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.

Clinical Experience in the Treatment of Vitiligo by the Method of Invigorating Qi,Promoting Blood Circulation and Detoxification

Studies have shown that traditional Chinese medicines have clear curative effects in the treatment of vitiligo with few side effects.Through literature research and clinical observation,the study summarized the etiology and pathogenesis of vitiligo in traditional Chinese medicine as"deficiency,toxin,and stasis",formulated the method of invigorating qi,promoting blood circulation and detoxification,and prescribed Fuse Hexue Jiawei Decoction for the treatment of vitiligo.

Treatment of Hypertensive Cerebral Hemorrhage by Activating Blood Circulation to Remove Stasis

The treatment of hy-pertensive cerebral hemorrhage(HCH)by activatingblood circulation to removestasis(ABCRS)is a newtherapeutic approach,which is initiated by clinical specialists of TCM andintegrative Chinese andwestern medicine.Al-though it is not a flawless

Exploration of the Effect and Mechanism of Activating Blood Circulation and Stasis-Removing Therapy on Tumor Metastasis

Metastasis is one of the specificities of late stage tumor and also a lethal factor often encountered. The study of tumor metastasis has important meaning for prolonging patients＇ survival and elevating their quality of life, but no really ideal prevention and treatment method has been found so far. Recent researches showed that tumor metastasis is correlated with platelet aggregation and blood hyperviscosity manner. Therefore, the early application of surgery, radiotherapy, chemotherapy and biological therapies, in combination with Chinese medicine therapy for activating blood circulation and removing stasis （ABCRS） may be, after all, an effective approach. ABCRS therapy is an important therapy of Chinese medicine, which, composed of several methods like smoothening blood flow in vessels, promoting blood circulation and dispersing stagnant blood, could influence tumor metastasis to different extents, and could coordinate with some other Chinese medicine therapeutic methods like supplementing qi, promoting qi, clearing heat, removing toxic substances, warming meridian, dispelling wind, eliminating dampness, nourishing yin, dissolving sputum, relieving stagnancy, emptying viscerals, etc. The effect and acting mechanism of ABCRS on tumor metastasis is summarized in this paper and its bi-directional regulatory effects discussed as well.

Effect of Removing Toxic Substances Combined with Activating Blood Circulation on Stabilizing the Atherosclerotic Plaque and Unstable Angina

The therapeutic effects of activating blood circulation to remove stasis of Chinese medicine （CM） in the prevention and treatment of atherosclerotic diseases such as coronary artery disease and angina are generally acknowledged. In recent years, to further improve the therapeutic effects of those Chinese herbs on such diseases, we have carried out a series of studies of CM medications with the function of clearing heat and removing toxic substances combined with activating blood circulation to remove stasis.

Study on the Therapeutic Mechanism of the Active Principle of the Chinese Drug Paeoniae Radix 801 through Affinity Biosensors IAsys Plus Quartz Crystal Microbalance

Objective: To study the targeted point and mechanism of the function of the blood-activating and stasis-removing Chinese drugs, Paeoniae Radix 801(PR801) in its cardiovascular protective effects and its specific binding with endothelin 1(ET-1) as well as the dynamics of the two's interactive function by means of using affinity biosensors: IAsys Plus and quartz crystal microbalance (IAQCM). Methods: ET-1 was immobilized on the surfaces of IAQCM by using the new surface modification methods. The PR801 in the solution was detected by modified substrates and the specific binding between PR801 and ET-1 was studied. Results: The curves went up or down after adding PR801.There is specific binding between PR801 and ET-1. The bound mass were 0.458 ng/mm 2 and 133.54 ng/cm 2, respectively. There exists relatively good stability with these two methods. Conclusion: The affinity biosensors: IAQCM can be used to study the interaction mechanism between PR801 and ET-1, providing a new way to study the interaction mechanism of TCM. PR801 can bind ET-1 specifically in the experiments. Therefore, ET-1 is another target that PR801 can bind specifically besides thromboxane A 2.

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.

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.

