Mechanism of action of Wuzi Yanzong pill in the treatment of oligoasthenozoospermia in rats determined via serum metabolomics

Objective:To investigate the mechanism of action of Wuzi Yanzong pill(WYP)in rats with oligoasthenozoospermia(OAZ)via metabolomics and to provide a possible basis for improving this WYP-based treatment.Methods:A rat model of OAZ was established by treating male SpragueeDawley rats with glucosides from Tripterygium wilfordii Hook.F.Seventy-two rats were randomly divided into six groups:control,L-carnitine(positive control),model,and low-,medium-,and high-dose WYP groups.Rats in the experimental groups were treated with WYP for 4 weeks.At the end of the treatment period,sperm cell quality(density,motility,and viability)was assessed using a semen analysis system,mitochondrial membrane potential(MMP)was assessed using flow cytometry,and testicular injury was assessed using hematoxylin and eosin staining to validate the therapeutic effect of WYP in OAZ.Further,serum metabolomics-based analysis was performed using high-performance liquid chromatography-mass spectrometry to identify differential metabolic pathways and possible mechanisms of action of WYP in OAZ treatment.Results:A rat model of OAZ was considered successfully-established after comparing the quality of spermatozoa in the model group to that in the control group.WYP-M and WYP-H treatments significantly improved sperm cell density,motility,and viability compared with those in the model group(all P<.05).Compared with the model group,both WYP-M and WYP-H treatments increased MMP values(P=.006 and P=.021 respectively),while there was no significant difference in the L-carnitine group.L-carnitine and WYP administration reversed damage to the testes to varying degrees compared with that in the model group.Further,44 differential metabolites and four metabolic pathways,especially autophagy pathway,related to OAZ were identified via metabolomics.Conclusions:WYP improves sperm cell quality and MMP in OAZ primarily via autophagy regulation.These findings can be employed to improve the efficacy of WYP in humans.

Can Tibetan medicine Honghua Ruyi pills relieve endometriosisassociated dysmenorrhea?Protocol for a randomized placebocontrolled trial

Objective:To provide high-quality clinical evidence of the efficacy of Tibetan medicine Honghua Ruyi(HHRY)pills for endometriosis-associated dysmenorrhea.Methods:This study constitutes a multicenter,randomized,double-blind,placebo-controlled trial encompassing a three-menstrual cycle intervention followed by a three-menstrual cycle follow-up period.A total of 164 eligible females with endometriosis-associated dysmenorrhea were randomly divided into HHRY pills and placebo groups in a 1:1 ratio.The primary outcome included dysmenorrhea symptoms assessed using Visual Analog Scale(VAS)scores and quality of life,whereas the secondary outcome measures included the maximum VAS for non-menstrual pelvic pain,duration of pain episodes(in days),frequency and quantity of the consumption of ibuprofen sustained-release capsules(or other non-steroidal anti-inflammatory drugs),and days off work/study for staff/student due to dysmenorrhea,ovarian cyst,and/or pelvic nodule size.The safety was monitored throughout the treatment period.All the analyses were based on the intention-to-treat principle.For continuous outcomes,simple or multiple linear regressions were used to estimate the differences between the HHRY pills and placebo groups,with categorical data expressed as the number and percentage of occurrences.Differences were compared using the chi-square test or Fisher's exact test.The predefined analysis was adjusted for concomitant treatment,a variable considered to be associated with outcomes but unaffected by treatment allocation.Estimates of treatment effects were reported with 95%confidence intervals.Two-tailed P values≤.05 were considered statistically significant.Conclusion:Positive results from this trial,upon completion would provide robust evidence for the efficacy and safety of HHRY pills in treating dysmenorrhea in patients with endometriosis.

