Network pharmacology-based exploration of molecular mechanisms underlying therapeutic effects of Jianpi Huatan Quyu recipe on chronic heart failure with spleen Qi deficiency syndrome

BACKGROUND Chronic heart failure is a complex clinical syndrome.The Chinese herbal compound preparation Jianpi Huatan Quyu recipe has been used to treat chronic heart failure;however,the underlying molecular mechanism is still not clear.AIM To identify the effective active ingredients of Jianpi Huatan Quyu recipe and explore its molecular mechanism in the treatment of chronic heart failure.METHODS The effective active ingredients of eight herbs composing Jianpi Huatan Quyu recipe were identified using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform.The target genes of chronic heart failure were searched in the Genecards database.The target proteins of active ingredients were mapped to chronic heart failure target genes to obtain the common drugdisease targets,which were then used to construct a key chemical componenttarget network using Cytoscape 3.7.2 software.The protein-protein interaction network was constructed using the String database.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed through the Metascape database.Finally,our previously published relevant articles were searched to verify the results obtained via network pharmacology.RESULTS A total of 227 effective active ingredients for Jianpi Huatan Quyu recipe were identified,of which quercetin,kaempferol,7-methoxy-2-methyl isoflavone,formononetin,and isorhamnetin may be key active ingredients and involved in the therapeutic effects of TCM by acting on STAT3,MAPK3,AKT1,JUN,MAPK1,TP53,TNF,HSP90AA1,p65,MAPK8,MAPK14,IL6,EGFR,EDN1,FOS,and other proteins.The pathways identified by KEGG enrichment analysis include pathways in cancer,IL-17 signaling pathway,PI3K-Akt signaling pathway,HIF-1 signaling pathway,calcium signaling pathway,cAMP signaling pathway,NF-kappaB signaling pathway,AMPK signaling pathway,etc.Previous studies on Jianpi Huatan Quyu recipe suggested that this Chinese compound preparation can regulate the TNF-α,IL-6,MAPK,cAMP,and AMPK pathways to affect the mitochondrial structure of myocardial cells,oxidative stress,and energy metabolism,thus achieving the therapeutic effects on chronic heart failure.CONCLUSION The Chinese medicine compound preparation Jianpi Huatan Quyu recipe exerts therapeutic effects on chronic heart failure possibly by influencing the mitochondrial structure of cardiomyocytes,oxidative stress,energy metabolism,and other processes.Future studies are warranted to investigate the role of the IL-17 signaling pathway,PI3K-Akt signaling pathway,HIF-1 signaling pathway,and other pathways in mediating the therapeutic effects of Jianpi Huatan Quyu recipe on chronic heart failure.

Clinical Observation of the Therapeutic Effects of Wenzhong Hewei Formula in Treating Spleen and Stomach Qi Deficiency Syndrome in Internal Medicine Diseases

Objective:To observe the clinical efficacy and safety of Wenzhong Hewei Formula in treating spleen and stomach qi deficiency syndrome in internal medicine diseases.Methods:Sixty patients with spleen and stomach qi deficiency syndrome admitted to the hospital from April 2022 to June 2023 were randomly divided into observation and control groups,with 30 patients in each group.The control group received conventional internal medicine treatment,while the observation group was additionally treated with Wenzhong Hewei Formula on the basis of conventional treatment.Both groups were treated for 4 weeks.Results:The total effective rate of treatment in the observation group was higher than that of the control group(P<0.05).After treatment,the traditional Chinese medicine syndrome scores of both groups were significantly lower than before treatment,with the observation group showing a more pronounced reduction(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Wenzhong Hewei Formula can effectively improve clinical symptoms in patients with spleen and stomach qi deficiency syndrome,enhance clinical efficacy,and have a high level of safety,making it worthy of clinical promotion.

