Exploring the medication pattern and mechanism of action of traditional Chinese medicine in treating polycystic ovary syndrome with kidney deficiency and blood stasis based on data mining and network pharmacology

Background:Using network pharmacology to explore the potential molecular mechanism of traditional Chinese medicine in treating polycystic ovary syndrome(PCOS)with kidney deficiency and blood stasis syndrome.Method:Collect the related literature materials of PCOS with kidney deficiency and blood stasis syndrome treated by traditional Chinese medicine in four databases in recent ten years,extract the information of prescriptions and complete the frequency analysis.Traditional Chinese Medicine Systems Pharmacology Database was used to screen out the effective components.Use Online Mendelian Inheritance in Man and other databases to screen PCOS disease targets.The intersection targets obtained by clustering prescription and PCOS disease targets were submitted to STRING database for protein-protein interaction network analysis,and Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes pathways were analysed by Metascape.Result:There are 155 kinds of traditional Chinese medicines used in the literature.The most commonly utilized ones are Cuscutae Semen,Angelicae Sinensis Radix,and Rehmanniae Radix Praeparata.The results of the cluster analysis indicated that the plants most commonly found throughout the prescription were Leonuri Herba,Lycopi Herba,Dipsaci Radix,etc.GO results show that biological processes include cell reaction to organic nitrogen compounds and cell reaction to nitrogen compounds.The functional display of GO molecule includes cytokine receptor binding,signal receptor regulator activity and so on.Kyoto Encyclopedia of Genes and Genomes results show that the possible mechanisms of action are cancer pathway,an endocrine resistance signal pathway.Conclusion:Through data mining,the cluster prescription for PCOS with kidney deficiency and blood stasis syndrome is Leonuri Herba,Lycopi Herba,Dipsaci Radix,etc.The network pharmacology research of cluster prescription shows that the main drug components for treating PCOS with kidney deficiency and blood stasis syndrome are quercetin,kaempferol,luteolin,tanshinone IIA,etc.,which act on PTGS2,NCOA2,and other targets,and treat PCOS with kidney deficiency and blood stasis syndrome through cancer and endocrine resistance.

Clinical Nursing Intervention of Moxibustion on Abdominal Distension Symptoms in Heart Failure (Heart and Kidney Yang Deficiency and Blood Stasis Blocking Collaterals Syndrome)

Objective:To investigate the clinical nursing intervention effect of moxibustion on abdominal distension symptoms in heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome).Methods:62 patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)admitted to our hospital from February 2023 to February 2024 were selected and divided into the observation group(n=31)and the control group(n=31)by using the random numerical table method.The control group adopted conventional nursing interventions,and the observation group received the nursing program of the control group with the addition of moxibustion nursing interventions.The nursing effectiveness,quality of life scores,and nursing satisfaction were compared between the two groups.Results:The nursing effectiveness of the observation group was significantly higher than the control group(P<0.05);the quality of life score of the observation group was significantly higher than the control group(P<0.05);the nursing satisfaction of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:The use of moxibustion nursing intervention in patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)can effectively relieve the symptoms of abdominal distension,improve patients'quality of life,and increase nursing satisfaction,which has promotion and application values.

Clinical observation on efficacy of compound of warming yang, descending turbidity and dredging collaterals in the treatment of diabetic kidney disease with Yin-Yang deficiency and blood stasis syndrome

