Rat model for study of the essence of spleen deficiency and dampness in Chinese medicine

Objective:To explore the essence of spleen deficiency and dampness in Chinese medicine by successfully constructing a rat model with this syndrome.Methods:Rat models with the syndrome of dampness and spleen deficiency were established with the use of a high-fat,low-protein diet and excessive fatigue induced by loaded swimming.A total of 25 common clinical serological markers were tested.The T test,rank test,and partial least squares regression-discriminant analysis were used to analyze the data.Results:Total protein,albumin,motilin,interferon-γ,interleukin-2,immunoglobulin A,immunoglobulin G,and complement 3 levels in the model rats were lower than those in the control group(P=0.029,P=0.032,P<0.001,P<0.001,P<0.001,P<0.001,P<0.001,P<0.001,respectively).The serum creatinine,total cholesterol,aldosterone,antidiuretic hormone,gastrin,interleukin-4,somatostatin,atrial natriuretic peptide,and vasoactive intestinal peptide levels in the model group were higher than those in the control group(P<0.001,P=0.015,P<0.001,P<0.001,P<0.001,P<0.001,P<0.001,P<0.001,P<0.001,respectively).There was no statistical difference between the two groups in aspartate transaminase,alanine aminotransferase,globulin,albumin/globulin,blood urea nitrogen,high-density lipoprotein,and low-density lipoprotein.The model animal syndrome used two important variables in analysis with partial least squares regression-discriminant analysis.At the same time,the two dimensions were difficult to distinguish for each biological index.Conclusion:Spleen deficiency is often associated with dampness.The index that represents spleen deficiency can also represent dampness.Cytokines,immunoglobulins,and gastrointestinal hormones play a major causative role in both spleen deficiency and dampness.

Rat Models of Fatty Liver due to Liver Depression and Spleen Deficiency

[Objectives] To establish animal models of fatty liver due to liver depression and spleen deficiency that were suitable for activity discovery of traditional Chinese medicine( TCM) compounds,efficacy evaluation,new drug research and development and correspondence between prescription and syndrome of TCM. [Methods] A syndrome score scale that was suitable for evaluating the rat models was established according to the evolvement rules of etiology and pathogenesis of TCM and the modern clinical pathological mechanism. At the same time,bifendate pills and Sanqi Zhigan pills were selected as drug counterevidence for the models. Rats in model groups were given different proportions of high-fat and low-protein fodder and different concentrations of alcohol every day,and intraperitoneally injected with porcine serum twice a week. Drug groups were given with bifendate pills and Sanqi Zhigan pills( 8. 1 mg/kg,and 2. 7 g/kg) respectively for 14 consecutive days.During the experiment,general status,weight,daily fodder intake and daily water intake of the animals were observed,and TCM syndromes were scored. After the experiment,the levels of alanine aminotransferase( ALT),aspartate aminotransferase( AST),γ-glutamine transpeptidase( γ-GT),total cholesterol( TC),triglycerides( TG),low density lipoprotein-cholesterol( LDL-C),and high density lipoprotein-cholesterol( HDL-C) in serum were detected,and the pathological changes in liver tissue were observed. [Results] Compared with the control group,body weight,daily fodder and water intake of rats increased slowly in the model group,and the levels of ALT,AST,γ-GT,TC,TG and LDL-C increased significantly,while the level of HDL-C dropped. Pathological examination showed that steatosis and fat granule were observed in hepatocytes of rats in the model group. Behavioral observation found that main symptoms and minor symptoms of rats in the model group conformed to the syndrome manifestation of liver depression and spleen deficiency,which suggested that the three model groups were established successfully. Among them,three rats died in model group 1,and one rat died in model group 2. The manifestation of all the above lesions can be alleviated by drug counterevidence. [Conclusions]The animal model of fatty liver due to liver depression and spleen deficiency shows an obviously lower mortality and shorter duration and can be used for research of correlation between prescription and syndrome and its mechanism.

Effects of Different Processed Products of Radix Codonopsis on Intestinal Flora of Rats with Spleen Deficiency

