Clinical Nursing Intervention of Moxibustion on Abdominal Distension Symptoms in Heart Failure (Heart and Kidney Yang Deficiency and Blood Stasis Blocking Collaterals Syndrome)

Objective:To investigate the clinical nursing intervention effect of moxibustion on abdominal distension symptoms in heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome).Methods:62 patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)admitted to our hospital from February 2023 to February 2024 were selected and divided into the observation group(n=31)and the control group(n=31)by using the random numerical table method.The control group adopted conventional nursing interventions,and the observation group received the nursing program of the control group with the addition of moxibustion nursing interventions.The nursing effectiveness,quality of life scores,and nursing satisfaction were compared between the two groups.Results:The nursing effectiveness of the observation group was significantly higher than the control group(P<0.05);the quality of life score of the observation group was significantly higher than the control group(P<0.05);the nursing satisfaction of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:The use of moxibustion nursing intervention in patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)can effectively relieve the symptoms of abdominal distension,improve patients'quality of life,and increase nursing satisfaction,which has promotion and application values.

Transcriptomic and metabolomic analysis of the effects of Zhenwu decoction on kidney yang deficiency pattern in chronic kidney disease

Objective:To explore the kidney yang deficiency pattern(KYDP)in a chronic kidney disease(CKD)rat model and the mechanisms underlying the effects of Zhenwu decoction(ZWD)by conducting tran-scriptomic and metabolomic analyses.Methods:Adriamycin(ADR)combined with hydrocortisone(HC)was used to induce CKD with KYDP in rats.ADR was injected into the tail vein twice.HC was injected intramuscularly for 8 weeks.ZWD was administered by gavage for 8 weeks.The general condition was observed,24-h urine protein was detected,serum corticosterone,triiodothyronine,thyroxine,TSH,testosterone,cAMP,and cGMP levels were determined,and pathological analysis was conducted.Transcriptomic and metabolomic analyses were conducted to screen differentially expressed genes(DEGs),differentially expressed metabolites(DEMs),and differentially expressed pathways(DEPs).The core DEMs and DEGs were input to Metab-oanalyst 5.0 to identify the pathways affected by ZWD.Results:In the HC group,KYDP symptoms were observed.Compared with control group,the levels of 24-h urine protein,TSH,and cGMP significantly increased(all P<0.01),and corticosterone,triiodothyronine,thyroxine,and cAMP significantly decreased(all P<0.01)in the HC group.After ZWD intervention,the levels of above-mentioned indicators could be reversed to some extent.Pathological analysis in the HC group revealed kidney lesions.DEGs in the ZWD group were mainly associated with pathways such as nucleotide synthesis and endocrine pathways.In the ZWD group,differences in biosynthesis of unsat-urated fatty acids and butanoate metabolism were observed.The following pathways were significantly affected by ZWD:arachidonic acid metabolism,valine,leucine,and isoleucine biosynthesis,linoleic acid metabolism,and alpha-linolenic acid metabolism.Conclusion:ZWD can be used to treat KYDP in CKD through regulating arachidonic acid metabolism,valine,leucine,and isoleucine biosynthesis,linoleic acid metabolism,and alpha-linolenic acid metabolism.

Proteomics analysis of IBS-D with spleen and kidney yang deficiency

Objective:To investigate the molecular mechanism underlying the development of diarrhea-predominant irritable bowel syndrome (IBS-D) with spleen and kidney yang deficiency (SKYD) using a proteomics approach.Methods:Male Sprague-Dawley rats (n =22) were divided into IBS-D (n =12) and normal control (n =10) groups.SKYD was then modeled in IBS-D rats by a combination of acetic acid enema,bondage,rectal dilation,tail stimulation,and Senna gavage.Colon tissue samples were subsequently collected and examined by Q Exactive mass spectrometry to identify differentially expressed proteins between the two groups.Results:The occurrence of SKYD/IBS-D was associated with ribosomal protein S23 (Rps23),protein phosphatase 2 catalytic subunit alpha (Pp2a),and growth factor receptor-bound protein 2 (Grb2),which are involved in the ribosome,neurotrophin signaling,and Janus kinase-signal transducer and activator of transcription (JAK-STAT) signaling pathways.Conclusion:These data suggest that SKYD/IBS-D pathophysiology likely involves inflammation,cell growth,apoptosis,stress granule formation,immune activation,loss of epithelial cell integrity,and visceral hypersensitivity.

