Effect of Chinese Herbs for Activating Blood Circulation,Removing Stasis and Supplementing Qi on the Circulating Endothelial Cells in Patients with Unstable Angina Pectoris

Objective: To observe the effect and clinical significance of circulating endothelial cells (CEC) in the pathogenesis of coronary heart disease with unstable angina pectoris (CHD-UAP), and to explore the protective effect of Chinese herbs for activating blood circulation, removing stasis and supplementing Qi (CH) on CHD-UAP patient's CEC. Methods: Sixty patients with diagnosis of CHD-UAP confirmed and differentiated to be Qi-deficiency and blood stasis by TCM were randomly divided into two groups and treated, on the basis of Western drug-therapy, with Tongxinluo capsule (通心络胶囊, TXL) and Huoxue Tongmai capsule (活血通脉胶囊, HXTM) respectively by way of oral taking three times a day, 3 capsules every time, with 1 month as one therapeutic course. The number of CEC in patients' blood circulation was counted before and after treatment. Besides, the number of CEC in 30 healthy persons was also counted for control. Results: The number of CEC in CHD-UAP patients was significantly higher than that in the healthy persons (P<0.01). After the patients were treated with CH, either TXL or HXTM, it significantly decreased (P<0.01)with insignificant difference between the two treated groups. Conclusion: CEC in CHD-UAP patients is severely damaged and endothelial function in disorder, Chinese herbs have protective effect on patients' CEC.

Effect of Chinese Drugs for Supplementing Qi,Nourishing Yin and Activating Blood Circulation on Myocardial Perfusion in Patients with Acute Myocardial Infarction after Revascularization

Objective:To observe the effects of Chinese drugs for supplementing qi,nourishing yin and activating blood circulation on the myocardial perfusion in acute myocardial infarction(AMI) patients after revascularization.Methods:Eighty patients with anterior or inferior ventricular wall AMI,who had received revascularization by intravenous thrombolysis or coronary bypass,were randomized into the treated group and the control group equally,both treated with conventional Western medical treatment,but combined,resp...

Protective Effect of Chinese Herbs for Supplementing Qi,Nourishing Yin and Activating Blood Circulation on Heart Function of Patients with Acute Coronary Syndrome after Percutaneous Coronary Intervention

Objective： To investigate the effects of Chinese herbs for supplementing qi, nourishing yin and activating blood circulation on heart function of patients with acute coronary syndrome （ACS） after successful percutaneous coronary intervention （PCI）. Methods： One hundred patients with ACS after successful PCI were randomly assigned to a Western medicine （WM） treatment group （WMG） and a combined treatment group （CMG） treated by Chinese herbs for supplementing qi, nourishing yin and activating blood circulation, besides Western medicine treatment, with 50 cases in each group. Both treatment courses were 6 months. The follow- up was scheduled at baseline, 6 months and 1 year after PCI, and New York Heart Association （NYHA） functional class, Chinese medicine （CM） symptom scores, blood stasis syndrome scores, and major adverse cardiovascular events （MACE） were observed, serum levels of N-terminal pro-brain natriuretic peptide （NT-proBNP） and hyper-sensitivity C-reactive protein （Hs-CRP） were measured, an echocardiogram was conducted to examine left ventricular ejection fraction （LVEF）, left ventricular end-diastolic volume （LVEDV）, left ventricular end-systolic volume （LVESV）, inter-ventricular septal thickness （IVST）, left ventricular posterior wall thickness （LVPWT）, and ventricular wall motion index （VWMI）. Results： Compared with the baseline, LVEF significantly increased （P〈0.01）, and CM symptom scores, blood stasis syndrome scores, VWMI, LVEDV, LVESV, NT-proBNP, and Hs-CRP all decreased （P〈0.01） in both groups at 6 months and at 1 year after PCI. There were no significant differences in all the above parameters at 1 year vs those at 6 months after PCI （P〉0.05）. VWMI, LVEDV, LVESV, NT-proBNP, Hs-CRP, LVEF, and CM symptom and blood stasis syndrome scores were all improved obviously in CMG than those in WMG （P〈0.05 or P〈0.01） at 6 months and at 1 year after PCI. There were no significant differences in NYHA functional class between CMG and WMG at different follow-up timepoints; it was notable that P value was 0.054 when comparing the cases of NYHA functional class between the two groups at 1-year follow-up. During the 1-year follow-up, 3 MACE and 11 MACE occurred in CMG and WMG, respectively; the MACE rate in CMG was lower than that in WMG （6% vs 22%, P〈0.05）. Conclusion： Chinese herbs for supplementing qi, nourishing yin and activating blood circulation could improve heart function, reduce the CM symptom scores and blood stasis syndrome scores, and decrease the incidence of MACE in patients with ACS after successful PCI.

