Exploring the medication pattern and mechanism of action of traditional Chinese medicine in treating polycystic ovary syndrome with kidney deficiency and blood stasis based on data mining and network pharmacology

Background:Using network pharmacology to explore the potential molecular mechanism of traditional Chinese medicine in treating polycystic ovary syndrome(PCOS)with kidney deficiency and blood stasis syndrome.Method:Collect the related literature materials of PCOS with kidney deficiency and blood stasis syndrome treated by traditional Chinese medicine in four databases in recent ten years,extract the information of prescriptions and complete the frequency analysis.Traditional Chinese Medicine Systems Pharmacology Database was used to screen out the effective components.Use Online Mendelian Inheritance in Man and other databases to screen PCOS disease targets.The intersection targets obtained by clustering prescription and PCOS disease targets were submitted to STRING database for protein-protein interaction network analysis,and Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes pathways were analysed by Metascape.Result:There are 155 kinds of traditional Chinese medicines used in the literature.The most commonly utilized ones are Cuscutae Semen,Angelicae Sinensis Radix,and Rehmanniae Radix Praeparata.The results of the cluster analysis indicated that the plants most commonly found throughout the prescription were Leonuri Herba,Lycopi Herba,Dipsaci Radix,etc.GO results show that biological processes include cell reaction to organic nitrogen compounds and cell reaction to nitrogen compounds.The functional display of GO molecule includes cytokine receptor binding,signal receptor regulator activity and so on.Kyoto Encyclopedia of Genes and Genomes results show that the possible mechanisms of action are cancer pathway,an endocrine resistance signal pathway.Conclusion:Through data mining,the cluster prescription for PCOS with kidney deficiency and blood stasis syndrome is Leonuri Herba,Lycopi Herba,Dipsaci Radix,etc.The network pharmacology research of cluster prescription shows that the main drug components for treating PCOS with kidney deficiency and blood stasis syndrome are quercetin,kaempferol,luteolin,tanshinone IIA,etc.,which act on PTGS2,NCOA2,and other targets,and treat PCOS with kidney deficiency and blood stasis syndrome through cancer and endocrine resistance.

Clinical Nursing Intervention of Moxibustion on Abdominal Distension Symptoms in Heart Failure (Heart and Kidney Yang Deficiency and Blood Stasis Blocking Collaterals Syndrome)

Objective:To investigate the clinical nursing intervention effect of moxibustion on abdominal distension symptoms in heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome).Methods:62 patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)admitted to our hospital from February 2023 to February 2024 were selected and divided into the observation group(n=31)and the control group(n=31)by using the random numerical table method.The control group adopted conventional nursing interventions,and the observation group received the nursing program of the control group with the addition of moxibustion nursing interventions.The nursing effectiveness,quality of life scores,and nursing satisfaction were compared between the two groups.Results:The nursing effectiveness of the observation group was significantly higher than the control group(P<0.05);the quality of life score of the observation group was significantly higher than the control group(P<0.05);the nursing satisfaction of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:The use of moxibustion nursing intervention in patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)can effectively relieve the symptoms of abdominal distension,improve patients'quality of life,and increase nursing satisfaction,which has promotion and application values.

Clinical observation on efficacy of compound of warming yang, descending turbidity and dredging collaterals in the treatment of diabetic kidney disease with Yin-Yang deficiency and blood stasis syndrome

Objective:To observe the clinical efficacy of compound of owarming yang,descending turbidity and dredging collaterals in the treatment of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome.Methods:Seventy-six patients of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome were randomly divided into observation group and control group,thirty-eight cases in each group.The control group was given conventional western medicine treatment,while the observation group took compound of owarming yang,descending turbidity and dredging collaterals orally on the basis of conventional western medicine treatment.The course of treatment covered for one month.Before and after treatment,we observed the scores of traditional Chinese medicine symptoms,indicators of renal function[serum creatinine(Scr),blood urea nitrogen(BUN),microalbuminuria(MALB)],indicators of glucose metabolism[fasting plasma glucose(FPG),2-hour postprandial blood glucose(2hPG),glycosylated hemoglobin(HbAlc)],indicators of hemorheology[plasma viscosity(PV),platelet aggregation rate(PAR),fibrinogen(FIB)],Cystatin-C(Cys-C),C-reactive protein(CRP)in the two groups.Results:After treatment,the clinical effect of the observation group was significantly better than the control group(P<0.05).The scores of traditional Chinese medicine symptoms,indicators of renal function(Scr、BUN、UAER),indicators of glucose metabolism(FPG、2hPG、HbAlc),indicators of hemorheology(PV、PAR、FIB),Cys-C and CRP in the two groups were decreased significantly compared with those before treatment(P<0.05),and the decrease in the observation group was superior to that in the control group(P<0.05).Conclusion:Compound of warming yang,descending turbidity and dredging collaterals has remarkable efficacy in treating of diabetic kidney disease patients with yin-yang deficiency and blood stasis syndrome by alleviating clinical symptoms,glucose metabolism,renal function and microcirculatory disturbance,and the mechanism related to alleviation of microinflammation.

