Erxian decoction potentially prevents postmenopausal osteoporosis by modulating miR-335: a study based on bioinformatics analysis and preliminary clinical case validation

Background:miRNAs are closely related to bone metabolism.Studies have shown that Erxian decoction can improve bone metabolism,possibly achieving this regulatory effect through miRNA targets.Netinfer was used to predict the miRNA targets of Erxian decoction for the treatment of postmenopausal osteoporosis,and the results were validated by clinical trials.Methods:In this study,we identified possible targets of Erxian decoction in osteoporosis by means of network pharmacological analysis and bioinformatic prediction.Fifteen cases of postmenopausal osteoporosis with kidney Yin and Yang deficiency(In traditional Chinese medicine,kidney Yin nourishes and moistens the tissues of the internal organs of the body,while kidney Yang promotes and warms the tissues of the internal organs of the body.)were treated with Erxian decoction for four weeks,and serum bone metabolism indices(P1NP,osteocalcin,andβ-CTX)and miRNA-335-5p expression were measured before and after treatment.Results:The constructed miRNA postmenopausal osteoporosis related gene network of the effective compound of the Erxian decoction has 296 points and 981 edges.The 39 postmenopausal osteoporosis related genes regulated by miRNA-335-5p were enriched in ossification,while the signaling pathways were enriched in rheumatoid arthritis,the Toll signaling pathway,the HIF-1 signaling pathway,and the MAPK signaling pathway.After taking Erxian decoction,the expression of the serum bone formation index(P1NP,osteocalcin)and miRNA-335-5p gene expression levels increased significantly.The alterations in P1NP and osteocalcin were correlated with the changes in miRNA-335-5p.Conclusion:Circulating miRNA-335-5p may serve as an important target of Erxian decoction in the treatment of postmenopausal women.The effect of Erxian decoction on bone formation is significant,but the underlying mechanism requires further investigation.

Observation on Therapeutic Effect of Erxian Decoction on Relieving Low Back Pain after PVP of PMOP-derived Vertebral Fracture

[Objectives]To explore the clinical effect of Erxian decoction on relieving low back pain after percutaneous vertebroplasty(PVP)of vertebral compression fracture caused by postmenopausal osteoporosis(PMOP).[Methods]Ninety patients who were treated in Suzhou TCM Hospital from September 2021 to January 2023 were randomly divided into three groups:traditional Chinese medicine group(n=30),western medicine group(n=30)and blank group(n=30).The patients in all the three groups were treated with basic anti-osteoporosis drugs.The patients in the traditional Chinese medicine group were treated with Erxian decoction after PVP,and those in the western medicine group were treated with celecoxib to relieve pain after operation.The visual analogue(VAS)score,Oswestry dysfunction index(ODI)score,TCM syndrome score and serum indexes such as interleukin-6(IL-6)and estrogen E2 were recorded before treatment and 2 weeks,1 month and 3 months after treatment.[Results](i)In terms of pain relief,the VAS score of the western medicine group was lower than that of the traditional Chinese medicine group after 2 weeks of treatment,but there was no significant difference in VAS score between the two groups after 1 month and 3 months,and the pain improvement of the two groups was better than that of the blank group.(ii)After 3 months of treatment,the ODI score in the traditional Chinese medicine group was lower than that in the western medicine group,and the improvement of TCM syndrome in the traditional Chinese medicine group was better than that in the other two groups 1 and 3 months after treatment(P<0.05).(iii)The level of IL-6 in the western medicine group was lower than that in the other groups after 2 weeks,and there was no significant difference between the two groups after 3 months of treatment.After 3 months of treatment,the level of E2 in the traditional Chinese medicine group was higher than that before treatment and higher than that in the western medicine group and the blank group,but there was no significant difference between the two groups(P>0.05).[Conclusions]Both Erxian decoction and non-steroidal anti-inflammatory drugs can relieve residual low back pain after PVP,and their long-term effects are similar,but Erxian decoction has more advantages in alleviating pain,muscle and joint pain and sensory abnormalities in postmenopausal women.Moreover,it is safe and reliable,and is worthy of clinical application.

