围绕传统中医药研究，本期精选发表在《中华中医药学刊》5篇双语文章，欢迎阅读！
精选文章·Selected Articles
01
从“气阴两虚”论探讨玉液汤治疗2型糖尿病研究进展
Research Progress on Yuye Decoction (玉液汤) Treating Type 2 Diabetes from Both Deficiency of Qi and Yin
【摘要】玉液汤由清代名医张锡纯所创，记载于《医学衷中参西录》,是以益气养阴法治疗消渴病的经典名方，而气阴两虚作为糖尿病的主要病因病机之一，临床根据此病机运用玉液汤治疗糖尿病及合并症有独特优势，临床疗效显著且安全性较高。系统检索中国知网，万方数据知识服务平台等数据库近年来公开发表的关于玉液汤治疗2型糖尿病的临床应用及相关的药效机制研究文献，总结发现玉液汤无论是单独运用还是与西药联用治疗2型糖尿病以及糖尿病肾病、视网膜病变、周围神经病变等并发症，均获得较好的疗效。基于此从气阴两虚的角度对玉液汤治疗2型糖尿病的一系列研究及临床运用进行整理和分析总结，以期为今后开展玉液汤在临床得到更加深入与广泛的运用。
【Abstract】Yuye Decoction (玉液汤) was created by ZHANG Xichun, a famous doctor in the Qing Dynasty, and recorded inMedicine Zhongzhong Shenxilu. According to this pathogenesis, the use of Yuye Decoction in the treatment of diabetes and comorbidities has unique advantages, with significant clinical efficacy and high safety. The author systematically searched databases such as CNKI, Wanfang Data Knowledge Service Platform, and other databases published in recent years on the clinical application of Yuye Decoction in the treatment of type 2 diabetes and related pharmacodynamic mechanisms. Combination with western medicine in the treatment of type 2 diabetes and diabetic nephropathy, retinopathy, peripheral neuropathy, and other complications has achieved good curative effects. Based on this, this article organizes and analyzes a series of studies and clinical applications of Yuye Decoction in the treatment of type 2 diabetes from the perspective of both deficiency of Qi and Yin, with a view to further in-depth and extensive clinical application of Yuye Decoction in the future.
02
补阳还五汤配合温阳针灸法治疗老年缺血性脑卒中恢复期气虚血瘀证的疗效观察
Efficacy of Buyang Huanwu Decoction (补阳还五汤) Combined with Acupuncture and Moxibustion for Warming Yang in Treatment of Elderly Ischemic Stroke in Convalescent Stage of Qi Deficiency and Blood Stasis Syndrome
【摘要】目的 分析补阳还五汤配合温阳针灸法治疗老年缺血性脑卒中恢复期气虚血瘀证的临床疗效。方法 选取三亚市中医院2019年1月—2021年10月收治的102例缺血性脑卒中恢复期气虚血瘀证老年患者，采用随机数字表简单随机分组法分为针灸组与联合组，各51例，针灸组行温阳针灸治疗，联合组在针灸组基础上配合补阳还五汤治疗，均治疗4周。记录两组患者临床疗效，比较两组患者治疗前、治疗4周后中医证候积分、日常活动能力[改良Barthel指数评定量表(Modified Barthel Index, MBI)、Fugl-Meyer运动功能评分(Fugl-Meyer Motor Assessment, FMA)]、心肺耐力[6 min步行测试(6-min walk test, 6MWT)、最大摄氧量(maximal oxygen uptake, VO2max)、最大运动负荷(maximum exercise load, Metsmax)]、血清学指标[成纤维细胞生长因子23(fibroblast growth factor 23，FGF23)、Klotho]差异。结果 两组患者均完成4周的治疗，其间未出现治疗相关不良事件，联合组临床疗效明显高于针灸组(P<0.05)。治疗4周后，两组患者中医证候积分及血清FGF23、Klotho水平均较治疗前降低(P<0.05),且联合组治疗后低于针灸组(P<0.05);两组患者MBI指数、上肢及下肢FMA评分、6MWT、VO2max、Metsmax均较治疗前升高(P<0.05),且联合组治疗后高于针灸组(P<0.05)。结论 补阳还五汤配合温阳针灸治疗缺血性脑卒中恢复期气虚血瘀证疗效显著，具有良好应用前景。
【Abstract】ObjectiveTo analyze the clinical efficacy of Buyang Huanwu Decoction (补阳还五汤) combined with acupuncture and moxibustion for warming Yang in the treatment of convalescent stage of elderly ischemic stroke of Qi deficiency and blood stasis syndrome.MethodsA total of 102 elderly patients with convalescent ischemic stroke of Qi deficiency and blood stasis syndrome who were admitted to Sanya Hospital of Traditional Chinese Medicine were selected between January 2019 and October 2021, and they were divided into acupuncture and