Influence of tonifying kidney recipe on advanced glycation endproducts and lipid peroxidation in ovariectomized rats

BACKGROUND： Previous studies have demonstrated that reduced estrogen levels may accelerate the formation of advanced glycation endproducts （AGE） in brain tissue, raise the concentration of lipid peroxidation products in vivo, and speed up deterioration of learning and memory. A tonifying kidney recipe is hypothesized to improve the ability of learning and memory in ovariectomized rats by downregulating AGE and lipid peroxidation products. OBJECTIVE： To simulate a postmenopausal state, bilateral ovariectomy （OVX） was performed in rats, and the effects of tonifying kidney recipe （TKR） on AGE and lipid peroxidation in the rat cerebral cortex, hippocampus, and blood serum levels was measured. In addition, the effects on learning and memory were evaluated, and the effect of AGE -specific inhibitor aminoguanidine （AG） was compared with TKR. DESIGN, TIME AND SETTING： A randomized, in vivo, control experiment was performed at the scientific research center （Provincial Key Laboratory） in the Fourth Hospital of Hebei Medical University （Shijiazhuang, Hebei Province, China） from May 2005 to January 2007. MATERIALS： Forty healthy, adult, female, Sprague Dawley rats were used for this study. TKR was composed of prepared rehmannia rhizome, epimedium herb, desert-living cistanche, and Szechwan lovage rhizome, which were provided by Shijiazhuang Medical Materials Company （China）. A TKR extraction was prepared for further use. AG was provided by Sigma （USA）. Forty rats were randomly divided into four groups： sham, OVX, AG, and TKR, with 10 rats in each group. METHODS： The rat ovaries were resected in the OVX, AG, and TKR groups, whereas the same volume of fat was resected in the sham group. At four weeks after OVX, the AG group received 1% AG water solution by lavage; the TKR group was administrated by lavage once per day at a dose of 6.3 g （crude drug）/kg; OVX and sham groups received equal volumes of tap water. MAIN OUTCOME MEASURES： Learning and memory behavior of rats was tested in a Y-electric maze 16 weeks after the OVX procedure. The contents of advanced glycation endproducts in the rat cerebral cortex, hippocampus, serum, and urine were detected by competitive ELISA and spectrofluorophotometer. The contents of lipid peroxidation in rat serum, cerebral cortex, and hippocampus were assayed using a biochemical method. RESULTS： Compared with the sham group, serum content of advanced glycation endproducts in the OVX group was significantly increased, and lipid peroxidation content increased in cerebral cortex, hippocampus, and serum （t = 3.04-4.22, P 〈 0.05 0.01）. Both AG and TKR decreased the amount of AGE in cerebral cortex and serum （t = 2.53, 3.64, P 〈 0.05, 0.01）, increased AGE urine content （t = 3.25 4.87, P 〈 0.01）, and decreased lipid peroxidation content in cerebral cortex, hippocampus, and serum （t = 2.80 3.70, P 〈 0.05 0.01）. In comparison to the OVX and sham groups, the correct escape rate in the Y-electric maze was significantly increased （t = 3.46, 3.28, P 〈 0.01）, and escape latency was significantly decreased （t=3.12, 2.48 P 〈 0.05） in the AG and TKR groups, which indicated that both AG and TKR improved learning and memory The OVX group had a significantly lower correct escape compared with the sham group （t = 4.21, P 〈 0.01 ）.CONCLUSION： The tonifying kidney recipe decreased deposition of advanced glycation endproducts and lipid peroxidation in ovariectomized rats, and concomitantly improved learning and memory. The effect of TKR was equal to that of AG.

