External Application of Herbal Medicine to Acupoints

Application of herbal medicine to acupoints is to regulate the meridians, yin-yang, and qi and blood for preventing and treating diseases through the pharmacological action of herbal medicines and with their stimulation to the acupoints. This article explains how to apply herbal medicines and gave the examples for the treatment of hypertension, asthma, chronic bronchitis and allergic rhinitis. Application of herbal medicines to acupoints is one of the important components of TCM, which shows satisfactory effects in treatment of some chronic diseases.

Application of external treatment of traditional Chinese medicine in the treatment of cancer-related fatigue

External treatment of traditional Chinese medicine(TCM),also known as external treatment of internal diseases,has many advantages,such as simple,easy to operate,cost-effective and so on.Therefore,external treatment of TCM is favored by the majority of medical workers.By consulting the domestic literature reports on the treatment of cancer-related fatigue(CRF),it is found that the external treatment of TCM has a significant effect on the intervention of CRF,and has a good effect on reducing fatigue,improving the quality of life and prolonging the survival time.The purpose of this paper is to summarize the application of several external treatments in this disease,and to provide a variety of references for clinical treatment of CRF.

Recent advances in network pharmacology applications in Chinese herbal medicine

Network pharmacology is a new discipline based on the theory of systems biology and network analysis of biological systems to design the drugs.It comprehensively observes the intervention and influence of drugs on the disease network,and reveals the mystery of multi-molecular drugs synergistically acting on disease.These concepts reflect the ideas of multi-component,multi-target and system regulation,and have many similarities with the research ideas of traditional Chinese medicine,which focuses on syndrome differentiation and treatment,emphasizes the overall understanding of the etiology and pathogenesis.Network pharmacology can be used to predict and identify the target and active component of traditional herbal medicine,to clarify the mechanism of action,to scientifically explain the rules of the prescription,to explore the rules of real-world prescription,to discover new indications and new active compounds,and to study drug relocation,etc.The applications of network pharmacology in traditional herbal medicine were systematically summarized to demonstrate the significant value in these areas.

Consensus statement on research and application of Chinese herbal medicine derived extracellular vesicles-like particles(2023 edition)

To promote the development of extracellular vesicles of herbal medicine especially the establishment of standardization,led by the National Expert Committee on Research and Application of Chinese Herbal Vesicles,research experts in the field of herbal medicine and extracellular vesicles were invited nationwide with the support of the Expert Committee on Research and Application of Chinese Herbal Vesicles,Professional Committee on Extracellular Vesicle Research and Application,Chinese Society of Research Hospitals and the Guangdong Engineering Research Center of Chinese Herbal Vesicles.Based on the collation of relevant literature,we have adopted the Delphi method,the consensus meeting method combined with the nominal group method to form a discussion draft of“Consensus statement on research and application of Chinese herbal medicine derived extracellular vesicles-like particles(2023)”.The first draft was discussed in online and offline meetings on October 12,14,November 2,2022 and April and May 2023 on the current status of research,nomenclature,isolation methods,quality standards and research applications of extracellular vesicles of Chinese herbal medicines,and 13 consensus opinions were finally formed.At the Third Academic Conference on Research and Application of Chinese Herbal Vesicles,held on May 26,2023,Kewei Zhao,convenor of the consensus,presented and read the consensus to the experts of the Expert Committee on Research and Application of Chinese Herbal Vesicles.The consensus highlights the characteristics and advantages of Chinese medicine,inherits the essence,and keeps the righteousness and innovation,aiming to provide a reference for colleagues engaged in research and application of Chinese herbal vesicles at home and abroad,decode the mystery behind Chinese herbal vesicles together,establish a safe,effective and controllable accurate Chinese herbal vesicle prevention and treatment system,and build a bridge for Chinese medicine to the world.

Research Progress of Chinese Herbal Medicine Additives in Layer Breeding

Chinese herbal medicine have dual effects of medicinal value and nutrition regulation. In recent years, antibiotics have been widely forbidden in live- stock production, which are inevitably replaced by natural Chinese herbal medicine in livestock breeding. A brief summary of current research progress of Chinese herbal medicine in layer breeding is given in the paper.

