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.

Study on Sustainable Utilization of Resources of the Damp-heat Karst Mountainous Areas in China

Damp-heat karst mountainous areas are unique areas in terms of socialeconomic development, resource endowment and eco-environment in China, where natural resources are abundant,unique and diverse. However, fragile eco-environment, undeveloped economy and culture, and conflict of human and environment should not be ignored. In the research, a framework of integration of resource-development and environment-protection in damp-heat karst was designed on basis of resource and environment integration, which was applied to Daxin County in Guangxi Province. Furthermore, some integration models were proposed, including integration of development of characteristic agricultural resources and protection of eco-environment, integration of development of manganese ore resources and protection of eco-environment, integration of development of tourism resources and protection of ecoenvironment and integration of development of clean energy and protection of eco-environment.

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。

基于湿热证的三仁汤研究进展

湿热证是中医临床常见证型,而湿热也是许多难治性疾病的重要病机,且其患病占比率逐年增加。三仁汤是开上、畅中、渗下的经典方剂,具有宣畅气机、清热利湿的功效,主要症状包括头痛恶寒,身重疼痛,面色淡黄,胸闷不饥等。现代临床将其广泛应用于呼吸、心血管、消化、泌尿等系统疾病,并取得了显著的效果。三仁汤能够明显改善湿热证患者的临床症状,提高生活质量,尤其对一些难治性疾病,可以延缓病情发展,延长生存期。目前基于湿热证的三仁汤作用机制主要包括抗炎、调节免疫功能,调节水通道蛋白表达,调节神经内分泌功能,调节胃肠激素水平和胃黏膜蛋白差异表达,改善糖脂代谢及能量代谢紊乱等。笔者对近年来基于湿热证的三仁汤在临床疗效和实验研究进行整合与梳理,阐述了三仁汤的理论基础、临床与机制研究,为扩展三仁汤的现代临床应用提供理论依据和参考。

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。

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。

国医大师杨春波辨治脾胃湿热证胃肠病经验

杨春波教授为全国第3届国医大师,擅长运用“脾胃湿热”理论诊治胃肠系统疾患。杨老认为,脾胃湿热由内外因素共同作用而成,应从“三因制宜”角度辨识脾胃湿热证胃肠病的个体化病因病机及临床特征。针对脾胃湿热证胃肠病的辨治用药,杨老以清化湿热、调气舒络为总治则,创制“清化饮”为基本方,并结合辨析寒热、分利三焦、顾护正气、扶正防邪等辨治心得立方。作者结合杨老临床验案,阐述杨老辨治脾胃湿热证胃肠病的临证经验,以期对指导临床诊治有所裨益。

补肾强督清化汤联合依那西普治疗肾虚湿热证强直性脊柱炎患者的疗效观察

目的探讨补肾强督清化汤联合依那西普治疗肾虚湿热证强直性脊柱炎的疗效。方法选取2021年2月-2023年2月期间在山东省临沂市中医医院风湿病科就诊的肾虚湿热证强直性脊柱炎患者86例,按随机数字表法分为对照组和治疗组,每组各43例。对照组予依那西普治疗,治疗组在对照组基础上加用补肾强督清化汤。持续用药12周。观察两组患者治疗前后中医证候积分、炎症反应指标[红细胞沉降率(Erythrocyte sedimentation rate,ESR)、血清白细胞介素4(Interleukin-4,IL-4)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、C反应蛋白(C-neactveprotein,CRP)]水平、疾病活动度[Bath功能指数(Bath andylosing spondylitis function index,BASFI)、Bath强直性脊柱炎活动性指数(Bath ankylosing spondylitis metroloty index,BASDAI)],临床疗效及不良反应情况。结果治疗后两组患者中医证候积分均较治疗前明显降低,差异有统计学意义(P<0.05);且治疗组中医证候积分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者ESR、IL-4、TNF-α及CRP水平均较治疗前降低,差异有统计学意义(P<0.05);且治疗组ESR、IL-4、TNF-α及CRP水平明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者BASFI、BASDAI评分均较治疗前降低,差异有统计学意义(P<0.05);且治疗组BASFI、BASDAI评分明显低于对照组,差异有统计学意义(P<0.05)。治疗后治疗组临床总有效率95.35%(41/43)明显高于对照组79.07%(34/43),差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应发生情况比较,差异无统计学意义(P>0.05)。结论补肾强督清化汤联合西药治疗肾虚湿热证强直性脊柱炎能够有效减轻炎症反应,缓解临床症状,其临床疗效确切,且无明显不良反应。

