摘要:To investigate the therapeutic effect and mechanism of Qingwen Baiduyin on acute lung injury (ALI) in mice induced by lipopolysaccharide (LPS).MethodA total of 144 C57BL/6 mice were randomly divided into the following groups: a normal group, a model group (LPS, 5 mg·kg-1), a dexamethasone group (5 mg·kg-1), and low-, medium-, and high-dose Qingwen Baiduyin groups (14.105, 28.21, 56.42 g·kg-1). The mice were treated once daily for 5 days. One hour after the final administration, the ALI model was established by intratracheal instillation of LPS, and samples were collected at 6 h and 24 h after modeling. The arterial blood gas index of mice was analyzed. The total protein content, total cell count, Evans blue dye (EBD) content, and lung tissue wet-to-dry weight ratio (W/D) of bronchoalveolar lavage fluid (BALF) were measured. Hematoxylin-eosin (HE) staining was performed to assess the pathological changes in mouse lung tissue. Western blot was used to detect the expression levels of key proteins in the Janus kinase 1/signal transducer and activator of transcription 1/interferon regulatory factor 1 (JAK1/STAT1/IRF1) signaling pathway in lung tissue.ResultCompared with the normal group, the model group showed reduced arterial oxygen pressure (pO2), oxygen saturation (SO2), and lung tissue W/D (P<0.05, P<0.01), increased carbon dioxide pressure (pCO2), total protein content, total cell count, EBD content, interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), chemokine CXC ligand 1 (CXCL1), chemokine CXC ligand 2 (CXCL2), chemokine CXC ligand 9 (CXCL9), and chemokine CXC ligand 10 (CXCL10) content (P<0.05, P<0.01), thickening of the alveolar walls, fusion of alveolar cavities, and infiltration of inflammatory cells in lung tissue, increased proportion of M1 macrophage polarization and lung cell apoptosis (P<0.05), and increased protein expression levels of JAK1, phosphorylated JAK1 (p-JAK1), inducible nitric oxide synthase (iNOS), STAT1, phosphorylated STAT1 (p-STAT1), IRF1, gasdermin D (GSDMD), and mixed lineage kinase domain-like protein (MLKL) (P<0.05, P<0.01). Compared with the model group, Qingwen Baiduyin significantly increased pO2, SO2, and lung tissue W/D (P<0.05, P<0.01), improved the pathological changes in lung tissue, and reduced pCO2, total protein content, total cell count, EBD content, IFN-γ, TNF-α, IL-1β, CXCL1, CXCL2, CXCL9, and CXCL10 content, proportion of M1 macrophage polarization, and protein expression levels of JAK1, p-JAK1, iNOS, STAT1, p-STAT1, IRF1, GSDMD, and MLKL (P<0.05, P<0.01).ConclusionQingwen Baiduyin can improve the lung inflammatory response and reduce lung cell apoptosis in mice with ALI by inhibiting the JAK1/STAT1/IRF1 signaling pathway, thereby exerting a lung-protective effect.
关键词:Qingwen Baiduyin;acute lung injury;inflammation;apoptosis;Janus kinase 1/signal transducer and activator of transcription 1/interferon regulatory factor 1 (JAK1/STAT1/IRF1) signaling pathway
摘要:ObjectiveTo observe the therapeutic effect and underlying mechanism of Linggui Zhugantang on lipopolysaccharide (LPS)-induced acute lung injury (ALI) in mice.MethodSeventy-two 7-week-old C57BL/6 mice of SPF grade were randomly divided into a normal group, a model group, a dexamethasone group (5 mg·kg-1), and high-, medium-, and low-dose Linggui Zhugantang groups (9.36, 4.68,2.34 g·kg-1), with 12 mice in each group. Except for the normal group, the remaining groups underwent intranasal instillation of LPS (50 μg per mouse) for the induction of the ALI model. The treatment groups received oral administration for 7 days prior to modeling. After 12 hours of modeling, mouse lung tissues were taken to measure the wet/dry weight ratio (W/D). Hematoxylin-eosin (HE) staining was performed to observe the pathological morphological changes in lung tissues. Bronchoalveolar lavage fluid (BALF) was collected for total cell count using a cell counter, and Wright-Giemsa staining was conducted to classify and quantify inflammatory cells (neutrophils and macrophages). Enzyme-linked immunosorbent assay (ELISA) was used to determine the expression levels of inflammatory cytokines tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in BALF. Western blot analysis was performed to detect the expression of nuclear factor-κB (NF-κB) inhibitory protein α (IκBα), NF-κB p65, and their phosphorylated proteins, and the ratio of phosphorylated protein/total protein was calculated.ResultCompared with the normal group, the model group exhibited severe lung tissue damage, disrupted alveolar structure, thickened alveolar walls, infiltration of extensive inflammatory cells and red blood cells, and significantly aggravated lung edema (P<0.01). The total cell count, inflammatory cell count, expression levels of IL-6, and TNF-α in BALF, as well as NF-κB p65 and phosphorylated IκBα in lung tissues, were significantly upregulated in the model group (P<0.01). Compared with the model group, high-, medium-, and low-dose Linggui Zhugantang groups, as well as the dexamethasone group, showed improved lung injury, reduced lung edema (P<0.01), downregulated total cell count, neutrophil count, expression levels of IL-6 and TNF-α in BALF, and NF-κB p65 and phosphorylated IκBα in lung tissues (P<0.01), and reduced macrophage count (P<0.05).ConclusionLinggui Zhugantang has anti-inflammatory and protective effects on LPS-induced ALI in mice, effectively reducing inflammation and promoting diuresis and edema elimination. Its mechanism may be related to the inhibition of NF-κB pathway activation.
摘要:ObjectiveTo investigate the effect and mechanism of Shenling Baizhusan on the treatment of oligoasthenospermia with hyperuricemia (HUA).MethodThirty-two male Kunming (KM) mice were randomly divided into blank group (n=6), model group (n=6), high-dose Shenling Baizhusan group (n=7), low-dose Shenling Baizhusan group (n=7), and febuxostat group (n=6). Except for the blank group, all other groups received intraperitoneal injection of potassium oxazinate suspension (600 mg·kg-1) for 7 days. After modeling, the high-dose Shenling Baizhusan group and the low-dose Shenling Baizhusan group were orally administered with 20.14 g·kg-1 and 10.07 g·kg-1 of Shenling Baizhusan, respectively. The Febuxostat group was orally administered with 0.25 g·kg-1 of Febuxostat, while the blank group and model group were orally administered with the same volume of physiological saline. Oral administration was performed once a day for 14 consecutive days, after which samples were collected. Biochemical methods were used to measure serum uric acid (UA), superoxide dismutase (SOD) and malondialdehyde (MDA) in testicular tissue. Hematoxylin-eosin (HE) staining was used to observe the histopathological changes in testicular tissue and evaluate the spermatogenesis function. Automated sperm analyzer was used to measure sperm density and motility. Single-cell gel electrophoresis (SCGE) was used to assess sperm DNA integrity. Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL) was used to detect testicular cell apoptosis rate. Western blot analysis was performed to measure the protein expression levels of Kelch-like ECH-associated protein 1 (Keap1), nuclear factor E2-related factor 2 (Nrf2), heme oxygenase-1 (HO-1), B-cell lymphoma-2 (Bcl-2), Bcl-2-associated X protein (Bax), and Caspase-3 in testicular tissue. Real-time polymerase chain reaction (PCR) was conducted to evaluate the mRNA expression levels of Keap1, Nrf2, and HO-1 in testicular tissue.ResultCompared with the blank group, the model group showed elevated serum UA level (P<0.01), decreased testicular spermatogenesis function, sperm density, and motility (P<0.01), and increased sperm trailing rate and testicular cell apoptosis rate (P<0.01). Compared with the model group, the high-dose Shenling Baizhusan group showed significant improvements in the above-mentioned indicators (P<0.05, P<0.01). Additionally, the expression levels of Keap1, Bax, and Caspase-3 in testicular tissue were reduced, while the expression levels of Nrf2, HO-1, and Bcl-2 increased (P<0.05, P<0.01). The mRNA level of Keap1 decreased (P<0.05, P<0.01), while the mRNA levels of Nrf2 and HO-1 increased (P<0.05, P<0.01).ConclusionShenling Baizhusan can significantly improve HUA oligoasthenospermia, and its mechanism may be related to the Nrf2/antioxidant response element (ARE) signaling pathway.