Research Status of Serum Pharmacology and Serum Pharmacochemistry of Traditional Chinese Medicine

Serum pharmacochemistry of traditional Chinese medicine has become a more accurate and rapidly developing reasonable way to analyze the effective material basis of traditional Chinese medicine in recent years. Through this method, we can select very complex Chinese medicine components and clarify the effective substances consistent with the main functions, and then separate and purify effective ingredients in traditional Chinese medicine, so as to explain the material basis of the drug effect and prove the rationality and principle of action of Chinese medicine compounds. It can show the multi-component and multi-target characteristic of traditional Chinese medicine, and after analyzing the migrating components of serum, we can explore the direct effective substances that act on the patient’s body, so as to accelerate and accurately complete the in-depth study of the effective substances of Chinese medicine.

The latest research progress of traditional Chinese medicine in the treatment of early and middle femoral head necrosis

At present,the development of orthopedics,the conservative treatment of femoral head necrosis in the early and middle stages is still a difficult problem.With the progress of osteonecrosis,it may deteriorate into irreversible bone destruction,affecting the hip joint and even causing severe disability of the hip.In traditional medicine,femoral head necrosis belongs to the category of"bone erosion"and"bone erosion".As a common disease in orthopedics,the treatment difficulty is relatively large.In the view of Chinese medicine,the pathogenesis of femoral head necrosis is kidney deficiency,stagnation and so on.Clinically,most doctors use the principle of promoting blood circulation,tonifying kidney and strengthening spleen.In the early and middle femoral head necrosis,traditional Chinese medicine treatment methods are more diverse and economical,and have always been valued by the modern medical community.This study reviews the latest research progress of traditional Chinese medicine in the treatment of early and mid-stage femoral head necrosis,in order to provide more basis for clinical medical research and related disease treatment.

中药外敷联合复合超声关节治疗仪治疗膝骨关节炎的临床效果

目的探究中药外敷联合复合超声关节治疗仪在膝骨关节炎(KOA)中的应用效果。方法选取2022年8月至2023年8月就诊于安阳市中医院的99例KOA患者为研究对象,随机分为3组,每组33例。超声组接受超声关节治疗仪治疗,中药组接受中药外敷治疗,联合组接受中药外敷联合超声关节治疗仪治疗。对比3组疗效及治疗前后西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、视觉模拟评分法(VAS)、奎森功能演算(Lequesne)指数评分、成纤维细胞生长因子2(FGF-2)、Ⅰ型胶原C-末端肽(CTX-I)、软骨寡聚基质蛋白(COMP)及不良反应。结果联合组总有效率[93.94%(31/33)]高于超声组[75.76%(25/33)]、中药组[72.73%(24/33)](P<0.05),超声组与中药组总有效率对比,差异无统计学意义(P>0.05);治疗3个疗程后联合组FGF-2高于超声组、中药组,CTX-1、COMP、Lequesne、WOMAC评分低于超声组、中药组(P<0.05),超声组、中药组组间对比,差异无统计学意义(P>0.05);治疗3个疗程后联合组静态、动态VAS评分<中药组<超声组(P<0.05);治疗期间3组均未出现不良反应。结论中药外敷与复合超声关节治疗仪联合治疗KOA患者效果确切,可有效调节骨代谢指标,有助于缓解患者疼痛感,恢复膝关节功能。

敏感性皮肤的中医辨治初探

敏感性皮肤发生率较高,国内女性敏感性皮肤发生率在15.93%,男性为8.62%。本文分析了敏感性皮肤的中医病因病机及辨证论治,介绍了肺经风热、肝经湿热、脾虚湿蕴、肝郁血燥、阳虚水饮五型及相应治则、方药,中药湿敷、中药膏/油外用、中药提取物护肤品的应用及体针、放血治疗方案。认为本症可通过中医内服外治联合的方案,以取得促进皮肤屏障修复、降低神经血管高反应性、控制炎症反应、提高皮肤耐受性的效果。

