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.

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.

Dredging hand Yang meridians with deep tissue massage combined with neck movement in stiff-neck syndrome:A randomized controlled trial

Objective:The objective of this study is to observe the therapeutic effects of dredging hand Yang meridian with deep tissue massage combined with neck movement on stiff-neck syndrome.Materials and Methods:This is a randomized controlled trial.The consecutive patients with the stiff-neck syndrome were randomly allocated into the intervention group and patch group(1:1)according to the random number table.The intervention group was treated with dredging hand Yang meridian with deep tissue massage combined with neck movement once a day for 3 days,while the patch group therapy was treated with a 3-patch therapy and every patch included 24-h patch and 24-h patch-free.A needle electromyogram would be exerted if the patients were at their willingness in different stages.The pain of patients was assessed by Visual Analog Scale in the two groups at every 24 h time point.Results:Finally,212 patients completed the trial,106 in each group.The curative rate in the intervention group was higher than in the patch group(99.06%vs.84.91%,χ^(2)=0.890,P<0.01).Repeated measures of the general linear model showed a significant difference in pain score within the subject-factors(factor of time F=4548.577,P<0.001;factor of time-group F=490.034,P<0.001).There was a significant difference between groups regarding pain score(F=3016.315,P<0.001).Conclusion:Dredging hand Yang meridian with deep tissue massage combined with neck movement is better than patch therapy in stiff-neck syndrome,with a shorter duration and instant effects.

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.

Clinical observation of kidney-qi deficiency syndrome patients with hypertension by Bushenjiangya decoction

OBJECTIVE: To observe the clinical efficacy of Bushenjiangya(reinforcing kidney and lowering blood pressure) decoction in curing hypertension of kidney Qi deficiency type. METHODS: First 60 patients with hypertension of kidney Qi deficiency type were divided into control group and treatment group randomly; the conventional western medicine was given to patients of the control group for antihypertensive therapy, while the traditional Chinese medicine Bushenjiangya decoction was added for patients in the treatment group based on the therapy for those in control group; after 2 months, the blood pressure, clinical efficacy and urine microalbumin changes of patients in the two groups before and after the treatment were observed. RESULTS: a. The systolic pressure of patients in the two groups was all reduced obviously(P<0.05); b. The total effective rate of experiment group in antihypertensive effect was 76.7%, while that of control group was 83.3%(P>0.05); c. The total effective rate of experiment group in TCM syndrome effect was 86.7%, while that of control group was 63.3%, showing that the effect of experiment group was better than that of control group(P<0.05); d. The 24 h urine microalbumin reduction of experiment group was better than that of control group(P<0.05). CONCLUSIONS: The curative effect of Bushenjiangya decoction in combination with the western medicine is better than that of simple western medicine for hypertension of kidney Qi deficiency type, and also the urine microalbumin can be obviously reduced to protect the kidney function.

眩晕的经络相关性研究

目的观察眩晕患者的中医经络检测仪能量值的变化,探讨中医经络能量值与眩晕的相关性。方法选取2021年3月—2022年3月于北京世纪坛医院门诊及住院诊治的106例眩晕患者为研究组,以同期健康受试者117例为对照组,采用中医经络检测仪对2组受试者十二正经原穴经络能量值进行测量和比较,采用Logistic回归分析法对经络能量值和眩晕相关性进行分析。结果2组受试者的性别、年龄及十二正经原穴中冲阳(胃经)、太白(脾经)、神门(心经)、腕骨(小肠经)、太溪(肾经)、大陵(心包经)、阳池(三焦经)、丘虚(胆经)、太冲(肝经)能量值比较差异均无统计学意义(P均>0.05),而太渊(肺经)、阳溪(大肠经)、束骨(膀胱经)能量值比较差异均有统计学意义(P均<0.05)。Logistic回归分析显示,膀胱经能量偏低为眩晕的独立影响因素(OR=0.957,95%CI:0.923~0.991,P=0.014)。结论眩晕患者膀胱经能量低(束骨),肺经(太渊)及大肠经(阳溪)能量亢进,其他经络能量变化无规律可言,提示该病症的发生可能与膀胱经能量值异常相关。

外来中药辣木叶的药性与功用再探索

辣木叶(Moringa spp.)是印度传统草药,因其具有降血糖、降血脂、抗氧化、利尿、改善睡眠、增强人体免疫力、延缓衰老、抗肿瘤等作用而引起人们的广泛关注。辣木叶目前合法引入中国,并因其确切的药理活性与安全无毒的药物属性,应用与研究日益增多。但当前其暂无中药标准,仅有少量药性记载。辣木叶的中药药性亟待完善,以有利于辣木叶与中药合理配伍运用从而充分发挥其应有的价值。以“文献研究→理论探讨→药性验证→临床实践”为路径构建新外来药物“中药化”的研究策略与范式,以临床应用为依据、实验研究为参考,进行外来中药辣木叶的药性与功用的深入探讨,对规范其应用具有重要意义。

