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.

Qingfei Paidu Decoction for COVID-19: A Bibliometric Analysis

Traditional Chinese medicine(TCM)has been used for thousands of years in fighting epidemics and has achieved remarkable therapeutic effects[1].The coronavirus disease 2019(COVID-19)pandemic has been effectively controlled in China under a series of policies.

Analysis of Clinical Effect of Wumen Qingyi Decoction on Acute Pancreatitis

[Objectives]To examine the effects of Wumen Qingyi Decoction on inflammatory responses in patients with acute pancreatitis(AP).[Methods]Eighty patients with mild or severe AP were randomly allocated to a treatment group(Wumen Qingyi Decoction+baseline treated)or a control group(baseline treated).All patients were managed conservatively.In addition,the Group A received Wumen Qingyi Decoction for 400 mL/d for 7 d.Laboratory parameters,condition of disease and therapeutic effect indexes,and so on,between the two groups were compared.[Results]The recovery of serum levels of amylase(AMS),C reaction protein(CRP),and tumor necrosis factor(TNF-α),interleukin1(IL-1),IL-6,IL-10,as well as the scores of Balthazar and BISAP in Treatment group were quicker than those in Control group(P<0.05).In addition,the improvement of organic dysfunction in Treatment group was better than that in Control group.[Conclusions]The course of combined Wumen Qingyi Decoction and basic treatment of western medicine could effectively adjust the body's inflammatory response to promote the recovery process of acute pancreatitis.

Echocardiographic Evaluation of Qiangxin Decoction Combined with Cardiac Resynchronization Therapy for Patients with Chronic Heart Failure

OBJECTIVE: To explore the echocardiographic evaluation of patients with chronic heart failure (CHF) after Qiangxin Decoction combined with cardiac resynchronization therapy. METHODS: A total of 140 CHF patients admitted to our hospital were randomly divided into combined group (Qiangxin Decoction and cardiac resynchronization, n = 70) and routine group (cardiac resynchronization, n = 70), and they were treated for 2 courses (16 weeks), with 8 weeks as a course. The improvement of heart function classification (HYHA) was observed before and after treatment, and the therapeutic effects were evaluated according to the improvement of heart function classification (markedly effective, effective, invalid, and worsening). The traditional Chinese medicine (TCM) diagnostic criteria was the main symptoms (0 to 6 points), secondary symptoms (0 to 3 points), tongue picture (0 to 1 point) and pulse condition (0 to 1 point), and the higher the score was, the more obvious the symptoms were. The left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular ejection fraction (LVEF) and cardiac output (CO) were observed and recorded according to the heart color ultrasound before and after treatment. And the Minnesota Living with Heart Failure Questionnaire (MLHFQ) was used to evaluate the life quality before and after treatment, and the highest score of the scale was 105 points. The higher the score was, the obvious the symptoms were, and the worse the life quality was. And the adverse reactions were recorded in the 2 groups. RESULTS: After the treatment, the total effective rate in the routine group was significantly lower than that in the combined group (75.71% vs . 94.30%), and there was statistically significant difference (P < 0.05). After the treatment, the TCM syndrome score in the routine group was higher than that in the combined group ((14.37±3.59) points vs.(10.53±3.11) points), and there was statistically significant difference (P < 0.05). After the treatment, the levels of LVEDD and LVESD in the routine group were higher than those in the combined group, and there were statistically significant differences (P < 0.05). The levels of LVEF and CO in the routine group were lower than those in the combined group, and there were statistically significant differences (P < 0.05). After the treatment, the score of MLHFQ scale in the routine group was higher than that in the combined group ((57.38±8.53) points vs.(46.39±7.14) points), and there was statistically significant difference (P < 0.05). CONCLUSION: Qiangxin Decoction combined with cardiac resynchronization therapy has good echocardiographic evaluation in patients with chronic heart failure.

Mechanism of Shugan Lidan decoction in treating chronic calculous cholecystitis

Chronic calculous cholecystitis is a common clinical medical disease,which is classified as"hypochondriac pain"in traditional Chinese medicine(TCM).It is caused by liver failure and stagnation of liver qi.Therefore,the method of Soothing the liver and promoting bile flow is often used for regulating and harmonizing qi and blood.This paper discusses its mechanism of action,and points out that Shugan Lidan decoction has great effect on the treatment of chronic calculous cholecystitis,especially in the early treatment of the disease and delaying the progress of the disease,which provides help for the clinical treatment of chronic calculous cholecystitis.