Activating Blood Circulation to Remove Stasis Treatment of Hypertensive Intracerebral Hemorrhage:A Multi-Center Prospective Randomized Open-Label Blinded-Endpoint Trial

Objective： To investigate the efficacy and safety of the Chinese herbal therapeutic regimen of activating blood circulation （TRABC） in treatment of hypertensive intracerebral hemorrhage （HICH）. Methods： This was a multi-center prospective randomized open-label blinded-endpoint （PROBE） trial with HICH admitted to 12 hospitals. Totally 240 participants were randomized to the treatment group treated with TRABC in addition to conventional Western treatment or the control group with conventional Western treatment equally for 3 months. Primary outcome was degree of disability as measured by modified Rankin Scale （mRS）. Secondary outcomes were the absorption of hematoma and edema, National Institutes of Health Stroke Scale （NIHSS） scores and patient-reported outcome measures for stroke and Barthel activities of daily living index. Adverse events and mortality were also recorded. Results： After 3 months of treatment, the rate of mRS 0-1 and mRS 0-2 in the treatment group was 72.5% and 80.4%, respectively, and in the control group 48.1% and 63.9%, respectively, with a significant difference between groups （P〈0.01）. Hematoma volume decreased significantly at day 7 of treatment in the treatment group than the control group （P=0.038）. Average Barthel scores in the treatment group after treatment was 89.11 ＋ 19.93, and in the control group 82.18 ＋ 24.02 （P=0.003）. NIHSS scores of the two groups after treatment decreased significantly compared with before treatment （P=0.001）. Patient-reported outcomes in the treatment group were lower than the control group at day 21 and 3 months of treatment （P〈0.05）. There were 4 deaths, 2 in each group, and 11 adverse events, 6 in the treatment group and 5 in the control group. Conclusion： The integrative therapy combined TRABC with conventional Western treatment for HICH could promote hematoma absorption thus minimize neurologic impairment, without increasing intracerebral hematoma expansion and re-bleeding.

凉血解毒透邪法调节皮肤常驻记忆性T细胞缓解寻常型银屑病复发的作用及机制研究

目的:观察凉血解毒透邪法(银屑灵方)对寻常型银屑病复发症状的影响及其对皮肤常驻记忆性T细胞(TRM)的影响。方法:选择72只SPF级Balb/C小鼠,体质量18~22 g,雄性,随机分为正常对照组、单发模型组,复发模型组、阳性药组(甲氨蝶呤,0.3 mg·kg-1·d-1)、银屑灵方低、高剂量组(生药23.5 g·kg-1·d-1,47.0 g·kg-1·d-1),共6组,每组12只。除正常对照组外,其它小鼠裸背处涂抹5%咪喹莫特乳膏(IMQ)50 mg,每天1次,连续7 d。放置不作处理,为银屑病缓解期模型。4周后进行2次造模(复发造模),除了正常对照组和单发模型组以外,其余小鼠背部涂抹5%IMQ 50 mg,每天1次,连续5 d。给药:给药时间为首次造模期间和造模后2周。在2次造模的第3天,对各组小鼠皮损进行了第1次银屑病面积与严重性指数(PASI)评分;在2次造模的第5天,再次对各组小鼠皮损进行了PASI评分;并处死动物,对小鼠体质量丢失量、脾脏指数进行分析。采用HE染色,在显微镜下评价黏膜病理损伤指数;采用免疫组织化学检测小鼠皮损的PCNA蛋白的表达;采用荧光定量qPCR检测银屑病相关炎症因子mRNA的表达;采用流式细胞术检测皮损区TRM细胞数量的变化,并用荧光定量qPCR检测TRM细胞产生与存活相关因子的表达水平,采用免疫组织化学和蛋白免疫印迹法检测TRM细胞表型和存活相关蛋白的表达。结果:与复发模型组比较,银屑灵方能够缓解银屑病复发模型小鼠皮损外观症状,抑制体质量丢失和表皮增厚;减低皮损处白细胞介素(IL)17、IL23、肿瘤坏死因子α(TNFα)mRNA的表达和皮肤PCNA蛋白的表达。银屑灵方能够减少银屑病小鼠缓解期皮损区表型为CD3+TCRγδ+CD8+CD103+的TRM细胞数量;并能抑制皮损区IL7、IL15、BCL6和PRDM1 mRNA的表达水平及STAT5磷酸化水平。结论:银屑灵方有效减缓银屑病复发小鼠的皮损,其机制可能是通过抑制TRM形成的转录因子水平、调控TRM存活与增殖的信号STAT5通路及下游信号分子IL7、IL15的表达,减少缓解期原皮损区TRM细胞数量,达到改善银屑病复发的效果。

