Novel insights into the effect of Xiaoyao san on corticosterone-induced hepatic steatosis:inhibition of glucocorticoid receptor/perilipin-2 signaling pathway

Objective:Xiaoyao san(XYS)is a classic traditional Chinese medicinal formula.It has been clinically administered to regulate liver function.However,its mechanisms in glucocorticoid-induced hepatic steatosis are unknown.This study aimed to investigate whether XYS protects against corticosterone(CORT)-induced hepatic steatosis,and to explore its mechanism.Methods:High-fat diet mice induced with hepatic steatosis by 2mg/kg CORT were administered 2.56 g/kg or 5.12 g/kg XYS daily for 7 weeks.The effects of XYS on hepatic steatosis in mice were evaluated by H&E and Oil Red O staining and by measuring their plasma lipids(triglyceride,total cholesterol,and free fatty acids).The mechanism of XYS against hepatic steatosis was investigated by network pharmacology,immunohistochemistry,western blotting,and gain-of-function/loss-offunction experiments.Results:XYS alleviated CORT-induced steatosis,decreased plasma lipids,and inhibited glucocorticoid receptor(GR)activation in the liver.Network pharmacology data indicated that XYS may have mitigated hepatic steatosis via GR which mediated adipose differentiation-related protein(ADFP).Gain-of-function/loss-of-function experiments in vitro confirmed that GR positively regulated ADFP expression.Conclusions:XYS ameliorated CORT-induced hepatic steatosis by downregulating the GR/ADFP axis and inhibiting lipid metabolism.Our studies implicate that XYS is promising as a therapy for CORT-induced hepatic steatosis,and lay the foundation for designing novel prophylactic and therapeutic strategies on CORT-induced hepatic steatosis.

The Efficacy and Safety of Modified Xiaoyao San for Perimenopausal Syndrome (PMS): A Systematic Review and Meta-Analysis

Objectives: To assess the efficacy and safety of modified Xiaoyao San (XYS) for treating Perimenopausal syndrome (PMS). Methods: Literature searches were carried out on PubMed, Cochrane Library, CNKI Database, Chinese Biomedical Literature Database, Wan Fang Database, and VIP Database up to December 2018. Hand search for further references was conducted. Study selection, data extraction, quality assessment, and data analyses were performed as request of the Cochrane standards. Results: Nine publications in total were suitable for inclusion. There was evidence that modified XYS was tested to be more effective in improving overall symptoms compared with HRT (odds ratio 3.50, 95% CI 2.56 to 4.78). Whereas HRT was more sensitive and direct in decreasing FSH (WMD 6.69, 95% CI 5.60 to 9.52) and LH (WMD 7.00, 95% CI, 5.75 to 8.25) in comparison with XYS group. It was also strongly supported that XYS had less adverse effect than HRT (odds ratio 0.07, 95% CI 0.05 to 0.10). Conclusion: Modified XYS might be more effective and safer in treatment of perimenopausal syndrome. However, due to poor methodological quality in the majority of included studies, the potential benefit and safety about XYS need to be confirmed in rigorously designed, multi-centre, and large-scale trials.

Effects of Xiaoyao San on exercise capacity and liver mitochondrial metabolomics in rat depression model

