The Combined Use of Tonification and Purgation in Treatment of Fatty Liver

Fatty liver is a disease caused by excessive accumulation of fat in the liver due to long-term ort repeated affection of various causative factors'When the pathogenic factor prevails,the qi is sure to be deficient',Therefore,deficiency of the vital-qicontributes greatly to the occurrence of fatty liver.For many years,the author has concentrated ont the treatment of fatty liver with the tonificatioin method,or tonification followed by purgation,or the combination of tonificaytioin with purgation,so as to effectively prevent the liver from being injured by harmful substances ,and to benefit the recovery of fatty liver.The following is a report of his experience in treatment of fatty liver with the combined use of tonification and purgation.

Clinical Study of Acupotomy Trinity Lysis on Cervical Spondylotic Myelopathy with Liver and Kidney Deficiency Syndrome

Objective:To compare the therapeutic effects of acupotomy trinity lysis and traditional acupotomy on cervical spondylotic myelopathy.Methods:A total of 205 patients with cervical spondylotic myelopathy of liver and kidney deficiency syndrome were randomly divided into the experimental group(105 cases)and the control group(100 cases).The experimental group was relaxed with acupotomy in three positions:Heaven(tian),Human(ren)and Earth(di).Traditional acupotomy was used to relax Ashi acupoints of the affected vertebra in the control group.One treatment was conducted in one week,and the duration of one course of treatment was three weeks.The VAS,JOA score and NDI index were observed after treatment.Results:Before and after treatment,the total treatment efficiency of the treatment group was 95.23%,and that of the control group was 80.00%,there was significant difference between the two groups,P<0.05;Before operation,there was no significant difference in JOA score,NDI index score,and VAS score between the treatment group and the control group(P>0.05);there was no significant difference after 1 week(P>0.05),but there were significant differences between the two groups 2 weeks and 3 weeks after operation(P<0.05).Conclusion:Acupotomy trinity lysis is a safe,effective and economical treatment for cervical spondylotic myelopathy.

The Clinical Experience of Prof. Zhang Xiaofeng in the Treatment of Small Follicular, Ovulatory Infertility with Traditional Chinese Medicine

With the popularization of clinical ultrasound technology,small follicular ovulation infertility is gradually being recognized in clinical practice.Low follicle ovulation refers to the phenomenon that the average value of the three diameter lines of the dominant follicle is less than 14mm-18mm under continuous ultrasound monitoring.The dominant follicle ovulates before it develops to maturity,which is a kind of ovulation disorder and one of the leading causes of unexplained infertility[1],accounting for 25%-30%of the total number of patients with infertility[2].At present,Western medicine mostly uses ovulation,stimulating drugs to treat this disease.Still,due to the clinical result of“high ovulation but low pregnancy”,there are certain obstacles in treatment.The purpose of this article is to discuss Zhang Xiaofeng’s understanding of TCM of this disease.The tutor believes that the location of the disease is in the kidney,and the mechanism of the disease is kidney yin deficiency and blood heat.The treatment principle is sequential therapy,nourishing yin and clearing heat,taking into account the protection of the spleen and stomach,and the therapeutic effect is perfect.

Therapeutic observation of 'warming-unblocking needling technique'for knee osteoarthritis due to deficiency of liver and kidney

Objective:To compare the clinical efficacy between'warming-unblocking needling technique7 and reinforcing method by twirling in treating knee osteoarthritis(KOA)due to deficiency of liver and kidney.Methods:A total of 72 patients with KOA were divided into a warming-unblocking group and a reinforcing group by complete randomized method,with 36 cases in each group.Xuehai(SP 10),Heding(EX-LE 2),Liangqiu(ST 34);Neixiyan(EX-LE 4),Xizhong(Extra),Dubi(ST 35),Yinlingquan(SP 9),Zusanli(ST 36)and Yanglingquan(GB 34)were the main points in both groups.Taichong(LR 3),Taixi(Kl 3)and Sanyinjiao(SP 6)were the combined points.'Warming-unblocking needling technique'was applied in the warming-unblocking group,and reinforcing method by twirling was applied in the reinforcing group.The treatments were performed once a day,10 times as a treatment course,at a 2-day interval between two courses,for 3 courses in total.The scores of Western Ontario and McMaster Universities osteoarthritis index(WOMAC)in the two groups were observed before and after the treatment,and the clinical efficacy was compared.Results:After treatment,the total effective rate was 94.3%in the warming-unblocking group and 87.9%in the reinforcing group,and the difference between the two groups was statistically significant(P<0.05).The component scores of pain,stiffness and daily activities in WOMAC and total WOMAC scores in both groups decreased after treatment(all P<0.01).The component and total WOMAC scores in the warming-unblocking group were lower than those in the reinforcing group(P<0.05 or P<0.01).Conclusion:'Warming-unblocking needling technique' has significant efficacy than reinforcing method by twirling in treating KOA due to deficiency of liver and kidney.It can significantly improve pain,stiffness and daily functional activities of patients.

