Clinical Effect of Modified Shengyang Yiwei Decoction in the Treatment of Diarrhea-Predominant Irritable Bowel Syndrome due to Spleen and Stomach Weakness

Objective:To explore the therapeutic effect of Shengyang Yiwei Decoction in patients with diarrhea-predominant irritable bowel syndrome(IBS)due to spleen and stomach weakness.Methods:40 patients with diarrhea-predominant IBS who were treated from April 2018 to April 2020 were taken as samples.TCM(traditional Chinese medicine)syndrome differentiation found that they were all due to spleen and stomach weakness.They were randomly divided into two groups.Group A was treated with modified prescriptions of Shengyang Yiwei Decoction,while Group B was treated with Western medicine.The therapeutic effects in the two groups were compared.Results:The treatment efficacy in Group A was higher than that in Group B(P<0.05);the symptom scores of Group A such as loose stools,chills,physical weakness,poor appetite,and abdominal distension after meals were all lower than those in Group B(P<0.05);the SF-36(36-Item Short Form Health Survey)scores of patients with diarrhea-predominant IBS in Group A were higher than those in Group B(P<0.05);the treatment satisfaction of Group A was higher than that of Group B(P<0.05).Conclusion:Treatment of diarrhea-predominant IBS patients with spleen and stomach weakness by Shengyang Yiwei Decoction can promote the disappearance of gastrointestinal discomfort symptoms,improve the quality of life,and enhance treatment efficacy.Hence,it is an efficient and feasible treatment for diarrhea-predominant IBS due to spleen and stomach weakness.

Clinical Observation of the Therapeutic Effects of Wenzhong Hewei Formula in Treating Spleen and Stomach Qi Deficiency Syndrome in Internal Medicine Diseases

Objective:To observe the clinical efficacy and safety of Wenzhong Hewei Formula in treating spleen and stomach qi deficiency syndrome in internal medicine diseases.Methods:Sixty patients with spleen and stomach qi deficiency syndrome admitted to the hospital from April 2022 to June 2023 were randomly divided into observation and control groups,with 30 patients in each group.The control group received conventional internal medicine treatment,while the observation group was additionally treated with Wenzhong Hewei Formula on the basis of conventional treatment.Both groups were treated for 4 weeks.Results:The total effective rate of treatment in the observation group was higher than that of the control group(P<0.05).After treatment,the traditional Chinese medicine syndrome scores of both groups were significantly lower than before treatment,with the observation group showing a more pronounced reduction(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Wenzhong Hewei Formula can effectively improve clinical symptoms in patients with spleen and stomach qi deficiency syndrome,enhance clinical efficacy,and have a high level of safety,making it worthy of clinical promotion.

Current concept of Spleen Stomach theory and Spleen deficiency syndrome in TCM

ＣｕｒｅｎｔｃｏｎｃｅｐｔｏｆＳｐｌｅｅｎＳｔｏｍａｃｈｔｈｅｏｒｙａｎｄＳｐｌｅｅｎｄｅｆｉｃｉｅｎｃｙｓｙｎｄｒｏｍｅｉｎＴＣＭＷＵＸｉｅＮｉｎｇＳｕｂｊｅｃｔｈｅａｄｉｎｇｓｓｐｌｅｅｎｄｅｆｉｃｉｅｎｃｙｓｙｎｄｒｏｍｅ；ｓｐｌｅｅｎｓ...

The new idea of children with tic syndrome:regulating the five Zang-organs with spleen and stomach system as the center

The pediatric body of pure yang,the liver is often more than enough,the spleen is often insufficient,Yang moving surplus,and Yin essence is insufficient,at the same time,children are the body of immature yin and yang,prone to imbalance of yin and Yang,so deficiency of phlegm accumulation and endogenous liver wind,feel ill at ease,dysfunction of lung qi,Insufficiency of kidney yin are the fundamental pathogenesis of children with tic syndrome.This article discusses the relationship between children with tic syndrome and the five Zang-organs,and how to regulate the viscera through regulating the spleen and stomach system,treating both manifestation and root cause of disease,and put forward a new treatment that the spleen and stomach system should be taken as the center to regulate the five Zang-organs in children with tic syndrome,which should be resolved in order of importance and urgency and treated in stages.

