Regulatory Effect of Shenge Yifei Capsule on TGF-β1/Smad Signaling Pathway in Rats with Chronic Obstructive Pulmonary Disease

[Objectives]This study aimed to study the effects of Shenge Yifei capsule on the TGF-β1/Smad signaling pathway in rats with chronic obstructive pulmonary disease(COPD).[Methods]Ten rats were randomly selected as the control group,and the other 40 rats were selected for modeling by fumigation combined with Klebsiella pneumoniae infection.A total of 38 rats were successfully modeled.They were randomly divided into model group(8 rats),low-dose Shenge Yifei capsule group(10 rats),high-dose Shenge Yifei capsule group(10 rats)and theophylline group(10 rats)in accordance with the principle of half male and half female.The rats in the model and control groups were given with distilled water by gavage,and the rats in the drug administration groups were given with corresponding drugs.The TGF-β1 level in the serum,and the expression levels of TGF-β1,Smad2,Smad3 and Smad7 and TGF-β1,Smad3 and Smad7 in airway tissues were detected.[Results]After 12 weeks,the serum TGF-β1 levels of the theophylline group and high-dose Shenge Yifei capsule group were lower than that of the low-dose Shenge Yifei capsule group(P<0.05).The expression levels of TGF-β1 and Smad3 in the theophylline group and high-dose Shenge Yifei capsule group were lower than that in the low-dose Shenge Yifei capsule group(P<0.05).The expression levels of TGF-β1 and Smad3 in the high-dose Shenge Yifei capsule group were lower than those in the low-dose Shenge Yifei capsule group and theophylline group(P<0.05).The expression levels of Smad7 and the proteins in the model group were lower than those in the other groups(P<0.05).The expression levels of Smad7 in the theophylline group and high-dose Shenge Yifei capsule group were higher than that in the low-dose Shenge Yifei capsule group(P<0.05).After 18 weeks,no significant difference was found in serum TGF-β1 level among the theophylline group and low and high-dose Shenge Yifei capsule groups(P>0.05).The expression levels of Smad7 and the proteins in the model group were lower than those in the other groups.The expression level of Smad7 in the high-dose Shenge Yifei capsule group was lower than that in the theophylline group(P<0.05).[Conclusions]Shenge Yifei capsule can regulate the TGF-β1/Smads signaling pathway.They can down-regulate the expression of TGF-β1,Smad2 and Smad3 and up-regulate the expression of Smad7,reducing the degree of airway modeling,delaying the development of COPD disease.Conventional high-dose Shenge Yifei capsule is more effective in inhibiting the expression of Smad2.

Intervention effect of Danbei Yifei formula on pulmonary fibrosis based on urine metabolomics by UHPLC-Q-Exactive

Objective:Determine the urinary biomarkers and pathogenesis of pulmonary fibrosis rats,and elaborate the intervention mechanism of DanBei YiFei formula.Methods:Bleomycin was injected into the trachea to induce pulmonary fibrosis in rats after anesthesia,and the diagnostic indexes of clinical pulmonary fibrosis,including superoxide dismutase,glutathione and malondialdehyde,were measured.High-throughput metabolic data of rats with pulmonary fibrosis were obtained by the latest high-resolution liquid-mass spectrometry technology,the multidimensional data were processed by Chemometrics algorithm to screen biomarkers related to pulmonary fibrosis.While,metabolic function indexes of rats after administration was observed,and the effective mechanism of DanBei YiFei formula on pulmonary fibrosis was expounded.Results:The clinical biochemical indexes showed that there were significant differences in metabolism in the model group,which confirmed the success of the preparation of the model of pulmonary fibrosis.Metabolisms research showed that the metabolic contour of the rats with pulmonary fibrosis was found to be significantly deviated,and the metabolism in vivo was abnormal.After the DanBei YiFei formula was given,the overall metabolic contour of the rats showed a trend of back modulation,and developed in the direction of healthy rats.With database matching and data processing 12 biomarkers,including Fumaric acid,Arginine and Spermidine,were obtained which were radically different from those of healthy rats and pulmonary fibrosis rats.Conclusion:DanBei YiFei formula has definite therapeutic effect on pulmonary fibrosis rats.Regulation of Tricarboxylic acid cycle and Arginine metabolic pathway may be the mechanism of its treatment of pulmonary fibrosis.