关键词:Shenling Baizhusan;oligoasthenospermia;hyperuricemia;treating different diseases with same method;nuclear factor E2-related factor 2 (Nrf2)/antioxidant response element (ARE)
摘要:Xiaoruwan is one of the classic prescriptions included in the Catalogue of Ancient Classic Prescriptions (the Second Batch of Pediatrics) published by the National Administration of Traditional Chinese Medicine(TCM) in 2022 with definite clinical efficacy, but it has not been converted into Chinese patent medicine preparations. The authors collected 173 pieces of data based on ancient literature on Xiaoruwan by the method of bibliometrics and selected 99 pieces of effective data, involving 46 ancient books of TCM. The study analyzed the historical development origin, prescription names, formulation rules, dosage, drug origin, preparation method and usage, indications and functions, and other aspects of Xiaoruwan. The results showed that Xiaoruwan was presumably derived from Ying Hai Miao Jue Lun(《婴孩妙诀论》) written by TANG Minwang, a doctor in the Song Dynasty. In the records of ancient medical books, there are names such as Xiaoshiwan,Yangshi Xiaoruwan, and Kuaige Xiaoshiwan, but they are mainly recorded in the name of Xiaoruwan. The prescription was composed of Cyperi Rhizoma, Amomi Fructus, Citri Reticulatae Pericarpium, Massa Medicata Fermentata, Hordei Fructus Germinatus, and Glycyrrhizae Radix et Rhizoma. In terms of processing method, Cyperi Rhizoma, Massa Medicata Fermentata, and Hordei Fructus Germinatus are fried, Glycyrrhizae Radix et Rhizoma is processed, and raw materials of Amomi Fructus and Citri Reticulatae Pericarpium are used directly. In terms of function, it is effective in warming the middle, improving digestion, stopping vomiting, and digesting milk and food. The main indications include vomiting, diarrhea, night crying, and other diseases caused by milk and food stagnation. The dosage of the most used prescription in the records of ancient books is Cyperi Rhizoma 41.30 g, Amomi Fructus 20.65 g, Citri Reticulatae Pericarpium 20.65 g, Massa Medicata Fermentata 20.65 g, Hordei Fructus Germinatus 20.65 g, and Glycyrrhizae Radix et Rhizoma 20.65 g, which are prepared into pills. In the taking method, it is recommended to take it with warm boiled water or ginger soup after meals. The study summarized the historical evolution of Xiaoruwan and identified the key information, with a view to providing a reference for the modern development and research of Xiaoruwan.
关键词:classical prescription;Xiaoruwan;Ying Hai Miao Jue Lun;drug base;literature research
摘要:ObjectiveTo investigate the effects of the volatile oil of Linderae Radix on the apoptosis and autophagy of human gastric cancer cell line AGS, and to explore the regulatory role of adenosine monophosphate-activated protein kinase (AMPK)/mammalian target of rapamycin (mTOR) signaling pathway in this process.MethodThe volatile oil of Linderae Radix was extracted by steam distillation, and the effect of the volatile oil on the viability of AGS cells was detected by thiazolyl tetrazolium (MTT) colorimetry. The optimal intervention dose and time were determined according to the half maximal inhibitory concentration (IC50) for subsequent research. The blank, low, medium, and high-dose volatile oil (0, 15, 30, 60 mg·L-1) groups and the positive drug cyclophosphamide (CTX, 350 mg·L-1) group were designed. AGS cells were treated with different doses of volatile oil for 48 h. The changes in cell proliferation, cycle, and migration were measured by colony formation assay, flow cytometry, and cell scratch test, respectively. Hematoxylin-eosin (HE) staining was employed to observe the changes of cell morphology, Annexin-V/propidium iodide (PI) double staining to measure the apoptosis, and acridine orange (AO) staining to measure the autophagy level of the cells. Western blotting was employed to determine the expression of the autophagy effectors Beclin-1, p62, microtubule-associated protein 1-light chain 3 (LC3), B-cell lymphoma-2 (Bcl-2), Bcl-2-associated X protein (Bax), cleaved Caspase-3, cleaved poly ADP-ribose polymerase (PARP), adenosine monophosphate-activated protein kinase (AMPK), phosphorylated AMPK (p-AMPK), mTOR, and phosphorylated mTOR (p-mTOR).ResultCompared with the blank group, 24 h and 48 h of intervention with the volatile oil of Linderae Radix inhibited the viability of AGS cells in a concentration- and time-dependent manner (P<0.05, P<0.01). Compared with the blank group, the volatile oil decreased the cell proliferation and migration (P<0.05, P<0.01) and blocked the AGS cell cycle in G2/M phase (P<0.05, P<0.01) in a concentration-dependent manner. The cells treated with the volatile oil became spherical and smaller, with the formation of apoptotic bodies and increased apoptosis rate (P<0.05, P<0.01). As the dose of the volatile oil increased, the number of autophagosomes increased and the red fluorescence gradually enhanced, indicating the elevated level of autophagy. Compared with the blank group, different doses of volatile oil up-regulated the protein levels of Beclin-1, LC3 Ⅱ/LC3 Ⅰ, cleaved Caspase-3, cleaved PARP, Bax/Bcl-2, and AMPK (P<0.05, P<0.01) and down-regulated the protein levels of p62 and p-mTOR (P<0.05, P<0.01).ConclusionThe volatile oil of Linderae Radix induces the apoptosis and exerts the autophagy-mediated growth inhibition of AGS cells by regulating the AMPK/mTOR signaling pathway.
摘要:ObjectiveTo investigate the therapeutic effect of Lycopi Herba extract on chronic prostatitis (CNP) and explore the underlying action mechanism via the inflammasome NOD-like receptor protein 3 (NLRP3) pathway.MethodNormal human prostatic stromal cells, namely WPMY-1 were induced by lipopolysaccharide (LPS) of 5 mg·L-1, and the effects of Lycopi Herba extract of 3.125, 6.25, 12.5, 25, 50, and 100 mg·L-1 on interleukin-6 (IL-6) level released by LPS-induced WPMY-1 cells were detected by enzyme-linked immunosorbent assay (ELISA). The half-maximal inhibitory concentration (IC50) was calculated. The expression of key proteins in the NLRP3 pathway was detected by western blot after Lycopi Herba extract of 50, 75, and 100 mg·L-1 was administered to WPMY-1 cells. The rat model of CNP was established by injecting carrageenan salt solution into the abdominal lobe of the prostate gland. Hematoxylin-eosin (HE) staining was used to observe the histopathological changes in the prostate gland in rats. The prostate organ index of rats was measured. The level of 5α-dihydrotestosterone (5α-DHT) in serum, as well as the levels of IL-6, tumor necrosis factor-α (TNF-α), transforming growth factor-β1 (TGF-β1), cyclooxygenase-2 (COX-2), prostaglandin E2 (PGE2), and inducible nitric oxide synthase (iNOS) in prostate tissue were detected by ELISA. The key protein expressions of COX-2, TGF-β1, and NLRP3 pathway in prostate tissue were detected by Western blot. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was used to detect the expressions of COX-2, IL-1β, TGF-β1, and TNF-α mRNA in prostate tissue.ResultCompared with the normal group, the level of IL-6 and the protein expression levels of NLRP3, ASC, Caspase-1, and IL-1β of WPMY-1 cells in the model group were increased (P<0.05, P<0.01). Compared with the model group, Lycopi Herba extract could inhibit the levels of IL-6 (P<0.01) released by LPS-induced WPMY-1 cells, with IC50 of 38.26 mg·L-1. The protein expression levels of NLRP3, ASC, and IL-1β in the low-, medium-, and high-dose groups of Lycopi Herba extract were significantly down-regulated (P<0.05, P<0.01). The expression levels of Caspase-1 protein in medium- and high-dose groups of Lycopi Herba extract were significantly down-regulated (P<0.05, P<0.01). Compared with the sham operation group, the prostate organ index of rats in the model group was significantly increased (P<0.01), a large number of inflammatory cells were infiltrated in the prostate tissue, and the histopathological score was significantly increased (P<0.05); the levels of 5α-DHT in serum, the levels of TNF-α, PGE2, IL-6, TGF-β1, NOS2/iNOS, and COX-2 in prostate tissue, and expression levels of COX-2, IL-1β, and TGF-β1 were significantly increased (P<0.05, P<0.01). The mRNA expression levels of COX-2, TGF-β1, NLRP3, Caspase-1, ASC, and IL-1β in prostate tissue were significantly up-regulated (P<0.05, P<0.01). Compared with model group, the low and high doses of Lycopi Herba extract could alleviate the pathological changes in prostate tissue induced by carrageenan, significantly reduce the level of 5α-DHT in serum, levels of TNF-α, PGE2, TGF-β1, and iNOS in prostate tissue (P<0.05, P<0.01), and mRNA expression levels of COX-2, IL-1β, and TGF-β1 (P<0.05, P<0.01). The protein expression levels of COX-2, Caspase-1, ASC, and NLRP3 in prostate tissue were significantly down-regulated (P<0.05, P<0.01). The prostate organ index of the low-dose group of Lycopi Herba extract was significantly decreased (P<0.01). The level of COX-2 in prostate tissue of the high-dose group of Lycopi Herba extract was significantly decreased, and the protein expression levels of TGF-β1 and IL-1β were significantly down-regulated (P<0.05).ConclusionLycopi Herba extract has an obvious therapeutic effect on CNP and may reduce inflammation by inhibiting the activation of the inflammasome NLRP3 signaling pathway.
