Effect of Chinese Herbs for Activating Blood Circulation,Removing Stasis and Supplementing Qi on the Circulating Endothelial Cells in Patients with Unstable Angina Pectoris

Objective: To observe the effect and clinical significance of circulating endothelial cells (CEC) in the pathogenesis of coronary heart disease with unstable angina pectoris (CHD-UAP), and to explore the protective effect of Chinese herbs for activating blood circulation, removing stasis and supplementing Qi (CH) on CHD-UAP patient's CEC. Methods: Sixty patients with diagnosis of CHD-UAP confirmed and differentiated to be Qi-deficiency and blood stasis by TCM were randomly divided into two groups and treated, on the basis of Western drug-therapy, with Tongxinluo capsule (通心络胶囊, TXL) and Huoxue Tongmai capsule (活血通脉胶囊, HXTM) respectively by way of oral taking three times a day, 3 capsules every time, with 1 month as one therapeutic course. The number of CEC in patients' blood circulation was counted before and after treatment. Besides, the number of CEC in 30 healthy persons was also counted for control. Results: The number of CEC in CHD-UAP patients was significantly higher than that in the healthy persons (P<0.01). After the patients were treated with CH, either TXL or HXTM, it significantly decreased (P<0.01)with insignificant difference between the two treated groups. Conclusion: CEC in CHD-UAP patients is severely damaged and endothelial function in disorder, Chinese herbs have protective effect on patients' CEC.

Clinical and experimental study of effect of Raondix Salviae Militiorrhiza and other blood activating and stasis eliminating Chinese herbs on hemodynamics of portal hypertension

AIM To study the effects of Radix Salviae Militiorrhiza (RSM), other blood-activating and stasis-eliminating Chinese herbs on hemodynamics of portal hypertension.METHODS Portal pressure of cirrhotic dogs after chronic common bile duct ligation was measured directly; portal blood flow in patients with liver cirrhosis were detected by ultrasound Doppler.RESULTS After administration of RSM and Radix Angelicae Sinensis (RAS) by intravenous infusion in cirrhosis dogs, the portal venous pressure (Ppv), wedge hepatic venous pressure (WHVP), hepatic venous pressure gradient (HVPG), were significantly decreased (P＜0.05-0.01), but the mean arterial pressure (MAP), and the heart rate (HR) remained unchanged. When nifedipine was used, Ppv, WHVP, MAP and HR were significantly decreased (P＜0.05), and the MVPG unchanged (P＞0.05). After administration of RSM, RSM+nifedipine and RSM+Hirudin+Nifedpin for 10-12 weeks, the diameter of portal vein (Dpv), spleen vein (Dsv), the portal venous flow (Qpv) and splenic venous flow (Qsv) in patients with hepatic cirrhosis were significantly lowered (P＜0.05-0.01), and the effect of RAS was weaker.CONCLUSIONS The efficacy of decreasing Ppv by Chinese herbs-RSM, RAS, etc. as compared with nifedipine, demonstrated that the Chinese herbs were slower in action than that of nifedipine, but more long-lasting and without side effects. Hence, long-term administration of Chinese herbs, would be more beneficial.

Effect of the Principle of Activating Blood Circulation to Break Stasis on GMP-140 and D_2 Dimer in Patients with Acute Cerebral Infarction

Objective: To explore the clinical efficacy of the principle of activating blood circulation to break stasis (ABCBS) and its influence on platelet membranous protein particle (GMP-140) and D 2 dimer (D-dimer) before and after treatment. Methods: Eighty-eight patients with blood stasis syndrome (BSS) of acute cerebral infarction (ACI) were randomly divided into two groups, both of which were treated with conventional treatment, i.e. with western medicine (WM), with Salvia injection added through intravenously dripping.One of the two groups was used as the control and the other group as the treated group who had ABCBS herbs orally taken in addition. The duration of treatment course for both groups was 3 weeks. Results: There were changes in both groups over clinical symptoms, nerve function deficit scoring and GMP-140, D-dimer, but the treated group showed significantly better than that of the control group, ( P <0.05). Conclusion: ABCBS principle could serve as an important auxiliary treating method for BSS of ACI, as it can effectively alter the blood of ACI patients which was viscous, condense, coagulant and aggregating.

