Mechanism of Simiao Yongan decoction in the treatment of arteriosclerosis obliterans of lower extremity through JAK/STAT signaling pathway

Objective:To predict the effective components,potential targets and pathways of Simiao Yong’an Decoction in the treatment of lower extremity arteriosclerosis obliterans(ASO)based on the method of network pharmacology,and to explore the mechanism of Simiao Yong’an Decoction in treating ASO combined with cell experiment.Methods:TCMSP database was used to screen the active components and targets of Simiao Yong’an decoction,and Genecards and OMIM databases were used to obtain ASO related proteins;PPI network of drug disease target proteins was constructed by string platform;go function and KEGG pathway enrichment of Simiao Yong’an Decoction ASO target were analyzed by David database.The drug target pathway with high correlation with ASO was selected.The model of vascular smooth muscle cell injury(VSMCs)induced by ox LDL was used,and Simiao Yong’an decoction containing pharmaceutical Qing was given to verify the therapeutic effect of Simiao Yong’an Decoction on ox LDL induced VSMCs and its regulation on highly correlated target pathway.Results:A total of 126 active components of Simiao Yong'an Decoction were screened,40 targets of Simiao Yong’an Decoction ASO were selected,99 go biological processes and 48 related signal pathways were related to ASO;the experimental results showed that with the passage of time,Simiao Yongan decoction could significantly inhibit the proliferation of VSMCs(P<0.05);compared with the model group,the percentage of BrdU positive cells in each dose group of Simiao Yong’an decoction was significantly higher than that in the model group In addition,Simiao Yong’an decoction could significantly inhibit the proliferation of VSMCs(P<0.05);in addition,Simiao Yongan decoction could inhibit the levels of IL-6 and IL-1β(P<0.05);significantly inhibit the expression of PCNA,JAK2 and STAT3 mRNA(P<0.05);Conclusions:Simiao Yong’an decoction has the effect of"multi-component,multi-target and multi-channel"in the treatment of ASO.It can inhibit the activation of JAK/STAT signaling pathway,play an anti-inflammatory role and inhibit the proliferation of vascular smooth muscle cells.

Effect of Simiao Yongan Decoction on atherosclerotic carotid plaque in ApoE-/-mice via antagonizing Ox-LDL lipid metabolism pathway

Objective:To explore the intervention effects and mechanism of Simiao Yongan(SMYA)Decoction on carotid atherosclerotic plaque in ApoE knockout mice by antagonizing lipid metabolism of oxidation low density lipoprotein(Ox-LDL).Methods:ApoE-/-mice were fed high-fat feeding for 2 weeks,combined with perivascular collar placement(PCCP)and high fat feeding for 8 weeks to establish carotid AS plaque model.All the mouses were divided into 5 groups,after successful AS model preparation.The sham operation as well as model group intragastrically administered with deionized water.The rest mouses were intragastrically administered with SMYA decoction or Pioglitazone,or treated with Atorvastatin for 8 weeks.Then adopting automatic biochemical analyzer to test total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C)content.The content of ox-LDL in serum,which was tested by enzyme-linked immunosorbent assay(ELISA).The pathological changes of carotid artery were observed by hematoxylin-eosin(HE)staining and the vascular parameters were measured.Immunohistochemical method and Western blot assay was used to detect the manifestations of protein include fatty acid binding protein 4(FABP4)and peroxisome proliferator-activated receptorγ(PPARγ)as well as matrix metalloproteinase 2(MMP 2).Results:Compared with the sham operation group,the serum ox-LDL content of the model group was increased,and the intima thickness(IT),intima-media thickness(IT/MT),plaque area(PA)as well as lumen area ratio of plaque vessels(PA/LA)were enlarged(P<0.05).Immunohistochemistry and Western blot results showed that the relative expression of FABP4 and MMP2 in the model group increased markedly,while the relative expression of PPARγsignificantly decreased.Compared SMYA decoction group and Atorvastatin group as well as Pioglitazone with model group,the serum ox-LDL content was decreased(P<0.05).In the mean time,the IT,PA,IT/MT and PA/LA in carotid artery were reduced(P<0.05).Immunohistochemistry and Western blot results showed that the expression of FABP4 and MMP2 was reduced,while PPARγprotein expression increased of mouses in each administration group.Conclusion:SMYA decoction is able to antagonize Ox-LDL,increase the expression of PPARγ,decrease the level of FABP4,reduce MMP2 in carotid arteries of ApoE-/-atherosclerotic mice,and increase the stability of plaque.