Clinical observation of Guipi Decoction Combined with non steroidal drugs on sleep in elderly patients with acute traumatic pain and Qi deficiency constitutionabortion

Objective:To explore the effect of Guipi Decoction Combined with non steroidal anti-inflammatory drugs on sleep time of elderly patients with traumatic pain and Qi deficiency constitution during hospitalization.Methods:A total of 52 elderly patients hospitalized in the orthopedic(trauma)ward of the Second Affiliated Hospital of Zhejiang Chinese Medical University from November 2020 to may 2021 were randomly divided into control group and treatment group.Patients in the control group were treated with loxoprofen sodium tablets immediately after admission,and placebo was added to loxoprofen sodium tablets from the second day of admission;The patients in the treatment group were treated with loxoprofen sodium tablets after admission.Guipi Decoction was added on the basis of loxoprofen sodium tablets from the second day of admission.Before and after admission,all patients used the TCM constitution classification judgment table to evaluate the score of qi deficiency and VAS;From the first day to the fourth day after admission,the bracelet was worn to monitor the sleep time(total sleep time,deep sleep time,light sleep time and awakening times)every night.The patients were scored by VAS after taking drugs every morning.Results:Finally 25 patients in the control group and 24 patients in the treatment group completed the experiment.There was no significant difference in gender,age,fracture location,chronic medical history VAS score and TCM Qi deficiency constitution score,between two groups at admission(P>0.05).At the time of discharge,the score of qi deficiency constitution in the treatment group was 33.724±12.634;The TCM Qi deficiency constitution score of the control group was 42.25±15.912,and there was significant difference between the two groups(P<0.05);and there was significant difference in VAS score between the two groups at discharge(P<0.05).There were significant differences in total sleep time,light sleep time,deep sleep time and night awakening times between the two groups on the second,third and fourth day of admission(P<0.05).Conclusion:1.Guipi Decoction can significantly improve the sleep time of patients with Qi deficiency acute traumatic pain.2.Guipi Decoction can not only improve the constitution of patients with Qi deficiency bias,but also improve the VAS score at discharge.

国医大师熊继柏治疗失眠的方药规律分析

目的对国医大师熊继柏教授治疗失眠的病案进行数据挖掘,分析熊继柏教授诊治失眠的用方、用药经验。方法基于中医传承辅助平台软件(V3.5),归纳和分析熊继柏教授在湖南中医药大学第一附属医院治疗失眠患者的门诊病历数据,利用该平台软件的关联规则、复杂系统熵聚类等统计方法进行数据挖掘和分析,总结药物的性味、归经、应用频次、药对组合及合方,对“证-症-方”“证-症-药”“证-方-药”进行关联,结合熊继柏教授对失眠病因病机、治则治法的认识,明确核心用药,探索其对失眠的诊治规律及遣方用药心得。结果通过总结分析,共纳入病历276份,处方中用药频次较多的有酸枣仁、龙齿、茯神、甘草,重在补虚安神;黄连、陈皮、竹茹、半夏、珍珠母、远志,重在清热化痰安神。用药性味偏甘、苦、辛,归经多为心、脾经。并归纳出虚证治疗常用合方为酸枣仁汤、枕中丹和甘麦大枣汤;因痰所致失眠治疗的主方为温胆汤及温胆汤类方(枣仁温胆汤、黄连温胆汤及十味温胆汤)。结论国医大师熊继柏治疗失眠以“补脾化痰清热,养血补肝宁心”为治疗原则,以温胆汤为基础进行加减化裁。

血府逐瘀汤治疗冠心病研究进展

冠心病是临床常见的心血管疾病之一,其发病率和病死率呈上升趋势,严重危害居民健康,加重国家经济负担。血府逐瘀汤有活血化瘀、理气止痛的功效,主治胸中血瘀证。临床上根据其功效常用于治疗血瘀证冠心病,并取得良好疗效。此文旨在对血府逐瘀汤治疗冠心病的临床运用、作用机制及研究进展展开探讨,为深入挖掘血府逐瘀汤临床及实验研究提供新思路。

