外用中药防治靶向药物皮肤毒性反应的网络药理分析

目的:基于网络药理学分析外用中药防治恶性肿瘤患者靶向治疗相关皮肤毒性反应的用药规律及潜在作用靶点。方法:计算机检索Pubmed、Cochrane对照试验、中国学术期刊数据库、中国知网数据库外用中药防治靶向药物皮肤毒性反应临床研究文献。统计中药使用频次,参照《中华人民共和国药典》对药物分类,分析药物功效、性味归经。采用BATMAN-TCM在线工具分析核心中药主要活性成分及潜在作用靶点。结果:共纳入文献22篇,涉及方剂16首,药物50味。使用频次最多的药物为金银花,分别在68.42%的皮疹研究和66.67%的手足皮肤反应研究中应用;其次为苦参,出现在52.63%的皮疹研究中。使用频率最高的为寒性味苦具有清热功效的中药。网络药理分析确定金银花及苦参共有196个共同作用靶点,其中19种有效成分可作用于靶向药皮肤毒性反应相关的10个靶点,包括ADORA、PIK3CD、PTGS2、TNF、TYR、HTR3A等。结论:外用中药防治恶性肿瘤患者靶向治疗相关皮疹及手足皮肤反应临床研究中多采用苦寒类药物,以清热解毒、清热燥湿为基本用药原则,潜在作用信号通路需进一步实验研究进行验证。     

从“清、透、滋”三治则论治靶向药物皮肤毒性

表皮生长因子受体抑制剂已成为多种肿瘤靶向治疗的重要药物,而皮肤毒性是运用靶向药物发挥抗肿瘤效应同时出现的主要不良反应,因此减轻其不良反应对于提高患者治疗耐受性、改善其生活质量至关重要。临床上发现中医药干预本病有其疗效,但对其的认识并不明确。本文将从温病三治则对其病机要素及治法、立法选方进行分析,总结中医临证治疗此病的思路。     

肺癌靶向药物相关皮肤不良反应的中西医治疗进展

肺癌是目前世界上死亡率最高的恶性肿瘤,传统治疗方法包括手术、放疗和化疗,随着基因组学、分子生物学技术的发展,个体化靶向治疗应运而生。近年来,以表皮生长因子受体等为靶点的靶向药物研制取得重大进展,有些药物已经应用于临床并取得了满意的效果,但其临床不良反应也不容忽视。肺癌靶向药物中常见的不良反应是皮肤毒性,运用中医辨证结合西医治疗,患者相应皮肤不良反应的发生率可有效降低。故对近年来肺癌靶向药物相关皮肤不良反应进行归纳总结,探讨皮疹、皮肤干燥瘙痒、甲沟炎等皮肤不良反应的中西医治疗方法,旨在为临床提供参考。     

从温病“透法”探讨表皮生长因子受体酪氨酸激酶抑制剂皮肤毒性的辨治思路

靶向治疗已成为肿瘤治疗的重要手段,而皮肤毒性是其常见的不良反应。针对皮肤毒性西医疗效欠佳,在临床使用过程中发现中医药有较好疗效,但对其认识尚欠深入。文章从温病"透法"的角度,就表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)在治疗非小细胞肺癌过程中引起的皮肤毒性进行探讨,包括EGFR-TKI的药物偏性、引起皮肤毒性的病因病机、治疗中的立法选方等,为中医临证提供思路。     

从痰论治表皮生长因子受体抑制剂所致皮肤毒性理论探讨

表皮生长因子受体抑制剂(EGFRIs)相关皮肤毒性是指使用靶向药物EGFRIs治疗肿瘤过程中皮肤出现的毒性反应。其出现可能干扰正常治疗,甚至影响患者生活质量并导致治疗中断而影响疗效。局部外用抗生素、类固醇激素等疗效不理想且不良反应大,因此,在优先保证疗效前提下,有效控制皮肤毒性的发生具有重要临床意义。中医防治EGFRIs相关皮肤毒性具有优势和前景。本文结合临床提出从痰论治,疗效满意,可供参考。     

