A study on the treatment of chloasma with moxibustion based on the theory of“Yang transforming Qi,and Yin shaping”

Background:“Yang Transforming Qi and Yin shaping”comes from“Plain Question Yin and Yang should be like the theory”.Chinese medicine believes that the imbalance of yin and yang is the cause of human diseases.One of the strengths of TCM in treating diseases is holistic regulation.The theory of“Yang transforming Qi,and Yin shaping”implies a strong holistic view.Chloasma,one of the common skin diseases,seriously affects the physical and mental health of patients due to its unclear etiology,difficult treatment and easy recurrence.The occurrence and development of chloasma are closely related to internal organs.This paper is based on the theory of internal meridian,“Yang transforming Qi,and Yin shaping”which attaches importance to the concept of“Yang Qi”,from a new understanding of the pathogenesis etiology of chloasma.Methods:The author believes that the incidence of the disease is the deficiency of Yang Qi,which can’t promote the movement of Qi and blood to nourish the face,resulting in tangible material condensation,so proposes that this disease needs to be promoted by Yang transforming Qi and warm to dissipate.Moxibustion belongs to the fire,and its warming effect can dissipate the tangible evil.Results:Combined with clinical practice and the theory of internal meridian,the author elaborated that moxibustion is one of the effective methods for treating chloasma,which provides a new way of thinking for the treatment of chloasma.Conclusion:“Yang Transforming Qi and Yin shaping”can be used to guide the treatment of chloasma.

Evaluation of the Effect and Efficiency of Ear Tip Bloodletting Combined with Xianfang Huoming Yin in the Treatment of Early-Stage Wheals

Objective:To evaluate the effect and efficiency of ear tip bloodletting combined with Xianfang Huoming Yin(XFH)in the treatment of early-stage wheals.Methods:70 patients with early-stage wheals admitted from September 2020 to September 2022 were divided into two groups by randomized numerical table method,with 35 cases/group.Both groups received conventional treatment,the control group combined with XFH,and the observation group combined with ear tip bloodletting therapy and XFH.Conscious symptom scores,ocular indexes,therapeutic effects,and sleep quality between the two groups were compared.Results:After the treatment,the patients in the observation group had lower self-awareness symptom scores and sleep quality scores as compared to those in the control group;the diameter of the mass in the observation group was smaller than that of the control group after treatment;the average tear film rupture time and the time taken for the first non-contact tear film to rupture were longer in the observation group than those in the control group;the total effective rate of the treatment in the observation group was higher than that of the control group(P<0.05).Conclusion:Ear tip bloodletting combined with XFH was ideal for the treatment of early-stage wheals and has a high effective rate.

Clinical Study on the Effectiveness of Xian Fang Huo Ming Yin for Treating Cutaneous Infections and Promoting Wound Healing in Patients with Perianal Abscess

Objective:To explore the effect of the Xian Fang Huo Ming Yin(XFHM)for treating cutaneous infections and promoting wound healing in patients with perianal abscesses.Methods:Sixty-one patients with perianal abscesses who were admitted to our hospital(Xinghua City People’s Hospital)from May 2022 to May 2023 were selected and randomly divided into two groups,a control group(30 cases)and a study group(31 cases).Both groups received surgical treatment.The control group received conventional treatment and warm water fumigation,sitz bath,and surgical dressing change after surgery,while the research group received XFHM based on the control group.XFHM was taken orally and replaced with warm water for fumigation and sitz bathing.Both groups received treatment for 4 weeks but discontinued sitz bathing after 2 weeks.Various clinical indicators between the two groups were compared.Results:The total clinical effective rate and wound recovery rate of the study group were higher than that of the control group.There were differences in the wound pain scores,surrounding tissue edema,and wound secretions at different time points.Both groups experienced wound pain.The scores of wound pain,surrounding tissue edema,and wound secretions of the study group were lower than those of the control group,7 and 14 days after surgery.The serum interleukin 6(IL-6),tumor necrosis factor-alpha(TNF-α)levels,and pH values of the study group were lower than those of the control group 10 days after surgery(P<0.05).Conclusion:The application of XFHM for treating cutaneous infections and promoting wound healing in patients with perianal abscesses improved the treatment outcome,alleviated clinical symptoms,and promoted healing.

