Clinical Observation on Influence of Chinese Medicines for Promoting Blood Circulation to Remove Blood Stasis on FIB and DD in Plasma of Patients with Cerebral Thrombosis

to study the influence of Chinese medicines for promoting blood circulation to remove blood stasis on fibrinogen(FIB)and D-dimer(DD)in plasma of patients with cerebral thrombosis. Method:73 inpatients with acute cerebral thrombosis were randomly divided into a control group of 34 cases and a treatment group of 39 cases.The content of FIB and DD in plasma was detected before treatment and on the 7th and 14th days after treatment.Result:FIB content in plasma after treatment was lower than that before treatment in the control group(P<0.01)and more remarkable in the treatment group(P<0.001).There was an obvious difference in DD content before and after treatment in both groups.DD content on the 7th and 14th days after treatment in the treatment group was obviously higher than that in the control group(P<0.01 and P<0.05 respectively). Conclusion:Chinese medicines for promoting blood circulation to remove blood stasis can reduce the FIB content in plasma of patients with cerebral thrombosis,raise the DD content in plasma, cause the peak of DD content appear earlier and obviously improve hypercoagulability of blood in patients with cerebral thrombosis.

Treatment for non-alcoholic steatohepatitis with type 2 diabetes by traditional Chinese medicine:a case report and experience

Non-alcoholic fatty liver disease and type 2 diabetes are common comorbidities or target organ damage,which can lead to adverse metabolism and increased risk of cardiovascular and cerebrovascular diseases.In the management plan of non-alcoholic fatty liver disease and type 2 diabetes,there is no drug with significant efficacy or both.The dialectical idea of traditional Chinese medicine has a good curative effect and significant advantages in treating metabolic disorders.The author now reviewed a case of non-alcoholic steatohepatitis combined with type 2 diabetes.In this case,the method of invigorating the spleen and eliminating turbidity was effective,which effectively prevented the progression of liver disease in the patient,and T2DM was alleviated by maintaining within the standard range after the use of insulin was stopped.It can be said that“killing two birds with one stone”,more fully reflects the advantages of traditional Chinese medicine in the integrated treatment of metabolic-related diseases.

Observation on Therapeutic Effect of Lotus Needle Cupping Therapy for Removing Blood Stasis in Zhuang Medicine on PHN and Its Influ-ence on Inflammatory Mediators

[Objectives]To observe the clinical effect of the lotus needle cupping therapy for removing blood stasis in Zhuang medicine in treating PHNand its influence on inflammatory factors.[Methods]96 patients with PHN were randomly divided into three groups:lotus nee-dle cupping therapy group,TCM surrounding acupuncture group and gabapentin group.Venous blood and acupoint blood were collected at 0,21 and 42 d of treatment,and the expression levels of 5-HT,SP and CGRPinflammatory mediators were detected before and after treatment.The changes of VAS scores before,during and after treatment and the clinical efficacy were observed.[Results]The total effective rate of the lotus needle cupping group was 87.50%,which was better than that of the TCM acupuncture group(81.25%)and the gabapentin group(62.50%);after treatment,the VAS scores and the expression of inflammatory mediators in the three groups of patients were lower than those before treatment,and the decrease was more significant in the treatment group(P<0.05).[Conclusions]The lotus needle cupping therapy for removing blood stasis in Zhuang medicine is effective in treating PHN,and its mechanism is to reduce the release of inflammatory media-tors,reduce hyperalgesia,relieve pain and improve the quality of life of patients.

Analysis on the rules of prescriptions for ischemic stroke based on the traditional Chinese medicine inheritance auxiliary system

In China,traditional Chinese medicine is widely used in the treatment of ischemic stroke,but its prescription rules needs to be further studied.This paper uses the traditional Chinese medicine inheritance auxiliary system(a software)to analyze the composition rules of a large number of prescriptions for the treatment of ischemic stroke,and discusses the clinical rationality of the new prescriptions.We found that the prescriptions for the treatment of ischemic stroke are mainly composed by herbs for promoting blood circulation and removing blood stasis,dredging collaterals and tonifying deficiency,and some of the new prescriptions are also in line with this characteristic.This paper can provide reference for clinical prescription in the treatment of ischemic stroke and the development of related new drugs.