Clinical trial with traditional Chinese medicine intervention ''tonifying the kidney to promote liver regeneration and repair by affecting stem cells and their microenvironment'' for chronic hepatitis B-associated liver failure

AIM:To study the clinical efficacy of traditional Chinese medicine(TCM)intervention"tonifying the kidney to promote liver regeneration and repair by affecting stem cells and their microenvironment"("TTK")for treating liver failure due to chronic hepatitis B.METHODS:We designed the study as a randomized controlled clinical trial.Registration number of Chinese Clinical Trial Registry is Chi CTR-TRC-12002961.A total of 144 patients with liver failure due to infection with chronic hepatitis B virus were enrolled in this randomized controlled clinical study.Participants were randomly assigned to the following three groups:(1)a modern medicine control group(MMC group,36patients);(2)a"tonifying qi and detoxification"("TQD")group(72 patients);and(3)a"tonifying the kidney to promote liver regeneration and repair by affecting stem cells and their microenvironment"("TTK")group(36patients).Patients in the MMC group received general internal medicine treatment;patients in the"TQD"group were given a TCM formula"tonifying qi and detoxification"and general internal medicine treatment;patients in the"TTK"group were given a TCM formula of"TTK"and general internal medicine treatment.All participants were treated for 8 wk and then followed at 48 wk following their final treatment.The primaryefficacy end point was the patient fatality rate in each group.Measurements of various virological and biochemical indicators served as secondary endpoints.The one-way analysis of variance and the t-test were used to compare patient outcomes in the different treatment groups.RESULTS:At the 48-wk post-treatment time point,the patient fatality rates in the MMC,"TQD",and"TTK"groups were 51.61%,35.38%,and 16.67%,respectively,and the differences between groups were statistically significant(P<0.05).However,there were no significant differences in the levels of hepatitis B virus DNA or prothrombin activity among the three groups(P>0.05).Patients in the"TTK"group had significantly higher levels of serum total bilirubin compared to MMC subjects(339.40μmol/L±270.09μmol/L vs 176.13μmol/L±185.70μmol/L,P=0.014).Serum albumin levels were significantly increased in both the"TQD"group and"TTK"group as compared with the MMC group(31.30 g/L±4.77g/L,30.72 g/L±2.89 g/L vs 28.57 g/L±4.56 g/L,P<0.05).There were no significant differences in levels of alanine transaminase among the three groups(P>0.05).Safety data showed that there was one case of stomachache in the"TQD"group and one case of gastrointestinal side effect in the"TTK"group.CONCLUSION:Treatment with"TTK"improved the survival rates of patients with liver failure due to chronic hepatitis B.Additionally,liver tissue was regenerated and liver function was restored.

Review for treatment and signaling pathway regulation of kidney-tonifying traditional Chinese medicine on osteoporosis

The treatment and signaling pathway regulation effects of kidney-tonifying traditional Chinese medicine on osteoporosis have been widely studied,but without a systematic summary currently.This review comprehensively collected and analyzed the traditional Chinese medicine on the treatment and signaling pathway regulation of osteoporosis in recent ten years,such as Epimedium,Drynariae Rhizoma,Cnidium,Eucommia,Psoralen and Dipsacus.Based on the existing findings,we concluded the following conclusions:(1)kidney-tonifying traditional Chinese medicine treats osteoporosis mainly through BMP-Smads,Wnt/β-catenin,MAPK,PI3K/AKT signaling pathway to promote osteoblast bone formation and through OPG/RANKL/RANK,estrogen,CTSK signaling pathway to inhibit osteoclasts of bone resorption.(1)Epimedium,Drynariae Rhizoma,Cnidium and Psoralen up-regulate the key proteins and genes of BMP-Smads and Wnt/β-catenin signaling pathways to promote bone formation.(2)Epimedium,Drynariae Rhizoma,Cnidium,Eucommia,Psoralen,Dipsacusinhibit the bone resorption by mediating the OPG/RANKL/RANK signaling pathway.(2)Kidney-tonifying traditional Chinese medicine prevent and treat osteoporosis through a variety of ways:Icariin,Naringin,Osthol,Psoralen can regulate BMP-Smads,Wnt/β-catenin signaling pathway to promote bone formation,but also activate OPG/RANKL/RANK,CTSK and other signaling pathway to inhibit bone resorption.(3)The crosstalk of the signaling pathways and the animal experiments of the traditional Chinese medicine on the prevention and treatment of osteoporosis as well as their multi-target mechanism and comprehensive regulation need further clarification.

