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.

Study of Interference Treatment by Xuesaitong (血塞通) Soft Capsuleon Patients of Nephrosis Syndrome with Qi Deficiency and Blood Stasisduring Dose Reducing Stage of Corticosteroid

Objective: To observe the effect of Xuesaitong (血塞通, XST) soft capsule in interference treatment on patients of nephrosis syndrome (NS) during corticosteroid (CS) dose reducing stage. Methods: Seventy-one NS patients applying prednisone and initiating dose reducing stage were randomized into trial group and control group. On the basis of conventional prednisone dose reduction of both groups, the trial group was given additionally XST, and the treatment course ended with the reduction to maintenance dose. In the course of observation, those who did not comply with the criteria of observation were excluded. Before and after the dose reduction, TCM syndrome scoring, 24 hrs urinary protein amount, blood β2-microglobulin (β2-MG), urinary β2-MG, blood fibrinogen (Fbg), plasma prothrombin time (PT), blood lipid, etc. were observed. Results: The trial group of XST could obviously lower their urinary protein amount and blood lipid level (P<0.05 or P<0.01), markedly improve the blood coagulation parameters (P<0.01), improve the TCM syndrome and CS induced adverse reaction (P<0.05 or P<0.01), also obviously reduced the recurrence rate of NS (P<0.05). Conclusion: XST could obviously improve the clinical symptoms and renal impairment parameters in NS patients during CS dose reduction stage, improve the CS induced adverse reaction and prevent the recurrence of NS.

Effects of Lycii Fructus and Salviae Miltiorrhizae on the Syndrome of Deficiency with Blood Stasis in RCS(rdy-/-, p-/-) Rats with Retinitis Pigmentosa: An Intervention Study

Objective To investigate the effects of Lycii Fructus(LF,Gou Qi Zi,枸杞子)and Salviae Miltiorrhizae Radix Ex Rhizoma(SM,Dan Shen,丹参)on the syndrome of deficiency with blood stasis in the RCS(rdy-/-,p-/-)rats with retinitis pigmentosa(RP).Methods A total of 32 RCS(rdy-/-,p-/-)rats were divided into 4 groups(equal amounts of female and male rats in each group):model group treated with 0.9%normal saline,LF group treated with LF formula granules,SM group treated with SM formula granules,and LF and SM(L·S)group treated with LF and SM formula granules.Eight RCS(rdy+/+,p+/+)rats(4 males and 4 females)were treated with 0.9%normal saline to serve as blank group.The contents of E2,PG,P-Selectin,plasma viscosity,whole blood relative index of the high shear rate and fibrinogen content in plasma,and the content of cAMP and cGMP in retinal homogenate were detected.The retina was evaluated by hematoxylin-eosin staining.Results The contents of E2,PG,P-Selectin,plasma viscosity,whole blood relative index of the high shear rate,and fibrinogen content in the plasma of L·S group significantly differed from those of model group(P<0.01),but were similar to those of blank group.The contents of cAMP and cGMP in the retinal homogenate of L·S group significantly differed from those in model group(P<0.01)but were similar to those in blank group(P>0.05).Conclusions LF and SM can effectively treat retinitis pigmentosa by ameliorating the syndrome of deficiency with blood stasis.

Serum proteomic approach in patients with Qi deficiency and blood stasis syndrome in coronary heart disease:to explore therapeutic mechanism of Yiqi Huoxue decoction

