高才达自拟五子参药汤治疗慢性阻塞性肺疾病急性加重期合并心功能不全痰热壅肺证疗效

目的探究高才达名老中医自拟五子参药汤治疗慢性阻塞性肺疾病急性加重期(acute exacerbation of chronic obstructive pulmonary disease,AECOPD)合并心功能不全痰热壅肺证疗效。方法根据治疗方法将该院2021年1月—2021年12月收治的117例慢性阻塞性肺疾病急性加重期合并心功能不全患者分为观察组(57例)与对照组(60例),对照组采用常规抗感染、扩张支气管药物沙美特罗替卡松粉雾剂和给予单硝酸异山梨酯片治疗,观察组在此基础上联合使用五子参药汤治疗。观察两组患者治疗前后左室舒张末期容积(left ventricular end diastolic volume,EDV)、左室射血分数(left ventricular ejection fraction,LVEF)、肌红蛋白(myoglobin,MYO)、B型利钠肽(B-type natriuretic peptide,BNP)、肌酸激酶(creatine kinase,CK)水平。观察两组患者治疗前与治疗后动脉血氧分压(arterial partial pressure of oxygen,PaO_(2))、动脉血二氧化碳分压(arterial partial pressure of carbon dioxide,PaCO_(2))、血氧饱和度(blood oxygen saturation,SaO_(2))、C反应蛋白(C-reactive protein,CRP)并测量两组患者治疗前后肺活量(forced vital capacity,FVC)、第1秒用力呼气量(forced expiratory volume in the first second,FEV_(1))及第1秒用力呼气量与肺活量的比值(FEV_(1)/FVC),观察两组患者两组患者临床疗效与不良反应发生率。运用慢阻肺患者自我评测表(COPD assessment test,CAT)。结果两组患者治疗前LVEF、EDV水平差异无统计学意义(P>0.05)。治疗后观察组LVEF水平较对照组显著升高、EDV水平较对照组显著降低(P<0.05)。两组患者治疗前PaO_(2)、PaCO_(2)、SaO_(2)水平差异无统计学意义(P>0.05)。治疗后观察组的PaO_(2)、SaO_(2)水平较对照组显著上升,PaCO_(2)水平较对照显著降低(P<0.05)。两组患者治疗前BNP、CK、CRP、MYO水平差异无统计学意义(P>0.05)。治疗后观察组BNP、CK、CRP、MYO水平较对照组显著降低(P<0.05)。治疗前两组患者FVC、FEV_(1)、FEV_(1)/FVC水平差异无统计学意义(P>0.05)。治疗后观察组FVC、FEV_(1)、FEV_(1)/FVC水平较对照组显著身高(P<0.05)。观察组优良总有效率为84.20%(48/57)显著高于对照组66.66%(40/60)(χ^(2)=4.825,P=0.028)。观察组不良反应发生率为8.75%(5/57)略低于对照组13.28%(8/60),但两组患者不良反应发生率差异无统计学意义(χ^(2)=0.615,P=0.432)。两组患者治疗前CAT评分差异无统计学意义(P>0.05)。治疗后观察组CAT评分显著低于对照组(P<0.05)。结论高才达名老中医自拟五子参药汤联合传统西医治疗更能有效改善心功能指标、降低炎性水平、促进肺功能恢复、缓解呼吸困难、减少不良反应发生率,提高疗效和提升患者生活水平。

运用国医大师孙光荣参、芪-丹参药组结合和中运脾理论的实践

孙光荣教授是第二届国医大师,他是中医中和医派创始人。他提出了“中和辨证-中和组方-中和用药”的中和学术思想,并在该学术思想的指导下,创建了中医处方模式新体系——“三联组药法”,用于临床其疗效确切,在诸多的药组中参、芪-丹参药对组是最重要的一组。笔者认为在疗疾时持“守中、和中、运中”之和中运脾理论观点,处理疾病以“和在于脾,运在于肾,舒在于络”十二字要诀为指导处理疾病。学习孙光荣教授运用参、芪-丹参药对经验,在临床中结合和中运脾理论积极实践,现予以总结加以提高。

陕西省“参”药的种类及分布

陕西位于我国中部偏东靠北,跨越冷凉、温和与温热三个气候区,被秦岭山脉和乔山山脉划分为陕北黄土高原、关中平原和秦巴山地各具特色的自然区,地形、地貌、气候、植被复杂多样,为各种药用动植物的生存、繁衍提供了有利条件,中草药资源丰富,种类繁多并具有不少参类药物。据调查,全省中草药3291味。

