Huangqi Guizhi Wuwu Decoction for treating diabetic peripheral neuropathy：a meta-analysis of 16 randomized controlled trials

OBJECTIVE：This meta-analysis was performed to systematically assess the efficacy and safety of the Chinese herbal medicine Huangqi Guizhi Wuwu Decoction（HGWWD） for treating diabetic peripheral neuropathy.DATA SOURCES：Six electronic databases,including the Cochrane Library,MEDLINE database,Chinese Biomedical Database,Chinese National Knowledge Infrastructure Database,Chinese Science and Technique Journals Database,and the Wanfang Database,were search ed on the internet for randomized controlled trials published up until 1 December 2015.The search terms included ＂Chinese herbal medicine＂,＂diabetic peripheral neuropathy＂ and ＂randomized controlled trials＂ in Chinese and in English.DATA SELECTION：We included randomized controlled trials using HGWWD/modified HGWWD for the treatment group,without restriction for the control group.We assessed literature quality in accordance with the Cochrane Review Handbook.A random or a fixed effects model was used to analyze outcomes using Rev Man 5.2 software.OUTCOME MEASURES：The primary outcomes were changes in symptoms and nerve conduction velocities.The secondary outcomeswere fasting blood glucose and hemorheological indexes.RESULTS：Sixteen randomized controlled trials,with a total of 1,173 patients,were included.Meta-analysis revealed that the efficacy of HGWWD for diabetic peripheral neuropathy was significantly superior compared with the control treatment（i.e.,control group）（risk ratio = 0.36,95% confidence interval（CI）：0.29–0.46,Z =8.33,P 〈 0.00001） Compared with the control group,there was an increase in median motor nerve conduction velocity（mean difference（MD） = 3.46,95%CI：1.88–5.04,Z = 4.30,P 〈 0.01） and median sensory nerve conduction velocity（MD = 3.30,95%CI：2.04–4.56,Z = 5.14,P 〈 0.01）.There was also an increase in peroneal motor nerve conduction velocity（MD = 3.22,95%CI：2.45–3.98,Z = 8.21,P 〈 0.01） and peroneal sensory nerve conduction velocity（MD = 3.05,95%CI：2.01–4.09,Z = 5.75,P 〈 0.01） in the treatment groups.No significant difference in fasting blood glucose was found between the treatment groups and the control groups（MD =-0.12,95%CI：-0.42–0.19,Z = 0.76,P = 0.45）.Plasma viscosity was significantly decreased after treatment（MD =-0.11,95%CI：-0.21 to-0.02,Z = 2.30,P = 0.02）.No significant difference in fibrinogen was detectable（MD =-0.53,95%CI：-1.28–0.22,Z = 1.38,P = 0.17）.Four trials reported that treatment groups experienced no adverse reactions.Adverse events were not mentioned in the other 12 trials.No trial reported the incidence of complications,quality of life outcomes,or health economics.CONCLUSION：HGWWD treatment improves diabetic neurologic symptoms and ameliorates nerve conduction velocities.Our study suggests that HGWWD may have significant therapeutic efficacy for the treatment of diabetic peripheral neuropathy.However,the methodological quality of the randomized controlled trials was generally low.Larger and better-designed randomized controlled trials are required to more reliably assess the clinical effectiveness of HGWWD.

Gualou Guizhi decoction promotes neurological functional recovery and neurogenesis following focal cerebral ischemia/reperfusion

