Objective: To characterize the traditional Chinese medicine（TCM） syndromes of mild corona virus disease 2019（COVID-19） cases infected with Omicron variant for better prevention and treatment of COVID-19 infection.Methods A total of 188 mild covid-19 patients infected with Omicron variant infection in the northern section of Ruijin Hospital affiliated to Shanghai Jiao Tong university school of medicine and Jiahe Xinyuan shelter from March 24 through April 24, 2022 were enrolled, the tongue manifestation features, basic information, TCM syndrome and the time of negative turning were collected by the questionnaires. Results The mild cases were generally in good health status, with less than20% patients having other major diseases. There was statistical significance in the median time of turning negative among different tongue shapes. The tongue coating indicated that the syndrome of cold-dampness stagnating, of evil-heat accumulating and dampness blocking in the lung pattern accounted for 38.8%, 34.5% and 23.4% of all cases. The syndrome of cold-dampness stagnating in the lung pattern and the syndrome of evil-heat accumulating in the lung pattern were found in majority of patient investigated. It took similar time for patients with different syndrome types to become COVID-19 virus negative（P＞0.05）. Conclusions The cold dampness was most common among mild COVID-19 patients with Omicron infection, who predominately presented syndrome of cold-dampness stagnating in the lung pattern.

[目的]评价槐耳颗粒治疗乳腺癌的疗效及安全性.[方法]检索2000年1月至2021年8月国内外数据库公开发表的治疗乳腺癌的临床随机对照试验(randomized controlled trial,RCT),根据考克兰手册偏倚风险评估工具进行文献质量评价,提取相关数据资料,应用RevMan 5.3对效应指标的相对危险度(relative risk,RR)或优势比(odds ratio,OR)进行Meta分析,并列出其95％置信区间(confidence interval,CI).[结果]最终纳入23个RCT研究,共包含2183例患者,其中治疗组1075例、对照组1108例.Meta分析结果显示,槐耳颗粒能提高患者的治疗有效率[OR=2.07,95％CI(1.37,3.13),P<0.05)];提高患者3、5年总生存率,分别为[OR=2.043,95％CI(1.16,3.55),P=0.01)]、[OR=1.74,95％CI(1.18,2.57),P=0.005)];降低2、3年的复发转移率,分别为[OR=0.28,95％CI(0.16,0.48),P<0.00001)]、[OR=0.21,95％CI(0.13,0.34),P<0.00001)],但对5年的复发转移率没有显著影响(P=0.24);改善患者的各项免疫指标,对CD3+、CD4+、CD8+、CD4+/CD8+、NK值均有显著影响(P<0.05);减少不良反应发生率,主要包括消化道不良反应[OR=0.69,95％CI(0.51,0.94),P=0.02)]及血液毒性[OR=0.46,95％CI(0.26,0.82),P=0.008)].[结论]槐耳颗粒对于乳腺癌的疗效及安全性优于单用西医治疗,可显著提高治疗有效率及总生存率,降低复发转移率及不良反应,并有助于改善免疫系统功能.

目的 观察小金丸联合消肿散结汤治疗痰瘀互结证非哺乳期乳腺炎患者的临床疗效.方法 选取2018年1月—2019年12月上海交通大学医学院附属瑞金医院收治的痰瘀互结证非哺乳期乳腺炎患者100例,按随机数字表法分为对照组和治疗组,各50例.对照组给予常规治疗,治疗组在对照组的治疗基础上给予小金丸联合消肿散结汤治疗,两组患者均治疗1个月.观察比较两组患者治疗前后临床症状变化、临床疗效、血清中炎性因子、免疫因子水平及不良反应发生情况.结果 经过治疗,治疗组总有效率92.00％明显高于对照组78.00％,差异有统计学意义(P<0.05).与对照组治疗后比较,治疗组乳房疼痛、红肿、肿块评分均明显降低,差异有统计学意义(P<0.05);治疗组治疗后白细胞介素-6、白细胞介素-10、肿瘤坏死因子-α、C-反应蛋白水平均明显降低,免疫球蛋白G、免疫球蛋白M水平均明显降低,差异均有统计学意义(P<0.05),免疫球蛋白A水平虽有降低,但差异无统计学意义(P>0.05).治疗组不良反应发生率2.00％明显低于对照组8.00％,差异有统计学意义(P<0.05).结论 小金丸联合消肿散结汤可有效改善非哺乳期乳腺炎患者的临床症状,降低炎性因子水平,提高免疫功能,提高临床治疗效果,值得临床推广.

