书写痉挛是一种具有致残性的局灶性肌张力障碍,属于中医学"痉病"范畴,为难诊难治之病.本案患者以右手书写时手臂僵硬、乏力、震颤为主要临床表现,结合既往缺血缺氧性脑病病史,其病位在脑,与足太阳经、足少阳经、跷脉、肝脏相关,病机为瘀阻脑窍,足太阳经和足少阳经经气不利,阳气敷布失常,脑神、经筋失养,加之跷脉失调、肝血失濡,致经筋失养失调,故发为此病.证属瘀阻脑窍,阴阳失调.本案采用特色浅刺针法,通过温养阳气而养神、柔筋,同时配合常规针刺、精灸等针灸治疗技术,杂合以治.经治疗患者书写困难的症状得到明显缓解,随访3 月疗效稳定.本案提示针灸是治疗书写痉挛的有效方法.
Objective To explore the mechanisms of Zuogui Wan intervention in liver-kidney depletion of osteoarthritis(OA)based on a'disease-syndrome-symptom-formula'association network analysis.Methods Search the GEO database to obtain the gene chip of OA.Search the HPO and DisGeNET database to obtain the gene set of liver-kidney depletion.The effective chemical components and related targets of Zuogui Wan were found in TCMSP database.The intersection of the above gene sets was taken as the'disease-syndrome-symptom-formula'association network genes.The intersection genes were uploaded to the STRING database to build a PPI network,using the Cytoscape software to build a biomolecular network,calculate the topological eigenvalues(Degree,Betweenness Centrality,and Closeness Centrality),screen the key targets and core nodes.Finally,analysis the Gene Ontology(GO)function enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment by DAVID analysis platform.Results In total,there were 5394 OA disease genes,2073 genes for liver-kidney depletion,241 targets for Zuogui Wan,51 common targets of'disease-syndrome-symptom-formula'association network,17 key targets and 5 core nodes(Akt1、EGFR、IL6、TNF、VEGFA).The common target of'disease-syndrome-symptom-formula'accounted for 14.29%,13.04%,6.02%,4.81%,4.41%,3.26%and1.41%in the night sweats,low back pain,tinnitus,arthralgia,vertigo,fatigable weakness,and muscle weakness,respectively.The biological process of GO enrichment analysis include positive regulation of transcription,cellular response to lipopolysaccharide.The cellular component include extracellular space,endoplasmic reticulum lumen.The molecular function include identical protein binding,and enzyme binding.KEGG pathway enrichment results include regulation of bone and muscle metabolism,regulation of immune and inflammatory systems,blood circulation and pain relief,and regulation of the nervous system.Conclusion The treatment of liver-kidney depletion of OA by Zuogui Wan has the characteristics of multi components,multiple targets and multiple pathways,which are consistent with the current pathogenesis of OA.
郑惠芳教授学宗易水学派,临证擅用温补法,以脾肾为核心,重视阳气,认为脾肾亏虚,寒凝血瘀是崩漏的主要病机,治疗采用的温补法包括温阳育阴、温肾化气、温阳化瘀、健脾升阳等治法.在辨证基础上,分期分时用药,出血期止血塞流以健脾升阳、温阳化瘀为主,血止后复旧固本以补肾健脾为主;青春期以滋肾益阴为主,围绝经期宜健脾升阳,兼以调养肾气.临证灵活加减,疗效显著,并指导患者预防调护,防止崩漏复发.
Objective To investigate the effect of Zaoren Anshen granule on sleep-wake pattern in normal SD rats.Method Eight male SD rats were subjected to invasive electroencephalography(EEG)and electromyography(EMG)implantation surgery,and were housed in a single cage for 7 days for postopera-tiverecovery;on the 8th day after surgery,wireless remote sensing was performed to monitor sleep-wake on the machine,and light and darkness were naturally alternated for 12 hours to ensure their normal circadian rhythm for 3 days;then Zaoren Anshen granules were given,according to874.05 mg/(kg·d),water 33 mL/d,and the liquid mixture was freely available for 8 days;from the 6th day of administration,sleep-wake was monitored on the machine for 3 days;EEG and EMG data were exported after the end,and sleep-wake analysis was performed on the recorded data by EDFbrowser software,and the analysis results were exported;IBM SPSS Statistics 25 statistical analysis was used.Result Compared with normal sleep,the total sleep duration of rats given Zaoren Anshen granule was significantly increased(P＜0.05),and the awake duration was significantly decreased(P＜0.05);among them,the non-rapid eye movement(NREM)duration was significantly increased(P＜0.05),and the rapid eye movement(REM)duration was significantly increased(P＜0.05).Conclusion During the awakening period,EEG exhibits high frequency and low amplitude,while EMG exhibits high frequency muscle contraction;during non rapid eye movement sleep,EEG showed irregular images with alternating high and low amplitudes,in the form of slow waves;during rapid eye movement sleep,EEG showed low radiation and fast wave.Zaoren Anshen granule can intervene the sleep-wake regularity of normal rats,decrease the awake time and increase the sleep of rats,and increase the non-rapid eye movement sleep period and rapid eye movement sleep period.
Glaucoma is the first irreversible ophthalmopathy causing blindness in the world.Optic nerve atrophy is its characteristic manifestation.Apoptosis of retinal ganglion cells(RGCs)is the pathological basis of glaucoma optic nerve atrophy.As a survival pathway,PI3K/Akt signal pathway is widely involved in cell proliferation,differentiation,apoptosis and other activities.Traditional Chinese medicine such as Huoluo Xiaoling Dan can inhibit RGCs apoptosis and protect the optic nerve by targeting apoptosis signal molecules on PI3K/Akt pathway.MAPK signal pathway can regulate inflammation,apoptosis,oxidation and other pathological activities.Quercetin can inhibit the activation of this pathway and down-regulate the injury of RGCs inflammation and oxidative stress.HIF-1 is the initial transcription factor of eukaryotic cells in response to hypoxia.Excessive HIF-1 will promote apoptosis and neovascularization.Shugan Tongqiao recipe can improve the survival rate of RGCs by inhibiting the expression of HIF-1.ROCK signal pathway is involved in regulating cytoskeleton reorganization,changing trabecular cell structure and affecting aqueous humor excretion.QingguanganⅡ can inhibit the activation of ROCK pathway,reduce intraocular pressure and delay the progression of glaucoma.Wnt/β-catenin signal pathway is an important pathway of cell growth,tissue remodeling and organogenesis,which can lead to a variety of neurodegenerative diseases.Traditional Chinese medicine compound Huoxue recipe can reduce the loss of RGCs by down-regulating the related factors of this pathway.This paper summarized the key genes and signal pathways of traditional Chinese medicine intervention in glaucoma RGCs apoptosis,looking for targeted agonists or blockers of related signal pathways,in order to guide clinical and follow-up research most preferably.