Rules of Ren Shunping's prescription for trearing Spleen Deficiency and Qi Stagnation Syndrome of Functional Dyspepsia Based on Data Mining

Objective:To explore the medication rules of Professor Ren Shunping treating spleen deficiency and qi stagnation syndrome of functional dyspepsia,so as to provide reference for clinical prevention and development of new drugs.Methods:The 144 Chinese herbal formulas considered as active prescribed by professor Ren Shunping for the first time treating the patients with spleen deficiency and qi stagnation syndrome of functional dyspepsia were collected,entered into TCM inheritance auxiliary platform(V2.5),and then mined by some data mining methods of the software,such as the association rules and unsupervised entropy hierarchical clustering.Results:This study involved 144 Chinese herbal formulas,including a total of 56 Chinese herbal medicines.Of these Chinese herbal medicines,the herbs of cold and warm nature,and pungent,bitter and sweet in flavors were used in a quite high frequency,all of which act on spleen,stomach,lungs,large intestine,liver and gallbladder meridians.One core Chinese herbal formula was excavated,composed of patchouli,perilla stem,radix bupleuri,scutellaria,ginger pinellia,codonopsispilosula,magnolia bark,tangerine peel,large-headed atractylodes,immature bitter orange,wood incense,fructus amomi,inula britannica chinensis,ginger,medicated leaven,fried rice and fried malt based on the association rules.And a total of 17 groups of core used drugs and 2 groups of new Chinese herbal formulas undiscovered were mined based on unsupervised entropy hierarchical clustering.Conclusion:In treating spleen deficiency and qi stagnation syndrome of functional dyspepsia,professor Ren is good at treating spleen deficiency and qi stagnation syndrome of functional dyspepsia from the perspective of"tong jiang",using the"five-in-one"strategy of strengthening the spleen,evacuating the liver,coming down qi from the stomach,dispersing lung,and bowel-reflexing to treat patients as a whole.And the herbal medicines were light in dose,lovely and mild in nature for the formulars.At the same time,he paid attention to the combination of syndromes and symptoms,and flexible arbitration.

Rat Models of Fatty Liver due to Liver Depression and Spleen Deficiency

[Objectives] To establish animal models of fatty liver due to liver depression and spleen deficiency that were suitable for activity discovery of traditional Chinese medicine( TCM) compounds,efficacy evaluation,new drug research and development and correspondence between prescription and syndrome of TCM. [Methods] A syndrome score scale that was suitable for evaluating the rat models was established according to the evolvement rules of etiology and pathogenesis of TCM and the modern clinical pathological mechanism. At the same time,bifendate pills and Sanqi Zhigan pills were selected as drug counterevidence for the models. Rats in model groups were given different proportions of high-fat and low-protein fodder and different concentrations of alcohol every day,and intraperitoneally injected with porcine serum twice a week. Drug groups were given with bifendate pills and Sanqi Zhigan pills( 8. 1 mg/kg,and 2. 7 g/kg) respectively for 14 consecutive days.During the experiment,general status,weight,daily fodder intake and daily water intake of the animals were observed,and TCM syndromes were scored. After the experiment,the levels of alanine aminotransferase( ALT),aspartate aminotransferase( AST),γ-glutamine transpeptidase( γ-GT),total cholesterol( TC),triglycerides( TG),low density lipoprotein-cholesterol( LDL-C),and high density lipoprotein-cholesterol( HDL-C) in serum were detected,and the pathological changes in liver tissue were observed. [Results] Compared with the control group,body weight,daily fodder and water intake of rats increased slowly in the model group,and the levels of ALT,AST,γ-GT,TC,TG and LDL-C increased significantly,while the level of HDL-C dropped. Pathological examination showed that steatosis and fat granule were observed in hepatocytes of rats in the model group. Behavioral observation found that main symptoms and minor symptoms of rats in the model group conformed to the syndrome manifestation of liver depression and spleen deficiency,which suggested that the three model groups were established successfully. Among them,three rats died in model group 1,and one rat died in model group 2. The manifestation of all the above lesions can be alleviated by drug counterevidence. [Conclusions]The animal model of fatty liver due to liver depression and spleen deficiency shows an obviously lower mortality and shorter duration and can be used for research of correlation between prescription and syndrome and its mechanism.

