Clinical effects of a traditional Chinese medicine nursing programme to intervene in gastric pain of the spleen and stomach with Qi deficiency

BACKGROUND Gastroparesis is a common digestive disorder characterized by delayed gastric emptying,which can lead to symptoms such as nausea,vomiting,abdominal pain,and poor appetite.Traditional Chinese medicine(TCM)has been used for centuries to treat gastrointestinal disorders,including gastroparesis.TCM theory suggests that spleen and stomach qi deficiency syndrome is one of the main pathogenic factors in gastroparesis.Nursing care plays an important role in the treatment of gastroparesis,and TCM nursing interventions have shown promising results in improving patient outcomes.However,there is limited research on the clinical effectiveness of TCM nursing interventions for gastroparesis with spleen stomach deficiency syndrome.This study aimed to evaluate the clinical effect of TCM nursing intervention in the treatment of gastroparesis with spleen stomach deficiency syndrome and to compare it with routine nursing interventions.AIM To analyze the clinical effect of traditional Chinese medicine nursing intervention in the treatment of gastric paraplegia with spleen stomach deficiency syndrome.METHODS From January 2020 to July 2021,80 patients with gastroparesis of spleen stomach qi deficiency type diagnosed in our hospital were selected for the study.The 80 patients were randomly divided into a control group and an experimental group,with 40 cases in each group.During the treatment period,the control group received routine nursing interventions,while the experimental group received traditional Chinese medicine nursing procedures.Compare the nursing effects of the two groups and observe the changes in traditional Chinese medicine symptom scores,pain levels,and sleep quality before and after treatment.RESULTS After treatment,comparing the treatment effects of the two groups,the total effective rate of the experimental group was significantly higher than that of the control group,with statistical significance(P<0.05).There was no statistically significant difference in the TCM symptom score,visual analogue scale(VAS)score,and Pittsburgh sleep quality index(PSQI)score between the two groups before treatment(P>0.05).However,after treatment,the TCM syndrome scores,VAS scores,and PSQI scores of the experimental group were significantly lower than those of the control group,with a statistically significant difference(P<0.05).CONCLUSION In the clinical nursing intervention of patients with mild gastroparesis due to spleen and stomach qi deficiency,the traditional Chinese medicine nursing plan has good clinical application value and nursing effect,and has a good effect on improving patients’pain and sleep quality.

Effect of Sijunzi Decoction on the Myonuclear Domain of Rat Soleus in Spleen Qi Deficiency

Objective: To study the mechanism of Sijunzi decoction treating limb weakness in spleen Qi deficiency (SQD) based on the myonuclear domain (MND) theory. Methods: 40 male Sprague-Dawley rats were randomly divided into the normal group, SQD model group (model group), SQD+ still water group (SW group) and SQD+ Sijunzi decoction group (CM group), 10 rats each group;Grip-Strength Meter was used to measure limb grip strength;transmission electron microscope was employed to observe the ultrastructural changes of the myofibers, Image Pro 6.0 was used to measure the myonuclear numbers, cross-section area (CSA) and then their ratios (the MND sizes) were calculated, immunofluorescence assay was chosen to test the expressions of paired box gene 7 (Pax7) and myogenic differentiation antigen (MyoD). Results: Compared with those in the normal group, limb grip strength was decreased, sarcomeres were abnormal, and all the myonuclear numbers, CSA and MND sizes were reduced, but the Pax7+ cell numbers were increased, significantly, in the model and SW groups;Compared with those in the model and SW groups, limb grip strength was increased, sarcomeres were basically normal, the myonuclear number and CSA were both greater, and the Pax7+ and MyoD+ cell numbers were both increased, significantly, in the CM group. Conclusion: Sijunzi decoction might increase the myonuclear number by activating the MSCs to treat limb weakness in SQD.