新外来中药香蜂草的药性探讨

香蜂草为唇形科植物Melissa officinalis L.的叶。原产于欧洲地中海地区,欧洲、北美、亚洲各大洲均有分布,我国的中南、西南部以及台湾也有野生种分布。香蜂草在国外有长久的应用历史,被广泛应用于治疗精神和中枢神经系统疾病、心血管疾病等。也作为抗焦虑药、睡眠辅助剂以及解毒剂。目前香蜂草在我国作为香料使用,并有多种以香蜂草为原料的专利。中医药学自古就广泛吸收外来药物不断扩大我国中药资源,如藿香、丁香、木香等源自域外的“香药”至今也是我国的常用中药。将香蜂草列入中药潜在的引入对象进行研究,以其临床研究和应用文献为基础,结合中医药理论对香蜂草的中药药性进行理论分析。结果为香蜂草药性辛、凉,归心、肝经,具有宁心安神益智、疏肝解郁、缓急止痛的功效,用于治疗心神不宁,失眠,健忘,心悸;情志抑郁,烦躁多虑;腹痛、牙痛等症状。

基于六经辨证探讨颈椎病的防治

颈椎病是临床常见病之一,通过药物、功能康复等,在一定程度上可缓解患者的临床症状。六经辨证是中医诊疗疾病的方法论,是中医辨证施治整体观的具体体现,通过六经辨证,医者可以准确地定位包括颈椎病在内的临床各类疾病的位置和病因,为临床诊疗提供更有针对性的方案。本文通过检索文献,探讨六经辨证理论在颈椎病防治中的应用,以期为临床诊疗提供一定的思路和方法。

“辽派中医”医籍《集验良方》六经证治述略

“辽派中医”是根植于东北文化基础上的一个具有区域特色的地方医学流派,有着悠久的历史传统和深厚的学术底蕴,从古至今产生了诸多医学名家及经典著作。文章重点归纳了“辽派中医”代表医籍《集验良方》一书中伤寒六经证治的学术思想特点。分析探讨《集验良方》所蕴含的学术思想、辨证方法、遣方用药,对梳理“辽派中医”的传承脉络,发掘古代医家学术思想及效方验方,对当今中医药学术经验继承工作具有重要的参考意义。中医药学源远流长,传承千载而不衰,薪火相传的学术流派发展与传承是中医药发展的一个重要途径。把握中医药传承的基本规律,推进中医药传承工作全面健康发展,是当今中医药工作者面临的首要的、最为紧迫的战略任务。

经络拍打联合五音疗法用于稳定期COPD患者护理的价值

目的探讨手太阴肺经拍打联合中医五音疗法在稳定期慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者护理中的价值。方法选取2022年1月—2023年5月福建中医药大学附属第二人民医院收治的94例稳定期COPD患者作为研究对象,通过随机抽取编号(1~90号)后根据单双号分为2组,各47例。对照组实施常规护理干预,试验组在常规护理基础上增加手太阴肺经拍打联合中医五音疗法。比较2组的肺功能指标、呼吸困难指数(modified medical research council,mMRC)、症状情况、6 min步行试验(6-minute walking test,6MWT)距离。结果护理前,2组的肺功能指标第1秒用力呼气容积(forced expiratory volume in one second,FEV1)与用力肺活量(forced vital capacity,FCV)比值(FEV1/FCV)、FEV1占预计值的百分比(FEV1%)、mMRC、COPD评估测试量表(COPD assessment test,CAT)评分以及6MWT距离比较,差异均无统计学意义(P>0.05)。护理后4、8周后,差异均有统计学意义(P<0.05)。与对照组相比,试验组的FEV1/FCV[4周后,(54.69±4.04)vs.(57.72±4.18);8周后:(55.95±4.28)vs.(59.85±3.44)]、FEV1%[4周后,(51.37±3.85)%vs.(54.08±4.26)%;8周后,(53.89±3.94)%vs.(58.63±4.07)%]更高,mMRC级别3~4级比率(4周后,46.81%vs.19.15%;8周后,38.30%vs.14.89%)更低,CAT评分更低[4周后,(18.25±5.12)分vs.(15.46±4.35)分;8周后,(14.19±4.25)分vs.(12.08±3.36)分],6MWT距离更长[4周后,(438.58±32.69)m vs.(459.42±31.86)m;8周后,(466.49±30.57)m vs.(482.08±29.15)m]。结论在稳定期COPD患者的护理中,实施手太阴肺经拍打联合中医五音疗法干预,对患者的肺功能改善有显著效果,有助于减轻其呼吸困难程度及其临床症状的严重程度,促进患者的活动耐力提升。

