Clinical Observation on Influence of Chinese Medicines for Promoting Blood Circulation to Remove Blood Stasis on FIB and DD in Plasma of Patients with Cerebral Thrombosis

to study the influence of Chinese medicines for promoting blood circulation to remove blood stasis on fibrinogen(FIB)and D-dimer(DD)in plasma of patients with cerebral thrombosis. Method:73 inpatients with acute cerebral thrombosis were randomly divided into a control group of 34 cases and a treatment group of 39 cases.The content of FIB and DD in plasma was detected before treatment and on the 7th and 14th days after treatment.Result:FIB content in plasma after treatment was lower than that before treatment in the control group(P<0.01)and more remarkable in the treatment group(P<0.001).There was an obvious difference in DD content before and after treatment in both groups.DD content on the 7th and 14th days after treatment in the treatment group was obviously higher than that in the control group(P<0.01 and P<0.05 respectively). Conclusion:Chinese medicines for promoting blood circulation to remove blood stasis can reduce the FIB content in plasma of patients with cerebral thrombosis,raise the DD content in plasma, cause the peak of DD content appear earlier and obviously improve hypercoagulability of blood in patients with cerebral thrombosis.

Research Progress and Research Ideas on Anti-hepatic Fibrosis and Promoting Blood Circulation and Removing Blood Stasis of the National Drug Plumbapin Based on TLR4 Signal Pathway

Hepatic fibrosis is a reversible pathological phenomenon in the early and middle stages,but but no satisfactory intervention drugs have been available so far.Recent studies have suggested that microcirculation disturbance of liver is one of the important pathogenesis of chronic liver disease,the improvement of microcirculation is beneficial to the recovery of liver function and the delay of liver fibrosis.Hepatic stellate cells are the core cells of hepatic fibrosis,and also the most critical cells that affect the microcirculation of the liver.While TLR4/MyD88/NF-κB and TLR4/MyD88/MAPKs which are based on the action of hepatic stellate cells are two pathways that have very important influence on the inflammatory response of liver,the proliferation and apoptosis of hepatic stellate cells,and the secretion of fibrogenic cytokines.It was found that Plumbapin,the active ingredient of Guangxi specialty ethnic medicine,has the definite effect of promoting blood circulation and removing blood stasis and anti-hepatic fibrosis,but its mechanism is not clear.In this study,the research progress of the above problems was reviewed,and further research ideas were derived as follows:the pharmacological effect of Plumbapin on anti-hepatic fibrosis,promoting blood circulation and removing stasis was based on the influence of TLR4/MyD88/NF-κB and MAPKs signal pathway.

Research Progress and Prospects on the Anti-liver Fibrosis,Blood Circulation-promoting and Stasis-resolving Effects of Curcuma kwangsiensis Based on W-P Bodies

Liver fibrosis is a necessary stage in the progression of chronic liver disease to cirrhosis.So far,no satisfactory drugs have been found to intervene in liver fibrosis.Liver microcirculation disorders are one of the important pathogenesis of chronic liver disease,and hepatic sinusoidal endothelial cells(HSECs)are the main cells that constitute the liver microcirculation barrier.In clinical practice,W-P bodies have been detected in HSECs of most patients with liver fibrosis.W-P bodies serve as a site for the synthesis and storage of vW factors,ET-1 and other cytokines that promote liver fibrosis.They can disrupt the structure and function of HSECs,cause liver microcirculation disorders,and exacerbate the progression of liver fibrosis.Previous studies have found that the Guangxi specialty ethnic medicine,C.kwangsiensis S.G.Lee et C.F.Liang,has definite effects in promoting blood circulation,resolving blood stasis,and resisting liver fibrosis.Based on this,a further research idea has been derived,stating that the blood circulation-promoting,blood stasis-resolving,and anti-liver fibrosis effects of C.kwangsiensis are produced by affecting the formation of W-P bodies,the synthesis and storage of contents in W-P bodies,and intervening in their exocytosis capacity.

