Objective: This multi-center, randomized, double-blind, placebo-controlled study aimed to evaluate the clinical efficacy and safety of Elian Granule in treating chronic atrophic gastritis (CAG). Methods: Over a 24-week period, 240 CAG patients were randomized to receive either Elian Granule or placebo. Primary outcomes included histological improvement of gastric mucosa via biopsy, while secondary outcomes assessed dyspepsia symptom scores and quality of life (QOL) scores. Safety was monitored through physical examinations, laboratory tests (blood and urine tests, liver function, and renal function), and electrocardiograms (ECGs). Results: The Elian Granule group exhibited significantly higher improvement rates in gastric mucosal atrophy (76.29% vs. 48.96%, P < 0.001) and intestinal metaplasia (62.89% vs. 34.38%, P < 0.001) compared to the placebo group. Total dyspepsia scores improved at 4, 12, and 24 weeks (P < 0.001), the individual symptom scores showed significant improvement in epigastric pain, epigastric distension, epigastric discomfort, early satiety, heartburn, belching and acid reflux at both the 4-week and 12-week timepoints (P < 0.05, P < 0.01, P < 0.001), of these, epigastric pain, epigastric distension, early satiety, belching and acid reflux maintained their statistically significant improvement through the 24-week evaluation period (P < 0.05, P < 0.01, P < 0.001). The total effective rate for symptom relief was 85.57% in the Elian group versus 47.92% in the placebo group (P < 0.001). QOL scores for physical health (GH, PF, BP, and PCS total score) and mental health (VT, SF, MH, and MCS total score) also improved significantly (P < 0.05, P < 0.01). No adverse impact was observed. Conclusion: Elian Granule significantly improves gastric mucosal atrophy and intestinalization, alleviates dyspeptic symptoms, and enhances QOL in CAG patients, demonstrating a favorable safety profile. Clinical Trial Registration:: http://itmctr.ccebtcm.org.cn/zh-CN/Home/ProjectView?pid=7a00ecee-da6a-4939-bae1-e6a58cd97cdb, identifier ChiMCTR2000003929, 2020-9-13.

IntroductionFunctional dyspepsia (FD) is a prevalent functional gastrointestinal disorder associated with oxidative stress (OS) and dysbiosis. Chaihushugan powder (CHSGP) demonstrates efficacy in treating FD; however, the underlying therapeutic mechanism is not yet elucidated. This study aims to investigate the effects of CHSGP on OS and gut microbiota (GM) in FD rats, with a particular emphasis on the role of GM as a potential target for the antioxidant properties of CHSGP.MethodsThe FD rat model was established with a modified tail-clamp stimulation and the administration of the CHSGP decoction at a dosage of 9.6 g/kg via gavage for a duration of 4 weeks. The GM was depleted by the administration of a cocktail of metronidazole (200 mg/kg), ampicillin (200 mg/kg), neomycin sulfate (200 mg/kg), and vancomycin (100 mg/kg). Fecal microbiota transplantation (FMT) was performed with CHSGP-treated fecal supernatant at a dosage of 10 mL/kg. The gastrointestinal motility was measured using the rates of gastric emptying and small intestine propulsion. Hematoxylin and eosin staining was employed to elucidate the pathological changes, while the transmission electron microscope was used to examine the microstructures of the interstitial cells of Cajal (ICC). Chemiluminescence, colorimetric assay, immunofluorescence co-staining, and western blot assay were employed to identify the OS-related markers (ROS, SOD, NOX4, PRDX1, and TRX2). Sequencing of fecal microbiota was performed utilizing 16S rDNA.ResultsThe CHSGP decoction promoted gastrointestinal motility, protected the microstructure of ICC, and reduced OS in FD rats. The GM composition was also regulated by CHSGP. However, these effects disappeared after microbiota depletion. Fortunately, the FMT therapy reinstated them.ConclusionChaihushugan powder decoction might regulate the GM to alleviate mitochondrial OS in the gastric tissues of FD rats.