基于“玄府气液”理论治疗慢性难愈性溃疡

慢性难愈性溃疡是“虚”“瘀”两种致病因素相互交织、相互作用的结果,“虚”“瘀”贯穿疾病发展的始终。而“玄府开阖失司,气液代谢失调”是本病迁延难治的病机关键。刘丽芳教授综合运用煨脓生肌、阳和通玄、托里消毒诸法开玄府、调气液,令玄府开阖有司,气液代谢调和,临床疗效满意,附验案一则加以阐明。

Metabonomic phenotype and identification of “heart blood stasis obstruction pattern” and “qi and yin deficiency pattern” of myocardial ischemia rat models

The traditional Chinese medicine concepts of "Xinxueyuzuzheng (heart blood stasis obstruction pattern)" and "Qiyinliangxuzheng (qi and yin deficiency pattern)" for myocardial ischemia rat models were constructed in the present study. Endogenous metabolites in rat plasma were analyzed using the GC/TOF-MS-based metabonomic method. Significant metabolic differences were observed between the control and two model groups, and the three groups were distinguished clearly by pattern recognition. Compared with those of the control, the levels of hydroxyproline, threonic acid, glutamine and citric acid were strikingly up or down-regulated in model rats. The metabolites contributing most to the classification between the two "pattern" rats were identified, such as valine, serine, threonine, ornithine, hydroxyproline, lysine, 2-hydroxybutanoic acid, 3-hydroxybutanoic acid, galactofuranose and inositol. These compounds were indicated as the potential biomarkers. The results suggested that the two "patterns" are involved in dysfunction in oxidative stress, energy metabolism and amino acid metabolism. These findings also provided the substantial foundation for exploring the scientific connotation of these two "Zhengxing (pattern types)" of myocardial ischemia, and "Bianzheng (pattern identification)".

针灸联合西药治疗腰椎间盘突出症腰腿痛肾虚血瘀证疗效观察

目的:探讨针灸联合西药治疗腰椎间盘突出症(lumbar disc herniation,LDH)腰腿痛肾虚血瘀证的疗效。方法:纳入LDH腰腿痛肾虚血瘀证患者66例,根据随机数字表法分为观察组和对照组,每组33例。对照组采取甲钴胺片+塞来昔布胶囊治疗,观察组在对照组治疗基础上给予针灸治疗,两组疗程均为2周。比较两组腰腿疼痛程度、腰椎功能、肾虚血瘀证症状评分、临床疗效及不良反应。结果:治疗后两组腰部与腿部疼痛视觉模拟量表评分、症状评分均降低(P<0.05),日本骨科协会评分增加(P<0.05),且观察组降低或增加较对照组明显(P<0.05)。观察组总有效率为93.94%(31/33),高于对照组的69.70%(23/33)(P<0.05)。不良反应发生率观察组为3.03%(1/33),低于对照组的6.06%(2/33),但差异无统计学意义(P>0.05)。结论:在西医常规治疗的基础上,针灸联合艾灸治疗有助于缓解LDH患者腰腿痛,减轻临床症状,改善腰椎功能,提高治疗效果,且安全性好。

