Dachaihu decoction ameliorates pancreatic fibrosis by inhibiting macrophage infiltration in chronic pancreatitis

AIM To explore the role of macrophages in chronic pancreatitis(CP) and the effect of Dachaihu decoction(DCHD) on pancreatic fibrosis in mice.METHODS Kun Ming mice were randomly divided into a control group, CP group, and DCHD group. In the CP and DCHD groups, mice were intraperitoneally injected with 20% L-arginine(3 g/kg twice 1 d/wk for 6 wk). Mice in the DCHD group were administered DCHD intragastrically at a dose of 14 g/kg/d 1 wk after CP induction. At 2 wk, 4 wk and 6 wk post-modeling, the morphology of the pancreas was observed using hematoxylin and eosin, and Masson staining. Interleukin-6(IL-6) serum levels were assayed using an enzyme-linked immunosorbent assay. Double immunofluorescence staining was performed to observe the co-expression of F4/80 and IL-6 in the pancreas. Inflammatory factors including monocyte chemoattractant protein-1(MCP-1), macrophage inflammatory protein-1α(MIP-1α) and IL-6 were determined using real time-polymerase chain reaction. Western blot analysis was used to detect fibronectin levels in the pancreas. RESULTS Compared with the control group, mice with 20% L-arginine-induced CP had obvious macrophage infiltration and a higher level of fibrosis. IL-6 serum concentrations were significantly increased. Double immunofluorescence staining showed that IL-6 and F4/80 were co-expressed in the pancreas. With the administration of DCHD, the infiltration of macrophages and degree of fibrosis in the pancreas were significantly attenuated; IL-6, MCP-1 and MIP-1α m RNA, and fibronectin levels were reduced. CONCLUSION The dominant role of macrophages in the development of CP was mainly related to IL-6 production. DCHD was effective in ameliorating pancreatic fibrosis by inhibiting macrophage infiltration and inflammatory factor secretion in the pancreas.

Effect of Dachaihu decoction on non-alcoholic fatty liver disease model rats induced by a high-fat high-sugar diet

Objective:To establish an animal model consistent with the occurrence and development of non-alcoholic fatty liver disease(NAFLD)with which to assess the effects of a classical traditional Chinese medicine formula known as Dachaihu Decoction(DD)on NAFLD.Methods:Sixty rats were randomized into four groups:control,model,pioglitazone hydrochloride(PH)and DD in equal.NAFLD was produced via administration of a high-fat high-sugar diet for 16 weeks in all but the control group.From the 13th week,a solution of PH or DD prepared with water was delivered via intragastric administration to the PH and DD groups;the remaining two groups received an equivalent volume of distilled water.Twelve hours from the last administration,we selected eight rats from each group in random.After anesthetization,the abdominal aorta blood and liver tissues were collected.The morphological changes were observed and the levels of alanine aminotransferase(ALT),aspartate aminotransferase(AST),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),highdensity lipoprotein cholesterol(HDL-C),fasting plasma glucose(FBG),transforming growth factor-β1(TGF-β1),tumor necrosis factor-α(TNF-α),toll-like receptor-4(TLR4),and nuclear factor-kappa B(NF-κB)were tested.Results:Compared with the control group,the levels of serum ALT,AST,TC,TG,LDL-C and FBG,and TGF-β1,TNF-α,TLR4,NF-κB in the model group all showed significant increases(P<.01).Compared with the model group,these same indicators in the PH and DD groups all showed remarkable decreases(P<.05).Conclusion:The efficacy of DD in NAFLD rats was shown to be effectively equivalent to that of PH,with demonstrated effects of DD that included reductions in hepatic steatosis and serum and hepatic lipid levels,and lowered blood glucose levels.We deduce that DD has an inhibitory effect on NAFLD induced by a high-fat high-sugar diet in rats.