Objective: This study aimed to investigate the therapeutic effects of Xiaoyao San(XYS), a herbal medicine formula, on exercise capacity and liver mitochondrial metabolomics in a rat model of depression induced by chronic unpredictable mild stress(CUMS).Methods: A total of 24 male SD rats were randomly divided into four groups: control group(C), CUMS control group(M), Venlafaxine positive treatment group(V), and XYS treatment group(X). Depressive behaviour and exercise capacity of rats were assessed by body weight, sugar-water preference test, open field test, pole test, and rotarod test. The liver mitochondria metabolomics were analyzed by using liquid chromatography-mass spectrometry(LC-MS) method. TCMSP database and Gene Cards database were used to screen XYS for potential targets for depression, and GO and KEGG enrichment analyses were performed.Results: Compared with C group, rats in M group showed significantly lower body weight, sugar water preference rate, number of crossing and rearing in the open field test, climbing down time in the pole test,and retention time on the rotarod test(P < 0.01). The above behaviors and exercise capacity indices were significantly modulated in rats in V and X groups compared with M group(P < 0.05, 0.01). Compared with C group, a total of 18 different metabolites were changed in the liver mitochondria of rats in M group.Nine different metabolites and six metabolic pathways were regulated in the liver mitochondria of rats in X group compared with M group. The results of network pharmacology showed that 88 intersecting targets for depression and XYS were obtained, among which 15 key targets such as IL-1β, IL-6, and TNF were predicted to be the main differential targets for the treatment of depression. Additionally, a total of 1 553 GO signaling pathways and 181 KEGG signaling pathways were identified, and the main biological pathways were AGE-RAGE signaling pathway, HIF-1 signaling pathway, and calcium signaling pathway.Conclusion: XYS treatment could improve depressive symptoms, enhance exercise capacity, positively regulate the changes of mitochondrial metabolites and improve energy metabolism in the liver of depressed rats. These findings suggest that XYS exerts antidepressant effects through multi-target and multi-pathway.

Jiawei Xiaoyao San in treatment of anxiety disorder and anxiety:A review

Jiawei Xiaoyao San(JWXYS)has shown excellent clinical efficacy in anxiety disorder,but has not yet attracted widespread attention.The animal experiments,clinical trials and mechanism studies of JWXYS were reviewed in this article,which may provide a reference for developing new anxiolytic drugs based on this prescription.The literature was searched in PubMed and CNKI and the documents written in English or with English abstracts were selected.JWXYS could reduce the anxiety symptoms of patients alone and reduce the adverse reactions when it is used in combination with other drugs in the clinic.In preclinical studies,JWXYS also showed therapeutic effects in reducing anxiety-like behavior.The mechanisms may include improving the hypothalamic–pituitaryadrenal(HPA)axis and hormone disorders,increasing neurotransmitter content,neurogenesis,and regulating the synthesis of related enzymes.This article shows that JWXYS could effectively treat anxiety disorders by regulating the central nervous system.In the future,with the participation of more researchers,it is expected to develop innovative drugs for the treatment of anxiety disorders based on JWXYS.

Xiaoyao San,a Chinese herbal formula,ameliorates depression-like behavior in mice through the AdipoR1/AMPK/ACC pathway in hypothalamus

Objective Depression and metabolic disorders have overlapping psychosocial and pathophysiological causes.Current research is focused on the possible role of adiponectin in regulating common biological mechanisms.Xiaoyao San(XYS),a classic Chinese medicine compound,has been widely used in the treatment of depression and can alleviate metabolic disorders such as lipid or glucose metabolism disorders.However,the ability of XYS to ameliorate depression-like behavior as well as metabolic dysfunction in mice and the underlying mechanisms are unclear.Methods An in vivo animal model of depression was established by chronic social defeat stress(CSDS).XYS and fluoxetine were administered by gavage to the drug intervention group.Depression-like behaviors were analyzed by the social interaction test,open field test,forced swim test,and elevated plus maze test.Glucose levels were measured using the oral glucose tolerance test.The involvement of certain molecules was validated by immunofluorescence,histopathology,and Western blotting.In vitro,hypothalamic primary neurons were exposed to high glucose to induce neuronal damage,and the neuroprotective effect of XYS was evaluated by cell counting kit-8 assay.Immunofluorescence and Western blotting were used to evaluate the influences of XYS on adiponectin receptor 1(AdipoR1),adenosine 5’-monophosphate-activated protein kinase(AMPK),acetyl-coenzyme A carboxylase(ACC)and other related proteins.Results XYS ameliorated CSDS-induced depression-like behaviors and glucose tolerance impairment in mice and increased the level of serum adiponectin.XYS also restored Nissl bodies in hypothalamic neurons in mice that exhibited depression-like behaviors and decreased the degree of neuronal morphological damage.In vivo and in vitro studies indicated that XYS increased the expression of AdipoR1 in hypothalamic neurons.Conclusion Adiponectin may be a key regulator linking depression and metabolic disorders;regulation of the hypothalamic AdipoR1/AMPK/ACC pathway plays an important role in treatment of depression by XYS.