基于网络药理学探讨中药复方龙牡汤治疗特应性皮炎的作用机制

目的利用网络药理学探索中药复方龙牡汤在特应性皮炎(Atopic dermatitis,AD)中的作用机制。方法从TCMSP、BATMAN-TCM数据库获取龙牡汤的活性成分及其所对应的药物靶点,构建药物靶点的蛋白质互作网络及功能富集分析。从GEO数据库下载有关特应性皮炎的普通转录组数据进行差异分析,通过GeneCards、DisGeNET数据库检索得到AD相关靶点。将药物靶点和疾病靶点取交集得到药效靶点,对药效靶点进行GO、KEGG富集分析,构建出“中药-活性成分-药效靶点-AD”网络。结果获得复方龙牡汤55种活性成分以及262个药物靶点以及AD的157个疾病靶点,交叉分析后得到龙牡汤治疗特应性皮炎的药效靶点10个。通过GO分析这10个药效靶点基因在内皮细胞凋亡过程的调控(Regulation of endothelial cell apoptotic process)、内皮细胞凋亡过程(Endothelial cell apoptotic process)、上皮细胞凋亡过程的调控(Regulation of epithelial cell apoptotic process)等通路上显著富集;KEGG分析药效靶点基因在TNF信号通路(TNF signaling pathway)、脂质与动脉粥样硬化(Lipid and atherosclerosis)、流体剪切应力和动脉粥样硬化(Fluid shear stress and atherosclerosis)等通路上显著富集。结论复方龙牡汤通过多个信号通路起效,其中CCL2、FOS、MMP9、IRF1、VCAM1与TNF信号通路显著正相关。

医院中药饮片入库质量分析与控制措施

目的 分析我院中药饮片入库验收存在的质量问题,探讨提高中药饮片质量的措施,保障临床用药安全。方法 汇总2019年1月~2022年12月我院HIS信息管理系统中药饮片入库验收记录共223 123批次,对2019年1月~2022年12月中药饮片拒收情况的数据运用Excel软件进行统计分析,整理归纳。结果 4年拒收不合格中药饮片2756批次,退货率为1.24%。退货原因主要为加工炮制不当、霉变、虫蛀、掺伪、采收不当、包装问题、送货问题等。结论 影响中药饮片质量的因素较多,我院利用中药饮片质量控制体系,提高了中药饮片入库质量,增强了我院临床用药安全和疗效,更好地服务患者。

基于中药监管科学创新技术体系破解国家中药类产品集中带量采购难点

在国家推动药品集中带量采购(以下简称集采)工作常态化背景下,中成药大品种在全国范围内的集采已经落地开展,中药饮片的省际联合采购也正在进行,而未来中药配方颗粒纳入集采也是大势所趋。然而,中药不同于化学药品,其原料来源于天然资源,组成成分复杂、功效主治多样,是一个多功效、多组分的复杂体系,加之中药类产品生产过程复杂,产品质量良莠不齐,生产成本相差悬殊,如何在中药类产品集采中科学评价产品质量,体现优质优价,以及如何科学评估中药类产品的生产成本,制定合理的最高限价,都是中药集采工作执行中亟待解决的难点问题。针对上述难点,笔者提出基于中药监管科学体系,创新制定中药类产品质量等级标准以及构建全产业链溯源与供应保障平台,从而确保中药类产品集采保质、提级、稳供、高质量发展的新思路。

