Study on the pharmacological mechanism of chaihu shugan powder in the treatment of hepatocellular carcinoma

Liver depression and qi stagnation type liver cancer accounts for a high proportion of primary liver cancer,western medicine has no special treatment for this type of liver cancer in addition to routine treatment,while patients with this type of liver cancer often show pain in the right flank,mass under the right side,chest depression and other clinical symptoms seriously affect the quality of life of patients with liver cancer and bring great trouble to patients and their families.Chaihu Shugan San,which originated from the General order of Medicine in the Ming Dynasty,has a serious impact on the quality of life of patients with liver cancer and brings great trouble to patients and their families.It is the representative prescription of soothing the liver and regulating qi in traditional Chinese medicine.in recent years,its clinical application and pharmacological action in liver cancer have been studied more and more deeply,but the anti-tumor pharmacological research and effective components of Chaihu Shugan Powder are still lack of systematic summary.Based on the relevant studies at home and abroad,this paper summarizes the anti-tumor mechanism and possible effective components of Chaihu Shugan Powder,so as to provide further pharmacodynamic material basis and mechanism reference for the further clinical application of primary liver cancer.

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

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

Rapid Antidepressant-Like Potential of Chaihu Shugan San Depends on Suppressing Glutamate Neurotransmission and Activating Synaptic Proteins in Hippocampus of Female Mice

Objective To explore the rapid antidepressant potential and the underlying mechanism of Chaihu Shugan San(CSS)in female mice.Methods Liquid chromatography mass spectrometry(LC-MS)/MS was used to determine the content of main components in CSS to determine its stability.Female C57BL/6J mice were randomly divided into 4 groups,including control(saline),vehicle(saline),CSS(4 g/kg)and ketamine(30 mg/kg)groups.Mice were subjected to irregular stress stimulation for 4 weeks to establish the chronic mild stress(CMS)model,then received a single administration of drugs.Two hours later,the behavioral tests were performed,including open field test,tail suspension test(TST),forced swimming test(FST),novelty suppression feeding test(NSF),and sucrose preference test(SPT).Western blot analysis was used to detect the expression levels of N-methyl-D-aspartate receptor(NMDA)subtypes[N-methyl-D-aspartate receptor 1(NR1),NR2A,NR2B],synaptic proteins[synapsin1 and post synaptic density protein 95(PSD95)],and brain-derived neurotrophic factor(BDNF).Moreover,the rapid antidepressant effect of CSS was tested by pharmacological technologies and optogenetic interventions that activated glutamate receptors,NMDA.Results Compared with the vehicle group,a single administration of CSS(4 g/kg)reversed all behavioral defects in TST,FST,SPT and NSF caused by CMS(P<0.05 or P<0.01).CSS also significantly decreased the expressions of NMDA subtypes(NR1,NR2A,NR2B)at 2 h in hippocampus of mice(all P<0.01).In addition,similar to ketamine,CSS increased levels of synaptic proteins and BDNF(P<0.05 or P<0.01).Furthermore,the rapid antidepressant effects of CSS were blocked by transient activation of NMDA receptors in the hippocampus(all P<0.01).Conclusion Rapid antidepressant effects of CSS by improving behavioral deficits in female CMS mice depended on rapid suppression of NMDA receptors and activation of synaptic proteins.

Mechanism of Chaihu Shugan Powder(柴胡疏肝散) for Treating Depression Based on Network Pharmacology

