Xuefuzhuyu decoction and astragalus prevent hypoxic-ischemic brain injury

Hypoxic-ischemic brain injury models were generated by bilateral carotid artery ligation in Sprague-Dawley rats. Successful models were treated with a combination of Xuefuzhuyu decoction and 10g of astragalus. The experimental results showed that neuronal morphology and structure recovered, nerve growth factor mRNA expression increased in brain tissues, and neurological function signifi-cantly improved. There was no significant difference in these measures compared with rats treated with Xuefuzhuyu decoction alone or a combined treatment of Xuefuzhuyu decoction with 40 g as-tragalus. These experimental findings revealed that, Xuefuzhuyu decoction combined with astra-galus may up-regulate the expression of nerve growth factor mRNA and accordingly exert a neu-roprotective effect; however, this protection is not dependent on astragalus dosage.

Effects of Buyang Huanwu decoction and Astragalus mongholicus on platelet activating factor receptor activity in rabbits in vitro

BACKGROUND: The pharmacological action of traditional Chinese medicine compound is the comprehensive effect of the various ingredients, and the interactions of various ingredients are closely correlated with the final effect. In order to reveal the compatibility mechanism of BHD's prescription in treating and preventing ischemic cerebrovascular disease, we needed explore the effect and relation of ingredients in the prescription. OBJECTIVE: To observe the effect of Buyang Huanwu decoction (BHD) and Astragalus mongholicus on the activity of platelet activating factor receptor (PAFR) in the platelet of rabbits in vitro, and investigate the mechanism of Astragalus mongholicus. DESIGN: A decomposed recipes study. SETTING: Guangzhou University of Traditional Chinese Medicine. MATERIALS: Five New Zealand rabbits, weighing 2-3 kg, both sexes, were used. BHD was composed of Sheng Huang Qi 120 g, Dang Gui Wei 6 g, Chi Shao 4.5 g, Chuan Xiong 3 g, Di Long 3 g, Tao Ren 3 g, Hong Hua 3 g. The prescription for activating blood circulation consisted of Dang Gui Wei 6 g, Chi Shao 4.5 g, Chuan Xiong 3 g, Di Long 3 g, Tao Ren 3 g and Hong Hua 3 g. The prescription for invigorating qi consisted of 120 g Sheng Huang Qi. The prepared herbal pieces were purchased from the traditional Chinese medicine Dispensary of Foshan Second People's Hospital, and appraised by Professor Xu from Science of Chinese Materia Medica College, Guangzhou University of Traditional Chinese Medicine. 3H-PAF was supplied by Amersham Co., Ltd. (specific activity: 6. 475 TBq/mmol; batch number: 200402); PAF standard by Biomol Co., Ltd. (batch number: P1318V). METHODS: The experiments were carried out in the Laboratory of Nuclear Medicine, Guangzhou University of Traditional Chinese Medicine from September to December 2004. ① Injections of BHD, prescriptions for activating blood circulation and invigorating qi were prepared by the decoction and alcohol sedimentation technique. Rabbit common carotid artery blood (40 mL) was drawn via intubation to prepare platelet suspension of (0.8-1.0)×1010 L-1. ② Determination of 3H-PAF and washed PAFR binding: The general combination tube (T) contained washed platelet-rich plasma (WPRP) 380 μL + 3H-PAF (0.35 nmol/L)10 μL+distilled water 5 μL; The nonspecific binding tube (P) contained WPRP 380 μL+3H-PAF(0.35 nmol/L)10 μL+cold PAF (1 μmol/L) 5 μL; The sample tube (Y) contained WPRP 380 μL+3H-PAF(0.35 nmol/L)10 μL+experimental medicine (injection of BHD, prescriptions for activating blood circulation or invigorating qi) 5 μL. The test was conducted for three times for each sample in the same way as mentioned above. The samples were shaken on the oscillator for 30 s, then bathed at 25 ℃ for 40 minutes, and the reaction was terminated with cold Tris buffer containing 0.1% BSA, multichannel cell detachment separator was used for vacuum suction to filter the separated free 3H-PAF, and the filter paper was washed with cold Tris buffer for four times, then dried in the baking oven (80 ℃) for 1 hour, and placed in xylol liquid scintillator, and the radioactivity was determined automatically by the liquid scintillation detector. The mean of the three parallel tubes was calculated. The specific binging inhibition rate was calculated: SBIR=[(T-Y)/(T-P)]×100%]. ③ Univariate analysis of variance was conducted. And for comparison of each paired groups, the q test was adopted. MAIN OUTCOME MEASURES: Effect of BHD whole prescription, prescriptions for activating blood circulation and invigorating qi on the specific binding inhibition rate of 3H-PAF and PAFR. RESULTS: BHD, prescriptions for activating blood circulation and invigorating qi were all able to inhibit the specific binding of 3H-PAF to PAFR, the specific blinding inhibition rates were (45.90±7.50)%, (97.90±1.84)% and (26.75±2.48)%, respectively, and there were significant differences between every two groups (P < 0.01). CONCLUSION: Single Astragalus mongholicus (120 g) can inhibit the specific blinding of PAFR in the platelet of the rabbit with 3H-PAF, but the combination of Astragalus mongholicus with the drugs for activating blood circulation in BHD can significantly decrease the inhibiting action of the latter on PAFR activity of the platelet, reflecting the combined mechanism of 'removing blood stasis without injuring the vital qi' in BHD.

