Danggui Niantong decoction ameliorates joint inflammation and cardiopulmonary injury in TNF-Tg mice

Objective:Rheumatoid arthritis(RA)is a common autoimmune disease characterized by multiple joint lesions and systemic complications.Danggui Niantong decoction(DGNTT)has been clinically used for RA treatment;however,its beneficial effect on cardiopulmonary complications has not been reported.Methods:Female tumor necrosis factor-transgenic(TNF-Tg)mice were used to evaluate the therapeutic effects of DGNTT on arthritis and cardiopulmonary complications.Methotrexate(MTX)served as a positive control.Histopathological assessment of the joint sections was performed using hematoxylin and eosin(HE),Alcian Blue/Orange G,and tartrate-resistant acid phosphatase staining.Bone mass was assessed by micro-computed tomography,inflammatory infiltrates in the heart and lungs were evaluated by HE staining,cardiopulmonary fibrotic injury was identified by Masson’s trichrome staining,and hypertrophy of mouse cardiomyocytes was measured by wheat germ agglutinin(WGA)staining.Results:DGNTT mitigated the inflammation of the ankle joint synovium,decreased the number of osteoclasts,and increased the area of cartilage and bone mass in TNF-Tg mice.In addition,DGNTT decreased the infiltration of inflammatory cells into the lung and heart tissues,accompanied by a reduction in cardiopulmonary fibrosis and myocardial cell hypertrophy in TNF-Tg mice.As a positive control drug,MTX attenuated the pathological changes in joints,but had no beneficial effect on cardiopulmonary inflammation and fibrosis in TNF-Tg mice.Conclusions:DGNTT improved joint lesions and alleviated cardiopulmonary complications in TNF-Tg mice.

Study on the Molecular Mechanism of Danggui Buxue Decoction in Intervention of Perimenopausal Syndrome Based on Network Pharmacology and Molecular Docking

[Objectives]This study was conducted to explore the intervention mechanism of Danggui Buxue Decoction in perimenopausal syndrome based on network pharmacology and molecular docking.[Methods]The chemical components and targets of Danggui Buxue Decoction were acquired through the TCMSP database,and the main targets of perimenopausal syndrome were obtained through the GeneCards database.The component targets and disease targets were intersected,and combining with active components and Chinese herbs in the decoction,a traditional Chinese medicine-component-target network was constructed using Cytoscape 3.7.1 software.The STRING platform was employed for protein-protein interaction analysis.The DAVID analysis platform was used to conduct target GO and KEGG enrichment analysis,so as to predict the action mechanism Danggui Buxue Decoction.Finally,an active component-disease target-signal pathway network diagram was constructed.[Results]Twenty two components in Danggui Buxue Decoction related to perimenopausal syndrome and 120 corresponding targets were obtained,including active components such as 1,7-dihydroxy-3,9-dimquercetin and kaempferol,and key targets such as TNF,ESR1 and PPARG.The results of GO analysis and KEEG analysis indicated that Danggui Buxue Decoction might regulate the transcription of RNA polymerase II promoter,DNA templating,gene expression,signal transduction,hypoxia response and other biological processes by regulating multiple signal pathways such as chemical carcinogenesis-receptor activation,cancer pathways,lipid and atherosclerosis,tryptophan metabolism,malaria,steroid hormone biosynthesis and chemical carcinogenesis-DNA adduct.[Conclusions]Danggui Buxue Decoction intervenes in perimenopausal syndrome through multiple components,targets and pathways,providing a basis for elucidating the intervention mechanism of Danggui Buxue Decoction and expanding its clinical application.

