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.

Study on the Characteristics of Gut Microbiota in Chronic Hepatitis B(CHB)Patients with Damp Heat Syndrome and Liver Depression and Spleen Deficiency Syndrome

Objective:This study was designed to explore the characteristics of gut microbiota in CHB patients with two most common traditional Chinese medicine(TCM)Syndromes—damp heat syndrome and liver depression and spleen deficiency syndrome.Methods:According to the diagnostic criteria of Western medicine,TCM and screening exclusion criteria,65 cases of CHB with damp heat syndrome and 28 cases of CHB with liver depression and spleen deficiency syndrome were finally included in the study.All the basic information was gathered and the fresh fecal samples were collected for 16S rDNA sequencing.16S rDNA of gut microbiota was sequenced using Illumina hiseq 2,500 high-throughput sequencing platform.Based on the optimized sequence,Operational Taxonomic Units(OTU)clustering analysis and taxonomic annotation were carried out.Results:The difference in relative abundance of gut microbiota was significant between damp heat syndrome and liver depression and spleen deficiency syndrome in CHB patients.Cyanobacteria was only found in damp heat syndrome.The relative abundance of Erysipelotrichia and Subdoligranulum were higher in liver depression and spleen deficiency syndrome,while the relative abundance of Rhodospirillales,Alphaproteobacteria and Lachnospira were higher in the damp heat syndrome.LDA Effect Size(LEfSe)analysis showed that Lachnospira,Olsenella and Subdoligranulum had significant difference in species among the two TCM syndromes.Conclusion:The different characteristics of gut microbiota in the two TCM syndromes of CHB patients may play an important role in syndrome formation of TCM,which provides a new field of vision for the accurate diagnosis and treatment of TCM.

Observation on Therapeutic Effects of Electroacupuncture on Polycystic Ovary Syndrome of Kidney Deficiency and Phlegm Dampness Type and Oxidative Stress Level

Objective:To observe the clinical effect of electroacupuncture on improving polycystic ovary syndrome(PCOS)of kidney deficiency and phlegm dampness type and serum oxidative stress level.Methods:There were 68 patients with polycystic ovary syndrome were randomly divided into observation group(34 cases)and the control group(34 cases),The observation group was treated by electroacupuncture,while the control group was treated by placebo electroacupuncture.Combined with the evaluation of menstrual cycle,menstrual color,quality,quantity and TCM symptom integral index,the difference of curative effect between the two groups was observed,and the levels of peripheral blood,sex hormones,insulin resistance and oxidative stress were detected before and after treatment for 3 months.Results:The total effective rate in the observation group was better than that in the control group(P<0.01);After intervention,serum LH,FSH,E_(2) and LH/FSH in the observation group were significantly different from those before intervention.The D values of serum LH,FSH,LH/FSH and E_(2) before and after intervention were significantly different between the two groups(P<0.01);Comparing the level of androgen,the serum A4 and T in the observation group were significantly different from those before intervention(P<0.01);After intervention,there was a significant difference in serum A4 and T between the two groups(P<0.01),and there was a significant difference in D value between the two groups before and after intervention;There was a difference in insulin resistance in the observation group before and after intervention(P<0.05),and there was a significant difference in D value between the two groups before and after intervention(P<0.01);After the intervention,the serum SOD,MDA,ROS in the observation group were significantly different from those before the intervention;After intervention,the results of serum SOD and ROS in the observation group were significantly different from those in the control group;There was no significant difference in serum MDA results.There were significant differences in SOD,MDA,ROS between the two groups before and after intervention.Conclusion:Electroacupuncture can improve oxidative stress injury,insulin resistance and hyperandrogenism in PCOS patients.