Analysis of metallic elements dissolution in the Astragalus at different decocting time by using LIBS technique

Astragalus is an important traditional Chinese herb that has therapeutic potential in the treatment of diseases. In this study, the dissolution of metallic elements during the material decoction process was investigated using laser-induced breakdown spectroscopy(LIBS). The Ca, Mg, Al, and Fe in the drug residues, liquid, and vapor were selected for the study of the transfer of elements after different decocting times. It was found that the intensities of the spectral lines for these elements in the drug liquid increased with increasing decocting times.The contrast trend was observed in the residues and only calcium was detected in the vapor.Furthermore, the relative mass concentrations of Ca, Mg, Al, and Fe in the liquid were quantitatively determined by a combination of the standard addition method and calibrationfree-LIBS method by adding the standard concentration solution of Cu and Cd elements into the drug liquids, it can be found that the maximum error between Cd concentration calculated by internal CF-LIBS and the standard is within 10%. This provides a new method of achieving the on-line monitoring and analysis of metallic elements in the production of traditional Chinese medicines.

基于化学成分与药理作用评价当归-黄芪药对配方颗粒汤剂与传统汤剂的差异

目的评价当归-黄芪药对配方颗粒汤剂(DGD)与传统汤剂在化学成分和药理效应方面的差异,为合理应用该配方颗粒提供参考。方法以原料来源批次统一和不统一2种对比方式,设不同样品组,采用高效液相色谱(HPLC)法建立特征图谱,从特征图谱相似度、成分种类、指标成分含量、共有峰面积等角度对化学成分进行评价;采用失血性血虚模型小鼠评价药效。结果①DGD特征图谱与传统汤剂相似度较高(相似度>0.87);②共有色谱峰数目不一致,传统汤剂-自购饮片和传统汤剂-A厂饮片共有色谱峰各12个,A厂DGD共有色谱峰15个,B厂DGD共有色谱峰10个;③A厂DGD中阿魏酸、毛蕊异黄酮苷含量高于传统汤剂(P<0.05);B厂DGD与传统汤剂阿魏酸含量差异无统计学意义,但毛蕊异黄酮苷含量较传统汤剂低(P<0.05);④DGD共有峰面积总和与传统汤剂相比,自购传统汤剂、A厂传统汤剂及A厂配方颗粒、B厂配方颗粒中各成分含量相对比值分别为1.00、0.96、2.14、0.60;⑤DGD及传统汤剂均能明显促进失血性贫血模型小鼠血红蛋白(Hb)、红细胞(RBC)恢复(P<0.01);与模型对照组比较,除B厂DGD组外均差异有统计学意义(P<0.05);A厂DGD与传统汤剂差异无统计学意义,B厂DGD与传统汤剂差异有统计学意义(P<0.01)。结论无论原料来源批次是否一致,DGD与传统汤剂在化学成分上均存在一定差异;在药理作用上,来源于同一批次饮片制备的DGD与传统汤剂对改善失血性贫血药效相当,来源于不同批次饮片制备的DGD与传统汤剂在药效上存在一定差异;不同来源批次的饮片和不同制备工艺造成不同厂家配方颗粒存在质量差异,说明国家统一配方颗粒质量标准及制定相关过程规范具有必要性与紧迫性。

