Latest Issue
      2022 Year 28 Vol. 9 Issue

        Original Article

      • Chun-mei WANG,Xiang-feng GUO,Li-min LIU,Ying HUANG,Liang MENG,Li-po SONG,Ying-feng WU,Ya-chan NING,Kathleen H. Reilly,Hai-bo WANG
        2022, 28(9): 771-778. DOI: 10.1007/s11655-022-2894-3
        Abstract：目的:在外科住院患者, 评估三七总皂苷 (panax notoginseng saponins, PNS) 联合低分子肝素 (low-molecular-weight heparin, LMWH) 预防深静脉血栓形成 (deep vein thrombosis, DVT) 真实世界疗效.方法:2016 年 1 月至 2018 年 11 月, 在首都医科大学宣武医院外科住院患者行前瞻性队列研究. 参与者接受单独LMWH 或 PNS + LMWH 预防 DVT. 主要结果是下肢 DVT 的发生率. LMWH 组参与者通过皮下注射给予 LMWH, 每天一次 4000-8000 AxaIU; PNS + LMWH组参与者给予PNS (血塞通片, 100mg, 每日3次) 联合LMWH, LMWH的给药方法与LMWH组相同.结果:在为研究筛选的 325 名患者中, 281 名参与者被纳入最终分析. 该队列的 PNS + LMWH 组和 LMWH 组分别有 134 和 147 名参与者. 两组间 DVT 发生率有显着差异 (P=0.01), PNS + LMWH 组发生 DVT 21 例 (15.7%), LMWH 组发生 DVT 41 例 (27.9%) . 与没有 DVT 的参与者相比, 诊断为 DVT 的参与者年龄更大, D-二聚体水平更高. 多变量逻辑回归模型显示, 与 LMWH 组相比, PNS + LMWH 组参与者发生 DVT 的风险显着降低 (odds ratio 0.46, 95% confidence interval, 0.25-0.86) . 两组间血栓弹力图检测的R、K、Angle 和 MA值和严重出血事件无显着差异, 研究期间未发生有症状的肺栓塞.结论:与LMWH单药治疗相比, PNS联合LMWH应用可有效降低外科住院患者DVT的发生率, 且不增加出血风险.  
        Keywords：三七总皂苷;深静脉血栓形成;低分子肝素;血栓弹力图;危险因素   
        155
        |
        15
        |
        0
        <HTML>
        <Meta-XML>
        <CITATION> <Bulk Citation> 29747204 false
        Published：2022-09-08
      • Xin-yu JI,Yan MA,Shuai SHI,Si-hong LIU,Lin TONG,Cheng LYU,Hua-min ZHANG,Yan-ping WANG
        2022, 28(9): 779-784. DOI: 10.1007/s11655-021-2880-1
        Abstract：目的:总结中医药防治新型冠状病毒肺炎 (以下简称“新冠肺炎”) 诊疗方案的用药规律, 为临床诊治提供参考.方法:搜索从2019年12月8日到2020年3月10日的各省市政府网站和官方媒体网站上的中医药防治新冠肺炎诊疗方案. 分防治阶段和地区对诊疗方案的中药组方进行用药频次、中药配伍、聚类以及复杂网络分析等.结果:在27个中医诊治方案中, 治疗处方共有203个, 用药频次较高的前4位中药分别为: 甘草、杏仁、麻黄、藿香, 核心组合是麻黄和杏仁. 在48个预防处方中, 使用频率最高的中药分别为: 黄芪、甘草、防风、金银花等. 核心配伍处方为黄芪、甘草、防风, 是玉平风散的主要成分. 中国华东地区的诊疗方案中, 防治处方共45个, 使用频率最多的中药是甘草、藿香、陈皮和石膏等. 中国华北地区的诊疗方案中, 防治处方共50个, 使用频率最多的中药是藿香、杏仁、麻黄和茯苓等.结论:在预防新冠肺炎方面, 中医药主要侧重于提高人体免疫力; 治疗上, 则重在清肺利湿. 中药处方的应用因地制宜, 可能是由于气候和环境的差异, 这些结果有助于临床医生快速制定中医药诊疗计划.  