Study on the Expression of Organic Anion Transporting Polypeptide (oatp2a1) in Rat with Spleen Deficiency Syndrome and the Exploration of Clinical Significance

Objective: to explore the mechanism of transportation and transformation of dampness by the way of the expression of organic anion transporting polypeptide (oatp) superfamily member 2a1 (oatp2a1) mRNA in rat with spleen deficiency syndrome and the significance in transportation and transformation of dampness. Methods: 32 wistar male rats were divided randomly into four groups: normal group (n = 6), normal + AA group (n = 6), spleen deficiency group (n = 10), Spleen deficiency + AA group (n = 10). After reserpine-induced spleen deficiency model was made, intragastric administration of aristolochic acid (AA) was adopted for three days, the expression of oatp2a1 mRNA were detected in the tissues of lung, liver, kidney, stomach, small intestine and large intestine in four groups by using Fluorescent Quantitative-Polymerase Chain Reaction (FQ-PCR). Results: the expression of oatp2a1 mRNA in above six tissues could be detected. The ex-pression of oatp2a1 mRNA in liver tissue of rat with spleen deficiency syndrome was up-regulated compared to normal group (P = 0.035, P < 0.05), the expression of oatp2a1 mRNA in small intestinal tissue of rat with spleen deficiency syndrome was down-regulated compared to normal group (P = 0.004, P < 0.01), the expression of oatp2a1 in intestinal tissue in normal + AA group is down-regulated compared to normal group (P = 0.032, P < 0.05). Conclusions: oatp2a1 might be one of the material basis involved in transportation and transformation of dampness. The changes of expression of oatp2a1 mRNA in small intestine, liver tissue suggests that small intestine, liver might play an important role in the transportation and transformation of dampness in the state of spleen deficiency. We further concluded that the function of spleen’s governing transportation and transformation of dampness was not only including the function of the gastrointestinal, but also part of the liver function in some degree, which needs to be further studied.

Abnormal expression and significance of circ-CBLB/miR-486-5p in patients with rheumatoid arthritis of spleen deficiency and dampness excess type

Objective:To explore the abnormal expression and significance of circ-CBLB/miR-486-5p in patients with rheumatoid arthritis of spleen deficiency and dampness excess type.Methods:The 30 healthy individuals included in the method were from the Physical Examination Center of Anhui Provincial Hospital of Traditional Chinese Medicine,and the 60 rheumatoid arthritis patients included were from the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine.The disease activity score of patients with rheumatoid arthritis was evaluated using VAS score and DAS28 score,joint symptoms and spleen deficiency syndrome score were evaluated using graded quantification method,immune inflammation indicators were detected using relevant instruments,inflammatory cytokines were detected using ELISA method,macrophage markers were detected using FCM method,and pathway gene expression was detected using RT-qPCR;Evaluate the predictive effect of circ-CBLB and miR-486-5p on disease activity in rheumatoid arthritis using ROC curves.Results:(1)miR-486-5p,CD14^(+)CD86^(+),ESR,CRP,RF,Anti CCP Ab,IL-6,TNF in patients with rheumatoid arthritis-αThe levels of circ-CBLB,CD14^(+)CD163^(+),IL-4,and IL-10 were significantly higher than those of healthy individuals;(2)The expression level of circ-CBLB in patients with rheumatoid arthritis is positively correlated with CD14^(+)CD163^(+),and negatively correlated with miR-486-5p and CD14^(+)CD86^(+);The expression level of miR-486-5p is negatively correlated with CD14^(+)CD163^(+)and positively correlated with CD14^(+)CD86^(+);There is a negative correlation between CD14^(+)CD86^(+)and CD14^(+)CD163^(+);ESR is negatively correlated with circ-CBLB,and positively correlated with miR-486-5p,CD14^(+)CD86^(+),CRP;CRP is negatively correlated with circ-CBLB,CD14^(+)CD163^(+),and positively correlated with CD14^(+)CD86^(+),ESR;(3)The expression level of circ-CBLB in patients with rheumatoid arthritis is negatively correlated with joint tenderness,morning stiffness,lack of qi and lazy speech,and postprandial abdominal distension score;The expression level of miR-486-5p is positively correlated with the scores of joint tenderness and decreased appetite.(4)The ROC curve shows that in terms of circ-CBLB,ESR,CRP,VAS,and DAS28 AUC are 0.662(P=0.032),0.658(P=0.035),0.516(P=0.830),and 0.791(P=0.000),respectively.In terms of miR-486-5p,ESR,CRP,VAS,and DAS28 AUC were 0.566(P=0.385),0.511(P=0.883),0.592(P=0.223),and 0.727(P=0.003),respectively.Conclusion:The abnormal expression of circ CBLB and miR-486-5p in peripheral blood mononuclear cell of patients with rheumatoid arthritis of spleen deficiency and dampness excess type is related to inflammatory polarization markers,immune inflammation,disease activity,joint symptoms and spleen deficiency syndrome of rheumatoid arthritis,and the low expression of circ CBLB and high expression of miR-486-5p have certain predictive value for disease activity of rheumatoid arthritis.

