目的 基于数据挖掘技术分析白彦萍教授治疗白癜风的用药规律.方法 收集2010年4月至2020年9月中日友好医院白彦萍教授治疗白癜风的中药方剂,描述性分析中药的频次、分类、功效、四气、五味及归经,通过关联规则和聚类分析挖掘潜在药物组合,通过网络图实现数据可视化.结果 纳入研究的方剂535个,中药221味,在药性方面,以温性药为主,寒、平性药次之;在药味方面,以苦味药最多,甘、辛药味次之;在药物归经方面,人肝经药物出现频次最高.在中药分类上,则以补虚药应用最多.治疗最常用的药物为补骨脂.关联规则法分析得到41个白癜风常用药物组合;聚类分析得到2个潜在新处方.结论 研究得出的用药规律与白彦萍教授治疗白癜风以虚论治,攻补兼施为基础,兼以养血疏风,通窍袪白,调和阴阳的理论相符,效果显著.

Panax ginseng and Fructus mume (Renshen Wumei in Chinese, RW) are natural medicines with high nutritional and pharmacological value. They have been widely used together in China to treat gastrointestinal diseases, especially persistent diarrhea, but the potential mechanisms remain elusive. In this study, a diarrhea model was established in rats using a 30% aqueous extract of senna. The therapeutic effects of RW were evaluated by recording the prevalence of loose stools, the diarrhea index, and histopathological changes in colon tissue. The levels of mucins, tight junction (TJ) proteins, inflammatory cytokines, and phosphoinositide 3-kinase/Akt/nuclear factor-κB (PI3K/Akt/NF-κB) signaling pathway proteins were measured. Metagenomic sequencing was used to analyze the gut microbiota. Treatment with RW alleviated injury to the intestinal barrier in rats with diarrhea and also upregulated levels of Muc2 and TJ proteins, such as occludin, zonula occludens-1, and claudin-1. Administration of RW regulated the structure of the gut microbiota in diarrheal rats. Furthermore, RW suppressed levels of interleukin (IL), tumor necrosis factor (TNF)-α, IL-1, PI3K, Akt, and p-NF-κB p65 and also increased IL-4 levels. Our study indicates that P. ginseng and Fructus mume help improve the symptoms of diarrhea, possibly by alleviating the intestinal barrier injury, regulating intestinal flora composition, and inhibiting the PI3K/Akt/NF-κB signaling pathway.

目的:拟挖掘分析中药内服复方专利制剂治疗便秘的用药规律,为研发中药新方提供参考.方法:通过检索国家专利数据库中治疗便秘的内服中药复方,运用Excel表格建立数据库并对药物频数、性味归经进行统计,运用SPSS 26.0软件进行聚类分析、因子分析,IBM SPSS Modeler 18.0软件进行Apriori关联规则分析.结果:纳入治疗便秘的中药内服复方专利数据1156项、涉及中药1051味,得到核心药物:当归、火麻仁、白术、大黄、枳实、肉苁蓉、厚朴、黄芪、白芍;高频药物多归肺、肝、脾胃经,性味多为甘、寒,药物类别以补虚药、泻下药为主.核心对药有当归-黄芪、当归-白芍等,角药有当归-黄芪、白术;当归-肉苁蓉、白术等;并得到4组新的药物组合.结论:国家中药复方专利制剂治疗便秘有规律可循,多以益气养血、滋阴润燥、泻热通便等为治疗原则,得到的核心药物和药物组合有助于指导临床用药.

酸甘化阴法是中医学传统特色治则治法,吴鞠通所著《温病条辨》中酸甘化阴法理论的临床运用颇具特色,具有独特的代表性.吴氏创立三焦辨证,根据温病上、中、下三焦病邪初、中、后期阴伤程度不同,将顾护津液视为温病治疗第一要义,其使用贯穿温病治疗始终.吴氏以性味配伍理论为指导,选取生脉散、麦冬麻仁汤、人参乌梅汤等酸甘化阴分治上、中、下三焦病证,同时以灵活多样的酸甘化阴辛甘化阳、酸甘化阴酸苦泄热、酸甘化阴辛淡为阳等酸甘化阴复法,适应温病三焦实际存在的寒热虚实夹杂的复杂病机,灵活展现了酸甘化阴法及其复法的临床运用,具有极大的临床指导意义,值得深入探讨.

