最新刊期
期 9 ， 2021
- 摘要：肝癌属中医学"肝积""癥积""黄疸"等范畴,是临床最常见的恶性肿瘤之一。全国名中医朴炳奎教授从阴阳虚实角度辨治原发性肝癌（PLC）,结合审因论治,概括总结肝阴虚、肝阳虚、肝阴实、肝阳实四种分型,在总体把握循因论治、扶正培本的治疗原则基础上,强调分期、辨病论治。围手术期主张肝脾同治、调气为本,肝动脉栓塞化疗期主张行气散结、祛瘀生新,围靶向治疗期主张减毒增效、气血同治。辨病论治倡导中西医结合、中西医互参。在自拟主方的基础上,根据主要矛盾的不同,分别运用三脏同调、辅以通行,清热利湿、散结解毒,扶正为主、随症治之等治疗思路,改善ALT、AST、AFP、HBV-DNA等现代医学指标异常以及晚期并发症。其辨证思路创新、治则治法见解独到,取得了良好的临床疗效。关键词：朴炳奎;肝癌;辨证;治则
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发布时间：2023-04-10 - 摘要：胰腺癌恶性程度高、生存期短,缺乏有效治疗手段,中医药在延长患者生存期、提高生存质量、综合治疗增效减毒等方面存在优势,但复方中药治疗缺乏高级别循证医学证据支持,胰腺癌中药创新药物发现缺乏系统性方法。基于中医经典、人用经验（名老中医经验方药与有效医案,成方制剂与单方制剂,中药与中药制剂专利,临床研究与药理学成果）等先验知识,通过文献学、机器学习、逻辑学、认知心理学等方法,有望构建中医经典与人用经验证据体系和胰腺癌防治方药发掘方法体系,为胰腺癌新药研发提供理论依据和指引。关键词：中医经典;人用经验;胰腺癌;方药发掘;方法学
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发布时间：2023-04-10 - 摘要：Objective To explore the influence of Chinese patent herbal medicine Quxie Capsule（ QX） on advanced colorectal cancer（ CRC） patients’ serum metabolism and gut microbiome. Methods A double blinded randomized placebo-controlled clinical trial was used to intervene all participants by QX capsule or placebo for one month. The patients’ peripheral blood and stool samples before and after intervention were collected. LC-MS non-targeted metabolomics analysis and 16 SrRNA gut micro-biome analysis were used to preform difference and variance test through bio-analysis platform. Results Among all 40 patients who had been enrolled,34 of them finished all visits and were analyzed. Student’s test showed that the abundance of pelargonidin 3-sophoroside,3-amino-2-naphthoic acid and tryptophan betaine had increased after QX treatments. However,Niacinamide had declined after QX treatments and increased after placebo intervention. Joint analysis with gut microbiome showed that pelargonidin 3-sophoroside had positive association with distribution of gut Parasutterella and Lentisphaerae,and negative association with Streptococcus. Conclusion QX capsule could promote anti-cancer effect amomg advanced CRC patients through modulating Nicotinic acid and nicotinamide,Anthocyanin and tryptophan metabolism pathway,and maybe related to Quxie Capsule’s improving beneficial bacteria in intestinal tract and reducing the distribution ratio of harmful bacteria.关键词：Quxie Capsule;colorectal cancer;metabolomic;gut Microbiome;randomized Controlled Trial（RCT）
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发布时间：2023-04-10 - 摘要：Objective To investigate the effect of Xihuang Pill on vasculogenic mimicry（VM） of gastric cancer MGC-803 cells in tumor-bearing mice by regulating HIF-1α.Methods BALB/c nude mice were randomly divided into four groups by numerical table method after tumor bearing modeling: Blank control group, Xihuang Pill group, 2-ME group, Xihuang Pill+2-ME combination group, 6 mice in each group, and they were given corresponding intervention measures for 14 days respectively.Tumor volume of mice in each group was measured and calculated, mice were killed with their necks removed, and tumor tissues were collected from each group.The mRNA expressions of VE-cadherin, EphA2,MMP-2 and HIF-1α were detected by RT-qPCR,the protein expressions of VE-cadherin, EphA2,p-EPHA2 and MMP-2 were detected by immunohistochemistry, and the protein expression of HIF-1α was detected by Western-blot.Results Xihuang Pill could inhibit the proliferation of gastric cancer cells and decrease the volume and mass of gastric cancer cells（P<0.05）,decrease the number of VM formation in gastric cancer tissues, decrease the mRNA expression of VE-cadherin and MMP-2（P<0.01） and protein expression（P<0.05）,inhibit the phosphorylation of EPHA2（P<0.05）,and reduce the expression of HIF-1α protein and mRNA,the key factor of hypoxia（P<0.01）.Conclusion Xihuang Pill can inhibit the VM formation of gastric cancer MGC803 cells by regulating HIF-1α.