益肾逐瘀汤联合中药外敷治疗前列腺增生伴膀胱过度活动症的疗效及机制研究

目的研究益肾逐瘀汤联合中药外敷治疗前列腺增生伴膀胱过度活动症的疗效及机制。方法选取2022年7月—2023年4月广西中医药大学第一附属医院泌尿外科收治的前列腺增生伴膀胱过度活动症患者90例,随机分为常规药物组、中药外敷组与益肾逐瘀汤组,每组30例。3组均给予常规药物(托特罗定)治疗,中药外敷组在托特罗定治疗的基础上给予中药敷贴于神阙关元穴,益肾逐瘀汤组在托特罗定治疗的基础上给予中药外敷联合益肾逐瘀汤浓缩丸剂口服治疗。治疗2周后比较3组患者治疗有效率,治疗前后的最大尿流率(maximum flow rate,Qmax)、尿量(urine volume,VV),国际前列腺症状评分(international prostate symptom score,IPSS)、膀胱活动过度症评分(overactive bladder syndrome score,OABSS),前列腺小体外泄蛋白(prostatic exosomal potein,PSEP)、血液流变学[全血高切黏度(high blood viscosity,HBV)、全血低切黏度(low blood viscosity,LBV)]和血清性激素[促黄体生成素(Luteinizing hormone,LH)、睾酮(testosterone,T)]的水平。结果常规药物组、中药外敷组与益肾逐瘀汤组治疗总有效率分别为73.33%(22/30)、90.00%(27/30)、96.67%(29/30),益肾逐瘀汤组显著高于常规药物组(P<0.05)。治疗后3组患者Qmax、VV均显著升高,并且益肾逐瘀汤组显著高于常规药物组、中药外敷组(P<0.05)。治疗后3组患者IPS、OABSS评分均显著降低,并且益肾逐瘀汤组显著低于常规药物组、中药外敷组(P<0.05)。治疗后3组患者PSEP、HBV、LBV、LH水平均显著下降,T水平显著升高,益肾逐瘀汤组PSEP、HBV、LBV、LH水平显著低于常规药物组、中药外敷组,T水平显著高于常规药物组、中药外敷组,差异均有统计学意义(P<0.05)。结论益肾逐瘀汤联合中药外敷治疗前列腺增生伴膀胱过度活动症效果满意,可提高治疗总有效率,并改善患者血流流变学、促进性激素水平处于平衡状态,促进患者康复。

火针联合黄连膏包敷治疗慢性湿疹血虚风燥证的临床观察

目的观察火针联合黄连膏包敷治疗慢性湿疹血虚风燥证的临床疗效。方法将100例慢性湿疹血虚风燥证患者按照随机数字表法分为2组,对照组50例予局部火针方法治疗,治疗组50例在对照组基础上予黄连膏包敷方法治疗。2组均治疗4周。比较2组治疗前后湿疹面积及严重程度指数(EASI)评分、瘙痒程度评分、瘙痒频率评分,并统计2组疗效及复发率。结果治疗组总有效率96.00%(48/50),对照组总有效率82.00%(41/50),治疗组临床疗效优于对照组(P<0.05)。2组治疗后EASI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组治疗后瘙痒程度评分、瘙痒频率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)。治疗组复发率低于对照组(P<0.05)。结论火针联合黄连膏包敷治疗慢性湿疹血虚风燥证患者效果显著,能够减轻患者的瘙痒症状,降低复发率,值得推广应用。