Key to Treating COVID-19: Removing Phlegm from Small Airways

According to autopsy reports,patients who died from COVID-19 had a lot of mucus in the lung that obstructed the airways,reduced the effect of mechanical ventilation,and even led to pulmonary failure.Traditional Chinese medicine literature mentions that"Inability to remove phlegm impair s the lung,which leads to death."Hence one of the most urgent problems to be solved is to remove phlegm from the small airways.This article elaborates ten methods to remove phlegm for clinical reference.

Key to Treating COVID‑19:Removing Phlegm from Small Airways

According to autopsy reports,patients who died from COVID‑19 had a lot of mucus in the lung that obstructed the airways,reduced the effect of mechanical ventilation,and even led to pulmonary failure.Traditional Chinese medicine literature mentions that“Inability to remove phlegm impairs the lung,which leads to death.”Hence one of the most urgent problems to be solved is to remove phlegm from the small airways.This article elaborates ten methods to remove phlegm for clinical reference.

Efficacy and safety of activating blood circulation and removing blood stasis of Traditional Chinese Medicine for managing renal fibrosis in patients with chronic kidney disease:a systematic review and Meta-analysis

OBJECTIVE:To evaluate the efficacy and safety of activating blood circulation and removing blood stasis in terms of Traditional Chinese Medicine(TCM) for managing renal fibrosis(RF) in patients with chronic kidney disease(CKD).METHODS:We searched randomized controlled trials(RCTs) from eight databases.RESULTS:Sixteen eligible studies with 1,356 participants were included in this study.Compared to treatment with Western Medicine(WM) alone,the combined treatment with activating blood circulation and removing blood stasis in terms of TCM(ARTCM) and WM to manage RF in patients with CKD significantly ameliorated type Ⅳ collagen(C-Ⅳ)(SMD:-2.17,95% CI:3.01 to-1.34),type Ⅲ procollagen(PC-Ⅲ)(SMD:-1.08,95% CI:-1.64 to-0.53),laminin(LN)(SMD:-1.28,95% CI:-1.65 to-0.90),transforming growth factor β 1(TGF-β1)(SMD:-0.65,95% CI:-1.18 to-0.12),serum creatinine(Scr)(SMD:-1.36,95% CI:-1.85 to-0.87),blood urea nitrogen(BUN)(MD:-1.51,95% CI:-2.59 to-0.43),and 24 h urine protein(24h Upro)(SMD:-1.23;95% CI:-1.96 to-0.50).The level of hyaluronic acid(HA) was similar in both types of treatment(SMD:-0.74,95% CI:-1.91 to 0.44).The subgroup analysis showed that the duration of 8 weeks might affect the concentration of C-Ⅳ,PC-Ⅲ,and LN(P < 0.05).The effectiveness of the longer duration to C-Ⅳ,PC-Ⅲ,and LN was not certain.However,the result should be interpreted in care.The safety of the treatment using ARTCM and WM could not be evaluated because a few studies had reported adverse effects.The results of the Meta-analysis were not stable enough.There was publication bias for the reports on Scr(P = 0.001),C-Ⅳ(P = 0.001),PC-Ⅲ(P = 0.026),and LN(P = 0.030) and no publication bias for the reports on BUN(P = 0.293).The quality of evidence varied from low to very low.CONCLUSIONS:The combined treatment using ARTCM and WM to manage RF in patients with CKD has some advantages over treatment with WM alone.High-quality RCTs need to be conducted for the strong support.

活血化瘀治疗冠脉微循环障碍的研究进展

冠状动脉微循环障碍广泛存在于多种心血管疾病中,与左室重构、心血管事件密切相关。本病病机演变以血瘀为核心,活血化瘀法可改善患者冠状动脉血流储备及微循环阻力指数,对于冠状动脉微循环障碍具有良好的治疗效果。机制方面,活血化瘀诸法可调节冠状动脉微血管功能障碍的诸多关键病理生理环节:如,活血化瘀可有效抑制炎症、氧化应激及血栓形成;活血化痰可保护血管内皮;益气活血能改善能量代谢;补肾活血促进血管新生、建立冠脉侧支循环。应用现代科学深入挖掘活血化瘀诸法治疗本病的机制,或为解决本病治疗提供新的思路。

