Neuroprotective effects of Shaoyao Gancao decoction against excitatory damage in PC12 cells based on the Src-NR2-nNOS pathway

Objective To explore the neuroprotective effects of the Shaoyao Gancao decoction(SGD)against excitatory damage in PC12 cells and the role of the Src-NR2-nNOS pathway mediation by SGD in regulatingγ-aminobutyric acid(GABA)-glutamate(Glu)homeostasis.Methods N-Methyl-d-aspartic acid(NMDA)was used to establish a PC12 cell excitability injury model.To investigate the neuroprotective effect of SGD,a cell counting kit-8(CCK-8)assay was used to determine PC12 cell viability,Annexin V/Propidium Iodide(Annexin V/PI)double staining was used to determine PC12 cell apoptosis,and Ca^(2+)concentration was observed using laser confocal microscopy.GABA receptor agonists and antagonists were used to analyze the neuroprotective interactions betweenγ-aminobutyric acid(GABA)and NMDA receptors.Additionally,molecular biology techniques were used to determine mRNA and protein expression in the Src-NR2-nNOS pathway.We analyzed the correlations between the regulatory sites of GABA and NMDA interactions,excitatory neurotoxicity,and brain damage at the molecular level.Results NMDA excitotoxic injury manifested as a significant decrease in cell activity,increased apoptosis and caspase-3 protein expression,and a significant increase in intracellular Ca^(2+)concentration.Administration of SGD,a GABAA receptor agonist(muscimol),or a GABAB receptor agonist(baclofen)decreased intracellular Ca^(2+)concentrations,attenuated apoptosis,and reversed NMDA-induced upregulation of caspase-3,Src,NMDAR2A,NMDAR2B,and nNOS.Unexpectedly,a GABA_(A)receptor antagonist(bicuculline)and a GABA_(B)receptor antagonist(saclofen)failed to significantly increase excitatory neurotoxicity.Conclusions Taken together,these results not only provide an experimental basis for SGD administration in the clinical treatment of central nervous system injury diseases,but also suggest that the Src-NR2A-nNOS pathway may be a valuable target in excitotoxicity treatment.

Shao Yao Decoction exerts a protective effect on ulcerative colitis by inhibiting inflammation mediated by hypercoagulability

Background:Shaoyao decoction(SYD)has been found widespread clinical use in treating ulcerative colitis(UC).However,the mechanism underlying SYD impact on UC remains elusive.Materials and methods:We preliminarily evaluated the therapeutic effect of SYD intervention in a dextran sulfate sodium-induced UC mouse model by analyzing the body weight change,disease activity index score,colon length,and HE staining results of colon tissue in each group of mice.Subsequently,we determined pro-inflammatory cytokines level and blood coagulation markers in the colon tissues of mice in each group to evaluate the effect of SYD intervention on colonic inflammatory response and coagulation function in UC mice.Results:Our findings emphasize the significant therapeutic effect of SYD on UC,including slowed down body weight loss,reduced disease activity index score,increased colon length,and reduced inflammatory infiltration in colon tissue.Moreover,SYD intervention significantly downregulated the levels of pro-inflammatory cytokines IL-1β,IL-6,and IL-17A in the colon.Furthermore,SYD intervention reversed the coagulation-related indicators such as prothrombin time,fibrinogen,P-selectin,D-dimer,and platelet glycomembrane protein IIb/IIIa.Conclusion:Our results elucidate the substantial therapeutic impact of SYD on UC mice.Importantly,the therapeutic mechanism of SYD in addressing UC potentially involves the inhibiting of inflammatory response mediated by hypercoagulability.

