Effect of Chinese Herbs for Activating Blood Circulation,Removing Stasis and Supplementing Qi on the Circulating Endothelial Cells in Patients with Unstable Angina Pectoris

Objective: To observe the effect and clinical significance of circulating endothelial cells (CEC) in the pathogenesis of coronary heart disease with unstable angina pectoris (CHD-UAP), and to explore the protective effect of Chinese herbs for activating blood circulation, removing stasis and supplementing Qi (CH) on CHD-UAP patient's CEC. Methods: Sixty patients with diagnosis of CHD-UAP confirmed and differentiated to be Qi-deficiency and blood stasis by TCM were randomly divided into two groups and treated, on the basis of Western drug-therapy, with Tongxinluo capsule (通心络胶囊, TXL) and Huoxue Tongmai capsule (活血通脉胶囊, HXTM) respectively by way of oral taking three times a day, 3 capsules every time, with 1 month as one therapeutic course. The number of CEC in patients' blood circulation was counted before and after treatment. Besides, the number of CEC in 30 healthy persons was also counted for control. Results: The number of CEC in CHD-UAP patients was significantly higher than that in the healthy persons (P<0.01). After the patients were treated with CH, either TXL or HXTM, it significantly decreased (P<0.01)with insignificant difference between the two treated groups. Conclusion: CEC in CHD-UAP patients is severely damaged and endothelial function in disorder, Chinese herbs have protective effect on patients' CEC.

Clinical effect of enriching qi, activating blood circulation, clearing away dampness and heat combined with western medicine in the treatment of idiopathic membranous nephropathy: A meta-analysis

Objective:To systemically review the efficacy and safety about the method of enriching qi,activating blood circulation,clearing away dampness and heat combined with western medicine in the therapy of patients with idiopathy membranous nephropathy(IMN).Methods:We collected the randomized controlled trials(RCTs)of enriching qi,activating blood circulation,clearing away dampness and heat for the treatment of IMN from Pub Med,The Cochrane Library,Medline,China National Knowledge Infrastructure(CNKI),China Biology Medicine disc(CBM),Wanfang Data and Wiper Databases.Bias of risk of retrieval literature was evaluated according to Cochrane Collaboration standard,and Review Manager 5.3 software was used for statistical analysis.Results:Fourteen trials(836 participants)were included in the meta-analysis.This kind of traditional Chinese method combined with western medicine in the treatment of IMN exerted statistical differences in reducing 24-hour urinary protein[WMD=-0.97,95%CI(-1.30,-0.65),Z=5.86(P<0.00001)]and elevating serum albumin[WMD=3.83,95%CI(2.10,5.57),Z=4.33,P<0.0001],lowering serum cholesterol[WMD=-0.82,95%CI(-1.08,-0.56),Z=6.18,P<0.00001],triglycerides[WMD=-0.39,95%CI(-0.67,-0.11),Z=2.77,P=0.006]and reducing the risk of adverse events[OR=0.29,95%CI[0.16,0.50],Z=4.35,P<0.0001]in the patients with IMN as compared with controls.However,there was no statistically significant difference between the method and controls when combining all trials in serum creatinine[WMD=-5.52,95%CI(-18.06,7.03),Z=0.86,P=0.39],when combining all trials in urea nitrogen[WMD=-0.90,95%CI(-2.22,0.41),Z=1.35,P=0.18].Conclusion:The method of enriching qi,activating blood circulation,clearing away dampness and heat combined with western medicine exerts certain advantages and better safety in treating patients with IMN.However,for the inferiority of the included studies,the conclusion still needs high-quality and large-sample prospective randomized controlled trials to verify.

Supplementing Qi and activating blood circulation method to treat vertebrobasilar dolichoectasia with posterior circulatory watershed infarction:a case report of two patients

Vertebrobasilar dolichoectasia(VBD),a rare posterior circulation vascular variant disease,is an important risk factor for many acute cerebrovascular diseases.An insufficient understanding of VBD often leads to misdiagnose.Two cases of VBD that were initially diagnosed as posterior circulation watershed infarction are reported here.Absence of common causes of stroke including hypoperfusion,blood system diseases,carotid and aortic dissection,and eosinophil elevation,the symptoms of the 2 patients met the diagnostic criteria of VBD.Both patients displayed symptoms that were in line with the Traditional Chinese Medicine(TCM)syndrome pattern of"Qi deficiency and blood stasis".Accordingly,they were comprehensively treated with Supplementing Qi and activating blood circulation method.The clinical manifestations of the 2 patients were remarkably improved and no recurrence of watershed infarction was found in a 1-year follow-up.A detailed medical history and laboratory examination are capable of improving diagnostic accuracy of VBD.TCM treatment based on syndrome identification might be a promising candidate for VBD management.