Background and AimsMounting evidence highlights a strong association between chronic pancreatitis (CP) and type 2 diabetes (T2D), although the exact mechanism of interaction remains unclear. This study aimed to investigate the crosstalk genes and pathogenesis between CP and T2D.MethodsTranscriptomic gene expression profiles of CP and T2D were extracted from Gene Expression Omnibus, respectively, and the common differentially expressed genes (DEGs) were subsequently identified. Further analysis, such as Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), protein-protein interaction, transcription factors (TFs), microRNA (miRNAs), and candidate chemicals identification, was performed to explore the possible common signatures between the two diseases.ResultsIn total, we acquired 281 common DEGs by interacting CP and T2D datasets, and identified 10 hub genes using CytoHubba. GO and KEGG analyses revealed that endoplasmic reticulum stress and mitochondrial dysfunction were closely related to these common DEGs. Among the shared genes, EEF2, DLD, RAB5A, and SLC30A9 showed promising diagnostic value for both diseases based on receiver operating characteristic curve and precision-recall curves. Additionally, we identified 16 key TFs and 16 miRNAs that were strongly correlated with the hub genes, which may serve as new molecular targets for CP and T2D. Finally, candidate chemicals that might become potential drugs for treating CP and T2D were screened out.ConclusionThis study provides evidence that there are shared genes and pathological signatures between CP and T2D. The genes EEF2, DLD, RAB5A, and SLC30A9 have been identified as having the highest diagnostic efficiency and could be served as biomarkers for these diseases, providing new insights into precise diagnosis and treatment for CP and T2D.

Context Chaihu Shugan San (CHSGS) was effective in the treatment of functional dyspepsia (FD).Objective To investigate the mechanism of CHSGS in FD through dynamin-related protein 1 (Drp-1)-mediated interstitial cells of cajal (ICC) mitophagy.Materials and methods Forty Sprague-Dawley (SD) rats were randomly divided into control, model, mdivi-1, mdivi-1 + CHSGS and CHSGS groups. Tail-clamping stimulation was used to establish the FD model. Mdivi-1 + CHSGS and CHSGS groups were given CHSGS aqueous solution (4.8 g/kg) by gavage twice a day. Mdivi-1 (25 mg/kg) was injected intraperitoneally once every other week for 4 w. Mitochondrial damage was observed by corresponding kits and related protein expressions were assessed by Immunofluorescence and (or) Western Blot.Results Compared with the mean value of the control group, superoxide dismutase (SOD) and citrate synthase (CS) in the model group were decreased by 11% and 35%; malondialdehyde (MDA) and reactive oxygen species (ROS) were increased by 1.2- and 2.8-times; ckit fluorescence and protein expressions were decreased by 85% and 51%, co-localization expression of LC3 and voltage dependent anion channel 1 (VDAC1), Drp-1 and translocase of the outer mitochondrial membrane 20 (Tom20) were increased by 10.1- and 5.4-times; protein expressions of Drp-1, Beclin-1, and LC3 were increased by 0.5-, 1.4-, and 2.5-times whereas p62 was decreased by 43%. After mdivi-1 and (or) CHSGS intervention, the above situation has been improved.Discussion and conclusion CHSGS could improve mitochondrial damage and promote gastric motility in FD rats by regulating Drp-1-mediated ICC mitophagy.

脾胃治中央,兼四气,脏腑气血阴阳皆禀气于脾胃,若脾胃功能失常,营卫不和,清浊相干,就会发生多种内伤疾病.蔡淦教授治疗内伤疾病,时时注意顾护脾胃.脾胃亏虚,肺卫失养,表卫不固之证,予六君子汤合玉屏风散加减;脾胃虚弱,荣卫俱不足者,予四君子汤合黄芪建中汤;久病脾胃亏虚,兼见外感后痰嗽久延不愈,或外感日久,正气亏耗,脾肺俱虚者,用六君子汤作为基础方加减治疗.心主血,血藏神,脾主运化,主思,心与脾胃,母病及子,子病及母,往往形成心脾两虚证.心脾不足,营血亏虚者,用归脾丸加减治疗;心气不足者用妙香散加减;气血不足,兼有痰浊内扰者,则用十味温胆汤加减治疗.肝主疏泄,主升发,肝气易动而化火,脾胃属土,主运化,其气冲和.木本克土,但脾气强,对易动之肝气有反制作用,对于肝脾不和者,蔡淦教授用小建中汤加减治疗;肝郁脾虚明显者,予柴芍六君子汤加减,或补中益气汤加防风、桂枝、羌活等;肝郁脾虚,兼有肝血亏虚者,用逍遥散治疗.补肾需重视脾胃,且补肾之药,大多滋腻重沉,难于消化,补脾胃之药有助运化作用.肾虚症状较轻,且肾之阴阳虚损不典型者,常选用香砂六君子汤加菟丝子、沙苑子、杜仲、川续断、桑寄生、怀牛膝等温和补肾药物,如脾胃虚寒明显,用理中汤和四神丸加减;脾肾阴亏者,用参苓白术散合水陆二仙丹加减化裁;阴虚明显者,加乌梅、山茱萸、熟地黄、枸杞子、覆盆子等.

