Comparative evaluation in treating qi-yin deficiency and phlegm stasis syndrome of type 2 diabetes mellitus in a rat model

Objective:To compare the efficacy of traditional Chinese medicine (TCM),western medicine and integrative medicine in treating type 2 diabetes mellitus (T2DM) in a rat model.Methods:The T2DM rat model was established with a high-fat diet (HFD) for 35 days and a single injection of streptozotocin (STZ,30 mg/kg).The T2DM-induced rats were divided into three groups,and treated with Yiqi Yangyin Huatan (YQYYHT) granules (3.84 g/kg per day),pioglitazone (1.35 mg/kg per day) or YQYYHT granules + pioglitazone (3.84 g/kg per day+1.35 mg/kg per day) respectively for 14 days.Clinical features and behavioral changes,as well as T2DM indicators,were recorded to evaluate therapeutics effects in each treatment group.Results:The T2DM rat model expressed insulin resistance (IR),with features similar to qi-yin deficiency and phlegm stasis syndrome,including decreased cyclic adenosine monophosphate/cyclic guanosine monophosphate (cAMP/cGMP) ratio,decreased levels of Na+-K+-ATPase,superoxide dismutase (SOD) and high density lipoprotein-cholesterol (HDL-C),and increased levels of serum triglyceride (TG),total cholesterol (TC) and low density lipoprotein (LDL-C).All three treatment groups showed significant decreases in fasting blood glucose (FBG) and fasting insulin (Fins),and improvement of TCM syndrome to different degrees.Importantly,YQYYHT improved the most of the indicators of T2DM,followed by integrative medicine and pioglitazone alone.Conclusion:Compared with western medicine or integrative medicine,prescription of TCM based on syndrome differentiation may offer more advantages in the prevention and treatment of T2DM.

Study of Interference Treatment by Xuesaitong (血塞通) Soft Capsuleon Patients of Nephrosis Syndrome with Qi Deficiency and Blood Stasisduring Dose Reducing Stage of Corticosteroid

Objective: To observe the effect of Xuesaitong (血塞通, XST) soft capsule in interference treatment on patients of nephrosis syndrome (NS) during corticosteroid (CS) dose reducing stage. Methods: Seventy-one NS patients applying prednisone and initiating dose reducing stage were randomized into trial group and control group. On the basis of conventional prednisone dose reduction of both groups, the trial group was given additionally XST, and the treatment course ended with the reduction to maintenance dose. In the course of observation, those who did not comply with the criteria of observation were excluded. Before and after the dose reduction, TCM syndrome scoring, 24 hrs urinary protein amount, blood β2-microglobulin (β2-MG), urinary β2-MG, blood fibrinogen (Fbg), plasma prothrombin time (PT), blood lipid, etc. were observed. Results: The trial group of XST could obviously lower their urinary protein amount and blood lipid level (P<0.05 or P<0.01), markedly improve the blood coagulation parameters (P<0.01), improve the TCM syndrome and CS induced adverse reaction (P<0.05 or P<0.01), also obviously reduced the recurrence rate of NS (P<0.05). Conclusion: XST could obviously improve the clinical symptoms and renal impairment parameters in NS patients during CS dose reduction stage, improve the CS induced adverse reaction and prevent the recurrence of NS.

Serum proteomic approach in patients with Qi deficiency and blood stasis syndrome in coronary heart disease:to explore therapeutic mechanism of Yiqi Huoxue decoction

