Modified Xiaochaihu Decoction for gastroesophageal reflux disease:A randomized double-simulation controlled trial

BACKGROUND Gastroesophageal reflux disease(GERD)has a high prevalence worldwide,and its incidence is increasing annually.Modified Xiaochaihu Decoction(MXD)could relieve the symptoms of GERD,but the effects of MXD on GERD manifestations and relapse prevention need to be further explained.Therefore,we performed a prospective,double-blind,and double-simulation study.AIM To verify the efficacy of MXD for GERD and its effect on esophageal motility.METHODS Using randomization,double-blinding,and a simulation design,288 participants with GERD were randomized to the treatment group and control group and received herbs(MXD)plus omeprazole simulation and omeprazole plus herbs simulation,respectively,for 4 wk.The GERD-Q scale score and esophageal manometry were measured at baseline,after treatment,and at 1 mo and 3 mo follow-up visits when medication was complete to evaluate recurrence indicators.RESULTS The GERD-Q scale score in both groups decreased significantly compared to those before treatment(P<0.01).However,no significant difference was observed between the two groups(P>0.05).Esophageal manometry showed that participants with lower esophageal sphincter pressure reduction and the proportion of ineffective swallowing(more than 50%)improved in both groups from baseline(P<0.01),especially in the treatment group(P<0.05).The percentage of small intermittent contractions,large intermittent contractions,and increased pre-phase contractions in the treatment group significantly improved compared with baseline(P<0.05)but did not improve in the control group(P>0.05).There was no significant difference between the groups after treatment(P>0.05).The percentage of weak esophageal contractility(distal contractile integral<450 mmHg·s·cm),improved in both groups(P<0.01),but no significant difference was observed between the groups after treatment(P>0.05).The relapse rate in the treatment group was lower than that in the control group at the 1 mo(P<0.01)and 3 mo follow-up(P<0.05).CONCLUSION MXD has a similar therapeutic effect to omeprazole in mild-to-moderate GERD.The therapeutic effect may be related to increased pressure in the lower esophageal sphincter and reduced ineffective swallowing.

New treatment for gastroesophageal reflux disease:Traditional Chinese medicine Xiaochaihu decoction

Gastroesophageal reflux disease(GERD)has a high prevalence worldwide.Li et al performed a well-designed study on the efficacy of modified Xiaochaihu decoction(MXD)for GERD,which showed that MXD is an optional therapy for GERD beyond proton pump inhibitors(PPIs).The herbal granule administration mode minimized the bias from traditional herbal formula in clinical trials.One limitation of that study was that it lacked records of side effects and rescue medication.As a chronic disease with recurrent symptoms,GERD rehabilitation requires prolonged observation of the clinical course with MXD therapy.

Systematic evaluation and Meta-analysis of the efficacy of Xiaochaihu Decoction in the treatment of chronic superficial gastritis

Objective:To compare the effectiveness of Xiaochaihu Decoction(XCHD)or the modified XCHD combined with western medicine in the treatment of superficial gastritis.Methods:We collected the studies about XCHD or the modified XCHD combined with western medicine for superficial gastritis in China Biology Medicine(CBM)Database(2010-2018),China National Knowledge Infrastructure(CNKI)Database(2010-2018),VIP Database(2010-2018),Wanfang Database(2010-2018)and the Back Issues Database of Hebei University.The randomized controlled trials(RCTs)were included in this study.The literatures were independently extracted by two researchers and the Cochrane Review Handbook(version 5.1.0)was applied to assess the quality of included trials.Statistical analysis was performed with RevMan(version 5.3).Results:A total of 8 RCTs,including 732 cases,were included finally.Meta-analysis results showed that compared with the western medicine treatment group,XCHD or the modified XCHD combined with western medicine could improve the total effective rate[OR=4.67,95%CI(2.90,7.55),P<0.00001],physiological function[MD=10,95%CI(8.78,11.23),P<0.00001],role physical[MD=13.85,95%CI(11.19,16.51),P<0.00001],physical pain[MD=11.64,95%CI(9.05,14.23),P<0.00001],general health[MD=11.20,95%CI(9.52,12.88),P<0.00001],vitality[MD=13.46,95%CI(12.30,14.62),P<0.00001],social function[MD=19.20,95%CI(17.32,21.09),P<0.00001],affection function[MD=30.3,95%CI(28.99,31.62),P<0.00001],mental health[MD=9.80,95%CI(8.44,11.16),P<0.00001].Conclusion:XCHD or the modified XCHD combined with western medicine in the treatment of superficial gastritis has good performance in clinical efficacy and the improvement of quality of life.However,with several methodology problems existing in the included RCTs,the effectiveness of XCHD or the modified XCHD is still need more high-quality randomized,double-blind,placebo-controlled trials to further confirmed.

