Objective: To study the effect of Shufeng Xingbi Therapy (SFXBT) on Th1/Th2 immune balance and intestinal flora in allergic rhinitis (AR) rats. Methods: 32 SD rats were randomly divided into control group, OVA group, antibiotic + SFXBT group and acetic acid + SFXBT group. Evaluate the AR behavioral score, observe the pathological changes of nasal mucosa with H&E, detect the composition and content of colonic contents with 16S rDNA, the levels of serum IgE, IL-4 and short-chain fatty acid (SCFAs) with ELISA, the mRNA expressions of STAT5, STAT6 and GATA3 in nasal mucosa with RT-qPCR, and the protein expressions of IL-4, STAT5, STAT6 and GATA3 in nasal mucosa with Western Blot. Results: Compared with the OVA group, the AR behavioral score in the antibiotic + SFXBT group and acetic acid + SFXBT group decreased (P < 0.01), and the pathological changes of nasal mucosa were alleviated. At the door level, the relative abundance of Firmicutes in feces increased significantly, while the relative abundance of Bacteroidetes decreased significantly. At the genus level, The relative abundance of fecal Lactobacillus, Romboutsia, Allobaculum and Dubosiella increased significantly, the levels of serum IgE and IL-4 decreased (P < 0.05), the content of SCFAs increased significantly (P < 0.05), and the expression levels of STAT5, STAT6 and GATA3 mRNA and protein in nasal mucosa decreased significantly (P < 0.05). Conclusion: Shufeng Xingbi Therapy can significantly improve the inflammatory symptoms of nasal mucosa in AR rats, and its mechanism may be closely related to regulating Th1/Th2 immune balance and intestinal flora. ### Competing Interest Statement The authors have declared no competing interest.

Objective To explore the effect of Xingbi gel nasal drops on rats with allergic rhinitis(AR)based on the nasal mucosa-hippocampus neuroimmune mechanism.Methods A total of 40 SPF SD rats at postnatal day 21(PND21)were randomly divided into normal group,model group,traditional Chinese medicine group and western medicine group,with 10 cases in each group.Except for the normal group,the other three groups were sensitized by ovalbumin(OVA)to establish AR animal models.Af-ter the model was successfully established,the normal group and model group were both given normal saline nasal drops(50 μL once),the traditional Chinese medicine group was given Xingbi gel nasal drops(50 μL once),and the western medicine group was given budesonide nasal spray(20 μL once),twice a day,and the interventions were continued for 12 days.The AR rat behavioral scoring criteria was used to evaluate rhinitis behavior of rats;Morris water maze test was used to evaluate learning and memory function of rats;enzyme-linked immunosorbent assay(ELISA)was used to detect serum levels of immunoglobulin E(IgE)and transforming growth factor-β1(TGF-β1);hematoxylin-eosin(HE)staining was used to observe pathological changes of nasal mucosa and eosinophil(EOS)count;immunohistochemistry method was used to detect expression levels of non-receptor tyrosine kinases Fyn,substance P(SP),vasoactive intestinal peptide(VIP)and neuropeptide Y(NPY)in the hippocampus;and real-time polymerase chain reaction(RT-PCR)was used to detect mRNA transcription levels of Fyn,SP,VIP and NPY in the hippocampus.Results(1)Behavioral scores of rhinitis:compared with the normal group,behavioral scores of rhinitis were significantly higher in the model group,the traditional Chinese medicine group and the western medicine group before treatment(P<0.05).Compared with the model group,behavioral scores of rhinitis were significantly lower in the traditional Chinese medicine group and the western medicine group after treatment(P<0.05).Compared with that before treatment,behavioral scores of rhinitis were significantly lower in the traditional Chinese medicine group and the model group after treatment(P<0.05).(2)Learning and memory function:compared with the normal group,the model group showed significantly longer platform latency and the total distance of swimming,as well as lower platform crossing frequency and shorter stay time in the target quadrant(P<0.05);compared with the model group,both the traditional Chinese medicine group and the western medicine group showed significantly shorter platform latency and total distance of swimming,and more times of platform crossing and longer stay in the target quadrant(P<0.05).(3)IgE and TGF-β1 contents in serum:compared with the normal group,IgE and TGF-β1 contents in serum were significantly higher in the model group(P<0.05).Compared with the model group,IgE and TGF-β1 contents in serum in both the traditional Chinese medicine group and the western medicine group were significantly lower(P<0.05).(4)Pathological changes of nasal mucosa and EOS counts:the nasal mucosa in the model group was edematous and the epithelial cells were arranged in disorder;the nasal mucosa edema were alleviated signifi-cantly in the traditional Chinese medicine group and the western medicine group after treatment,and the epithelial cell structure was more intact.Compared with the normal group,the nasal mucosal EOS counts all significantly increased in the model group,the traditional Chinese medicine group and the western medicine group after treatment(P<0.05);compared with the model group,the nasal mucosa EOS counts decreased significantly in the traditional Chinese medicine group and the western medicine group after treatment(P<0.05).(5)mRNA transcription levels and protein expression levels of Fyn,SP,VIP and NPY in hippocampus:com-pared with the normal group,mRNA transcription levels of Fyn,SP and VIP and average OD values of Fyn,SP and VIP increased significantly in the hippocampus in the model group(P<0.05),while mRNA transcription levels of NPY and average OD values of NPY decreased significantly(P<0.05).Compared with the model group,mRNA transcription levels of Fyn,SP and VIP and aver-age OD values of Fyn,SP and VIP in the hippocampus decreased significantly in the traditional Chinese medicine group and the western medicine group after treatment(P<0.05),while mRNA transcription levels of NPY and average OD values of NPY in-creased significantly(P<0.05).Conclusion Xingbi gel nasal drops can improve the behavioral scores of rhinitis and learning and memory functions of rats with AR,which may be related to the regulation of nasal mucosa-hippocampus neuroimmune mechanism through the Fyn signaling pathway.

