Meta-analysis of clinical efficacy and safety of kidney Tonifying therapy in the treatment of interstitial lung disease

Objective:To evaluate the efficacy and safety of kidney tonifying therapy in the treatment of Interstitial Lung Disease(ILD).Methods:We searched Wanfang Data,CNKI,CBM,VIP,Pub Med,EMBASE,Web of science and Cochrane Library for Randomized Controlled Trials(RCTs)of kidney tonifying therapy in the treatment of ILD.The retrieval time was from the establishment of the database to December 15,2020.Rev man 5.3 software was used to analyze and summarize the collected literature,and the methodological quality of the included studies was evaluated by the bias risk assessment scale of Cochrane Collaboration Network.Results:A total of 15 articles with 1045 patients were included.The results of meta-analysis showed that compared with the control group treated with conventional western medicine alone,kidney tonifying therapy or combined with conventional western medicine was beneficial to improve the clinical total effective rate[RR=1.33(95%CI 1.24-1.43),P<0.00001].At the same time,compared with the control group treated with routine western medicine,kidney tonifying therapy or combined with routine western medicine can improve cough and wheezing symptoms of patients[MD=-0.62(95%CI-0.78~-0.46),P<0.00001]and MD=-0.79(95%CI-0.18~-0.49),P<0.00001].However,there was no significant improvement in 6-minute walk test and lung function(DLCO%)(P>0.05);only one study reported 7 patients with adverse reactions,but after corresponding treatment,the symptoms were significantly relieved.The analysis of the characteristics of intervention measures in the treatment group showed that there were a total of 80 traditional Chinese medicines involved,of which Shu Dihuang appeared the most frequently,and the tonic drugs were used the most.The two meridians of the lung and kidney appear most frequently.Among the four qi and five flavors,warm and sweet medicines have the highest frequency.Conclusion:Adopting kidney-tonifying method or combined with conventional Western medicine treatment can improve the total clinical effectiveness of patients.Adopting kidney-tonifying method or combined with conventional Western medicine treatment to improve symptoms such as coughing and wheezing.No serious adverse reactions have been reported,and the safety is reliable.Due to the low quality of the included literature,the results of this study need to be verified by high-quality,large sample randomized controlled trials.

Meta-analysis of the treatment of chronic obstructive pulmonary disease by tonifying lung and kidney

Objective:To A randomized controlled trial(RCTS)of lung tonifying and kidney tonifying in the treatment of chronic obstructive pulmonary disease(copd)by meta-analysis.Methods:Computer retrieval of databases such as CNKI、VIP、WanFang、Cochrane Library、EMbase、PubMed.The retrieval time was from the database construction to March 2020,and two evaluators were selected to screen the documents according to the na sorting standards,extract the data with Excel 2010 software,and perform Meta analysis with Rev Man5.3 software.Results:21 RCTS were included.Meta-analysis results show that compared with the conventional treatment,the method of supplementing lung and tonifying kidney can obviously improve lung function(MD=1.69,95%CI[1.36,2.01],P<0.00001)、reduce TCM syndrome score(MD=39.83,95%CI[18.10,61.56],P=0.0003)、improve life quality(MD=-5.90,95%CI[-8.95,-2.85],P=0.0001)、regulates serum immunoglobulin(MD=0.37,95%CI[0.31,0.44],P<0.00001)、improve 6MWD(MD=39.83,95%CI[18.10,61.56],P=0.0003)、improve CAT(MD=-1.68,95%CI[-2.05,-1.30],P<0.00001).The differences were statistically significant.For improved T lymphocyte subsets(MD=0.96,95%CI[-0.10,2.03],P=0.08)not statistically significant.Conclusion:Lung-tonifying kidney-tonifying method had better efficacy in improving lung function,reducing TCM syndrome score,improving quality of life,improving immunoglobulin,improving 6WMD,improving CAT,but the efficacy in improving t-lymphocyte subgroup was similar to that in the control group.Due to the limited quantity and quality of samples included in this paper,more multicenter randomized controlled trials with rigorous design of large samples should be carried out for verification.