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发布时间：2023-04-10 - 摘要：慢加急性肝衰竭（ACLF）是在慢性肝病基础上,由各种诱因引起以急性黄疸加深、凝血功能障碍为肝衰竭表现的临床症候群,以慢性肝病急性失代偿、多脏器功能衰竭及高病死率为主要特征,属中医学"急黄""瘟黄"等范畴。ACLF基本病机为"湿热毒邪互结交蒸于脾胃,熏蒸肝胆,肝胆疏泄失司,胆汁不循常道外溢";病位在肝胆,连及脾肾;病机多属"正虚邪实"。本专家共识从慢加急性肝衰竭的流行病学现状、中西医结合诊断标准、中西医结合辨证分型及分型论治、中西医结合预防调护等方面进行了全面系统的编写,突出了中西医结合的诊治原则。在"病因病机"方面强调了中西医结合对发病原因、病理机制的认识,创新性提出了疾病不同进展阶段的中西医病机演变及虚实变化,形成了"慢加急性肝衰竭"中西医结合病机的新认识。在治疗方面,本共识推荐根据慢加急性肝衰竭的分期进行中医辨证治疗,根据慢加急性肝衰竭不同发病阶段的特点,根据主要病机、主症遣方用药,同时根据次症、兼夹症进行辨证加减,细化和优化了诊疗方案,突出体现了中西医结合诊断、治疗疾病的理念。关键词：慢加急性肝衰竭;中西医结合;专家共识
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发布时间：2023-04-10 - 摘要：Objective To explore the mechanism of Huiyang Shengji Ointment on inflammatory reaction of microvascular endothelial cells and improving repair of wound.Methods In vitro experiment: the cells were divided into four groups: normal group（normal endothelial cell）,model group（diseased endothelial cell）,experimental group（diseased endothelial cell + Huiyang Shengji ointment）,and control group（diseased endothelial cell + Longzhu Ointment）.The expression of tumor necrosis factor-α（TNF--α）,interleukin-6（IL6） and endothelial nitric oxide synthase（eNOS） were detected.In vivo experiment: the rats were divided into three groups: normal group; model group（diabetic rats + Vaseline gauze） and experimental group（diabetic rats + Huiyang Shengji Ointment gauze）.The healing and morphological changes of the sore surface were observed, and the serum of rats was taken to detect the expression of TNF-α and vascular endothelial growth factor（VEGF）.Results In vitro experiment: compared with the normal group, the expression of eNOS in the model group was increased significantly and the difference was not statistically significant（P>0.05）;compared with the model group, the expression of eNOS in the experimental group and control group was higher and the difference was not statistically significant（P>0.05）; and compared with the control group, the expression of eNOS in the experiment group was increased significantly and the difference was not statistically significant（P>0.05）.Compared with the normal group, the expression of TNF-αin the model group was increased significantly and the difference was statistically significant（P<0.05）;compared with the model group, the expression of TNF-αin the experimental group was lower and the difference was statistically significant（P<0.05）;compared with the control group, the expression of TNF-αin the experimental group was lower and the difference was statistically significant（P<0.05）.Compared with the normal group, the expression of IL-6 in the model group were significantly lower and the difference was