Clinical observation on efficacy of compound of warming yang, descending turbidity and dredging collaterals in the treatment of diabetic kidney disease with Yin-Yang deficiency and blood stasis syndrome

Objective:To observe the clinical efficacy of compound of owarming yang,descending turbidity and dredging collaterals in the treatment of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome.Methods:Seventy-six patients of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome were randomly divided into observation group and control group,thirty-eight cases in each group.The control group was given conventional western medicine treatment,while the observation group took compound of owarming yang,descending turbidity and dredging collaterals orally on the basis of conventional western medicine treatment.The course of treatment covered for one month.Before and after treatment,we observed the scores of traditional Chinese medicine symptoms,indicators of renal function[serum creatinine(Scr),blood urea nitrogen(BUN),microalbuminuria(MALB)],indicators of glucose metabolism[fasting plasma glucose(FPG),2-hour postprandial blood glucose(2hPG),glycosylated hemoglobin(HbAlc)],indicators of hemorheology[plasma viscosity(PV),platelet aggregation rate(PAR),fibrinogen(FIB)],Cystatin-C(Cys-C),C-reactive protein(CRP)in the two groups.Results:After treatment,the clinical effect of the observation group was significantly better than the control group(P<0.05).The scores of traditional Chinese medicine symptoms,indicators of renal function(Scr、BUN、UAER),indicators of glucose metabolism(FPG、2hPG、HbAlc),indicators of hemorheology(PV、PAR、FIB),Cys-C and CRP in the two groups were decreased significantly compared with those before treatment(P<0.05),and the decrease in the observation group was superior to that in the control group(P<0.05).Conclusion:Compound of warming yang,descending turbidity and dredging collaterals has remarkable efficacy in treating of diabetic kidney disease patients with yin-yang deficiency and blood stasis syndrome by alleviating clinical symptoms,glucose metabolism,renal function and microcirculatory disturbance,and the mechanism related to alleviation of microinflammation.

Warm needling moxibustion versus electroacupuncture for simple obesity due to yang deficiency of the spleen and kidney: a controlled clinical trial

Objective: To compare the therapeutic efficacy between warm needling moxibustion and electroacupuncture (EA) in the treatment of simple obesity due to yang deficiency of the spleen and kidney. Methods: Seventy patients with simple obesity due to yang deficiency of the spleen and kidney were randomly divided into a warm needling moxibustion group and an EA group, with 35 subjects in each group. Same major acupoints were selected for the two groups, including Shuifen (CV 9), Guanyuan (CV 4), Daheng (SP 15), Shuidao (ST 28), Shousanli (LI 10), Zusanli (ST 36), Sanyinjiao (SP 6) and Taixi (KI 3). The warm needling moxibustion group received warm needling moxibustion, while the EA group received EA treatment. The interventions were performed once every other day, with 15 treatments as one course. The therapeutic efficacy, body weight and body mass index (BMI) were then observed and compared. Results: The total effective rate in the warm needling moxibustion group was 85.7% versus 77.1% in the EA group, and the between-group difference was statistically significant (P<0.05). The warm needling moxibustion was remarkably superior to the EA in weight loss and lowering BMI, both with statistical significance (P<0.05, P<0.01). At the three-month follow-up, the body weight and BMI further decreased in the warm needling moxibustion group (both P<0.05), and the levels were lower than those in the EA group (P<0.05, P<0.01). Conclusion: Warm needling moxibustion can produce reliable and consistent efficacy in the treatment of simple obesity due to yang deficiency of the spleen and kidney. Compared with EA, warm needling moxibustion shows advantage in both short-term and long-term efficacies, and thus is worth promotion in clinical practice.

