Establishment and evaluation of a mouse model of bronchial asthma with Yin deficiency syndrome

Objective: To establish and evaluate a mouse model of bronchial asthma with Yin deficiency syndrome. Methods: The mouse model of bronchial asthma with Yin deficiency syndrome was established by the treatment with injecting ovalbumin(OVA) two times to sensitize, inhaling OVA 14 times to stimulate, and using thyroxin through lavage during late stimulation. This model was evaluated through body weight, asthmatic behaviors, respiratory function, autonomous activity, lung pathology, and pulmonary fluid clearance. Results: OVA combined with thyroxin was an appropriate method to induce the mouse model with increased food and water intake, autonomous activity, asthmatic behaviors score, and respiratory rate, decreased body weight, tidal volume, and wet/dry ratio of lung, and changed with pathology of lung tissue. The changes of the above mentioned parameters indicated that the model was the bronchial asthma with Yin deficiency syndrome. Conclusion: The OVA combined with thyroxin is a good pattern to establish a mouse model of bronchial asthma with Yin deficiency syndrome successfully, which can highly simulate the clinical symptoms of this disease.

Study on syndrome differentiation based on pharmacology of syndrome management system-a case of Qi and Yin deficiency syndrome

Taking the Qi and Yin deficiency syndrome as an example,the research method of pharmacology of syndrome management system was proposed.By means of text mining,systematic pharmacology and target analysis,to attempt to reveal the essence of the corresponding syndrome by studying the drugs and targets of Qi and Yin deficiency.Fourteen Chinese herbs treating Qi and Yin deficiency were retrieved and used more than 30 times,and 9,317 related targets were predicted.The common targets of action were 85.Topological analysis was carried out by using degree centrality,closeness centrality and betweenness centrality to confirm that estrogen receptor(ESR1),tumor necrosis factor(TNF),D(2)dopamine receptor(DRD2),vitamin D3 receptor(VDR),glucocorticoid receptor(NR3C1),acetylcholinesterase(ACHE)and endothelin-1(EDN1)were highly correlated with Qi and Yin deficiency syndrome.Through the target to find Qi and Yin deficiency syndrome corresponding to 17 categories of diseases.A new idea was provided for studying the biological essence of TCM clinical syndrome differentiation.

Summary and correlation analysis of TCM syndromes in 159 elderly patients with acute myeloid leukemia

Objective:To investigate the characteristics of TCM syndromes in elderly patients with acute myeloid leukemia(AML)at the onset,and to analyze the main syndrome types and their correlation with age,percentage of bone marrow blasts,and genetic prognostic stratification.Methods:A retrospective analysis was performed on 159 AML patients aged over 60 years who were diagnosed and treated in our hospital,and the clinical data were collected and analyzed statistically.Results:In 159 elderly AML patients,the main clinical symptoms were fatigue,poor appetite,conscious fever,and various hemorrhages.The main syndromes were Ying(42.01%),Wei(31.25%),Essential(14.81%)and Blood(11.69%);the syndromes are divided into Qi and Yin deficiency(32.70%),Qi and blood deficiency(30.19%),true Yin deficiency(28.03%)and Qi heat and blood(8.81%).The age difference between the two groups was statistically significant(P<0.001),and the multiple comparison results showed that the age of the Qi-blood deficiency group was younger than the true-Yin deficiency group and the Qi-Yin deficiency group;the percentage of bone marrow blasts was statistically significant in the three groups at the initial diagnosis(P<0.05),multiple comparison results showed that the percentage of bone marrow blasts in the true Yin deficiency group was higher than that in the Qi-blood deficiency group and the Qi-Yin deficiency group;the genetic prognostic stratification of the three groups was statistically significant(P<0.05),multiple comparisons.The results showed that the genetic prognosis of the true Yin deficiency group was poorer than that of the Qi and blood deficiency group and the Qi and Yin deficiency group.Conclusion:The most common clinical symptoms of elderly AML patients are fatigue,the disease is located in the bone marrow,and the disease is Ying,Wei,essence,and blood.With the increase in the patient's age,the TCM syndrome types tend to be more insufficiency of true Yin and deficiency of both Qi and Yin,and the prognosis of patients with insufficiency of true Yin is poor.It provides a directional scientific basis for the treatment of senile AML with integrated traditional Chinese and Western medicine.

