Molecular Mechanism of Prescription for the Syndrome of Cold-Dampness Obstructing the Lung in the Treatment of COVID-19 Based on Network Pharmacology

Objective:To explore the molecular mechanism of the prescription for the syndrome of cold-damp-ness obstructing the lung in the treatment of corona virus disease 2019(COVID-19).Methods:The medicinals for the treatment of the syndrome of cold-dampness obstructing the lung,such as Cangzhu(Rhizoma Atractylo-dis),Chenpi(Pericarpium Gitri Reticulatae),Houpo(Cortex Magnoliae Officinalis),Huoxiang(Herba Agastachis),Caoguo(Fructus Tsaoko),Mahuang(Herba Ephedrae),Qianghuo(Rhizoma et Radix Notoptery-gi),Shengjiang(Rhizoma Zingiberis Recens),Binlang(Semen Arecae)in the Diagnosis and Treatment Pro-gram of COVID-19(Trial Version 6)were taken as research subjects,and the combination of these nine me-dicinals can be called Hanshi Zufei Fang(寒湿阻肺方,HSZFF).The active components and targets of each single Chinese materia medica was screened and obtained through the Traditional Chinese Medicine Systems Pharmacology(TCMSP)database.The target information related to COVID-19 was retrieved through the Gene-Cards disease-related target database.The medicinal prediction targets were mapped to the disease target to ob-tain the intersection targets.The DAVID database was applied to perform gene ontology(GO)enrichment anal-ysis and kyoto encyclopedia of genes and genomes(KEGG)pathway analysis on the targets;GraphPad Prism 5.0 software was applied to plot the biological process(BP)of GO enrichment analysis,cellular component(CC),molecular function(MF)histograms;OmicShare online software was applied to make KEGG advanced bubble chart;Cytoscape software was applied to visualize the interaction with the targets and Chinese materia medica-components-targets results.Results:Totally 56 key active components of 9 Chinese materia medica for cold-dampness obstructing lung syndrome were screened,and 55 targets were obtained.The results of GO and KEGG enrichment analysis showed that the compound prescription mainly regulated the body's immune re-sponse and reduced inflammation by regulating such signaling pathways of inflammatory response and immune regulation as TNF signaling pathway,HIF-1 signaling pathway,Toll-like receptor signaling pathway,infuenza A signaling pathway,T cell receptor signaling pathway.Conclusion:HSZFF can eliminate infl ammation and inhibit virus by regulating immune inflammatory factors closely related to the occurrence and development of diseases through multi-component and multi-target.

Traditional Chinese medicine Master XIONG Jibo’s medication experience in treating arthralgia syndrome through data mining

