Clinical Nursing Intervention of Moxibustion on Abdominal Distension Symptoms in Heart Failure (Heart and Kidney Yang Deficiency and Blood Stasis Blocking Collaterals Syndrome)

Objective:To investigate the clinical nursing intervention effect of moxibustion on abdominal distension symptoms in heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome).Methods:62 patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)admitted to our hospital from February 2023 to February 2024 were selected and divided into the observation group(n=31)and the control group(n=31)by using the random numerical table method.The control group adopted conventional nursing interventions,and the observation group received the nursing program of the control group with the addition of moxibustion nursing interventions.The nursing effectiveness,quality of life scores,and nursing satisfaction were compared between the two groups.Results:The nursing effectiveness of the observation group was significantly higher than the control group(P<0.05);the quality of life score of the observation group was significantly higher than the control group(P<0.05);the nursing satisfaction of the observation group was significantly higher than that of the control group(P<0.05).Conclusion:The use of moxibustion nursing intervention in patients with heart failure(heart and kidney yang deficiency and blood stasis blocking collaterals syndrome)can effectively relieve the symptoms of abdominal distension,improve patients'quality of life,and increase nursing satisfaction,which has promotion and application values.

Exploring the medication pattern and mechanism of action of traditional Chinese medicine in treating polycystic ovary syndrome with kidney deficiency and blood stasis based on data mining and network pharmacology

Background:Using network pharmacology to explore the potential molecular mechanism of traditional Chinese medicine in treating polycystic ovary syndrome(PCOS)with kidney deficiency and blood stasis syndrome.Method:Collect the related literature materials of PCOS with kidney deficiency and blood stasis syndrome treated by traditional Chinese medicine in four databases in recent ten years,extract the information of prescriptions and complete the frequency analysis.Traditional Chinese Medicine Systems Pharmacology Database was used to screen out the effective components.Use Online Mendelian Inheritance in Man and other databases to screen PCOS disease targets.The intersection targets obtained by clustering prescription and PCOS disease targets were submitted to STRING database for protein-protein interaction network analysis,and Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes pathways were analysed by Metascape.Result:There are 155 kinds of traditional Chinese medicines used in the literature.The most commonly utilized ones are Cuscutae Semen,Angelicae Sinensis Radix,and Rehmanniae Radix Praeparata.The results of the cluster analysis indicated that the plants most commonly found throughout the prescription were Leonuri Herba,Lycopi Herba,Dipsaci Radix,etc.GO results show that biological processes include cell reaction to organic nitrogen compounds and cell reaction to nitrogen compounds.The functional display of GO molecule includes cytokine receptor binding,signal receptor regulator activity and so on.Kyoto Encyclopedia of Genes and Genomes results show that the possible mechanisms of action are cancer pathway,an endocrine resistance signal pathway.Conclusion:Through data mining,the cluster prescription for PCOS with kidney deficiency and blood stasis syndrome is Leonuri Herba,Lycopi Herba,Dipsaci Radix,etc.The network pharmacology research of cluster prescription shows that the main drug components for treating PCOS with kidney deficiency and blood stasis syndrome are quercetin,kaempferol,luteolin,tanshinone IIA,etc.,which act on PTGS2,NCOA2,and other targets,and treat PCOS with kidney deficiency and blood stasis syndrome through cancer and endocrine resistance.

Clinical observation on efficacy of compound of warming yang, descending turbidity and dredging collaterals in the treatment of diabetic kidney disease with Yin-Yang deficiency and blood stasis syndrome

