Network pharmacology-based exploration of molecular mechanisms underlying therapeutic effects of Jianpi Huatan Quyu recipe on chronic heart failure with spleen Qi deficiency syndrome

BACKGROUND Chronic heart failure is a complex clinical syndrome.The Chinese herbal compound preparation Jianpi Huatan Quyu recipe has been used to treat chronic heart failure;however,the underlying molecular mechanism is still not clear.AIM To identify the effective active ingredients of Jianpi Huatan Quyu recipe and explore its molecular mechanism in the treatment of chronic heart failure.METHODS The effective active ingredients of eight herbs composing Jianpi Huatan Quyu recipe were identified using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform.The target genes of chronic heart failure were searched in the Genecards database.The target proteins of active ingredients were mapped to chronic heart failure target genes to obtain the common drugdisease targets,which were then used to construct a key chemical componenttarget network using Cytoscape 3.7.2 software.The protein-protein interaction network was constructed using the String database.Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed through the Metascape database.Finally,our previously published relevant articles were searched to verify the results obtained via network pharmacology.RESULTS A total of 227 effective active ingredients for Jianpi Huatan Quyu recipe were identified,of which quercetin,kaempferol,7-methoxy-2-methyl isoflavone,formononetin,and isorhamnetin may be key active ingredients and involved in the therapeutic effects of TCM by acting on STAT3,MAPK3,AKT1,JUN,MAPK1,TP53,TNF,HSP90AA1,p65,MAPK8,MAPK14,IL6,EGFR,EDN1,FOS,and other proteins.The pathways identified by KEGG enrichment analysis include pathways in cancer,IL-17 signaling pathway,PI3K-Akt signaling pathway,HIF-1 signaling pathway,calcium signaling pathway,cAMP signaling pathway,NF-kappaB signaling pathway,AMPK signaling pathway,etc.Previous studies on Jianpi Huatan Quyu recipe suggested that this Chinese compound preparation can regulate the TNF-α,IL-6,MAPK,cAMP,and AMPK pathways to affect the mitochondrial structure of myocardial cells,oxidative stress,and energy metabolism,thus achieving the therapeutic effects on chronic heart failure.CONCLUSION The Chinese medicine compound preparation Jianpi Huatan Quyu recipe exerts therapeutic effects on chronic heart failure possibly by influencing the mitochondrial structure of cardiomyocytes,oxidative stress,energy metabolism,and other processes.Future studies are warranted to investigate the role of the IL-17 signaling pathway,PI3K-Akt signaling pathway,HIF-1 signaling pathway,and other pathways in mediating the therapeutic effects of Jianpi Huatan Quyu recipe on chronic heart failure.

Effect of Sijunzi Decoction on the Myonuclear Domain of Rat Soleus in Spleen Qi Deficiency

Objective: To study the mechanism of Sijunzi decoction treating limb weakness in spleen Qi deficiency (SQD) based on the myonuclear domain (MND) theory. Methods: 40 male Sprague-Dawley rats were randomly divided into the normal group, SQD model group (model group), SQD+ still water group (SW group) and SQD+ Sijunzi decoction group (CM group), 10 rats each group;Grip-Strength Meter was used to measure limb grip strength;transmission electron microscope was employed to observe the ultrastructural changes of the myofibers, Image Pro 6.0 was used to measure the myonuclear numbers, cross-section area (CSA) and then their ratios (the MND sizes) were calculated, immunofluorescence assay was chosen to test the expressions of paired box gene 7 (Pax7) and myogenic differentiation antigen (MyoD). Results: Compared with those in the normal group, limb grip strength was decreased, sarcomeres were abnormal, and all the myonuclear numbers, CSA and MND sizes were reduced, but the Pax7+ cell numbers were increased, significantly, in the model and SW groups;Compared with those in the model and SW groups, limb grip strength was increased, sarcomeres were basically normal, the myonuclear number and CSA were both greater, and the Pax7+ and MyoD+ cell numbers were both increased, significantly, in the CM group. Conclusion: Sijunzi decoction might increase the myonuclear number by activating the MSCs to treat limb weakness in SQD.

