Identifying medication regularity of traditional Chinese medicine and potential pharmacological mechanism of Jiedu Sangen decoction in colorectal cancer treatment by data mining and network pharmacology

Objective:Colorectal cancer(CRC)is one of the most common malignancies in the world,and traditional Chinese medicine(TCM)is widely used in its treatment in China.However,the medication rules of TCM for CRC treatment remain unclear.Therefore,data mining combined with network pharmacology was utilized to establish treatment principles and rules.Methods:The CRC cases treated at Zhejiang Provincial Hospital of Chinese Medicine from January 1,2016 to October 31,2021 were analyzed using data mining methods.UPLC-Q/TOF-MS analysis was performed to identify the chemical composition of Jiedu Sangen decoction(JSD).Network pharmacology was used to reveal the therapeutic mechanism of JSD.Results:A total of 312 cases 2,998 prescriptions that met the inclusion criteria used 343 kinds of traditional Chinese medicines.The nature of the herbs used in treatment was mainly warm and mild.The taste was mainly sweet,bitter,and pungent.The meridian tropisms were mainly the spleen meridian,followed by lung and stomach meridians.Tonifying and replenishing herbs were the most frequently used in treatment.High-frequency herbs were classified into 11 categories by cluster analysis,and 42 association rules were obtained by association rule analysis.Combined with complex network analysis,3 core prescriptions for clinical CRC treatment were obtained.Jiedu Sangen decoction contains 64 chemical ingredients,out of which 31 active ingredients were identified,including polydatin,caffeic acid,and glutamic acid,along with 130 potential targets such as AKT1,SRC,and MAPK1.Jiedu Sangen decoction may play a role in regulating inflammation,immunity,metabolism,and hormones in the development of CRC via pathways such as the relaxin signaling pathway,IL-17 signaling pathway,prolactin signaling pathway,and T cell receptor signaling pathway.Conclusions:This study summarizes the treatment and medication principles for clinical CRC treatment,promoting the inheritance and development of the traditional Chinese medical experience.

Meta-analysis of traditional Chinese medicine Jiedu therapy in the treatment of psoriasis vulgaris

Objective:To evaluate the clinical efficacy of traditional Chinese medicine Jiedu therapy in treatment of psoriasis.Methods: CNKI, Wanfang knowledge service platform, VIP journal database, Chinese biomedical literature database ( CBM), PubMed, the Cochrane Library and EMbase database from the establishment of the database to March 2020 were searched for the randomized controlled trials (Rcts) on traditional Chinese medicine Jiedu therapy in treatment of psoriasis. Literature selection and information extraction was completed and screened by two independent reviewers, and then the Cochrane recommended bias risk assessment method was used to evaluate the bias risk, and Review Manager5.3 was used for the data analysis. Totally 17clinical Rcts were included in this study, involving 1376 patients.Results:Analysis results showed that traditional Chinese medicine Jiedu therapy had higher clinical effective rate, with statistically significant difference ( OR= 4.53, 95% CI[3.17,6.46], Z =8.32, P<0. 00001);the improvement of score was more evident, PASI score (WMD =-2.21, 95%CI[-2.77, -1.64], Z = 7.60, P<0. 00001);and trial-related adverse events were reported in 6RCTs. Conclusion: Studies have shown that traditional Chinese medicine Jiedu therapy had higher clinical efficacy.