Effects of Different Processed Products of Radix Codonopsis on Intestinal Flora of Rats with Spleen Deficiency

[Objectives]This study aimed to observe the effects of different processed products of Radix Codonopsis on intestinal flora in rats with spleen deficiency.[Methods]Rat models with spleen deficiency were established by bitter-cold purgation method with Radix et Rhizoma Rhei.Normal group,model group,Radix Codonopsis group,fried Radix Codonopsis group,rice-fried Radix Codonopsis group,honey-fried Radix Codonopsis group and bran-fired Radix Codonopsis group were designed.After subjecting to corresponding treatments,the changes in the quantity of intestinal microorganisms of the rats were detected.[Results]There was no significant change in the quantity of intestinal microorganisms of the rats in the normal group and model group.The rats in the rice-fried Radix Codonopsis group were administered after successful modeling,and the abundance of Bifidobacterium and Lactobacillus in the intestines of the rats increased,and the quantity of Escherichia coli and Staphylococci reduced.The rats in the Radix Codonopsis group,fried Radix Codonopsis groups,honey-fried Radix Codonopsis group and bran-fried Radix Codonopsis group were administered after successful modeling,and the abundance of Bifidobacterium and Lactobacillus in the intestines of the rats increased(the increases were smaller than those in the rice-fried Radix Codonopsis group),and the abundance of E.coli and Staphylococci reduced,close to normal levels.[Conclusions]Different processed products of Radix Codonopsis have obvious regulation effect on intestinal flora of rats with spleen deficiency,and the regulation effect of rice-fried Radix Codonopsis on rats with spleen deficiency is better than that of Radix Codonopsis,fried Radix Codonopsis,honey-fried Radix Codonopsis and bran-fried Radix Codonopsis.

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.

Study of establishing disease-syndrome combined with animal model for immune thrombocytopenic purpura without additional conditions

Objective:To explore the feasibility of establishing the disease-syndrome combined animal model for immune thrombocytopenic purpura(ITP)without additional conditions.Methods:Three batches of data related to the ITP model mice obtained by replication at different time were analyzed,and whether the APS-injected model mice replicated through the passive immune modeling method could simulate the pathogenesis and clinical characteristics of human ITP was evaluated according to the differentiation criteria for diseasesyndrome combined model.Results:The APS-injected replicated ITP model mice possessed the following traits:(1)Compared with the normal group,the platelet count was significantly decreased,and coagulation time was significantly increased in the model group(P<.01).(2)Compared with the normal group,the medullary thrombocytogenous megakaryocytes were significantly decreased(P<.05,.01,.001).(3)The APS-injected sites and other parts of the model mice had spontaneous hemorrhage.(4)Behavioral changing signs were observed 1 week after the modeling(i.e.low activity,delayed activity,poor appetite,skin petechia/hemorrhage and spontaneous hemorrhage at the injected sites or other parts),and were getting more and more severe.Conclusion:According to the syndrome differentiation criteria for disease-syndrome combined model of ITP,the APS-injected animal model of ITP replicated through the passive immune modeling method without additional conditions possesses the characteristics of disease-syndrome combined model.It provides an ideal tool for the development of traditional Chinese medicine pharmacology experiment.

Metabonomic phenotype and identification of “heart blood stasis obstruction pattern” and “qi and yin deficiency pattern” of myocardial ischemia rat models

The traditional Chinese medicine concepts of "Xinxueyuzuzheng (heart blood stasis obstruction pattern)" and "Qiyinliangxuzheng (qi and yin deficiency pattern)" for myocardial ischemia rat models were constructed in the present study. Endogenous metabolites in rat plasma were analyzed using the GC/TOF-MS-based metabonomic method. Significant metabolic differences were observed between the control and two model groups, and the three groups were distinguished clearly by pattern recognition. Compared with those of the control, the levels of hydroxyproline, threonic acid, glutamine and citric acid were strikingly up or down-regulated in model rats. The metabolites contributing most to the classification between the two "pattern" rats were identified, such as valine, serine, threonine, ornithine, hydroxyproline, lysine, 2-hydroxybutanoic acid, 3-hydroxybutanoic acid, galactofuranose and inositol. These compounds were indicated as the potential biomarkers. The results suggested that the two "patterns" are involved in dysfunction in oxidative stress, energy metabolism and amino acid metabolism. These findings also provided the substantial foundation for exploring the scientific connotation of these two "Zhengxing (pattern types)" of myocardial ischemia, and "Bianzheng (pattern identification)".