OBJECTIVE:To observe the effect of five-element music therapy of traditional Chinese medicine (TCM) on the clinical symptoms and the quality of life in the patients with suboptimal health status (SHS) of liver stagnation and spleen deficiency and explore the corresponding specificity changes in the temperature of acupoints when zangfu functions are of dysfunction and recovered to be balanced, separately. METHODS:Sixty patients with SHS of liver stagnation and spleen deficiency were randomized into an observation group and a control group, 30 cases in each one. In the control group, the conventional health education was provided. In the observation group, on the base of the therapeutic regimen as the control group, the patients received the five-element music therapy to pacify the liver qi and strengthen the spleen functions, once every two days, 30 min each time, 3 treatments a week. The course of treatment consisted of 4 weeks. Before and after treatment, the TCM syndrome score and the MOS 36-item short form healthy survey (SF-36) score were compared between the two groups and the clinical therapeutic effect was evaluated. Using infrared thermal imaging, the temperature at the acupoints of the affected organs (liver, spleen), the related organs (gallbladder, stomach) and the other non-related zangfu organs (pericardium, lung) was detected before and after treatment in the two groups. RESULTS:After treatment, the TCM syndrome scores were reduced when compared with those before treatment in the two groups (P<0.01, P<0.05); the reduction in the observation group was larger than that of the control group (P<0.01). The score of each domain for the SF-36 in the observation group and the score of role-emotional domain in the control group were all increased when compared with the scores before treatment (P<0.01, P<0.05); and the score of each domain for the SF-36 in the observation group was higher than that in the control group (P<0.01). The total effective rate was 66.7% (20/30) in the observation group, which was higher than 10.0% in the control group (3/30, P<0.05). In the observation group, the temperature of the yuan-primary point, the back-shu point and the front-mu point related to the liver, as well as those related to the gallbladder after treatment was reduced when compared with the temperature before treatment; and the changes were larger than those of the control group (P<0.01). The temperature of the yuan-primary point, the back-shu point and the front-mu point related to the spleen, as well as the back-shu point and the front-mu point related to the stomach in the observation group was increased when compared with the temperature before treatment (P<0.01); and the changes were larger than those of the control group (P<0.01). For the temperature of the non-specific points related to the liver and spleen, as well as the yuan-primary point, the back-shu point and the front-mu point related to the pericardium and the lung, there was no significant differences when compared with the temperature at the above-mentioned acupoints before and after treatment (P>0.05). CONCLUSION:TCM five-element music therapy associated with the conventional health education may effectively relieve the clinical symptoms and improve the quality of life in the patients with suboptimal health status of liver stagnation and sleep deficiency; and the therapeutic effect is better than the simple health education. The changes in the temperature of acupoints may reflect the functional regulation of the related zangfu organs in the body.

