Exploring the mechanism of Guizhi decoction’s“Jun-Chen-Zuo-Shi”in treating plant nervous disorders based on weighted network pharmacology and molecular docking techniques

Objective:To explore the mechanism of Guizhi decoction’s“Jun-Chen-Zuo-Shi”in treating plant nervous disorders based on network pharmacology and molecular docking methods.Methods:The main active ingredients of Guizhi decoction were screened from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP),and plant nervous disorder-related targets were screened from the Gene Cards database,OMIM database,and PharmGKB database.The intersection of the two was obtained.The intersection targets were used to draw a protein interaction network and a“Traditional Chinese Medicine-active ingredient-target”network using the STRING database and Cytoscape 3.9.1.The nodes in the“Traditional Chinese Medicine-active ingredient-target”network were weighted according to the“Jun-Chen-Zuo-Shi”principle.Kyoto Encyclopedia of Genes and Genomes,and gene ontology enrichment analysis were performed on the intersection targets.Molecular docking was used to verify the affinity between core targets and key ingredients.Results:A total of 225 effective components of Guizhi decoction were screened,among which 127 components could bind to 160 common targets and play a therapeutic role.The common targets were mainly enriched in 2785 gene ontology entries and 189 Kyoto Encyclopedia of Genes and Genomes pathways.Molecular docking confirmed that core targets could spontaneously bind to key ingredients.Conclusion:The key targets for the treatment of plant nervous disorders by Guizhi decoction are MAPK1,TP53,RB1,STAT3,MAPK3,MAPK14,etc.,which reflect the characteristics of the synergistic mechanism of traditional Chinese medicine with multiple components,targets,and pathways through the regulation of inflammatory signal pathways and oxidative stress processes.

Effects of Chaihu Guizhi Ganjiang Decoction Combined with Standard Triple Therapy on Reducing Serum CagA and Hp-NAP in Patients with H.pylori-Related Gastritis

OBJECTIVE: To explore the effects of Chaihu Guizhi Ganjiang Decoction combined with standard triple therapy on treating H.pylori-related gastritis. METHODS: Eighty-two patients with H. pylori-related gastritis treated in our hospital from January 2016 to December 2017 were selected according to the random number table method and divided into experimental group and control group, with 41 patients in each group. The control group was treated with standard triple therapy, while the experimental group was additionally treated with modified Chaihu Guizhi Ganjiang Decoction. The venous blood of one elbow was taken before and after treatment. The concentrations of serum CagA and Hp-NAP were detected by enzyme-linked immunosorbent assay(ELISA). The symptoms were evaluated according to the change of symptom scores before and after the intervention. The H.pylori eradication rate was calculated. RESULTS: There was no significant difference in CagA and Hp-NAP concentrations between the 2 groups before intervention(P > 0.05). After intervention, CagA and Hp-NAP concentrations in experimental group were(19.21±6.27) ng/L and(24.37±6.10) ng/L respectively which were lower than(25.81±7.14) ng/L and(32.09±5.73) ng/L of control group. The differences were statistically significant(P < 0.05). The total effective rate of major symptoms in experimental group was 39 cases(95.12%), which was significantly higher than that of the control group(31 cases, 75.61%). There was statistically significant difference between the 2 groups(P < 0.05). The eradication rate of H.pylori was 38 cases(92.68%) in the experimental group, which was significantly higher than 31 cases(75.61%) of the control group. The difference between the 2 groups was statistically significant(P < 0.05). CONCLUSION: Chaihu Guizhi Ganjiang Decoction combined with standard triple therapy can effectively reduce CagA, Hp-NAP of serum level in patients with H.pylori-related gastritis, improve efficacy of symptoms and eradication rate of H.pylori, and is worthy of clinical promotion.

