Changes of free radicals and digestive enzymes in saliva in cases with deficiency inspleen-yin syndrome

Objective：To explore the nature of deficiency in spleen-yin syndrome,which could provide scientific theoretical support and practical guidance for clinical Traditional Chinese Medicine（TCM）syndrome differentiation based on biology,and had a strong clinical significance.Methods：Serum Cu and Zn were detected by atomic absorption spectrophotometer,serum vitamin E by high performance liquid chromatography,serum vitamin C by 2,4-Dinitrophenylhydrazine Colorimetry,total superoxide dismutase（SOD）and Cu and Zn- SOD by the xanthine oxidase method,and malondialdehyde（MDA）by the 2-thiobarbituric acid method（TBA）.Total antioxidant capacity was detected by a colorimetry kit.Amylase Activity was detected by an automatic biochemical analyzer.Lysozyme was detected by lysozyme detection plate,the diameter of bacteriolysis circle was measured and the corresponding content of lysozyme was obtained from a table of standard curve values.Results： No significant difference in total SOD and Cu,Zn-SOD was found between deficiency in spleen-yin group and normal group.However,such factors in deficiency in kidney-yin group were significantly lower than the other groups（P〈0.05）.The MDA content in both deficiency in spleen-yin group and deficiency in kidney-yin group were significantly higher than that of normal group（P〈0.05）,while the total antioxidant capacity was significantly lower than normal group（P〈0.05）.The vitamin E content in deficiency in kidney-yin group was significantly lower than that in the other two groups（P〈0.05）.No significant difference in the contents of vitamin C,Cu and Zn were observed in these groups.The Zn/Cu level in deficiency in kidney-yin group and the vitamin E level in deficiency in spleen-yin group decreased,but with no significant difference.Amylase activity in unit time in cases with deficiency in spleen-yin was lower than and had significant differences with that in normal cases,and higher than that in cases with deficiency in kidney-yin.The sectional velocity of saliva and the ratio of lysozyme in normal case group were significantly higher than other two groups,while deficiency in the spleen-yin group was significantly higher than the deficiency in kidney-yin group.Conclusion：All the results indicated that the objective pathological mechanism between the deficiency in spleen-yin and deficiency in kidney-yin was different.

TCM Treatment for 40 Cases of Rheumatoid Arthritis with Channel Blockage due to Yin Deficiency

To verify the therapeutic effects of the method of softening and lubricating the joints,and calming the endogenous wind in case of rheumatoid arthritis (RA) with the syndrome of channel blockage due to yin deficiency,60 RA patients with the syndrome of channel blockage due to yin deficiency were randomly divided into a treatment group (40 cases) and a control group (20 cases) and treated respectively by the above method for the former and with Zheng Qing Feng Tong Ning Tablets (正清风痛宁片) for the latter. The result turned out to be that the effect in the treatment group was very satisfying.The treatment group obtained a better result in the accumulated points of syndrome and RA,morning rigidity of the joints,grip strength,20m walking time and erythrocyte sedimentation rate (ESR) (P<0.01 or P<0.05).The above indicates that channel blockage due to yin deficiency is an important pathogenesis of RA,and calming the endogenous wind is a method of choice for treating RA.

Efficacy of integrative medicine in deficiency of both qi and yin in the rat model of type 2 diabetes

Objective:To establish a rat model of type 2 diabetes(T2DM)manifesting the Chinese medicine syndrome pattern of both qi and yin deficiency for evaluating the efficacy of a Chinese herbal formula(CHF),integrative medicine(IM),and pioglitazone(PIO)on T2DM indicators in the animal model.Methods:The rat model was induced by a high-fat diet(HFD)and streptozotocin(STZ,30 mg/kg).CHF(3.4 g/kg),PIO(2.7 mg/kg),and IM(3.4 g CHF+2.7 mg PIO)were administered to rats once daily for 14 days.Related laboratory parameters were observed.Results:Diabetic rats showed unsmooth fur,alopecia,reduced activity,huddling,somnolence,depression,pale or reddened tongue,damp/dark red tail,and high levels of water and food intake,urine volume,and stool weight,but weakened grip strength.Low levels of serum SOD,Nat-Kt-ATPase,cAMP/cGMP,and a high level of iNOS were observed.Hyperglycemia,hyperinsulinemia,insulin resistance,high levels of serum glucagon/IDE and pancreatic amylin,and low serum and pancreatic SS levels were evident as well.Conclusions:A rat model of T2DM with both qi and yin deficiency was successfully replicated.CHF appeared to be more efficacious than IM and PIO in the rat model of qi and yin deficiency pattern of T2DM,though IM and PIO were each found to have their merits and drawbacks in attenuating T2DM indicators in the rat model.

