Shenlian (SL) decoction is a herbal formula composed of Coptis and ginseng, of which berberine and ginsenoside are the main constituents. Even though SL decoction is widely used in treating diabetes in China, the mechanism of its antidiabetes function still needs further study. Gut microbiota disorder is one of the important factors that cause diabetes. To explore the effect of SL decoction on intestinal microbiota, gut microbiota of mice was analyzed by sequencing the gut bacterial 16S rRNA V3+V4 region and metagenomics. In this study, results demonstrated that SL decoction had a better hypoglycemic effect and β cell protection effect than either ginseng or Coptis chinensis. Alpha diversity analysis showed that all interventions with ginseng, Coptis, and SL decoction could reverse the increased diversity and richness of gut microbiota in db/db mice. PCoA analysis showed oral SL decoction significantly alters gut microbiota composition in db/db mice. 395 OTUs showed significant differences after SL treatment, of which 37 OTUs enriched by SL decoction showed a significant negative correlation with FBG, and 204 OTUs decreased by SL decoction showed a significant positive correlation with FBG. Results of KEGG analysis and metagenomic sequencing showed that SL decoction could reduce the Prevotellaceae, Rikenellaceae, and Helicobacteraceae, which were related to lipopolysaccharide biosynthesis, riboflavin metabolism, and peroxisome, respectively. It could also upregulate the abundance of Bacteroidaceae, which contributed to the metabolism of starch and sucrose as well as pentose-glucuronate interconversions. In the species level, SL decoction significantly upregulates the relative abundance of Bacteroides_acidifaciens which showed a significant negative correlation with FBG and was reported to be a potential agent for modulating metabolic disorders such as diabetes and obesity. In conclusion, SL decoction was effective in hypoglycemia and its mechanism may be related to regulating gut microbiota via upregulating Bacteroides_acidifaciens.

[目的]应用数据挖掘及网络药理学技术,对赵进喜教授治疗2型糖尿病(T2DM)药物的核心配伍、潜在靶点、作用机制进行探讨和研究.[方法]收集325例赵进喜教授诊治2型糖尿病的医案,应用关联规则算法筛选核心药物配伍.使用中药系统药理学数据库与分析平台(TCMSP)筛选核心处方的活性成分,应用STITCH、TTD、DrugBank、GAD和DisGeNET数据库,筛选药物及T2DM相关靶点.采用Cytoscape中的MCODE算法识别功能模块,应用ClueGO插件进行功能分析.[结果]通过关联分析得到黄芩、葛根、丹参、仙鹤草、荔枝核、地骨皮等6味药物的核心处方.通过网络药理学分析,得到58个药物-疾病相关靶点,识别出5个功能模块.对重要靶点进行KEGG通路分析,得到18条相关通路.[结论]核心处方治疗T2DM是多成分、多靶点、多环节、协同作用的过程,其作用靶点可能为SLC2A2、SLC2A4、TNF,PPARA和PPARG,并可以通过调节脂肪因子信号通路和PPAR信号通路发挥作用.

目的 分析《医方类聚·消渴门》中方剂的组方规律.方法 通过对《医方类聚·消渴门》中所有方剂进行整理,利用频次统计与Apriori算法对数据进行频次与关联规则分析.结果共收录符合标准498首方剂,涉及279种药物.清热药与补虚药为方药的基本组成部分,其中天花粉、麦冬、黄连、人参应用频次位居前四位,占总药物用药频次近20％;通过对高频药物进行关联规则分析,按照最低条件支持度5％,最小规则置信度30％,共得出关联规则12项,涉及麦冬、天花粉、人参、黄连、炙甘草、知母、黄芪、茯苓8种药物.结论 可见明代以前医家对消渴病的治疗以清热药、益气药、养阴药为主.常用清热、益气、养阴治法,重视消渴病火热、气虚、阴虚证候.

中医内科治疗学理论处处闪耀着哲学的智慧,具体体现在辨证论治、扶正祛邪、治病求本、三因制宜等多个层次,多个角度.对疾病的认知方面,强调透过外在的临床表现抓住疾病的内在本质.学习中医应当重视传统文化,尤其是哲学修养,如此才能造就仁心仁术,成为德才兼备的大医.

中医"腹诊"历史悠久,是中医四诊的重要内容之一,临床应用前景广阔.早在张仲景《伤寒杂病论》就有系统论述.医者通过腹诊所得到的客观体征与患者所描述的主观感觉可统称为腹证,是《伤寒论》与《金匮要略》临床选方用药的重要依据.临床上,通过辨识腹证,构建方证与腹证之间的对应关系,则可以指导临床经方应用,以提高临床疗效.