Proteomics analysis of IBS-D with spleen and kidney yang deficiency

Objective:To investigate the molecular mechanism underlying the development of diarrhea-predominant irritable bowel syndrome (IBS-D) with spleen and kidney yang deficiency (SKYD) using a proteomics approach.Methods:Male Sprague-Dawley rats (n =22) were divided into IBS-D (n =12) and normal control (n =10) groups.SKYD was then modeled in IBS-D rats by a combination of acetic acid enema,bondage,rectal dilation,tail stimulation,and Senna gavage.Colon tissue samples were subsequently collected and examined by Q Exactive mass spectrometry to identify differentially expressed proteins between the two groups.Results:The occurrence of SKYD/IBS-D was associated with ribosomal protein S23 (Rps23),protein phosphatase 2 catalytic subunit alpha (Pp2a),and growth factor receptor-bound protein 2 (Grb2),which are involved in the ribosome,neurotrophin signaling,and Janus kinase-signal transducer and activator of transcription (JAK-STAT) signaling pathways.Conclusion:These data suggest that SKYD/IBS-D pathophysiology likely involves inflammation,cell growth,apoptosis,stress granule formation,immune activation,loss of epithelial cell integrity,and visceral hypersensitivity.

Regulating and tonifying spleen and kidney traditional Chinese medicine in the treatment of chronic uric acid nephropathy: A systematic review

Objective:To systematically evaluate the efficacy and safety of traditional Chinese medicine for regulating spleen and kidney.Methods:We developed a search strategy and then retrieved the database including CNKI,Wanfang data knowledge service platform,VIP journals resource integration service platform,PubMed,Embasefor randomized controlled trial of regulating spleen and kidney traditional Chinese medicine compared with conventional western medicine in the treatment of chronic uric acid nephropathy.The search deadline was set to June 30,2020.For the included literature,we applied the cochrane collaboration network risk bias assessment tool to evaluate the methodological quality,and evaluated the level of evidence according to GRADE standards.Quantitative data was analyzed by RevMan5.3 software,and trial sequential analysis method was used to analyze its efficiency.Results:A total of 709 cases in 10 articles were included.Compared with the control group,the related traditional Chinese medicine group improved the effective rate[RR=1.45,95%CI(1.32,1.58)],reduced the level of UA[MD=-36.24,95%CI(-41.03,-31.45)],BUN[SMD=-1.27,95%CI(-1.47,-1.07)]and SCR[MD=-36.33,95%CI(-55.79,-16.87),P=0.0003],the difference between the two groups was statistically significant(P<0.05).There was no evidence that a significant adverse reaction occurred.The results of TSA analysis showed that the Chinese medicine group had definite evidence for improving the efficiency.According to the GRADE evaluation criteria,the efficiency,UA,BUN and SCR outcome indicators were extremely low-quality evidence.Conclusions:Traditional Chinese medicine for regulating spleen and kidney in the treatment of chronic uric acid nephropathy improved efficiency,reduced the level of UA,BUN,SCR.Meanwhile,the therapy was proved to be safe.Nevertheless,the conclusions need further high-quality evidence to support.

Ectopic Spleen Mimicking Kidney Activity Post-Nephrectomy

Ectopic spleen may simulate kidney activity on renal scintigraphic imaging. Accurate diagnosis requires correlation with the patient’s history and anatomic imaging studies. We report a case where the spleen migrated to the left renal fossa and mimicked the left kidney after a left nephrectomy.

Water metabolism from lung,spleen and kidney

Water and liquid are the material basis of human metabolism.Traditional Chinese medicine believes that water and liquid metabolism is a very complex process that requires the synergy of the internal organs,but mainly the physiological functions of the lungs,spleen and kidneys.If the function or structure of the spleen,lungs,kidneys,or triple-burner is abnormal,it is easy to cause abnormalities in the body's water metabolism,which in turn leads to the production of pathological products such as damp phlegm.

Theoretical Discussion on Treatment of Cubital Tunnel Syndrome Based on Theory of Liver,Spleen and Kidney

Cubital tunnel syndrome is a disease in which ulnar nerve is compressed by its surrounding tissues,and its main clinical manifestations are pain,sensory disturbance and dyskinesia.Its incidence rate is the second highest among peripheral nerve entrapment diseases,and it is one of the common clinical diseases.The theory of liver,spleen and kidney can guide the treatment of cubital tunnel syndrome with traditional Chinese medicine and acupuncture.By discussing the traditional Chinese medicine(TCM)pathogenesis and treatment principles of cubital tunnel syndrome,it provides modern medical theoretical support for TCM treatment of cubital tunnel syndrome.

