Mechanism of action of Wuzi Yanzong pill in the treatment of oligoasthenozoospermia in rats determined via serum metabolomics

Objective:To investigate the mechanism of action of Wuzi Yanzong pill(WYP)in rats with oligoasthenozoospermia(OAZ)via metabolomics and to provide a possible basis for improving this WYP-based treatment.Methods:A rat model of OAZ was established by treating male SpragueeDawley rats with glucosides from Tripterygium wilfordii Hook.F.Seventy-two rats were randomly divided into six groups:control,L-carnitine(positive control),model,and low-,medium-,and high-dose WYP groups.Rats in the experimental groups were treated with WYP for 4 weeks.At the end of the treatment period,sperm cell quality(density,motility,and viability)was assessed using a semen analysis system,mitochondrial membrane potential(MMP)was assessed using flow cytometry,and testicular injury was assessed using hematoxylin and eosin staining to validate the therapeutic effect of WYP in OAZ.Further,serum metabolomics-based analysis was performed using high-performance liquid chromatography-mass spectrometry to identify differential metabolic pathways and possible mechanisms of action of WYP in OAZ treatment.Results:A rat model of OAZ was considered successfully-established after comparing the quality of spermatozoa in the model group to that in the control group.WYP-M and WYP-H treatments significantly improved sperm cell density,motility,and viability compared with those in the model group(all P<.05).Compared with the model group,both WYP-M and WYP-H treatments increased MMP values(P=.006 and P=.021 respectively),while there was no significant difference in the L-carnitine group.L-carnitine and WYP administration reversed damage to the testes to varying degrees compared with that in the model group.Further,44 differential metabolites and four metabolic pathways,especially autophagy pathway,related to OAZ were identified via metabolomics.Conclusions:WYP improves sperm cell quality and MMP in OAZ primarily via autophagy regulation.These findings can be employed to improve the efficacy of WYP in humans.

Efficacy and safety of Jiawei Simiao powder combined with celecoxib for acute gouty arthritis:A meta-analysis

Objective:To evaluate the efficacy and safety of Jiawei Simiao powder(JWSMP)combined with celecoxib for the treatment of acute gouty arthritis by conducting a meta-analysis of randomized controlled trials(RCTs).Methods: The Chinese National Knowledge Infrastructure Databases,Chinese Scientific Journal Database,Wanfang,Cochrane Library,EMBASE,PubMed,and Web of Science databases were searched from inception until December 2023.Continuous variables were analyzed using the mean difference(MD)for analysis,and dichotomous variables were used as risk ratios.Data with similar characteristics were pooled for meta-analysis,and heterogeneity was assessed using I2.The Cochrane Handbook was used to assess the risk of bias and quality.RevMan 5.3 software was used to perform the meta-analysis.Results: Thirteen RCTs involving 1007 patients were included in the study.The quality of the included studies was low(unclear randomization processes and insufficient blinding reporting).The group receiving JWSMP combined with celecoxib showed significantly lower levels of serum uric acid(SUA,MD=−66.32,95%confidence interval(CI):−80.97 to−51.67,P<.001),erythrocyte sedimentation rate(ESR,MD=−6.05,95%CI:−8.29 to−3.82,P<.001),C-reactive protein(CRP,MD=−7.39,95%CI:−11.15,−3.63,P<.001),and joint pain score(VAS score,MD=−2.14,95%CI:−2.4 to−1.88,P<.001)compared to celecoxib alone.Additionally,the JWSMP combined group had a higher total effective rate(risk ratio=1.22,95%CI:1.14 to 1.29,P<.001)and fewer adverse compared to celecoxib alone.Conclusions: JWSMP combined with celecoxib is more effective than celecoxib alone in improving the total efficacy rate,alleviating joint pain,and improving SUA,ESR,and CRP levels.JWSMP also reduced the occurrence of adverse events caused by celecoxib.However,the quality of the included studies was low,highlighting the need for further high-quality research with larger sample sizes and robust methodologies,such as double-blind randomization,to confirm these findings.