Lysine deficiency impaired growth performance and immune response and aggravated inflammatory response of the skin,spleen and head kidney in grown-up grass carp (Ctenopharyngodon idella)

This dissertation was primarily focused on the immune response,inflammatory response and molecular mechanisms in the skin,head kidney and spleen of grown-up grass carp(Ctenopharyngodon idella).Six iso-nitrogen diets differing in lysine concentrations(5.6,8.5,11.6,14.4,17.5 and 20.7 g/kg)were fed to 540 grass carp(164.85±0.79 g)for 60 d.After that,grass carp were challenged by Aeromonas hydrophila for 6 d.This study revealed that lysine deficiency(1)suppressed the growth performa,nce of the fish and decreased their ability to resist skin lesion morbidity,(2)impaired the immune organ s immune response by decreasing the gene expressions of mucin,liver-expressed antimicrobial peptide(LEAP)-2B,β-defensin-1 and LEAP-2A and the production of antibacterial compounds of grown-up grass carp,and(3)aggravated the inflammatory response of immune organs in the fish by increasing the gene expressions of pro-inflammatory cytokines(interferon y2[IFN-γ2],tumor necrosis factorα[TNF-α],interleukin[IL]-15,IL-17D,IL-12p40,IL-6 and IL-8)and down-regulating anti-inflammatory cytokines(IL-11,transforming growth factorβ1[TGF-β1],IL-10 and IL-4/13A),which were tightly correlated with signal transducer and activator of transcription(STAT)1 and STAT3 signaling pathway,respectively.The different phenomenon in the skin,spleen and head kidney of fish may be correlated with the difference in gene subtype.In addition,using quadratic regression analysis of percent weight gain(PWG),skin lesion morbidity,and the lysozyme activities in the spleen and head kidney,the dietary lysine requirements for grown-up grass carp were estimated to be 13.58,13.51,14.56 and 14.18 g/kg,respectively.

Regulatory mechanism of hormones of the pituitary-target gland axes in kidney-Yang deficiency based on a support vector machine model

OBJECTIVE:To study the development mechanism of kidney-Yang deficiency through the establishment of support vector machine models of relevant hormones of the pituitary-target gland axes in rats with kidney-Yang deficiency syndrome.METHODS:The kidney-Yang deficiency rat model was created by intramuscular injection of hydrocortisone,and contents of the hormones of the pituita- ry-thyroid axis:thyroid stimulating hormone(TSH),3,3',5-triiodothyronine(T_3) and thyroxine(T_4);hormones of the pituitary-adrenal gland axis:adrenocorticotropic hormone(ACTH) and Cortisol(CORT);and hormones of the pituitary-gonadal axis:luteinizing hormone(LH),follicle-stimulating hormone(FSH),and testosterone(T),were determined in the early,middle,and advanced stages.Ten support vector regression(SVR) models of the hormones were established to analyze the mutual relationships among the hormones of the three axes.RESULTS:The feedback control action of the pituitary-adrenal axis began to lose efficacy from the middle stage of kidney-Kong deficiency.The contents all hormones of the three pituitary-target gland axes decreased in the advanced stage.Relative errors of the jackknife test of the SVR models all were less than 10%.CONCLUSION:Imbalances in mutual regulation among the hormones of the pituitary-target gland axes,especially loss of effectiveness of the pituitary-adrenal axis,is one pathogenesis of kidney-Yang deficiency.The SVR model can accurately reflect the complicated non-linear relationships among pituitary-target gland axes in rats with of kidney-Yang deficiency.

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.

Clinical observation of acupuncture and moxibustion for functional dyspepsia due to Yang deficiency of the spleen and stomach