Objective:To analyze the effective components of Chinese medicine(CM)contained in Chaihu Shugan Powder(柴胡疏肝散,CSP)in the treatment of depressive disorders and to predict its anti-depressant mechanism by network pharmacology.Methods:Absorption,distribution,metabolism,excretion,and toxicity calculation method was used to screen the active components of CSP.Traditional Chinese Medicine System Pharmacological Database Analysis Platform and text mining tool(GoPuMed database)were used to predict and screen the active ingredients of CSP and anti-depressive targets.Through Genetic Association Database,Therapeutic Target Database,and PharmGkb database targets for depression were obtained.Cytoscape3.2.1 software was used to establish a network map of the active ingredients-targets of CSP,and to analyze gene function and metabolic pathways through Database for Annotation,Visualization and Integrated Discovery and the Omicshare database.Results:The 121 active ingredients and 15 depression-related targets which were screened from the database can exert antidepressant effects by improving the neural plasticity,growth,transfer condition and gene expression of neuronal cell,and the raise of the expression of gap junction protein.The 15 targets passed 14 metabolic pathways,mainly involved in the regulation of neurotransmitters(5-hydroxytryptamine,dopamine and epinephrine),inflammatory mediator regulation of TRP channels,calcium signaling pathway,cyclic adenosine monophosphate signaling pathway and neuroactive ligand-receptor interaction and other signal channels to exert anti-depressant effects.Conclusion:This article reveals the possible mechanism of CSP in the treatment of depression through network pharmacology research,and lays a foundation for further target studies.

Antidepressant-Like Effects of Chaihu Shugan Powder(柴胡疏肝散)on Rats Exposed to Chronic Unpredictable Mild Stress through Inhibition of Endoplasmic Reticulum Stress-Induced Apoptosis

Objective:To investigate the antidepressant-like effects of Chaihu Shugan Powder(CSP,柴胡疏肝散)and to explore its underlying mechanisms.Methods:Thirty-two Sprague-Dawley rats were randomly divided into control(CON),chronic unpredictable mild stress(CUMS),fluoxetine(FLU),and CSP groups,8 rats in each group.All of the rats except for those in the control group were subjected to 3 consecutive weeks of CUMS to establish the depression model.The open field test(OFT),forced swimming test(FST),and sucrose preference test were used to assess the anti-anxiety and antidepressant effects of CSP.Terminal deoxynucleotidyl transferase(Td T)d UTP nick-end labeling was used to determine the apoptosis rate in the hippocampal tissues.The m RNA and protein levels of glucose-regulated protein(GRP)78,spliced X-box-binding protein(XBP)-1,CCAAT/enhancerbinding protein homologous protein(CHOP),caspase-12,and c-Jun N-terminal kinase(JNK)in the hippocampus of rats were evaluated by real-time PCR and Western blot analysis,respectively.Results:Administration of CSP alleviated anxiety and depression-like behavior in CUMS rats,as revealed by enhanced time and distance in the center of the OFT(P<0.05),an increased preference for sucrose,and longer swimming time and shorter immobility time during the FST(all P<0.05).In addition,CSP treatment significantly reduced the rate of apoptosis in rat hippocampal neurons(P<0.05).The m RNA and protein expression levels of GRP78,spliced XBP-1,and CHOP were down-regulated along with the expression of caspase-12 and cleaved caspase-12 proteins(all P<0.05),whereas total and phosphorylated JNK1 protein levels did not differ significantly between control and CSP-treated rats.Conclusion:CSP can improve depression-like behavior in rats exposed to CUMS,possibly by suppressing CHOP and caspase-12 mediated apoptosis in the rat hippocampus.

Mechanism underlying effect of Chaihu Shugan San(柴胡疏肝散)on major depressive disorder:a network pharmacology-based study

OBJECTIVE:To investigate the mechanism underpinning the effect of Chaihu Shugan San(柴胡疏肝散,CHSGS)on major depressive disorder(MDD).METHODS:We searched the compound components of from seven herbal ingredients of CHSGS from TCMSP,SymMap,ETCM,NPASS databases,and the chemical structure of the compound from PubChem,and collected the compound targets from TCMSP and TargetNet databases,and MDD-related targets from DiseaseGene Network.We established protein-protein interaction in the STRING database.Through gene mapping,topology analysis and enrichment analysis,the core targets and pathways of CHSGS for MDD,and the involved biological processes(BP),cell components(CC),and molecular functions(MF)were predicted.RESULTS:We collected a total of 1135 CHSGS compounds.After screening by ADME standards and the five rules of Ribinski,we obtained 99 different chemical components with different chemical structures,and related targets of 183 different CHSGS compounds.In the DiseaseGene Network,a total of 740 relevant targets for MDD were collected.Through gene mapping and topological analysis,62 related targets of CHSGS for MDD,24 targets with topological Chinese herbal medicine were obtained.Through enrichment analysis,10 relevant pathways and 3 core pathways were obtained with the involvement of 127 BP,27 CC,and 43 MF.CONCLUSION:There are multiple targets and signaling pathways are involved in the action of CHSGS in the treatment of MDD.