基于肝脏蛋白质组学探讨加味丹栀逍遥散的抗抑郁作用及机制

[目的]探讨加味丹栀逍遥散对慢性不可预知性温和应激(CUMS)抑郁小鼠模型的干预作用及可能机制.[方法]C57BL/6N小鼠分为正常组、模型组、加味丹栀逍遥散组和氟西汀组.采用CUMS复制抑郁模型,模型成功后灌胃给药4周.末次给药后进行行为学测试,采用串联质谱标签法(TMT)蛋白质组学分析小鼠肝脏差异蛋白的表达谱,通过Kyoto encyclopedia of genes and genomes(KEGG)通路富集加味丹栀逍遥散抗抑郁的相关通路和蛋白;血液生化检测总胆固醇及总胆汁酸含量.[结果]与正常组相比,模型组小鼠糖水偏好率下降,自主活动次数减少,加味丹栀逍遥散给药后上调小鼠糖水偏好率及自主活动次数.蛋白组学结果显示模型组与加味丹栀逍遥散给药组之间肝脏差异表达蛋白20个,其中上调11个,下调9个.KEGG通路富集分析发现差异表达蛋白主要参与了胆固醇代谢、初级胆汁酸的合成等.生化检测发现,与正常组相比,模型组总胆固醇含量下降而胆汁酸含量升高,加味丹栀逍遥散给药能显著增加总胆固醇含量而减少总胆汁酸含量.[结论]加味丹栀逍遥散具有良好的抗抑郁效应,其机制可能与调节肝脏胆固醇异常代谢、降低血液总胆汁酸有关.

逍遥散联合水飞蓟素胶囊治疗肝郁脾虚证非酒精性脂肪性肝病临床研究

目的:逍遥散联合水飞蓟素胶囊治疗肝郁脾虚证非酒精性脂肪性肝病(NAFLD)的疗效。方法:选取90例肝郁脾虚证NAFLD患者,按随机数字表法分为对照组及治疗组各45例。2组行非药物措施,对照组予以水飞蓟素胶囊口服,治疗组在对照组基础上加逍遥散治疗。2组均连续治疗12周。比较2组临床疗效,比较2组治疗前后肝功能指标[谷草转氨酶(AST)、丙氨酸转氨酶(ALT)、谷氨酰转肽酶(GGT)]值、血脂指标[总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)]值、血清TLR4/NF-κB信号通路相关蛋白水平[血清TOLL样受体4(TLR4)、髓样分化因子88(MyD88)、核转录因子-κB(NF-κB)]、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)的变化。结果:治疗12周后,治疗组临床疗效总有效率为91.11%,对照组为73.33%,2组比较,差异有统计学意义(P<0.05)。治疗12周后,2组AST、ALT、GGT指标值均较治疗前下降(P<0.05),治疗组上述3项指标值均低于对照组(P<0.05)。治疗12周后,2组TC、TG、LDL-C水平均较治疗前下降(P<0.05),HDL-C水平均较治疗前上升(P<0.05);治疗组TC、TG、LDL-C水平均低于对照组(P<0.05),HDL-C水平高于对照组(P<0.05)。治疗12周后,2组血清TLR4、MyD88、NF-κB、IL-6、TNF-α水平均较治疗前下降(P<0.05),治疗组上述5项水平均低于对照组(P<0.05)。结论:逍遥散联合水飞蓟素胶囊对肝郁脾虚证NAFLD的疗效确切,可有效改善肝功能及血脂状况,调节血清TLR4-NF-κB信号通路,抑制炎症反应。