Therapeutic effect and apoptosis mechanism of lung-tonifying and expectorant decoction on lung cancer rats with Qi deficiency and blood stasis

Objective:To explore the effect and specific mechanism of lung-tonifying and expectorant decoction on lung cancer rats with Qi deficiency and blood stasis,and aim to provide a new idea on treating the disease with traditional Chinese medicine based on syndrome differentiation.Methods:A total of 60 C57BL/6J male rats were included in the study.The model of Qi deficiency and blood stasis was established in 60 rats by using multiple-factor stimulation.About 10 rats were randomly taken to verify whether the model establishment was successful and the rest of 50 rats were divided into 5 groups with 10 rats each:blank control group,cisplatin group,low dose group,medium dose group and high dose group.The blank control group was treated with normal saline,and cisplatin group was treated with cisplatin while the other three groups were treated with lung-tonifying and expectorant decoction at different doses.The volume change in transplanted tumor,tumor inhibition rate,apoptosis rate,and expression of Bc1-2,Bax.cleaved caspase-3 and cleaved caspase-9 in 5 groups were compared.Results:The rapidest growth rate of transplanted tumor volume was observed in blank control group and the slowest in cisplatin group.The growth rate was gradually decreased with the increasing dose of lung-tonifying and expectorant decoction,and the difference in growth of tumor volume among groups was statistically significant(P<0.05).The cisplatin group showed the highest tumor inhibition rate,with dose-dependent increase(P<0.05).The apoptosis rate in low dose group was higher than blank control group but lower than high dose group(P<0.05).The apoptosis rate in medium dose group was significantly higher man blank control group(P).05).The apoptosis rate in high dose group was significantly higher than control group(P<0.05).The positive expression rates of Bel-2 and Bax in all groups showed statistically significant difference(P<0.05),while expression of cleaved caspase-3 and cleaved caspase-9 in 5 groups was significantly different,with dose-dependent increase(P<0.05).Conclusions:The lung-tonifying and expectorant decoction inhibits the proliferation of tumor cells by inducing and activating the cell apoptosis in treatment of lung cancer with Qi deficiency and blood stasis,probably with good clinical therapeutic effect.

Effect of Yiqi Jianpi plus anticancer herbs on spleen deficiency in colorectal cancer and its anti-tumor role

Objective:To observe the effect of Yiqi Jianpi plus anticancer herbs on spleen deficiency in colorectal cancer and its anti-tumor role.Methods:Human intestinal cancer cell HT29 xenograft of nude mice model was established.The expression of ECF,VEGF,gastric cancer tumor growth in mice were observed.Results:Protein kinase C expression in in the Yiqi Jianpi group and Yiqi Jianpi anti-tumor group was significantly better than the model group(P<0.01,P<0.05).There was significantly more apoptotic cells in Yiqi Jianpi anti-tumor group than Yiqi Jianpi group and model group(P<0.01).Epidermal growth factor and vascular endothelial growth factor expression in Yiqi Jianpi group was significantly lower than Yiqi Jianpi group and model group(P<0.05).Conclusions:Tumor can inhibit the expression of PKC inhibition.Yiqi Jianpi and anticancer treatment can reduce this inhibition.Besides this treatment can also inhibit expression of tumor related genes such as epidermal growth factor and vascular endothelial growth factor.

Expression Imbalance of Cholinergic M₂and M₃Receptors Contributes to the Motility Reduction of the Small Intestine in Spleen Qi Deficiency

Objective: To study roles of cholinergic M2 and M3 receptors in the motility reduction of small intestine (SI) in spleen qi deficiency. Methods: 16 male SD rats were randomly divided in the control group and spleen qi deficiency group (model group)—8 rats each group;spleen qi deficiency model of the improper diet and overfatigue was established;the SI propelling rate (SIPR) was used to evaluate the SI motility;ELISA was used to measure concentrations of acetylcholine (ACh), cyclic adenosine monophosphate (cAMP) and protein kinase A (PKA) in the SI tissue;immohistochemistry was employed to detect expressions of cholinergic M2 and M3 receptors. Results: Compared with those in the control group, SIPR was reduced;expression of M2 receptors was increased;and expression of M3 receptors and concentrations of cAMP and PKA were decreased, significantly, in the model group. Conclusions: Expression imbalance of cholinergic M2 and M3 receptors might contribute to the motility reduction of the SI in spleen qi deficiency.

