Experience of Professor Chen Xiao-hu in treating"Double Heart Disease"with the method of activating blood and soothing the mind

"Double Heart Disease",that is,patients with cardiovascular disease often have mental and psychological disorders such as anxiety and depression.Professor Chen Xiao-hu is guided by the holistic concept of Chinese medicine and based on the dual physiological functions of the heart as the main blood vessel and the main god.He believes that the internal resistance of blood stasis and mental disturbance are the core pathogenesis of"Double Heart Disease".Advocating the use of activating blood to calm the nerves to treat"double heart disease",and taking advantage of the overall adjustment of traditional Chinese medicine to achieve the purpose of harmonizing viscera and balancing Yin and Yang.The article summarizes Professor Chen Xiao-hu's experience in using the method of activating blood to soothe the nerves to treat"Double Heart Disease",with a view to clinical treatment Provide new ideas.

A summary of research on benefiting Qi and activating blood to regulate mitophagy to prevent and treat ischemic heart disease

Ischemic heart disease has the characteristics of high morbidity and high mortality, which seriously endangers people's health. Mitophagy can selectively remove damaged organelles, and has a role in maintaining the homeostasis of myocardial cells and protecting ischemic myocardium. Significance. More and more studies have found that traditional Chinese medicine can improve ischemic damage of cardiomyocytes by regulating mitochondrial function and autophagy. Using mitochondria as the target of traditional Chinese medicine in cardiomyocytes to explore the treatment of ischemic Effective measures for heart disease have become a hotspot for related Chinese medicine workers. Based on the above background, this article outlines the main regulatory pathways of mitochondrial autophagy, and reviews related researches on traditional Chinese medicine of benefiting qi and activating blood and mitophagy in this field.

Pharmacological effects of Paeoniflorin and Albiflorin on IL-3, GM-CSF, IL-6 and TNF-α in the rats of syndrome of stagnation of liver qi and blood deficiency

Objective： To observe the effect of paeoniflorin （PF）, albiflorin （AF） on the hemogram, visceral index and hematopoiesis cytokine in the rats of syndrome of stagnation of liver qi and blood deficiency, and to discuss the material base and mechanism of effect of nourishing blood and smoothing the liver of Baishao （Radix Paeoniae Alba）. Methods： Male SD rats were randomly divided into groups according to the sucrose preference test and body weight （n = 12）. Except the normal control, the other groups were treated with the chronic stress stimulation combined with radiation respectively to establish the model of syndrome of stagnation of liver qi and blood deficiency. The body weight, visceral index and the quantity of Leucocyte, Red Blood Cells, Hemoglobin in peripheral hemogram were monitored, then plasma and serum were separated. Radioimmunoassay was used to analyze the levels of Lnterleukin-3, Granulocyte-macrophage Colony-stimulating Factor, Lnterleukin-6 and Tumor Necrosis Factor-α in plasma. Results： Compared with that of model group, 30 mg·kg^-1 PF and 30 mg·kg^-1 AF of the weight, spleen index, quantity of Leucocyte were increased significantly （P 〈 0.05, P 〈 0.01）. The results of Radioimmunoassay showed that the levels of Interleukin-3 increased （P 〈 0.05, P 〈 0.05） and the levels of Tumor Necrosis Factor-α decreased in both 30 mg·kg^-1 PF and 30 mg·kg^-1 AF groups （P 〈 0.05, P 〈 0.05）. Conclusion： The effect of PF and AF on the regulation of bone marrow hematopoietic system and immune system play a role in the blood of rats with syndrome of stagnation of liver qi and blood deficiency, which suggests that both of them are the main active ingredients of nourishing blood and smoothing the liver of Baishao.

Can Sitaglipten Attenuate Hypertension, Myocardial Changes and Vascular Reactivity Induced by Long Term Blockade of Nitric Oxide Synthesis in the Rat?

