Meta-analysis of the efficacy and safety of Bushen Huoxue decoction in the treatment of Osteoporosis

Objective:To systematically evaluate the long-term efficacy of Bushen Huoxue Decoction combined with vertebroplasty(PVP or PKP)in the treatment of osteoporotic vertebral compression fractures(OVCF),in order to provide evidence-based reference for clinical application.Methods:To ensure the novelty of research data,a computer search was conducted between 2017 and February 2023 to publicly publish all randomized controlled studies and clinical trials at home and abroad on the treatment of OVCF with Bushen Huoxue Decoction combined with vertebroplasty published in CNKI,Wanfang,Vip,PubMed,CBM,and Cochrane libraries.Two researchers independently conducted literature screening and data extraction,evaluated the quality of randomized controlled trials included one by one according to the Cochrane collaboration network standards,and conducted a meta statistical analysis using RevMan5.3 for studies that met the inclusion criteria.Results:A total of 684 patients were included in 7 randomized controlled trials,including 342 patients in the observation group and 342 patients in the control group,with a ratio of 1:1;The meta-analysis results showed that in the observation group,the overall effective rate[RR=1.30,95%CI(1.14,1.47),P<0.001],visual analog pain(VAS)score[SMD=1.19,95%CI(0.77,1.61),P<0.0001],bone mineral density score[SMD=1.09,95%CI(0.15,2.04),P=0.02],COQOL score[SMD=0.99,95%CI(0.68,1.30),P<0.00001],OPG score[SMD=0.48,95%CI(0.18,0.77),P=0.002]The RANKL score[SMD=1.33,95%CI(1.00,1.65),P<0.0001]was significantly superior to the control group,with statistically significant differences.There was no significant difference in the Oswestry Disability Index(ODI)score[SMD=0.27,95%CI(-0.03,0.57),P=0.08],Cobb score[SMD=1.52,95%CI(-1.05,4.09),P=0.25],and vertebral height score[SMD=0.43,95%CI(-0.14,1.01),P=0.14].Conclusion:The results show that Bushen Huoxue Decoction combined with vertebroplasty has significant advantages in improving bone mineral density and alleviating pain in patients after OVCF,which is significantly superior to using OVCF alone.

Neuroprotective Effects of Bushen Decoction Against Glutamate-Induced Neurotoxicity in PC12 Cells

Aim The enhanced effect of Bushen (Kidney-tonifying) decoction (BS) oncultured PC12 cell proliferation and its antagonistic action on neurotoxicity induced by glutamatewere investigated by serum pharmacological method of the Chinese material medica (CMM) in vitro.Methods The effect of BS on cultured PC12 cell activity and its antagonistic action on neurotoxicityinduced by glutamate was observed by MTT method. Flow cytometry and fluorescence microscopetechniques were employed to observe the antagonistic effect of BS on early period apoptosis of PC12cells induced by glutamate. Results The serum with BS was able to enhance activity of PC12 cells andexert antagonistic effect on glutamate-induced neurotoxicity. Meanwhile, these beneficial effectsproduced by BS were found to be the strongest in 20% concentration of in serum BS. Moreover, it caninhibit apoptosis of PC12 cells induced by glutamate , which occurs in the early period. ConclusionBS may exert a potential neuroprotective effect.

Protective effects of Bushen Tiansui decoction on hippocampal synapses in a rat model of Alzheimer's disease

Bushen Tiansui decoction is composed of six traditional Chinese medicines：Herba Epimedii,Radix Polygoni multiflori,Plastrum testudinis,Fossilia Ossis Mastodi,Radix Polygalae,and Rhizoma Acorus tatarinowii.Because Bushen Tiansui decoction is effective against amyloid beta（Aβ） toxicity,we hypothesized that it would reduce hippocampal synaptic damage and improve cognitive function in Alzheimer＇s disease.To test this hypothesis,we used a previously established animal model of Alzheimer＇s disease,that is,microinjection of aggregated Aβ25–35 into the bilateral brain ventricles of Sprague-Dawley rats.We found that long-term（28 days） oral administration of Bushen Tiansui decoction（0.563,1.688,and 3.375 g/m L;4 m L/day） prevented synaptic loss in the hippocampus and increased the expression levels of synaptic proteins,including postsynaptic density protein 95,the N-methyl-D-aspartate receptor 2 B subunit,and Shank1.These results suggested that Bushen Tiansui decoction can protect synapses by maintaining the expression of these synaptic proteins.Bushen Tiansui decoction also ameliorated measures reflecting spatial learning and memory deficits that were observed in the Morris water maze（i.e.,increased the number of platform crossings and the amount of time spent in the target quadrant and decreased escape latency） following intraventricular injections of aggregated Aβ25–35 compared with those measures in untreated Aβ_（25–35）-injected rats.Overall,these results provided evidence that further studies on the prevention and treatment of dementia with this traditional Chinese medicine are warranted.