Rules of Ren Shunping's prescription for trearing Spleen Deficiency and Qi Stagnation Syndrome of Functional Dyspepsia Based on Data Mining

Objective:To explore the medication rules of Professor Ren Shunping treating spleen deficiency and qi stagnation syndrome of functional dyspepsia,so as to provide reference for clinical prevention and development of new drugs.Methods:The 144 Chinese herbal formulas considered as active prescribed by professor Ren Shunping for the first time treating the patients with spleen deficiency and qi stagnation syndrome of functional dyspepsia were collected,entered into TCM inheritance auxiliary platform(V2.5),and then mined by some data mining methods of the software,such as the association rules and unsupervised entropy hierarchical clustering.Results:This study involved 144 Chinese herbal formulas,including a total of 56 Chinese herbal medicines.Of these Chinese herbal medicines,the herbs of cold and warm nature,and pungent,bitter and sweet in flavors were used in a quite high frequency,all of which act on spleen,stomach,lungs,large intestine,liver and gallbladder meridians.One core Chinese herbal formula was excavated,composed of patchouli,perilla stem,radix bupleuri,scutellaria,ginger pinellia,codonopsispilosula,magnolia bark,tangerine peel,large-headed atractylodes,immature bitter orange,wood incense,fructus amomi,inula britannica chinensis,ginger,medicated leaven,fried rice and fried malt based on the association rules.And a total of 17 groups of core used drugs and 2 groups of new Chinese herbal formulas undiscovered were mined based on unsupervised entropy hierarchical clustering.Conclusion:In treating spleen deficiency and qi stagnation syndrome of functional dyspepsia,professor Ren is good at treating spleen deficiency and qi stagnation syndrome of functional dyspepsia from the perspective of"tong jiang",using the"five-in-one"strategy of strengthening the spleen,evacuating the liver,coming down qi from the stomach,dispersing lung,and bowel-reflexing to treat patients as a whole.And the herbal medicines were light in dose,lovely and mild in nature for the formulars.At the same time,he paid attention to the combination of syndromes and symptoms,and flexible arbitration.

Occurrence of spleen qi deficiency as defined by Chinese medicine in Parkinson disease

Objective:To investigate the frequency of deficiency of spleen qi (DSQ) in persons with Parkinson disease (PD) as well as the correlation between DSQ and PD.Methods:This study comprised three parts:determining the frequency of DSQ in participants with PD;comparing the frequency of DSQin PD and non-PD participants;and monitoring DSQ in participants with PD for 24 weeks.Outcome measurements were a modified DSQ scale and the Chinese version of the Parkinson Disease Questionnaire 39 (C-PDQ39).Results:A total of 187 participants with PD (mean ages 69.9 ± 9.6 years) completed the assessment in Part 1.Of these,170 (90.9%) were diagnosed as having DSQ.Thirty non-PD participants (mean ages 66.6 ± 10.2 years) completed the assessment in Part 2.Of these 11 (36.7%) were diagnosed as having DSQ.Positive correlations between total DSQ score and Hoehn-and-Yahr (H&Y) stage (correlation 0.316;P <.001),as well as between DSQ and total C-PDQ39 score (correlation 0.572;P <.001),were observed.For Part 3,47 participants from Part 1 were observed for 24 weeks.Variation in DSQ symptoms was noted,but all participants developed DSQ by the end of the study.Conclusions:DSQ is 2.5 times higher in PD participants than in the non-PD participants.More PD participants had DSQ in the advanced H&Y stages.A larger study is needed to validate these results on the prevalence of DSQ in persons with PD.