300 CASES OF MENOPAUSAL SYNDROME TREATED BY ACUPUNCTURE

Caused by hypo-ovarianism, menopausal syndrome usually occurs in women aged from 45-55 years. With high incidence and various symptoms, the disease often severely jeopardize the health of the women. The authors had treated 300 cases of menopausal syndrome by acupuncture and obtained a good result.

Liver metabolomic characteristics in three different rat models of Yin deficiency based on ultra-performance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry

OBJECTIVE:To investigate the mechanism of Yin deficiency syndrome(YDS) by analyzing the liver metabolomic characteristics of three different Yin deficiency rat models METHODS:Following the TCM etiology,for clinical features and pathological manifestations of modern medicine,three kinds of animal models of Yin deficiency were induced and replicated.Totally 48 Sprague-Dawley(SD) male rats were randomly divided into blank group,irritation induced model group,Fuzi-Ganjiang induced model group,and thyroxine-reserpine induced model group.After successful development of model,the ultraperformance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry was carried out to detect metabolites in each group.The metabolites of rat liver were analyzed for the characteristics of their biomarkers.The pathway enrichment analysis and metabolic network construction were performed through various online databases including Metabolite Biology Role,Human Metabolome Database,MetaboAnalyst,and Kyoto Encyclopedia of Genes and Genomes.RESULTS:The SD rats in the experimental group showed symptoms like less weight gain,reduced diet and water intake,high body temperature,increased liver and kidney indexes,and abnormal liver and kidney tissue morphology.Moreover,the rats showed high increased levels of serum cyclic adenosine monophosphate,estradiol,alanine transaminase,and aspartate aminotransferase and decreased levels of cyclic guanosinc monophosphate and testosterone.We found four key interrelated metabolic pathways in the liver tissue metabolomics,including the biosynthesis of pantothenic acid and coenzyme A,and metabolism of alpha-linolenic acid metabolism,glycerophospholipid metabolism,and sphingolipid.CONCLUSION:The liver and kidney YDS is closely related to the biosynthesis of pantothenic acid and CoA and abnormal metabolism of α-linolenic acid,glycerophospholipid,and sphingolipid in SD rats.

基于PI3K/AKT/mTOR信号通路探讨复方地黄颗粒对帕金森病阴虚动风证大鼠的影响

目的观察复方地黄颗粒对帕金森病(PD)阴虚动风证大鼠黑质PI3K/AKT/mTOR信号通路的影响,探讨其治疗PD的作用机制。方法通过向黑质注射6-羟多巴胺制备PD阴虚动风证大鼠模型。将大鼠随机分为对照组、假手术组、模型组、美多芭组和复方地黄颗粒低、中、高剂量组,每组10只。各组分别予相应溶液灌胃,连续28 d。检测大鼠神经行为学变化,HE染色观察黑质形态变化,RT-qPCR检测受损黑质PI3K、AKT、mTOR、p62、LC3BmRNA表达,免疫组化检测受损黑质p-PI3K、p-AKT、p-mTOR表达,Western blot检测受损黑质p-PI3K、PI3K、p-AKT、AKT、p-mTOR、mTOR、p62、LC3B蛋白表达。结果与对照组和假手术组比较,模型组大鼠旋转圈数增加,爬杆时间延长,悬挂时间及移动格数减少(P<0.01);黑质神经元排列紊乱,胞核固缩、结构模糊;受损黑质PI3K、AKT、mTOR、p62 mRNA表达升高,p-PI3K、p-AKT、p-mTOR、p62蛋白表达升高,LC3B mRNA和LC3BⅡ/Ⅰ蛋白表达降低(P<0.01)。与模型组比较,美多芭组及复方地黄颗粒各剂量组大鼠旋转圈数减少,爬杆时间缩短,悬挂时间及移动格数增加(P<0.01);黑质神经元数目增多,结构形态明显改善;受损黑质PI3K、AKT、mTOR、p62 mRNA表达降低,p-PI3K、p-AKT、p-mTOR、p62蛋白表达降低,LC3B mRNA和LC3BⅡ/Ⅰ蛋白表达升高(P<0.05,P<0.01),以复方地黄颗粒高剂量组作用最明显(P<0.05,P<0.01),与美多芭组差异无统计学意义(P>0.05)。结论复方地黄颗粒可能通过抑制PI3K/AKT/mTOR信号通路增强受损黑质自噬能力,保护多巴胺能神经元,从而治疗PD。