Clinical observation of kidney tonifying and collateral tonifying acupuncture combined with thermosensitive moxibustion in the treatment of knee osteoarthritis and its effect on TRACP and CTX-I

Objective:To observe the clinical effect of kidney-tonifying and colllateral-tonifying acupuncture combined with thermosensitive moxibustion in the treatment of knee osteoarthritis and cold congealing syndrome and the effect on Tartrate-resistant Acid Phosphatase(TRACP)andⅠcollagen C-terminal foreign body peptide(CTX-I).Methods:Totally 90 patients with knee osteoarthritis were divided into three groups:acupuncture group,thermosensitive moxibustion group and routine group with 30 cases in each group.In the conventional group,sodium hyaluronate was injected into the joint cavity and diclofenac sustained release tablets were taken orally.Thermosensitive moxibustion group was given thermosensitive moxibustion on the basis of conventional treatment.Acupuncture and moxibustion group in the heat sensitive moxibustion group treatment was given kidney tonifying acupuncture.VAS score,JKOM score and Ly-Sholm knee score were observed before and after treatment and followed up for 2 weeks.The levels of TRACP and CTX-I in serum before and after treatment.Results:Before treatment,there were statistically significant differences in VAS score,JKOM score and Ly-Sholm knee score among all groups(P>0.05).After treatment,the VAS score and JKOM score decreased,and the decrease degree was the greatest in the acupuncture group(P<0.05).Ly-Sholm knee score increased,and the change degree was the greatest in acupuncture group(P<0.05).Before treatment,the levels of TRACP and CTX-I in serum of all groups were significantly different(P>0.05).After treatment,serum TRACP and CTX-I levels were decreased,and the decrease degree was the greatest in acupuncture group(P<0.05).The total effective rates of the acupuncture group,the thermal sensitive moxibustion group and the conventional group were 96.7%,80%and 66.7%,respectively,and the difference between each group was statistically significant(P<0.05).Conclusion:Kidney-tonifying and collature-tonifying acupuncture combined with thermosensitive moxibustion can significantly relieve knee pain and other symptoms of knee osteoarthritis in patients and cold congealing syndrome,which is worthy of clinical promotion.

Meta-analysis of clinical efficacy and safety of kidney Tonifying therapy in the treatment of interstitial lung disease

Objective:To evaluate the efficacy and safety of kidney tonifying therapy in the treatment of Interstitial Lung Disease(ILD).Methods:We searched Wanfang Data,CNKI,CBM,VIP,Pub Med,EMBASE,Web of science and Cochrane Library for Randomized Controlled Trials(RCTs)of kidney tonifying therapy in the treatment of ILD.The retrieval time was from the establishment of the database to December 15,2020.Rev man 5.3 software was used to analyze and summarize the collected literature,and the methodological quality of the included studies was evaluated by the bias risk assessment scale of Cochrane Collaboration Network.Results:A total of 15 articles with 1045 patients were included.The results of meta-analysis showed that compared with the control group treated with conventional western medicine alone,kidney tonifying therapy or combined with conventional western medicine was beneficial to improve the clinical total effective rate[RR=1.33(95%CI 1.24-1.43),P<0.00001].At the same time,compared with the control group treated with routine western medicine,kidney tonifying therapy or combined with routine western medicine can improve cough and wheezing symptoms of patients[MD=-0.62(95%CI-0.78~-0.46),P<0.00001]and MD=-0.79(95%CI-0.18~-0.49),P<0.00001].However,there was no significant improvement in 6-minute walk test and lung function(DLCO%)(P>0.05);only one study reported 7 patients with adverse reactions,but after corresponding treatment,the symptoms were significantly relieved.The analysis of the characteristics of intervention measures in the treatment group showed that there were a total of 80 traditional Chinese medicines involved,of which Shu Dihuang appeared the most frequently,and the tonic drugs were used the most.The two meridians of the lung and kidney appear most frequently.Among the four qi and five flavors,warm and sweet medicines have the highest frequency.Conclusion:Adopting kidney-tonifying method or combined with conventional Western medicine treatment can improve the total clinical effectiveness of patients.Adopting kidney-tonifying method or combined with conventional Western medicine treatment to improve symptoms such as coughing and wheezing.No serious adverse reactions have been reported,and the safety is reliable.Due to the low quality of the included literature,the results of this study need to be verified by high-quality,large sample randomized controlled trials.