Study on Extraction Technology for Polysaccharide from Blood-Supplementing Angelica Sinensis Decoction

Purpose:Optimize water-alcohol technology for extracting polysaccharide from blood-supplementing angelica sinensis decoction to improve the extraction rate.Method:Draw the standard curve of glucose reference substance and build the regression equation to calculate the polysaccharide content.Investigate the effect of water addition times,extraction duration,extraction times,ethanol concentration for ethanol precipitation and times of ethanol precipitation on the extraction rate of polysaccharide.Result Add 8 times the medicinal material quality of water,and perform 2 extractions for 120min each time;it shows that conducting 2 ethanol precipitations with 80%ethanol concentration results in the maximum polysaccharide content,indicating the best extraction condition.Conclusion:The experiment establishes an easy and convenient water-alcohol method for extracting polysaccharide from blood-supplementing angelica sinensis decoction,and lays a research foundation on pharmacodynamics of polysaccharide in blood-supplementing angelica sinensis decoction.

Danggui Buxue decoction promotes proliferation and differentiation of Caco-2 cells and antagonizes obesity by stimulating apolipoprotein-IV expression

Background:Chinese medicine has been proposed as a novel approach to the prevention of metabolic disorders such as obesity.Danggui Buxue decoction,a decoction prepared from Huangqi(Astragali Radix)and Danggui(Angelicae Sinensis Radix),has been used to nourish vitality and enhance blood circulation in traditional Chinese medicine.However,the effect of Danggui Buxue decoction on obesity is still primarily unknown.Methods:Cell proliferation,differentiation,and apolipoprotein-IV transcription were investigated to explore the function of Danggui Buxue decoction by methyl thiazolyl tetrazolium assay,alkaline phosphatase assay,and luciferase assay,respectively.Results:Danggui Buxue decoction promoted cell growth by up to 15%(P=0.034)and induced cell differentiation by up to 38%(P=0.006)at 0.3 mg/mL.Moreover,Danggui Buxue decoction enhanced the transcription of apolipoprotein-IV by 2.4 times(P=0.027),activating its promoter by 28.9%(P=0.031)at 0.3 mg/mL.In addition,Danggui Buxue decoction functioned in a dose-dependent manner.Conclusion:These results suggest that Danggui Buxue decoction promotes cell differentiation by enhancing apolipoprotein-IV transcription and alkaline phosphatase activity,and it may also have a potential anti-obesity effect because apolipoprotein-IV transcription is closely related to the reduction of food intake.

Mechanism of Danggui Sini Decoction(当归四逆汤)for Atherosclerosis Obliterans Based on Network Pharmacology and Molecular Docking

Objective:Based on network pharmacology and molecular docking,we want to explore the pharmacological effects and mechanism of Danggui Sini Decoction in the treatment of lower extremity arteriosclerosis obliterans.Methods:Using TCMSP database to search the main active components of Danggui Sini Decoction(当归四逆汤,DSD)and their related targets,Cytoscape3.8.1 software was used to construct a"component-disease-target"interaction network.Meanwhile,DAVID database was used to enrich the key target genes with GO and KEGG functions.And we used Auto Dock Tools 1.5.6 for molecular docking.Results:A total of 45 candidate active molecules and 250 potential target proteins related to ASO were screened.Key genes such as TNF,IL6,VEGFA,MMP9,IL1B,CCL2,CXCL8,ICAM1,VCAM1,and IL10 are mainly through TNF signaling pathway,HIF-1 signaling pathway,cytokine-cytokine receptor interaction,Toll-like receptor signaling pathway,NF-kappa B signaling pathway,MAPK signaling pathway and other biological pathways exert their effects.The results of molecular docking showed that 5UUI-sesamin,5UUI-paeoniflorin,4XCT-sesamin,and 4XCT-sesamin have extremely strong binding ability.Conclusion:Danggui Sini Decoction(当归四逆汤,DSD)can synergistically exert pharmacological effects through multiple components,multiple targets,and multiple pathways.On the basis of regulating immunity and inhibiting smooth muscle proliferation,it can prevent the occurrence and development of ASO.

