Network pharmacology-based exploration of molecular mechanisms underlying therapeutic effects of Jianpi Huatan Quyu recipe on chronic heart failure with spleen Qi deficiency syndrome

BACKGROUND Chronic heart failure is a complex clinical syndrome.The Chinese herbal compound preparation Jianpi Huatan Quyu recipe has been used to treat chronic heart failure;however,the underlying molecular mechanism is still not clear.AIM To identify the effective active ingredients of Jianpi Huatan Quyu recipe and explore its molecular mechanism in the treatment of chronic heart failure.METHODS The effective active ingredients of eight herbs composing Jianpi Huatan Quyu recipe were identified using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform.The target genes of chronic heart failure were searched in the Genecards database.The target proteins of active ingredients were mapped to chronic heart failure target genes to obtain the common drugdisease targets,which were then used to construct a key chemical componenttarget network using Cytoscape 3.7.2 software.The protein-protein interaction network was constructed using the String database.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed through the Metascape database.Finally,our previously published relevant articles were searched to verify the results obtained via network pharmacology.RESULTS A total of 227 effective active ingredients for Jianpi Huatan Quyu recipe were identified,of which quercetin,kaempferol,7-methoxy-2-methyl isoflavone,formononetin,and isorhamnetin may be key active ingredients and involved in the therapeutic effects of TCM by acting on STAT3,MAPK3,AKT1,JUN,MAPK1,TP53,TNF,HSP90AA1,p65,MAPK8,MAPK14,IL6,EGFR,EDN1,FOS,and other proteins.The pathways identified by KEGG enrichment analysis include pathways in cancer,IL-17 signaling pathway,PI3K-Akt signaling pathway,HIF-1 signaling pathway,calcium signaling pathway,cAMP signaling pathway,NF-kappaB signaling pathway,AMPK signaling pathway,etc.Previous studies on Jianpi Huatan Quyu recipe suggested that this Chinese compound preparation can regulate the TNF-α,IL-6,MAPK,cAMP,and AMPK pathways to affect the mitochondrial structure of myocardial cells,oxidative stress,and energy metabolism,thus achieving the therapeutic effects on chronic heart failure.CONCLUSION The Chinese medicine compound preparation Jianpi Huatan Quyu recipe exerts therapeutic effects on chronic heart failure possibly by influencing the mitochondrial structure of cardiomyocytes,oxidative stress,energy metabolism,and other processes.Future studies are warranted to investigate the role of the IL-17 signaling pathway,PI3K-Akt signaling pathway,HIF-1 signaling pathway,and other pathways in mediating the therapeutic effects of Jianpi Huatan Quyu recipe on chronic heart failure.

Efficacy and safety of Guipi Decoction combined with conventional Western medicine in the treatment of insomnia with deficiency of heart and spleen:a meta-analysis

Objective:To systematically evaluate the efficacy and safety of Guipi Decoction combined with Western medicine in the treatment of insomnia with deficiency of heart and spleen.Methods:English databases(PubMed,Web of Science,The Cochrane Library,EMBASE)and Chinese databases(CNKI,Wanfang database,China Biomedical Literature Service System,VIP database)were searched by computer.Randomized controlled trials of Guipi Decoction on insomnia with deficiency of heart and spleen were searched from the database construction to November 2021.After the first and second authors independently screened the literature,extracted the data and evaluated the risk of bias in the included studies,meta-analysis was performed using RevMan5.3 software.Results:A total of 9 RCTS were included after screening,including 914 patients.Meta-analysis results showed that:Total effective rate[RR=1.22,95%CI(1.16,1.30),P<0.00001],total PSQI score[MD=-3.05,95%CI(-3.96,-2.14),P=0.008],number of night awakening times[[MD=-1.18,95%CI(-1.42,-0.94),P<0.00001],adverse reaction rate[RR=0.32,95%CI(0.21,0.51),P<0.00001]were better than the control group,and the differences were statistically significant.Conclusion:The current evidence shows that,compared with pure using conventional western medicine,belongs to the spleen decoction combined western medicine therapy,cases both deficiency type of insomnia in the total effective rate,reducing the total PSQI score(improve sleep quality,sleep efficiency,sleep disorder,daytime function,etc.),reducing frequency of nighttime awakening,security,have more advantages.However,due to the limitation of the quality and quantity of articles included in the study,more randomized,double-blind,large-sample clinical studies are needed to confirm the above conclusions.