逍遥散合大黄[庶虫]虫丸治疗原发性肝癌经肝动脉化疗栓塞术后气滞血瘀型疗效研究

目的:研究逍遥散合大黄[庶虫]虫丸对经肝动脉化疗栓塞(TACE)术后的原发性肝癌(PLC)患者气滞血瘀型的治疗效果。方法:将80例肝癌气滞血瘀型患者采用随机数字表法分为观察组和对照组各40例。对照组肝癌患者TACE术后予对症治疗,观察组肝癌患者在对症治疗的基础上联合逍遥散合大黄[庶虫]虫丸进行治疗。经治疗1个月后复查肝功能、凝血功能、肿瘤指标及上腹部影像学检查的变化情况。结果:观察组血清甲胎蛋白(AFP)、糖类抗原199(CA199)、糖类抗原125(CA125)等肿瘤指标,谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆红素(TBIL)、总蛋白(TP)、白蛋白(ALB)等肝功能指标,凝血酶原时间(PT)、凝血酶原活动度(PTA)、国际标准化比值(INR)、纤维蛋白原(FIB)等凝血功能指标低于对照组,差异具有统计学意义(P<0.05),观察组总有效率75.00%,获益率90.00%,对照组总有效率32.50%,获益率57.50%,观察组总有效率高于对照组(P<0.05)。结论:肝癌气滞血瘀型患者在经过TACE术后,在对症治疗的基础上加用中药内服方逍遥散合大黄[庶虫]虫丸具有更好的疗效,逍遥散合大黄[庶虫]虫丸可以加强对肝功能的保护,有效地改善凝血功能,降低肝癌的转移程度。

朱氏头皮针联合丹栀逍遥散治疗肝郁化火型耳鸣的临床观察

【目的】观察朱氏头皮针联合丹栀逍遥散治疗肝郁化火型耳鸣的临床疗效。【方法】将70例肝郁化火型耳鸣患者随机分为治疗组和对照组,每组各35例。治疗组给予朱氏头皮针联合丹栀逍遥散治疗,对照组给予银杏叶片与甲钴胺片治疗,疗程为3周。治疗3周后,评价2组临床疗效,并于治疗结束后3、6个月进行电话随访,评价临床疗效。观察2组患者治疗前后耳鸣评价量表(TEQ)评分的变化情况,以及焦虑自评量表(SAS)评分的情况。比较2组患者治疗前后耳鸣残疾评估量表(THI)评分的变化情况。并评价2组的安全性及不良反应的发生情况。【结果】(1)治疗后,治疗组总有效率88.57%(31/35),对照组为62.86%(22/35),治疗组疗效优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者TEQ、SAS、THI评分均明显改善(P<0.01),且治疗组在改善TEQ、SAS、THI评分方面明显优于对照组,差异均有统计学意义(P<0.05)。(3)治疗结束后3个月随访,治疗组的总有效率为85.71%(30/35),对照组为60.00%(21/35)。治疗结束后6个月随访,治疗组的总有效率为82.86%(29/35),对照组为54.29%(19/35)。治疗结束后3、6个月随访,治疗组疗效均优于对照组,差异均有统计学意义(P<0.05)。(4)2组患者均未见明显不良反应。2组患者的不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】朱氏头皮针联合丹栀逍遥散治疗肝郁化火型耳鸣,可明显改善患者的耳鸣症状,安全性高,无不良反应,疗效显著。

加味逍遥散通过外泌体miRNA途径发挥抗肝癌作用

背景:在课题组先前研究中发现加味逍遥散具有明显的抗肝癌作用,但具体作用机制不明。目的:基于高通量测序结合生物信息学,探讨加味逍遥散对二乙基亚硝胺慢性诱导的原发性肝癌模型大鼠血浆外泌体miRNA水平的调节作用。方法:将SD大鼠随机分为空白对照组、肝癌模型组、加味逍遥散组。以二乙基亚硝胺持续给药12周诱导肝癌模型,从第17周开始,加味逍遥散组大鼠给予加味逍遥散灌服,每日1次,直至第20周末停药,空白对照组和肝癌模型组大鼠给予等量生理盐水灌胃,通过检测大鼠肝组织的形态结构、肝癌标志物Glypican-3蛋白和血清甲胎蛋白表达验证抗肝癌效应。使用超速离心法分离提取各组大鼠血浆外泌体,利用高通量测序技术筛选出大鼠血浆外泌体中差异表达的miRNA,生物信息学预测加味逍遥散通过肝癌血浆来源外泌体miRNA发挥抗肝癌作用的潜在生物标志物,并进行功能分析。结果与结论:①加味逍遥散对肝癌模型大鼠肝组织的形态结构有显著改善作用,与肝癌模型组相比,加味逍遥散组肝癌标志物Glypican-3蛋白和血清甲胎蛋白的表达均显著降低;②生物信息学分析显示,加味逍遥散组对肝癌模型组上调的miR-223-3p与基因E2F1、NCOA1存在靶向结合位点,并且与肝癌生存率及预后密切相关。由此可见,加味逍遥散对肝癌有治疗作用,可能是通过肝癌血浆来源外泌体miR-223-3p靶向负调控NCOA1/E2F1进而发挥抗肝癌效应。