not statistically significant（P>0.05）;compared with the model group, the expression of IL-6 in the experimental group were significantly higher and the difference was statistically significant（P>0.05）; compared with the control group, the expression of IL-6 in the experimental group were significantly higher than that in the normal group and the difference was not statistically significant（P>0.05）.In vivo experiment: on the 3 rd, compared with the normal group, the wound healing rate in the model group was significantly higher and there was significant statistical difference（P< 0.05）; and compared with the model group, the wound healing rate in the experimental group was significantly higher and there was no significant statistical difference（P> 0.05）.on the 7 th day, compared with the normal group, the wound healing rate in the model group was significantly lower and there was significant difference（P<0.05）, compared with the model group, the wound healing rate in the experimental group was significantly higher and the difference was statistically significant（P<0.05）.On the 14 th day, compared with the normal group, the wound healing rate in the experimental group was significantly lower in the model group and the difference was statistically significant（P<0.05）; compared with the model group, the wound healing rate in the experimental group was significantly higher and the difference was statistically significant（P< 0.05）.On the 3 rd day, Compared with the normal group, the expression of TNF-α in the model group was significantly lower than and the difference was statistically significant（P<0.05）;compared with the model group, the expression of TNF-α in the experimental group was significantly higher, and the difference was statistically significant（P<0.05）.On the 7 th day, Compared with the normal group, the expression of TNF-α in the model group was significantly lower than and the difference was statistically significant（P<05）;compared with the model group, the expression of TNF-α in the experimental group was significantly higher, and the difference was statistically significant（P<0.05）.On the 14 th day, compared with the normal group, the expression of TNF-α in the model group was significantly higher and the difference was statistically significant（P<0.05）;compared with the model group, the expression of TNF-α in the experimental group was significantly lower, and the difference was statistically significant（P<0.05）.On the 3 rd day and 7 th day, compared with the normal group, the expression of VEGF in the model group was significantly lower and the difference was statistically significant（P<0.05）.On the 14 th