Characteristic metabolic and microbial profiles in acute ischemic stroke patients with phlegm-heat pattern

Objective:To explore the characteristics of plasma metabolites,feces gut microbiota and the crosstalk between gut microbiota and host metabolism in patients with acute ischemic stroke and phlegm-heat pattern(AIS-PHP).Methods:The metabolic and microbiome profiles of 20 AIS-PHP patients and 20 healthy controls(HCs)were analyzed using liquid chromatography-tandem mass spectrometry(LC-MS/MS)-based metabolomics and 16s rDNA sequencing,respectively.The covariation between LC-MS/MS-based metabolite data and 16s rDNA sequence data was presented.Results:Distinct alterations in the plasma metabolic phenotype of AIS-PHP patients were found,in which 16 metabolites differed significantly between the AIS-PHP patients and the HCs.These metabolites represented 17 different metabolic pathways,including amino acid metabolism,lipid metabolism,and nucleotide metabolism.Additionally,significant alterations of gut microbiota composition and taxon were revealed at the phylum level between the AIS-PHP patients and the HCs.In AIS-PHP,Bacteroidetes,Firmicutes,and Proteobacteria dominated.Moreover,some microbes that differed between the 2 groups manifested a sole association with certain metabolites,such as the connection between Bacteroides and inosine and between Lachnospiraceae_unclassified and hypoxanthine.Conclusion:The present study preliminarily investigated the metabolomic and gut microbiome characteristics of AIS-PHP patient indicators.The link between metabolic and microbial dysbiosis in AIS-PHP sheds new light on the function of gut microbiota and associated metabolomics in the pathogenesis of the disease.

A multicenter randomized, double-blind, placebo-controlled trial to evaluate the safety and efficacy of rhubarb in treating acute exacerbation of chronic obstructive pulmonary disease of the syndrome type phlegm-heat obstructing the lungs

Objective:To observe the clinical efficacy and safety of oral administration of the traditional Chinese herb rhubarb to treat acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Method:This was a multicenter randomized double-blinded placebo controlled study that took place in 7 provinces of China that enrolled 244 patients(aged 18e80 years)who had acute exacerbation of COPD with the traditional Chinese syndrome pattern of phlegm-heat obstructing lung.Participants were divided into experimental and control groups.The experimental group received 4.5 g of rhubarb granules twice daily and the control group received placebo granules.Both groups also received conventional Western therapy consisting of oxygen therapy,an antibiotic,expectorant,and a bronchodilator.Treatment lasted 10 days.Symptom scores for cough,sputum volume and color,wheezing and chest tightness before treatment and on days 3,5,7,and 10 during the treatment were recorded.Lung function,arterial blood gas and levels of serum inflammatory factors,interleukin-4(IL-4),interleukin-8(IL-8),and interleukin-10(IL-10)and tumor necrosis factor-alpha(TNF-a),before and after treatment were measured.Results:The sample size of the full analysis set(FAS)was 244 participants,and the sample size of per protocol set(PPS)was 235.Following 10 days’treatment,symptom scores of the experimental group were markedly lower than those of the placebo group(FAS:mean difference
1.67,95%CI:e2.66 to
0.69,P Z 0.001;PPS:mean difference
1.55,95%CI:
2.56 to
0.54,P Z 0.003).Lung function in the experimental group was significantly higher than in the placebo group(FEV1,FAS:mean difference 0.12,95%CI:0.06 to 0.18;P<0.001;PPS:mean difference 0.12,95%CI 0.05 to 0.18;P<0.001.FVC:FAS:mean difference 0.16,95%CI:0.06 to 0.26;P Z 0.002;PPS:mean difference 0.16,95%CI 0.05 to 0.26;P Z 0.003.FEV1%,FAS:mean difference 5.95,95%CI:3.36 to 8.53;P<0.001;PPS:mean difference 5.92,95%CI 3.28 to 8.56;P<0.001.).PaO2,PaCO2,as well as serum inflammatory factors were also improved when compared to the placebo group.There were no significant differences in the incidence rate of adverse reaction between the two groups.Conclusions:Compared with placebo,rhubarb granules significantly reduced symptom scores,improved blood oxygen level,controlled systemic inflammatory response,without significant adverse effects.Thus,rhubarb may be a beneficial adjuvant method for treating the phlegm-heat obstructing the lung syndrome pattern of AECOPD.