Background: Glucagon-like peptide-1 (GLP-1) is an incretin hormone with insulinotropic properties that regulates glucose metabolism. GLP-1 receptors are the most extensively key modulators of lipid and glucose homeostasis. They are predominantly expressed in adipose tissues, some non adipose tissues including heart, kidney, spleen, and all relevant cells of the vasculature: endothelial cells, smooth muscle cells, and macrophages. The vascular distribution suggests their involvement in the control of cardiovascular function. Objective: The present experiment was designed to study the effect of sitaglipten alone or in combination with captopril on blood pressure, antioxidant enzymes, vascular reactivity and cardiac hypertrophy in NG-nitro-L-arginine methylester (L-NAME) induced hypertension in rats. Methods: One hundred male albino rats weighing from 150 - 200 g were included in this study. Rats were divided into two main groups. Group I, (20 rats) served as a control group for group II, and received 1 ml of physiological saline (0.9%), orally for seven weeks. Group II: hypertensive group, (80 rats) was given daily L-NAME in a dose of 40 mg/kg orally for seven weeks. Rats were further subdivided into A, B, C, and D, each of 20 rats. Group-A, received 1 ml of distilled water daily orally for six weeks, starting one week after L-NAME administration. Groups B, C and D were treated with daily sitaglipten (10 mg/kg b.wt. orally) and captopril (100 mg/kg b.wt. orally), alone or together for six weeks. Blood pressure, serum tumor necrosis factor-α (TNF-α), body weight (BW) and heart weight (HW) were measured. Malondialdehyde (MDA) and reduced glutathione (GSH) were estimated in cardiac tissues. Thoracic aorta was isolated and the aortic rings were allowed to achieve maximal tension by cumulative addition of phenylephrine (PE) (10-9-10-5 M) to the bath solution. Results: Sitaglipten and captopril, alone or together produced significant decreases in blood pressure and TNF-α. Higher oxidative stress accompanying hypertension was significantly reduced by sitaglipten and captopril treatment. The results showed that both drugs significantly attenuated the augmented contractile response to PE in hypertensive rats. In addition, they inhibited the cardiac hypertrophy (reduction in HW/BW ratio). Conclusion: These data suggest that DPP4 inhibitor (sitaglipten) “is away from being insulinotropic and regulates glucose metabolism”, contributes to normal regulation of blood pressure and exerts protective effects in hypertension via many mechanisms, as inhibition of generation of free radicals.

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。

基于“脑-骨连接”关系的补肾活血治法在骨质疏松症中的研究进展

骨质疏松症是临床最常见的代谢性骨病之一,是我国乃至全世界亟需解决的问题,西医在该病的治疗上缺乏安全且有效的方法,当今越来越多的学者将目光转移到中医药治疗上来。骨质疏松症属于中医“骨痿”范畴,其中医证型复杂多样,传统理论认为其病机以“肾虚为本,血瘀为标”,治疗上以“补肾活血”为主。本文首先论述了肾虚血瘀型骨质疏松症的致病机制,并在此基础上拓展了“脑-骨连接”新的理论关系。治疗上突破传统治疗理论,提出补肾活血汤一方面通过“肾-髓-骨”路径直接改善骨质疏松,另一方面通过调节中枢神经系统,即通过“肾-髓-脑-骨”路径,从而间接改善骨质疏松症的治疗新策略,以期论证从脑治骨的治疗新路径,发挥中医药的特色和优势,完善中医药理论体系,为预防和治疗骨质疏松症提供临床指导,为进一步的研究提供思路。

Effect of Chinese Herbal Medicine for Nourishing Yin,Supplementing Qi,and Activating Blood on the Th1/Th2 Immune Balance in Peripheral Blood in Patients with Primary Sjogren's Syndrome

