Objective To investigate the role of the PGE2 and EP2/EP3 receptor on improving lung function of rats with pulmonary fibrosis treated with Youguiyin Decoction. Methods 32 SPF SD male rats were divided into normal group, model group, Youguiyin low dose group and Youguiyin high dose group, according to the random number table method. The normal group (8 rats) was given no intervention and was given normal feeding. The other 3 groups were established by intravenous injection of Bleomycin (6 mg/kg) via tracheal intubation. Youguiyin low dose group (8 rats) and Youguiyin high dose group (8 rats) were given 5 g/kg and 10 g/kg of Youguiyin Decoction at specific time from the 14 th day after model establishment. The model group (8 rats) was given the same dose of drinking water once a day for 20 days. The lung weight and body weight were recorded, and the lung coefficient was calculated. The concentration of PGE2 in serum and lung tissue was measured with ELISA. The expression of EP2 and EP3 in lung tissue and tissue localization were analyzed by immunohistochemical staining, and the number of positive cells was counted. Results Compared with the normal group, the lung weight (3. 1 ± 0. 44 g, P ＜ 0. 05) and lung coefficient (0. 69 ± 0. 13％, P ＜0. 05) of the model group increased pathologically, and the level of PGE2 increased in both serum (45. 49 ± 7. 38 pg/ml, P ＜ 0. 05) and lung tissue (113. 64 ± 16. 78 pg/ml, P ＜ 0. 05). Abnormal proliferation of AEC IIs associated with strong EP2-positive in the consolidation of lung tissues, and the macrophages accumulated in the alveolar ducts and alveolar spaces were EP3-positive. The positive cells in the two groups increased significantly (P ＜ 0. 05). Compared with the model group, the lung weight (2. 63 ± 0. 24 g, P ＜ 0. 05) and lung coefficient (0. 57 ± 0. 08％, P＜ 0. 05) of Youguiyin low dose group decreased, and the level of PGE2 decreased in both serum (23. 01 ± 8. 61 pg/ml, P ＜ 0. 05) and lung tissue (89. 84 ± 20. 54 pg/ml, P ＜ 0. 05). The expression of EP2 in the AEC IIs with strong EP2-positive decreased, and the number of cell reduced (P ＜ 0. 05). The number of macrophages with EP3-positive increased (P ＜ 0. 05). In the Youguiyin high dose group, there was no statistical difference except the decreased level of PGE2 in serum (P ＜ 0. 05). Conclusion Youguiyin can significantly improve pulmonary fibrosis induced by Bleomycin in rats, which may be associated with lowing PGE2 level in the consolidation of lung tissues, inhibiting the expression of EP2 in the consolidation area, reduction of AECIIs with EP2-positive, and increase of macrophages with EP3-positive.

目的 系统评价三子养亲汤治疗慢性阻塞性肺疾病的临床疗效及安全性.方法 计算机检索PubMed、EMbase、CNKI、VIP以及WanFang Data数据库,搜集三子养亲汤加减治疗慢性阻塞性肺疾病的相关随机对照试验(RCT),检索时间均为建库时间至2016年10月.2名评价员独立进行筛选文献、资料提取以及评价偏倚风险后,采用Cochrane协作网RevMan 5.3软件进行Meta分析.结果 共纳入21篇RCT,包括1858例患者.Meta分析结果显示,治疗组治疗COPD可明显提高临床有效率、同时可有效改善肺功能、血气分析、中医证侯积分,而在呼吸困难评分方面与西医常规治疗比较无统计学意义.结论 三子养亲汤加减(或联合西医常规方案)治疗COPD疗效肯定,但受纳入研究的数量和质量限制,其疗效及安全性尚需更多高质量临床研究予以验证.

Objective:Analysis the clinical phenotype characteristics and imaging performance of different syndromes of patients with chronic obstructive pulmonary disease (COPD).Methods:One hundred and eighty COPD cases were collected with the date of demographic,disease duration,body mass index (BMI),smoking index,the frequency of exacerbations,complications,degree of dyspnea (mMRC),COPD assessment test (CAT),pulmonary function,imaging performance,etc.were analyzed by using cluster analysis.Results:One hundred and eighty cases of patients were divided into 5 categories by cluster analysis as following:blood stasis due to deficient qi and phlegm-heat obstructing lung (group Ⅰ),yin deficiency and blood stasis and phlegm-heat obstructing lung (group Ⅱ),deficiency of both qi and yin of heart and intermingled phlegm and blood stasis (group Ⅲ),yang deficiency of spleen and kidney and inundation of fluid-dampness (group Ⅳ),exogenous wind (group Ⅴ).Patients in group Ⅰ with younger age,overweight,short duration,mild condition were in COPD A group.Patients in group Ⅳwith older ages,long duration,severe illness,imaging more complicated pulmonary interstitial changes,pneumonia,and pulmonary heart disease were in COPD D group.Patients in group Ⅱ mostly elderly people who do not smoke,and female patients more common with complications.Patients in group Ⅲ were poor in nutritional status.Patients often associated with hyperlipidemia and arrhythmia,pulmonary texture thickening blurred,and bronchiectasis were in group Ⅴ.The results showed that chronic inflammation as lung texture disorder,bronchial dilatation,and so on might be one of the risk factors of COPD patients.Conclusion:The clinical features and imaging performance of patients with different syndromes are also different.

