Clinical research progress of oral administration of traditional Chinese medicine in the treatment of dry eyes

Dry eye is a common and frequently occurring ophthalmology disease with complex etiology and easy recurrence.Oral administration of traditional Chinese medicine has the characteristicsof high curative effect and little toxic and side effect in the treatment of dry eye.This paper collates the domestic reported clinical studies on the oral administration of traditional Chinese medicine in the treatment of dry eye,which are discussed from four aspects:special prescription for specific disease,addition and subtraction of main prescription,treatment based on syndrome differentiation and proprietary Chinese medicine.The curative effect and advantages of traditional Chinese medicine in the treatment of dry eye are demonstrated,providing a reference for the treatment of dry eye in the future.

Therapeutic Effect of Oral Administration and External Therapy of Traditional Chinese Medicine on Cervical Tuberculous Lymphadenopathy

Objective:To analyze the clinical effect and value of oral administration and external therapy of traditional Chinese medicine for treatment of cervical tuberculous lymphadenopathy.Methods:A total of 56 patients with cervical tuberculous lymphadenopathy admitted to our hospital from January 1 to January 2018 were recruited.By using double-blind method,the patients were divided into control group(n=28)and experimental group(n=28).Control group comprised of patients with conventional anti-tuberculosis treatment,while the experimental group comprised of patients treated with oral administration and external therapy of traditional Chinese medicine.Total effective rate,incidence of complication and level of T lymphocyte subsets were compared between the two groups of cervical tuberculous lymphadenopathy patients.Results:Post-treatment data of total effective rate,complication rate,CD3+,CD4+,CD8+,CD4+/CD8+of the experimental group were compared with the control group.P<0.05;statistical analysis showed statistical significance.Post-treatment data of CD3+,CD4+,CD8+,CD4+/CD8+of both control and experimental groups were compared with pre-treatment data.P<0.05;statistical analysis showed statistical significance.Conclusion:Oral administration and external therapy of traditional Chinese medicine possesses significant effect in treatment of cervical tuberculous lymphadenopathy.

New therapy for oral ulcer:Evodia rutaecarpa patch combined with acupoint application

Background:Oral ulcer is the most common and easily recurrent disease in stomatology,which influence the patients’communication,normal dietary,and sleep.Evodia rutaecarpa(ER)is a traditional Chinese herbal medicine recorded in ancient Chinese medical books,which has a medicinal history of more than 2,000 years.Clinically,the application of ER at plantar Yongquan point(KI1)is effective in the treatment of oral ulcer.The purpose of this study was to combine the modern transdermal drug delivery system with traditional Chinese medicine to develop the transdermal absorption patch of ER and apply it to the treatment of oral ulcer at Yongquan point of plantar.Methods:Firstly,the medicinal materials of ER were extracted and the extracted materials were prepared into dispersed ER patch.The formulation and preparation process were screened by orthogonal design method and single factor investigation method.The adhesive and transdermal properties of the patch were used as the evaluation index of the preparation.Secondly,Wistar rats were used as experimental animals to establish a rat model of mouth ulcers.Wistar rats were randomly divided into normal group,model group(A),model group(B),low dose group,medium dose group and high dose group.the efficacy of ER on rat’s oral ulcer model was evaluated through three aspect such as apparent index,pathological index and biochemical index.Results:The patch had suitable adhesion and good skin penetration,which was an effective treatment for oral ulcer.In vivo pharmacodynamic studies,compared with the normal group,the body mass and food intake of rats in each group after modeling decreased,the amount of drinking water increased,the tissue structure of oral mucosa was damaged,and the levels of inflammatory factors(TNF-α,IL-6)and malondialdehyde increased,the levels of anti-inflammatory factors(IL-10),cell growth factor(epidermal growth factor,TGF-β_(1))and superoxide dismutase decreased.Compared with the model group,the body weight and food intake of each dosing group increased,water consumption decreased,the oral mucosal tissue structure was more complete,the levels of TNF-α,IL-6 and malondialdehyde decreased,the levels of IL-10,epidermal growth factor,TGF-β1 and superoxide dismutase increased,and the changes of various indexes were dose-related.Conclusion:ER patch can inhibit inflammatory reaction,enhance the antioxidant defense ability of the body,and promote the repair of damaged oral mucosa,so as to play an effective role in the treatment of oral ulcer.