Chinmedomics facilitated quality-marker discovery of Sijunzi decoction to treat spleen qi deficiency syndrome

Sijunzi decoction (SJZD) is a Chinese classical formula to treat spleen qi deficiency syndrome (SQDS) and has been widely used for thousands of years.However,the quality control (QC) standards of SJZD are insufficient.Chinmedomics has been designed to discover and verify bioactive compounds of a variety of formularapidly.In this study,we used Chinmedomics to evaluate the SJZD's efficacy against SQDS to discover the potential quality-markers (q-markers) for QC.A total of 56 compounds in SJZD were characterized in vitro,and 23 compounds were discovered in vivo.A total of 58 biomarkers were related to SQDS,and SJZD can adjust a large proportion of marker metabolites to normal level and then regulate the metabolic profile to the health status.A total of 10 constituents were absorbed as effective ingredients that were associated with overall efficacy.We preliminarily determined malonyl-ginsenoside Rb2 and ginsenoside Ro as the q-markers of ginseng;dehydrotumulosic acid and dihydroxy lanostene-triene-21-acid as the q-markers of poria;glycyrrhizic acid,isoglabrolide,and glycyrrhetnic acid as the q-markers of licorice;and 2-atractylenolide as the q-marker of macrocephala.According to the discovery of the SJZD q-markers,we can establish the quality standard that is related to efficacy.

Effects of different doses of ginger-partitioned moxibustion on trefoil factor 1,mucin 5AC and epidermal growth factor receptor in rats with spleen deficiency syndrome

To observe the effects of different doses of ginger-partitioned moxibustion on serum trefoil factor 1 （TFF1） and mucin 5AC （MUCSAC） levels, as well as the expression of epidermal growth factor receptor （EGFR） in gastric mucosa of rats with spleen deficiency syndrome, therefore, to explore the possible mechanism and the dose-effect characteristics of ginger-partitioned moxibustion in spleen deficiency syndrome. Methods： Seventy-five SPF grade Sprague-Dawley （SO） rats were randomly divided into a blank control group （group A）, a model group （group B）, a 3 moxa-cone ginger-partitioned moxibustion group （group C1）, a 6 moxa-cone ginger-partitioned moxibustion group （group C2） and a 9 moxa-cone ginger-partitioned moxibustion group （group C3） using random number table method, 15 rats in each group. Except group A, rats in the other groups received intragastric administration of 4 ~C 200% concentrated Da Huang （Radix et RhizomaRhei） to prepare spleen deficiency syndrome model. After successful modeling, rats in group B received no treatment; rats in group C1, C2 and C3 were treated with 3, 6 and 9 moxa-cone ginger-partitioned moxibustion at Zusanli （ST 36）and Zhongwan （CV 12） respectively for 8 continuous days. The general symptom score of rats was observed. The serum levels of TFF1 and MUC5AC were detected by enzyme-linked immunosorbent assay （ELISA）. The expression of EGFR protein in gastric mucosa was detected by immunohistochemistry. Results： After the treatment, compared with group A, the spleen deficiency symptom score was increased in group B, the levels of serum TFF1 and MUC5AC, the EGFR protein expression in gastric tissues of group C1, C2 and C3 were significantly increased （all P〈0.01）; compared with group B, the spleen deficiency scores were decreased in group C1, C2 and C3, and the serum levels of TFF1 and MUC5AC, as well as EGFR protein expression in gastric tissues were increased （all P〈0.01）. Compared with group C1, the spleen deficiency scores were decreased in group C2 and C3, the serum levels of TFF1 and MUC5AC, and the expression of EGFR protein in gastric tissues were increased （all P〈0.01）, however, there was no significant difference between group C2 and C3 （all P〉0.05）. The mechanism may be related to the increase of serum TFF2 and MUC5AC levels and activation of EGFR protein. Conclusion： Ginger-partitioned moxibustion can improve the symptoms, as well as promote the proliferation and repair of gastric mucosa in rats with spleen deficiency. The therapeutic efficacy of 6 or 9 moxa-cone ginger-partitioned moxibustion is better than that of 3 moxa-cone ginger-partitioned moxibustion, while the efficacies are equivalent between 6 and 9 moxa-cone Ringer-Dartitioned moxibustion groups.

