Systematic review and meta-analysis of additional Yupingfeng powder combined with western medicine treatment at stable period of chronic obstructive pulmonary disease

Objective:To systematically evaluate the effect and safety of additional Yupingfeng powder combined with western medicine for the stable period of chronic obstructive pulmonary disease(COPD).Method:Databases including Pubmed、Web of Science、Cochrane Library、CNKI、VIP、CBM and Wanfang Data base,were searched for relevant randomized controlled trials.for Chinese and English literature about randomized controlled trials of additional Yupingfeng in the treatment of COPD on stable stage which were published from the establishment of the database to December 2019.Two researchers independently screened for,selected studies according to the inclusion and exclusion criteria and extracted data.Methodological quality was evaluated using the Cochrane Risk of Bias tool.Meta-analysis was performed using Revman 5.3 software.Results:Ninetine randomized controlled trials including 1511 patients with COPD were meta-analyzed.The total sample size was 1511.The results showed that the treatment grop with additional Yupingfeng powder could improve the clinical efficacy[OR=0.26,95%CI(0.18,0.37)],FEV1 percentage of the estimated value[MD=4.61,95%CI(2.43,6.79)],6MWD[MD=43.90,95%CI(29.48,58.32)]and patient's immunity IgA[MD=0.25,95%CI(0.17,0.34)]and can mitigate cough effectively[MD=-0.34,95%CI(-0.46,-0.23)].Conclusion:Additional Yupingfeng powder combined with routine treatment for COPD has more advantages than conventional treatment alone in improving the clinical efficacy,lung function,immune function and have less adverse events.As most of the included studies in this systematic evaluation had poor quality,the evidence to support conclusion was weak,so it was necessary to conduct more multi-center clinical trials with high quality methods and rigorous design.

Study on the mechanism of Yupingfeng Powder in the treatment of non-small cell lung cancer based on network pharmacology and molecular docking method

Objective:The mechanism of Yupingfeng Powder in the treatment of non-small cell lung cancer was analyzed by network pharmacology and molecular docking method.Methods:Search the related literature and TCMSP database,query the chemical composition and action target of Yupingfeng powder,query the disease database of Genecards,OMIM,DisGeNET,Drugbank,etc.,use"non-small cell lung cancer"as the keyword to search the disease-related target,select the intersection target with Yupingfeng powder as the research target,and use Cytoscape 3.7.2 software to construct the active component-target network map.The protein-protein interaction network map was constructed by using STRING database,and the treatment core targets were further screened by topological parameters,and GO analysis and KEGG signal pathway enrichment analysis were carried out.Finally,molecular docking was verified.Results:37 active components of Yupingfeng Powder were screened,including 146 common targets and 44 core targets.GO analysis and KEGG analysis show that the core target participates in many biological processes such as angiogenesis and cell proliferation,and acts on a variety of signal pathways such as AGE-RAGE,IL-17,TNF,MAPK and so on.Molecular docking shows that the core compound has good docking activity with the target.Conclusion:Network pharmacological analysis shows that Yupingfeng powder in the treatment of non-small cell lung cancer involves multi-target and multi-pathway mechanism,and the drug and target have good docking activity,which can provide theoretical basis for follow-up experimental research.

Research Progress of Yupingfeng Powder in Clinical Application

Yupingfeng Powder is widely used in the treatment of respiratory,digestive,urinary,dermatological and ENT diseases.The author reviewed the animal pharmacology experiments and clinical cases in recent years,and summarized and analyzed the diseases he treated,providing ideas and methods for clinical users.

