Xiaojianzhong decoction prevents gastric precancerous lesions in rats by inhibiting autophagy and glycolysis in gastric mucosal cells

BACKGROUND Gastric precancerous lesions(GPL)precede the development of gastric cancer(GC).They are characterized by gastric mucosal intestinal metaplasia and dysplasia caused by various factors such as inflammation,bacterial infection,and injury.Abnormalities in autophagy and glycolysis affect GPL progression,and their effective regulation can aid in GPL treatment and GC prevention.Xiaojianzhong decoction(XJZ)is a classic compound for the treatment of digestive system diseases in ancient China which can inhibit the progression of GPL.However,its specific mechanism of action is still unclear.AIM To investigate the therapeutic effects of XJZ decoction on a rat GPL model and the mechanisms underlying its effects on autophagy and glycolysis regulation in GPLs.METHODS Wistar rats were randomly divided into six groups of five rats each and all groups except the control group were subjected to GPL model construction for 18 wk.The rats’body weight was monitored every 2 wk starting from the beginning of modeling.Gastric histopathology was examined using hematoxylin-eosin staining and Alcian blue-periodic acid-Schiff staining.Autophagy was observed using transmission electron microscopy.The expressions of autophagy,hypoxia,and glycolysis related proteins in gastric mucosa were detected using immunohistochemistry and immunofluorescence.The expressions of the following proteins in gastric tissues:B cell lymphoma/Leukemia-2 and adenovirus E1B19000 interacting protein 3(Bnip-3),microtubule associated protein 1 light chain 3(LC-3),moesin-like BCL2-interacting protein 1(Beclin-1),phosphatidylinositol 3-kimase(PI3K),protein kinase B(AKT),mammalian target of rapamycin(mTOR),p53,AMP-activated protein kinase(AMPK),and Unc-51 like kinase 1(ULK1)were detected using western blot.The relative expressions of autophagy,hypoxia,and glycolysis related mRNA in gastric tissues was detected using reverse transcription-polymerase chain reaction.RESULTS Treatment with XJZ increased the rats’body weight and improved GPL-related histopathological manifestations.It also decreased autophagosome and autolysosome formation in gastric tissues and reduced Bnip-3,Beclin-1,and LC-3II expressions,resulting in inhibition of autophagy.Moreover,XJZ down-regulated glycolysis-related monocarboxylate transporter(MCT1),MCT4,and CD147 expressions.XJZ prevented the increase of autophagy level by decreasing gastric mucosal hypoxia,activating the PI3K/AKT/mTOR pathway,inhibiting the p53/AMPK pathway activation and ULK1 Ser-317 and Ser-555 phosphorylation.In addition,XJZ improved abnormal gastric mucosal glucose metabolism by ameliorating gastric mucosal hypoxia and inhibiting ULK1 expression.CONCLUSION This study demonstrates that XJZ may inhibit autophagy and glycolysis in GPL gastric mucosal cells by improving gastric mucosal hypoxia and regulating PI3K/AKT/mTOR and p53/AMPK/ULK1 signaling pathways,providing a feasible strategy for the GPL treatment.

Long-Term Chinese Herbs Decoction Administration for Management of Hot Flashes Associated with Endocrine Therapy in Breast Cancer Patients

Objective：To evaluate the effect of Chinese herbs decoction Shu-Gan-Liang-Xue on endocrine therapy-associated hot flashes symptom in breast cancer patients.Methods：Sixty-six patients with breast cancer receiving adjuvant endocrine therapy were categorized to two groups,the control group received endocrine therapy alone,the other group is administered with Chinese herbs decoction Shu-Gan-Liang-Xue besides the endocrine therapy：Shu-Gan-Liang-Xue decoction was administered above 6 months per year for more than 2 years.Frequency of hot flashes per day was recorded,and the effect of Shu-Gan-Liang-Xue decoction on hot flashes symptom being assessed with Kupperman Scoring Index.Results：Sixty cases were analyzed,32 cases in endocrine therapy combining Chinese herbs decoction group,28 cases in mere endocrine therapy group.For hot flashes symptom,in Chinese herbs decoction administration group,7 cases（21.9%） reported symptom disappeared,22 cases（68.7%） reported symptom alleviated,3 cases（9.4%） reported symptom not changed;in endocrine therapy alone group,5 cases（17.9%） reported symptom disappeared,13 cases（46.4%） reported symptom alleviated,10 cases（10/28,35.7%） reported symptom not changed.The difference between two groups was statistically significant（P=0.013）.For sleeping disorder,in Chinese herbs decoction administration group,27 cases（84.4%） reported symptom improved,5 cases（15.6%） reported no change;in endocrine therapy alone group,16 cases（57.1%） symptom improved,12 cases（42.9%） reported no change in sleeping disorder（P=0.019）,the difference was also of significance statistically.Conclusion：Long-term Chinese herbs decoction administration remarkably improved hot flashes symptom and sleeping disorder associated with endocrine therapy,meanwhile without definite toxicity and influence on the risk of recurrence of tumor.

