Vitamin D axis: a new target for treatment depression via tonifying kidney of chinese medicine

Accumulating data indicate that kidney tonifying recipe to treat depression patients may significantly reduce clinical symptoms, effectively improve the quality and prognosis of the patient's life. Clinical and experimental studies have suggested that tonifying kidney recipe has multiple targets, and thereby via multiple ways to accomplish antidepressant effect. The tonifying kidney recipe has been used in traditional Chinese medicine to control neurotrophic factor so as to promote the growth, differentiation, maturation of neurons. The tonifying kidney recipe participates in protection of neural plasticity, brain development, immune regulation, and a variety of other physiological processes to act as an antidepressant that has great similarity as vitamin D axis. In this article, we describe the current knowledge to introduct the relationship between kidney deficiency and vitamin D axis, and speculate about the molecular mechanism of tonifying kidney recipe in the treatment of depression by regulating vitamin D axis.

Mechanism underlying treatment of diabetic kidney disease using Traditional Chinese Medicine based on theory of Yin and Yang balance

The pathogenic mechanism of diabetic kidney disease(DKD) is complex. The development of DKD cannot be fully explained by a single mechanism.Traditional Chinese Medicine(TCM) has been applied extensively for the treatment of DKD in China.However, studying the mechanism of DKD using theories and methods that are appropriate for TCM characteristics and searching for theoretical bases for TCM clinical application are topics that still need to be explored and researched. Activation of the transforming growth factor(TGF)-β1/Smad and PI3 K/Akt/mTOR signaling pathways functions as a self-protection mechanism against renal microinflammation in DKD. However, the persistent abnormal overactivation of reactions causes secondary cell dysfunction, cell apoptosis, increased extracellular matrix(ECM) secretion, and eventually renal fibrosis. During this process, the dysregulation of self-balance among a variety of signaling pathways and the loss of self-feedback regulatory mecha-nisms downstream of these signaling pathways are critical causes of the occurrence and development of DKD. TCM may both inhibit the expression or activation of "hyperactive" signaling pathways(NFB, Smad3, and PI3 K/Akt/mTOR) and increase the expression or activation of "deficient" signaling pathways(Smad7 and PTEN) to restore balance to cells with an abnormal pathophysiological status and achieve the goal of DKD treatment.

Effects of Traditional Chinese Medicine herbs for tonifying Qi and kidney, and replenishing spleen on intermittent asthma in children aged 2 to 5 years old

OBJECTIVE: To evaluate the efficacy and safety of Traditional Chinese Medicine(TCM) herbs for tonifying Qi and kidney, and replenishing spleen on intermittent asthma in children aged 2 and 5 years.METHODS: A randomized, single-blind, placebo controlled trial was conducted. Children with intermittent asthma were enrolled and their baseline conditions were measured using a questionnaire. A total of 60 participants, aged 2 to 5, were randomized into either the treatment group(n = 40) or the placebo group(n = 20). The treatment group was treated with granules of TCM herbs for tonifying Qi and kidney, and replenishing spleen, and the placebo group was given placebo granules for 3 months.The number of asthma attacks was counted and TCM syndrome scores were measured at 1, 2, 3, 6, 9,and 12 months. The airway resistance and levels of eosinophil cationic protein for the two groups were observed before and after 3 months. The results were statistically analyzed.RESULTS: Compared with the placebo group, the number of asthma attacks significantly decreased in the treatment group(P < 0.05). For the treatment group, the TCM syndrome scores decreased after 1 and 2 months; there was also a significant difference in scores between the two groups(P < 0.05).The difference remained after the medicine was stopped for 9 months(P < 0.05). After the 3-month treatment, compared with the placebo group, the airway resistance decreased in the treatment group(P < 0.05). No adverse events were reported in the treatment group.CONCLUSION: The TCM herbs for tonifying Qi and kidney, and replenishing spleen reduced the number of intermittent asthma attacks, decreased the TCM syndrome scores, and reduced the airway resistance in the children aged 2 to 5.