Effect of Chinese Herbal Medicine for Nourishing Yin,Supplementing Qi,and Activating Blood on the Th1/Th2 Immune Balance in Peripheral Blood in Patients with Primary Sjogren's Syndrome

Objective： To observe the effect of Chinese herbal medicine for nourishing yin, supplementing qi, and activating blood on the expression of interferen- γ （IFN-γ,）/interleukin-4 （IL-4） in peripheral blood and disease activity in primary Sjogren＇s syndrome （pSS） patients, and to study the relationship between the immune balance of Th1/Th2 and the disease activity. Methods： A total of 66 pSS patients were randomized with tossing coins method into two groups： the integrative therapy group （34 cases） and the control group （32 cases）; and 28 healthy subjects were taken as the normal group. The integrative therapy group was treated by Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood combined with hydroxychloroquine sulfate tablets and the control group was treated with hydroxychloroquine sulfate tablets. The treatment course was 3 months for both groups. The levels of serum immunoglobulin G （IgG）, erythrocyte sedimentation rate （ESR）, IFN-γand IL-4 in peripheral blood were measured before and after treatment. Results： Compared with the normal group, the levels of IgG, ESR, IFN- γ and IL-4 were significantly increased in pSS patients （P〈0.05）. Remarkably, after 3 months of treatment, these levels were dramatically decreased in both the integrative therapy group and the control group, although still higher than the normal group. The levels of IgG, ESR, IFN- and IL-4 in the integrative therapy group were lower than the control group and the same group before treatment （P〈0.05）. The ratio of IFN-γ/IL-4 also significantly decreased after treatment. Moreover, the level of IFN- γ, and the ratio of IFN- γ/IL-4 in the integrative theraphy group were significantly lower than the control group （P〈0.05）. For all patients the ratio of IFN-γ/IL-4 before and after treatment was positive correlated with the levels of IgG and ESR. Conclusion： Chinese herbal medicine for nourishing yin, supplementing qi, and activating blood can alleviate the disease activity of pSS by regulating the immune balance of Th1/Th2.

Effect of Chinese Herbal Medicines for Nourishing Yin,Supplementing Qi,and Activating Blood on Reproductive Endocrine Activity and Immune Functions in Patients with Primary Sjogren's Syndrome

ABSTRACT Objective： To investigate the effect of Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood on the reproductive endocrine-immune network and its mechanisms in patients with primary Sjogren＇s syndrome （pSS）. Methods： Seventy pSS patients were randomly assigned to two groups using a randomized digital table： the integrative therapy group （36 cases） and the control group （34 cases）. Thirty healthy subjects were taken as a normal group. The control group was treated with hydroxychloroquine sulfate tablets alone, and the integrative therapy group was treated by Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood combined with hydroxychloroquine sulfate tablets. The treatment course was 6 months for both groups. Before and after treatment, serum estradiol （E2）, testosterone （T）, luteinizing hormone （LH）, prolactin （PRL） by radioimmunoassay and immunoglobulin （IgG） by immunodiffusion, erythrocyte sedimentation rate （ESR） by Westergren, interferon-γ （IFN-γ） and interleukin-4 （IL-4） by enzyme linked immunosorbent assay were determined. Results： E2 and T levels in all patients were lower than those of normal subjects before treatment （P〈0.05） and were increased significantly after 6-month treatment （P〈0.05）. ESR, FSH, LH, IgG, IFN - γ, IL - 4 and ratios of E2/T, and IFN --γ/IL in the patients were higher than those of normal subjects before the treatments （P〈0.05）, and were reduced significantly after the treatments （P〈0.05）. The T and IFN -γ levels and E2/T ratio in the patients treated with integrative therapy were reduced significantly compared with the control group （P〈0.05）. However, the PRL levels before and after treatment were not significantly changed in the two groups （P〉0.05）. The ratios of E2/T and IFN -γ/IL-4, and levels of IgG and ESR were positively correlated before and after treatment （P〈0.05）. Conclusions： The ratios of E2/T and IFN - γ/ IL-4 might be used as indicators of pSS activity. Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood combined with Western medicine could improve the therapeutic effect by regulating the reproductive endocrine-immune network in pSS patients.

