Objective: To explore the potential molecular targets and mechanisms of the “Schizonepetae HerbaSaposhnikoviae Radi” drug pair in the treatment of psoriasis based on computer network pharmacology and molecular docking technology. Methods: The TCMSP database was used to screen the effective active ingredients and targets of “Schizonepetae Herba-Saposhnikoviae Radi” drug pair. The psoriasis-related targets were GeneCards, OMIM and other databases, and the intersection targets were obtained by Venny 2.1.0. Cytoscape 3.7.2 software and STRING database were used to construct the drug-disease mapping target gene network map and PPI protein interaction network, and the key effective active ingredients and core target proteins were screened. The intersection targets were enriched by GO and KEGG pathways through R language program. Finally, the molecular docking experiment was carried out by AutoDock Vina 1.1.2software, and the results were visualized by PyMol 2.5.4 software. Results: A total of 27 effective active ingredients of Schizonepeta tenuifolia-Saposhnikovia divaricata herb pair were screened and obtained. The key effective active ingredients of the herb pair were quercetin, β-sitosterol and wogonin, and mainly through AKT1, TP53, TNF, IL6, VEGFA, JUN, IL1 B,CASP3, ESR1, PTGS2, MYC and other core target proteins. The enrichment analysis of GO and KEGG pathways suggested that drug pairs mainly interfered with psoriasis by regulating Pl3 K-Akt signaling pathway, IL-17 signaling pathway, TNF signaling pathway, AGE-RAGE signaling pathway in diabetic complications; molecular docking results confirmed that there was a good binding ability between the key active ingredients and the core target proteins. Conclusion: The mechanism of “Schizonepetae Herba-Saposhnikoviae Radix” interfering with psoriasis has the characteristics of multi-component, multitarget and multi-pathway, which not only provides the theoretical basis for the future clinical treatment of psoriasis with prescription, but also adds the scientific basis for the treatment of psoriasis by the method of “dredging the xuanfu”.

总结席建元基于玄府理论运用汗法辨治寻常型银屑病经验.席建元认为"玄府闭塞"为该病的病机要点,广义汗法及狭义汗法均可调和阴阳,使正汗得出,从而恢复玄府的正常生理功能.其提出汗法开玄是寻常型银屑病的基本治则,以辛温发汗、养阴发汗等为治法,临床疗效满意.附验案2则以佐证.

帛书《五十二病方》是我国现存最古老的古医学方书之一,古代医家多崇尚重阳思想,《五十二病方》在治法上多受温阳思想的指导,书中运用大量的温阳药物及温阳治法,在治疗疾病上取得了不错的效果.通过对帛书的认真研读、分析,文章对其中的重阳思想及其相关应用进行归纳研究总结,从而强调重阳思想在治疗各类疾病时的重要指导作用,以期日后指导临床用药.

张仲景《伤寒杂病论》组方精炼严谨,用药精简,紧扣病机,疗效确切,流传经久,沿用至今.《伤寒杂病论》多在所载方剂后详细记载煎煮、服药方法及服药禁忌,对疾病的治疗具有一定的指导作用.该文简要概括《伤寒论》用药特点、方法及禁忌.

目的 探讨加味安魂汤联合艾司唑仑治疗对原发性失眠急性期患者的疗效,评价其治疗失眠的有效性及科学性,为失眠的治疗提供新思路.方法 选取60例原发性急性失眠患者,按照随机数字表法分为中药组(加味安魂汤)、西药组(艾司唑仑)及中西医结合组(加味安魂汤加艾司唑仑),各20例,均分别治疗4周,比较3组患者服药后的中医证候积分、匹兹堡睡眠质量指数量表(PSQI)评分以及药物不良反应情况.结果 治疗前,3组PSQI评分比较,差异无统计学意义(P>0.05);治疗后,3组PSQI评分均下降,中西医结合组较其他2组下降更明显,差异有统计学意义(P<0.05).治疗后,中药组总有效率为75.0％,西药组为80.0％,中西医结合组为90.0％,中西医结合组总有效率高于中药组和西药组,差异有统计学意义(P<0.05).中药组不良反应发生率为15.0％,西药组为35.0％,中西医结合组为10.0％,西药组不良反应发生率高于其他2组,差异有统计学意义(P<0.05).结论 加味安魂汤联合艾司唑仑治疗失眠有明显临床疗效,可改善患者睡眠质量,提高生活质量,降低匹兹堡睡眠质量指数,为原发性急性失眠提供了新的方法和思路.

目的:观察自拟养心宁神汤联合右佐匹克隆片治疗心虚胆怯型失眠的临床疗效及其作用机制.方法:选取河南中医药大学第三附属医院及河南省中医药研究院附属医院门诊就诊的心虚胆怯型失眠患者60例,按照随机数字表法分为治疗组和对照组各30例.对照组给予右佐匹克隆片,3 mg/次,1次/d,睡前口服.治疗组在对照组治疗基础上给予自拟养心宁神汤(龙眼肉、酸枣仁、山萸肉、柏子仁、生龙骨、生牡蛎、生乳香、生没药、生代赭石、茯苓、川黄连),1剂/d,由河南中医药大学第三附属医院药剂科统一煎制,每袋200 mL,早、晚餐后半小时各温服1袋.两组均治疗8周.治疗结束,对比两组的疗效,对比两组治疗前后匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)评分、睡眠状态自评量表(self-rating scale of sleep,SRSS)评分、血清肿瘤坏死因子-α(tumor nec-rosis factor-α,TNF-α)水平、白细胞介素-6(interleukin-6,IL-6)水平.结果:治疗组临床治愈10例,显效12例,有效7例,无效1例,有效率为96.67％(29/30);对照组临床治愈7例,显效7例,有效5例,无效11例,有效率为63.33％(19/30).两组疗效对比,差异有统计学意义(P<0.05).与同组治疗前对比,两组治疗后的SRSS评分、PSQI评分、血清TNF-α 和IL-6水平均降低,差异有统计学意义(P<0.05).治疗后,两组上述诸指标对比,除入睡时间外,治疗组均低于对照组,差异有统计学意义(P<0.05).结论:自拟养心宁神汤联合右佐匹克隆片治疗心虚胆怯型失眠有较好疗效,可提高睡眠质量,其机制可能与降低炎症因子TNF-α、IL-6水平有关.

在《伤寒杂病论》中仲景对沉脉的描述十分丰富,原文中虽以沉脉为主,但在主症及辨证论治上却又有所不同.沉脉有生理病理之分,生理性沉脉见于肥胖之人,病理性沉脉主里亦主表;主阳虚,少阴多见;主水饮.通过对《伤寒杂病论》中相关沉脉的条文进行浅析,以便探究平脉辨证之理,更好地指导临床实践.