摘要:ObjectiveTo establish and evaluate a mouse model of heart failure with Qi deficiency syndrome.MethodForty-four KM mice were randomly divided into sham operation group, model group, and modified Si Junzitang group (12.89 g·kg-1). The model group and the modified Si Junzitang group underwent thoracic aortic constriction (TAC), while the sham operation group only underwent suture without constriction. Echocardiography and pathological examination were used to assess the heart failure model and evaluate the pharmacological effects. Macroscopic characterization, microscopic biology, and formula identification were conducted to collect general signs, body weight, open-field behavior, grip strength, mitochondrial ultrastructure, and other macroscopic and microscopic characteristics of mice. Mitochondrial fission and fusion protein expression were measured to determine the syndrome type.ResultEight weeks after TAC, compared with the sham operation group, the model group showed a significant decrease in left ventricular ejection fraction (LVEF) (P<0.01), and modified Si Junzitang improved LVEF in mice (P<0.05). Hematoxylin-eosin (HE) staining of the heart showed inflammatory cell infiltration and thickening of blood vessel walls in the model group, which was significantly improved by modified Si Junzitang. After 6-8 weeks, compared with the sham operation group and the modified Si Junzitang group, the model group exhibited significant hair loss, hair yellowing, decreased activity, and depression. Moreover, compared with the sham operation group, the model group had a significantly lower increase in body weight (P<0.05), while the modified Si Junzitang group showed a significant increase in body weight (P<0.05) compared with the model group. After 6-8 weeks, compared with the sham operation group, the model group showed a significant decrease in open-field distance and speed (P<0.05), while the modified Si Junzitang group exhibited significantly improved open-field distance and speed in the 8th week (P<0.05). After 6-8 weeks, compared with the sham operation group, the model group exhibited a significant decrease in maximum grip strength (P<0.05), while the modified Si Junzitang group showed a significant increase in maximum grip strength 8 weeks after TAC (P<0.05). Transmission electron microscopy of the gastrocnemius muscle showed uneven muscle tissue matrix, mitochondrial swelling, increased volume, matrix dissolution, ridge loss, and vacuolization in the model group, while modified Si Junzitang improved mitochondrial swelling, ridge fracture, and matrix vacuolization. Western blot analysis showed that the expression of the kinetic associated protein 1 (DRP1) in the gastrocnemius muscle of the model group significantly increased (P<0.01), and the expression of mitochondrial fusion hormone 1 (MFN1) significantly decreased (P<0.05) as compared with those in the sham operation group. Furthermore, compared with the model group, the modified Si Junzitang group exhibited a significant decrease in the expression of DRP1 (P<0.05) and a significant increase in MFN1 expression (P<0.01).ConclusionMice exhibited significant manifestations of qi deficiency syndrome 6-8 weeks after TAC, accompanied by abnormal mitochondrial morphology and function in the gastrocnemius muscle, which were significantly improved by modified Si Junzitang.
摘要:ObjectiveTo investigate the regulatory effect of Mankuining Formula (MKNF) on the gut microbiota and the NOD-like receptor (NLR)P3/Caspase-1/gasdermin D (GSDMD) pyroptosis pathway-mediated inflammation in dextran sulfate sodium (DSS)-induced ulcerative colitis (UC) mice.MethodSixty SPF C57BL/6 mice were randomly divided into a blank group, a model group, a MKNF group (20 g·kg-1), and a mesalazine group (0.266 g·kg-1), with 15 mice in each group. The UC model was induced in mice by freely drinking a 3% DSS solution for 7 days. After 12 hours of modeling, the treatment groups received daily oral administration, while the other groups received an equal volume of normal saline by gavage. Daily body weight and disease activity index (DAI) were recorded. On the 8th day, mice were euthanized after anesthesia, and the colon and feces were collected. The colon length was measured, and histopathological changes were observed after hematoxylin-eosin (HE) staining. Tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-18 (IL-18) levels in the colon were detected by enzyme-linked immunosorbent assay (ELISA). The differences in gut microbiota among the groups were analyzed using 16S rRNA sequencing technology. The protein content of NLRP3/Caspase-1/GSDMD in colon tissues was detected by Western blot.ResultCompared with the blank group, mice in the model group showed increased DAI (P<0.01), shortened colon length (P<0.01), severe colon mucosal damage, elevated levels of TNF-α, IL-1β, and IL-18 (P<0.01), increased protein content of NLRP3/Caspase-1/GSDMD in colon tissues (P<0.01), altered gut microbiota structure with decreased abundance of Actinobacteria, Bacteroidetes, and Proteobacteria, and increased abundance of Firmicutes at the phylum level. At the genus level, there was a decrease in Lactobacillus, Alloprevotella, and Yersinia, and an increase in Bacteroides, Bacillus, and Lachnospiraceae_NK4A136. Compared with the model group, the MKNF group and the mesalazine group showed a significant reduction in DAI after the 3rd day (P<0.01), a significant increase in colon length (P<0.01), alleviated colon inflammation and mucosal structural damage, and decreased TNF-α, IL-1β, and IL-18 levels in the colon (P<0.01), reduced protein content of NLRP3/caspase-1/GSDMD in colon tissue (P<0.05, P<0.01),an increase in the abundance of Proteobacteria and Bacteroidetes, and a decrease in Firmicutes at the phylum level.ConclusionMKNF can alleviate UC-induced colonic inflammation, reduce colon damage, and improve dysbiosis of the gut microbiota by inhibiting the classical pyroptosis pathway.
摘要:ObjectiveTo explore the clinical efficacy and safety of the combination of Erchentang and Bixie Fenqingyin in the treatment of patients with acute cerebral infarction accompanied by hyperuricemia of phlegm and blood stasis blocking collaterals syndrome to provide a new method and evidence for the treatment of acute cerebral infarction with hyperuricemia.MethodA total of 132 eligible patients with acute cerebral infarction accompanied by hyperuricemia of phlegm and blood stasis blocking collaterals syndrome admitted to the Putuo Hospital of Shanghai University of Traditional Chinese Medicine(TCM) from May 2021 to May 2022 were randomly divided into a Chinese medicine group, a western medicine group, and a control group, with 44 cases in each group. All three groups received routine western medical treatment for acute cerebral infarction. Additionally, the Chinese medicine group received Erchentang combined with Bixie Fenqingyin, the western medicine group received Benzbromarone tablets, and the control group did not receive any uric acid-lowering treatment. The treatment duration was four weeks. The modified Rankin Scale (mRS) score after three months of onset, as well as the National Institutes of Health Stroke Scale (NIHSS) scores, TCM syndrome scores, serum uric acid (SUA) levels, serum C-reactive protein (CRP) and interleukin-6 (IL-6) levels, serum superoxide dismutase (SOD) and malondialdehyde (MDA) levels, and other safety indicators were observed before and after treatment.ResultA total of 129 cases completed the trial observation, with 43 cases in the Chinese medicine group, 42 cases in the western medicine group, and 44 cases in the control group. The rate of good prognosis in the Chinese medicine group (83.7%,36/43) was higher than that in the western medicine group (64.3%,27/42) and the control group (40.9%,18/44) (χ2=4.184,16.930,P<0.05), and the western medicine group was superior to the control group (χ2=4.707,P<0.05). After treatment, the NIHSS scores, TCM syndrome scores, SUA, CRP, IL-6, and MDA levels of the patients in all three groups decreased, while the SOD levels increased compared with those before treatment (P<0.05). Among them, the improvement in NIHSS score was better in the Chinese medicine group and the western medicine group than in the control group (P<0.05). The Chinese medicine group showed the greatest improvement in TCM syndrome (P<0.05), while the western medicine group showed the greatest reduction in uric acid levels (P<0.05). No significant abnormalities in safety indicators were observed before and after treatment in the three groups, and no serious adverse reactions were reported.ConclusionThe combination of Erchentang and Bixie Fenqingyin can significantly improve the prognosis, early neurological deficits, and TCM syndromes of patients acute cerebral infarction accompanied by hyperuricemia of phlegm and blood stasis blocking collaterals syndrome. It can also lower uric acid levels and inhibit inflammatory and oxidative stress reactions.