目的 探讨不同证型高血压肾病中药组方的用药规律.方法 随机抽取2年内肾病科门诊高血压中药处方共1209张,复杂网络结合BK算法挖掘其核心处方.结果 发现4种主要证型(脾肾两虚、脾虚血瘀、肝肾阴虚、脾虚湿热),其核心处方中各有10种药味.结论 数据挖掘可用于分析中药组方规律,本研究所得核心处方为高血压肾病的治疗提供了参考.

目的 观察舒肝滋肾汤联合米诺环素治疗女性迟发型痤疮的临床疗效及其对血清游离睾酮(FT)、性激素结合球蛋白(SHBG)的影响.方法 60例女性迟发型痤疮患者,随机分为研究组与对照组,各30例.研究组,采用舒肝滋肾汤联合盐酸米诺环素胶囊口服治疗;对照组,单用盐酸米诺环素胶囊口服治疗.治疗时间均为8周.观察对比2组治疗前后的临床疗效、皮损评分、中医证候积分及血清FT、SHBG水平.结果 研究组治疗后皮损评分、中医证候积分、血清FT水平、SHBG水平均优于治疗前(P<0.05);对照组,治疗后患者的皮损评分、中医证候积分优于治疗前(P<0.05),血清FT水平、SHBG水平与治疗前比较差异不明显(P>0.05);2组的皮损积分、中医证候积分、血清FT水平、SHBG水平治疗前与治疗后的差值比较,研究组优于对照组(P<0.05).结论 舒肝滋肾汤联合盐酸米诺环素对女性迟发型痤疮临床疗效显著,对患者的皮损积分、中医证候积分的改善效果均优于单用盐酸米诺环素治疗;舒肝滋肾汤女可能对女性迟发型痤疮患者的雄激素水平具有调节作用.

Objective To evaluate an effective and feasible quantitative evaluation table of traditional Chinese medicine (TCM) syndrome differentiation, and to observe the effect of combination of TCM syndrome differentiation and standard bundle therapy in patients with septic shock. Methods A prospective randomized controlled trial was conducted. The septic shock patients with acute deficiency syndrome admitted to department of critical care medicine of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine from January 1st, 2016 to December 31st, 2017 were enrolled. The patients were randomly divided into control group and Shenfu group. The patients in both groups received early application of standardized bundle therapy; those in Shenfu group received 60 mL Shenfu injection infusion in addition for 7 days. The TCM syndrome score was evaluated by classification and scoring method of TCM symptoms. The circulation and tissue perfusion, severity of disease, organ function, inflammation response, adjuvant treatment and 28-day mortality were compared between the two groups. Results A total of 50 patients with septic shock were enrolled in the analysis, 25 in control group and 25 in Shenfu group. The markedly effective rate of TCM symptoms score in Shenfu group was significantly higher than that in control group [60.0% (15/25) vs. 16.0% (4/25), P < 0.01]. There was no significant difference in all parameters before treatment between the two groups. After treatment, the observation indexes of both groups were improved. Compared with control group, the mean arterial pressure (MAP) in Shenfu group increased more significantly [mmHg (1 mmHg = 0.133 kPa): 13.0 (2.5, 28.5) vs. 6.0 (0, 13.5)], the lactate (Lac) and procalcitonin (PCT) decreased more significantly [Lac (mmol/L): 0.8 (0.1, 3.7) vs. 0.5 (-0.6, 1.7), PCT (μg/L): 2.0 (0.7, 32.3) vs. 0 (-1.8, 3.8)], activated partial thromboplastin time (APTT) was shortened more significantly [s: 8.5 (0, 12.9) vs. 0 (-7.2, 10.0)], and interleukins (IL-2 receptor and IL-6) levels decreased more significantly [IL-2 receptor (ng/L):1 031.0 (533.0, 1 840.0) vs. 525.5 (186.0, 1 166.8), IL-6 (ng/L): 153.1 (21.4, 406.8) vs. 35.1 (16.3, 110.1)] with significant differences (all P < 0.05). There was no significant difference in the use time of vasoactive drugs, duration of mechanical ventilation, severity of the disease or 28-day mortality between the two groups. However, the use time of vasoactive drugs in Shenfu group was shorter than that in control group (days: 5.48±4.81 vs. 8.28±7.83), and the 28-day mortality was decreased [8.0% (2/25) vs. 20.0% (5/25)]. Conclusions TCM syndrome score is helpful to evaluate the effect of TCM syndrome differentiation and treatment, and it is effective and feasible in clinical application. Septic shock patients treated with TCM syndrome differentiation and treatment combined with standard bundle therapy were significantly improved in circulation, tissue perfusion, coagulation function and inflammation reaction.