Tonifying Kidney, Lung, and Spleen Combined with Western Medicine for Stable Chronic Obstructive Pulmonary Disease: A Systematic Review

Introduction:This study aimed to evaluate the clinical effectiveness and safety of tonifying kidney,lung,and spleen(TKLS)combined with Western medicine for stable chronic obstructive pulmonary disease(COPD).Materials and Methods:Randomized controlled trials(RCTs)of TKLS for stable COPD were searched from four databases including Pub Med,the Cochrane Library,China Biology Medicine,and China National Knowledge Infrastructure from inception to December 2017.Two reviewers independently screened the literature,extracted the data,and assessed the risk of bias in the included studies.Rev Man5.3 software was used for meta-analysis.Results:Fourteen RCTs involving 1339 patients with stable COPD were included.Five of the included articles described the specific method of randomization,1 of them was double-blind method research,and 1 of them was single-blind method research.Compared with the conventional Western medicine(CWM)group,the use of TKLS,if combined with CWM demonstrated significantly improved effective rate(relative risk=1.25,95%confidence interval[CI]:1.18–1.33,P<0.00001),decreased traditional Chinese medicine syndrome score(mean difference[MD]-5.72,95%CI:-8.31 to-3.14,P<0.0001),Decreased St George's Respiratory Questionnaire total score(MD-7.39,95%CI:-10.46 to-4.31,P<0.00001),increased 6-min walk distance in meters(MD 78.46,95%CI:60.18–96.73,P<0.00001),increased forced expiratory volume 1%(MD 6.49,95%CI:3.64–9.33,P<0.00001),increased CD4(MD 9.84,95%CI:6.73–12.94,P<0.00001),CD8(MD-1.84,95%CI:-3.62 to-0.06,P=0.04)and CD4/CD8(MD 0.26,95%CI:0.20–0.32,P<0.0001),and increased immunoglobulin M(MD 0.15,95%CI:0.10–0.20 P<0.00001)..Conclusions:For stable COPD,TKLS combined with CWM is superior to CWM alone with regard to clinical effectiveness,symptoms,and quality of life.The above conclusion needs to be validated by further well-designed,multicentric,large-scale,double-blinded RCTs.

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。

中药复方基于Wnt/β-catenin信号通路调控糖尿病肾病研究进展

糖尿病肾病是糖尿病最常见的微血管并发症之一,也是造成终末期肾病的主要原因。Wnt/β-catenin信号通路与糖尿病肾病肾小管间质纤维化密切相关,主要通过足细胞、肾小球系膜细胞、肾小管上皮细胞等来改善糖尿病肾病。中药复方基于调控Wnt/β-catenin信号通路来改善肾脏病变及纤维化,保护肾脏功能,进而延缓病程进展,在治疗中发挥激活自噬、减少炎症反应及减弱氧化应激等作用。目前,关于中药复方基于Wnt/β-catenin信号通路的研究仍存在以下不足之处:(1)在中药复方的研究中,能够得出中药复方可通过Wnt/β-catenin信号通路发挥作用,但由于中药复方成份复杂多样,大多数仅仅发现相关性,而没有分析其具体的活性成分;(2)Wnt/β-catenin信号通路的相关研究并未深入探索该信号通路在肾纤维化中的作用机制;(3)目前关于中医药的大部分实验为动物体内实验,缺乏体外细胞的相关实验探究。今后,需加强对中药复方活性成分的研究,并开展更多的体外细胞实验,进行深层次的作用机制及靶点研究。

补肾温阳汤治疗卵巢储备功能低下临床研究

目的:观察补肾温阳汤治疗卵巢储备功能低下的临床疗效。方法:将60例卵巢储备功能低下患者按照随机数字表法分为对照组和观察组,每组各30例。对照组给予戊酸雌二醇/雌二醇环丙孕酮片治疗,观察组在对照组治疗的基础上加用补肾温阳汤。比较两组患者的临床疗效以及治疗前后中医证候积分、激素水平[卵泡刺激素(follicle-stimulating hormone,FSH)、雌二醇(estradiol,E_(2))、黄体生成素(luteinizing hormone,LH)、抗米勒管激素(anti mullerian hormone,AMH)]、卵巢功能指标[卵巢体积、卵巢窦卵泡数、卵巢间质动脉收缩期峰值流速(peak systolic velocity,PSV)]变化情况。结果:观察组有效率为93.33%,对照组有效率为73.33%,两组患者有效率比较,差异具有统计学意义(P<0.05)。两组患者治疗后各项中医证候积分低于本组治疗前,且治疗后观察组低于对照组(P<0.05)。两组患者治疗后血清FSH、LH低于本组治疗前,E_(2)高于本组治疗前,且治疗后组间比较,差异具有统计学意义(P<0.05)。两组患者治疗后卵巢窦卵泡数、PSV高于本组治疗前,且治疗后观察组高于对照组(P<0.05)。结论:补肾温阳汤治疗卵巢储备功能低下,可改善患者的临床症状,调节激素水平,促进卵巢功能恢复。

