A systematic study of Erzhu Erchen decoction against damp-heat internalized type 2 diabetes based on data mining and experimental verification

Background:Erzhu Erchen decoction(EZECD),which is based on Erchen decoction and enhanced with Atractylodes lancea and Atractylodes macrocephala,is widely used for the treatment of dampness and heat(The clinical manifestations of Western medicine include thirst,inability to drink more,diarrhea,yellow urine,red tongue,et al.)internalized disease.Nevertheless,the mechanism of EZECD on damp-heat internalized Type 2 diabetes(T2D)remains unknown.We employed data mining,pharmacology databases and experimental verification to study how EZECD treats damp-heat internalized T2D.Methods:The main compounds or genes of EZECD and damp-heat internalized T2D were obtained from the pharmacology databases.Succeeding,the overlapped targets of EZECD and damp-heat internalized T2D were performed by the Gene Ontology,kyoto encyclopedia of genes and genomes analysis.And the compound-disease targets-pathway network were constructed to obtain the hub compound.Moreover,the hub genes and core related pathways were mined with weighted gene co-expression network analysis based on Gene Expression Omnibus database,the capability of hub compound and genes was valid in AutoDock 1.5.7.Furthermore,and violin plot and gene set enrichment analysis were performed to explore the role of hub genes in damp-heat internalized T2D.Finally,the interactions of hub compound and genes were explored using Comparative Toxicogenomics Database and quantitative polymerase chain reaction.Results:First,herb-compounds-genes-disease network illustrated that the hub compound of EZECD for damp-heat internalized T2D could be quercetin.Consistently,the hub genes were CASP8,CCL2,and AHR according to weighted gene co-expression network analysis.Molecular docking showed that quercetin could bind with the hub genes.Further,gene set enrichment analysis and Gene Ontology represented that CASP8,or CCL2,is negatively involved in insulin secretion response to the TNF or lipopolysaccharide process,and AHR or CCL2 positively regulated lipid and atherosclerosis,and/or including NOD-like receptor signaling pathway,and TNF signaling pathway.Ultimately,the quantitative polymerase chain reaction and western blotting analysis showed that quercetin could down-regulated the mRNA and protein experssion of CASP8,CCL2,and AHR.It was consistent with the results in Comparative Toxicogenomics Database databases.Conclusion:These results demonstrated quercetin could inhibit the expression of CASP8,CCL2,AHR in damp-heat internalized T2D,which improves insulin secretion and inhibits lipid and atherosclerosis,as well as/or including NOD-like receptor signaling pathway,and TNF signaling pathway,suggesting that EZECD may be more effective to treat damp-heat internalized T2D.

Effect of the Haoqinqingdan decoction on damp-heat syndrome in rats with influenza viral pneumonia

Objective: To investigate the effect of Chinese medicine prescription-Haoqinqingdan decoction on damp-heat syndrome in rats with influenza viral pneumonia and its influence on the immune function. Methods: A total of 48 Wistar rats were randomly divided into the normal control group, the damp-heat syndrome model group, the Haoqinqingdan decoction group (high, medium and low dose group) and the ribavirin group. The body temperature and weight of rats in each group were recorded after modeling. After treatment for 6 d, the concentration of T lymphocyte subgroup (CD3+ CD4+ , CD3+ CD8+ ) was determined by flow cytometry. The OD value of IFN毭/IL-4 was detected by double-antibody sandwich ELISA method, and its concentration was acquired through conversion. Results: After modeling, the temperature and weight of rats in each modeling group showed the increasing trend ( P<0.01). From the second day of treatment, there was significant difference in the body mass between groups, and the rat weight of the control group was higher than in the modeling group ( P<0.05 or 0.01). With the advances of treatment, only the temperature in the medium and high dose Haoqinqingdan decoction groups declined significantly ( P<0.05). After treatment, the CD4+ /CD8+ ratio of the damp-heat syndrome model group decreased more significantly compared with the control group. Elevated CD3+ CD8+ percentages and declined CD4+ /CD8+ ratios can be observed in the low dose group and ribavirin group ( P<0.05). Moreover, the CD3+ CD4+ percentage of ribavirin group was lower than in the control group ( P<0.05). After treatment, the IFN-毭 and IFN-毭/ IL-4 levels in the peripheral blood of rats in the dampheat syndrome group were obviously higher than in the control group ( P<0.05). Conclusions: Compared with ribavirin, the high dose Haoqinqingdan decoction can improve the ratio of T lymphocyte subgroup and Th1/Th2 cell balance more effectively.