Preventive online and offline health management intervention in polycystic ovary syndrome

BACKGROUND Polycystic ovary syndrome(PCOS) is characterized by hyperandrogenism, hyperinsulinemia, ovarian polycystic changes, and irregular ovulation, often occurring in women of childbearing age for whom it can be a cause of infertility. Hypothalamus-pituitary-ovarian axis dysregulation is important in the pathogenesis of PCOS and the associated chronic excess of sex hormones can lead to cardiovascular and cerebrovascular diseases, diabetes, and malignancies such as endometrial cancer, and breast cancer. At present, most scholars agree that lifestyle interventions in conjunction with drug treatment can help PCOS patients achieve their goals of successful pregnancy and childbirth.AIM To investigate the clinical effect of an online and offline(O2O) preventive health management model on PCOS with kidney deficiency and phlegm dampness.METHODS A total of 82 patients with PCOS of the kidney deficiency and phlegm dampness type who were admitted to Beijing Luhe Hospital Affiliated to Capital Medical University from April 2019 to June 2020 were randomly divided into two groups. The treatment group was treated with oral Diane-35 for 3 mo and received preventive O2O medical health management for 6 mo(including eating and living, exercise, drug management). The control group was treated with oral Diane-35 for 3 mo and completed outpatient health education. The traditional Chinese medicine(TCM) syndrome score, acne score, hair score, sex hormone level and clinical effects were compared between the two groups before and after the intervention. RESULTS After treatment, the TCM syndrome score, acne score, and serum luteinizing hormone/follicle stimulating hormone level were significantly lower in the treatment group than in the control group(P < 0.05). After 3 mo of treatment, the TCM syndrome curative effect index in the treatment group was 97.30% compared to 54.05% in the control group(P < 0.05), whereas the total treatment effect in the treatment group was 91.89%, compared to 54.05% in the control group(P < 0.05).CONCLUSION An integrated therapeutic approach incorporating medication, TCM methods and social media is more effective than standard treatment for PCOS.

The prescription rule analysis of the New Theory on Spleen Dampness Syndrome by Academician TONG Xiaolin

