Effects of Wuwei Xiaodu Decoction on Uterine Energy Metabolism and Serum Inflammatory Factors in Rats with Acute Pelvic Inflammatory Disease

[Objectives]To observe the effects of Wuwei Xiaodu Decoction on uterine energy metabolism and serum inflammatory factors in the acute pelvic inflammatory disease(APID)model.[Methods]75 Wistar rats(females)were randomly divided into control group,model group and Wuwei Xiaodu Decoction low,medium and high dose groups(n=15).Except for the control group,the rat APID model was established by right uterine inoculation.On the fifth day after inoculation,the low,medium and high dose groups of Wuwei Xiaodu Decoction were administered at 4,8 and 16 g/kg,and the control group and model group received normal saline.Rats were killed 12 h after nondose administration,blood was collected from the abdominal aorta and measured by ELISA for serum interleukin-6(interleukin-6,IL-6),IL-8,and C-reactive proteins(CRP);the right uterus of rats was tested for high-energy phosphate adenosine phosphate(AMP),adenosine diphosphate(ADP),adenosine triphosphate(ATP)and total adenine nucleotides(TAN)level to evaluate the uterine energy metabolism.[Results]AMP,ADP,ATP and TAN were significantly higher in the Wuwei Xiaodu Decoction of low,medium and high dose than the model group,while the serum IL-6,IL-8 and CRP were significantly lower than the model group,and the difference between the low,medium and high doses(P<0.05).[Conclusions]The Wuwei Xiaodu Decoction can dose-dependent promote uterine energy metabolism and inhibit inflammatory response in APID model rats.

Clinical efficacy of modified Ganlu Xiaodu Dan and kuhuangsan combined with interferon on the treatment of HFMD of damp-heat accumulation toxin syndrome and its effects on liver function, myocardial enzymes, inflammatory factors and immunoglobulin

Objective:To observe the curative effect of Modified Ganlu Xiaodu Dan and Kuhuang San combined with interferon on the treatment of HFMD of damp-heat accumulation toxin syndrome and its effects on liver function, myocardial enzymes, inflammatory factors and immunoglobulin.Merhods:From June 2018 to November 2018, 74 children with damp-heat accumulation toxin syndrome who were diagnosed with hand, foot and mouth disease have been randomly divided into the observation group (38 cases) and the control group (36 cases).The control group is given conventional Western medicine symptomatic treatment, and sprayed on the oral cavity with IFN- atomized inhalation or IFN- 2b spray. On the basis of the control group, the observation group is given Modified Ganlu Xiaodu Dan, and Kuhuangsan for washing body. 7 d is a course of treatment. The recurrence time of the two groups, the time of rash regression and the efficacy of the children have been observed. The changes of liver function, myocardial zymogram, inflammatory factors and immunoglobulin are compared before and after treatment.Results: The efficacy of the observation group was 92.1% higher than that of the control group (83.3%), and the difference was statistically significant. The time required for the body temperature of the observation group (2.64±0.57) d was lower than that of the control group (3.12±0.62) d, and the time required for the rash to resolve was (4.18±0.69) d, which was lower than that of the control group (5.25±0.73) d. Statistically significant. The levels of ALT, AST, CK-MB, IL-4 and IL-6 in the observation group were lower than those in the control group after treatment, the difference was statistically significant. The serum IgA and IgM levels in the observation group were higher than those in the control group after treatment. Conclusion: Modified Ganlu Xiaodu Dan and Kuhuang San combined with interferon for the treatment of HFMD of damp-heat accumulation toxin syndrome have a sound curative effect and it can improve liver function, protect cardiomyocytes, reduce inflammatory factors, and regulate immune function for children.

