作者机构：
[Zhi-Hua G.; Yu-Ying L.; Jia-Ming W.; Tong-Yu Z.; Lin K.; Ya L.] Hunan University of Chinese Medicine, Changsha, Hunan 410208, China;[Jun-Ping Z.] Shenzhen Pingle Hospital of Orthopedics and Traumatology, Shenzhen Pingshan Chinese Medicine Hospital, Shenzhen, Guangdong 518001, China
通讯机构：
[Guo Zhi-Hua; Li Ya] H;Hunan University of Chinese Medicine, Changsha, Hunan, 410208, China
摘要：
Objective:To explore the effect of Qingwen Baidu Decoction(清瘟败毒饮,QWBDD)on TLR4/NF-κB signaling pathway and downstream inflammatory factor IL-6 and TNF-αin sepsis rabbits.Methods:10 rabbits were randomly extracted from 40 New Zealand rabbits as blank group.The sepsis model was established by intravenous injection of colibacillus endotoxin into rabbit ear vein,30 rabbits were randomly divided into model group(10 rabbits),QWBDD group(10 rabbits)and Xuebijing(血必净)group(10 rabbits).The three sepsis groups were given corresponding pharmaceutical preparations after modeling.The blank group was given the same amount of physiological saline by gastric lavage.Toll 4,NF-κB and its downstream inflammatory factors IL-6 and TNF-αwere detected by ear vein blood sampling at 24 and 48 hours after modeling.Results:Compared with the blank group,the levels of TLR4,NF-κB,IL-6 and TNF-αin model group,QWBDD group and Xuebijing injection group were higher(P<0.05),suggesting that the model was successful.24 hours after administration,the levels of TLR4,NF-κB,IL-6 and TNF-αin QWBDD group and Xuebijing group were lower than those in model group(P<0.05).After 48 hours of administration,the levels of TLR4,NF-κB,IL-6 and TNF-αin QWBDD group were lower than those in Xuebijing injection group(P<0.05).Conclusion:Qingwen Baibu Decoction can alleviate systemic inflammatory response in sepsis rabbits through Toll 4/NF-κB signaling pathway.
摘要：
目的观察加味大承气汤保留灌肠辅助治疗腑实热结证重症急性胰腺炎(SAP)并发急性呼吸窘迫综合征(ARDS)的疗效。方法将腑实热结证SAP并发ARDS患者90例随机分为观察组和对照组各45例。对照组予以常规治疗,观察组在常规治疗的基础上加用加味大承气汤保留灌肠,每次200ml,每日2次,疗程为5天。记录患者腹痛腹胀缓解时间、首次排便或排气时间、机械通气时间、ICU住院时间以及患者的病死率;分别于治疗前及治疗第3天、第5天测定胰腺炎相关指标:血淀粉酶(AMS)、尿淀粉酶(UAMY)、腹腔内压(IAP);肠黏膜屏障功能指标:二胺氧化酶(DAO)、内毒素(ET)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、超敏C反应蛋白(hs-CRP);ARDS评价指标:气道峰压(Peak)、气道平台压(Plat)、呼吸频率(F)、动脉血氧分压(PaO_2)、氧合指数(PaO_2/FiO_2)。治疗前后进行中医证候评分,治疗后评价中医证候疗效。结果观察组中医证候疗效总有效率为82.2%,对照组为64.5%,观察组明显高于对照组(P<0.01);与本组治疗前比较,两组治疗第3天和第5天,AMS、UAMY、IAP、DAO、ET、TNF-α、IL-6、hs-CRP、Peak、Plat、F水平均明显降低,PaO_2、PaO_2/FiO_2均明显升高(P<0.05);与对照组治疗第3天、第5天比较,观察组相应时间点的AMS、UAMY、IAP、DAO、ET、TNF-α、IL-6、hs-CRP、Peak、Plat、F明显降低(P<0.05),PaO_2、PaO_2/FiO_2明显升高(P<0.05);与对照组比较,观察组患者腹痛腹胀缓解时间、首次排便或排气时间、机械通气时间、ICU住院时间明显缩短,病死率明显下降(P<0.05)。结论加味大承气汤保留灌肠联合西医常规治疗腑实热结证SAP并发ARDS患者,能促进肠功能的恢复,修复受损的肠黏膜屏障,降低腹腔压力,提高氧合,降低气道压力,减轻ARDS所致的呼吸衰竭,减少住院时间,降低病死率,临床疗效优于单用西医常规治疗。 <&wdkj&>Objective To observe the effect of Modified Dachengqi Decoction (加味大承气汤) retention enema on severe acute pancreatitis (SAP) complicated with acute respiratory distress syndrome (ARDS).Methods A total of 90 patients with SAP complicated with ARDS were randomly divided into an observation group and a control group. The control group received routine treatment. The observation group was treated with Modified Dachengqi Decoction retention enema on the basis of treatment of the control group, 200ml each time, 2 times a day for 5 days. The patient's abdominal pain and bloating relief time, first defecation/exhaustion time, mechanical ventilation time, ICU hospitalization days, and patient mortality were recorded. Pancreatitis related indicators were measured before treatment and on the 3rd and 5th day of treatment including blood amylase (AMS), urinary amylase (UAMY), intra-abdominal pressure (IAP); intestinal mucosal barrier function indicators including diamine oxidase (DAO), endotoxin (ET), tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), high-sensitivity C-reactive protein (hs-CRP) and ARDS evaluation index including peak airway pressure (Peak), airway platform pressure (Plat), respiratory rate (F), arterial oxygen partial pressure ( PaO_2), oxygenation index (PaO_2/FiO_2) were detected. Traditional Chinese medicine (TCM) syndrome scores were evaluated before and after treatment, and the efficacy of TCM syndromes was evaluated after treatment.Results The total effective rate of TCM syndromes in the observation group was 82.2%, and that in the control group was 64.5%. The observation group was significantly higher than the control group (P<0.01). On the 3rd day and the 1st day, the levels of AMS, UAMY, IAP, DAO, ET, TNF-α, IL-6, hs-CRP, Peak, Plat, and F of both groups were significantly decreased compared with the time before treatment, and PaO_2 and PaO_2/FiO_2 were significantly increased (P<0.05). Compared with the control group on the 3rd and 5th day, the AMS, UAMY, IAP, DAO, ET, TNF-α, IL-6, hs-CRP, Peak, Plat, F were significantly decreased in the observation group at the corresponding time points (P<0.05), and PaO_2, PaO_2/FiO_2 increased significantly (P<0.05); Compared with the control group, abdominal pain and bloating relief time, first defecation/exhaustion time, mechanical ventilation time, ICU hospitalization days of the observation group patients were significantly reduced, and mortality was significantly decreased (P<0.05).Conclusion On the basis of comprehensive treatment of western medicine, Modified Dachengqi Decoction enema in the treatment of SAP with ARDS of fu-viscera excess and heat stagnation syndrome, can promote the recovery of intestinal function, repair damaged intestinal mucosal barrier, reduce abdominal pressure and improve oxygenation, reduce airway pressure, reduce respiratory failure caused by ARDS, improve the condition, delay the progress of the disease, reduce the length of hospital stay, reduce the mortality rate, and the clinical effect is better than the comprehensive treatment with western medicine.
摘要：
Objective: By establishing the acute myocardial ischemia (AMI) model, to investigate the effects of Xintongtai granule on new blood vessels density, the expression of Notch1, D114 protein in rats with AMI. Methods: The rats were randomly divided into six groups, except for the 10 rats in sham -operation group, the other rats were ligatured left anterior of coronary artery to establish the rat models of AML Then randomly di-vided into the model group, high-, medium- and low-dose of Xintongtai groups, and Shexiang Baoxin pill (麝香保心丸)group, which were treated separately with distilled water, high-dose, medium-dose and low-dose of Xin-tongtai and Shexiang Baoxin pill by gavaged for 2 weeks, the new blood vessels density in myocardial tissue, the expression of Notch1 and D114 protein in myocardial tissue was tested using immunohistochemical method. Results: The expression of Notch1 and D114 in ischemic myocardium and the microvessel density of ischemic myocardium in model group were higher than those in sham-operated group (P<0.05), and the expression of Notch1 and D114 in ischemic myocardium in Xintongtai group and Shexiang Baoxin Pill group were higher than those in model group (P<0.05). Conclusion: Xintongtai has protective effect on ischemic myocardium, which may-be related to its activation of Notch signaling pathway, up-regulation of Notch1 and D114 protein expression in ischemic area and promotion of angiogenesis.