Effects of Activating Blood Circulation to Resolve Blood Stasis and Glucosamine Capsules Therapy on the Expression of Matrix Metalloproteinase in Post-traumatic Knee Osteoarthritis

[Objectives] To observe the clinical effects of activating blood circulation to resolve blood stasis and glucosamine hydrochloride capsules therapy on post-traumatic knee osteoarthritis treatment,to measure the expression of matrix metalloproteinase in post-traumatic knee osteoarthritis patients before and after treatment,and to explore its relevant molecular mechanisms. [Methods]A total of 60 patients with posttraumatic knee osteoarthritis in early stage in Affiliated Hospital of Shannxi University of Chinese Medicine from January 2015 to December2017 were selected and randomly divided into the control group( n = 30) and the observation group( n = 30). The control group was given oral administration of glucosamine hydrochloride capsules for 6 courses of the treatment. The observation group was using the activating blood circulation to resolve blood stasis therapy for 6 courses of treatment. The recovery of traumatic knee osteoarthritis and the symptom of traditional Chinese medicine( TCM) in 2 groups was compared before and after treatment. The symptoms and the quantitative assessment rating scale of knee osteoarthritis,the pain index of knee and the TCM symptom scores were recorded in both groups. And the synovial fluid and serum of patients were collected to detect the expression of matrix metalloproteinase. [Results]The symptoms and the quantitative assessment rating scale of knee osteoarthritis,the pain index of knee and TCM symptom scores of the 2 groups in the 1 st week,the 12 th week and the 24 th week after the treatment were significantly lower than those before the treatment,and the difference was statistically significant( P < 0. 05). Two therapeutic methods had certain therapeutic effects on the recovery from traumatic knee osteoarthritis,and could significantly improve the TCM syndrome. There were better therapeutic effects on oral decoction of traditional Chinese medicine than oral glycosaminoglycans hydrochloride capsules on treating traumatic knee osteogenesis( P < 0. 05). The expression level of MMP3 was decreased significantly in both groups( P <0. 001),while the expression level of MMP13 had no significant change in both groups( P >0. 05). The expression level of MMP1 was decreased significantly in the observation group( P < 0. 001),but there was no significant change in the control group after treatment( P >0. 05). [Conclusions]Two treatment methods have been effective in this clinical study. We found that the expression level of MMP3 was decreased significantly after treatment in 2 therapies,which can be clinically applied.

Treatment of Hypertensive Cerebral Hemorrhage by Activating Blood Circulation to Remove Stasis

The treatment of hy-pertensive cerebral hemorrhage(HCH)by activatingblood circulation to removestasis(ABCRS)is a newtherapeutic approach,which is initiated by clinical specialists of TCM andintegrative Chinese andwestern medicine.Al-though it is not a flawless

Treating Ulcerative Colitis by Activating Blood Circulation to Dissipate Blood Stasis

Ulcerative colitis(UC)is a worldwide refractory bowel disease with unclear pathogenesis.Its lesions can lead to colorectal cancer over time・UC is classified as"diarrhea,""dysentery,"and other categories in traditional Chinese medicine.Its etiology and pathogenesis in traditional Chinese medicine are complex,but it has been found that blood stasis plays an important role in its occurrence and development.Combined with modem research,the relationship between blood stasis and ulcerative colitis is analyzed in this article along with a discussion on the therapeutic effect of activating blood and removing blood stasis on the disease,aiming to provide new ideas for the treatment of UC.

Efficacy and safety of activating blood circulation and removing blood stasis of Traditional Chinese Medicine for managing renal fibrosis in patients with chronic kidney disease:a systematic review and Meta-analysis