Clinical Observation of the Therapeutic Effects of Wenzhong Hewei Formula in Treating Spleen and Stomach Qi Deficiency Syndrome in Internal Medicine Diseases

Objective:To observe the clinical efficacy and safety of Wenzhong Hewei Formula in treating spleen and stomach qi deficiency syndrome in internal medicine diseases.Methods:Sixty patients with spleen and stomach qi deficiency syndrome admitted to the hospital from April 2022 to June 2023 were randomly divided into observation and control groups,with 30 patients in each group.The control group received conventional internal medicine treatment,while the observation group was additionally treated with Wenzhong Hewei Formula on the basis of conventional treatment.Both groups were treated for 4 weeks.Results:The total effective rate of treatment in the observation group was higher than that of the control group(P<0.05).After treatment,the traditional Chinese medicine syndrome scores of both groups were significantly lower than before treatment,with the observation group showing a more pronounced reduction(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Wenzhong Hewei Formula can effectively improve clinical symptoms in patients with spleen and stomach qi deficiency syndrome,enhance clinical efficacy,and have a high level of safety,making it worthy of clinical promotion.

Clinical effects of a traditional Chinese medicine nursing programme to intervene in gastric pain of the spleen and stomach with Qi deficiency

BACKGROUND Gastroparesis is a common digestive disorder characterized by delayed gastric emptying,which can lead to symptoms such as nausea,vomiting,abdominal pain,and poor appetite.Traditional Chinese medicine(TCM)has been used for centuries to treat gastrointestinal disorders,including gastroparesis.TCM theory suggests that spleen and stomach qi deficiency syndrome is one of the main pathogenic factors in gastroparesis.Nursing care plays an important role in the treatment of gastroparesis,and TCM nursing interventions have shown promising results in improving patient outcomes.However,there is limited research on the clinical effectiveness of TCM nursing interventions for gastroparesis with spleen stomach deficiency syndrome.This study aimed to evaluate the clinical effect of TCM nursing intervention in the treatment of gastroparesis with spleen stomach deficiency syndrome and to compare it with routine nursing interventions.AIM To analyze the clinical effect of traditional Chinese medicine nursing intervention in the treatment of gastric paraplegia with spleen stomach deficiency syndrome.METHODS From January 2020 to July 2021,80 patients with gastroparesis of spleen stomach qi deficiency type diagnosed in our hospital were selected for the study.The 80 patients were randomly divided into a control group and an experimental group,with 40 cases in each group.During the treatment period,the control group received routine nursing interventions,while the experimental group received traditional Chinese medicine nursing procedures.Compare the nursing effects of the two groups and observe the changes in traditional Chinese medicine symptom scores,pain levels,and sleep quality before and after treatment.RESULTS After treatment,comparing the treatment effects of the two groups,the total effective rate of the experimental group was significantly higher than that of the control group,with statistical significance(P<0.05).There was no statistically significant difference in the TCM symptom score,visual analogue scale(VAS)score,and Pittsburgh sleep quality index(PSQI)score between the two groups before treatment(P>0.05).However,after treatment,the TCM syndrome scores,VAS scores,and PSQI scores of the experimental group were significantly lower than those of the control group,with a statistically significant difference(P<0.05).CONCLUSION In the clinical nursing intervention of patients with mild gastroparesis due to spleen and stomach qi deficiency,the traditional Chinese medicine nursing plan has good clinical application value and nursing effect,and has a good effect on improving patients’pain and sleep quality.