A Meta-analysis of Dachaihu Decoction combined with western medicine in the treatment of acute pancreatitis with the TCM syndrome of liver qi depression and liver-gallbladder dampness-heat

Backgroud:To evaluate the clinical efficacy and safety of Dachaihu Decoction in the treatment of acute pancreatitis(AP)with the traditional Chinese medicine(TCM)syndrome of liver qi depression and liver-gallbladder dampness-heat.Methods:We searched randomized controlled trials of Dachaihu Decoction in the treatment of AP with the TCM syndrome of liver qi depression and liver-gallbladder dampness-heat from databases in CNKI,WanFang,VIP,Embase,PubMed,and Cochrane Library(from established to August 2019).All the retrieved documents were imported into the Noteexpress software for screening and management,and the included documents were evaluated for quality and data extracted.Statistical analysis was performed with RevMan(version 5.3).Results:A total of 132 articles were retrieved and 8 studies were included to analysis,including 679 patients.Quality evaluation of included studies suggested that the quality of the literatures is generally not high.Meta-analysis showed that the total clinical effective rate of AP was higher in the treatment group than in the control group[OR=5.00,95%CI(2.86,8.73)],and the difference was statistically significant(P<0.00001).The patient's abdominal pain relief time[MD=-0.57,95%CI(-0.86,-0.27),P=0.0002],bloating relief time[MD=-0.71,95%CI(-1.05,-0.37),P=0.04],time of serum amylase returning to normal[MD=-1.00,95%CI(-1.60,-0.40),P=0.001]and time of urinary amylase returning to normal[MD=-1.62,95%CI(-2.88,-0.37),P=0.01]all lower than the control group.But there was no statistically significant difference between the treatment group and the control group at the first defecation time[MD=-0.86,95%CI(-1.75,-0.03),P=0.06].The patient's serum TNF-a levels on the 3rd[MD=-28.53,95%CI(-49.57,-7.49),P=0.008]and 7th day[MD=-26.13,95%CI(-49.76,-2.50),P=0.03]in the treatment group were statistically lower in the treatment group than in the control group.Similarly,the patient's serum IL-6 levels on the 3rd[MD=-6.62,95%CI(-12.49,-0.75),P=0.03]and 7th day[MD=-11.98,95%CI(-22.25,-1.71),P=0.02]were also statistically lower in the treatment group than in the control group.No serious complications or adverse reactions were observed.Conclusion:Dachaihu Decoction combined with western medicine in the treatment of AP with the TCM syndrome of liver qi depression and liver-gallbladder dampness-heat can improve clinical efficacy compared with western medicine alone.In addition,the combination therapy method is safe and can be used for syndrome differentiation of AP patients in the clinic.

Clinical Practice Examples of Dachaihu Decoction

This paper mainly describes the experiences of clinical application of Dachaihu Decoction in treating chronic pelvic infection, coronary heart disease, insomnia, and hepatolithiasis.

Dachaihu decoction inhibits hypernutrition-induced liver metastasis from colorectal cancer by maintaining the gut vascular barrier

