BanXiaXieXin decoction treating gastritis mice with drug-resistant Helicobacter pylori and its mechanism

BACKGROUND Helicobacter pylori(H.pylori)is the main pathogen that causes a variety of upper digestive diseases.The drug resistance rate of H.pylori is increasingly higher,and the eradication rate is increasingly lower.The antimicrobial resistance of H.pylori is an urgent global problem.It has been confirmed that Banxia Xiexin decoction(BXXXT)demonstrates the effects of treating gastrointestinal diseases,inhibiting H.pylori and protecting gastric mucosa.The purpose of the present study is to further explore the therapeutic effects of BXXXT on drug-resistant H.pylori.AIM To confirm that BXXXT demonstrates therapeutical effects in vivo and in vitro on gastritis mice with drug-resistant H.pylori and explain its mechanism to provide an experimental basis for promoting the application of BXXXT.METHODS The aqueous extract of BXXXT was gained by water decocting method.The inhibitory effect of the aqueous extract on H.pylori was detected by dilution in vitro;drug-resistant H.pylori cells were used to build an acute gastritis model in vivo.Thereafter,the model mice were treated with the aqueous extract of BXXXT.The amount of H.pylori colonization,the repair of gastric mucosal damage,changes of inflammatory factors,apoptosis,etc.,were assessed.In terms of mechanism exploration,the main medicinal compositions of BXXXT aqueous extract and the synergistic bacteriostatic effects they had demonstrated were analyzed using mass spectrometry;the immune function of peripheral blood cells such as CD3+T and CD4+T of mice with gastritis before and after treatment with BXXXT aqueous extract was detected using a flow cytometry;the H.pylori transcriptome and proteome after treatment with BXXXT aqueous extract were detected.Differently expressed genes were screened and verification was performed thereon with knockout expression.RESULTS The minimum inhibitory concentration of BXXXT aqueous extract against H.pylori was 256-512μg/mL.A dose of 28 mg/kg BXXXT aqueous extract treatment produced better therapeutical effects than the standard triple therapy did;the BXXXT aqueous extract have at least 11 ingredients inhibiting H.pylori,including berberine,quercetin,baicalin,luteolin,gallic acid,rosmarinic acid,aloe emodin,etc.,of which berberine,aloe emodin,luteolin and gallic acid have a synergistic effect;BXXXT aqueous extract was found to stimulate the expressions of CD3+T and CD4+T and increase the number of CD4+T/CD8+T in gastritis mice;the detection of transcriptome and proteome,quantitative polymerase chain reaction,Western blotting and knockout verification revealed that the main targets of BXXXT aqueous extract are CFAs related to urea enzymes,and CagA,VacA,etc.CONCLUSION BXXXT aqueous extract could demonstrate good therapeutic effects on drug-resistance H.pylori in vitro and in vivo and its mechanism comes down to the synergistic or additional antibacterial effects of berberine,emodin and luteolin,the main components of the extract;the extract could activate the immune function and enhance bactericidal effects;BXXXT aqueous extract,with main targets of BXXXT aqueous extract related to urease,virulence factors,etc.,could reduce the urease and virulence of H.pylori,weaken its colonization,and reduce its inflammatory damage to the gastric mucosa.

Efficacy and safety of Banxia Xiexin Decoction in the treatment of gastric ulcer:a systematic review and meta-analysis of twenty-seven randomized controlled trials

Background:Banxia XieXin Decoction(BXD)is a traditional Chinese medicine decoction commonly used in the Chinese clinical treatment of gastric ulcer(GU).Although some people believe that it may have some advantages in this regard,There is no reliable evidence-based study demonstrating its effectiveness.This study aims to systematically evaluate the healing effect and security of BXD in the treatment of GU.Methods:PubMed,Cochrane Library,EMBASE,ScienceNet,China National Knowledge Infrastructure(CNKI),Wanfang database,Weipu database,and China biomedical literature service(CBM)database were systematically searched to obtain all randomized controlled trials(RCTs)evaluating the treatment GU of BXD published as of April 2022.Two researchers independently screened and extracted all research data,finally evaluated the bias risk of inclusion in the study using revman 5.4.Results:This meta-analysis included 27 randomized controlled trials and 1411 patients.The clinical effective rate,recurrence rate,HP eradication rate,adverse reaction rate,and visual analog score(VAS)of BXD combined treatment and standard treatment alone were compared.The results of the meta-analysis showed that BXD combined treatment improve the symptoms related to the gastric ulcers and reduce drug-related adverse reactions.Due to the low quality of the research included in this analysis,in-depth high-quality research is crucial for verifying these results.

