Meta-analysis of the curative efficacy of Duhuo Jisheng Decoction combined with western medicine on knee osteoarthritis

Objective:To evaluate the efficacy and safety of Duhuo Jisheng Decoction combined with western medicine in the treatment of knee osteoarthritis.Methods:The databases of CNKI,VIP,CBM,WANFANG DATA and PubMed were electronically to collect randomized controlled trials(RCTs)of the treatment of knee osteoarthritis with Duhuo Jisheng Decoction combined with western medicine.After literature was strictly screened and the study quality was evaluated according to relevant procedures,the Meta analysis was performed by RevMan5.3 software.Resluts:A total of 15 RCTs were included.The result of meta-analysis showed that:compared with the western medicine alone,Duhuo Jisheng Tang combined with western medicine could significantly improve the efficacy(RR=1.25,95%CI(1.18,1.32),p<0.00001),the posttreatment pain visual analogue scale scores(MD=-0.85,95%CI(-1.00,-0.71),p<0.00001)、the western ontario and mcmaster universities arthritis index scores(MD=-7.76,95%CI(-10.37,-5.15),p<0.00001)and matrix metalloproteinase3(MD=-11.72,95%CI(-17.39,-6.05),p<0.0001)were lower in treatment group compared to control group.There was no statistical difference in the incidence of adverse reactions between the 2groups.Conclusions:The current evidence shows that Duhuo Jisheng Decoction combined with western medicine can further improve the clinical efficacy for knee osteoarthritis.

Breeding and Simple-rapid Regeneration Protocol for Jisheng 1 with Glandless Trait and High-frequency Somatic Embryo Production Ability

Most of model cotton varieties used in tissue culture have glands on both the reproductive and vegetative parts of the plant.These glands contain compounds that are toxic to human and non-ruminant animals.The presence of these compounds limits their usage as food and feed.To obtain a glandless cotton variety with high-frequency somatic embryo production ability,27 glandless varieties

Meta-analysis of clinical efficacy of Duhuo Jisheng Decoction in the treatment of lumbar intervertebral disc herniation

Objective:To explore the clinical effect of Duhuo Jisheng Decoction in the treatment of lumbar disc herniation.Methods:CNKI,VIP,Wan Fang Data,Pubmed,Cochrane Library,Medline Complete and Embase databases were searched by computer.The randomized controlled trial(RCT)of Duhuo Jisheng Decoction combined with western medicine in the treatment of lumbar intervertebral disc herniation was studied.The searching time was from the establishment of the database to July 20,2019.Data were extracted and analyzed by Revman 5.3 software.Results:Twenty-four literatures involving 1980 patients were included.Meta-analysis showed that the total effective rate of Duhuo Jisheng Decoction group was significantly higher(OR=5.26,95%CI(4.13,6.69),Z=13.47,P<0.00001)and the incidence of adverse reactions was significantly lower(OR=0.45,95%CI(0.23,0.87),Z=2.36,P=0.00001)than that of Western medicine group.02).Conclusion:Duhuo Jisheng Decoction is effective and safe in the treatment of lumbar intervertebral disc herniation.However,the literature included in this study is limited,and the quality of the literature is low.It is necessary to carry out in-depth verification of high-quality,large-sample RCT.

Mechanism of Duhuo Jisheng Decoction based on bioinformatics and network pharmacology in treating osteoporosis of kidney Yin deficiency

Objective:To study the active ingredients,target and mechanism of Duhuo JiSheng Decoction for the treatment of osteoporosis by bioinformatics analysis and network pharmacology.Methods:The gene expression profile of GSE56116 was acquired through the NCBI GEO database,and the software R was used for differential analysis.The Chinese medicine system pharmacology technology platform(TCMSP)was used to retrieve the chemical components,target genes of Duhuo,Fangfeng,Xixin,and Sangjisheng.The differential genes acquired from GSE56116 were intersected and analyzed by GO enrichment analysis and KEGG pathway to study the mechanism of Duhuo JiSheng Decoction.Results:A total of 33 active ingredients and 9 differential genes of Duhuo JiSheng Decoction for the treatment of Shengyin deficiency osteoporosis were screened.GO function enrichment analysis focuses on the regulation of intracellular signal transduction,calcium-mediated signaling,and steroid hormone mediated signaling.KEGG analysis showed that it was mainly concentrated in signal pathways such as P53 signal pathway,TNF signal pathway,and IL-17 signal pathway.Conclusion:Through bioinformatics and network pharmacological analysis,Duhuo JiShenng Decoction may exert therapeutic effects by acting on AR,IGFBP3,and FOS target genes.

