目的 运用中医传承辅助系统(V2.5)软件,分析挖掘秦国政教授治疗尿石症的处方用药规律.方法 收集整理秦国政教授2010年1月至2022年1月治疗尿石症的门诊初诊患者112例的首诊处方,录入中医传承辅助平台,利用该软件分析挖掘秦国政教授治疗尿石症的处方规律.结果 对筛选出的门诊初诊患者112例的首诊处方进行数据分析,提取1个核心药物组合,为金钱草、牛膝、丹参、白芍、海金沙、威灵仙、川芎、厚朴、桔梗、鸡内金、琥珀、通草、穿山甲、炙黄芪、石韦;从四气、五味、归经研究发现,寒性692次(42.38％)>温性472次(28.90％)>平性463次(28.35％)>凉性6次(0.37％);甘味823次(30.94％)>苦味709次(26.65％)>辛味474次(17.82％)>咸味433次(16.28％)>酸味218次(8.20％)>涩味3次(0.11％);秦国政教授治疗尿石症药物归经前5位为肝>膀胱>脾>肺>心.结论 秦国政教授治疗尿石症多以通淋排石、清热利尿、活血行气散瘀为法,谨守病机,随症化裁.

Background. Fuzheng Yiliu decoction (FZYLD) was a traditional prescription with an antitumor effect. We aimed to explore the antitumor effect of FZYLD and its active ingredient, quercetin, on prostate cancer (PCa). Methods. The effective components and potential targets of FZYLD were obtained from the TCMSP, Herb, and Batman databases. The relationship between the active compounds of FZYLD and PCa's potential targets or pathways was analyzed by Cytoscape 3.8.0 software and the String database. The compound composition of FZYLD was detected by HPLC. The effects of quercetin, with the most effective active ingredient of FZYLD, on PC-3 cell growth, metastasis, and PI3K/AKT pathway were seen by CCK-8 Kit, transwell experiment, TUNEL assay, nude mouse tumorigenesis test, and Western blot analysis. Results. Through network pharmacological analysis, we screened 195 effective active components of FZYLD, covering 290 targets, of which 198 were related to PCa. Quercetin, luteolin, kaempferol, anhydroicaritin, and 7-O-methylismucronulatol were important active compounds. MAPK1, AKT1, MAPK3, STAT3, and Jun were common targets of PCa and FZYLD. Our in vivo and in vitro experimental results confirmed that quercetin inhibited PCa's growth, cell migration, and the PI3K/AKT pathway and promoted cell apoptosis. Conclusions. As predicted by the network pharmacological strategy and verified by the basic experimental results, FZYLD might play an antitumor role through multiple components, targets, and pathways. These results provide a new basis for developing and applying FZYLD and its compound quercetin.

"金水相生"理论源于中医对五行及五脏的认识,是中医五行理论中对肺肾关系的高度概括,在临床治疗肺肾系统疾病中越来越被广泛应用.文章基于近20年来应用"金水相生"理论治疗肺肾系统疾病的研究概况及现状分析,对"金水相生"理论在肺肾疾病中的临床应用进行综述,以期为临床更好地应用金水相生理论治疗肺肾系统疾病提供理论依据.

目的 应用Meta分析研究六味地黄方制剂治疗特发性少、弱精子症的疗效.方法 检索中国知网、维普、万方、Cochrane、PubMed等数据库,收集六味地黄方制剂治疗特发性少、弱精子症的随机对照试验,检索时限设定为建库至2022年5月.运用方法学质量评价,使用RevMan 5.4软件工具进行统计分析,并进行偏倚分析.结果 共纳入6篇文献.六味地黄方制剂在提高特发性少、弱精子症的总有效率(RR=1.13,95％CI:1.06～1.20,P=0.0003)、精子密度(WMD=5.00,95％CI:2.89～7.11,P<0.00001)、精子活动率(A+B级)(WMD=5.80,95％CI:4.83～6.78,P<0.00001)、妊娠率(RR=2.06,95％CI:1.47～2.90,P<0.0001)方面均显著优于对照组.结论 六味地黄方制剂具有生精、强精、助育的功效.

