慢性心力衰竭是由各种心血管疾病发展到最后阶段复杂的临床综合征,是高患病率和高病死率的公共卫生问题.根据中医学辨证体系,慢性心力衰竭基本病机是气虚血瘀水停.考虑到患者具体病情常兼杂有"毒"邪、肝郁脾虚等不同情况,可配合不同治法.对于慢性心力衰竭存在"毒"邪的患者配合使用清热解毒法;对于病情急重或者"毒"邪无所出的患者,可根据"心与小肠相表里"的理论,采用利水清小便中药排除"毒"邪;合并有抑郁焦虑状态的采用疏肝解郁法配合治疗,从整体改善慢性心力衰竭患者的心脏以及身体机能.临床实践显示,以上疗法能够改善慢性心力衰竭患者的心功能、生活质量,降低住院率及病死率,体现了中医药辨证治疗的优势.

目的 通过数据挖掘技术探究冼绍祥教授治疗冠心病的用药规律,进而分析冼绍祥教授治疗冠心病的证治规律.方法 收集整理冼绍祥教授门诊治疗冠心病的病历处方,建立数据库,利用SPSS、clementine等工具,运用频次分析、聚类分析及关联规则Apriori等数据挖掘方法,分析用药配伍规律及方药与病症的联系.结果 对321个门诊病历的证型分类及处方用药进行分析,"痰浊证"是冠心病的主要证型之一,化痰降浊法成为冼绍祥教授治疗冠心病的重要法则.结论 数据挖掘技术适用于名老中医经验总结;冼绍祥教授基于岭南人群体质特点,补虚泻实,寒温共用,主以化痰降浊,温阳通络,健脾益气,行气活血等为法,体现了冼绍祥教授从"痰浊"论治冠心病的学术思想,反映了冼绍祥教授诊疗冠心病的临床用药特点与经验.

高脂血症是脂肪肝、冠心病、脑血管疾病的危险因素.中医学认为,高脂血症是由脾、肾、肝三脏功能失调、痰瘀交阻而成,其病机以脾气虚弱为本,痰瘀致病为标.探讨从气治疗高脂血症的理论依据,并从健脾气、补肾气、疏肝气三方面具体论述从气论治高脂血症的可行性.

从“毒”邪致病和慢性心力衰竭(简称慢性心衰)发病探讨两者的相关性.“毒”邪致病具有发病急骤,传变迅速,复杂多变,顽固难治,病症缠绵难愈,败坏机体形质,损伤脏腑结构功能,对人体造成严重危害的特点.慢性心衰发病具有多邪合并,顽固不化;病情复杂,牵涉多脏;易于变化,危及生命等特征.从发病特点的相似性,说明在慢性心衰发病的过程中,有“毒”邪存在的可能.在治疗中,应予以解毒药物,并根据“毒”邪形成机制及所依附邪气的不同予以辨证施治.研究提示,中医药治疗有改善心功能不全动物的血流动力学指标,抑制心肌细胞的凋亡,防止心肌肥厚,抑制氧化酶的表达和肾素-血管紧张素系统过度激活等作用,还能够改善慢性心衰患者的生活质量及心功能.

Objective To investigate cellular model IL-1β-induced apoptosis in INS-1 cells,and observe the protective effect of Hanwenbingyong prescription. Methods The effects of Hanwenbingyong prescription(1,0. 5,0. 25,0. 125 g / L)on proliferation of INS-1 cell were observed by MTT after acting 24,48 and 72 h. Hanwenbingyong prescription (1,0. 5,0. 25,0. 125 g / L)pretreated cell for 12 h,and then 50 ng / L IL-1β-treated cells continue to 24 h. At the same time,made control group and IL-1β treatment group. Apoptosis was detected by V-FITC Annexin flow cytometry. Expression of Caspase3 and Bax Bcl-2 was detected by Western blotting. Results MTT showed Hanwenbingyong pre-scription promoted proliferation of INS-1 cells with a time and dose dependence. But the cells of 1g / L concentration were better than other groups after effected 72h. AnnexinV-FITC / PI showed that IL-1β promoted apoptosis. Western blotting showed that IL-1β promoted apoptosis protein synthesis,Hanwenbingyong prescription inhibited expression of IL-1β. Conclusion Hanwenbingyong prescription can promote proliferation of INS-1 cells,and inhibit the apoptosis of INS-1 induced by IL-1β,which can be used in prevention and treatment of inflammatory islet cell damage.