Discussion on the mechanism of Erxian Decoction in the treatment of premature ovarian failure based on network pharmacology and molecular docking

Objective:To explore the mechanism of Erxian Decoction in the treatment of premature ovarian failure.Methods:Based on the method of network pharmacology and molecular docking,the active ingredients of each drug in Erxian Decoction were obtained by searching the TCMSP database;the premature ovarian failure disease targets were collected from the GeneCards,OMIM,PharmGkb and Drugbank databases,and the active ingredients and the disease gene targets were collected Click the intersection to get the predictive target of Erxian Decoction for the treatment of premature ovarian failure.Use Cytoscape 3.8.0 to construct a"drug-component-target-disease"network;construct a protein interaction network(PPI)and streamline the core network through STRING database and Cytoscape;use R Studio software to enrich the Erxiantang treatment POF with GO And KEGG pathway enrichment analysis.Use molecular docking technology to verify the results of the"drug-component-target-disease"network.Results:68 main active ingredients were screened,involving 182 gene targets,among which the main active ingredients include Quercetin,Luteolin,Kaempferol,etc.;The core target genes include RB1,TP53,FOS,CDKN1A,ESR1,AKT1,MAPK1,TNF,etc.;GO enrichment items were obtained,including the 2545 Biological Process(BP),89 Cellular Component(CC),212 Molecular Function(MF);KEGG pathways,including PI3K-Akt signaling pathway,MAPK signaling pathway,and AGE-RAGE signaling pathway in diabetic complications.The verification of the molecular docking results indicated that the main active ingredient has a good binding activity with the core target.Conclusion:This study preliminarily revealed that Erxian Decoction may play a role in the treatment of POF through multi-component,multi-target,and multi-channel synergy,which provides a reference for the next in-depth research.

To explore the mechanism of Erxian decoction in treating insomnia based on network pharmacology

Objective:This paper aims to explore the mech-anism of Erxian Decoction in treating insoimnia by means of network pharmacology research method.Methods:The com-ponents and related targets of Erxian Decoction are screened by TCMSP database.Disease targets are obtained by OMMM and Gene Cards database,and the common targets of drugs and diseases are obtained.The network diagram of"drug-coumponent-disease-target"is constructed and analyzed.STRING database constructs PPI network and finds the core target.GO and KEGG enrichnent analysis are employed on intersection targets.Results:84 effective components and 169 drug targets.of Erxian Decoction as well as 2614 targets of insomnia are screened out.Seventy-two intersection targets are selected by Venn diagram,and the core targets include IL-6,TNF,VEGFA and L-1β.These intersection targets contain 404 GO processes and 67 KEGG pathways,including TOLL-like receptor signaling pathway,cyclic adenosine monophosphate(CAMP)signaling pathway and tumor necrosis factor(TNF)signaling pathway.Conclusion:Erxian Decoction may play a role in treating insomnia by regulating TOLL-like receptor signaling pathway,cyclic adenosine monophosphate(CAMP)signaling pathway and tumnor necrosis factor(TNF)signaling pathway.