从“补虚泻实,燮理阴阳”探讨中药靶向线粒体稳态改善糖尿病合并脑梗死的机制

糖尿病合并脑梗死是糖尿病严重血管并发症,线粒体可能是糖尿病合并脑梗死的治疗新靶点。线粒体稳态与中医“气血阴阳”密切相关。线粒体是细胞“动力工厂”,为人体生命活动提供能量,与中医学“气血”功能具有相似性。线粒体动力学包括分裂、融合和自噬,其对立制约、互根互用、动态平衡的特点是中医学“阴阳”理论微观化的体现。脑为髓海,是元神之府,是新陈代谢的主要调节者,线粒体为大脑供能,并调节人体胰岛素分泌。线粒体稳态失衡与“消渴病中风”病机相符合,消渴日久,气阴亏虚,人体线粒体能量代谢不足;瘀毒阻于脑络,缺血侧脑组织细胞存在受损线粒体和离子潴留等病理产物的堆积,人体气血阴阳失调,虚实夹杂,线粒体稳态失衡。宜以“补虚泻实,燮理阴阳”为基本治则,滋阴益气、活血解毒、改善线粒体稳态。益气活血类中药单体及复方可靶向线粒体质量控制,维护线粒体稳态,改善糖尿病合并脑梗死。

金凤丽教授“益气升阳”法在妇科中的运用

由于脾胃虚弱、清阳不升可导致很多妇科疾病的发生。金凤丽教授围绕益气升阳法“以辛甘温之剂,补其中而升其阳”的核心思想,以补中益气汤作为该法的代表方,广泛地运用于妇科疾病治疗,其认为临证仔细分析病因病机,把握患者证候及舌脉特点,抓牢气虚证及因气虚引起的诸类证候的辨证依据是益气升阳法的运用特点。

从疏肝补肾健脾论治高泌乳素血症

高泌乳素血症是一种内分泌紊乱性疾病,可影响男女的生殖功能,属中医“乳泣”等范畴。笔者导师曹振健认为,本病应以肝郁、肾虚、脾虚为辨证要点,采用疏肝、补肾、健脾为治疗原则,同时兼顾气滞、血瘀、痰湿等病理因素。其据此拟定清乳汤(柴胡、炒白芍、生麦芽、香附、当归、黄芪、白术、茯苓、续断、桑寄生、菟丝子、女贞子、甘草),并归纳出肝气郁结、肝郁化火、气滞血瘀、肝肾阴虚、脾肾阳虚、肝郁脾虚、脾虚痰湿7种临床常见证型,治疗在主方基础上进行加减,探索中医药治疗高泌乳素血症的临床方法。

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.

益气温阳方对变应性鼻炎肺脾虚寒证的临床疗效

目的以安慰剂对照,评价中医益气温阳方对变应性鼻炎肺脾虚寒证患者的临床疗效。方法多中心分层随机双盲研究,分为益气温阳方组(治疗组)和安慰剂(对照组),样本量100例(1∶1),治疗组服用益气温阳方,对照组服用安慰剂,疗程4周。观察临床综合疗效及主要症状体征疗效。结果益气温阳方组显效率74.0%,总有效率92.0%;对照组显效率20.0%,总有效率46.0%,经统计学检验,2组疗效有非常显著差异(P<0.01);益气温阳方组能明显改善鼻痒、喷嚏、流涕、鼻塞、鼻甲肿大等临床症状,与对照组比,P<0.01。结论益气温阳方是治疗变应性鼻炎肺脾虚寒证的有效方剂,有进一步研究和临床推广应用价值。