OBJECTIVE:To evaluate the efficacy and safety of activating blood circulation and removing blood stasis in terms of Traditional Chinese Medicine(TCM) for managing renal fibrosis(RF) in patients with chronic kidney disease(CKD).METHODS:We searched randomized controlled trials(RCTs) from eight databases.RESULTS:Sixteen eligible studies with 1,356 participants were included in this study.Compared to treatment with Western Medicine(WM) alone,the combined treatment with activating blood circulation and removing blood stasis in terms of TCM(ARTCM) and WM to manage RF in patients with CKD significantly ameliorated type Ⅳ collagen(C-Ⅳ)(SMD:-2.17,95% CI:3.01 to-1.34),type Ⅲ procollagen(PC-Ⅲ)(SMD:-1.08,95% CI:-1.64 to-0.53),laminin(LN)(SMD:-1.28,95% CI:-1.65 to-0.90),transforming growth factor β 1(TGF-β1)(SMD:-0.65,95% CI:-1.18 to-0.12),serum creatinine(Scr)(SMD:-1.36,95% CI:-1.85 to-0.87),blood urea nitrogen(BUN)(MD:-1.51,95% CI:-2.59 to-0.43),and 24 h urine protein(24h Upro)(SMD:-1.23;95% CI:-1.96 to-0.50).The level of hyaluronic acid(HA) was similar in both types of treatment(SMD:-0.74,95% CI:-1.91 to 0.44).The subgroup analysis showed that the duration of 8 weeks might affect the concentration of C-Ⅳ,PC-Ⅲ,and LN(P < 0.05).The effectiveness of the longer duration to C-Ⅳ,PC-Ⅲ,and LN was not certain.However,the result should be interpreted in care.The safety of the treatment using ARTCM and WM could not be evaluated because a few studies had reported adverse effects.The results of the Meta-analysis were not stable enough.There was publication bias for the reports on Scr(P = 0.001),C-Ⅳ(P = 0.001),PC-Ⅲ(P = 0.026),and LN(P = 0.030) and no publication bias for the reports on BUN(P = 0.293).The quality of evidence varied from low to very low.CONCLUSIONS:The combined treatment using ARTCM and WM to manage RF in patients with CKD has some advantages over treatment with WM alone.High-quality RCTs need to be conducted for the strong support.

Efficacy and safety of a sequential treatment with clearing heat and eliminating phlegm and tonifying Qi and activating blood circulation in treating acute ischemic stroke: study protocol for a randomized controlled trial

OBJECTIVE:To investigate the short-term efficacy and safety outcomes following a sequential treatment with clearing heat and eliminating phlegm(CHEP)formula and tonifying Qi and activating blood circulation(TQABC)formula in patients with acute ischemic stroke(AIS)within a 72 h time window.METHODS:In this randomized,multicenter,doubleblinded,placebo-controlled trial,500 participants will be randomly assigned in a ratio of 1∶1 to the CHEP+TQABC group or control group.In addition to guidelinebased standard medical care,participants in the treatment group will receive the CHEP formula for the first 5 consecutive days followed by the TQABC formula for another 10 consecutive days,while those in the control group will receive CHEP formula placebo and TQABC formula placebo consecutively.The primary outcome measure will be the comparison of the change in the National Institutes of Health Stroke Scale score from baseline to 15 days after randomization.The secondary outcome measures will include the scores on the modified Rankin Scale,Barthel Index,Patient-Reported Outcomes,TCM symptom pattern(Zheng-hou)evaluation Scale,and the incidence of in-hospital complications.Safety assessment will include the physical examination,laboratory detection,any adverse events or serious adverse events,and the proportion of any complications during hospitalization.DISCUSSION:The results of this study will provide objective and scientific data with which to assess the efficacy and safety of a sequential treatment based on“integrating disease and symptom pattern”for patients with AIS.

Study on the Protective Effects of Compound Blood-activating Soup on Bone Marrow Hematopoietic Cells in Acute Radiation Injured Mice

After irradiation with 8 Gy 60Coγ-ray,mice were immediaterly given intraperitoneal injection of 200 mg 100 % compound blood-activating soup twice a day. On the 3rd and 7th day, the P53 gene expression of bone marrow hematopoietic cells in Chinese drug group was found to be higher than that in normal group, and it was also significantly higher than that in control group. The expression level of GADD153 gene which was not expressed in normal group was much lower in Chinese drug group than that in control group. On the 7th day after irradiation, the P53 and GADD153 gene expression levels of splenic mononuclear cells were consistent with those of bone marrow hematopoietic cells both in Chinese drug group and control group. On the 3rd and 7th day, the bone marrow hematopoietic tissue volume in Chinese drug group was higher than that in control group, with no difference found between the two groups. While on the 14th day, the difference became significant (P＜0. 01). The results showed that commonly used blood-activating and stasis-eliminating drugs may strengthen .the viability of hematopoietic cells and promote the rehabilitation of hematopoiesis by inducing wt-P53 expression to block the bone marrow hematopoietic cells in G1 phase, during which DNA could be repaired.

