Integrated gut microbiota,plasma metabolomics and network pharmacology to reveal the anti-ischemic stroke effect of cooked rhubarb

Background:Cooked rhubarb(CR)is obtained by steaming raw rhubarb(Rheum palmatum L.,Rheum officinale Baill.,or Rheum tanguticum Maxim.ex Balf.)with millet wine.It is used as a traditional Chinese medicine for treating cerebral stroke,where patients often face severe constipation.This study explored the pharmacological effects and mechanisms of CR against ischemic stroke(IS)in rats.We used integrated analysis of gut microbiota,metabolomics,and network pharmacology.Methods:The compounds in CR were identified using LC-MS/MS.The impact of CR on rat middle cerebral artery occlusion/reperfusion(MCAO/R)-induced cerebral infarct size and brain tissue pathology was assessed through 2,3,5-triphenyl tetrazolium chloride and HE staining.Changes in hemorheology were measured by evaluating blood viscosity,and serum levels of pro-inflammatory cytokine were also determined.Gut microbiota composition was analyzed through 16S rRNA gene sequencing.Serum metabolites were examined using untargeted metabolomics and Spearman correlation analysis.The pseudo-germ-free test was used to determine whether tumour necrosis factor-α(TNF-α)and interleukin-1β(IL-1β)improvement in IS are dependent on gut microbiota.Results:In vivo studies showed CR enhances neurobehavioral function in MCAO/R rats and reduces cerebral infarction area.CR also ameliorates brain and intestinal barrier damage caused by stroke.It also decreased inflammation and oxidative stress in IS rats.Furthermore,CR promotes the growth of Akkermansia and Verrucomicrobia,aiding in intestinal barrier repair.Notably,CR primarily influences the primary bile acid biosynthesis pathway.The pseudo-germ-free experiment and network pharmacology confirmed TNF-αand IL-1βas potential targets.CR relies on gut microbiota for its anti-inflammatory effects to improve IS.Conclusion:Cooked rhubarb offers neuroprotective benefits by enhancing beneficial bacteria abundance and regulating bile acid metabolism.It emerges as a potential therapeutic agent for IS.

Technical Points of Green Prevention and Control Technology of Major Diseases and Pests in Lixian Rhubarb(Rheum palmatum L.)

Based on different types of diseases,pests and weeds in the whole growth period of rhubarb(sowing period-harvesting period),the corresponding green prevention and control technology is proposed,aiming to further reduce the application amount of pesticides and fertilizers in the production of medicinal sources of Lixian rhubarb during the"14 th Five-Year Plan"period.The results will provide a theoretical basis for increasing the promotion and application of agricultural prevention and control(including disease-resistant varieties,ecological regulation),physical prevention and control,biological prevention and control measures,thus ensuring effective protection of the ecological environment,green,healthy and sustainable development of traditional Chinese medicine agriculture in Longnan,and source quality of authentic medicinal materials.

Effect of Rhubarb Decoction on the Isolated Intestinal Movement of Ophicephalus argus

[Objective] The aim of this study was to investigate effects of rhubarb decoction with different concentrations on the isolated intestinal movement performance of Ophicephalus argus,and to discuss its pharmacological mechanism.[Method] With RM6240C biological signal collection and processing system,tension values of the isolated intestine before and after the treatment by rhubarb decoction with different concentrations were recorded by the isolated organ method.[Result] Rhubarb decoction with concentration of 0.062 and 0.125 g/ml showed obvious enhancement on the isolated intestinal contraction of Ophicephalus argus,while rhubarb decoction with concentration of 0.250 and 0.500 g/ml showed inhibition on the isolated intestinal contraction of Ophicephalus argus.There was an extremely significant difference in rhubarb decoction with concentration of lower than 0.500 g/ml and more than 0.500 g/ml.With the increase of rhubarb concentration,the intestinal movement of Ophicephalus argus enhanced,but the contraction frequency did not change obviously.[Conclusion] Rhubarb decoction has remarkable effects on the contraction of smooth muscle in the isolated intestines of Ophicephalus argus.