Objective： To observe the effect of Chinese herbal medicine for nourishing yin, supplementing qi, and activating blood on the expression of interferen- γ （IFN-γ,）/interleukin-4 （IL-4） in peripheral blood and disease activity in primary Sjogren＇s syndrome （pSS） patients, and to study the relationship between the immune balance of Th1/Th2 and the disease activity. Methods： A total of 66 pSS patients were randomized with tossing coins method into two groups： the integrative therapy group （34 cases） and the control group （32 cases）; and 28 healthy subjects were taken as the normal group. The integrative therapy group was treated by Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood combined with hydroxychloroquine sulfate tablets and the control group was treated with hydroxychloroquine sulfate tablets. The treatment course was 3 months for both groups. The levels of serum immunoglobulin G （IgG）, erythrocyte sedimentation rate （ESR）, IFN-γand IL-4 in peripheral blood were measured before and after treatment. Results： Compared with the normal group, the levels of IgG, ESR, IFN- γ and IL-4 were significantly increased in pSS patients （P〈0.05）. Remarkably, after 3 months of treatment, these levels were dramatically decreased in both the integrative therapy group and the control group, although still higher than the normal group. The levels of IgG, ESR, IFN- and IL-4 in the integrative therapy group were lower than the control group and the same group before treatment （P〈0.05）. The ratio of IFN-γ/IL-4 also significantly decreased after treatment. Moreover, the level of IFN- γ, and the ratio of IFN- γ/IL-4 in the integrative theraphy group were significantly lower than the control group （P〈0.05）. For all patients the ratio of IFN-γ/IL-4 before and after treatment was positive correlated with the levels of IgG and ESR. Conclusion： Chinese herbal medicine for nourishing yin, supplementing qi, and activating blood can alleviate the disease activity of pSS by regulating the immune balance of Th1/Th2.

Protective Effect of Chinese Herbs for Supplementing Qi,Nourishing Yin and Activating Blood Circulation on Heart Function of Patients with Acute Coronary Syndrome after Percutaneous Coronary Intervention

Objective： To investigate the effects of Chinese herbs for supplementing qi, nourishing yin and activating blood circulation on heart function of patients with acute coronary syndrome （ACS） after successful percutaneous coronary intervention （PCI）. Methods： One hundred patients with ACS after successful PCI were randomly assigned to a Western medicine （WM） treatment group （WMG） and a combined treatment group （CMG） treated by Chinese herbs for supplementing qi, nourishing yin and activating blood circulation, besides Western medicine treatment, with 50 cases in each group. Both treatment courses were 6 months. The follow- up was scheduled at baseline, 6 months and 1 year after PCI, and New York Heart Association （NYHA） functional class, Chinese medicine （CM） symptom scores, blood stasis syndrome scores, and major adverse cardiovascular events （MACE） were observed, serum levels of N-terminal pro-brain natriuretic peptide （NT-proBNP） and hyper-sensitivity C-reactive protein （Hs-CRP） were measured, an echocardiogram was conducted to examine left ventricular ejection fraction （LVEF）, left ventricular end-diastolic volume （LVEDV）, left ventricular end-systolic volume （LVESV）, inter-ventricular septal thickness （IVST）, left ventricular posterior wall thickness （LVPWT）, and ventricular wall motion index （VWMI）. Results： Compared with the baseline, LVEF significantly increased （P〈0.01）, and CM symptom scores, blood stasis syndrome scores, VWMI, LVEDV, LVESV, NT-proBNP, and Hs-CRP all decreased （P〈0.01） in both groups at 6 months and at 1 year after PCI. There were no significant differences in all the above parameters at 1 year vs those at 6 months after PCI （P〉0.05）. VWMI, LVEDV, LVESV, NT-proBNP, Hs-CRP, LVEF, and CM symptom and blood stasis syndrome scores were all improved obviously in CMG than those in WMG （P〈0.05 or P〈0.01） at 6 months and at 1 year after PCI. There were no significant differences in NYHA functional class between CMG and WMG at different follow-up timepoints; it was notable that P value was 0.054 when comparing the cases of NYHA functional class between the two groups at 1-year follow-up. During the 1-year follow-up, 3 MACE and 11 MACE occurred in CMG and WMG, respectively; the MACE rate in CMG was lower than that in WMG （6% vs 22%, P〈0.05）. Conclusion： Chinese herbs for supplementing qi, nourishing yin and activating blood circulation could improve heart function, reduce the CM symptom scores and blood stasis syndrome scores, and decrease the incidence of MACE in patients with ACS after successful PCI.

