Areview of the prescription containingHirudo for diabeticnephropathy

Background:Based on the modern literature,this paper discusses the characteristics of the medication and the prescription rules of the prescriptions containing Shuizhi(Hirudo)for diabetic nephropathy.Methods:We searched the China National Knowledge Infrastructure Database,Wanfang Academic Journals Full-text Database,VIP Chinese Journals Database and China Biomedical Literature Database,as well as Pubmed,the Cochrane Library and EMbase.The time limit is from setup time to November 4,2020.Include literatures published in journals containing prescriptions for treating diabetic nephropathy with Hirudo.These data was established a standardized database and then mined these data using association rules,improved mutual information method,complex system entropy clustering and other mining methods with traditional Chinese medicine inheritance auxiliary system(V2.5)software to excavate the characteristics of medication and the rules of prescription.Results:The study finally included 477 literatures,involving 477 prescriptions,235 Chinese medicines,5,552 times of total medicine frequency,and unearthed 20 core formulas and 9 new formula combinations.Among them,high-frequency drugs are Hirudo,HuangQi(Astragali radix),Danshen(Salviae miltiorrhizae radix et rhizoma),Shanyao(Dioscoreae rhizoma),Dahuang(Rhei radix et rhizoma),Shanzhuyu(Corni fructus),Fuli(Poria),Danggui(Angelicae sinensis radix),Shengdihuang(Rehmanniae radix),Chuanxiong(Chuanxiong rhiazoma)et al.The core prescription is a combination of Astragali radix,Hirudo,Dioscoreae rhizoma,Poria,Corni fructus,Angelicae sinensis radix,et al.Conclusion:High-frequency drugs and core prescriptions embody the characteristics of“Replenishing Qi”,“Activating Blood”,and“Nourishing Yin”.The core prescription rules were“Replenishing Qi”and“Activating Blood”.Promoting the circulation of“Qi”,promoting“Urination and Draining”,“Downbearing”the turbid were the auxiliary functions.The unearthed new prescriptions provide new ideas for the combination of prescriptions containing Hirudo in the treatment of diabetic nephropathy.

Effects of Yishenbupi (tonifying-kidney and invigorating-spleen) prescription on the expression of renal fibrosis-associated proteins in unilateral ureteral occlusion rats

Objective:To evaluate the effects and mechanism of the Yishenbupi(tonifying-kidney and invigorating-spleen)prescription on the expression of renal fibrosis-associated vimentin,α-SMA,and fibronectin in unilateral ureteral occlusion rats.Methods:A total of 48 SD(Sprague-Dawley)rats were randomly divided into the model,sham-operated(sham),irbesartan,and Yishenbupi groups,with 12 rats in each group.After the unilateral ureteral occlusion model was established,rats in the model and sham groups were administered normal saline,whereas rats in the Yishenbupi group were administered Yishenbupi prescription(18 g/kg/d)intragastrically and those in the irbesartan group were administered irbesartan(10 mg/kg/d)intragastrically.All rats were sacrificed 21 days later.Pathological changes in rat renal tissue were evaluated by H&E staining.The expression of vimentin,α-SMA,and fibronectin in renal tissues was detected by western blotting.Results:Compared with the sham group the model group had renal tubular epithelial cell atrophy,inflammatory cell infiltration accompanied with the proliferation of interstitial collagen fibers,fewer glomeruli,or glomerulosclerosis.Compared with the model group,significantly less renal tubular and glomerular damages,inflammatory cell infiltration,and collagen fibers were observed in different intervention groups,especially in the Yishenbupi group.Compared with the sham group,significantly higher expressions of fibrosis markers,including vimentin,α-SMA,and fibronectin,were observed in the model group.Compared with the model group,the expression of anti-fibrosis markers,including vimentin,α-SMA and fibronectin,was significantly decreased in both the irbesartan and Yishenbupi groups(P<0.01);however,the Yishenbupi group showed higher efficacy than the irbesartan group(P<0.05).Conclusion:The Yishenbupi prescription may improve renal fibrosis by reducing the expression of fibrosis-associated vimentin,α-SMA,and fibronectin.