Effect of Huqian Wan on liver-Yin and kidney-Yin deficiency patterns in patients with knee osteoarthritis

OBJECTIVE: To observe the curative effect of Huqian Wan on liver and kidney-Yin deficiency knee osteoarthritis(KOA).METHODS: One hundred patients were randomly divided into a treatment(50 patients) and control group(50 patients). In the treatment group, patients orally took the Chinese medicine Huqian Wan. Control group patients orally took Votalin, 75 mg, once a day, for 8 weeks. The visual analog scale(VAS), Western Ontario and Mc Master University Osteoarthritis Index(WOMAC), and Medical Outcomes Study Short Form 36-Item Health Survey(SF36) were used to evaluate the curative effect before treatment and after 8 and 16 weeks of treatment.RESULTS: VAS and WOMAC scores significantly decreased and SF 36 scores significantly increased after treatment in both groups compared with before treatment(P < 0.05). There were significant differences in VAS, WOMAC, and SF 36 score changes between the two groups at week 16(P < 0.05).There was a significant increase in VAS and WOMAC scores in the control groups(P < 0.05) between weeks 8 and 16, but no significant difference was found in the treatment group(P > 0.05).CONCLUSION: Huqian Wan could effectively improve the clinical symptoms and quality of life in patients with KOA. It could also have a better and longer lasting curative effect without obvious adverse events compared with Votalin.

Liuwei Dihuang Pill(六味地黄丸)Treats Postmenopausal Osteoporosis with Shen(Kidney) Yin Deficiency via Janus Kinase/Signal Transducer and Activator of Transcription Signal Pathway by Up-regulating Cardiotrophin-Like Cytokine Factor 1 Expression

Objectives： To investigate the mechanism of Liuwei Dihuang Pill （六味地黄丸, LDP） in treating postmenopausal osteoporosis （PMOP） with Shen （Kidney） yin deficiency. Methods： In this study, 205 cases of PMOP were divided into the PMOP Shen-yin deficiency group （Group A）, PMOP Shen-yang deficiency group （Group B）, PMOP without Shen deficiency group （Group C）, and control group （Group N）. Real-time polymerase chain reaction （RT-PCR） and Western blot techniques were used to observe the effects of LDP treatment on the cardiotrophin-like cytokine factor 1 （CLCF1）, ankyrin repeat and SOCS box containing 1 （ASB1）, and proldneticin 2 （PROK2） genes and the Janus kinase/signal transducer and activator of transcription （JAK/STAT） signaling pathway. Results： The mRNA （P〈0.05） and protein （P〈0.01） expression levels of the CLCF1 gone in Group A were significantly lower than the corresponding levels in Group N. After LDP treatment for 3 months, the mRNA expression levels of the CLCF1 gone were obviously up-regulated （P〈0.01）. After 6-month treatment, the expression levels of CLCF1 mRNA and protein were significantly up-regulated （both P〈0.01）, and the average bone density of the top femur had significantly increased （P〈0.05）. In vitro, CLCF1 overexpression resulted in a significant increase in the total protein and phosphorylated protein levels of JAK2 and STAT3. Conclusions： The CLCF1 gone is an important gone associated with PMOP Shen-yin deficiency and the therapeutic effects of LDP may be mediated by up-regulation of CLCF1 gone expression and activation of the JAK/STAT signaling pathway.