Clinical Observation on the Treatment of Insomnia in Germany with Deficiency of Heart and Spleen by the Ear Bean Therapy

Objective: To observe the effect of insomnia patients with deficiency of heart and spleen in Germany by the therapy of ear points pressing with bean. Methods: A total of 80 cases of insomnia with deficiency of heart and spleen in Germany were divided into the observation group and the control group, with 40 cases in each group. The patients in the control group were treated with oral modified Guipi Decoction(归脾汤), while the patients in the observation group were treated with oral traditional Chinese medicine(TCM) and the therapy of ear points pressing with bean. The efficacy, sleep quality, the TCM syndromes score and the incidence of adverse reactions were compared between the two groups. Results: The effective rate in the observation group was higher than that in the control group, and there was statistical difference between the two group(P<0.05). After treatment, the Pittsburgh sleep quality index scale(PSQI) score, insomnia severity index(ISI) score and the TCM syndromes score in the two groups were decreased sharply(P<0.01), and those scores in the observation group were lower than that in the control group(P<0.05). There was no adverse reaction between the two groups. Conclusion: The therapy of ear points pressing with bean is effective on insomnia in Germany, which is worth further study and promotion.

ACUPUNCTURE TREATMENT FOR 100 CASES WITH INSOMNIA OF THE TYPE OF THE HEART AND SPLEEN DEFICIENCY

cases of insomnia of the type of heart and spleen deficiency were treated by acupuncture.Results indicated that 95 cases were cured,accounting for 95%;3 cases were markedly effective,accounting for 3% and the 2 cases were ineffective,accounting for 2%,the total effective rate was 98%.

Effect of Yiqi Jianpi plus anticancer herbs on spleen deficiency in colorectal cancer and its anti-tumor role

Objective:To observe the effect of Yiqi Jianpi plus anticancer herbs on spleen deficiency in colorectal cancer and its anti-tumor role.Methods:Human intestinal cancer cell HT29 xenograft of nude mice model was established.The expression of ECF,VEGF,gastric cancer tumor growth in mice were observed.Results:Protein kinase C expression in in the Yiqi Jianpi group and Yiqi Jianpi anti-tumor group was significantly better than the model group(P<0.01,P<0.05).There was significantly more apoptotic cells in Yiqi Jianpi anti-tumor group than Yiqi Jianpi group and model group(P<0.01).Epidermal growth factor and vascular endothelial growth factor expression in Yiqi Jianpi group was significantly lower than Yiqi Jianpi group and model group(P<0.05).Conclusions:Tumor can inhibit the expression of PKC inhibition.Yiqi Jianpi and anticancer treatment can reduce this inhibition.Besides this treatment can also inhibit expression of tumor related genes such as epidermal growth factor and vascular endothelial growth factor.

Efficacy and Safety of Jianpi Jieyu Decoction for Patients with Mild-to-Moderate Depression of Xin(Heart)-Pi(Spleen)Deficiency Syndrome:A Multi-centre Randomized Controlled Study

Objective:To evaluate the efficacy and safety of Jianpi Jieyu Decoction(JJD)for treating patients with mild-to-moderate depression of Xin(Heart)-Pi(Spleen)deficiency(XPD)syndrome.Methods:In this multi-center,randomized,controlled study,140 patients with mild-to-moderate depression of XPD syndrome were included from Xiyuan Hospital of China Academy of Chinese Medical Sciences and Botou Hospital of Traditional Chinese Medicine from December 2017 to December 2019.They were randomly divided into JJD group and paroxetine group by using a random number table,with 70 cases in each group.The patients in the JJD group were given JJD one dose per day(twice daily at morning and evening,100 m L each time),and the patients in the paroxetine group were given paroxetine(10 mg/d in week 1;20 mg/d in weeks 2-6),both orally administration for a total of 6 weeks.The primary outcome was the change of 17-item Hamilton Depression Rating Scale(HAMD-17)score at week 6 from baseline.The secondary outcomes included the Hamilton Anxiety Scale(HAMA)score,Traditional Chinese Medicine Symptom Scale(TCMSS),and Clinlcal Global Impression(CGI)scores at the 2nd,4th,and 6th weekends of treatment,HAMD-17 response(defined as a reduction in score of>50%)and HAMD-17 remission(defined as a score of 7)at the end of the 6th week of treatment.Adverse events(AEs)were also recorded.Results:From baseline to week 6,the HAMD-17 scores decreased 10.2±4.0 and 9.1±4.9 points in the JJD and paroxetine groups,respectively(P=0.689).The HAMD-17 response occurred in 60%of patients in the JJD group and in 50%of those in the paroxetine group(P=0.292);HAMD-17 remission occurred in 45.7%and 30%of patients,respectively(P=0.128).The differences of CGI scores at the 6th week were not statistically significant(P>0.05).There were significant differences in HAMD-17 scores between the two groups at 2nd and 4th week(P=0.001 and P=0.014).The HAMA scores declined 8.1±3.0 and 6.9±4.3 points from baseline to week 6 in the JJD and paroxetine groups,respectively(P=0.905 between groups).At 4th week of treatment,there was a significant difference in HAMA between the two groups(P=0.037).TCMSS decreased 11.4±5.1,and 10.1±6.8 points in the JJD and paroxetine groups,respectively(P=0.080 between groups).At the 6th week,the incidence of AEs in the JJD group was significantly lower than that in the paroxetine group(7.14%vs.22.86%,P<0.05).Conclusion:Compared with paroxetine,JJD was associated with a significantly lower incidence of AEs in patients with mild-tomoderate depression of XPD syndrome,with no difference in efficacy at 6 weeks.(Trial registration No.Chi CTR2000040922).