day, compared with the normal group at the same time, the expression of VEGF in the experimental group was significantly lower and the difference was statistically significant（P<0.05）.On the 3 rd, 7 th, and 14 th day, compared with the model group, the difference was statistically significant（P<0.05）.Conclusion Huiyang Shengji Ointment can maintain endothelial cell homeostasis by increasing the expression of eNOS and VEGF and reducing the expression of pro-inflammatory factors, thus reducing inflammatory reaction and promoting vascular regeneration and wound repair with better effect than Longzhu Ointment.关键词：Huiyang Shengji Ointment;diabetic foot ulcer;endothelial cells;tumor Necrosis Factor-α;Interleukin-6;Endothelial nitric oxide synthase;vascular endothelial growth factor
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发布时间：2023-04-10 - 摘要：Objective To study the mechanism of Bimin Decoctionin on γδ T cells in mice.Methods Rats-derived Bimin Decoction medicated serum was prepared and γδ T cells obtained from mice spleen were isolated and amplified.After activated respectively with Bimin Decoction medicated serum, IL-2 and both Bimin Decoction medicated serum and IL-2,Vδ1 T and Vδ2 T cells were selected negatively.Flow cytometry was used to analyze the effect of Bimin Decoction medicated serum on the signaling pathway of mice γδ T cells.Milliplex method was used to detect the cytokines during activation and proliferation of mouse gamma delta T cells.The expression levels of transcription factors T-bet, GATA3,Foxp3 and RORγ were detected by Western blot method.Results Activation of Bimin Decoction medicated serum with IL-2 could inhibit STAT3 phosphorylation of Vδ1 T cells.The medicated serum decreased IL-4,IL-6 and TNF-α and increased IL-10 secretion significantly.The transcription factor T-bet and GATA3 in the nucleus of γδ T cells were down-regulated and GATA3 was up-regulated when stimulated with medicated serum or IL-2,however there was no significant change in co-activation.Conclusion Bimin Decoction medicated serum could interfere the activation of γδ T cells and the secretion of inflammatory Th1/Th2/Treg/Th17 cells related factors through STAT3 signaling pathway and nuclear transcription factors T-bet and GATA3 in vitro.关键词：Allergic rhinitis;γδ T cell;signaling transduction pathway;cytokine;transcription factor;mice
