Application of Guizhi Fuling Pill in Gynecology

This paper reviews the research progress of Guizhi Fuling Pill in the clinical application of gynecology,such as the treatment of uterine leiomyoma,ovarian cyst,infertility and dysmenorrhea,in order to provide further research ideas for clinical researchers.

Study on the mechanism of Guizhi Fuling pill in the treatment of ovarian cancer based on network pharmacology and molecular docking

Objective:To explore the main active components and mechanism of Guizhi Fuling pill in the treatment of ovarian cancer based on network pharmacology and molecular docking technology.Methods:TCMSP database was used to retrieve and screen the active components of each Chinese medicine in Guizhi Fuling pill.The main active components of the medicine were screened through the network analysis function of Cytoscape software,and the target of the main active components of the medicine was found in UniProt database.Using genecards,OMIM,digsee,TTD,and drugbank database to retrieve the related targets of ovarian cancer.The interaction between the target of the main active components of the drug and the related target of ovarian cancer was obtained by R software.The intersection targets are imported into string database for PPI analysis,and then the results are imported into Cytoscape to get the hub gene using the cyclohubba plug-in.KEGG pathway analysis and go enrichment analysis were carried out in metascape database.At last,autodock tools was used to verify the main active ingredients and the selected target proteins.PyMOL and LigPlus software visualized the results.Results:The main active components of Guizhi Fuling pills were quercetin,β-sitosterol,kaempferol,hederagenin,catechin,ellagic acid,stigmasterol and Douglas fir.There are 20 pivotal genes of drug effect on ovarian cancer,including VEGFA,AKT1,mapk8,Jun,MMP9,IL6,TNF,CXCL8,PTGS2,TP53,CASP3,mapk1,EGF,ESR1,EGFR,Myc,FOS,CCL2,CXCL8 and IL1B.According to KEGG pathway analysis,10 pathways with the highest correlation were found:cancer signaling pathway,MAPK signaling pathway,fluid shear stress and atherosclerosis,hepatitis B,trypanosomiasis,age-rage signaling pathway in diabetic complications,tumor necrosis factor signaling pathway,pertussis,IL-17 signaling pathway,and bladder cancer.Go enrichment analysis has screened out 10 important items in molecular biological function,cell components and biological process.The proteins encoded by IL6,mapk1,VEGFA,AKT1,TP53,TNF and CCL2 were used as targets to dock with the main active components of the drug respectively,and the best results were TNFαand ellagic acid.Conclusion:The main active components of Guizhi Fuling pill regulate multiple signal pathways by regulating IL6,VEGFA,CCL2,TNF,MMP9 and other cytokines,and inhibit the proliferation and metastasis of cancer cells.

Network pharmacology-based approach to investigate the mechanisms of Guizhi Fuling pill in the treatment of atherosclerosis

Objective:To investigate the mechanism of action of Guizhi Fuling pill in the treatment of atherosclerosis with network pharmacology.Methods:The active components of Guizhi Fuling pill were screened by specific ADME features on Traditional Chinese Medicine Systems Pharmacology platform,and their targets were obtained.Targets of atherosclerosis were extracted and screened from GeneCards database,OMIM database,DrugBank database and DisGeNET database,and the intersection of component targets and disease targets were regarded as potential targets.The protein-protein interaction network of potential targets was constructed by STRING database and Cytoscape 3.7.2.GO analysis and KEGG pathway analysis of potential targets were performed by Metascape platform.The“drugs-componenst-targets-pathways”network was constructed by Cytoscape 3.7.2.SwissDock was used for molecular docking of active components and key targets.Results:The main components of Guizhi Fuling pill in the treatment of atherosclerosis were quercetin,beta-sitosterol,kaempfero,hederagenin,baicalein,etc.The key targets mainly included PGST2,RELA,AKT1,etc.Molecular docking analysis showed that the binding energy of the main active components to the core target was less than-7 kcal/mol.The associated pathways mainly included fluid shear stress and atherosclerosis,PI3K-Akt signaling pathway and AGE-RAGE signaling pathway.Conclusion:Through this study,we initially revealed the possible mechanism of Guizhi Fuling pill in treating atherosclerosis through anti-inflammatory,reducing blood lipids,and regulating endothelial function.

