Clinical Efficacy of Modified Erchen Decoction on Cervical Spondylotic Vertebral Arteriopathy with Stagnation and Blockade of Phlegm-dampness Syndrome and Effects on Cerebral Blood Flow Parameters

OBJECTIVE: To observe the effect of Modified Erchen Decoction on cervical spondylotic vertebral arteriopathy with stagnation and blockade of phlegm-dampness syndrome and effects on cerebral blood flow parameters. METHODS: A total of 80 cervical spondylotic vertebral arteriopathy(CSA) patients with stagnation and blockade of phlegmdampness syndrome admitted to our hospital from October 2016 to April 2017 were selected and randomly divided into observation group and control group, with 40 cases in each group. The observation group was treated with Modified Erchen Decoction and the control group was given conventional treatment with Western medicine. After 4 weeks of treatment, the main clinical symptoms and signs(vertigo, neck and shoulder pain, headache, psychological and social adjustment, daily life and work) and cerebral blood flow parameters [the peak values of intracranial vertebral-basal artery diastolic blood flow velocity(Vd) and systolic blood flow velocity(Vp)] were compared between the 2 groups. The total clinical effective rate and adverse reactions during treatment were also compared. RESULTS: After treatment, the total effective rate of the observation group was 90.0%, which was significantly higher than that of the control group(77.5%). The difference between the two groups was statistically significant(P < 0.05). After treatment, The scores of vertigo, neck and shoulder pain, headache, psychology and society adaptation, daily life and work were significantly increased(P < 0.05), and the above scores of the observation group were increased more obviously. The difference between the groups was statistically significant(P < 0.05). After treatment, the levels of Vd and Vp were significantly increased(P < 0.05), and the increase of the above indexes was more obvious in the observation group. The difference between the 2 groups was statistically significant(P < 0.05). There were no significant abnormalities in blood routine, urine routine, liver function and renal function. There was no significant difference in the incidence of adverse reactions between the 2 groups.(P > 0.05). CONCLUSION: The treatment of vertebral artery type cervical spondylopathy with stagnation and blockade of phlegm-dampness syndrome by Modified Erchen Decoction can effectively relieve the main clinical symptoms and signs, improve cerebral blood flow parameters, and improve the peak values of vertebral-basal artery diastolic blood flow velocity(Vd) and systolic blood flow velocity(Vp), which is safe and effective, and helps to promote the recovery of cervical function.

A Clinical Study of Safflower Yellow Injection in Treating Coronary Heart Disease Angina Pectoris with Xin-Blood Stagnation Syndrome

Objective： To evaluate the clinical effect and safety of Safflower Yellow injection （SYI） in treating coronary heart disease angina pectoris （OHD-AP） with Xin-blood stagnation syndrome （XBSS）. Methods： Adopted was the multi-centered, randomized, positive parallel controlled method, 448 patients with CHD-AP-XBSS were enrolled and divided into two groups, 336 in the tested group treated with SYI and 112 in the control group treated with Salvia injection by intravenous dripping once a day for 14 days, so as to observe the conditions of angina, electrocardiogram, and therapeutic effect on traditinal Chinese medicine （TCM） symptoms as well as the safety of the treatment. Results： The significantly effective rate and total effective rate in the tested group were 60.06% （194/323） and 91.02 % （294/323） respectively; those in improvement of TOM symptoms were 40. 18% （129/321） and 75.23% （243/323） respectively, which were better than those in the control group （P〈0.01）. Conclusion： SYI Injection is effective and safe in treating OHD-AP-XBSS.

