Cardioprotective effect of Yiqi Huoxue granule through regulation of mitophagy after myocardial infarction in rats

Objective:To investigate the cardioprotective effect of Yiqi Huoxue granule(YQHXG)in the regulation of autophagy in rats induced with myocardial infarction(MI).Methods:An acute MI animal model was established by ligation of the left anterior descending branch of the coronary artery in Sprague-Dawley rats.Besides,20 rats received sham operation were classified into a control group.The remaining 59 rats were randomly divided into MI model group(n=19),YQHXG group(n=20),and perindopril group(n=20).Relevant indicators on days 7 and 28 were observed in each group.Left ventricular function was determined by echocardiography.The structure and morphology of mitochondria,and the number of autophagic vesicles,were observed by transmission electron microscopy.The mRNA and protein expression levels of LC3,FUNDC1,Beclin-1,and BNIP3 were examined in the tissue of the MI marginal area.Results:Compared with the MI model group,YQHXG showed obvious improvements in cardiac functions.Observing the microscopic morphology of the heart tissue,myocardial tissue damage attenuated,autophagic signs of autophagosomes and autolysosomes reduced,vacuolization in mitochondria mitigated,and mitochondria arranged in order.YQHXG could reduce the degree of tissue lesion after MI and regulate the expression of autophagy-related molecules at different stages.On Day 7,YQHXG significantly downregulated the expression of Fundc1,Becn1,Bnip3 mRNA and reduced the levels of FUNDC1,Beclin-1,BNIP3,and LC3 B proteins expression(all P<.001).On Day 28,YQHXG could upregulate the expression of Becn1,Fundc1 and Bnip3 mRNA and increased the levels of the corresponding proteins expression(all P<.001).Besides,it also increased LC3 B protein expression level(P=.0344).Conclusion:YQHXG regulated the expression of mitochondrial autophagy-related factors in myocardial tissue and mitochondrial autophagic activity at different stages to protect the heart following MI.

Astragalus Salvia Granules to Benefit the Qi (Qishen Yiqi Keli) protects H9C2 cardiomyocytes by suppressing oxidative stress

Objective:To investigate the effects of Qishen Yiqi Keli(QSYQ;Astragalus Salvia Granules to Benefit the Qi)on ROS scavenging and inhibition of NADPH oxidase in an effort to identify new natural antioxidants.Methods:A total of 23 representative components in QSYQ were investigated,their effects on hydrogen peroxide induced ROS were assayed by dichlorofluorescein assay.Lucigenin chemiluminescence was adopted to test the effect on NADPH oxidase activity in H9C2 cardiomyocyte cells,and pyrogallol autoxidation was adopted to test the superoxide scavenging capacity.Results:Nine compounds in QSYQ could significantly inhibited H2O2-induced ROS increase compared with the model group(P<.05),including tanshinone I,salvianolic acid A,danshinone IIA,and cryptotanshinone from salvia root,luteolin from salvia root,harpagoside,harpagide,and angoroside C from scrophularia root.Nine compounds in QSYQ could significantly inhibited the production of
O2in H9C2 cell.Tanshinone I showed a lowest IC50 value 0.07 mM,the other including salvianolic acid A,cryptotanshinone,and salvianolic acid B,luteolin,isochlorogenic acid C,astragaloside IV,and glycyrrhetinic acid.Licochalcone A inhibited the autoxidation of pyrogallol at a low concentration,and tanshinone I showed no significant inhibitory effect from 2 mM to 20 mM.Conclusion:QSYQ had significant effects on ROS scavenging and inhibition of NADPH oxidase.Tanshinone I and salvianolic acid A are potential NADPH oxidase inhibitors.

Yiqi Yangyin and Huatan Quyu granule can improve skeletal muscle energy metabolism in a type 2 diabetic rat model by promoting the AMPK/SIRT/PGC-1α signalling pathway