A Novel Apprehension of the Primary Lung Meridian, Sinew Channel, Divergent Channel, Luo-Connecting Channel Acting as a Single Unit System to Serve Respiration Function Based on Modern Neurophysiology and Kinesiology

The TCM philosophy of a meridian and associated channels pertains to the specific function of one or more organs. We define the Lung Primary Meridian (LUM) together with the Lung Sinew (LUSC), Divergent (LUDC), Luo-connecting (LULCC) Channels as a system of routes plus some parts of the body (such as muscles) to fulfil respiration, as a main function under different situations. There is very limited information about the Lung associated channels in classical literature of TCM. With a clear focus on the function of respiration, we have carried out a detailed analysis of the biomedical consequence of stimulating the LUM, analysed the roles played by LUSC, LUDC, and LULCC. The updated LUM and LUDC include acupoints of other meridians, serving the same purpose of performing satisfactory respiration starting from checking the quality of the inflow through the nose. The LUSC includes the respiratory muscles (plus the associated connective tissues) extending to various parts of the body. The muscles of the limb (as part of the LUSC) embrace the nerves that provide routes for somatosensory reflexes and play the role of locomotion, providing voluntary respiration via the pectoralis muscles. The muscles of LUSC are bounded by stiff connective tissue layers, forming compartments, and are part of the pulley system for various body locomotions. Within a compartment, the interstitial fluid, blood, lymph flows must be potent to protect the associated nerves related to LUM;the healthy state of the LUSC also provides freedom of various types of locomotion. The LULCC exists because the vagus nerve has a part of it passing through the spinal cords all the way down to the sacrum domain, with exiting nerve innervating two-third of the large intestine. The crucial steps of our deductions are supported by experimental evidence based on modern neurophysiology and kinesiology. We discover that all the four channels stated above work as a unit system to allow respiration to be possible under various postures/conditions. The complexity of structures and processes is eased off by providing 29 figures and 13 tables for the relevant muscles and nerves. In addition to respiration, the Lung system in TCM context includes interaction of this system with the sweat gland and neuroendocrine system;such aspects will be left to another study.

Premature ovarian insufficiency identified as a kidney deficiency and liver constraint pattern treated by Professor Zhiqiang Guo:A retrospective analysis

Objective:To study the efficacy of Professor Zhiqiang Guo's unique sequential herbal therapy in the treatment of premature ovarian insufficiency(POI)of the kidney deficiency and liver constraint pattern.Methods:Ninety patients with POI who consulted with Professor Guo at Dongzimen Hospital,Beijing University of Chinese Medicine from January 2012 to December 2015 were enrolled.Treatment consisted of sequential therapy using traditional Chinese medicine formulae with the actions of nourishing the liver and kidney.Course of treatment was 3 consecutive menstrual cycles for each participant except for those who became pregnant during treatment.Baseline data including age,course of disease,past medical history,lifestyle,pregnancy outcome,menstrual status(cycle length,menstrual flow duration and volume),as well as gonadal hormone levels before and after treatment were recorded and analyzed.Results:During treatment,18(20.0%)participants became pregnant.Symptoms including scanty menstrual flow,irritability,low libido,insomnia and excessive dreaming at night,nightsweats,hot flashes,and depression were markedly alleviated.Changes in follicle-stimulating hormone(FSH)and luteinizing hormone(LH)levels at early follicular stage were observed(P=.009 and P=.002,respectively),and FSH/LH differed significantly pre-and posttreatment(P=.0.44).Conclusion:Professor Guo's sequential Chinese herbal therapy with the actions of nourishing the liver and kidney to treat POI can enhance ovarian function,promote pregnancy,and improve quality of life.