Plasma L-ENK, AVP, ANP and serum gastrin in patients with syndrome of Liver-Qi-stagnation

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A Clinical Study on the Treat ment of Chronic Pelvic Inflammation of Qi-stagnation with Blood Stasis Syndrome by Penyanqing Capsule (盆炎清胶囊)

Objective： To observe the clinical efficacy of Penyanqing Capsule （盆炎清胶囊, PYQC） in treating pelvic inflammation of Qi-stagnation with blood stasis syndrome. Methods： The randomized, single blinded, parallel positive drug controlled method was adopted, with 82 patients assigned into two groups by envelop method. The 42 patients in the treated group received PYQC 3 times a day, 4 capsules each time taken orally; the 40 patients in the control group were given orally Fuyankang tablets （妇炎康片, FYKT） 3 times a day, 6 tablets each time. The therapeutic course for both groups was 2 months, and 2 courses of treatment were given successively to observe the comprehensive effect, changes of symptoms and signs before and after treatment. The effects of PYQC on hemorrheological character in part of the patients and on the pathogenetic chlamydia and mycoplasma were also observed. Results： The total effective rate in the treated group was 83.3%, which was insignificantly different from that in the control group （77.5%, P〉0.05）. However, PYQC could significantly lower the hemorrheologic indexes in patients and showed definite influence on the pathogenetic chlamydia and mycoplasma. Conclusion： PYQC has good therapeutic effect in treating chronic pelvic inflammation of Qi-stagnation with blood stasis syndrome, and showed definite effect on chlamydia and mycoplasma.

Study on the relationship between syndrome characteristics degree and inflammatory factor and negative emotional scale in"double heart disease"patients with Qi stagnation blood stasis and heart gallbladder heat stagnation

Objective:To Discuss the correlation between Hypersensitivity C-reactive Protein(Hs-CRP),Total Cholesterol(TC),Triglyceride(TG),negative emotion scale and TCM syndrome scores in“Double Heart Disease”patients with Qi stagnation blood stasis and heart gallbladder heat stagnation.Method:Fifty-two patients in Western Medicine Diagnosis of Double Heart Disease,in TCM syndrome identified as Qi stagnation blood stasis Heart gallbladder heat stagnation syndrome,detects it Hs-CRP,TC,TG levels by ELISA,use TCM Syndromes Scale to evaluate TCM Syndrome,use the Pittsburgh Sleep Quality Index(PSQI)and Self-rating symptom scale(SCL-90)to assess anxiety and sleep levels,analyze the correlation between TCM syndrome scores and Hs-CRP,TC,TG level,PSQI index,SCL-90 index.Result:There was a significant positive correlation between Hs-CRP,TG level and TCM Syndrome scores(P<0.05);TC level was postively correlated with TCM Syndrome scores,but there was no statistical significance(P>0.05);There was a significant positive correlation between PSQI index,SCL-90 index and TCM Syndrome scores(P<0.05).Conclusion:In“Double Heart Disease”patients with Qi stagnation blood stasis and heart gallbladder heat stagnation,there have characteristic syndrome changes in terms of inflammatory factor level,blood lipid level and negative emotion score;Which the above indexes can reflect the severity of TCM syndromes to a certain extent and provide the basis for the effective intervention treatment of TCM.

Biological basis of “depression with liver-qi stagnation and spleen deficiency syndrome”: A digital gene expression profiling study

Objective:To investigate the biological basis of“depression with liver-qi stagnation and spleen deficiency syndrome”.Methods:A digital gene expression profiling method was conducted to explore global changes in the mRNA transcriptome in a rat model of depression with liver-qi stagnation and spleen deficiency syndrome.Real-time quantitative polymerase chain reaction(q-PCR)was performed to verify the five genes most interest based on the Kyoto Encyclopedia of Genes and Genome(KEGG)analysis.Sini San,which disperses stagnated liver qi and strengthens the spleen,was administered to the model rats to observe whether it could reverse these genetic changes in the liver.Results:Forty-six differentially expressed genes were identified.Three of the five genes of most interestdHnf4a,Hnf4g and Cyp1a1dbased on KEGG analysis,were confirmed by realtime q-PCR.Sini San reduced the gene expression changes of Hnf4a,Hnf4g and Cyp1a1 in the rat model.Conclusions:Hnf4a,Hnf4g and Cyp1a1 are involved in“depression with liver-qi stagnation and spleen deficiency syndrome”.These findings indicate that depressed rats with liver-qi stagnation and spleen deficiency syndrome are at risk of liver diseases.Furthermore,our results will inform exploration of the etiology of depression and help in the development of effective therapeutic strategies.