Protective Effects of Chaihu Shugan San(柴胡疏肝散) on Nonalcoholic Fatty Liver Disease in Rats with Insulin Resistance

Objective： To investigate the protective effects of Chinese medicine formulation Chaihu Shugan San（柴胡疏肝散, CHSGS） on nonalcoholic fatty liver disease（NAFLD） in rats with insulin resistance（IR） and its molecular mechanisms. Methods： Male Sprague-Dawley rats were randomly divided into six groups： the control group, the model group, Dongbao Gantai group（东宝肝泰, DBGT, 0.09 g methionine/kg）, CHSGS high-dose group（CHSG-H, 12.6 g crude drug/kg）, CHSGS medium-dose group（CHSG-M, 6.3 g crude drug/kg）, and CHSGS low-dose group（CHSG-L, 3.15 g crude drug/kg）. After establishing the NAFLD rat model and treatment for 8 weeks, total cholesterol（TC）, triglyceride（TG）, high-density lipoprotein cholesterol（HDL-C）, free fatty acid（FFA）, fasting blood glucose（FBG）, fasting insulin（FINS） contents in blood serum, and TC, TG contents in the hepatic homogenate were measured by an automatic biochemical analyzer, and a homeostasis model assessment was applied to assess the status of IR, insulin sensitivity index（ISI）, and homeostasis model assessment for insulin secretion（HOMA-IS）. The expression levels of adiponectin and leptin mRNA in liver tissue were analyzed by reverse transcription polymerase chain reaction. Pathological changes of livers were observed by hematoxylineosin staining of paraffin section. Results： Compared with the model group, the serum levels of TC, TG, FFA, FBG, FINS, IRI, ISI, and the liver levels of TC and TG in CHSG-H, CHSG-M, CHSG-L groups showed significant declines（P〈0.01 or P〈0.05）; the serum levels of HDL-C, HOMA-IS were significantly increased（P〈0.01 or P〈0.05）; the expression of leptin mRNA was dramatically decreased and the expression of adiponectin mRNA was increased in the hepatic tissue（P〈0.01 or P〈0.05）. The fatty deposition of liver cells could also be alleviated. Conclusion： CHSGS could up-regulate the expression of adiponectin mRNA and down-regulate the expression of leptin mRNA on the liver, suggesting the CHSGS had positive therapeutic effect on NAFLD in rats with IR.

Chaihu-Shugan-San exerts an antidepressive effect by downregulating miR-124 and releasing inhibition of the MAPK14 and Gria3 signaling pathways

Dysregulation of mi R-124 has been reported to be involved in the pathophysiology of depression. Chaihu-Shugan-San, a traditional Chinese medicine, has antidepressive activity; however, the underlying mechanisms remain unclear. In this study, to generate a rodent model of depression, rats were subjected to a combination of solitary confinement and chronic unpredictable mild stress for 28 days. Rats were intragastrically administered Chaihu-Shugan-San（2.835 m L/kg/d） for 4 weeks, once a day. Real-time reverse-transcription quantitative polymerase chain reaction, mi RNA microarray, western blot assay and transmission electron microscopy demonstrated that ChaihuShugan-San downregulated mi R-124 expression and upregulated the m RNA and protein levels of mitogen-activated protein kinase 14（MAPK14） and glutamate receptor subunit 3（Gria3）. Chaihu-Shugan-San also promoted synapse formation in the hippocampus. The open field test, sucrose consumption test and forced swimming test were used to assess depression-like behavior. After intragastric administration of Chaihu-Shugan-San, sucrose consumption increased, while the depressive behaviors were substantially reduced. Together, these findings suggest that Chaihu-Shugan-San exerts an antidepressant-like effect by downregulating mi R-124 expression and by releasing the inhibition of the MAPK14 and Gria3 signaling pathways.