基于网络药理学和分子对接技术探讨丹栀逍遥散“异病同治”抑郁伴干眼的作用机制

目的:应用网络药理学方法和分子对接技术探讨丹栀逍遥散治疗抑郁伴干眼的作用机制。方法:首先借助中药系统药理学数据库与分析平台(TCMSP)获取并筛选丹栀逍遥散的成分靶点,结合OMIM数据库、DRUGBANK数据库、TTD数据库和GeneCards数据库获取疾病靶点,得到丹栀逍遥散治疗抑郁症和干眼的靶点,再用Cytoscape 3.7.1软件绘制丹栀逍遥散“单一药物-有效成分-共同靶点”网络图,寻找治疗抑郁伴干眼的关键靶点,然后对两种疾病的共同靶点进行京都基因与基因组百科全书(KEGG)通路富集分析和基因本体论(GO)富集分析,最终将关键活性成分与核心靶点进行分子对接。结果:本研究共收集到丹栀逍遥散“异病同治”抑郁伴干眼有效成分128种,丹栀逍遥散“异病同治”靶点52个。关键的生物学通路涵盖癌症通路、糖尿病并发症中的晚期糖基化终末产物(Advanced Glycation End Product,AGE)-晚期糖基化终末产物受体(Advanced Glycation End Product Receptor,RAGE)信号通路等。丹栀逍遥散治疗抑郁伴干眼的核心靶蛋白为肿瘤坏死因子(Tumor Necrosis Factor,TNF)、白细胞介素(Interleukin,IL)-6、IL-1B、血管内皮生长因子(Vascular Endothelial Growth Factor,VEGF)A、半胱氨酸蛋白酶3(Caspase 3,CASP3)、信号转导和转录激活因子3(Signal Transducers and Activators of Transcription 3,STAT3)等,关键活性成分涵盖山柰酚、槲皮素、柚皮素、芍药苷、木犀草素、芦荟大黄素等,分子对接的结果显示丹栀逍遥散中的关键活性成分与对应的靶点结合效果良好。结论:丹栀逍遥散可通过控制炎症反应治疗抑郁伴干眼。本研究结果为深入了解丹栀逍遥散治疗抑郁伴干眼的作用机制和探索其新的药理作用提供理论依据,也为中医科学内涵的解读指明新的思路和方向。

董氏奇穴联合中药治疗混合性焦虑抑郁障碍痰气郁结证的疗效观察

目的:观察针刺董氏奇穴联合内服中药治疗混合性焦虑抑郁障碍(Mixed Anxiety and Depressive Disorder,MADD)痰气郁结证的疗效。方法:选择2020年4月至2021年10月江海区中西医结合医院治疗的MADD患者90例,随机分为对照组、观察A组、观察B组各30例。对照组予口服氟哌噻吨美利曲辛片,观察A组予内服温胆汤合丹栀逍遥散加减,观察B组在观察A组治疗的基础上予针刺董氏奇穴,均治疗12周,治疗后对比三组患者的医院焦虑抑郁量表(Hospital Anxiety and Depression Scale,HADS)评分、中医证候评分、临床疗效及不良反应。结果:治疗前,三组患者的HADS评分、痰气郁结证评分对比,差异无统计学意义(P>0.05);治疗后,三组患者的HADS评分、痰气郁结证评分均较治疗前下降(P<0.05),其中观察A组、观察B组的HADS评分、痰气郁结证评分均明显低于对照组(P<0.05),观察B组的HADS评分、痰气郁结证评分均明显低于观察A组(P<0.05)。观察B组的总有效率(93.33%)高于观察A组(86.67%)、对照组(73.33%)(P<0.05)。治疗期间,对照组不良反应发生率为13.33%,观察A组为6.67%,观察B组为10.00%,差异无统计学意义(P>0.05)。结论:针刺董氏奇穴联合内服中药具有行气开郁、化痰散结、清肝泻火之功效,治疗MADD痰气郁结证安全有效,值得在临床中推广应用。