Jujing Zhuyu decoction (JZD) is a traditional Chinese medicine that effectively improves sperm motility. However, the molecular mechanism of JZD on asthenozoospermia still remains unknown. In this study, we investigated the effect of JZD on the mitochondrial apoptosis pathway in an asthenozoospermia rat model. Sixty Sprague-Dawley rats were randomly divided into five groups-control, tripterygium glycosides (GTW) model, JZD-low (JZD-L), JZD-medium (JZD-M), and JZD-high (JZD-H) groups (n = 12/group). GTW was used to generate the asthenozoospermia model. The JZD-L, JZD-M, and JZD-H groups were administered 5, 10, or 15 g kg-1 day-1 of JZD granules respectively, for 4 weeks. Testicular tissue morphology was examined using histological staining, while sperm count was determined using manual and computer-aided semen analyses. Apoptosis of spermatogenic cells was detected with the TUNEL assay, and the expression of proteins and genes related to mitochondrial apoptosis was detected using western blotting and quantitative reverse transcription-polymerase chain reaction respectively. Histomorphological evaluation revealed superior seminiferous tubule structure and arrangement as well as improved spermatogenic cell morphology in the JZD-L, JZD-M, and JZD-H groups compared to those in the model group. Moreover, semen quality and the apoptotic index were significantly improved in the JZD-L, JZD-M, and JZD-H groups compared to those in the model group. Additionally, the mRNA expression and protein abundance of Apaf-1, Bax, Cyto-c, and caspase-3 was reduced, while those of Bcl-2 were increased in all JZD groups compared to those in the model group. JZD reduces the apoptosis rate of sperm cells and significantly promotes sperm survival by regulating the mitochondrial apoptosis pathway. This mechanism provides experimental support for the treatment of asthenozoospermia by JZD.

目的 分析少弱精子不育症患者中医证候的流行病学特征.方法 应用临床流行病学调查中横断面研究的方法,全部数据由两个横断面数据组成,统计数据中人口学、病史、中医证候诊断等30余种指标并进行整理汇总,运用SPSS20.0 for windows对数据进行处理,采用构成比的方法进行统计学分析.结果 在所调查的所有少弱精子不育症患者中,年龄平均值为32.8岁,出现最多的六个症状为腰膝酸软、神疲乏力、耳鸣盗汗、早泄、阴囊潮湿、失眠多梦;证型分布上,以肾阳虚衰证与肾阴不足证的患者最多,复合型证候中占比最多的为肾阴阳两虚证.结论 少弱精子不育症患者中医证候以肾虚证为主,肾阳亏虚与肾阴不足可影响肾的功能进而引起不育,中医以肾为核心的生殖生理理论对于指导不育症的防治具有重要意义.

目的 系统评价曲唑酮治疗勃起功能障碍(ED)的疗效和安全性.方法 检索CNKI、WanFang、VIP、CBM、ClinicalKey、PubMed、Embase、Cochrane Library 等数据库,检索时间范围从建库之日至2021年6月1日.筛选应用曲唑酮治疗ED的随机对照试验(RCT)的文献,参照Jadad评分系统进行文献方法学质量评价,使用RevMan 5.4软件对结局指标进行Meta分析,使用Stata 15.1软件对主要结局指标的发表偏倚进行Egger's分析.结果 纳 21篇RCT文献,共1 704例患者.Meta分析结果显示:曲唑酮可显著提高ED患者的临床疗效(OR=3.86,95％CI:2.50～5.95,P＜0.000 01)、明显降低患者汉密尔顿抑郁量表(HAMD)评分(MD=-2.02,95％CI:-2.53～-1.52,P＜0.000 01)、显著提升患者国际勃起功能指数(IIEF-5)评分(MD=4.54,95％CI:3.64～5.43,P＜0.000 01),但同时也会增加不良反应发生率(OR=1.90,95％CI:1.15～3.13,P=0.01).亚组分析表明:曲唑酮用量≥25mg/d、≤50mg/d时,治疗组疗效即高于对照组(OR=3.07,95％CI:1.79～5.28,P＜0.000 1),继续增加曲唑酮使用剂量后,疗效不会显著提升;而当曲唑酮最大使用剂量＞100mg/d、≤150mg/d时,治疗组不良反应发生率显著高于对照组(OR=3.28,95％CI:1.41～7.59,P=0.005).曲唑酮治疗ED见效较快,一般治疗4周即可明显提升患者 IIEF-5(MD=2.44,95％CI:1.77～3.10,P＜0.000 01).Egger's 分析结果显示,有效率和不良反应发生事件的各研究间存在发表偏倚的可能性较低(P=0.083,P=0.516).结论 曲唑酮治疗ED疗效确切且见效较快,当曲唑酮使用剂量≤100mg/d时较为安全.

慢性胃炎是一种以慢性胃黏膜炎性病变为特征的消化系统疾病,临床表现为上腹隐痛、食欲减退、腹胀、反酸等.外感六淫或内生五邪致使脾胃运化失职,气机升降失衡,清阳不升,浊阴不降,积湿而不化浊,气郁而不布津,血不养经,胃体失于濡养,日久"毒邪"积聚,导致胃炎发生.主要病位在胃,与脾、肝、肾密切相关.秦国政教授认为,即使胃腑受邪,也不可过用"通"法,以免耗伤正气,应遵循"以通为补"思想,结合外科疮疡理论,确立本病治法为温中托毒、益气托毒、清热养阴托毒、清消托毒,四君子汤、平胃散、玉女煎、三仁汤等为其常用方剂,同时加入治疗"内痈"常用药蒲公英、白芷、黄芪等,随症加减变化,临床疗效显著.