        Keywords：COVID-19;中药;用药规律   
        134
        |
        6
        |
        0
        <HTML>
        <Meta-XML>
        <CITATION> <Bulk Citation> 29747100 false
        Published：2022-09-08
      • Yi-ping LI,Ting-ting QIANG,Ke-yan WANG,Xiao-long WANG
        2022, 28(9): 785-793. DOI: 10.1007/s11655-022-2891-6
        Abstract：目的:总结中医药防治新型冠状病毒肺炎 (以下简称“新冠肺炎”) 诊疗方案的用药规律, 为临床诊治提供参考.方法:搜索从2019年12月8日到2020年3月10日的各省市政府网站和官方媒体网站上的中医药防治新冠肺炎诊疗方案. 分防治阶段和地区对诊疗方案的中药组方进行用药频次、中药配伍、聚类以及复杂网络分析等.结果:在27个中医诊治方案中, 治疗处方共有203个, 用药频次较高的前4位中药分别为: 甘草、杏仁、麻黄、藿香, 核心组合是麻黄和杏仁. 在48个预防处方中, 使用频率最高的中药分别为: 黄芪、甘草、防风、金银花等. 核心配伍处方为黄芪、甘草、防风, 是玉平风散的主要成分. 中国华东地区的诊疗方案中, 防治处方共45个, 使用频率最多的中药是甘草、藿香、陈皮和石膏等. 中国华北地区的诊疗方案中, 防治处方共50个, 使用频率最多的中药是藿香、杏仁、麻黄和茯苓等.结论:在预防新冠肺炎方面, 中医药主要侧重于提高人体免疫力; 治疗上, 则重在清肺利湿. 中药处方的应用因地制宜, 可能是由于气候和环境的差异, 这些结果有助于临床医生快速制定中医药诊疗计划.  
        Keywords：麝香保心丸;miR-451;血小板源性生长因子BB刺激的血管平滑肌细胞;增殖   
        61
        |
        7
        |
        0
        <HTML>
        <Meta-XML>
        <CITATION> <Bulk Citation> 29747185 false
        Published：2022-09-08
      • Ming-qing ZHANG,Qiang ZHANG,Wei YUAN,Jun-yuan WU,Yong LIANG,Hong-jie QIN,Chun-sheng LI
        2022, 28(9): 794-801. DOI: 10.1007/s11655-021-2876-x
        Abstract：目的:探讨参附注射液对猪失血性休克 (HS) 模型内皮损伤的影响.方法:32头实验猪采用快速放血法维持在平均动脉压为40±3毫米汞柱并保持60分钟后, 分别随机分为静脉输血 (输血组)、输血联合生理盐水 (生理盐水组)、输血联合静脉输注参附注射液 (参附组) 或不复苏 (假手术组) . 在基线和HS后0、1、2、4和6小时采集静脉血样本并进行分析. 通过酶联免疫吸附试验 (ELISA) 测定肿瘤坏死因子-α (TNF-α)、血清白介素-6和白介素-10的水平; Western blot检测血管细胞粘附分子-1 (VCAM-1)、细胞间粘附分子-1 (ICAM-1)、血管性血友病因子 (vWF)、纤溶酶原激活物抑制剂-1 (PAI-1)、Bcl-2、Bax和caspase-3蛋白的表达.结果:参附组在复苏的整个6小时内, 实验猪血清TNF-α水平显著低于其他组, IL-6水平在4和6小时低于其他组 (P<0.01或P<0.05) . 复苏全程参附组血清IL-10浓度显著升高其他组, 差异有统计学意义 (P<0.01) . 血管组织的Western blot和免疫组化显示, 与其他组相比, 参附组caspase-3的表达下调, Bcl-2和Bax的表达上调 (P<0.05) .结论:参附注射液通过抑制细胞凋亡、抑制促炎细胞因子的形成及减少内皮细胞的活化, 减轻了失血性休克猪模型中的内皮损伤.  
