Wenjing Zhitong recipe exhibits potential anti-primary dysmenorrhea properties by inhibiting COX2 and PKC signaling pathway in rats induced by estradiol benzoate and oxytocin

Objective:To explore the effect and mechanism of action of the Wenjing Zhitong recipe(WZR)in primary dysmenorrhea(PD)treatment.Methods:Uterine contractions were induced by estradiol benzoate and oxytocin in a PD model and WZR was administrated.The rate of change in uterine contractility and the writhing test were used to evaluate the effects of WZR.The serum levels of prostaglandin F_(2a)(PGF_(2a))and prostaglandin E_2(PGE_2),and the activity of cyclooxygenase-2(COX2)were detected by enzyme-linked immunosorbent assay(ELISA).The changes in phosphor-phospholipase C(pPLC/PLC),phosphor-protein kinase C(pPKC/PKC),and connexin 43(CX43)expression were detected using immunohistochemistry and western blot.Results:WZR significantly reduced the rate of change in uterine contractility and writhing times in the PD model.WZR treatment inhibited the enzymatic activity of COX2 and reduced the levels of PGF_(2a),PGF_(2a)/PGE2and COX2 in the PD model.WZR also significantly reduced the expression of pPLC/PLC,pPKC/PKC and CX43.Targeting the inhibition of COX2 activity,caffeic acid and 1-acetyl-β-carboline were validated as the active ingredients in WZR responsible for reducing uterine contractions.Conclusion:WZR attenuated PD by inhibiting COX2 activity,downregulating PGF_(2a)/PGE_2 expression,and inhibiting the PKC signaling pathway.

Quantitative and qualitative analysis of common peaks in chemical fingerprint of Yuanhu Zhitong tablet by HPLC-DAD–MS/MS

A quality control （QC） strategy for quantitative and qualitative analysis of “common peaks” in chemical fingerprint was proposed to analyze Yuanhu Zhitong tablet （YZT）, using high performance liquid chromatography with diode array detector and tandem mass spectrometry （HPLC-DAD-MS/MS）. The chromatographic separation was achieved on an Agilent Eclipse plus C18 column with a gradient elution using a mixture of 0.4‰ ammonium acetate aqueous （pH 6.0 adjusted with glacial acetic acid） and acetonitrile. In chemical fingerprint, 40 peaks were assigned as the “common peaks”. For quantification of “common peaks”, the detection wavelength was set at 254 nm, 270 nm, 280 nm and 345 nm, respectively. The method was validated and good results were obtained to simultaneously determine 10 analytes （protopine, jatrorrhizine, coptisine, palmatine, berberine, xanthotoxin, bergapten, tetrahydropalmatine, imperatorin and isoimperatorin）. For qualification of “common peaks”, 33 compounds including 10 quantitative analytes were identified or tentatively characterized using LC-MS/MS. These results demonstrated that the present approach may be a powerful and useful tool to tackle the complex quality issue of YZT.

Study on the Analgesic Effect and Mechanism of Zhitong Capsule (止痛胶囊) in Adjuvant Arthritis Rats

Objective: To observe the analgesic effect of Zhitong Capsule (止痛胶囊, ZTC) and study its mechanism in adjuvant arthritis (AA) rats. Methods: Forty-eight male Sprague-Dawley rats were randomly divided into six groups with 8 rats in each group. On the first day, except to those in the normal group that were treated with normal saline, the same amount of Freund's complete adjuvant (FCA) was given through intradermal injection into the right hind paw to all the rats in the other groups. From the 17th day of the modeling on, the rats in groups of ZTC were administered daily through gastrogavage with a dose of 1000, 500, 250 mg/kg respectively, while equal volume of normal saline was given to those in the normal group and model group, and an equal volume of aspirin (ASA) solution was given to rats in the ASA group through gastrogavage for 10 days, once per day, and on the 27th day, the analgesic effect of ZTC was measured with heat withdraw method. The activities and contents of superoxide dismutase (SOD) and lipid peroxides (LPO) in serum were observed by spectrophotometry, and the level of beta-endorphin (β-EP) in hypothalamus were determined by the assay of immunohistochemistry. Results: ZTC showed significant effects on enhancing the pain threshold and at the same time it increased the activities of SOD and reduced the contents of LPO in serum. ZTC could also increase the level of β-EP in hypothalamus. Conclusion: ZTC has analgesic effect and its mechanism is probably related with its effect in inhibiting the level of oxygen free radicals in serum and increasing the level of β-EP of hypothalamus in rats.KEY WORD Zhitong Capsule, adjuvant arthritis, superoxide dismutase, lipid peroxides, β-endorphin