Screening of Traditional Chinese Medicine Prescription for Treating Damp-heat Diarrhea of Piglets

[Objective] The paper was to explore the therapeutic effect of traditional Chinese medicine on damp-heat diarrhea of piglets in summer.[Method] Three prescriptions were developed with a dozen of traditional Chinese medicines,and in vitro antibacterial test against swine standard Escherichia coli [O149：K91,K88 ac（C83907）] was conducted.Moreover,106 natural cases of diarrhea piglets caused by coinfection of damp-heat and E.coli through clinical and laboratory diagnosis were then treated.[Result] The oral liquids prepared by three traditional Chinese medicine prescriptions had certain antibacterial effect on standard pathogenic E.coli.Prescription 2 presented the strongest inhibitory effects on swine E.coli in vitro,with the MIC of 31.25 mg/m L.It had better therapeutic effect,and the effective rate reached 94.74%.[Conclusion] The prescription 2 mainly consisted of Coptis chinensis and Prunus mume might be effective in treatment of piglet diarrhea caused by damp heat and E.coli in clinic.

The role of endothelial biomarkers in predicting damp-heat syndrome in diabetic kidney disease

Objective:To explore the role of endothelial biomarkers in predicting damp-heat syndrome in diabetic kidney disease(DKD).Methods:A total of 183 patients with DKD were divided into 3 groups:the early DKD group,established DKD group,and advanced DKD group.All patients were classified according to traditional Chinese medicine(TCM)syndrome type,and clinical indexes were collected for statistical analysis.Results:A total of 183 DKD patients were included in this study.Fibroblast growth factor 23(FGF23),chitinase-3-like protein 1(CHI3L1),endocan,tumor necrosis factor receptor 1(TNFR1),secretory leukocyte protease inhibitor(SLPI),and vascular endothelial growth factor A(VEGF-A)were increased in advanced DKD.FGF23,CHI3L1,endocan,SLPI,and TNFR1 showed a negative correlation with estimated glomerular filtration rate(eGFR),while they had a positive correlation with 24 h urine protein.After adjusting for age,gender,diabetes duration,body mass index(BMI),hemoglobin,glucose,uric acid,24 h urine protein,cholesterol,triglyceride,low-density lipoprotein,and hemoglobin A1c(HbA1c),the multiple regression analysis showed that FGF23,endocan,TNFR1,and SLPI significantly correlated with eGFR.Conclusions:FGF23,endocan,TNFR1,and SLPI are elevated in advanced DKD compared with early stage,and they may take part in the pathogenesis and progression of DKD.Our study provides useful biomarkers for predicting the appearance of damp-heat syndrome,including FGF23,endocan,TNFR1,and SLPI.

"Heterozygous Treatment"Method to Improve the Biased Status of the Damp-Heat Constitution and Symptom Integral:Randomized Controlled Trial

Objective:To observe the clinical effect of"heterozygous treatment"intervening the damp-heat constitution.Method:One hundred and six cases with damp-heat constitution were randomly divided into the observation group and control group,fifty-three cases for each group.Lianpu drink was given to the two groups,and the observation group was treated with scraping,acupuncture,cupping,constitution care and popularization of constitution science for"heterozygous treatment"based on the control group.70 days later,"constitution classification and determination table of traditional Chinese medicine"was used to determine,and statistics was applied to analyze the change of the symptoms of the two groups before and after the intervention.Results:in the observation group,compared to before the intervention,symptoms like dirty and oily complexion,yellow greasy tongue,bitter taste,dullness and scanty dark urine were significantly improved(P<0.05),and improvement of the above symptoms was greater than the control group(P<0.05).Conclusion:There is no significant difference between the two groups(P>0.05).Conclusion:the"heterozygous treatment"method can significantly improve the clinical symptoms of people with damp-heat constitution,with a better role in regulating.