Recovery following stroke involves neurogenesis and axonal remodeling within the ischemic brain. Gualou Guizhi decoction （GLGZD） is a Chinese traditional medicine used for the treatment of post-stroke limb spasm. GLGZD has been reported to have neuroprotective effects in cerebral ischemic injury. However, the effects of GLGZD on neurogenesis and axonal remodeling following cerebral ischemia remain unknown. In this study, a rat model of focal cerebral ischemia/reperfusion was established by middle cerebral artery occlusion. Neurologi- cal function was assessed immediately after reperfusion using Longa＇s 5-point scoring system. The rats were randomly divided into vehicle and GLGZD groups. Rats in the sham group were given sham operation. The rats in the GLGZD group were intragastrically administered GLGZD, once daily, for 14 consecutive days. The rats in the vehicle and sham groups were intragastrically administered distilled water. Modified neurological severity score test, balance beam test and foot fault test were used to assess motor functional changes. Nissl staining was performed to evaluate histopathological changes in the brain. Immunofluorescence staining was used to examine cell proliferation using the marker 5-bromo-2＇-deoxyuridine （BrdU） as well as expression of the neural precursor marker doublecortin （DCX）, the astrocyte marker glial fibrillary acidic protein （GFAP） and the axon regeneration marker growth associated protein-43 （GAP-43）. GLGZD substan- tially mitigated pathological injury, increased the number of BrdU, DCX and GFAP-immunoreactive cells in the subventricular zone of the ischemic hemisphere, increased GAP-43 expression in the cortical peri-infarct region, and improved motor function. These findings suggest that GLGZD promotes neurological functional recovery by increasing cell proliferation, enhancing axonal regeneration, and in- creasing the numbers of neuronal precursors and astrocytes in the peri-infarct area.

Clinical Study of Jiawei Huangqi Guizhi Wuwu Decoction (加味黄芪桂枝五物汤) in Preventing and Treating Peripheral Neuro-sensory Toxicity Caused by Oxaliplatin

Objective： To evaluate the efficacy of Jiawei Huangqi Guizhi Wuwu Decoction （加味黄芪桂枝五物汤, JHGWD） in treating neuro-sensory toxicity induced by oxaliplatin. Methods： A randomized controlled self-crossover trial was performed. Thirty-one patients were randomly divided into AB and BA groups. Patients in A cycle belonged to the treated group, who were treated with chemotherapy combined with oxaliplatin plus JHGWD. Patients in B cycle belonged to the control group and were treated with chemotherapy alone. The peripheral neuro-sensory toxicity was observed and analyzed. Results： The main neurotoxicity was cold-induced paresthesia after the use of oxaliplatin, which included hyperaesthesia, chill, anaesthesia in the extremities, electrified sensation, formication, foreign body sensation and pain that might be exacerbated by exposure to cold. Twenty patients （64.5 % ） suffered from neuro-sensory toxicity in the treated group and 27 cases （87.1% ） in the control group. Symptoms were more serious and lasted longer in the control group than those in the treated group （P〈0.01）. Conclusion： JHGWD could prevent and reduce the occurence and intensity of acute peripheral neuro-sensory toxicity caused by oxaliplatin.

Effects of Guizhi Shaoyao Zhimu Decoction on Laboratory Indicators and Immune Functions of Patients with Rheumatoid Arthritis

[Objectives]To explore the effects of Guizhi Shaoyao Zhimu Decoction on laboratory indicators and immune functions of patients with rheumatoid arthritis.[Methods]A total of 110 patients with rheumatoid arthritis admitted to the Second Department of Orthopedics,the Affiliated Chinese and Western Medicine Hospital of Nanjing,Nanjing University of Chinese Medicine from December 2014 to December 2016 were selected as the research objects and divided into a control group and an observation group using the random number table method,with 55 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with Guizhi Shaoyao Zhimu Decoction on the basis of the control group.Both groups were treated for one month.The clinical effects,improvement of clinical symptoms,laboratory indicators and immune function indicator levels between the two groups were compared;the incidence of adverse reactions in the two groups was counted.[Results]The total effective rate of the observation group was 92.73%,higher than that of the control group(78.18%)(P<0.05).Compared with that before treatment,after one month of treatment,the grip strength of the two groups increased,and the observation group was greater than the control group(P<0.05);the morning stiffness time and 20 m walking time of both groups were shortened,and the observation group was shorter than the control group(P<0.05);the number of joint tenderness,joint swelling,ESR,MPV,PDW,serum CRP,plasma IgA,IgG,IgM,RF levels in both groups decreased,and the observation group was lower than the control group(P<0.05);the serum C3 levels in both groups increased,and the observation group was higher than the control group(P<0.05).During the treatment,the incidence of adverse reactions in the observation group was 0.00%,which was lower than that in the control group(10.91%,P<0.05).[Conclusions]Using Guizhi Shaoyao Zhimu Decoction to treat rheumatoid arthritis can improve the laboratory indicators of patients,and enhance their immune functions,improve the curative effect,and the safety is high.