BACKGROUND:Huashi Baidu granule (HSBD) and Paxlovid (Nirmatrelvir-Ritonavir) are antiviral Chinese patent medicine and western medicine specially developed for treating coronavirus disease 2019 (COVID-19). Their efficacy and safety in treating COVID-19 are still under investigated. PURPOSE:To assess and compare the efficacy and safety of HSBD, Paxlovid, and the combination in treating high-risk patients infected with SARS-CoV-2 Omicron. STUDY DESIGN:The study was a prospective single-center, open-label, randomized, controlled clinical trial conducted from April 18 to June 5, 2022. (ClinicalTrial.gov registration number: ChiCTR2200059390) METHODS: 312 severe patients aged 18 years and older infected with SARS-CoV-2 Omicron from Shuguang Hospital in Shanghai were randomly allocated to HSBD monotherapy (orally 137 g twice daily for 7 days, n = 105), Paxlovid monotherapy (orally 300 mg of Nirmatrelvir plus 100 mg of Ritonavir every 12 h for 5 days, n = 103), or combination therapy (n = 104). The primary outcome was SARS-CoV-2 nucleic acid negative conversion within 7-day treatment. The secondary outcome included hospital discharging conditions, severe conversion of symptom, and adverse events. RESULTS:Of 312 participants, 85 (82%) of 104 in combination therapy, 71 (68%) of 105 in HSBD monotherapy, and 73 (71%) of 103 in Paxlovid monotherapy had a primary outcome event. The hazard ratios of primary outcome were 1.37 (95% CI 1.03 - 1.84, p = 0.012) for combination versus HSBD, 1.28 (0.98-1.69, p = 0.043) for combination versus Paxlovid, and 0.88 (0.66-1.18, p = 0.33) for HSBD versus Paxlovid. There was no statistical difference of efficacy between HSBD and Paxlovid, while combination therapy exhibited more effective than either alone. For secondary outcomes, the hospital discharging rates within 7 days exhibited the significant increase in combination therapy than in HSBD or Paxlovid monotherapy (71% (74/104) vs 55% (58/105) vs 52% (54/103), p < 0.05). The risk of severe conversion of symptom showed no statistical significance among three interventions (1% (1/104) vs 3% (3/105) vs 3% (3/103), p > 0.05). No severe adverse events occurred among combination therapy and monotherapies in the trial. CONCLUSION:For patients with severe COVID-19, HSBD exhibits similar efficacy to Paxlovid, while combination therapy is more likely to increase the curative efficacy of Omicron variant than monotherapies, with few serious adverse events.

目的 评价真实世界中蔡淦教授治疗慢性萎缩性胃炎(CAG)的疗效和安全性.方法 选取316例CAG患者,均接受蔡淦教授中药处方(新胃方为主)治疗,疗程至少6个月.观察治疗2周、治疗4周时的中医症状疗效及治疗6个月时的胃镜病理疗效,比较治疗前与治疗2周、治疗4周时自评结局量表(MYMOP2),焦虑自评量表(SAS),抑郁自评量表(SDS)评分的变化情况,同时进行安全性评价.结果 ①治疗2周、治疗4周时的中医症状总有效率分别为95.8％、99.4％;治疗4周时的中医症状疗效优于治疗2周时,差异有统计学意义(P<0.05).②与治疗前比较,治疗2周、治疗4周时的MYMOP2、SAS、SDS评分降低(P<0.05);与治疗2周时比较,治疗4周时MYMOP2、SAS、SDS评分降低(P<0.05).③治疗6个月后,病理萎缩、肠上皮化生及胃镜病理总体有效率分别为54.8％、74.0％、71.2％.④治疗过程中,无不良反应发生,血常规、肝肾功能无明显变化.结论 真实世界中蔡淦教授治疗CAG疗效满意,能显著缓解患者的消化不良症状;随着治疗时间的延长,能有效改善CAG患者胃组织病理萎缩和肠上皮化生,且安全性良好.