基于气阴两虚夹瘀运用五参汤治疗肺癌术后发热浅析

肺癌术后发热有非感染性发热与感染性发热之分,在气虚、阴虚、瘀血阻滞病理状态下形成热蕴状态,是为非感染性发热;而术中感染或外感风寒入里化热则形成感染性发热表现。其基本病机均可概括为气阴两虚夹瘀。五参汤具有益气养阴、清热解毒之功,为证属正气亏虚、外感邪毒者而设,用于肺癌术后发热契合其病机。

冠状动脉粥样硬化性心脏病肾虚血瘀证理论源流及临床应用

冠状动脉粥样硬化性心脏病(CHD)是心血管疾病死亡的首要原因,是我国乃至全球亟待解决的重大公共卫生问题。目前的医学研究发现,CHD与慢性肾脏疾病相关,慢性肾脏疾病的许多常见指标是CHD发生发展的独立危险因素,控制肾脏疾病的进展或成为防治CHD的新思路。中西医结合防治CHD具有确切疗效。中医认为心肾生理相关、病理相通,随着社会生活方式的改变,CHD的中医证候不仅呈现出血瘀证,“肾虚血瘀”证的组合形式逐渐增多,成为CHD形成过程中的重要证候组合。本研究旨在梳理和探讨CHD肾虚血瘀证的理论源流与临床应用,以期为提高CHD的中医药防治水平提供理论依据。

Effects of Chinese herbs capable of replenishing qi, nourishing yin and activating blood circulation and their compatibility on differentially expressed genes of ischemic myocardium

This study was conducted to investigate the effects of Chinese herbs capable of replenishing qi, nourishing yin and activating blood circulation and their compatibility on differentially expressed genes of ischemic myocardium which were selected from differential expression profile we had established before, and to explore the underlying mechanism. The acute myocardial infarction (AMI) model was established by ligating the left anterior descending (LAD) coronary artery, then the model rats were randomly divided into the model group, the Metoprolol group, the replenishing qi nourishing yin (RN) group, the activating blood circulation (AB) group, and the replenishing qi, nourishing yin and activating blood circulation (RA) group. In addition, the normal group and the sham group were set up. The rats of medication groups were administered by intragastric gavage with corresponding drugs on the second day after operations, and the rats of the normal group and the sham group were given normal saline as the same time.Then the ischemic hearts were harvested on the 8th day after operation. The myocardial pathomorphological changes were observed under a light microscope. The mRNA changes of target genes such as COX5a and ATP5e were detected using Realtime fluorescence quantitative PCR (QPCR), and the activities of related enzymes were detected by colorimetric assay. The main results were as follows: the histological changes were observed by HE staining, and cardiocyte swelling, inflammatory cell infiltration and cytolysis were showed in regional ischemic myocardium of the model group, while the pathomorphological changes in all medication groups did not show obvious changes. Two genes related to energy metabolism, COX5a and ATP5e, were selected as the target genes which were downregulated at the mRNA level in the medication groups. The activities of correlative functional enzymes also decreased in the RA group compared to that in the model group accordingly (P<0.05). The results indicated that the abnormal expression of genes involved in energy metabolism pathways could be one of the molecular mechanisms of AMI. The compatibility of Chinese herbs capable of replenishing qi, nourishing yin and activating blood circulation affects the expression of energyrelative gene COX5a, ATP5e, which is probably the mechanism of myocardial preservation, and is more effective than single herb of replenishing qi and nourishing yin or activating blood circulation.