OBJECTIVE To explore the curative effect and mechanism of Yiqi Huoxue decoction in the treatment of coronary heart disease with Qi deficiency and blood stasis syndrome.METHODS The patients with coronary heart disease of Qi deficiency and blood stasis syndrome were treated with Yiqi Huoxue decoction for 3 months,and the changes of cardiac function were observed.61 serum samples(including 29 cases of disease group and 32 cases of Yiqi Huoxue expression group)were analyzed by non labeled proteomics.The disease group was used as the control group,and the protein with expression level difference of more than 1.2 folds(P<0.05)was screened.The molecular function,biological pathway and protein interaction of the different proteins were analyzed by bioinformatics,so as to identify the molecular and biological pathway of Yiqi Huoxue decoction in the treatment of coronary heart disease with Qi deficiency and blood stasis syndrome.RESULTS Clinical treatment found that Yiqi Huoxue decoction can improve TCM syndrome score and left ventricular ejection fraction,regulate blood glucose and blood lipid levels,prolong thrombin time,and improve heart function.The results of proteomic quantitative analysis showed that there were 69 proteins with different expression levels in the disease group.Bioinformatics analysis results showed that Yiqi Huoxue decoction may regulate ApoA1,alpha-2 and other proteins to act on HDL assembly,platelet degradation,PI3K Akt signaling pathway,and then play a therapeutic role in coronary heart disease with Qi deficiency and blood stasis syndrome.CONCLUSION Yiqi Huoxue decoction can effectively improved the heart function decline caused by Qi deficiency and blood stasis syndrome of coronary heart disease.It mainly act on energy metabolism and platelet activation pathway by activating HDL assembly and platelet degradation signal pathway proteins.This study can provide reference for the follow-up treatment mechanism of Qi deficiency and blood stasis syndrome of coronary heart disease.

On the Treatment of Kidney Fibrosis from the Theory of Internal Deficiency of Qi and the Coexistence of Phlegm and Blood Stasis

Traditional Chinese medicine believes that the etiology and pathogenesis of renal fibrosis are characterized by deficiency of the lung,spleen and kidney,and phlegm,blood stasis,dampness and poison.The positive and the evil can influence each other and cause and effect each other,forming the pathological characteristics of the deficiency,the deficiency,the deficiency and the reality.Chinese medicine treatment of the disease has its unique advantages,external and internal injury equal emphasis,correction and dispelling evil and regulation.From the point of view of"deficiency of qi and coexistence of phlegm and blood stasis",the treatment of renal fibrosis can provide theoretical basis for the treatment of the disease.

Effects of Lycii Fructus and Salviae Miltiorrhizae on the Syndrome of Deficiency with Blood Stasis in RCS(rdy-/-, p-/-) Rats with Retinitis Pigmentosa: An Intervention Study

Objective To investigate the effects of Lycii Fructus(LF,Gou Qi Zi,枸杞子)and Salviae Miltiorrhizae Radix Ex Rhizoma(SM,Dan Shen,丹参)on the syndrome of deficiency with blood stasis in the RCS(rdy-/-,p-/-)rats with retinitis pigmentosa(RP).Methods A total of 32 RCS(rdy-/-,p-/-)rats were divided into 4 groups(equal amounts of female and male rats in each group):model group treated with 0.9%normal saline,LF group treated with LF formula granules,SM group treated with SM formula granules,and LF and SM(L·S)group treated with LF and SM formula granules.Eight RCS(rdy+/+,p+/+)rats(4 males and 4 females)were treated with 0.9%normal saline to serve as blank group.The contents of E2,PG,P-Selectin,plasma viscosity,whole blood relative index of the high shear rate and fibrinogen content in plasma,and the content of cAMP and cGMP in retinal homogenate were detected.The retina was evaluated by hematoxylin-eosin staining.Results The contents of E2,PG,P-Selectin,plasma viscosity,whole blood relative index of the high shear rate,and fibrinogen content in the plasma of L·S group significantly differed from those of model group(P<0.01),but were similar to those of blank group.The contents of cAMP and cGMP in the retinal homogenate of L·S group significantly differed from those in model group(P<0.01)but were similar to those in blank group(P>0.05).Conclusions LF and SM can effectively treat retinitis pigmentosa by ameliorating the syndrome of deficiency with blood stasis.