郑健教授认为,风饮伏肺是儿童变应性鼻炎的关键病机,疏风化饮法是重要的治疗方法.治疗上采取分期论治的方法,发作期以疏风醒鼻为主,辅以醒脾化饮,临证选用疏风醒鼻方加减治疗;缓解期以益气固表为主,辅以疏风化饮,常选用玉屏风散或黄芪桂枝五物汤为基础方加减治疗.并附验案1则加以佐证.

目的 研究疏风醒鼻法对风邪犯肺型变应性鼻炎(AR)儿童Th1/Th2免疫平衡的影响.方法 采用随机数字表法将54例AR患儿分为中药组和西药组各27例,同时招募30例健康体检儿童为健康组.健康组不做任何干预,西药组予内服盐酸西替利嗪片联合外用糠酸莫米松鼻喷雾剂治疗,中药组予内服疏风醒鼻方联合外用醒鼻凝胶滴鼻剂治疗,疗程均为4周.检测3组治疗前后血清白细胞介素-33(IL-33)、白细胞介素-25(IL-25)、卵清蛋白特异性IgE(OVA IgE)含量;观察中药组和西药组治疗前后症状体征评分,并比较其疗效.结果 与健康组比较,西药组和中药组治疗前血清IL-33、IL-25、OVA IgE含量均明显提高(P＜0.05);与治疗前比较,西药组和中药组治疗后血清IL-33、IL-25、OVA IgE含量和症状体征评分均明显降低(P＜0.05).中药组和西药组疗效比较,差异无统计学意义(P＞0.05).结论 疏风醒鼻法可明显改善风邪犯肺型AR儿童临床症状,其机制可能与调节Th1/Th2免疫平衡有关.