Study on the effect of Danbei Yifei formula on pulmonary fibrosis based on network pharmacology and molecular docking technology

Objective:To determine the pharmacodynamic material basis and mechanism of Danbei Yifei formula on pulmonary fibrosis.Methods:Starting with the clear absorbed components of Danbei Yifei formula or the potential effective components in line with the five rules of Ribinsky,the network pharmacology method and technology of traditional Chinese medicine were used to predict and analyze the action targets of Danbei Yifei formula in vivo,such as Salvia miltiorrhiza,PINBEI,Taoren,etc.On the basis of enrichment analysis,the core pathway of Danbei Yifei formula in the treatment of pulmonary fibrosis was identified,and the binding energy of drug ligand and protein target was determined through molecular docking technology simulation and verification,and its affinity and stability were evaluated.To clarify the material basis and mechanism of Danbei Yifei formula in the treatment of pulmonary fibrosis.Result:The results of network pharmacology prediction of traditional Chinese medicine showed that Danbei Yifei formula contained 72 potential pharmacodynamic components and 26 corresponding targets,including CHRM1、MAPK14、CCL2、ADRB1、PTGS1、PPARG、ALOX5、Pde3a、CHRM2、Adrb2、TNF、JUN、Adora2a、LTA4H、CYP1A2、OPRD1、CHRM3、DRD2、OPRM1、ARG1、EDNRA、Il6st、TACR1、MMP1、MMP8、Ptgs2,which were related to pulmonary fibrosis and pulmonary fibrosis Lung related diseases are highly correlated.There were 26 Go items(P<0.05)in go functional enrichment analysis,including 22 biological process(BP),9 cellular component(CC)and 3 molecular function(MF)categories.The results of network pharmacology showed that many components,such as protocatechuic acid and aminosuccinic acid,had direct effects on known targets of pulmonary fibrosis.Conclusion:Danbei Yifei formula contains many effective components which have inhibitory effect on pulmonary fibrosis,and it may play its role through the mechanism of multi-component and multi-target synergistic effect.

益肺温阳贴对慢性阻塞性肺疾病急性加重期临床疗效及炎性因子的影响

目的:探讨益肺温阳贴对慢性阻塞性肺疾病急性加重期(AECOPD)的临床疗效、炎性因子的影响。方法:选取2020年1月—2022年6月郑州市中医院肺病科收治的AECOPD患者,随机分为对照组、试验组各50例,对照组接受单纯西医治疗,试验组在接受西医治疗的基础上联合中药穴位贴敷治疗。记录并比较2组患者的临床疗效、治疗前后炎性因子水平及不良反应。结果:试验组患者治疗总有效率(96.0%,48/50)与对照组(72.0%,36/50)差异有统计学意义(P<0.05);试验组患者C反应蛋白、肿瘤坏死因子-α及白细胞介素-6水平均显著低于对照组,差异有统计学意义(P<0.05)。结论:益肺温阳贴联合西药治疗,可有效减轻炎症反应、提高临床疗效。

Effect of Yifei Huoxue Granule (益肺活血颗粒) on the Proliferation of Rat Pulmonary Artery Smooth Muscle Cells upon Exposure to Chronic Hypoxic Conditions in Vitro

Objective： To investigate the inhibitory effect of Yifei Huoxue Granule （益肺活血颗粒, YFHXG） on the hypoxia-induced proliferation of rat pulmonary artery smooth muscle cells （PASMCs） and its mechanism of decreasing pulmonary arterial pressure. Methods： Twenty male Sprague-Dawley （SD） rats were randomly divided into four groups： saline, and 0.66, 3.30 and 16.50 g/kg of YFHXG groups, the saline and different concentrations of YFHXG were given twice daily for 7 days, respectively. Serum-pharmacology method was used in the preparation of YFHXG serum. Tissue block anchorage was employed in the primary culture of rat PASMCs. The PASMCs were randomly divided into normoxia group, hypoxia group, and hypoxia＋YFHXG group （0.66, 3.30 and 16.50 g/kg doses of YFHXG-treated serum groups, exposed to hypoxic condition）. PASMCs in normoxia and hypoxia group were cultured with saline serum, hypoxia＋YFHXG groups were cultured with different concentrations of YFHXG serum. Cell viability was assessed with 3-（4,5-dimethylthiazol-2-yl）-2,5- diphenyltetrazolium bromide （MTT） assay. Cell cycle was analyzed using flow cytometry. In addition, hypoxia inducible factor-l-alpha （HIF-1α） protein expression was evaluated by immunocytochemistry analysis, the concentration of intracellular reactive oxygen species （ROS） and Ca2＋ were determined by laser scanning confocal microscopy （LSCM）. Results： MTT assay and flow cytometry showed that hypoxia could directly activate the proliferation of PASMCs, while YFHXG dose-dependently inhibited hypoxia-induced proliferation of rat PASMCs. Immunocytochemistry showed that hypoxia enhanced HIF-1α protein expression, and LSCM showed that hypoxia significantly increased intracellular ROS and Ca2., while YFHXG decreased the expression of HIF- 1α and attenuated the hypoxia-induced increase in intracellular concentration of ROS and Ca2＋. Conclusions： YFHXG could inhibit hypoxia-induced proliferation of rat PASMCs, which may decrease pulmonary arterial pressure and vascular remodeling. The anti-hypoxia effect of YFHXG may be explained by its regulation of HIF- 1 α expression and of the levels of intracellular ROS and Ca2＋.