Modified Xiaochaihu Decoction(小柴胡汤)Prevents the Progression of Chronic Pancreatitis in Rats Possibly by Inhibiting Transforming Growth Factor-β 1/Sma-and Mad-Related Proteins Signaling Pathway

Objective： To investigate the effect of modified Xiaochaihu Decoction （小柴胡汤, MXD） on transforming growth factor- [3 1/Sma- and Mad-related proteins （TGF- 13 1/Smads） signaling pathway in rats with chronic pancreatitis （CP） induced by dibutyltin dichloride. Methods： Thirty healthy male Wistar rats were randomly divided into the normal control group, CP group and CP＋MXD-treated group. CP was induced by injection of dibutyltin dichloride （DBTC, 7 mg/kg of body weight） into the right caudal vein, and the control rats were treated with vehicle. MXD was given daily by gavage at a dose of 10 g/kg of body weight, starting from the day after CP induction. After 28-day treatment, the n-benzoyl-tyrosyl para-aminobenzoic acid （NBT-PABA） test was carried out to evaluate exocrine pancreatic function. Then, rats were sacrificed, and pancreatic tissues were harvested for histological evaluation. In addition, the mRNA expression of TGF- β 1, TGF- β 1 type Ⅱ receptor （TGF β R 11 ）, Smad3 and Smad7 was determined in pancreatic tissues by using real-time polymerase chain reaction. Results： Treatment of CP with MXD improved the PABA recovery, decreased the histological lesion, and reduced the mRNA expression of TGF- β 1, TGF β R 11 and Smad3 （P〈0.05）. However, MXD had no effect on Smad7 mRNA level. Conclusions： MXD could protect the pancreas against chronic injury and improve pancreatic exocrine function in DBTC induced rat CP model. Its mechanism may involve inhibition of the TGF-β 1/Smads signaling pathway.

Modified Xiaochaihu Decoction(加味小柴胡汤) Promotes Collagen Degradation and Inhibits Pancreatic Fibrosis in Chronic Pancreatitis Rats

Objective:To investigate the effect of Modified Xiaochaihu Decoction(MXD,加味小柴胡汤)on collagen degradation in rats with chronic pancreatitis(CP).Methods:Rats were injected dibutyltin dichloride(DBTC,7 mg/kg of body weight)into the right caudal vein to induce CP model.Thirty heallhy male Wistar rats were randomly divided into three groups by a random number table:the control,the model and the treatment groups.Rats of treatment group were administered MXD(10 g/kg of body weight)orally once daily starting from the day post-model establishment.Pancreatic tissues were harvested after 28-day feeding and fibrosis was evaluated by picro-sirius red staining.The contents of collagen typeⅠandⅢwere detected using enzymelinked immunosorbent assay(ELISA),the expression of matrix metalloproteinase 13(MMP13)and tissue inhibitor of metalloproteinase 1(TIMP1)was analyzed by Western blot and real-time polymerase chain reaction(PCR).Results:The fibrosis scoring of pancreatic tissues,the concentrations of collagen typeⅠandⅢ,the expression levels of MMP13 and TIMP1 proteins and mRNA in the model group were all increased compared with the control group(P<0.05).After treatment with MXD,the fibrosis scoring of pancreatic tissues,the concentrations of collagen typeⅠandⅢ,the expression levels of MMP13 proteins and m RNA in the teatment group were all decreased compared with the model group(P<0.05),but there were no significant differences in the expression levels of TIMP1 proteins and m RNA(P>0.05).Conclusion:MXD could promote collagen degradation and reverse pancreatic fibrosis in CP rats via a mechanism involve up-regulation of MMP13 expression.

