Effect of Chinese Herbs for Activating Blood Circulation,Removing Stasis and Supplementing Qi on the Circulating Endothelial Cells in Patients with Unstable Angina Pectoris

Objective: To observe the effect and clinical significance of circulating endothelial cells (CEC) in the pathogenesis of coronary heart disease with unstable angina pectoris (CHD-UAP), and to explore the protective effect of Chinese herbs for activating blood circulation, removing stasis and supplementing Qi (CH) on CHD-UAP patient's CEC. Methods: Sixty patients with diagnosis of CHD-UAP confirmed and differentiated to be Qi-deficiency and blood stasis by TCM were randomly divided into two groups and treated, on the basis of Western drug-therapy, with Tongxinluo capsule (通心络胶囊, TXL) and Huoxue Tongmai capsule (活血通脉胶囊, HXTM) respectively by way of oral taking three times a day, 3 capsules every time, with 1 month as one therapeutic course. The number of CEC in patients' blood circulation was counted before and after treatment. Besides, the number of CEC in 30 healthy persons was also counted for control. Results: The number of CEC in CHD-UAP patients was significantly higher than that in the healthy persons (P<0.01). After the patients were treated with CH, either TXL or HXTM, it significantly decreased (P<0.01)with insignificant difference between the two treated groups. Conclusion: CEC in CHD-UAP patients is severely damaged and endothelial function in disorder, Chinese herbs have protective effect on patients' CEC.

Supplementing Qi and activating blood circulation method to treat vertebrobasilar dolichoectasia with posterior circulatory watershed infarction:a case report of two patients

Vertebrobasilar dolichoectasia(VBD),a rare posterior circulation vascular variant disease,is an important risk factor for many acute cerebrovascular diseases.An insufficient understanding of VBD often leads to misdiagnose.Two cases of VBD that were initially diagnosed as posterior circulation watershed infarction are reported here.Absence of common causes of stroke including hypoperfusion,blood system diseases,carotid and aortic dissection,and eosinophil elevation,the symptoms of the 2 patients met the diagnostic criteria of VBD.Both patients displayed symptoms that were in line with the Traditional Chinese Medicine(TCM)syndrome pattern of"Qi deficiency and blood stasis".Accordingly,they were comprehensively treated with Supplementing Qi and activating blood circulation method.The clinical manifestations of the 2 patients were remarkably improved and no recurrence of watershed infarction was found in a 1-year follow-up.A detailed medical history and laboratory examination are capable of improving diagnostic accuracy of VBD.TCM treatment based on syndrome identification might be a promising candidate for VBD management.

益气活血方药治疗原发性肝癌的免疫学机制概述

归纳总结具有益气和/或活血功效的中药单体、单味中药以及中药复方治疗原发性肝癌的免疫学机制,包括对T淋巴细胞亚群、巨噬细胞、髓源性抑制细胞(myeloid-derived suppressor cell,MDSC)、肿瘤细胞表面受体、细胞因子以及红细胞免疫在数量和功能上的调节,阐述其抗肿瘤作用,为进一步的基础研究和临床应用提供思路。

Effect of Chinese Drugs for Supplementing Qi,Nourishing Yin and Activating Blood Circulation on Myocardial Perfusion in Patients with Acute Myocardial Infarction after Revascularization

Objective:To observe the effects of Chinese drugs for supplementing qi,nourishing yin and activating blood circulation on the myocardial perfusion in acute myocardial infarction(AMI) patients after revascularization.Methods:Eighty patients with anterior or inferior ventricular wall AMI,who had received revascularization by intravenous thrombolysis or coronary bypass,were randomized into the treated group and the control group equally,both treated with conventional Western medical treatment,but combined,resp...

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.

骨质疏松症“亏瘀致痿”的理论构建及临床应用

骨质疏松症(OP)是一种以增龄性骨量降低,骨微结构破坏,骨脆性增加且易骨折的代谢性骨病。该病好发于绝经后女性和中老年男性,起病隐匿,多数患者在骨折后才被确诊,造成了大量的医疗资源消耗。浙江中医药大学附属第三医院姚新苗教授研究团队基于“肾主骨”“肾气虚损”等基础理论,创新性提出了OP“亏瘀致痿”的致病理论,认为OP的病机是亏虚瘀互结、夹杂致痿。在该理论指导下,认为应采用“补肾健脾活血法”对OP患者进行辨证论治。补肾健脾活血法主要包括虚瘀同治;补肾为本、健脾为要;筋骨并重3个方面。该研究团队开展了一系列临床与基础研究,从不同角度阐释“亏瘀致痿”理论指导下OP康复策略的科学内涵。