Objective To observe the clinical efficacy of acupuncture and moxibustion for functional dyspepsia(FD)due to Yang deficiency of the spleen and stomach.Methods A total of 90 patients meeting the inclusion criteria of FD due to Yang deficiency of the spleen and stomach were randomized into an acupuncture-moxibustion group,an electroacupuncture(EA)group,and a mosapride group by the random number table method,with 30 cases in each group.The mosapride group was treated with mosapride citrate dispersible tablets.The EA group was treated with EA treatment.The acupuncture-moxibustion group was treated with additional moxibustion therapy based on the treatment in the EA group.All three groups took 10 d as one treatment course and 2 courses in total,with a 2-day interval between two courses.The traditional Chinese medicine(TCM)symptoms score,functional digestive disorder quality of life questionnaire(FDDQL)score,oral-colon transit time(OCTT),and serum glucagon-like peptide-1(GLP-1)level was compared before and after treatment among the three groups.And the clinical efficacy was evaluated.Results The total effective rate in the acupuncture-moxibustion group was 96.7%,which was higher than 86.7%in the EA group and 73.3%in the mosapride group,and the total effective rate in the EA group was higher than that in the mosapride group;the inter-group differences were all statistically significant(P<0.05).After treatment,the TCM symptom score in the three groups was lower than that before treatment(P<0.05),and the FDDQL score was higher than that before treatment(P<0.05).The change after treatment in the TCM symptom score in the acupuncture-moxibustion group and the EA group was more significant than that in the mosapride group,and the change in the acupuncture-moxibustion group was more significant than that in the EA group;the inter-group differences were statistically significant(P<0.05).The change after treatment in the FDDQL score in the acupuncture-moxibustion group and the EA group was greater than that in the mosapride group,and the change in the acupuncture-moxibustion group was larger than that in the EA group;the inter-group differences were all statistically significant(P<0.05).After treatment,the OCTT in all three groups was lower than that before treatment(P<0.05),and the serum GLP-1 level was higher than that before treatment(P<0.05);the change after treatment in the OCTT in the acupuncture-moxibustion group and the EA group was more significant than that in the mosapride group,and the change in the acupuncture-moxibustion group was more significant than that in the EA group;the inter-group differences were statistically significant(P<0.05).The change after treatment in the serum GLP-1 level in the acupuncture-moxibustion group and the EA group was greater than that in the mosapride group,and the change in the acupuncture-moxibustion group was larger than that in the EA group;the inter-group differences were statistically significant(P<0.05).Conclusion Acupuncture and moxibustion can improve the clinical symptoms in patients with FD and enhance their quality of life,producing better effects than EA or mosapride alone.Shortening gastrointestinal movement time and increasing gastrointestinal hormone levels may be its mechanism.

The Effect of Hormones of the Hypothalamic-pituitary-target Gland Axes in a Kidney-Yang Deficiency Syndrome Model

Kidney-yang deficiency syndrome(KYDS)is a diagnostic pattern in the traditional Chinese medicine.Studies have shown that KYDS is related to the functional disorder of hormones of the hypothalamic-pituitary-target gland axes.The standard procedure used to mimic KYDS is the injection of a high dose of exogenous glucocorticoid(hydrocortisone and corticosterone).Such a model showed symptoms such as exhaustion,body twists,cold limbs,lying crowded together,decreased rectal temperature,sexual dysfunction,decreased reaction speed,reduced spontaneous activity,hair loss,loss of appetite,and weight loss.Moreover,the model manifested an imbalance in mutual control among the hormones of the pituitary-target gland axes,including adrenocorticotrophic hormone,CORT,CRH,thyroid-stimulating hormone,triiodothyronine,thyroxine,T,E2,follicle-stimulating hormone,luteinizing hormone,and 17-OHCS.

Progress of studies on cancer-related anemia in Chinese and Western medicine

Cancer-related anemia is a common complication in patients with a malignant tumor caused by the tumor itself or the tumor's treatment.It can seriously affect the quality of life of patients and even accelerate the progression of the tumor.Western medicine is often given a blood transfusion,erythropoietin,and iron agent in cancer-related anemia treatment,but there are also some problems such as increasing tumor-related mortality.Traditional Chinese medicine believes that cancer-related anemia's occurrence is related to the“Deficiency of Spleen and Kidney and Deficiency of Qi and Blood”,so clinical treatment is mainly to“Tonify Spleen and Kidney and Qi and Blood”.The combination of traditional Chinese and Western medicine is useful in cancer-related anemia's treatment,which provides a new idea and method for cancer-related anemia's clinical treatment.