Therapeutic targets and signal transduction mechanisms of medicinal plant formula Gancao Xiexin decoction against ulcerative colitis:A network pharmacological study

Background:Ulcerative colitis(UC)is a chronic disease that often presents with abdominal pain,diarrhea,hematochezia,and significant morbidity.Gancao Xiexin decoction(GXD),a traditional Chinese medicine,has been applied for the clinical treatment of UC,while its action mechanisms are unclear.Methods:The active ingredients and their targets of GXD,and UC-related targets,were derived from public databases.Protein-protein interaction,Gene Ontology(GO),and the Kyoto Encyclopedia of Genes and Genomes(KEGG)were used to analyze the important active compounds,key targets,and signaling pathways.Then,molecular docking and animal experiments were performed to verify the findings.A total of 213 active compounds and 89 common targets of GXD for UC were obtained.Results:The hub gene network showed ALB,AKT1,IL6,TNF,VEGFA,TP53,CXCL8,MAPK1,PTGS2,and IL1βmay be potential targets of GXD against UC.GO and KEGG pathway enrichment analyses suggested that the action of GXD against UC was mainly related to response to oxygen levels,lipopolysaccharide,and molecule of bacterial origin,etc.,and achieved by advanced glycation endproducts/receptors for advanced glycation endproducts signaling pathway in diabetic complications,hypoxia-inducible factor(HIF)-1 signaling pathway,interleukin-17/HIF-1 signaling pathway,TNF signaling pathway,etc.Molecular docking results showed that the GXD had good potency of action with the hub target.In vivo experiments showed that GXD significantly alleviated the symptoms of UC and down-regulated the expression of inflammatory factors,nuclear factor-κB and signal transducer and activator of transcription 3.Conclusions:The anti-UC action of GXD is mainly attributed to its anti-oxidative stress,antiinflammatory,and immunomodulatory functions.

Investigating the effect of Banxia Houpu decoction for the treatment of gastrointestinal dysfunction after multiple fractures: involvement of interstitial cells of Cajal

Background:Fracture is a common large-organ traumatic injury and usually leads to complications in other systems.Multiple fractures are often associated with gastrointestinal(GI)dysfunction.However,no study has evaluated the treatment of GI dysfunction.The purpose of the study is to explore the efficacy and mechanism based on ICC pathway of Banxia-Houpu decoction on GI.Methods:Male Sprague-Dawley mice were randomly divided according to the fracture modeling method and intervention.We detected the“GI residual rate”and motility.Gastric antrum and jejunum tissues were dissected for hematoxylin and eosin staining to observe the structural integrity of the GI tract,and immunohistochemistry was used to detect the expression of c-kit protein.Results:Compared with the fracture group the GI residual rates in the Banxia Houpu decoction and mosapride groups were significantly low,while GI motility was significantly high.HE staining revealed significant GI tissue necrosis and inflammatory cell infiltrations in the fracture groups.The Banxia Houpu decoction and mosapride groups,exhibited less pathology.Immunohistochemical staining showed upregulated c-kit protein expression in the fracture groups.The c-kit protein level was decreased in the mosapride group.Additionally,c-kit protein expression in the Banxia Houpu decoction groups was significantly decreased in a concentration-dependent manner.Conclusion:Banxia Houpu decoction improves GI dysfunction after multiple fractures,reduces inflammation and necrosis of gastric epithelial cells,and inhibits c-kit protein expression in GI tissues of mice.Results showed revealed one of the mechanisms underlying the effects of this decoction on the GI dysfunction in mice after multiple fractures.

