Latest Issue
2022 Year 28 Vol. 3 Issue
- Abstract：目的:探索补肾益气活血方治疗卵巢储备功能低下的临床疗效.方法:将2013年12月至2014年12月被诊断为卵巢储备功能低下的180例患者纳入本临床研究, 分为补佳乐+达芙通 (E+D) 组 (n=60) 、左归丸组 (n=60) 和补肾益气活血方 (BYHD) 组 (n=60) , 每组患者分别予补佳乐联合达芙通、左归丸、补肾益气活血方治疗12个月. 比较并分析三组患者治疗前后的卵泡刺激素 (FSH) 、黄体生成素 (LH) 、雌二醇 (E2) 、抗缪勒氏管激素 (AMH) 、窦卵泡数 (AFC) 、卵巢体积、子宫内膜厚度以及子宫和卵巢动脉血流阻力.结果:9例病例在研究过程中脱落 (E+D组4例, 左归丸组3例, BYHD组2例) . 分别将三组患者治疗6个月和12个月后与治疗前的指标对比, 左归丸组和BYHD组均出现了显著疗效, 表现为FSH、LH降低, 子宫内膜厚度、AMH增加 (P < 0.01) . BYHD组还较治疗前具有显著的E2升高、卵巢体积增大、卵巢动脉血流阻力降低 (P < 0.05) 以及窦卵泡数增加 (P < 0.01) . 治疗12个月后, BYHD组较左归丸组具有更显著的疗效, 表现为FSH降低, 卵巢体积和子宫内膜厚度增加 (P < 0.01) , 但三组患者间的子宫动脉血流阻力没有明显差异; 此外, E+D组在治疗过程中仅显著增厚了患者的子宫内膜厚度 (P < 0.01) .结论:补肾益气活血方对卵巢储备功能低下的患者具有显著的临床疗效, 其机制可能与调节内分泌激素水平、改善排卵以及影响子宫内膜功能有关. 在中医治疗中, 补肾、益气、活血同时应用对治疗卵巢储备功能低下具有良好效果.Keywords：Bushen Yiqi Huoxue Decoction;diminished ovarian reserve;randomized controlled trial;Chinese medicine
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Published：2022-03-18 - Abstract：目的:本研究旨在分析血脂康对绝经早期高胆固醇血症妇女胆固醇合成和吸收的血脂水平标志物的影响, 并初步探讨其降脂机制.方法:本研究将首都医科大学北京安贞医院收治的90例绝经早期高胆固醇血症妇女随机分配接受血脂康 (每日1200毫克 ,口服) 或阿托伐他汀 (每日10毫克, 口服) 治疗. 在干预前和干预后8周, 检测相关生化指标、胆固醇合成标志物 (角鲨烯、二氢胆固醇、脱氢胆固醇和板条甾醇) 和吸收标志物 (营甾醇、豆甾醇和谷甾醇) 的水平.结果:治疗8周后, 血脂康较基线明显降低TC水平 (5.45±0.86 vs 4.93±0.83 , P=0.000) 、甘油三酯 (1.66±1.34 vs 1.31±0.68 , P=0.003) 、LDL胆固醇 (3.34±0.76 vs 2.93±0.70 , P=0.001) , 同时阿托伐他汀也较基线明显降低总胆固醇 (5.69±0.86 vs 4.98±1.14 , P=0.001) 、甘油三酯 (1.91±1.07 vs 1.41±0.60 , P=0.001) 、LDL胆固醇 (3.42±0.79 vs 2.99±0.90 , P = 0.001) . 血脂康较基线明显降低角鲨烯 (0.83±0.41 , vs 0.53±0.27 , P=0.001) 、脱氢胆固醇 (5.60±3.24 vs 3.80±1.63 , P=0.001) 、7-烯胆甾烷醇 (7.44±7.53 vs 4.08±2.66 , P=0.000) 水平, 而阿托伐他汀仅较基线明显降低角鲨烯 (0.91±0.87 vs . 0.59±0.29 , P=0.001) 水平. 所有胆固醇吸收标志物治疗前后差异无统计学意义 (P > 0.05) , 但下降趋势更为明显.结论:血脂康可能通过其“天然合剂”中的麦角甾醇和类黄酮类物质对绝经早期女性高胆固醇血症患者的胆固醇的合成代谢产生更全面的影响.Keywords：early menopausal women;hypercholesterolemia;Xuezhikang;cholesterol metabolism markers;atorvastatin
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Published：2022-03-18 - Abstract：目的:探讨壮医药线点灸(ZMTM)治疗寻常型银屑病的疗效和安全性.方法:本试验设计为多中心随机对照临床试验, 收集2015年6月至2018年5月期间共241例寻常型银屑病患者, 随机分为对照组 (120例) 和治疗组 (121例) . 对照组给予西药匹多莫德分散片、复合维生素B片、复方鱼肝油氧化锌软膏治疗; 治疗组给予西药联合ZMTM治疗; 两组均连续治疗30天, 并于治疗后30天进行随访. 主要疗效指标是患者治疗前后皮损面积和严重程度 (PASI) , 次要疗效指标是瘙痒、皮肤病生活质量指数量表(DLQI)、汉密顿焦虑量表(HAMA)评分及PASI应答率.结果:本次试验有5例脱落病例, 最终纳入236例, 每组各118例. 治疗第30天, 两组患者的PASI评分均低于基线(P<0.01), 治疗组的PASI评分低于对照组(P<0.01); 两组治疗后瘙痒评分、DLQI、HAMA评分均低于基线, 且治疗组低于对照组(P<0.01); PASI 50和75的应答率显著高于对照组[81.4% (96/118) 、43.2% (51/118) 和41.5% (49/118) 、11.0% (13/118) , P<0.05]. 随访期间, 治疗组的PASI、瘙痒评分、DLQI、HAMA评分低于对照组(P<0.01). 治疗组PASI50和75的应答率均高于对照组(P<0.05). 两组患者均无明显的不良反应.结论:ZMTM联合西药治疗寻常型银屑病疗效较好, 无明显不良反应.Keywords：psoriasis vulgaris;Zhuang medicated thread moxibustion;traditional medicine;multicenter randomized controlled trial
