets to promote coagulation state and cascade, and 3) the degree of clotting increases with the total amount of applied OI by means of the CAAP effluent. It took only 16 s of the CAAP treatment to reach full clotting, which was considerably shortened from the natural clotting time of about 25 minutes. The tests on smeared blood samples show that the reduction of the platelet count and the increase of RBC count are proportional to the amount of applied OI. A plausible CAAP hemostasis mechanism is concluded from the in vitro test results and the animal model trials.

The research idea of Xuebijing injection in influencing severe pneumonia-pulmonary fibrosis with blood stasis syndrome evolution by inhibiting inflammation, endotoxin and dispersing blood stasis

Severe pneumonia is one of the most serious infectious diseases.Delayed intervention may lead to pulmonary fibrosis,which greatly threatens people’s life and health.Blood stasis syndrome is an important underlying syndrome throughout the evolution of severe pneumonia-pulmonary fibrosis.Xuebijing injection(XBJ)was developed under the theoretical system of“Three syndromes and three methods”,demonstrating a good efficacy in treating severe pneumonia and pulmonary fibrosis due to its effect of removing blood stasis and dispersing toxins.Previous studies have shown that XBJ can protect vascular endothelial function,improve coagulation function and regulate immunity by inhibiting inflammatory.Hence,the research hypothesis is put forward that XBJ treats blood stasis syndrome by removing blood stasis and dredging blood vessels,to inhibit the disease progress of severe pneumonia to pulmonary fibrosis.Further researches are need to confirm the function and explore the mechanism of XBJ.

武权生基于周期疗法治疗寒凝血瘀型子宫腺肌症痛经临床经验

介绍武权生教授运用周期疗法治疗寒凝血瘀型子宫腺肌症痛经的临床经验。武权生教授认为该病本质在于寒凝经脉胞宫致使气血运行不畅,其病机为寒凝阻滞、血瘀于内、日久成癥,治疗应当结合女性月经周期阴阳消长规律,结合中医周期疗法,分期论治。经期予以少腹逐瘀汤祛瘀散寒、养血通经以治标;经后期予以温肾暖宫方补气养血、温肾健脾以固本,辨证施治,达到标本兼治之效。本文将结合一则临床医案以探讨武教授运用周期疗法治疗寒凝血瘀型子宫腺肌症痛经的临床经验。

基于NLRP3/NF-κB/COX-2信号通路探讨痛经胶囊对原发性痛经大鼠的影响

目的:探讨痛经胶囊对原发性痛经大鼠NLRP3/NF-κB/COX-2信号通路的影响及相关作用机制。方法:选取成年健康清洁级SD雌性未孕且未交配大鼠60只,均处于动情间期。对实验动物进行分组处理,一共分为六组,每组分配动物10只,分组方法为随机数字表法,所分研究小组分别为:正常对照组、模型组、布洛芬胶囊组、痛经胶囊高剂量组、痛经胶囊中剂量组、痛经胶囊低剂量组。除空白组外,其余组建立寒凝血瘀痛经模型。正常对照组每日灌胃蒸馏水(1 ml/100 mg),模型组给予蒸馏水(1 ml/100 g)灌胃,痛经胶囊低、中、高剂量给予相应剂量灌胃,布洛芬胶囊组给予布洛芬胶囊(0.06 g/kg)灌胃,连续灌胃7 d。观察各组大鼠扭体反应次数;苏木精-伊红(HE)染色观察子宫病理情况;酶联免疫吸附测定法(ELISA)检测前列腺素F2α(PGF2α)、前列腺素F2(PGF2)含量;蛋白免疫印迹法检测大鼠子宫组织NLRP3、NF-κB、COX-2蛋白表达;实时荧光定量PCR(RT-PCR)检测大鼠子宫组织NLRP3、NF-κB、COX-2 mRNA表达情况。结果:与对照组相比,模型组大鼠扭体次数、PGF2α、OT水平增加(P<0.001),PGE2水平下降(P<0.001),子宫腺轻度扩张,可见粒细胞、淋巴细胞浸润,子宫组织中COX-2、NF-κB、NLRP3蛋白相对表达量明显上调(P<0.001),COX-2、NF-κB、NLRP3 mRNA水平明显上调(P<0.001);与模型组相比,各治疗组大鼠扭体次数、PGF2α、OT水平显著降低(P<0.05,P<0.01或P<0.001),PGE2水平显著上升(P<0.05,P<0.01或P<0.001),子宫结构清晰,内膜完整,无明显腺体肥大、子宫肌层增生,炎性浸润减少,COX-2、NF-κB、NLRP3蛋白相对表达量下调(P<0.05,P<0.01或P<0.001),COX-2、NF-κB、NLRP 3 mRNA水平下调(P<0.05,P<0.01或P<0.001)。结论:痛经胶囊可以改善子宫炎症细胞浸润的情况,通过调控NLRP3/NF-κB/COX-2信号通路调节痛经大鼠炎症反应从而起到镇痛作用。