Study on mechanism of Simiao Yong'an Decoction in treatment of deep venous thrombosis based on network pharmacology

Objective:To explore the mechanism of Simiao Yong'an Decoction in treating deep venous thrombosis based on the method of network pharmacology.Methods:Through TCMSP database,the effective components of each traditional Chinese medicine in Simiao Yong'an Decoction were obtained and their targets were predicted.The targets of deep venous thrombosis were collected by CTD database,and the key targets were obtained by intersection of the component targets and the disease targets;Protein-Protein Interaction(PPI)network was constructed by String database.The drugs-components-targets-disease network map was constructed by using the software of Cytoscape 3.7.2.GO function and KEGG pathway enrichment of Simiao Yong'an Decoction in the treatment of deep venous thrombosis were analyzed by using the plug-in of ClueGo.Results:121 effective components and 137 potential targets of Simiao Yong'an Decoction were obtained.There were 1172 targets of deep venous thrombosis.There were 214 biological processes analyzed by GO Biological Process and 72 pathways analyzed by KEGG analysis.Conclusion:Simiao Yong'an Decoction may act on ESR1,AR,PTGS2 and other key targets,as well as AGE-RAGE signaling pathway,PI3K-Akt signaling pathway,MAPK signaling pathway,IL-17 signaling pathway,TNF signaling pathway,RLX signaling pathway and other pathways to treat deep venous thrombosis.

Meta-analysis on clinical efficacy of Simiao Yong'an decoction in treatment of peripheral arterial occlusive diseases

Objective:To systematically evaluate the clinical efficacy and safety of Simiao Yong'an Decoction in the treatment of peripheral occlusive disease(PAOD).Methods:Eight randomized controlled clinical trials(RCT)of Simiao Yong'an Decoction in the treatment of PAOD were searched and screened from domestic and foreign databases(all from database construction to March 2020).The quality of the retrieved original studies was evaluated according to the evaluation criteria of Cochrane Handbook 5.1.0,and the included studies were meta-analyzed by RevMan5.3 software.Results:A total of 350 articles were retrieved,among which 14 studies met the inclusion criteria,with a total sample size of 1254 cases.The results of meta-analysis showed that:compared with conventional western Med,combined with Simiao Yong'an Decoction on the basis of western Med treatment can significantly improve the total clinical response rate of patients[RR=1.20,95%CI(1.14,1.27),P<0.00001],improve ankle brachial index(ABI)level[MD=0.79,95%CI(0.66,0.92),P<0.00001]and toe brachial index(TBI)level[RR=0.13,95%CI(0.10,0.16),P<0.00001],decreased c-reactive protein levels[MD=-8.55,95%CI(-8.99,-8.11),P<0.00001]and LDL levels[MD=-0.41,95%CI(-0.62,-0.19),P=0.0002],and increased HDL levels[MD=0.32(0.22,0.43),P<0.00001].There was no statistically significant difference in the incidence of adverse reactions[RR=0.50,95%CI(1.15,1.64),P=0.25].Conclusion:Simiao Yong'an Decoction combined with conventional western Med is more effective than conventional western Med in the treatment of PAOD.However,in view of the limitations of the quality of the analyzed literature,the positive results obtained in this study still need to be further verified by a large sample and multi-center clinical trial with a reliable research program.

