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.

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 Bushen Huoxue Decoction(补肾活血饮) on the Orphan Receptor and Tyrosine Hydroxylase in the Brain of Rats with Parkinson's Disease

Objective：To explore the effect of Bushen Huoxue Decoction（补肾活血饮,BHD） on the orphan receptor（Nurr1） and tyrosine hydroxylase（TH） in the brain of rats with Parkinson＇s disease（PD）.Methods：One hundred and twenty SD rats were divided into 100 in the model group and 20 in the normal control group,fifty-eight SD rats from the model group,established into PD model successfully by injuring their substantia nigra （SSN） with 6-hydroxydopamine,were divided equally into the model group and the test group,and they were treated with saline and BHD,respectively,for eight successive weeks.The change in the rats＇ behavior before and after treatment was observed by counting the cycles of rotation induced by apomorphine injection; the pathology of neurons,level of Nurr1 mRNA expression,and amount of TH positive cells in SSN were observed after treatment.Results：The rats＇ behavior was improved in the tested group significantly,the rotation cycle after treatment being 84.0±20.0 cycles/40 min,which was significantly lower than that in the model group（377.0±62.3 cycles/40 min,P〈0.01）.Besides,the Nurr1 mRNA expression and TH positive cell in the test group were 0.97±0.15 and 49.40±14.72,respectively,which were significantly higher than those in the model group,0.22±0.03 and 5.45±2.58,respectively（all P〈0.01）.Conclusion：BHD could treat PD by enhancing the Nurr1 mRNA expression,increasing the TH content in brain,and promoting the repairing of injured neuron in cerebral SSN.

Effects of Bushen Yiqi Huoxue Decoction in Treatment of Patients with Diminished Ovarian Reserve:A Randomized Controlled Trial

Objective:To explore the therapeutic effect of Bushen Yiqi Huoxue Decoction BYHD)in patients with diminished ovarian reserve(DOR).Methods:A total of 180 patients with DOR diagnosed from December2013 to December 2014 were equally assigned into progynova and duphaston(E+D)group,Zuogui Pill group and BYHD group with 60 cases in each by computerized randomization.Patients received E+D,Zuogui Pill or BYHD for 12 months,respectively.Follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E_(2)),anti-Mullerian hormone(AMH),antral follicle count(AFC),ovarian volume,endometrial thickness,and the resistance indices(Rls)of ovarian arteries and uterine arteries were observed before and after treatment.Results:Nine women(4 from the E+D group,3 from the Zuogui Pill group,and 2 from the BYHD group)withdrew from the study.After 6 months,Zuogui Pill and BYHD significantly decreased FSH and LH and increased endometrial thickness and AMH(all P<0.01),BYHD also resulted in E2 elevation(P<0.05),ovary enlargement(P<0.05),AFC increase(P<0.01),and RI of ovarian arteries decrease(P<0.05).After 12 months,further improvements were observed in the Zuogui Pill and BYHD groups(all P<0.01),but BYHD showed better outcomes,with lower FSH,larger ovaries and a thicker endometrium compared with the Zuogui Pill group(all P<0.01).However,E+D only significantly increased endometrial thickness(P<0.01)and no significant improvements were observed in the RI of uterine arteries in the three groups.Conclusions:BYHD had a favorable therapeutic effect in patients with DOR by rebalancing hormone levels,promoting ovulation,and repairing the thin endometrium.The combination of tonifying Shen(Kidney),benefiting qi and activating blood circulation may be a promising therapeutic strategy for DOR.

Efficacy of Bushen Culuan decoction(补肾促卵方)on ovarian follicle and follicular granulosa cells in mice with premature ovarian insufficiency induced by tripterygium wilfordii polyglycoside

OBJECTIVE:To investigate the protective efficacy of Bushen Culuan decoction补肾促卵方,BCD)on ovarian follicle and follicular granulosa cells in mice with premature ovarian insufficiency(POI)induced by tripterygium wilfordii polyglycoside,and to study the potential mechanism underlying the action.METHODS:Eighty female Balb/c mice were randomly divided into 4 groups(n=20 each):blank group,model group,Bushen Culuan decoction intervening group(BCD group)and estradiol valerate intervening group(EV group).In the first 14 model establishing d,mice in model group,BCD group and EV group were under Tripterygium wilfordii polyglycoside(TWP)gavage to establish POI models.In the 14-day therapeutic stage,mice in BCD group were taken BCD 18.35 mg·kg^(-1)·d^(-1),mice in EV group were taken EV solution 0.15 mg·kg^(-1)·d^(-1),while mice in blank group and model group were taken normal saline.When the mice accomplished therapy,whole blood was collected for serum hormone including follicle stimulating hormone(FSH),luteal hormone(LH),estradiol(E2),antimullerian hormone(AMH)levels and vascular endothelial growth factor(VEGF),bone morphogenetic protein-7(BMP-7)measurement.Ovarian tissues were harvested for morphologic observation,follicle counting,ovarian follicular graulosa cell apoptosis test and testing BMP-7 and caspase-3 expressions.RESULTS:The body weights of the mice kept growing stably in the process expect in TWP intervening stage.Compared with model group,BCD group had significantly higher ovarian index,serum E_(2),AMH,VEGF,BMP-7 levels and significantly lower FSH level(P<0.05).Meanwhile the VEGF level in BCD group was higher than in EV group(P<0.05).Compared with model group,the histopathological damage and GCs apoptosis were mitigated;developing follicle counting,BMP-7 expression were up-regulated,and caspase-3 expression was downregulated in BCD groups(P<0.05).CONCLUSION:BCD treatment could attenuate pathological process in POI ovaries,suppress GC apoptosis,probably through promoting BMP-7 expression and following inhibiting caspase-3 activation.

