Analysis on the formation principle and present situation of nano phase state of multi-component self-assembly of traditional Chinese compound medicine decoction

Traditional Chinese medicine decoction is a complex polydispersed phase system containing real solution,colloid solution,emulsion and suspension.The compound decoction of traditional Chinese medicine has complex components,including saponins,alkaloids,polysaccharides,flavonoids,amino acids and so on,which can be self-assembled to form gels,fibers,micelles,vesicles and so on.The self-assembled nano-phase not only neutralizes the single drug and reduces the toxicity and side effects,but also has its own pharmacological effects,which complement each other to achieve synergistic effect,so as to achieve the role of drug supplement,which is of research significance.The formation principle,solubilization and synergism principle and characterization method of multi-component self-assembly of traditional Chinese medicine compound decoction are discussed in this paper.

Protective Effects of Self-made Compound Taoren Danshen Decoction on Rats with Acute Liver Injury

[Objectives] To study the protective effects of self-made Compound Taoren Danshen Decoction( CTDD) on acute liver injury induced by D-galactosamine in rats,and to explore its mechanism. [Methods]An acute liver injury model was established by intraperitoneal injection of 500 mg/kg of D-galactosamine. The ALT,AST,MDA,SOD and GSH-Px in serum,as well as serum TNF-α,IL-1β and IL-6 levels were measured,and liver tissue lesions were observed under microscope. [Results] CTDD can significantly reduce ALT,AST and MDA levels,increase SOD,GSH-Px activity,and significantly reduce serum TNF-α,IL-1β and IL-6 levels,and improve liver tissue lesions.[Conclusions]CTDD has a protective effect on D-galactosamine-induced acute liver injury in rats,and its mechanism may be related to inhibition of oxidative stress and inflammatory reaction.

Gualou Guizhi decoction promotes neurological functional recovery and neurogenesis following focal cerebral ischemia/reperfusion

Recovery following stroke involves neurogenesis and axonal remodeling within the ischemic brain. Gualou Guizhi decoction （GLGZD） is a Chinese traditional medicine used for the treatment of post-stroke limb spasm. GLGZD has been reported to have neuroprotective effects in cerebral ischemic injury. However, the effects of GLGZD on neurogenesis and axonal remodeling following cerebral ischemia remain unknown. In this study, a rat model of focal cerebral ischemia/reperfusion was established by middle cerebral artery occlusion. Neurologi- cal function was assessed immediately after reperfusion using Longa＇s 5-point scoring system. The rats were randomly divided into vehicle and GLGZD groups. Rats in the sham group were given sham operation. The rats in the GLGZD group were intragastrically administered GLGZD, once daily, for 14 consecutive days. The rats in the vehicle and sham groups were intragastrically administered distilled water. Modified neurological severity score test, balance beam test and foot fault test were used to assess motor functional changes. Nissl staining was performed to evaluate histopathological changes in the brain. Immunofluorescence staining was used to examine cell proliferation using the marker 5-bromo-2＇-deoxyuridine （BrdU） as well as expression of the neural precursor marker doublecortin （DCX）, the astrocyte marker glial fibrillary acidic protein （GFAP） and the axon regeneration marker growth associated protein-43 （GAP-43）. GLGZD substan- tially mitigated pathological injury, increased the number of BrdU, DCX and GFAP-immunoreactive cells in the subventricular zone of the ischemic hemisphere, increased GAP-43 expression in the cortical peri-infarct region, and improved motor function. These findings suggest that GLGZD promotes neurological functional recovery by increasing cell proliferation, enhancing axonal regeneration, and in- creasing the numbers of neuronal precursors and astrocytes in the peri-infarct area.