化瘀去疣汤内服外用治疗对扁平疣患者中医证候、血清免疫球蛋白及复发的影响

目的:探讨化瘀去疣汤内服外用治疗对扁平疣患者中医证候、血清免疫球蛋白及复发的影响。方法:选取2021年8月~2023年8月收治的132例扁平疣患者,按照随机数表法分为观察组和对照组各66例,对照组采用常规药物治疗,观察组在对照组的基础上采用化瘀去疣汤内服外用治疗,比较两组临床疗效、中医证候积分(皮疹颜色、瘙痒感、身热口干、便干尿黄)、血清免疫球蛋白[IgG、IgA、IgM]、免疫细胞因子[IL-2、IL-10、IFN-γ]及复发率。结果:观察组总有效率高于对照组(P<0.05);治疗后,观察组的中医症候积分(皮疹颜色、瘙痒感、身热口干、便干尿黄)低于对照组(t=6.114;t=5.552;t=6.705;t=5.435,P<0.05);治疗后,观察组血清IgG、IgA、IgM水平高于对照组(t=4.056;t=3.630;t=5.918,P<0.05);治疗后,观察组血清IFN-γ、IL-2高于对照组,IL-10低于对照组(t=9.462;t=5.429;t=8.314,P<0.05);随访6个月,观察组复发率低于对照组(4.55%vs 16.67%,χ2=5.114,P<0.05)。结论:化瘀去疣汤内服外用治疗扁平疣患者的效果显著,可有效提高免疫球蛋白水平,改善免疫细胞因子,降低复发率。

滋肾通淋排石汤辅助治疗在肾结石术后患者中的应用及机制

目的探讨滋肾通淋排石汤辅助治疗在肾结石术后患者中的应用及机制。方法选取该院2021年2月—2022年2月收治的肾结石术后患者202例,按照随机数字表法分为对照组和观察组各101例。两组患者均给予常规的输尿管软镜碎石术进行治疗,术后给予对照组患者常规体位排石治疗,观察组患者在对照组基础上给予滋肾通淋排石汤联合进行治疗,两组均治疗2周。比较两组治疗后的临床疗效,治疗前后的中医证候积分、肾功能、炎性应激指标水平,不同时点的视觉模拟评分(visual analog scale,VAS)。结果治疗后观察组临床总有效率高于对照组;与治疗前比较,治疗后两组尿频、腰痛、少腹急满、血尿、淋漓不爽评分及血清β2微球蛋白(β2 microglobulin,β2-MG)、肌酐(serum creatinine,Scr)、中性粒细胞明胶酶相关脂质运载蛋白(neutrophil gelatinase-associated lipocalin,NGAL)、尿素氮(blood urea nitrogen,BUN)、白细胞介素-10(interleukin-10,IL-10)、超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、高迁移率族蛋白-1(high mobility group box-1 protein,HMGB1)、单核细胞趋化蛋白-1(monocyte chemoattractant protein-1,MCP-1)水平均降低,观察组低于对照组;与治疗前比较,治疗3 d~2周后两组VAS评分呈逐渐降低趋势,观察组低于对照组,差异均有统计学意义(均P<0.05)。结论滋肾通淋排石汤应用于肾结石术后患者,可以减轻疼痛,改善肾功能,抑制炎症反应和应激反应,提升临床治疗效果。

熄风活血化湿汤联合手法复位治疗良性阵发性位置性眩晕的效果观察

目的:探究熄风活血化湿汤联合手法复位治疗良性阵发性位置性眩晕(BPPV)的效果。方法:选取常州市武进中医医院2018年4月—2022年4月收治的BPPV患者86例,随机分为对照组和研究组,每组43例,对照组采用手法复位治疗,研究组在对照组基础上联合熄风活血化湿汤治疗。治疗2周后,比较两组患者的中医证候积分、疗效、眩晕及呕吐的发作频次,比较汉密尔顿焦虑/抑郁量表(HAMA/HAMD)评分和不良反应及并发症发生状况。结果:治疗后,两组主症、次症评分,出现眩晕、呕吐的发作频率,HAMA评分及HAMD评分均降低(P<0.01),研究组低于对照组(P<0.01)。研究组总有效率为97.67%(42/43),高于对照组81.40%(35/43),差异有统计学意义(P<0.05)。两组患者的不良反应及并发症发生率比较,差异无统计学意义(P>0.05)。结论:熄风活血化湿汤联合手法复位治疗BPPV,有助于改善患者的临床症状,降低眩晕发生频率,改善负面情绪,疗效及安全性良好。

