Therapeutic effect of traditional Chinese medicine on coagulation disorder and accompanying intractable jaundice in hepatitis B virus-related liver cirrhosis patients

AIM： TO observe the therapeutic effects of new traditional Chinese medicine （TClVl） therapy on coagulation disorder and accompanying intractable jaundice in HBV-related liver cirrhosis patients. METHODS： Using stratified random sampling according to fibrinogen （Fib） levels, 145 liver cirrhosis patients due to hepatitis B complicated by coagulation disorder were treated. Of them, 70 in research group were treated with TCM by ＂nourishing yin, cooling blood and invigorating blood circulation＂ and Western medicine, 75 in control group were treated with conventional Western medicine. The indexes of liver function, coagulation function and bleeding events were observed and compared. RESULTS： The prothrombin time （PT） was shorter and the fibrinogen （Fib） level was higher in the research group than in the control group （Fib = 1.6-2.0 g/L, 1.1-1.5 g/L, and ≤ 1.0 g/L）. The total bilirubin （TBIL） level was significantly lower in the research group than in the control group, except for the subgroup of FIB ≤ 1.0 g/L. CONCLUSION： TCM therapy can improve coagulation fuction and decrease TBIL.

Effect of Chinese Drugs for Supplementing Qi,Nourishing Yin and Activating Blood Circulation on Myocardial Perfusion in Patients with Acute Myocardial Infarction after Revascularization

Objective:To observe the effects of Chinese drugs for supplementing qi,nourishing yin and activating blood circulation on the myocardial perfusion in acute myocardial infarction(AMI) patients after revascularization.Methods:Eighty patients with anterior or inferior ventricular wall AMI,who had received revascularization by intravenous thrombolysis or coronary bypass,were randomized into the treated group and the control group equally,both treated with conventional Western medical treatment,but combined,resp...

Effect of Chinese Herbal Medicine for Nourishing Yin,Supplementing Qi,and Activating Blood on the Th1/Th2 Immune Balance in Peripheral Blood in Patients with Primary Sjogren's Syndrome

Objective： To observe the effect of Chinese herbal medicine for nourishing yin, supplementing qi, and activating blood on the expression of interferen- γ （IFN-γ,）/interleukin-4 （IL-4） in peripheral blood and disease activity in primary Sjogren＇s syndrome （pSS） patients, and to study the relationship between the immune balance of Th1/Th2 and the disease activity. Methods： A total of 66 pSS patients were randomized with tossing coins method into two groups： the integrative therapy group （34 cases） and the control group （32 cases）; and 28 healthy subjects were taken as the normal group. The integrative therapy group was treated by Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood combined with hydroxychloroquine sulfate tablets and the control group was treated with hydroxychloroquine sulfate tablets. The treatment course was 3 months for both groups. The levels of serum immunoglobulin G （IgG）, erythrocyte sedimentation rate （ESR）, IFN-γand IL-4 in peripheral blood were measured before and after treatment. Results： Compared with the normal group, the levels of IgG, ESR, IFN- γ and IL-4 were significantly increased in pSS patients （P〈0.05）. Remarkably, after 3 months of treatment, these levels were dramatically decreased in both the integrative therapy group and the control group, although still higher than the normal group. The levels of IgG, ESR, IFN- and IL-4 in the integrative therapy group were lower than the control group and the same group before treatment （P〈0.05）. The ratio of IFN-γ/IL-4 also significantly decreased after treatment. Moreover, the level of IFN- γ, and the ratio of IFN- γ/IL-4 in the integrative theraphy group were significantly lower than the control group （P〈0.05）. For all patients the ratio of IFN-γ/IL-4 before and after treatment was positive correlated with the levels of IgG and ESR. Conclusion： Chinese herbal medicine for nourishing yin, supplementing qi, and activating blood can alleviate the disease activity of pSS by regulating the immune balance of Th1/Th2.

