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.

Proteomics analysis of IBS-D with spleen and kidney yang deficiency

Objective:To investigate the molecular mechanism underlying the development of diarrhea-predominant irritable bowel syndrome (IBS-D) with spleen and kidney yang deficiency (SKYD) using a proteomics approach.Methods:Male Sprague-Dawley rats (n =22) were divided into IBS-D (n =12) and normal control (n =10) groups.SKYD was then modeled in IBS-D rats by a combination of acetic acid enema,bondage,rectal dilation,tail stimulation,and Senna gavage.Colon tissue samples were subsequently collected and examined by Q Exactive mass spectrometry to identify differentially expressed proteins between the two groups.Results:The occurrence of SKYD/IBS-D was associated with ribosomal protein S23 (Rps23),protein phosphatase 2 catalytic subunit alpha (Pp2a),and growth factor receptor-bound protein 2 (Grb2),which are involved in the ribosome,neurotrophin signaling,and Janus kinase-signal transducer and activator of transcription (JAK-STAT) signaling pathways.Conclusion:These data suggest that SKYD/IBS-D pathophysiology likely involves inflammation,cell growth,apoptosis,stress granule formation,immune activation,loss of epithelial cell integrity,and visceral hypersensitivity.

Transcriptomic and metabolomic analysis of the effects of Zhenwu decoction on kidney yang deficiency pattern in chronic kidney disease

Objective:To explore the kidney yang deficiency pattern(KYDP)in a chronic kidney disease(CKD)rat model and the mechanisms underlying the effects of Zhenwu decoction(ZWD)by conducting tran-scriptomic and metabolomic analyses.Methods:Adriamycin(ADR)combined with hydrocortisone(HC)was used to induce CKD with KYDP in rats.ADR was injected into the tail vein twice.HC was injected intramuscularly for 8 weeks.ZWD was administered by gavage for 8 weeks.The general condition was observed,24-h urine protein was detected,serum corticosterone,triiodothyronine,thyroxine,TSH,testosterone,cAMP,and cGMP levels were determined,and pathological analysis was conducted.Transcriptomic and metabolomic analyses were conducted to screen differentially expressed genes(DEGs),differentially expressed metabolites(DEMs),and differentially expressed pathways(DEPs).The core DEMs and DEGs were input to Metab-oanalyst 5.0 to identify the pathways affected by ZWD.Results:In the HC group,KYDP symptoms were observed.Compared with control group,the levels of 24-h urine protein,TSH,and cGMP significantly increased(all P<0.01),and corticosterone,triiodothyronine,thyroxine,and cAMP significantly decreased(all P<0.01)in the HC group.After ZWD intervention,the levels of above-mentioned indicators could be reversed to some extent.Pathological analysis in the HC group revealed kidney lesions.DEGs in the ZWD group were mainly associated with pathways such as nucleotide synthesis and endocrine pathways.In the ZWD group,differences in biosynthesis of unsat-urated fatty acids and butanoate metabolism were observed.The following pathways were significantly affected by ZWD:arachidonic acid metabolism,valine,leucine,and isoleucine biosynthesis,linoleic acid metabolism,and alpha-linolenic acid metabolism.Conclusion:ZWD can be used to treat KYDP in CKD through regulating arachidonic acid metabolism,valine,leucine,and isoleucine biosynthesis,linoleic acid metabolism,and alpha-linolenic acid metabolism.

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.

Warm needling moxibustion versus electroacupuncture for simple obesity due to yang deficiency of the spleen and kidney: a controlled clinical trial

Objective: To compare the therapeutic efficacy between warm needling moxibustion and electroacupuncture (EA) in the treatment of simple obesity due to yang deficiency of the spleen and kidney. Methods: Seventy patients with simple obesity due to yang deficiency of the spleen and kidney were randomly divided into a warm needling moxibustion group and an EA group, with 35 subjects in each group. Same major acupoints were selected for the two groups, including Shuifen (CV 9), Guanyuan (CV 4), Daheng (SP 15), Shuidao (ST 28), Shousanli (LI 10), Zusanli (ST 36), Sanyinjiao (SP 6) and Taixi (KI 3). The warm needling moxibustion group received warm needling moxibustion, while the EA group received EA treatment. The interventions were performed once every other day, with 15 treatments as one course. The therapeutic efficacy, body weight and body mass index (BMI) were then observed and compared. Results: The total effective rate in the warm needling moxibustion group was 85.7% versus 77.1% in the EA group, and the between-group difference was statistically significant (P<0.05). The warm needling moxibustion was remarkably superior to the EA in weight loss and lowering BMI, both with statistical significance (P<0.05, P<0.01). At the three-month follow-up, the body weight and BMI further decreased in the warm needling moxibustion group (both P<0.05), and the levels were lower than those in the EA group (P<0.05, P<0.01). Conclusion: Warm needling moxibustion can produce reliable and consistent efficacy in the treatment of simple obesity due to yang deficiency of the spleen and kidney. Compared with EA, warm needling moxibustion shows advantage in both short-term and long-term efficacies, and thus is worth promotion in clinical practice.