畅尔舒方联合针刺治疗脾肾阳虚型便秘临床研究

目的:观察畅尔舒方联合针刺治疗脾肾阳虚型便秘的疗效。方法:选取70例脾肾阳虚型便秘患者,按随机数字表法分为治疗组及对照组各35例。治疗组给予畅尔舒方联合针刺治疗,对照组给予乳果糖口服溶液治疗。比较2组临床疗效,比较2组治疗前后便秘症状积分、中医证候积分、生活质量评分标准(PAC-QOL)、血清胃泌素(GAS)、胃动素(MTL)、P物质(SP)、血管活性肽(VIP)、一氧化氮(NO)水平的变化。结果:治疗后,2组便秘状积分及中医证候积分均较治疗前下降(P<0.05),治疗组上述2项积分均低于对照组(P<0.05)。治疗后,2组血清SP、GAS、MTL水平均较治疗前升高(P<0.05),NO、VIP水平均较治疗前下降(P<0.05);治疗组血清SP、GAS、MTL水平均高于对照组(P<0.05),NO、VIP水平均低于对照组(P<0.05)。治疗后,2组PAC-QOL评分均较治疗前下降,治疗组PAC-QOL评分低于对照组(P<0.05)。治疗组临床疗效总有效率为91.43%,对照组为68.57%,2组比较,差异有统计学意义(P<0.05)。结论:畅尔舒方联合针刺治疗脾肾阳虚型便秘能较好地改善患者临床症状,提高生活质量。

健脾益气汤加味联合常规化疗治疗脾肾阳虚型晚期结直肠癌患者的临床研究

目的:探讨健脾益气汤加味联合常规化疗治疗脾肾阳虚型晚期结直肠癌患者的临床疗效。方法:选取2019年5月~2020年4月期间某院收治的92例脾肾阳虚型晚期结直肠癌患者作为研究对象,采用随机数字表法分为对照组和观察组,每组46例。对照组患者给予常规化疗进行治疗,观察组患者在对照组治疗基础上给予健脾益气汤加味治疗。比较两组患者中医症状评分、临床疗效、T淋巴细胞亚群(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+))及不良反应发生情况。结果:治疗后,两组患者中医症状主症、次症评分和总分均降低,且观察组低于对照组(P<0.05);观察组患者疾病控制率(97.83%)高于对照组(82.61%,P<0.05);观察组患者CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)均高于对照组,CD8^(+)低于对照组(P<0.05);观察组患者骨髓抑制、消瘦、脱发、恶心呕吐不良反应发生率均低于对照组(P<0.05)。结论:健脾益气汤加味联合常规化疗治疗脾肾阳虚型晚期结直肠癌患者临床疗效较佳,可有效缓解临床症状,改善机体免疫功能,且能降低不良反应的发生风险。

参杞强精颗粒对慢性疲劳综合征脾肾阳虚证大鼠免疫调节作用研究

目的:探讨参杞强精颗粒对慢性疲劳综合征(CFS)脾肾阳虚证模型大鼠的影响以及免疫调节作用。方法:将50只无特定病原体(SPF)级健康雄性斯泼累格·多雷(SD)大鼠随机分为正常对照组,模型对照组,参杞强精颗粒高剂量组、中剂量组、低剂量组,采用游泳力竭实验造成大鼠体力疲劳,慢性束缚应激造成大鼠心理疲劳,同时给予番泻叶煎煮液灌胃造成脾肾阳虚证候,构建CFS脾肾阳虚证大鼠模型,造模成功后分别按照各组剂量灌胃,连续给药21 d后,测定各组大鼠的胸腺和脾脏指数,酶联免疫吸附试验(ELISA)检测血清免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、免疫球蛋白A(IgA)浓度以及细胞因子白细胞介素2(IL-2)、白细胞介素6(IL-6)和γ干扰素(IFN-γ)含量,MTT法检测脾脏T、B淋巴细胞增殖能力,流式细胞法检测各组大鼠外周血T淋巴细胞亚群分布情况。结果:行为学结果显示,模型大鼠的体质量增长缓慢,精神萎靡,摄食水量减少,活动减少,便质稀软,力竭游泳时间减少,悬尾静止时间增加。药物干预后,与模型组比较,各给药组大鼠精神状态、体质量、摄食水量均显著改善,力竭游泳时间增加、悬尾静止时间减少(P<0.01或P<0.05);参杞强精颗粒各剂量组能显著提升大鼠胸腺和脾脏指数,提高IgG、Ig M、IgA浓度和IL-2、IL-6、IFN-γ的含量,显著提高脾脏T、B淋巴细胞增殖能力,也能提高CD3+、CD4+T淋巴细胞百分率和CD4+/CD8+T比值,降低CD8+T淋巴细胞百分率,差异有统计学意义(P<0.01或P<0.05)。结论:参杞强精颗粒能显著改善慢性疲劳综合征脾肾阳虚证大鼠免疫功能,缓解疲劳症状,且具有很好的免疫调节作用。

