Discussion on the treatment of Alzheimer's disease from the spleen based on intestinal flora

Alzheimer's disease(AD)is a clinically common degenerative disease of the central nervous system with a complex pathogenesis,which seriously endangers the physical and mental health of the elderly.In recent years,a large number of studies have shown that the intestinal flora can regulate the central nervous system through the brain-gut axis,thereby participating in the occurrence and development of AD.AD belongs to the category of"dementia"and"forgetfulness"in traditional Chinese medicine.It is caused by internal injury of seven emotions,old age and chronic illness,which can cause insufficient blood,deficiency of kidney essence,and blockage of phlegm and blood.To use,treat more from the heart,liver and kidney.We believe that phlegm turbidity blocking the orifice is the key to the pathogenesis of AD.It should be treated from the spleen,and according to the characteristics of the pathogenesis,the method of warming the spleen and dredging the collaterals and resuscitation is proposed to prevent AD.This article takes the intestinal flora as the starting point to discuss the research progress of treating AD from the spleen.

Therapeutic strategies for gastroenteropancreatic neuroendocrine neoplasms: State-of-the-art and future perspectives

Although gastroenteropancreatic neuroendocrine neoplasms(GEP-NENs)have always been considered rare tumors,their incidence has risen over the past few decades.They represent a highly heterogeneous group of neoplasms with several prognostic factors,including disease stage,proliferative index(Ki67),and tumor differentiation.Most of these neoplasms express somatostatin receptors on the cell surface,a feature that has important implications in terms of prognosis,diagnosis,and therapy.Although International Guidelines propose algorithms aimed at guiding therapeutic strategies,GEP-NEN patients are still very different from one another,and the need for personalized treatment continues to increase.Radical surgery is always the best option when feasible;however,up to 80%of cases are metastatic upon diagnosis.Regarding medical treatments,as GEP-NENs are characterized by relatively long overall survival,multiple therapy lines are adopted during the lifetime of these patients,but the optimum sequence to be followed has never been clearly defined.Furthermore,although new molecular markers aimed at predicting the response to therapy,as well as prognostic scores,are currently being studied,their application is still far from being part of daily clinical practice.As they represent a complex disease,with therapeutic protocols that are not completely standardized,GEP-NENs require a multidisciplinary approach.This review will provide an overview of the available therapeutic options for GEP-NENs and attempts to clarify the possible approaches for the management of these patients and to discuss future perspectives in this field.

The transition and current pattern of drug therapy for advanced gastric cancer

Gastric cancer is one of the most common malignant tumors in the world.Its incidence ranks fifth among all malignant tumors worldwide and is the third leading cause of death among cancer patients.Surgery is currently considered to be the only radical treatment.However,the low rate of early diagnosis means that most patients have an advanced-stage disease at diagnosis which lost the chance of surgery.Therefore,the main treatment for advanced gastric cancer includes chemotherapy,targeted therapy,immunotherapy.The purpose of this study is to review the transition and current patterns of drug therapy for advanced gastric cancer and to provide assistance for subsequent clinical studies in advanced gastric cancer.

Effect of Yiqi Jianpi plus anticancer herbs on spleen deficiency in colorectal cancer and its anti-tumor role

Objective:To observe the effect of Yiqi Jianpi plus anticancer herbs on spleen deficiency in colorectal cancer and its anti-tumor role.Methods:Human intestinal cancer cell HT29 xenograft of nude mice model was established.The expression of ECF,VEGF,gastric cancer tumor growth in mice were observed.Results:Protein kinase C expression in in the Yiqi Jianpi group and Yiqi Jianpi anti-tumor group was significantly better than the model group(P<0.01,P<0.05).There was significantly more apoptotic cells in Yiqi Jianpi anti-tumor group than Yiqi Jianpi group and model group(P<0.01).Epidermal growth factor and vascular endothelial growth factor expression in Yiqi Jianpi group was significantly lower than Yiqi Jianpi group and model group(P<0.05).Conclusions:Tumor can inhibit the expression of PKC inhibition.Yiqi Jianpi and anticancer treatment can reduce this inhibition.Besides this treatment can also inhibit expression of tumor related genes such as epidermal growth factor and vascular endothelial growth factor.