Advancing oral cancer care:Insights from Tongluo Jiedu prescription

This editorial highlights the study which investigated the potential of traditional Chinese medicine(TCM)as an adjunctive therapy in oral cancer management.The study included 80 patients with oral cancer to evaluate the effects of the Tongluo Jiedu prescription on inflammatory stress markers,peripheral blood T-cell subsets,and overall immune function.The results indicated that Tongluo Jiedu substantially enhances immune function and reduces oxidative stress,thereby aiding in patient recovery and potentially minimizing treatment-related complications.This editorial discusses the broader implications of these findings for oral cancer care and emphasizes the importance of integrating TCM principles into modern oncology practices.

Varieties of Chinese Traditional Medicines Protected by the State (Part One)

Approved by the Ministry of Public Health,the following Medicines,producedby the named enterprises,are listed as varieties of Chinese traditionalmedicines that are protected by the state.

A meta-analysis of the efficacy of traditional Chinese medicine alone in the treatment of refractory gastroesophageal reflux disease

Background:To systematically evaluate the efficacy and safety of traditional Chinese medicine in the treatment of refractory gastroesophageal reflux.Methods:PubMed,The Cochrane Library,Embase,Web of Science,China National Knowledge Infrastructure,Wanfang Database,China Science and Technology Journal Database and Chinese BioMedical Literature Database were searched for randomized controlled trials of traditional Chinese medicine in the treatment of refractory gastroesophageal reflux from database establishment time to December 2020.After two researchers independently screened the literature,extracted data and evaluated the bias risk included in the study,RevMan5.3 software was used for meta-analysis.Results:A total of 12 randomized controlled trials,were included,including 893 patients.The results of meta-analysis showed that the total effective rate of the treatment group(relative risk=1.28,95%confidence interval(CI)(1.19,1.38),P<0.00001),RGERDQ(refractory gastroesophageal reflux disease)score(mean difference(MD)=−3.35,95%CI(−4.13,−2.57),P<0.00001],acid reflux(acid in the stomach comes out of the mouth)[MD=−0.30,95%CI(−0.45,−0.15),P<0.00001],heartburn(the feeling that the heart is burned)(MD=−0.44,95%CI(−0.60,−0.29),P<0.00001,and retrosternal pain(MD=−0.27,95%CI(−0.44,−0.10),P<0.00001,belching(MD=−0.40,95%CI(−0.57,−0.24),P<0.00001],endoscopic mucosal score(MD=−0.62,95%CI(−0.78,−0.46),P<0.00001],the differences were statistically significant,and the effective rate of mucosal improvement under endoscopy was P=0.93>0.05,with no statistically significant difference.Conclusion:The current evidence shows that traditional Chinese medicine in the treatment of refractory gastroesophageal reflux disease is better than that of western medicine in the total effective rate,relieving acid reflux,heartburn,retrosternal pain and belching symptoms,but it is impossible to judge the improvement of mucosa under endoscope.Due to the limitations of the quality and quantity of included studies,more high-quality studies are needed to confirm the above conclusions.

Efficacy and safety of Shen Zhi Ling oral liquid(a Chinese patent)for Alzheimer's disease:A meta-analysis of randomized controlled trials

Objective:To evaluate the efficacy and safety of Shen Zhi Ling oral liquid(SZL)alone or combined with basic treatment in treating Alzheimer's Disease(AD).Methods:Databases including PubMed,the Cochrane Library,Embase,Web of science,China National Knowledge Infrastructure(CNKI),Wanfang Database and the Chinese Science and Technology Journal Database(VIP)were searched from inception to September 20,2020 to collect relevant randomized controlled trials(RCTs)comparing SZL with other nootropic drugs for AD.The primary clinical outcomes were scores of the Mini Mental State Examination(MMSE)and the Activities of Daily Living(ADL)during treatment.The secondary outcomes of our study included other neuropsychological scale scores including Rapid Verbal Retrieve(RVR),Digit Span(DS),Fuld Object-Memory Evaluation(FOM)and adverse events or reactions.Two authors searched and screened the literature independently,then extracted the data and evaluated the methodological quality by using the handbook of Cochrane Collaboration,and analyzed the data via the Review Manager 5.3 software.Results:In total,we included four studies,covering 217 participants.All studies were in a low methodological quality.The result of MMSE score,ADL score,RVR score,DS score and FOM score in the meta-analysis showed that no statistically significant difference(P>0.05)between the treatment groups and control groups,and the statistical heterogeneity of all meta-analyses was small(I2<50%).SZL was indicated no better than other nootropic drugs.Among the included studies,no study described adverse events.Conclusions:Considering the low quality of the included trials and the different levels of AD patients,we are unable to come to any conclusion about the efficacy and safety of SZL compared with other nootropic drugs.Moreover,we still need rigorously designed,multi-center,large-scale trials to further confirm the efficacy and safety of SZL.

