Network pharmacology-based exploration of molecular mechanisms underlying therapeutic effects of Jianpi Huatan Quyu recipe on chronic heart failure with spleen Qi deficiency syndrome

BACKGROUND Chronic heart failure is a complex clinical syndrome.The Chinese herbal compound preparation Jianpi Huatan Quyu recipe has been used to treat chronic heart failure;however,the underlying molecular mechanism is still not clear.AIM To identify the effective active ingredients of Jianpi Huatan Quyu recipe and explore its molecular mechanism in the treatment of chronic heart failure.METHODS The effective active ingredients of eight herbs composing Jianpi Huatan Quyu recipe were identified using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform.The target genes of chronic heart failure were searched in the Genecards database.The target proteins of active ingredients were mapped to chronic heart failure target genes to obtain the common drugdisease targets,which were then used to construct a key chemical componenttarget network using Cytoscape 3.7.2 software.The protein-protein interaction network was constructed using the String database.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed through the Metascape database.Finally,our previously published relevant articles were searched to verify the results obtained via network pharmacology.RESULTS A total of 227 effective active ingredients for Jianpi Huatan Quyu recipe were identified,of which quercetin,kaempferol,7-methoxy-2-methyl isoflavone,formononetin,and isorhamnetin may be key active ingredients and involved in the therapeutic effects of TCM by acting on STAT3,MAPK3,AKT1,JUN,MAPK1,TP53,TNF,HSP90AA1,p65,MAPK8,MAPK14,IL6,EGFR,EDN1,FOS,and other proteins.The pathways identified by KEGG enrichment analysis include pathways in cancer,IL-17 signaling pathway,PI3K-Akt signaling pathway,HIF-1 signaling pathway,calcium signaling pathway,cAMP signaling pathway,NF-kappaB signaling pathway,AMPK signaling pathway,etc.Previous studies on Jianpi Huatan Quyu recipe suggested that this Chinese compound preparation can regulate the TNF-α,IL-6,MAPK,cAMP,and AMPK pathways to affect the mitochondrial structure of myocardial cells,oxidative stress,and energy metabolism,thus achieving the therapeutic effects on chronic heart failure.CONCLUSION The Chinese medicine compound preparation Jianpi Huatan Quyu recipe exerts therapeutic effects on chronic heart failure possibly by influencing the mitochondrial structure of cardiomyocytes,oxidative stress,energy metabolism,and other processes.Future studies are warranted to investigate the role of the IL-17 signaling pathway,PI3K-Akt signaling pathway,HIF-1 signaling pathway,and other pathways in mediating the therapeutic effects of Jianpi Huatan Quyu recipe on chronic heart failure.

Exploration and Study of Jianpi Qushi Powder Combined with Standard Anti HP Quadruple Therapy in the Treatment of HP Infectious Gastritis of Spleen Deficiency and Dampness Stagnation Type

Objective: To explore the therapeutic effect of traditional Chinese medicine Jianpi Qushi powder combined with standard anti-HP quadruple therapy in the treatment of HP infectious gastritis with spleen deficiency and dampness stagnation. Methods: From January 2020 to December 2021, 223 patients with laboratory-confirmed HP infection who were admitted to the Outpatient and Inpatient Department of Internal Medicine in our hospital were selected as the research objects and randomly divided into two groups. 101 patients in the control group were given standard anti HP quadruple therapy;122 cases in the treatment group were given traditional Chinese medicine Jianpi Qushi powder combined with standard anti HP quadruple therapy. The two groups were rechecked carbon breath test after the designed course of treatment, and the curative effects of the two groups were compared. Results: 113 cases in the treatment group were cured by traditional Chinese medicine Jianpi Qushi powder combined with standard anti HP quadruple therapy, and the cure rate was 92.62%. 84 cases in the control group were cured by standard anti HP quadruple therapy, and the cure rate was 83.17%, χ2 = 4.7955, P = 0.0285, the difference was statistically significant (P < 0.05). Conclusion: Traditional Chinese medicine Jianpi Qushi powder combined with standard anti HP quadruple therapy in the treatment of HP infectious gastritis with spleen deficiency and dampness stagnation is one of the best treatment schemes for HP infection. The results of this study achieve the best clinical treatment effect, and provide a more valuable and reliable method for the treatment of gastropathy in clinical internal medicine, which is worthy of popularization and application.

