Regulating and tonifying spleen and kidney traditional Chinese medicine in the treatment of chronic uric acid nephropathy: A systematic review

Objective:To systematically evaluate the efficacy and safety of traditional Chinese medicine for regulating spleen and kidney.Methods:We developed a search strategy and then retrieved the database including CNKI,Wanfang data knowledge service platform,VIP journals resource integration service platform,PubMed,Embasefor randomized controlled trial of regulating spleen and kidney traditional Chinese medicine compared with conventional western medicine in the treatment of chronic uric acid nephropathy.The search deadline was set to June 30,2020.For the included literature,we applied the cochrane collaboration network risk bias assessment tool to evaluate the methodological quality,and evaluated the level of evidence according to GRADE standards.Quantitative data was analyzed by RevMan5.3 software,and trial sequential analysis method was used to analyze its efficiency.Results:A total of 709 cases in 10 articles were included.Compared with the control group,the related traditional Chinese medicine group improved the effective rate[RR=1.45,95%CI(1.32,1.58)],reduced the level of UA[MD=-36.24,95%CI(-41.03,-31.45)],BUN[SMD=-1.27,95%CI(-1.47,-1.07)]and SCR[MD=-36.33,95%CI(-55.79,-16.87),P=0.0003],the difference between the two groups was statistically significant(P<0.05).There was no evidence that a significant adverse reaction occurred.The results of TSA analysis showed that the Chinese medicine group had definite evidence for improving the efficiency.According to the GRADE evaluation criteria,the efficiency,UA,BUN and SCR outcome indicators were extremely low-quality evidence.Conclusions:Traditional Chinese medicine for regulating spleen and kidney in the treatment of chronic uric acid nephropathy improved efficiency,reduced the level of UA,BUN,SCR.Meanwhile,the therapy was proved to be safe.Nevertheless,the conclusions need further high-quality evidence to support.

Theoretical Discussion on Treatment of Cubital Tunnel Syndrome Based on Theory of Liver,Spleen and Kidney

Cubital tunnel syndrome is a disease in which ulnar nerve is compressed by its surrounding tissues,and its main clinical manifestations are pain,sensory disturbance and dyskinesia.Its incidence rate is the second highest among peripheral nerve entrapment diseases,and it is one of the common clinical diseases.The theory of liver,spleen and kidney can guide the treatment of cubital tunnel syndrome with traditional Chinese medicine and acupuncture.By discussing the traditional Chinese medicine(TCM)pathogenesis and treatment principles of cubital tunnel syndrome,it provides modern medical theoretical support for TCM treatment of cubital tunnel syndrome.

Summary and Prospect of Treating Ulcerative Colitis by Warming the Kidney and Strengthening the Spleen

The method of warming the kidney and strengthening the spleen is widely used in the treatment of ulcerative colitis (UC) with significant curative effect.This paper reviews the relevant literature in recent years.

Clinical Factors Affecting Platelet Growth in the Treatment of Aplastic Anemia by Tonifying Kidney and Generating Blood