Huangqi Guizhi Wuwu Decoction for treating diabetic peripheral neuropathy：a meta-analysis of 16 randomized controlled trials

OBJECTIVE：This meta-analysis was performed to systematically assess the efficacy and safety of the Chinese herbal medicine Huangqi Guizhi Wuwu Decoction（HGWWD） for treating diabetic peripheral neuropathy.DATA SOURCES：Six electronic databases,including the Cochrane Library,MEDLINE database,Chinese Biomedical Database,Chinese National Knowledge Infrastructure Database,Chinese Science and Technique Journals Database,and the Wanfang Database,were search ed on the internet for randomized controlled trials published up until 1 December 2015.The search terms included ＂Chinese herbal medicine＂,＂diabetic peripheral neuropathy＂ and ＂randomized controlled trials＂ in Chinese and in English.DATA SELECTION：We included randomized controlled trials using HGWWD/modified HGWWD for the treatment group,without restriction for the control group.We assessed literature quality in accordance with the Cochrane Review Handbook.A random or a fixed effects model was used to analyze outcomes using Rev Man 5.2 software.OUTCOME MEASURES：The primary outcomes were changes in symptoms and nerve conduction velocities.The secondary outcomeswere fasting blood glucose and hemorheological indexes.RESULTS：Sixteen randomized controlled trials,with a total of 1,173 patients,were included.Meta-analysis revealed that the efficacy of HGWWD for diabetic peripheral neuropathy was significantly superior compared with the control treatment（i.e.,control group）（risk ratio = 0.36,95% confidence interval（CI）：0.29–0.46,Z =8.33,P 〈 0.00001） Compared with the control group,there was an increase in median motor nerve conduction velocity（mean difference（MD） = 3.46,95%CI：1.88–5.04,Z = 4.30,P 〈 0.01） and median sensory nerve conduction velocity（MD = 3.30,95%CI：2.04–4.56,Z = 5.14,P 〈 0.01）.There was also an increase in peroneal motor nerve conduction velocity（MD = 3.22,95%CI：2.45–3.98,Z = 8.21,P 〈 0.01） and peroneal sensory nerve conduction velocity（MD = 3.05,95%CI：2.01–4.09,Z = 5.75,P 〈 0.01） in the treatment groups.No significant difference in fasting blood glucose was found between the treatment groups and the control groups（MD =-0.12,95%CI：-0.42–0.19,Z = 0.76,P = 0.45）.Plasma viscosity was significantly decreased after treatment（MD =-0.11,95%CI：-0.21 to-0.02,Z = 2.30,P = 0.02）.No significant difference in fibrinogen was detectable（MD =-0.53,95%CI：-1.28–0.22,Z = 1.38,P = 0.17）.Four trials reported that treatment groups experienced no adverse reactions.Adverse events were not mentioned in the other 12 trials.No trial reported the incidence of complications,quality of life outcomes,or health economics.CONCLUSION：HGWWD treatment improves diabetic neurologic symptoms and ameliorates nerve conduction velocities.Our study suggests that HGWWD may have significant therapeutic efficacy for the treatment of diabetic peripheral neuropathy.However,the methodological quality of the randomized controlled trials was generally low.Larger and better-designed randomized controlled trials are required to more reliably assess the clinical effectiveness of HGWWD.

Gualou Guizhi decoction promotes neurological functional recovery and neurogenesis following focal cerebral ischemia/reperfusion

Recovery following stroke involves neurogenesis and axonal remodeling within the ischemic brain. Gualou Guizhi decoction （GLGZD） is a Chinese traditional medicine used for the treatment of post-stroke limb spasm. GLGZD has been reported to have neuroprotective effects in cerebral ischemic injury. However, the effects of GLGZD on neurogenesis and axonal remodeling following cerebral ischemia remain unknown. In this study, a rat model of focal cerebral ischemia/reperfusion was established by middle cerebral artery occlusion. Neurologi- cal function was assessed immediately after reperfusion using Longa＇s 5-point scoring system. The rats were randomly divided into vehicle and GLGZD groups. Rats in the sham group were given sham operation. The rats in the GLGZD group were intragastrically administered GLGZD, once daily, for 14 consecutive days. The rats in the vehicle and sham groups were intragastrically administered distilled water. Modified neurological severity score test, balance beam test and foot fault test were used to assess motor functional changes. Nissl staining was performed to evaluate histopathological changes in the brain. Immunofluorescence staining was used to examine cell proliferation using the marker 5-bromo-2＇-deoxyuridine （BrdU） as well as expression of the neural precursor marker doublecortin （DCX）, the astrocyte marker glial fibrillary acidic protein （GFAP） and the axon regeneration marker growth associated protein-43 （GAP-43）. GLGZD substan- tially mitigated pathological injury, increased the number of BrdU, DCX and GFAP-immunoreactive cells in the subventricular zone of the ischemic hemisphere, increased GAP-43 expression in the cortical peri-infarct region, and improved motor function. These findings suggest that GLGZD promotes neurological functional recovery by increasing cell proliferation, enhancing axonal regeneration, and in- creasing the numbers of neuronal precursors and astrocytes in the peri-infarct area.