        Keywords：失血性休克;参附注射液;血管内皮损伤;中药   
        47
        |
        2
        |
        0
        <HTML>
        <Meta-XML>
        <CITATION> <Bulk Citation> 29747190 false
        Published：2022-09-08
      • Bo-Ra Jeon,Muhammad Irfan,Seung Eun Lee,Jeong Hoon Lee,Man Hee Rhee
        2022, 28(9): 802-808. DOI: 10.1007/s11655-021-2873-0
        Abstract：Objective:To examine the antiplatelet and antithrombotic activity of Rumex acetosella extract.Methods:Standard light aggregometry was used for platelet aggregation, intracellular calcium mobilization assessed using Fura-2/AM, granule secretion (ATP release) by luminometer, and fibrinogen binding to integrin αⅡbβ3 detected using flow cytometry. Western blotting is carried out to determine the phosphorylation of mitogen-activated protein kinase (MAPK) and phosphoinositide 3-kinase (PI3K)/Akt signaling.Results:Rumex acetosella displayed the ability to inhibit platelet aggregation, calcium mobilization, granule secretion, and fibrinogen binding to integrin αⅡbβ3. Rumex acetosella has also down-regulated MAPK and PI3K/Akt phosphorylation (all P<0.01).Conclusion:Rumex acetosella extract exhibits antiplatelet activity via modulating GPVI signaling, and it may protect against the development of platelet-related cardiovascular diseases.  
        Keywords：antiplatelet;ethnomedicine;integrin αⅡbβ3;mitogen-activated protein kinase;Rumex acetosella L.   
        59
        |
        2
        |
        0
        <HTML>
        <Meta-XML>
        <CITATION> <Bulk Citation> 29747107 false
        Published：2022-09-08
      • Ling DING,Hong YE,Long-dian GU,An-qing DU,Xin-lu YUAN
        2022, 28(9): 809-816. DOI: 10.1007/s11655-022-2893-4
        Abstract：Objectives:To evaluate the effect of echinacoside (ECH) on cognitive dysfunction in post cerebral stroke model rats.Methods:The post stroke cognitive impairment rat model was created by occlusion of the transient middle cerebral artery (MCAO). The rats were randomly divided into 3 groups by a random number table: the sham group (sham operation), the MCAO group (received operation for focal cerebral ischemia), and the ECH group (received operation for focal cerebral ischemia and ECH 50 mg/kg per day), with 6 rats in each group. The infarct volume and spatial learning were evaluated by triphenyl tetrazolium chloride staining and Morris water maze. The expression of α7nAChR in the hippocampus was detected by immunohistochemistry. The contents of acetylcholine (ACh), malondialdehyde (MDA), glutathione (GSH), superoxide dismutase (SOD), activities of choline acetyltransferase (ChAT), acetylcholinesterase (AChE), and catalase (CAT) were evaluated by enzyme linked immunosorbent assay. The neural apoptosis and autophagy were determined by TUNEL staining and LC3 staining, respectively.Results:ECH significantly lessened the brain infarct volume and ameliorated neurological deficit in infarct volume and water content (both P<0.01). Compared with MCAO rats, administration of ECH revealed shorter escape latency and long retention time at 7, 14 and 28 days (all P<0.01), increased the α7nAChR protein expression, ACh content, and ChAT activity, and decreased AChE activity in MCAO rats (all P<0.01). ECH significantly decreased MDA content and increased the GSH content, SOD, and CAT activities compared with MCAO rats (all P<0.05). ECH suppressed neuronal apoptosis by reducing TUNEL-positive cells and also enhanced autophagy in MCAO rats (all P<0.01).Conclusion:ECH treatment helped improve cognitive impairment by attenuating neurological damage and enhancing autophagy in MCAO rats.  