Differential Effects of Yin- and Yang-Chinese Tonifying Herbs on Innate and Adaptive Immunity

The present study investigated the effect of treatment with methanolic extracts of Yin- and Yang-Chinese tonifying herbs on concanavalin A (Con A)/lipopolysaccharide (LPS)-stimulated splenocyte proliferation (adaptive immunity) and natural killer (NK) cell activity (innate immunity) in an ex vivo mouse model. The results indicated that while treatment with most Yin herbal extracts potentiated the Con A/LPS-stimulated splenocyte proliferation, only Yang (but not Yin) herbal extracts stimulated NK cell activity. The differential effects of Yin- and Yang-Chinese tonifying herbs on innate and adaptive immunity are consistent with the Chinese medicine theory which depicts the Yin and Yang functional components of Zheng Qi (vital energy), with the Yang component being responsible for the first line of defense against invading microorganisms (i.e., innate immunity) and the Yin oner serving as a follow-up defensive response (adaptive immunity).

Continuity and Change in Dao Yin:Comparing and Contrasting the Therapeutic Exercises in Yin Shu(The Book of Pulling,c.2nd Century BCE)and Zhu Bing Yuan Hou Lun(Treatise on the Origins and Manifestations of Various Diseases,610 CE)

The manuscript Yin Shu(The Book of Pulling),excavated from Zhangjiashan Han Tomb No.247,is the earliest surviving text on therapeutic exercise known as Dao Yin(lit.guiding and pulling).Discovered in 1983,this Dao Yin text,together with the drawings of 44 figures performing“guiding and pulling”exercises found in the Mawangdui Han Tomb in 1974,are of great significance to the study of the early history of Dao Yin.Prior to these discoveries,researchers into Dao Yin relied mainly on material found in the Dao Zang(the Daoist Canon),compiled in 1145.This led to their conclusion that Dao Yin was essentially Daoist.The development of Dao Yin reached its zenith during the Sui Dynasty(581–618 CE),when it became one of the three medical departments at the imperial medical education institution.As part of the medical reform of the second Sui Emperor,Yang Di,Dao Yin became the treatment of choice,and the employment of a large number of Dao Yin specialists to the Sui court transformed the state medical service.The compilation of Zhu Bing Yuan Hou Lun(Treatise on the Origins and Manifestations of Various Diseases)under Yang Di’s decree,incorporated an abundance of resources on Dao Yin,enabling physicians to potentially“prescribe”Dao Yin to their patients.Situating both Yin Shu and Zhu Bing Yuan Hou Lun in their social and historical contexts,this article analyses their editorial treatments,examines their different objectives,styles,and readerships,and compares the various exercises described in the two texts.It emphasizes the fact that over a period of nearly a thousand years,from the late Warring States(475–221 BCE)to the Sui and Tang periods,Dao Yin was an important medical practice,culminating in its institutionalization by the Sui government.

TianmaGouteng yin attenuates ischemic stroke-induced brain injury by inhibiting the AGE/RAGE pathway

Background:Ischemic stroke is characterized by permanent or transient obstruction of blood flow,leading to a growing risk factor and health burden.Tianmagouteng yin(TMG)is commonly used in Chinese medicine to treat cerebral ischemia.The aim of this study was to investigate the neuroprotective effects of TMG against ischemic stroke.Methods:Either permanent middle cerebral artery occlusion(pMCAO)or sham operation was performed on anesthetized Wistar male rats(n=36).Results:Results demonstrated that TMG administration reduced the infarction volume and mitigated the neurobehavioral deficits.Hematoxylin and eosin(HE)staining and Prussian blue staining revealed that TMG attenuated tissue disruption and microbleeds in hippocampus tissues.In addition,TMG down-regulated the receptor of advanced glycation end products(RAGE)and p-JAK2.It also inhibited the concentrations of advanced glycation end products(AGEs),ferritin,malondialdehyde(MDA),and reactive oxygen species(ROS).Conclusion:As repetitive clinical trials of neuroprotectants targeting stroke have failed previously,our results suggested that the natural product,TMG,can probably help in the vicious cycles of ischemic stroke pathology.