OBJECTIVE To explore the curative effect and mechanism of Yiqi Huoxue decoction in the treatment of coronary heart disease with Qi deficiency and blood stasis syndrome.METHODS The patients with coronary heart disease of Qi deficiency and blood stasis syndrome were treated with Yiqi Huoxue decoction for 3 months,and the changes of cardiac function were observed.61 serum samples(including 29 cases of disease group and 32 cases of Yiqi Huoxue expression group)were analyzed by non labeled proteomics.The disease group was used as the control group,and the protein with expression level difference of more than 1.2 folds(P<0.05)was screened.The molecular function,biological pathway and protein interaction of the different proteins were analyzed by bioinformatics,so as to identify the molecular and biological pathway of Yiqi Huoxue decoction in the treatment of coronary heart disease with Qi deficiency and blood stasis syndrome.RESULTS Clinical treatment found that Yiqi Huoxue decoction can improve TCM syndrome score and left ventricular ejection fraction,regulate blood glucose and blood lipid levels,prolong thrombin time,and improve heart function.The results of proteomic quantitative analysis showed that there were 69 proteins with different expression levels in the disease group.Bioinformatics analysis results showed that Yiqi Huoxue decoction may regulate ApoA1,alpha-2 and other proteins to act on HDL assembly,platelet degradation,PI3K Akt signaling pathway,and then play a therapeutic role in coronary heart disease with Qi deficiency and blood stasis syndrome.CONCLUSION Yiqi Huoxue decoction can effectively improved the heart function decline caused by Qi deficiency and blood stasis syndrome of coronary heart disease.It mainly act on energy metabolism and platelet activation pathway by activating HDL assembly and platelet degradation signal pathway proteins.This study can provide reference for the follow-up treatment mechanism of Qi deficiency and blood stasis syndrome of coronary heart disease.

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.

Protocol to study the effects of AMPK-mTOR/PINK-Parkin dual signaling pathways on the formation of coronary heart disease showing blood stasis symptom pattern based on traditional Chinese medicine theory of“heart governing blood and vessels”

In this study,we aim to combine gene transfection techniques with the modeling methods previously employed by the research group to deeply investigate the corresponding theories of traditional Chinese medicine regarding“myocardial energy metabolism”and“aortic thrombosis”.Our goal is to elucidate the biological mechanism underlying the occurrence and development of coronary heart disease with blood stasis syndrome from the perspectives of“heart and vessels”and“Qi(in traditional Chinese medicine,it refers to the most fundamental and subtle substances that constitute the human body and maintain life activities.At the same time,it also has the meaning of physiological function.In terms of traditional Chinese medicine,Qi and different words are used together to express different meanings)and blood”.The research content is divided into four modules as follows:1.establishment of an animal model of coronary heart disease with blood stasis syndrome through fibrinogen overexpression.2.Investigation of the mitochondrial quality control system in coronary heart disease with blood stasis syndrome under fibrinogen overexpression.3.Study of platelet autophagy in coronary heart disease with blood stasis syndrome under fibrinogen overexpression.4.Examination of the relationship between the AMPK-mTOR pathway and metabolism in platelet autophagy of coronary heart disease with blood stasis syndrome under fibrinogen overexpression.Ninety-six Sprague Dawley rats will be randomly assigned to the following groups:control group,model group,fibrinogen group and adeno-associated virus group.All rats will undergo a 14-week model construction process,and modern molecular biology methods will be employed to evaluate the model and examine relevant research indicators.The obtained data will be analyzed according to a predefined statistical analysis plan.

Pharmacokinetics of traditional Chinese syndrome and recipe:a hypothesis and its verification(Ⅰ)