Objective:To observe the clinical efficacy of compound of owarming yang,descending turbidity and dredging collaterals in the treatment of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome.Methods:Seventy-six patients of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome were randomly divided into observation group and control group,thirty-eight cases in each group.The control group was given conventional western medicine treatment,while the observation group took compound of owarming yang,descending turbidity and dredging collaterals orally on the basis of conventional western medicine treatment.The course of treatment covered for one month.Before and after treatment,we observed the scores of traditional Chinese medicine symptoms,indicators of renal function[serum creatinine(Scr),blood urea nitrogen(BUN),microalbuminuria(MALB)],indicators of glucose metabolism[fasting plasma glucose(FPG),2-hour postprandial blood glucose(2hPG),glycosylated hemoglobin(HbAlc)],indicators of hemorheology[plasma viscosity(PV),platelet aggregation rate(PAR),fibrinogen(FIB)],Cystatin-C(Cys-C),C-reactive protein(CRP)in the two groups.Results:After treatment,the clinical effect of the observation group was significantly better than the control group(P<0.05).The scores of traditional Chinese medicine symptoms,indicators of renal function(Scr、BUN、UAER),indicators of glucose metabolism(FPG、2hPG、HbAlc),indicators of hemorheology(PV、PAR、FIB),Cys-C and CRP in the two groups were decreased significantly compared with those before treatment(P<0.05),and the decrease in the observation group was superior to that in the control group(P<0.05).Conclusion:Compound of warming yang,descending turbidity and dredging collaterals has remarkable efficacy in treating of diabetic kidney disease patients with yin-yang deficiency and blood stasis syndrome by alleviating clinical symptoms,glucose metabolism,renal function and microcirculatory disturbance,and the mechanism related to alleviation of microinflammation.

范孝叁教授辨治带状疱疹性神经痛临证经验

文章总结范孝叁教授治疗带状疱疹性神经痛的经验,范孝叁教授以治病求本、整体治疗为原则,从三焦、湿、虚、瘀等立论治疗本病,活用经方,形成了规范的诊疗思路,认为本病主要病机为湿蕴三焦、寒湿阻络、气滞血瘀、肝阴不足,在辨证论治的同时配合中医特色外治,疗效甚佳。

克癃胶囊对BPH肾虚血瘀证大鼠前列腺增生和性激素水平的影响

目的探讨克癃胶囊对肾虚血瘀证大鼠前列腺增生(BPH)的影响及其对性激素水平的调节作用。方法建立前列腺增生症肾虚血瘀证大鼠模型,观察空白组,模型组,保列治组,前癃通组,低、中、高剂量克癃组(以下简称克癃低组、克癃中组、克癃高组)大鼠前列腺和性激素水平的影响。结果 (1)保列治组、前癃通组、克癃高、中、低组大鼠前列腺湿质量、前列腺指数均显著低于模型组(P<0.05)。各组组织病理学变化有一定区别。(2)与模型组比较,前列治组、克癃低组血清T含量和E2含量无显著性差异(P>0.05);前隆通组、克癃中组、克癃高组血清T含量降低(P<0.05)、血清E2含量显著升高(P<0.01);与前隆通组比较,克癃中组、克癃高组血清T和E2含量无显著性差异(P>0.05)。(3)与模型组比较,保列治组血清FSH和LH的含量无显著性差异(P>0.05),前隆通组、克癃低、中、高组血清FSH和LH的含量降低(P<0.05);与前隆通组比较,克癃低、中、高组血清FSH和LH的含量无显著性差异(P>0.05)。结论克癃胶囊可显著抑制大鼠前列腺增生,且呈剂量依赖性关系。克癃胶囊可能通过同时降低T、E2、FSH和LH的水平,调节大鼠的性激素平衡,从而起到抑制前列腺增生的作用。

不同配比黄芪丹参对气虚血瘀证模型大鼠血液流变学及TXB_2、6-keto-PGF_(1α)影响的研究

目的探讨黄芪丹参不同配比对气虚血瘀证大鼠血液流变学及血栓素B2(TXB2)、6-酮前列腺素F1α(6-ketoPGF1α)的影响。方法将SD大鼠随机分为正常组、模型组和黄芪丹参不同配比组,每组各10只。黄芪、丹参的总给药量均为原药材15 g/kg,黄芪、丹参比例分别为5∶1、3∶1、1∶1、1∶3、1∶5。采用饥饿、游泳加皮下注射肾上腺素的方法复制气虚血瘀证大鼠模型,各组大鼠给予不同配比的水煎液冻干物,测定血液流变学指标和TXB2、6-ketoPGF1α含量。结果气虚血瘀模型组血流变参数和TXB2显著升高,6-keto-PGF1α显著降低,与正常组比较差异有高度统计学意义(P<0.01),模型复制成功。黄芪丹参3∶1、1∶1、1∶3、1∶5配比组可改善血瘀状态,使升高的TXB2水平降低,提升6-keto-PGF1α及6-keto-PGF1α/TXB2比值,差异有高度统计学意义(P<0.01)。结论黄芪丹参对大鼠气虚血瘀证确有疗效,其中1∶3配比组效果最佳。