Network pharmacology study on the mechanism of Shaoyao Gancao decoction in treating cancer pain

Objective:This paper aims to explore the key targets and mechanism of action of Shaoyao Gancao Decoction in the treatment of cancer pain.Methods:TCMSP database was adopted to screen the active components and potential targets of Shaoyao Gancao Decoction.Genecards and OMIM databases were used to collect disease targets for cancer pain.Cytoscape software was used to construct the drug-component-target-disease network diagram.STRING database was used to draw PPI network.Finally,gene ontology(GO)enrichment analysis and KEGG pathway enrichment analysis were performed on key targets.Results:There were 98 potential targets for the treatment of cancer pain in Shaoyao Gancao Decoction.The protein interaction network suggested that IL-6,VEGFA,CASP3,EGFR and MAPK8 may be the core targets for the treatment of cancer pain in Shaoyao Gancao Decoction.GO enrichment analysis showed 127 cellular biological processes,and KEGG pathway enrichment analysis showed 116 related signaling pathways,including MPAK,AGE-RAGE,TNF,ErbB and so on.Conclusions:The treatment of cancer pain by Shaoyao Gancao Decoction may be multi-target,multi-channel and multi-level.This consequence may provide ideas and basis for further research.

Effects of Guizhi Shaoyao Zhimu Decoction on Laboratory Indicators and Immune Functions of Patients with Rheumatoid Arthritis

[Objectives]To explore the effects of Guizhi Shaoyao Zhimu Decoction on laboratory indicators and immune functions of patients with rheumatoid arthritis.[Methods]A total of 110 patients with rheumatoid arthritis admitted to the Second Department of Orthopedics,the Affiliated Chinese and Western Medicine Hospital of Nanjing,Nanjing University of Chinese Medicine from December 2014 to December 2016 were selected as the research objects and divided into a control group and an observation group using the random number table method,with 55 cases in each group.The control group was treated with conventional western medicine,and the observation group was treated with Guizhi Shaoyao Zhimu Decoction on the basis of the control group.Both groups were treated for one month.The clinical effects,improvement of clinical symptoms,laboratory indicators and immune function indicator levels between the two groups were compared;the incidence of adverse reactions in the two groups was counted.[Results]The total effective rate of the observation group was 92.73%,higher than that of the control group(78.18%)(P<0.05).Compared with that before treatment,after one month of treatment,the grip strength of the two groups increased,and the observation group was greater than the control group(P<0.05);the morning stiffness time and 20 m walking time of both groups were shortened,and the observation group was shorter than the control group(P<0.05);the number of joint tenderness,joint swelling,ESR,MPV,PDW,serum CRP,plasma IgA,IgG,IgM,RF levels in both groups decreased,and the observation group was lower than the control group(P<0.05);the serum C3 levels in both groups increased,and the observation group was higher than the control group(P<0.05).During the treatment,the incidence of adverse reactions in the observation group was 0.00%,which was lower than that in the control group(10.91%,P<0.05).[Conclusions]Using Guizhi Shaoyao Zhimu Decoction to treat rheumatoid arthritis can improve the laboratory indicators of patients,and enhance their immune functions,improve the curative effect,and the safety is high.

Therapeutic Effect of Shaoyao Jiawei Gancao Decoction(芍药加味甘草汤)with Acupoint Application on Chronic Lumbar Muscle Strain and the Recovery of Lumbar Strength

Objective:To study the therapeutic effect of Shaoyao Jiawei Gancao Decoction(芍药加味甘草汤)with acupoint application on chronic lumbar muscle strain and the recovery of lumbar strength.Methods:From August 2018 to August 2019,100 patients with chronic lumbar muscle strain admitted to our hospital were selected and randomly divided into an acupoint application group and a combined group of 50 cases each.The acupoint application group was treated by acupoint application,and the combined group was treated with Shaoyao Jiawei Gancao Decoction(芍药加味甘草汤)based on acupoint application.The indexes scores,VAS scores,ADL scores,ODI scores,lumbar endurance,TCM syndrome scores and the treatment effects of the two groups before and after treatment were statistically analyzed,and TNF-αand TXB2 levels were detected.Results:After treatment,the scores of indexes,VAS,ODI,TCM syndrome,TNF-αand TXB2 in the combined group were lower than those in the acupoint application group,and the ADL score,lumbar endurance and treatment efficiency were higher than those in the acupoint application group,with a statistical difference(P<0.05).Conclusion:Shaoyao Jiawei Gancao Decoction(芍药加味甘草汤)with acupoint application can effectively reduce pain,improve lumbar function,restore lumbar strength,effectively relieve inflammation,with significant effects.

