Effects of Jiawei Wendan decoction on hippocampal p-CREB protein expression in a rat model of depression

BACKGROUND： Jiawei W＇endan decoction can elevate hippocampal brain-derived neurotrophic factor （BDNF） protein expression in rats with depression. It has been hypothesized that Jiawei Wendan decoction can exhibit antidepressant effects through the hippocampal signal transduction pathway of cyclic adenosine monophosphate response element binding protein （CREB）-BDNF. OBJECTIVE： Using phosphorylated-CREB （p-CREB） as an entry point, the present study was designed to observe intervention effects ofJiawei Wendan decoction compared with fluoxetine. DESIGN, TIME AND SETTING： A randomized, controlled, cellular biology experiment was performed at the Central Laboratory of Guangxi University of Traditional Chinese Medicine, MATERIALS： A total of 40 healthy, male, Sprague-Dawley rats were included in the present study. Rhizoma Acori Talarinowii （Shichangpu）, Flos Albiziae （Hehuanhua）, Rhizoma Pinelliae （Banxia）, Caulis Bambusae in Taeniam （Zhuru）, Fructus Aurantii Immaturus （Zhishi）, Poria （Fuling）, and Radix Bupleuri （Chaihu）, the primary ingredients ofJiawei Wendan decoction, were purchased from First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine. The raw drug was decocted at a concentration of 1.5 g/mL. Fluoxetine capsules were purchased from Shanghai Zhongxi Pharmaceutical Co., Ltd., China. METHODS： Following behavioral testing, 36 rats were selected from the initial 40 rats according to similar behavioral scores, and were randomly divided into 4 groups： model （n = 8）, Jiawei Wendan decoction-treated （n = I 0）, fluoxetine-treated （~ = 10）, and normal control （n = 8）. All rats, except for those in the normal control group, were separately raised in a chronic and unpredictable, mild-stimulation environment for 2 l days to establish a depression model. The Jiawei Wendan decoction-treated and fluoxetine-treated groups were intragastrically administered Jiawei Wendan decoction （12 g/kg/d） and fluoxetine （1.8 mg/kg/d）, respectively. The model and normal control groups received double-distilled water （2 mL/kg/d） once a day for a total of 21 days. MAIN OUTCOME MEASURES： Prior to depression induction and subsequent to administration, memory and degree of depression were measured by open field and tail suspension tests, respectively. At 24 hours after administration, p-CREB expression in the hippocampat CA3 region was analyzed by the immunohistochemical SABC method. RESULTS： Two rats from the Jiawei Wendan decoction-treated group, and one from the fluoxetine-treated group, died of unknown causes. The remaining rats in each group, except for one rat that was randomly selected from the fluoxetine-treated group, were included in the final analysis. Following administration, the model group exhibited significantly decreased numbers of hippocampal p-CREB-positive cells, horizontal and vertical movements, and significantly prolonged duration of immobility in tail-suspension test, compared with the normal control group （P 〈 0.01）. The numbers of p-CREB-positive cells, as well as horizontal and vertical movements, were significantly greater, and the duration of immobility was significantly shorter, in the Jiawei Wendan decoction and fluoxetine groups, compared with the model group （P 〈 0.05-0.01）. There was no significant difference in the above-mentioned three indices between the Jiawei Wendan decoction and fluoxetine groups （P 〉 0.05）. CONCLUSION： Jiawei Wendan decoction increased hippocampal p-CREB expression by influencing the rat hippocampal signal transduction pathway of CREB-BDNF. Jiawei Wendan decoction exhibited antidepressant effects equivalent to fluoxetine.

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.

Clinical Observation of Jiawei Buzhong Yiqi Decoction in the Treatment of Obese Polycystic Ovarian Syndrome

[Objectives] To observe the clinical efficacy of Jiawei Buzhong Yiqi Decoction in the treatment of polycystic ovarian syndrome(PCOS).[Methods]Obese patients with PCOS were recruited for the study in September 2014-December 2016 from Chinese medicine gynecological clinic in the affiliated hospital of Hubei University of Medicine.All these patients were given one dose of Jiawei Buzhong Yiqi Decoction one time a day for three months.Body mass index(BMI) was measured before and after treatment.Sex hormone levels and ovulation were measured,and the improvement of clinical symptoms was compared before and after treatment.[Results] After treatment,the levels of BMI and serum luteinizing hormone(LH),testosterone(T) were significantly decreased,and the level of serum estradiol(E2) was significantly higher than that before treatment.Ovarian enlargement and polycystic changes,menstrual cycle,menstrual flow and menstrual period were improved in varying degrees.[Conclusions] Jiawei Buzhong Yiqi Decoction has a good clinical effect in the treatment of obese PCOS.