Systematic Review and Meta-analysis of Efficacy of Banxia Xiexin Decoction for Treatment of Bile Reflux Gastritis

[Objectives]The purpose was to study the clinical efficacy and safety of Banxia Xiexin decoction in treating bile reflux gastritis(BRG).[Methods]Randomized controlled trial was adopted to conduct scientific and standardized assessment on the risk of bias in the included articles.With overall effect and epigastric pain relief as indices,meta-analysis was performed,and sensitivity and safety analysis was conducted on the included literature.[Results]A total of 13 articles were included,involving a total of 1478 patients.The results of meta-analysis show that the efficacy of Banxia Xiexin decoction alone and Banxia Xiexin decoction-Western medicine combination is better than that of Western medicine alone.[Conclusions]Banxia Xiexin decoction is safe and effective in treating bile reflux gastritis.However,as the 13 articles included are all low in quality and there is a certain degree of publication bias,the objectivity of the results is affected to some extent.

Banxia Xiexin Decoction for patients with peptic ulcer or chronic gastritis infected with Helicobacter pylori

Objective:To compare the effectiveness and safety of Banxia Xiexin Decoction (BXD) as alternative therapy versus standard triple therapy or quadruple therapy for patients with peptic ulcer or chronic gastritis infected with Helicobacter pylori (H.pylori).Methods:Databases including China National Knowledge Infrastructure,Chongqing VIP,Wanfang Database,PubMed,the Cochrane Library and clinicaltrials.gov were searched in December 2018 for relevant randomized controlled trials (RCTs).Two authors independently screened and selected studies,extracted data and checked data extraction.Methodological quality was evaluated using the Cochrane Risk of Bias tool.Meta-analysis was performed by using RevMan 5.3.5 software.Results:Fourteen RCTs were included in our analysis involving 1300 patients.Thirteen RCTs compared the effects of BXD alone versus standard therapy,11 involving triple therapy and 2 in quadruple therapy.The cure rate for both diseases were higher in the BXD alone group than in the standard therapy group (RR and 95% Cl:1.85 [1.07,3.17] and 1.48 [1.24,1.75],respectively).And also,the same result with effectiveness rate (RR and 95% CI:1.18 [1.08,1.29] and 1.14 [1.08,1.20],respectively).However,there was no significant difference in the clearance of H.pylori one month after treatment,neither compared with quadruple therapy nor triple therapy (RR and 95% CI:1.10 [1.00,1.22] and 1.04 [0.97,1.12],respectively).Adverse events appeared in 3 participants in the BXD group and 26 participants in the conventional therapy group.The quality of the trials included in this review was not very good.Conclusion:BXD has a superior effect to standard conventional therapy in improving clinical symptoms and repair of the mucosal lesion,and a similar effect to standard conventional therapy in clearing H.pylori.We still need good quality trials,especially placebo-controlled trials,in the future to confirm this result.

Research progress and clinical experience of Banxia Xiexin Decoction in the treatment of insomnia

Insomnia is a common clinical disease.At present,with the increase of work and life pressure,the incidence of insomnia is increasing year by year,which seriously affects people's physical and mental health and quality of life.Although stable drugs are effective in the treatment of insomnia,they have long-term side effects.Traditional Chinese medicine has unique advantages in the treatment of insomnia.Among them,Banxia Xiexin Decoction is based on the theory of"stomach disorder,sleep restlessness".Curative effect.By searching relevant literature,this article discusses the research progress of Banxia Xiexin Decoction in the treatment of insomnia from the theory,prescription and clinical research of Banxia Xiexin Decoction,and describes the clinical experience of using Banxia Xiexin Decoction.In order to provide some reference for the clinic.