Objective:To investigate how Yiqi Yangyin and Huatan Quyu granule (YYHO) improves skeletal muscle insulin resistance in a type 2 diabetic rat model and to discover whether the molecular mechanism is related to the promotion of the AMPK/SIRT/PGC-1α signalling pathway.Methods:Rats were randomly divided into 4 groups:the normal group,the model group,the YYHQ granule group,and the pioglitazone group.The type 2 diabetic rat model was established by feeding a high-fat diet for 5 weeks along with a single intraperitoneal injection of 30 mg/kg streptozotocin (STZ).After modelling successfully,the appropriate drug was intragastrically administered to diabetic rats for 2 weeks,once per day.The YYHQ granule group was given a dose of 4.8 g/kg body weight per day,the pioglitazone group was given a dose of 1.35 mg/kg body weight per day.The doses for both groups were equivalent to the clinical equivalent dose based on a previous study.Other groups were gavaged with the same amount of saline water.Body weight,food intake,water intake,urine volume and grip strength were recorded weekly.The fasting blood glucose(FBG) was determined weekly using blood glucose test strips.The related glucose and lipid metabolism indexes,e.g.,fasting insulin (Fins),glycated haemoglobin (GHb),HOMA-IR,ISI,triglycerides (TG),total cholesterol (TC),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C) and free fatty acid (FFA),were determined using biochemical method.The mRNA expression levels of adenosine monophosphate-activated protein kinase (AMPK),peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PGC-1α),carnitine palmitoyl transterase-1 (CPT-1),Sirtuin 1 (SIRT1),and Sirtuin 3 (SIRT3) were assessed using quantitative real-time PCR (qRT-PCR).The protein expression levels of creatine kinase (CK),Ca2+ ATPase,α-Actin,AMPK,PGC-1α and CPT-1 were determined using enzyme-linked immunosorbent assay method (ELISA).Results:Body weight decreased significantly (P <.01),food intake,water intake and urine volume increased significantly (P <.01),and grip strength decreased significantly (P <.01) in the model group compared with the normal group.The levels of FBG,Fins,GHb and HOMA-IR increased significantly (P <.01),and the ISI decreased significantly (P <.01) in the model group.The levels of TG,TC,LDL-C and FFA increased significantly (P <.05 or P <.01),and the level of HDL-C decreased significantly (P <.05) in the model group.These changes were reversed after treatment with YYHQ granule or pioglitazone.Compared with the model group,the YYHQ granule and pioglitazone groups significantly improve body weight,water intake and urine volume (P <.05 or P <.01),however,both treatments had no significant effect on food intake (P >.05).The levels of FBG,Fins,GHb,HOMA-IR and ISI were improved significantly (P <.01) and the levels of TG,TC and LDL-C were improved significantly (P <.05 or P <.01),however,both treatments had no significant effect on the levels of HDL-C and FFA (P >.05).Further results indicated that YYHQ granule significantly decreased the mRNA expression of AMPK,PGC-1α,CPT-1,SIRT1 and SIRT3 in skeletal muscle (P <.01) and the pioglitazone group showed similar effects;moreover,the protein expression levels of CK,Ca2+ATPase,α-Actin,AMPK,PGC-1α and CPT-1 in skeletal muscle significantly decreased (P <.01),however,pioglitazone had no significant effect on CK and α-Actin (P >.05).Conclusion:The possible molecular mechanism of YYHQ granule improving skeletal muscle insulin resistance in a type 2 diabetic rat model may be related to the stimulation of energy metabolism in skeletal muscle via the AMPK/SIRT/PGC-1α signalling pathway.

Effect of Yiqi Huoxue (益气活血) Herbs on Vascular Endothelial Cells and Platelets in Patients with Chronic Cor Pulmonale

Objective: To observe the clinical effect of Yiqi Huoxue (益气活血, YQHX) herbs in treating the patients with chronic cor pulmonale and to explore its mechanism by determining the relationship of oxida-tion/antioxidation system and how such herbs change on the function of endothelial cells and platelets. Methods: Fifty-eight patients were divided into two groups: conventional therapy group (control group, 28 patients) and convention plus YQHX herbs group (treated group, 30 patients). The control group received conventional management. The treated group were treated with YQHX 150 ml, twice a day, plus the conventional treatment, and the clinical efficacy was recorded. The lipid peroxidation (LPO), superoxide dismutase (SOD), ot-granule membrane protein (GMP140), partial pressure of arterial oxygen (PaO2), partial pressure of carbon dioxide in artery (PaCO2) and circulating endothelial cells (CEC) were measured respectively before and after treatment, and the relationship between various parameters were analyzed. The results were compared with those of 10 healthy subjects got at the same period. Results: (1) The effective rate and PaO2 of the treated group was higher than that of the control group and there were no difference in PaCO2 between the two groups. (2) The levels of LPO, GMP140, CEC in all the patients before therapy were significantly higher than those of the healthy group, and there were marked decrease in the levels of those after treatment (all P<0. 01). On the contrary, the levels of SOD in all the patients before therapy were markedly lower than those in the healthy subjects and increased after treatment, P<0. 01. (3) The increase of SOD in the treated group was significantly more obvious than that of the control group. In the treated group, the decrease of LPO, GMP140, CEC were markedly more obvious than those in the control group (all P<0. 01). (4) The number of CEC, as well as GMP140, was negatively correlated to PaO2(P<0.01) and SOD (P< 0. 01), which was positively correlated to LPO (P<0. 01). There was a positive correlation between CEC and GMP140 (P<0.05). Conclusion: YQHX herbs in treating chronic cor pulmonale proved to be effective by balancing the oxidation and antioxidation, protecting the pulmonary endothelial cells and activated platelets and helpful in treating respiratory failure.