The therapeutic effect of Jiawei Danshen Decoction on myocardial ischemia-reperfusion injury by inhibiting H_(2)S-mediated autophagy signaling pathway

Objective To investigate the protective effects of Jiawei Danshen Decoction(加味丹参饮,JWDSD)on myocardial ischemia-reperfusion injury(MIRI)via the regulation of serum Hydrogen sulfide(H2S)and cardiac Beclin1,light Chain 3 A/B(LC3 A/B),p62,and autophagy protein5(ATG5).Methods Seventy specific pathogen free(SPF)Sprague-Dawley(SD)rats were randomly assigned to seven groups(n=10 in each group),including normal control,sham operation,MIRI model(model),ischemic preconditioning,Na HS,JWDSD,and JWDSD+CSE inhibitor(JWDSD+PPG)groups,and orally administered the indicated drugs for 14 d.Two hours after the last administration,the left anterior decreased branch of the coronary artery of each rat in model,Na HS,JWDSD,and JWDSD+PPG groups was ligated for 30 min and subsequently reperfused for 90 min to establish the MIRI model,and the rats in the sham operation group were only exposed to the thorax after surgery without coronary ligation.Blood samples were collected to detect H2S levels using an enzyme-linked immunosorbent assay(ELISA).Heart tissues were harvested for histopathological and immunohistochemical examination and quantitative reverse transcription polymerase chain reaction analysis of Beclin1 and ATG5 m RNA expression and Western blot analysis of Beclin1,LC3 A/B,and p62 protein expression.Results(1)The serum H2S content in model group rats was significantly reduced(P<0.01),JWDSD significantly increased the serum H2S content of model group rats(P<0.01),and the CSE inhibitor(PPG)significantly reduced H2S levels in the JWDSD group rats(P<0.01).(2)Compared with the normal control group,the myocardial tissue necrosis and cell destruction occurred in the MIRI model group,and JWDSD could alleviate the myocardial tissue necrosis of model rats,but the ameliorative effect of JWDSD could be reversed by PPG.(3)Beclin1,LC3 A/B,and p62 expression levels in the heart tissues of the model group were significantly increased(P<0.001),whereas decreased by JWDSD(P<0.05,P<0.01,and P<0.001,respectively),and the inhibitory effects of JWDSD on Beclin1,LC3 A/B,and p62 expression were partially reversed by PPG(P<0.01,P<0.05,and P<0.01,respectively).(4)The expression levels of autophagy-related genes Beclin1 and ATG5 were significantly increased in the model group(P<0.001).JWDSD clearly downregulated the expression levels of Beclin1 and ATG5(P<0.05 and P<0.001,respectively),which were reversed by PPG(P<0.001).Conclusion Our experimental data show that JWDSD can exhibit an anti-MIRI role by increasing endogenous H2S generation,and downregulating the expression of Beclin1,LC3 A/B,p62 and ATG5,which are related to inhibiting autophagy signaling.

Effects of Jiawei Buzhong Yiqi Decoction on the Endometrial Receptivity of Rats with Polycystic Ovary Syndrome