散结透脓方外敷联合消肿清热解毒汤内服治疗泛发性肛周脓肿术后的效果及对创面愈合时间、肛门功能的影响

目的观察散结透脓方外敷联合消肿清热解毒汤内服在泛发性肛周脓肿术后的应用效果及对创面愈合时间、肛门功能的影响。方法将102例热毒炽盛型泛发性肛周脓肿术后患者按照随机数字表法分为2组,对照组51例术后予以抗感染及对症支持等治疗方法,治疗组51例在对照组基础上予以散结透脓方外敷联合消肿清热解毒汤内服治疗,2组均治疗4周。比较2组治疗后创面愈合情况(创面腐肉脱落时间、创面愈合时间、治疗2周创面回缩率)、治疗前后中医证候评分、治疗前和治疗2周疼痛视觉模拟评分(VAS)、治疗前和术后2个月肛门失禁Wexner评分量表评分、治疗前和治疗2周炎症相关指标[白细胞计数(WBC)、C反应蛋白(CRP)、白细胞介素6(IL-6)],并统计2组临床疗效,记录治疗期间不良反应发生情况。结果治疗组总有效率90.20%(46/51),对照组总有效率74.51%(38/51),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)。治疗组创面腐肉脱落时间、愈合时间均低于对照组(P<0.05),治疗2周时创面回缩率高于对照组(P<0.05)。2组治疗2周时疼痛VAS均较本组治疗前降低(P<0.05),且治疗组治疗2周时疼痛VAS低于对照组同期(P<0.05)。2组术后2个月Wexner评分均较本组治疗前降低(P<0.05),且治疗组术后2个月Wexner评分低于对照组同期(P<0.05)。2组治疗2周后外周血WBC、CRP、IL-6水平均较本组治疗前降低(P<0.05),且治疗组治疗2周后均低于对照组同期(P<0.05)。结论散结透脓方外敷联合消肿清热解毒汤内服可提高泛发性肛周脓肿术后疗效,缩短愈合时间,减轻术后疼痛,缓解炎症反应,有利于改善患者肛门功能。

止疼膏1号外敷治疗肺癌癌痛患者的临床观察

目的 观察止疼膏1号外敷痛点及穴位治疗肺癌癌痛患者的临床疗效。方法 选取2022年1月—2022年12月期间山东省昌乐人民医院收治的80例肺癌患者作为研究对象,按随机数字表法分为对照组和观察组,每组各40例。对照组仅采用规范的三阶梯止痛方案,观察组在接受三阶梯止痛方案治疗的基础上,采用止疼膏1号外敷痛点及穴位。治疗2周后,观察比较两组患者临床疗效、不良反应情况,治疗前后疼痛程度[数字疼痛分级法(Numberical rating scale, NRS)]、生活质量[肺癌治疗功能评价系统(Functional Assessment of Cancer Therapy-Lungcancer, FACT-L)]评分。结果 治疗后观察组总有效率87.50%(35/40)高于对照组67.50%(27/40),差异有统计学意义(P<0.05)。治疗后两组患者NRS评分均较治疗前降低,差异有统计学意义(P<0.05);且观察组NRS评分均较对照组同期明显降低,差异有统计学意义(P<0.05)。治疗后两组患者FACT-L评分均较治疗前升高,差异有统计学意义(P<0.05);且观察组FACT-L评分明显高于对照组,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率比较,差异无统计学意义(P>0.05)。结论 止疼膏1号外敷治疗具有协同止痛作用,能够有效减轻肺癌癌痛患者的疼痛程度,提高肺癌患者的生活质量。

Efficacy and safety of external application of Traditional Chinese Medicine for the treatment of acute gouty arthritis: a systematic review and Meta-analysis

OBJECTIVE:To evaluate the clinical efficacy and safety of external application of Traditional Chinese Medicine (EATCM) on acute gouty arthritis (AGA).METHODS:Six electronic data bases were retrieved from their inception to march 2017.15 randomized controlled clinical trials (RCTs) were included.The quality of the literatures was assessed according to Cochrane review criteria by using RevMan5.3 software;and related data was counted using Stata14.0 software.RESULTS:There was no significant difference in C-reactiveprotein (CRP) between experimental intervention group and control group [(WMD =1.093,95% C/(-2.514,4.701);P =0.553)].In terms of overall efficacy,the EATCM's treatment group was significantly superior to control group [(OR =3.692;95% CI (2.408,5.661);P <0.001)].The EATCM was better than western medicine treatments or other interventions in reducing the adverse reactions [(OR =0.135;95% CI (0.067,0.274);P < 0.001)].All these funnel plots showed unlikelihood of publishing bias.But due to excessive heterogeneity,the statistical results of serum uric acid and visual analogue scale and CRP between the two groups became uncertain.CONCLUSION:The results indicate that EATCM may have greater overall efficacy with fewer adverse drug reactions,although the evidence is weak owing to the low methodological quality and the small number of the included trials.