Objective:To observe the clinical efficacy of compound of owarming yang,descending turbidity and dredging collaterals in the treatment of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome.Methods:Seventy-six patients of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome were randomly divided into observation group and control group,thirty-eight cases in each group.The control group was given conventional western medicine treatment,while the observation group took compound of owarming yang,descending turbidity and dredging collaterals orally on the basis of conventional western medicine treatment.The course of treatment covered for one month.Before and after treatment,we observed the scores of traditional Chinese medicine symptoms,indicators of renal function[serum creatinine(Scr),blood urea nitrogen(BUN),microalbuminuria(MALB)],indicators of glucose metabolism[fasting plasma glucose(FPG),2-hour postprandial blood glucose(2hPG),glycosylated hemoglobin(HbAlc)],indicators of hemorheology[plasma viscosity(PV),platelet aggregation rate(PAR),fibrinogen(FIB)],Cystatin-C(Cys-C),C-reactive protein(CRP)in the two groups.Results:After treatment,the clinical effect of the observation group was significantly better than the control group(P<0.05).The scores of traditional Chinese medicine symptoms,indicators of renal function(Scr、BUN、UAER),indicators of glucose metabolism(FPG、2hPG、HbAlc),indicators of hemorheology(PV、PAR、FIB),Cys-C and CRP in the two groups were decreased significantly compared with those before treatment(P<0.05),and the decrease in the observation group was superior to that in the control group(P<0.05).Conclusion:Compound of warming yang,descending turbidity and dredging collaterals has remarkable efficacy in treating of diabetic kidney disease patients with yin-yang deficiency and blood stasis syndrome by alleviating clinical symptoms,glucose metabolism,renal function and microcirculatory disturbance,and the mechanism related to alleviation of microinflammation.

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.

Study of Interference Treatment by Xuesaitong (血塞通) Soft Capsuleon Patients of Nephrosis Syndrome with Qi Deficiency and Blood Stasisduring Dose Reducing Stage of Corticosteroid

Objective: To observe the effect of Xuesaitong (血塞通, XST) soft capsule in interference treatment on patients of nephrosis syndrome (NS) during corticosteroid (CS) dose reducing stage. Methods: Seventy-one NS patients applying prednisone and initiating dose reducing stage were randomized into trial group and control group. On the basis of conventional prednisone dose reduction of both groups, the trial group was given additionally XST, and the treatment course ended with the reduction to maintenance dose. In the course of observation, those who did not comply with the criteria of observation were excluded. Before and after the dose reduction, TCM syndrome scoring, 24 hrs urinary protein amount, blood β2-microglobulin (β2-MG), urinary β2-MG, blood fibrinogen (Fbg), plasma prothrombin time (PT), blood lipid, etc. were observed. Results: The trial group of XST could obviously lower their urinary protein amount and blood lipid level (P<0.05 or P<0.01), markedly improve the blood coagulation parameters (P<0.01), improve the TCM syndrome and CS induced adverse reaction (P<0.05 or P<0.01), also obviously reduced the recurrence rate of NS (P<0.05). Conclusion: XST could obviously improve the clinical symptoms and renal impairment parameters in NS patients during CS dose reduction stage, improve the CS induced adverse reaction and prevent the recurrence of NS.

Preliminary molecular basis of Danggui-buxue-tang on Qi deficiency and blood stasis syndrome

Objective To study the molecular biology mechanism of Danggui-buxue-tang on tonifying Qi and controlling blood circulation through modulation the immune functional genes.Methods Rats were randomly divided into control group,model group,and Danggui-buxue-tang group.Effect of Dang-guibuxue-tang on mRNA expressions of IL-1β,TNF-α,HSP-70,NF-κB,p38MAPK and JNK in blood cells of rats with Qi deficiency and blood stasis were measured with real-time fluorescent quantitative-PCR at 5th,14th and 28th day.And that in artery wall were determined at the 28th day.NF-κB/p65 and p-c-jun protein expressions in rat artery wall were detected by western blotting as well.Results In model group,TNF-α,IL-1β,NF-κB,HSP-70,p38MAPK and JNK mRNA expression in blood cell increased significantly compared with control group.Compared with model group,mRNA expression of IL-1βand JNK decreased significantly;TNF-α decreased at 5th,14th day;HSP-70,p38MAPK decreased at 14th,28th day;NF-κB decreased at 28th day.In model group,TNF-α,IL-1β,NF-κB,p38MAPK and JNK mRNA expression in artery increased compared with control group,excluded HSP-70,and that in Danggui-buxue-tang group decreased significantly.In model group,NF-κB/p65 and p-c-jun protein expression in artery increased compared with control group,and that in Danggui-buxue-tang group decreased significantly.Conclusions The effects of Dang-guibuxue-tang on Qi deficiency and blood stasis syndrome was brought from the regulating of cytokine network at multi-link and multi-target,NF-κB,p38MAPK and JNK signal transduction pathways included.Through which the immune system and whole body reached to a functional balance status.

