柴芩温胆汤治疗少阳病痰热内扰型失眠症临床观察

目的观察柴芩温胆汤治疗痰热内扰型失眠症的临床疗效。方法将70例失眠症患者随机分为治疗组和对照组,各35例。对照组口服艾司唑仑,治疗组予柴芩温胆汤治疗。两组疗程均为60天,观察临床疗效以及匹兹堡睡眠质量指数量表(PSQI)积分、中医证候积分变化情况。结果 1治疗组总有效率为85.7%,对照组总有效率为77.1%;组间临床疗效比较,差异有统计学意义(P0.05)。2治疗前后组内比较,两组PSQI积分差异均有统计学意义(P0.05);组间治疗后比较,PSQI积分差异有统计学意义(P0.05);3治疗前后组内比较,治疗组不寐、痰多、脘闷、心烦口苦、目眩、舌红、苔黄腻积分差异有统计学意义(P0.05),对照组仅不寐积分差异有统计学意义(P0.05);组间治疗后比较,不寐、痰多、脘闷、心烦口苦、目眩、苔黄腻积分差异有统计学意义(P0.05)。结论柴芩温胆汤治疗少阳病痰热内扰型失眠症疗效确切,能有效改善包括失眠在内的相关中医证候。     

柴芩温胆汤联合阿普唑仑治疗痰热扰心型原发性失眠合并焦虑临床研究

目的：观察柴芩温胆汤联合阿普唑仑治疗痰热扰心型原发性失眠合并焦虑的临床疗效。方法：选 取60 例痰热扰心型原发性失眠合并焦虑患者,按随机数字表法分为治疗组和对照组,每组30 例。对照组给予 阿普唑仑治疗,治疗组在对照组基础上给予柴芩温胆汤治疗,2 组均治疗4 周。比较2 组临床疗效,以及治疗 前后匹兹堡睡眠质量指数（PSQI）、焦虑自评量表（SAS）、中医证候评分。结果：治疗后,治疗组总有效率 90.00%,高于对照组60.00%,差异有统计学意义（P＜0.05）。2 组PSQI、SAS、中医证候评分均较治疗前降 低,治疗组PSQI、SAS、中医证候评分均低于对照组,差异均有统计学意义（P＜0.05）。结论：柴芩温胆汤联 合阿普唑仑治疗痰热扰心型原发性失眠合并焦虑,可有效缓解患者的临床症状及焦虑情绪,改善睡眠质量,疗 效优于单独使用阿普唑仑治疗。     

安神醒脑汤治疗依非韦伦致HIV/AIDS患者失眠症的临床观察

目的 探讨安神醒脑汤治疗依非韦伦所致感染人类免疫缺陷病毒(HIV)/获得性免疫缺陷综合征(AIDS)患者失眠症的临床疗效.方法 选取2016年5月—2018年9月就诊于首都医科大学附属北京地坛医院的初次依非韦伦抗病毒治疗后出现失眠(肝郁化火兼痰热内扰证)的HIV/AIDS患者108例,采用随机数字表法分为治疗组与对照组,各54例.治疗组给予安神醒脑汤治疗,对照组给予艾司唑仑片治疗,疗程均为8周.比较2组治疗前后匹兹堡睡眠质量指数(PSQI)评分、中医证候积分,并依据中医失眠疗效判定标准评价疗效.结果 治疗4、8周,2组PSQI评分及中医证候积分均较治疗前减少,差异有统计学意义(P＜0.01);治疗4周,2组间PSQI评分差异无统计学意义(P＞0.05),中医证候积分差异有统计学意义(P＜0.01);治疗8周,2组间PSQI评分差异有统计学意义(P＜0.01),中医证候积分差异有统计学意义(P＜0.01);治疗8周,治疗组总有效率高于对照组(P＜0.01);2组未观察到严重不良反应.结论 安神醒脑汤可有效改善依非韦伦所致HIV/AIDS患者的失眠症.     