Network pharmacology analysis of the mechanisms of Banxia Xiexin Decoction against Ulcerative Colitis

Banxia Xiexin Decoction(BXXXD),a traditional herbal formula,has been used to treat ulcerative colitis(UC)clinically.In this study,chemical compounds and putative targets of BXXXD and UC related therapeutic targets were screened from multiple databases.The protein-protein interaction(PPI)was conducted using String database,and 31 candidate targets were screened from CytoNCA database.The Database for Annotation,Visualization and Integrated Discovery(DAVID)and Metascape database were used for Kyoto Encyclopedia of Genes and Genomes(KEGG)channel and Gene Ontology(GO)enrichment analysis respectively,and the enrichment analysis results were visualized by OmicShare platform.Meanwhile,the interaction network among Chinese herbs,active compounds,candidate targets and pathways was built by Cytoscape 3.7.2 software,and the potential compounds of BXXXD in the treatment of UC were screened.Finally,molecular docking technology was used to verify the putative key compounds.Combined with literature research,5 key compounds for the treatment of UC were identified,which are mainly involved in TNF signaling pathway,cancer signaling pathway,inflammatory bowel disease(IBD),Toll-like receptor signaling pathway,and NF-κB signaling pathway.This study provides a scientific basis for BXXXD as an effective alternative therapeutic agent for UC from a new perspective,and also provides a feasible method for basic chemical research and pharmacological research of BXXXD.

Discussion on the Theoretical Basis of Banxia Xiexin Decoction in the Treatment of Insulin Resistance Obesity

Through reading Chinese ancient book Huangdi Nejing,and summarizing and analyzing related literature,the basic pathogenesis of obesity have been found to be the stomach preponderance and spleen weakness,and the imbalance of ascending and descending.Banxia Xiexin Decoction not only has the functions of relieving heat to inhibit stomach intake,supplementing deficiency to assist spleen transport,regulate the ascending and descending,but also has the effects of improving insulin resistance and regulating glucolipid metabolism.Therefore,it is suggested that Banxia Xiexin Decoction can be used in the treatment of insulin resistant obesity,which provides ideas and methods for its treatment.

A meta-analysis of Banxia Xiexin decoction versus omeprazole in the treatment of gastroesophageal reflux disease

Objective:To investigate the clinical efficacy and safety of Banxia Xiexin decoction and omeprazole in the treatment of gastroesophageal reflux disease(GERD).Methods:EMbase,Cochrane,PubMed,CNKI,Wan Fang and VIP database were searched from inception to November 2018 according to the search strategy.Eligible randomized controlled clinical trials related to the efficacy of omeprazole compared with Banxia Xiexin decoction in the treatment of GERD were included according to the inclusion and exclusion criteria.Total effective rate,pathological improvement rate,total symptom score,acid reflux symptoms,heartburn symptoms,improvement of post-sternal pain symptoms,and incidence of adverse reactions were evaluated.Data analysis was performed with RevMan5.3 software provided by Cochrane Collaboration.Results:A total of 15 studies were enrolled,including 1,532 patients.Meta-analysis results showed that the total effective rate of Banxia Xiexinfang was higher than that of omeprazole in the treatment of GERD(odds ratio(OR)=3.99,95%confidence intervals(CI)(2.58,6.15),P<0.00001).Pathological improvement under endoscopy was not obvious(OR=1.98,95%CI(0.94,4.19),P=0.07)between the two groups.The total symptom score improved significantly,indicating that Banxia Xiexin decoction has an objective advantage over omeprazole in the treatment of GERD(standardised mean difference(SMD)=?2.56,95%CI(?3.86,?1.26),P=0.0001),The incidence of adverse reactions in patients treated with Banxia Xiexin decoction is lower than omeprazole group(OR=0.09,95%CI(0.02,0.39),P=0.001].In addition,total effective rate of Banxia Xiexin decoction combined with omeprazole was higher than omeprazole alone(OR=6.31,95%CI(2.86,13.92),P<0.00001).Conclusion:Banxia Xiexin decoction is superior to omeprazole in total effective rate,total symptom score and adverse reaction rate in the treatment of GERD.The clinical efficacy of Banxia Xiexin decoction combined with omeprazole is better than that of omeprazole alone.However,due to the low quality of the included literatures,large-scale and high-quality RCTs are still needed for further confirmation.

Explanation of Banxia Xiexin decoction based on “Xinkai Kujiang”

Banxia Xiexin decoction(BXD)is a representative formula of Zhang Zhongjing(Eastern Han Dynasty)for the treatment of pi syndrome,which is a combination of cold and heat,and its application in the treatment of digestive system diseases is remarkable.In this paper,we discuss how Chinese medicine recognizes“spleen”and“Pi syndrome”to explain and explore the basis of BXD prescription and analyze both clinical examples and drug toxicity to provide more basis for the clinical application of BXD.