[Objectives]The study aims to discuss the effects of Jiawei Buzhong Yiqi Decoction on the endometrial receptivity of rats with polycystic ovarian syndrome(PCOS).[Methods]Adult female SD rats were selected and randomly divided into the model group and control group.In the model group,the PCOS model was established by using the method of Poretsky L.Rats in the control group were given physiological saline intervention at the same time.The successfully modeled rats were randomly divided into the PCOS group and traditional Chinese medicine group.Among them,rats in the Chinese medicine group were given Jiawei Buzhong Yiqi Decoction by gavage;rats in the model group and the control group were given normal saline for 14 d.All rats were killed by anesthesia after the last administration,and serum and uterine specimens were collected.Serum sex hormones(including T,E_(2),and P),glucose and insulin levels were detected;the equivalent diameter and area of endometrial gland and gland cavity,and the endometrial thickness of rats were measured;the expression of endometrial leukemia inhibitory factor(LIF),integrinαvβ3 protein and mRNA was detected by using Elisa and RT-PCR methods.[Results]The serum T,glucose,and insulin levels of rats in the PCOS group were significantly higher than those of the control group and the traditional Chinese medicine group,and there was no significant difference in the above indicators between the control group and the traditional Chinese medicine group;there was no significant difference in the E_(2) and P levels between the three groups.The equivalent diameter and area of endometrial gland and gland cavity,and the endometrial thickness of rats in the PCOS group were lower than those of the control group and the traditional Chinese medicine group;there was no significant difference in the above indicators between the traditional Chinese medicine group and the control group.The expression of LIF,integrinαvβ3 protein and mRNA in the endometrium of rats in various groups was basically the same.The expression of LIF and integrinαvβ3 in the endometrium of rats in the PCOS group was significantly lower than that of the control group and the traditional Chinese medicine group;there was no significant difference in the above indicators between the control group and the traditional Chinese medicine group.[Conclusions]The endometrial receptivity of PCOS rats was decreased;Jiawei Buzhong Yiqi Decoction can improve the endometrial receptivity of PCOS rats by increasing the expression of LIF and integrinαvβ3 in the endometrium.

Therapeutic Effect of Shaoyao Jiawei Gancao Decoction(芍药加味甘草汤)with Acupoint Application on Chronic Lumbar Muscle Strain and the Recovery of Lumbar Strength

Objective:To study the therapeutic effect of Shaoyao Jiawei Gancao Decoction(芍药加味甘草汤)with acupoint application on chronic lumbar muscle strain and the recovery of lumbar strength.Methods:From August 2018 to August 2019,100 patients with chronic lumbar muscle strain admitted to our hospital were selected and randomly divided into an acupoint application group and a combined group of 50 cases each.The acupoint application group was treated by acupoint application,and the combined group was treated with Shaoyao Jiawei Gancao Decoction(芍药加味甘草汤)based on acupoint application.The indexes scores,VAS scores,ADL scores,ODI scores,lumbar endurance,TCM syndrome scores and the treatment effects of the two groups before and after treatment were statistically analyzed,and TNF-αand TXB2 levels were detected.Results:After treatment,the scores of indexes,VAS,ODI,TCM syndrome,TNF-αand TXB2 in the combined group were lower than those in the acupoint application group,and the ADL score,lumbar endurance and treatment efficiency were higher than those in the acupoint application group,with a statistical difference(P<0.05).Conclusion:Shaoyao Jiawei Gancao Decoction(芍药加味甘草汤)with acupoint application can effectively reduce pain,improve lumbar function,restore lumbar strength,effectively relieve inflammation,with significant effects.

加味百合地黄汤对围绝经期抑郁症模型大鼠HPO轴和雌激素受体表达的影响

目的基于下丘脑-垂体-卵巢(hypothalamic-pituitary-ovarian,HPO)轴及雌激素受体(estrogen receptor,ER)探明加味百合地黄汤治疗围绝经期抑郁症的功效及潜在机制。方法将大鼠随机分为正常对照组、模型组、阳性药物组(氟哌噻吨美利曲水溶液1.89 mg/kg)以及加味百合汤高、中、低剂量组(16.2 g/kg、8.1 g/kg、4.05 g/kg),每组10只。除正常对照组外,其他组均采用双侧卵巢摘除联合慢性不可预见性应激建立围绝经期抑郁症大鼠模型。各组给药21 d后采用糖水偏好实验和强迫游泳实验评价大鼠抑郁样行为,酶联免疫吸附法检测血清促性腺激素释放激素(gonadotropin-releasing hormone,GnRH)、卵泡刺激素(follicle-stimulating hormone,FSH)、黄体生成素(luteinizing hormone,LH)、雌二醇(estradiol,E2)含量,HE染色观察下丘脑、垂体、海马等组织病理损伤情况,RT-PCR和Western blot法检测下丘脑、海马组织雌激素受体基因及蛋白的表达。结果与正常对照组比较,模型组大鼠糖水偏好度显著下降(P<0.01),强迫游泳不动时间显著增加(P<0.01),表现出明显抑郁样行为,血清GnRH、FSH、LH含量均显著升高(P<0.01或P<0.05),E2降低(P<0.01),下丘脑、垂体及海马组织受损,雌激素受体表达显著降低(P<0.01);经加味百合地黄汤干预治疗后,模型组大鼠抑郁样行为显著改善(P<0.01或P<0.05),HPO轴亢进状态及海马损伤得以缓解,下丘脑、海马雌激素受体表达均显著增加(P<0.01或P<0.05)。与阳性药物组比较,加味百合地黄汤高剂量组下丘脑雌激素受体基因表达显著增加(P<0.05)。结论加味百合地黄汤通过抑制HPO轴亢进及增加脑内雌激素受体水平,发挥抗围绝经期抑郁症作用。