转移性结直肠癌维持治疗的临床研究进展

转移性结直肠癌经化疗和(或)靶向标准治疗后,维持治疗已成为临床广泛应用的治疗方案,并展现出较好的临床疗效,已成为临床研究热点。当前化疗药物、靶向药物、化疗药物联合靶向药物等临床研究相继大量开展。文章对转移性结直肠癌维持治疗临床进展进行综述,在此基础上,对存在的问题进行分析与展望。     

中医药防治分子靶向治疗药物相关不良反应的研究进展

分子靶向治疗药物使恶性肿瘤的治疗进入一个新的时代,但相关的不良反应严重影响患者生活质量,导致靶向治疗药物减量或中断,降低抗肿瘤疗效。采用中医药防治靶向药物相关皮疹、手足皮肤反应、腹泻、周围神经病变等,取得了良好的疗效。检索中国期刊全文数据库、万方数据库及Pubmed中关于中药干预靶向药物相关不良反应的临床研究报道,并进行系统综述。     

冯正权治疗靶向治疗相关性皮疹经验介绍

<正>目前恶性肿瘤的治疗受到世界各国的重视,传统的治疗方法,如手术、化疗、放疗等仍然是不可缺少的。分子靶向药物最常见的不良反应是皮肤毒性,主要指由外来化合物引起的皮肤毒性不良反应,它可分为原发刺激直接引起的皮肤刺激腐蚀和致敏引起的迟发型超敏反应(Ⅳ型反应),发病率高达70%到88%[1],给患者的身心造成一定程度的损害。因此,许多患者常选择自主减少药物治疗剂量,在一定程度上影响药物治疗的效果。冯正权是浙江中医药大学教授,硕士研究生导师,师从国家级名中医吴良村教授。冯教授从事中西医结合治疗恶性肿     

转铁蛋白作为主动靶向载体的研究进展

 目的介绍国内外对转铁蛋白(Tf)在主动靶向中的应用研究的最新进展。方法根据近年来的文献资料,对转铁蛋白在主动靶向中的应用研究方面进行综述。结果转铁蛋白可以与药物、生物活性物质、聚合物、脂质体等多种物质相连,不同程度地提高药物在肿瘤组织、脑组织中的分布量,降低毒性,延长药物血浆半衰期,提高药物主动靶向活性。结论转铁蛋白是一种新型的药物主动靶向载体,在肿瘤靶向及脑靶向领域中有广阔的应用前景。     

四妙勇安汤治疗恶性肿瘤相关并发症的研究进展

四妙勇安汤由金银花、玄参、当归、甘草4味组成，具有清热解毒、活血止痛之功效，此用于治疗热毒炽盛之脱疽，现代临床上根据其功效特点而扩大使用范围并取得了较好的疗效。此文综述四妙勇安汤治疗各种恶性肿瘤相关并发症的临床研究进展，如妇科恶性肿瘤术后肢体水肿、放疗后局部皮肤损伤、靶向治疗所致皮肤毒性等，既能较好地缓解患者临床症状，对于抑制肿瘤复发转移也有潜在作用，值得研究推广。     

微波消解-电感耦合等离子体质谱法测定脉络宁注射液中25种矿物质元素

目的建立微波消解-电感耦合等离子体质谱(ICP-MS)直接稀释测定脉络宁注射液中25种矿物质元素(Mg、Ca、Fe、Cu、Zn、Mn、Al、B、Ba、Co、Cr、K、Li、Mo、Na、Ni、P、Pb、Sr、Th、Ti、V、As、Cd和Hg)的方法。方法分别对微波消解条件和测试条件进行考察;样品经微波消解后,采用电感耦合质谱仪测定25种矿物质元素,并对测定方法学进行考察。结果确定最佳消解条件为3步缓慢升温:400 W 80℃升温10 min,保留5 min;600 W 120℃升温10 min,保留5 min;900 W 200℃升温20 min,保留20 min;25种矿物质元素在各自的线性范围内线性关系良好,r≥0.999 6,精密度、稳定性和重复性试验的RSD均符合定量分析要求;加标回收率为94.7%~106.1%,RSD在0.34%~2.79%。脉络宁注射液中检测出Mg、Ca、Fe、Cu、Zn、Mn、Al、B、Ba、Co、Cr、K、Li、Mo、Na、Ni、P、Pb、Sr、Th、Ti、V,未检出As、Cd和Hg。结论该方法简便、迅速、准确,适用于脉络宁注射液中25种矿物质元素的同时测定。     

Die Lateralität und Lateralitätsinstabilität in der Diagnostik und Therapie

The disturbance and instability of laterality are obstacles to diagnostics and therapy. Correction prior to starting therapy is required. They also predispose toward defined health problems and unspecific diseases. Numerous research activities provide evidence of the relevance of undisturbed laterality in diagnostics and therapy. Techniques of testing and therapeutic corrections will allow for optimized therapy success.     