Abstract Context Elian Granules have been applied in the treatment of precancerous lesions of gastric cancer (PLGC) and achieved good results. However, its exact mechanism remains unclear. Objectives To explore the mechanism of Elian granules in treating PLGC through the mitogen-activated protein kinase (MAPK) signalling pathway based on network pharmacology. Materials and methods Through network pharmacological methods, the targets of the active component of Elian granules against PLGC were obtained. Subsequently, Specific Pathogen Free (SPF) male Sprague Dawley (SD) rats were randomly divided into normal, model, and Elian granule groups. The N-methyl-N′-nitro-N-nitrosoguanidine comprehensive method was used to establish the PLGC rat model. The model and Elian granule groups were given normal saline and Elian granule aqueous solution (3.24 g/kg/d) intragastric administration, respectively, for 24 weeks. The pathological changes in gastric tissues were observed by hematoxylin-eosin staining. The protein expression of p-JNK and p-p38 was verified by western blotting. Results 394 and 4,395 targets were identified in Elian granules and PLGC, respectively. The 190 common targets were mainly enriched in MAPK signalling pathways. The gastric mucosal epithelium was still intact, the glands were arranged regularly, and no goblet cells or apparent inflammatory cell infiltration were observed in the Elian granule group. The expression of p-JNK and p-p38 protein of the Elian granule group (0.83 ± 0.08; 1.18 ± 0.40) was significantly higher than the model group (0.27 ± 0.14; 0.63 ± 0.14) (p < 0.01; p < 0.05). Discussion and conclusions Elian granules may play a critical role in the treatment of rat PLGC by up-regulating the expression of p-JNK and p-p38 proteins in the MAPK signalling pathway, thus providing a scientific basis for clinical application.

目的 观察肠吉泰颗粒治疗老年大肠癌术后腹泻患者的疗效.方法 选取2018年3月—2021年3月华东医院中医科病房和门诊收治的大肠癌术后肝郁脾虚型腹泻的患者72例,采用随机数字法分为观察组和对照组,每组36例.观察组采用口服肠吉泰颗粒治疗,对照组采用口服谷参治疗,2组疗程均为4周,观察患者治疗前后MSKCC肠道功能积分、肝郁脾虚中医证候评分、Bristol粪便性状评分,评价临床疗效.结果(1)观察组总有效率94.1％,对照组总有效率71.4％,观察组优于对照组(P<0.05);(2)组内比较,治疗后2组的中医证候积分、Bristol粪便性状评分均显著下降,而观察组的MSKCC肠道功能积分上升(P<0.05);(3)组间对比,治疗后观察组的MSKCC肠道功能积分、Bristol粪便性状评分以及中医证候积分均高于对照组(P<0.05);(4)2组在治疗期间均未出现严重不良反应及肝肾功能异常.结论 肠吉泰能安全有效改善老年大肠癌术后肝郁脾虚型腹泻患者的临床症状和中医证候.

目的 基于网络药理学探讨莪术—黄连药对治疗慢性萎缩性胃炎(CAG)的作用机制.方法 利用TC-MSP数据库分别检索莪术、黄连化学成分及靶点基因,并通过Cytoscape软件构建药对—成分—靶点基因网络;利用GeneCards数据库获得CAG疾病靶点;将莪术—黄连药对有效成分靶点基因和CAG相关靶点基因同时录入VENNY2.1软件,构建维恩图以获取交集基因,获得药对与CAG疾病的共同靶点.挑选共同靶点基因中度值前25位的基因,通过String数据库构建蛋白—蛋白相互作用(PPI)网络,对网络特征进行分析,根据度值预测各节点的重要性;通过DAVID数据库对交集基因进行GO富集分析和KEGG通路分析.最后通过Cytoscape软件构建药对—成分—靶点基因—信号通路与疾病靶点相互作用网络,根据度值预测治疗节点.结果 莪术—黄连药对共筛选出12个化学成分药动学特征良好的活性成分,得到靶点基因180个;CAG靶点基因639个;二者交集基因78个,度值排名前3位的基因为AKT1、IL-6、PTGS2;78个基因的生物学功能涉及凋亡过程的负调控、酶结合、相同蛋白结合等,以及TNF信号通路、MAPK信号通路、Toll样受体信号通路、HIF-1信号通路、NF-κB信号通路、p53信号通路.结论 莪术—黄连药对可能是通过调节AKT1、IL-6等靶点基因和TNF信号通路、MAPK信号通路,从而发挥抗CAG作用.