AIM To propose a hypothesis defining theabsorption,distribution,metabolism andelimination of traditional Chinese recipe（TCR）-component in blood of healthy subjects andpatients,and estimate its correctness.METHODS The pharmacokinetics（PK）of samedose of drug was studied in the animal model oftraditional Chinese syndrome（S）and healthyanimals.The classification,terminology,concept and significance of the hypothesis wereset forth with evidence provided in the presentstudy.The hypotheses consisted of traditionalChinese syndrome PK（S-PK）and traditionalChinese recipe PK（R-PK）.Firstly,the observedtetramethylpyrazine（TMP）PK in healthy,chronically reserpinized rats（rat model ofspleen deficiency syndrome,RMSDS）andRMSDS treated with Sijunzi decoction（SJZD）forconfirmation were used to verify S-PK; secondly,the ferulic acid（FA）PK in healthy andhigh molecular weight dextran（HMWD）-inducedrabbit model with blood stasis syndrome（RDBSS）was also used to verify S-PK;andlastly,TMP PK parameters in serum of healthyrats after orally taken Ligusticum wallichii（LW）,LW and Salvia miltiorrhiza（LW&SM）decoctions were compared to verify R-PK.RESULTS The apparent first-order absorption[Ka,（13.61±2.56）h-1,area under the blooddrug concentration-time curve[AUC,（24.88±9.76）μg.h-1mL-1],maximum drug concentration[Cmax,（4.82±1.23）μg·mL-1]of serum TMP inRMSDS were increased markedly（P【0.05）compared with those[Ka=（5.41±1.91）h-1,AUC=（5.20±2.57）μg·h-1·mL-1,Cmax=（2.33±1.77）μg·mL-1]of healthy rats（HR）.Theapparent first-order rate constant for α and βdistribution phase[α=（0.38±0.09）h-1,β=（0.06±0.03）h-1,the apparent first-orderintercompartmental transfer rate constants[K10=（0.24±0.07）h-1,K12=（0.11±0.02）h-1,K21=（0.11±0.02）h-1]of serum TMP in RMSDS weredecreased significantly（P【0.01）comparedwith those[K10=（0.88±0.20）h-1,K12=（1.45±0.47）h-1,K21=（0.72±0.22）h-1]of HR.However,no apparent differences occurredbetween HR and RMSDS treated with SJZD.Theserum FA concentration and its AUC[（5.6690±2.3541）μg·h-1·mL-1] in RMBSS were also higherthan those[AUC=（2.7566±0.8232）μg·h-1·mL-1]of healthy rabbits（P【0.05）.The Ka（11.51±2.82）h-1,AUC（0.84±0.17）μg·h-1·mL-1of LW & SM-derived TMP in serum weremuch lower（P【0.05）than those[Ka=（19.58±4.14）h-1,AUC=（1.27±0.26）μg·h-1·mL-1]ofLW-derived TMP in serum after oral decoctions.CONCLUSION The SDS and blood stasissyndrome state could affect significantly thepharmacokinetic parameters of drugs and theabnormal SDS pharmacokinetic parameters couldbe normalized by SJZD.The combination ofChinese medicine in TCR could reciprocallyaffect the pharmacokinetic parameters of othercomponents absorbed into the systemiccirculation.These results support the S-and R-PK hypothesis.

