Establishment and evaluation of a mouse model of bronchial asthma with Yin deficiency syndrome

Objective: To establish and evaluate a mouse model of bronchial asthma with Yin deficiency syndrome. Methods: The mouse model of bronchial asthma with Yin deficiency syndrome was established by the treatment with injecting ovalbumin(OVA) two times to sensitize, inhaling OVA 14 times to stimulate, and using thyroxin through lavage during late stimulation. This model was evaluated through body weight, asthmatic behaviors, respiratory function, autonomous activity, lung pathology, and pulmonary fluid clearance. Results: OVA combined with thyroxin was an appropriate method to induce the mouse model with increased food and water intake, autonomous activity, asthmatic behaviors score, and respiratory rate, decreased body weight, tidal volume, and wet/dry ratio of lung, and changed with pathology of lung tissue. The changes of the above mentioned parameters indicated that the model was the bronchial asthma with Yin deficiency syndrome. Conclusion: The OVA combined with thyroxin is a good pattern to establish a mouse model of bronchial asthma with Yin deficiency syndrome successfully, which can highly simulate the clinical symptoms of this disease.

Study on syndrome differentiation based on pharmacology of syndrome management system-a case of Qi and Yin deficiency syndrome

Taking the Qi and Yin deficiency syndrome as an example,the research method of pharmacology of syndrome management system was proposed.By means of text mining,systematic pharmacology and target analysis,to attempt to reveal the essence of the corresponding syndrome by studying the drugs and targets of Qi and Yin deficiency.Fourteen Chinese herbs treating Qi and Yin deficiency were retrieved and used more than 30 times,and 9,317 related targets were predicted.The common targets of action were 85.Topological analysis was carried out by using degree centrality,closeness centrality and betweenness centrality to confirm that estrogen receptor(ESR1),tumor necrosis factor(TNF),D(2)dopamine receptor(DRD2),vitamin D3 receptor(VDR),glucocorticoid receptor(NR3C1),acetylcholinesterase(ACHE)and endothelin-1(EDN1)were highly correlated with Qi and Yin deficiency syndrome.Through the target to find Qi and Yin deficiency syndrome corresponding to 17 categories of diseases.A new idea was provided for studying the biological essence of TCM clinical syndrome differentiation.

Abnormal expression and significance of circ-CBLB/miR-486-5p in patients with rheumatoid arthritis of spleen deficiency and dampness excess type

Objective:To explore the abnormal expression and significance of circ-CBLB/miR-486-5p in patients with rheumatoid arthritis of spleen deficiency and dampness excess type.Methods:The 30 healthy individuals included in the method were from the Physical Examination Center of Anhui Provincial Hospital of Traditional Chinese Medicine,and the 60 rheumatoid arthritis patients included were from the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine.The disease activity score of patients with rheumatoid arthritis was evaluated using VAS score and DAS28 score,joint symptoms and spleen deficiency syndrome score were evaluated using graded quantification method,immune inflammation indicators were detected using relevant instruments,inflammatory cytokines were detected using ELISA method,macrophage markers were detected using FCM method,and pathway gene expression was detected using RT-qPCR;Evaluate the predictive effect of circ-CBLB and miR-486-5p on disease activity in rheumatoid arthritis using ROC curves.Results:(1)miR-486-5p,CD14^(+)CD86^(+),ESR,CRP,RF,Anti CCP Ab,IL-6,TNF in patients with rheumatoid arthritis-αThe levels of circ-CBLB,CD14^(+)CD163^(+),IL-4,and IL-10 were significantly higher than those of healthy individuals;(2)The expression level of circ-CBLB in patients with rheumatoid arthritis is positively correlated with CD14^(+)CD163^(+),and negatively correlated with miR-486-5p and CD14^(+)CD86^(+);The expression level of miR-486-5p is negatively correlated with CD14^(+)CD163^(+)and positively correlated with CD14^(+)CD86^(+);There is a negative correlation between CD14^(+)CD86^(+)and CD14^(+)CD163^(+);ESR is negatively correlated with circ-CBLB,and positively correlated with miR-486-5p,CD14^(+)CD86^(+),CRP;CRP is negatively correlated with circ-CBLB,CD14^(+)CD163^(+),and positively correlated with CD14^(+)CD86^(+),ESR;(3)The expression level of circ-CBLB in patients with rheumatoid arthritis is negatively correlated with joint tenderness,morning stiffness,lack of qi and lazy speech,and postprandial abdominal distension score;The expression level of miR-486-5p is positively correlated with the scores of joint tenderness and decreased appetite.(4)The ROC curve shows that in terms of circ-CBLB,ESR,CRP,VAS,and DAS28 AUC are 0.662(P=0.032),0.658(P=0.035),0.516(P=0.830),and 0.791(P=0.000),respectively.In terms of miR-486-5p,ESR,CRP,VAS,and DAS28 AUC were 0.566(P=0.385),0.511(P=0.883),0.592(P=0.223),and 0.727(P=0.003),respectively.Conclusion:The abnormal expression of circ CBLB and miR-486-5p in peripheral blood mononuclear cell of patients with rheumatoid arthritis of spleen deficiency and dampness excess type is related to inflammatory polarization markers,immune inflammation,disease activity,joint symptoms and spleen deficiency syndrome of rheumatoid arthritis,and the low expression of circ CBLB and high expression of miR-486-5p have certain predictive value for disease activity of rheumatoid arthritis.