[Objectives]This study aimed to observe the effects of different processed products of Radix Codonopsis on intestinal flora in rats with spleen deficiency.[Methods]Rat models with spleen deficiency were established by bitter-cold purgation method with Radix et Rhizoma Rhei.Normal group,model group,Radix Codonopsis group,fried Radix Codonopsis group,rice-fried Radix Codonopsis group,honey-fried Radix Codonopsis group and bran-fired Radix Codonopsis group were designed.After subjecting to corresponding treatments,the changes in the quantity of intestinal microorganisms of the rats were detected.[Results]There was no significant change in the quantity of intestinal microorganisms of the rats in the normal group and model group.The rats in the rice-fried Radix Codonopsis group were administered after successful modeling,and the abundance of Bifidobacterium and Lactobacillus in the intestines of the rats increased,and the quantity of Escherichia coli and Staphylococci reduced.The rats in the Radix Codonopsis group,fried Radix Codonopsis groups,honey-fried Radix Codonopsis group and bran-fried Radix Codonopsis group were administered after successful modeling,and the abundance of Bifidobacterium and Lactobacillus in the intestines of the rats increased(the increases were smaller than those in the rice-fried Radix Codonopsis group),and the abundance of E.coli and Staphylococci reduced,close to normal levels.[Conclusions]Different processed products of Radix Codonopsis have obvious regulation effect on intestinal flora of rats with spleen deficiency,and the regulation effect of rice-fried Radix Codonopsis on rats with spleen deficiency is better than that of Radix Codonopsis,fried Radix Codonopsis,honey-fried Radix Codonopsis and bran-fried Radix Codonopsis.

Guipi decoction effects on brain somatostatin levels and receptor mRNA expression in rats with spleen deficiency

BACKGROUND： Somatostatin is abundant in the hypothalamus, cerebral cortex, limbic system, and mesencephalon. Somatostatin mRNA expression in the brain of rats with spleen deficiency is noticeably reduced, as well as attenuation of cognitive function. OBJECTIVE： To observe the interventional effect of Guipi decoction on somatostatin level and somatostatin receptor 1 （SSTRl） mRNA expression in different encephalic regions of rats with spleen deficiency, and to compare the interventional effects of Guipi decoction, Chaihu Shugan powder, and Tianwang Buxin pellet. DESIGN： A randomized controlled observation. SETTING： Basic Medical College, Beijing University of Traditional Chinese Medicine. MATERIALS： Fifty adult Wistar male rats, of clean grade, weighing （160 ± 10） g, were provided by Beijing Weitong Lihua Laboratory Animal Technology Co., Ltd. The protocol was performed in accordance with ethical guidelines for the use and care of animals. Somatostatin 1 polyclonal anti-rabbit antibody and SSTRl in situ hybridization kit were provided by Department of Neuroanatomy, Shanghai Second Military Medical University of Chinese PLA. The drug for developing rat models of spleen deficiency was composed of Dahuang, Houpu and Zhishi, and prepared at 2：1：1. Guipi decoction, Chaihu Shugan powder, and Tianwang Buxin pellet recipes were made according to previous studies. METHODS： This study was performed at the Basic Medical College, Beijing University of Traditional Chinese Medicine from March 2002 to March 2005. The rats were randomly divided into 5 groups, with 10 rats in each group： normal, model, Guipi decoction, Chaihu Shugan powd.er, and Tianwang Buxin pellet groups. Rat models of the latter 4 groups were developed by methods of purgation with bitter and cold nature drugs, improper diet, and overstrain. The rats received 7.5 g/kg of the drugs each morning and were fasted every other day, but were allowed free access to water at all times. The rats were forced to swim in 25 ℃ water until fatigued. Rats in the normal group were intragastrically administered the same amount of normal saline. Rats in the Guipi decoction, Chaihu Shugan powder, and Tianwang Buxin pellet groups were intragastrically administered 7.5 g/kg Guipi decoction, Chaihu Shugan powder, and Tianwang Buxin pellet, respectively, every afternoon. All rats were treated for 6 weeks. MAIN OUTCOME MEASURES： Somatostatin protein and SSTRI mRNA expression in the ventral nucleus of hypothalamus, hippocampal CAl region, and cortex of prefrontal lobe were determined by immunohistochemistry and in situ hybridization, respectively. RESULTS： Fifty rats were included in the final analysis. In the model group, expression of somatostatin protein and SSTRl mRNA in the ventral nucleus of hypothalamus, hippocampal CAl region, and cortex of prefrontal lobe were significantly less than in the normal group （P 〈 0.01）. Above-mentioned indices were identical in the Chaihu Shugan powder and model groups. However, expression of somatostatin protein and SSTRl mRNA were significantly higher in the Guipi decoction group compared to model group （P 〈 0.01）. In the Tianwang Buxin pellet group, SSTRl mRNA expression in rat ventral nucleus of hypothalamus and somatostatin level in rat hippocampal CAl region and cortex of prefrontal lobe, as well as ventral nucleus of hypothalamus, were significantly higher compared to model group （P 〈 0.01 ）. CONCLUSION： Somatostatin level and SSTRl mRNA expression in rats with spleen deficiency were lower than in normal rats. Guipi decoction and Tianwang Buxin pellet up-regulated somatostatin level and SSTRl mRNA expression.