佩兰治疫浅析

在古今的疫病治疗中,中医药发挥了极为重要的作用,其中芳香化湿类药物在疫病的治疗中受到了历代医家的重视。据古籍研究及文献整理结果显示,佩兰是治疗疫病的高频药物,其芳香走窜之性可宣化清阳,辛轻扬上之性则能畅通气机,具有化湿辟疫、开窍醒神、醒脾开胃等功效。通过系统梳理佩兰的药性、方剂配伍规律、医论基础、药理研究等,探讨其治疫机制,推动佩兰的研究与开发,为临床应用佩兰治疫提供参考依据,丰富疫病治疗手段。

从“络病-风药”理论探讨独活寄生汤治疗类风湿关节炎

类风湿关节炎(RA)属中医“痹病”范畴,其发生、发展、转归与络病密切相关。本文通过分析类风湿关节炎微小血管新生的病理状态与络脉生理和络病病机特点,以络脉为其邪伏、邪发、邪伤及邪阻之所展开论述,可认为“络病”是其病理基础,络虚是其根本病机,风挟寒湿之邪内侵络脉为发病关键。基于“络病”理论和“风药”理论相关认识,从独活寄生汤为治风之剂视角认识其治疗类风湿关节炎的作用,并提出病变早期络脉郁滞、风药先行,中期络脉瘀塞、健脾化瘀,晚期络脉空虚、风引入肾,探讨独活寄生汤在病变不同时期风药与他药的组方原理,丰富独活寄生汤的组方配伍理论,扩展独活寄生汤的临床指导意义,为其临床应用提供参考。

槐米药材、饮片、标准汤剂与配方颗粒的HPLC特征图谱相关性研究及量值传递分析

目的 建立槐米药材、饮片、标准汤剂及配方颗粒的HPLC特征图谱,对其相关性进行评价并考察量值传递规律。方法 色谱柱为Agilent ZORBAX SB-C18柱(250 mm×4.6 mm,5μm),以乙腈-0.1%磷酸溶液为流动相进行梯度洗脱,检测波长为257 nm,柱温为30℃,流速为1.0 mL·min^(-1)。以特征图谱为对照,比较15批槐米药材-饮片-标准汤剂-配方颗粒特征图谱及相关性,分析其量值传递规律。结果 15批槐米药材、饮片、标准汤剂及配方颗粒HPLC特征图谱共确定了7个共有峰,并指认出芦丁、异槲皮苷、山柰酚-3-O-芸香糖苷、水仙苷、槲皮素、异鼠李素6种成分,经过相似度比较,槐米药材、饮片、标准汤剂、配方颗粒特征图谱相似度均大于0.90,主要化学成分组成基本相同,相关性较好。对生产过程中各关键环节样品测定指标成分含量及转移率,未出现离散的数据,有较好的传递性。结论 建立的槐米药材、饮片、标准汤剂及配方颗粒的HPLC特征图谱,能较全面地反映槐米药材、饮片、标准汤剂及配方颗粒的多成分整体面貌,为槐米配方颗粒生产过程的质量控制提供了科学依据。