Effect of Guizhi Fuling capsule and its extracts on human breast cancer cells proliferation

OBJECTIVE To evaluate the effect of Guizhi Fuling Capsule active pharmaceutical ingredient(API)and its fractions on human breast cancer cells proliferation by high-throughput screening assay.METHODS The crude fractions were obtained from the extraction and elution of the API of Guizhi Fuling Capsule,and 929 standard fractions were obtained by the optimal separation conditions.Sulforhodamine B(SRB)method was used to evaluate the effects of the Guizhi Fuling capsule API and929 kinds of fractions on the proliferation of human breast cancer cells MCF-7 and MDA-MB-231.RESULTS The Guizhi Fuling capsule API had a strong ability to inhibit the proliferation of MCF-7 cells at high concentration and the ability to inhibit MDA-MB-231 cells' proliferate at low concentration following 72 h treatment;some samples of 929 fractions(5μg·mL^(-1))was found to have a breast cancer cell growth inhibition rate above 50%,without toxicity on HUVECs proliferation.CONCLUSION The API of Guizhi Fuling capsule had significant cytotoxicity effects on these two human breast cancer cells,with significant concentration-and time-dependent manner.

Guizhi Fuling Wan reverses drug resistance by regulating PTEN and MTDH in ovarian cancer SKOV3/DDP Cells

Abscract:OBJECTIVE To detect the reversal effect of Guizhi Fuling Wan on cisplatin-resistant ovarian cancer SKOV3/DDP cells and its relationship with protein expression of phosphatase and tensin homolog(PTEN) and metadherin(MTDH).METHODS Guizhi Fuling Wan(GFW) concentrated solution was prepared according to the Chinese Pharmacopoeia 2015 edition,Wistar rats were given GFW viagavage at 4 g·kg^(-1)·d^(-1),8 g·kg^(-1)·d^(-1),16 g·kg^(-1)·d^(-1),or given saline as blank control for 5 days.Blood samples were taken and the corresponding drug-containing low-dose sera,medium-dose sear,highdose sera and blank sera were prepared.The XCELLigence RTCA S16 real-time label-free cell analyzer was used to detect the reversal effect by the sera combined with cisplatin or paclitaxel in SKOV3/DDP cells.Annexin V-FITC and PI double-staining were used to detect the apoptosis-inducing effect of the sera in the cells.RT-qPCR and western blot were used to detect the mRNA and protein expression of PTEN and MTDH after the cells treated with the sera.RESULTS The inhibition rate of low-dose sera against SKOV3/DDP cells was less than 5%.After the low-dose sera combined with cisplatin or pacli.taxel,the IC50 of SKOV3/DDP cells against cisplatin and paclitaxel decreased by 3.01 and 1.79-fold,respectively.The total apoptosis rates induced by the low-dose sera,medium-dose sear,high-dose sera and blank sera in SKOV3/DDP cells were 11.08±0.13,19.42±0.30,24.23±0.31,and 3.21±0.24,respec.tively;there was a significant difference between the groups(P<0.01).RT-qPCR results showed that,compared with the blank serum,the sera can up-regulate the expression of PTEN mRNA and downregulate the expression of MTDH mRNA in a dose-dependent manner.Western blot results showed that the induction effect to PTEN protein and the inhibition effect to MTDH protein by the sera were gradually enhanced with thesera dose increasement.CONCLUSION The resistance reversal effect of Guizhi Fuling Wan on ovarian cancer SKOV3/DDP cells may be related to the inhibition of MTDH,up-regulation of PTEN and induction of apoptosis,providing with an experiment basis for the applica.tion of Guizhi Fuling Wan as a reversal agent for chemotherapy resistance of ovarian cancer.