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Published：2022-03-18 - Abstract：目的:探讨不同剂型中药治疗类风湿关节炎 (RA) 的用药规律及对免疫炎症指标的影响.方法:通过数据挖掘收集2012年8月至2018年6月安徽省4家医院(3家三甲医院和1家二甲医院)RA患者的临床资料. 将病历资料分为颗粒剂组和饮片组. 提取处方信息后, 根据知识库对各处方药物进行量化和标准化, 建立RA治疗方剂数据库. 首先, 利用Liquorice软件(一种复杂的网络分析工具)从两组病例资料中获得核心处方及其组合模式. 其次, 用SPSS 23.0软件比较两组免疫炎症指标和肝肾功能指标的变化. 然后, 应用SPSS Clementine 11.1软件的Aprior模块, 分析中药与各项指标改善的相关性. 最后用ORACLE 10g工具对两组间免疫炎症指标进行随机行走模型评价.结果:1) 共6829例RA患者符合本研究要求, 其中颗粒剂组3816例, 饮片组3013例; 2) 安徽省4家医院治疗类风湿关节炎的中药颗粒剂和中药饮片的处方模式一致. 核心处方为健脾化湿药、清热解毒药、活血通络药、祛风除湿药. 3) 两种剂型中药均可改善RA患者免疫炎症指标, 疗效相似, 且均对肝肾功能无影响; 4) 豨莶草和白花蛇舌草与免疫炎症指标的改善关联度较高; 5) 中药颗粒剂和中药饮片干预治疗后免疫炎症指标均有明显改善, 免疫炎症指标与干预措施之间存在长程关联.结论:安徽省四家代表性医院从脾论治类风湿关节炎, 中药颗粒剂与饮片用药基本规律一致, 均以健脾化湿药、清热解毒药、活血通络药、祛风除湿药为主, 中药颗粒剂与中药饮片可明显改善RA患者的免疫炎症指标, 且疗效相当, 均可作为治疗类风湿关节炎的选择.Keywords：类风湿关节炎;中药;颗粒剂;饮片;数据挖掘
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Published：2022-03-18 - Abstract：Objective:To determine the prevalence, factors associated with and patterns of concomitant Chinese medicine (CM) with Western treatment use among patients with rheumatoid arthritis (RA) in a tertiary referral centre (Singapore General Hospital) in Singapore.Methods:We conducted a cross-sectional intervieweradministered survey of a consecutive sample of patients with RA in Singapore General Hospital centre regarding their CM use including data on patient demographics, disease characteristics, concomitant use of CM and reasons, concerns and disclosure patterns from March to August 2015. Univariate and multivariate logistic regression analyses were performed to determine the associations of CM use.Results:Prevalence of CM use among the 258 patients surveyed (male: female 42: 216; Chinese: Malay: Indian 191: 29: 34; mean age: 61 years; mean duration of RA: 10 years) was 46.1% (119/258). On multivariate analysis, Chinese ethnicity (OR, 95% CI: 4.11, 1.49–11.36), Chinese speakers (OR, 95% CI: 2.35, 1.03–5.54), middle-income group (OR, 95% CI: 2.53, 1.01–6.31) and greater learned helplessness (OR, 95% CI: 1.13, 1.04–1.22) were significantly associated with CM use. More CM users disclosed their CM use to CM physicians (87.3%, 96/110), sought advice from them on treatment interactions (59.4%, 57/96) and how best to combine treatments (49.0%, 47/96) than did so with rheumatologists (42.0%, 50/119; 40.0%, 20/50; and 42.0%, 21/50, respectively). Forty-two percentage (29/69) of patients who concealed CM use from rheumatologists because their rheumatologists did not specifically enquire about CM use.Conclusions:Concomitant CM use among patients with RA treated in a tertiary referral centre in Singapore is high but voluntary disclosure is low. The associations identified can help doctors identify and enquire about CM use, minimizing potential adverse interactions.Keywords：pevalence;rheumatoid arthritis;Chinese medicine;complementary therapies