Exploring the mechanism of Guizhi decoction’s“Jun-Chen-Zuo-Shi”in treating plant nervous disorders based on weighted network pharmacology and molecular docking techniques

Objective:To explore the mechanism of Guizhi decoction’s“Jun-Chen-Zuo-Shi”in treating plant nervous disorders based on network pharmacology and molecular docking methods.Methods:The main active ingredients of Guizhi decoction were screened from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP),and plant nervous disorder-related targets were screened from the Gene Cards database,OMIM database,and PharmGKB database.The intersection of the two was obtained.The intersection targets were used to draw a protein interaction network and a“Traditional Chinese Medicine-active ingredient-target”network using the STRING database and Cytoscape 3.9.1.The nodes in the“Traditional Chinese Medicine-active ingredient-target”network were weighted according to the“Jun-Chen-Zuo-Shi”principle.Kyoto Encyclopedia of Genes and Genomes,and gene ontology enrichment analysis were performed on the intersection targets.Molecular docking was used to verify the affinity between core targets and key ingredients.Results:A total of 225 effective components of Guizhi decoction were screened,among which 127 components could bind to 160 common targets and play a therapeutic role.The common targets were mainly enriched in 2785 gene ontology entries and 189 Kyoto Encyclopedia of Genes and Genomes pathways.Molecular docking confirmed that core targets could spontaneously bind to key ingredients.Conclusion:The key targets for the treatment of plant nervous disorders by Guizhi decoction are MAPK1,TP53,RB1,STAT3,MAPK3,MAPK14,etc.,which reflect the characteristics of the synergistic mechanism of traditional Chinese medicine with multiple components,targets,and pathways through the regulation of inflammatory signal pathways and oxidative stress processes.

Potential Mechanism of Huangqi Guizhi Wuwu Decoction for Cervical Spondylosis treatment based on Network Pharmacology

Objective:To study the potential mechanism of Huangqi Guizhi Wuwu Decoction in the treatment of cervical spondylosis based on the network pharmacological method,and to provide a basis for clinical application and pharmacological research.Methods:TCMSP search was used to screen the main active compounds and related action targets of Huangqi Guizhi Wuwu Decoction,the standard names of action targets were obtained through the Uniprot database,and the"drug-target"interaction network was constructed by using Cytoscape3.6.1 software.The related targets of cervical spondylosis were obtained by searching GeneCards,OMIM,DisGeNET,and CTD databases,and the disease targets and drug targets were mapped by the Venny platform,and the intersection genes of them were the potential targets for drug treatment of this disease.Then,the intersection genes were input into the STRING database and Cytoscape 3.6.1 software,and the protein-protein interactions(PPI)network of"drug-disease intersection targets"was constructed,and we screened the core targets.Finally,GO biological function analysis and KEGG signaling pathway analysis of core targets were carried out through the DAVID database.Results:According to the screening conditions,74 effective compounds and 138 drug action targets of Huangqi Guizhi Wuwu Decoction were obtained,12179 genes related to cervical spondylosis were obtained,and the Venny platform analysis obtained 105 intersecting targets.With visual network processing by Cytoscape software,33 core targets were obtained by analyzing and calculating the core target degree values,which were JUN,PTGS2,NR3C1,TNF,IL6,TP53,EGFR,VEGFA,NOS3,IL1B,and so on.GO analysis showed that there were 133 items(P<0.05),involving adrenergic receptor activation,neurotransmitter receptor activation,nuclear receptor activation,catecholamine binding,etc.KEGG analysis obtained a total of 139 pathways(P<0.05),involving IL-17 signaling pathway,and tumor necrosis factor signaling pathway,relaxin signaling pathway,AGE-RAGE signaling pathway of diabetic complications,fluid shear stress,and atherosclerosis.Conclusion:the active components in Huangqi Guizhi Wuwu decoction may act on the core targets such as JUN,PTGS2,NR3C1,TNF,IL6,TP53,VEGFA through IL-17 signal pathway,tumor necrosis factor signal pathway,and AGE-RAGE signal pathway of diabetic complications,and exert their therapeutic effects.The research results can provide a basis for future basic and clinical research.