Objective This study aimed to examine and propagate the medication experience and group formula of traditional Chinese medicine(TCM)Master XIONG Jibo in diagnosing and treat-ing arthralgia syndrome(AS)through data mining.Methods Data of outpatient cases of Professor XIONG Jibo were collected from January 1,2014 to December 31,2018,along with cases recorded in A Real Famous Traditional Chinese Medicine Doctor:XIONG Jibo's Clinical Medical Record 1,which was published in December 2019.The five variables collected from the patients’data were TCM diagnostic information,TCM and western medicine diagnoses,syndrome,treatment,and prescription.A database was established for the collected data with Excel.Using the Python environment,a custom-ized modified natural language processing(NLP)model for the diagnosis and treatment of AS by Professor XIONG Jibo was established to preprocess the data and to analyze the word cloud.Frequency analysis,association rule analysis,cluster analysis,and visual analysis of AS cases were performed based on the Traditional Chinese Medicine Inheritance Computing Platform(V3.0)and RStudio(V4.0.3).Results A total of 610 medical records of Professor XIONG Jibo were collected from the case database.A total of 103 medical records were included after data screening criteria,which comprised 187 times(45 kinds)of prescriptions and 1506 times(125 kinds)of Chinese herbs.The main related meridians were the liver,spleen,and kidney meridians.The properties of Chinese herbs used most were mainly warm,flat,and cold,while the flavors of herbs were mainly bitter,pungent,and sweet.The main patterns of AS included the damp heat,phlegm stasis,and neck arthralgia.The most commonly used herbs for AS were Chuanniuxi(Cyathu-lae Radix),Huangbo(Phellodendri Chinensis Cortex),Cangzhu(Atractylodis Rhizoma),Qinjiao(Gentianae Macrophyllae Radix),Gancao(Glycyrrhizae Radix et Rhizoma),Huangqi(Astragali Radix),and Chuanxiong(Chuanxiong Rhizoma).The most common effect of the herbs was“promoting blood circulation and removing blood stasis”,followed by“supple-menting deficiency(Qi supplementing,blood supplementing,and Yang supplementing)”,and“dispelling wind and dampness”.The data were analyzed with the support≥15%and con-fidence=100%,and after de-duplication,five second-order association rules,39 third-order association rules,39 fourth-order association rules,and two fifth-order association rules were identified.The top-ranking association rules of each were“Cangzhu(Atractylodis Rhizoma)→Huangbo(Phellodendri Chinensis Cortex)”“Cangzhu(Atractylodis Rhizoma)+Chuanniuxi(Cyathulae Radix)→Huangbo(Phellodendri Chinensis Cortex)”“Chuanniuxi(Cyathulae Radix)+Danggui(Angelicae Sinensis Radix)+Gancao(Glycyrrhizae Radix et Rhizoma)→Qinjiao(Gentianae Macrophyllae Radix)”and“Chuanniuxi(Cyathulae Radix)+Danggui(Angelicae Sinensis Radix)+Gancao(Glycyrrhizae Radix et Rhizoma)+Huangbo(Phello-dendri Chinensis Cortex)→Qinjiao(Gentianae Macrophyllae Radix)”,respectively.Five clusters were obtained using cluster analysis of the top 30 herbs.The herbs were mainly dry-ing dampness,supplementing Qi,and promoting blood circulation.The main prescriptions of AS were Ermiao San(二妙散),Gegen Jianghuang San(葛根姜黄散),and Huangqi Chongteng Yin(黄芪虫藤饮).The herbs of core prescription included Cangzhu(Atractylodis Rhizoma),Chuanniuxi(Cyathulae Radix),Gancao(Glycyrrhizae Radix et Rhizoma),Huangbo(Phellodendri Chinensis Cortex),Mugua(Chaenomelis Fructus),Qinjiao(Gentianae Macro-phyllae Radix),Danggui(Angelicae Sinensis Radix),and Yiyiren(Coicis Semen).Conclusion Clearing heat and dampness,relieving collaterals and pain,and invigorating Qi and blood are the most commonly used therapies for the treatment of AS by Professor XIONG Jibo.Additionally,customized NLP model could improve the efficiency of data mining in TCM.

Efficacy of TCM Fumigation Using Dampness-and-cold-dispelling Formula Combined with Methotrexate and Leflunomide Treating Rheumatoid Arthritis with Cold-dampness Bi Syndrome