Effects of Chinese herbs capable of replenishing qi, nourishing yin and activating blood circulation and their compatibility on differentially expressed genes of ischemic myocardium

This study was conducted to investigate the effects of Chinese herbs capable of replenishing qi, nourishing yin and activating blood circulation and their compatibility on differentially expressed genes of ischemic myocardium which were selected from differential expression profile we had established before, and to explore the underlying mechanism. The acute myocardial infarction (AMI) model was established by ligating the left anterior descending (LAD) coronary artery, then the model rats were randomly divided into the model group, the Metoprolol group, the replenishing qi nourishing yin (RN) group, the activating blood circulation (AB) group, and the replenishing qi, nourishing yin and activating blood circulation (RA) group. In addition, the normal group and the sham group were set up. The rats of medication groups were administered by intragastric gavage with corresponding drugs on the second day after operations, and the rats of the normal group and the sham group were given normal saline as the same time.Then the ischemic hearts were harvested on the 8th day after operation. The myocardial pathomorphological changes were observed under a light microscope. The mRNA changes of target genes such as COX5a and ATP5e were detected using Realtime fluorescence quantitative PCR (QPCR), and the activities of related enzymes were detected by colorimetric assay. The main results were as follows: the histological changes were observed by HE staining, and cardiocyte swelling, inflammatory cell infiltration and cytolysis were showed in regional ischemic myocardium of the model group, while the pathomorphological changes in all medication groups did not show obvious changes. Two genes related to energy metabolism, COX5a and ATP5e, were selected as the target genes which were downregulated at the mRNA level in the medication groups. The activities of correlative functional enzymes also decreased in the RA group compared to that in the model group accordingly (P<0.05). The results indicated that the abnormal expression of genes involved in energy metabolism pathways could be one of the molecular mechanisms of AMI. The compatibility of Chinese herbs capable of replenishing qi, nourishing yin and activating blood circulation affects the expression of energyrelative gene COX5a, ATP5e, which is probably the mechanism of myocardial preservation, and is more effective than single herb of replenishing qi and nourishing yin or activating blood circulation.

Supplementing Qi and activating blood circulation method to treat vertebrobasilar dolichoectasia with posterior circulatory watershed infarction:a case report of two patients

Vertebrobasilar dolichoectasia(VBD),a rare posterior circulation vascular variant disease,is an important risk factor for many acute cerebrovascular diseases.An insufficient understanding of VBD often leads to misdiagnose.Two cases of VBD that were initially diagnosed as posterior circulation watershed infarction are reported here.Absence of common causes of stroke including hypoperfusion,blood system diseases,carotid and aortic dissection,and eosinophil elevation,the symptoms of the 2 patients met the diagnostic criteria of VBD.Both patients displayed symptoms that were in line with the Traditional Chinese Medicine(TCM)syndrome pattern of"Qi deficiency and blood stasis".Accordingly,they were comprehensively treated with Supplementing Qi and activating blood circulation method.The clinical manifestations of the 2 patients were remarkably improved and no recurrence of watershed infarction was found in a 1-year follow-up.A detailed medical history and laboratory examination are capable of improving diagnostic accuracy of VBD.TCM treatment based on syndrome identification might be a promising candidate for VBD management.