Background:Colorectal cancer(CRC)is the third most common malignancy and the second deadliest cancer worldwide.Metastasis to the liver,the most common metastatic site in CRC,is the leading cause of death in patients with CRC.Hyperlipidemia,which is common in patients with CRC,promotes CRC progression and metastasis.Hyperlipidemia is commonly observed in obese patients and is often induced by hypernutrition.The underlying mechanism of hypernutrition-induced hyperlipidemia in promoting CRC liver metastasis remains unclear,and there is an unmet need for effective and low-cost treatments for patients with CRC.Methods:A mouse cecum orthotopic CRC model combined with high-fat diet(HFD)feeding,was established to mimic liver metastasis in CRC in obese patients.The effects of Dachaihu decoction(DCHD),a traditional herbal medicine used to treat inflammation and nonalcoholic fatty liver disease,and of the conventional prescription medicine obeticholic acid(OCA)were evaluated.HFD-induced obesity,hyperlipidemia,and CRC liver metastasis were assessed,along with the histology and pathology of the liver and intestine and the expression of metabolic genes in these tissues.The effects of DCHD and OCA on HFD-induced outcomes were evaluated,and human umbilical vein endothelial cells(HUVECs)treated with bile acids(BAs)and DCHD were used to study the underlying mechanisms in vitro.Results:HFD-mediated obesity and hyperlipidemia promoted CRC metastasis,accompanied by disruption of the gut vascular barrier(GVB)and altered bile acid(BA)metabolism.DCHD decreased HFD-induced hyperlipidemia and liver metastasis in CRC,improving overall survival.Those effects of DCHD were equivalent to or better than those of OCA.DCHD regulated the expression of genes of BA metabolism and tight junctions(TJ)to prevent HFDinduced disruption of the GVB.In HUVECs,DCHD prevented the increases in intracellular Ca2t and accumulation of reactive oxygen species induced by primary conjugated BAs,assisting in the maintenance of redox homeostasis and preventing the downregulation of TJ proteins,thereby maintaining the integrity of the endothelial barrier.Conclusions:The data provide a link between hypernutrition and GVB disruption,which contributes to high liver metastasis in patients with CRC.DCHD may represent a novel therapy in CRC,and targeting abnormal lipid metabolism could be a promising therapeutic strategy for avoiding hypernutrition-associated CRC metastasis.

浅析大柴胡汤在肝癌经动脉化疗栓塞术后并发栓塞综合征中的应用

经动脉化疗栓塞术是目前被公认为非手术治疗肝癌最常用的方法之一,栓塞综合征是原发性肝癌经动脉化疗栓塞术后的常见并发症,主要表现为术后发热、肝区疼痛、恶心呕吐、便秘、肝功能损害等。目前西医尚无特效的治疗方法,多以对症支持治疗为主。天津中医药大学第一附属医院方文岩教授临证三十余年,尤擅中西医结合治疗晚期恶性肿瘤及其并发症,对于肝癌的介入治疗及经动脉化疗栓塞术后并发栓塞综合征的临床处理颇有经验,深受患者好评。对肝癌患者的经动脉化疗栓塞术后并发栓塞综合征进行治疗,因患者体质不同,证型不一,当遵“知犯何逆,随证治之”之原则,灵活辨证处方。方教授认为肝癌的发生是以肝郁气滞为核心的长期缓慢病理改变的最终结果,认为肝瘀气滞、湿热内阻证是肝癌患者经动脉化疗栓塞术后并发栓塞综合征较为常见的证型之一。大柴胡汤出自《伤寒论》,有和解少阳、内泻热结之功,气血同治之妙。方教授认为肝癌以肝郁气滞为发病基础,患者常伴肝络瘀阻和神不内守的临床表现,病性总属本虚标实,运用大柴胡汤化裁治疗肝癌经动脉化疗栓塞术后并发肝瘀气滞、湿热内阻型的栓塞综合征效果显著。兹就方师临床应用思想试作浅析,并附验案一则,以期为经方在治疗恶性肿瘤方面的应用提供理论参考。

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。

Effects of Dachaihu Decoction and Its “Prescription Elements” on Intestinal Flora of Nonalcoholic Fatty Liver Disease Model Rats