Clinical study about the effect of Simiao Yong'an Decoction on preventing in-stent restenosis and regulating inflammation and oxidative stress after lower extremity stent angioplasty stenting

Objective:To study the effect of Simiao Yong'an Decoction on the prevention of in-stent restenosis and the regulation of inflammation and oxidative stress after lower extremity stent angioplasty.Methods:A prospective study was conducted on 60 ASO patients who underwent lower extremity stent angioplasty in our hospital between January 2014 and January 2018.The patients were randomly divided into observation group receiving postoperative Simiao Yong'an Decoction combined with antiplatelet drug treatment and control group receiving postoperative antiplatelet drug treatment.The conditions of in-stent restenosis were followed up,and the indicators of coagulation,inflammation and oxidative stress were detected.Results:The incidence of in-stent restenosis in observation group 1 year after operation was significantly lower than that in control group;6 months and 12 months after operation,the ankle brachial index(ABI)levels,minimal lumen diameter(MLD)levels at the stent and superoxide dismutase(SOD)contents of observation group were significantly higher than those of control group,whereas D-dimer(D-D)and fibrinogen degradation product(FDP)levels as well as P-selectin,C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),malondialdehyde(MDA)and inducible nitric oxide synthase(iNOS)contents were significantly lower than those of control group.Conclusions:Simiao Yong'an Decoction can prevent the in-stent restenosis and inhibit the inflammation and oxidative stress after lower extremity stent angioplasty.

四妙勇安汤含漱配合刮痧治疗瘀热互结型小儿慢性扁桃体炎的效果观察

目的:探究四妙勇安汤含漱配合刮痧治疗小儿慢性扁桃体炎的效果。方法:前瞻性随机选取2022年3月—2023年3月在江阴市中医院进行诊治的80例慢性扁桃体炎患儿纳入研究。将其用随机数字表法分成对照组和观察组,每组40例。对照组予以生理盐水含漱治疗;观察组予以四妙勇安汤含漱配合刮痧治疗。比较两组临床疗效、临床症状体征积分、炎症水平、免疫水平及不良反应发生情况。结果:观察组临床疗效优于对照组(P<0.05)。治疗后,两组主要和次要症状体征积分、白细胞介素1β(IL-1β)、降钙素原(PCT)水平均下降(P<0.05),观察组低于对照组(P<0.01)。两组干扰素-γ(IFN-γ)、CD3^(+)、CD4^(+)/CD8^(+)水平均升高(P<0.05),观察组高于对照组(P<0.01)。两组不良反应比较差异无统计学意义(P>0.05)。结论:四妙勇安汤含漱配合刮痧治疗用于小儿慢性扁桃体炎,可明显提升疗效、改善临床症状和体征,减轻炎症反应,提升免疫功能,且用药较为安全。

穴位注射结合四妙勇安汤辅助治疗糖尿病足溃疡临床效果观察

目的:探讨穴位注射维生素B1结合四妙勇安汤辅助治疗糖尿病足溃疡(DFU)的临床疗效。方法:选取2021年10月-2023年2月我院收治的湿热毒盛型DFU患者96例,随机分为观察组与对照组各48例,对照组给予西医常规治疗,观察组在对照组基础上给予穴位注射结合四妙勇安汤治疗。观察两组患者治疗前后的临床疗效、中医证候评分、踝肱指数及创面情况(创面面积、创面深度),血清炎症指标(超敏C反应蛋白、白细胞介素-1、肿瘤坏死因子-α)、超声检查指标(足背动脉的血流速度、血管内径、阻力指数),血管内皮功能(血管内皮生长因子及血清碱性成纤维细胞生长因子)及复发率。结果:治疗后观察组总有效率为91.67%,显著高于对照组的77.08%(P <0.05);治疗后两组中医证候评分、血清炎症指标、创面面积、创面深度均较治疗前降低,且观察组低于对照组(P <0.05);两组治疗后血清血管内皮生长因子、血清碱性成纤维细胞生长因子水平、踝肱指数及各超声检查指标均较治疗前升高,且观察组高于对照组(P<0.05);观察组复发率10.42%低于对照组的27.08%(P<0.05)。结论:穴位注射维生素B1结合四妙勇安汤辅助治疗湿热毒盛型DFU患者临床疗效显著。