Effect of Gualou Xiebai Banxia decoction combined with Danshen Decoction on clinical efficacy of unstable angina with phlegm and blood stasis syndrome

Objective:To observe the clinical efficacy and safety of Gualou Xiebai Banxia decoction combined with Danshen decoction on unstable angina(UA)with phlegm and blood stasis syndrome.Method:Eighty patients with UA were randomly divided into treatment group(40 cases)and control group(40 cases)by random number table.The control group was given conventional western medicine treatment,and the experimental group was given Gualou Xiebai Banxia decoction and Danshen decoction on the basis of the control group.Both groups were treated for 4 weeks.Before and after treatment,the angina attacks,dosage of nitroglycerin,traditional Chinese medicine syndrome score,quality of life score,blood lipid,coagulation index and clinical total efficacy were observed and recorded.Results:After 4 weeks of treatment,the attack times and duration of angina in the two groups were both decreased compared with those before treatment.And the treatment group was more significantly reduced than the control group,the difference was statistically significant(p<0.05);the consumption of nitroglycerin of the treatment group was 90.0%,which was better than 67.5%of the control group,the difference was statistically significant(p<0.05);the total effective rate of the treatment group was 90%,which was better than 65%of the control group,the difference was statistically significant(p<0.05);the traditional Chinese medicine(TCM)syndrome score of the experimental group was lower than that of the control group,the differences was significant(p<0.05).The improvement of low density lipoprotein(LDL-C),total cholesterol(TC)and prothrombin time(PT)in the experimental group was better than that in the control group(p<0.05).During the study,there were no obvious adverse reactions in both groups.Conclusion:Gualou Xiebai Banxia decoction combined with Danshen decoction can effectively relieve the attack of angina and the consumption of nitroglycerin,improve clinical symptoms,regulate blood lipid and blood flow state,and improve the quality of life of patients with UA,with good clinical efficacy and safety.

UPLC-Q-TOF/MS-Based Serum Metabolomics Reveals Potential Anti-tumor Mechanism of Banxia Xiexin Decoction in Colorectal Cancer Mice

Objective To clarify the potential mechanism of Banxia Xiexin Decoction(BXD)on colorectal cancer(CRC)from the perspective of metabolomics.Methods Forty male C57BL/6 mice were randomly divided into normal control(NC),azoxymethane/dextran sulfate sodium(AOM/DSS)model,low-dose BXD(L-BXD),high-dose BXD(H-BXD)and mesalamine(MS)groups according to a random number table,8 mice in each group.Colorectal cancer model was induced by AOM/DSS.BXD was administered daily at doses of 3.915(L-BXD)and 15.66 g/kg(H-BXD)by gavage for consecutive 21 days,and 100 mg/kg MS was used as positive control.Following the entire modeling cycle,colon length of mice was measured and quantity of colorectal tumors were counted.The spleen and thymus index were determined by calculating the spleen/thymus weight to body weight.Inflammatory cytokine and changes of serum metabolites were analyzed by enzyme-linked immunosorbent assay kits and ultra performance liquid chromatography-quadrupole/time-of-flight mass spectrometry(UPLC-Q/TOF-MS),respectively.Results Notably,BXD supplementation protected against weight loss,mitigated tumor formation,and diminished histologic damage in mice treated with AOM/DSS(P<0.05 or P<0.01).Moreover,BXD suppressed expression of serum inflammatory enzymes,and improved the spleen and thymus index(P<0.05).Compared with the normal group,102 kinds of differential metabolites were screened in the AOM/DSS group,including 48 potential biomarkers,involving 18 main metabolic pathways.Totally 18 potential biomarkers related to CRC were identified,and the anti-CRC mechanism of BXD was closely related to D-glutamine and D-glutamate metabolism,phenylalanine,tyrosine and tryptophan biosynthesis,arginine biosynthesis,nitrogen metabolism and so on.Conclusion BXD exerts partial protective effects on AOM/DSS-induced CRC by reducing inflammation,protecting organism immunity ability,and regulating amino acid metabolism.