基于“肝脾同调”阐析慢性肝病的中医治疗

慢性肝病是临床常见疾病,“郁、虚、湿、毒、瘀”是其核心病机,在疾病的不同阶段各有侧重,其中,以“郁、虚”为核心的肝脾失调是慢性肝病发生发展的关键。“肝脾同调”是治疗慢性肝病的基本治法,在慢性肝病不同阶段,其“肝脾同调”内涵同中有异。根据肝、脾生理病理特性,治脾明辨虚实,厘清轻重,活用运脾、健脾、温脾、醒脾、补脾等法;调肝体用并重,精准辨证,活用疏肝、缓肝、散肝、柔肝等法。临床上,治脾与调肝相辅相成,治调并举,常获良效。

健脾祛痰法治疗血脂异常研究概况

血脂异常在我国普遍存在,中医药干预血脂异常越来越得到人们的重视。中医学认为脾主运化水谷精微,脂质亦需要脾的运化功能布散周身。脾气虚则脾失健运,清气不升,浊阴独留,生湿生痰;痰湿进一步阻碍气机,影响脾胃运化,使脾虚更甚,加重脂浊,浸润血脉。近年来健脾祛痰法被越来越多地应用于血脂异常的防治中,且在临床中收到不错的疗效。

国医大师刘嘉湘从脾肾论治肺癌经验

刘嘉湘教授认为,肺癌病位在肺,亦与脾、肾密切相关。其病机以正气亏虚为本,而脾肾为正虚之关键,治疗时强调“治病必求于本”,创立扶正培本治癌大法,开创了中医药治疗恶性肿瘤的新思路,扶正培本又重在脾肾,同时补虚不忘祛邪,扶正祛邪相辅相成,将扶正培本法贯穿于治疗肺癌的始终。

基于“脾气散精”理论探讨慢性肝病的中医治疗

慢性肝病的发病与脾密切相关,“脾气散精”是《黄帝内经》对脾功能的高度概括,脾气散精功能障碍贯穿慢性肝病始终,脾失运化,生湿生痰,瘀血阻络为慢性肝病进展的关键因素。治疗时应将健脾作为慢性肝病的基本治法之一,并根据脾运的不同状态,配合运脾、醒脾、温脾等不同治法,以复脾气散精之能,病程中尤应抓住瘀血络阻这一关键病机,活血化瘀通络,防止慢性肝病进一步向肝积、鼓胀发展,使脾运得复,瘀阻得除,标本兼治。

李延从脾胃论治冠心病的临床经验

冠心病为临床中常见的心血管疾病,可归属中医学的“胸痹”“心痛”等疾病范畴。李延教授认为本病之病性总属本虚标实之证,以脾虚、脾胃健运失常为本,标实在于痰浊、血瘀、气滞、寒凝等有形实邪痹阻心脉。治疗时重视调理脾胃,重用黄芪、白术、党参、五味子等健脾养心以治本,结合通阳化浊、活血化瘀、疏肝理气、温阳散寒等治法,标本兼治,通补兼顾,使脾气健旺,心气充沛,瘀去痰消,胸阳得以舒展,则心之血脉恢复畅通,胸痹心痛诸症得到缓解。李延教授从脾胃论治冠心病的经验可为中医临床诊治冠心病提供参考。

