目的:通过总结前期动物实验结果,分析比较理肠四方(乌梅丸、白头翁汤、参苓白术散、痛泻要方)治疗溃疡性结肠炎疗效.方法:收集笔者近期发表理肠四方治疗溃疡性结肠炎相关文章的结论,分别从动物实验中症状、体征、病理改变、细胞因子及其蛋白表达、血液黏附分子、细胞凋亡及调控基因几方面进行比较,分析溃疡性结肠炎中医的病机和理肠四方的中医作用机制.理肠四方即乌梅丸(出自《伤寒论》《金匮要略》),由乌梅、细辛、干姜、黄连、当归、附子、蜀椒、桂枝、人参(生晒参)、黄柏等药组成,主治蛔厥证又主久利,白头翁汤(出自《伤寒论》),由白头翁、黄连、黄柏、秦皮等药组成,有清热解毒止痢等作用,主治热痢.参苓白术散(出自《太平惠民和剂局方》),由莲子肉、薏苡仁、砂仁、桔梗、白扁豆、茯苓、人参(生晒参)、甘草、白术、山药等药组成,有益气健脾,渗湿止泻之功,主治脾虚泄泻.痛泻要方(来源于《景岳全书》),由白术、白芍、陈皮、防风4味药组成,有舒肝健脾止泻等作用,主治肝旺脾虚、肠鸣腹痛泄泻.结果:①溃疡性结肠炎由于慢性久痢,正气已虚,邪气未尽,其治疗如专事清化导滞则徒伤其正,如一味扶正兜涩则恋邪碍积,唯扶正祛邪是其正治,与乌梅丸的主治相一致.②而白头翁汤以清热燥湿,凉血止痢为主治大法,与本虚为主的溃疡性结肠炎不完全相同.③参苓白术散有益气健脾,渗湿止泻之功,与兼外邪的溃疡性结肠炎亦不完全相同.④痛泻要方主要治疗土虚木乘,脾受肝制,升降失常所致泄泻,虽与溃疡性结肠炎的主要病机脾虚湿盛之脾虚相吻合,但对溃疡性结肠炎缓解期补脾之力较参苓白术散稍弱,故乌梅丸疗效最好,白头翁汤次之,参苓白术散居中,痛泻要方稍差.结论:溃疡性结肠炎可归属于中医"休息痢"范畴,其病机与乌梅丸的主治相一致,其他三方与之不完全一致,所以乌梅丸是治疗溃疡性结肠炎最有效的方剂.中医辨证施治是取得最佳疗效的前提,动物实验的造模必须符合中医证型.
目的:通過總結前期動物實驗結果,分析比較理腸四方(烏梅汍、白頭翁湯、參苓白術散、痛瀉要方)治療潰瘍性結腸炎療效.方法:收集筆者近期髮錶理腸四方治療潰瘍性結腸炎相關文章的結論,分彆從動物實驗中癥狀、體徵、病理改變、細胞因子及其蛋白錶達、血液黏附分子、細胞凋亡及調控基因幾方麵進行比較,分析潰瘍性結腸炎中醫的病機和理腸四方的中醫作用機製.理腸四方即烏梅汍(齣自《傷寒論》《金匱要略》),由烏梅、細辛、榦薑、黃連、噹歸、附子、蜀椒、桂枝、人參(生曬參)、黃柏等藥組成,主治蛔厥證又主久利,白頭翁湯(齣自《傷寒論》),由白頭翁、黃連、黃柏、秦皮等藥組成,有清熱解毒止痢等作用,主治熱痢.參苓白術散(齣自《太平惠民和劑跼方》),由蓮子肉、薏苡仁、砂仁、桔梗、白扁豆、茯苓、人參(生曬參)、甘草、白術、山藥等藥組成,有益氣健脾,滲濕止瀉之功,主治脾虛洩瀉.