中药复方基于Wnt/β-catenin信号通路调控糖尿病肾病研究进展

糖尿病肾病是糖尿病最常见的微血管并发症之一,也是造成终末期肾病的主要原因。Wnt/β-catenin信号通路与糖尿病肾病肾小管间质纤维化密切相关,主要通过足细胞、肾小球系膜细胞、肾小管上皮细胞等来改善糖尿病肾病。中药复方基于调控Wnt/β-catenin信号通路来改善肾脏病变及纤维化,保护肾脏功能,进而延缓病程进展,在治疗中发挥激活自噬、减少炎症反应及减弱氧化应激等作用。目前,关于中药复方基于Wnt/β-catenin信号通路的研究仍存在以下不足之处:(1)在中药复方的研究中,能够得出中药复方可通过Wnt/β-catenin信号通路发挥作用,但由于中药复方成份复杂多样,大多数仅仅发现相关性,而没有分析其具体的活性成分;(2)Wnt/β-catenin信号通路的相关研究并未深入探索该信号通路在肾纤维化中的作用机制;(3)目前关于中医药的大部分实验为动物体内实验,缺乏体外细胞的相关实验探究。今后,需加强对中药复方活性成分的研究,并开展更多的体外细胞实验,进行深层次的作用机制及靶点研究。

基于特征图谱及化学模式识别的当归补血汤质量评价研究

目的:建立当归补血汤超高效液相色谱-串联四极杆飞行时间质谱(UPLC-Q-TOF-MS)的特征图谱,综合评价其质量。方法:采用Waters Acquity UPLC BEH C18柱(100 mm×2.1 mm,1.7μm),以0.1%甲酸水(A)-乙腈(B)溶液为流动相,梯度洗脱,流速为0.3 mL/min,进样量2μL;使用电离子喷雾源(ESI),负离子模式扫描。并以指纹图谱相似度评价软件结合聚类分析(HCA)、主成分分析(PCA)和偏最小二乘判别分析(PLS-DA)对11批当归补血汤进行评价。结果:通过对照品比对及软件预测,从当归补血汤中鉴别出24种成分。图谱标定出41个共有峰,指认出6个色谱峰,分别为毛蕊异黄酮葡萄糖苷、阿魏酸、芒柄花苷、毛蕊异黄酮、黄芪甲苷、芒柄花素。HCA、PCA和PLS-DA3种方法均将11批样品分为3类,对黄芪统货、选货和精品饮片进行了明显区分,说明当归补血汤的特征图谱与原药材的质量和等级具有强相关性。结论:构建的高分辨质谱的特征图谱结合化学模式识别方法快速高效全面,适用于当归补血汤整体质量的评价,同时也为中药复方质量标准建立与全程质量控制提供了重要支撑。

黄芪桂枝五物加味汤联合甲钴胺治疗紫杉醇化疗后周围神经病变疗效观察

目的观察黄芪桂枝五物加味汤联合甲钴胺治疗紫杉醇化疗后周围神经病变的临床疗效。方法选取2021年9月—2022年9月于陕西中医药大学第二附属医院肿瘤乳腺外科住院治疗的恶性肿瘤患者96例,根据随机数字表法将患者分为3组,加味汤组35例给予黄芪桂枝五物加味汤联合甲钴胺治疗,原汤组32例给予黄芪桂枝五物汤联合甲钴胺治疗,对照组29例给予甲钴胺治疗,3组均连续治疗14 d。观察3组治疗前后周围神经病变分级、体力状况(ECOG)评分、卡氏功能状态(KPS)评分及治疗14 d后的临床疗效和治疗安全性。结果与治疗前比较,3组治疗后周围神经病变分级、ECOG评分、KPS评分均明显改善(P均<0.05);治疗后组间比较,加味汤组、原汤组周围神经病变分级、ECOG评分与对照组比较差异均无统计学意义(P均>0.05),KPS评分均明显高于对照组(P均<0.05),加味汤组和原汤组周围神经病变分级、ECOG评分、KPS评分比较差异均无统计学意义(P均>0.05)。3组治疗总有效率比较差异无统计学意义(P均>0.05),且均未出现不良反应。结论黄芪桂枝五物加味汤联合甲钴胺可减轻紫杉醇化疗后周围神经病变,改善患者体力状况和身体功能状态。

