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.

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.

Application of Chinese Traditional Medicine in Kidney Transplantation

Kidney transplantation is one of the important means in saving the life of patients with renal diseases of the terminal stage. However, rejection reaction often results in the loss of the grafted organs’ function. Almost half the recipients have been found to suffer from loss of graft function due to rejection reaction within 10 years of post-transplantation. Part of them have bad quality of life

A new perspective of traditional Chinese and western medicine as a potential remedy to improve intestinal flora in the treatment of chronic kidney disease

Intestinal flora imbalance is closely related to the occurrence and development of various diseases,however,the relationship between intestinal flora and chronic kidney disease has also become a hot topic.Intestinal flora imbalance,intestinal pathogenic bacteria and toxins increase,causing renal damage,chronic kidney disease patients also have a decrease in intestinal beneficial bacteria,an increase in pathogenic bacteria,more and more experimental studies show that the treatment of chronic Kidney disease is closely related to maintaining the balance of intestinal flora.However,at this stage,it has not been widely used in clinical practice by improving the protection of intestinal flora imbalance and delaying the deterioration of renal function.Therefore,this paper mainly discusses the research on the improvement of intestinal flora imbalance in the treatment of chronic kidney disease by traditional Chinese and Western medicine,and provides a new perspective for the treatment of chronic kidney disease.

Network pharmacology and verification experiment-based prediction of active components and potential targets of Alpiniae Oxyphyllae Fructus-Saposhnikoviae Radix(Yizhiren-Fangfeng)for treatment of diabetic kidney disease

Background:In this study,we analyzed the potential active components,related crucial targets and possible signaling pathway mechanisms of Alpiniae Oxyphyllae Fructus and Saposhnikoviae Radix(AOF-SR)herb pairs in the treatment of diabetic kidney disease(DKD)using network pharmacology and verification experiments.Methods:The active compounds and potential targets of AOF-SR were derived from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform,The Encyclopedia of Traditional Chinese Medicine,and PubChem databases,and the potential therapeutic targets of DKD were derived from the OMIM,Drugbank,and DisGeNET databases.The“compounds-diseases-targets”network was constructed using Cytoscape 3.6.0.ClusterMaker functionality in Cytoscape is being used to screen important targets for AOF-SR treatment of DKD.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis of important targets were performed using DAVID database.In addition,according to the predicted results of network pharmacology,HK-2 cells were used to construct DKD model for verification experiment.HK-2 cells were divided into control group,high glucose(HG)group and AOF-SR(HG+AOF-SR)group to detect survival rate and expression of key proteins in NF-κB and PI3K/Akt signaling pathways.Results:A total of 38 compounds were selected from AOF-SR,of which 23 were Alpiniae Oxyphyllae Fructus and 15 were Saposhnikoviae Radix.Through enrichment analysis of 82 important targets,88 signaling pathways were identified;some of these pathways,such as the NF-κB,PI3K-Akt,IL-17,and JAK/STAT signaling pathways,regulate the pathological process of DKD.In verification experiment,the HK-2 cells survival rate was higher in the HG+AOF-SR group than in the HG group(P<0.05).Moreover,western blotting results showed that the expression levels of NF-κB,p-PI3K,and p-Akt in HG+AOF-SR group were significantly lower than those in HG group(P<0.05).Conclusion:Overall,this study revealed the active compounds,important targets and possible mechanisms of AOF-SR treatment for DKD,and conducted preliminary verification experiments on its correctness,provided novel insights into the treatment of DKD by AOF-SR.

Exploring the molecular mechanism of Suoquan pill in the treatment of diabetic kidney disease based on network pharmacology,molecular docking,in vitro experiment