Research Progress of Jianpi Qushi Powder Combined with Standard Anti Hp Quadruple Therapy in the Treatment of Hp Infectious Gastritis with Spleen Deficiency and Dampness Stagnation

Stomach Helicobacter pylori infection is one of the common gastric diseases. Helicobacter pylori infectious gastritis of spleen deficiency and dampness stagnation is a relatively intractable chronic disease. In recent years, traditional Chinese medicine methods have emerged one after another in the treatment of gastric Helicobacter pylori infection. By collecting references, the author reviewed the clinical characteristics of gastric Helicobacter pylori infection and the new progress of traditional Chinese medicine treatment.

OBSERVATION ON THERAPEUTIC EFFECTS OF ELECTRICAL HEAT ACUPUNCTURE TREATING 68 CASES OF CHRONIC SUPERFICIAL GASTRITIS WITH INSUFFICIENCY OF SPLEEN YANG

In the present experiments,68 cases of chronic superficial gastritis with insufficieney of Spleen Yang were randomly divided into electrical heat acupuncture group（EHAG,n=32）,filiform needling group（FNG,n=19）and medication group（MG,n=17）.Bilateral Zusanli（ST 36）,Neiguan（PC 6）,Sanyinjiao（SP 6）and Hegu（LI 4）were selected for both EHAG andFNG.The needles applied at Zusanli and Neiguan in EHAG were connected to a DR 2-1 electricalheat acupuncture apparatus.The main drug administered in MG was Weimeisu.Thirty treatmentsmade a course,and the treatment was given once daily.The therapeutic effects were evaluated after 3courses of treatment.The results were as follows:The total effective rate was 90.63％ in EHAG,63.16％ in FNG and 29.41％ in MG.There was a remarkable difference in therapeutic effects amongthe three groups（X^2=19.20,P【0.01）.

Effects of H pylori therapy on erythrocytic and iron parameters in iron deficiency anemia patients with H pylori-positive chronic gastristis

AIM： To elucidate the influences of Hpylori infection on oral iron treatment for iron deficiency anemia （IDA）.METHODS： A total of 86 patients were divided into two groups： group A, receiving ferrous succinate combined with triple therapy for H pylori eradication, and group B （control）, treated with ferrous succinate only. During treatment of IDA, dynamic changes in hemoglobin （Hb） level, mean corpuscular volume （MCV）, mean corpuscular hemoglobin （MCH）, serum iron （SI）, and serum ferritin （SF） were compared between the groups.RESULTS： Hb was slightly higher in group A at d 14 alter the start of triple therapy for H pylori eradication （P 〉 0.05）. After the therapy, the increase of Hb in group A became significantly faster than that in group B （P 〈 0.05）. At d 56, the mean Hb in group A returned to the normal level, however, in group B, it was lower than that in group A （P 〈 0.05） although it had also increased compared with that before oral iron treatment. The MCV and MCH in group A recovered to the normal level, and were much higher than those in group B （P 〈 0.05） at d 21. In Group B, the MCV and MCH remained at lower than normal levels until d 42 alter the start of therapy. And then, they reached a plateau in both groups and the differences disappeared （P 〉 0.05）. The SF in group A was higher than that in group B （P 〈 0.05） 28 d alter the treatment and its improvement was quicker in group A （P 〈 0.05）, and the difference between the two groups was even more significant （P 〈 0.01） at d 56. The SI in group A was higher than that in group B （P 〈 0.05） at d 14 and this persisted until d 56 when the follow-up of this research was finished.CONCLUSION： Treatment of H pylori can enhance the efficacy of ferrous succinate therapy in IDA patients with Hpylori-positive chronic gastritis.