Clinical relevance of Chinese syndrome factors and thromboelastography levels in patients with phlegm-heat and fu-organ excess syndrome

Objective:Syndrome differentiation is a unique part of traditional Chinese medicine(TCM).Syndrome factors play an important role in the diagnosis and treatment of TCM syndromes.Thromboelastography(TEG)intuitively reflects the blood status of patients with acute ischemic stroke(AIS)and is important in the treatment and prognosis of AIS.To identify the relationship between TCM syndrome factors and TEG in AIS patients and standardize TCM syndrome differentiation and treatment objectives,we designed a prospective cohort study of 103 AIS patients.Methods:We used the diagnostic criteria for AIS in the Chinese Guideline for Diagnosis and Management of Acute Ischemic Stroke 2010.Diagnosis of phlegm-heat and fu-organ excess syndrome was based on the TCM Scale for the Syndrome of Phlegm-heat and fu-organ Excess.The ischemic Stroke TCM Syndrome Factor Diagnostic Scale was used to identify and diagnose syndrome factors.General information,scores of syndrome factors and values of TEG parameters of all enrolled patients were recorded.Results:There were significant differences in internal fire and phlegm-dampness scores between patients with and without phlegm-heat and fu-organ excess syndrome(P<.05).In patients with phlegm-heat and fu-organ excess syndrome,internal fire was negatively correlated with TEG parameters R and K(P<.05)and positively correlated with alpha Angle and coagulation index(P<.01).There were no significant correlations between the two syndrome factors and MA(P Z.058)and LY30(P>.05)or between both syndrome factors and TEG parameters in patients without phlegm-heat and fu-organ excess syndrome.Conclusion:The syndrome factor internal fire is a potential predictor of increased platelet function and fibrinogen activity in AIS patients with phlegm-heat and fu-organ excess,and a potentially important predictor of blood hypercoagulability in TCM.

Medication rules in treating phlegm-heat syndrome of acute ischemic stroke based on data mining

Objective:To analyze the medication rule of Traditional Chinese Medicine(TMC)in treating acute ischemic stroke(AIS)with phlegm-heat syndrome based on date mining.Methods:All clinical studies of TMC treatment for phlegm heatexcess pattern stroke at acute stage were searched from SinoMed,CNKI,VIP,Wanfang,Pubmed.The retrieval time was from the establishment of each database to 27 April 2020.Establish database through"Ancient and Modern Medical record Cloud platform(V2.2.3)"software.SPSS20.0 and SPSS Modeler 18.0 software was used to explore clustering analysis and drug association rule analysis of high frequency drugs.Results:60 articles were finally included and 59 prescriptions were collected.The result shows that the commonly used drugs are mostly warm and cold,and the taste is mainly sweet and bitter.The main distribution of meridian tropism is stomach,liver and spleen.In these prescriptions,the frequently used drug pairs were“Trichosanthis fructus”,“Rhei radix et rhizoma”and so on.The association analysis results showed that“Arisaema cum bile-Rhei radix et rhizoma”had the highest correlation.The clustering analysis figured out 2 groups of the herbs.Conlusion:The TCM treatment of AIS should be based on the drugs of clearing heat,resolving phlegm and dredging viscera.Because most of these drugs are bitter and cold,we should pay attention to taking care of the spleen and stomach while expelling evil.

Application Value of Lung-Fire-Clearing,Phlegm-Resolving,and Bowels-Relaxing Decoction in Treating Lung Cancer of Phlegm-Heat Pattern

Objective:This article explores the clinical effects of lung-fire-clearing,phlegm-resolving and bowels-relaxing decoction in the treatment of lung cancer of phlegm-heat pattern.Methods:A total of 6 cases of lung cancer patients with phlegm-heat pattern were randomly selected from Inner Mongolia Baicaotang Qin's Zhong Meng Medical Hospital from March 2018 to December 2020 to conduct the study.They were divided into the reference group and the study group by using the digital table method.The patients in the reference group were treated with conventional Western medicine whereas the patients in the study group were treated with lung-fire-clearing,phlegm-resolving,and bowels-relaxing decoction to observe the curative effect.Results:There were no significant differences in the levels of the tumor markers between the two groups before treatment(P>0.05).However,after treatment,the levels of cytokeratin 19 soluble fragments(CYFRA21-1),carbohydrate antigen 125(CA125),and carcinoembryonic antigen(CEA)in the study group were lower than those in the control group(P<0.05).The effective rate and the quality of life score of the study group were higher than those of the reference group while the incidence of adverse reactions was lower than that of the reference group,P<0.05.Conclusion:Lung-fire-clearnig,phlegm-resolving,and bowels-relaxing decoction can effectively improve the symptoms of patients with lung cancer and improve their quality of life.