Effect of Chinese Herbal Medicines for Nourishing Yin,Supplementing Qi,and Activating Blood on Reproductive Endocrine Activity and Immune Functions in Patients with Primary Sjogren's Syndrome

ABSTRACT Objective： To investigate the effect of Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood on the reproductive endocrine-immune network and its mechanisms in patients with primary Sjogren＇s syndrome （pSS）. Methods： Seventy pSS patients were randomly assigned to two groups using a randomized digital table： the integrative therapy group （36 cases） and the control group （34 cases）. Thirty healthy subjects were taken as a normal group. The control group was treated with hydroxychloroquine sulfate tablets alone, and the integrative therapy group was treated by Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood combined with hydroxychloroquine sulfate tablets. The treatment course was 6 months for both groups. Before and after treatment, serum estradiol （E2）, testosterone （T）, luteinizing hormone （LH）, prolactin （PRL） by radioimmunoassay and immunoglobulin （IgG） by immunodiffusion, erythrocyte sedimentation rate （ESR） by Westergren, interferon-γ （IFN-γ） and interleukin-4 （IL-4） by enzyme linked immunosorbent assay were determined. Results： E2 and T levels in all patients were lower than those of normal subjects before treatment （P〈0.05） and were increased significantly after 6-month treatment （P〈0.05）. ESR, FSH, LH, IgG, IFN - γ, IL - 4 and ratios of E2/T, and IFN --γ/IL in the patients were higher than those of normal subjects before the treatments （P〈0.05）, and were reduced significantly after the treatments （P〈0.05）. The T and IFN -γ levels and E2/T ratio in the patients treated with integrative therapy were reduced significantly compared with the control group （P〈0.05）. However, the PRL levels before and after treatment were not significantly changed in the two groups （P〉0.05）. The ratios of E2/T and IFN -γ/IL-4, and levels of IgG and ESR were positively correlated before and after treatment （P〈0.05）. Conclusions： The ratios of E2/T and IFN - γ/ IL-4 might be used as indicators of pSS activity. Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood combined with Western medicine could improve the therapeutic effect by regulating the reproductive endocrine-immune network in pSS patients.

Protective Effect of Chinese Herbs for Supplementing Qi,Nourishing Yin and Activating Blood Circulation on Heart Function of Patients with Acute Coronary Syndrome after Percutaneous Coronary Intervention

Objective： To investigate the effects of Chinese herbs for supplementing qi, nourishing yin and activating blood circulation on heart function of patients with acute coronary syndrome （ACS） after successful percutaneous coronary intervention （PCI）. Methods： One hundred patients with ACS after successful PCI were randomly assigned to a Western medicine （WM） treatment group （WMG） and a combined treatment group （CMG） treated by Chinese herbs for supplementing qi, nourishing yin and activating blood circulation, besides Western medicine treatment, with 50 cases in each group. Both treatment courses were 6 months. The follow- up was scheduled at baseline, 6 months and 1 year after PCI, and New York Heart Association （NYHA） functional class, Chinese medicine （CM） symptom scores, blood stasis syndrome scores, and major adverse cardiovascular events （MACE） were observed, serum levels of N-terminal pro-brain natriuretic peptide （NT-proBNP） and hyper-sensitivity C-reactive protein （Hs-CRP） were measured, an echocardiogram was conducted to examine left ventricular ejection fraction （LVEF）, left ventricular end-diastolic volume （LVEDV）, left ventricular end-systolic volume （LVESV）, inter-ventricular septal thickness （IVST）, left ventricular posterior wall thickness （LVPWT）, and ventricular wall motion index （VWMI）. Results： Compared with the baseline, LVEF significantly increased （P〈0.01）, and CM symptom scores, blood stasis syndrome scores, VWMI, LVEDV, LVESV, NT-proBNP, and Hs-CRP all decreased （P〈0.01） in both groups at 6 months and at 1 year after PCI. There were no significant differences in all the above parameters at 1 year vs those at 6 months after PCI （P〉0.05）. VWMI, LVEDV, LVESV, NT-proBNP, Hs-CRP, LVEF, and CM symptom and blood stasis syndrome scores were all improved obviously in CMG than those in WMG （P〈0.05 or P〈0.01） at 6 months and at 1 year after PCI. There were no significant differences in NYHA functional class between CMG and WMG at different follow-up timepoints; it was notable that P value was 0.054 when comparing the cases of NYHA functional class between the two groups at 1-year follow-up. During the 1-year follow-up, 3 MACE and 11 MACE occurred in CMG and WMG, respectively; the MACE rate in CMG was lower than that in WMG （6% vs 22%, P〈0.05）. Conclusion： Chinese herbs for supplementing qi, nourishing yin and activating blood circulation could improve heart function, reduce the CM symptom scores and blood stasis syndrome scores, and decrease the incidence of MACE in patients with ACS after successful PCI.