论朝夕分补滋化源法对肺肾亏虚型慢性阻塞性肺疾病患者急性加重复发率的影响

慢性阻塞性肺疾病具有高患病率、高复发率、高致残率、高致死率四大特征,在稳定期有效缓解症状、改善健康状况进而控制复发率对于慢阻肺患者的治疗尤为重要。临床发现朝夕分补滋化源法能提高患者的抗病能力,改善患者的运动耐力及营养状况,控制复发率。现从中医脏腑论治和时间医学的角度深入探讨朝夕分补滋化源法与肺肾亏虚型慢阻肺复发率之间的相关性,为慢阻肺稳定期的中医治疗提供新的思路。

姚德蛟教授养正消积法论治肺结节经验

肺癌的早期筛查对于降低肺癌病死率、提高生存率具有至关重要的作用。随着体检的普及,肺结节的检出率逐年增加,其对当代社会造成的压力也越来越大。对于西医不做特殊处理的肺结节患者,中医药的及时参与不仅能稳定甚至缩小病灶,还能缓解焦虑等负面情绪,从而改善生存质量。姚德蛟教授运用中药治疗肺结节经验丰富,其用养正消积法辨证治疗肺脾气虚证肺结节患者,常能取得良好的疗效。临床推广此治法,可为肺结节的治疗提供更多思路,进一步体现中医药的价值。

补肾纳气法联合肺康复治疗对慢性阻塞性肺疾病患者运动能力影响的临床研究

目的 研究慢性阻塞性肺疾病患者接受补肾纳气法联合肺康复治疗对其运动能力的影响。方法 选择2021年1月至2022年8月广东省阳江市人民医院接诊的慢性阻塞性肺疾病患者60例作为研究对象,采用随机数表法将患者分为对照组、治疗组,每组各30例,对照组采取常规西药治疗,治疗组在常规治疗基础之上采取补肾纳气法联合肺康复治疗,比较两组患者治疗后运动能力改善情况。结果 治疗组患者治疗后的肺功能指标明显高于对照组,差异有统计学意义(P <0.05);治疗组患者治疗后的6 min步行试验距离明显长于对照组,综合症状评分(CAT)明显低于对照组,差异有统计学意义(P <0.05);治疗组患者治疗后的生活质量评分明显高于对照组,差异有统计学意义(P <0.05)。结论 临床中对慢性阻塞性肺疾病患者采用补肾纳气法联合肺康复治疗,能够有效改善患者的肺功能,提升患者生活质量水平,值得加以推广。

滋阴生津益气温阳法治疗晚期原发性肺腺癌的临床研究

临床选择晚期原发性肺腺癌304例均未经手术或放疗,于住院时随机分为中药与化疗组进行前瞻性治疗观察。中药组171例,根据中医辨证分别以滋阴、益气、温阳等扶正为主方药,治疗后1、2、3年及5年生存率分别为60.94％、36.77％、31.86％和24.22％,生存期中位数为417天,化疗组133例用MOF方案治后1、2、3年生存率分别为36.67％、26.79％、24.56％,无5年生存病例,生存期中位数为265天。两组差异显著;治后病灶稳定率中药组为67.83％,化疗组为48.12％;中位稳定期中药组为6个月,化疗组为3个月;治后临床症状改善、体重增加及健康状况中药组均优于化疗组。中药组治后多项免疫指标均较治前显著提高,化疗组则无明显变化;血清唾液酸及血清抑制因子含量,两组治后均有所降低。说明本疗法有提高晚期肺癌的免疫功能的作用。

基于益气养阴法治疗肺癌的科学性探讨

通过对肺癌的基本病机、肺癌气阴两虚证候的临床研究、基于益气养阴法治疗肺癌的临床研究和基于益气养阴法治疗肺癌的实验研究这4方面阐述中药基于益气养阴法治疗肺癌的科学性。