Establishment and evaluation of a mouse model of bronchial asthma with Yin deficiency syndrome

Objective: To establish and evaluate a mouse model of bronchial asthma with Yin deficiency syndrome. Methods: The mouse model of bronchial asthma with Yin deficiency syndrome was established by the treatment with injecting ovalbumin(OVA) two times to sensitize, inhaling OVA 14 times to stimulate, and using thyroxin through lavage during late stimulation. This model was evaluated through body weight, asthmatic behaviors, respiratory function, autonomous activity, lung pathology, and pulmonary fluid clearance. Results: OVA combined with thyroxin was an appropriate method to induce the mouse model with increased food and water intake, autonomous activity, asthmatic behaviors score, and respiratory rate, decreased body weight, tidal volume, and wet/dry ratio of lung, and changed with pathology of lung tissue. The changes of the above mentioned parameters indicated that the model was the bronchial asthma with Yin deficiency syndrome. Conclusion: The OVA combined with thyroxin is a good pattern to establish a mouse model of bronchial asthma with Yin deficiency syndrome successfully, which can highly simulate the clinical symptoms of this 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.

Effect of Huangqi Xiaoke Recipe combined with alprostadil on qi and yin deficiency type diabetic nephropathy and its effect on vascular endothelium and oxidative stress

Objective: To observe the clinical efficacy of Huangqi Xiaoke Decoction combined with alprostadil on qi and yin deficiency type diabetic nephropathy (DN) and its effect on vascular endothelium and oxidative stress. Methods: A total of 72 patients with qi and yin deficiency type DN who were admitted to the diabetes specialist ward and outpatient department of Baoan District Hospital of Shenzhen from January 2017 to July 2018 were enrolled. The patients were divided into the control group and the observation group according to the random number method. 36 cases in each group. Both groups were treated with conventional treatments such as hypoglycemic, hypotensive, lipid-lowering and anti-platelet aggregation. The control group was treated with alprostadil on the basis of conventional treatment. The observation group was given orally on the basis of the control group. Both groups were treated once a day for a total of 4 weeks. Compare the clinical syndrome scores and clinical efficacy of the two groups before and after treatment;fasting blood glucose (FPG), glycosylated hemoglobin (HbA1C), blood lipids (TC, TG, LDL, HDL), serum creatinine (SCr), blood urea nitrogen (BUN Endothelin-1 (ET-1), nitric oxide (NO), von Willebrand factor (vWF);glutathione peroxidase (GSH-Px), superoxide disproportionation The level of enzyme (SOD), malondialdehyde (MDA). Results:The total effective rate of TCM syndromes in observation group was 94.44%, which was significantly different from 72.22% in the control group. The scores of TCM syndromes in the observation group were significantly lower than those in the control group;Compared with the control group, the HDL-C of the observation group did not change much, there was no statistical difference;FBG, HbA1C, SCr, BUN, TC, TG, LDL-C, ET-1, vWF, MDA Significantly decreased, NO, GSH-Px, SOD increased significantly, with significant difference. Conclusion: Huangqi Xiaoke Decoction combined with alprostadil in the treatment of qi and yin deficiency type DN has significant curative effect, which can not only lower blood sugar, regulate blood lipids, improve renal function and clinical symptoms, but also inhibit oxidative stress and protect endothelial function.

Study on syndrome differentiation based on pharmacology of syndrome management system-a case of Qi and Yin deficiency syndrome

Taking the Qi and Yin deficiency syndrome as an example,the research method of pharmacology of syndrome management system was proposed.By means of text mining,systematic pharmacology and target analysis,to attempt to reveal the essence of the corresponding syndrome by studying the drugs and targets of Qi and Yin deficiency.Fourteen Chinese herbs treating Qi and Yin deficiency were retrieved and used more than 30 times,and 9,317 related targets were predicted.The common targets of action were 85.Topological analysis was carried out by using degree centrality,closeness centrality and betweenness centrality to confirm that estrogen receptor(ESR1),tumor necrosis factor(TNF),D(2)dopamine receptor(DRD2),vitamin D3 receptor(VDR),glucocorticoid receptor(NR3C1),acetylcholinesterase(ACHE)and endothelin-1(EDN1)were highly correlated with Qi and Yin deficiency syndrome.Through the target to find Qi and Yin deficiency syndrome corresponding to 17 categories of diseases.A new idea was provided for studying the biological essence of TCM clinical syndrome differentiation.