益心解毒方对气虚血瘀证心衰大鼠心肌组织中血小板——内皮细胞黏附分子和血管内皮生长因子表达的影响研究

目的从血管新生的角度,探讨益心解毒方对气虚血瘀证心衰大鼠心肌保护的作用机制。方法利用左冠状动脉结扎术制备大鼠心梗后心衰动物模型,通过宏观表征判定该疾病模型的证候属性,将成模后存活大鼠随机分为8组:假手术组,模型组,益心解毒方高、中、低剂量组,中西结合组,福辛普利组和芪苈强心组。治疗4周后取梗死边缘区组织进行Western Blot及RT-PCR法检测血小板—内皮细胞黏附分子(又称CD31)和血管内皮生长因子的表达。结果 Western Blot结果显示:模型组大鼠心肌组织中CD31蛋白表达量较假手术组显著下降(P=0.004),而高剂量组(P=0.042)、低剂量组(P=0.027)和芪苈强心组(P=0.015)与模型组相比均可提高心肌组织中CD31的表达。PCR结果显示:与假手术组相比,大鼠心肌组织的血管内皮生长因子表达在模型组(P=0.047),高剂量(P=0.023),中西结合组(P=0.008)均显著升高;而低剂量组大鼠心肌组织中血管内皮生长因子的表达显著低于模型组(P=0.004)和其它治疗组(P<0.05)。结论益心解毒方对心梗所致气虚血瘀证心衰大鼠的心肌保护作用,可能是通过促进血管新生实现的,其机制可能与血管内皮生长因子有关,且具有剂量相关性。

酒精性肝病的中西医结合治疗进展

酒精性肝病是临床常见肝病之一,甘草酸制剂、水飞蓟素类、还原性谷胱甘肽等能起到抗氧化、抗炎、保护肝细胞膜等作用,是西医临床常用的保肝药物。中医根据患者的临床表现进行辨证论治,湿热蕴结型方选茵陈蒿汤加减;气滞血瘀型方选膈下逐瘀汤加减;肝肾阴虚型方选一贯煎加减;脾肾阳虚型方选济生肾气丸加减;肝郁脾虚型方选逍遥散加减。中药对酒精性肝病的治疗有非常重要的作用,不仅能够保护肝脏,减缓肝纤维化的进程,而且在减轻患者腹胀,腹水程度,提高生存质量等方面均有不错的临床效果。中西医结合治疗酒精性肝病,可以兼容中药和西药两者共同的优势,取长补短,可以获得更好的疗效。

继人工流产后复发性流产的中医证候分布规律研究

目的:分析继人工流产后出现复发性流产患者的中医证候分布规律,以探讨人工流产次数与复发性流产的关系,为中医药预防该病和规范化治疗提供辨证施治依据。方法:选取本院接受诊治的自然流产患者300例,应用流行病学分析法分析临床资料,并自拟"继人工流产后自然流产的中医证候分布"信息表,建立数据库并给予统计分析,聚类中医四诊指标,探讨相关中医证候分布规律,同时对患者年龄、病程、自然流产次数以及人工流产次数等进行统计分析并探讨与中医证候分布的关联性。结果:继人工流产后自然流产的中医证型共5种,构成比按照降序排列分别为:肾虚血瘀证、肾虚内热证、肾虚血虚证、脾肾阳虚证、肾虚湿热证,其中,以肾虚血瘀证为主。随人工流产次数增多,自然流产的次数则增多,肾虚血瘀证构成比呈上升趋势。结论:人工流产次数与复发性流产的发病率呈正相关,为复发性流产的发病因素之一;肾虚血瘀证为继人工流产后复发性流产患者的主要中医证候。