BACKGROUND:Using network pharmacology and molecular docking, this study aimed to explore the active pharmaceutical ingredients (APIs) and molecular mechanism of Qinshi Simiao San (QSSMS) in the treatment of chronic prostatitis (CP) and verify our findings in the rat model.METHODS:The APIs of QSSMS and the common targets of QSSMS and CP were screened from the TCMSP database. The STRING database and Cytoscape software were used to construct the network graph. The enriched GO and KEGG pathways were displayed by David software and R software. Molecular docking was performed to visualize key components and target genes. In addition, the rats model of CP was established to verify the molecular mechanism of QSSMS.RESULTS:Network pharmacology showed that the APIs of QSSMS mainly included quercetin, kaempferol, formononetin, isorhamnetin, and calycosin. QSSMS alleviated CP mainly through the negative regulation of the apoptotic process, oxidation-reduction process, inflammatory response, and immune response. Molecular docking showed that the APIs could bind to the corresponding targets. QSSMS repaired the pathological damage of prostate tissue, upregulated the expression of oxidative stress scavenging enzymes CAT and SOD, and downregulated the peroxidative product MDA, inflammatory factors IL-1β, IL-6, TNF-α, COX-2, PGE2, and NGF, and immune factors IgG and SIgA.CONCLUSION:The APIs in QSSMS may inhibit inflammation in the rat CP model by regulating immune and oxidative stress.

《石室秘录》系清代医家陈士铎所著,其在吸收前人的学术思想同时结合自己的临床实践对遗精的论述颇具特色.对于遗精病机,该书继承丹溪景岳等先贤的学术观点,认为遗精之本在于心、肾两脏功能失调,提出遗精的基本病机为心肾失交,同时在五脏遗精说的基础上丰富了肝、脾二脏与遗精的关系.对于本病的治疗,该书提出需从心肾两脏出发,以调补心肾为基础,兼顾健脾、疏肝,并结合不同脏腑的特点,拟定了具体的辨证论治方;在明辨病机差异的同时,反对一味使用固涩,注重通法以清实邪、畅精路,对后世医家影响深远.该书对遗精的论治在前人基础之上又有所创新,前承于经旨,后验于临床,为遗精病的治疗提供了新的思路,对现代临床实践仍具有重要的参考价值.

目的 探讨消糖灵胶囊联合艾塞那肽注射液治疗2型糖尿病的临床疗效.方法 选取2019年1月—2021年3月河南中医药大学第一附属医院收治的72例2型糖尿病患者作为研究对象,按照随机数字表法将所有患者分为对照组和治疗组,每组各36例.对照组皮下注射艾塞那肽注射液,10μg/次,2次/d.治疗组在对照组基础上口服消糖灵胶囊,3粒/次,2次/d.两组患者连续治疗3个月.观察两组的治疗效果,比较两组患者治疗前后白细胞介素-1β(IL-1β)、白细胞介素-18(IL-18)、肿瘤坏死因子-α(TNF-α)、空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)水平.结果 治疗后,治疗组的总有效率为94.44％,对照组的总有效率为77.78％,组间比较有明显差异(P<0.05).治疗后,两组的IL-1β、IL-18、TNF-α水平显著降低(P<0.05),且以治疗组IL-1β、IL-18、TNF-α水平降低的更明显(P<0.05).治疗后,两组的FBG、2 h PG、HbA1c均明显降低(P<0.05);且治疗组的FBG、2 h PG、HbA1c明显低于对照组(P<0.05).结论 消糖灵胶囊联合艾塞那肽注射液治疗糖尿病疗效确切,能够降低血清炎症指标水平和血糖,安全性良好.

Background: Sperm DNA fragmentation (SDF) may hinder embryonic development and growth, increasing the risk of spontaneous miscarriage, and is considered an important factor affecting male infertility (MI). Traditional Chinese herbal medicine is considered effective in the treatment of MI due to SDF by nourishing kidney essence or promoting blood circulation for removing blood stasis. The objective of this systematic review protocol is to evaluate the effectiveness and safety of traditional Chinese herbal medicine on the treatment of MI associated with SDF. Methods: We searched the PubMed, Embase, Web of Science, Cochrane Library, CNKI, VIP Chinese Science, Technology Journal Database, and Wanfang Database until the end of 2020 for English and Chinese published literature. Randomized controlled trials (RCTs) to evaluate the effectiveness and safety of traditional Chinese herbal medicine for the treatment of MI associated with SDF will be included. Study selection and data extraction were performed independently by 2 reviewers, and the quality evaluation and risk assessment were assessed by the Cochrane collaboration's tool, and use the RevMan 5.3 software for meta-analysis. Conclusion: This study will evaluate the efficacy and safety of traditional Chinese herbal medicine for the treatment of MI due to SDF, which may provide some help for the clinician's decision. Prospero registration number: CRD42020221053.