关键词:Erchentang;Bixie Fenqingyin;acute cerebral infarction;hyperuricemia;syndrome of phlegm and blood stasis blocking collaterals
摘要:ObjectiveTo evaluate the clinical efficacy of Qimai Qinlou prescription in the treatment of elderly community-acquired pneumonia (CAP) (non-severe) with Qi and Yin deficiency and phlegm-heat obstructing lung syndrome and its impact on immune-inflammatory factors.MethodA total of 120 eligible patients were randomly divided into an observation group (60 cases) and a control group (60 cases). Both groups received intravenous cefoxitin sodium. In addition, the observation group received oral Qimai Qinlou prescription, while the control group received an oral placebo simulating Qimai Qinlou prescription. The treatment course was 14 days. The disappearance time of major clinical symptoms and signs was recorded. Traditional Chinese medicine (TCM) syndrome scores and the Clinical Research Outcome (CAP-CRO) scale scores for pneumonia of the two groups were compared. Chest computed tomography (CT) scans were performed, and peripheral blood levels of procalcitonin (PCT), interleukin-6 (IL-6), serum amyloid A (SAA), high-sensitivity C-reactive protein (hs-CRP), CD4+, CD8+, and CD4+/CD8+ were measured. The conversion rate to severe condition during hospitalization, readmission rate within 30 days after discharge, and safety evaluation were recorded.ResultAfter treatment, the observation group showed significantly shorter time of fever, cough, expectoration, and disappearance time of lung moist rales than the control group (P<0.01). The TCM syndrome scores, CAP-CRO scores in all dimensions, and total scores in both groups were significantly reduced as compared with those before treatment (P<0.01). After treatment, the observation group had a more significant reduction than the control group (P<0.01). The levels of PCT, IL-6, SAA, and hs-CRP in both groups were significantly reduced as compared with those before treatment (P<0.01). After treatment, the observation group showed a more significant reduction than the control group (P<0.01). There was no statistically significant difference in the changes of CD4+, CD8+, and CD4+/CD8+ in the control group before and after treatment. However, in the observation group, CD4+ and CD4+/CD8+ levels significantly increased (P<0.01), while CD8+ level significantly decreased (P<0.01) after treatment. After treatment, CD4+ and CD4+/CD8+ in the observation group significantly increased (P<0.01), and CD8+ significantly decreased as compared with those in the control group (P<0.01). At 7, 10, and 14 days after treatment, the curative rates in the observation group were 53.33% (32/60), 85.00% (51/60), and 91.67% (55/60), respectively, which were higher than 31.67% (19/60), 61.67% (37/60), and 68.33% (41/60) in the control group (χ2=5.763, 8.352, 10.208, P<0.05). After treatment, the total effective rate of CT scanning in the observation group was 93.33% (56/60), higher than 80.00% (48/60) in the control group (χ2=4.615, P<0.05). The conversion rate to severe condition during hospitalization in the observation group was 3.33% (2/60), lower than 15.00% (9/60) in the control group (χ2=4.904, P<0.05). The readmission rate within 30 days after discharge in the observation group was 8.33% (5/60), lower than 23.33% (14/60) in the control group (χ2=5.065, P<0.05). No serious adverse drug reactions were observed in either group during the treatment period.ConclusionQimai Qinlou prescription can enhance immune function, alleviate inflammatory reactions, significantly relieve clinical symptoms, shorten the duration of the disease, improve the curative rate and CT scanning efficacy, prevent disease progression, reduce the readmission rate in the short term, and is clinically safe for the treatment of elderly patients with non-severe CAP with Qi and Yin deficiency and phlegm-heat obstructing lung syndrome. It is worthy of further research and application.
关键词:community-acquired pneumonia;elderly;Qi and Yin deficiency and phlegm-heat obstructing lung syndrome;Qimai Qinlou prescription;Beimu Gualousan;immune function;inflammatory factors
摘要:ObjectiveTo evaluate the therapeutic effect of Guizhi Gegentang on cervical vertigo and its impact on hemodynamics and vascular endothelial function.MethodA total of 144 patients with cervical vertigo treated from April 2019 to June 2022 were included in the study and randomly divided into a control group and an observation group, with 72 patients in each group. During the study, three patients dropped out from the observation group and two patients from the control group. The control group received conventional treatment (oral betahistine mesylate tablets), while the observation group received conventional treatment combined with Guizhi Gegentang. The clinical efficacy, changes in the frequency and duration of dizziness attacks per month before and after treatment, changes in symptoms and functional evaluation scores of cervical vertigo assessed by the European Scale for Cervical Vertigo (ESCV), changes in the average blood flow velocity of the left vertebral artery, right vertebral artery, and basilar artery, changes in indicators such as endothelin-1 (ET-1), neuropeptide Y (NPY), calcitonin gene-related peptide (CGRP), changes in the Neck Disability Index (NDI) score, changes in the Functional Assessment of Cancer Therapy-General (FACT-G) score, and adverse reactions were observed and compared between the two groups.ResultThe total effective rate in the observation group was 95.65% (66/69), significantly higher than 84.29% (59/70) in the control group (χ2=4.957, P<0.05). Before treatment, there were no significant differences in the frequency and duration of dizziness attacks per month, ESCV scores, average blood flow velocity of the left vertebral artery, right vertebral artery, and basilar artery, levels of ET-1, NPY, CGRP, NDI score, and FACT-G score between the two groups. After treatment, compared with the baseline within each group, there were improvements in the frequency and duration of dizziness attacks per month, ESCV scores, average blood flow velocity of the left vertebral artery, right vertebral artery, and basilar artery, levels of ET-1, NPY, CGRP, NDI score, and FACT-G score in both groups (P<0.05, P<0.01). Compared with the control group, the observation group showed better improvements in the frequency and duration of dizziness attacks per month, ESCV score, average blood flow velocity of the left vertebral artery, right vertebral artery, and basilar artery, levels of ET-1, NPY, CGRP, NDI score, and FACT-G score (P<0.05, P<0.01). During the study period, one case of nausea occurred in the control group, and one case of dizziness occurred in the observation group. There was no statistically significant difference in the incidence of adverse reactions between the two groups.ConclusionGuizhi Gegentang can improve the therapeutic effect of cervical vertigo, effectively improve patients' hemodynamics and vascular endothelial function, and enhance their quality of life with few adverse reactions. It is worth applying in clinical practice.
关键词:cervical vertigo;Guizhi Gegentang;betastine mesylate tablets;hemodynamics;curative effect;vascular endothelial function
摘要:ObjectiveTo observe the effect of the Fangfeng Tongshengsan on post-chemoembolization syndrome with primary liver cancer or postoperative liver metastases of colorectal cancer.MethodSeventy-two patients suffered from post-chemoembolization syndrome after transcatheter hepatic arterial chemoembolization were randomly divided into 2 groups, including a Fangfeng Tongshengsan group and a control group, with 36 patients in each group. The patients in Fangfeng Tongshengsan group orally took the decoction for consecutive 7 d. The patients in the control group were physically cooled down with alcohol rub bath and ice pack for consecutive 7 d. Furthermore, the difference of fever, Karnofsky performance status (KPS), pain in the liver region, nausea vomiting, constipation, and liver function between these two groups were observed.ResultCompared with the control group, Fangfeng Tongshengsan significantly relieved fever, reduced the body temperature (P<0.05), and shortened the duration of fever (P<0.05), indicating that Fangfeng Tongshengsan remarkably improved the KPS (P<0.05). Meanwhile, Fangfeng Tongshengsan obviously alleviated nausea, vomiting, and constipation status and shortened the duration time compared with the control group (P<0.05). In addition, the parameters of liver function including alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyl transpeptidase (GGT), and total bilirubin (TBIL) were significantly decreased in the Fangfeng Tongshengsan group (P<0.05), which indicated that Fangfeng Tongshengsan alleviated liver dysfunction of patients with post-chemoembolization syndrome.ConclusionFangfeng Tongshengsan can be used to treat post-chemoembolization syndrome with primary liver cancer and postoperative liver metastases of colorectal cancer.