不同治疗对哮喘模型大鼠气道顺应性和肺病理变化的影响

为探讨中医不同治疗对哮喘的疗效与机理,将SD大鼠用卵蛋白、灭活百日咳杆菌、氢氧化铝干粉混合液腹腔注射以致敏后,用2％卵蛋白雾化吸入诱发哮喘发作。然后分别以宣肺固本方(主药:生地黄、熟地黄、党参、泽泻、黄精、淫羊藿、南沙参、北沙参、半夏、地龙、黄岑)、宣肺方(主药:麻黄、半夏、地龙、柴胡、黄芩、葶苈子)、补肾方(主药:生地黄、熟地黄、党参、茯苓、黄精、玉竹、淫羊藿)水煎剂灌胃,共3周,并与西药顺尔宁、地塞米松比较。观察各组大鼠治疗后的气道顺应性(Co,Cp),肺与气管的FN、CF,及肺与气管的病理切片。结果:三种不同治疗对哮喘模型均有一定疗效,均能降低Cp、FN、CF,并可减轻肺泡壁中嗜酸性粒细胞浸润和肺部病变,其中尤以宣肺固本组为佳。提示宣肺固本法是治疗哮喘的有效方法。

论气道高反应性咳嗽的发病机制及治疗

目的:探讨气道高反应性咳嗽的病机和治疗。方法:从肺肾气阴两虚、阴虚内热等方面阐述气道高反应性咳嗽的中医病机特征。结果:提出肺肾两虚是气道高反应性咳嗽发生的内在条件,阴虚内热是其发病的必然因素。结论:肺肾两虚、阴虚内热是气道高反应性咳嗽的基本病机特征,临床可选用补肺益肾、滋阴清热兼宣肺肃降、祛痰化瘀法治疗,为气道高反应性咳嗽的治疗提供了新的思路和方法。

益气养阴法在肺癌治疗中的应用

[目的]综述益气养阴法在肺癌治疗中的应用。[方法]检索近10年来益气养阴法治疗肺癌的相关中医临床文献,对益气养阴法治疗肺癌的病因病机,临床作用和基础研究作总结。[结果]大量研究显示,气阴亏虚是肺癌的基本病机,益气养阴法具有减轻放化疗副反应,增加放化疗效果,提高机体免疫功能,改善生活质量,延长生存时间等多方面的作用。[结论]益气养阴法治疗肺癌优势明显,但有待于进一步临床和基础研究。

益气养阴法对肺癌患者外周血肿瘤免疫逃逸相关因子的影响

目的:观察益气养阴法对肺癌免疫逃逸的干预作用。方法:采用前瞻性随机对照研究方法,将60例中晚期非小细胞肺癌气阴两虚型患者随机分为治疗组(n=30)和对照组(n=30),观察治疗前后外周血CD4+CD25+Tr、CD8+CD28+Tc、IL-10、sIL-2R、VEGF、sCD44v6、TGFβ1表达的水平变化,并从肺癌患者瘤体变化、KPS评分、中医证候疗效方面评价肺积方临床疗效。结果:与对照组相比,治疗组外周血CD4+CD25+Tr、VEGF、sCD44v6、TGFβ1、IL-10、sIL-2R水平降低,CD8+CD28+Tc水平升高;在瘤灶的稳定率方面,治疗组优于对照组;治疗组Karnofsky评分改善情况明显优于对照组;治疗组气阴两虚证候改善明显优于对照组。结论:益气养阴法可干预肺癌免疫逃逸,恢复机体的免疫监视作用,提高临床疗效。

益气养阴法维持治疗非小细胞肺癌

目的观察益气养阴法维持治疗中晚期非小细胞肺癌的疗效及安全性。方法入组患者随机分为治疗组和对照组。治疗组口服益气养阴中药治疗,对照组单纯随访。结果治疗组身体状况评分改善情况明显优于对照组,治疗组中位无疾病进展生存时间(PFS)为6.3个月,对照组为4.9个月,治疗组较对照组延长1.4个月,2组间比较有统计学意义(P<0.05)。治疗组未见明显不良反应,无治疗相关死亡。结论益气养阴法维持治疗中晚期非小细胞肺癌毒副反应不明显,可以改善患者生活质量,延长无疾病进展生存时间。