Observation on the Therapeutic Effect of Heatclearing and Dampness-eliminating Dredging Collaterals Combined with Papaya Antirheumatic Pills on Treatment of Damp-heat Obstructive Ankylosing Spondylitis

Objective:Therapeutic effect of heatclearing and dampness-eliminating dredging collaterals combined with papaya antirheumatic pills on treatment of damp-heat obstructive ankylosing spondylitis.Methods:A total of 200 patients with ankylosing spondylitis who were treated in our hospital from January 2018 to October 2019 were selected as the research objects and randomly divided into 2 groups,each with 100 patients.The control group was treated with leflunomide+papaya antirheumatic pills,and the observation group was treated with self-drafted recipe of heat-clearing and dampness-eliminating,the curative effect,visual analogue score(VAS),barthel AS function index(BASFI)score,biochemical indicators and adverse reactions between the two groups were compared.Results:After 12 weeks of treatment,the efficacy of the observation group was higher than that of the control group.The pain score,BASFI score,and biochemical index were lower than those of the control group,and the differences were statistically significant(P<0.05);There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Heat-clearing and dampnesseliminating dredging collaterals combined with papaya antirheumatic pills is effective in the treatment of damp-heat obstructive ankylosing spondylitis,which is beneficial to reduce the degree of pain and inflammation of the affected area,helps patients remain active,and improves activities of daily living.

Efficacy of Pidan Jianqing decoction in treatment of type 2 diabetes with spleen deficiency and damp-heat syndrome

Introduction:This study aimed to assess the clinical efficacy of Pidan Jianqing decoction in the treatment of type 2 diabetes.Methods:A total of 72 patients with type 2 diabetes differentiated as spleen deficiency with damp-heat syndrome were randomly assigned to a treatment group(n=35)or control group(n=32).Patients in the control group received diet and exercise guidance and medication in the form of 0.5 g metformin hydrochloride tablets,while patients in the treatment group received Pidan Jianqing decoction in addition to the treatment given to the control group.Efficacy was evaluated after 8 weeks of treatment.Results:Efficacy was 91.4%in the treatment group versus 68.8%in the control group,which was a statistically significant difference(P<0.05).Significant group differences were also noted in the number of patients with improvement in symptoms such as dry mouth and polydipsia,frequency of urination and polyuria,abdominal distention and loss of appetite,fatigue and weakness,and sticky stools(all P<0.05),with greater improvement in the treatment group compared to the control group.The fasting blood glucose(FBG)and 2 h postprandial blood glucose levels significantly improved in both groups after treatment(P<0.05);however,there was no significant difference in glycated hemoglobin levels before and after treatment in both groups.Conclusion:Pidan Jianqing decoction can lower blood glucose levels and improve symptoms in patients with type 2 diabetes.

Clinical Efficacy of Western Medicine Combined with Chinese Medicine for Pelvic Inflammatory Disease(Damp-Heat and Stasis Type)

Objective:This study was undertaken to evaluate the clinical efficacy of Western medicine combined with Chinese medicine for pelvic inflammatory disease(damp-heat and stasis type).Methods:Seventy-four patients who were diagnosed with pelvic inflammatory disease(damp-heat and stasis type)by our hospital during July 2021 to July 2022 were randomized into two groups:the participants in the control group received conventional Western medicine treatment,and the participants in the study group received Western medicine combined with Chinese medicine.Results:After treatment,the total effectiveness of the control group(72.98%)was significantly lower than that of the study group(94.59%),(P<0.05);the whole blood viscosity high cut,whole blood viscosity low cut,fibrinogen and plasma viscosity of the control group were all lower than those of the study group(P<0.05);the levels of CRP,IL-6,and TNF-αin the control group were higher and IL-2 levels in the control group were lower than those in the study group(P<0.05).Conclusion:Western medicine combined with Chinese medicine is more effective in curing damp-heat and stasis-type pelvic inflammatory disease by improving the blood rheological indexes and lowering the level of inflammatory factors.

新型乌蔹莓水凝胶对湿热蕴结型痛风性关节炎的干预效果

目的探讨新型乌蔹莓水凝胶对湿热蕴结型痛风性关节炎的干预效果及作用机制。方法选取90例符合痛风性关节炎西医诊断标准、中医辨证属湿热蕴结证的患者作为研究对象,随机分成治疗组、对照组和空白组,每组30例。空白组仅采用依托考昔治疗,对照组采用依托考昔联合乌蔹莓膏治疗,治疗组采用依托考昔联合外敷乌蔹莓水凝胶治疗。比较3组临床疗效、症状改善时间、安全性、舒适性和治疗前后中医证候积分、血清炎性因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、血沉(ESR)]、NF-κB信号通路相关蛋白、疼痛视觉模拟评分法(VAS)评分、关节活动度变化情况。结果治疗组、对照组治疗总有效率分别为93.33%、90.00%,高于空白组的70.00%,差异有统计学意义(P<0.05);治疗组疼痛、红肿、压痛、关节活动受限症状改善的时间短于对照组、空白组,差异有统计学意义(P<0.05);治疗7 d后,治疗组中医证候积分低于对照组、空白组,治疗组、对照组血清CRP、TNF-α、ESR水平和NF-κB信号通路相关蛋白P50、P65表达低于空白组,差异有统计学意义(P<0.05);治疗组治疗7 d后VAS评分低于对照组、空白组,且治疗组用药舒适度评分高于对照组,差异有统计学意义(P<0.05);3组不良反应发生率比较,差异无统计学意义(P>0.05)。结论乌蔹莓水凝胶对痛风性关节炎的治疗效果优于乌蔹莓膏,其作用机制可能与调控NF-κB通路、抑制炎性因子表达有关,且水凝胶使用方便卫生,舒适性高,有望成为安全、有效、便捷的痛风性关节炎外敷中药。