Revealing the material basis of MMP9-mediated activating blood and removing blood stasis drugs on Danshen-Ligusticum chuanxiong anti- vascular effect

Objective:Reveal the material basis and mechanism of angiogenesis effect of Danshen-chuanxiong herb-partners.Methods:The effective components of Danshen and chuanxiong were searched in the TCM System Pharmacology Database(TCMSP),and the drug targets were searched in the Swiss Target Prediction database;in the Disease-Gene Database(DisGeNET))Search for angiogenesis-promoting and inhibiting angiogenesis targets;use the protein interaction database(STRING)database and Cytoscape software to analyze the network core targets;use the DAVID database to enrich the drug-disease target intersection for GO and KEGG;RT-qPCR experiments verified the effect of luteolin on MMP9 gene expression;in vitro tube formation experiments analyzed the effect of luteolin on endothelial cell neovascularization.Results:After analysis,it is concluded that Danshen has 10 active ingredients and 50 angiogenesis targets;Chuanxiong has 2 active ingredients and 4 angiogenesis targets.The intersection of drug-taking targets yielded 9 targets,including AR,PARP1,MMP9,MMP2,MMP12,AKR1B10,ABCC1,CDK6,and STAT3.After analyzing the active ingredient-target network graph of Danshen/Chuanxiong,it was concluded that luteolin is the key chemical ingredient.After protein interaction(PPI)analysis,the results showed that MMP9 is the core target.The KEGG pathway is mainly enriched in 5 signaling pathways,the most important pathway is cancer-related pathways.There are 22 main biological processes of GO,which mainly involve collagen catabolism,protein extracellular matrix,metal endopeptidase activity,etc.The preliminary analysis of tubule formation experiment shows that luteolin inhibits angiogenesis and down-regulates the expression of MMP9 gene.Conclusion:Luteolin,the key chemical component of the Danshen-Ligusticum chuanxiong drug pair,inhibits angiogenesis by regulating the MMP9 target,and develops the reverse regulation of angiogenesis for the traditional Chinese medicine for promoting blood circulation and removing blood stasis on the basis of the known treatment of ischemic diseases.Provide a new perspective and theoretical basis for the use of Danshen and Chuanxiong medicine in clinical cancer patients.Reveal the material basis and mechanism of angiogenesis effect of Danshen-chuanxiong herb-partners.

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.

Research Progress in Chinese Medicine Preparations for Promoting Blood Circulation and Removing Blood Stasis for Cirrhotic Patients with Portal Vein Thrombosis Following Splenectomy

This article presented an overview of the therapeutic effects of Chinese medicine(CM)preparations for promoting blood circulation and removing blood stasis for patients with portal vein thrombosis(PVT)after splenectomy.Based on published clinical researches of CM preparations for PVT after splenectomy in patients with cirrhotic portal hypertension(CPH),this paper evaluated the incidence of PVT,and explored potential active components and mechanisms of CM preparations.Safflower Yellow Injection,Danshen Injection,Danhong Injection,and Compound Danshen Dropping Pill achieved good curative effect alone or combined with anticoagulant therapy.In addition,Compound Biejia Ruangan Tablet and Anluo Huaxian Pill can also significantly improve the hemodynamic disorders of portal vein system in patients with cirrhosis.Considering the role of CM preparations in ameliorating the incidence of PVT after splenectomy in patients with CPH,we suggested that future research should provide more attention to CM alone or CM combined with anticoagulant for cirrhosis with PVT.

Traditional Chinese Medicines alleviated myocardial ischemia by regulating Qi and promoting blood circulation

