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.

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.

Study on Mitochondrial Ultrastructure, Traco Elementsand Their Correlative Factore in Cells ot Gastric Mucosa ot theGastropathic Patienta with Spleen Deficiency Syndrome

Atfer examining 88 gastropathic patieiits with Spleen deficiency syndrome by iJsing transmis-sion electron microscope, X-ray energy disperse analysis system, histochemical staining and radioimmunomethods, the authors found that the gastric mucosa cyclic adenosine monophosphate, superoxide dismutaselevel, quantity of mitochondria and its crista, the ratio of diameter between ventricle and cavity of mitochon-dria aiid the conteiit ot zinc (Zn) , copper (Cu) of mitochondria were decreasing to certain extent which tendsto get lower and lower with different groups in the order of health coritrol group, Spleen Qi deficiency groupaiid SPIeen deficiency with Qi stagnation group; chronic superficial gastritis group, chronic atrophic gastritisgroup and gastric cancor group , complete small intestinal metaplasia (IM) group, incomplete small iM group,complete colonic iM groiJp and incomplete colonic iM group (P< 0 . 05￣0 . 001 ) . While tlie degeiieratiori rateof mitochondria, Cu/Zn ratio, metaplasia rate of gastric mucosa, rate of incomplete colonic IM and content ofIipid peroxide were increasing in the above order (P < 0 . 05 ￣0 . 001 ) . It is suggested that tlie comprehensiveeffect ot the degeneration of mitochoridria and the quantitative changes of its correlative factors is the phys-iopathologic base for indecing SPIeen deficiency disease, gastric mucosa iM and canceration.

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.

Clinical treatment of myasthenia gravis with deficiency of spleen and kidney based on combination of disease with syndrome theory

OBJECTIVE: To study the use of Jianjining in the treatment of myasthenia gravis (MG) patients with a deficiency of both spleen and kidney via the theory on the combination of disease with syndrome. METHODS: Sixty MG patients with a deficiency of both spleen and kidney were randomly divided into an treatment group (n=30) treated with Jianjining granules and Western Medicine (prednisone or pyridostigmine bromide) and a control group (n= 30) treated with Jianjining granules. The dosage of the three drugs was reduced over the course of treatment. After 3 and 6 months of treatment, the curative effect was evaluated with the muscle weakness severity scale (MWSS). RESULTS: The MWSS score after treatment declined significantly in both groups. The score in the treatment group was much lower than that in thecontrol group (P<0.05). The total effective rate was 63.33% (19/30) in the treatment group and 36.67% (11/30) in the control group after 3 months of treatment, and 80.00% (24/30) and 50.00% (15/30), respectively, after 6 months of treatment. The obvious and total effective rates in the treatment group were much higher than those in the control group (P<0.05). After 6 months of treatment, there were no obvious differences (P>0.05) in the obvious and effective rates between the 2 groups. However, the total effective rate in the treatment group was much higher than that in the control group (P<0.01). CONCLUSION: Using the theory on the combination of disease with syndrome, we found that the curative effect of Jianjining and Western Medicine on MG patients with deficiency of both spleen and kidney is worth further exploration.

芒针联合中医辨证干预肝郁脾虚型溃疡性结肠炎临床疗效观察

目的评价芒针疗法联合中医辨证干预肝郁脾虚型溃疡性结肠炎的有效性和安全性。方法选择肝郁脾虚型溃疡性结肠炎患者64例,按照随机数字表法将其分为两组,分别为治疗组和对照组,治疗组根据中医辨证,给予芒针治疗,配合培土疏郁汤口服;对照组口服美沙拉嗪缓释颗粒。比较两组治疗前后的中医证候积分及治疗后临床有效率。结果治疗后,治疗组中医证候积分低于对照组,差异有统计学意义(P<0.01);治疗组的临床总有效率高于对照组,差异有统计学意义(P<0.05)。结论芒针疗法联合中医辨证干预肝郁脾虚型溃疡性结肠炎较单纯西药口服更具有优势,值得临床推广。