Mechanism of Ganlu Xiaodu MicroPill against COVID-19 based on network pharmacology and molecular docking method

Objective: To analyze the potential active components and molecular mechanism of Ganlu Xiaodu MicroPill in the treatment of COVID-19 by network pharmacology and molecular docking. Methods: the active chemical constituents and action targets of Ganlu Xiaodu MicroPill were searched by TCMSP and BATMAN-TCM platform, and the key targets were matched with the COVID-19 targets searched by CTD database. The core targets were selected and analyzed by GO and KEGG enrichment analysis by R software to predict the action mechanism of traditional Chinese medicine compound. The key component sets were docked with 3CLpro and ACE2. Results: 138 active components and 53 key targets were obtained. There are 1298 items in GO biological process, 59 items in cell composition, 62 items in molecular function, and 120 items enriched in KEGG pathway. Results: molecular docking showed that the affinity of 20 chemical components such as quercetin, luteolin and kaempferol with ACE2 and 3CLpro was higher than that of ribavirin and chloroquine. Conclusion: Ganlu Xiaodu MicroPill may regulate and interfere with SARS-CoV-2 infection through antivirus, inhibition of inflammatory factors and regulation of immunity, which fully reflects the therapeutic advantages of multi-components, multi-targets and multi-pathways of traditional Chinese medicine.

甘露消毒丹加减治疗妊娠期肝内胆汁淤积综合征的临床效果

目的探讨甘露消毒丹加减治疗妊娠期肝内胆汁淤积综合征(ICP)的临床效果。方法选取2021年10月至2022年6月在江西省妇幼保健院就诊的60例ICP患者作为研究对象,根据随机数字表法分为对照组和研究组,每组各30例。对照组给予常规西药治疗,研究组给予甘露消毒丹加减治疗。比较两组患者的瘙痒程度评分,胆红素[总胆红素(TBil)、间接胆红素(IBil)、结合胆红素(DBil)],肝功能[丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)],并对两组患者不良妊娠结局进行观察。结果研究组治疗后的皮肤瘙痒评分及TBil、IBil、DBil水平均低于对照组,差异有统计学意义(P<0.05);研究组的ALT、AST水平均低于对照组,差异有统计学意义(P<0.05);研究组的不良妊娠结局总发生率低于对照组,差异有统计学意义(P<0.05)。结论甘露消毒丹加减治疗ICP患者能改善患者临床症状及肝功能,缓解皮肤瘙痒程度,减少不良妊娠结局的发生。

基于氧化应激反应探讨慢性体表溃疡发病机理及象皮生肌膏联合托里消毒散的干预作用

目的 探讨慢性体表溃疡发病机理以及象皮生肌膏联合托里消毒散的干预作用。方法 将30只SPF级雄性SD大鼠按随机数字表法分为空白对照组、模型组、象皮生肌膏组、托里消毒散组、象皮生肌膏联合托里消毒散组,每组各6只。采用金黄色葡萄球菌造模,连续给药1周后,检测创面组织中血管内皮生长因子(Vascular endothelial growth factor,VEGF)、血管内皮细胞生长因子受体2(Vascular endothelial growth factor receptor 2,VEGFR-2)、核因子E2相关因子2(Nuclear factor erythroid 2-related factor 2,Nrf2)、NAD(P)H醌氧化还原酶1[NAD(P)H quinone oxidoreductase1,NQO1)、血红素加氧酶1(Heme oxygenase-1,HO-1)]表达水平。结果 与空白对照组比较,模型组创面组织中VEGF、VEGFR-2表达均明显降低,差异有统计学意义(P<0.01);与模型组比较,象皮生肌膏组、托里消毒散组、象皮生肌膏联合托里消毒散组VEGF、VEGFR-2表达均明显升高,差异有统计学意义(P<0.01)。与对照组比较,模型组中Nrf2、NQO1、HO-1表达水平升高,差异有统计学意义(P<0.01);与模型组比较,象皮生肌膏组、托里消毒散组、象皮生肌膏联合托里消毒散组Nrf2表达水平均明显升高,NQO1和HO-1表达降低,差异有统计学意义(P<0.01)。结论 大鼠慢性溃疡的形成可能与氧化应激反应抑制了VEGF通路及Nrf2通路有关,而象皮生肌膏联合托里消毒散可能通过调节上述通路促进溃疡处血管新生和抗氧化应激,进而提高创面愈合能力。