Background:Diabetic kidney disease(DKD)is a microvascular complication of diabetes mellitus and is the main cause of end-stage renal failure.Suoquan pills(SQP)has a variety of pharmacological activities and multiple therapeutic effects,and it is used clinically as a basic formula for the treatment of DKD.Methods:Public databases were used to identify SQP compounds and the potential targets of SQP and DKD.A drug-component-therapeutic target network was constructed.Protein-protein interaction network analysis,Gene Ontology functional analysis,and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis were used to analyse the potential molecular mechanisms of SQP based on common targets of drugs and diseases.Molecular docking simulations were conducted to confirm the binding abity of the core compounds to key targets.The efficacy and predicted molecular mechanisms of SQP were validated using cell counting kit-8 assay,flow cytometry,and western blotting with HK-2 cells as a model.Results:Network pharmacology analysis showed that 26 compounds and 207 potential targets of SQP were involved in the treatment of DKD;boldine,denudatin B,pinocembrin,kaempferoid,and quercetin were considered core compounds,and epidermal growth factor receptor(EGFR)and proto-oncogene,non-receptor tyrosine kinase(SRC)were considered key targets.Gene Ontology enrichment analysis indicated that protein phosphorylation and negative regulation of apoptotic processes are important biological processes in the treatment of DKD by SQP.Molecular docking confirmed the excellent binding abilities of boldine,denudatin B,kaempferide,and quercetin to EGFR and SRC.The results of in vitro experiments showed that treatment with an ethanolic extract of SQP significantly protected HK-2 cells from high glucose-induced cell damage.In addition,the SQP ethanol extract inhibited the phosphorylation of EGFR and SRC,suppressed the apoptosis rate,and regulated apoptosis-related proteins in HK-2 cells under high glucose stress.Conclusion:This study systematically and intuitively illustrated the possible pharmacological mechanisms of SQP against DKD through multiple components,targets,and signalling pathways,especially the inhibition of EGFR and SRC phosphorylation and apoptosis.

Effects of Traditional Chinese Medicine herbs for tonifying Qi and kidney, and replenishing spleen on intermittent asthma in children aged 2 to 5 years old

OBJECTIVE: To evaluate the efficacy and safety of Traditional Chinese Medicine(TCM) herbs for tonifying Qi and kidney, and replenishing spleen on intermittent asthma in children aged 2 and 5 years.METHODS: A randomized, single-blind, placebo controlled trial was conducted. Children with intermittent asthma were enrolled and their baseline conditions were measured using a questionnaire. A total of 60 participants, aged 2 to 5, were randomized into either the treatment group(n = 40) or the placebo group(n = 20). The treatment group was treated with granules of TCM herbs for tonifying Qi and kidney, and replenishing spleen, and the placebo group was given placebo granules for 3 months.The number of asthma attacks was counted and TCM syndrome scores were measured at 1, 2, 3, 6, 9,and 12 months. The airway resistance and levels of eosinophil cationic protein for the two groups were observed before and after 3 months. The results were statistically analyzed.RESULTS: Compared with the placebo group, the number of asthma attacks significantly decreased in the treatment group(P < 0.05). For the treatment group, the TCM syndrome scores decreased after 1 and 2 months; there was also a significant difference in scores between the two groups(P < 0.05).The difference remained after the medicine was stopped for 9 months(P < 0.05). After the 3-month treatment, compared with the placebo group, the airway resistance decreased in the treatment group(P < 0.05). No adverse events were reported in the treatment group.CONCLUSION: The TCM herbs for tonifying Qi and kidney, and replenishing spleen reduced the number of intermittent asthma attacks, decreased the TCM syndrome scores, and reduced the airway resistance in the children aged 2 to 5.

Qiming granule in treating type 2 diabetic kidney disease patients:study protocol for a randomized controlled trial

Background:Diabetic kidney disease(DKD)is a chronic renal microvascular complication associated with abnormal glucose metabolism.According to traditional Chinese medicine(TCM)theory,Qi and Yin deficiency with blood stasis(the name of TCM symptoms,its main clinical features are fatigue,dry mouth,red or pale tongue,weak pulse,etc.)is the primary TCM syndrome of DKD,and Qiming granule(QMG)is suitable for the treatment of Qi and Yin deficiency with blood stasis syndrome.In view of this,we designed a randomized controlled trial to assess whether QMG is efficacious and safe in treating DKD patients.Methods:This protocol is for a randomized,double-blind,placebo-controlled,parallel group,six-centre clinical trial.A total of 180 participants will be randomized into the QMG group or placebo group,with a 1:1 ratio.The study will last for 50 weeks,including a 2-week run-in period,24 weeks of intervention,and 24 weeks of follow-up.The experimental intervention will be QMG,and the control intervention will be a placebo.The primary outcome will be the 24h urinary albumin excretion ratio and the change in the albumin-to-creatinine ratio.The secondary outcome will be evaluation of renal function,fundus changes,management of blood lipids,TCM symptom improvement and safety assessments.Adverse events will be recorded during the trial.Discussion:This study is a randomized controlled trial to test the effectiveness and safety of QMG for DKD patients.The findings of this study will help to provide evidence-based recommendations in treating DKD patients.Trial registration:Chinese Clinical Trial Registry,ChiCTR-TRC-12002953.Registered 23 December 2012.