生髓健骨胶囊对酒精性骨质疏松大鼠股骨生物力学影响的研究

目的研究生髓健骨胶囊对酒精性骨质疏松大鼠股骨生物力学的影响。方法按数字表法随机选取大鼠120只分为4组,每组30只,造模前对各组大鼠体质量进行比较,差异无统计学意义(P>0.05)。模型组用酒精灌胃法造模,正常对照组用生理盐水灌胃,西药对照组用生理盐水、碳酸钙阿法D3灌胃,中药干预组用生理盐水、生髓健骨胶囊灌胃给药。干预后分别在8、12、16周后各处死10只取材,用游标卡尺测量股骨中段外径,算出截面面积。完毕后采用电子万能试验机进行股骨三点弯曲试验。指标为最大载荷、极限强度、弹性模量、最大挠度。采用SPSS 19.0软件进行统计分析(P<0.05),进行t检验。结果模型组的最大载荷、极限强度、最大挠度、弹性模量与正常组比较均显著降低(P<0.01),西药对照组和中药干预组均有不同程度改善。中药干预组最大载荷、极限强度、最大挠度均优于西药对照组,而弹性模量经比较差异无统计学意义(P>0.05)。结论生髓健骨胶囊可明显改善大鼠股骨生物力学的性能,提高骨硬度和骨弹性,能够有效防治酒精性骨质疏松,改善大鼠股骨生物力学性能。

健脾温阳法治疗慢性乙型肝炎肝纤维化临床研究

目的观察健脾温阳法治疗慢性乙型肝炎肝纤维化的临床疗效。方法 30例慢性乙型肝炎肝纤维化患者均采用以温阳健脾立法的雄芍汤治疗,疗程为6个月;评价临床疗效,观察治疗前后症状体征、肝功能指标、血清肝纤维化指标(HA、PCⅢ、IV-C、LN)及肝脾B超的变化情况。结果总有效率为93.3%;除肝脏B超疗效不明显外,患者症状和体征、肝功能、肝纤维化指标、脾脏厚度、门静脉直径均有明显改善(P<0.01,P<0.05)。结论雄芍汤对脾肾阳虚型慢性乙型肝炎肝纤维化有较好疗效,可保护肝细胞、改善肝功能,并有抗肝纤维化作用。

常用抗疲劳中药作用机制及研究进展

目的近些年来,中药在抗疲劳方面以其毒副作用低,效果明显等优势受到国内外学者的广泛重视。针对补气助阳,养阴清热与理气疏肝3类抗疲劳治则中常用的中药及其研究进展做一综述。方法查阅文献。结果中药可通过加强机体抗氧化,清除自由基及减少机体由于疲劳引起的代谢产物堆积;或通过改善疲劳所致骨骼肌细胞超微结构改变、神经系统功能异常及调节免疫等发挥抗疲劳作用。结论中药可通过多种途径发挥抗疲劳作用,开发中药抗疲劳产品将成为今后中药的研究方向之一。

补肾健脾方治疗脾肾不足型多囊卵巢综合征疗效及对血清内脂素及hs-CRP水平的影响

目的:探讨自拟补肾健脾方治疗脾肾不足型多囊卵巢综合征患者疗效及对患者血清内脂素及hsCRP水平的影响。方法:选择2012年10月—2015年3月医院收治的肝肾不足型多囊卵巢综合征患者98例,将其随机分为观察组50例、对照组48例,对照组给予达英-35治疗,观察组在对照组基础上给予医院自拟补肾健脾方,比较两组临床疗效、血清激素水平、症状评分、血清内脂素以及hs-CRP水平变化情况。结果:观察组治疗总有效率显著高于对照组(P<0.05);治疗前两组患者血清LH、FSH、T水平均无显著差异(P>0.05),治疗后观察组各血清激素水平显著降低(P<0.05),对照组仅LH、T水平显著降低(P<0.05),且治疗后观察组患者血清激素水平显著低于对照组(P<0.05);两组患者治疗前各症状评分无显著差异(P>0.05),治疗后患者各症状评分均显著降低(P<0.05),且治疗后观察组患者各症状评分均显著低于对照组(P<0.05);两组患者治疗前血清内脂素及hs-CRP水平无显著差异(P>0.05),治疗后观察组患者血清内脂素及hs-CRP均显著降低(P<0.05),而对照组患者血清内脂素及hs-CRP水平无显著差异(P>0.05),治疗后观察组患者血清内脂素及hsCRP水平显著低于对照组(P<0.05)。结论:医院自拟补肾健脾方治疗多囊卵巢综合征具有着显著的临床疗效,且能够有效改善患者的血清激素水平以及患者相关临床症状,有助于血清内脂素、hs-CRP水平的降低,改善患者机体炎症状态,且用药安全,值得推广。