基于网络药理学和分子对接技术研究四鲜汤治疗急性白血病的作用机制

目的:利用网络药理学和分子对接技术对四鲜汤治疗急性白血病(AcuteLeukemia,AL)的作用机制进行研究。方法:通过中药系统药理学数据库与分析平台(Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform,TCMSP)、中药分子机制生物信息学分析工具(Bioinformatics Analysis Tool for Molecular Mechanism of Traditional Chinese Medicine,BATMAN—TCM)和中医药百科全书数据库(Encyclopedia of Traditional Chinese Medicine,ETCM)检索并获取鲜药复方四鲜汤组方中药(生地、白茅根、小蓟、蒲公英)的化学成分,建立鲜药复方-四鲜汤的天然药物活性化学成分数据集;检索人类基因数据库(Human Gene Data Base,Gencards)、人类疾病相关基因和变异的信息的数据库(Database of Gene-Disease Associations,DisGeNET)、在线生物信息学和化学信息学数据库(Database for Drug and Drug Target Info,DrugBank)、人类疾病数据库(Human Disease Database,MalaCards)以获得AL疾病相关靶点,建立疾病靶点数据库。获取药物以及疾病的交集靶点后,在线画出两者共同靶点venn图;利用String11.5平台构建药物疾病蛋白互作网络;利用cytoscape3.8.2软件构建“药物—疾病—靶点—信号通路”网络,获取相关靶点网络拓扑参数。结果:经TcMSp\BAT-MAN—TcM和ETcM三个数据库检索,获得四鲜汤活性成分30个,相关靶点677个;通过Gencards、DrugBank、MalaCards和DisGeNET四个数据库获得12110个AL疾病潜在靶点;通过R4.2.2平台的ClusterProfiler软件包获得生物功能富集(Gene Ontology,GO)信息条目1011条,其中生物过程(Biological Process,BP)467条,分子功能(Molecular Function,MF)236条,细胞组分(Cellular Component,CC)308条;获得富集的京都基因与基因组百科全书(Kyoto Encyclopedia of Genesand Genomes,KEGG)信号通路220条,主要涉及化学致癌受体激活、脂质与动脉粥样硬化、流体剪切力与动脉粥样硬化、前列腺癌、AGE-RAGE信号通路在糖尿病并发症中的作用等;网络拓扑分析发现,四鲜汤治疗AL疾病作用的主要活性成分有γ-氨基丁酸、腺嘌呤核苷、槲皮素、东莨菪碱和蒲公英萜醇等化合物。结论:四鲜汤治疗AL是一种多成分多靶点多信号通路的共同调节过程,网络药理学为阐明四鲜汤治疗AL的作用机理提供了坚实的研究基础。

《清宫医案集成》中熏洗方运用初探

[目的]探究《清宫医案集成》中熏洗方治疗疾病的特殊性和有效性,为现代临床外治法提供参考。[方法]以《清宫医案集成》中117首熏洗方为研究对象,运用Excel软件,对清宫熏洗方的组成、剂量、药性、功效进行整理统计,并结合该书中的相关医案及按语,对熏洗方在清宫中的特色运用进行系统整理。[结果]《清宫医案集成》中的117首宫廷熏洗方在遣方用药上展现出种类繁多、质量上乘,方简药精、效专力宏,随证加减、用药灵活,治病为先、不拘药量,善用风药、不避毒药等多种特色;且另有受众广泛、方式独特、器具考究、药液制备过程细致等其他优势。[结论]《清宫医案集成》中的熏洗方颇具宫廷特色及优势,对其运用展开探索能够获得独特的见解和启示,有助于发扬宫廷用药特色,促进中医药外治疗法的发展,具有较高的研究价值。

隔药灸配合中药口服治疗寒凝血瘀型原发性痛经临床观察

目的探讨隔药灸配合中药口服治疗寒凝血瘀型原发性痛经的临床效果。方法选取2020年1月—2020年12月在南昌市洪都中医院就诊的寒凝血瘀型原发性痛经患者75例,按随机数字表法将其分为西药组及中药组,西药组37例,中药组38例。西药组患者采用布洛芬治疗,中药组在西药组的基础上,使用隔姜灸的同时口服温经汤治疗。3个疗程后,观察2组患者的临床治疗效果;评估2组患者的经期疼痛程度及疼痛持续时间;检测2组患者的β-内啡肽(β-EP)及前列腺素E2(PGE2)的水平。结果3个疗程后,中药组总有效率为92.11%(35/38),高于对照组的72.97%(27/37);中药组疼痛程度低于西药组,疼痛持续时间短于西药组;中药组患者的PGE2水平低于西药组,β-EP水平高于西药组,差异均有统计学意义(P<0.05)。结论隔药灸配合中药口服治疗寒凝血瘀型原发性痛经,可在减轻患者疼痛程度的基础上,缩短患者疼痛时间,有效抑制机体疼痛介质因子的释放,临床效果显著。