复方红藤糖浆联合抗菌药物治疗盆腔炎性疾病的效果

目的探讨复方红藤糖浆联合抗菌药物治疗盆腔炎性疾病(PID)患者的效果及安全性。方法选取2018年1月至2021年12月安徽中医药大学第一附属医院妇科收治入院的60例PID患者为研究对象,按随机数字表法分为研究组和对照组,各30例。2组采用盐酸头孢替安联合奥硝唑氯化钠注射液静脉输注治疗,研究组同时予复方红藤糖浆口服,2组均治疗1周。比较2组患者临床疗效、疼痛视觉模拟评分(VAS)、盆腔痛客观体征(McCormack)评分、下腹疼痛、腰骶疼痛、带下异常、乏力中医症候积分、白细胞计数(WBC)、超敏C反应蛋白(hs-CRP)、白细胞介素(IL)-10、肿瘤坏死因子(TNF)-α。结果治疗后,研究组及对照组的总有效率分别为93.33%及73.33%;研究组总有效率高于对照组,差异有统计学意义(P<0.05)。与治疗前相比较,2组治疗后VAS评分、McCormack评分、下腹疼痛积分、腰骶疼痛积分、带下异常积分、乏力积分、WBC、hs-CRP、TNF-α降低,IL-10升高(P均<0.01)。与对照组治疗后相比较,研究组治疗后VAS评分、McCormack评分、下腹疼痛积分、腰骶疼痛积分、带下异常积分、乏力积分、WBC、hs-CRP、TNF-α降低,IL-10升高(P均<0.05)。结论复方红藤糖浆联合抗菌药物可改善湿热蕴结证盆腔炎患者临床症状,疗效明显。

岭南地区亚健康人群睡眠状况与中医体质类型的相关性研究

【目的】探究岭南地区亚健康人群睡眠状况与中医体质类型的相关性。【方法】选取2022年5月~2023年5月于深圳市宝安区中医院治未病中心就诊的688例在深圳市居住5年以上,无严重心血管疾病,经亚健康人群评定量表评定为亚健康的人群为研究对象,采用匹兹堡睡眠质量指数(PSQI)量表、中医体质评定量表对其进行问卷调查,并将其睡眠状况与中医体质类型进行多元线性回归分析。【结果】(1)调查问卷发放回收情况:共发放688份问卷,其中,失访19份,回收669份,剔除无效问卷29份,最终共纳入有效问卷640份。(2)不同睡眠状况人群的PSQI量表评分情况:根据PSQI量表得分情况将人群分为睡眠优组(PSQI总分<8分)350例和睡眠差组(PSQI总分≥8分)290例,组间比较,睡眠优组的入睡时间、睡眠时间、睡眠障碍得分以及总分均明显低于睡眠差组(P<0.05或P<0.01)。(3)不同睡眠状况人群的中医体质类别分布情况:睡眠优者多表现为平和质(86.86%),睡眠差者多表现为偏颇体质(79.64%)。睡眠差人群中,偏颇体质排前3位的分别是湿热质(15.52%)、痰湿质(13.79%)以及气郁质(13.10%)。(4)多元线性回归分析结果显示,入睡时间与痰湿质、气郁质呈正相关(P<0.01),与平和质呈负相关(P<0.05);睡眠效率与湿热质、特禀质呈正相关(P<0.05或P<0.01),与平和质呈负相关(P<0.05);睡眠障碍与气郁质、阴虚质呈正相关(P<0.01);催眠药物与阴虚质呈正相关(P<0.01);日间功能障碍与痰湿质呈正相关(P<0.05)。【结论】岭南地区亚健康人群睡眠状况与其中医体质类型具有一定相关性,湿热质、痰湿质、气郁质、阴虚质、平和质、特禀质是影响睡眠状况主要的6种中医体质类别;结合中医体质辨识指导亚健康人群通过改善其体质从而达到未病先防的目的是很有意义的。