Glyco-sphingo biology: a novel perspective for potential new treatments in Huntington's disease

Huntington＇s disease （HD） is the most common dominantly inherited neurodegenerative disorder, mainly characterized by the progressive striatal and cortical neurodegeneration and as- sociated motor, cognitive and behavioural disturbances （Zuccato et al., 2010）. The disease-causing mutation is an expansion of a GAG trinucleotide repeat （〉 36 repeats） encoding a polygluta- mine stretch in the N-terminal region ofhuntingtin （Htt） （Zuc- cato et al., 2010）, a ubiquitous protein whose function is still unclear （Zuccato et al., 2010）. Expansion of the polyQ stretch endows mutant Htt （mHtt） with toxic properties, and results in the development of a broad array of undesirable effects in both neuronal and non-neuronal cells （Zuccato et al., 2010）. Among all cellular dysfunctions and biochemical imbalances classically associated with HD, perturbed metabolism of （glyco） sphingolipids appears to play a crucial role in the pathogenesis of the disease. Over the last years, we and other have extensively contributed to these findings （Desplats et al., 2007;

基于“肝脾同调”阐析慢性肝病的中医治疗

慢性肝病是临床常见疾病,“郁、虚、湿、毒、瘀”是其核心病机,在疾病的不同阶段各有侧重,其中,以“郁、虚”为核心的肝脾失调是慢性肝病发生发展的关键。“肝脾同调”是治疗慢性肝病的基本治法,在慢性肝病不同阶段,其“肝脾同调”内涵同中有异。根据肝、脾生理病理特性,治脾明辨虚实,厘清轻重,活用运脾、健脾、温脾、醒脾、补脾等法;调肝体用并重,精准辨证,活用疏肝、缓肝、散肝、柔肝等法。临床上,治脾与调肝相辅相成,治调并举,常获良效。

国医大师刘嘉湘从脾肾论治肺癌经验

刘嘉湘教授认为,肺癌病位在肺,亦与脾、肾密切相关。其病机以正气亏虚为本,而脾肾为正虚之关键,治疗时强调“治病必求于本”,创立扶正培本治癌大法,开创了中医药治疗恶性肿瘤的新思路,扶正培本又重在脾肾,同时补虚不忘祛邪,扶正祛邪相辅相成,将扶正培本法贯穿于治疗肺癌的始终。

从肝脾论治甲状腺良性结节研究进展

甲状腺结节为常见的内分泌系统疾病,多为良性结节。西医对于甲状腺结节缺乏有效的治疗措施,对于部分病情严重的患者可进行手术治疗,但相关并发症较多。中医认为,甲状腺结节的发生与患者情志失调密切相关,而情志畅达与肝脏气机调畅密切相关,患者情志抑郁可致肝气郁结,日久使得脾胃生化功能失调,肝郁脾虚则水液输布失常,痰气瘀结于颈前而发为“瘿病”,因此,从疏肝理气、健脾利水、化痰消瘀为基本原则,治疗甲状腺结节能取得良好的效果。

健脾祛痰法治疗血脂异常研究概况

血脂异常在我国普遍存在,中医药干预血脂异常越来越得到人们的重视。中医学认为脾主运化水谷精微,脂质亦需要脾的运化功能布散周身。脾气虚则脾失健运,清气不升,浊阴独留,生湿生痰;痰湿进一步阻碍气机,影响脾胃运化,使脾虚更甚,加重脂浊,浸润血脉。近年来健脾祛痰法被越来越多地应用于血脂异常的防治中,且在临床中收到不错的疗效。

基于“脾气散精”理论探讨慢性肝病的中医治疗

慢性肝病的发病与脾密切相关,“脾气散精”是《黄帝内经》对脾功能的高度概括,脾气散精功能障碍贯穿慢性肝病始终,脾失运化,生湿生痰,瘀血阻络为慢性肝病进展的关键因素。治疗时应将健脾作为慢性肝病的基本治法之一,并根据脾运的不同状态,配合运脾、醒脾、温脾等不同治法,以复脾气散精之能,病程中尤应抓住瘀血络阻这一关键病机,活血化瘀通络,防止慢性肝病进一步向肝积、鼓胀发展,使脾运得复,瘀阻得除,标本兼治。