Study of establishing disease-syndrome combined with animal model for immune thrombocytopenic purpura without additional conditions

Objective:To explore the feasibility of establishing the disease-syndrome combined animal model for immune thrombocytopenic purpura(ITP)without additional conditions.Methods:Three batches of data related to the ITP model mice obtained by replication at different time were analyzed,and whether the APS-injected model mice replicated through the passive immune modeling method could simulate the pathogenesis and clinical characteristics of human ITP was evaluated according to the differentiation criteria for diseasesyndrome combined model.Results:The APS-injected replicated ITP model mice possessed the following traits:(1)Compared with the normal group,the platelet count was significantly decreased,and coagulation time was significantly increased in the model group(P<.01).(2)Compared with the normal group,the medullary thrombocytogenous megakaryocytes were significantly decreased(P<.05,.01,.001).(3)The APS-injected sites and other parts of the model mice had spontaneous hemorrhage.(4)Behavioral changing signs were observed 1 week after the modeling(i.e.low activity,delayed activity,poor appetite,skin petechia/hemorrhage and spontaneous hemorrhage at the injected sites or other parts),and were getting more and more severe.Conclusion:According to the syndrome differentiation criteria for disease-syndrome combined model of ITP,the APS-injected animal model of ITP replicated through the passive immune modeling method without additional conditions possesses the characteristics of disease-syndrome combined model.It provides an ideal tool for the development of traditional Chinese medicine pharmacology experiment.

国医大师刘嘉湘从脾肾论治肺癌经验

刘嘉湘教授认为,肺癌病位在肺,亦与脾、肾密切相关。其病机以正气亏虚为本,而脾肾为正虚之关键,治疗时强调“治病必求于本”,创立扶正培本治癌大法,开创了中医药治疗恶性肿瘤的新思路,扶正培本又重在脾肾,同时补虚不忘祛邪,扶正祛邪相辅相成,将扶正培本法贯穿于治疗肺癌的始终。

七味白术散治疗老年肺炎肺脾气虚证的疗效及对胃肠功能的影响

目的 观察七味白术散对老年肺炎肺脾气虚证的疗效及对胃肠功能的影响。方法 将60例老年肺炎肺脾气虚证患者按照随机数字表法分为2组,对照组30例予常规基础治疗,治疗组30例在对照组治疗基础上予七味白术散加减治疗。2组均治疗2周。比较2组治疗前后中医证候评分、外周血炎症因子[白细胞介素6(IL-6)、白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)]水平、胃肠功能指标(腹内压、肠鸣音次数)及肠道菌群情况,并统计2组疗效及安全性。结果 治疗组总有效率93.33%(28/30),对照组总有效率73.33%(22/30),治疗组临床疗效优于对照组(P<0.05)。2组治疗后中医证候各项评分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后IL-6、WBC、CRP、PCT水平均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后腹内压均较本组治疗前降低(P<0.05),肠鸣音次数均增加(P<0.05),且治疗组治疗后腹内压低于对照组(P<0.05),肠鸣音次数高于对照组(P<0.05)。2组治疗后肠道乳酸杆菌、双歧杆菌菌落数均较本组治疗前增加(P<0.05),肠球菌、肠杆菌菌落数均降低(P<0.05),且治疗组治疗后乳酸杆菌、双歧杆菌菌落数均高于对照组(P<0.05),肠球菌、肠杆菌菌落数均低于对照组(P<0.05)。2组治疗期间未出现肝肾功能异常。结论 七味白术散治疗老年肺炎肺脾气虚证疗效显著,可有效降低炎症因子水平,调节肠道菌群,改善胃肠功能,安全性高。