Objective To evaluate the synergistic effect of Baoxinkang on chronic heart failure(CHF) rats by observing the effect of the combination of Baoxinkang and conventional medicine intervention on cardiac function and adenylate metabolism.Methods Sixty Sprague-Dawley rats were randomly divided into 6 groups,namelysham-operation group,model group,Baoxinkang group(Baoxinkang 1 020 mg/kg),conventional medicine intervention group(metoprolol 10 mg/kg,captopril 5 mg/kg,and digoxin 0.022 5 mg/kg),combination group 1(conventional medicine intervention + Baoxinkang 1 020 mg/kg),and combination group 2(conventional medicine intervention + trimetazidine 10 mg/kg).Abdominal aora was constricted to establish CHF rat model.The rats except for the sham-operation group and model group were given the corresponding medicine according to the experimental design for 6 weeks.Echocardiography(ECHO) was performed to evaluate the cardiac function of rats.High performance liquid chromatography was utilized to investigate the contents of myocardiac adenylate of adenosine triphosphate(ATP),adenosine diphosphate(ADP),adenosine monophosphate(AMP).Total adenylate nucleotide pool(TAN) was equal to ATP+ADP+AMP,energy charge(EC) was equal to(ATP+0.5×ADP)/TAN.Results The results of ECHO showed that the heart size was reduced,left ejection fraction and cardiac output were increased in the combination group 1 compared with the model group and conventional medicine intervention group.The levels of ATP,TAN,and EC were significantly increased,whereas the levels of ADP and AMP were decreased in the combination group 1(P0.05 or P0.01).However,there were no significant differences of heart size,left ejection fraction,cardiac output,ATP,ADP,AMP,TAN or EC between combination group 1 and combination group 2(P 0.05).Conclusion Baoxinkang may have some synergistic effect on the improvement of CHF rat cardiac energy metabolism disorder treated by conventional medicine.

目的 观察保心康与常规药物疗法联用对慢性心力衰竭模型大鼠的心肌线粒体DNA及COX酶活性的影响.方法 选用60只SD大鼠随机分为假手术组、模型组、保心康组、常规治疗组、常规治疗+保心康组、常规治疗+曲美他嗪组.采用腹主动脉缩窄术复制慢性心力衰竭大鼠模型.各治疗组分别给予保心康(1 020 mg/kg)、常规治疗(美托洛尔10 mg/kg、卡托普利5 mg/kg、地高辛0.022 5 mg/kg)、曲美他嗪(10 mg/kg)6周,以心脏彩超测定各组大鼠的心功能后处死取心肌组织,以qPCR测定线粒体DNA缺失率、光谱法测定线粒体COX酶活性.结果 保心康组COX酶活性高于模型组(P＜0.05),保心康组与常规治疗组间COX酶活性则无显著性差异(P＞0.05).常规治疗+保心康组COX酶活性高于常规治疗组(P＜0.01).常规治疗+曲美他嗪组与模型组比较,mtDNA缺失率较低(P＜0.01).其它各药物治疗组与模型组相比较,mtDNA缺失率无显著性差异(P＞0.05).结论 提示保心康可能通过保护心肌COX酶活性来改善衰竭心肌的能量代谢障碍,但其对COX酶活性的改善并不是通过保护编码COX酶的mtDNA来实现的.

目的 通过对广州中医药大学第一附属医院2012年的膏方处方进行统计分析,初步探讨岭南地区膏方的组方特色.方法 从2012年所开具的膏方处方中去除不规范处方后共获得符合要求处方829份,将患者的年龄、性别、诊断、证型及组方用药等方面资料进行统计分析.结果 膏方患者中44岁以下患者544例,占65.92％,女性患者613例占73.94％;使用膏方治疗月经病及脾胃系疾病者比例最大,分别为23.01％和21.08％;气虚者居多;从膏方的组方来看,运用了大量岭南道地药材,理气消食药、清热药、祛湿药也有广泛应用.结论 我院膏方除在按照传统中医理论进行辨证论治的基础上使用相应的补益药外,较多运用了岭南道地药材.此外,消食药、祛湿药、清热药、行气药也较多地出现在膏方处方中.