CLINICAL STUDY ON SPLEEN-STOMACH-REINFORCING MOXIBUSTION TREATMENT OF DIARRHEA-TYPE IRRITABLE BOWEL SYNDROME

In the present paper, the therapeutic effect of spleen- stomach- reinforcing moxibustion for treatment of irritable bowel syndrome (IBS) is observed and its underlying mechanisms on immunity are analyzed. A total of 72 IBS patients are randomly divided into moxibustion group (n= 46) and acupuncture group (control group, n = 26). Acu-points used are Zhongwan (CV 12), Qihai (CV 6) and Zusanli (ST 36), etc. Serum IgG, IgA and IgM contents, blood T-lympocytes (T3+, T4+, T8+) counts, T4+ /T8+, cancer embryonic antigen (CEA) content, serum IL-2 and slL-2R contents are assayed for evaluating changes of the immunocompetence. After two courses of treatment (24 sessions), results show that in moxibustion group, 25 cases (54.35%) are cured, 17 experience improvement in clinical symptoms and 4 have no apparent changes, with an effective rate of 91.30% ; in control group, 8 cases (30. 78%) are cured, 12 experience improvement and 6 have no marked improvement, with an effective rate of 76.92% . The therapeutic effect of moxibustion is significantly superior to that of acupuncture (P<0.01). In addition, moxibustion can effectively rectify abnormal immune function and stabilize human's immunity. This research provides a reliable experimental basis for clinical application of 'principal prescription of moxibustion for reinforcing the spleen and stomach'.

基于GC-TOF/MS代谢组学技术探讨藿香正气滴丸干预湿困脾胃型大鼠的作用机制

目的通过基于气相色谱-飞行时间质谱联用(GC-TOF/MS)技术的代谢组学方法探讨藿香正气滴丸干预湿困脾胃型大鼠的作用机制。方法将雄性SD大鼠随机分为正常组、模型组和藿香正气滴丸组(1 g·kg^(-1))。采用综合物理模型复制方法结合饮食失节制备湿困脾胃大鼠模型。灌胃给药,每日1次,连续给药10 d。观察大鼠宏观体征和行为学指标(体质量、体长、尾长、腹围指数与自主活动次数)。利用GC-TOF/MS方法对大鼠血清和尿液代谢组进行分析,鉴定与湿困脾胃相关的潜在生物标志物,分析藿香正气滴丸干预湿困脾胃型大鼠的代谢通路。结果与正常组比较,模型组大鼠的体质量、体长、尾长、自主活动次数明显减少(P<0.05),腹围指数明显升高(P<0.05)。与模型组比较,藿香正气滴丸组大鼠的体质量、体长、自主活动次数明显增加(P<0.05),腹围指数明显降低(P<0.05)。在大鼠血清、尿液中分别鉴定了38、44个与湿困脾胃相关的潜在生物标志物。藿香正气滴丸对模型大鼠的血清和尿液代谢表型能产生有效的干预,并能使血清、尿液中的17、13个潜在生物标志物水平显著回调,共涉及7条代谢通路。结论藿香正气滴丸对湿困脾胃型大鼠的干预机制可能与调节色氨酸代谢、组氨酸代谢、谷氨酸-谷氨酰胺代谢、能量代谢及肠道菌群等有关。

Study on the Resolving Phlegm Effect of D-Limonene in Mice with Spleen Deficiency and Phlegm-Dampness Syndrome