苏葶止喘汤联合西医治疗小儿支气管哮喘急性发作期(痰热阻肺证)38例

目的探讨苏葶止喘汤联合西医治疗小儿支气管哮喘急性发作期(痰热阻肺证)临床疗效。方法收集2020年2月至2022年3月河北省沧州中西医结合医院就诊的急性发作期的支气管哮喘病儿78例,根据随机数字表法分为对照组与治疗组各39例,对照组病儿给予硫酸沙丁胺醇、异丙托溴铵、布地奈德雾化吸入等西医治疗,治疗组在对照组基础上给予苏葶止喘汤治疗,观察两组治疗前后的临床疗效,症状缓解时间(咳痰消失时间、哮鸣音消失时间、咳嗽消失时间、喘息消失时间),肺功能指标[用力肺活量(FVC)、第1秒用力呼吸容积(FEV_(1))、第1秒用力呼气量占所有呼气量的比例(FEV_(1)/FVC)、最大呼气流量(PEF)、呼气中断流速(PEF25%)、呼吸中期瞬间流速(PEF50%)、呼吸后期瞬间流速(PEF75%)],血清炎症因子指标[C反应蛋白(CRP)、白细胞介素-22(IL-22)、白细胞介素-4(IL-4)],Toll样受体2(TLR2)、Toll样受体4(TLR4)表达水平。结果治疗后治疗组总有效率94.74%显著高于对照组71.05%(P<0.05);治疗组症状缓解时间快于对照组(P<0.05);治疗后两组FVC、FEV_(1)、FEV_(1)/FVC、PEF、PEF25%、PEF50%、PEF75%值均较治疗前升高且治疗组高于对照组(P<0.05);治疗后两组血清CRP、IL-22、IL-4、TLR2、TLR4水平均较治疗前降低,且治疗组CRP[(10.23±3.26)mg/L比(15.25±5.37)mg/L]、IL-22[(37.13±9.84)ng/L比(45.46±11.08)ng/L]、IL-4[(48.15±12.28)ng/L比(56.07±14.36)ng/L]、TLR2[(16.78±1.91)ng/L比(21.15±2.08)ng/L]、TLR4[(18.05±2.53)ng/L比(22.44±3.27)ng/L]低于对照组(P<0.05)。结论苏葶止喘汤联合西医治疗小儿支气管哮喘急性发作期临床疗效显著。

痰热清注射液联合清燥救肺汤立体时相给药治疗放射性肺炎的临床研究

目的:观察痰热清注射液联合清燥救肺汤加减立体时相给药对放射性肺炎(RP)的治疗效果。方法:选择接受胸部三维适形放射治疗,同时中医辨证为痰热阻肺型的肺癌患者100例作为研究对象,随机分为对照组和观察组,每组50例。对照组患者采用单纯放疗,观察组在放疗基础上,给予痰热清静脉注射联合清燥救肺汤加减立体时相给药,于治疗结束后评估2组患者临床疗效及RP发生率,观察2组放疗前、中、后中医证候评分及血清肿瘤坏死因子-α(TNF-α)、转化生长因子-β1(TGF-β1)、白细胞介素-6(IL-6)的水平变化,观察患者放疗前后肺功能指标卡诺夫斯凯计分(KPS)评分的变化。结果:观察组RP发生率较对照组明显降低,临床总有效率明显优于对照组(P<0.05);2组中医证候评分及血清TNF-α、TGF-β1、IL-6水平于放疗后不同时期均明显降低(P<0.05),与对照组比较,观察组放疗后2个月、4个月及放疗结束时中医证候评分及血清TNF-α、TGF-β1、IL-6水平明显降低(P<0.05);观察组肺活量(VC)、用力肺活量(FVC)、第一秒用力呼气量(FEV1)、FEV1/FVC肺功能指标及KPS评分较对照组显著提高(P<0.05)。结论:痰热清注射液联合清燥救肺汤立体时相给药可有效减轻放射治疗所致的放射性肺炎,通过降低血清炎症介质水平,改善肺功能起到减毒增效作用,对提升患者生命质量,提高放疗安全性和有效性具有积极意义。