Background:Rheumatoid arthritis(RA),a chronic autoimmune disease,has a high incidence and disability rate,causing patients significant discomfort.Although several medicines can be effective,they are also associated with significant adverse effects.In contrast,fumigation as one of the most often used traditional Chinese medicine(TCM)external therapy has shown both efficacy and safety with less side effect.In light of this,we comple-ment western medicine treatment with TCM fumigation therapy to improve patients’clinical efficacy,alleviate symptoms,and improve prognosis.Objective:To investigate the therapeutic effect of TCM fumigation and modern medicine combined therapy in treating RA patients with cold-dampness Bi syndrome.Methods:A single-center,randomized,controlled study was designed.From January 2022 to December 2022,a total of 60 RA patients with cold-dampness Bi syndrome were enrolled in the study.The control group(30 cases)received conventional modern medicine treatment with methotrexate for 4 weeks,while the observation group(30 cases)for 4 weeks received a combination of TCM fumigation treatment and conventional modern medicine.The effects of the two groups were comprehensively compared,including the changes in TCM symptom scores and laboratory indicators,as well as the use of visual analogue scale(VAS)and health status rating scale(HAQ)before and after treatment.Results:The total effective rate of the observation group was 93.3%,which was significantly higher than that of the control group,which is 70%(P<0.05).Before treatment,there were no significant differences in joint functional activity,pain visual analogue scale(VAS),health assessment questionnaire(HAQ-DI)and laboratory indexes between the two groups(P>0.05).After treatment,each group compared to their initial condition,respectively,showed major improvement of joint functional activity and significantly decreased VAS,HAQ-DI,and RA-related biomarkers(P<0.05);inter-group comparison of these indicators showed significanty further enhanced effect of TCM fumigation combined therapy on the RA-related biomarkers and joint functional activity of patients(P<0.05),yet the control group receiving only modern medicine showed better results of the VAS and HAQ-DI.Conclusion:The TCM fumigation combined therapy is effective to treat RA patients with cold-dampness Bi syn-drome,and to enhance their life quality,improving the joint function,and reducing inflammation.

Effective Observation of 518 Cases with Arthralgia－Syndrome treated by High Voltage－Low Frequency Electrotherapy on Acupoints

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Treatment of Arthralgia Syndrome from Eliminating Pathogen and Strengthening Vital Qi

More than 40 medical history works and classical medical literatures about the theory and prescription of arthralgia syndrome treated from eliminating pathogen and strengthening vital qi were sorted out,summarized and analyzed,and the theory of treating arthralgia syndrome from eliminating pathogenic factors including dampness,heat,cold,phlegm and blood stasis,and strengthening vital qi basically reflected the academic thought of treating Bi syndrome from eliminating pathogen and strengthening vital qi in traditional Chinese medicine books.

A Case with XXXX Syndrome Who Was Incidentally Diagnosed during Examination for Suspected Post-Human Papillomavirus Vaccination Syndrome

A 19-year-old Japanese woman was referred to us with the complaints of arthralgia and meralgia following human papillomavirus (HPV) vaccination. She received HPV vaccination at the age of 15 years and three years later, she developed intermittent arthralgia, meralgia, and numbness in limbs. There were no orthostatic dysregulation symptoms. She had hypertelorism, and brachydactyly in both the hands, and revealed mild cubitus varus deformity with lateral instability. X-ray examination disclosed hypoplasia of the humeral capitellum and trochlea in elbow joints. G-banded chromosomes were shown to be composed of 48, XXXX. She was, therefore, diagnosed with XXXX syndrome, which explained the reason for her limb symptoms. Although some girls with HPV vaccination complain of various symptoms including limb pain and numbness, exact underlying cause of these symptoms needs to be ascertained carefully for reaching a final diagnosis.

类风湿关节炎中医证候客观化研究

目的探究类风湿关节炎(RA)相关指标与中医证型之间的关系。方法选取RA患者300例,根据中医辨证分型的不同将其分为湿热痹阻证、寒湿痹阻证、肾气虚寒证、肝肾阴虚证和瘀血痹阻证5个证型,每个证型60例。分析各个证型患者的临床表现、免疫学指标、检验学指标与各个证型之间的联系。结果中医证候在关节肿胀、关节疼痛、关节畸形3种临床表现方面,差异有统计学意义(P<0.05);各证型RA患者的类风湿因子(RF)、抗环瓜氨酸多肽(CCP)抗体、红细胞沉降率(ESR)、C反应蛋白(CRP)、血小板计数(PLT)、D-二聚体(DD)等指标之间比较,差异无统计学意义(P>0.05)。结论类风湿关节炎严重程度与各指标无明显相关性;各指标与中医证候无明显相关性。中医治疗各个证型的RA患者主要原则是活血化瘀,并贯穿于整个治疗过程。