清金化痰益肺汤合保和丸在支气管肺炎治疗中作用及对肺功能、免疫功能、FeNO、EOS、PCT、CRP水平的影响

目的清金化痰益肺汤合保和丸对支气管肺炎的应用价值以及对肺功能、免疫功能、一氧化氮(Fractional ex-haled nitric oxide,FeNO)、血清嗜酸粒细胞(Eosinophil,EOS)、降钙素原(Procalcitonin,PCT)及C反应蛋白(C-reactive protein,CRP)水平的影响。方法选取医院收治的支气管肺炎患儿100例,并将患儿随机分为对照组和观察组,每组50例。对照组均给予常规西药对症治疗,观察组在对照组方案的基础上给予清金化痰益肺汤合保和丸,两组疗程均为1周,对比两组临床治疗效果、肺功能、免疫功能、呼出气FeNO、EOS、PCT及CRP水平。结果两组患者治疗后,观察组总有效率为94.00%(47/50),显著高于对照组(76.00%,38/50)(P<0.05);对照组及观察组经治疗后一秒呼气最大容积(Forced expiratory volume in one second,FEV_(1))、用力肺活量(Forced vital capacity,FVC)及FEV_(1)/FVC水平均显著提升(P<0.05),同时观察组改善显著优于对照组(P<0.05);对照组及观察组经治疗后免疫球蛋白G(Immunoglobulin G,IgG)、免疫球蛋白A(Immunoglobulin A,IgA)、免疫球蛋白M(Immunoglobulin A,IgM)水平均较治疗前提升显著(P<0.05),同时观察组改善显著优于对照组(P<0.05);对照组及观察组经治疗后FeNO、EOS、PCT及CRP水平均较治疗前降低显著(P<0.05),同时观察组改善显著优于对照组(P<0.05)。结论清金化痰益肺汤合保和丸能显著提高小儿支气管肺炎的临床治疗效果,改善患儿的肺功能及免疫功能,减轻相关炎性反应,具有临床研究意义。

Clinical Observation on 271 Cases of Non-Small Cell Lung Cancer Treated with Yifei Kangliu Yin

To observe the effects of Yifei Kangliu Yin(YFKLY) in treating non-small cell lung cancer (NSCLC). Methods:Two hundred and seventy-one patients with NSCLC were randomly divided into three groups, Group A treated only by YFKLY, Group B treated by the combination of YFKLY and chemotherapy, and Group C treated only by chemotherapy as the control group for control. Results: (1) Of the 127 cases in Group A, 1 case got complete remission (CR), 13 got partial remission (PR), 89 had no change (NC), and 24 had progression of disease (PD), thus CR+PR+NC accounting for 81.10%; of the 80 patients in Group B, 17 got PR , 53 got NC, 10 got PD, PR+NC accounting for 87.50%; of the 64 cases of chemotherapy group, 7 cases got PR, 39 cases got NC, 18 cases got PD, PR+NC accounting for 71.88% (P<0.01). (2) The metastasis rate was 23.52% in Group A, 20.00% in Group B and 35.71% in Group C respectively after treatment. (3) The 1-, 2-, 3- and 4-year survival rate were 73.09%, 32.01%, 13.18% and 13.18% in Group A, 71.85%, 46.35%, 29.19% and 23.35% in Group B and 37.61%, 13.67%, 9.7% and 0% in Group C. The symptoms were improved, and Karnofsky score was elevated in Group A and B. Conclusion: YFKLY could increase survival rate and quality of life, decrease metastasis rate, and enhance the immune function in NSCLC patients.