桂枝芍药知母汤治疗痛风性关节炎急性期疗效及对患者可调节相关因子与嘌呤受体水平变化的影响

目的:观察桂枝芍药知母汤联合非布司他、塞来昔布治疗痛风性关节炎(GA)急性期的效果,为临床治疗提供参考。方法:选取GA患者110例,根据随机原则分为对照组(西药)和观察组(桂枝芍药知母汤+西药),每组55例。记录两组治疗前及治疗3、7 d后血尿酸(UA)、血沉(ESR)、白细胞介素-1β(IL-1β)、Diekkopf-1(DKK-1)、白细胞介素-18(IL-18)、嘌呤能受体(P2X7R)水平及中医证候积分的变化,统计两组疗效和不良反应。结果:治疗7 d后,观察组总有效率为90.91%(50/55),明显高于对照组的76.36%(42/55),差异有统计学意义(P<0.05)。治疗3、7 d后,两组皮色皮温、全身症状及关节相关积分较治疗前下降,观察组低于对照组,且两组治疗7 d后低于治疗3 d后(P<0.05)。治疗3、7 d后,两组UA、IL-1β、DKK-1、IL-18、P2X7R、ESR较治疗前下降,观察组低于对照组,且两组治疗7 d后上述因子低于治疗3 d后(P<0.05)。观察组不良反应发生率为9.09%(胸闷1例、胃肠道症状4例),与对照组的20.00%(胸闷2例、胃肠道症状8例和皮疹1例)比较,差异无统计学意义(P>0.05)。结论:桂枝芍药知母汤联合西药治疗GA急性期可减轻症状,提高疗效,可能与调节相关因子的表达水平有关。

芍药甘草汤加味联合针灸对骨质疏松性椎体压缩性骨折术后Oswestry功能障碍指数的影响

【目的】探析芍药甘草汤加味联合针灸治疗对骨质疏松性椎体压缩性骨折(OVCF)患者术后Oswestry功能障碍指数(ODI)的影响。【方法】将94例肝肾不足、阴血亏虚型OVCF患者随机分为观察组和对照组,每组各47例。2组患者均接受手术治疗(包括经皮穿刺球囊椎体后凸成形术或经皮椎体成形术),术后对照组接受针灸治疗,观察组接受芍药甘草汤加味联合针灸治疗,连续治疗12周(共3个月)。观察2组患者术后不同观察时点的疼痛程度视觉模拟量表(VAS)评分、ODI评分、骨密度[腰椎第2~4节椎体(L2~4)、股骨颈、Wards三角、全髋]、骨代谢指标[人Ⅰ型胶原C端肽(CTX-1)、骨碱性磷酸酶(BALP)、血钙]血清水平的变化情况,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100.00%(47/47),对照组为87.23%(41/47),组间比较(Fisher精确检验),观察组的临床疗效明显优于对照组(P<0.01)。(2)疼痛程度及胸腰椎功能评分方面,术后第7天及1个月和3个月,2组患者的疼痛程度VAS评分及胸腰椎ODI评分均较前一观察时点明显下降(P<0.05),且观察组在术后第7天及1个月和3个月对疼痛程度VAS评分及胸腰椎ODI评分的下降幅度均明显优于对照组(P<0.05或P<0.01)。(3)骨密度方面,治疗后(术后1个月),2组患者的L2~4、股骨颈、Wards三角、全髋骨密度值均较治疗前明显升高(P<0.05),且观察组对L2~4、股骨颈、Wards三角、全髋骨密度值的升高幅度均明显优于对照组(P<0.01)。(4)骨代谢指标方面,治疗后(术后1个月),2组患者的血清CTX-1、BALP和血钙水平均较治疗前明显下降(P<0.05),且观察组对血清CTX-1、BALP和血钙水平的下降幅度均明显优于对照组(P<0.01)。【结论】芍药甘草汤加味联合针灸治疗肝肾不足、阴血亏虚型OVCF患者疗效确切,能显著减轻患者术后疼痛症状,改善患者骨密度和骨代谢,促进胸腰椎功能恢复,有效提升其整体治疗效果。