Study on blood pressure rhythm in hypertensive patients with Yin deficiency syndrome and a random forest model for predicting hypertension with Yin deficiency syndrome

OBJECTIVE: To investigate blood pressure rhythm(BPR)in Yin deficiency syndrome of hypertension(YDSH)patients and develop a random forest model for predicting YDSH.METHODS: Our study was consistent with technical processes and specification for developing guidelines of Evidence-based Chinese medicine clinical practice(T/CACM 1032-2017). We enrolled 234 patients who had been diagnosed with primary hypertension without antihypertensive medications prior to the enrollment. All participants were divided into Yin deficiency group(YX, n = 74) and non-Yin deficiency group(NYX, n = 160).Participants were professionally grouped by three experienced chief Traditional Chinese Medicine(TCM)physicians according to four examinations(i.e.,inspection, listening and smelling, inquiry and palpation).We collected data on 24 h ambulatory blood pressure monitoring(ABPM) and YDSH rating scale. We divided 24 h of a day into 12 two-hour periods [Chen-Shi(7:00-9:00), Si-Shi(9:00-11:00), Wu-Shi(11:00-13:00), Wei-Shi(13:00-15:00), Shen-Shi(15:00-17:00), You-Shi(17:00-19:00), Xu-Shi(19:00-21:00), Hai-Shi(21:00-23:00), ZiShi(23:00-1:00), Chou-Shi(1:00-3:00), Yin-Shi(3:00-5:00), Mao-Shi(5:00-7:00)] according to the theory of “midnight-midday ebb flow”. We used random forest to build the diagnostic model of YDSH, with whether it was Yin deficiency syndrome as the outcome. RESULTS: Compared with NYX group, YX group had more female participants with older age, lower waist circumference, body mass index(BMI), diastolic blood pressure(DBP), and smoking and drinking rate(all P < 0.05). The YDSH rating scores of YX group [28.5(21.0-36.0)] were significantly higher than NYX group [13.0(8.0-22.0)](P < 0.001), and the typical symptoms of YX group included vexing heat in the chest, palms and soles, dizziness, dry eyes, string-like and fine pulse, soreness and weakness of lumbus and knees, palpitations, reddened cheeks, and tinnitus(all P < 0.05). The ratio of non-dipper hypertension in YX group was higher than in NYX group(56.9% vs 44.4%, P = 0.004). Compared with NYX group, 24 h DBP standard deviation(SD), nighttime DBP SD, Si-Shi DBP, Si-Shi mean arterial pressure(MAP), Hi-Shi systolic blood pressure(SBP), Hi-Shi DBP, Hi-Shi MAP, Zi-Shi SBP, Zi-Shi DBP, Zi-Shi MAP, ChouShi SBP SD, Chou-Shi DBP SD, Chou-Shi SBP coefficient of variation(CV) were lower in YX group(all P < 0.05). Binary Logistic Regression analysis showed that the diagnosis of YDSH was positively correlated with age, heart rate, YDSH rating scores, and four TCM symptoms including vexing heat in the chest, palms and soles, string-like and fine pulse, soreness and weakness of lumbus and knees, and reddened cheeks(all P < 0.05), but was negatively correlated with smoking(P﹥0.05). In addition, the diagnosis of YDSH was positively correlated with daytime SBP SD, nighttime SBP SD, nighttime SBP CV, and Hi-Shi SBP CV, but was negatively correlated with 24 h SBP CV, daytime DBP SD, nighttime DBP SD, and Hi-Shi DBP(all P < 0.05). Hi-Shi SBP CV had independent and positive correlation with the diagnosis of YDSH after adjusting the variables of age, gender, course of hypertension, BMI, waist circumference, SBP, DBP, heart rate, smoking and drinking(P = 0.029). Diagnostic model of YDSH was established and verified based on the random forest. The results showed that the calculation accuracy, specificity and sensitivity were 77.3%, 77.8% and 76.9%, respectively. CONCLUSION: The BPR was significantly attenuated in YDSH patients, including lower 24 h DBP SD and nighttime DBP SD, and Hi-Shi SBP CV is independently correlated with the diagnosis of YDSH. The prediction accuracy of diagnosis model of YDSH based on the random forest was good, which could be valuable for clinicians to differentiate YDSH and non-Yin deficiency patients for more effective hypertensive treatment of TCM.