益肺健脾方对慢性阻塞性肺疾病大鼠血清和支气管肺泡灌洗液中炎症因子水平的影响

目的观察益肺健脾方对慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)模型大鼠血清和支气管肺泡灌洗液(bronchoalveolar lavage fluid,BALF)中炎症因子水平的影响。方法将SD大鼠随机分为空白组,模型组,益肺健脾方低、中、高剂量组,地塞米松组和氨溴索组;除空白组外,其余6组大鼠均采用熏烟、气管内滴注脂多糖及番泻叶灌胃多因素联合制备肺脾两虚型COPD大鼠模型,共49 d。模型复制完成后,给予相应药物灌胃6周:空白组大鼠每日予生理盐水10 mL/kg灌胃;益肺健脾方低、中、高剂量组大鼠每日分别予益肺健脾方药液0.8、1.6、3.2 g/kg灌胃;地塞米松组大鼠每日予地塞米松混悬液0.05252mg/kg灌胃;氨溴索组大鼠每日予氨溴索混悬液1.4 mg/kg灌胃。采用苏木精—伊红染色法观察大鼠右肺下叶及支气管病理变化;阿尔辛蓝—过碘酸雪夫(Alcian blue-periodic acid Schiff,AB-PAS)染色法观察大鼠支气管杯状细胞增生情况;ELISA法检测大鼠血清和BALF中白细胞介素(interleukin,IL)-8、IL-10、IL-17、肿瘤坏死因子(tumor necrosis factor,TNF)-α、单核细胞趋化蛋白-1(monocyte chemoattractant protein-1,MCP-1)、瘦素(leptin)、C反应蛋白(C-reactive protein,CRP)、基质金属蛋白酶-9(matrix metallo proteinase-9,MMP-9)水平。结果苏木精—伊红染色结果显示,益肺健脾方高剂量和地塞米松能显著改善COPD大鼠气道重塑、炎症细胞浸润;AB-PAS染色显示,各用药组大鼠支气管杯状细胞增生明显减少。益肺健脾方高剂量能显著降低COPD大鼠血清和BALF中IL-8、IL-17、MCP-1、leptin、TNF-α、CRP、MMP-9水平(P<0.05),升高IL-10水平(P<0.05)。结论益肺健脾方能有效减轻大鼠气道炎症,改善气道重塑,其机制可能与调控IL-8、IL-10、IL-17、MCP-1、leptin、TNF-α、CRP、MMP-9水平有关。

田理教授运用芪丹益肺通窍方治疗肺脾气虚型鼻鼽验案举隅

芪丹益肺通窍方为四川省名中医田理教授基于鼻鼽虚实夹杂的病机特点,以肺脾同治、未病先防为治则,兼顾调理脏腑与抵御外邪,达到标本兼治的经验效方。文章通过分享本方临床验案,以期为中医药治疗肺脾气虚型鼻鼽提供思路。

健脾益肺颗粒联合布地奈德福莫特罗治疗慢性阻塞性肺疾病临床研究

目的观察健脾益肺颗粒联合布地奈德福莫特罗对慢性阻塞性肺疾病的治疗效果。方法将90例患者分成对照组45例和治疗组45例。对照组雾化吸入布地奈德福莫特罗治疗。治疗组患者在对照组基础上,口服健脾益肺颗粒。对比两组患者在治疗3个月后的总有效率、不良反应的发生情况、圣乔治呼吸量表(St.George s Respiratory Scale,SGRQ)。检测两组患者的诱导痰炎症指标[前列腺素E2(Prostaglandin E2,PEG2)、白细胞介素6(Interleukin 6,IL-6)、白细胞介素17(Interleukin 17,IL-17)]和主要肺功能指标[一秒钟用力呼气容积/用力肺活量(Forced expiratory volume per second/forced vital capacity,FEV1/FVC)、FEV1%预计值、最大呼气流量(peak expiratory flow,PEF)]的水平。结果治疗组患者在治疗后的总有效率为95.56%,明显高于对照组的80.00%,差异有统计学意义(P<0.05)。两组治疗后的病情程度(SGRQ评分)显著减轻,且治疗组降低更明显(P<0.05)。治疗后,两组的诱导痰PEG2、IL-6、IL-17明显降低,FEV1/FVC、FEV1%预计值、PEF均显著升高(P<0.05);治疗组诱导痰PEG2、IL-6、IL-17比对照组低,FEV1/FVC、FEV1%预计值、PEF比对照组高,差异有统计学意义(P<0.05)。两组的药物主要不良反应发生率无明显差异(P>0.05)。结论健脾益肺颗粒联合布地奈德福莫特罗治疗慢性阻塞性肺疾病,有助于控制病情,减轻患者气道炎症反应,提高肺功能。