中药鼻咽冲洗结合中药汤剂内服治疗鼻咽癌放射性鼻咽黏膜损伤患者的疗效

目的探讨中药鼻咽冲洗结合中药汤剂内服治疗鼻咽癌放射性鼻咽黏膜损伤患者的临床疗效。方法采取乱数表法将100例鼻咽癌放射性鼻咽黏膜损伤患者分为研究组和对照组,每组50例,对照组患者给予中药鼻咽冲洗治疗,研究组患者给予中药鼻咽冲洗结合中药汤剂内服治疗。比较两组患者的临床疗效、黏膜损伤程度、疼痛程度[数字分级评分法(NRS)]、生活质量[欧洲癌症研究与治疗组织头颈癌生存质量测定量表(EORTC QLQ-H&N35)]。结果研究组患者的临床疗效优于对照组,差异有统计学意义(P﹤0.05)。治疗7周后,研究组患者的黏膜损伤程度明显低于对照组,差异有统计学意义(P﹤0.01)。治疗3、7周后,两组患者NRS评分均低于本组治疗前,研究组患者NRS评分均低于对照组,差异均有统计学意义(P﹤0.05)。治疗7周后,两组患者EORTC QLQ-H&N35评分均低于本组治疗前,研究组患者EORTC QLQ-H&N35评分低于对照组,差异均有统计学意义(P﹤0.05)。结论中药鼻咽冲洗结合中药汤剂内服治疗鼻咽癌放射性鼻咽黏膜损伤患者的疗效较为显著,能够有效减轻黏膜损伤和疼痛程度,提高生活质量。

“十四五”时期国家中医药综合改革示范区构建中药饮片溯源体系实践与探讨——以上海为例

介绍了中药材及中药饮片溯源的重要性,分析目前国家中医药综合改革示范区相关省市在中药材和中药饮片溯源方面开展的工作及问题,探讨上海作为国家中医药综合改革示范区在中药饮片溯源方面开展的实践、经验及面临的问题,提出完善我国构建中药饮片溯源体系的对策及建议。

中和思想指导下苇茎汤治疗胸腔积液临床观察

目的 在中和医派思想的指导下探讨苇茎汤治疗胸腔积液的临床疗效。方法 选取2022年1月—2023年1月收治的胸腔积液患者60例,随机分为观察组和试验组,每组30例。观察组采用常规西医治疗,试验组在常规西医治疗的同时,联合应用苇茎汤进行治疗,3个疗程后观察2组临床疗效并对患者肺功能进行评价。结果 治疗后,试验组FVC、FEV1、FEV1/FVC、PEER均高于观察组(P<0.05)。结论 苇茎汤能够提高胸腔积液患者的肺功能,改善肺循环及气道阻塞,提高重症患者治愈率及生活质量。

半夏白术天麻汤合通窍活血汤联合治疗痰瘀互结型高血压颈动脉斑块疗效及对中医证候积分和血脂代谢的影响

目的:观察半夏白术天麻汤合通窍活血汤联合治疗痰瘀互结型高血压(HTN)颈动脉斑块疗效及对中医证候积分和血脂代谢的影响。方法:选取我院2021年1月~2022年6月收治的HTN伴颈动脉斑块患者62例。按照随机数字表法将患者分为治疗组(n=31)与对照组(n=31),两组均予以基础治疗,对照组以西药服用治疗,治疗组以西药+半夏白术天麻汤合通窍活血汤治疗,比较治疗后临床疗效,治疗前后中医症候积分、血压监测、血脂水平、超声检查[颈动脉内膜-中层厚度(IMT)、Grouse积分]、实验室指标[同型半胱氨酸(Hcy)、C反应蛋白(CRP)]。结果:治疗4个疗程后,治疗组临床疗效为28/31(90.32%)较对照组22/31(70.97%)更高(P<0.05);两组中医证候积分、收缩压(SBP)、舒张压(DBP)、低密度脂蛋白(LDL-C)、总胆固醇(TC)、甘油三酯(TG)、IMT、Crouse积分、血清Hcy、CRP水平均降低(P<0.05),且治疗组降幅高于对照组(P<0.05);两组高密度脂蛋白(HDL-C)均升高(P<0.05),且治疗组升幅高于对照组(P<0.05)。结论:半夏白术天麻汤合通窍活血汤联合治疗痰瘀互结型HTN伴颈动脉斑块可通过调节血脂代谢及血压水平,有效促进斑块消除,进而改善患者临床症状。

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。