Effects of Chaihu Guizhi Ganjiang Decoction Combined with Standard Triple Therapy on Reducing Serum CagA and Hp-NAP in Patients with H.pylori-Related Gastritis

OBJECTIVE: To explore the effects of Chaihu Guizhi Ganjiang Decoction combined with standard triple therapy on treating H.pylori-related gastritis. METHODS: Eighty-two patients with H. pylori-related gastritis treated in our hospital from January 2016 to December 2017 were selected according to the random number table method and divided into experimental group and control group, with 41 patients in each group. The control group was treated with standard triple therapy, while the experimental group was additionally treated with modified Chaihu Guizhi Ganjiang Decoction. The venous blood of one elbow was taken before and after treatment. The concentrations of serum CagA and Hp-NAP were detected by enzyme-linked immunosorbent assay(ELISA). The symptoms were evaluated according to the change of symptom scores before and after the intervention. The H.pylori eradication rate was calculated. RESULTS: There was no significant difference in CagA and Hp-NAP concentrations between the 2 groups before intervention(P > 0.05). After intervention, CagA and Hp-NAP concentrations in experimental group were(19.21±6.27) ng/L and(24.37±6.10) ng/L respectively which were lower than(25.81±7.14) ng/L and(32.09±5.73) ng/L of control group. The differences were statistically significant(P < 0.05). The total effective rate of major symptoms in experimental group was 39 cases(95.12%), which was significantly higher than that of the control group(31 cases, 75.61%). There was statistically significant difference between the 2 groups(P < 0.05). The eradication rate of H.pylori was 38 cases(92.68%) in the experimental group, which was significantly higher than 31 cases(75.61%) of the control group. The difference between the 2 groups was statistically significant(P < 0.05). CONCLUSION: Chaihu Guizhi Ganjiang Decoction combined with standard triple therapy can effectively reduce CagA, Hp-NAP of serum level in patients with H.pylori-related gastritis, improve efficacy of symptoms and eradication rate of H.pylori, and is worthy of clinical promotion.

Application of Huangqi Guizhi Wuwu Decoction in Orthopaedics and Traumatology

The Huangqi Guizhi Wuwu Decoction(HQGZWWT)is composed of Huangqi(Astragali Radix),Shaoyao(Paeoniae Radix Alba),Guizhi(Cinnamomi Ramulus),Shengjiang(Zingiberis Rhizoma Recens),and Dazao(Jujubae Fructus)which has various pharmacological anti-inflammatory,analgesic,antioxidant,antitumor,lipid-lowering,and immunity-regulating activities.It has certain advantages in the treatment of orthopaedic diseases,such as cervical spondylosis,scapulohumeral periarthritis,lumbar disc herniation,knee osteoarthritis,rheumatoid arthritis,myofascial pain syndrome,etc.,with outstanding clinical efficacy,few adverse reactions,and high patient compliance.However,modern pharmacological researches on the whole prescription of HQGZWWT are insufficient and the therapeutic targets are not clear which needs further exploration.Besides,this prescription cannot treat ll orthopaedic diseases,so we should adhere to the thinking of four diagnostics in traditional Chinese medicine(TCM),select prescriptions based on syndrome differentiation,closely follow the pathogenesis,innovate and expand its scope of application,reflect the application advantages of this prescription in orthopaedics and traumatology and improve the total clinical efficiency.