SOD-like Activities of Fifteen Constituents from Rhubarb

It is important to search for the ingredients with SOD—like activity present in Chinese traditional drugs.Four classes of constituents including fifteen compounds isolated from Chinese rhubarb were studied for their SOD-like activity by determining the percentage of scavenging effect of the superoxide radical anion (O2),(S％),The results showed that the SOD-like activities of four tanninoid compounds were stronger among which(—)-epi- catechin has the strongest SOD-like activity at lower concentrations:the activity of five stil- bene compounds is weaker:while chrysophanol-8-glucoside and desoxyrhaponticin have no SOD-like activity and,on the contrary.may promote the production of O_2^-

X-ray Comparative Analysis of Rhubarb in Different Production Areas of Qinghai

[Objective] The aim of this study was to provide a basis for distinguishing quality of rhubarb in different production areas. [Method ] X-ray diffraction patterns of rhubarbs in different production areas of Qinghai were obtained by X-ray diffraction analysis, and then its similarity analysis was also investigated. [ Result] The content of chemical components in rhubarbs from different production areas had differences, but its diffraction patterns and diffraction peaks had certain fingerprint characteristics. [ Conclusion] X-ray diffraction method is a fast and effective method for identifying rhubarb and other Chinese herbal medicines in different production areas.

Effects of rhubarb on isolated gastric muscle strips of guinea pigs

AIM:To study the effects of rhubarb (dried root of Rheum officinale Baill.) on contractile activity of isolated gastric muscle strips of guinea pigs and its possible mechanism. METHODS: A total of 48 guinea pigs were killed to remove the whole stomach. Then, the stomach was opened and the mucosal layer was removed. Parallel to the circular fibers, muscle strips were cut from the body. Each isolated gastric muscle strip was suspended in a tissue chamber containing 5 mL Krebs solution, constantly warmed by water jacket at 37℃ and bubbled continuously with a mixed gas of 950 mL/L O2 and 50 mL/L CO2. After being incubated for 1 h with 1 g tension, rhubarb of varied concentrations (1%, 2%, 7%, 20% and 70%) was added cumulatively into the tissue chamber at intervals of 2 min. Atropine (10-6 mol/L) or isoptin (5x10-8 mol/L) or hexamethonium (10-5 mol/L) was given 2 min before the administration of rhubarb. The isometrical response was measured with an ink-writing recorder. RESULTS: Rhubarb dose dependently increased the resting tension of gastric body circular muscle (CM) (r = 0.726, P<0.05). Atropine (r= 0.829, A:0.05), isoptin (r= 0.764, A;0.05) and hexamethonium (r = 0.797, P<0.05) did not affect its action in a dose-related manner. Atropine apparently reduced the increasing action of 1%, 3%, 10%, 30% and 100% rhubarb on the resting tension of gastric body CM. Isoptin inhibited the effect of 10%, 30% and 100% rhubarb on the resting tension of gastric body CM. Hexamethonium reduced the increasing action of 1%, 10%, 30% and 100% rhubarb on the resting tension of gastric body CM. Rhubarb increased the contractile frequency of CM of body. While atropine, isoptin and hexamethonium did not inhibit the contractile frequency of gastric body CM in comparison with rhubarb at the same concentration, rhubarb at the highest concentration (100%) decreased the mean contractile amplitude of gastric body CM. Atropine, isoptin and hexamethonium did not affect the mean contractile amplitude of gastric body CM compared to rhubarb at the same concentration. CONCLUSION: Rhubarb has exciting actions on isolated gastric smooth muscle strips of guinea pig. The exciting action of rhubarb is partly mediated via cholinergic M receptor, cholinergic N receptor and L-type calcium channel.