黄芪保心汤治疗对心梗后心衰(气虚血瘀证)患者LVEF、LVEDd、BNP的影响

目的观察黄芪保心汤治疗对心梗后心衰(气虚血瘀证)患者临床效果。方法选取心梗后气虚血瘀证心衰患者90例,随机分为两组各45例,对照组应用西医常规治疗,研究组在对照组基础上应用黄芪保心汤治疗。记录两组治疗2周后纽约心脏病协会(NYHA)心功能分级疗效及中医疗效,记录治疗前和治疗2周的左室射血分数(LVEF)、左室内径(LVEDd)、血浆脑钠肽(BNP)水平及焦虑(SAS)与生活质量(QOL)评分。结果NYHA及中医疗效与对照组比较,研究组的总有效率较高(P<0.05)。治疗2周后,两组患者的LVEF、QOL评分均明显增加(P<0.05),LVEDd、BNP、SAS评分均明显降低(P<0.05),与对照组比较,研究组的LVEF、QOL评分均明显增加(P<0.05),LVEDd、BNP、SAS评分均明显降低(P<0.05)。两组治疗3、7、14 d后心功能Ⅰ、Ⅱ级的患者均逐渐增多,心功能Ⅲ、Ⅳ级的患者逐渐减少,研究组改善明显优于对照组(P<0.05)。结论应用黄芪保心汤治疗心梗后心衰(气虚血瘀证)可增强疗效,促进左心室功能的恢复,改善患者预后。

原发性肝癌证型分布及用药分析

目的:探讨原发性肝癌中医证型分布特点及中医治疗用药特点。方法:收集、整理2004年1月1日至2017年3月1日就诊于上海中医药大学附属岳阳中西医结合医院肿瘤科的原发性肝癌患者248例,进行中医辨证分型,辨证论治,采用SPSS 24.0统计软件对中医证型、中药进行频次分析。结果:248例肝癌患者中,肝郁脾虚证85例(34.3%),气滞血瘀证63例(25.4%),肝肾阴虚证54例(21.8%),湿瘀互结证31例(12.5%),湿热内蕴证15例(6.0%),肝郁脾虚证、气滞血瘀证、肝肾阴虚证出现频率最高;临床用药中,补虚药(27.2%)、利水渗湿药(14.8%)、清热药(14.1%)出现频率最高;排名前十的药物依次为白术、柴胡、陈皮、茯苓、半夏、山楂、当归、黄芪、半枝莲、山药。结论:肝郁脾虚证、气滞血瘀证、肝肾阴虚证是原发性肝癌患者的常见证型,临床治疗常用补虚药、利水渗湿药、清热药。

自拟益气活血方治疗冠心病慢性心力衰竭临床效果及对炎症因子水平的影响

目的:分析自拟益气活血方治疗冠心病慢性心力衰竭(CHF)临床效果及对炎症因子水平的影响。方法:选择冠心病CHF患者120例,根据入组序列号奇偶数分为观察组与对照组各60例,其中对照组给予常规西医综合治疗,观察组在常规西医治疗的基础上给予自拟益气活血方治疗,比较2组治疗后中医证候、心功能改善情况及炎症因子C反应蛋白(CRP)、白介素-6(IL-6)、N端脑钠肽前体(NT-pro BNP)水平。结果:⑴观察组治疗后中医证候和心功能改善有效率为90.00%、91.67%,对照组为75.00%、78.33%,比较差异有显著性(P<0.05);⑵2组治疗后左室射血分数(LVEF)均较治疗前增高,观察组治疗后左心室舒张末期内径(LVEDD)降低,治疗前后差异有显著性(P<0.05),其中观察组治疗后LVEF高于对照组,LVEDD水平低于对照组,2组治疗后比较差异有显著性(P<0.05);⑶2组治疗后血清CRP、NT-pro BNP、IL-6水平均较治疗前明显降低,治疗前后差异有显著性(P<0.05),其中观察组治疗后血清CRP、NT-pro BNP、IL-6水平明显低于对照组,2组治疗后比较差异有显著性(P<0.05)。结论:自拟益气活血方治疗冠心病CHF可有效改善心功能,缓解临床症状,改善心功能,降低炎症因子水平。