普济消毒饮古代文献考证与分析

搜集有关普济消毒饮的中医古籍文献,采用文献计量学方法对普济消毒饮的历史源流、药物组成、组方原理、剂量炮制、主治病证、用法等进行统计分析。经筛选得到普济消毒饮相关古籍文献235条,涉及中医古籍139部。普济消毒饮源于《东垣试效方》,由黄芩、黄连、人参、陈皮、玄参、甘草、连翘、牛蒡子、板蓝根、马勃、僵蚕、升麻、柴胡、桔梗14味中药组成,主要功效为清热解毒、疏风散邪,主治为上焦热盛所致的大头瘟等疾病。在涉及药味炮制的76条文献中,以甘草最多,多为生(44/45);其次为僵蚕,多为炒(38/44);黄连、黄芩多为酒炒(28/40、24/37);用法上以煮散剂为主,自明末剂型逐渐转变为汤剂。通过数据挖掘整理、系统分析记载普济消毒饮的中医古籍文献,为古代名方的临床应用和现代制剂研发提供参考。

托里消毒散联合千金苇茎汤治疗腹膜炎及腹透导管相关感染的病例分析

患者行腹膜透析治疗过程中易发生腹膜炎、腹透导管相关感染,万古霉素联用头孢哌酮舒巴坦二联抗感染治疗后效果不佳,予以托里消毒散合千金苇茎汤,感染得到有效控制。患者病程迁延,正气不足,正虚邪陷,治以益气补血,清热解毒,托里排脓。选方托里消毒散合千金苇茎汤加减,及时控制患者感染情况,为临床治疗腹膜炎、腹透导管相关感染提供新的选择。

托里消毒散治疗慢性创面的作用机制及应用研究进展

慢性创面是临床常见的难愈性疾病,多发生于糖尿病溃疡、外伤、静脉曲张性溃疡、压疮等急慢性损伤患者。中医学认为,慢性创面迁延不愈多为气血凝滞,难以托毒外出,使邪毒久积于肌肤所致。而托里消毒散可托毒外出,养血生络,助疮疽消散,在慢性创面的治疗中发挥了独特的优势。基于此,本文主要对托里消毒散在慢性创面治疗中的作用机制及应用研究进展进行综述,以期进一步指导其在临床中的应用。

Protective effects of Wuwei Xiaodu Drink against chronic osteomyelitis through Foxp3^(+)CD25^(+)CD4^(+) Treg cells via the IL-2/STAT5 signaling pathway

To explore the effectiveness and safety of a Chinese medicinal decoction Wuwei Xiaodu Drink(WWXDD)in inhibiting chronic osteomyelitis via regulatory T cells signaling.The effective constitutes of WWXDD and osteomyelitis related genes were screened.Target proteins were cross-validated using the Venny database.GO function and KEGG pathway analysis were performed for target proteins,while pharmacological network was constructed.The bone properties were analyzed by HE staining and the concentrations of immune factors were measured by ELISA.The expression of CTLA-4 and Foxp3 mRNA and STAT5,p-STAT5,CTLA-4 and Foxp3 protein were detected using Real-time PCR and Western blot,respectively.FACS was used to analyze the percentages of cells.A total of 117 genes overlapped between 785 target genes of the active compounds of WWXDD and 912 osteomyelitis related genes.Inflammation-related genes,including IL-6,TNFα,IL-1βand IL-2 showed high connection degree in the drug-compound-disease-target network.GO function and KEGG pathway analysis revealed that 117 intersection genes mainly enriched in virus infection related pathways,immune related pathways and chemokine signaling pathway.Furthermore,the development of chronic osteomyelitis was suppressed in model rats after treatment with WWXDD.Meanwhile,the concentrations of IL-2 and CD4^(+)CD25^(+)Foxp3 Treg perr centages together with the levels of p-STAT5,CTLA-4 and Foxp3 were also down-regulated.Furthermore,IL-2 and WWXDD drug-containing serum exhibited opposite effects on regulating IL-2,IL-10,TGF-β1,Foxp3,CTLA4 and STAT5.In addition,a STAT5 phosphorylation inhibitor suppressed the expression of Foxp3 and CTLA-4.WWXDD can treat chronic osteomyelitis through suppressing the main regulating factors of Tregs and interfere its immunodepression.Our results bring a new solution for chronic osteomyelitis.