Can Tibetan medicine Honghua Ruyi pills relieve endometriosisassociated dysmenorrhea?Protocol for a randomized placebocontrolled trial

Objective:To provide high-quality clinical evidence of the efficacy of Tibetan medicine Honghua Ruyi(HHRY)pills for endometriosis-associated dysmenorrhea.Methods:This study constitutes a multicenter,randomized,double-blind,placebo-controlled trial encompassing a three-menstrual cycle intervention followed by a three-menstrual cycle follow-up period.A total of 164 eligible females with endometriosis-associated dysmenorrhea were randomly divided into HHRY pills and placebo groups in a 1:1 ratio.The primary outcome included dysmenorrhea symptoms assessed using Visual Analog Scale(VAS)scores and quality of life,whereas the secondary outcome measures included the maximum VAS for non-menstrual pelvic pain,duration of pain episodes(in days),frequency and quantity of the consumption of ibuprofen sustained-release capsules(or other non-steroidal anti-inflammatory drugs),and days off work/study for staff/student due to dysmenorrhea,ovarian cyst,and/or pelvic nodule size.The safety was monitored throughout the treatment period.All the analyses were based on the intention-to-treat principle.For continuous outcomes,simple or multiple linear regressions were used to estimate the differences between the HHRY pills and placebo groups,with categorical data expressed as the number and percentage of occurrences.Differences were compared using the chi-square test or Fisher's exact test.The predefined analysis was adjusted for concomitant treatment,a variable considered to be associated with outcomes but unaffected by treatment allocation.Estimates of treatment effects were reported with 95%confidence intervals.Two-tailed P values≤.05 were considered statistically significant.Conclusion:Positive results from this trial,upon completion would provide robust evidence for the efficacy and safety of HHRY pills in treating dysmenorrhea in patients with endometriosis.

The Effect of Ginkgo Biloba Leaf Dropping Pill Combined with Butylphthalide Capsule on Cognitive Dysfunction in Patients after Acute Ischemic Stroke and Its Impact on Serum Cytokines

Objective: To investigate the therapeutic effect of Ginkgo biloba extract dropping pills combined with butylphthalide capsules on cognitive dysfunction in patients after acute ischemic stroke (AIS) and its impact on serum cytokines CRP, IL-6, and Hcy. Methods: This study selected 76 patients with cognitive dysfunction after ischemic stroke who were hospitalized at Zhuji People’s Hospital from January 2023 to January 2024. The patients were divided into two groups. The control group was treated with butylphthalide capsules, while the combination group received Ginkgo biloba extract dropping pills in addition to the treatment given to the control group. The neurological function, cognitive function, activities of daily living, and levels of serum cytokines CRP, IL-6, and Hcy were compared between the two groups after 1 month and 3 months of treatment. Results: The NIHSS scores, MMSE scores, ADL scores, and levels of CRP, IL-6, and Hcy in both groups showed statistically significant differences compared to before treatment (P Conclusion: The combination of Ginkgo biloba extract dropping pills and butylphthalide capsules has a better therapeutic effect on cognitive dysfunction in patients after ischemic stroke. It can improve the neurological function and cognitive function of patients, enhance their ability to perform daily activities, and reduce inflammatory responses.

Exploring the molecular mechanism of Suoquan pill in the treatment of diabetic kidney disease based on network pharmacology,molecular docking,in vitro experiment