柴胡疏肝散合半夏厚朴汤联合五行针灸对脑卒中后焦虑抑郁的神经调控作用及对免疫炎症反应、认知功能损害和HPG、HPT的影响

目的:观察柴胡疏肝散合半夏厚朴汤联合五行针灸对脑卒中后焦虑抑郁患者的神经调控作用及对免疫炎症反应、认知功能损害和下丘脑-垂体-性腺轴(HPG)、下丘脑-垂体-甲状腺轴(HPT)的影响。方法:选择2021年3月至2023年5月于该院治疗的脑卒中后焦虑抑郁患者102例,根据随机数字表法分组,其中五行针灸组51例(脱落2例,最终纳入49例),方剂联合组51例(脱落2例,最终纳入49例)。两组患者同时给予常规西医基础治疗,五行针灸组患者在常规西医基础治疗的基础上给予五行针灸治疗,方剂联合组患者在五行针灸组的基础上给予柴胡疏肝散合半夏厚朴汤治疗。观察两组患者的临床疗效,比较患者治疗前后的中医证候评分、简易精神状态量表(MMSE)评分、广泛性焦虑障碍量表(GAD-7)评分、汉密顿抑郁量表(HAMD)评分和简明幸福与生活质量满意度问卷(Q-LES-Q-SF)评分,检测患者治疗前后血清神经生长因子(NGF)、白细胞介素1β(IL-1β)、胶质纤维酸性蛋白(GFAP)、白细胞介素17a(IL-17a)、促甲状腺激素(TSH)、5-羟色胺(5-HT)和雌二醇(E2)水平。结果:方剂联合组患者的总有效率为97.96%(48/49),高于五行针灸组的81.63%(40/49),差异有统计学意义(P<0.05)。治疗后,方剂联合组患者精神焦虑抑郁、脘痞、胸胁作胀、善太息和嗳气频作等中医证候评分较五行针灸组降低,HAMD、GAD-7评分较五行针灸组降低,MMSE、Q-LES-Q-SF评分较五行针灸组升高,差异均有统计学意义(P<0.05)。治疗后,方剂联合组患者的IL-1β、IL-17a和GFAP水平较五行针灸组降低,NGF水平较五行针灸组升高,5-HT、E2和TSH水平较五行针灸组升高,差异均有统计学意义(P<0.05)。结论:柴胡疏肝散合半夏厚朴汤联合五行针灸治疗脑卒中后焦虑抑郁患者,可减少免疫炎症反应,减少神经及认知功能损害,调节HPG、HPT,改善焦虑及抑郁情绪,缓解病情,提高生活质量及临床疗效。

柴胡疏肝散对胃肠功能紊乱大鼠结肠肌层缝隙连接蛋白43表达的影响

目的:探讨柴胡疏肝散对胃肠功能紊乱大鼠结肠肌层缝隙连接蛋白43(CX43)表达的影响。方法:将8周龄SD大鼠100只随机分为对照(sham)组、模型(FGID)组、FGID+药物组及sham+药物组,每组25只。对于FGID组、FGID+药物组,利用腹腔注射利血平的方式建立胃肠功能紊乱大鼠模型;sham组及sham+药物组大鼠实施生理盐水腹腔注射;完成造模后,为sham+药物组及FGID+药物组大鼠实施柴胡疏肝散汤剂灌服,sham组与FGID组大鼠灌服灭菌注射用水;通过实时荧光定量聚合酶链反应、Westeron Blot及组织免疫荧光技术检测四组大鼠结肠肌层CX43 mRNA、CX43蛋白表达水平及CX43阳性表达率。结果:四组大鼠结肠肌层CX43 mRNA、CX43蛋白表达水平及CX43阳性表达率比较,差异无统计学意义(P>0.05)。结论:柴胡疏肝散能够提高胃肠功能紊乱大鼠结肠肌层CX43的表达水平,从而改善胃肠功能。

