Objective: To investigate the compatibility of a modified prescription of Simiao Pill (四妙丸) in the treatment of acute gouty arthritis and to verify the clinical efficacy and safety of the drug through a clinical...Objective: To investigate the compatibility of a modified prescription of Simiao Pill (四妙丸) in the treatment of acute gouty arthritis and to verify the clinical efficacy and safety of the drug through a clinical trial. Methods: A randomized and controlled clinical trial was designed based on clinical epidemiological principles. A total of 107 patients with acute gouty arthritis were enrolled and randomly assigned to four groups. The first group (Group Ⅰ ) included 27 patients taking gout prescription Ⅰ ; the second group (Group Ⅱ ) included 27 patients taking gout prescription Ⅱ ; the third group (Group Ⅲ) included 28 patients taking gout prescription Ⅲ; and the fourth group (control group) included 25 patients taking indomethacin and Benzobromarone as a control group. The duration of the treatment in all 4 groups was two weeks. After the treatment, the index of blood uric acid, blood leukocyte count, score of clinical symptoms, etc. were observed and measured. Results: The total clinical effective rate of the three different modified prescriptions of the Simiao Pill was above 96%, significantly superior to that of the control group (68%, P〈0.05). In terms of the improvement of main symptoms, the scores of four symptoms in all TCM treatment and control groups decreased after treatment, with statistically significant differences (P〈0.05). Moreover, the scores markedly fell more so in the three Chinese herb groups than in the control group, and especially in Group Ⅲ (P〈0.05). There was a statistically significant difference in blood uric acid values before and after the treatment in the same group but no significant inter-group difference was seen. Conclusion: The modified prescriptions, based on the clinical research, clinical experience and traditional Chinese medicine theory, did show a better effect than Western medicine in this clinical study. Moreover, the prescriptions were precise, with the herbs inexpensive and readily available. The patient展开更多
目的采用网络药理学的方法,对四妙丸治疗痛风及高尿酸血症的作用机制进行研究探讨。方法通过在中药系统药理学数据库与分析平台(Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform,TCMSP)对四妙丸进...目的采用网络药理学的方法,对四妙丸治疗痛风及高尿酸血症的作用机制进行研究探讨。方法通过在中药系统药理学数据库与分析平台(Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform,TCMSP)对四妙丸进行活性成分筛选,运用Cytoscape 3.7.1构建化合物-靶点网络;检索治疗靶点数据库(Therapeutic Target Database,TTD)和DisGenet数据库获取疾病靶标;通过韦恩图,得到疾病与药物的共同靶点;对四妙丸治疗痛风及高尿酸血症的关键靶点进行基因本体(Gene Ontology,GO)功能注释和京都基因与基因组百科全书(Kyoto Encyclopedia of Genes and Genomes,KEGG)通路富集分析;构建四妙丸化合物-共同靶点-信号通路网络。