Objective:The study objective was to observe the effect of Dachaihu decoction and its "prescription elements" on intestinal flora of model rats with nonalcoholic fatty liver disease (NAFLD). Materials and Methods:Healthy male Sprague-Dawley rats were randomly divided into the following seven groups (n=105):normal, model, pioglitazone hydrochloride (PH), Shuganlidan, Jianpihuatan, Tongfuxiezhuo, and dachaihu decoction (DD). 16SrRNA high-throughput IIlumina sequencing platform was used for sequencing, and bioinformatics analysis of rat intestinal flora was done. Results:Compared with the normal group, rats in the model, PH, Shuganlidan, Jianpihuatan, Tongfuxiezhuo,and DD groups showed significant differences in the intestinal microflora structure. The microorganisms that play an important role in the normal group are Ruminococcaceae, Oscillospira, Lactobacillales, Lactobacillaceae, Lactobacillus, bacilli, Ruminococcus, TM7, Spirochaetes,Clostridium, Elusimicrobia, Elusimicrobiaceae, Elusimicrobiales, Lactobacillus helveticus, Lactobacillus reuteri, Elusimicrobium, RF39, and Christensenellaceae;in the model group are Ruminococcus gnavus;in the PH group are Prevotella, Paraprevotellaceae, and Blautia;in the Jianpihuatan group are Bacteroidetes, Bacteroidia, Bacteroidales, Roseburia, Rikenellaceae, and?Stridium methylpentosum;in the TongfuXiezhuo group are Bacteroidaceae, Bacteroides, Porphyromonadaceae, Parabacteroide, 4C0d2, Cyanobacteria, YS2, Parabacteroides distasonis,Bacteroides uniformis, Verrucomicrobiaceae, Verrucomicrobiae, Verrucomicrobiales, Akkermansia, Akkermansia muciniphila, Coprobacillus,Parabacteroides gordonii, Blautia producta, and Ruminococcus torques;and in the DD group are Erysipelotrichales, Erysipelotrichi, and Erysipelothrichaceae. Conclusion:The Tongfuxiezhuo prescription elements of the DD significantly improved the intestinal flora of rats with NAFLD, improving the relative abundance of beneficial bacteria in the intestinal flora of NAFLD rats such as Bacteroides, Sartre genus,Vibrio pseudobutyrate bacteria, and Akkermansia muciniphila. This subsequently improved the glucose and lipid metabolism in NAFLD rats,reducing fat deposition in the liver, inhibiting intestinal inflammatory reaction, and maintaining the integrity of intestinal mucosal barrier. The action target is the intestinal axis of "intestinal–hepatic axis."

大柴胡汤通过TLR4/NF-κB通路改善重症中暑大鼠炎症的机制研究

目的观察大柴胡汤对重症中暑大鼠炎症的治疗效果并探寻其作用机制。方法SPF级SD雄性大鼠60只随机分为空白对照组、模型组、中药低剂量组、中药高剂量组。将大鼠置于高温气候动物培养箱内[温度(40.50±0.50)℃,湿度(65.00±2.00)%]制备经典中暑模型,模型制备成功后6 h开始灌胃给药,8 h 1次,连续2 d。在造模成功后6、24、48 h各处死5只大鼠,检测血清白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α),同时取回肠组织,采用蛋白质免疫印迹试验测定肠道组织中TLR4、核转录因子-κB(NF-κB)蛋白表达。结果与空白对照组比较,模型组、中药低剂量组和中药高剂量组各时间点血清IL-1、TNF-α水平和肠道组织中TLR4、NF-κB蛋白表达水平均升高(P<0.05或P<0.01);中药低、高剂量组造模后24、48 h血清TNF-α、IL-1水平和肠道组织中TLR4、NF-κB的蛋白表达水平均较模型组显著下降(P<0.05)。中药高剂量组TNF-α、TLR4、NF-κB蛋白表达水平在造模后24、48 h较低剂量组明显下降,而IL-1水平在造模后48 h明显下降(P<0.05)。结论大柴胡汤能抑制TLR4/NF-κB信号通路,减轻肠道炎症反应,从而起到保护重症中暑大鼠的作用。

腹腔镜阑尾切除术联合大柴胡汤加减方辅助治疗在复杂性阑尾炎患者中的应用效果

目的:探讨腹腔镜阑尾切除术联合大柴胡汤加减方辅助治疗在复杂性阑尾炎患者中的应用效果。方法:选取2020年1月—2023年1月铜仁市人民医院收治的55例复杂性阑尾炎患者,按随机数表法分为对照组(n=28)与观察组(n=27)。对照组予以腹腔镜阑尾切除术治疗,观察组在对照组基础上加用大柴胡汤加减方辅助治疗。比较两组术后恢复情况、炎症水平、术后疼痛评分及并发症发生情况。结果:观察组首次排气时间、首次排便时间、肠鸣音恢复时间及饮食恢复时间均早于对照组,差异有统计学意义(P<0.05)。术后7 d,观察组C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞计数(WBC)水平低于对照组,差异有统计学意义(P<0.05);术后24 h、48 h,观察组视觉模拟评分法(VAS)评分均低于对照组,差异有统计学意义(P<0.05)。观察组并发症总发生率低于对照组,差异有统计学意义(P<0.05)。结论:腹腔镜阑尾切除术联合大柴胡汤加减方辅助治疗可加快复杂阑尾炎患者术后排气、排便,促进炎症消退,减轻疼痛症状,且并发症少。