Clinical Study of Jiawei Huangqi Guizhi Wuwu Decoction (加味黄芪桂枝五物汤) in Preventing and Treating Peripheral Neuro-sensory Toxicity Caused by Oxaliplatin

Objective： To evaluate the efficacy of Jiawei Huangqi Guizhi Wuwu Decoction （加味黄芪桂枝五物汤, JHGWD） in treating neuro-sensory toxicity induced by oxaliplatin. Methods： A randomized controlled self-crossover trial was performed. Thirty-one patients were randomly divided into AB and BA groups. Patients in A cycle belonged to the treated group, who were treated with chemotherapy combined with oxaliplatin plus JHGWD. Patients in B cycle belonged to the control group and were treated with chemotherapy alone. The peripheral neuro-sensory toxicity was observed and analyzed. Results： The main neurotoxicity was cold-induced paresthesia after the use of oxaliplatin, which included hyperaesthesia, chill, anaesthesia in the extremities, electrified sensation, formication, foreign body sensation and pain that might be exacerbated by exposure to cold. Twenty patients （64.5 % ） suffered from neuro-sensory toxicity in the treated group and 27 cases （87.1% ） in the control group. Symptoms were more serious and lasted longer in the control group than those in the treated group （P〈0.01）. Conclusion： JHGWD could prevent and reduce the occurence and intensity of acute peripheral neuro-sensory toxicity caused by oxaliplatin.

Effect of Chaihu Shugan decoction on gastric smooth muscle cell apoptosis in rats with functional dyspepsia

Objective:To investigate the effect of Chaihu Shugan decoction(CSD)on gastric smooth muscle cells(GSMCs)apoptosis in rats with functional dyspepsia(FD).Methods:48Sprague-Dawley(SD)rats were randomly assigned into six groups:a normal control group,a model group,apositive control(domperidone)group and low-,middle-and high-dose CSD groups.A rat model of FD was established by constantly squeezing their tails.The rats were administered CSD(0.16g/mL,0.32g/mL,0.64g/mL)or domperidone(0.3 g/L)via intragastric gavage for four weeks.The gastric emptying rate was detected at 4 weeks post-administration.Apoptosis of GSMCs was determined by terminal deoxynucleotidyl transferase dUTP nick end labeling(TUNEL)staining and the mitochondrial morphology was observed by transmission electron microscopy.The expression of Bcl-2and Bax was measured by immunohistochemistry.Results:FD resulted in marked reduction of gastric emptying rate,severe gastric tissue damage and mitochondria injury,but were reversed by CSD treatment(P<0.05).The apoptosis-induced protein Bax was markedly down-regulated by CSD,whereas the expression of the anti-apoptotic Bcl-2 protein was notably increased(P<0.05).Furthermore,CSD could protect the FD rats against GSMCs apoptosis manifested by a decreased in TUNEL-positive cells(P<0.05).Conclusion:CSD could alleviate GSMCs apoptosis in FD rats,possibly by the modulation of Bcl-2 and Bax expression,and the suppression of mitochondria injury.