冬柏通淋合剂治疗慢性前列腺炎的临床观察

目的:评估冬柏通淋合剂治疗湿热下注型慢性前列腺炎(CP)的有效性。方法:选择76例湿热下注型CP患者随机分为2组,每组各38例。对照组口服前列泰片,治疗组口服冬柏通淋合剂,共治疗8周。分别在基线(治疗前)和第8周(治疗结束)后进行美国国立卫生研究院慢性前列腺炎症状评分(NIH-CPSI)和中医证候评分,并检测前列腺按摩液实验室指标。结果:治疗后两组NIH-CPSI总评分均较治疗前降低(P<0.05),且治疗组降低程度优于对照组(P<0.05)。其中,两组对排尿症状评分、疼痛和不适评分、生活质量评分均较治疗前降低(P<0.05),且治疗组改善情况均优于对照组(P<0.05)。两组前列腺中医证候评分均较治疗前显著降低(P<0.05),治疗组降低程度优于对照组(P<0.05),在改善尿不尽、少腹疼痛、会阴疼痛、阴囊潮湿方面尤为明显(P<0.05)。两组前列腺按摩液实验室指标中,白细胞(WBC)计数均较治疗前下降(P<0.05),卵磷脂小体(SPL)均较治疗前升高(P<0.05),治疗组对SPL的改善效果优于对照组(P<0.05)。治疗组总体有效率(88.89%)高于对照组(70.27%)(P<0.05)。结论:冬柏通淋合剂能有效治疗湿热下注型CP,可为临床应用提供参考。

柏薏灌肠液联合丹白颗粒治疗盆腔炎性疾病后遗症(湿热瘀结证)的临床研究

目的:探讨柏薏灌肠液联合丹白颗粒治疗盆腔炎性疾病后遗症(湿热瘀结证)的临床疗效。方法:选取2021年3月至2023年3月该院收治的盆腔炎性疾病后遗症(湿热瘀结证)患者90例,采用随机数字表法分为中药灌肠组、中药颗粒组和联合组,每组30例。中药灌肠组患者采用常规治疗+柏薏灌肠液,中药颗粒组患者采用常规治疗+丹白颗粒,联合组患者采用常规治疗+柏薏灌肠液+丹白颗粒。治疗3个月经周期后,评估三组患者的临床疗效、中医证候积分、血流动力学、炎症因子和治疗安全性。结果:联合组患者的总有效率为93.33%(28/30),高于中药灌肠组、中药颗粒组的70.00%(21/30)、66.67%(20/30),差异均有统计学意义(P<0.05)。治疗后,联合组患者中医证候积分(包括腰骶胀痛、经行不畅、带下增多和舌红苔黄积分)低于中药灌肠组、中药颗粒组,差异均有统计学意义(P<0.05)。治疗后,联合组患者子宫动脉收缩期最大流速、舒张末期最大流速和搏动指数高于中药灌肠组、中药颗粒组,阻力指数低于中药灌肠组、中药颗粒组,差异均有统计学意义(P<0.05)。治疗后,联合组患者炎症因子[白细胞介素18、前列腺素E2和β淀粉样前体蛋白]水平低于中药灌肠组、中药颗粒组,差异均有统计学意义(P<0.05)。联合组、中药灌肠组和中药颗粒组患者的不良反应发生率分别为13.33%(4/30)、10.00%(3/30)和6.67%(2/30),组间差异无统计学意义(P>0.05)。结论:柏薏灌肠液联合丹白颗粒治疗盆腔炎性疾病后遗症(湿热瘀结证)的效果良好,可改善患者中医证候,提高盆腔子宫动脉血流动力学,抑制炎症因子水平,安全性良好。