Clinical Significance and Changes of ECG in the Patients with Cardiac Deficiency of the Qi and the Yin

In order to explore the changes and clinical significance of ECG in the patients with cardiac deficiency of the Qi and Yin, 124 patients with heart diseases were examined by means of ECG. The results showed that the prevalence of left ventricular hypertrophy in cardiac deficiency of the Qi (CDQ) was obviously higher than that of cardiac deficiency of the Yin (CDY). The higher prevalence of tachycardia occurred in the patients with CDY.The prevalence of the Q - T interval prolongation and abnormalities of ST - T segment in the patients with CDY was also higher than that of CDQ. The difference between two groups suggests that the diagnosis of two syndromes by ECG may be of important value.

Study on blood pressure rhythm in hypertensive patients with Yin deficiency syndrome and a random forest model for predicting hypertension with Yin deficiency syndrome

OBJECTIVE: To investigate blood pressure rhythm(BPR)in Yin deficiency syndrome of hypertension(YDSH)patients and develop a random forest model for predicting YDSH.METHODS: Our study was consistent with technical processes and specification for developing guidelines of Evidence-based Chinese medicine clinical practice(T/CACM 1032-2017). We enrolled 234 patients who had been diagnosed with primary hypertension without antihypertensive medications prior to the enrollment. All participants were divided into Yin deficiency group(YX, n = 74) and non-Yin deficiency group(NYX, n = 160).Participants were professionally grouped by three experienced chief Traditional Chinese Medicine(TCM)physicians according to four examinations(i.e.,inspection, listening and smelling, inquiry and palpation).We collected data on 24 h ambulatory blood pressure monitoring(ABPM) and YDSH rating scale. We divided 24 h of a day into 12 two-hour periods [Chen-Shi(7:00-9:00), Si-Shi(9:00-11:00), Wu-Shi(11:00-13:00), Wei-Shi(13:00-15:00), Shen-Shi(15:00-17:00), You-Shi(17:00-19:00), Xu-Shi(19:00-21:00), Hai-Shi(21:00-23:00), ZiShi(23:00-1:00), Chou-Shi(1:00-3:00), Yin-Shi(3:00-5:00), Mao-Shi(5:00-7:00)] according to the theory of “midnight-midday ebb flow”. We used random forest to build the diagnostic model of YDSH, with whether it was Yin deficiency syndrome as the outcome. RESULTS: Compared with NYX group, YX group had more female participants with older age, lower waist circumference, body mass index(BMI), diastolic blood pressure(DBP), and smoking and drinking rate(all P < 0.05). The YDSH rating scores of YX group [28.5(21.0-36.0)] were significantly higher than NYX group [13.0(8.0-22.0)](P < 0.001), and the typical symptoms of YX group included vexing heat in the chest, palms and soles, dizziness, dry eyes, string-like and fine pulse, soreness and weakness of lumbus and knees, palpitations, reddened cheeks, and tinnitus(all P < 0.05). The ratio of non-dipper hypertension in YX group was higher than in NYX group(56.9% vs 44.4%, P = 0.004). Compared with NYX group, 24 h DBP standard deviation(SD), nighttime DBP SD, Si-Shi DBP, Si-Shi mean arterial pressure(MAP), Hi-Shi systolic blood pressure(SBP), Hi-Shi DBP, Hi-Shi MAP, Zi-Shi SBP, Zi-Shi DBP, Zi-Shi MAP, ChouShi SBP SD, Chou-Shi DBP SD, Chou-Shi SBP coefficient of variation(CV) were lower in YX group(all P < 0.05). Binary Logistic Regression analysis showed that the diagnosis of YDSH was positively correlated with age, heart rate, YDSH rating scores, and four TCM symptoms including vexing heat in the chest, palms and soles, string-like and fine pulse, soreness and weakness of lumbus and knees, and reddened cheeks(all P < 0.05), but was negatively correlated with smoking(P﹥0.05). In addition, the diagnosis of YDSH was positively correlated with daytime SBP SD, nighttime SBP SD, nighttime SBP CV, and Hi-Shi SBP CV, but was negatively correlated with 24 h SBP CV, daytime DBP SD, nighttime DBP SD, and Hi-Shi DBP(all P < 0.05). Hi-Shi SBP CV had independent and positive correlation with the diagnosis of YDSH after adjusting the variables of age, gender, course of hypertension, BMI, waist circumference, SBP, DBP, heart rate, smoking and drinking(P = 0.029). Diagnostic model of YDSH was established and verified based on the random forest. The results showed that the calculation accuracy, specificity and sensitivity were 77.3%, 77.8% and 76.9%, respectively. CONCLUSION: The BPR was significantly attenuated in YDSH patients, including lower 24 h DBP SD and nighttime DBP SD, and Hi-Shi SBP CV is independently correlated with the diagnosis of YDSH. The prediction accuracy of diagnosis model of YDSH based on the random forest was good, which could be valuable for clinicians to differentiate YDSH and non-Yin deficiency patients for more effective hypertensive treatment of TCM.