Rules of Ren Shunping's prescription for trearing Spleen Deficiency and Qi Stagnation Syndrome of Functional Dyspepsia Based on Data Mining

Objective:To explore the medication rules of Professor Ren Shunping treating spleen deficiency and qi stagnation syndrome of functional dyspepsia,so as to provide reference for clinical prevention and development of new drugs.Methods:The 144 Chinese herbal formulas considered as active prescribed by professor Ren Shunping for the first time treating the patients with spleen deficiency and qi stagnation syndrome of functional dyspepsia were collected,entered into TCM inheritance auxiliary platform(V2.5),and then mined by some data mining methods of the software,such as the association rules and unsupervised entropy hierarchical clustering.Results:This study involved 144 Chinese herbal formulas,including a total of 56 Chinese herbal medicines.Of these Chinese herbal medicines,the herbs of cold and warm nature,and pungent,bitter and sweet in flavors were used in a quite high frequency,all of which act on spleen,stomach,lungs,large intestine,liver and gallbladder meridians.One core Chinese herbal formula was excavated,composed of patchouli,perilla stem,radix bupleuri,scutellaria,ginger pinellia,codonopsispilosula,magnolia bark,tangerine peel,large-headed atractylodes,immature bitter orange,wood incense,fructus amomi,inula britannica chinensis,ginger,medicated leaven,fried rice and fried malt based on the association rules.And a total of 17 groups of core used drugs and 2 groups of new Chinese herbal formulas undiscovered were mined based on unsupervised entropy hierarchical clustering.Conclusion:In treating spleen deficiency and qi stagnation syndrome of functional dyspepsia,professor Ren is good at treating spleen deficiency and qi stagnation syndrome of functional dyspepsia from the perspective of"tong jiang",using the"five-in-one"strategy of strengthening the spleen,evacuating the liver,coming down qi from the stomach,dispersing lung,and bowel-reflexing to treat patients as a whole.And the herbal medicines were light in dose,lovely and mild in nature for the formulars.At the same time,he paid attention to the combination of syndromes and symptoms,and flexible arbitration.

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

目的：观察芍药苷（PF）、芍药内酯苷（AF）对血虚肝郁证候模型大鼠外周血细胞、脏器指数、造血细胞因子的影响,探讨白芍养血柔肝功效的物质基础及作用机制.方法：将SD雄性大鼠,根据体质量随机分组,每组12只.除空白组外,其余均采用放射线辐照结合慢性束缚应激复制血虚肝郁证候模型.观察大鼠体质量、脏器指数,并监测外周全血中白细胞（WBC）、红细胞（RBC）、血红蛋白（HGB）的数量,分离血清用放射免疫法（RIA）检测大鼠白细胞介素-3（IL-3）、粒细胞-巨噬细胞集落刺激因子（GM-CSF）、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）的含量.结果：与模型组比较,PF30mg·kg^-1组和AF30mg·kg^-1组体质量、脾脏指数、白细胞数量明显增加（P〈0.05、P〈0.01）.RIA结果显示,PF30mg·kg^-1组和AF30mg·kg^-1组均可增加该组IL-3含量（P〈0.05、P〈0.05）和减少该组TNF-α含量（P〈0.05、P〈0.05）.结论：芍药苷、芍药内酯苷通对骨髓造血系统和免疫系统的调节作用,发挥对血虚肝郁大鼠的补血作用,提示二者均为白芍养血柔肝功效的主要有效成分.