柴胡疏肝散加减联合水飞蓟宾胶囊治疗慢性乙型肝炎合并非酒精性脂肪性肝病的疗效与安全性分析

目的分析柴胡疏肝散加减联合水飞蓟宾胶囊在慢性乙型肝炎合并非酒精性脂肪性肝病患者中的治疗效果。方法选取2019年6月—2023年6月徐州市传染病医院收治的116例慢性乙型肝炎合并非酒精性脂肪性肝病患者,按不同治疗方法分为两组,各58例。在常规抗病毒、保肝治疗的基础上,对照组口服水飞蓟宾胶囊治疗,观察组在此基础上增加柴胡疏肝散加减治疗。比较两组治疗总有效率、肝功能、血脂水平、体重指数及不良反应发生情况。结果观察组治疗总有效率为91.37%(53/58),高于对照组的74.14%(43/58),差异有统计学意义(χ^(2)=4.614,P<0.05)。治疗后,观察组患者的γ-谷氨酰转肽酶、天门冬氨酸氨基转移酶、丙氨酸氨基转移酶、低密度脂蛋白、甘油三酯、总胆固醇、体重指数低于对照组,高密度脂蛋白高于对照组,差异有统计学意义(P均<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论柴胡疏肝散加减联合水飞蓟宾胶囊治疗慢性乙型肝炎合并非酒精性脂肪性肝病可提升疗效,改善肝功能及血脂,且安全性高。

基于5-HT-BDNF轴研究针刺联合柴胡疏肝方对大鼠缺血再灌注脑损伤的保护作用及机制

目的探讨针刺联合柴胡疏肝方对脑卒中大鼠脑功能的保护活动和机制。方法构建大鼠大脑中动脉闭塞(MCAO)模型,针刺联合柴胡疏肝方治疗前后进行脑功能评价;酶联免疫吸附试验检测各组大鼠脑组织中单胺类神经递质5-羟色胺(5-HT)、多巴胺(DA)和去甲肾上腺素(NE)的表达水平;免疫印迹法检测各组大鼠脑组织中脑源性神经营养因子(BDNF)蛋白表达水平。结果相比于针刺或柴胡疏肝方单独治疗,针刺联合柴胡疏肝方对大鼠脑卒中模型的脑功能损伤具有更好的保护作用;针刺联合柴胡疏肝方能够上调大鼠脑组织中单胺类递质5-HT、DA和NE的表达;针刺联合柴胡疏肝方能够上调大鼠脑组织中BDNF蛋白表达。结论针刺联合柴胡疏肝方对大鼠缺血再灌注脑损伤具有更好的保护作用,其可能与单胺类神经递质的相互作用以及上调BDNF蛋白的表达有关。

柴胡疏肝散治疗非酒精性脂肪肝的网络药理学机制

目的基于网络药理学探究柴胡疏肝散治疗非酒精性脂肪肝(NAFLD)的作用机制。方法检索TCMSP数据库获取柴胡疏肝散活性成分及靶标,通过Gene Cards获取NAFLD相关靶标,随后利用Omicshare数据库获取药物及疾病的交集靶标并进行富集分析。借用STRING数据库对交集靶标构建PPI。利用cytoscape软件分析所得网络图,得到柴胡疏肝散治疗NAFLD的关键化合物及关键靶标。结果筛得柴胡疏肝散治疗NAFLD关键化合物4个,关键靶标包括蛋白激酶(AKT1)、白细胞介素-6(IL-6)、肿瘤坏死因子(TNF)、肿瘤蛋白p53(TP53)和血管内皮生长因子A(VEGFA),涉及AGE-RAGE、NAFLD、核因子-κB(NF-κB)等信号通路。结论柴胡疏肝散通过多成分激活AGE-RAGE和NAFLD等信号通路治疗NAFLD,为临床应用提供理论新依据。