桂枝汤在女性经带胎产病症的应用探讨

女性在青春期、月经期、妊娠期、产后、围绝经期等生命各个特殊时期,体内气血变动剧烈,气血阴阳重新分布,容易导致营卫、气血不和、阴阳失衡而出现各种不和谐的病理状态。该文通过分析女性青春期、月经期、妊娠期、产后、围绝经期等出现营卫不和的机制,提出采用调和营卫法治疗经带胎产病症的思路,并认为桂枝汤为仲景群方之魁,具有解肌和营卫、化气和阴阳的功效,其加减方可用于妇科病症。在女性不同时期应用调和营卫之桂枝汤以治疗妇科病症,可拓展经方在妇科病症中的应用。

黄芪桂枝五物汤对糖尿病性下肢动脉硬化闭塞症大鼠动脉炎症的作用及其机制研究

目的:研究黄芪桂枝五物汤对糖尿病性下肢动脉硬化闭塞症大鼠的治疗作用及其机制。方法:将48只健康雄性SD大鼠随机分为模型组、低剂量中药组、高剂量中药组和空白对照组,每组12只,低剂量中药组和高剂量中药组分别给予1倍和2倍等效剂量中药汤剂灌胃,模型组和空白对照组给予生理盐水灌胃,连续干预4周。末次给药后24 h,观察大鼠一般情况、体质量、血糖水平,酶联免疫吸附法检测血清肿瘤坏死因子-α(TNF-α)、白细胞介素-16(IL-16)、一氧化氮(NO)、内皮素-1(ET-1)水平,观察腓肠肌新生血管密度,HE染色观察动脉血管病理变化,免疫印迹法检测缺氧诱导因子-1α(HIF-1α)/血管内皮生长因子(VEGF)通路蛋白表达水平。结果:低剂量中药组、高剂量中药组及模型组大鼠较空白对照组精神状态差,活跃性减弱,血糖升高,血清炎症因子水平升高,血管内皮功能受损。与模型组比较,低剂量中药组大鼠精神状态更好,行动较活跃,血糖下降,血清炎症因子水平降低,内皮细胞功能更完善,腓肠肌组织新生血管密度更高,HIF-1α及VEGF蛋白表达水平更高(P <0.05)。与低剂量中药组比较,高剂量中药组大鼠血糖下降,血清炎症因子水平降低,NO水平无显著差异,ET-1水平下降,腓肠肌组织新生血管密度更高,VEGF蛋白表达水平更高(P <0.05)。结论:黄芪桂枝五物汤可能通过调节HIF-1α/VEGF信号通路而抑制局部炎症反应,改善内皮细胞功能,从而起到治疗糖尿病性下肢动脉硬化闭塞症的作用。

黄芪桂枝五物汤改善环磷酰胺致生精障碍小鼠的肠道菌群紊乱

[目的]基于肠道菌群探究黄芪桂枝五物汤治疗少精子症的机制,并通过生精障碍动物实验进行初步验证。[方法]采用环磷酰胺造模小鼠生精障碍模型,研究黄芪桂枝五物汤对生精功能及肠道菌群的调节作用。实验随机选取10只昆明小鼠为正常组,连续7 d腹腔注射生理盐水;其余小鼠连续7 d腹腔注射环磷酰胺[60 mg/(kg·d)]制备生精障碍模型,而后随机分为模型组、黄芪桂枝五物汤低、中、高剂量组(8、16、32 g/kg),每组10只。药物灌胃干预35 d后,记录小鼠睾丸指数、附睾指数;采用计算机辅助精子分析系统检测附睾中精子质量;苏木素-伊红染色观察睾丸组织形态,并采用16S rDNA高通量测序技术分析小鼠的肠道菌群组成。[结果]黄芪桂枝五物汤可提高生精障碍模型小鼠的睾丸系数和附睾系数,增加精液浓度和精子活力,减轻睾丸组织病理损伤程度,改善肠道菌群结构,使得Parabacteroides丰度增加、Roseburia丰度减少。[结论]表明黄芪桂枝五物汤改善环磷酰胺导致的小鼠生精障碍和肠道菌群紊乱。