Study on the correlation between CD80/CD163 and clinical prognosis and the syndrome differentiation in patients with colorectal cancer

Background:To analyze the expression of cluster of differentiation 80(CD80)/cluster of differentiation 163(CD163)in colorectal cancer(CRC)patients and their correlation with the syndrome of traditional Chinese medicine,pathology and prognosis.Methods:(1)The correlation between the pathological characteristics of 232 postoperative CRC patients and the deficiency and excess syndromes of traditional Chinese medicine was analyzed using the chi-square test,Spearman’s correlation,and Cox regression methods.(2)Immunohistochemistry and quantitative real-time PCR were used to detect the expression of CD80 and CD163 in cancer and paracancer tissues of CRC patients.(3)The relationships between the changes of CD80 and CD163 and the prognosis of CRC patients with deficiency syndrome.Patient survival were analyzed using cardinality and Cox regression proportional-hazards model regression.Results:(1)The degree of differentiation and tumor node metastasis stage of CRC were statistically different between patients with deficiency and excess syndromes(P<0.05);carcinoembryonic antigen and carbohydrate antigen 19-9 were highly expressed in the excess syndrome group,and both were significantly correlated with the distribution of traditional Chinese medicine syndromes(P<0.001);deficiency and excess syndromes,and carbohydrate antigen 19-9 were all independent factors affecting the postoperative survival of CRC patients.(2)The distribution of post-operative survival in CRC patients was significantly correlated with the distribution of the disease type(P<0.001).(3)The expression levels of CD163 protein and message RNA were significantly higher in CRC cancer tissues than in paraneoplastic tissues(P<0.001);whereas the expression of CD80 was significantly higher in paraneoplastic tissues than in cancer tissues(P<0.001).(4)The expression levels of CD80/CD163 were significantly different in different parts of the tissues of patients with deficiency and excess syndromes(P<0.001).(5)CRC patients with high CD80 expression and low CD163 expression had longer survival cycles(P<0.001).Conclusion:The malignant progression of CRC patients with deficiency syndrome is faster than that with excess syndrome.The correlation between deficiency and excess syndromes and the expression levels of CD80 and CD163 could be an independent risk factor for the survival prognosis of patients with CRC.