参芪地黄汤合桃红四物汤化裁治疗Ⅲ~Ⅳ期糖尿病肾脏病疗效及对氧化应激的影响

目的观察参芪地黄汤合桃红四物汤化裁治疗Ⅲ~Ⅳ期糖尿病肾脏病(DKD)患者的临床疗效及对氧化应激指标的影响。方法选取2021年3月—2023年3月就诊于河北医科大学第三医院肾内科门诊及住院的126例DKD患者,随机分为对照组及观察组,每组63例。2组患者均接受常规西医治疗,观察组同时给予参芪地黄汤合桃红四物汤化裁方治疗,2组均治疗12周。观察2组治疗前后中医证候积分及肾功能指标[24 h尿蛋白定量及血清尿素氮(BUN)、血肌酐(SCr)]、空腹血糖(FPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、三酰甘油(TG)、血流变学指标(纤维蛋白原、血浆黏度、全血黏度)、氧化应激指标[血浆丙二醛(MDA)、超氧化物歧化酶(SOD)]变化,统计2组临床疗效、终点事件和不良反应发生情况。结果对照组59例、观察组58例完成研究。2组治疗后中医证候积分及24h尿蛋白定量、BUN、SCr、FPG、HbA1c、TC、TG、纤维蛋白原、血浆黏度、全血黏度、MDA水平均明显降低(P均<0.05),SOD水平均明显升高(P均<0.05);治疗后观察组中医证候积分及24 h尿蛋白定量、BUN、纤维蛋白原、血浆黏度、全血黏度、MDA水平均明显低于对照组(P均<0.05),SOD水平明显高于对照组(P<0.05)。治疗后,观察组的总有效率明显高于对照组[84.48%(49/58)比66.10%(39/59),P<0.05]。2组终点事件和不良反应发生率比较差异均无统计学意义(P均>0.05)。结论参芪地黄汤合桃红四物汤化裁能有效减轻Ⅲ~Ⅳ期DKD患者的临床症状,减少尿蛋白排泄,保护肾功能,改善糖脂代谢紊乱,调节血液高凝状态,抗氧化应激,效果优于常规西医治疗。

基于代谢组学研究黄芪甘草汤调控SIRT1/FOXO1通路预防三氧化二砷诱导的QT间期延长的作用机制

目的:基于代谢组学探索黄芪甘草汤防治三氧化二砷诱导QT间期延长的保护作用及其机制。方法:建立三氧化二砷诱导大鼠QT间期延长模型。检测大鼠心电图、血常规、代谢组学差异代谢物,并结合网络药理学收集关键靶点,通过功能注释、通路富集分析筛选黄芪甘草汤保护作用的可能候选基因与通路,并进行体外实验验证。结果:黄芪甘草汤对三氧化二砷诱导的SD大鼠QT间期具有显著的缓解作用(P<0.05);GO富集分析发现黄芪甘草汤和三氧化二砷诱导QT间期延长的关键靶点主要涉及炎症应答、活性氧、氧化应激等生物过程,内细胞囊泡、褶皱、内细胞囊泡膜等细胞组分,SMAD结合、R-SMAD结合、信号受体激活剂的活性等分子功能;KEGG通路分析发现其主要富集于PI3K-Akt信号通路、脂质和动脉硬化、FOXO信号通路、TNF信号通路、HIF-1等信号通路。通过体外H9c2细胞模型,验证了黄芪甘草汤能够逆转SIRT1、FOXO1蛋白表达。结论:黄芪甘草汤可能通过调控SIRT1/FOXO1信号通路,从而改善三氧化二砷诱导QT间期延长,减轻三氧化二砷心脏毒性。