Effect of "Fuzheng Qingre Tonglin" prescription on rats with complicated urinary tract infection caused by ESBLs-producing Escherichia coli

Objective: To observe the effect of traditional Chinese medicine "Fuzheng Qingre Tonglin"prescription on rats with complicated urinary tract infection caused by extended-spectrumβ-lactamases (ESBLs)-producing Escherichia coli and its possible mechanism. Methods:Specific-pathogen-free female SD rats with 7-9 weeks old were randomly divided into model group, levofloxacin group, low-dose Fuzheng Qingre Tonglin group, high-dose Fuzheng Qingre Tonglin group, levofloxacin+Fuzheng Qingre Tonglin group (n=8 in each above group), and also there was a control group with 5 rats. Each group was administered intragastrically 2 days after model establishment for 14 consecutive days. The general condition of the rats was observed. Renal pathological changes were observed by light microscopy under hematoxylin-eosin staining. The number of white blood cells and the percentage of neutral particles (NEUT%) were detected. ELISA was used for the determination of C-reactive protein (CRP), CD4+, CD8+ in the blood, and secretory immunoglobulin A (SIgA), N-acetyl-β-D-glucosidase (NAG) molecules in urine. Results: There were a large number of inflammatory cells in the kidney of the model group and the levofloxacin group. The inflammatory cells in the treatment group were significantly reduced. The NEUT% and CRP in the blood of each treatment group and the NAG in the urine were significantly lower than those in the model group (P<0.05), except levofloxacin group. Compared with the model group, except for the levofloxacin group, serum CD4 concentration and CD4/CD8 ratio in the other treatment groups were significantly decreased, and CD8 molecules were significantly increased (P<0.05). Conclusion: "Fuzheng Qingre Tonglin" can alleviate systemic and local inflammation of complicated urinary tract infections in rats. It may also have the effect of re-sensing the insensitive antibacterial drug to bacteria and may have the function of regulating immune function and protecting kidney function in rats.

Mechanism and Research Progress of Fuyang Huoxue Jiedu Formula against Recurrence of Ulcerative Colitis

By introducing the composition and modern pharmacology of Fuyang Huoxue Jiedu Formula,the paper further explored the mechanism and research progress of Fuyang Huoxue Jiedu Formula against recurrence of ulcerative colitis(UC).The formula can effectively improve the TCM syndromes of UC patients,reduce the recurrence rate,and improve clinical efficacy and patients’quality of life.

清热利湿方联合美沙拉嗪治疗湿热内蕴证糖尿病肠病临床疗效观察

目的探讨清热利湿方治疗糖尿病肠病疗效及对患者生活质量的影响。方法将48例湿热内蕴证糖尿病肠病患者按随机数字表法分观察组和对照组,每组24例;两组均口服美沙拉嗪肠溶片,观察组加予清热利湿方日2次口服治疗,统计肠炎疾病量表(inflammatory bowel disease questionnaire,IBDQ)评分及相关症状体征。结果观察组与对照组IBDQ评分各分项得分治疗后均高于治疗前,但观察组分数增加较为明显,且观察组在全身症状、肠道症状、情感功能、社会功能、总分等方面得分增加均高于对照组,在全身症状改善方面尤为显著。两组在生活质量量表(the MOS item short from health survey,SF-36)量表中生理机能(physical functioning,PF)、生理职能(role physical,RP)、活力(vitality,VT)、精神健康(mental health,MH)、整体健康(general health,GH)等方面治疗前与治疗后差异有统计学意义(均P<0.05)。观察组总有效率91.67%(22/24),两组间疗效比较差异有统计学意义(P<0.05)。两组病例均耐受良好,未见明显不良反应,1年内复发率观察组低于对照组(均P<0.05)。结论清热利湿方可以有效清热利湿,改善患者病情,是针对糖尿病肠病的一种有效治疗方案,可以提高湿热内蕴证糖尿病肠病患者的治疗有效率,明显提高患者的生活质量,值得临床进一步研究及推广。

