Efficacy and safety of the decoction of nourishing marrow and raising energy in terms of Traditional Chinese Medicine in patients with vascular dementia:a randomized controlled trial

OBJECTIVE: To explore the efficacy and safety of the decoction of nourishing marrow and raising energy in terms of Traditional Chinese Medicine(TCM) in patients with vascular dementia.METHODS: Totally 86 patients with vascular dementia patients hospitalized from September 2010 to January 2015 were recruited and randomly divided into two groups: control group and observation group. Patients in control group received the conventional treatment, whereas patients in another group were treated with the therapy of nourishing marrow and raising energy according to the theory of TCM. Blesse dementia scale scores were measured before and after the treatment for both groups and adverse effect was documented as well.RESULTS: After treatment, Blesse dementia scale scores reduced in both groups, and the difference in score reduction between the two groups was significant(P<0.05). The rate of adverse events was significantly lower in observation group than in control group(P<0.05).CONCLUSION: Our results demonstrate that the decoction of nourishing marrow and raising energy was an effective and safe alternative to vascular dementia in human subjects.

Cultural Nourishment for the Development of Chinese Medicine

Medicine,especially traditional Chinese medicine,is by no means a single level of knowledge system and operational skills,blit is frill of humanistic color,encompassing natural science and social science,medical theory and traditional culture.Traditional Chinese medicine is rooted in the splendid traditional culture of China,and its theoretical exploration methods and explanations are based on the historical and colorful traditional Chinese culture.This article will give advice on the irrigation and nourishment of traditional culture.

Therapeutic effect of traditional Chinese medicine on coagulation disorder and accompanying intractable jaundice in hepatitis B virus-related liver cirrhosis patients

AIM： TO observe the therapeutic effects of new traditional Chinese medicine （TClVl） therapy on coagulation disorder and accompanying intractable jaundice in HBV-related liver cirrhosis patients. METHODS： Using stratified random sampling according to fibrinogen （Fib） levels, 145 liver cirrhosis patients due to hepatitis B complicated by coagulation disorder were treated. Of them, 70 in research group were treated with TCM by ＂nourishing yin, cooling blood and invigorating blood circulation＂ and Western medicine, 75 in control group were treated with conventional Western medicine. The indexes of liver function, coagulation function and bleeding events were observed and compared. RESULTS： The prothrombin time （PT） was shorter and the fibrinogen （Fib） level was higher in the research group than in the control group （Fib = 1.6-2.0 g/L, 1.1-1.5 g/L, and ≤ 1.0 g/L）. The total bilirubin （TBIL） level was significantly lower in the research group than in the control group, except for the subgroup of FIB ≤ 1.0 g/L. CONCLUSION： TCM therapy can improve coagulation fuction and decrease TBIL.

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.

Therapeutic Effect of Chinese Herbal Medicine for Strengthening Qi,Nourishing Yin,and Removing Stasis on Serum Osteopontin and Quality of Life of Patients with Primary Sjogren's Syndrome

Objective：To observe the therapeutic effect of Chinese herbal medicine for strengthening qi, nourishing yin,and removing stasis on serum osteopontin（OPN） and quality of life（QOL） in patients with primary Sjogren＇s syndrome（pSS） and to study the correlation between OPN level and the disease.Methods：Sixtyeight pSS patients were randomly assigned to two groups：the treatment group（35 cases） treated by Chinese herbal medicine for strengthening qi,nourishing yin,and removing stasis combined with hydroxychloroquine sulfate tablet（HCQ） and the control group（33 cases） treated by HCQ only.Both were treated for 3 months. Before and after treatment,immunoglobulin G（IgG） level,erythrocyte sedimentation rate（ESR）,and OPN level were measured.The QOL in patients was evaluated using the Short Form-36 Health Survey（SF-36） before and after treatment.Thirty healthy females were taken as the normal control.Results：Before treatment,levels of IgG,ESR,and OPN in patients were higher than those in the normal control.After 3 months of treatment, those in both treatment groups decreased but were lower in the treatment group than those in the control group （P0.05）.The scores of 8 dimensions of SF-36 were lower in the pSS patients than those in the normal control （P0.05） and higher in the treatment group than in the control group after treatment（P0.05）.Furthermore, there was a positive correlation between the levels of OPN and the levels of IgG and ESR,and a negative correlation between OPN levels and the overall score of SF-36（P0.05）.Conclusions：Chinese herbal medicine for strengthening qi,nourishing yin,and removing stasis could alleviate pSS disease and improve the QOL.In addition,the OPN level might be used as an evaluating index for pSS disease.