肺热咳喘方联合常规疗法治疗社区获得性肺炎痰热壅肺证临床研究

目的:观察肺热咳喘方联合常规疗法治疗社区获得性肺炎痰热壅肺证的疗效。方法:选取123例痰热壅肺证社区获得性肺炎患者,按随机数字表法分为对照组60例及联合组63例。对照组采用常规西药治疗,联合组采用肺热咳喘方联合常规西药治疗,2组均治疗2周。观察2组临床疗效、影像学检查结果、不良反应发生情况及临床症状消退时间,比较2组治疗前后中医证候积分、血清C-反应蛋白(CRP)、降钙素原(PCT)、白细胞计数(WBC)水平的变化。结果:治疗后,2组中医证候积分主症、次症、总分均较治疗前下降(P<0.05),联合组中医证候积分主症、次症、总分均低于对照组(P<0.05)。治疗后,联合组退热、咳嗽消退、咳痰消退及肺部啰音消退时间均短于对照组,差异均有统计学意义(P<0.05)。治疗后,2组CRP、PCT、WBC水平均较治疗前下降(P<0.05),联合组上述3项水平均低于对照组(P<0.05)。治疗后,联合组影像学吸收率为95.24%,对照组为81.67%,2组比较,差异有统计学意义(P<0.05)。联合组临床疗效总有效率为95.24%,对照组为81.67%,2组比较,差异有统计学意义(P<0.05)。联合组不良反应发生率为6.35%,对照组不良反应发生率为8.33%,2组比较,差异无统计学意义(P>0.05)。结论:肺热咳喘方联合现代医学治疗社区获得性肺炎痰热壅肺证能明显缓解症状,降低炎症水平,临床疗效显著,且安全性良好。

Effects of acetylcysteine on micro-inflammation and pulmonary ventilation in chronic obstructive pulmonary disease exacerbation

BACKGROUND Acute exacerbation of chronic obstructive pulmonary disease(AECOPD)is a serious complication of chronic obstructive pulmonary disease,often characterized by increased morbidity and mortality.In traditional Chinese medicine,AECOPD is linked to phlegm-heat and blood-stasis,presenting symptoms like thick sputum,fever,and chest pain.It has been shown that acetylcysteine inhalation in conjunction with conventional therapy significantly reduced inflammatory markers and improved lung function parameters in patients with AECOPD,suggesting that acetylcysteine may be an important adjunctive therapy for patients with phlegm-heat-blood stasis type AECOPD.AIM To investigate the effect of acetylcysteine on microinflammation and lung ventilation in patients with phlegm-heat and blood-stasis-type AECOPD.METHODS One hundred patients with phlegm-heat and blood-stasis-type AECOPD were randomly assigned to two groups.The treatment group received acetylcysteine inhalation(10%solution,5 mL,twice daily)along with conventional therapy,whereas the control group received only conventional therapy.The treatment duration was 14 d.Inflammatory markers(C-reactive protein,interleukin-6,and tumor necrosis factor-alpha)in the serum and sputum as well as lung function parameters(forced expiratory volume in one second,forced vital capacity,and peak expiratory flow)were assessed pre-and post-treatment.Acetylcysteine inhalation led to significant reductions in inflammatory markers and improvements in lung function parameters compared to those in the control group(P<0.05).This suggests that acetylcysteine could serve as an effective adjunct therapy for patients with phlegm-heat and blood-stasis-type AECOPD.RESULTS Acetylcysteine inhalation significantly reduced inflammatory markers in the serum and sputum and improved lung ventilation function parameters in patients with phlegm-heat and blood-stasis type AECOPD compared with the control group.These differences were statistically significant(P<0.05).The study concluded that acetylcysteine inhalation had a positive effect on microinflammation and lung ventilation function in patients with this type of AECOPD,suggesting its potential as an adjuvant therapy for such cases.CONCLUSION Acetylcysteine inhalation demonstrated significant improvements in reducing inflammatory markers in the serum and sputum,as well as enhancing lung ventilation function parameters in patients with phlegm-heat and bloodstasis type AECOPD.These findings suggest that acetylcysteine could serve as a valuable adjuvant therapy for individuals with this specific type of AECOPD,offering benefits for managing microinflammation and optimizing lung function.