小儿肺咳颗粒辅助阿奇霉素序贯疗法治疗小儿支原体肺炎临床研究

目的:观察小儿肺咳颗粒辅助阿奇霉素序贯疗法治疗小儿支原体肺炎的临床疗效及对患儿肺功能、血清炎症因子的影响。方法:回顾性分析100例支原体肺炎患儿的临床资料,按治疗方法的不同分为观察组与对照组各50例。对照组以阿奇霉素序贯疗法治疗,观察组在对照组基础上给予小儿肺咳颗粒治疗。比较2组临床疗效、症状改善时间,比较2组治疗前后肺功能及血清炎症因子水平。结果:观察组临床总有效率98.00%,高于对照组84.00%(P<0.05)。观察组气促消失时间、咳嗽消失时间及肺部啰音消失时间均早于对照组(P<0.05)。治疗后,2组第1秒用力呼气容积(FEV_(1))、呼吸气流量分值(PEF)及用力肺活量(FVC)水平均升高(P<0.05),且观察组高于对照组(P<0.05)。治疗后,2组血清白细胞介素-6(IL-6)、C-反应蛋白(CRP)水平均降低(P<0.05),且观察组低于对照组(P<0.05)。结论:小儿肺咳颗粒辅助阿奇霉素序贯疗法治疗小儿支原体肺炎临床疗效确切,能促进患儿症状缓解,改善患儿肺功能,减轻炎症反应。

益气平悸颗粒联合酒石酸美托洛尔对气阴两虚证室性早搏患者心功能、血管内皮功能的影响

目的探讨益气平悸颗粒联合酒石酸美托洛尔对气阴两虚证室性早搏患者心功能、血管内皮功能的影响。方法选取2019年1月至2020年12月100例气阴两虚证室性早搏患者,采用随机数字表法均分为2组。对照组予酒石酸美托洛尔治疗,观察组在此基础上予益气平悸颗粒治疗。2组均以1个月为1个疗程,连续治疗2个疗程后比较疗效。比较2组治疗前、治疗1个疗程后、治疗2个疗程后中医证候积分、24 h动态心电图指标、左心功能指标、血管内皮相关因子,并分析2组临床疗效及治疗安全性。结果观察组临床总有效率为92.00%高于对照组的76.00%(P<0.05);治疗1个疗程及2个疗程后,观察组中医证候积分较对照组降低(P<001);治疗1个疗程及2个疗程后,观察组室性早搏次数少于对照组,NN间期标准差、RR间期平均值标准差高于对照组(P<001);治疗2个疗程后,观察组左心室收缩末期内径、左心室舒张末期内径较对照组降低,左心室射血分数较对照组升高(P<001);治疗1个疗程及2个疗程后,观察组血栓素B2、内皮素-1水平均较对照组降低,一氧化氮较对照组升高(P<001);2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论益气平悸颗粒联合酒石酸美托洛尔能改善气阴两虚证室性早搏患者临床症状体征,促进心功能恢复,调控血栓素B2、内皮素-1、一氧化氮等血管内皮相关因子表达,且具有较高的疗效和治疗安全性。

益气逐瘀解毒颗粒联合抗病毒药物治疗低病毒血症的慢性乙型肝炎肝纤维化及肝硬化患者的回顾性疗效观察

目的:评价中药复方益气逐瘀解毒颗粒治疗低病毒血症的慢性乙型肝炎肝纤维化及肝硬化患者(肝郁脾虚型)的临床疗效及联合不同抗病毒药物治疗慢性乙型肝炎肝纤维化的疗效差异。方法:收集2019年1月到2022年12月在成都中医药大学附属医院门诊就诊的165例口服抗病毒药物(ETV或TDF或TAF)和益气逐瘀解毒颗粒治疗低病毒血症的慢性乙型肝炎肝纤维化及肝硬化患者,将其定义为中药联合抗病毒药物治疗组,根据LSM值分为3个程度:轻度纤维化(39例)、显著/进展肝纤维化(54例)及肝硬化(72例),采用自身前后对照的研究方法,回顾性分析中药治疗疗程为3个月的上述患者治疗前后的LSM值、FIB-4、APRI、GPR及S指数,并进行疗效分析。另将165例患者分为中药联合ETV治疗组(94例)和中药联合TDF/TAF治疗组(71例),根据LSM值分为3组:中药联合ETV治疗组(轻度肝纤维化29例、显著/进展肝纤维化27例、肝硬化38例),中药联合TDF/TAF治疗组(轻度肝纤维化10例、显著/进展肝纤维化27例、肝硬化34例),分别组间比较上述指标。结果:中药联合抗病毒药物治疗组的轻度纤维化、显著/进展肝纤维化及肝硬化患者治疗前后LSM值均具有明显差异(P<0.01);中药联合抗病毒药物治疗组仅肝硬化患者治疗前后FIB-4、APRI、GPR、S指数四个指标比较有统计学意义(P<0.01),轻度纤维化及显著/进展肝纤维化患者治疗前后比较四个指标均无统计学意义;中药联合抗病毒药物治疗组的轻度纤维化、显著/进展肝纤维化及肝硬化患者临床有效率分别为46.15%、74.07%、63.89%,合计总有效率为63.03%(n=165)。中药联合ETV治疗组与中药联合TDF/TAF治疗组两组患者基线资料比较无统计学差异(P>0.05),治疗前LSM值、FIB-4、APRI、GPR、S指数无统计学差异(P>0.05),治疗后LSM值、FIB-4、APRI、GPR、S指数无统计学差异(P>0.05)。结论:益气逐瘀解毒颗粒对长期抗病毒治疗(≥5年)的低病毒血症的慢性乙型肝炎肝纤维化及肝硬化患者用药治疗3个月后均有疗效,对显著/进展纤维化患者比轻度纤维化疗效更好;益气逐瘀解毒颗粒联合不同抗病毒药物(ETV或TDF/TAF)治疗肝纤维化及肝硬化患者无明显差异。