Background:Diabetic kidney disease(DKD)is a microvascular complication of diabetes mellitus and is the main cause of end-stage renal failure.Suoquan pills(SQP)has a variety of pharmacological activities and multiple therapeutic effects,and it is used clinically as a basic formula for the treatment of DKD.Methods:Public databases were used to identify SQP compounds and the potential targets of SQP and DKD.A drug-component-therapeutic target network was constructed.Protein-protein interaction network analysis,Gene Ontology functional analysis,and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis were used to analyse the potential molecular mechanisms of SQP based on common targets of drugs and diseases.Molecular docking simulations were conducted to confirm the binding abity of the core compounds to key targets.The efficacy and predicted molecular mechanisms of SQP were validated using cell counting kit-8 assay,flow cytometry,and western blotting with HK-2 cells as a model.Results:Network pharmacology analysis showed that 26 compounds and 207 potential targets of SQP were involved in the treatment of DKD;boldine,denudatin B,pinocembrin,kaempferoid,and quercetin were considered core compounds,and epidermal growth factor receptor(EGFR)and proto-oncogene,non-receptor tyrosine kinase(SRC)were considered key targets.Gene Ontology enrichment analysis indicated that protein phosphorylation and negative regulation of apoptotic processes are important biological processes in the treatment of DKD by SQP.Molecular docking confirmed the excellent binding abilities of boldine,denudatin B,kaempferide,and quercetin to EGFR and SRC.The results of in vitro experiments showed that treatment with an ethanolic extract of SQP significantly protected HK-2 cells from high glucose-induced cell damage.In addition,the SQP ethanol extract inhibited the phosphorylation of EGFR and SRC,suppressed the apoptosis rate,and regulated apoptosis-related proteins in HK-2 cells under high glucose stress.Conclusion:This study systematically and intuitively illustrated the possible pharmacological mechanisms of SQP against DKD through multiple components,targets,and signalling pathways,especially the inhibition of EGFR and SRC phosphorylation and apoptosis.

Integrated network pharmacology and metabolomics to explore the mechanisms of Shenzao dripping pill against chronic myocardial ischemia

Background:Shenzao dripping pill(SZDP)is empirically prescribed for treating cardiac diseases.Nevertheless,there is a lack of comprehensive knowledge regarding the underlying mechanisms contributing to its therapeutic effects.The objective of this study is to investigate the underlying mechanism of SZDP against chronic myocardial ischemia(CMI)in a rat model.Methods:In this study,we utilized electrocardiographic and echocardiographic detection along with pathological tissue analysis to evaluate the efficacy of SZDP.The integration of network pharmacology and metabolomics was conducted to investigate the mechanisms.Molecular docking and molecular dynamics simulations were used to validate the binding energy between the compounds of SZDP and the associated targets.Results:The results showed that SZDP was able to improve T wave voltage,reverse CMI abnormalities in ejection fraction and fractional shortening,and restore histopathological heart damage.Metabolomics results indicated that disturbances of metabolic profile in CMI rats were partly corrected after SZDP administration,mainly affecting purine metabolism.13-Docosenamide may be the potential metabolic biomarker of the therapeutic application of SZDP for CMI.Integrating network pharmacology and metabolomics,thiopurine S-methyltransferase(TPMT),xanthine dehydrogenase/oxidase(XDH),bifunctional purine biosynthesis protein ATIC(ATIC),and cytochrome p4501A1(CYP1A1)were identified as possible targets of SZDP to exert therapeutic effects by enhancing the metabolic levels of L-Tryptophan,Deoxyribose 1-phosphate and Phosphoribosyl formamidocarboxamide.Conclusion:SZDP has a therapeutic effect on CMI by regulating metabolite levels,acting on the targets of TMPT,XDH,ATIC,and CYP1A1,and reducing cardiomyocyte injury and myocardial fibrosis.

Clinical efficacy of Baijin pills in the treatment of generalized tonicclonic seizure epilepsy with cognitive impairment