Objective:According to Traditional Chinese Medicine theory,spleen deficiency and phlegm-dampness syndrome(SDPDS)are caused by abnormal water metabolism in the body because of spleen dysfunction.The purpose of this article was to evaluate the efficacy of D-limonene(DL)in resolving phlegm in mice with SDPDS from the perspective of regulating the level of aquaporin 3(AQP3).Methods:The model of SDPDS was induced in mice using the multifactor modeling method,which combines internal and external dampness.An artificial climate box was used to create a humid environment,whereas the irregular diet was caused by different feeding methods on odd-even days.The mice were divided into blank control,model group,DL low-dose,DL high-dose,and positive groups.The mice were modeled and treated for 7 day.Levels of gastrin and amylase(AMS)in the serum,mucus secretion in the trachea,and AQP3 in the tissue near the gastric cardia.Results:DL significantly reduced mucus secretion in the trachea(P<0.001).It also increased the level of AMS in the serum(P<0.01)and decreased the level of AQP3 in the gastric tissue(P<0.01).Conclusions:Mice with SDPDS exhibited disturbed water metabolism and significantly increased AQP3 levels.DL can restore the levels of AQP3 and plays an important role in resolving phlegm.This study may also help expand the efficacy of natural drugs containing DL and improve the utilization of natural drug resources.

Discussion on the Theoretical Basis of Banxia Xiexin Decoction in the Treatment of Insulin Resistance Obesity

Through reading Chinese ancient book Huangdi Nejing,and summarizing and analyzing related literature,the basic pathogenesis of obesity have been found to be the stomach preponderance and spleen weakness,and the imbalance of ascending and descending.Banxia Xiexin Decoction not only has the functions of relieving heat to inhibit stomach intake,supplementing deficiency to assist spleen transport,regulate the ascending and descending,but also has the effects of improving insulin resistance and regulating glucolipid metabolism.Therefore,it is suggested that Banxia Xiexin Decoction can be used in the treatment of insulin resistant obesity,which provides ideas and methods for its treatment.

Efficacy of Gastrosis No.1 Compound on Functional Dyspepsia of Spleen and Stomach Deficiency-Cold Syndrome:A Multi-Center,Double-Blind,Placebo-Controlled Clinical Trial

To assess the efficacy and safety of Gastrosis No.1 compound in the treatment of functional dyspepsia with Spleen （Pi） and Stomach （Wei） deficiency-cold syndrome. Methods： A randomized, double-blind, placebo-controlled trial was performed in 5 centers. Patients with functional dyspepsia （FD） of Spleen-deficiency and qi-stagnation syndrome （162 cases） were randomly assigned to groups given Chinese herbal medicine （CHM） Gastrosis No.1 compound or placebo in a 2：1 ratio. This trial included a 4-week treatment period and a 4-week follow-up period. The outcomes were the dyspepsia symptom scores （measured by total dyspepsia symptom scale and single dyspepsia symptom scale） and syndromes of traditional Chinese medicine score （measured by traditional Chinese medicine syndrome scale）. The outcomes were noted at weeks 0, 4 and 8. Results： Compared with patients in the placebo group, patients in the CHM group showed significant improvement in the dyspepsia symptom scores as rated by patients and investigators （P〈0.01）, and also showed improvement in syndromes of traditional Chinese medicine score （P〈0.01）. No serious adverse event was reported. Safety tests obtained after 4 weeks of treatment showed no abnormal values. Conclusion： CHM Gastrosis No.1 compound was effective and safe in the treatment of functional dyspepsia with Spleen and Stomach deficiency-cold syndrome.