基于GnRH及其受体介导下丘脑-垂体-卵巢轴探讨温和灸干预妇科寒凝血瘀证作用机制

目的观察温和灸“气海”“关元”“中极”对妇科寒凝血瘀证模型大鼠促性腺激素释放激素(GnRH)及其受体的影响,探讨艾灸干预妇科寒凝血瘀证生殖功能的作用机制。方法将48只雌性SD大鼠随机分为空白组、模型组、艾灸组、抑制剂组、抑制剂+艾灸组和激动剂组,每组8只。采用冰水浴+肾上腺素注射法制备妇科寒凝血瘀证模型,各干预组造模同时分别予GnRH抑制剂/激动剂注射及温和灸干预。对大鼠进行症状评分,激光散斑检测在体子宫微循环血流灌注量,HE染色观察卵巢、子宫组织形态,ELISA检测血清生殖激素GnRH、卵泡刺激素(FSH)、黄体生成素(LH)及神经递质多巴胺(DA)、γ-氨基丁酸(GABA)含量,免疫组化染色、RT-qPCR、Western blot检测卵巢、子宫组织GnRH受体(GnRHR)、FSH受体(FSHR)、LH受体(LHR)mRNA和蛋白表达。结果与空白组比较,模型组大鼠症状评分明显升高,子宫微循环血流灌注量减少,卵泡减少,子宫内膜上皮变薄、结构混乱;血清GnRH、FSH、LH、GABA含量降低,DA含量升高;卵巢组织GnRHR、FSHR、LHR mRNA和蛋白表达下降(P<0.01)。与模型组比较,各干预组大鼠症状评分降低,子宫微循环血流灌注量增加,卵泡增多,子宫内膜增厚、腺体增多;血清GnRH、FSH、LH、GABA含量升高,DA含量降低;卵巢组织GnRHR、FSHR、LHR mRNA和蛋白表达升高(P<0.05,P<0.01)。结论艾灸可通过调节神经递质调控GnRH及其受体,改善下丘脑-垂体-卵巢轴功能,从而改善妇科寒凝血瘀证模型大鼠一般状态,提高生殖功能。

温经活血汤联合布洛芬治疗原发性痛经临床研究

目的:观察温经活血汤联合布洛芬治疗原发性痛经的效果及对前列腺素F2α(PGF2α)、内皮素-1(ET-1)的影响。方法:选取2021年3月—2023年3月苍南县中医院收治的80例原发性痛经患者作为研究对象,按随机数字表法分为中医组和西医组各40例。西医组给予布洛芬治疗,中医组在西医组的基础上给予温经活血汤治疗,2组均持续治疗6个月经周期。评价2组临床疗效,比较2组治疗前后中医证候评分、PGF2α、ET-1水平及生活质量评分,统计不良反应发生情况。结果:2组总有效率比较,差异无统计学意义(P>0.05);中医组愈显率高于西医组(P<0.05)。治疗后,2组各项中医证候评分较治疗前降低(P<0.05),且中医组各项中医证候评分低于西医组(P<0.05)。治疗后,2组PGF2α、ET-1水平较治疗前降低(P<0.05),且中医组PGF2α、ET-1水平低于西医组(P<0.05)。治疗后,2组生存质量量表(WHOQOLBREF)各维度评分较治疗前升高(P<0.05),且中医组WHOQOL-BRFF量表各维度评分高于西医组(P<0.05)。2组均未出现恶心、呕吐、皮疹、头晕等不良反应。结论:温经活血汤联合布洛芬能够有效缓解原发性痛经患者的临床症状,降低患者疼痛程度,从而提高患者生活质量。

