Regulating and tonifying spleen and kidney traditional Chinese medicine in the treatment of chronic uric acid nephropathy: A systematic review

Objective:To systematically evaluate the efficacy and safety of traditional Chinese medicine for regulating spleen and kidney.Methods:We developed a search strategy and then retrieved the database including CNKI,Wanfang data knowledge service platform,VIP journals resource integration service platform,PubMed,Embasefor randomized controlled trial of regulating spleen and kidney traditional Chinese medicine compared with conventional western medicine in the treatment of chronic uric acid nephropathy.The search deadline was set to June 30,2020.For the included literature,we applied the cochrane collaboration network risk bias assessment tool to evaluate the methodological quality,and evaluated the level of evidence according to GRADE standards.Quantitative data was analyzed by RevMan5.3 software,and trial sequential analysis method was used to analyze its efficiency.Results:A total of 709 cases in 10 articles were included.Compared with the control group,the related traditional Chinese medicine group improved the effective rate[RR=1.45,95%CI(1.32,1.58)],reduced the level of UA[MD=-36.24,95%CI(-41.03,-31.45)],BUN[SMD=-1.27,95%CI(-1.47,-1.07)]and SCR[MD=-36.33,95%CI(-55.79,-16.87),P=0.0003],the difference between the two groups was statistically significant(P<0.05).There was no evidence that a significant adverse reaction occurred.The results of TSA analysis showed that the Chinese medicine group had definite evidence for improving the efficiency.According to the GRADE evaluation criteria,the efficiency,UA,BUN and SCR outcome indicators were extremely low-quality evidence.Conclusions:Traditional Chinese medicine for regulating spleen and kidney in the treatment of chronic uric acid nephropathy improved efficiency,reduced the level of UA,BUN,SCR.Meanwhile,the therapy was proved to be safe.Nevertheless,the conclusions need further high-quality evidence to support.

Theoretical Discussion on Treatment of Cubital Tunnel Syndrome Based on Theory of Liver,Spleen and Kidney

Cubital tunnel syndrome is a disease in which ulnar nerve is compressed by its surrounding tissues,and its main clinical manifestations are pain,sensory disturbance and dyskinesia.Its incidence rate is the second highest among peripheral nerve entrapment diseases,and it is one of the common clinical diseases.The theory of liver,spleen and kidney can guide the treatment of cubital tunnel syndrome with traditional Chinese medicine and acupuncture.By discussing the traditional Chinese medicine(TCM)pathogenesis and treatment principles of cubital tunnel syndrome,it provides modern medical theoretical support for TCM treatment of cubital tunnel syndrome.

Professor Fengjie He’s Experience in Treating Polycystic Ovary Syndrome of Kidney Asthenia and Liver Depression

Polycystic ovary syndrome is a common reproductive endocrine metabolic disease in clinic.Professor Fengjie He has accumulated rich clinical experience in the process of diagnosis and treatment of the disease.He believes that the key to the pathogenesis of the disease is the dysfunction of the reproductive axis of“kidney-Tiangui-Chongren-uterus,”which is based on kidney deficiency and involves the liver and spleen.Clinically,patients with kidney deficiency and liver depression are common.The treatment takes tonifying the kidney and regulating the menstrual cycle as the main method,and the clinical effect is very effective.

Effectiveness of tonifying-kidney and regulating-liver therapy on diminished ovarian reserve: a systematic review and Meta-analysis of randomized controlled trials