Chaihu Longgu Muli Decoction relieving temporal lobe epilepsy in rats by inhibiting TLR4 signaling pathway through miR-146a-3p and miR-146a-5p

Objective To explore the effect and mechanism of Chaihu Longgu Muli Decoction(柴胡龙骨牡蛎汤,CHLGMLD)in rats with temporal lobe epilepsy(TLE).Methods A total of 80 Sprague-Dawley(SD)male rats were randomized into control(CON),model(MOD),carbamazepine(CBZ,0.1 g/kg),CHLGMLD low dose(CHLGMLD-L,12.5 g/kg),and high dose(CHLGMLD-H,25 g/kg)groups,with 16 rats in each group.TLE rat models were established in the four groups with the use of lithium-pilocarpine except for the CON group.After the successful establishment of TLE models,all drugs were administered through gavage,and distilled water was given to rats in the CON and MOD groups for four weeks.The frequency and duration of seizures before and after treatment were recorded for the evaluation of the alleviation degree.Quantitative real-time polymerase chain reaction(qRT-PCR)was used to detect the expression levels of miR-146a-3p and miR-146a-5p.The expression levels of toll-like receptor 4(TLR4),interleukin-1 receptor-associated kinase 1(IRAK1),tumor necrosis factor(TNF)receptor-associated factor 6(TRAF6),TAK1-binding protein(TAB),nuclear factor-kappa B(NF-κB),and interleukin-1 beta(IL-1β)in hippocampus were tested by immunofluorescence assay.Correlation analysis between the above factors and expressions of miR-146a-3p and miR-146a-5p were performed separately.Results CHLGMLD decreased the frequency(P<0.05)and duration(P<0.01)of seizures in rats.CHLGMLD down-regulated the expression levels of miR-146a-5p and miR-146a-3p(P<0.05),and inhibited the expression levels of TLR4,IRAK1,TRAF6,TAB,NF-κB,and IL-1β(P<0.01).The correlation analysis revealed that the expression levels of TLR4,IRAK1,TRAF6,TAB,NF-κB,and IL-1β were positively correlated with the expression levels of miR-146a-3p and miR-146a-5p detected by qRT-PCR,respectively(P<0.01).Conclusion CHLGMLD can inhibite the TLR4 signaling pathway by lowering the expression levels of miR-146a-3p and miR-146a-5p to alleviate hippocampal dentate gyrus inflammation in TLE rats,thus relieving seizures.

Application of Chaihu plus Longgu Muli Decoction in Treatment of Physical and Mental Diseases

Chaihu plus Longgu Muli Decoction is the representative treatment method of harmonizing and releasing combined with easing for lesser yang disease proposed by famous physician Zhang Zhongjing.Through clinical cases,this paper firstly introduced the main framework of Chaihu plus Longgu Muli Decoction,to make the treatment method of harmonizing and releasing become more flexible in clinical application.Besides,it introduced the common changes in the learning and application of the decoction,to respond to various changes in the clinical diseases.

Effects of Guizhi Shaoyao Zhimu Decoction on Laboratory Indicators and Immune Functions of Patients with Rheumatoid Arthritis

[Objectives]To explore the effects of Guizhi Shaoyao Zhimu Decoction on laboratory indicators and immune functions of patients with rheumatoid arthritis.[Methods]A total of 110 patients with rheumatoid arthritis admitted to the Second Department of Orthopedics,the Affiliated Chinese and Western Medicine Hospital of Nanjing,Nanjing University of Chinese Medicine from December 2014 to December 2016 were selected as the research objects and divided into a control group and an observation group using the random number table method,with 55 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with Guizhi Shaoyao Zhimu Decoction on the basis of the control group.Both groups were treated for one month.The clinical effects,improvement of clinical symptoms,laboratory indicators and immune function indicator levels between the two groups were compared;the incidence of adverse reactions in the two groups was counted.[Results]The total effective rate of the observation group was 92.73%,higher than that of the control group(78.18%)(P<0.05).Compared with that before treatment,after one month of treatment,the grip strength of the two groups increased,and the observation group was greater than the control group(P<0.05);the morning stiffness time and 20 m walking time of both groups were shortened,and the observation group was shorter than the control group(P<0.05);the number of joint tenderness,joint swelling,ESR,MPV,PDW,serum CRP,plasma IgA,IgG,IgM,RF levels in both groups decreased,and the observation group was lower than the control group(P<0.05);the serum C3 levels in both groups increased,and the observation group was higher than the control group(P<0.05).During the treatment,the incidence of adverse reactions in the observation group was 0.00%,which was lower than that in the control group(10.91%,P<0.05).[Conclusions]Using Guizhi Shaoyao Zhimu Decoction to treat rheumatoid arthritis can improve the laboratory indicators of patients,and enhance their immune functions,improve the curative effect,and the safety is high.