结果研究显示共挖掘到四妙丸中64种成分及163个潜在靶点,痛风及高尿酸血症165个相关靶点,得到四妙丸-痛风及高尿酸血症共同靶点9个,共同作用靶点主要富集于533个生物过程和20条信号通路上。结论四妙丸可能是通过调节前列腺素内过氧化物合酶2(Prostaglandin-endoperoxide synthase 2,PTGS2)、前列腺素内过氧化物合酶1(Prostaglandin-endoperoxide synthase 1,PTGS1)、肿瘤坏死因子α(tumor necrosis factor,TNF-α)、白介素1β(interlukin-1β,IL-1β)、过氧化物酶体增殖物激活受体γ(peroxisome proliferative activated receptor gamma,PPARG)等靶点,调控破骨细胞分化、c型凝集素受体信号通路、核转录因子κB(nuclear factor kappa-B,NF-κB)信号通路、白介素17(interlukin-17,IL-17)信号通路等通路,从而发挥抗炎、细胞凋亡、细胞周期调控、抗氧化应激来治疗痛风及高尿酸血症。展开更多
目的:观察四妙丸对高尿酸血症肾病患者血尿酸水平、肾功能及NLRP3炎症小体活化的影响。方法:选择60例高尿酸血症肾病患者,随机分为非布司他组、四妙丸组和综合治疗组(非布司他+四妙丸),监测每组患者血尿酸、血肌酐水平,同时利用实时荧...目的:观察四妙丸对高尿酸血症肾病患者血尿酸水平、肾功能及NLRP3炎症小体活化的影响。方法:选择60例高尿酸血症肾病患者,随机分为非布司他组、四妙丸组和综合治疗组(非布司他+四妙丸),监测每组患者血尿酸、血肌酐水平,同时利用实时荧光定量PCR法检测NLRP3、ASC、caspase-1等炎症小体活化指标。结果:(1)血尿酸水平方面,非布司他组、综合治疗组2月时与0月相比即差异有统计学意义(424.3±38.99 vs 460.45±56.37,412.65±42.27 vs 486.0±67.19,P<0.05);四妙丸组3月时与0月比较差异有统计学意义(410.55±47.65 vs 454.75±70.79,P<0.05);3月时,综合治疗组与四妙丸组比较下降明显(382.55±33.34 vs 410.55±47.65,P<0.05)。(2)血肌酐水平方面,综合治疗组2月时与0月比较即明显降低(244.35±74.03 vs 304.65±87.21,P<0.05);四妙丸组3月时与0月比较显著下降(225.60±74.12 vs 281.55±101.36,P<0.05);3月时组间比较差异无统计学意义;(3)NLRP3炎症小体活化方面,非布司他组、四妙丸组和综合治疗组在NLRP3、ASC、caspase1水平上3月时与0月比较均下降明显(P<0.05);3月时,与非布司他组相比,四妙丸组、综合治疗组在NLRP3水平(0.55±0.07 vs 0.75±0.01,0.47±0.03 vs 0.75±0.01,P<0.05)、caspase-1水平(0.49±0.05 vs 0.68±0.08,0.42±0.01 vs 0.68±0.08,P<0.05)降低明显,综合治疗组ASC水平显著降低(0.42±0.03 vs 0.70±0.02,P<0.05)。结论:四妙丸能够通过降低血尿酸水平及抑制NLRP3炎症小体的活化对高尿酸血症肾病患者产生肾脏保护作用。展开更多
基金Supported by Bureau of Traditional Chinese Medicine of Jiangsu Province(No.25[2003])
文摘Objective: To investigate the compatibility of a modified prescription of Simiao Pill (四妙丸) in the treatment of acute gouty arthritis and to verify the clinical efficacy and safety of the drug through a clinical trial. Methods: A randomized and controlled clinical trial was designed based on clinical epidemiological principles. A total of 107 patients with acute gouty arthritis were enrolled and randomly assigned to four groups. The first group (Group Ⅰ ) included 27 patients taking gout prescription Ⅰ ; the second group (Group Ⅱ ) included 27 patients taking gout prescription Ⅱ ; the third group (Group Ⅲ) included 28 patients taking gout prescription Ⅲ; and the fourth group (control group) included 25 patients taking indomethacin and Benzobromarone as a control group. The duration of the treatment in all 4 groups was two weeks. After the treatment, the index of blood uric acid, blood leukocyte count, score of clinical symptoms, etc. were observed and measured. Results: The total clinical effective rate of the three different modified