马勇教授辨治腰椎间盘突出症微创术后残留症状经验撷菁

文章介绍马勇教授辨治腰椎间盘突出症微创术后残留症状经验,其认为该病本质为术后正气虚损,邪气留恋。当前中医治疗方案存在一定局限,马勇教授主张建立以经方为根基的辨治体系,提出“扶阳”治疗理念:益气扶阳、调补脏腑、宣痹通络。继而创制了个人验方—扶阳宣痹汤用以临证治疗,取得了显著疗效,同时也为临床治疗该病提供了一定参考。

加味四妙汤联合地塞米松治疗痛风性关节炎患者的效果

目的:探究加味四妙汤联合地塞米松治疗痛风性关节炎患者的临床效果。方法:回顾性选取2021年6月—2023年6月厦门市中医院收治的86例痛风性关节炎患者。根据治疗方案的不同将其分为单一组和联合组,各43例。两组均给予基础治疗,单一组给予地塞米松,联合组在单一组基础上给予加味四妙汤。比较两组临床疗效,治疗前后中医症候积分、疼痛程度、实验室指标、炎症因子、免疫功能及不良反应。结果:联合组总有效率为90.70%,高于单一组的74.42%,差异有统计学意义(P<0.05)。治疗后,两组主症、次症、视觉模拟评分法(VAS)评分均低于治疗前,联合组主症、次症、VAS评分均低于单一组,差异有统计学意义(P<0.05)。治疗后,两组血尿酸、血沉、C反应蛋白(CRP)水平均低于治疗前,联合组血尿酸、血沉、CRP水平均低于单一组,差异有统计学意义(P<0.05)。治疗后,两组白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、降钙素原(PCT)水平均低于治疗前,联合组IL-1β、TNF-α、PCT水平均低于单一组,差异有统计学意义(P<0.05)。治疗后,两组免疫球蛋白M(IgM)、免疫球蛋白A(IgA)、免疫球蛋白E(IgE)水平均低于治疗前,联合组IgM、IgA、IgE水平均低于单一组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:加味四妙汤联合地塞米松治疗痛风性关节炎的效果确切,可改善临床症状,减轻疼痛程度,抑制炎症反应,纠正免疫功能失衡状态,且具有一定安全性。

加味四妙勇安汤抗大鼠心肌缺血再灌注损伤作用及机制初探

目的该研究旨在初步探讨加味四妙勇安汤对大鼠心肌缺血再灌注损伤的影响及其机制。方法首先构建大鼠心肌缺血再灌注损伤模型,随机分为正常对照组、模型组、NLRP3抑制剂(MCC950)组、四妙勇安汤组及加味四妙勇安汤组。分别检测心脏超声,血清肌酸激酶同工酶(CK-MB)及高敏C反应蛋白(hs-CRP),血浆D-二聚体,血清NLRP3炎症相关因子caspase-1、IL-1β、IL-18含量的变化。通过HE、马松染色观察心肌病理变化及胶原纤维含量;采用TUNEL法检测心肌细胞凋亡;免疫组织化学法检测炎症通路相关基因阳性表达。结果与正常对照组比较,模型组大鼠左室射血分数(LVEF)、左心室短轴缩短率(LVFS)、左室心输出量(LVCO)、左室舒张末期前壁厚度(LVAWd)、左室收缩末期前壁厚度(LVAWs)明显降低(P<0.05);与模型组比较,给药组大鼠LVEF、LVFS、LVCO、LVAWs、LVAWd均升高。此外与模型组相比,给药组显著降低血清心肌酶CK-MB、炎症因子hs-CRP以及血浆D-二聚体含量(P<0.05),降低血清NLRP3通路相关炎症因子caspase-1、IL-1β、IL-18含量(P<0.05);TUNEL检测细胞凋亡结果提示,与正常对照组相比,模型组细胞凋亡显著增加(P<0.05),给药组均可明显减少心肌细胞凋亡(P<0.05)。心肌组织HE染色提示正常组大鼠心肌结构与形态均好,心肌纤维排列有序,模型组大鼠表现出急性损伤心肌坏死、中性粒细胞浸润和间质水肿,而经药物干预后的心肌纤维排列、中性粒细胞浸润和间质水肿均较模型组改善。马松染色表明正常对照组无明显胶原纤维沉积,模型组胶原纤维沉积显著增加(P<0.05),药物干预后心肌胶原纤维沉积较模型组显著减少(P<0.05)。免疫组化结果提示,NLRP3、caspase-1、IL-1β蛋白在心肌细胞质呈黄色或棕黄色为阳性表达,与正常对照组比较,模型组NLRP3、caspase-1、IL-1β蛋白表达明显增加(P<0.05),药物干预后阳性细胞表达明显降低(P<0.05)。结论加味四妙勇安汤具有保护大鼠心肌缺血再灌注损伤的作用,表现为改善大鼠心功能、缓解炎症反应、改善血液高凝状态、改善心肌损伤、减少细胞凋亡及胶原纤维沉积等,其机制可能与抑制NLRP3炎症通路的激活有关。且与单纯四妙勇安汤比较,加味四妙勇安汤在改善心功能、减轻细胞凋亡等方面更具优势。