OBJECTIVE: To evaluate the effectiveness of the Traditional Chinese Medicine tonifying-kidney and regulating-liver therapy on diminished ovarian reserve(DOR).METHODS: The literature was comprehensively searched up to August 2019 using four Chinese and three English electronic databases to extract randomized clinical trials(RCTs) comparing Traditional Chinese Medicine tonifying-kidney and regulating-liver prescriptions(combined with hormone therapy or not) with Western Medicine. Data quality evaluation was conducted using the Cochrane risk of bias tool. Meta-analysis was conducted using Revman 5.3 software with effect estimates presented as mean difference(MD), risk ratio(RR), and95% confidence interval(CI).RESULTS: A total of nine RCTs with 512 participants were extracted and eligible for Meta-analysis.There were no significant differences between Chinese medicine and Western Medicine on basal serum follicle-stimulating hormone(FSH) level(MD0.11, 95% CI-0.52 to 0.74, 392 participants, seven trials), anti-Müllerian hormone level(MD 0.48, 95%CI-0.62 to 1.58, 95 participants, two trials), and the FSH and luteinizing hormone ratio(MD 0.01,95% CI-0.95 to 0.96, 115 participants, two trials).Chinese medicine was more effective at improving Traditional Chinese Medicine symptom scores(TCMSS)(MD-2.39, 95% CI-3.83 to-0.94, 160 participants, three trials), effective rate of TCMSS(RR1.18, 95% CI 1.02 to 1.36, 160 participants, three trials), antral follicle count(AFC)(MD 0.55, 95% CI 0.05 to 1.04, 155 participants, three trials), and FSH levels at 3 months post-treatment(MD-4.77, 95% CI-6.09 to-3.45, 137 participants, two trials).CONCLUSION: Compared with Western Medicine,tonifying-kidney and regulating-liver therapy is more effective at relieving symptoms and improving AFC and FSH at 3 months post-treatment.

Influence of electroacupuncture therapy of tonifying the kidney and regulating governor vessel on Aβ related degradation enzymes in the hippocampus of a rat model of Alzheimer's disease induced by Aβ_(1-42)

Objective： To explore influence of electroacupuncture（EA） therapy of tonifying the kidney and regulating governor vessel on amyloid beta（Aβ） related degradation enzymes in the hippocampus of a rat model of Alzheimer＇s disease（AD） induced by Aβ（1-42）.Methods： Forty Wistar male rats were randomly divided into 4 groups： a normal group, a sham operation group, a model group and an EA group, 10 rats in each one. The rats in normal group were normally fed. The rats in sham operation group were bilaterally injected in the hippocampus with 5 μL of saline and they were normally fed after the injection. The rats in the model group and the EA group were bilaterally injected in the hippocampus with 5 μL of Aβ（1-42） on each side. Rats in the EA group received EA of 5 Hz continuous wave at the ＂Bǎihuì（百会 GV20）＂ and bilateral ＂Shènshū（肾俞 BL23）＂ for a duration of 15 min per time every day and continuously for 15 days. After 15 days, the hippocampal expression levels of insulin degrading enzyme（IDE）, lipoprotein（LPL）, transthyretin（TTR）, apolipoprotein E（APoE）,a2 macroglobulin（a2 M） and Aβ（1-42） of the 4 groups were tested by Western blot.Results： Compared with the sham operation group, the expression levels of IDE, LPL, TTR, APoE and a2 M in the hippocampus were significantly lower（P〈 0.05, P〈 0.01） and the expression of Aβ（1-42） was significantly higher（P〈 0.01） in the model group. Compared with the model group, the expression levels of IDE, LPL, TTR,APoE and a2 M in the hippocampus of these rats were significantly lower（P〈 0.05,P〈 0.01）, the expression of Aβ（1-42） was significantly higher（P〈 0.01） in the EA group.Conclusion： EA therapy of tonifying the kidney and regulating governor vessel can enhance the expression of IDE, LPL, TTR, APoE, and a2 M in the hippocampus of AD rats injected by Aβ（1-42）, and may consequently promote the degradation of aβ（1-42） to help improve the pathological manifestations of AD and therefore delay its progression.

针灸治疗卵巢功能减退类疾病的选穴规律

【目的】运用数据挖掘技术探讨针灸治疗卵巢功能减退类疾病的选穴规律。【方法】通过计算机检索中国知网期刊全文数据库(CNKI)、万方学术期刊全文数据库(Wanfang)、维普中文科技期刊数据库(VIP)等各大数据库中有关针灸治疗卵巢储备功能减退类疾病(包括卵巢储备功能下降、早发性卵巢功能不全、卵巢早衰)的临床研究类文献,利用Excel 2021建立选穴处方数据库,采用SPSS Modeler 18.0、SPSS Stastics 26.0软件对腧穴进行频数、归经、部位、特定穴、关联规则分析、聚类分析等,研究针灸治疗卵巢储备功能减退类疾病的选穴规律。【结果】共筛选出符合要求的文献215篇,使用穴位共96个,总频次为2 110次,高频腧穴为关元、三阴交、肾俞等,常用经脉为任脉与足太阳膀胱经,腧穴多分布在腹部及下肢部,以五输穴和原募穴居多。分析得出核心穴组及4个有效聚类群。【结论】针灸治疗卵巢储备功能减退类疾病选穴重在补益气血,培元补肾。多选取与生殖相关的经脉,旨在调精补血,预培其损。注重“近部”与“远部”取穴相配合,重视特定穴的配伍使用,多脏同调。