Objective:To investigate the influence of kidney-tonifying and blood-generating method on platelet(PLT)growth in the treatment of aplastic anemia(AA)and analyze the characteristics of the clinical factors affecting PLT growth.We enrolled patients treated from September 2018to March 2021 in the China Academy of Traditional Chinese Medicine(TCM)Xiyuan Hospital,China Academy of TCM hospital gate 19sub-center.We enrolled 128 AA patients,for whom the inclusion criteria were:treatment is given priority to with kidney and heart's-blood method,on the basis of western medicine treatment for kidney fill party avoid Fried instant particles,stay for 3 months for a period of treatment,taking two consecutive period of treatment,changes in the PLT were observed,and the clinical characteristics of AA patients,such as PLT growth and recovery from baseline value,were analyzed.Materials and Methods:A total of 128 AA patients from 19 branches of Xiyuan Hospital,China Academy of Chinese Medical Sciences and Guang'anmen Hospital,China Academy of Chinese Medical Sciences treated from September 2018 to March 2021 were enrolled.The treatment was based on the kidney-tonifying and blood-generating method and lasted for 3 months as a course of treatment.The changes in the number of PLT in patients were observed,and the clinical characteristics of AA affecting PLT growth and recovery from baseline value were analyzed.Results:After 6 months of treatment following the kidney-tonifying and blood-generating method,PLT increased from the baseline values in 75 cases,including 21 cases of AA with normal PLT recovery and 54 cases of AA without normal PLT recovery.There were 53 cases of AA in whom PLT did not increase from the baseline.Analysis of the general data showed that patients with lower Karnofsky Performance Status(KPS)score were more likely to experience PLT growth or even return to normal after therapy(P<0.05).The results of routine blood analysis showed that when hemoglobin(HGB)was≥60 g/L and the reticulocyte(RET)proportion was≥0.3%before treatment,PLTs were more likely to increase,even returning to normal in some patients(P<0.05).Analysis of bone puncture results before treatment showed that when the proliferation of nucleated cells was low or extremely low in bone puncture examination,with the proportion of granulocytes<40%,and the proportion of erythroid cells<20%,the treatment method was more effective at increasing PLT count(P<0.05).Analysis of the chromosome karyotype results before treatment showed that when the chromosome karyotype was normal,PLTs were more likely to increase or even return to normal after treatment(P<0.05).Analysis of T-lymphocyte subsets before treatment showed that when CD3+human leukocyte antigen(HLA)-DR+proportion was≥30%,PLTs were more likely to increase or even return to normal(P<0.05).Conclusions:AA patients with a low KPS score,higher HGB≥60 g/L,RET proportion≥0.3%,low or extremely low proliferation of nucleated cells,granulocytes proportion<40%,erythroid proportion<20%,normal chromosome karyotype,CD3+HLA-DR+≥30%,should be treated with a kidney-tonifying and blood-generating method.Such patients are more likely to show PLT growth and the values may even return to normal.

Chief Physician Defen Wang’s Clinical Experience in Dialectical Treatment with Mediation Method of Perimenopausal Sweating

The objective of this paper is to outline Chief Physician Defen Wang’s clinical experience in perimenopausal sweating syndrome differentiation and treatment,to inherit Mr.Gao’s academic concept of mediation technique,and to integrate multiple prescriptions under Mr.Gao’s thinking.The deficiency is based on the deficiency of liver and kidney Yin,the weakness of spleen and stomach,and the standard is the imbalance of Ying and Wei,the imbalance of Qi,blood and body fluid,and the main method of treatment is nourishing liver and kidney,soothing liver and invigorating spleen,regulating Ying and Wei,as well as tonifying Qi and absorbing fluid.

Study of Different Patterns of Immuno-Modulatory Mechanism byTonifying Kidney and Invigorating Spleen Drugs

Objective: To observe the acting pattern on the immune system by Kidney tonifying (KT) drugs. Methods: Three composite recipes were used on the 7- and 14-day corticosterone rat model to study the effect of recipes on the different patterns of immuno-modulatory and neuro- endocrinological systems. Results:The immune system of Spleen Invigorating(SI) group was well protected in either 7- or 14-day experiments,with the SI recipe showing no effect on the neuroendocrine system. It suggested that SI recipe might have direct action on immune system. On the other hand, KT group with no effect on neuroendocrine-immune (NEI) system in 7-day experiment, but showed a remarkable protective effect of the whole NEI system in 14-day experiment. Conclusion: The results indicated that KT recipe acts on the neuroendocrine system first, and then influence the immune system. It means that the action took place through down pathway of NEI network.