Effect of Guizhi Fuling Capsule on sex hormone level and tumor markers in patients with uterine fibroids

Objective:To investigate the effect of Guizhi Fuling Capsule on sex hormones and tumor markers in patients with uterine fibroids, and observe its clinical efficacy.Methods: A total of 120 patients with uterine fibroids who were treated in our hospital from August 2016 to August 2017 were selected according to the order of treatment and divided into observation group and control group, 60 cases each. Mifepristone was administered to the control group and mifepristone combined with Guizhi Fuling Capsules was administered to the observation group. The levels of hemoglobin, vascular endothelial growth factor (VEGF), sex hormones, tumor markers, and inflammatory factors before and after treatment were compared between the two groups.Result:The levels of hemoglobin, vascular endothelial growth factor (VEGF), sex hormones, tumor markers, and inflammatory factors before and after treatment were compared between the two groups. After treatment, hemoglobin levels increased significantly in the two groups, VEGF, sex hormones FSH, LH and E2, tumor markers HE4, CA125, inflammatory cytokines TNF-α and IFN-γ levels decreased significantly. The hemoglobin level of the observation group was (117.09±11.51) g/L higher than that of the control group , and the level of VEGF was (0.69±0.06) pg/mL lower than that of the control group. The levels of sex hormone FSH, LH and E2 in the observation group were (15.87±1.56) U/L, (10.69±1.06) U/L and (4.95±0.51) pmol/L lower than those of the control group. The levels of HE4, CA125, TNF-α and IFN-γ gamma in the observation group were (52.47±5.24) pmol/L, (15.46±1.53) U/mL, (40.41±4.05) and (16.72±1.62) pg/mL lower than those of the control group.Conclusion:Guizhi Fuling Capsule can significantly improve the level of sex hormones and tumor markers, relieve inflammatory stress and improve the therapeutic effect.

Guizhi Fuling capsule can induce apoptosis of myeloma cells through the mitochondrial apoptosis pathway

Objective To observe the effects of Guizhi Fuling capsule(GZFLC)on RPMI 8226 cells and explore the mechanisms.Methods Cell Counting Kit-8(CCK-8)assays and flow cytometry were used to detect the viability and apoptosis levels of RPMI 8226 cells.The effects on mitochondria were examined by ROS and JC-1 assays.Western blotting was used to detect the expression of B cell lymphoma-2(Bcl-2),Bax,cleaved caspase-3,and Apoptotic protease-activating factor 1(Apaf-1).Results GZFLC drug serum decreased the viability and increased the apoptosis of RPMI 8226 cells.In addition,this drug increased ROS levels and decreased the mitochondrial membrane potential(MMP).Western blotting showed that the Bcl-2/Bax ratios were decreased in the GZFLC drug serum-treated groups,whereas the expression levels of cleaved caspase-3 and Apaf-1 were increased.Conclusion GZFLC promoted apoptosis of myeloma cells through the mitochondrial apoptosis pathway.

疏调气机法联合桂枝茯苓胶囊治疗子宫肌瘤的疗效及其对血清TGF-β_(1)、TSGF的影响

目的:探究疏调气机法联合桂枝茯苓胶囊治疗子宫肌瘤的疗效及其对血清转化生长因子β_(1)(transforming growth factor-β_(1),TGF-β_(1))、肿瘤特异性生长因子(tumor specific growth factor,TSGF)的影响。方法:将135例子宫肌瘤患者采用随机数字表法分为对照A组、对照B组和联合组,每组45例。3组均给予常规西药治疗,在此基础上,对照A组采用疏调气机法治疗,对照B组采用桂枝茯苓胶囊治疗,联合组采用疏调气机法联合桂枝茯苓胶囊治疗。比较3组疗效、不良反应发生率及治疗前后子宫肌瘤体积、子宫体积、子宫内膜厚度、中医证候积分、血清雌激素指标[雌二醇(estradiol,E_(2))、黄体生成素(luteinizing hormone,LH)、催乳素(prolactin,PRL)]、氧化应激指标[晚期氧化蛋白产物(advanced oxidation protein products,AOPP)、丙二醛(malonaldehyde,MDA)、超氧化物歧化酶(superoxide dismutase,SOD)]、TGF-β_(1)、TSGF水平。结果:联合组总有效率为97.78%(44/45),高于对照A组的84.44%(38/45)、对照B组的80.00%(36/45)(P<0.05);治疗后3组患者子宫肌瘤体积、子宫体积均小于治疗前,联合组小于对照A组、对照B组;子宫内膜厚度大于治疗前,联合组大于对照A组、对照B组(P<0.05);与本组治疗前比较,治疗后3组患者月经异常、下腹胀痛、面色晦暗积分均降低,联合组低于对照A组、对照B组(P<0.05);治疗后3组患者血清PRL、LH、E_(2)水平均低于治疗前,联合组低于对照A组、对照B组(P<0.05);治疗后3组患者血清SOD水平均高于治疗前,且联合组高于对照A组、对照B组,血清AOPP、MDA水平均低于治疗前,联合组低于对照A组、对照B组(P<0.05);与本组治疗前比较,治疗后3组患者血清TGF-β_(1)、TSGF水平均降低,联合组低于对照A组、对照B组(P<0.05);联合组不良反应发生率为13.33%(6/45),与对照A组的6.67%(3/45)、对照B组的8.89%(4/45)比较,差异无统计学意义(P>0.05)。结论:疏调气机法联合桂枝茯苓胶囊能提高子宫肌瘤临床疗效,下调血清TGF-β_(1)、TSGF水平,且具有一定安全性。