基于中医传承辅助平台探讨子宫内膜异位症常见证候类型的用药规律

目的:挖掘当代医家治疗子宫内膜异位症(EMT)3种常见证型(肾虚血瘀证、寒凝血瘀证、气滞血瘀证)的用药规律,以期为临床治疗及新药的研发提供参考。方法:建立文献的纳入及排除标准,对中国知网、维普期刊资源数据库、万方数据知识服务平台、中国生物医学文献服务系统从建库至2022年4月30日治疗EMT的相关文献进行筛选,利用中医传承辅助平台(V2.5)进行数据挖掘分析。采用关联规则分析法、复杂系统熵聚类、聚类分析法等高级数据挖掘方法,分析治疗EMT常见证型的用药规律。结果:最终纳入方剂113首,治疗肾虚血瘀证、气滞血瘀证、寒凝血瘀证的方剂分别为55首、31首、27首。治疗EMT肾虚血瘀证常用药物有菟丝子、莪术、当归、丹参、香附等,常用药对有三棱-莪术、菟丝子-当归、川芎-当归等,演化出16个核心组合、8个新方。治疗EMT寒凝血瘀证常用药物有甘草、当归、延胡索、五灵脂、肉桂等,常用药对有延胡索-五灵脂、蒲黄-五灵脂、五灵脂-当归等,演化出10个核心组合、5个新方。治疗EMT气滞血瘀证常用药物有延胡索、赤芍、当归、丹参、柴胡等,常用药对有延胡索-当归、赤芍-当归、赤芍-丹参等,演化出16个核心组合、8个新方。治疗EMT的中药,药性以温性、平性为主,药味以苦味、辛味、甘味为主,归经以肝经、脾经、心经、肾经等为主。结论:EMT为本虚标实之证,关键病机为伏邪伤肾阳,瘀血阻滞,治疗以活血化瘀、温补肾阳为主,用药攻补兼施,标本兼治,重视肝脾两脏,使瘀去而不伤正。

针刺联合通窍活血汤对脑胶质瘤患者术后输液港并发症的预防作用

目的:观察针刺联合通窍活血汤对脑胶质瘤患者术后输液港并发症的预防作用。方法:将脑胶质瘤手术切除术后接受完全植入式输液港(totally implantable access ports,TIAP)的气虚血瘀证患者128例按随机数字表法分为对照组和观察组各64例。对照组术后第1天予常规护理干预;观察组在对照组基础上予中医针刺护理联合通窍活血汤干预。干预2周后观察两组患者TIAP并发症发生率、气虚血瘀证症状评分及护理满意度。结果:观察组TIAP并发症中感染、静脉内血栓、导管堵塞、纤维蛋白鞘的发生率低于对照组(P<0.05);干预后两组患者气虚血瘀证症状(气短、神疲乏力、懒言、自汗、刺痛、皮下瘀斑、肌肤甲错、肢体麻木)评分均降低(P<0.01),观察组低于对照组(P<0.01);观察组护理满意度为93.75%(60/64),高于对照组的79.69%(51/64)(P<0.05)。结论:在常规护理基础上加针刺联合通窍活血汤能降低脑胶质瘤术后气虚血瘀型患者输液港并发症的发生率,改善中医证候,提高护理满意度。

补中益气汤联合倍他司汀治疗气虚血瘀型良性阵发性位置性眩晕复位后残余症状的临床观察

目的观察补中益气汤联合倍他司汀治疗良性阵发性位置性眩晕(BPPV)复位后残余症状的有效性和安全性。方法2020年6月~2021年6月我院收治的原发性BPPV复位成功后伴残余症状的气虚血瘀型患者160例,随机分为观察组和对照组,每组80例。两组患者均口服甲磺酸倍他司汀治疗,观察组患者联合应用补中益气汤,疗程2周;自治疗开始随访2个月。比较两组患者治疗前后眩晕障碍量表(DHI)评分、临床疗效以及不良反应发生情况以及残余症状持续时间。结果治疗结束后,两组患者DHI评分均较治疗前显著降低(P<0.05),但观察组治疗后DHI评分低于对照组,差异有统计学意义(P<0.05);观察组总有效率95.00%,显著高于对照组的78.75%(P<0.05);观察组和对照组患者残余症状持续时间分别为13(9~23)d和17(10~29)d,观察组患者残余症状持续时间显著低于对照组(P<0.05);治疗过程中,两组患者均未发生不良反应。结论补中益气汤联合倍他司汀能快速、有效地缓解气虚血瘀型BPPV患者复位后残余症状,安全性良好,值得临床推广。