Objective:This study was to explore the impact on survival by Fuzhong Xiaoji (FZXJ) staging therapy in rectal cancer patients.Methods:By the method of retrospective cohort and selected into the group of 149 cases of rectal cancer patients.97 patients were collected in the treatment group (treated with FZXJ staging therapy)and 52 patients were collected in the control group (treated without FZXJ staging therapy).Overall survival,median overall survival and disease free survival,progress free survival and the starting time and lasting time of using Chinese medicine were all observed.The cases were also analysised by multiple factor COX regression method.Results:By COX regression analysis,the factor of influence are the tumor stage and the time of taking Chinese medicine.Protection factor was taking Chinese medicine time,risk factor was the tumor stage.The difference was statistically significant (P＜0.01);Compared two groups of patients survival time,the OS of the control group was (67.0 ± 0) months,The OS of the treatment group was (111.61 ± 6.39) months,the difference was statistically significant (P＜0.01);DFS in the two group in the stage of Ⅱ,Ⅲ was statistically significant different (P＜0.01).PFS in the two group in the stage of Ⅳ was no statistically significant different (P＞0.05).OS had statistically significant difference both in the group by not taking Chinese medicine,taking Chinese medicine after operations,taking Chinese medicine after chemotherapy and taking Chinese medicine after recurrence and metastasis.Conclusion:Overall survival of the patients in rectal cancer can be prolonged by using FZXJ staging therapy.The rate of recurrence and metastasis in stages Ⅱ-Ⅲ can be reduced,PFS in stage Ⅳ patients can be extended,OS can be prolonged both after operations and chemotherapy by also using FZXJ staging therapy.Protection factor is taking Chinese medicine time,risk factor is the tumor stage.

目的:观察扶正治癌中药组方联合表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)靶向药物治疗晚期非小细胞肺癌的疗效及安全性.方法:采用双盲、随机、安慰剂对照的前瞻性临床研究方法,将60例伴有EGFR基因突变的晚期非小细胞肺腺癌一线或二线治疗患者按照1:1比例随机分为2组:试验组(扶正治癌组方辨证中药+靶向治疗组)和对照组(安慰剂+靶向治疗组).研究主要疗效指标为:无进展生存时间(PFS);次要疗效指标:总生存时间(0S);客观缓解率(0RR);肺癌症状量表(LSCC量表);中医症候评分;不良反应和安全性评估;组织或血液标本的EGRF基因外显子(E19～21)、Kras、Braf、PI3KCA、ALK基因突变和ROS1基因重排检测.结果:实际50例患者进入意向性分析(试验组28例,对照组22例).试验组辨证分型气虚型患者中医临床证候改善显著优于对照组(P=0.001).LSCC量表分析试验组症状改善显著优于对照组(P=0.001).13例疾病进展患者进行基因突变动态监测,试验组未发现p.T790M耐药突变,对照组发现3例p.T790M突变率为42.86％.两组总体治疗相关药物不良反应发生率无显著差异.试验组严重药物不良反应发生率为6.67％,对照组为16.67％.结论:扶正治癌中药组方有延长TKI靶向治疗的晚期非小细胞肺腺癌患者PFS和OS的趋势,能够显著改善肺癌症状,提高生活质量,同时能够改善气虚型患者临床症候,以及减少严重不良反应事件发生.