Summary and Prospect of Treating Ulcerative Colitis by Warming the Kidney and Strengthening the Spleen

The method of warming the kidney and strengthening the spleen is widely used in the treatment of ulcerative colitis (UC) with significant curative effect.This paper reviews the relevant literature in recent years.

从芍药甘草汤方证与药量探讨胞轮振跳的治疗

胞轮振跳是临床中的难治性疾病,该病严重影响患者的情绪及生活质量。目前临床治疗手段有限,西医多以手术为主,且容易反复,创伤性较大。中医药治疗该病不良反应少且疗效稳固。芍药甘草汤主治肝脾阴虚证,而胞轮振跳的病机之一则为肝脾阴虚,这是与芍药甘草汤证的契合点。因此,根据异病同治原则,该方治疗此类疾病是辨病与辨证结合的临床思路的体现。通过文献考证古今度量衡质量的单位换算,芍药(白芍)与炙甘草的用量需达60 g以上方可获得良好临床疗效。本文总结了芍药甘草汤的临床使用经验,并结合文献从方义与药量角度论证其治疗胞轮振跳的可行性与合理性。

基于“阳虚阴结”理论探析温阳法论治特发性膜性肾病

膜性肾病是成人肾病综合征常见的病理类型之一,其中病因未明者称为特发性膜性肾病,中医学将其归属于“水肿病”范畴。“阳虚阴结”理论源于《素问·阴阳应象大论篇》中“阳化气,阴成形”。阳化气不足,阴成形太过,造成痰饮、水湿、瘀血等有形之物聚积,从而产生“阳虚阴结”的病理状态,发为特发性膜性肾病。张琳教授基于此提出,用温阳法论治特发性膜性肾病思路的方法和实践经验,强调温肾阳以化气利水湿。张琳教授临证时将温阳法视为特发性膜性肾病的治疗总纲,即“益火之源,以消阴翳”,注重调补脾肾、温阳散寒通络;同时针对有形实邪,予以温阳化湿、温阳化瘀,并附验案一则以供临床参考。

Lysine deficiency impaired growth performance and immune response and aggravated inflammatory response of the skin,spleen and head kidney in grown-up grass carp (Ctenopharyngodon idella)

This dissertation was primarily focused on the immune response,inflammatory response and molecular mechanisms in the skin,head kidney and spleen of grown-up grass carp(Ctenopharyngodon idella).Six iso-nitrogen diets differing in lysine concentrations(5.6,8.5,11.6,14.4,17.5 and 20.7 g/kg)were fed to 540 grass carp(164.85±0.79 g)for 60 d.After that,grass carp were challenged by Aeromonas hydrophila for 6 d.This study revealed that lysine deficiency(1)suppressed the growth performa,nce of the fish and decreased their ability to resist skin lesion morbidity,(2)impaired the immune organ s immune response by decreasing the gene expressions of mucin,liver-expressed antimicrobial peptide(LEAP)-2B,β-defensin-1 and LEAP-2A and the production of antibacterial compounds of grown-up grass carp,and(3)aggravated the inflammatory response of immune organs in the fish by increasing the gene expressions of pro-inflammatory cytokines(interferon y2[IFN-γ2],tumor necrosis factorα[TNF-α],interleukin[IL]-15,IL-17D,IL-12p40,IL-6 and IL-8)and down-regulating anti-inflammatory cytokines(IL-11,transforming growth factorβ1[TGF-β1],IL-10 and IL-4/13A),which were tightly correlated with signal transducer and activator of transcription(STAT)1 and STAT3 signaling pathway,respectively.The different phenomenon in the skin,spleen and head kidney of fish may be correlated with the difference in gene subtype.In addition,using quadratic regression analysis of percent weight gain(PWG),skin lesion morbidity,and the lysozyme activities in the spleen and head kidney,the dietary lysine requirements for grown-up grass carp were estimated to be 13.58,13.51,14.56 and 14.18 g/kg,respectively.