Objective To analyze the basic characteristics,drug features,prescription rules,and drug-symptom relationships of patients in the splenic deficiency and impairment stage,by data mining of medical records under the New Theory on Spleen Dampness Syndrome(Pi Dan Xin Lun,《脾瘅新论》).Methods Medical records listed in the“New Theory on Spleen Dampness Syndrome-Under-standing and Treatment of Metabolic Syndrome from the Perspective of Traditional Chinese Medicine”,and which were diagnosed with the spleen dampness syndrome at the splenic de-ficiency and impairment stage,during January 2004 and December 2016 were selected.These patients’data,including basic information,clinical symptoms,laboratory examination res-ults,traditional Chinese medicine(TCM)and western medicine diagnoses,treatment meth-ods,prescriptions,etc.,were collected.The collected data were subsequently compiled into a medical record database using the Epidata 3.1 data management software,followed by the use of Apriori algorithm provided in the SPSS Modeler 14.2 statistical software to investigate the association rules between drug-drug,drug-symptom,and drug-western medicine indices.Results(i)A total of 51 medical records were included,involving 17 types of syndromes.Among them,the top three with frequency≥3 included“Phlegm and blood stasis,and thoracic obstruction”“Deficiency-weakness of the spleen Qi,and static blood blocking collat-erals”,and“Deficiency-weakness of the spleen Qi,and static blood blocking collaterals”.Al-ternatively,of the 14 treatment methods,the top three treatments with frequency of≥3 in-cluded“Activating Yang and eliminating turbidity,and removing phlegm and dredging chan-nel blockage”“Strengthening the spleen and benefiting Qi,and eliminating phlegm to activ-ate the channels”,and“Warming Yang and benefiting Qi,and expelling cold to remove ob-structions”.Among the 15 prescriptions,the top three used with frequency≥3 included Huangqi Guizhi Wuwu Tang(黄芪桂枝五物汤),Gualou Xiebai Banxia Tang(瓜蒌薤白半夏汤),and Ganjiang Huangqin Huanglian Renshen Tang(干姜黄芩黄连人参汤).Lastly,of the 83 drugs used for a total of 476 times,those with frequency≥15 included Huanglian(Coptid-is Rhizoma),Huangqi(Astragali Radix),Jiudahuang(Wine-processed Rhei Radix et Rhizoma),Jixueteng(Spatholobi Caulis),Shengjiang(Zingiberis Rhizoma Recens),Huangqin(Scutellariae Radix),and Guizhi(Cinnamomi Ramulus).(ii)For the drug-drug associations,under the criteria of support≥15%and confidence=100%,seven second-order association rules,seven third-order rules,and six fourth-order roles were identified.The top-ranking rule of each was“Huangqin(Scutellariae Radix)→Huanglian(Coptidis Rhizoma)”“Ganjiang(Zingiberis Rhizoma)+Huangqin(Scutellariae Radix)→Huanglian(Coptidis Rhizoma)”,and“Baishao(Paeoniae Radix Alba)+Guizhi(Cinnamomi Ramulus)+Jixueteng(Spatho-lobi Caulis)→Huangqin(Scutellariae Radix)”,respectively.Alternatively,the drug-symptom associations were analyzed under the criteria of support≥5%and confidence=100%,which derived eight second-order association rules,31 third-order rules,and 30 fourth-order rules.The top-ranking association rule of each order was“Huangqi(Astragali Radix)→Limb ed-ema”“Guizhi(Cinnamomi Ramulus)+Jixueteng(Spatholobi Caulis)→Limb numbness and pain”,and“Guizhi(Cinnamomi Ramulus)+Jixueteng(Spatholobi Caulis)+Huangqi(As-tragali Radix)→Limb numbness and pain”,respectively.Similarly,the drug-western medi-cine index associations were investigated under the criteria of support≥5%and confidence=100%,and five second-order association rules,16 third-order rules,and 16 fourth-order rules were identified.In this category,the top-ranking association rule of each order was“Qinpi(Fraxini Cortex)→Uric acid”“Huanglian(Coptidis Rhizoma)+Ganjiang(Zingiberis Rhizoma)→Glycated hemoglobin”,and“Huanglian(Coptidis Rhizoma)+Ganjiang(Zing-iberis Rhizoma)+Huangqin(Scutellariae Radix)→Glycated hemoglobin”,respectively.Conclusion Through association rule mining,this study objectively and quantitatively demonstrated the drug-drug,drug-symptom,and drug-physicochemical index associations of patients with the spleen dampness syndrome at the splenic deficiency and impairment stage treated by Academician TONG Xiaolin.The results indicated that treatment for these patients adopted the“state-target”syndrome differentiation method.The drug combination was characterized by“small prescriptions”,targeting both the patient’s symptoms and signs(syndrome target)and western medicine indices(treatment target).This study could provide references for future research on the academic thoughts and medical experience of Academi-cian TONG Xiaolin.

