Research Progress of Tonifying Kidney and Promoting Blood Circulation in the Treatment of Steroid-induced Necrosis of Femoral Head

Osteonecrosis of the femoral head is a common disability disease of the hip joint in China,and osteonecrosis of the femoral head caused by hormone factors is the most common,which is related to the gradual increase in the utilization rate of glucocorticoids in recent years.It is a refractory disease in orthopaedics with a poor prognosis.For this disease,the treatment of traditional Chinese medicine has certain advantages.In view of this,the author reads,analyzes and summarizes its materials by searching China Journal full-text Database and Wanfang Database.This paper reviews the mechanism and clinical research progress of tonifying kidney and activating blood circulation in the prevention and treatment of steroid-induced osteonecrosis of the femoral head,hoping to provide help for the clinical treatment of hormone-related osteonecrosis of the femoral head.

Clinical Factors Affecting Platelet Growth in the Treatment of Aplastic Anemia by Tonifying Kidney and Generating Blood

Objective:To investigate the influence of kidney-tonifying and blood-generating method on platelet(PLT)growth in the treatment of aplastic anemia(AA)and analyze the characteristics of the clinical factors affecting PLT growth.We enrolled patients treated from September 2018to March 2021 in the China Academy of Traditional Chinese Medicine(TCM)Xiyuan Hospital,China Academy of TCM hospital gate 19sub-center.We enrolled 128 AA patients,for whom the inclusion criteria were:treatment is given priority to with kidney and heart's-blood method,on the basis of western medicine treatment for kidney fill party avoid Fried instant particles,stay for 3 months for a period of treatment,taking two consecutive period of treatment,changes in the PLT were observed,and the clinical characteristics of AA patients,such as PLT growth and recovery from baseline value,were analyzed.Materials and Methods:A total of 128 AA patients from 19 branches of Xiyuan Hospital,China Academy of Chinese Medical Sciences and Guang'anmen Hospital,China Academy of Chinese Medical Sciences treated from September 2018 to March 2021 were enrolled.The treatment was based on the kidney-tonifying and blood-generating method and lasted for 3 months as a course of treatment.The changes in the number of PLT in patients were observed,and the clinical characteristics of AA affecting PLT growth and recovery from baseline value were analyzed.Results:After 6 months of treatment following the kidney-tonifying and blood-generating method,PLT increased from the baseline values in 75 cases,including 21 cases of AA with normal PLT recovery and 54 cases of AA without normal PLT recovery.There were 53 cases of AA in whom PLT did not increase from the baseline.Analysis of the general data showed that patients with lower Karnofsky Performance Status(KPS)score were more likely to experience PLT growth or even return to normal after therapy(P<0.05).The results of routine blood analysis showed that when hemoglobin(HGB)was≥60 g/L and the reticulocyte(RET)proportion was≥0.3%before treatment,PLTs were more likely to increase,even returning to normal in some patients(P<0.05).Analysis of bone puncture results before treatment showed that when the proliferation of nucleated cells was low or extremely low in bone puncture examination,with the proportion of granulocytes<40%,and the proportion of erythroid cells<20%,the treatment method was more effective at increasing PLT count(P<0.05).Analysis of the chromosome karyotype results before treatment showed that when the chromosome karyotype was normal,PLTs were more likely to increase or even return to normal after treatment(P<0.05).Analysis of T-lymphocyte subsets before treatment showed that when CD3+human leukocyte antigen(HLA)-DR+proportion was≥30%,PLTs were more likely to increase or even return to normal(P<0.05).Conclusions:AA patients with a low KPS score,higher HGB≥60 g/L,RET proportion≥0.3%,low or extremely low proliferation of nucleated cells,granulocytes proportion<40%,erythroid proportion<20%,normal chromosome karyotype,CD3+HLA-DR+≥30%,should be treated with a kidney-tonifying and blood-generating method.Such patients are more likely to show PLT growth and the values may even return to normal.