Yupingfeng Powder regulates immunity in patients with stable chronic obstructive pulmonary disease: a meta-analysis

Objective:To use Meta-analysis to evaluate the effectiveness and safety of Yupingfeng Powder(YPFP)in regulating the immune function of patients with chronic obstructive pulmonary disease.Methods:Computers were used to search databases such as China National Knowledge Infrastructure(CNKI),VIP Database,China Biology Medicine disc(CBMdisc),Wanfang Database,PubMed,Cochrane Library,etc.Search all randomized controlled trials(RCTs)of YPFP in the treatment of stable chronic obstructive pulmonary disease,with CD4,CD8,CD4/CD8,IgE,IgA,IgM,and IgG as the outcome indicators.Two reviewers independently conducted literature search,conducted literature quality evaluation with the risk bias assessment tool recommended by Cochrane Handbook,and conducted data extraction,discussed and resolved disputes,and used RevMan 5.3 software for Meta-analysis.Results:A total of 11 randomized controlled trials with 1,058 patients were included.According to the Meta-analysis,the results of the effectiveness analysis showed that after oral administration of YPFP in the stable phase of chronic obstructive pulmonary disease,the test group CD3,CD4,CD8,CD4/CD8,IgA,IgE,IgM,IgG8 were better than the control group(P<0.05).Conclusion:Oral administration of YPFP in the stable period of chronic obstructive pulmonary disease can effectively regulate the immunity.However,the number of studies included in this study is small and the heterogeneity is large,and it is still necessary to design high-quality clinical trials for in-depth research.

Effects of Sijunzi decoction and Yupingfeng powder on expression of janus kinase-signal transducer and activator of transcription signal pathway in the brain of spleen-deficiency model rats

OBJECTIVE： To observe the influence of Sijunzi decoction and Yupingfeng powder on the expression of the relevant DNAs of janus kinase （JAK）-signal transducer and activator of transcription （STAT） sig- nal pathway of the brain in spleen-deficiency mod- el rats. METHODS： Eighty male Wistar rats of sanitary degree were divided randomly into four groups： nor- mal group, model group, treatment group 1, treatment group 2. Besides the rats in the normal group, all the rats in other 3 groups were prepared as spleen deficiency model. The treatment group 1 were treated with Sijunzi decoction and the treat- ment group 2 were treated with Yupingfeng powder. After treatment for 6 weeks, perfusion was given and the brain was taken for detection of the ex- pression of the relevant DNAs of JAK-STAT signal pathwayofthe brain in SD rats bygene chip method. RESULTS： Spleen deficiency could lead to increase expression of JAKI, STATI and Interleukin 4 （IL-4） in the brain, but the decrease expression of Suppres- sor of cytokine signaling I （SOCSI）, prolactin recep- tor （PRLR） and binding protein 3 （GATA 3）. Sijunzi decoction could increase expression of STAT3, Pro- lactin （PRL） and GATA3, but decrease expression of JAKI, STAT, STAT4, Interleukin 10 receptor, alpha （ILIORA）, Coagulation factor II （F2）, PRLR, MAD homolog 3 （SMAD3） and IL-4. Yupingfeng powder could decrease expression of JAKI, STATI, STAT4, SOCS4_ predicted, Epidermal growth factor receptor （EGFR）, PRLR, High mobility group AT-hook I （HMGAI 0）, IL-4. CONCLUSION： Sijunzi decoction and Yupingfeng powder can improve immune function of the rat through influencing the genetic expression of JAK-STAT signal pathway.

Identifying absorbable bioactive constituents of Yupingfeng Powder acting on COVID-19 through integration of UPLC-Q/TOF-MS and network pharmacology analysis