The effect of Shufengzhitong decoction combined with four cervical needles on cervical spondylotic radiculopathy and leukotriene and inflammatory factors

Objective:To investigate the effect of shufengzhitong decoction combined with four cervical needles on cervical spondylotic radiculopathy(CSR)and leukotriene and inflammatory factors.Methods:110 patients with CSR were randomly divided into two groups,with 55 in each group.There was no significant difference in baseline data between the two groups(P>0.05).The control group were treated with Shufeng Zhitong decoction orally,and the treatment group were treated with four neck acupuncture on the basis of the control group.Neck pain scale score(NPQ),Cervical spondylosis clinical evaluation scale score(CASCS)Cervical range of motion score(CROM),Emg surface signal and serum Levels of leukotriene B4(LTB4),leukotrieneC4(LTC4),leukotrieneD4(LTD4),interleukin(IL)-1β,tumor necrosis factor-alpha(TNF-α),IL-6,IL-8 and IL-18 were compared before and after treatment.The clinical effect of the two groups was compared.Results:NPQ of the treatment group was lower than that of the control groupafter treatment(P<0.01),the scores of CASCS and CROM were higher than those of the control group(P<0.01),the median frequency of surface EMG signal of biceps brachii and superior trapezius muscle were higher than those of the control group(P<0.01),the levels of serum LTB4,LTC4,LTD4,IL-1β,TNF-α,IL-6,IL-8 and IL-18 were lower than those of the control group(P<0.01),the clinical effect was better than that of the control group(P<0.05),and the differences were statistically significant.Conclusion:Shufengzhitong decoction combined with cervical four acupuncture can effectively alleviate the symptoms of cervical spondylosis,regulate the myoelectric signal of muscle surface,reduce the content of leukotriene in serum,reduce the expression of inflammatory factors,and it has a significant effect on the treatment of CSR.

Action mechanism of Zhitong Rushen Decoction in treating functional anorectal pain based on network pharmacology

Objective:Network pharmacology method was adopted in this study to screen the target of Zhitong Rushen Decoction of the treatment to Functional Anorectal Pain(FAP)and explore its mechanism of treatment.Methods:Chemical components and selected targets related to the ten traditional Chinese medicine(TCM)herbs were searched through the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP).Through GeneCards database,OMIM database,disease targets of FAP were searched.R language was used to screen the common targets between drugs and disease,and then the interaction network diagram of the targets was constructed by String.Cytoscape3.7.0 was applied to construct the active ingredients-targets interacted network.GO enrichment analysis and KEGG enrichment analysis of targets were based on R language.Results:Four main chemical components including quercetin,wogonin,fisetin and kaempferol were screened,and four key targets including ESR1、NOS2、PGR and CHRM3 were identified.In GO enrichment analysis,66 molecular function entries,1040 biological process entries,26 cell component entries were obtained.KEGG pathway enrichment analysis showed that zhitong rushen decoction played a therapeutic role in functional anorectal pain by regulating AGE-RAGE signaling pathway in diabetic complications,Bladder cancer,Estrogen signaling pathway,HIF-1 signaling pathway.Conclusion:Zhitong rushen decoction for the treatment of functional anorectal pain may be related to its multi-component effect on multiple targets and multiple signaling pathways,providing theoretical basis for further study of active ingredients and mechanism of action.