BACKGROUND The generalized tonic-clonic seizure(GTCS)is the most usual variety of epileptic seizure.It is mainly characterized by strong body muscle rigidity,loss of consciousness,a disorder of plant neurofunction,and significant damage to cognitive function.The effect of antiepileptic drugs on cognition should also be considered.At present,there is no effective treatment for patients with epilepsy,but traditional Chinese medicine has shown a significant effect on chronic disease with fewer harmful side effects and should,therefore,be considered for the therapy means of epilepsy with cognitive dysfunction.AIM To investigate the clinical efficacy of Baijin pills for treating GTCS patients with cognitive impairment.METHODS This prospective study enrolled patients diagnosed with GTCS between January 2020 and December 2023 and separate them into two groups(experimental and control)using random number table method.The control group was treated with sodium valproate,and the experimental group was Baijin pills and sodium valproate for three months.The frequency and duration of each seizure,the Montreal Cognitive Assessment Scale(MoCA),and the Quality of Life Rating Scale(QOLIE-31)were recorded before and after treatment.RESULTS There were 85 patients included(42 in the control group and 43 in the experimental group).After treatment,the seizure frequency in the experimental group was significantly reduced(P<0.05),and seizure duration was shortened(P<0.01).The total MoCA score in the experimental group significantly increased compared to before treatment(P<0.01),and the sub-item scores,except naming and abstract generalization ability,significantly increased(P<0.05),whereas the total MoCA score in the control group significantly decreased after treatment(P<0.05).The QOLIE-31 score of the experimental group increased significantly after treatment compared to before treatment(P<0.01).CONCLUSION Baijin pills have a good clinical effect on epilepsy with cognitive dysfunction.

Effect of dietary with Zhibai dihuang pills and gonadotropinreleasing-hormone-analogue on girls with precocious and rapidly progressive puberty

BACKGROUND At present,the clinical mechanisms underlying precocious puberty remain unclear,making effective intervention for children experiencing this condition and rapidly progressive puberty essential.AIM To explore the effects of Zhibai dihuang pills and gonadotropin-releasing hormone analogue(GnRHa)on growth and ovarian function in girls with precocious puberty.METHODS The clinical data of 84 adolescent girls with precocious puberty and rapidly progressive puberty from February 2017 to August 2023 were retrospectively analyzed.Girls were divided into a control group and an observation group,with 42 cases in each group.The control group received diet intervention combined with GnRHa treatment,while the observation group received diet intervention combined with Zhibai dihuang pills+GnRHa treatment.Outcomes such as clinical efficacy,growth indicators,ovarian function,and adverse reactions were compared between the two groups.RESULTS The observation group showed superior clinical efficacy compared to the control group(P<0.05).Prior to the intervention,no significant differences were found in growth or ovarian function between the groups(P>0.05).Post-intervention,the observation group exhibited significantly lower rates in growth,height,and bone age,along with reduced levels of progesterone,testosterone,estradiol,prolactin,luteinizing hormone,and follicle-stimulating hormone compared to the control group(P<0.05).The incidence of adverse reactions was similar across both groups(P>0.05).CONCLUSION Combining Zhibai dihuang pills with GnRHa and dietary intervention effectively improves growth,enhances ovarian function,and minimizes adverse reactions in adolescent girls with precocious and rapidly progressive puberty.

Application of Guizhi Fuling Pill in Gynecology

This paper reviews the research progress of Guizhi Fuling Pill in the clinical application of gynecology,such as the treatment of uterine leiomyoma,ovarian cyst,infertility and dysmenorrhea,in order to provide further research ideas for clinical researchers.

Assessing core body temperature in a cool marathon using two pill ingestion strategies

Objectives The purpose was to directly assess in-competition thermoregulatory responses in recreational runners during a city marathon conducted in cool,ambient conditions using a two-pill ingestion strategy.Methods Thirty-two recreational runners(age:38.7±10.2 years,mass:73.9±11.0 kg,height:177±8 cm)were invited to participate in this study.Core temperature was continuously assessed using telemetric ingestible pills.Each runner swallowed two pills:the first pill(Pill 1)11 h:47 min±1 h:01 min pre-race(before overnight sleep)and the second(Pill 2)2 h:35 min±0 h:54 min pre-race(on wakening).Results Pre-race core temperature for Pill 1 was significantly different from Pill 2,with values of 37.4±0.4℃and 37.1±0.6℃,respectively(p=0.006).The mean core temperature during the race was higher for Pill 1 compared to Pill 2(38.5±0.5℃and 37.8±1.0℃,respectively;p<0.001).Peak core temperature was higher for Pill 1 compared to Pill 2(39.1±0.5℃and 38.8±0.5℃,respectively;p=0.03).Post-race core temperature was higher for Pill 1 compared to Pill 2(38.8±0.7℃and 38.1±1.3℃,respectively;p=0.02).Conclusions The timing of pill ingestion significantly impacted core temperature and hence timing of pill ingestion should be standardised(5 h:30 min–7 h prior to measurement).Despite the relatively cool ambient conditions during the race,a significant number of runners achieved a high core body temperature(≥39℃),which was not accompanied by any signs of heat illness.