参苓白术散加减治疗肺脾气虚津亏干燥综合征疗效及对Toll样受体4/核因子-κB水平的影响

目的探究参苓白术散加减治疗肺脾气虚津亏干燥综合征的疗效及对血清Toll样受体4(TLR4)和核因子-κB(NF-κB)水平的影响。方法选取2019年3月—2022年3月收治的107例干燥综合征患者为研究对象,采用信封法从密封箱子抽取带有数字的纸团,大于等于54的号码为观察组,小于54的号码为对照组。观察组54例,对照组53例。对照组给予硫酸羟氯喹片、甲泼尼龙片治疗,观察组在此基础上联合使用参苓白术散加减治疗。观察两组患者治疗前后中医证候评分、疾病活动指数(ESSDAI)和自我报告指数(ESSPRI)评分、γ-干扰素(IFN-γ)、白介素-17(IL-17)、免疫功能(CD_(8)^(+)、CD_(4)^(+)和CD^(+)_(4/)CD_(8)^(+))、血清TLR4和NF-κB水平。观察两组患者临床疗效。结果治疗前两组患者两目干涩、关节疼痛、口燥咽干、皮肤干燥、体倦乏力和唾液腺肿评分差异无统计学意义(P>0.05)。治疗后观察组两目干涩、关节疼痛、口燥咽干、皮肤干燥、体倦乏力和唾液腺肿评分显著低于对照组(P<0.05)。治疗前两组患者ESSDAI和ES⁃SPRI评分差异无统计学意义(P>0.05)。治疗后观察组ESSDAI和ESSPRI评分显著低于对照组(P<0.05)。治疗前两组患者IFN-γ、IL-17水平差异无统计学意义(P>0.05)。治疗后观察组IFN-γ、IL-17水平显著低于对照组(P<0.05)。两组患者治疗前CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD^(+)8水平差异无统计学意义(P>0.05)。治疗后观察组的CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平较对照组显著升高,而CD^(+)8水平较对照组显著降低(P<0.05)。两组患者治疗前TLR4/NF-κB水平差异无统计学意义(P>0.05)。治疗后观察组TLR4/NF-κB水平较对照组显著降低(P<0.05)。观察组总有效率为96.30%(52/54),显著高于对照组的84.91%(45/53)(χ^(2)=4.096,P=0.043)。结论参苓白术散加减能有效提高干燥综合征患者临床疗效、降低ESSDAI和ESSPRI评分、改善TLR4/NF-κB的水平,有利于提高患者免疫力。

自噬相关基因在HIV/AIDS肺脾气虚证中的表达及意义

目的探讨自噬相关基因在人类免疫缺陷病毒(human immunodeficiency virus,HIV)/艾滋病(acquired immune deficiency syndrome,AIDS)肺脾气虚证中的表达及意义。方法选取河南驻马店市20例HIV/AIDS肺脾气虚证患者作为研究对象,同地区20例健康人为对照,HIV/AIDS肺脾气虚证患者用益艾康胶囊进行干预治疗。采用基因芯片技术,检测分析两组人群外周血单个核细胞(peripheral blood mononuclear cell,PBMC)中自噬相关基因的表达。结果HIV/AIDS肺脾气虚证组患者中DDIT4、IRS2、CXCR4表达下调,PDPK1表达上调,经益艾康治疗后差异基因发生转归,差异有统计学意义(P<0.05)。应用KEGG分析发现DDIT4、CXCR4、PDPK1、IRS2与磷脂酰肌醇3-激酶/蛋白激酶B/哺乳动物雷帕霉素靶蛋白(phosphoinositide 3-kinase/protein kinase B/mammalian target of rapamycin,PI3K/PKB,又称Akt/mTOR)信号通路相关。结论HIV/AIDS肺脾气虚证人群中自噬相关基因差异表达,益艾康可能通过调节DDIT4、CXCR4、IRS2的表达影响HIV/AIDS肺脾气虚证患者的自噬过程。