Intervention effect and mechanism of Jisheng Shenqi Decoction plus Panax notoginseng and Bionjia on CCl4-induced hepatic fibrosis rat model

Objective:To investigate the intervention effect and specific mechanism of Jisheng Shenqi Decoction plus Panax notoginseng and Turmeric on carbon tetrachloride(CCl4)-induced liver fibrosis in rats.Methods:SPF SD rats were randomly divided into control group,model group,and Chinese medicine treatment(low,medium and high dose)groups.The model group and Chinese medicine treatment group were given intraperitoneal injection of 40%CCl4 olive oil solution twice a week.A rat model of liver fibrosis was replicated by the method for 8 weeks.After successful modeling,each drug-administered group was gavaged with corresponding drugs,and the control group and model group were gavaged with equal volume of distilled water,once a day,for 4 weeks.After the last intragastric administration,HE staining and Masson staining were used to observe the pathological morphology of liver tissue,and liver function(ALT,AST)was detected;ELISA method was used to determine transforming growth factorβ(TGF-β),angiotensin II(Ang-Ⅱ),chitinase 3-like protein 1(CHI3L1),interleukin-1(IL-1),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)content;The expression levels of type I,type III collagen(Col-Ⅰ,Col-Ⅲ)and TGF-βmRNA were determined by RT-PCR.Results:①HE and Masson staining showed that a large number of liver cells in the model group were inflamed and necrotic,the collagen fibers in the liver tissue were extensively proliferated,the fibrous septa were interconnected,and the pseudolobules were formed.Compared with the model group,the levels of ALT,AST,TGF-β,Ang-Ⅱ,CHI3L1,IL-1,IL-6 and TNF-αin the traditional Chinese medicine treatment group were decreased,while the levels of Col-Ⅰ,Col-ⅢThe expressions ofⅢand TGF-βmRNA were decreased,and the effect was most obvious in the middle and high dose groups of traditional Chinese medicine(P<0.01).Conclusion:Jisheng Shenqi Decoction combined with Panax notoginseng and Biejia can significantly improve liver fibrosis induced by CCl4 in rats,and its mechanism may be related to the down-regulation of angiotensin-converting enzyme(ACE)-angiotensin II(Ang-II)-angiotensin II receptor 1(AT1R)signaling pathway related gene expression,reducing the level of related cytokines,promoting the degradation of extracellular matrix and so on.

A Systematic Review and Meta-analysis for Duhuo Jisheng Decoction Combined with Manipulation in Treatment of Lumbar Disc Herniation

Objective:To systematically evaluate the efficacy and safety of Duhuo Jisheng decoction combined with manipulation in the treatment of lumbar disc herniation.Method:We systematically searched 8 databases at home and abroad.Literature quality of the included studies was evaluated by the bias risk assessment tool of Cochrane collaboration network,and the Meta-analysis was performed by RevMan 5.3 software.Result:A total of 427 related literature were retrieved,and 12 studies were eventually included,involving 1153 patients.All studies were in Chinese.Meta-analysis results showed that the total effective rate of Duhuo Jisheng decoction combined with manipulation in the treatment of LDH was better than that of the control group(RR=1.23,95%CI[1.17,1.29],P<0.00001).Subgroup analysis showed that Duhuo Jisheng decoction combined with manipulation had a more significant effect than conventional treatment(RR=1.34,95%CI[1.20,1.50],P<0.00001),nonsteroidal anti-inflammatory drugs(RR=1.24,95%CI[1.12,1.37],P<0.0001),and Yaotongning capsules(RR=1.19,95%CI[1.10,1.29],P<0.0001).It has obvious advantages in improving VAS scores(MD=-1.19,95%CI-1.19[-1.87,-0.51],P=0.0006),but it has no obvious advantages in improving JOA scores(MD=2.6595%CI[0.06,5.24],P=0.05).In terms of safety,Duhuo Jisheng decoction combined with manipulation treatment reported fewer adverse events.Conclusion:The Duhuo Jisheng decoction combined with manipulation treatment can effectively relieve the clinical symptoms of patients with lumbar disc herniation,with obvious clinical efficacy,and fewer adverse events.But in view of the limitations of clinical studies,there are some limitations in this study,and more studies with high quality of evidence are needed to further confirm its efficacy and safety.

