Observation on Curative Effect of Self-made Wubeizi Decoction Combined with rhaFGF in Promoting Postoperative Wound Healing in Patients with Anal Fistula

[Objectives]To explore the curative effect of Self-made Wubeizi Decoction combined with recombinant human acidic fibroblast growth factor(rhaFGF)in promoting postoperative wound healing in patients with anal fistula.[Methods]A total of 82 patients with anal fistula who underwent anal fistula resection+use of setons in Luodian Hospital during January and March of 2020 were randomly divided into observation group and control group with 41 cases in each group.The control group was given rhaFGF external application regimen,and the observation group was treated with Self-made Wubeizi Decoction on the basis of the control group.After 3 weeks of treatment,the differences in curative effects of TCM syndromes were compared between the two groups.Besides,the changes in TCM symptom scores,inflammatory mediators[interleukin-12(IL-12),tumor necrosis factor-α(TNF-α),interferon-γ(IFN-γ)],anorectal functions[anal resting pressure(ARP),maximal systolic pressure(MSP)and maximum tolerated volume(MTV)of the anal canal],quality of life[GQOLI-74 scores]were compared.[Results]After 3 weeks of treatment,the total effective rate of the observation group was significantly higher than that of the control group(P<0.05);the levels of TCM symptom scores,IL-12,TNF-α,IFN-γ,ARP,MSP,and MTV in both groups were significantly lower than those before treatment,and these levels in the observation group was significantly lower than that in the control group at the same time(P<0.05).The GQOLI-74 scores of both groups were significantly higher than those before treatment,and the observation group was significantly higher than the control group(P<0.05).[Conclusions]The Self-made Wubeizi Decoction combined with rhaFGF therapy has a significant effect in promoting postoperative wound healing in patients with anal fistula.It can effectively inhibit the local inflammation of patients,facilitate the recovery of anorectal function and improve the quality of life,thus has high clinical application value.

Protective Effects of Self-made Compound Taoren Danshen Decoction on Rats with Acute Liver Injury

[Objectives] To study the protective effects of self-made Compound Taoren Danshen Decoction( CTDD) on acute liver injury induced by D-galactosamine in rats,and to explore its mechanism. [Methods]An acute liver injury model was established by intraperitoneal injection of 500 mg/kg of D-galactosamine. The ALT,AST,MDA,SOD and GSH-Px in serum,as well as serum TNF-α,IL-1β and IL-6 levels were measured,and liver tissue lesions were observed under microscope. [Results] CTDD can significantly reduce ALT,AST and MDA levels,increase SOD,GSH-Px activity,and significantly reduce serum TNF-α,IL-1β and IL-6 levels,and improve liver tissue lesions.[Conclusions]CTDD has a protective effect on D-galactosamine-induced acute liver injury in rats,and its mechanism may be related to inhibition of oxidative stress and inflammatory reaction.

益气温阳化瘀法对糖尿病肾病大鼠肾脏蛋白激酶C活性的影响

目的:探讨益气温阳化瘀法之肾消方对糖尿病肾病大鼠肾脏蛋白激酶C活性的影响。方法:单肾切除加链脲佐菌素(STZ)腹腔注射制作糖尿病肾病动物模型。分别予以中药肾消方和厄贝沙坦干预治疗16周,测定大鼠肾组织PKC活性,检测24 h尿蛋白排出量(Upro),肾脏常规染色光镜观察病理变化。结果:16周时单肾糖尿病大鼠肾组织出现肾小球硬化病理改变,Upro明显升高,细胞膜PKC活性(mPKC)明显升高,细胞浆PKC活性(cPKC)明显降低,mPKC和cPKC比值(M/C)明显升高。肾消方和厄贝沙坦干预治疗显著降低Upro,降低mP-KC和M/C,升高cPKC(P<0.01),改善肾组织病理改变。结论:肾消方对单肾切除STZ糖尿病大鼠具有肾保护作用,可通过抑制PKC的活性进而延缓DN的发生。

肾消通络方对糖尿病肾病大鼠肾脏TGF-β1/Smad信号传导通路的影响

目的:探讨肾消通络方对糖尿病肾病大鼠TGF-β1/Smad信号传导通路的影响。方法:将实验动物分为正常组、模型组、厄贝沙坦组及中药组4组,免疫组化法测定肾组织TGF-β1蛋白表达,RT-PCR法测定TGF-β1mRNA表达,Western blot法测定Smad2/3及Smad7的表达。结果:中药组和厄贝沙坦组TGF-β1蛋白的表达水平较模型组有所降低,TGF-β1 mRNA水平明显低于模型组,Smad2/3水平明显低于模型组,Smad7水平明显高于模型组。结论:肾消通络方可抑制TGF-β1mRNA及其蛋白的表达,同时抑制Smad2/3表达而提高Smad7的表达。

基于吕仁和“肾络微型癥瘕”理论治疗糖尿病肾脏病体悟

糖尿病肾脏病是由糖尿病引起的一种慢性肾脏病,中西医结合治疗在改善患者症状、减少尿蛋白、保护肾功能、延缓疾病进展方面具有明显优势,国医大师吕仁和教授创立了“肾络微型癥瘕”理论,以该理论为指导的芪蛭肾消汤,运用活血化瘀、消癥散结、平补气血阴阳之法,选择通肾络的靶向药即虫类药,收到满意效果。