Chinmedomics facilitated quality-marker discovery of Sijunzi decoction to treat spleen qi deficiency syndrome

Sijunzi decoction (SJZD) is a Chinese classical formula to treat spleen qi deficiency syndrome (SQDS) and has been widely used for thousands of years.However,the quality control (QC) standards of SJZD are insufficient.Chinmedomics has been designed to discover and verify bioactive compounds of a variety of formularapidly.In this study,we used Chinmedomics to evaluate the SJZD's efficacy against SQDS to discover the potential quality-markers (q-markers) for QC.A total of 56 compounds in SJZD were characterized in vitro,and 23 compounds were discovered in vivo.A total of 58 biomarkers were related to SQDS,and SJZD can adjust a large proportion of marker metabolites to normal level and then regulate the metabolic profile to the health status.A total of 10 constituents were absorbed as effective ingredients that were associated with overall efficacy.We preliminarily determined malonyl-ginsenoside Rb2 and ginsenoside Ro as the q-markers of ginseng;dehydrotumulosic acid and dihydroxy lanostene-triene-21-acid as the q-markers of poria;glycyrrhizic acid,isoglabrolide,and glycyrrhetnic acid as the q-markers of licorice;and 2-atractylenolide as the q-marker of macrocephala.According to the discovery of the SJZD q-markers,we can establish the quality standard that is related to efficacy.

Correlation between slow transit constipation and spleen Qi deficiency, and gut microbiota: a pilot study

OBJECTIVE:To investigate the effect of slow transit constipation(STC)and spleen Qi deficiency on gut microbiota,and the mechanism underlying the action that the positive drug Maren Runchang(MR)alleviates STC.METHODS:STC was induced,using the cathartic method of Senna and the hunger-fullness disorder method,in ICR mice;one group of model mice was treated with MR(6.24 g/kg).The changes in the general condition,fecal parameters,D-xylose content in the serum,intestinal propulsion rate,and histopathology of the colon were assessed after STC induction in the control,model,and MR groups.Fecal microbiota transplantation(FMT)was performed from STC mice into pseudo germ-free mice.Changes in the contents of substance P(SP),vasoactive intestinal peptide(VIP),and gut microbiota in STC mice and pseudo germ-free mice were assessed after FMT.RESULTS:Compared with the control group,the model mice showed the following results:the time of the first black stool was significantly longer(P<0.01),the number and weight of black stools were significantly reduced within 6 h(P<0.05),the D-xylose content in the serum was significantly reduced(P<0.05),the intestinal propulsion rate decreased(P<0.01),the content of VIP in colon tissue significantly increased(P<0.05),and SP content in the colon tissue significantly decreased(P<0.01);moreover,the colon showed significant inflamemation and injury.Furthermore,the abundance of Firmicutes was increased,the abundance of Bacteroides decreased,and the abundance of Alistipes,unclassified_o_Bacteroidales,Alloprevotella,Bilophila,and Anaerotruncus decreased,while the abundance of the conditional pathogenic bacteria Escherichia and Klebsiella increased.However,after treatment with MR,the time of the first black stool decreased(P<0.01),the number of black stools within 6 h increased,and the intestinal propulsion rate increased(P<0.05).Moreover,the content of D-xylose in the serum and the content of VIP in colon tissue significantly decreased(P<0.05),the content of SP in colon tissue significantly increased(P<0.01),and colon inflammation significantly improved.Additionally,the abundance of Firmicutes decreased,and the abundance of Bacteroides increased.The abundance of unclassified_o_Bacteroidales and Bilophila increased,and the abundance of Klebsiella decreased.In the model+FMT group,compared with control+FMT group,the content of VIP in colon tissue decreased(P<0.05),the content of SP in colon tissue significantly increased(P<0.01),and the abundance of probiotics,such as Lactobacillus and Akkermansia,decreased.In the MR+FMT group,compared with the model+FMT group,the content of VIP in colon tissue increased,the content of SP in colon tissue significantly decreased(P<0.01),and the abundance of probiotics increased.CONCLUSIONS:STC mice with spleen Qi deficiency show a decreased abundance of beneficial bacteria,such as Alistipes,unclassified_o_Bacteroidales,Alloprevotella,Bilophila,and Anaerotruncus,and an increased abundance of the conditional pathogenic bacteria Escherichia coli and Klebsiella.Furthermore,the mechanism of action of MR in treating STC may involve the regulation of intestinal movement,reduction of intestinal inflammation,elevation of intestinal absorption,and regulation of gut microbiota.

