Effect of sitagliptin combined with Yiqi yangyin huoxue decoction on clinical efficacy and hemorheology in early diabetic nephropathy

BACKGROUND Early diabetic nephropathy(DN)is a complication of diabetes mellitus.It mainly affects kidney microvessels and glomerular function,and its timely and effective treatment is critical for early DN.However,the effects of treatments comprising simple Western medicine are not optimal.With the promotion and implementation of integrated Chinese and western medicine treatments,remarkable results have been achieved for many diseases.To this end,we explored the clinical efficacy of integrated traditional Chinese and western medicines for the treatment of early DN.AIM To investigate the effect of sitagliptin tablets combined with Yiqi yangyin huoxue decoction on clinical efficacy and hemorheology in patients with early DN.METHODS Through a retrospective analysis,123 patients with early DN were admitted to the endocrinology clinic of the Changzhou NO.7 People’s Hospital from January 2021 to October 2022 and were selected as study subjects.After rigorous screening,100 patients with early DN were enrolled.The control group(CG,n=50)and the observation group(OG,n=50)were divided according to the treatment method.The CG were treated with sitagliptin,and the OG were treated with sitagliptin plus the Yiqi yangyin huoxue decoction.Both groups were treated for 3 mo.For both groups,the baseline data and clinical efficacy were compared,and changes in blood glucose levels,lipid levels,renal function,and hematological indicators before(T0)and after(T1)treatment were assessed.RESULTS The total effective rate for the OG was 94.00%and that of the CG was 80.00%(P<0.05).After treatment(T1),the levels of fasting blood glucose,2 h postprandial glucose,total cholesterol,triacylglycerol,and low-density lipoprotein cholesterol in OG patients were obviously lower than those in the CG(P<0.05),and cystatin C,homocysteine,urinary microalbumin,and blood creatinine values in OG patients were also obviously lower than those in the CG(P<0.05);erythrocyte deposition,plasma viscosity,whole blood high shear viscosity,and whole blood low shear viscosity were markedly lower in OG patients than in the CG(P<0.05).CONCLUSION Sitagliptin combined with Yiqi yangyin huoxue decoction has a remarkable effect when used to treat patients with early DN.Further,it is helpful in improving hemorheological indices and controlling disease progression.

Effects of Haobie Yangyin Ruanjian Decoction on hepatic fibrosis induced by carbon tetrachloride in rats

AIM:To explore the anti-fibrotic effect of Haobie Yangyin Ruanjian Decoction(HYRD)on CCl4-induced hepatic fibrosis in rats and its modulation on the transforming growth factor(TGF)β-Smad signaling pathway.METHODS:Fifty-six healthy Wistar rats were randomly divided into five groups:normal control group(n=6),CCl4-induced hepatic fibrosis group(n=14) and three treatment groups(the treated rats received HYRD via oral administration at daily dosages of 8.2,2.5 and 0.82 g/kg,respectively)of HYRD(n=12,respectively).Experimental hepatic fibrosis was induced by subcutaneous injection of carbon tetrachloride solution(CCl4 dissolved in peanut oil,4:6,V/V)with 0.5 mL/100 g body weight for the first time,and then 0.3 mL/100 g body weight twice a week for 8 wk.In the former 2 wk,rats were raised by feedstuffⅠ(80% corn meal,20%lard,0.5%cholesterol).After 2 wk,they were raised by feedstuffⅡ(corn meal and 0.5% cholesterol).Except for the control group,30%alcohol solution was given orally to each rat every other day from the beginning,1 mL for each rat.Liver function parameters and hepatic hydroxyproline content were detected by chromatometry.Serum levels of hyaluronic acid(HA),typeⅣcollagen(CIV),typeⅢprecollagen(PCⅢ)and laminin(LN)were assayed with radioimmunoassay.Deposition of collagen was observed with hematoxylin-eosin staining and collagen staining.Gene expression of TGFβ1 and Smad3 were detected with real-time reverse transcriptase-polymerase chain reaction and Western blotting,respectively.RESULTS:The serum levels of alanine transaminase and aspartate transaminase were increased in the model group compared with the control group(P<0.01),and they were decreased in the three treatment groups compared with the model group.The serum levels of total protein and albumin were decreased in the model group and increased in the three treatment groups.The hepatic hydroxyproline content and serum levels of PCⅢ,HA,LN and CIV were markedly increased in the model group compared with the control group,and decreased in the treatment groups.The gene expression of TGFβ1 and Smad3 was enhanced in the model group compared with the control group,and HYRD could down regulate their expression.CONCLUSION:HYRD can inhibit hepatic fibrosis induced by CCl4 in rats,which is probably associated with its down-regulation on fibrogenic signal transduction of TGFβ-Smad pathway.

