目的 探讨宣清导浊汤加减方联合血液透析治疗对老年慢性肾衰竭（CRF）患者肾功能、微炎症状态和毒素清除率的影响。方法 回顾性选取2019年10月—2022年10月我院收治的82例老年CRF患者,将其根据治疗方法分为联合组与单一组,每组41例。单一组仅采取血液透析治疗,联合组联合宣清导浊汤加减方治疗,对比两组患者治疗前后中医证候积分、毒素清除率、炎症因子变化。结果 治疗后,两组患者口淡不渴、肢体麻木、腰膝酸软、倦怠乏力、食少纳呆以及面色晦暗相关中医证候积分均降低,且联合组低于单一组（P<0.05）;治疗后两组患者血肌酐、尿素氮、血β₂-微球蛋白均降低,联合组低于单一组（P<0.05）;治疗后两组患者白细胞介素-6、C-反应蛋白、肿瘤坏死因子-α炎性因子水平明显降低,且联合组更低（P<0.05）。两组在治疗期间均无不良反应。结论 宣清导浊汤加减方联合血液透析治疗老年CRF患者效果较佳,可通过降低机体炎症因子表达水平、提高毒素清除率来改善患者临床症状,且不会增加不良反应。

Objective To explore the effect of Xuanqing Daozhuo Decoction modified formula combined with hemodialysis treatment on renal function,micro inflammatory status,and toxin clearance rate in elderly patients with chronic renal failure（CRF）．Methods Retrospectively,82 elderly CRF patients admitted to our hospital from October 2019 to October 2022 were selected and divided into a combination group and a single group according to the treatment methods,with 41 cases in each group． The single group was treated with hemodialysis only,and the combined group was treated with Xuanqing Daozhuo Decoction modified formula additionally．The changes of TCM syndrome scores,toxin clearance rate and inflammatory factors before and after treatment were compared between the two groups．Results After treatment,the scores of TCM syndroms including tasteless mouth and no thirst,numbness of limbs,soreness and weakness of waist and knee,fatigue,poor appetite and sluggish stomach were all decreased in 2 groups,and those in combined group were lower（P<0.05）．After treatment,serum creatinine,blood urea nitrogen and β₂-microglobulin were decreased in 2 groups,and those in combined group were lower（P<0.05）．After treatment,the levels of interleukin-6,C-reactive protein and tumor necrosis factor-α inflammatory factors were significantly decreased in 2 groups,which were lower in combination group（P<0.05）．The two groups had no adverse effects during the treatment period．Conclusions Xuanqing Daozhuo Decoction modified formula and hemodialysis can improve the clinical symptoms of elderly patients with CRF,reduce the expression level of inflammatory factors in patients,and increase the clearance rate of toxins in patients,and does not increase the adverse effects．

目的 探讨在早期早产儿配方奶(PF)喂养失败下,更换母乳(HM)或深度水解奶(eHF)对极低出生体质量儿喂养不耐受(FI)的改善情况。方法 选择2016年1月—2018年1月在广州市妇女儿童医疗中心出生、生后PF喂养失败、出现FI的极低出生体质量儿84例,根据家长HM喂养意愿及条件,分为HM喂养组38例和eHF喂养组46例,比较2组患儿更换喂养配方后FI消失时间、FI改善率、达全肠内喂养时间及体质量增长情况等喂养结局。结果 相对于eHF喂养组,HM喂养组FI消失时间更快,FI改善率更高,达全肠内喂养时间更快,差异有统计学意义。HM喂养组平均每日体质量增长量、出院时体质量均明显大于eHF喂养组,住院时间更短,出院时宫外发育迟缓(EUGR)发生率更低,差异有统计学意义。2组患儿坏死性小肠结肠炎、胆汁淤积症、院内感染发生率比较无统计学差异。结论 当极低出生体质量儿PF喂养失败、出现FI时,选择HM或eHF均可改善FI,但HM效果更好,达全肠内喂养时间更快且体质量增长更理想,出院时EUGR发生率较低。