基于重症病例及现代病理生理机制的四妙勇安汤方证条文内涵解读及其治疗糖尿病足伴感染、脓毒症、动脉硬化性闭塞症等急危重症体会

四妙勇安汤出自《验方新编》,该方具有清热解毒,活血止痛功效,主治热毒炽盛之脱疽,临床表现为患肢暗红微肿,皮温灼热,溃烂腐臭,疼痛剧烈,或见发热口渴,舌质红,脉数。现今临床多将该方用于血管闭塞性脉管炎、下肢动脉硬化闭塞性溃疡、下肢血管支架成形术后支架内再狭窄、深脓疱病、深静脉血栓、糖尿病性下肢动脉硬化闭塞症、糖尿病足溃疡、急性膝关节炎、下肢静脉曲张、冠心病、经皮冠状动脉介入(PCI)术后、脓毒症、痛风、肿瘤、小儿慢性扁桃体炎等疾病的治疗。研究发现,糖尿病足伴感染、脓毒症、动脉硬化性闭塞症、血管闭塞性脉管炎等,属中医学“脱骨疽”范畴。四妙勇安汤为古代治疗“脱骨疽”的专病专方。四妙勇安汤的方证指征,(1)疾病方面,可用于动脉硬化性闭塞症、血管闭塞性脉管炎、糖尿病足、深脓疱病等。(2)症状方面,指征包括手指、足趾部位黯红,发黑,微肿,灼热,溃烂腐臭,甚则脚趾脱落,手脚腐烂坍陷,剧烈疼痛,难以忍受;皮肤溃烂蔓延,脓水淋漓,淋巴结肿大增生;伴见口干,口渴,烦躁,小便黄,大便干;舌暗红,苔薄白,脉弦数。(3)方证加减规律方面,针对合并顽固性低血压时,笔者用四妙勇安汤加大剂量黄芪以益气、扶正、托毒,常能达到升血压、抗炎作用。(4)合方规律方面,该方常与四妙丸、桂枝茯苓丸合方。大剂量用药是该方取效的关键。中西医结合疗法在糖尿病足伴感染、脓毒症、感染性休克、动脉硬化性闭塞症、血管闭塞性脉管炎的治疗中具有重要作用。

乌梅丸治疗脓毒症合并腹泻及胃肠功能障碍的临床疗效观察

目的观察乌梅丸汤剂治疗脓毒症合并腹泻及胃肠功能障碍的临床疗效。方法选取2016年4月—2022年3月就诊于首都医科大学附属北京中医医院急诊科的64例脓毒症合并腹泻及胃肠功能障碍患者为研究对象,通过随机数字表法将患者分为观察组和对照组,各32例。2组均给予常规治疗,观察组在常规治疗基础上加乌梅丸汤剂口服、鼻饲或直肠滴注。2组疗程均为7 d。观察2组病死率、腹泻疗效、安全性,及治疗前后胃肠功能障碍评分、序贯器官衰竭(SOFA)、急性生理与慢性健康评分系统Ⅱ(APACHEⅡ)评分。结果观察组死亡5例(16.13%),对照组死亡9例(29.03%),2组病死率差异无统计学意义(P>0.05)。死亡RR为0.85(95%CI 0.644~1.112)。观察组总有效率高于对照组(P<0.05)。与治疗前比较,2组治疗后胃肠功能障碍评分、SOFA评分、APACHEⅡ评分均降低(P<0.05),且观察组治疗后胃肠功能障碍评分、SOFA评分、APACHEⅡ评分均低于对照组(P<0.05)。2组患者均未出现药物相关的不良反应,2组血常规及肝、肾功能均无异常改变。结论乌梅丸汤剂对脓毒症合并腹泻及胃肠功能障碍,有明显的胃肠保护作用,同时也能减轻患者整体病情严重程度。