Activating Blood Circulation to Remove Stasis Treatment of Hypertensive Intracerebral Hemorrhage:A Multi-Center Prospective Randomized Open-Label Blinded-Endpoint Trial

Objective： To investigate the efficacy and safety of the Chinese herbal therapeutic regimen of activating blood circulation （TRABC） in treatment of hypertensive intracerebral hemorrhage （HICH）. Methods： This was a multi-center prospective randomized open-label blinded-endpoint （PROBE） trial with HICH admitted to 12 hospitals. Totally 240 participants were randomized to the treatment group treated with TRABC in addition to conventional Western treatment or the control group with conventional Western treatment equally for 3 months. Primary outcome was degree of disability as measured by modified Rankin Scale （mRS）. Secondary outcomes were the absorption of hematoma and edema, National Institutes of Health Stroke Scale （NIHSS） scores and patient-reported outcome measures for stroke and Barthel activities of daily living index. Adverse events and mortality were also recorded. Results： After 3 months of treatment, the rate of mRS 0-1 and mRS 0-2 in the treatment group was 72.5% and 80.4%, respectively, and in the control group 48.1% and 63.9%, respectively, with a significant difference between groups （P〈0.01）. Hematoma volume decreased significantly at day 7 of treatment in the treatment group than the control group （P=0.038）. Average Barthel scores in the treatment group after treatment was 89.11 ＋ 19.93, and in the control group 82.18 ＋ 24.02 （P=0.003）. NIHSS scores of the two groups after treatment decreased significantly compared with before treatment （P=0.001）. Patient-reported outcomes in the treatment group were lower than the control group at day 21 and 3 months of treatment （P〈0.05）. There were 4 deaths, 2 in each group, and 11 adverse events, 6 in the treatment group and 5 in the control group. Conclusion： The integrative therapy combined TRABC with conventional Western treatment for HICH could promote hematoma absorption thus minimize neurologic impairment, without increasing intracerebral hematoma expansion and re-bleeding.

活血化瘀涂搽药治疗冠脉介入穿刺并发症临床观察

目的观察活血化瘀涂搽药剂外敷治疗冠脉介入穿刺并发症的疗效。方法选取2021年1月1日—2022年12月31日在江西中医药大学附属医院行冠脉介入治疗后伴桡动脉穿刺点并发症的患者100例,随机分为试验组和对照组,各50例。对照组采用50%硫酸镁湿敷,试验组采用活血化瘀涂搽药剂湿敷,均连续治疗7 d,比较2组穿刺部位淤青面积变化、穿刺部位肿胀程度、穿刺部位疼痛程度及临床有效率。结果2组患者淤青面积、肿胀程度及疼痛评分均较治疗前降低(P<0.05),且试验组均低于对照组(P<0.05),试验组总有效率高于对照组(P<0.05)。结论活血化瘀涂搽药剂外敷相对于硫酸镁外敷更能有效减少冠脉介入穿刺并发症患者的淤青面积、肿胀程度及疼痛评分,提高临床有效率,疗效好,值得临床推广应用。

Platelet proteomics and its advanced application for research of blood stasis syndrome and activated blood circulation herbs of Chinese medicine

The development of novel and efficient antiplatelet agents that have few adverse effects and methods that improve antiplatelet resistance has long been the focus of international research on the prevention and treatment of cardiovascular and cerebrovascular diseases.Recent advances in platelet proteomics have provided a technology platform for high-quality research of platelet pathophysiology and the development of new antiplatelet drugs.The study of blood stasis syndrome(BSS)and activated blood circulation of traditional Chinese medicine(TCM)is one of the most active fields where the integration of TCM and western medicine in China has been successful.Activated blood circulation herbs(ABC herbs)of Chinese medicine are often used in the treatment of BSS.Most ABC herbs have antiplatelet and anti-atherosclerosis activity,but knowledge about their targets is lacking.Coronary heart disease(CHD),BSS,and platelet activation are closely related.By screening and identifying activated platelet proteins that are differentially expressed in BSS of CHD,platelet proteomics has helped researchers interpret the antiplatelet mechanism of action of ABC herbs and provided many potential biomarkers for BSS that could be used to evaluate the clinical curative effect of new antiplatelet drugs.In this article the progress of platelet proteomics and its advanced application for research of BSS and ABC herbs of Chinese medicine are reviewed.