Cerebral vasorelaxant material basis of Xiaoxuming decoction study with rat basilar artery

OBJECTIVE To investigate the cerebralvasorelaxant material basis of Xiaoxuming decoction.METHODS According to the Xiaoxuming decoction herb sources,we retrieved the chemical structure from the literatures and the Chinese Natural Product Database(http://pharmdata.ncmi.cn).By using microvessel tension system,we checked the vasorelaxanteffects of Xiaoxuming decoction anti-cerebral ischemia effective components group(XXMDECG)and the available composition compounds on pre-contracted basilar artery ring.RESULTS963 compoundsin the decoction,including 81Fangfeng,77 Mahuang,130 Shengjiang,31 Guizhi,91 Huangqin,127 Renshen,73 Chuanxiong,44 Shaoyao,39 Xingren,42 Fangji,62 Fuzi and 166 Gancao were collected.The five largest number classes of compounds in the decoction are volatile oil(32%),flavone(32%),alkaloid(13%),saponin(7%),polyphenol and organic acid(5%).XXMDECG at concentration from 1 to 400μg·mL-1can dilate the KCl(60 mmol·L-1)and ET-1(0.01μmol·L-1)pre-contracted rat basilar artery rings in a dose-dependent manner.There are 6 compounds with vasorelaxant ratio more than 50%at the concentration of 10μmol·L-1.CONCLUSION Xiaoxuming decoction contains abundant chemical structure.It has the material basis of multiple ingredients and multiple targets.The XXMDECG are able to dilate the rat basilar artery rings in a dose-dependent manner.The network interactions between varies of chemical compounds in Xiaoxuming decoction and the vasoconstriction associated targets result in the comprehensive regulation mechanisms of vascular function.

Network pharmacology analysis of the mechanisms of Banxia Xiexin Decoction against Ulcerative Colitis

Banxia Xiexin Decoction(BXXXD),a traditional herbal formula,has been used to treat ulcerative colitis(UC)clinically.In this study,chemical compounds and putative targets of BXXXD and UC related therapeutic targets were screened from multiple databases.The protein-protein interaction(PPI)was conducted using String database,and 31 candidate targets were screened from CytoNCA database.The Database for Annotation,Visualization and Integrated Discovery(DAVID)and Metascape database were used for Kyoto Encyclopedia of Genes and Genomes(KEGG)channel and Gene Ontology(GO)enrichment analysis respectively,and the enrichment analysis results were visualized by OmicShare platform.Meanwhile,the interaction network among Chinese herbs,active compounds,candidate targets and pathways was built by Cytoscape 3.7.2 software,and the potential compounds of BXXXD in the treatment of UC were screened.Finally,molecular docking technology was used to verify the putative key compounds.Combined with literature research,5 key compounds for the treatment of UC were identified,which are mainly involved in TNF signaling pathway,cancer signaling pathway,inflammatory bowel disease(IBD),Toll-like receptor signaling pathway,and NF-κB signaling pathway.This study provides a scientific basis for BXXXD as an effective alternative therapeutic agent for UC from a new perspective,and also provides a feasible method for basic chemical research and pharmacological research of BXXXD.

Network pharmacology and molecular docking analysis on molecular targets and mechanism prediction of Huanglian Jiedu Decoction in the treatment of COVID-19

Objective To investigate and predict the molecular targets and mechanism of Huanglian Jiedu Decoction(黄连解毒汤,HLJDD)in the treatment of Corona Virus Disease 2019(COV-ID-19)through network pharmacology and molecular docking analysis.Methods The chemical constituents and action targets of HLJDD were retrieved on Tradi-tional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP),SymMap v2,Encyclopedia of Traditional Chinese Medicine(ETCM),a High-throughput Ex-periment-and Reference-guided Database of Traditional Chinese Medicine(HERB),and Tra-ditional Chinese Medicine Integrated Database(TCMID).UniProt and GeneCards were used to query the target genes that corresponding to the active compounds,and then a compound-target network was constructed using Cytoscape 3.7.2.Gene Ontology(GO)database was used to annotate GO functions.Kyoto Encyclopedia of Genes and Genomes(KEGG)was used to predict the possible mechanisms of active compounds.The Database for Annotation,Visu-alization and Integrated Discovery(DAVID)was used to analysis the tissue enrichment.The main active compounds in HLJDD are molecularly docked with their corresponding related targets.Results Seventy-six compounds were screened and 458 corresponding targets in the network were obtained.Gene annotation showed that the targets were involved mainly in 1953 biolo-gical processes.884 signaling pathways was enriched,involving signaling by interleukins,cy-tokine signaling in immune system,generic transcription pathway,and RNA polymerase II transcription.The targets mainly distributed in the lung,liver,and placenta,involving a vari-ety of immune cells,such as T cells and B cells.The molecular docking results showed that core compounds such as wogonin,berberine,and baicalein had high affinity with tumor nec-rosis factor(TNF),insulin(INS),and tumor protein 53(TP53).Conclusion The active compounds in HLJDD may have a therapeutic effect on COVID-19 through regulating multiple signal pathways by targeting genes such as vascular endothelial growth factor A(VEGFA),INS,interleukin-6(IL-6),TNF,caspase-3,TP53,and mitogen-activ-ated protein kinase 3(MAPK3).