Warm needling moxibustion versus electroacupuncture for simple obesity due to yang deficiency of the spleen and kidney: a controlled clinical trial

Objective: To compare the therapeutic efficacy between warm needling moxibustion and electroacupuncture (EA) in the treatment of simple obesity due to yang deficiency of the spleen and kidney. Methods: Seventy patients with simple obesity due to yang deficiency of the spleen and kidney were randomly divided into a warm needling moxibustion group and an EA group, with 35 subjects in each group. Same major acupoints were selected for the two groups, including Shuifen (CV 9), Guanyuan (CV 4), Daheng (SP 15), Shuidao (ST 28), Shousanli (LI 10), Zusanli (ST 36), Sanyinjiao (SP 6) and Taixi (KI 3). The warm needling moxibustion group received warm needling moxibustion, while the EA group received EA treatment. The interventions were performed once every other day, with 15 treatments as one course. The therapeutic efficacy, body weight and body mass index (BMI) were then observed and compared. Results: The total effective rate in the warm needling moxibustion group was 85.7% versus 77.1% in the EA group, and the between-group difference was statistically significant (P<0.05). The warm needling moxibustion was remarkably superior to the EA in weight loss and lowering BMI, both with statistical significance (P<0.05, P<0.01). At the three-month follow-up, the body weight and BMI further decreased in the warm needling moxibustion group (both P<0.05), and the levels were lower than those in the EA group (P<0.05, P<0.01). Conclusion: Warm needling moxibustion can produce reliable and consistent efficacy in the treatment of simple obesity due to yang deficiency of the spleen and kidney. Compared with EA, warm needling moxibustion shows advantage in both short-term and long-term efficacies, and thus is worth promotion in clinical practice.

Clinical treatment of myasthenia gravis with deficiency of spleen and kidney based on combination of disease with syndrome theory

OBJECTIVE: To study the use of Jianjining in the treatment of myasthenia gravis (MG) patients with a deficiency of both spleen and kidney via the theory on the combination of disease with syndrome. METHODS: Sixty MG patients with a deficiency of both spleen and kidney were randomly divided into an treatment group (n=30) treated with Jianjining granules and Western Medicine (prednisone or pyridostigmine bromide) and a control group (n= 30) treated with Jianjining granules. The dosage of the three drugs was reduced over the course of treatment. After 3 and 6 months of treatment, the curative effect was evaluated with the muscle weakness severity scale (MWSS). RESULTS: The MWSS score after treatment declined significantly in both groups. The score in the treatment group was much lower than that in thecontrol group (P<0.05). The total effective rate was 63.33% (19/30) in the treatment group and 36.67% (11/30) in the control group after 3 months of treatment, and 80.00% (24/30) and 50.00% (15/30), respectively, after 6 months of treatment. The obvious and total effective rates in the treatment group were much higher than those in the control group (P<0.05). After 6 months of treatment, there were no obvious differences (P>0.05) in the obvious and effective rates between the 2 groups. However, the total effective rate in the treatment group was much higher than that in the control group (P<0.01). CONCLUSION: Using the theory on the combination of disease with syndrome, we found that the curative effect of Jianjining and Western Medicine on MG patients with deficiency of both spleen and kidney is worth further exploration.

火龙罐通阴三阳灸辅治结肠癌腹水(脾肾阳虚证)的临床观察

目的探索火龙罐通阴三阳灸在治疗结肠癌腹水脾肾阳虚证方面的效果,为结肠癌腹水辅助治疗提供参考。方法采集2023年4月—2023年10月在湖北中医药大学附属随州市中医医院接受住院治疗的66例结肠癌腹水脾肾阳虚证患者的临床资料,根据不同的治疗方法分组,对照组中的33例患者接受艾灸治疗,观察组33例患者使用火龙罐通阴三阳灸疗法。比较两组治疗2周后的24 h尿量、体质量、腹围、腹水消退分级及中医证候积分的变化。结果治疗后,观察组的24 h尿量增加,体质量减轻,腹围减小,腹水消退分级、中医证候积分降低,差异有统计学意义(P<0.05)。结论火龙罐通阴三阳灸法辅助治疗结肠癌腹水脾肾阳虚证具有安全、显著的疗效和较少的不良反应等特点,值得在临床上加以应用。