四妙汤对高脂血症斑马鱼中性粒细胞募集的影响

目的:建立高脂血症斑马鱼模型,探讨四妙汤对高脂血症斑马鱼脂质代谢及中性粒细胞募集的影响。方法:受精5 d后的斑马鱼胚胎随机分为空白对照组,模型组,四妙汤高(2 mg/mL)、中(1 mg/mL)、低(0.5 mg/mL)剂量组,维生素D组(10μmol/L),阿托伐他汀钙组(0.3μg/mL),每组30条。采用高脂饲料喂养斑马鱼构建高脂血症斑马鱼模型,受精18 d后进行油红O染色、脂质水平、血管荧光成像、中性粒细胞募集检测。结果:与模型组比较,四妙汤低、中、高剂量组,维生素D组和阿托伐他汀钙组斑马鱼血管油红O染料附着减少,脂质沉积稍改善;四妙汤中、高剂量组,维生素D组和阿托伐他汀钙组总胆固醇、甘油三酯水平降低(P<0.05,P<0.01),四妙汤高剂量组和维生素D组血管荧光减少、管壁厚度降低(P<0.05),中性粒细胞在血管内的募集受到显著抑制(P<0.05)。结论:四妙汤可通过改善高脂血症斑马鱼模型脂质水平、降低血管荧光强度和管壁厚度、抑制中性粒细胞在血管内的募集实现对高脂血症的治疗。

基于网络药理学分析四妙勇安汤治疗银屑病的作用机制

目的基于网络药理学方法探讨四妙勇安汤治疗银屑病的物质基础和作用机制。方法通过中药系统药理数据库与分析平台(TCMSP)获取四妙勇安汤的有效成分和靶点,利用GeneCards数据库检索银屑病的有关靶点,运用Jvenn在线作图工具平台绘制韦恩图,得到药物与疾病共同靶点。应用String数据库绘制蛋白质-蛋白质互相作用(PPI)网络,将PPI网络导入Cytoscape3.8.2,进行拓扑结构分析,筛选核心靶点,构建活性成分-靶点网络图。通过GO和KEGG对核心靶点进行富集分析。结果共筛选出四妙勇安汤274个药物活性成分,353个作用靶点,银屑病相关靶点1364个,交集靶点136个。主要活性成分有槲皮素、熊果酸、山柰酚等;核心靶点包括AKT1、TP53、IL6等;GO功能富集分析得到356个条目,BP主要富集于细菌来源分子的反应,多肽反应,蛋白质磷酸化正调控等;KEGG通路富集分析得到165条相关信号通路,包括血脂与动脉粥样硬化,表皮生长因子受体酪氨酸激酶抑制剂抵抗,癌症发病途径等通路。结论四妙勇安汤通过槲皮素、山柰酚、芹黄素等高黄酮类成分,作用于AKT1、TP53、IL6等靶点,调控血脂与动脉粥样硬化,表皮生长因子受体酪氨酸激酶抑制剂抵抗,癌症发病途径等通路,发挥调节炎症、血脂、免疫微环境等药理作用治疗银屑病。