艾灸联合虎地肠溶胶囊治疗活动期溃疡性结肠炎临床观察

目的探究艾灸联合虎地肠溶胶囊治疗活动期溃疡性结肠炎的临床效果。方法采用随机数字表法将南昌大学第四附属医院2019年7月—2021年8月收治的60例活动期溃疡性结肠炎患者分为两组,各30例。对照组应用美沙拉嗪肠溶片治疗,试验组在此基础上应用艾灸联合虎地肠溶胶囊治疗。对比两组临床疗效、肠黏膜病变评分、Mayo活动指数评分及不良反应发生情况。结果试验组的治疗总有效率为93.33%(28/30),高于对照组的73.33%(22/30)(P<0.05)。治疗后,试验组肠黏膜病变评分、Mayo活动指数评分均低于对照组(P<0.05)。试验组不良反应发生率为3.33%(1/30),对照组为13.33%(4/30),差异无统计学意义(P>0.05)。结论艾灸联合虎地肠溶胶囊能够有效减轻活动期溃疡性结肠炎患者肠黏膜病变程度,改善各临床症状,疗效显著,且安全可靠,值得推广应用。

基于解痉多肽表达化生病证结合的小鼠模型探讨胃癌前病变脾胃虚实证候的本质

目的为了构建病证结合的小鼠模型及进行胃癌前病变(gastric precancerous lesions,GPL)脾胃虚实证候的本质研究。方法采用他莫昔芬(tamoxifen,TMXFR)诱导构建解痉多肽表达化生(spasmolytic peptide expression metagenesis,SPEM)小鼠模型,并在SPEM模型基础上分别模拟构建脾胃湿热证、脾气虚证模型,结合TMXFR诱导的SPEM模型具有自恢复的特性,以TMXFR组及生理盐水处理组作为对照组,监测小鼠一般情况,HE染色检测SPEM模型的构建及恢复情况,ELISA检测小鼠血清胃泌素水平,PCR检测各组小鼠胃黏膜中miR-7a-5p含量,免疫组化检测各组小鼠胃黏膜中白细胞介素-1β(interleukin-1β,IL-1β)、白细胞介素-13(interleukin-13,IL-13)表达。结果病证结合的脾胃湿热证、脾气虚证组较TMXFR组、SPEM组织恢复明显延迟;脾胃湿热证较对照组及TMXFR组的胃泌素表达异常升高(P<0.05),SPEM模型组小鼠胃黏膜中miR-7a-5p较对照组水平降低(P<0.05),病证结合的脾胃虚实组miR-7a-5p表达较TMXFR有下降趋势;病证结合的脾胃虚实组IL-1β表达较TMXFR组、对照组升高(P<0.05),脾胃湿热证、脾气虚证组中IL-13表达有升高趋。结论此项研究结果侧面证实了在癌前病灶已形成的前提下,虽无幽门螺杆菌感染,在外感湿热之邪、进食肥甘厚腻、饥饱失常、过劳伤脾等诱因下,机体可突破自身代偿修复能力,延缓SPEM恢复甚至使GPL进一步进展。这可能跟miR-7a-5p介导炎症因子IL-1β使得Th1/Th2细胞失衡相关,但具体机制尚待进一步研究。

脾虚证动物模型研究述评

中医界运用现代科学方法进行相关研究已有多年历史,在病证动物模型上颇有收获。本文对脾虚证动物模型发展历程进行回顾,对动物选择、造模方法、评价指标、消化系统病证结合模型进行总结和评论。模型动物多选用以大鼠为代表的小型啮齿类。目前,多基于病因病机造模,而较少使用化学药物与物理因素造模,复合因素造模法最常见。评价指标则分为中医证型指标、与“脾”功能和特性有关量化指标,以及方剂反证。功能性腹泻/消化不良为代表的脾虚证病证结合模型是目前研究的重心。脾虚证动物模型研究成绩斐然的同时仍存在许多不足,如缺乏脾虚证模型行业标准和共识,评价指标缺乏系统性和整体性,脾虚理论的现代阐释缺乏统一,学界亟需解决上述问题以促进发展。

基于“土虚木郁”探讨腹泻型肠易激综合征与溃疡性结肠炎共同发病机制及证治

腹泻型肠易激综合征(IBS-D)与溃疡性结肠炎(UC)是临床较为常见的消化系统疾病,二者虽在疾病性质上有所不同,但在临床症状表现、发病机制及治疗策略等方面有诸多类似之处。基于对中医古籍的研究及临证经验的总结,众多中医学者认为“土虚木郁”是此二者疾病共同的发病机制,治疗时从肝脾论治往往可取得满意的临床疗效。多项现代医学研究表明中医“土虚木郁”与脑肠互动异常、肠道菌群-胆汁酸轴失衡等IBS-D和UC共同的病理生理学改变密切相关。该文基于中医“异病同治”理念及现代医学研究进展,以“土虚木郁”为切入点,探讨IBS-D和UC共同的发病机制及临床证治。