皮肤病血毒丸治疗寻常痤疮湿热夹毒证的临床观察

目的观察皮肤病血毒丸治疗寻常痤疮湿热夹毒证的临床疗效与安全性。方法采用自身前后对照,对120例中度寻常痤疮患者给予皮肤病血毒丸单药治疗4周,疗程结束后随访4周,比较治疗前后患者皮损程度、生活质量的变化及不良反应等。结果治疗4周后,患者痤疮综合分级系统(GAGS)、皮肤病生活质量评分(DLQI)、研究者整体评估(IGA)、Cardiff痤疮伤残指数(CADI)、中医证候评分均较基线降低(P<0.001);疗程结束后随访第4周患者GAGS、DLQI、IGA、CADI、中医证候评分持续降低,相比基线差异有统计学意义(P<0.001)。研究过程中未发生不良反应。结论皮肤病血毒丸治疗寻常痤疮湿热夹毒证疗效确切,安全性较好。

鸡湿热泄泻病证模型的建立

中兽医病证模型是评价药效及研究中兽药作用机制的有效工具。为了建立鸡湿热泄泻病证模型,本研究以SPF雏鸡为试验动物,分别选取大肠杆菌CVCC1558标准株和09-29分离株,采用胸部肌内注射、口腔灌服、泄殖腔灌注3种不同方式,选择不同感染剂量,进行大肠杆菌人工感染试验,观察各组鸡临床症状,进行体温、病理剖检、十二指肠黏膜组织病理学、血细胞计数等多项检查。结果显示,采用不同的感染方法,试验鸡表现出不同的临床表现和病理变化。与空白对照组相比,口腔灌服09-29菌株试验组无任何症状出现,其他各组鸡群均表现出不同程度的病症,其中口腔灌服或泄殖腔灌注大肠杆菌CVCC1558菌株2个组试验鸡表现为排黄绿色稀粪,体温升高,剖检表现为典型卡他性或出血性肠炎变化,无心包炎、肝周炎、气囊炎病变,白细胞数增多,十二指肠黏膜肠绒毛上皮细胞脱落,无病鸡死亡,从病因、症状、病机等方面进行辨证分析,完全符合中兽医湿热泄泻的特征。采用肌内注射感染方式的3个组试验鸡虽然也出现排黄色稀粪、肠炎等湿热泄泻的表现,但发病鸡更多表现为精神极度沉郁以及心包炎、肝周炎、气囊炎等全身败血症变化,死亡率高,全身症状明显,已表现为热入营血,并不符合单纯的湿热泄泻特征。试验表明,采用SPF雏鸡每只口腔灌服大肠杆菌CVCC1558菌株3 mL,或泄殖腔灌注大肠杆菌CVCC1558菌株3 mL,均可成功构建出鸡的湿热泄泻病证模型。该方法建立的病证模型完全符合中兽医湿热泄泻证的病因、病位、病机和证候特点,临床症状明显,剖检特征典型,病程时间长,模型稳定,重复性好,适用于鸡湿热泄泻证的中兽医防治研究。

枯芩与条芩提取物对湿热型溃疡性结肠炎大鼠的药效学比较研究

目的比较枯芩、条芩提取物对湿热型溃疡性结肠炎(UC)大鼠模型的药效学差异。方法50只健康SD大鼠随机分为5组:正常组、模型组、枯芩组、条芩组和美莎拉嗪组,每组10只。采用高脂高糖饲料喂养+高度白酒灌胃+5%葡聚糖硫酸钠(DSS)联合诱导法,建立湿热型UC大鼠模型;各组分别于造模第1天开始灌胃给药,枯芩组、条芩组给药剂量均为5.25 g·kg^(-1)·d^(-1),美沙拉嗪组给药剂量为0.266 g·kg^(-1)·d^(-1),正常组、模型组灌服等体积生理盐水。连续给药28 d。观察大鼠一般情况;评价大鼠体质量变化和疾病活动指数(DAI)评分;称取大鼠结肠质量,量取结肠长度,并计算结肠单位长度质量;进行大鼠结肠组织HE染色和PAS染色,观察大鼠结肠组织病理学变化;Elisa法检测大鼠血清白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)、转化生长因子-β_(1)(TGF-β_(1))炎症因子水平。结果与正常组比较,模型组大鼠的体质量显著降低,结肠长度显著缩短,DAI评分、结肠质量、结肠单位长度质量和血清IL-6、TNF-α、IL-1β水平均显著增加,TGF-β_(1)水平显著降低(P<0.01);结肠组织上皮层发生脱落,边缘散乱,隐窝不清晰,黏膜层有水肿,炎症细胞浸润且入侵黏膜下层,肠腺紊乱。与模型组比较,枯芩组、条芩组、美沙拉嗪组大鼠上述指标和相关症状均有明显改善(P<0.05,P<0.01);与枯芩组比较,条芩组、美沙拉嗪组在增加结肠单位长度质量、降低DAI评分、改善炎症因子水平方面均优于枯芩组(P<0.05或P<0.01)。结论枯芩、条芩提取物对湿热型UC大鼠均有较好的改善作用,且条芩优于枯芩。