Clinical Study on Effect of Chinese Herbal Medicine for Supplementing Kidney and Qi and Activating Blood Circulation in Treating Intrauterine Growth Retardation of Fetus

Objective: To explore the therapeutic effect and the possible working mechanism in using Chinese herbal medicine (CHM) for supplementing Kidney and Qi, and activating blood circulation in treating intrauterine growth retardation of fetus (IUGR). Methods: Fifty-five cases of IUGR were divided into two groups, 30 cases in the CHM group treated with CHM and the 25 in the control group treated with amino acids. The effect of CHM treatment was observed and compared with that of the control group, normal pregnancy group and non-treated IUGR group. Results: Body weight of the newborns in the CHM was markedly higher than that in the control group. Not only the maternal fundal height (FH) and the abdominal circumference (AC), but also the fetal growth parameters, including biparietal diameter, head circumference (HC), and femur length (FL) in the CHM group increased much faster than those in the control group. After CHM treatment, the maternal serum levels of estriol (E3) and human placental lactogen (hPL) approached to those in the normal pregnancy group, but the control group,in comparison with the normal pregnancy group, was significantly different. The umbilical venous plasma concentration of essential amino acids in both treated groups improved, but the improvement in the CHM group was more significant than that in the control group. No apparent adverse effect of CHM was observed in either mother or fetus.Conclusion: CHM for supplementing Kidney and Qi and activating blood circulation was more effective in improving placental function and enhancing amino acid transportation than amino acid

益气活血方药治疗原发性肝癌的免疫学机制概述

归纳总结具有益气和/或活血功效的中药单体、单味中药以及中药复方治疗原发性肝癌的免疫学机制,包括对T淋巴细胞亚群、巨噬细胞、髓源性抑制细胞(myeloid-derived suppressor cell,MDSC)、肿瘤细胞表面受体、细胞因子以及红细胞免疫在数量和功能上的调节,阐述其抗肿瘤作用,为进一步的基础研究和临床应用提供思路。

基于气阴两虚夹瘀运用五参汤治疗肺癌术后发热浅析

肺癌术后发热有非感染性发热与感染性发热之分,在气虚、阴虚、瘀血阻滞病理状态下形成热蕴状态,是为非感染性发热;而术中感染或外感风寒入里化热则形成感染性发热表现。其基本病机均可概括为气阴两虚夹瘀。五参汤具有益气养阴、清热解毒之功,为证属正气亏虚、外感邪毒者而设,用于肺癌术后发热契合其病机。

单味中药有效成分治疗溃疡性结肠炎研究进展

研究表明,中药治疗溃疡性结肠炎不良反应少且复发率低,临床常用益气健脾、清热祛湿、活血化瘀、补血养阴类中药组方治疗,其主要药物的有效成分具有减轻炎症反应、修复黏膜损伤、调节肠道微生态、调节免疫反应等作用。本文对常用单味中药有效成分治疗溃疡性结肠炎的作用机制进行综述,为其临床治疗与中药新药研发提供参考。

基于“二阳结谓之消”探讨糖尿病性便秘病机及防治策略

“二阳结谓之消”语出《素问·阴阳别论篇》,是认识糖尿病性便秘的早期记载,但目前学界多据此仅从二阳(足阳明胃经、手阳明大肠经)结滞化热来解释消渴期发生便秘的病机,存在一定局限性。通过考究发现“二阳”并不单指手足阳明经脉或胃肠二腑,而是包括胃、大肠二腑及手足阳明经脉;“结”也并不完全指结热这一病邪,而是指病邪胶结难解、疾病难以治愈的程度,并且“二阳”之热易伤血脉,造成络脉瘀滞。基于对“二阳结谓之消”的重新理解,笔者认为糖尿病性便秘在糖尿病期以“热伤气阴”为主要病机,糖尿病并发症期以热伤血络、血脉瘀滞为主要病机。治疗方面,糖尿病期以清热益气养阴为本,糖尿病并发症期以活血化瘀为核心,此外还需重视体质从化,全面把握糖尿病性便秘的诊治。

活血通络类方剂治疗糖尿病肾脏疾病的研究进展

糖尿病肾脏疾病(DKD)是导致慢性肾脏病和终末期肾病的首要病因,严重危害人类健康。中医认为血瘀是贯穿DKD全病程的重要病机,多项研究拟定了多个活血通络类方治疗DKD患者,其临床症状好转、蛋白尿减少、肾功能保护、治疗有效率提高和疾病进展延缓等方面均有成效。