香砂六君颗粒对脾虚患者及大鼠胃肠运动的调节作用

目的:观察香砂六君颗粒对脾虚患者及大鼠胃肠运动的影响.方法:将患者随机分为治疗组和对照组,治疗前后以B超法检测胃半排空时间,放免法测血浆胃动素(motilin,MTL)、生长抑素(somatostatin,SS)和血清胃秘素(gastrin,GAS)水平,同时观察症状积分.利血平股四头肌注射复制脾虚大鼠模型,分别用香砂六君颗粒高、中、低剂量进行治疗,并设空白对照组、模型对照组和香砂六君丸对照组,用葡聚糖蓝2000(BD2000)标记测量胃残留率和小肠推进比,同时下腔静脉采血测GAS、MTL及SS.结果:临床观察中香砂六君颗粒组与香砂六君丸组比较,症状积分显著降低(3.27±1.93vs6.41±2.35,P<0.01),胃半排空时间缩短(24.32±5.07vs27.14±4.59,P<0.05),MTL升高(341.58±92.47vs284.03±78.40,P<0.05),两组间GAS、SS差异无显著性.实验研究中香砂六君颗粒中剂量组与香砂六君丸对照组比较,胃残留率、小肠推进比、SS降低,MTL、GAS升高(39.93±8.99vs49.23±8.68,55.83±6.91vs65.28±6.24,94.57±12.50vs111.67±13.81,246.98±48.58vs196.52±53.01,150.35±30.12vs113.82±21.34,均P<0.05).结论:香砂六君颗粒通过调节胃肠激素的含量可明显促进胃排空,减慢小肠的蠕动,改善脾虚症状,且优于香砂六君丸对照组.

经脾脏hMSCs移植对乙酰氨基酚所致小鼠急性肝损伤的治疗作用

目的:评价经脾脏途径行骨髓间充质干细胞(hSMCs)移植对对乙酰氨基酚所致小鼠急性肝损伤的疗效.方法:建立对乙酰氨基酚导致的急性药物性肝损伤动物模型,将SCID小鼠20只,随机分成2组,经脾脏注射组和对照组(n=10),经脾脏途径行hSMCs移植,采用肝功能检查、免疫荧光、荧光显微镜、网状纤维染色等方法观察hMSC移植前后重症联合免疫缺陷病(severe combined immunodeficiency disease,SCID)小鼠肝腺泡结构的恢复与肝功能的改善情况.结果:SCID小鼠肝功能在经脾脏移植组与对照组相比较呈现显著性改善(28d时,ALT:26.3U/L vs 50.1U/L,P<0.01;AST:108.0U/L vs 154.3U/L,P<0.05;ALB:40.0g/L vs 31.9g/L,P<0.05).免疫荧光显示经脾脏移植的hMSCs在脾脏、肝脏均有较多量定植、分化与增殖.免疫荧光观察到脾脏移植后肝腺泡结构有较明显改善.结论:经脾脏途径行hMSCs移植能改善小鼠急性肝损伤肝功能,hMSCs在小鼠肝内生长良好,是hMSCs移植治疗的有效途径.

痛泻药方加减对肠易激综合征肝郁脾虚型腹泻患者的临床研究

目的探讨痛泻药方加减对肠易激综合征(IBS)肝郁脾虚型腹泻患者的临床疗效。方法 2012年1月至2014年1月该院就诊符合罗马Ⅱ诊断标准的84例IBS腹泻患者(中医辨证分型为肝郁脾虚型),根据随机数字表法分为观察组和对照组,各42例,对照组患者给予得舒特治疗,观察组患者采用痛泻药方加减治疗,2组患者均治疗2个月。比较2组患者的临床疗效及血浆血管活性肠肽(VIP)、生长抑素(SS)、胆囊收缩素(CCK)的变化情况。结果观察组患者总有效率为90.48%,对照组为71.43%,差异有统计学意义(P<0.05)。观察组患者治疗后腹泻频率、大便形状、腹痛、肠鸣音及临床症状总评分显著低于对照组,差异有统计学意义(P<0.05)。观察组患者治疗后血浆VIP、SS、CCK水平显著低于对照组,差异有统计学意义(P<0.05)。观察组患者治疗后心理维度、生理维度、社会适应性以及生存质量总评分显著高于对照组,差异有统计学意义(P<0.05)。结论痛泻药方加减能有效降低IBS肝郁脾虚型腹泻患者血浆VIP、SS、CCK水平,改善患者临床症状,提高生活质量。