费伯雄学术思想浅论骨肿瘤证治思路

本文在费伯雄的“醇正和缓,平淡和调”思想基础上的创新与发挥,阐述了中医对骨肿瘤的认识,将“固本清源”、“脾肾同治”“、费氏活血化瘀法”等应用于骨肿瘤辨证体系,对于“龙火汤”“立极汤”“后辛汤”“新定拯阴理劳汤”等进行创新应用,使其内涵与意义更符合现代中医药辨治肿瘤病的特点。在临床上灵活地按照肿瘤病发生发展的不同阶段分成了四期演变,并从病因、病机与治则方面辨治骨肿瘤发热以及骨肿瘤相关性失眠,在费伯雄学术思想指导下为临床骨肿瘤的诊治提供新思路。

Clinical Study on Effect of Chinese Herbal Medicine for Supplementing Kidney and Qi and Activating Blood Circulation in Treating Intrauterine Growth Retardation of Fetus

Objective: To explore the therapeutic effect and the possible working mechanism in using Chinese herbal medicine (CHM) for supplementing Kidney and Qi, and activating blood circulation in treating intrauterine growth retardation of fetus (IUGR). Methods: Fifty-five cases of IUGR were divided into two groups, 30 cases in the CHM group treated with CHM and the 25 in the control group treated with amino acids. The effect of CHM treatment was observed and compared with that of the control group, normal pregnancy group and non-treated IUGR group. Results: Body weight of the newborns in the CHM was markedly higher than that in the control group. Not only the maternal fundal height (FH) and the abdominal circumference (AC), but also the fetal growth parameters, including biparietal diameter, head circumference (HC), and femur length (FL) in the CHM group increased much faster than those in the control group. After CHM treatment, the maternal serum levels of estriol (E3) and human placental lactogen (hPL) approached to those in the normal pregnancy group, but the control group,in comparison with the normal pregnancy group, was significantly different. The umbilical venous plasma concentration of essential amino acids in both treated groups improved, but the improvement in the CHM group was more significant than that in the control group. No apparent adverse effect of CHM was observed in either mother or fetus.Conclusion: CHM for supplementing Kidney and Qi and activating blood circulation was more effective in improving placental function and enhancing amino acid transportation than amino acid

益气活血中药治疗慢性心力衰竭机制的研究进展

慢性心力衰竭是一种进行性的、使患者身体衰弱的疾病,病死率和再住院率居高不下。据报道,我国慢性心力衰竭患者基数庞大且持续增加,已成为严重的社会公共卫生问题。近年来,虽然现代医学在药物治疗方面不断改进,但是仍无法克服其致死率高、不良反应明显等不足。中医学认为慢性心力衰竭病位在心,心气亏虚,推动无力,从而导致血脉瘀滞。因此,益气活血法是治疗慢性心力衰竭的有效方法。益气活血药是以补虚扶弱、疏通血脉为主要功效,以治疗气虚血瘀证为主的一类中药。其代表药物有人参、黄芪、丹参、当归、川芎等,是治疗慢性心力衰竭心气虚证的常用药物。人参、黄芪益气强心,配合当归、川芎活血化瘀,在缓解心气不足、心血不运中显示出了良好疗效。诸多研究表明益气活血类中药具有多成分、多途径、多靶点的特点,在改善慢性心力衰竭患者症状,提高生活质量方面具有独特优势。近期研究发现其作用机制与血流动力学、神经内分泌系统、内皮损伤、免疫调节、炎症因子、氧化应激、心肌能量代谢、心室重构、自噬和凋亡等机制有关。文章旨在总结益气活血类中药改善心功能的作用机制,以期为慢性心力衰竭气虚血瘀证的治疗提供新思路。

肝豆状核变性脾切除肝功能变化对脾虚证的影响及健脾活血中药干预

目的:观察肝豆状核变性(HLD)脾大脾亢行脾切除术患者肝功能的变化及其对脾虚证形成的影响,并探讨健脾活血中药的干预效果。方法:选取安徽中医药大学第一附属医院普外一科80例HLD脾大脾亢行脾切除术患者,随机分为观察组(40例)与对照组(40例),采用单因素分析肝功能对HLD脾切除患者脾虚证形成的影响,观察2组患者治疗前后丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBIL)、直接胆红素(DBIL)、白蛋白(ALB)水平。并比较2组中脾虚证患者(观察组35例,对照组29例)的症状评分。结果:单因素分析结果显示术前与术后第1天ALT、AST、TBIL以及术前ALB水平与脾虚证形成有统计学意义;2组患者术前与术后第1天、第7天肝功能指标差异无统计学意义,术后第14天,观察组相比于对照组ALT、AST、DBIL水平显著下降,ALB水平显著升高,差异具有统计学意义。观察组运用健脾活血中药治疗脾虚证疗效明显优于对照组,差异具有统计学意义。结论:术前与术后早期肝功能是影响HLD脾切除患者脾虚证形成的重要因素,健脾活血中药显著地促进了脾切除术后肝功能恢复,同时对脾虚证的改善具有确切的疗效。