Clinical Effect of Yinma Zhisou Decoction Combined with Western Medicine in the Treatment of Acute COPD(Stagnation of PhlegmDampness in Lung)

[Objectives]To explore the effectiveness and safety of Yinma Zhisou Decoction in the treatment of AECOPD with phlegm-heat obstructing lung syndrome,and observe the symptoms of Yinma Zhisou decoction in the treatment of AECOPD patients with phlegm-heat stagnation lung syndrome improvement,inflammatory indicators,lung function,blood gas analysis,etc.[Methods]A total of 92 cases who met the inclusion criteria and exclusion criteria were included in the study according to 1∶1 were randomly divided into treatment group and control group,control group with conventional Western medicine treatment,the treatment group on the basis of control group with Yinma Zhisou decoction treatment,a course of 10 d.The changes in TCM syndrome score,arterial blood gas analysis,pulmonary function,serum inflammatory indicator,mMRC score,and the CAT scores between the two groups after treatment were observed.All collected data were statistically analyzed with SPSS 26.0.[Results](i)Comparison of the curative effect between the two groups.After treatment,the total effective rate of the treatment group was 93.5%,which was higher than that of the control group(76.1%,P<0.05).The curative effect of the treatment group was better than that of the control group(P<0.05).(ii)Comparison of single TCM symptom scores.After treatment,the single TCM symptom scores of the two groups were lower than before(P<0.05),but the improvement of wheezing,cough,phlegm and chest pain in the treatment group was better than that in the control group(P<0.05).There was no significant difference in the improvement of wheezing sound(P>0.05),but there was a trend of difference.(iii)Comparison of mMRC score and CAT score between the two groups.After treatment,the mMRC score and CAT score of the two groups were significantly improved(P<0.05),and the difference was statistically significant.(iv)Comparison of blood gas analysis indicators between the two groups.Intra-group comparison after treatment:PaOof the control group and the treatment group after treatment was significantly improved compared with that before treatment(P<0.05),and the difference was statistically significant.Comparison between the two groups after treatment:PaOand PaCOof the two groups after treatment(P>0.05),and the difference was not statistically significant.It indicated that Yinma Zhisou decoction had more advantages in improving hypoxia.(v)Comparison of pulmonary function between the two groups.After treatment,the FEV1/FVC of the treatment group and the control group was significantly different(P<0.05),and there was a statistical difference(P<0.05).(vi)Comparison of inflammatory indicators between the two groups.Intra-group comparison after treatment:the inflammatory indicators WBC,CRP and PCT in the control group and the treatment group were significantly lower than before treatment(P<0.05),and the differences were statistically significant.It indicated that Yinma Zhisou decoction could effectively control inflammation and reduce inflammation reaction.[Conclusions]Compared with the control group,Yinma Zhisou decoction has obvious advantages in improving cough,expectoration and wheezing,and can significantly improve the total effective rate.Compared with Western medicine alone,Yinma Zhisou decoction can significantly improve patients’hypoxia,reduce mMRC and CAT scores,improve body activity tolerance,improve airway symptoms,and significantly reduce WBC,CRP,PCT and other serum inflammatory indicators.It can be seen that Yinma Zhisou decoction combined with Western medicine treatment is obviously better than simple Western medicine treatment,the curative effect is better,and the safety is better,and there are no serious adverse reactions in the course of the trial.

Study on the Resolving Phlegm Effect of D-Limonene in Mice with Spleen Deficiency and Phlegm-Dampness Syndrome

Objective:According to Traditional Chinese Medicine theory,spleen deficiency and phlegm-dampness syndrome(SDPDS)are caused by abnormal water metabolism in the body because of spleen dysfunction.The purpose of this article was to evaluate the efficacy of D-limonene(DL)in resolving phlegm in mice with SDPDS from the perspective of regulating the level of aquaporin 3(AQP3).Methods:The model of SDPDS was induced in mice using the multifactor modeling method,which combines internal and external dampness.An artificial climate box was used to create a humid environment,whereas the irregular diet was caused by different feeding methods on odd-even days.The mice were divided into blank control,model group,DL low-dose,DL high-dose,and positive groups.The mice were modeled and treated for 7 day.Levels of gastrin and amylase(AMS)in the serum,mucus secretion in the trachea,and AQP3 in the tissue near the gastric cardia.Results:DL significantly reduced mucus secretion in the trachea(P<0.001).It also increased the level of AMS in the serum(P<0.01)and decreased the level of AQP3 in the gastric tissue(P<0.01).Conclusions:Mice with SDPDS exhibited disturbed water metabolism and significantly increased AQP3 levels.DL can restore the levels of AQP3 and plays an important role in resolving phlegm.This study may also help expand the efficacy of natural drugs containing DL and improve the utilization of natural drug resources.

