黄芪活血功效及现代药理学研究进展

黄芪始载于《神农本草经》,有补气升阳、益卫固表,利水消肿,托毒生肌之效。被誉为补气健脾之要药,临床上常用于气虚乏力、脾虚泄泻等疾病,已为医者所熟知。近年来,研究学者围绕其补气、健脾、利水功效机制已有较全面的认识。然陶弘景在《本草经集注》首载黄芪"逐五脏间恶血",表明本品兼有活血作用。目前,对于本品活血作用机制阐释,中医常基于"补气活血""气行血行"理论进行论证,但并不等同于本品无活血作用。通过梳理历代本草文献中对黄芪的记载,发现其活血作用应用广泛。综合传统方剂与现代方剂中有关其活血作用的应用,本品在方中行活血通络、活血利水、活血扶正作用,尤能体现其活血作用。且现代药理学研究在有关瘀血病理指标的分子机制中,黄芪有很好的调控作用,表明黄芪有活血作用,但未深入探究,存在研究价值。该文从历代文献对黄芪活血功效的论述、黄芪活血作用的临床应用及现代药理学研究深入探讨其活血作用机制,以期扩展黄芪的临床应用范围,为临床治疗提供理论指导。     

健康教育对老一代流动人口健康的影响——来自中国流动人口动态监测调查的证据

目的 评估健康教育对老一代流动人口健康的影响,为提升老一代流动人口健康水平提供建议。方法 基于全国流动人口动态监测调查2018年数据,运用Probit模型和倾向得分匹配方法,分析健康教育对老一代流动人口健康的影响;通过中介效应中的逐步回归法和KHB分解法探究健康教育影响老一代流动人口健康状况的作用机理。结果 Probit模型显示,健康教育对老一代流动人口健康状况有一定促进作用（β = 0.017,95%CI:0.012～0.021）;纠正模型中的内生性问题后,接受健康教育能够使老一代流动人口自评健康状况向好的概率增加2.2%～2.3%（P＜0.001）;异质性分析发现健康教育对于60岁及以上和低收入的老一代流动人口健康水平的提升效果更为明显;健康教育可以显著提高老一代流动人口的健康意识。结论 健康教育既能直接促进老一代流动人口健康状况,又可以通过健康意识间接促进其健康状况;提升老一代流动人口健康水平需从扩大老一代流动人口健康教育的覆盖面,加大对老一代流动人口中健康弱势群体健康教育的普及力度以及引导老一代流动人口树立良好的健康意识三方面入手。     

Penetration moxibustion for postpartum subinvolution of uterus: Two case reports and mechanism analysis: 透灸法成功治疗产后子宫复旧不良:两则病例报告及机制分析

This article introduced the application of penetration moxibustion in successfully treating two cases of postpartum subinvolution of uterus. The main complaint of one case was increasing volume of abnormal vaginal bleeding for five days after delivery. The bleeding stopped after the patient received 7 times treatment of warming needle and penetration moxibustion on Zhōngjí (中极CV3), Guānyuán (关元CV4) and Qìhăi (气海CV6). The other case complained about persistent abdominal pain for 15 days, which was worsening for the recent 2 days. The symptom of abdominal pain was relieved after the penetration moxibustion was applied on CV4, CV6 and Zǐgōng (子宫 EX-CA1) for 5 times for the case. Penetration moxibustion can relieve abdominal pain during the postpartum period, accelerate lochia discharge, and recovery of menstrual and uterine cavity. Àiyè (艾叶 Artemisiae Argyi Folium) was proved to have antibacterial, hemostatic, and analgesic effects. The warming function and radiation features of moxibustion can help to alleviate spasm of the smooth muscle in the uterus and enhance the metabolism of the uterine tissue by expanding microvessels and improving the circulations of both blood and lymph. It can also activate cells in the uterine tissue by increased temperature in order to enhance the decomposition and elimination of pathological wastes, such as inflammation and hematoma. In addition, it can also relieve pelvic pain by inhibiting neuronal excitability.     

Study of electroacupuncture with different frequencies for the treatment of headache and anxiety-depression symptoms in patients with migraine: A randomized clinical trial: 不同频率电针改善偏头痛患者头痛及焦虑抑郁症状的差异性研究-随机临床试验