防己黄芪汤联合穴位埋线治疗脾虚痰湿型单纯性肥胖的回顾性队列研究

目的:观察防己黄芪汤联合穴位埋线治疗脾虚痰湿型单纯性肥胖的疗效与安全性。方法:采用回顾性队列研究方法,选取上海市嘉定区中医医院代谢与肥胖专病门诊收治的单纯性肥胖患者,最终纳入统计分析共175例,其中治疗组95例,对照组80例。治疗组予以防己黄芪汤联合穴位埋线治疗,对照组予以二甲双胍缓释片治疗,疗程3个月,观察患者体质量、腰围、BMI、减重结局、中医证候疗效等主要指标;胰岛素抵抗指数(HOMA-IR)、糖化血红蛋白(HbA1c)和血脂等次要指标;肝肾功能等安全性指标。结果:与对照组比较,治疗组患者随时间的延长,体质量、BMI、腰围明显下降,达到临床减重结局的发生率明显更高,且治疗组HOMA-IR、HbA1c、甘油三酯等指标明显改善(P<0.05)。中医证候疗效方面,治疗组总有效率89.47%(85/95),优于对照组51.25%(41/80),差异具有统计学意义(P<0.05)。治疗过程中两组患者均未见肝肾功能异常。结论:防己黄芪汤联合穴位埋线可明显减轻患者体质量,改善血糖和胰岛素抵抗以及脂代谢,患者依从性良好,具有较好的安全性。

基于网络药理学探究黄芪、红芪在益气活血通便方治疗慢传输型便秘中的作用机制差异

目的:在黄芪、红芪本草药用历史对比总结基础上,利用网络药理学探究黄芪、红芪在益气活血通便方治疗慢传输型便秘中的作用机制差异,利用分子对接进行验证。方法:利用TCMSP和PharmMapper数据库筛选益气活血通便方中当归、黄芪、肉苁蓉、火麻仁、红芪的活性成分及靶点;通过GeneCards、DrugBank、OMIM等数据库筛选慢传输型便秘相关靶点,利用Venny 2.1.0工具作图比较益气活血通便方Ⅰ和组方Ⅱ治疗慢传输型便秘的靶点;通过STRING数据库构建活性成分和关键靶点PPI网络;利用Metascape平台进行GO和KEGG通路富集分析,比较网络药理学差异。构建益气活血通便方的成分-靶点-通路网络图,利用AutoDock软件进行分子对接。结果:得到组方Ⅰ60个活性成分,501个作用靶点;组方Ⅱ50个活性成分,622个作用靶点。得到疾病作用靶点1035个,组方Ⅰ和组方Ⅱ与慢传输型便秘交集靶点分别为161个和201个。GO富集分析得到益气活血通便方Ⅰ553条生物进程或通路,组方Ⅱ899条生物进程或通路。KEGG富集分析预测组方Ⅰ126条信号通路,组方Ⅱ144条信号通路。分子对接结果显示槲皮素、木犀草素、花生酸、山柰酚、3,9-二-O-甲基尼森香豌豆紫檀酚与EGFR、SRC、CASP3、HSP90AA1、ESR1有良好的结合活性。结论:益气活血通便方通过多点显效、协同增效治疗慢传输型便秘,红芪可发挥与黄芪相似的作用,但能否替代黄芪还有待于结合药效学实验、临床试验进一步深入研究。

桂枝汤类方在风湿痹病中的应用

风湿痹内因为正气不足、机体营卫失调,外因为感受风寒湿等外邪,外湿侵袭肌表,正气不足,营卫失调,腠理疏松,汗出当风,外邪入体,流窜全身、流注关节,发为风湿痹病,治应调和营卫。桂枝汤用于治疗风寒邪伤人肌表,腠理疏松,卫外不固,营阴不守之证,切中风湿痹病病机。风重于湿,痹着肌表,阻滞营卫,气血不利,选桂枝附子汤;太阳中风兼经气不利者,选桂枝加葛根汤;风湿侵袭入体,在体郁遏日久,化热伤阴者,选桂枝芍药知母汤;营卫气血俱不足之血痹重证,选黄芪桂枝五物汤。