基于数据挖掘及网络药理学的益气活血法治疗膝骨关节炎的机制研究

目的:基于数据挖掘分析益气活血法的高频配伍规律,并通过网络药理学方法研究其核心药物组治疗膝骨关节炎的作用机制。方法:应用Python 3.8.1编程对中国中医药在线数据库进行智能抓取,分析其配伍规律,以符合支持度≥0.30,置信度≥0.90,提升度≥1.00的中药为核心药物组,通过中药系统药理学数据库与分析平台(TCMSP)获取核心药物组的主要活性成分,利用PubChem平台、Swiss Target Prediction平台收集药物靶标基因,通过GeneCards及OMIM数据库获得膝骨关节炎相关靶基因,利用Venny数据库获取药物靶点及疾病靶点的交集,采用Cysoscape软件和STRING数据库分析蛋白质-蛋白质相互作用网络,借助DAVID软件对关键靶基因进行基因本体论(GO)分析和京都基因与基因组百科全书(KEGG)通路分析,通过Systems Dock Web Site对成分与关键靶标基因进行分子对接验证。结果:以益气活血法中使用频次最高的药对黄芪-当归为核心药物组,并筛选得到22个活性成分,涉及74个关键靶基因。网络分析结果表明,核心药物组治疗膝骨关节炎的关键靶点为肿瘤坏死因子(Tumor Necrosis Factor,TNF)、Jun原癌基因(Jun Proto-Oncogene,JUN)、白细胞介素(Interleukin,IL)-6、IL-4、IL-1β和趋化因子2(C-X-C Motif Chemokine Ligand 2,CXCL2)等;GO富集分析主要涉及脂多糖反应、细胞死亡、迁移的正向调节、细胞因子受体结合等生物学过程,KEGG通路中晚期糖基化终末产物(Advanced Glycation End-product,AGE)与其受体(Receptor for Advanced Glycation End Products,RAGE)信号通路、TNF信号通路、IL-17信号通路与治疗膝骨关节炎密切相关,分子对接显示关键靶点与山柰酚、β-谷甾醇、槲皮苷具有较高亲和力。结论:初步预测了益气活血法核心药物组对膝骨关节炎的基本药理基础及作用机制,益气活血法治疗膝骨关节炎具有多基因参与、多信号通路的特点。

益气活血法在糖尿病周围神经病变中的应用进展

糖尿病周围神经病变(Diabetic Peripheral Neuropathy,DPN)是糖尿病(Diabetes mellitus,DM)持续发展所引起的常见慢性并发症之一。研究报道,50%~66%的DM患者最终均会出现该病变。DPN主要包括感觉神经、运动神经及自主神经系统的病变,其标志性临床特征是大、小神经纤维的进行性损伤。DPN患病率高、致病广泛、致残率高,给家庭及社会造成沉重负担。其所造成的反复肢体感染、溃疡甚至截肢是导致DM患者死亡和残疾的主要原因。目前,西医治疗以控制血糖、缓解氧化应激、改善微循环等疗法为主,在改善患者临床症状、控制疾病进展等方面效果有限。中医治疗本病历史悠久,认为本病病机多以气虚为本,瘀血为标,呈现虚实夹杂的病机特征。纵观文献,笔者发现诸医家论治本病多从健脾益气,活血通络入手,以黄芪桂枝五物汤、补阳还五汤等经典方剂加减论治,标本兼治,消补兼施,并以益气活血法为主,配合针刺、足浴等中医外治法实现多靶点、多途径防治本病,在改善患者临床症状、提高神经传导速度、减轻炎症反应、改善神经营养状态等方面疗效确切而显著,兹将近年益气活血法指导下的相关中医内治法包括中药汤剂、中成药及外治法在DPN中的应用进展综述如下。