小儿定喘颗粒改善Th17/Treg免疫失衡减轻RSV感染诱导哮喘小鼠气道炎症

目的探讨小儿定喘颗粒对呼吸道合胞病毒(Respiratory syncytial virus,RSV)感染诱导哮喘小鼠肺组织炎症反应的影响及机制。方法将60只SPF级雄性Balb/c小鼠随机分为空白组,模型组,小儿定喘颗粒高、中、低剂量组,阳性药(地塞米松)对照组,每组10只。除空白组外,其它组采用呼吸道合胞病毒、复合鸡卵蛋白(Ovalbumin,OVA)雾化吸入激发哮喘,造模成功后连续给药2周。HE染色法观察小鼠肺组织病理学改变;Masson与过碘酸-雪夫染色(PAS)染色法观察气道胶原沉积和黏液情况;ELISA法检测肺组织、血清中IL-6、lL-10、IL-17和TGF-β细胞因子含量;Western Blot检测STAT3、p-STAT3、RORγt、Foxp3蛋白表达水平,qRT-PCR检测RORγt、Foxp3mRNA表达。结果HE染色显示模型组小鼠气道结构改变,炎性分泌物增多,Masson、PAS染色发现模型组中气道黏液、胶原沉积显著增高;与模型组相比,小儿定喘颗粒各剂量组及地塞米松组小鼠气道结构逐渐恢复,黏液储备与胶原沉积情况改善;与空白组相比,模型组肺组织、血清中IL-6、IL-17和TGF-β细胞因子含量明显升高,lL-10含量下降(P<0.01),小儿定喘颗粒各剂量组与地塞米松组IL-6、IL-17和TGF-β细胞因子表达下降,lL-10表达增高(P<0.01);与空白组组比较,模型组p-STAT3、RORγt显著升高,Foxp3蛋白表达显著降低(P<0.01);与空白组相比,模型组RORγt、Foxp3mRNA含量显著升高(P<0.01);与模型组比较,小儿定喘颗粒各剂量组及地塞米松组RORγt、Foxp3mRNA表达均显著降低(P<0.01)。结论小儿定喘颗粒可以改善Th17/Treg免疫失衡抑制,降低血清及肺组织中IL-6、lL-10、IL-17和TGF-β水平,减少炎细胞迁移、气道炎性浸润及胶原沉积情况,减轻RSV诱导的哮喘小鼠气道炎症反应。

益气逐瘀解毒颗粒对肝纤维化模型大鼠GIV及下游信号通路PKA/CREB表达的影响

目的观察益气逐瘀解毒颗粒对四氯化碳(carbon tetrachloride,CCl 4)诱导的肝纤维化模型大鼠的抗纤维化作用及其对与Gα相互作用的囊泡相关蛋白(Gα-interacting vesicle-associated protein,GIV)、下游信号通路蛋白激酶A(protein kinase A,PKA)/环磷酸腺苷反应元件结合蛋白(cyclic adenosine monophosphate response element binding protein,CREB)表达水平的影响并探讨其作用机制。方法SD雄性大鼠予以CCl 4橄榄油混合物腹部皮下注射7周诱导肝纤维化模型,造模成功后随机分为益气逐瘀解毒颗粒高、中、低剂量组,扶正化瘀组及模型对照组,另设阴性对照组,共6组,每组大鼠8只。益气逐瘀解毒颗粒高、中、低剂量组分别予益气逐瘀解毒颗粒10.8 g/(kg·d)、5.4 g/(kg·d)、2.7 g/(kg·d)灌胃给药,扶正化瘀组予扶正化瘀胶囊0.405 g/(kg·d)灌胃给药,其余组等量蒸馏水灌胃,持续5周后处死大鼠收集标本。检测外周血丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天门冬氨酸氨基转移酶(aspartate aminotransferase,AST);肝组织苏木精—伊红(hematoxylin-eosin,HE)、MASSON染色检测肝纤维化程度;免疫组化法检测肝组织α-平滑肌激动蛋白(alpha smooth muscle actin,α-SMA)含量,并采用实时荧光定量PCR法(real time quantitative PCR,RT-qPCR)和蛋白免疫印迹法分别检测大鼠肝组织中Ⅰ型胶原α1链(collagen type I alpha 1 chain,Col1A1)、Ⅰ型胶原α2链(collagen type I alpha 2 chain,Col1A2)、GIV、PKA、CREB mRNA和蛋白表达水平。结果益气逐瘀解毒颗粒可减少肝纤维化模型大鼠胶原纤维增生及肝细胞损伤,且与模型对照组相比,益气逐瘀解毒颗粒各剂量组α-SMA含量显著下降(P<0.05),Col1A1、Col1A2、GIV表达显著下调(P<0.05),益气逐瘀解毒颗粒高、中剂量组PKA表达上调(P<0.05),中剂量组CREB表达显著上调(P<0.05);与扶正化瘀组比较,益气逐瘀解毒颗粒高、中剂量组α-SMA含量显著下降(P<0.05),高剂量组GIV表达下调(P<0.05),中剂量组PKA表达上调(P<0.05)。结论益气逐瘀解毒颗粒对CCl 4诱导的肝纤维化模型大鼠具有抗肝纤维化作用,可能与调节GIV表达及其下游信号通路PKA/CREB的表达有关。