New Clinical Application of Chaihu Decoction

The classified prescriptions from Chaihu decoction have been widely used in ancient and modern times.In spite of many previous research studies,the extensiveness and diversity of their applications have not been systematically studied.The author applied Chaihu Wendan decoction to treat phlegm and qi stagnation in the middle energizer,applied Chaihu Guizhi decoction to treat simultaneous disease of Shaoyang and Taiyang,applied Chaihu Xiexin decoction to treat simultaneous disease of the spleen,stomach,liver,and gallbladder,applied Chaihu Ermiao powder to treat simultaneous disease of hand Shaoyang and foot Taiyin,applied Chaihu Erchen decoction to treat simultaneous disease of Shaoyang and Taiyin,applied Chailing decoction to treat simultaneous disease of hand Shaoyin and foot Taiyang,applied Chaihu Guizhi Ganjiang decoction to treat Shaoyang and Taiyin cold fluid retention and heat stagnation syndrome of Shaoyang complicated with Taiyin,applied Chaihu Xingren decoction to treat simultaneous disease of hand Shaoyang and hand Taiyin,applied Chaihu Sanren decoction to treat the disease caused by damp-heat stagnation in the hand Shaoyang and the foot Taiyin,and applied Chaihu Ganlu Xiaodu pellet to treat the diseases of hand Shaoyang and foot Yangming.The effects were all remarkable.

Potential Mechanism of Huangqi Guizhi Wuwu Decoction for Cervical Spondylosis treatment based on Network Pharmacology

Objective:To study the potential mechanism of Huangqi Guizhi Wuwu Decoction in the treatment of cervical spondylosis based on the network pharmacological method,and to provide a basis for clinical application and pharmacological research.Methods:TCMSP search was used to screen the main active compounds and related action targets of Huangqi Guizhi Wuwu Decoction,the standard names of action targets were obtained through the Uniprot database,and the"drug-target"interaction network was constructed by using Cytoscape3.6.1 software.The related targets of cervical spondylosis were obtained by searching GeneCards,OMIM,DisGeNET,and CTD databases,and the disease targets and drug targets were mapped by the Venny platform,and the intersection genes of them were the potential targets for drug treatment of this disease.Then,the intersection genes were input into the STRING database and Cytoscape 3.6.1 software,and the protein-protein interactions(PPI)network of"drug-disease intersection targets"was constructed,and we screened the core targets.Finally,GO biological function analysis and KEGG signaling pathway analysis of core targets were carried out through the DAVID database.Results:According to the screening conditions,74 effective compounds and 138 drug action targets of Huangqi Guizhi Wuwu Decoction were obtained,12179 genes related to cervical spondylosis were obtained,and the Venny platform analysis obtained 105 intersecting targets.With visual network processing by Cytoscape software,33 core targets were obtained by analyzing and calculating the core target degree values,which were JUN,PTGS2,NR3C1,TNF,IL6,TP53,EGFR,VEGFA,NOS3,IL1B,and so on.GO analysis showed that there were 133 items(P<0.05),involving adrenergic receptor activation,neurotransmitter receptor activation,nuclear receptor activation,catecholamine binding,etc.KEGG analysis obtained a total of 139 pathways(P<0.05),involving IL-17 signaling pathway,and tumor necrosis factor signaling pathway,relaxin signaling pathway,AGE-RAGE signaling pathway of diabetic complications,fluid shear stress,and atherosclerosis.Conclusion:the active components in Huangqi Guizhi Wuwu decoction may act on the core targets such as JUN,PTGS2,NR3C1,TNF,IL6,TP53,VEGFA through IL-17 signal pathway,tumor necrosis factor signal pathway,and AGE-RAGE signal pathway of diabetic complications,and exert their therapeutic effects.The research results can provide a basis for future basic and clinical research.