Mitophagy in the Skeletal Muscle Is Suppressed in Spleen Qi Deficiency

Objective: Mitochondrial impairment in the skeletal muscle contributes to useless of limbs in spleen qi deficiency;however the genesis of such impairment is not clear. Herein, PTEN-induced putative kinase 1 (PINK1)-Parkin pathway and mitophagy were studied to explore the machinery of mitochondrial impairment. Methods: 16 male SD rats were randomly divided in the control group and spleen qi deficiency group (model group);transmission electron microscope was used to observe mitochondrial morphology;mitochondrial oxidative phosphorylation was assessed by testing mitochondrial membrane potential (MMP) and levels of ATP and ROS;western blot was used to analyze expressions of PINK1, Parkin, microtubule-associated protein 1 light chain 3-II (LC3-II) and p62. Results: Compared with those in the control group, mitochondria became small, less and scattered, MMP and the ATP level were reduced, the ROS level was elevated, PINK1 expression was decreased, p62 expression was increased, but Parkin and LC3-II expressions were not altered, in the model group. Conclusions: Suppression of mitophagy might be related to the mitochondrial damage in the skeletal muscle when spleen qi deficiency develops.

Network pharmacology-based exploration of molecular mechanisms underlying therapeutic effects of Jianpi Huatan Quyu recipe on chronic heart failure with spleen Qi deficiency syndrome

BACKGROUND Chronic heart failure is a complex clinical syndrome.The Chinese herbal compound preparation Jianpi Huatan Quyu recipe has been used to treat chronic heart failure;however,the underlying molecular mechanism is still not clear.AIM To identify the effective active ingredients of Jianpi Huatan Quyu recipe and explore its molecular mechanism in the treatment of chronic heart failure.METHODS The effective active ingredients of eight herbs composing Jianpi Huatan Quyu recipe were identified using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform.The target genes of chronic heart failure were searched in the Genecards database.The target proteins of active ingredients were mapped to chronic heart failure target genes to obtain the common drugdisease targets,which were then used to construct a key chemical componenttarget network using Cytoscape 3.7.2 software.The protein-protein interaction network was constructed using the String database.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed through the Metascape database.Finally,our previously published relevant articles were searched to verify the results obtained via network pharmacology.RESULTS A total of 227 effective active ingredients for Jianpi Huatan Quyu recipe were identified,of which quercetin,kaempferol,7-methoxy-2-methyl isoflavone,formononetin,and isorhamnetin may be key active ingredients and involved in the therapeutic effects of TCM by acting on STAT3,MAPK3,AKT1,JUN,MAPK1,TP53,TNF,HSP90AA1,p65,MAPK8,MAPK14,IL6,EGFR,EDN1,FOS,and other proteins.The pathways identified by KEGG enrichment analysis include pathways in cancer,IL-17 signaling pathway,PI3K-Akt signaling pathway,HIF-1 signaling pathway,calcium signaling pathway,cAMP signaling pathway,NF-kappaB signaling pathway,AMPK signaling pathway,etc.Previous studies on Jianpi Huatan Quyu recipe suggested that this Chinese compound preparation can regulate the TNF-α,IL-6,MAPK,cAMP,and AMPK pathways to affect the mitochondrial structure of myocardial cells,oxidative stress,and energy metabolism,thus achieving the therapeutic effects on chronic heart failure.CONCLUSION The Chinese medicine compound preparation Jianpi Huatan Quyu recipe exerts therapeutic effects on chronic heart failure possibly by influencing the mitochondrial structure of cardiomyocytes,oxidative stress,energy metabolism,and other processes.Future studies are warranted to investigate the role of the IL-17 signaling pathway,PI3K-Akt signaling pathway,HIF-1 signaling pathway,and other pathways in mediating the therapeutic effects of Jianpi Huatan Quyu recipe on chronic heart failure.