浅述脾虚湿盛型泄泻中医辨治思路

脾虚湿盛型是泄泻中最常见的症型之一,就近年来相关的临床研究文献进行梳理,总结并提出新的中医辨治思路。脾虚湿盛型泄泻传统的中医内治法以健脾、渗湿为主,外治法以脐灸、穴位贴敷、灌肠等为主,而内外联合治疗是当今中医药治疗的研究热点与趋势。在临床实践中另辟蹊径,予以升阳止泻法治疗脾虚湿盛型泄泻疗效同样显著,并且发现联合应用升阳除湿法内涵组方的隔药灸脐法疗效更佳,通过使阳气升、浊气降,升降恢复有序达到止泻的效果。故提出升阳止泻法可以用于治疗脾虚湿盛型泄泻,升阳止泻法不但是内服中药组方用药的法则,而且还是隔药灸脐法的核心,临床疗效显著。基于此,阐述升阳止泻法的内涵及病机,并结合临床经验来论证其有效性,为脾虚湿盛型泄泻的中医治疗提供了一个新思路。

基于网络药理学探讨桑白皮汤治疗支气管扩张症的潜在作用机制

目的基于网络药理学方法探讨桑白皮汤(Sangbaipi Decoction,SBPD)治疗支气管扩张症的潜在作用机制。方法通过TCMSP数据库收集SBPD中药的主要活性成分和靶点;检索GeneCards数据库、NCBI基因数据库、OMIM数据库以及CTD数据库获取支气管扩张症的疾病靶点。获取交集靶点后利用STRING数据库构建蛋白质互作网络,通过DAVID数据库进行GO和KEGG功能富集分析。结果筛选得到SBPD的152个活性化合物和261个靶点,支气管扩张症疾病靶点1950个,交集靶点133个。GO功能富集分析结果显示SBPD可涉及2256条生物学过程、149项分子功能、60项细胞组成。KEGG通路富集分析得到164条信号通路,主要包括白细胞介素-17(IL-17)信号通路、肿瘤坏死因子(TNF)信号通路、甲型流感信号通路等。结论SBPD治疗支气管扩张症具有多成分、多靶点、多通路的网络化互作特点,多成分通过调控与支扩病理生理密切相关的一系列信号通路,发挥抗氧化应激、抗炎、肺损伤保护等多重调控作用。

响应面优化畜禽归芪益母汤酶解提取工艺

为了掌握传统中兽药畜禽归芪益母汤最佳纤维素酶提取工艺,采用单因素试验结合响应面优化法对提取工艺进行优化,包括酶解时间、温度、pH值,并测定优化后畜禽归芪益母汤酶解提取液中毛蕊异黄酮葡萄糖苷和阿魏酸质量浓度。结果表明,畜禽归芪益母汤最佳纤维素酶酶解工艺为温度50℃、pH值为5.0的条件下提取9 h,提取后酶解液中毛蕊异黄酮葡萄糖苷质量浓度为0.217 mg/mL,阿魏酸质量浓度为0.122 mg/mL,与模型预测值相近。与传统提取方法相比,纤维素酶酶解提取的畜禽归芪益母汤中毛蕊异黄酮葡萄糖苷和阿魏酸质量浓度分别提升48.63%和69.52%。