Progress of studies on cancer-related anemia in Chinese and Western medicine

Cancer-related anemia is a common complication in patients with a malignant tumor caused by the tumor itself or the tumor's treatment.It can seriously affect the quality of life of patients and even accelerate the progression of the tumor.Western medicine is often given a blood transfusion,erythropoietin,and iron agent in cancer-related anemia treatment,but there are also some problems such as increasing tumor-related mortality.Traditional Chinese medicine believes that cancer-related anemia's occurrence is related to the“Deficiency of Spleen and Kidney and Deficiency of Qi and Blood”,so clinical treatment is mainly to“Tonify Spleen and Kidney and Qi and Blood”.The combination of traditional Chinese and Western medicine is useful in cancer-related anemia's treatment,which provides a new idea and method for cancer-related anemia's clinical treatment.

砭石罐灸联合八部金刚功对炎症性肠病脾肾阳虚证患者疗效、疲劳及生活质量的影响

目的:探讨砭石罐灸联合八部金刚功对炎症性肠病脾肾阳虚证患者疗效、疲劳及生活质量的影响。方法:将104例炎症性肠病脾肾阳虚证患者随机分为观察组和对照组,每组52例。对照组采用基础治疗及护理,观察组在对照组基础上实施砭石罐灸联合八部金刚功,治疗12周。比较两组患者治疗前后中医症状评分、炎症因子、多维疲劳量表(MFI-20)、炎症性肠病患者生活质量问卷(IBDQ)变化及治疗后的总有效率。结果:共101例患者完成研究,观察组50例,对照组51例,治疗后观察组患者中医症状评分、MFI-20评分、炎症因子水平均低于对照组,差异有统计学意义(P<0.05);治疗后观察组患者IBDQ评分高于对照组,差异有统计学意义(P<0.05);治疗后观察组患者总有效率为94.00%(47/50)优于对照组的82.35%(42/51)(P<0.05)。结论:砭石罐灸联合八部金刚功可改善炎症性肠病脾肾阳虚证患者临床症状,降低炎症因子水平,缓解疲劳,提高生活质量。

复肾膏联合真武汤治疗脾肾阳虚型肾性水肿的疗效及对肾小管损害标志物、凝血指标的影响

目的 观察复肾膏联合真武汤治疗肾性水肿脾肾阳虚型的疗效及对肾小管损害标志物、凝血指标的影响。方法 选取80例肾性水肿脾肾阳虚型患者为研究对象,按照随机数字表法分为对照组和治疗组,对照组40例予真武汤治疗,治疗组40例复肾膏联合真武汤治疗。2组均10天为1个疗程,连续3个疗程后统计疗效。比较2组治疗前及治疗1、2、3个疗程后肾小管损害标志物[中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、肾损伤分子-1(KIM-1)]、肾功能[24 h尿蛋白定量(24 h Upro)、尿素氮(BUN)、血肌酐(SCr)、血清白蛋白(ALB)]、凝血功能[D-二聚体(D-D)、活化部分凝血活酶时间(APTT)、血小板计数(PLT)]变化,观察记录2组治疗过程中不良反应情况。结果 治疗组总有效率92.50%(37/40),明显高于对照组的70.00%(28/40)(P<0.05)。治疗1、2、3个疗程后,2组NGAL、KIM-1、24 h Upro、BUN、SCr水平均较本组治疗前明显降低(P<0.05),ALB均较本组治疗前明显升高(P<0.05),且2组组间同期比较差异均有统计学意义(P<0.05)。治疗1、2、3个疗程后,2组D-D、APTT均较本组治疗前明显降低(P<0.05),且治疗组均低于对照组同期(P<0.05);治疗3个疗程后,2组PLT均较本组治疗前明显降低(P<0.05),且治疗组低于对照组同期(P<0.05)。治疗组不良反应发生率为7.50%(3/40),对照组为12.50%(5/40),2组不良反应发生率比较差异无统计学意义(P>0.05)。结论 复肾膏联合真武汤治疗肾性水肿脾肾阳虚型可有效改善肾功能及凝血功能,降低NGAL、KIM-1水平,效果显著。