线粒体功能障碍及其影响因素在不同脏腑虚损哮喘患者中的变化趋势分析

【目的】通过对不同脏腑虚损哮喘患者线粒体功能及其相关受损因素的分析,探寻不同脏腑虚损哮喘患者的病例特征,并通过对不同脏腑虚损组哮喘患者的线粒体功能变化及影响因素的差异性分析,试图发现不同脏腑虚损哮喘患者DDAH1/L-Arg/ADMA通路以及线粒体功能、氧代谢的变化趋势及规律。【方法】选取符合纳入标准的支气管哮喘急性发作期患者共122例,对入组患者进行临床资料采集,按脏腑虚损辨证分型标准分为肺气虚组47例、肺脾气虚组39例、肺脾肾虚组36例;并于同期选取正常对照组44例。观察不同脏腑虚损哮喘患者的第1秒用力呼气量(FEV1)、第1秒用力呼气量与用力肺活量的比值(FEV1/FVC)、呼气峰值流速(PEF)等肺功能指标和病情严重程度情况;同时,抽取患者静脉血,采用高效液相联合质谱法(HPLC-MS/MS)检测左旋精氨酸(L-Arg)及不对称二甲基精氨酸(ADMA)水平,采用酶联免疫吸附法(ELASA)检测蛋白精氨酸甲基转移酶1(PRMT1)、二甲基精氨酸二甲氨基水解酶1(DDAH1)等精氨酸代谢相关指标及活性氧自由基(ROS)、硫代巴比妥酸反应产物(TBARS)、8-异前列腺素(8-Iso)、过氧化脂质(LPO)、丙二醛(MDA)等氧化损伤标记物水平;提取哮喘患者及正常对照组的血小板及线粒体,JC-1流式细胞法测定血小板线粒体膜电位(MMP)、三磷酸腺苷(ATP)和细胞色素C氧化酶(COX)的活性,以此评估线粒体功能;分析不同脏腑虚损组哮喘患者的线粒体功能变化及影响因素的差异性,并与正常对照组比较。【结果】(1)不同脏腑虚损哮喘患者的年龄和肺功能(FEV1、FEV1/FVC、PEF)比较,差异均有统计学意义(P<0.01)。表现为肺脾肾虚组的年龄明显高于肺气虚组和肺脾气虚组(P<0.05),以及随脏腑虚损情况的加重,肺功能(FEV1、FEV1/FVC、PEF)呈显著下降趋势(P<0.05)。(2)不同脏腑虚损患者的病情严重程度分布比较,差异有统计学意义(P<0.01)。其中,肺气虚组以间歇状态(1级)为主(65.96%),其次为轻度哮喘(2级)(25.53%);肺脾气虚组以中度哮喘(3级)为主(41.03%),其次为间歇状态(1级)(30.77%);肺脾肾虚组以重度哮喘(4级)为主(52.78%),其次为中度哮喘(3级)(33.33%)。即随着脏腑虚损情况的加重,哮喘的病情严重程度也表现出随之加重的趋势。(3)不同脏腑虚损组哮喘患者与正常对照组的血浆8-Iso、ROS、LPO、MDA水平比较,差异均有统计学意义(P<0.05)。其中,不同脏腑虚损组哮喘患者的血浆8-Iso、LPO水平和肺脾气虚组、肺脾肾虚组患者的血浆MDA、ROS水平均明显高于正常对照组(P<0.05),且肺脾气虚组、肺脾肾虚组患者的血浆ROS水平均明显高于肺气虚组(P<0.05);而不同脏腑虚损组哮喘患者的血浆TBARS水平有高于正常对照组趋势,但差异无统计学意义(P>0.05)。表明不同脏腑虚损哮喘患者机体内均有活性氧及过氧化脂质类物质的蓄积,且随脏腑虚损情况的加重其水平均呈增高趋势。(4)不同脏腑虚损哮喘患者与正常对照组的MMP、ATP、COX比较,差异均有统计学意义(P<0.05或P<0.01),表现为不同脏腑虚损哮喘患者的MMP、ATP、COX水平均较正常对照组明显降低(P<0.05),且随着脏腑虚损的加重,COX活性有下降趋势。(5)不同脏腑虚损哮喘患者与正常对照组的血浆L-Arg、L-Arg/ADMA、DDAH1水平比较,差异均有统计学意义(P<0.05)。表现为不同脏腑虚损哮喘患者的血浆L-Arg、L-Arg/ADMA、DDAH1水平均较正常对照组明显降低(P<0.05),且随脏腑虚损的加重,上述指标均有逐渐降低的趋势;而不同脏腑虚损哮喘患者与正常对照组的血浆ADMA、PRMT1比较,差异均无统计学意义(P>0.05)。【结论】该研究从机体代谢角度论证了中医脏腑虚损理论对病情变化趋势判断的正确性,证实了哮喘患者的脏腑虚损状况与临床病情进展、氧代谢及其影响因素和机体氧化损伤程度均表现出一致的变化趋势。

HIV/AIDS肺脾气虚证相关心脑血管疾病风险因素探析

目的通过检测血脂四项、血管内皮损伤因子、炎症相关因子,并结合前期的基因芯片结果,初步探讨人类免疫缺陷病毒(HIV)/艾滋病(AIDS)肺脾气虚证相关心脑血管疾病风险因素及机制,为中医药早期干预心脑血管疾病提供依据。方法2020年9月—2020年11月选取河南省某地区确诊的20例HIV/AIDS肺脾气虚证患者作为研究对象,同地区20例HIV抗体阴性作为健康对照组。检测CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)计数,并计算CD_(4)^(+)/CD_(8)^(+)比值;检测血脂四项甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C);检测氧化低密度脂蛋白(Ox-LDL)、载脂蛋白A-I(ApoAⅠ)、载脂蛋白A-Ⅱ(ApoAⅡ)、载脂蛋白B(ApoB)、锌-α2-糖蛋白1(AZGP1)、可溶性血栓调节蛋白(sTM)、血管性血友病因子(vWF)、脂联素、瘦素(LEP)、超敏C反应蛋白(Hs-CRP)、单核细胞趋化因子1(MCP-1)、肿瘤坏死因子α(TNF-α)。结果HIV/AIDS肺脾气虚证患者与健康对照组比较CD_(4)^(+)降低,CD_(4)^(+)/CD_(8)^(+)比值倒置,TC降低,sTM、AZGP1、Ox-LDL、Hs-CRP升高。结论HIV/AIDS肺脾气虚证患者存在炎性反应、血脂异常的表现,罹患心脑血管疾病风险增加。为中医药早期干预心脑血管疾病的发生提供新思路。