Study on the therapeutic effect of external application of Shounian powder combined with acupuncture at Zhitong acupoint on intercostobrachial nerve syndrome after breast cancer operation

Background:To explore the clinical effect of external application of ShouNian Powder combined with acupuncture at Zhitong acupoint in the treatment of intercostobrachial nerve syndrome(ICBNs)after breast cancer operation.Methods:A total of 80 patients with ICBNs who underwent modified radical mastectomy in our hospital from July 2014 to July 2016 were collected and divided into control group and study group according to the different treatment methods of ICBNs.40 patients in the control group were treated with symptomatic analgesia and 40 patients in the study group were treated with external application of ShouNian Powder combined with acupuncture at Zhitong acupoint to compare and analyze the pain relief,quality of life and analgesic recurrence rate of ICBNs between the two groups.Results:Compared with the control group,the pain relief rate of ICBNs in the study group was higher.The patient satisfaction and long-term quality of life in the study group were better than those in the control group.However,there was no significant difference in postoperative pain recurrence rate.Conclusion:External application of ShouNian Powder combined with acupuncture at Zhitong acupoint can effectively relieve pain and improve quality of life for patients with ICBNs after breast cancer operation,which has a certain popularizing significance in clinical practice.

Effectiveness of acupoint application of Xiaozhong Zhitong Tie on diarrhea in patients:a retrospective cohort study in China

OBJECTIVE:To provide the evidence for the efficacy of acupoint application(AA)for patients with diarrhea in a real-world setting.METHODS:This study is a national multicenter retrospective cohort study.Our study consecutively collected outpatient medical records of patients with diarrhea from hundreds of primary hospitals nationwide registered in Chun Bo Wan Xiang cloud platform from 22nd August,2020 to 5th November,2020.The patients were divided into the treatment group and the control group according to patient's condition and willingness.The control group was treated with Western Medicine,oral Chinese Medicine decoction,or both.The treatment group was added with AA based on the control group.Multiple logistic regression was used to evaluate the independent efficacy of AA in diarrheal recovery on the 3rd,7th,14th and 28th day.As a next step,we also performed stratified analysis and likelihood ratio test(LRT).Sensitivity analyses included propensity score matching(PSM),four PSM-related analyses and E-value.RESULTS:The treatment group showed better efficacy than the control group on the 14th and 28th day[the 14th day:OR=1.58,95%CI(1.15,2.19),P=0.005;the 28th day:OR=2.03,95%CI(1.43,2.88),P<0.001].No difference was observed in efficacy of AA for the treatment of diarrhea among the subgroups(P>0.05).PSM-related analyses confirmed the efficacy of AA in diarrheal recovery.The findings are unlikely to be nullified by an unmeasured confounding variable according to the results of E-values.CONCLUSIONS:The efficacy in the treatment group was significantly more improved than that in the control group on the 14th and 28th day.

调经止痛丸对子宫内膜异位症气滞血瘀证患者腹腔镜术后CA125的影响

目的观察调经止痛丸对子宫内膜异位症(endometriosis,EMS)气滞血瘀证患者腹腔镜术后临床症状及癌胚抗原125(carcinoembryonic antigen 125,CA125)的影响。方法选取河北省沧州中西医结合医院120例接受腹腔镜手术治疗的EMS气滞血瘀证患者,随机分为对照组和观察组,各60例。对照组术后予以常规西药进行治疗,观察组在对照组基础上服用调经止痛丸,连续治疗6个月。比较两组临床疗效、中医证候积分、血清CA125、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)水平及不良反应。结果观察组总有效率96.67%,高于对照组85.00%(P<0.05);观察组治疗后中医证候积分及CA125、TNF-α水平显著低于对照组(P<0.01);两组患者不良反应发生率差异无统计学意义(P>0.05)。结论调经止痛丸可有效减轻EMS气滞血瘀证患者腹腔镜术后临床症状,改善TNF-α及CA125水平。