关键词:Fangfeng Tongshengsan;post-chemoembolization syndrome;transcatheter hepatic arterial chemoembolization;primary liver cancer;postoperative liver metastases of colorectal cancer
摘要:ObjectiveTo investigate the clinical efficacy of Tenghuang Jiangu tablets (THJGT) combined with oral non-steroidal anti-inflammatory drugs (NSAIDs) in the treatment of osteoarthritis of the knee and its applicable stage based on real-world data, and provide a basis for the rational clinical use of THJGT.MethodA total of 218 cases treated with THJGT combined with oral NSAIDs included in the "THJGT for knee osteoarthritis case registry" from September 2019 to January 2021 were selected as the observation group, and 126 cases treated with oral NSAIDs alone as the control group (CG). The data of gender, age, body mass index, Kellgren-Lawrence grading scale (K-L scale) score, visual analogue score (VAS score), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, swelling grade, joint fear of cold score, back pain and weakness score, and occurrence of adverse events/reactions of the patients in both groups were used for the evaluation of efficacy with full analysis set. The propensity score matching method was used to exclude the influence of confounding factors between groups, and the sub-data sets were established, with which the repeated measures analysis of variance (ANOVA) was carried out to evaluate the efficacy. Visit points were at registration, 4 weeks and 8 weeks after registration. The data were statistically analyzed in Excel 2019 and SPSS 23.0.ResultThe proportion of females in the observation group was 66.06% (144/218), which was higher than that (58.73%, 74/126) in the control group (χ2=1.846). The average age in the observation group was (61.12±7.01) years, which was higher than that [(59.38±5.99) years] in the control group (W=19 918.50, P<0.05). The remission rate in the observation group was 98.17% (214/218). In the observation group, the proportions of the patients at K-L grades Ⅱ and Ⅲ were 64.22% (144/218) and 25.23% (55/218), respectively. The effect analysis of the whole data set for enrollment and treatment for 8 weeks showed that the VAS score of the experimental group decreased by (3.27±1.24) points on average, which was better than that of the control group [(2.75±1.20), W=34 179.00, P<0.05]. The average WOMAC score decreased (23.43±11.46) points, which was better than that of the control group [(16.71±8.86), W=32 387.00, P<0.05]. The average swelling grade decreased (0.63±0.64), which was better than the control group [(0.33±0.59), W=33 847.50, P<0.05]. The average score of joint chills decreased (1.90±1.84), points, which was better than that of control group [(1.40±1.28), W=35 165.00, P<0.05]. The average lumbar acid fatigue score decreased by (2.02±1.64) points, which was better than that of the control group [(1.10±1.28), W=32 986.50, P<0.05]. Efficacy analysis of subdata sets for enrollment, 4 weeks of medication and 8 weeks of medication showed that VAS scores of both groups showed a downward trend after treatment, and the improvement of experimental group was more significant than that of control group at 4 weeks, with statistical significance (P<0.05). After treatment, the total WOMAC score of both groups showed a downward trend, and the improvement of experimental groups was more significant at 4 weeks and 8 weeks (P<0.05). After treatment, swelling, cold fear grade and lumbar acid fatigue score of both groups showed a decreasing trend,, and the improvement of experimental group was more significant at 8 weeks (P<0.05). The therapeutic effect analysis of patients in the attack stage and remission stage of the experimental group showed that the total WOMAC score of the two groups showed a downward trend after treatment, and the trend was basically the same, and there was no statistical difference between the two groups at enrollment, 4 weeks after treatment, and 8 weeks after treatment (t=1.675, t=2.068, t=2.364). The total WOMAC score of the patients in remission stage in the experimental group with K-L grading between grade 0 and grade Ⅲ had statistical significance at 4 weeks after treatment compared with the time of entry (P<0.05, P<0.01). Group of adverse event rate was 4.13% (9/218), lower than the control group 10.32% (13/126) (χ2= 5.109, P<0.05).ConclusionThe population receiving THJGT combined with oral NSAIDs is mostly female, old, in remission, and with K-L grades Ⅱ and Ⅲ. THJGT can enhance the anti-inflammatory and analgesic effects of oral NSAIDs and keep the drug effect in improving joint function and alleviating fear of cold, swelling, and back pain and weakness. The drug combination can be applied to patients in both attack and remission, and the clinical application should take patient's disease stage and degree of osteoarthritis into account. Furthermore, the combination has the potential to reduce the incidence of adverse events caused by NSAIDs.
关键词:osteoarthritis of the knee;Tenghuang Jiangu tablets;case registry;propensity score matching method;real-world study
摘要:ObjectiveTo analyze the utilization of outcome indexes and other trial design elements in randomized controlled trials (RCTs) of Chinese medicine for diabetic kidney disease (DKD) and provide a basis for the design of clinical trials and the development of core outcome index sets for Chinese medicine treatment of DKD.MethodSeven medical databases (CNKI, Wanfang Data, VIP, SinoMed, etc.) and two clinical trial registration centers (clinicaltrials.gov and chinadrugtrials.org.cn) were searched for RCTs of Chinese medicine for DKD published in the past 5 years. The included studies were assessed for risk of bias using the Cochrane Handbook for Systematic Reviews of Interventions, and the outcome indexes and other trial design elements were statistically analyzed.ResultNinety-seven RCTs were enrolled, including five trial registration protocols. The overall risk of bias was found to be high in the included studies. Stage Ⅲ DKD (36 studies, 41.38%) and the Qi-Yin deficiency with blood stasis syndrome (16 studies, 26.23%) were the top DKD stage and traditional Chinese medicine (TCM) syndrome, respectively. The treatment duration ranged from 2 weeks to 96 weeks, with 12 weeks being the most common duration (52 studies, 56.52%). A total of 152 outcome indexes were used in 92 RCTs and five registered trials, with a frequency of 1 040 times. These indexes were classified into eight categories: Laboratory tests (blood), laboratory tests (urine), clinical efficacy, TCM syndrome score, quality of life scales, vital signs, other indexes, and other events. The most frequently used outcome indexes were serum creatinine (68 times, 70.10%), clinical response rate (55 times, 56.70%), fasting blood glucose (51 times, 52.58%), blood urea nitrogen (48 times, 49.48%), total cholesterol (47 times, 48.45%), and 24-hour urinary protein excretion (43 times, 44.33%). Safety indexes were used in 56 RCTs and two registered trials, with 53 different indexes and a frequency of 227 times. The most frequently used safety indexes were adverse reactions (49 times, 84.48%), liver function (28 times, 48.28%), complete blood count (24 times, 41.38%), electrocardiogram (17 times, 29.31%), and urinalysis (14 times, 24.14%). Ten RCTs and five registered trials reported primary outcome indexes, and 54 RCTs reported clinical response rates.ConclusionThe current design of outcome indexes in RCTs of Chinese medicine for DKD is not standardized. In the future, efforts should be made to develop core outcome index sets that highlight the characteristics of TCM, improve the quality of clinical research, and enhance the applicability of trial results.
关键词:traditional Chinese medicine;diabetic kidney disease;randomized controlled trial;trial design;outcome index
摘要:ObjectiveTo systematically review the existing studies on Xueshuantong for injection(lyophilized) in the treatment of acute cerebral infarction(ACI), and to clarify the clinical value of Xueshuantong for injection(lyophilized) through comprehensive clinical evaluation, so as to promote clinical rational drug use and relevant policy transformation.MethodEvidence of Xueshuantong for injection(lyophilized) in terms of safety, effectiveness, economy, innovation, suitability, accessibility, traditional Chinese medicine(TCM) characteristics(6+1 dimensions) and information service was comprehensively collected. Evidence-based medicine, questionnaire survey, health technology assessment, pharmacoeconomic evaluation and other research methods were used, and the multi-criteria decision analysis model was used to measure each dimension, in order to comprehensively evaluate the clinical value of Xueshuantong for injection(lyophilized).ResultSpontaneous reporting system, Meta-analysis of adverse reactions, and active safety monitoring study showed that the main adverse reactions of Xueshuantong for injection(lyophilized) were rash, pruritus, chest tightness, headache, dizziness and other general adverse reactions, the incidence of serious adverse reactions was judged to be rare, the known risk was small, the evidence was sufficient, and the safety evaluation was grade A. The results of Meta-analysis showed that Xueshuantong for injection(lyophilized) combined with conventional treatment for ACI was superior to conventional treatment in terms of improving neurological deficit score, improving daily activity score and clinical efficacy, and the effectiveness evaluation was grade B. The results of pharmacoeconomic evaluation showed that Xueshuantong for injection(lyophilized) combined with conventional treatment was relatively economic compared with conventional treatment alone, with the total clinical effective rate as the effect parameter, but the incremental effect was not significant, the economic evaluation was grade B. In addition to ACI and unstable angina of coronary heart disease, the drug also had good clinical efficacy in central retinal vein occlusion, and had a wider range of indications and awarded 16 patents, and its innovation evaluation was grade B. The suitability of medical personnel and patients was good without special technical and management requirements, and the suitability was evaluated as grade B. Xueshuantong for injection(lyophilized) had reasonable price, good affordability, certain prescription restrictions and general availability, the accessibility evaluation was grade B. Since the drug is an injection of effective parts of TCM, no grade evaluation of its TCM characteristics is conducted. The legal and non-legal information evaluation results of Xueshuantong for injection(lyophilized) showed that all the information was complete and in accordance with the requirements of national standards. Based on the grade scores of the 6 dimensions, the clinical comprehensive evaluation of Xueshuantong for injection(lyophilized) in the treatment of ACI was calculated as category B by CSC 2.0.ConclusionThe clinical value of Xueshuantong for injection(lyophilized) is good, and it is suggested that it can be directly translated into relevant policy outcomes for basic clinical medication management.