加味消癥方对慢性肾衰竭大鼠肾纤维化的保护作用及对肾小管上皮细胞TGF-β_(1)/Smad3信号通路的影响

目的:探讨加味消癥方对慢性肾衰竭大鼠肾纤维化的保护作用及对肾小管上皮细胞TGF-β_(1)/Smad3信号通路的作用影响。方法:观察加味消癥方对慢性肾衰竭大鼠的血肌酐、尿素氮、24 h尿蛋白定量、肾脏病理及肾组织中FN1、Col-Ⅰ、Col-Ⅲ表达水平的影响;观察加味消癥方对TGF-β_(1)诱导肾小管细胞损伤中TGF-β_(1)、Smad3、LC3、Beclin1及P62蛋白表达的影响。结果:与模型组相比,加味消癥方高剂量组的Scr水平及加味消癥各组和缬沙坦组的24 h尿蛋白水平显著降低(P<0.05,P<0.01);实时荧光定量PCR法检测提示加味消癥方高剂量组的FN1、Col-ⅠmRNA相对表达量、加味消癥方中剂量组和缬沙坦组的Col-ⅢmRNA相对表达量、高剂量组和缬沙坦组的TGF-β_(1)mRNA相对表达量以及高、中、低剂量组和缬沙坦组的Smad3 mRNA相对表达量均较模型组显著降低(P<0.05,P<0.01);Western Blot法检测提示加味消癥方高、中剂量组和缬沙坦组的FN蛋白表达量、加味消癥方高剂量组的Col-Ⅰ蛋白表达量、加味消癥方高、低剂量组和缬沙坦组的Col-Ⅲ蛋白表达量以及高、中剂量组的Beclin1蛋白表达量均较模型组显著降低(P<0.05,P<0.01);Masson染色观察加味消癥方高剂量组的肾间质纤维化程度显著减轻(P<0.01)。此外,该组的48 h/72 h细胞存活率显著升高(P<0.01)。结论:加味消癥方可有效提升细胞存活率,改善肾间质纤维化程度保护肾功能,可能是通过TGF-β_(1)/Smad3通路调控自噬水平,下调FN1、Col-Ⅰ、Col-Ⅲ水平实现的。

基于Caspase-3/Bcl-2/Bax信号通路探究加味旋覆代赭汤治疗食管癌前病变的作用机制

目的:探究加味旋覆代赭汤对食管癌前病变大鼠Caspase-3/Bcl-2/Bax信号通路的调控作用机制。方法:将48只雄性SD大鼠随机分为4组,空白组、模型组、中药组、西药组,每组各12只。除空白组外均采用复合造模法制作食管癌前病变大鼠模型,造模成功后,分别进行药物灌胃干预,空白组、模型组用生理盐水灌胃,中药组和西药组分别给予加味旋覆代赭汤、西药(雷贝拉唑+莫沙必利)灌胃,给药8周取材。利用光学显微镜观察食管上皮组织的形态学变化;分别应用蛋白质印迹法(Western-blot)及聚合酶链式反应(PCR)检测食管上皮组织Caspase-3、Bcl-2及Bax的表达水平。结果:与空白组比较,模型组大鼠食管上皮病理积分升高(P<0.01);与模型组比较,中药组、西药组大鼠食管上皮病理积分均降低(P<0.01)。PCR及Western-blot检测结果显示,与空白组比较,模型组大鼠Caspase-3、Bax mRNA、蛋白表达均降低(P<0.01);与模型组比较,中药、西药组大鼠Caspase-3、Bax mRNA、蛋白表达均增高(P<0.05)。与空白组比较,模型组大鼠食管组织中Bcl-2 m RNA及蛋白表达水平均升高(P<0.05);与模型组比较,中药组和西药组Bcl-2 mRNA及蛋白表达水平均降低(P<0.05)。结论:加味旋覆代赭汤可能通过下调Bcl-2/Bax比值,增加线粒体外膜通透性,释放凋亡因子,激活Caspase-3,使病变组织发生凋亡,扭转食管上皮异型增生,从而起到治疗食管癌前病变的作用。