益气活血解毒法促进卵巢癌由“冷”向“热”转化基于免疫-炎性微环境的理论探讨分析

卵巢癌是致死率高居首位的妇科恶性肿瘤,探索有效的治疗方法预防转移成为亟待解决的临床难题。免疫治疗是肿瘤治疗的新视野,然而卵巢癌由于普遍缺乏细胞毒性T细胞的浸润,并且浸润的T细胞并不能识别所有的肿瘤抗原,属于“冷肿瘤”范畴,对免疫治疗并不敏感。中医认为气虚血瘀毒浊是卵巢癌的关键病机,益气活血解毒法是重要治法,有必要在理论研究上进一步阐明。免疫抑制和慢性炎症构成肿瘤微环境两大核心特征,共同促进肿瘤发生、发展及转移。本文分析了免疫-炎性微环境与中医“阴阳”“毒邪”理论的高度契合性:阳化气不足,如同正性免疫细胞如细胞毒性T细胞不足;阴成形太过,一方面,如同过多的免疫抑制性细胞、因子、代谢产物浸润,另一方面,如同人体的因虚致毒,维持并放大了炎性微环境,炎症促进肿瘤进展,炎症反过来又可促进免疫抑制。从免疫-炎症的角度阐明该法的治疗思路:“温阳扶正,平衡阴阳”以激活正性免疫;“活血、化痰、散寒、清热”以驱散阴邪,解化毒滞,从而缓解免疫抑制,调控炎性微环境;“以毒攻毒”以抗炎治疗,完善了该法转化“冷”“热”免疫原性的理论基础,为进一步物质研究提供理论依据。

益气固表解毒合剂预防新冠病毒感染的临床疗效——一项多中心真实世界前瞻性观察性研究

目的 基于多中心前瞻性真实世界研究评价益气固表解毒合剂预防新冠病毒感染的临床疗效。方法 纳入2022年12月10日—2023年2月28日在辽宁省7家定点医院购买服用益气固表解毒合剂者472例及其未服药但出现新冠病毒感染相关临床症状的配偶家属124例。采用前瞻性队列研究方式,观察受访者在服用益气固表解毒合剂后出现新冠病毒感染相关临床症状的比例及各个症状发生率,对比服药组与未服药组发热、咳嗽、乏力、咽痛症状发生率、症状评分及持续时间。结果 服用益气固表解毒合剂的受访者平均(55.76±17.91)岁,51.91%的受访者为退离休人员,55.30%的受访者在服用益气固表解毒合剂后出现新冠病毒感染相关临床症状,服药组较未服药组患者发热、乏力、咽痛症状发生率降低(P<0.05);发热、咳嗽、乏力、咽痛症状评分降低,症状持续时间缩短(P<0.05)。结论 益气固表解毒合剂可有效预防新冠病毒感染并可减轻新冠病毒感染后的发热、咳嗽、乏力、咽痛症状。

清热愈疡汤治疗溃疡性结肠炎对患者肠道菌群紊乱和改善炎症效果的组方分析

目的探究清热愈疡汤治疗溃疡性结肠炎的效果,分析其组方对患者肠道菌群和炎症因子的影响。方法选取上海中医药大学附属曙光医院肛肠科2021年1月-2022年9月收治的溃疡性结肠炎患者100例,按随机数字表法将患者分成观察组与对照组,各50例。对照组采用常规治疗,观察组在常规治疗的基础上采用清热愈疡汤灌肠治疗。比较2组患者的临床疗效、治疗前后的肠道菌群、炎症因子[肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、单核细胞趋化蛋白-1(monocyte chemotactic protein 1,MCP-1)、白细胞介素-10(interleukin 10,IL-10)]水平、中医证候积分、Baron内镜积分、梅奥(Mayo)评分以及不良反应的发生情况。结果观察组的治疗总有效率(92.00%)较对照组(82.00%)明显提高,差异具有统计学意义(P<0.05)。治疗后较治疗前,2组双歧杆菌水平上升,乳酸杆菌、肠杆菌、肠球菌水平均下降,且观察组较对照组的双歧杆菌水平上升明显,乳酸杆菌、肠杆菌、肠球菌水平下降明显,差异具有统计学意义(P<0.05)。治疗后较治疗前2组TNF-α、MCP-1水平均下降,IL-10水平上升,且观察组较对照组的TNF-α、MCP-1水平下降明显,IL-10水平上升明显,差异具有统计学意义(P<0.05)。治疗后较治疗前2组的中医证候积分、Baron内镜积分及Mayo评分均下降,且观察组较对照组的中医证候积分、Baron内镜积分及Mayo评分下降明显,差异具有统计学意义(P<0.05)。观察组的不良反应总发生率(2.00%)较对照组(14.00%)明显降低,差异具有统计学意义(P<0.05)。结论清热愈疡汤在溃疡性结肠炎中的治疗效果较好,能够调节患者肠道菌群紊乱,减轻炎症反应,且安全性较好,值得临床推广应用。