基于“脏腑别通”理论运用加味小柴胡汤结合捏脊法治疗心肌炎的实验研究

本研究旨在探明加味小柴胡汤结合捏脊法治疗心肌炎(MC)的作用机制。方法:将30只小鼠随机分成空白组、模型组、西药组、柴治组、捏治组、合治组共6组,每组5只。空白组不造模,其余各组均制成自身免疫性MC模型。各组施以相应处理7 d,结束后取心肌组织和血清分别检测肿瘤坏死因子-ɑ(TNF-ɑ)、白细胞介素-1β(IL-1β)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白T(cTnT)、Toll样受体4(TLR4)、核因子-κB p65(NF-κB p65)、B淋巴细胞瘤-2基因(Bcl-2)、Bcl-2相关X蛋白(Bax)、半胱氨酸天冬氨酸蛋白酶-3(Caspase-3)的含量及心肌切片观察。结果:中医各治疗组对阻断心肌TLR4/NF-κB p65炎症通路及抑制心肌细胞凋亡的作用均优于西药组(P<0.05),且合治组在降低NF-κB p65、TNF-ɑ、Bax、Caspase-3和升高Bcl-2中的作用较其余治疗组为优(P<0.05);同时,与西药组比较,各中医治疗组心肌切片显示心肌细胞排列紊乱均有不同程度改善,心肌间隙炎细胞浸润较少,以合治组表现最佳。结论:加味小柴胡汤结合捏脊法可能通过抑制心肌TLR4/核因子-κB(NF-κB)信号通路阻止心肌炎症反应,同时抑制凋亡因子减少心肌凋亡来发挥对MC的治疗作用;二者结合运用能发挥良好的协同作用。

加味小柴胡汤联合乌司他丁治疗重症急性胰腺炎的效果研究

目的探究加味小柴胡汤联合乌司他丁治疗重症急性胰腺炎(SAP)的临床疗效,及对患者肠道黏膜屏障功能标志物和炎症因子的影响。方法回顾性收集2020年4月——2022年11月湖北中医药大学附属武汉市中医医院收治的SAP患者临床资料进行研究,按照治疗方法分为加味小柴胡汤联合乌司他丁治疗组(双药组)和乌司他丁单药组(单药组)。单药组患者使用乌司他丁治疗,双药组在单药组基础上联合加味小柴胡汤治疗,持续治疗2周。比较两组治疗前后中医证候积分、急性生理与慢性健康(APACHE II)评分、肠道黏膜屏障功能、炎性因子水平及总有效率。结果共纳入SAP患者82例,其中双药组41例,单药组41例。单药组与双药组在治疗前的中医证候积分、APACHE II评分、血清二胺氧化酶(DAO)、D-乳酸、白细胞介素-6(IL-6)、C反应蛋白(CRP)及肿瘤坏死因子α(TNF-α)差异均无统计学意义(P>0.05),治疗后中医证候积分、APACHE II评分、血清DAO、D-乳酸、IL-6、CRP、TNF-α均降低(P<0.05),且双药组低于单药组(P<0.05)。经治疗后,双药组总有效率显著高于单药组[双药组vs.单药组:92.68%(38/41)vs.75.61%(31/41),P<0.05]。结论加味小柴胡汤联合乌司他丁较单用乌司他丁能显著改善SAP患者的临床症状、缓解病情进展、改善胃肠道黏膜屏障功能、降低炎性因子水平、提高临床疗效,值得临床广泛应用。