The Effect of Ginkgo Biloba Leaf Dropping Pill Combined with Butylphthalide Capsule on Cognitive Dysfunction in Patients after Acute Ischemic Stroke and Its Impact on Serum Cytokines

Objective: To investigate the therapeutic effect of Ginkgo biloba extract dropping pills combined with butylphthalide capsules on cognitive dysfunction in patients after acute ischemic stroke (AIS) and its impact on serum cytokines CRP, IL-6, and Hcy. Methods: This study selected 76 patients with cognitive dysfunction after ischemic stroke who were hospitalized at Zhuji People’s Hospital from January 2023 to January 2024. The patients were divided into two groups. The control group was treated with butylphthalide capsules, while the combination group received Ginkgo biloba extract dropping pills in addition to the treatment given to the control group. The neurological function, cognitive function, activities of daily living, and levels of serum cytokines CRP, IL-6, and Hcy were compared between the two groups after 1 month and 3 months of treatment. Results: The NIHSS scores, MMSE scores, ADL scores, and levels of CRP, IL-6, and Hcy in both groups showed statistically significant differences compared to before treatment (P Conclusion: The combination of Ginkgo biloba extract dropping pills and butylphthalide capsules has a better therapeutic effect on cognitive dysfunction in patients after ischemic stroke. It can improve the neurological function and cognitive function of patients, enhance their ability to perform daily activities, and reduce inflammatory responses.

Exploring the molecular mechanism of Suoquan pill in the treatment of diabetic kidney disease based on network pharmacology,molecular docking,in vitro experiment

Background:Diabetic kidney disease(DKD)is a microvascular complication of diabetes mellitus and is the main cause of end-stage renal failure.Suoquan pills(SQP)has a variety of pharmacological activities and multiple therapeutic effects,and it is used clinically as a basic formula for the treatment of DKD.Methods:Public databases were used to identify SQP compounds and the potential targets of SQP and DKD.A drug-component-therapeutic target network was constructed.Protein-protein interaction network analysis,Gene Ontology functional analysis,and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis were used to analyse the potential molecular mechanisms of SQP based on common targets of drugs and diseases.Molecular docking simulations were conducted to confirm the binding abity of the core compounds to key targets.The efficacy and predicted molecular mechanisms of SQP were validated using cell counting kit-8 assay,flow cytometry,and western blotting with HK-2 cells as a model.Results:Network pharmacology analysis showed that 26 compounds and 207 potential targets of SQP were involved in the treatment of DKD;boldine,denudatin B,pinocembrin,kaempferoid,and quercetin were considered core compounds,and epidermal growth factor receptor(EGFR)and proto-oncogene,non-receptor tyrosine kinase(SRC)were considered key targets.Gene Ontology enrichment analysis indicated that protein phosphorylation and negative regulation of apoptotic processes are important biological processes in the treatment of DKD by SQP.Molecular docking confirmed the excellent binding abilities of boldine,denudatin B,kaempferide,and quercetin to EGFR and SRC.The results of in vitro experiments showed that treatment with an ethanolic extract of SQP significantly protected HK-2 cells from high glucose-induced cell damage.In addition,the SQP ethanol extract inhibited the phosphorylation of EGFR and SRC,suppressed the apoptosis rate,and regulated apoptosis-related proteins in HK-2 cells under high glucose stress.Conclusion:This study systematically and intuitively illustrated the possible pharmacological mechanisms of SQP against DKD through multiple components,targets,and signalling pathways,especially the inhibition of EGFR and SRC phosphorylation and apoptosis.

Integrated network pharmacology and metabolomics to explore the mechanisms of Shenzao dripping pill against chronic myocardial ischemia