Objective:Yupingfeng Powder(YPF),a kind of preventative patent medicine,is chosen for treatment of coronavirus disease 2019(COVID-19)due to its high frequency application in respiratory tract diseases,such as chronic obstructive pulmonary disease,asthma,respiratory tract infections,and pneumonia,with the advantage of reducing the relapse rate and the severity.However,the active components of YPF and the mechanisms of components affecting COVID-19 are unclear.This study aimed to determine active constituents and elucidate its potential mechanisms.Methods:Ultra performance liquid chromatography-quadrupole-time of flight mass spectrometry(UPLCQ/TOF-MS)and liquid chromatography-triple quadrupole mass spectrometry(LC-QQQ-MS)were used to determine the components and absorbable constituents of YPF.Secondly,TCMSP,Drugbank,Swiss and Pharm Mapper were used to search the targets of absorbable bioactive constituents of YPF,and the targets of COVID-19 were identified based on Gene Cards and OMIM databases.STRING database was used to filter the possible inter-protein interactions.Thirdly,Gene Ontology(GO)enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathways analysis were performed to identify molecular function and systemic involvement of target genes.Results:A total of 61 components of YPF and 36 absorbable constituents were identified through UPLC-Q/TOF-MS.Wogonin,prim-O-glucosylcimifugin,5-O-methylvisamminol,astragalosideⅣand 5-Omethylvisamminol(hydroxylation)were vital constituents for the treatment of COVID-19,and RELA,TNF,IL-6,MAPK14 and MAPK8 ere recognized as key targets of YPF.The major metabolic reactions of the absorbed constituents of YPF were demethylation,hydroxylation,sulfation and glucuronidation.GO and KEGG pathway analysis further showed that the most important functions of YPF were T cell activation,response to molecule of bacterial origin,cytokine receptor binding,receptor ligand activity,cytokine activity,IL-17 signaling pathway,Chagas disease,lipid and atherosclerosis,etc.Conclusion:The approach of combining UPLC-Q/TOF-MS with network pharmacology is an effective tool to identify potentially bioactive constituents of YPF and its key targets on treatment of COVID-19.

玉屏风散加减联合西药治疗促进轻型新冠病毒感染孕妇核酸转阴的疗效观察

[目的]探讨玉屏风散加减联合西药治疗轻型新冠病毒感染孕妇的临床疗效。[方法]以上海市公共卫生临床中心2022年4月至6月收治的轻型新冠病毒感染孕妇作为研究对象,随机分成治疗组(48例)及对照组(52例)。对照组给予退热、止咳对症及维生素C等西药治疗,治疗组在对照组基础上给予玉屏风散加减治疗。对比两组患者治疗前后的各症状积分、不良妊娠结局发生率、总有效率和淋巴细胞、C反应蛋白、白细胞介素-2受体、白细胞介素-6等实验室指标变化,并观察两组患者病毒核酸转阴和疾病转归情况。[结果]与对照组比较,治疗组症状总积分显著下降(P<0.001),总有效率显著升高(P<0.01),炎症指标C反应蛋白、白细胞介素-6水平较前显著下降(P<0.001,P<0.01),而淋巴细胞计数较前显著升高(P<0.001),不良妊娠结局发生率两组间差异无统计学意义(P>0.05)。[结论]玉屏风散加减联合西药治疗可显著改善轻型新冠病毒感染孕妇的临床症状,缩短核酸转阴时间,且不会增加不良妊娠结局,具有一定的临床价值,值得临床推广应用。

玉屏风散联合西药治疗慢性荨麻疹临床观察

目的 探究玉屏风散在慢性荨麻疹中的治疗效果。方法 选取2019年3月—2021年3月于安福县人民医院治疗的70例慢性荨麻疹患者,随机分为两组,各35例。对照组采用西药治疗,研究组采用西药联合玉屏风散治疗。对比两组临床疗效、中医证候积分、皮肤病生活质量指数(DLQI)、炎性因子水平及不良反应。结果 治疗后,研究组的中医证候积分、DLQI评分、白细胞介素-4(IL-4)及白细胞介素-10(IL-10)水平均低于对照组,干扰素-γ(IFN-γ)水平高于对照组(P<0.05)。研究组的总有效率为94.29%(33/35),高于对照组的77.14%(27/35)。两组不良反应发生率对比,差异无统计学意义(P>0.05)。结论 慢性荨麻疹患者加用玉屏风散治疗,能够有效缓解临床症状、抑制炎性因子水平、提升生活质量,且不良反应较少。