小柴胡汤加味联合中药热奄包治疗经行泄泻的临床研究

目的探讨小柴胡汤加味联合中药热奄包治疗经行泄泻的临床效果。方法选取2022年1月至2023年9月抚州市中医医院收治的60例经行泄泻患者作为研究对象,按随机数字表法分为对照组(30例)及观察组(30例)。对照组予以小柴胡汤加味治疗,观察组加用中药热奄包治疗,持续2周。比较两组的临床疗效、临床症状评分、泄泻改善时间、排便恢复正常时间、生活质量、心理状态及不良反应。结果观察组的总有效率高于对照组,差异有统计学意义(P<0.05)。观察组治疗后的腹痛、腹泻、腹胀、粪便性状积分分别为(0.53±0.12)、(0.69±0.14)、(0.43±0.08)、(4.01±0.49)分,均低于对照组的(0.79±0.15)、(0.95±0.18)、(0.57±0.11)、(4.84±0.53)分,差异有统计学意义(P<0.05)。观察组的泄泻改善时间、排便恢复正常时间分别为(1.58±0.23)、(2.35±0.32)d,短于对照组的(3.22±0.37)、(4.85±0.45)d,差异有统计学意义(P<0.05)。观察组治疗后的生活质量各领域评分分别为(89.65±5.32)、(90.41±4.25)、(88.74±5.33)、(91.32±3.57)分,高于对照组的(81.41±5.25)、(82.64±4.85)、(80.39±5.25)、(83.04±4.71)分,差异有统计学意义(P<0.05)。观察组治疗后的汉密尔顿焦虑量表(HAMA)评分、汉密尔顿抑郁量表(HAMD)评分分别为(7.03±1.05)、(8.12±1.13)分,低于对照组的(9.65±1.13)、(10.52±1.25)分,差异有统计学意义(P<0.05)。两组的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论小柴胡汤加味联合中药热奄包可提高经行泄泻治疗效果,减轻患者疾病症状,缩短排便恢复正常时间,纠正异常心理状态,改善生活质量,安全可靠。

加味小柴胡汤联合阿奇霉素治疗小儿支原体肺炎的效果及对患儿中医证候积分、炎症反应的影响

目的探究加味小柴胡汤联合阿奇霉素应用于小儿支原体肺炎患儿中的临床效果及对中医证候积分、炎症反应的影响。方法102例小儿支原体肺炎患儿,按随机数字表法分为对照组和观察组,每组51例。对照组给予阿奇霉素治疗,观察组在对照组基础上联合加味小柴胡汤治疗。对比两组中医证候积分、临床疗效、炎症指标[C反应蛋白(CRP)、白细胞介素-10(IL-10)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]、不良反应发生情况。结果治疗后,两组发热、咳嗽、气喘、咯痰痰鸣、痰黄粘稠、痰涎壅盛积分均较本组治疗前降低,且观察组发热、咳嗽、气喘、咯痰痰鸣、痰黄粘稠、痰涎壅盛积分分别为(1.13±0.17)、(1.12±0.20)、(0.93±0.15)、(1.05±0.19)、(0.83±0.11)、(1.16±0.12)分,较对照组的(1.89±0.26)、(1.93±0.31)、(1.62±0.19)、(1.68±0.22)、(1.58±0.24)、(1.83±0.15)分低(P<0.05)。观察组治疗总有效率96.08%较对照组的82.35%高(P<0.05)。治疗后,两组CRP、IL-10、IL-6、TNF-α水平均较本组治疗前降低,且观察组CRP、IL-10、IL-6、TNF-α水平分别为(5.69±0.73)mg/L、(13.19±2.56)ng/L、(20.06±1.35)ng/L、(10.75±1.42)μg/L,较对照组的(7.51±0.92)mg/L、(21.06±3.85)ng/L、(23.51±1.87)ng/L、(13.62±1.88)μg/L低(P<0.05)。两组不良反应发生率对比无差异(P>0.05)。结论加味小柴胡汤联合阿奇霉素治疗小儿支原体肺炎患儿效果显著,可有效减轻临床症状、炎症反应,且安全性高。