苍术健脾、燥湿的作用机制及研究进展

综述苍术健脾、燥湿的作用机制及研究进展。古代医家常用苍术治疗多种疾病的脾胃湿证。苍术有效成分能改善胃排空及小肠推进率;可增加胃泌素、胃动素等,促进胃酸分泌,增加胃肠动力;可降低血管活性肠肽水平,抑制肠蠕动亢进。苍术能双向调节胃肠功能紊乱,且还能改善胃黏膜的异常形态,减轻胃组织损伤,改善肠组织异常结构。苍术燥湿的主要有效成分为挥发油,可导致体液丢失,血黏度增加,影响唾液腺分泌,引起口干,降低肾脏水通道蛋白2的表达量。苍术及其提取物能降低大鼠胃、大肠、尿液中水通道蛋白含量,通过多脏器调节体内水液代谢。故苍术能从影响脏器形态、胃肠道激素水平、水通道蛋白表达等多方面达到健脾、燥湿的功效。

中药滋阴补阳方剂治疗肾气亏虚型多囊卵巢综合征不孕症对患者超声动态多参数的影响评价

目的评价中药滋阴补阳方剂治疗肾气亏虚型多囊卵巢综合征不孕症对患者超声动态多参数的影响。方法选取2022年1月至2023年1月江西省妇幼保健院收治的80例肾气亏虚型多囊卵巢综合征患者作为研究对象,按照随机数字法将其分为观察组(40例)与对照组(40例)。对照组采用枸橼酸氯米芬片治疗,观察组在对照组方法的基础上联合中药滋阴补阳方剂治疗。比较两组患者的治疗效果、卵泡发育情况、激素水平、子宫动脉血流灌注情况及子宫内膜厚度。结果观察组的有效率高于对照组,差异有统计学意义(P<0.05);观察组治疗后的卵泡及优势卵泡数目多于对照组,差异有统计学意义(P<0.05);观察组治疗后的黄体生成素(LH)、促卵泡激素(FSH)、睾酮(T)均低于对照组,雌二醇(E2)高于对照组,差异有统计学意义(P<0.05);观察组治疗后的搏动指数(PI)、阻力指数(RI)均低于对照组,差异有统计学意义(P<0.05);观察组治疗后的子宫内膜厚度高于对照组,差异有统计学意义(P<0.05)。结论将中药滋阴补阳方剂应用于肾气亏虚型多囊卵巢综合征不孕症患者治疗中,可积极改善患者的激素水平及子宫动脉血流灌注情况,同时能够促进卵泡发育,增加子宫内膜厚度,改善症状,值得推广。

小针刀联合补肾活血祛痛方治疗腰椎间盘突出症临床观察

目的 探讨小针刀联合补肾活血祛痛方治疗腰椎间盘突出症(LDH)的临床效果。方法 选取2016年7月—2018年4月沈阳市中医院收治的135例患者作为研究对象,将所有患者随机分为甲组(小针刀联合补肾活血祛痛方)、乙组(补肾活血祛痛方)和丙组(小针刀),观察与对比3组患者的腰痛分级、治疗前后视觉模拟量表(VAS)评分和总体效果。结果 甲组总有效率为97.78%(44/45),高于乙组的88.89%(40/45)、丙组的82.22%(37/45),差异具有统计学意义(P<0.05);甲组治疗后VAS评分下降程度明显大于乙组和丙组;甲组治疗后Denis腰痛分级明显优于乙组和丙组,差异具有统计学意义(P<0.05)。结论对LDH患者进行小针刀联合补肾活血祛痛方治疗可以有效缓解患者的疼痛程度、缩短患者的住院时间、提升患者的生活质量,同时患者腰椎功能可以得到快速恢复,值得临床应用与推广。