Summary and correlation analysis of TCM syndromes in 159 elderly patients with acute myeloid leukemia

Objective:To investigate the characteristics of TCM syndromes in elderly patients with acute myeloid leukemia(AML)at the onset,and to analyze the main syndrome types and their correlation with age,percentage of bone marrow blasts,and genetic prognostic stratification.Methods:A retrospective analysis was performed on 159 AML patients aged over 60 years who were diagnosed and treated in our hospital,and the clinical data were collected and analyzed statistically.Results:In 159 elderly AML patients,the main clinical symptoms were fatigue,poor appetite,conscious fever,and various hemorrhages.The main syndromes were Ying(42.01%),Wei(31.25%),Essential(14.81%)and Blood(11.69%);the syndromes are divided into Qi and Yin deficiency(32.70%),Qi and blood deficiency(30.19%),true Yin deficiency(28.03%)and Qi heat and blood(8.81%).The age difference between the two groups was statistically significant(P<0.001),and the multiple comparison results showed that the age of the Qi-blood deficiency group was younger than the true-Yin deficiency group and the Qi-Yin deficiency group;the percentage of bone marrow blasts was statistically significant in the three groups at the initial diagnosis(P<0.05),multiple comparison results showed that the percentage of bone marrow blasts in the true Yin deficiency group was higher than that in the Qi-blood deficiency group and the Qi-Yin deficiency group;the genetic prognostic stratification of the three groups was statistically significant(P<0.05),multiple comparisons.The results showed that the genetic prognosis of the true Yin deficiency group was poorer than that of the Qi and blood deficiency group and the Qi and Yin deficiency group.Conclusion:The most common clinical symptoms of elderly AML patients are fatigue,the disease is located in the bone marrow,and the disease is Ying,Wei,essence,and blood.With the increase in the patient's age,the TCM syndrome types tend to be more insufficiency of true Yin and deficiency of both Qi and Yin,and the prognosis of patients with insufficiency of true Yin is poor.It provides a directional scientific basis for the treatment of senile AML with integrated traditional Chinese and Western medicine.

不同滋阴补肾法干预去势大鼠破骨通路的机制

背景:六味地黄丸以“三补三泻”为配伍特点,补泻兼施以滋阴补肾;左归丸以“阳中求阴”为配伍特点,以阳促阴补肾。二者同属于滋阴补肾法,其在证候和细胞分子水平等都发挥较好的疗效。目的:观察六味地黄丸和左归丸在骨代谢中的作用,探讨其在破骨通路骨保护素(osteoprotegerin,OPG)/核因子κB受体活化因子配体(receptoractivatorofnuclearfactor-κBligand,RANKL)的作用机制。方法:将32只SD随机大鼠分为模型组、六味地黄丸组、左归丸组、假手术组,每组8只。除假手术组大鼠外,其余大鼠切除双侧卵巢制备骨质疏松模型。术后30 d开始六味地黄丸组大鼠灌胃六味地黄丸1.125 g/(kg·d);左归丸组大鼠灌胃左归丸2.25 g/(kg·d);假手术组和模型组灌胃生理盐水10 mL/(kg·d)。灌胃12周后,取大鼠胫骨检测骨密度,采用ELISA检测血清中雌激素E2、骨碱性磷酸酶、cAMP/cGMP水平,Westernblot法检测股骨中OPG/RANKL的表达情况。结果与结论:①与假手术组相比,模型组骨密度及雌激素E2、骨碱性磷酸酶水平降低(P<0.05),cAMP/cGMP水平升高(P<0.05)。②与模型组相比,六味地黄丸组和左归丸组骨密度显著提高(P<0.05);骨碱性磷酸酶均显著提高(P<0.05);左归丸组cAMP/cGMP水平明显降低(P<0.05)和上调OPG蛋白表达(P<0.05),六味地黄丸组上调OPG蛋白表达和下调RANKL蛋白表达均有作用(P<0.05);两组均不能显著提高雌激素E2水平(P>0.05)。③结果显示,“阳中求阴”的左归丸能够有效提高OPG表达,不能下调RANKL蛋白,而“三补三泻”的六味地黄丸能双向调节OPG和RANKL蛋白的表达,提示了六味地黄丸对抑制破骨功能方面可能比左归丸显著,此结论仍有待进一步的研究加以验证。