ObjectiveTo observe the effects of electroacupuncture (EA) with varied frequencies on headache and anxiety-depression symptoms in patients with migraine and to screen optimal frequency of EA for patients with such conditions.DesignSingle-center, randomized, controlled clinical trial was designed, and the outcome assessors and statisticians were blinded. The patients with migraine were randomized into 2 Hz EA group, 100 Hz EA group and sham-stimulation group. In each group, the changes in migraine attacks, days with headache, the scores of visual analogy scale (VAS), self-rating anxiety scale (SAS), self-rating depression scale (SDS) and migraine-specific quality-of-life questionnaire (MSQ), as well as the dosage of analgesics were observed at the baseline, during treatment, in 1, 2 and 3 months of follow-up separately.SettingPatients were enrolled in the Third Affiliated Hospital of Zhejiang Chinese Medical University, between 1^st August 2018 and 31^st July 2021.ParticipantsSixty-five migraine patients with or without aura.InterventionsIn the EA groups, the acupoints were bilateral Fengchi (GB20), Gongxue (Extra), Sizhukong (TE23), Taiyang (EX-HN5), Shuaigu (GB8), Waiguan (TE5) and Yanglingquan (GB34). Electric stimulation was exerted at GB20 and Gongxue (Extra), with 2 Hz and 100 Hz separately. In the sham-stimulation group, the shallow acupuncture was operated at the sites 1 cm lateral to GB20 and Gongxue (Extra), and on the radial side of TE5 and GB34. The output wires were cut off after attached to the acupoints. The patients in each group received the treatment 3 times weekly, once every two days, for consecutive 4 weeks. The complete intervention was composed of 12 treatments.Main outcome measuresChanges in numbers of migraine attacks at treatment phase (week 1 to week 4) from the baseline(week -4 to week 0) in patients of each groupResults(1) Changes in migraine attacks and days with headache: In the 2 Hz EA and 100 Hz EA groups, the changes for migraine attacks and days of headache were higher significantly when compared with that in the sham-stimulation group at the same time stage (P < 0.05). There was no statistical difference between two EA groups. (2) Changes of VAS score: In the 2 Hz EA and 100 Hz EA groups, the changes of VAS score were significantly higher when compared with that in the sham-stimulation group at the same time stage (P < 0.05). There was no statistical difference between two EA groups. (3) Assessment of anxiety and depression: The differences in the changes of SAS and SDS scores had no statistical significance in patients of each group at each assessment stage (P > 0.05). (4) Assessment on the quality of life: Compared with the sham-stimulation group at the same time stage, the improvement in MSQ score was increased significantly during treatment in patients of the 2 Hz EA and 100 Hz groups (P < 0.05). There was no statistical difference between two EA groups. (5) Assessment on safety and compliance: The patients of each group had sound compliance. There was no adverse events during trial, suggesting promising safety of treatment.ConclusionEA may effectively reduce the migraine attacks, and the days and intensity of headache, presenting promising safety. However, there was no significant improvement on anxiety-depression symptoms, and no significant difference between high and low frequencies of EA treatment in relieving headache and anxiety/depression symptoms in the patients with migraine.Trial registrationChiCTR1800017259     

基于复杂网络的《新针灸学》与《经络腧穴学》比较分析研究（英文）

提取《新针灸学》《经络腧穴学》中穴位名称、主治病症信息,基于复杂网络建立穴-症网络,分析两者穴位数量、相互关联程度及主治规律变化,借助拓扑学数据解释变化原因,为传统针灸知识体系的结构化、标准化研究提供具体思路和方法。共纳入《新针灸学》386穴、773种症状、形成152163个穴位配伍对,《经络腧穴学》403穴、253种症状、28755个穴位配伍对。两本教材的穴-症网络存在丰富的差异性,其所载的病症结构化程度随医学知识的更新而提升。《新针灸学》模型具有更加典型的小世界效应,或因其以病症为主要分类手段的优势体现。两本教材穴位定位与主治方面发生许多变化,学科发展、时代背景等方面是变化的主要原因。     

当归四逆汤化学成分、药理作用和临床应用的研究进展及质量标志物（Q-Marker）的预测分析

当归四逆汤（Danggui Sini Decoction,DSD）是治疗血虚寒厥证的代表方剂,具有温经散寒、养血通脉等功效,临床多用于治疗冠心病、心绞痛、雷诺氏征、糖尿病周围神经病变、痛经、膝骨关节炎等疾病。在对DSD化学成分、药理作用和临床应用研究进展进行综述的基础上,依据中药质量标志物（quality marker,Q-Marker）“五原则”对其Q-Marker进行预测分析。结果提示阿魏酸、藁本内酯、肉桂酸、桂皮醛、芍药苷、芍药内酯苷、甘草苷、甘草酸和细辛脂素可作为DSD的Q-Marker,为DSD及其相关制剂的质量控制等后续研究提供参考。     