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Published：2022-03-18 - Abstract：目的:研究人参提取的总皂苷 (TG) 对神经干细胞 (NSC) 增殖和分化的影响及作用机制.方法:不同浓度的TG (50、100或200 μg/mL) 处理NSC后, 检测NSC迁移, 用CCK-8和神经球实验检测TG诱导的NSC增殖; 通过Western blot和免疫荧光染色法检测nestin和MAP2蛋白表达评估TG对NSC分化的影响; Western blot检测TG处理后NSC中GSK-3β/β-catenin通路活性. 腺病毒转染构建GSK-3β持续激活型NSC, 并检测TG对其增殖和分化的影响.结果:TG促进NSC的迁移 (P<0.01或P<0.05) 和增殖 (P<0.01或P<0.05) ; TG使NSC中MAP2蛋白表达增加、nestin蛋白表达降低 (P<0.01或P<0.05) ; TG促进GSK-3β在Ser9位点的磷酸化使GSK-3β失活, 从而激活了GSK-3β/β-catenin途径 (P<0.01或P<0.05) . 此外, 转染GSK-3β S9A构建GSK-3β持续激活型的NSC可以抵抗TG促NSC增殖和分化的作用 (P<0.01或P<0.05) .结论:TG通过抑制GSK-3β活性促进NSC增殖和分化为神经元.Keywords：ginsenoside;neural stem cell;proliferation;neuronal differentiation;GSK-3β
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Published：2022-03-18 - Abstract：目的:神经生长因子(NGF)作为神经内分泌-细胞免疫网络的主要节点, 该递质及其受体系统参与了银屑病皮损形成的早期过程, 在银屑病的发病中起到了至关重要的作用. 本研究目的在于阐明神经生长因子对角质形成细胞、T细胞的诱导增殖作用及活血解毒方的4种有效单体: 紫草素、丹皮酚、落新妇苷和熊果酸的可能干预机制.方法:培养Hacat细胞、Jurkat cell细胞, 添加NGF溶液(NGF+DMEM, 100ng/mL)对两种细胞进行诱导增殖24小时, 作为诱导组; 此外另加入NGF受体阻滞剂NTRK1 ((K252a+DEME, 300 nmol/L) 1小时作为对照. 以上各组分别使用清热活血解毒方中4种有效单体: 紫草素、丹皮酚、落新妇苷和熊果酸进行干预. 通过流式细胞术分析和CCK8测定来检测细胞凋亡和增殖, 实时定量荧光检测 (RT-PCR) 评估凋亡基因Bax、Bcl-xl, 神经生长因子受体(NGFR)mRNA表达水平, 同时进行蛋白质印迹分析 (Western blot analysis) .结果:(1) 清热活血解毒有效单体干预组与NGF诱导组相比, 细胞凋亡增加, 细胞增殖抑制 (<0.05) . 且同时加入NTRK1及清热活血解毒有效单体的干预组在细胞凋亡、细胞增殖抑制作用方面更显著, 特别是熊果酸组表现更为明显, (2) 清热活血解毒有效单体干预组Bax、Bcl-xl蛋白表达水平高于其他组(<0.05). 且同时加入NTRK1及清热活血解毒有效单体显着增加了细胞Bax、Bcl-xl和NGFR的蛋白质表达水平, 尤其是紫草素组表现更为明显.结论:清热活血解毒方治疗银屑病的作用机制可能与影响细胞凋亡增殖, 并上调Bax、Bcl-xl和NGFR的表达水平相关, 但具体机制仍需要进一步研究.Keywords：psoriasis;inflammatory dermatosis;nerve growth factor;keratinocyte;Chinese medicine formula
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Published：2022-03-18 - Abstract：目的:研究丹酚酸B是否通过抑制细胞凋亡、焦亡减轻糖尿病周围神经病变损伤.方法:RSC96细胞分为对照组 (5.6mmol/L葡萄糖) , 高糖组 (125mmol/L葡萄糖) 和丹酚酸B组 (0.1, 1, 10μmol/L) . MTT法检测细胞增殖、流式检测细胞活性氧和细胞凋亡率、免疫印迹法检测poly ADP-ribose polymerase、Cleaved-caspase3, Cleaved-caspase9, Bcl-2, Bax, NLRP3, ASC和IL-1β的表达水平.结果:相对于对照组, 125mmol/L高糖可抑制细胞增殖, 促进细胞活性氧的生成, 增加细胞凋亡率, 上调凋亡、焦亡相关蛋白的表达 (P<0.05) ; 相对于高糖组, 丹酚酸B可促进细胞增殖, 减少细胞活性氧的生成、下调细胞凋亡率, 不仅如此, 丹酚酸B可下调凋亡、焦亡相关蛋白的表达 (P<0.05) .结论:丹酚酸B可能通过抑制氧化应激诱导的细胞凋亡、焦亡减轻高糖诱导的RSC96细胞损伤.Keywords：apoptosis;pyroptosis;salvianolic acid B;hyperglycemia