基于五运六气探讨李东垣学术思想--以壬戌与壬辰之疫为中心

李东垣一生中经历2次大疫,对其学术思想的构建产生了直接影响。在传统认知中,五运六气是疫灾发生的重要影响因素之一,在五运六气视域下探析李东垣学术思想发现:壬戌年风火与燥金迭加的异常气象导致大头瘟毒,进而促成普济消毒饮的产生;壬辰年寒湿相遘的气化状态构成“脾胃不足为百病之始”的认知基础;壬辰大疫“病寒反为热中”的性质与阴火的气化状态相互吻合。由此验证了五运六气对李东垣学术思想的重要影响。并在2次大疫的对比中探讨气化力量的碰撞与交合,在隐而不显的干支推衍中探究文本背后的象数之道,从而揭示五运六气与李东垣具体学术问题以及整体学术框架之间的深刻联系,力图为探索金元医家学术体系提供新视角和新思路。

五味消毒饮加减联合面部滚针治疗痤疮后色素沉着疗效观察

目的:研究五味消毒饮加减联合面部滚针治疗痤疮后色素沉着的临床疗效。方法:选取2022年5月-2023年5月石家庄市中医院收治的100例痤疮后色素沉着患者为研究对象,依照就诊次序、按照随机数字表法分为对照组(n=50)及观察组(n=50)。对照组运用面部滚针疗法进行治疗,观察组在此基础上实施五味消毒饮加减联合治疗。比较两组临床疗效、皮损情况、色素沉着情况及不良反应发生情况。结果:观察组临床总有效率(92.00%)高于对照组(76.00%)(P<0.05);两组治疗前皮损情况差异无统计学意义(P>0.05),治疗后皮损颜色、数目及大小评分均较治疗前低,且观察组各项评分均低于对照组(P<0.05);两组均未出现不良反应;随访患者满意度情况,观察组总满意度(90.00%)高于对照组(72.00%)(P<0.05)。结论:五味消毒饮加减联合面部滚针治疗痤疮后色素沉着,效果显著,可提高患者满意度,且安全性良好。

多技术联合治愈药物外渗性皮肤坏死1例报告

给予2023年5月16日酒泉市中医医院收治的1例药物外渗致手背皮肤坏死患者在静脉滴注盐酸克林霉素注射液抗感染以及口服五味消毒饮加减消散疔疮、清热解毒的同时,局部创面行湿润烧伤膏换药联合光子治疗仪照射治疗,治疗24 d后,创面完全愈合,愈后皮肤可见红色表浅性瘢痕。

基于多指标成分含量测定的五味消毒饮制备工艺及特征图谱研究

目的:该实验通过五味消毒饮水煎液的特征图谱结合其有效成分秦皮乙素、绿原酸的含量及出膏率考察其制备工艺。方法:遵循传统煎煮方法结合现代分析方法,以五味消毒饮水煎液的特征图谱、有效成分绿原酸、秦皮乙素含量及出膏率为指标对煎煮过程中参数进行考察,包括粉碎粒度、煎器、加热方式、滤材、不同浓缩温度、不同浓缩密度、干燥方式等,并确定最佳工艺。制备15批五味消毒饮物质基准,建立五味消毒饮物质基准的特征图谱,进行共有峰的归属、指认及相似度评价。结果:确定五味消毒饮物质基准的制备工艺:取处方量药材饮片,置1.8 L砂锅中,加水400 mL,用电陶炉作为热源,先武火加热至沸,后文火煎至160 mL,加入黄酒100 mL,再滚二三沸时(沸腾后离火,不沸后再加热,重复3次),以200目滤布滤过;药渣同法再煎煮1次。合并2次煎液,60~65℃下减压浓缩至相对密度为1.10~1.15(60℃),放冷,预冻至结冰,冷冻干燥,研细,混匀,即得。五味消毒饮物质基准供试品特征图谱中应有8个特征峰,并指认了其中7个峰。8个峰涵盖了五味消毒饮物质基准中的所有药味,较好表明了五味消毒饮物质基准的质量特性。结论:五味消毒饮物质基准的制备工艺,稳定可行,为五味消毒饮及其相关制剂的开发奠定了基础。