Lysine deficiency impaired growth performance and immune response and aggravated inflammatory response of the skin,spleen and head kidney in grown-up grass carp (Ctenopharyngodon idella)

This dissertation was primarily focused on the immune response,inflammatory response and molecular mechanisms in the skin,head kidney and spleen of grown-up grass carp(Ctenopharyngodon idella).Six iso-nitrogen diets differing in lysine concentrations(5.6,8.5,11.6,14.4,17.5 and 20.7 g/kg)were fed to 540 grass carp(164.85±0.79 g)for 60 d.After that,grass carp were challenged by Aeromonas hydrophila for 6 d.This study revealed that lysine deficiency(1)suppressed the growth performa,nce of the fish and decreased their ability to resist skin lesion morbidity,(2)impaired the immune organ s immune response by decreasing the gene expressions of mucin,liver-expressed antimicrobial peptide(LEAP)-2B,β-defensin-1 and LEAP-2A and the production of antibacterial compounds of grown-up grass carp,and(3)aggravated the inflammatory response of immune organs in the fish by increasing the gene expressions of pro-inflammatory cytokines(interferon y2[IFN-γ2],tumor necrosis factorα[TNF-α],interleukin[IL]-15,IL-17D,IL-12p40,IL-6 and IL-8)and down-regulating anti-inflammatory cytokines(IL-11,transforming growth factorβ1[TGF-β1],IL-10 and IL-4/13A),which were tightly correlated with signal transducer and activator of transcription(STAT)1 and STAT3 signaling pathway,respectively.The different phenomenon in the skin,spleen and head kidney of fish may be correlated with the difference in gene subtype.In addition,using quadratic regression analysis of percent weight gain(PWG),skin lesion morbidity,and the lysozyme activities in the spleen and head kidney,the dietary lysine requirements for grown-up grass carp were estimated to be 13.58,13.51,14.56 and 14.18 g/kg,respectively.

温脾除胀汤治疗脾阳虚型胃肠功能障碍的临床效果

目的探讨温脾除胀汤治疗脾阳虚型胃肠功能障碍的临床效果。方法按随机数字表法将2021年1月至2022年9月在河北省中医院重症监护病房住院的脾阳虚型胃肠功能障碍患者50例分入观察组和对照组,各25例。对照组给予西医常规治疗,观察组在对照组的基础上予以温脾除胀汤治疗,2组均连续治疗7 d。比较2组治疗前后的临床疗效、急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、中医证候积分、胃肠功能相关指标和炎症因子水平及不良反应发生情况。结果观察组总有效率明显高于对照组[96.0%(24/25)比72.0%(18/25)](P<0.05)。治疗后2组患者APACHEⅡ评分、中医证候积分均低于治疗前,且观察组均低于对照组(均P<0.05)。治疗后2组胃肠功能障碍评分、腹内压、腹围、平均胃潴留量均低于/小于治疗前,且观察组上述指标均低于/小于对照组(均P<0.05)。治疗后2组患者白细胞计数、肿瘤坏死因子α、降钙素原水平均低于治疗前,且观察组各炎症因子水平均低于对照组(均P<0.05)。治疗期间,2组患者均未出现不良反应,同时患者血常规、尿常规、便常规指标均保持正常。结论温脾除胀汤治疗脾阳虚型胃肠功能障碍患者效果确切,能改善患者胃肠功能,抑制炎症因子。

Clinical observation of acupuncture and moxibustion for functional dyspepsia due to Yang deficiency of the spleen and stomach