Application of Huangqi Guizhi Wuwu Decoction in Orthopaedics and Traumatology

The Huangqi Guizhi Wuwu Decoction(HQGZWWT)is composed of Huangqi(Astragali Radix),Shaoyao(Paeoniae Radix Alba),Guizhi(Cinnamomi Ramulus),Shengjiang(Zingiberis Rhizoma Recens),and Dazao(Jujubae Fructus)which has various pharmacological anti-inflammatory,analgesic,antioxidant,antitumor,lipid-lowering,and immunity-regulating activities.It has certain advantages in the treatment of orthopaedic diseases,such as cervical spondylosis,scapulohumeral periarthritis,lumbar disc herniation,knee osteoarthritis,rheumatoid arthritis,myofascial pain syndrome,etc.,with outstanding clinical efficacy,few adverse reactions,and high patient compliance.However,modern pharmacological researches on the whole prescription of HQGZWWT are insufficient and the therapeutic targets are not clear which needs further exploration.Besides,this prescription cannot treat ll orthopaedic diseases,so we should adhere to the thinking of four diagnostics in traditional Chinese medicine(TCM),select prescriptions based on syndrome differentiation,closely follow the pathogenesis,innovate and expand its scope of application,reflect the application advantages of this prescription in orthopaedics and traumatology and improve the total clinical efficiency.

Huangqi Guizhi Wuwu Decoction suppresses inflammation and bone destruction in collagen-induced arthritis mice

Objective: Rheumatoid arthritis(RA) is a chronic inflammatory and destructive arthritis, characterized by inflammatory infiltration and bone destruction. Huangqi Guizhi Wuwu Decoction(HGWD) is traditional Chinese medicine, which has been applied in the treatment of RA in clinical. The aim of this study was to investigate the therapeutic effect of HGWD on collagen-induced arthritis(CIA) mouse model.Methods: DBA/1J female mice were used to establish the collagen-induced arthritis(CIA) model. HGWD was administered intragastrically once a day for four weeks starting on the 22nd day after the first immunization. The body weight, hind paw thickness and clinical score were measured every five days. Gait analysis, histopathological staining, enzyme-linked immunosorbent assay(ELISA), ultrasound imaging and micro-computed tomography imaging were performed to determine the effects of HGWD treatment on inflammation and bone structure in this model. Moreover, Real-time PCR and Western blot analysis were used to detect inflammatory factors m RNA and protein levels after HGWD intervention in RAW264.7 cells.Results: HGWD attenuated symptoms of arthritis, suppressed inflammatory synovium area and the serum levels of inflammatory factors, inhibited joint space enlargement in the knee and ankle joints,reduced numbers of osteoclasts, protected bone destruction, as well as improved motor function.HGWD decreased the expression of m RNA for inflammatory factors and the protein expression levels of p-NF-ΚB and IL-17.Conclusion: These results suggested that HGWD suppresses inflammation, attenuates bone erosion and maintains motor function in collagen-induced arthritis mice.

Identification and characterization of chemical constituents in Mahuang Guizhi Decoction and their metabolites in rat plasma and brain by UPLC-Q-TOF/MS

Objective:Mahuang Guizhi Decoction(MGD),an essential herbal pair in traditional Chinese medicine,is able to release cold,fever and asthma,mainly containing alkaloids,flavonoids,phenylpropanoids and amino acids.However,the absorption and distribution of these four category compounds in vivo still remained unclearly.Methods:In our research,we utilized UPLC-Q-TOF-MS technique to identify the constituents within MGD,as well as the prototypes of MGD and their metabolites absorbed in plasma and brain.We further profiled the drug-time curve of prototypes and metabolites of MGD both in plasma and brain.Results:Our results showed that 105 constituents were characterized in MGD.Thirty of them could be absorbed into blood,and ten of them could be distributed into brain.We also discovered eight new bio-transformed metabolites in blood,and a half of which could pass through the blood–brain barrier.In addition,all components detected in vivo could be absorbed and distributed immediately.Conclusion:These findings provide an approachable method to analyze the potential bio-active compounds in MGD and their in vivo behaviors,which could promote the efficacious material basis study of MGD and the security of clinical utilization.