Protective effect of thyroid and restores of ovarian function of Buzhong Yiqi granule(补中益气颗粒)on experimental autoimmune thyroiditis in female rats

OBJECTIVE:To observe the effects of Buzhong Yiqi granule(补中益气颗粒)on thyroid function and ovarian function in rats with experimental autoimmune thyroiditis(EAT).METHODS:EAT model was replicate by using the method of mixing and injecting porcine thyroglobulin with Freund's adjuvant and high iodine.Rats were randomly divided into normal control(NC)group,EAT model(EAT)group,selenium yeast(PC)group,low dose Buzhong Yiqi(BZYQ-L)group,medium dose Buzhong Yiqi(BZYQ-M)group and high dose Buzhong Yiqi(BZYQ-H)group.After two months of drug intervention according to dosage,enzyme-linked immunosorbent assay(ELISA)was used to measure the levels of free triiodothyronine(FT3),free thyroxine(FT4),thyroid-stimulating hormone(TSH),antithyroid peroxidase antibody(TPOAb),thyroglobulin antibody(TGAb)in peripheral blood of rats.The pathological changes of rat thyroid tissues were observed under light microscope with HE staining;ELISA was used to determine estradiol(E2),follicle-stimulating hormone(FSH),luteinizing hormone(LH),testosterone(T),antimüllerian hormone(AMH),and the pathological changes of rat ovarian tissues were observed under light microscope with hematoxylin and eosin staining.RESULTS:Compared with the NC group,BZYQ granule improved the thyroid and ovarian tissue morphology,and the levels of TPOAb,TGAb and TSH in the model group rats significantly increased(P<0.05),the thyroid tissue was severely destroyed,the levels of E2,FSH,LH,T,AMH significantly increased(P<0.05),and the ovary exhibited polycystic changes;Compared with the model group,TSH level in the BZYQ-L group rats decreased(P<0.05),FSH,T,AMH levels decreased(P<0.05),in the BZYQ-M group TPOAb,TSH levels decreased(P<0.05),FSH,LH,T,AMH levels significantly decreased(P<0.05),BZYQ-H group TPOAb,TGAb,TSH levels significantly decreased(P<0.05),FSH,LH,T,AMH levels significantly decreased(P<0.05),with the greatest improvement and significantly better than selenium yeast group(P<0.05).CONCLUSIONS:BZYQ granule could regulate the thyroid function of EAT rats,reduce thyroid antibody titers,then act on the ovarian function,regulate hormone disorders,and alleviate the pathological damage of rat's ovarian tissues.The effect of high dose Buzhong Yiqi granule is the best.

益气活血类方对心肌梗死恢复期病人心功能、中医证候的影响

目的:观察益气活血类方对心肌梗死恢复期病人心功能、中医证候的影响。方法:选取2021年5月—2022年12月首都医科大学附属北京中医医院及北京中医医院平谷医院门诊及住院治疗的心肌梗死恢复期病人144例作为研究对象,采用随机数字法将病人分为补阳还五颗粒组(31例)、脑心通胶囊组(49例)、养阴通脑颗粒组(31例)、对照组(33例)。补阳还五颗粒组给予标准化治疗+补阳还五颗粒+胶囊模拟剂,脑心通胶囊组给予标准化治疗+脑心通胶囊+颗粒模拟剂,养阴通脑颗粒组给予标准化治疗+养阴通脑颗粒+胶囊模拟剂,对照组给予标准化治疗+颗粒模拟剂+胶囊模拟剂。连续治疗3个月。比较各组左室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、N末端B型利钠肽原(NT-proBNP)水平、NT-proBNP变化率、中医证候积分及中医证候疗效。结果:治疗后,补阳还五颗粒组、脑心通胶囊组及养阴通脑颗粒组LVEF水平较治疗前升高,且优于对照组(P<0.05)。补阳还五颗粒组、脑心通胶囊组及养阴通脑颗粒组治疗前后LVEDD、LVESD水平比较差异无统计学意义(P>0.05)。治疗后,补阳还五颗粒组、脑心通胶囊组NT-proBNP水平均较治疗前下降(P<0.05)。以NT-proBNP下降30%为标准,补阳还五颗粒组NT-proBNP下降≥30%的病人较其他3组多(P<0.05)。治疗后,脑心通胶囊组及养阴通脑颗粒组胸痛积分均优于对照组(P<0.05);脑心通胶囊组出汗积分较治疗前下降(P<0.05);脑心通胶囊组面色紫暗积分及总分均优于对照组(P<0.05)。补阳还五颗粒能缓解病人神疲乏力的症状,脑心通胶囊能缓解病人胸闷、气短的症状且能更加全面地减轻病人临床症状。结论:补阳还五颗粒、脑心通胶囊、养阴通脑颗粒能够提高心肌梗死恢复期病人心功能水平,改善临床症状。

