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...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。展开更多
Objective: To investigate the effect of Yang-warming and Kidney-tonifying Prescription (YKP) on the treatment of steroid-induced avascular necrosis of the femoral head (SANFH) in rabbits. And to further explore whethe...Objective: To investigate the effect of Yang-warming and Kidney-tonifying Prescription (YKP) on the treatment of steroid-induced avascular necrosis of the femoral head (SANFH) in rabbits. And to further explore whether its therapeutic mechanism is related to the expression of HIF-1α and VEGF (angiogenic factors), BMP2 and Osterix (osteogenic factor), CD31 (type H vascular marker) and MMP13 (bone destruction-related factor). Methods: Twenty-seven healthy male New Zealand white rabbits were divided into a normal group, model group, traditional Chinese medcine (TCM) group (clinical equivalent dose group of YKP), miR-130a inhibitor group and TCM + inhibitor group. The SANFH model was established by combining horse serum with methylprednisolone. After the model is successfully established, TCM group was given 6.44 g/kg·d YKP by gavage, and the miR-130a gene inhibitor group was intraperitoneally injected with 25 mg/kg miR-130a inhibitor, locked nucleic acid (LNA)-anti-miR-130a. TCM + inhibitor group was treated with YKP intragastrically and miR-130a inhibitor intraperitoneally. The rabbits in the normal group and the model group were intragastrically administered with normal saline 10 ml/d. Once a day for 4 weeks. The avascular necrosis was detected by HE staining. The contents of HIF-1α, VEGF, BMP2 and Osterix in rabbit tissues were detected by qRT-PCR kit, and the expression of CD31 and MMP13 was detected by immunofluorescence staining. Results: In the normal group, the surface of the cartilage layer of the femoral head was smooth, the bone trabeculae were intact and densely arranged, the cells of each layer were neatly arranged, the morphology of the bone cells, the chondrocytes and the adipocytes were normal. In the model group, cartilage surfaces of the femoral head showed exfoliative cracks. The bone trabecular structure was loose and incomplete, chondrocytes, osteoblasts and bone marrow cells were significantly reduced, and the number of empty bone traps was significantly increased. In the TCM-treated group, more chondrocytes, thicker cartilage layer, and more regular bone trabeculae were detected as compared to model rabbits. In contrast, the cartilage layer was thinner, the destruction and fracture of bone trabeculae was more serious, chondrocytes and osteocytes were decreased as compared to model group. The expression of HIF-1α, VEGF, BMP2, and Osterix in the model group decreased significantly as compared to the normal group (P Conclusion: YKP can regulate the expression of angiogenic-related factors (VEGF and HIF-α), osteogenic-related factors (BMP2 and Osterix), and H-type vascular marker CD31, resulting in increased expressions of VEGF, HIF-α, BMP2, and Osterix, which promote intra-femoral head revascularization. Meanwhile, YKP decreased the expression of bone-destruction-related factor MMP13, thus enhancing the ability of bone tissue to repair itself. Regulation of these molecules’ expression may be one of the mechanisms of YKP in the treatment of hormonal femoral head necrosis.展开更多
文摘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。
文摘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。
文摘Objective: To investigate the effect of Yang-warming and Kidney-tonifying Prescription (YKP) on the treatment of steroid-induced avascular necrosis of the femoral head (SANFH) in rabbits. And to further explore whether its therapeutic mechanism is related to the expression of HIF-1α and VEGF (angiogenic factors), BMP2 and Osterix (osteogenic factor), CD31 (type H vascular marker) and MMP13 (bone destruction-related factor). Methods: Twenty-seven healthy male New Zealand white rabbits were divided into a normal group, model group, traditional Chinese medcine (TCM) group (clinical equivalent dose group of YKP), miR-130a inhibitor group and TCM + inhibitor group. The SANFH model was established by combining horse serum with methylprednisolone. After the model is successfully established, TCM group was given 6.44 g/kg·d YKP by gavage, and the miR-130a gene inhibitor group was intraperitoneally injected with 25 mg/kg miR-130a inhibitor, locked nucleic acid (LNA)-anti-miR-130a. TCM + inhibitor group was treated with YKP intragastrically and miR-130a inhibitor intraperitoneally. The rabbits in the normal group and the model group were intragastrically administered with normal saline 10 ml/d. Once a day for 4 weeks. The avascular necrosis was detected by HE staining. The contents of HIF-1α, VEGF, BMP2 and Osterix in rabbit tissues were detected by qRT-PCR kit, and the expression of CD31 and MMP13 was detected by immunofluorescence staining. Results: In the normal group, the surface of the cartilage layer of the femoral head was smooth, the bone trabeculae were intact and densely arranged, the cells of each layer were neatly arranged, the morphology of the bone cells, the chondrocytes and the adipocytes were normal. In the model group, cartilage surfaces of the femoral head showed exfoliative cracks. The bone trabecular structure was loose and incomplete, chondrocytes, osteoblasts and bone marrow cells were significantly reduced, and the number of empty bone traps was significantly increased. In the TCM-treated group, more chondrocytes, thicker cartilage layer, and more regular bone trabeculae were detected as compared to model rabbits. In contrast, the cartilage layer was thinner, the destruction and fracture of bone trabeculae was more serious, chondrocytes and osteocytes were decreased as compared to model group. The expression of HIF-1α, VEGF, BMP2, and Osterix in the model group decreased significantly as compared to the normal group (P Conclusion: YKP can regulate the expression of angiogenic-related factors (VEGF and HIF-α), osteogenic-related factors (BMP2 and Osterix), and H-type vascular marker CD31, resulting in increased expressions of VEGF, HIF-α, BMP2, and Osterix, which promote intra-femoral head revascularization. Meanwhile, YKP decreased the expression of bone-destruction-related factor MMP13, thus enhancing the ability of bone tissue to repair itself. Regulation of these molecules’ expression may be one of the mechanisms of YKP in the treatment of hormonal femoral head necrosis.