Danggui Sini decoction treatment of refractory allergic cutaneous vasculitis:A case report

BACKGROUND Allergic cutaneous vasculitis(ACV)is a difficult disease to treat.At present,there is no effective treatment for this condition.Traditionally,immunosuppressants and hormones have been primarily used in its management,but the treatment effect is suboptimal,and it has several side effects.CASE SUMMARY We present the case of a 19-year-old woman who presented at our hospital with a four-year history of symmetric skin lesions mainly affecting her lower extremities.She had previously undergone treatment with prednisolone acetate,cetirizine hydrochloride,and loratadine tablets but had not experienced any relief in her condition.Thereafter,she was treated with oral traditional Chinese medicine.Her skin damage gradually improved within two months of treatment initiation.After six months,the skin ulcers had completely subsided.No evidence of skin ulcer recurrence was observed during the subsequent follow-up.This report presents the first case of a female patient who received oral Danggui Sini decoction for the treatment of ACV.CONCLUSION Danggui Sini decoction may be a promising oral treatment for ACV patients.

Dissecting the underlying pharmaceutical mechanism of Danggui Buxue decoction acting on idiopathic pulmonary fibrosis with network pharmacology

Backgroud:Danggui Buxue decoction(DBD),a classical prescription in traditional Chinese medicine,has been found to have protective effect on bleomycin-induced pulmonary fibrosis in rats by reducing alveolar inflammation and fibrosis.However,the biological activity of individual chemical components and mechanism of action of whole formula are not clear.Methods:Potential targets of active ingredients of DBD were collected through Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform and SymMap database.Target genes related to idiopathic pulmonary fibrosis were obtained from the Online Mendelian Inheritance in Man database,Therapeutic Targets Database and Gkb database.Then,the common targets were obtained by overlapping the potential targets of active ingredients in DBD and diseases related targets.The selected targets were subjected to Kyoto Encyclopedia of Genes and Genomes signaling pathway and Gene Ontology analysis,and the network map of active component-target-pathway was established using Cytoscape 3.7.1 software.The active components of DBD with most targets were selected for fibrosis-related marker verification.The mRNA and protein expression of fibrosis markers,α-smooth muscle actin,collagen 1 and fibronectin,were detected in TGF-β1-induced fibroblast cell line after treatment with the active components.Results:The 14 active ingredients,such as quercetin and kaempferol,were screened from DBD.It acts on 26 targets like estrogen receptor 2 and prostaglandin-endoperoxide synthase 2,and mainly involves 38 signaling pathways such as cell inflammation and autophagy.Kaempferol and quercetin are the two compounds with the highest network regulation,which can inhibit the transformation of fibroblasts into myofibroblasts and reduce the expression of fibrosis markersα-smooth muscle actin,collagen 1 and fibronectin.Conclusion:The integration mode of multi-component,multi-target,multi-channel and mechanism of DBD in the treatment of idiopathic pulmonary fibrosis are predicted by means of network pharmacology.Our study could indicate the direction of further anti-fibrotic mechanism research.

Potential Mechanism of Danggui Buxue Decoction in Treating Iron Deficiency Anemia Based on Network Pharmacology and Molecular Docking Technology

[Objectives]To explore the potential mechanism of Danggui Buxue Decoction in treating the iron deficiency anemia(IDA)based on network pharmacology and molecular docking technology.[Methods]The active components and target proteins of Danggui Buxue Decoction were searched in databases such as TCMSP,OMIM,GeneCards,Drugbank,String,Metascape,etc.,and the target proteins shared with IDA were screened out,and the information about the signal pathways and biological functions of these target proteins was obtained.[Results]17 active components of Danggui Buxue Decoction and 24 potential targets for the treatment of IDA were obtained.With the aid of String database and Cytoscape software,the protein interaction network was obtained and the network topology analysis was performed.Four potential core targets with higher scores were obtained,namely F2,NOS2,NOS3,and PPARG.Using the Metascape database,GO function enrichment analysis and KEGG pathway enrichment analysis were performed on the potential targets of Danggui Buxue Decoction in the treatment of IDA,and the important biological processes,cell composition,molecular functions and signal pathways related to the target were screened through the R language.The results show that biological processes are related to positive regulation of growth,cell composition is related to membrane microdomain,and molecular functions are related to oxidoreductase activity.The signal pathways involved are mainly AGE-RAGE signal pathway,TNF signal pathway and IL-17 signal pathway.Finally,the molecular docking results confirmed that the active components of Danggui Buxue Decoction have a good binding ability with the target.[Conclusions]Danggui Buxue Decoction treats the IDA through multiple components,multiple targets,multiple signal pathways,and multiple biological functions.