基于NF-κB信号通路的玉屏风散加味含药血清对RLE-6TN细胞炎症反应的影响

目的观察玉屏风散加味含药血清对大鼠肺上皮Ⅱ型细胞RLE-6TN炎症反应的影响,基于核因子(NF)-κB信号通路探讨其作用机制。方法采用脂多糖诱导RLE-6TN细胞炎症反应,将细胞分为对照组、模型组、地塞米松血清组和5%、10%、20%中药血清组,分别以不同血清干预细胞24 h。试剂盒检测细胞上清液乳酸脱氢酶(LDH)含量,荧光染色检测细胞活性氧(ROS)含量,Hoechst/PI双染观察细胞凋亡情况,ELISA检测细胞上清液肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6、IL-1β含量,RT-qPCR检测细胞Toll样受体4(TLR4)、髓样分化因子88(MyD88)、NF-κB抑制蛋白α(IκBα)mRNA表达,Western blot检测细胞TLR4、MyD88、NF-κBp65、IκBα蛋白表达。结果与对照组比较,模型组RLE-6TN细胞上清液LDH、TNF-α、IL-6、IL-1β及细胞ROS含量显著升高(P<0.01),细胞凋亡率显著升高(P<0.01),TLR4、MyD88 mRNA和蛋白表达显著升高(P<0.01),IκBαmRNA表达显著降低(P<0.01),p-NF-κBp65/NF-κBp65、p-IκBα/IκBα比值显著升高(P<0.01);与模型组比较,20%中药血清组和地塞米松血清组细胞RLE-6TN细胞上清液LDH、TNF-α、IL-6、IL-1β及细胞ROS含量显著降低(P<0.01),细胞凋亡率显著降低(P<0.01),TLR4、MyD88 mRNA和蛋白表达显著降低(P<0.05,P<0.01),IκBαmRNA表达显著升高(P<0.01),p-NF-κBp65/NF-κBp65、p-IκBα/IκBα比值显著降低(P<0.05,P<0.01)。结论玉屏风散加味含药血清可减轻RLE-6TN细胞炎症反应,其机制可能与调控NF-κB信号通路有关。

玉屏风散加减颗粒联合分时间针刺治疗体外受精-胚胎移植反复移植失败的临床研究

目的分析玉屏风散加减颗粒联合分时间针刺治疗体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)胚胎植入前遗传学筛查(Pre-implantation Genetic Screening,PGS)反复失败(recurrent implantation failure,RIF)患者的临床治疗价值。方法选取2020年1月—2022年1月就诊于医院的RIF患者173例,采用随机数表法分为对照组(常规治疗)41例,观察组1(玉屏风散+常规治疗组)37例,观察组2(分时间针刺+常规治疗组)44例,观察组3(玉屏风散+分时间针刺+常规治疗)51例。对各组患者治疗前后子宫内膜容受性[子宫内膜厚度、血管化血流指数(vascu⁃larization-flow index,VFI)、血管化指数(vascularization index,VI)及血流指数(flow index,FI)]、汉密尔顿焦虑评量表-焦虑自评量表(Hamilton Anxiety Scale-Self-Rating Anxiety Scale,HAMA-SAS)评分及汉密尔顿抑郁量表(Hamilton de⁃pression scale,HAMD)评分和治疗后生化妊娠率、临床妊娠率、早期流产率、异位妊娠率及活产率结果进行分析。结果治疗后观察组3子宫内膜厚度、VFI、VI及FI高于对照组(P<0.05);各观察组HAMA-SAS及HAMD评分均低于对照组(P<0.05);观察组3生化妊娠率及临床妊娠率高于对照组,且各观察组产活率均高于对照组(P<0.05),但各观察组早期流产率与异位妊娠率与对照组相比差异无统计学意义(P>0.05)。结论玉屏风散加减颗粒联合分时间针刺治疗能显著提高RIF患者生化妊娠率、临床妊娠率及产活率,其作用机理可能是改善内膜厚度,增加子宫血流动力学参数,促进内膜生长,提高子宫内膜容受性且减低患者移植失败的焦虑抑郁情绪,调节舒畅情志,从而改善RIF患者妊娠结局。