基于Citespace的益气活血类方治疗心力衰竭临床研究的可视化分析

目的总结益气活血类方治疗心力衰竭临床研究的热点演变及研究不足,并且预测发展趋势。方法检索中国知网和Web of Science数据库(CNKI)建库至2022年11月1日期间有关益气活血类方治疗心力衰竭的相关临床研究文献,借助CiteSpace 6.1R4软件来完成文献研究作者、机构、关键词等可视化研究分析。结果1988—2022年有关益气活血类方治疗心力衰竭的文章整体呈波动上升趋势。发文最多的作者为张艳,辽宁中医药大学(含附属医院)、北京中医药大学(含附属医院)等机构的发文数量较多。根据高频关键词可知研究热点主要集中于证型(气虚血瘀等)、治法(益气活血、活血利水、益气温阳等)、疗效评价标准(心功能、生活质量、脑钠肽等)、合并疾病(冠心病等)。关键词突变、时间线图综合分析显示,益气活血类方治疗心力衰竭的治疗方式、评价标准都呈现多元化趋势。文献横向分析提示,目前临床报告规范仍存在较大的提升空间,疗效评价指标描述存在偏于主观等问题。结论益气活血类方治疗心力衰竭的相关临床研究领域,不同研究机构、团队间的合作仍需进一步加强,以便开展多中心大样本的高质量研究;心力衰竭的证型、治法、疗效评价标准以及合并疾病是目前的研究热点,但在临床报告规范方面仍有待完善,建议制定客观、科学的诊疗标准及报告规范,进一步探索中医或中西医结合治疗心力衰竭的临床优势。

中医药益气温阳、活血利水法治疗慢性心力衰竭作用机制的研究进展

综述中医药益气温阳、活血利水法治疗慢性心力衰竭作用机制的研究进展。慢性心力衰竭可依据阳气虚弱、心血瘀阻、水饮内停的病机,采用中医药益气温阳、活血利水法治疗。研究显示,该法治疗慢性心力衰竭的临床疗效显著,其机制主要与改善心肌纤维化及心室重构、调节氧化应激反应、改善血流动力学障碍与心肌能量代谢、干预相关信号通路、缓解利尿剂抵抗等有关。

基于络病学说探讨小儿慢性荨麻疹的辨治规律

慢性荨麻疹是儿科临床上常见皮肤病之一,属于皮肤黏膜血管反应性疾病,常反复发作,危害儿童的身心健康。其发病、演变及预后和络病学说密不可分。现从络病学说角度总结小儿慢性荨麻疹的基本病机为禀赋不耐,风邪搏于肌腠,营卫失和,络脉受损而发。初期治疗方法应以祛邪通络为主,以祛除风邪为要,同时可结合运用散寒、清热、解毒、除湿等法以疏经通络,祛内邪,通达络脉;结合心部于表理论,注重调理心;恢复期应以扶正养络为要,以固本扶正、祛邪兼顾。无论在早期或后期治疗过程常贯穿活血化瘀法。

活血通络类方剂治疗糖尿病肾脏疾病的研究进展

糖尿病肾脏疾病(DKD)是导致慢性肾脏病和终末期肾病的首要病因,严重危害人类健康。中医认为血瘀是贯穿DKD全病程的重要病机,多项研究拟定了多个活血通络类方治疗DKD患者,其临床症状好转、蛋白尿减少、肾功能保护、治疗有效率提高和疾病进展延缓等方面均有成效。

吴伟基于“瘀毒致悸”辨治房颤思路探讨

吴伟教授在辨治房颤过程中,创新性地提出“心-血-脉三位一体论”与“瘀毒致悸”论。认为房颤由瘀毒所致,其病位在心-血-脉,核心病机为“气滞血瘀毒成”。治法当紧扣病机,提倡“从瘀论治,兼以解毒,缓消其毒”,且认为理气活血化瘀便是解毒。方拟桃仁红花煎加减,主要组成药物有桃仁、红花、川芎、延胡索、生地黄、赤芍、丹参、大枣、葛根、甘松、牡蛎、茯苓、玉竹等,并根据岭南之气候与房颤多影响情志之特点,去方中辛烈之品,而加特色解毒药对葛根-甘松以辨病而治。吴伟教授治疗房颤还常配合沐足、针灸、导引等中医外治法和保健法,全面调理,缓消其毒,以复其元。吴伟教授治疗房颤采用中医药精准干预,综合调理,可达到促进症状消失及恢复窦性心律、改善体质等目的,其辨治思路可为房颤的中医药治疗提供参考。