桂枝茯苓丸联合亮丙瑞林对子宫内膜异位症患者卵巢功能及血清VEGF和MCP-1的影响

目的:观察桂枝茯苓丸联合亮丙瑞林对子宫内膜异位症患者卵巢功能及血清血管内皮生长因子(VEGF)和单核细胞趋化蛋白-1(MCP-1)的影响。方法:选取佳木斯市中心医院2021年1月—2023年4月收治的87例子宫内膜异位症患者,按照随机数字表法分为研究组和对照组。对照组(n=43)采用亮丙瑞林治疗,研究组(n=44)在对照组的基础上联用桂枝茯苓丸。比较两组临床疗效、卵巢功能、免疫代谢、细胞因子及子宫动脉血流参数。结果:研究组治疗总有效率高于对照组,子宫动脉阻力指数(RI)、搏动指数(PI)及VEGF、MCP-1、卵泡刺激素(FSH)、黄体生成素(LH)均低于对照组,差异均有统计学意义(P<0.05)。结论:桂枝茯苓丸联合亮丙瑞林治疗子宫内膜异位症的效果较好,能够改善患者卵巢功能、免疫代谢。

桂枝茯苓丸化裁异病同治血瘀型功能性肛门直肠痛经验

目的总结运用桂枝茯苓丸化裁治疗血瘀型功能性肛门直肠痛的诊疗思路。方法通过研究古籍、搜集整理文献、整理验方,结合现代医家研究,从病因病机、用药特点等方面,分析总结运用桂枝茯苓丸化裁治疗血瘀型功能性肛门直肠痛的诊疗思路,并列举验案加以佐证。结果功能性肛门直肠痛始于气机升降功能的紊乱,血瘀是该病最终趋势,活血化瘀是中医辨治功能性肛门直肠痛的核心方法。结论桂枝茯苓丸在临床中多用于治疗妇科相关疾病,以异病同治创新性地将其引入血瘀型功能性肛门直肠痛的治疗中,临证经验提示疗效显著,为功能性肛门直肠痛的临床诊治提供了新的思路。

胃肠三针调神针法联合桂枝茯苓丸对开腹子宫肌瘤剔除术后胃肠功能恢复、应激反应及炎症水平的影响

目的探讨胃肠三针调神针法联合桂枝茯苓丸对开腹子宫肌瘤剔除术后患者胃肠功能恢复、应激反应及炎症水平的影响。方法收集2021年8月—2022年8月在医院择期进行开腹子宫肌瘤剔除术的53例子宫肌瘤患者,根据随机数字分配法分为试验组(27例)和对照组(26例),对照组予以常规针刺治疗,试验组予以胃肠三针调神针法联合桂枝茯苓丸,所有患者均治疗7 d。对比两组临床疗效、胃肠功能、胃肠激素水平、应激反应、血清炎症因子、不良反应及随访复发率。采用SPSS 23.0软件进行统计学分析。结果治疗后与对照组相比,试验组临床总有效率较高(P<0.05)。与对照组相比,试验组肠鸣音恢复时间、肛门排气、首次排便时间缩短(P<0.05)。与治疗前比,治疗后两组胃泌素(gastrin,GAS)、胃动素(motilin,MTL)水平升高,血管活性肠肽(vasoactive intestinal peptide,VIP)水平降低;与对照组比,治疗后试验组MTL、GAS水平较高,VIP水平较低(P<0.05)。与治疗前比,治疗后两组C-反应蛋白(C-reactive protein,CRP)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平降低;与对照组比,治疗后试验组CRP、IL-6、TNF-α水平较低(P<0.05)。与治疗前比,治疗后两组胰岛素抵抗指数(insulin resistance index,HOMA-IR)及血管阻力指数(vascular resistance index,RI)水平降低;与对照组比,治疗后试验组RI、HOMA-IR水平较低(P<0.05)。两组不良反应发生情况相比,差异无统计学意义(P>0.05)。与对照组相比,试验组复发率较低(P<0.05)。结论胃肠三针调神针法联合桂枝茯苓丸能有效促进开腹子宫肌瘤剔除术后胃肠功能恢复,调节胃肠激素水平,通过调节机体内炎症指标及应激状态提高治疗效果,远期复发率较低,适宜临床应用推广。