通窍鼻炎颗粒治疗中重度持续性变应性鼻炎的临床观察

目的观察通窍鼻炎颗粒治疗中重度持续性变应性鼻炎的有效性和安全性。方法在5家医院招募251例中重度持续性变应性鼻炎患者,随机平行分配至西药组、中成药组及联合治疗组。西药组为氯雷他定联合糠酸莫米松,中成药组为通窍鼻炎颗粒,联合治疗组为西药方案联合中成药方案。观察治疗前后鼻部症状评分(Total Nasal Symptoms Scores,TNSS),眼部症状评分(Total Ocular Symptom Score,TOSS),鼻结膜炎生活质量(Rhinoconjunctivitis Quality of Life Questionnaire,RQLQ),肝肾功能,血清免疫学,前鼻镜评分变化情况,并访视不良反应发生率及24周后变应性鼻炎复发情况。结果各组患者在治疗后TNSS、前鼻镜评分、TOSS、RQLQ以及IL-4、IL-5、IL-13、TGF-β均下降,且有统计学差异(P<0.05)。治疗后总体有效率为80.9%,且3组间无统计学差异(P=0.5552)。治疗后24周复发率,西药组为61.9%,中成药组为45.8%,西药联合中成药组为21.4%,3组间有统计学差异(P<0.01)。总体不良反应发生率6.0%,各组间无统计学差异(P=0.8267)。结论通窍鼻炎颗粒治疗中重度持续性变应性鼻炎疗效显著,安全性高,可改善患者免疫状况并防止复发,值得推广应用。

肺癌研究40年:痰毒理论的构建与益气除痰法的应用

肺癌是我国发病率和死亡率均居第一位的肿瘤。该研究团队在国医大师周岱翰教授指导下,根据近40年的肺癌诊疗经验,认为“痰”为肺癌发病的关键,并结合肺癌的临证特点,进一步提出“痰毒”致病的理论。肺癌为本虚标实之病,肺脾气虚为“痰毒”产生的关键,“痰毒”为肺癌发生发展的关键病机因素,据此凝练出益气除痰的肺癌治疗大法。该研究团队近年来的临床实践表明,益气除痰法治疗中晚期肺癌尤其是老年中晚期肺癌疗效确切,可延长中晚期肺癌患者的生存期、改善肺癌患者的生活质量及肺癌相关症状、增效减毒抗肿瘤治疗、防治早期肺癌等;益气除痰方的抗肿瘤机制与抑制肺癌的转移、调控细胞周期、抑制上皮间质转化、调控细胞凋亡与自噬、改善表皮生长因子受体酪氨酸激酶抑制剂(EGFRTKIs)耐药性等有关。

益元宣肺汤对25例新冠肺炎CT值的影响

目的分析深圳地区2022年新型冠状病毒肺炎患者的舌象、症状及用药史,多辨为三焦壅滞、肺脾肾虚,拟益元宣肺汤,观察其对CT值恢复的临床疗效。方法选取25例符合益元宣肺汤证型者进行治疗观察,选同期对照组25例,观察益元宣肺汤对CT值的影响。结果治疗前对照组的N基因(31.99±1.16)、O基因(33.49±1.94)与治疗组的N基因(31.45±2.85)、O基因(33.40±3.96)比较,差异无统计学意义(P>0.05);对照组治疗到CT值符合出院标准所需时间为(4.28±1.88)d,治疗组为(2.80±1.26)d,差异有统计学意义(P<0.05)。结论治疗组通过服用益元宣肺汤,CT值恢复明显比对照组快,表明以调动肺脾肾之气、疏通三焦气机为主的益元宣肺汤效果明显。扶正补肺脾肾、通宣三焦的治疗方法,在促进病情好转,加快人体清除病毒的速度方面作用明显,利于新型冠状病毒肺炎患者康复。