益气活血方调控METTL3/HAND2/TGF-β1信号轴对冠心病气虚血瘀证大鼠的影响

目的观察益气活血方调控METTL3/HAND2/TGF-β1信号轴对冠心病气虚血瘀证大鼠的影响。方法将48只雄性SD大鼠随机分为假手术组、模型组、益气活血方组和西药(单硝酸异山梨酯)组,每组12只。除假手术组外,其余各组采用左冠状动脉前降支结扎结合游泳力竭法制备冠心病气虚血瘀证大鼠模型。造模结束后,益气活血方组及西药组灌胃干预28d。观察大鼠一般状况,采集心电图,超声心动图检测大鼠心功能,血液流变学检测血瘀程度,HE染色观察心肌组织形态,免疫组化法检测心肌组织甲基化转移酶3(METTL3)、转化生长因子(TGF)-β1、Smad2、Smad3表达,RT-PCR和Western blot检测心肌组织METTL3、心脏神经嵴衍生物表达蛋白2(HAND2)、TGF-β1、Smad2、Smad3mRNA和蛋白表达。结果与假手术组比较,模型组大鼠出现精神萎靡、行动迟缓、嗜睡、体质量降低等气虚表现,心电图ST段显著抬高,左室射血分数(LVEF)、左室短轴缩短率(LVFS)下降(P<0.01),左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、左室舒张末期内径(LVEDd)、左室收缩末期内径(LVEDs)升高(P<0.01),红细胞聚集指数、卡松黏度及全血黏度升高(P<0.01);心肌细胞肿大、坏死,心肌纤维排列紊乱,心肌组织有炎性细胞浸润,心肌组织METTL3、TGF-β1、Smad2、Smad3mRNA和蛋白表达均升高(P<0.05,P<0.01),HAND2 mRNA和蛋白表达均降低(P<0.01)。与模型组比较,益气活血方组和西药组大鼠精神状态明显改善,心电图ST段明显回落,LVEF、LVFS升高(P<0.01),LVEDV、LVESV、LVEDd、LVEDs下降(P<0.05,P<0.01),红细胞聚集指数、卡松黏度及全血黏度下降(P<0.01);心肌纤维排列整齐,心肌细胞结构及形态改善,炎性细胞浸润减少,心肌组织METTL3、TGF-β1、Smad2、Smad3 mRNA和蛋白表达降低(P<0.05,P<0.01),HAND2mRNA和蛋白表达升高(P<0.05,P<0.01)。结论益气活血方能减轻冠心病气虚血瘀证大鼠心肌组织病理损伤,提高心功能,抑制炎症反应,其作用机制可能与调控METTL3/HAND2/TGF-β1信号轴有关。

Metabonomics analysis of the urine of rats with Qi deficiency and blood stasis syndrome based on NMR techniques

Metabonomics analysis of the urine of rats with Qi deficiency and blood stasis syndrome has been performed by comparison with those of normal rats based on NMR techniques. The relative contents of formate,creatinine,2-oxoglutarate(2-OG) ,citrate,taurine,trimethylamine-N-oxide(TMAO) ,succinate and hippurate in the urine of the rats with Qi deficiency and blood stasis syndrome have been changed. These results have provided evidence for understanding the mechanism and the therapy of Qi defi-ciency and blood stasis syndrome.

Energy Metabolism Disorder and Myocardial Injury in Chronic Myocardial Ischemia with Qi Deficiency and Blood Stasis Syndrome Based on 2-DE Proteomics

Objective： To inquire the characteristic proteins in chronic myocardial ischemia by testing twodimensional electrophoresis （2-DE） map to explore the possible inherent pathological mechanism and the therapeutic intervention of qi deficiency and blood stasis syndrome. Methods： Ameroid constrictor ring was placed on the first interval of left anterior descending coronary artery to prepare chronic myocardial ischemia model on Chinese miniature swine. Animals were randomly divided into sham group and model group with 10 animals in each group, respectively. The dynamic symptoms observation of the four diagnostic information was collected from 0 to 12 weeks. Echocardiography was employed to evaluate cardiac function and the degree of myocardial ischemia, 2-DE and matrix-assisted laser desorption/ionization-time of flight mass spectrometry （MALDI-TOF-MS） were used to carry out proteomics research on animals. Enzyme-linked immunosorbent assay was applied to identify the relevant differential proteins on chronic myocardial ischemia with qi deficiency and blood stasis syndrome. Results： The preliminary study found that at the 12th week, chronic myocardial ischemia with qi deficiency and blood stasis syndrome model was established stably. Compared with the sham group, there were 8 different proteins down-regulated, 22 proteins up-regulated significantly. After validated by MALDI- TOF-MS/MS, 11 protein spots were identified. Distinct proteins were mainly associated with energy metabolism and myocardial structural injury, including isocitrate dehydrogenase 3 （NAD＋） alpha, NADH dehydrogenase （NAD） Fe-S protein 1, chain A （crystal structure of aidose reductase by binding domain reveals a new Nadph）, heat shock protein 27 （HSP27）, oxidoreductase （NAD-binding protein）, antioxidant protein isoform, cardiac troponin T （cTnT）, myosin （myosin light polypeptide）, cardiac alpha tropomyosin, apolipoprotein A- I and albumin. Conclusion： Down-regulated energy metabolism disorder mediated by NADH respiratory chain and myocardial injury may be the pathogenesis of myocardial ischemia with qi deficiency and blood stasis syndrome. These proteins may be the potential diagnostic marker（s） for qi deficiency and blood stasis syndrome, finally provided new clues for new therapeutic drug target of Chinese medicine

