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.

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.

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...

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.

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 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.

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

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.

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。

从“清激调补”探讨新型冠状病毒二次感染的临证思路

结合新型冠状病毒二次感染的现状,在辨病与辨证、辨分期结合的基础上,提出“清激调补”的中医临证思路。“清”即清除外来邪毒与内生浊物,祛邪外出,是新型冠状病毒二次感染治疗的关键;“调”为调理脏腑,随证治之,是新型冠状病毒二次感染治疗的重要内容;“激”是激发人体正气,调动先天之气补充后天之气以抗邪,“补”即补益气血阴阳,“激”与“补”二者均扶正以祛邪,是促使新型冠状病毒二次感染患者恢复健康的重要手段。

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。

益气活血开窍类中药及复方调控干细胞促进缺血性脑卒中急性期神经修复的作用

背景:大脑内源性神经发生和外源性干细胞移植对包括缺血性脑卒中在内的神经系统疾病展现出巨大的治疗潜力,能够修复和替代丢失的神经元、促进突触重构、抑制细胞凋亡。益气活血开窍类中药及复方治疗缺血后神经功能障碍具有一定的优势,通过多种途径靶向神经修复,包括促进内源性神经发生及外源性干细胞存活、增殖、归巢、诱导神经元分化。目的:综述益气活血开窍类中药及复方促进缺血性脑卒中急性期神经修复的机制,以期为缺血性脑卒中的新药研究及治疗提供参考。方法:检索中国知网和PubMed数据库2010-2022年期间关于益气活血开窍类中药及复方促进缺血性脑卒中急性期神经修复的文献,以“益气活血;开窍;中药;复方;缺血性脑卒中;神经修复;干细胞”为中文检索词,以“supplementing qi and activating blood circulation;inducing resuscitation;traditional Chinese medicine(TCM);compounds;ischemic stroke;nerve repair;stem cells”为英文检索词。排除陈旧及重复的观点,将检索到的文献进行分析整理,共纳入124篇文献进行分析。结果与结论:①梳理了干细胞、缺血性脑卒中的定义及缺血性脑卒中急性期神经修复途径。②总结了益气活血开窍类中药及复方促进缺血性脑卒中急性期神经修复的作用机制,主要包括促进干细胞增殖、提高干细胞活力及存活率、促进干细胞归巢、诱导干细胞向神经元分化、抑制神经细胞凋亡、促进轴突再生、调控血管新生及重塑、提高神经营养因子水平及修复血脑屏障完整性。③通过现有的研究总结了益气活血开窍类中药及复方促进缺血性脑卒中急性期神经修复的相关因子及信号通路,如Nestin蛋白表达、DCX蛋白表达、脑源性神经营养因子、血管内皮生长因子及Wnt/β-catenin信号通路、Notch信号通路、PI3k/Akt信号通路、BDNF/TrkB信号通路和ERK/MAPK信号通路等,为今后缺血性脑卒中特效药物及新的临床治疗方法的研究提供相关参考。

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。

参芪地黄汤合多靶点免疫抑制治疗IgA肾病合并膜性肾病个案报道

报道1例IgA肾病重复肾活检为IgA肾病合并膜性肾病的病例。患者病史长达11年且多种免疫抑制治疗均疗效不佳,属于难治性肾病,临床主要表现为大量蛋白尿及肾功能异常,伴有血尿、高血压。李伟教授根据多年用药经验及相关文献研究结果,给予参芪地黄汤联合多靶点免疫抑制治疗,重点分析中医辨证论治同西医病理结合,以益气活血清泄为原则,探讨其治疗方案及疾病转归,并复习相关文献,为中西医结合诊治IgA肾病合并膜性肾病提供治疗方向和临床依据。

基于络病理论探析溃疡性结肠炎发病机制及治疗

现代医家提出“脉络-血管系统病”概念,认为通畅无滞、气血运行正常是络脉系统维持人体正常生命活动的基础。溃疡性结肠炎作为一种慢性肠道炎症性疾病,常久病不愈,与络病相关,本文基于络病理论探讨溃疡性结肠炎的发病机制及治疗策略。溃疡性结肠炎活动期病理特征以肠黏膜炎性病变为主,为湿热毒邪损伤脾胃气机枢纽功能,使“无形”之邪留于肠络所致,治疗上宜分消湿热,调气和血通络;缓解期病理表现多见肠黏膜血管破坏,病机责之于瘀滞肠络,治疗上宜分理气血,益气活血通络。

甘温除热法治疗乳腺癌化疗后并发症

乳腺癌的发病以气郁、痰凝、血瘀为因,患之日久,积聚为核,囿于乳络,终耗气伤血,应用化疗药物后,毒邪进入体内最先伤及脾胃,脾胃受损则气血生化无本,输布无源,进而影响其他脏腑生理功能,致正气虚损、气血耗伤。甘温除热法可扶正祛邪、调畅气机、补益气血、安和诸脏,病及于心可用泻火升阳汤,病及于肝可用补中益气汤,病及于肺可用升阳益胃汤,病及于肾可用神圣复气汤。临证时需把握甘温除热法对应证的病机变化,选用方除李东垣著作中所载方外,亦可选黄芪建中汤、人参养荣汤、十全大补汤、七味白术散等符合甘温除热思想之方。

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。

张仲景复脉法探析

复脉法出自《伤寒论》,指通过益气、养血、温阳、滋阴、通阳以平衡脉之气血阴阳,使脉象返之如常的治法。张仲景以复脉法治疗多种严重脉象失常,具体形式体现为益气复脉、养血复脉、温阳复脉、滋阴复脉、气血阴阳并补复脉以及通阳复脉。在临床中应根据患者病情选择相应的复脉法,从而实现“脉复”的治疗预期。此外,“脉复”的表现应视具体情况而论。

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。