益肺汤调控TGF-β1/Smad2通路抗肺纤维化机制研究

目的:研究益肺汤含药血清对血管紧张素Ⅱ(AngⅡ)诱导的肺成纤维细胞(NIH-3T3)的影响,探讨其抑制肺纤维化的作用机制。方法:采用SPF级C57小鼠灌胃益肺汤,1次/d,连续给药3 d制备含药血清。实验分为正常对照组、模型组、模型+正常血清组、模型+含药血清组,给药48 h后0.1%FBS的培养基饥饿处理24 h,100 ng/μl的AngⅡ诱导造模24 h。免疫组化检测α-平滑肌肌动蛋白(α-SMA);免疫荧光检测Smad2;Western blot检测Ⅰ型胶原蛋白(ColⅠ)、α-SMA、纤维连接蛋白(FN)、Smad2;ELISA检测细胞上清转化生长因子-β1(TGF-β1)的表达情况。结果:Western blot和免疫荧光显示,造模后,α-SMA、FN、ColⅠ、Smad2的蛋白相对表达显著升高,差异具有统计学意义(均P<0.05)。益肺汤含药血清干预48 h后造模,α-SMA、FN、Smad2、ColⅠ的相对量较模型组下降(均P<0.05)。ELISA结果显示,造模后,TGF-β1的相对表达显著升高(P<0.05),益肺汤含药血清干预48 h后,TGF-β1相对量较模型组下降(P<0.05)。结论:益肺汤含药血清对AngⅡ诱导的NIH-3T3有一定影响,可有效减轻肺纤维化,其作用机制可能与调控TGF-β1/Smad2信号通路,降低α-SMA、ColⅠ、FN的表达有关。

益肺养阴方加减联合西医常规治疗肺结核合并2型糖尿病患者的临床观察

目的分析益肺养阴方加减联合常规西医治疗对肺结核伴2型糖尿病患者的疗效。方法选取2021.01-2021.12本院收治的肺结核伴2型糖尿病患者总共80例进行研究,经随机分组法分成对照组(西医常规治疗)和观察组(在对照组基础上开展益肺养阴方加减治疗)各有40例,观察两组基线资料、治疗前和治疗6个月后的空腹血糖、餐后2h血糖及糖化血红蛋白水平;治疗6个月后的痰菌转阴率及空洞闭合率;治疗前和治疗6个月后的外周血CD4+、CD8+、CD4+/CD8+、CD3+水平;不良反应出现情况。结果治疗前,两组空腹血糖、餐后2h血糖、糖化血红蛋白相比无显著差异(P>0.05);治疗后,观察组空腹血糖、餐后2h血糖、糖化血红蛋白均低于对照组(P<0.05)。观察组治疗后的痰菌转阴率及空洞闭合率高于对照组(P<0.05)。治疗前,两组CD4+、CD8+、CD3+及CD4+/CD8+相比无显著差异(P>0.05);治疗后,观察组CD4+、CD3+及CD4+/CD8+高于对照组(P<0.05),CD8+低于对照组(P<0.05)。两组用药期间肝功能受损、过敏性皮炎、视神经炎以及胃肠道反应等出现相比无显著差异(P>0.05)。结论益肺养阴方加减联合常规西医治疗对肺结核伴2型糖尿病患者疗效理想,能控制其血糖水平,降低其痰菌转阴率及空洞闭合率,改善其免疫功能,且安全性较高,值得采用。