温胆汤加减治疗痰热郁结型冠心病的临床疗效观察

目的观察温胆汤加减治疗痰热郁结型冠心病的临床疗效及安全性。方法纳入合并焦虑症(痰热郁结型)的冠心病患者60例,随机分为中西医结合组30例,西医组30例。西医组患者给予口服给予西药常规治疗加氟哌噻吨美利曲辛片。中西医结合组患者在西医治疗组基础上,联合温胆汤加减,每日2次口服,每次100 ml。两组疗程均为28 d。比较两组治疗的临床疗效和安全性。结果连续治疗28 d后,中西医结合组治疗的临床总有效率90%,高于西医组的76%;中西医结合组中医证候积分明显高于西医组;中西医结合组西雅图心绞痛量表各项评分改善均优于西医组,以上指标比较差异均具有统计学意义(均P<0.05)。两组均未发现明显不良反应。结论对于痰热郁结型冠心病患者,温胆汤加减治疗联合西医常规治疗,相比单纯西医治疗能进一步改善患者心绞痛发作及精神状态,减少心绞痛发作次数,减轻发作程度,且安全性良好。

清金化痰汤加减对痰热郁肺型慢性支气管炎急性发作期的临床治疗效果

目的 探究清金化痰汤加减对痰热郁肺型慢性支气管炎急性发作期患者的应用价值。方法选取2019年1月—2022年10月青岛市黄岛区人民医院收治的80例痰热郁肺型慢性支气管炎急性发作期患者进行研究。依据抽签法分为对照组(40例)与研究组(40例),分别实施常规治疗、常规治疗+清金化痰汤治疗。比较两组炎症因子、治疗效果与中医证候积分等。结果 研究组治疗有效率为97.50%,高于对照组的72.50%,差异有统计学意义(χ^(2)=9.804,P<0.05)。研究组复发率低于对照组,差异有统计学意义(P<0.05)。研究组中医证候积分低于对照组,差异有统计学意义(P<0.05)。研究组炎症因子相关指标较对照组低,差异有统计学意义(P<0.05)。结论 清金化痰汤加减应用于痰热郁肺型慢性支气管炎急性发作期患者时,对炎症因子水平及中医证候的改善有一定促进作用,可提高整体治疗效果。

生脉散合千金苇茎汤加减治疗痰热壅肺型老年重症肺炎临床研究

目的:观察生脉散合千金苇茎汤加减治疗痰热壅肺型老年重症肺炎的临床疗效。方法:80例痰热壅肺型老年重症肺炎患者按随机数字表法分成对照组与观察组各40例。对照组给予常规西医对症治疗,观察组在对照组基础上给予生脉散合千金苇茎汤加减治疗,2组均连续治疗2周。比较2组治疗前后中医证候评分、临床肺部感染(CPIS)评分、多器官功能障碍综合征(MODS)评分、急性生理和慢性健康评分(APACHE Ⅱ)、肺功能指标[用力肺活量(FVC)、最大呼气流速峰值(PEF)、第1秒用力呼气容积(FEV_(1))、FEV_(1)/FVC]、白细胞计数(WBC)、降钙素原(PCT)、C-反应蛋白(CRP)、白细胞介素-6 (IL-6)水平;比较2组临床疗效及不良反应发生情况。结果:治疗后,观察组总有效率92.50%,高于对照组75.00%(P<0.05)。2组治疗后中医证候评分、CPIS评分、MODS评分、APACHE Ⅱ评分、WBC、PCT、CRP、IL-6水平均较治疗前降低(P<0.05),且观察组治疗后各项评分、炎症指标均低于对照组(P<0.05)。2组治疗后FVC、PEF、FEV_(1)水平及FEV_(1)/FVC均较治疗前升高(P<0.05),且观察组治疗后肺功能指标高于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:生脉散合千金苇茎汤加减治疗老年重症肺炎痰热壅肺证疗效确切,能够进一步缓解患者临床症状,抑制肺部炎症反应,改善肺功能,安全性较高。