芍药汤治疗湿热内蕴型溃疡性结肠炎疗效及对患者炎症因子和T淋巴细胞亚群的影响

目的:观察芍药汤治疗溃疡性结肠炎(UC)患者(湿热内蕴证)的临床疗效及对患者炎症因子和T淋巴细胞亚群的影响。方法:选择接受治疗的110例UC患者作为研究对象,掷硬币法分为两组,各55例。对照组采取美沙拉秦治疗,观察组在对照组基础上采取芍药汤治疗,两组均连续治疗3个月。治疗3个月时比较两组患者临床疗效;比较两组治疗前、治疗3个月时临床症状、Mayo、Geboes指数评分、炎症因子、T淋巴细胞亚群(CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))及肠道菌群水平;统计并比较两组治疗期间不良反应发生情况。结果:治疗后,观察组总有效率高于对照组(P<0.05);治疗后,两组主症、次症及总分低于治疗前,观察组低于对照组(P<0.05);治疗后,两组Mayo活动指数、Geboes指数评分低于治疗前,观察组低于对照组(P<0.05);治疗后,两组超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平低于治疗前,观察组低于对照组(P<0.05);治疗后,两组CD4^(+)、CD4^(+)/CD8^(+)高于治疗前,CD8^(+)低于治疗前,观察组CD4^(+)、CD4^(+)/CD8^(+)高于对照组,CD8^(+)低于对照组(P<0.05);治疗后,两组双歧杆菌、乳酸杆菌高于治疗前,大肠杆菌低于治疗前,观察组大肠杆菌低于对照组(P<0.05);观察组发生1例恶心,1例皮肤瘙痒,对照组未发生不良反应(P>0.05)。结论:芍药汤能够有效改善湿热内蕴证UC患者临床症状,促进肠黏膜愈合,降低机体炎症反应,提高免疫功能,恢复胃肠道菌群平衡,提升临床疗效。

基于网络药理学方法和分子对接技术探讨芍药甘草汤合桃红四物汤治疗糖尿病周围神经病变的作用机制

目的:运用网络药理学方法及分子对接技术探讨芍药甘草汤合桃红四物汤治疗糖尿病周围神经病变(DPN)的作用机制。方法:利用中药系统药理学数据库与分析平台(TCMSP)数据库筛选芍药甘草汤合桃红四物汤的活性成分及相关靶点信息;从DrugBank、PharmGKB、GeneCards、OMIM和TTD数据库中获取DPN的靶点基因。运用Cytoscape软件、STRING数据库构建芍药甘草汤合桃红四物汤活性成分-DPN共同靶点基因关系网络及共同靶点基因的蛋白质相互作用(PPI)网络。利用R语言软件进行基因本体论(GO)功能富集分析和京都基因与基因组百科全书(KEGG)通路富集分析。采用AutoDock Vina软件进行分子对接。结果:共获得161个芍药甘草汤合桃红四物汤活性成分,184个芍药甘草汤合桃红四物汤活性成分-DPN共同靶点基因。核心活性成分为槲皮素、木犀草素、山奈酚、柚皮素、7-甲氧基-2-甲基异黄酮,核心靶点基因为信号传导及转录激活蛋白3(STAT3)、丝裂原活化蛋白激酶3(MAPK3)、热休克蛋白90AA1(HSP90AA1)、丝裂原活化蛋白激酶1(MAPK1)、转录因子p65(RELA)。GO功能富集分析得到2940条GO条目,KEGG通路富集分析得到182条信号通路。分子对接结果显示,木犀草素与HSP90AA1的结合活性最好。结论:芍药甘草汤合桃红四物汤具有多成分、多靶点、多通路的效应特点,其作用机制可能是槲皮素、木犀草素、山奈酚、柚皮素、7-甲氧基-2-甲基异黄酮等活性成分作用于STAT3、MAPK3、HSP90AA1、MAPK1、RELA等靶点基因,调控磷脂酰肌醇3-激酶/蛋白激酶B(PI3K-Akt)、晚期糖基化终末产物-晚期糖基化终末产物受体(AGE-RAGE)、白细胞介素-17(IL-17)、肿瘤坏死因子(TNF)、缺氧诱导因子1(HIF-1)等多条信号通路,通过抗氧化应激、抑制炎症反应、保护神经细胞、改善胰岛素抵抗发挥治疗DPN的作用。