A meta-analysis of Duhuo Jisheng decoction combined with non-operative therapy on lumbar disc herniation

Objective:To systematically evaluate the cllinical efficacy of Duhuo Jisheng decoction(DHJSD)combined with non-surgical therapy on lumbar disc herniation(LDH).Methods:China Science and Technology Journal Database(VIP),Chinese National Knowledge Infrastructure(CNKI),WanFang Data,PubMed were searched and eligible randomized controlled clinical trials(RCTs)were included.Two reviewers evaluated the quality of the included RCTs and extracted data independently.Then,data analysis was performed with RevMetn 4.2 software.Results:A total of 18 RCTs were enrolled,including 1682 patients.Meta-analysis results showed that the overall response rate of DHJSD combined with non-operative therapy group(treatment group)in the treatment of LDH was better than that of the non-operative therapy group(control group)[OR=4.29,95%CI(3.19,5.76),P<0.001].JOA score of the treatment group was significantly higher than that of control group[OR=3.96,95%CI(3.4,4.52),P<0.001].VAS score was dramatically lower in the treatment group than the control group[OR=-1.58,95%CI(-1.97,-1.18),P<0.001].Conclusion:The clinical efficacy of DHJSD combined with non-surgical therapy is better than that of non-surgical therapy alone.However,due to the low quality of the included literatures,large-scale and high-quality RCTs are still needed for further confirmation.

寒湿阻滞型腰痛大鼠模型构建及独活寄生汤干预效果的实验研究

目的构建大鼠寒湿阻滞型腰痛动物模型,评估独活寄生汤对该模型的干预效果。方法24只雄性SD大鼠适应性喂养7 d后,随机分为空白组、模型组和独活寄生汤组。空白组仅腹腔注射戊巴比妥钠麻醉,模型组、独活寄生汤组在腹腔注射戊巴比妥钠麻醉下行“腰椎后柱结构部分切除术”,并在寒湿环境下饲养6周。造模2周后,空白组、模型组予等体积蒸馏水灌胃,独活寄生汤组予独活寄生汤18.6 g/(kg·d)灌胃,均连续灌胃4周。比较各组大鼠一般情况、自发性疼痛行为学评分和神经功能评分,CT三维成像评估脊柱生理曲度形态改变情况,椎间盘组织病理切片评估椎间盘髓核病变程度。结果造模后1周,与空白组比较,模型组、独活寄生汤组开始出现少动、皮毛无光泽、嗜睡蜷缩、反应迟钝、大便稀溏表现,体质量减轻(P<0.05),自发性疼痛行为学评分和神经功能评分升高(P<0.05);给药后3周,与模型组比较,独活寄生汤组疼痛行为学评分和神经功能评分降低(P<0.05)。给药后4周,与模型组比较,独活寄生汤组大鼠脊柱CT三维成像形态退变不明显,椎间盘组织病理切片显示,独活寄生汤组椎间盘髓核病变不明显。结论“腰椎后柱结构部分切除术+寒湿环境饲养”可成功构建SD大鼠寒湿阻滞型腰痛动物模型,独活寄生汤对该模型有较好的干预效果。

