人参皂苷在肾脏的作用及机制研究

人参皂苷(Ginsenoside)是人参、西洋参、三七的主要活性成分之一,具有极强的生理活性,逐渐成为国内外研究的热点。在肾脏具有抗氧化应激、抗纤维化、改善微循环、抑制血小板聚集、Ca2+拮抗、提高免疫等作用。因此,研究人参皂苷单体的活性及作用机制对肾脏病临床应用有重大意义。     

慢性阻塞性肺疾病生存质量评估与中医临床疗效评价的研究

目的:探讨慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)缓解期患者国际生存质量量表[圣乔治呼吸问卷(SGRQ)]与中医症状分级量化表之间的相互关系;评价培土生金法对改善COPD缓解期患者生存质量的临床疗效及安全性。方法:(1)根据2007年修订的《慢性阻塞性肺疾病全球倡议(GOLD)》及中华医学会呼吸病学分会于2003年修订的《慢性阻塞性肺疾病诊治指南》[1]的诊断及分级标准入组确定患者;通过观察2008年10月-2011年6月期间杭州市中医院老年病科门诊及住院COPD稳定期患者,选择60～85岁COPD稳定期肺脾气虚证90例,分别记录患者病程、SGRQ评测生存质量、检测肺功能,统计分析肺脾气虚型稳定期COPD患者疾病程度与上述指标之间的相关性;(2)以随机编码法将上述入组病例随机分为两组,两组患者均采用西医标准疗法(茶碱缓释片,1片,每日2次),治疗组联合应用以培土生金法拟方的中药汤剂(由人参、生黄芪、炒白术、茯苓、当归、沙参等药组成),疗程6个月;从中医临床证候、肺功能(FEV1%)、营养状态、急性发作加重次数等指标评定疗效。结果:(1)COPD稳定期肺脾气虚型患者的中医症状得分与SGRQ评测生存质量量表之间呈正相关。(2)治疗前,两组病人中医症状评分均无统计学意义(P0.05)。治疗后,两组综合疗效分析,有统计学意义(P0.05)。而两组治疗前后喘息、哮鸣音症状于治疗前后均有统计学意义(P0.05)。(3)治疗前两组患者的肺功能指标无统计学意义(P0.05),治疗后有统计学意义(P0.05),且治疗组对FEV1/FVC的提高明显于对照组,有统计学意义(P0.05)。(4)治疗后,两组相比较,治疗组在预防感冒及预防COPD急性加重方面具有明显疗效(P0.05),而对照组则治疗前后差异不显著。(5)营养状况比较,治疗前两组具有可比性,治疗后中药治疗组明显优于对照组(P0.05)。结论:(1)COPD稳定期患者中医症状得分与SGRQ评价呈现正相关。(2)培土生金法治疗COPD稳定期患者,可以明显改善患者的临床症状及体征;有效提高患者肺功能;减少患者急性加重次数及外感次数。     

火针点刺承泣穴治疗周围性面瘫后遗溢泪症的临床观察

ObjectiveTo compare the clinical therapeutic effect on epiphora as sequela of peripheral facial paralysis treated with pricking technqiue of fire needling therapy at Chéngqì (承泣 ST1) and acupuncture treatment at conventional acupoints.MethodsFrom September 2018 through to October 2018, 64 cases of epiphora as sequela of peripheral facial paralysis were collected from the Department of Acupuncture-Moxibustion in Suzhou TCM Hospital. According to random number table, they were divided into an observation group and a control group, 32 cases in each one. In the observation group, pricking technique of fire needling therapy was used at ST1, once every two days. In the control group, acupuncture with filiform needle was applied to Jīngmíng (睛明BL1), Tàiyáng (太阳EX-HN5), Tóngzĭliáo (瞳子髎GB1), Sìbái (四白ST2) and Quánliáo (颧髎SI18) on the affected side as well as Hégŭ (合谷LI4) on the contralateral side, once per day. The 10-day treatment was as one 1 course and the consecutive 3 courses of treatment were required in either of the groups. Before and after treatment, Munk grade, clinical effective rate and the number of treatments were observed in the evaluation of therapeutic effect.ResultsAfter treatment, Munk grade was improved in the patients of the two groups (both P < 0.05). The improvement range in the observation group was larger than that of the control group (P < 0.05). The treatment in either group achieved the obviously therapeutic effect on epiphora as sequela of peripheral facial paralysis. The effective rate in the observation group was 90.32%, higher than 61.29% in the control group (P < 0.05). The mean number of treatments of the curative case were 5.11 in the observation group and were 13.73 in the control group, indicating the statistical significance in difference (P < 0.05).ConclusionPricking technique of fire needling therapy at ST1 achieves the better effect on epiphora as sequela of peripheral facial paralysis as compared with acupuncture at conventional acupoints.     