OBJECTIVE:To investigate the efficacy of Chinese medicines on Qi stagnation and blood stasis in rats with myocardial ischemia.METHODS:Fifty male Wistar rats were randomly divided into five groups(n=10)as follows:(a)sham operation(Sham),(b)myocardial ischemia(Model),(c)treatment that regulates Qi(Qi),(d)treatment that promotes blood circulation(Blood),(e)treatment that both regulates Qi and promotes blood circulation(QB).The rat model was established via activities restriction for 6 h followed by tail clamp stimulation for 5 mins every day for 7 d and occlusion left coronary anterior descending artery.Afterwards rats were treated with medicines that regulate Qi and/or promote blood circulation via gavage for 14 d.Behavioral parameters were evaluated using open field and elevated plus-maze tests.The tongue color and sublingual vein were visually examined.Blood flow perfusion of tongue and auricle were detected using PIMⅡ.The mesenteric microcirculation was examined via capillaroscopy,and hemodynamics was assessed using a polygraph system.Serum homocysteine(Hcy),creatine kinase isoenzyme(CKMB)levels and endothelin-1(ET-1)were measured.Hematoxylin and eosin staining and transmission electron microscopy were employed to detect the myocardial morphology and ultrastructure,respectively.RESULTS:Compared with findings in Sham group,rats in model group had coarse hair,dark mucosa of the lips and claw,low activity,and increased anxiety.Compared with findings in Model group,rats in the three treatment groups exhibited a lighter tongue color without an extended and varicose sublingual vein.There were significant increases of auricle blood flow perfusion in the Qi group and tongue bottom blood flow perfusion in the QB group.Compared with findings in Model rats,rats in Blood group exhibited improved mesenteric microcirculation associated with increased mesenteric blood flow and a larger arteriole diameter.Moreover,compared with findings in Model rats,Qi and QB rats exhibited increased left ventricular±dp/dtmax,decreased serum CKMB,Hcy,ET-1 levels,and reduced myocardial ultrastructural damage.CONCLUSION:Myocardial ischemia damage was suppressed by Traditional Chinese Medicines that regulate Qi and promote blood circulation.

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.

冯志荣基于“治风先治血,血行风自灭”理论诊治荨麻疹经验

冯志荣教授认为,风邪为荨麻疹的重要致病因素,秉承“治风必先治血,血行风自灭”之核心理念,提出“血瘀风动”理论。冯教授认为,在荨麻疹的病理演变过程中,“血瘀”和“风动”是两大重要致病因素,“风动”为标,“血瘀”为本。将荨麻疹的病机分为热灼血瘀、寒凝血瘀、血虚滞瘀,以“治血则内风熄,祛风则外风去”为治则。在治疗时,分别予以凉血、温经、养血之法,并以活血祛风法贯穿治疗始终。热盛血瘀证常用方剂为清营汤或消风散加减,寒凝血瘀证常用方剂为麻黄桂枝各半汤或当归四逆汤加减,血虚风燥证常用方剂为当归饮子加减。此外,冯教授还重视预防调护,在实际临床中,面对复杂多变的病情,秉持具体问题具体分析的严谨态度,充分考虑地域、时令、个体差异等因素,进行全面而细致的辨证施治。

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.

基于络病学说探讨动脉粥样硬化辨治规律

动脉粥样硬化属中医脉络病范畴,发生与发展与络病学说密切相关。基于络病学说,总结本病病机为本虚标实,其中本虚为脏腑功能受损,络虚不荣,标实为痰、瘀、毒互结,络阻不通,络道亢变、络道绌急、络久成积是本病病情进展的重要因素,治疗采用攻补兼施的原则,具体治法有益气养阴荣络、活血化痰通络和平衡阴阳宁络,以使气血充和,阴阳平衡,络脉条达。

行气活血方治疗甲状腺癌全切术后甲状旁腺功能减退气滞血瘀证临床观察

目的探讨行气活血方对甲状腺癌全切术后甲状旁腺功能减退气滞血瘀证的临床疗效,希望探寻有效的预防及治疗方案。方法选取在山东中医药大学附属医院住院的甲状腺癌全切手术患者60例,随机分为试验组和对照组,各30例。对照组予常规补钙治疗,试验组在此基础上加用行气活血方治疗,比较两组术后不同时间节点的血甲状旁腺素(PTH)、血钙及引流液PTH水平。结果术后1 d,两组血PTH、血钙及引流液PTH水平比较,差异均无统计学意义(P>0.05)。与术后1 d比较,两组患者术后不同时间节点的血PTH、血钙及引流液PTH水平均更优,且试验组各数值均优于对照组,差异均有统计学意义(P<0.05)。结论行气活血方能够促进甲状腺癌全切术后甲状旁腺功能的恢复。