炙甘草汤对顽固性复发性口腔溃疡患者的疗效研究

目的探讨炙甘草汤对顽固性复发性口腔溃疡患者的疗效。方法按照随机数字表法分配原则将196例2019年1月—2021年12月该院收治的复发性口腔溃疡患者分为对照组(98例)和治疗组(98例)。对照组给予复合维生素B片、维生素C片、西地碘片进行治疗,治疗组在对照组基础上给予炙甘草汤进行治疗,两组均持续治疗2周,并随访1年。比较两组治疗2周后的疗效,临床症状改善情况及复发情况,治疗前、治疗2周后的中医证候积分、疼痛程度、睡眠质量、生活质量、炎症、免疫指标水平及治疗期间的安全性情况。结果与对照组治疗2周后的总有效率(84.69%,83/98)比较,治疗组总有效率更高(93.88%,92/98)(P<0.05)。与对照组比较,治疗组溃疡疼痛改善时间、溃疡愈合时间更短(P<0.05);与对照组随访期间的总复发率比较(13.27%,13/98),治疗组总复发率(5.10%,5/98)更低(P<0.05)。治疗2周后,两组溃疡隐痛、反复发作、口干口苦、胃脘痞闷、视觉模拟评分法(VAS)、匹兹堡睡眠质量量表(PSQI)评分、全血CD_(8)^(+)、血清肿瘤坏死因子-α(TNF-α)、白细胞介素-2(IL-2)水平与治疗前比较降低,治疗组更低(P<0.05);两组生存质量测定量表(QOL-100)评分、全血CD_(4)^(+)、CD_(4)^(+)/CD_(8)^(+)水平与治疗前比较升高,治疗组更高(P<0.05)。治疗组和对照组治疗期间均未发生恶心呕吐、皮疹、头晕等情况。结论炙甘草汤可有效调节顽固性复发性口腔溃疡患者炎症及免疫指标水平,减轻机体炎症,改善免疫功能,并可改善疼痛程度、睡眠和生活质量,进而可促进患者中医证候及临床症状的改善,预防复发,疗效显著,安全性良好。

从虚论治慢性复发性口腔溃疡

口腔溃疡是一种常见的口腔黏膜溃疡损伤性疾病。该病病因复杂,复发率高,对患者的饮食、说话等均有一定影响。以20年的临床经验为基础,通过辨证、辨体、辨病的中医辨证方法,认识到该病多为“上虚不足”,导致反复发作,并通过补虚升提的方法治疗,取得了较好的效果。

干燥综合征的中西医结合护理进展

干燥综合征(SS)是一种以泪腺和唾液腺的淋巴细胞浸润,伴有干燥性角膜结膜炎及口腔干燥为主要临床表现的免疫反应介导疾病,临床上分为原发性和继发性。本文主要对SS相关中西医结合护理进行总结,主要包括各器官、皮肤、呼吸道护理、饮食干预等,对SS患者给予心理指导,保证护理措施的正确性、系统性,提高SS患者及家属对疾病的认知,建立患者治疗信心,临床中医护人员需积极主动配合,保证治疗、护理工作顺利开展,最终改善患者生命质量。