参附药对改善大鼠阳气虚衰型心衰的最佳配比研究

[目的]建立阳气虚衰型心力衰竭(heart failure,HF)大鼠模型,筛选参附药对改善HF的最佳配比,阐明参附药对的配伍与疗效关系。[方法]取术后存活的阳气虚衰型HF模型大鼠,以不同配比参附药对(红参:附子=1:0.1、1:0.5、1:1、1:2、1:10)灌服,同时设置红参组、附子组、手术组和假手术组为对照,采用酶联免疫吸附法(enzyme-linked immunosorbent assay,ELISA)测定各组大鼠血清中三碘甲状腺原氨酸(triiodothyronine,T3)、甲状腺素(thyroxin,T4)、促甲状腺素(thyrotropin,TSH)、醛固酮(aldosterone,ALD)、脑钠素(brain natriuretic peptide,BNP)含量。[结果]1:10配比参附药对组比手术组能有效提高大鼠血清T4含量;1:0.5、1:10配比参附药对组均能有效提高大鼠血清TSH含量,同时降低大鼠血清ALD、BNP含量,从而起到治疗阳气虚衰型HF大鼠的作用。[结论]不同配比参附药对对阳气虚衰型HF大鼠具有治疗效果,其中以参附药对1:10组的疗效最佳。

六种参类补益中药微量元素含量的比较

微量元素与人体健康的研究工作,近年来已有很大进展,特别是中药中所含微量元素及其对人体的作用,引起了越来越多学者的重视。中医的补益药能补充人体内某些物质的缺乏或增强人体的机能,治疗各种虚证。补益药中以补气药最为常用,人参、党参、西洋参、佛手参都属于补气药,且均称为“参”。晚近,对这些药物的有机成分和药理方面的研究。

基于波长切换法测定参三七伤药胶囊(片)中松香酸和苏丹红Ⅳ的含量

目的:建立HPLC-DAD波长切换法同时测定参三七伤药胶囊(片)中非法添加松香酸和苏丹红Ⅳ的含量。方法:Phenomenex Gemini C_(18)柱(250 mm×4.6 mm,5μm);以乙腈-0.1%甲酸水溶液为流动相,梯度洗脱;检测波长:0~48 min,260 nm(松香酸);48~70 min,520 nm(苏丹红Ⅳ),流速:1 ml·min^(-1),柱温:20℃,进样量:10μl。结果:松香酸在5.14~514.50μg·ml^(-1)、苏丹红Ⅳ在0.05~5.02μg·ml^(-1)浓度范围内与峰面积线性关系良好(r>0.999);加样回收率分别为99.53%,99.60%,RSD分别为0.43%,0.72%(n=9)。结论:该方法的专属性、准确度、耐用性均表现良好,适合作为测定参三七伤药胶囊(片)中非法添加松香酸和苏丹红Ⅳ的定量分析方法。

氧化苦参碱注射液治疗病毒性肝炎的评述

博尔泰力(苦参素)注射液即氧化苦参碱。自1998年12月31日由中华医学会重点推广使用以来,全国各大医院,特别是各传染病专科医院已普遍用于治疗慢性病毒性肝炎。实践证明:在慢性乙型肝炎(以下简称乙肝)的抗病毒治疗中,博尔泰力已起到了与α-干扰素类似的效果。由于副作用小,经济安全,效果较好。

MTT法检测牛黄参胶囊对HepG2细胞增殖影响的实验研究

观察牛黄参胶囊对体外培养的人肝癌细胞HepG2的影响。方法制备牛黄参胶囊含药血清(NHS),MTT法检测不同浓度含药血清对肝癌细胞HepG2的影响。结果 20%浓度含药血清能明显抑制HepG2细胞增殖。结论 NHS含药血清对体外培养的人肝癌细胞HepG2具有抑制作用,能促进肝癌细胞HepG2的凋亡。