通腑宣肺汤加味治疗儿童肺炎支原体肺炎痰热闭肺证临床研究

目的:观察通腑宣肺汤加味治疗儿童肺炎支原体肺炎痰热闭肺证的临床效果。方法:选择80例肺炎支原体肺炎痰热闭肺证患儿为研究对象,按随机数表法分为观察组和对照组各40例。2组均采用常规对症处理措施,对照组在常规治疗基础上采用阿奇霉素治疗,观察组在对照组基础上给予通腑宣肺汤加味治疗,2组均治疗7 d。评价2组临床疗效,比较2组症状改善时间,比较2组治疗前后中医证候积分、血清降钙素原(PCT)、C-反应蛋白(CRP)、白细胞介素-6 (IL-6)的水平,观察不良反应发生情况。结果:观察组总有效率为92.50%,高于对照组75.00%(P<0.05)。观察组咳嗽消失时间及肺啰音消失时间均短于对照组(P<0.05)。治疗后,2组主症、次症评分及中医证候总积分较治疗前降低(P<0.05),且观察组主症、次症积分及中医证候总积分均低于对照组(P<0.05)。治疗后,2组血清PCT、CRP、IL-6水平较治疗前降低(P<0.05),且观察组血清PCT、CRP、IL-6水平均低于对照组(P<0.05)。2组治疗期间均无严重不良反应发生。结论:通腑宣肺汤加味治疗儿童肺炎支原体肺炎痰热闭肺证的临床效果明显,能有效缓解症状,降低血清炎症因子水平,安全可靠。

清热化痰类中药治疗痰火扰心型室性期前收缩疗效及安全性的Meta分析

目的:系统评价清热化痰类中药治疗痰火扰心型室性期前收缩的疗效及安全性。方法:检索中国知网(CNKI)、维普数据库(VIP)、万方数据库、中国生物医学文献数据库(CBM)、PubMed、Web of Science及the Cochrane Library。检索时间限定为自建库至2022年5月1日。纳入运用清热化痰类中药治疗痰火扰心型室性期前收缩的随机对照试验(RCT),2名研究者通过阅读文献题目和摘要,并结合全文,对文献进行资料提取,应用RevMan 5.4软件进行Meta分析。结果:最终纳入符合标准的RCT 12项,涉及1 608例病人,Meta分析结果显示:试验组临床疗效优于对照组[RR=1.23,95%CI(1.15,1.32),P<0.000 01],不良反应发生率低于对照组[RR=0.50,95%CI(0.27,0.92),P=0.03],中医证候疗效优于对照组[RR=1.22,95%CI(1.07,1.39),P=0.002],室性期前收缩次数较对照组明显降低[MD=-706.53,95%CI(-951.62,-461.44),P<0.000 01],中医证候积分较对照组明显降低[MD=-16.30,95%CI(-21.53,-11.08),P<0.000 01]。结论:现有证据表明,清热化痰类中药联合西药治疗痰火扰心型室性期前收缩的疗效优于单纯西药治疗,且具有较高的安全性。

岭南地区亚健康人群睡眠状况与中医体质类型的相关性研究

【目的】探究岭南地区亚健康人群睡眠状况与中医体质类型的相关性。【方法】选取2022年5月~2023年5月于深圳市宝安区中医院治未病中心就诊的688例在深圳市居住5年以上,无严重心血管疾病,经亚健康人群评定量表评定为亚健康的人群为研究对象,采用匹兹堡睡眠质量指数(PSQI)量表、中医体质评定量表对其进行问卷调查,并将其睡眠状况与中医体质类型进行多元线性回归分析。【结果】(1)调查问卷发放回收情况:共发放688份问卷,其中,失访19份,回收669份,剔除无效问卷29份,最终共纳入有效问卷640份。(2)不同睡眠状况人群的PSQI量表评分情况:根据PSQI量表得分情况将人群分为睡眠优组(PSQI总分<8分)350例和睡眠差组(PSQI总分≥8分)290例,组间比较,睡眠优组的入睡时间、睡眠时间、睡眠障碍得分以及总分均明显低于睡眠差组(P<0.05或P<0.01)。(3)不同睡眠状况人群的中医体质类别分布情况:睡眠优者多表现为平和质(86.86%),睡眠差者多表现为偏颇体质(79.64%)。睡眠差人群中,偏颇体质排前3位的分别是湿热质(15.52%)、痰湿质(13.79%)以及气郁质(13.10%)。(4)多元线性回归分析结果显示,入睡时间与痰湿质、气郁质呈正相关(P<0.01),与平和质呈负相关(P<0.05);睡眠效率与湿热质、特禀质呈正相关(P<0.05或P<0.01),与平和质呈负相关(P<0.05);睡眠障碍与气郁质、阴虚质呈正相关(P<0.01);催眠药物与阴虚质呈正相关(P<0.01);日间功能障碍与痰湿质呈正相关(P<0.05)。【结论】岭南地区亚健康人群睡眠状况与其中医体质类型具有一定相关性,湿热质、痰湿质、气郁质、阴虚质、平和质、特禀质是影响睡眠状况主要的6种中医体质类别;结合中医体质辨识指导亚健康人群通过改善其体质从而达到未病先防的目的是很有意义的。