Effects of Yangyin Jiedu Decoction on Acute Oral Mucositis Caused by Radiation

[Objectives] The aim was to observe the clinical effect of Yangyin Jiedu Decoction for acute oral mucositis caused by radiotherapy for nasopharyngeal carcinoma( NPC). [Methods]Total 64 patients with non-keratinizing squamous cell carcinoma of nasopharynx were divided evenly and randomly into two groups,treatment group and control group. In the treatment group,the patients began to take Yangyin Jiedu Decoction one week before radiotherapy; while in the control group,the patients were treated with mixed solution of dexamethasone,lidocaine,recombinant human granulocyte colony stimulating factor and vitamin B12. From the beginning to the end of radiotherapy,the curative effect in the two groups was observed and compared. In addition,the levels of serum CRP,TGF-β1 and IL-6 were measured to detect the inflammatory response. [Results] The incidence of acute oral mucositis in the treatment group was significantly lower than that in the control group( P <0. 05). The effective rate was 96. 88% in the treatment group and 67. 74% in the control group. The levels of serum CRP,TGF-β1 and IL-6 in the treatment group were also lower than those in the control group. [Conclusions]Yangyin Jiedu Decoction has a good effect on prevention and treatment of acute radioactive oral mucositis and it is worthy of clinical application.

Mechanism of Qingre Yangyin Chushi Pill in the treatment of gout based on NLRP3/GSDMD pyroptosis pathway

Background:The study was conducted with the interest of exploring the effects of Qingre Yangyin Chushi pill as anti-inflammatory agent in gout treatment based on the NLRP3/GSDMD coke death pathway.Methods:In this study,48 male SD rats were randomly divided into 6 groups,namely model group,blank control group(BC),Qingre Yangyin Chushi pill low-dose treatment group(MSD1),medium-dose treatment group(MSD2),high-dose treatment group(MSD3),and colchicine group(PC),with eight members in each group.The BC and model groups were administered with saline twice a day.The MSD1,MSD2,and MSD3 groups were administered with Qingre Yangyin Chushi pill at a dose of 1.8 g·kg^?1,3.6 g·kg^?1,and 7.2 g·kg^?1 twice a day.The colchicine group was administered with a colchicine suspension at a dose of 0.6×10^?3 g kg^?1 twice a day for 7 days.After gavage of animals in each group for 4 days,the rats'ankle joints were injected with sodium urate suspension×3 days to induce a gouty arthritis model.Then,serum and tissue samples were collected on the third and seventh day after gavage.The synovial tissue from the rat ankle joints was taken,and immunohistochemical technique was used to detect NOD-like receptor protein 3(NLRP3),inflammatory bodies,cysteine protease-1(Caspase-1),and Gasdermin-D protein(GSDMD)expression.Image-Pro Plus image analysis system was used to measure the average integrated absorbance and calculate IHS.Integral enzyme-linked immunosorbent assay was used to determine the interleukin 1β(IL-1β)and interleukin 18(IL-18)expression of tumor necrosis factor-α(TNF-α).Western blot was used to detect NLRP3,Caspase-1,GSDMD,and apoptosis-associated speck-like protein containing a CARD(ASC)expression levels.Results:After 48 hours of modeling,compared with the PC group,the arthritis indices of the MSD1,MSD2,and MSD3 groups were insignificant(P>0.05).The levels of IL-1β,IL-18,and TNF-αwere lower in the PC and MSD2 groups compared with the BC group.However,compared with the control group,MSD1,MSD2,and PC groups had lower levels of IL-1βand IL-18.Regarding TNF-αlevels(P<0.05);compared with the PC group,the levels of IL-1β,IL-18,and TNF-αin MSD2 decreased more significantly(P<0.05).The levels of NLRP3,Caspase-1,GSDMD,ASC,IHS score,and mRNA were lower in the PC and MSD2 groups(P<0.05)compared with the control group.The MSD1 and MSD2 groups had lower levels of NLRP3,Caspase-1,GSDMD,ASC protein levels,IHS points,and mRNA levels(P<0.05)compared with the PC group.Moreover,NLRP3,Caspase-1,GSDMD,ASC protein levels,IHS points,and mRNA levels were more reduced in the MSD2 group(P<0.05).Conclusion:Qingre Yangyin Chushi pill can inhibit the activation of the NLPR3 inflammatory complex,reduce the production of GSDMD protein,regulate the occurrence of pyroptosis,reduce the expression of inflammatory factors,and thus reduce arthritis.All these processes are achieved through the NLRP3/GSDMD pathway.