Effect of Chinese Drugs for Supplementing Qi,Nourishing Yin and Activating Blood Circulation on Myocardial Perfusion in Patients with Acute Myocardial Infarction after Revascularization

Objective:To observe the effects of Chinese drugs for supplementing qi,nourishing yin and activating blood circulation on the myocardial perfusion in acute myocardial infarction(AMI) patients after revascularization.Methods:Eighty patients with anterior or inferior ventricular wall AMI,who had received revascularization by intravenous thrombolysis or coronary bypass,were randomized into the treated group and the control group equally,both treated with conventional Western medical treatment,but combined,resp...

Tonifying Qi and activating blood circulation in terms of Traditional Chinese Medicine: their effects in patients with myocardial infarction

OBJECTIVE: To investigate the effects of tonifying Qi and activating blood circulation(SQABC), a method in Traditional Chinese Medicine(TCM), on end-point events in patients with myocardial infarction(MI) in this retrospective cohort study.METHODS: Clinical data were obtained from the medical records of patients with acute MI(AMI),both during hospitalization and follow-up, and included general demographic information(age, gender, and contact information), TCM regimens used,and end-point events.RESULTS: A total of 1596 patients with AMI were enrolled to this study, but data of only 1210 casesare accessible till follow-up. We classified the patients based on the exposure levels of SQABC.When comparing the results between all exposure and non-exposure groups, significant differences were identified, both during hospitalization and follow-ups. During hospitalization, cardiac death(4.40% vs 21.55%, P < 0.05) and cardiac shock(3.04% vs 11.62%, P < 0.05) were significantly lower in the exposure group than the non-exposure group. Similarly, during the follow-up, cardiac death(12.04% vs 20.49%, P < 0.05), acute heart failure(7.27% vs 11.81%, P < 0.05), composite endpoint of reinfarction and stroke(9.11% vs 15.28%,P < 0.05), and rehospitalization due to angina(25.49% vs 34.38%, P < 0.05) were significantly lower in the exposure group than the non-exposure group.CONCLUSION: Our findings suggest that SQABC can significantly benefits the subjects in the management of high-risk AMI in them.

Protective Effect of Chinese Herbs for Supplementing Qi,Nourishing Yin and Activating Blood Circulation on Heart Function of Patients with Acute Coronary Syndrome after Percutaneous Coronary Intervention

Objective： To investigate the effects of Chinese herbs for supplementing qi, nourishing yin and activating blood circulation on heart function of patients with acute coronary syndrome （ACS） after successful percutaneous coronary intervention （PCI）. Methods： One hundred patients with ACS after successful PCI were randomly assigned to a Western medicine （WM） treatment group （WMG） and a combined treatment group （CMG） treated by Chinese herbs for supplementing qi, nourishing yin and activating blood circulation, besides Western medicine treatment, with 50 cases in each group. Both treatment courses were 6 months. The follow- up was scheduled at baseline, 6 months and 1 year after PCI, and New York Heart Association （NYHA） functional class, Chinese medicine （CM） symptom scores, blood stasis syndrome scores, and major adverse cardiovascular events （MACE） were observed, serum levels of N-terminal pro-brain natriuretic peptide （NT-proBNP） and hyper-sensitivity C-reactive protein （Hs-CRP） were measured, an echocardiogram was conducted to examine left ventricular ejection fraction （LVEF）, left ventricular end-diastolic volume （LVEDV）, left ventricular end-systolic volume （LVESV）, inter-ventricular septal thickness （IVST）, left ventricular posterior wall thickness （LVPWT）, and ventricular wall motion index （VWMI）. Results： Compared with the baseline, LVEF significantly increased （P〈0.01）, and CM symptom scores, blood stasis syndrome scores, VWMI, LVEDV, LVESV, NT-proBNP, and Hs-CRP all decreased （P〈0.01） in both groups at 6 months and at 1 year after PCI. There were no significant differences in all the above parameters at 1 year vs those at 6 months after PCI （P〉0.05）. VWMI, LVEDV, LVESV, NT-proBNP, Hs-CRP, LVEF, and CM symptom and blood stasis syndrome scores were all improved obviously in CMG than those in WMG （P〈0.05 or P〈0.01） at 6 months and at 1 year after PCI. There were no significant differences in NYHA functional class between CMG and WMG at different follow-up timepoints; it was notable that P value was 0.054 when comparing the cases of NYHA functional class between the two groups at 1-year follow-up. During the 1-year follow-up, 3 MACE and 11 MACE occurred in CMG and WMG, respectively; the MACE rate in CMG was lower than that in WMG （6% vs 22%, P〈0.05）. Conclusion： Chinese herbs for supplementing qi, nourishing yin and activating blood circulation could improve heart function, reduce the CM symptom scores and blood stasis syndrome scores, and decrease the incidence of MACE in patients with ACS after successful PCI.