玉屏风散对肺气虚型变应性鼻炎豚鼠模型IL-4、IL-12、TNF-γ表达水平及鼻腔黏病理变化的影响

目的探讨玉屏风散对肺气虚型变应性鼻炎(allergic rhinitis,AR)豚鼠的作用机制。方法将40只健康杂色英国种豚鼠,随机分为空白组、模型组、玉屏风组、氯雷他定组。除空白组外,其余各组均以鸡卵清蛋白(ovalbumin,OVA)与烟熏法建立肺气虚型AR模型。造模成功后,玉屏风组、氯雷他定组分别予玉屏风散[4.52 g/(kg·d)]、氯雷他定片(0.903 mg/kg)灌胃,空白组及模型组予等体积生理盐水灌胃,处理15 d后,取各组豚鼠血清及鼻腔黏膜。经HE染色法观察鼻腔黏膜细胞形态,ELISA与免疫组化法检测豚鼠血清中白细胞介素-4(interleukin-4,IL-4)、白细胞介素-12(interleukin-12,IL-12)、γ干扰素(interferon-γ,IFN-γ)等细胞因子表达水平。结果HE染色发现,模型组细胞形态结构明显紊乱,玉屏风组、氯雷他定组细胞形态结构异常状态相对减轻。ELISA结果显示,与空白组比较,模型组、玉屏风组、氯雷他定组豚鼠血清中IL-4、IL-12表达水平升高(P<0.05),IFN-γ表达水平降低(P<0.05);与模型组比较,玉屏风组、氯雷他定组豚鼠血清IL-4与IL-12含量降低(P<0.05),氯雷他定组IFN-γ表达水平升高(P<0.05)。免疫组化染色显示,与空白组比较,模型组豚鼠鼻腔黏膜IL-4、IL-12表达明显降低(P<0.05),IFN-γ表达明显升高(P<0.01);与模型组比较,玉屏风组与氯雷他定组IL-4表达明显降低(P<0.05),氯雷他定组IL-12表达明显降低(P<0.05)。结论玉屏风散可能通过影响IL-4、IL-12、IFN-γ水平,改变鼻腔黏膜细胞形态治疗肺气虚型AR。

玉屏风散的研究进展及质量标志物预测分析

玉屏风散为扶正固本的经典名方,主治表虚自汗证,具有抗肿瘤、抗炎、抗菌、抗病毒、调节免疫作用等药理作用,现代临床多用于治疗感冒、过敏性鼻炎、支气管哮喘、肺炎、肾病综合征、慢性肾炎等。总结了近年来玉屏风散的化学成分、药理作用和临床应用,并基于中药质量标志物(Q-Marker)“五原则”对玉屏风散的质量标志物进行预测分析,揭示升麻素、5-O-甲基维斯阿米醇苷、汉黄芩素、槲皮素、山柰酚、亥茅酚苷、芒柄花素、白术内酯Ⅰ-Ⅲ、黄芪皂苷Ⅰ-Ⅱ、毛蕊异黄酮、毛蕊异黄酮-7-O-β-D-葡萄糖苷、β-谷甾醇、黄芩素、大豆皂苷、黄芪皂苷Ⅳ、异黄芪皂苷Ⅰ-Ⅱ、β-香树脂醇、异紫花前胡内酯可作为玉屏风散的质量标志物,可为建立玉屏风散复方制剂的质量控制体系提供科学参考依据。