小儿体质生理特点与小儿水肿病的发生、发展、病理变化和治疗息息相关,明确其病因、病机，进而辨证施治，对小儿肾病的预防、治疗及预后有指导意义。该篇以明代万全提出的“三有余、四不足”理论为依据，探讨小儿水肿的发生和发展与五脏的密切关系，进而为小儿水肿临床中医用药提供理论依据。

BACKGROUND:The purpose of this meta-analysis is to systematically evaluate the efficacy of probiotics on allergic rhinitis (AR).METHODS:Collecting randomized controlled trials (RCTs) with probiotics as intervention measures for AR, two researchers independently screened the literature, extracted the data and evaluated the methodological quality of the included studies, and used RevMan 5.3 software for meta-analysis to observe the effects of probiotics on Rhinitis Quality of Life (RQLQ) scores, Rhinitis Total Symptom Scores (RTSS), blood eosinophil count, total and antigen-specific serum immunoglobulin E (IgE) levels by using the fixed- or the random-effects model to calculate the pooled risk for significant heterogeneity.RESULTS:A total of 2708 patients were included in 30 RCTs. Meta-analysis results showed that the RQLQ global scores (mean difference [MD] = -9.43; P < 0.00001), RQLQ nasal scores (MD = -1.52; P = 0.03), and RTSS nasal scores (MD = -1.96; P = 0.02) significantly improved in the probiotic group when compared with those in the placebo group. There was no significant difference in blood eosinophil count (MD = -0.09; P=0.82), RQLQ eye scores (MD = -1.45; P = 0.07), RTSS global scores (MD = -2.24; P = 0.26), RTSS eye scores (MD = -0.39; P = 0.31), total and antigen-specific serum IgE levels (MD = -0.04; P = 0.7 and MD = -0.08; P = 0.81) between the probiotic and the placebo group.CONCLUSION:Compared with the placebo group, the quality of life and symptoms of patients with AR significantly improved in the probiotic group, thus providing a new potential method for the application of probiotics in AR. However, because of the limited evidence for the current study outcomes, the heterogeneity of research, and the differences in research results, more high-quality studies are needed to in the future.

原发性肾病综合征(PNS)是小儿常见的肾系疾病之一,传统单纯西医治疗存在诸多不足与弊端,近年来中西医结合治疗成果颇丰,笔者通过分析总结郑健教授治疗小儿PNS临床经验,以期为儿童肾病的临床治疗提供思路.自宋代钱乙提出"肾主虚,无实"思想以来,肾无实证之风于历代医家中盛行不衰,然肾实证在古代医籍中的记载早已有之,在《黄帝内经》《金匮要略》《脉经》等著作中均不乏见论,郑健教授认为钱氏之观点多可解为"肾多主虚,亦有实证"之意.基于此思想,郑教授总结小儿PNS中医病机主要是以肾虚为本,但在病程中,亦可有因风邪、瘀血、湿热等邪致实的症候表现,又因本病在临床上常具有本虚标实、虚实夹杂、病情反复、迁延难愈等特点,临证时需要以病程分期来辨肾病之虚实主次,治疗上主以顾护肾虚的同时,又要兼顾祛风、除湿、清热、化瘀等,可以益肺、健脾、温肾、清肝、扶正降浊等法来调理诸脏阴阳,郑教授从医30余年,运用此法于治疗小儿PNS时每获良效,并附病案一则,以资验证.