湿性年龄相关性黄斑变性脾虚证大鼠模型的建立与评价

目的 使用大黄水煎液灌胃联合视网膜光凝建立湿性年龄相关性黄斑变性(wAMD)脾虚证大鼠模型,并对模型进行评价。方法 将24只10周龄BN大鼠随机分为对照组(CG)、光凝组(PG)、大黄联合光凝组(RPG),每组8只。RPG组大鼠予10 mL/kg灌胃大黄水煎液,行右眼视网膜氪激光光凝诱导脉络膜新生血管(CNV);PG组仅予氪激光光凝和等剂量蒸馏水灌胃;CG组仅灌胃蒸馏水,均连续干预10 d。记录3组大鼠10 d内的一般情况及表观行为情况;光凝后7 d、14 d活体进行眼底照相、荧光素眼底血管造影(FFA)、光学相干断层扫描(OCT)观察CNV病灶。14 d后取材,计算大鼠脾脏及胸腺指数,间苯三酚法检测血清D-木糖表达,测定血清α-淀粉酶活力;分离大鼠眼球视网膜色素上皮(RPE)层—脉络膜—巩膜的复合体,AF488偶联同工凝集素B4法观察CNV病灶;苏木精—伊红(HE)染色观察视网膜形态。结果 (1)一般情况及表观行为:RPG组大鼠毛发色泽、四肢肌肉、行动、精神状态等得分持续下降,体质量、体温低于PG组,差异均有统计学意义(t_(体质量)=6.014,P=0.000;t_(体温)=3.125,P=0.005)。(2)脾脏及胸腺指数:3组间大鼠胸腺及脾脏指数比较,差异均无统计学意义(P>0.05)。(3)血清D-木糖与α-淀粉酶:PG、RPG组大鼠血清D-木糖水平均低于CG组(t_(PG)=11.270,t_(RPG)=17.990,均P=0.000),且RPG组低于PG组(t=6.720,P=0.000),差异均有统计学意义;而3组间血清α-淀粉酶差异无统计学意义(P>0.05)。(4)眼底CNV:RPG组大鼠第7天、第14天CNV渗出面积高于PG组(t_(7 d)=2.217,t_(14 d)=2.210,均P=0.032),且灰度值高于PG组(t_(7 d)=3.448,P=0.001;t_(14 d)=2.215,P=0.032),差异均有统计学意义。(5)视网膜形态结构:CG组大鼠视网膜结构完整清晰,PG、RPG组视网膜结构破坏,伴有出血、水肿以及新生血管生成,且RPG组较PG组更为显著。(6)视网膜病变面积:RPG组平均病灶面积高于PG组,差异有统计学意义(t=4.645,P=0.000)。结论 大黄水煎液灌胃联合视网膜激光光凝法可以成功建立脾虚证wAMD病证结合大鼠模型。

溃结汤联合美沙拉嗪肠溶片治疗脾肾阳虚型溃疡性结肠炎临床观察

目的观察溃结汤联合美沙拉嗪肠溶片治疗脾肾阳虚型溃疡性结肠炎临床效果。方法将菏泽市中医医院2022年1月—2023年1月收治的82例溃疡性结肠炎患者,以随机数字表法分为对照组和观察组,各41例。对照组给予美沙拉嗪肠溶片进行治疗,观察组给予溃结汤联合美沙拉嗪肠溶片治疗。观察2组患者治疗前后中医症状积分(TCMPS)变化、肝细胞生长因子(HGF)和细胞间质上皮转换因子(c-MET)的变化。结果观察组总有效率高于对照组;观察组的中医症状积分相比对照组下降更为明显;观察组HGF与c-MET的阳性率比对照组增加更为明显,均P<0.05。结论溃结汤联合美沙拉嗪肠溶片治疗脾肾阳虚型溃疡性结肠炎的临床疗效好。