玉屏风散化学成分、药理作用、临床应用研究进展及质量标志物预测分析

玉屏风散是历代医家常用的经典名方之一,由黄芪、白术、防风3味药组成,具有益气固表止汗之功效,主治表虚自汗症,现代药理学研究表明该方具有抗炎、抗菌、抗病毒、调节机体免疫功能、抗肿瘤等药理作用,临床常用于治疗消化系统、免疫系统、呼吸系统、皮肤科及儿科常见疾病。该文总结了近年来玉屏风散的化学成分、药理作用及临床应用的研究情况,并基于中药质量标志物(Q-marker)“五原则”——传递与溯源、特有性、有效性、复方配伍环境及可测性对玉屏风散的Q-marker进行预测分析,提示黄芪甲苷、毛蕊异黄酮苷、芒柄花素、芒柄花苷、升麻素、升麻素苷、5-O-甲基维斯阿米醇苷、亥茅酚苷、白术内酯I可作为玉屏风散的Q-marker,后续可选择以上成分为指标对玉屏风散及其制剂进行全程质量把控和评价,并建立质量溯源体系。

玉屏风散通过ZBP1介导的巨噬细胞泛凋亡抑制哮喘气道炎症的机制研究

目的:观察玉屏风散对ZBP1介导的肺泡巨噬细胞泛凋亡的影响,从而阐明其抑制哮喘气道炎症的分子机制。方法:采用脂多糖诱导肺泡巨噬细胞(MH‑S)构建哮喘细胞模型,并给予不同浓度玉屏风散含药血清进行干预,分别采用CCK8法检测NH‑S细胞活性,ELISA法检测LDH、IL‑1β和IL‑18的含量,流式细胞术检测细胞死亡情况,Western blot法检测泛凋亡相关蛋白和ZBP1蛋白的表达,RT‑qPCR法检测ZBP1基因的表达。结果:与空白组相比,模型组肺泡巨噬细胞LDH释放、IL‑1β与IL‑18的含量和死亡细胞比例显著增加,细胞焦亡蛋白Cleaved caspase‑1与GSDMD‑NT、坏死性凋亡蛋白p‑RIPK3与p‑MLKL、凋亡蛋白Cleaved caspase‑3的表达显著上调,差异均具有统计学意义(P<0.01)。与模型组相比,玉屏风散组肺泡巨噬细胞LDH释放、IL‑1β与IL‑18的含量和死亡细胞比例显著降低,细胞焦亡蛋白Cleaved caspase‑1与GSDMD‑NT、坏死性凋亡蛋白p‑RIPK3与p‑MLKL、凋亡蛋白Cleaved caspase‑3的表达显著下调,差异均具有统计学意义(P<0.01)。此外,与模型组相比,玉屏风散组肺泡巨噬细胞中ZBP1蛋白和ZBP1mRNA的表达显著降低,差异均具有统计学意义(P<0.01)。结论:玉屏风散通过抑制巨噬细胞中ZBP1的表达,从而抑制细胞泛凋亡水平改善气道炎症。

玉屏风散对肺癌细胞PD-L1表达及T细胞功能的影响

目的探讨玉屏风散对程序性死亡受体1(PD-1)-程序性死亡配体-1(PD-L1)结合及对肺癌细胞在体内外生长的影响。方法MTT法检测玉屏风散提取物对小鼠Lewis肺癌LLC细胞生长的影响;乳酸脱氢酶(LDH)释放实验检测玉屏风散提取物对T细胞和LCC细胞共培养中靶细胞杀伤性作用;酶联免疫吸附(ELISA)实验检测玉屏风散提取物对PD-1和PD-L1结合的阻断作用,以及对γ干扰素(IFN-γ)和肿瘤坏死因子-α(TNF-α)释放水平的影响;同基因肿瘤模型分析玉屏风散对肺癌LLC细胞体内生长的抑制作用;免疫组化染色考察玉屏风散对肿瘤组织内CD4^(+)T细胞、CD8^(+)T细胞浸润的影响。结果玉屏风散呈剂量依赖性抑制LLC细胞的生长及内源性PD-L1蛋白表达(P<0.05,P<0.01),竞争性阻断PD-1和PD-L1结合(P<0.05,P<0.01),促进T细胞IFN-γ和TNF-α的释放(P<0.05,P<0.01),阻断PD-L1对T细胞功能性抑制作用(P<0.05,P<0.01)。玉屏风散可以抑制LLC肿瘤生长(P<0.01),增加CD4^(+)T、CD8^(+)T细胞的浸润数量(P<0.01)。结论玉屏风散在体外细胞模型中可阻断PD-L1对T细胞功能的抑制作用,在同源小鼠肿瘤模型中具有抗肿瘤效果,可增强CD4^(+)T细胞、CD8^(+)T细胞对癌细胞的杀伤作用。