目的:研究加味人参乌梅汤对腹泻模型大鼠结肠组织中γ-氨基丁酸(GABA)能信号通路相关调控因子的影响,进一步揭示加味人参乌梅汤益气生津止泻的作用机制.方法:从48只SD幼龄大鼠中随机抽取12只作为正常组,其余大鼠以番泻叶泻下、劳倦力竭及饮食失宜等复合因素造模14 d.造模成功后,随机分为模型组、西药组及中药组,每组12只.正常组与模型组给予生理盐水灌胃(20 mL·kg-1),西药组给予妈咪爱灌胃(0.7g·kg-1),中药组给予加味人参乌梅汤灌胃(35g·kg-1),均1次/d,连续干预7d.每日观测记录大鼠一般情况、稀便率及腹泻指数.获取大鼠结肠标本,采用免疫组化法(IHC)检测大鼠结肠GABA蛋白积分吸光度表达;酶联免疫吸附测定法(ELISA)检测磷脂酰肌醇3-激酶(PI3K)、蛋白激酶B2(Akt2)、磷酸化(p-)Akt及白细胞介素-1β(IL-1β)的含量,实时荧光定量聚合酶链式反应(Real-time PCR)及蛋白免疫印迹法(Western blot)检测大鼠结肠PI3K、Akt2及γ-氨基丁酸A型受体β2亚基(GABRB2)mRNA和蛋白的表达水平.结果:与正常组比较,模型组大鼠一般情况明显变差,稀便率及腹泻指数差异无统计学意义,GABA蛋白表达明显升高(P＜0.05),PI3K、Akt2、p-Akt及IL-lβ表达含量明显升高(P＜0.05,P＜0.01),PI3K、Akt2、GABRB2 mRNA及蛋白表达均极显著升高(P＜0.01).与模型组比较,中药组、西药组大鼠一般情况明显好转,稀便率及腹泻指数显著下调(P＜0.01),中药组、西药组PI3K、Akt2、p-Akt及IL-1β含量均明显下调(P＜0.05),中药组PI3K、Akt2、GABRB2 mRNA均明显下调(P＜0.05,P＜0.01),GABA、PI3K及GABRB2蛋白表达明显下调(P＜0.05,P＜0.01);西药组PI3K及Akt2mRNA和PI3K蛋白表达均明显下降(P＜0.05).结论:加味人参乌梅汤能通过调节腹泻大鼠结肠GABA能信号通路,减少肠上皮细胞中Cl-向肠腔流动,改善腹泻模型大鼠结肠水液代谢失衡状态,进而发挥其益气生津止泻效应.

目的:观察加味人参乌梅汤治疗小儿气阴两虚证泄泻的临床疗效.方法:120例随机分为治疗组与对照组各60例.治疗组予以加味人参乌梅汤治疗,对照组予以思密达联合金双歧治疗.结果:显控率治疗组高于对照组(P＜0.05).两组症状均改善,精神、食欲、尿量、口渴、舌质、舌苔及缩短泄泻时间改善治疗组优于对照组(P＜0.05).结论:加味人参乌梅汤治疗小儿气阴两虚证泄泻临床疗效较好.

To investigate the effects of Xiaoning liquid on gut microbiota in mouse during asthma. A total of 60 mice were randomly and averagely assigned to healthy control group, control group, budesonide group, and Xiaoning liquid group. The later three groups were used to establish an Ovalbumin (OVA) asthma model. The intestinal bacterial communities were compared among groups using 16S rRNA gene amplification. Analyzing the structure of gut microbiota with OTU analysis, Shannon-Wiener, PCA, PCOA, etc. 16S rDNA high-throughput sequencing. The abundance and diversity of the gut microbiota in asthmatic mice increased, most obviously in the control group. The Bacteroidetes and Firmicutes levels increased in all asthmatic mice. The level of Bacteroides increased most obviously, making Bacteroides a useful marker of gut microbiota changes in asthmatic mice. The levels of Proteobacterium, Deferribacteraceae and Mucispirillum dropped significantly in the Xiaoning liquid group. Xiaoning liquid can reduce the species and numbers of pathogenic bacteria and restored the intestinal microecology of asthmatic mice. Xiaoning liquid has a positive effect on the function of gut microbiota.