        Keywords：cerebral ischemia;cognitive impairment;autophagy;echinacoside;cholinergic activity   
        46
        |
        5
        |
        1
        <HTML>
        <Meta-XML>
        <CITATION> <Bulk Citation> 29747319 false
        Published：2022-09-08
      • Juan LU,Yue YU,Xiao-jing WANG,Rui-ping CHAI,Xin-kai LYU,Ming-hui DENG,Mei-geng HU,Yun QI,Xi CHEN
        2022, 28(9): 817-822. DOI: 10.1007/s11655-021-3292-y
        Abstract：Objective:To study the mechanism of Shengmai Injection (SMI) on anti-sepsis and protective activities of intestinal mucosal barrier.Methods:The contents of 11 active components of SMI including ginsenoside Rb1, Rb2, Rb3, Rd, Re, Rf, Rg1, Rg2, ophioposide D, schisandrol A and schisantherin A were determined using ultra-performance liquid chromatography. Fifty mice were randomly divided into the blank, the model, the low-, medium- and high-dose SMI groups (0.375, 0.75, 1.5 mL/kg, respectively) by random number table, 10 mice in each group. In SMI group, SMI was administrated to mice daily via tail vein injection for 3 consecutive days, while the mice in the blank and model groups were given 0.1 mL of normal saline. One hour after the last SMI administration, except the blank group, the mice in other groups were intraperitoneally injected with lipopolysaccharide (LPS) saline solution (2 mL/kg) at a dosage of 5 mL/kg for development of endotoxemia mice model. The mice in the blank group were given the same volume of normal saline. Inflammatory factors including interferon-γ (INF-γ), tumor necrosis factor-α (TNF-α), interleukin (IL)-2 and IL-10 were measured by flow cytometry. Myosin light-chain kinase (MLCK), nuclear factor κB (NF-κB) levels, and change of Occludin proteins in jejunum samples were analyzed by Western blot.Results:The decreasing trends of INF-γ, TNF-α and IL-2 were found in serum of SMI treatment groups. In SMI-treated mice, the content of Occludin increased and MLCK protein decreased compared with the model group (P<0.05 or P<0.01). The content of cellular and nuclear NF-κB did not change significantly (P>0.05).Conclusion:SMI may exert its anti-sepsis activity mainly through NF-κB-pro-inflammatory factor-MLCK-TJ cascade.  
        Keywords：Shengmai Injection;sepsis;intestinal mucosal barrier;mechanism;Chinese medicine   
        11
        |
        0
        |
        1
        <HTML>
        <Meta-XML>
        <CITATION> <Bulk Citation> 29747225 false
        Published：2022-09-08

        Acupuncture Research

      • Sen GUO,Jing ZHOU,Liang ZHANG,Chun-hui BAO,Ji-meng ZHAO,Yan-ling GAO,Pin WU,Zhi-jun WENG,Yin SHI
        2022, 28(9): 823-832. DOI: 10.1007/s11655-022-2888-1
        Abstract：目的:探究针灸疗法是否通过影响转化生长因子β1 (TGF-β1) /Smad3/Snail通路阻抑克罗恩病上皮间质转化.方法:通过随机数字表将63例轻、中度CD患者随机分为观察组 (31例) 和对照组 (32例), 观察组接受43℃灸结合针刺治疗, 对照组采用37℃灸结合假针刺治疗, 连续治疗12周. 克罗恩病活动指数 (CDAI) 用于评估疾病活动度. 苏木精-伊红采用染色和透射电镜观察细胞形态和超微结构变化. 免疫组织化学技术检测肠粘膜组织中转化生长因子β1 (TGF-β1)、TβR1、TβR2、Smad3、Snail、E-钙粘蛋白和纤维连接蛋白的表达.结果:观察组CDAI评分下降、形态学和超微结构改善更为明显. 观察组TGF-β1、TβR2、Smad3、Snail治疗后的表达水平均显著低于治疗前 (P<0.05或P<0.01) . 观察组治疗后TGFβ1、TβR2和Snail的表达水平均显著低于对照组治疗后 (P均<0.05) ; 与对照组治疗后比较, 观察组治疗后纤维连接蛋白的表达显著降低, E-钙粘蛋白的表达显著升高 (P均<0.05) .结论:43℃灸结合针刺治疗可能通过抑制TGF-β1、TβR2、Smad3和snail的表达水平阻抑TGF-β1/Smad3/Snail通路介导的克罗恩患者的肠上皮间质转化.  