隔药灸配合药物防治宫颈癌患者化疗后骨髓抑制的临床研究

目的观察隔药灸配合固髓生血汤对脾肾阳虚型宫颈癌患者紫杉醇联合顺铂(paclitaxel-cisplatin,TP)化疗后骨髓抑制的防治效果及其对Notch信号通路蛋白的影响。方法将74例脾肾阳虚型宫颈癌患者随机分为观察组和对照组,每组37例。两组均接受TP化疗,对照组采用常规骨髓抑制防治方案,观察组采用隔药灸配合固髓生血汤防治骨髓抑制。观察两组治疗前后各项中医证候积分、骨髓抑制发生率、血常规各项指标[血红蛋白(hemoglobins,Hb)、白细胞(white blood cell,WBC)、血小板(platelet,PLT)、中性粒细胞比例(neutrophil percentage,NEUT%)水平]及Notch信号通路相关蛋白(Jagl、Notch2、Numb1、Nubm2)水平的变化情况,比较两组治疗后不良反应发生率。结果与同组治疗前比较,两组治疗1个周期后各项中医证候积分均显著增加(P<0.05),各项血常规指标及Numb1、Numb2水平均显著降低(P<0.05),Notch2、Jag1水平均显著升高(P<0.05)。治疗2个周期后,两组各项中医证候积分均较同组治疗1个周期后显著降低(P<0.05);各项血常规指标均较同组治疗1个周期后显著增加(P<0.05),但仍低于同组治疗前(P<0.05);Notch2、Jag1水平均较同组治疗1个周期后显著降低(P<0.05),但仍高于同组治疗前(P<0.05);Numb1、Numb2水平均较同组治疗1个周期后显著升高(P<0.05),但仍低于同组治疗前(P<0.05)。观察组治疗1、2个周期后各项中医证候积分、骨髓抑制发生率、消化道反应发生率及Notch2、Jag1水平均明显低于对照组,各项血常规指标及Numb1、Numb2水平均明显高于对照组,差异均具有统计学意义(P<0.05)。两组肝、肾功能损害发生率比较,差异均无统计学意义(P>0.05)。结论隔药灸配合固髓生血汤能减轻脾肾阳虚型宫颈癌患者TP化疗后骨髓抑制症状,改善血常规,且有助于降低消化道反应发生率,其作用机制可能与调节Notch信号通路有关。

不同配伍比例对大黄-栀子药对中蒽醌和栀子苷含量的影响

通过研究大黄与栀子在不同配伍比例、不同提取方法下蒽醌和栀子苷成分含量的变化,明确配伍对中药物质基础的影响并筛选最佳的配伍比例。将大黄∶栀子分别按照1∶1、3∶4、4∶3的比例(大黄分为后下和不后下)制备常规煎煮液、水煎醇沉的上清液和沉淀,用HPLC法测定不同样品中栀子苷和蒽醌含量。结果显示,按单药煎煮含量折算后,水煎醇沉的沉淀中栀子苷含量以及煎煮液、水煎醇沉的上清液和沉淀中蒽醌含量均高于理论值;大黄∶栀子按照1∶1及4∶3比例、大黄后下煎煮液中总蒽醌含量分别高于同比例大黄不后下药液。表明大黄长时间加热降低了蒽醌成分含量,配伍后提高了蒽醌和栀子苷成分的溶出。

方明治教授基于“虚气留滞”理论辨治肺癌相关性厌食经验

肺癌相关性厌食是晚期肺癌患者普遍存在的严重并发症,急性期可致恶病质综合征、呼吸困难、休克状态。方明治教授认为,“虚气留滞”是肺癌相关性厌食的病机关键,“虚气”即患者肺胃之气虚惫,痹而不通,失于斡旋;“留滞”指津血不得气机推动,凝滞不化,酿生痰饮。“虚气”与“留滞”互为因果,贯穿始终。所谓“平治于权衡,去菀陈莝”,临床辨治需分清主次缓急,急性期以经方外台茯苓饮治之,药简效宏。