Effects of Danqi Yishen Capsule on Blood Lipid Levels and Hemorheological Indicators of Hyperlipidemia Patients

Objective: To explore the effects of Danqi Yishen Capsule (Danqi Capsule for Tonifying Kidney) on blood lipid levels and hemorheological indicators of hyperlipidemia patients. Methods: A total of 96 patients with hyperlipidemia were randomly divided into the control group and observation group of 48 cases respectively. The control group was given by simvastatin in oral administration of 10 mg half an hour after dinner, once a day, while the observation group based on the treatment of the control group, was orally given Danshen Yishen Capsule of three capsules each time, three times a day. The treatment of both groups lasted for two months. Then the comparison focused on blood lipid levels, hemorheological indicators, and adverse reactions between both groups before and after the treatment. Results: There was no significant difference in blood lipid levels and hemorheological indicators between both groups before the treatment (P > 0.05). The symptoms of both groups were significantly improved after the treatment, and the difference before and after the treatment was statistically significant (P < 0.05), and the difference between both groups was also statistically significant (P < 0.05). There was no significant difference in the incidence rate of adverse reactions between both groups (P > 0.05). Conclusion: Danqi Yishen Capsule has a significant value in clinical applications, which can optimize clinical efficacy, improve blood lipid levels and hemorheological indicators of hyperlipidemia patients, as well as reduce the probability of adverse reactions in patients.

补气凉血汤联合卡前列素氨丁三醇对宫缩乏力性产后出血的效果及对氧化应激的影响

目的 探讨补气凉血汤联合卡前列素氨丁三醇对宫缩乏力性产后出血的效果及对氧化应激的影响。方法 纳入2022年1—12月本院收治的宫缩乏力性产后出血患者共90例,采用随机数字表法分为对照组(45例)和试验组(45例),分别给予卡前列素氨丁三醇治疗和补气凉血汤联合卡前列素氨丁三醇治疗;比较两组治疗总有效率、出血量、出血持续时间、产后出血相关并发症发生率、治疗前后超氧化物歧化酶、脂质过氧化物及谷胱甘肽过氧化物酶水平。结果 试验组治疗总有效率显著高于对照组(P<0.05);试验组出血量和出血持续时间均显著少于对照组;试验组后期出血和产褥感染发生率显著低于对照组(P<0.05);两组治疗后超氧化物歧化酶显著高于治疗前(P<0.05);两组治疗后脂质过氧化物和谷胱甘肽过氧化物酶水平均显著低于治疗前(P<0.05);但试验组治疗后超氧化物歧化酶、脂质过氧化物及谷胱甘肽过氧化物酶水平均显著优于对照组(P<0.05)。结论 补气凉血汤联合卡前列素氨丁三醇治疗宫缩乏力性产后出血可有效促进子宫收缩,控制出血量,缩短出血时间,降低产后出血相关并发症发生率,并有助于调节机体氧化应激水平。

Clinical Observation on Patients with Endometriosis Treated by Tonifying Kidney and Removing Blood Stasis

Objective: To explore the mechanism of treating endometriosis by tonifying Kidney and removing blood stasis with Neiyixiao recipe, ( , NYXR).Methods: One hundred and three patients of endometriosis were divided randomly into the NYXR group (58 cases, treated with NYXR) and the control group (45 cases, treaed with danazol) and were reviewed for the improvement of clinical symptoms, serum level of FSH, LH, PRL, E2, P and T, humoral and cellular immunity (C3, C4, CD3, CD4, CD8), and plasma prostaglandin after treatment.Results: There was no significant difference in effect between the NYXR group and the control group in relief of dysmenorrhea and degradation of elevated plasma prostaglandin (x2 = 0.71,P >0.05). But there was significant difference between the two groups in curing infertility (x2 = 14.77, P<0. 01), and the effect of NYXR in regulating endocrine and immunity was significantly better than that of danazol.Conclusion: By tonifying Kidney and removing blood stasis, NYXR is multi-effective and being one of effective methods in clinical practice for treatment of endometriosis.