Screening the effective components in treating dampness stagnancy due to spleen deficiency syndrome and elucidating the potential mechanism of Poria water extract

Poria is an important medicine for inducing diuresis to drain dampness from the middle energizer.However,the specific effective components and the potential mechanism of Poria remain largely unknown.To identify the effective components and the mechanism of Poria water extract(PWE)to treat dampness stagnancy due to spleen deficiency syndrome(DSSD),a rat model of DSSD was established through weight-loaded forced swimming,intragastric ice-water stimulation,humid living environment,and alternate-day fasting for 21 days.After 14 days of treatment with PWE,the results indicated that PWE increased fecal moisture percentage,urine output,D-xylose level and weight;amylase,albumin,and total protein levels;and the swimming time of rats with DSSD to different extents.Eleven highly related components were screened out using the spectrum-effect relationship and LC-MS.Mechanistic studies revealed that PWE significantly increased the expression of serum motilin(MTL),gastrin(GAS),ADCY5/6,p-PKAα/β/γcat,and phosphorylated cAMP-response element binding protein in the stomach,and AQP3 expression in the colon.Moreover,it decreased the levels of serum ADH,the expression of AQP3 and AQP4 in the stomach,AQP1 and AQP3 in the duodenum,and AQP4 in the colon.PWE induced diuresis to drain dampness in rats with DSSD.Eleven main effective components were identified in PWE.They exerted therapeutic effect by regulating the AC-cAMP-AQP signaling pathway in the stomach,MTL and GAS levels in the serum,AQP1 and AQP3 expression in the duodenum,and AQP3 and AQP4 expression in the colon.

Clinical treatment of myasthenia gravis with deficiency of spleen and kidney based on combination of disease with syndrome theory

OBJECTIVE: To study the use of Jianjining in the treatment of myasthenia gravis (MG) patients with a deficiency of both spleen and kidney via the theory on the combination of disease with syndrome. METHODS: Sixty MG patients with a deficiency of both spleen and kidney were randomly divided into an treatment group (n=30) treated with Jianjining granules and Western Medicine (prednisone or pyridostigmine bromide) and a control group (n= 30) treated with Jianjining granules. The dosage of the three drugs was reduced over the course of treatment. After 3 and 6 months of treatment, the curative effect was evaluated with the muscle weakness severity scale (MWSS). RESULTS: The MWSS score after treatment declined significantly in both groups. The score in the treatment group was much lower than that in thecontrol group (P<0.05). The total effective rate was 63.33% (19/30) in the treatment group and 36.67% (11/30) in the control group after 3 months of treatment, and 80.00% (24/30) and 50.00% (15/30), respectively, after 6 months of treatment. The obvious and total effective rates in the treatment group were much higher than those in the control group (P<0.05). After 6 months of treatment, there were no obvious differences (P>0.05) in the obvious and effective rates between the 2 groups. However, the total effective rate in the treatment group was much higher than that in the control group (P<0.01). CONCLUSION: Using the theory on the combination of disease with syndrome, we found that the curative effect of Jianjining and Western Medicine on MG patients with deficiency of both spleen and kidney is worth further exploration.

苍术健脾、燥湿的作用机制及研究进展

综述苍术健脾、燥湿的作用机制及研究进展。古代医家常用苍术治疗多种疾病的脾胃湿证。苍术有效成分能改善胃排空及小肠推进率;可增加胃泌素、胃动素等,促进胃酸分泌,增加胃肠动力;可降低血管活性肠肽水平,抑制肠蠕动亢进。苍术能双向调节胃肠功能紊乱,且还能改善胃黏膜的异常形态,减轻胃组织损伤,改善肠组织异常结构。苍术燥湿的主要有效成分为挥发油,可导致体液丢失,血黏度增加,影响唾液腺分泌,引起口干,降低肾脏水通道蛋白2的表达量。苍术及其提取物能降低大鼠胃、大肠、尿液中水通道蛋白含量,通过多脏器调节体内水液代谢。故苍术能从影响脏器形态、胃肠道激素水平、水通道蛋白表达等多方面达到健脾、燥湿的功效。