坚骨胶囊对气滞血瘀型肘关节骨关节炎的影响

目的 探讨坚骨胶囊治疗气滞血瘀型肘关节骨关节炎的临床效果。方法 选择2018年1月至2021年6月河北省沧州中西医结合医院收治的气滞血瘀型肘关节骨关节炎患者90例,按照随机数字表法将其分成两组,每组45例。观察组采用坚骨胶囊联合玻璃酸钠治疗,对照组单用玻璃酸钠治疗,两组连续治疗5周。比较两组临床疗效,比较治疗前后Mayo肘关节功能评分(MEPS)、患侧肘关节关节活动度(ROM)、视觉模拟评分法(VAS)评分,以及关节滑液中基质金属蛋白酶-3(MMP-3)、白细胞介素-1β(IL-1β)、软骨寡聚基质蛋白(COMP)、转化生长因子-β_(1)(TGF-β_(1))水平。比较两组不良反应发生情况。结果 观察组临床疗效优于对照组(P<0.05)。治疗后,两组MEPS评分、肘关节ROM高于治疗前,VAS评分低于治疗前,且观察组MEPS评分、肘关节ROM高于对照组,VAS评分低于对照组(P<0.05)。治疗后,两组关节滑液中MMP-3、IL-1β、COMP水平低于治疗前,关节滑液中TGF-β_(1)水平高于治疗前,且观察组关节滑液中MMP-3、IL-1β、COMP水平低于对照组,关节滑液中TGF-β_(1)水平高于对照组(P<0.05)。两组治疗过程中均无明显不良反应发生。结论 联合坚骨胶囊治疗能更有效地调控气滞血瘀型肘关节骨关节炎患者关节滑液中MMP-3、IL-1β、COMP和TGF-β_(1)的表达水平,促进关节软骨修复。

三七活骨丸联合体外冲击波对气滞血瘀型早期股骨头缺血性坏死患者的影响

目的 观察三七活骨丸联合体外冲击波(ESW)对气滞血瘀型早期股骨头缺血性坏死的影响。方法 选取2021年4月至2022年10月黑龙江中医药大学附属第二医院收诊的72例气滞血瘀型早期股骨头缺血性坏死患者,采用随机数字表法将其分为对照组和观察组,各36例。对照组采用ESW治疗,观察组在对照组的基础上口服三七活骨丸,两组均治疗4周。观察治疗前及治疗2、4周后两组视觉模拟评分法(VAS)评分、髋关节Harris评分、中医证候评分,并进行疗效评价。比较两组治疗前后血清白细胞介素(IL)-1β、IL-6、肿瘤坏死因子-α(TNF-α)、骨保护素(OPG)水平。结果 对照组有4例患者在治疗期间服用其他药物,故剔除。观察组临床疗效优于对照组(P<0.05)。两组治疗2、4周后VAS、中医证候评分均低于治疗前,髋关节Harris评分高于治疗前,两组治疗4周后VAS、中医证候评分均低于治疗2周后,髋关节Harris评分高于治疗2周后(P<0.05)。治疗2、4周后,观察组髋关节Harris评分高于同期对照组,中医证候评分低于同期对照组(P<0.05)。治疗4周后,观察组VAS评分低于同期对照组(P<0.05)。治疗4周后,两组血清IL-1、IL-6、TNF-α水平低于治疗前,血清OPG水平高于治疗前,且观察组血清IL-1、IL-6、TNF-α水平低于对照组,血清OPG水平高于对照组(P<0.05)。结论 三七活骨丸联合ESW对于改善气滞血瘀型早期股骨头缺血性坏死患者的症状疗效良好,适合临床应用。