七味三七口服液辅助中药外洗治疗对髋关节置换手术患者术后患肢疼痛及肿胀情况的影响

目的 研究七味三七口服液辅助中药外洗治疗对髋关节置换手术患者术后患肢疼痛、肿胀情况的影响。方法 选取四川省骨科医院2021年6月至2022年6月行髋关节置换手术患者共120例。采用随机数字表法分为观察组和对照组,各60例。观察组患者术后予中药外洗、七味三七口服液治疗,对照组患者予术后常规治疗。比较2组中医证候积分、疼痛因子水平、患肢肿胀及不良反应发生情况。结果 治疗后,2组粗肿、胀痛、皮温升高、皮色改变中医证候积分均低于治疗前,且观察组均低于对照组(均P<0.05);2组β-内啡肽水平均高于治疗前,且观察组高于对照组,而2组前列腺素E2、5-羟色胺水平和视觉模拟量表评分均低于治疗前,且观察组均低于对照组(均P<0.05)。术后第3、7天,2组肿胀值均降低,且观察组均低于对照组[(0.63±0.21)cm比(0.75±0.24)cm、(0.47±0.12)cm比(0.66±0.17)cm](均P<0.05)。观察组不良反应发生率低于对照组(P<0.05)。结论 七味三七口服液辅助中药外洗可有效缓解髋关节置换手术患者术后患肢疼痛和肿胀,降低恶心、呕吐等不良反应发生的可能性,促进术后恢复。

关节腔靶向注射臭氧联合中药外敷治疗早期类风湿关节炎膝关节病变的临床研究

目的:探究关节腔靶向注射臭氧联合中药外敷治疗早期类风湿关节炎膝关节病变的临床效果。方法:回顾性选取九江市第一人民医院2022年6月—2023年9月收治的80例早期类风湿关节炎膝关节病变患者,根据治疗方案将其分为联合组(n=47)和对照组(n=33),对照组采用临床常规治疗方案,即采用曲安奈德进行关节腔注射治疗,联合组采用关节腔靶向注射臭氧联合中药外敷治疗。均治疗3周。比较两组疗效;比较两组治疗前后的C反应蛋白(CRP)、抗环瓜氨酸多肽抗体(ACCP)、类风湿因子(RF)和甘露聚糖结合凝集素(MBL)水平;比较两组治疗前后的视觉模拟评分法(VAS)评分及关节超声评估情况。结果:联合组总有效率为93.62%,高于对照组的72.73%,差异有统计学意义(P<0.05)。治疗后,两组血清RF、CRP、ACCP水平均低于治疗前,且联合组均低于对照组;两组血清MBL水平均高于治疗前,且联合组高于对照组,差异均有统计学意义(P<0.05)。治疗后,两组髌上囊积液深度、髌上囊滑膜厚度、VAS评分均低于治疗前,且联合组均低于对照组,差异均有统计学意义(P<0.05)。结论:关节腔靶向注射臭氧联合中药外敷治疗早期类风湿关节炎膝关节病变的效果较好,可以显著改善患者的血清学指标和疼痛程度,并减轻膝关节病变。

四磨汤口服液治疗功能性消化不良临床综合评价

目的以药品临床价值为导向,对四磨汤口服液治疗功能性消化不良开展临床综合评价,为四磨汤口服液的合理定价、合理用药以及药品目录遴选提供科学依据。方法基于当前可获得数据以及调研数据,围绕四磨汤口服液与两种对照药治疗功能性消化不良的有效性、安全性、经济性、创新性、适宜性和可及性6个维度开展临床综合评价。结果有效性方面,四磨汤口服液可提高临床有效率,药理作用机制明确。安全性方面,未见毒性反应,不良反应较轻,预后良好。经济性方面,日均费用略高于对照药,具有一定成本效果优势。创新性方面,获中国专利授权,并作为中药创新药上市。适宜性方面,方便服用,在药物技术特性和药品使用方面都具有较好的适宜性。可及性方面,医院覆盖较广,产能充足,患者负担较低,长期应用无较大环境风险。3种中成药的综合价值分数从高到低依次为四磨汤口服液(92.01分)>对照药A(85.11分)>对照药B(77.51分)。专家组推荐意见为A类(21/23),建议可直接转化为决策使用。结论四磨汤口服液治疗功能性消化不良的临床综合价值较高,可为药品合理定价、合理用药以及药品目录遴选提供参考依据。