Exploring the mechanism of Danggui Buxue Decoction in treating osteoporosis from vitamin D-axis

Osteoporosis is a common disease in the middle-aged and elderly population and is a global health problem that needs to be solved urgently.Vitamin D deficiency is closely related to osteoporosis,and it is of practical significance to prevent and treat kidney and strengthen bone therapy.A large number of literature have confirmed that qi and blood to represent Danggui Buxue Decoction has a reliable therapeutic effect on osteoporosis,but the mechanism is still unclear.Based on the previous work of the research group,it is believed that the vitamin D axis may be a potential target for TCM Bushen Recipe.Syndrome and vitamin D deficiency have similar pathological changes,so it is suggested that Danggui Buxue Decoction may regulate osteoporosis by regulating the vitamin d axis.

Effect of Danggui Buxue Decoction on the expression of VDR,CYP27B1,CYP19,and ERβin the ovary of osteoporosis rats

Investigate the effects of the classic ancient prescription Danggui Buxue decoction on the vitamin D receptor,25-hydroxyvitamin D-1αhydroxylase,estrogen synthesis aromatase and estrogen receptorβmRNA and protein expression in osteoporotic rats.The classic ancient prescription Danggui Buxue decoction may affect the levels of estrogen synthesis aromatase,estrogen receptorβ,FSH,and Klotho in the body through regulating the expression of ovarian vitamin D receptor and 25-hydroxyvitamin D-1αhydroxylase to achieve the therapeutic effect of retinoic acid-induced osteoporosis in rats.The results of this experiment showed that compared with the control group,the serum FSH level of the model group was significantly increased,the Klotho level was decreased,the relative expression of ovarian tissue CYP27B1,CYP19,ERβmRNA and protein was significantly reduced,and the relative expression of vitamin D receptor mRNA and protein was significantly rise.After the intervention of the classic ancient prescription Danggui Buxue decoction and vitamin D,compared with the model group,the serum FSH content decreased,Klotho content increased,ovarian CYP27B1,CYP19,ERβmRNA and protein expression significantly increased,ovarian vitamin D receptor mRNA and protein expression significantly decreased.Based on the effect of the classic ancient prescription Danggui Buxue decoction on the vitamin D system,combined with the results of this experiment,it is concluded that the classic ancient prescription Danggui Buxue decoction may affect the levels of CYP19,ERβ,follicle-stimulating hormone,and Klotho in the body by regulating the expression of ovarian VDR and CYP27B1.The specific mechanism of the treatment of ovarian injury in osteoporosis rats needs further study.Background:Investigate the effects of the classic ancient prescription Danggui Buxue decoction on the vitamin D receptor,25-hydroxyvitamin D-1αhydroxylase,estrogen synthesis aromatase and estrogen receptorβmRNA and protein expression in osteoporotic rats.Methods:The experiment was divided into 6 groups:control group,model group(retinoic acid 100 mg/kg/d),vitamin D group(calcitriol 30 ng/kg/d),the classic ancient prescription Danggui Buxue decoction high,middle and low dose group(7.2 g/kg/d,3.6 g/kg/d,1.8 g/kg/d).Enzyme-linked immunosorbent assay method was used to detect the effects of different doses of the classic ancient prescription Danggui Buxue decoction on serum follicle-stimulating hormone and Klotho levels in retinoic acid-induced osteoporosis rats;real-time fluorescence quantitative PCR was used to detect the classic ancient prescription Danggui Buxue decoction on retinoic acid effect of ovary vitamin D receptor,25-hydroxyvitamin D-1αhydroxylase,estrogen synthesis aromatase,estrogen receptorβmRNA expression in induced osteoporosis rats;Western-blot detection of the classic ancient prescription Danggui Buxue decoction on retinoic acid-induced osteoporosis ovary vitamin D receptor,CYP27B,estrogen synthesis aromatase,estrogen receptorβprotein The impact of expression.Results:Compared with the control group,the serum follicle-stimulating hormone level of the model group was significantly increased,the Klotho level was decreased,the relative expression levels of 25-hydroxyvitamin D-1αhydroxylase,estrogen synthesis aromatase,estrogen receptorβmRNA and protein in the ovarian tissue were significantly decreased,and the relative expression levels of vitamin D receptor mRNA and protein were significantly increased.After the intervention of the classic ancient prescription Danggui Buxue decoction and vitamin D,compared with the model group,the serum follicle-stimulating hormone content decreased,Klotho content increased,ovarian 25-hydroxyvitamin D-1αhydroxylase,estrogen synthesis aromatase,estrogen receptorβmRNA and protein expression significantly increased,ovarian vitamin D receptor mRNA and protein expression significantly decreased.Conclusion:The classic ancient prescription Danggui Buxue decoction may affect the levels of estrogen synthesis aromatase,estrogen receptorβ,follicle-stimulating hormone,and Klotho in the body through regulating the expression of ovarian vitamin D receptor and 25-hydroxyvitamin D-1αhydroxylase to achieve the therapeutic effect of retinoic acid-induced osteoporosis in rats.