Effect of Chanfukang(Chinese Medicine)on Endothelin and Nitric Oxide in Postpartum Cows with Qi Deficiency and Blood Stasis

[ Objective] To observe effect of Chanfukang on vascular endothelial cells of postpartum cows with Oi deficiency and Blood stasis, and to explore the treatment mechanism of Chanfukang. [Method] A total of 58 cows were assigned to four groups. The cows in group 1 and group 2 suffered from Qi deficiency and Blood stasis. The cows in group 1 were gavaged with Chanfukang （0.5 g/kg-BW, 5 d） at 12 h post partum, but the cows in group 2 were not treated. The cows in group 3 were healthy and gavaged with Chanfukang （0.4 g/kg.BW, 5 d） at 12 h post partum. Cows in group 4 were healthy control cows. The plasma endothelin （ET） concentration and serum nitric oxide （NO） concentration were determined before and after parturition, respectively. [ Result ] The plasma ET concentration and serum NO concentration were significantly higher in the cows with Qi deficiency and Blood stasis than in the healthy control cows （P 〈 0.05）. The NO concentration decreased on Day 10 post partum in the cows with Qi deficiency and Blood stasis, but it was still higher than that in the healthy control cows. After taking Chanfukang for 7 d, the ET concentration and NO concentration decreased, and no significant difference was found between the cows with Qi deficiency and Blood stasis treated with Chanfukang and the healthy control cows. [ Conclusion] Chanfukang may relieve Qi deficiency and Blood stasis of postpartum cows through decreasing plasma ET concentration and serum NO concentration.

Serum proteomic approach in patients with Qi deficiency and blood stasis syndrome in coronary heart disease:to explore therapeutic mechanism of Yiqi Huoxue decoction

OBJECTIVE To explore the curative effect and mechanism of Yiqi Huoxue decoction in the treatment of coronary heart disease with Qi deficiency and blood stasis syndrome.METHODS The patients with coronary heart disease of Qi deficiency and blood stasis syndrome were treated with Yiqi Huoxue decoction for 3 months,and the changes of cardiac function were observed.61 serum samples(including 29 cases of disease group and 32 cases of Yiqi Huoxue expression group)were analyzed by non labeled proteomics.The disease group was used as the control group,and the protein with expression level difference of more than 1.2 folds(P<0.05)was screened.The molecular function,biological pathway and protein interaction of the different proteins were analyzed by bioinformatics,so as to identify the molecular and biological pathway of Yiqi Huoxue decoction in the treatment of coronary heart disease with Qi deficiency and blood stasis syndrome.RESULTS Clinical treatment found that Yiqi Huoxue decoction can improve TCM syndrome score and left ventricular ejection fraction,regulate blood glucose and blood lipid levels,prolong thrombin time,and improve heart function.The results of proteomic quantitative analysis showed that there were 69 proteins with different expression levels in the disease group.Bioinformatics analysis results showed that Yiqi Huoxue decoction may regulate ApoA1,alpha-2 and other proteins to act on HDL assembly,platelet degradation,PI3K Akt signaling pathway,and then play a therapeutic role in coronary heart disease with Qi deficiency and blood stasis syndrome.CONCLUSION Yiqi Huoxue decoction can effectively improved the heart function decline caused by Qi deficiency and blood stasis syndrome of coronary heart disease.It mainly act on energy metabolism and platelet activation pathway by activating HDL assembly and platelet degradation signal pathway proteins.This study can provide reference for the follow-up treatment mechanism of Qi deficiency and blood stasis syndrome of coronary heart disease.

Observation of tongue picture and tongue and nailbed microcirculation before and after blood dialysis in 125 uremic patients with deficiency of kidney-yang

using a WZD—1 microcirculation microscope,we observed the tongue tipand nail-bed microcirculation of uremic patients with deficiency of kidney-yangbefore and after blood dialysis.The results showed that the pathological basis ofuremia with deficiency of kidney-yang may be microcirculation disturbance,in-crease of metabolites and water retention.The effusion from capillary loops intongue tip may be one of the pathogenetic factors of a swollen and jaggedtongue.The flow rate of blood in capillary loops in the nail-bed was apparentlyabnormal and markedly improved after blood dialysis.The weighted integral ofnail-bed microcirculation decreased from moderately abnormal (4.99±1.52) toapproximately normal (1.98±0.97) (P【0.01).Microcirculation seems to be a sensi-tive criterion for reflecting the pathologic changes of uremia with deficiency ofkidney-yang.