基于网络药理学及分子对接探讨健脾益肺颗粒治疗慢性阻塞性肺疾病急性加重合并急性呼吸衰竭的作用机制

目的:应用网络药理学探析健脾益肺颗粒治疗慢性阻塞性肺疾病急性加重合并急性呼吸衰竭的潜在作用机制,并通过分子对接技术加以验证,以期为后续基础及临床试验的开展提供方向和依据。方法:通过中药系统药理学数据库与分析平台(TCMSP)、SwissADME、PharmMapper数据库及文献筛选健脾益肺颗粒的活性成分并预测相应的作用靶点,利用GeneCards、DisGeNet、OMIM、DrugBank和NCBI数据库分别获得慢性阻塞性肺疾病急性加重、急性呼吸衰竭的疾病靶点,取药物与疾病的交集靶点。利用STING数据库及Cytoscape 3.8.2软件构建“中药-活性成分-靶点”与蛋白质-蛋白质相互作用网络。利用R软件进行交集靶点的基因本体论(GO)与京都基因与基因组百科全书(KEGG)富集分析。通过分子对接验证主要活性成分与核心靶点间的对接活性。结果:共筛选出健脾益肺颗粒111种活性成分和119个潜在作用靶点,与慢性阻塞性肺疾病急性加重及急性呼吸衰竭的交集靶点有32个。核心活性成分包括茯苓酸A、茯苓酸B、桑根酮B等;核心靶点包括白蛋白(Albumin,ALB)、表皮生长因子受体(Epidermal Growth Factor Receptor,EGFR)、酪氨酸蛋白激酶(Sarcoma,SRC)、胱天蛋白酶3(Caspase 3,CASP3)、激酶插入区受体(Kinase Insert Domain Receptor,KDR)等;治疗主要涉及血管内皮生长因子(Vascular Endothelial Growth Factor,VEGF)信号通路、酪氨酸激酶受体(Receptor Tyrosine Protein Kinase,ErbB)信号通路及促性腺激素释放激素(Gonadotropin-releasing Hormone,GnRH)信号通路。主要活性成分与核心靶点间有较高的结合活性。结论:健脾益肺颗粒可能通过多成分、多靶点在慢性阻塞性肺疾病急性加重合并急性呼吸衰竭的治疗中发挥抗炎、抗血管生成的辅助性治疗作用。

自拟通鼻益肺汤联合雷火灸治疗小儿腺样体肥大的临床效果

目的观察自拟通鼻益肺汤联合雷火灸治疗小儿腺样体肥大的临床效果。方法选取2021年8月至2023年8月国药医疗(潍坊)医院收治的76例腺样体肥大患儿作为研究对象,按照随机数字表法分为两组,每组38例。对照组接受自拟通鼻益肺汤治疗,实验组接受自拟通鼻益肺汤联合雷火灸治疗,比较两组治疗效果。结果实验组治疗总有效率高于对照组,差异有统计学意义(P<0.05);治疗后,两组鼻塞、流涕、打鼾症状积分均降低,且实验组鼻塞、流涕、打鼾症状积分低于对照组,差异有统计学意义(P<0.05)。结论自拟通鼻益肺汤联合雷火灸治疗小儿腺样体肥大的临床效果显著,能够促进症状的缓解,值得推广。

益肺健脾化痰法联合金字塔模式对肺癌术后患者的治咳抗炎及免疫营养调节作用的临床研究

目的:探讨中医益肺健脾化痰法联合金字塔模式治疗肺癌术后咳嗽的疗效和对炎症反应、免疫功能、营养状态的调节作用。方法:选取2019年9月—2021年12月本院胸腔镜肺癌术后咳嗽患者76例作为研究对象,随机分成两组。对照组38例,采用金字塔模式下围手术期治疗,观察组38例在对照组相同治疗基础上加用中医益肺健脾化痰法。采用视觉模拟评分(VAS)和简易咳嗽程度评分表(CET))评估治疗咳嗽的效果。通过比较两组患者炎症因子(TNF-α、IL-6、IL-10、CRP)、淋巴细胞亚群(CD^(+)_(4)、CD^(+)_(8)、CD^(+)_(4)/CD^(+)_(8)、血清蛋白(PA、TF、ALB)等指标评估炎症反应、免疫功能及营养状态变化。监测肝肾功能评估药物的安全性。结果:治疗后观察组咳嗽VAS评分为(0.98±0.47)分、CET评分为(8.18±2.08)分,均低于对照组(P<0.05)。治疗后观察组炎症因子TNF-α(6.34±2.41)ng/L、IL-6(9.50±3.30)ng/L、CRP(4.05±1.06)mg/L均低于对照组(P<0.05),IL-10(25.32±3.41)ng/L高于对照组(P<0.05)。治疗后观察组CD^(+)_(4)(38.66±4.82)%和CD^(+)_(4)/CD^(+)_(8)(1.55±0.35)高于对照组(P<0.05)。治疗后观察组营养指标PA(200.92±31.24)mg/L、TF(2.76±0.66)g/L、ALB(38.32±3.40)g/L均高于对照组(P<0.05)。治疗期间两组患者均未发生肝肾功能损害。结论:中医益肺健脾化痰法联合金字塔模式治疗肺癌术后咳嗽效果良好,也有助于增强免疫力,减轻炎症反应,改善营养状态。