Background Multifocal atrophic gastritis and intestinal metaplasia are considered to be important links in the gastric precancerous cascade. However, there are no specific drugs for these conditions. Although many studies have shown that traditional Chinese medicine is effective with no serious side effects, these studies have not been scientifically rigorous trials. Our aim is to design a high-quality trial for a Chinese patent medicine, Elian Granules, to investigate its efficacy and safety in treating patients with chronic atrophic gastritis with or without intestinal metaplasia. Methods This is a phase II, randomized, double-blind, placebo-controlled, multicenter clinical trial. A total of 240 participants will be assigned to a treatment or placebo control group in a 1:1 ratio. The experimental drug or placebo will be taken with boiling water, two small bags (24.2 g) each time, twice a day, half an hour after a meal, for 24 weeks. The primary outcome is the observation of histological changes in the gastric mucosa of patients with atrophic gastritis with or without intestinal metaplasia after 6 months based on the OLGA/OLGIM staging systems. The secondary outcomes include the assessment of dyspepsia and quality of life based on the dyspepsia symptom score and the quality-of-life scale. Discussion This study is designed to evaluate the efficacy and safety of Elian Granules in a randomized, double-blind, placebo-controlled, multicenter manner. This trial may not only provide evidence for a phase III clinical trial, but also an alternative option for the treatment of chronic atrophic gastritis (CAG). Trial registration Registry Platform For Evidence-Based Traditional Chinese Medicine ChiMCTR2000003929 . Registered on 13 September 2020

Hesperidin is one of the main active ingredients of Citrus aurantium L. (Rutaceae) and tangerine peel, which have anti-inflammatory and antioxidant effects. In previous study, we found that gastric motility disorder in functional dyspepsia (FD) rats accompanied by excessive autophagy/mitochondrial swelling and even vacuolization in the interstitial cells of cajal (ICC), but the exact mechanism has not yet been investigated. Therefore, we used different doses of hesperidin (50 mg/kg, 100 mg/kg, and 200 mg/kg) to intervene in FD rats, and found that medium doses of hesperidin (100 mg/kg) significantly increased gastric motility in FD rats. Subsequently, FD rats were randomly divided into control group, model group, mdivi-1 group, mdivi-1+hesperidin group and hesperidin group, and mitochondrial division inhibitor (mdivi-1) was injected intraperitoneally to further investigate whether hesperidin could regulate dynamin-related protein 1 (Drp1)-mediated mitophagy in ICC to improve mitochondrial damage. The results showed that compared with the model group, the serum malondialdehyde (MDA) level decreased and the superoxide dismutase (SOD) level increased in the mdivi-1 and hesperidin groups (p < 0.001). Transmission electron microscopy (TEM) observed that the mitochondrial nuclear membrane was intact in gastric tissues with a clear internal cristae pattern, and autophagy lysosomes were rare. The co-localization expression of microtubule associated protein 1 light chain 3 (LC3) and voltage dependent anion channel 1 (VDAC1), Drp1 and translocase of the outer mitochondrial membrane 20 (Tom20) was significantly decreased (p < 0.001), the protein expression of mitochondrial Drp1, Beclin1 and LC3 were significantly decreased (p < 0.001), the protein expression of mitochondrial P62 and ckit in gastric tissue were significantly increased (p < 0.05, p < 0.001). The above situation was improved more significantly by the synergistic intervention of mdivi-1 and hesperidin. Therefore, hesperidin can improve mitochondrial damage and promote gastric motility in FD rats by regulating Drp1-mediated ICC mitophagy.