活血化瘀类中药饮片与口服抗凝血药联合应用的出血风险研究

目的:探讨联合应用活血化瘀类中药饮片与口服抗凝血药治疗疾病的出血风险。方法:回顾性研究2022年该院服用口服抗凝血药和活血化瘀类中药饮片的住院患者158例,根据是否联合应用活血化瘀类中药饮片分为联合组(80例)和对照组(78例)。对照组患者使用的口服抗凝血药包括华法林、利伐沙班、达比加群酯;联合组患者联合应用的活血化瘀类中药饮片包括丹参、川芎、牛膝等。观察两组患者的凝血功能相关指标如凝血酶原时间-国际标准化比值(PT-INR)、纤维蛋白原(FIB)、D-二聚体(D-D)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)和出血事件发生率等。结果:联合组与对照组患者PT-INR、FIB、D-D、APTT和TT的差异均无统计学意义(P>0.05);联合组患者的出血事件发生率为66.25%(53/80),高于对照组的42.31%(33/78),差异有统计学意义(P<0.05)。结论:患者联合应用活血化瘀类中药饮片与口服抗凝血药后,虽然相关凝血指标并未出现明显变化,但是出血事件发生率显著升高。临床用药时,需重点关注含有丹参、川芎、牛膝和红花等的活血化瘀类中药饮片或中药复方制剂与口服抗凝血药联合应用会增加出血的风险。本研究为中西药相互作用研究提供了一定的借鉴。

基于集合可视化分析名老中医王秀霞教授治疗卵巢巧克力囊肿患者的用药规律

目的:利用集合可视化分析系统探讨名老中医王秀霞治疗卵巢巧克力囊肿的学术思想及用药规律。方法:收集2017年9月1日至2018年12月31日黑龙江中医药大学附属医院王秀霞教授治疗卵巢巧克力囊肿的有效方剂,建立处方数据库,利用集合可视化分析王秀霞教授治疗卵巢巧克力囊肿的用药规律。结果:共纳入有效处方145首,涉及中药115味,分析处方中的常用药对及药物组合,演化得到新处方1首。结论:王教授治疗卵巢巧克力囊肿谨守“正虚邪实”的本质,在益肾疏肝的基础上,辅以化瘀、消癥之品,充分体现了“益肾疏肝为主兼顾化瘀消癥”的学术思想。

基于“成骨-成血管耦联”理论探讨中医药防治激素性股骨头坏死的科学内涵

激素性股骨头坏死(steroid-induced necrosis of the femoral head, SNOFH)是骨科常见难治性疾病,又被视为“不死癌症”,若不及时干预将导致患者面临人工全髋关节置换术的风险。近些年研究证实,“成骨-成血管耦联”途径研究SNOFH发生发展的机制具有重要意义。SNOFH中医病机责之于脾肾亏虚为本,瘀血为病,痰阻为渐,毒聚为损。“成骨-成血管耦联”机制与“瘀去-新生-骨合”中医理论存在高度契合性。越来越多的临床证据表明中医药治疗SNOFH不仅具有疗效显著、不良反应小、价格低廉等优势,还能提高患者生存质量,为促进股骨头血管重建与再生以及股骨头坏死骨修复等发挥重要作用。基于“瘀去-新生-骨合”理论,临床上多采用补肾活血类中药及中药复方用于SNOFH防治,运用“成骨”之健脾补肾药,“成血管”之活血化瘀药,祛除“抑制因素”之化痰药、祛湿药,有步骤、有层次的治疗SNOFH取得显著效果。因此,从“成骨-成血管耦联”角度探讨SNOFH中医药干预的科学内涵已成为当今研究新热点,能够为后续SNOFH的防治研究和新药研发提供理论参考和借鉴。

小针刀联合补肾活血祛痛方治疗腰椎间盘突出症临床观察

目的 探讨小针刀联合补肾活血祛痛方治疗腰椎间盘突出症(LDH)的临床效果。方法 选取2016年7月—2018年4月沈阳市中医院收治的135例患者作为研究对象,将所有患者随机分为甲组(小针刀联合补肾活血祛痛方)、乙组(补肾活血祛痛方)和丙组(小针刀),观察与对比3组患者的腰痛分级、治疗前后视觉模拟量表(VAS)评分和总体效果。结果 甲组总有效率为97.78%(44/45),高于乙组的88.89%(40/45)、丙组的82.22%(37/45),差异具有统计学意义(P<0.05);甲组治疗后VAS评分下降程度明显大于乙组和丙组;甲组治疗后Denis腰痛分级明显优于乙组和丙组,差异具有统计学意义(P<0.05)。结论对LDH患者进行小针刀联合补肾活血祛痛方治疗可以有效缓解患者的疼痛程度、缩短患者的住院时间、提升患者的生活质量,同时患者腰椎功能可以得到快速恢复,值得临床应用与推广。