Effect of herbal cake-partitioned moxibustion on MEK1/2 and ERK1/2 expressions of gastric tissues in rats with spleen deficiency syndrome

Objective： To observe the effect of herbal cake-partitioned moxibustion on the expressions of mitogen-activated protein kinase （MEK：1/2） and extracellular regulatory protein kinase （ERK：1/2） in gastric tissues of rats with spleen deficiency syndrome, and to explore the possible mechanisms of herbal cake-partitioned moxibustion in treating spleen deficiency syndrome. Methods： Sixty Sprague-Dawley （SD） rats were randomly divided into a blank control group （group A）, a model group （group B）, a ranitidine group （group C）, and a herbal cake-partitioned moxibustion group （group D） by random digit, 15 rats in each group. Rat models of spleen deficiency syndrome were made by intragastric administration of 4℃ 200% concentrated Da Huang （Radix et Rhizoma Rhei）. After successful modeling, the rats in group C were treated with 25 mg/（kg.bw） ranitidine by intragastric adminstration and rats in group D were treated with herbal cake-partitioned moxibustion at Zusanli （ST 36） and Zhongwan （CV 12）, for 8 d. Excepted for rats in group A, all the other rats were treated with indomethacin at 5 mg/（kg.bw） at 8：00 a.m. on the second day after finishing all the intervention and sacrificed 7 h later to isolate the stomach. Histopathological changes of the gastric tissues were observed under light microscope after hematoxylin-eosin （HE） staining. The protein expressions of MEK：1/2 and ERK：1/2 in the gastric tissues were detected by immunohistochemistry. Results： After intervention, the gastric mucosal injury in group B was significantly severer than that in group A, with large breakage and ablating; the damage of gastric mucosa was decreased in group C compared with group B; the gastric mucosal surface remained relatively complete, and the status of breakage and ablating was significantly improved. After intervention, compared with group A, the protein expressions of MEK：1/2 and ERK：12 in gastric tissues of the other groups were significantly higher （P〈0.01）. Compared with group B, the protein expressions of MEK：1/2 and ERK：1/2 in group C and D were significantly higher （all P〈0.01）. Compared with group C, the protein expressions of MEK：1/2 and ERK：1/2 in group D were significantly higher （P〈0.01）. Conclusion： Herbal cake-partitioned moxibustion promotes the repair of gastric mucosa in rats with spleen deficiency syndrome, via improving protein expressions of MEK：1/2 and ERK：1/2 in gastric tissues, as well as activating MEK/ERK signaling pathway.