Clinical efficacy of angina pectoris after pci in patients with coronary heart disease complicated with type 2 diabetes by Yiqi Yangyin and Huatan Tongluo recipe

Objective:To evaluate the clinical efficacy of Yiqi Yangyin and Huatan Tongluo Recipe in improving the symptoms of angina pectoris and cardiac function in patients with coronary heart disease complicated with type 2 diabetes after PCI.Methods Sixty-two patients with coronary heart disease complicated with type 2 diabetes after PCI were randomly divided into treatment group and control group,with 31 patients in each group.Both groups were treated with western medicine.The treatment group added Yiqi Yangyin and Huayu Tongluo Recipe granules.The changes of metabolic equivalent(METs),angina symptoms,TCM symptoms,BNP,hypersensitive C-reactive protein(hs-CRP),Interleukin-6(IL-6),Tumor necrosis factor-(TNF-α)and left ventricular ejection fraction(LVEF)were analyzed after 1 course of treatment and Corrected TIMI Frame Count(CTFC)after six month.Results The improvement of METS and LVEF in the treatment group was better than that in the control group(P<0.05);the improvement of BNP,hs-CRP,IL-6,TNF-αand CTFC in the treatment group was better than that in the control group;the curative effect of angina pectoris in the treatment group was better than that in the control group;the effective rate of TCM syndrome improvement in the treatment group was better than that in the control group.Conclusion Yiqi Yangyin and Huatan Tongluo Recipe can effectively alleviate angina pectoris symptoms in patients with coronary heart disease complicated with type 2 diabetes after PCI,suggesting cardiac function,inhibiting inflammatory response,and improving microcirculation disturbance.

Clinical Observation on Xiehuo Yangyin Powder (泻火养阴散) in Treating 30 Initial Stage of Toxic and Diffuse Goiter Patients

Objective: To observe the therapeutic effect of Xiehuo Yangyin powder (XHYY) in treating the initial stage of toxic and diffuse goiter (Graves disease). Methods: Sixty patients were randomly divided into two groups, the treated group (n = 30) was treated with XHYY and methimazole, while the control group (n = 30) was treated with methimazole alone. The TCM syndrome score and

Yiqi Yangyin and Huatan Quyu granule can improve skeletal muscle energy metabolism in a type 2 diabetic rat model by promoting the AMPK/SIRT/PGC-1α signalling pathway

Objective:To investigate how Yiqi Yangyin and Huatan Quyu granule (YYHO) improves skeletal muscle insulin resistance in a type 2 diabetic rat model and to discover whether the molecular mechanism is related to the promotion of the AMPK/SIRT/PGC-1α signalling pathway.Methods:Rats were randomly divided into 4 groups:the normal group,the model group,the YYHQ granule group,and the pioglitazone group.The type 2 diabetic rat model was established by feeding a high-fat diet for 5 weeks along with a single intraperitoneal injection of 30 mg/kg streptozotocin (STZ).After modelling successfully,the appropriate drug was intragastrically administered to diabetic rats for 2 weeks,once per day.The YYHQ granule group was given a dose of 4.8 g/kg body weight per day,the pioglitazone group was given a dose of 1.35 mg/kg body weight per day.The doses for both groups were equivalent to the clinical equivalent dose based on a previous study.Other groups were gavaged with the same amount of saline water.Body weight,food intake,water intake,urine volume and grip strength were recorded weekly.The fasting blood glucose(FBG) was determined weekly using blood glucose test strips.The related glucose and lipid metabolism indexes,e.g.,fasting insulin (Fins),glycated haemoglobin (GHb),HOMA-IR,ISI,triglycerides (TG),total cholesterol (TC),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C) and free fatty acid (FFA),were determined using biochemical method.The mRNA expression levels of adenosine monophosphate-activated protein kinase (AMPK),peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PGC-1α),carnitine palmitoyl transterase-1 (CPT-1),Sirtuin 1 (SIRT1),and Sirtuin 3 (SIRT3) were assessed using quantitative real-time PCR (qRT-PCR).The protein expression levels of creatine kinase (CK),Ca2+ ATPase,α-Actin,AMPK,PGC-1α and CPT-1 were determined using enzyme-linked immunosorbent assay method (ELISA).Results:Body weight decreased significantly (P <.01),food intake,water intake and urine volume increased significantly (P <.01),and grip strength decreased significantly (P <.01) in the model group compared with the normal group.The levels of FBG,Fins,GHb and HOMA-IR increased significantly (P <.01),and the ISI decreased significantly (P <.01) in the model group.The levels of TG,TC,LDL-C and FFA increased significantly (P <.05 or P <.01),and the level of HDL-C decreased significantly (P <.05) in the model group.These changes were reversed after treatment with YYHQ granule or pioglitazone.Compared with the model group,the YYHQ granule and pioglitazone groups significantly improve body weight,water intake and urine volume (P <.05 or P <.01),however,both treatments had no significant effect on food intake (P >.05).The levels of FBG,Fins,GHb,HOMA-IR and ISI were improved significantly (P <.01) and the levels of TG,TC and LDL-C were improved significantly (P <.05 or P <.01),however,both treatments had no significant effect on the levels of HDL-C and FFA (P >.05).Further results indicated that YYHQ granule significantly decreased the mRNA expression of AMPK,PGC-1α,CPT-1,SIRT1 and SIRT3 in skeletal muscle (P <.01) and the pioglitazone group showed similar effects;moreover,the protein expression levels of CK,Ca2+ATPase,α-Actin,AMPK,PGC-1α and CPT-1 in skeletal muscle significantly decreased (P <.01),however,pioglitazone had no significant effect on CK and α-Actin (P >.05).Conclusion:The possible molecular mechanism of YYHQ granule improving skeletal muscle insulin resistance in a type 2 diabetic rat model may be related to the stimulation of energy metabolism in skeletal muscle via the AMPK/SIRT/PGC-1α signalling pathway.