从肝脾论治甲状腺良性结节研究进展

甲状腺结节为常见的内分泌系统疾病,多为良性结节。西医对于甲状腺结节缺乏有效的治疗措施,对于部分病情严重的患者可进行手术治疗,但相关并发症较多。中医认为,甲状腺结节的发生与患者情志失调密切相关,而情志畅达与肝脏气机调畅密切相关,患者情志抑郁可致肝气郁结,日久使得脾胃生化功能失调,肝郁脾虚则水液输布失常,痰气瘀结于颈前而发为“瘿病”,因此,从疏肝理气、健脾利水、化痰消瘀为基本原则,治疗甲状腺结节能取得良好的效果。

皮内针联合子午流注五音疗法用于心脾两虚型不寐临床观察

目的探讨皮内针联合子午流注五音疗法对心脾两虚不寐症患者的临床效果。方法选择天水市中医医院脾胃病科2021年5月—2021年10月入住的心脾两虚型不寐患者100例,根据随机数字表法分为对照组、观察组,各50例。对照组给予皮内针干预,观察组在对照组基础上加用子午流注五音疗法干预,2周后比较两组总有效率、匹兹堡睡眠质量指数(PSQI)得分。结果观察组总有效率为94.00%(47/50),高于对照组的74.00%(37/50),差异有统计学意义(P<0.05);干预后,两组PSQI得分较干预前均下降,且观察组低于对照组,差异有统计学意义(P<0.01)。结论皮内针联合子午流注五音疗法能有效改善心脾两虚型不寐患者的睡眠质量,值得临床推广应用。

基于“心受气于脾”论治类风湿关节炎累及心脏病变

类风湿关节炎累及心脏病变属于复合病证,根据其发病过程与临床表现,可归属于中医学“脏痹-心痹”。心痹为痹证日久缠绵不愈,复感风、寒、湿邪,向内传入于心所致。该文基于“心受气于脾”理论探讨其病因、病机与治疗。通过梳理古代文献,发现类风湿关节炎累及心脏病变的病因为脾气不足,卫阳不固,外感风、寒、湿邪气侵入机体,瘀血顽痰阻滞发为心痹。其病机为脾气不足,营卫虚弱;脾阳不足,痰浊内生;脾失健运,痰瘀互结。现代研究表明,细胞免疫失调、血脂异常以及血凝与类风湿关节炎合并心脏病变关系密切,这与中医病机一致。在治疗时选用补益卫阳,和营通痹;温阳散寒,化痰逐饮;益气活血,健脾祛痰之法,代表方剂分别为黄芪桂枝五物汤、苓桂术甘汤、赤茯苓汤。该文提出“心受气于脾”理论,为临床治疗类风湿关节炎累及心脏病变提供思路与指导。

慢性心力衰竭气虚血瘀证潜在亚组人群特征探索研究

目的探索慢性心力衰竭(CHF)气虚血瘀证潜在亚组人群,为心力衰竭的中医精准辨治提供客观依据。方法收集126例CHF气虚血瘀证患者的19种症状/体征指标和21种生化指标,利用R和Python软件进行K-mediods聚类算法分析,以轮廓系数确定最佳的聚类数目。组间比较,连续变量采用Kruskal-Wallis检验,分类变量采用Pearson's chi-squared检验或者Fisher's exact检验。结果CHF气虚血瘀证患者被聚类为3组,组间比较发现,气喘、不寐、颈脉怒张、纳差、畏寒5个症状/体征以及NYHA分级、氨基末端脑钠肽前体(NT-proBNP)、红细胞比容、尿素氮4个临床指标差异具有统计学意义(P<0.05)。第1组人群整体各症状/体征发生频率和临床指标严重程度相对较低;第2组人群以颈脉怒张发生频率较其他组高为特征,且促甲状腺激素、总胆固醇及低密度脂蛋白有偏高趋势,血小板有偏低的趋势;第3组人群以畏寒、纳差、不寐的发生率较其他组显著升高为特征,伴随尿素氮增高、红细胞比容降低。结论CHF气虚血瘀证潜在3种亚型,分别是气虚血瘀证本证型、气虚血瘀兼痰浊型、气虚血瘀兼阳虚型。

加裁调脾护心方治疗高血压心脾两虚证的临床研究

目的:观察加裁调脾护心方治疗高血压心脾两虚证的临床疗效。方法:选取2022年10月—2023年11月就诊于安徽中医药大学第一附属医院心内科的高血压病人60例,采用随机数字表法分为治疗组与对照组,每组30例。对照组予以常规西药规范治疗,治疗组在对照组基础上加用加裁调脾护心方。观察两组中医证候积分、中医证候疗效、匹兹堡睡眠质量指数(PSQI)评分、生活质量评价量表(SF-36)评分。结果:治疗4周后,两组中医证候积分较治疗前下降(P<0.05),且治疗组低于对照组(P<0.05);治疗组中医证候疗效总有效率高于对照组,差异有统计学意义(P<0.05)。两组治疗后PSQI评分、SF-36评分均较治疗前改善(P<0.05),且治疗组改善程度优于对照组(P<0.05)。结论:加裁调脾护心方可减轻病人临床症状,提高睡眠质量,改善生活质量。