Objective To observe the clinical efficacy of acupuncture and moxibustion for functional dyspepsia(FD)due to Yang deficiency of the spleen and stomach.Methods A total of 90 patients meeting the inclusion criteria of FD due to Yang deficiency of the spleen and stomach were randomized into an acupuncture-moxibustion group,an electroacupuncture(EA)group,and a mosapride group by the random number table method,with 30 cases in each group.The mosapride group was treated with mosapride citrate dispersible tablets.The EA group was treated with EA treatment.The acupuncture-moxibustion group was treated with additional moxibustion therapy based on the treatment in the EA group.All three groups took 10 d as one treatment course and 2 courses in total,with a 2-day interval between two courses.The traditional Chinese medicine(TCM)symptoms score,functional digestive disorder quality of life questionnaire(FDDQL)score,oral-colon transit time(OCTT),and serum glucagon-like peptide-1(GLP-1)level was compared before and after treatment among the three groups.And the clinical efficacy was evaluated.Results The total effective rate in the acupuncture-moxibustion group was 96.7%,which was higher than 86.7%in the EA group and 73.3%in the mosapride group,and the total effective rate in the EA group was higher than that in the mosapride group;the inter-group differences were all statistically significant(P<0.05).After treatment,the TCM symptom score in the three groups was lower than that before treatment(P<0.05),and the FDDQL score was higher than that before treatment(P<0.05).The change after treatment in the TCM symptom score in the acupuncture-moxibustion group and the EA group was more significant than that in the mosapride group,and the change in the acupuncture-moxibustion group was more significant than that in the EA group;the inter-group differences were statistically significant(P<0.05).The change after treatment in the FDDQL score in the acupuncture-moxibustion group and the EA group was greater than that in the mosapride group,and the change in the acupuncture-moxibustion group was larger than that in the EA group;the inter-group differences were all statistically significant(P<0.05).After treatment,the OCTT in all three groups was lower than that before treatment(P<0.05),and the serum GLP-1 level was higher than that before treatment(P<0.05);the change after treatment in the OCTT in the acupuncture-moxibustion group and the EA group was more significant than that in the mosapride group,and the change in the acupuncture-moxibustion group was more significant than that in the EA group;the inter-group differences were statistically significant(P<0.05).The change after treatment in the serum GLP-1 level in the acupuncture-moxibustion group and the EA group was greater than that in the mosapride group,and the change in the acupuncture-moxibustion group was larger than that in the EA group;the inter-group differences were statistically significant(P<0.05).Conclusion Acupuncture and moxibustion can improve the clinical symptoms in patients with FD and enhance their quality of life,producing better effects than EA or mosapride alone.Shortening gastrointestinal movement time and increasing gastrointestinal hormone levels may be its mechanism.

Regulatory mechanism of hormones of the pituitary-target gland axes in kidney-Yang deficiency based on a support vector machine model

OBJECTIVE:To study the development mechanism of kidney-Yang deficiency through the establishment of support vector machine models of relevant hormones of the pituitary-target gland axes in rats with kidney-Yang deficiency syndrome.METHODS:The kidney-Yang deficiency rat model was created by intramuscular injection of hydrocortisone,and contents of the hormones of the pituita- ry-thyroid axis:thyroid stimulating hormone(TSH),3,3',5-triiodothyronine(T_3) and thyroxine(T_4);hormones of the pituitary-adrenal gland axis:adrenocorticotropic hormone(ACTH) and Cortisol(CORT);and hormones of the pituitary-gonadal axis:luteinizing hormone(LH),follicle-stimulating hormone(FSH),and testosterone(T),were determined in the early,middle,and advanced stages.Ten support vector regression(SVR) models of the hormones were established to analyze the mutual relationships among the hormones of the three axes.RESULTS:The feedback control action of the pituitary-adrenal axis began to lose efficacy from the middle stage of kidney-Kong deficiency.The contents all hormones of the three pituitary-target gland axes decreased in the advanced stage.Relative errors of the jackknife test of the SVR models all were less than 10%.CONCLUSION:Imbalances in mutual regulation among the hormones of the pituitary-target gland axes,especially loss of effectiveness of the pituitary-adrenal axis,is one pathogenesis of kidney-Yang deficiency.The SVR model can accurately reflect the complicated non-linear relationships among pituitary-target gland axes in rats with of kidney-Yang deficiency.