逍遥散加减治疗女性绝经综合征的Meta分析

目的:评价逍遥散加减治疗女性绝经综合征(MPS)的临床疗效。方法:检索Pubmed、Cochrance、Embase、中国生物医学文献数据库(CBM)、中国学术期刊网络出版总库(CNKI)、中国科学引文数据库、维普(VIP)等数据库,收集建库至2021年12月逍遥散加减治疗MPS的临床随机对照试验,纳入研究采用Cochrance风险偏倚评估工具进行质量评价与偏倚风险评估,应用RevMan5.3软件进行Meta分析。结果:共检索文献624篇,最终纳入13篇随机对照研究,合计1337例患者。Meta分析结果显示,逍遥散加减治疗组与激素治疗组相比,临床总有效率(OR=5.14,95%CI:3.69,7.14,P<0.00001)、血清雌二醇(E_(2))水平(MD=9.46,95%CI:2.01,16.90,P=0.01)、血清卵泡刺激素(FSH)水平(MD=-6.61,95%CI:-8.93,-4.30,P<0.00001)、黄体生成素(LH)水平(MD=-5.84,95%CI:-8.14,-3.54,P<0.00001)、Kupperman症状评分(MD=-3.58,95%CI:-5.97,-1.19,P=0.003)等疗效指标差异均有统计学意义(P<0.05)。结论:基于现有证据,逍遥散加减治疗女性MPS有一定临床效果,可改善血清E_(2)水平,降低FSH、LH水平,缓解Kupperman症状,但仍需开展更多高质量研究进一步分析。

逍遥散对雷公藤多苷致胃黏膜损伤大鼠TNF-α、IL-1β、NF-κB P65表达的影响

目的:研究逍遥散对雷公藤多苷致大鼠胃黏膜损伤的治疗效果及机制。方法:将24只SD大鼠随机分为空白对照组、雷公藤多苷组、逍遥散组,每组8只。雷公藤多苷组和逍遥散组通过灌胃雷公藤多苷混悬液(0.037 5 g·kg^(-1))制备胃黏膜损伤模型大鼠,逍遥散组在灌服雷公藤多苷混悬液1 h前灌服逍遥散水煎液(19.27 g·kg^(-1)),给药每日1次,持续5周。观测各组大鼠体质量、摄食量;采用苏木素-伊红染色法(HE)观察各组大鼠胃黏膜病理变化;酶联免疫吸附法(ELISA)检测血清白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)水平变化;免疫组化、实时荧光定量PCR法(qRT-PCR)和蛋白质印迹法(WB)检测胃黏膜IL-1β、TNF-α、核转录因子-κB P65(NF-κB P65)蛋白和基因表达。结果:胃黏膜损伤模型大鼠体质量及摄食量明显低于正常大鼠,胃黏膜细胞排列紊乱,腺上皮萎缩呈囊状,黏膜层变薄,毛细血管充血明显,细胞发生水肿现象,肠上皮化生明显,黏膜固有层内有大量中性粒细胞浸润,核分裂多见,核大深染,异型性明显,细胞增生、细胞凋亡与坏死明显,血清中IL-1β、TNF-α含量升高(P <0.05),胃黏膜IL-1β、TNF-α、NF-κB P65蛋白与基因表达增加(P <0.05)。逍遥散干预后,大鼠体质量及摄食量增加,大鼠胃黏膜病理形态有不同程度减轻,血清中IL-1β、TNF-α含量降低(P <0.05),胃黏膜IL-1β、TNF-α、NF-κB P65蛋白与基因表达降低(P <0.05)。结论:逍遥散可在一定程度上缓解雷公藤多苷所致胃黏膜损伤,其机制可能与调节IL-1β、TNF-α、NF-κB P65的异常表达、减轻炎症级联反应有关。