草酸艾司西酞普兰联合复方解郁汤治疗青少年抑郁症的临床疗效分析

目的 探讨草酸艾司西酞普兰联合复方解郁汤治疗青少年抑郁症的临床疗效。方法 选择该院2021年12月—2022年12月期间精神科收治青少年抑郁症患者86例,按照随机数字表法分试验组(43例)和对照组(43例)。所有患者均予以认知行为疗法治疗,对照组予以草酸艾司西酞普兰片,试验组在对照组的基础上联用复方解郁汤治疗。两组均以4周为1个疗程,共治疗2个疗程。对比两组治疗前后脑源性神经营养因子水平、血清炎症因子水平、单胺类神经递质水平、抑郁情况评分、睡眠质量评分、自杀态度评分,观察并评估两组治疗效果及治疗期间不良反应。结果 与治疗前比,治疗后两组BDNF水平较高,IL-1β、IL-6、TNF-α水平降低;与对照组比,治疗后试验组BDNF水平较高,IL-1β、IL-6、TNF-α水平较低(P<0.05)。与治疗前比,治疗后两组NE、5-HT、DA水平升高;与对照组比,治疗后试验组NE、5-HT、DA水平较高(P<0.05)。与治疗前比,治疗后两组HAMA及PSQI评分降低;与对照组比,治疗后试验组HAMA及PSQI评分较低(P<0.05)。试验组临床总有效率较对照组高,差异有统计学意义(P<0.05)。与治疗前比,治疗后两组自杀意念QSA评分较高;与对照组比,治疗后试验组自杀意念QSA评分较高(P<0.05)。两组均未出现严重不良反应,比较差异无统计学意义(P>0.05)。结论 草酸艾司西酞普兰联合复方解郁汤对青少年抑郁症患者的治疗效果显著,能上调脑源性神经营养因子及单胺类神经递质水平,降低血清炎症因子水平,改善睡眠质量及自杀意念,不良反应较少,是一种安全有效的治疗方案。

清化复肝汤联合复方甘草酸苷注射液治疗急性早幼粒细胞白血病化疗后肝损伤患者的效果

目的:观察清化复肝汤联合复方甘草酸苷注射液治疗急性早幼粒细胞白血病(APL)化疗后肝损伤患者的效果。方法:选取2021年1月至2022年1月该院收治的152例化疗后出现肝损伤的APL患者进行前瞻性研究,按照随机数字表法将其分为对照组和研究组各76例,两组均采用维A酸联合亚砷酸化疗,对照组采用复方甘草酸苷注射液进行保肝治疗,研究组在对照组基础上联合清化复肝汤治疗。比较两组临床疗效,治疗前后血清炎性因子[超敏C反应蛋白(hs-CRP)、白细胞介素-6(IL-6)]水平、肝功能指标[丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)]水平、细胞免疫指标(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))水平,以及不良反应发生率。结果:研究组治疗总有效率为98.68%(75/76),高于对照组的86.84%(66/76),差异有统计学意义(P<0.05);治疗后,研究组血清hs-CRP、IL-6、AST、ALT、CD8^(+)水平均低于对照组,CD4^(+)、CD4^(+)/CD8^(+)水平均高于对照组,差异有统计学意义(P<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:清化复肝汤联合复方甘草酸苷注射液治疗APL化疗后肝损伤患者效果显著,可降低ATL、AST、hs-CRP、IL-6水平,改善细胞免疫指标水平,效果优于单用复方甘草酸苷注射液。