黄芪建中汤加味对脾胃虚寒型胃溃疡的影响

目的:探讨黄芪建中汤加味对脾胃虚寒型胃溃疡的影响。方法:选取2022年6月—2023年8月淄博市中医医院收治的76例脾胃虚寒型胃溃疡患者。随机将其分为对照组和观察组,各38例。对照组给予常规治疗,观察组在对照组基础上给予黄芪建中汤加味治疗。比较两组治疗前后炎症因子、中医症候积分、氧化应激指标及临床疗效。结果:治疗后,两组白细胞介素-10(IL-10)、白细胞介素-6(IL-6)与肿瘤坏死因子-α(TNF-α)水平低于治疗前,观察组IL-6、IL-10、TNF-α水平低于对照组,差异有统计学意义(P<0.05)。治疗后,两组丙二醛(MDA)低于治疗前,超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)高于治疗前,观察组MDA低于对照组,SOD及GSH-Px均高于对照组,差异有统计学意义(P<0.05)。治疗后,两组胃脘疼痛、胸胁满闷、食欲不振、嗳气吞酸及倦怠乏力评分均低于治疗前,观察组胃脘疼痛、胸胁满闷、食欲不振、嗳气吞酸及倦怠乏力评分均低于对照组,差异有统计学意义(P<0.05)。观察组总有效率为94.74%,高于对照组的76.32%,差异有统计学意义(P<0.05)。结论:在西药治疗基础上联合黄芪建中汤加味可有效减轻脾胃虚寒型胃溃疡患者的炎症反应,改善其氧化应激反应,改善其病情,提高治疗效果。

1746例胃息肉中医证型与内镜特征、病理类型的相关性研究

【目的】探究胃息肉中医证型与内镜特征、病理类型的相关性。【方法】选择广州中医药大学东莞医院总院脾胃病科收治的胃息肉住院患者1746例,收集患者的各项临床资料,包括性别、年龄、中医四诊资料以及胃息肉的病理类型、好发部位、数量、大小等,分析胃息肉患者的中医证型分布规律及其与内镜特征、病理类型的相关性。【结果】(1)性别方面,1746例患者中,女性1107例(63.40%),男性639例(36.60%),男女之比为1∶1.73;年龄方面,发病率与年龄呈正相关(P<0.01),年龄越大,发病率越高,中老年人是胃息肉的好发人群,≥40岁者占比高达87.40%。(2)中医证型方面,胃息肉患者的中医证型以脾胃气虚证最多[418例(23.94%)],其他按分布频次从高到低依次为寒湿阻滞证394例(22.57%)、脾胃湿热证353例(20.22%)、气滞痰阻证311例(17.81%)和痰瘀互结证70例(15.46%)。(3)不同性别中医证型分布比较,差异有统计学意义(P<0.01),其中脾胃气虚证、寒湿阻滞证、气滞痰阻证、痰瘀互结证女性多于男性,而脾胃湿热证男性多于女性;不同年龄段中医证型分布比较,差异有统计学意义(P<0.01),其中<30岁患者多见脾胃气虚证,30~39岁和40~49岁患者多见脾胃湿热证,50~59岁患者多见气滞痰阻证,≥60岁患者多见寒湿阻滞证。(4)病理类型方面,胃息肉患者的主要病理类型为胃底腺息肉1327例(76.00%),其他依次为增生性息肉266例(15.23%)、炎性息肉146例(8.36%)、腺瘤性息肉7例(0.40%);不同病理类型中医证型分布比较,差异有统计学意义(P<0.01),其中胃底腺息肉以脾胃气虚证为主,增生性息肉以气滞痰阻证为主,炎性息肉以寒湿阻滞证为主,腺瘤性息肉以痰瘀互结证为主。(5)胃息肉数量方面,以多发性息肉为主[1120例(64.15%)],单发性息肉较少[626例(35.85%)];不同胃息肉数量的中医证型分布比较,差异有统计学意义(P<0.05),其中多发性息肉以脾胃气虚证的占比最高(25.45%),单发性息肉以脾胃湿热证的占比最高(24.28%)。(6)好发部位及大小方面,胃息肉好发于胃体、胃底等部位,直径常≤0.5 cm;但不同发病部位及胃息肉大小之间的中医证型分布比较,差异均无统计学意义(P>0.05)。【结论】胃息肉患者的中医证型与性别、年龄、病理类型和数量具有相关性;发病率与年龄呈正相关,中老年是胃息肉的好发人群;女性明显高于男性,脾胃湿热证男性多于女性,其余证型均以女性多见;胃底腺息肉以脾胃气虚证为主,增生性息肉以气滞痰阻证为主,炎性息肉以寒湿阻滞证为主,腺瘤性息肉以痰瘀互结证为主。