益气养阴解毒法配合化疗治疗中晚期肺癌的研究进展

在中晚期肺癌的治疗中,化疗作为主要手段取得了一定的疗效,但是其不良反应较大。通过对1994年—2006年相关文献的回顾和分析,显示肺癌中晚期患者病机特点为气阴两虚、余毒未清,中医治疗以益气养阴解毒法为主。益气养阴解毒法(汤剂、口服液、注射液和胶囊)配合化疗治疗中晚期NSCLC,能够显著改善机体的营养状况及物质代谢,增强化疗耐受性,减轻毒副反应,保护机体免疫功能,提高生存质量。益气养阴解毒方与化疗联用能保护骨髓、对抗化疗所致的白细胞减少,保证化疗顺利完成。

补气温阳法对慢性阻塞性肺疾病肺阳虚证大鼠的治疗作用及机制

【目的】探讨补气温阳法对慢性阻塞性肺疾病(COPD)肺阳虚证大鼠的治疗作用及其机制。【方法】将50只大鼠随机分成2组,即正常组10只和造模组40只。将造模组大鼠构建COPD肺阳虚证复合模型。再将全部造模成功的40只大鼠随机分成4组,即模型组,中药低、中、高剂量干预组,每组各10只。中药低、中、高剂量干预组大鼠分别给予补气温阳方煎液8.0、16.0、32.0 g·kg-1·d-1灌胃,模型组大鼠给予16 mL/kg生理盐水灌胃,持续灌胃30 d。给药结束后,大鼠动脉采血检测二氧化碳分压(PaCO2)及氧分压(PaO2);酶联免疫吸附分析(ELISA)检测各组大鼠血清中炎性细胞因子白细胞介素(IL)-8、IL-10及肿瘤坏死因子(TNF)-α含量变化;收集各组大鼠支气管肺泡灌洗液(BALF)进行白细胞(WBCs)、中性粒细胞(NEUTs)计数分析;苏木素-伊红(HE)染色法观察各组大鼠的肺组织形态病理学变化。【结果】与正常组比较,模型组大鼠PaO2及血清IL-10水平均显著降低(P <0.01),PaCO2,血清IL-8、TNF-α水平,支气管肺泡灌洗液WBCs和NEUTs数目均显著升高(P <0.01),肺组织出现明显的支气管腔炎性细胞浸润、气道黏膜变性坏死等病理变化;与模型组比较,中药低、中、高剂量干预组大鼠PaO2及血清IL-10水平均显著上升(P <0.01),PaCO2,血清IL-8、TNF-α水平,支气管肺泡灌洗液WBCs和NEUTs数目均显著降低(P <0.05或P <0.01),肺组织病理变化得到显著缓解,其中高剂量中药干预组的上述指标变化最为显著。【结论】补气温阳法能显著缓解COPD肺阳虚证大鼠炎症反应,改善其肺功能。

养肺消积分期疗法治疗晚期非小细胞肺癌的疗效观察

目的观察养肺消积分期疗法对晚期(IIIb-IV期)非小细胞肺癌患者的临床疗效及生存的影响。方法采用队列研究,选取符合入组标准非小细胞肺癌患者156例,其中综合治疗组82例,单纯西医组74例,综合治疗组在西医规范化疗的基础上采用养肺消积分期疗法按阶段治疗,以中位无疾病进展时间(M-PFS)、中位生存期(MST)为主要观察指标,中医临床症状积分变化、肿瘤控制率(DCR)、不良反应等为次要观察指标。结果综合治疗组第1年、第2年总生存率分别较单纯西医组提高了23.9%、14.6%(P<0.05);与单纯西医组比较,综合治疗组无疾病进展时间、中位生存期均提高了3个月(P<0.01);综合治疗组瘤体控制率比单纯西医组提高13.2%(P<0.05)。结论养肺消积分期疗法联合西医治疗能够提高晚期非小细胞肺癌患者的总生存期,延长中位无疾病进展时间、中位生存期;同时,可以改善患者中医临床症状积分,增加肿瘤控制率,不良反应小,具有增效减毒作用。