Clinical Observation on the Efficacy Enhancing and Toxicity Attenuating Effect of Nuzhen Yangyin Granule to the Anti-Parkinsonism Therapy Mainly with Medopa

Objective: To observe and assess the efficacy enhancing and toxicity attenuating effect of Nuzhen Yangyin Granule (NYG) to the anti-parkinsonism (paralysis agitans) therapy with medopa and ar-tane. Methods: Adopting the randomized double-blinded method, the effect of adding NYG to 30 patients with Parkinsonism in the treated group,

Clinical Evaluation of Yangyin Qingre Shengji Decoction(养阴清热生肌汤)in Preventing and Treating Acute Radiation Esophagitis

Objective:To explore the prevention and treatment effect of Yangyin Qingre Shengji Decoction(养阴清热生肌汤)on acute radiation esophagitis.Methods:From May 2020 to February 2021,60 patients with malignant tumor who underwent radiotherapy were selected as the research objects.They were divided into two groups by odd and even number drawing,30 cases in the control group and 30 cases in the observation group.The control group took mixed solution orally,while the observation group took Yangyin Qingre Shengji Decoction.The clinical effects,occurrence time,duration,grading of acute radiation esophagitis and TCM syndrome scores of dry mouth and constipation were compared between the two groups.Results:The effective rate of the observation group was significantly higher than that of the control group(P<0.05);Compared with the control group,the time of acute radiation esophagitis was prolonged and the duration of symptoms was shortened in the observation group(P<0.05);The incidence of above gradeⅡin the observation group was significantly lower than that in the control group,and the incidence of below gradeⅠwas significantly higher than that in the control group(P<0.05);There was no significant difference in the scores of dry mouth and constipation between the two groups before treatment(P>0.05),the scores of the two groups were decreased after treatment,and the observation group was lower than the control group(P<0.05).Conclusion:Yangyin Qingre Shengji Decoction(养阴清热生肌汤)has a positive effect on prevention and treatment of acute radiation esophagitis in patients with malignant tumor undergoing radiotherapy,which can be popularized.

Effects of yiqi yangyin huoxue therapy on IgA nephropathy: a systematic review and meta-analysis of randomized controlled trials

评估益气养阴活血法治疗IgA肾病的疗效和安全性。方法:2018年2月检索关于益气养阴活血法治疗IgA肾病的数据库文献。以益气养阴活血法单独或联合西药作为实验干预,以西药作为对照的随机对照试验。Cochrane协作工具用于评估偏倚风险,以评估方法学质量。应用RevMan5.3软件对纳入的试验数据进行分析。结果:共纳入21项研究,涉及1473例患者。Meta分析结果显示,单用益气养阴活血法或益气养阴活血法联合西药较单独西药治疗蛋白尿[MD=-0.41,95%CI(-0.53,-0.29),P<0.00001]及尿红细胞[MD=-7.46,95%CI(-9.28,-5.64),P<0.00001]疗效更加显著,临床总有效率也有所提高[OR=2.78,95%CI(2.14,3.61),P<0.00001]。其中一些试验没有报告不良反应。结论:目前研究表明益气养阴活血法能降低蛋白尿和尿红细胞,提高总有效率。由于一些实验的质量和出版偏倚很差,需要更多的循证医学研究来明确益气养阴活血法在治疗IgA肾病中的作用。