Exploration of the Effect and Mechanism of Activating Blood Circulation and Stasis-Removing Therapy on Tumor Metastasis

Metastasis is one of the specificities of late stage tumor and also a lethal factor often encountered. The study of tumor metastasis has important meaning for prolonging patients＇ survival and elevating their quality of life, but no really ideal prevention and treatment method has been found so far. Recent researches showed that tumor metastasis is correlated with platelet aggregation and blood hyperviscosity manner. Therefore, the early application of surgery, radiotherapy, chemotherapy and biological therapies, in combination with Chinese medicine therapy for activating blood circulation and removing stasis （ABCRS） may be, after all, an effective approach. ABCRS therapy is an important therapy of Chinese medicine, which, composed of several methods like smoothening blood flow in vessels, promoting blood circulation and dispersing stagnant blood, could influence tumor metastasis to different extents, and could coordinate with some other Chinese medicine therapeutic methods like supplementing qi, promoting qi, clearing heat, removing toxic substances, warming meridian, dispelling wind, eliminating dampness, nourishing yin, dissolving sputum, relieving stagnancy, emptying viscerals, etc. The effect and acting mechanism of ABCRS on tumor metastasis is summarized in this paper and its bi-directional regulatory effects discussed as well.

活血化瘀中药联合富血小板血浆改善激素性股骨头坏死的作用机制

背景:目前发现活血化瘀中药、富血小板血浆技术都能够修复受损血管,促进血管再生,重建股骨头内血运,恢复正常血供,进一步促进成骨作用,在早期干预激素性股骨头坏死方面均表现出一定的优势,可更加深入了解活血化瘀中药及富血小板血浆技术改善激素性股骨头坏死的作用机制,为今后治疗提供新思路。目的:根据国内外相关文献,综述活血化瘀中药联合富血小板血浆技术改善激素性股骨头坏死作用机制的研究进展。方法:检索PubMed、Web of Science、Metstr、中国知网及万方数据库收录的相关文献。以“中药、信号通路、激素性股骨头坏死、血管内皮生长因子、富血小板血浆”及“traditional Chinese medicine、signal pathways、steroid induced necrosis of femoral head、vascular endothelial growth factor、platelet rich plasma”分别作为中、英文检索词,检索文献时限为2000年1月至2022年7月,最终纳入相关文献75篇。结果与结论:活血化瘀中药及富血小板血浆技术在干预早期激素性股骨头坏死方面均表现出一定的优势。对于中医药而言,无论是活血化瘀单体药还是复方药都可以有效缓解激素性股骨头坏死疾病进一步发展,具体作用机制如下:①活血化瘀中药有显著抗凝作用,可以拮抗激素药物造成的血液异常(高凝)状态,进一步恢复股骨头内的正常血供;②活血化瘀中药可修复受损的血管内皮,通过激活血管内皮生长因子,使血管再生,重塑股骨头内血运;③活血化瘀中药祛瘀效果明显,可减少骨髓腔内的脂肪细胞堆积,缓解股骨头内压力;④活血化瘀中药可调控相关信号通路,维持骨代谢,促进成骨细胞、破骨细胞分化平衡,有效减轻激素性股骨头坏死。此外,富血小板血浆中含有大量高浓度细胞生长因子,对成骨作用及血管再生均起到正向作用,同时也可改善血液异常状态。活血化瘀中药联合富血小板血浆技术可发挥二者自身生物作用,干预效果更加显著。

柳国斌教授从“寒凝血瘀”论治血栓闭塞性脉管炎的经验

本文对柳国斌教授治疗血栓闭塞性脉管炎的学术思想进行总结。柳教授提出阳虚寒凝是血栓闭塞性脉管炎的始动病机,而后形成瘀血、脉络闭阻等病理环节,故将本病的病机概括为“寒凝经脉,瘀血阻络”,其提出以“温经散寒,活血通络”为治疗法则,遣方用药注重扶阳,认为机体的阳气充足后,气血得以运行顺畅,瘀血等病理因素随之消散。柳教授强调只有抓住病机才能抓住治疗的关键,在复杂的疾病中找出矛盾所在,才能取得良效。现将柳教授临证经验总结如下,并附验案1则,为治疗血栓闭塞性脉管炎提供思路。

Therapeutic Effects of Herbs Activating Blood Circulation and Dispersing Stasis on Acute Lung Injury after Abdominal Operations