六腑之中,除三焦外的其余五腑,与五脏分别具有表里关系,独余三焦一腑孤存,因而三焦被称为"孤腑".但作者认为三焦是一贯通上下、交通左右的运行通路,其作用有三:一是使五脏精气得以互资互传互化;二是使五脏产生的代谢废物得以泄出;三是使其余五腑得到与其相表里的五脏精气之滋养.三焦看似无脏与之表里,实则与五脏均为表里,故云"孤腑不孤".该文通过对三焦生理特点和功能、五脏精气、三焦与五脏关系的新认识,从三个角度对"孤腑不孤"的内涵进行了阐释,并结合国内近年来的临床研究与名医经验,探讨了"孤腑不孤"的临床意义.基于此,便可化繁为简,从三焦入手调治其余的诸脏腑之病,在错综复杂的临床表现之中,分析出核心病机,则治疗方可中正无偏,迅速恢复脏与脏、脏与腑之间生理活动上的联系,尤其对于临床所遇到的一些疑难病,以此法诊治或可收到满意的临床疗效.

精子发生与不同的生物学机制相关,自噬作为细胞代谢和细胞更新的必要过程,可直接参与精子发生的各个环节.根据降解的内容物不同,自噬可分为本体自噬(非选择性自噬)和选择性自噬.本体自噬的主要作用是分解非特异性胞质物质以满足能量代谢,而选择性自噬则针对特定的受体,包括受损的细胞器、蛋白质聚集体和细胞内病原体等.选择性自噬与生殖过程相关,包括精子的发生、受精以及睾酮的生物合成等.深入研究选择性自噬在精子发生过程中的作用,可为男性不育的治疗提供新思路.

秦国政教授认为,"湿、热"是痛风发病的关键因素,"瘀"是其发病的关键环节,亦为病久之变,湿热瘀阻是其发病的基本病机,湿、热、瘀均可阻滞脉络肌腠,表现为络病的病理状态,不通则痛.因此,秦国政教授临床基于"络病理论",以"清热利湿通络"为治法,采用经验方通络止痛汤加减治疗痛风患者,多获良效.

癫痫是一种严重威胁人类健康的神经系统疾病,临床表现为阵发性、暂时性惊厥发作,伴意识、感觉及情感等方面短暂异常.秦国政教授认为癫痫发作与先天因素、骤受惊恐、脑部外伤等有一定关系,主要病位在脑,与心、脾胃、肝、肾关系密切,病机责之于气血瘀阻引起脑络损伤、脾胃虚损致使清阳不升、血虚生风导致肝风内动,基本治法为活血开窍、益气升阳、养血柔肝,采用通窍活血汤合益气聪明汤加小红参为基础方,根据患者实际情况随症加减,临床疗效显著,值得进一步推广应用.

扶正托毒理论是中医外科疾病治疗中的重要理论,也是外科疮疡中、后期的主要治法治则.秦国政教授认为慢性前列腺炎和外科疮疡在病因病机及临床表现上具有相似性,将慢性前列腺炎视为内痈发病中后期,并以此为切入点,把握慢性前列腺炎患者往往以正气不足为本、热毒偏盛为标,基于中医扶正托毒的理论思想,运用验方秦氏四妙散治疗慢性前列腺炎,重视辨证论治,标本兼顾,综合施治,取得较好的疗效,为临床防治该疾病提供了新的思路.

ED与高血压经常伴随发生,高血压患者ED发病率远高于正常血压人群.现代中医家比较统一的认识是,勃起功能障碍的病机关键在于本虚标实,并都较为重视脾肾亏虚、肝郁血瘀的相关学说;高血压病机本质上也是本虚标实,虚在脏腑,实在痰瘀.而西医有关研究显示,ED的严重程度与全身性血管功能障碍程度呈正相关关系,其中,心血管/代谢性疾病(CVMD),例如高血压、冠心病、糖尿病和周围血管疾病,与ED的关系最为密切.本文基于系统生物学阐述了NO信号受损、氧化应激和血管内皮功能障碍是阴茎和全身性血管病变的关键机制,认为中、西医对于ED的病因病机都有广泛深入的研究和阐述,并且二者之间存在很强的契合度、共通性和互补性.