柴胡疏肝汤治疗癫痫大鼠的效果及其对miR-34a表达的影响

目的探讨柴胡疏肝汤治疗癫痫大鼠的效果及其对miR‑34a表达的影响。方法将42只大鼠随机分为癫痫组(n=15)、柴胡疏肝汤组(n=12)及空白组(n=15)。除空白组外,另两组采用腹腔注射氯化锂-盐酸匹罗卡品法构建癫痫大鼠模型。造模结束后,给予柴胡疏肝汤组大鼠灌胃2 mL/100 g柴胡疏肝汤,空白组、癫痫组给予等量生理盐水灌胃,均为1次/d,持续灌胃3周。造模结束后,采用microRNA微阵列芯片检测癫痫大鼠模型海马组织差异表达的miRNA。干预期间观察记录3组大鼠的癫痫发作情况。最后一次灌胃结束后采用实时荧光定量PCR检测3组大鼠海马组织miR‑34a表达水平。结果MicroRNA微阵列芯片测序分析从癫痫大鼠海马组织中共筛选出40个差异表达的miRNA,其中miR‑34a在癫痫大鼠模型海马组织中呈高表达。与癫痫组比较,柴胡疏肝汤组大鼠癫痫发作次数、发作持续时间减少(P<0.05)。与空白组比较,癫痫组、柴胡疏肝汤组大鼠模型海马组织中miR‑34a的表达水平升高(P<0.05);与癫痫组比较,柴胡疏肝汤组大鼠模型海马组织中miR‑34a的表达水平降低(P<0.05)。结论柴胡疏肝汤可能通过抑制癫痫大鼠模型海马组织中miR‑34a的表达而减少癫痫发作。

基于数据挖掘探讨杨小军教授治疗功能性消化不良用药规律

目的探讨杨小军教授治疗功能性消化不良的用药规律,为临床用药提供参考和借鉴。方法收集杨小军教授治疗功能性消化不良的门诊病历,通过建立数据库进行数据挖掘。结果高频药物有陈皮、白术、半夏、茯苓、砂仁、太子参、柴胡、木香、枳壳、香附、白芍、鸡内金、川芎等。药味以甘、苦、辛为主,药性以温、寒、平为主,涉及药物主要归于脾、胃、肝、肺经。药物功效分类主要归为理气药和补虚药两大类。核心处方由香砂六君子汤合柴胡疏肝散加减组成。结论杨小军教授治疗功能性消化不良以辛开苦降、寒温并用、多脏同调、燮理气机、健脾和胃、疏肝解郁为特点。