《金匮要略》黄汗及其转归

《金匮要略·水气病脉证并治》中对黄汗症状的记载有“脉浮”与“脉沉”、“小便通利”与“小便不利”、“渴”与“不渴”等,看似矛盾,实为黄汗病机的动态描述,“脉浮”与“脉沉”为表里之别、“小便通利”与“小便不利”为寒热之变、“渴”与“不渴”亦为寒热之变。当黄汗还处于表证阶段,小便通利,汗出不黄,用桂枝加黄芪汤祛风解表;病邪深入,入里化热,用黄芪芍药桂枝苦酒汤发散蕴热。黄汗日久,寒郁化热,积腐成脓,则转为痈脓;若黄汗患者平素肝肾阴虚,日久寒邪深入,则转为历节。临证常需考虑寒热关系与病机演变。黄汗包括了大部分风水的典型症状,二者皆起于感受风寒,皆存在由表入里、由寒化热的动态变化过程,但病机的侧重点不同,治疗亦不同。

黄芪建中汤联合三联疗法治疗消化性溃疡疗效

目的分析黄芪建中汤+三联疗法在消化性溃疡患者治疗中的可行性以及对患者症状的影响。方法选取2022年4月—2023年5月本院接诊的70例消化性溃疡患者为观察对象,采用随机数字表法分为对照组和观察组,每组35例。其中,对照组采取三联疗法治疗干预,观察组则在对照组的基础上实施黄芪建中汤治疗,评价两组患者治疗效果差异。结果观察组患者的治疗总有效率高于对照组,组间差异有统计学意义(P<0.05)。治疗后,胃脘隐痛、食后腹胀、泛吐清水评分低于对照组,组间差异有统计学意义(P<0.05)。观察组患者临床症状消失时间早于对照组,组间差异有统计学意义(P<0.05)。两组患者不良反应发生率对比,差异无统计学意义(P>0.05)。结论在消化性溃疡患者治疗干预期间,在常规三联疗法的基础上对患者实施黄芪建中汤治疗可达到提升治疗效果、促进患者症状临床改善的目标,是一种安全的药物治疗方案。

黄芪桂枝五物汤加味治疗周围神经病变临床研究

目的:观察黄芪桂枝五物汤加味治疗周围神经病变的临床疗效。方法:选取驻马店市中医院2021年6月至2023年11月治疗的周围神经病变患者106例,按照随机数字表法分为对照组和观察组,每组各53例。对照组给予常规西药治疗,观察组在对照组治疗的基础上加用黄芪桂枝五物汤加味治疗。比较两组患者治疗前后中医证候积分、神经传导速度[感觉神经传导速度(sensory nerve conduction velocity,SCV)、运动神经传导速度(motor nerve conduction velocity,MCV)]、炎性因子[白细胞介素-6(interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]、氧化应激指标[丙二醛(malondialdehyde,MDA)、超氧化物歧化酶(superoxide dismutase,SOD)]变化情况,比较两组患者不良反应发生情况。结果:两组患者治疗后肢体麻木、疼痛以及乏力等中医证候积分低于本组治疗前,且治疗后观察组低于对照组(P<0.05)。两组患者治疗后MCV、SCV高于本组治疗前,且治疗后观察组高于对照组(P<0.05)。两组患者治疗后IL-6、CRP、TNF-α水平低于本组治疗前,且治疗后观察组低于对照组(P<0.05)。两组患者治疗后MDA低于本组治疗前,SOD高于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。观察组不良反应发生率低于对照组(P<0.05)。结论:黄芪桂枝五物汤加味治疗周围神经病变,可改善患者的临床症状、降低炎性因子水平,其作用机制可能与改善应激反应水平有关。

