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目的探讨复方苔藓散结合醋酸地塞米松贴膜治疗口腔糜烂型扁平苔藓的临床疗效。方法将2003—2006年大连大学附属中山医院口腔科92例糜烂型扁平苔藓患者随机分为中药组31例,西药组30例及中西医结合治疗组31例。前两组分别采用复方苔藓散(中药)或地塞米松贴膜(西药)进行治疗,中西医结合组则采用二者结合进行治疗。于治疗结束时及治疗后1年内追踪疗效。结果停药后临床疗效的总有效率比较显示,与中药组(51.61%)相比,西药组(86.67%)及中西医结合组(80.65%)的差异均有统计学意义(P均<0.01);治疗后1年内追踪观察西药组有效病例总复发率(61.53%)明显高于其余两组(P<0.05)。结论中西医结合治疗口腔糜烂型扁平苔藓短期及长期观察均可取得良好疗效。     

中草药治疗哮喘的免疫调节作用最新研究进展

哮喘是由多种免疫细胞参与的慢性呼吸道炎症疾病,常常导致气促、胸闷、咳嗽以及反复发作的喘息等症状,往往出现气流阻塞,影响人体健康。中草药(CHM)用于治疗哮喘已经有上千年的历史,大量研究表明中草药能有效的调节细胞免疫反应减缓哮喘症状。该文综述了近几年来中草药对免疫细胞的调节作用及相关分子机制的研究,包括炎症细胞数量、树突状细胞成熟、辅助性T细胞亚型之间的平衡、调节性T细胞的诱导及胞内信号通路,并展望了未来的研究方向。     

中药材产业扶贫重点优先区域划分和推荐种植中药材名录整理

推进中药材产业扶贫,是贯彻落实中央重大战略部署的重要举措。我国的贫困县绝大部分都是分布在14个集中连片贫困地区,这些地区由于生产生活条件恶劣,农林牧业的生产效益非常低下,仅靠生态补偿或传统农业难以脱贫致富,中药材产业是我国农村贫困人口脱贫增收的重要途径。为推进国家中医药管理局和国务院扶贫办等5部门联合印发《中药材产业扶贫行动计划(2017—2020年)》的实施,因地制宜的指导和规划中药材生产实践,促进中药材产业扶贫相关工作向最佳生产区域集中,该文基于贫困地区的相关数据资料,对具有优先开展中药材产业扶贫条件的区域进行划分,并在宏观层面对贫困地区可种植的中药材名录进行分析整理。结果显示:国家级贫困县和集中连片贫困地区涉及的县中至少有10%以上的贫困县,已经有很好的中药材产业基础,是中药材产业扶贫的重点优先区域;有53%的贫困县,具有一定的发展中药材产业扶贫条件,需要加强相关工作拓展中药材产业扶贫的基础和能力;有37%的贫困县发展中药材产业扶贫的基础条件较弱。建议:先期重点优先考虑,已经有很好中药材产业基础的县,通过近百个重点优先发展的县,带动其他有条件的贫困县,实施好《中药材产业扶贫行动计划》。     

中药热熨联合耳穴压豆及辨证施护对颈性眩晕治疗效果的影响

目的:观察中药热熨联合耳穴压豆及辨证施护对颈性眩晕治疗效果的影响。方法:将60例患者随机分为观察组、对照组各30例。2组均给予相同的治疗方法,对照组给予常规护理,观察组采用中药热熨联合耳穴压豆及辨证施护进行干预,观察2组临床疗效。结果:总有效率观察组为90%,对照组为76.7%,2组比较差异有统计学意义(P0.05)。结论:中药热熨联合耳穴压豆及辨证施护有助于颈性眩晕的治疗。     

基于中医传承辅助系统的毕荣修教授治疗激素性股骨头坏死处方规律探析

目的:分析毕荣修教授门诊及病房治疗激素性股骨头缺血性坏死(SANFH)方剂的处方规律。方法:收集并严格筛选毕荣修教授治疗SANFH的方剂,使用中医传承辅助系统(v2.5)软件进行逐一录入并进行数据处理,对筛选出的治疗SANFH的方剂,进行处方规律分析。结果:筛选出符合要求的61首治疗SANFH的处方,确定了处方中药物出现的常用药物和4味核心药物以及6首新处方等。结论:治疗SANFH应以补养肝肾、活血化瘀为主要治法,并根据不同兼证,酌情配伍具有行气止痛、益气养阴、接骨续筋等功效的药物,以达到标本同治的目的。中医传承辅助系统对于分析名中医处方用药规律具有科学性、实用性,能够客观全面地总结分析名中医的临证经验,对于中医药的传承与发展具有重大意义。     

HPLC-MS/MS同时测定尿酸调节类中药及含中草药食品中22种非法添加药物

目的 采用高效液相色谱-串联质谱法同时测定尿酸调节类中药及含中草药食品中22种非法添加药物。方法 样品经含0.1%氨水的甲醇超声提取后,采用Agilent Poroshell 120 Bonus-RP(2.1 mm×100 mm,2.7μm)色谱柱进行分离,以甲醇-乙腈(1∶1)和0.005 mol·L^-1甲酸铵溶液为流动相梯度洗脱。采用电喷雾离子源正、负离子模式,以多反应监测扫描方式检测。结果 22种药物在10.0～200μg·L^-1内线性关系良好,相关系数r²均>0.99,检测限和定量限分别为0.125～0.750 mg·kg^-1和0.416～2.81 mg·kg^-1,平均回收率为80.2%～120.1%,RSD为1.1%～5.9%。收集的37批样品中均未检出非法添加的药物。结论 该方法操作简单、快速、灵敏度高,可实现同时检测尿酸调节类中药及含中草药食品中22种非法添加药物。     