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。

参苓白术散加减治疗肺脾气虚津亏干燥综合征疗效及对Toll样受体4/核因子-κB水平的影响

目的探究参苓白术散加减治疗肺脾气虚津亏干燥综合征的疗效及对血清Toll样受体4(TLR4)和核因子-κB(NF-κB)水平的影响。方法选取2019年3月—2022年3月收治的107例干燥综合征患者为研究对象,采用信封法从密封箱子抽取带有数字的纸团,大于等于54的号码为观察组,小于54的号码为对照组。观察组54例,对照组53例。对照组给予硫酸羟氯喹片、甲泼尼龙片治疗,观察组在此基础上联合使用参苓白术散加减治疗。观察两组患者治疗前后中医证候评分、疾病活动指数(ESSDAI)和自我报告指数(ESSPRI)评分、γ-干扰素(IFN-γ)、白介素-17(IL-17)、免疫功能(CD_(8)^(+)、CD_(4)^(+)和CD^(+)_(4/)CD_(8)^(+))、血清TLR4和NF-κB水平。观察两组患者临床疗效。结果治疗前两组患者两目干涩、关节疼痛、口燥咽干、皮肤干燥、体倦乏力和唾液腺肿评分差异无统计学意义(P>0.05)。治疗后观察组两目干涩、关节疼痛、口燥咽干、皮肤干燥、体倦乏力和唾液腺肿评分显著低于对照组(P<0.05)。治疗前两组患者ESSDAI和ES⁃SPRI评分差异无统计学意义(P>0.05)。治疗后观察组ESSDAI和ESSPRI评分显著低于对照组(P<0.05)。治疗前两组患者IFN-γ、IL-17水平差异无统计学意义(P>0.05)。治疗后观察组IFN-γ、IL-17水平显著低于对照组(P<0.05)。两组患者治疗前CD_(4)^(+)、CD_(8)^(+)、CD_(4)^(+)/CD^(+)8水平差异无统计学意义(P>0.05)。治疗后观察组的CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平较对照组显著升高,而CD^(+)8水平较对照组显著降低(P<0.05)。两组患者治疗前TLR4/NF-κB水平差异无统计学意义(P>0.05)。治疗后观察组TLR4/NF-κB水平较对照组显著降低(P<0.05)。观察组总有效率为96.30%(52/54),显著高于对照组的84.91%(45/53)(χ^(2)=4.096,P=0.043)。结论参苓白术散加减能有效提高干燥综合征患者临床疗效、降低ESSDAI和ESSPRI评分、改善TLR4/NF-κB的水平,有利于提高患者免疫力。

HIV/AIDS肺脾气虚证相关心脑血管疾病风险因素探析

目的通过检测血脂四项、血管内皮损伤因子、炎症相关因子,并结合前期的基因芯片结果,初步探讨人类免疫缺陷病毒(HIV)/艾滋病(AIDS)肺脾气虚证相关心脑血管疾病风险因素及机制,为中医药早期干预心脑血管疾病提供依据。方法2020年9月—2020年11月选取河南省某地区确诊的20例HIV/AIDS肺脾气虚证患者作为研究对象,同地区20例HIV抗体阴性作为健康对照组。检测CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)计数,并计算CD_(4)^(+)/CD_(8)^(+)比值;检测血脂四项甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C);检测氧化低密度脂蛋白(Ox-LDL)、载脂蛋白A-I(ApoAⅠ)、载脂蛋白A-Ⅱ(ApoAⅡ)、载脂蛋白B(ApoB)、锌-α2-糖蛋白1(AZGP1)、可溶性血栓调节蛋白(sTM)、血管性血友病因子(vWF)、脂联素、瘦素(LEP)、超敏C反应蛋白(Hs-CRP)、单核细胞趋化因子1(MCP-1)、肿瘤坏死因子α(TNF-α)。结果HIV/AIDS肺脾气虚证患者与健康对照组比较CD_(4)^(+)降低,CD_(4)^(+)/CD_(8)^(+)比值倒置,TC降低,sTM、AZGP1、Ox-LDL、Hs-CRP升高。结论HIV/AIDS肺脾气虚证患者存在炎性反应、血脂异常的表现,罹患心脑血管疾病风险增加。为中医药早期干预心脑血管疾病的发生提供新思路。