益气活血化瘀方联合微生态制剂治疗早期糖尿病肾病临床观察

目的 探讨益气活血化瘀方联合微生态制剂对早期糖尿病肾病的影响。方法 选取脾肾气虚型早期糖尿病肾病患者共84例,随机分为对照组和试验组,每组42例。2组都给予常规干预,对照组予微生态制剂治疗,试验组在对照组基础上联合益气活血化瘀方治疗。比较24 h尿微量白蛋白含量、中医证候积分、临床疗效及血清HCY、CysC、CRP水平。结果 治疗3个月,试验组24 h尿微量白蛋白含量、中医证候积分低于对照组,临床疗效优于对照组,血清HCY、CysC、CRP水平低于对照组,差异均有统计学意义(P<0.05)。结论 益气活血化瘀方联合微生态制剂是早期糖尿病肾病的有效治疗方案,能够提高疗效、减少尿微量白蛋白含量、减轻临床症状和降低血清HCY、CysC、CRP水平。

韩氏中医治疗慢性肝病验案2则

验方攻补汤治疗慢性肝病以疏肝健脾、活血消癥为治疗大法。临证时刻注意攻伐勿过,以健脾疏肝、攻补兼施为大法,重视健脾益气药物的运用,结合疏肝、柔肝、补肝、潜肝阳敛肝阴以防理气药香燥戕害肝体。慢性肝病病程较长,久病穷肾患者多表现为肝肾亏虚的症状,针对这种情况临床重视补肾药物的应用,常用补肾药物有巴戟天、菟丝子、枸杞子、熟地黄等,同时为防止此类药物滋腻碍胃多配伍炒白术、醋青皮等动化药物,以防呆滞。治疗慢性肝病慎用破血逐瘀药,以活血养血滋养肝体为要,治黄勿忘治血,活血以退黄,和肝理脾重视气机,辨病与辨证相结合,分型施治,久病补肾兼以清化。韩氏中医认为肝脾不和、肝郁脾虚是慢性肝病主要病因,故治疗时应时时注意和肝理脾、调畅气机,并注意疏肝解郁,把握病机灵活化裁,标本兼治。气机不通,肝脉瘀阻为慢性肝病的主要病机,治疗应注重理气活血化瘀以阻止和逆转肝硬化,临床时针对肝病患者本虚标实、虚中夹实的病理实质,时刻注意破血药度和量,勿妄用逐瘀之品。依据慢性肝病不同阶段,结合辨证施治,在采用攻补汤治疗的基础上分型施治。文章分析韩氏中医治疗慢性肝病验案2则,以期为相关研究提供参考。

健脾活血利水方联合异甘草酸镁治疗失代偿期肝硬化临床研究

目的:观察健脾活血利水方联合异甘草酸镁治疗失代偿期肝硬化的临床疗效。方法:将184例失代偿期肝硬化患者按照随机数字表法分为对照组和试验组,每组各92例。对照组在常规对症及保肝治疗治疗的基础上给予异甘草酸镁注射剂,试验组在对照组治疗的基础上给予健脾活血利水方治疗。比较两组患者生活质量评分、临床疗效及不良反应发生情况,检测两组患者治疗前后血清丙氨酸转氨酶(alanine transaminase,ALT)及天冬氨酸转氨酶(aspartateaminotransferase,AST)水平。结果:试验组情感功能、系统症状、腹部症状等评分高于对照组(P<0.05)。两组患者治疗后ALT及AST低于本组治疗前,且治疗后试验组低于对照组(P<0.05)。对照组有效率为80.43%,试验组有效率为96.74%,两组有效率比较,差异具有统计学意义(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:健脾活血利水方联合异甘草酸镁治疗失代偿期肝硬化,临床疗效确切,可提高患者的生活质量,改善其肝功能。

Chinese Drugs That Invigorate Spleen to Remove Dampness and Activate Blood Circulation to Eliminate Turbid for Retarding Progression of Chronic Renal Failure

Objective: To investigate the effect of Chinese drugs (CD) that invigorate Spleen to remove Dampness and activate the blood circulation to eliminate Turbid for retarding progression of chronic renal failure (CRF).Methods: Thirty-nine patients with CRF were divided into two groups at random: the 18 patients in group A (the control group) were treated with low protein diet and controlling blood pressure and 21 patients in group B (the treatment group) were treated similarly with that of the control group and additional CD. Levels of serous creatinine (SCr), blood urea nitrogen (BUN), blood albumin (Alb), total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL) and hemoglobin (Hb) were checked every two months and the rate of progression of CRF was estimated by slope of the creatinine reciprocal (1/SCr) with time (months).Results: Levels of SCr and BUn in group B were lower and HDL higher than those in group A significantly,P < 0.05. Mean slopes of the creatinine reciprocal with time in the two groups were markedly different,P < 0.01.Conclusion: Additional CD treatment based upon the low protein diet and controlling blood pressure could retard the rate of progression of CRF evidently.