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。

大柴胡汤加减联合复方嗜酸乳杆菌片治疗功能性便秘患者临床疗效观察

目的探讨大柴胡汤加减联合复方嗜酸乳杆菌片治疗功能性便秘(FC)患者的临床疗效。方法根据随机数字表法将河南中医药大学第三附属医院2020年5月—2022年4月门诊治疗的70例FC患者随机分为两组,对照组(35例)服用复方嗜酸乳杆菌片治疗,治疗组联合大柴胡汤加减治疗。对比两组临床疗效、临床症状和便秘评分、胃肠道生活质量指数(GIQLI)、胃肠激素[P物质(SP)、胃动素(MTL)、胃泌素(GAS)]水平及不良反应。结果治疗组临床有效率(97.14%)高于对照组(80.00%)(P<0.05)。与治疗前相比,治疗后两组临床症状评分和便秘评分降低,胃肠激素水平和生活质量评分升高(P<0.05);与对照组相比,治疗组上述指标均优于对照组(P<0.05)。对照组与治疗组不良反应发生率(8.57%vs 5.71%)无统计学差异(P>0.05)。结论大柴胡汤加减联合复方嗜酸乳杆菌片治疗FC安全有效,且可减轻患者便秘症状,调节胃肠激素水平,提高生活质量。

复方玉液汤通过调控PI3K/Akt信号通路抑制糖尿病大鼠心肌细胞凋亡和炎症反应

目的运用网络药理学技术分析复方玉液汤防治糖尿病心肌病(DCM)的作用机制,并通过动物实验进行验证。方法利用TCMSP数据库检索复方玉液汤所含6种中药(黄芪、山药、知母、葛根、五味子、天花粉)中的化学成分,根据口服生物利用度(OB)和药物相似性(DL)筛选出活性化学成分以及与DCM相关的靶点;利用Drugbank、Gene Cards、OMIM和PharmGKb数据库获取与DCM相关靶点;STRING数据库对核心靶点进行PPI网络的构建和分析;Metascape进行核心靶点的GO和KEGG富集分析;利用Cytoscape3.9.1构建“中药-关键成分-核心靶点-关键通路”网络,并对核心靶点对接的关键成分进行分子对接。建立糖尿病心肌病Wistar大鼠动物模型,将大鼠分为正常组、模型组、玉液汤低剂量组(YYT-低组,0.29 g/kg)、玉液汤高剂量组(YYT-高组,1.15 g/kg),15只/组,药物剂量为生药含量。给药8周后观察各组大鼠的心脏组织病理切片,检测各组大鼠心脏电生理变化、血清中的LDH、CK、CK-MB含量变化以及心脏组织中PI3K、P-PI3K、Akt、P-AKT、BAX、IL-6、TNF-α蛋白的表达情况。结果筛选后得到复方玉液汤中61个活性化合物,1057个靶点;3682个DCM相关疾病靶点,共同靶点551个。根据筛选获得的核心靶点富集得到的核心通路发现,凋亡和炎症及相关PI3K/Akt信号通路可能是治疗DCM的关键信号通路;分子对接结果显示,金色酰胺醇酯、山柰酚等活性成分与AKT1和PIK3R1的结合活性较好。利用动物实验对筛选的靶点及通路进行验证,结果显示,与DCM模型组大鼠比较,复方玉液汤能改善模型大鼠心肌组织细胞紊乱及炎性浸润的病理特征,降低模型大鼠血清中LDH、CK、CK-MB水平及模型大鼠心脏组织中BAX、IL-6、TNF-α的蛋白含量并升高P-PI3K和P-AKT的蛋白含量(P<0.05)。结论复方玉液汤防治DCM是多成分、多靶点和多信号通路共同作用的结果。复方中主要活性成分金色酰胺醇酯、山柰酚等通过调控PI3K/Akt信号通路,抑制DCM发病过程中心肌细胞凋亡及炎症反应,发挥对DCM的保护作用。