病理性近视新生血管导致黄斑出血的治疗研究进展

从病理性近视新生血管导致黄斑出血的发病机制出发,总结中医治疗该病的研究现状。指出肝血不通、肾精衰弱和脾胃运化不良会影响黄斑的功能。肝肾阴虚证选驻景丸加减补益肝肾;加味知柏地黄丸补肾健脾、清热凉血;脾气虚弱证选加味八珍丸健脾益气;肝郁化火证用丹栀逍遥散加味疏肝解郁、泻火明目。当患者出血时间长或量较多时,通过驻景丸、点睛复明汤、桂枝茯苓丸合归脾汤、生蒲黄汤加减专方治疗以减少出血,提高患者视力。根据患者的病情缓急选择中医治疗或中西医结合治疗,能有效预防并减少病理性近视新生血管引起黄斑出血导致的并发症,在提高视功能及改善全身症状方面具有一定优势。参考文献33篇。

孙丽蕴教授辨治儿童银屑病经验撷菁

儿童银屑病由多种因素共同诱发,由于小儿脏腑娇嫩,与成人相比治疗方法较为局限。中医药疗法安全有效,在儿童银屑病治疗中发挥重要作用。燕京赵氏流派学术传承人孙丽蕴教授在传承运用燕京赵氏皮科流派银屑病“从血论治”辨证体系基础上,总结出儿童银屑病多为“脾胃失和,血热内郁”发于肌肤所致,以“清热凉血、理脾消导”为基本治则。对孙教授治疗儿童银屑病经验进行了阐述,并附病案一则,以飨同道。

祛风凉血补肾法治疗难治性特发性血小板减少性紫癜的临床观察

【目的】观察祛风凉血补肾法对难治性特发性血小板减少性紫癜(ITP)患者的治疗效果。【方法】对15例难治性ITP患者,予以祛风凉血补肾法治疗,经治疗3个疗程(共18周)后统计临床疗效,并观察治疗前后血小板数量和巨核细胞成熟情况的变化。【结果】(1)15例患者中,临床治愈8例,显效4例,有效2例,无效1例,总有效率为93.3%。(2)治疗后患者的血小板明显上升(与治疗前比较,P<0.01);骨髓中幼巨细胞、颗粒巨细胞明显减少,产板巨细胞明显增多(与治疗前比较,P<0.05)。【结论】以祛风凉血补肾法治疗难治性ITP,疗效满意,值得进一步推广应用。

祛风法对凉血补肾中药治疗慢性特发性血小板减少性紫癜疗效的影响

【目的】观察祛风法对凉血补肾中药治疗慢性特发性血小板减少性紫癜(C ITP)的疗效及其对免疫调节功能的影响。【方法】将42例C ITP患者随机分为两组,治疗组22例,予祛风凉血补肾法治疗;对照组20例,予凉血补肾法治疗。两组均以6周为1个疗程,连续治疗3个疗程。观察两组临床疗效及治疗前后血清白介素-2(IL-2)、可溶性白介素-2受体(sIL-2R)、Fas蛋白、Fas-L蛋白、血小板相关抗体(PAIgG)和淋巴细胞亚群等免疫学指标的变化。【结果】治疗组治愈14例,显效5例,有效2例,无效1例,总有效率为95.5%;对照组治愈8例,显效4例,有效3例,无效5例,总有效率为75.0%;两组比较治疗组疗效优于对照组(P<0.05)。治疗后两组的血清IL-2水平较治疗前显著性提高,sIL-2R水平则显著性下降(与治疗前比较,P<0.01),且治疗组提高IL-2、降低sIL-2R的作用更明显(与对照组比较,P<0.05)。治疗后两组血小板Fas蛋白和Fas-L蛋白表达及PAIgG水平均下调(与治疗前比较,P<0.01),且治疗组的下调作用更明显(与对照组比较,P<0.05)。治疗后两组患者CD4+T细胞百分率、CD4+/CD8+比值均明显提高,CD8+T细胞百分率明显降低(与治疗前比较,P<0.05)。【结论】加用祛风药能提高凉血补肾中药治疗慢性特发性血小板减少性紫癜的疗效。