Efficacy of the method of tonifying Qi,resolving phlegm and eliminating stasis in thetreatment of AECOPD:A meta analysis

Objective:To systematically evaluate the efficacy and safety of the method of tonifying qi,resolving phlegm and eliminating stasis in the treatment of acute exacerbation of chronic obstructive pulmonary disease.Methods:Search the China Knowledge Network(CNKI),VIP Chinese Science and Technology Journal Database(VIP),Wanfang Data Knowledge Service Platform,China Biomedical Literature Database(CBM),PubMed,Embase,Cochrane Library,and select the databases that meet the requirements for tonifying qi,resolving phlegm and eliminating stasis.The stasis method in the treatment of AECOPD was included in the standard literature,and RevMan 5.4 software was used for statistical analysis.Results:A total of 10 articles were included,with a total of 854 patients,435 in the treatment group and 419 in the control group.Systematic analysis shows that the method of tonifying qi,resolving phlegm and eliminating stasis combined with conventional Western medicine treatment of AECOPD is significantly different in total clinical effective rate than conventional Western medicine treatment alone[OR=3.98,95%CI(2.23,7.11),P<0.00001];In terms of lung function,FEV1/FVC[MD=6.08,95%CI(5.01,7.15),P<0.00001],FEV1[MD=0.07,95%CI(0.01,0.13),P=0.02],FEV1%[MD=4.56,95%CI(3.09,6.02),P<0.00001]is significantly higher than the control group;arterial oxygen partial pressure(PaO_(2))[MD=18.47,95%CI(16.77,20.16),P<0.00001]Significant improvement compared to the control group;arterial partial pressure of carbon dioxide(PaCO_(2))[MD=-7.48,95%CI(-8.7,-6.26),P<0.00001]was significantly lower than the control group.Conclusion:The current evidence shows that the method of tonifying qi,resolving phlegm and eliminating stasis combined with conventional Western medicine treatment of chronic obstructive pulmonary disease in acute exacerbations can improve clinical efficacy and improve the quality of life of patients.

Protective effects of kidney-tonifying Chinese herbal preparation on substantia nigra neurons in a mouse model of Parkinson's disease

The Chinese herbs Herba Epimedii, Fructus Ligustri Lucidi and Rhizoma Polygonati were injected into Parkinson＇s disease mice established via intraperitoneal injection of 1-methyl-4-phenyl-1, 2, 3, 6-tetrahydropyridine hydrochloride. The selective monoamine oxidase B inhibitor selegiline was used as a positive control drug. After successive administration for 4 weeks, Herba Epimedii could downregulate the expression of caspase-3 and increase the brain-derived neurotrophic factor level, as well as increase tyrosine hydroxylase activity in the substantia nigra of Parkinson＇s disease mouse models. Rhizoma Polygonaticould downregulate the expression of caspase-3 and FasL, and increase neural growth factor and brain-derived neurotrophic factor levels. Fructus Ligustn Lucidi could downregulate caspase-3 expression. Rhizoma Polygonati and Fructus Ligustn Lucidi did not produce obvious effects on tyrosine hydroxylase activity. Herba Epimedii and Fructus Ligustri Lucidi yielded similar effects on apoptosis-promoting factors to those elicited by selegiline. Herba Epimedii and Rhizoma Polygonati significantly increased the levels of neurotrophic factors compared with selegiline. Herba Epimedii significantly increased tyrosine hydroxylase activity compared with selegiline. It is indicated that the kidney-tonifying Chinese herbal preparation can downregulate the expression of apoptosis-promoting factors, increase neurotrophic factors levels in the substantia nigra and striatum, as well as increase tyrosine hydroxylase activity in the substantia nigra of Parkinson＇s disease mouse models, thereby exerting a stronger or similar neuroprotective effects compared with selegiline.