参蝎止痛胶囊联合董氏奇穴对寒湿痹阻型膝骨关节炎患者的临床疗效

目的 探讨参蝎止痛胶囊联合董氏奇穴对寒湿痹阻型膝骨关节炎患者的临床疗效。方法 80例患者随机分为对照组和观察组,每组40例,对照组给予董氏奇穴,观察组在对照组基础上加用参蝎止痛胶囊,疗程1个月。检测临床疗效、中医证候评分、LKSS评分、WOMAC评分、NRS评分、AIMS2-SF评分、sIL-4R、TNF-α、HMGBl、TLR-4、BALP、BGP、β-CTX变化。结果 观察组总有效率高于对照组(P<0.05)。治疗后,2组中医证候评分、WOMAC评分、NRS评分、sIL-4R、TNF-α、HMGBl、TLR-4、β-CTX降低(P<0.05),LKSS评分、AIMS2-SF评分、BALP、BGP升高(P<0.05),以观察组更明显(P<0.05)。结论 参蝎止痛胶囊联合董氏奇穴可抑制寒湿痹阻型膝骨关节炎患者机体炎症反应,改善骨代谢,缓解膝关节疼痛及临床症状。

化瘀止痛贴膏调节IL-6/STAT3信号通路对急性软组织损伤大鼠炎症反应的影响

目的探讨化瘀止痛贴膏调节白细胞介素-6(IL-6)/信号转导与转录激活子3(STAT3)信号通路对急性软组织损伤(ASTI)大鼠炎症反应的影响。方法将SPF级SD大鼠随机分为对照组、模型组、化瘀止痛贴膏低、中、高剂量组、精制狗皮膏组。利用机械冲击挫伤法建立ASTI动物模型,建模成功后,各组贴敷相应药物,1次/d,每次给药8 h,连续7 d。对大鼠进行ASTI损伤评分;采用血液流变检测仪检测血液流变学指标;苏木精和伊红(HE)染色法观察大鼠损伤部位肌肉组织病理变化;酶联免疫吸附法(ELISA)检测各组大鼠损伤部位肌肉组织中IL-6、IL-β、肿瘤坏死因子-α(TNF-α)水平;实时荧光定量PCR(qRT-PCR)法检测损伤部位肌肉组织中IL-6与STAT3 mRNA表达;蛋白免疫印迹(Western blot)法检测大鼠损伤部位肌肉组织中IL-6/STAT3信号通路蛋白表达。结果与对照组比较,模型组大鼠软组织损伤评分、全血黏度、血浆黏度、红细胞压积、肌肉组织病理学评分、IL-6、IL-β、TNF-α水平、IL-6与STAT3 mRNA表达水平及IL-6、p-STAT3/STAT3蛋白表达水平升高(均P<0.05);与模型组比较,化瘀止痛贴膏低、中、高剂量组和狗皮膏药组大鼠软组织损伤评分、全血黏度、血浆黏度、红细胞压积、肌肉组织病理学评分、IL-6、IL-β、TNF-α水平、IL-6与STAT3 mRNA表达水平及IL-6、p-STAT3/STAT3蛋白表达水平降低(均P<0.05);化瘀止痛贴膏高剂量组与精制狗皮膏组大鼠以上指标差异均无统计学意义(P>0.05)。结论化瘀止痛贴膏可能通过下调IL-6/STAT3信号通路缓解ASTI大鼠的炎症反应。

止痛如神汤在腰骶部带状疱疹后神经痛(脾虚湿蕴)患者中的应用及对疼痛程度的影响

目的:观察止痛如神汤在腰骶部带状疱疹后神经痛(脾虚湿蕴)患者中的应用及对疼痛程度的影响。方法:本研究纳入2020年1月—2023年1月于彭州市人民医院就诊的60例腰骶部带状疱疹后神经痛(脾虚湿蕴)患者作为研究对象,根据随机数表法将患者分为观察组和对照组,各30例。对照组给予基础治疗,观察组给予基础治疗联合口服止痛如神汤。比较两组临床疗效、疼痛程度[视觉模拟评分法(visual analogue scale,VAS)]、睡眠质量[匹兹堡睡眠质量指数量表(Pittsburgh sleep quality index,PSQI)]及不良反应发生情况。结果:观察组总有效率高于对照组,差异有统计学意义(χ^(2)=8.822,P=0.003)。治疗前,两组VAS评分比较,差异无统计学意义(P>0.05);治疗后3周、4周、12周,两组VAS评分低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗前,两组PSQI评分比较,差异无统计学意义(P>0.05);治疗后3周、4周、12周两组PSQI评分低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。两组整个研究过程中均治疗顺利,治疗期间无过敏、皮肤感染等不良反应发生。结论:腰骶部带状疱疹后神经痛(脾虚湿蕴)患者在基础治疗基础上加用止痛如神汤,具有镇痛效果好,安全性高,对睡眠质量改善作用明显。