千金苇茎汤加减方治疗小儿肺炎支原体肺炎(痰热闭肺证)的疗效及对血清因子的影响

目的探究与分析千金苇茎汤加减方治疗小儿肺炎支原体肺炎(痰热闭肺证)的疗效及对血清因子的影响。方法选择2018年12月—2020年12月山东大学附属儿童医院收治的126例小儿肺炎支原体肺炎患者作为研究对象,采取随机数表法分为对照组和观察组,每组63例。两组均采取基础治疗,观察组加用千金苇茎汤加减方治疗,比较两组临床效果。结果观察组临床总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组咯痰、气喘、发热及唇绀评分均较治疗前降低,且观察组治疗后咯痰、气喘、发热及唇绀评分较对照组低,差异有统计学意义(P<0.05)。观察组胸片阴影消失时间、肺部湿啰音消失时间、咳嗽消失时间以及退热时间均较对照组早,差异有统计学意义(P<0.05)。治疗后,两组白细胞介素-2(IL-2)、白细胞介素-4(IL-4)、D-二聚体、单核细胞趋化蛋白-4(MCP-4)、可溶性白细胞介素2受体(sIL-2R)水平均较治疗前降低,且观察组治疗后IL-2、IL-4、D-二聚体、MCP-4、sIL-2R水平均较对照组低,差异有统计学意义(P<0.05)。两组患儿在用药期间均未出现明显的消化道反应或肝肾功能障碍。结论千金苇茎汤加减方治疗小儿肺炎支原体肺炎(痰热闭肺证)临床效果较好,明显缩短了主要症状恢复时间,调节了血清因子水平,且用药期间无明显不良反应,安全性可获得保障。

消痛愈甲方联合醋酸泼尼松片治疗亚急性甲状腺炎风热痰凝证的有效性及安全性

目的:探讨消痛愈甲方联合醋酸泼尼松片治疗亚急性甲状腺炎(SAT)风热痰凝证的有效性及安全性。方法:选取2022年3月-2023年8月江阴市中医院收治的SAT患者70例为研究对象,按照随机数字表法分为对照组和观察组,各35例。对照组予以醋酸泼尼松片治疗,观察组在对照组基础上予以消痛愈甲方治疗。比较两组临床疗效、甲状腺功能、甲状腺功能减退发生率、复发情况及不良反应。结果:观察组总有效率高于对照组,差异有统计学意义(P=0.046);治疗后,两组游离三碘甲状腺原氨酸(FT3)、游离甲状腺素(FT4)水平降低,促甲状腺激素(TSH)水平升高,观察组FT3、FT4水平低于对照组,TSH水平高于对照组,差异有统计学意义(P<0.05);观察组甲状腺功能减退发生率、复发率均低于对照组,差异有统计意义(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:消痛愈甲方联合醋酸泼尼松片治疗SAT风热痰凝证的效果确切,可以改善甲状腺功能,减少甲状腺功能减退的发生及复发,安全性好。

肺苏颗粒治疗慢性阻塞性肺疾病急性加重期痰热瘀肺证临床研究

目的观察肺苏颗粒治疗慢性阻塞性肺疾病急性加重期(AECOPD)痰热瘀肺证的临床疗效及对患者生活质量、凝血功能和免疫功能的影响。方法采用随机数字表法将120例患者分为观察组和对照组各60例。对照组予常规西医治疗,观察组在对照组基础上予肺苏颗粒口服,每次1袋,每日3次,连续7 d。观察2组临床疗效,比较2组治疗前后中医症状评分、圣乔治呼吸问卷(SGRQ)评分、凝血功能指标(纤维蛋白原、D-二聚体)、免疫功能指标(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)),并观察不良反应。结果观察组总有效率为93.10%(54/58),对照组为79.66%(47/59),2组比较差异有统计学意义(P<0.05)。与本组治疗前比较,2组治疗后中医症状积分及咳嗽、喘息、脉络瘀血评分,SGRQ评分均下降(P<0.05);2组治疗后比较,观察组上述评分均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后血浆纤维蛋白原和D-二聚体含量均下降(P<0.05);2组治疗后比较,观察组血浆纤维蛋白原和D-二聚体含量均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后外周血CD4^(+)和CD4^(+)/CD8^(+)均显著升高,CD8^(+)显著降低(P<0.05);2组治疗后比较,观察组外周血CD4^(+)和CD4^(+)/CD8^(+)高于对照组,CD8^(+)低于对照组(P<0.05)。2组均未出现药物相关的不良反应。结论在常规西医治疗基础上联合肺苏颗粒治疗AECOPD痰热瘀肺证可显著提高临床疗效,改善患者生活质量,利于凝血功能恢复,并增强细胞免疫功能。