Evaluation of a granulated formula for the nerve root type and vertebral artery type of cervical spondylosis：a multicenter,single-blind,randomized,controlled,phase Ⅲ clinical trial

OBJECTIVE:To evaluate the effectiveness and safety of cervical spondylosis formula granules in reducing the symptoms of patients with the nerve root type and the vertebral artery type of cervical spondylosis.METHODS:This was a multicenter, single-blind,randomized, controlled trial.From April 2002 to November 2003, 499 patients were randomly assigned to either the treatment or the control group.The treatment group was orally administered granules prepared with a formula for cervical spondylosis, while the control group was given Jingfukang granules.The treatment course was 1 month for both groups.RESULTS:In patients with the nerve root type of cervical spondylosis, the total effect rate in the treatment group(87.21%) was significantly higher than that in the control group(80.70%, P < 0.01).After the treatment period in both groups, the treatment group had a significantly greater rate of resolution of pain, numbness of the upper limbs, muscle strength of the upper limbs, and fatigue than the control group(all P < 0.05).In patients with the vertebral artery type of cervical spondylosis, the total effect rate in the treatment group(82.07%) was similar to that in the control group(71.21%, P >0.05).After the treatment period in both groups,the treatment group had a significantly greater rate of resolution of weakness of the waist and knees than the control group(P < 0.05).CONCLUSION:The cervical spondylosis formula granules significantly improve numbness, muscle strength, and fatigue, and reduce pain in patients with the nerve root type of cervical spondylosis,and improve the weakness of the waist and knees in patients with the vertebral artery type of cervical spondylosis.

Comparative observation of the effect of electroacupuncture combined with heat-sensitive moxibustion and western medicine for premature ovarian failure

Objective To compare the clinical efficacy between electroacupuncture combined with heat-sensitive moxibustion and western medicine for treatment of premature ovarian failure. Methods Eighty patients were randomly divided into an electroacupuncture combined with heat-sensitive moxibustion group（group A, n=40） and a western medicine group（group B, n=40）. Zǐgōng（子宫 EX-CA 1）, Xuèhǎi（血海 SP 10）, Gānshū（肝俞 BL 18） and Shènshū（肾俞 BL 23） were selected in group A, and acupuncture combined with heat-sensitive moxibustion were carried out. Climen was taken orally in group B. The score changes of menstrual cycle, tidal fever and sweatiness, emotional excitement, soreness and weakness of waist and knees, dizziness and tinnitus, as well as the cured and markedly effective rate of the patients in the two groups before and after two courses of treatment were compared. Results The cured and markedly effective rate of group A was 72.5%（29/40）, which was superior to that of group B（37.5%, 15/40）（ P〈0.05）. The symptom scores were improved significantly in the two groups after treatment（all P〈0.05）, and the improvement in group A was superior to that in group B（all P〈0.05）. Conclusion The efficacy of electroacupuncture combined with heat-sensitive moxibustion is superior to that of conventional western medicine in treatment of premature ovarian failure.

Curative effect of assisted reproduction technology by Traditional Chinese Medicine multi-channel interventional therapy on 95 cases of in vitro fertilization and embryo transfer failure

OBJECTIVE: To evaluate the curative effect of Traditional Chinese Medicine(TCM) multi-channel interventional therapy on women with Assisted Reproductive Technology(ART) failure, to compare the curative effect of the dual therapy and triple therapy on women with ART Failure, and to choose the best TCM interventional therapeutic plan.METHODS: The 95 cases with ART Failure from West China second University Hospital of Sichuan University meeting the inclusion criteria were randomly divided into three groups:dual therapy group(31 cases), triple therapy group(33 cases)and control group(31 cases). According to the intervene treatment of in vitro Fertilization and Embryo Transfer(IVF-ET) long cycle scheme, the control group wait naturally for 3 months before IVFET. The dual therapy group take TCM prescriptionⅡ of cultivating emotion and assisting reproduction and auricular acupoint therapy for 3 months before IVF-ET, then Western Medicine treatment progestin supporting as well as auricular application and Antai Recipe after IVF-ET transplantation.The triple therapy group take TCM prescription Ⅱof cultivated emotion and assisted reproduction,auricular acupoint therapy and retention enema of TCM, and combination treatment the same as dual therapy group after transplantation. The natural pregnancy number, the period condition of secondary IVF-ET and the improvement of the kidney deficiency, liver depression and blood stasis syndrome among those three groups were compared.RESULTS: It was showed from analysis in 95 cases with ART failure that the number of natural preg-nancy was as followings: 3 patients from the dual therapy group, 10 patients from the triple therapy group, and no patient from the control group. The comparison among three groups have statistical significance(P < 0.05). The treatment group is superior to the control group, while the triple therapy is superior to the dual therapy. The comparison of the condition of the fertility rate, clinical pregnancy rate, biochemical pregnancy rate and early abortion rate during the period of secondary IVF-ET between pre-therapy and post-treatment of both the dual therapy group and the triple therapy group have statistical significance(P < 0.05). The comparison of the improvement of the kidney deficiency,liver depression and blood stasis syndrome between pre-therapy and post-treatment of both the dual therapy group and the triple therapy group have statistical significance(P < 0.05). The comparison between three groups after treatment have statistical significance(P < 0.05).CONCLUSION: TCM multi-channel interventional therapy can increase the natural pregnancy rate of patients with ART Failure(the triple therapy is superior to the dual therapy); it can increase the fertility rate, clinical pregnancy rate, and decrease the early abortion rate during the period of secondary IVF-ET; it can improve syndromes of kidney deficiency, liver depression and blood stasis.