金志春教授治疗盆腔炎性不孕症临证经验探赜

盆腔炎性不孕症属于临床常见病,中医治疗在增强机体免疫力、促进炎症吸收、改善盆腔环境等方面具有优势。本文从辨证思路、治疗特色、临证施治等方面系统阐述金志春教授治疗盆腔炎性不孕症的学术思想与经验。辨证思路提出本病属本虚标实之症,肾虚为本,血瘀为标,二者互为因果互促。引“邪之所凑、其气必虚”思想,断肾虚血瘀胞阻病因病机。治疗特色以“补肾活血、祛瘀通胞脉”为基本大法,因人制宜,灵活辨证,兼夹症状,顾阴阳气血平衡。辅以清热利湿、温阳暖宫、滋阴降火、疏肝调脾、气血双补等治法。衷中西合参,喜抗炎中药。临证施治承前人之学术思想,立足整体,谨守病机,补肾活血祛瘀,结合兼证行辨证论治,促进妊娠,为解决患者不孕症难题提供参考和思路。

不同炮制方法对益母草化学成分及活血化瘀作用的影响

研究不同炮制方法对益母草化学成分及活血化瘀作用的影响,为合理用药提供指导。选择盐酸益母草碱、盐酸水苏碱、芦丁、金丝桃苷、异槲皮苷为指标,评价醋制、酒制、四制对益母草生物碱类和黄酮类成分的影响;采用急性血瘀大鼠模型,以凝血酶时间、纤维蛋白原、全血高切粘度、全血中切粘度、全血低切粘度、血浆粘度、全血高切还原粘度、全血中切还原粘度、全血低切还原粘度为指标,评价醋制、酒制、四制对益母草活血化瘀作用的影响。结果显示不同方法炮制后益母草中盐酸益母草碱、盐酸水苏碱等生物碱类成分含量略有下降,芦丁、金丝桃苷、异槲皮苷等黄酮类成分含量明显下降;不同方法炮制后益母草能不同程度改善模型大鼠的血液流变学指标。本研究表明不同炮制方法对益母草生物碱类成分的影响较小,对黄酮类成分的影响较大;不同炮制方法均能不同程度增强益母草的活血化瘀作用。

补气活血法应用于冠心病治疗的教学评价

目的分析中医补气活血法运用于冠状动脉粥样硬化性心脏病治疗中的教学评价情况。方法选择2021年9月—2022年9月滨州医学院烟台附属医院的实习生12人作为研究对象,分为对照组与观察组,对照组运用冠状动脉粥样硬化性心脏病传统教学模式,观察组运用中医补气活血法进行冠状动脉粥样硬化性心脏病教学,比较两组最终理论成绩以及对教学模式的满意度。结果观察组实习生最终的理论成绩高于对照组(P<0.05)。观察组对教学模式的总满意度为100.00%(6/6),高于对照组的50.00%(3/6)(P<0.05)。因此观察组应用的教学模式更容易受到实习生喜欢。结论在冠状动脉粥样硬化性心脏病治疗的教学中采取中医补气活血法,教学效果较好,受到了实习生的喜爱,且教学满意度较高,能有效提高实习生理论成绩。

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.