凉血化瘀法和补肾法对实验性肾小球肾炎大鼠低蛋白血症影响的比较

为比较凉血化瘀法和补肾法对肾小球肾炎患者血清白蛋白含量的影响，采用肾毒血清性肾小球肾炎大鼠模型，以用赵绍琴“肾炎１号”方（由小蓟、赤芍、丹参、紫草等组成）为凉血化瘀法治疗组，用“六味地黄丸”为补肾法治疗组，同时设病理组与正常组，各组分别于实验的第１、４、８周测定血清白蛋白含量，并进行组间比较。结果：凉血化瘀法治疗组血清白蛋白含量明显高于病理组及补肾法治疗组（Ｐ＜０．０５，Ｐ＜０．０１）。提示凉血化瘀法可明显改善肾小球肾炎低蛋白血症，作用强于补肾法。

中医辨治肾性血尿研究进展

中医中药治疗肾性血尿取得了较好疗效,但关于疾病的基础实验、辨证分型与疗效判断标准缺乏统一标准,系统的临床研究治疗方案;临床报道大多为回顾性总结,缺乏大样本严密观察。另外,需重视中医治疗与现代研究相结合,宏观与微观相结合,辨证与辨病相结合,注意病因、病位、病性与证候类型、理法方药的关系,在今后的临床研究中,应多加强基础研究,规范临床研究疗效判定标准,进行治疗作用机理的深层次探讨,寻求治疗肾炎血尿的有效方理方药。

中西医结合治疗小儿肾炎肾病型紫癜性肾炎远期疗效观察

应用中西医结合方法治疗21例肾炎肾病型紫癜性肾炎疗效满意,有16例痊愈或完全缓解,5例部分缓解。平均随访7.34年,未发现有肾功能不全者。应用雷公藤多甙配合中药或加强的松的治疗方法较好,副作用少。积极防治上呼吸道感染。对减少病情反复起重要作用。

血瘤病因及辨治源流考

从病名、病因病机、治疗三个方面梳理血瘤病的学术源流。血瘤病最早载于《外台秘要》,唐代以后,亦有医家将此病命名为胎瘤、红丝瘤。心火妄动、肝火燔灼、肾伏虚火、气滞血瘀是本病常见病机,病涉心、肝、肾及气机;中医治疗本病多用内服与外敷相结合,因本病若用外科手术,处理不当多可致血流不止而成危证。内治法有:软坚散结,益肾养阴,补养气血和清心凉肝。外治法有外敷、针灸、手术等相结合运用。

国医大师邹燕勤从瘀论治过敏性紫癜性肾炎经验撷要

过敏性紫癜性肾炎是临床常见疑难肾脏病。国医大师邹燕勤认为过敏性紫癜性肾炎的病机以热、虚、瘀为主,以“瘀”为要。疾病分急性期和缓解期,急性期以皮肤紫斑而鲜、血尿、烦躁为主要临床表现,而缓解期皮肤以紫斑消退,反复发作的血尿为主要临床表现,在此基础上提出以治血为主,活血化瘀贯穿始终;分期论治,急性期以清热凉血为主,缓解期以补肾凉血为重。

金实教授应用滋阴凉血畅络法治疗白塞病经验

[目的]探讨金实教授应用滋阴凉血畅络法治疗白塞病经验。[方法]从病因病机、辨证论治等方面论述金实教授应用滋阴凉血畅络法治疗白塞病经验的学术观点和临床经验,对其辨证选方和灵活选用药组、药对的经验特色予以总结,并举案例佐证。[结果]金实教授认为本病的基本病机为阴虚血热、络脉瘀滞。治疗上强调标本兼顾、扶正祛邪,并以滋阴凉血、祛邪畅络作为治疗本病的基本大法。少数病人病情缠绵难解,以气虚湿阻为主要表现,则以益气健脾、除湿畅络治疗取效。金实教授指出,临证应谨守病机,辨证选方施治,灵活运用药组、药对,以提高临床疗效。所举验案以滋阴凉血、祛邪畅络方法治疗,并参以药组、药对,取得较好疗效。[结论]金实教授应用滋阴凉血畅络法治疗白塞病经验临床上行之有效,其辨证选方和灵活用药的经验特色对临床实践有启示意义,具有推广应用价值。

张涤教授治疗川崎病经验拾萃

川崎病是一种以全身性血管炎为主要病变的急性发热出疹性疾病。张涤教授在临床中运用中医药治疗川崎病,以卫气营血辨证为纲,依据病症,治疗以解毒化瘀、清热凉营、养阴益气为主,临床获满意疗效。