中药膏药外敷治疗类风湿关节炎的研究进展

清代医家吴师机提出“外治之理即内治之理,外治之药即内治之药”,为中药膏药外治法奠定了基础。文章就近10年来中药膏药外敷治疗类风湿关节炎相关文献进行梳理总结,并对其用药特点、中医证型及作用机制进行探讨和分析,以期为中药膏药外敷治疗类风湿关节炎的挖掘与应用研究提供依据。

活血类膏药外敷治疗膝关节炎及中医药对其认识的进展

膝关节炎具有发病率高、治疗相对困难、易复发等特点,且与多种因素密切相关,严重威胁中老年的生活质量与身体健康。对于膝关节炎患者,目前可采用止痛治疗、激素治疗、物理治疗、手术治疗、中医药治疗等。近年来,中医药对膝关节炎认识越来越深入,这对于提高中老年膝关节炎的关注度,提升膝关节炎的治疗效果,促进中老年膝关节炎患者疾病的恢复与生活健康有重要的参考意义。本文从膝关节炎的特点、中医药治疗膝关节炎相关研究方面进行综述,重点叙述活血类膏药外敷治疗及相关疗法的作用。

Effects of External Application of Chinese Medicine on Diabetic Ulcers and the Expressions of β-catenin,c-myc and K6

Objective：To observe the clinical efficacy of Chinese medicine（CM） treatment of Hongyou Ointment（红油膏） and Shengji Powder（生肌散） on diabetic ulcers,and to observe the influence of CM treatment on the expressions of proteins associated with the Wnt signaling pathway,such asβ-catenin,c-myc and K6.Methods：sixty-two patients fitting the registration standards were randomly divided into the CM group（31 patients） and the Western medicine（WM） group（31 patients） by a random number table.The patients in the CM group were treated with Hongyou Ointment and Shengji Powder externally.The patients in the WM group were treated with mupirocin ointment,growth factor（bFGF）,and Vaseline gauze for external use and with basic therapies.Wound-healing time and four-week healing rate were recorded.The wounds were measured by digital photography and ImageJ software.Skin biopsies were obtained from 24 patients before CM treatment and 20 patients after CM treatment.Immunohistochemical tests and semi-quantitative imaging with NIH ImageJ 1.42 software were used to analyze the changes in protein expression ofβ-catenin,c-myc,and K6.Results：Fifty-three patients completed the trial;four patients in the CM treatment group and five patients in the WM group dropped out.Among them,four were dissatisfied with the treatment process,two could not continue because of their jobs,two failed to complete the course of follow-up appointments,and one was diagnosed with squamous cell carcinoma during treatment.The comparison of ulcer healing rates between the two groups showed insignificant differences（P=0.77）.The ulcer healing rates were 33.33%（9/27） in the CM group and 26.92%（7/26） in the WM group.However,the effective rate was significantly higher in the CM group（81.48%,22/27） than in the WM group（57.69%,15/26,P=0.04）.The mean wound healing time was shorter in the CM group（22.71±5.46 days） than in the WM group（26.56±7.56 days,P=0.04）.CM treatment was well tolerated,and there was no withdrawal due to adverse reactions.Immunohistochemical analysis in the refractory wound indicated higher expressions ofβ-catenin,c-myc and K6 compared with the normal skin.β-catenin was abnormally expressed in the nuclei of the keratinocytes and fibroblasts at the wound margins,and the expressions of c-myc and K6 were highly expressed in the full hyperplastic epidermis,especially in the granular layer（P0.05）.The expressions of these proteins decreased after CM treatment.The expression levels ofβ-catenin,c-myc,and K6 proteins before and after the treatment were 101.88±10.76 vs.140.42±8.45;113.27±16.75 vs.153.79±8.32; 90.39±11.07 vs.151.29±7.39,respectively.Conclusions：CM treatment using Hongyou Ointment and Shengji Powder was efficient in the management of diabetic skin ulcers.The mechanism of action might be related to the inhibition of the Wnt signaling pathway.