章勤求嗣种子经验探析

[目的]总结章勤教授对乏嗣的理解以及从夫妻同治角度求嗣种子的经验。[方法]通过门诊跟师学习,总结章师治疗夫妻乏嗣的诊疗思路和用药经验,并附验案一则佐证。[结果]章师认为,男女乏嗣皆本于肾虚,与精亏、血虚相关,故求嗣种子以补肾养血为核心,尤重于温阳。其中男子重于养精,并结合“乙癸同源”理论,补肾养血之余,更要疏肝行气,填精之余更助精行,此乃养精之法;女子重于调经,调经是种子的前提。文中夫妻同治医案,章师根据男女生理特点,针对不育男子,补肾养精、行气活血,针对不孕女子,补肾活血、调经助孕,夫妻同治,男精盛、女经调,阴阳交合,终成胎孕。[结论]章师认为夫妻乏嗣,与双方均有关,世间多重于调女而忽略于男,提出夫妻同治是治疗乏嗣的重要手段,应用于临床,效果显著,为治疗不孕不育这项疑难杂症提供了新思路。

针药结合对卵泡发育不良者卵泡发育情况及子宫内膜超声评分的作用研究

目的通过针药结合治疗卵泡发育不良的临床研究,探索针药结合促进卵泡发育、提高子宫内膜容受性的优势。方法将150例卵泡发育不良者随机分为针药结合组、中药组及西药组,每组50例。针药结合组采用中药补肾调周疗法及针刺治疗,中药组单纯采用中药补肾调周疗法,西药组口服克罗米芬。连续治疗3个疗程后,比较三组患者肾气虚证候改善情况、卵泡发育情况、子宫内膜超声评分等。结果治疗后针药结合组和中药组肾气虚证候改善情况明显与西药组比较,差异有统计学意义(P<0.05)。三组优势卵泡最大直径治疗前后比较,差异有统计学意义(P<0.05)。针药结合组和中药组可显著提高子宫内膜超声评分,两组治疗前后比较,差异有统计学意义(P<0.05);且针药结合组疗效优于中药组,两组比较,差异有统计学意义(P<0.05)。西药组对子宫内膜超声评分无改善。结论针灸配合补肾调周方药可促进卵泡发育,并改善患者肾气虚证候,提高子宫内膜容受性。针药结合治疗卵泡发育不良,疗效佳、副作用少,可在临床中推广应用。

补肾调周联合长方案对辅助生殖技术中多囊卵巢综合征不孕症患者临床结局干预的研究

目的观察补肾调周法联合长方案对辅助生殖技术中多囊卵巢综合征不孕症患者临床结局的影响,从而探讨多囊卵巢综合征不孕症患者在长方案中运用补肾调周法的可行性及有效性。方法 80例患者随机分为治疗组(40例)和对照组(40例)。治疗组采用常规长方案联合补肾调周法,对照组单纯采用常规长方案。比较2组患者的一般情况,Gn启动量、Gn总用量、Gn天数、HCG日雌二醇水平、获卵数、2PN数、优质胚胎数、ET日子宫内膜厚度、临床妊娠率、流产率。结果治疗组HCG日雌二醇水平、2PN数、优质胚胎数显著高于对照组,2组比较有统计学意义(P<0.05);治疗组获卵数增加,Gn启动量、Gn总用量、Gn天数均减少,但2组比较无统计学意义;治疗组子宫内膜厚度增加,但2组之间均无统计学意义;治疗组临床妊娠率高于对照组,流产率低于对照组,但2组之间无统计学意义。结论补肾调周法联合常规长方案治疗可以增加患者2PN数、优质胚胎数,提高子宫内膜容受性,最终提高妊娠率,降低流产率。