        Keywords：克罗恩病;艾灸;针刺;转化生长因子-β1/Smad3/Snail;肠上皮-间质转化通路   
        18
        |
        2
        |
        1
        <HTML>
        <Meta-XML>
        <CITATION> <Bulk Citation> 29747310 false
        Published：2022-09-08
      • Feng-jiao WANG,She SHI,Yong-qiang WANG,Ke WANG,Shen-dong FAN,Ya-nan ZHANG,Chen-chen FENG,Zi-yong JU
        2022, 28(9): 833-839. DOI: 10.1007/s11655-022-2896-1
        Abstract：目的:研究电针 (EA) 对奥沙利铂诱导的大鼠周围神经病变 (OIPN) 的影响.方法:雄性SD大鼠按随机数字表法分为3组:对照组、OIPN组和EA (OIPN + EA)组, 每组10只. 测定机械敏感度、冷敏感性和微循环血流强度的时间进程. 电镜观察背根神经节(DRG)的形态. Western blot检测DRGs中核因子E2相关因子2 (Nrf2)、血红素加氧酶-1 (HO-1)和瞬时受体电位(TRP)蛋白家族的表达水平.结果:EA 治疗显着降低OIPN 大鼠的机械异常性疼痛和冷异常性疼痛 (P<0.01) . 值得注意的是, 奥沙利铂治疗导致DRGs微循环血流受损和病理形态缺陷 (P<0.01) . 而电针治疗增加了微循环血流量, 减轻了奥沙利铂引起的病理变化 (P<0.01) . 此外, OIPN大鼠DRGs中Nrf2和HO-1表达下调, TRP蛋白家族过度表达 (P<0.01) . EA增加了DRG中Nrf2和HO-1的表达水平, 降低了TRP蛋白家族的水平 (P<0.05或P<0.01) .结论:电针可能是一种潜在的 OIPN 替代疗法, 其机制可能主要由恢复 Nrf2/HO-1 信号通路介导.  
        Keywords：电针;奥沙利铂;周围神经病变;背根神经节;核因子E2相关因子2 (Nrf2)   
        23
        |
        3
        |
        0
        <HTML>
        <Meta-XML>
        <CITATION> <Bulk Citation> 29747352 false
        Published：2022-09-08

        Clinical Experience

      • Dan-ping XU,Jun-peng XU,Zhi-ling HE,Guang-ming PAN,Xia WANG
        2022, 28(9): 840-846. DOI: 10.1007/s11655-021-2874-z
        Abstract：Objective:To analyse the correlation between the characteristics of coronary plaque in coronary heart disease (CHD) patients with phlegm-blood stasis syndrome (PBS) and blood stasis syndrome (BSS).Methods:Patients were divided into different groups based on Chinese medicine (CM) syndrome differentiation. The baseline demographics and clinical variables were collected from the medical records. Additionally, the characteristics of plaque and pathological manifestations in coronary artery were evaluated using intravascular ultrasound (IVUS).Results:A total of 213 CHD patients were enrolled in two groups: 184 were diagnosed with PBS and the remaining 29 were diagnosed with BSS. There were no significant differences in age, body mass index, proportions of patients with high blood pressure, diabetes mellitus, smoking, hyperlipidemia, history of coronary artery bypass graft and percutaneous coronary intervention, medications, index from cardiac ultrasound image, blood lipids and C-reactive protein between the two groups (P>0.05), except gender, weight and proportions of IVUS observed target vessels (P<0.05 or P<0.01). More adverse events such as acute myocardial infarction (P=0.003) and unstable angina (P=0.048) were observed in BSS. Additionally, dissection, thrombus and coronary artery ectasia were significantly increased in BSS (P<0.05 or P<0.01). In contrast, PBS had more patients with stable angina and chronic total occlusion with significantly higher SYNTAX (synergy between percutaneous coronary intervention with Taxus and coronary artery bypass surgery) scores (P<0.05 or P<0.01). Moreover, dense-calcium was significantly elevated in PBS (P<0.01).Conclusions:Coronary plaque characteristics were correlated with different CM syndromes. Patients with PBS were associated with a higher degree of calcified plaque and severe coronary artery stenosis, indicating poor clinical prognosis but with a low probability of acute coronary events. In contrast, the degree of calcified plaque in patients with BSS remained relatively low, and plaque was more vulnerable, resulting in the possibility of the occurrence of acute coronary events remaining high.  