脾虚泄泻模型大鼠肠组织结构及分泌型免疫球蛋白A含量变化研究

为研究脾虚泄泻大鼠肠道结构和肠道分泌型免疫球蛋白A的变化,试验选取24只健康SD大鼠,雌雄各半,随机分为脾虚泄泻模型组和空白对照组,在不同阶段采用“饮食失调+苦寒泻下”的方法人工复制大鼠脾虚泄泻模型,连续14 d监测大鼠的采食量、饮水量、精神状态、粪便等临床特征变化,记录第7天和第14天时大鼠的空腹体质量,采集小肠组织进行结构观察,并测定盲肠内容物中分泌型免疫球蛋白A的含量。结果表明,与空白对照组相比,模型组大鼠在试验期间出现粪便稀溏、食欲下降、消瘦、蜷缩扎堆、精神萎靡等临床症状;与空白对照组相比,模型组大鼠的体质量显著降低(P<0.05);模型组大鼠十二指肠绒毛高度,空肠隐窝深度、绒毛高度、绒毛宽度,回肠隐窝深度和绒毛宽度均显著低于空白对照组(P<0.05);模型组大鼠十二指肠隐窝深度、绒毛宽度及回肠绒毛高度均极显著低于空白对照组(P<0.01);模型组大鼠小肠不同段的绒毛高度与隐窝深度比值均低于空白对照组,但差异不显著(P>0.05);模型组大鼠盲肠内容物中sIgA含量极显著低于空白对照组(P<0.01)。结果提示,本试验成功建立了脾虚泄泻大鼠模型,脾虚泄泻可损伤大鼠小肠黏膜结构并降低盲肠中sIgA含量。

王有鹏教授治疗寒地儿童荨麻疹的临证经验

王有鹏教授基于对寒地地域特点及小儿生理病理特点认识,立足临床实践,对寒地儿童荨麻疹的诊疗具有独到见解。王有鹏教授从发病邪气、脏腑、体质三个层面总结其病因病机为风邪主导,寒、热、湿邪兼杂为患;肺脾肾三脏虚损,心肝亢盛为本;同时受先天禀赋及体质因素的影响。根据寒地儿童荨麻疹发病特点将其分为风邪袭表证、湿热蕴肤证、肺脾气虚证,治疗以调和脏腑为本,祛除病邪为标,运用合方随证施治,同时兼顾调体养护,防患于未然,可取得较好疗效。

艾灸联合免疫检查点抑制剂与化疗治疗晚期非鳞非小细胞肺癌临床研究

目的:观察艾灸联合免疫检查点抑制剂与化疗治疗肺脾气虚型晚期非鳞非小细胞肺癌的临床疗效。方法:选取62例肺脾气虚型晚期非鳞非小细胞肺癌患者,按照随机数字表法分成对照组与试验组各31例。对照组予免疫检查点抑制剂与化疗治疗,直至疾病进展或发生不可耐受的毒性反应,化疗期间予常规抑酸护胃、止吐、护肝等对症支持治疗。试验组在对照组基础上给予艾灸治疗。比较2组中医证候积分,中医证候疗效,实体瘤疗效,无进展生存时间(PFS),CD3^(+)、CD4^(+)、CD8^(+)T淋巴细胞百分比,CD4^(+)/CD8^(+)值,以及药物不良反应。结果:治疗后,对照组中医证候积分与同组治疗前比较,差异无统计学意义(P>0.05);试验组中医证候分较治疗前降低,且低于对照组(P<0.05)。试验组与对照组中医证候改善率分别为77.42%、41.94%,2组比较,差异有统计学意义(P<0.05)。试验组与对照组肿瘤总缓解率(ORR)分别为58.06%、51.61%,疾病控制率(DCR)分别为83.87%、77.41%,2组ORR、DCR比较,差异均无统计学意义(P>0.05)。试验组PFS长于对照组(Log Rank P<0.05)。治疗方式为影响晚期非鳞非小细胞肺癌PFS的独立因素,与对照组比较,试验组疾病进展风险较低[HR=0.57 (95%CI 0.33~0.99)]。治疗后,试验组CD3^(+)、CD4^(+)T淋巴细胞百分比及CD4^(+)/CD8^(+)值均较治疗前升高,CD8^(+)T淋巴细胞百分比均较治疗前下降,差异均有统计学意义(P<0.05);对照组CD3^(+)、CD8^(+)T淋巴细胞百分比均较治疗前下降,差异均有统计学意义(P<0.05);对照组CD4^(+)T淋巴细胞百分比及CD4^(+)/CD8^(+)值治疗前后比较,差异均无统计学意义(P>0.05);试验组CD3^(+)、CD4^(+)T淋巴细胞百分比及CD4^(+)/CD8^(+)值均高于对照组(P<0.05)。2组白细胞减少、中性粒细胞减少、贫血、血小板减少、肝功能异常、肾功能异常、恶心呕吐、反应性毛细血管增生、乏力、食欲下降、免疫性肺炎总发生率及上述不良反应程度≥3级发生率比较,差异均无统计学意义(P>0.05)。结论:艾灸联合免疫检查点抑制剂与化疗治疗能改善肺脾气虚型晚期非鳞非小细胞肺癌的临床症状,提高其免疫功能和延长PFS。