冲击波针灸治疗痰热内扰型失眠36例

目的:评价冲击波针灸治疗痰热内扰型失眠症的临床疗效。方法:将108名痰热内扰型失眠症患者随机分为冲击波针灸观察组36例、传统针刺对照组36例、西药对照组36例,治疗2个疗程后观察疗效。结果:治疗前后PSQI积分及睡眠质量分级水平比较均有极显著性差异(P0.01),冲击波针灸观察组改善程度与传统针刺对照组相当(P0.05),优于西药对照组(P0.05);总有效率冲击波针灸观察组为88.89%,传统针刺对照组为86.11%,西药对照组为77.78%;治疗后三组中医证候积分比较,对于睡眠不安、痰多等主症的改善,冲击波针灸观察组显著优于传统针刺对照组和西药对照组。结论:冲击波针灸治疗痰热内扰型失眠症疗效显著。     

黄连温胆颗粒治疗痰热扰心证失眠40例临床研究

目的:探讨黄连温胆颗粒对痰热扰心证失眠的疗效并探讨其作用机制。方法:根据(CCMD-3)诊断标准诊断为失眠症,中医辨证为痰热内扰者40例,随机分为治疗组与对照组,观察2组失眠患者匹兹堡睡眠质量指数(PSQI)7个因子成分评分、中医证候积分及舒乐安定停减率并评定疗效。结果:治疗4周后2,组痊愈、显效和总有效率均有显著差异(P<0.05);且治疗后组间比较有显著性差异(P<0.05)。结论:黄连温胆颗粒是治疗痰热内扰证失眠的有效方剂。     

黄连温胆汤加味治疗痰热内扰型失眠临床观察

目的:观察黄连温胆汤加味治疗痰热内扰型失眠的临床疗效。方法:选取2016年12月至2018年3月确诊的痰热内扰型失眠患者64例,按随机数字表法分为治疗组和对照组,每组32例。对照组给予艾司唑仑片治疗,治疗组在对照组治疗的基础上加用黄连温胆汤加味治疗。结果:治疗组有效率93.75%,对照组有效率81.25%,两组有效率比较,治疗组优于对照组,差异有统计学意义(P0.05);治疗组治疗后中医证候评分优于对照组,中医证候评分差异有统计学意义(P0.05);治疗组治疗后匹兹堡睡眠质量指数量表评分优于对照组,差异有统计学意义(P0.05);对照组不良反应发生率50.00%,治疗组不良反应发生率31.25%,治疗组优于对照组,差异有统计学意义(P0.05)。结论:黄连温胆汤加味治疗痰热内扰型失眠疗效显著,能明显改善患者中医证候和睡眠质量。     

礞石滚痰汤加减治疗痰热内扰型不寐30例

目的:观察礞石滚痰汤治疗痰热内扰型不寐的临床疗效。方法:将60例患者随机分为观察组和对照组,每组30例。观察组予以礞石滚痰汤加减治疗,1剂/d,2次/d。对照组予以阿普唑仑。0.4 mg,口服,1次/d。2组均连续治疗4周,比较2组给药前后匹兹堡睡眠质量指数(PSQI)、体质评分和临床疗效。结果:总有效率观察组为86.67%,对照组为60.00%,2组比较差异有统计学意义(P0.05)。PSQI评分及体质评分治疗前后2组组内比较,差异有统计学意义(P0.05);治疗后组间比较差异也有统计学意义(P0.05)。结论:礞石滚痰汤治疗痰热型不寐,可明显改善患者睡眠质量。     

清肝化痰宁魂汤治疗痰热内扰型失眠临床疗效

目的:观察清肝化痰宁魂汤治疗痰热内扰型失眠临床疗效。方法:随机数字表法将2012年5月~2015年8月我院收治的90例痰热内扰型失眠患者均分为中药组及对照组各45例,对照组给予常规西药治疗,中药组另给予本院自制清肝化痰宁魂汤治疗,观察2组治疗前后不良情绪[焦虑自评量表(SAS)、抑郁自评量表(SDS)]、匹兹堡睡眠质量指数(PSQI)积分、多导睡眠监测指标[睡眠潜伏期、睡眠效率、总睡眠时间]变化及药物不良反应发生情况。结果:治疗前2组SAS、SDS评分、PSQI积分、多导睡眠监测指标相较均无明显差异(P0.05);与治疗前相较,治疗后2组SAS、SDS评分、PSQI积分、睡眠潜伏期、总睡眠时间明显减小,睡眠效率明显增大,且治疗后与对照组相较,中药组SAS、SDS评分、PSQI积分、睡眠潜伏期、总睡眠时间均减小明显,睡眠效率增大明显,均有统计学意义(P0.05);中药组药物不良反应总发生率11.11%较对照组48.89%明显低(χ~2=15.291,P0.05)。结论:清肝化痰宁魂汤可明显减轻痰热内扰型失眠患者焦虑、抑郁状况,有效提高失眠患者睡眠质量及延长睡眠时间,是一种疗效确切、安全可靠药物方案。     