基于中性粒细胞胞外诱捕网途径探讨胃黏膜肠上皮化生的发生机制及中药预测研究

目的探讨中性粒细胞胞外诱捕网(NETs)对胃黏膜肠上皮化生(Intestinal metaplasia,IM)的作用机制及治疗靶点,为中医药防治IM提供新思路和新方向。方法从公共数据库下载IM及NETs相关数据集,通过免疫浸润分析、差异分析及基因相关性分析获得IM与NETs共表达的关键基因集;采用功能富集分析、蛋白互作网络、分子对接技术及实验验证等方法进一步阐述IM及NETs的相关性;最后将获得的关键基因与Coremine Medical平台相互映射,预测中医治疗IM的有效中药和治法。结果共筛选出6个IM与NETs形成相关的共表达的差异基因,分别为THBD、HDAC9、FGA、AQP9、DECR1和PIK3CD,这些基因与NETs的3个标记性蛋白(NE、PADI4、MPO)存在不同程度的相关性,其功能主要富集在呼吸爆发与防御反应、纤维蛋白溶解等生物学过程上;中药预测共映射出中医治疗IM的中药112味,按照功效可归为34类,其中清热解毒类中药出现频次最高,其次为活血化瘀药、温里药、补气药等。结论在IM的病理发生及发展过程中存在NETs,靶标基因NE和THBD可能存在相互关联作用,共同通过NETs通路参与IM进展;健脾化瘀解毒法是中医治疗IM的核心治法,其可能通过抑制NETs的形成,从而减缓IM的发展进程。

清热利湿中药熏洗联合穴位贴敷治疗靶向药相关皮肤不良反应及对睡眠质量的影响

目的 观察清热利湿中药熏洗联合穴位贴敷治疗靶向药相关皮肤不良反应及对睡眠质量的影响。方法 将108例靶向药相关皮肤不良反应患者按照随机数字表法分为2组,对照组54例予常规干预,观察组54例在对照组干预基础上应用清热利湿中药熏洗联合穴位贴敷干预,2组连续干预3天为1个疗程,共干预3个疗程。比较2组皮肤不良反应干预疗效、恶心呕吐干预疗效;比较2组干预前后排便时间评分、腹胀评分、便后不尽感评分、排便顺畅度评分、睡眠质量评分。结果 观察组皮肤不良反应总有效率96.30%(52/54),对照组总有效率77.78%(42/54),观察组皮肤不良反应干预疗效优于对照组(P<0.05)。观察组恶心呕吐总有效率85.19%(46/54),对照组总有效率64.81%(35/54),观察组恶心呕吐干预疗效优于对照组(P<0.05)。2组干预后排便时间评分、腹胀评分、便后不尽感评分、排便顺畅度评分均较本组干预前降低(P<0.05),且观察组降低更明显(P<0.05)。2组干预后各项睡眠质量评分均较本组干预前降低(P<0.05),且观察组降低更明显(P<0.05)。结论 清热利湿中药熏洗联合穴位贴敷,可有效减轻靶向药相关皮肤不良反应的临床症状,改善患者睡眠质量。