Mechanism of'Invigorating Qi and Promoting Blood Circulation'Drug Pair Ginseng-Danshen on Treatment of Ischemic Heart Disease Based on Network Pharmacology

Objective:Using network pharmacology to explore the mechanism of the'invigorating qi and promoting blood circulation'drug pair Ginseng-Danshen(Salvia miltiorrhiza)on treatment of ischemic heart disease(IHD).Methods:The chemical constituents of ginseng and Danshen drug pair were identified by searching the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP),and the potential targets of the pair were identified.The pharmacodynamics of the pair was analyzed using network pharmacology.The targets of IHD were identified by database screening.Using protein-protein interaction network,the interaction targets of Ginseng-Danshen on IHD were constructed.A"constituent-target-disease"interaction network was constructed using Cytoscape software,Gene Ontology(GO)term enrichment analysis and biological pathway enrichment analysis were carried out,and the mechanism of improving myocardial ischemia by the Ginseng-Danshen drug pair was investigated.Results:Seventeen active constituents and 53 targets were identified from ginseng,53 active constituents and 61 targets were identified from Danshen,and 32 protein targets were shared by ginseng and Danshen.Twenty GO terms were analyzed,including cytokine receptor binding,cytokine activity,heme binding,and antioxidant activity.Sixty Kyoto Encyclopedia of Genes and Genomes(KEGG)signaling pathways were analyzed,including phosphatidylinositol 3-kinase-serine-threonine kinase(PI3 K-AKT)signaling pathway,p53 signaling pathway,interleukin 17 signaling pathway,tumor necrosis factor signaling pathway,and the advanced glycation end product(AGE)-the receptor for AGE(RAGE)signaling pathway in diabetic complications.Conclusion:The specific mechanism of Ginseng-Danshen drug pair in treating IHD may be associated with improving the changes of metabolites inbody,inhibiting the production of peroxides,removing the endogenous oxygen free radicals,regulating the expression of inflammatory factors,reducing myocardial cell apoptosis and promoting vascular regeneration.

Efficacy and safety of a sequential treatment with clearing heat and eliminating phlegm and tonifying Qi and activating blood circulation in treating acute ischemic stroke: study protocol for a randomized controlled trial

OBJECTIVE:To investigate the short-term efficacy and safety outcomes following a sequential treatment with clearing heat and eliminating phlegm(CHEP)formula and tonifying Qi and activating blood circulation(TQABC)formula in patients with acute ischemic stroke(AIS)within a 72 h time window.METHODS:In this randomized,multicenter,doubleblinded,placebo-controlled trial,500 participants will be randomly assigned in a ratio of 1∶1 to the CHEP+TQABC group or control group.In addition to guidelinebased standard medical care,participants in the treatment group will receive the CHEP formula for the first 5 consecutive days followed by the TQABC formula for another 10 consecutive days,while those in the control group will receive CHEP formula placebo and TQABC formula placebo consecutively.The primary outcome measure will be the comparison of the change in the National Institutes of Health Stroke Scale score from baseline to 15 days after randomization.The secondary outcome measures will include the scores on the modified Rankin Scale,Barthel Index,Patient-Reported Outcomes,TCM symptom pattern(Zheng-hou)evaluation Scale,and the incidence of in-hospital complications.Safety assessment will include the physical examination,laboratory detection,any adverse events or serious adverse events,and the proportion of any complications during hospitalization.DISCUSSION:The results of this study will provide objective and scientific data with which to assess the efficacy and safety of a sequential treatment based on“integrating disease and symptom pattern”for patients with AIS.