Effect of traditional Chinese comprehensive therapy on gestation in patients with previously failed in vitro fertilization and embryo transfer

OBJECTIVE: To explore the effect of traditional Chinese comprehensive therapy(TCCT) on promoting gestation in patients with previously failed in vitro fertilization and embryo transfer(IVF-ET) because of kidney deficiency, liver stagnation, and blood stasis(KLB).METHODS: Sixty-seven patients were enrolled in this study and divided into two groups: a trial group with 35 patients and a control group with 32 patients. The trial group was given TCCT for 3months, then administered IVF-ET or awaited natural pregnancy. The control group was administered IVF-ET without TCCT 3 months after the previous IVF-ET or natural pregnancy attempt. The patterns of KLB were observed both before and after treatment. The natural pregnancy rate of the two groups was calculated after treatment. Differences between the two groups were compared after using IVF-ET treatment again in fertilized egg number and fertilization rate were evaluated.RESULTS: After treatment with TCM comprehensive therapy, seven patients in the treatment group became pregnant, while there were no successful conceptions in the control group. The difference in clinical pregnancy rate in the initial cycle and transfer cycle of IVF were significantly different(P <0.05). The trial group had a significantly higher conception rate than that of the control group(P <0.05).CONCLUSION: TCCT can promote the natural pregnancy rate in patients with previously failed IVF-ET.TCCT could increase patients' fertilized egg number, fertilization rate, pregnancy rate, and clinical pregnancy rate after another IVF-ET treatment.TCCT can also relieve the symptoms of KLB.

加减柴胡温经汤治疗对围绝经期失眠(肝郁阴虚夹瘀型)患者中医症候积分、神经递质及炎症因子的影响

目的:探究加减柴胡温经汤治疗对围绝经期失眠(肝郁阴虚夹瘀型)患者中医症候积分、神经递质及炎症因子的影响。方法:于2021年12月~2022年12月本院收治的围绝经期失眠患者中选取102例作为研究对象,并按随机数字表法分成对照组(51例)和研究组(51例)。对照组给予舒乐安定治疗,研究组给予加减柴胡温经汤治疗,时长均为8周。比较两组疗效、中医症候(长期失眠、健忘、心烦易怒、肌肤甲错瘙痒、疲乏酸痛)积分、神经递质因子[β-内啡肽(β-EP)、神经肽Y(NPY)、5-羟色胺(5-HT)]水平、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)、白介素-6(IL-6)]水平、睡眠结构[总睡眠时间(TST)、睡眠潜伏期(SL)、睡眠效率(SE)、觉醒时间(AT)]和不良反应发生率的变化。结果:治疗8周后,研究组的总有效率为92.16%高于对照组的76.47%(P<0.05);两组的各项症候积分低于治疗前(P<0.05),且研究组低于对照组(P<0.05);两组NPY、β-EP、5-HT水平高于治疗前,IL-6、TNF-α、IL-1β水平低于治疗前,且研究组变化的幅度高于对照组(P<0.05);两组TST、SE高于治疗前,SL、AT均低于治疗前,且研究组变化的幅度高于对照组(P<0.05);两组不良反应发生率对比,差异无统计学意义(P>0.05)。结论:加减柴胡温经汤治疗肝郁阴虚夹瘀型围绝经期失眠患者的效果显著,能有效改善中医症候,提高神经递质含量,降低炎症因子水平,优化睡眠结构。