大柴胡汤联合穴位贴敷治疗肝胃郁热型2型糖尿病的临床效果

目的观察大柴胡汤联合穴位贴敷治疗肝胃郁热型2型糖尿病的临床效果。方法选取2022年2月—2023年1月抚州市中医医院收治的肝胃郁热型2型糖尿病患者97例为研究对象,根据随机数字表法分为观察组49例和对照组48例。对照组给予盐酸二甲双胍、格列美脲治疗,观察组在对照组基础上给予大柴胡汤联合穴位贴敷治疗,2组均治疗12周。比较2组临床疗效,治疗前后空腹血糖、餐后2 h血糖、糖化血红蛋白、空腹胰岛素(FINS)、血脂指标[三酰甘油(TG)、总胆固醇(TC)]及中医证候积分。结果观察组总有效率为93.88%,高于对照组的77.08%(χ^(2)=5.538,P=0.019)。治疗12周后,2组空腹血糖、餐后2 h血糖、糖化血红蛋白、FINS、TG、TC水平及中医证候积分低于治疗前,且观察组低于对照组(P<0.05或P<0.01)。结论大柴胡汤联合穴位贴敷治疗肝胃郁热型2型糖尿病疗效确切,可显著改善血糖、血脂水平,改善胰岛素分泌功能及中医证候。

大柴胡汤联合非诺贝特治疗高脂血症患者的效果

目的:观察大柴胡汤联合非诺贝特治疗高脂血症患者的效果。方法:选取2021年5月至2023年3月该院收治的60例高脂血症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30例。对照组使用非诺贝特治疗,研究组在对照组基础上联合大柴胡汤治疗,比较两组临床疗效、治疗前后血脂指标[总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和三酰甘油(TG)]水平、炎性指标[胱抑素C(CysC)、同型半胱氨酸(Hcy)、C反应蛋白(CRP)和降钙素原(PCT)]水平、不良反应发生率和血清脂联素(APN)水平。结果:研究组治疗总有效率为93.33%(28/30),高于对照组的73.33%(22/30),差异有统计学意义(P<0.05);治疗后,研究组TC、TG、LDL-C水平均低于对照组,HDL-C水平高于对照组,差异有统计学意义(P<0.05);治疗后,研究组CysC、Hcy、CRP、PCT水平均低于对照组,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);治疗后,两组血清APN水平均高于治疗前,且研究组高于对照组,差异有统计学意义(P<0.05)。结论:大柴胡汤联合非诺贝特治疗高脂血症患者可提高治疗总有效率和血清APN水平,改善血脂指标水平,降低炎性指标水平,效果优于单纯非诺贝特治疗。

大柴胡汤合针刺治疗肝郁胃热型多囊卵巢综合征临床观察

目的 观察大柴胡汤加减合针刺治疗肝郁胃热型多囊卵巢综合征的临床效果。方法 选取山西省汾阳医院2020年1月—2023年1月收治的80例肝郁胃热型多囊卵巢综合征患者,按照随机数字表法分为研究组与对照组,均40例。对照组采用针刺治疗,研究组联用大柴胡汤加减治疗,对比2组临床疗效。结果 研究组治疗总有效率较对照组更高(P<0.05)。研究组月经周期及两侧卵巢体积改善较对照组更高(P<0.05)。研究组中医证候积分较对照组更低(P<0.05)。研究组FSH、LH水平较对照组更低(P<0.05)。结论 大柴胡汤加减联合针刺治疗肝郁胃热型多囊卵巢综合征,能够显著促进患者经期和卵巢正常化,改善其临床症状,减轻卵巢功能衰退程度,具有良好的临床实用价值。