加味补中益气汤治疗哮喘机制的分子对接研究

目的运用分子对接技术预测加味补中益气汤治疗哮喘的作用机制。方法依托中药系统药理学数据库平台(Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform,TCMSP),筛选出加味补中益气汤的主要化学成分和相应靶点,利用Cytoscape软件构建“药物-疾病-靶点”的网络关系,将药物主要成分及疾病的交集靶点导入STRING平台构建蛋白相互作用(Protein-protein interaction networks,PPI)网络,并利用AutoDock软件将加味补中益气汤的主要成分与哮喘的关键靶点进行分子对接。结果共筛选出加味补中益气汤有效成分338种,支气管哮喘相关靶点1744个,其中交集靶点120个。PPI网络分析加味补中益气汤主要作用于蛋白激酶Cα(Protein kinase C alpha,PRKCA)、丝裂原活化蛋白激酶14(Mitogen-activated protein kinase 14,MAPK14)、V-Rel网状内皮增生病毒癌基因同源物A(V-Rel reticuloendotheliosis viral oncogene homolog A,RELA)、V-Jun肉瘤病毒17癌基因同源物(V-Jun sarcoma virus 17 oncogene homolog,JUN)和B细胞中κ轻型多肽基因增强子的核因子15(Nuclear factor-k-gene binding15,NFKB15)个核心靶点。分子对接结果表明筛选得到的主要活性成分与靶点有较强的结合。结论加味补中益气汤治疗支气管哮喘或许具有积极作用,其作用机制可能与调节PRKCA、MAPK14、RELA、JUN和NFKB1等信号通路有关。

加味理肠饮治疗肝郁脾虚型腹泻型肠易激综合征临床研究

目的:观察加味理肠饮治疗肝郁脾虚型腹泻型肠易激综合征(IBS-D)的疗效及对主要症状、疾病相关评分、炎症表现的影响。方法:将60例肝郁脾虚型IBS-D患者按随机数字表法分为中药复方组和西药组各30例,中药复方组给予加味理肠饮治疗,西药组给予利福昔明片,两组均持续治疗2周,治疗结束后4周进行随访。主要疗效指标为治疗2周后(治疗后)和治疗结束4周后(随访时)的有效应答率,即最严重腹痛评分的平均值较基线期改善30%且排便日记中6型或7型Bristol粪便天数较基线期减少50%的患者百分比。次要结局指标包括每周稀便天数、每周平均腹痛评分、IBS症状严重程度量表(IBS-SSS)评分、IBS专用生活质量问卷(IBS-QOL)评分、中医症状评分、血清炎症因子水平、结肠及回肠末端黏膜组织病理形态。结果:两组治疗后及随访时的有效应答率比较,差异无统计学意义(P>0.05)。与治疗前比较,两组患者治疗后及随访时每周稀便天数均减少(P<0.01),每周平均腹痛评分均降低(P<0.01),IBS-SSS、IBS-QOL、中医症状评分均改善(P<0.01);两组患者治疗后血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、P物质(SP)水平较治疗前均降低(P<0.01)。随访时,中药复方组每周稀便天数少于西药组(P=0.046),IBS-SSS评分优于西药组(P<0.01);治疗后及随访时,中药复方组IBS-QOL、中医症状评分均优于西药组(P<0.01);治疗后,西药组血清TNF-α水平低于中药复方组(P<0.01)。随访时,两组患者结肠及回肠末端黏膜组织绒毛结构完整,排列整齐,无炎症细胞浸润。结论:加味理肠饮能减轻肝郁脾虚型IBS-D患者的腹痛、腹泻症状,降低患者血清炎症因子水平,缓解肠黏膜组织低度炎症反应,作用较持久。