Effects of Chinese herbs capable of replenishing qi, nourishing yin and activating blood circulation and their compatibility on differentially expressed genes of ischemic myocardium

This study was conducted to investigate the effects of Chinese herbs capable of replenishing qi, nourishing yin and activating blood circulation and their compatibility on differentially expressed genes of ischemic myocardium which were selected from differential expression profile we had established before, and to explore the underlying mechanism. The acute myocardial infarction (AMI) model was established by ligating the left anterior descending (LAD) coronary artery, then the model rats were randomly divided into the model group, the Metoprolol group, the replenishing qi nourishing yin (RN) group, the activating blood circulation (AB) group, and the replenishing qi, nourishing yin and activating blood circulation (RA) group. In addition, the normal group and the sham group were set up. The rats of medication groups were administered by intragastric gavage with corresponding drugs on the second day after operations, and the rats of the normal group and the sham group were given normal saline as the same time.Then the ischemic hearts were harvested on the 8th day after operation. The myocardial pathomorphological changes were observed under a light microscope. The mRNA changes of target genes such as COX5a and ATP5e were detected using Realtime fluorescence quantitative PCR (QPCR), and the activities of related enzymes were detected by colorimetric assay. The main results were as follows: the histological changes were observed by HE staining, and cardiocyte swelling, inflammatory cell infiltration and cytolysis were showed in regional ischemic myocardium of the model group, while the pathomorphological changes in all medication groups did not show obvious changes. Two genes related to energy metabolism, COX5a and ATP5e, were selected as the target genes which were downregulated at the mRNA level in the medication groups. The activities of correlative functional enzymes also decreased in the RA group compared to that in the model group accordingly (P<0.05). The results indicated that the abnormal expression of genes involved in energy metabolism pathways could be one of the molecular mechanisms of AMI. The compatibility of Chinese herbs capable of replenishing qi, nourishing yin and activating blood circulation affects the expression of energyrelative gene COX5a, ATP5e, which is probably the mechanism of myocardial preservation, and is more effective than single herb of replenishing qi and nourishing yin or activating blood circulation.

Invigorating Qi and Promoting Blood Circulation in Treatmentof Chronic Idiopathic Thrombocytopenic Purpura

Twenty patients of chronic idiopathic thrombocytopenic purpura (ITP) were treated with suchkind of Chinese herbal medicine as invigorating Qi and promoting blood circulation for 4-8 weeks. The ther-apeutic effect was observed and compared with that of the two control groups treated with prednisone and co-enzyme A respectively. In the TCM group, the number of patients with marked effect, good effect and im-provement were 2, 4 and 7, the total effective rate being 65% . This efficacy was higher than that of the co-enzyme group and lower than that of the prednisone group. The changes of antiplatelet IgG antibody and hap-toglobin were also observed in the meantime, and results showed that after TOM treatment, both of themwere decreased as disease improved.

Clinical Study on Effect of Chinese Herbal Medicine for Supplementing Kidney and Qi and Activating Blood Circulation in Treating Intrauterine Growth Retardation of Fetus

Objective: To explore the therapeutic effect and the possible working mechanism in using Chinese herbal medicine (CHM) for supplementing Kidney and Qi, and activating blood circulation in treating intrauterine growth retardation of fetus (IUGR). Methods: Fifty-five cases of IUGR were divided into two groups, 30 cases in the CHM group treated with CHM and the 25 in the control group treated with amino acids. The effect of CHM treatment was observed and compared with that of the control group, normal pregnancy group and non-treated IUGR group. Results: Body weight of the newborns in the CHM was markedly higher than that in the control group. Not only the maternal fundal height (FH) and the abdominal circumference (AC), but also the fetal growth parameters, including biparietal diameter, head circumference (HC), and femur length (FL) in the CHM group increased much faster than those in the control group. After CHM treatment, the maternal serum levels of estriol (E3) and human placental lactogen (hPL) approached to those in the normal pregnancy group, but the control group,in comparison with the normal pregnancy group, was significantly different. The umbilical venous plasma concentration of essential amino acids in both treated groups improved, but the improvement in the CHM group was more significant than that in the control group. No apparent adverse effect of CHM was observed in either mother or fetus.Conclusion: CHM for supplementing Kidney and Qi and activating blood circulation was more effective in improving placental function and enhancing amino acid transportation than amino acid