Effects of Chinese herbs capable of replenishing qi, nourishing yin and activating blood circulation and their compatibility on differentially expressed genes of ischemic myocardium

This study was conducted to investigate the effects of Chinese herbs capable of replenishing qi, nourishing yin and activating blood circulation and their compatibility on differentially expressed genes of ischemic myocardium which were selected from differential expression profile we had established before, and to explore the underlying mechanism. The acute myocardial infarction (AMI) model was established by ligating the left anterior descending (LAD) coronary artery, then the model rats were randomly divided into the model group, the Metoprolol group, the replenishing qi nourishing yin (RN) group, the activating blood circulation (AB) group, and the replenishing qi, nourishing yin and activating blood circulation (RA) group. In addition, the normal group and the sham group were set up. The rats of medication groups were administered by intragastric gavage with corresponding drugs on the second day after operations, and the rats of the normal group and the sham group were given normal saline as the same time.Then the ischemic hearts were harvested on the 8th day after operation. The myocardial pathomorphological changes were observed under a light microscope. The mRNA changes of target genes such as COX5a and ATP5e were detected using Realtime fluorescence quantitative PCR (QPCR), and the activities of related enzymes were detected by colorimetric assay. The main results were as follows: the histological changes were observed by HE staining, and cardiocyte swelling, inflammatory cell infiltration and cytolysis were showed in regional ischemic myocardium of the model group, while the pathomorphological changes in all medication groups did not show obvious changes. Two genes related to energy metabolism, COX5a and ATP5e, were selected as the target genes which were downregulated at the mRNA level in the medication groups. The activities of correlative functional enzymes also decreased in the RA group compared to that in the model group accordingly (P<0.05). The results indicated that the abnormal expression of genes involved in energy metabolism pathways could be one of the molecular mechanisms of AMI. The compatibility of Chinese herbs capable of replenishing qi, nourishing yin and activating blood circulation affects the expression of energyrelative gene COX5a, ATP5e, which is probably the mechanism of myocardial preservation, and is more effective than single herb of replenishing qi and nourishing yin or activating blood circulation.

益气养阴化痰祛瘀法对甲状腺机能亢进症激素抗体及氧化应激因子表达的影响

目的研究益气养阴化痰祛瘀法对甲状腺机能亢进症(Hyperthyroidism,简称甲亢)患者激素抗体和氧化应激因子表达的影响。方法选取2022年1月—2023年12月收治的76例甲亢患者,按照随机数字表法分组,对照组(38例)采用常规西药治疗,观察组(38例)在对照组基础上加用益气养阴化痰祛瘀方治疗;治疗2个月后对比两组临床疗效、中医证候积分、甲状腺功能(各项激素水平)、氧化应激因子、促甲状腺激素受体抗体(TRAb)、甲状腺过氧化物酶抗体(TPOAb)的表达。结果观察组治疗总有效率为94.74%(36/38),高于对照组(76.32%,29/38),差异有统计学意义(P<0.05)。治疗后,两组主症积分、次症积分和舌脉积分均降低,观察组低于对照组;两组促甲状腺激素(TSH)上升,游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)下降(P<0.05),观察组改善高于对照组;两组超氧化物歧化酶(SOD)升高,观察组SOD水平高于对照组,差异有统计学意义(P<0.05)。结论益气养阴化痰祛瘀法用于甲亢患者的治疗取得确切治疗成果,可以有效改善甲状腺功能,通过调控甲状腺激素水平、TRAb、TPOAb以及氧化应激因子的表达以改善病情,缓解症状。