Effect of Chinese Herbal Medicines for Nourishing Yin,Supplementing Qi,and Activating Blood on Reproductive Endocrine Activity and Immune Functions in Patients with Primary Sjogren's Syndrome

ABSTRACT Objective： To investigate the effect of Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood on the reproductive endocrine-immune network and its mechanisms in patients with primary Sjogren＇s syndrome （pSS）. Methods： Seventy pSS patients were randomly assigned to two groups using a randomized digital table： the integrative therapy group （36 cases） and the control group （34 cases）. Thirty healthy subjects were taken as a normal group. The control group was treated with hydroxychloroquine sulfate tablets alone, and the integrative therapy group was treated by Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood combined with hydroxychloroquine sulfate tablets. The treatment course was 6 months for both groups. Before and after treatment, serum estradiol （E2）, testosterone （T）, luteinizing hormone （LH）, prolactin （PRL） by radioimmunoassay and immunoglobulin （IgG） by immunodiffusion, erythrocyte sedimentation rate （ESR） by Westergren, interferon-γ （IFN-γ） and interleukin-4 （IL-4） by enzyme linked immunosorbent assay were determined. Results： E2 and T levels in all patients were lower than those of normal subjects before treatment （P〈0.05） and were increased significantly after 6-month treatment （P〈0.05）. ESR, FSH, LH, IgG, IFN - γ, IL - 4 and ratios of E2/T, and IFN --γ/IL in the patients were higher than those of normal subjects before the treatments （P〈0.05）, and were reduced significantly after the treatments （P〈0.05）. The T and IFN -γ levels and E2/T ratio in the patients treated with integrative therapy were reduced significantly compared with the control group （P〈0.05）. However, the PRL levels before and after treatment were not significantly changed in the two groups （P〉0.05）. The ratios of E2/T and IFN -γ/IL-4, and levels of IgG and ESR were positively correlated before and after treatment （P〈0.05）. Conclusions： The ratios of E2/T and IFN - γ/ IL-4 might be used as indicators of pSS activity. Chinese herbal medicines for nourishing yin, supplementing qi, and activating blood combined with Western medicine could improve the therapeutic effect by regulating the reproductive endocrine-immune network in pSS patients.

Effect of Chinese Medicine Therapy for Strengthening-Pi and Nourishing-Shen in Preventing Lamivudine Induced YMDD Mutation and Its Immunologic Mechanism