Objective This research is to figure out whether the combination of Baoxinkang formula and conventional medicine therapy is better than conventional medicine therapy only in preservation of ATPase activity in chronic heart failure rat model. Methods Sprague-Dawley rats were randomly divided into 6 groups, the Baoxinkang group, conventional medicine therapy group, the Baoxinkang and conventional medicine therapy group, the trimetazidine and conventional medicine therapy group, control group and sham-operation group. Abdominal aortic constriction was performed to induce chronic heart failure . Baoxinkang(1020 mg·kg-1) in combination with conventional medicine therapy(Metoprolol 10 mg·kg-1, Captopril 5 mg·kg-1, Digoxin 0.0225 mg·kg-1) was administrated for 6 weeks. Echocardiography was performed to evaluate the cardiac function. The activity of Na+-K+-ATPase(NKA), Ca2+-Mg2+-ATPase(CMA) was examined by spectrometry. Results Echocardiography showed that either comparing with the control group or conventional medicine therapy group, Baoxinkang+conventional medicine therapy group had improved enlarged heart, higher ejection fraction, higher cardiac output and lower heart rate. Myocardial ATPase activity in Baoxinkang+conventional medicine therapy group were higher than those in the control group. Comparing with control group, Baoxinkang group has higher CMA activity, but similar NKA activity. No significant difference was observed in ATPase activity between Baoxinkang+conventional medicine therapy group and conventional medicine therapy group. Conclusion Baoxinkang formula could provide better protection to the activity of CMA, modulate the consumption of ATP to improve the cardiac function. The synergistic protection of Baoxinkang formula in combination with conventional medicine therapy may not completely cause by the preservation of ATPase activity. How does the Baoxinkang formula protect the activity of myocardial NKA and CMA needs further study.

目的:探讨十枣汤对悬饮(胸腔积液)模型大鼠的干预治疗作用.方法:72只Wistar大鼠采用简单随机法分为对照组(8只)、模型组(32只)、治疗组(32只),模型组、治疗组根据胸腔内注入角叉菜胶后处死时间,再分为12、24、36、48 h组,每组8只.观察动物的一般情况、尿量、大便性状.测定各组大鼠胸腔积液量,对胸腔积液进行细胞分类和计数,采用HE染色观察胸膜的病理变化.结果:注入角叉菜胶后大鼠胸膜腔有明显渗出,数据显示渗出液量24 h达高峰,36 h后开始下降,至48 h仅有极少量的液体渗出.治疗组也有相似的规律,但与模型组同时点相比较,胸水量明显减少(均P＜0.05).渗出液中白细胞总数升高且以多核细胞为主,与模型组比较总体有减少趋势,但个别组无统计学意义(P＞0.05).大鼠胸膜病理切片显示治疗组各时相胸膜间质水肿及白细胞浸润均比模型组同时点为轻.结论:十枣汤对悬饮(胸腔积液)模型大鼠有明显的治疗效果,能够明显减少胸腔积液量;减轻胸膜间质水肿及胸膜组织炎性细胞浸润;降低胸腔积液白细胞的总数.

岭南中医药文化对养生保健有重大的指导意义,体现了中医"治未病"理念。从分析岭南中医药文化发展,结合岭南的自然条件和人群体质特点,论述岭南中医药文化,指导民众的养生保健。

Objective:To observe the effects of reinforcing lung prescription on MCP-1,VCAM-1 and ICAM-1 of lung asthenia model rats to explore the mechanism of viscous phlegm.Methods:40 SD rats were randomly divided into model group(n=19) and treatment group(n=21).Establish the rats model of lung asthenia and phlegm stagnation using cold stimulation and smudging.The treatment group was given intragastric administration of reinforcing lung prescription and the model group was given equal volume of normal saline,14D.Observe the general activities,cough numbers after 3 min with ammonia stimulation,pathological changes of rat lung tissue and MCP-1,VCAM-1 and ICAM-1 changes.Results:Compared the cough numbers in 3 min,the difference was statistically significant(P<0.05).The pathological sections showed the trachea,bronchial goblet cell proliferation,adenoid hypertrophy and hyperplasia in treatment group were better than those of model group.The intercellular adhesion molecule-1(ICAM-1),vascular cell adhesion molecule-1(VCAM-1) and monocyte ingratiate oneself factor-1(MCP-1) were significantly higher than those in model group(P<0.05).Conclusion:Reinforcing lung prescription can reduce the content of MCP-1,ICAM-1 and VCAM-1 in lung tissue.

岭南内科学术流派的发展促进了岭南医学的发展,成为中医学的重要组成部分,对岭南地区疾病的诊疗有指导意义.从分析岭南内科学术流派的形成发展历程,探讨其形成因素,研究各个学术流派的特征及代表人物,并总结其意义,可为各地医学学术流派的发展提供一定理论依据.