独活寄生汤治疗骨质疏松症患者的临床效果研究

目的分析独活寄生汤治疗骨质疏松症患者的临床效果。方法选择60例骨质疏松症患者,按随机数字表法分为研究组和对照组,各30例。对照组采取碳酸钙D3片治疗,研究组在对照组基础上增加独活寄生汤治疗。对比两组治疗后临床疗效、疼痛评分、骨代谢与骨密度指标及日常生活能力。结果研究组的治疗总有效率93.33%明显高于对照组的73.33%(P<0.05)。治疗7、21、35 d,研究组疼痛评分均明显低于对照组(P<0.05)。治疗后,研究组的腰椎骨密度(0.84±0.09)g/cm2明显高于对照组的(0.76±0.07)g/cm2,Ⅰ型胶原羧基端肽β特殊序列(0.21±0.03)ng/ml和Ⅰ型胶原氨基末端肽(60.42±2.10)ng/ml明显低于对照组的(0.25±0.07)、(62.54±3.11)ng/ml(P<0.05)。治疗21 d、35 d及3个月,研究组日常生活能力评分均明显高于对照组(P<0.05)。结论独活寄生汤应用于骨质疏松症治疗中可提高临床疗效和日常生活能力,减轻疼痛负担,改善骨密度。

独活寄生汤联合几丁糖对寒湿痹阻型膝骨关节炎的临床疗效

目的 观察独活寄生汤联合几丁糖治疗寒湿痹阻型膝骨关节炎的临床效果。方法 选取2023年1月至8月黑龙江中医药大学附属第一医院门诊的60例膝骨关节炎患者,采用随机数字表法将其分为观察组和对照组,各30例。观察组采用独活寄生汤(加水煎煮,200 ml/剂,1剂/d,早晚两次温服,连续服用3周)联合几丁糖注射液(2 ml/次,1次/周,共3周)治疗,对照组口服洛索洛芬钠片(120 mg/次,3次/d)联合几丁糖注射液(2 ml/次,1次/周,共3周)治疗。评价两组临床疗效。比较两组治疗前后中医症状评分、西安大略和麦克马斯特大学骨关节炎指数评分(WOMAC评分)、视觉模拟评分法(VAS)评分,血清白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)的水平和血清环氧合酶(COX-2)和前列腺素(PGE2)的改善情况,并对两组患者于治疗后六周进行电话追踪和随访观察复发率。结果 观察组临床疗效优于对照组,差异有统计学意义(P<0.05)。治疗后,两组VAS评分低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组WOMAC评分较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组IL-1、TNF-α水平较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后两组血清COX-2、PGE2降低,且观察组低于对照组,差异有统计学意义(P<0.05)。两组复发率比较,差异无统计学意义(P>0.05)。结论 独活寄生汤联合几丁糖对寒湿痹阻型膝骨关节炎有显著疗效,并且能恢复膝关节功能,提高生活质量。

独活寄生汤内服联合中药外洗治疗类风湿关节炎肝肾亏虚证的疗效观察

目的 探讨独活寄生汤内服联合中药外洗治疗类风湿关节炎肝肾亏虚证的临床疗效。方法 选取2019年12月—2022年12月南京中医药大学徐州附属医院收治的86例类风湿关节炎肝肾亏虚证患者,依照随机数表法分为观察组和对照组各43例。观察组予甲氨蝶呤+硫酸羟氯喹,并配合独活寄生汤+中药外洗治疗,对照组予甲氨蝶呤+硫酸羟氯喹治疗。比较两组患者临床疗效、简化疾病活动指数(SDAI)、临床疾病活动指数(CDAI)、红细胞沉降率(ESR)、C反应蛋白(CRP)及白细胞介素-6(IL-6)等指标。结果 观察组总有效率高于对照组(P<0.05)。治疗后,两组CDAI评分和SDAI评分均较本组治疗前下降(P<0.05),且观察组下降水平高于对照组(P<0.05)。治疗后,两组ESR、CRP、IL-6水平均较本组治疗前降低(P<0.05),且观察组低于对照组(P<0.05)。结论 独活寄生汤内服联合中药外洗治疗类风湿关节炎肝肾亏虚证,改善患者临床症状,疗效确切,并且能够减少炎症因子释放,安全可靠。