一种我国自主研发rhFⅧ的临床前药代动力学初步比较研究

目的初步研究具有自主知识产权的重组表达人凝血因子(rFⅧ)在研品种的临床前药代动力学。方法建立并优化生色底物活性检测方法,用于测定血浆样品中FⅧ活性浓度(FⅧ∶C);选择市售进口的同类药物Xyntha为参比药物,对只敲除了FⅧ基因的模型小鼠(HA小鼠)分组(n=18)单次尾静脉注射280 IU·kg-1受试药rhFⅧ或参比药Xyntha,在0、0.083、1、3、6、9、24、36和48 h采集血浆样品(30μL/只,每个时间点6个样品),测定其FⅧ∶C并计算药代动力学参数。结果受试rhFⅧ组和参比药Xyntha组给药后,0.083、1、3、6、9、24、36和48 h的血浆FⅧ∶C(IU·mL-1)分别为3.218±1.511 vs 3.616±1.504、2.089±0.593 vs 2.786±1.157、1.953±0.546 vs1.942±0.807、0.613±0.360 vs 1.025±0.321、0.515±0.370 vs 0.894±0.297、0.187±0.082 vs 0.310±0.108、0.061±0.038 vs 0.115±0.040、0.043±0.042 vs 0.023±0.012(P>0.05);主要药代动力学参数:t1/2(h)分别为8.83 vs9.15,AUC0-t(h·IU·mL-1)分别为19.67 vs 27.70,Vd(mL·kg-1)分别为176.37 vs 132.00,CL(mL·h-1·kg-1)分别为13.85 vs 10.00,MRT0-t(h)分别为8.64 vs 9.62。结论受试rhFⅧ单次HA小鼠尾静脉给药280 IU·kg-1后在小鼠体内的药代动力学过程与市售同类进口药物Xyntha基本一致。

参菝抗瘤液联合化疗治疗晚期胃癌的临床观察

目的:评价参菝抗瘤液联合化疗治疗晚期胃癌的临床疗效。方法:将40例晚期胃癌患者随机分为治疗组(参菝抗瘤液+化疗组)和对照组(化疗组)。对照组给予FOLFOX4方案化疗,治疗组同时加用参菝抗瘤液30 m L/d口服,连用1周,2周为一周期。结果:1)治疗组肿瘤近期客观疗效有效率高于对照组,但无统计学意义(P>0.05);2)经治疗后,治疗组患者KPS评分升高率优于对照组,2组比较有统计学意义(P<0.01);3)治疗组体重增加及稳定者比例均高于对照组,2组比较差异有统计学意义(P<0.05);4)骨髓抑制比较,治疗组显著低于对照组(P<0.01);5)消化道反应比较,治疗组明显低于对照组,化疗不良反应小(P<0.05)。结论:参菝抗瘤液联合化疗治疗晚期胃癌有改善生活质量,减轻化疗不良反应的作用。

Study on Tanshinone Extracted from Salvia miltiorrhiza Bge. Dregs

[Objective]The aim was to extract tanshinone from Salvia miltiorrhiza Bge. dregs and to determine tanshinone components. [Method]Organic solvent method was adopted to extract tanshinone from S. miltiorrhiza dregs and TLC was used to determine the optimum extraction solvent. The components of tanshinone were measured with HPLC. [Result]Ether was the best solvent to extract tanshinone from S. miltiorrhiza dregs. After water immersion,dry dregs of S. miltiorrhiza and Panax notoginseng were extracted with ethanol to obtain fat-soluble extracts. Then with ether as the solvent for Soxhlet extraction,the yield of crude tanshinone was 2.17%. The HPLC detection showed that the contents of tanshinone Ⅱ A,methylene tanshinquinone,cryptotanshinone,tanshinone Ⅰ were 3.62%,1.02%,2.56%,2.75% respectively. [Conclusion]The components of tanshinone in S. miltiorrhiza dregs were basically the same as tanshinone in medicine S. miltiorrhiza. S. miltiorrhiza dregs could be used as a kind of tanshinone resource,which has the value of development and utilization.

牛黄参含药血清调控Bax、Bcl-2表达诱导人肝癌细胞HepG-2凋亡的实验研究

目的观察牛黄参胶囊含药血清对人肝癌细胞HepG-2的Bax、Bcl-2的调控作用。方法建立并分为空白对照组,环磷酰胺组和牛黄参胶囊5%、10%和20%含药血清组。采用实时定量PCR检测Bax、Bcl-2 mRNA的表达水平;免疫组织化学法检测HepG-2细胞Bax、Bcl-2的表达;Western blotting检测Bcl-2蛋白的表达水平。结果牛黄参胶囊20%含药血清能在基因和蛋白水平明显上调Bax表达(P<0.01),明显抑制Bcl-2的表达(P<0.01),并具有明显的剂量依赖性。结论牛黄参胶囊含药血清能明显上调Bax表达,同时下调Bcl-2表达,可能是其诱导肝细胞凋亡的机制之一。