参杞强精颗粒对慢性疲劳综合征脾肾阳虚证大鼠免疫调节作用研究

目的:探讨参杞强精颗粒对慢性疲劳综合征(CFS)脾肾阳虚证模型大鼠的影响以及免疫调节作用。方法:将50只无特定病原体(SPF)级健康雄性斯泼累格·多雷(SD)大鼠随机分为正常对照组,模型对照组,参杞强精颗粒高剂量组、中剂量组、低剂量组,采用游泳力竭实验造成大鼠体力疲劳,慢性束缚应激造成大鼠心理疲劳,同时给予番泻叶煎煮液灌胃造成脾肾阳虚证候,构建CFS脾肾阳虚证大鼠模型,造模成功后分别按照各组剂量灌胃,连续给药21 d后,测定各组大鼠的胸腺和脾脏指数,酶联免疫吸附试验(ELISA)检测血清免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、免疫球蛋白A(IgA)浓度以及细胞因子白细胞介素2(IL-2)、白细胞介素6(IL-6)和γ干扰素(IFN-γ)含量,MTT法检测脾脏T、B淋巴细胞增殖能力,流式细胞法检测各组大鼠外周血T淋巴细胞亚群分布情况。结果:行为学结果显示,模型大鼠的体质量增长缓慢,精神萎靡,摄食水量减少,活动减少,便质稀软,力竭游泳时间减少,悬尾静止时间增加。药物干预后,与模型组比较,各给药组大鼠精神状态、体质量、摄食水量均显著改善,力竭游泳时间增加、悬尾静止时间减少(P<0.01或P<0.05);参杞强精颗粒各剂量组能显著提升大鼠胸腺和脾脏指数,提高IgG、Ig M、IgA浓度和IL-2、IL-6、IFN-γ的含量,显著提高脾脏T、B淋巴细胞增殖能力,也能提高CD3+、CD4+T淋巴细胞百分率和CD4+/CD8+T比值,降低CD8+T淋巴细胞百分率,差异有统计学意义(P<0.01或P<0.05)。结论:参杞强精颗粒能显著改善慢性疲劳综合征脾肾阳虚证大鼠免疫功能,缓解疲劳症状,且具有很好的免疫调节作用。

基于脾火论辨治原发性干燥综合征

基于脾火论辨治原发性干燥综合征(pSS)。论述了脾火论的理论内涵,并区分脾火与阴火及其他脏腑之火的差异。阐释了脾火论与pSS的相关性,认为脾气亏虚,运化无权,脾不升清,郁而化火是pSS病机关键;久而病及他脏,导致络脉瘀滞是pSS的病机转化特点。以健脾益气,除火润燥,生津通络为pSS的治疗大法,为pSS的中医辨治提供思路与方法。

益胃宁胶囊联合瑞巴派特片治疗慢性萎缩性胃炎脾胃气虚证临床研究

目的观察益胃宁胶囊联合瑞巴派特片治疗慢性萎缩性胃炎(CAG)脾胃气虚证的临床疗效。方法采用随机数字表法将80例CAG患者分为研究组和对照组各40例,2组均予瑞巴派特片,0.1 g/次,每日3次,口服;研究组在此基础上予益胃宁胶囊,2 g/次,每日3次,口服。2组均连续治疗12周。观察2组治疗前后中医疗效、胃镜疗效和病理疗效,比较2组治疗前后中医症状评分,监测2组不良反应。结果2组均无病例脱落。研究组中医疗效总有效率为92.5%(37/40),对照组为70.0%(28/40),研究组中医疗效优于对照组(P<0.01)。与本组治疗前比较,2组治疗后中医症状总分下降(P<0.05,P<0.01);2组治疗后比较,研究组中医症状总分低于对照组(P<0.01)。研究组胃镜疗效总有效率(82.5%)优于对照组(67.5%),研究组病理疗效总有效率(87.5%)优于对照组(70.0%),差异均有统计学意义(P<0.05,P<0.01)。2组未见明显不良反应。结论益胃宁胶囊联合瑞巴派特片可有效改善CAG患者的临床症状、胃镜表现及黏膜病变程度,疗效显著。

