Effect of Yang-Warming and Kidney-Tonifying Prescription on Expression of Osteogenic and Angiogenic Factors and H-Type Vascular Markers in Steroid-Induced Avascular Necrosis of Femoral Head in Rabbits

Objective: To investigate the effect of Yang-warming and Kidney-tonifying Prescription (YKP) on the treatment of steroid-induced avascular necrosis of the femoral head (SANFH) in rabbits. And to further explore whether its therapeutic mechanism is related to the expression of HIF-1α and VEGF (angiogenic factors), BMP2 and Osterix (osteogenic factor), CD31 (type H vascular marker) and MMP13 (bone destruction-related factor). Methods: Twenty-seven healthy male New Zealand white rabbits were divided into a normal group, model group, traditional Chinese medcine (TCM) group (clinical equivalent dose group of YKP), miR-130a inhibitor group and TCM + inhibitor group. The SANFH model was established by combining horse serum with methylprednisolone. After the model is successfully established, TCM group was given 6.44 g/kg·d YKP by gavage, and the miR-130a gene inhibitor group was intraperitoneally injected with 25 mg/kg miR-130a inhibitor, locked nucleic acid (LNA)-anti-miR-130a. TCM + inhibitor group was treated with YKP intragastrically and miR-130a inhibitor intraperitoneally. The rabbits in the normal group and the model group were intragastrically administered with normal saline 10 ml/d. Once a day for 4 weeks. The avascular necrosis was detected by HE staining. The contents of HIF-1α, VEGF, BMP2 and Osterix in rabbit tissues were detected by qRT-PCR kit, and the expression of CD31 and MMP13 was detected by immunofluorescence staining. Results: In the normal group, the surface of the cartilage layer of the femoral head was smooth, the bone trabeculae were intact and densely arranged, the cells of each layer were neatly arranged, the morphology of the bone cells, the chondrocytes and the adipocytes were normal. In the model group, cartilage surfaces of the femoral head showed exfoliative cracks. The bone trabecular structure was loose and incomplete, chondrocytes, osteoblasts and bone marrow cells were significantly reduced, and the number of empty bone traps was significantly increased. In the TCM-treated group, more chondrocytes, thicker cartilage layer, and more regular bone trabeculae were detected as compared to model rabbits. In contrast, the cartilage layer was thinner, the destruction and fracture of bone trabeculae was more serious, chondrocytes and osteocytes were decreased as compared to model group. The expression of HIF-1α, VEGF, BMP2, and Osterix in the model group decreased significantly as compared to the normal group (P Conclusion: YKP can regulate the expression of angiogenic-related factors (VEGF and HIF-α), osteogenic-related factors (BMP2 and Osterix), and H-type vascular marker CD31, resulting in increased expressions of VEGF, HIF-α, BMP2, and Osterix, which promote intra-femoral head revascularization. Meanwhile, YKP decreased the expression of bone-destruction-related factor MMP13, thus enhancing the ability of bone tissue to repair itself. Regulation of these molecules’ expression may be one of the mechanisms of YKP in the treatment of hormonal femoral head necrosis.

《温病条辨》护阳方药研究

目的:探讨《温病条辨》护阳思想的遣方用药特点。方法:筛选《温病条辨》中有关顾护阳气的条文和方药,从方药频数、性味、归经、功用主治入手,建立方药数据库并进行频数分析。结果:《温病条辨》中护阳方剂71条,护阳药物67种。其中,散寒祛湿类方剂所占比例最重;护阳用药以温里药及补气药为主,护阳药物中应用频次最高的为人参,其次是干姜、附子;药物性味以辛温药和甘温药为主,其次为苦温、甘平、辛热药,药物归经以脾、胃、肾、肺经为主。结论:《温病条辨》护阳多用辛甘、温热药物,脾、肾、胃、肺同调,在配伍上用辛甘配伍、化生阳气,辛散酸收、升阳最速,慎用苦寒、防止伤阳,芳香走窜、祛湿温阳等。

温补心肾法治疗缓慢性心律失常简况

缓慢性心律失常多为体质虚弱、饮食劳倦、七情所伤及感受外邪等。心肾阳虚是发病之本,病位在心,根本在肾。温补心肾为主,疗效好,毒副作用小,远期疗效可靠,可提高心率、改善症状和生活质量。包括中药方剂(麻黄附子细辛汤加减、温阳定悸饮、生脉饮合淫阳藿),中药针剂,中成药口服制剂(参仙升脉口服液、温阳补心胶囊、强心复脉饮)及针刺。不足之处辨证分型、诊断及疗效评价标准不统一,药物具体作用部位不明确,研究心肾阳虚型缓慢性心律失常报告较少,临床证据级别较低。日后研究应严格临床设计,遵循循证医学,开展多中心、大样本、随机对照试验,探索中医药复杂作用途径机理。