Protective effect of rhubarb on barrier of intestinal mucosa

AIM To investigate the mechanism of the rhubarb on gut barrier protection. METHODS The models of gut barrier damage caused by hemorrhagic shock and intraperitoneal endotoxin were used to study the protective effect of rhubarb on the barrier of intestinal mucosa. They were randomly divided into four groups: treatment (rhubarb) group; positive control group; negative control group; placebo treatment group. The concentration of plasma endotoxin, tissue superoxide dismutase and lipoperoxide were measured. The histological analysis was also used. The effect of rhubarb on gut protection was observed. RESULTS The rhubarb could decrease intestinal permeability, attenuate endotoxin absorption within the gut, (the content of endotoxin in serum: shock group 0 557EU/ml±0 069EU/ml vs rhubarb group 0 345EU/ml±0 055EU/ml), obviously decrease the consumption of tissue SOD and the formation of tissue LPO (the content of SOD in serum, intestine and liver: endotoxin group 122 92NU/ml±43 19NU/ml, 292 24NU/ml±88 76NU/ml, 272 70NU/ml±85 79NU/ml vs rhubarb group 312 23NU/ml±54 93NU/ml, 391 09NU/mg±98 16NU/mg, 542 86NU/mg±119 93NU/mg; The content of LPO in intestine and liver: endotoxin group 8 57μmol/L±2 58μmol/L, 86 97μmol/L±46 54μmol/L vs rhubarb group 3 05μmol/L±1 13μmol/L, 13 18μmol/L±19 64μmol/L). Gut histopathology revealed that rhubarb could promote proliferation of gut goblet cells, increase secretion of mucus and protect intestinal mucosa in hemorrhagic shock model. CONCLUSION The mechanism of the rhubarb on gut barrier protection might involve in decreasing intestinal permeability, scavenging oxygen free radicals, promoting proliferation of goblet cells within intestinal mucosa.

Effect of rhubarb on contractile response of gallbladder smooth muscle strips isolated from guinea pigs

AIM: To investigate the effect of rhubarb on contractile response of isolated gallbladder muscle strips from guinea pigs and its mechanism.METHODS: Guinea pigs were killed to remove the whole gallbladder. Two or three smooth muscle strips (8 mm×3mm) were cut along the longitudinal direction. The mucosa on each strip was carefully removed. Each longitudinal muscle strip was suspended in a tissue chamber containing 5 mL Krebs solution (37 ℃), bubbled continuously with 950 mL/L O2 and 50 mL/L CO2. The resting tension (g), mean contractile amplitude (mm),and contractile frequency (waves/min) were simultaneously recorded on recorders. After 2-h equilibration, rhubarb (10, 20, 70, 200, 700, 1 000 g/L) was added cumulatively to the tissue chamber in turns every 2 min to observe their effects on gallbladder.Antagonists were given 3 min before administration of rhubarb to investigate the possible mechanism.RESULTS: Rhubarb increased the resting tension (from 0 to 0.40±0.02, P＜0.001), and decreased the mean contractile amplitude (from 5.22±0.71 to 2.73±0.41,P＜0.001). It also increased the contractile frequency of the gallbladder muscle strips in guinea pigs (from 4.09±0.46to 6.08±0.35, P＜0.001). The stimulation of rhubarb on the resting tension decreased from 3.98±0.22 to 1.58±0.12by atropine (P＜0.001), from3.98±0.22 to 2.09±0.19 by verapamil (P＜0.001) and from 3.98±0.22 to 2.67±0.43by phentolamine (P＜0.005). But the effect was not inhibited by hexamethonium (P＞0.05). In addition, the action of mean amplitude and frequency was not inhibited by the above antagonists.CONCLUSION: Rhubarb can stimulate the motility of isolated gallbladder muscle strips from guinea pigs. The stimulation of rhubarb might be relevant with M receptor,Ca2+ channel and α receptor partly.

EXPRESSION OF INTERCELLULAR ADHESION MOLECULE IN LUNG TISSUES OF EXPERIMENTAL ACUTE LUNG INJURY AND THE AFFECT OF RHUBARB ON IT

Objective. To approach the relation and the possible mechanism between the expression of intercellular adhesion molecule (ICAM1) mRNA and acute lung injury (ALI) and the mechanisms of rhubarb in the prevention and treatment of the lung injury. Methods. Lipopolysaccharide (LPS) was injected into the sublingual vein of male Wistar rats to perform ALI animal model. The rats were divided into 4 groups: LPS group, control group, rhubarb group and dexamethasone group. Macroscopic and histopathological examinations were performed and biological markers were measured for the lung specimens. The markers included lung wet/dry weight, the rate of neutrophils and protein content in the pulmonary alveolar lavage fluid, pulmonary vascular permeability and pulmonary alveolar permeability index. Molecular hybridization method was used to determine the expression of ICAM1 mRNA. Results. In the lung tissues, the ICAM1 mRNA expression was increased in the endothelial cells of pulmonary veins and capillaries, rhubarb and dexamethasone had the action of decreasing the expression. The light reflex value in the gray scale scanning showed that in the comparison between the LPS and the control group, the gray scale value of the lung tissues in ALI was significantly increased, thus the light reflex value was markedly decreased (P<001), demonstrating the expression of ICAM1 mRNA was increased. In comparison with the LPS group, dexamethasone and rhubarb could decrease the gray scale value of the lung tissue significantly, thus the light reflex value was elevated (P<001, P<005); the corresponding pathologic changes of lung tissues and the biological markers of the lung injury were significantly decreased or ameliorated. Conclusions. The increase of the expression of ICAM1 mRNA in the lung tissues of ALI plays the roles in ALI. The application of rhubarb and dexamethasone can decrease the expression and ameliorate the lung damage; its mechanism is possibly via the inhibition of ICAM1 mRNA expression.