Purity control of some Chinese crude herbal drugs marketed in Italy

The widespread use of herbal drugs, among which those coming from eastern Countries, has created a more compelling need for quality, a pre-requisite that can influence safety. In the present study, 10 Chinese crude herbal drugs marketed in Italy (Radix Ginseng, Radix Astragali, Rhizoma Coptidis, Rhizoma Atractylodis Macrocephalae, Radix Bupleuri, Radix Rehmanniae, Radix Paeoniae Alba, Pericarpium Citri Reticulatae, Radix Polygalae, Radix Salviae Miltiorrhizae) were analysed by the following purity assays: foreign matter, total ash, microbial and heavy metal contamination. Each herbal drug was purchased in Italy from three different sources: two Chinese firms and one Chinese herbal shop. Except for the heavy metal content, the tests were performed according to the European Pharmacopoeia. The presence of parasites was shown in two samples; moreover, level of ash (in three samples), lead content (in one sample) and total viable aerobic count (in one sample), were higher than the limits set by the European or Italian Pharmacopoeias. Our results, even if obtained from a small number of herbal drugs, show some purity issues and underline the importance of the quality control, particularly for this kind of products whose therapeutic value is not always demonstrated.     

Comparative evaluation of chemical profiles of three representative 'snow lotus' herbs by UPLC‐DAD‐QTOF‐MS combined with principal component and hierarchical cluster analyses

Herbal healthcare products are used worldwide as relatively safe and effective alternatives to allopathic drugs. Saussurea laniceps Hand.‐Mazz. (SL), S . medusa Maxim. (SM) and S . involucrata (Kar. et Kir.) Sch.Bip. (SI) are three sources of the renowned 'snow lotus', Chinese materia medica for treating inflammatory diseases. The three species have different therapeutic effects, among which SL has been proved to be the most potent, but they are frequently confused on the market and in the academic community. An ultra‐high performance liquid chromatography‐diode array detector‐quadrupole time of flight‐mass spectrometry (UPLC‐DAD‐QTOF‐MS) method was developed and used to analyze 49 herbal samples for species analysis and overall quality evaluation. With 25 simultaneously identified constituents, of which 12 were quantified, the three herbs showed different chemical profiles. Four‐dimensional principle component analysis (4D‐PCA) and orthogonal hierarchical cluster analysis (2D‐HCA) results illustrated that SL should be grouped away from SM and SI, contradicting the botanical record in Flora of China . The present chemical determination and pattern recognition results directly explain the therapeutic potency of SL and distinguish the three confused snow lotus herbs. Furthermore, the findings suggest a possible extensive quality evaluation model for multi‐origin medicinal plants and help monitor falsification of snow lotus herbal products on the market, contributing to a more regulated pharmaceutical industry. Copyright © 2016 John Wiley & Sons, Ltd.     

Alpha‐PVP as an active component of herbal highs in Poland between 2013 and 2015

Alpha‐PVP (alpha‐pyrrolidinovalerophenone, α‐PVP) is a synthetic derivative of cathinone. It has been one of the most frequently detected new psychoactive substances (NPS) available on the drug market in recent years in Poland. The usual routes of administration of the drug include oral, insufflation, and injection. Unexpectedly, we dealt with a great number of herbal samples that turned out to contain α‐PVP. A total number of 352 herbal samples from 19 cases in which we detected synthetic cathinones, were investigated in the Institute of Forensic Research (IFR) from 2013 to 2015. The seized products that were received by our laboratory were first screened by gas chromatography coupled to mass spectrometry (GC–MS). Quantification of α‐PVP and other cathinones was performed by ultra‐performance liquid chromatography with photodiode array detection (UPLC‐PDA). Of the samples, 84% contained only α‐PVP. Other groups of products were those containing only α‐PVT, α‐PVP and α‐PVT, α‐PVP and synthetic cannabinoid A‐834, 735, and α‐PVP and cannabis. In one herbal sample, α‐PVP was detected along with caffeine and tadalafil. The herbal products present on the market containing only α‐PVP usually had a mass of 0.3 to 0.6 g, and concentration range in this group of samples was 3.0–44.0% (content: 13.0–222.0 mg per package). The amount of α‐PVP in samples below 0.30 g was in a range 9–18 mg whiles in samples above 0.60 g it was in the range 30–716 mg. There were also products containing a mixture of α‐PVP and α‐PVT. In those samples, α‐PVP concentrations were: 3.0–6.0% (amount: 15.0–34.0 mg). Copyright © 2016 John Wiley & Sons, Ltd.     

中药干预中风临床证据年度分析

目的:通过系统检索中英文医学期刊发表的中医药干预中风的临床随机对照试验,分析年度证据产出情况。方法:CNKI、Sino Med、维普、万方、Cochrane library、Pub Med、Embase、Web of Science等数据库,检索时限为2018年1月1日至2018年12月31日。收集中医药干预中风的临床随机对照试验。对全年发文概况、期刊分布、省份和单位分布、疾病类型、干预措施、结局指标以及干预疗程等内容进行描述性分析。结果:2018年发表的中医药干预中风的RCT共有1 084篇研究中,近90%研究重点是缺血性中风;近70%的研究采用的干预措施是中药方剂,剂型主要是汤剂;共涉及69个口服中成药和18个中药注射剂。干预疗程以2和4周为主,占64. 91%,疗程≤6个月的研究占98. 32%。神经功能、运动功能、生活能力以及生命质量评价为研究关注的结局指标。结论:中医药干预中风研究年度发文较多,但干预措施较为分散,干预疗程显著不足,研究设计存在较多问题。建议整合区域研究力量,围绕重点问题进行协同攻关,提高研究质量,减少研究浪费。