Xanthatin,a novel potent inhibitor of VEGFR2 signaling,inhibits angiogenesis and tumor growth in breast cancer cells

Anti-angiogenesis targeting vascular endothelial growth factor receptor 2 (VEGFR2) has emerged as an important tool for cancer treatment. In this study, we described a novel VEGFR2 inhibitor, xanthatin, which inhibits tumor angiogenesis and growth. The biochemical profiles of xanthatin were investigated using kinase assay, migration assay, tube formation, Matrigel plug assay, western blot, immunofluorescence and human tumor xenograft model. Xanthatin significantly inhibited growth, migration and tube formation of human umbilical vascular endothelial cell as well as inhibited vascular endothelial growth factor (VEGF)-stimulated angiogenesis. In addition, it inhibited VEGF-induced phosphorylation of VEGFR2 and its downstream signaling regulator. Moreover, xanthatin directly inhibit proliferation of breast cancer cells MDA-MB-231. Oral administration of xanthatin could markedly inhibit human tumor xenograft growth and decreased microvessel densities (MVD) in tumor sections. Taken together, these preclinical evaluations suggest that xanthatin inhibits angiogenesis and may be a promising anticancer drug candidate.     

中医药防治滑胎研究

中医药防治滑胎历史悠久,疗效显著。从未病先防和既病防变两个方面综述了近十年来防治滑胎的中医药研究。     

触发点针刺治疗神经根型颈椎病的临床疗效观察

目的:探讨触发点针刺疗法治疗神经根型颈椎病的临床疗效。方法:分别观察触发点针刺组和常规针刺组各40例,治疗组用针刺颈椎病五大触发点,对照组用常规穴位针刺。经2周治疗后,观察臂丛神经牵拉试验和椎间孔挤压试验的阳性率、疼痛评分(VAS)、疗效3个指标评定临床疗效。结果:触发点针刺组治疗后的臂丛牵拉试验和椎间孔挤压试验阳性率较对照组低(P<0.05),疼痛评分较对照组减低(P<0.05),虽然疗效评价与对照组比无明显差异(P>0.05),但治愈率较对照组明显升高。结论:触发点针刺组的效果要好于常规针刺组,可以肯定触发点的针刺治疗的效果。触发点与相应腧穴定位相近,触发点似乎与相应腧穴相合,或者认为是对相应腧穴进一步精确的定位。     

太阳病表证虚实状态病机新解

表证虚实的决定因素在正邪力量的对比。人感邪后有四种可能状态:邪重气实,邪重气虚,邪轻气实,邪轻气虚。太阳中风表虚证属太阳伤风寒,邪轻气虚表虚状态;太阳伤寒表实证属太阳伤风寒,邪重气实表实状态。本文从状态分析,结合传统的营卫学说,以脾胃为中心,通过阐述不同状态下营卫在三焦表里的生理病理变化,对太阳病表实表虚证的病机作了新的解释。     

不同中医证型肝硬化患者T细胞亚群NK细胞及补体系统检测的意义

目的：探讨不同中医证型肝硬化与血T细胞亚群、NK细胞、补体系统的关系。方法：对92例肝硬化患者进行中医分型，分为气滞湿阻型、肝脾血瘀型、脾肾阳虚型，并进行了外周血T细胞亚群、NK细胞以及补体C3、C4、B因子的测定；并设立正常对照组。结果：不同中医证型肝硬化的血CD3^＋、CD4^＋、CD4^＋／CD8^＋、NK细胞均有不同程度的降低，CD3^＋无明显变化；补体C3、C4、B因子均有不同程度的降低。结论：肝硬化的血T细胞亚群、NK细胞、补体系统存在着不同程度的变化，并与中医证型相关。     

补肾壮筋汤对兔早期实验性膝骨关节炎软骨细胞凋亡及增殖细胞核抗原表达的影响

目的:探讨以补肝益肾为治疗手段的补肾壮筋汤对兔早期膝关节实验性OA的软骨细胞凋亡和增殖细胞核抗原(PCNA)表达的影响。方法:40只青紫蓝兔随机分为4组,每组10只,分别为中药组、假模组、模型组、正常组,参照Hulth法造成早期骨关节炎模型。术后第4周开始,中药组、假模组口服补肾壮筋汤,模型组、正常组口服生理盐水。7周末取兔膝关节软骨,肉眼、光镜、透射电镜观察形态学变化,用原位末端标记法(TUNEL法),免疫组化法分别观察软骨细胞凋亡和PCNA的表达。结果:中药组的软骨细胞凋亡指数小于模型组(P<0.05);而中药组的PCNA表达要高于其他各组(P<0.05)。结论:补肾壮筋汤减少兔早期膝关节实验性OA软骨细胞的凋亡,促进软骨细胞的增殖,对早期OA有治疗作用。     

杨少山运用膏方调治老年病经验浅谈

杨少山教授临证擅长运用膏方调治老年疾病,主张补肾益精,重在养阴抑阳;补益脾胃,主张"清养";兼顾祛邪,重在化痰、祛瘀;调治精气神三宝,不可偏废。