Effects of rhubarb extracts on hyperexcitability of hippocampal CA1 neurons after fluid percussion injury

Objective To investigate the effects of rhubarb extracts,i.e.rhein and emodin,on the neuronal hyperexcitability and synaptic transmission,and to further reveal the mechanism of the secondary brain damage.Methods The fluid percussion injury(FPI) rat model and extracellular recording method were used.The evoked field potentials by stimulating Schaffer collaterals were collected from the ipsilateral(impact side) and the contralateral hippocampal CA1 areas of rat in vitro.And the field potentials,including the field excitatory postsynaptic potential and the population spike,were analyzed.Results After the impact was performed on the rat parietal cortex,the evoked field potentials in the ipsilateral hippocampus CA1 area were enhanced obviously.Rhubarb extracts reduced the slope of the field excitatory postsynaptic potential and the number of the population spike significantly while rhein and emodin increased the latency of the population spike obviously.Conclusion Rhubarb extracts,i.e. rhein and emodin,can depress the neuronal hyperexcitability,which suggests that rhein and emodin play an important role in protecting the central nervous system from neuronal damage after traumatic brain injury.FPI produces hyperexcitability of hippocampal CA1 neurons,probably by enhancing excitatory synaptic transmission.

Organ specific differences in alteration of aquaporin expression in rats treated with sennoside A,senna anthraquinones and rhubarb anthraquinones

OBJECTIVE Senna and rhubarb are classified as stimulative laxatives,and known to have similar effective constituents,the anthraquinones.Being protected by theβ-glucoside bond,the anthraquinones can reach the intestines where they are degraded into complex metabolites by enzymes secreted from the intestinal microbiome.It is these complex metabolites that produce the laxative effects.Then the similarities and differences of action between the anthraquinones require further elucidation.METHODS Here,we studied metabolites of senna anthraquinones(SAQ),rhubarb anthraquinones(RAQ)and their chemical marker,sennoside A(SA),in a rat diarrhea model.In the in vitro biotransformation experiments,SAQ,RAQ and SA were incubated with rat fecal flora solution and the metabolites produced were analyzed using HPLC.In the in vivo studies,the same compounds were investigated for purgation induction,with measurement of histopathology and multiple aquaporins(Aqps)gene expression in six organs.RESULTS SAQ and RAQ had similar principal constituents but could be degraded into different metabolites.A similar profile of Aqps down-regulation for all compounds was seen in the colon,suggesting a similar mechanism of action for purgation.However,in the kidneys and livers of the diarrhea-rats,down-regulation of Aqps was found in the RAQ-rats whereas up-regulation of Aqps was seen in the SAQ-rats.Furthermore,the RAQ-rats showed lower aquaporin 2(Aqp2)protein expression in the kidneys,whilst the SA-rats and SAQ-rats had higher Aqp2 protein expression in the kidneys.This may have implications for side effects of SAQ or RAQ in patients with chronic kidney or liver diseases.CONCLUSION SAQ and RAQ showed similar laxative actions with a similar mechanism,they could display different actions in rat kidneys and livers.We suggest that the clinical usage of senna or rhubarb products should be clarified for patients having chronic kidney or liver diseases.

Effects of rhubarb and the active ingredients of rhubarb on the cytoplasmic free calcium in INTMNC of rabbits

INTRODUCTIONThe recent studies have shown that rhubarb has notonly the effect of removing stasis by purgation,butalso intestinal barrier effects.In order tofurther clarify the intestinal barrier mechanism ofrhubarb,we studied the effects of rhubarbdecoction and the active ingredients of rhubarb onthe cytoplasmic free calcium in isolated intestinalmononuclear ceils (INT-MNC).