HPLC Determination of Harpagoside and Cinnamic Acid in Radix Scrophulariae

A gradient HPLC method was established for the determination of harpagoside and cinnamic acid in Radix Scrophulariae (Xuanshen) and a proposition was put forward for the lowest content of the characteristic and active constituent (harpagoside) for qualified Radix Scrophulariae. The experimental conditions were as follows: Ultrasphere ODS column (250 mm 4.6 mm, 5 mm), mobile phase: acetonitrile-water (containing 1.0% acetic acid) (20:8050:50) (20 min), flow-rate 1 mLmin-1, room temperature, detection wavelength 278 nm. Twenty-eight samples of Xuan-shen (Radix Scrophulariae) from different districts of China were analyzed and the contents of harpagoside and cinnamic acid in Xuan-shen were 0.041~0.244% and 0.012~0.068% respectively. The recoveries (RSD)% were 97.13(0.80)% for harpagoside and 99.38(0.51)% for cinnamic acid. The method is simple and accurate. It can be used for the quality control of Radix Scrophulariae. We propose that the content of harpagoside in qualified Radix Scrophularia should be no less than 0.05%.

复方丹参多元释药微丸对心肌细胞缺氧/复氧损伤的保护作用研究

目的:运用血清药理学的方法,探讨复方丹参多元释药微丸对心肌细胞缺氧/复氧损伤的保护作用,评价复方丹参多元释药微丸制剂的有效性。方法:单次灌胃给予市售复方丹参片和复方丹参多元释药微丸(折算生药材2911.14 mg/kg),于给药后0.25,0.5,0.75,1,2,4,8,12 h眼眶取血制备含药血清,并将不同时间点的含药血清作用于心肌细胞,检测心肌细胞的活性。结果:与模型组比较,市售复方丹参片4,8 h的含药血清对缺氧/复氧损伤心肌细胞有促增殖作用,而复方丹参多元释药微丸0.25,0.5,0.75,1,4,8,12 h的含药血清均能够显著促进缺氧/复氧损伤心肌细胞的增殖。结论:复方丹参多元释药微丸对心肌细胞缺氧/复氧损伤具有良好的保护作用,相对于复方丹参片,具有起效快,作用时间长的特点。

Analysis of the Constituents in the Chinese Drug Notoginseng by Liquid Chromatography-Electrospray Mass Spectrometry

To develop a HPIX-UV-MS method for identifying the constituents in theChinese drug Notoginseng (the root of Panax notoginseng). Methods A Phenomenex Luna C_(18) column(250 mm x 4.6 mm ID, 5 μm) was utilized. Water containing 0.005% formic acid (A) and acetonitrilecontaining 0.005% formic acid (B) were used as gradient eluents. UV spectra were recorded in range195 - 400 nm. Both positive and negative ion ESI modes were used. Results The constituents inNotoginseng were well separated and detected. Fourteen compounds were identified by comparing theirretention time and ESI-MS data with those obtained from the reference compounds. Forty-one compoundswere deduced by data analysis of MS and literature; among them, yesanchinosides-H and -E,chikusetsusaponin-L_5, malonyl-ginsenoside-R_(g_1), the isomers of notoginsenosides-J, -A, -R_1, -G,-R_2, and ginsenoside-Rh_3 were discovered in Notoginseng for the first time. Conclusion Thismethod gives high sensitivity and good separation, and is suitable for identifying the constituentsin Notoginseng. This result is helpful for further phytochemical research on Notoginseng. Based onthis result, further quality control can be studied.

牛黄参含药血清诱导人肝癌细胞HepG-2凋亡的机理研究

目的探讨牛黄参胶囊含药血清对人肝癌Hep G-2细胞凋亡及Fas表达的影响。方法将实验分为对照组,环磷酰胺组,牛黄参胶囊含药血清5%、10%和20%组。采用DNA Ladder观察DNA凋亡条带的形成,运用荧光显微镜观察凋亡细胞核的形态,采用流式细胞术检测其诱导细胞凋亡的凋亡率;分别采用免疫组织化学和流式细胞术检测牛黄参胶囊含药血清对Hep G2细胞表面Fas表达的影响。结果牛黄参胶囊含药血清作用于Hep G2细胞48 h后,有明显的DNA凋亡条带的形成,Hep G2细胞核染色质明显固缩和碎裂,产生凋亡小体;其促进Hep G2细胞的凋亡具有明显的浓度依赖性(P<0.01);能明显上调Hep G2细胞表面Fas的表达,具有明显的剂量依赖性(P<0.01)。结论牛黄参胶囊含药血清能促进人肝癌Hep G-2细胞凋亡,上调Fas蛋白表达可能是其抗肝癌药效机制之一。