Jianpi Qingchang Bushen decoction improves inflammatory response and metabolic bone disorder in inflammatory bowel disease-induced bone loss

BACKGROUND Bone loss and osteoporosis are commonly described as extra-intestinal manifestations of inflammatory bowel disease(IBD).Jianpi Qingchang Bushen decoction(JQBD)is a prescription used in clinical practice.However,further studies are needed to determine whether JQBD regulates the receptor activator of nuclear factor kappa B(NF-κB)(RANK)/receptor activator of NF-κB ligand(RANKL)/osteoprotegerin(OPG)pathways and could play a role in treating IBD-induced bone loss.AIM To evaluate the therapeutic effect of JQBD in IBD-induced bone loss and explore the underlying mechanisms.METHODS An IBD-induced bone loss model was constructed by feeding 126-to-8-wk-old interleukin-10(IL-10)-knockout mice with piroxicam for 10 d.The mice were randomly divided into model and JQBD groups.We used wild-type mice as a control.The JQBD group was administered the JQBD suspension for 2 wk by gavage,while the control and model groups were given normal saline at the corresponding time points.All mice were killed after the intervention.The effect of JQBD on body weight,disease activity index(DAI),and colon length was analyzed.Histopathological examination,colon ultrastructure observation,and micro-computed tomographic scanning of the lumbar vertebrae were performed.The gene expression of NF-κB,tumor necrosis factor-α(TNF-α),IL-1β,IL-6,and IL-8 in the colon was evaluated by real-time polymerase chain reaction.Colon samples were assessed by Western blot for the expression of RANKL,OPG,RANK,and NF-κB proteins.RESULTS The model group lost body weight,had a shorter colon,and showed a dramatic increase in DAI score,whereas JQBD had protective and therapeutic effects.Treatment with JQBD significantly improved inflammatory cell infiltration and reduced crypt abscess and ulcer formation.Threedimensional imaging of the vertebral centrum in the model group revealed a lower bone mass,loose trabeculae,and“rod-shaped”changes in the structure compared to the control group and JQBD groups.The bone volume/total volume ratio and bone mineral density were significantly lower in the model group than in the control group.JQBD intervention downregulated the NF-κB,TNF-α,IL-1β,IL-6,and IL-8 m RNA expression levels.The RANKL and OPG protein levels were also improved.CONCLUSION JQBD reduces inflammation of the colonic mucosa and inhibits activation of the RANK/RANKL/OPG signaling pathway,thereby reducing osteoclast activation and bone resorption and improving bone metabolism.

Clinical application of Bushen Jianpi Gutai Decoction in threatened abortion

Objective:To discuss the clinical application of the"seven,five and three"odd-numbered law theory and analyze the effect on serum sex hormone level.Methods:A total of 100 patients with early threatened abortion admitted from January 2021 to October 2021 were randomly divided into study group and control group,with 50 patients in each group.Patients in the control group were treated with dydrogesterone tablets,while patients in the study group were treated with Bushen JianpiGutai Decoction combined with dydrogesterone tablets.Clinical efficacy and progesterone level before and after treatment were observed and compared between the two groups,as well as clinical symptom relief time of the two groups,including hemostasis time,abdominal pain relief time and lumbar acid relief time,and sex hormone level of the two groups were observed and compared.Results:The clinical efficacy was significantly better than control patients(P<0.05),no significant difference in progesterone level comparison before treatment(P>0.05),significantly better than control patients(P<0.05),hemostasis,abdominal pain remission and waist acid remission were significantly shorter than control patients(P<0.05),and both significantly better sex hormone levels after treatment(P<0.05).Conclusion:Traditional Chinese medicine has certain advantages in the treatment of threatened abortion,odd-numbered law theoryguidesthe regulation of Yin and Yang in the female menstrual cycle and reproductive function is mainly the regular change of Yin and Yang.Under the guidance of"seven,five,three"odd-numbered law theoryof Traditional Chinese medicine master Xia Guicheng,master the key date and the best time of its transformation,regulate Yin and Yang in the female body,to prevent the occurrence and development of menstrual diseases and adverse childbirth.Bushen Jianpi Gutai decoction can effectively treat threatened abortion,significantly improve the clinical symptoms,improve the level of serum sex hormone,worthy of clinical promotion.