基于文献研究及德尔菲法构建寻常型银屑病脾虚湿蕴证的诊断标准

【目的】采用文献研究、专家主观经验评价及数理统计分析三者结合以构建寻常型银屑病脾虚湿蕴证的诊断标准。【方法】通过文献研究构建寻常型银屑病脾虚湿蕴证相关症状、体征备选条目池,运用德尔菲法对全国32位专家进行4轮问卷调查,分析专家对各备选条目意见的集中程度及协调程度。第三轮调查根据各条目的权重系数将诊断指标分为主症及次症,形成多个证候诊断判断条件选项,再通过第四轮专家调查,明确脾虚湿蕴证的诊断模式及诊断条件。【结果】根据专家意见集中程度、变异系数对各证候诊断备选条目进行筛选,经同类合并,形成诊断指标24个,形成主症3个(纳呆食少、便溏、舌淡胖边有齿印),次症21个(如腹胀、口淡不渴、形体肥胖、嗜睡、倦怠乏力、脉细滑、脉濡、大便完谷不化、皮损颜色淡红等)。第四轮专家调查确认了“病位脾”“病性气虚”“病性湿”为诊断的必要条件;银屑病脾虚湿蕴证的诊断条件确定为:(1)具有3个主要症状;(2)具备2个主要症状+任2个次要症状。【结论】所构建的寻常型银屑病脾虚湿蕴证的诊断标准包含主症及次症,条件要求明确,易于临床操作,具有较好的临床适用性。

健脾利湿解毒方治疗慢性结肠炎脾虚湿毒证疗效研究

目的:观察健脾利湿解毒方治疗慢性结肠炎脾虚湿毒证的临床疗效。方法:选取120例确诊为慢性结肠炎脾虚湿毒证的患者,采取随机数字表法分为观察组以及对照组,每组60例。对照组采取口服复方嗜酸乳杆菌片治疗,观察组在对照组治疗的基础上采取口服健脾利湿解毒方治疗,疗程均为3个月。治疗完成后比较两组治疗前后中医证候积分及脑肠肽[血管活性肠肽(VIP)、5-羟色胺(5-HT)、P物质(SP)、生长抑素(SS)]、炎症因子[C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-17(IL-17)]和粪便钙卫蛋白(FC)水平。比较两组总有效率及不良反应发生情况。结果:治疗后,观察组总有效率高于对照组(P<0.05);治疗后,两组中医证候积分均较治疗前降低,组间相比,观察组水平更低(均P<0.05);治疗后,两组VIP、5-HT、SP、SS、CRP、TNF-α、IL-17水平以及FC水平较治疗前降低,组间相比,观察组水平更低(均P<0.05)。两组均无不良反应。结论:健脾利湿解毒方可改善慢性结肠炎患者各项症状,抑制脑肠肽水平及炎性反应,且临床安全性高、无明显不良反应。

益元宣肺汤对25例新冠肺炎CT值的影响

目的分析深圳地区2022年新型冠状病毒肺炎患者的舌象、症状及用药史,多辨为三焦壅滞、肺脾肾虚,拟益元宣肺汤,观察其对CT值恢复的临床疗效。方法选取25例符合益元宣肺汤证型者进行治疗观察,选同期对照组25例,观察益元宣肺汤对CT值的影响。结果治疗前对照组的N基因(31.99±1.16)、O基因(33.49±1.94)与治疗组的N基因(31.45±2.85)、O基因(33.40±3.96)比较,差异无统计学意义(P>0.05);对照组治疗到CT值符合出院标准所需时间为(4.28±1.88)d,治疗组为(2.80±1.26)d,差异有统计学意义(P<0.05)。结论治疗组通过服用益元宣肺汤,CT值恢复明显比对照组快,表明以调动肺脾肾之气、疏通三焦气机为主的益元宣肺汤效果明显。扶正补肺脾肾、通宣三焦的治疗方法,在促进病情好转,加快人体清除病毒的速度方面作用明显,利于新型冠状病毒肺炎患者康复。