Energy Metabolism Disorder and Myocardial Injury in Chronic Myocardial Ischemia with Qi Deficiency and Blood Stasis Syndrome Based on 2-DE Proteomics

Objective： To inquire the characteristic proteins in chronic myocardial ischemia by testing twodimensional electrophoresis （2-DE） map to explore the possible inherent pathological mechanism and the therapeutic intervention of qi deficiency and blood stasis syndrome. Methods： Ameroid constrictor ring was placed on the first interval of left anterior descending coronary artery to prepare chronic myocardial ischemia model on Chinese miniature swine. Animals were randomly divided into sham group and model group with 10 animals in each group, respectively. The dynamic symptoms observation of the four diagnostic information was collected from 0 to 12 weeks. Echocardiography was employed to evaluate cardiac function and the degree of myocardial ischemia, 2-DE and matrix-assisted laser desorption/ionization-time of flight mass spectrometry （MALDI-TOF-MS） were used to carry out proteomics research on animals. Enzyme-linked immunosorbent assay was applied to identify the relevant differential proteins on chronic myocardial ischemia with qi deficiency and blood stasis syndrome. Results： The preliminary study found that at the 12th week, chronic myocardial ischemia with qi deficiency and blood stasis syndrome model was established stably. Compared with the sham group, there were 8 different proteins down-regulated, 22 proteins up-regulated significantly. After validated by MALDI- TOF-MS/MS, 11 protein spots were identified. Distinct proteins were mainly associated with energy metabolism and myocardial structural injury, including isocitrate dehydrogenase 3 （NAD＋） alpha, NADH dehydrogenase （NAD） Fe-S protein 1, chain A （crystal structure of aidose reductase by binding domain reveals a new Nadph）, heat shock protein 27 （HSP27）, oxidoreductase （NAD-binding protein）, antioxidant protein isoform, cardiac troponin T （cTnT）, myosin （myosin light polypeptide）, cardiac alpha tropomyosin, apolipoprotein A- I and albumin. Conclusion： Down-regulated energy metabolism disorder mediated by NADH respiratory chain and myocardial injury may be the pathogenesis of myocardial ischemia with qi deficiency and blood stasis syndrome. These proteins may be the potential diagnostic marker（s） for qi deficiency and blood stasis syndrome, finally provided new clues for new therapeutic drug target of Chinese medicine

Metabonomics analysis of the urine of rats with Qi deficiency and blood stasis syndrome based on NMR techniques

Metabonomics analysis of the urine of rats with Qi deficiency and blood stasis syndrome has been performed by comparison with those of normal rats based on NMR techniques. The relative contents of formate,creatinine,2-oxoglutarate(2-OG) ,citrate,taurine,trimethylamine-N-oxide(TMAO) ,succinate and hippurate in the urine of the rats with Qi deficiency and blood stasis syndrome have been changed. These results have provided evidence for understanding the mechanism and the therapy of Qi defi-ciency and blood stasis syndrome.

Relationship between Two Blood Stasis Syndromes and Inflammatory Factors in Patients with Acute Coronary Syndrome

Objective： To investigate the relationship between inflammatory factors and two Chinese medicine（CM） syndrome types of qi stagnation and blood stasis（QSBS） and qi deficiency and blood stasis（QDBS） in patients with acute coronary syndrome（ACS）. Methods： Sixty subjects with ACS, whose pathogenesis changes belongs to qi disturbance blood stasis syndrome, were divided into 2 groups： 30 in the QSBS group and 30 in the QDBS group. The comparative analysis on them was carried out through comparing general information, coronary angiography and inflammatory factors including intracellular adhesion molecule-1（ICAM-1）, chitinase-3-like protein 1（YKL-40） and lipoprotein-associated phospholipase A2（Lp-PLA2）. Results： Compared with the QSBS group, Lp-PLA2 and YKL-40 levels in the QDBS group showed no-significant difference（P〉0.05）; ICAM-1 was significantly higher in the QDBS group than in the QSBS group in the pathological processes of qi disturbance and blood stasis syndrome of ACS（P〈0.05）. Conclusion： Inflammatory factor ICAM-1 may be an objective basis for syndrome typing of QSBS and QDBS, which provides a research direction for standardization research of CM syndrome types.