Empirical Prescriptions Used in Treatment of Epigastralgia due to Blood Stasis of Deficiency Type

Epigastralgia,a commonly-seen symptom inchronic gastritis or gastric ulcer,and usually causesinjury of the vital-qi and thereby deficiency of thehuman body due to its chronicity.The deficiency isdivided into deficiency of yin,yang,qi,and blood.Asis said in A Guide to Clinical Practice with MedicalRecords(临证指南医案),illnesses at the early stageaffect channels which dominate qi while at the latestage collaterals which dominate blood,and

基于糖代谢和胰岛素抵抗评估益气养阴法治疗气阴两虚型2型糖尿病的疗效

目的分析益气养阴法治疗气阴两虚型2型糖尿病对患者糖代谢和胰岛素抵抗评估的影响。方法南京中医药大学附属南京市中西医结合医院2019年6月—2022年3月收治的90例气阴两虚型2型糖尿病患者随机分为胰岛素泵治疗组(45例)和益气养阴治疗组(45例)。益气养阴治疗组采用胰岛素泵强化治疗联合益气养阴法进行治疗,胰岛素泵治疗组单独进行胰岛素泵强化治疗,两组均治疗2周。统计两组治疗2周后的临床疗效及治疗期间不良反应发生情况,比较两组治疗前和治疗2周后中医证候积分、糖代谢情况、胰岛素抵抗情况。结果治疗2周后,益气养阴治疗组总有效率为91.11%(41/45),高于胰岛素泵治疗组[73.33%(33/45),P<0.05]。治疗2周后与治疗前比较,两组口燥咽干、倦怠乏力、失眠、自汗盗汗、五心烦热、气短懒言评分及血清空腹血糖(fasting blood glucose,FPG)、餐后2 h血糖(postprandial 2-hour blood glucose,2 h PG)、糖化血红蛋白(glycated hemoglobin,HbA1c)、空腹胰岛素(fasting insulin,FINS)水平、胰岛素抵抗指数(Homa-IR)降低,益气养阴治疗组低于胰岛素泵治疗组(P<0.05),两组胰岛素敏感指数(insulin sensitivity index,ISI)、胰岛功能指数(Homa-islet)升高,益气养阴治疗组高于胰岛素泵治疗组(P<0.05)。治疗期间,益气养阴治疗组总不良反应发生率与胰岛素泵治疗组比较,差异无统计学意义(P>0.05)。结论气阴两虚型2型糖尿病患者采用益气养阴法进行治疗,可有效改善患者中医证候、糖代谢,降低患者机体胰岛素抵抗程度,具有较好的治疗效果。