Rules of Ren Shunping's prescription for trearing Spleen Deficiency and Qi Stagnation Syndrome of Functional Dyspepsia Based on Data Mining

Objective:To explore the medication rules of Professor Ren Shunping treating spleen deficiency and qi stagnation syndrome of functional dyspepsia,so as to provide reference for clinical prevention and development of new drugs.Methods:The 144 Chinese herbal formulas considered as active prescribed by professor Ren Shunping for the first time treating the patients with spleen deficiency and qi stagnation syndrome of functional dyspepsia were collected,entered into TCM inheritance auxiliary platform(V2.5),and then mined by some data mining methods of the software,such as the association rules and unsupervised entropy hierarchical clustering.Results:This study involved 144 Chinese herbal formulas,including a total of 56 Chinese herbal medicines.Of these Chinese herbal medicines,the herbs of cold and warm nature,and pungent,bitter and sweet in flavors were used in a quite high frequency,all of which act on spleen,stomach,lungs,large intestine,liver and gallbladder meridians.One core Chinese herbal formula was excavated,composed of patchouli,perilla stem,radix bupleuri,scutellaria,ginger pinellia,codonopsispilosula,magnolia bark,tangerine peel,large-headed atractylodes,immature bitter orange,wood incense,fructus amomi,inula britannica chinensis,ginger,medicated leaven,fried rice and fried malt based on the association rules.And a total of 17 groups of core used drugs and 2 groups of new Chinese herbal formulas undiscovered were mined based on unsupervised entropy hierarchical clustering.Conclusion:In treating spleen deficiency and qi stagnation syndrome of functional dyspepsia,professor Ren is good at treating spleen deficiency and qi stagnation syndrome of functional dyspepsia from the perspective of"tong jiang",using the"five-in-one"strategy of strengthening the spleen,evacuating the liver,coming down qi from the stomach,dispersing lung,and bowel-reflexing to treat patients as a whole.And the herbal medicines were light in dose,lovely and mild in nature for the formulars.At the same time,he paid attention to the combination of syndromes and symptoms,and flexible arbitration.

Clinical observation on spleen-invigorating and qi-benefiting pediatric massage for treating recurrent respiratory tract infection in children with cerebral palsy due to qi deficiency of spleen and lung

Objective:To observe the clinical efficacy of spleen-invigorating and qi-benefiting pediatric massage(tuina)for treating recurrent respiratory tract infection in children with cerebral palsy due to qi deficiency of spleen and lung.Methods:A total of 70 children with cerebral palsy who suffered from recurrent respiratory tract infection due to qi deficiency of spleen and lung were randomized into an observation group and a control group by the random number table method,with 35 cases in each group.Both groups were treated with conventional rehabilitation training,while the observation group was given additional spleen-invigorating and qi-benefiting pediatric massage,and the control group additionally took oral Yu Ping Feng granule.The clinical efficacy was evaluated by the total effective rate,traditional Chinese medicine(TCM)symptom score,and serum levels of immunoglobulin(Ig)A,IgM and IgG.Results:The difference in total effective rate between the two groups after treatment was statistically significant(P<0.05).After treatment,the TCM symptom scores in both groups decreased to varying degrees than those before treatment,and the intra-group differences were statistically significant(all P<0.01);the differences in the scores of various TCM symptoms between the two groups were statistically significant(all P<0.05).After treatment,the levels of IgA,IgM and IgG of the children in both groups increased to varying degrees,and the intra-group differences were statistically significant(all P<0.05).The between-group differences in the IgA,IgM and IgG levels after treatment were statistically significant(all P<0.05).Conclusion:Spleen-invigorating and qi-benefiting pediatric massage can effectively treat recurrent respiratory tract infection due to qi deficiency of spleen and lung in children with cerebral palsy,relieve the clinical symptoms and improve immune function,and thus is worthy of clinical promotion and application.