黄芪甲苷抗肿瘤作用机制研究进展

黄芪甲苷是从黄芪Astragali Radix中提取得到的皂苷类化合物,是黄芪的主要有效成分之一,具有抗炎、抗氧化、免疫调节、调节代谢及抗肿瘤等药理作用,近年来在抗肿瘤领域备受关注。研究发现黄芪甲苷能抑制肿瘤细胞增殖,进一步抑制肺癌、结直肠癌、肝癌、宫颈癌、卵巢癌等癌症进展。其抗肿瘤作用机制主要有抑制肿瘤细胞增殖、促进肿瘤细胞凋亡、阻滞细胞周期进程、抑制肿瘤细胞侵袭等,此外还发现黄芪甲苷能在一定程度上增强抗肿瘤药物敏感性和提高机体免疫力。黄芪甲苷可通过多种途径发挥抗肿瘤作用,在抗肿瘤治疗领域有广阔的应用前景。对其抗肿瘤作用及机制进行综述,以期为临床的肿瘤治疗提供新的理论支持与借鉴。     

山橙中生物碱类化学成分的研究

目的 研究山橙Melodinus suaveolens茎乙醇提取物氯仿部位中的生物碱类成分。方法 采用酸溶碱沉法富集,运用正相硅胶柱色谱、半制备高效液相色谱等多种色谱方法进行分离和纯化,并利用一维和二维核磁共振波谱、高分辨质谱以及圆二色谱等技术鉴定化合物的结构。结果 从山橙乙醇提取物氯仿部位分离得到12个生物碱类成分,分别鉴定为美乐苏胺A（1）、柳叶水甘草碱（2）、3-羰基柳叶水甘草碱（3）、白坚木胺（4）、Δ14-长春布宁（5）、Δ14-vincamenine（6）、3-羰基-11-甲氧基柳叶水甘草碱（7）、alstoyunine G（8）、pachysiphine（9）、洛柯宁碱（10）、土波台文碱（11）、venalstonine（12）。初步的抗肿瘤活性评价实验表明,化合物2、8～10显示出不同程度的肿瘤细胞增殖抑制活性。结论 化合物1为1个新的单萜吲哚类生物碱,化合物4、11和12首次从该植物中分离得到;化合物10对人肺癌A549、人肝癌Hep G2和人前列腺癌PC-3肿瘤细胞具有显著的增殖抑制活性,半数抑制浓度（median inhibition concentration...     

肉豆蔻化学成分和药理作用研究进展及其质量标志物（Q-Marker）预测分析

肉豆蔻Myristicae Semen是常用药食同源中药,具有温中行气、涩肠止泻的功效,主要包括木脂素类、挥发油类和多酚类等化学成分,具有调节消化系统、抗癌、抗炎镇痛、抗菌、抗氧化等药理作用。通过对肉豆蔻化学成分、药理作用、毒性和临床应用进行综述,根据中药质量标志物（quality marker,Q-Marker）理念,从植物亲缘、采收时期和炮制方法、药效、药性、配伍、化学成分可测性等方面对肉豆蔻的Q-Marker进行预测分析,初步预测去氢二异丁香酚、肉豆蔻醚、安五脂素、甲氧基丁香酚、榄香素、丁香酚和α-蒎烯等为其可能的Q-Marker,为肉豆蔻质量评价和药品研发提供参考。     

基于指纹图谱和多指标含量测定的蜜远志质量评价

目的 建立指纹图谱和多指标定量的蜜远志质量评价方法。方法 Kromasil 100-5-C₁₈色谱柱（250 mm×4.6 mm,5 μm）为固定相,以乙腈（A）-0.2%磷酸水溶液（B）为流动相进行梯度洗脱,体积流量为1.0 mL/min,检测波长318 nm。对16批蜜远志建立指纹图谱,确定共有峰并进行相似度分析结合化学计量学分析。采用Waters Xbridge Shiled RP C₁₈色谱柱（250 mm×4.6 mm,5 μm）进行同时测定远志（口山）酮III、3,6''-二芥子酰基蔗糖、细叶远志皂苷、远志酸、远志皂苷元的含量。结果 在指纹图谱研究中,标定了27个共有峰,结合对照品和HPLC-Q-TOF-MS共指认8个成分,分别为西伯利亚远志糖A5、西伯利亚远志糖A6、远志（口山）酮IX、远志（口山）酮III、3,6''-二芥子酰基蔗糖、细叶远志皂苷、远志酸、远志皂苷元。聚类分析将16批样品分为3类;经主成分分析,主成分1～3是影响蜜远志质量评价的主要因子。多指标含量测定中远志（口山）酮III、3,6''-二芥子酰基蔗糖、细叶远志皂苷、远志酸、远志皂苷元的质量分数分别为0.027%～0.068%、0.074%～0.798%、1.1%～1.4%、0.15%～0.36%、0.15%～0.37%。经方法学验证,线性关系良好（r≥0.999 6）,平均加样回收率为97.15%～100.9%。结论 所建立的指纹图谱结合多指标含量测定方法准确、高效,特征性强,可为蜜远志饮片的质量评价和临床应用提供有效参考。