从肝主疏泄辨治杂病

肝主疏泄,疏可使气运行通而不滞;泄可使气散而不郁,调畅全身气机运行;肝失疏泄,气机运行不畅则可致多种疾病。气是构成和维持人体生命活动的最基本物质。"百病生于气",疾病多因脏腑经脉气机失调。消化系统可见胃黏膜糜烂,肝气疏泄失常,气血运行不畅,胃部黏膜失养而出现糜烂,治以逍遥散或丹栀逍遥散化裁;情志不畅还可引发胆汁排泄障碍,出现胆系疾病,治以疏肝利胆、养肝柔肝,小柴胡汤。妇科疾病如乳腺增生、子宫肌瘤与情绪失调密切相关,肝在女子生理、病理中的重要作用,应激能力失常,导致乳腺增生或子宫肌瘤,治以逍遥散、神效瓜蒌散、当归芍药散。内分泌受下丘脑中枢神经系统调节,情志不遂可导致内分泌失常,发生糖尿病、甲状腺结节等,治疗注重疏肝、调肝、柔肝、养肝,乌梅丸、柴胡舒肝散。从肝论治,紧抓肝失疏泄这一病机,以疏肝解郁为法,则气血调和,经络通利,诸病得治。

肾消通络方对db/db小鼠肾脏的保护作用及对CD31表达的影响

目的:研究肾消通络方对db/db小鼠肾脏的保护作用及其对CD31表达的影响。方法:将30只6周龄雄性db/db小鼠随机分为模型组、肾消通络组和坎地沙坦组,每组10只;以10只同源不发病db/m小鼠作为对照组。给药共计8周,于第8周末收集24h尿液,采血并留取肾脏组织。检测24h尿蛋白、血肌酐及尿素氮含量,观察肾脏的病理改变情况,采用免疫组化法检测血管内皮细胞标记物CD31在肾小球中的表达,并分析CD31的表达与24h尿蛋白的相关性。结果:与对照组比较,模型组小鼠体质量增加,血糖升高,尿蛋白、血肌酐、血尿素氮含量及CD31表达显著增高(P<0.01);与模型组比较,肾消通络组、坎地沙坦组的体质量、尿蛋白、血肌酐、血尿素氮含量及CD31的表达均明显降低(P<0.05),而血糖无明显变化,病理损伤明显改善,两组间差异无统计学意义。相关性分析结果显示,CD31表达与24h尿蛋白呈正相关。结论:肾消通络方可显著降低db/db小鼠的24h尿蛋白含量、血肌酐及尿素氮,改善肾功能,并降低CD31的表达,减轻肾组织病理改变,从而发挥肾脏保护作用。

基于RUNX3/Smad3信号通路研究肾消方治疗自发性糖尿病肾脏疾病db/db小鼠肾纤维化的机制

目的:观察肾消方对自发性糖尿病肾脏疾病(DKD)db/db小鼠肾小球系膜细胞RUNX3与肾脏纤维化的影响,探讨RUNX3与DKD的关系。方法:选取12只C57BL/KsJ-+/db雄性小鼠作为正常组,60只db/db小鼠造模成功后随机分成模型组、肾消方组、补益中气组、通利三焦组和厄贝沙坦组,每组12只。药物干预12周后全自动生化仪检测肾功能相关的参数,PAS染色观察肾脏病理变化,免疫荧光观察RUNX3在细胞中的分布,Western Blot法测定肾脏中RUNX3/Smad3信号通路关键蛋白表达情况。结果:与正常组比较,模型组小鼠24h进食量、体质量、空腹血糖、糖化血红蛋白、尿肌酐、尿素氮、尿微量白蛋白/尿肌酐、p-Smad3、H3K9me2、E-cadherin表达水平显著上升(P<0.01),而RUNX3、H3K27me3表达水平显著下降(P<0.01)。与模型组比较,肾消方组和拆方组小鼠RUNX3(补益中气组除外)、H3K27me3、尿肌酐表达水平显著上升(P<0.01,P<0.05),H3K9me2、E-cadherin、p-Smad3表达水平均显著下降(P<0.01)。结论:肾小球系膜细胞RUNX3在自发性糖尿病db/db小鼠的表达与DKD密切相关,在肾消方的干预下可以延缓糖尿病小鼠的肾脏结局。

巴元明运用自拟肾消汤治疗糖尿病肾病经验

糖尿病肾病是糖尿病最常见的并发症之一,临床表现主要为蛋白尿、高血压和肾功能进行性损伤、水肿等,严重者可形成肾病综合征,最终发展为慢性肾功能不全、尿毒症,其发病隐匿、机制复杂,具有迁延不愈的特点,巴元明教授认为其中医病机为气阴两虚,久病入络,毒损肾络,临床中运用自拟肾消汤治疗本病,疗效显著,现将巴教授运用自拟肾消汤治疗糖尿病肾病的经验介绍如下。