益气清利化瘀方治疗原发性IgA肾病

目的探讨益气清利化瘀方对脾肾气虚兼湿瘀证IgA肾病患者症状改善和炎性因子水平的影响。方法选取2020年3月—2021年3月在我院接受治疗的264例脾肾气虚兼湿瘀证原发性IgA肾病患者作为研究对象,依据治疗方法不同分为对照组与治疗组,各132例。对照组予以氯沙坦钾治疗,治疗组在对照组基础上予以益气清利化瘀方治疗。分析益气清利化瘀方对该证型肾病患者中医症状改善状况、肾功能及炎症因子变化情况,以及治疗的有效性和安全性分析。结果治疗后,2组尿红细胞数、24 h-UTP、Scr、BUN、UA水平均降低;与对照组比较,益气清利化瘀方组降低幅度更显著(P<0.05);治疗后,2组中医证候积分均降低,益气清利化瘀方组积分低于对照组(P<0.05);益气清利化瘀方组治疗有效率(95.45%)高于对照组(68.18%),治疗后,2组hs-CRP、TNF-α、IL-2、IL-4、IL-5、IL-6水平降低,IFN-γ、IL-10水平升高;与对照组比较,益气清利化瘀方组变化幅度更显著(P<0.05);组间比较,差异具有统计学意义(P<0.05)。结论益气清利化瘀方对脾肾气虚兼湿瘀证原发性IgA肾病患者的中医症状、尿红细胞计数及肾功能改善作用明显,可降低炎性反应,安全性可靠。

铋剂四联疗法联合针刺督脉背段压痛穴位治疗脾胃虚寒型Hp感染性胃溃疡疗效分析

目的分析铋剂四联疗法联合针刺督脉背段压痛穴位治疗脾胃虚寒型幽门螺杆菌(Hp)感染性胃溃疡的临床疗效。方法选取2020年1月至2021年12月河南科技大学第一附属医院收治的80例脾胃虚寒型Hp感染性胃溃疡患者作为研究对象,按照不同治疗方法将其分为联合组(40例)与对照组(40例),联合组患者采用铋剂四联疗法联合针刺督脉背段压痛穴位治疗,对照组患者单纯采用铋剂四联疗法治疗,对比观察两组患者中医症候评分、溃疡长径、血清胃泌素(GAS)水平、Hp转阴率及临床疗效。结果治疗14 d后,联合组患者胃脘疼痛、食后腹胀、嗳气泛酸、恶心反胃评分以及血清GAS水平均明显低于对照组(t=6.910、6.318、7.140、9.345、8.819,P均<0.001),溃疡长径明显短于对照组(t=18.860,P<0.001);联合组患者Hp转阴率为87.5%,明显高于对照组患者的Hp转阴率67.5%(χ^(2)=4.588,P=0.032);联合组患者中显效26例、有效11例、无效3例,明显优于对照组患者的显效19例、有效10例、无效11例(Z=-1.997,P=0.046)。结论铋剂四联疗法联合针刺督脉背段压痛穴位治疗脾胃虚寒型Hp感染性胃溃疡,可明显降低GAS水平,提高Hp转阴率,改善患者脾胃虚寒症状,促进溃疡愈合。

芪竹健胃方治疗慢性萎缩性胃炎及癌前病变临床研究

目的研究芪竹健胃方治疗脾虚湿热血瘀型慢性萎缩性胃炎及癌前病变的临床疗效,并探讨该方药的作用机制。方法采用自身前后对照研究方法,纳入符合中西医诊断标准的患者31例作为治疗组,予芪竹健胃方中药汤剂进行治疗,疗程12 w,对比治疗前后中医症状疗效、胃镜征象、粘膜病理、癌变风险,血清胃功能三项的变化。另外,用蛋白免疫印迹法检测20例治疗组患者治疗前、治疗后胃粘膜Lgr5、Wnt1、C-myc蛋白表达情况,进行对比分析,对该方的作用机制开展探索性研究。结果治疗12 w后,治疗组患者的中医证候评分、胃镜病理改善情况具有统计学意义(P<0.01),降低癌变风险,血清G17、PGⅠ值升高,有统计学差异(P<0.01),PGR有升高趋势,且具有统计学差异(P<0.05);PGⅡ方面,结果不具统计学差异(P>0.05)。20例治疗组患者治疗前后胃粘膜Lgr5、Wnt1、C-myc蛋白表达情况皆呈逐渐下降的趋势。结论芪竹健胃方能明显改善慢性萎缩性胃炎及胃癌前病变患者的中医证候,促进胃黏膜的修复,降低癌变风险的机制可能与调控Wnt/Lgr5信号通路,抑制Lgr5标记的胃干细胞异常增殖分化有关。