桂枝芍药知母汤治疗痛风性关节炎急性期疗效及对患者可调节相关因子与嘌呤受体水平变化的影响

目的:观察桂枝芍药知母汤联合非布司他、塞来昔布治疗痛风性关节炎(GA)急性期的效果,为临床治疗提供参考。方法:选取GA患者110例,根据随机原则分为对照组(西药)和观察组(桂枝芍药知母汤+西药),每组55例。记录两组治疗前及治疗3、7 d后血尿酸(UA)、血沉(ESR)、白细胞介素-1β(IL-1β)、Diekkopf-1(DKK-1)、白细胞介素-18(IL-18)、嘌呤能受体(P2X7R)水平及中医证候积分的变化,统计两组疗效和不良反应。结果:治疗7 d后,观察组总有效率为90.91%(50/55),明显高于对照组的76.36%(42/55),差异有统计学意义(P<0.05)。治疗3、7 d后,两组皮色皮温、全身症状及关节相关积分较治疗前下降,观察组低于对照组,且两组治疗7 d后低于治疗3 d后(P<0.05)。治疗3、7 d后,两组UA、IL-1β、DKK-1、IL-18、P2X7R、ESR较治疗前下降,观察组低于对照组,且两组治疗7 d后上述因子低于治疗3 d后(P<0.05)。观察组不良反应发生率为9.09%(胸闷1例、胃肠道症状4例),与对照组的20.00%(胸闷2例、胃肠道症状8例和皮疹1例)比较,差异无统计学意义(P>0.05)。结论:桂枝芍药知母汤联合西药治疗GA急性期可减轻症状,提高疗效,可能与调节相关因子的表达水平有关。

黄芪桂枝五物汤治疗乳腺癌化疗后手足麻木的效果

目的:探讨乳腺癌化疗后手足麻木采用黄芪桂枝五物汤治疗的效果。方法:选取2018年1月—2022年12月南通市第三人民医院收治的乳腺癌化疗后手足麻木患者110例作为研究对象,按照双色球法随机分为两组,各55例。对照组采用常规西药治疗,观察组采用黄芪桂枝五物汤治疗。比较两组手足麻木消退时间、治疗效果、关节活动度。结果:观察组手足麻木消退时间短于对照组,差异有统计学意义(P<0.001)。观察组治疗总有效率高于对照组,差异有统计学意义(P=0.019)。治疗前,两组关节前屈、外展、后伸、内收角度比较,差异无统计学意义(P>0.05);治疗后,两组关节前屈、外展、后伸、内收角度大于治疗前,且观察组大于对照组,差异有统计学意义(P<0.05)。结论:黄芪桂枝五物汤治疗乳腺癌化疗后手足麻木的效果显著,可有效改善患者肢体功能,缓解手足麻木症状。

加味柴胡桂枝干姜汤治疗伴睡眠障碍胃食管反流病的效果

目的观察加味柴胡桂枝干姜汤治疗伴睡眠障碍胃食管反流病的临床效果。方法选取2022年1月至2023年11月三明市第二医院70例伴睡眠障碍胃食管反流病患者作为研究对象,按照随机数字表法分为对照组和观察组,每组35例。对照组采用雷贝拉唑肠溶片,观察组在对照组基础上联合采用加味柴胡桂枝干姜汤。比较两组患者临床效果、中医证候总积分、胃食管反流病问卷量表(GerdQ)评分、匹茨堡睡眠质量指数(PSQI)评分、1周平均每天反酸次数及睡眠时间。结果观察组中医证候总积分、GerdQ评分、PSQI评分、1周平均每天反酸次数低于对照组,临床效果优于对照组,差异有统计学意义(P<0.05);观察组1周平均每晚睡眠时间长于对照组,差异有统计学意义(P<0.05)。结论加味柴胡桂枝干姜汤治疗伴睡眠障碍胃食管反流病患者比单用西药雷贝拉唑肠溶片效果更佳,能有效改善消化系统症状,提升睡眠质量,减少反酸次数,延长睡眠时间。