On the Treatment of Kidney Fibrosis from the Theory of Internal Deficiency of Qi and the Coexistence of Phlegm and Blood Stasis

Traditional Chinese medicine believes that the etiology and pathogenesis of renal fibrosis are characterized by deficiency of the lung,spleen and kidney,and phlegm,blood stasis,dampness and poison.The positive and the evil can influence each other and cause and effect each other,forming the pathological characteristics of the deficiency,the deficiency,the deficiency and the reality.Chinese medicine treatment of the disease has its unique advantages,external and internal injury equal emphasis,correction and dispelling evil and regulation.From the point of view of"deficiency of qi and coexistence of phlegm and blood stasis",the treatment of renal fibrosis can provide theoretical basis for the treatment of the disease.

Pharmacokinetics of traditional Chinese syndrome and recipe:a hypothesis and its verification(Ⅰ)

AIM To propose a hypothesis defining theabsorption,distribution,metabolism andelimination of traditional Chinese recipe（TCR）-component in blood of healthy subjects andpatients,and estimate its correctness.METHODS The pharmacokinetics（PK）of samedose of drug was studied in the animal model oftraditional Chinese syndrome（S）and healthyanimals.The classification,terminology,concept and significance of the hypothesis wereset forth with evidence provided in the presentstudy.The hypotheses consisted of traditionalChinese syndrome PK（S-PK）and traditionalChinese recipe PK（R-PK）.Firstly,the observedtetramethylpyrazine（TMP）PK in healthy,chronically reserpinized rats（rat model ofspleen deficiency syndrome,RMSDS）andRMSDS treated with Sijunzi decoction（SJZD）forconfirmation were used to verify S-PK; secondly,the ferulic acid（FA）PK in healthy andhigh molecular weight dextran（HMWD）-inducedrabbit model with blood stasis syndrome（RDBSS）was also used to verify S-PK;andlastly,TMP PK parameters in serum of healthyrats after orally taken Ligusticum wallichii（LW）,LW and Salvia miltiorrhiza（LW&SM）decoctions were compared to verify R-PK.RESULTS The apparent first-order absorption[Ka,（13.61±2.56）h-1,area under the blooddrug concentration-time curve[AUC,（24.88±9.76）μg.h-1mL-1],maximum drug concentration[Cmax,（4.82±1.23）μg·mL-1]of serum TMP inRMSDS were increased markedly（P【0.05）compared with those[Ka=（5.41±1.91）h-1,AUC=（5.20±2.57）μg·h-1·mL-1,Cmax=（2.33±1.77）μg·mL-1]of healthy rats（HR）.Theapparent first-order rate constant for α and βdistribution phase[α=（0.38±0.09）h-1,β=（0.06±0.03）h-1,the apparent first-orderintercompartmental transfer rate constants[K10=（0.24±0.07）h-1,K12=（0.11±0.02）h-1,K21=（0.11±0.02）h-1]of serum TMP in RMSDS weredecreased significantly（P【0.01）comparedwith those[K10=（0.88±0.20）h-1,K12=（1.45±0.47）h-1,K21=（0.72±0.22）h-1]of HR.However,no apparent differences occurredbetween HR and RMSDS treated with SJZD.Theserum FA concentration and its AUC[（5.6690±2.3541）μg·h-1·mL-1] in RMBSS were also higherthan those[AUC=（2.7566±0.8232）μg·h-1·mL-1]of healthy rabbits（P【0.05）.The Ka（11.51±2.82）h-1,AUC（0.84±0.17）μg·h-1·mL-1of LW & SM-derived TMP in serum weremuch lower（P【0.05）than those[Ka=（19.58±4.14）h-1,AUC=（1.27±0.26）μg·h-1·mL-1]ofLW-derived TMP in serum after oral decoctions.CONCLUSION The SDS and blood stasissyndrome state could affect significantly thepharmacokinetic parameters of drugs and theabnormal SDS pharmacokinetic parameters couldbe normalized by SJZD.The combination ofChinese medicine in TCR could reciprocallyaffect the pharmacokinetic parameters of othercomponents absorbed into the systemiccirculation.These results support the S-and R-PK hypothesis.