加味海龙黄精饮联合来曲唑治疗脾肾两虚型高雌二醇合并ED的临床研究

目的探究加味海龙黄精饮联合来曲唑治疗脾肾两虚型高雌二醇合并阴茎勃起功能障碍(erectile dysfunction,ED)的疗效。方法选择2016年1月至2018年5月大连大学附属中山医院中医科诊治的脾肾两虚型高雌二醇合并ED的70例患者,将其随机平均分为治疗组和对照组,每组35例患者。治疗组患者采用加味海龙黄精饮联合来曲唑治疗方法,对照组患者采用来曲唑治疗方法。治疗结束后去除失访者,实际完成治疗的治疗组有29例患者,对照组有29例患者,对两组患者治疗结果进行统计学分析。结果采用国际勃起功能指数(international index of erectile function,IIEF-5)评分,治疗后对照组患者病情无明显改善(P>0.05),治疗组患者评分[23(21,24)分]明显优于对照组患者[5(5,10)分],两者差异具有统计学意义(P<0.05)。血清雌二醇(estradiol,E2)含量,治疗后两组患者均有所降低,且治疗组患者E2含量[(28.45±8.94)pg/mL]明显优于对照组患者[(40.93±9.79)pg/mL],两者差异具有统计学意义(P<0.05)。血清睾酮(testosterone,T)水平,治疗后两组患者均有所提高,且治疗组患者水平[(21.20±5.50)nmol/L]与对照组患者水平[19.37(13.98,22.60)nmol/L]比较,其差异无统计学意义(P>0.05)。促性腺激素(follicule-stimulating hormone,FSH)和(luteinizing hormone,LH)的含量,治疗后两组患者均有所提高,且治疗组患者FSH[(14.59(8.19,18.88)mIU/mL]、LH[11.96(6.39,16.46)mIU/mL]明显优于对照组患者FSH[6.01(4.21,9.31)mIU/mL]、LH[5.38(3.86,9.30)mIU/mL],其差异均具有统计学意义(均P<0.05)。血清泌乳素(prolactin,PRL)含量,两组患者治疗前后比较,其差异均无统计学意义(均P>0.05)。结论加味海龙黄精饮联合来曲唑治疗脾肾两虚型高雌二醇合并阴茎勃起功能障碍的疗效显著,不仅能够降低E2、提高T水平,而且能够提高性欲。

麻黄附子细辛汤合六味地黄丸加味治疗糖尿病性ED临床疗效观察

目的:观察麻黄附子细辛汤合六味地黄丸加味治疗糖尿病性ED临床疗效。方法:对41例糖尿病性ED患者使用麻黄附子细辛汤合六味地黄丸加味经过6wk的连续治疗,查看评分,评定疗效。结果:临床治愈17例,显效12例,有效8例,无效4例,总有效率90.24%。结论:麻黄附子细辛汤合六味地黄丸加味治疗糖尿病性ED疗效明显,值得推广。

双侧卵巢切除大鼠下丘脑⁃垂体的转录组学特征及二仙汤的调节效应

目的利用RNA测序技术研究围绝经期综合征模型大鼠下丘脑-垂体的转录组学特征及二仙汤的作用。方法以大鼠双侧卵巢切除术模拟围绝经期综合征雌激素骤然下降状态。48只雌性SD大鼠,随机取假手术组12只,其余36只大鼠双侧卵巢切除术后再随机分为双侧卵巢切除组、17β-雌二醇组、二仙汤组,每组12只。大鼠双侧卵巢切除术后第7天,17β-雌二醇组灌胃17β-雌二醇(0.1 mg·kg^(-1)·d^(-1)),二仙汤组灌胃二仙汤提取液(8 g·kg^(-1)·d^(-1)),每日灌胃1次,持续6周;假手术组与双侧卵巢切除组均灌胃等量的灭菌水。采用酶联免疫吸附测定(ELISA)法检测血清雌二醇(E2)、促性腺激素释放激素(GnRH)与β-内啡肽(β-EP)含量。采用mRNA转录组测序技术检测下丘脑与垂体,根据FPKM值与edgeR算法筛选组间差异表达基因,进行基因本体(GO)与京都基因与基因组百科全书(KEGG)富集分析,并以实时荧光定量逆转录聚合酶链式反应(RT-qPCR)法验证下丘脑雌激素受体α(Esr1)与线粒体编码的NADH脱氢酶亚基4(Mt-nd4)、垂体钙/钙调素依赖性蛋白激酶Ⅱα(Camk2a)与甲状腺激素受体α(Thra)共4个差异表达基因。结果①与假手术组比较,双侧卵巢切除组大鼠血清E2与β-EP显著下降(P<0.05);与双侧卵巢切除组比较,二仙汤组E2与β-EP水平显著升高(P<0.05)。②大鼠下丘脑与垂体可检测基因数量均为30957个。③与假手术组比较,双侧卵巢切除大鼠下丘脑上调基因135个、下调基因348个,垂体上调基因409个、下调基因82个。与双侧卵巢切除组比较,17β-雌二醇治疗后大鼠下丘脑上调基因126个、下调基因225个,垂体上调基因93个、下调基因273个;二仙汤治疗后大鼠下丘脑上调基因91个、下调基因92个,垂体上调基因390个、下调基因376个。④GO分析表明,下丘脑与垂体差异表达基因富集于细胞过程、生物学调控、代谢过程等。⑤KEGG呈现了下丘脑与垂体的差异表达基因富集前30个信号通路,其中二仙汤调节尼古丁成瘾、氮代谢、突触囊泡循环等信号通路。⑥RT-qPCR所验证的二仙汤显著调节的Esr1、Mt-nd4、Camk2a基因表达变化与转录测序结果一致。结论双侧卵巢切除大鼠下丘脑与垂体的神经内分泌系统处于紊乱状态,17β-雌二醇侧重于调节下丘脑基因,二仙汤对垂体调节更广、更深。