针刺联合循经按摩及中药外敷治疗哺乳期急性乳腺炎患者的疗效观察

目的探讨针刺联合循经按摩、中药外敷治疗哺乳期急性乳腺炎患者的临床疗效。方法回顾性分析2021年1月—2022年12月期间唐山市妇幼保健院中医科门诊收治的360例早期哺乳期急性乳腺炎患者,按随机数字表法分为对照A组(循经按摩+中药外敷)77例、对照B组(针刺+循经按摩)82例、对照C组(针刺+中药外敷)98例、治疗组(针刺+循经按摩+中药外敷)113例。对照A组患者循经按摩+中药外敷治疗,对照B组患者针刺+循经按摩治疗,对照C组患者针刺+中药外敷治疗,治疗组患者针刺+循经按摩+中药外敷治疗。治疗2个疗程后,观察比较4组患者临床疗效、临床症状、体征消退时间、疼痛及体温变化及复发率,治疗前后血清炎性指标[白细胞计数(White blood cell,WBC)、中性粒细胞百分比(Neutrophilicgranulocyte,NE%)、C-反应蛋白(Creactiveprotein,CRP)]水平。结果治疗后治疗组患者临床总有效率68.14%(77/113)明显高于对照A组患者53.25%(41/77)、对照B组患者51.22%(42/82)、对照C组患者53.06(52/98),差异有统计学意义(P<0.05)。治疗后治疗组患者疼痛消退时间、肿块消失时间、皮肤发红消退时间、体温恢复时间均明显优于对照A组、对照B组、对照C组患者,差异有统计学意义(P<0.05)。治疗后4组患者外周血WBC、NE%、CRP水平均较治疗前明显降低,差异有统计学意义(P<0.05);且治疗组患者外周血WBC、NE%、CRP水平均明显低于对照A组、对照B组、对照C组患者,差异有统计学意义(P<0.05)。治疗后治疗组患者哺乳意愿、哺乳行为率明显高于对照A组、对照B组、对照C组患者,差异有统计学意义(P<0.05);复发率明显低于对照A组、对照B组、对照C组患者,差异有统计学意义(P<0.05)。结论针刺联合循经按摩、中药外敷治疗哺乳期急性乳腺炎患者能有效提高临床疗效,降低患者炎症因子水平及疼痛感,增加哺乳意愿及哺乳行为,降低复发率。

中西医结合视角下《伤寒论》“六经病篇”提要

“六经病篇”构成了《伤寒论》之主体内容,笔者结合ICU中西医结合救治重症感染性疾病、新发突发传染病等的临床经验体会,认为“六经病篇”是多种感染性疾病诊疗经验之整合。太阳病篇论述了各类外感病初期发汗法及禁忌证,以及发汗后基础病种加重等变证之应对;阳明病篇论述了外感病中“发热、汗出、恶热”为主之病症,并详论了下法之应用时机、力度、禁忌等,旁及阳明中寒病、谷疸病等;少阳病篇之意义在于后世医家之发挥和推广;太阴病篇主要叙述了具有自限性的急性胃肠炎;少阴病篇主要论述了表现为中医“寒邪直中”和“伏气温病”之重症感染,亦涉及了较多之“下利”;厥阴病篇论述了表现为“热深厥深”之感染性休克,亦涉及病情危重之“下利”。

“经脉-脏腑相关”理论现代化诠释和发展思路

“经脉-脏腑相关”理论是经络学说的核心内容,是指导中医诊断和针灸治疗的重要理论基础。在该理论内容下,“司外揣内”反映脏腑病变可在体表出现特定症状或体征;而“辨经论治”则反映了经脉体表刺激可以治疗相应的脏腑疾病。在当下的多学科交叉和大数据时代下,验证及科学诠释经络学说是我们亟须解决的问题。从“经脉-脏腑相关”的角度,探讨应用大数据技术发现诊治疾病的规律,利用多学科前沿技术研究该学说的现代生物学机制,以梳理总结传统经络理论所蕴含的科学内涵及提升经络理论的临床指导价值。