Effect of Danggui Shaoyao San with Huangqi on adriamycin-induced nephrotic syndrome in rats

Objective:To determine the therapeutic effect of Danggui Shaoyao San with Huangqi on rats with nephrotic syndrome(NS)was discussed,and the scientific connotation of TCM treatment principle was elaborated,so as to provide experimental basis for its clinical application.Methods:The NS rat model was established by iv administration of adriamycin;The rats were divided into model group,Danggui Shaoyao San group,Danggui Shaoyao San with Huangqi group,Huangqi group and positive drug group,with 10 rats in control group;The best dosage ratio of Danggui Shaoyao San and Huangqi was screened by Excel;24 h urine protein was measured by BCA method;The electrolyte level was detected by automatic biochemical analyzer;In serum Urea nitrogen(BUN),Creatinine(SCr),Total cholesterol(TC),Triglyceride(TG),Total protein(TP),Albumin(ALB),Immunoglobulin M(Ig-M)and Immunoglobulin G(Ig-G)were detected by the kit;hematoxylin-eosin staining was used to observe the renal morphology;The Total water content(TBW),Extracellular water content(ECF)and Intracellular water content(ICF)were measured by experimental animal body composition analyzer.Results:Compared with the model group,the urine protein in the modified Astragalus group of Danggui Shaoyao Powder was significantly decreased(P<0.01);Urine electrolytes were significantly decreased and serum electrolytes were significantly increased(P<0.01);Serum BUN,SCR,TC and TG were significantly decreased(P<0.01),while TP,ALB,TBW and ICF were significantly increased(P<0.01);The levels of Ig-M and Ig-G were significantly increased(P<0.01),TBW and ICF were significantly increased,and ECF was significantly decreased(P<0.01);Histopathology showed that the pathological changes of renal tissue were obviously alleviated;The improvement of each index was better than that of Danggui Shaoyao San group and Huangqi group.Conclusion:Danggui Shaoyao San with Huangqi group can significantly improve the edema,proteinuria,blood lipid and immune function of NS rats,and the effect is better than that of Danggui Shaoyao San group and Huangqi group.It has the best therapeutic effect on NS,which indicates that Huangqi plays a key synergistic effect on Danggui Shaoyao San,which verifies the scientific connotation of"Yiqi Huoxue Lishui"in the treatment of NS.

苏筋通络方结合“行气活血”针刺法治疗急性踝关节扭伤临床观察

目的观察苏筋通络方结合“行气活血”针刺法治疗急性踝关节扭伤临床效果。方法将医院创伤骨科门急诊就诊的102例急性踝关节扭伤患者(2020年5月—2022年7月)纳入研究,以随机数字表法将患者分为两组,每组51例,对照组采取西医常规治疗,观察组采取西医常规治疗同时结合苏筋通络方及“行气活血”针刺法治疗。数据比较:临床治疗效果、中医症状(踝关节疼痛肿胀、皮下瘀斑、关节活动受限等)积分变化、踝关节跖屈活动度与背伸活动度变化、视觉模拟评分(Visual Analogue Scale,VAS)变化、美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)踝-后足评分变化、血清疼痛物质(神经生长因子、神经肽、P物质)水平变化、白细胞介素-6(Interleukin-6,IL-6)、白细胞介素-1β(Interleukin-1β,IL-1β)、超敏C反应蛋白(Hypersensitive C-reactive protein,hs-CRP)变化。结果观察组患者与对照组患者治疗总有效率相比[98.04%(50/51)vs86.27%(44/51)],P<0.05;治疗后各组患者中医症状(踝关节疼痛肿胀、皮下瘀斑、关节活动受限等)积分、踝关节跖屈活动度与背伸活动度、VAS评分、AOFAS踝-后足评分、神经生长因子、神经肽、P物质、IL-6、IL-1β、hs-CRP等指标均改善,观察组患者治疗后中医症状(踝关节疼痛肿胀、皮下瘀斑、关节活动受限等)积分、踝关节跖屈活动度与背伸活动度、VAS评分、AOFAS踝-后足评分、神经生长因子、神经肽、P物质、IL-6、IL-1β、hs-CRP等指标均明显优于对照组患者,P均<0.05。结论苏筋通络方结合“行气活血”针刺法治疗急性踝关节扭伤临床效果显著,患者经治疗后临床症状显著改善,疼痛缓解,踝关节功能改善,值得应用。