从气血水论治溃疡性结肠炎的理论探索及应用

溃疡性结肠炎(ulcerative colitis,UC)与中医学中“泄泻”“便血”等疾病关系密切,作为消化系统中常见的疑难慢性疾病,目前尚无疗效确切的治疗手段,因其具有反复发作、缠绵难愈的特点,已成为严重影响人类健康的常见病。现代医学认为UC的发病机制主要与肠道菌群失调、免疫异常等因素相关,而肠道菌群的失调又被认为与中医学中“气血水失调理论”不谋而合。因此文章试从气血水理论入手,认为气滞、血瘀、水停是UC发病的重要病机之一,发病初期多为气滞所致,瘀血、水饮既为病理产物又为致病因素,促进疾病的发作或复发。临证治疗时当遵循“调气活血利水法”原则,气、血、水并调是治疗的关键,同时注重健脾、疏肝、补肾等治疗,健脾益气可重用黄芪、党参、白术等,活血利水当用当归、川芎、白芍、茯苓、泽泻之品。文章从气血水理论源流,气血水理论在UC发病及治疗中的应用等方面,结合古今医家之见,探讨调气活血利水法治疗UC的辨证思路,为UC的临床治疗提供理论支持。

从虚、痰、瘀、毒论治肺部磨玻璃结节

随着体检中胸部CT的普及,肺部磨玻璃结节(ground-glass nodule,GGN)的检出率越来越高,其具有一定比例的恶性概率,容易引起患者的恐慌,值得临床重视。目前对于无手术适应症的肺部GGN西医只是随访观察,而中医学对肺部GGN的研究尚不足,并且未形成统一的认识。通过查阅文献以及临床上四诊合参发现磨玻璃结节的病机特点多以虚痰瘀毒夹杂为主,基于虚、痰、瘀、毒讨论肺部GGN的病机特点及治疗方法,希冀为肺部磨玻璃结节的诊疗提供一定的思路。

中西医通过调节肠道菌群防治慢性肾脏病研究进展

基于“肠-肾轴”理论,肾脏疾病与肠道菌群的关系可以概括为慢性肾脏病发生发展过程中肠道菌群的破坏,包括肠道菌群改变、肠源性尿毒症毒素增多、肠道屏障功能障碍和内毒素水平升高。西医常用微生态制剂、吸附剂、缓泻剂、粪菌移植调整肠道菌群,增加尿毒症毒素的排泄,修复肠道黏膜及降低内毒素水平。中医认为,肾脏疾病的核心病机为脾肾亏虚,浊毒内蕴,补益脾肾法可调节菌群改变,通腑泄浊法可清除肠源性尿毒症毒素,活血化浊解毒法可降低内毒素水平。诸法合用,整体调节人体内环境,显著改善患者的肠道菌群情况,缓解临床症状。但目前治疗方案尚不完善,作用机制研究还不深入,之后可完善治疗方案,深入研究其作用机制和具体的作用通路与靶点,为中西医通过调节肠道菌群治疗慢性肾脏病提供客观依据。

不同炮制方法对益母草化学成分及活血化瘀作用的影响

研究不同炮制方法对益母草化学成分及活血化瘀作用的影响,为合理用药提供指导。选择盐酸益母草碱、盐酸水苏碱、芦丁、金丝桃苷、异槲皮苷为指标,评价醋制、酒制、四制对益母草生物碱类和黄酮类成分的影响;采用急性血瘀大鼠模型,以凝血酶时间、纤维蛋白原、全血高切粘度、全血中切粘度、全血低切粘度、血浆粘度、全血高切还原粘度、全血中切还原粘度、全血低切还原粘度为指标,评价醋制、酒制、四制对益母草活血化瘀作用的影响。结果显示不同方法炮制后益母草中盐酸益母草碱、盐酸水苏碱等生物碱类成分含量略有下降,芦丁、金丝桃苷、异槲皮苷等黄酮类成分含量明显下降;不同方法炮制后益母草能不同程度改善模型大鼠的血液流变学指标。本研究表明不同炮制方法对益母草生物碱类成分的影响较小,对黄酮类成分的影响较大;不同炮制方法均能不同程度增强益母草的活血化瘀作用。