李军教授从“虚、痰、瘀(郁)、热”辨证治疗急性冠脉综合征经验

急性冠脉综合征(Acute Coronary Syndrome,ACS)是冠心病急症。李军教授临证概括为“虚、痰、瘀(郁)、热”致病,虚证以气虚、阳虚、阴虚为主,实证为痰浊、瘀血、气郁、热蕴,以脏腑阴阳虚损、气血两伤为本,痰瘀郁热、邪气痼结为标,形成本虚标实、虚实夹杂证候。急性期、亚急性期、慢性期病机特点分别为“虚瘀痰热”“虚瘀痰滞”“虚瘀饮”。胸阳不振、心脉痹阻为病机关键。临证明辨病因病机,重视气血辨证。治疗强调扶阳活血、益气养阴、辛开苦降、凉血活血,临床疗效显著。

吴克明教授治疗崩漏经验采撷

崩漏是妇科常见病、多发病之一。其病因病机错综复杂,为妇科疑难重症。吴克明教授据其数十年的临床经验,认为崩漏之本在于脾肾亏虚,冲任不固,而致经血失约,血不归经;虚热瘀互结为标,而致虚实夹杂,病情变化多端。吴克明教授在治疗此病上强调治病求本,以正本清源(补肾健脾,益气养血,固冲止血,兼凉血化瘀)为法,以安冲汤加减化裁治疗此病,在临床上取得了显著疗效。

Effects of Bushenyiqihexue Formula on the Endometrial Gland Apoptosis in Mice with Blastocyst Implantation Dysfunction

Objective: To observe the effects of Bushenyiqihexue Formula (补肾益气和血方 Formula for Tonifying the Kidney, Replenishing qi and Harmonizing Blood, FTKRQHB) on the endometrial gland apoptosis in the mice with blastocyst implantation dysfunction. Methods: The mice with the first-day pregnancy were divided into the control, model and treatment groups, with 30 in each group, and blastocyst implantation dysfunction was induced by subcutaneous injection of mifepristone in the mice of the model and treatment groups. The pregnancy rate and implantation number of blastocysts were measured and the expressions of proliferating cell nuclear antigen (PCNA), Bax, Bcl-2, and activated caspase-3 were detected in all the three groups. Results: The model group had significantly depressed pregnancy rate, implantation number of blastocysts and apoptosis index, and elevated proliferation index of endometrial gland as compared with the control group (P<0.05 or P<0.01). Administration of FTKRQHB (the treatment group) resulted in significant increases in pregnancy rate, implantation number of blastocysts and apoptosis index of the endometrial gland, and a significant decrease in the proliferation index of the endometrial gland as compared with the model group (P<0.05 or P<0.01). The differences in the four indexes between the treatment group and control group were not significant statistically. The Bax and activated caspase-3 expressions in endometrial gland in the model group became significantly lower than that of the control group (P<0.01), whereas those in the treatment group were significant higher than that of the model group (P<0.01). However, the Bax and activated caspase-3 expressions in endometrial gland were similar in both treatment and control groups. Conclusion: Promoting the increases in Bax and activated caspase-3 expressions in the endometrial gland and bringing into balance between apoptosis and proliferation of the glandular cells at the implantation window phase by FTKRQHB may contribute to the effects of promoting the establishment of endometrial receptivity and improving blastocyst implantation dysfunction.

Mechanism of Erhuang capsule for treatment of multiple sclerosis

Erhuang capsule, a typical formula based on traditional Chinese medicine theory, is widely used to ameliorate multiple sclerosis, inflammation and side effects of glucocortJcoid treatment. Oligodendrocyte precursor cells are neural stem cells that are important for myelin repair and regeneration. In the present study, Erhuang capsule effectively improved clinical symptoms and neurological function scores, reduced mortality and promoted recovery of neurological functions of mice with experimental autoimmune encephalomyelitis. The mechanism of action involved significant increases in oligodendrocyte precursor cell proliferation in specific regions of the brain and spinal cord, increased oligodendrocyte lineage gene 2 expression and enhanced oligodendrocyte precursor cell differentiation.