健脾固肾方隔药灸治疗脾肾两虚型小儿遗尿临床疗效观察

目的:观察探讨健脾固肾方隔药灸治疗脾肾两虚型小儿遗尿症的临床疗效,总结临床治疗经验。方法:将保定市第一中医院儿科2018年6月~2021年6月收治的90例小儿遗尿症(脾肾两虚型)患儿作为研究对象,以随机数字表平均分为2组,各45例,对照组给予盐酸甲氯芬酯胶囊口服治疗,观察组在对照组基础上加用健脾固肾方隔药灸治疗,观察对比两组患儿治疗前和治疗1个月后的每周夜间遗尿次数、血浆抗利尿激素(ADH)、尿渗透压(Uosm)、睡眠质量(PSQI)评分、中医证候积分,并对比两组患儿治疗1个月后的临床疗效和观察两组治疗期间不良反应。结果:观察组患儿治疗1个月后夜间遗尿次数、Uosm1、Na^(+)、Cl^(-)浓度、PSQI各项评分均显著低于治疗前和对照组治疗后同期水平,AHD1、K^(+)、BUN浓度均显著高于治疗前和对照组治疗后同期水平,组内及组间比较均有统计学意义(P<0.05);观察组治疗1个月后疗效总有效率为95.6%,复发率为2.2%,对照组为73.3%,复发率为22.2%,组间比较均有统计学意义(P<0.05)。对照组不良反应发生率为13.3%,观察组不良反应发生率为8.9%,对比两组患儿的不良反应发生率无统计学意义(P>0.05)。结论:健脾固肾方隔药灸治疗脾肾两虚型小儿遗尿症的临床疗效显著,提高夜间ADH水平,降低夜间尿渗透压,减少小儿遗尿次数,明显改善患儿中医证候和睡眠质量,不良反应少,安全可靠,值得临床合理推广。

Combined acupuncture and Chinese herb decoction for 5 cases with graphospasm

Combined acupuncture and Chinese herb decoction were applied for 5 cases with graphospasm.Acupuncture included scalp acupuncture and body acupuncture.Using transcranial repeated needling,Baihui(百会GV20),Chorea-trembling controlled area,Emotional area,as well as Dazhui(大椎GV14),Fengchi(风池GB20),and Yingxiang(迎香EX-HN8)etc.were stimulated by proposed by Sun Shentian.Meanwhile,the patients took orally Chinese herb decoction,on the basis of the Siwu decoction(四物汤four substances decoction)addition and subtraction,relieve symptoms under syndrome differentiation.The treatment was carried out for 4 courses in total.One course consisted of 5 days,with an interval of 2 days between two courses.After treatment of 5 patients,2 patients were cured,2 patients achieved markedly effective response,and 1 patient achieved effective response.

酸枣仁汤加味联合隔药灸对阴虚火旺证失眠的疗效及睡眠质量、生活质量的影响

目的探讨酸枣仁汤加味联合隔药灸对阴虚火旺证失眠的疗效及睡眠质量、生活质量的影响。方法随机选取2020年5月—2022年3月福建省泉州市正骨医院收治的阴虚火旺证失眠患者80例为研究对象,采用随机数字表法分为对照组和观察组,各40例。对照组接受常规西药治疗,观察组接受酸枣仁汤加味联合隔药灸治疗。比较两组患者疗效、β-内啡肽(β-EP)、5-羟吲哚乙酸(5-HIAA)、5-羟色胺(5-HT)、睡眠质量、生活质量、不良反应情况。结果观察组总有效率高于对照组(95.00%vs 75.00%),差异有统计学意义(χ^(2)=6.274,P<0.05)。治疗前,两组β-EP、5-HIAA、5-HT指标比较,差异无统计学意义(P>0.05);治疗后,与对照组相比,观察组β-EP、5-HT水平更高,5-HIAA水平更低,差异有统计学意义(P<0.05)。治疗前,两组PSQI评分、SRSS评分、SF-36评分比较,差异无统计学意义(P>0.05);治疗后,与对照组相比,观察组PSQI评分、SRSS评分更低,SF-36评分更高,差异有统计学意义(P<0.05)。两组不良反应发生率比较(5.00%vs 7.50%),差异无统计学意义(P>0.05)。结论临床治疗阴虚火旺证失眠患者可应用酸枣仁汤加味联合隔药灸治疗,以更好地改善机体β-EP、5-HIAA、5-HT指标,提升睡眠和生活质量,安全高效。

Studies of the intestinal absorption of the alkaloids in the Wu-tou decoction combined with different incompatible medicinal herbs in a Caco-2 cell culture system using UPLC-MS/MS