Serum protein profiles suggest a possible link between qi deficiency constitution and Pi-qi-deficiency syndrome of chronic superficial gastritis

Objective:To identify potential serum protein candidates involved in linking the traditional Chinese medicine(TCM)-defined qi deficiency constitution(QDC)to Pi-qi-deficiency syndrome(PQDS)of chronic superficial gastritis(CSG).Methods:Using participants with the TCM-defined balanced constitution as a control population,labelfree quantitative proteomics was adopted to identify differentially expressed proteins(DEPs)in serum samples from two case populations:case population 1(participants with QDC)and case population 2(patients with PQDS of CSG).The DEPs discovered in both case populations were analyzed to identify common DEPs as potential candidates for proteins involved in the link between QDC and PQDS.Based on Kyoto Encyclopedia of Genes and Genomes pathway(KEGG)and Gene Ontology(GO)enrichment analysis and analysis of proteineprotein interaction networks,we evaluated the possible functions of these potential serum candidates.Results:We discovered 24 and 28 proteins that were differentially expressed in case populations 1 and 2,respectively,compared with the control population.Hierarchical clustering analysis showed that the expression profile of DEPs of individuals from the same population clustered well,while those from different populations were segregated.Furthermore,GO analysis revealed the 10 DEPs that were common to both case populations to be mainly associated with negative regulation of cellular metabolic and immune system processes while KEGG analysis indicated these proteins to be associated with complement and coagulation cascades and peroxisome proliferator-activated receptor signaling.Notably,serum levels of C4b-binding protein beta chain,glycosylphosphatidylinositol-specific phospholipase D1 and MS-F1 light chain variable region proteins were notably higher in the two case populations compared with the control,particularly in the case of CSG with PQDS.Conclusion:The results presented here provide new insights into the molecular mechanisms underlying development of PQDS of CSG from QDC,and suggest candidate serum biomarkers for future application in integrative medicine.

Screening for blood leukocyte microRNA biomarkers responsible for association between qi deficiency constitution and Pi-qi-deficiency syndrome of chronic superficial gastritis

Objective:To screen for blood leukocyte microRNA(miRNA)biomarkers responsible for the association between the traditional Chinese medicine(TCM)qi deficiency constitution(QDC)and the Pi-qi-deficiency syndrome(PQDS)of chronic superficial gastritis(CSG).Methods:Peripheral blood leukocytes were separated from people of two TCM constitutions(balance and qi deficiency)and from CSG patients with PQDS.Total RNA was isolated from the leukocytes and subjected to subsequent high-throughput miRNA sequencing to identify the miRNAs that are specifically and highly expressed in persons of QDC and CSG patients with PQDS.In addition,the target genes of the associated miRNAs were predicted.Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway-based enrichment analyses of these target genes were performed to further evaluate the associated miRNA candidates as potential biomarkers responsible for the association between QDC and PQDS of CSG.Results:Compared with the control group with a balance constitution(P<.05,fold change>1.5 or<0.5),31 and 38 differentially expressed miRNAs were found in persons of QDC and CSG patients with PQDS,respectively.In particular,hsa-miR-145-5p and hsa-miR-146a-3p were highly expressed in both the persons of QDC and CSG patients with PQDS.GO analysis of the target genes of the two common miRNAs showed that they were mainly associated with functions related to synthesis and metabolism,such as cellular nitrogen compound metabolic processes,biosynthetic processes,cellular protein modification processes,and cellular component assembly.KEGG analysis identified the common pathways enriched among the target genes,including the Hippo signaling pathway and the transcriptional misregulation pathway.The common target genes of the two miRNAs seemed to be associated with the spliceosome pathway and the RNA degradation pathway.Conclusion:Hsa-miR-145-5p and hsa-miR-146a-3p may serve as candidate biomarkers responsible for the association between QDC and PQDS of CSG.

Clinical Observation on 34 Cases of Chronic Atrophic Gastritis Treated with Shenlian Twelve Flavors

[Objectives]The research aimed to observe the curative effect of Shenlian Twelve Flavors in treating CAG patients with spleen deficiency and blood stasis toxin.[Methods]66 cases of CAG patients with spleen deficiency and blood stasis toxin were selected,32 cases in the control group and 34 cases in the observation group were generated according to the random number table method.The control group was treated with Moluodan;the observation group was treated with Shenlian Twelve Flavors.After treatment,the effective rate,TCM symptom score,gastroscopic score,pathological score,serum gastrin 17(G-17)level,and adverse reactions were compared between the two groups.[Results]The total effective rates of control group and observation group were 84.37%and 91.18%,respectively,and there was no statistical significance between the two groups(P>0.05).For the improvement of TCM symptom score,both groups were improved significantly compared with that before treatment,and observation group was better than control group(P<0.05).For the improvement of gastroscopic score,both groups were improved compared with that before treatment,and observation group was better than control group(P<0.05).For the improvement of pathological scores,both groups were improved compared with that before treatment,but there was no statistical significance between the two groups(P>0.05).[Conclusions]Shenlian Twelve Flavors has definite clinical efficacy in the treatment of CAG with spleen deficiency and blood stasis toxin.It could improve clinical symptoms,delay pathological progress,and regulate the level of G-17.There is no obvious adverse reaction,and it is worthy of clinical reference.