基于足三阴经筋理论的小针刀松解疗法联合桃红四物汤治疗早中期股骨头坏死研究

目的 研究在足三阴经筋理论指导下的闭合性小针刀松解疗法联合桃红四物汤治疗早中期股骨头坏死的临床效果。方法 选取2020年6月至2023年6月在该院就诊的72例早中期股骨头坏死患者作为研究对象,对其临床资料进行回顾性分析。根据治疗方案不同将患者分为2组,其中38例接受足三阴经筋理论指导下的闭合性小针刀松解疗法联合桃红四物汤治疗(观察组),另34例接受常规闭合性松解术治疗(对照组)。比较2组治疗效果,以及治疗前后髋关节功能、疼痛程度及生活质量评分。结果 观察组患者整体疗效优于对照组,差异有统计学意义(P<0.05)。治疗后3、6个月时,观察组患者Harris髋关节功能评分高于对照组,视觉模拟评分法评分低于对照组,差异均有统计学意义(P<0.05)。治疗后6个月时,观察组患者生理功能、躯体疼痛、活力、情感职能、社会功能、生理职能、精神健康及总体健康等简明健康状况调查问卷评分显著高于对照组,全血黏度高切、低切及血浆黏度水平均低于对照组,差异均有统计学意义(P<0.05)。结论 基于足三阴经筋理论指导下的小针刀松解术联合桃红四物汤治疗早中期股骨头坏死患者效果显著,有助于改善患者血液流变学,减轻躯体疼痛,提高患者生活质量。

高血压六经辨证论治思路与方法

基于六经辨证理论体系,探析高血压的六经辨治用药思路。高血压早期病在三阳,阳气尚足,病多属实;病变后期,病在三阴,阳气衰弱,病多属虚。高血压病在太阳,以解表祛邪为主;病在阳明,以清热通下为要;病在少阳,宜调畅气机;病在太阴,需温补脾胃;病在少阴,需调理心肾;病在厥阴,需调和寒热。

基于子午流注理论中药贴敷神阙穴治疗老年胸腰椎骨折术后阳明腑实证便秘患者的效果

目的:探讨基于子午流注理论中药贴敷神阙穴治疗老年胸腰椎骨折术后阳明腑实证便秘患者的临床效果。方法:将2022年8月—2023年9月中国人民解放军联勤保障部队第九〇七医院骨科(脊柱病区)收治的60例老年胸腰椎骨折术后阳明腑实证便秘患者作为研究对象,以随机数表法将患者分为对照组和研究组,各30例。对照组应用脊柱骨折术后常规治疗,研究组在对照组基础上应用基于子午流注理论中药贴敷神阙穴治疗。比较两组临床疗效、首次排便时间、首次排气时间及生活质量[便秘患者生活质量量表(PAC-QOL)]。结果:研究组临床总有效率为93.33%,高于对照组的70.00%,差异有统计学意义(P<0.05)。研究组首次排便时间、首次排气时间早于对照组,差异有统计学意义(P<0.05)。干预后,两组PAC-QOL各维度评分及总分低于干预前,且研究组低于对照组,差异有统计学意义(P<0.05)。结论:基于子午流注理论中药贴敷神阙穴在老年胸腰椎骨折术后阳明腑实证便秘患者中应用可有效促进排气、排便,改善便秘,提升生活质量。

新外来中药非洲马铃果皮的药性研究

目的:分析非洲马铃果皮的中药药性,为促进非洲马铃果作为外来中药引入中国,实现其与传统中药配伍应用提供理论依据。方法:选用科学期刊文献数据库进行检索,对相关文献进行纳入、排除、分类及统计。结合中医药理论探讨非洲马铃果皮的中药药性,总结分析相关历史应用、化学成分、药理活性等研究。结果:非洲马铃果皮为夹竹桃科马铃果属植物非洲马铃果(Voacanga africana Stapf)的根皮和树皮,中药药性为味苦、甘,性凉,归脾、胃、心、肝经,具有清热燥湿、解毒止痢、镇惊安神、止痉止痛之功。可用于热毒血痢、休息痢,呆钝健忘,胃脘痛、睾丸肿痛、痛经、跌打伤痛、惊厥等。水煎服,10~25 g/d,无毒。结论:研究赋予非洲马铃果皮中药药性,可为其引入中医临床并进一步与中药配伍应用奠定理论基础,同时对丰富我国中药资源、促进中医药可持续发展有重要意义。

新外来中药丽杯角的中药药性研究

目的:基于外来植物药丽杯角[Hoodia gordonii(Masson) Sweet ex Decne]的研究文献,结合中医药理论探讨丽杯角的中药药性,为丽杯角引入中药奠定理论基础。方法:选取国家知识基础设施数据库(CNKI)、中国学术期刊数据库(CSPD)、中文科技期刊数据库(CCD)、Web of Science、PubMed、Scopus文献数据库进行检索查阅,筛选丽杯角可信度高和结论可靠的科学研究文献。最终纳入132篇相关文献,将其分为综述研究、历史应用、化学成分、临床研究、药理作用、安全性文献共6类,结合中医药理论探讨丽杯角的中药药性。结果:通过概括、归纳以及理论研究分析丽杯角中药药性为苦,微寒;归脾、胃、肝经;具有清热泻火、化浊降脂、疏肝解郁的功效。主要用于胃火炽盛,多食易饥,形体肥胖,内热消渴,肝气郁结,胸胁胀闷。结论:赋予丽杯角中药药性对将非洲植物资源引入中药,加强物种多样化,促进中医药可持续发展有重要意义。