温胆汤加味联合耳穴贴压治疗痰热内扰型失眠症临床研究

目的:观察温胆汤加味联合耳穴贴压治疗痰热内扰型失眠症的临床疗效。方法:选取86例痰热内扰型睡眠障碍患者,按随机数字表法分为对照组和观察组各43例。对照组给予艾司唑仑口服,观察组给予温胆汤加味联合耳穴压豆治疗。比较2组临床治疗效果,以及治疗前后睡眠质量、睡眠时间变化,并观察治疗过程中的不良反应情况。结果:观察组临床疗效优于对照组,经秩和检验,差异有统计学意义(P<0.05)。治疗前,2组匹兹堡睡眠质量指数量表(PSQI)评分和每晚睡眠时间比较,差异无统计学意义(P>0.05)。治疗后,2组PSQI评分均较治疗前降低(P<0.05),每晚睡眠时间均较治疗前延长(P<0.05);且观察组PSQI评分低于对照组(P<0.05),每晚睡眠时间长于对照组(P<0.05)。观察组不良反应发生率为9.30%,对照组为51.16%,2组比较,差异有统计学意义(P<0.05)。结论:温胆汤加味联合耳穴贴压治疗痰热内扰型失眠症可提高临床疗效,改善睡眠质量,且安全性良好。     

情志干预对老年急性心律失常患者中医证候积分、心理应激反应及生活质量的影响

目的:探讨中医系统情志干预对老年急性心律失常患者中医证候积分、心理应激反应及生活质量的影响。方法:将100例患者按照随机数字表法分为对照组(50例)和观察组(50例),对照组患者给予常规护理,观察组患者在对照组基础上给予中医系统情志干预,2周后观察临床疗效,心悸、胸闷痛、气短乏力、头身困重、脘腹痞满、口黏多痰中医证候积分,抑郁和焦虑等心理应激反应和生活质量。结果:总有效率观察组为92.00%,对照组为74.00%,2组比较差异有统计学意义(P0.05)。心悸、胸闷痛、气短乏力、头身困重、脘腹痞满、口黏多痰等中医证候积分治疗前后2组组内比较,差异有统计学意义(P0.05);治疗后组间比较,差异也有统计学意义(P0.05)。焦虑评分和抑郁评分治疗前后2组组内比较,差异有统计学意义(P0.05);治疗后组间比较,差异也有统计学意义(P0.05)。情绪功能、认知功能、角色功能、躯体功能、社会功能等生活质量评分治疗前后2组组内比较,差异有统计学意义(P0.05);治疗后组间比较,差异也有统计学意义(P0.05)。结论:中医系统情志干预老年急性心律失常患者可降低中医证候积分,减轻心理应激反应,提高生活质量,临床疗效较好。     

The Evolutional Development of Traditional Chinese Medicine (TCM) Outside China Mainland: Challenges,Training, Practice, Research, and Future Development

This overview has provided an account of evolutional changes of an experience-based traditional medical practice of traditional Chinese medicine (TCM) towards modernisation to keep up with recent advances in analytical and biomedical sciences, and information technology, which may help readers to understand why applying biomedical research methodology to TCM modernisation, while maintaining the experience-based concepts, principles and heritage of TCM’s personalised health and medical approaches in balancing body’s functions with physical and mental harmony when facing environmental changes, can contribute to gain global appreciation and acceptance of TCM in healthcare. It is envisaged that such future development and integration with biomedicine-based main-stream medicine (MSM) in practice will provide valuable medical care in the development of future personalised health and medicine as well as TCM product development.     

Antimicrobial, anti-inflammatory, antiparasitic, and cytotoxic activities of Galium mexicanum

Ethnopharmacological relevance

To study the potential benefit of the traditional Mexican medicinal plant Galium mexicanum Kunth (Rubiaceae). Hexane, chloroform, and methanol extracts as well as various fractions from these extracts were tested to determine antibacterial, antifungal, antiparasitic or anti-inflammatory activities in vitro.