复方葛根汤调控IL-6/STAT3和铁死亡通路抑制在体结肠癌发展

目的 探究复方葛根汤在体抗结肠癌的分子机制。方法 建立HCT116细胞荷瘤小鼠模型,每日以1.0 g·kg^(-1)的剂量灌胃给予复方葛根汤或等体积生理盐水,每3日测量一次体重和瘤体大小,连续给药23 d;Western blot检测铁死亡通路、IL-6通路和细胞迁移相关蛋白。结果 与对照组相比,复方葛根汤显著抑制HCT116细胞衍生瘤体增长,显著上调铁死亡相关蛋白ACSL4、PTGS2,而明显下调SLC7A11、GPX4,还显著下调IL-6、p-STAT3/STAT3比及其下游蛋白MMP2、TWIST和MMP7水平。结论 复方葛根汤能显著抑制体内结肠癌发展,其机制可能为通过抑制IL-6/STAT3和诱导铁死亡通路。

基于电子感官系统和GC-IMS技术的大黄饮片基原辨识研究

目的探寻不同基原大黄饮片滋味、气味和挥发性有机物的差异,对大黄饮片进行基原辨识。方法采用电子舌、电子鼻和气相-离子迁移谱(GC-IMS)技术,对不同基原大黄饮片间的滋味、气味和挥发性有机物进行对比分析,运用主成分分析(PCA)、偏最小二乘法判别分析(PLS-DA)、正交偏最小二乘法判别分析(OPLS-DA)、Fisher判别等方法对大黄饮片基原进行辨识研究并建立基原判别标准。结果3种基原大黄饮片的滋味差异主要表现在苦味、涩味以及苦和涩的回味,气味的差异主要表现在无机硫化物、芳香成分有机硫化物、甲烷等短链烷烃、醇醚醛酮类化合物以及氮氧化合物,差异性挥发性有机物主要为醇醛酮酸类成分,并且8批样品均能很好地聚集为3类。根据差异性挥发物质之间的峰强度比值可有效辨识3种大黄饮片,如当2-乙酰基呋喃峰强度是异丁酸[二聚体]峰强度的3~19倍时为药用大黄。结论本研究建立的判别模型以及特征挥发性物质峰强度判别标准可用于大黄饮片基原的鉴别。

基于网络药理学和分子对接技术探讨复方菖蒲益智汤治疗轻度认知功能障碍的作用机制

目的:基于网络药理学和分子对接技术探究复方菖蒲益智汤治疗轻度认知功能障碍(MCI)的药理学作用机制。方法:通过TCMSP平台和PubChem、Swiss Target Prediction数据库获取复方菖蒲益智汤主要的6味中药的活性成分和作用靶点,从GeneCards、DisGeNet、OMIM、TTD数据库获取MCI的相关基因。利用Venny 2.1.0平台将药物的成分靶点与MCI相关的靶基因取交集,利用Cytoscape 3.7.2进行“药物-成分-靶点-疾病”网络图的构建,并利用STRING平台构建蛋白-蛋白相互作用(PPI)网络图,然后利用Metascape平台进行KEGG通路富集分析与GO功能富集分析。最后利用Autodock vina V1.2.0对核心作用靶点及主要药效成分进行分子对接,验证它们之间的紧密联系程度。结果:复方菖蒲益智汤治疗MCI的潜在靶基因共178种。PPI网络图筛选出AKT1、TNF、EGFR、CASP3、IL1B、VEGFA 6个关键核心靶点,涉及7NH5、6Q00、8A27等关键核心靶蛋白;KEGG通路富集分析结果表明,AKT1、TNF、IL1B、VEGFA 4个关键核心靶点在AGE-RAGE信号通路中。分子对接结果显示,复方菖蒲益智汤的有效成分与上述6个关键核心靶点的结合活性良好。结论:复方菖蒲益智汤中主要的6味中药的活性成分可作用于AKT1、TNF、IL1B等多个靶点,通过调控AGE-RAGE通路发挥治疗MCI的作用。

Identification of prototype compounds and their metabolites in rats’ serum from Xuefu Zhuyu Decoction by UPLC-Q-TOF/MS