A study on the clinical prediction model of the yin deficiency type of perimenopausal syndrome

Background:The yin deficiency type of perimenopausal syndrome(PMS)as a common category of PMS based on the theory of traditional Chinese medicine(TCM)has a high prevalence with severe symptoms and long course of disease.Therefore,it is necessary to construct a prediction model to assist in diagnosis.Objective:This study aimed to investigate the independent predictors of the yin deficiency type of PMS and to develop a clinical prediction model of this disease.Methods:PMS patients who attended the Third Affiliated Hospital of Zhejiang Chinese Medical University between February 2020 and August 2023 were selected and divided chronologically into training and validation groups.Logistic regression analysis was applied in the training group to clarify the independent predictors of the yin deficiency type of PMS,and a nomogram was plotted.Internal and external validations were performed in the training and validation groups to evaluate the model’s accuracy,goodness of fit,and clinical adaptability.Results:Hot flashes and sweating(≥10 episodes/day),palpitations,emotional fluctuations,and abnormal sexual activity were independent predictors of the yin deficiency type of PMS(P>0.05).Based on the clinical prediction model constructed,the area under the receiver operating characteristic curve(AUR OC)in the training group was 0.989(95%CI 0.980–0.998),and the AUR OC in the validation group was 0.971(95%CI 0.940–0.999).This demonstrates that the model has superior prediction performance.The Hosmer-Lemeshow test was used to evaluate the model’s goodness of fit with P=0.596 for the training group and P=0.883 for the validation group,indicating a good fit.The decision curve analysis(DCA)curve and clinical impact curve(CIC)indicated good clinical adaptability.Conclusion:The model can accurately predict the occurrence of the yin deficiency type of PMS,which may help clinicians identify such patients at an early stage.

子午流注择时电温针联合双补增津汤治疗结肠慢传输型便秘气阴两虚证的疗效观察

目的:观察子午流注择时电温针联合双补增津汤治疗结肠慢传输型便秘(STC)气阴两虚证的临床疗效。方法:选择符合纳入标准的152例STC气阴两虚证患者,按随机抽取法分为对照组(枸橼酸莫沙必利治疗)、电针组(枸橼酸莫沙必利+子午流注择时电温针治疗)、中药组(枸橼酸莫沙必利+双补增津汤治疗)和结合组(枸橼酸莫沙必利+子午流注择时电温针+双补增津汤治疗),每组各38例,均治疗4周。观察比较4组患者治疗前后中医症状积分和总积分、结肠传输试验标志物含量、肠道菌群数量、焦虑自评量表评分(SAS)、抑郁自评量表评分(SDS)、慢性便秘严重度评分(CSS)的变化情况,比较临床疗效及随访6个月复发率。结果:4组患者治疗后中医症状积分和总积分、结肠传输试验标志物含量和SAS、SDS、CSS评分均较治疗前比较均明显下降(P<0.05),肠道内大肠埃希数量与治疗前比较明显减少(P<0.05),双歧杆菌、乳酸杆菌数量与治疗前比较明显增多(P<0.05);结合组临床疗效明显优于其他3组(P<0.05),随访期复发率明显低于其他3组(P<0.05)。结论:子午流注择时电温针联合双补增津汤治疗STC气阴两虚证的疗效显著,二者可发挥协同增效作用,能有效缓解便秘症状,调节肠道菌群,恢复肠道运动功能,改善焦虑、抑郁心理状态,降低复发率。