Following the COVID-19 outbreak, psychological stress was particularly pronounced in the student population due to prolonged home isolation, online study, closed management, graduation, and employment pressures. The objective of this study is to identify the incidence of psychological stress reactions in student populations following a global outbreak and the associated influencing factors. Four English databases (Pubmed, Embase, Cochrane Library, Web of Science) and four Chinese biomedical databases (Chinese Biomedical Literature Database, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure, Wanfang) were searched in this study. We also retrieved other search engines manually. The search period was from the time of database creation to 10 March 2022. This study included cross-sectional studies related to psychological stress reactions in student populations during the COVID-19 epidemic. Three groups of researchers screened the retrieved studies and assessed the quality of the included studies using the Agency for Healthcare Research and Quality Cross-Sectional Study Quality Assessment Checklist. A random-effects model was used to analyze the prevalence of depression, anxiety, stress, and fear symptoms in the student population during the COVID-19 epidemic. Of the 146,330 records retrieved, we included 104 studies (n = 2,088,032). The quality of included studies was moderate. The prevalence of depressive symptoms in the student population during the epidemic was 32.0% (95% CI [28.0–37.0%]); anxiety symptoms was 28.0% (95% CI [24.0–32.0%]); stress symptoms was 31.0% (95% CI [23.0–39.0%]); and fear symptoms was 33.0% (95% CI [20.0–49.0%]). The prevalence differed by gender, epidemic stage, region, education stage, student major and assessment tool. The prevalence of psychological stress in the student population during the COVID-19 epidemic may be higher compared to the global prevalence of psychological stress. We need to alleviate psychological stress in the student population in a targeted manner to provide mental health services to safeguard the student population.

目的 观察哮喘补益膏加减联合三伏贴治疗儿童哮喘缓解期的临床疗效.方法 选择2017年8月至2018年6月四川省中医院就诊的哮喘缓解期患儿70例为研究对象,随机分为对照组34例和观察组36例.对照组采用吸入用布地奈德混悬液及口服孟鲁司特钠咀嚼片治疗,观察组采用口服哮喘补益膏加减及三伏贴治疗.疗程3个月.治疗结束后,从哮喘症状控制水平、肺功能、中医症状积分、中医证候疗效、安全性方面对比两种方案的临床疗效.结果 治疗结束后观察组脱落6例,对照组脱落4例.两组在哮喘症状控制水平和无喘息症状时间方面比较差异无统计学意义(P>0.05).在肺功能方面,两组治疗后最大呼气流速峰值均低于治疗前,差异有统计学意义(P<0.05),治疗后两组最大呼气流速峰值比较差异无统计学意义(P>0.05).观察组治疗后中医症状总积分低于对照组,差异有统计学意义(P<0.05).观察组治疗后反复感冒次数、自汗、纳差、大便异常中医症状积分低于对照组,差异有统计学意义(P<0.05).观察组总有效率为96.7％(29/30),显著高于对照组43.3％(13/30),差异有统计学意义(P<0.05).在哮喘补益膏联合三伏贴对儿童哮喘缓解期肺脾气虚证的治疗期间、治疗结束后患儿均无明显不良反应.结论 哮喘补益膏加减联合三伏贴治疗儿童哮喘缓解期的临床疗效效果好且用药安全.

In this paper, the theory of " Fear injury kidney " in traditional Chinese medicine is systematically reviewed, and it is found that long-term or excessive psychological changes of fear are likely to damage kidney qi and kidney essence. On this basis, the psychological studies of patients, medical staff and the public during the COVID-19 epidemic in China were analyzed, and fear psychology was found to be prevalent among all kinds of people. Modern researches on “Fear injury kidney" have also found that long-term or excessive fear could cause changes in the neuro-endocrine-immune system, which can induce diseases or susceptibility to some diseases. Therefore, during or after the prevalence of COVID-19, different groups of people may have emotional reactions such as stress and fear, which should be paid long-term attention, and the influence of fear on the body cannot be ignored. According to the change rule of psychological state under stress reaction, we should actively respond to and take psychological crisis intervention measures in time to reduce the harm of psychological stress to the body.