经方治疗良性前列腺增生症的研究进展

正气不足、瘀血留结、水饮停留为良性前列腺增生症(benign prostate hyperplasia,BPH)发病的主要病机。正气不足为BPH发病之根本,以金匮肾气丸、真武汤化生肾气、温阳利水;瘀血留结是BPH发病的关键病机,以桂枝茯苓丸、抵当汤以化瘀消瘢、利窍通便;水饮停留为BPH最为紧急之症,治以五苓散、当归芍药散以化气利水,解标症之急。

桂枝加葛根汤联合当归芍药散治疗良性位置性眩晕的效果

目的 探讨桂枝加葛根汤联合当归芍药散治疗良性位置性眩晕(benign paroxysmal positional vertigo,BPPV)的效果。方法 选取2021年2月-2023年8月收治的80例老年后半规管BPPV痰瘀互阻证患者,按照掷硬币法分为2组,对照组(n=40)采取常规西药治疗,观察组(n=40)另用桂枝加葛根汤联合当归芍药散治疗,比较2组疗效。结果 治疗7 d、14 d后,观察组中医证候积分较对照组低(P<0.05)。14 d治疗后,观察组眩晕评分、血液流变学指标、血清同型半胱氨酸(homocysteine,Hcy)水平均优于对照组(P<0.05)。治疗后,观察组脑血流动力学较对照组优(P<0.05)。2组在治疗期间均未出现头痛、乏力不良反应。结论 对老年后半规管BPPV痰瘀互阻证患者采取桂枝加葛根汤联合当归芍药散治疗,可明显减轻患者眩晕症状和中医证候积分,改善其血液流变学和脑血流动力学,值得推广。

雷火灸联合加味芍药甘草汤对单开门颈椎管扩大椎板成形术后轴性症状的临床疗效

目的:探讨雷火灸联合加味芍药甘草汤治疗单开门颈椎管扩大椎板成形术后轴性症状的临床效果,探索治疗术后轴性症状新途径。方法:选取2021年10月—2023年10月于赣州市人民医院脊柱外科就诊的单开门颈椎管扩大椎板成形术后轴性症状且中医辨证属于气血不足症型的70例患者,通过随机数字表法将其分为试验组和对照组,各35例。试验组采用雷火灸联合加味芍药甘草汤内服的治疗方案,对照组采用常规西药治疗。采用视觉模拟评分法(visual analogue scale,VAS)、颈椎日本骨科协会(Japanese orthopaedic association,JOA)评分、C反应蛋白和红细胞沉降率评估治疗效果。结果:治疗前,两组VAS评分、颈椎JOA评分及C反应蛋白和红细胞沉降率比较,差异均无统计学意义(P>0.05);治疗后,试验组C反应蛋白和红细胞沉降率均低于对照组;治疗后2、4周,试验组VAS评分均低于对照组;治疗后4周,颈椎JOA评分高于对照组,差异有统计学意义(P<0.05)。结论:雷火灸配合加味芍药甘草汤治疗颈椎单开门椎管扩大成形术后轴性症状的效果较好,能够有效缓解疼痛,改善脊髓功能障碍,缓解轴性症状。

当归芍药散在妇产科临床中的应用

当归芍药散出自《金匮要略》,由三味“血分药”和三味“水分药”组成,共奏肝脾调和、气血水同调之功。血虚为主者,三味水药量宜小,血滞者三味血药量宜大,湿盛浮肿者,三味水药应重用,以达药专力宏之效;水酒同煎,取其宣通药势。临床用于妇人腹痛、子肿、月经不调、更年期综合征等妇产科疾病,有良好效果。