温肾汤治疗慢性肾功能不全脾肾阳虚证的临床疗效及对肾脏纤维化的影响

目的:探究温肾汤治疗慢性肾功能不全脾肾阳虚证的效果及其对肾脏纤维化的影响。方法:选择符合纳入标准的慢性肾功能不全脾肾阳虚证患者96例,依据随机数字表随机分为对照组和观察组。对照组采用常规西药治疗,观察组在对照组基础上口服温肾汤治疗,2周为1个疗程,两组均治疗2个疗程。比较治疗前后两组患者中医症状评分(畏寒肢冷、面浮肢肿、神疲乏力、食少纳呆、腰膝畏寒和脘腹胀痛)、肾功能相关损伤指标(24 h Pro、BUN、Ccr和GFR)及肾纤维化相关指标(CTGF、CIV、PCⅢ和BMP-7)变化情况及临床疗效。结果:对照组临床总有效率为77.1%(37/48),观察组临床总有效率为91.7%(44/48),差异有统计学意义(P<0.05);治疗后两组患者畏寒肢冷、面浮肢肿、神疲乏力、食少纳呆、腰膝畏寒和脘腹胀痛的中医症状评分均较治疗前显著降低(P<0.05),且观察组改善程度优于对照组(P<0.05);治疗后两组患者24 h Pro、BUN水平均较治疗前显著降低(P<0.05),Ccr、GFR水平显著升高(P<0.05),且观察组改善程度优于对照组(P<0.05);治疗后两组患者CTGF、CIV及PCⅢ水平较治疗前明显降低(P<0.05),BMP-7水平明显升高(P<0.05),且观察组改善程度优于对照组(P<0.05)。结论:温肾汤可以有效改善慢性肾功能不全脾肾阳虚证患者的肾功能,降低蛋白尿,显著抑制肾脏纤维化。

袁兴石验方济川延寿膏治疗老年功能性便秘脾肾阳虚证的临床效果研究

目的探究袁兴石验方济川延寿膏治疗老年功能性便秘脾肾阳虚证的临床效果。方法选择70例老年功能性便秘脾肾阳虚证患者作为研究对象,根据随机数字表法分为对照组与观察组,各35例。观察组给予袁兴石验方济川延寿膏治疗,对照组给予乳果糖口服溶液治疗。比较两组治疗效果、中医证候积分、生活质量及不良反应发生情况。结果观察组患者治疗总有效率97.14%明显高于对照组的80.00%(P<0.05)。治疗后观察组患者大便干、排便困难、脉沉主症中医证候积分及小便清长、舌淡苔白、腹中痛冷次症中医证候积分均明显低于对照组(P<0.05)。治疗后,两组患者的生活质量评分均高于治疗前,且观察组患者的生活质量评分(88.14±5.62)分显著高于对照组的(74.05±4.37)分(P<0.05)。观察组与对照组不良反应比较(2.86%VS 5.71%)无差异(P>0.05)。结论在老年功能性便秘脾肾阳虚证治疗中,袁兴石验方济川延寿膏可以有效提高治疗效果,且患者中医证候积分改善显著,生活质量明显提高,用药安全可靠,有显著应用价值,值得推广应用。

刘小斌运用麻附细辛汤合甘草干姜汤加减治疗先天性肌无力综合征经验

先天性肌无力综合征(congenital myasthenia syndrome,CMS)为临床罕见的遗传性肌病。CMS患者虽与重症肌无力患者的症状相似,均有肌无力、易疲劳等症,但CMS为先天禀赋不足疾病,以肾元亏损为本,而重症肌无力为后天失养疾病,故在辨治侧重上有所区别。刘小斌教授认为,CMS的中医病机特点为“先天不足,肾元亏损”“脾胃虚损,五脏相关”,属于中医“痿病”范畴;根据患者不易出汗、舌淡红苔白、脉细的病症表现,可辨为脾肾阳虚兼寒邪束表证(少阴太阴兼太阳证);治疗可采用温阳补肾、健脾益损法,常以麻附细辛汤合甘草干姜汤加减,可酌加桑螵蛸、紫河车等益精养血之品,可获显效。