基于UPLC-QTOF-MS技术的藿香正气口服液治疗大鼠湿困脾胃证的血清代谢组学研究

目的基于超高效液相色谱-四极杆-飞行时间质谱联用(UPLC-QTOF-MS)技术的血清代谢组学方法寻找与湿困脾胃证相关的潜在生物标志物,探讨藿香正气口服液对湿困脾胃证的干预机制。方法采用综合物理造模方法建立湿困脾胃证大鼠模型。观测大鼠体质量、体长、尾长、腹围指数与自主活动次数;利用UPLCQTOF-MS方法对大鼠血清进行代谢组分析,结合正交偏最小二乘法-判别分析(OPLS-DA),寻找藿香正气口服液治疗湿困脾胃证大鼠后相关潜在生物标志物的变化及其相关代谢通路。结果与正常组比较,模型组大鼠的体质量、体长、自主活动次数明显减少(P<0.001),腹围指数明显升高(P<0.001);正离子和负离子模式下分别鉴定了与湿困脾胃证相关的15、10个血清潜在生物标志物,涉及磷脂代谢、氨基酸代谢、能量代谢等9条代谢通路。藿香正气口服液对湿困脾胃证模型大鼠的血清代谢表型能产生有效的干预,并使14个潜在生物标志物产生显著回调(P<0.05)。结论藿香正气口服液对大鼠湿困脾胃证的干预作用可能与调节磷脂代谢、氨基酸代谢、能量代谢等通路有关。

黄芪建中汤合暖胃汤治疗患儿脾胃虚寒型急性肠胃炎

目的观察黄芪建中汤合暖胃汤治疗脾胃虚寒型急性肠胃炎患儿的疗效。方法选取2021年2月-2023年5月医院收治的74例脾胃虚寒型急性肠胃炎患儿,以随机数字表法分为研究组与对照组,各37例。2组均接受对症治疗,对照组在此基础上采用奥美拉唑肠溶胶囊治疗,研究组在对照组的基础上接受黄芪建中汤合暖胃汤治疗。2组均治疗14 d。对比2组中医证候评分、病症恢复时间、临床疗效、炎症反应、胃肠激素及不良反应。结果治疗后,2组主症评分、次症评分、总评分明显降低(P<0.05),且研究组降低更为明显(P<0.05)。研究组发热、腹痛、呕吐、腹泻等病症恢复时间短于对照组(P<0.05)。研究组总有效率高于对照组(P<0.05)。治疗后,2组白细胞介素-17(IL-17)、基质金属蛋白酶-3(MMP-3)、中性粒细胞与淋巴细胞比值(NLR)水平明显降低(P<0.05),且研究组降低更为明显(P<0.05)。治疗后,2组胃泌素(GSA)水平明显降低(P<0.05),且研究组降低更为明显(P<0.05)。治疗后,2组胃动力素(MTL)水平明显升高(P<0.05),且研究组升高更为明显(P<0.05)。2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论黄芪建中汤合暖胃汤治疗脾胃虚寒型急性肠胃炎患儿疗效确切,可改善患儿临床症状与胃肠功能,促进患儿康复,减轻炎症反应,且安全可靠。

田耀洲教授辨治慢性萎缩性胃炎经验采撷

慢性萎缩性胃炎(CAG)是消化系统常见病,具有病情反复、缠绵难愈的特点。病理主要以胃腺体的萎缩、伴或不伴有肠上皮化生或异型增生为特征。肠上皮化生和异型增生属于癌前病变,与胃癌的发生关系密切,积极控制CAG患者的临床症状,延缓其病理进展或逆转其病理变化,有利于改善患者的生活质量、减轻经济负担及预防胃癌发生。田耀洲教授认为此病属本虚标实,脾胃虚弱是本,气滞、湿郁、瘀血为标,虚、滞、湿、瘀相互胶结推动着疾病的进展,在辨证上推崇微观与宏观相结合,用药上推崇中西医结合,并擅用经方与药对,精准辨治与用药。田教授开创的自拟方剂芪芝方,疗效显著,可有效改善脾胃湿热型CAG的临床症状。今将田教授辨治CAG之经验及自拟方剂分享给大家,以期为临床辨治CAG提供参考借鉴。

国医大师杨春波辨治脾胃湿热证胃肠病经验

杨春波教授为全国第3届国医大师,擅长运用“脾胃湿热”理论诊治胃肠系统疾患。杨老认为,脾胃湿热由内外因素共同作用而成,应从“三因制宜”角度辨识脾胃湿热证胃肠病的个体化病因病机及临床特征。针对脾胃湿热证胃肠病的辨治用药,杨老以清化湿热、调气舒络为总治则,创制“清化饮”为基本方,并结合辨析寒热、分利三焦、顾护正气、扶正防邪等辨治心得立方。作者结合杨老临床验案,阐述杨老辨治脾胃湿热证胃肠病的临证经验,以期对指导临床诊治有所裨益。