中西医诊治儿童性早熟研究进展

目前,越来越多的无创诊断技术正在运用到儿童性早熟的诊断中,基因检测技术促进了该病遗传病因诊断的发展。对于该病的治疗,西医主要通过病因治疗继发性性早熟,对于特发性外周性性早熟没有特殊治疗方案,目前,中枢性性早熟治疗首选促性腺激素释放激素类似物(gonadotropin-releasing hormone agonist, GnRHa)。中医认为,性早熟病机为阴虚火旺,肝郁化火,痰湿壅滞,治以滋阴降火、疏肝解郁或燥湿化痰,可改善症状,抑制骨龄快速增长。但目前中医药治疗性早熟的临床研究证据等级不高,缺少样本量大、严格且全面的临床研究,未来可通过开展多中心的随机对照、大样本研究以验证中医药治疗性早熟的疗效。网络药理学和中药成分动物实验研究证明了中药治疗性早熟的部分机制,但中药方剂成分复杂,多通过胃肠道吸收后起效,是否可以调节肠道菌群、产生特异性菌群,该菌群是否改变了机体中某些代谢产物水平从而发挥治疗作用尚无相关研究,今后可开展更多的相关机制研究。

中药熏蒸对肝肾阴虚型干眼症的疗效研究

目的探讨干眼症(肝肾阴虚型)患者采用中药熏蒸治疗的临床价值。方法以随机样本抽样法,于2019年3月—2021年1月首都医科大学附属北京潞河医院中医科和眼科收治的肝肾阴虚型干眼症患者中,抽取60例,随机分为对照组、观察组,各30例。对照组:人工泪液;观察组:中药熏蒸。对比两组眼表疾病指数量表(ocular surface disease index,OSDI)评分、治疗效果、中医证候积分、泪膜稳定性、不良反应。结果治疗前,两组的OSDI评分比较,差异无统计学意(P>0.05);治疗后,同组较治疗前、组间OSDI评分对比,P<0.05;两组治疗效果比较,P>0.05;治疗前,两组各项中医证候评分对比,差异无统计学意义(P>0.05);治疗后,两组患者自觉眼睛干涩不爽和不耐久视症状较治疗前、组间各评分对比,P<0.05,白睛赤脉、口干鼻燥、咽干、便秘症状两组治疗前后、组间各评分对比,差异无统计学意义(P>0.05);治疗前,两组的SIT、FL对比,差异无统计学意义(P>0.05);治疗后,同组较治疗前、组间各指标对比,差异有统计学意义(P<0.05);两组患者均未发生不良反应。结论对肝肾阴虚型干眼症用中药熏蒸治疗,可改善患者视功能、眼表功能,效果显著。

加味地黄汤辅助治疗肝肾阴虚型老年糖尿病视网膜病变的临床研究

目的 探讨加味地黄汤辅助治疗肝肾阴虚型老年糖尿病视网膜病变(DR)的临床效果。方法 选取2021年5月至2023年1月海南省中医院收治的肝肾阴虚型老年DR患者108例,根据随机数字表法将其分为对照组和观察组。对照组(54例)接受常规降糖和羟苯磺酸钙胶囊治疗,观察组(54例)在对照组基础上接受加味地黄汤辅助治疗,以4周为1个疗程,连续治疗3个疗程。比较两组临床疗效和治疗前后中医证候积分、视力水平、血糖指标[空腹血糖(FBG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)]、血管内皮生长因子(VEGF)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)],并比较两组治疗安全性。结果 观察组临床疗效优于对照组(P<0.05)。治疗后,两组中医证候积分、FBG、2 hPG、HbA1c、VEGF、TNF-α、IL-6、MDA水平均低于治疗前,视力、SOD水平高于治疗前,且观察组中医证候积分、FBG、2 hPG、HbA1c、VEGF、TNF-α、IL-6、MDA水平均低于对照组,视力、SOD水平高于对照组(P<0.05)。两组治疗期间均未出现明显的不良反应。结论 加味地黄汤辅助治疗肝肾阴虚型老年DR的效果确切,能显著改善症状,提高视力水平,且安全性高。