《伤寒论》方药中的对立统一观

张仲景以六经作为辨证论治的总纲,分为三阴(太阴、少阴、厥阴)和三阳(太阳、少阳、阳明),认为人体生理、病理都存在着对立统一的阴阳两方面。论中遣方用药,结构规范,法度严明,丝丝入扣。其中承前启后、独树一帜的对立统一思想是《伤寒论》组方的一大特色,很多方剂皆是散收相协、寒热并用、升降互调、补泻兼施、表里同治、润燥共济、阴阳同调。对立统一规律是万事万物的基本规律,张仲景正是基于对此的深刻认识,创立了一系列千古名方,配伍组方充分体现了阴阳既对立,又统一的这一重要思想。深入研究仲景方剂中蕴含的对立统一观,对于探讨疑难杂症的治疗方法,指导临证组方用药,提高临床疗效,都有着十分重要的意义。

中药辅助治疗原发性骨质疏松症的用药规律

目的:分析中药辅助治疗原发性骨质疏松症处方的用药规律。方法:通过中国知网、重庆维普、万方数据库搜集2011—2016年治疗原发性骨质疏松症的中药处方,采用TCMISS中医传承辅助平台软件,对处方中各药物的使用频次、四气五味、归经、归类、以及药物之间的关联规则等进行分析和提取。结果:对160个中药处方进行分析,发现使用频率较高的中药有熟地黄、当归、淫羊藿、黄芪、山药、骨碎补、杜仲、补骨脂、牛膝、丹参、山茱萸、茯苓、枸杞子、鹿角胶、川芎、菟丝子。药物的四气分布主要为温、平、凉,五味分布主要为甘、苦、辛,归经分布主要为肝、肾、脾。药物归类分布主要为伞形科、豆科。结论:治疗原发性骨质疏松症常用中药有补益肾阳药、补益气血药、活血化瘀药。温肾壮阳、补益气血可作为原发性骨质疏松症患者中药保守治疗的原则。

温补肾阳方药治疗肾阳虚证作用机制分子生物学研究进展

肾阳虚证为临床常见的中医证候。温补肾阳方药因具其有补肾助阳、益精填髓、生精化气等功效,在治疗肾阳虚证的各类疾病中发挥了不同的治疗效果。现代分子生物学以基因、递质、激素、细胞、信号分子为切入点,研究温补肾阳方药对肾阳虚证在分子生物学层面发挥的作用,为临床疾病治疗提供了新的研究方向,不仅在一定意义上推动了中医药的现代化发展,也为更好地运用现代分子生物学技术研究中医、中药提供较好的思路与方法。

温补脾肾方联合血液透析治疗脾肾阳虚型慢性肾脏疾病40例

目的:观察温补脾肾方联合血液透析治疗脾肾阳虚型慢性肾脏疾病(Chronic kidney disease,CKD)的临床疗效。方法:选择80例脾肾阳虚型CKD5期患者,随机分为对照组和治疗组,每组各40例。对照组予以血液透析治疗,治疗组在对照组的基础上联合温补脾肾方。观察两组患者的临床疗效及治疗前后血尿素氮(blood urea nitrogen,BUN)、血肌酐(serum creatinine,Scr)的变化情况。结果:治疗组有效率为90.00%,对照组有效率为55.00%,两组有效率比较,差异具有统计学意义(P<0.05)。两组患者治疗后Scr、BUN较治疗前改善,且治疗组优于对照组,差异具有统计学意义(P<0.05)。结论:温补脾肾方联合血液透析治疗CKD临床疗效显著。

自拟补肾温阳方治疗肾阳虚衰型腰椎间盘突出临床研究

目的探讨自拟补肾温阳方治疗肾阳虚衰型腰椎间盘突出的临床效果。方法选取2018年1月-2019年1月在辽宁省沈阳市沈阳中大骨科医院中医科就诊的80例腰椎间盘突出患者,对照组40例患者依据西医诊疗指南采取常规治疗,试验组40例患者在对照组的基础上使用自拟补肾温阳方治疗,比较2组患者的腰腿痛视觉模拟评分(VAS)。结果试验组患者的临床VAS评分低于对照组患者,差异有统计学意义(P<0.05)。结论对腰椎间盘突出患者采取自拟补肾温阳方治疗可以降低患者的临床VAS评分,减轻患者的疼痛感,其临床效果显著,并能提高患者的生活质量,值得在临床推广。