益气养阴通络汤联合贝那普利治疗糖尿病肾病疗效及对血清TGF-β1、VEGF指标影响

目的探讨益气养阴通络汤联合贝那普利治疗糖尿病肾病(diabetic nephropathy,DN)的疗效及对转化生长因子-β_(1)(transforming growth factor-β_(1),TGF-β_(1)),血管内皮生长因子(vascular endothelial growth factor,VEGF)影响。方法选取2019年10月—2021年10月医院收治的DN病人94例,随机分为对照组(n=48)和观察组(n=46)。入院后两组病人均实施生活方式相关的指导,包括体质量控制、运动、戒烟酒等,给予脂质的代谢紊乱相关纠正、血糖控制、血压等基础的治疗,对照组实施盐酸贝那普利片的口服治疗,观察组则在此基础上实施益气养阴通络汤治疗,两组持续治疗4周。对比两组临床疗效、尿微量白蛋白(microalbumin,mALB)、尿白蛋白肌酐比(urine albumin creatine ratio,UACR)、β_(2)微球蛋白(β_(2)-microglobulin,β_(2)-MG)水平、中医证候评分、血清同型半胱氨酸(homocysteine,Hcy)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(Interleukin-6,IL-6)、血清TGF-β_(1)和VEGF及空腹血糖(fasting plasma glucose/fasting blood glucose,FPG)、餐后2 h血糖(2 hour postprandial blood glucose,2 h PG)和糖化血红蛋白(glyeosylated hemoglobin,HbAlc)指标变化。结果治疗前两组mALB、UACR、β_(2)-MG指标间无统计学意义(P>0.05);治疗后两组mALB、UACR、β_(2)-MG指标较治疗前显著降低(P<0.05);并且观察组降低较明显(P<0.05);观察组治疗总有效率较对照组明显较高(P<0.05);治疗后两组主症评分、次症评分和中医证候总评分明显降低(P<0.05);且观察组降低较明显(P<0.05);治疗后两组血清Hcy、TNF-α、IL-6指标明显降低(P<0.05);且观察组降低较明显(P<0.05);治疗后两组血清TGF-β_(1)和VEGF指标较治疗前明显降低(P<0.05);且观察组降低较明显(P<0.05);治疗后两组FPG、2 h PG和HbAlc指标较治疗前明显降低(P<0.05);且观察组降低较明显(P<0.05)。结论采用益气养阴通络汤联合贝那普利治疗DN具有较好的临床疗效,可降低血清TGF-β_(1),VEGF指标,降低蛋白尿水平。

益气养阴活血利水法联合康柏西普治疗糖尿病性黄斑水肿的临床研究

目的评估益气养阴活血利水法联合康柏西普治疗糖尿病性黄斑水肿(DME)的安全性和有效性,为中西医结合治疗DME提供更多的临床手段和思路。方法选取2019年6月至2022年6月在萍乡市人民医院眼科住院的70例DME患者作为研究对象,每治疗周期中行单眼药物注射,均为单眼入组。随访脱失6例,共64例患者计入统计。按入院先后分为治疗组(29例)与对照组(35例),治疗组采用玻璃体腔注射康柏西普1次联合口服益气养阴活血利水中药组方3个月;对照组采用单纯玻璃体腔注射康柏西普1次。比较两组治疗前及治疗后1、3、6个月的最佳矫正视力(BCVA)、中心视网膜厚度(CRT)、中医证候评分、需要重复眼内药物注射次数的差异。结果两组患者治疗前后的BCVA、CRT及中医证候评分的时点比较,差异有统计学意义(P<0.05),两组患者治疗前后的BCVA、CRT及中医证候评分的组间、交互作用比较,差异无统计学意义(P>0.05),治疗组治疗后1、3个月以及对照组治疗后1个月的BCVA、CRT及中医证候评分均高于治疗前,差异有统计学意义(P<0.05)。对照组治疗后3个月及两组治疗后6个月的BCVA、CRT及中医证候评分治疗前后比较,差异无统计学意义(P>0.05)。治疗后3月检查CRT较治疗后1个月反弹,其中治疗组有5例需要再次注射康柏西普,少于对照组的15例(χ^(2)=4.844,P=0.033),差异有统计学意义;两组治疗后的BCVA、CRT及中医证候评分与治疗前的平均变化比较,治疗组BCVA、CRT及中医证候评分的改善始终优于对照组。此外,治疗期间两组均没有发生重大的安全问题。结论益气养阴活血利水中药组方联合康柏西普治疗DME,有助于提高BCVA,延缓黄斑水肿复发,疗效优于单独康柏西普治疗。