逍遥散加味颗粒对大鼠肝纤维化TGF-β1/Smad通路的影响

目的:探讨逍遥散加味颗粒通过转化生长因子-β1(TGF-β1)/Smad通路改善肝纤维化的作用与机制。方法:将78只雌雄各半的SD大鼠随机分为正常组(n=12)和模型组(n=66)。模型组采用四氯化碳皮下注射,喂养高脂饲料造模9周后,将其随机分为对照组(n=12)、高剂量组(n=13)、低剂量组(n=13)、复方鳖甲组(n=13)及扶正化瘀组(n=12)。正常组与模型组不进行干预;高剂量组用逍遥散加味颗粒灌胃16 g•kg^(-1)•d^(-1);低剂量组用逍遥散加味颗粒灌胃8 g•kg^(-1)•d^(-1);复方鳖甲组采用复方鳖甲软肝片灌胃0.5 g•kg^(-1)•d^(-1);扶正化瘀组采用扶正化瘀胶囊灌胃0.5 g•kg^(-1)•d^(-1),1次/d,连续4周。末次给药禁食8 h后,大鼠进行目内眦取血,采用酶联免疫法(ELISA)测定血浆TGF-β1的含量;禁食24 h后,麻醉,固定,解剖肝组织,苏木素-伊红(HE)染色观察肝脏组织的变化情况,蛋白质免疫印迹检测肝组织中TGF-β1、Smad2蛋白的表达情况,并用RT-qPCR检测肝组织中TGF-β1 mRNA的表达情况。结果:与正常组对比,对照组肝脏组织可见肝纤维化改变,肝脏组织中的TGF-β1、Smad2表达水平上升;其余各治疗组肝脏组织肝纤维化改变较轻,高、低剂量治疗组肝脏组织病理改变明显,较扶正化瘀组及复方鳖甲组轻,且组织中TGF-β1、Smad2表达水平低于对照组、扶正化瘀组及复方鳖甲组。结论:逍遥散加味颗粒可以通过抑制TGF-β1/Smad2通路,改善大鼠肝纤维化病变及逆转肝纤维化。

逍遥散改善肠道内环境治疗抑郁症的研究进展

抑郁症是目前威胁人类身心健康的重要疾病之一。肠道内环境紊乱可导致抑郁症,而改善肠道内环境可显著缓解抑郁症状。逍遥散是祖国医学治疗抑郁症的千古名方,其可通过不同机制改善肠道内环境,且效果显著。逍遥散主治两胁作痛、头痛目眩等,也包括肝郁脾弱引起的神疲食少症状,因此抑郁症与消化系统也存在一定联系。未来,深入研究逍遥散通过改善肠道内环境治疗抑郁症的机制,可以为疾病的治疗提供新思路。

李霞博士运用和法治疗痞满经验撷菁

痞满是中医脾胃科常见疾病,多因脾胃功能失调所致。痞满所描述的是堵塞、不通、沉闷,按压时触感柔软而又没有产生疼痛感的一种状态,其临床主要表现为胃脘胀满不舒。西医消化不良、胃动力不足、胃肠道功能紊乱、慢性胃炎等问题与痞满类似。中医治疗痞满以调和脾胃为主。和法为中医经典《医学心悟》八法之一,经过历代医家的拓展,和法可理解为通过和解与调和的方法,用于由半表半里、寒热错杂、虚实夹杂等病机引起的疾病的治疗,旨在使人体内在的平衡得到恢复,激发人体自身的抗邪功能,从而达到阴阳平衡、虚实平衡、表里相和、疾病治愈的目的,临床运用十分广泛。山西省中医药大学博士李霞总结长期临床实践,运用和法治疗痞满收效甚佳。文章通过3则临床案例介绍李霞运用和法治疗痞满,以期为临床提供参考。