通督调神针法治疗阴虚动风型脑梗死偏瘫疗效及对患者血清Hcy、CRP水平的影响

目的:探讨通督调神针法治疗阴虚动风型脑梗死偏瘫患者疗效及对患者血清同型半胱氨酸(Hcy)、C反应蛋白(CRP)水平的影响。方法:选取脑梗死偏瘫患者76例,1∶1随机分为观察组(西医治疗+通督调神针法)与对照组(常规西医治疗)各38例。持续治疗1个月后,评估两组临床疗效,比较两组治疗前后中医证候积分、血清炎症因子(Hcy、CRP)水平、运动功能[Fugl-Meyer评定量表(FMA)]、平衡功能[Berg平衡量表(BBS)]和移动功能[功能性步态评价表(FGA)]变化情况,并记录两组不良事件发生率。结果:观察组总有效率更高(P<0.05);观察组治疗后中医证候积分降低程度比对照组更明显(P<0.05)。观察组治疗后FMA、FGA和BBS评分升高水平均比对照组更明显(P<0.05),观察组治疗后Hcy、CRP水平下降程度均比对照组更明显(P<0.05)。治疗期间两组均无不良事件发生。结论:阴虚动风型脑梗死偏瘫患者应用通督调神针法联合常规西医治疗具有较好的增益效果,可有效提高临床疗效,缓解患者临床症状,提高运动、平衡和移动能力,降低炎症反应。

参松养心胶囊治疗老年冠心病室性早搏气阴两虚、心络瘀阻型患者临床观察

目的:观察参松养心胶囊对老年冠心病室性早搏气阴两虚、心络瘀阻型患者临床疗效、动态心电图室性早搏次数及中医证候积分的影响。方法:选择老年冠心病室性早搏气阴两虚、心络瘀阻型患者60例,按照随机数字表法分为对照组和观察组,每组30例。对照组给予口服酒石酸美托洛尔,观察组在对照组基础上口服参松养心胶囊。两组均连续治疗4周。观察两组治疗前后临床疗效,24 h动态心电图室性早搏次数及中医证候积分。结果:对照组有效率[73.33%(22/30)]高于观察组[96.67%(29/30)](P<0.05)。两组治疗后室性早搏次数均减少,观察组减少较对照组更明显(P<0.05)。与治疗前比较,两组心悸、悸动不安、神疲乏力、气短、五心烦热等中医证候积分均下降(P<0.05),且治疗后观察组上述指标改善优于对照组(P<0.05)。结论:参松养心胶囊能有效减少老年冠心病室性早搏患者的室性早搏次数,改善患者临床症状。

黄芪竹叶汤配合益气生津丸治疗2型糖尿病气阴两虚证患者的临床观察

目的观察黄芪竹叶汤配合益气生津片治疗2型糖尿病气阴两虚证的临床效果。方法选取2020年1月—2022年1月期间河南省安阳市中医院收治的2型糖尿病(T2DM)患者90例作为研究对象,按随机数字表法分为对照组和治疗组,每组各45例。两组患者均给予常规西药治疗,对照组采用黄芪竹叶汤,治疗组在对照组基础上加用益气生津丸治疗,均连续治疗3个月。观察比较两组患者临床疗效、不良反应发生率,治疗前后中医证候积分、血糖指标[空腹血糖(Fasting plasma glucose,FPG),糖化血红蛋白(Glycosylated hemoglobin,HbA1c),空腹胰岛素(Fasting insulin,FINS)]及血清炎性因子[C-反应蛋白(C-reactive protein,CRP)、白细胞介素-1β(Interleukin-1β,IL-1β)、白细胞介素-6(Interleukin-6,IL-6)]水平。结果治疗后治疗组总有效率91.11%(41/45)明显高于对照组75.55%(34/45),差异有统计学意义(P<0.05)。治疗后两组患者中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且治疗组各主症及各次症积分均低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血糖指标FPG、FINS、HbA1c均较治疗前降低,差异有统计学意义(P<0.05);且治疗组FPG、FINS、HbA1c均低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清炎性因子水平CRP、IL-6、IL-1β均较治疗前降低,差异有统计学意义(P<0.05);且治疗组CRP、IL-6、IL-1β均低于对照组,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)。结论黄芪竹叶汤配合益气生津丸是治疗2型糖尿病有效且安全的方案,能明显控制患者血糖,减轻炎症反应。