Effect of Acupuncture and Jianpi Bushen Decoction on Ovarian Function and Metabolic Disorders in Patients with PCOS

Objective:To study the effects of acupuncture combined with Jianpi Bushen Decoction on ovarian function and metabolic disorders in patients with polycystic ovary syndrome(PCOS).Methods:A total of 100 PCOS patients admitted in our hospital from October 2018-January 2020 were selected,and the patients were divided into the Jianpi Bushen Decoction group and the combined group with 50 patients each according to a completely random method.The patients in the Jianpi Bushen Decoction group were given Jianpi Bushen Decoction;the combined group was given acupuncture on the basis of the Jianpi Bushen Decoction group.Detection of follicle stimulating hormone(FSH),testosterone(T),pituitary prolactin(PRL),estradiol(E2),fasting insulin(FIN),fasting blood glucose(FBG),insulin resistance index(HOMA-IR),triglyceride Ester(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),endometrial thickness,ovarian volume,number of ovarian sinus follicles,C-reactive protein(CRP),procalcitonin(PCT).Statistical treatment is effective.Results:After treatment,FSH,T,PRL,FIN,FBG,HOMA-IR,TG,TC and LDL-C were lower in Jianpi Bushen Decoction group,and E2 and HDL-C levels were higher than Jianpi Bushen Decoction group(P<0.05).The endometrial thickness of the combined group was higher than that of Jianpi Bushen Decoction group,and the ovarian volume and the number of ovarian sinus follicles were lower than that of Jianpi Bushen Decoction group(P<0.05).The levels of CRP and PCT in the combination group were lower than those in the Jianpi Bushen Decoction group(P<0.05).The total effective rate of patients in combination group was higher than that in Jianpi Bushen Decoction group(P<0.05).Conclusion:Acupuncture combined with Jianpi Bushen Decoction has significant therapeutic effects on patients with PCOS,effectively improves patients'ovarian function,improves endocrine and metabolic disorders,and reduces inflammatory reactions,which deserves clinical promotion.

Effect of Bushen Hemai Decoction on vascular stiffness in elderly patients with isolated systolic hypertension

Objective: To investigate the effect of Bushen Hemai Decoction on the wall stiffness of middle-aged and elderly patients with isolated systolic hypertension. Methods: A total of 126 patients with middle and old systolic hypertension were selected from March 2017 to March 2018 in our hospital. According to the random table method, there were 63 cases in the observation group and 63 cases in the control group. The control group was treated with conventional western medicine, while the observation group was treated with kidney tonifying and pulse prescription hypothyroidism on the basis of the control group. The two groups were treated for 12 weeks. The changes of blood pressure, pulse conduction velocity and endothelium-dependent vasodilation function were compared between the two groups before and after treatment. Results: the systolic pressure in the two groups was lower than that before the treatment, but the diastolic pressure was not significantly changed, and the systolic pressure in the observation group was lower than that of the control group, while the diastolic pressure was not statistically significant. After treatment, the pulse conduction velocity of the two groups was lower than that before the treatment, and the pulse conduction velocity of the observation group was lower than that of the control group after treatment. After two groups of treatment, FMD was higher than before treatment, but there was no significant change in the diameter of vascular base, and FMD in the observation group was higher than that of the control group, but there was no statistical difference between the blood vessel base diameter. The total effective rate of the observation group (93.65%) was higher than that of the control group (74.60%). Conclusion: Bushen Hemai Decoction is effective in treating isolated systolic hypertension in middle-aged and old patients, and can reduce the stiffness of patients' tube wall, which is worthy of clinical reference.

Effect of Bushen Hemai decoction on vascular stiffness in elderly patients with isolated systolic hypertension

Objective: To investigate the effect of Bushen Hemai decoction on the wall stiffness of middle-aged and elderly patients with simple systolic hypertension. Methods: The 126 middle-aged and elderly patients with simple systolic hypertension admitted to our hospital from May 2010 to May 2015 were randomly divided into control group (63 cases) and observation group (63 cases). The control group was treated with conventional Western medicine, while the observation group was treated with Bushen Hemai decoction on the basis of the control group. The two groups were treated for 4 weeks. Results: The systolic blood pressure of the two groups decreased after treatment (observation group: T=16.165, control group: T=13.537, P<0.05);the systolic blood pressure of the two groups did not change significantly after treatment (observation group: T=1.857, control group: T=0.483, P>0.05);the systolic blood pressure of the observation group was lower than that of the control group after treatment (T=16.165, P<0.05). After treatment, the level of ST segment of ECG in the two groups was lower than that before treatment (observation group: T=22.145, control group: T=11.007, P<0.05);after treatment, the level of ST segment of ECG in the observation group was lower than that in the control group (T=8.130, P<0.05). After treatment, the pulse conduction velocity of the two groups was lower than that of the control group (observation group:T=8.694, control group: T=3.944, P<0.05);after treatment, the pulse conduction velocity of the observation group was lower than that of the control group (T=5.326, P<0.05). The total effective rate of the observation group (93.65%) was higher than that of the control group (76.19%) (P<0.05). Conclusion: Bushen Hemai Decoction has a significant clinical effect on middle-aged and elderly patients with simple systolic hypertension, and can improve the stiffness of the tube wall, which is worthy of clinical reference.