基于糖代谢和胰岛素抵抗评估益气养阴法治疗气阴两虚型2型糖尿病的疗效

目的分析益气养阴法治疗气阴两虚型2型糖尿病对患者糖代谢和胰岛素抵抗评估的影响。方法南京中医药大学附属南京市中西医结合医院2019年6月—2022年3月收治的90例气阴两虚型2型糖尿病患者随机分为胰岛素泵治疗组(45例)和益气养阴治疗组(45例)。益气养阴治疗组采用胰岛素泵强化治疗联合益气养阴法进行治疗,胰岛素泵治疗组单独进行胰岛素泵强化治疗,两组均治疗2周。统计两组治疗2周后的临床疗效及治疗期间不良反应发生情况,比较两组治疗前和治疗2周后中医证候积分、糖代谢情况、胰岛素抵抗情况。结果治疗2周后,益气养阴治疗组总有效率为91.11%(41/45),高于胰岛素泵治疗组[73.33%(33/45),P<0.05]。治疗2周后与治疗前比较,两组口燥咽干、倦怠乏力、失眠、自汗盗汗、五心烦热、气短懒言评分及血清空腹血糖(fasting blood glucose,FPG)、餐后2 h血糖(postprandial 2-hour blood glucose,2 h PG)、糖化血红蛋白(glycated hemoglobin,HbA1c)、空腹胰岛素(fasting insulin,FINS)水平、胰岛素抵抗指数(Homa-IR)降低,益气养阴治疗组低于胰岛素泵治疗组(P<0.05),两组胰岛素敏感指数(insulin sensitivity index,ISI)、胰岛功能指数(Homa-islet)升高,益气养阴治疗组高于胰岛素泵治疗组(P<0.05)。治疗期间,益气养阴治疗组总不良反应发生率与胰岛素泵治疗组比较,差异无统计学意义(P>0.05)。结论气阴两虚型2型糖尿病患者采用益气养阴法进行治疗,可有效改善患者中医证候、糖代谢,降低患者机体胰岛素抵抗程度,具有较好的治疗效果。

基于文献及计量学方法研究脾阴学说古今发展及参苓白术散滋补脾阴作用阐释

脾乃后天之本、气血生化之源,脾之阳气为脾脏功能的发挥提供了“动力”,而脾阴则提供了“物质基础”。脾阴学说成说较晚、论说较少,基于文献研究系统梳理了脾阴理论内涵及历史发展源流,认为“辅运化”“主滋养”和“和胃阳”是脾阴主要的生理功能;脾阴理论的发展主要经历了《黄帝内经》构建脏腑阴阳理论体系、《伤寒论》初识脾阴方证、“丹溪学派”首开滋阴法先河、缪希雍系统建立脾阴理论体系、吴澄引申“芳香甘平”治法5个历史时期。此外,通过文献计量学Citespace分析脾阴学说现代整体发展应用情况,对比古今常用11个滋补脾阴类中药复方发现:现代研究中对脾阴学说的认识主要传承自唐容川、叶天士、吴澄、李东垣、缪希雍、张锡纯几位医家;其理论主要应用在消渴(糖尿病)、泄泻、便秘、肉痿等疾病治疗中;用药偏以甘淡,兼顾养胃阴为特色;局方参苓白术散成方早,充分体现了“甘淡”补脾之滋补脾阴用药的基本法则,具有健脾气、滋脾阴、渗脾湿之功效,全方升降相因、散收并用、补行兼施,尤宜于脾气阴虚夹湿的患者,乃滋补脾阴理论应用的基础方。