基于MEK/ERK通路研究桂枝茯苓丸改善慢性阻塞性肺疾病小鼠气道重塑的作用与机制

目的:研究桂枝茯苓丸通过丝裂原活化细胞外信号调节蛋白激酶(MEK)/细胞外调节蛋白激酶(ERK)通路改善慢性阻塞性肺疾病(COPD)小鼠气道重塑的作用与机制。方法:采用烟熏的方法建立COPD小鼠模型,将32只造模成功小鼠随机分为模型组、桂枝茯苓丸组、PD98059组和桂枝茯苓丸+PD98059组,每组8只。另取8只未烟熏的小鼠为空白组。各组予相应药物灌胃14 d。采用小动物肺功能仪测定小鼠每分钟通气量(MV)、呼气峰值流速(PEF)和吸气峰值流速(PIF),HE染色评估肺组织炎症,Masson染色观察气道重塑改变,Western blotting检测COL1A1、COL3A1、MEK1、p-MEK1、ERK(1/2)和p-ERK(1/2)蛋白相对表达量。结果:模型组小鼠MV、PIF和PEF水平均低于空白组(P<0.05)。与空白组比较,模型组小鼠肺组织出现明显炎症和气道重塑,且肺组织COL1A1、COL3A1、p-MEK1、p-ERK(1/2)、p-MEK/MEK和p-ERK(1/2)/ERK(1/2)均高于空白组(P<0.05)。桂枝茯苓丸组、PD98059组和桂枝茯苓丸+PD98059组小鼠MV、PEF、PIF水平均高于模型组(P<0.05),肺组织COL1A1、COL3A1、p-MEK1、p-ERK(1/2)、p-MEK/MEK和p-ERK(1/2)/ERK(1/2)均低于模型组(P<0.05)。与模型组比较,桂枝茯苓丸组、PD98059组和桂枝茯苓丸+PD98059组小鼠的肺组织炎症和气道重塑改善。桂枝茯苓丸+PD98059组小鼠MV、PIF、PEF水平高于桂枝茯苓丸组和PD98059组(P<0.05)。桂枝茯苓丸组小鼠MV、PIF和PEF水平与PD98059组比较,差异无统计学意义(P>0.05)。桂枝茯苓丸组小鼠肺组织COL1A1和COL3A1蛋白相对表达量低于PD98059组(P<0.05),高于桂枝茯苓丸+PD98059组(P<0.05)。PD98059组小鼠肺组织COL1A1和COL3A1蛋白相对表达量高于桂枝茯苓丸+PD98059组(P<0.05)。桂枝茯苓丸组小鼠肺组织p-MEK1、p-ERK(1/2)、p-MEK1/MEK1和p-ERK(1/2)/ERK(1/2)低于PD98059组(P<0.05),高于桂枝茯苓丸+PD98059组(P<0.05)。PD98059组小鼠肺组织p-MEK1、p-ERK(1/2)、p-MEK1/MEK1和p-ERK(1/2)/ERK(1/2)高于桂枝茯苓丸+PD98059组(P<0.05)。结论:桂枝茯苓丸能显著改善COPD小鼠气道重塑过程,抑制MEK/ERK通路可能是其作用机制之一。

经方治疗良性前列腺增生症的研究进展

正气不足、瘀血留结、水饮停留为良性前列腺增生症(benign prostate hyperplasia,BPH)发病的主要病机。正气不足为BPH发病之根本,以金匮肾气丸、真武汤化生肾气、温阳利水;瘀血留结是BPH发病的关键病机,以桂枝茯苓丸、抵当汤以化瘀消瘢、利窍通便;水饮停留为BPH最为紧急之症,治以五苓散、当归芍药散以化气利水,解标症之急。