Regulating and tonifying spleen and kidney traditional Chinese medicine in the treatment of chronic uric acid nephropathy: A systematic review

Objective:To systematically evaluate the efficacy and safety of traditional Chinese medicine for regulating spleen and kidney.Methods:We developed a search strategy and then retrieved the database including CNKI,Wanfang data knowledge service platform,VIP journals resource integration service platform,PubMed,Embasefor randomized controlled trial of regulating spleen and kidney traditional Chinese medicine compared with conventional western medicine in the treatment of chronic uric acid nephropathy.The search deadline was set to June 30,2020.For the included literature,we applied the cochrane collaboration network risk bias assessment tool to evaluate the methodological quality,and evaluated the level of evidence according to GRADE standards.Quantitative data was analyzed by RevMan5.3 software,and trial sequential analysis method was used to analyze its efficiency.Results:A total of 709 cases in 10 articles were included.Compared with the control group,the related traditional Chinese medicine group improved the effective rate[RR=1.45,95%CI(1.32,1.58)],reduced the level of UA[MD=-36.24,95%CI(-41.03,-31.45)],BUN[SMD=-1.27,95%CI(-1.47,-1.07)]and SCR[MD=-36.33,95%CI(-55.79,-16.87),P=0.0003],the difference between the two groups was statistically significant(P<0.05).There was no evidence that a significant adverse reaction occurred.The results of TSA analysis showed that the Chinese medicine group had definite evidence for improving the efficiency.According to the GRADE evaluation criteria,the efficiency,UA,BUN and SCR outcome indicators were extremely low-quality evidence.Conclusions:Traditional Chinese medicine for regulating spleen and kidney in the treatment of chronic uric acid nephropathy improved efficiency,reduced the level of UA,BUN,SCR.Meanwhile,the therapy was proved to be safe.Nevertheless,the conclusions need further high-quality evidence to support.

Vitamin D axis: a new target for treatment depression via tonifying kidney of chinese medicine

Accumulating data indicate that kidney tonifying recipe to treat depression patients may significantly reduce clinical symptoms, effectively improve the quality and prognosis of the patient's life. Clinical and experimental studies have suggested that tonifying kidney recipe has multiple targets, and thereby via multiple ways to accomplish antidepressant effect. The tonifying kidney recipe has been used in traditional Chinese medicine to control neurotrophic factor so as to promote the growth, differentiation, maturation of neurons. The tonifying kidney recipe participates in protection of neural plasticity, brain development, immune regulation, and a variety of other physiological processes to act as an antidepressant that has great similarity as vitamin D axis. In this article, we describe the current knowledge to introduct the relationship between kidney deficiency and vitamin D axis, and speculate about the molecular mechanism of tonifying kidney recipe in the treatment of depression by regulating vitamin D axis.

补肾化痰法治疗多囊卵巢综合征胰岛素抵抗研究进展

多囊卵巢综合征(polycystic ovarian syndrome,PCOS)是育龄期女性常见的生殖内分泌及代谢紊乱性疾病。胰岛素抵抗(insulin resisitance,IR)是PCOS发生发展的重要病理因素,且50%及以上的PCOS患者伴有IR。中医认为肾虚痰湿是多囊卵巢综合征胰岛素抵抗(PCOS-IR)的主要病机之一,西医认为PCOS-IR的发生机制可能与胰岛素信号通路异常、炎症反应、氧化应激和肠道菌群失调有关。补肾化痰法治疗PCOS-IR能够起到改善糖脂代谢、调节性激素、抗炎抗氧化的作用。文章就PCOS-IR的中医病机、西医发生机制及补肾化痰法在PCOS-IR中的临床应用进行综述,以期为补肾化痰法应用于临床PCOS-IR的诊疗提供依据。

从宗气功能失调探讨阵发性心房颤动的辨治

本文通过梳理中医宗气学说形成背景、发展源流及主要内涵,解析宗气生理功能及其病理状态下的不同表现,并结合阵发性心房颤动(PAF)的中医病机特点,认为“宗气失调、治节不出”为PAF主要病机,“心下空豁,脉律不齐”为PAF具体表现,脉象节律至数变化是PAF临床辨证治的重要参考,宗气亏虚、宗气郁滞、宗气下陷是其常见证型。治疗当以“调补宗气”为根本,通补兼施,包含调和营卫、安神定悸,开郁息风、化瘀通络,培元顾本、升阳举陷等法,并佐以养心、滋阴、温阳之品,气血并治,心神同调,则枢机得利、脏气得平、血脉得利、脏腑得安。