小柴胡汤加味联合常规疗法治疗感染后咳嗽邪郁少阳证的临床效果

目的:分析小柴胡汤加味联合常规疗法治疗感染后咳嗽邪郁少阳证的临床效果。方法:选取2020年10月—2023年10月湖南中医药大学附属常德医院收治的感染后咳嗽邪郁少阳证患者60例作为研究对象,经随机数字表法分为研究组和常规组,各30例。常规组给予可待因桔梗片联合氯雷他定片治疗,研究组在常规组基础上给予小柴胡汤加味治疗。比较两组临床治疗效果。结果:研究组治疗总有效率高于常规组,差异有统计学意义(P=0.037)。治疗前,两组咳嗽、咳痰、口干或口苦、咽干、咽痒、胸闷、咳引胁痛积分比较,差异无统计学意义(P>0.05);治疗后,两组咳嗽、咳痰、口干或口苦、咽干、咽痒、胸闷、咳引胁痛积分低于治疗前,且研究组低于常规组,差异有统计学意义(P<0.05)。研究组咳嗽症状消失时间短于常规组,差异有统计学意义(P<0.001)。结论:小柴胡汤加味联合常规疗法治疗感染后咳嗽邪郁少阳证的临床效果较好,能够减轻症状,促进患者康复。

2型糖尿病治疗中小柴胡汤加减的应用效果分析

目的探究2型糖尿病(type 2 diabetes mellitus,T2DM)治疗中小柴胡汤加减的应用效果。方法选取2022年1月—2023年12月福建省三明市尤溪县总医院中仙分院中医内科收治的120例T2DM患者为研究对象,按照治疗方法不同分为参照组和研究组,各60例。参照组进行西医治疗,研究组在参照组基础上辅以小柴胡汤加减治疗。比较两组血糖指标、胰岛功能指标、中医证候积分、临床疗效。结果治疗后,研究组空腹血糖、餐后2 h血糖、糖化血红蛋白、平均血糖波动幅度、空腹胰岛素、胰岛素抵抗指数均低于参照组,差异有统计学意义(P均<0.05)。治疗后,研究组中医证候积分低于参照组,治疗总有效率高于参照组,差异有统计学意义(P均<0.05)。结论小柴胡汤加减辅以常规西医疗法治疗T2DM可缓解症状,稳定血糖水平,改善健康状况,提升治疗效果。

小柴胡汤加减治疗慢传输型便秘临床疗效评价

目的:观察小柴胡汤加减治疗慢传输型便秘的临床疗效。方法:采用随机对照方法,将120例STC患者分为治疗组(小柴胡汤加减)与对照组(琥珀酸普芦卡必利片)各60例。观察比较两组患者便秘症状评分、结肠传输试验标记物排出数量,以及焦虑、抑郁自评量表评分评价临床疗效,并在疗程结束3个月后对患者进行随访。结果:(1)在改善便秘方面,治疗组有效率为79.3%,对照组有效率为72.4%,两组在改善便秘症状方面无明显差异;治疗组与对照组3个月后复发率有统计学差异。(2)在改善焦虑抑郁方面,治疗组优于对照组,有统计学差异。结论:小柴胡汤加减治疗慢传输型便秘可有效改善便秘症状,与琥珀酸普芦卡必利效果相当,临床疗效肯定,远期疗效较西药好。此外,小柴胡汤加减同时能有效改善患者焦虑抑郁心理状态,缓解焦虑、抑郁的情绪优于琥珀酸普芦卡必利,提高生活质量,体现中医优势。

加味小柴胡汤及其有效物质部位群抗炎实验研究

目的对加味小柴胡汤及其有效物质部位群进行抗炎活性实验研究,确定其有效物质部位群,以期阐述其药效物质基础,为该经典方剂治疗慢性胃炎的临床疗效提供科学实验依据。方法将加味小柴胡汤复方视为整体,采用系统溶剂法将其提取分离为挥发油、多糖、生物碱、酚酸类、皂苷类等化学物质部位;采用二甲苯致小鼠耳廓肿胀和角叉菜胶致大鼠足趾肿胀抗炎实验动物模型,对该方剂及其各物质部位进行抗炎实验研究。结果二甲苯致小鼠耳廓肿胀模型实验研究结果表明,与模型组比较,全方高及低剂量组、皂苷部位高及低剂量组、多糖部位高剂量组均能极显著抑制小鼠耳肿胀(P<0.01);酚酸类物质部位高剂量组能显著抑制小鼠耳肿胀(P<0.05)。角叉菜胶致大鼠足趾肿胀模型实验结果表明,与模型组比较,全方高及低剂量组、皂苷部位高及低剂量组、酚酸类物质部位高剂量组均能极显著地减轻大鼠足趾肿胀(P<0.01);多糖部位高剂量组能显著减轻大鼠足趾肿胀(P<0.05)。结论确定了加味小柴胡汤及其有效物质部位群的抗炎作用,从而为该临床经验方治疗慢性胃炎提供了现代药理学实验依据。