解毒润燥汤治疗阴虚热毒型原发性干燥综合征临床观察

目的:观察解毒润燥汤治疗阴虚热毒型原发性干燥综合征的临床疗效。方法:将60例患者随机分为两组各30例。对照组予白芍总苷胶囊、硫酸羟氯喹片治疗,治疗组在对照组基础上予解毒润燥汤。治疗12周后,比较两组患者中医证候积分、实验室指标(ESR、CRP、IgG)、泪液流率、唾液流率及临床疗效。结果:治疗组总有效率83.33%,对照组总有效率56.67%,两组比较差异具有统计学意义(P﹤0.05)。治疗后,两组中医证候积分、实验室指标、泪液流率、唾液流率均较治疗前有所改善(P﹤0.05),且治疗组均优于对照组(P﹤0.05)。结论:解毒润燥汤治疗阴虚热毒型原发性干燥综合征疗效较好,优于单用西药治疗。

中医扶正解毒法治疗晚期非小细胞肺癌的Meta分析

目的 系统评价中医扶正解毒法对晚期非小细胞肺癌的治疗效果。方法 计算机检索PubMed、中国生物医学文献数据库、中国期刊全文数据库、维普数据库和万方数据服务平台,检索时限为数据库建库起至2023年10月,收集中医扶正解毒法+常规化疗(试验组)对比常规化疗(对照组)治疗非小细胞肺癌的随机对照试验。2名研究人员分别筛选文献、提取资料,按照Cochrane5.4偏倚风险工具评价文献质量,并使用RevMan 5.3软件对数据进行Meta分析。结果 本研究最终纳入19篇文献。Meta分析结果显示,试验组患者的疾病控制率[RR=1.15,95%CI(1.07,1.23),P=0.000 1]、客观缓解率[RR=1.47,95%CI(1.29,1.67),P<0.000 01]、卡氏评分[WMD=6.11,95%CI(2.97,9.25),P=0.000 1]、免疫功能指标(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))水平、炎症因子指标[白细胞介素2(IL-2)、干扰素γ(IFN-γ)]水平、肺功能指标(用力肺活量、第1秒用力呼气容积、最大呼气流量)均高于对照组(P<0.05)。试验组患者的证候情况评分[WMD=-2.83,95%CI(-4.42,-1.24),P=0.000 5]、IL-6[WMD=-11.20,95%CI(-21.75,-0.64),P=0.04]水平、不良反应(骨髓抑制、肝肾损伤、胃肠反应)发生率均低于对照组(P<0.05)。此外,试验组患者的自然杀伤细胞水平虽高于对照组,但差异无统计学意义(P>0.05)。结论 与单纯常规化疗相比,中医扶正解毒法联合常规化疗在提高晚期非小细胞肺癌患者疾病控制率和客观缓解率、提高生活质量、改善中医证候和炎症状态、增强免疫力和肺部功能、降低不良反应发生率等方面具有明显优势。

清热散结胶囊对流行性角结膜炎患者视力、泪膜稳定性及泪液蛋白水平的影响

目的:探讨清热散结胶囊对流行性角结膜炎患者视力、泪膜稳定性及泪液蛋白水平的影响。方法:随机将316例流行性角结膜炎患者纳入对照组和试验组,各158例。对照组给予更昔洛韦眼用凝胶进行治疗,试验组在此基础上加用清热散结胶囊,两组均治疗2周,并随访6个月。比较两组疗效、中医证候、眼表功能、视力情况、泪膜稳定性、泪液蛋白水平、不良反应及复发情况。结果:试验组治疗2周后的总有效率高于对照组(P<0.05)。治疗2周后与治疗前比,两组中医证候、眼表疾病指数(OSDI)、泪膜破裂时间(BUT)、泪液分泌量(SIT)、角膜荧光素染色(FL)评分降低,试验组更低(P<0.05);两组视力及泪液乳铁蛋白(LF)、总蛋白(TP)、分泌型免疫球蛋白A(sIgA)、溶菌酶(LZM)水平升高,试验组更高(P<0.05)。两组治疗期间的并发症总发生率比较无统计学差异(P>0.05);试验组随访期间的复发率为1.90%,低于对照组的12.03%(P<0.05)。结论:流行性角结膜炎患者经清热散结胶囊治疗后其泪液蛋白水平得到有效调节,中医证候、眼表功能、视力情况及泪膜稳定性得到有效改善,疗效提高,且复发风险降低,安全性良好。