加味苓桂术甘汤对阳虚水停证慢性心力衰竭患者TGF-β1、TNF-α、NT-proBNP及心室重构的影响

目的探究加味苓桂术甘汤对阳虚水停证慢性心力衰竭患者TGF-β1、TNF-α、NT-proBNP及心室重构的影响。方法将2017年12月至2020年11月六安市中医院收治的98例阳虚水停证慢性心力衰竭患者纳入本研究,随机分为两组,各49例。对照组行西医常规治疗,观察组在此基础上行加味苓桂术甘汤口服治疗,治疗6个月后检测心功能,血清肿瘤坏死因子(tumor necrosis factor,TNF)-α、转化生长因子(transforming growth factor,TGF)-β1、同型半胱氨酸(homocysteine,Hcy)、氨基末端脑钠素原(amminoterminal brain sodium minogen,NT-proBNP)水平并比较临床疗效。结果两组患者治疗后各项指标均较治疗前明显改善(P<0.05)。其中观察组患者治疗后血清TNF-α、TGF-β1、Hcy、NT-proBNP、左室舒张末期内径、左室收缩末期内径和中医证候总积分低于对照组,左室射血分数、6 min步行距离和临床疗效高于对照组(P<0.05)。结论加味苓桂术甘汤治疗阳虚水停证慢性心力衰竭可减轻患者炎症反应,预防心室重构,提高临床疗效。

基于Thinc-it工具分析抑郁症不同证型患者认知功能

目的:通过Thinc-it工具探讨抑郁症不同证型患者认知功能特点。方法:从2020年6月至2022年7月宁波市第一医院心身医学科确诊为抑郁症的患者中选取肝气郁结、气郁化火、痰气郁结、心脾两虚证型患者各50例为受试者,并选取同期在医院健康体检志愿者50例为健康对照组。应用汉密尔顿抑郁量表(hamilton depression scale,HAMD)、汉密尔顿焦虑量表(hamilton anxiety scale,HAMA)对各组受试者临床症状进行评估,并分别通过Thinc-it工具进行认知功能评估,具体包括认知损害5项问卷(5-item questionnaire for cognitive impairment,PDQ-5-D)、选择反应时间任务(selection response time,CRT)、1-Back记忆任务(selection response time,1-Back)、数字符号替代测试(digit symbol substitution test,DSST)和连线测试B(line test B,TMT-B)测试。结果:抑郁症各证型组病程、HAMD评分、HAMA评分比较,痰气郁结证组和心脾两虚证组病程时间相对更长,但组间比较,差异无统计学意义(P>0.05)。郁证各证型组HAMD评分、HAMA评分高于健康对照组,差异具有统计学意义(P<0.05)。郁证各证型组PDQ-5-D评分高于健康对照组(P<0.05),郁证各证型组间比较,差异无统计学意义(P>0.05)。与健康对照组比较,郁证各证型组CRT计数减少,CRT反应时间延长,差异具有统计学意义(P<0.05)。组间比较,心脾两虚证组CRT计数高于肝气郁结证组,痰气郁结证组CRT反应时间长于肝气郁结证组,差异具有统计学意义(P<0.05)。与健康对照组比较,郁证各证型组1-Back计数减少,痰气郁结证组、心脾两虚证组1-Back反应时间延长,差异具有统计学意义(P<0.05),郁证各证型组间比较,差异无统计学意义(P>0.05)。与健康对照组比较,郁证各证型组DSST计数减少,DSST反应时间、TMT-B耗时延长,差异具有统计学意义(P<0.05)。心脾两虚证组、痰气郁结证组DSST反应时间长于肝气郁结证组、气郁化火证组,差异具有统计学意义(P<0.05)。结论:抑郁症各证型患者均存在主观认知功能、注意力、记忆力、执行功能、信息加工处理速度等方面的损害,且各证型受损程度不一,且痰气郁结证组、心脾两虚证组在注意力、执行功能、处理速度方面较肝气郁结证组和气郁化火证组受损更严重。