Objective: To observe the effect of acute lung injury after abdominal surgical operations treated with herbs activating blood circulation and dispersing stasis. Methods: Forty-four patients complication with acute lung injury after abdominal operation were analyze with multiple clinical and laboratory parameters and were treated early with herbs activating blood circulation and dispersing stasis. Results: After 2 days of medication,arterial oxygen saturation (SaO2 ) and partial pressure of oxygen in artery (PaO2 ) markedly improved, with significant difference as compared with those before medication (P < 0. 01 ). After continous medication for 4 days, SaO2, PaO2 and chest X-ray as well as synthetic physiologic parameters obviously improved, prostaglandin F1a,thromboxane B2 (TXB2 ), C-reactive protein (CRP), erythrocyte C3b were very significantly different from those medication (P < 0. 01 ), the synthetic physiological parameters returned generally to normal. After 5 days of herbal medication, all parameters resumed normal with satisfactory physiologic criteria. Conclusions: Early application of herbs activating blood circulation and dispersing stasis could obviously improve hypoxemia and the lung lesions, and consequently the general condition of the patient.

基于数据挖掘和整体观探究活血化瘀法治疗经皮冠状动脉介入术后再狭窄的用药规律

目的探究活血化瘀法治疗经皮冠状动脉介入(percutaneous coronary intervention,PCI)术后再狭窄的用药规律。方法检索中英文数据库中相关文献,筛选符合标准的中药处方,构建原始数据库,运用Excel 2021、IBM SPSS 18.0、Cytoscape 3.9.1、SPSS Statistics 26.0等软件进行高频药物、功效主治、性味归经、关联规则、系统聚类分析以总结其用药规律。结果最终纳入73篇文献、73首中药处方,共涉及125味中药。高频药物有丹参、黄芪、川芎、当归、赤芍、红花等。功效主治以活血化瘀药物最多,其次为补虚药。四气中以温、寒为主,五味以苦、甘、辛为主,归经多入肝、脾经。关联规则分析得到3条对药,红花-桃仁支持度最高,26条角药,以川芎、赤芍、红花、当归、黄芪、桃仁等相互组合为主。系统聚类分析得到5组药物组合。结论PCI术后再狭窄的基本病机为心气亏虚、心阳不振,瘀血是贯穿疾病全程的关键病理因素,病位累及心、肝、脾等。五脏之气,相互灌溉,以整体观为指导,治疗以活血化瘀为主,兼以调气、化痰、温阳,组方用药多由补阳还五汤、血府逐瘀汤、当归补血汤、瓜蒌薤白半夏汤、二陈汤等经典名方化裁而来。

基于EGFR/MAPK/ERK信号通路探讨鳖甲煎丸对MHCC-97H肝癌细胞皮下瘤的抑瘤作用

目的基于表皮生长因子受体(epidermal growth factior receptor,EGFR)/丝裂原活化蛋白激酶(mitogen-activated protein kinase,MAPK)/细胞外信号调节激酶(extracellular signal-regulated kinase,ERK)信号通路探究鳖甲煎丸对MHCC-97H肝癌细胞皮下瘤的抑瘤作用及作用机制。方法选取30只雄性BLAB/c裸鼠,建立MHCC-97H肝癌细胞皮下瘤模型。造模成功后随机分为模型组,鳖甲煎丸低、中、高剂量组(0.55、1.1、2.2 g/kg),西药组(乐伐替尼4 mg/kg+吉非替尼80 mg/kg),每组6只。鳖甲煎丸低、中、高剂量组灌胃2次/d,西药组每周灌胃5 d,模型组予以等量生理盐水2次/d灌胃,每组连续干预2周。观察大鼠一般情况;计算各组大鼠抑瘤率;HE染色观察病理形态学变化;RT-qPCR检测瘤体组织中EGFR、丝裂原活化蛋白质激酶激酶(mitogen-activated protein kinase kinase,MEK)、ERK1、ERK2 mRNA表达水平;Western blot检测EGFR、磷酸化的EGFR(p-EGFR)、MEK、磷酸化的MEK(p-MEK)、ERK1、ERK2、磷酸化的ERK1/2(p-ERK1/2)、基质金属蛋白酶-1(matrix metalloproteinase-1,MMP-1)、细胞周期蛋白D1(cell cycle protein D1,Cyclin D1)、神经型钙黏附蛋白(N-cadherin)、上皮型钙黏附蛋白(E-cadherin)相对表达水平。结果与模型组比较,鳖甲煎丸低、中、高剂量组及西药组精神、反应、进食饮水等情况均明显改善。与第0天比较,各组第14天体质量明显降低(P<0.01)。与模型组、鳖甲煎丸低剂量组比较,鳖甲煎丸中、高剂量组和西药组瘤体质量减轻(P<0.05,P<0.01)。鳖甲煎丸低、中、高剂量组和西药组抑瘤率分别为20%、47.73%、55.91%、75.45%。与模型组比较,鳖甲煎丸低、中、高剂量组及西药组肿瘤细胞排列疏松,边界模糊,细胞核固缩、破裂,其中西药组最明显。与模型组比较,鳖甲煎丸低、中、高剂量组和西药组EGFR、MEK、ERK1、ERK2 mRNA表达水平明显下降(P<0.01);与鳖甲煎丸低剂量组比较,鳖甲煎丸高剂量组和西药组EGFR、MEK、ERK1、ERK2 mRNA表达水平显著降低(P<0.01),鳖甲煎丸中剂量组ERK1 mRNA表达水平显著降低(P<0.01);与鳖甲煎丸中剂量组比较,西药组EGFR、ERK2 mRNA表达水平降低(P<0.05,P<0.01)。与模型组比较,鳖甲煎丸中、高剂量组和西药组p-EGFR/EGFR、p-MEK/MEK、p-ERK1/ERK1、p-ERK2/ERK2、MMP-1、Cyclin D1、N-cadherin蛋白相对表达水平下降(P<0.05,P<0.01),E-cadherin蛋白相对表达水平明显升高(P<0.01)。与鳖甲煎丸高剂量组比较,西药组p-EGFR/EGFR、p-ERK1/ERK1、MMP-1、Cyclin D1、N-cadherin蛋白相对表达水平明显下降(P<0.01),E-cadherin蛋白相对表达水平升高(P<0.05)。结论鳖甲煎丸可能通过抑制EGFR/MAPK/ERK信号通路激活,从而下调MMP-1、Cyclin D1、N-cadherin蛋白,上调E-cadherin蛋白表达,进而对MHCC-97H肝癌细胞皮下瘤产生显著的抑制作用。