近10年中医辨治胃癌前病变的研究进展

对近10年来有关中医辨治胃癌前病变(precancerous lesions of gastric cancer,PLGC)的研究进行综述。PLGC是指在慢性萎缩性胃炎基础上出现的胃黏膜肠上皮化生和异型增生,作为慢性萎缩性胃炎与胃癌的中间阶段,PLGC的病程较缓慢。中医辨治PLGC具有一定的优势。PLGC主要可分为脾胃虚弱证、脾胃湿热证、肝胃气滞证、胃络瘀阻证、胃阴不足证5种证型。胃镜技术的普及促进了胃病微观辨证的发展,微观辨证与宏观辨证的结合为PLGC的中医辨证论治提供了更加丰富的理论支持。PLGC根本病机为脾胃虚弱,脾胃气机不畅,兼有湿热、瘀毒、痰湿等病理因素蕴结,日久胃阴亏耗。中药治疗PLGC的临床研究开展较多,治疗主要采用以益气健脾为主,兼以疏肝活血、化湿消瘀、化瘀解毒、养阴益胃,从而防止PLGC向胃癌进一步发展。针灸治疗胃癌前病变的研究开展较少。今后需开展更多严格且规范的多中心、大样本的临床随机对照试验,深入研究针灸治疗胃癌前病变机制,以期为中医辨治PLGC提供更多高级别的循证依据。

益气活血中药治疗慢性心力衰竭机制的研究进展

慢性心力衰竭是一种进行性的、使患者身体衰弱的疾病,病死率和再住院率居高不下。据报道,我国慢性心力衰竭患者基数庞大且持续增加,已成为严重的社会公共卫生问题。近年来,虽然现代医学在药物治疗方面不断改进,但是仍无法克服其致死率高、不良反应明显等不足。中医学认为慢性心力衰竭病位在心,心气亏虚,推动无力,从而导致血脉瘀滞。因此,益气活血法是治疗慢性心力衰竭的有效方法。益气活血药是以补虚扶弱、疏通血脉为主要功效,以治疗气虚血瘀证为主的一类中药。其代表药物有人参、黄芪、丹参、当归、川芎等,是治疗慢性心力衰竭心气虚证的常用药物。人参、黄芪益气强心,配合当归、川芎活血化瘀,在缓解心气不足、心血不运中显示出了良好疗效。诸多研究表明益气活血类中药具有多成分、多途径、多靶点的特点,在改善慢性心力衰竭患者症状,提高生活质量方面具有独特优势。近期研究发现其作用机制与血流动力学、神经内分泌系统、内皮损伤、免疫调节、炎症因子、氧化应激、心肌能量代谢、心室重构、自噬和凋亡等机制有关。文章旨在总结益气活血类中药改善心功能的作用机制,以期为慢性心力衰竭气虚血瘀证的治疗提供新思路。