桂枝汤合止嗽散加减治疗小儿慢性咳嗽临证经验

“五脏六腑皆令人咳,非独肺也”,由于小儿脏腑娇嫩,行气未充,加之复杂的病因使咳嗽诊治难度加大,临床上常出现咳嗽久治难愈的现象。小儿久咳常因肺脾不足,素体本虚,复感风寒邪气,因正虚抗邪无力,致使风邪恋肺,造成卫气疏泄失常,出现营卫失和。因此在治疗中除补益肺脾、调和营卫,还应兼顾宣肺疏风、化痰止咳。中医药治疗咳嗽历史悠久且疗效确切,桂枝汤能补脾益肺、调和营卫,止嗽散能宣肺疏风、化痰止咳。临床中因小儿肺脾不足,风邪恋肺,伴见营卫不和而久咳者,可予两方加减合用,使营卫自和,肺脾功能恢复。

柴胡桂枝干姜汤调节Toll 样受体4/核因子κB/NOD样受体蛋白3信号通路对非酒精性脂肪性肝炎小鼠肝脏炎症反应和纤维化的影响

目的 探讨柴胡桂枝干姜汤通过调节Toll样受体4/核因子κB/NOD样受体蛋白3(TLR4/NF-κB/NLRP3)信号通对非酒精性脂肪性肝炎(NASH)小鼠肝脏炎症反应和纤维化的影响。方法 构建小鼠NASH模型,将小鼠分为5组:正常饮食组(NOR组)、蛋氨酸胆碱缺乏饮食组(NASH组)、柴胡桂枝干姜汤低剂量组(CGGD-L组,6 g/kg)、中剂量组(CGGD-M组,12 g/kg)、高剂量组(CGGD-H组,24 g/kg)。苏木精-伊红(HE)染色和油红O染色观察肝组织病理变化;天狼星红(Sirius red)染色观察纤维化程度;自动生化分析仪测定血清天冬氨酸氨基转移酶(AST)和丙氨酸氨基转移酶(ALT)、甘油三酯(TG)水平;酶联免疫吸附法(ELLISA)检测肝脏组织白细胞介素1β(IL-1β)、IL-6、肿瘤坏死因子α(TNF-α)含量;实时荧光定量聚合酶链式反应(RT-PCR)检测Ⅰ型胶原蛋白α链(ColⅠα)、结缔组织生长因子(CTGF)、组织金属蛋白酶抑制因子1(TIMP1)的mRNA表达;蛋白免疫印迹法(Western blot)检测TLR4、p-NF-κB、NF-κB、NLRP3蛋白表达。结果 NASH组小鼠出现明显的肝脏大泡脂肪性变性和炎症细胞浸润,AST、ALT、TG、IL-1β、IL-6、TNF-α含量,ColⅠα、CTGF、TIMP1的mRNA表达及α-SMA、TLR4、p-NF-κB、NF-κB、NLRP3蛋白表达,均较NOR组显著增加(P<0.05);与NASH组比较,CGGD-L组、CGGD-M组、CGGD-H组小鼠AST、ALT、TG、IL-1β、IL-6、TNF-α含量,ColⅠα、CTGF、TIMP1的mRNA表达及α-SMA、TLR4、p-NF-κB、NF-κB、NLRP3蛋白表达呈剂量依赖性降低(P<0.05)。结论 柴胡桂枝干姜汤通过抑制TLR4/NF-κB/NLRP3信号通路减轻NASH小鼠肝脏炎症和纤维化。

基于网络药理学和分子对接技术探讨桂枝加厚朴杏子汤治疗慢性阻塞性肺疾病作用机制

目的通过网络药理学和分子对接技术探究桂枝加厚朴杏子汤治疗慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)的主要活性成分、关键靶点和作用机制。方法利用相关数据库分别获取药物活性成分及其靶点以及疾病靶点,取交集靶点后利用Cytoscape3.10.0制作“药物-活性成分-核心靶点”网络图,运用STRING平台获取交集靶点相互作用关系。通过Metascape数据库对交集靶点进行GO和KEGG富集分析。选取主要活性成分与关键靶点由AutoDock Vina进行分子对接验证。结果共筛选得到122个药物活性成分,268个药物靶点,1595个疾病靶点,148个交集靶点。GO功能富集分析得到条目2233个(P<0.01),KEGG通路富集分析得到197条信号通路(P<0.01)。分子对接的结果显示主要活性成分和关键靶点有结合性良好。结论桂枝加厚朴杏子汤可通过多成分、多靶点、多通路协同作用治疗COPD,其主要作用机制可能与介导IL-17、PI3K/AKT、TNF等信号通路抑制炎症有关。