林丽珠中医维持治疗鼻咽癌用药规律的数据挖掘分析

收集林丽珠教授中医维持治疗鼻咽癌门诊患者的处方,采用“中医传承辅助平台”分析林丽珠教授中医维持治疗鼻咽癌的用药规律。结果共筛选出林丽珠教授中医维持治疗鼻咽癌的处方360首,涉及中药168味;使用频次在52次以上的药物有39味,前3味分别是甘草、红豆杉、僵蚕;用药频次居前58位的中药主要可归为宣肺清热药、化痰散结药、养阴补肾药、祛瘀通络药和健脾益气药共5类药;聚类分析后演化得到11首新方组合。分析结果提示林丽珠教授中医维持治疗鼻咽癌用药以宣肺清热、疏肝理气、滋补肝肾为主,常辅以化痰祛瘀、利窍通络之品,体现其诊治鼻咽癌多从肺、肝、肾三脏入手,在整体观念指导下将辨病与辨证、扶正与祛邪相结合,着重提高患者的生活质量及延长生存期,倡导“带瘤生存”的理念。

肺脾双补治疗小儿反复呼吸道感染

目的 :观察肺脾双补法治疗小儿反复呼吸道感染 (RRTI)的疗效并探讨其作用机理。方法 :RRTI患儿 1 2 0例随机分为治疗组及对照组 ,治疗组在急性呼吸道感染期给以中药汤剂 ,感染好转后口服中药 (玉屏风散合四君子汤加减 ) ,每日一剂 ,连用两周。对照组感染期间使用西药抗生素及抗病毒剂治疗 ,感染缓解后不用药 ,两组于治疗前及治疗后 1月检测免疫球蛋白、T细胞亚群。结果 :治疗组有效率为 92 .6% ,对照组有效率为 34.6% ,两组比较差异显著( p <0 .0 1 )。治疗组IgA、IgG及CD3、CD4、CD4/CD8增高 ,CD8降低 ,与对照组比较有显著差异。结论 :肺脾双补法对RRTI有较好疗效 。

益气养阴解毒方辅助厄洛替尼靶向治疗对晚期非小细胞肺癌患者血清糖类抗原199、环氧化酶2和免疫功能的影响

目的观察益气养阴解毒方辅助厄洛替尼靶向治疗对晚期非小细胞肺癌(NSCLC)患者血清糖类抗原199(CA199)、环氧化酶-2(COX-2)和免疫功能的影响。方法将86例晚期NSCLC患者按照随机数字表法分为2组。对照组43例采用厄洛替尼靶向治疗;治疗组43例在对照组治疗基础上加用益气养阴解毒方治疗。2组均持续治疗2个月。观察2组治疗前后中医证候改善情况及血清CA199、COX-2水平,外周血CD3^+、CD4^+、CD8^+、自然杀伤(NK)细胞比例和CD4^+/CD8^+值,比较2组临床疗效。结果治疗组病情控制率(83.72%)高于对照组(62.79%,P<0.05),临床疗效优于对照组。治疗组中医证候改善总有效率(88.37%)高于对照组(69.77%,P<0.05)。治疗后2组血清CA199、COX-2水平均较本组治疗前明显降低(P<0.05),且治疗组低于对照组(P<0.05)。治疗后治疗组CD3^+、CD4^+、NK细胞比例及CD4^+/CD8^+均较本组治疗前升高(P<0.05),CD8^+比例明显降低(P<0.05),且与对照组治疗后比较差异均有统计学意义(P<0.05)。结论益气养阴解毒方配合厄洛替尼靶向治疗有助于提高晚期NSCLC患者治疗效果,降低血清CA199、COX-2水平,改善免疫功能。