清化方治疗湿热蕴结型非酒精性脂肪性肝病临床研究

目的:观察清化方治疗非酒精性脂肪性肝病(NAFLD)的临床疗效。方法:将66例NAFLD患者按随机数字表法分为对照组和观察组各33例,因研究过程中有脱落,对照组、观察组最终完成研究的患者例数分别为30例、32例。两组均给予生活方式干预,观察组在此基础上给予清化方干预。两组均以12周为1个疗程,共治疗2个疗程。观察两组患者干预前、干预12周、干预24周的受控衰减参数(CAP)、血脂代谢指标、肝功能指标、血糖代谢指标及体质量指数(BMI),并评价干预24周的腹部B超疗效和中医证候疗效。结果:①干预12周、24周后,两组CAP较干预前均降低(P<0.05);干预24周后,两组CAP较干预12周均降低(P<0.05)。干预12周、24周后,观察组CAP均低于对照组(P<0.05)。②干预24周后,观察组血清TG水平较干预前及干预12周降低(P<0.05),且低于同时点对照组(P<0.05)。③干预24周后,观察组空腹胰岛素(FINS)水平和HOMA胰岛素抵抗(HOMA-IR)指数较干预前降低(P<0.05),且低于同时点对照组(P<0.05)。④干预12周、24周后,两组BMI较干预前均降低(P<0.05)。干预24周后,观察组BMI较干预12周降低(P<0.05),且低于同时点对照组(P<0.05)。⑤干预24周后,观察组腹部B超疗效和中医证候疗效均优于对照组(P<0.05)。结论:清化方联合生活方式干预有助于改善NAFLD患者肝脏脂肪沉积,并可改善患者中医证候,疗效确切。

枯芩与条芩提取物对湿热型溃疡性结肠炎大鼠肠道菌群的影响及肠黏膜屏障的保护作用机制

目的探讨枯芩、条芩提取物对湿热型溃疡性结肠炎(UC)大鼠肠道菌群的影响及对肠黏膜屏障的保护作用机制。方法50只健康SD大鼠随机分为5组:正常组、模型组、枯芩组、条芩组和美莎拉嗪组,每组10只。采用高脂高糖饲料喂养+高度白酒灌胃+5%葡聚糖硫酸钠(DSS)联合诱导法,建立湿热型UC大鼠模型;各组分别于造模第1天开始灌胃给药,枯芩组、条芩组给药剂量均为5.25 g·kg^(-1)·d^(-1),美沙拉嗪组给药剂量为0.266 g·kg^(-1)·d^(-1),正常组、模型组灌服等体积生理盐水。连续给药28 d。给药结束后,收集大鼠无菌粪便,解剖取大鼠结肠黏膜组织,进行匀浆,Elisa法检测大鼠结肠黏膜白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白介素-1β(IL-1β)炎症因子水平;采用实时荧光定量聚合酶链式反应(qRT-PCR)法检测大鼠结肠组织紧密连接蛋白-1(claudin-1)、黏蛋白2(MUC2)、咬合蛋白(occludin)、闭锁小带蛋白-1(ZO-1)mRNA表达水平;采用16S rDNA测序技术检测大鼠粪便肠道菌群数量及丰度。结果与正常组比较,模型组大鼠结肠黏膜IL-6、TNF-α、IL-1β炎症因子含量均明显上升(P<0.01),Claudin-1、MUC2、Occludin、ZO-1 mRNA表达水平均明显上升(P<0.01);给药28 d后,与模型组比较,各给药组大鼠结肠黏膜IL-6、TNF-α、IL-1β水平均出现显著的降低(P<0.01),Claudin-1、MUC2、Occludin、ZO-1m RNA表达水平均出现不同程度的显著降低(P<0.05或P<0.01);与枯芩组比较,条芩组、美沙拉嗪组在降低IL-6、TNF-α、IL-1β、Claudin-1、Occludin、ZO-1 mRNA表达水平方面均优于枯芩组(P<0.05或P<0.01),对MUC2指标改善不明显,以美沙拉嗪组药效最好。肠道菌群测序结果显示,湿热型UC模型组大鼠肠道菌物种多样性及丰度降低,厚壁杆菌门(firmicutes)、拟杆菌门(bacteroidota)相对丰度明显减少(P<0.05),变形菌门(proteobacteria)相对丰度显著增加(P<0.05),枯芩组、条芩组对厚壁杆菌门、拟杆菌门明显增多(P<0.05),变形菌门明显减少(P<0.05),美沙拉嗪组调节菌群作用不明显(P>0.05)。枯芩组和条芩组也有一定的差异性,枯芩组长于增加厚壁菌门,条芩组长于增加拟杆菌门。结论枯芩、条芩可能通过回调失衡的肠道菌群,保护肠道黏膜屏障受损,抑制炎症反应,从而发挥治疗湿热型UC的作用。