Comprehensive analysis of the potential biological mechanism of Danggui Buxue Decoction in the treatment of Thalassemia

Background:This study aimed to deeply explore the active components of Danggui Buxue Decoction(DBD)through systematic network pharmacology and molecular docking methods and to demonstrate its mechanism of regulating Thalassemia.Methods:Obtain and screen the active ingredients and targets of DBD from the TCMSP database.Use the GeneCards database to search for the gene corresponding to the target.The target protein-protein interaction(PPI)network was built using STRING database.A DBD-drug-Tha-target PPI network was established,and its core target network was analyzed using Cytoscape software.Then,enrichment analysis of DBD core targets was performed by Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG),and their binding activities were verified by molecular docking.Results:Finally,19 active ingredients and 504 targets were obtained from DBD,of which 98 targets were repeated with the related targets of Tha.The major genes include HSP90AA1,IL-6 and HRAS.Through the final analysis,we found that the main mechanisms of DBD in the treatment of thalassemia include increasing the expression of the γ-globin gene in red blood cells,inducing fetal hemoglobin and reducing the inflammatory response.Conclusion:The potential mechanism of DBD improving thalassemia can be preliminarily predicted by network pharmacology and molecular docking,which can provide some reference for clinical treatment.

基于化学成分与药理作用评价当归-黄芪药对配方颗粒汤剂与传统汤剂的差异

目的评价当归-黄芪药对配方颗粒汤剂(DGD)与传统汤剂在化学成分和药理效应方面的差异,为合理应用该配方颗粒提供参考。方法以原料来源批次统一和不统一2种对比方式,设不同样品组,采用高效液相色谱(HPLC)法建立特征图谱,从特征图谱相似度、成分种类、指标成分含量、共有峰面积等角度对化学成分进行评价;采用失血性血虚模型小鼠评价药效。结果①DGD特征图谱与传统汤剂相似度较高(相似度>0.87);②共有色谱峰数目不一致,传统汤剂-自购饮片和传统汤剂-A厂饮片共有色谱峰各12个,A厂DGD共有色谱峰15个,B厂DGD共有色谱峰10个;③A厂DGD中阿魏酸、毛蕊异黄酮苷含量高于传统汤剂(P<0.05);B厂DGD与传统汤剂阿魏酸含量差异无统计学意义,但毛蕊异黄酮苷含量较传统汤剂低(P<0.05);④DGD共有峰面积总和与传统汤剂相比,自购传统汤剂、A厂传统汤剂及A厂配方颗粒、B厂配方颗粒中各成分含量相对比值分别为1.00、0.96、2.14、0.60;⑤DGD及传统汤剂均能明显促进失血性贫血模型小鼠血红蛋白(Hb)、红细胞(RBC)恢复(P<0.01);与模型对照组比较,除B厂DGD组外均差异有统计学意义(P<0.05);A厂DGD与传统汤剂差异无统计学意义,B厂DGD与传统汤剂差异有统计学意义(P<0.01)。结论无论原料来源批次是否一致,DGD与传统汤剂在化学成分上均存在一定差异;在药理作用上,来源于同一批次饮片制备的DGD与传统汤剂对改善失血性贫血药效相当,来源于不同批次饮片制备的DGD与传统汤剂在药效上存在一定差异;不同来源批次的饮片和不同制备工艺造成不同厂家配方颗粒存在质量差异,说明国家统一配方颗粒质量标准及制定相关过程规范具有必要性与紧迫性。

