竹叶石膏汤合清气化痰丸加减治疗急性加重期慢性阻塞性肺疾病分析

目的:分析竹叶石膏汤合清气化痰丸加减治疗急性加重期慢性阻塞性肺疾病(Acute Exacerbations of Chronic Obstructive Pulmonary Disease,AECOPD)疗效。方法:以2017年1月-2019年1月收治的AECOPD患者80例,随机分为两组,各40例。对照组采用常规西药治疗,观察组在对照组基础上采用竹叶石膏汤合清气化痰丸加减治疗。比较两组治疗前后肺功能指标[第1秒用力呼气容积占预计值百分比(Forced Expiratory Volume,FEV1%)、第一秒用力呼气肺容积(Forced Expiratory Volume,FEV1)]、改良版英国医学研究委员会呼吸问卷(mMRC)、慢阻肺患者自我评估测试问卷(CAT)等评分变化以及疗效。结果:在FEV1%、FEV1等肺功能指标上,两组治疗前对比无统计学差异(P>0.05);而观察组治疗后均高于对照组,二者差异存在统计学意义(P<0.05)。在mMRC、CAT等评分上,两组治疗前差异对比无统计学意义(P>0.05);而观察组治疗后均低于对照组,二者差异存在统计学意义(P<0.05)。在治疗有效率上,对照组总体为82.5%(33/40),观察组总体为95.0%(38/40),二者差异对比存在统计学意义(P<0.05)。结论:竹叶石膏汤合清气化痰丸加减治疗AECOPD的疗效确切,即可有效改善患者肺功能和临床症状,且利于其预后康复,因此值得应用推广。     

《伤寒杂病论》黄连黄芩药对应用规律探究

黄连配黄芩是苦寒燥湿药物相须配伍的经典药对,《伤寒杂病论》中含有黄连黄芩药对的方剂共9首,涉及条文12条,共12个症状,依次是:心下痞(5次)、下利(4次)、呕吐(3次)、肠鸣(3次)、心烦(2次)、出汗(2次)、干噫食臭(1次)、失眠(1次)、出血(1次)、恶寒(1次)、喘(1次)、狐■(1次)。症状不同,配伍的药物选择也各不相同。量效关系方面,黄连在清心火、安心神时用量最重,达到四两,辅以黄芩二两,二者比例为2∶1;治疗病机以湿热为主的呕吐、下利时,黄连、黄芩的剂量均为三两,二者比例为1∶1;治疗寒热错杂痞证时,黄连仅用一两,黄芩仍为三两,二者比例为1∶3;治疗无形邪热阻滞中焦之热气痞或出血证,黄连、黄芩用量仅为一两,二者比例为1∶1。黄连、黄芩各自的剂量大小与两药在全书中的用药规律具有相关性。     

基于药物代谢组学的中药及方剂中组分间协同增效作用

针对中药及方剂中多组分间配伍协同作用的特点,提出了利用药物代谢组学解析多组分间协同增效作用的机制的假说,并介绍了作者近期利用药物代谢组学研究方剂及组成药物相互关系的成果。     

Effect of Yikun Neiyi Wan on the Expression of Aromatase P450, COX-2, and ER Related Receptor in Endometrial Cells in Vitro from Patients with Endometriosis

To investigate the effect of Yikun Neiyi Wan （益坤内异丸YKNYW） and gestrinone on the expression of aromatase P450 （P450arom）, cyclo-oxygenase-2 （COX-2） and estrogen receptor （ER） in isolated ectopic and normal endometriat stroma cells in vitro. Methods： Digestion and serial filtration were used to isolate and culture the ectopic and eutopic endometrial cells from patients with chocolate cyst in virto Transformation of the cell morphology was observed in a inverted microscope. The effect of YKNYW on the expression of aromatase P450, cyclo-oxygenase-2, estrogen receptor in cultured endometriosis cells were detected by immunohistochemical method. Results： The expression levels of P450arom, COX-2 in glandular epithelium cells in vitro were decreased significantly by YKNYW compared with gestrinone （P〈0.05）. ER expression in mesenchymal cells of endometriosis was increased by YKNYW in the large and medium dosage groups compared with gestrinone. Conclusion： The mechanism by which YKNYW alleviates endometriosis pain is possibly related to the decrease in ectopic endometrial P450 arom and COX-2 expression in glandular epithelium, contrary to gestrinone, and the increase in ER expression in mesenchymalis, consistent with gestrione in patients with endometriosis.     

岩黄连生物碱在大鼠胃肠道的吸收动力学研究

目的:以脱氢卡维丁为指标成分研究岩黄连总生物碱在大鼠胃、肠的吸收动力学特征.方法:采用大鼠在体胃、肠吸收模型,以高效液相色谱法测定胃、肠灌注液中药物的含量.结果:药物在胃和小肠中的每小时吸收百分率分别为8.88%,2.08%;药物在大鼠十二指肠、空肠的吸收速率常数略高于回肠和结肠部位,但无显著性差异;药物中、高浓度的吸收速率常数基本一致,低浓度的吸收速率常数明显降低;随灌流液pH升高,药物吸收速率常数增大,但也无显著性差异.结论:药物在胃、全肠道均有吸收,但吸收均较差,胃中高于小肠中;不同肠段和灌流液不同pH对吸收无显著性影响;中、高浓度范围内表现为被动扩散吸收机制.     