Progress of studies on cancer-related anemia in Chinese and Western medicine

Cancer-related anemia is a common complication in patients with a malignant tumor caused by the tumor itself or the tumor's treatment.It can seriously affect the quality of life of patients and even accelerate the progression of the tumor.Western medicine is often given a blood transfusion,erythropoietin,and iron agent in cancer-related anemia treatment,but there are also some problems such as increasing tumor-related mortality.Traditional Chinese medicine believes that cancer-related anemia's occurrence is related to the“Deficiency of Spleen and Kidney and Deficiency of Qi and Blood”,so clinical treatment is mainly to“Tonify Spleen and Kidney and Qi and Blood”.The combination of traditional Chinese and Western medicine is useful in cancer-related anemia's treatment,which provides a new idea and method for cancer-related anemia's clinical treatment.

七味白术散治疗老年肺炎肺脾气虚证的疗效及对胃肠功能的影响

目的 观察七味白术散对老年肺炎肺脾气虚证的疗效及对胃肠功能的影响。方法 将60例老年肺炎肺脾气虚证患者按照随机数字表法分为2组,对照组30例予常规基础治疗,治疗组30例在对照组治疗基础上予七味白术散加减治疗。2组均治疗2周。比较2组治疗前后中医证候评分、外周血炎症因子[白细胞介素6(IL-6)、白细胞计数(WBC)、C反应蛋白(CRP)、降钙素原(PCT)]水平、胃肠功能指标(腹内压、肠鸣音次数)及肠道菌群情况,并统计2组疗效及安全性。结果 治疗组总有效率93.33%(28/30),对照组总有效率73.33%(22/30),治疗组临床疗效优于对照组(P<0.05)。2组治疗后中医证候各项评分均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后IL-6、WBC、CRP、PCT水平均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后腹内压均较本组治疗前降低(P<0.05),肠鸣音次数均增加(P<0.05),且治疗组治疗后腹内压低于对照组(P<0.05),肠鸣音次数高于对照组(P<0.05)。2组治疗后肠道乳酸杆菌、双歧杆菌菌落数均较本组治疗前增加(P<0.05),肠球菌、肠杆菌菌落数均降低(P<0.05),且治疗组治疗后乳酸杆菌、双歧杆菌菌落数均高于对照组(P<0.05),肠球菌、肠杆菌菌落数均低于对照组(P<0.05)。2组治疗期间未出现肝肾功能异常。结论 七味白术散治疗老年肺炎肺脾气虚证疗效显著,可有效降低炎症因子水平,调节肠道菌群,改善胃肠功能,安全性高。

李延从脾胃论治冠心病的临床经验

冠心病为临床中常见的心血管疾病,可归属中医学的“胸痹”“心痛”等疾病范畴。李延教授认为本病之病性总属本虚标实之证,以脾虚、脾胃健运失常为本,标实在于痰浊、血瘀、气滞、寒凝等有形实邪痹阻心脉。治疗时重视调理脾胃,重用黄芪、白术、党参、五味子等健脾养心以治本,结合通阳化浊、活血化瘀、疏肝理气、温阳散寒等治法,标本兼治,通补兼顾,使脾气健旺,心气充沛,瘀去痰消,胸阳得以舒展,则心之血脉恢复畅通,胸痹心痛诸症得到缓解。李延教授从脾胃论治冠心病的经验可为中医临床诊治冠心病提供参考。