补阳还五汤治疗气虚血瘀型一氧化碳中毒迟发性脑病的Meta分析

目的 :系统评价补阳还五汤治疗气虚血瘀型一氧化碳中毒迟发性脑病(delayed encephalophathy after acute carbon monoxide poisoning,DEACMP)的有效性。方法 :检索知网、万方、维普、PubMed、EMbase数据库及The Cochrane Library,检索时限从数据库建库至2022年9月30日,搜集补阳还五汤治疗气虚血瘀型DEACMP的随机对照试验,根据纳入和排除标准由2名研究者独立筛选符合标准的文献,提取文献资料并评价纳入文献的文献质量、偏倚风险,应用Revman5.3软件进行Meta分析。结果:共纳入7篇对照试验,包括患者718例。Meta分析结果显示,补阳还五汤联合西医治疗气虚血瘀型DEACMP的总有效率(OR=0.49,95%CI[0.16,0.41],P<0.00001)、脑电图正常率(OR=0.34,95%CI[0.18,0.64],P=0.0009)高于常规西医治疗,且改善认知功能(MD=-3.00,95%CI[-5.54,-0.46],P=0.02)的有效性优于常规西医治疗。亚组分析结果显示,不同疗程亚组的补阳还五汤联合西医治疗总有效率优于常规西医治疗(P<0.05)。结论:与常规西医治疗相比,联合补阳还五汤治疗气虚血瘀型DEACMP在提高整体疗效、脑电图正常率及改善患者认知功能方面有效性更高,但尚需更高质量的随机双盲对照研究进一步验证。

桑丹通络颗粒治疗阴虚血瘀证缺血性脑卒中恢复期的回顾性队列研究

目的评价桑丹通络颗粒治疗阴虚血瘀证缺血性脑卒中恢复期的临床有效性与安全性。方法采用回顾性队列研究方法,通过湖南省中医药研究院附属医院门诊与住院病历系统收集2021年7月至2022年6月收治的缺血性脑卒中恢复期患者临床资料,选择应用桑丹通络颗粒联合西医常规治疗的51例患者为暴露组,匹配仅应用西医常规治疗的102例患者为对照组,两组均治疗2周。比较治疗前后总有效率、美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分、日常生活活动能力(activity of daily living,ADL)评分、血脂水平、血液流变学指标和症状总积分等,并对所有患者治疗期间不良反应事件进行记录。结果暴露组临床总有效率84.31%,高于对照组的67.65%(P<0.05)。与治疗前比较,两组治疗后NIHSS、TC、LDL降低(P<0.01或P<0.05),且暴露组低于对照组(P<0.05);两组ADL升高(P<0.01),且暴露组高于对照组(P<0.01)。与治疗前比较,暴露组治疗后症状总积分、血液流变学各项指标降低(P<0.01或P<0.05),且暴露组低于对照组(P<0.01或P<0.05);HDL-C升高(P<0.01),且暴露组高于对照组(P<0.01)。结论桑丹通络颗粒联合西医常规治疗可明显改善阴虚血瘀证缺血性脑卒中恢复期患者症状,降低其神经缺损程度,改善血脂水平和血液流变学指标,有效提高其生存质量,疗效确切且安全稳定。因此,推测桑丹通络颗粒具有一定的临床应用与推广价值。

益气活血自拟方对冠心病气虚血瘀证大鼠心功能的影响

目的 探讨益气活血自拟方(YQHXF)对冠心病气虚血瘀证大鼠心功能的保护作用。方法 将24只雄性SD大鼠随机分为假手术组、模型组、YQHXF组(17.1 g/kg)和西药组(单硝酸异山梨酯3.6 mg/kg),每组6只。除假手术组外,其余各组均采用“结扎冠状动脉左前降支合并游泳力竭”的方法制备冠心病气虚血瘀证动物模型,假手术组只穿线不结扎。造模结束后,分别对YQHXF组及西药组予以灌胃干预28 d。观察大鼠一般状态、体质量、心电图、血液流变学指标变化,彩色多普勒超声检查心功能,HE、Masson染色观察心脏组织。结果 造模后7、14、28 d,与假手术组比较,模型组体质量显著降低(P<0.01);与模型组比较,YQHXF组和西药组体质量显著升高(P<0.01)。造模后7、14 d,与西药组比较,YQHXF组体质量显著降低(P<0.05,P<0.01)。与假手术组比较,模型组一般状态变差,心电图ST段抬高,心肌纤维排列紊乱,心肌细胞出现肿大、坏死,且有炎症细胞浸润,心肌纤维化增加;左心室射血分数(left ventricular ejection fraction, LVEF)、左心室短轴缩短率(left ventricular fraction shortening, LVFS)均显著降低(P<0.01),左心室舒张末期容积(left ventricular end-diastolic volume, LVEDV)、左心室收缩末期容积(left ventricular end-systolic volume,LVESV)、左心室舒张末期内径(left ventricular end-diastolic internal dimension, LVEDID)、左心室收缩末期内径(left ventricular endsystolic internal dimension, LVESID)、红细胞聚集指数、卡松黏度、全血黏度(低、中、高切黏度)、胶原容积分数均显著升高(P<0.01)。与模型组比较,YQHXF组和西药组一般状态改善,心电图ST段降低,心肌纤维排列整齐,心肌细胞结构及形态改善,炎症细胞减少,心肌纤维化减少;LVEF、LVFS均显著升高(P<0.01),LVEDV、LVESV、LVEDID、LVESID、红细胞聚集指数、卡松黏度、全血黏度(低、中、高切黏度)、胶原容积分数均显著降低(P<0.01)。与西药组比较,YQHXF组心肌纤维减少;高切黏度、胶原容积分数显著降低(P<0.01)。结论 YQHXF可以明显改善大鼠一般状态,调节血液流变学指标,抑制心肌组织病理损伤,提高心功能,从而有效治疗冠心病气虚血瘀证。