加味独活寄生合剂对膝骨关节炎小鼠血清IL-6、IL-1β、TNF-α及滑膜炎症的影响

目的探讨加味独活寄生合剂对膝骨关节炎小鼠血清白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)及滑膜炎症的影响,初步判定加味独活寄生合剂治疗膝骨关节炎的最佳剂量。方法将36只C57/BL6j小鼠随机分为空白组、模型组、西药对照组及中药低、中、高剂量组,除空白组外均通过膝关节注射木瓜蛋白酶溶液建立膝骨关节炎模型,空白组、模型组予生理盐水灌胃,西药对照组予双醋瑞因胶囊溶液灌胃,中药低、中、高剂量组分别按照6.28、12.56、25.12 g/kg剂量灌胃加味独活寄生合剂。连续灌胃8周后,各组小鼠进行改良Lequesen MG量表评分,ELISA测定各组小鼠血清中IL-6、IL-1β、TNF-α含量;HE染色及Masson染色观察膝关节滑膜组织结构形态及纤维组织增生情况。结果与空白组相比,模型组改良Lequesen MG量表评分显著升高(P<0.01),血清炎症因子含量明显升高(P<0.01),HE染色可见滑膜组织丰富的血管增生及大量炎性细胞浸润等滑膜炎症表现,Masson染色可见大量胶原纤维增生;西药对照组、中药低剂量组改良Lequesen MG量表评分较模型组显著降低(P<0.01),血清炎症因子含量均明显降低(P<0.01),HE染色见滑膜炎症改善,Masson染色见胶原纤维增生减轻;中药中、高剂量组较西药对照组和中药低剂量组改良Leque⁃sen MG量表评分显著降低(P<0.01),血清炎症因子含量明显降低(P<0.01);HE染色示滑膜炎症明显好转,Masson染色见胶原纤维增生明显减轻。结论加味独活寄生合剂可降低膝骨关节炎小鼠血清IL-6、IL-1β、TNF-α含量,改善膝关节滑膜炎症;12.56 g/kg剂量的加味独活寄生合剂对膝骨关节炎小鼠病情改善最明显。

独活寄生汤治疗痹症研究进展

独活寄生汤是唐代著名医家孙思邈《备急千金要方》中治疗风寒湿痹的经典名方,其临床应用广泛且疗效较好。药理学研究已证实独活寄生汤不仅可以抗炎镇痛、调节免疫、干预氧化应激、促进骨代谢,在抗阿尔茨海默病、抗肿瘤、扩张血管,改善循环等方面也具有明显疗效。古代医家多用该方治疗痹证日久,肝肾两虚,气血不足,正虚邪实者。现代医家已将该方广泛用于治疗类风湿性关节炎、膝骨关节炎、腰椎间盘突出症、骨质疏松、骨折、腰背痛、神经根型颈椎病等骨伤科疾病。同时有研究表明,独活寄生汤联合针灸、手法、艾灸、中药熏洗等,疗效更为显著。随着现代医学技术和中西医结合的发展,后世医家的不断探究,独活寄生汤治疗痹症的地位和发展进程不断受到认可和推进。多项实验研究已证实,独活寄生汤的药理作用和治疗痹症的临床效果。现从药理作用及该方在痹症中的临床应用对近十年独活寄生汤相关37篇文献进行梳理,研究探讨独活寄生汤的应用,为临床应用提供更为科学的参考。

从“络病-风药”理论探讨独活寄生汤治疗类风湿关节炎

类风湿关节炎(RA)属中医“痹病”范畴,其发生、发展、转归与络病密切相关。本文通过分析类风湿关节炎微小血管新生的病理状态与络脉生理和络病病机特点,以络脉为其邪伏、邪发、邪伤及邪阻之所展开论述,可认为“络病”是其病理基础,络虚是其根本病机,风挟寒湿之邪内侵络脉为发病关键。基于“络病”理论和“风药”理论相关认识,从独活寄生汤为治风之剂视角认识其治疗类风湿关节炎的作用,并提出病变早期络脉郁滞、风药先行,中期络脉瘀塞、健脾化瘀,晚期络脉空虚、风引入肾,探讨独活寄生汤在病变不同时期风药与他药的组方原理,丰富独活寄生汤的组方配伍理论,扩展独活寄生汤的临床指导意义,为其临床应用提供参考。