揿针治疗肺肾气虚型慢性阻塞性肺疾病稳定期疗效研究

目的:研究揿针治疗肺肾气虚型慢性阻塞性肺疾病(COPD)稳定期的临床疗效。方法:前瞻性选择COPD患者200例,随机分为两组,对照组给予常规西医治疗,观察组在其基础上加用予揿针治疗,疗程为8周。记录两组的临床疗效,并比较两组治疗前后中医症状积分、6 min步行距离和衰弱筛查量表评分、改良英国MRC呼吸困难指数问卷(mMRC)、肺功能及圣乔治呼吸问卷(SGRQ)评分。两组治疗后均随访6个月,记录两组急性加重的次数。结果:观察组与对照组临床总有效率分别为92.00%和71.00%,前者显著高于后者(P<0.05)。与治疗前比较,两组治疗后中医症状积分和衰弱筛查量表评分均明显降低,6 min步行距离增加(P<0.05),且观察组治疗后中医症状积分和衰弱筛查量表评分低于对照组,6 min步行距离大于对照组(P<0.05)。与治疗前比较,两组治疗后mMRC分级及平均分、SGRQ问卷总分及各维度评分均明显降低,第1秒用力呼气容积(FEV 1)、用力肺活量(FVC)、最大呼气流量(PEF)、第1秒用力呼气量/用力肺活量(FEV 1/FVC)均明显增大(P<0.05),且观察组治疗后的mMRC分级及平均分、SGRQ问卷总分及各维度评分均低于对照组(P<0.05),肺功能指标高于对照组(P<0.05)。两组治疗后均随访6个月,观察组急性加重次数显著低于对照组(P<0.05)。结论:揿针治疗肺肾气虚型COPD稳定期患者的疗效确定,不仅能改善其临床症状,改善疲劳衰弱状况与增强运动耐量,还能减轻呼吸困难程度并提高肺功能,显著改善生存质量,减少COPD急性发作次数。

HIV/AIDS肺脾气虚证相关心脑血管疾病风险因素探析

目的通过检测血脂四项、血管内皮损伤因子、炎症相关因子,并结合前期的基因芯片结果,初步探讨人类免疫缺陷病毒(HIV)/艾滋病(AIDS)肺脾气虚证相关心脑血管疾病风险因素及机制,为中医药早期干预心脑血管疾病提供依据。方法2020年9月—2020年11月选取河南省某地区确诊的20例HIV/AIDS肺脾气虚证患者作为研究对象,同地区20例HIV抗体阴性作为健康对照组。检测CD_(3)^(+)、CD_(4)^(+)、CD_(8)^(+)计数,并计算CD_(4)^(+)/CD_(8)^(+)比值;检测血脂四项甘油三酯(TG)、胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C);检测氧化低密度脂蛋白(Ox-LDL)、载脂蛋白A-I(ApoAⅠ)、载脂蛋白A-Ⅱ(ApoAⅡ)、载脂蛋白B(ApoB)、锌-α2-糖蛋白1(AZGP1)、可溶性血栓调节蛋白(sTM)、血管性血友病因子(vWF)、脂联素、瘦素(LEP)、超敏C反应蛋白(Hs-CRP)、单核细胞趋化因子1(MCP-1)、肿瘤坏死因子α(TNF-α)。结果HIV/AIDS肺脾气虚证患者与健康对照组比较CD_(4)^(+)降低,CD_(4)^(+)/CD_(8)^(+)比值倒置,TC降低,sTM、AZGP1、Ox-LDL、Hs-CRP升高。结论HIV/AIDS肺脾气虚证患者存在炎性反应、血脂异常的表现,罹患心脑血管疾病风险增加。为中医药早期干预心脑血管疾病的发生提供新思路。