Efficacy of Yangyin Yiqi Huoxue Granule (养阴益气活血颗粒) in Treatment of Ischemic Stroke Patients with Qi-Yin Deficiency and Blood Stasis Syndrome: A Randomized, Double-Blind, Multicenter, Phase-2 Clinical Trial

Objective To evaluate the efficacy and safety of Yangyin Yiqi Huoxue Granule(养阴益气活血颗粒,YYHG)in the treatment of ischemic stroke(IS)patients with qi-yin deficiency and blood stasis syndrome(QYDBSS),and to explore its effective dosage.Methods The total of 288 patients were randomly assigned to the YYHG high-dose,YYHG low-dose,positive control(administered Xiaoshuantong Granule,XSTG,消栓通颗粒),or placebo control(administered inert granule)groups(72 cases per group)by software-drived competitive block randomization.The trial was conducted for a 28-day period,with a 180-day follow-up period.The primary outcome was the comprehensive curative evaluation,and secondary outcomes were the National Institute of Health Stroke Scale(NIHSS)score,Barthel activities of daily living(ADL)index score,the quality of life index(QLI)score,and the Chinese medicine syndrome(CMS)score.All analyses were done on an intention-to-treat basis.The clinical safety was also assessed.Results The total of 288 participants were recruited between June 1,2008 and September 30,2009,and 287 patients received intervention;the treatment groups were well balanced at baseline.The comprehensive cure rates of YYHG high-dose,low-dose,positive and placebo control groups were 63.38%,31.94%,36.11%and 6.14%,respectively;there was a statistical difference between the two groups(P<0.01),while the high-dose YYHG treatment group was significantly higher than the other 3 groups(P<0.01).The improvement of NIHSS,ADL,QLI and CMS scores of the YYHG high-dose and low-dose groups was significantly better than that of the positive control group and the placebo control group(P<0.05).In terms of improving the classification of the NIHSS scale and the assessment of the ADL scale,the YYHG high-dose group was significantly better than the other three groups(P<0.05),and the YYHG low-dose group was better than the placebo control group(P<0.01).At the same time,except for the QLI score,the high-dose group was better than the low-dose group(P<0.05).In terms of safety,adverse reactions after YYHG treatment were generally mild(3.78%),and no serious adverse reactions have been reported.Conclusion YYHG is safe and effective in the treatment of IS patients with QYDBSS.

Advances in Research on Treatment of Heart Failure with Yangxinshi Tablet

The advances in the treatment of heart failure with Yangxinshi tablet are reviewed in this paper.Yangxinshi tablet has effects of nourishing myocardia,improving myocardial metabolism,reducing myocardial oxygen consumption,dilating coronary artery,improving cardiac blood supply,reducing blood viscosity and improving microcirculation,and it can improve the functions of heart and curative effect of heart failure.

补肾活血方治疗肾虚血瘀型卵巢储备功能下降患者的临床疗效观察

目的观察补肾活血方对肾虚血瘀型卵巢储备功能下降(DOR)患者的治疗效果。方法选取北京妇产医院中医科2021年1月至2022年12月就诊的180例诊断为DOR的肾虚血瘀型患者作为研究对象,采用计算机随机分组法分为雌二醇片/雌二醇地屈孕酮片组(西药组)、补肾活血方组(中药组)和补肾活血方联合雌二醇片/雌二醇地屈孕酮片组(联合组),各60例。观察三组治疗前后卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_(2))、抗米勒管激素(AMH)、窦卵泡数(AFC)、卵巢体积、卵巢动脉和子宫动脉阻力指数(RI)、子宫内膜厚度的变化,比较三组中医证候评分及疗效。结果11例患者(4例来自西药组,3例来自中药组,4例来自联合组)退出研究。6个月后,三组FSH和LH均显著降低,E_(2)和AMH升高(P<0.05);西药组和联合组较中药组FSH降低更显著,E_(2)升高更显著(P<0.01)。治疗后,中药组和联合组卵巢体积增加(P<0.05),AFC显著增加(P<0.01),卵巢动脉RI显著降低(P<0.01);西药组卵巢体积增加不显著(P>0.05),AFC显著增加(P<0.05),卵巢动脉RI显著降低(P<0.05);三组子宫动脉RI均无显著改善(P>0.05)。三组子宫内膜厚度均显著增加(P<0.05),西药组和联合组较中药组增加更显著(P<0.01)。与治疗前相比,三组治疗后中医证候评分均显著降低(P<0.05),且中药组和联合组中医证候评分降低的程度大于西药组(P<0.05)。西药组总有效率为71.43%,中药组为82.46%,联合组为85.96%;联合组的疗效优于西药组(P<0.05)。结论补肾活血方能够通过平衡激素水平、促进排卵和修复子宫内膜对DOR患者产生良好的治疗效果,联合应用雌二醇片/雌二醇地屈孕酮片可能是治疗DOR的一种行之有效的治疗策略。