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发布时间：2023-04-10 - 摘要：Objective To evaluate the effect of Xihuang Pill on the proliferation and dry spheroidization ability of triple negative breast cancer cell 4 T1 based on Wnt/β-catenin signaling pathway.Methods Prepare Xihuang Pill extract, use CCK-8,select the best concentration of drug, and the effect on the proliferation ability of 4 T1 cells was tested and the effect on the dry spheroidization ability of 4 T1 cells was detected by serum-free stem cell spheroidization experiment.The effect of sphere formation ability was tested by Transwell cell migration and invasion experiment to detect the effect of Xihuangwan extract on migration and invasion ability of 4 T1 cells, and the expression of related mRNA of Wnt/cetenin pathway was detected by RT-PCR.Results The proliferation, stem spheroidizing ability, migration, invasion of tumor cell.RT-PCR Results showed that E-cadherin was up-regulated and Vimentin and β-catenin were down-regulated.Xihuang Pill could cooperate with Wnt/β-catenin pathway inhibitor XAV939 to inhibit cell proliferation, stem cell spheroidizing ability, and migration and invasion of tumor cell.Conclusion Xihuang Pill may interfere with the “dryness” of tumor cells by inhibiting the EMT transformation mediated by Wnt/β-catenin signaling pathway, thus preventing and treating tumor metastasis.关键词：Xihuang Wan;triple negative breast cancer;cell 4T1;Wnt/β-catenin signaling pathway;cell proliferation;cell migration;cell invasion;dry spheroidizing ability
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发布时间：2023-04-10 - 摘要：李乾构教授临床诊疗扁平苔藓（OLP）基于"补土法",首先注重"脾胃为后天之本",治疗上注意顾护患者脾胃,以"四君子汤"为基础方加减。其次重视辨证论治及兼症,临床上多分为虚实两证,实证多为心脾蕴热、气滞血瘀证,治宜清心脾热、理气化瘀;虚证多为阴津亏虚、血虚风燥,治宜滋阴养血、疏风润燥。在用药方面,加用金银花、金莲花、绿萼梅、野菊花、蒲公英等花类药物,取其质地轻扬的特性。重视中医整体观念,强调人与自然环境、外界环境的统一,内治服药与外治调护相结合,关注患者生活习惯,在临床上取得了良好的疗效。关键词：李乾构;口腔扁平苔藓;脾胃虚弱;心脾热盛
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发布时间：2023-04-10 - 摘要：王少杰教授认为高尿酸血症为本虚标实之证,脾肾亏虚为病之根本,而湿毒、痰浊、瘀血既是代谢产物又是致病因素。在治疗上依据引痰出络的指导思想从三方面论治,急性期清热利湿引浊减轻疼痛;慢性期养肝健脾、温肾利湿引浊,促进浊邪从二便排泄,同时活血化瘀贯穿始终;恢复期补肾温阳减少复发。依据性激素六项检查中的雌激素、雄激素比例,创平衡阴阳法,结合生活方式干预治疗高尿酸血症。关键词：王少杰;高尿酸血症;利湿温肾引浊法
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发布时间：2023-04-10 - 摘要：性欲低下严重影响男性的生活质量,中医并未对性欲低下有详细的记载,临床上性欲低下常与阳痿早泄并见,但对其治疗效果不显著。首先需要明确该病诊断,探求可能的病因病机,进行针对性治疗。中国中医科学院西苑医院男科郭军教授总结临床经验后发现,心火不降、肾水不升导致的"心肾不交"是引起本病的重要原因;又因脾胃为后天之本,脾胃运化正常是心肾功能得以发挥的重要基础。故其在治法上以泻南补北为主,以求南北通调、心肾相交,性欲复来;在选方用药上常以交泰丸加减化裁的归欲丹进行治疗;配合针刺疗法,选用神门、肾俞、心俞等穴;同时重视女方因素,常可取得令患者满意的疗效。关键词：性欲低下;心肾不交;泻南补北
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发布时间：2023-04-10 - 摘要：<正>为促进京津冀地区优势医疗资源共享,2015年初,北京中西医结合学会与津、冀两地中西医结合学会签署战略合作协议,整合三地中西医结合学科优势,创建三地"中西医结合论坛"。实践过程中,学会不断探索完善,逐渐形成了"前期调研-意见征集-会前讨论-主题报告-会后交流-凝聚共识"的论坛建设模式,凝聚专家力量,围绕中西医结合事业的发展建设、京津冀合作、中西医结合人才培养等问题展开深入交流和探讨,打造富有国际影响力、兼具中国特色的品牌学术论坛。自创办以来,