基于网络药理学研究独活寄生汤治疗腰椎间盘突出症的作用机制

目的基于网络药理学研究独活寄生汤治疗腰椎间盘突出症的作用机制。方法通过TCMSP中药系统药理学数据库搜索有关于独活寄生汤中中药的有效成分,然后分析成分靶点,利用UniProt蛋白质数据库将有效成分靶点蛋白转换为靶点基因信息,然后以腰椎间盘突出症的医学英文全称在OMIM、Gene Cards、DisGeNET等疾病基因数据库搜索其的基因靶点。利用绘图软件venny绘制韦恩图,将获得的靶点与腰椎间盘突出症的靶点汇总并且取交集,获得两者共有靶点。运用String蛋白质相互作用数据库和Cytoscape绘图软件,绘制出核心靶点蛋白质相互作用图,以及中药-有效成分-交集靶点-疾病通路-疾病的网络结构图。查找独活寄生汤治疗腰椎间盘突出的核心靶点基因,并且对其分别进行GO功能富集分析和KEGG通路富集分析。结果筛选出中药有效成分180个,成分靶点290个,腰椎间盘突出症靶点2681个,交集靶点54个,在PPI蛋白互作分析中占关键的靶点为:丝氨酸/苏氨酸蛋白激酶(AKT1)、细胞肿瘤抗原p53(TP53)、白蛋白(ALB)、半胱氨酸蛋白酶(CASP3)、白细胞介素6(IL6)、前列腺素内过氧化物合酶2(PTGS2)等;GO通路富集分析最终得出了463条结果,结果中分别有生物过程364条,分子功能69条,细胞成分30条,主要涉及内容有RNA聚合酶II转录因子活性,炎症、药物反应,细胞生长凋亡等。KEGG通路富集分析显示出了112条信号通路,这些信号通路中涉及到了各种肿瘤相关通路、乙型肝炎、丙型肝炎相关通路、炎症产生相关通路以及脂质生成与代谢等通路。结论网络药理学研究显示了独活寄生汤中各种药物成分,通过多靶点相互联系、多通路共同调控,协同治疗腰椎间盘突出症,利用已证实的药物数据为基础分析了其药物中的活性成分、关键靶点、蛋白质的相互作用关系和潜在通路,进一步阐明独活寄生汤治疗腰椎间盘突出症的作用机制。

独活寄生汤抑制NLRP3炎性小体活化治疗痛风性关节炎

背景:研究发现NLRP3炎症小体的激活是痛风性关节炎发病的重要因素,通过调控PTEN诱导激酶1(PTEN-induced kinas 1,PINK1)/Parkin信号通路能有效抑制NLPR3炎性小体的活化。目的:探究独活寄生汤对PINK1/Parkin/NLRP3信号通路的影响。方法:①动物实验:将雄性SD大鼠随机分为对照组、模型组、阳性对照组(秋水仙片0.3 mg/kg)和独活寄生汤低、中、高剂量组(分别给予6.9,13.8,27.6 g/kg),除对照组外其余各组大鼠通过右后踝关节腔注射尿酸单钠盐晶体混悬液构建大鼠痛风性关节炎模型。②细胞实验:将人单核细胞(THP-1)分为空白对照组、模型组、独活寄生汤含药血清组、PINK1 siRNA+独活寄生汤含药血清组,除空白对照组外其余各组细胞采用尿酸钠刺激建立体外痛风性关节炎模型。③观察大鼠踝关节肿胀度、关节周径、步态评分、关节炎症指数和病理分级程度;酶联免疫吸附法检测尿酸、C-反应蛋白、NLRP3和白细胞介素1β水平;免疫印迹法检测PINK1/Parkin/NLRP3通路相关蛋白表达水平;四甲基偶氮唑蓝法检测细胞活性;免疫荧光双染检测线粒体自噬水平;免疫荧光检测NLRP3和白细胞介素1β表达。结果与结论:①与对照组比较,模型组大鼠在6-48 h的踝关节肿胀度、踝关节周径升高(P<0.05),在24和48 h时的步态评分与关节炎症指数升高(P<0.05),血清尿酸和C-反应蛋白水平、病理分级程度、滑膜组织中PINK1、Parkin和NLRP3蛋白表达及白细胞介素1β水平均升高(P<0.05);与模型组比较,独活寄生汤各剂量组大鼠上述指标中除PINK1和Parkin蛋白表达升高(P<0.05)外,其他指标均降低(P<0.05)。②与模型组比较,独活寄生汤含药血清组细胞NLRP3活性、白细胞介素1β水平和线粒体外膜转位蛋白20(TOM20)蛋白水平降低(P<0.05),而增殖抑制率、PINK1、Parkin和LC3B蛋白水平增加(P<0.05);细胞线粒体自噬水平升高(P<0.05),而NLRP3和白细胞介素1β蛋白水平降低(P<0.05)。③与独活寄生汤含药血清组相比,PINK1 siRNA+独活寄生汤含药血清组细胞线粒体自噬水平降低(P<0.05),NLRP3和白细胞介素1β表达水平升高(P<0.05)。④结果表明,独活寄生汤通过调控PINK1/Parkin信号通路抑制NLRP3炎性小体活化,进而对痛风性关节炎起到治疗作用。