膝关节骨性关节炎中医证候分型与血清中MDA、SOD、NO含量相关性研究

目的:探讨膝关节骨性关节炎(knee osteoarthritis,KOA)中医证候分型与患者血清中丙二醛(maledic diadehyde,MDA)、超氧化物歧化酶(superoxide dismutase,SOD)、硝酸还原酶法测定一氧化氮(nitric Oxide,NO)含量之间的相互关系。方法:将符合KOA诊断标准的96例患者按中医学证候分型标准分为风湿热痹证组30例,风寒湿痹证组24例,肝肾亏虚证组24例和瘀血痹阻证组18例。抽取各组对象的晨起空腹血液,硫代巴比妥法测MDA,黄嘌呤氧化酶法测定SOD,硝酸还原酶法测定NO。结果:各证型MDA含量比较,差异具有统计学意义(P<0.05)。风湿热痹证组和风寒湿痹证SOD值低于肝肾亏虚证组,差异具有统计学意义(P<0.05)。NO含量和风湿热痹证组、风寒湿痹证组及瘀血痹阻证组NO含量低于肝肾亏虚证组,差异具有统计学意义(P<0.05)。结论:KOA患者血清中MDA、SOD、NO的含量变化为反应自由基变化情况指标和反应软骨细胞凋亡的相关指标,可以作为中医膝关节骨性关节炎宏观辨证分型的依据。

Theory discussion on airway remodeling of bronchial asthma

According to modern research,the pathogenesis of asthma mainly includes airway inflammation,airway hyperresponsiveness,airway remodeling,etc.Airway remodeling is the key factor that leads to the progress of asthma,and it is also the main factor that leads to airway hyperresponsiveness and irreversible airflow restriction.Traditional Chinese medicine believes that"phlegm and blood stasis"block the airway and narrow the lumen is the most important factor in the treatment of asthma.

中西医治疗应激性溃疡临床研究进展

西医认为,应激性溃疡发病的直接原因是胃酸分泌过多,损伤黏膜的屏障保护功能,治疗方法主要有抑制胃酸分泌药、抗酸药、胃黏膜保护药、肠内营养及止血药物等。中医认为,其病机主要包括脾胃亏虚、胃肠腑实、热毒炽盛、寒热错杂、气机郁滞、血行瘀滞等,多采用单味药、辨证论治、针灸治疗等。目前,中医药治疗应激性溃疡存在以下问题:相关文献报道以实验研究居多,且模型多为水浸束缚应激,应激类型尚不全面;临床研究较少,且缺乏大样本研究,说服力需加强;中医药治疗应激性溃疡的具体作用机制研究尚不全面等。今后,应加强对临床大样本研究,进一步完善应激性溃疡的中医证型,以期为应激性溃疡的中医规范治疗提供系统的思路和方法。

丹蛭降糖胶囊对2型糖尿病亚临床血管病变患者血管重构的影响

目的:探讨丹蛭降糖胶囊对2型糖尿病亚临床血管病变气阴两虚夹瘀证患者血管重构的作用及对血清中转化生长因子(transforming growth factor,TGF)-β1和核因子(nuclear factor,NF)-κB水平的影响。方法:98例2型糖尿病亚临床血管病变患者随机分为观察组49例和对照组49例。对照组依据《中国2型糖尿病防治指南》行常规治疗;观察组在对照组基础上口服丹蛭降糖胶囊,每次5粒,3次·d-1。治疗后,比较两组患者气阴两虚夹瘀证主症评分、颈部动脉指标及血管重构发生情况。检测两组患者血清中TGF-β1和NF-κB水平。结果:治疗后,观察组气阴两虚夹瘀证主症评分、颈动脉内膜中层厚度(intima-media thickness,IMT)和斑块积分明显低于对照组(P<0.01)。治疗后,观察组重构发生率及负性重构明显少于对照组(P<0.05)。治疗后,观察组血清中TGF-β1和NF-κB水平明显低于对照组(P<0.01)。结论:丹蛭降糖胶囊治疗2型糖尿病亚临床血管病变气阴两虚夹瘀证临床疗效显著,可显著减轻颈动脉IMT,缩小斑块,降低血管重构发生,其作用机制可能与降低血清中TGF-β1和NF-κB水平有关。