栀黄止痛颗粒治疗痛风性关节炎作用机制的网络药理学及分子对接技术研究

目的通过网络药理学和分子对接技术研究栀黄止痛颗粒治疗痛风性关节炎(GA)的科学原理及作用机制。方法通过HERB数据库查找栀黄止痛颗粒的主要活性成分和作用靶点,利用UniProt数据库进行靶点名称规范及转化,通过GeneCards、OMIM、PharmGkb、TTD、DrugBank数据库总结GA相关疾病靶点,将疾病靶点与药物靶点取交集,利用Cytoscape3.8.0软件生成“药物-活性成分-靶点网络”,通过STRING数据库构建交集靶点的蛋白相互作用网络,使用Cytoscape进行拓扑分析,获得核心基因;运用Metascape网页、R软件构建的数据包对核心基因进行基因本体(GO)功能和基因组数据库(KEGG)通路富集分析,最后选取核心靶点与药物活性成分进行分子对接验证。结果筛选出栀黄止痛颗粒活性成分88种,作用靶点212个;GA疾病靶点312个,疾病与药物交集靶点43个。GO富集分析共包含56条富集通路,其中生物过程4条、分子功能21条、细胞组成31条;KEGG通路富集分析得到133条通路,涉及脂质和动脉粥样硬化、IL-17信号通路、糖尿病并发症中的AGE-RAGE信号通路、TNF信号通路、流体剪切应用与动脉粥样硬化等通路。分子对接结果表明药物主要活性成分与核心基因之间能相互结合并有较好的亲和力。结论栀黄止痛颗粒是通过多成分、多靶点、多途径对GA产生药理作用,这为探索该方剂药效药理作用机制建立了基础。

消癌止痛散穴位贴敷联合埋针疗法对结直肠癌术后患者疼痛以及胃肠功能的意义分析

目的 分析消癌止痛散穴位贴敷联合埋针疗法对结直肠癌术后患者疼痛以及胃肠功能的意义。方法 选取60例结直肠癌手术患者,随机分为对照组和试验组,每组30例。对照组采取临床常规治疗,试验组在对照组基础上术后采取消癌止痛散穴位贴敷联合埋针疗法治疗。比较两组患者胃肠功能恢复情况、临床治疗效果、临床疼痛情况。结果 试验组患者临床治疗效果优于对照组患者,差异有统计学意义(P<0.05)。试验组患者胃肠功能恢复时间、肠鸣恢复时间、首次肛门排气时间、首次排便时间分别为(4.79±0.45)、(2.11±0.18)、(2.67±0.55)、(3.12±1.01)d,均短于对照组患者的(7.99±0.51)、(3.75±0.42)、(3.20±0.66)、(4.21±1.03)d,差异有统计学意义(P<0.05)。试验组患者术后第1、2、3天的视觉模拟评分法(VAS)评分分别为(5.62±0.15)、(3.30±0.12)、(1.62±0.15)分,均低于对照组患者的(6.61±0.13)、(5.35±0.21)、(3.66±0.13)分,差异有统计学意义(P<0.05)。结论 消癌止痛散穴位贴敷联合埋针疗法对结直肠癌术后患者临床效果显著,可缓解患者疼痛程度,促进患者尽快恢复,值得推广。