益心泰颗粒对慢性心衰(心气虚兼血瘀水停证)大鼠AMPK、PGC-1α的影响

目的观察益心泰颗粒对慢性心力衰竭(CHF)(心气虚兼血瘀水停证)大鼠AMPK、PGC-1α的影响。方法采用丙硫氧嘧啶灌胃及阿霉素腹腔注射复制CHF(心气虚兼血瘀水停证)模型大鼠,将造模成功大鼠分为模型组与益心泰低、中、高剂量组和曲美他嗪组;另设正常对照组。灌胃4周后观察心肌组织病理结构,检测LVEF、血清NT-proBNP及心肌组织FFA、ATP/AMP、LAC、pAMPK、AMPK、PGC-1α水平。结果与模型组比较,益心泰颗粒低、中、高剂量组及曲美他嗪组LVEF、心肌组织ATP/AMP值、心肌组织p-AMPK、AMPK、PGC-1α相对灰度值均明显升高(P<0.05或P<0.01),血清NT-proBNP及心肌组织FFA、LAC明显降低(P<0.05或P<0.01)。结论益心泰颗粒能促进慢性心力衰竭(心气虚兼血瘀水停证)大鼠AMPK、PGC-1α表达,改善心肌能量代谢。

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。

补肾活血膏方对肾虚血瘀证强直性脊柱炎患者的临床疗效

目的 探讨补肾活血膏方对肾虚血瘀证强直性脊柱炎患者的临床疗效。方法 167例患者随机分为对照组(常规治疗,55例)、暴露组(常规治疗+补肾活血汤剂,54例)、高暴露组(常规治疗+补肾活血汤剂+补肾活血膏方,58例),疗程2年。检测临床疗效、BASDAI评分、ASDAS-CRP、BASFI评分、脊柱痛评分、PGA评分、BASMI评分、ASQoL评分、SPARCC评分、肾虚血瘀证评分、ESR、CRP、IL-6、TNF-α、IL-17、IL-23、IL-35、NLR、PLR、安全性指标变化。结果 高暴露组ASAS40、ASAS5/6、BASDAI50例数多于暴露组和对照组(P<0.05)。治疗后,高暴露组BASDAI评分、ASDAS-CRP、BASFI评分、脊柱痛评分、PGA评分、BASMI评分、SPARCC评分、ASQoL评分、肾虚血瘀证评分、ESR、CRP、IL-6、TNF-α、IL-17、IL-23低于其他2组(P<0.05),IL-35更高(P<0.05)。经Logistic回归分析校正混杂因素后,补肾活血汤、补肾活血膏方降低BASDAI评分和ASDAS-CRP(P<0.05),提高临床疗效(P<0.05)。3组未发现严重不良反应。结论 补肾活血膏方可安全有效地抑制肾虚血瘀证强直性脊柱炎患者炎症,降低疾病活动度,减轻骨髓水肿,改善临床症状,提高关节功能和生活质量。

益气复脉方治疗气虚血瘀、痰瘀互阻型室性期前收缩的临床疗效

目的:观察益气复脉方治疗气虚血瘀、痰瘀互阻型室性期前收缩的临床疗效。方法:选取2021年8月—2022年8月在北京中医药大学东方医院住院治疗的室性期前收缩病人60例,按照随机数字表法分为对照组和治疗组。在常规治疗基础上,治疗组采用益气复脉方(颗粒剂)治疗,对照组采用颗粒安慰剂治疗。评估并比较两组治疗前后室性期前收缩数量变化,中医证候积分及中医单项症状心悸、气短、神疲乏力、胸闷、胸痛、痰浊、自汗、食少纳呆积分变化。结果:治疗后,治疗组室性期前收缩数量较治疗前减少,且治疗组少于对照组,差异有统计学意义(P<0.05)。治疗后,两组中医证候总积分较治疗前降低,且治疗组低于对照组,差异均有统计学意义(P<0.001)。治疗后,两组心悸、气短、神疲乏力、胸闷、胸痛、痰浊、自汗、食少纳呆的症状积分均较治疗前降低,且治疗组低于对照组,差异均有统计学意义(P<0.05)。治疗后,治疗组总有效率高于对照组,差异有统计学意义(77.8%与24.0%,P<0.05)。结论:益气复脉方可减少气虚血瘀、痰瘀互阻型室性期前收缩病人室性期前收缩次数,改善中医证候。