加味桃红四物汤联合利伐沙班在髋关节置换术后的应用

目的探讨加味桃红四物汤联合利伐沙班在髋关节置换术后应用的效果,旨在评估其对术后血栓预防、炎症因子水平及并发症的影响。方法本研究为随机对照试验,前瞻性选取2019年11月至2023年11月在宝鸡市中医医院行髋关节置换手术的120例患者,采用随机数字表法将患者分为观察组(60例)和对照组(60例)。观察组男30例,女30例;年龄(65.25±10.33)岁;病程(4.72±1.15)年。对照组男28例,女32例;年龄(63.96±10.87)岁;病程(4.68±1.13)年。对照组采用利伐沙班治疗方案,观察组采用加味桃红四物汤与利伐沙班的联合治疗方案。比较两组在治疗前及治疗14 d后的凝血功能指标[血浆凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)及D-二聚体(D-D)]、血流变学指标(全血粘度、血浆粘度、红细胞比容、红细胞刚性指数及红细胞变形指数)、促炎性细胞因子指标[C反应蛋白(CRP)]、并发症及深静脉血栓(DVT)方面的差异。采用独立样本t检验、配对样本t检验和χ^(2)检验。结果治疗前,两组各项指标比较,差异均无统计学意义(均P>0.05)。治疗14 d后,观察组PT[(15.79±2.33)s]、TT[(19.05±3.12)s]和APTT[(30.21±4.07)s]均长于对照组[(14.01±2.67)s、(15.52±2.79)s、(27.33±3.49)s](均P<0.05);观察组FIB[(3.52±1.08)g/L]和D-D水平[(0.22±0.04)mg/L]均低于对照组[(4.09±1.06)g/L、(0.33±0.06)mg/L](均P<0.05)。治疗14 d后,观察组全血粘度[(4.07±1.28)mPa·S]、血浆粘度[(1.48±0.43)mPa·S]、红细胞比容[(37.56±2.79)%]、红细胞刚性指数(5.47±0.77)均低于对照组[(4.65±0.27)mPa·S、(2.02±0.39)mPa·S、(42.06±2.17)%、(6.23±0.84)](均P<0.05);观察组红细胞变形指数(0.84±0.03)高于对照组(0.74±0.07)(P<0.05)。治疗14 d后,观察组CRP水平[(4.25±1.09)mg/L]低于对照组[(7.97±2.14)mg/L](P<0.05)。治疗后14 d内,观察组并发症总发生率[13.33%(8/60)]和DVT阳性率[6.67%(4/60)]均低于对照组[25.00%(15/60)、20.00%(12/60)](均P<0.05)。结论加味桃红四物汤与利伐沙班的联合应用在预防髋关节或膝关节置换术后DVT的效果显著,能有效改善血流变学参数,抑制血液凝集,降低并发症发生率。

加味真武汤治疗慢性心力衰竭合并缓慢性心律失常患者的疗效及对其血流动力学的影响

目的研究加味真武汤治疗慢性心力衰竭合并缓慢性心律失常患者的疗效及对其血流动力学的影响。方法选取2019年1月—2022年1月期间开封市中医院心内科收治的慢性心力衰竭合并缓慢性心律失常患者80例,按随机数字表法分为对照组和研究组,每组各40例。对照组采用西医常规治疗,研究组在对照组基础上给予加味真武汤口服治疗。治疗6周后,观察比较两组患者临床疗效、不良反应,治疗前后两组患者心功能指标[左心室舒张末期内径(Left ventricular end-diastolic diameter,LVEDD)、左心室射血分数(Left ventricular ejection fraction,LVEF)、心率]、血流动力学指标[心排血量(Cardiac output,CO)、心排血指数(Cardiac output index,CI)]、N末端B型利钠肽原(N-terminal pro-B-type natriuretic peptide,NT-proBNP)、基质金属蛋白酶-9(Matrix metalloproteinases-9,MMP-9)及内皮素-1(Endothelin-1,ET-1)水平。结果治疗后研究组临床总有效率90.00%(36/40)明显高于对照组70.00%(28/40),差异有统计学意义(P<0.05)。治疗后两组患者心功能指标LVEDD均较治疗前降低、LVEF及心率均较治疗前升高,差异有统计学意义(P<0.05);且研究组LVEDD明显低于对照组、LVEF及心率明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者CO、CI均较治疗前升高,差异有统计学意义(P<0.05);且研究组CO、CI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NT-proBNP、MMP-9、ET-1水平均较治疗前降低,差异有统计学意义(P<0.05);且研究组NT-proBNP、MMP-9、ET-1水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗期间,对照组总不良反应发生率17.50%(7/40)与研究组15.00%(6/40)比较,差异无统计学意义(χ^(2)=0.092,P=0.762)。结论慢性心力衰竭合并缓慢性心律失常患者应用加味真武汤治疗效果较佳,可有效改善心功能,调节血流动力学,值得临床推广使用。