益心泰颗粒对慢性心衰(心气虚兼血瘀水停证)大鼠AMPK、PGC-1α的影响

目的观察益心泰颗粒对慢性心力衰竭(CHF)(心气虚兼血瘀水停证)大鼠AMPK、PGC-1α的影响。方法采用丙硫氧嘧啶灌胃及阿霉素腹腔注射复制CHF(心气虚兼血瘀水停证)模型大鼠,将造模成功大鼠分为模型组与益心泰低、中、高剂量组和曲美他嗪组;另设正常对照组。灌胃4周后观察心肌组织病理结构,检测LVEF、血清NT-proBNP及心肌组织FFA、ATP/AMP、LAC、pAMPK、AMPK、PGC-1α水平。结果与模型组比较,益心泰颗粒低、中、高剂量组及曲美他嗪组LVEF、心肌组织ATP/AMP值、心肌组织p-AMPK、AMPK、PGC-1α相对灰度值均明显升高(P<0.05或P<0.01),血清NT-proBNP及心肌组织FFA、LAC明显降低(P<0.05或P<0.01)。结论益心泰颗粒能促进慢性心力衰竭(心气虚兼血瘀水停证)大鼠AMPK、PGC-1α表达,改善心肌能量代谢。

基于气络学说运用芪归通络口服液联合艾灸治疗气虚血瘀型慢性疲劳综合征的临床观察

【目的】观察基于气络学说,运用芪归通络口服液(广东省第二中医院院内制剂,由黄芪、当归、三七、赤芍、牛膝、鸡血藤、丹参、地龙等中药组成)联合艾灸治疗气虚血瘀型慢性疲劳综合征(chronic fatigue syndrome,CFS)的临床疗效。【方法】采用回顾性研究方法,根据治疗方法的不同将60例气虚血瘀型CFS患者分为观察组和对照组,每组各30例。对照组给予艾条温和灸神阙穴治疗,观察组在对照组的基础上联合芪归通络口服液治疗,疗程为4周。观察2组患者治疗前后中医证候积分、疲劳量表-14(FS-14)评分、血清免疫球蛋白IgA、IgM、IgG含量及皮质醇(COR)水平的变化情况,并评价2组患者的临床疗效和安全性。【结果】(1)疗效方面,治疗4周后,观察组的总有效率为96.67%(29/30),对照组为80.00%(24/30),组间比较,观察组的临床疗效明显优于对照组(P<0.05)。(2)量表评分方面,治疗后,2组患者的中医证候积分、FS-14评分均较治疗前明显降低(P<0.01),且观察组对中医证候积分、FS-14评分的降低作用均明显优于对照组(P<0.01)。(3)实验室指标方面,治疗后,2组患者血清IgA、IgG水平以及观察组血清IgM、COR水平均较治疗前明显升高(P<0.01),且观察组对血清IgA、IgM、IgG及COR水平的升高作用均明显优于对照组(P<0.05或P<0.01)。(4)安全性方面,治疗过程中,2组患者均未发生明显不良反应。【结论】基于中医气络学说,以正虚络阻为CFS核心病机,运用补虚通络法,采用芪归通络口服液联合艾灸治疗气虚血瘀型CFS患者疗效确切,能明显缓解患者的临床症状,提高患者的免疫力水平,调节患者的神经-内分泌-免疫(NEI)网络。