moxibustion group and combined group by simple random grouping method of the random number table method, with 51 cases in each group. The acupuncture and moxibustion group was treated with acupuncture and moxibustion for warming Yang, while the combined group was combined with Buyang Huanwu Decoction on the basis of the acupuncture and moxibustion group, and both groups were treated for 4 weeks. The clinical efficacy of the two groups was recorded, and the scores of TCM syndromes, daily activity ability [Modified Barthel Index (MBI), Fugl-Meyer Motor Assessment (FMA)], cardiopulmonary endurance [6-min walk test (6MWT), maximal oxygen uptake (VO2max), maximum exercise load (Metsmax)] and serological indicators [fibroblast growth factor 23 (FGF23), Klotho] were compared between the two groups before and after 4 weeks of treatment.ResultsBoth groups completed 4 weeks of treatment, and no treatment-related adverse events occurred during the period. The clinical efficacy in the combined group was significantly higher than that in the acupuncture and moxibustion group (P< 0.05). After 4 weeks of treatment, the scores of TCM syndromes and levels of serum FGF23 and Klotho in the two groups were reduced compared with those before treatment (P< 0.05), and the scores and levels were lower in the combined group than those in the acupuncture and moxibustion group after treatment (P< 0.05). The MBI index, FMA scores, 6MWT, VO2maxand Metsmaxof upper and lower extremities in the two groups were all higher than those before treatment (P< 0.05), and the above indicators in the combined group after treatment were higher compared to those in the acupuncture and moxibustion group (P< 0.05).ConclusionBuyang Huanwu Decoction combined with acupuncture and moxibustion for warming Yang has a significant efficacy in the treatment of convalescent stage of ischemic stroke of Qi deficiency and blood stasis syndrome, with a good application prospect.
03
邹忆怀教授从肝心论治慢性失眠的用药规律
ZOU Yihuai’s Medication Patterns in Treatment of Chronic Insomnia from Perspective of Liver and Heart
【摘要】目的 基于中医传承计算平台(V3.0),分析邹忆怀教授对慢性失眠的用药规律。方法 收集2018年1月1日—2021年9月30日邹忆怀教授门诊治疗慢性失眠的首诊处方，运用中医传承辅助平台进行数据录入，构建邹忆怀教授诊治慢性失眠的医案数据库。运用频数统计分析、关联规则分析、聚类分析等方法，分析患者性别、年龄，用药频数，药物四气五味，归经分布，组方规律及药物组合，统计中药应用特点和组方规律分析结果。结果 共筛得有效方剂154首，涉及中药110味，累计使用频数为4732次。使用频数≥30的中药有30味，药性主要为寒性、温性、平性，药味主要为苦、辛、甘味，归经多属肝、心、脾、肺经，功效以清热类、理气类、安神类为多。常用核心药物组合共364组。聚类分析结合临床经验得到5组可以用于新处方的聚类药物组合。结论 邹忆怀教授认为治疗慢性失眠当从肝心论治，辨证应用疏肝、宁心并举的治法，兼顾调和脾胃、宣肃肺气，体现了补虚泻实、升降得宜、平调气机的整体指导思想。
【Abstract】ObjectiveTo analyze Professor ZOU Yihuai’s medication patterns for chronic insomnia based on the Traditional Chinese Medicine (TCM) Inheritance Computing Platform (V3.0).MethodsThe initial diagnosis prescriptions of Professor ZOU’s outpatient treatment of chronic insomnia, spanning from January 1, 2018, to September 30, 2021, were collected. The data were input into the TCM Inheritance Computing Platform to construct a medical case database for ZOU’s diagnosis and treatment of chronic insomnia. Frequency statistical analysis, association rule analysis, cluster analysis, and other methods were employed to analyze the patient’s gender, age, medication frequency, four natures and five tastes of drugs, meridian distribution, prescription pattern, and drug combinations. Statistical analysis was conducted on the characteristics of TCM medication application and prescription patterns.ResultsA total of 154 effective prescriptions were screened, involving 110 Chinese drugs, with a cumulative usage frequency of 4,732 times. 