桂枝芍药知母汤治疗膝骨性关节炎关节镜清理术后肿痛临床观察

目的探究桂枝芍药知母汤治疗膝骨性关节炎关节镜清理术后肿痛的临床效果。方法选取南昌市洪都中医院收治的膝骨性关节炎关节镜清理术后肿痛患者69例作为研究对象,按随机数字表法分为对照组(34例)和观察组(35例)。对照组予常规治疗,观察组在对照组基础上予桂枝芍药知母汤治疗,比较两组术前及术后1 d、3 d、7 d、14 d视觉模拟量表(VAS)评分、膝关节肿胀值并评估临床疗效。结果术前,两组VAS评分、膝关节肿胀值比较,差异无统计学意义(P>0.05);术后1 d、3 d、7 d、14 d,观察组VAS评分、膝关节肿胀值均低于对照组(P<0.05)。观察组临床治疗总有效率为97.14%(34/35),高于对照组的82.35%(28/34),差异有统计学意义(P<0.05)。结论对膝骨性关节炎关节镜清理术后肿痛患者实施桂枝芍药知母汤治疗,可有效缓解疼痛、消除肿胀,提高临床效果。

针灸推拿联合黄芪桂枝五物汤治疗神经根型颈椎病临床效果观察

目的观察针灸推拿联合黄芪桂枝五物汤治疗神经根型颈椎病的临床效果。方法选取2021年4月—2023年4月首钢水钢医院收治的神经根型颈椎病患者106例,根据治疗方法不同分为观察组(针灸推拿联合黄芪桂枝五物汤)和对照组(针灸推拿)各53例。比较两组治疗效果、中医症候积分、疼痛程度、颈椎病症状、颈椎功能、颈椎旋转活动度和炎症因子水平。结果治疗4周后,观察组中医症候积分(疼痛、麻木、头晕、乏力)、疼痛程度、颈椎功能障碍指数评分、炎症因子(白细胞介素-8、超敏C反应蛋白)水平低于对照组,总有效率、颈椎病症状评分、颈椎旋转活动度高于对照组,差异有统计学意义(P<0.05)。结论神经根型颈椎病患者采用针灸推拿联合黄芪桂枝五物汤治疗效果显著,可促使患者症状缓解,减轻疼痛程度,抑制炎症反应,利于颈椎功能恢复正常。

柴胡桂枝汤联合火龙罐对面瘫患者的临床疗效观察

[目的]通过观察柴胡桂枝汤联合火龙罐治疗(风寒袭络证)面瘫患者的面部表情,分析面部表情肌弹性,并探究其对社会功能的影响。[方法]将2021年1月—2023年7月医院收治的120例面瘫患者随机分为试验组60例和对照组60例,对照组给予火龙罐治疗,试验组在对照组基础上联合柴胡桂枝汤治疗,连续治疗14 d。治疗结束后,比较两组临床疗效、中医证候积分、弹性模量值、面神经功能以及社会功能的变化。[结果]治疗后,试验组总有效率高于对照组(χ^(2)=5.065,P=0.024);治疗后,两组患者中医证候积分、各表情肌弹性模量值、面神经功能以及面部残疾指数表(FDI)评分均明显改善(P<0.05)。[结论]柴胡桂枝汤联合火龙罐治疗面瘫患者疗效较好,可疏通经络,调整气血,有效改善临床症状和社会功能,安全性较好。