Micronutrient deficiencies in patients with chronic atrophic autoimmune gastritis: A review

Chronic atrophic autoimmune gastritis (CAAG) is an organ-specific autoimmune disease characterized by an immune response, which is directed towards the parietal cells and intrinsic factor of the gastric body and fundus and leads to hypochlorhydria, hypergastrinemia and inadequate production of the intrinsic factor. As a result, the stomach&#x02019;s secretion of essential substances, such as hydrochloric acid and intrinsic factor, is reduced, leading to digestive impairments. The most common is vitamin B12 deficiency, which results in a megaloblastic anemia and iron malabsorption, leading to iron deficiency anemia. However, in the last years the deficiency of several other vitamins and micronutrients, such as vitamin C, vitamin D, folic acid and calcium, has been increasingly described in patients with CAAG. In addition the occurrence of multiple vitamin deficiencies may lead to severe hematological, neurological and skeletal manifestations in CAAG patients and highlights the importance of an integrated evaluation of these patients. Nevertheless, the nutritional deficiencies in CAAG are largely understudied. We have investigated the frequency and associated features of nutritional deficiencies in CAAG in order to focus on any deficit that may be clinically significant, but relatively easy to correct. This descriptive review updates and summarizes the literature on different nutrient deficiencies in CAAG in order to optimize the treatment and the follow-up of patients affected with CAAG.

CLINICAL RESEARCH ON TREATMENT OF CHRONIC PROSTATITIS WITH ACUPUNCTURE

In the present study, the authors put forward that Zhibian(BL 54) and Sanyin-jiao(SP 6) are the effective acupoints for treatment of chronic prostatitis and possess an unique cura-tive effect in treatment of this disease with the type of deficiency of both the spleen and the kidney. Atotal effective rate was 92% in group of 1OO cases treated with acupuncture and comparison betweenpre- and post-treatment in examinations of prostatic fluid and other 6 items showed, significantly bet-ter than that of oral compound Sinohan(P【0. 01 ).

Study on the Drug Selection Law for Treatment of Chronic Gastritis with Spleen Deficiency and Stomach Dryness by Complex System Entropy Cluster

Objective:To study on Prof. GAO Zhong-ying’s drug selection law for treatment of chronic gastritis with data mining technique. Methods: The 407 medical records of chronic gastritis treated by Prof. GAO Zhong-ying were collected and the study on these drugs in the recipes was carried out with data mining method. Among them, the recipe composed of one drug was studied with frequency statistical method, correlativity between drug pairs with improved mutual information, correlativity among multi-drugs with complex system entropy cluster technique. Results: In treatment of chronic gastritis by Prof. GAO Zhong-ying there were 30 drugs with a higher use frequency of over 38 times, 94 commonly-used drug pairs with correlation coefficient of over 0.05, 11 commonly-used drug core combinations. Conclusion: The results attained with data mining technique for studying experience of famous and old TCM physicians conform to the clinical practice and the method is of an important significance for summarization of famous and old TCM physicians’ experiences.

Study on the pathological basis of classification of spleen deficiency in chronic gastritis