芍药甘草汤通过JAK2/STAT3信号通路对神经病理性疼痛大鼠的镇痛及对免疫调节机制影响

目的探寻芍药甘草汤对神经病理性疼痛(NP)的改善作用及其机制。方法采用坐骨神经分支选择性损伤(SNI)法建立NP大鼠模型,模型制备成功后予以芍药甘草汤灌胃治疗14 d。治疗前后监测大鼠疼痛行为学指标变化,TUNEL染色检测脊髓背角细胞凋亡情况,免疫荧光组织化学法测定p-STAT3在脊髓中与Iba1的共定位情况,RT-PCR检测CD68、SOCS3、Arg-1的mRNA表达,ELISA检测白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)表达,Western blotting检测JAK2/STAT3通路蛋白表达。结果与假手术组比较,模型组大鼠机械缩足阈值(MWT)、热缩足潜伏期(TWL)明显降低(P<0.01),脊髓背角中凋亡细胞显著增加(P<0.05),IL-1β、1L-6和TNF-α的表达显著增加(P<0.01),JAK2、p-JAK2、STAT3、p-STAT3的表达显著增加(P<0.01),术后7、14 d的CD68、SOCS3 mRNA表达显著增加(P<0.01),Arg-1 mRNA表达显著降低(P<0.01)。与模型组比较,芍药甘草汤组大鼠治疗后MWT、TWL明显上升(P<0.01),脊髓背角中凋亡细胞减少,IL-1β、IL-6、TNF-α的水平显著减少(P<0.01),JAK2、p-JAK2、STAT3、p-STAT3蛋白表达水平明显降低(P<0.01),CD68、SOCS3 mRNA表达显著减少(P<0.01),Arg-1 mRNA表达水平显著增加(P<0.01)。结论芍药甘草汤可能通过调控JAK2/STAT3通路调控小胶质细胞极化状态进而发挥改善NP的作用。

“止痛之祖方”芍药甘草汤治疗颈椎病网络药理学机制研究

目的:探究颈椎病中医常用方芍药甘草汤的网络药理学机制。方法:依据BATMAN-TCM数据库和文献查询选出芍药甘草汤(芍药、甘草)的主要活性成分并经Uniprot蛋白质数据库对照后获得其靶点,同时从疾病数据库OMIM、GeneCards等和相关文献获得颈椎病靶点。整理收集芍药甘草汤和颈椎病交集,获得共有靶点。通过蛋白质相互作用网络数据库STRING构建已获得的共有靶点蛋白质-蛋白质相互作用网络图,再用生物信息数据库DAVID平台进行基因本体论(GO)和京都基因与基因组百科全书(KEGG)富集通路分析芍药甘草汤治疗颈椎病过程中可能相关的生物过程和信号通路。结果:(1)筛选出芍药甘草汤的活性成分79个,潜在作用靶点442个;疾病靶点765个,药物、疾病共有靶点45个;(2) GO分析显示芍药甘草汤治疗颈椎病可能是通过调节丝氨酸/苏氨酸蛋白激酶1(Akt Serine/Threonine Kinase 1,AKT1)、白细胞介素-6(Interleukin-6,IL-6)、表皮生长因子受体(Epidermal Growth Factor Receptor,EGFR)、雌激素受体1(Estrogen Receptor 1,ESR1)等靶点,并与蛋白质和DNA结合酶相关,还涉及脂多糖反应、细胞凋亡和分化的负调节、细胞对有机环状化合物的反应等多个生物过程;(3) KEGG富集分析显示芍药甘草汤治疗颈椎病主要与丝裂原活化蛋白激酶(Mitogen-Activated Protein Kinase,MAPK)、核因子-κB(Nuclear Factor-κB,NF-κB)、肿瘤坏死因子(Tumor Necrosis Factor,TNF)等多条信号通路相关。结论:推测芍药甘草汤主要通过调节调节AKT1、IL-6、EGFR、ESR1等靶点以调控MAPK、NF-κB、TNF等信号通路,进而干预颈椎病抗凋亡、黏附、髓核细胞外基质降解、血管的生长、炎症和分解代谢介质水平。