基于“阴阳自和”理论探讨自噬在老年血脂异常中的作用

自噬是近年来的医学热点领域,在此过程中,受损细胞器、蛋白质聚集物和脂滴等通发生降解(阴),并在此过程中生成能量(阳)与机体衰老和能量代谢密切相关。自噬在维持细胞内稳态、应对细胞内应激中的作用与阴阳消长、阴阳互用实现动态平衡,从而达到阴阳自和状态的过程不谋而合。中医理论分析认为老年血脂异常为本虚标实之证,与脾肾功能相关,与机体阴阳自和能力下降相关。文章尝试以中医阴阳理论为基础,探讨细胞自噬在老年血脂异常中的作用。

针刺关元-三阴交对DOR患者卵巢储备功能及卵巢血流灌注的影响

目的探究针刺关元-三阴交对卵巢储备功能下降(DOR)患者卵巢储备功能及卵巢血流灌注的影响。方法选取2021年1月至2022年12月我院收治的DOR患者80例进行研究。将80例患者均分为观察组和对照组各40例。对照组:基础治疗。观察组:基础治疗+针刺关元-三阴交。观察卵巢储备功能、卵巢血流灌注及不良反应。结果两组治疗前后的AFC比较差异均不显著(P>0.05),治疗前,两组FSH、FSH/LH、AMH差异不显著,P>0.05,治疗后的FSH、FSH/LH均降低,AMH增加,P<0.05,且观察组FSH(9.32±2.15)U/L、FSH/LH(1.81±0.21)低于对照组(10.77±2.22)U/L、(1.98±0.23),AMH(1.75±0.50)ng/mL高于对照组(1.51±0.54)ng/mL,差异显著,P<0.05。两组治疗前后的卵巢直径比较差异均不显著(P>0.05),治疗前,两组DOR患者PI、RI差异不显著,P>0.05,治疗后,PI、RI均降低,观察组PI(0.80±0.11)、RI(0.53±0.10)低于对照组(0.86±0.14)、(0.58±0.12),差异显著,P<0.05。两组均无血肿、感染、疼痛、晕针、滞针等不良反应。结论针刺关元-三阴交能够显著改善DOR患者卵巢储备功能及卵巢血流灌注,且安全性高。

黄芪竹叶汤配合益气生津丸治疗2型糖尿病气阴两虚证患者的临床观察

目的观察黄芪竹叶汤配合益气生津片治疗2型糖尿病气阴两虚证的临床效果。方法选取2020年1月—2022年1月期间河南省安阳市中医院收治的2型糖尿病(T2DM)患者90例作为研究对象,按随机数字表法分为对照组和治疗组,每组各45例。两组患者均给予常规西药治疗,对照组采用黄芪竹叶汤,治疗组在对照组基础上加用益气生津丸治疗,均连续治疗3个月。观察比较两组患者临床疗效、不良反应发生率,治疗前后中医证候积分、血糖指标[空腹血糖(Fasting plasma glucose,FPG),糖化血红蛋白(Glycosylated hemoglobin,HbA1c),空腹胰岛素(Fasting insulin,FINS)]及血清炎性因子[C-反应蛋白(C-reactive protein,CRP)、白细胞介素-1β(Interleukin-1β,IL-1β)、白细胞介素-6(Interleukin-6,IL-6)]水平。结果治疗后治疗组总有效率91.11%(41/45)明显高于对照组75.55%(34/45),差异有统计学意义(P<0.05)。治疗后两组患者中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且治疗组各主症及各次症积分均低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血糖指标FPG、FINS、HbA1c均较治疗前降低,差异有统计学意义(P<0.05);且治疗组FPG、FINS、HbA1c均低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血清炎性因子水平CRP、IL-6、IL-1β均较治疗前降低,差异有统计学意义(P<0.05);且治疗组CRP、IL-6、IL-1β均低于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论黄芪竹叶汤配合益气生津丸是治疗2型糖尿病有效且安全的方案,能明显控制患者血糖,减轻炎症反应。