Patients with Metastatic Colorectal Cancer after Failure of Second-Line Treatment May Benefit from Low-Dose Apatinib and S-1 Combined with Jianpi Bushen Jiedu Decoction

Objective: To evaluate the effect and safety of low-dose of apatinib and S-1 combined with Jianpi Bushen Jiedu Decoction(JBJD) in patients with metastatic colorectal cancer(mCRC) who have failed second or above lines treatment, in order to provide more treatment option for mCRC patients by integrated medicine. Methods: Thirteen patients were selected from a single-arm, open-label clinical study from April 2019 to September 2020. The patients were treated with low-dose apatinib(250 mg, once a day) and S-1(20 mg, twice a day) combined with JBJD for at least one cycle and were followed up to August 2021. The primary endpoint was disease progression-free survival(PFS). Disease control rate(DCR), objective response rate(ORR), and overall survival(OS) of patients were observed as the secondary endpoints. Adverse events were recorded as well. Results: The average age of the 13 patients was 56.5±13.0 years and 76.9% were male. The median PFS and median OS were 4.6 and 8.3 months, respectively. The ORR was 7.7%(1/13) while the DCR was 61.5%(8/13). The common adverse events were hypertension, proteinuria, elevated transaminase, and thrombocytopenia. One patient experienced thrombocytopenia of grade 3. Conclusions: Patients with mCRC after failure of the second or above lines of treatment may potentially benefit from the treatment of low-dose apatinib and S-1 combined with JBJD because of its similar effect as the standard dose of target therapy and relatively better safety.(Registration No. ChiCTR1900022673)

Effect of Bushen Qingre Yuyin Decoction on Salivary Secretion, Spleen Index, Submandibular Gland Index, Submandibular Gland Histomorphology, and aqp5 Expression in the Nonobese Diabetic Mouse Model

Objective:The objective of this study was to observe the effect of Bushen Qingre Yuyin Decoction on the spleen index,submandibular gland index,salivary secretion,submandibular gland morphology,and aquaporin 5(AQP5)expression levels in the submandibular gland.Materials and Methods:Fifty 8-week-old nonobese diabetic(NOD)female mice were randomly divided into the following five groups:model;hydroxychloroquine;and high-,medium-,and low-dose Bushen Qingre Yuyin Decoction prescription.The blank group consisted of ten 8-week-old Balb/C rats.Bushen Yuyin Qingre Decoction was administered by gavage at 20,40,and 80 g/kg in the low-,medium-,and high-dose groups,respectively.The hydroxychloroquine group was administered hydroxychloroquine at a dose of 80 mg/kg by gavage.The normal and model groups were administered the same amount of saline.After the different administrations,the amount of salivary secretion in the mice was regularly observed.After 12 weeks,the mice were sacrificed,and their submandibular gland tissues were excised,stained with hematoxylin-eosin,and pathologically scored.AQP5 expression levels in the tissues were detected using real-time polymerase chain reaction.Results:The spleen index of mice in the high-dose group was higher than that in the model group(P<0.05),and the submandibular gland index of the hydroxychloroquine group and all the Bushen Qingre Yuyin Decoction prescription groups was higher than that in the model group(P<0.05).After 6 weeks,the salivary volume of the hydroxychloroquine group and all the Bushen Qingre Yuyin Decoction prescription groups was significantly higher than that of the model group(P<0.05);the amount of lymphocyte infiltration in mice among each administration group was significantly reduced(P<0.05);and the AQP5 expression levels in the submandibular glands of mice had significantly increased in the hydroxychloroquine and high-dose groups(P<0.05),with the high-dose group showing the best effect.Conclusion:Bushen Qingre Yuyin Decoction can effectively increase the spleen and submandibular gland indexes of NOD mice,increase the amount of salivary secretion,reduce lymphocyte infiltration in submandibular gland tissue,and significantly increase AQP5 expression levels,which may be positively correlated with the administered dose.

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。