中医经典方剂治疗痤疮的现代临床应用

通过查阅相关文献,探索治疗寻常痤疮的经典方剂(枇杷清肺饮、仙方活命饮、五味消毒饮、引火汤)的辨证要点及现代临床应用,以期为临床中医师辨治痤疮提供更多思路。

基于“阳有余阴不足”理论的一组药物治疗肺胃热盛型痤疮

目的:观察基于“阳有余阴不足”理论的一组药物治疗肺胃热盛型痤疮的临床效果。方法:选取2019年5月-2022年5月笔者医院收治的肺胃热盛型痤疮患者110例,随机分为对照组和治疗组。给予治疗组五味消毒饮合增液汤加减,每日1剂水煎口服及压缩面膜浸泡后湿敷面部治疗。对照组口服丹参酮胶囊及外用夫西地酸乳膏。治疗8周后比较两组痤疮综合分级系统(Global acne grading system,GAGS)评分、中医症状评分、Qol-Acne评分和临床疗效。结果:治疗8周后,两组的皮损程度明显改善,治疗组GAGS评分低于对照组(P<0.05);两组中医证候评分均显著低治疗前,且治疗组低于对照组(P<0.05),两组治疗后的Qol-Acne评分均高于同组治疗前,且治疗组高于对照组(P<0.05)。治疗组总有效率高于对照组(P<0.05)。结论:基于“阳有余阴不足”理论使用五味消毒饮合增液汤加减治疗肺胃热盛型痤疮临床效果显著,并能改善患者生活质量。

基于疫毒湿热理论探讨岭南疫病防治

系统梳理中医经典理论和岭南医家对疫病的认识,分析近年岭南地区的疫病流行与防治情况,提出岭南疫病流行的关键在疫毒、湿、热,应重视清热解毒化湿法的运用,以甘露消毒丹、银翘柴桂汤及白虎清解汤临证化裁使用。岭南疫病的防治应在疫毒湿热病机指导下,明确天、地、人之间的关系,以清热解毒化湿法施治。解毒是核心,祛湿清热是基础,防止疾病传变、截断病势是关键,同时注重养阴保津,根据病情联用西药。

HPLC法测定加味甘露消毒丹中大黄素的含量

目的建立高效液相色谱(HPLC)法测定加味甘露消毒丹中大黄素的含量。方法参考2015年版《中国药典》中的提取方法提取加味甘露消毒丹中的大黄素,采用Agilent ZORMAX SB-C_(18)色谱柱(4.6 mm×150.0 mm,5μm),进样10μl,以甲醇为流动相A,0.1%磷酸水溶液为流动相B,梯度洗脱15 min,柱温为常温,在254 nm的检测波长下测定大黄素含量。结果加味甘露消毒丹中大黄素在2.000~8.000μg(R^(2)=0.9998)范围内与峰面积呈良好线性关系,加样回收率为100.17%(n=6),相对标准差(RSD)为1.87%,该方中大黄素平均含量为13.9368~14.8311μg/g。结论建立的HPLC法可用于测定加味甘露消毒丹中大黄素的含量,该方法简便快捷、准确可靠,分离效果理想,重复性良好,为加味甘露消毒丹的质量控制提供实验依据。