Clinical observation on moxibustion therapy plus tuina in treating children with recurrent respiratory tract infections due to qi deficiency of spleen and lung

Objective:To observe the clinical efficacy of moxibustion therapy plus Liu's pediatric massage(tuina)for children with recurrent respiratory tract infections due to qi deficiency of spleen and lung.Methods:A total of 60 children who met the inclusion criteria were divided into an observation group and a control group according to the visiting sequence,with 30 cases in each group.Children in the observation group were treated with moxibustion therapy plus Liu's pediatric massage,and those in the control group were treated with Liu's pediatric massage alone.The incidence of respiratory tract infections and traditional Chinese medicine(TCM)symptoms score were observed and recorded in both groups before and after treatment.And the clinical efficacy was compared between the two groups・Results:The total effective rate of the observation group was 93.3%,and that of the control group was 83.3%.The differenee between the two groups was statistically significant(P<0.05).After treatment,the TCM symptoms score and total times of infections in both groups were all statistically different from those before treatment(all P<0.05).The differences in TCM symptoms score and infection frequency before and after treatment in the observation group were statistically different from those in the control group(both P<0.05).Conclusion:Moxibustion therapy plus Liu's pediatric massage has a better effect in improving the clinical symptoms and reducing the frequency of respiratory tract infections for children with recurrent respiratory tract infections due to qi deficiency of spleen and lung than the pediatric massage alone.

Study of establishing disease-syndrome combined with animal model for immune thrombocytopenic purpura without additional conditions

Objective:To explore the feasibility of establishing the disease-syndrome combined animal model for immune thrombocytopenic purpura(ITP)without additional conditions.Methods:Three batches of data related to the ITP model mice obtained by replication at different time were analyzed,and whether the APS-injected model mice replicated through the passive immune modeling method could simulate the pathogenesis and clinical characteristics of human ITP was evaluated according to the differentiation criteria for diseasesyndrome combined model.Results:The APS-injected replicated ITP model mice possessed the following traits:(1)Compared with the normal group,the platelet count was significantly decreased,and coagulation time was significantly increased in the model group(P<.01).(2)Compared with the normal group,the medullary thrombocytogenous megakaryocytes were significantly decreased(P<.05,.01,.001).(3)The APS-injected sites and other parts of the model mice had spontaneous hemorrhage.(4)Behavioral changing signs were observed 1 week after the modeling(i.e.low activity,delayed activity,poor appetite,skin petechia/hemorrhage and spontaneous hemorrhage at the injected sites or other parts),and were getting more and more severe.Conclusion:According to the syndrome differentiation criteria for disease-syndrome combined model of ITP,the APS-injected animal model of ITP replicated through the passive immune modeling method without additional conditions possesses the characteristics of disease-syndrome combined model.It provides an ideal tool for the development of traditional Chinese medicine pharmacology experiment.

Interleukin-12 and interferon-γacting on damp-heat of spleen-stomach syndrome triggered by helicobacter pylori