基于网络药理学、分子对接和动物实验探究柴胡疏肝散治疗抑郁症作用机制

目的基于网络药理学、分子对接技术预测柴胡疏肝散治疗抑郁症的作用机制,并利用慢性不可预见性温和应激(CUMS)抑郁模型大鼠进行实验验证。方法通过TCMSP数据库检索柴胡疏肝散活性成分,获取药物靶点,通过DisGeNET、GeneCards、GEO数据库检索抑郁症靶点,通过构建蛋白相互作用(PPI)网络及GO和KEGG通路富集分析确定柴胡疏肝散治疗抑郁症的作用途径,对主要活性成分和靶点进行分子对接。采用CUMS结合孤养建立大鼠抑郁模型,给予柴胡疏肝散和PI3K特异性抑制剂LY294002干预,通过Western blot和qPCR分别检测大鼠海马组织相关蛋白和mRNA表达,ELISA检测海马组织单胺类神经递质5-羟色胺(5-HT)、去甲肾上腺素(NE)含量,并与作用途径进行整合分析。结果通过检索和筛选得到柴胡疏肝散治疗抑郁症的活性成分118个和潜在靶点74个,KEGG通路富集分析表明柴胡疏肝散治疗抑郁症的作用途径主要与PI3K-Akt信号通路、糖尿病并发症中的AGE-RAGE信号通路等有关。分子对接显示,活性成分槲皮素、山柰酚、β-谷甾醇、异鼠李素、柚皮素与靶点AKT1、PIK3CA、GSK3B、IL6、IL1B结合活性较好。动物实验显示,柴胡疏肝散可有效改善模型大鼠抑郁样行为,提高大鼠海马组织PI3K、Akt磷酸化水平,下调GSK3β表达,提高5-HT、NE含量,LY294002可逆转柴胡疏肝散的效果。整合分析结果表明,柴胡疏肝散治疗抑郁症的作用途径PI3K/Akt信号通路与5-HT、NE代谢密切相关。结论柴胡疏肝散可通过激活PI3K/Akt信号通路,抑制GSK3β表达并提高单胺类神经递质5-HT、NE水平,从而发挥抗抑郁作用。

加味柴胡疏肝散辅助治疗冠脉痉挛心绞痛随机对照研究

目的探讨加味柴胡疏肝散辅助治疗冠脉痉挛心绞痛的疗效。方法随机将126例2019年10月—2022年8月河南中医药大学第二附属医院心内科收治的冠脉痉挛心绞痛患者分为对照组(63例)和试验组(63例)。对照组给予阿托伐他汀钙片、酒石酸美托洛尔缓释片、阿司匹林肠溶片、硝酸甘油片,试验组在此基础上加用加味柴胡疏肝散,两组均治疗4周。比较两组治疗4周后的疗效,对比两组治疗前和4周后的临床相关指标、中医症状评分、血脂水平、心功能及治疗期间的安全性。结果与对照组治疗4周后的总有效率(79.37%,50/63)比较,试验组总有效率更高[93.65%(59/63),P<0.05]。治疗4周后,两组心绞痛持续时间与治疗前比较均缩短,试验组短于对照组(P<0.05);两组心绞痛发作次数、硝酸甘油片用量与治疗前比较均减少,试验组少于对照组(P<0.05);两组胸闷胸痛、心烦急躁、心悸、口干口苦评分及血清低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、总胆固醇(total cholesterol,TC)、三酰甘油(triacylglycerol,TG)、心肌肌钙蛋白I(cardiac troponin I,CTnI)、缺血修饰蛋白(ischemic modification protein,IMA)、心脏型脂肪酸结合蛋白(cardiac fatty acid binding protein,H-FABP)水平与治疗前比较降低,试验组低于对照组(P<0.05);两组血清高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)水平及左心射血分数(left ventricular ejection fraction,LVEF)、心脏指数(cardiac index,CI)、心输出量(cardiac output,CO)与治疗前比较升高,试验组高于对照组(P<0.05)。试验组和对照组治疗期间的不良反应总发生率比较差异无统计学意义(P>0.05)。结论加味柴胡疏肝散辅助治疗冠脉痉挛心绞痛可有效调节患者血脂水平,改善心功能,进而可促进患者中医症状及临床症状的改善,提高疗效,且具有良好的安全性。