朱莹基于“土得木而达”理论治疗溃疡性结肠炎经验

朱莹教授在论治溃疡性结肠炎时强调辨病论治与辨证论治相结合,溃疡性结肠炎临床常见证型为肝脾不和证、湿热郁滞证、肝郁血虚证、脾肾亏虚证、气滞血瘀证。朱教授治疗肝脾不和型溃疡性结肠炎常用柴芍六君子汤加减疏肝健脾;湿热郁滞型溃疡性结肠炎多用香砂六君子汤加黄芩、黄连、苦参、蒲公英清利湿热、调和肝脾、祛湿止泻;肝郁血虚型溃疡性结肠炎常用逍遥散、四物汤化裁;脾肾亏虚型溃疡性结肠炎常用四君子汤合参苓白术散加补骨脂、肉桂、熟地黄、杜仲、干姜等中药温补脾肾;气滞血瘀型溃疡性结肠炎运用分期祛瘀通络之法,在瘀病初期运用丹参、川芎、桃仁等配合白芍达到行气活血、养血合营、缓急止痛之效;滞瘀同病期配伍莪术、牛膝、牡丹皮以行滞通络;虚瘀同病期常用地龙、土鳖虫等血肉有情之品配合山药、当归以搜风通络、攻积破瘀、补脾益气,从而起到标本兼治之功。

甘草泻心汤合外治法治疗脾虚湿热型复发性口腔溃疡的临床研究

目的:观察甘草泻心汤合外治法治疗脾虚湿热型复发性口腔溃疡临床疗效及机理。方法:选取2018年6月—2023年2月于内蒙古自治区中医医院牛兴东教授门诊就诊的符合入选标准的62名复发性口腔溃疡患者,进行前瞻性随机对照临床试验。治疗组和对照组各31例,对照组给予复合维生素片和西地碘含片;治疗组另行给予甘草泻心汤治疗并配合外治法治疗,用药14天。统计两组患者治疗前后的VAS评分、匹兹堡睡眠量表评分、腹泻程度评分、血清中炎性因子指标(IL-2、IL-6、TNF-α)的变化情况、治疗效果情况。试验数据录入均采取SPSS 22.0专业统计学软件进行统计学分析。试验过程中未发现不良反应。结果:在总有效率方面,治疗组临床治疗总有效率为93.5%,显著高于对照组的74.2%,差异有统计学意义(P<0.05)。两组患者在治疗后口腔溃疡的VAS评分均有降低,疼痛程度均得到改善,差异有统计学意义(P<0.05)。但两组间比较发现,治疗组的疼痛改善程度明显优于对照组。两组患者治疗后统计发现,治疗组患者的失眠和腹泻症状得到明显改善,差异有统计学意义(P<0.05)。而对照组在治疗前后未见统计学差异。两组患者在治疗前均进行统计学分析,统计结果显示,两组患者在治疗前无统计学意义(P>0.05)。而经分组治疗后两组患者与治疗前相比较均有统计学差异,表明两组患者在治疗后IL-2、IL-6、TNF-α水平均有一定程度降低。但二者在治疗后的降低程度相比有统计学意义(P<0.05),表明治疗组对降低复发性口腔溃疡患者炎性指标的控制优于对照组。结论:甘草泻心汤合外治法治疗脾虚湿热型复发性口腔溃疡疗效显著,可有效改善患者疼痛、失眠及腹泻的主要症状,缩短病程,提高免疫功能,减少复发率。

黄芪建中汤治疗脾胃虚寒型胃溃疡效果观察

目的探讨黄芪建中汤治疗脾胃虚寒型胃溃疡的临床效果。方法选取医院2020年5月至2023年5月收治的脾胃虚寒型胃溃疡患者96例,随机分为对照组和观察组,各48例。对照组予常规西医治疗,观察组予黄芪建中汤治疗。结果观察组总有效率为93.75%,显著高于对照组的79.17%(P<0.05)。观察组胃消化功能指标生长抑素、胃动素水平均显著高于对照组,胃泌素、血管活性肠肽水平均显著低于对照组(P<0.05)。观察组不良反应发生率为4.17%,显著低于对照组的25.00%(P<0.05)。结论应用黄芪建中汤治疗脾胃虚寒型胃溃疡,能改善患者的临床症状,有利于其胃功能恢复。