Objective: 1)To investigate the formative mechanism of phlegm obstruction due to lung-deficiency syndromes.2)To investigate the dynamic changes of the above parameters by detecting the effects of the herbal compound that "invigorates the lung and promotes expectorant" on the expression of AQP1 and AQP5 in the phlegm obstruction due to lung-deficiency syndromes model rats.Methods:Male SD Rats were randomly divided into three groups:normal,model,and treatment(with herbal Rats were treated by "invigorate lung expectorant" herbal compound).The pathologic changes of lung were analyzed by microscopy with H&E staining.The mRNA and protein expressions of AQP1 and AQP5 were assayed by semi-quantitative RT-PCR and western blot respectively.Results:There was no expression of AQP1 mRNAs in the model and treated groups,while the expression of AQP5 mRNAs increased in the model group.Western blot analysis showed similar pattems of AQP5 protein being upregulated(P＜0.01)while AQP1 downregulated(P＜0.05).The expression of the AQP5 protein in the treated group decreased compared with that in the normal group(P＜0.05).Conclusions:1)One of the pathological mechanisms of the syndrome of "phelgm obstuction due to lung deficiency" is caused by the up-regulation of AQP5 and down-regulation of AQP1 gene and protein expression in lungs of the alveolar epithelium of rats.2)The expectorant herbal compound treatment can regulate the gene and protein expression of AQP5 but can't regulate the AQP1 when the rats have this desease.These results suggest that the mechanism of this compound acting on this desease is related to the regulation of the expression of AQP1 AQP5.

目的 观察益气活血化痰方对老年舒张性心力衰竭气虚血瘀痰滞证患者6 min步行试验(6MWT)、生活质量和安全性指标的影响.方法 将患者随机分为两组,对照组采用单纯西医治疗；治疗组在西医治疗基础上加用益气活血化痰方治疗.疗程为30 d.观察两组近期临床疗效、6MWT距离、生活质量评分及安全性指标治疗前后的变化.结果 治疗组临床疗效优于对照组.两组6MWT以及明尼苏达生活质量问卷调查评分均有改善,且治疗组优于对照组.两组药物对人体血常规、肝功能、肾功能均无明显影响.结论 益气活血化痰方治疗老年舒张性心力衰竭气虚血瘀痰滞证患者有确切疗效,在提高6MWT距离和生活质量评分方面优于单纯西医常规,且对血常规、肝功能和肾功能无影响,安全可靠.

AIM To use the basic molecular parameters of genomic expression and protein expression of αENaC to study the rat model for phlegm obstruction due to lung-deficiency syndromes and to observe the dynamic changes of the parameters after medication with Bufei Huatan Decoction.METHODS Sixty male SD rats were randomized into three groups: normal,model,and treatment group(with herbal compound).Model and treatment groups were induced continuously by fumigation for 40 days.After 26 days of induction,the treatment group was given Bufei Huatan Decoction by intragastric administration for two weeks.The mRNA and protein expressions of αENaC in lung were assayed by semi-quantitative RT-PCR and Western blot as well as immunohistochemical staining,respectively.RESULTS Immunohistochemical staining assay showed that the positive rate of αENaC protein expression in lung tissues of the model group was significantly higher than those of normal and treatment groups(P0.001).In the treatment group,protein expression was remarkably increased over the normal group(P0.05);mRNA and protein expression of αENaC were significantly higher in the model group compared with the normal group(P0.01).The same parameters were significantly higher in the treatment group when compared with the normal group(P0.05),but lower than the model group(P0.05).CONCLUSION These results suggest that one of the pathological mechanisms of the syndrome of phelgm obstuction due to lung deficiency may be caused by the upregulation ofαENaC gene and protein expression lungs of the alveolar epithelium of rats;Bufei Huatan Decoction downregulates the gene and protein expression of αENaC in the lungs of model rats.