芍药甘草汤缓急止痛有效部位筛选及其入血成分分析

目的研究芍药甘草汤缓急止痛的药效物质基础。方法通过大鼠离体肠张力实验考察芍药甘草汤全方、芍药甘草汤乙酸乙酯萃取物及其大孔树脂流出部位和大孔树脂90%乙醇洗脱部位(给药质量浓度按生药量计均为13.44 g/mL)的解痉效果。通过小鼠醋酸扭体实验评价大孔树脂流出部位和大孔树脂90%乙醇洗脱部位(给药剂量以生药量计均为2.4 g/kg)的止痛效果,并检测小鼠血清中肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、前列腺素E(2 PGE2)、环氧合酶2(COX-2)水平。采用高效液相色谱-飞行时间质谱技术对灌胃大孔树脂90%乙醇洗脱部位后的小鼠血清进行原型成分及代谢产物鉴定。结果大鼠体外实验中,以大孔树脂90%乙醇洗脱部位的解痉效果最好,其小肠张力抑制率显著高于大孔树脂流出部位(P<0.05),且与芍药甘草汤全方比较差异无统计学意义(P>0.05)。小鼠醋酸扭体实验中,与模型组比较,大孔树脂90%乙醇洗脱部位组小鼠的扭体次数显著减少(P<0.05),扭体潜伏期显著延长(P<0.05),且小鼠血清中COX-2、IL-1β、PGE2、TNF-α水平均显著降低(P<0.05)。从血清中共鉴定出包括芍药苷、甘草酸等在内的10种原型成分和包括羟基化甘草苷、葡萄糖醛酸化甘草素等在内的22种代谢产物。结论芍药甘草汤缓急止痛的有效部位为乙酸乙酯萃取物的大孔树脂90%乙醇洗脱部位,甘草酸、芍药苷等10种成分可能是其药效物质基础。

从芍药甘草汤方证与药量探讨胞轮振跳的治疗

胞轮振跳是临床中的难治性疾病,该病严重影响患者的情绪及生活质量。目前临床治疗手段有限,西医多以手术为主,且容易反复,创伤性较大。中医药治疗该病不良反应少且疗效稳固。芍药甘草汤主治肝脾阴虚证,而胞轮振跳的病机之一则为肝脾阴虚,这是与芍药甘草汤证的契合点。因此,根据异病同治原则,该方治疗此类疾病是辨病与辨证结合的临床思路的体现。通过文献考证古今度量衡质量的单位换算,芍药(白芍)与炙甘草的用量需达60 g以上方可获得良好临床疗效。本文总结了芍药甘草汤的临床使用经验,并结合文献从方义与药量角度论证其治疗胞轮振跳的可行性与合理性。

5种中药汤剂治疗类风湿性关节炎有效性和安全性的网状Meta分析

目的系统评价常用的5种中药汤剂治疗类风湿关节炎(RA)的疗效及安全性。方法计算机检索PubMed、Embase、Cochrane Library、Web of Science、CNKI、WanFang Data和VIP数据库,搜集蠲痹汤、乌头汤、白虎加桂枝汤、桂枝芍药知母汤和独活寄生汤等5种中药汤剂联合甲氨蝶呤、美洛昔康等常规疗法治疗RA的随机对照试验(RCT),检索时限均从建库至2024年1月1日,由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Stata 17软件进行网状Meta分析。结果共纳入35个RCT,包括3316例患者。网状Meta分析结果显示,与单纯常规疗法相比,5种中药汤剂+常规疗法均显著提高临床总有效率(P<0.05),蠲痹汤+常规疗法、桂枝芍药知母汤+常规疗法、独活寄生汤+常规疗法均显著降低类风湿因子(RF)水平(P<0.05),蠲痹汤+常规疗法、乌头汤+常规疗法、桂枝芍药知母汤+常规疗法、独活寄生汤+常规疗法均显著降低C-反应蛋白(CRP)水平和血清红细胞沉降率(ESR)(P<0.05),桂枝芍药知母汤+常规疗法、独活寄生汤+常规疗法均显著降低不良反应发生率(P<0.05)。累积概率排序结果显示,桂枝芍药知母汤+常规疗法对提高临床总有效率、降低RF水平、降低不良反应发生率的效果均最佳,乌头汤+常规疗法对降低CRP水平的效果最佳,蠲痹汤+常规疗法对降低血清ESR效果最佳。结论中药汤剂与常规疗法联合应用治疗RA的效果显著优于单纯常规疗法,在改善指标方面,可选择桂枝芍药知母汤或蠲痹汤联合常规疗法;在提高安全性方面,可选择桂枝芍药知母汤或独活寄生汤联合常规疗法。受纳入研究数量和质量限制,上述结论尚需开展更多高质量研究予以验证。