        Keywords：coronary heart disease;coronary plaque;intravascular ultrasound;Chinese medicine syndrome;syndrome differentiation   
        17
        |
        1
        |
        0
        <HTML>
        <Meta-XML>
        <CITATION> <Bulk Citation> 29747380 false
        Published：2022-09-08

        Data Mining Research

      • Hong-xin GUO,Jian-ru WANG,Guang-cao PENG,Ping LI,Ming-jun ZHU
        2022, 28(9): 847-854. DOI: 10.1007/s11655-022-2892-5
        Abstract：目的:基于数据挖掘对中药治疗射血分数保留心衰 (HFPEF) 的用药规律进行总结, 为临床用药提供参考.方法:检索中国知网 (CNKI)、万方数据 (Wanfang)、维普网 (VIP)、中国生物医学文献数据库 (CBM)、PubMed、Embase和Cochrane Library数据库中有关中药治疗HFPEF的文献, 检索时限为各数据库建库起至2021年10月. 首先使用Microsoft Excel 2019建立数据库, 然后使用R-Studio (Version 4.0.3)中apriori函数和hclust函数进行关联规则分析和层次聚类分析.结果:最终纳入合格文献182篇, 共包含方剂92首, 涉及单味中药130味, 中药累计使用872次, 平均每首处方含中药9.5味. 最常用的6味中药依次是黄芪、丹参、茯苓、甘草、桂枝和人参. 使用频次>5次的中药有35味, 涉及11种功效类别, 以补虚药、活血化瘀药和利水渗湿药占比最高, 药性以温性和甘味为主, 多归肺、心和脾经. 关联规则分析共得到黄芪&丹参、茯苓, 桂枝&白术等26条较强关联. 层次聚类分析共得到4类中药组合, 功效以益气温阳, 活血利水为主.结论:HFPEF为本虚标实之证, 核心病机为“虚”、“瘀”、“水”, 以“虚”最为主要, 与心肺脾三脏关系密切. 该病治以益气温阳、活血利水, 黄芪配伍丹参为基础用药组合.  
        Keywords：heart failure with preserved ejection fraction;data mining;Chinese herbs;medication rules;association rules;cluster analysis   
        30
        |
        3
        |
        1
        <HTML>
        <Meta-XML>
        <CITATION> <Bulk Citation> 29747341 false
        Published：2022-09-08

        Review

      • Ding-qi ZHANG,Yong-ping MU,Ying XU,Jia-mei CHEN,Ping LIU,Wei LIU
        2022, 28(9): 855-863. DOI: 10.1007/s11655-020-3271-8
        Abstract：本文综述了活血化瘀中药制剂治疗肝硬化门脉高压 (cirrhotic portal hypertension, CPH) 脾切除术后门静脉血栓形成 (portal vein thrombosis, PVT) 的疗效. 根据已发表的中药制剂对CPH脾切除术后PVT的临床研究, 评估干预治疗后PVT发生率的变化, 并探讨中药制剂潜在的活性成分及作用机制. 目前研究表明, 注射用红花黄色素、丹参注射液、丹红注射液及复方丹参滴丸等单用或联合抗凝治疗均取得较好疗效. 此外, 复方鳖甲软肝片和安洛化纤丸也能显著改善肝硬化患者门静脉系统血流动力学紊乱. 基于中药制剂对CPH患者脾切除术后PVT的改善作用, 中药制剂单用或联合抗凝剂治疗肝硬化PVT应当在今后的研究中给予更多关注.  
        Keywords：门静脉血栓;脾切除;肝硬化门静脉高压症;中药制剂;活血化瘀   
        15
        |
        2
        |
        0
        <HTML>
        <Meta-XML>
        <CITATION> <Bulk Citation> 29747378 false
        Published：2022-09-08
      0