Objective: As a classic prescription in traditional Chinese medicine, Xuefu Zhuyu Decoction(XFZYD) has been widely used in the clinical treatment of cardiovascular and cerebrovascular diseases. In order to unveil the potentially effective compounds, a rapid ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF/MS) method was established to identify prototype compounds and their metabolites from XFZYD in rats’ serum.Methods: The serum from rats after intragastric administration of XFZYD aqueous extract was analyzed by UPLC-Q-TOF/MS method. The prototype compounds and their metabolites were identified by comparison with the reference standards and tentatively characterized by comprehensively analyzing the retention time, MS data, characteristic MS fragmentation pattern and retrieving literatures.Results: A total of 175 compounds(24 prototype compounds and 151 metabolites) were identified and tentatively characterized. The metabolic pathways of prototype compounds in vivo were also summarized, including glucuronidation, hydrolyzation, sulfation, demethylation, and hydroxylation, and so on.Conclusion: In this study, a UPLC-Q-TOF/MS technique was developed to analyze prototype compounds and their metabolites from XFZYD in serum, which would provide the evidence for further studying the effective compounds of XFZYD.

复方大黄膏联合活血消肿汤对混合痔术后切口恢复的影响

目的:观察复方大黄膏联合活血消肿汤对混合痔术后切口恢复的影响。方法:采用随机数字表法将择期行手术治疗的90例混合痔患者分为对照组、观察A组、观察B组各30例。对照组给予常规西药治疗,观察A组在对照组基础上给予活血消肿汤治疗,观察B组在观察A组基础上给予复方大黄膏治疗。比较3组治疗前后中医证候积分、视觉模拟评分法(VAS)评分、创面渗液评分及炎症相关因子[CXC型趋化因子受体4 (CXCR4)、白细胞介素-8 (IL-8)、白细胞介素-22 (IL-22)]水平,并评估3组临床疗效及不良反应发生情况。结果:治疗后,观察B组总有效率96.67%,高于观察A组83.33%与对照组66.67%(P<0.05),观察A组总有效率高于对照组(P<0.05)。3组治疗后中医证候积分、VAS评分、创面渗液评分及血清CXCR4、IL-8、IL-22水平均低于治疗前(P<0.05),且观察B组中医证候积分、VAS评分、创面渗液评分及炎症相关因子水平均低于观察A组与对照组(P<0.05),观察A组上述指标低于对照组(P<0.05)。观察组B组不良反应发生率低于观察A组、对照组(P<0.05),观察A组不良反应发生率低于对照组(P<0.05)。结论:复方大黄膏联合活血消肿汤治疗能够有效缓解患者术后切口疼痛,减轻炎症反应,临床疗效显著,安全性较高。

补阳还五汤治疗糖尿病周围神经病变研究进展

作为糖尿病最常见的慢性并发症之一,糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)的发病率与糖尿病病程长短有关。在现代医学中经常使用降糖药联合镇痛药和抗癫痫药物治疗DPN,效果确切,但存在毒副作用大、耐药性高、依从性差等问题。传统医学治疗DPN的特点是辨证论治,运用中药复方,有作用靶点多,疗效机制广和药物毒性低的优点。补阳还五汤是治疗气虚血瘀证型的代表方剂,具有补气活血、通经活络的功效。本文主要从基础方证分析、临床研究和基础研究三个方面探讨补阳还五汤对DPN的治疗作用,旨在研究其治疗DPN的新进展,以期为临床诊疗提供更广阔的思路。