基于“心受气于脾”论治类风湿关节炎累及心脏病变

类风湿关节炎累及心脏病变属于复合病证,根据其发病过程与临床表现,可归属于中医学“脏痹-心痹”。心痹为痹证日久缠绵不愈,复感风、寒、湿邪,向内传入于心所致。该文基于“心受气于脾”理论探讨其病因、病机与治疗。通过梳理古代文献,发现类风湿关节炎累及心脏病变的病因为脾气不足,卫阳不固,外感风、寒、湿邪气侵入机体,瘀血顽痰阻滞发为心痹。其病机为脾气不足,营卫虚弱;脾阳不足,痰浊内生;脾失健运,痰瘀互结。现代研究表明,细胞免疫失调、血脂异常以及血凝与类风湿关节炎合并心脏病变关系密切,这与中医病机一致。在治疗时选用补益卫阳,和营通痹;温阳散寒,化痰逐饮;益气活血,健脾祛痰之法,代表方剂分别为黄芪桂枝五物汤、苓桂术甘汤、赤茯苓汤。该文提出“心受气于脾”理论,为临床治疗类风湿关节炎累及心脏病变提供思路与指导。

健脾祛湿和络方治疗特发性膜性肾病内涵探讨

从多维论治角度结合部分健脾祛湿和络方的研究进展,阐释健脾祛湿和络方有效治疗特发性膜性肾病(IMN)的中医学内涵。IMN以脾虚证、肾虚证为核心证候,健脾祛湿和络方立方以调理脾胃为基础,脾肾同治。从肺肾相关、肠肾相关、肺与大肠相表里等理论看,健脾祛湿和络方亦体现出了脾肺同治、肠肾同治、肠肺同治的中医学内涵,脾、肺、肠、肾相结合的多维论治是健脾祛湿和络方取效之根本。

丁书文从脾胃论治心系疾病的临证应用

丁书文教授推崇李东垣的脾胃内伤学说,强调脾胃在人体脏腑功能中的重要性,主张心系疾病从脾胃论治。丁书文教授基于李东垣的学术思想,创立了心系疾病“热毒”学说,指出心系热毒是脾胃功能失调、湿痰瘀热胶结导致。治疗既治心系疾病之标,亦调脾胃后天之本。

基于脾肺同治探讨复发性脓疱疮发病机制及治疗思路

脓疱疮是一种儿童常见的感染性皮肤病,具有一定的传染性。因小儿稚阴稚阳的生理特点,素体娇弱、禀赋不耐,或正气相对不足,肌肤娇嫩,腠理不固,加之难以控制搔抓,皮疹更易播散,出现疾病反复发作,邪毒久羁,迁延难愈。小儿肝常有余,脾常不足,而脾为后天之本,脾肺两脏相互配合,互通互用,共同调节脏腑功能。因此可通过健脾固本,补益肺气,脾肺相协,共调脏腑,以促进疾病的恢复。故而在临证治疗脓疱疮反复发作中,特别对于儿童患者,更应时刻谨记顾护脾胃、补益肺气、脾肺同治的重要性。

从“气舍于脾”论治肺癌

基于《黄帝内经》中“五脏气舍于其所生”的理论,从“气舍于脾”论治肺癌,认为肺癌可责之肺脾,基本病机是正气亏虚、气血阴阳失调。并基于肺与脾胃的关系,针对肺癌气虚、气机失调、津液代谢失常等病机,以培土生金为关键治法,辨证论治。另外,以《黄帝内经》的思想为基础,论述如何调理肺脏、顾护脾胃。在现已诊治的肺癌病例中对改善患者的临床症状和生存质量疗效肯定。

改良隔药脐灸联合敷贴序贯治疗小儿厌食症(脾气虚证)的临床观察

目的:探究与分析改良隔药脐灸联合敷贴序贯治疗小儿厌食症(脾气虚证)的临床疗效及对预后复发的影响。方法:选取我院2019年2月至2022年3月收治的小儿厌食症(脾气虚证)120例患儿,采取随机数字表法将其随机分为3组,每组各40例,对照组采用中药制剂厌食贴外敷治疗;治疗A组在对照组的基础上加用传统隔姜脐灸治疗;在对照组的基础上治疗B组加用改良隔药脐灸治疗,3组患儿均连续治疗4周,对比3组患儿的临床疗效、治疗前后主症积分和次症积分,同时对比3组治疗后4周、8周及12周的复发率。结果:治疗B组、治疗A组、对照组临床总有效率分别为95.00%(38/40)、80.00%(32/40)、62.5%(25/40),治疗B组临床总有效率均高于治疗A组和对照组(P<0.05)。3组患儿治疗后主症积分及次症积分均较治疗前降低,治疗B组患儿治疗后主症积分及次症积分均低于治疗A组、对照组,治疗A组患儿治疗后主症积分及次症积分均低于对照组,差异均有统计学意义(P<0.05)。随访8周时,治疗B组复发率[2.50%(1/40)]低于对照组[20.00%(8/40)],随访12周时,治疗B组复发率[2.50%(1/40)]低于治疗A组[17.50%(7/40)]和对照组[30.00%(12/40)],差异均有统计学意义(P<0.05)。结论:改良隔药脐灸与敷贴序贯联合治疗小儿厌食症(脾气虚证)可获得显著的临床疗效,促进改善患儿的临床症状及体征,同时在短期时间内有效避免了疾病的复发,具有较高的应用价值。