Objective To explore the efficacy ofTiaogan-Bushen-Xiaoji recipe (TGBSXJ Recipe) on overall survival and progression free survival (PFS) in patients with advanced breast cancer.Methods A total of 105 patients with advanced breast cancer, who received the first-line treatment, were divided into two groups, 56 cases in the control group and 49 in the experimental group. The control group received standard therapy according to guidelines, including chemotherapy, targeted therapy, endocrine therapy and treatment of bisphosphonates.The experimental group received the treatment of TGBSXJ Recipe besides the standard therapy. The overall survival (OS), progression-free survival (PFS) and Karnofsky (KPS) of the patients in two groups were observed and compared. The treatment ended with the sighs of the observation ending, the second progress for the disease or death.Results The overall survival of the experimental group was significantly higher than that of the control group [OS: 58.2(50.7-65.8)/monthsvs. 43.8(30.6-51.6)/months,P=0.040]. The PFS of the experimental group was significantly higher than the control group [PFS: 30.7(23.8-37.7)/monthsvs. 15.2(11.3-19.1)/months,P=0.001]. The KPS of the experimental group was significantly higher than the control group (88.6 ± 10.0vs. 80.5 ± 19.0,t=2.654). The PFS of the triple negative breast cancer (TNBC) in the experimental group was significantly higher than control group [(25.1(12.1-38.0)/monthsvs. 9.9(4.7-15.0)/months,P=0.038].Conclusions The TGBSXJ recipe could extend the OS and PFS and improve the life quality of the patients with advanced breast cancer. In this study, no severe adverse effects had been found in the experimental group.

Objective:To study the effect of Qinhuang mixture on the life quality and immune function of patients with non-Hodgkin lymphoma with syndrome of intermingled deficiency and excess.Method:By the Real World Study method,patients were divided into observation group and control group according to their own willing.All patients received routine chemotherapy and followed up at Ruijin Hospital during January 2015 and December2016.Patients in observation group took Qinhuang mixture during routine chemotherapy and follow-up period,while patients in control group did not take Qinhuang mixture.The observation period was 6 months.Kanofsky score (KPS),quality of life score (EORTC-QLQ-C30),peripheral blood cell immunity,humoral immunity and immune-related cytokine levels were compared between two groups after all patients reached the end of the study.Result:A total of 222 valid cases were collected.Specifically,74 cases were in the observation group,including 20 cases in chemotherapy and 54 cases in the follow-up period;and 148 cases were in control group,including 87 cases in the chemotherapy period and 61 cases in the follow-up period.The improvement rate of KPS score in observation group was significantly superior to that in control group (P ＜ 0.05).Scores of fatigue,constipation and diarrhea in EORTC-QLQ-C30 in observation group were lower than those in control group (P ＜ 0.05).Physical,emotional function and overall health status scores of observation group were higher than those of the control group (P ＜ 0.05).Levels of CD3 +,CD4 +,CD4 +/CD8 + ratio,immunoglobulin G (IgG),immunoglobulin M (IgM),interleukin (IL)-2 and alexin C3 in peripheral blood of the observation group were higher than those in control group (P ＜ 0.05),whereas IL-6,IL-8 and IL-10 were lower than those in control group (P ＜ 0.05).Conclusion:Qinhuang mixture can effectively improve the quality of life and immune function of patients with non-Hodgkin lymphoma with syndrome of intermingled deficiency and excess.

Autophagy is an evolutionary conserved method in cell self-degradation and metabolism progress.Generally speaking,autophagy contains the steps of phagophore devouring none-essential or damaged organelles,lysosome-mediated degradation and reusing of contents in autophagosome.Autophagy plays a significant role in cellular biosynthesis,nutritional and metabolic balance,stress responses and cell survival.Regulating autophagy can induce multiple cascade reactions,which could be a kind of promising tumor therapy.Different flavonoids could induce different roles of autophagy,when they act on different tumor cell lines.Flavonoids can induce non-apoptosis or non-typical apoptosis related inhibitory autophagy to suppress tumor cells proliferation directly,and induce apoptosis or other lethal pathways after induction of autophagy to indirectly inhibit tumor cells proliferation.Flavonoids can also suppress protective autophagy to strengthen other lethal pathways,but sometimes induce protective autophagy which would weaken the cytotoxic effect.This paper reviews the advances in studies on flavonoids regulating autophagy in the last 10 years,in order to provide reference for the further study on the regulation of autophagy by traditional Chinese Medicine.