关键词:Xueshuantong for injection(lyophilized);acute cerebral infarction(ACI);comprehensive clinical evaluation;multi-criteria decision analysis;safety;effectiveness;pharmacoeconomics
摘要:ObjectiveTo investigate the pharmacological effect and metabolic mechanism of Linderae Radix on the intrauterine adhesion (IUA) rat model.MethodAn IUA rat model was induced by mechanical injury and infection. Molecular biology and pharmacology techniques were employed to evaluate the inhibitory effect of Linderae Radix extract (LAE) on fibrosis in IUA. Serum metabolomics analysis based on gas chromatography-mass spectrometry (GC-MS) was conducted to explore the metabolic regulation mechanism of LAE.ResultAnimal experiments showed that LAE significantly improved the morphology and structural damage of uterine tissue cells in the IUA rat model, promoted endometrial proliferation, vascular regeneration, and morphological recovery, inhibited the mRNA expression of transforming growth factor-β1 (TGF-β1), Smad2, and Smad3, and increased the expression of Smad7 mRNA to suppress fibrosis. Additionally, LAE significantly suppressed the levels of estrogen (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and tumor necrosis factor-α (TNF-α) expression (P<0.01), thereby improving the uterine microenvironment. Metabolomics analysis revealed significant metabolic abnormalities in the serum of IUA rats compared with the results in the normal group, and nine differential metabolites were identified. LAE effectively ameliorated these metabolic abnormalities, primarily by influencing six differential metabolites, including five shared metabolites among the nine identified markers: L-aspartic acid, L-pyroglutamic acid, L-serine, glucose, and L-norvaline. Pathway enrichment analysis indicated that the aminoacyl-tRNA biosynthesis pathway was the main affecting mechanism.ConclusionIn combination with the pharmacological research results, LAE effectively improved uterine damage and inhibited fibrosis in the IUA rat model. Its mechanism may involve the inhibition of the aminoacyl-tRNA biosynthesis pathway and the improvement of the microenvironment.
摘要:High quality is the premise for the implementation of high quality and good price for decoction pieces, and grade is the most direct manifestation of high quality of decoction pieces. However, there is still a lack of scientific and reasonable methods for evaluating the grade of decoction pieces, and it is urgent to establish a widely recognized and unified standard for the grade of decoction pieces to ensure the quality of the decoction pieces and guarantee the safety and efficacy of clinical use. Based on this, this paper focused on analyzing the problems of the current grade evaluation methods, such as unclear distinction between quality standards and grade standards, unreasonable selection of grade evaluation indicators, and inaccurate application of mathematical statistical methods. Based on the analysis of the grade evaluation of decoction pieces, this paper proposed four criteria for establishing the grade evaluation method of decoction pieces, namely universality, comprehensiveness, reliability and convenience, in order to establish a more reasonable and unified grade standard for decoction pieces and promote the quality improvement of decoction pieces and the development of the industry.
关键词:traditional Chinese medicine decoction pieces;grade evaluation method;quality standard;high quality and good price;index components;appearance
摘要:Strengthening the standard formulation and quality management of traditional Chinese medicine(TCM) dispensing granules is an important part of the strategic planning for the development of TCM in China. In order to examine the clinical application and overall quality control of the existing national standards for TCM dispensing granules, this study classified and summarized the varieties in the existing standards, analyzed their clinical applicability, and discussed the characteristics of the test methods for identification, content determination and specific chromatogram/fingerprint. It was found that the coverage of the existing standards was inadequate in terms of quantity, and it was even weaker in the aspects of therapeutic efficacy, herb family, processing method and preparation method of TCM dispensing granules. It was concluded that the characteristics of national standards in test methods were summarized as follows:guided by clinical application, based on the reference system, taking specific chromatogram as a breakthrough, so as to improve the overall quality control of TCM dispensing granules. It is suggested that the coverage of national standards should be subsequently expanded to meet the needs of market development. In order to enhance clinical applicability, the content of national quality standards should be increased, including increasing variety diversity to meet the needs of clinical application, raising the standard requirements to improve the clinical medication experience, and strengthening effectiveness research to highlight clinical efficacy. At the same time, the accessibility of regulatory inspection is enhanced, the rules for the management of varieties without national standards are promulgated to lay the foundation for the healthy and orderly development of TCM dispening granule industry.
关键词:traditional Chinese medicine dispensing granules;national standards;quality control;Chinese Pharmacopoeia;clinical application;fingerprint/specific chromatogram;content determination
摘要:Endothelial cells in the inner wall of blood vessels respond to physical and chemical signals of the body by regulating vascular homeostasis, vascular tension, cell adhesion, cell proliferation, coagulation resistance and inflammatory factors, to maintain the stability of blood vessels. Angiogenesis is the key condition for tumor evolution, and the pathological mode of tumor angiogenesis provides nutrients and oxygen for tumor growth and promotes its proliferation. In recent years, endothelial cells have participated in tumor vascular infiltration and driven angiogenesis, which is considered to be the point link in tumor metastasis. By regulating metabolic remodeling, vascular endothelial cells provide the materials and energy needed in the process of tumor angiogenesis, and their abnormal metabolic characteristics facilitate their adaption to the changes of tumor microenvironment, which is often regarded as an important basis for tumor angiogenesis. The ''Yin fire'' theory in traditional Chinese medicine, originating from Huangdi's Internal Classic (Huang Di Nei Jing), originally meant Yin deficiency generates internal heat, and belonged to the category of fire of internal injury. After the deduction and changes by physicians over the ages, the pathogenesis of ''spleen and stomach Qi deficiency-Yin fire rising-Qi and fire disharmony'' was gradually formed. The pathogenesis of metabolic remodeling of endothelial cells manifests the pathological characterization of Yin fire in an objective way, which is consistent with the disease state of uncontrolled and hyperactive tumor neovascularization. Changes in spleen and stomach Qi deficiency as well as imbalance of Qi movement lead to the failure of water and food in distribution, and thus metabolic disorders occur. Long term retention turns in phlegm and blood stasis, which combat with blood vessels, and result in abnormal local environment (formation of tumor microenvironment), adverse pulse channel (imbalance of endothelial cell metabolism), and tumor neovascularization. Under the guidance of ''Yin fire'' syndrome elements and by focusing on the correlation between Qi and fire, prescriptions are made based on the treatment method of ''strengthening the body and regulating Qi'' to regulate the metabolic function of endothelial cells, thus achieving a relatively balanced state of the body and inhibiting tumor angiogenesis. As a result, this study, centering on the metabolic remodeling of endothelial cells and ''Yin fire'' theory, elucidated the academic ideas, with the purpose of providing some theoretical support for the intervention of tumor vascularization by Chinese medicine.