基于TLR2/MyD88/NF-κB信号通路探讨加味少腹逐瘀汤对寒湿瘀结证子宫内膜异位症痛经小鼠腹腔炎症微环境干预作用

目的探讨加味少腹逐瘀汤对寒湿瘀结证子宫内膜异位症痛经小鼠腹腔炎症微环境的干预机制。方法构建动物模型后随机分组。以自主活动次数、粪便含水率、热痛潜伏期评价证候;以子宫及异位病灶大小评价疗效;HE染色比较病理变化;免疫组化检测异位组织中NF-κB的表达及其入核情况;qPCR法和Western blot测定病灶中TLR2、MyD88、NF-κB的mRNA和蛋白表达;ELISA检测TNF-α、IL-6、PGE2、E2、P。结果与假手术组对比,模型小鼠自主活动减少,热痛潜伏期缩短,粪便含水率增加;子宫体积增大,腹腔可见明显异位灶且HE染色显示炎症浸润;免疫组化显示NF-κB表达增加;异位组织TLR2、MyD88、NF-κB mRNA及蛋白表达增加,外周血TNF-α、IL-6、PGE2、E2增高,P下降。与模型组相比,各治疗组子宫体积减小、异位灶重量减轻、疼痛潜伏期延长;中药高剂量组小鼠自主活动次数增加、粪便含水率减少;药物干预后炎症反应改善、NF-κB表达下降;TLR2、MyD88、NF-κB的mRNA及蛋白表达降低;且外周血TNF-α、IL-6、PGE2、E2降低、P升高。结论加味少腹逐瘀汤可以降低寒湿瘀结证子宫内膜异位症小鼠血清炎症因子,这可能与抑制TLR2/MyD88/NF-κB信号通路改善腹腔炎症微环境有关。

加味地黄汤辅助治疗肝肾阴虚型老年糖尿病视网膜病变的临床研究

目的 探讨加味地黄汤辅助治疗肝肾阴虚型老年糖尿病视网膜病变(DR)的临床效果。方法 选取2021年5月至2023年1月海南省中医院收治的肝肾阴虚型老年DR患者108例,根据随机数字表法将其分为对照组和观察组。对照组(54例)接受常规降糖和羟苯磺酸钙胶囊治疗,观察组(54例)在对照组基础上接受加味地黄汤辅助治疗,以4周为1个疗程,连续治疗3个疗程。比较两组临床疗效和治疗前后中医证候积分、视力水平、血糖指标[空腹血糖(FBG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)]、血管内皮生长因子(VEGF)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)],并比较两组治疗安全性。结果 观察组临床疗效优于对照组(P<0.05)。治疗后,两组中医证候积分、FBG、2 hPG、HbA1c、VEGF、TNF-α、IL-6、MDA水平均低于治疗前,视力、SOD水平高于治疗前,且观察组中医证候积分、FBG、2 hPG、HbA1c、VEGF、TNF-α、IL-6、MDA水平均低于对照组,视力、SOD水平高于对照组(P<0.05)。两组治疗期间均未出现明显的不良反应。结论 加味地黄汤辅助治疗肝肾阴虚型老年DR的效果确切,能显著改善症状,提高视力水平,且安全性高。

加味柴胡桂姜汤介导乳腺癌细胞黏附分子PSGL-1改善炎症-黏附-转移作用研究

目的研究炎症微环境下黏附分子PSGL-1异常表达对乳腺癌细胞增殖、黏附、侵袭及迁移能力的影响及加味柴胡桂姜汤干预作用机制。方法制备加味柴胡桂姜汤含药血清,选择高转移乳腺癌MDA-MB-231细胞株,筛选药物最佳浓度;运用脂多糖刺激乳腺癌细胞形成炎症微环境模型,将细胞分为空白对照组、LPS模型组、顺铂组、PSGL-1中和抗体组、加味柴胡桂姜汤组、加味柴胡桂姜汤与PSGL-1中和抗体联合组,采用CCK-8法、明胶黏附、Transwell及细胞划痕实验检测细胞增殖、黏附、侵袭和迁移能力;qRT-PCR和Western blot实验检测PSGL-1与其受体及Vimentin等EMT相关基因表达。结果LPS刺激乳腺癌细胞后细胞生物学行为改变,黏附分子及EMT基因表达增加,加味柴胡桂姜汤、PSGL-1中和抗体均能抑制LPS诱导的增强作用,联合组较加味柴胡桂姜汤组抑制作用降低。结论炎症微环境下肿瘤细胞侵袭及迁移能力增强,加味柴胡桂姜汤能够靶向调控PSGL-1抑制乳腺癌细胞侵袭及迁移。