钱秋海教授“益气养阴、祛瘀散结”法治疗肺结节的经验探讨

肺结节是一种常见的肺部疾病,其特点是肺内直径小于或等于3 cm的局灶性、类圆形、密度增高的实性或亚实性阴影,属于中医学“肺积”范畴。现代医学诊断和治疗肺结节的手段有限,通常采用影像学动态观察和定期随访的策略监测结节的变化情况。中医在治疗肺结节方面有独特的理论优势和实践经验。钱秋海教授从肺的生理特性出发,提出了一套治疗肺结节的中医临床思路和用药经验。钱教授认为治疗肺结节应当遵照“肺为娇脏、喜润恶燥”的特点,强调扶正与祛邪兼顾,并提倡使用行气化痰、散结祛瘀的药物,这些药物具有走窜之性,能够有效疏通肺的气机,化解痰湿,消散结节,祛除瘀血,从而起到“养阴不敛邪,祛瘀不伤正,散结不耗津”的功效。钱教授将中医治疗法与现代医学的检查手段相结合,更全面、更有效地对肺结节进行诊断和治疗,提高了患者的生活质量。本研究对钱秋海教授治疗肺结节的临床思路和用药经验进行归纳总结,得出中医治疗疾病时基于整体观念和辨证施治原则,通过调和人体的阴阳平衡,强化正气,驱除病邪,展现了中医在治疗肺结节方面独特的优势和潜力。

滋阴安神膏治疗围绝经期失眠的效果

目的分析滋阴安神膏治疗围绝经期失眠的效果。方法选取2021年7月—2023年6月在本院就诊的59例围绝经期失眠患者为研究对象,按照随机数字表法将其分为对照组(29例)和观察组(30例)。对照组接受西医治疗,观察组在对照组治疗的基础上加用滋阴安神膏治疗,两组均治疗1个月。比较两组治疗效果。结果观察组临床总有效率高于对照组(P<0.05);治疗后,两组匹兹堡睡眠质量指数(PSQI)、失眠时间、噩梦纷纭、易惊易醒评分、血清促黄体生成素(LH)、卵泡刺激素(FSH)水平均比治疗前更低,且观察组上述指标值低于对照组;两组血清雌激素(E2)水平比治疗前更高,且观察组E2水平高于对照组(P<0.05)。结论滋阴安神膏治疗围绝经期失眠可显著缓解患者临床症状,提高其睡眠质量,调节性激素水平,临床应用效果显著。

基于气阴两虚夹瘀运用五参汤治疗肺癌术后发热浅析

肺癌术后发热有非感染性发热与感染性发热之分,在气虚、阴虚、瘀血阻滞病理状态下形成热蕴状态,是为非感染性发热;而术中感染或外感风寒入里化热则形成感染性发热表现。其基本病机均可概括为气阴两虚夹瘀。五参汤具有益气养阴、清热解毒之功,为证属正气亏虚、外感邪毒者而设,用于肺癌术后发热契合其病机。

活血养阴明目方对非增生性糖尿病视网膜病变的影响

目的 探讨活血养阴明目方对于非增生性糖尿病视网膜病变(NPDR)患者中医证候评分以及视力水平的影响。方法 将NPDR患者80例采用随机数字表法分为试验组和对照组,各40例。对照组采取羟苯磺酸钙胶囊治疗,试验组在对照组的基础上加用活血养阴明目方,观察2组临床疗效并比较治疗前后视力水平、中医证候评分、黄斑中心视网膜凹厚度变化。结果 试验组的总有效率高于对照组(P<0.05);试验组治疗后1、2个月的最佳矫正视力优于对照组,黄斑中心视网膜凹厚度低于对照组(P<0.05);试验组治疗后中医证候评分低于对照组(P<0.05)。结论 给予NPDR患者活血养阴明目方治疗能提高治疗有效率、改善视力水平、减少中医证候评分、降低黄斑中心视网膜凹厚度。