加味苇茎汤治疗支气管扩张症稳定期(痰热蕴肺证)的系列单病例随机对照研究

目的评价加味苇茎汤治疗支气管扩张症稳定期(痰热蕴肺证)的临床疗效和安全性。方法运用系列单病例随机对照试验(N-of-1试验)的方法,选取诊断为支气管扩张症稳定期,辨证属于痰热蕴肺证的患者,在一个治疗周期内先后接受两种不同的治疗方案,试验期治疗用加味苇茎汤,对照期治疗用西药氨溴索片,期间设置洗脱期,试验期和对照期的用药先后顺序按随机化方式决定,以目测模拟尺测量法(visual analogue scales,VAS法)评价治疗前后的症状改变,记录24 h痰量和自我评估测试(COPD Assessment Test,CAT)评分,并观察研究期间的不良反应。采用SPSS 25.0、GraphPad Prism 8软件进行统计分析和绘图,入组前的组间差异比较采用独立样本t检验分析;试验期和对照期治疗前后的症状得分、24 h痰量和CAT评分对比,以及两组治疗前后的差值对比采用配对t检验,比较临床差异和统计学差异。结果共有9例患者入组,最终纳入分析的治疗轮次为16次。试验期治疗后中医证候总积分,咳嗽、咳痰、痰液颜色、胸闷胸痛、口苦口干、乏力疲倦等症状,24 h痰量和CAT评分较治疗前改善,差异均具有统计学意义(P<0.05)。试验期和对照期中医证候总积分、痰液颜色评分、胸闷胸痛评分和24 h痰量治疗前后差值比较,试验组较对照组改善明显,差异有统计学意义(P<0.05)。观察期间未出现与试验方法或药物有关的不良事件。结论加味苇茎汤能综合改善支气管扩张症稳定期患者的临床症状,总体疗效优于西药氨溴索,且安全性良好。

缺血性脑卒中痰热腑实证大鼠模型的建立与评价

背景:中医药在治疗缺血性脑卒中痰热腑实证中具有丰富的经验和独特的优势,为深入挖掘中医药对该病的治疗靶点和治疗机制,建立稳定、可靠的缺血性脑卒中痰热腑实证病证结合动物模型是关键。目的:探讨缺血性脑卒中痰热腑实证大鼠模型的建立方法及评价体系。方法:采用随机数字表法将60只SD大鼠随机分为4组:空白对照组(n=12)、缺血性脑卒中组(n=18)给予普通饲料喂养25 d,病证结合组(n=18)、痰热腑实证组(n=12)给予高脂饲料喂养25 d;第26天,空白对照组、缺血性脑卒中组灌胃给予生理盐水,病证结合组、痰热腑实证组灌胃给予自体粪便混悬液,连续灌胃3 d(灌胃期间继续给予高脂饲料);灌胃结束后,缺血性脑卒中组、病证结合组采用线栓法建立缺血性脑卒中模型,记录各组大鼠饮食量、饮水量、体质量、体温、粪便性状、鼻分泌物、喉中痰鸣、舌象等表征变化。造模结束后24 h,进行神经功能缺损评分、舌象表征、血脂水平检测、脑组织及颈动脉形态学观察以及血清胃动素和生长抑素水平检测。结果与结论:(1)与空白对照组比较,病证结合组大鼠呼吸急促、精神萎靡、烦躁、行动迟缓,鼻周可见大量分泌物、可闻及厚重的喉中痰鸣,饮食量、饮水量下降,体质量、体温及舌下脉络评分升高,粪便粒数、Bristol评分及粪便含水率降低;血清总胆固醇、三酰甘油、低密度脂蛋白胆固醇及生长抑素水平升高,胃动素水平降低,神经功能缺损评分升高,颈动脉发生显著病理改变,脑组织显示明显缺血形态学改变。缺血性脑卒中组仅能造成缺血性脑组织病理改变,不能复制出痰热腑实证的证候特征。痰热腑实证组能复制出典型的中医证候特征,但不能构建出缺血性脑卒中的脑组织病理改变。(2)结果表明,高脂诱导结合线栓法及自体粪便灌胃的多因素复合造模方法,可建立缺血性脑卒中痰热腑实证病证结合动物模型。