培本清利通络方治疗慢性肾脏病3~5期伴CKD-MBD脾肾两虚兼湿瘀证的临床研究

目的:观察基于吴门医派“络病理论”创立的培本清利通络方联合骨化三醇胶丸治疗慢性肾脏病(CKD)3~5期伴CKD-矿物质及骨代谢紊乱(CKD-MBD)脾肾两虚兼湿瘀证患者的效果。方法:选择2022年7月—2023年6月于南京中医药大学附属苏州市中医医院就诊的脾肾两虚兼湿瘀证CKD 3~5期合并有CKD-MBD的患者60例,随机分为治疗组和对照组,每组30例。对照组予控制血压、控制血糖、改善贫血等基础治疗,同时口服骨化三醇胶丸;治疗组在对照组治疗基础上加服培本清利通络方,两组疗程均为12周。比较两组患者治疗前后肾功能[血肌酐(Scr)、血尿素氮(BUN)、尿酸(UA)]、矿物质及骨代谢[钙(Ca)、磷(P)、全段甲状旁腺激素(iPTH)、碱性磷酸酶(ALP)]、中医症候积分、生活质量评分,并评估临床疗效;治疗前后检测两组血常规、肝功能、血钾,以评估用药安全性。结果:两组治疗后中医症候积分均较治疗前降低,且治疗组低于对照组(P<0.05);治疗组总有效率为93.33%,明显高于对照组的73.33%(P<0.05);治疗后,治疗组BUN、UA均明显低于治疗前,且Scr、BUN均明显低于对照组,差异均有统计学意义(P<0.05);治疗后,治疗组P、iPTH均明显低于治疗前,Ca明显高于治疗前,且治疗组Ca高于对照组,iPTH低于对照组,差异均有统计学意义(P<0.05);治疗后,治疗组生活质量评分较治疗前明显下降,且治疗组低于对照组(P<0.05);两组治疗后安全性指标比较,差异均无统计学意义(P>0.05)。结论:培本清利通络方可改善CKD 3~5期合并CKD-MBD脾肾两虚兼湿瘀证患者Ca、P、iPTH指标,延缓肾功能减退,减轻患者腰脊酸痛、皮肤瘙痒、倦怠乏力等症状,并可提高患者生活质量。

肾衰Ⅰ号方对慢性肾脏病3~4期脾肾气虚湿浊证患者的临床疗效分析

目的分析肾衰Ⅰ号方治疗慢性肾脏病3~4期脾肾气虚湿浊证患者的疗效。方法便利选取南京中医药大学附属姜堰医院于2021年4月—2023年10月收治的76例慢性肾脏病3~4期脾肾气虚湿浊证患者为研究对象,采用随机数表法分为观察组、对照组,各38例。对照组实施西医治疗,观察组采用西医联合肾衰Ⅰ号方治疗,比较两组治疗效果。结果观察组患者的肾功能指标优于对照组,差异有统计学意义(P<0.05)。观察组患者的血红蛋白、红细胞计数、红细胞比容分别(122.63±15.17)g/L、(6.62±0.69)×10^(12)/L、(28.75±4.78)%,均高于对照组的(110.50±15.24)g/L、(6.59±0.73)×10^(12)/L、(25.94±4.51)%,差异有统计学意义(P均<0.05)。观察组患者的超敏C反应蛋白和疗效均优于对照组,差异有统计学意义(P均<0.05)。结论肾衰Ⅰ号方治疗慢性肾脏病3~4期脾肾气虚湿浊证可改善肾功能,降低炎性指标,促进患者健康。