小儿豉翘清热颗粒联合复方鱼腥草糖浆治疗儿童上呼吸道感染临床研究

目的:观察小儿豉翘清热颗粒联合复方鱼腥草糖浆治疗儿童上呼吸道感染对症状控制、炎性细胞因子、免疫功能的影响。方法:选取116例儿童上呼吸道感染患儿为研究对象,按随机数字表法分为对照组及观察组各58例。对照组给予氨酚麻美干混悬剂、复方鱼腥草糖浆、布洛芬混悬液治疗,观察组在对照组基础上联合小儿豉翘清热颗粒治疗。比较2组临床疗效、症状控制时间及不良反应发生情况。比较2组治疗前、治疗3 d、5 d炎性细胞因子[白细胞介素-6 (IL-6)、肿瘤坏死因子-α (TNF-α)、C-反应蛋白(CRP)、白细胞介素-1 (IL-1)]、免疫球蛋白A (IgA)、免疫球蛋白M (IgM)、免疫球蛋白G (IgG)、T细胞亚群(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))水平。结果:观察组总有效率98.28%,高于对照组84.48%(P<0.05)。治疗后,观察组体温恢复正常时间、鼻塞与流涕消失时间、咳嗽消失时间、咽喉红肿消失时间均短于对照组(P<0.05)。治疗3 d、5 d后,2组血清IL-6、TNF-α、CRP、IL-1水平均逐渐降低(P<0.05);治疗3 d后观察组血清IL-6、TNF-α、CRP、IL-1水平均低于对照组(P<0.05);治疗5 d后,2组血清IL-6、TNF-α、CRP、IL-1水平比较,差异均无统计学意义(P>0.05)。治疗3 d、5 d后,2组血清IgA、IgM、IgG水平均逐渐升高(P<0.05),且观察组高于同期对照组(P<0.05)。治疗3 d、5 d后,2组血清CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平均逐渐升高(P<0.05),且观察组高于同期对照组(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:小儿豉翘清热颗粒联合复方鱼腥草糖浆治疗儿童上呼吸道感染,能加快症状缓解,促进患儿恢复,增强机体细胞和体液免疫功能。

基于谱效关系的小儿肺热咳喘颗粒抑菌作用研究

目的 建立小儿肺热咳喘颗粒高效液相色谱(HPLC)特征图谱,研究小儿肺热咳喘颗粒对肺炎链球菌的抑菌活性并建立谱效关系模型。方法 以HPLC法测定15批小儿肺热咳喘颗粒特征图谱;牛津杯法研究抑菌活性。采用《中药指纹图谱相似度评价系统》(2012A版)建立15小儿肺热咳喘颗粒特征图谱并进行相似度评价和特征峰指认。以相对抑菌活性为抑菌作用指标,进行灰色关联度分析,利用SPSS 21.0软件进行Pearson相关性分析,建立谱效关系模型并验证。结果 共得到13个特征峰,相似度不低于0.936;指认2、9、11号峰为绿原酸、黄芩苷、木犀草素,13个特征峰均与相对抑菌活性呈正相关,灰色关联度值为0.743~0.924,2、9、11、12号峰为抑菌主要活性成分;验证3批小儿肺热咳喘颗粒样品相对抑菌活性的预测值与测量值相对误差均小于6%。结论 小儿肺热咳喘颗粒抑制肺炎链球菌主要成分包括绿原酸、黄芩苷、木犀草素,且抑菌作用可能由多种成分协同作用产生,与多味药材的配伍有关,验证了中成药具有多成分协同作用的特点;初步确定建立的谱效关系模型可用于小儿肺热咳喘颗粒抗菌作用的预测与评价。

益气活血固肾颗粒中5种有效成分在大鼠体内的药动学及组织分布研究

目的探究益气活血固肾颗粒中巴马汀、药根碱、小檗碱、表小檗碱、芒柄花素在大鼠体内的药动学特征及组织分布规律,为进一步阐明该方的药效物质基础提供依据。方法建立HPLC-MS/MS法测定大鼠口服给药4.75 g/kg益气活血固肾颗粒后血浆及各组织中的药物浓度,色谱柱选择Kromasil C_(18)柱(3.5μm,2.1 mm×100 mm),流动相为乙腈-0.1%甲酸水溶液,流速为0.3 mL/min,进样量5μL,采用电喷雾电离源(ESI)分别在正、负离子多反应监测模式(MRM)下进行扫描,选择WinNonlin 3.3软件计算主要药动学参数。结果所建立的分析方法符合生物样品的检测要求,给予复方灌胃药液后,5种成分均可快速吸收入血,在30 min内血药浓度达到高峰,且药物在体内半衰期较短,消除速率快。各成分的达峰浓度Cmax、药时曲线下面积AUC_(0-t)分别为4.87~233.12μg/L、16.11~493.13 h/(μg·L)。组织分布结果显示,5种成分在体内分布迅速且广泛,具有不均衡的特征,在胃和小肠中分布较多,其次是肝、肾、肺等组织,而在脾脏、心脏中分布较少。结论该方法稳定、可靠,为复方益气活血固肾颗粒临床应用提供了参考。