Background Spleen in Traditional Chinese Medicine (TCM) is not actually the spleen in the anatomic sense designated in western medicine because its functions basically belong to the physiological category of digestive system in modern medicine, and it represents a macroscopic concept of digestion, absorption and nutrition metabolism Spleen deficiency syndrome refers to the clinical phenomena such as hypofunction of digestion, absorption and nutrition metabolism By integrating TCM with modern medicine , this paper is intended to explore the pathological basis of classification of spleen deficiency in chronic gastritis Method By means of optical microscope, scanning electron microscope (SEM), transmission electron microscope (TEM) and histochemical staining, we conducted histopathological and subcellular ultrastructural (nuclei and mitochondrial) analysis of gastric mucosa of 188 patients of spleen deficiency, and that of 42 voluntary blood donors without clinical symptoms Results The gastric mucosa of patients with spleen Qi deficiency (SQD) and spleen yang deficiency (SyangD) could either be affected by organic lesion (type G-occurring on the basis of chronic superficial gastritis (CSG), chronic atrophic gastritis (CAG)) or unaffected (type F-chiefly belonging to functional indigestion); spleen yin deficiency (SyinD) and spleen deficiency with Qi stagnation (SDQS) both occurred on the basis of CSG and CAG; and the degree of mucosa inflammatory cells infiltration, the degree of decrease in glands propria, and the incidence of IMⅡ b in CSG and CAG were more serious than those of G-SQD and G-SyangD, P <0 05-0 01 Conclusion Spleen deficiency syndrome is likely to occur on the basis of organic lesion of gastric mucosa (disease with symptoms of both CSG or CAG and spleen deficiency symptoms), as well as on the basis of inorganic lesion of gastric mucosa (nondisease with symptoms, which is, despite spleen deficiency symptoms, there is no CSG or CAG) Besides, the clinical phenomenon of disease without symptoms (despite CSG or CAG, there is no spleen deficiency symptoms) occurres because of such factors as genetic diathesis and compensation The lesion degree of CSG or CAG and the incidence of IMⅡ b of SyinD and SDQS are more serious than those CSG and CAG of G-SQD and G-Syang D.

Study on the pathophysiologic basis of classification of‘spleen’ deficiency in chronic gastritis

Background Most of the studies on traditional Chinese medicine (TCM) ‘spleen’ deficiency syndrome in the recent 30 years were conducted only on the basis of single functional index, neglecting the study on the pathophysiologic internal relationship between spleen deficiency syndrome and gastric diseases in modern medicine. But it was at the subcellular molecular biological level that we explored the pathophysiologic basis of classification of spleen deficiency in chronic gastritis by detecting the bioactive substances in gastric mucosa nuclei and mitochondria. Methods By means of optical microscope, scanning electron microscope (SEM), transmission electron microscopy (TEM) and histochemical staining, we conducted histopathological, subcellular ultrastructural analysis and nuclei and mitochondrial ultrastructural analysis of gastric mucosa of 188 spleen deficiency patients and of 42 voluntary blood donors. At the same time, bioactive substances were measured by means of X-ray energy dispersive analysis system (EDAX) image analysis system, radioimmunoassay method and chemiluminescence method. Results The content of cAMP, superoxide dismutase (SOD), Zn and Cu in gastric mucosa, and the content of Zn and Cu in mitochondria decreased progressively in order of groups: healthy control (HC), spleen Qi deficiency without organic lesion (F-SQD), spleen Yang deficiency without organic lesion (F-SyangD), disease without symptoms group, spleen Qi deficiency with organic lesion (G-SQD), spleen Yang deficiency with organic lesion (G-SyangD), spleen Yin deficiency (SyinD) and spleen deficiency with Qi stagnation (SDQS), chronic spleen deficiency gastritis (CSG) and chronic atrophic gastritis (CAG); decreased in order of HC, intestinal metaplasia (IM)Ⅰ_a, IMⅠ_b, IMⅡ_a and IMⅡ_b, P<0.05. The content of DNA, Zn and Cu in nuclei progressively increased in order mentioned above, P<0.05.Conclusions The quantitative changes of gastric mucosal cAMP, SOD, Zn, Cu, of mitochondrial Zn, Cu and of nuclear DNA, Zn and Cu are not only the substance base on which the lesion of gastric mucosa tissue structure occurs, but also the substance base on which spleen deficiency is classified. G-SQD and G-SyangD were more likely to be found in low-grade or middle-grade CSG and CAG, while SyinD and SDQS in middle-grade or high-grade CSG, CAG and IMⅡ_b.