单味中药有效成分治疗溃疡性结肠炎研究进展

研究表明,中药治疗溃疡性结肠炎不良反应少且复发率低,临床常用益气健脾、清热祛湿、活血化瘀、补血养阴类中药组方治疗,其主要药物的有效成分具有减轻炎症反应、修复黏膜损伤、调节肠道微生态、调节免疫反应等作用。本文对常用单味中药有效成分治疗溃疡性结肠炎的作用机制进行综述,为其临床治疗与中药新药研发提供参考。

从肺论治胆石症

胆石症的形成与精气血津液失调密切相关,肺参与精气血津液的生成与运行,并因此对胆气通降、胆汁排泄、胆腑疏通等产生影响。通过宣肃肺气、补益肺阴、顾护肺卫,可改善机体因精气血津液失调而产生的气滞、血瘀、湿盛、阴虚等病理变化,从而达到治疗胆石症的目的。当前临床治疗胆石症多从脾胃肝肾入手,从肺论治是一种新思路。

基于“二阳结谓之消”探讨糖尿病性便秘病机及防治策略

“二阳结谓之消”语出《素问·阴阳别论篇》,是认识糖尿病性便秘的早期记载,但目前学界多据此仅从二阳(足阳明胃经、手阳明大肠经)结滞化热来解释消渴期发生便秘的病机,存在一定局限性。通过考究发现“二阳”并不单指手足阳明经脉或胃肠二腑,而是包括胃、大肠二腑及手足阳明经脉;“结”也并不完全指结热这一病邪,而是指病邪胶结难解、疾病难以治愈的程度,并且“二阳”之热易伤血脉,造成络脉瘀滞。基于对“二阳结谓之消”的重新理解,笔者认为糖尿病性便秘在糖尿病期以“热伤气阴”为主要病机,糖尿病并发症期以热伤血络、血脉瘀滞为主要病机。治疗方面,糖尿病期以清热益气养阴为本,糖尿病并发症期以活血化瘀为核心,此外还需重视体质从化,全面把握糖尿病性便秘的诊治。

毛静远教授治疗心肌桥致难治性心绞痛经验

心肌桥导致的难治性心绞痛常给患者带来沉重的躯体和精神负担,中医药治疗能够进一步改善症状,提高生活质量。现总结毛静远教授治疗心肌桥致难治性心绞痛经验,毛教授认为该病病机以血瘀为始动环节,因实致虚,本虚以阴虚为主,血瘀、痰热为标,治疗应注重养阴,兼用活血、化痰、清热,同时须注意顾护调理,避免心衰等并发症的发生。

庞鹤辨治下肢丹毒经验

庞鹤教授认为下肢丹毒根据病程可分为急性期和慢性期,急性期为火毒夹湿所致,多为实证,急性期未得及时治疗则转为慢性丹毒,可见脾虚有瘀,为本虚标实之证。治疗上当以祛邪为首要任务,灵活选择清热解毒、凉血解毒、滋阴清热之法;同时还要注意引邪外出,使邪气或向外散发,或从大小便而解。此外,在疾病治疗的全过程中均应根据湿与热的轻重程度合理选方,强调活血化瘀、注意顾护脾胃、积极防治变证。

活血通络类方剂治疗糖尿病肾脏疾病的研究进展

糖尿病肾脏疾病(DKD)是导致慢性肾脏病和终末期肾病的首要病因,严重危害人类健康。中医认为血瘀是贯穿DKD全病程的重要病机,多项研究拟定了多个活血通络类方治疗DKD患者,其临床症状好转、蛋白尿减少、肾功能保护、治疗有效率提高和疾病进展延缓等方面均有成效。