水陆二仙丹联合抵挡汤加减方对早中期糖尿病肾病患者的临床疗效

目的探讨水陆二仙丹联合抵挡汤加减方对早中期糖尿病肾病患者的临床疗效。方法83例患者随机分为对照组(42例)和观察组(41例),对照组给予厄贝沙坦片,观察组在对照组基础上加用水陆二仙丹联合抵挡汤加减方,疗程12周。检测临床疗效、中医证候评分、血糖指标(FBG、HbA1c)、血脂指标(TC、TG)、肾功能指标(BUN、Scr、24 h UTP、eGFR)、炎症因子(IL-1β、hs-CRP、IL-6、TNF-α、IL-18、TGF-β1)、免疫功能指标(淋巴细胞、中性粒细胞、CD8^(+)、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))、不良反应发生率变化。结果观察组总有效率高于对照组(P<0.05)。治疗后,观察组中医证候评分、血糖指标、血脂指标、BUN、Scr、24 h UTP、炎症因子、CD8^(+)降低(P<0.05),淋巴细胞、中性粒细胞减少(P<0.05),eGFR、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)升高(P<0.05),并比对照组更明显(HbA1c、TG、SCr、24 h UTP、淋巴细胞、中性粒细胞除外)(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论水陆二仙丹联合抵挡汤加减方可安全有效地改善早中期糖尿病肾病患者临床症状,其机制可能与降低炎症水平、改善机体免疫功能有关。

仝小林教授治疗帕金森病伴嗜睡验案一则

帕金森病是一种进行性神经退行性疾病,以肌强直、运动迟缓、静止性震颤等运动症状及便秘、认知、情绪、睡眠障碍等非运动症状为突出临床特征。帕金森病属中医学“颤证”“震颤”等范畴,仝小林教授综合“四焦八系”与“态靶理论”治疗帕金森伴嗜睡病例一则,提出颤证为髓系疾病,病位在顶焦,本案患者以“虚态”“老态”为本,痰浊、血瘀为标,以地黄饮子加减作为“调态方”联合“靶方”二仙汤加减治疗,取得良好临床疗效,为临床治疗帕金森病伴嗜睡提供了新的诊疗思路。