30 kinds of Chinese drugs were used more than 30 times. Their natures were mainly cold, warm, and neutral, and their tastes were bitter, acrid, and sweet. These drugs belonged to the liver, heart, spleen, and lung meridians, and their effects were mainly clearing heat, regulating Qi, and tranquilizing. There were 364 groups of common core drug combinations. Through cluster analysis combined with clinical experience, five groups of cluster drug combinations applicable to new prescriptions were obtained.ConclusionZOU believes that the treatment of chronic insomnia should be based on the treatment of the liver and heart. The approach involves the application of liver-soothing and heart-calming methods in syndrome differentiation, Additionally, it includes consideration for harmonizing the spleen and stomach, as well as promoting and regulating lung Qi. This reflects the overall guiding philosophy of tonifying deficiency and dispelling excess, appropriately lifting and lowering Qi, and regulating the Qi mechanism.
04
苍耳草化学成分、药理作用及质量标志物预测分析
Chemical Components and Pharmacological Action for Cang’ercao ( Xanthium sibiricum Patrin ex Widder) and Predictive Analysis on its Q-marker
【摘要】苍耳草广泛分布于东北、华北、华东、华南、西北及西南各省区，药用资源丰富，用药历史悠久，其化学成分主要包括酚酸及其衍生物类、倍半萜内酯类、挥发油类和脂肪酸类等成分，具有抗炎、抗菌、抗病毒、抗肿瘤、增强免疫、调节血糖等药理作用，临床用于治疗鼻炎、肩周炎、麻风、痢疾、关节炎、癌症等疾病。在对其化学成分、药理作用及临床应用和安全性评价做概述的基础上，根据中药质量标志物的核心概念，对苍耳草的质量标志物(quality marker, Q-marker)进行预测分析，认为苍耳草的酚酸类、倍半萜内酯类、挥发油类及水溶性苷类成分是苍耳草的质量标志物，为苍耳草质量评价体系的建立提供参考。
【Abstract】Cang’ercao (Xanthium sibiricumPatrin ex Widder, XPW) is widely distributed in northeastern, northern, eastern, southern, northwestern, and southwestern China. It has abundant resources and a long history of use. Its chemical components mainly include phenolic acids and their derivatives, sesquiterpene lactones, volatile oils, and fatty acids. These components exhibit anti-inflammatory, antimicrobial, antiviral, antitumor, immunity-enhancing, and blood glucose-regulating effects. In clinical practice, XPW is used to treat conditions such as rhinitis, periarthritis of the shoulder, leprosy, dysentery, arthritis, and cancer. Based on an overview of its chemical components, pharmacological effects, clinical applications, and safety evaluation, and in accordance with the core concept of traditional Chinese medicine quality markers (Q-markers), this paper predicts the Q-markers of XPW. Phenolic acids, sesquiterpene lactones, volatile oils, and water-soluble glycosides are considered as the Q-markers of XPW. The findings provide a reference for the establishment of a quality evaluation system for this medicinal plant.