Materials and methods

Aerial parts of the plant were extracted with various solvents and fractionated accordingly. Their antibacterial and antifungal activities were assessed on nine bacterial and four fungal strains. Leishmania donovani was used as a protozoan strain for antiparasitic activity. The anti-inflammatory activity of the compounds was investigated by measuring the secretion of interleukin-6 when macrophages were exposed to lipopolysaccharide.

Results

Various extracts and fractions obtained from this plant exhibit antibacterial, antifungal, antiparasitic, and anti-inflammatory activities. Of special interest was the hexane fraction HE 14b, which show antibacterial (ranging between 67 and 666 μg/ml) and antifungal (at concentrations of 333 μg/ml) activities. Also the hexane fraction HE 5 exhibited antiparasitic activity (at concentrations of 260 μg/ml), whereas the methanol fraction ME 13-15 showed a potent anti-inflammatory activity when compared to dexamethasone. Chemical analyses of the chloroform extract show the presence of triterpenes, saponins, flavonoids, sesquiterpene lactones, and glucosides, but no tannins were detected in the assayed extract.

Conclusions

The benefit of Galium mexicanum as a traditional medicinal plant was confirmed using antibacterial and antifungal assays in vitro. We also report for the first time, and to the best of our knowledge, antiparasitic and anti-inflammatory activities of this plant.     

血清CEA、CA-125、CA-153、CA-199、CA242联合检测对消化道肿瘤诊断的临床意义

目的：探讨血清CEA、CA-125、CA-153、CA-199、CA242联合检测对消化道肿瘤诊断的临床意义。方法：采用酶联免疫吸附法（ELISA法）检测130例恶性消化道肿瘤患者（食管癌32例、胃癌34例、胰腺癌30例、大肠癌34例）血清CEA、CA-125、CA-153、CA-199、CA242水平。结果：表明上述四种消化道肿瘤的血清CEA、CA-125、CA-153、CA-199、CA242与对照组比较结果统计学上均有显著性差异（P〈0．01）。除胰腺癌之外，其余3种消化道肿瘤五项肿瘤标记物联合检测的阳性率均显著高于单一标志物检测（P〈0．05），分别为食管癌62．5％、胃癌85．2％、大肠癌82．3％。结论：血清CEA、CA-125、CA-153、CA-199、CA242联合检测可以显著提高消化道恶性肿瘤诊断的敏感性。     

分段开窗旷置结合切扩挂线置管引流术治疗复杂性肛瘘的安全性多中心临床研究

目的探讨分段开窗旷置结合切扩挂线置管引流术治疗复杂性肛瘘的安全性。方法采用随机对照、多中心平行试验的设计方法,将240例复杂性肛瘘患者随机分为2组:试验组120例采用分段开窗旷置结合切扩挂线置管引流术治疗,对照组120例采用切开挂线术治疗,比较2组肛门直肠结构和功能改善情况。结果术后试验组肛门失禁和肛门狭窄、移位、变形等发生率低;肛管直肠压力、直肠容量感觉功能和直肠肛管反射强度降低幅度对照组明显大于试验组。结论分段开窗旷置结合切扩挂线置管引流术治疗复杂性肛瘘可控性与安全性好,值得作为肛瘘手术的新规范化术式在临床中推广应用。     

方剂剂量与君臣佐使关系初探

以2 022个方剂为研究对象, 围绕其中中药剂量及君臣信息, 计算中药的相对剂量, 并进行方剂内的中药相对剂量排名, 利用相关关系分析方法, 进行"中药相对剂量排名"与"君臣佐使情况"之间的相关关系假设检验。探讨中药剂量与中药"君、臣、佐、使"之间的关系。中药相对剂量排名与君、臣地位存在相关关系, 且为负相关。中药相对剂量排名与佐、使地位不存在相关关系。某味中药在处方中如果相对剂量高, 越有可能成为该方的主要药物, 而某味中药是否为该方的佐药或使药与相对剂量无关。     

A prospective,randomized, double-blind,multicenter comparative study on the safety and efficacy of Celecoxib and GCSB-5, dried extracts of six herbs,for the treatment of osteoarthritis of knee joint

Ethnopharmacological relevance

This prospective, randomized, double-blind, multicenter study compared the efficacy and safety of Celecoxib and GCSB-5, a new product from extracts of six herbs, for the treatment of knee osteoarthritis.