加味二仙汤对多囊卵巢综合征不孕患者胰岛素抵抗及性激素水平的影响

目的 探讨加味二仙汤对多囊卵巢综合征(Polycystic ovarysyndrome, PCOS)不孕患者胰岛素抵抗及性激素水平的影响。方法 选取2020年1月—2022年1月期间河南省濮阳市妇幼保健院收治的PCOS不孕患者120例,按随机数字表法分为对照组和观察组,每组各60例。对照组常规服用二甲双胍治疗,观察组在对照组基础上加用加味二仙汤治疗。1个月经周期为1个疗程,两组患者均治疗3个疗程。观察比较两组患者临床疗效、治疗前后胰岛素指标[空腹血糖(Fasting plasma glucose, FPG)、空腹胰岛素(Fasting insulin, FINS)以及稳态模式胰岛素抵抗指数(Homeostasis model insulin resistanceindex, HOMA-IR)]变化、性激素水平[雌二酮(Estradiol, E_(2))、促卵泡雌激素(Follicle stimulating hormone, FSH)、睾酮(Testosterone, T)以及促黄体生成素(Luteinizing hormone, LH)]变化、子宫及卵巢功能[卵巢体积、子宫内膜厚度、成熟卵泡数量]变化以及治疗后排卵、妊娠、复发情况。结果 治疗后观察组临床总有效率96.67%(58/60)高于对照组85.00%(51/60),差异有统计学意义(P<0.05)。治疗后两组患者胰岛素指标FPG、FINS、HOMA-IR均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组胰岛素指标FPG、FINS、HOMA-IR均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者性激素E_(2)、FSH、T、LH水平均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组性激素E_(2)、FSH、T、LH水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者卵巢体积较治疗前降低,子宫内膜厚度以及成熟卵泡数量较治疗前升高,差异有统计学意义(P<0.05);且观察组卵巢体积明显低于对照组,子宫内膜厚度以及成熟卵泡数量明显高于对照组,差异有统计学意义(P<0.05)。随访3个月经周期,观察组排卵率86.67%(52/60)、妊娠率76.67%(46/60)均高于对照组71.67%(43/60)、58.33%(35/60),复发率1.67%(1/60)低于对照组11.67%(7/60),差异有统计学意义(P<0.05)。结论 加味二仙汤治疗PCOS的临床疗效显著,可有效降低患者的胰岛素抵抗以及调节性激素水平,改善卵巢功能,促进排卵,提高妊娠成功率,值得临床推广。

Systems Pharmacology Uncovers Multiple Mechanisms of Erxian Decoction (二仙汤) for Treatment of Premature Ovarian Failure

Objective:To predict the chemical compositions and drug targets and to systematically dissect the pharmacological mechanism of Erxian Decoction(二仙汤,EXD)as a treatment for premature ovarian failure(POF)using a systems pharmacology approach.Methods:The compounds present in EXD were obtained from three databases.The active ingredient was identified by analyzing the values of oral bioavailability(OB),drug-like ness(DL),and Lipin ski's rule(LR).The active in gredients were further searched in research articles,drug targets in the DrugBank database,and the C-T and T-P networks,as well as by pathway analysis using the Cytoscape platform.Results:A total of 728 compounds were identified in EXD.Of these,59 were identified as active compounds that conformed to the criteria with OB>30%and DL>0.18.By further searches in the literature,126 related targets were ide ntified that could in teract with the active compounds.Additi on ally,it was found that the beneficial effects of EXD in POF are probably exerted via regulation of the immline system,modulation of estrogen levels,and anti-oxidative activities,and that it may act in a synergistic or cooperative manner with other therapeutic agents.Conclusions:The systems pharmacology approach is a comprehensive system that was used to elucidate the pharmacological mechanism of EXD as a treatment for POF.The results of this study will also facilitate the application of traditional medicine in modern treatment strategies.