补肾调经系列方对功能失调性子宫出血患者生殖激素及子宫内膜激素受体的影响

目的探讨补肾调经系列方对功能失调性子宫出血患者生殖激素及子宫内膜雌激素受体(ER)、孕激素受体(PR)的影响。方法运用补肾调经系列方周期给药对39例功能失调性子宫出血患者进行治疗,采用磁分离酶免激素定量测定法测定患者治疗前后血浆雌二醇(E2)、孕酮(P)、促卵泡素(FSH)、黄体生成素(LH);采用流式细胞术测定子宫内膜ER、PR。结果与治疗前相比,治疗后患者子宫内膜ER表达量明显降低(P<0.05),E2水平明显升高(P<0.01)。结论补肾调经系列方有调节生殖激素和子宫内膜ER的作用。

郭霞珍教授调经促孕临床经验总结

郭霞珍教授通过对黄帝内经基础理论的理解,参考历代医家对调经促孕种子的认识,继承程士德教授学术思想和临床经验,总结了女性经、带、孕的特殊生理特点和不孕的病因病机。主要针对肾-天癸-冲任-胞宫这一生殖轴的调理,提出了以平调阴阳,补肾益精为主,益气养血,疏肝解郁,活血软坚为辅的一套调经促孕的治则治法,临床取得良好的疗效。

王隆卉运用补肾调周法治疗多囊卵巢综合征不孕经验

介绍王隆卉教授治疗多囊卵巢综合征不孕经验。认为肾、脾、肝三脏功能失调与气滞、血瘀、痰湿的变化为其发病的主要机制,治疗采用中医补肾调周法。经后期滋阴养血,佐以助阳;经间期补肾活血,重在促排;经前期补肾助阳,扶助阳长;行经期活血调经,重在祛瘀。

疏肝补肾结合调经促孕针刺治疗卵巢早衰临床观察

目的观察疏肝补肾结合调经促孕针刺治疗卵巢早衰的临床疗效。方法纳入医院收治的65例卵巢早衰患者(2022年1月—2022年8月收治)进行随机分组研究,将患者以随机数字表法分为对照组(32例)与治疗组(33例),对照组患者口服坤泰胶囊治疗,治疗组患者口服坤泰胶囊治疗,并结合疏肝补肾法+调经促孕针刺法治疗,两组数据观察:治疗效果、治疗前后患者中医证候各项积分(闭经或月经紊乱、阴道干涩、烦躁易怒、性欲减退等)变化、卵巢体积与子宫体积、子宫内膜厚度变化、性激素水平变化、免疫功能指标变化、抑郁自评量表评分(SDS)变化、不良反应。结果治疗组患者治疗总有效率(93.94%,31/33)显著高于对照组患者(75.00%,24/32),P<0.05;治疗前,各组患者中医证候各项积分(闭经或月经紊乱、阴道干涩、烦躁易怒、性欲减退等)、卵巢体积与子宫体积、子宫内膜厚度、促黄体生成素(luteinizing hormone,LH)以及促卵泡生成素(follicle-stimulating hormone,FSH)、雌二醇(estradiol,E_(2))等性激素水平、免疫功能指标(CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+))、SDS评分等比较,P>0.05,治疗后各组患者中医证候各项积分(闭经或月经紊乱、阴道干涩、烦躁易怒、性欲减退等)、卵巢体积与子宫体积、子宫内膜厚度、LH及FSH、E_(2)、免疫功能指标(CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+))、SDS评分均改善,治疗组患者治疗后中医证候各项积分(闭经或月经紊乱、阴道干涩、烦躁易怒、性欲减退等)、卵巢体积与子宫体积、子宫内膜厚度、LH及FSH、E_(2)、免疫功能指标(CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD_(8)^(+))、SDS评分均优于对照组,P<0.05;各组均未见严重不良反应,P>0.05。结论疏肝补肾法结合调经促孕针刺法治疗卵巢早衰临床疗效显著,患者症状及卵巢功能、免疫功能及心理状态均改善,无不良反应,安全可靠。