Clinical effects of Banxia Baizhu Tianma decoction in the treatment of hypertension

Objective:To observe the clinical effect of Banxia Atractylodes macrocephala Tianma decoction in the treatment of hypertension.Methods:A total of 100 patients with hypertension were selected from our hospital(April 2016 to July 2019)and divided into 2 groups by random digital method.The control group was given routine symptomatic treatment of western medicine,and the observation group was given Banxia Atractylodes Gastrodia decoction on the basis of the control group.the levels of syndrome score and adiponectin(apn),cysc(cysc),uric acid(ua),c-reactive protein(crp),superoxide dismutase(sod),malondialdehyde(mda),8-hydroxydeoxyguanylic acid(8-ohdg)were recorded before and after treatment in group 2,and the total effective rate of clinical treatment was counted in group 2.Results:After treatment,the total effective rate(92.00%)in the observation group was higher than that in the control group(74.00%),and the difference was statistically significant(P<0.05).The APN、SOD level of the observation group was higher than that of the control group after treatment,and the CysC、UA、CRP、MDA、8-OHdG level and TCM symptom score were lower than those of the control group(P<0.05).Conclusion:Rhizoma Pinelliae and Rhizoma Gastrodiae decoction for treating hypertension can relieve oxidative stress injury,adjust the expression level of APN,CysC,CRP and UA,and improve the symptoms and improve the curative effect.

Study on the mechanism of Shengjiang Xiexin Decoction in the treatment of chemotherapy-induced diarrhea based on network pharmacology and molecular docking

Objective:To explore the key targets and mechanism of Shengjiang Xiexin Decoction in the treatment of chemotherapy-induced diarrhea based on network pharmacological methods.Methods:The effective components and corresponding target proteins of Shengjiang Xiexin Decoction were screened by TCMSP,and the target of chemotherapy-induced diarrhea were screened by the GeneCards.R software was used to obtain the common targets of drugs and diseases,and the“component-target-disease”network diagram was constructed by Cytoscape3.8.0 software.The string datebase was used to draw the protein interaction(PPI)network,and the Bioconductor software was used to perform GO function and KEGG pathway enrichment analysis on effective targets.Result:The result showed that 216 components were screened and 276 effective targets were screened.There were 1764 chemotherapy-induced diarrhea targets.The 173 common targets were obtained through venn diagram.The GO function analysis found 2427 items of biological process,168 items of molecular function and 79 items of cellular component.The KEGG pathway analysis found 169 items.Conclusion:The PPI network found that STAT3、AKT1、MAPK3、JUN、MAPK1、RELA、IL6、etc.may be the key targets for Shengjiang Xiexin Decoction in treatment of chemotherapy-induced diarrhea.GO biological processes include DNA-binding transcription factor activity,cytokine receptor binding,cytokine activity,response to lipopolysaccharide,cellular response to chemical stress and so on.The KEGG pathways involved mainly include Toll-like receptor signaling pathway,TNF signaling pathway,inlfuenza A signaling pathway、hepatitise B signaling pathway and other pathways,that Play the role of anti-inflammatory and repair barrier.

Clinical effect of Yin-Yang blending acupuncture combined with Banxia Baizhu Tianma Decoction in treatment of cervical vertigo