基于Ca^(2+)浓度及线粒体氧化应激探讨补阳还五汤对脊髓损伤大鼠受损红核神经元的保护作用

目的从Ca^(2+)浓度及线粒体氧化应激的角度探讨补阳还五汤(Buyang Huanwu Decoction,BYHWD)对脊髓损伤(spinal cord injury,SCI)气虚血瘀证红核神经元的影响。方法将大鼠随机分为5组:对照组、模型组、BYHWD低剂量组(BL组)、BYHWD中剂量组(BM组)和BYHWD高剂量组(BH组)。除对照组外,其余4组均采用游泳力竭法联合红核脊髓束(rubrospinal tract,RST)横断术制备SCI气虚血瘀证模型。BL组、BM组、BH组大鼠分别以BYHWD生药12.825、25.650、51.300 g/kg的剂量灌胃,对照组和模型组以生理盐水灌胃。采用斜板实验检测大鼠的肢体运动功能,血液流变学检测血液的状态,氧化应激和抗氧化能力检测红核超氧化物歧化酶(superoxide dismutase,SOD)活性和丙二醛(malondialdehyde,MDA)含量,原子分光光度法测定红核Ca^(2+)浓度,透射电子显微镜观察红核线粒体的状态。结果术后第1、第14、第28天,模型组斜板实验角度均明显低于对照组(P<0.01)。术后第14、第28天,BL组、BM组、BH组斜板实验角度均明显高于模型组(P<0.01);BL组斜板实验角度明显低于BH组(P<0.01)。与术后第1天比较,术后第14、第28天BL组、BM组、BH组斜板实验角度均明显升高(P<0.01)。与对照组比较,模型组全血低切黏度、全血中切黏度、全血高切黏度、红细胞聚集指数、卡松黏度、MDA含量和Ca^(2+)浓度均明显升高(P<0.01),SOD含量明显降低(P<0.01)。与模型组比较,BL组、BM组、BH组全血低切黏度、全血中切黏度、全血高切黏度、红细胞聚集指数、卡松黏度和Ca^(2+)浓度均明显降低(P<0.01),BM组、BH组MDA含量均明显降低(P<0.05或P<0.01),BH组SOD含量明显升高(P<0.05)。与BH组比较,BL组、BM组卡松黏度均明显升高(P<0.05)。模型组出现线粒体结构模糊、排列紊乱、染色质边集的典型凋亡现象。BL组、BM组、BH组线粒体结构变得清晰,数目增多,染色质边集现象改善,其中,BH组改善最为明显。结论BYHWD对SCI气虚血瘀证大鼠受损红核神经元有保护作用,促进肢体运动功能的恢复,其机制可能与BYHWD调节血液微循环,改变线粒体形态,增强线粒体抗氧化应激能力,降低Ca^(2+)浓度有关。