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Published：2022-03-18 - Abstract：Objective:To explore potential natural products against severe acute respiratory syndrome coronavirus (SARS-CoV-2) via the study of structural and non-structural proteins of human coronaviruses.Methods:In this study, we performed an in-silico survey of 25 potential natural compounds acting against SARS-CoV-2. Molecular docking studies were carried out using compounds against 3-chymotrypsin-like protease (3CLPRO), papain-like protease (PLPRO), RNA-dependent RNA polymerase (RdRp), non-structural protein (nsp), human angiotensin converting enzyme 2 receptor (hACE2R), spike glycoprotein (S protein), abelson murine leukemia viral oncogene homolog 1 (ABL1), calcineurin-nuclear factor of activated T-cells (NFAT) and transmembrane protease serine 2.Results:Among the screened compounds, amentoflavone showed the best binding affinity with the 3CLPRO, RdRp, nsp13, nsp15, hACE2R¸ ABL1 and calcineurin-NFAT; berbamine with hACE2R and ABL1; cepharanthine with nsp10, nsp14, nsp16, S protein and ABL1; glucogallin with nsp15; and papyriflavonol A with PLPRO protein. Other good interacting compounds were juglanin, betulinic acid, betulonic acid, broussooflavan A, tomentin A, B and E, 7-methoxycryptopleurine, aloe emodin, quercetin, tanshinone Ⅰ, tylophorine and furruginol, which also showed excellent binding affinity towards a number of target proteins. Most of these compounds showed better binding affinities towards the target proteins than the standard drugs used in this study.Conclusion:Natural products or their derivatives may be one of the potential targets to fight against SARS-CoV-2.Keywords：SARS-CoV-2;natural products-derived anti-SARS-CoV-2 candidates;structural proteins;nonstructural proteins;molecular docking
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Published：2022-03-18
Original Article
- Abstract：目的:探讨穴位注射能否改善采用腰硬联合麻醉 (combined spinal-epidural analgesia, CSEA) 及自控硬膜外麻醉 (patient-controlled epidural analgesia, PCEA) 实施分娩镇痛产妇的镇痛效果及分娩结局.方法:前瞻性收集2017 年7月至2019年12月期间病例共307例, 按照随机数字表法将产妇随机分为穴位注射联合CSEA+ PCEA组 (AICP组, n=168) 和CSEA+ PCEA组 (CP组, n=139) . 两组产妇均在宫口扩张3 cm实施CSEA+ PCEA, AICP组病人同时选取双侧足三里 (ST 36) 和三阴交 (SP 6) 实施穴位注射. 主要结果是视觉模拟量表 (Visual Analogue Scale, VAS) 评分, 次要结果是分娩结局及麻醉药物剂量. 所有产妇实施干预后均进行安全性评价.结果:AICP组产妇在实施分娩镇痛10、30、60、120分钟时的VAS评分均低于CP组 (P均<0.05) ; AICP组产妇潜伏期较CP组缩短 (P<0.05) ; AICP组产妇的麻醉药物剂量及宫缩乏力、发热、瘙痒、尿潴留的发生率均低于CP组 (P均<0.05) .结论:穴位注射联合CSEA+ PCEA实施分娩镇痛可减少麻醉药物剂量, 改善镇痛效果并降低副作用的发生率. (注册号: ChiMCTR-2000003120)Keywords：穴位注射;腰硬联合麻醉;分娩镇痛;麻醉药物剂量;多模式
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Published：2022-03-18
Acupuncture Research