Objective:To explore the clinical effect of Yin-yang blending acupuncture with traditional Chinese medicine combined with Banxia Baizhu Tianma Decoction in treating patients with cervical vertigo.Methods:120 patients with cervical vertigo treated in our hospital were selected,and the acupuncture group and the acupuncture group were divided into 60 cases each according to the order of the patients.The two groups of patients were given basic treatment measures.Xia Baizhu Tianma Decoction was treated,and the control group was given Yin and Yang blending acupuncture.The left and right vertebral arteries(LVA),right vertebral arteries(RVA),and basal arteries(BA)were compared before and after treatment in the two groups.,Clinical symptom score,clinical efficacy.Results:after treatment,the Vm values of LVA,RVA,and BA in the acupuncture group were lower than those in the acupuncture group(P<0.05);after treatment,acupuncture The dizziness,neck and shoulder pain,headache,daily life work,psychological and social adaptability scores of the drug group were higher than those of the acupuncture group(P<0.05);after treatment,the cure rate of the acupuncture group was 42.37%,and the effective rate was 37.29%.The efficiency was 16.95%,the inefficiency was 3.39%,the cure rate in the acupuncture group was 26.32%,the marked efficiency was 35.09%,the effective rate was 29.82%,and the ineffective rate was 8.77%.The clinical efficacy of the acupuncture group was better than that of the acupuncture group(P<0.05).Conclusion:Traditional Chinese medicine Yin-yang reconciliation acupuncture combined with Pinellia Baizhu Tianma Decoction is definitely effective in treating patients with cervical vertigo,and it can effectively improve the clinical symptoms and clinical effects of patients.

The Efficacy of Banxia Baizhu Tianma Decoction(半夏白术天麻汤)Combined with Xuefu Zhuyu Decoction(血府逐瘀汤)for Essential Hypertension and the Effects on Endothelial Function:A Systematic Review and Meta-analysis

Objective:Banxia Baizhu Tianma Decoction(半夏白术天麻汤,BBTD)combined with Xuefu Zhuyu Decoction(血府逐瘀汤,XFZYD)is widely used to treat essential hypertension in China,but its efficacy remains largely unexplored.We systemically summarized relevant evidence from randomized controlled trials(RCTs)to assess the therapeutic efficacy of BBTD+XFZYD.Methods:This review retrieved 6 databases like Pubmed,Cochrane Library,Embase,CNKI,et al.RCTs of BBTD+XFZYD plus conventional Western drugs(experimental group)and conventional Western drugs alone(control group)for hypertension was collected from the database establishment to August 5,2020.And the outcomes included clinical total effective rate,systolic blood pressure(SBP),diastolic blood pressure(DBP),nitric oxide(NO)and endothelin-1(ET-1).All studies’risk of bias were assessed by the Cochrane Collaboration tool 5.1.0.The data was statistically analyzed by RevMan5.3 Software.Results:Six studies with 608 participants were identified.About duration of treatment,4 studies were 1 month,2 studies were 2 months.The quality presented a high risk of bias.The experimental group showed that clinical total effective rate of the 1-month and 2-month was higher(P<0.00001),the systolic pressure was significantly lower(P<0.05),the NO increased(P<0.00001),and the ET-1 decreased(P<0.00001)compared with the conventional Western drugs used alone.However,DBP was significantly lower(P<0.05)at 2 months of treatment.Conclusion:BBTD+XFZYD plus conventional Western drugs might reduce blood pressure,improve clinical efficacy,repair endothelial function,but still need high-quality RCTs to better assess the outcomes.

Application of network pharmacology in uncovering the biological basis of using the Banxia Baizhu Tianma decoction for hypertension treatment

Background:The Banxia Baizhu Tianma decoction(BBTD)is widely used in the clinical treatment of hypertension and has definite curative effects.However,its active ingredients and mechanism of action in hypertension treatment are still unknown.In this study,network pharmacology was used to elucidate the potential antihypertensive mechanism of BBTD.Methods:The active ingredients and targets of BBTD were screened in the pharmacological database of the Chinese medicine system.The targets that are related to hypertension were obtained from the Online Mendelian Inheritance in Man(OMIM),Drugbank,and Genecards databases.The String database was used to analyze the prevention and treatment of hypertension by BBTD.The interaction of important targets was assessed,and the related network data was visualized using the Cytoscape software.The OmicShare platform was employed in conducting enrichment analyses of gene functions and pathways of important targets,in addition to evaluating the relationship between important targets and the phenotype of hypertension.Molecular docking of the main active ingredients with important targets was also assessed.Results:In this study,194 main active ingredients and 616 targets of BBTD were screened,and 5,819 related targets that are closely related to hypertension were unearthed.A total of 445 BBTD key targets for the treatment of hypertension were obtained,along with 73 core targets from performed network topology and module analysis on the key targets.The enrichment analyses of GO and KEGG showed that oxidative stress,HIF-1 signal,IL-17 signal,and TNF signal play a vital role in hypertension.Molecular docking studies have revealed that the main biologically active components can be combined with key targets quite well.Conclusion:The potential mechanism of BBTD in treating hypertension involves many components,targets,and pathways.Some of the potential targets for the prevention and treatment of hypertension are ESR1,MAPK,TP53,TNF,and MMP9.These findings provide a reference for further research on the potential mechanism of action for the BBTD-based treatment of hypertension.