消积豁痰汤加减联合玉屏风散对肺脾气虚型支气管哮喘患者疗效及免疫功能的影响

目的 分析消积豁痰汤加减联合玉屏风散对肺脾气虚型支气管哮喘患者的疗效及对免疫功能的影响。方法 62例支气管哮喘患者以随机数字表法分研究组(31例)、对照组(31例),对照组给予玉屏风散,研究组在对照组基础上给予消积豁痰汤加减方剂治疗,两组均持续治疗3个月后评价效果。比较两组中医症状评分、肺功能及临床疗效,对比两组外周血因子、体液免疫因子、细胞免疫因子变化情况,记录两组治疗期间不良事件发生情况。结果 两组治疗后的主症、次症中医证候评分均低于治疗前(P<0.05),研究组治疗后的主症、次症中医证候评分均低于对照组(P<0.05)。两组治疗后第1秒用力肺活量(forced expiratory volume in the first second, FEV1)/用力肺活量(forced vital capacity, FVC)均高于治疗前,最大呼气流量(peak expiratory flow, PEF)变化率与FEV1变化率均低于治疗前(P<0.05),研究组治疗后的FEV1/FVC高于对照组,PEF变化率与FEV1变化率低于对照组(P<0.05)。研究组总有效率(96.77%,30/31)高于对照组(77.42%,24/31)(P<0.05)。两组治疗后血清干扰素γ(interferon-γ,IFN-γ)、白细胞介素-4(interleukin-4,IL-4)、转化生长因子-β(transforming growth factor-β,TGF-β)、白细胞介素-17(interleukin-17,IL-17)均低于治疗前(P<0.05),研究组治疗后的IFN-γ、IL-4、TGF-β、IL-17均低于对照组(P<0.05)。两组治疗后外周血中免疫球蛋白E(immunoGlobin E,IgE)、IgG、IgM均低于治疗前,补体C3、C4均高于治疗前(P<0.05),研究组治疗后的IgE、IgG、IgM均低于对照组,C3、C4均高于对照组(P<0.05)。两组治疗后辅助性T细胞1(Helper T cell 1,Th1)/Th2、Th17/调节性T细胞(Regulatory T cells, Treg)均低于治疗前,CD_(4)^(+)/CD_(8)^(+)均高于治疗前(P<0.05),研究组治疗后的Th1/Th2、Th17/Treg均低于对照组,CD_(4)^(+)/CD_(8)^(+)高于对照组(P<0.05)。两组总不良事件发生率对比差异无统计学意义(P>0.05)。结论 消积豁痰汤加减联合玉屏风散治疗肺脾气虚证支气管哮喘可改善临床症状及肺功能,增强治疗效果,改善患者外周血因子分泌及免疫功能,且安全性良好。

玉屏风散加减辅助卡介菌多糖核酸注射液治疗过敏性皮炎患者的效果及对T淋巴细胞亚群水平的影响

目的探讨玉屏风散加减辅助卡介菌多糖核酸注射液治疗过敏性皮炎患者的效果。方法选择2019年3月至2022年3月就诊于医院的150例过敏性皮炎患者,以随机数字表法将其分为A组和B组,各75例。A组给予卡介菌多糖核酸注射液治疗,B组在A组治疗基础上行玉屏风散加减治疗。比较两组的治疗效果。结果B组的治疗总有效率高于A组,随访3个月内复发率低于A组(P<0.05)。治疗后,两组的CD3^(+)、CD4^(+)高于治疗前,CD8^(+)低于治疗前,且B组优于A组(P<0.05)。B组的瘙痒消失时间、皮疹消失时间短于A组(P<0.05)。治疗后,两组的皮肤病生活质量指数(DLQI)评分低于治疗前,且B组低于A组(P<0.05)。两组的不良反应总发生率无显著差异(P>0.05)。结论玉屏风散加减辅助卡介菌多糖核酸注射液治疗过敏性皮炎患者的效果显著,能减少病情复发,改善T淋巴细胞亚群水平,加速症状消失,且提高其生活质量。