瓜石汤联合当归芍药散对多囊卵巢综合征合并胰岛素抵抗小鼠的影响

目的:探讨瓜石汤联合当归芍药散对多囊卵巢综合征联合胰岛素抵抗(PCOS-IR)小鼠模型性激素和内膜炎症介质的影响。方法:用来曲唑和高脂饮食构建PCOS-IR模型小鼠,观察小鼠动情周期变化及检测小鼠空腹血糖、空腹胰岛素评价模型成功是否。将小鼠随机分为对照组、模型组、中药组,中药组造模成功后给予瓜石汤联合当归芍药散中药方灌胃,对照组及模型组给予等体积纯净水。干预21 d后用酶联免疫吸附试验(ELISA)法测定血清卵泡刺激素(FSH)、促黄体生成素(LH)、总睾酮(T)水平,检测内膜组织肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)的水平。结果:造模后对照组小鼠动情周期正常,模型组小鼠动情周期紊乱,多数位于动情间期;对照组小鼠胰岛素抵抗指数(HOMA-IR)均小于2.69,而模型组均大于2.69。给药21 d后,中药组小鼠血清LH、T、LH/FSH较模型组低(P<0.05),内膜组织TNF-α、IL-1β、IL-6 mRNA和蛋白表达水平较模型组低(P<0.05)。结论:瓜石汤联合当归芍药散能改善PCOS-IR小鼠血清激素水平,降低内膜炎症介质水平,改善内膜炎症。

基于药材原产地芍药甘草汤质量评价体系研究

目的采用高效液相色谱法(HPLC)同时测定芍药甘草汤中没食子酸、芍药苷、甘草苷、甘草素和甘草酸5种指标成分的含量并建立芍药甘草汤指纹图谱,探究芍药甘草汤中间体关键质量属性,为其药材基源筛选和质量控制提供参考。方法制备来自不同产地不同批次的18批芍药甘草汤冻干粉作为中间体样品;采用Agilent ZORBAX Eclipse Plus C_(18)(4.6 mm×250 mm,5μm)色谱柱,以乙腈-0.2%磷酸水溶液为流动相,梯度洗脱,柱温35℃,流速0.8 mL/min,进样量10μL,对指标成分的含量和指纹图谱进行检测,评价多批次芍药甘草汤中间体质量属性差异,为其质量标准的建立提供参考。结果5种成分线性关系(R^(2)>0.999)、精密度(RSD≤0.89%,n=6)、重复性(RSD≤1.35%,n=6)、稳定性(RSD≤1.87%,72 h)均良好,加样回收率为(98.24±1.85)%~(104.88±1.38)%(n=6)。含量测定结果显示在不同批次芍药甘草汤中间体中仅没食子酸的含量波动范围较小(4.74~5.92 mg/g),芍药苷、甘草苷、甘草素和甘草酸在不同产地不同批次中的含量均有较大差异,含量范围分别为29.58~38.24、7.21~12.12、0.18~0.89、12.14~42.83 mg/g;建立芍药甘草汤指纹图谱,确定了14个共有峰,并对各峰进行药材归属,其中1、4、5、10号峰来自白芍,2、3、6、7、8、9、11、12、13、14号峰来自炙甘草,炙甘草对共有峰的贡献最大。其中13批芍药甘草汤中间体的HPLC指纹图谱与对照指纹图谱的相似度均大于0.98,第S4、S8、S16、S17、S18批次的相似度大于0.91,说明不同产地批次的药材质量差异较大。结论该方法准确可靠、灵敏度高,具有良好的重复性,可用于测定芍药甘草汤中5种成分的含量及建立芍药甘草汤的指纹图谱,可为经典名方芍药甘草汤的质量标准建立及评价提供依据。