基于“苦欲补泻”从脾论治慢性心力衰竭

慢性心力衰竭是各种心脏疾病的严重和终末阶段。中医概括其病机为“虚”“瘀”“水”,以心之气阳亏虚为本,以血瘀、水停为标,病位涉及五脏,尤以心脾关系密切。苦欲补泻理论源于《黄帝内经》,是指导临床组方用药的重要原则。本文结合脾苦欲补泻理论,探讨慢性心衰病机,论述苦温燥湿、甘淡补脾、甘温补虚的治疗原则,以期为慢性心衰治疗提供新的方法及思考。

健脾补肺法联合西药治疗肺脾气虚型维生素D缺乏性佝偻病疗效观察

目的:维生素D缺乏性佝偻病是以骨骼病变为主的慢性营养缺乏性疾病,主要特征是形成骨基质钙化障碍,常伴有反复呼吸道感染、肌肉松弛、食欲降低、便溏、囟门迟闭、夜惊、出汗等症状,若不及时进行治疗,将会发生骨骼异常,严重影响患儿的生长发育。西医目前治疗该病多通过补充维生素D促进钙磷吸收,但长期连续口服维生素D存在一定的不良反应,可导致软组织钙沉着、肾功能损害。近年来中医中药在防治维生素D缺乏性佝偻病中表现出了良好的技术优势,本研究主要观察健脾补肺法联合西药治疗肺脾气虚型维生素D缺乏性佝偻病疗效。方法:将90例患儿随机分为治疗组45例、对照组45例。对照组予以骨化三醇及葡萄糖酸钙,治疗组在对照组基础上口服以健脾益气、补肺固表为基础的中药颗粒剂,服药3个月后,观察两组的综合疗效及比较治疗前后症状(精神、毛发情况、食量状况、出汗、面色、大便性状、患感冒次数)的中医证候总积分。结果:治疗组总有效率为95.24%(40/42),对照组总有效率为78.05%(32/41),两组差异有统计学意义(P <0.05);治疗后两组中医证候总积分比较,差异有统计学意义(P <0.05)。结论:健脾补肺法联合西药治疗肺脾气虚型维生素D缺乏性佝偻病疗效确切,可显著降低患者中医证候评分,值得临床推广。

Mechanism of Erhuang capsule for treatment of multiple sclerosis

Erhuang capsule, a typical formula based on traditional Chinese medicine theory, is widely used to ameliorate multiple sclerosis, inflammation and side effects of glucocortJcoid treatment. Oligodendrocyte precursor cells are neural stem cells that are important for myelin repair and regeneration. In the present study, Erhuang capsule effectively improved clinical symptoms and neurological function scores, reduced mortality and promoted recovery of neurological functions of mice with experimental autoimmune encephalomyelitis. The mechanism of action involved significant increases in oligodendrocyte precursor cell proliferation in specific regions of the brain and spinal cord, increased oligodendrocyte lineage gene 2 expression and enhanced oligodendrocyte precursor cell differentiation.

Tonifying Kidney, Lung, and Spleen Combined with Western Medicine for Stable Chronic Obstructive Pulmonary Disease: A Systematic Review

Introduction:This study aimed to evaluate the clinical effectiveness and safety of tonifying kidney,lung,and spleen(TKLS)combined with Western medicine for stable chronic obstructive pulmonary disease(COPD).Materials and Methods:Randomized controlled trials(RCTs)of TKLS for stable COPD were searched from four databases including Pub Med,the Cochrane Library,China Biology Medicine,and China National Knowledge Infrastructure from inception to December 2017.Two reviewers independently screened the literature,extracted the data,and assessed the risk of bias in the included studies.Rev Man5.3 software was used for meta-analysis.Results:Fourteen RCTs involving 1339 patients with stable COPD were included.Five of the included articles described the specific method of randomization,1 of them was double-blind method research,and 1 of them was single-blind method research.Compared with the conventional Western medicine(CWM)group,the use of TKLS,if combined with CWM demonstrated significantly improved effective rate(relative risk=1.25,95%confidence interval[CI]:1.18–1.33,P<0.00001),decreased traditional Chinese medicine syndrome score(mean difference[MD]-5.72,95%CI:-8.31 to-3.14,P<0.0001),Decreased St George's Respiratory Questionnaire total score(MD-7.39,95%CI:-10.46 to-4.31,P<0.00001),increased 6-min walk distance in meters(MD 78.46,95%CI:60.18–96.73,P<0.00001),increased forced expiratory volume 1%(MD 6.49,95%CI:3.64–9.33,P<0.00001),increased CD4(MD 9.84,95%CI:6.73–12.94,P<0.00001),CD8(MD-1.84,95%CI:-3.62 to-0.06,P=0.04)and CD4/CD8(MD 0.26,95%CI:0.20–0.32,P<0.0001),and increased immunoglobulin M(MD 0.15,95%CI:0.10–0.20 P<0.00001)..Conclusions:For stable COPD,TKLS combined with CWM is superior to CWM alone with regard to clinical effectiveness,symptoms,and quality of life.The above conclusion needs to be validated by further well-designed,multicentric,large-scale,double-blinded RCTs.