Correlation between constitution of Yin deficiency syndrome and polymorphism of HLADQA1 / treatment response of Peg-IFNα therapy in HBeAg positive chronic hepatitis B patients

Objective To observe the correlation between constitution of yin deficiency syndrome(YDS)and polymorphism of HLA-DQA1/treatment response of Peg-IFNαtherapy in HBe Ag positive chronic hepatitis B(CHB)patients,and to explore constitution of Chinese medicine(CM)in response to interferon therapy.Methods Totally 120 HBe Ag positive CHB patients who were

中药滋阴补阳方剂治疗肾气亏虚型多囊卵巢综合征不孕症对患者超声动态多参数的影响评价

目的评价中药滋阴补阳方剂治疗肾气亏虚型多囊卵巢综合征不孕症对患者超声动态多参数的影响。方法选取2022年1月至2023年1月江西省妇幼保健院收治的80例肾气亏虚型多囊卵巢综合征患者作为研究对象,按照随机数字法将其分为观察组(40例)与对照组(40例)。对照组采用枸橼酸氯米芬片治疗,观察组在对照组方法的基础上联合中药滋阴补阳方剂治疗。比较两组患者的治疗效果、卵泡发育情况、激素水平、子宫动脉血流灌注情况及子宫内膜厚度。结果观察组的有效率高于对照组,差异有统计学意义(P<0.05);观察组治疗后的卵泡及优势卵泡数目多于对照组,差异有统计学意义(P<0.05);观察组治疗后的黄体生成素(LH)、促卵泡激素(FSH)、睾酮(T)均低于对照组,雌二醇(E2)高于对照组,差异有统计学意义(P<0.05);观察组治疗后的搏动指数(PI)、阻力指数(RI)均低于对照组,差异有统计学意义(P<0.05);观察组治疗后的子宫内膜厚度高于对照组,差异有统计学意义(P<0.05)。结论将中药滋阴补阳方剂应用于肾气亏虚型多囊卵巢综合征不孕症患者治疗中,可积极改善患者的激素水平及子宫动脉血流灌注情况,同时能够促进卵泡发育,增加子宫内膜厚度,改善症状,值得推广。

参莲胶囊联合奥希替尼对EGFR突变的晚期非小细胞肺癌(气阴两虚证)的疗效分析

[目的]探讨参莲胶囊联合奥希替尼对EGFR突变的晚期非小细胞肺癌(气阴两虚证)的疗效分析。[方法]选取2021年4月—2022年4月本院收治的表皮生长因子受体(EGFR)突变的晚期非小细胞肺癌患者110例,按照随机数表法分2组,对照组(55例)给予奥希替尼,研究组(55例)在对照组基础上加用参莲胶囊。比较两组治疗效果、用药安全性、欧洲癌症研究和治疗组织肿瘤患者生存质量量表(EORTCQLQ-LC43)评分以及癌胚抗原(CEA),细胞角蛋白19片段(CYFRA21-1),糖类抗原125(CA125)。[结果]研究组总有效率高于对照组(P<0.01)。治疗后,两组患者血清CEA,CA125,CYFRA21-1水平明显低于治疗前(P<0.01),研究组血清CEA,CA125和CYFRA21-1水平明显低于对照组(P<0.05)。研究组不良反应发生率低于对照组(P<0.05)。治疗后研究组和对照组患者角色功能、生理功能、认知功能、社会功能、情感功能、总健康状况评分均较治疗前明显增加(P<0.05),治疗后研究组角色功能、生理功能、认知功能、社会功能、情感功能、总健康状况评分高于对照组(P<0.05)。[结论]参莲胶囊联合奥希替尼对EGFR突变的晚期非小细胞肺癌(气阴两虚证)的治疗效果较好,并具有安全性,还可以有效降低血清CEA,CA125和CYFRA21-1水平,提高患者生活质量,在临床上有着广阔的应用前景。