腕踝针联合药物罐治疗寒湿痹阻型肩周炎临床观察

目的观察腕踝针联合药物罐治疗寒湿痹阻型肩周炎的临床效果。方法将80例寒湿痹阻型肩周炎患者随机分为A组、B组、C组和D组,每组20例。A组采用口服双氯芬酸钠缓释片治疗,B组、C组和D组在A组基础上分别采用腕踝针、药物罐及腕踝针联合药物罐治疗。观察各组治疗前后视觉模拟量表(VAS)评分、肩关节功能Mallet评分的变化情况,以及各组临床效果。结果各组治疗后1 d、7 d、14 d、21 d的VAS及肩关节功能Mallet评分与治疗前比较,差异均有统计学意义(P<0.05);治疗后1 d、7 d、14 d、21 d,B组、C组和D组VAS及肩关节功能Mallet评分与A组比较,差异均有统计学意义(P<0.05),D组VAS及Mallet评分与B组和C组比较,差异均有统计学意义(P<0.05)。结论腕踝针联合药物罐治疗寒湿痹阻型肩周炎效果确切,能有效改善患者肩关节疼痛及活动受限的症状。

热敏灸联合Maitland松动术治疗卒中后偏瘫肩痛临床观察

目的 探讨热敏灸联合Maitland松动术治疗卒中后偏瘫肩痛(HPS)疗效。方法 104例HSP患者来源2021年1月—2022年12月江西中医药大学附属医院,对照A组用热敏灸治疗、对照B组用Maitland术、观察组二法联合治疗,评价临床疗效、数字评定量表(NRS)、上肢Fugl-Meyer和Barthel指数。结果 3组治疗后NRS评分下降、Fugal-Meyer和Barthel指数上升,观察组较对照A组和B组变化明显,观察组有效率明显优于其他2组,差异有统计学意义(P<0.05)。结论 热敏灸联合Maitland术治疗卒中后HPS临床疗效显著,能有效缓解肩部疼痛和痉挛程度,有助于恢复肩关节功能,改善生活质量,对卒中后康复有指导意义。

活血通痹方膏摩治疗膝骨关节炎临床观察

目的观察自拟活血通痹方膏摩治疗膝骨关节炎(KOA)的临床效果。方法选取2021年7月—2022年7月于北京市石景山区中医医院骨科门诊治疗的KOA患者74例,随机分为试验组和对照组,试验组采用自拟活血通痹方药膏,通过膏摩治疗患膝,对照组采用双氯芬酸二乙胺乳胶剂,通过膏摩治疗患膝,每次15 min,14次为1个疗程,记录治疗前后患者膝关节视觉模拟量表(VAS)评分、中医证候评分以及西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评分,进行疗效评价和对比。结果两组患者治疗后VAS评分、中医证候评分及WOMAC评分较治疗前均有降低,差异有统计学意义(P<0.05);试验组与对照组VAS评分比较差异无统计学意义(P>0.05),试验组中医证候评分及WOMAC评分均优于对照组,差异有统计学意义(P<0.05)。结论活血通痹方膏摩治疗KOA可有效缓解患者疼痛,改善其膝关节功能,延缓病情进展。

基于脾火论辨治原发性干燥综合征

基于脾火论辨治原发性干燥综合征(pSS)。论述了脾火论的理论内涵,并区分脾火与阴火及其他脏腑之火的差异。阐释了脾火论与pSS的相关性,认为脾气亏虚,运化无权,脾不升清,郁而化火是pSS病机关键;久而病及他脏,导致络脉瘀滞是pSS的病机转化特点。以健脾益气,除火润燥,生津通络为pSS的治疗大法,为pSS的中医辨治提供思路与方法。

王丹辉教授对痛风性关节炎病因病机的认识

从继承、整理老中医经验角度系统阐释王丹辉教授对痛风性关节炎病因病机的独特认识。王丹辉教授提出“湿热毒邪”病机贯穿疾病始终,湿热毒邪伤及肢体关节,致使经络痹阻,影响气血津液的输布,不通则痛,发为痹证,并指出痛风性关节炎在病理上日久必耗伤气血、累及脏腑,出现肝脾肾功能失调的表现。