经方治疗良性前列腺增生症的研究进展

正气不足、瘀血留结、水饮停留为良性前列腺增生症(benign prostate hyperplasia,BPH)发病的主要病机。正气不足为BPH发病之根本,以金匮肾气丸、真武汤化生肾气、温阳利水;瘀血留结是BPH发病的关键病机,以桂枝茯苓丸、抵当汤以化瘀消瘢、利窍通便;水饮停留为BPH最为紧急之症,治以五苓散、当归芍药散以化气利水,解标症之急。

断指再植术后应用当归四逆汤的临床疗效观察

目的探讨断指再植术后应用当归四逆汤的临床疗效。方法240例手指离断行断指再植术后的患者随机分为对照组与治疗组各120例。对照组常规应用抗炎、抗凝、抗痉挛等经典西药3抗治疗;治疗组在对照组常规治疗基础上加用当归四逆汤颗粒剂,1剂·d^(-1),分2次水冲服,1疗程10 d。1疗程后观察患者再植指成活率、感染率、血运情况、疼痛评分。结果治疗组与对照组再植指成活率、感染率差异无统计学意义(P>0.05);治疗组血运情况、疼痛评分优于对照组(P<0.05)。结论当归四逆汤有抗凝、抗血栓形成、扩张末梢血管、增加血管灌流量及镇痛、抗炎、解痉作用,可明显改善再植指的血液循环,减轻患者疼痛,符合断指再植术后的3抗治疗原则,临床疗效良好。

当归补血汤配合十枣汤治疗肝硬化顽固性腹水患者临床观察

目的探究当归补血汤配合十枣汤在肝硬化顽固性腹水患者临床治疗中的应用效果。方法选取邳州市中医院2021年3月—2022年3月收治的肝硬化顽固性腹水患者60例为研究对象,采取Excel软件随机分为中药组和西药组,各30例,西药组给予常规西药治疗;中药组给予当归补血汤配合十枣汤治疗。比较2组临床疗效。结果中药组治疗效果优于西药组(P<0.05);中药组治疗满意度高于西药组(P<0.05);中药组不良反应发生率低于西药组(P<0.05)。结论肝硬化顽固性腹水患者服用当归补血汤配合十枣汤治疗可显著提升满意度和治疗效果,调节血清电解质水平,值得临床推广。

当归芍药散在妇产科临床中的应用

当归芍药散出自《金匮要略》,由三味“血分药”和三味“水分药”组成,共奏肝脾调和、气血水同调之功。血虚为主者,三味水药量宜小,血滞者三味血药量宜大,湿盛浮肿者,三味水药应重用,以达药专力宏之效;水酒同煎,取其宣通药势。临床用于妇人腹痛、子肿、月经不调、更年期综合征等妇产科疾病,有良好效果。