中药复方益肾康加减治疗气阴两虚兼血瘀证早期糖尿病肾病疗效观察及对炎症因子影响

目的 观察益肾康治疗早期糖尿病肾病(diabetic kidney disease,DKD)气阴两虚兼血瘀证患者的临床疗效及对血清炎症因子白介素-1β(IL-1β)、白介素-18(IL-18)的调节作用。方法 选取2019年1月—2021年1月就诊于辽宁中医药大学附属医院内分泌科确诊为气阴两虚兼血瘀证的早期DKD患者96例,采用随机对照研究方法,对照组(n=48)进行西医综合治疗(包括生活方式干预、控制血糖、控制血压、调脂),中药组(n=48)在对照组的基础上,加用益肾康煎剂100 mL,日3次口服;两组患者均持续治疗12周。观察两组患者临床疗效、尿微量白蛋白/尿肌酐(UACR)、中医证候评分、临床蛋白尿发生率,以及血清炎症因子IL-1β、IL-18的水平。结果 中药组治疗临床总有效率(83.33%)高于对照组(60.47%)(P<0.05);与治疗前相比,两组患者治疗后UACR均有所降低,但中药组差异具有统计学意义(P<0.01),而对照组差异无统计学意义(P>0.05);治疗后两组患者中医证候评分整体均呈下降趋势,且中药组中医证候评分下降更明显(P<0.01);两组患者临床蛋白尿发生率方面比较差异无统计学意义(P>0.05);与治疗前比较,治疗后两组患者血清IL-1β、IL-18水平均有所降低(P<0.01),与对照组相比,中药组患者血清IL-1β、IL-18水平降低更明显,差异有统计学意义(P<0.01)。结论 益肾康联合西医综合疗法治疗早期2型糖尿病肾病能提高临床疗效,改善患者中医症状,降低蛋白尿,减轻机体炎症反应,且安全性良好。

One Case of Professor ZHAO Jun's Effective Intervention in Children's Height After Menstrual Onsets

A clinical case of Professor ZHAO Jun's intervention in children's height after menstrual onsets is introduced in this paper,and she believes that regulating spleen and kidney should be paid attention to children in the middle and late stages of puberty.In clinical practice,Pericarpium Citri Reticulatae,Rhizoma Pinelliae and Poria in Erchen Decoction(二陈汤)are used to remove dampness and resolve phlegm,as well as to regulate Qi(气)and invigorate spleen.Fructus Ligustri Lucidi and Herba Ecliptae in Erzhi Pills(二至丸)are applied to invigorate liver and kidney,as well as to regulate Thoroughfare and Conception Channels,so as to achieve the effect of Yin(阴)and Yang(阳)coordination.It has significant efficacy.