健脾利湿解毒方内外兼治宫颈锥切术后持续HPV感染的临床效果研究

目的探讨健脾利湿解毒方内外兼治宫颈锥切术后持续人乳头瘤病毒(HPV)感染的临床效果。方法选取2021年1月至2022年12月沧州市人民医院收治的104例宫颈锥切术后持续HPV感染患者作为研究对象,按照随机数字表法分为对照组和观察组,各52例。对照组以重组人干扰素α-2b阴道泡腾片治疗,观察组增加健脾利湿解毒方内外兼治。3个疗程后,比较两组临床疗效、中医证候积分、炎症因子、免疫功能、治疗安全性。结果观察组总有效率为92.31%(48/52),高于对照组的76.92%(40/52),差异具有统计学意义(P<0.05)。观察组各项中医证候积分均低于对照组(P<0.05)。观察组沉默调节蛋白1(SIRT1)、Nod样受体蛋白3(NLRP3)、基质金属蛋白酶组织抑制因子-3(TIMP-3)低于对照组(P<0.05)。观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)高于对照组,CD8^(+)低于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论健脾利湿解毒方内外兼治宫颈锥切术后持续HPV感染临床效果显著,可促进HPV转阴,改善中医证候,抑制炎症因子表达,提升免疫水平,安全性良好。

清热祛湿通络方辨证加减联合西医常规治疗湿热蕴结型急性痛风性关节炎的临床效果分析

目的分析湿热蕴结型急性痛风性关节炎采用清热祛湿通络方辨证加减联合西医常规治疗的效果。方法110例湿热蕴结型急性痛风性关节炎患者,根据不同治疗方法分为对照组与干预组,每组55例。对照组给予西医常规治疗,干预组在对照组基础上联合清热祛湿通络方辨证加减治疗。比较两组的治疗效果、血尿酸水平、中医症状评分、生活质量、不良反应发生情况和复发情况。结果干预组治疗总有效率为96.36%,比对照组的83.64%要高(P<0.05)。治疗1、2、3个月后,两组患者的血尿酸水平较本组治疗前降低(P<0.05);干预组治疗3个月后的血尿酸水平(355.47±42.38)μmol/L低于对照组的(387.24±47.65)μmol/L(P<0.05)。与本组治疗前相比,两组治疗后的中医症状评分明显降低,日常生活能力量表(ADL)评分明显升高(P<0.05);干预组治疗后的中医症状评分(4.65±1.20)分低于对照组的(5.27±1.49)分,ADL评分(80.10±7.55)分高于对照组的(77.26±6.36)分(P<0.05)。治疗过程中,两组不良反应发生率比较无明显差异(P>0.05)。随访3个月,干预组复发率为7.27%,低于对照组的23.64%(P<0.05)。结论清热祛湿通络方辨证加减联合西医常规治疗湿热蕴结型急性痛风性关节炎的疗效更好,能显著降低血尿酸水平和复发率,改善中医症状和生活质量,且不良反应少,具有临床推广价值。