益气化瘀汤联合羟苯磺酸钙治疗糖尿病肾病气虚血瘀证的疗效及对VEGF,IGF-1表达水平的影响研究

【目的】观察益气化瘀汤(由黄芪、山药、茯苓、炒芡实、旱莲草、金樱子、焦山楂、女贞子、丹参、益母草等组成)联合羟苯磺酸钙治疗糖尿病肾病(DN)气虚血瘀证的临床疗效及对血管内皮生长因子(VEGF)、胰岛素样生长因子1(IGF-1)的影响。【方法】将90例DN气虚血瘀证患者随机分为观察组和对照组,每组各45例。所有患者均接受基础降糖治疗和控制血压、调节脂代谢紊乱等治疗。在此基础上,对照组患者给予羟苯磺酸钙治疗,观察组患者在对照组的基础上联合益气化瘀汤治疗,疗程为3个月。观察2组患者治疗前后中医证候积分、肾功能指标及血清VEGF、IGF-1水平的变化情况,并评价2组患者的临床疗效。【结果】(1)疗效方面,治疗3个月后,观察组的总有效率为91.11%(41/45),对照组为75.56%(34/45),组间比较(χ2检验),观察组的疗效明显优于对照组(P<0.05)。(2)中医证候积分方面,治疗1个月和3个月后,2组患者的中医证候积分均较治疗前明显降低(P<0.05),且治疗3个月后又均较治疗1个月后明显降低(P<0.05);组间比较,观察组在治疗1个月和3个月后对中医证候积分的降低作用均明显优于对照组(P<0.01)。(3)肾功能指标方面,治疗后,2组患者的血肌酐(Scr)、尿素氮(BUN)、肾小球滤过率(GFR)等肾功能指标均较治疗前明显改善(P<0.05),且观察组对各项肾功能指标的改善作用均明显优于对照组(P<0.01)。(4)血清VEGF、IGF-1水平方面,治疗后,2组患者的血清VEGF、IGF-1水平均较治疗前明显降低(P<0.05),且观察组对血清VEGF、IGF-1水平的降低作用均明显优于对照组(P<0.01)。(5)治疗过程中,2组患者均无明显不良反应发生,具有较高的安全性。【结论】益气化瘀汤联合羟苯磺酸钙治疗DN气虚血瘀证患者疗效确切,可有效下调血清VEGF、IGF-1水平,明显改善患者肾功能,显著减轻患者临床症状,且具有较高的安全性。

李延从脾胃论治冠心病的临床经验

冠心病为临床中常见的心血管疾病,可归属中医学的“胸痹”“心痛”等疾病范畴。李延教授认为本病之病性总属本虚标实之证,以脾虚、脾胃健运失常为本,标实在于痰浊、血瘀、气滞、寒凝等有形实邪痹阻心脉。治疗时重视调理脾胃,重用黄芪、白术、党参、五味子等健脾养心以治本,结合通阳化浊、活血化瘀、疏肝理气、温阳散寒等治法,标本兼治,通补兼顾,使脾气健旺,心气充沛,瘀去痰消,胸阳得以舒展,则心之血脉恢复畅通,胸痹心痛诸症得到缓解。李延教授从脾胃论治冠心病的经验可为中医临床诊治冠心病提供参考。

益气活血祛痰方治疗支气管哮喘合并阻塞性睡眠呼吸暂停低通气综合征气虚痰瘀证的研究

目的评价益气活血祛痰方联合西医治疗慢性持续期支气管哮喘合并阻塞性睡眠呼吸暂停低通气综合征气虚痰瘀证患者的临床疗效。方法选择2016年1月—2021年6月于泰州市第四人民医院就诊的80例慢性持续期支气管哮喘合并阻塞性睡眠呼吸暂停低通气综合征气虚痰瘀证患者,根据随机数字表分成对照组及观察组各40例,对照组给予常规治疗及持续气道正压通气,观察组在对照组治疗基础上给予益气活血祛痰方水煎液口服,2组均持续干预3个月。观察2组患者治疗前后中医证候积分(包括气喘、咳嗽、咳痰、打鼾、憋醒、日间嗜睡、倦怠乏力)、哮喘控制测试问卷(ACT)评分、圣乔治呼吸问卷(SGRQ)评分、Epworth嗜睡量表(ESS)评分、匹兹堡睡眠指数(PSQI)评分、肺功能指标[呼气峰值流速(PEF)、第一秒用力呼气容积占预计值百分比(FEV_(1)%预计值)、第一秒用力呼气容积与用力肺活量比值(FEV_(1)/FVC)]、多导睡眠图参数[呼吸暂停低通气指数(AHI)、快速眼动睡眠期(REM)、氧减指数(ODI)、动脉血氧饱和度(SaO_(2))、最低SaO_(2)、觉醒指数]、炎症相关指标[血清C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、血管内皮生长因子(VEGF)水平和呼出气一氧化氮(FeNO)水平]变化,统计2组总体治疗效果及不良反应发生情况。结果2组治疗后中医证候积分、SGRQ评分、ESS评分、PSQI评分、AHI、ODI、觉醒指数及血清CRP、IL-6、TNF-α、VEGF水平和FeNO水平均较治疗前明显降低(P均<0.05),且观察组上述各项指标均明显低于对照组(P均<0.05);2组治疗后ACT评分、PEF、FEV_(1)%预计值、FEV_(1)/FVC、REM、SaO_(2)、最低SaO_(2)均较治疗前明显升高(P均<0.05),且观察组上述各项指标均明显高于对照组(P均<0.05)。观察组治疗3个月后的总有效率明显高于对照组[92.5%(37/40)比82.5%(33/40),P<0.05],治疗期间不良反应发生率明显低于对照组[10.0%(4/40)比27.5%(11/40),P<0.05]。结论益气活血祛痰方联合西医治疗支气管哮喘合并阻塞性睡眠呼吸暂停低通气综合征气虚痰瘀证患者的效果优于单纯西医治疗,在减轻患者临床症状,控制哮喘发作,改善肺功能和睡眠质量方面具有明显优势,其作用机制可能与抑制炎症反应相关。