基于特征图谱及化学模式识别的当归补血汤质量评价研究

目的:建立当归补血汤超高效液相色谱-串联四极杆飞行时间质谱(UPLC-Q-TOF-MS)的特征图谱,综合评价其质量。方法:采用Waters Acquity UPLC BEH C18柱(100 mm×2.1 mm,1.7μm),以0.1%甲酸水(A)-乙腈(B)溶液为流动相,梯度洗脱,流速为0.3 mL/min,进样量2μL;使用电离子喷雾源(ESI),负离子模式扫描。并以指纹图谱相似度评价软件结合聚类分析(HCA)、主成分分析(PCA)和偏最小二乘判别分析(PLS-DA)对11批当归补血汤进行评价。结果:通过对照品比对及软件预测,从当归补血汤中鉴别出24种成分。图谱标定出41个共有峰,指认出6个色谱峰,分别为毛蕊异黄酮葡萄糖苷、阿魏酸、芒柄花苷、毛蕊异黄酮、黄芪甲苷、芒柄花素。HCA、PCA和PLS-DA3种方法均将11批样品分为3类,对黄芪统货、选货和精品饮片进行了明显区分,说明当归补血汤的特征图谱与原药材的质量和等级具有强相关性。结论:构建的高分辨质谱的特征图谱结合化学模式识别方法快速高效全面,适用于当归补血汤整体质量的评价,同时也为中药复方质量标准建立与全程质量控制提供了重要支撑。

养血散寒通脉方治疗血虚寒凝型子宫内膜异位症的临床研究

【目的】观察养血散寒通脉方(由当归四逆加吴茱萸生姜汤加减而成)治疗血虚寒凝型子宫内膜异位症(EMS)的临床疗效。【方法】将120例血虚寒凝型EMS患者随机分为研究组和对照组,每组各60例。研究组给予养血散寒通脉方治疗,对照组给予少腹逐瘀颗粒治疗,疗程为3个月,并于疗程结束后随访1年。观察2组患者治疗前后各种疼痛评分[包括经期腹痛视觉模拟量表(VAS)评分和痛经、非经期盆腔痛、性交痛、盆腔压痛、骶韧带结节触痛分级评分]、卵巢子宫内膜异位囊肿大小及血清糖类抗原125(CA125)、血管内皮生长因子(VEGF)、可溶性细胞间黏附分子1(SICAM-1)、基质金属蛋白酶9(MMP-9)、组织金属蛋白酶抑制因子2(TIMP-2)水平的变化情况,并观察2组患者的临床疗效、安全性、复发情况及妊娠情况。【结果】(1)研究过程中,研究组脱落3例,对照组脱落5例,最终共112例患者纳入统计分析,其中研究组57例,对照组55例。(2)治疗3个月后,研究组的总有效率为92.98%(53/57),对照组为85.45%(47/55),组间比较,研究组的疗效明显优于对照组(P<0.05)。(3)治疗后,2组患者的各种疼痛评分(包括经期腹痛VAS评分和痛经、非经期盆腔痛、性交痛、盆腔压痛、骶韧带结节触痛分级评分)均较治疗前明显下降(P<0.05),且研究组的下降幅度均明显优于对照组(P<0.05)。(4)治疗后,2组患者的卵巢子宫内膜异位囊肿均略有缩小,但组内治疗前后及治疗后组间比较,差异均无统计学意义(P>0.05)。(5)治疗后,2组患者血清CA125、VEGF、SICAM-1、MMP-9水平均较治疗前下降(P<0.05),血清TIMP-2水平均较治疗前升高(P<0.05),且研究组对血清CA125、VEGF、SICAM-1、MMP-9水平的下降幅度及对血清TIMP-2水平的升高幅度均明显优于对照组(P<0.05)。(6)随访1年,研究组的复发率为30.19%(16/53),明显低于对照组的68.09%(32/47),组间比较,差异有统计学意义(P<0.05)。研究组21例有生育要求,其中14例妊娠,妊娠率为66.67%(14/21);对照组20例有生育要求,其中4例妊娠,妊娠率为20.00%(4/20);组间比较,研究组的妊娠率明显高于对照组,差异有统计学意义(P<0.05)。(7)治疗期间,2组患者均无明显不良反应发生,且患者的血、尿、大便常规及心电图、肝肾功能等安全性指标均无异常变化。【结论】养血散寒通脉方治疗血虚寒凝型EMS患者疗效确切,能够显著缓解患者各种疼痛症状,改善妊娠结局,有效调节血清CA125、VEGF、SICAM-1、MMP-9、TIMP-2水平。