二仙补骨活血汤联合芪骨胶囊对绝经后骨质疏松症患者骨代谢及预后的影响

目的:探讨绝经后骨质疏松症(PMOP)患者应用二仙补骨活血汤联合芪骨胶囊治疗的效果。方法:采用随机数字表法将2021年1月—2023年2月于南昌市洪都中医院就诊的80例PMOP患者分为两组,各40例。对照组口服碳酸钙D3+芪骨胶囊治疗,观察组加用二仙补骨活血汤治疗,两组均连续治疗6个月。比较两组临床疗效、骨代谢指标[β胶联降解产物(β-CTx)、Ⅰ型胶原氨基端延长肽(PⅠNP)]、骨密度(BMD)和血清性激素雌二醇(E_(2))、骨折率及安全性。结果:相比于对照组,观察组治疗总有效率更高,治疗后PⅠNP、β-CTx水平均更低,BMD和E_(2)水平均更高,差异均有统计学意义(P<0.05);两组骨折率比较,差异无统计学意义(P>0.05);两组均无明显不良反应发生。结论:PMOP患者应用二仙补骨活血汤联合芪骨胶囊治疗效果较佳,可改善骨代谢指标、BMD,提高E_(2)水平,且安全性好,利于预后。

加味二仙汤联合来曲唑对PCOS患者促排卵及血清性激素水平的影响

目的:探究加味二仙汤联合来曲唑治疗多囊卵巢综合征(PCOS)对患者促排卵及血清抗缪勒管激素(AMH)等性激素水平的影响。方法:选取本院2020年3月-2023年8月确诊的PCOS患者86例,随机数字表法分为西药组(n=43)和中西药组(n=43)。两组均服用来曲唑治疗,中西药组加服加味二仙汤治疗,统计两组治疗前后促排卵情况(成熟卵泡个数、宫颈粘液评分、排卵期子宫内膜厚度),性激素[雌激素(E_(2))、促卵泡激素(FSH)、睾酮(T)、黄体生成素(LH)]水平,AMH水平以及不良反应。结果:治疗后,中西药组成熟卵泡个数(5.3±0.6个)、宫颈粘液评分(11.9±1.4分)、排卵期子宫内膜厚度(9.2±1.1mm)、妊娠率(74.4%)均高于西药组(3.8±0.5个、9.2±1.1分、6.5±0.9mm、46.5%),两组血清E_(2)、T、LH、AMH水平均降低,FSH两组均升高,且中西药组变化幅度大于西药组(均P<0.05);两组不良反应发生率(16.3%、9.3%)无差异(P>0.05)。结论:加味二仙汤联合来曲唑治疗PCOS,可显著改善患者排卵情况及性激素水平,降低AMH水平,提高治疗妊娠率。

二仙汤治疗肾阳虚型老年性骨质疏松症临床观察

目的观察二仙汤治疗肾阳虚型老年性骨质疏松症的临床疗效。方法选取肾阳虚型老年性骨质疏松症患者90例,分为对照组与治疗组,各45例。对照组予口服碳酸钙D3片和阿仑膦酸钠,治疗组在此基础上加用二仙汤。比较2组治疗12周后临床疗效。结果治疗组总有效率高于对照组(P>0.05);治疗组VAS评分低于对照组(P<0.05);治疗后,2组骨密度水平差异无统计学意义(P>0.05);β-CTX治疗前后无明显变化,治疗组PINP、BGP高于对照组。结论二仙汤联合碳酸钙D3与阿仑膦酸钠治疗肾阳虚型老年性骨质疏松症疗效优于对照组,能延缓骨质疏松进展,缓解临床症状,可供临床参考使用。