麒麟丸联合手术治疗精索静脉曲张不育临床疗效的Meta分析

目的系统评价麒麟丸联合手术治疗精索静脉曲张不育的临床疗效。方法检索中英文数据库建库至2024年3月收录的关于麒麟丸联合手术治疗精索静脉曲张不育的文献,采用RevMan 5.3软件进行Meta分析。结果共纳入8项研究,均为随机对照试验,试验组为麒麟丸联合手术治疗(n=383),对照组为单纯手术治疗(n=334)。Meta分析结果显示,麒麟丸联合手术治疗对精索静脉曲张不育总有效率、精液量、精子密度、a+b精子活力及妊娠率改善程度高于单纯手术治疗(P<0.05)。结论麒麟丸联合手术治疗精索静脉曲张不育总有效率、精液量、精子密度、a+b活力及妊娠率疗效高于单纯手术治疗,未见明显不良反应报道。

超高效液相色谱法同时测定抗瘤丸(活血益气方)中10种活性成分含量

目的建立同时测定抗瘤丸(活血益气方)中10种活性成分含量的超高效液相色谱(UPLC)法。方法色谱柱为Waters Acquity BEH C18柱(50 mm×2.1 mm,1.7μm),流动相为水-乙腈(梯度洗脱),流速为0.3 mL/min,检测波长为220 nm(山柰酚、落新妇苷、槲皮素、大黄酸、大黄素、大黄素甲醚)和203 nm(人参皂苷Rg1、人参皂苷Rb1、三七皂苷R1、薯蓣皂苷),柱温为40℃,进样量为2μL。结果10种活性成分在各自质量浓度范围内与峰面积线性关系良好(r≥0.9995,n=7);精密度、稳定性、重复性试验结果的RSD均小于4.0%(n=6);平均加样回收率为89.02%~94.65%,RSD为0.66%~8.70%(n=6)。样品中10种活性成分的平均含量为0.07~7.32 mg/g(n=3)。结论该方法操作简便、重复性好、结果准确,可用于同时测定抗瘤丸(活血益气方)中10种活性成分的含量。

基于网络药理学探讨速效救心丸联合复方丹参注射液治疗不稳定型心绞痛的机制

目的采用网络药理学和分子对接技术探索速效救心丸联合复方丹参注射液治疗不稳定型心绞痛的分子调控机制。方法中药系统药理学数据库与分析平台(TCMSP)、中医药百科全书平台(ETCM)、中药分子机制研究的生物信息学分析工具(BATMA-TCM)、本草组鉴平台(HERB)数据库结合成分检测文献筛选速效救心丸联合复方丹参注射液的成分和靶点,同时GeneCards、DisGeNET和OMIM数据库获取不稳定型心绞痛的靶点。用于进行基因本体和京都基因与基因组百科全书富集分析。结果本研究筛选出川芎嗪、丹参酮ⅡA、丹酚酸B等33种主要活性成分,得到前列腺素内过氧化物合成酶2、白细胞介素6(IL-6)等32个速效救心丸联合复方丹参注射液治疗不稳定型心绞痛的靶点。分子对接结果证明,本研究获得的活性成分与其对应的不稳定型心绞痛靶点间均有较高的亲和力。结论速效救心丸联合复方丹参注射液通过川芎嗪、丹参酮ⅡA、丹酚酸B等活性成分靶向IL-6、白细胞介素1β(IL-1β)、肿瘤坏死因子(TNF)等关键靶点发挥治疗不稳定型心绞痛的功效。