小青龙汤联合玉屏风散治疗季节性变应性鼻炎疗效观察

目的:分析小青龙汤联合玉屏风散对预防季节性变应性鼻炎(seasonal allergic rhinitis,SAR)的治疗效果。方法:随机将132例SAR患者分为观察组(n=66)和对照组(n=66),观察组患者应用小青龙汤联合玉屏风散治疗,对照组应用布地奈德治疗,通过过敏性鼻炎症状(TNSS)评分、鼻腔结膜炎患者的生活质量状况调查问卷(RQLQ)对两组患者治疗前(W0)、治疗2周(W2)、治疗3周(W3)和治疗4周(W4)进行对比。结果:连续治疗2周后,两组受试者TNSS评分、RQLQ评分较治疗前明显下降,差异有统计学意义(P<0.05);连续治疗3周和4周,观察组TNSS评分、RQLQ评分较对照组明显下降,差异有统计学意义(P<0.05);观察组TNSS评分、RQLQ评分治疗总有效率明显高于对照组,差异有统计学意义(P<0.01);观察组治疗过程中共4例(6.06%)患者出现不适,包括腹泻3例(4.55%),腹胀1例(1.52%)。结论:小青龙汤联合玉屏风散对预防季节性变应性鼻炎效果明确,且具有良好的安全性,具有一定推广意义。

基于网络药理学与分子对接探索玉屏风散辅助治疗糖尿病肾病的作用机制

目的通过网络药理学以及分子对接技术,阐明玉屏风散辅助治疗糖尿病肾病可能的作用机制。方法采用中药系统药理学数据库与分析平台(TCMSP)检索玉屏风散中黄芪、防风、白术各个中药材的化学成分及其作用靶点;并通过Perl语言将蛋白靶点规范为相应的基因名称;通过人类基因(GeneCards)数据库检索糖尿病肾病的相关基因;两者取交集之后,通过STRING平台构建蛋白互作网络;使用CytoScape软件构建“药物成分-靶点”网络;采用R语言进行基因本体(GO)功能富集分析和京都基因与基因组百科全书(KEGG)通路富集分析,筛选主要成分、核心靶点进行分子对接研究。结果玉屏风散作用于糖尿病肾病的有效成分有45个,相关靶点基因有143个。KEGG通路富集分析得到46条信号通路。分子对接结果显示,玉屏风散中的主要活性成分槲皮素、山萘酚、异鼠李素和主要靶点白细胞介素-6(IL-6)、过氧化物酶体增殖物激活受体γ(PPARG)、血管内皮生长因子A(VEGFA)有较好的结合活性。结论本研究初步证实了玉屏风散可通过多成分、多靶点、多途径治疗糖尿病肾病,为进一步研究其活性成分及分子机制提供了参考依据。

玉屏风散化学成分及药理作用研究进展

为了系统性总结玉屏风散的化学活性成分及药理作用,为科研人员提供新的实验思路,为其临床应用提供参考,查阅近年来中外文献。玉屏风散由黄芪、白术、防风三种中药组成,是中医扶正固本的经典名方。玉屏风散含有多糖类、黄酮类、内酯类、色原酮类、挥发油类等化合物,在药理作用上具有抗肿瘤、抗炎、抗氧化、抗菌、抗纤维化、调节免疫等作用。玉屏风散药理作用广泛,具有广阔的发展前景,值得进一步深入研究。