Efficacy of Yangyin Yiqi Huoxue Granule (养阴益气活血颗粒) in Treatment of Ischemic Stroke Patients with Qi-Yin Deficiency and Blood Stasis Syndrome: A Randomized, Double-Blind, Multicenter, Phase-2 Clinical Trial

Objective To evaluate the efficacy and safety of Yangyin Yiqi Huoxue Granule(养阴益气活血颗粒,YYHG)in the treatment of ischemic stroke(IS)patients with qi-yin deficiency and blood stasis syndrome(QYDBSS),and to explore its effective dosage.Methods The total of 288 patients were randomly assigned to the YYHG high-dose,YYHG low-dose,positive control(administered Xiaoshuantong Granule,XSTG,消栓通颗粒),or placebo control(administered inert granule)groups(72 cases per group)by software-drived competitive block randomization.The trial was conducted for a 28-day period,with a 180-day follow-up period.The primary outcome was the comprehensive curative evaluation,and secondary outcomes were the National Institute of Health Stroke Scale(NIHSS)score,Barthel activities of daily living(ADL)index score,the quality of life index(QLI)score,and the Chinese medicine syndrome(CMS)score.All analyses were done on an intention-to-treat basis.The clinical safety was also assessed.Results The total of 288 participants were recruited between June 1,2008 and September 30,2009,and 287 patients received intervention;the treatment groups were well balanced at baseline.The comprehensive cure rates of YYHG high-dose,low-dose,positive and placebo control groups were 63.38%,31.94%,36.11%and 6.14%,respectively;there was a statistical difference between the two groups(P<0.01),while the high-dose YYHG treatment group was significantly higher than the other 3 groups(P<0.01).The improvement of NIHSS,ADL,QLI and CMS scores of the YYHG high-dose and low-dose groups was significantly better than that of the positive control group and the placebo control group(P<0.05).In terms of improving the classification of the NIHSS scale and the assessment of the ADL scale,the YYHG high-dose group was significantly better than the other three groups(P<0.05),and the YYHG low-dose group was better than the placebo control group(P<0.01).At the same time,except for the QLI score,the high-dose group was better than the low-dose group(P<0.05).In terms of safety,adverse reactions after YYHG treatment were generally mild(3.78%),and no serious adverse reactions have been reported.Conclusion YYHG is safe and effective in the treatment of IS patients with QYDBSS.

Effect of Shenqiyixin prescription on myocardial energy metabolism in patients with chronic heart failure

Objective:To observe the heart function、MEE and serum FFA of Shenqiyixin prescription for heart qi(yang)deficiency with blood stasis and fluid retention type of chronic heart failure patients,to evaluate the clinical efficacy and safety.Methods:64 cases with chronic heart failure of heart qi(yang)deficiency with blood stasis and fluid retention were randomly divided into two groups,3 cases were excluded,31 cases in the control group and 30 cases in the treatment group.The control group was treated with western medicine,and the treatment group was treated with Shenqiyixin prescription additionally.The course of treatment was 3 weeks.Observe the changes of TCM syndrome score,6MWD,LVEF,cESS,MEE,serum NTproBNP,serum FFA and safety indexes of each group before and after treatment.Results:after treatment,the TCM Syndromes of each group were improved.The total effective rate of the treatment group was 93.33%,and the control group was 83.87%.The treatment group was more effective(P<0.05).After treatment,the TCM syndrome score,cESS,MEE,NTproBNP and FFA of each group were decreased,6MWD and LVEF were increased(P<0.05),and the treatment group was superior to the control group(P<0.05).Conclusion:Shenqiyixin prescription can improve the TCM syndrome and heart function in patients with chronic heart failure of heart qi(yang)deficiency with blood stasis and fluid retention,at the same time,it can reduce the level of MEE and serum FFA in patients with heart failure.