Effect of invigorating kidney and invigorating bone decoction on sex hormones and cytokines in women with postmenopausal osteoporosis

Objective:To investigate the effects of Bushen Jiangu decoction (kidney invigorating and bone invigorating decoction) on sex hormones and cytokines in women with postmenopausal osteoporosis (PMOP).Methods:From February 2014 to May 2016, 98 PMOP patients were selected as the research objects, randomly divided into observation group and control group (n=49). Two groups were given oral alendronate 70 mg/ times, 1 time/week, Caltrate D 1 tablets, 2 times/d. The observation group was given Bushen Jiangu decoction, daily 1 agent. The treatment period was 6 months. The fasting peripheral venous blood was collected before and after treatment and analyzed by automated chemiluminescence immunoassay analyzer for determination of serum estradiol (E2), follicle stimulating hormone (FSH) and luteinizing hormone (LH), prolactin (PRL), testosterone (T) and type I collagen carboxy terminal peptide (CTX), type I precollagen (PINP);using radioimmunoassay method of interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha), insulin-like growth factor (IGF-1).Results:The E2 and T levels of the observation group after treatment were significantly increased compared with before treatment (P<0.05). The IL-6 and TNF-alpha of the observation group after treatment were lower than before treatment, while IGF-1 increased than that before treatment, significantly better than the control group (P<0.05);The CTX, P of NP of the observation group after treatment was significantly lower than the control group during the same period (P<0.05).Conclusions:The combination of Bushen Jiangu decoction combined with sodium hyaluronate can effectively improve the level of sex hormones in patients with PMOP, regulate the level of IL-6, TNF-alpha and IGF-1, inhibit the formation of osteoclasts and bone resorption, and improve the treatment effect of osteoporosis.

补肾通腑方对脂多糖诱导的认知障碍模型大鼠学习记忆能力的影响及作用机制研究

【目的】探讨补肾通腑方对脂多糖(lipopolysaccharide,LPS)诱导的认知障碍模型大鼠学习记忆能力的改善作用及抗炎保护机制。【方法】选取6周龄健康SPF级雄性SD大鼠,采用LPS侧脑室注射法制备认知障碍大鼠模型。选取造模成功的大鼠,随机分为模型组,甘露特钠胶囊组,补肾通腑方高、中、低剂量组,并设假手术组。分别给予对应的药物灌胃,1次/d,连续8周,其中补肾通腑方高、中、低剂量组的灌胃剂量分别为15.12、7.56、3.78 g/kg,甘露特钠胶囊组灌胃剂量为0.094 g/kg。模型组和假手术组给予等体积的纯水灌胃。于第8周末,采用Morris水迷宫法观察各组大鼠空间学习记忆能力的变化,采用苏木素伊红(HE)染色观察大鼠海马区病理形态学的变化,采用免疫荧光检测大鼠海马区小胶质细胞活化情况,采用Western blotting方法检测大鼠海马区肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-6(interleukin-6,IL-6)、IL-1β、N-甲基-D-天门冬胺酸受体(N-methyl-D-aspartate receptor,NMDA)、γ-氨基丁酸(γ-aminobutyric acid,GABA)、乙酰胆碱(acetylcholine,Ach)等的表达。【结果】与假手术组比较,模型组大鼠空间逃避潜伏期、游泳路程明显延长,撤除平台后跨越原平台次数显著减少(P<0.05);HE染色结果显示,细胞排列紊乱、稀疏,有细胞空洞等损伤表现;免疫荧光结果显示,诱导型一氧化氮合酶(inducible nitric oxide synthase,iNOS)/离子钙结合适配器分子1(ionized calcium binding adapter molecule 1,Iba1)共表达升高、精氨酸酶1(arginase-1,Arg1)/Iba1共表达降低(P<0.05);海马区TNF-α、IL-6、IL-1β等的表达显著升高,NMDA、GABA、Ach等的表达显著降低(P<0.05)。与模型组比较,补肾通腑方高、中、低剂量组甘露特钠胶囊组逃避潜伏期、游泳路程显著缩短,撤除平台后跨越原平台次数显著增多(P<0.05),HE染色结果显示细胞排列较紧密、整齐,细胞形态趋于正常,iNOS/Iba1共表达显著降低,仅补肾通腑方高剂量组Arg1/Iba1共表达显著升高(P<0.05);海马区TNF-α、IL-6、IL-1β等的表达显著降低,NMDA、GABA、Ach等的表达显著升高(P<0.05)。【结论】补肾通腑方能够改善LPS诱导的认知障碍模型大鼠的学习记忆能力,其作用机制可能与抑制促炎型小胶质细胞的激活,降低海马区TNF-α、IL-6、IL-1β等炎症因子水平,提高海马区NMDA、GABA、Ach等记忆相关因子水平有关。