芪蛭三七汤辅助西药治疗胸痹心痛气虚血瘀证的临床效果

目的:探讨芪蛭三七汤辅助西药治疗胸痹心痛气虚血瘀证的临床效果。方法:选取2022年1月—2024年1月南京中医药大学附属苏州市中医医院收治的86例胸痹心痛气虚血瘀证患者作为研究对象,按随机数表法将患者分为对照组与观察组,各43例。对照组给予常规西医治疗,观察组在对照组基础上给予芪蛭三七汤治疗。比较两组临床疗效、中医症候评分、凝血指标、心功能及不良反应。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05);治疗后,两组胸闷、胸痛、心悸、气短、神倦乏力评分低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)长于治疗前,观察组长于对照组,两组纤维蛋白原(FIB)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,两组左室射血分数(LVEF)高于治疗前,且观察组高于对照组,两组左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)短于治疗前,且观察组短于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:芪蛭三七汤辅助西药治疗胸痹心痛气虚血瘀证患者可缓解症状,改善凝血功能,促进心功能改善,安全可靠。

丹芪益肾方对糖尿病肾病患者临床疗效及肾保护作用机制研究

【目的】观察丹芪益肾方对糖尿病肾病(DN)的治疗效果,并分析其肾保护作用机制。【方法】将2021年10月至2023年4月广州中医药大学附属三亚中医院收治的150例DN气阴两虚夹瘀证患者按随机数字表法随机分成对照组和观察组,每组各75例。2组患者均给予饮食治疗、控制血糖、控制血压、降脂治疗以及并发症治疗等常规治疗,在此基础上,对照组给予注射用还原型谷胱甘肽静脉滴注治疗,观察组给予丹芪益肾方煎剂内服及肾区中药离子导入治疗。30 d为1个疗程,共治疗3个疗程。观察2组患者治疗前后中医证候积分、肾功能指标、肾脏血流动力学指标、凝血纤溶指标、血管内皮功能指标的变化情况。【结果】(1)中医证候积分方面,治疗后,2组患者的疲倦乏力、心悸气短、头晕耳鸣、自汗盗汗、心烦失眠、口渴喜饮等中医证候积分均较治疗前降低(P<0.01),且观察组的降低幅度均明显优于对照组(P<0.01)。(2)肾功能指标方面,治疗后,2组患者的血尿素氮(BUN)、血肌酐(SCr)、Ⅳ型胶原(CⅣ)、血浆层黏蛋白(LN)等肾功能指标均较治疗前改善(P<0.01),观察组的改善幅度均明显优于对照组(P<0.01)。(3)肾脏血流动力学指标方面,治疗后,2组患者肾主动脉(MRA)、叶间动脉(IRA)处的收缩期最大血流速度(Vsmax)、舒张期最低血流速度(Vdmin)均较治疗前升高(P<0.05或P<0.01),MRA处的阻力指数(RI)、搏动指数(PI),IRA处的RI以及观察组IRA处的PI均较治疗前降低(P<0.05或P<0.01),且观察组对MRA和IRA处Vsmax、Vdmin的升高幅度及对MRA和IRA处RI、PI的降低幅度均明显优于对照组(P<0.05或P<0.01)。(4)凝血纤溶指标方面,治疗后,2组患者的血浆凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、D-二聚体(D-D)和纤维蛋白原(FIB)等凝血纤溶指标均较治疗前改善(P<0.01),且观察组的改善幅度均明显优于对照组(P<0.01)。(5)血管内皮功能指标方面,治疗后,2组患者的血清血管生成抑制蛋白1(VASH-1)水平均较治疗前升高(P<0.01),血清血管内皮生长因子(VEGF)、内皮素1(ET-1)水平均较治疗前降低(P<0.01),且观察组对血清VASH-1水平的升高幅度及对血清VEGF、ET-1水平的降低幅度均明显优于对照组(P<0.01)。【结论】丹芪益肾方在DN气阴两虚夹瘀证患者中具有良好的临床应用效果,其可能通过改善患者凝血纤溶系统及血管内皮功能达到保护肾功能的作用。