白头翁汤合益脾祛湿理肠汤加减对大肠湿热型溃疡性结肠炎患者的临床疗效

目的:探讨大肠湿热型溃疡性结肠炎(UC)患者给予白头翁汤合益脾祛湿理肠汤加减的临床疗效。方法:选取2022年3月—2023年2月江西中医药大学附属医院收治的大肠湿热型UC患者共计86例,以随机数字表法分成研究组(43例)与对照组(43例),对照组给予白头翁汤治疗,研究组给予白头翁汤合益脾祛湿理肠汤加减治疗,两组均治疗6周。比较两组临床疗效、肠黏膜屏障功能、炎症因子水平及不良反应。结果:研究组治疗总有效率(90.70%)较对照组(74.42%)更高,差异有统计学意义(P<0.05);两组治疗后D-乳酸(D-LA)、内毒素(BT)、二胺氧化酶(DAO)水平均降低,研究组均较对照组更低,差异均有统计学意义(P<0.05);两组治疗后白细胞介素-17(IL-17)、白细胞介素-23(IL-23)水平均降低,研究组均较对照组更低,差异均有统计学意义(P<0.05);研究组不良反应发生率(6.98%)与对照组(2.33%)比较差异无统计学意义(P>0.05)。结论:大肠湿热型UC患者给予白头翁汤合益脾祛湿理肠汤加减治疗,能够提升临床效果,改善患者肠黏膜屏障功能、炎症因子水平,安全性较高。

葛根芩连汤通过IRS-1/PI3K/AKT通路对胃肠湿热型2型糖尿病大鼠糖脂代谢的影响

目的探究葛根芩连汤通过胰岛素受体底物-1(IRS-1)/磷脂酰肌醇3激酶(PI3K)/蛋白激酶B(AKT)通路对胃肠湿热型2型糖尿病大鼠糖脂代谢的影响。方法将40只SD大鼠随机分为正常组(2 mL生理盐水灌胃)、造模组(2 mL生理盐水灌胃)、二甲双胍组(4.17 mg/100 g二甲双胍灌胃)和葛根芩连汤组(1 g/100 g葛根芩连汤灌胃),每组10只。采用高脂高糖饲料加腹腔注射链脲佐菌素(STZ)构建2型糖尿病大鼠模型,随后喂食油脂、42°白酒及蜂蜜水构建胃肠湿热型2型糖尿病大鼠模型。测量各组大鼠不同时间节点体质量,血糖仪测定空腹血糖(FBG);ELISA检测空腹胰岛素(FINS)、三酰甘油(TG)、总胆固醇(TC)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平变化、计算胰岛素抵抗指数(HOMA-IR);HE染色检测肝组织病理学变化;检测肝组织过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)及丙二醛(MDA)含量变化。Western blot检测肝组织IRS-1、PI3K、p-PI3K、AKT及p-AKT蛋白变化。结果与正常组比较,造模组大鼠体质量、FBG、FINS及HOMA-IR、GSH-Px、CAT、SOD、IRS-1、p-PI3K/PI3K及p-AKT/AKT水平均明显下降(P<0.05)、TG、TC、IL-6、TNF-α及MDA含量均显著升高(P<0.05),可见局灶性肝实质损失。与造模组比较,二甲双胍组及葛根芩连汤组大鼠体质量、FBG、FINS及HOMA-IR、GSH-Px、CAT、SOD、IRS-1、p-PI3K/PI3K及p-AKT/AKT水平均明显升高(P<0.05)、TG、TC、IL-6、TNF-α及MDA含量均显著降低(P<0.05),显示正常的肝实质。结论葛根芩连汤可明显改善胃肠湿热型2型糖尿病糖脂紊乱,可能是通过IRS-1/PI3K/AKT通路发挥作用。