Background:Shenzao dripping pill(SZDP)is empirically prescribed for treating cardiac diseases.Nevertheless,there is a lack of comprehensive knowledge regarding the underlying mechanisms contributing to its therapeutic effects.The objective of this study is to investigate the underlying mechanism of SZDP against chronic myocardial ischemia(CMI)in a rat model.Methods:In this study,we utilized electrocardiographic and echocardiographic detection along with pathological tissue analysis to evaluate the efficacy of SZDP.The integration of network pharmacology and metabolomics was conducted to investigate the mechanisms.Molecular docking and molecular dynamics simulations were used to validate the binding energy between the compounds of SZDP and the associated targets.Results:The results showed that SZDP was able to improve T wave voltage,reverse CMI abnormalities in ejection fraction and fractional shortening,and restore histopathological heart damage.Metabolomics results indicated that disturbances of metabolic profile in CMI rats were partly corrected after SZDP administration,mainly affecting purine metabolism.13-Docosenamide may be the potential metabolic biomarker of the therapeutic application of SZDP for CMI.Integrating network pharmacology and metabolomics,thiopurine S-methyltransferase(TPMT),xanthine dehydrogenase/oxidase(XDH),bifunctional purine biosynthesis protein ATIC(ATIC),and cytochrome p4501A1(CYP1A1)were identified as possible targets of SZDP to exert therapeutic effects by enhancing the metabolic levels of L-Tryptophan,Deoxyribose 1-phosphate and Phosphoribosyl formamidocarboxamide.Conclusion:SZDP has a therapeutic effect on CMI by regulating metabolite levels,acting on the targets of TMPT,XDH,ATIC,and CYP1A1,and reducing cardiomyocyte injury and myocardial fibrosis.

Clinical efficacy of Baijin pills in the treatment of generalized tonicclonic seizure epilepsy with cognitive impairment

BACKGROUND The generalized tonic-clonic seizure(GTCS)is the most usual variety of epileptic seizure.It is mainly characterized by strong body muscle rigidity,loss of consciousness,a disorder of plant neurofunction,and significant damage to cognitive function.The effect of antiepileptic drugs on cognition should also be considered.At present,there is no effective treatment for patients with epilepsy,but traditional Chinese medicine has shown a significant effect on chronic disease with fewer harmful side effects and should,therefore,be considered for the therapy means of epilepsy with cognitive dysfunction.AIM To investigate the clinical efficacy of Baijin pills for treating GTCS patients with cognitive impairment.METHODS This prospective study enrolled patients diagnosed with GTCS between January 2020 and December 2023 and separate them into two groups(experimental and control)using random number table method.The control group was treated with sodium valproate,and the experimental group was Baijin pills and sodium valproate for three months.The frequency and duration of each seizure,the Montreal Cognitive Assessment Scale(MoCA),and the Quality of Life Rating Scale(QOLIE-31)were recorded before and after treatment.RESULTS There were 85 patients included(42 in the control group and 43 in the experimental group).After treatment,the seizure frequency in the experimental group was significantly reduced(P<0.05),and seizure duration was shortened(P<0.01).The total MoCA score in the experimental group significantly increased compared to before treatment(P<0.01),and the sub-item scores,except naming and abstract generalization ability,significantly increased(P<0.05),whereas the total MoCA score in the control group significantly decreased after treatment(P<0.05).The QOLIE-31 score of the experimental group increased significantly after treatment compared to before treatment(P<0.01).CONCLUSION Baijin pills have a good clinical effect on epilepsy with cognitive dysfunction.

Effect of dietary with Zhibai dihuang pills and gonadotropinreleasing-hormone-analogue on girls with precocious and rapidly progressive puberty

