经方阶段性干预控制不理想肝胆湿热型高血压病的临床疗效分析

目的:分析经方龙胆泻肝汤加减阶段性干预控制不理想肝胆湿热型高血压病患者的临床疗效。方法:选取144例阶段性控制不理想高血压病患者,且经中医辨证均为肝胆湿热证型,就诊时体质辨识为湿热质,随机分为干预组和对照组进行治疗。结果:干预组患者的临床治疗效果显著优于对照组(P<0.05),患者的满意度显著高于对照组(P<0.05)。结论:高血压患者血压控制不理想时不要一味地加大西药用量或改变治疗方案,而要适当运用一些中药调理,剔除影响病人血压的不利因素,使患者阴阳平和、血压自然平稳。

Integrating proteomics and targeted metabolomics to reveal the material basis of liver-gallbladder damp-heat syndrome in chronic hepatitis B

Objective To elucidate the biological basis of liver-gallbladder damp-heat syndrome(LGDHS)within the framework of traditional Chinese medicine(TCM)as a complementary diagnostic and therapeutic approach in chronic hepatitis B(CHB).Methods CHB patients and healthy volunteers were enrolled from Shuguang Hospital Affili-ated to Shanghai University of Traditional Chinese Medicine between August 21,2018 and December 31,2020.They were divided into three groups:healthy group,LGDHS group,and latent syndrome(LP)group.Proteomic analysis using isobaric tags for relative and absolute quantitation(iTRAQ)was performed to identify differentially expressed proteins(DEPs).Metabolomic profiling via ultra-performance liquid chromatography-tandem mass spec-trometry(UPLC-MS/MS)was applied to serum samples to detect differentially regulated metabolites(DMs).Kyoto Encyclopedia of Genes and Genomes(KEGG)and Gene Ontology(GO)enrichment were employed to explore dysregulated pathways.Principal component analysis(PCA)and orthogonal partial least squares discriminant analysis(OPLS-DA)were utilized to visualize group separation and identify key metabolites and proteins contributing to LGDHS differentiation.Receiver operating characteristic(ROC)curve analysis evaluated the diagnostic performance of key biomarkers,while logistic regression models assessed their predictive accuracy.P values were corrected for multiple tests using the Benjamini-Hochberg method to control the false discovery rate(FDR).Validation of potential biomarkers was con-ducted using independent microarray data and real-time quantitative polymerase chain reac-tion(RT-qPCR).Results A total of 150 participants were enrolled,including healthy group(n=45),LGDHS group(n=60),and LP group(n=45).254 DEPs from proteomics data and 72 DMs from metabolomic profiling were identified by PCA and OPLS-DA.DEPs were mainly enriched in immune and complement pathways,while DMs involved in amino acid and energy metabolism.The integrated analysis identified seven key biomarkers:α1-acid glycoprotein(ORM1),asparagine synthetase(ASNS),solute carrier family 27 member 5(SLC27A5),glu-cosidase II alpha subunit(GANAB),hexokinase 2(HK2),5-methyltetrahydrofolate-homocys-teine methyltransferase(MTR),and maltase-glucoamylase(MGAM).Microarray validation confirmed the diagnostic potential of these genes,with area under the curve(AUC)values for ROC analysis ranging from 0.536 to 0.759.Among these,ORM1,ASNS,and SLC27A5 showed significant differential ability in differentiating LGDHS patients(P=0.016,P=0.035,and P<0.001,respectively),with corresponding AUC of 0.749,0.743,and 0.759,respectively.A logis-tic regression model incorporating these three genes demonstrated an AUC of 0.939,indicat-ing a high discriminatory power for LGDHS.RT-qPCR further validated the differential ex-pression of ORM1 and SLC27A5 between LGDHS and LP groups(P=0.011 and P=0.034,re-spectively),with ASNS showing a consistent trend in expression(P=0.928).Conclusion This study integrates multi-omics approaches to uncover the molecular mecha-nisms underlying LGDHS in CHB.The identification of biomarkers ORM1,ASNS,and SLC27A5 offers a solid basis for the objective diagnosis of LGDHS,contributing to the stan-dardization and modernization of TCM diagnostic practices.

清肝解毒胶囊的临床试验研究

目的 :观察清肝解毒胶囊治疗急性甲、乙型肝炎 (中医辨证属肝胆湿热证型 )的临床疗效。方法 :42 0例患者采用随机单盲对照与开放试验相结合的方法进行临床试验观察 ,试验病例为 30 0例。结果 :清肝解毒胶囊治疗急性甲、乙型肝炎的总有效率为 87 0 0 % ,明显优于对照组总有效率 71 67% (P <0 0 5)。对中医辨证属肝胆湿热所致的胁肋胀痛、身目俱黄、烦热口苦、脘闷腹胀、恶心纳呆、神倦乏力、小便黄赤、大便溏滞不爽或秘结等症状具有显著改善作用 ,总有效率为 99 33 % ,与对照组总有效率 96 67%相比存在显著性差异 (P <0 0 5) ,随访疗效稳定。与降酶灵胶囊、乙肝解毒胶囊对照组比较 ,差异有显著性意义 (P <0 0 5)。结论 :清肝解毒胶囊对急性甲、乙型肝炎 (中医辨证属肝胆湿热证型 )有较好的治疗效果 ,临床使用安全方便 ,无明显毒副作用。