宣痹消瘤方联合硼替佐米治疗多发性骨髓瘤的临床观察

目的观察宣痹消瘤方联合硼替佐米治疗多发性骨髓瘤(multiple myeloma,MM)的临床疗效。方法将80例肾虚血瘀型MM患者随机分为观察组和对照组,每组40例。两组均接受硼替佐米治疗的基础方案,观察组加用宣痹消瘤方,21 d为1个疗程,共4个疗程。比较两组患者治疗前后中医证候积分、欧洲癌症研究与治疗组织生活质量核心量表(European organization for research and treatment of cancer quality of life questionnaire core 30,EORTC QLQ-C30)评分、生活质量问卷多发性骨髓瘤模块(Quality of life multiple myeloma questionnaire,QLQ-MY20)评分以及临床疗效和不良反应发生情况。结果治疗后两组患者中医证候积分中的瘀、痰、虚、睡眠、饮食维度评分及总分均较治疗前显著减少(P<0.05),观察组热维度评分较治疗前显著降低(P<0.05),且治疗后观察组中医证候积分中瘀、虚、睡眠、饮食维度评分及总分均显著低于对照组(P<0.05)。治疗后两组患者EORTC QLQ-C30量表中疲乏、疼痛、呼吸困难、睡眠障碍、经济压力评分均较治疗前显著降低(P<0.05),躯体功能、角色功能、情绪功能、认知功能、社会功能、整体生活质量评分均较治疗前显著增加(P<0.05),且治疗后观察组躯体功能、整体生活质量评分均显著高于对照组(P<0.05),疲乏、食欲减退、便秘评分均显著低于对照组(P<0.05)。治疗后两组患者QLQ-MY20量表中疾病症状、治疗不良反应评分均较治疗前显著降低(P<0.05),身体意象、未来期望评分均显著增加(P<0.05),且治疗后观察组治疗不良反应评分显著低于对照组(P<0.05)。两组患者临床疗效比较,差异无统计学意义(P>0.05)。观察组胃肠道反应发生率、肺部感染发生率均显著低于对照组(P<0.05)。结论宣痹消瘤方联合硼替佐米治疗MM,可显著改善患者中医证候,提高患者生活质量,降低不良反应发生率。

益气温阳通痹方联合西药治疗肾虚血瘀型腰椎间盘突出症临床研究

目的:观察益气温阳通痹方联合西药治疗肾虚血瘀型腰椎间盘突出症的临床疗效。方法:选取2023年3月—2024年3月在广东省中医院脊柱科门诊就诊的60例肾虚血瘀型腰椎间盘突出症患者,采用随机数字表法分为对照组和试验组各30例。2组均服用依托考昔片、甲钴胺片治疗,试验组加服益气温阳通痹方治疗。2组均治疗4周。治疗前后评定2组患者的中医证候评分、腰部疼痛视觉模拟评分法(VAS)评分、下腰痛日本骨科协会(JOA)评分和Oswestry功能障碍指数(ODI)评分。评价2组的临床疗效,观察不良反应发生情况。结果:治疗4周后,2组总有效率、临床疗效分别比较,差异均无统计学意义(P>0.05)。2组腰部疼痛,腰膝酸软,面色不华、手足不温,下肢乏力、麻木及活动受限评分及总分均呈降低趋势;2组内各时间点的5项中医证候评分及总分比较,差异均有统计学意义(P<0.05)。治疗2周,2组5项中医证候评分及总分均较治疗前下降,差异均有统计学意义(P<0.05)。治疗4周,2组5项中医证候评分及总分均较治疗前、治疗2周下降,差异均有统计学意义(P<0.05);试验组5项中医证候评分及总分均低于对照组(P<0.05)。治疗后,2组VAS评分及ODI评分均呈降低趋势,JOA评分均呈升高趋势。2组内各时间点VAS评分、JOA评分及ODI评分分别比较,差异均有统计学意义(P<0.05)。治疗2周,2组VAS评分、ODI评分均较治疗前下降,JOA评分均较治疗前升高,差异均有统计学意义(P<0.05);2组VAS评分、JOA评分及ODI评分比较,差异均无统计学意义(P>0.05)。治疗4周,2组VAS评分、ODI评分均较治疗前、治疗2周下降,JOA评分均较治疗前、治疗2周升高,差异均有统计学意义(P<0.05);试验组VAS评分、ODI评分均低于对照组,JOA评分高于对照组,差异均有统计学意义(P<0.05)。2组治疗期间均未发生不良反应。结论:益气温阳通痹方联合依托考昔片及甲钴胺片治疗方案有利于改善肾虚血瘀型腰椎间盘突出症患者的症状和腰椎功能,提升生活质量,其疗效较依托考昔片联合甲钴胺片治疗具有一定优势,安全性较好。