中医辨证治疗排卵性不孕

目的分析中医辨证治疗排卵性不孕的临床效果。方法选取排卵性不孕患者90例,采取随机数字表法分为观察组与对照组,每组各45例。对照组给予克罗米芬治疗,观察组给予中药辨证治疗,对比2组患者的内膜厚度、直径≥10 mm的卵泡数目、优势卵泡直径、排卵率、妊娠率及不良反应发生率。结果 2组患者治疗后较治疗前相比内膜厚度增厚,直径≥10 mm的卵泡数目增多,优势卵泡直径扩大,观察组较对照组相比上述指标改善更加显著(P<0.05)。观察组较对照组相比妊娠率及排卵率较高,未破裂卵巢黄素化综合征率、卵巢过度刺激综合征率、身体明显不适率较低(P<0.05)。结论采用中医辩证施治排卵性不孕相比于常规西医治疗能进一步改善临床疗效,提高排卵率及妊娠率。

《妇人规》调经用药规律探析

[目的]总结《妇人规》中治疗月经不调的用药规律。[方法]本文通过统计《妇人规》中"经脉类·经不调"的方药使用频次,整理分析,探讨其用药规律。[结果]《妇人规》"经脉类·经不调"平均每首方用药8味,用药精简;治疗血虚经乱时使用补益脾气方剂数最多;使用频次较高的药物有熟地、当归、人参、白术、茯苓。[结论]《妇人规》调经以详审病因病机为基础,以后天之本为重点,依据药性选药,用药精简,严谨组方,对后世月经不调的诊疗思路产生了深刻影响。

祛斑养颜汤治疗黄褐斑

目的观察祛斑养颜汤治疗黄褐斑的临床疗效。方法将符合纳入及排除标准的80例黄褐斑患者随机分为治疗组和对照组,各40例,治疗组口服祛斑养颜汤,对照组口服还原型谷胱甘肽片。结果治疗组总有效率82.86%,对照组总有效率72.97%。2组比较,差异具有统计学意义(P<0.05)。结论祛斑养颜汤治疗黄褐斑,能疏肝健脾、补肾调经、养血活血,提高临床疗效。

尤昭玲教授辨治不孕症的临证思路

尤昭玲是我国著名中医妇科学教授、博士生导师、享受国务院政府特殊津贴专家、国家第四批名老中医学术经验继承指导老师、中国首席健康科普专家、中华中医药学会常务理事、中华中医药学会妇科分会主任委员。从事中医和中西医结合妇科临床、

王昕补肾调经祛痰化瘀-抑囊助孕汤治疗多囊卵巢综合征

王昕教授认为多囊卵巢综合征病因病机主要为"肾虚为本,痰瘀互结",肾虚乃本病之关键,唯肾精充盛,气血充足,女经方能调畅,加之阴阳和合,两精相搏,始能成孕;提出"补肾调经,祛痰化瘀"的独到见解,治疗补肾是关键,并于补肾之中活血化瘀、化痰通络,标本同治。独创抑囊助孕汤治疗多囊卵巢综合征临床疗效显著。

崩漏临床辨证四原则

崩漏是妇科常见病,临床辨证论治,综合八纲、气血、脏腑等全面分析,从治肾调经、清热固经、益气健脾、固经养血四个方面深入探讨,辨证用药,临床疗效显著,副作用小,值得推广。

中药补肾调周序贯疗法治疗53例多囊卵巢综合征患者疗效观察

目的观察中药补肾调周序贯疗法治疗多囊卵巢综合征(PCOS)的临床疗效。方法53例患者口服补肾调周中药,每日1剂,连服6个月,或服至确认妊娠。观察患者治疗前后月经周期、性激素水平[促黄体生成素(LH)、促卵泡生成素(FSH)、雌二醇(E_(2))、睾酮(T)、催乳素(PRL)]、卵巢大小变化情况,及治疗6个月内的妊娠率。结果6个月内,妊娠率为23.8%(10/42)。治疗6个月后,43例未妊娠的患者T、LH及LH/FSH明显下降,月经周期缩短,双卵巢体积减小(P<0.01),差异均有统计学意义;FSH、E_(2)及PRL治疗前后差异无统计学意义。结论中药补肾调周序贯疗法能调节PCOS患者月经周期,降低其T、LH、LH/FSH水平,缩小卵巢体积,改善临床妊娠率,值得推广。