补肾活血膏方对肾虚血瘀证强直性脊柱炎患者的临床疗效

目的 探讨补肾活血膏方对肾虚血瘀证强直性脊柱炎患者的临床疗效。方法 167例患者随机分为对照组(常规治疗,55例)、暴露组(常规治疗+补肾活血汤剂,54例)、高暴露组(常规治疗+补肾活血汤剂+补肾活血膏方,58例),疗程2年。检测临床疗效、BASDAI评分、ASDAS-CRP、BASFI评分、脊柱痛评分、PGA评分、BASMI评分、ASQoL评分、SPARCC评分、肾虚血瘀证评分、ESR、CRP、IL-6、TNF-α、IL-17、IL-23、IL-35、NLR、PLR、安全性指标变化。结果 高暴露组ASAS40、ASAS5/6、BASDAI50例数多于暴露组和对照组(P<0.05)。治疗后,高暴露组BASDAI评分、ASDAS-CRP、BASFI评分、脊柱痛评分、PGA评分、BASMI评分、SPARCC评分、ASQoL评分、肾虚血瘀证评分、ESR、CRP、IL-6、TNF-α、IL-17、IL-23低于其他2组(P<0.05),IL-35更高(P<0.05)。经Logistic回归分析校正混杂因素后,补肾活血汤、补肾活血膏方降低BASDAI评分和ASDAS-CRP(P<0.05),提高临床疗效(P<0.05)。3组未发现严重不良反应。结论 补肾活血膏方可安全有效地抑制肾虚血瘀证强直性脊柱炎患者炎症,降低疾病活动度,减轻骨髓水肿,改善临床症状,提高关节功能和生活质量。

补肾化痰活血方治疗多囊卵巢综合征合并胰岛素抵抗不孕症的临床研究

[目的]观察补肾化痰活血方治疗多囊卵巢综合征合并胰岛素抵抗(PCOS-IR)不孕症的临床疗效。[方法]将62例肾虚痰瘀型PCOS-IR不孕症患者随机分为治疗Ⅰ组和治疗Ⅱ组,每组各31例。两组均给予基础干预,治疗Ⅰ组给予二甲双胍,治疗Ⅱ组给予补肾化痰活血方,治疗及随访周期均为3个月。统计两组的妊娠及排卵情况,比较两组治疗前后身体质量指数(BMI)、中医证候积分、糖代谢指标[空腹血糖(FBG)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)]、性激素水平[睾酮(T)、促黄体生成素(LH)、促卵泡刺激素(FSH)、LH/FSH、雌二醇(E2)、催乳素(PRL)]、着床期(排卵后6~9 d)子宫内膜三维超声参数[厚度、分型、容积、血管化指数(VI)、血流指数(FI)、血管化-血流指数(VFI)]和不良反应。[结果]与治疗前比较,治疗后两组的BMI、中医证候积分、FINS、HOMA-IR、LH、LH/FSH水平均降低(P<0.01或P<0.05),且治疗Ⅱ组的中医证候积分降低显著(P<0.01)。与治疗Ⅰ组比较,治疗Ⅱ组的周期排卵率较高,但比较后差异无统计学意义(P>0.05),着床期子宫内膜血流参数VI、VFI水平较高(P<0.05)。治疗结束及随访后,治疗Ⅱ组的临床妊娠率分别为61.54%(16/26)和73.08%(19/26),明显高于治疗Ⅰ组对应时间节点的妊娠率[33.33%(8/24)和41.67%(10/24)],差异有统计学意义(P<0.05),且胚胎停育率更低(P<0.05)。治疗Ⅱ组的不良反应率显著低于治疗Ⅰ组(15.38%vs 41.67%,P<0.05)。[结论]补肾化痰活血方治疗肾虚痰瘀型PCOS-IR不孕症临床效果良好,能够改善胰岛素抵抗及肥胖体征,调节内分泌紊乱,显著增加着床期子宫内膜血流灌注,提高临床妊娠率并改善妊娠结局,且不良反应小,值得推广应用。