蒲地蓝消炎口服液治疗小儿支原体肺炎有效性和安全性的Meta分析

目的:系统评价中成药蒲地蓝消炎口服液联合西药治疗小儿支原体肺炎(MPP)的临床有效性和安全性。方法:通过全面检索关于蒲地蓝消炎口服液联合西药治疗小儿支原体肺炎的随机对照试验(RCT)文献,利用统计软件RevMan5.3提取并分析数据。结果:共纳入13项研究,共包含1313例患者,其中观察组661例,对照组652例。蒲地蓝消炎口服液联合西药治疗小儿支原体肺炎,临床有效率高于单用西药(RR=1.17,95%CI为1.13~1.22,P<0.0001),退热时间(MD=-1.29,95%CI为-1.35~-1.22,P<0.0001),听诊肺部啰音消退时间(MD=-1.77,95%CI为-1.85~-1.69,P<0.0001)及咳嗽症状消退时间(MD=-2.59,95%CI为-2.67~-2.52,P<0.0001)4个方面均优于单用西药。GRADE评价结果显示证据质量以低质量为主。结论:蒲地蓝消炎口服液联合西药优于单独应用西药,且不良反应较少,安全性较好。

中医治疗紧张性头痛的研究进展

紧张性头痛(TTH)又称肌收缩性头痛,属于功能性头痛中最常见的类型之一,其表现为紧束性或压迫性非搏动性头痛,可伴或不伴有头部肌群的挛缩性收缩及压痛,呈发作性或持续性,病程数日至数年不等。随着生活节奏的加快,社会压力的增大,其发病率呈逐渐上升的趋势,好发育中青年,女性略高于男性。中医学将其归于“头痛”“首风”“头风”等范畴,虽然在发病中有多种致病因素在起作用,但是中医学通过四诊合参进行辨证论治,针对每个患者病因病机不同处以方药、针灸、推拿、按摩等中医外治,近年来各项研究数据显示,中医内服用药及外治疗法所达到的成效不容小觑,随着中医学的现代化发展,现代医家汲取古代医家宝贵经验,去粗取精,对于紧张性头痛不断深入研究,在传统治疗的基础上加上现代化仪器等,在治疗方面涌现出了更多的诊治方法,且其临床疗效满意。文章归纳近10年关于中医治疗紧张性头痛的文献,归纳中医治疗方法,以探讨更有效的治疗方案,提高临床疗效。

基于数据挖掘技术分析中药治疗肩周炎的用药规律

目的基于数据挖掘技术分析中药治疗肩周炎的用药规律。方法计算机检索中国知网、维普资讯中文期刊服务平台、万方数据知识服务平台,收集中药内外治法治疗肩周炎的临床研究文献,检索时间为2010年1月至2023年9月。对涉及的药物进行使用频次统计、性味归经功效频次统计、关联规则分析、聚类分析。结果(1)筛选出中药内服治疗肩周炎244条处方,功效以补虚药、祛风湿药多见,药性以温性为主,药味以苦味、辛味为主,主要归肝经、脾经、肾经。关联规则分析得到二联药物组合5组,三联药物组合8组,四联药物组合1组,核心药物包括甘草、白芍、当归、川芎、防风、黄芪、桂枝、细辛等。聚类分析得到3个有效聚类群。(2)筛选出中药外治治疗肩周炎245条处方,功效以祛风湿药、活血化瘀药多见,药性以温性为主,药味以苦味、辛味居多,主要归肝经、脾经、肾经。关联规则分析得到二联药物组合4组,三联药物组合5组,核心药物包括草乌、川乌、没药、乳香、羌活、红花等。聚类分析得到5个有效聚类群。结论中药内服治疗肩周炎主要以葛根汤与独活寄生汤两方化裁,以外感为主要原因导致的肩周炎可选用葛根汤加减,以肝肾不足为主要病因所致的肩周炎可选用独活寄生汤加减。对于中药外治,则多选用活血化瘀药、祛风湿药、解表药相配伍,从而改善患者症状。