益气养阴活血法治疗2型糖尿病合并慢性心力衰竭患者的疗效观察

目的 探讨中医益气养阴活血法辨证治疗2型糖尿病(Type 2 diabetes, T2DM)合并慢性心力衰竭(Chronic heart failure, CHF)患者的临床疗效。方法 选取2021年1月—2022年1月期间唐山市中医医院内分泌一科收治的T2DM合并CHF患者102例作为研究对象,按随机数字表法分为对照组与治疗组,每组各51例。对照组给予常规西医治疗,治疗组在对照组基础上联合中医益气养阴活血法辨证治疗,均治疗12周。观察比较两组患者西医疗效、中医证候疗效、安全性及治疗前后血糖水平[空腹血糖(Fasting blood glucose, FPG)、餐后2 h血糖(Blood glucose 2 h after a meal, 2 h PG)、糖化血红蛋白(Glycosylated hemoglobin, HbAlc)]、心功能指标[6分钟步行试验距离(6 min walking test, 6MWT)、左室射血分数(Left ventricular ejection fraction, LVEF)、N末端B型脑钠肽前体(N-terminal B-type brain natriuretic peptide precursor, NT-pro BNP)]、生活质量评分[T2DM生活质量(Quality of life specific scale for diabetes patients, DSQL)、CHF生活质量(Minnesota Living with Heart Failure Questionnaire, MLHFQ)]变化。结果 临床疗效:治疗后治疗组西医疗效总有效率96.08%(49/51)高于对照组82.35%(42/51),差异有统计学意义(P<0.05);治疗组中医证候疗效总有效率92.16%(47/51)高于对照组68.63%(35/51),差异有统计学意义(P<0.05)。血糖水平:治疗后两组患者血糖FPG、2 h PG及HbAlc水平均较治疗前降低,差异有统计学意义(P<0.05);且治疗组血糖FPG、2 h PG及HbAlc水平均明显低于对照组,差异有统计学意义(P<0.05)。心功能指标:治疗后两组患者心功能6MWT、LVEF水平较治疗前升高,NT-pro BNP水平较治疗前降低,差异有统计学意义(P<0.05);且治疗组6MWT、LVEF水平高于对照组,NT-pro BNP水平低于对照组,差异有统计学意义(P<0.05)。生活质量:治疗后两组患者DSQL、MLHFQ评分均较治疗前降低,差异有统计学意义(P<0.05);且治疗组DSQL、MLHFQ评分均明显低于对照组,差异有统计学意义(P<0.05)。安全性:治疗期间,两组患者不良反应均为轻度或一过性,未影响治疗,且不良反应发生率组间比较,差异无统计学意义(P>0.05)。结论 中医益气养阴活血法辨证治疗T2DM合并CHF效果显著、安全性高,有利于控制患者血糖,改善心功能与生活质量。

益气养阴化瘀法对糖尿病视网膜病变患者微血管功能、动脉血流、微视野及血清Vaspin和SCUBE2水平的影响

目的:观察益气养阴化瘀法对糖尿病视网膜病变患者微血管功能、动脉血流、微视野及血清脂肪特异性丝氨酸蛋白酶抑制剂(Vaspin)和骨形态发生蛋白1-表皮生长样结构域蛋白2(SCUBE2)水平的影响。方法:选择2021年1月至2022年12月于该院治疗的糖尿病视网膜病变患者102例,以随机数字表法分组。对照组50例患者给予常规西医治疗,观察组52例患者在对照组的基础上给予益气养阴化瘀方治疗。比较两组患者的临床疗效、治疗前后的中医证候评分,检测视野平均敏感度、视力、收缩期血流速度峰值、眼动脉阻力指数(RI)和舒张期血流速度峰值,检测患者Vaspin、低氧诱导因子-1(HIF-1)、可溶性细胞黏附分子(sICAM-1)、SCUBE2、外周血内皮细胞(CEC)和循环祖细胞(CPC)水平。结果:观察组患者总有效率为98.08%(51/52),高于对照组的84.00%(42/50),差异有统计学意义(P<0.05)。治疗后,观察组患者的中医证候评分较对照组降低,差异有统计学意义(P<0.05)。治疗后,观察组患者的RI低于对照组,收缩期血流速度峰值、舒张期血流速度峰值、视野平均敏感度和最佳矫正视力高于对照组,差异均有统计学意义(P<0.05)。治疗后,观察组患者的CPC水平较对照组升高,CEC水平较对照组降低,Vaspin、HIF-1、sICAM-1和SCUBE2水平较对照组降低,差异均有统计学意义(P<0.05)。结论:益气养阴化瘀法治疗糖尿病视网膜病变,可改善患者微血管功能、动脉血流、微视野和视力,提高临床疗效。