司徒仪辨治子宫内膜异位症规律的数据挖掘

【目的】基于个性化知识图谱分析和数据挖掘技术,探讨广东省名中医司徒仪教授辨治子宫内膜异位症(endometriosis,EMs)规律,为EMs的中医诊疗提供参考。【方法】基于EMs诊治的文献研究基础,采用人机结合方法建立名医理法方药本体知识树;采集司徒仪教授于2013年至2019年在广东省中医院门诊诊治的EMs患者的病历,对采集的病案信息进行规范化处理后,形成知识集,构建EMs的中医药诊疗知识图谱,分析疾病特征与用药规律。【结果】EMs患者的核心症状群为痛经、慢性盆腔痛、不孕,证候以血瘀为核心,气滞、肾虚、气虚为主要病机。频繁项集分析得到的核心药物组合有“延胡索-香附-白芍”“枸杞子-桑寄生-茯苓-山药”“枳壳-益母草”等。基于知识元聚类和神经网络算法而构建的EMs词云图显示,丹参-赤芍、延胡索-郁金、桂枝-牡丹皮-赤芍-茯苓、丹参-赤芍-三棱-莪术、川芎-延胡索、桑寄生-菟丝子等为司徒仪教授治疗EMs的常用药物组合。有关中药、症状、证型之间的层次聚类分析和关联网络构建结果显示,证型、症状、用药间存在复杂的内在联系。【结论】司徒仪教授治疗EMs以活血化瘀、补肾为主要治疗方法,同时顺应月经周期,攻补兼施。基于语义网络的知识图谱分析与数据挖掘有助于将司徒仪教授的临床诊治经验的隐性知识显性化,可为EMs的中医辨治提供借鉴。

芎芍胶囊治疗冠心病心绞痛临床疗效及安全性的系统评价

目的:系统评价芎芍胶囊治疗冠心病心绞痛的临床效果及安全性。方法:计算机检索Web of SCI、PubMed、EMbase、the Cochrane Library、万方数据资源系统(WanFang Database)、维普中文科技期刊全文数据库(VIP)、中国知网(CNKI)、中国生物医学文献服务系统(SinoMed)等数据库,纳入芎芍胶囊对比单独使用常规西药或血府逐瘀胶囊干预冠心病心绞痛的随机对照试验研究(RCT)。由2位评价者独立筛选提取文献资料、评定偏倚风险,使用RevMan 5.3进行Meta分析。结果:纳入12项研究,涉及1309例病人。Meta分析结果显示,试验组在提高临床总有效率[RR=1.17,95%CI(1.11,1.23),P<0.00001]、提高心电图疗效[RR=1.22,95%CI(1.09,1.36),P=0.0003]、降低三酰甘油(TG)[MD=-0.19,95%CI(-0.35,-0.04),P=0.02]、升高高密度脂蛋白胆固醇(HDL-C)[MD=0.13,95%CI(0.07,0.19),P<0.0001]方面均优于对照组,而两组在减低总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及不良反应发生率方面比较差异无统计学意义(P>0.05)。结论:现有证据表明,芎芍胶囊治疗冠心病心绞痛的临床效果明确,安全性较好。

毛静远教授治疗心肌桥致难治性心绞痛经验

心肌桥导致的难治性心绞痛常给患者带来沉重的躯体和精神负担,中医药治疗能够进一步改善症状,提高生活质量。现总结毛静远教授治疗心肌桥致难治性心绞痛经验,毛教授认为该病病机以血瘀为始动环节,因实致虚,本虚以阴虚为主,血瘀、痰热为标,治疗应注重养阴,兼用活血、化痰、清热,同时须注意顾护调理,避免心衰等并发症的发生。

基于心脏稳态失衡探析高血压心脏病从虚和瘀论治内涵

高血压心脏病是高血压病常见的靶器官损害,是阴阳虚损、瘀久内结的结果,与心脏稳态失衡机制有共通性。本文结合现代医学与传统医学对高血压心脏病的认识,提出以潜阳育阴、调和气血为法,从虚和瘀论治高血压心脏病。