Objective:To observe the effect of Huayu Jiedu Yiqi principle on pathologic tissues of gastric mucosa and methylation status of p16 in rats with gastric precancerous lesion.Methods:Low concentration of MNNG with ranitidine were used to set up model of gastric precancerous lesion.After the model was succeeded at the 20th weekend,rats were randomly divided into model group,tretinoin group and Yiqi Tongluo Jiedu San group.After treatment,observed the rat gastric mucosa pathological changes,and methylation-specific technique was used to examine the methylation status of p16.Results:20 weeks after the rat model was built,the rats in the model set were diagnosed to have pathological changes including intestinal metaplasea and atypical hyperplasia.In terms of gastric mucosa pathological changes,Yiqi Tongluo Jiedu San group significantly improved.The positive rate of CpG island methylation of p16 tumor suppressor gene in Yiqi Tongluo Jiedu San group was 33.33％,compared with the model group 76.92％,the difference was statistically significant (P ＜ 0.05).24 cases of gastric mucosa pathological intestinal metaplasia or dysplasia in rats,there were 16 cases of p16 tumor suppressor gene promoter region CpG island hypermethylation;In 32 non gastric precancerous rats,there were 23 cases of p16 tumor suppressor gene promoter region CpG Island non methylation.By two variables correlation analysis,the Spearman coefficient was 0.383 67,and P =0.003 5 ＜ 0.01.Conclusion:Huayu Jiedu Yiqi principle can induce demethylation of p16 in gastric mucosa cells in rats with gastric precancerous lesion.The way can decrease methylation level of CpG island of promoter region of suppressor tumor gene p16 and improve the condition of gastric mucosa gland damage in rats so as to treat gastric precancerous lesion effectively.

目的 探讨中医药治疗慢性阻塞性肺疾病(COPD)急性加重期的常用药物组方规律.方法 以中国期刊全文数据库、中国医院数字图书馆、万方数据库、中国生物医学文献数据库为主要检索目标,纳入中医药复方治疗COPD急性加重期临床研究文献,提取药物建立数据库,统计药物使用频次,并分别对高频药物对药、三药组合、四药组合、五药组合、六药组合进行关联规则分析.结果 共纳入文献251篇,涉及中药181味,共计使用2612频次,使用频次＞15的药物共44味.关联规则显示,COPD急性加重期高频药物组方中,置信度最高的药对为紫苏子、莱菔子;三药组合为半夏、紫苏子、陈皮;四药组合为杏仁、桑白皮、黄芩、半夏;五药组合为半夏、桑白皮、黄芩、杏仁、甘草;六药组合为紫苏子、桑白皮、黄芩、杏仁、半夏、甘草.结论 COPD急性加重期的用药是以祛邪为主,重在清肺化痰、宣肺止咳、降气平喘.

Objective To observe the effect of"Jiangzhuo Huayu Mixture"on NF-κB pathway of rats with type 2 diabetes and nonalcoholic fatty liver disease.Methods The rats models were established by fatty diet and small dose Streptozotocin Injection and randomly divided into three groups: Chinese medicine group was treated by"Jiangzhuo Huayu Mixture",western medicine group was treated by Rosiglitazone and model group was treated by distilled water,and normal control group was established as well.After treated for 8 weeks,the TNF-α was observed and expression of NF-κB and IκB of liver and aorta abdominalis were detected by Western-blotting.Results After 8 weeks administration,the TNF-α in blood serum in Chinese medicine group was decreased(P < 0.05) and lower than that of the western medicine group(P < 0.01).Compared with the model group,the expression of NF-κB(P65) of liver and aorta abdominalis in Chinese medicine group was decreased(P < 0.01),and no significant difference was found in NF-κB(P65) of liver between model group and western medicine group(P >0.05),expression of NF-κB(P65) of aorta in western medicine was decreased(P <0.01);the indexes in Chinese medicine group were lower than that of the western medicine group(P < 0.01).Compared with model group,the expression of IκB protein in liver of the Chinese medicine group was increased(P <0.05),and no significant difference was found between western medicine group and Chinese medicine group(P > 0.05).No significant difference was found in expression of IκB protein of aorta abdominalis among all the groups(P > 0.05).Conclusion "Jiangzhuo Huayu Mixture"can obviously suppress the liver and abdominal aortic NF-κB pathway activation in rats with type 2 diabetes and nonalcoholic fatty liver disease.

<正>慢性萎缩性胃炎(CAG)临床以上腹胀痛、纳少、嗳气、消瘦乏力为主要表现,是消化系统中常见病和难治病之一,属于中医"胃脘痛""痞满""嘈杂""腹胀""嗳气"等范畴[1]。目前临床上西医药治疗仍无特效疗法。中医治疗CAG有一定的优势,近年来亦取得了一些成果,现将中医药干预治疗CAG伴异型增生(Dys)的研究进展综述如下。

Objective:To observe the clinical therapeutic effect ofWangShi WeiWeiNing Decoctionon chronic atrophic gastritis(CAG) with intestinal metaplasia(IM) .Methods:80 subjects were randomly divided into two groups:treatment group in which 50 cases were treated withWangShi WeiWeiNing Decoctionand control group in which 50 cases were treated withWeiFuChun Tablet.A course of treatment was 3 months,totally 2 courses.Results:Tested by Ridit,it showed the treatment group was better than the matched controlled group in curative effect of symptom(P 0.05) ,elcctro-gastroscope examination(P 0.05) and pathological effect(P 0.05) .Conclusion:WangShi WeiWeiNing Decoctionis quite effective for chronic atrophic gastritis with intestinal metaplasia.

肝纤维化是各种慢性肝病演变为肝硬化的必经阶段,其在细胞外基质过度沉积的同时造成功能性肝细胞的相对减少,设法补充丢失的肝细胞已成为近年来研究的热点.