Journal of Acupuncture and Tuina Science Instructions for Authors

The Journal of Acupuncture and Tuina Science, a journal with an international scope （IS SN 1672-3597, CN 31-1908/R, Bimonthly）, is embodied by ＇Springer Verlag＇ Database, Index Copernicus （IC） and Chinese Scientific and Technical Paper and Citations Data （CSTPCD）. You can search full text on http：//www, springerlink, com/content/1672 -3597.     

Yerba Mate or Paraguay Tea

正Beverages based on Ilex paraguariensis A.St.-Hil.are used in the south Brazil and other Latin American countries located at the so-called southern cone.It is known as chimarro or mate in south and southeast Brazil,tererêin     

Ethnopharmacologic study of chinese rhubarb

This paper deals with an interdisciplinary study covering historic, botanical, phytochemical, pharmacological and clinical aspects of rhubarb and related species, to lay stress on the correlation between plant phylogeny, chemical constituents and purgative activity.

It was found that the official rhubarbs were exclusively restricted in the Sect. Palmata e.g. Rheum palmatum R. palmatum var. tanguticum R. officinale; the following criteria may serve as their standard, viz., the presence of sennoside derivatives and rhein, the occurrence of the reduced form of rhein and aloe-emodin, the leaves with any kind of palmate incision. Comprehensive multivariate analyses showed that there is a very close relationship between the leaf incision, existence of sennosides or rhein and purgative activity.     

Wirksamkeit der Akupunktur bei der Therapie von idiopathischen Schmeckstörungen: Eine randomisierte Placebo-kontrollierte Studie

Background

At present, the state-of-the-art medication in treating idiopathic taste disorder (gustatory dysfunction) is zinc. If zinc medication was unsuccessful, not tolerated or if it is contraindicated the persons affected can hardly be helped.

Objectives

In a randomized placebo-controlled clinical trial an attempt was made to determine the efficacy of acupuncture.

Methods

The treatment group was treated with acupuncture needles, the placebo group with an inactive acupuncture-laser. Endpoints of the study were changes in the taste test, the quality of life and the severity of symptoms of depression (BDI) as well as mood changes (ZMS). Satisfaction with the success of the respective therapy was also evaluated. Data were collected before and after therapy and again for the treatment group 10 weeks after completion of the treatment period.

Findings

Treatment with real acupuncture showed a significant improvement in gustatory function as well as a significant improvement in psychological symptoms. Greater satisfaction with the treatment results was evident in the treatment group. The treatment results of acupuncture remained stable over a period of ten weeks after completion of the treatment.

Conclusion

Acupuncture was effective in the therapy of idiopathic taste disorders and therefore it is an effective alternative when zinc medication is not tolerated or unsuccessful. But it is also suitable as a therapy of first choice. Acupuncture can be considered as an extension of the therapeutic spectrum in the difficult treatment of taste disorders.     

Veränderungen der Herzratenvariabilität (HRV) während Low Level Lasernadelakupunktur: Placebokontrollierte Studie an 19 herzgesunden Probanden

Background

Experimental and clinical studies postulate a neurobiological mechanism of acupuncture by modulating central pain systems, neurohormones and -transmitters. It seems to be quite likely that the autonomic nervous system (ANS) plays an important mediating role in this neuromodulation.

Aim

In measuring heart rate variability (HRV), as a non-invasive approach to the ANS-function, the object of this study was to monitor probable acupuncture-induced changes of autonomic balance. The innovative technology of laser-needle acupuncture offers for the first time a stimulation method which fulfils the demands on a placebo-controlled acupuncture trial not requiring controversial sham acupuncture.