中医护理联合认知疗法对气虚血瘀型卒中后认知功能障碍的影响

目的:探讨中医护理联合认知疗法对气虚血瘀型卒中后认知功能障碍(post-stroke cognitive impairment,PSCI)的影响。方法:将PSCI患者100例采用随机数字表法分为对照组和观察组各50例,对照组给予认知疗法,观察组在对照组基础上增加中医护理。观察两组患者治疗前后神经功能缺损程度、日常生活能力、认知功能障碍程度和中医症状评分及临床疗效和不良反应。结果:1)治疗后两组患者美国国立卫生研究院卒中量表(national institute of health stroke scale,NIHSS)和日常生活活动能力量表(activity of daily living,ADL)评分较治疗前下降,蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)和简易精神状态检查量表(mini-mental state examination,MMSE)评分较治疗前升高,且观察组各评分改善均优于对照组(P<0.05);2)治疗后两组患者中医各症状评分较治疗前下降,观察组低于对照组(P<0.05);3)观察组总有效率为95.92%,高于对照组的82.98%(P<0.05);4)两组患者治疗期间均无严重不良反应发生。结论:中医护理联合认知疗法对改善气虚血瘀型PSCI疗效更好,安全性较高。

中药穴位贴敷联合推拿对腹腔镜子宫肌瘤剔除术后气虚血瘀证患者胃肠功能的影响

目的:探讨中药穴位贴敷联合推拿对腹腔镜子宫肌瘤剔除术后气虚血瘀证患者胃肠功能的影响。方法:将腹腔镜子宫肌瘤剔除术患者88例按照随机数字表法分为对照组和治疗组各44例。两组患者术后给予常规干预措施;对照组在常规干预的基础上口服吗丁啉;治疗组在对照组基础上予中药穴位贴敷联合推拿治疗,治疗4天后观察两组患者症状体征改善时间、胃肠道症状分级评分量表评分、气虚血瘀主证症状评分及临床疗效。结果:治疗组患者首次排气时间、肠鸣音恢复时间、腹胀消失时间均短于对照组(P<0.01);治疗后两组患者症状、体征评分及气虚血瘀主证症状评分降低,治疗组低于对照组(P<0.01);治疗组总有效率为97.73%(43/44),高于对照组的81.82%(36/44)(P<0.05)。结论:在常规干预与口服吗丁啉的基础上实施中药穴位贴敷联合推拿能缩短腹腔镜子宫肌瘤剔除术后气虚血瘀证患者胃肠功能障碍改善时间,改善患者中医证候,效果优于常规干预联合口服吗丁啉。

《妇科良方大全》中抗子宫肌瘤方剂的用药规律分析

目的运用数据挖掘技术分析《妇科良方大全》中治疗子宫肌瘤的中药复方,探究其用药规律。方法整理《妇科良方大全》中治疗子宫肌瘤的方剂,使用Microsoft Office Excel 2017统计纳入方剂中药的使用频次、性味、归经和功效。运用IBM SPSS Modeler 18.0进行高频中药关联规则分析,并绘制关联规则网络可视化展示图。利用IBM SPSS Statistics 23.0软件进行系统聚类分析。结果共纳入方剂64首,涉及中药156味,累计使用695次。涉及中药多为补虚药、活血化瘀药和清热药,药性以寒性、温性为主,五味中多见苦味、甘味和辛味,大多归肝经、脾经和肾经。高频中药组合中支持度最高的为“莪术-三棱”,聚类分析得到5个核心组方。结论中药治疗子宫肌瘤应寒温平调,甘辛共施,辩证使用活血化瘀、补虚等功效的中药以攻补兼施,消积化聚。

益肾骨康膏治疗肾虚血瘀型癌性躯体痛的临床研究

目的:通过规范化的临床研究验证中药益肾骨康膏外敷治疗肾虚血瘀型癌性躯体痛的有效性和安全性。方法:本研究采用随机、对照前瞻性临床试验方法,将符合方案69例中重度癌性躯体痛患者随机分为试验组(n=35)和对照组(n=34),对照组给予盐酸羟考酮治疗癌性疼痛,治疗组在盐酸羟考酮基础治疗之上给予益肾骨康膏外敷痛处,通过1个疗程共计10 d的观察期,通过对治疗前后NRS评分、疼痛影响评分、体力状况等关键指标的对比,评价益肾骨康膏治疗癌性躯体痛的有效性和安全性。结果:益肾骨康膏试验组的总有效率为94.3%,显效率为85.6%,与对照组(总有效率84.3%,显效率58.9%)相比,有统计学差异(P=0.013,P<0.05)。疼痛影响评分较治疗前降低(治疗前40.23±12.533,治疗后23.77±12.386,P<0.05),与对照组比较均具有统计学意义(P=0.039,P<0.05);试验组患者治疗期间平均爆发痛次数较对照组少(试验组0.77±0.424,对照组1.22±0.726,P=0.002,P<0.01);试验组KPS评分改善优于对照组(试验组70.00±15.339,对照组62.94±11.685,P=0.036,P<0.05);治疗过程中及治疗前后,患者未出现明显皮肤不良反应,安全性指标检查较前无明显变化。结论:益肾骨康膏治疗肾虚血瘀型癌性躯体痛疗效确切,能够改善患者生活质量,而且安全性好,值得进一步深入研究、推广。