Clinical treatment of myasthenia gravis with deficiency of spleen and kidney based on combination of disease with syndrome theory

OBJECTIVE: To study the use of Jianjining in the treatment of myasthenia gravis (MG) patients with a deficiency of both spleen and kidney via the theory on the combination of disease with syndrome. METHODS: Sixty MG patients with a deficiency of both spleen and kidney were randomly divided into an treatment group (n=30) treated with Jianjining granules and Western Medicine (prednisone or pyridostigmine bromide) and a control group (n= 30) treated with Jianjining granules. The dosage of the three drugs was reduced over the course of treatment. After 3 and 6 months of treatment, the curative effect was evaluated with the muscle weakness severity scale (MWSS). RESULTS: The MWSS score after treatment declined significantly in both groups. The score in the treatment group was much lower than that in thecontrol group (P<0.05). The total effective rate was 63.33% (19/30) in the treatment group and 36.67% (11/30) in the control group after 3 months of treatment, and 80.00% (24/30) and 50.00% (15/30), respectively, after 6 months of treatment. The obvious and total effective rates in the treatment group were much higher than those in the control group (P<0.05). After 6 months of treatment, there were no obvious differences (P>0.05) in the obvious and effective rates between the 2 groups. However, the total effective rate in the treatment group was much higher than that in the control group (P<0.01). CONCLUSION: Using the theory on the combination of disease with syndrome, we found that the curative effect of Jianjining and Western Medicine on MG patients with deficiency of both spleen and kidney is worth further exploration.

The Effect of Hormones of the Hypothalamic-pituitary-target Gland Axes in a Kidney-Yang Deficiency Syndrome Model

Kidney-yang deficiency syndrome(KYDS)is a diagnostic pattern in the traditional Chinese medicine.Studies have shown that KYDS is related to the functional disorder of hormones of the hypothalamic-pituitary-target gland axes.The standard procedure used to mimic KYDS is the injection of a high dose of exogenous glucocorticoid(hydrocortisone and corticosterone).Such a model showed symptoms such as exhaustion,body twists,cold limbs,lying crowded together,decreased rectal temperature,sexual dysfunction,decreased reaction speed,reduced spontaneous activity,hair loss,loss of appetite,and weight loss.Moreover,the model manifested an imbalance in mutual control among the hormones of the pituitary-target gland axes,including adrenocorticotrophic hormone,CORT,CRH,thyroid-stimulating hormone,triiodothyronine,thyroxine,T,E2,follicle-stimulating hormone,luteinizing hormone,and 17-OHCS.

中医证候动物模型建立及评价方法研究

中医证候动物模型是揭示中医基础理论、促进中医药临床发展的重要载体,更是促进中医药现代化与国际化不可或缺的重要工具。目前,中医证候动物模型建立方法多样,评价标准不一。基于五脏的主要生理功能,以临床常见的心气虚证、肝郁证、脾气虚证、肺气虚证、肾阳虚证为代表,总结分析近年来最常用的中医证候动物模型的构建及评价方法,为建立更为科学客观的中医证候动物模型构建方法及评价体系提供参考。

四神丸治疗腹泻型肠易激综合征的作用机制研究进展

肠易激综合征是临床常见的胃肠道疾病之一,其发病率高,以腹泻型多见。中医认为脾肾阳虚是腹泻型肠易激综合征(IBS-D)的核心病机,四神丸是治疗脾肾阳虚型泄泻的经典方剂,且临床效果显著。四神丸在治疗IBS-D方面具有丰富的生物学基础,并通过缓解胃肠内脏高敏、调控脑-肠轴功能、调节肠道菌群、增强肠黏膜屏障功能、调节胃肠道动力、抑制肠道炎症反应等多重作用机制发挥治疗作用。本文系统综述四神丸治疗IBS-D的具体作用机制,旨在为后续的深入研究及临床应用提供更全面的理论支撑与参考。