痛瀉要方(來源于《景嶽全書》),由白術、白芍、陳皮、防風4味藥組成,有舒肝健脾止瀉等作用,主治肝旺脾虛、腸鳴腹痛洩瀉.結果:①潰瘍性結腸炎由于慢性久痢,正氣已虛,邪氣未儘,其治療如專事清化導滯則徒傷其正,如一味扶正兜澀則戀邪礙積,唯扶正祛邪是其正治,與烏梅汍的主治相一緻.②而白頭翁湯以清熱燥濕,涼血止痢為主治大法,與本虛為主的潰瘍性結腸炎不完全相同.③參苓白術散有益氣健脾,滲濕止瀉之功,與兼外邪的潰瘍性結腸炎亦不完全相同.④痛瀉要方主要治療土虛木乘,脾受肝製,升降失常所緻洩瀉,雖與潰瘍性結腸炎的主要病機脾虛濕盛之脾虛相吻閤,但對潰瘍性結腸炎緩解期補脾之力較參苓白術散稍弱,故烏梅汍療效最好,白頭翁湯次之,參苓白術散居中,痛瀉要方稍差.結論:潰瘍性結腸炎可歸屬于中醫"休息痢"範疇,其病機與烏梅汍的主治相一緻,其他三方與之不完全一緻,所以烏梅汍是治療潰瘍性結腸炎最有效的方劑.中醫辨證施治是取得最佳療效的前提,動物實驗的造模必鬚符閤中醫證型.
목적:통과총결전기동물실험결과,분석비교리장사방(오매환、백두옹탕、삼령백술산、통사요방)치료궤양성결장염료효.방법:수집필자근기발표리장사방치료궤양성결장염상관문장적결론,분별종동물실험중증상、체정、병리개변、세포인자급기단백표체、혈액점부분자、세포조망급조공기인궤방면진행비교,분석궤양성결장염중의적병궤화리장사방적중의작용궤제.리장사방즉오매환(출자《상한론》《금궤요략》),유오매、세신、간강、황련、당귀、부자、촉초、계지、인삼(생쇄삼)、황백등약조성,주치회궐증우주구리,백두옹탕(출자《상한론》),유백두옹、황련、황백、진피등약조성,유청열해독지리등작용,주치열리.삼령백술산(출자《태평혜민화제국방》),유련자육、의이인、사인、길경、백편두、복령、인삼(생쇄삼)、감초、백술、산약등약조성,유익기건비,삼습지사지공,주치비허설사.통사요방(래원우《경악전서》),유백술、백작、진피、방풍4미약조성,유서간건비지사등작용,주치간왕비허、장명복통설사.결과:①궤양성결장염유우만성구리,정기이허,사기미진,기치료여전사청화도체칙도상기정,여일미부정두삽칙련사애적,유부정거사시기정치,여오매환적주치상일치.②이백두옹탕이청열조습,량혈지리위주치대법,여본허위주적궤양성결장염불완전상동.③삼령백술산유익기건비,삼습지사지공,여겸외사적궤양성결장염역불완전상동.④통사요방주요치료토허목승,비수간제,승강실상소치설사,수여궤양성결장염적주요병궤비허습성지비허상문합,단대궤양성결장염완해기보비지력교삼령백술산초약,고오매환료효최호,백두옹탕차지,삼령백술산거중,통사요방초차.결론:궤양성결장염가귀속우중의"휴식리"범주,기병궤여오매환적주치상일치,기타삼방여지불완전일치,소이오매환시치료궤양성결장염최유효적방제.중의변증시치시취득최가료효적전제,동물실험적조모필수부합중의증형.