黄芪当归汤对晚期肺癌化疗患者肿瘤标志物及骨髓抑制的影响

目的观察黄芪当归汤对晚期肺癌化疗骨髓抑制患者免疫功能的影响。方法选取2020年1月—2022年1月沙市区妇幼保健院收治的110例晚期肺癌化疗患者为研究对象,根据随机数字表法将符合纳入标准的患者分为对照组(n=55,单纯化疗)与实验组(n=55,化疗+黄芪当归汤),对比两组临床疗效,并记录治疗前后骨髓抑制及血清TNF-α、NK以及T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平的变化。结果两组各脱落1例,实际每组54例;两组化疗后临床有效率比较,差异无统计学意义(P>0.05);实验组化疗后血小板计数(PLT)、血红蛋白(Hb)、白细胞计数(WBC)、中性粒细胞计数高于对照组,差异有统计学意义(P<0.05);实验组血清肿瘤坏死因子(TNF-α)低于对照组,自然杀伤细胞(NK)水平高于对照组,差异有统计学意义(P<0.05);实验组CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)均高于对照组,差异有统计学意义(P<0.05)。结论黄芪当归汤能有效改善晚期肺癌化疗骨髓抑制患者的骨髓抑制情况和免疫功能,疗效确切,具有较好的临床应用前景。

黄芪建中汤加减在消化性溃疡患者中的应用价值

目的分析黄芪建中汤加减治疗消化性溃疡效果。方法选取2021年2月—2022年2月在本院就诊的70例消化性溃疡患者为研究对象,以双色球法分组,每组35例。其中,对照组采用常规西药治疗,观察组联合中药黄芪建中汤加减治疗,对比两组患者的临床疗效。结果观察组总有效率高于对照组,组间差异有统计学意义(P<0.05);观察组治疗后中医症候积分低于对照组,组间差异有统计学意义(P<0.05);观察组恢复时间短于对照组,组间差异有统计学意义(P<0.05);两组用药不良反应发生率差异不显著(P>0.05);观察组治疗2周、4周的溃疡直径短于对照组,组间差异有统计学意义(P<0.05);观察组随访1年的疾病复发率低于对照组,组间差异有统计学意义(P<0.05);观察组Hp清除率高于对照组,组间差异有统计学意义(P<0.05)。结论黄芪建中汤加减在消化性溃疡的辅助治疗中,疗效好,疾病症状改善明显,恢复时间短,Hp清除率高,远期随访的复发率低。

基于网络药理学与细胞实验探讨加味黄芪桂枝五物汤治疗类风湿关节炎的作用机制

目的:基于网络药理学与细胞实验探讨加味黄芪桂枝五物汤治疗类风湿关节炎(rheumatoid arthritis, RA)的作用机制。方法:通过中药系统药理学数据库与分析平台(Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform, TCMSP)、BATMAN-TCM数据库检索并筛选加味黄芪桂枝五物汤的活性成分和作用靶点。在GeneCards数据库、OMIM数据库检索RA的作用靶点,将加味黄芪桂枝五物汤与RA的靶点取交集。通过Bioconductor平台和R软件对交集基因进行基因本体(Gene Ontology, GO)分析和京都基因与基因组百科全书(Kyoto Encyclopedia of Genes and Genomes, KEGG)分析。将20只SD大鼠随机分为加味黄芪桂枝五物汤组(1.8 g·kg^(-1))和正常组,每组各10只。灌胃7 d后,制备体积分数为5%、10%、20%的含药血清。利用CCK-8法检测MH7A细胞的增殖情况;Annexin V-PI双染色法检测MH7A细胞凋亡情况;Western Blot检测MH7A细胞磷脂酰肌醇-3-激酶(phosphatidylinositol-3-hydroxykinase, PI3K)、磷酸化蛋白激酶B(phosphorylated protein kinase B,p-AKT)蛋白表达水平;ELISA检测MH7A细胞白细胞介素-17(interleukin-17,IL-17)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)含量。结果:共检索加味黄芪桂枝五物汤的活性成分141个,作用靶点303个。RA的作用靶点4 937个,加味黄芪桂枝五物汤与RA的交集靶点127个。GO分析主要涉及对脂多糖的反应、对细胞增殖的负反馈调节、对细胞因子的反应、细胞活化调节、细胞凋亡过程的正调节等。KEGG通路主要包括PI3K/AKT信号通路、TNF信号通路、钙信号通路等。细胞培养12 h、24 h、48 h时,与对照组比较,加味黄芪桂枝五物汤高剂量组、中剂量组与低剂量组细胞的增殖抑制率升高(P<0.05)。细胞培养24 h时,与对照组比较,加味黄芪桂枝五物汤低剂量组、中剂量组、高剂量组细胞凋亡率增加(P<0.05)。与对照组比较,模型组细胞PI3K、p-AKT表达水平升高(P<0.05);与模型组比较,加味黄芪桂枝五物汤低剂量组、中剂量组、高剂量组细胞PI3K、p-AKT表达水平降低(P<0.05)。与对照组比较,模型组细胞IL-17、TNF-α、IL-6含量升高(P<0.05);与模型组比较,加味黄芪桂枝五物汤低剂量组、中剂量组、高剂量组细胞IL-17、TNF-α、IL-6含量下降(P<0.05)。结论:加味黄芪桂枝五物汤可能通过调节PI3K/AKT信号通路等相关途径、抑制MH7A细胞增殖、促进细胞凋亡、降低炎症因子水平,从而发挥抗RA的作用。