Objective： To observe the effect of Chinese medicine therapy for strengthening-Pi （脾） and nourishing-Shen （肾, SPNS） in preventing lamivudine induced YMDD mutation and its immunological mechanism. Methods： One hundred and sixty chronic hepatitis B （CHB） patients with positive HBeAg were equally assigned to two groups at random： the observation group and the control group. Patients in the observation group were treated with lamivudine combined with SPNS, and those in the control group were treated with lamivudine only, with the treatment lasting for 52 weeks in total. Changes in indexes, including liver function, HbeAg, HBV-DNA, YMDD variation, CD4, CD4/CD8 ratio, interferon- γ, （IFN-γ）, interleukin-4 （IL-4）, blood routine, renal function, as well as any adverse reactions that occurred in patients, were observed at different time points. Results： The ALT, AST recovery rate and HBV-DNA negatively inversing rate at the 24th week, the 36th week and the 52nd week were all higher （P〈0.05）; meanwhile, the YMDD mutation rate at the 36th week and the 52nd week was lower （P〈0.05） in the observation group than in the control group. The post- treatment levels of CD4, CD4/CD8 ratio, IFN- γ, and IL-4 as well as the pre-post treatment difference of these indexes in the observation group were significantly different from those in the control group （n=〈0.05）. Conclusion： Chinese medicine SPNS therapy can significantly reduce the YMDD variation of HBV, and the mechanism may be related to its regulation of the CD4 level, CD4/CD8 ratio and Th1/Th2 balance. KEYWORDS Chinese medicine therapy for strengthening-Pi and nourishing-Shen, lamivudine, YMDD mutation, mechanism

中药滋阴补阳方剂治疗肾气亏虚型多囊卵巢综合征不孕症对患者超声动态多参数的影响评价

目的评价中药滋阴补阳方剂治疗肾气亏虚型多囊卵巢综合征不孕症对患者超声动态多参数的影响。方法选取2022年1月至2023年1月江西省妇幼保健院收治的80例肾气亏虚型多囊卵巢综合征患者作为研究对象,按照随机数字法将其分为观察组(40例)与对照组(40例)。对照组采用枸橼酸氯米芬片治疗,观察组在对照组方法的基础上联合中药滋阴补阳方剂治疗。比较两组患者的治疗效果、卵泡发育情况、激素水平、子宫动脉血流灌注情况及子宫内膜厚度。结果观察组的有效率高于对照组,差异有统计学意义(P<0.05);观察组治疗后的卵泡及优势卵泡数目多于对照组,差异有统计学意义(P<0.05);观察组治疗后的黄体生成素(LH)、促卵泡激素(FSH)、睾酮(T)均低于对照组,雌二醇(E2)高于对照组,差异有统计学意义(P<0.05);观察组治疗后的搏动指数(PI)、阻力指数(RI)均低于对照组,差异有统计学意义(P<0.05);观察组治疗后的子宫内膜厚度高于对照组,差异有统计学意义(P<0.05)。结论将中药滋阴补阳方剂应用于肾气亏虚型多囊卵巢综合征不孕症患者治疗中,可积极改善患者的激素水平及子宫动脉血流灌注情况,同时能够促进卵泡发育,增加子宫内膜厚度,改善症状,值得推广。

基于本体方法探讨“养血”中医护理概念模型的构建

目的探讨建立“养血”中医护理概念模型的思路与方法,实现该领域概念术语的规范、管理和利用。方法通过对中医文献中“养血”护理相关信息的提取,基于本体建模三步法“分析—描述—验证”,构建概念模型框架、概念的属性及概念间的语义关系。结果构建的“养血”中医护理概念模型框架,包括6个一级类目、25个二级类目,语义关系涉及功能、概念、空间、时间、物理上相关。结论本文为“养血”中医护理概念模型的完成、该领域知识的共建、共享及运用奠定基础。

补肾益髓法治疗阿尔茨海默病临床疗效的荟萃分析

目的系统评价补肾益髓中药复方治疗阿尔茨海默病的疗效。方法检索6个国内外常用数据库,检索时间为自建库起至2022年7月5日,收集补肾益髓中药复方治疗阿尔茨海默病的临床随机对照试验文献,进行Meta分析。结果共纳入文献研究12篇,共计733例患者,其中试验组371例,对照组362例。分析结果显示应用补肾益髓中药复方治疗阿尔茨海默病在临床治疗有效率[RR=1.63,95%CI(1.37,1.93),Ρ<0.00001],提高患者MMSE评分[MD=1.19,95%CI(0.98,1.40),Ρ<0.00001],降低患者ADAS-cog评分[MD=-2.68,95%CI(-4.95,-0.40),Ρ=0.02],降低患者中医证候评分[SMD=-0.64,95%CI(-0.92,-0.36),Ρ<0.00001]方面优于单纯的常规西医治疗;在降低患者ADL评分上与西医比较差异无统计学意义[MD=-0.78,95%CI(-2.24,-0.40),Ρ=0.69],具有相同疗效;在安全性指标及不良反应方面未见明显异常。结论补肾益髓中药复方治疗阿尔茨海默病对比单纯西医治疗在临床治疗有效率,提高MMSE评分、降低ADAS-Cog和中医证候积分上具有一定优势,但因纳入文献多数质量不高,故仍需开展大规模、多中心、高质量临床试验以进一步验证结论。