继人工流产后复发性流产的中医证候分布规律研究

目的:分析继人工流产后出现复发性流产患者的中医证候分布规律,以探讨人工流产次数与复发性流产的关系,为中医药预防该病和规范化治疗提供辨证施治依据。方法:选取本院接受诊治的自然流产患者300例,应用流行病学分析法分析临床资料,并自拟"继人工流产后自然流产的中医证候分布"信息表,建立数据库并给予统计分析,聚类中医四诊指标,探讨相关中医证候分布规律,同时对患者年龄、病程、自然流产次数以及人工流产次数等进行统计分析并探讨与中医证候分布的关联性。结果:继人工流产后自然流产的中医证型共5种,构成比按照降序排列分别为:肾虚血瘀证、肾虚内热证、肾虚血虚证、脾肾阳虚证、肾虚湿热证,其中,以肾虚血瘀证为主。随人工流产次数增多,自然流产的次数则增多,肾虚血瘀证构成比呈上升趋势。结论:人工流产次数与复发性流产的发病率呈正相关,为复发性流产的发病因素之一;肾虚血瘀证为继人工流产后复发性流产患者的主要中医证候。

毫火针疗法对脾虚型高胰岛素血症患者腹围、腰臀比影响的临床研究

目的观察毫火针治疗对脾虚型高胰岛素血症患者腹围、腰臀比的临床疗效。方法将62例脾虚型高胰岛素血症的患者随机分为治疗组和对照组。治疗组采用毫火针治疗,对照组采用普通毫针针刺治疗。治疗16周后,记录体质量、腹围、臀围、腰臀比、中医证候学指标。结果治疗组治疗后的腰围、腰臀比优于对照组(P<0.05)。在中医证候评分中,治疗组在“食少纳呆、体倦乏力、食后腹胀”等主症方面疗效优于对照组(P<0.05)。结论毫火针疗法可显著改善脾虚型高胰岛素血症患者的临床症状。

四君子汤类方治疗小儿泄泻脾虚证

小儿泄泻是我国儿科重点防治和研究的“四病”之一,小儿脾常不足的生理特性决定了小儿泄泻脾虚证在临床较为多见,在脾虚基础上进行进一步辨证,常见参苓白术散证、健脾丸证、异功散证、七味白术散证,均可在四君子汤基础上进行加减施治。通过梳理四君子汤类方在治疗小儿脾虚泄泻的现代临床运用情况,为临床对脾虚泄的辨证论治和立法处方提供借鉴和依据,以更好的运用经方指导临床。

温中饮联合脐敷治疗脾胃虚寒型妊娠恶阻30例疗效观察

目的探讨温中饮联合脐敷对脾胃虚寒型妊娠恶阻呕吐、厌食等临床症状的干预效果。方法将我院符合诊断标准的60例脾胃虚寒型妊娠恶阻门诊患者随机分为治疗组30例及对照组30例。对照组采用西医补液治疗,治疗组在西医补液的基础上予温中饮联合脐敷治疗,治疗前后对临床症状、体征积分及尿酮体进行统计,比较两组治疗效果。结果治疗组有效率、治愈率分别为96.7%、40.0%,显著高于对照组的63.3%、13.3%(P<0.05);治疗后中医症状、体征评分低于对照组(P<0.05);治疗3 d,尿酮体转阴率治疗组为63.3%,对照组为56.7%,差异无统计学意义(P>0.05),治疗5 d、7 d,治疗组尿酮体转阴率(均为93.3%)显著高于对照组(均为63.3%)(P<0.05)。结论温中饮联合脐敷治疗脾胃虚寒型妊娠恶阻疗效确切,值得临床应用。

疏肝健脾养心法对慢性乙型肝炎伴焦虑抑郁状态患者肝纤维化的影响

目的探讨疏肝健脾养心法对慢性乙型肝炎(CHB)伴焦虑抑郁状态患者纤维化指标的影响。方法采用随机数字表法将72例患者按1:1对照原则随机分为治疗组(疏肝健脾养心组)和对照组(疏肝健脾组),各36例。分别在西医基础治疗的同时予疏肝健脾养心法组方及疏肝健脾法组方治疗,疗程为12周。最终纳入患者69例,其中治疗组34例,对照组35例。对治疗前后患者的肝纤四项及肝纤维化评分进行观察。结果疏肝健脾养心法联合西医基础治疗可显著改善患者肝纤四项及肝纤维化评分,其疗效优于疏肝健脾法联合西医基础治疗。结论疏肝健脾养心法中药联合基础治疗慢性乙型肝炎伴焦虑抑郁状态患者疗效显著。