活血化瘀涂搽药治疗冠脉介入穿刺并发症临床观察

目的观察活血化瘀涂搽药剂外敷治疗冠脉介入穿刺并发症的疗效。方法选取2021年1月1日—2022年12月31日在江西中医药大学附属医院行冠脉介入治疗后伴桡动脉穿刺点并发症的患者100例,随机分为试验组和对照组,各50例。对照组采用50%硫酸镁湿敷,试验组采用活血化瘀涂搽药剂湿敷,均连续治疗7 d,比较2组穿刺部位淤青面积变化、穿刺部位肿胀程度、穿刺部位疼痛程度及临床有效率。结果2组患者淤青面积、肿胀程度及疼痛评分均较治疗前降低(P<0.05),且试验组均低于对照组(P<0.05),试验组总有效率高于对照组(P<0.05)。结论活血化瘀涂搽药剂外敷相对于硫酸镁外敷更能有效减少冠脉介入穿刺并发症患者的淤青面积、肿胀程度及疼痛评分,提高临床有效率,疗效好,值得临床推广应用。

蔡平平基于八纲辨证治疗绒毛膜下血肿经验采撷

介绍蔡平平教授基于八纲辨证治疗绒毛膜下血肿(SCH)的临床经验。在SCH的诊疗中,以八纲辨证为指导,强调阴阳辨证,灵活使用活血化瘀法;以“活血不留瘀、不动血、不动胎、不碍胎”为原则,提出“急则止血,缓则消瘀,澄源安胎为本”的治疗方法,同时宏观和微观相结合,重视脉诊。

观察复方雪药修复液对甲沟炎门诊拔甲术后患者临床疗效及睡眠质量的效果

目的:分析在甲沟炎门诊拔甲术患者护理过程中运用复方雪药修复液对术后愈合以及睡眠质量的影响。方法:选取2022年2月至2023年10月福建中医药大学附属第二人民医院普外科收治的门诊拔甲术患者76例作为研究对象,按照随机数字表法分为对照组和观察组,每组38例。对照组给予常规护理干预,观察组给予复方雪药修复液辅助护理干预。采用匹兹堡睡眠质量指数(PSQI)比较2组患者睡眠质量的差异,并比较2组患者的夜间觉醒次数、日平均睡眠时间、夜间最长连续睡眠时间,并比较2组患者的创面恢复情况,包括换药次数、结痂厚度、结痂时间、结痂脱落时间。结果:干预后,观察组PSQI评分显著低于对照组,观察组日平均睡眠时间、夜间最长连续睡眠时间显著长于对照组,观察组夜间觉醒次数显著低于对照组,观察组患者换药次数、结痂厚度、结痂时间均显著低于对照组,差异均有统计学意义(均P<0.05)。结论:对门诊拔甲术患者进行术后护理过程中,辅助使用复方雪药修复液可以降低换药次数、结痂厚度、结痂时间,提升患者术后睡眠质量,值得临床推广应用。

活血化瘀方治疗子宫肌瘤临床观察

目的分析活血化瘀方辨证对子宫肌瘤的治疗效果及安全性。方法选取2020年1月—2022年1月江西省乐安县人民医院收治的60例子宫肌瘤患者临床资料,分为对照组与治疗组,各30例。对比两组治疗3周后的临床效果、性激素水平[卵泡生成素(FSH)、黄体生成素(LH)、雌二醇(E_(2))、孕激素(P)]、中医证候积分、不良反应。结果治疗组总有效率为93.33%(28/30),对照组为80.00%(24/30),两组比较差异无统计学意义(P>0.05)。治疗前两组性激素水平比较差异无统计学意义(P>0.05);治疗后两组FSH、LH、E2、P均降低,且治疗组均低于对照组(P<0.05)。治疗前两组中医证候积分比较差异无统计学意义(P>0.05),治疗后治疗组经期异常、下腹胀痛、乳房胀痛、肛门下坠评分均低于对照组(P<0.05)。治疗组不良反应发生率为6.67%(2/30),对照组为16.67%(5/30),两组比较差异无统计学意义(P>0.05)。结论活血化瘀方辨证对子宫肌瘤的治疗效果好,可改善患者临床症状及性激素水平,用药安全性高。