真武汤治疗老年慢性心力衰竭临床研究

目的:比较真武汤治疗气虚血瘀型老年慢性心力衰竭和心肾阳虚型老年慢性心力衰竭的临床疗效。方法:根据中医辨证标准,选择53例气虚血瘀证患者为气虚血瘀组,55例心肾阳虚证患者为心肾阳虚组,两组患者均给予常规西医治疗及口服真武汤。比较两组患者的临床疗效及治疗前后中医证候积分、平均血压、心功能等级、6分钟步行试验(6 minute walk test,6MWT)、呼吸困难程度评分、心功能指标[左心室射血分数(left ventricular ejection fraction,LVEF)、左心室收缩末期内径(left ventricular end-systolic diameter,LVESD)和左心室舒张末期内径(left ventricular end diastolic diameter,LVEDD)]变化情况。结果:治疗前心肾阳虚组中医证候积分高于气虚血瘀组(P<0.05),两组患者治疗后中医证候积分低于本组治疗前(P<0.05),但两组患者治疗后比较,差异无统计学意义(P>0.05);两组治疗前后平均血压比较,差异均无统计学意义(P>0.05)。气虚血瘀组有效率为75.5%,心肾阳虚组有效率为90.9%,两组患者有效率比较,差异具有统计学意义(P<0.05)。治疗前心肾阳虚组6MWT小于气虚血瘀组(P<0.05),治疗后两组6MWT大于本组治疗前,且心肾阳虚组差值大于气虚血瘀组(P<0.05);两组治疗后Brog评分低于本组治疗前(P<0.05),但组间比较,差异无统计学意义(P>0.05)。两组患者治疗前NYHA心功能等级比较,差异无统计学意义(P>0.05),两组患者治疗后心功能等级较治疗前有所改善(P<0.05),但组间比较,差异无统计学意义(P>0.05)。治疗前,心肾阳虚组LVEF低于气虚血瘀组(P<0.05);治疗后心肾阳虚组LVEF高于气虚血瘀组,LVESD及LVEDD低于气虚血瘀组,但差异无统计学意义(P>0.05)。结论:真武汤治疗气虚血瘀型老年慢性心力衰竭和心肾阳虚型老年慢性心力衰竭,均可改善患者的临床症状和心功能,但心肾阳虚证患者的临床疗效优于气虚血瘀证。

Correlation of Platelet and Coagulation Function with Blood Stasis Syndrome in Coronary Heart Disease: A Systematic Review and Meta-Analysis

Objective To investigate the correlation of platelet and coagulation function with blood stasis syndrome(BSS)in coronary heart disease(CHD).Methods The protocol for this meta-analysis was registered on PROSPERO(CRD42019129452).PubMed,Excerpta Medica Database(Embase),the Cochrane Library,and China National Knowledge Infrastructure(CNKI)were searched from inception to 1st June,2020.Trials were considered eligible if they enrolled BSS and non-BSS(NBSS)patients with CHD and provided information on platelet and coagulation function.The platelet function,coagulation function,and fibrinolytic activity were compared between the BSS and NBSS groups.Forest plots were generated to show the SMDs or ESs with corresponding 95%CIs for each study.Subgroup analysis and sensitivity analysis were performed to explore potential sources of heterogeneity.Results The systematic search identified 1,583 articles.Thirty trials involving 10,323 patients were included in the meta-analysis.The results showed that mean platelet volume,platelet distribution width,platelet aggregation rate,platelet P selectin,fibrinogen,plasminogen activator inhibitor-1(PAI-1),thromboxane B2(TXB2),6-keto-prostaglandin F1alpha(6-keto-PGF1α),and TXB2/6-keto-PGF1αwere higher in the BSS group than in the NBSS group(P<0.05 or P<0.01).Activated partial thromboplastin time was lower in the BSS group than in the NBSS group in the acute phase of CHD(P<0.01).The R and K values in thromboelastography and tissue plasminogen activator(t-PA)and t-PA/PAI-1 were lower in the BSS group than in the NBSS group(all P<0.01).No difference was found in the results of platelet count,plateletcrit,maximum amplitude,von Willebrand factor,prothrombin time,thrombin time,international normalized ratio,etc.between groups.Conclusions Increased platelet function,hypercoagulability,and decreased fibrinolytic activity were found among CHD patients with BSS.