补肾活血序贯法对薄型子宫内膜大鼠内膜形态及VEGF、Vimentin、CK12蛋白表达的影响

目的:观察补肾活血序贯法中药对薄型子宫内膜大鼠内膜形态、血管内皮生长因子(VEGF)蛋白、波形蛋白(Vimentin)和组织细胞角蛋白12(cytokeratin 12,CK12)表达的影响。方法:将SPF级雌性SD大鼠连续灌胃羟基脲8 d复制肾虚薄型子宫内膜模型,造模成功后50只大鼠随机分为模型组、中药低剂量组、中剂量组、高剂量组及补佳乐组(阳性对照组)每组10只,另取10只大鼠为假手术组。假手术组和模型组灌胃等量蒸馏水,补佳乐组灌胃补佳乐0.3 mg/kg。其余3组动情期分别灌胃给予低、中、高剂量的消癥合剂;动情前期、动情后期和动情间期分别灌胃给予低、中、高剂量的养膜助孕包,连续给药3个动情周期,共15 d。干预结束后,HE染色观察大鼠子宫内膜形态;免疫组化检测大鼠子宫内膜VEGF、Vimentin和CK12表达。结果:模型组大鼠子宫内膜厚度、腺体数和血管数明显低于假手术组(P<0.01)。中药中、高剂量组及补佳乐组大鼠子宫内膜厚度、腺体数和血管数明显高于模型组(P<0.05或0.01)。中药中、高剂量组和补佳乐组大鼠子宫内膜组织VEGF的表达量均明显多于模型组(P<0.01),中药高剂量组子宫内膜组织Vimentin蛋白表达量明显高于模型组(P<0.01),中药低、中、高剂量组和补佳乐组子宫内膜组织CK12的表达明显多于模型组(P<0.05或0.01)。结论:补肾活血序贯法中药可以增加肾虚薄型子宫内膜模型大鼠的子宫内膜厚度及内膜组织VEGF、Vimentin、CK12蛋白表达。

基于调控免疫炎症微血管损伤的补气活血法治疗肺炎“瘥后防复”思路的提出

肺炎恢复期后遗症严重影响患者身心健康,存在二次感染的风险,且与基础病相互影响导致恶性循环。做好肺炎恢复期康复工作,减少后遗症并预防反复发作是疾病防治的首选。研究显示肺炎长期后遗症和反复发作的机制可能与持续的机体免疫抑制和全身微炎症状态及微血管损伤有关。团队根据传统中医理论,结合长期临床与基础研究,提出“气虚血瘀”是肺炎恢复期的核心病机。因此,团队提出补气活血法治疗肺炎“瘥后防复”的机制与调控免疫炎症微血管损伤有关,调控T淋巴细胞紊乱提高免疫、抑制炎症因子改善机体微炎症状态和抗氧化保护内皮细胞调控微血管损伤,阐明其内在机制将为中医药治疗呼吸系统重大感染性疾病提供理论依据,传承精华、守正创新。

益气活血方药治疗原发性肝癌的免疫学机制概述

归纳总结具有益气和/或活血功效的中药单体、单味中药以及中药复方治疗原发性肝癌的免疫学机制,包括对T淋巴细胞亚群、巨噬细胞、髓源性抑制细胞(myeloid-derived suppressor cell,MDSC)、肿瘤细胞表面受体、细胞因子以及红细胞免疫在数量和功能上的调节,阐述其抗肿瘤作用,为进一步的基础研究和临床应用提供思路。