从“虚气留滞夹火”探讨应激敏化所致抑郁症辨治思路

中医学认为“虚气留滞夹火”是抑郁症的核心病机,具有“虚气”为本,本虚在脾、标虚在脑,“留滞”为标,气滞、痰凝、血瘀留滞脑络,“夹火”灼脑络,郁生火热、火生虚滞的病机特点和演变规律。本文基于现代医学对抑郁症“应激敏化”发病机制的认识,探讨其与中医学“虚气留滞夹火”核心病机的潜在关联,提出补虚、通滞、泻火是抑郁症的基本治法,通过抑制炎症反应,改善神经元及小胶质细胞的应激敏化状态,发挥中药复方多靶点及多维度的治疗特性。

Research Progress of Tonifying Kidney and Promoting Blood Circulation in the Treatment of Steroid-induced Necrosis of Femoral Head

Osteonecrosis of the femoral head is a common disability disease of the hip joint in China,and osteonecrosis of the femoral head caused by hormone factors is the most common,which is related to the gradual increase in the utilization rate of glucocorticoids in recent years.It is a refractory disease in orthopaedics with a poor prognosis.For this disease,the treatment of traditional Chinese medicine has certain advantages.In view of this,the author reads,analyzes and summarizes its materials by searching China Journal full-text Database and Wanfang Database.This paper reviews the mechanism and clinical research progress of tonifying kidney and activating blood circulation in the prevention and treatment of steroid-induced osteonecrosis of the femoral head,hoping to provide help for the clinical treatment of hormone-related osteonecrosis of the femoral head.

基于网络药理学与分子对接探讨山茱萸-菟丝子治疗认知障碍的作用机制

目的 利用网络药理学和分子对接方法探讨山茱萸-菟丝子治疗认知障碍的潜在作用机制。方法 利用TCMSP筛选山茱萸、菟丝子活性成分,并预测潜在靶点,从UniProt数据库获得药物成分对应靶点,通过TTD、GeneCards和OMIM数据库获取认知障碍相关靶点,利用R4.2.2软件获取山茱萸-菟丝子与认知障碍的共同靶点。利用Cytoscape3.7.2软件构建“药物-活性成分-靶点”网络,通过STRING11.5数据库构建共有靶点蛋白相互作用网络,利用R4.2.2软件进行GO功能及KEGG通路富集分析,利用AutoDock1.5.6、PyMoL2.4.0软件进行分子对接验证。结果 经过筛选共得到30个药物活性成分,184个药物-疾病交集靶点,通过GO功能和KEGG通路富集分析得到2 678个GO条目和179条信号通路。共同靶点的通路富集分析显示主要与PI3K-Akt、HIF-1α/VEGF等信号通路相关,分子对接结果显示,认知障碍核心靶点与山茱萸-菟丝子主要成分亲和力较好,可能有效自由结合。结论 山茱萸-菟丝子中槲皮素、山柰酚、β-谷甾醇、异鼠李素、豆甾醇、四氢鸭脚木碱等成分可能通过抗氧化应激、抗炎及免疫调节、糖脂调节等作用治疗认知障碍。