张艳自拟冠心方治疗冠心病心绞痛临证经验

冠心病心绞痛在心血管疾病中较为常见,属于中医学中“胸痹”“心痛”等范畴。张艳教授行医四十余载,治疗胸痹心痛疗效显著。认为其发病以气虚痰瘀交阻证型较为多见,提出“虚痰瘀”理论,自拟“冠心方”从脾论治冠心病心绞痛,治法为补气健脾,养血活血,化瘀止痛,化痰祛湿。该文章将张艳教授自拟冠心方治疗冠心病心绞痛的临证经验总结作出详细介绍。

补益脾胃溃结方对脾胃虚弱型溃疡性结肠炎患者的临床疗效

目的 探讨补益脾胃溃结方对脾胃虚弱型溃疡性结肠炎患者的临床疗效。方法 132例患者随机分为对照组和观察组,每组66例,对照组给予常规治疗,观察组在对照组基础上加用补益脾胃溃结方,疗程4周。检测临床疗效、Mayo评分、SF-36评分、中医证候评分、5-HT、IL-6、TNF-α、IL-4、CD4^(+)/CD8^(+)、LPS、TGF-β1、DAO变化。结果 观察组总有效率高于对照组(P<0.05)。治疗后,2组Mayo评分、中医证候评分、TNF-α、LPS、5-HT、IL-6、CD4^(+)/CD8^(+)、DAO降低(P<0.05),SF-36评分、TGF-β1、IL-4升高(P<0.05),以观察组更明显(P<0.05)。结论 补益脾胃溃结方可减轻脾胃虚弱型溃疡性结肠炎患者炎症反应,调节免疫功能,抑制疼痛介质分泌,促进肠黏膜修复,提高临床疗效。

四神丸治疗溃疡性结肠炎研究进展

四神丸是治疗脾肾泻的经典方剂,具有温肾暖脾、涩肠止泻功效。临床治疗溃疡性结肠炎脾肾阳虚证常以四神丸为基础方加减联合中医其他治法或中西医结合治疗,疗效显著。药理学研究显示,四神丸可能通过调控相关信号通路蛋白表达,调节炎症因子、抑制炎症反应,调节自噬,调节肠道菌群、改善肠黏膜通透性、修复肠黏膜屏障,调节细胞能量代谢,抗氧化应激,调节细胞免疫功能等治疗溃疡性结肠炎。本文对四神丸治疗溃疡性结肠炎研究现状进行整理、归纳,为进一步研究其作用机制及临床应用提供参考。

基于“诸湿肿满,皆属于脾”辨治癌性腹水

癌性腹水患者预后差、生活质量低、病死率高,目前临床治疗疗效差,不良反应明显,且易反复发作。中医中药治疗癌性腹水有一定的临床疗效,不良反应低,值得进一步探讨。文章基于《素问·至真要大论篇》“诸湿肿满,皆属于脾”的理论基础,总结癌性腹水的发病机制及临床治疗思路,以期为癌性腹水的临床诊疗提供依据。生理功能上脾主运化,是维持机体正常水液代谢的关键枢纽,病理上,若脾脏功能失常,则水湿、水谷不能正常运化,内停于腹则成鼓胀,日久阻滞气机,脉络受损,正虚邪恋而成积聚,可见脾失健运在癌性腹水的形成过程中起到了重要的作用,脾脏功能失常是癌性腹水发生的关键,因此临床治疗上应以益气健脾,芳香化湿为基本治则,并根据临床辨证,结合温补脾肾阳气,活血化瘀利水等治法,在调理脾胃的基础上,根据患者的证候灵活配伍,调节五脏平衡,以达到更好的疗效。