二丁二仙汤加减联合环丙沙星对肾盂肾炎患者免疫应答功能的影响

目的:探究二丁二仙汤加减联合环丙沙星对肾盂肾炎患者免疫应答功能的影响。方法:选取2022年7月~2023年7月我院接诊的148例肾盂肾炎患者作为研究对象,按照双盲法分为环丙沙星组和联合治疗组各74例。环丙沙星组采用环丙沙星进行治疗,联合治疗组在环丙沙星组基础上加服二丁二仙汤加减进行治疗。观察两组患者临床症状体征消失时间、生活质量、中医症候积分及治疗效果;采用全自动生化分析仪检测血肌酐(Scr)、尿素氮(BUN)水平;炎性因子白细胞介素-6(IL-6)、子白细胞介素-17(IL-17)、肿瘤坏死因子-α(TNF-α)水平;酶联免疫吸附双抗体夹心法检测血清免疫球蛋白IgA、IgG、IgM水平。结果:与环丙沙星组相比,联合治疗组临床症状体征消失时间较短(P<0.05)。与环丙沙星组相比,联合治疗组肾功能指标Scr、BUN及炎性因子IL-6、IL-17、TNF-α水平,中医症候积分较低(P<0.05)。与环丙沙星组相比,联合治疗组免疫球蛋白IgA、IgG、IgM水平,生活质量评分及治疗总有效率较高(P<0.05)。结论:二丁二仙汤加减联合环丙沙星可有效改善肾盂肾炎患者临床症状,增强免疫应答功能,可用于此病的治疗中。

二仙汤辅治骨质疏松临床研究

目的:观察二仙汤辅治骨质疏松的效果。方法:88例随机分为对照组和观察组各44例。两组均以常规西药治疗,观察组加用二仙汤治疗。结果:总有效率观察组高于对照组(P<0.05)。观察组中医证候评分低于对照组(P<0.05)。治疗后观察组I型前胶原氨基末端前肽(PINP)、I型胶原羧基端肽β特殊序列(β-CTX)低于对照组而骨形成蛋白6(BMP6)高于对照组(P<0.05)。治疗后观察组炎症因子白介素-1(IL-1)、核因子(NF-κB)、肿瘤坏死因子-α(TNF-α)低于对照组(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:二仙汤辅治骨质疏松效果良好,且安全。

助脉二仙汤联合镇心膏穴位贴敷治疗缓慢型心律失常患者的临床研究

目的:探讨助脉二仙汤联合镇心膏穴位贴敷治疗缓慢型心律失常患者的临床疗效及对患者心功能、炎症因子水平的影响。方法:选取2021年2月~2023年2月期间于某院就诊的120例缓慢型心律失常患者作为研究对象,采用随机数字表法分为对照组和观察组,每组60例。对照组患者给予硫酸阿托品片治疗,观察组在对照组治疗基础上加用助脉二仙汤口服、镇心膏穴位贴敷治疗,两组均治疗4周。比较两组患者临床疗效、中医证候积分、心功能[心脏指数(CI)、每搏输出量(SV)、左室射血分数(LVEF)]、炎症因子[白介素-6(IL-6)、白介素-8(IL-8)、超敏C反应蛋白(hs-CRP)、核转录因子-κB p65(NF-κB p65)、磷酸化细胞核转录因子κB抑制蛋白α(p-IκBα)]水平及不良反应发生情况。结果:治疗后,观察组患者治疗总有效率(96.67%)高于对照组(83.33%,P<0.05);两组患者心悸胸闷、短气乏力、身寒肢冷、面色晦暗、胸痛、腰膝酸软得分均降低(P<0.05),且观察组低于对照组(P<0.05);两组患者CI、SV、LVEF均升高(P<0.05),且观察组高于对照组(P<0.05);两组患者IL-6、IL-8、hs-CRP、NF-κB p65及p-IκBα均降低(P<0.05),且观察组低于对照组(P<0.05);两组患者用药期间均未发生明显不良反应。结论:在硫酸阿托品片的治疗基础上联合助脉二仙汤口服、镇心膏穴位贴敷治疗缓慢型心律失常临床疗效较佳,可有效减轻患者临床症状,改善心功能,减轻炎症反应,且安全性较高。