养阴宁神方对去势小鼠海马神经元突触的可塑性调节

目的观察养阴宁神方对雌性小鼠去势后认知功能的影响。方法将60只C57BL/6J雌性小鼠随机分为假手术组,模型组,雌激素组,低、中、高剂量组,每组10只。假手术组仅切开皮肤和腹膜,不摘除小鼠的卵巢;其余各组均进行双侧卵巢切除术。假手术组、模型组均给予等容量的生理盐水(0.1 mL/10 g),雌激素[雌二醇(estradiol,E2),0.09 mg/kg]组及低剂量组(9.459 g/kg)、中剂量组(18.459 g/kg)、高剂量组(36.99 g/kg)灌胃药液,均灌胃3周。记录小鼠术后伤口愈合时间,去势前、去势1周、去势4周进行水迷宫潜伏实验和穿梭实验测试小鼠的学习记忆功能。采用ELISA法测定血清E2含量;HE染色观察小鼠海马神经元的形态;尼氏染色观察海马神经尼氏染色阳性细胞的数量;共聚焦显微镜下观察小鼠海马神经元细胞超微结构情况。结果与假手术组相比,模型组伤口愈合时间延长(P<0.05);与模型组、雌激素组及低、高剂量组比较,中剂量组伤口愈合时间缩短(P<0.05)。去势1周,与假手术组比较,模型组、雌激素组及低、中、高剂量组逃避潜伏期延长、穿梭次数减少(P<0.05)。去势4周,与假手术组比较,模型组逃避潜伏期延长、穿梭次数减少(P<0.05);与模型组相比,雌激素组及低、中、高剂量组逃避潜伏期缩短、穿梭次数增加(P<0.05)。去势4周,与假手术组比较,模型组E2浓度明显降低(P<0.01);与模型组比较,雌激素组及低、中、高剂量组E2浓度明显增高(P<0.01)。尼氏染色显示,与假手术组比较,模型组尼氏阳性细胞数减少(P<0.01);与模型组比较,雌激素组及低、中、高剂量组尼氏阳性细胞数增加(P<0.01)。HE染色显示,假手术组,雌激素组,低、中、高剂量组锥体神经元增多,且突起明显;模型组锥体神经元较少、颗粒细胞较多。共聚焦显微镜下见,假手术组,雌激素组,低、中、高剂量组海马神经元囊泡和突触粗面内质网结构增多;模型组海马神经元囊泡和突触减少。结论养阴宁神方可能通过提高血浆E2水平、改善海马神经元突触形态和功能可塑性、增加去势小鼠的认知功能,从而发挥脑保护作用。

基于单细胞测序数据分析养阴活胃合剂下调AQP3对MC细胞表型的影响及机制

目的 观察养阴活胃合剂对MC细胞(MNNG诱导人胃黏膜上皮细胞GES-1恶性转化)增殖、迁移、侵袭及凋亡的影响,探讨其下调AQP3抑制IL-10/JAK1/STAT3信号通路激活进而阻断或逆转慢性萎缩性胃炎(CAG)病变的作用机制。方法 选取GEO数据库中的CAG单细胞转录组测序数据,绘制数据的表达矩阵。采用R语言的Seurat 4.3.0包进行处理后分群绘制UMAP可视化图谱。将MC细胞分为养阴活胃合剂组(YYHWM组)、AQP3低表达慢病毒转染组(AQP3低表达组)、养阴活胃合剂+AQP3高表达慢病毒转染组(YYHWM+AQP3高表达组)并以MC细胞和正常人胃黏膜上皮细胞GES-1分别作为模型组(MC组)和空白对照组(Control组)。采用平板克隆、划痕实验、Transwell及流式细胞术检测细胞表型变化情况,采用ELISA检测细胞培养上清IL-10表达水平,Western blot检测酪氨酸激酶1(JAK1)、信号转导和转录激活因子3(STAT3)蛋白表达水平。结果 单细胞测序数据集分析显示AQP3在CAG样本及上皮细胞群中表达升高,AQP3可能通过IL-10抗炎性信号通路影响胃癌前病变病理进程。与MC组相比,AQP3低表达组和YYHWM组细胞侵袭、迁移、增殖能力减弱,凋亡率增加,细胞培养上清中的IL-10水平降低,细胞中JAK1、STAT3蛋白表达下调(P<0.05或P<0.01),YYHWM+AQP3高表达组差异均不显著(P>0.05)。结论 养阴活胃合剂可通过下调AQP3表达抑制IL-10/JAK1/STAT3信号通路激活进而减弱MC细胞侵袭、迁移及增殖能力,促进细胞凋亡进而阻断或逆转CAG病理进程。

清热养阴柔肝汤联合脑电生物反馈加感统训练对注意缺陷多动障碍儿童核心症状和执行功能的影响

目的探讨清热养阴柔肝汤联合脑电生物反馈加感统训练对注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)儿童核心症状和执行功能的影响。方法选择该院2017年3月—2022年3月收治的注意缺陷多动障碍患儿96例,按照随机数字表法分为对照组和观察组,对照组48例,观察组48例。对照组患者选用脑电生物反馈加感统训练,观察组患者在对照组的基础上加用清热养阴柔肝汤,比较两组患者治疗前后的临床疗效、症状改善程度、执行功能、脑电波频率。结果对照组治疗总有效率79.17%(35/48),观察组治疗总有效率91.67%(44/48),与对照组ADHD患儿相比,观察组ADHD患儿的治疗总有效率更高,差异有统计学意义(P<0.05);治疗后两组的多动指数、冲动问题、学习问题、品行问题、身心问题、焦虑等指标评分均下降,且观察组各指标评分更低(P<0.05);治疗前两组患者的BRIEF行为管理指数、BRIEF元认知功能指数比较,差异无统计学意义(P>0.05),治疗后两组的BRIEF行为管理指数、BRIEF元认知功能指数评分均下降,且观察组的评分低于对照组(P<0.05)。结论清热养阴柔肝汤联合脑电生物反馈加感统训练治疗儿童ADHD效果明显,对儿童的临床核心症状和执行功能有很好的改善作用,该方法具有较好的安全性和有效性,有一定的临床应用价值。