Clinical Observation on the Treatment of Hypertension by Combination of Modified Banxia Baizhu Tianma Decoction and Auricular Acupuncture

Objective:To observe the curative effect of Jiawei Banxia Baizhu Tianma Decoction(BBTD)in combination with auricular acupuncture in the treatment of primary hypertension with phlegm-dampness syndrome.Methods:120 patients with hypertension were randomly divided into a pure Western medicine treatment control group(referred to as the control group)and an integrated traditional Chinese and Western medicine treatment group(referred to as the treatment group),with 60 cases in each group.The control group was given nifedipine sustained-release tablets orally;the treatment group:nifedipine sustained-release tablets were given on the basis of modified BBTD combined with auricular acupuncture.The treatment course duration of the two groups was 4 weeks.Before and after treatment,the two groups were evaluated for treatment efficacy and quality of life.Results:There is statistically significant difference in blood pressure lowering between the treatment group and the control group(P<0.05);the treatment group was better than the control group in symptoms improvement of the patients(P<0.05);in terms of the improvement in quality of life,the treatment group was significantly better than the control group(P<0.05,P<0.01).Conclusion:Modified BBTD combined with auricular acupuncture method can reduce blood pressure and improve clinical symptoms in patients with primary hypertension with phlegm-dampness syndrome,and significantly improve the quality of life of patients.

半夏泻心汤对功能性消化不良大鼠抑郁状态及促肾上腺皮质激素释放因子相关通路的影响

目的:观察半夏泻心汤对功能性消化不良(FD)大鼠抑郁样行为、下丘脑促肾上腺皮质激素释放因子(CRF)及其受体CRF-R1、CRF-R2的影响。方法:48只SPF级Wistar大鼠随机分为空白组、模型组、氟西汀组、半夏泻心汤低、中、高剂量组,共六组,每组各8只。空白组正常饲养,其余五组采用不规则喂养+夹尾激惹刺激法造模,造模成功后半夏泻心汤低、中、高各剂量组分别给予0.62、1.24、2.48 g/ml剂量灌胃,氟西汀组给予2 mg/kg氟西汀,空白组及模型组均给予同等容积的蒸馏水,各组连续灌胃14 d。干预结束后采用糖水偏好实验和旷场实验测试各组抑郁样行为;HE染色观察大鼠胃窦组织基本形态;RT-qPCR和Western blot检测大鼠下丘脑中CRF、CRF-R1和CRF-R2 mRNA和蛋白的表达。结果:与空白组比较,模型组大鼠体重、糖水偏好度、旷场实验移动总距离和直立次数均明显下降(P<0.05);下丘脑中CRF、CRF-R1 mRNA和蛋白表达均明显升高(P<0.01),CRF-R2 mRNA和蛋白的表达均明显降低(P<0.01)。与模型组比较,半夏泻心汤各剂量组大鼠的体重、糖水偏好度、旷场实验移动总距离和直立次数均明显增加(P<0.05);半夏泻心汤各剂量组FD大鼠下丘脑中CRF、CRF-R1 mRNA的表达量均明显降低(P<0.01),CRF-R2 mRNA的表达明显升高;半夏泻心汤高剂量组FD大鼠下丘脑中CRF蛋白表达均明显降低(P<0.01),半夏泻心汤各剂量组FD大鼠下丘脑中CRF-R1蛋白表达明显降低(P<0.01),CRF-R2蛋白表达升高(P<0.05)。结论:半夏泻心汤可通过调控CRF通路,恢复CRF-R1和CRF-R2的平衡状态,发挥抗抑郁的作用。