加味小柴胡汤对乙肝病毒转基因小鼠白介素-12、白介素-4、干扰素-γ mRNA表达的影响

目的:通过实验研究观察加味小柴胡汤对HBV转基因小鼠IL-12、IL-4、IFN-γmRNA表达的影响。方法:36只经筛选HBV DNA阳性的转基因小鼠随机分为3组,每组12只,中药组给予加味小柴胡汤水煎剂、西药组给予拉米夫定、空白对照组(简称盐水组)给予生理盐水,观察各组实验动物血清IL-12、IL-4和肝组织中IFN-γmR-NA活性的变化情况。结果:对IL-12、IL-4活性的影响,与盐水组和西药组比较,给药后中药组小鼠血清IL-12明显升高,而IL-4显著降低,差异有显著性意义(P<0.01,P<0.05);而对小鼠肝组织IFN-γmRNA的表达,中药组与盐水组和西药组比较,差异均有显著性意义(P<0.01)。结论:加味小柴胡汤有明显的调节和改善HBV转基因小鼠IL-12、IL-4、IFN-γmRNA活性的作用。

《伤寒论》经方小柴胡汤加减治疗亚健康病症的研究

目的:探究《伤寒论》经方小柴胡汤用于亚健康病证的治疗效果。方法:选取2017年8月—2018年6月来就诊的亚健康病证患者260例,根据随机数字表法将其分为对照组及观察组,每组各130例患者。对照组患者采用常规治疗,观察组患者运用《伤寒论》经方小柴胡汤进行治疗。对比分析两组患者治疗前后睡眠质量、疲劳状态、中医亚健康症状评分;对比治疗后两组亚健康量表各因子评分变化情况。结果:治疗后,两组患者睡眠质量、疲劳状态均优于治疗前,且观察组患者睡眠质量评分(156.02±15.34)、疲劳状态评分(65.10±12.72)明显低于对照组睡眠质量评分(200.79±16.46)、疲劳状态评分(80.89±14.15),差异有统计学意义(P<0.05);观察组患者精神不振、失眠多梦、胸闷气短、倦怠乏力、头晕头重、自汗多汗、食欲不振、心烦易怒等症状评分明显低于对照组,差异有统计学意义(P<0.05)。观察组患者疲劳、躯体不适、负性情绪因子评分明显低于对照组,而睡眠、小便、消化功能、正性情绪、能力及社会关系因子则明显高于对照组,差异有统计学意义(P<0.05)。结论:《伤寒论》经方小柴胡汤用于治疗亚健康病症的效果显著,提高患者睡眠质量,缓解疲劳状态,改善亚健康症状,临床意义重大。

加味小柴胡汤对系统性红斑狼疮患者临床症状及免疫生化指标的影响

目的探讨加味小柴胡汤对系统性红斑狼疮(SLE)患者的临床疗效及对免疫生化指标的影响。方法选择2014年2月至2017年2月期间收治的80例SLE患者,随机分为对照组和治疗组,各40例。对照组患者给予泼尼松联合环磷酰胺治疗,治疗组患者给予加味小柴胡汤联合泼尼松、环磷酰胺治疗,两组患者均连续治疗8周。评价并比较两组患者临床疗效。比较两组患者治疗前后的中医证候积分,检测并比较两组患者治疗前后红细胞沉降率(ESR)、血清C-反应蛋白(CRP)、补体C3及补体C4水平。结果治疗组患者治疗后的总有效率为90. 00%,明显高于对照组的65. 00%,差异具有统计学意义(χ2=7. 168,P=0. 007,P <0. 01)。治疗后,两组患者血清ESR、CRP水平均明显低于治疗前,两组患者血清C3、C4水平均明显高于治疗前,且治疗组患者ESR、血清CRP、C3及C4水平变化优于对照组,差异均有统计学意义(P <0. 05)。治疗后,两组患者中医证候积分均明显低于治疗前,且治疗组降低更为显著,差异均有统计学意义(P <0. 05)。治疗过程中,治疗组患者的不良反应发生率明显低于对照组,差异有统计学意义(χ2=10. 323,P=0. 001,P <0. 01)。结论加味小柴胡汤联合泼尼松、环磷酰胺治疗SLE患者临床疗效显著,有助于患者免疫功能的恢复,且安全性较好,值得在临床上推广应用。