Objective To investigate the improvement of feeding intolerance (FI) by changing human milk (HM) or extensively hydrolyzed formula(eHF) after failure of preterm formula (PF) feeding in very low birth weight (VLBW) infants. Methods Eighty-four VLBW infants who were born in Guangzhou Women and Children's Medical Center from January 2016 to January 2018 with PF feeding failure and FI were divided into HM feeding group (n=38) and eHF feeding group (n=46) according to their parents' HM feeding willingness and conditions.The time of FI disappearance, FI improvement rate, total enteral feeding time and weight gain were compared between the two groups after changing feeding formula. Results Compared with the eHF feeding group, the disappearance time of FI, the time of getting total intestinal feeding in the HM feeding group were shorter, and the improvement rate of FI was higher,the differences were statistically significant.The average daily weight increase and discharge weight of the HM feeding group were significantly more than those of the eHF feeding group, and the length of hospital stay, the incidence of extrauterine growth retardation(EUGR) at discharge were lower, the differences were statistically significant.There was no significant difference in the incidence of necrotizing enterocolitis, cholestasis and nosocomial infection between the two groups. Conclusions In the case of failure of PF feeding and FI in VLBW infants, both HM and eHF could ameliorate FI, but HM had a better effect, with a shorter time of getting total intestinal feeding, better weight gain and a lower incidence of EUGR at discharge.

目的 观察翘芩清肺剂中药免煎颗粒剂及饮片煎煮剂的体外抑制金黄色葡萄球菌和鲍曼不动杆菌抑菌的效果,以评估其体外抑菌效果的差异,为翘芩清肺剂临床应用提供新的思路及科学依据。方法 使用KB试纸扩散法和改良液体稀释法观察翘芩清肺剂中药免煎颗粒剂和饮片煎煮剂对金黄色葡萄球菌ATCC25923、鲍曼不动杆菌ATCC19606的最小抑菌浓度(MIC)。结果 用KB法检测颗粒冲服剂和饮片煎煮剂金黄色葡萄球菌最低抑菌浓度为1.38 g/mL(P<0.01);鲍曼不动杆菌最低抑菌浓度为2.75 g/mL(P<0.01)。用改良液体稀释法冲服剂金黄色葡萄球菌最低抑菌浓度为10.0 g/mL(P<0.01);鲍曼不动杆菌最低抑菌浓度为5.5 g/mL(P<0.01)。煎煮剂两菌MIC均为5.5 g/mL(P<0.01)。饮片煎煮剂效果较冲服剂好(P<0.01)。结论 翘芩清肺剂中药免煎颗粒冲服剂及饮片煎煮剂均可有效抑制金黄色葡萄球菌和鲍曼不动杆菌的生长,饮片煎煮剂的抑菌效果比免煎颗粒剂较优;对鲍曼不动杆菌的抑菌效果均较金黄色葡萄球菌弱,但无显著性差异性。

Objective To observe the antibacterial effects of Qiaoqinqingfei traditional Chinese medicine decoction and herbal concentrate-granules on Staphylococcus aureus (SA) and Acinetobacter baumannii (AB) in vitro. To assess the different antibacterial effects in vitro between them. It would provide a new idea and scientific basis for the clinical application of Qiaoqinqingfei Formula. Methods The KB test paper diffusion method and modified liquid dilution method were used to observe the minimum inhibitory concentration (MIC) of Qiaoqinqingfei traditional Chinese medicine decoction and herbal concentrate-granules on the Staphylococcus aureus ATCC25923 and Acinetobacter baumannii ATCC19606. Results The MIC of SA and AB in the two form of Qiaoqinqingfei were 1.38 g/mL (P<0.01) and 2.75 g/mL(P<0.01) by the KB test paper diffusion method. The MIC of SA and AB in herbal concentrate-granules of Qiaoqinqingfei were10.0 g/mL (P<0.01) and 5.5 g/mL (P<0.01) by the modified liquid dilution method. And the MIC of SA and AB in decoction both were 5.5 g/mL (P<0.01) in traditional Chinese medicine decoction of Qiaoqinqingfei. Decoction was better than granules (P<0.01). Conclusion Traditional Chinese medicine decoction and herbal concentrate-granules of Qiaoqinqingfei may both effectively inhibited the growth of SA and AB. The bacteriostatic effect of decoction was better than decoction-free granules. The bacteriostatic effect of AB was weaker than Staphylococcus aureus, but there was no significant difference between them.