益气复脉方治疗气虚血瘀、痰瘀互阻型室性期前收缩的临床疗效

目的:观察益气复脉方治疗气虚血瘀、痰瘀互阻型室性期前收缩的临床疗效。方法:选取2021年8月—2022年8月在北京中医药大学东方医院住院治疗的室性期前收缩病人60例,按照随机数字表法分为对照组和治疗组。在常规治疗基础上,治疗组采用益气复脉方(颗粒剂)治疗,对照组采用颗粒安慰剂治疗。评估并比较两组治疗前后室性期前收缩数量变化,中医证候积分及中医单项症状心悸、气短、神疲乏力、胸闷、胸痛、痰浊、自汗、食少纳呆积分变化。结果:治疗后,治疗组室性期前收缩数量较治疗前减少,且治疗组少于对照组,差异有统计学意义(P<0.05)。治疗后,两组中医证候总积分较治疗前降低,且治疗组低于对照组,差异均有统计学意义(P<0.001)。治疗后,两组心悸、气短、神疲乏力、胸闷、胸痛、痰浊、自汗、食少纳呆的症状积分均较治疗前降低,且治疗组低于对照组,差异均有统计学意义(P<0.05)。治疗后,治疗组总有效率高于对照组,差异有统计学意义(77.8%与24.0%,P<0.05)。结论:益气复脉方可减少气虚血瘀、痰瘀互阻型室性期前收缩病人室性期前收缩次数,改善中医证候。

NFAT3在充血性心力衰竭气虚血瘀证患者舌苔液中的表达及意义

目的研究活化T细胞核因子3(nuclear factor of activated T-cells 3,NFAT3)在充血性心力衰竭(congestive heart failure,CHF)气虚血瘀证患者舌苔液中的表达及与临床指标相关性,初步拟定该证候的诊断界值。方法收集CHF气虚血瘀证患者及健康对照者各30例,酶联免疫吸附法(enzyme linked immunosorbent assay,ELISA)检测舌苔液中NFAT3的含量。结果NFAT3在CHF气虚血瘀证患者舌苔液的含量为(481.40±103.00)pg/mL,明显高于健康对照者舌苔液的含量[(237.90±156.50)pg/mL](P<0.01);且随着美国纽约心脏协会(New York Heart Association,NYHA)心功能分级的增加,CHF气虚血瘀证患者舌苔液中NFAT3含量不断升高(P<0.01);CHF气虚血瘀证患者舌苔液NFAT3与NYHA心功能分级呈正相关性(r=0.927,P<0.01),与B型脑钠肽(brain natriuretic peptide,BNP)(r=0.806,P<0.01)呈正相关性,与左室射血分数(left ventricular ejection fraction,LVEF)呈负相关性(r=-0.739,P<0.01)。绘制受试者操作特性曲线(receive operating characteristic,ROC)初步拟定舌苔液清中NFAT3诊断CHF气滞血瘀证的界值为363.37 pg/mL,曲线下面积为0.91。结论NFAT3能够反映CHF病情轻重程度,可为CHF气虚血瘀证提供客观化、量化的参考和依据。