Objective It is to investigate the curative effect of Jianpi keaining combined with Sijunzi Decoction in the treatment of spleen-deficiency type stomach cancer and its influence on the immune function of organism.Methods 80 cases of spleen-deficiency type stomach cancer patients were randomly divided into 2 groups, 40 cases in the the control group were treated with Jianpi keaining based on the treatment of chemotherapy and symptomatic treatment, and the other 40 cases in the observation group were treated with Sijunzi Decoction based on the treatment of the control group.The TCM syndrome integral, the levels of serum tumor markers CEA, immune function indexes of IgG, IgA, IgM, and C3, C4 were observed before and after treatment in the two groups, and the incidence of adverse reactions of two groups were recorded.Results After 12 weeks of treatment, the scores of epigastric pain, eat less anorexia, lassitude, abdominal distention after eating, abnormal stools, nausea and vomiting, and abdominal pain in the two groups were significantly decreased (all P<0.05), and the scores of the observation group were significantly lower than those of the control group (all P<0.05).After 12 weeks of treatment, the level of CEA in the two groups were significantly decreased (all P<0.05), and the level of the observation group was significantly lower than that of the control group (P<0.05);after 12 weeks of treatment, the levels of IgG, IgA, IgM were significantly decreased and the levels of C3 and C4 were significantly increased than before treatment (all P<0.05), there were significant difference between the two groups (all P<0.05).The chemotherapy completion rate of the observation group was significantly higher than that of control group after 12 weeks of treatment (P<0.05);there was no significant difference in the adverse effects between the two groups (P>0.05).Conclusion Jianpi Keaining combined with Sijunzi Decoction in the treatment of spleen-deficiency type stomach cancer has good curative effect and can significantly improve clinical symptoms, enhance the immune function of the body and the chemotherapy tolerance of patients, and with good safety.

目的 观察扶中消积方对胃癌术后化疗患者免疫功能的影响.方法 将胃癌根治术后化疗患者60例随机分为观察组和对照组各30例.对照组给予CapeOX方案化疗,21 d为1个周期.观察组则在对照组化疗基础上口服扶中消积方,共观察6个周期.观察两组患者治疗前后T细胞亚群和NK细胞数量、中性粒细胞计数、PS评分、免疫相关临床积分及安全性指标的变化.结果 对照组化疗后外周血CD3+、CD4+、CD4+/CD8+细胞比值及NK细胞数量较化疗前显著下降(P＜0.05),而CD8+细胞水平显著升高(P＜0.05);观察组化疗后上述各项指标与化疗前相比,无统计学差异(P＞0.05);对照组化疗后中性粒细胞计数低于同期观察组(P＜0.05);观察组治疗后PS评分较治疗前明显降低(P＜0.05),与对照组治疗后比较,差异有统计学意义(P＜0.05);对照组化疗后免疫功能相关症状乏力、易感冒、发热均有不同程度加重(P＜0.05),而观察组无明显变化(P＞0.05).结论 扶中消积方对胃癌术后化疗患者的机体免疫功能有正向调节作用,临床疗效明确,安全性良好,在促进肿瘤整体治疗方面有优势.