BACKGROUND At present,the clinical mechanisms underlying precocious puberty remain unclear,making effective intervention for children experiencing this condition and rapidly progressive puberty essential.AIM To explore the effects of Zhibai dihuang pills and gonadotropin-releasing hormone analogue(GnRHa)on growth and ovarian function in girls with precocious puberty.METHODS The clinical data of 84 adolescent girls with precocious puberty and rapidly progressive puberty from February 2017 to August 2023 were retrospectively analyzed.Girls were divided into a control group and an observation group,with 42 cases in each group.The control group received diet intervention combined with GnRHa treatment,while the observation group received diet intervention combined with Zhibai dihuang pills+GnRHa treatment.Outcomes such as clinical efficacy,growth indicators,ovarian function,and adverse reactions were compared between the two groups.RESULTS The observation group showed superior clinical efficacy compared to the control group(P<0.05).Prior to the intervention,no significant differences were found in growth or ovarian function between the groups(P>0.05).Post-intervention,the observation group exhibited significantly lower rates in growth,height,and bone age,along with reduced levels of progesterone,testosterone,estradiol,prolactin,luteinizing hormone,and follicle-stimulating hormone compared to the control group(P<0.05).The incidence of adverse reactions was similar across both groups(P>0.05).CONCLUSION Combining Zhibai dihuang pills with GnRHa and dietary intervention effectively improves growth,enhances ovarian function,and minimizes adverse reactions in adolescent girls with precocious and rapidly progressive puberty.

Application of Guizhi Fuling Pill in Gynecology

This paper reviews the research progress of Guizhi Fuling Pill in the clinical application of gynecology,such as the treatment of uterine leiomyoma,ovarian cyst,infertility and dysmenorrhea,in order to provide further research ideas for clinical researchers.

乌梅丸治疗脓毒症合并腹泻及胃肠功能障碍的临床疗效观察

目的观察乌梅丸汤剂治疗脓毒症合并腹泻及胃肠功能障碍的临床疗效。方法选取2016年4月—2022年3月就诊于首都医科大学附属北京中医医院急诊科的64例脓毒症合并腹泻及胃肠功能障碍患者为研究对象,通过随机数字表法将患者分为观察组和对照组,各32例。2组均给予常规治疗,观察组在常规治疗基础上加乌梅丸汤剂口服、鼻饲或直肠滴注。2组疗程均为7 d。观察2组病死率、腹泻疗效、安全性,及治疗前后胃肠功能障碍评分、序贯器官衰竭(SOFA)、急性生理与慢性健康评分系统Ⅱ(APACHEⅡ)评分。结果观察组死亡5例(16.13%),对照组死亡9例(29.03%),2组病死率差异无统计学意义(P>0.05)。死亡RR为0.85(95%CI 0.644~1.112)。观察组总有效率高于对照组(P<0.05)。与治疗前比较,2组治疗后胃肠功能障碍评分、SOFA评分、APACHEⅡ评分均降低(P<0.05),且观察组治疗后胃肠功能障碍评分、SOFA评分、APACHEⅡ评分均低于对照组(P<0.05)。2组患者均未出现药物相关的不良反应,2组血常规及肝、肾功能均无异常改变。结论乌梅丸汤剂对脓毒症合并腹泻及胃肠功能障碍,有明显的胃肠保护作用,同时也能减轻患者整体病情严重程度。

基于网络药理学探讨速效救心丸联合复方丹参注射液治疗不稳定型心绞痛的机制

目的采用网络药理学和分子对接技术探索速效救心丸联合复方丹参注射液治疗不稳定型心绞痛的分子调控机制。方法中药系统药理学数据库与分析平台(TCMSP)、中医药百科全书平台(ETCM)、中药分子机制研究的生物信息学分析工具(BATMA-TCM)、本草组鉴平台(HERB)数据库结合成分检测文献筛选速效救心丸联合复方丹参注射液的成分和靶点,同时GeneCards、DisGeNET和OMIM数据库获取不稳定型心绞痛的靶点。用于进行基因本体和京都基因与基因组百科全书富集分析。结果本研究筛选出川芎嗪、丹参酮ⅡA、丹酚酸B等33种主要活性成分,得到前列腺素内过氧化物合成酶2、白细胞介素6(IL-6)等32个速效救心丸联合复方丹参注射液治疗不稳定型心绞痛的靶点。分子对接结果证明,本研究获得的活性成分与其对应的不稳定型心绞痛靶点间均有较高的亲和力。结论速效救心丸联合复方丹参注射液通过川芎嗪、丹参酮ⅡA、丹酚酸B等活性成分靶向IL-6、白细胞介素1β(IL-1β)、肿瘤坏死因子(TNF)等关键靶点发挥治疗不稳定型心绞痛的功效。