Objective:The research starts to explore the impact of different parts of Acorus Tatarinowii Schott pentylenetetrazol kindled rats on neuropeptide Y content.Methods:80 SD rats, intraperitoneal injection of pentylenetetrazol solution, 35mg·kg-1 body weight, one time every other day, a total of 14 times.The successfully kindled rats are divided into 8 groups and drug is fed into the stomach once a day.Acorus tatarinowii volatile oil was given at 50mg·kg-1 body weight; high doses of Acorus tatarinowii liquid extract with the volatile oil removed at 28 g·kg-1 body weight; Medium doses were given at 14 g·kg-1 body weight; low-doses were given at 7 g· kg-1 body weight,β-asarone 100mg·kg-1 body weight、α-asarone 70mg·kg-1 body weight.Positive control group was given sodium valproate (VPA) at 126mg·kg-1 body weight treatment.The normal group of 5 rats was given a normal ration without any special treatment.The model group was given the same volume of physiological saline.36 days after treatment with the same dose of intraperitoneal injection of pentylenetetrazol, a test was done to determine the efficacy, the potential seizure observation time, the level and frequency of attacks, and the number of wet dogs.All rats were decapitated and their brains were obtained.Neuropeptide Y content in hippocampus was measured by means of radioimmunoassay.Results:After treatment, hippocampal neuropeptide Y content in rats of various groups is raise compared with the normal group.The best result is shown in the low dose group of Acorus Tatarinowii water extracts with volatile oil removed ,and the positive group,statistical significance is shown compared with the normal group(P0.01).The next best group is model group, statistical significance is shown compared with the normal group (P0.05).Conclusion:After treatment, hippocampal neuropeptide Y content in rats of various groups is raise.

Objective:To analyze the components of waterextraction in Rhizoma Acori Tatarinowii removing volatile oil by Liquid chromatography-mass spectrometry (LC-MS).Methods:A full-scan was done under the conditions including Meth:H2O (5:95), pH10 (ammonia adjust), 400 μL/min of the flow rate, column temperature and room temperature (24 ℃).In accordance with literatures, some of the known compounds were chosen to do a selected ion monitoring (SIM).From the results of the selected ion monitoring, a number of possible compounds with more intense signal were earmarked for two full-scan MS.Results:There were nine known compounds in water extraction of Rhizoma Acori Tatarinowii removing volatile oil by LC-MS Monitoring:4,5,8-trimethoxy-xanthone-2-o-β-D-gluco-pyranosy (1→2)-o-β-D-gdactopyranoside (Ⅰ)3β,22α,24,29-tetrahydroxyole-12-en-3-o-{-β-D-arabinosy-(1→3)-β-D-arabinopyranoside(Ⅱ)Luteolin-6,8-C-diglucoside(Ⅲ)、1β,2α,3β,19α-tetrahydroxyurs-12-en-28-oic acid-28-o-{-β-glucopy-ranosil(1→2)}-β-glactopyranoside(Ⅳ), tatarine B (Ⅴ), galangin(Ⅵ), asaryladehyde(Ⅶ), 1,2-dimethoxy-4-(E-3'-methyloxiranyl)benzene (Ⅷ) and tatarine A (Ⅸ).Conclusions:In the nine components of water extraction in Rhizoma Acori Tatarinowii removing volatile oil, it might contain the effective constituent forepilepsy treatment.

Objective To study the effect of Bufei Huatan Formula (Herbal formula for reinforcing the lung to dissolve phlegm) on the changes of activity of Na+-K+-ATPase of the rat models with phlegm retention due to lung deficiency. Methods Thirty SD rats were randomized into normal group,model group and treatment group with 10 in each. The models of lung deficiency with phlegm retention were made with cold wind and smoking. The treatment group received Bufei Huatan Formula,the normal group and model group were given normal saline of equal-volume for 14 days. General activities,times of cough induced by the stimulation of concentrated ammonia within 3 minutes,pathological changes in the lung tissues,and changes of activity of Na+-K+-ATPase were observed. Results The times of cough of the model and treatment groups were increased compared to that of the normal group (P0.05). The pathological section of the treatment group showed that the goblet cell hyperplasia and glandular hypertrophy of trachea and bronchi were milder than those of the model group. The activity of Na+-K+-ATPase of the model and treatment group was lower than that of the normal group (P0.05),but the treatment group was significantly higher than the model group (P0.05). Conclusion Bufei Huatan Formula is able to up-regulate the activity of Na+-K+-ATPase of the model rats with phlegm retention due to lung deficiency. The decrease of activity of Na+-K+-ATPase of the alveolar wall basement membrane is possibly one of the important mechanisms inducing the lung deficiency with phlegm retention.

Objective:To observe effects of Shenchang Injection on platelet activation and thrombosis in MCAO rats. Method: The cerebral injury model induced by ischemia /reperfusion was made in rat by MCAO. Shenchang injection was given by iv for 7 times,then CD62p、CD63 were measured by flow-cytometry. Thrombosis and clotting time were observed. Result:Shenchang injection could decrease expression of CD62p and CD63 in blood,decline thrombosis in kidney vein,delay clotting time in MCAO rats. Conclusion:Shenchang injection is effect for antiplatelet activities and postponement of thrombosis by extending blood clotting. These are likely the pharmacological basis of the injection for treating stroke.