中西医结合治疗腰椎小关节骨关节炎临床观察

目的 外搽舒活酒外贴伤科止痛膏联合口服盐酸氨基葡萄糖配合运动治疗腰椎小关节骨关节炎的临床疗效观察。方法 选择145例腰椎小关节骨关节炎患者,随机分为试验组73例、对照组72例。对照组予红外线照射、电针、外贴膏药治疗,观察组在对照组的基础上增加外搽舒活酒外贴伤科止痛膏联合口服盐酸氨基葡萄糖片配合运动治疗;对比分析治疗前、治疗后6周、治疗后12周、治疗周期结束后3个月的CDTY评分及临床疗效。结果 治疗周期结束后3个月,试验组的CDTY评分、痊愈率、显效率均优于对照组(P<0.05)。结论 外搽舒活酒外贴伤科止痛膏联合口服盐酸氨基葡萄糖配合运动治疗腰椎小关节骨关节炎能明显改善症状,且远期疗效明显,值得临床推广。

自拟清化止痛汤联合中药灌肠治疗湿热瘀结型急性盆腔炎的临床效果观察

目的分析湿热瘀结型急性盆腔炎患者临床治疗过程中使用自拟清化止痛汤联合中药灌肠治疗的效果。方法选取60例急性盆腔炎(湿热瘀结型)患者,根据随机数字表法将患者分为两组,每组30例。对照组接受常规西药治疗,治疗组在对照组基础上接受自拟清化止痛汤联合中药灌肠治疗。对比两组治疗效果。结果相比对照组,治疗后治疗组症状缓解时间明显缩短(P<0.05),且主症评分和次症评分明显降低(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)。结论自拟清化止痛汤联合中药灌肠治疗湿热瘀结型急性盆腔炎具有较好的效果和安全性。

温肾通络止痛方抑制巨噬细胞衰老改善BMSC成骨分化和老年性骨质疏松模型小鼠骨丢失的研究

目的探讨温肾通络止痛方调控巨噬细胞衰老对老年性骨质疏松症(Senile osteoporosis,SOP)的干预作用。方法利用过氧化氢制备衰老巨噬细胞模型并随机分为对照组、模型组、含药血清低剂量组、含药血清高剂量组。β-半乳糖苷酶染色以及qPCR、Western blot检测衰老指标p21和p53的mRNA及蛋白表达水平,探讨含药血清对巨噬细胞衰老的影响。使用活性氧(Reactive oxygen species,ROS)染色和线粒体膜电位检测试剂盒(JC-1)检测巨噬细胞线粒体功能。qPCR检测巨噬细胞极化相关分子白细胞介素-6(Interleukin-6,IL-6)、白细胞介素-10(Interleukin-10,IL-10)、CD206、一氧化氮合酶(Inducible nitric oxide synthase,iNOS)的mRNA水平,免疫荧光检测巨噬细胞极化相关分子精氨酸酶(Arginase,ARG1)和iNOS的蛋白表达,评估含药血清对巨噬细胞极化的影响。qPCR检测成骨相关指标骨钙蛋白(Osteocalcin,OCN)、Ⅰ型胶原蛋白(Collagen typeⅠα1,Col1a1)、Runt相关转录因子2(Runt-related transcription factor 2,Runx2)的mRNA水平以及ALP染色和茜素红染色,评估含药血清处理的巨噬细胞条件培养基对骨髓间充质干细胞(Bone marrow mesenchymal stem cell,BMSC)成骨分化的影响。将C57BL/6J小鼠随机分为对照组、模型组、温肾通络止痛方低剂量组、温肾通络止痛方高剂量组,D-半乳糖制备SOP小鼠模型。Micro-CT分析小鼠股骨微结构,HE染色检测小鼠股骨病理变化,Western blot检测小鼠胫骨衰老相关分子p21、p53和成骨相关指标OCN、Runx2蛋白表达水平,qPCR检测小鼠胫骨衰老相关分子p21、p53 mRNA和巨噬细胞极化相关分子IL-6、iNOS、CD206、IL-10 mRNA的表达水平,评估温肾通络止痛方对小鼠SOP模型的影响。结果与模型组相比,温肾通络止痛方含药血清干预后,衰老阳性细胞数量明显减少,p21和p53 mRNA和蛋白表达均显著降低(P<0.05,P<0.01,P<0.001)。此外,含药血清可显著抑制H_(2)O_(2)诱导的巨噬细胞ROS的产生(P<0.05,P<0.001)、线粒体膜电位下降(P<0.05)。含药血清处理后,巨噬细胞M1相关基因iNOS的mRNA表达下调(P<0.01),M2相关基因CD163和CD206 mRNA表达上调(P<0.05),iNOS荧光强度显著降低(P<0.01),ARG1的荧光强度显著增加(P<0.05)。含药血清处理的巨噬细胞条件培养基可增加ALP阳性细胞数(P<0.01,P<0.001)、茜素红阳性面积(P<0.05),以及升高成骨相关基因Runx2、Col1a1和OCN mRNA表达(P<0.05,P<0.01)。Micro-CT结果显示,与模型组相比,温肾通络止痛方组小鼠股骨BMD、BV/TV、Tb.N显著增加(P<0.05,P<0.01,P<0.001),Tb.Sp显著降低(P<0.05,P<0.01);HE结果显示,骨小梁明显改善,数量增多变宽。此外,温肾通络止痛方可显著抑制D-半乳糖诱导的小鼠胫骨衰老相关基因p21和p53 mRNA和蛋白上调(P<0.05,P<0.001,P<0.0001),促进成骨相关指标OCN、Runx2蛋白表达(P<0.01,P<0.0001),促进M1相关基因IL-6和iNOS下调(P<0.05),同时可促进M2相关基因IL-10和CD206表达(P<0.05,P<0.01)。结论温肾通络止痛方可能通过抑制巨噬细胞衰老,促进BMSC成骨分化,从而发挥抗骨质疏松效应。