Materials and methods

A total of 198 eligible patients were randomly assigned to the Celecoxib group (n=99 patients) or the GCSB-5 group (n=99 patients) for the 12-week study. The amount of change and percentage of the change in Western Ontario and McMaster Universities (WOMAC) Arthritis Index from the baseline, the change in pain on walking by visual analogue scale (VAS), physician's global assessment on response to therapy (PGART) by five point Likert scale, and the amount of rescue medicine taken were used as parameters for efficacy. Adverse drug reactions (ADRs) were carefully investigated.

Results

The WOMAC score improved in both the Celecoxib group and GCSB-5 group by 20.5 and 21.3 (P=0.79). The percentage of the change in WOMAC score were −42.0% and −38.9% (P=0.54). The pain VAS score decreased by 29.9 and 27.9 (P=0.58). The responders by PGART were 95.3% and 93.8% (P= 0.66), and the median amount of rescue medicine taken were 2.0 and 6.5 tablets (P=0.06). The incidence of ADRs were 31.3% and 21.2% (P=0.11). The most common ADRs were gastrointestinal system related; 17.2% in GCSB-5 group and 22.2% in Celecoxib group. Any severe ADR was not observed in either group.

Conclusions

The result of this study supports that GCSB-5 is comparable to Celecoxib in terms of the efficacy and safety for the treatment of osteoarthritis of knee joint.     

Anti-inflammatory and cicatrizing activities of thymol, a monoterpene of the essential oil from Lippia gracilis, in rodents

Ethnopharmacological relevance

Lippia gracilis Schauer (Verbenaceae) has long been recognized in folk medicine as a medicinal plant. The essential oil of Lippia gracilis has antimicrobial activity and is used externally to treat cutaneous diseases, burns, wounds, and ulcers. Recently, our research group demonstrated that the essential oil of Lippia gracilis leaves possesses antinociceptive and anti-inflammatory actions and its major component identified was thymol. The objective of this study was to assess the anti-inflammatory and wound healing activities of thymol in rodents.

Materials and methods

For the anti-inflammatory analysis the paw oedema and peritonitis models were used, followed by the assessment of the mieloperoxidase (MPO) activity, total cell counting, and histological analysis. The animals were treated (i.p., n=6/group) with thymol (10, 30, and 100 mg/kg), dexamethasone (2 mg/kg), or vehicle (1% Tween 80). In order to assess the wound healing potential, thymol was vehiculated into collagen-based dressing films and a biological wound healing test was conducted. The retraction index of the wounds and histological analysis were performed on the 3rd, 7th, 14th, and 21th days, split into three groups: undressed wounds (CTR), dressed with collagen-based films (COL), and dressed with collagen-based containing thymol (COLTHY) films.

Results

Thymol reduced significantly the oedema (100 mg/kg, P<0.001) and, besides, diminished the influx of leukocytes to the injured area (10, 30, and 100 mg/kg), according to the assessment of MPO activity (P<0.001), total cell count (P<0.05), and histological analysis. Wounds dressed with COLTHY films showed significantly bigger wound retraction rates (7 and 14 day, P<0.05) and improved the granulation reaction, as well provided better collagenization density and arrangement during wound healing.

Conclusions

This study suggests that thymol is a promising compound to be used in treatment of inflammatory processes as well as wound healing. The pharmacological actions of Lippia gracilis in popular medicine practices may be related, at least in part, to the presence of thymol in the essential oil.     

Comparative biological study of roots,stems, leaves,and seeds of Angelica shikokiana Makino

Ethnopharmacological relevance

Angelica shikokiana has been used as a health food for its anticancer, anti-inflammatory, antibacterial, antiallergic, and blood vessel dilating effects in Japan. It can also be used to prevent and treat hepatitis, diabetes, hyperlipidemia, and arteriosclerosis.

Aim of the study

The present study was designed to compare the biological activities such as melanin synthesis inhibitory, anti-allergy, anti-lipase, anti-bacterial, anti-oxidant, and neuroprotective activities of different parts of the plant that may justify the use of this plant in folk medicine.