复方黄杞汤治疗Ⅰ、Ⅱ型老年重症肌无力回顾性分析

目的观察复方黄杞汤治疗Ⅰ、Ⅱ型老年重症肌无力的疗效及对西药减停的影响。方法回顾性选取2021年1月—2022年1月就诊于辽宁中医药大学附属医院重症肌无力门诊的Ⅰ、Ⅱ型老年重症肌无力患者(年龄≥60岁)30例,其中男13例,女17例,Ⅰ型16例,Ⅱ型14例,25例患者初诊时服用西药治疗(Ⅰ型11例,Ⅱ型14例),19例患者单独服用溴吡斯的明片治疗(Ⅰ型10例,Ⅱ型9例),6例患者服用溴吡斯的明片联合醋酸泼尼松片治疗(Ⅰ型1例,Ⅱ型5例)。对其门诊病历及随访得出的信息进行回顾,收集其接受中药治疗前及治疗3个月、6个月、12个月时的重症肌无力绝对评分和相对计分以及服用西药量的变化情况,利用IBM SPSS Statistics 26.0软件进行统计分析。结果30例老年患者服药3个月、6个月、12个月后,重症肌无力临床绝对评分较上一时间节点均显著下降(P<0.05)。服药12个月后,Ⅰ型患者有效率为93.75%,Ⅱ型患者有效率为100%,总体有效率可达96.67%,且87.5%的Ⅰ型老年患者可达到临床基本痊愈,42.86%的Ⅱ型老年患者可达到临床基本痊愈,共66.67%的老年患者可达到临床基本痊愈。治疗后上述各时间节点溴吡斯的明片及醋酸泼尼松片用量较上一时间节点均显著下降,差异具有统计学意义(P<0.05)。服药12个月后,共有60%的患者停服溴吡斯的明片(Ⅰ型8例,Ⅱ型7例),50%的患者停服醋酸泼尼松片(Ⅰ型1例,Ⅱ型2例)。结论复方黄杞汤对Ⅰ、Ⅱ型老年重症肌无力的疗效明确,可明显改善Ⅰ、Ⅱ型老年重症肌无力患者临床症状,并能减少Ⅰ、Ⅱ型老年患者西药用量。

中药有效成分及复方调控巨噬细胞治疗腰椎间盘突出症研究进展

腰椎间盘突出症(lumbar disc herniation,LDH)多由风寒湿热邪侵袭或年老失养,肝肾亏虚;或因跌扑损伤,气血凝滞,经脉不利所致。故病机总属本虚标实,治疗应注重祛风除湿散寒、清热利湿、活血通络治其标,补益肝肾、强筋壮骨治其本。巨噬细胞极化在LDH发生进展中占有重要地位,能改善局部炎性微环境状态,发挥镇痛作用,是治疗LDH的潜在靶点。LDH中巨噬细胞相关的信号通路有:核因子-κB信号通路、NOD样受体热蛋白结构相关蛋白3炎症小体信号通路、丝裂原活化蛋白激酶信号通路、Notch信号通路等。中药有效成分及复方能够通过多途径调节巨噬细胞极化状态,恢复促炎/抗炎因子平衡,减缓LDH的进展。中药提取有效成分有:芦荟中的芦荟醇,骨碎补中的柚皮苷,姜黄中的姜黄素,秦艽、威灵仙中的木兰花苷,黄连中的小檗碱等。三痹汤、宣痹汤、血府逐瘀汤、独活寄生汤等为治疗LDH的代表复方。中药具有多靶点、多机制、疗效高、质优价廉、副作用少等的特点,靶向调控巨噬细胞极化,恢复腰椎间盘突出物局部炎症微环境平衡,可能是未来治疗LDH的潜在方向。目前,中药有效成分及其复方靶向调控巨噬细胞治疗LDH的研究中,对其作用机制的研究还非常有限,缺乏深层标准化的临床前证据与基础实验。因此,在未来的研究中,需加强中药有效成分与复方对调控巨噬细胞极化的研究,明确中药复方调控巨噬细胞治疗LDH的具体作用机制,为研制延缓腰椎间盘退变的新型药物,以及中医药更好的应用提供可靠依据。

小承气汤中药灌肠联合复方聚乙二醇电解质散剂用于妇科术前的效果

目的探讨小承气汤中药灌肠联合复方聚乙二醇电解质散剂用于妇科手术前肠道清洁的临床效果。方法选取2021年3月—2022年12月江苏省邳州市中医院收治的82例妇科手术患者为研究对象,以双盲抽签法随机分为对照组和研究组,各41例。对照组予以复方聚乙二醇电解质散剂治疗,研究组在对照组基础上联合应用小承气汤中药灌肠治疗,比较两组临床效果。结果研究组肠道清洁效果优良性为97.56%,高于对照组的85.37%,差异有统计学意义(χ^(2)=3.904,P<0.05)。研究组不良反应发生率为2.44%,低于对照组的4.88%,但差异无统计学意义(P>0.05)。研究组术后首次排气、排便时间明显短于对照组,差异有统计学意义(P均<0.05)。结论小承气汤中药灌肠联合复方聚乙二醇电解质散剂用于妇科手术前可保障良好的肠道清洁效果,且安全性较高,可促使术后及早排气及排便。