基于数据挖掘探究补肾益髓法治疗阿尔茨海默病的用药规律

目的运用数据挖掘分析方法总结归纳补肾益髓类中药复方治疗阿尔茨海默病(alzheimer′s disease,AD)的核心药物及用药规律。方法将自数据库建立起至2022年4月于中文数据库中国知网、万方、维普,中国临床试验注册中心,英文数据库PubMed、Web of science中检索到的补肾益髓法治疗AD的临床研究文献作为数据来源,利用SPSS modeler 18.0和SPSS Statistic 25.0软件对纳入文献中记载的复方药物进行频次统计、关联分析、系统聚类分析和因子分析;通过Cytoscape 3.8.0构建中药核心复杂网络,并对网络中的中药进行拓扑分析。结果经筛选,得到69篇文献共计70首处方,108味中药;单味药物属熟地黄应用次数最高;补虚药、活血化瘀药、安神药应用最为广泛;网络拓扑学筛选得到包括熟地黄、石菖蒲、枸杞子、远志在内的12味核心中药;关联分析得到常用药物关联规则37条,最为常见的药对为“熟地黄-枸杞子”“石菖蒲-远志”等,使用频次最高的药物组合为“熟地黄-石菖蒲-远志”;系统聚类分析在欧式平方距离为15时可归纳为3个潜在聚类方,因子分析共提取4个公因子,其药物组成体现了地黄饮子、六味地黄丸、左归丸等补肾经方的药物配伍规律。结论补肾益髓法治疗AD以补肾填精益髓为主体,辅以活血祛瘀、宁心安神、豁痰开窍;针对AD病机治疗标本兼顾,体现了中医药整体观念、辨证施治的诊疗特点。

国医大师张大宁教授以膏方辨治阴虚型慢性肾脏病经验总结

慢性肾脏病逐渐成为临床最常见的慢性疾病之一,严重影响了人民群众的身体健康,国医大师张大宁教授作为中医肾脏病的奠基人,在长期的临床实践中,最早提出了“肾虚血瘀论”并首创“补肾活血法”,同时将补肾活血法融入膏方之中来治疗阴虚型慢性肾脏病。文章总结了张大宁教授利用膏方治疗慢性肾脏病的经验,供读者参考。

补肾中药联合双膦酸盐治疗恶性肿瘤骨转移有效性及安全性的Meta分析

目的系统评价补肾中药联合双膦酸盐类药物治疗恶性肿瘤骨转移的有效性及安全性,以期为临床治疗提供参考。方法通过检索CNKI、CBM、VIP、Wanfang Data等数据库,检索时间为所有数据库建库至2023年5月5日,筛选补肾中药联合双膦酸盐类药物治疗恶性肿瘤骨转移的随机对照临床试验,使用Cochrane偏倚风险评估工具对纳入的文献质量进行评估,并采用Rev Man 5.3软件对纳入研究进行Meta分析。结果共纳入18项临床研究,总样本量为1213例,其中对照组594例,治疗组619例。治疗组患者骨转移无进展生存时间、骨转移病灶疗效、止痛效果、数字化评估量表(NRS)疼痛评分、Karnofsky功能状态评估表(KPS)评分、活动能力、血钙水平及不良反应发生情况均优于对照组,差异均有统计学意义(P<0.05)。2组患者治疗前后碱性磷酸酶水平差异无统计学意义(P>0.05)。结论补肾中药联合双膦酸盐类药物可以抑制骨转移病灶进展,减轻骨转移引起的疼痛,改善患者生活质量及活动能力,并且可以降低血钙水平及不良反应发生率,证明从肾论治恶性肿瘤骨转移有一定的临床意义。

调补脾肾法配合西医对症治疗肥胖型多囊卵巢综合征患者的疗效观察

目的观察调补脾肾法配合西医对症治疗肥胖型多囊卵巢综合征(Polycystic ovary syndrome,PCOS)患者的临床疗效。方法选取2020年6月-2022年6月期间石家庄市中医院妇产科就诊的80例PCOS患者,根据入院顺序随机分为对照组和观察组,每组各40例。对照组给予常规治疗,观察组在对照组基础上以调补脾肾法立方口服治疗。治疗6个月后,观察比较两组患者临床疗效,治疗前后中医证候积分、血清激素[雌二醇(Estradiol2,E_(2))、促黄体生成素(Luteinizing hormone,LH)、睾酮(Androstenedione,T)、促卵泡生成素(Follicle stimulating hormone,FSH)]水平、血脂指标[总胆固醇(Total cholesterol,TC)、甘油三酯(Triglyceride,TG)、低密度脂蛋白胆固醇(Low density lipoprotein cholesterol,LDL-C)]、氧化应激指标[血清丙二醛(Malondialdehyde,MDA)及超氧化物歧化酶(Superoxide dismutase,SOD)]、体质量指数(Body mass index,BMI)及腰臀比(Waist hip ratio,WHR)。结果治疗后两组患者中医证候积分均较治疗前明显降低,差异有统计学意义(P<0.05);且观察组中医证候积分明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者BMI及WHR指数均较治疗前降低,差异有统计学意义(P<0.05);且观察组BMI、WHR指数均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者E_(2)、LH及T水平均较治疗前降低,FSH水平均较治疗前升高,差异有统计学意义(P<0.05);且观察组E_(2)、LH及T水平均明显低于对照组,FSH水平明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者TC、TG及LDL-C水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组TC、TG及LDL-C水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者MDA水平均较治疗前降低,SOD水平均较治疗前明显升高,差异有统计学意义(P<0.05);且观察组MDA水平明显低于对照组,SOD水平明显高于对照组,差异有统计学意义(P<0.05)。治疗后观察组临床总有效率92.50%(37/40)明显高于对照组75.00%(30/40),差异有统计学意义(P<0.05)。结论调补脾肾法配合西医能够有效减轻肥胖型PCOS患者临床症状,调节患者激素水平,在降低患者血脂水平及控制肥胖方面具有一定优势,其机制可能与联合治疗方案能够有效降低肥胖型PCOS患者氧化应激反应,增加机体抗氧能力有关。