基于血管内皮指标、IL-23、IL-17分析速效救心丸联合新活素对PCI后AMI患者的治疗效果

目的 基于血管内皮指标、白细胞介素-23(IL-23)、白细胞介素-17(IL-17)分析速效救心丸联合新活素对经皮冠状动脉介入术(PCI)后急性心肌梗死(AMI)患者的治疗效果。方法 选取2021年1月至2022年10月该院收治的104例AMI患者作为研究对象,根据随机数字表法分为对照组和观察组,各52例。两组均进行PCI,对照组术后采用新活素治疗,观察组术后采用新活素+速效救心丸治疗。比较两组疗效、不良反应、主要不良心血管事件(MACE)发生情况及治疗期间中医证候积分、心功能指标、血管内皮指标、血清IL-23、IL-17水平。结果 观察组总有效率高于对照组(P<0.05)。重复测量方差分析显示,两组治疗期间的中医证候积分、左心室射血分数(LVEF)、心脏指数(CI)、N末端脑钠肽前体(NT-proBNP)及血清IL-23、IL-17、血管内皮生长因子B(VEGF-B)、血管性假血友病因子(vWF)、生长分化因子-15(GDF-15)水平变化有交互效应(F=13.455、10.336、7.513、17.011、23.468、25.178、14.556、13.182、18.712,P<0.001),故进一步做单独效应分析。两组不同时间血清IL-23、IL-17、GDF-15、vWF水平及中医证候积分、NT-proBNP水平比较结果显示,治疗6个月后<治疗3个月后<治疗前,任意两两比较,差异均有统计学意义(P<0.05)。两组不同时间血清VEGF-B水平、LVEF、CI比较结果显示,治疗6个月后>治疗3个月后>治疗前,任意两两比较,差异均有统计学意义(P<0.05)。多变量方差分析结果显示,观察组治疗3个月后、6个月后血清IL-23、IL-17、vWF、GDF-15、NT-proBNP水平及中医证候积分低于对照组,血清VEGF-B水平及LVEF、CI均高于对照组,差异均有统计学意义(P<0.05)。两组治疗期间不良反应、MACE发生情况比较,差异无统计学意义(P>0.05)。结论 新活素联合速效救心丸应用于PCI后AMI患者的治疗,有助于下调患者血清IL-23、IL-17水平,改善治疗效果。

Determination of Plasma Concentration of Cinnamic Acid by High-Performance Liquid Chromatography and Its Pharmacokinetics in Rats after Oral Administration of Zi-Shen Pill

Aim To develop a simple and sensitive high-performance liquid chromatographicmethod for determination of plasma concentration of cinnamic acid and pharmacokinetic study in ratsafter a single oral dose of traditional Chinese medicinal preparation Zi-Shen pill. Method Plasmasamples were acidified with hydrochloric acid and extracted with ethyl acetate . Cinnamic acid wasdetermined by HPLC using a G_(18) column. A mobile phase ofmethanbl-acetonitrile-water-triethyl-amine (7:22:73 = 0.2, V/V), with the pH adjusted to 4.0 withphosphoric acid, and with a UV detector set at 340 nm. Results The standard curve was linear overthe range of 1.92- 192.0 μg·mL^(-1). The LLOQ was 1.92 μg·mL^(-1) . The RSDs of within-day andbetween-day precision were < 8%. The mean recovery was 82.0% . Conclusion After validation, themethpd has been used to investigate the pharmacokinetic profiles of the traditional Chinesemedicinal preparation Zi-Shen pill.