胃酸过多相关性疾病是消化科门诊常见的一类上消化道疾病.西医常用质子泵抑制剂、H2受体拮抗剂或胃黏膜保护剂等具有抑制胃酸或中和胃酸作用的药物治疗,药物使用的不合理及长期应用导致治疗存在一定风险.首届全国名中医蔡淦教授长期从事中医防治脾胃病的研究,采用中医辨证治疗胃酸过多相关性疾病颇有心得,并能实现西药的逐渐减停.

中医藏象理论中关于脏腑的概念,有的不具有现代解剖属性,而有的是与实体的器官及客观功能相关的,即"形藏".中医形藏理论虽具有一定的解剖属性,但与现代解剖学还是有很大的差异.在现代影像诊断技术飞速发展的时代背景下,推进中医形藏理论研究,具有重要的现实性和必要性.应直面人体脏腑器官广泛存在解剖属性,且对具有非解剖属性的"神藏"区别对待;在"形藏"认识层面,可借鉴学习现代解剖学成果,并开展中医病理形态学研究,且在可行的范围内发展中医实证医学理论.

目的:观察中药定向透药联合红外线治疗功能性腹泻肾阳亏虚证的疗效.方法:将142例功能性腹泻肾阳亏虚证患者采用随机数字表分为治疗组和对照组,每组71例.治疗组患者予中药定向透药联合红外线治疗,每周3次,对照组患者口服马来酸曲美布汀胶囊(0.2 g/次,3次/d)和酪酸梭活菌片(40 mg/次,3次/d),疗程为4周.比较治疗前后两组患者每日大便次数、Bristol粪便性状评分、中医证候积分、中医证候疗效以及治疗3个月后的复发率.结果:治疗2周、4周后,两组患者大便次数和Bristol粪便性状评分均低于治疗前(P<0.05);治疗组患者Bristol粪便性状评分低于对照组(P<0.05).治疗2周、4周后,两组患者中医证候积分均低于治疗前(P<0.05),且治疗组患者中医证候积分均低于对照组(P<0.05).治疗4周后,治疗组中医证候疗效总有效率为94.37％(67/71),对照组中医证候疗效总有效率为81.69％(58/71),治疗组优于对照组(P<0.05).治疗3个月后,治疗组复发率[31.34％(21/67)]低于对照组[58.62％(34/58)],差异有统计学意义(P<0.05).结论:中药定向透药联合红外线治疗功能性腹泻肾阳亏虚证有较好疗效.

目的:探讨肠吉泰对内脏高敏感模型大鼠的调节作用.方法:选择新生SD大鼠40只,按照随机数字表法随机分为空白组、模型对照组、阳性对照组及肠吉泰组,每组10只.参照Alchaer直肠醋酸刺激法建立IBS内脏高敏感大鼠模型.造模期间阳性对照组大鼠给予腹腔注射Capsazepine,其余各组除空白组外均给予相同体积的溶剂腹腔注射.从第8周开始,肠吉泰组每日给予0.423 g/mL的剂量中药灌胃,空白组、模型对照组和阳性对照组每日予以等量去离子水灌胃,各组均持续灌胃4周.干预4周后,采用结直肠气囊扩张法测定并记录大鼠腹壁反射(abdominal withdrawal reflex,AWR)评分,进行肠道敏感性评估;使用Western blot法检测大鼠结肠黏膜组织蛋白酶激活受体2(proteinase-activated receptors 2,PAR2)、下游物质蛋白激酶Cε(protein kinaseCε,PKCε)、瞬时感受器电位香草酸受体1(transient receptor potential vanilloid1,TRPV1)、磷酸化TRPV1(p-TRPV1)的表达.结果:当气囊压力为40、60 mm Hg(1 mm Hg≈0.133 kPa)时,模型对照组大鼠AWR评分较空白组明显升高(P<0.01);肠吉泰组和阳性对照组AWR评分与模型组比较均明显降低(P<0.05).与模型对照组比较,阳性对照组及肠吉泰组PAR2、PKCε、TRPV1、p-TRPV1的表达显著降低(P<0.05).结论:肠吉泰可能是通过下调PAR2、PKCε、TRPV1、p-TRPV1的表达,抑制其活化,从而改善IBS内脏高敏感.