高强度聚焦超声消融术联合桂枝茯苓丸治疗子宫肌瘤45例临床观察

目的:观察高强度聚焦超声消融术(HIFUA)联合桂枝茯苓丸治疗子宫肌瘤的临床疗效。方法:选取2020年1月—8月在江西省妇幼保健院住院治疗、年龄大于18岁、术前中医辨证属血瘀型的未绝经子宫肌瘤患者90例,随机分为观察组和对照组,各45例。观察组先行HIFUA治疗,术后口服桂枝茯苓丸3个月,对照组单纯采用HIFUA治疗。2组患者手术后1个月、3个月复查妇科B超,比较2组患者症状及生活质量改善情况。结果:(1)2组术后1个月、3个月子宫肌瘤缩小率比较,观察组均优于对照组,差异均有统计学意义(P<0.05);(2)2组术后1个月、3个月子宫肌瘤症状评分比较,观察组下降程度均优于对照组,健康相关生活质量问卷评分比较,观察组提高程度优于对照组,差异均有统计学意义(P<0.05)。结论:与单用HIFUA相比,HIFUA联合桂枝茯苓丸治疗子宫肌瘤的临床疗效更显著,肌瘤体积缩小率更大,症状及生活质量改善更明显,值得临床推广。

桂枝茯苓胶囊联合米非司酮配伍米索前列醇治疗不全流产的效果

目的:评价桂枝茯苓胶囊联合米非司酮配伍米索前列醇治疗不全流产的效果。方法:选取2020年3月—2022年6月酒泉市人民医院收治的82例不全流产患者作为研究对象。根据随机数表法将其分为对照组和观察组,各41例。对照组给予米非司酮配伍米索前列醇治疗,观察组在对照组基础上给予桂枝茯苓胶囊。比较两组临床疗效,时间指标,治疗前、治疗后5 d子宫螺旋动脉血流指标,治疗前、治疗后14 d性激素。结果:观察组总有效率为92.68%,高于对照组的78.05%,差异有统计学意义(P<0.05)。观察组完全流产患者孕囊排出时间、阴道出血停止时间早于对照组,腹痛持续时间短于对照组,腹痛程度分级低于对照组,差异有统计学意义(P<0.05)。观察组治疗后5 d舒张末期流速(PDV)明显低于治疗前和对照组,阻力指数(RI)明显高于治疗前和对照组,差异有统计学意义(P<0.05)。两组治疗前、治疗后14 d血清雌二醇(E_(2))、孕酮(P)水平比较,差异无统计学意义(P>0.05);两组治疗后14 d血清E_(2)、P水平均明显高于治疗前,差异有统计学意义(P<0.05)。结论:桂枝茯苓胶囊联合米非司酮配伍米索前列醇治疗不全流产可缩短阴道流血时间,减轻腹痛程度,提高子宫螺旋动脉血流阻力和疗效。