养阴清肺汤联合中药熏蒸治疗干眼症临床观察

目的 探讨养阴清肺汤联合中药熏蒸治疗干眼症的临床效果。方法 选取中国医科大学附属盛京医院122例干眼症患者随机分为对照组和试验组,各61例。对照组予以玻璃酸钠滴眼液治疗,试验组在对照组基础上予以养阴清肺汤联合中药熏蒸治疗,均连续治疗4周。比较2组临床疗效、泪膜破裂时间(BUT)和泪液分泌量、中医症状积分及视觉相关生命质量。结果 治疗后,试验组总有效率为90.16%(55/61),高于对照组的72.13%(44/61)(P<0.05);试验组泪液分泌量、BUT高于对照组(P<0.05);试验组眼疲劳感、干涩感、异物感及烧灼感等中医症状积分低于对照组(P<0.05);试验组一般健康状况、活动障碍及视力障碍评分高于对照组(P<0.05);2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 养阴清肺汤联合中药熏蒸治疗干眼症的临床效果显著,能明显促进泪液分泌,提高泪膜稳定性。

HPLC指纹图谱结合多指标含量测定的养阴生肌肠溶胶囊质量评价研究

目的建立养阴生肌肠溶胶囊HPLC指纹图谱,测定龙胆苦苷、芍药内酯苷、芍药苷、甘草苷、盐酸小檗碱、吴茱萸碱和吴茱萸次碱的含量,为其质量控制提供参考。方法按照制备工艺对组方药物进行水解和醇沉,将样品内容物溶于70%甲醇进行供试品溶液制备,采用Agilent5HC-C18(2)色谱柱(250mm×4.6mm,5μm)进行分析,流动相为乙腈-0.1%磷酸水溶液,梯度洗脱,流速1.0 mL/min,柱温30℃,检测波长230 nm。采用OriginPro2021、《中药色谱指纹图谱相似度评价系统》(2012版)、SIMCA14.1软件及SPSS25.0统计软件对结果进行聚类分析、相似度评价及主成分分析。结果建立了养阴生肌肠溶胶囊HPLC指纹图谱及同时测定7个成分的方法,13批样品指纹图谱共标定25个共有峰,相似度良好(r≥0.994),聚类分析、主成分分析均将13批样品分为2类;7个成分在各自范围内线性关系良好(r≥0.9991),加样回收率为95.77%~103.80%,RSD为1.0%~2.5%。结论本研究建立的HPLC指纹图谱和含量测定方法简便可靠、重复性好,可为全面、有效地控制养阴生肌肠溶胶囊的质量提供依据。

益气养阴活血方调控Nrf2/NLRP3信号通路对糖尿病肾病大鼠的肾脏保护作用研究

目的探讨益气养阴活血方通过调控核因子E2相关因子2(Nrf2)/NOD样受体蛋白3(NLRP3)信号通路对糖尿病肾病(DN)大鼠的肾脏保护作用机制。方法清洁级雄性SD大鼠40只,适应性喂养1周后,随机分为:空白组、模型组、缬沙坦组、益气养阴活血方等剂量(等剂量)组及高剂量(高剂量)组。除空白组外各组均应用高脂高糖喂养,联合单次注射链脲佐菌素(STZ)建立DN大鼠模型。造模成功后中药两组均灌服益气养阴活血方颗粒剂,缬沙坦组灌服缬沙坦,空白组和模型组灌服生理盐水,6周后留取大鼠24 h尿液、血液和肾脏组织。生化检测各组大鼠24 h尿总蛋白定量(24 h-UTP)、血肌酐(SCr)、血尿素氮(BUN)、葡萄糖(GLU)、总胆固醇(CHO)、甘油三酯(TG);酶联免疫吸附测定法(ELISA)检测血清白介素1β(IL-1β)、白介素18(IL-18)水平;HE染色光镜观察肾组织病理改变;蛋白免疫印迹(Western Blot)检测肾组织中Nrf2、血红素加氧酶-1(HO-1)、NLRP3蛋白水平;实时荧光定量聚合酶链式反应(PCR)检测大鼠肾脏Nrf2、HO-1、NLRP3mRNA表达水平。结果生化:与空白组相比,模型组24 hUTP、Scr、BUN、GLU、CHO、TG均显著升高(P<0.01);与模型组对比,各干预组24 h-UTP、Scr、BUN、GLU、CHO、TG均显著降低(P<0.05或P<0.01)。ELISA:与空白组相比,模型组血清IL-1β、IL-18水平显著升高(P<0.01);与模型组比较,各干预组血清IL-1β、IL-18水平明显降低(P<0.05或P<0.01)。肾脏病理:与空白组对比,模型组大鼠肾脏组织病变严重;与模型组对比,各干预组肾脏病理均有改善。WB及PCR:与空白组对比,模型组肾脏Nrf2 mRNA、HO-1 mRNA及Nrf2、HO-1蛋白表达降低(P<0.05或P<0.01),NLRP3mRNA、NLRP3蛋白表达升高(P<0.05或P<0.01);与模型组对比,各干预组Nrf2 mRNA、HO-1 mRNA及Nrf2、HO-1蛋白表达升高(P<0.05或P<0.01),NLRP3mRNA、NLRP3蛋白表达降低(P<0.05或P<0.01)。结论益气养阴活血方可能通过调控Nrf2/NLRP3信号通路,减轻氧化应激,抑制DN大鼠炎症反应,从而改善上述生化指标,减轻肾脏病理损害。