破格救心汤加减对心力衰竭合并室性心律失常患者生物标志物和近期不良心血管事件的影响

目的评价破格救心汤加减对心力衰竭合并室性心律失常患者生物标志物和近期不良心血管事件的影响。方法将88例心力衰竭合并室性心律失常患者随机分为对照组与观察组各44例。对照组进行抗心衰治疗,并口服美托洛尔缓释片和盐酸胺碘酮胶囊。观察组在对照组治疗的基础上口服破格救心汤加减治疗。比较治疗前后左室射血分数(LVEF)、每搏心输出量(SV)、左心室收缩末期内径(LVESD)、正常窦性心搏间期标准差(SDNN)、校正TP-Te间期(TP-Tec)每5分钟窦性心搏间期平均值的标准差(SDANN)、校正QT间期(QTc)和正常相邻R-R间期差值>50ms的百分比(Pnn50%);检测N末端B型利钠肽原(NT-proBNP)、生长分化因子15(GDF-15)可溶性肿瘤生成抑制因子-2(sST-2)和半乳糖凝集素-3(GAL-3)水平;记录近期不良心血管事件;进行治疗前后阳气亏虚血瘀证评分;比较心功能疗效和室性心律失常疗效。结果治疗后,观察组心功能疗效和室性心律失常疗效的总有效率均高于对照组(P<0.05);两组患者LVEF、SV升高,LVESD降低(P<0.05),均以观察组更明显(P<0.05);两组患者NT-proBNP、GAL-3、GDF-15和sST2水平下降(P<0.05),且观察组低于对照组(P<0.05);两组患者主要症状评分及阳气亏虚血瘀证总积分降低(P<0.05),且观察组低于对照组(P<0.05);两组患者QTc、TP-Tec减少,SDNN、SDANN和Pnn50%增加(P<0.05),且观察组改善明显(P<0.05)。观察组近期不良心血管事件累积发生率低于对照组(P<0.05)。结论破格救心汤加减方联合西医常规疗法治疗心力衰竭合并室性心律失常,能够抑制心室重构,提高心功能,减少不良心血管事件发生,临床疗效优于单纯的西医治疗。

体质贴联合八段锦功法治疗气虚血瘀质新型冠状病毒感染恢复期患者的临床研究

[目的]观察气虚血瘀体质贴(简称体质贴)联合八段锦功法对气虚血瘀体质的新型冠状病毒感染恢复期患者的临床疗效。[方法]符合入选标准的43例新型冠状病毒感染恢复期患者分为试验组(21例)和对照组(22例)两组均在八段锦功法的基础上予体质贴辅助治疗,治疗12周后,观察两组患者治疗前后在中医症状积分量表、改良英国医学研究委员会呼吸困难量表(mMRC)、Borg自觉疲劳量表和匹兹堡睡眠问卷(PSQI)的评分改善情况。[结果]治疗12周后,与治疗前相比,试验组中医症状总积分明显降低(P<0.05);组间比较显示试验组总积分明显低于对照组(P<0.05)。在改善单项症状积分方面,两组与各自治疗前相比,试验组在改善肌肉疲劳、气短、胸闷、干咳的方面积分明显降低(P<0.05),对照组在改善肌肉疲劳、自汗盗汗方面的积分明显降低(P<0.05)。组间比较显示,试验组在改善肌肉疲劳、气短、心悸、胸闷、干咳上的积分较对照组积分明显降低(P<0.05)。mMRC量表评分结果显示,两组患者与治疗前相比,呼吸症状评分无明显变化(P>0.05)。Borg量表和PSQI量表结果显示,与治疗前相比,两组患者症状积分均明显下降(P<0.05),但组间比较差异无统计学意义(P>0.05)。[结论]体质贴联合八段锦康复治疗对气虚血瘀质新型冠状病毒感染恢复期患者的中医症状有改善作用,尤对肌肉疲劳、气短、心悸、胸闷、干咳改善明显,同时可以减轻患者疲劳,改善患者睡眠质量。