补气健脾疏肝法联合生物反馈治疗出口梗阻型便秘的临床研究

目的探究补气健脾疏肝法联合生物反馈治疗出口梗阻型便秘的临床疗效。方法选择河北省石家庄市中医院肛肠科气虚秘型出口梗阻型便秘患者80例作为研究对象,根据随机数字法分为试验组与对照组,两组各40例。对照组予以生物反馈治疗,30 min/次,每周3次;试验组在对照组基础上予补气健脾疏肝法治疗,每日1剂,水煎取汁400 mL,分早晚两次温服。两组均连续治疗4周。观察两组治疗前后的中医临床疗效、证候评分、肛门疼痛情况、生活质量及安全性。结果治疗后,试验组的临床总有效率(97.5%)优于对照组(72.5%)(P<0.05)。治疗后,与治疗前比较,两组排便频率、排便困难、粪便性状、排便时间、肛门堵塞感、排便不尽感的中医证候评分、疼痛数字评定量表(numerical rating scale,NRS)、便秘患者生活质量自评量表(patient assessment of constipation quality of life questionnaire,PAC-QOL)评分均下降(P<0.05);与对照组比较,试验组各项证候评分、NRS评分、PAC-QOL评分较低(P<0.05)。与对照组相比,试验组不良反应较低(P<0.05)。结论生物反馈联合补气健脾疏肝法治疗出口梗阻型便秘疗效确切,可有效缓解患者的临床症状,减轻患者的肛门疼痛,并提高患者的生活质量。

基于正邪平衡理论探讨肠道菌群在肿瘤免疫治疗中的双向作用

免疫治疗作为新兴的抗肿瘤疗法被逐步运用。人体中的肠道菌群,通过代谢转化或移植,依附于肠道黏膜表面,分泌抗体形成保护屏障,或者激活免疫信号传导通路,释放免疫细胞,菌群辅助免疫疗法消杀肿瘤。而菌群失调,特别是有益菌与致病菌或者条件致病菌分布失衡,则会诱发炎症反应,错误性攻击正常免疫细胞或组织,免疫功能下降,最终导致病邪入侵积聚成瘤。现基于正邪消长平衡,从肠道菌群在肿瘤免疫治疗作用的两面性出发,剖析其诱发肿瘤增长或者增强肿瘤免疫治疗的主要因素,即菌群比例与免疫系统的相关平衡,同时从扶正祛邪观点出发,提出以脾肾为中心,清补兼施为法调整肠道菌群平衡,增强机体御邪能力,力求为肿瘤免疫治疗带来新思路。

从患者视角漫话大方复法治疗慢性肾功能不全的体会

肾功能不全可分为急性肾功能损伤和慢性肾功能衰竭。此病是由原发或继发性肾脏疾病导致的肾小球滤过功能下降、肾小管浓缩功能障碍,并由此引发的血尿、蛋白尿、水肿、高血压等一系列临床综合征。如果不及时治疗,常可导致尿毒症的发生。文章介绍一例以大方复法结合中西医基础治疗治愈慢性肾功能不全(Chronic Renal Failure,CRF)的案例,患者宏观症状消失或减轻,微观检查指标消失或改善。文章从态靶辨证的观点出发,探讨患者病情,大方复法的定义、理论根据、内涵,以及大方复法在CRF中的疗效,以期为临床提供参考。

补肾健脾法联合顺势牵引对脾肾两虚型腰椎间盘突出症患者的临床疗效

目的考察补肾健脾法联合顺势牵引对脾肾两虚型腰椎间盘突出症患者的临床疗效。方法84例患者随机分为对照组和观察组,每组42例,对照组采用顺势牵引,观察组在对照组基础上加用补肾健脾法,疗程6个月。检测临床疗效、VAS评分、腰椎功能指标(JOA评分、ODI)、脊柱椎旁肌肌电图指标(竖脊肌和多裂肌平均振幅、平均频率斜率)、疼痛介质因子(PEG2、5-HT、NPY)、安全性指标变化。结果观察组总有效率高于对照组(P<0.05)。治疗后,2组VAS评分、ODI评分、竖脊肌和多裂肌平均频率斜率、疼痛介质因子降低(P<0.05),JOA评分、竖脊肌和多裂肌平均振幅升高(P<0.05),以观察组更明显(P<0.05)。2组未发现不良反应。结论补肾健脾法联合顺势牵引可安全有效地减轻脾肾两虚型腰椎间盘突出症患者疼痛症状,改善腰椎、椎旁肌功能。