桂枝汤内服联合半夏茯苓汤穴位贴敷治疗太阴证型妊娠恶阻的临床研究

【目的】评价桂枝汤内服联合半夏茯苓汤穴位贴敷治疗太阴证型妊娠恶阻(妊娠期恶心呕吐)的临床疗效。【方法】将60例太阴证型妊娠恶阻患者按1∶1比例随机分为治疗组和对照组,每组各30例。对照组给予半夏茯苓汤穴位贴敷(取穴:中脘、双侧内关、双侧足三里、双侧阴陵泉),治疗组在对照组的基础上加用桂枝汤内服,共治疗2周。观察2组患者治疗前后孕期呕吐和恶心专用量表(PUQE)评分、孕期妊娠恶心呕吐生活质量量表(NVPPQOL)评分和中医证候积分的变化情况,并对2组患者治疗前PUQE评分的影响因素进行多元线性回归分析,同时比较2组患者的愈显率以及妊娠焦虑转阴率、尿酮体转阴率。【结果】(1)疗效方面,治疗2周后,治疗组的愈显率为86.67%(26/30),对照组为56.67%(17/30),组间比较,治疗组的愈显率明显优于对照组(P<0.05)。(2)量表评分方面,治疗后,2组患者的PUQE评分、NVPPQOL评分和中医证候积分均较治疗前明显降低(P<0.05),且治疗组对PUQE评分、NVPPQOL评分和中医证候积分的降低程度均明显优于对照组(P<0.05)。(3)PUQE评分的影响因素方面,Pearson相关性分析结果显示,PUQE评分与患者妊娠年龄呈负相关(P<0.05),与妊娠周数、焦虑评分无相关性(P>0.05)。(4)妊娠焦虑转阴率方面,治疗后,治疗组的妊娠焦虑转阴率为16.67%(5/30),对照组为6.67%(2/30),组间比较,差异无统计学意义(P>0.05)。(5)尿酮体转阴率方面,治疗后,治疗组的尿酮体转阴率为53.33%(16/30),对照组为13.33%(4/30),组间比较,治疗组的尿酮体转阴率明显高于对照组(P<0.01)。(6)安全性方面,治疗过程中,2组患者均无明显不良反应和不良事件发生,患者的血、尿常规和肝肾功能等安全性指标均无异常变化,具有较高的安全性。【结论】桂枝汤内服联合半夏茯苓汤穴位贴敷可有效缓解太阴证型妊娠恶阻患者的恶心、呕吐症状,改善患者生活质量,提高尿酮体转阴率;同时表明患者的恶心、呕吐症状PUQE评分与年龄之间存在一定的相关性。

经腹子宫肌瘤剔除术联合米非司酮、桂枝茯苓胶囊治疗子宫肌瘤的效果及对生长因子水平的影响

目的探讨经腹子宫肌瘤剔除术联合米非司酮、桂枝茯苓胶囊治疗子宫肌瘤的效果及对生长因子水平的影响。方法选择2019年4月至2022年4月收治的120例子宫肌瘤患者为研究对象,按照随机数字表法将其分为对照组与观察组,各60例。两组均给予经腹子宫肌瘤剔除术,对照组术后给予米非司酮治疗,观察组术后给予米非司酮联合桂枝茯苓胶囊治疗。比较两组的治疗效果。结果观察组的治疗总有效率明显高于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的转化生长因子-β1(TGF-β1)、表皮生长因子(EGF)、缺氧诱导因子-1α(HIF-1α)水平低于对照组,差异具有统计学意义(P<0.05)。治疗后,观察组的微血管密度、血管内皮生长因子(VEGF)水平低于对照组,差异具有统计学意义(P<0.05)。治疗后6、12个月,观察组的复发率低于对照组,差异具有统计学意义(P<0.05)。结论经腹子宫肌瘤剔除术联合米非司酮、桂枝茯苓胶囊治疗子宫肌瘤效果满意,可有效抑制生长因子水平,减少新生血管生成,降低复发率,值得推广。

桂枝茯苓丸加味治疗慢性前列腺炎患者的疗效及对其炎症调控的作用机制

目的观察枝茯苓丸加味治疗慢性前列腺炎(Chronic prostatitis,CP)患者的疗效及对其炎症调控的作用机制。方法选取2022年1月—2023年1月期间河南省中医院收治的CP患者122例,采用电脑随机数字表法分为对照组和观察组,每组各61例。对照组给予常规西药治疗,观察组在对照组基础上给予桂枝茯苓丸加味治疗,疗程8周。观察比较治疗前后评价中医证候积分和慢性前列腺炎症状指数(NIH-CPSI),测量尿动力学参数[最大尿流率(Maximum urinary flow rate,Qmax)、平均尿流率(Average urinary flow rate,Qave)和残余尿量(Residual urine volume,RUV)],检测前列腺按摩液(Expressed prostatic secretious,EPS)中炎症因子[白介素-1β(Interleukin-1β,IL-1β)、白介素-6(Interleukin-6,IL-6)、肿瘤坏死因子α(Tumor necrosis factor-α,TNF-α)]水平,临床疗效、安全性及3个月后复发率。结果治疗后两组患者NIH-CPSI评分和中医证候积分均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组NIH-CPSI评分和中医证候积分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者Qmax、Qave均较治疗前明显升高,RUV均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组Qmax、Qave明显高于对照组,RUV明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者IL-1β、IL-6和TNF-α水平均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组IL-1β、IL-6和TNF-α水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后观察组临床控制率68.85%(42/61)、总有效率91.80(56/61)均明显高于对照组47.54%(29/61)、75.41%(46/61),差异有统计学意义(P<0.05)。治疗期间,两组患者均未出现明显不良反应,治疗前后检查肝肾功能、三大常规等均无明显异常变化。随访期间,观察组3例复发(7.14%),对照组7例复发(24.14%),观察组的短期复发率明显低于对照组,差异有统计学意义(χ^(2)=9.701,P=0.002)。结论桂枝茯苓丸加味治疗CP近期疗效确切,能够改善临床症状及尿流动力学,降低复发率,其机制可能与炎症调控作用有关。