固肾解毒汤联合西医常规治疗终末期肾病临床研究

目的:观察固肾解毒汤联合西医常规治疗终末期肾病血液透析患者的临床疗效。方法:选择110例终末期肾病血液透析患者为研究对象,按随机数字表法分为研究组和对照组各55例。对照组给予常规西医治疗,研究组在对照组基础上给予固肾解毒汤治疗。2组疗程均为3个月。评价2组临床疗效,比较2组中医证候评分、肾功能、微炎症反应及预后情况。结果:研究组总有效率为89.09%,对照组为74.55%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组各项中医证候评分均较治疗前降低(P<0.05),且研究组各项中医证候评分均低于对照组(P<0.05)。治疗后,2组血肌酐(SCr)、尿素氮(BUN)指标均较治疗前降低(P<0.05),且研究组SCr、BUN指标均低于对照组(P<0.05)。治疗后,2组血清白细胞介素-6 (IL-6)、肿瘤坏死因子-α (TNF-α)水平均较治疗前降低(P<0.05),且研究组血清IL-6、TNF-α水平均低于对照组(P<0.05)。研究组1年生存率为87.76%,病死率为12.24%;对照组1年生存率为70.73%,病死率为29.27%。2组1年生存率和病死率比较,差异有统计学意义(P<0.05)。结论:固肾解毒汤联合西医常规治疗终末期肾病血液透析患者的临床疗效较好,可以减轻临床症状,改善肾功能及微炎症反应,还可有效改善预后,延长患者生存时间。

基于玄府理论探讨健脾开玄解毒汤联合中药药浴治疗斑块状银屑病临床观察

目的基于玄府理论探讨健脾开玄解毒汤联合中药药浴治疗斑块状银屑病临床观察。方法选择医院治疗的斑块型银屑病患者68例。根据随机数字表法随机分为对照组与治疗组各34例。对照组给予窄谱中波紫外线光疗联合甲氨蝶呤片口服治疗,治疗组在对照组基础上给予健脾开玄解毒汤联合中药药浴治疗。观察两组治疗前后的临床疗效,PASI评分、皮损面积评分、皮损严重程度(红斑、浸润、鳞屑)评分,血清白细胞介素-1家族细胞因子促炎因子(IL-1α、IL-1β、IL-18、IL-33)表达水平,斑块型银屑病病变组织K17表达水平及复发率。结果治疗组治疗后总有效率为90.91%(30/33)显著高于对照组72.73%(24/33)(P<0.05);治疗后两组皮损严重程度评分,PASI评分,皮损面积评分,血清IL-1α、IL-1β、IL-18、IL-33水平,斑块型银屑病病变组织K17表达水平均较治疗前降低,且治疗组低于对照组(P<0.05);治疗后随访3个月,治疗组复发率为3.03%(1/33)显著低于对照组18.18%(6/33)(P<0.05)。结论健脾开玄解毒汤联合中药药浴治疗斑块状银屑病临床疗效显著,复发率低。

Qingre Lishi Tuihuang therapy for acute icteric hepatitis B: A systematic review

Objective:To assess the efficacy of Qingre Lishi Tuihuang therapy (QLTT) for acute icteric hepatitis B infection.Methods:Eight electronic databases were searched from inception to December 2016 with no language restrictions for reports of randomized controlled trials evaluating the effect of QLTT treating acute icteric hepatitis B.Two researchers independently extracted detailed data and assessed methodological quality.ReviewManager 5.3.0 software was used to analyze the data.Results:A total of 13 randomized controlled trials involving 2238 participants were included in this review.The methodological quality was generally poor.The results indicated that supplemented Yinchenhao decoction combined with non-specific treatments was more effective in improving the cure rate (risk ratio =1.80;95% CI 1.21-2.68) and reducing the serum levels of total bilirubin (mean difference =-29.74;95% CI-31.91 to-27.57) and aspartate aminotransferase.Other self-made prescriptions conforming to QLTT plus non-specific treatments had beneficial effect for acute icteric hepatitis B in curing this disease (risk ratio =1.48;95% CI 1.27-1.73),as well as for negative seroconversion of HBeAg (risk ratio =1.39;95% CI 1.11-1.74).Supplemented Yinchenhao decoction plus non-specific treatments was more effective than other self-made prescriptions conforming to QLTT in reducing serum total bilirubin level.Conclusion:Qingre Lishi Tuihuang therapy appears to improve effect based on non-specific treatments for the treatment of acute icteric hepatitis B.However,it is premature to draw confirmative conclusions,owing to the poor methodological quality and high clinical heterogeneity of the included trials.Further well-designed clinical randomized controlled trials with large sample sizes should be undertaken.