益气活血方联合复方樟柳碱注射液治疗缺血性视神经病变的疗效分析

目的:探讨益气活血方联合复方樟柳碱注射液治疗缺血性视神经病变(ION)的疗效及对患者血清25-羟维生素D、内皮素-1的影响。方法:选本院2021-08-2022-08收治102例ION患者,随机数字表法分观察组(50例)和对照组(52例),对照组患者使用益气活血法治疗,观察组在对照组的基础上联合复方樟柳碱注射液治疗,检测并比较治疗前后两组患者血清25-羟维生素D、内皮素-1、中医证候积分水平、视野缺损度(MD)、视盘各象限视神经纤维层厚度(ATRN-FL)、视野敏感度(MS)等。结果:较同组治疗前比较,治疗后两组中医证候积分水平、MD、ATRN-FL、内皮素-1水平均降低,而血清25-羟维生素D、MS水平升高(P<0.05或P<0.01);且观察组治疗后视物模糊、视疲劳、暗影遮挡、头晕、面色淡白、身倦乏力、气少懒言评分以及MD、ATRN-FL、内皮素-1水平均低于对照组,而25-羟维生素D、MS水平高于对照组,差异均有统计学意义(P<0.01);观察组临床疗效优于对照组(P<0.01);且两组不良反应差异无统计学意义(P>0.05)。结论:益气活血方联合复方樟柳碱注射液可有效降低缺血性视神经病变患者中医证候积分水平,改善和提升患者视野及视力,利于患者恢复。

Summary of 32 Patients with Cardiac Syndrome X Treated by TCM Therapy of Regulating Qi Relieving Chest Stuffiness and Promoting Blood Circulation

Objective： To evaluate the clinical effect of Liqi Kuanxiong Huoxue method （宽胸活血,LKH, traditional Chinese medicine, TCM therapeutic method for regulating qi, relieving chest stuffiness and promoting blood circulation） in treating patients with cardiac syndrome X （CSX）. Methods： The prospective, non-randomized controlled study was conducted on 51 selected patients with CSX, who were non-randomly assigned to 2 groups, the treated group treated with LKH in addition to the conventional treatment （32 patients）, and the control group treated with conventional treatment （19 patients） like nitrate, diltiazem hydrochloride, etc. The treatment course was 14 days. The changes of such symptoms as angina pectoris, TCM syndrome and indexes of treadmill exercise test before and after treatment were observed. Results： After treatment, such symptoms as chest pain and stuffy feeling and palpitation in the treated group were improved more than those in the control group （P〈0.05）; the total effective rate on angina pectoris and TCM syndrome in the treated group was better than that in the control group （P〈0.05）. The treadmill exercise test showed that the maximal metabolic equivalent （Max MET）, the time of angina onset and ST segment depression by 0.1 mV were obviously improved after treatment in both groups, but the improvement in the treated group was better than that in the control group respectively （P〈0.05）. Conclusion： The LKH method could reduce the frequency of angina attacks and improve the clinical condition of patients with CSX.

骨质疏松症“亏瘀致痿”的理论构建及临床应用

骨质疏松症(OP)是一种以增龄性骨量降低,骨微结构破坏,骨脆性增加且易骨折的代谢性骨病。该病好发于绝经后女性和中老年男性,起病隐匿,多数患者在骨折后才被确诊,造成了大量的医疗资源消耗。浙江中医药大学附属第三医院姚新苗教授研究团队基于“肾主骨”“肾气虚损”等基础理论,创新性提出了OP“亏瘀致痿”的致病理论,认为OP的病机是亏虚瘀互结、夹杂致痿。在该理论指导下,认为应采用“补肾健脾活血法”对OP患者进行辨证论治。补肾健脾活血法主要包括虚瘀同治;补肾为本、健脾为要;筋骨并重3个方面。该研究团队开展了一系列临床与基础研究,从不同角度阐释“亏瘀致痿”理论指导下OP康复策略的科学内涵。

益气活血法调控自噬延缓失神经肌萎缩的理论

周围神经损伤后骨骼肌将不可避免地发生肌肉萎缩,而气虚血瘀是失神经肌萎缩发病的主要病理机制,益气活血法是防治失神经肌萎缩的重要治则。神经损伤后局部血脉瘀滞与远端靶组织气血亏虚,可能是导致自噬溶酶体系统过度激活的主要病理机制,益气活血法(补阳还五汤)可通过益气生血与活血化瘀,恢复靶组织的气血供应,改善神经血脉瘀滞与靶组织气血亏虚的病理状态,从而抑制自噬溶酶体系统过度激活,发挥失神经肌萎缩的保护作用。