基于VIP/cAMP/PKA/AQP3信号通路探讨溃结宁膏穴位敷贴对脾肾阳虚型大鼠功能性便秘的影响

目的:以功能性便秘(FC)大鼠为实验对象,探讨溃结宁膏穴位敷贴基于VIP/cAMP/PKA/AQP3通路的作用研究。方法:取雄性大鼠40只,随机将其分为空白组和造模组,然后除空白组外剩余大鼠用盐酸洛哌丁胺和氢化可的松制作FC脾肾阳虚型的模型,成功造模以后再随机分为四组,空白组正常饲养未作任何处理,莫沙必利组灌服莫沙必利+巴布剂基质穴位贴敷,其余各组灌服0.9%氯化钠溶液,对照组进行无药的穴位贴敷,穴位敷贴组在穴位处贴溃结宁膏,非穴位敷贴组贴在后肢肌肉丰富处,连续贴敷14 d。采用ELISA法测定血清中血管活性肠肽(VIP)的含量、HE染色法观察结肠组织黏膜、RT-PCR法检测结肠组织中环状磷酸腺苷(cAMP)、蛋白激酶A(PKA)mRNA的表达情况。结果:与对照组相比,空白组首次排黑便时间缩短,粪便含水量增加,差异均有统计学意义;穴位敷贴组及莫沙必利组首粒排黑便时间、血清VIP、结肠组织中cAMP、PKA含量均明显上升(P<0.05),含水量同样明显升高(P<0.05),而穴位敷贴组与莫沙必利组之间差异无统计学意义(P>0.05)。溃结宁膏能显著改善由洛哌丁胺所致FC大鼠结肠的损害。结论:溃结宁膏穴位敷贴法可上调VIP的含量,进而通过cAMP-PKA途径调控AQP3,从而改善便秘。

晚期非小细胞肺癌患者免疫治疗所致甲状腺功能减退症的中医证候、证素特点研究

【目的】探索晚期非小细胞肺癌(NSCLC)患者接受免疫检查点抑制剂(ICIs)治疗后出现甲状腺功能减退症(以下简称“甲减”)的中医证候特点、证素分布与组合情况以及中医证型的分布规律。【方法】选择2020年1月至2023年6月就诊于广州中医药大学附属中山中医院,经病理确诊为ⅢB-ⅣB期、表皮生长因子受体/间变性淋巴瘤激酶(EGFR/ALK)阴性、并使用ICIs治疗后出现甲减的NSCLC患者,共168例。收集患者的四诊信息,运用聚类分析总结出晚期NSCLC免疫治疗后出现甲减的中医证候特点和证型分布规律,并对不同性别、年龄段和甲减分级的中医证型分布规律进行分析。【结果】(1)168例晚期NSCLC患者接受免疫治疗后出现甲减的中医证候以虚为主,表现为咳嗽、倦怠乏力、健忘、面色少华、自汗、皮肤干燥、痰色白、懒言、头晕、夜尿多、视物模糊、形体消瘦、皮肤弹性差、纳呆恶食、嗜睡、长期食少、水肿、失眠、声低、隐痛、指甲淡白、吐痰、经常畏冷、口渴、面色?白、喜温恶凉、渴欲热饮、气喘、经常便秘、大便干结、面睑浮肿、多梦、腹胀、腰痛、排便无力等;舌脉象主要包括:舌苔薄白、舌淡红、舌边齿印、舌淡胖、舌淡、脉沉、脉滑、脉虚、尺脉弱、脉细。(2)总体病位证素以肺、脾、肾多见,病性证素以气虚、阳虚、血虚、水停多见。(3)经聚类分析,得出以下3种证型,分布频次由高到低依次为肺脾气虚证、肾阳亏虚证和气虚水停证。(4)不同年龄段的中医证型分布比较,差异有统计学意义(P<0.01)。其中,60~69岁患者以肺脾气虚为主要证型,≥70岁患者以肾阳亏虚为主要证型,<50岁患者以气虚水停证为主要证型。而不同性别、甲减等级的中医证型分布比较,差异均无统计学意义(P>0.05)。【结论】晚期NSCLC免疫治疗所致甲减患者的中医证型以肺脾气虚、肾阳亏虚、气虚水停为主,正气亏虚是其变化、发展的主要病机。临床医师应及时关注患者的症状变化,监测患者甲状腺功能指标,避免发生严重免疫治疗相关不良反应。

CLINICAL RESEARCH ON TREATMENT OF CHRONIC PROSTATITIS WITH ACUPUNCTURE

In the present study, the authors put forward that Zhibian(BL 54) and Sanyin-jiao(SP 6) are the effective acupoints for treatment of chronic prostatitis and possess an unique cura-tive effect in treatment of this disease with the type of deficiency of both the spleen and the kidney. Atotal effective rate was 92% in group of 1OO cases treated with acupuncture and comparison betweenpre- and post-treatment in examinations of prostatic fluid and other 6 items showed, significantly bet-ter than that of oral compound Sinohan(P【0. 01 ).