二仙汤合桂枝茯苓丸加减治疗PCOS对患者代谢紊乱及卵巢血流动力学的改善作用

目的:观察二仙汤合桂枝茯苓丸加减治疗多囊卵巢综合征(PCOS)疗效及对患者代谢紊乱、卵巢血流动力学的影响。方法:将2021年3月-2023年3月本院就诊的PCOS患者104例分为两组,对照组(n=52)给予炔雌醇环丙孕酮片治疗,观察组(n=52)给予炔雌醇环丙孕酮片联合二仙汤合桂枝茯苓丸加减治疗,治疗3个月经周期后评估疗效。检测血清性激素及代谢指标,超声测量卵巢间质动脉收缩期峰值血流速度(PSV)、阻力指数(RI)和舒张末期血流速度(EDV)。结果:治疗后观察组中医证候积分(5.58±1.89分)、血清睾酮(2.01±0.33nmol/L)、空腹血糖(4.65±0.37mmol/L)、黄体生成素(7.12±0.64U/L)、总胆固醇(4.11±0.32mmol/L)、黄体生成素/卵泡刺激素(1.31±0.12)、低密度脂蛋白胆固醇(2.46±0.31mmol/L)、空腹胰岛素(11.07±2.65)、三酰甘油(1.09±0.19mmol/L)均低于对照组(7.96±2.03分、2.74±0.42nmol/L、5.22±0.51mmol/L、9.34±0.85U/L、4.52±0.36mmol/L、1.72±0.21、2.67±0.43mmol/L、12.89±2.97、1.23±0.21mmol/L),雌二醇(68.85±5.96ng/L)水平高于对照组(62.48±5.17ng/L)(均P<0.05),但两组卵泡刺激素和高密度脂蛋白胆固醇水平无差异(P>0.05),卵巢PSV(12.21±1.98cm/s)、EDV(10.02±2.17cm/s)均低于对照组(15.88±2.01cm/s、11.53±2.25cm/s),RI(0.82±0.21)和治疗总有效率(98.1%)均高于对照组(0.62±0.13、84.6%)(均P<0.05)。结论:二仙汤合桂枝茯苓丸加减治疗PCOS能够改善患者临床症状,纠正内分泌及糖脂代谢紊乱,改善卵巢血流动力学,提高临床疗效。

二仙汤加减治疗桥本氏甲状腺炎甲状腺功能减退临床观察

目的:观察二仙汤加减治疗桥本氏甲状腺炎甲状腺功能减退的临床疗效及对甲状腺功能的影响。方法:选取符合纳入标准的60例桥本氏甲状腺炎甲状腺功能减退症患者,根据随机数字表法分为两组各30例。对照组予西医基础治疗,治疗组在对照组基础上予二仙汤随症加减治疗,观察并记录两组患者治疗前后的中医症状积分、促甲状腺激素(TSH)、游离三碘甲状腺原氨酸(FT3)、游离四碘甲状腺原氨酸(FT4)、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)水平、血清γ-干扰素(IFN-γ)、白细胞介素-10(IL-10)水平,评估临床疗效。结果:治疗组总有效率90.00%,对照组总有效率56.67%,治疗组明显优于对照组(P﹤0.05)。治疗后,两组患者中医症状积分、TSH、TPOAb、TGAb、IFN-γ水平均下降,IL-10、FT3、FT4水平均上升,差异有统计学意义(P﹤0.05);同时,治疗组各指标改善情况均优于对照组,差异有统计学意义(P﹤0.05)。结论:二仙汤加减能有效改善桥本氏甲状腺炎甲状腺功能减退症患者的临床症状及甲状腺功能,提高临床疗效。

耳穴压豆联合二仙汤加味治疗腰椎间盘突出症临床观察

目的:观察耳穴压豆联合二仙汤加味治疗腰椎间盘突出症(LDH)的疗效。方法:108例按照随机数字表法分为两组各54例。常规组给予二仙汤加味,试验组给予耳穴压豆联合二仙汤加味治疗。结果:总有效率试验组高于常规组(P<0.05),试验组治疗后VAS、JOA评分改善优于常规组(P<0.05),试验组治疗后血清CRP、TNF-α、IL-1β水平低于常规组(P<0.05),治疗后两组血清Apaf-1、TFAR-19、Caspase-3水平均下降但试验组下降更为明显(P<0.05)。结论:耳穴压豆联合二仙汤加味治疗LDH效果较好且安全。