六君子汤合玉屏风散对肺脾气虚型慢性阻塞性肺疾病稳定期患者免疫功能的影响

目的:探讨六君子汤合玉屏风散对肺脾气虚型慢性阻塞性肺疾病(COPD)稳定期患者免疫功能的影响。方法:选取符合纳入标准的60例证属肺脾气虚型COPD稳定期患者,依据随机数字表随机分为对照组和观察组,每组各30例。对照组根据初始评估给予常规西医基础治疗方案,观察组在对照组治疗基础上加用六君子汤合玉屏风散,两组治疗时间均为4周。比较两组患者治疗前后中医证候积分、六分钟步行试验(6MWT)、改良版英国医学研究委员会呼吸困难量表(mMRC)分级、免疫球蛋白(IgA、IgG、IgM)含量和CD4^(+)、CD8^(+)水平及CD4^(+)/CD8^(+)比值的变化情况,并比较临床疗效。结果:观察组临床总有效率93.33%(28/30)显著高于对照组73.33%(22/30),两组比较差异有统计学意义(P<0.01);治疗后两组患者中医证候积分均较治疗前明显降低(P<0.01),且观察组优于对照组(P<0.01);与治疗前比较,治疗后两组患者6MWT、免疫球蛋白(IgA、IgG、IgM)水平以及CD4^(+)水平、CD4^(+)/CD8^(+)比值均明显升高(P<0.01),mMRC分级、CD8^(+)水平均明显改善(P<0.01,P<0.05),且观察组优于对照组(P<0.05,P<0.01)。结论:六君子汤合玉屏风散可明显改善肺脾气虚型COPD稳定期患者的症状及免疫功能。

Clinical observation on spleen-invigorating and qi-benefiting pediatric massage for treating recurrent respiratory tract infection in children with cerebral palsy due to qi deficiency of spleen and lung

Objective:To observe the clinical efficacy of spleen-invigorating and qi-benefiting pediatric massage(tuina)for treating recurrent respiratory tract infection in children with cerebral palsy due to qi deficiency of spleen and lung.Methods:A total of 70 children with cerebral palsy who suffered from recurrent respiratory tract infection due to qi deficiency of spleen and lung were randomized into an observation group and a control group by the random number table method,with 35 cases in each group.Both groups were treated with conventional rehabilitation training,while the observation group was given additional spleen-invigorating and qi-benefiting pediatric massage,and the control group additionally took oral Yu Ping Feng granule.The clinical efficacy was evaluated by the total effective rate,traditional Chinese medicine(TCM)symptom score,and serum levels of immunoglobulin(Ig)A,IgM and IgG.Results:The difference in total effective rate between the two groups after treatment was statistically significant(P<0.05).After treatment,the TCM symptom scores in both groups decreased to varying degrees than those before treatment,and the intra-group differences were statistically significant(all P<0.01);the differences in the scores of various TCM symptoms between the two groups were statistically significant(all P<0.05).After treatment,the levels of IgA,IgM and IgG of the children in both groups increased to varying degrees,and the intra-group differences were statistically significant(all P<0.05).The between-group differences in the IgA,IgM and IgG levels after treatment were statistically significant(all P<0.05).Conclusion:Spleen-invigorating and qi-benefiting pediatric massage can effectively treat recurrent respiratory tract infection due to qi deficiency of spleen and lung in children with cerebral palsy,relieve the clinical symptoms and improve immune function,and thus is worthy of clinical promotion and application.

温脾消痈散结汤治疗间质性肺疾病脾肾虚冷,瘀毒化痈证

目的观察温脾消痈散结汤治疗间质性肺疾病脾肾虚冷,瘀毒化痈证的临床疗效。方法选择长春中医药大学附属医院疗区就诊的72例间质性肺疾病患者,随机分为治疗组和对照组,各36例。治疗组口服温脾消痈散结汤;对照组口服乙酰半胱氨酸泡腾片,每次600 mg,每日3次。4周后,观察患者临床疗效、症状积分、呼吸困难评分、全肺CT评分,肺功能6 min步行距离。结果治疗组总有效率91.67%,优于对照组总有效率58.33%(P<0.05);2组治疗后主要症状积分、呼吸困难CAT评分、全肺CT评分,肺功能6 min步行距离均较治疗前好转(P<0.05),且治疗组优于对照组(P<0.05)。结论温脾消痈散结汤可用于温脾助阳、消痈散结,有效降低间质性肺疾病病死率、延缓病情进展,提高患者生活质量。