丁丽仙灵活运用“丹栀逍遥散”治疗慢性盆腔痛经验介绍

慢性盆腔痛是妇科临床常见病,其病因及发病机制涉及多个系统疾病。在妇科疾病中,本病属于盆腔炎性疾病后遗症的常见症状之一,其发病率逐渐上升,但相关研究发现有患者治疗效果未达到预期值,仍持续承受着病情折磨,久病产生一系列身心健康问题,如出现烦躁焦虑、悲伤欲哭等一系列症状,严重影响当代女性的家庭、生活、工作质量,成为一个全球探讨的社会公共健康热点话题。中医认为,本病据临床表现可归属于中医妇科的“妇人腹痛”“带下病”“癥瘕”等范畴。遵从中医治病原则,正确辨证论治,合理选方用药,充分发挥中医优势,可取得良效。丁丽仙教授出身于近300年历史的中医世家,为首批国家级名老中医、著名中医妇科专家丁启后教授学术继承人,黔贵丁氏妇科流派第十代传人,全国名中医,贵州省非遗《丁氏妇科中医诊疗法》代表性传承人,潜心专研丁氏妇科学术思想,她承上启下,继承先辈们的学术经验,融汇自己在中医妇科临床40余年实战经验,对慢性盆腔痛有独到见解,灵活运用“丹栀逍遥散”治疗本病,取得较好的临床疗效。文章对丁丽仙教授治疗因盆腔炎性疾病后遗症所致慢性盆腔痛的临床经验进行介绍并附医案两则。

逍遥散中药配方颗粒与传统中药饮片治疗肝郁脾虚型月经失调的疗效差异研究

目的:对比分析中药配方颗粒与传统中药饮片在逍遥散治疗肝郁脾虚型月经失调的疗效差异,为两者临床应用奠定基础。方法:采用随机对照研究方法,选择符合肝郁脾虚证的月经失调患者120例,其中,中药配方颗粒组与中药饮片组每组60例,1剂/d,早晚分2次服用,中药配方颗粒组采用逍遥散的中药配方颗粒剂型治疗,中药饮片组采用逍遥散的传统中药汤剂剂型治疗,疗程为3个月经周期,用药期间两组患者不接受其他治疗。比较两组患者治疗前后的月经周期、经期、经量状况的改善状况,并对两组患者治疗前后的中医症状积分进行评分量化比较,对比两组患者临床疗效。结果:经3个月经周期治疗后,中药配方颗粒组总有效率为75.00%,中药饮片组总有效率为71.67%,两组患者治疗有效率比较,差异无统计学意义(P>0.05),两组患者的治疗效果比较,差异无统计学意义(P>0.05)。中医症状积分方面,经治疗后两组患者中医症状均有不同程度改善。两组患者中医症状积分治疗前后组内自身比较,差异均有统计学意义(两组均为P<0.05)。而两组患者中医症状积分组间比较,治疗前差异无统计学意义(P>0.05);治疗后差异亦无统计学意义(P>0.05)。结论:中药配方颗粒与传统中药饮片在逍遥散治疗肝郁脾虚型月经失调临床总有效率基本一致,均能用于治疗肝郁脾虚型月经失调,且经治疗后,可显著改善患者的中医症状。

逍遥散和丹栀逍遥散抗焦虑作用的实验研究

【目的】探讨逍遥散、丹栀逍遥散的抗焦虑作用。【方法】Wistar大鼠随机分为5组:模型对照组、丹栀逍遥散高剂量组(剂量为14.4 g/kg)、丹栀逍遥散低剂量组(剂量为7.2 g/kg)、逍遥散高剂量组(剂量为21.06 g/kg)、逍遥散低剂量组(剂量为10.53 g/kg),采用群居接触模型及旷场实验模型观察逍遥散和丹栀逍遥散对模型大鼠的抗焦虑作用。模型组灌服生理盐水,其他组灌服相应剂量的药物,连续14 d后,由2名观察者观察大鼠在5 min内的活动情况并记录结果,取其平均值。【结果】丹栀逍遥散高、低剂量组均能增加群居接触时间,增加大鼠竖起或修饰次数,逍遥散低剂量组可增加大鼠竖起或修饰次数(P<0.05或P<0.01)。【结论】逍遥散和丹栀逍遥散均具有一定的抗焦虑作用,以丹栀逍遥散作用更佳。