健脾补肾法对人结直肠癌裸鼠VEGF-C、VEGFR-3、E-cadherin、Vimentin表达的影响

目的:探讨健脾补肾法对人结直肠癌裸鼠血管内皮生长因子C(VEGF-C)、血管内皮生长因子受体3(VEGFR-3)、E黏钙蛋白(E-cadherin)、波形纤维蛋白(Vimentin)的影响。方法:16只裸鼠接种人结直肠癌细胞株HCT116构建结直肠癌移植瘤模型,随机分为对照组和实验组,对照组给予生理盐水灌胃,实验组给予健脾补肾中药复方灌胃,两组均隔天给药1次,持续14 d。给药结束后,脱颈处死后剥离瘤体,免疫组化检测肿瘤组织中VEGF-C、VEGFR-3、E-cadherin、Vimentin的表达。结果:16只结直肠癌移植瘤模型裸鼠均构建成功,免疫组化结果显示:与对照组比较,实验组移植瘤组织中VEGFC、VEGFR-3、Vimentin的表达均明显下调(P<0.05),E-cadherin的表达明显上调(P<0.05)。结论:健脾补肾法能下调人结直肠癌裸鼠中促进肿瘤淋巴管生成和转移的VEGF-C、VEGFR-3表达及上皮-间质转化标志物Vimentin表达,同时上调E-cadherin表达,有抑制肿瘤细胞转移的作用。

国医大师王庆国教授辨治胃下垂经验

[目的]总结国医大师王庆国教授辨治胃下垂的临床经验。[方法]通过跟师随诊,整理并分析王教授治疗胃下垂的医案,总结王教授治疗胃下垂的辨治思路、临床心得、常用方剂及用药特色,并附验案两则加以佐证。[结果]王教授认为胃下垂属内伤杂病,气虚始终为本,病情发展由简单到复杂,一病到多病;病在脾胃,与肝胆密切相关,久病可累及肾。治疗时重视辨别病症之标本缓急,病情单纯、胃下垂为主要病症时,以恢复脏器位置为主,方用补中益气汤、枳术汤、三仙汤;病情复杂、胃下垂为次要病症时,以调理脏腑气机寒热为主,方用半夏泻心汤、柴胡桂枝汤,益气贯穿全程。所举验案一以胃下垂为主要病症,治以补脾益肾、升阳举陷;一以胃下垂为次要病症,治以平调寒热、疏肝和胃。[结论]王教授治疗胃下垂,辨别标本缓急,虚实异治,时刻顾护胃气,随证加减,精当用药,取得了良好疗效,值得学习借鉴。

李应存教授运用敦煌补脾调肾法治疗脾肾两虚型泄泻验案举隅

泄泻类疾病在临床上存在兼症变化多、难治愈、易反复等问题。中医药治疗可对其根本的病因病机进行辨证治疗,并对全身气血气机进行调理,中药治疗泄泻具有疗效明显,且不易反复的特点。李应存教授认为脾肾两虚型泄泻常由饮食不节、情绪、外感湿邪等导致。因脾肾虚衰,其运化输布水液不力,更会出现湿气内阻,水液内停之虚实夹杂的症状。李应存教授根据此病型病因病机,结合挖掘敦煌大补脾汤与大补肾汤,提出补脾调肾法治疗脾肾两虚型泄泻,以补法为主,并根据其兼症进行加减组方。临床疗效显著。

健脾益气法治疗癌症术后食欲不振临床观察

目的 观察健脾益气法治疗癌症术后食欲不振的临床效果,为解决癌症术后患者食欲不振的问题寻找更加有效的治疗方法。方法 选择滦州市人民医院癌症术后食欲不振患者60例,分为对照组和试验组。对照组在基础治疗基础上加醋酸甲地孕酮分散片治疗,试验组在基础治疗基础上给予健脾益气法治疗。对比2组患者1个月后的体质量、进食量、血清白蛋白水平,评价健脾益气法对癌症术后食欲不振患者的作用。结果 醋酸甲地孕酮分散片与健脾益气法均能显著提高患者体质量、进食量、血清白蛋白水平,其中进食量方面健脾益气法优于醋酸甲地孕酮分散片。结论 健脾益气法可改善癌症术后食欲不振的症状,且改善进食量的效果显著,值得临床推广。