关键词:Yin fire;endothelial cells;metabolic remodeling;tumor angiogenesis;strengthening the body and regulating Qi;Chinese medicine
摘要:Primary lung cancer, as one of the most commonly diagnosed malignancies and the top leading cause of cancer death worldwide, has seriously endangered human life. In China, due to regional differences, although the impact of lung cancer on different regions is different, it still has the highest mortality among malignant tumors. Western medicine often has certain limitations in the treatment of lung cancer. At present, the combination of western medicine and traditional Chinese medicine (TCM) or the direct application of TCM has become an inevitable trend in the treatment of lung cancer. TCM treatment is guided by the holistic view, which includes the view of integration of the five internal organs and the integration of the body and spirit. Therefore, the treatment of lung cancer in TCM emphasizes that although the disease is located in one organ, the whole body should be treated, which corresponds to the theory of the view of integration of the five internal organs. In addition to the lung in the treatment of lung cancer, the spleen and kidney should also be treated. The lung, spleen, and kidney correspond to metal, earth, and water, respectively on the five elements. According to the generation relationship of the five elements, since earth generates metal and metal generates water, earth is the mother of metal and water is the child of metal. Therefore, benefiting fire (kidney) can replenish earth. Tonifying the mother and son of the lung can treat lung diseases, reflecting mutual generation and transformation and ceaseless generation and transformation. Long-term consumption of Qi by lung cancer can affect mother-organ. In the context of disorder of child-organ affecting mother-organ, mother-organ should be tonified in the face of deficiency. The treatment principle of banking up earth to generate metal should be followed to reinforce healthy Qi and treat the root. Effulgent earth can promote the generation of metal and the syndrome of lung deficiency can be resolve. The lung and kidney deficiency is an important factor in the incidence of lung cancer. Yin deficiency for a long time can hinder the generation of water by metal, resulting in failure of water in moistening metal, so both mother organ and child organ should be tonified. The treatment principle of mutual generation between metal and water should be employed to moisten the kidney and lung, thereby facilitating the vigorous ventilation and descending of the lung. The spleen is the mother organ of the lung, and the kidney is the child organ of the lung. Long-term lung cancer causes the deficiency of the mother and child organs, so the treatment principle of replenishing fire to nourish earth should be adopted to benefit the kidney and tonify the spleen. Therefore, innate basis and acquired foundation are both filled, and the lung can be regulated properly. When the lung, spleen, and kidney are harmonized, the generation and transformation of Qi and blood are active, and the Yin and Yang of Qi and blood are balanced, so the self-rehabilitation ability of the body is ensured, and the treatment of lung cancer will achieve a good curative effect. According to the holistic view of TCM, the whole body should be regulated to treat lung cancer. The lung, spleen, and kidney are all treated in the treatment of lung cancer. With the lung, spleen, and kidney as the central axis, the treatment principles of banking up earth to generate metal, replenishing fire to nourish earth, and mutual generation between metal and water should be followed in the treatment of lung cancer, and a good therapeutic effect can be achieved.
关键词:banking up earth to generate metal;mutual generation between metal and water;replenishing fire to nourish earth;lung cancer;lung, spleen, and kidney
摘要:BackgroundIn order to implement the spirit of the 20th National Congress of the Communist Party of China, and the Opinions on Promoting the Inheritance, Innovation and Development of Traditional Chinese Medicine(TCM), to regularly summarize the research results of TCM, to present the academic progress of TCM dynamically, and to give full play to the academic leadership of academic groups, the China Association of Chinese Medicine had organized the selection of the top 10 academic progress of TCM in 2022. The selection work adhered to the four orientations, eliminated the four only, highlighted the solution of clinical problems, answered scientific questions, led the development of the industry, reflected the exploratory and forward-looking, innovative and breakthrough, focused on new laws, new discoveries, new methods, new products, new theories in the field of basic research and applied basic research in TCM. After dynamic collection, preliminary examination, review and final judgment, the top 10 academic progress of TCM in 2022 were determined.
摘要:Pyroptosis, a new type of inflammatory programmed cell death, is different from apoptosis, necrosis, cytosis, ferroptosis, and autophagy. Pyroptosis is dependent on the activation of cysteine aspartate-specific protease (Caspase), which cleaves key mediator proteins to form pores in the cell membrane and induces the maturation and release of the proinflammatory cytokines interleukin-1β and interleukin-18 into the extracellular environment, resulting in a cascade of inflammatory reactions. Gastric cancer as a malignant tumor of the digestive tract is refractory and has poor prognosis, and the chemoradiotherapy of this disease may lead to a variety of complications. At present, the pathogenesis of gastric cancer remains unclear. Studies have proved that pyroptosis is associated with the occurrence and development of gastric cancer, which has attracted wide attention. Pyroptosis is a double-edged sword for gastric cancer. On the one hand, it can release the contents of proinflammatory cells to amplify or maintain inflammation and induce the "inflammation-cancer" transformation of cells. On the other hand, pyroptosis can enhance the sensitivity of drugs for chemotherapy to improve the therapeutic effect and survival. In recent years, the anti-tumor mechanism of traditional Chinese medicine (TCM) has become a research hotspot as TCM has demonstrated significant effects in clinical application. Therefore, the regulation of pyroptosis by TCM may be a new direction for the treatment of gastric cancer in the future. Based on the available studies, this paper introduces the roles of pyroptosis-associated key proteins in the occurrence and development of gastric cancer. Furthermore, this paper summarizes the effects of TCM prescriptions and active ingredients on alleviating gastric mucosal damage, reducing the incidence of gastric cancer, and preventing tumor metastasis and recurrence by mediating pyroptosis pathways, aiming to provide new ideas for deciphering the mechanism of pyroptosis and exploring the TCM treatment of gastric cancer in the future.
关键词:pyroptosis;gastric cancer;virulence factor;gasdermin E (GSDME);gasdermin D (GSDMD);NOD-like receptor protein 3 (NLRP3)
摘要:Diabetic kidney disease (DKD) is a common complication of diabetes and a leading cause of end-stage kidney disease. Its pathogenesis is complex, and it presents a significant challenge in treatment, gradually becoming a major global public health issue. One of the main pathological changes in DKD is tubulointerstitial fibrosis, clinically characterized by proteinuria and declining kidney function, which severely impacts the daily life of patients. Currently, western medicine commonly uses methods such as controlling blood sugar and blood pressure, and reducing proteinuria to treat DKD, but the efficacy is unsatisfactory, and there are many side effects. As reported, traditional Chinese medicine (TCM) treatment for DKD has many advantages, such as low cost, significant efficacy, and minimal adverse reactions. More researchers focusing on DKD are turning their attention to TCM, and progress has been made in related studies both in China and abroad. The Wnt/β-catenin signaling pathway is relatively evolutionarily conserved and plays a crucial role in normal biological development and the entire life process. Studies have demonstrated that abnormal activation of the Wnt/β-catenin signaling pathway is related to renal fibrosis, which coincides with TCM theory of "collateral diseases". By reviewing relevant literature, this article reviewed the Wnt/β-catenin signaling pathway and its role in DKD and summarized the research status of TCM monomers, single drug extracts, and TCM formulas in improving renal fibrosis and treating DKD through the improvement of glomerular mesangial cells, renal tubular epithelial cells, and podocyte injury, aiming to provide new ideas and directions for TCM treatment of DKD.
关键词:traditional Chinese medicine;diabetic kidney disease;Wnt/β-catenin signaling pathway;renal fibrosis
摘要:Ulcerative colitis (UC) is a common inflammatory bowel disease (IBD) in clinical practice, characterized by symptoms such as abdominal pain, diarrhea, and bloody mucus in the stool. It is difficult to cure and has a high recurrence rate. The pathogenesis of UC is related to abnormal immune response, oxidative stress in intestinal tissues, and inflammatory reactions. As reported, the abnormal activation of the NOD-like receptor pyrin domain-containing protein 3 (NLRP3) inflammasome is involved in the pathological process of UC. This activation triggers pathological mechanisms such as oxidative stress, pyroptosis, and inflammation in intestinal epithelial cells. Therefore, blocking the abnormal activation of NLRP3 is beneficial for alleviating UC. Currently, western medicine treatment for UC mainly includes salicylic acid derivatives, corticosteroids, and biologics, but the overall efficacy is unsatisfactory. Traditional Chinese medicine (TCM) treatment of this disease has the advantages of significant efficacy and low recurrence rate. In recent years, great advances have been made in the basic research of using TCM methods to treat UC. Studies have found that TCM intervention targeting the NLRP3 inflammasome can significantly promote intestinal mucosal healing and treat UC, and the mechanism of action involves multiple targets, levels, and pathways. This article summarized the experimental research on the impact of TCM targeting the NLRP3 inflammasome on UC in recent years, and found that NLRP3 interacted with factors such as Caspase-1 and nuclear factor-κB (NF-κB), thereby promoting the release of pro-inflammatory factors and cell pyroptosis in intestinal epithelial cells. This activation triggered oxidative stress, inflammatory reactions, and other pathological mechanisms. TCM acted on the NLRP3 inflammasome and its upstream and downstream factors to block the pathological process of UC, inhibit the pathological damage to the intestinal mucosa, and thereby alleviate colonic ulcers. The findings of this study provide a theoretical basis for the prevention and treatment of UC and further drug development.