自拟穴位贴敷配合中药热奄包对良性肛肠病术后便秘患者的治疗效果及安全性分析

目的:分析自拟穴位贴敷配合中药热奄包对良性肛肠病术后便秘患者的治疗效果及安全性。方法:选取2023年1月~2023年10月上海市宝山区罗店医院收治的120例混合痔和肛瘘术后便秘患者作为研究对象,根据不同的治疗方案分为对照组(n=60)与观察组(n=60)。对照组给予常规西药口服治疗,观察组在对照组的基础上,给予自拟穴位贴敷配合中药热奄包进行辅助治疗,均治疗14d。比较两组的治疗效果;比较两组治疗前、治疗1d、治疗7d以及治疗14d的便秘评分量表(CCS)、便秘患者生存质量量表(PAC-QOL)评分;比较两组不良反应发生率。结果:观察组的治疗有效率优于对照组,差异有统计学意义(P<0.05);两组治疗1d的CCS、PAC-QOL评分比较差异无统计学意义(P>0.05);两组治疗7d以及治疗14d的CCS、PAC-QOL均优于治疗前,且观察组均优于对照组,差异均有统计学意义(P<0.05);两组治疗后的不良反应发生率比较差异无统计学意义(P>0.05)。结论:自拟穴位贴敷配合中药热奄包能够改善良性肛肠病术后便秘患者的临床症状,提高患者的生活质量,且安全性良好。

基于气血通化探讨外敷膝骨关节炎用药规律

目的在气血通化观点指导下,对膝骨关节炎外敷中药处方进行挖掘研究,探讨其用药规律。方法收集整理2020年—2022年院内治疗膝骨关节炎外敷用药处方并建立电子数据库,使用IBM SPSS Statistics 26.0和IBM SPSS Modeler 18.0软件中关联分析、聚类分析等数据挖掘方法,分析膝骨关节炎的外敷用药规律。结果本研究收集2020年—2022年治疗膝骨关节炎处方418首,运用关联分析得出强关联对药有川芎-当归、透骨草-川芎、透骨草-伸筋草等共13组,聚类分析产生3个聚类方,高频药物前5为透骨草、川芎、当归、伸筋草、牛膝。结论治疗膝骨关节炎418首处方中常用祛风除湿药、活血化瘀药,涉及脏腑主要为肝、肾、脾,与肝脾气血密切相关,关联规则配伍原则大体从气血、风湿方面论治,以疏通气血、舒解经络为法,故可从疏通气血入手,旨在达到气血通化的状态。

护肩载药用于脑卒中肩手综合征Ⅰ期的疗效观察

目的评估护肩载药对脑卒中患者肩手综合征Ⅰ期的疗效。方法脑卒中肩手综合征Ⅰ期患者96例,随机分为对照组、中药外敷组与护肩载药组,每组各32例。所有患者均接受脑卒中基础治疗和常规护理,对照组予传统康复治疗,中药外敷组予传统康复治疗和中药外敷治疗,护肩载药组予护肩载药、传统康复治疗和中药外敷治疗。比较三组治疗前、治疗后2、4周疼痛评分(VAS)、上肢功能评分(FMA)、日常生活能力(Barthel指数)、手部肿胀情况,以及治疗后满意度和舒适度。结果4周后,护肩载药组总有效率高于中药外敷组和对照组,差异有统计学意义(P<0.05)。治疗2周后,护肩载药组和中药外敷组VAS评分和手部肿胀程度较治疗前下降,Barthel指数和FMA评分提高(P<0.05),护肩载药组效果优于中药外敷组和对照组(P<0.05)。治疗4周后,三组患者VAS评分和手部肿胀程度较治疗前明显降低;FMA评分和Barthel指数提高(P<0.05)。护肩载药组在改善VAS评分和FMA评分方面优于中药外敷组和对照组(P<0.05)。护肩载药组患者满意度和舒适度高于中药外敷组和对照组(P<0.05)。结论护肩载药对脑卒中后肩手综合征Ⅰ期治疗效果满意,能够有效缓解疼痛、减轻肿胀、提高患者肢体功能和日常生活能力,同时增强患者的舒适感和满意度。