HIV脑病中医证型分布规律研究

目的:探索HIV脑病的中医证型分布规律。方法:制定《HIV脑病四诊信息调查表》,引入聚类分析的方法,对186例诊断明确的HIV脑病患者的四诊资料进行统计分析。结果:HIV脑病证候具体可分为5个,分别为:心脾两虚证、肝肾阴虚证、气虚血瘀证、肾虚髓减证、痰浊阻窍证。结论:采用聚类分析的方法对HIV脑病的中医证候分布规律进行研究能较准确的反映临床,可作为本病中医证候客观量化诊断标准的依据。

糖尿病周围神经病变中医血瘀证客观化研究

目的:分析糖尿病周围神经病变中医血瘀证的客观化指标。方法:90例糖尿病周围神经病变患者按照血瘀证类型分为气虚血瘀证、阴虚血瘀证、阳虚血瘀证等3种类型,每组30例患者,比较3组患者年龄、糖尿病病程、体质量指数(body mass index,BMI)、糖化血红蛋白、C反应蛋白等指标。结果:阴虚血瘀证组患者的糖化血红蛋白值明显高于气虚血瘀组、阳虚血瘀组(P<0.05)。3组患者发病的BMI、平均年龄、平均病程比较,差异无统计学意义(P>0.05)。结论:阴虚血瘀证组患者的糖化血红蛋白明显较高,其他指标在不同血瘀证之间无显著差异。

Evaluation of a granulated formula for the nerve root type and vertebral artery type of cervical spondylosis：a multicenter,single-blind,randomized,controlled,phase Ⅲ clinical trial

OBJECTIVE:To evaluate the effectiveness and safety of cervical spondylosis formula granules in reducing the symptoms of patients with the nerve root type and the vertebral artery type of cervical spondylosis.METHODS:This was a multicenter, single-blind,randomized, controlled trial.From April 2002 to November 2003, 499 patients were randomly assigned to either the treatment or the control group.The treatment group was orally administered granules prepared with a formula for cervical spondylosis, while the control group was given Jingfukang granules.The treatment course was 1 month for both groups.RESULTS:In patients with the nerve root type of cervical spondylosis, the total effect rate in the treatment group(87.21%) was significantly higher than that in the control group(80.70%, P < 0.01).After the treatment period in both groups, the treatment group had a significantly greater rate of resolution of pain, numbness of the upper limbs, muscle strength of the upper limbs, and fatigue than the control group(all P < 0.05).In patients with the vertebral artery type of cervical spondylosis, the total effect rate in the treatment group(82.07%) was similar to that in the control group(71.21%, P >0.05).After the treatment period in both groups,the treatment group had a significantly greater rate of resolution of weakness of the waist and knees than the control group(P < 0.05).CONCLUSION:The cervical spondylosis formula granules significantly improve numbness, muscle strength, and fatigue, and reduce pain in patients with the nerve root type of cervical spondylosis,and improve the weakness of the waist and knees in patients with the vertebral artery type of cervical spondylosis.

中西医诊疗糖尿病足概况

糖尿病足是糖尿病日久进行性发展的慢性并发症,重点在于预防病情发生,控制疾病发展、延缓恶化。对于糖尿病病史较久的患者,在发病初期应积极明确诊断,早期干预,在控制血糖、抗感染、改善循环、营养神经的基础治疗上,结合中医辨证施治,辅助介入治疗、高压氧治疗、胰岛素外敷、中药熏洗治疗,能够取得满意疗效,较好地改善患者的生存质量。