加减柴胡温经汤辅助治疗肝郁阴虚夹瘀型失眠的疗效及对神经递质、情绪的影响

目的探讨加减柴胡温经汤辅助治疗肝郁阴虚夹瘀型失眠患者的疗效及对神经递质、情绪的影响。方法选取2021年5月至2022年5月该院收治的94例肝郁阴虚夹瘀型失眠患者作为研究对象,采用随机数字表法分为常规组和试验组,每组各47例。常规组采用百乐眠胶囊治疗,试验组采用百乐眠胶囊联合加减柴胡温经汤治疗。比较两组临床疗效、治疗前后相关评分[汉密尔顿抑郁量表(HAMD)、匹兹堡睡眠质量指数(PSQI)、汉密尔顿焦虑量表(HAMA)]、中医证候积分、血清神经递质[5-羟色胺(5-HT)、神经肽(NPY)、去甲肾上腺素(NE)、P物质(SP)]水平、性激素[雌二醇(E 2)、黄体生成素(LH)、卵泡刺激素(FSH)]水平。结果试验组治疗后临床总有效率为97.87%,高于常规组的82.98%,差异有统计学意义(P<0.05);两组治疗后PSQI、HAMD及HAMA评分均明显低于治疗前,且试验组均明显低于常规组,差异均有统计学意义(P<0.05);试验组治疗后烦躁易怒、入睡困难、多梦易醒及情志抑郁积分均明显低于常规组,差异均有统计学意义(P<0.05);试验组治疗后NPY、5-HT水平均高于常规组,NE、SP水平均低于常规组,差异均有统计学意义(P<0.05);试验组治疗后FSH、LH水平均明显低于常规组,E 2水平明显高于常规组,差异均有统计学意义(P<0.05)。结论加减柴胡温经汤辅助治疗肝郁阴虚夹瘀型失眠可提高疗效,改善患者临床症状、神经递质及性激素水平,减轻其负面情绪,有助于患者恢复。

基于NF-κB和STAT3探讨白芍总苷对化学性肝损伤肝阴虚证大鼠的作用机制

[目的]基于核因子-κB(NF-κB)和信号转导和转录激活因子3(STAT3)研究白芍总苷对化学性肝损伤肝阴虚型大鼠的保护作用机制。[方法]将雄性SD大鼠随机分为空白组、模型组、一贯煎组(6.35 g/kg)、白芍总苷组(50 mg/kg)。采用20%四氯化碳(CCL4)橄榄油溶液联合30 mg/kg甲状腺片造模,造模的同时给药,时间为6周。观察大鼠体质量、肛温、摄食量、摄水量、舌面干湿度,以及测定血清环磷酸腺苷(cAMP)、环磷酸鸟苷(cGMP)含量、cAMP/cGMP。测定血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、γ-谷氨酰转肽酶(γ-GT)、碱性磷酸酶(ALP)、总胆红素(TBIL)、总胆汁酸(TBA)的含量变化并取肝脏进行Masson染色评估肝纤维化程度;测定血清白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、白细胞介素-10(IL-10)、白细胞介素-1受体拮抗剂(IL-1Ra)的水平及大鼠肝脏NF-κB p65、STAT3 mRNA及蛋白水平。[结果]与模型组相比,白芍总苷组体质量上升(P>0.05);白芍总苷组肛温下降(P<0.01),24 h摄食量和饮水量减少(P<0.01),舌面干湿度增加(P<0.01);白芍总苷组cAMP降低,cGMP升高,cAMP/cGMP下降(P<0.01);白芍总苷组ALT、AST、γ-GT、ALP、TBIL均下降(P<0.01),TBA含量无统计意义(P>0.05);白芍总苷组肝纤维化程度明显减轻;白芍总苷组IL-1、IL-6、TNF-α均下降,IL-10、IL-1Ra水平均上升(P<0.05或P<0.01);白芍总苷组NF-κB p65 mRNA和蛋白表达显著下降(P<0.01),STAT3 mRNA和蛋白表达升高(P<0.01)。[结论]研究结果显示,白芍总苷对肝阴虚型肝损伤具有较好的保护作用,可能通过抑制NF-κB的激活,促进STAT3的表达,从而减少促炎细胞因子分泌,增加抗炎细胞因子释放。

基于“肝-脑-目”轴探讨中医药论治干眼

“肝”“脑”“目”三者在生理及病理上相互联系,形成了“肝-脑-目”轴交互体系。其关系存在多向交互串扰,影响干眼的发生发展。应用脏腑辨证理论从生理和病理两个层面对“肝-脑-目”轴的内涵进行阐述,并提出“肝-脑-目”轴的3种失衡状态及其与干眼发病的关系,且肝、肾与目的关系为“肝-脑-目”轴理论之关键。提出清肝疏肝以畅“肝-脑-目”轴、益精生髓以充“肝-脑-目”轴、补肝肾阴以理“肝-脑-目”轴的中医药治疗干眼思路,以期为临床治疗干眼提供参考。