目的 挖掘整理名老中医胡天成教授治疗小儿脾胃病证的用药规律及诊治经验.方法 采集胡天成教授门诊治疗小儿脾胃病的病例,运用聚类、关联及Ward算法等数据挖掘方法,研究总结胡天成教授治疗小儿脾胃病证的用药规律.结果 筛选所得310首处方涉及中药115种,使用频次3 458次,均方用药11.15味次;提取了常用高频(核心)药物16味;通过聚类分析得到4大类核心用方;挖掘常见药对6对.结论 初步获取了胡天成教授辨治小儿脾胃病的用药规律.胡天成教授治疗小儿脾胃病讲求纳运相依,燥湿相济,力求恢复脾胃升清降浊之功;其选方精当,用药轻灵,小儿脾胃虚弱,慎用攻伐,亦不偏倚补益,且重视调畅气机,佐以调护,活用温清补泻药物,治验良多.

脾胃乃后天之本,脾胃功能正常与否对儿科疾病的防治有着重要的意义.胡天成教授在多年临床实践中感悟“转磨”与脾胃功能相似,并深入探究了“转磨说”与脾胃之间的关系.通过“转磨”中谷物过多,推磨费力;谷多水少,干涩难磨;水多谷少,磨物清稀;磨槽已浅或推磨无力,磨物不细等情况来解释小儿脾胃常见病发生的病因病机.详细阐述了伤食、厌食、腹胀、腹痛、呕吐、泄泻等不同病证的病因病机和诊治经验.

目的 研究中药复方哮宁口服液对哮喘模型小鼠血液代谢表型的影响,初步探讨哮宁口服液止咳平喘效应的作用机制.方法 将60只BALB/c小鼠随机分成空白组15只,造模组45只.造模组腹腔注射两次致敏后,随机均分为模型组、阳性组、中药组,每组15只.用1％OVA高频雾化吸入进行激发,每次激发哮喘前1h,模型组、空白组给予等容积生理盐水灌胃,中药组以哮宁口服灌胃,阳性组以普米克令舒雾化.治疗7天后,分析各组小鼠血清的代谢产物差异.结果 多元统计学方法分析结果显示,空白组、模型组、阳性组、中药组呈显著性分离,其中中药组的血清样本比模型组更靠近空白组.中药哮宁口服液中对血清中偏离的葡萄糖、3-磷酸甘油酸等物质具有明显的良性调节作用.结论 哮宁口服液对哮喘小鼠血清代谢物存在良性调节作用,其中葡萄糖、3-磷酸甘油可能为哮宁口服液治疗哮喘模型小鼠的关键代谢物.

In this paper, the theory of " Fear injury kidney " in traditional Chinese medicine is systematically reviewed, and it is found that long-term or excessive psychological changes of fear are likely to damage kidney qi and kidney essence. On this basis, the psychological studies of patients, medical staff and the public during the COVID-19 epidemic in China were analyzed, and fear psychology was found to be prevalent among all kinds of people. Modern researches on "Fear injury kidney" have also found that long-term or excessive fear could cause changes in the neuro-endocrine-immune system, which can induce diseases or susceptibility to some diseases. Therefore, during or after the prevalence of COVID-19, different groups of people may have emotional reactions such as stress and fear, which should be paid long-term attention, and the influence of fear on the body cannot be ignored. According to the change rule of psychological state under stress reaction, we should actively respond to and take psychological crisis intervention measures in time to reduce the harm of psychological stress to the body.

In this paper, the theory of " Fear injury kidney " in traditional Chinese medicine is systematically reviewed, and it is found that long-term or excessive psychological changes of fear are likely to damage kidney qi and kidney essence. On this basis, the psychological studies of patients, medical staff and the public during the COVID-19 epidemic in China were analyzed, and fear psychology was found to be prevalent among all kinds of people. Modern researches on "Fear injury kidney" have also found that long-term or excessive fear could cause changes in the neuro-endocrine-immune system, which can induce diseases or susceptibility to some diseases. Therefore, during or after the prevalence of COVID-19, different groups of people may have emotional reactions such as stress and fear, which should be paid long-term attention, and the influence of fear on the body cannot be ignored. According to the change rule of psychological state under stress reaction, we should actively respond to and take psychological crisis intervention measures in time to reduce the harm of psychological stress to the body.