益气除瘟颗粒对急性肺损伤小鼠作用机制研究

目的:观察中药益气除瘟颗粒对急性肺损伤(ALI)小鼠模型的治疗效果,探讨其潜在作用机制,尤其是在抑制炎症和细胞因子风暴方面的作用。方法:使用293T-ACE2细胞和Omicron BA.5假病毒进行体外细胞毒性及假病毒抑制实验。体内实验部分,采用脂多糖(LPS)诱导的BALB/c小鼠急性肺损伤模型,分为正常组、模型组、地米组、益气除瘟组四组,通过HE染色、PAS染色、免疫荧光和ELISA等技术评估益气除瘟颗粒的疗效。观察细胞因子IL-6、IL-10、IFN-γ和TNF-α的表达水平变化。结果:益气除瘟颗粒在体外实验中表现出明显的抗病毒活性,能有效抑制Omicron BA.5假病毒的细胞入侵。体内实验结果显示,益气除瘟颗粒明显减轻了LPS诱导的肺组织病理损伤,减少炎症细胞浸润,改善肺组织湿/干比(P﹤0.05)。此外,该药物还能调节免疫反应,降低促炎因子的表达(P﹤0.05),增加抗炎因子IL-6的表达(P﹤0.05),减轻细胞因子风暴的影响。结论:益气除瘟颗粒对急性肺损伤具有良好的治疗效果,其作用机制可能涉及抑制病毒入侵、调节炎症反应和细胞因子表达。

UPLC法同时测定清金益气颗粒中橙皮苷、黄芩苷、甘草酸含量

[目的]建立1种能够同时测定清金益气颗粒中橙皮苷、黄芩苷、甘草酸含量的超高效液相色谱(UPLC)。[方法]色谱柱为Waters CORTECS UPLC T3(2.1 mm×100 mm,1.6μm),以0.1%磷酸水溶液(A)-乙腈(B)为流动相,梯度洗脱(0~13 min,11%B;13~18 min,11%~15%B;18~35 min,15%B;35~45 min,15%~26%B;45~55 min,26%~40%B;55~60 min,40%B),流速为0.3 mL/min,柱温为30℃,进样体积为2μL,检测波长为237 nm、280 nm。[结果]3种成分在所设浓度范围内线性关系良好(r^(2)≥0.9998),精密度、重复性RSD均小于2%,平均加样回收率为90%~99%,RSD均小于5%,常温放置24 h内稳定性良好。[结论]此方法稳定准确、重复性好,可为清金益气颗粒的质量评价提供一定的参考依据。

补肾益气化瘀冲剂促进骨质疏松大鼠骨折术后骨痂血管形成的作用机制

背景:补肾益气化瘀冲剂具有益气化瘀、补肾通络的功效,常用于治疗骨质疏松,目前关于补肾益气化瘀冲剂对骨质疏松性骨折骨痂血管形成的影响研究较少。目的:探究补肾益气化瘀冲剂上调细胞外调节蛋白激酶/丝裂原活化蛋白激酶(extracellular signal-regulated kinase/mitogen-activated protein kinases,ERK/MAPK)信号通路改善骨质疏松大鼠骨折术后骨痂血管形成的具体机制。方法:①收集骨质疏松SD大鼠骨髓间充质干细胞、C57BL/6小鼠骨髓单核细胞,MTT法检测不同剂量补肾益气化瘀冲剂对骨髓间充质干细胞的毒性。分别使用添加0,1.5 mg/mL补肾益气化瘀冲剂的培养基培养骨髓间充质干细胞、骨髓单核细胞,进行体外成骨分化、破骨分化实验。②144只SD大鼠随机分为假手术组、模型组、冲剂组、冲剂+PD98059组,每组36只,后3组切除双侧卵巢建立骨质疏松模型,假手术组仅切除卵巢附近部分脂肪组织。8周后所有大鼠接受左侧胫骨横断截骨,冲剂+PD98059组给予5 g/kg补肾益气化瘀冲剂灌胃,尾静脉注射0.3 mg/kg PD98059(ERK1/2抑制剂);冲剂组给予5 g/kg补肾益气化瘀冲剂灌胃,尾静脉注射等体积生理盐水;假手术组、模型组给予等体积生理盐水,尾静脉注射等体积生理盐水;每日给药1次,持续8周。X射线、微型计算机断层扫描、微血管灌注造影观察骨折愈合与骨痂血管生成情况,检测骨痂骨密度与机械强度,苏木精-伊红、Masson染色观察胫骨组织形态,Western blotting、免疫组化检测ERK/MAPK信号通路相关分子表达情况。结果与结论:①与0 mg/mL补肾益气化瘀冲剂组相比,1.5 mg/mL补肾益气化瘀冲剂组成骨细胞碱性磷酸酶活性、矿化水平、p-ERK1/2、p-p38 MAPK表达水平升高(P<0.05),破骨细胞密度、体积减小(P<0.05);②与假手术组相比,冲剂组大鼠第4,8周骨折愈合程度相近,Lane-Sandhu评分、愈伤组织总体积、矿化愈伤组织体积、矿化愈伤组织体积/愈伤组织总体积、骨小梁厚度、血管数量、间距、厚度、血管体积/总体积、骨密度、骨痂极限荷载、刚度、p-ERK1/2、p-p38 MAPK、p-IκB-α、p-p65表达水平差异无显著性意义(P>0.05),模型组、冲剂+PD98059组大鼠骨折愈合缓慢,Lane-Sandhu评分、愈伤组织总体积、矿化愈伤组织体积、矿化愈伤组织体积/愈伤组织总体积、骨小梁厚度、血管数量、厚度、血管体积/总体积、骨密度、骨痂极限荷载、刚度、p-ERK1/2、p-p38 MAPK、p-IκB-α、p-p65表达水平降低(P<0.05),血管间距增加(P<0.05);③提示补肾益气化瘀冲剂能够通过增强ERK/MAPK信号通路相关分子表达改善骨质疏松大鼠骨折愈合情况,促进骨痂血管形成,减轻骨质疏松症状。