单味中药有效成分治疗溃疡性结肠炎研究进展

研究表明,中药治疗溃疡性结肠炎不良反应少且复发率低,临床常用益气健脾、清热祛湿、活血化瘀、补血养阴类中药组方治疗,其主要药物的有效成分具有减轻炎症反应、修复黏膜损伤、调节肠道微生态、调节免疫反应等作用。本文对常用单味中药有效成分治疗溃疡性结肠炎的作用机制进行综述,为其临床治疗与中药新药研发提供参考。

活血化瘀中药联合富血小板血浆改善激素性股骨头坏死的作用机制

背景:目前发现活血化瘀中药、富血小板血浆技术都能够修复受损血管,促进血管再生,重建股骨头内血运,恢复正常血供,进一步促进成骨作用,在早期干预激素性股骨头坏死方面均表现出一定的优势,可更加深入了解活血化瘀中药及富血小板血浆技术改善激素性股骨头坏死的作用机制,为今后治疗提供新思路。目的:根据国内外相关文献,综述活血化瘀中药联合富血小板血浆技术改善激素性股骨头坏死作用机制的研究进展。方法:检索PubMed、Web of Science、Metstr、中国知网及万方数据库收录的相关文献。以“中药、信号通路、激素性股骨头坏死、血管内皮生长因子、富血小板血浆”及“traditional Chinese medicine、signal pathways、steroid induced necrosis of femoral head、vascular endothelial growth factor、platelet rich plasma”分别作为中、英文检索词,检索文献时限为2000年1月至2022年7月,最终纳入相关文献75篇。结果与结论:活血化瘀中药及富血小板血浆技术在干预早期激素性股骨头坏死方面均表现出一定的优势。对于中医药而言,无论是活血化瘀单体药还是复方药都可以有效缓解激素性股骨头坏死疾病进一步发展,具体作用机制如下:①活血化瘀中药有显著抗凝作用,可以拮抗激素药物造成的血液异常(高凝)状态,进一步恢复股骨头内的正常血供;②活血化瘀中药可修复受损的血管内皮,通过激活血管内皮生长因子,使血管再生,重塑股骨头内血运;③活血化瘀中药祛瘀效果明显,可减少骨髓腔内的脂肪细胞堆积,缓解股骨头内压力;④活血化瘀中药可调控相关信号通路,维持骨代谢,促进成骨细胞、破骨细胞分化平衡,有效减轻激素性股骨头坏死。此外,富血小板血浆中含有大量高浓度细胞生长因子,对成骨作用及血管再生均起到正向作用,同时也可改善血液异常状态。活血化瘀中药联合富血小板血浆技术可发挥二者自身生物作用,干预效果更加显著。

国医大师刘柏龄运用补肾祛瘀法治疗膝骨性关节炎经验

介绍国医大师刘柏龄教授运用补肾祛瘀法治疗膝骨性关节炎的经验。刘柏龄主张“治肾亦即治骨”,认为膝骨性关节炎以肝肾亏虚为根本原因,瘀血痹阻为标实,病位在肝肾,治疗上应抓住主要矛盾,以补肾壮骨为主,祛瘀通络为辅,补肾祛瘀法贯穿膝骨性关节炎整个疗程的始终。临证常选用膝痛1号方化裁治疗膝骨性关节炎,善用海螵蛸、藤类药、虫类药,内外兼治,临床疗效显著。

活血化瘀类中药通过调控细胞自噬防治心血管疾病的研究进展

细胞自噬是由多分子多通路共同介导完成的,在心血管疾病中,自噬可以通过磷脂酰肌醇3激酶/蛋白激酶B/哺乳动物雷帕霉素靶蛋白(mTOR)、腺苷一磷酸活化的蛋白激酶/mTOR、丝裂原活化蛋白激酶、p53、Wnt/β-连环蛋白等关键信号通路发挥作用。活血化瘀类中药单体如羟基红花黄色素A、人参皂苷Rb1、红景天苷、川芎内酯、姜黄素等,中药复方及制剂如黄芪保心汤、桃红四物汤、通心络胶囊、双参宁心胶囊、速效救心丸等均能通过上述关键信号通路调控细胞自噬,进而缓解心血管疾病的进程。