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发布时间：2023-04-10 - 摘要："胸满"多表现为患者胸胁部的胀闷不舒感,若无器质性病变,西医学多将其归为神经官能症类病。中医可从外感六经和内伤杂病两个角度来辨治胸满病证。外感传变有六经之别,病机多责之表邪郁闭肺气、少阳经气不利抑或暑热上犯,内伤病位有上下之别,病机需详辨痰实上壅胸膈、腑实腑气不降、气陷短气不相顺接等。临证时需鉴明清补两端,外邪盛则清之,内伤甚则补之,权衡祛邪与扶正的时机,在把握主要病机的基础上,进行药味配伍,方可发挥出中医学独特的临床疗效。关键词：胸满;六经;杂病;辨证
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发布时间：2023-04-10 - 摘要：心力衰竭（HF）是所有心血管疾病的终末阶段,西医治疗过程中需要使用利尿剂控制体液潴留,减轻心脏负荷。利尿剂作为容量超负荷HF的最根本治疗,在使用过程中可能会出现合并利尿剂抵抗的（DR）现象,成为利尿剂使用时影响疗效的关键问题。西医常采取联合应用利尿剂、加用新型利尿剂、使用糖皮质激素和超滤等措施。中医学认为,人体是一个有机整体,心衰不仅关乎心这一脏,应是多脏腑相互关联、影响的结果。本文从五脏辨证的角度阐述中医对HF合并DR的认识和临床治疗,以期为临床治疗提供参考。关键词：心力衰竭;利尿剂抵抗;五脏理论
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发布时间：2023-04-10 - 摘要：失眠病机总属阳不入阴,随着人们生活压力增大、嗜食肥甘,易引起气机不畅,形成气郁,从而导致脏腑功能及气血津液运行不畅,产生痰湿瘀热（火）等病理产物,影响阴阳交通,阳不入阴而致失眠。气郁与失眠的发生密切相关,气郁为六郁之始,可化火伤阴,可兼夹他邪,包括痰瘀食郁等,气郁日久又可导致阴阳两虚,故临床治疗应当以调气解郁安神为本,清热除烦为辅,兼以益气养阴、温阳健脾以固本,活血化痰治标,同时配以养心、重镇安神之品。治疗时运用柴胡疏肝散、小柴胡汤、逍遥散、四逆散、柴胡加龙骨牡蛎汤等加减,并配合心理疏导,包括言语安慰、生活方式指导等,可对临床治疗失眠提供一定的参考。关键词：失眠;气郁;解郁安神
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发布时间：2023-04-10 - 摘要："阴火"指脾胃元气虚损,阳气郁闭而产生的内伤之火,可广泛存在于五脏六腑中,或虚或实,寒热错杂。"客气"出自于仲景之著,起于中气不足而生寒热。两论对临床治疗寒热错杂型消化道系统症候群均有积极指导意义,"阴火"可谓是对"客气"进一步的继承与发扬。本文从病因病机、病证特点、治则治法入手,对两论作简要分析,以希加深对两论认识,对临床消化道疾病治疗提供新的思路与方法。关键词：阴火;客气;脾胃阳虚;阳郁;寒热错杂
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发布时间：2023-04-10 - 摘要：节食后闭经病因病机主要包括气血不足、胃热阴虚2个方面,治疗上应遵循"慢养脾胃,血海自生"及"清热养阴"之法,前者主张慢养脾胃以恢复脾胃健运水谷之功能,脾胃健则水谷运、血海充,后者则以清胃热、养胃阴以改善脾胃腐熟水谷之功能,将水谷之精微转化为可以充养血海之营血阴精。结合女性月经周期审证求因、辨证施治、因势利导则月经下。同时基于该病特点,应在个体化治疗基础上重视心理疏导,同时做好养成良好饮食习惯及健康减重知识宣教,嘱咐患者起居有常、规律饮食或少食多餐、适当运动,助其建立信心,循序渐进,方能避免闭经、早衰或不孕等严重后果。关键词：闭经;节食;慢养脾胃,血海自生;胃热阴虚
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发布时间：2023-04-10 - 摘要：产后痹因妇人产后调护不慎而出现,具有较高的发病率,且反复发作,严重影响患者的生活质量,西医尚无针对该症状的诊断及治疗方案。中医古籍中多有类似病症的记载,其中《妇人大全良方》由南宋陈自明所著,书中探讨了产后出现肢体关节疼痛症状的病名,包括"产后风虚劳冷""产后中风""产后遍身疼痛""产后腰痛""产后头痛";结合产后的特殊身体条件,提出了气血亏虚、肾气亏虚、外邪侵袭、气滞血瘀是产后痹的关键病机;并提出了益气活血散瘀、补气养血祛风的治疗原则;方剂选用趁痛散、黄芪散、木香散、人参散等。对《妇女大全良方》中产后痹的治疗进行探析,并附一则典型医案,以期为临床治疗产后痹提供中医理论依据。关键词：妇人大全良方;产后痹;中医辨证
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发布时间：2023-04-10 - 摘要：臁疮俗称"裤口毒、裙边疮、老烂腿",该病缠绵难愈,治疗极为棘手。中医外科治疗臁疮经验丰富,且疗效较好。《外科正宗》记录大量治疗外科疾病的临床经验,其中就有关于臁疮的记载,包括臁疮的成因、证候特点、治法。本文总结其对于臁疮的诊治思想,旨在为当今臁疮治疗提供思路。关键词：外科正宗;臁疮;经验;下肢慢性溃疡
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发布时间：2023-04-10 - 摘要：中医临床实践指南共识专家的选择是融合了指南制定者对行业内专家认知基础上的主观思辨和判断,专家选择的方法问题可以看作指南制定者主观思辨过程,其实施路径以中医临床实践指南共识专家作为样本,以国内外相关网络专家的介绍为目标对象,筛选构建中医临床实践指南共识专家特征集。从公开数据库、网络平台中寻找相关信息,进行每一位专家的特征标记和数据清洗,利用机器学习的特征选择方法,去除不相关和冗余的特征,优选中医临床实践指南共识专家的特征子集。该方法可能为遴选中医临床实践指南共识专家提供新思路、新方法。关键词：中医临床实践指南;共识法;专家遴选;机器学习
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发布时间：2023-04-10 - 摘要：眩晕、头晕、头昏是临床常见的主诉,其症状有明显区别,相关的靶器官也不同。眩晕症的病位主要是前庭系统,头晕症的病位主要是小脑和脑干,头昏的病位主要是大脑皮质。针刺治疗眩晕、头晕、头昏的效果显著,选穴思路首先通过问诊和望诊,明确区分眩晕、头晕和头昏;然后确定相关的经络,根据经络的循行,在病变器官附近局部选穴。与眩晕相关的经络是三焦经和胆经,选择的穴位主要是翳风、耳门、风池等;与头晕相关的经络是督脉、膀胱经、胆经,选择的穴位是脑户、风府、玉枕、天柱、脑空、风池等;与头昏相关的经络是督脉、膀胱经和胆经,治疗头昏选穴除考虑经络的循行外,应重点选择有醒脑开窍功能的穴位,包括神庭、本神、四神聪等。关键词：眩晕;头晕;头昏;针刺疗法