丁书文从脾胃论治心系疾病的临证应用

丁书文教授推崇李东垣的脾胃内伤学说,强调脾胃在人体脏腑功能中的重要性,主张心系疾病从脾胃论治。丁书文教授基于李东垣的学术思想,创立了心系疾病“热毒”学说,指出心系热毒是脾胃功能失调、湿痰瘀热胶结导致。治疗既治心系疾病之标,亦调脾胃后天之本。

改良隔药脐灸联合敷贴序贯治疗小儿厌食症(脾气虚证)的临床观察

目的:探究与分析改良隔药脐灸联合敷贴序贯治疗小儿厌食症(脾气虚证)的临床疗效及对预后复发的影响。方法:选取我院2019年2月至2022年3月收治的小儿厌食症(脾气虚证)120例患儿,采取随机数字表法将其随机分为3组,每组各40例,对照组采用中药制剂厌食贴外敷治疗;治疗A组在对照组的基础上加用传统隔姜脐灸治疗;在对照组的基础上治疗B组加用改良隔药脐灸治疗,3组患儿均连续治疗4周,对比3组患儿的临床疗效、治疗前后主症积分和次症积分,同时对比3组治疗后4周、8周及12周的复发率。结果:治疗B组、治疗A组、对照组临床总有效率分别为95.00%(38/40)、80.00%(32/40)、62.5%(25/40),治疗B组临床总有效率均高于治疗A组和对照组(P<0.05)。3组患儿治疗后主症积分及次症积分均较治疗前降低,治疗B组患儿治疗后主症积分及次症积分均低于治疗A组、对照组,治疗A组患儿治疗后主症积分及次症积分均低于对照组,差异均有统计学意义(P<0.05)。随访8周时,治疗B组复发率[2.50%(1/40)]低于对照组[20.00%(8/40)],随访12周时,治疗B组复发率[2.50%(1/40)]低于治疗A组[17.50%(7/40)]和对照组[30.00%(12/40)],差异均有统计学意义(P<0.05)。结论:改良隔药脐灸与敷贴序贯联合治疗小儿厌食症(脾气虚证)可获得显著的临床疗效,促进改善患儿的临床症状及体征,同时在短期时间内有效避免了疾病的复发,具有较高的应用价值。

归脾汤加味联合黛力新治疗心脾两虚型缺血性脑卒中后抑郁临床研究

目的:观察归脾汤加味联合黛力新治疗心脾两虚型缺血性脑卒中后抑郁患者的疗效。方法:选取心脾两虚型缺血性脑卒中后抑郁患者80例,随机分为2组,每组40例。对照组予口服黛力新片治疗,中药组在对照组基础上加服归脾汤加味,两组疗程均为4周,观察比较两组治疗前后美国国立卫生院卒中量表(NIHSS)评分、汉密尔顿抑郁量表(HAMD)评分、健康调查简表(SF-36)评分、血清5-羟色胺(5-HT)水平、血清同型半胱氨酸(Hcy)水平变化情况及临床疗效、不良反应发生率。结果:治疗后,两组患者HAMD评分、SF-36评分、NIHSS评分及5-HT、Hcy水平均较治疗前改善(P<0.05),且中药组较对照组改善明显,差异具有统计学意义(P<0.05)。中药组总有效率为95.00%,高于对照组的80.00%,差异具有统计学意义(P<0.05)。中药组不良反应总发生率为5.0%,低于对照组的17.5%(P<0.05)。结论:归脾汤加味联合黛力新可改善心脾两虚型缺血性脑卒中后抑郁患者抑郁状态,安全性较好。

张艳自拟冠心方治疗冠心病心绞痛临证经验

冠心病心绞痛在心血管疾病中较为常见,属于中医学中“胸痹”“心痛”等范畴。张艳教授行医四十余载,治疗胸痹心痛疗效显著。认为其发病以气虚痰瘀交阻证型较为多见,提出“虚痰瘀”理论,自拟“冠心方”从脾论治冠心病心绞痛,治法为补气健脾,养血活血,化瘀止痛,化痰祛湿。该文章将张艳教授自拟冠心方治疗冠心病心绞痛的临证经验总结作出详细介绍。