清热化痰活血方加减对急性缺血性卒中疗效及抗炎作用的研究

目的探讨清热化痰活血方加减治疗急性缺血性卒中的疗效及其抗炎作用。方法选取2014年1月-2016年12月无锡市中医医院及宿迁市中医院60例急性缺血性卒中患者,采用随机数字表法将患者分为研究组(30例,接受常规西药联合清热化痰活血方加减治疗)与对照组(30例,接受常规西药治疗),疗程10 d。对比2组治疗前后的中医证候积分、脑卒中专用生活质量量表(SS-QOL)、白细胞计数(WBC)、Fugl-Meyer运动功能评定量表(FMA)、中性粒细胞比率(NEUT)、美国国立卫生研究院卒中量表(NIHSS)、C-反应蛋白(hs-CRP)水平,临床疗效及不良反应。结果治疗前2组患者的中医证候积分、SS-QOL、NEUT、FMA、WBC、NIHSS、hs-CRP比较,差异无统计学意义(P>0.05);治疗后研究组的hs-CRP、WBC、NEUT水平低于对照组,NIHSS评分低于对照组,SS-QOL、FMA评分高于对照组,差异具有统计学意义(P<0.05);研究组总有效率高于对照组(P<0.05);2组的总不良反应率差异无统计学意义(P>0.05)。结论清热化痰活血方加减治疗可有效改善急性缺血性卒中患者神经功能,减轻患者局部炎症反应并提高患者生活质量。

涌泉穴贴敷合清利活血解毒汤治疗急性痛风性关节炎的疗效观察

目的 分析涌泉穴贴敷合清利活血解毒汤治疗急性痛风性关节炎的临床疗效。方法 200例急性痛风性关节炎患者,按照随机数字表法分为治疗A组与治疗B组,各100例。治疗B组应用洛索洛芬钠片治疗,治疗A组在治疗B组基础上应用涌泉穴贴敷合清利活血解毒汤治疗。对比两组治疗效果及炎性因子水平、中医证候积分、疼痛评分、生活质量评分。结果 治疗A组治疗总有效率97.00%高于治疗B组的85.00%,差异有统计学意义(P<0.05)。治疗后,治疗A组血清C反应蛋白、血尿酸、血沉、肿瘤坏死因子-α、白细胞介素-6水平分别为(11.45±2.34)mg/L、(423.45±56.78)μmol/L、(10.43±2.34)mm/h、(43.25±2.34)ng/dl、(32.14±4.36)pg/ml,均低于治疗B组的(32.14±6.53)mg/L、(545.32±34.56)μmol/L、(26.78±3.56)mm/h、(54.32±4.53)ng/dl、(42.36±3.25)pg/ml,差异有统计学意义(P<0.05)。治疗后,治疗A组关节疼痛、关节压痛、关节急性红肿、关节活动障碍评分分别为(1.45±0.45)、(1.47±0.32)、(1.65±0.32)、(0.54±0.21)分,均低于治疗B组的(2.67±0.34)、(2.87±0.32)、(2.54±0.32)、(1.57±0.34)分,差异有统计学意义(P<0.05)。治疗后,治疗A组疼痛评分(2.15±0.32)分低于治疗B组的(3.45±0.46)分,差异有统计学意义(P<0.05)。治疗后,治疗A组生活质量评分(86.53±1.54)分高于治疗B组的(75.46±2.78)分,差异有统计学意义(P<0.05)。结论 对急性痛风性关节炎患者采用涌泉穴贴敷合清利活血解毒汤治疗,对炎症改善作用较为显著,同时能够降低中医证候积分,且治疗效果较好,在急性痛风性关节炎患者的治疗中有着重要意义。