通调针刺法联合康复疗法治疗气虚血瘀型脑梗死后运动障碍临床观察

目的评估通调针刺法联合康复疗法治疗气虚血瘀型脑梗死后运动障碍的临床疗效。方法将60例气虚血瘀型脑梗死后运动障碍患者随机分为对照组和治疗组,每组30例。两组患者均给予基础治疗,对照组患者给予康复治疗,治疗组患者给予康复治疗联合通调针刺法治疗,两组疗程均为4周。比较治疗前后两组患者简化Fugl-Meyer评估(Fugl-Meyer assessment,FMA)量表评分和日常生活活动能力(activity of daily living,ADL)量表评分、气虚血瘀证证候积分、血清转铁蛋白(transferrin,TF)和神经生长因子(nerve growth factor,NGF)水平,对比两组总体疗效。结果治疗组脱落2例患者,对照组脱落1例患者。与治疗前比较,两组患者治疗后FMA量表评分和ADL量表评分均显著上升(P<0.05),气虚血瘀证证候积分显著降低(P<0.05),血清TF和NGF水平显著升高(P<0.05),且治疗组FMA量表评分和ADL量表评分及血清TF和NGF水平升高程度、气虚血瘀证证候积分降低程度均显著大于对照组(P<0.05)。治疗组临床疗效显著优于对照组(P<0.05)。结论通调针刺法联合康复疗法治疗气虚血瘀型脑梗死后运动障碍疗效显著。

温胆汤加减治疗气虚血瘀痰阻型缺血性脑卒中急性期的疗效及对NT-proBNP、ICAM-1和MCP-1的影响研究

目的:探讨温胆汤加减治疗气虚血瘀痰阻型缺血性脑卒中急性期患者的疗效,以及对N末端脑钠肽前体(NT-proBNP)、细胞间黏附分子-1(ICAM-1)和单核细胞趋化蛋白-1(MCP-1)水平的影响。方法:以2021年5月至2022年5月该院收治的气虚血瘀痰阻型缺血性脑卒中急性期患者100例为研究对象,根据随机数字表法分为对照组和观察组,每组50例。对照组患者给予常规治疗,观察组患者在对照组的基础上给予温胆汤加减治疗。比较两组患者的临床疗效,NT-proBNP、ICAM-1和MCP-1水平,美国国立卫生院卒中神经功能缺损评分量表(NIHSS)评分、改良Rankin量表(mRS)评分及中医证候积分。结果:治疗1个月后,观察组患者的总有效率为94.00%(47/50),显著高于对照组的80.00%(40/50),差异有统计学意义(P<0.05)。治疗1个月后,观察组患者NT-proBNP、ICAM-1和MCP-1水平显著低于对照组,血液流变学各指标(血浆黏度、血低切黏度、血高切黏度、纤维蛋白原和红细胞压积)水平显著低于对照组,差异均有统计学意义(P<0.05)。治疗7 d、1个月后,观察组患者的NIHSS评分低于对照组;治疗1个月后,观察组患者的mRS评分、中医证候积分低于对照组,差异均有统计学意义(P<0.05)。结论:温胆汤加减治疗气虚血瘀痰阻型缺血性脑卒中急性期患者的效果较好,可显著降低NT-proBNP、ICAM-1和MCP-1水平,促进血液流通和疾病的恢复,提高患者的生活质量。