气机升降理论内涵及不寐病辨证分型探讨

气机升降理论是“汉派李氏脑病流派”辨治不寐病的核心理论思想,基于气机升降理论将不寐病分为升降太过和升降不及两大类,根据气机运行的部位、气的多少、气机升降出入的不同形式将不寐病分为营卫不和型、脏腑气机失调型、阴阳不交型三大类型;每一类型又有各自不同亚型,共有卫阳虚不敛营阴证、卫气盛夜不入营阴证、卫气入于阴而日不得出于阳证、肝胆气机疏泄失调证、心肾气机上下相济失调证、脾升胃降枢机失调证、阳不入阴证、阳盛阴虚证、阴不潜阳证九种亚型,并表现出各自独有的临床特征。基于气机升降理论的辨证分型法补充完善了现阶段不寐病辨证分型类别,为临床诊治不寐病开拓了新思路。

从“阳化气,阴成形”探讨慢性咳嗽之因机证治

慢性咳嗽是以咳嗽为主症或唯一症状、病程持续8周以上的呼吸系统疾病。慢性咳嗽病因复杂,病程较长,病势缠绵,且极易复发。西医诊断该病过程繁琐,治疗手段有限,而中医药以整体观念和辨证论治思想为指导,在缓解临床症状、预防疾病复发方面具有独特优势。该文以“阳化气,阴成形”为抓手,分析阴阳在慢性咳嗽因机证治全周期的重要意义,认为慢性咳嗽之病机关键为“阳化气,阴成形”功能失衡,以肺之气血失和、阴阳虚损为本,阳化而气行不畅、周流有碍,阴变而凝结停滞、壅塞肺络为标。治疗上,需要补肺、脾、肾阴阳之不足,泄气滞、水湿、痰饮、瘀血、热毒之有余,以恢复“阳化气,阴成形”之平衡。具体用药方面,主张以偏纠偏,以药物气味之偏性纠正人体阴阳之偏颇。另附典型医案二例,加以验证说明,以期为中医药防治慢性咳嗽提供新的诊疗思路和方法。

通督调神针法治疗阴虚动风型脑梗死偏瘫疗效及对患者血清Hcy、CRP水平的影响

目的:探讨通督调神针法治疗阴虚动风型脑梗死偏瘫患者疗效及对患者血清同型半胱氨酸(Hcy)、C反应蛋白(CRP)水平的影响。方法:选取脑梗死偏瘫患者76例,1∶1随机分为观察组(西医治疗+通督调神针法)与对照组(常规西医治疗)各38例。持续治疗1个月后,评估两组临床疗效,比较两组治疗前后中医证候积分、血清炎症因子(Hcy、CRP)水平、运动功能[Fugl-Meyer评定量表(FMA)]、平衡功能[Berg平衡量表(BBS)]和移动功能[功能性步态评价表(FGA)]变化情况,并记录两组不良事件发生率。结果:观察组总有效率更高(P<0.05);观察组治疗后中医证候积分降低程度比对照组更明显(P<0.05)。观察组治疗后FMA、FGA和BBS评分升高水平均比对照组更明显(P<0.05),观察组治疗后Hcy、CRP水平下降程度均比对照组更明显(P<0.05)。治疗期间两组均无不良事件发生。结论:阴虚动风型脑梗死偏瘫患者应用通督调神针法联合常规西医治疗具有较好的增益效果,可有效提高临床疗效,缓解患者临床症状,提高运动、平衡和移动能力,降低炎症反应。

基于“阳化气,阴成形”理论辨治痿证

津气两伤是痿证的病变基础,亦是“阳化气,阴成形”失衡的结果。阳化气不足,阴成形失衡,而致脏腑功能失调,水饮痰瘀内生,四肢九窍失养,发为痿证。本文基于“阳化气,阴成形”理论,探讨高颖教授采用助阳化气法治疗阳化气不足的重症肌无力,益肾调形法治疗阴成形失衡的多发性硬化,阴阳双补法治疗阴阳俱损的运动神经元病。治疗痿证,需审证求因,明辨阴阳,调整偏颇,在疾病早期给予中医药治疗,以延缓疾病演变进程、改善预后。