中药复方益肾康加减治疗气阴两虚兼血瘀证早期糖尿病肾病疗效观察及对炎症因子影响

目的 观察益肾康治疗早期糖尿病肾病(diabetic kidney disease,DKD)气阴两虚兼血瘀证患者的临床疗效及对血清炎症因子白介素-1β(IL-1β)、白介素-18(IL-18)的调节作用。方法 选取2019年1月—2021年1月就诊于辽宁中医药大学附属医院内分泌科确诊为气阴两虚兼血瘀证的早期DKD患者96例,采用随机对照研究方法,对照组(n=48)进行西医综合治疗(包括生活方式干预、控制血糖、控制血压、调脂),中药组(n=48)在对照组的基础上,加用益肾康煎剂100 mL,日3次口服;两组患者均持续治疗12周。观察两组患者临床疗效、尿微量白蛋白/尿肌酐(UACR)、中医证候评分、临床蛋白尿发生率,以及血清炎症因子IL-1β、IL-18的水平。结果 中药组治疗临床总有效率(83.33%)高于对照组(60.47%)(P<0.05);与治疗前相比,两组患者治疗后UACR均有所降低,但中药组差异具有统计学意义(P<0.01),而对照组差异无统计学意义(P>0.05);治疗后两组患者中医证候评分整体均呈下降趋势,且中药组中医证候评分下降更明显(P<0.01);两组患者临床蛋白尿发生率方面比较差异无统计学意义(P>0.05);与治疗前比较,治疗后两组患者血清IL-1β、IL-18水平均有所降低(P<0.01),与对照组相比,中药组患者血清IL-1β、IL-18水平降低更明显,差异有统计学意义(P<0.01)。结论 益肾康联合西医综合疗法治疗早期2型糖尿病肾病能提高临床疗效,改善患者中医症状,降低蛋白尿,减轻机体炎症反应,且安全性良好。

从线粒体自噬探讨脓毒性心肌病中西医微观层面的结合点

脓毒症是严重威胁人类生命健康的疾病,是当今急危重症医学领域亟待研究和攻克的感染性疾病。因氧化应激和心肌能量代谢障碍导致的心功能障碍是尚未解决的临床问题,目前尚无特效药物治疗。线粒体自噬在脓毒症心肌损伤的改善过程中具有重要意义,赋予线粒体自噬中医属性并将其与中医的益气活血相联系,有助于中西医对脓毒性心肌病微观层面的结合,促进脓毒性心肌病的中西医结合治疗,为脓毒性心肌病的机制研究和临床治疗提供一定的参考。

王苹从脾论治崩漏经验

崩漏可见于月经来潮后各年龄阶段的女性,但常见于青春期初潮及围绝经期女性,王苹教授认为,不同阶段的崩漏治疗侧重点不同,但在临证中应始终贯彻“从脾论治”的学术思想。脾虚气陷,统摄失司,或忧思伤脾者,方选黄土汤以甘温建中,补气养血;气机郁滞者,在健脾益气的同时常配伍使用柴胡、香附、陈皮、木香等药,肝气郁结,久而化热者,方选泻心汤加减以健脾疏肝,清热止血;冲任不固者,在健脾补肾,固冲止血的同时配伍菟丝子、补骨脂、女贞子、墨旱莲、淫羊藿、山茱萸等药;情志郁结,气机不畅者,方选桂枝茯苓丸以健脾止血,活血化瘀。王苹教授治疗崩漏以中焦为切入点,健脾益气摄血,疏肝补肾,调理气血以恢复正常月经周期,取得良好的疗效。

非痴呆型血管性认知障碍中西医治疗进展

西医治疗非痴呆型血管性认知障碍(VCIND)的有效药物主要有以下三类:以尼莫地平、丁苯酞为代表的脑循环改善剂,以奥拉西坦、甲磺酸二氢麦角碱为代表的脑代谢改善剂,以多奈哌齐为代表的胆碱酯酶抑制剂。中医认为VCIND可归属于呆证、健忘范畴,疾病的发生与痰、瘀、毒、虚相关,以活血、化痰、解毒、补肾填髓为基本治则。针灸、针药联合、中西药联合治疗临床应用广泛,其他疗法如认知康复训练、重复经颅电刺激、中文朗读等也逐渐在临床中推广应用。参考文献44篇。