苏筋通络方结合“行气活血”针刺法治疗急性踝关节扭伤临床观察

目的观察苏筋通络方结合“行气活血”针刺法治疗急性踝关节扭伤临床效果。方法将医院创伤骨科门急诊就诊的102例急性踝关节扭伤患者(2020年5月—2022年7月)纳入研究,以随机数字表法将患者分为两组,每组51例,对照组采取西医常规治疗,观察组采取西医常规治疗同时结合苏筋通络方及“行气活血”针刺法治疗。数据比较:临床治疗效果、中医症状(踝关节疼痛肿胀、皮下瘀斑、关节活动受限等)积分变化、踝关节跖屈活动度与背伸活动度变化、视觉模拟评分(Visual Analogue Scale,VAS)变化、美国足踝外科协会(American Orthopaedic Foot and Ankle Society,AOFAS)踝-后足评分变化、血清疼痛物质(神经生长因子、神经肽、P物质)水平变化、白细胞介素-6(Interleukin-6,IL-6)、白细胞介素-1β(Interleukin-1β,IL-1β)、超敏C反应蛋白(Hypersensitive C-reactive protein,hs-CRP)变化。结果观察组患者与对照组患者治疗总有效率相比[98.04%(50/51)vs86.27%(44/51)],P<0.05;治疗后各组患者中医症状(踝关节疼痛肿胀、皮下瘀斑、关节活动受限等)积分、踝关节跖屈活动度与背伸活动度、VAS评分、AOFAS踝-后足评分、神经生长因子、神经肽、P物质、IL-6、IL-1β、hs-CRP等指标均改善,观察组患者治疗后中医症状(踝关节疼痛肿胀、皮下瘀斑、关节活动受限等)积分、踝关节跖屈活动度与背伸活动度、VAS评分、AOFAS踝-后足评分、神经生长因子、神经肽、P物质、IL-6、IL-1β、hs-CRP等指标均明显优于对照组患者,P均<0.05。结论苏筋通络方结合“行气活血”针刺法治疗急性踝关节扭伤临床效果显著,患者经治疗后临床症状显著改善,疼痛缓解,踝关节功能改善,值得应用。

化浊解毒活血方对慢性萎缩性胃炎伴随肠上皮化生患者PG、PGR、LI-CD的影响

目的探讨化浊解毒活血方对慢性萎缩性胃炎(CAG)伴肠上皮化生患者血清胃蛋白酶原(PG)、胃蛋白酶原比值(PGR)及胃黏膜中肝肠钙黏连蛋白(LI-CD)表达的影响。方法采用随机数字表法,将2016年1月—2017年12月在河北省中医院脾胃病科诊治的120例CAG伴肠上皮化生患者分为中药组和中成药组,每组60例。中药组口服化浊解毒活血方(1剂/d,分2次温服),中成药组口服摩罗丹(每次8丸,3次/d),2组疗程均为6个月。比较2组患者治疗前后胃镜像病情程度、病理(炎症、腺体萎缩、肠上皮化生)变化程度、血清PG水平、PGR和胃黏膜肠化生组织中LI-CD阳性表达情况。结果治疗后,2组胃镜像和炎症、腺体萎缩、肠上皮化生程度均较治疗前明显改善(P均<0.05),且中药组的改善情况均明显优于中成药组(P均<0.05)。治疗后,2组血清PGⅠ水平和中药组PGR均较治疗前明显升高(P均<0.05),2组血清PGⅡ水平和中成药组PGR与治疗前比较差异均无统计学意义(P均>0.05);治疗后中药组血清PGⅠ和PGⅡ水平均明显高于中成药组(P均<0.05)。治疗后,2组胃黏膜肠化生组织中LI-CD阳性表达平均光密度值均较治疗前明显降低(P均<0.05),且中药组明显低于中成药组(P<0.05)。结论化浊解毒活血方能有效改善CAG伴肠上皮化生患者的病理表现,可能与其提升血清PGI水平,下调LI-CD在胃黏膜的表达有关。

基于调控免疫炎症微血管损伤的补气活血法治疗肺炎“瘥后防复”思路的提出

肺炎恢复期后遗症严重影响患者身心健康,存在二次感染的风险,且与基础病相互影响导致恶性循环。做好肺炎恢复期康复工作,减少后遗症并预防反复发作是疾病防治的首选。研究显示肺炎长期后遗症和反复发作的机制可能与持续的机体免疫抑制和全身微炎症状态及微血管损伤有关。团队根据传统中医理论,结合长期临床与基础研究,提出“气虚血瘀”是肺炎恢复期的核心病机。因此,团队提出补气活血法治疗肺炎“瘥后防复”的机制与调控免疫炎症微血管损伤有关,调控T淋巴细胞紊乱提高免疫、抑制炎症因子改善机体微炎症状态和抗氧化保护内皮细胞调控微血管损伤,阐明其内在机制将为中医药治疗呼吸系统重大感染性疾病提供理论依据,传承精华、守正创新。

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。

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。