益肾壮骨活血方联合针刀疗法治疗髌骨骨性关节炎临床观察

目的探讨髌骨骨性关节炎患者采用益肾壮骨活血方联合针刀疗法的临床效果。方法从南昌市洪都中医院2021年6月—2022年6月收治的髌骨骨性关节炎患者中抽取70例作为研究对象,使用随机数字表法将其分为对照组和观察组,每组35例。对照组和观察组的治疗方法分别为常规西医治疗、益肾壮骨活血方联合针刀治疗,对比两组治疗前后的炎性因子水平和西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分。结果治疗后,观察组的白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)水平均较对照组低(P<0.05),WOMAC评分较对照组低(P<0.05)。结论髌骨骨性关节炎患者采用益肾壮骨活血方与针刀联合治疗效果较显著,不仅能有效减轻炎症反应,还能改善关节功能,临床可进一步推广。

基于“血不利则为水”理论探讨RVO-ME形成的病机与辨治

本文基于“血不利则为水”理论阐释视网膜静脉阻塞继发黄斑水肿(RVO-ME)的中医病机和辨证治疗,认为RVO-ME的关键病机在于“血不利则为水”,因“血”病“水”。若细思忖,究其根源,“血不利”乃引起ME的中间环节,“为水”是“血不利”的病理产物,产生的主要原因在于脾、肾、肝等脏腑功能失调,血分、水分、气分功能紊乱。根据疾病特点对本病进行分期治疗,前期以急性出血为主,侧重以活血化瘀、兼以利水。病程较长时眼底水肿明显,故活血与利水并重,并基于脏腑功能失调与老年人易患本病的特点,健脾补肾疏肝以达到恢复气血,共奏消除ME、恢复视力之功。

某院2012~2022年中药注射剂不良反应分析

目的研究某院中药注射剂不良反应发生的特点及规律,为中药注射剂临床合理应用提供参考依据,尽可能减少中药注射剂致不良反应的发生概率。方法从国家不良反应监测系统中导出某院2012~2022年度中药注射剂相关不良反应171例,利用Excel软件整理归类并分析。结果171例中药注射剂相关不良反应中,男女比例为1∶1.67;年龄41~60岁区间占据比例最大;21种中药注射剂发生不良反应,活血化瘀类发生不良反应的病例数占比达70.76%,其中注射用血塞通发生不良反应例数最多;用药后超过7 d发生不良反应的例数最多,占比42.69%;过敏反应以皮疹瘙痒最常见;6例存在联合应用两种中药注射剂的现象。结论中药注射剂不良反应的发生与多种因素有关,通过整理某院中药注射剂不良反应的发生特点,提醒医护人员在临床用药过程中要足够重视,临床药师要加强药学监护,共同协作,关注用药过程中每一环节,促进临床用药的合理性和安全性。

肖长江教授基于“虚、瘀、水、毒”理论治疗慢性心力衰竭经验

慢性心力衰竭(CHF)是一种常见且复杂的临床病症,常伴有心室重构,可导致心脏顺应性降低、左室射血功能受限,表现为体能减退、呼吸困难和水液潴留等。CHF通常是各种心血管疾病发展至晚期的结果,极大地影响患者的生活质量。肖长江教授认为CHF的病理因素不外乎“虚、瘀、水、毒”,认为虚为发病之本,瘀、水、毒为发病之标。其中,气虚是本始原因,瘀血是中心环节,水肿是病理产物,染毒是终末结果。“瘀、水、毒”三者又互为因果,耗伤机体正气。对此,扶助正气是根本,消除诱因是前提,饮食调理是常法,活血祛瘀是主线,利水消肿是基石,防毒防变是关键。肖长江教授注重四诊合参、病证结合,梳理病因,分清主次,结合临床经验运用益气活血解毒、温阳利水养阴之法,设“益气解毒方”治疗CHF,取得良效,为中医学治疗CHF提供有益参考。