中西医诊治儿童性早熟研究进展

目前,越来越多的无创诊断技术正在运用到儿童性早熟的诊断中,基因检测技术促进了该病遗传病因诊断的发展。对于该病的治疗,西医主要通过病因治疗继发性性早熟,对于特发性外周性性早熟没有特殊治疗方案,目前,中枢性性早熟治疗首选促性腺激素释放激素类似物(gonadotropin-releasing hormone agonist, GnRHa)。中医认为,性早熟病机为阴虚火旺,肝郁化火,痰湿壅滞,治以滋阴降火、疏肝解郁或燥湿化痰,可改善症状,抑制骨龄快速增长。但目前中医药治疗性早熟的临床研究证据等级不高,缺少样本量大、严格且全面的临床研究,未来可通过开展多中心的随机对照、大样本研究以验证中医药治疗性早熟的疗效。网络药理学和中药成分动物实验研究证明了中药治疗性早熟的部分机制,但中药方剂成分复杂,多通过胃肠道吸收后起效,是否可以调节肠道菌群、产生特异性菌群,该菌群是否改变了机体中某些代谢产物水平从而发挥治疗作用尚无相关研究,今后可开展更多的相关机制研究。

阴虚水肿浅见

水肿病与肺的通调、脾的转输、肾的水液代谢调节、肝的疏泄、心的行血、三焦的气化有关。多数医家认为水为阴邪,得温则化,故虚证水肿多与脾肾阳气虚损有关,治疗常应用具有温热作用的中药以化水。但阴虚水肿亦不少见。阳虚、阴虚均可导致水肿的发生,现代医家多重视阳虚水肿,对阴虚水肿有所忽视。故此文对阴虚水肿的病因及治疗方剂(济阴汤、白茅根汤、加减八味地黄汤、滋阴清燥汤、猪苓汤)进行论述,尤推《医学衷中参西录》之济阴汤、白茅根汤、加减八味地黄汤。

扶正逐瘀方联合2HRZE/4HR方案治疗阴虚血瘀证肺结核患者的效果

目的探讨扶正逐瘀方联合2HRZE/4HR方案在肺结核患者阴虚血瘀证治疗中的应用效果。方法以随机数字表法将河南中医药大学第三附属医院2020年1月至2022年5月接收的肺结核患者106例分为两组,各53例。对照组接受2HRZE/4HR抗结核方案治疗,研究组接受扶正逐瘀方联合2HRZE/4HR方案治疗。比较两组疗效、痰菌转阴率、免疫功能[免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)]、不良反应发生率。结果研究组治疗总有效率较对照组高(P<0.05)。治疗3个月,研究组痰菌转阴率较对照组高(P<0.05);治疗6个月,两组痰菌转阴率差异无统计学意义(P>0.05)。治疗6个月,两组血清IgA、IgG、IgM水平均升高,且研究组较对照组高(P<0.05)。治疗期间,研究组不良反应发生率低于对照组(P<0.05)。结论扶正逐瘀方联合2HRZE/4HR方案治疗阴虚血瘀型肺结核疗效确切,可促进痰菌转阴,改善机体免疫功能,降低不良反应发生风险。

瑞格列奈片联合加味肾气丸治疗阴阳两虚型2型糖尿病临床观察

目的分析瑞格列奈片联合加味肾气丸对2型糖尿病阴阳两虚型患者的治疗效果。方法纳入2020年10月—2021年10月山东省枣庄市薛城区人民医院100例阴阳两虚型2型糖尿病患者进行探究,以单双号方式分两组,对照组使用常规治疗和瑞格列奈片治疗,观察组在此基础上联合加味肾气丸。通过症状积分观察两组疗效,并对比其血糖和临床指标。结果治疗后,观察组空腹血糖、餐后2 h血糖、糖化血红蛋白数据低于对照组(P<0.05);观察组血清视黄醇结合蛋白4、白细胞介素-6、尿N-乙酰-β-D-葡萄糖苷酶数据均低于对照组(P<0.05)。观察组的主要症状、次要症状积分低于对照组(P<0.05)。结论瑞格列奈片联合加味肾气丸治疗阴阳两虚型2型糖尿病患者,可以减轻炎性反应,提升抗氧化、抗纤维化能力,并能够减轻患者症状,对于控制并发症、延缓病情进展有着积极作用,值得推广。