Moxibustion with different doses for primary dysmenorrhea of cold congelation and blood stasis type:A randomized controlled trial

Objective:To explore the clinical effect differences of moxibustion with different doses on primary dysmenorrhea with cold congelation and blood stasis type.Methods:A total of 60 patients of primary dysmenorrhea were randomized into an intensified dose group and a conventional dose group.All of the patients were treated with moxibustion.In the intensified dose group,the treatment was given three times daily(once every morning,afternoon and at bedtime successively) and during the trial,1 case was dropped out and 29 cases were included in the statistical analysis finally.In the conventional dose group,the treatment was given once daily and 1 case was dropped out during trial and 29 cases were included in the statistical analysis.The score of visual analogue scale(VAS) at the worst painful time point,the score of dysmenorrhea symptoms and recurrence rate were observed and compared before and after treatment in the patients between the two groups.The clinical therapeutic effects were observed in the two groups too.Results:VAS difference value(D-value) and dysmenorrhea symptoms D-valuebefore and after treatment in the intensified dose group were higher than those in the conventional dose group respectively(both P<0.05).The recurrence rate was 14.29% in the intensified dose group,lower than 42.31% in the conventional dose group,with the statistical significance(P<0.05).The total clinical effective rate was 96.55%in the intensified dose group,higher than 89.66% in the conventional dose group,with the statistical significance(P<0.05).Conclusion:Compared with the conventional dose moxibustion,moxibustion with intensified dose achieves satisfactory therapeutic effect on primary dysmenorrhea of cold congelation and blood stasis type.This therapy is low in recurrent rate and convenient in manipulation,thus it deserves to be promoted in clinical application.

Effects of different directions of moxibustion therapy on hemorheology in rats with blood stasis due to cold retention

Objective： To investigate the effects of different directions of moxibustion therapy on hemorheology in rat models with blood stasis due to cold retention. Methods： A total of 32 Wistar rats were randomly divided into 4 groups, based on the random digits table, including a normal group, a model group, a moxibustion along the meridian group, and a moxibustion against the meridian group, with 8 rats in each group. Except the normal group, the other 3 groups were used to make the rat models with blood stasis due to cold retention. Rats in the moxibustion along and against the meridian groups accepted moxibustion therapy in different directions on the trunk segment of the Bladder Meridian after successful modeling. Moxibustion for 10 min every day, and 7 d as a course of treatment. Two courses of treatment（a total of 14 d） were carried out. Quantitative score of signs and symptoms change was observed once a week, with a total of 7 times. Hemorheological indexes of rats were detected when the treatment finished. Results： The quantitative scores of signs and symptoms in the model, moxibustion along the meridian and against the meridian groups were significantly higher than those in the normal group after modeling（P〈0.05）. When the treatment finished, the quantitative score of signs and symptoms in the model group was significantly higher than that in the normal group（P〈0.05）; the quantitative scores of signs and symptoms of rats in the moxibustion along and against the meridian groups were significantly lower than that in the model group（P〈0.05）; the quantitative score of signs and symptoms in the moxibustion along the meridian group was significantly lower than that in the moxibustion against the meridian group（P〈0.05）; the whole blood viscosity and erythrocyte aggregation index in the model group were significantly higher than those in the normal group（P〈0.05）, however the increases of erythrocyte hematocrit and erythrocyte sedimentation rate were not obvious（P〈0.05）; whole blood viscosity and erythrocyte aggregation index in the moxibustion along and against the meridian groups were significantly lower than those in the model group（P〈0.05）, while there were no statistically significant differences between the moxibustion along the meridian group and moxibustion against the meridian group（P〈0.05）. Conclusion： Moxibustion along and against the meridian both showed different degrees of improvement for hemorrheology and symptoms of blood stasis due to cold retention. Improvement for symptoms of blood stasis due to cold retention was better in the moxibustion along the meridian group than that in the moxibustion against the meridian group. The influence on rat hemorrheology showed no significant difference between moxibustion along the meridian and moxibustion against the meridian.