基于血管内皮指标、IL-23、IL-17分析速效救心丸联合新活素对PCI后AMI患者的治疗效果

目的 基于血管内皮指标、白细胞介素-23(IL-23)、白细胞介素-17(IL-17)分析速效救心丸联合新活素对经皮冠状动脉介入术(PCI)后急性心肌梗死(AMI)患者的治疗效果。方法 选取2021年1月至2022年10月该院收治的104例AMI患者作为研究对象,根据随机数字表法分为对照组和观察组,各52例。两组均进行PCI,对照组术后采用新活素治疗,观察组术后采用新活素+速效救心丸治疗。比较两组疗效、不良反应、主要不良心血管事件(MACE)发生情况及治疗期间中医证候积分、心功能指标、血管内皮指标、血清IL-23、IL-17水平。结果 观察组总有效率高于对照组(P<0.05)。重复测量方差分析显示,两组治疗期间的中医证候积分、左心室射血分数(LVEF)、心脏指数(CI)、N末端脑钠肽前体(NT-proBNP)及血清IL-23、IL-17、血管内皮生长因子B(VEGF-B)、血管性假血友病因子(vWF)、生长分化因子-15(GDF-15)水平变化有交互效应(F=13.455、10.336、7.513、17.011、23.468、25.178、14.556、13.182、18.712,P<0.001),故进一步做单独效应分析。两组不同时间血清IL-23、IL-17、GDF-15、vWF水平及中医证候积分、NT-proBNP水平比较结果显示,治疗6个月后<治疗3个月后<治疗前,任意两两比较,差异均有统计学意义(P<0.05)。两组不同时间血清VEGF-B水平、LVEF、CI比较结果显示,治疗6个月后>治疗3个月后>治疗前,任意两两比较,差异均有统计学意义(P<0.05)。多变量方差分析结果显示,观察组治疗3个月后、6个月后血清IL-23、IL-17、vWF、GDF-15、NT-proBNP水平及中医证候积分低于对照组,血清VEGF-B水平及LVEF、CI均高于对照组,差异均有统计学意义(P<0.05)。两组治疗期间不良反应、MACE发生情况比较,差异无统计学意义(P>0.05)。结论 新活素联合速效救心丸应用于PCI后AMI患者的治疗,有助于下调患者血清IL-23、IL-17水平,改善治疗效果。

基于熵权法结合星点设计-效应面法和反向传播人工神经网络优选黄柏苍术水丸制备工艺

目的优选黄柏苍术水丸制备工艺。方法以丸剂含水量、丸剂溶散时限、外观评分、盐酸小檗碱、苍术素、欧前胡素以及粉防己碱和防己诺林碱之和为评价指标,以挤滚比、加水量、干燥时间为影响因素,经单因素试验研究,再选用效应面法,采用熵权法进行综合评价,筛选黄柏苍术水丸最佳制备工艺参数,同时利用反向传播人工神经网络(back propagation artificial neural network,BP-ANN)预测最佳工艺参数,并对两者进行验证对比。结果最佳工艺条件为挤滚比为1∶1.2、加水量为26%、干燥时间为8.2 h时,各评价指标的综合评分最高;BP-ANN神经网络优化工艺参数优于响应面工艺,结果更精准稳定。结论优选的黄柏苍术水丸制备工艺科学合理,稳定可行,为后续大生产控制及质量标准建立打下良好基础。

Determination of Plasma Concentration of Cinnamic Acid by High-Performance Liquid Chromatography and Its Pharmacokinetics in Rats after Oral Administration of Zi-Shen Pill

Aim To develop a simple and sensitive high-performance liquid chromatographicmethod for determination of plasma concentration of cinnamic acid and pharmacokinetic study in ratsafter a single oral dose of traditional Chinese medicinal preparation Zi-Shen pill. Method Plasmasamples were acidified with hydrochloric acid and extracted with ethyl acetate . Cinnamic acid wasdetermined by HPLC using a G_(18) column. A mobile phase ofmethanbl-acetonitrile-water-triethyl-amine (7:22:73 = 0.2, V/V), with the pH adjusted to 4.0 withphosphoric acid, and with a UV detector set at 340 nm. Results The standard curve was linear overthe range of 1.92- 192.0 μg·mL^(-1). The LLOQ was 1.92 μg·mL^(-1) . The RSDs of within-day andbetween-day precision were < 8%. The mean recovery was 82.0% . Conclusion After validation, themethpd has been used to investigate the pharmacokinetic profiles of the traditional Chinesemedicinal preparation Zi-Shen pill.