滋阴泻火中药治疗女童功能性卵巢囊肿的临床疗效分析

目的:分析滋阴泻火中药治疗女童功能性卵巢囊肿的临床疗效。方法:选择2021年1月—2022年12月收治的卵巢囊肿患儿40例,所有患儿均给予滋阴泻火中药治疗,连续治疗3个月。比较患儿治疗前、治疗3个月后发育情况(身高、体质量、骨龄、乳房发育Tanner分期)、性激素水平、子宫与卵巢容积、卵巢囊肿体积及不良反应情况。结果:治疗前后患儿身高、体质量、骨龄比较,差异无统计学意义(P>0.05);治疗后患儿乳房发育Tanner分期较治疗前改善显著,差异有统计学意义(P<0.05);治疗后患儿黄体生成素(LH)、促卵泡激素(FSH)、雌二醇(E2)水平较治疗前均降低,差异有统计学意义(P<0.05);治疗后患儿子宫大小、卵巢容积、卵巢囊肿体积较治疗前降低,差异有统计学意义(P<0.05);患儿治疗期间未见严重不良反应。结论:滋阴泻火中药治疗女童功能性卵巢囊肿效果较佳,可调节患儿E2水平,抑制外周性性早熟,利于卵巢囊肿缩小。

养阴清肺解毒方联合靶向药物治疗阴虚热毒型非小细胞肺癌临床观察

目的观察运用养阴清肺解毒方联合靶向药物治疗阴虚热毒型非小细胞肺癌(NSCLC)的临床效果。方法180例患者随机分为观察组和对照组,每组90例。对照组采用常规西药治疗,观察组在对照组基础上联合养阴清肺解毒方内服治疗。观察两组临床疗效及治疗前后血清T细胞亚群水平、血清肿瘤标志物水平。结果观察组患者临床治疗总效率为55.56%(50/90),高于对照组的27.78%(25/90),差异有统计学意义(P<0.05)。治疗后,两组患者血清T细胞亚群水平均高于治疗前,差异有统计学意义(P<0.05),但两组间比较,差异无统计学意义(P>0.05)。两组患者各项血清肿瘤标志物水平均较治疗前降低,差异有统计学意义(P<0.05),但两组间比较,差异无统计学意义(P>0.05)。结论养阴清肺解毒方联合靶向药物治疗阴虚热毒型NSCLC的效果确切,患者耐受性佳。

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。

术后认知功能障碍的中医理论及临床应用研究进展

术后认知功能障碍(POCD)是围术期发病率较高的并发症之一,日益威胁着患者的脑健康以及快速康复进程,其具体发病机制尚未明确,因此缺少确切有效的预防治疗手段。中医对于认知功能疾病的理论研究,为POCD的综合防治提供了着力点,其临床实践以“神”为要点,术前养神,术后调神,心、肝、肾多脏腑共同调控,展现出了良好的效果。在中医理论指导下的临床实践极大地丰富了POCD的防治手段,并开拓了广阔的治疗前景。本文对近年来有关POCD的中医理论研究与临床防治方法作一综述,以期为POCD的预防与治疗探索更多、更有效的新思路及新方法。