益气养阴化瘀法治疗气阴两虚兼血瘀证中高危心房颤动的临床研究

目的:观察益气养阴化瘀法治疗气阴两虚兼血瘀证中高危心房颤动的临床疗效及安全性,并探究其作用机制。方法:选取2019年7月—2020年1月6所医院心血管科收治的90例心房颤动病人,脱落6例,采用随机数字表按1∶2分为对照组(28例)和观察组(56例)。对照组给予西药基础治疗,观察组给予西药基础治疗联合益气养阴化瘀法的复脉安心方治疗,两组均治疗24周。比较两组治疗前、治疗第12周、治疗第24周的中医证候积分、血清脑卒中指标[促甲状腺激素(TSH)、胰岛素样生长因子1(IGF-1)]、炎性因子[超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)]和血栓形成因子[血管性血友病因子(vWF)、D-二聚体(D-D)、P-选择素(GMP-140)]以及相关安全性指标。结果:治疗第12周、第24周,观察组中医证候积分低于对照组(P<0.05),且观察组中医证候积分低于治疗前(P<0.05)。治疗第12周,观察组胸闷、盗汗评分低于对照组(P<0.05);治疗第24周,观察组胸闷、疲倦乏力、气短、盗汗评分低于治疗前(P<0.05)。治疗第24周,观察组TSH、IGF-1水平低于对照组(P<0.05),且观察组TSH、IGF-1水平低于对照组(P<0.05);治疗第24周,观察组血清hs-CRP、IL-6、vWF、D-D、GMP-140水平改善程度优于对照组(P<0.05)。两组治疗前后安全性指标比较,差异均无统计学意义(P>0.05)。结论:益气养阴化瘀法治疗气阴两虚兼血瘀证中高危心房颤动病人,可改善中医证候积分,改善心房颤动症状,其机制可能通过减少血栓形成和炎性因子水平而预防脑卒中事件的发生。

益气养阴法联合西药治疗肾病综合征的疗效及安全性的Meta分析

【目的】系统评价益气养阴法联合西药治疗肾病综合征的有效性及安全性。【方法】检索中国知网(CNKI)、中国生物医学文献数据库(CBM)、万方(Wangfang)、维普(VIP)、PubMed、Web of Science、Cochrane Library、Embase等国内外主要文献数据库,筛选其中有关益气养阴法联合西药(试验组)对比单纯西药(对照组)治疗肾病综合征的临床随机对照试验(RCTs),采用Cochrane手册中的偏倚风险工具进行文献的质量评价,运用RevMan 5.3软件进行Meta分析。【结果】共纳入18个RCTs,包含1334例患者。Meta分析结果显示,益气养阴法联合西药在提高临床有效率(RR=1.24,95%CI[1.16,1.32],P<0.00001),改善24 h尿蛋白定量(24hUPRO)(MD=-0.92,95%CI[-1.09,-0.75],P<0.00001)、血清白蛋白(ALB)(MD=7.06,95%CI[4.73,9.39],P<0.00001)、尿素氮(BUN)(MD=-1.57,95%CI[-2.01,-1.13],P<0.00001)、血肌酐(SCr)(MD=-12.23,95%CI[-16.58,-7.88],P<0.00001)、总胆固醇(TC)(MD=-1.06,95%CI[-1.69,-0.43],P=0.0009)、甘油三酯(TG)(MD=-0.58,95%CI[-0.94,-0.21],P=0.002)水平,以及降低不良反应发生率(RR=0.50,95%CI[0.40,0.64],P<0.00001)方面优于单纯西药治疗。【结论】益气养阴法联合西药治疗肾病综合征在提高临床疗效及改善24hUPRO、ALB、BUN、SCr、TC、TG方面优于单纯西药治疗,且能降低激素产生的不良反应。因纳入文献较少,文献质量较低,潜在疗效需更多的高质量研究进行验证。

基于心脏稳态失衡探析高血压心脏病从虚和瘀论治内涵

高血压心脏病是高血压病常见的靶器官损害,是阴阳虚损、瘀久内结的结果,与心脏稳态失衡机制有共通性。本文结合现代医学与传统医学对高血压心脏病的认识,提出以潜阳育阴、调和气血为法,从虚和瘀论治高血压心脏病。