乌灵胶囊联合针灸治疗肝郁脾虚证腹泻型肠易激综合征的临床疗效及安全性

目的探讨乌灵胶囊联合针灸治疗肝郁脾虚证腹泻型肠易激综合征(irritable bowel syndrome with diarrhea,IBS-D)的临床疗效及安全性。方法选取肝郁脾虚证IBS-D患者140例。按随机数字表法将所有患者分为对照组和观察组,各70例。对照组给予水疗基础治疗+口服马来酸曲美布汀胶囊和乌灵胶囊治疗,观察组在对照组的治疗基础之上联合针灸治疗。评价两组患者的综合疗效和总体证候疗效,采用肠易激综合征生活质量量表(irritable bowel syndrome quality of life scale,IBS-QOL)对肝郁脾虚证IBS-D患者治疗前和疗程结束后生活质量变化情况进行评估,采用汉密顿焦虑量表(hamilton anxiety scale,HAMA)评估患者治疗前与疗程结束后焦虑程度,采用汉密顿抑郁量表(hamilton depression scale,HAMD)评估患者治疗前与疗程结束后的抑郁程度。采用酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)检测患者血清二胺氧化酶(diamine oxidase,DAO)、D-乳酸和肠脂肪酸结合蛋白(intestinal fatty acid binding protein,IFBP)、5-羟色胺(5-hydroxyteyptamine,5-HT)、降钙素基因相关肽(calcitonin gene related peptide,CGRP)水平。结果观察组的综合疗效97.14%(68/70)高于对照组85.71%(60/70),差异有统计学意义(χ^(2)=5.833,P<0.05);观察组的总体证候疗效98.57%(69/70)高于对照组82.86%(58/70),差异有统计学意义(χ^(2)=10.260,P<0.05);观察组疗程结束后IBS-QOL评分高于对照组,差异有统计学意义(t=4.272,P<0.05),观察组疗程结束后HAMA、HAMD评分低于对照组,差异有统计学意义(t=8.535,10.534,P<0.05);观察组疗程结束后DAO、D-乳酸、IFABP水平低于对照组,差异有统计学意义(t=7.229,13.046,7.016,P<0.05);观察组疗程结束后HT、CGRP表达水平低于对照组,差异有统计学意义(t=4.620,2.027,P<0.05);观察组患者不良反应发生率8.57%(6/70)高于对照组5.71%(4/70)(χ^(2)=0.431,P>0.05)。结论乌灵胶囊联合针灸可提升临床疗效,可有效改善IBS-D患者的生活质量和焦虑抑郁状态,同时对降低DAO、D-乳酸、IFABP、5-HT、CGRP水平,缓解胃肠道症状效果显著,且安全性较高。

柴芍胃康汤联合四联疗法治疗肝胃气滞证Hp阳性慢性萎缩性胃炎的疗效观察

目的:观察柴芍胃康汤联合四联疗法治疗肝胃气滞证幽门螺杆菌(Hp)阳性慢性萎缩性胃炎(CAG)的疗效及对患者胃泌素-17(G-17)、丙二醛(MDA)、胃蛋白酶原(PG)Ⅰ和PGⅡ水平,胃黏膜组织病理和Hp根除的影响。方法:选取2021年6月至2023年5月该院收治的肝胃气滞证Hp阳性CAG患者140例,按随机数字表法分为联合组和对照组(各70例)。对照组患者给予标准四联疗法,联合组患者在对照组的基础上给予柴芍胃康汤治疗。比较两组患者治疗前后血清G-17、MDA、PGⅠ和PGⅡ水平,胃黏膜组织病理评分、Hp根除率,观察安全性和临床疗效。结果:治疗后,两组患者血清G-17、PGⅠ水平明显升高,MDA、PGⅡ水平和胃黏膜组织病理评分明显降低;且联合组患者血清G-17、PGⅠ水平较对照组升高,MDA、PGⅡ水平和胃黏膜组织病理评分较对照组降低,差异均有统计学意义(P<0.05)。联合组患者的Hp根除率、总有效率分别为92.86%(65/70)、92.86%(65/70),明显高于对照组的81.43%(57/70)、81.43%(57/70),差异均有统计学意义(P<0.05)。结论:柴芍胃康汤联合四联疗法治疗肝胃气滞证Hp阳性CAG的疗效较好,可改善患者胃功能、氧化应激和胃黏膜组织病理损伤,并可有效提高Hp根除率。