补中益气汤合增液汤加减治疗功能性便秘气阴两虚证疗效评价

目的探讨补中益气汤合增液汤加减治疗功能性便秘气阴两虚证的临床疗效。方法将该院于2019年1月—2021年12月收治的80例功能性便秘气阴两虚证患者纳入研究,采用随机对照法将所选患者进行分组,分为治疗组及对照组各40例。其中治疗组患者应用补中益气汤合增液汤加减治疗,150 mL/次,每日2次。对照组予以枸橼酸莫沙必利分散片5 mg/次口服,每日3次。2组均以4周为1个疗程,比较治疗前后便秘主要症状评分、便秘患者症状自评量表(PAC-SYM)评分变化情况,并比较两组患者的临床疗效。结果药物干预前,两组患者临床症状包括大便性状、排便间隔、排便困难、排便不尽症状评分及腹部症状、直肠症状、大便症状、PAC-SYM量表总分评分对比,差异无统计学意义,均P>0.05;经药物干预后,两组患者大便性状、排便间隔、排便困难、排便不尽症状评分及腹部症状、直肠症状、大便症状、PAC-SYM量表总分评分均明显低于治疗前,且观察组明显低于对照组,均P<0.05。观察组的总有效率明显高于对照组(P<0.05)。结论补中益气汤合增液汤加减治疗功能性便秘气阴两虚证具有较好临床效果,能够显著缓解大便干燥症状,改善患者生存状态,且具有不良反应小、患者认可度高等优势,是值得广泛应用的方案之一。

Correlation between constitution of Yin deficiency syndrome and polymorphism of HLADQA1 / treatment response of Peg-IFNα therapy in HBeAg positive chronic hepatitis B patients

Objective To observe the correlation between constitution of yin deficiency syndrome(YDS)and polymorphism of HLA-DQA1/treatment response of Peg-IFNαtherapy in HBe Ag positive chronic hepatitis B(CHB)patients,and to explore constitution of Chinese medicine(CM)in response to interferon therapy.Methods Totally 120 HBe Ag positive CHB patients who were

加味升降散对早期糖尿病肾病患者肾小管功能的影响

目的:观察加味升降散对早期糖尿病肾病(DN)患者肾小管功能的影响及其作用机制。方法:选取2018年3月至2019年10月河北省中医院肾内科门诊及住院部收治的早期DN患者92例作为研究对象,中医辨证属气阴两虚、浊毒郁热证。用简单随机化法分为对照组和观察组,每组46例。对照组给予基础治疗;观察组在基础治疗上加服加味升降散,疗程均为2个月。记录2组患者治疗前后中医证候积分;临床指标:糖化血红蛋白(HbA1c),低密度脂蛋白(LDL),总胆固醇(TC),尿微量白蛋白排泄率(UAER),肾小球滤过率(GFR);肾小管功能标志物:β2-微球蛋白(β2-MG),肝型脂肪酸结合蛋白(L-FABP),α1-微球蛋白(α1-MG);氧化应激指标:NADPH氧化酶4(NOX4),超氧化物歧化酶(SOD),总抗氧化能力(T-AOC)。结果:治疗后,观察组总有效率为92.68%,对照组为81.40%,差异有统计学意义(P<0.05);2组患者中医证候积分、HbA1c、TC、LDL、UAER均较前下降,且观察组下降更为显著(均P<0.05);2组患者治疗前后GFR变化不明显,α1-MG、β2-MG、L-FABP水平均较前降低,且观察组下降更显著(均P<0.05);2组患者NOX4表达受到抑制,T-AOC、SOD水平回升(均P<0.05),观察组患者NOX4表达的下降以及T-AOC、SOD水平的回升更显著(P<0.05);2组患者均未出现不良反应。结论:加味升降散能够改善早期DN患者临床症状,调节氧化-抗氧化失衡,减轻氧化应激,缓解肾小管损伤。