子午流注择时电温针联合双补增津汤治疗结肠慢传输型便秘气阴两虚证的疗效观察

目的:观察子午流注择时电温针联合双补增津汤治疗结肠慢传输型便秘(STC)气阴两虚证的临床疗效。方法:选择符合纳入标准的152例STC气阴两虚证患者,按随机抽取法分为对照组(枸橼酸莫沙必利治疗)、电针组(枸橼酸莫沙必利+子午流注择时电温针治疗)、中药组(枸橼酸莫沙必利+双补增津汤治疗)和结合组(枸橼酸莫沙必利+子午流注择时电温针+双补增津汤治疗),每组各38例,均治疗4周。观察比较4组患者治疗前后中医症状积分和总积分、结肠传输试验标志物含量、肠道菌群数量、焦虑自评量表评分(SAS)、抑郁自评量表评分(SDS)、慢性便秘严重度评分(CSS)的变化情况,比较临床疗效及随访6个月复发率。结果:4组患者治疗后中医症状积分和总积分、结肠传输试验标志物含量和SAS、SDS、CSS评分均较治疗前比较均明显下降(P<0.05),肠道内大肠埃希数量与治疗前比较明显减少(P<0.05),双歧杆菌、乳酸杆菌数量与治疗前比较明显增多(P<0.05);结合组临床疗效明显优于其他3组(P<0.05),随访期复发率明显低于其他3组(P<0.05)。结论:子午流注择时电温针联合双补增津汤治疗STC气阴两虚证的疗效显著,二者可发挥协同增效作用,能有效缓解便秘症状,调节肠道菌群,恢复肠道运动功能,改善焦虑、抑郁心理状态,降低复发率。

补中益气汤合增液汤加减治疗功能性便秘气阴两虚证疗效评价

目的探讨补中益气汤合增液汤加减治疗功能性便秘气阴两虚证的临床疗效。方法将该院于2019年1月—2021年12月收治的80例功能性便秘气阴两虚证患者纳入研究,采用随机对照法将所选患者进行分组,分为治疗组及对照组各40例。其中治疗组患者应用补中益气汤合增液汤加减治疗,150 mL/次,每日2次。对照组予以枸橼酸莫沙必利分散片5 mg/次口服,每日3次。2组均以4周为1个疗程,比较治疗前后便秘主要症状评分、便秘患者症状自评量表(PAC-SYM)评分变化情况,并比较两组患者的临床疗效。结果药物干预前,两组患者临床症状包括大便性状、排便间隔、排便困难、排便不尽症状评分及腹部症状、直肠症状、大便症状、PAC-SYM量表总分评分对比,差异无统计学意义,均P>0.05;经药物干预后,两组患者大便性状、排便间隔、排便困难、排便不尽症状评分及腹部症状、直肠症状、大便症状、PAC-SYM量表总分评分均明显低于治疗前,且观察组明显低于对照组,均P<0.05。观察组的总有效率明显高于对照组(P<0.05)。结论补中益气汤合增液汤加减治疗功能性便秘气阴两虚证具有较好临床效果,能够显著缓解大便干燥症状,改善患者生存状态,且具有不良反应小、患者认可度高等优势,是值得广泛应用的方案之一。