陆氏健脾和胃针刺法治疗代谢综合征的随机对照研究

目的:观察陆氏健脾和胃针刺法治疗代谢综合征(MetS)的临床疗效。方法:选取2020年3月至2022年3月于上海市第七人民医院就诊的MetS患者90例作为研究对象,按照随机数字表法分为观察组和对照组,每组45例。对照组采用健康宣教及常规药物治疗,观察组在此基础上加用陆氏健脾和胃针刺法。比较2组患者治疗前后体质量、腰围、体质量指数(BMI)、血脂、血糖、血压的变化。结果:意向性治疗(ITT)分析结果显示,2组患者各时间点体质量、腰围及BMI均较治疗前显著降低(P<0.05),且观察组各时间点体质量、腰围及BMI显著低于对照组(P<0.05);2组患者治疗后血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)均较治疗前下降(P<0.05),高密度脂蛋白胆固醇(HDL-C)明显上升(P<0.05),治疗后观察组TC、TG、HDL-C变化幅度较对照组更显著(P<0.05);2组患者治疗后空腹血糖(FBG)、糖化血红蛋白(HbA1c)及胰岛素抵抗指数(HOMA-IR)均比治疗前降低(P<0.05),治疗后观察组FPG、HbA1c及HOMA-IR值均比对照组降低明显(P<0.05)。2组患者治疗前后血压指标无明显变化(P>0.05),针刺期待值与临床疗效无明显相关性(P>0.05)。结论:陆氏健脾和胃法针刺法能有效降低MetS患者的体质量、腰围、BMI,改善血脂、血糖水平,并且具有良好的远期疗效。

益胃宁胶囊联合瑞巴派特片治疗慢性萎缩性胃炎脾胃气虚证临床研究

目的观察益胃宁胶囊联合瑞巴派特片治疗慢性萎缩性胃炎(CAG)脾胃气虚证的临床疗效。方法采用随机数字表法将80例CAG患者分为研究组和对照组各40例,2组均予瑞巴派特片,0.1 g/次,每日3次,口服;研究组在此基础上予益胃宁胶囊,2 g/次,每日3次,口服。2组均连续治疗12周。观察2组治疗前后中医疗效、胃镜疗效和病理疗效,比较2组治疗前后中医症状评分,监测2组不良反应。结果2组均无病例脱落。研究组中医疗效总有效率为92.5%(37/40),对照组为70.0%(28/40),研究组中医疗效优于对照组(P<0.01)。与本组治疗前比较,2组治疗后中医症状总分下降(P<0.05,P<0.01);2组治疗后比较,研究组中医症状总分低于对照组(P<0.01)。研究组胃镜疗效总有效率(82.5%)优于对照组(67.5%),研究组病理疗效总有效率(87.5%)优于对照组(70.0%),差异均有统计学意义(P<0.05,P<0.01)。2组未见明显不良反应。结论益胃宁胶囊联合瑞巴派特片可有效改善CAG患者的临床症状、胃镜表现及黏膜病变程度,疗效显著。