益气养血通脉法治疗阵发性房颤的临床观察

目的探讨益气养血通脉法治疗阵发性房颤患者的疗效。方法60例阵发性房颤患者,采用随机数字表法分为对照组和治疗组,各30例。两组均给予常规抗心律失常西药(琥珀酸美托洛尔片)治疗,治疗组在此基础上应用中医益气养血通脉法治疗,3个月(12周)后比较两组患者中医证候、动态心电图改善效果,治疗前后P波离散度(Pd)及左房内径(LAd)。结果治疗组中医证候总有效率为93.33%,高于对照组的73.33%,差异有统计学意义(P<0.05)。治疗组动态心电图总有效率为96.67%,高于对照组的76.67%,差异有统计学意义(P<0.05)。治疗前,两组Pd及LAd比较,差异无统计学意义(P>0.05)。治疗后,两组Pd、LAd均较治疗前下降,且治疗组Pd(34.41±3.74)ms、LAd(37.00±3.25)mm低于对照组的(38.39±4.32)ms、(41.00±3.76)mm,差异有统计学意义(P<0.05)。结论益气养血通脉法治疗阵发性房颤疗效确切,在改善阵发性房颤患者的症状及预防复发方面疗效明显,值得临床推广应用。

基于玄府调控生殖轴理论探讨风药在月经病中的运用

风药具有风之轻扬上升、发散开泄、善行而无处不至的特性,能开通全身上下内外之玄府,是临床最常用的一类开通玄府药物。因此,在月经病中辨明病因、病位以及玄府闭塞的程度后,可用风药从多角度开通生殖轴玄府,达到理想的治疗效果。外感风寒型月经病祛风以通玄,常用药物有麻黄、桂枝、荆芥、防风、生姜等;气郁玄府型月经病理气以通玄,常用药物有柴胡、枳壳、青皮、香附、木香等;血瘀型月经病活血以通玄,常用药物有桂枝、川芎、荆芥、刺蒺藜、白芷、细辛、羌活、葛根等;痰湿型月经病化湿以通玄,常用药物有升麻、葛根、柴胡、羌活、独活等;虚实相兼型玄府病变补虚以通玄,常用药物有羌活、独活、防风、白芷等。通过正确的药物配伍,在月经病中灵活运用风药,可获良效。

基于数据挖掘及网络药理学的益气活血法治疗膝骨关节炎的机制研究

目的:基于数据挖掘分析益气活血法的高频配伍规律,并通过网络药理学方法研究其核心药物组治疗膝骨关节炎的作用机制。方法:应用Python 3.8.1编程对中国中医药在线数据库进行智能抓取,分析其配伍规律,以符合支持度≥0.30,置信度≥0.90,提升度≥1.00的中药为核心药物组,通过中药系统药理学数据库与分析平台(TCMSP)获取核心药物组的主要活性成分,利用PubChem平台、Swiss Target Prediction平台收集药物靶标基因,通过GeneCards及OMIM数据库获得膝骨关节炎相关靶基因,利用Venny数据库获取药物靶点及疾病靶点的交集,采用Cysoscape软件和STRING数据库分析蛋白质-蛋白质相互作用网络,借助DAVID软件对关键靶基因进行基因本体论(GO)分析和京都基因与基因组百科全书(KEGG)通路分析,通过Systems Dock Web Site对成分与关键靶标基因进行分子对接验证。结果:以益气活血法中使用频次最高的药对黄芪-当归为核心药物组,并筛选得到22个活性成分,涉及74个关键靶基因。网络分析结果表明,核心药物组治疗膝骨关节炎的关键靶点为肿瘤坏死因子(Tumor Necrosis Factor,TNF)、Jun原癌基因(Jun Proto-Oncogene,JUN)、白细胞介素(Interleukin,IL)-6、IL-4、IL-1β和趋化因子2(C-X-C Motif Chemokine Ligand 2,CXCL2)等;GO富集分析主要涉及脂多糖反应、细胞死亡、迁移的正向调节、细胞因子受体结合等生物学过程,KEGG通路中晚期糖基化终末产物(Advanced Glycation End-product,AGE)与其受体(Receptor for Advanced Glycation End Products,RAGE)信号通路、TNF信号通路、IL-17信号通路与治疗膝骨关节炎密切相关,分子对接显示关键靶点与山柰酚、β-谷甾醇、槲皮苷具有较高亲和力。结论:初步预测了益气活血法核心药物组对膝骨关节炎的基本药理基础及作用机制,益气活血法治疗膝骨关节炎具有多基因参与、多信号通路的特点。