桂枝芍药知母汤治疗痛风性关节炎急性期疗效及对患者可调节相关因子与嘌呤受体水平变化的影响

目的:观察桂枝芍药知母汤联合非布司他、塞来昔布治疗痛风性关节炎(GA)急性期的效果,为临床治疗提供参考。方法:选取GA患者110例,根据随机原则分为对照组(西药)和观察组(桂枝芍药知母汤+西药),每组55例。记录两组治疗前及治疗3、7 d后血尿酸(UA)、血沉(ESR)、白细胞介素-1β(IL-1β)、Diekkopf-1(DKK-1)、白细胞介素-18(IL-18)、嘌呤能受体(P2X7R)水平及中医证候积分的变化,统计两组疗效和不良反应。结果:治疗7 d后,观察组总有效率为90.91%(50/55),明显高于对照组的76.36%(42/55),差异有统计学意义(P<0.05)。治疗3、7 d后,两组皮色皮温、全身症状及关节相关积分较治疗前下降,观察组低于对照组,且两组治疗7 d后低于治疗3 d后(P<0.05)。治疗3、7 d后,两组UA、IL-1β、DKK-1、IL-18、P2X7R、ESR较治疗前下降,观察组低于对照组,且两组治疗7 d后上述因子低于治疗3 d后(P<0.05)。观察组不良反应发生率为9.09%(胸闷1例、胃肠道症状4例),与对照组的20.00%(胸闷2例、胃肠道症状8例和皮疹1例)比较,差异无统计学意义(P>0.05)。结论:桂枝芍药知母汤联合西药治疗GA急性期可减轻症状,提高疗效,可能与调节相关因子的表达水平有关。

黄芪桂枝五物汤治疗乳腺癌化疗后手足麻木的效果

目的:探讨乳腺癌化疗后手足麻木采用黄芪桂枝五物汤治疗的效果。方法:选取2018年1月—2022年12月南通市第三人民医院收治的乳腺癌化疗后手足麻木患者110例作为研究对象,按照双色球法随机分为两组,各55例。对照组采用常规西药治疗,观察组采用黄芪桂枝五物汤治疗。比较两组手足麻木消退时间、治疗效果、关节活动度。结果:观察组手足麻木消退时间短于对照组,差异有统计学意义(P<0.001)。观察组治疗总有效率高于对照组,差异有统计学意义(P=0.019)。治疗前,两组关节前屈、外展、后伸、内收角度比较,差异无统计学意义(P>0.05);治疗后,两组关节前屈、外展、后伸、内收角度大于治疗前,且观察组大于对照组,差异有统计学意义(P<0.05)。结论:黄芪桂枝五物汤治疗乳腺癌化疗后手足麻木的效果显著,可有效改善患者肢体功能,缓解手足麻木症状。

Infrared Thermography-Based Predictive Model for Syndrome Differentiation of Chaihu Guizhi Ganjiang Decoction

Objective:To evaluate the use of infrared thermography technology for objective and quantitative syndrome differentiation and treatment in traditional Chinese medicine(TCM),specifically in patients with Chaihu Guizhi Ganjiang Decoction syndrome.Methods:Data were collected from over 100 patients diagnosed with Chaihu Guizhi Ganjiang Decoction syndrome at Professor Li Leyu’s endocrinology clinic,Zhongshan Hospital of Traditional Chinese Medicine,Guangdong Province,between April 2021 and April 2022.Body surface temperature data were obtained using the MTI-EXPRO-2013-B infrared thermography system.Principal component analysis(PCA)was applied to differentiate temperature distribution characteristics between genders,and a neural network prediction model was constructed for syndrome diagnosis.Results:Infrared thermography effectively captured surface temperature characteristics of patients with Chaihu Guizhi Ganjiang Decoction syndrome.PCA identified one principal component with a variance explanation rate of 73.953%for females and two principal components with a cumulative variance explanation rate of 77.627%for males.The neural network model demonstrated high predictive performance,with an area under the ROC curve of 0.9743 for the training set and 0.9889 for the validation set.Sensitivity was 1,specificity 0.8636,precision 0.8846,accuracy 0.9333,and the F1 score 0.9388.Conclusion:Infrared thermography provides an innovative,objective,and quantitative method for syndrome differentiation and treatment in TCM.It represents a significant advancement in transitioning from traditional empirical approaches to modern,visualized,and precise diagnosis and treatment.This study underscores the potential of integrating advanced technologies in TCM for enhanced clinical application and modernization.