基于系统评价和网络药理学分析桂枝茯苓丸治疗冠心病的疗效及其抗动脉粥样硬化的作用机制

目的运用系统评价对桂枝茯苓丸治疗胸痹心痛患者的疗效进一步确认,同时基于网络药理学考察桂枝茯苓丸对动脉粥样硬化可能作用机制。方法通过计算机检索2005—2023年中国知网(CNKI)、万方、维普及PubMed数据库中收录的关于桂枝茯苓丸治疗胸痹心痛的随机对照试验(RCT)文献。经过纳入、排除及筛选标准,最终纳入9篇RCT文献,采用Cochrane协作网及Review Manager 5.1软件分析,同时运用网络药理学分析桂枝茯苓丸对动脉粥样硬化可能作用机制。结果心电图疗效Meta分析结果提示:Z=2.66(P<0.05),OR及95%CI为0.17(0.05,0.30),说明观察组的心电图有效率高于对照组。心绞痛Meta分析结果提示:Z=5.71(P<0.00001),OR及95%CI为4.70(2.76,7.99),说明观察组的心绞痛有效率高于对照组。临床总疗效Meta分析结果提示:Z=4.39(P=0.0001),OR及95%CI为5.31(2.52,11.19),说明观察组的临床总有效率高于对照组。网络药理学分析提示:桂枝茯苓丸治疗动脉粥样硬化的靶点和作用机制发现,FOS、IKBKB、MAPK8和RELA是核心靶点,作用通路包括流体剪切应力、TNF、凋亡或脂质通路。结论Meta分析证实桂枝茯苓丸可以提高胸痹心痛患者的心电图疗效、心绞痛疗效及临床总有效率,但由于纳入文献的质量偏低、未提及具体分组方式、是否盲法及不良反应,确切结论仍需要高质量文献支持;桂枝茯苓丸治疗动脉粥样硬化的靶点和作用机制发现,FOS、IKBKB、MAPK8和RELA是核心靶点,作用通路包括流体剪切应力、TNF、凋亡或脂质通路。

RP-HPLC Determination of Pinoresinol Diglucopyranoside in Qing′e Pill Extract

Aim To develop and determine pinoresinol diglucopyranoside in Qing'e Pill, atraditional Chinese compound preparation containing Eucommia ulmoides Oliv. as the principal drug,by a reverse-phase high-performance liquid chromatographic method (RP-HPLC) . Methods The extract ofQing'e Pill was refluxed with 75% ethanol, purified on an AB-8 macroporous adsorption resin columnand then injected into HPLC system. The HPLC assay was performed on an ODS analytical column with amixture of methanol-acetonitrile-water (24:3:78, V/V/V) as the mobile phase at a flow-rate of 1.0mL·min^(-1), and a UV detector set at 227 nm. Results Good linearity between peak area andconcentration was found in the range of 5.5 - 170 μg·mL^(-1) for pinoresinol diglucopyranoside ( r> 0.9998) . The average recovery was 99.3%. The intra-day assay RSD and the inter-day assay RSDwere 1.3% and 2.8%, respectively (n = 5). The content of pinoresinol diglucopyranoside in Qing'ePill was determined to be 0.446 +- 0.012 mg·g^(-1) (n = 10). Conclusion The RP-HPLC method wasproved to be sensitive, specific, accurate and precise for the determination of pinoresinoldiglucopyranoside in Qing' e Pill.

INVESTIGATION ON DRYING CHARACTERISTIC OF MEDICAL PILL USING MICROWAVE-CONVECTIVE DRYING

The combined microwave-convective drying is a novel drying method and has many advantages, such as swift drying, equable drying and sterilization. This paper studies the drying characteristic of medical pill in microwave-convective drying process. The influential parameters of pill drying characteristics including pill size, quality, air velocity, temperature and the input power of microwave, are experimentally investigated. Results show that the drying process is influenced by the intrinsic heat of microwave power, and the environment and the resistance of mass transfer. It has the advantage of the microwave-convective drying in saving energy, reducing labor intensity and sterilizing. The method with the high efficiency is suitable for pharmacy industry.