陈登铠“内外一统”发病观与痿证理论钩玄

探讨陈登铠《华医病理学》“内外一统”的病因和发病观,以及在伤寒、风论、痹论、痿论中的体现。其中痹论和痿论并论,主要表现为病因的“内外感召”和传变的“内外气化枢转”,并从“肺热叶焦”转向“痿疾取之阳明”的机制、悲哀太甚胞络绝致大经空虚、思虑过度与类“二阳之病发心脾”、治痿重视阳明4个方面探讨阳明在痿证理论中的重要意义。

基于气血通化探讨外敷膝骨关节炎用药规律

目的在气血通化观点指导下,对膝骨关节炎外敷中药处方进行挖掘研究,探讨其用药规律。方法收集整理2020年—2022年院内治疗膝骨关节炎外敷用药处方并建立电子数据库,使用IBM SPSS Statistics 26.0和IBM SPSS Modeler 18.0软件中关联分析、聚类分析等数据挖掘方法,分析膝骨关节炎的外敷用药规律。结果本研究收集2020年—2022年治疗膝骨关节炎处方418首,运用关联分析得出强关联对药有川芎-当归、透骨草-川芎、透骨草-伸筋草等共13组,聚类分析产生3个聚类方,高频药物前5为透骨草、川芎、当归、伸筋草、牛膝。结论治疗膝骨关节炎418首处方中常用祛风除湿药、活血化瘀药,涉及脏腑主要为肝、肾、脾,与肝脾气血密切相关,关联规则配伍原则大体从气血、风湿方面论治,以疏通气血、舒解经络为法,故可从疏通气血入手,旨在达到气血通化的状态。

仙灵骨葆胶囊联合唑来膦酸盐及碳酸钙D3片治疗老年骨质疏松症的临床观察

目的探讨仙灵骨葆胶囊联合唑来膦酸盐及碳酸钙D3片对老年骨质疏松症(OP)患者骨转换指标及骨密度的影响。方法选取江西省靖安县人民医院2020年5月—2021年12月收治的老年OP患者94例,随机分为观察组和对照组,各47例。对照组采用唑来膦酸盐联合碳酸钙D3片治疗,观察组在对照组基础上加服仙灵骨葆胶囊治疗,4周为1个疗程。比较2组骨转换指标[骨钙素(OC)、Ⅰ型胶原交联C-末端肽(CTX-1)]、骨密度、骨痛程度[数字疼痛评价量表(NRS)评分]、临床疗效及不良反应。结果治疗后,观察组OC水平高于对照组、CTX-1水平低于对照组,腰椎L_(1~4)、右股骨颈的骨密度高于对照组,NRS评分低于对照组,差异有统计学意义(P<0.05);观察组总有效率95.74%(45/47)高于对照组的80.85%(38/47),差异有统计学意义(P<0.05);2组治疗期间均未见不良反应。结论仙灵骨葆胶囊联合唑来膦酸盐及碳酸钙D_(3)片治疗老年OP效果确切,能改善患者骨转换指标及骨密度,减轻骨痛。