Effects of Yishenbupi (Tonifying-Kidney and Invigorating-Spleen) prescription on renal fibrosis

Background:This study aims to observe the effects of Yishenbupi(Tonifying-Kidney and Invigorating-Spleen)decoction on renal fibrosis of unilateral ureteral occlusion rats.Methods:Forty-eight sprague-dawley rats were randomly divided into the sham-operated group(sham group),model group,irbesartan group,and Yishenbupi group.Each group was intragastrically administered after the unilateral ureteral occlusion model was established.Rats in the Yishenbupi group were intragastrically administered with Yishenbupi decoction(18 g/kg/d)once every morning.Rats in the irbesartan group were intragastrically administered with 10 mg/kg/d of irbesartan tablets once every morning.Rats in the sham group and model group(unilateral ureteral occlusion group)were intragastrically administered with isovolumetric distilled water twice a day from the day the model was established.All rats were sacrificed 21 days later.Occluded kidney tissues were taken,and pathological sections were prepared.Masson,periodic acid-Schiff,Sirius Red,and immunohistochemical staining were performed to detect the expression of collagen III and fibronectin.Results:The pathological staining of rat kidneys(Masson,periodic acid-Schiff,and Sirius Red)showed that,compared to the unilateral ureteral occlusion model group,the renal interstitial injury was eased and collagen deposition was reduced in the irbesartan and Yishenbupi groups;after immunohistochemical staining,the expression of collagen III and fibronectin positively expressed cells was decreased and decreased more in the Yishenbupi group than in the irbesartan group.Conclusion:Yishenbupi decoction can alleviate the injury to kidney tissues in rats with unilateral ureteral obstruction,reduce the deposition of extracellular matrix,and act against renal fibrosis.

Mechanism of Shuizhi(Hirudo nipponica Whitman)for chronic kidney disease based on network pharmacology

Background:The network pharmacology method was adopted in this study to explore the mechanism of Shuizhi(Hirudo nipponicaWhitman)for chronic kidney disease(CKD).Method:Firstly,we obtained relative compounds of Shuizhibased on the TCMSP database,BATMAN-TCM database,and Traditional Chinese Medicine Integrated Database(TCMID)and collected potential targets of these compounds by target fishing.Then we built the pancreatic neoplasms target database by GeneCards.Based on the matching results between Shuizhipotential targets and CKD targets,we built a Protein-protein interaction(PPI)network to analyze the interactions among these targets.Then the network diagram of disease target interaction was constructed to screen the hub targets of the drug and diseaseinteraction diagram by topology.Cytoscape-ClueGene Ontology(GO)was used to carry out GO analysis of the nuclear target,and the Cluster profiler of R language to carry on the related pathway enrichment of the nuclear target.Result:In this study,22 active components and 147 predicted targets of Leech,3,587 CKD-related targets,and 100 intersection targets were screened out.A total of 172 enrichment results were obtained by GO enrichment analysis of intersection targets,including 101 biological processes,20 cell compositions,and 51 molecular structures.Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway enrichment analysis revealed 96 items related to the treatment of CKD,among which,AGE/RAGE,MAPK,HIF-1,VEGF,PI3K/Akt,AND NF-Kappa B were six hub pathways.Conclusion:Shuizhimolecular mechanisms can be predicted through the network pharmacology,including genipinic acid,genioisidic acid,gardenoside,and enoxaparin is likely to be the main material foundation for the treatment of CKD.Through the targeted effects of inflammatory and vascular growth factors,AGE/RAGE,MAPK,HIF-1,VEGF,PI3K/Akt,and other pathways,multiple targets and multiple ways to illustrate the mechanism of Shuizhi,delay the process of the development of CKD.