郑惠芳教授采用补肾活血法提高薄型子宫内膜容受性的经验总结

郑惠芳教授系全国首批名老中医,临证经验丰富,擅用温补,尤其重用补肾。近几年子宫内膜容受性已经成为生殖医学领域研究的焦点问题,而补肾提高子宫内膜容受性在临床中得到普遍的应用,并且取得可喜的成果,其中中医药发挥了自己独特的优势。郑惠芳教授认为薄型内膜所致不孕的主要病机为肾精亏虚,精血不足,并提出补肾填精、活血养血为主要治疗原则,结合患者的具体情况,辨证论治,取得了显著的疗效,并提供了明确的辨证思路及治疗的方法。

张勉之教授基于补肾活血法论治尿酸性肾病

尿酸升高是肾功能异常的独立危险因素,肾脏损伤也会导致患者尿酸排泄异常。尿酸性肾病的病因病机以禀赋素薄,脾肾亏虚为病理基础,饮食不节,湿瘀侵袭为发病机制。张勉之教授在以国医大师张大宁教授创立的补肾活血法为根本治疗大法的前提下,依据潜伏期、发作期、缓解期体现出的不同证型辨证施治,疗效满意。

骨质疏松症“亏瘀致痿”的理论构建及临床应用

骨质疏松症(OP)是一种以增龄性骨量降低,骨微结构破坏,骨脆性增加且易骨折的代谢性骨病。该病好发于绝经后女性和中老年男性,起病隐匿,多数患者在骨折后才被确诊,造成了大量的医疗资源消耗。浙江中医药大学附属第三医院姚新苗教授研究团队基于“肾主骨”“肾气虚损”等基础理论,创新性提出了OP“亏瘀致痿”的致病理论,认为OP的病机是亏虚瘀互结、夹杂致痿。在该理论指导下,认为应采用“补肾健脾活血法”对OP患者进行辨证论治。补肾健脾活血法主要包括虚瘀同治;补肾为本、健脾为要;筋骨并重3个方面。该研究团队开展了一系列临床与基础研究,从不同角度阐释“亏瘀致痿”理论指导下OP康复策略的科学内涵。

补肾益髓法治疗阿尔茨海默病临床疗效的荟萃分析

目的系统评价补肾益髓中药复方治疗阿尔茨海默病的疗效。方法检索6个国内外常用数据库,检索时间为自建库起至2022年7月5日,收集补肾益髓中药复方治疗阿尔茨海默病的临床随机对照试验文献,进行Meta分析。结果共纳入文献研究12篇,共计733例患者,其中试验组371例,对照组362例。分析结果显示应用补肾益髓中药复方治疗阿尔茨海默病在临床治疗有效率[RR=1.63,95%CI(1.37,1.93),Ρ<0.00001],提高患者MMSE评分[MD=1.19,95%CI(0.98,1.40),Ρ<0.00001],降低患者ADAS-cog评分[MD=-2.68,95%CI(-4.95,-0.40),Ρ=0.02],降低患者中医证候评分[SMD=-0.64,95%CI(-0.92,-0.36),Ρ<0.00001]方面优于单纯的常规西医治疗;在降低患者ADL评分上与西医比较差异无统计学意义[MD=-0.78,95%CI(-2.24,-0.40),Ρ=0.69],具有相同疗效;在安全性指标及不良反应方面未见明显异常。结论补肾益髓中药复方治疗阿尔茨海默病对比单纯西医治疗在临床治疗有效率,提高MMSE评分、降低ADAS-Cog和中医证候积分上具有一定优势,但因纳入文献多数质量不高,故仍需开展大规模、多中心、高质量临床试验以进一步验证结论。

补肾温阳汤治疗卵巢储备功能低下临床研究

目的:观察补肾温阳汤治疗卵巢储备功能低下的临床疗效。方法:将60例卵巢储备功能低下患者按照随机数字表法分为对照组和观察组,每组各30例。对照组给予戊酸雌二醇/雌二醇环丙孕酮片治疗,观察组在对照组治疗的基础上加用补肾温阳汤。比较两组患者的临床疗效以及治疗前后中医证候积分、激素水平[卵泡刺激素(follicle-stimulating hormone,FSH)、雌二醇(estradiol,E_(2))、黄体生成素(luteinizing hormone,LH)、抗米勒管激素(anti mullerian hormone,AMH)]、卵巢功能指标[卵巢体积、卵巢窦卵泡数、卵巢间质动脉收缩期峰值流速(peak systolic velocity,PSV)]变化情况。结果:观察组有效率为93.33%,对照组有效率为73.33%,两组患者有效率比较,差异具有统计学意义(P<0.05)。两组患者治疗后各项中医证候积分低于本组治疗前,且治疗后观察组低于对照组(P<0.05)。两组患者治疗后血清FSH、LH低于本组治疗前,E_(2)高于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。两组患者治疗后卵巢窦卵泡数、PSV高于本组治疗前,且治疗后观察组高于对照组(P<0.05)。结论:补肾温阳汤治疗卵巢储备功能低下,可改善患者的临床症状,调节激素水平,促进卵巢功能恢复。