05
杞黄降糖胶囊对初发2型糖尿病临床疗效分析及对胰岛功能的影响
Clinical Effect Analysis of Qihuang Jiangtang Capsule (杞黄降糖胶囊) on Primary Type 2Diabetes Mellitus and Its Effect on Islet Function
【摘要】目的 观察杞黄降糖胶囊对初发2型糖尿病患者的临床疗效及其对胰岛功能的影响。方法 选取76例初发2型糖尿病患者，随机分为两组，观察组(39例)给予杞黄降糖胶囊治疗，对照组(37例)给予盐酸二甲双胍肠溶片治疗，均治疗12周，检测并记录两组患者治疗前后的空腹血糖(FPG)、餐后2 h血糖(PPG)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、糖化血红蛋白(HbA1c)等指标，并于治疗前后行葡萄糖耐量试验及胰岛素释放试验，计算胰岛素抵抗指数(HOMA-IR),并计算30 min胰岛素(30 minINS)与空腹胰岛素(FINS)差值(ΔI30)和30 min血糖(30 minPG)与空腹血糖(FPG)差值(ΔG30)的比值(ΔI30/ΔG30),即ΔI30/ΔG30=(I30-I0)/G30-G0),同时比较两组不良反应情况。结果 两组患者治疗后，FPG、PPG、HbAlc、HOMA-IR等指标均明显下降(P<0.05),30 minFINS、ΔI30/ΔG30均明显上升(P<0.05);观察组治疗后的FPG、PPG、HbAlc、HOMA-IR、ΔI30/ΔG30等指标较对照组治疗后差异均没有统计学意义(P>0.05)。治疗前后，对照组及观察组的TC、TG、LDL-C水平均显著下降(P<0.05);观察组治疗后的LDL-C水平较对照组治疗后LDL-C水平低(P<0.05)。观察组胃肠道不良反应明显少于对照组(P<0.05)。结论 杞黄降糖胶囊能有效降低初发2型糖尿病患者血糖、血脂水平，具有减轻胰岛素抵抗及改善胰岛功能的作用，且用药安全性高、不良反应少。
【Abstract】ObjectiveTo observe the clinical effect of Qihuang Jiangtang Capsule (杞黄降糖胶囊) on patients with primary type 2 diabetes mellitus and its effect on islet function.MethodsIn our study, we enrolled 76 participants with type 2 diabetes mellitus at the beginning, and participants were randomly divided into two groups. The observation group was treated with Qihuang Jiangtang Capsule. The control group was treated with metformin. The treatment was lasted for 12 weeks. Participants in two groups were measured the fasting plasma glucose (FPG), 2-hour plasma glucose(PPG), total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL-C), high density lipoprotein cholesterol (HDL-C), glycated hemoglobin A1 c(HbA1 c), and performed oral glucose tolerance test and insulin release test before and after treatment. Homeostasis model insulin resistance index (HOMA-IR) was applied to assess the status of insulin resistance, 30 min net increment of insulin/30 min net increment of glucose(ΔI30/ΔG30) were used to evaluate the basic function of islet β cells.ResultsCompared with those before treatment, FPG, PPG, HbAlc and HOMA-IR were significantly lower after treatment in the two groups (P< 0.05), while 30 min FINS and ΔI30/ΔG30 were significantly higher after treatment in the two groups (P< 0.05). There were no significantly differences in FPG, PPG, HbAlc, HOMA-IR or ΔI30/ΔG30 after treatment in the control group compared with those of the observation group (P> 0.05). After treatment, the serum levels of TC, TG and LDL-C in the control group and the observation group were decreased significantly(P< 0.05). The LDL-C level in the observation group after treatment was lower than that in the control group after treatment (P< 0.05). The gastrointestinal adverse reactions in the observation group were significantly lower than those in the control group (P< 0.05).ConclusionQihuang Jiangtang Capsule could effectively reduce the level of plasma glucose, serum lipid levels and insulin resistance and improve the function of islet in patients with primary type 2 diabetes, and it had high drug safety and less adverse reactions.
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