中医滋阴潜阳法对多囊卵巢综合征伴胰岛素抵抗大鼠PI3K/Akt信号通路、性激素及胰岛素相关指标的影响

目的探讨中医滋阴潜阳法对多囊卵巢综合征(polycystic ovarian syndrome,PCOS)伴胰岛素抵抗(insulin resistance,IR)大鼠的磷脂酰肌醇3激酶/蛋白激酶B(phosphoinositide 3-kinase/protein kinase B,PI3K/Akt)信号通路、性激素及胰岛素相关指标的影响。方法以来曲唑加高脂饲料诱导建立多囊卵巢及胰岛素抵抗双重大鼠模型。采用滋阴潜阳法配合达英-35及二甲双胍干预,用免疫荧光法测定卵巢PI3K、Akt通路信号,实时荧光定量PCR检测卵巢PI3K、Akt途径信号分子mRNA表达及PI3K、Akt、胰岛素受体底物-1(insulin receptor substrate 1,IRS-1)、胰岛素受体(insulin receptor,INSR)蛋白表达,性激素、胰岛素生长因子-1(insulin-like growth factor 1,IGF-1),胰岛素敏感指数(insulin sensitivity index,ISI),观察卵巢组织形态变化。结果中医滋阴潜阳法能显著增加卵巢PI3K、Akt mRNA相对表达量(P<0.05),并能显著增加卵巢PI3K、Akt蛋白表达,上调IRS-1、INSR,降低血清睾酮(testos teron,T)、促黄体生成素(luteinizing hormone,LH)含量,调节ISI,增加卵巢颗粒细胞层数及黄体组织数量。结论中医滋阴潜阳法可提高PI3K/Akt通路信号表达水平,改善胰岛素抵抗及卵泡颗粒细胞功能,调节促黄体生成素/卵泡刺激素(LH/FSH)比值,控制LH异常增高,调节多囊卵巢综合征及胰岛素抵抗。

刘树民教授治疗气阴两虚型甲状腺功能亢进症临床经验

甲状腺功能亢进症(简称甲亢)是一种临床常见病、多发病。现代医学治疗甲亢的方案主要是口服甲巯咪唑片、放射性碘治疗和手术治疗,上述3种方法不良反应较多,后期容易出现甲状腺功能减退。刘树民教授从事内科杂病治疗30余年,擅长运用中医辨证思维治疗各种疑难杂症。他认为,甲亢的病因隐匿且复杂,其基本病机为本虚标实。本虚以气阴两虚为主;标实以肝郁气滞较为常见。研究从病因病机、临床特征、治疗等方面系统分析、总结了刘树民教授运用芪玄抑甲宁为基础方治疗甲亢气阴两虚证的临证经验。建议在辨证治疗时注意以下5个要点:第一,注重疏理肝之郁气。肝气郁结是标实的主要外在表现,理气调肝为其治疗大法。第二,注重肝与心对调节情志的协同之功。肝藏血与心主血、肝藏魂与心藏神乃调节情绪、情志,维持精神、思维愉悦的关键,临证时应肝、心同调,以求情志畅达。第三,注重肝与肾的子母生化关系。肾、肝为母子之脏,肾水涵木,肾阴可滋生肝阴,以制约肝阳。第四,注重肝与脾的关系。肝和脾属五行相克,但相克太过即出现肝木乘脾土的情况,应注重肝脾之生克以求木土之平衡。第五,注意饮食。避免进食辛辣之品以防耗伤阴津及削弱中药滋阴之效。

“瘦人多火症”的因机证治探析

提出消瘦是临床常见的体质状态,常常会伴随“瘦人多火症”相关证候表现。阴气不足是形体消瘦的主要生理、病理基础,燥火偏旺是形体消瘦的继发表现,病位涉及五脏,核心在脾。治疗原则以滋养阴气为主,宣发郁热为辅。具体包括治本与治标两个方面,治本当滋养阴气以改善“消瘦”体质,治标在发散郁热以消除“多火”状态,二者孰轻孰重应依据火旺轻重缓急而定。临床根据病情之标本缓急、消瘦而能食不能食、火热之虚实微盛、病机兼夹以及季节等因素进行药味加减。