基于网络药理学和分子对接探讨桂枝茯苓丸“异病同治”多囊卵巢综合征和子宫内膜异位症的作用机制

【目的】探讨桂枝茯苓丸治疗多囊卵巢综合征(PCOS)和子宫内膜异位症(EMT)的异病同治作用机制。【方法】利用TCMSP获取桂枝茯苓丸组成中药的活性成分及相关靶点。通过GeneCards、PharmGKB、TTD数据库分别筛选PCOS和EMT疾病靶点。使用R软件中的Venn R包获取药物与疾病的交集靶点后绘制Venn图,在Cytoscape中制作药物-活性成分-潜在靶点互作网络图,STRING平台中绘制交集靶点蛋白互作网络(PPI)图,Cytoscape对PPI网络进行优化并筛选核心靶点。应用R语言进行基因本体论(GO)富集和京都基因与基因组百科全书(KEGG)富集分析,AutoDockTools进行分子对接。【结果】获得桂枝茯苓丸85个活性成分及191个相应靶点,桂枝茯苓丸治疗PCOS、EMT的潜在靶点77个。桂枝茯苓丸治疗PCOS、EMT的核心活性成分为槲皮素、β-谷甾醇、山柰酚、常春藤皂苷元、黄芩素,核心靶点为AKT1、EGFR、IL-6、TNF、TP53。GO功能分析获得2020个生物过程、34个细胞成分、126个分子功能,KEGG富集分析得到165条信号通路。分子对接显示该方中核心成分与靶点对接良好。【结论】桂枝茯苓丸可能通过槲皮素、β-谷甾醇、山柰酚、常春藤皂苷元、黄芩素,调节脂质和动脉粥样硬化、AGE-RAGE信号通路、流体剪切应力和动脉粥样硬化、化学致癌-受体激活等信号通路,作用于靶点AKT1、EGFR、IL-6、TNF、TP53,从而“异病同治”PCOS和EMT。

加味桂枝茯苓丸治疗痰瘀互结型多囊卵巢综合征患者的效果

目的 探讨加味桂枝茯苓丸治疗痰瘀互结型多囊卵巢综合征(PCOS)患者的效果。方法 将2020年9月至2022年12月于河南中医药大学第一附属医院就诊的115例痰瘀互结型PCOS患者纳入研究,经过筛查以后最后纳入106例,根据随机数字表法将其分为中药组(在基础组的治疗上加用桂枝茯苓丸治疗,53例)和基础组(炔雌醇环丙孕酮片、来曲唑片治疗,53例)。对所有患者一般临床资料和内分泌代谢特征进行分析,并观察两组临床疗效、激素水平变化、月经改善情况和体外受精-胚胎移植(IVF-ET)妊娠结局。结果 两组年龄、体重指数(BMI)、腰臀比(WHR)、Ferriman-Gallway(F-G)评分、痤疮综合分级系统(GAGS)评分、左右卵巢体积比较,差异无统计学意义(P>0.05)。中药组治疗总有效率高于基础组(P<0.05)。中药组治疗后血清卵泡刺激素(FSH)、促黄体生成素(LH)、雌二醇(E_(2))、睾酮(T)水平改善均优于基础组;中药组月经各项改善情况均优于基础组,差异有统计学意义(P<0.05);中药组获卵数、成胚数受精率、优胚率和临床妊娠率高于基础组,差异有统计学意义(P<0.05)。结论 加用加味桂枝茯苓丸治疗痰瘀互结型PCOS患者,其临床疗效要优于常规治疗,能有效调整LH、T激素水平,改善月经情况和生殖功能,提高受精率、优胚率和妊娠率,值得临床推广。