暖宫灸联合补肾逐瘀汤对卵巢子宫内膜异位症术后患者卵巢储备功能和子宫内膜容受性的影响

目的探析暖宫灸联合补肾逐瘀汤对卵巢子宫内膜异位症(EMS)术后患者卵巢储备功能和子宫内膜容受性的影响。方法选取2020年8月至2022年8月江西省妇幼保健院住院部收治的腹腔镜手术治疗的60例EMS患者作为研究对象,采用随机数字表法分为对照组和观察组,每组各30例。对照组给予亮丙瑞林治疗+补肾逐瘀汤,观察组于对照组基础上加用暖宫灸,持续治疗3个月。比较两组患者临床疗效、卵巢储备功能[血清抗米勒管激素(AMH)及抑制素B(INHB)、窦卵泡计数(AFC)]、子宫受容性相关指标(子宫内膜厚度、子宫内膜容积)以及不良反应发生情况。结果观察组总有效率高于对照组,差异有统计学意义(P<0.05);治疗3个月后,两组患者AMH、INHB及AFC水平高于本组治疗前,且观察组各指标高于对照组,差异有统计学意义(P<0.05);治疗3个月后,两组患者子宫内膜容积、厚度均高于本组治疗前,且观察组各指标高于对照组,差异有统计学意义(P<0.05);治疗期间,两组不良反应发生情况比较,差异无统计学意义(P>0.05)。结论暖宫灸联合补肾逐瘀汤治疗卵巢EMS术后患者效果显著,可改善卵巢储备功能,提高子宫容受性。

补肾祛瘀汤联合常规治疗对肾虚血瘀型绝经后骨质疏松症患者的临床疗效

目的考察补肾祛瘀汤联合常规治疗对肾虚血瘀型绝经后骨质疏松症患者的临床疗效。方法106例患者随机分为对照组和观察组,每组53例,对照组给予常规治疗,观察组在对照组基础上加用补肾祛瘀汤,疗程6个月。检测临床疗效、中医证候评分、骨代谢指标(β-CTX、PINP、BGP)、骨密度、氧化应激指标(SOD、AOPP、MAOA)、不良反应发生率变化。结果观察组总有效率高于对照组(P<0.05)。治疗后,2组中医证候评分、β-CTX、BGP、AOPP、MAOA降低(P<0.05),PINP、骨密度、SOD升高(P<0.05),以观察组更明显(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论补肾祛瘀汤联合常规治疗可安全有效地改善肾虚血瘀型绝经后骨质疏松症患者骨密度和骨代谢指标,减轻机体氧化应激反应。

补肾益肺方治疗慢性阻塞性肺疾病合并骨质疏松症临床观察

目的:观察补肾益肺方治疗肺肾两虚型慢性阻塞性肺疾病(COPD)稳定期合并骨质疏松症的疗效。方法:以随机数字表法将128例COPD合并骨质疏松症患者分为观察组、对照组各64例,最终122例患者完成研究,观察组62例,对照组60例。除基础治疗外,对照组加用中药安慰剂治疗,观察组加用补肾益肺方治疗。治疗3个月后观察两组急性加重次数、中医证候积分、COPD患者自我评估测试(CAT)得分、骨密度、肺功能[第1秒用力呼气容积(FEV1)、第1秒用力呼气容积占预计值的百分比(FEV1%)、第1秒用力呼气容积占用力肺活量的百分比(FEV1/FVC)]、6 min行走距离(6MWD)、视觉模拟评分法(VAS)评分、骨代谢生化标志物[I型原胶原N端前肽(PINP)、血清β胶联降解产物(β-CTX)、25-羟基维生素D(25-OH-VD)]的变化情况。结果:治疗期间两组急性加重次数比较,观察组少于对照组(P<0.05)。治疗后,两组中医证候积分、CAT评分均降低,且观察组低于对照组(P<0.05);两组肺功能指标水平均升高,且观察组FEV1、FEV1%高于对照组(P<0.05);两组6MWD均较治疗前延长,且观察组长于对照组(P<0.05);观察组VAS评分较治疗前降低,且低于治疗后对照组(P<0.05);两组β-CTX水平均较治疗前降低,且观察组低于对照组(P<0.05);两组PINP、25-OHVD水平均较治疗前升高,且观察组高于对照组(P<0.05)。治疗期间,两组均未发生严重不良反应事件。结论:补肾益肺方治疗COPD合并骨质疏松症,可明显减少患者的急性加重次数,改善临床症状、肺功能指标及骨代谢水平。