大黄防治疫病的理论及应用探微

大黄是常用的攻下驱邪药,驱逐停滞,效用以除血之滞、饮之积和食之积为主。疫病里热积滞用大黄通食滞,常见大黄类方有表里双解的宣白承气汤和防风通圣散;调畅气机的治疫大黄类方有升降散和大柴胡汤等。疫病血瘀证用大黄导血滞如桃核承气汤,疫病津液代谢障碍用大黄除水滞如茵陈蒿汤等。

基于脾火论辨治原发性干燥综合征

基于脾火论辨治原发性干燥综合征(pSS)。论述了脾火论的理论内涵,并区分脾火与阴火及其他脏腑之火的差异。阐释了脾火论与pSS的相关性,认为脾气亏虚,运化无权,脾不升清,郁而化火是pSS病机关键;久而病及他脏,导致络脉瘀滞是pSS的病机转化特点。以健脾益气,除火润燥,生津通络为pSS的治疗大法,为pSS的中医辨治提供思路与方法。

益气清解方治疗气虚毒滞型桥本甲状腺炎的疗效观察及对T细胞亚群的影响

目的:观察益气清解方治疗气虚毒滞型桥本甲状腺炎甲状腺功能正常患者的疗效及对T淋巴细胞亚群的影响。方法:选取80例气虚毒滞型桥本曱状腺炎甲状腺功能正常患者进行随机分组,每组40例。观察组予益气清解方治疗,对照组予硒维尔治疗,治疗12周后评价疗效,观察两组治疗前及治疗12周后的中医证候积分、甲状腺功能、自身免疫抗体滴度水平、T淋巴细胞亚群水平变化。结果:治疗12周后,观察组中医证候总有效率高于对照组(P<0.05);两组甲状腺球蛋白抗体(TG-Ab)、甲状腺过氧化物酶抗体(TPO-Ab)水平均较治疗前下降(P<0.05),观察组下降幅度大于对照组(P<0.05);两组患者外周血调节T细胞CD_(4)^(+)CD_(25)^(+)Foxp3^(+)Tregs占CD_(4)^(+)T比值(CD_(4)^(+)CD_(25)^(+)Foxp3^(+)Tregs/CD_(4)^(+)T比值)、CD_(4)^(+)CD_(25)^(+)Foxp3 mRNA表达量较治疗前明显升高(P<0.05),CD_(4)^(+)/CD+8比值较治疗前下降(P<0.05);观察组变化幅度大于对照组(P<0.05)。结论:益气清解方能有效改善气虚毒滞型桥本曱状腺炎甲状腺功能正常患者的中医证候,下调甲状腺自身免疫性抗体,改善机体免疫功能。

汪龙德运用疏肝健脾法从脾胃论治干燥综合征经验

介绍汪龙德主任医师运用疏肝健脾法从脾胃论治干燥综合征的临床经验和学术思想。认为干燥综合征的关键病机是肝郁脾虚,发病部位在肝脾,属虚实夹杂证,临证强调运用疏肝健脾法为基本治法,使肝气畅达,疏泄正常,气行血行,则瘀血渐除,气机布散津液于全身;脾胃健运,气血津液化生有源,痰饮水湿自化,则清窍腠理得以濡润。辅以清热润燥、养血生津、活血祛瘀,标本同治,可获良效。并结合案例,介绍了疏肝健脾法治疗干燥综合征的应用,以期为临床诊疗提供参考。