健脾益肺补肾针刺疗法联合经皮神经肌肉电刺激治疗对机械通气患者肺功能的影响

目的:分析健脾益肺补肾针刺疗法联合经皮神经肌肉电刺激治疗对机械通气患者的影响。方法:选取130例机械通气患者作为研究对象,采用随机数字表法将其分为对照组62例、观察组68例。共有对照组57例、观察组61例患者完成治疗。对照组采用经皮神经肌肉电刺激治疗仪治疗,观察组在对照组基础上予健脾益肺补肾针刺疗法。比较两组患者肺部感染评分、急性生理与慢性健康(APACHEⅡ)评分、营养指标、免疫功能指标、肺功能指标、并发症发生情况。结果:治疗后,与对照组相比,观察组肺部感染评分、APACHEⅡ评分降低(P<0.05),前白蛋白(PA)、白蛋白(ALB)、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、第1秒用力呼气容积(FEV1)、第1秒用力呼气容积/用力肺活量(FEV1/FVC)、呼气流量峰值(PEF)、残气量/肺总量比值(RV/TLC)、最大通气量(MVV)水平均升高(P<0.05);观察组并发症总发生率低于对照组(P<0.05)。结论:健脾益肺补肾针刺疗法联合经皮神经肌肉电刺激治疗仪治疗干预机械通气患者,可提高肺功能,改善营养状况以及免疫功能,临床疗效理想。

基于胆碱能系统探讨益肺宣肺降浊方抗血管痴呆的作用研究

目的 探讨益肺宣肺降浊方通过胆碱能系统抗血管痴呆的作用及机制。方法 建立中动脉栓塞(middle cerebral artery occlusion, MCAO)大鼠血管性痴呆模型;给予益肺宣肺降浊方及联合应用胆碱受体拮抗剂山莨菪碱及其激动剂毛果芸香碱。具体分组:假手术组,模型组,益肺宣肺降浊方治疗组,益肺宣肺降浊方联合山莨菪碱组,益肺宣肺降浊方联合毛果芸香碱组,石杉碱组。水迷宫实验检测动物神经行为学;苏木精-伊红(HE)染色检测海马组织病理;透射电镜检测海马组织细胞超微结构;免疫荧光检测海马组织神经元MAP2及突触蛋白Synapsin表达。结果 益肺宣肺降浊方能有效提高血管性痴呆动物的学习和记忆能力,对海马组织病理改变具有显著的缓解作用,对神经元树突生长异常以及海马组织细胞超微结构的改变具有明显的改善作用。山莨菪碱有拮抗而毛果芸香碱有协同益肺宣肺降浊方对血管性痴呆动物的作用。结论 益肺宣肺降浊方可能通过调控胆碱能系统缓解血管性痴呆动物海马组织的病理改变、神经元细胞的超微结构改变、神经元突触生长异常从而改善血管性痴呆的认知功能障碍。

健脾补肾益肺方减轻慢性阻塞性肺疾病小鼠氧化应激的实验研究

目的观察健脾补肾益肺方对慢性阻塞性肺疾病(COPD)小鼠氧化应激的影响,探讨该方抗氧化应激的机制。方法将30只C57BL/6J小鼠随机分为正常组、模型组、中药高剂量组、中药低剂量组、西药组。每组6只。除正常组外,其余各组采用气管滴注脂多糖加熏香烟方法建立COPD小鼠模型。中药高、低剂量组分别给予健脾补肾益肺方[合生药量29.9、14.95 g/(kg·d)]灌胃,西药组给予丙卡特罗26μg/(kg·d)灌胃,正常组和模型组予同等体积的生理盐水灌胃。采用动物肺功能分析系统测定各组小鼠FEV0.15/FVC%、FEF50%、FEF75%并留取标本。采用ELISA法测定各组小鼠肺泡灌洗液中活性氧(ROS)、丙二醛(MAD)水平,采用免疫组织化学法测定各组小鼠超氧化物歧化酶(SOD)、血红素加氧酶1(HO-1)、醌氧化还原酶1(NQO1)、核因子红系2相关因子2(Nrf2)蛋白的表达量。结果中药高剂量组小鼠FEV0.15/FVC%、FEF50%、FEF75%较模型组显著增高(P<0.01);模型组ROS、MDA较正常组均显著增高(P<0.01),而模型组SOD较正常组显著减少(P<0.01),两组HO-1、NQO1无显著差异(P>0.05);中药高、低剂量组较模型组ROS均显著减少(P<0.01),中药高剂量组MDA比模型组显著减少(P<0.01),中药高、低剂量组SOD均较模型组显著增多(P<0.01或P<0.05),中药高剂量组HO-1、NQO1、Nrf2较模型组显著增多(P<0.01)。结论健脾补肾益肺方可能通过上调COPD小鼠Nrf2的表达而增加抗氧化剂的产生,从而减轻COPD小鼠的氧化应激程度。