基于“阳有余而阴不足”理论治疗甲状腺功能亢进症

甲状腺功能亢进症是临床常见的高代谢性疾病,西医治疗复发率高、副作用大,而中医治疗甲状腺功能亢进症具有较好的临床疗效。基于朱丹溪提出的“阳有余而阴不足”理论,对甲状腺功能亢进症的中医病因病机及各阶段治疗展开论述。该理论揭示了甲状腺功能亢进症的致病核心,提出了甲状腺功能亢进症的病理基础为“阴不足”,病理表现为“阳有余”。临证时,应针对其不同时期的病理特点辨证论治:疾病初起时实邪当泻,注重解郁泻火;疾病进展时多见虚实夹杂,需补虚泻实,既固护真阴又化痰逐瘀;疾病日久则重在平秘阴阳。附临床验案一则,以期为临床辨证论治提供参考。

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。

300 CASES OF MENOPAUSAL SYNDROME TREATED BY ACUPUNCTURE

Caused by hypo-ovarianism, menopausal syndrome usually occurs in women aged from 45-55 years. With high incidence and various symptoms, the disease often severely jeopardize the health of the women. The authors had treated 300 cases of menopausal syndrome by acupuncture and obtained a good result.

肿瘤患者呼吸道多重耐药菌感染中医证型及易感因素研究

【目的】探讨呼吸道多重耐药菌感染肿瘤患者的中医证候分布特点及易感因素。【方法】采用病例对照研究方法,以痰细菌培养阳性的250例呼吸道多重耐药菌感染肿瘤患者为多耐组,以痰细菌培养阳性的250例呼吸道非多重耐药菌感染肿瘤患者为对照组,收集2组患者的年龄、性别、临床相关检查结果及既往抗菌药物使用状况等临床资料,分析呼吸道多重耐药菌感染肿瘤患者的中医证候分布特点和易感因素。【结果】(1)易感因素方面:单因素分析结果提示,2组间的高血压史、糖尿病史、冠心病史、化疗周期、抗菌药物使用时间、白蛋白、血红蛋白比较,差异均有统计学意义(P<0.05或P<0.01);多因素Logistic回归分析结果提示,以上变量均是肿瘤患者呼吸道多重耐药菌感染的危险因素,差异均有统计学意义(P<0.05或P<0.01)。(2)病原菌分布方面:肿瘤患者呼吸道多重耐药菌感染最常见致病菌排前3位的依次为鲍曼不动杆菌、铜绿假单胞菌、大肠埃希菌。(3)中医证候分布方面:实证方面,多耐组痰浊阻肺、热陷心包、痰热蕴肺的证型表现均较对照组严重,差异均有统计学意义(P<0.05或P<0.01);虚证方面,多耐组脾肾两虚、肺肾两虚、肝肾阴虚及心肾阳虚的证型表现均较对照组严重,差异均有统计学意义(P<0.05或P<0.01)。【结论】合并基础病、化疗周期长、抗菌药物使用时间长、低水平白蛋白及低血红蛋白为肿瘤患者发生呼吸道多重耐药菌感染的危险因素;相对于非多重耐药菌感染肿瘤患者,多重耐药菌感染肿瘤患者病情较重,中医证型以虚实夹杂型为主,而非多重耐药菌感染肿瘤患者以实证居多。

从阴虚痰瘀阻络论治慢性咽炎的临床应用

慢性咽炎是咽黏膜、黏膜下及淋巴组织的慢性炎症,以咽干、咽痒、咽部异物感、咳嗽、恶心干呕为主要临床症状,具有病程长、易反复发作、迁延难愈等特点。西医治疗本病以去除病因、对症用药为主,但实际用药效果受到患者个体差异与其他干扰因素的影响。中医治疗讲究辨证治疗,多从阴虚、阳虚、痰瘀、气虚诸型论治,根据证型特点确定治则,并结合患者的临床表现、中医证候特点,予以辨证加减治疗。本文就慢性咽炎中医治疗的研究进展做一简要综述,并重点对从阴虚痰瘀阻络论治思想的临床应用进行分析。