六味地黄丸含药血清对椎间盘I型和Ⅱ型胶原表达的影响

背景：胶原纤维是维持椎间盘正常结构与功能的重要物质,椎间盘中胶原的类型及含量的变化,影响整个椎间盘的生理和病理状态,I型及Ⅱ型胶原是椎间盘胶原的主要组分。目的：观察六味地黄丸含药血清对肿瘤坏死因子a致伤兔椎间盘I型、Ⅱ型胶原蛋白和基因表达的影响。方法：将15只新西兰白兔带终板的45个L2-L5椎间盘随机分为空白第1天组、空白第14天组、肿瘤坏死因子a组、中药血清组、肿瘤坏死因子a＋中药血清组。后两种培养液中分别含5ug/L肿瘤坏死因子a和体积分数10％六味地黄丸血清,培养14d后收集髓核和纤维环观察。结果与结论：RT—PCR和WesternBlot检测结果表明,随着培养时间的延长,纤维环中I型胶原及髓核中Ⅱ型胶原蛋白和基因表达明显降低;加入肿瘤坏死因子a可加速这种变化,而含药血清可延缓I,Ⅱ型胶原蛋白和基因表达变化。提示六味地黄丸可通过稳定I,Ⅱ型胶原蛋白和基因表达,对椎间盘细胞外基质具有保护作用。     

Muscle spasm associated with therapeutic use of Cang Er Zi Wan

Introduction.?Cang Er Zi Wan (CEZW) is a herbal medication derived from Xanthium sibiricum that is used to treat allergies and upper respiratory problems. Its toxicity has been described in grazing animals, in experimental studies, and in human overdoses. We describe a case of muscular spasm that was associated with the therapeutic use of CEZW.?Case report.?A 17-year-old female was prescribed CEZW for chronic allergies. Shortly after her second dose of 10 pills BID, she developed intermittent muscular spasms. She was seen in an Emergency Department and had normal vital signs and no significant laboratory abnormalities. Her physical exam was significant only for intermittent spasm of the muscles of the face, neck, and upper extremities. No tremor, fasciculation, dystonia, akisthisia, chorea, bradykinesia, or clonus was noted. She discontinued the CEZW and the symptoms slowly decreased over 4 days. Testing of the product did not detect any other medications or drugs.?Discussion.?CEZW is a herbal medication that contains X. sibiricum. X. sibiricum is a widespread weed that has caused muscular spasm, seizures, and death in animals that graze on it as well as animals experimentally exposed to it. Eleven cases of accidental human ingestion of Xanthium leading to spasm, somnolence, hypoglycemia, renal, and liver toxicity have been described. We describe a unique case of isolated muscular spasms because of the therapeutic use of a CEZW product.     

中药复方天箭丸抗肿瘤作用实验研究

目的:研究复方天箭丸抗肿瘤作用及对荷瘤小鼠免疫功能的影响。方法:通过抑瘤率及小鼠生命延长率的检测观察天箭丸灌胃给药对S180、Lewis、小鼠艾氏腹水癌(EAC)、小鼠肝癌腹水型(HepA)等移植性肿瘤的生长抑制作用;通过检测小鼠血清半数溶血值、巨噬细胞吞噬功能、血清IgG水平及免疫器官重量考察天箭丸对荷瘤小鼠的体液免疫及细胞免疫功能的影响。结果:与空白对照组相比,天箭丸(5,2.5g/kg)皆可显著抑制小鼠S180、Lewis、EAC、HepA移植性肿瘤的生长,并呈剂量依赖性。天箭丸可显著提高荷瘤小鼠巨噬细胞吞噬功能,表明其可提高荷瘤小鼠的细胞免疫功能;天箭丸还可显著提高由荷瘤引起的小鼠血清半数溶血值及血清IgG水平的降低,表明其亦可明显提高荷瘤小鼠的体液免疫功能。结论:天箭丸提高荷瘤小鼠的免疫功能是其抗肿瘤效应的机制之一。     

交泰丸交通心肾治疗失眠作用机理研究

目的:观察交泰丸及不同拆方对HPA轴调节因子及相关中枢神经递质的影响。方法:将交泰丸分为泻心组(单用黄连)、补肾组(单用肉桂)及交通心肾组(交泰丸),观察各实验组对PCPA大鼠模型失眠状态、HPA轴调节因子CRH、ATCH、CORT及下丘脑相关神经递质5-HT、NE的影响,采用高效液相-库伦阵列电化学检测及放免法检测。结果:PCPA失眠模型大鼠HPA轴呈亢奋状态,下丘脑5-HT含量显著降低,NE的含量有所升高。交泰丸可以通过抑制HPA轴,明显增加失眠大鼠下丘脑5-HT的含量,降低NE的含量。结论:交泰丸是通过调节HPA轴达到交通心肾治疗失眠的目的。     

骨宝丸对维甲酸诱导小鼠骨质疏松的防治作用及机制探讨

目的研究骨宝丸对维甲酸诱导小鼠骨质疏松的防治作用,并探讨相关作用机制。方法将雌性BALB/c小鼠分为正常组(Control)、模型组(Model)以及骨宝丸高剂量组(GBW-H)、中剂量组(GBW-M)和低剂量组(GBW-L)。实验第1～30天,模型组和骨宝丸各剂量组小鼠灌服维甲酸(100 mg/kg)建立骨质疏松模型,同时骨宝丸各剂量组小鼠灌服药物溶液进行防治。实验结束后,取小鼠股骨,称取质量、测量股骨直径和股骨长度;利用HE染色法在光学显微镜下观察股骨组织变化;利用Micro-CT检测骨密度;采用ELISA试剂盒检测血清中BMP-2、OC、BALP、P1NP分泌水平。结果骨宝丸对维甲酸导致的小鼠股骨的质量、直径、骨密度和骨髓组织减少有防治作用,而且骨宝丸对维甲酸诱导小鼠血清OC和P1NP分泌增加、BALP和BMP-2分泌减少均有拮抗作用。结论骨宝丸可防治维甲酸诱导的小鼠骨质疏松,其作用机制可能与保护BMP-2分泌进而促进骨形成有关。