Effects of Dahuang( Rhubarb) Retention Enema on Leukocyte Interleukin-6,High Sentive C Reactive Protein and Endotoxin in Patients with Acute Pancreatitis

[Objectives] To observe the clinical effect of Dahuang( Rhubarb) retention enema on patients with severe acute pancreatitis and its influences on leukocyte interleukin 6( IL-6),high sentive C reactive protein( hs-CRP) and endotoxin. [Methods]86 cases of acute pancreatitis were randomly divided into the control group( 43 cases) and the treatment group( 43 cases). The control group was given saline enema and routine treatment of western medicine,while the treatment group was treated with Dahuang( Rhubarb) decoction retention enema and routine treatment,2 times/d. After 7 days of treatment,two groups of clinical curative effects were compared. And changes of IL-6,hs-CRP,endotoxin and amylase levels before and after treatment in two groups were compared. [Results] Abdominal pain,abdominal distension,exhaust defecation,bowel sounds in treatment group patients were obviously improved. After treatment,the decline levels of serum IL-6,hsCRP,endotoxin and amylase in the treatment group were significantly better than those in the control group. [Conclusions] Dahuang( Rhubarb) retention enema can significantly improve the clinical curative effect of severe acute pancreatitis,and its mechanism may be related to the inhibition of inflammatory reaction.

Effect of Prepared Rhubarb on Insulin Resistance in Patients With Pregnancy Induced Hypertension

Objective: To investigate the effect of prepared rhubarb on insulin resistance in patients with pregnancy induced hypertension (PIH) and its mechanism. Methods: All the 92 patients accepted 75 g oral glucose tolerance test (OGTT) and insulin release test before and after treatment. These patients were divided into two groups (treated group and control group). Prepared rhubarb and nifedipine were given to the treated group, while nifedipine was given to the control group alone. Circulating endothelial cell (CEC), tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) were measured and glucose area under curve (GAUC), insulin area under curve (IAUC), insulin sensitivity index (ISI) were calculated. And 30 normal pregnant women were selected as the healthy group. Results: CEC, TNF-a, IL-6, GAUC and IAUC of PIH patients were significantly higher than those of the normal healthy group; while ISI of PIH patients was significantly lower than that of the healthy group. ISI was significantly negatively correlated to CEC, TNF-a and IL-6. After treatment, CEC, TNF-α, IL-6, GAUC decreased and ISI increased significantly in the treated group; while in the control group, all above-mentioned parameters showed no change. Conclusion: Prepared rhubarb can improve insulin resistance of PIH by reducing vascular endothelial cell's damage.

Processing of Rhubarb and Determination of Five Free Anthraquinones in Raw Rhubarb and Stewed Rhubarb

[Objectives]To determine the content of five kinds of free anthraquinones in raw rhubarb and stewed rhubarb by HPLC,and compare their content difference,so as to reveal the change rule of material basis before and after processing of traditional Chinese medicine.[Methods]The content was determined by HPLC with Thermo BDS HYPERSII C18 column(4.6 mm×250 mm,5μm)as chromatographic column and methanol-0.1%phosphoric acid(85∶15)aqueous solution as mobile phase;the detection wavelength was 256 nm,the flow rate was 1.0 mL/min,the column temperature was 30℃,and the injection volume was 10μL.[Results]Aloe-emodin,rhein,emodin,chrysophanol and emodin methyl ether showed a good linear relationship in the linear range of 0.0207-0.414(R2=0.9999),0.1721-3.442(R2=0.9996),0.0203-0.406(R2=0.9999),0.148-2.96(R2=0.9998)and 0.164-3.28(R2=0.9993),respectively;the content of aloe-emodin decreased by about 8.26%,and rhein decreased by about 9.21%;the content of emodin increased by about 16.44%,chrysophanol increased by about 16.12%,and emodin methyl ether increased by about 20.01%,indicating that the processing technology had different effects on the components of rhubarb.[Conclusions]The content of five free anthraquinones in rhubarb was affected to different degrees after processing,and this method could be used as a quality control method for rhubarb and its different processed products.