- Abstract：Objective:To analyze the available data on the anti-anger effects of herbal medicines (HMs) as well as their underlying mechanisms in rat models.Methods:From 6 electronic databases [PubMed, EMBASE, China National Knowledge Infrastructure (CNKI), Wanfang, Oriental Medicine Advanced Searching Integrated System (OASIS), and Research Information Sharing Service (RISS)], relevant animal experiments were searched by using "anger," "rats," and "animal" as search keywords. The last search was conducted on November 22, 2019, and all experiments involving rat models of anger and treatment using HMs published until the date of the search were considered.Results:A total of 24 studies with 16 kinds of HMs were included. Most studies have used the "tail irritating method" and "social isolation and resident intruder" method to establish anger models. According to the included studies, the therapeutic mechanisms of HMs for anger regulation and important herbs by their frequency and/or preclinical evidence mainly incladed regulation of hemorheology (Bupleuri Radix, Paeoniae Radix Alba, and Glycyrrhizae Radix), regulation of sex hormones (Bupleuri Radix, Cyperi Rhizoma, and Paeoniae Radix Alba), regulation of neurotransmitters (Cyperi Rhizoma), regulation of anger-related genes (Bupleuri Radix, Glycyrrhizae Radix, and Paeoniae Radix Alba), and other effects. Overall, Liver (Gan) qi-smoothing herbs including Bupleuri Radix and Cyperi Rhizoma were the most frequently used.Conclusions:This review found the frequent methods to establish an anger model, and major mechanisms of anti-anger effects of HMs. Interestingly, some Liver qi-smoothing herbs have been frequently used to investigate the anti-anger effects of HM. These findings provide insight into the role and relevance of HMs in the field of anger management.Keywords：anger;anger management therapy;herbal medicine;Korean traditional medicine
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Published：2022-03-18
Literature Research
- Abstract：阿尔茨海默病(AD)是老年人中最常见的神经退行性疾病之一, 约占所有痴呆类型的80%. 迄今为止, AD的发病机制仍未完全阐明. 线粒体级联假说认为线粒体损伤可能介导、驱动或加速多种AD病理进展, 是导致晚发型AD的主要因素. 目前, 尚无明确证实可有效治疗AD线粒体损伤的药物, 越来越多的证据表明针刺可以有效改善AD线粒体结构和保护线粒体功能. 本文总结了针刺调节线粒体动力学、提高能量代谢、维持钙稳态和抑制细胞凋亡的机制, 以期为针刺治疗AD提供科学的理论依据.Keywords：acupuncture;Alzheimer's disease;mitochondrial damage;review
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Published：2022-03-18 - Abstract：DNA高甲基化是一种表观遗传学修饰, 在骨髓增生异常综合征的发生中起了关键作用. DNA甲基化的缺失可以抑制肿瘤抑制基因启动子的转录, 从而诱导基因沉默. 雄黄作为一种传统药物, 在古代被用于治疗多种疾病. 据报道, 雄黄对治疗急性早幼粒细胞白血病有疗效. 雄黄已被证实可有效降低骨髓增生异常综合征的DNA高甲基化. 这篇综述讨论了雄黄对抑制骨髓增生异常综合征DNA高甲基化的作用机理以及砷在体内的代谢与形态.Keywords：骨髓增生异常综合征;DNA高甲基化;雄黄;砷;综述
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Published：2022-03-18
Review
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