大柴胡汤加减结合常规西药治疗2型糖尿病的疗效及对临床症状积分、胰岛β细胞功能指标的影响

目的 探讨大柴胡汤加减结合常规西药治疗2型糖尿病的疗效及对临床症状积分、胰岛β细胞功能指标的影响。方法 选择2022年9月—2023年9月辽阳市中心医院收治的98例2型糖尿病患者为研究对象,以随机数表法分为两组,各49例。对照组用常规西药治疗,观察组用大柴胡汤加减结合常规西药治疗,比较两组的疗效及临床症状积分、胰岛β细胞功能指标。结果 观察组有效率高于对照组,差异有统计学意义(P<0.05);观察组治疗12周的临床症状积分低于对照组,差异有统计学意义(P均<0.05);观察组治疗4周、治疗12周胰岛β细胞功能指数高于对照组,差异有统计学意义(P均<0.05)。不良反应发生率组间比较,差异无统计学意义(χ^(2)=0.178,P=0.674)。结论 大柴胡汤加减结合常规西药治疗2型糖尿病的疗效较高,可降低临床症状积分,改善胰岛β细胞功能指标,且具有较高的安全性。

基于少阳阳明合病论治胆汁淤积型急性胰腺炎

急性胰腺炎为消化科常见危急重症之一,常见病因主要为胆石症、高三酰甘油血症及过度饮酒,单纯胆汁淤积导致的胰腺炎较为少见。目前中西医结合为此病主要的治疗手段,中医药在该病的治疗方面发挥重要作用,应充分挖掘其优势。少阳阳明合病为此病重要病机,大柴胡汤为主要治疗方剂,此文通过病位剖析、证治特点及结合具体临床医案对其进行深入阐释,以期为同道在此病的治疗方面提供一定思路。

急性胰腺炎患者使用复方大柴胡汤进行治疗的效果分析

目的研究并分析复方大柴胡汤治疗急性胰腺炎的临床效果。方法随机选取2021年1月—2023年11月武山县中医医院收治的100例急性胰腺炎患者为研究对象,按照随机数表法分为两组,每组50例。对照组给予常规西药治疗,研究组在常规西药治疗的基础上联合复方大柴胡汤治疗,对比两组临床治疗效果、症状改善时间、炎症因子指标水平。结果研究组临床治疗效果(98.00%)优于对照组(86.00%),差异有统计学意义(χ^(2)=4.891,P=0.026)。与对照组相比,研究组临床症状改善时间更短,炎症因子指标水平更优,差异有统计学意义(P均<0.05)。结论对急性胰腺炎患者使用复方大柴胡汤治疗,能够有效降低患者炎症指标水平,缓解相关临床症状,具有良好的临床治疗效果。

中药联合常规治疗在梗阻性黄疸患者中的应用效果

目的:分析中药联合常规治疗在梗阻性黄疸患者中的应用效果。方法:选取2022年1月—2023年7月天津市中西医结合医院收治的梗阻性黄疸患者94例作为研究对象,随机分为常规组与联合组,各47例。常规组实施常规治疗,联合组在常规组基础上给予中药治疗。比较两组中医证候积分、治疗效果、肝功能指标[天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)]。结果:治疗前,两组中医证候积分比较,差异无统计学意义(P>0.05);治疗后,两组中医证候积分下降,联合组低于常规组,差异有统计学意义(P<0.05)。联合组治疗总有效率高于常规组,差异有统计学意义(P=0.035)。治疗前,两组AST、ALT水平比较,差异无统计学意义(P>0.05);治疗后,两组AST、ALT下降,联合组低于常规组,差异有统计学意义(P<0.05)。结论:中药联合常规治疗在梗阻性黄疸疾病中的应用效果显著,能够减轻临床症状,改善肝功能指标。