目的:探究不同品种、炮制方法和剂量的芍药对复方地芬诺酯致便秘模型大鼠的通便作用.方法:采用15 mg·kg-1复方地芬诺酯混悬液灌胃14天建立便秘大鼠模型.基于粪便粒数、粪便质量和粪便含水率,分别考察高剂量生赤芍和生白芍、高剂量生赤芍和炒赤芍、低中高不同剂量生赤芍对便秘模型大鼠的作用,评估不同品种、炮制方法及给药剂量的芍药的通便作用.结果:造模后大鼠出现活动减少和炸毛现象,体质量增长缓慢,部分大鼠进食量、尿量减少;给药后大鼠尿量增加.与空白组比较,模型组大鼠的粪便粒数、粪便质量和粪便含水量显著降低(P＜0.05);与模型组相比,生赤芍高剂量组大鼠的粪便粒数、粪便质量及粪便含水量均显著增加(P＜0.05),生赤芍中剂量组大鼠的粪便含水量显著升高(P＜0.05),而生白芍高剂量组、炒赤芍高剂量组、生赤芍低剂量组大鼠各指标均无明显变化.结论:不同品种、炮制方法和剂量的芍药对复方地芬诺酯慢性功能性便秘模型大鼠的通便作用存在差异,大剂量生赤芍通便作用最佳.

目的:探讨莪连颗粒治疗脾虚瘀热型慢性萎缩性胃炎癌前病变(PLGC)的临床疗效及对患者免疫功能的影响.方法:收集60例脾虚瘀热型PLGC患者,随机分为治疗组和对照组,治疗组予以莪连颗粒口服治疗,对照组予以胃黏膜保护剂(西药)治疗,持续12周.观察2组患者治疗前后症状总积分、主要症状积分和次要症状积分、胃黏膜病理组织学变化、血清CD3+T、CD4+T、CD8+T、CD4+ T/CD8+T变化情况.结果:治疗组患者主要症状积分优于对照组(P＜0.05),次要症状积分与总积分均显著优于对照组(P＜0.01);治疗组患者胃黏膜肠上皮化生、萎缩、慢性炎症、活动等病理变化均明显改善(P＜0.01),异型增生改善也优于照组(P＜0.05);治疗组总体临床疗效指数为91.34％,明显优于对照组(71.87％,P＜0.01);治疗组患者CD3+T、CD4+T、CD4+ T/CD8+T均有明显上升(P＜0.01),CD8+T水平明显降低(P＜0.01).结论:莪连颗粒治疗PLGC作用明显,可以改善脾虚瘀热型PLGC患者的临床症状和胃黏膜病理变化,提高患者机体免疫力.

Patients with precancerous gastric conditions are at a high risk for gastric carcinoma. The Chinese medicine Weifuchun (WFC) is used in treating chronic superficial gastritis and in postoperative adjuvant treatment of gastric cancer. Both monotherapy and combination therapy of WFC with other drugs can result in a favorable therapeutic outcome. WFC can dramatically improve clinical outcomes in patients with gastric precancerous lesions by targeting multiple pathways including pathways involved in the pharmacological action of Radix Ginseng Rubra (red ginseng), Rabdosia amethystoides, and fried Fructus Aurantii, including regulation of NF-κB, RUNX3/TGF-beta/Smad, Hedgehog (Hh) and Wnt signaling pathways, modulation of the expression of oncogenes and tumor suppressor genes, and indirect inhibition of Helicobacter pylori (Hp) by maintaining gastric microbial ecosystem. In this review, we will discuss the clinical efficacy and therapeutic regimen of WFC for gastric precancerous lesions and the molecular mechanisms involved. This review will highlight WFC-based therapeutic strategies in disrupting progress to gastric cancer and provide more information on the pharmacological mechanisms of WFC and its clinical application for the treatment of precancerous gastric lesions.

基于《脾胃论》探讨新型冠状病毒肺炎(COVID-19)的中医药防治.认为《脾胃论》实由当时的汴京大疫催生而成,其中从内伤出发、重视扶正思想对防治疫病具有重要意义.结合《脾胃论》分析新型冠状病毒肺炎的致病特点、临床特征、病理免疫等,认为该病的发生发展与脾胃虚弱、阴火刑肺密切相关,补脾胃、泻阴火可用于防治新型冠状病毒感染和重型新型冠状病毒肺炎.