子午流注择时电温针联合双补增津汤治疗结肠慢传输型便秘气阴两虚证的疗效观察

目的:观察子午流注择时电温针联合双补增津汤治疗结肠慢传输型便秘(STC)气阴两虚证的临床疗效。方法:选择符合纳入标准的152例STC气阴两虚证患者,按随机抽取法分为对照组(枸橼酸莫沙必利治疗)、电针组(枸橼酸莫沙必利+子午流注择时电温针治疗)、中药组(枸橼酸莫沙必利+双补增津汤治疗)和结合组(枸橼酸莫沙必利+子午流注择时电温针+双补增津汤治疗),每组各38例,均治疗4周。观察比较4组患者治疗前后中医症状积分和总积分、结肠传输试验标志物含量、肠道菌群数量、焦虑自评量表评分(SAS)、抑郁自评量表评分(SDS)、慢性便秘严重度评分(CSS)的变化情况,比较临床疗效及随访6个月复发率。结果:4组患者治疗后中医症状积分和总积分、结肠传输试验标志物含量和SAS、SDS、CSS评分均较治疗前比较均明显下降(P<0.05),肠道内大肠埃希数量与治疗前比较明显减少(P<0.05),双歧杆菌、乳酸杆菌数量与治疗前比较明显增多(P<0.05);结合组临床疗效明显优于其他3组(P<0.05),随访期复发率明显低于其他3组(P<0.05)。结论:子午流注择时电温针联合双补增津汤治疗STC气阴两虚证的疗效显著,二者可发挥协同增效作用,能有效缓解便秘症状,调节肠道菌群,恢复肠道运动功能,改善焦虑、抑郁心理状态,降低复发率。

结核丸联合常规西药治疗阴虚火旺型耐药结核病临床研究

目的:观察结核丸联合常规西药治疗耐阴虚火旺型耐药结核病的临床疗效及对微小核糖核酸-30a-5p (miR-30a-5p)、微小核糖核酸-431 (miR-431)表达的影响。方法:采用随机数字表法将98例阴虚火旺型耐药结核病患者分为治疗组、对照组各49例。对照组予以常规西药治疗,治疗组予以结核丸联合常规西药治疗,2组均治疗6个月。比较2组治疗前后中医证候积分、T细胞亚群、炎症因子[白细胞介素-4 (IL-4)、C-反应蛋白(CRP)、干扰素-γ (INF-γ)]、miR-30a-5p、miR-431水平,评估2组临床疗效及不良反应发生情况。结果:治疗后,治疗组总有效率97.96%,对照组总有效率85.71%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组miR-30a-5p、CD3^(+)、CD4^(+)、INF-γ水平及CD4^(+)/CD8^(+)较治疗前升高(P<0.05),中医证候积分及CD8^(+)、miR-431、IL-4、CRP水平降低(P<0.05);治疗组治疗后miR-30a-5p、CD3^(+)、CD4^(+)、INF-γ水平及CD4^(+)/CD8^(+)高于对照组(P<0.05),中医证候积分及CD8^(+)、miR-431、IL-4、CRP水平低于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:结核丸联合常规西药治疗阴虚火旺型耐药结核病疗效显著,能调节患者miR-30a-5p、miR-431水平,提高免疫功能,减轻炎症反应,安全性较高。

CLINICAL OBSERVATION ON 84 CASES OF VENTRICULAR PREMATURE BEAT WITH DEFICIENCY SYNDROME TREATED BY QI LU TANG

From August 1989 to May 1994, 84 cases of ventricular premature beat (VPB) with deficiency syndrome were treated with our empirical prescription called Qi Lu Tang Decoction for Improving Abnormal Heart Beat). The total effective rate was 88.10%, being significantly different from that of the control group treated with the Western drug propafenone (P

玉液汤加减联合二甲双胍和德谷门冬双胰岛素对2型糖尿病气阴两虚证患者临床疗效观察

目的:对玉液汤加减联合二甲双胍和德谷门冬双胰岛素对2型糖尿病(T2DM)气阴两虚证患者的临床疗效进行探讨。方法:将60例T2DM患者随机分为对照组(n=30)和观察组(n=30),对照组采用二甲双胍联合德谷门冬双胰岛素治疗,观察组在此基础上应用玉液汤加减治疗,比较2组治疗后的中医证候积分、糖化血红蛋白(Hb Alc)、空腹血糖(FPG)、餐后2 h血糖(2h PG)、日内平均血糖波动幅度(MAGE)、胰岛素抵抗指数(HOMA-IR)和胰岛素分泌指数(HOMA-IS)。结果:治疗后,观察组总有效率显著高于对照组(93.33%vs 86.67%);观察组中医证候积分、Hb Alc、FPG、2h PG、MAGE和HOMA-IR等指标均低于对照组,HOMA-IS高于对照组(均P<0.05)。结论:玉液汤加减联合二甲双胍和德谷门冬双胰岛素对2型糖尿病气阴两虚证患者疗效显著,可有效控制患者的血糖并改善胰岛功能。