AIM: To analyze curative effect of four regulating-intestines prescriptions (Wumei Wan, Baitouweng Tang, Shenling Baizhu San and Tongxie Yao-fang) on the treatment of ulcerative colitis (UC) through summing up the previous animal experimental results.METHODS: We collected the conclusions in the papers related to four regulating-intestines prescriptions for the treatment of UC which were published recently, made comparisons from the aspectsof symptoms, physical sign, pathological change, cytokine and its protein expression, blood adhesion molecule, cell apoptosis and controlling gene and analyzed the pathogenesis of UC and action mechanism of four regulating-intestines prescriptions. Four regulating-intestines prescriptions included Wumei Wan,Baitouweng Tang, Shenling Baizhu San and Tongxie Yaofang. Wumei Wan is from Treatise on Exogenous Febrile Diseases and Synopsis of the Golden Chamber, which consists of dark plum, asarum herb, dried ginger, Chinese goldthread, Chinese angelica root, aconite root, pricklyash peel, cassia twig,ginseng (sun-dried ginseng) and bark of cork tree and has marked effect in treating colic caused by ascariasis and persistent dysentery. Baitouweng Tang, from Treatise on Exogenous Febrile Diseases, consists of medicinal herbs such as pulsatilla root, Chinese goldthread, bark of cork tree and ash bark, which has functions of clearing away the heat-evil, expelling superficial evils and relieving dysentery. In addition, it has marked effect in treating heat-type dysentery. Shenling Baizhu San, from Prescriptions of Peaceful benevolent Dispensary, consists of medicinal herbs such as pulp of lotus seed, coix seed, amomum fruit, balloon flower root, white hyacinth bean, poria, ginseng (sun-dried ginseng), glycyrrhiza, bighead atractylodes and rhizoma dioscoreae, which has the nature of replenishing qi to invigorate the spleen and eliminate wetness to arrest diarrhea and has marked effect on treating diarrhea due to the hypofunction of spleen. Tongxie Yao-fang which is from The Complete Works of Zhang Jingyue consists of four herbals of agehead atractylodes, root of herbaceous peony, dried tangerine peel and ledebouriella root and has the functions of soothing liver and invigorating spleen and stopping diarrhea, and has marked effect on treating liver sthenia and deficient spleen, borborygmus and abdominal pain and diarrhea.RFSULTS: ① Because UC is a chronic protracted dysentery with deficiency of vital energy and existing of evil energy, the vital energy will be harmed if its treatment is specialized in removing and dissolving the stagnation, evil energy will continue to exist and stagnation will continue to accumulate if its treatment is specialized in strengthening vital energy and inducing astringency. Only supporting healthy energy and expelling evil energy is the correct therapy method. This is in accordance with the main treatment of Wumei Wan ②Eliminating dampness and pathogenic heat from the blood to treat diarrhea is the main treatment method of Baitouweng Tang, and this is incompletely suitable for the treatment of UC.③Shenling Baizhu San had the effect on soothing liver and invigorating spleen and stopping diarrhea, and this is also incompletely suitable for the treatment of UC. ④ The prescription of Tongxie Yaofang is used for treating diarrhea caused by deficient spleen and liver sthenia, and spleen controlled by liver, and abnormal ascent and descent. It accords with main pathogenesis of UC, deficient spleen, excessive dampness of deficient spleen and it is weaker in invigorating the spleen in catabasis of UC than Shenling Baizhu San. Therefore, Wumei Wan has the best curative effect,Baitouweng Tang the second, Shengling Baizhu San the third and Tongxie Yaofang a little poor.CONCLUSION: UC belongs to recurrent dysentery, and its pathogenesis is in accordance with the main treatment of Wumei Wan, but not the other three prescriptions, so Wumei Wan is the most efficient prescription in treating ulcerative colitis. Diagnosis and treatment based on an overall analysis of signs and symptoms of TCM is the premise of obtaining the best curative effect. Modeling of animal tests must be consistent with the type of syndrome of the traditional Chinese medicine. Ating ulcerative colitis (UC) from aspects such as symptom, physical sign, pathological changes, adherence factor, cytokine and its protein expression, apoptosis and its controlling gene by means of modeling, which proves their functions and effects are different and their curative effect are also different due to their different ingredient though they all have the functions of treating. Results of this test show Wumei Wan has the best curative effect, Baitouweng Tang the second, Shenling Baizhu San the third and Tongxie Yaofang a little poor[1-11] Mechanism of four regulating-intestines prescription in the treatment of ulcerative colitis is discussed from the viewpoints of traditional Chinese medicine as follows.