补肾和脉方对老年自发性高血压大鼠下丘脑蛋白质组学的影响

目的探寻补肾和脉方治疗老年自发性高血压病的可能分子机制。方法选取16月龄雄性自发性高血压大鼠(SHR),采用随机数字表法随机分为2组:补肾和脉方组[10只,补肾和脉方生药浓度14.22 g/(kg·d)]和模型组(10只,生理盐水2 mL/d),以10只同龄雄性WKY大鼠作为正常对照组(生理盐水2 mL/d),共灌胃干预8周。定期观察并监测记录大鼠的收缩压和舒张压。干预结束后,取各组大鼠血清、下丘脑。ELISA法检测血清中神经肽(NPY)、去甲肾上腺素(NE)、C反应蛋白(CRP)和血管紧张素Ⅱ(AngⅡ)的含量。Label-free定量蛋白组学测序分析方法筛选下丘脑蛋白质表达谱的变化,通过生物信息学对差异蛋白进行GO富集分析,并对差异蛋白的分子功能、细胞成分和生物学途径3个方面进行功能方面的注释;对差异蛋白进行KEGG通路分析得到补肾和脉方靶蛋白及其涉及的信号通路;同时建立差异蛋白的互作网络综合分析补肾和脉方的药理机制,进而为研究老年自发性高血压寻找新的药物标志蛋白提供理论和思路。结果1)补肾和脉方能够稳步降低老年自发性高血压大鼠的收缩压、舒张压、脉压差和平均动脉压;降低大鼠血清NPY、NE、CRP、AngⅡ的水平,在一定程度上改善高血压的血管重塑。2)与模型组相比,应用补肾和脉方干预后的大鼠下丘脑中共检出2753个差异蛋白点,其中316个蛋白有统计学差异(P<0.05),201个蛋白表达升高,115个蛋白表达降低;差异蛋白主要富集于转运酶活性和离子通道活性方面。3)补肾和脉方干预老年SHR下丘脑的节点蛋白Cdc42、SIRT2、Ptk2b的表达与蛋白组学一致。结论补肾和脉方治疗老年自发性高血压的分子机制可能与其促进神经元细胞活力,维持动脉血管的稳定性等有关。

基于肠道菌群与代谢组学探讨补肾通腑方对AD小鼠神经炎症的影响

目的观察补肾通腑方对APP/PS1小鼠空间学习记忆能力的影响,探讨其可能的作用机制。方法APP/PS1小鼠给予补肾通腑方灌胃治疗8周后,采用Morris水迷宫法观察小鼠学习记忆能力变化;16S rDNA高通量测序和液相色谱-串联质谱(LC-MS/MS)方法检测小鼠肠道菌群及肠道代谢物的变化。结果与模型组比较,补肾通腑方能够明显缩短小鼠逃避潜伏期,减少游泳路程,增加跨越平台次数(P<0.01)。16S rDNA结果显示,补肾通腑方可以增加有益菌厚壁菌门Firmicutes丰度,降低有害菌拟杆菌门Bacteroidota的丰度。LC-MS/MS结果显示,共鉴定出25个差异代谢产物,主要涉及鞘脂代谢、赖氨酸代谢、酪氨酸代谢等代谢通路。KEGG富集分析显示,补肾通腑方主要通过NF-κB、Apelin等炎症相关信号通路发挥治疗作用。结论补肾通腑方改善APP/PS1小鼠学习记忆能力,可能与改善肠道菌群组成,影响鞘脂代谢、赖氨酸代谢、酪氨酸等的代谢,调控NF-κB、Apelin等炎症相关信号通路有关。

补肾壮骨温经汤配合针刺循经取穴治疗类风湿性膝关节炎的疗效研究

目的观察补肾壮骨温经汤配合针刺循经取穴治疗类风湿性膝关节炎(RG)的疗效。方法选取2020年6月至2022年6月宝鸡市中医医院收治的102例RG患者作为研究对象,按随机数表法分为联合组、对照1组与对照2组各34例。对照1组患者给予常规西药治疗,对照2组患者给予常规西药联合针刺循经取穴治疗,联合组患者则在对照2组基础上予以补肾壮骨温经汤联合治疗。治疗3个月后,比较三组患者的临床疗效及治疗前后的临床证候评分、骨关节炎指数(WOMAC)评分以及血清学指标[类风湿因子(RF)、红细胞沉降率(ESR)、抗环状瓜氨酸抗体(CCP)]水平;同时比较三组患者治疗期间的不良反应的发生情况。结果联合组患者的临床治疗总有效率为91.18%,明显高于对照1组的64.71%和对照2组的70.59%,差异均具有统计学意义(P<0.05),但对照1组与对照2组患者的治疗总有效率比较差异均无统计学意义(P>0.05);治疗3个月后,联合组患者的关节冷痛、屈伸不利、肿胀、头晕耳鸣以及肢体沉重各临床证候评分明显低于对照1组与对照2组,差异均具有统计学意义(P<0.05),但对照1组与对照2组患者的临床证候评分比较差异均无统计学意义(P>0.05);联合组患者的WOMAC评分为(38.45±11.48)分,明显低于对照1组的(45.58±12.71)分和对照2组的(44.34±12.06)分,且联合组患者的RF、ESR及CCP水平分别为(86.37±14.74)IU/mL、(32.27±3.38)mm/h、(187.34±19.08)IU/mL,明显低于对照1组的(103.22±16.75)IU/mL、(43.16±5.25)mm/h、(219.58±21.77)IU/mL和对照2组的(98.41±15.28)IU/mL、(41.83±5.19)mm/h、(210.66±19.48)IU/mL,差异均有统计学意义(P<0.05),但对照1组与对照2组患者的WOMAC评分、RF、ESR及CCP水平比较差异均无统计学意义(P>0.05);治疗期间三组患者的不良反应总发生率比较差异无统计学意义(P>0.05)。结论补肾壮骨温经汤配合针刺循经取穴治疗RG可有效缓解患者的相关临床症状,改善膝关节功能及血清学指标水平,临床疗效确切,具有临床应用价值。