加减大柴胡汤对胆总管结石患者湿热证候及肝功能的影响

目的:探究加减大柴胡汤对胆总管结石湿热证患者热证候及肝功能的影响。方法:选取江苏省苏州市相城区第二人民医院2021年6月—2023年6月符合标准的118例胆总管结石湿热证患者作为研究对象。所有患者进行基础治疗:根据患者病情进行必要的抗感染、止痛、保肝治疗以及手术治疗。另外实施加减大柴胡汤治疗。观察加减大柴胡汤治疗前后的总有效率、中医症候积分、肝功能指标变化、炎性因子水平变化、并发症。结果:加减大柴胡汤治疗后总有效率(96.61%)高于治疗前(89.83%),经χ^(2)检验,差异有统计学意义(χ^(2)=4.291,P=0.038)。加减大柴胡汤治疗后的中医症候积分均低于治疗前,经t检验,差异有统计学意义(P<0.05)。加减大柴胡汤治疗后的肝功能指标丙氨酸转氨酶、天冬氨酸转氨酶、总胆红素、γ谷氨酰转移酶均低于治疗前,经t检验,差异有统计学意义(P<0.05)。加减大柴胡汤治疗后的白细胞介素-6、肿瘤坏死因子-ɑ低于治疗前,白细胞介素-10高于治疗前,差异显著,P<0.05。118例患者中急性胰腺炎2例,急性胆管炎3例,并发症总发生率为4.24%。结论:加减大柴胡汤能够显著改善胆总管结石湿热证患者的肝功能,减轻炎症反应,且并发症少,安全性高,能够提升治疗效果,促进患者康复。

基于HPLC-FT-ICR-MS技术分析中药复方大柴胡汤中的化学成分

目的运用高效液相色谱联用傅里叶变换离子回旋共振质谱法(HPLC-FT-ICR-MS)对中药复方大柴胡汤中的化学成分进行快速鉴别。方法采用ZORBAX SB_C_(18)色谱柱(250 mm×4.6 mm,5μm),以乙腈-水(含体积分数0.1%甲酸)作为流动相进行梯度洗脱,流速为1.0 mL·min^(-1)。采用ESI源分别在正、负离子模式下采集数据。结果根据化合物保留时间、精确分子量以及二级碎片离子信息,结合对照品和相关文献,在大柴胡汤中共鉴定出163个化合物,包括黄酮及其苷类88个,蒽醌类18个,单萜苷类16个,鞣质类10个,五环三萜类8个,苯丙素类8个,姜辣素类5个,其他10个。结论运用HPLC-FT-ICR-MS技术能够快速、准确鉴定大柴胡汤化学成分,对该复方质量控制以及药效物质基础研究具有重要意义。

基于Meta分析探讨大柴胡汤加减联合西药对治疗2型糖尿病的优势

目的:系统评价大柴胡汤及加减联合西药治疗2型糖尿病的临床疗效。方法:计算机检索中国知网、维普、万方、中国生物医学文献数据库、PubMed等数据库,同时辅助人工检索,收集大柴胡汤及加减联合糖尿病基础用药治疗2型糖尿病的随机对照研究,采用RevMan5.3软件进行Meta分析。结果:共纳入14个随机对照研究,共1286例患者。Meta分析显示大柴胡汤及加减联合西药在改善空腹血糖、餐后2 h血糖、糖化血红蛋白的效果及降血糖的有效率优于对照组;身体质量指数的降低,总体效果优于对照组;胰岛素抵抗指数、β-细胞功能指数优于单纯西药治疗。在不良反应方面,与对照组差异无统计学意义。结论:在联合单纯西医降血糖药治疗中加用大柴胡汤及加减方在有效降低2型糖尿病患者糖化血红蛋白、餐后2 h血糖和空腹血糖水平的同时,可减低身体质量指数,增加胰岛素敏感性,提高β细胞的分泌,且用药安全。然而由于研究数量少,方法学质量低,本系统回顾的结果需要由质量更高的大型随机对照研究来进一步证实。