5-氨基水杨酸口服制剂及联合中药在炎症性肠病治疗中的应用

5-氨基水杨酸(5-ASA)是1种从中药柳树皮中分离提纯得到的天然抗炎活性成分水杨酸的衍生物,别名阿米诺水杨酸、美沙拉嗪,是临床治疗炎症性肠病(IBD)并预防其复发的一线药物。尽管目前莎尔福(Salofalk)、亚沙可(Asacol)和潘他沙(Pentasa)等5-ASA口服结肠靶向制剂已广泛用于IBD的临床治疗,但仍存在在小肠提前释药和受胃肠道生理状态影响显著等制剂缺陷、对克罗恩病和重度溃疡性结肠炎(UC)治疗效果不佳等临床未满足的需求,以及减少UC患者黏膜菌群多样性、长期使用增加用药风险和降低患者服药依从性等问题。开发硅胶纳米粒、水凝胶等新型递药载体,基于pH依赖、时滞控制和菌群/酶触发等多机制结合释药原理设计新型口服结肠靶向制剂从而解决制剂缺陷问题,提高5-ASA疗效和患者服药耐受性、依从性是目前制剂研究的重点。此外,5-ASA口服制剂联合中药保留灌肠、中药口服制剂和注射液等治疗IBD可发挥协同抗炎作用,实现增效减毒目的。对5-ASA口服制剂品种、近年来新型制剂和递药载体的研究进展,以及与中药联用的临床应用和研究现状等进行综述,为5-ASA口服制剂的剂型改造、载体材料研究和临床用药等提供参考。

慢性萎缩性胃炎与消化道菌群的研究进展

慢性萎缩性胃炎(CAG)被认定为胃癌的癌前状态,该病在全球的发病率不断攀升,对其发病机制研究、生物学诊断技术及治疗药物的革新势在必行。相关消化道菌群微生态的研究极有可能推动这一革新。随着对幽门螺杆菌(Hp)研究的深入,人们发现单独干预Hp并不能完全延缓萎缩性胃炎进展,由此口腔菌群、胃内非Hp菌群及肠道菌群组成的“口-胃-肠”菌群微生态轴在CAG中的表观特征逐步得到重视。本文通过查阅中国知网、万方、维普、PubMed等数据库自2000—2023年的相关文献,筛出48篇目标文献,并将对口腔及舌苔菌群、胃内非Hp菌群和肠道菌群3个方面与CAG的关系进行回顾,同时探讨中医药基于调节菌群对CAG治疗的可行性,展望“胆汁酸-菌群轴”在未来CAG的菌群研究中将发挥的重要作用。

基于中医传承辅助平台的中药内服治疗原发性骨质疏松症组方用药规律研究

目的:基于数据挖掘方法探讨中医药治疗原发性骨质疏松症的组方用药规律。方法:检索中国知网、维普、万方等中文数据库2006—2022年中药内服治疗原发性骨质疏松症的中药方剂,通过中医传承辅助平台系统软件(TCMISS)运用关联规则算法、复杂系统熵聚类方法,统计处方中药物的性味归经、使用频率、药物之间的关联规则、核心药物组合和高频中药组合。结果:纳入文献共计210篇,涉及224首方剂,168味中药。总结高频证候分型,居于前4位的分别是肾虚血瘀证、脾肾亏虚证、肝肾阴虚证、肾虚证。性味归经最多为温性药,五味频次最多为甘味药。药物归经前4位的是肝、肾、脾及心经。单味中药使用频次居于前10位的是熟地黄、淫羊藿、当归、杜仲、黄芪、骨碎补、补骨脂、山茱萸、山药、枸杞子。关联规则分析得到45个药对组合及44条关联规则。聚类分析得到20个药物核心组合,优化出10个新方组合。结论:原发性骨质疏松症病因以肾、脾亏虚为主,兼有血瘀,中医药治疗以补益肝肾、健脾益气、活血补血为主。

中药漱口液对脑卒中鼻饲患者口腔并发症的预防效果观察

目的:探讨中药漱口液在脑卒中鼻饲患者口腔护理中的应用效果。方法:选取2022年10月—2023年9月入住天津市中医药研究院附属医院确诊为脑卒中并留置胃管的60例患者作为研究对象。按照随机数字表法将其分为试验组和对照组,各30例,对照组采用生理盐水进行口腔护理,试验组采用中药漱口液进行口腔护理,比较两组患者的口腔溃疡发生率、口腔感染发生率、口腔pH值和口臭指数。结果:试验组患者口腔溃疡、口腔感染发生率降低,口腔pH值干预7 d后效果不显著,干预14 d后pH趋于正常水平,口臭指数明显降低,与对照组比较,差异具有统计学意义(P<0.05)。结论:中药漱口液可降低脑卒中鼻饲患者口腔溃疡及感染的发生率,稳定口腔pH值,缓解口臭症状。