OBJECTIVE: To investigate the expression of and interleukin-12(IL-12) and interferon-γ(IFN-γ) in relation to the pathology of damp-heat of spleen-stomach syndrome(DHSS) induced by Helicobacter pylori(H. pylori) infection.METHODS: In total, 114 individual gastric mucosal specimens including 83 DHSS, 19 spleen-qi deficiency syndrome(SQD) and 12 from healthy volunteers(CON) were collected by gastroscopy. To explore the relationship between the two syndromes and H. pylori infection, individual samples were tested using rapid urease and methylene blue tests. Hematoxylin and eosin stained sections were examined to grade for the degree of inflammation and inflammatory activity, and expression of IL-12 and IFN-γ was investigated by immunohistochemistry.RESULTS: Statistically significant differences in the degree of inflammation and inflammatory activity were observed between the groups of specimens:DHSS, SQD and CON(P < 0.05). Additionally, greater intestinal metaplasia(IM) and dysplasia were observed in the DHSS group, especially those with H.pylori infection. Expression of both IFN-γ and IL-12 was higher in DHSS samples infected with H. pylori than in uninfected samples and in the CON(P <0.05) but not in the SQD(P > 0.05) groups. Intriguingly, in gastric specimens exhibiting IM and dysplasia, IL-12 translocated from the nucleus into the cytoplasm.CONCLUSION: Our findings suggest that IL-12 and IFN-γ are involved in DHSS pathology, but not in SQD, acting as healthy-Qi. DHSS is not just the consequence of those two cytokines but results from the cross-talk between a number of cytokines and/or other proteins, which may warrant further investigation in DHSS patients infected with H. pylori.

Clinical and pathological analysis on Traditional Chinese Medicine syndromes in children with immunoglobulin A nephropathy

OBJECTIVE:To evaluate the common Traditional Chinese Medicine(TCM) syndromes and analyze their relationship to clinical and pathological manifestations in children with IgAnephropathy.METHODS:Forty five children diagnosed as having primary IgA nephropathy by renal biopsy for the first time were enrolled in this trial,and their TCM syndromes were evaluated and the distribution of TCM syndromes was observed.All the sick children were growed? according to clinical manifestations and pathological damages,and the differences in TCM syndromes were compared between the groups.RESULTS:The first 5 TCM symptoms were common cold,hyperhidrosis,red dry throat,dark yellow urine and lassitude.In the acute nephritis group,edema and aching pain in loin and knees were significant(P=0.021 and P=0.000).In the severe pathological damage group,edema was obvious(P= 0.004),and 24 h urinary protein was positively correlated with edema(P=0.015) while negatively with common cold(P=0,007).The score of mesangial cell proliferation was correlated with edema,red dry throat and common cold(P=0.006,0.013 and 0.029 respectively).The score of segmental pathological change was positively correlated with edema(P=0.039).CONCLUSION:Common cold,hyperhidrosis,red dry throat,dark yellow urine,lassitude and other symptoms of qi deficiency of the spleen and lung mainly seen in children with IgA nephropathy may bear a close relationship to clinical manifestations and pathological damages.

Clinical study on Tuina plus umbilical therapy for senile functional constipation

Objective To observe the clinical efficacy of Tuina(Chinese therapeutic massage)plus umbilical therapy for senile functional constipation due to Qi deficiency of lung and spleen.Methods A total of 60 patients who met the inclusion criteria were randomly divided into a control group and an observation group by the random number table method,with 30 cases in each group.The patients in the control group were given lactulose oral solution,while the patients in the observation group were treated with Tuina and umbilical therapy.After two weeks of treatment,the scores of the Wexner continence grading scale(WCGS)and patient assessment of constipation-quality of life questionnaire(PAC-QOL)were observed.The effective rates in the two groups were compared.Results After two weeks of treatment,the total effective rate in the observation group was 90.0%,while that in the control group was 76.7%,presenting a significant difference between the two groups(P<0.05).There were no significant differences in the WCGS and PAC-QOL scores between the two groups before treatment(P>0.05).After two weeks of treatment,the WCGS and PAC-QOL scores of both groups decreased significantly compared with those before treatment(P<0.05),and the two scores in the observation group were lower than those in the control group(P<0.05).Conclusion The efficacy of Tuina plus umbilical therapy for senile functional constipation is confirmed.This method can improve patients’quality of life.Its efficacy is better than that of taking lactulose oral solution.