柴胡疏肝散合左金丸联合内镜下贲门松弛紧缩术治疗胃食管反流病的疗效

目的探讨柴胡疏肝散合左金丸联合内镜下贲门松弛紧缩术治疗胃食管反流病的疗效。方法选取90例胃食管反流病患者作为研究对象,采用随机数字表法分为A、B、C组,均为30例。A组给予柴胡疏肝散合左金丸。B组给予内镜下贲门松弛紧缩术。C组给予联合治疗。结果治疗4周后,C组总有效率高于A组、B组(P<0.05)。与治疗前比较,治疗4周后,C组中医证候积分、胃食管反流病量表(GerdQ)评分、胃食管反流病程度、食管动力指标、Hill分级、细胞因子变化均优于B组、A组,B组优于A组(P<0.05)。治疗期间,3组不良反应发生率比较,差异无统计学意义(P>0.05);C组出院时间短于B组、A组,B组短于A组(P<0.05)。结论柴胡疏肝散合左金丸联合内镜下贲门松弛紧缩术可显著缓解胃食管反流病患者临床症状及胃食管反流病程度,改善患者食管动力指标、Hill分级及相关因子水平,缩短住院时间,进而提高疗效,且安全性良好,而内镜下贲门松弛紧缩术较柴胡疏肝散合左金丸优势明显。

加味柴胡舒肝散颗粒联合穴位敷贴治疗失眠的效果及对TLR/NF-κB信号通路的影响

目的 探讨加味柴胡舒肝散颗粒联合穴位敷贴治疗失眠的效果及对Toll样受体(TLR)/核因子-κB(NF-κB)信号通路的影响。方法 选取医院2021年1月至2023年1月收治的失眠患者100例,按随机数字表法分为观察组和对照组,各50例。两组患者均睡前口服右佐匹克隆片,观察组患者加予加味柴胡舒肝散颗粒口服联合宁静贴片贴敷于内关穴、神门穴。两组均持续治疗2周。结果 观察组总有效率为96.00%,显著高于对照组的84.00%(P <0.05)。两组患者治疗后的入睡困难、多梦易醒、神疲食少、目赤口苦、舌红少津、脉弦数等中医证候积分,睡眠状况自评量表和匹兹堡睡眠质量指数量表评分,汉密尔顿抑郁量表、汉密尔顿焦虑量表评分,以及TLR3、TLR4、髓分化因子(MyD88)、TAK1结合蛋白2(TAB2)、NF-κB的mRNA表达水平均显著降低;睡眠总时间、快速眼动睡眠期、睡眠潜伏期、醒觉时间、睡眠效率均显著改善(P <0.05);且观察组上述指标改善更显著(P <0.05)。观察组与对照组不良反应发生率相当(20.00%比14.00%,P> 0.05)。结论 加味柴胡舒肝散颗粒联合穴位敷贴治疗失眠,不仅能有效改善患者的临床症状、睡眠质量及睡眠结构,还能改善其焦虑、抑郁情绪,并能调节TLR/NF-κB信号通路。

自我超越理论护理模式结合柴胡疏肝散加减在乳腺癌术后治疗中的应用

目的:探讨自我超越理论护理模式结合柴胡疏肝散加减在乳腺癌术后治疗中国的应用及对患者自护能力的影响。方法:选取乳腺癌术后患者72例,随机分为对照组和观察组,每组各36例。对照组采用乳腺癌术后常规护理,观察组在此基础上采用自我超越理论护理模式结合柴胡疏肝散加减治疗,术后共干预2周。对比干预前后两组Herth希望量表(herth hope index,HHI)、自我超越量表(Chinese version of the self-transcendence scale,CSTS)、汉密顿焦虑量表(Hamilton anxiety scale,HAMA)、汉密顿抑郁量表(Hamilton depression scale,HAMD)、自我护理能力量表评分及血清肿瘤标志物水平。结果:干预后,两组HHI、CSTS及自我护理能力评分均高于治疗前(P<0.05),HAMA、HAMD评分及血清肿瘤标志物水平均低于治疗前(P<0.05)。干预后观察组HHI、CSTS及自我护理能力评分均高于对照组(P<0.05),HAMA、HAMD评分及血清肿瘤标志物水平均低于对照组(P<0.05)。结论:自我超越理论护理模式结合柴胡疏肝散加减治疗,能有效提高乳腺癌患者术后的希望水平、自我超越水平及自我护理能力,缓解患者焦虑和抑郁情绪,降低血清肿瘤标志物水平,提高生活质量。