目的 观察肾康灵对慢性肾脏病(CKD)小鼠肾功能和肾脏自噬水平的影响,探讨其对CKD肾损伤的保护机制.方法 24只C56BL/6小鼠随机分为正常组、模型组和肾康灵组,每组8只.腺嘌呤诱导法复制CKD小鼠模型,肾康灵组予肾康灵药液(1.5 g/kg)灌胃,连续28d.生化分析仪检测小鼠血尿素氮和血肌酐含量,HE染色、Masson染色和糖原PAS染色观察小鼠肾组织病理形态,透射电镜观察小鼠肾组织超微结构和自噬体变化,Western blot检测小鼠肾组织自噬相关蛋白p62、Beclin1、Atg5和LC3B表达.结果 与正常组比较,模型组小鼠肾脏萎缩,肾质量明显降低(P＜0.01),血尿素氮和血肌酐含量显著增加(P＜0.01),肾组织纤维化病变明显,Beclin1、Atg5蛋白表达和LC3BⅡ/LC3B Ⅰ比值显著升高,p62蛋白表达显著下降(P＜0.01);与模型组比较,肾康灵组小鼠肾质量增加(P＜0.05),血尿素氮和血肌酐含量明显减少(P＜0.05,P＜0.01),肾组织病理变化减轻,Beclin1、Atg5蛋白表达和LC3BⅡ/LC3B Ⅰ明显降低,p62蛋白表达显著升高(P＜0.05,P＜0.01).结论 肾康灵可能通过调控自噬改善CKD肾损伤,从而延缓CKD进展.

目的 观察醒鼻凝胶滴鼻剂治疗儿童变应性鼻炎及其对CD4+CD25+Foxp3+Treg的影响.方法 采用随机数字表法将67例变应性鼻炎患儿分为对照组35例和观察组32例,另选取体检中心健康儿童10例为健康组.对照组应用布地奈德喷雾剂治疗,观察组应用醒鼻凝胶滴鼻剂治疗,2周为1个疗程,连续治疗2个疗程.观察治疗前后症状总分、视觉模拟量表评分以及血清IgE、CD4+CD25+Foxp3+Treg水平变化.结果 观察组疗效与对照组比较差异无统计学意义(P>0.05).与治疗前比较,对照组和观察组治疗后症状总分、视觉模拟量表评分和总IgE水平均明显降低(P<0.05),Foxp3+CD4+CD25+Treg百分率明显提高(P<0.05).结论 醒鼻凝胶滴鼻剂可能通过提升CD4+CD25+Foxp3+Treg水平来调节Th1/Th2免疫平衡,从而治疗儿童变应性鼻炎.

现代医学对于小儿原发性肾病综合征的病因及发病机制目前尚不明确,而祖国医学认为该病的病因病机根据发病表现可以分为内因和外因两个方面,内因主要为肺、脾、肾三脏亏虚,外因则是感受风邪、水湿、湿热、瘀血,内、外因之间互为因果、相互影响从而导致了该病发病,在该病病程中肾虚血瘀贯穿始终,受《黄帝内经》启发,文章将从治疗水肿的三大治法"开鬼门,洁净府,去菀陈莝"论治小儿原发性肾病综合征,以期为临床工作者提供思路.

本文总结了清代中医儿科学代表著作之一《幼幼集成》在治疗小儿发热方面的学术思想,从病因、病性、病位及论治四个方面对医家陈复正治疗小儿发热的临床经验进行了探析.《幼幼集成》将小儿发热的病因分为外感和内伤两个方面,认为其病性包括表热、里热、虚热、实热,其病位涉及五脏,认为五脏均可生热,并根据小儿发热、退热的时间进行辨证,在发热的论治过程中尤为重视对小儿脾胃的顾护,并创立了九条神奇外治法,其学术思想影响深远.

目的 观察醒鼻凝胶滴鼻剂治疗儿童变应性鼻炎(AR)对IL-19的影响及AR患儿过敏原阳性情况.方法 采用电脑随机法将72例AR患儿分为中药组34例和西药组38例,同时招募体检健康的儿童作为健康组.健康组不予任何干预,西药组以布地奈德喷雾剂外用干预,中药组以醒鼻凝胶滴鼻剂干预,2周为1个疗程,连续治疗2个疗程.观察3组治疗前后IL-19基因和蛋白的变化,比较AR组与健康组过敏原阳性情况.结果 与治疗前比较,西药组和中药组治疗后IL-19 mRNA表达差异无统计学意义,IL-19蛋白表达明显降低(P<0.05).AR患儿过敏原分布情况由高到低排序前5位分别是:尘螨组合、牛奶、霉菌组合、屋尘、鸡蛋.与健康组相较,AR患儿过敏原阳性率显著升高(P<0.05),与IL-19表达成正相关.结论 IL-19参与了变应性鼻炎的发病,醒鼻凝胶滴鼻剂可能通过下调IL-19而抑制STAT信号通路,进而抑制AR免疫炎症反应,从而发挥临床疗效.