当归四逆汤物质基础研究进展

当归四逆汤是治疗血虚寒厥证的代表方剂,具有温经散寒、养血通脉等功效。现代研究发现,其具有抗凝及抗血栓形成、改善末梢及全身血液循环、抗炎镇痛、解痉、提高神经传导速度等药理活性。在对当归四逆汤化学成分、药理作用综述的基础上,基于传统植物化学分离分析、血清药物化学、代谢组学、谱效关系、网络药理学和多靶点高通量筛选等技术方法,对当归四逆汤的药效物质基础予以总结和分析,为当归四逆汤的深入开发及相关制剂的质量控制等后续研究提供参考。参考文献49篇。

当归四逆汤加减治疗糖尿病足患者的疗效及对其血液流变学的影响

目的 观察当归四逆汤加减治疗糖尿病足(Diabeticfoot,DF)的疗效及对患者血液流变学的改善作用。方法 选取2021年3月—2023年3月期间在黑龙江中医药大学附属第一医院确诊并接受非手术治疗的DF患者82例,按随机数字表法分为对照组和观察组,每组各41例。对照组予以常规治疗,观察组给予常规治疗联合当归四逆汤加减方剂治疗。治疗8周后评价两组患者临床综合疗效,评价中医证候评分、创面局部症状评分,检测糖代谢相关指标[空腹血糖(Fasting postprandial blood glucose,FPG)、餐后2 h血糖(2-hour postprandial blood glucose,2 h PG)、糖化血红蛋白(Glycosylated hemoglobin A1c,HbA1c)],监测足远端动脉血流速度及踝肱指数(Ankle brachial index,ABI),检测血液流变学指标[全血黏度、血浆黏度(Plasma viscosity,PV)],检测血清炎症因子[白介素-1β(Interleukin-1β,IL-1β)、白介素-6(Interleukin-6,IL-6)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)]、血管内皮生长因子(Vascular endothelial growth factor,VEGF)和低氧诱导因子-1(Hypoxia inducible factor-1α,HIF-1α)。结果 治疗后两组患者中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组中医证候积分明显低于对照组,观察组降分幅度优于对照组,差异有统计学意义(P<0.05)。治疗后两组患者创面面积、肉芽形态、渗出、疼痛评分均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组创面面积、肉芽形态、渗出、疼痛评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者FPG、2 h PG、HbA1c指标均较治疗前降低,差异有统计学意义(P<0.05);但两组间比较,差异无统计学意义(P>0.05)。治疗后两组患者胫后动脉、足背动脉的平均血流速度及ABI均较治疗前升高,差异有统计学意义(P<0.05);且观察组胫后动脉、足背动脉的平均血流速度及ABI均明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者全血低切和高切黏度、PV指标均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组全血低切和高切黏度、PV指标均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清IL-1β、IL-6和TNF-α水平均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组血清IL-1β、IL-6和TNF-α水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清VEGF水平较治疗前升高,HIF-1α水平较治疗前降低,差异有统计学意义(P<0.05);且观察组VEGF水平明显高于对照组,HIF-1α水平明显低于对照组,差异有统计学意义(P<0.05)。治疗后观察组总有效率92.86%(39/42)明显高于对照组的76.19%(32/42),差异有统计学意义(P<0.05)。治疗期间,两组间不良反应发生率比较,差异无统计学意义(P>0.05)。结论 当归四逆汤加减方剂对DF具有一定的治疗作用,可能通过调节血液流变学,改善血液循环状态、抑制炎症反应、调节HIF-1α和VEGF表达等促进病情缓解。