超高效液相色谱-电喷雾四极杆-飞行时间串联质谱法鉴定丹楂通脉丸化学成分

目的建立鉴定丹楂通脉丸化学成分的超高效液相色谱-电喷雾四极杆-飞行时间串联质谱法。方法色谱柱为Acquity UPLCBEHC18柱(100 mm×2.1 mm,1.7μm),流动相为0.1%甲酸水溶液-乙腈(梯度洗脱),流速为0.3 mL/min,柱温为30℃,进样量为1μL。通过对照品、一级和二级质谱数据离子信息、文献等预测裂解规律,鉴定化学成分。结果共鉴定出54种化学成分,包括皂苷类17种,有机酸类12种,黄酮类8种,醌类8种,酚及酚酸类6种,其他类4种。结论该方法快速准确,可为丹楂通脉丸的物质基础研究提供参考。

乌梅丸及其单味药有效成分在消化系统疾病中的研究进展

乌梅丸载于我国东汉时期的一部中医经典《伤寒杂病论》:“蛔厥者,乌梅丸主之。又主久利”,该方由乌梅、细辛、桂枝、黄连、黄柏、当归、干姜、附子、人参、蜀椒10种中药组成,其主要功效为暖肝调中,清上温下。临床研究中多以其加减方或联合西药治疗溃疡性结肠炎、肠易激综合征、慢性萎缩性胃炎、胃食管反流病、胃癌、肠息肉等多个消化系统疾病。现代药理学显示,乌梅丸治疗胃肠疾病发挥着抗炎、抗氧化、保护胃黏膜、抗肿瘤、抗溃疡等重要药理作用。借助文献报道,从该方临床报道、方剂组成中各药物有效成分与消化系统疾病药理研究、动物实验报道等三方面进行归纳总结,根据相关报道中该方的有效成分,总结出该方药物运用于常见消化系统疾病的主要有效成分,并通过其药理成分阐释该方的组方配伍规律,以期为乌梅丸临床应用及相关研究的开展提供参考。

银甲丸加减联合阿奇霉素治疗生殖道支原体感染(湿热瘀阻型)的临床观察

目的 对中药银甲丸(针对湿热瘀阻型)联合阿奇霉素治疗女性生殖道支原体感染的临床效果进行总结和分析。方法 选择2019年9月至2021年9月期间我科住院部收治的40例生殖道支原体感染女性患者(湿热瘀阻型)为观察组研究对象,联合给予中药银甲丸加减、阿奇霉素治疗。另将同期收住的40例患者纳入对照组,单纯应用阿奇霉素治疗。对两组患者支原体转阴率、不良反应率、中医证候积分、临床疗效进行观察对比。结果 (1)观察组UU转阴率92.5%高于对照组80.00%,存在差异(P<0.05);观察组不良反应率为10.00%、对照组为8.00%,两组之间不存在差异(P>0.05)。(2)两组治疗前患者的各项中医证候积分比较,不存在差异(P>0.05);两组治疗后患者的各项中医证候积分与治疗前比较,均降低,存在差异(P<0.05);治疗后,观察组中医证候改善显著,积分远低于对照组,存在显著差异(P<0.01)。(3)观察组40例患者的临床治疗总有效率为85%,高于对照组75%,存在差异(P<0.05)。结论 阿奇霉素联合中药银甲丸(针对症状加减)治疗女性生殖道支原体感染,效果突出,两者协同作用显著,为该病的治疗提供了新的有效方案,值得在临床实践中推广与应用。

苏合香丸急重症临床应用专家共识

苏合香丸是中医治疗寒闭证的辛温开窍经典名方,也用治因寒闭痰浊导致的心腹卒痛。为了深化苏合香丸在临床实践中的规范化应用,世界中医药学会联合会急症专业委员会及中国中西医结合学会重症医学专业委员会召集国内众多权威专家共同制定了《苏合香丸急重症临床应用专家共识》。本共识对苏合香丸的药学特性、作用机制研究、安全性研究及临床研究进行了阐述,对苏合香丸的适用人群、用法用量和注意事项等给出了明确的指导意见。