温阳健脾中药联合穴位埋线治疗功能性便秘临床观察

目的：观察温阳健脾中药联合穴位埋线治疗功能性便秘的临床疗效。方法：观察北京中医药大学东方医院肛肠科门诊2014年1月-2014年12月治疗的56例功能性便秘患者,其中治疗组26例应用温阳健脾中药联合穴位埋线法治疗,对照组30例应用乳果糖口服液,治疗4周后观察两组的临床疗效、便秘临床症状评分和不良反应发生情况。结果：治疗组总有效率为92.31%,对照组为60.0%,两组比较差异具有统计学意义（P〈0.05）;治疗组便秘临床症状评分（3.04±0.96）分,对照组（4.90±2.06）分,两组比较差异具有统计学意义;两组均未见严重不良反应。结论：温阳健脾中药联合穴位埋线临床疗效肯定,是一种治疗功能性便秘的有效方法。

蔡氏育肾培元方对辅助生殖中卵巢低反应改善作用的临床研究

目的探索蔡氏育肾培元方对辅助生殖中卵巢低反应(POR)的改善作用。方法选取74例POR患者,随机分为治疗组、对照组,每组37例。两组均于治疗前及12周后行拮抗剂方案超促排卵,期间治疗组予口服育肾培元方,对照组不服药。检测治疗前后两组患者血清卵泡刺激素(FSH)、抗缪勒氏管激素(AMH)、窦卵泡计数(AFC);再次拮抗剂方案促排后比较绒毛膜促性腺激素(hCG)日血E_2、子宫内膜厚度、≥18 mm卵泡数、促性腺激素(Gn)总剂量、Gn用药天数、获卵数、受精卵数、优质胚胎数、新鲜胚胎移植数、冷冻胚胎数、周期取消率、临床妊娠率。结果 (1)治疗组用药12周后,AFC及血清AMH水平较治疗前均显著升高(P<0.05),FSH水平明显下降(P<0.05),其中AFC、AMH显著高于对照组(P<0.05)。(2)再次超促排卵显示,治疗组的获卵数、hCG日≥18 mm卵泡数、hCG日子宫内膜厚度、受精卵数、鲜胚移植数及临床妊娠率都有增加趋势,Gn药量、Gn用药时间、周期取消率都有减少趋势,其中治疗组的优质胚胎数较对照组显著增加(P<0.05)。结论蔡氏育肾培元方可以改善POR患者卵巢储备功能,提高优质胚胎数,在中医药协助辅助生殖中有积极的治疗作用。