基于“肝脾同调”阐析慢性肝病的中医治疗

慢性肝病是临床常见疾病,“郁、虚、湿、毒、瘀”是其核心病机,在疾病的不同阶段各有侧重,其中,以“郁、虚”为核心的肝脾失调是慢性肝病发生发展的关键。“肝脾同调”是治疗慢性肝病的基本治法,在慢性肝病不同阶段,其“肝脾同调”内涵同中有异。根据肝、脾生理病理特性,治脾明辨虚实,厘清轻重,活用运脾、健脾、温脾、醒脾、补脾等法;调肝体用并重,精准辨证,活用疏肝、缓肝、散肝、柔肝等法。临床上,治脾与调肝相辅相成,治调并举,常获良效。

基于“脾气散精”理论探讨慢性肝病的中医治疗

慢性肝病的发病与脾密切相关,“脾气散精”是《黄帝内经》对脾功能的高度概括,脾气散精功能障碍贯穿慢性肝病始终,脾失运化,生湿生痰,瘀血阻络为慢性肝病进展的关键因素。治疗时应将健脾作为慢性肝病的基本治法之一,并根据脾运的不同状态,配合运脾、醒脾、温脾等不同治法,以复脾气散精之能,病程中尤应抓住瘀血络阻这一关键病机,活血化瘀通络,防止慢性肝病进一步向肝积、鼓胀发展,使脾运得复,瘀阻得除,标本兼治。

参杞强精颗粒对慢性疲劳综合征脾肾阳虚证大鼠免疫调节作用研究

目的:探讨参杞强精颗粒对慢性疲劳综合征(CFS)脾肾阳虚证模型大鼠的影响以及免疫调节作用。方法:将50只无特定病原体(SPF)级健康雄性斯泼累格·多雷(SD)大鼠随机分为正常对照组,模型对照组,参杞强精颗粒高剂量组、中剂量组、低剂量组,采用游泳力竭实验造成大鼠体力疲劳,慢性束缚应激造成大鼠心理疲劳,同时给予番泻叶煎煮液灌胃造成脾肾阳虚证候,构建CFS脾肾阳虚证大鼠模型,造模成功后分别按照各组剂量灌胃,连续给药21 d后,测定各组大鼠的胸腺和脾脏指数,酶联免疫吸附试验(ELISA)检测血清免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、免疫球蛋白A(IgA)浓度以及细胞因子白细胞介素2(IL-2)、白细胞介素6(IL-6)和γ干扰素(IFN-γ)含量,MTT法检测脾脏T、B淋巴细胞增殖能力,流式细胞法检测各组大鼠外周血T淋巴细胞亚群分布情况。结果:行为学结果显示,模型大鼠的体质量增长缓慢,精神萎靡,摄食水量减少,活动减少,便质稀软,力竭游泳时间减少,悬尾静止时间增加。药物干预后,与模型组比较,各给药组大鼠精神状态、体质量、摄食水量均显著改善,力竭游泳时间增加、悬尾静止时间减少(P<0.01或P<0.05);参杞强精颗粒各剂量组能显著提升大鼠胸腺和脾脏指数,提高IgG、Ig M、IgA浓度和IL-2、IL-6、IFN-γ的含量,显著提高脾脏T、B淋巴细胞增殖能力,也能提高CD3+、CD4+T淋巴细胞百分率和CD4+/CD8+T比值,降低CD8+T淋巴细胞百分率,差异有统计学意义(P<0.01或P<0.05)。结论:参杞强精颗粒能显著改善慢性疲劳综合征脾肾阳虚证大鼠免疫功能,缓解疲劳症状,且具有很好的免疫调节作用。

田耀洲教授辨治慢性萎缩性胃炎经验采撷

慢性萎缩性胃炎(CAG)是消化系统常见病,具有病情反复、缠绵难愈的特点。病理主要以胃腺体的萎缩、伴或不伴有肠上皮化生或异型增生为特征。肠上皮化生和异型增生属于癌前病变,与胃癌的发生关系密切,积极控制CAG患者的临床症状,延缓其病理进展或逆转其病理变化,有利于改善患者的生活质量、减轻经济负担及预防胃癌发生。田耀洲教授认为此病属本虚标实,脾胃虚弱是本,气滞、湿郁、瘀血为标,虚、滞、湿、瘀相互胶结推动着疾病的进展,在辨证上推崇微观与宏观相结合,用药上推崇中西医结合,并擅用经方与药对,精准辨治与用药。田教授开创的自拟方剂芪芝方,疗效显著,可有效改善脾胃湿热型CAG的临床症状。今将田教授辨治CAG之经验及自拟方剂分享给大家,以期为临床辨治CAG提供参考借鉴。