通脉开窍丸治疗血管性痴呆模型大鼠海马区神经元的铁死亡变化

背景:研究表明铁死亡与血管性痴呆存在密切联系,通脉开窍丸对于改善血管性痴呆患者的认知功能有一定疗效,但其作用机制不明确。目的:基于核因子E2相关因子2(nuclear factor erythroid-2 related factor 2,Nrf2)/血红素氧合酶1(heme oxygenase-1,HO-1)/谷胱甘肽过氧化物酶4(glutathione peroxidase 4,GPX4)信号通路调控铁死亡探讨通脉开窍丸对血管性痴呆干预作用以及分子机制。方法:84只雄性SD大鼠,其中12只大鼠用作假手术组,其余大鼠用改良2-VO法制备成血管性痴呆的模型,成模后随机分为模型组、通脉开窍丸高、中、低剂量(27.6,13.8,6.9 g/kg)组、联合组[通脉开窍丸高剂量+ML385(20 mg/kg)]、盐酸多奈哌齐组(0.45 mg/kg),灌胃给药1次/d,联合组同时腹腔注射Nrf2抑制剂ML385,1次/d,连续4周。采用Morris水迷宫检测大鼠的学习记忆能力;苏木精-伊红染色观察各组大鼠海马组织中神经元病理学变化;比色法试剂盒检测大鼠血清中还原型谷胱甘肽、Fe^(2+)、丙二醛的浓度;普鲁士蓝染色法检测大鼠海马组织中铁沉积情况;透射电镜观察大鼠海马组织中神经元线粒体超微结构变化;蛋白免疫印迹法检测大鼠海马神经元Nrf2、HO-1、GPX4、XCT、铁蛋白重链1(ferritin heavy chain 1,FTH1)蛋白的表达。结果与结论:(1)与假手术相比,模型组大鼠逃避潜伏期时间明显延长(P<0.05),穿越平台次数明显减少(P<0.05);海马组织松散,神经元细胞核深染,染色质固缩甚至裂解;CA1区铁离子聚集;线粒体萎缩变小,线粒体嵴溶解消失,线粒体膜密度增厚;血清中Fe^(2+)、丙二醛水平上升,还原型谷胱甘肽水平下降(P<0.05);海马组织GPX4、HO-1、XCT、Nrf2、FTH1蛋白表达显著降低(P<0.05)。(2)与模型组相比,通脉开窍丸各剂量组和盐酸多奈哌齐组大鼠平均逃避潜伏期均明显缩短(P<0.05),穿越平台次数增加(P<0.05);海马神经元恢复明显,CA1区神经元铁离子聚集明显减少,线粒体结构和功能好转;血清Fe^(2+)、丙二醛水平显著降低(P<0.05),血清还原型谷胱甘肽浓度及海马组织中GPX4,HO-1,XCT,Nrf2,FTH1蛋白表达显著升高(P<0.05)。(3)与通脉开窍丸高剂量组相比,盐酸多奈哌齐组治疗效果差异无显著性意义(P>0.05),联合组大鼠水迷宫逃避潜伏期时间延长(P<0.05),穿越平台次数减少(P<0.05),大鼠CA1区神经元病理改变情况不明显,铁沉淀增加,血清中丙二醛、Fe^(2+)浓度增加(P<0.05),还原型谷胱甘肽浓度减少(P<0.05),海马组织神经元线粒体萎缩变小,且Nrf2、XCT、HO-1、GPX4、FTH1蛋白的表达减少(P<0.05)。在一定范围内,通脉开窍丸剂量越高效果越好,且高剂量治疗效果不亚于盐酸多奈哌齐。(4)结果说明,通脉开窍丸可以减轻大鼠海马组织神经元病理改变,改善血管性痴呆大鼠的认知功能,其作用机制可能与Nrf2/HO-1/GPX4信号通路的激活抑制铁死亡有关。