止痛如神汤加减方联合康复新液灌肠治疗气滞血瘀型混合痔术后肛门疼痛的临床效果

目的:观察止痛如神汤加减方联合康复新液灌肠治疗气滞血瘀型混合痔术后肛门疼痛的临床效果。方法:选择2021年1月—2022年12月在崇州市人民医院收治的100例混合痔患者,按照随机数字表法分为A组、B组、C组三组。A组30例,予常规西医治疗;B组35例,在A组基础上予康复新液灌肠治疗;C组35例,在B组基础上,予止痛如神汤加减方治疗。三组术后1 d、7 d均评价创面水肿、创面肉芽组织生长情况,通过数字疼痛评分法(NRS)评价肛门疼痛情况,记录三组患者肛门水肿消退时间、创面分泌物消失时间、创面愈合时间,检测三组肿瘤坏死因子α(TNF-α)、表皮生长因子(EGF)、β-内啡肽(β-EP)、白细胞介素-22(IL-22)、纤维连接蛋白(FN)、血管内皮生长因子(VEGF)水平,术前、术后1个月测量患者直肠肛管抑制反射阈值、肛管静息压、肛管高压带长度。结果:C组创面水肿、NRS评分较A组、B组低(P<0.05),创面肉芽组织生长评分较A组、B组高(P<0.05);C组创面分泌物消失时间、肛门水肿消退时间、创面愈合时间较A组、B组短(P<0.05);C组直肠肛管抑制反射阈值、肛管静息压较A组、B组高(P<0.05),C组肛管高压带长度较A组、B组短(P<0.05);C组TNF-α、IL-22水平较A组、B组低(P<0.05),C组β-EP、EGF、FN、VEGF水平较A组、B组高(P<0.05)。结论:止痛如神汤加减方联合康复新液灌肠可抑制炎症因子水平,调节疼痛介质及EGF、FN、VEGF指标,缓解肛门疼痛,促进创面愈合,提升肛门功能。