消痞汤对脾胃虚弱证慢性萎缩性胃炎患者的临床疗效

目的考察消痞汤对脾胃虚弱证慢性萎缩性胃炎患者的临床疗效。方法97例患者随机分为对照组(48例)和观察组(49例),2组均采用常规治疗,同时对照组给予枸橼酸莫沙必利片和胰酶肠溶片,观察组给予消痞汤,疗程4周。检测临床疗效、脑肠肽指标(CGRP、5-HT、SP、NPY)、Hp转阴率、胃液成分(游离酸、胃蛋白酶、亚硝酸盐、总酸)、胃肠激素(GAS、MLT、SS)、胃黏膜病理评分、不良反应发生率变化。结果观察组总有效率高于对照组(P<0.05)。治疗后,2组脑肠肽指标、NPY、SS、游离酸、胃蛋白酶、总酸升高(P<0.05),MLT、亚硝酸盐、黏膜炎症和黏膜萎缩评分降低(P<0.05),以观察组更明显(P<0.05)。2组Hp转阴率、不良反应发生率比较,差异无统计学意义(P>0.05)。结论消痞汤可安全有效地缓解胃黏膜炎症和萎缩,改善胃液成分和胃肠激素,其机制可能与调节脑-肠轴有关。

温中和胃汤联合耳穴压豆对脾胃虚寒型慢性胃炎患者治疗疗效及对血清VIP、MTL水平的影响

目的 温中和胃汤联合耳穴压豆对脾胃虚寒型慢性胃炎(CG)患者的治疗疗效及对血清VIP、MTL水平的影响。方法 选取2021年1月—2022年5月该院接收的脾胃虚寒型CG患者90例,采用随机数字表法分为观察组47例和对照组43例。所有患者均行常规治疗,同时对照组给予耳穴压豆治疗,观察组在对照组基础上联合温中和胃汤治疗。对比两组的治疗疗效、中医证候评分、不良反应发生情况。治疗前后,检测两组患者外周血胃肠功能指标[胃动素(MTL)、血管活性肽(VIP)]以及炎症指标[白细胞介素-1β(IL-1β)以及白细胞介素-6(IL-6)]表达水平。在患者停药3个月后,对其进行为期半年的跟踪随访调查,记录其复发情况。结果 观察组、对照组治疗总有效率分别为93.62%、76.74%,不良反应总共发生率分别为17.02%、9.30%,6个月内复发率分别为0.00%、13.95%。,观察组治疗总有效率较高、6个月复发率较低(P<0.05),两组不良反应发生率无差异(P>0.05)。治疗后中医证候对比,观察组胃隐痛、喜温喜按、劳累/受凉后症状加重和泛吐清水评分低于对照组(P<0.05),两组神疲倦怠、舌淡胖评分无差异(P>0.05)。治疗后,观察组血清MTL高于对照组(P<0.05),VIP、IL-1β低于对照组(P<0.05),两组IL-6浓度无差异(P>0.05)。结论 温中和胃汤联合耳穴压豆可有效提高脾胃虚寒型CG治疗疗效,降低VIP和IL-1β表达,同时提高MTL表达水平,降低短期内复发率。

益胃宁胶囊联合瑞巴派特片治疗慢性萎缩性胃炎脾胃气虚证临床研究

目的观察益胃宁胶囊联合瑞巴派特片治疗慢性萎缩性胃炎(CAG)脾胃气虚证的临床疗效。方法采用随机数字表法将80例CAG患者分为研究组和对照组各40例,2组均予瑞巴派特片,0.1 g/次,每日3次,口服;研究组在此基础上予益胃宁胶囊,2 g/次,每日3次,口服。2组均连续治疗12周。观察2组治疗前后中医疗效、胃镜疗效和病理疗效,比较2组治疗前后中医症状评分,监测2组不良反应。结果2组均无病例脱落。研究组中医疗效总有效率为92.5%(37/40),对照组为70.0%(28/40),研究组中医疗效优于对照组(P<0.01)。与本组治疗前比较,2组治疗后中医症状总分下降(P<0.05,P<0.01);2组治疗后比较,研究组中医症状总分低于对照组(P<0.01)。研究组胃镜疗效总有效率(82.5%)优于对照组(67.5%),研究组病理疗效总有效率(87.5%)优于对照组(70.0%),差异均有统计学意义(P<0.05,P<0.01)。2组未见明显不良反应。结论益胃宁胶囊联合瑞巴派特片可有效改善CAG患者的临床症状、胃镜表现及黏膜病变程度,疗效显著。