加味独活寄生合剂联合体外冲击波对腰椎间盘突出症患者的临床疗效及其对NF-κB信号通路的影响

目的观察加味独活寄生合剂联合体外冲击波对寒湿痹阳型腰椎间盘突出症的临床疗效,及对NF-κB信号通路的影响。方法将湖南中医药大学第一附属医院68例寒湿痹阻型腰椎间盘突出症患者按入组顺序随机分为试验组与对照组,每组34例。对照组予体外冲击波治疗,试验组在体外冲击波的基础上给予加味独活寄生合剂治疗,两组均治疗2周。采用疼痛视觉模拟(visual analogue scale,VAS)评分、Oswestry功能量化指数(oswestry disability index,ODI)评分及日本骨科协会评分(Japanese orthopaedic association,JOA)评估两组患者的疗效;用ELISA检测治疗前后血清NF-κB信号通路指标(p50、p65)、白细胞介素-8(Interleukin-8,IL-8)、白细胞介素-10(Interleukin-10,IL-10)、肿瘤坏死因子-α(Tumor Necrosis Factor-alpha,TNF-α)表达含量。结果治疗后,两组患者NF-κB信号通路指标(p50、p65)、IL-8、TNF-α与治疗前比较均降低(P<0.01),IL-10明显升高(P<0.01)。治疗后,两组患者JOA评分、ODI评分与治疗前比较均显著改善(P<0.01);且试验组效果优于对照组(P<0.01)。两组患者VAS评分差异无统计学意义(P>0.05)。结论加味独活寄生合剂联合体外冲击波治疗腰椎间盘突出症可能通过抑制NF-κB信号通路的激活从而影响下游炎症因子表达,减轻LDH患者异常炎症反应,改善腰椎功能。

独活寄生汤治疗膝骨关节炎的研究进展

独活寄生汤是临床治疗膝骨关节炎的常用方剂,临床应用证明,可有效改善膝部疼痛、肿胀、僵硬,以及严重者出现的活动受限等症状,不良反应较少。中医认为该方具有止痹痛、祛风湿、补气血、益肝肾之效,当代医学则认为具有抗炎镇痛、抑凋亡、抗氧化、促再生等作用。然更有医者将独活寄生汤与其他疗法联合应用,使之临床疗效更为突出。综述近年来独活寄生汤的相关文献,从中医理论、作用机制、单方应用及联合其他疗法治疗膝骨关节炎几个方面进行系统总结,以期为科研和临床应用提供参考。