Rhubarb ameliorates cognitive dysfunction in a rat model of Alzheimer’s disease through regulation of the intestinal microbiome

Objective:To determine the mechanism whereby rhubarb(Rheum tanguticum MAXIM.Ex BALF.)may ameliorate cognitive dysfunction through regulation of the intestinal microbiome.Methods:We used a rat model of human microbiome-associated(HMA)-AD to characterize the therapeutic effect of rhubarb on cognitive dysfunction by assessing learning and spatial memory,tissue pathology,and neurotransmitter expression in brain tissue.Then,16S rRNA gene sequencing was used to analyze the intestinal microbial composition of the rats before and after rhubarb intervention,to determine whether changes in the intestinal microbiome might underpin the beneficial effect of rhubarb on cognitive dysfunction.Results:Morris water maze experiments showed that the learning and spatial memory of HMAAD rats were improved after rhubarb administration.Examination of brain sections showed that rhubarb had a protective effect on neurons in the brain tissue of HMA-AD rats.Brain tissue neurotransmitter analysis showed that rhubarb significantly reduces the 5-hydorxytryptamine concentration in the hippocampus of HMA-AD rats(P Z.0013).Furthermore,rhubarb affected the abundance of the Lachnospiraceae_NK4A136_group and Lactobacillus in the large intestine.Conclusion:This study suggests that rhubarb ameliorates cognitive dysfunction in rats with HMA-AD by regulating the abundance of beneficial bacteria,which likely affects the concentration of 5-hydorxytryptamine in the hippocampus.

Effect of rhubarb retention enema on interleukin-33 expression and uncontrolled inflammation in patients with severe acute pancreatitis complicated with ARDS

Objective:To investigate the effects of rhubarb enema on the expression of inflammatory factors and interleukin-33(IL-33)and its prognosis in patients with SAP complicated with sepsis.Methods:A total of 47 patients with SAP complicated with ARDS admitted to the Department of Critical Care Medicine,the First Affiliated Hospital of Chongqing Medical University from June 2016 to December 2018 were randomly divided into SAP with ARDS sepsis group(sepsis group)and SAP.In the ARDS non-sepsis group(non-sepsis group),20 patients were treated according to the guidelines for the diagnosis and treatment of acute pancreatitis in China in 2013.They were given regular fasting,gastrointestinal decompression,fluid resuscitation,acid suppression,and growth.On the basis of the inhibition of water,electrolytes,acid-base balance,add rhubarb 3 g/kg,water 200 mL,filter the slag juice to 37~38℃for retention enema for more than 15min,2 times a day For a total of 7 days.The inflammatory markers WBC,PCT,heart rate,respiratory rate,oxygenation index(PaO2/FiO2),pancreatic severity score(BISAP),and IL-33 and various cytokine changes were recorded in the two groups.Results:On the first day of admission,the patients in the sepsis group had more severe inflammation index(WBC:14.23±2.95,PCT:3.62±2.04,heart rate:104.02±8.89,respiration:26.81±2.44),and the oxygenation index was more.Poor(PaO2/FiO2:164.08±21.05),IL-33(46.32±7.82)and higher cytokine expression(TNF-α:266.78±72.89,IL-1:53.47±10.52,IL-6:1824.68±598.53,IL-8:160.42±50.34),the difference was statistically significant compared with the non-sepsis group,P<0.01.After the treatment of rhubarb enema,the above indicators were significantly decreased in both groups,and admission.The difference was statistically significant on the first day,P<0.01.However,on the seventh day after treatment,the sepsis patients hadΔIL-33(41.63±7.86)and cytokines(ΔTNF-α:258.90±72.18,ΔIL-1:47.87±11.85,ΔIL-6:1775.57±598.31,ΔIL-8:143.12±51.98),oxygenation index(162.01±43.23)improved better than non-sepsis group,P<0.01,and the rate of invasive ventilation was not statistically significant.P>0.05.Conclusion:SAP combined with sepsis leads to the use of rhubarb enema in patients with ARDS to significantly improve the concentration of IL-33 as a"target"factor and reduce the proinflammatory factors TNF-α,IL-1,IL-6 and IL-8.Level,improve the patient's oxygenation,has clinical application value.