芪茯化浊方治疗脾肾阳虚痛风的回顾性队列研究

目的:探究芪茯化浊方治疗脾肾阳虚痛风的临床疗效和安全性。方法:收集2020年9月—2022年8月广东省中医院风湿科门诊和广东省中医院珠海医院风湿血液科门诊就诊的脾肾阳虚痛风患者,以是否服用芪茯化浊方为暴露因素,分为对照组和治疗组。收集患者一般资料,比较2组在治疗后尿酸变化率,尿酸达标率和安全指标的差异。通过聚类分析法探究治疗组的优势人群。结果:共纳入139例痛风患者,其中对照组62例(44.6%),治疗组77例(55.4%),治疗组尿酸变化率明显低于西药组;治疗组尿酸达标率优于西药组,差异有统计学意义。治疗组治疗后肾功能异常患者较治疗前减少,但无统计学差异。聚类分析提示中西药组对平均年龄在48.5岁,平均病程在2.42年的痛风有较好的降尿酸效果。结论:对使用西药降尿酸药物尿酸控制不佳的脾肾阳虚患者,联合芪茯化浊方是一个有效的强化治疗手段;芪茯化浊方联合降尿酸药物更适合年龄在48岁左右,病程较短的脾肾阳虚痛风患者。

参芪真武汤加味治疗原发性肾病综合征疗效及对患者肾功能、微炎状态、凝血纤溶功能的影响

目的:探讨参芪真武汤加味治疗原发性肾病综合征效果及对患者肾功能、微炎状态、凝血纤溶功能的影响。方法:选取脾肾阳虚证原发性肾病综合征患者110例,根据治疗方案分为两组,观察组和对照组各55例。对照组给予常规对症治疗,观察组在对照组基础上给予参芪真武汤加味治疗,两组均连续治疗8周。比较两组治疗总有效率及不良反应发生情况,同时观察治疗前后中医证候积分、肾功能[24 h尿蛋白定量(24 hTP)、血白蛋白(ALB)、尿素氮(BUN)、血清肌酐(Cr)]、微炎状态[高敏-C反应蛋白(hs-CRP)、白细胞介素-21(IL-21)、白细胞介素-13(IL-13)]、凝血纤溶功能[纤维蛋白原(FIB)、D-二聚体(D-D)]变化情况。结果:观察组临床总有效率为90.91%,高于对照组的76.36%(P<0.05)。经治疗,观察组浮肿、面色白、畏寒肢冷、腰膝酸软、恶寒喜暖各项中医证候积分较对照组低(均P<0.05);观察组ALB水平较对照组高,24 hTP、BUN、Cr较对照组低(均P<0.05);观察组IL-13水平较对照组高,hs-CRP、IL-21水平较对照组低(均P<0.05)。两组FIB、D-D水平低于治疗前,且观察组低于对照组(均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:参芪真武汤加味治疗原发性肾病综合征脾肾阳虚证可提高临床效果,降低中医证候积分,促进肾功能和凝血纤溶功能改善,减轻机体微炎症状态,且安全性佳。

杨家林教授从调节卵泡论治多囊卵巢综合征经验探微

多囊卵巢综合征(polycystic ovary syndrome,PCOS)为妇科常见内分泌疾病,发病率逐年上升,其所致月经稀发、肥胖、流产、不孕等严重影响到女性生殖健康。杨家林教授从医60余年,认为该病发病责之于脾肾亏虚,痰浊、水湿、瘀血各自或交互为病,导致巢肿卵多,卵滞巢中,排卵无序。杨老在继承古人经方基础上,博采众长,拾遗补漏,创制了治疗PCOS的经验方,临床疗效肯定。本文探微杨家林教授治疗多囊卵巢综合征的临床经验,以飨同道。