补中益气汤合增液汤加减治疗功能性便秘气阴两虚证疗效评价

目的探讨补中益气汤合增液汤加减治疗功能性便秘气阴两虚证的临床疗效。方法将该院于2019年1月—2021年12月收治的80例功能性便秘气阴两虚证患者纳入研究,采用随机对照法将所选患者进行分组,分为治疗组及对照组各40例。其中治疗组患者应用补中益气汤合增液汤加减治疗,150 mL/次,每日2次。对照组予以枸橼酸莫沙必利分散片5 mg/次口服,每日3次。2组均以4周为1个疗程,比较治疗前后便秘主要症状评分、便秘患者症状自评量表(PAC-SYM)评分变化情况,并比较两组患者的临床疗效。结果药物干预前,两组患者临床症状包括大便性状、排便间隔、排便困难、排便不尽症状评分及腹部症状、直肠症状、大便症状、PAC-SYM量表总分评分对比,差异无统计学意义,均P>0.05;经药物干预后,两组患者大便性状、排便间隔、排便困难、排便不尽症状评分及腹部症状、直肠症状、大便症状、PAC-SYM量表总分评分均明显低于治疗前,且观察组明显低于对照组,均P<0.05。观察组的总有效率明显高于对照组(P<0.05)。结论补中益气汤合增液汤加减治疗功能性便秘气阴两虚证具有较好临床效果,能够显著缓解大便干燥症状,改善患者生存状态,且具有不良反应小、患者认可度高等优势,是值得广泛应用的方案之一。

针药并用治疗气阴两虚兼瘀型糖尿病性勃起功能障碍的疗效观察及对血管内皮功能及相关生长因子的影响

目的 观察针刺联合益气养阴活血方治疗气阴两虚兼瘀型糖尿病性勃起功能障碍的临床疗效及对血管内皮功能及相关生长因子的影响。方法 将90例气阴两虚兼瘀型糖尿病性勃起功能障碍患者随机分为治疗组和对照组,每组45例。对照组予糖尿病基础治疗及他达拉非片口服治疗,治疗组在对照组基础上采用针刺联合益气养阴活血方。比较两组国际勃起功能指数-5(international index of erectile function-5, IIEF-5)评分和中医证候积分变化,比较两组血清内皮素-1(endothelin-1, ET-1)、血管紧张素-Ⅱ(angiotensin Ⅱ, Ang-Ⅱ)、一氧化氮(nitric oxide, NO)和血管活性肠肽(vasoactive intestinal peptide, VIP)含量变化,比较两组血清内皮生长因子(vascular endothelial growth factor, VEGF)、转化生长因子-β(transforming growth factor-β, TGF-β)、成纤维细胞生长因子-21(fibroblast growth factor 21, FGF-21)和胰岛素样生长因子-1(insulin-like growth factor 1, IGF-1)含量变化,并比较两组临床疗效。结果 治疗后,两组IIEF-5评分高于治疗前(P<0.05),对照组勃起无力、腰膝酸软、阴部刺痛及中医证候积分总分低于治疗前(P<0.05),治疗组中医证候各项积分及总分低于治疗前(P<0.05);且治疗组IIEF-5评分高于对照组(P<0.05),治疗组中医证候各项积分及总分低于对照组(P<0.05)。治疗后,两组血清ET-1和AngⅡ低于治疗前,NO和VIP高于治疗前(P<0.05);且治疗组血清ET-1和AngⅡ低于对照组,NO和VIP高于对照组(P<0.05)。治疗后,两组血清VEGF和IGF-1高于治疗前,TGF-β和FGF-21低于治疗前(P<0.05);且治疗组血清VEGF和IGF-1高于对照组,TGF-β和FGF-21低于对照组(P<0.05)。治疗组总有效率为90.7%,高于对照组的73.8%(P<0.05)。结论 在西药治疗的基础上,针刺联合益气养阴活血方能够改善气阴两虚兼瘀型糖尿病性勃起功能障碍患者临床症状,提高治疗效果,可能与改善血管内皮功能、调节相关生长因子有关。