Material and methods

The roots, stems, leaves and, seeds of Angelica shikokiana were separately extracted with water and ethanol. Each extract was examined for melanin synthesis inhibitory and anti-allergy activity on B16-melanoma and RBL-2H3 cells using IgE and A23187 as a stimulant for β-hexosaminidase release, respectively. We also evaluated the inhibition of two enzymes, lipase and acetylcholine esterase, and of the bacterial growth of two species, Escherichia coli and Staphylococcus aureaus. The anti-oxidant activity was determined using oxygen radical anti-oxidant capacity, ORAC assay and its relation to the phenolic content was estimated using the Folin–Ciocalteu method. Besides, the protective effect of the extracts against H₂O₂-induced oxidative stress in mouse neuroblastoma, Neuro-2A cells was investigated.

Results

The most active extract exhibiting melanin synthesis inhibition (63%) and at the same time with low cytotoxicity (15%) was the ethanol extract of roots at 20 µg/ml, followed by the ethanol extract of stems (57% inhibition, 5% cytotoxicity). On the other hand, the highest inhibitions of β-hexosaminidase release were recorded for the ethanol extract of leaves with IC₅₀ value of 6.89 µg/ml followed by the water extract of the seeds and leaves with IC₅₀ value of 78.32 and 88.44 µg/ml, respectively. For anti-lipase assay, ethanol extracts of the stems and roots showed the strongest inhibition with IC₅₀ values of 204.06 and 216.24 µg/ml, respectively. None of the examined extracts showed any activity against Escherichia coli. while the ethanol extract of the roots and stems showed moderate inhibition for Staphylococcus aureus with minimum inhibitory concentration of 400 µg/ml. Ethanol extract of the roots showed only 30% inhibition of acetylcholine esterase enzyme. The results of anti-oxidant, phenolic content and protective effect against H₂O₂-induced cytotoxicity assays showed highly correlated data. Ethanol extract of the stems (ORAC value of 1.08 µmol Trolox/ mg and phenolic content 44.25 μg GAE/mg) increased the cell viability of H₂O₂-treated Neuro-2A cells by 28%.     

Sedative, vasorelaxant, and cytotoxic effects of convolvulin from Ipomoea tyrianthina

Aim of the study

Ipomoea tyrianthina has been used in Mexican traditional medicine as a mild purgative, for the treatment of nervous disorders, and against tumors. In this study, the effect of convolvulin (an ether-insoluble resin glycoside) from the root of Ipomoea tyrianthina on: Central Nervous System; as spasmolytic and vasodilator; cytotoxic against cancer cell lines is evaluated.

Materials and methods

Convolvulin isolated from the root of Ipomoea tyrianthina (IT-EM) was tested on pentylentetrazole induced seizures, pentobarbital-induced hypnosis, release of GABA and glutamic acid, isolated rat aorta and ileum rings, and against Caco-2 and KB cell lines.

Results

IT-EM increased the hypnotic effect induced by pentobarbital and the release of GABA in brain cortex of mice, but did not protect mice against pentylenetetrazole-induced convulsions. IT-EM produced a significant vasodilator effect in concentration- and endothelium-dependent manners on isolated rat aorta, but did not inhibit significantly contractions on rat ileum, colon, and jejune rings. IT-EM showed cytotoxic activity against nasopharyngeal carcinoma KB cell line.

Conclusions

Convolvulin (IT-EM) from Ipomoea tyrianthina has sedative effect, vasorelaxant effect in concentration- and endothelium-dependent manners, and cytotoxic activity against nasopharyngeal carcinoma KB cell line.     

熄风化痰活血通络方治疗缺血性中风85例总结

目的:观察熄风化痰活血通络方治疗缺血性中风的临床疗效.方法:将170例急性脑梗死患者随机分为治疗组与对照组各85例,治疗组口服熄风化痰活血通络方治疗,对照组静脉滴注胞二磷胆碱治疗.结果:治疗组总有效率为95.29％,对照组为74.11％,治疗组明显高于对照组(P＜0 01);且治疗组血液流变学指标变化与对照组比较有极显著性差异(P＜0 01).结论:熄风化痰活血通络方治疗缺血性中风疗效理想.