急性心肌梗死中西医结合诊疗平台标准化建设

急性心肌梗死(acute myocardial infraction,AMI)对全球人类健康构成了重大威胁,针对AMI的中西医结合诊疗平台的标准化建设显得尤为重要。广州中医药大学第二临床医学院(广东省中医院)重症医学科团队承担了这一历史使命,致力于探索和推进针对AMI的中医药防治策略以及中西医结合诊疗体系的建设。团队首创了AMI“救心·治心·养心”三位一体模式,专注于AMI中西医结合诊疗标准化构建,创建并实践了益气活血化痰法治疗AMI关键技术体系,突显AMI中西医结合诊疗平台标准化建设成果。

基于滋阴相关理论探讨甲状腺功能亢进症

甲状腺功能亢进症(简称甲亢)是临床常见的内分泌代谢疾病,其主要特征为甲状腺激素过多引起的一系列临床症状,如汗多、烦躁、手颤和消瘦快等。尽管西药治疗在控制甲亢方面取得了一定成效,但其常见的不良反应和高复发率限制了其长期应用。与此相比,中医药治疗甲亢的独特优势逐渐受到重视。文章以古代文献和现代研究为理论基础,从滋阴出发,核心思想为“阴常不足,阳常有余”,重在探讨滋补肝肾阴的治疗策略在甲亢中的应用。肝肾同源理论认为肝阴为血,肾阴为精,二者相互滋养,共同维持阴阳平衡和气血循环。肝肾阴虚会导致甲亢的发展和症状的加重。因此,在甲亢的防治中注重滋养肝肾之阴具有重要意义。研究显示,应用具有滋养肝肾阴之功效的中药,如加味二至方、六味地黄丸等,能够有效改善甲状腺功能、减轻症状,降低血清甲状腺相关指标和甲状腺内血管形成。这些药物通过打破肝肾阴虚状态使机体达到阴阳平衡,从而更有效地控制甲亢的进展。综上所述,滋补肝肾阴类中药在甲亢治疗中具有潜在优势。但目前其相关机制研究还不够明确,仍需更多的实验研究及临床多中心、随机对照、大样本研究作为理论支撑,将有助于临床实践中更好地应用中医药治疗甲亢。

基于“肾-脾-肠轴”探讨健脾滋肾法调节肠道菌群治疗系统性红斑狼疮的可行性

从肠道菌群对系统性红斑狼疮(SLE)发病机制的影响出发,推测以“肾-脾-肠轴”为理论指导,运用“立足脾肾,固本培元”“健脾滋肾,清肠祛邪”的治疗手段,可调节肠道菌群恢复机体平衡,延缓SLE的发展。

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。

亚健康失眠的中医辨证分型及临床用药思路

失眠是亚健康状态的主要表现之一。在病因病机上可归于劳逸失度、阴血亏耗,情志不舒、肝郁化火,饮食偏嗜、痰湿内生3方面。在中医证型上可分为心神失养证、火扰心神证、气郁痰阻证3型。针对亚健康失眠的中医保健,应以辨证保健为主结合对症保健。辨证保健上以利尿导热、滋阴降火法清心安神缩短入睡时间,以补虚敛神、益精养血法养心安神维持睡眠深度,以理气化痰、利胆和胃法疏泄通滞调节寐寤表现;对症保健上以重镇与甘缓类药物改善烦躁不宁、心神不安的表现,以导阳入阴药物改善节律紊乱症状,实现辨证、对症相结合。

基于“春夏养阳”理论指导运用脐疗法护理1例心力衰竭患者

本文总结1例基于“春夏养阳”理论指导的脐疗法在心力衰竭患者中的应用效果。基于中医辨证理论指导,运用因时施治原则,采取脐疗法隔姜灸联合穴位贴敷,配合生活指导、饮食指导、心理指导等综合干预,改善心力衰竭患者不适症状及伴随体征,提高患者的生活质量。