prescriptions of the Simiao Pill was above 96%, significantly superior to that of the control group (68%, P〈0.05). In terms of the improvement of main symptoms, the scores of four symptoms in all TCM treatment and control groups decreased after treatment, with statistically significant differences (P〈0.05). Moreover, the scores markedly fell more so in the three Chinese herb groups than in the control group, and especially in Group Ⅲ (P〈0.05). There was a statistically significant difference in blood uric acid values before and after the treatment in the same group but no significant inter-group difference was seen. Conclusion: The modified prescriptions, based on the clinical research, clinical experience and traditional Chinese medicine theory, did show a better effect than Western medicine in this clinical study. Moreover, the prescriptions were precise, with the herbs inexpensive and readily available. The patient
文摘目的采用网络药理学的方法,对四妙丸治疗痛风及高尿酸血症的作用机制进行研究探讨。方法通过在中药系统药理学数据库与分析平台(Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform,TCMSP)对四妙丸进行活性成分筛选,运用Cytoscape 3.7.1构建化合物-靶点网络;检索治疗靶点数据库(Therapeutic Target Database,TTD)和DisGenet数据库获取疾病靶标;通过韦恩图,得到疾病与药物的共同靶点;对四妙丸治疗痛风及高尿酸血症的关键靶点进行基因本体(Gene Ontology,GO)功能注释和京都基因与基因组百科全书(Kyoto Encyclopedia of Genes and Genomes,KEGG)通路富集分析;构建四妙丸化合物-共同靶点-信号通路网络。结果研究显示共挖掘到四妙丸中64种成分及163个潜在靶点,痛风及高尿酸血症165个相关靶点,得到四妙丸-痛风及高尿酸血症共同靶点9个,共同作用靶点主要富集于533个生物过程和20条信号通路上。结论四妙丸可能是通过调节前列腺素内过氧化物合酶2(Prostaglandin-endoperoxide synthase 2,PTGS2)、前列腺素内过氧化物合酶1(Prostaglandin-endoperoxide synthase 1,PTGS1)、肿瘤坏死因子α(tumor necrosis factor,TNF-α)、白介素1β(interlukin-1β,IL-1β)、过氧化物酶体增殖物激活受体γ(peroxisome proliferative activated receptor gamma,PPARG)等靶点,调控破骨细胞分化、c型凝集素受体信号通路、核转录因子κB(nuclear factor kappa-B,NF-κB)信号通路、白介素17(interlukin-17,IL-17)信号通路等通路,从而发挥抗炎、细胞凋亡、细胞周期调控、抗氧化应激来治疗痛风及高尿酸血症。
文摘目的:观察四妙丸对高尿酸血症肾病患者血尿酸水平、肾功能及NLRP3炎症小体活化的影响。方法:选择60例高尿酸血症肾病患者,随机分为非布司他组、四妙丸组和综合治疗组(非布司他+四妙丸),监测每组患者血尿酸、血肌酐水平,同时利用实时荧光定量PCR法检测NLRP3、ASC、caspase-1等炎症小体活化指标。结果:(1)血尿酸水平方面,非布司他组、综合治疗组2月时与0月相比即差异有统计学意义(424.3±38.99 vs 460.45±56.37,412.65±42.27 vs 486.0±67.19,P<0.05);四妙丸组3月时与0月比较差异有统计学意义(410.55±47.65 vs 454.75±70.79,P<0.05);3月时,综合治疗组与四妙丸组比较下降明显(382.55±33.34 vs 410.55±47.65,P<0.05)。(2)血肌酐水平方面,综合治疗组2月时与0月比较即明显降低(244.35±74.03 vs 304.65±87.21,P<0.05);四妙丸组3月时与0月比较显著下降(225.60±74.12 vs 281.55±101.36,P<0.05);3月时组间比较差异无统计学意义;(3)NLRP3炎症小体活化方面,非布司他组、四妙丸组和综合治疗组在NLRP3、ASC、caspase1水平上3月时与0月比较均下降明显(P<0.05);3月时,与非布司他组相比,四妙丸组、综合治疗组在NLRP3水平(0.55±0.07 vs 0.75±0.01,0.47±0.03 vs 0.75±0.01,P<0.05)、caspase-1水平(0.49±0.05 vs 0.68±0.08,0.42±0.01 vs 0.68±0.08,P<0.05)降低明显,综合治疗组ASC水平显著降低(0.42±0.03 vs 0.70±0.02,P<0.05)。结论:四妙丸能够通过降低血尿酸水平及抑制NLRP3炎症小体的活化对高尿酸血症肾病患者产生肾脏保护作用。