Objective:To observe the clinical curative effect of Hand Foot Syndrome patients with colorectal cancer induced by Capecitabine after using Wuwei Xuanbi Decoction. Methods:90 cases were randomly divided into control groups(30 cases), high dose group(30 cases), low dose group(30 cases). Control group: the Capecitabine 1 250 mg/(m2·d), continuous taken for 2 weeks, stop 1 week for 1 cycles. High dose group: Chemotherapy combined with Wuwei Xuanbi Decoction(Chuanwu Caowu Tougucao Honghua Jixuecao)each 30 g, fried 600 mL, hand and foot were soaked by heating. Low dose group: Chemotherapy combined with the concentration of 10% high dose group,hand and foot were soaked by heating. A total of 6 cycles were observed. Results:Clinical symptoms integral and hand foot pain score significantly improved; the incidence of hand foot syndrome reduced, life quality improved regardless of the high dose group or low dose group used Wuwei Xuanbi Decoction combined with chemotherapy.Curative effect of high dose group was significantly better than that of the low dose group(P0.05). Conclusions:The research manifests Wuwei Xuanbi Decoction has definite therapeutic effect on Hand Foot Syndrome in colorectal cancer patients caused by treatment of Capecitabine,which has the advantage to promote overall treatment of cancer, worthy of promotion.

[目的]探讨中医扶正通利(FZTL)法对胰腺癌患者生存状况的影响.[方法]采用回顾性队列研究方法,选取符合入组标准胰腺癌患者46例,其中对照组26例,采用规范化疗、放疗、营养支持等西医方法综合治疗.治疗组20例,在西医治疗的基础上采用中医FZTL法治疗,随访观察2组病例生存率,中位生存期,Kaplan-Meier生存曲线,并进行Cox回归多影响因子分析.[结果]随访率为98％,随访时间2～52个月,中位随访时间8个月;治疗组6、12、18、24、36个月累计相对生存率分别为69％、43％、43％、43％、29％,而对照组分别为44％、20％、15％、8％、8％,2组整体比较,差异有统计学意义(P＜0.05);总生存期治疗组为14个月,对照组为7个月,2组比较,差异有统计学意义(P＜0.05);Cox回归分析结果显示:中医FZTL法与肿瘤分期是影响因子,其中前者是保护因子,而后者是危险因子,FZTL法降低死亡风险61％.[结论]中医FZTL法可以延长未经手术治疗的胰腺癌患者生存期、提高生存率、降低患者死亡风险.具有较好的临床疗效和科研价值.

目的探求中药小复方制剂益气养血升血小板方对肠癌化疗所致血小板减少的治疗作用。方法临床选择有明确病理学诊断为肠癌的患者40例,随机分为2组。治疗组20例:以草酸铂、氟尿嘧啶和亚叶酸钙为基础的化疗方案治疗,在化疗的间歇期给予益气养血升血小板方;对照组20例:以草酸铂、氟尿嘧啶和亚叶酸钙为基础的化疗方案治疗。6个疗程及全疗程结束后1个月复查。观察患者的血小板计数、百杰依使用量、中医症候积分、生存质量评分、以及肝肾功能等安全性指标。结果益气养血升血小板方能延迟大肠癌患者因使用以草酸铂联合氟尿嘧啶和亚叶酸钙为基础的化疗方案所致血小板减少的出现时间;降低血小板减少的程度;促进化疗后血小板的恢复;减少百杰依使用剂量;改善该化疗方案导致血小板减少,促进化疗后血小板的恢复;改善中医临床症候,尤以对乏力、头晕的改善作用较为明显;且安全低毒。结论益气养血升血小板方是治疗肠癌患者化疗所致血小板减少的有效、安全、低毒中药小复方制剂。

目的:观察左归丸治疗肾阴虚型慢性疲劳综合症的临床疗效。方法:临床上选择肾阴虚型慢性疲劳综合症患者35例。口服左归丸4周。观察治疗前后患者的肾阴虚症状及体征积分。结果:左归丸可以明显改善慢性疲劳综合症患者肾阴虚症状及体征,治疗前后比较,差异有显著性(P<0.01),结果有统计学意义;疗效评定:显效率42.9%,总有效率88.6%。对缓解各个症状、体征的疗效,依次以腰膝酸软、五心烦热、眩晕、口燥咽干为佳,治疗前后比较,(P<0.01);其次为潮热、盗汗、耳鸣、遗精、月经不调、牙齿松动等症状,治疗前后比较,(P<0.05)。结论:左归丸是治疗肾阴虚型慢性疲劳综合症的有效中药制剂。