从瘀毒互结论治颈动脉粥样硬化易损斑块

颈动脉粥样硬化易损斑块已被认为是引发缺血性脑卒中的独立危险因素,严重威胁人类健康。目前现代医学通过西药与手术治疗易损斑块有一定效果,但存在不良反应大、复发率高等问题。中医认为瘀、毒是导致动脉粥样硬化易损斑块形成的重要原因。该文通过梳理总结中医古籍中的“瘀”“毒”理论,并结合易损斑块的现代病理研究,认为“瘀”“毒”贯穿动脉粥样硬化疾病发展始终,“瘀毒互结”为易损斑块形成和发展的核心病机。早期外毒引动,浊瘀郁脉,伏毒渐生;中期热毒炽盛,毒损瘀破,“苛毒”流散;后期虚毒内生,腐瘀溃疡,积癥成瘀。“活血解毒”应为易损斑块的治疗大法,在疾病早、中、后期分别理气活血解毒、清热活血解毒、补气活血解毒,并列举方药,以期为颈动脉粥样硬化易损斑块的中医药防治提供新思路和新方案。

芎芍胶囊治疗冠心病心绞痛临床疗效及安全性的系统评价

目的:系统评价芎芍胶囊治疗冠心病心绞痛的临床效果及安全性。方法:计算机检索Web of SCI、PubMed、EMbase、the Cochrane Library、万方数据资源系统(WanFang Database)、维普中文科技期刊全文数据库(VIP)、中国知网(CNKI)、中国生物医学文献服务系统(SinoMed)等数据库,纳入芎芍胶囊对比单独使用常规西药或血府逐瘀胶囊干预冠心病心绞痛的随机对照试验研究(RCT)。由2位评价者独立筛选提取文献资料、评定偏倚风险,使用RevMan 5.3进行Meta分析。结果:纳入12项研究,涉及1309例病人。Meta分析结果显示,试验组在提高临床总有效率[RR=1.17,95%CI(1.11,1.23),P<0.00001]、提高心电图疗效[RR=1.22,95%CI(1.09,1.36),P=0.0003]、降低三酰甘油(TG)[MD=-0.19,95%CI(-0.35,-0.04),P=0.02]、升高高密度脂蛋白胆固醇(HDL-C)[MD=0.13,95%CI(0.07,0.19),P<0.0001]方面均优于对照组,而两组在减低总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及不良反应发生率方面比较差异无统计学意义(P>0.05)。结论:现有证据表明,芎芍胶囊治疗冠心病心绞痛的临床效果明确,安全性较好。