In this study, seven alkaloids were detected in Wu-tou decoction using ultra performance liquid chromatography coupled with tandem mass spectrometry （UPLC-MSn）. The aim of this study was to investigate the effect of Fritillariae Cirrhosae Bulbus, Fritillariae Thunbergii Bulbus, Pinelliae Rhizoma in different ratios with Wu-tou decoction （2：1, 1：1, 1：2） by measuring the therapeutic effects in Wu-tou decoction of main seven alkaloids including benzoylaconitine （BA）, benzoylmesaconitine （BM）, benzoylhypaconitine （BH）, hypaconitine （HA）, fuziline （FU）, niaolin （NE） and deoxyaconitine （DA）. The permeability of aconitum alkaloids extract through a Caco-2 cell monolayer was analyzed in the absence and presence of Fritillariae Cirrhosae Bulbus, Fritillariae Thunbergii Bulbus, and Pinelliae Rhizoma, respectively. The results showed that Pinelliae Rhizoma could reduce the absorption of the alkaloids and increase the excretion of the alkaloids, which would attenuate the therapeutic effects of Wu-tou decoction. Therefore, Pinelliae Rhizoma is an incompatible herb of Wu-tou decoction because of the inhibition of the absorption of alkaloids in the intestine. And that Fritillariae Cirrhosae Bulbus and Fritillariae rhunbergii Bulbus showed the effects to improve the permeability of the alkaloids in Wu-tou decoction. These effects of these two herbs were similar, but the former was stronger than the latter, which most likely is due to the fact that the compositions of these two traditional Chinese medicines are similar. The in vitro data suggests that the compounds such as fritillary presented in alkaloids in the formula maybe improve the therapeutic function caused by the increased bioavailability of alkaloids in intestine.

基于“肠-肾轴”理论观察健脾益肾泄浊汤灌肠对慢性肾脏病非透析患者肠道机械屏障影响临床研究

目的:基于“肠-肾轴”理论,观察健脾益肾泄浊汤灌肠对CKD 3~5期非透析患者肠道机械屏障、微炎症状态等指标的影响,评价该方治疗CKD的潜在疗效性及安全性。方法:采用随机、单盲、安慰剂对照的方法,符合纳入标准的CKD 3~5期非透析患者116例,经区组随机法分为安慰剂灌肠组和中药灌肠组,每组58例,两组患者给予西医基础治疗+安慰剂/中药灌肠治疗。中药灌肠每次保留1 h,每天早晚各1次,每周5 d,疗程4周。检测两组患者治疗前后肠道机械屏障功能指标(内毒素、D-乳酸)、炎症状态(CRP、IL-6、TNF-α)、肠源性尿毒症毒素(硫酸吲哚酚)、中医症状分级量化评分、便秘患者症状(PAC-SYM)评分等指标。结果:与安慰剂灌肠相比,中药灌肠能够降低患者的内毒素、CRP、IL-6水平,降低中医症状评分及便秘症状评分,但对D-乳酸、TNF-α、硫酸吲哚酚水平没有影响。结论:健脾益肾泄浊汤灌肠可以保护CKD 3~5期非透析患者肠道机械屏障功能,减轻微炎症状态,缓解临床症状。

Investigation of Mechanism of Premature Ovarian Failure Regulation by Kidney-tonifying Herbs and Liver-clearing Herbs in Dingjing Decoction

Objective To investigate the mechanisms through which kidney-tonifying herbs（KTHs） and liver-clearing herbs（LCHs） in Dingjing Decoction（DJD） regulate premature ovarian failure（POF）. Methods One hundred and fifty Sprague-Dawley rats were randomly divided into five groups such as control, model, KTHs, LCHs, and DJD groups. POF-related biological molecules were examined. Factor analysis was performed to investigate the regulatory networks and key biomolecules involved in mediating POF after treatment with KTHs and LCHs. Results The master regulatory factors in the reproductive endocrine network associated with KTHs intervention included four molecules in the pituitary-ovarian axis, cortisol（CORT） in the target gland of pituitary-adrenal axis, and some molecules in the hypothalamus. In contrast, the master regulatory factors associated with LCHs intervention included four molecules in the pituitary-ovarian axis and some molecules in the hypothalamus; No biomolecules in the pituitary-adrenal axis were involved in the LCH-mediated mechanisms.Gonadotropin-releasing hormone（Gn RH）, which was identified as a common biological molecule in the hypothalamus, was involved in regulating the reproductive endocrine network in association with KTHs intervention. Conclusion KTHs directly regulates biological molecules in the pituitary-adrenal axis and indirectly regulates those in the pituitary-adrenal axis through the hypothalamus, while the LCHs only exert its effects indirectly. Gn RH is the key biological molecule associated with KTHs intervention.