基于“阳化气,阴成形”论治癌性腹水临床经验探讨

癌性腹水作为中晚期肿瘤的常见并发症之一,临床以腹部胀满和呼吸窘迫为主要症状,多见于晚期卵巢、胰腺和胃肠道恶性肿瘤等腹腔脏器恶性肿瘤患者。其发展速度快,病情进行性加重,一旦出现癌性腹水,患者的中位生存期将缩短至数月甚至数周,严重影响肿瘤患者的后续治疗及生活质量。癌性腹水的治疗至今仍是临床一大难题。“阳化气,阴成形”是《黄帝内经》中关于阴阳生理病理状态的重要论述,阳主“动”而流散以化气,阴主“静”而凝聚以成形,二者调和一致则为平人,若平衡被打破则百病由生。郭立中教授立足临床,结合古医籍和临床经验,提出“阳化气”不及、“阴成形”太过与癌性腹水的发生、发展密切相关。其中,“阳化气”不及是发病之本,“阴成形”太过是发病之标。肺、脾、肾阳虚化气不足,水液运化失常,水湿结聚,水为寒邪,寒性收引凝滞,易致血脉凝结,血凝又加重水湿留而不行,水湿、血瘀停聚腹腔形成癌性腹水。阳虚、水湿、血瘀是关键病因,病性为本虚标实,导师以扶阳消阴为治疗总则,重视扶肺、脾、肾阳气以固其本,消水湿瘀血以治其标,并根据疾病不同时期的病机特点在治疗上讲求次第,灵活变通,并配合外治法,临床收效显著。

应用阴阳锉跖趾关节成形治疗Freiberg病的临床研究

目的 探讨应用阴阳锉辅助进行跖趾关节成形配合间质填充治疗Freiberg病的临床疗效。方法 选取2019年8月至2023年9月郑州市骨科医院收治的30例Freiberg病患者。其中,男6例,女24例;年龄17~45岁,平均(26.5±6.8)岁。根据Smillie分期:Ⅲ期13例,Ⅳ期9例,Ⅴ期8例。均采用阴阳锉辅助进行跖趾关节成形配合间质填充治疗。术后采用AOFAS评分系统及跖趾关节屈伸活动度进行评价手术效果。结果 所有患者均获得随访,随访时间6~36个月,平均(26.5±13.9)个月。所有患者伤口均Ⅰ期愈合;AOFAS评分由术前(55.3±6.2)分提高到术后6个月的(90.8±5.9)分,差异有统计学意义(P<0.05),所有患者症状得到明显改变;跖趾关节活动度术前跖屈(20.3±5.3)°、背伸(15.2±5.6)°与术后6个月随访测量跖屈(18.9±5.1)°、背伸(14.1±5.2)°相比较,差异无统计学意义(P>0.05)。结论 采用阴阳锉辅助进行跖趾关节成形配合间质填充来治疗该疾病,该术式创伤小,操作简单,既减轻的疼痛症状,又保留了跖趾关节的外形及活动度,改善了患者的生活质量,是较为可靠的一种治疗方案,值得推广应用。

由“阳有余而阴不足”探讨自噬调节糖皮质激素介导的破骨分化

目前,糖皮质激素(glucocorticoids,GC)在临床上被广泛应用于抑制炎症反应与免疫系统,然而GC的长期大量应用会引起破骨细胞过度活跃,导致骨质疏松症以及相关骨折,被称为糖皮质激素性骨质疏松症(GIOP)。GIOP属于中医学“骨痿”“骨枯”的范畴,“骨痿”的发病病机与机体阴阳失衡密切相关。细胞自噬作为一种自我保护机制,对维持机体内环境平衡、调节“成骨-破骨”形成的骨稳态至关重要。成骨细胞与破骨细胞介导的骨稳态与中医理论中的阴阳自和理论不谋而合。本文基于GIOP发病的病机“阳有余而阴不足”探讨通过“调节自噬-平衡阴阳”来调控骨稳态,为防治GIOP提供新的思路。