化痰通络颗粒治疗不同中医证型稳定型心绞痛的疗效观察

目的:探讨化痰通络颗粒治疗不同中医证型稳定型心绞痛(SAP)的疗效差异。方法:纳入219例瘀证SAP患者,并根据中医证型分为气虚血瘀组53例、痰瘀互结组63例、气滞血瘀组56例、痰浊闭阻组47例,另纳入50例瘀证SAP患者为对照组。所有患者均接受常规治疗,除对照组外,其余患者均在常规治疗基础上予化痰通络颗粒治疗,连续治疗4周。观察治疗前后中医证候疗效、心绞痛情况、心功能、脂代谢、凝血功能。结果:治疗后,气虚血瘀组、痰瘀互结组、气滞血瘀组、痰浊闭阻组患者疗效均优于对照组(P<0.05),且痰瘀互结组和痰浊闭阻组患者疗效均优于气虚血瘀组和气滞血瘀组(P<0.05)。治疗后,5组患者心绞痛症状积分均低于治疗前(P<0.05),且气虚血瘀组、痰瘀互结组、气滞血瘀组、痰浊闭阻组患者心绞痛症状积分均低于对照组(P<0.05),痰瘀互结组、痰浊闭阻组患者心绞痛症状积分均低于气虚血瘀组和气滞血瘀组(P<0.05)。治疗后,5组患者左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)均低于治疗前,射血分数(EF)、每搏输出量(SV)均高于治疗前(P<0.05),且痰瘀互结组、痰浊闭阻组患者LVEDD、LVESD均低于对照组,EF、SV均高于对照组(P<0.05)。治疗前痰浊闭阻组、痰瘀互结组患者总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)水平均高于气虚血瘀组、气滞血瘀组、对照组;治疗后,5组患者TC、TG、LDL均低于治疗前,HDL均高于治疗前(P<0.05)。治疗后,5组患者纤维蛋白原(FIB)、凝血酶时间(TT)均低于治疗前,活化部分凝血活酶时间(APTT)均高于治疗前,且痰瘀互结组、痰浊闭阻组患者FIB、TT水平均低于气虚血瘀组、气滞血瘀组和对照组(P<0.05)。结论:化痰通络颗粒治疗不同中医证型的稳定型心绞痛均有一定效果,联合西医治疗应用优于单独西医治疗,且其更适用于痰瘀互结证和痰浊闭阻证两种证型。

中西医治疗急性痛风性关节炎的进展

急性痛风性关节炎(AGA)是一种临床常见疾病。近年来,随着人们生活水平的提高,急性AGA的发病率不断上升,严重影响人们的工作、学习和生活。痛风归属于中医学“痹证”“历节”的范畴,中医药治疗急性AGA具有效果显著、不良作用小、价格低廉等诸多优点,能够根据患者的具体症状、体征等辨证论治、标本兼治,减少复发概率。文章从中医内治法、中医外治法,以及西医治疗、外科治疗等方面进行综述,以期为急性AGA的治疗提供思路。

基于“络损脉痹”理论辨治糖尿病周围神经病变思路探析

“络损脉痹”是糖尿病周围神经病变(DPN)的病机关键。气阴两虚、肝肾亏虚、湿热伤络、痰瘀阻络等是形成该病的主要原因。研究显示,养络通痹方药具有减轻炎症反应、修复神经功能、改善血液流变性、调节生长因子等作用,深入研究DPN“络损脉痹”的病因病机及养络通痹法的作用机理,对提高DPN的防治水平具有重要的临床意义。

葛根汤联合中药热敷治疗神经根型颈椎病风寒阻络证临床观察

目的 观察葛根汤联合中药热敷治疗神经根型颈椎病风寒阻络证的临床效果。方法 选取吉林省吉林中西医结合医院骨伤科2021年7月—2022年7月收治的90例神经根型颈椎病风寒阻络证患者,运用掷硬币法分为2组,各45例。对照组用葛根汤治疗,观察组使用葛根汤加中药热敷治疗,比较2组颈椎功能障碍评分、临床疗效、颈肩疼痛程度评分。结果 治疗后,对照组总有效率低于观察组(P<0.05);观察组的颈椎功能障碍评分与颈肩疼痛程度评分更低(P<0.05)。结论 葛根汤联合中药热敷治疗神经根型颈椎病风寒阻络证临床效果较好,优于单一使用葛根汤治疗的方式,有较高临床应用价值。

类风湿关节炎的中医药特色治疗经验综述

近年,类风湿关节炎发病率逐渐升高,其致残率较高,严重危害人类健康,给患者的日常生活带来极大痛苦。目前对于类风湿关节炎的治疗,西医一般采用免疫抑制、抗炎镇痛等方法,暂时缓解患者疼痛,但不良作用较大。近几年研究发现,中医治疗类风湿关节炎具有独特的优势。中医从整体观念出发,针对不同个体,辨证论治施护,并运用独特的中医适宜技术等,临床效果显著。