补肾活血汤辅助VAD治疗多发性骨髓瘤肾损害临床疗效及对骨代谢、肾功能的影响

目的 探讨补肾活血汤辅助VAD治疗(长春新碱+阿霉素+地塞米松)多发性骨髓瘤肾损害的临床疗效,同时动态观察该治疗方案对骨代谢、肾功能的影响。方法 选择2019年1月—2021年1月88例确诊为多发性骨髓瘤且伴有肾损害的患者作为研究对象,采用随机数字法平均分为观察组与对照组两组:对照组给予VAD治疗方案,观察组在对照组基础上辅以补肾活血汤治疗。比较两组治疗4个疗程后临床疗效差异,与治疗前、治疗2个疗程、4个疗程后比较骨代谢指标、肾功能指标等差异。结果 观察组总有效率90.9%明显高于对照组75.0%,差异比较有统计学意义(P<0.05)。随着治疗时间延长,两组患者主症、次症及总积分均逐渐降低(P<0.05);治疗2疗程及4疗程后观察组主症、次症及总积分均低于对照组(P<0.05)。随着治疗时间延长,两组患者RANKL逐渐降低(P<0.05),ALP、OCN逐渐升高(P<0.05);治疗2疗程及4疗程后观察组RANKL均低于对照组(P<0.05),而ALP、OCN均高于对照组(P<0.05)。随着治疗时间延长,两组患者Scr、β2-MG、NGAL、KIM-1、Cys-C、尿mAlb逐渐降低(P<0.05);治疗2疗程及4疗程后观察组Scr、β2-MG、NGAL、KIM-1、Cys-C、尿mAlb均低于对照组(P<0.05)。结论 补肾活血汤辅助VAD治疗多发性骨髓瘤肾损害的临床疗效更显著,可以更好地改善症状,更好调节骨代谢,更有效地逆转肾功能损害。

补肾活血汤调控宫腔粘连大鼠内膜纤维化进程的作用机制研究

目的:探究微RNA-655(miR-665)/冷诱导核糖核酸结合蛋白(CIRBP)在宫腔粘连(IUA)子宫内膜纤维化中的作用以及补肾活血汤对其的调控作用。方法:使用miRNA靶基因数据库(TargetScan)分析miR-665和CIRBP的结合情况;通过实时定量聚合酶链反应(qRT-PCR)和蛋白免疫印迹技术检测细胞和动物模型中miR-665和CIRBP的转录和表达水平;借助双荧光素酶报告系统和构建过表达载体验证miR-665和CIRBP之间相互调控的作用,以及补肾活血汤对miR-665/CIRBP的调控作用;利用酶联免疫吸附测定(ELISA)和苏木精-伊红(HE)染色检测大鼠宫腔粘连模型中相关因子水平和组织病变程度。结果:在宫腔粘连模型大鼠组织中,CIRBP转录水平显著上升,而miR-665转录水平显著下降。体外实验显示,miR-665模拟物可降低子宫内膜基质细胞中CIRBP的表达水平。此外,补肾活血汤能够降低宫腔粘连的大鼠模型血清中转化生长因子β_(1)(TGF-β_(1))、雌二醇(E_(2))和肿瘤坏死因子-α(TNF-α)的水平。补肾活血汤可以提高miR-665的转录水平并降低CIRBP的表达水平,并减轻大鼠子宫内膜组织的病变程度。结论:补肾活血汤通过调控miR-665/CIRBP途径来减轻宫腔粘连大鼠子宫内膜纤维化程度,为宫腔粘连的治疗提供了新的策略和方向。