四妙汤对类风湿关节炎大鼠维生素D系统及中性粒细胞胞外诱捕网的影响研究

背景 随着我国进入人口老龄化加速发展期,类风湿关节炎(RA)患病比例不断增加,给社会和家庭造成沉重负担。四妙汤中药物的有效成分确有改善RA的作用,但分析方剂的作用及机制缺乏相关研究。目的 观察四妙汤对胶原诱导法建立的类风湿关节炎大鼠的干预效果及其对维生素D系统及中性粒细胞胞外诱捕网(NETs)的影响。方法 2021年11月—2023年1月选取SD雌性大鼠70只,采用随机数字表法将大鼠分为空白组(Control组)、模型组(Model组)、甲氨蝶呤组(MTX组)、维生素D组(VD组)、四妙汤低剂量组(SMT-L组)、四妙汤中剂量组(SMT-M组)、四妙汤高剂量组(SMT-H组),每组10只。通过胶原诱导法建立滑膜型关节炎大鼠模型,于造模7 d后开始灌胃治疗。观察药物干预前后大鼠踝部肿胀程度,测量关节炎指数(AI)评分。采用免疫组化法检测滑膜组织髓过氧化物酶(MPO)、肿瘤坏死因子α(TNF-α)表达情况,检测大鼠血清中白介素6(IL-6)、25-羟基维生素D3[25(OH)D3]、NETs水平,检测关节滑膜组织24-羟基化酶(CYP24A1)、1-α羟化酶(CYP27B1)、MPO、维生素D受体(VDR)、弹性蛋白酶(NE)表达水平。结果 药物干预第第7天Control组、MTX组、VD组、SMT-L组、SMT-M组、SMT-H组踝部肿胀程度低于Model组,第14天Model组踝部肿胀程度高于Control组,SMT-M组踝部肿胀程度高于Model组,第21天Model组踝部肿胀程度高于Control组、MTX组,低于VD组、SMT-L组、SMT-M组、SMT-H组,第28天Control组、MTX组、VD组、SMT-L组、SMT-M组、SMT-H组踝部肿胀程度低于Model组(P<0.05)。第14天SMT-H组大鼠AI评分低于Model组,第21天MTX组、VD组、SMT-L组、SMT-H组AI评分低于Model组,第28天MTX组、VD组、SMT-L组、SMT-M组、SMT-H组AI评分低于Model组(P<0.05)。7组大鼠滑膜组织MPO、TNF-α表达水平比较,差异有统计学意义(P<0.05),其中Model组MPO、TNF-α高于Control组,MTX组、VD组、SMT-H组MPO、TNF-α低于Model组,SMT-M组TNF-α低于Model组(P<0.05)。Model组IL-6、NETs高于Control组,25(OH)D3低于Control组;MTX组、VD组、SMT-H组IL-6、NETs低于Model组,25(OH)D3高于Model组;SMT-M组NETs低于Model组(P<0.05)。Model组CYP24A1高于Control组、MTX组、VD组、SMT-M组、SMT-H组,CYP27B1、VDR低于Control组、MTX组、VD组、SMT-M组、SMT-H组,MPO高于Control组、MTX组、VD组、SMT-L组、SMT-M组、SMT-H组,NE高于Control组、VD组、SMT-M组、SMT-H组(P<0.05)。结论 四妙汤可能通过调控维生素D系统抑制NETs的形成,进而治疗RA。