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发布时间：2023-04-10 - 摘要：便秘病位在大肠,但与五脏均有关系。其中肺与大肠相表里,经络上的络属决定了肺与大肠在生理病理上的紧密联系。肺为水之上源,肺疏布津液以润肠;肺主一身之气,肺宣发肃降以调大肠腑气。肺气虚则大肠推动无力;肺津亏则大肠燥而秘结;肺热盛则火移大肠耗伤津液;肺气不畅则大肠壅塞。故便秘可从肺辨治,通腑泻下不忘治肺,可从补肺气、养肺阴、清肺热、宣肺郁、降肺气等方面着手治疗以达到理肺通腑之效。关键词：便秘;肺;大肠;从肺辨证;理肺通腑
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发布时间：2023-04-10 - 摘要：目的观察安神和胃汤治疗慢性萎缩性胃炎（CAG）肝郁脾虚证的临床疗效。方法选择120例CAG肝郁脾虚证患者,采用前瞻性队列研究方法分为观察和对照组各60例,观察组给予王新佩老中医经验方安神和胃汤对症加减治疗,对照组给予柴胡疏肝散对症加减治疗。统计2组治疗前后中医症状评分、病理评分、焦虑抑郁评分变化及不良反应发生情况,比较临床有效率。结果中医整体症状疗效比较,观察组总有效率93.33%,优于对照组的81.66%,差异有统计学意义（P<0.05）。治疗后,2组中医症状评分、病理评分、焦虑抑郁评分均有一定改善,与治疗前比较,观察组差异有统计学意义（P<0.05,P<0.01）;与对照组比较,中医症状评分、焦虑抑郁评分及病理评分的萎缩、肠化和总分,差异亦有统计学意义（P<0.05）。结论辨证使用王新佩老中医经验方安神和胃汤疗效肯定,可以明显改善CAG肝郁脾虚证患者症状并减轻其抑郁、焦虑状态。关键词：慢性萎缩性胃炎;肝郁脾虚证;辨证论治;心胃相关;王新佩
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发布时间：2023-04-10 - 摘要：目的观察益气养阴辅助通下法治疗老年急性单纯性肠梗阻的临床疗效。方法将60例老年急性肠梗阻患者随机分为观察组及对照组,各30例。2组均予常规西医治疗,在此基础上观察组予口服新加黄龙汤加减治疗。观察2组首次排气排便时间、住院后前3天腹痛数字评价量表（NRS）评分、气阴两虚相关证候评分及不良反应。结果观察组及对照组分别脱落5例和4例。观察组首次排气、排便时间均早于对照组（P<0.05）;住院第2天和第3天观察组腹痛NRS评分低于对照组（P<0.05）;观察组气阴两虚证候评分较对照组低（P<0.05）。试验期间2组均未发现相关不良反应。结论益气养阴辅助通下治疗较单纯西医治疗可以更早使肠道排气排便,缓解腹痛症状,改善气阴两虚症状。关键词：益气养阴;肠梗阻;新加黄龙汤;老年人
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发布时间：2023-04-10 - 摘要：目的观察房芝萱糖尿病足一号方联合穴位贴敷治疗糖尿病周围血管病变的效果。方法选取2018年8月—2019年8月首都医科大学附属北京中医医院收治的98例糖尿病周围血管病变患者作为研究对象,采用随机数字表法分为观察组、对照组,各49例。2组在基础治疗同时,对照组采取常规西药治疗,观察组采取房芝萱糖尿病足一号方联合穴位贴敷治疗,分析比较2组疗效。结果治疗后,观察组总有效率91.84%,高于对照组的77.55%,差异有统计学意义（P<0.05）;观察组血管踝肱指数与足背动脉血流均高于对照组,静息痛、间歇性跛行、下肢冰凉等临床症状积分低于对照组,差异均有统计学意义（P<0.05）。2组空腹血糖（FBG）、餐后2 h血糖（2 hPG）以及糖化血红蛋白（HbA1c）等血糖指标,皮疹等不良反应发生率比较,差异无统计学意义（P>0.05）。结论房芝萱糖尿病足一号方联合穴位贴敷治疗糖尿病周围血管病变效果明显,可显著改善患者临床症状及下肢动脉血流、局部循环灌注。关键词：房芝萱;糖尿病足一号方;穴位贴敷;糖尿病周围血管病变
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发布时间：2023-04-10 - 摘要：目的评价中药联合雷珠单抗治疗湿性年龄相关性黄斑变性（AMD）的疗效及安全性。方法检索中国知网（CNKI）、万方数据知识服务平台、维普、SinoM ed、PubM ed及Cochrane Library等数据库从建库至2020年7月所有关于中医药联合雷珠单抗治疗湿性AMD的随机对照研究。使用改良后的Jadad量表进行质量评价后,使用Review Manager 5.3软件进行Meta分析。结果本研究纳入文献16篇,共1 432例1 443眼,其中高质量文献3篇（18.75%）。Meta分析结果显示:中药联合雷珠单抗组（中西医结合组）在黄斑中心凹厚度[MD=-18.41,95%CI（-27.99,-8.84）,P=0.000 2]、最佳矫正视力有效率[OR=3.16,95%CI（1.81,5.51）,P <0.000 1]、CNV渗漏有效率[OR=4.37,95%CI（2.81,6.81）,P <0.000 01]、临床总有效率[OR=6.60,95%CI （2.85,15.29）,P <0.0001]及抗VEGF治疗次数[MD=-0.58,95%CI（-0.85,-0.31）,P <0.0001)]结局指标方面疗效均优于对照组,2组患者不良事件发生率无统计学差异[OR=0.57,95%CI（0.19,1.72）,P=0.34]。结论中药联合雷珠单抗治疗湿性AMD不仅可提高临床疗效,还可减少患者眼内注药次数,且安全性有保证,但存在一定潜在发表偏倚,仍需进一步高质量的RCT进行论证。关键词：中药;雷珠单抗;年龄相关性黄斑变性;湿性AMD;Meta分析