独活寄生汤含药血清细胞外囊泡对类风湿关节炎滑膜成纤维细胞的影响

背景:独活寄生汤是治疗类风湿关节炎的经典方剂,但具体作用机制尚不清楚,细胞外囊泡具有细胞间通讯及传递信号的强大功能,可能是该方剂发挥作用的信号载体。目的:探讨独活寄生汤含药血清细胞外囊泡对类风湿关节炎滑膜成纤维细胞增殖、迁移、侵袭及凋亡的影响。方法:肿瘤坏死因子α体外诱导构建类风湿关节炎滑膜成纤维细胞模型,实验分为5组:正常组、模型组、独活寄生汤含药血清组、独活寄生汤含药血清细胞外囊泡组、生理盐水血清细胞外囊泡组。采用CCK-8法筛选独活寄生汤含药血清及独活寄生汤含药血清细胞外囊泡作用的最佳浓度及时间;ELISA检测细胞上清炎症因子水平;划痕实验检测细胞迁移能力;Transwell实验检测细胞侵袭能力及迁移能力;Hoechst染色检测细胞凋亡情况;qRT-PCR及Western blot检测细胞凋亡相关基因及蛋白表达。结果与结论:(1)独活寄生汤含药血清作用的最佳体积分数为10%,独活寄生汤含药血清细胞外囊泡作用的最佳质量浓度为10 ng/mL,二者作用的最佳时间均为24 h;(2)与模型组相比,独活寄生汤含药血清、独活寄生汤含药血清细胞外囊泡及生理盐水血清细胞外囊泡均能抑制类风湿关节炎滑膜成纤维细胞的炎症因子表达(P<0.05)、划痕愈合(P<0.05)、迁移及侵袭(P<0.05),且独活寄生汤含药血清细胞外囊泡的抑制作用更为突出(P<0.05);(3)独活寄生汤含药血清及独活寄生汤含药血清细胞外囊泡均可促进类风湿关节炎滑膜成纤维细胞的凋亡;(4)与模型组相比,独活寄生汤含药血清、独活寄生汤含药血清细胞外囊泡及生理盐水血清细胞外囊泡均可增加促凋亡因子Caspase-3、Caspase-9、Bax表达(P<0.05),降低抑凋亡因子Bcl-2表达(P<0.05),且独活寄生汤含药血清细胞外囊泡对凋亡相关因子的调节作用更显著。上述实验结果表明独活寄生汤含药血清细胞外囊泡可以抑制类风湿关节炎滑膜成纤维细胞的过度增殖、迁移、侵袭并促进其凋亡。

5种中药汤剂治疗类风湿性关节炎有效性和安全性的网状Meta分析

目的系统评价常用的5种中药汤剂治疗类风湿关节炎(RA)的疗效及安全性。方法计算机检索PubMed、Embase、Cochrane Library、Web of Science、CNKI、WanFang Data和VIP数据库,搜集蠲痹汤、乌头汤、白虎加桂枝汤、桂枝芍药知母汤和独活寄生汤等5种中药汤剂联合甲氨蝶呤、美洛昔康等常规疗法治疗RA的随机对照试验(RCT),检索时限均从建库至2024年1月1日,由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Stata 17软件进行网状Meta分析。结果共纳入35个RCT,包括3316例患者。网状Meta分析结果显示,与单纯常规疗法相比,5种中药汤剂+常规疗法均显著提高临床总有效率(P<0.05),蠲痹汤+常规疗法、桂枝芍药知母汤+常规疗法、独活寄生汤+常规疗法均显著降低类风湿因子(RF)水平(P<0.05),蠲痹汤+常规疗法、乌头汤+常规疗法、桂枝芍药知母汤+常规疗法、独活寄生汤+常规疗法均显著降低C-反应蛋白(CRP)水平和血清红细胞沉降率(ESR)(P<0.05),桂枝芍药知母汤+常规疗法、独活寄生汤+常规疗法均显著降低不良反应发生率(P<0.05)。累积概率排序结果显示,桂枝芍药知母汤+常规疗法对提高临床总有效率、降低RF水平、降低不良反应发生率的效果均最佳,乌头汤+常规疗法对降低CRP水平的效果最佳,蠲痹汤+常规疗法对降低血清ESR效果最佳。结论中药汤剂与常规疗法联合应用治疗RA的效果显著优于单纯常规疗法,在改善指标方面,可选择桂枝芍药知母汤或蠲痹汤联合常规疗法;在提高安全性方面,可选择桂枝芍药知母汤或独活寄生汤联合常规疗法。受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证。