冠心汤治疗气虚血瘀型冠心病介入术后残余病变心绞痛的临床研究

目的观察本院自制汤剂冠心汤对气虚血瘀型冠心病介入术(PCI)后残余病变心绞痛患者的临床治疗效果。方法将100例气虚血瘀型冠心病介入术后残余病变心绞痛患者随机分为对照组和冠心汤组,对照组(50例)给予常规西药方案(阿司匹林、氯吡格雷、阿托伐他汀钙、美托洛尔、单硝酸异山梨酯等),冠心汤组(50例)在对照组用药基础上加服冠心汤,疗程3个月。比较治疗前后超敏C反应蛋白(hs-CRP)、脂代谢(TC、HDL-C、LDL-C)和心肌缺血总负荷(TIB)的水平,观察患者生活质量评分(SF-36)、心绞痛复发率、西雅图心绞痛量表(SAQ)、中医证候积分疗效变化。结果治疗后2组患者在心绞痛复发率、西雅图心绞痛量表、生活质量评分、中医证候积分疗效等方面较前改善(P<0.05~0.01),冠心汤组优于对照组(P<0.05~0.01);治疗后冠心汤组的中医证候有效率较对照组高(P<0.01)。2组hs-CRP、TC、LDL-C均显著下降(P<0.05~0.01),冠心汤组降低更明显(P<0.05~0.01);2组HDL-C水平均高于治疗前(P<0.05),但2组间比较无统计学差异(P>0.05)。2组TIB均较前降低(P<0.05~0.01),冠心汤组降低更为显著(P<0.05)。结论冠心汤可有效改善气虚血瘀型冠心病PCI后残余病变心绞痛患者的临床症状,减轻心肌缺血,调节血脂代谢,减少炎症反应,提高生活质量。

艾灸联合中药保留灌肠治疗气虚血瘀型慢性盆腔炎30例

目的观察艾灸联合中药保留灌肠治疗气虚血瘀型慢性盆腔炎的临床疗效。方法将60例气虚血瘀型慢性盆腔炎患者随机分为治疗组和对照组(各30例);在采用常规抗生素治疗的基础上,治疗组采用艾灸联合中药理冲汤加减方保留灌肠,对照组单用中药理冲汤加减方保留灌肠。两组疗程均为14天,观察临床疗效。结果治疗组、对照组总有效率分别为93.3%、70.0%;组间临床疗效比较,差异有统计学意义(P<0.05)。结论艾灸联合中药保留灌肠治疗气虚血瘀型慢性盆腔炎疗效确切。

防治抗生素相关性腹泻不可忽视血瘀证

目的:研究血瘀证对抗生素相关性腹泻(Antibiotic-Associated Diarrhea,AAD)发病率的影响及其在AAD证型分布中所占比例。方法:对2012年2月至2013年2月在我院ICU病房接受抗生素治疗的216例病例进行回顾性调查,研究血瘀证、非血瘀证患者接受抗生素治疗后AAD的发病率;血瘀证在AAD证型分布中所占的比例;引发AAD合并血瘀证的病理机制。结果:血瘀证患者接受抗生素治疗后AAD发病率45.26%>非血瘀证者31.67%,P<0.05;其中,脾气亏虚患者合并血瘀证者发生AAD几率58.33%>非血瘀证者12.50%,P<0.05;湿浊内阻患者合并血瘀证者发生AAD几率62.50%>非血瘀证者19.23%,P<0.05;脾虚湿浊患者合并血瘀证者发生AAD几率75.00%>非血瘀证者27.27%,P<0.05。在AAD证型分布中,血瘀证比例为29.63%,仅次于脾虚痰湿证64.20%居第二。在导致AAD合并血瘀证的病理机制中,痰饮瘀血互化占54.17%。结论:血瘀证、特别是脾虚湿阻型患者在合并血瘀证时更易发生AAD;血瘀证是AAD证型分布中的重要组成部分,其地位仅次于脾虚痰湿证;在多数情况下,导致AAD合并血瘀证的病理机制是痰饮瘀血互化。