柴胡四物汤对围绝经期综合征模型大鼠血清E_(2)水平、子宫形态及ERα表达的影响

目的:通过观察柴胡四物汤对围绝经期综合征模型大鼠血清E_(2)水平、子宫形态及子宫、下丘脑ERα表达的影响,初步探讨柴胡四物汤治疗围绝经期综合征的作用机制。方法:将75只雌性SD大鼠随机分为假手术组、模型组、西药组、柴胡四物汤高、中、低剂量组,采用双侧卵巢切除法造模,选取符合条件的60只大鼠纳入实验,每组10只。从术后第14天开始,连续给药28 d。给药结束后,观察各组大鼠子宫指数及形态学的改变;采用ELISA法检测血清E_(2)水平;采用RT-PCR法及Western Blot法检测子宫、下丘脑ERα的表达水平。结果:与假手术组比较,模型组血清E_(2)水平明显下降(P<0.01),子宫湿重、子宫指数显著下降(P<0.01),子宫体积明显缩小,宫腔变窄,腺体数量较少,内膜及肌层萎缩,子宫ERαmRNA及蛋白的表达水平明显下降(P<0.01),下丘脑ERαmRNA及蛋白的表达水平显著升高(P<0.01)。与模型组比较,西药组、柴胡四物汤高、中剂量组血清E_(2)水平明显升高(P<0.01),西药组、柴胡四物汤高、中、低剂量组的子宫指数明显上升(P<0.01),子宫腺体数量增加,内膜及肌层的萎缩程度有所缓解,西药组、柴胡四物汤高、中剂量组子宫ERαmRNA表达水平增加(P<0.01),西药组、柴胡四物汤高剂量组子宫ERα蛋白表达水平增加(P<0.01),西药组、柴胡四物汤高、中、低剂量组下丘脑ERαmRNA及蛋白的表达水平降低(P<0.01)。结论:柴胡四物汤可改善围绝经期的各类症状,其作用机制可能与升高围绝经期综合征模型大鼠血清E_(2)水平,改善子宫指数及萎缩程度,提高子宫ERα的表达并同时下调下丘脑ERα的表达有关。

基于网络药理学、分子对接和动物实验探究柴胡龙骨牡蛎合甘麦大枣汤治疗脑卒中后抑郁的作用机制

目的:基于网络药理学、分子对接与动物实验探究柴胡龙骨牡蛎合甘麦大枣汤治疗脑卒中后抑郁(PSD)的作用机制。方法:利用TCMSP等数据库预测柴胡龙骨牡蛎合甘麦大枣汤的活性成分及靶点;在PharmGKB等数据库检索PSD疾病靶点,利用Cytoscape(v 3.9.1)建立交集靶点网络,String(v11.5)数据库构建PPI网络,利用DAVID 6.8数据库进行GO富集及KEGG通路分析;运用AutoDock vina(v 1.1.2)软件进行分子对接,并使用Pymol(v 2.5)等软件进行可视化分析;动物实验设置空白组、模型组、盐酸氟西汀组、中药组、中药+盐酸氟西汀组,给药21 d后检测各组大鼠神经行为学评分、脑组织内神经递质以及炎症因子表达,RT-qPCR和Western blot检测关键基因PPARG、MAPK3、AKT1、PIK3CA mRNA及蛋白表达。结果:得到柴胡龙骨牡蛎合甘麦大枣汤活性成分225种,作用于PSD的靶点119个,关键靶点包括MAPK3、AKT1、PIK3CA、PPARG,关键通路包括MAPK信号通路、PI3K-Akt信号通路等。与模型组比较,中药组与中药+盐酸氟西汀组MAPK3 mRNA及蛋白表达降低,AKT1、PIK3CA、PPARG mRNA及蛋白表达升高(P<0.05)。结论:柴胡龙骨牡蛎合甘麦大枣汤治疗PSD的作用机制可能与抑制MAPK3表达、促进AKT1、PIK3CA、PPARG表达,减缓脑组织炎症反应和氧化应激有关。

基于六经辨病浅析柴胡桂枝干姜汤证及验案举隅

“六经辨病”指的是一种中医临床诊疗思维。即先诊断疾病,分属六经病范畴,再辨别方证,寻找方证对应线索,一一对号入座,精准用药。柴胡桂枝干姜汤证属《伤寒论》六经病中少阳病范畴,临证首先把握少阳病特点,再结合其方证要点(往来寒热、胸胁苦满、心烦、但头汗出、周身无汗、口渴而不呕、小便不利、大便溏泄等),适证选方,则药随方出。如此,病证方药,环环相扣,病下是证,证下是方,药出方下,呈无缝对接,具有精准性及可重复性,更有助提高临证有效率。