基于“诸湿肿满,皆属于脾”探讨颈动脉粥样硬化斑块中医病机及防治思路

颈动脉粥样硬化斑块加大了缺血性脑血管疾病的发病率、致残率及死亡率,目前临床药物治疗虽有疗效,但须长期服药,且不良反应较多。基于《素问》“诸湿肿满,皆属于脾”的理论,探讨颈动脉粥样硬化斑块的中医病因病机及防治思路,以期为临床诊疗提供依据。中医认为本病病机为脾虚失运,痰湿瘀阻脉络,痰瘀互化、胶着日久而发病,治疗上宜益气健脾、温阳运脾、祛痰化瘀,并根据临床特点,随证配伍,以收到更好的临床疗效。

杨家林教授从调节卵泡论治多囊卵巢综合征经验探微

多囊卵巢综合征(polycystic ovary syndrome,PCOS)为妇科常见内分泌疾病,发病率逐年上升,其所致月经稀发、肥胖、流产、不孕等严重影响到女性生殖健康。杨家林教授从医60余年,认为该病发病责之于脾肾亏虚,痰浊、水湿、瘀血各自或交互为病,导致巢肿卵多,卵滞巢中,排卵无序。杨老在继承古人经方基础上,博采众长,拾遗补漏,创制了治疗PCOS的经验方,临床疗效肯定。本文探微杨家林教授治疗多囊卵巢综合征的临床经验,以飨同道。

升阳泻湿法治疗非酒精性脂肪性肝病初探

非酒精性脂肪性肝病是目前的多发病,为多因素所致,严重影响公共健康,目前对于该病的证治报道较多。该病的临床表现多数不典型,病机证候复杂,笔者汲取李东垣理论思想中升发脾之清气,以及黄元御理论思想中泻湿疏木的治法,把二者进行优化组合,拟定了升阳化湿,培土疏木为治疗大法运用于临床,立足于“湿”,分为“湿浊内蕴”和“脾虚湿困”2个证型,驭繁就简,取得了理想的临床疗效。

参苓健脾饮治疗脾虚湿盛型慢性乙型病毒性肝炎临床研究

目的观察参苓健脾饮治疗脾虚湿盛型慢性乙型病毒性肝炎患者的临床效果及对肝功能指标、乙型肝炎病毒(HBV)DNA水平、肝脏硬度的影响。方法将70例脾虚湿盛型慢性乙型肝炎患者随机平均分为两组,对照组给予保肝、降酶、抗病毒治疗,治疗组在对照组的基础上给予参苓健脾饮治疗。治疗3个月后观察两组患者中医证候评分、肝功能、肝脏硬度、血清病毒载量等情况。结果治疗后治疗组中医证候评分、肝功能各指标、肝脏硬度均低于对照组(P<0.05)。结论参苓健脾饮联合恩替卡韦分散片在改善脾虚湿盛型慢性乙型病毒性肝炎患者中医证候、肝功能、肝硬度值方面效果优于单用恩替卡韦分散片。

脾虚湿盛证动物模型构建方法探析

近年来,脾虚湿盛证动物模型的构建已成为中医证候研究的热点。脾虚湿盛证病位在脾,病性为虚与湿,因此模型的构建较为复杂,目前尚无公认的动物模型。现从脾虚湿盛证模型构建的思路方法及模型评价指标2个维度为核心对当前研究进行探析与总结,研究表明脾虚湿盛证动物模型常选用饮食失宜、久居湿地及劳倦过度等因素从病因角度进行模型构建,造模方法分为单因素、双因素与混合多因素;脾虚湿盛证模型评价指标常以症状及表证进行宏观与证候评价、多通过疲劳指标、胃肠功能指标及水液代谢指标进行客观评价;并从脾虚湿盛模型证候命名、模型证候评价标准及构建模型的方法剖析目前模型构建存在的问题、以此讨论并分析脾虚湿盛证动物模型未来的发展方向,以期为脾虚湿盛证动物模型的研究提供参考,为研究者提供便利。