扶阳健脾汤-滋阴养胃汤顺势给药和逆势给药对健康大鼠生理指标的影响

目的通过顺势和逆势给药大鼠扶阳健脾汤和滋阴养胃汤的研究来进一步验证中医阴阳分药分时服用方剂学理论,以及评价扶阳健脾汤和滋阴养胃汤的亚急性毒性。方法选取无特定病原体级SD大鼠48只,雌雄各半,按性别、体质量(空腹)排序,采用计算机随机法分为顺势饲喂组、逆势饲喂组、阴阳合药饲喂组和对照组,每组12只。对顺势饲喂组大鼠早上给予滋阴养胃汤颗粒制剂溶液,下午给予扶阳健脾汤颗粒制剂溶液灌胃,逆势饲喂组大鼠给药顺序与顺势饲喂组相反;阴阳合药饲喂组大鼠给予扶阳健脾汤和滋阴养胃汤合药颗粒制剂混合溶液灌胃,分早晚两次给药;给予对照组早晚灌胃等量超纯水,四组大鼠均每周给药5 d,共给药7周。分别于饲喂第1天、第10天、第20天、第30天、第45天时观察各级大鼠的皮肤毛发、行为状态、兴奋程度、激怒反应、睡眠状态、大便状态。分别于饲喂后第1周、第3周、第5周、第7周的周一、三、五测定大鼠采食量和体质量,饲喂7周后检测大鼠血液常规和血生化指标,计算脏器系数。结果饲喂第3周、第5周、第7周,顺势饲喂组日均采食量明显低于对照组;饲喂第5周、第7周,逆势饲喂组体质量明显高于对照组;饲喂7周后,顺势饲喂组和逆势饲喂组的心脏脏器系数明显低于对照组,而顺势饲喂组的脾脏脏器系数明显高于对照组;顺势饲喂组单核细胞计数明显低于对照组,顺势饲喂组和阴阳合药饲喂组的甘油三酯明显低于对照组,顺势饲喂组的血清总胆固醇明显低于对照组,顺势饲喂组、逆势饲喂组、阴阳合药饲喂组的空腹血糖明显低于对照组,顺势饲喂组、逆势饲喂组、阴阳合药饲喂组的肌酐明显高于对照组;顺势饲喂组和阴阳合药饲喂组的白蛋白明显高于对照组。结论顺势给药、逆势给药、混合给药可引起大鼠空腹血糖降低,肌酐增高;此外,顺势给药还可引起大鼠心脏脏器系数、单核细胞计数、甘油三酯、总胆固醇降低,脾脏脏器系数、白蛋白增高,表明顺势给药会促进大鼠的气血运行,有利于减少食物的摄入以及促进大鼠代谢体内的碳水化合物和蛋白质的代谢,从而进一步验证了中医阴阳分药分时服用方剂学理论。

玉液汤加减联合二甲双胍和德谷门冬双胰岛素对2型糖尿病气阴两虚证患者临床疗效观察

目的:对玉液汤加减联合二甲双胍和德谷门冬双胰岛素对2型糖尿病(T2DM)气阴两虚证患者的临床疗效进行探讨。方法:将60例T2DM患者随机分为对照组(n=30)和观察组(n=30),对照组采用二甲双胍联合德谷门冬双胰岛素治疗,观察组在此基础上应用玉液汤加减治疗,比较2组治疗后的中医证候积分、糖化血红蛋白(Hb Alc)、空腹血糖(FPG)、餐后2 h血糖(2h PG)、日内平均血糖波动幅度(MAGE)、胰岛素抵抗指数(HOMA-IR)和胰岛素分泌指数(HOMA-IS)。结果:治疗后,观察组总有效率显著高于对照组(93.33%vs 86.67%);观察组中医证候积分、Hb Alc、FPG、2h PG、MAGE和HOMA-IR等指标均低于对照组,HOMA-IS高于对照组(均P<0.05)。结论:玉液汤加减联合二甲双胍和德谷门冬双胰岛素对2型糖尿病气阴两虚证患者疗效显著,可有效控制患者的血糖并改善胰岛功能。