加味附子汤在RA中的应用价值及其对NF-κB信号通路的影响

目的探讨加味附子汤在类风湿关节炎(RA)中的应用价值及其对核因子-κB(NF-κB)信号通路的影响。方法选取2022年1月至2023年7月该院收治的120例RA患者作为研究对象,随机分为观察组(60例)和对照组(60例)。对照组采用来氟米特与氨甲蝶呤治疗,观察组在对照组基础上加服加味附子汤,两组疗程均为2周。记录两组临床疗效;记录两组治疗前及治疗2周后临床症状指标、炎症指标[类风湿因子(RF)、红细胞沉降率(ESR)、C反应蛋白(CRP)、白细胞介素(IL)-6、IL-1β]、NF-κB信号通路表达[磷酸化NF-κB P65(p-NF-κB-P65)、磷酸化NF-κB抑制蛋白α(p-IκBα)];记录两组不良反应。结果观察组总有效率高于对照组(P<0.05)。两组治疗2周后视觉模拟量表评分、晨僵时间、关节肿胀数、关节压痛数均低于治疗前,且观察组均低于对照组,双手平均握力高于治疗前,且观察组高于对照组(P<0.05)。两组治疗2周后RF、ESR、CRP、IL-6、IL-1β水平均低于治疗前,且观察组均低于对照组(P<0.05)。两组治疗2周后p-NF-κB-P65、p-IκBα水平均低于治疗前,且观察组均低于对照组(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)。结论加味附子汤在RA中具有较好的疗效,能够有效减轻临床症状,抑制炎症因子分泌及NF-κB信号通路表达,且具有较强的安全性。

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。

加味参芪化浊饮联合高通量血液透析治疗慢性肾功能衰竭患者的临床疗效及对其氧化应激炎症反应的影响

目的 探究加味参芪化浊饮联合高通量血液透析(High-flux hemodialysis,HFHD)对慢性肾功能衰竭患者氧化应激、炎症反应的影响。方法 选取2022年4月—2023年4月期间广州中医药大学附属宝安中医院收治的慢性肾功能衰竭患者94例,按照随机数字表法分为HFHD组和联合组,每组各47例。HFHD组患者使用HFHD治疗,联合组使用加味参芪化浊饮联合HFHD治疗,连用4周。观察比较两组患者临床疗效,治疗前后中医证候评分、肾功能[尿素氮(Blood Urea Nitrogen BUN)、血肌酐(Serum creatinine Scr)]、肾血流动力学、免疫功能[CD4^(+)、CD3^(+)]、氧化应激[TAOC、AOPP]、炎症反应[超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)]水平。结果 治疗后两组患者中医证候评分均较治疗前降低,差异有统计学意义(P<0.05);且联合组中医证候评分明显低于HFHD组,差异有统计学意义(P<0.05)。治疗后两组患者肾功能指标BUN、SCr水平均较治疗前降低,差异有统计学意义(P<0.05);且联合组肾功能指标BUN、SCr水平均明显低于HFHD组,差异有统计学意义(P<0.05)。治疗后两组患者肾动脉内径、肾血流量均较治疗前升高,差异有统计学意义(P<0.05);且联合组肾动脉内径、肾血流量均明显高于HFHD组,差异有统计学意义(P<0.05)。治疗后两组患者CD4^(+)、CD3^(+)水平均较治疗前升高,差异有统计学意义(P<0.05);且联合组CD4^(+)、CD3^(+)水平均明显高于HFHD组,差异有统计学意义(P<0.05)。治疗后两组患者TAOC、AOPP、hs-CRP、TNF-α水平均较治疗前降低,差异有统计学意义(P<0.05);且联合组TAOC、AOPP、hs-CRP、TNF-α水平均明显低于HFHD组,差异有统计学意义(P<0.05)。治疗后联合组临床总有效率93.62%(44/47)明显高于HFHD组78.72%(37/47),差异有统计学意义(P<0.05)。结论 使用加味参芪化浊饮联合HFHD对慢性肾功能衰竭患者进行治疗,能够减轻患者中医证候严重程度,改善患者肾功能、肾血流动力学、免疫功能,减轻患者氧化应激损伤、炎症反应严重程度,治疗效果显著。

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。