健脾益气补肝健肾中药治疗重症肌无力眼肌型患儿的乙酰胆碱受体抗体的临床研究

目的:1统计重症肌无力(MG)眼肌型患儿乙酰胆碱受体抗体的阳性率;2评价和探讨健脾益气补肝健肾中药治疗肾上腺糖皮质激素治疗复发或无效的重症肌无力眼肌型(MGI型)患儿的临床疗效,以及疗效与乙酰胆碱受体抗体(Ach R-Ab)之间的关系。方法:选择2010年5月—2015年1月就诊于石家庄市第一医院住院或门诊的明确诊断重症肌无力眼肌型、发病年龄小于15岁、肾上腺糖皮质激素治疗无效或复发的患儿149例,单纯接受我院健脾益气补肝健肾为主方的中药治疗,在治疗前、后1、3、6、12个月时应用重症肌无力许氏绝对与相对评分法评价重症肌无力症状的严重程度[1],同时检测治疗前和治疗后1、3、6、12个月外周血液中乙酰胆碱受体抗体的滴度。结果:1149例患儿中,98例乙酰胆碱受体抗体阳性的患儿,占65.77%;51例阴性的患儿,占34.23%。2乙酰胆碱受体抗体阳性与阴性患儿在治疗后1、3、6、12个月时临床相对评分≥75%(有效率)的患儿相比较有显著性差异(P<0.05),到12个月时Ach R-Ab阳性患儿达到98.9%,阴性患儿达90.9%,有统计学意义;3相对评分≥90%(临床痊愈率)的患儿在1、3、6、12个月时相比有显著性差异(P<0.05),到12个月时Ach R-Ab阳性患儿达到97.8%,阴性患儿达88.0%,有统计学意义。4乙酰胆碱受体抗体阳性患儿的Ach RAb滴度治疗后3、6、12个月与治疗前相比有显著性差异(P<0.05),有统计学意义;经两两比较,治疗后3个月与治疗前患儿Ach R-Ab滴度比较差异无统计学意义(P>0.05),其余组内两两比较均有统计学意义(P<0.05);12个月时Ach R-Ab滴度由(3.40±2.08)nmmol/L下降至(0.38±1.08)nmmol/L,有统计学意义。结论:本组研究乙酰胆碱受体抗体阳性患儿阳性率65.77%;健脾益气补肝健肾中药治疗乙酰胆碱受体抗体阳性的重症肌无力眼肌型患儿的总有效率和临床痊愈率均高于Ach R-Ab阴性的患儿;乙酰胆碱受体抗体阳性眼肌型患儿的抗体浓度随着肌无力的缓解逐渐下降至阴性。

补肾健脾法联合FOLFOX化疗方案治疗脾肾阳虚型大肠癌患者的疗效观察

目的探讨补肾健脾药方联合FOLFOX化疗方案治疗脾肾阳虚型大肠癌患者的临床疗效。方法选取2019年8月—2021年8月期间昆明市中医医院收治的辨证为脾肾阳虚型的中晚期大肠癌患者92例,按随机数字表法分为对照组和治疗组,每组各46例。对照组接受单纯FOLFOX化疗方案治疗,治疗组患者接受FOLFOX化疗方案+健脾补肾法治疗,21 d为1个化疗周期。治疗3个周期后,观察比较两组患者临床疗效[疾病控制率(Disease control rate,DCR)]、化疗毒副作用发生及分级情况,治疗前后的中医症状积分、生活质量[生活质量问卷(Quality of life,QOL)、KPS评分量表(Karnofsky,KPS)]以及肿瘤标志物[血清癌胚抗原(Carcinoembryonic antigen,CEA)以及血清糖类抗原199(Carbohydrate antigen199,CA199)]水平。结果治疗后治疗组DCR为93.33%(42/45)明显高于对照组75.00%(33/44),差异有统计学意义(P<0.05)。治疗后两组患者中医症状积分较治疗前降低,差异有统计学意义(P<0.05);且治疗组中医症状积分较对照组明显降低,差异有统计学意义(P<0.05)。治疗后两组患者QOL、KPS评分均较治疗前升高,差异有统计学意义(P<0.05);且治疗组QOL、KPS评分均较对照组明显升高,差异有统计学意义(P<0.05)。治疗后两组患者血清CEA、CA199水平均较治疗前降低,差异有统计学意义(P<0.05);且治疗组血清CEA、CA199水平均较对照组明显降低,差异有统计学意义(P<0.05)。治疗期间,两组患者均未出现Ⅳ级程度的毒副作用。两组患者分级进行比较结果显示,对照组在恶心呕吐、腹泻这两项的反应剧烈程度高于治疗组,差异有统计学意义(P<0.05);两组患者在白细胞减少、血小板降低、转氨酶升高以及肌酐升高方面比较,差异无统计学意义(P>0.05)。结论FOLFOX化疗方案联合健脾补肾法治疗在改善中晚期大肠癌患者症状表现、生活质量,降低血清肿瘤标志物水平等方面更具优势,疗效佳,且能够降低化疗导致的胃肠道反应的剧烈程度,是治疗中晚期大肠癌的有效方案。