骨髓增生异常综合征中医证型与遗传学及预后的相关性研究

目的:探讨骨髓增生异常综合征(MDS)患者中医证型与分子生物学、细胞遗传学及预后的相关性。方法:采用非参数秩和检验或卡方检验的统计学方法,回顾性分析85例初诊MDS患者的中医证型、外周血指标、疾病分型、分子生物学情况、细胞遗传学情况、预后情况,并探讨中医证型与其后几项之间的相关性。结果:85例MDS患者的中医证型以气阴两虚、毒瘀阻滞证为主,其次为脾肾两虚、毒瘀阻滞证和邪热炽盛、毒瘀阻滞证。邪热炽盛、毒瘀阻滞证患者的中性粒细胞绝对值(ANC)水平显著低于脾肾两虚、毒瘀阻滞证患者(P<0.01),气阴两虚、毒瘀阻滞证患者的血红蛋白(HGB)水平显著低于脾肾两虚、毒瘀阻滞证患者(P<0.001)。3组证型间疾病分型分布比较,差异有统计学意义(P<0.05);邪热炽盛、毒瘀阻滞证患者的疾病分型全为原始细胞增多型(EB型)。3组证型间转录调节因子1(ASXL1)基因突变率、染色质重塑和转录调控基因功能组突变率、3种预后系统积分比较,差异有统计学意义(P<0.05),邪热炽盛、毒瘀阻滞证组转录调控基因功能组突变率和3种预后系统积分均高于其他两组(P<0.05)。在3个预后积分系统的较高危组中,邪热炽盛、毒瘀阻滞证患者占比均高于其他两种证型。结论:MDS病机以虚为本,临床患者以虚实夹杂证多见;邪热炽盛、毒瘀阻滞证预后较差,推测其机制可能与ASXL1基因突变、7号染色体的完全丢失和其长臂的部分缺失(-7/7q-)等遗传学情况相关。

2型糖尿病阴虚证与尿AQP2、AQP7表达的相关性研究

目的观察2型糖尿病阴虚证临床特征,明确患者尿中水通道蛋白-2(aquaporin-2,AQP2)、水通道蛋白-7(aquaporin-7,AQP7)表达特点及相关因素对其的影响,以利于进一步探索2型糖尿病阴虚证病证结合证候特点。方法制定2型糖尿病临床观察表、2型糖尿病阴虚证辨证标准量表以及中医证候诊断标准量表,将2021年3月—2021年12月北京中医药大学东直门医院肾病内分泌科住院部34例2型糖尿病患者分为阴虚证组(观察组)和阳虚证组(对照组)。采集两组患者血生化标本及清晨第一次全部尿液并采用酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA)检测尿AQP2、AQP7的表达水平。对病例的性别、年龄、病程等多因素进行校正,分析两组尿AQP2、AQP7的差异。结果经校正后,2型糖尿病阴虚证患者尿AQP2水平明显低于阳虚证患者,MD(95%CI)为-64.23(-93.59,-34.87)(P<0.01),而尿AQP7水平低于阳虚证患者,MD(95%CI)为-3.98(-9.77,1.80)(P>0.05)。结论该研究所纳入2型糖尿病阴虚证患者尿AQP2指标表达低于阳虚证患者,提示AQP2可能是2型糖尿病阴虚证特异性生物标志物。

缺铁性贫血孕妇的中医体质分布及影响因素研究

【目的】分析缺铁性贫血(iron deficiency anemia,IDA)孕妇的中医体质分布规律及相关影响因素,为中医药防治妊娠期IDA提供指导方案。【方法】纳入109例符合条件的妊娠期IDA患者,收集孕妇的一般资料、中医体质鉴别结果和相关实验室指标,包括血清铁蛋白(Fer)、血红蛋白(Hb)及平均红细胞体积(MCV)。对IDA孕妇的中医体质分布规律及相关影响因素、妊娠结局进行统计分析。【结果】(1)109例IDA孕妇中医体质以偏颇质为主,有60例(55.05%),各体质分布人数和比例从高到低依次为:平和质49例(44.95%)>湿热质13例(11.93%)>阳虚质12例(11.01%)>阴虚质11例(10.09%)>气虚质10例(9.17%)>气郁质9例(8.26%)>血瘀质3例(2.75%)>痰湿质2例(1.83%)。(2)不同体质类型IDA孕妇的Hb和MCV水平比较,差异均无统计学意义(P>0.05),但湿热质IDA孕妇的Fer水平显著高于平和质(P<0.01),湿热质IDA孕妇发生羊水混浊的概率显著高于平和质及其他偏颇体质(P<0.05)。【结论】湿热质是IDA孕妇最常见的偏颇体质,其次是阳虚质、阴虚质和气虚质,湿热质可能是IDA孕妇的易感体质,此体质类型IDA孕妇的Fer水平显著高于平和质,而其发生羊水混浊的概率显著高于平和质及其他偏颇体质。