甘露消毒丹联合退黄汤治疗慢加急性肝衰竭湿热蕴结证患者的临床观察

目的探讨甘露消毒丹联合退黄汤治疗慢加急性肝衰竭湿热蕴结证患者的临床疗效。方法选择安徽中医药大学第一附属医院就诊的慢加急性肝衰竭患者74例,根据随机数字表法分为对照组与观察组,各37例,两组均给予西药常规治疗,对照组患者给予退黄汤灌肠治疗,观察组在对照组基础上给予甘露消毒丹口服治疗,水煎服400 mL,日1剂,分早晚2次,饭后温服各200 mL,连续治疗8周。观察两组治疗前后临床疗效;进行中医证候评分;检测丙氨酸氨基转移酶(alanine aminotransferase,ALT)、天冬氨酸氨基转移酶(aspartate aminotransferase,AST)、白蛋白(albumin,ALB)以及总胆红素(total bilirubin,TBIL)评价肝功能;检测凝血酶原时间(prothrombin time,PT)、凝血酶原活动度(prothrombin time activity,PTA)评价凝血功能;腹部彩超检查肝右叶厚度、门静脉内径和胆囊壁厚度。结果治疗后观察组总有效率91.89%,显著高于对照组的70.27%(P<0.05)。治疗后两组中医证候评分均较治疗前降低,且观察组低于对照组(P<0.05)。治疗后两组ALT、AST、TBIL指标均较治疗前降低,ALB较治疗前升高,且观察组优于对照组(P<0.05)。治疗后两组PT指标均较治疗前降低,两组PTA指标均较治疗前升高,且观察组优于对照组(P<0.05)。治疗后两组门静脉内径、胆囊壁厚度均较治疗前降低,肝右叶厚度较治疗前升高,且观察组优于对照组(P<0.05)。结论甘露消毒丹联合退黄汤治疗慢加急性肝衰竭患者具有一定临床疗效。

基于网络药理学和分子对接探讨五味消毒饮治疗痤疮的作用机制

目的通过网络药理学和分子对接的相关方法探讨五味消毒饮治疗痤疮的作用机制,为五味消毒饮临床拓展应用及其相关成分新药的开发提供参考。方法通过中药系统药理学数据库与分析平台(TCMSP)获取五味消毒饮的主要化学成分及其靶点,筛选中药活性成分;利用功能蛋白关联(STRING)网络进行蛋白质相互作用(PPI)分析,构建PPI网络,根据靶点的作用强度得出关键靶标;采用Metascape数据库分析其参与的生物过程及通路;利用有机小分子生物活性数据库(PubChem)和蛋白质结构数据库(PBD)找出药物关键成分的小分子结构和疾病蛋白结构,经过设置受体与配体后对两者进行分子对接。结果五味消毒饮共42个主要有效成分,252个作用靶点,整合多个数据库的疾病靶点后得出痤疮靶点466个,两者相交靶点52个。在GO功能富集分析中包含了生物过程(BP)3998个,细胞组分(CC)285个,分子功能(MF)429个,KEGG通路获得53条。五味消毒饮治疗痤疮的关键活性成分为芹菜素、槲皮素、木犀草素等,核心靶点有白细胞介素6(IL-6)、蛋白激酶β(Akt1)、血管内皮生长因子A(VEGFA)、前列腺素内过氧化物合酶2(PTGS2)等。分子对接验证亦显示槲皮素、芹菜素、木犀草素与Akt1、IL-6、PTGS2、VEGFA的结合能展现出良好的结合力。结论本研究初步展示了五味消毒饮治疗痤疮的多成分、多靶点、多通路的作用机制,其关键活性成分槲皮素、木犀草素、芹菜素与关键靶点IL-6、AKT1、PTGS2、VEGFA的结合可能是其治疗痤疮时产生效用的重要机制。

托里消毒散治疗恶性肿瘤术后伤口愈合不良例析

恶性肿瘤术后伤口愈合不良是临床难治病症。通过系统回顾托里消毒散的历史演变及真实世界临证案例的全程管理,分析托里消毒散的临证用药思路及特点。认为托里消毒散补虚托毒并行,适用于治疗痈疽已成,因气血不足不能助其托毒腐化之证,可使其速溃,令腐肉脱新肉生。因此在灵活辨病辨证的基础上,将托里消毒散应用于恶性肿瘤术后伤口愈合不良是方证对应,可获良效。