加味黄芪桂枝五物汤联合温针灸治疗2型糖尿病周围神经病变临床研究

目的:观察加味黄芪桂枝五物汤联合温针灸治疗2型糖尿病周围神经病变(type 2 diabetic peripheral neuropathy,T2DPN)的临床疗效。方法:选取2021年2月至2022年2月于洛阳市中医院内分泌科治疗的T2DPN患者100例,按照随机数字表法分为对照组和观察组,各50例。对照组给予硫辛酸片治疗,观察组在对照组治疗的基础上加用加味黄芪桂枝五物汤联合温针灸治疗。观察两组治疗前后多伦多临床评分系统(tronto clinical scoring system,TCSS)评分、空腹血糖(fasting plasma glucose,FPG)、餐后2 h血糖(2-hour postprandial blood glucose,2 hPG)、感觉神经传导速度(sensory-nerve conduction velocity,SCV)、运动神经传导速度(motor-nerve conduction velocity,MCV)变化情况及临床疗效。结果:观察组治疗后TCSS评分、FPG、2 hPG均低于对照组,差异有统计学意义(P<0.05);观察组治疗后SCV、MCV均高于对照组,差异有统计学意义(P<0.05);观察组有效率为86.00%,对照组有效率为80.00%,观察组有效率高于对照组,差异有统计学意义(P<0.05)。结论:加味黄芪桂枝五物汤联合温针灸治疗T2DPN能改善患者周围神经病变的临床症状,提高神经传导速度,改善血糖水平。

Chinese herbal decoction astragalus and angelica exerts its therapeutic effect on renal interstitial fibrosis through the inhibition of MAPK,PI3K-Akt and TNF signaling pathways

Astragalus and Angelica decoction(A&A)has been clinically used as a classical traditional Chinese medicine(TCM)formula in China for many years for the treatment of kidney diseases,especially renal interstitial fibrosis(RIF).However,the mechanisms underlying the therapeutic effects of A&A on RIF remains poorly understood.In the present study,systematic network pharmacology and effective experimental verification were utilized for the first time to elucidate the pharmacological efficacy and potential mechanism.The outcomes indicated that 22 active components and 87 target genes of A&A were identified and cross-referenced with RIF-associated genes,contributing to confirmation of 74 target genes of A&A for RIF.Pathway and functional enrichment analyses revealed that A&A had substantial effects on MAPK,PI3K-Akt and TNF signaling pathways.In addition,seven core targets with relatively higher betweenness and degree were identified in the constructed Chinese medicine material-chemical component-target-signal pathway network.Moreover,we verified the potential therapeutic effect of A&A in vivo(using a mouse model of RIF),confirming that A&A could effectively protect the kidney by regulating these target genes.The therapeutic effect of A&A on RIF could be attributed to its role in regulating the cell cycle,limiting the apoptosis,and inhibiting the inflammation.