揿针联合耳穴压丸治疗干眼的疗效观察

目的观察揿针联合耳穴压丸治疗干眼的临床疗效。方法纳入2022年8月—2023年1月诊治的干眼患者62例(124只眼),证属肝肾阴虚证,随机分为对照组和治疗组,最终纳入对照组30例(60只眼),治疗组31例(62只眼)。对照组予0.1%玻璃酸钠滴眼液点双眼,治疗组予揿针联合耳穴压丸治疗。2组均治疗4周。分别于治疗前、后检查患者泪膜破裂时间(BUT)、泪液分泌试验(SⅠT)、眼表疾病指数(OSDI)评分和中医证候积分。结果(1)干眼指标:2组治疗前后比较,BUT、SⅠT均较治疗前延长,而OSDI评分均较治疗前下降,差异均有统计学意义(BUT:t_(治疗组)=44.680、t_(对照组)=22.380,均P=0.000;SⅠT:t_(治疗组)=30.548、t_(对照组)=17.689,均P=0.000;OSDI评分:t_(治疗组)=32.061、t_(对照组)=35.643,均P=0.000)。2组治疗后比较,治疗组BUT、SⅠT均长于对照组,而OSDI评分低于对照组,差异均有统计学意义(tBUT=11.780、tSⅠT=7.010、t_(OSDI)=4.369,均P=0.000)。(2)中医证候积分:2组治疗前后比较,治疗组治疗后的中医证候积分较治疗前下降,差异有统计学意义(t=11.152,P=0.000)。对照组中医证候积分与治疗前比较,差异无统计学意义(P>0.05)。2组治疗后比较,治疗组中医证候积分低于对照组,差异有统计学意义(t=4.864,P=0.000)。(3)临床疗效:治疗组的总有效率为100.00%,高于对照组的90.00%,差异有统计学意义(χ^(2)=4.558,P=0.033)。结论揿针联合耳穴压丸治疗干眼能有效改善干眼患者的临床症状,且安全有效,值得临床推广。

基于滋阴相关理论探讨甲状腺功能亢进症

甲状腺功能亢进症(简称甲亢)是临床常见的内分泌代谢疾病,其主要特征为甲状腺激素过多引起的一系列临床症状,如汗多、烦躁、手颤和消瘦快等。尽管西药治疗在控制甲亢方面取得了一定成效,但其常见的不良反应和高复发率限制了其长期应用。与此相比,中医药治疗甲亢的独特优势逐渐受到重视。文章以古代文献和现代研究为理论基础,从滋阴出发,核心思想为“阴常不足,阳常有余”,重在探讨滋补肝肾阴的治疗策略在甲亢中的应用。肝肾同源理论认为肝阴为血,肾阴为精,二者相互滋养,共同维持阴阳平衡和气血循环。肝肾阴虚会导致甲亢的发展和症状的加重。因此,在甲亢的防治中注重滋养肝肾之阴具有重要意义。研究显示,应用具有滋养肝肾阴之功效的中药,如加味二至方、六味地黄丸等,能够有效改善甲状腺功能、减轻症状,降低血清甲状腺相关指标和甲状腺内血管形成。这些药物通过打破肝肾阴虚状态使机体达到阴阳平衡,从而更有效地控制甲亢的进展。综上所述,滋补肝肾阴类中药在甲亢治疗中具有潜在优势。但目前其相关机制研究还不够明确,仍需更多的实验研究及临床多中心、随机对照、大样本研究作为理论支撑,将有助于临床实践中更好地应用中医药治疗甲亢。

基于“血实宜决之”辨治老年慢性失眠

“血实宜决之”出自《素问·阴阳应象大论》,意为通过针药并用祛邪逐瘀以治疗血瘀壅滞等血实之象。慢性失眠是老年人的常见病,瘀血内阻是老年慢性失眠的核心病机。临床治疗老年慢性失眠可遵循“血实宜决之”治则,以血府逐瘀汤为基础方,根据肝郁、痰火、阴虚、气虚、血虚等不同致瘀原因加减化裁,同时配合针刺、耳穴等疗法,以提高疗效。