线粒体功能障碍及其影响因素在不同脏腑虚损哮喘患者中的变化趋势分析

【目的】通过对不同脏腑虚损哮喘患者线粒体功能及其相关受损因素的分析,探寻不同脏腑虚损哮喘患者的病例特征,并通过对不同脏腑虚损组哮喘患者的线粒体功能变化及影响因素的差异性分析,试图发现不同脏腑虚损哮喘患者DDAH1/L-Arg/ADMA通路以及线粒体功能、氧代谢的变化趋势及规律。【方法】选取符合纳入标准的支气管哮喘急性发作期患者共122例,对入组患者进行临床资料采集,按脏腑虚损辨证分型标准分为肺气虚组47例、肺脾气虚组39例、肺脾肾虚组36例;并于同期选取正常对照组44例。观察不同脏腑虚损哮喘患者的第1秒用力呼气量(FEV1)、第1秒用力呼气量与用力肺活量的比值(FEV1/FVC)、呼气峰值流速(PEF)等肺功能指标和病情严重程度情况;同时,抽取患者静脉血,采用高效液相联合质谱法(HPLC-MS/MS)检测左旋精氨酸(L-Arg)及不对称二甲基精氨酸(ADMA)水平,采用酶联免疫吸附法(ELASA)检测蛋白精氨酸甲基转移酶1(PRMT1)、二甲基精氨酸二甲氨基水解酶1(DDAH1)等精氨酸代谢相关指标及活性氧自由基(ROS)、硫代巴比妥酸反应产物(TBARS)、8-异前列腺素(8-Iso)、过氧化脂质(LPO)、丙二醛(MDA)等氧化损伤标记物水平;提取哮喘患者及正常对照组的血小板及线粒体,JC-1流式细胞法测定血小板线粒体膜电位(MMP)、三磷酸腺苷(ATP)和细胞色素C氧化酶(COX)的活性,以此评估线粒体功能;分析不同脏腑虚损组哮喘患者的线粒体功能变化及影响因素的差异性,并与正常对照组比较。【结果】(1)不同脏腑虚损哮喘患者的年龄和肺功能(FEV1、FEV1/FVC、PEF)比较,差异均有统计学意义(P<0.01)。表现为肺脾肾虚组的年龄明显高于肺气虚组和肺脾气虚组(P<0.05),以及随脏腑虚损情况的加重,肺功能(FEV1、FEV1/FVC、PEF)呈显著下降趋势(P<0.05)。(2)不同脏腑虚损患者的病情严重程度分布比较,差异有统计学意义(P<0.01)。其中,肺气虚组以间歇状态(1级)为主(65.96%),其次为轻度哮喘(2级)(25.53%);肺脾气虚组以中度哮喘(3级)为主(41.03%),其次为间歇状态(1级)(30.77%);肺脾肾虚组以重度哮喘(4级)为主(52.78%),其次为中度哮喘(3级)(33.33%)。即随着脏腑虚损情况的加重,哮喘的病情严重程度也表现出随之加重的趋势。(3)不同脏腑虚损组哮喘患者与正常对照组的血浆8-Iso、ROS、LPO、MDA水平比较,差异均有统计学意义(P<0.05)。其中,不同脏腑虚损组哮喘患者的血浆8-Iso、LPO水平和肺脾气虚组、肺脾肾虚组患者的血浆MDA、ROS水平均明显高于正常对照组(P<0.05),且肺脾气虚组、肺脾肾虚组患者的血浆ROS水平均明显高于肺气虚组(P<0.05);而不同脏腑虚损组哮喘患者的血浆TBARS水平有高于正常对照组趋势,但差异无统计学意义(P>0.05)。表明不同脏腑虚损哮喘患者机体内均有活性氧及过氧化脂质类物质的蓄积,且随脏腑虚损情况的加重其水平均呈增高趋势。(4)不同脏腑虚损哮喘患者与正常对照组的MMP、ATP、COX比较,差异均有统计学意义(P<0.05或P<0.01),表现为不同脏腑虚损哮喘患者的MMP、ATP、COX水平均较正常对照组明显降低(P<0.05),且随着脏腑虚损的加重,COX活性有下降趋势。(5)不同脏腑虚损哮喘患者与正常对照组的血浆L-Arg、L-Arg/ADMA、DDAH1水平比较,差异均有统计学意义(P<0.05)。表现为不同脏腑虚损哮喘患者的血浆L-Arg、L-Arg/ADMA、DDAH1水平均较正常对照组明显降低(P<0.05),且随脏腑虚损的加重,上述指标均有逐渐降低的趋势;而不同脏腑虚损哮喘患者与正常对照组的血浆ADMA、PRMT1比较,差异均无统计学意义(P>0.05)。【结论】该研究从机体代谢角度论证了中医脏腑虚损理论对病情变化趋势判断的正确性,证实了哮喘患者的脏腑虚损状况与临床病情进展、氧代谢及其影响因素和机体氧化损伤程度均表现出一致的变化趋势。