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发布时间：2023-04-10 - 摘要：目的系统评价中药熏蒸治疗寻常型银屑病的临床疗效及安全性。方法计算机检索CNKI、VIP、WanFang、SinoMed、PubMed、Cochrane Library and CENTRAL、Embase等数据库,从建库至2020年11月5日,获取中药熏蒸对比其他疗法治疗寻常型银屑病的随机对照临床试验。使用Cochrane偏倚风险评估方法评价纳入研究的质量,应用RevMan5.3软件进行统计分析。结果共纳入11篇RCT,共计1 367例患者。Meta分析结果显示:联用中药熏蒸组的有效率高于窄谱中波紫外线（NB-UVB）组（RR=1.31,95%CI 1.20～1.42,P<0.000 01）、西药外用组（RR=5.00,95%CI 2.13～11.75,P=0.000 2）以及中药口服组（RR=1.37,95%CI 1.20～1.56,P<0.000 01）,差异均有统计学意义（P<0.05）。联用中药熏蒸组的PASI评分、不良反应发生率与中药口服组相比,差异无统计学意义,但均低于NB-UVB组及西药外用组（P<0.05）。结论中药熏蒸治疗寻常型银屑病在提高疗效、改善皮损严重程度方面具有一定的优势,且安全性高。关键词：寻常型银屑病;中药熏蒸;系统评价;临床效果;安全性
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发布时间：2023-04-10 - 摘要：目的探讨中医药治疗贝赫切特综合征（BS）的组方用药规律。方法检索2000年1月—2020年10月中国期刊全文数据库（CNKI）内中医药治疗BS的文献,检索词为"贝赫切特综合征""白塞氏综合征""白塞病""狐惑",将符合标准的处方药物录入中医传承辅助平台,构建中医药治疗BS处方数据库,采用数据分析、关联规则、新方分析等功能进行用药规律分析。结果共筛选出符合标准的中医药治疗BS的文献335篇,涉及处方274首,包括中药289味,高频药物22味（频次≥40次）,药性方面四气以寒性为主,五味以甘、苦居多,归经以胃、脾、肝经为主,挖掘得出高频药物组合29组,核心药物组合16个及新处方8首。结论中医药治疗BS在组方上重视清热利湿药物的应用,并适当搭配活血、补虚药物,标本兼治。关键词：贝赫切特综合征;用药规律;中医传承辅助平台;数据挖掘
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发布时间：2023-04-10 - 摘要：目的利用网络药理学理念和网络分析技术,探讨胃苏颗粒治疗慢性胃炎的潜在活性成分和可能作用机制。方法利用TCMSP平台获得胃苏颗粒（主要由紫苏、香附、陈皮、香橼、佛手、枳壳、槟榔组成）主要活性成分和作用靶点信息;利用GeneCards数据库获取与慢性胃炎相关的基因靶点,采用Cytoscape 3.7.1软件构建"药物-活性成分-靶点-疾病"网络,并利用R软件进行基因富集分析。结果共获得胃苏颗粒活性成分34个;收集到药物与疾病共有靶点基因54个。基因富集分析结果显示,胃苏颗粒主要通过癌症相关通路,如前列腺癌、大肠癌、膀胱癌、癌症中蛋白聚糖,细胞凋亡通路,TNF信号通路,PI3K-Akt信号通路等改善慢性胃炎。结论基于网络药理学方法分析发现,胃苏颗粒从预防胃黏膜上皮细胞癌变,调节胃黏膜上皮细胞凋亡,抑制胃黏膜上皮细胞炎症等多途径、多成分、多靶点、多通路改善慢性胃炎。关键词：胃苏颗粒;慢性胃炎;作用机制;网络药理学
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发布时间：2023-04-10 - 摘要：目的基于网络药理学探讨左金丸治疗胃食管反流病（GERD）的分子机制。方法通过文献检索及数据库挖掘搜集左金丸化学成分,根据药物动力学（ADME）参数筛选其活性成分,通过网络药理学寻找与其相关的潜在作用靶点。检索OMIM、DrugBank、GeneCard、TTD数据库中治疗胃食管反流病的靶点,通过Cytoscape软件中的关联功能（Merge）将筛选得到的成分、疾病相关作用靶点进行映射挖掘,构建药物-活性成分-关键靶点-疾病网络图,并进行网络拓扑分析。利用STRING数据库构建蛋白相互作用网络,并提取重要靶点模块。利用Metascape数据库对靶点进行基因本体GO富集分析,以及基因组百科全书（KEGG）通路分析。结果通过限制口服吸收利用度（OB）、药物相似性（DL）的数值,共筛选出32种活性成分。左金丸作用于ACHE、AKT1、EGFR、MAPK、PTGS2、DRD2等关键靶点,调控钙信号通路、趋化因子信号通路、NF-κB信号通路、TNF信号通路、多巴胺能突触等生物学通路,从而发挥治疗GERD的作用。结论从网络药理学的角度初步揭示了左金丸治疗GERD的靶点、作用通路等,预测抑制炎症反应、减少氧化应激、阻断一氧化氮合酶（NOS）等途径或为左金丸治疗GERD的潜在机制。关键词：胃食管反流病;网络药理学;左金丸;靶点预测
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发布时间：2023-04-10 - 摘要：近年来疾病危急重症的发生率呈上升趋势,护理质量的高低对疾病的发生、发展、预后及转归有着重要的影响。中医特色护理技术就是在"整体护理"和"辨证施护"原则的指导下,在熟识急危重症患者的共性疾病发生发展的规律下,实施"辨证施护",做到一人一方、一人一护理方案。中医特色护理技术主要包括针灸、中药灌肠、穴位敷贴、艾灸、情志调护等。本研究通过梳理中国知网、万方等数据库相关文献发现,中医特色护理技术在重症胃肠功能障碍、重症胰腺炎、重症肺炎、重症颅脑外伤昏迷等患者的护理中应用广泛,中医特色护理技术的有效性和安全性俱佳,一定程度上可缩短疾病病程,提高患者的生存率和生活质量,值得应用推广。关键词：急危重症;中医特色护理;整体观念;辨证施护
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发布时间：2023-04-10
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