温阳活血汤联合艾灸治疗寒凝血瘀型痛经临床研究

目的:探讨温阳活血汤联合艾灸治疗寒凝血瘀型痛经临床疗效。方法:选取原发性寒凝血瘀型痛经患者60例,将其随机分为两组,其中对照组单纯接受艾灸腰阳关治疗,观察组则接受艾灸腰阳关联合温阳活血汤治疗。观察两组治疗后临床疗效,同时进行痛经症状评分,在干预前、干预3个月经周期后采用VAS评分量表评估两组疼痛程度。另取血清以酶联免疫法检测白细胞介素-8(IL-8)、超敏C反应蛋白(hs-CRP)和肿瘤坏死因子-α(TNF-α)水平及前列腺素E2(PGE2)、神经生长因子(NGF)和前列腺素F2α(PGF2α)水平。结果:对照组和观察组总有效率分别为76.67%和93.33%,观察组明显高于对照组(P<0.05)。治疗后3个月,两组的痛经相关中医症状评分均显著低于治疗前,且观察组的症状评分均显著降低(均P<0.05);两组的疼痛视觉模拟评分(VAS)评分和COX痛经症状量表(CMSS)评分均降低,且与对照组相比,观察组的VAS评分和CMSS评分更低(均P<0.05)。治疗后,两组IL-8、hs-CRP、TNF-α、PGE2、NGF和PGF2α水平均较治疗前显著降低,与对照组比较,观察组水平降低更明显(均P<0.05)。观察组和对照组的不良反应发生率分别为6.67%和10.00%(P>0.05)。结论:温阳活血汤联合艾灸可降低IL-8、hs-CRP、TNF-α、PGE2、NGF和PGF2α水平,改善患者痛经症状。

Effect of blood stasis caused by cold on the gut microbiota of endometriosis mice

Objective To observe the effect of blood stasis caused by cold on the gut microbiota and lipopolysaccharides(LPS)content in abdominal cavity of C57 BL/6 mice with endometriosis(EM).Methods The mice were randomly divided into the blank control group.

Evaluation of the Therapeutic Effect of Contrast-Enhanced Ultrasound on Different Types of Knee Osteoarthritis in the Elderly

Objective: To evaluate the curative effect of the Traditional Chinese Medicine (TCM) external therapy on knee osteoarthritis patients with different TCM constitutions using musculoskeletal ultrasonography and contrast-enhanced ultrasonography, and to explore the application value of contrast-enhanced ultrasonography in knee joint diseases. Methods: A total of 57 patients diagnosed with knee osteoarthritis in Shaanxi University of Traditional Chinese Medicine from December 2019 to May 2021 were collected, and they were divided into qi stagnation and blood stasis type group (23 cases) and cold-dampness obstruction type group (34 cases) according to the traditional Chinese medicine method. All patients were given acupuncture combined with TCM fumigation and washing. All patients underwent musculoskeletal ultrasonography and contrast-enhanced ultrasonography before and after treatment, observed and recorded relevant data, and compared the treatment effects between the two groups. Results: 85.96% (49/57) of knee osteoarthritis (KOA) patients had suprapatellar bursa effusion, 42.1% (24/57) had iliotibial band bursae effusion, some of which had poor sound transmission, and thickened synovium was seen in most effusions, 33.33% (19/57) had osteophyte formation. Compared with before treatment, the depth of suprapatellar sac effusion in the Qi stagnation and blood stasis type group decreased after treatment (P Conclusion: Musculoskeletal contrast-enhanced ultrasonography was used to quantitatively evaluate the efficacy of TCM external therapy on KOA for different TCM constitutions. Dynamic observation of synovial lesions of knee osteoarthritis provides a valuable imaging method for evaluating the efficacy of traditional Chinese medicine.

化瘀丸治疗中晚期恶性肿瘤患者血液高凝状态的临床研究

目的:探讨化瘀丸治疗中晚期恶性肿瘤患者血液高凝状态的临床疗效和安全性。方法:选取2018年6月至2021年12月北京中医医院肿瘤科门诊和病房的中晚期恶性肿瘤血液高凝状态患者72例作为研究对象。采用前瞻性队列研究,根据是否应用化瘀丸分为观察组(n=35)和对照组(n=37)。对照组接受必要的物理对症支持治疗,观察组在对照组基础上口服化瘀丸8周,2组共随访24周。观察2组患者的血液高凝状态改善率、凝血指标变化、中医证候积分、静脉血栓栓塞(VTE)大出血发生,以及不良事件发生情况。结果:4周后,观察组血液高凝状态改善率为43.75%,对照组为29.41%(P>0.05);8周后,观察组血液高凝状态改善率为65.63%,对照组为41.18%(P<0.05)。进一步分析凝血相关指标变化,发现4周和8周后观察组血浆纤维蛋白原(FIB)低于对照组(P<0.05)。观察组患者中医证候积分改善的总有效率为50.00%,对照组为14.81%(P<0.05),2组患者均未出现大出血情况,观察组未发生药物相关不良事件。结论:化瘀丸可以在必要的物理支持治疗外,进一步改善中晚期恶性肿瘤患者血液高凝状态,缓解血瘀证相关症状。