文章收集整理纪立金教授运用柴胡加龙骨牡蛎汤治疗不寐、郁病、心悸3类情志病验案,并分析其诊治思路,从而总结其临床运用经验.少阳枢机不利是不寐、郁病、心悸3类情志病的主要病机,柴胡加龙骨牡蛎汤具有和解少阳、调达气机的功效,能够有效治疗因少阳枢机不利而致的情志病.纪立金教授运用柴胡加龙骨牡蛎汤从少阳枢机不利病机治疗不寐、郁病、心悸3类情志病,疗效显著.

从病因病机、辨证分型、中医内治、中医外治4个方面总结归纳中医药治疗儿童变应性鼻炎(AR)的研究进展,中医药治疗该病临床疗效确切,但尚存在一些问题,如缺乏标准化治疗方案、中医药治疗儿童AR的作用机制研究不够深入、缺乏大数据研究等,旨在为中医临床工作者治疗儿童AR提供文献参考.

小儿慢性荨麻疹主要是以风团、瘙痒、痒无定处,易反复发作且病程较长为主要临床表现,目前,现代医学以抗组胺药物为主要治疗方法,中医主要以养血祛风为治则,辅以清热、利湿、散寒等治法,郑健教授在临床上擅长用四物消风饮加减治疗小儿慢性荨麻疹,颇有成效.

小儿多发性抽动症是儿科门诊常见疾病.涤痰汤为祛痰名方,介绍郑健教授在临床上根据其以痰聚为本、风动为标的病机,运用涤痰汤为基础方随证加减治疗小儿多发性抽动症的经验,以供同道参考.

Purpose: To observe the effect of traditional Chinese medicine Xingbi nasal gel on the signal pathway of PLCE1-PKC-NF-kappa B in rats with allergic rhinitis (AR). Methods: Fifty rats were selected and randomly divided into normal group (group A), pseudo model group (group B), model group (group C), Xingbi nasal gel group (group D) and Rhinocort group (group E) with 10 rats in each group. The AR rat model was established by ovalbumin sensitization method and given the intervention therapy respectively with the traditional Chinese medicine Xingbi Nasal Gel and western medicine Rhinocort (as control). HE staining was used to observe the pathological changes of nasal mucosa in AR rats and calculate the number of eosinophils (EOS). The serum levels of IgE, IL-4 and IL-5 were detected by ELISA. Real-time PCR, and Western blot was used to detect the expression changes of mRNA and protein levels in PLCE1-PKC-NF-kappa B signaling pathway (PLCE1, PKC and NF-kappa B) in nasal mucosa. Results: (1) The replication success rate of the AR rat model was 86.67%. (2) The number of inflammatory cells and EOS in the model group was higher than that in the normal group and the pseudo model group. The number of EOS in the treatment group was lower than that in the model group (P<0.01). (3) The concentration levels of IgE, IL-4 and IL-5 in the model group were higher than those in the normal group and the pseudo model group (P<0.01); (4) The mRNA and protein expression levels of PLCE1, PKC and NF kappa B in the model group were higher than those of the normal group and the pseudo model group (P<0.01). Conclusion: Xingbi Nasal gel drop may inhibit activation of NF-kappa B by inhibiting activation of PKC in the nasal epithelial cells of AR rats, or directly inhibit activation of NF-kappa B, block PLCE1-PKC-NF-kappa B signaling pathway in the nasal mucosa of AR rats, reduce secretion of Th2 cytokines and decrease the advantage of Th2 immune response so as to reduce the nasal inflammation of AR rats and alleviate the nasal immune response.