围绝经期综合征肾阴虚证大鼠汗液分泌及其生化指标的变化

目的评估围绝经期综合征肾阴虚证“病证结合”模型大鼠的汗液分泌情况,并探讨其生化指标的变化。方法将18只SD雌性大鼠随机分为假手术组、模型组、阳性药组,每组6只。假手术组行假手术,模型组和阳性药组大鼠行双侧去卵巢手术,术后第7天给予L-甲状腺素(92 mg/kg),每天1次,连续给药7 d建立围绝经期综合征肾阴虚证“病证结合”模型。阳性药组每日灌胃清骨散汤剂(7.3 g/kg),假手术组和模型组灌胃等量蒸馏水,每天1次,共14 d。采用和田-高垣试剂着色法测定大鼠足跖部汗液分泌。酶联免疫吸附实验(ELISA)检测大鼠血清cAMP、cGMP、LH、GnRH、E2水平。蛋白免疫印迹(Western Blot)法测定大鼠足趾肉垫组织的激动M3胆碱能受体(M3R)、激动β2得上腺素能受体(β2AR)、水通道蛋白5(aquaporin,AQP5)表达水平。结果(1)与假手术组相比,模型组出现体温升高、双耳发红、易激惹、毛发干枯等阴虚证的典型行为学表现,且大鼠汗液分泌显著增多。(2)模型组血清cAMP水平显著升高,cGMP水平显著降低,cAMP/cGMP比值显著升高,LH、GnRH水平显著升高,E2水平显著降低。(3)大鼠足趾组织的M3R表达下调,β2AR、AQP5表达水平上调。与模型组相比,阳性药组体温降低、毛发脱落减少等阴虚证典型行为学表现缓解;血清cAMP水平显著下降,cAMP/cGMP比值显著降低,LH、GnRH水平降低,但不影响血清E2水平。大鼠足趾组织的M3R上调,β2AR、AQP5表达水平下调。结论去势联合L-甲状腺素建立的围绝经期综合征肾阴虚证“病证结合”模型大鼠汗液分泌显著增多,其机制可能与cGMP、cAMP及其在汗腺上调控汗液分泌的关键蛋白M3R、β2AR、AQP5的变化有关。

从《伤寒论》少阴篇讨论阳虚阴盛证辨治规律

[目的]讨论《伤寒论》中阳虚阴盛证的病势、层次、治法及用药规律,探究并扩充阳虚阴盛证的辨治规律及临床意义。[方法]结合后世医家的医论,明确阳虚阴盛证的病机及证候;从病理生理学角度,阐释阳虚阴盛证的机制;分析少阴篇中各版本条文的差异,论述病位、邪气性质、胃气、津液的不同,治法、主方、配伍的变化,归纳在少阴篇中隐含的辨治规律。[结果]阳虚阴盛证的辨治原则是“保胃气、存津液”,可将其细分为太阴湿土病、少阴君火病、厥阴风木病。细致的望闻问切,并结合现代医学的病理生理基础能精确辨阳虚阴盛证。少阴为三阴枢机,少阴篇结构完整,能动态反映少阴发病、两阴合病或并病、三阴合病的相互变化过程。由条文可发现,病位由表入里,治法有灸焫、温经、温阳、通阳之别;病情由轻而重、痰饮有无,治法有散寒、散饮、利水之别;津液损伤程度不同,治法有救逆、救阴之别。[结论]从病理生理角度,能阐释中医主症的变化机制。辨治阳虚阴盛证时,应根据病位、邪气性质、胃气、津液择取方药,阳虚阴盛证的辨治规律对于其他证候的辨治同样具有指导意义。