小儿肺咳颗粒联合阿奇霉素对小儿肺炎的治疗作用及对患者炎性因子水平的影响

目的分析小儿肺咳颗粒联合阿奇霉素在小儿肺炎中疗效及对炎性因子水平的影响。方法将南阳市中心医院在2022年2月至2023年2月期间收治的肺炎患儿(72例)作为研究对象,依据区间随机法将其分为对照组、研究组,各纳入36例,对照组药物治疗方案为单纯阿奇霉素,研究组药物治疗方案为阿奇霉素联合小儿肺咳颗粒。比较两组治疗有效率、基础症状消失时间、治疗前后炎性因子指标[C反应蛋白(CRP)、降钙素原(PCT)、白介素6(IL-6)、肿瘤坏死因子-α(TNF-α)]变化情况及治疗前后肺部感染评分(CPIS)变化情况。结果研究组治疗有效率(97.22%)高于对照组(80.56%),差异有统计学意义(P<0.05)。研究组发热、咳嗽、气促、湿啰音消失时间短于对照组,差异有统计学意义(P<0.05)。治疗前,两组间各炎症因子水平对比,差异无统计学意义(P>0.05);治疗后,两组CRP、PCT、TNF-α、IL-6较治疗前均有明显降低,且研究组低于对照组,差异有统计学意义(P<0.05)。治疗前,两组间CPIS评分对比,差异无统计学意义(P>0.05);治疗后,两组CPIS评分较治疗前均有明显降低,且研究组低于对照组,差异有统计学意义(P<0.05)。结论小儿肺咳颗粒联合阿奇霉素在小儿肺炎中疗效理想,可有效控制肺部感染、炎性因子水平,值得应用。

小儿益气颗粒治疗气虚型儿童便秘的临床疗效研究

目的分析小儿益气颗粒治疗气虚型儿童便秘的临床疗效。方法选择气虚型便秘患儿70例,信封法随机分为对照组和治疗组,每组35例。对照组患儿给予复方嗜酸乳杆菌片治疗,治疗组患儿给予小儿益气颗粒治疗。比较两组治疗效果、便秘程度、中医证候积分、血清P物质、血管活性肠肽及不良反应发生情况。结果治疗2周后,两组便秘程度评分、中医证候积分、血清P物质、血管活性肠肽均较治疗前改善,且治疗组便秘程度评分(3.56±0.46)分、中医证候积分(18.19±2.35)分、血清P物质(63.56±10.46)ng/L、血管活性肠肽(11.12±2.35)ng/L均显著优于对照组的(2.52±0.45)分、(21.14±2.12)分、(38.21±6.48)ng/L、(14.67±2.88)ng/L(P<0.05)。治疗组总有效率(94.29%)高于对照组(74.29%)(P<0.05)。治疗组不良反应发生率0低于对照组的17.14%(P<0.05)。结论小儿益气颗粒治疗儿童便秘对比西医治疗方法的疗效更优,安全有效。

小儿麻甘颗粒联合孟鲁司特钠对支气管肺炎患儿炎症指标的影响

目的:观察小儿麻甘颗粒联合孟鲁司特钠对支气管肺炎患儿炎症指标的影响。方法:随机将2022年1—10月赣州市南康区第一人民医院收治78例支气管肺炎患儿分为两组,各39例。对照组给予孟鲁司特钠治疗,在此基础上,观察组联合小儿麻甘颗粒治疗,连续治疗7 d。比较两组临床疗效、炎症指标、症状改善时间、住院时间、不良反应。结果:观察组治疗总有效率较对照组高(P<0.05)。治疗后,两组C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平均降低,且观察组均降低更显著(P<0.05);与对照组相比,观察组咳嗽、啰音、气喘消失时间及住院时间均更短(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:小儿麻甘颗粒联合孟鲁司特钠治疗支气管肺炎患儿效果较佳,可降低炎症指标,促进临床症状的改善,且联合治疗安全性较高。