肌萎缩侧索硬化症个案处方用药规律挖掘

目的为中医临床治疗肌萎缩侧索硬化症(ALS)提供参考。方法计算机检索中国知网中以中药治疗ALS的个案文献,检索时限为自建库起至2022年11月。采用Excel软件统计复方中组方药物的使用频次(率)、四气(性)、五味、归经、功效,并导入中医传承计算平台(V 3.0)进行数据挖掘。结果共纳入个案文献110篇,涉及中药组方139个、中药218味,累计使用频次1946次。常用药物(使用频率>10%)45味,性味归经分别以温性(47.35%)、甘味(42.45%)、归脾经(20.29%)为主,药物功效以补虚类(41.37%)为主。中药组合98个,涉及中药24味,其中以黄芪、白术、党参组合(33次)最常见,药对以黄芪-山药、黄芪-熟地黄最常见(均使用32次);聚类分析提取核心药物组合5类。结论ALS个案用药处方以补虚类中药为核心,分补气、补血、补阳、补肝肾,配以升阳、温里、行气等药味。处方组合以气血双补、阴阳双补、清热化痰和益气活血为主要功效。

国医大师刘柏龄运用补肾祛瘀法治疗膝骨性关节炎经验

介绍国医大师刘柏龄教授运用补肾祛瘀法治疗膝骨性关节炎的经验。刘柏龄主张“治肾亦即治骨”,认为膝骨性关节炎以肝肾亏虚为根本原因,瘀血痹阻为标实,病位在肝肾,治疗上应抓住主要矛盾,以补肾壮骨为主,祛瘀通络为辅,补肾祛瘀法贯穿膝骨性关节炎整个疗程的始终。临证常选用膝痛1号方化裁治疗膝骨性关节炎,善用海螵蛸、藤类药、虫类药,内外兼治,临床疗效显著。

补益类中药治疗阿尔茨海默病作用及机制研究进展

随着人口老龄化的加剧,阿尔茨海默病(AD)患者数量持续攀升,然其确切发病机制尚未完全明确,现有药物仅能缓解症状而无法根治。中医将AD纳入“痴呆”等范畴,认为其病机与肾精亏虚密切相关,多采用补益肾精治法,并在实践中重用补益类中药。随着现代科学方法的引入,补益类中药治疗AD的作用机制正逐渐被揭示。本文系统性回顾了近年来补益类中药为主的中药复方、单味药及活性部位、活性成分在AD治疗中的研究进展,重点梳理和总结了其复杂的作用机制,包括降低淀粉样蛋白β(Aβ)/tau蛋白、神经细胞保护和神经炎症抑制等。尽管补益类中药在AD治疗研究中取得了显著进展,但其临床转化应用仍面临着诸多挑战,未来我们需要更加专注于药效明确的补益类中药,进一步明晰其活性成分,阐明分子机制网络,以促进临床转化应用;同时,对尚未充分研究的补益类中药进行系统活性评价与活性部位筛选,以期发现新的治疗靶点,为AD治疗提供更多选择。

朱生樑运用“以补开塞”法治疗老年不完全性肠梗阻经验探析

介绍朱生樑教授基于“塞因塞用”理论,运用“以补开塞”法治疗老年不完全性肠梗阻的临证经验。认为治疗本病应紧紧把握中医学“治病不忘人”的重要观点,人虚为本,病实为标,应宗“塞因塞用”之旨,从“以补开塞”立法,着眼于“脾”,以健运中焦、调畅气机为治疗大法,再视证情不同,或益气,或补血,或滋阴,或温阳,攻补兼施,使气血复充、运化复健、气机复畅,则疾病自除。并附验案1则。