壮医针灸治疗寒凝血瘀型原发性痛经疗效观察

目的:观察壮医针灸治疗寒凝血瘀型原发性痛经的临床疗效。方法:选取2020年6月-2021年6月广西中医药大学第一附属医院壮医针灸科60例原发性痛经患者,按照随机数字分组法分为观察组和对照组,每组各30例。对照组采用布洛芬片口服治疗;观察组采用壮医针灸治疗。连续治疗3个月经周期。分别在治疗1月后、治疗3月后及疗程后1个月比较两组患者VAS视觉模拟评分及中医证候积分变化,观察治疗3个月经周期后,两组患者治疗的临床疗效和不良反应发生率。结果:经治疗后,两组患者各时间点VAS评分及中医证候积分与治疗前比较,均得到明显改善(P<0.05)。组间比较,观察组中医证候积分改善程度均优于对照组,且起效快,疗效更稳定(P<0.05);观察组临床疗效优于对照组,不良反应发生率也低于对照组,差异均有统计学意义(P<0.05)。结论:壮医针灸治疗寒凝血瘀型原发性痛经起效快,能明显减轻疼痛程度,临床疗效显著、稳定,且无痛、操作简便,副作用少,值得临床推广应用。

少腹逐瘀汤治疗寒凝血瘀型原发性痛经有效性和安全性的meta分析

目的对少腹逐瘀汤治疗寒凝血瘀型原发性痛经(PD)的有效性和安全性进行系统评价。方法检索中文和外文数据库关于少腹逐瘀汤治疗寒凝血瘀型PD的随机对照试验。数据提取和质量评估分别由2名独立评估员进行,有效数据则使用RevMan 5.3.3软件进行meta分析。结果共纳入8个临床对照试验研究,收集病例797例,meta分析研究结果表明,对寒凝血瘀型PD患者,使用少腹逐瘀汤治疗痛经在总有效率、中医症候评分、疼痛视觉模拟评分、前列腺素E_(2)(PGE_(2))方面相较于单纯常规治疗差异有统计学意义(P<0.05)。结论寒凝血瘀型PD患者服用少腹逐瘀汤有较好的疗效,安全性较高,但仍存在一定的局限性,需要更多大样本、高质量、多中心、随机、双盲对照试验加以验证,提供更高级别的循证医学证据支持。

淋巴瘤证型及其“痰瘀”证素与趋化因子及凝血指标的相关性研究

目的分析淋巴瘤证型和主要病性证素“痰瘀”与常见趋化因子及其受体、凝血指标的相关性,初步探讨淋巴瘤“痰瘀”证素的现代科学本质。方法选择198例淋巴瘤患者,统计并分析不同证型患者趋化因子及受体(CXCL2、CXCR2、CXCL8、CXCL12、CXCR4)和凝血指标(PT、APTT、FIB、FDP、D-D)水平差异;并采用二元Logistic回归分析探讨“痰”、“瘀”与上述各指标的相关性。结果CXCL2、CXCR2、CXCR4、CXCL8、PT、APTT、FIB、FDP、D-D在不同证型中均有差异(P<0.05),在痰瘀互结证型的表达水平高于其他证型(P<0.05);CXCL12在不同证型之间的水平差异无统计学意义(P>0.05)。痰、瘀是淋巴瘤最主要的病性证素,其中CXCR2、CXCR4、D-D、FIB对“痰”有影响,D-D与“瘀”有密切相关性。结论淋巴瘤证型、“痰瘀”证素与常见趋化因子及其受体、凝血指标具有明确相关性,趋化因子和凝血功能异常可能是淋巴瘤“痰瘀”证素相关的生物标志物。