四妙勇安汤加味方对THP-1巨噬细胞源性泡沫细胞的影响

目的:观察不同给药量和给药频次条件下,四妙勇安汤加味方提取物对THP-1源性巨噬细胞泡沫化模型细胞因子水平和泡沫细胞数量及形态的影响。方法:把建模成功的THP-1巨噬细胞源性泡沫细胞分成整方组和精细化组,并把四妙勇安汤加味方提取物加入到细胞培养基中,调节至药材浓度相当于0.1g·μL^(-1),刺激体外培养的THP-1巨噬细胞源性泡沫细胞48小时,取上清液用酶联免疫吸附(ELISA)法检测细胞因子水平,观察泡沫细胞数量和形态变化。整方组,每日给药1次,给药量分别为1~10、12和16μL,共12个剂量组;精细化组每日给药3次,单次给药量分别是1、3和4μL共3个剂量组。结果:整方组中,除IL-8和TNF-α水平超过检测上限外,随着给药量的增加,小于12μL·d^(-1)时,IL-1β和IL-10水平快速下降,其他细胞因子水平大致保持平稳,大于12μL·d^(-1)时,IFN-α和IL-5水平快速降低,IL-1β、IL-2、IL-6、IL-17水平快速上升。泡沫细胞数量方面,在给药小于6μL·d^(-1)区间内,呈现增加趋势,6~12μL·d^(-1)区间,呈现下降趋势,给药16μL·d^(-1)时,泡沫细胞数量显著增加。整方组和精细化组间比较,IL-1β(给药3、9和12μL·d^(-1))、IL-6(给药9μL·d^(-1))和IL-10(给药12μL·d^(-1))水平有显著差异(P<0.05),其他细胞因子水平无显著差异(P>0.05);泡沫细胞数量方面,给药3μL·d^(-1)时,组间无显著差异(P>0.05),9μL·d^(-1)和12μL·d^(-1)时,组间有显著差异(P<0.05)。结论:四妙勇安汤加味方存在量效关系,当给药量超过剂量阈值时,日给药量和给药频次都会对泡沫细胞数量、形态和细胞因子水平产生影响,因此,中药的给药量和给药频次都是影响临床效果的重要因素,改变给药模式可能是提高临床效果的有效途径。

四妙勇安汤的高效液相色谱指纹图谱及含量测定

采用高效液相色谱法测定四妙勇安汤物质基准的指纹图谱及含量。使用ZORBAX SB-C_(18)色谱柱(250mm×4.6 mm,5μm),以乙腈-0.2%磷酸为流动相,梯度洗脱,流量为0.8 mL/min,检测波长为210 nm,柱温为25℃。建立15批四妙勇安汤物质基准的高效液相色谱指纹图谱,运用中药色谱指纹图谱相似度评价系统(国家药典委员会2012 A版)进行相似度评价,对共有峰进行药味归属,建立了绿原酸、哈巴苷、哈巴俄苷的含量测定方法。15批四妙勇安汤物质基准相似度均大于0.90,指纹图谱中含有11个共有峰,其中归属于金银花5个,玄参2个,当归2个,甘草2个。绿原酸、哈巴苷、哈巴俄苷平均质量分数分别为2.24%、0.59%、0.14%。建立的15批四妙勇安汤高效液相色谱指纹图谱精密度、稳定性良好,能够较好的反映其化学成分组成,可用于四妙勇安汤物质基准的质量控制与评价。

基于“六郁理论”论治湿郁

贾跃进继承朱震亨的六郁思想,强调百病生于气,并加以发挥,提出气郁、食郁可致湿郁,湿郁可致血郁、痰郁、气郁、火郁、血郁、寒郁、水郁,导致多郁兼夹。湿郁并非均为实证,久病多为虚郁之证,气虚、阳虚亦可导致湿郁。并论述湿郁所形成的原因,以及湿郁的表现。治疗关键在于审证求因。若为虚郁夹杂,当补中兼疏;若为气虚所致湿郁,当健脾益气,化湿解郁,方以三仁汤合香砂六君子汤加减;若为阳虚所致湿郁,当补脾肾之阳,化湿解郁,方以附子理中汤合三仁汤加减;若为湿郁兼有气郁,当行气化湿解郁,方以四逆散合藿朴夏苓汤加减;若为湿郁兼有血郁,当行气活血,化湿解郁,方以三仁汤合四物汤加减;若为湿郁兼有痰郁,当行气燥湿化痰,方以二陈丸合平胃散加减;若为湿郁兼有火郁,当行气化湿,分消郁热,方以四妙散合泻黄散加减;若为湿郁兼有寒郁,当行气化湿,温散寒邪,方以羌活胜湿汤加减;若为湿郁兼有水郁,当行气化湿,温化水饮,方以三仁汤合苓桂术甘汤加减。并强调苍术为治疗湿郁要药,三仁汤为治疗湿郁之证的要方,善用三仁汤、四妙散、藿朴夏苓汤治疗各种类型的湿郁之证。