序贯服法对2型糖尿病合并稳定型心绞痛患者的疗效观察

目的探讨中药常规服法与序贯服法对气虚血瘀型2型糖尿病合并稳定型心绞痛在临床效果上的差异。方法选择2型糖尿病合并稳定型心绞痛患者,随机分成对照组、整方组和序贯组,对照组80例,整方组和序贯组各40例,维持现有的化药治疗方式不变,对照组服用安慰剂,整方组与序贯组每日服用中药一致,序贯组早上用补阳还五汤加减,中午用泽泻汤加味,晚上用四妙勇安汤加减,疗程24周,比较治疗前后以及停药后的心绞痛1周发作次数、心绞痛单次发作持续时间和硝酸甘油1周消耗量,中医证候积分,FPG、HbA1c以及100 g和200 g馒头餐负荷后2 h-PG变化。结果治疗前后,心绞痛相关指标、中医证候积分和血糖相关指标,整方组和序贯组明显优于对照组(P<0.05),治疗后序贯组馒头餐负荷后2 h-PG波动幅度较整方组更小,差异无统计学意义(P>0.05);停药后回访,整方组相关数值反弹明显,与对照组比较差异无统计学意义(P>0.05),序贯组则较为稳定(P>0.05),与对照组和整方组比较差异有显著性意义(P<0.05)。结论中药整方服法和序贯服法均能有效改善T2DM-SAP患者心绞痛相关指标、中医证候积分和血糖相关指标,序贯服法在停药后的疾病稳定上效果更优。

血府逐瘀汤联合替扎尼定治疗椎动脉型颈椎病气虚血瘀证患者的效果

目的:观察血府逐瘀汤联合替扎尼定治疗椎动脉型颈椎病(CSA)气虚血瘀证患者的效果。方法:选取2019年8月至2023年8月该院收治的94例气虚血瘀证椎动脉型CSA患者进行前瞻性研究,按照随机数字表法将其分为研究组与对照组各47例。对照组采用替扎尼定治疗,研究组在对照组基础上联合血府逐瘀汤治疗,比较两组临床疗效,治疗前后中医证候积分、眩晕症状和功能[改良颈性眩晕症状与功能评估量表(ESCV)]评分、椎动脉血流动力学指标[左、右椎动脉收缩期峰值流速(PSV)、舒张期末流速(EDV)]水平,以及不良反应发生率。结果:研究组治疗总有效率为95.74%(45/47),高于对照组的78.72%(37/47),差异有统计学意义(P<0.05);治疗后,研究组颈项强痛、上肢放射痛、上肢麻木等中医证候积分均低于对照组,差异有统计学意义(P<0.05);治疗后,研究组ESCV评分高于对照组,差异有统计学意义(P<0.05);治疗后,研究组左、右椎动脉PSV、EDV均高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:血府逐瘀汤联合替扎尼定治疗椎动脉型CSA气虚血瘀证患者可提高治疗总有效率、ESCV评分和椎动脉血流动力学指标水平,降低中医证候积分,效果优于单纯替扎尼定治疗。