破格救心汤加减对心力衰竭合并室性心律失常患者生物标志物和近期不良心血管事件的影响

目的评价破格救心汤加减对心力衰竭合并室性心律失常患者生物标志物和近期不良心血管事件的影响。方法将88例心力衰竭合并室性心律失常患者随机分为对照组与观察组各44例。对照组进行抗心衰治疗,并口服美托洛尔缓释片和盐酸胺碘酮胶囊。观察组在对照组治疗的基础上口服破格救心汤加减治疗。比较治疗前后左室射血分数(LVEF)、每搏心输出量(SV)、左心室收缩末期内径(LVESD)、正常窦性心搏间期标准差(SDNN)、校正TP-Te间期(TP-Tec)每5分钟窦性心搏间期平均值的标准差(SDANN)、校正QT间期(QTc)和正常相邻R-R间期差值>50ms的百分比(Pnn50%);检测N末端B型利钠肽原(NT-proBNP)、生长分化因子15(GDF-15)可溶性肿瘤生成抑制因子-2(sST-2)和半乳糖凝集素-3(GAL-3)水平;记录近期不良心血管事件;进行治疗前后阳气亏虚血瘀证评分;比较心功能疗效和室性心律失常疗效。结果治疗后,观察组心功能疗效和室性心律失常疗效的总有效率均高于对照组(P<0.05);两组患者LVEF、SV升高,LVESD降低(P<0.05),均以观察组更明显(P<0.05);两组患者NT-proBNP、GAL-3、GDF-15和sST2水平下降(P<0.05),且观察组低于对照组(P<0.05);两组患者主要症状评分及阳气亏虚血瘀证总积分降低(P<0.05),且观察组低于对照组(P<0.05);两组患者QTc、TP-Tec减少,SDNN、SDANN和Pnn50%增加(P<0.05),且观察组改善明显(P<0.05)。观察组近期不良心血管事件累积发生率低于对照组(P<0.05)。结论破格救心汤加减方联合西医常规疗法治疗心力衰竭合并室性心律失常,能够抑制心室重构,提高心功能,减少不良心血管事件发生,临床疗效优于单纯的西医治疗。

黄芪桂枝五物汤加减联合针刺治疗重症骨创伤患者ICU获得性衰弱的疗效

目的观察黄芪桂枝五物汤加减联合针刺治疗重症骨创伤患者重症监护病房(intensive care unit,ICU)获得性衰弱的效果。方法将66例重症骨创伤ICU获得性衰弱患者,按照随机数字表法分为对照组33例和观察组33例。对照组给予功能锻炼,观察组在此基础上联合黄芪桂枝五物汤加减联合针刺,连续治疗2周。比较两组的临床疗效、机械通气时间、ICU住院天数、日常生活活动能力Barthel指数(BI)评分、APACHEⅡ评分、肌力状态(MRC)评分。结果观察组的有效率90.91%(30/33),高于对照组的有效率69.70%(23/33)(P<0.05);观察组机械通气天数、住ICU时间明显短于对照组(P<0.05);治疗14d,观察组患者的BI等级优于对照组(P<0.05);治疗3d、治疗5d、治疗7d的观察组的APACHEⅡ评分明显低于对照组,肌力状态MRC评分明显高于对照组(P<0.05)。结论黄芪桂枝五物汤加减联合针刺治疗能明显缩短重症骨创伤ICU获得性衰弱患者的机械通气时间、ICU住院天数,提高日常活动能力,改善肢体肌力,更利于促进疾病康复。

补肾化痰通脉法治疗颈动脉粥样硬化不稳定斑块临床观察

目的 观察补肾化痰通脉法干预颈动脉粥样硬化不稳定斑块的临床疗效。方法 选择2020年12月—2021年12月太仓市中医医院收治的78例明确诊断颈动脉不稳定斑块患者为研究对象,采用随机数字表法将其分成对照组和试验组,各39例。其中对照组予西药干预;试验组在对照组的基础上加入补肾化痰通脉颗粒。观察每组颈动脉粥样硬化不稳性斑块的变化,同时检测血脂指标水平以及评定中医证候积分并进行对比分析。结果 两组颈动脉内中膜厚度和最大斑块大小明显改善,但两组间的最大斑块面积差异无统计学意义(P>0.05);两组血脂水平均改善,且试验组优于对照组(P<0.05);两组中医证候积分均降低,且试验组明显优于对照组(P<0.05)。结论 补肾化痰通脉法可能通过改善患者颈动脉内中膜厚度、血脂水平,控制颈动脉粥样硬化病变的进展。