益肺宣肺降浊方对星形胶质细胞-神经元氧糖剥夺损伤的缓解作用及其可能机制

目的 分析益肺宣肺降浊方对星形胶质细胞-神经元氧糖剥夺(OGD)损伤的缓解作用,并基于胆碱乙酰转移酶(ChAT)、α7烟碱型乙酰胆碱受体(α7-nAChR)及炎症因子探讨其可能的作用机制。方法 (1)制备对照血清及益肺宣肺降浊方含药血清。(2)分离培养新生大鼠海马星形胶质细胞和神经元。将细胞分为对照组、OGD组、OGD+YFXF组、OGD+YFXF+山莨菪碱组。在对照组中,常规培养原代海马神经元和星形胶质细胞;在OGD组、OGD+YFXF组、OGD+YFXF+山莨菪碱组中,建立星形胶质细胞-神经元OGD模型,并分别使用含5%对照血清的高糖DMEM、含5%益肺宣肺降浊方含药血清的高糖DMEM、含5%益肺宣肺降浊方含药血清及100μg/mL山莨菪碱的高糖DMEM进行培养。(3)干预24 h后,观察各组细胞形态,检测星形胶质细胞和神经元的标志物表达情况,星形胶质细胞活性氧簇含量、ChAT活性、α7-nAChR和ChAT的mRNA和蛋白表达量,以及上清液乳酸脱氢酶(LDH)、白细胞介素(IL)-1β、肿瘤坏死因子α(TNF-α)和IL-6水平。结果 与对照组相比,OGD组星形胶质细胞及神经元标志物荧光强度减弱,神经元形态异常,星形胶质细胞的活性氧簇含量及上清液LDH、IL-1β、TNFα、IL-6水平增加,星形胶质细胞的ChAT活性降低且α7-nAChR、ChAT的mRNA和蛋白表达量下调(P<0.05)。与OGD组相比,OGD+YFXF组星形胶质细胞及神经元标志物荧光强度增强,神经元形态有所改善,星形胶质细胞的活性氧簇含量及上清液LDH、IL-1β、TNF-α、IL-6水平降低,星形胶质细胞的ChAT活性增强且α7-nAChR、ChAT的mRNA和蛋白表达量上调(P<0.05)。与OGD+YFXF组相比,OGD+YFXF+山莨菪碱组的星形胶质细胞和神经元的标志物荧光强度减弱,神经元形态异常,星形胶质细胞的活性氧簇含量及上清液LDH、TNF-α水平增加,星形胶质细胞的α7-nAChR mRNA和蛋白表达量降低(P<0.05)。结论 益肺宣肺降浊方可能通过上调海马星形胶质细胞中α7-nAChR的表达、增强ChAT活性、抑制炎症反应,来缓解星形胶质细胞-神经元OGD损伤,这或许是该方改善缺血再灌注损伤介导的血管性痴呆的作用机制。

补肾益肺解毒方联合化疗治疗非小细胞肺癌疗效及对血清基质金属蛋白酶-2和基质金属蛋白酶-9表达的影响

目的探讨补肾益肺解毒方联合化疗治疗非小细胞肺癌的疗效及对血清基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶9-(MMP-9)表达的影响。方法选取2018年2月至2020年5月于上海中医药大学附属龙华医院就诊的80例非小细胞肺癌患者作为研究对象,按随机数字表法分为对照组与研究组,每组40例。对照组给予吉西他滨和白蛋白紫杉醇(GP)化疗,研究组在对照组基础上增加补肾益肺解毒方治疗,比较两组治疗前后血清MMP-2及MMP-9水平和中医证候疗效。结果治疗前,两组血清MMP-2、MMP-9水平比较差异无统计学意义;治疗后,研究组MMP-2、MMP-9水平均低于对照组,差异有统计学意义(P<0.05)。研究组中医证候总有效率(82.5%)高于对照组(62.5%),差异有统计学意义(P<0.05)。结论补肾益肺解毒方联合化疗治疗非小细胞肺癌疗效确切,可有效改善患者血清MMP-2、MMP-9表达,提高中医证候疗效,值得临床推广应用。