脾虚泄泻模型大鼠肠组织结构及分泌型免疫球蛋白A含量变化研究

为研究脾虚泄泻大鼠肠道结构和肠道分泌型免疫球蛋白A的变化,试验选取24只健康SD大鼠,雌雄各半,随机分为脾虚泄泻模型组和空白对照组,在不同阶段采用“饮食失调+苦寒泻下”的方法人工复制大鼠脾虚泄泻模型,连续14 d监测大鼠的采食量、饮水量、精神状态、粪便等临床特征变化,记录第7天和第14天时大鼠的空腹体质量,采集小肠组织进行结构观察,并测定盲肠内容物中分泌型免疫球蛋白A的含量。结果表明,与空白对照组相比,模型组大鼠在试验期间出现粪便稀溏、食欲下降、消瘦、蜷缩扎堆、精神萎靡等临床症状;与空白对照组相比,模型组大鼠的体质量显著降低(P<0.05);模型组大鼠十二指肠绒毛高度,空肠隐窝深度、绒毛高度、绒毛宽度,回肠隐窝深度和绒毛宽度均显著低于空白对照组(P<0.05);模型组大鼠十二指肠隐窝深度、绒毛宽度及回肠绒毛高度均极显著低于空白对照组(P<0.01);模型组大鼠小肠不同段的绒毛高度与隐窝深度比值均低于空白对照组,但差异不显著(P>0.05);模型组大鼠盲肠内容物中sIgA含量极显著低于空白对照组(P<0.01)。结果提示,本试验成功建立了脾虚泄泻大鼠模型,脾虚泄泻可损伤大鼠小肠黏膜结构并降低盲肠中sIgA含量。

四君子汤调控AMPK-SIRT1蛋白改善运动性疲劳小鼠学习记忆的机制研究

目的:观察四君子汤对运动性疲劳(EF)小鼠AMPK/SIRT1信号通路的影响,并探讨其改善EF认知损伤和学习记忆能力的机制。方法:将60只C57BL/6小鼠随机分为空白组、模型组、四君子汤高剂量组、四君子汤中剂量组、四君子汤低剂量组。除空白组外,其他各组小鼠构建脾气虚证EF小鼠模型。四君子汤高、中、低剂量组小鼠分别给予不同浓度的四君子汤灌胃,空白组和模型组以等体积蒸馏水灌胃,各组连续灌胃4周。采用Morris水迷宫实验评估小鼠的认知功能,采用ELISA法检测小鼠血清中乳酸、血糖、肝糖原、肌糖原的水平,Western Blot法检测小鼠脑组织中AMPK和SIRT1的蛋白表达量。结果:实验后,模型组小鼠体质量、摄食量、血糖、肝糖原含量、肌糖原含量、目标象限游泳时间、穿越平台次数、AMPK蛋白表达量、SIRT1蛋白表达量低于空白组,血清乳酸水平高于空白组(P<0.05)。给药干预后,四君子汤高、中、低剂量组小鼠体质量、摄食量、力竭游泳时间、肝糖原含量、肌糖原含量、目标象限游泳时间、穿越平台次数高于模型组,血清乳酸水平低于模型组(P<0.05)。四君子汤高剂量小鼠游泳力竭时间高于低剂量组,乳酸水平低于低剂量组(P<0.05)。四君子汤高、中剂量组肝糖原、肌糖原含量高于低剂量组(P<0.05)。与模型组比较,四君子汤高、中剂量组AMPK及SIRT1蛋白表达量增多(P<0.05),四君子汤低剂量组SIRT1蛋白表达量增多(P<0.05)。与四君子汤低剂量组比较,四君子汤高、中剂量组AMPK及SIRT1蛋白表达量增多(P<0.05)。结论:四君子汤可在一定程度调控AMPK/SIRT1的活性,进而改善EF小鼠脾虚症状。

从“内伤脾胃,百病由生”探析糖尿病泌汗异常

《脾胃论》提出了“内伤脾胃,百病由生”的认识,以此为理论基础探讨糖尿病泌汗异常病机演变及辨证治疗。认为本病的发展为饮食劳役,先伤脾胃,导致元气亏损,阴火上行,进而营卫失和,阳损及阴,致汗出异常。治疗上应当注重糖尿病的治疗,兼顾汗证。食疗为先,重用甘味,补阳泻火,平衡气火。明确糖尿病泌汗异常与中焦脾胃功能的密切关系,以期提高临床辨证论治疗效。