Method

19 healthy voluntary subjects underwent 3 treatments in randomized sequence, consisting of placebo-, 1-point- (PC 6) and simultaneous 3-point- (PC 6, LR 3, SI 3) laser-needle-stimulation over 20 minutes. Before, during and after placebo-/verum laser-needle acupuncture, HRV-data for normalized HF(high frequency)- and LF(low frequency)-Power (nHF, nLF) and their quotient nLF/nHF obtained by power spectrum analysis (FFT), were measured and analyzed statistically at 5 different time points (ANOVA repeated measures, p < 0,05).

Results

During both verum applications, the 1-point- (PC 6) as well as the simultaneous 3-point- (PC 6, LR 3, SI 3) laser-needle stimulation, significant changes of the ANS-activity were found in comparison to the placebo application. The most significant modification of HRV was an increase of nHF (p < 0,05 (PC 6), p < 0,0001 (PC 6, LR 3, SI 3)) as an expression of growing vagal activity during acupuncture.

Conclusion

Laser-needle acupuncture causes in 1-point-stimulation (PC 6) as well as in simultaneous 3-point-stimulation (PC 6, LR 3, SI 3) significant changes in HRV in comparison to placebo application. HRV-monitoring seems to be a suitable approach in exploration of acupuncture-induced changes of ANS and could possibly be established in combination with laser needle acupuncture as a standard for further scientific and clinical acupuncture investigations which are greatly needed.     

瑞香科五属植物中酚性聚合物的结构特征、分布及药理活性研究进展

瑞香科植物广泛分布于世界热带和温带地区,其中多种植物可供药用。在对该科植物的研究中发现,黄酮类、木脂素和香豆素等酚性化合物的低聚体为其重要的特征性成分,药理活性主要表现在抗肿瘤、抗炎、抗氧化、抗菌和抗病毒等方面。对已发现的酚性聚合体的化学结构、植物来源及药理活性进行综述,为瑞香科植物今后的研究和开发利用提供参考。     

HPLC法同时测定沉香化滞丸中11种成分

目的采用HPLC梯度洗脱法同时测定沉香化滞丸中沉香四醇、柚皮苷、橙皮苷、新橙皮苷、和厚朴酚、大黄素、厚朴酚、木香烃内酯、去氢木香内酯、大黄酚、大黄素甲醚11种成分。方法采用Thermo Syncronis C18色谱柱(250 mm×4.6 mm,5μm),流动相为水-乙腈,梯度洗脱:0～10 min,20%乙腈;10～20 min,20%～40%乙腈;20～24 min,40%乙腈;24～26 min,40%～52%乙腈;26～30 min,52%乙腈;30～31 min,52%～90%乙腈;31～35 min,90%乙腈;35～40 min,90%～100%乙腈;40～43min,100%乙腈;43～45min,100%～20%乙腈;检测波长215nm,体积流量1.0m L/min,柱温30℃,进样量20μL。结果各成分在43 min内分离良好,沉香四醇、柚皮苷、橙皮苷、新橙皮苷、和厚朴酚、大黄素、厚朴酚、木香烃内酯、去氢木香内酯、大黄酚、大黄素甲醚的线性范围分别为1.4～13.6、10.0～200.0、31.5～315.0、1.0～120.1、1.8～50.6、0.93～10.1、1.8～30.0、0.2～40.3、1.8～18.1、1.7～25.0、0.45～10.70μg/mL;样品中各成分的平均回收率均在98.90%～100.87%;11种成分精密度RSD在0.55%～1.54%;供试品溶液在30 h内稳定性良好,RSD在0.75%～1.94%;重复性RSD在0.39%～1.73%。6批次样品中沉香四醇、柚皮苷、橙皮苷、新橙皮苷、和厚朴酚、大黄素、厚朴酚、木香烃内酯、去氢木香内酯、大黄酚、大黄素甲醚质量分数分别为92.0～201.0、511.5～9 033.0、5 475.0～12 635.5、54.5～5 095.5、192.0～2 137.5、117.0～391.5、106.5～1 281.5、13.0～136.5、93.5～199.0、177.0～1 207.0、33.5～251.5μg/g。结论本方法准确、快速、简便,重复性好,精密度高,适用于沉香化滞丸中多种活性成分的定量分析。