芪蛭三七汤辅助西药治疗胸痹心痛气虚血瘀证的临床效果

目的:探讨芪蛭三七汤辅助西药治疗胸痹心痛气虚血瘀证的临床效果。方法:选取2022年1月—2024年1月南京中医药大学附属苏州市中医医院收治的86例胸痹心痛气虚血瘀证患者作为研究对象,按随机数表法将患者分为对照组与观察组,各43例。对照组给予常规西医治疗,观察组在对照组基础上给予芪蛭三七汤治疗。比较两组临床疗效、中医症候评分、凝血指标、心功能及不良反应。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05);治疗后,两组胸闷、胸痛、心悸、气短、神倦乏力评分低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)长于治疗前,观察组长于对照组,两组纤维蛋白原(FIB)低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组左室射血分数(LVEF)高于治疗前,且观察组高于对照组,两组左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)短于治疗前,且观察组短于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:芪蛭三七汤辅助西药治疗胸痹心痛气虚血瘀证患者可缓解症状,改善凝血功能,促进心功能改善,安全可靠。

Relationship between Two Blood Stasis Syndromes and Inflammatory Factors in Patients with Acute Coronary Syndrome

Objective： To investigate the relationship between inflammatory factors and two Chinese medicine（CM） syndrome types of qi stagnation and blood stasis（QSBS） and qi deficiency and blood stasis（QDBS） in patients with acute coronary syndrome（ACS）. Methods： Sixty subjects with ACS, whose pathogenesis changes belongs to qi disturbance blood stasis syndrome, were divided into 2 groups： 30 in the QSBS group and 30 in the QDBS group. The comparative analysis on them was carried out through comparing general information, coronary angiography and inflammatory factors including intracellular adhesion molecule-1（ICAM-1）, chitinase-3-like protein 1（YKL-40） and lipoprotein-associated phospholipase A2（Lp-PLA2）. Results： Compared with the QSBS group, Lp-PLA2 and YKL-40 levels in the QDBS group showed no-significant difference（P〉0.05）; ICAM-1 was significantly higher in the QDBS group than in the QSBS group in the pathological processes of qi disturbance and blood stasis syndrome of ACS（P〈0.05）. Conclusion： Inflammatory factor ICAM-1 may be an objective basis for syndrome typing of QSBS and QDBS, which provides a research direction for standardization research of CM syndrome types.

益心泰颗粒对慢性心衰(心气虚兼血瘀水停证)大鼠AMPK、PGC-1α的影响

目的观察益心泰颗粒对慢性心力衰竭(CHF)(心气虚兼血瘀水停证)大鼠AMPK、PGC-1α的影响。方法采用丙硫氧嘧啶灌胃及阿霉素腹腔注射复制CHF(心气虚兼血瘀水停证)模型大鼠,将造模成功大鼠分为模型组与益心泰低、中、高剂量组和曲美他嗪组;另设正常对照组。灌胃4周后观察心肌组织病理结构,检测LVEF、血清NT-proBNP及心肌组织FFA、ATP/AMP、LAC、pAMPK、AMPK、PGC-1α水平。结果与模型组比较,益心泰颗粒低、中、高剂量组及曲美他嗪组LVEF、心肌组织ATP/AMP值、心肌组织p-AMPK、AMPK、PGC-1α相对灰度值均明显升高(P<0.05或P<0.01),血清NT-proBNP及心肌组织FFA、LAC明显降低(P<0.05或P<0.01)。结论益心泰颗粒能促进慢性心力衰竭(心气虚兼血瘀水停证)大鼠AMPK、PGC-1α表达,改善心肌能量代谢。