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。

2型糖尿病湿热困脾证合并血脂紊乱胰岛功能变化及其影响因素分析

目的探讨2型糖尿病湿热困脾证合并血脂紊乱患者胰岛功能变化及其影响因素。方法选择2020年1月—2020年12月医院收治的2型糖尿病湿热困脾证患者100例,根据美国ATPIII评估标准将其分为血脂紊乱组62例与血脂正常组38例。比较各组SF-36积分、胰岛素分泌功能(Homeostasis model assessment-β,HOMA-β)、胰岛素抵抗水平(Homeostasis model assessment-IR,HOMA-IR)、胰岛素敏感指数(Insulin sensitivity index,ISI)、空腹C肽和空腹胰岛素。应用单因素和多因素分析法研究血脂异常的相关因素。结果高甘油三酯组与混合型高脂组空腹胰岛素水平显著高于高胆固醇组与血脂正常组,差异有统计学意义(P<0.05)。高甘油三酯组空腹C肽水平显著高于高胆固醇组,差异有统计学意义(P<0.05)。混合型高脂组与高甘油三酯组的ISI水平低于高胆固醇组(P<0.05)。高甘油三酯组HOMA-β水平明显高于高胆固醇组与血脂正常组,差异有统计学意义(P<0.05)。高甘油三酯组及混合型高脂组HOMA-IR水平显著高于高胆固醇组,差异有统计学意义(P<0.05)。两组患者在躯体疼痛、整体健康、活力、社会功能和精神健康维度方面比较,差异有统计学意义(P<0.01)。多因素Logistic分析显示,喜食油腻、吸烟史、腰围和空腹胰岛素是2型糖尿病湿热困脾证患者血脂异常的危险因素,有氧运动是2型糖尿病湿热困脾证患者血脂异常的保护因素(P<0.05)。结论不同血脂紊乱类型对胰岛功能的影响并不相同,应针对相关因素积极预防,降低胰岛分泌负担,促使胰岛功能恢复。

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。

清热利湿方联合美沙拉嗪治疗湿热内蕴证糖尿病肠病临床疗效观察

目的探讨清热利湿方治疗糖尿病肠病疗效及对患者生活质量的影响。方法将48例湿热内蕴证糖尿病肠病患者按随机数字表法分观察组和对照组,每组24例;两组均口服美沙拉嗪肠溶片,观察组加予清热利湿方日2次口服治疗,统计肠炎疾病量表(inflammatory bowel disease questionnaire,IBDQ)评分及相关症状体征。结果观察组与对照组IBDQ评分各分项得分治疗后均高于治疗前,但观察组分数增加较为明显,且观察组在全身症状、肠道症状、情感功能、社会功能、总分等方面得分增加均高于对照组,在全身症状改善方面尤为显著。两组在生活质量量表(the MOS item short from health survey,SF-36)量表中生理机能(physical functioning,PF)、生理职能(role physical,RP)、活力(vitality,VT)、精神健康(mental health,MH)、整体健康(general health,GH)等方面治疗前与治疗后差异有统计学意义(均P<0.05)。观察组总有效率91.67%(22/24),两组间疗效比较差异有统计学意义(P<0.05)。两组病例均耐受良好,未见明显不良反应,1年内复发率观察组低于对照组(均P<0.05)。结论清热利湿方可以有效清热利湿,改善患者病情,是针对糖尿病肠病的一种有效治疗方案,可以提高湿热内蕴证糖尿病肠病患者的治疗有效率,明显提高患者的生活质量,值得临床进一步研究及推广。