泻黄散加味治疗脾胃积热型小儿便秘疗效及对证候积分的影响

目的研究泻黄散加味与排便训练联合治疗脾胃积热型小儿便秘疗效以及对证候积分和复发的影响。方法将2019年7月—2021年7月共101例脾胃积热型便秘患儿纳入研究,采用随机数字表法将患儿分为两组,分别为对照组50例和观察组51例,对照组接受双歧杆菌三联活菌胶囊和排便训练,而观察组采用泻黄散加味颗粒和排便训练治疗。观察治疗后2组患儿用药前后便秘改善程度及临床疗效差异,比较治疗前后2组患儿中医证候积分、胃肠激素水平[血清胃动素(MTL)、胃泌素(GAS)、胃饥饿素(GHR)]、血清学指标水平[血清P物质(SP)、血管活性肠肽(VIP)、一氧化氮(NO)],统计2组不良反应以及半年内复发率并进行比较。结果治疗4周后,2组便秘患者症状自评量表(PAC-SYM)各项评分、大便干结、腹胀、舌红苔黄、口干口臭均较治疗前明显降低(P<0.05),且观察组低于对照组(P<0.05);2组患儿MTL、GAS、GHR、SP、VIP指标均较治疗前显著提升(P<0.05),且观察组比对照组更高(P<0.05),NO显著降低(P<0.05),且观察组比对照组更低(P<0.05)。2组患儿在治疗期间不良反应发生率相似,差异没有统计学意义(P>0.05)。所有患儿治疗2个月均已治愈,经过6个月的随访,观察组便秘复发率明显低于对照组(P<0.05)。结论泻黄散加味与排便训练联合治疗脾胃积热型患儿便秘表现出显著效果,使患儿便秘症状和胃肠激素表达均得到可观改善,纠正其消化系统的神经调节机制,有利于预防复发。

从“内伤脾胃,百病由生”探析糖尿病泌汗异常

《脾胃论》提出了“内伤脾胃,百病由生”的认识,以此为理论基础探讨糖尿病泌汗异常病机演变及辨证治疗。认为本病的发展为饮食劳役,先伤脾胃,导致元气亏损,阴火上行,进而营卫失和,阳损及阴,致汗出异常。治疗上应当注重糖尿病的治疗,兼顾汗证。食疗为先,重用甘味,补阳泻火,平衡气火。明确糖尿病泌汗异常与中焦脾胃功能的密切关系,以期提高临床辨证论治疗效。

四合汤对脾胃虚弱证慢性萎缩性胃炎的影响

目的 探究加味四合汤对脾胃虚弱型慢性萎缩性胃炎的疗效。方法 选取2020年8月—2023年6月河南省永城市人民医院门诊收治的脾胃虚弱证慢性萎缩性胃炎患者120例,根据随机数字表法分为观察组和对照组,每组60例,观察组采用加味四合汤治疗,对照组采用西药治疗,比较2组中医证候积分、胃镜下黏膜表现、组织病理结果的改变。结果 观察组疗效明显优于对照组,差异具有统计学意义(P<0.05)。结论 加味四合汤对脾胃虚弱证慢性萎缩性胃炎患者疗效显著,能有效改善患者临床中医证候、症状、胃镜黏膜表现、组织病理的变化,部分患者黏膜腺体萎缩出现逆转。

消食药在肿瘤治疗中的运用规律

中医认为脏腑气血亏虚、痰瘀毒邪互结是肿瘤发病中的重要因素。消食药健运中焦、疏肝理气、祛痰逐瘀等功效与肿瘤正虚邪实的核心病机高度契合,在肿瘤治疗中发挥着独特作用,现代药理学研究表明此类药物可以通过调节肠道菌群、抑制炎症介质表达、抑制血管生成、诱导细胞凋亡等抗肿瘤。临证时应谨守病机、随证加减、合理配伍、巧妙化裁、注意禁忌。

刘小斌运用麻附细辛汤合甘草干姜汤加减治疗先天性肌无力综合征经验

先天性肌无力综合征(congenital myasthenia syndrome,CMS)为临床罕见的遗传性肌病。CMS患者虽与重症肌无力患者的症状相似,均有肌无力、易疲劳等症,但CMS为先天禀赋不足疾病,以肾元亏损为本,而重症肌无力为后天失养疾病,故在辨治侧重上有所区别。刘小斌教授认为,CMS的中医病机特点为“先天不足,肾元亏损”“脾胃虚损,五脏相关”,属于中医“痿病”范畴;根据患者不易出汗、舌淡红苔白、脉细的病症表现,可辨为脾肾阳虚兼寒邪束表证(少阴太阴兼太阳证);治疗可采用温阳补肾、健脾益损法,常以麻附细辛汤合甘草干姜汤加减,可酌加桑螵蛸、紫河车等益精养血之品,可获显效。