国医大师刘嘉湘从脾肾论治肺癌经验

刘嘉湘教授认为,肺癌病位在肺,亦与脾、肾密切相关。其病机以正气亏虚为本,而脾肾为正虚之关键,治疗时强调“治病必求于本”,创立扶正培本治癌大法,开创了中医药治疗恶性肿瘤的新思路,扶正培本又重在脾肾,同时补虚不忘祛邪,扶正祛邪相辅相成,将扶正培本法贯穿于治疗肺癌的始终。

基于“脾气散精”理论探讨慢性肝病的中医治疗

慢性肝病的发病与脾密切相关,“脾气散精”是《黄帝内经》对脾功能的高度概括,脾气散精功能障碍贯穿慢性肝病始终,脾失运化,生湿生痰,瘀血阻络为慢性肝病进展的关键因素。治疗时应将健脾作为慢性肝病的基本治法之一,并根据脾运的不同状态,配合运脾、醒脾、温脾等不同治法,以复脾气散精之能,病程中尤应抓住瘀血络阻这一关键病机,活血化瘀通络,防止慢性肝病进一步向肝积、鼓胀发展,使脾运得复,瘀阻得除,标本兼治。

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。

益胃宁胶囊联合瑞巴派特片治疗慢性萎缩性胃炎脾胃气虚证临床研究

目的观察益胃宁胶囊联合瑞巴派特片治疗慢性萎缩性胃炎(CAG)脾胃气虚证的临床疗效。方法采用随机数字表法将80例CAG患者分为研究组和对照组各40例,2组均予瑞巴派特片,0.1 g/次,每日3次,口服;研究组在此基础上予益胃宁胶囊,2 g/次,每日3次,口服。2组均连续治疗12周。观察2组治疗前后中医疗效、胃镜疗效和病理疗效,比较2组治疗前后中医症状评分,监测2组不良反应。结果2组均无病例脱落。研究组中医疗效总有效率为92.5%(37/40),对照组为70.0%(28/40),研究组中医疗效优于对照组(P<0.01)。与本组治疗前比较,2组治疗后中医症状总分下降(P<0.05,P<0.01);2组治疗后比较,研究组中医症状总分低于对照组(P<0.01)。研究组胃镜疗效总有效率(82.5%)优于对照组(67.5%),研究组病理疗效总有效率(87.5%)优于对照组(70.0%),差异均有统计学意义(P<0.05,P<0.01)。2组未见明显不良反应。结论益胃宁胶囊联合瑞巴派特片可有效改善CAG患者的临床症状、胃镜表现及黏膜病变程度,疗效显著。

益气健脾汤治疗脾气亏虚型IGT患者的临床观察及对血糖变异系数的影响

目的:研究益气健脾汤治疗脾气亏虚型糖耐量减低(IGT)患者的疗效以及对血糖波动指数的影响。方法:纳入2023年12月—2024年2月在黑龙江中医药大学附属第三医院内分泌(老年病)科门诊、住院部的60例IGT(脾气亏虚型)患者,按照随机数字表法分为对照组和治疗组,每组30例。两组患者均给予饮食、宣教、运动等一般基础治疗。对照组在基础治疗的基础上给予阿卡波糖胶囊;治疗组在对照组基础上加用益气健脾汤联合治疗。两组患者均治疗6周。观察两组在治疗前后的空腹血糖(FPG)、2 h血糖(2 h PG)、糖化血红蛋白(HbA1c);甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL);血糖变异系数(GLUCV)、血糖标准差(GLUsd)、平均血糖值(GLUmean)、日内平均血糖波动幅度(MAGE)、日间血糖平均绝对差(MODD)及中医证候评分,并观察其疗程结束时的随访转归情况。结果:治疗6周后,两组患者的糖代谢指标、GLUsd、GLUmean、GLUCV、MAGE、中医证候评分均显著降低(P<0.05),治疗组的糖代谢指标、GLUsd、GLUCV、MAGE、中医证候评分显著低于对照组,差异有统计学意义(P<0.05)。结论:益气健脾汤能有效改善IGT患者症状,调节糖代谢,并能缩小血糖波动,延缓2型糖尿病发生发展,比单纯生活方式干预和阿卡波糖治疗持久有效。