加味小柴胡汤对顺铂诱导BRL细胞核转录因子和热休克蛋白70表达的影响

目的观察加味小柴胡汤对顺铂诱导的大鼠肝BRL细胞核转录因子-kB(NF-kB)、热休克蛋白70(HSP70)表达的影响。方法将BRL细胞分为4组:空白组、顺铂组及加味小柴胡汤大、小剂量组。采用完整细胞蛋白质斑点印迹、免疫组织化学等方法,检测各组细胞NF-kB、HSP70变化。结果顺铂组NF-kB表达明显较空白组升高,HSP70表达降低,组间比较差异有统计学意义;加味小柴胡汤大、小剂量组NF-kB明显较顺铂组低,差异有统计学意义;加味小柴胡汤大、小剂量组HSP70表达均升高,但仅加味小柴胡汤大剂量组差异明显。结论加味小柴胡汤可下调顺铂诱导的BRL细胞NF-kB表达,上调HSP70表达,此作用可能是该方减轻细胞氧化损伤、抑制细胞凋亡重要机理之一。

加味补阳还五汤对周围神经再生的形态学实验研究

用钳夹法造成大鼠腓总神经损伤动物模型,灌胃给加味补阳还五汤进行治疗。研究结果显示:用药组再生神经轴索数和损伤神经再生率明显高于对照组P<0.05～0.01;用药组类似正常结构的髓鞘数目多;雪旺氏细胞增殖活跃;失神经肌萎缩程度轻。表明加味补阳还五汤对神经纤维再生、雪旺氏细胞活跃增殖、髓鞘形成及结构完整有明显促进作用。对失神经性肌萎缩有改善作用。为用中医中药治疗神经损伤提供了科学依据。

加减小柴胡汤治疗儿童过敏性鼻炎理论探析

儿童过敏性鼻炎为正气不足,卫阳不固,腠理疏松,外邪乘虚而入,阳气无从泄越,导致气机不畅,津液停于鼻窍而形成本病。加减小柴胡汤,寒温并用,升降并行,攻补兼施,和畅气机,扶正驱邪,为和解之剂。苦寒调畅气机,宣通表里,辛温疏郁达邪,扶正驱邪,使肺之宣降有序,脾胃和降有因,肾纳气有根,则过敏性鼻炎自愈。

加味小柴胡汤治疗小儿支原体肺炎临床研究

目的:观察加味小柴胡汤治疗小儿支原体肺炎的疗效及对患者炎症反应、免疫功能及不良反应的影响。方法:选取2017年6月^2018年7月收治的小儿支原体肺炎患者102例,采用随机数表法将患者分为两组,每组51例。对照组患者接受大环内酯类抗生素治疗,观察组患者在对照组的基础上服用加味小柴胡汤,10天后比较两组患者的疗效、中医症候积分、临床指标改善时间、炎症反应指标、免疫指标及不良反应发生情况。结果:观察组患者治疗总有效率及治疗后CD3^+、CD4^+、CD4^+/CD8^+较对照组高(P<0.05);治疗后观察组患者中医症候积分、CRP、IL-6、TNF-α水平及不良反应发生率较对照组低(P<0.05);观察组患者发热、咳嗽、喘息症状消失及胸片恢复时间均较对照组明显缩短(P<0.05),两组患者肺部啰音消失时间无显著性差异(P>0.05)。结论:加味小柴胡汤治疗小儿支原体肺炎可提高疗效,改善中医症候,提高免疫功能,降低机体炎症反应及不良反应发生率,促进患者康复。