四妙勇安汤联合热敏灸对急性膝骨性关节炎的影响

目的探究四妙勇安汤联合热敏灸治疗急性膝骨性关节炎(KOA)的疗效。方法选取上饶市人民医院2018年3月—2021年3月收治的80例急性KOA患者,随机数字表法分为联合组和对照组各40例。联合组接受四妙勇安汤联合热敏灸治疗,对照组采用热敏灸治疗。比较2组临床疗效、疼痛程度、血清指标、膝关节功能评分(LKSS)以及不良反应。结果联合组总有效率高于对照组(P<0.05)。治疗后联合组视觉模拟评分(VAS)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平低于对照组,白细胞介素-10(IL-10)水平、LKSS评分高于对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论四妙勇安汤联合热敏灸疗效确切,可改善KOA患者疼痛、血清指标以及膝关节功能。

四妙勇安汤加减联合激光腔内闭合术治疗下肢静脉曲张临床研究

目的:观察四妙勇安汤加减联合激光腔内闭合术治疗下肢静脉曲张的效果。方法:84例按随机数字表法分为两组各42例。两组均予以激光腔内闭合术治疗,观察组加用四妙勇安汤加减治疗。结果:观察组治疗后VCSS评分、AVVQ评分低于对照组(P<0.05),BI评分高于对照组(P<0.05)。观察组治疗后HBV、PV、LBV、FIB低于对照组(P<0.05)。观察组治疗后皮肤瘙痒、酸胀疼痛、皮肤色素沉着、口渴不欲饮积分低于对照组(P<0.05)。观察组治疗后生活质量各领域评分高于对照组(P<0.05);观察组并发症少于对照组(P<0.05)。结论:四妙勇安汤加减联合激光腔内闭合术治疗下肢静脉曲张可提高疗效,减少并发症。

中医药治疗痛风性关节炎的研究进展

痛风性关节炎是一种非特异性炎症反应性疾病,其病理机制是嘌呤代谢异常紊乱,尿酸排泄异常,进而引起尿酸盐结晶沉积于关节及周围软组织。急性期以迅速缓解症状为治疗目的,非急性期则以降低血尿酸水平及预防关节炎复发为目的,但治疗棘手,且不良反应较明显,病情容易反复。该文通过查阅近年文献,从病因病机、中药内服、中药外治及中医药综合治疗等方面了解中医药治疗痛风性关节炎的最新研究进展并展开综述,发现中医药治疗痛风性关节炎疗效显著,不良反应少,具有更好的发展前景。

桂芍四妙汤治疗霉菌性阴道炎临床观察

目的分析桂芍四妙汤在霉菌性阴道炎患者中的治疗效果。方法选取2020年3月—2022年3月江西省安福县人民医院收治的82例霉菌性阴道炎患者,按随机数字表法分为两组,各41例。对照组给予常规西医治疗,观察组在对照组的基础上加用桂芍四妙汤治疗,连续1个月。对比两组临床疗效、治疗前后炎症因子水平、症状消退时间、不良反应情况。结果观察组治疗总有效率92.68%(38/41)高于对照组的75.61%(31/41)(P<0.05),外阴瘙痒、白带异常、外阴充血消退时间短于对照组(P<0.05)。治疗后,观察组白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)水平低于对照组(P<0.05)。两组不良反应发生率相当,差异无统计学意义(P>0.05)。结论桂芍四妙汤治疗霉菌性阴道炎效果显著,可有效促进症状消退、降低炎症因子水平,且无严重不良反应,临床应用价值较高。