温肾通络止痛方对小鼠H型骨微血管内皮细胞/骨髓间充质干细胞共培养体系的影响

背景:骨骼依赖血管与骨细胞之间的密切连接来维持完整性,骨骼处在生理低氧环境中,因此在低氧环境下研究血管生成与骨生成具有重要意义。目的:探究在低氧环境下温肾通络止痛方对H型骨微血管内皮细胞/骨髓间充质干细胞共培养体系的影响及相关机制。方法:运用酶消化法及流式分选技术,分选小鼠H型血管特异型骨微血管内皮细胞;应用骨髓贴壁法分离获取小鼠骨髓间充质干细胞;采用Transwell小室以及缺氧培养工作站建立两种细胞低氧共培养体系,使用50,100μg/m L质量浓度温肾通络止痛方冻干粉进行干预;通过划痕迁移实验与管形成实验评估共培养体系内H型骨微血管内皮细胞的成血管功能;通过碱性磷酸酶染色与茜素红染色评估共培养体系内骨髓间充质干细胞的成骨分化能力;使用Western Blotting与q-PCR检测共培养体系内H型骨微血管内皮细胞中PDGF/PI3K/AKT信号轴相关分子的蛋白表达及mRNA表达。结果与结论:(1)与常氧组相比,低氧组H型骨微血管内皮细胞划痕迁移率及新生血管长度均显著升高(P<0.05),骨髓间充质干细胞成骨分化能力增强(P<0.05);PDGF/PI3K/AKT信号轴相关分子的蛋白、mRNA表达升高(P<0.05);(2)与低氧组相比,经不同质量浓度温肾通络止痛方干预后H型骨微血管内皮细胞划痕迁移率及新生血管长度进一步提高(P<0.05),骨髓间充质干细胞成骨分化能力更强(P<0.05),PDGF/PI3K/AKT信号轴相关分子的蛋白、mRNA表达也进一步升高(P<0.05)。结果表明:低氧条件下H型血管生成及骨生成可能与PDGF/PI3K/AKT信号轴有关,而温肾通络止痛方可能通过激活PDGF/PI3K/AKT信号轴促进“H型血管生成-骨生成”作用从而防治骨质疏松症。

Rapid Analysis and Identification of Absorbed Components and Their Metabolites of Yuanhu Zhitong Dropping Pill in Rat Plasma and Brain Tissue Using UPLC-Q-TOF/MS with Multivariate Statistical Analysis

Objective To establish an effective approach for rapid and comprehensive analysis on the absorbed and metabolic components in rats after ig administration of Yuanhu Zhitong Dropping Pill（YHZT）. Methods Based on the combination of UPLC-Q-TOF/MS and multivariate statistical analysis, the absorbed prototype constituents and their metabolites in rat plasma were rapidly analyzed and identified, and the components absorbed into brain were further identified by comparing the extracted ion chromatograms（EICs） of control and brain tissue samples of dosed rats. Results A total of 38 YHZT-related xenobiotic compounds were detected and identified as the potential bioactive constituents in rat plasma, including 24 absorbed prototype constituents and 14 metabolites. In particular, of all prototype constituents, 14 were also detected in rat brain tissue, indicating that they could penetrate the blood-brain barrier and enter into brain. Conclusion An effective method is established and applied to analyze the potential bioactive constituents in YHZT, which provides a pathway to further investigate the pharmacological pattern and mechanism of YHZT.

生肌止痛方坐浴联合紫草纱条创面引流对小儿肛周脓肿术后患者的临床疗效

目的探讨生肌止痛方坐浴联合紫草纱条创面引流对小儿肛周脓肿术后患者的临床疗效。方法100例患者随机分为对照组和观察组,每组50例,对照组给予常规治疗,观察组给予生肌止痛方坐浴联合紫草纱条创面引流。检测创面水肿评分、创面分泌物评分、创面肉芽组织生长评分、FLACC评分、中医证候评分、创面愈合情况(渗出物消失时间、创面水肿消失时间、创面愈合时间)、PCT、TNF-α、sTREM-1、白细胞、SP、NPY、5-HT、肛门功能指标(直肠最大耐受容量、直肠肛管抑制反射阈、肛管高压带长度)变化。结果观察组创面愈合情况优于对照组(P<0.05)。术后14 d,2组创面水肿评分、创面分泌物评分、FLACC评分、中医证候评分、PCT、TNF-α、sTREM-1、白细胞、SP、NPY、5-HT降低(P<0.05),创面肉芽组织生长评分、直肠肛管抑制反射阈升高(P<0.05),直肠最大耐受容量减少(P<0.05),肛管高压带长度缩短(P<0.05),以观察组更明显(P<0.05)。结论生肌止痛方坐浴联合紫草纱条创面引流可抑制小儿肛周脓肿术后患者机体炎症,促进创面愈合,提升肛门功能。