关键词:traditional Chinese medicine;ulcerative colitis;NOD-like receptor pyrin domain-containing protein 3 (NLRP3) inflammasome;experimental study;pyroptosis
摘要:Diabetic nephropathy (DN) is a common clinical complication of diabetes, the main cause of end-stage renal disease (ESRD), and a key determinant of survival in diabetic patients. The pathogenesis of DN is complex, and it is currently believed to be associated with hemodynamic abnormalities, intestinal flora disturbances, glucose and lipid metabolism disorders, oxidative stress, genetic susceptibility, and protein non-enzymatic glycosylation. The local renin-angiotensin system (RAS) has always been the core of the pathogenic and progressive changes of DN. Once activated, it will induce the massive release of oxygen free radicals in the blood vessels, damage the endothelial function, and affect the microcirculation of the body. The recent studies demonstrate that intestinal flora and its metabolites may affect the occurrence and development of DN by activating or antagonizing the local RAS. Compared with western medicine treatment, traditional Chinese medicine (TCM) has the advantages of multiple targets and little toxic and side effects. Many TCM scholars have found that single herbs, their active ingredient extracts, and TCM compound prescriptions can improve kidney function by regulating the local RAS or intestinal flora. Specifically, the Chinese medicinal materials tonifying spleen (Codonopsis Radix, Dioscoreae Rhizoma, Atractylodis Macrocephalae Rhizoma, and Poria), replenishing kidney (Rehmanniae Radix Praeparata, Corni Fructus, and Pseudostellariae Radix), and activating blood, resolving stasis, and dredging collaterals (Hirudo, Salviae Miltiorrhizae Radix et Rhizoma, and Angelicae Sinensis Radix) have the regulatory effect. This article summarizes the roles of intestinal flora and local RAS in the occurrence and development of DN, and analyzes the animal experiments or clinical trials of TCM intervention in DN in recent years, aiming to provide more therapies and a theoretical basis for the treatment of DN with integrated TCM and Western medicine.
关键词:diabetic nephropathy(DN);intestinal flora;renin-angiotensin system (RAS);traditional Chinse medicine;Chinese medicinal materials
摘要:Ulcerative colitis (UC), a disease that affects the colon or rectum, is characterized by long-term recurrent inflammation and eventually leads to ulcers in the inner wall of the intestine. The disease has a high incidence and is difficult to be cured, which causes severe physical and mental discomfort and economic burden to the patients. Therefore, it is urgent to develop new therapies with high cure rate and low side effect. The pathological mechanism of UC is complex and involves multiple factors. The intestinal mucosal barrier damage is the main pathological basis of UC, which is a hot topic and a new research direction. Intestinal tight junction (TJ), as the structural basis of the intestinal mucosal mechanical barrier, can actively regulate mucosal function and play a key role in the pathogenesis of UC. Traditional Chinese medicine (TCM) can regulate TJ protein via multiple pathways and multiple targets, repair the intestinal mucosal barrier, and thus block the progression of UC. Studies have demonstrated that Chinese herbal medicines and their components, Chinese medicine compound prescriptions, and Chinese medicine preparations can treat UC by regulating TJ protein to maintain the function and reduce the permeability of intestinal epithelium, providing a new therapeutic strategy for UC. Although TCM has unique advantages that western medicine cannot replace by mediating TJ protein expression in UC, a comprehensive review of this field remains to be carried out. Focusing on the status of UC and TCM syndrome differentiation and treatment, we retrieved relevant articles with ''ulcerative colitis'', ''tight junction'', and ''Chinese medicine'' as the keywords, and summarized the relationship of TJ and its key target proteins with UC to clarify the critical role of TJ in UC pathophysiology. Furthermore, we summarized the Chinese medicines regulating TJ in the treatment of UC in recent years, aiming to provide a theoretical basis for the development of drugs for this disease.
摘要:Ischemic stroke is caused by a variety of factors caused by intracerebral artery stenosis or obstruction, can lead to cerebral ischemia, hypoxia, neuronal necrosis and neurological dysfunction and other pathological injuries, with high morbidity, high disability rate, high mortality characteristics. Cerebral ischemia-reperfusion injury is the main secondary injury, which can lead to permanent disability or even death in severe cases. With the development of traditional Chinese medicine(TCM) modernization, the extraction and application of active components of TCM have been paid more and more attention. Salidroside, as the main active component of Rhodirosea, a rare Chinese medicinal herb, has been proved to fight cerebral ischemia injury by inhibiting cell apoptosis, anti-oxidative stress, reducing inflammatory response, protecting blood-brain barrier, regulating autophagy, promoting nerve remodeling and synaptic regeneration in preclinical trials. However, due to its multi-pathway, multi-pathway and multi-target action characteristics, the specific mechanism of salidroside to improve cerebral ischemia injury has not been fully elucidated. By reviewing relevant literature in the past decade, the author reviewed the mechanism of action of salidroside in the treatment of ischemic brain injury, and summarized the recent progress of its pharmacokinetic studies and safety evaluation, in order to provide theoretical basis and new research ideas for the development and clinical application of the active ingredients of traditional Chinese medicine.
摘要:The four properties of Chinese herbal medicine have a history of several thousand years and are one of the important theoretical guides for the clinical application of Chinese herbal medicine. However, there have been few reviews of research methods and techniques for the four properties of Chinese herbal medicine in recent years. Therefore, this article summarized the advances and techniques for the four properties of Chinese herbal medicine by screening relevant literature on the four properties of Chinese herbal medicine and clarifying the characteristics, advantages, and applicable objects of each technique, in order to provide references for in-depth research on the four properties in the future. Chinese databases such as China national knowledge infrastructure (CNKI), Wanfang data, and VIP, as well as international databases including PubMed, Cochrane Library, and EMbase were searched for relevant literature on the four properties of Chinese herbal medicine. The advances, research objects, and research techniques involved in the literature were extracted, classified, and summarized. Currently, the research techniques for the four properties of Chinese herbal medicine mainly include six categories, i.e., literature data research, network pharmacology, biothermodynamics, cell biology, proteomics, and metabolomics. The research hierarchy can be divided into micro-level, small-level, medium-level, and macro-level. The research objects used in each experimental study are different, mainly single Chinese herbal medicine, Chinese herbal monomers, targets, microbial communities, cells, mice, and rats. Different research techniques explain the four properties of Chinese herbal medicine from different dimensions, which overall indicate the material basis of the four properties of Chinese herbal medicine. In future research, the interpretation of the four properties of Chinese herbal medicine can be first located at the research hierarchy, then corresponding research techniques can be selected according to the research hierarchy, and research indicators can be determined to obtain research conclusions. This can help researchers of traditional Chinese medicine effectively carry out research design and perform related experiments on the four properties of Chinese herbal medicine.
关键词:medicinal properties of Chinese herbal medicine;research progress;research methods;research technology
摘要:Chinese herbal medicines play a great role in disease prevention and treatment, while some may cause adverse effects on the human body after of long-term application. Liver injury, one of such adverse effects, is an important check item in the development of new Chinese medicines for clinical application and has become a major reason for the withdrawal of many listed drugs from the market. With the rising concern about the safety of Chinese herbal medicines, studies about liver injury caused by herbal medicines are increasing. Most of the studies focus on liver injury caused by Chinese herbal medicines or their ingredients. To improve the safety of Chinese herbal medicines, this paper summarizes the material basis and mechanisms of several Chinese herbal medicines that cause liver injury and the measures to reduce liver injury. These measures include reducing the dose and course of administration, changing the route of administration, and altering the dosage form, compatibility, and processing. In addition, this paper introduces the biological effects and mechanisms of single Chinese herbal medicines, Chinese medicine prescriptions, and active components in the prevention and treatment of liver injury. Furthermore, this paper proposes the safe dose and efficacy-toxicity boundary of Chinese herbal medicines that may cause liver injury by referring to the modern research on toxicity reduction, clarifies the mechanisms of toxicity reduction measures, and determines the material basis of liver injury induced by Chinese herbal medicines, which will ensure the safe application of herbal medicines in clinical practice. Finally, this paper suggests that efforts should be made to strengthen the clinical research on the prevention and treatment of liver injury and elucidate the scientific connotation of the prevention and treatment of liver injury by Chinese herbal medicines by using modern science and technology, aiming to provide a scientific basis for the clinical prevention and treatment of liver injury.
关键词:Chinese herbal medicine;prevention and control;liver injury;toxicity reduction measures