清热养阴法阻断社区获得性肺炎转化重症的回顾性分析

目的总结非重症社区获得性肺炎(CAP)院内发生重症肺炎(SP)的相关因素,同时探究早期运用清热养阴方对减少SP发生及相关预后的影响。方法采取回顾性研究的方法,收集符合标准的2018年6月至2023年3月间江苏省中医院急诊科病房收治的CAP病例资料,分析院内SP的发生情况,以及影响SP发生的因素,并根据住院前5 d完整运用清热养阴方中药参与治疗,定义为中药组,其余为对照组,分析中药治疗对减少SP发生与临床疗效的影响。结果共纳入研究病例1235例,其中院内14 d内发生SP 79例,其中,年龄≥65(OR=3.673)、中药治疗(OR=2.683)、低氧血症(OR=5.788)、白细胞(OR=1.592)、降钙素原(OR=0.491)、胆碱酯酶(OR=0.998)为影响中低危CAP院内发生SP的因素;中药组680例,对照组555例,在倾向性匹配后,各497例纳入分析,中药组院内SP发生率低于对照组(P=0.041),临床有效率优于对照组(P=0.025)。结论中低危CAP病患中,年龄≥65岁,PSI评分、白细胞计数、降钙素原高,胆碱酯酶低,合并低氧血症可增加院内发生SP的风险,同时清热养阴方早期运用可减少重症的发生,并对预后有积极意义。

Changes of Intestinal Microecology in Patients with Primary Sjogren’s Syndrome after Therapy of Yangyin Yiqi Huoxue Recipe(养阴益气活血方)

Objective: To explore the change of intestinal microecology in patients with primary Sjogren’s syndrome(p SS) and correlation with disease activity, and also discuss the therapy effect of Yangyin Yiqi Huoxue Recipe(养阴益气活血方, YYHD). Methods: Sixteen p SS patients were enrolled in the present study, who received 3-month treatment of YYHR, 200 mL orally twice daily. Their pre-and post-test ESSDAI scores, erythrocyte sedimentation rate(ESR) and serum immunoglobulin G(IgG) levels were measured respectively. The 16 Sr DNA metagenomic sequencing was used to detect and analyze the abundance and diversity of intestinal bacteria flora and the proportion of bacteria at the levels of phylum, family, and genus, in comparision with those of 6 healthy subjects in the control group. Results: The abundance and diversity of intestinal bacteria flora in pSS patients were lower than those of healthy subjects(P<0.05). After the treatment with YYHD, patients’ ESSDAI score and levels of IgG and ESR have decreased significantly(P<0.05). At the phylum level, the proportions of Actinobacteria, Firmicutes, Fusobacteria and Proteobacteria have reduced sharply, while the proportions of Bacteroidetes, Teneriquetes and Candidate-division-TM7 have increased significantly by treatment(all P<0.05). At the classification level, such treatment has caused a significant decrease in the proportions of Bacteroidaceae, Ruminococcaceae, Veillonellaceae, and Enterobacteriacea(all P<0.05), but a significant increase in the proportion of Lachnospiraceae(P<0.05). At the genus level, the treatment has significantly decreased the proportions of Bifidobacterium, Bacteroides, Escherichia-Shigella, Faecalibacterium and Prevotella(all P<0.05), but significantly increased the proportion of Clostridia(P<0.05), close to the levels of healthy subjects(P>0.05). Conclusions: There exists an imbalance of intestinal microecology in p SS patients, which can be improved through the treatment with YYHD. Besides, such treatment can also improve the disease activity and adjust the diversity of intestinal bacteria flora, the composition and the abundance of intestinal flora.