基于系统评价和网络药理学分析桂枝茯苓丸治疗冠心病的疗效及其抗动脉粥样硬化的作用机制

目的运用系统评价对桂枝茯苓丸治疗胸痹心痛患者的疗效进一步确认,同时基于网络药理学考察桂枝茯苓丸对动脉粥样硬化可能作用机制。方法通过计算机检索2005—2023年中国知网(CNKI)、万方、维普及PubMed数据库中收录的关于桂枝茯苓丸治疗胸痹心痛的随机对照试验(RCT)文献。经过纳入、排除及筛选标准,最终纳入9篇RCT文献,采用Cochrane协作网及Review Manager 5.1软件分析,同时运用网络药理学分析桂枝茯苓丸对动脉粥样硬化可能作用机制。结果心电图疗效Meta分析结果提示:Z=2.66(P<0.05),OR及95%CI为0.17(0.05,0.30),说明观察组的心电图有效率高于对照组。心绞痛Meta分析结果提示:Z=5.71(P<0.00001),OR及95%CI为4.70(2.76,7.99),说明观察组的心绞痛有效率高于对照组。临床总疗效Meta分析结果提示:Z=4.39(P=0.0001),OR及95%CI为5.31(2.52,11.19),说明观察组的临床总有效率高于对照组。网络药理学分析提示:桂枝茯苓丸治疗动脉粥样硬化的靶点和作用机制发现,FOS、IKBKB、MAPK8和RELA是核心靶点,作用通路包括流体剪切应力、TNF、凋亡或脂质通路。结论Meta分析证实桂枝茯苓丸可以提高胸痹心痛患者的心电图疗效、心绞痛疗效及临床总有效率,但由于纳入文献的质量偏低、未提及具体分组方式、是否盲法及不良反应,确切结论仍需要高质量文献支持;桂枝茯苓丸治疗动脉粥样硬化的靶点和作用机制发现,FOS、IKBKB、MAPK8和RELA是核心靶点,作用通路包括流体剪切应力、TNF、凋亡或脂质通路。

RP-HPLC Determination of Pinoresinol Diglucopyranoside in Qing′e Pill Extract

Aim To develop and determine pinoresinol diglucopyranoside in Qing'e Pill, atraditional Chinese compound preparation containing Eucommia ulmoides Oliv. as the principal drug,by a reverse-phase high-performance liquid chromatographic method (RP-HPLC) . Methods The extract ofQing'e Pill was refluxed with 75% ethanol, purified on an AB-8 macroporous adsorption resin columnand then injected into HPLC system. The HPLC assay was performed on an ODS analytical column with amixture of methanol-acetonitrile-water (24:3:78, V/V/V) as the mobile phase at a flow-rate of 1.0mL·min^(-1), and a UV detector set at 227 nm. Results Good linearity between peak area andconcentration was found in the range of 5.5 - 170 μg·mL^(-1) for pinoresinol diglucopyranoside ( r> 0.9998) . The average recovery was 99.3%. The intra-day assay RSD and the inter-day assay RSDwere 1.3% and 2.8%, respectively (n = 5). The content of pinoresinol diglucopyranoside in Qing'ePill was determined to be 0.446 +- 0.012 mg·g^(-1) (n = 10). Conclusion The RP-HPLC method wasproved to be sensitive, specific, accurate and precise for the determination of pinoresinoldiglucopyranoside in Qing' e Pill.