Two New Triterpenoid Saponins from Morina nepalensis var. alba

Two new triterpenoid saponins, monepaloside K (1) and monepaloside L (2), together with a known saponin, mazusaponin I (3), were isolated from the water-soluble part of the whole plant of Marina nepalensis var. alba Hand.-Mazz. The structures of monepalosides K and L were determined to be 3-O-α-L-arabinopyranosyl-(1-3)-α-D-xylopyranosyl siaresinolic acid (1) and 3-O-β-D-glucopyranosyl-( 1-3)-β-L-arabinopyranosy1 siaresinolic acid 28-O-β-D-glucopyranosyl-(1-6)-β-D-glucopyranoside (2) respectively, on the basis of chemical and spectroscopic evidence.

Study on Detection of Organochlorine Pesticide Residue in Ginseng

To investigate the residue situation of pesticides in ginseng, total 17 samples of ginseng-growing soil, ginseng roots and ginseng seeds were collected from 5 regions of Fusong County, and the contents of organochlorine pesticide residues in the samples were detected by using ultrasonic-assisted extraction and gas chromatography with acetone-ligroin as the solvent, thereby providing suitable recommendations and scientific basis for the selection of ginseng-growing soil.

Resource Characteristics and Sustainable Utilization of Codonopsis convolve, a Tibetan Medicinal Plant

In this paper, the resources of Codonopsis convolvulacea subsp. Vinciflora in 13 counties of Tibet were investigated and analyzed by field investigation, sample point-sample set-sample survey, market investigation and expert visit. The results showed that among the 13 counties, the distribution area of C. convolvulacea ranked as Gongbujiangda County 〉 Zuogong County 〉 Milin County 〉 Mozhugongka County 〉 Lang County 〉 Duilongdeqing County 〉 Chayu County=Jiali County= Mangkang County=Dingqing County=Baqing County=Suo County=Nimu County. The Gongbujiangda County showed the largest distribution, while Zuogong County and Milin County showed relatively small distribution. Chayu County, Jiali County, Mangkang County, Dingqing County, Baqing County, Suo County and Nimu County showed no distribution. The average plant dry weight C. convolvulacea ranked as Duilongdeqing County 〉 Lang County, Gongbujiangda County 〉Milin County 〉Chayu County =Jiali County =Zuogong County =Mangkang County =Dingqing County =Baqing County=Suo County=Mozhugongka County=Nimu County. Among them, Duilongdeqing County showed the largest average plant dry weight. The average plant dry weight of C. convolvulacea in Chayu County, Jiali County, Zuogong County, Mangkang County, Dingqing County, Baqing County, Suo County, Mozhugongka County and Nimu County was all 0 g. The order of biomass of C. convolvulacea in the 13 counties was Mozhugongka County 〉Duilongdeqing County 〉 Lang County 〉 Gongbujiangda County 〉Milin County 〉Zuogong County 〉Dingqing County =Jiali County=Mangkang County=Chayu County=Nimu County=Suo County=Baqing County. Mozhugongka County showed the largest biomass, while the biomass of C. convolvulacea in Dingqing County, Jiali County, Mangkang County, Chayu County, Nimu County, Suo County and Baqing County was all 0 t. The reserve of C. convolvulacea is determined by distribution area habitat and its own growth. In the 13 counties, the reserve of C. convolvulacea ranked as Gongbujiangda County 〉Mozhugongka County 〉 Lang County 〉Zuogong County 〉Milin County 〉Duilongdeqing County 〉Dingqing County=Jiali County=Mangkang County=Chayu County=Nimu County=Suo County=Baqing County. The reserve of C. convolvulacea was biggest in Gongbujiangda County and was relatively small in Dingqing County, Jiali County, Mangkang County, Chayu County, Nimu County, Suo County and Baqing County. Targeting at the problems existing in the utilization of C. convolvulacea, some suggestions are put forward, such as establishment of reserve for medicinal plant ecological industry, artificial cultivation, renewing concept and rational exploitation and utilization. In this paper, the resource characteristics and sustainable utilization of Tibetan medicinal plants were studied so as to provide a theoretical basis for the rational development and utilization of C. convolvulacea in the region.