A multicenter randomized, double-blind, placebo-controlled trial to evaluate the safety and efficacy of rhubarb in treating acute exacerbation of chronic obstructive pulmonary disease of the syndrome type phlegm-heat obstructing the lungs

Objective:To observe the clinical efficacy and safety of oral administration of the traditional Chinese herb rhubarb to treat acute exacerbation of chronic obstructive pulmonary disease(AECOPD).Method:This was a multicenter randomized double-blinded placebo controlled study that took place in 7 provinces of China that enrolled 244 patients(aged 18e80 years)who had acute exacerbation of COPD with the traditional Chinese syndrome pattern of phlegm-heat obstructing lung.Participants were divided into experimental and control groups.The experimental group received 4.5 g of rhubarb granules twice daily and the control group received placebo granules.Both groups also received conventional Western therapy consisting of oxygen therapy,an antibiotic,expectorant,and a bronchodilator.Treatment lasted 10 days.Symptom scores for cough,sputum volume and color,wheezing and chest tightness before treatment and on days 3,5,7,and 10 during the treatment were recorded.Lung function,arterial blood gas and levels of serum inflammatory factors,interleukin-4(IL-4),interleukin-8(IL-8),and interleukin-10(IL-10)and tumor necrosis factor-alpha(TNF-a),before and after treatment were measured.Results:The sample size of the full analysis set(FAS)was 244 participants,and the sample size of per protocol set(PPS)was 235.Following 10 days’treatment,symptom scores of the experimental group were markedly lower than those of the placebo group(FAS:mean difference
1.67,95%CI:e2.66 to
0.69,P Z 0.001;PPS:mean difference
1.55,95%CI:
2.56 to
0.54,P Z 0.003).Lung function in the experimental group was significantly higher than in the placebo group(FEV1,FAS:mean difference 0.12,95%CI:0.06 to 0.18;P<0.001;PPS:mean difference 0.12,95%CI 0.05 to 0.18;P<0.001.FVC:FAS:mean difference 0.16,95%CI:0.06 to 0.26;P Z 0.002;PPS:mean difference 0.16,95%CI 0.05 to 0.26;P Z 0.003.FEV1%,FAS:mean difference 5.95,95%CI:3.36 to 8.53;P<0.001;PPS:mean difference 5.92,95%CI 3.28 to 8.56;P<0.001.).PaO2,PaCO2,as well as serum inflammatory factors were also improved when compared to the placebo group.There were no significant differences in the incidence rate of adverse reaction between the two groups.Conclusions:Compared with placebo,rhubarb granules significantly reduced symptom scores,improved blood oxygen level,controlled systemic inflammatory response,without significant adverse effects.Thus,rhubarb may be a beneficial adjuvant method for treating the phlegm-heat obstructing the lung syndrome pattern of AECOPD.

Bidirectional solid fermentation using Trametes robiniophila Murr. For enhancing efficacy and reducing toxicity of rhubarb (Rheum palmatum L.)

Objective:To investigate the potential of bidirectional solid fermentation of rhubarb (Rheum palmatum L.) for reducing its toxicity and enhancing its medicinal efficacy.Methods:The fungus Trametes robiniophila Murr.was inoculated into rhubarb.The chemical ingredients as well as antioxidant,antibacterial,and anticancer activities of fermented and unfermented rhubarb extracts were then determined.Results:After fermentation,levels of anthraquinone glycosides (purgative ingredients) decreased significantly,while the level of anthraquinone aglycone increased.The level of gallic acid was also reduced after fermentation.Ethanol extract of rhubarb (0.8 mg/mL) exhibited DPPH-scavenging activity of 7.6% ± 0.8% while the blank control (0.8 mg/mL rhubarb)showed 31.3% ± 2.0% activity.Antibacterial activities in fermented samples were found to be enhanced compared with unfermented samples and anticancer activity was evident at concentrations of 2000 and 5000 μg/mL.Conclusion:Bidirectional solid fermentation appears to be an effective processing method that can be used to improve the efficacy and reduce the toxicity of rhubarb.

Studies on the Anti-atherosclerosis Effects of Rhubarb and Salvia Miltiorrhiza

The effects of Rhubarb and Salvia Miltiorrhiza on serum lipids, aortic cholestercl contentand liver LDL receptor mRNA level in experimental rats were observed. The result showed that:(1)Rhuberb significantly decreased serum TC, LDL-C and aortic cholesterol content,which might be partlyattributed to its effect on LDL clearance by LDL receptor pathway.(2) Salvia Miltiorrhiza reduced moreeffectively the cholesterol accumulation in aorta,which might be due to its inhibition of endogenouscholesterol synthesis and anti-oxidative action.