酉时补肾法、易筋经锻炼联合常规西药治疗骨质疏松症的效果分析

目的:分析酉时补肾法、易筋经锻炼联合常规西药治疗骨质疏松症的效果。方法:选取2018年4月-2020年6月上海市枫林街道社区卫生服务中心收治的骨质疏松症患者61例作为研究对象,随机分为治疗组(n=31)和对照组(n=30)。对照组实施常规西药治疗,治疗组在对照组基础上实施酉时补肾法、易筋经锻炼。比较两组骨密度、中医证候积分、生活质量。结果:治疗后,治疗组骨密度T值高于治疗前,差异有统计学意义(P<0.05)。治疗后,两组腰背四肢酸痛、下肢肌肉痉挛评分及总分低于治疗前,差异有统计学意义(P<0.05)。治疗后,两组疼痛、日常活动、家务劳动、日常运动、休闲及社交活动、一般健康观念、精神状况评分及总分低于治疗前,且治疗组疼痛、家务劳动、日常运动、休闲及社交活动、精神状况评分及总分均低于对照组,一般健康观念高于对照组,差异有统计学意义(P<0.05)。结论:酉时补肾法、易筋经锻炼联合常规西药治疗骨质疏松症的效果较好,可在一定程度上改善患者临床症状,提高生活质量。

药食同源药材与中国老年人认知损害关系的横断面研究

目的明确药食同源药材与老年人认知损害的关系,并探讨这种作用在各特征分层人群中的差异性。方法基于中国老年健康影响因素跟踪调查(Chinese longitudinal healthy longevity survey,CLHLS)2018年的数据,采用二元Logistic回归分析药食同源药材与中国老年人认知损害的相关性;并按人口学、社会经济、健康及生活方式等特征分层后进行全调整模型亚组分析。结果共有10564名受访者纳入分析,相对于很少食用药食同源药材组,经常食用药食同源药材组可以降低认知风险28%(OR:0.72,95%CI:0.52~0.99)。亚组分析显示经常(几乎每天)食用药食同源药材,80岁以上、家庭高收入组、患有1种或多种心血管代谢和神经疾病、体重偏低或超重的老年人,可以分别降低认知损害风险30%(OR:0.70,95%CI:0.492~0.983)、57%(OR:0.43,95%CI:0.23~0.80)、46%(OR:0.54,95%CI:0.35~0.85)、67%(OR:0.33,95%CI:0.16~0.71)和64%(OR:0.36,95%CI:0.15~0.87)。结论老年人经常食用药食同源药材(人参、黄芪、当归、枸杞子)的一种或多种有可能降低认知损害的风险。80岁以上、家庭高收入组、患有心血管代谢及神经疾病、体重偏低或超重、居住在东部地区的老年人食用药食同源药材更有可能获益。应优先在我国东部地区,重点识别患有心血管代谢及神经疾病、体重偏低或超重的老年人,采用因地制宜的方案开展药食同源药材预防痴呆。