目的:探讨加味人参乌梅汤及其拆方对腹泻模型大鼠差异基因表达的影响,从基因层面揭示加味人参乌梅汤酸甘化阴生津止泻作用的机制.方法:84只SD大鼠随机抽取12只为空白组,其余72只采用复合因素制作腹泻模型,造模成功后随机分为模型组、西药组、全方组、去甘味药组、去酸味药组及去辛味药组,每组12只.造模21d后开始干预,空白组及模型组给予0.9％氯化钠溶液,其余各组分别给予5％枯草杆菌二联活菌颗粒溶液,加味人参乌梅汤全方、去甘味药、去酸味药及去辛味药,1次/d,连续给药7d.取各组大鼠结肠标本,采用全基因芯片技术进行检测,比较各组与模型组受试大鼠的基因表达谱,筛选差异基因,采用生物信息学方法获得基因富集的GO功能及pathway,明确差异基因的相关功能,并对部分差异基因进行RT-PCR验证.结果:与模型组比较,空白组筛选差异基因34个,西药组16个,全方组51个,去甘味药组45个,去酸味药组145个,去辛味药组126个.挑选8条基因进行RT-PCR验证,各组表达趋势与芯片结果基本一致.结论:加味人参乌梅汤对腹泻模型大鼠结肠基因表达具有调控作用,其作用依赖于药物间酸甘化阴、性味合化的协同作用共同发挥生津止泻效应.

线粒体脑肌病伴高乳酸血症和卒中样发作(mitochondrial encephalomyopathy,lactic acidosis,and strokelike episode,MELAS)是一种母系遗传性脑肌病,以癫痫、偏头痛、高乳酸血症、呕吐及反复的卒中样发作为特征.它主要与DNA突变有关,可以引起线粒体蛋白合成缺陷,从而造成三磷酸腺苷(ATP)生成不足[1].笔者通过MRI动态追踪观察了2例MELAS患者卒中样发作区域代谢的变化情况,以促进对病变发展的病理生理学机制的了解。

Objective Using gradient-echo sampling of spin-echo (GESSE) sequence to study the change of oxygen extraction fraction (OEF) in patients with unilateral cerebral vessel stenosis and the relationship between OEF and cerebral blood flow (CBF). Methods Eight normal volunteers and 16 patients with unilateral cerebral vessel stenosis were enrolled in this study. Written informed consents were obtained from all subjects. Routine MRI, GESSE and arterial spin labeling (ASL) sequences were performed for all patients. Raw data from GESSE and VE-ASL sequences were transferred to PC to conduct postprocessing. To obtain quantitative OEF and CBF of the brain parenchyma, 6 ROIs were placed respectively in the anterior, middle and posterior part of both hemispheres. The relative CBF (rCBF) was defined as the ratio of CBF of ischemic hemisphere to that of contralateral hemisphere. T test was used for statistics. Results The mean value and normal range of OEF in the volunteers were 0. 318 ± 0. 023 and 0. 272-0. 364, respectively. In the 16 patients with unilateral cerebral vessel stenosis, 8 patients had ROIs with greater OEF in unilateral hemisphere than those in contralateral hemisphere. These cases presented multiple intracranial main arterial stenoses in digital subtraction angiography (DSA) or MR angiography (MRA) examination. The other 8 patients had normal OEF in all ROIs. And they only had single arterial stenosis in DSA or MRA. Set rCBF = 0. 50 as a dividing point, the mean OEF value was 0. 397 ±0. 010 in the patients with rCBF ＜ 0. 50. In the patients with rCBF ≥ 0. 5, the mean OEF value was 0. 325 ±0. 028. The difference between the two groups was statistically significant (t = - 8. 840, P = 0. 000).Conclusion Patients with chronic cerebral ischemia may present with various hemodynamic impairment.The more CBF decreases, the more OEF increases. Those with increased OEF tended to have more than one lesion in the major intracranial arteries.