目的 研究我院自拟肿痛消方中药离子导入联合关节镜手术治疗膝骨性关节炎的疗效。方法 将76 例膝骨性关节炎患者分为2组,即肿痛消方离子导入联合关节镜组和单纯关节镜组,在治疗前、后分别对两组患者进行Lysholm膝关节功能评分。结果 肿痛消方联合关节镜手术治疗对膝骨性关节炎的治疗效果有明显的提高,总有效率达到92.11%,高于对照组。结论 肿痛消方联合关节镜手术治疗对膝骨性关节炎具有良好的治疗效果。可明显降低患者的疼痛感,改善膝关节功能,促进骨关节的恢复。

Objective To study the effect of Zhongtongxiao formula combined with arthroscopy in the treatment of knee osteoarthritis. Methods 76 patients with knee osteoarthritis were divided into two groups, namely, the group of Zhongtongxiao square ion-implantation combined with arthroscopy and the group of arthroscopy alone. Lysholm knee function scores were performed on the two groups before and after treatment. Results The therapeutic effects of Zhongtongxiao formula combined with arthroscopic surgery on knee osteoarthritis were improved, the total effective rate was 92.11%, higher than the control group. Conclusion Zhongtongxiao formula combined with arthroscopy has good therapeutic effect on knee osteoarthritis.It can obviously reduce the pain of patients, improve the function of knee joint and promote the recovery of bone and joint.

目的 运用网络药理学方法预测生白术活性成分、作用靶点及生物学意义,探讨其防治便秘的作用机制,并结合导师临床应用取得的疗效进行进一步的验证。方法 借助TCMSP在线数据库查找白术的药效成份并选择其生物利用度(OB)>30%且类药性(DL)>0.18的化合物,并查询每种成分所对应的靶标。通过Gene Cards、OMIM共2个疾病相关靶点的数据库检索便秘相关靶点信息。将二者靶基因相映射获得交集靶点。借助 cytoscape 3.7.1 软件对查询结果进行可视化。所得到的基因通过相互作用数据库(STRING)进行相互作用蛋白查询并构建蛋白质相互作用(PPI)网络。使用R语言对关键靶点行GO和KEGG富集分析,以构建“成分-靶点-信号通路”的网络。结果 共得到白术人源靶蛋白7个,便秘相关的人源基因2 859个。发现其主要通过干预PGR、CHRM3、CHRM1、ACHE、CHRM2五个基因并参与胆碱能突触、钙信号通路、肌动蛋白细胞骨架的调控、神经活性配体-受体相互作用、cAMP信号通路、PI3K-AKT信号通路共6条信号通路以达到防治便秘的效果。结论 应用网络药理学方法分析预测得到重用生白术防治便秘的潜在药效成分、作用靶点及其信号通路,为临床应用提供了理论依据。

Objective To predict the active ingredients, targets and biological significance of Atractylodes macrocephala by network pharmacology, to explore the mechanism of its prevention and treatment of constipation, and to further verify its efficacy in combination with the clinical application of tutors. Methods The constituents of Atractylodes macrocephala were searched by TCMSP database and the compounds with bioavailability (OB) > 30% and drug-like property (DL) > 0.18 were screened, and the corresponding targets of each constituent were queried. Constipation-related target information was retrieved from two disease-related target databases of GeneCards and OMIM, mapping the two target genes to obtain intersecting targets, by visualization of query results with cytoscape 3.7.1. The resulting genes were queried by the interaction database (STRING) and the protein interaction (PPI) network was constructed. GO and KEGG enrichment analysis of key targets was carried out by R language in order to construct the network of “component-target-signal pathway”. Results Seven human target proteins and 2 859 constipation related human genes were obtained from Atractylodes macrocephala. It was found that the effect of prevention and treatment of constipation was mainly achieved by interfering with five genes of PGR, CHRM3, CHRM1, ACHE and CHRM2 and participating in six signaling pathways: cholinergic synapse, calcium signaling pathway, regulation of actin cytoskeleton, neuroactive ligand-receptor interaction, cAMP signaling pathway and PI3K-AKT signaling pathway. Conclusion The potential pharmacodynamic components, targets and signaling pathways of reuse Rhizoma atractylodis macrocephalae in the prevention and treatment of constipation can be predicted by network pharmacological method, which provides a theoretical basis for clinical application.