Clinical Effect of Modified Gegen Qinlian Decoction Combined with Western Medicine on Children with Rotavirus Enteritis with Damp-Heat Syndrome

[Objectives] To explore the clinical effect of Modified Gegen Qinlian Decoction combined with western medicine on children with rotavirus enteritis with damp-heat syndrome and its influence on myocardial enzymes.

The potential role of Gegen Qinlian decoction in the treatment of coronavirus disease 2019 based on network pharmacology and validation of lipopolysaccharide-induced macrophages

Background:Coronavirus disease 2019(COVID-19)is caused by severe acute respiratory syndrome coronavirus 2,which has led to deaths and currently lacks an efficient treatment.Despite studies suggesting the potential of the Gegen Qinlian decoction(GQD)in preventing COVID-19,comprehensive analyses of its anti-COVID-19 potential are still lacking.Methods:GQD treatment was evaluated for its efficacy in ameliorating the early stage(24 hours)of lipopolysaccharide(LPS)-induced cytokine storm in vivo.Additionally,target genes of GQD were co-analyzed with COVID-19 signature genes to identify key ingredients and their pathways.Validation was also conducted using an LPS-induced macrophage model.Results:GQD treatment effectively ameliorated the early stage of LPS-induced cytokine storm in vivo.Key ingredients such as quercetin were found to be involved in multiple pathways,including inflammation,immunity,oxidative stress,cell proliferation,and apoptosis,through the AGE-RAGE signaling pathway and IL-17 signaling pathway.In the LPS-induced macrophage model,quercetin inhibited macrophage polarization(M1)and the secretion of inflammatory factors(IL-6,TNF-α,IL-17A).Conclusions:Our results indicate that GQD can be utilized in the treatment of cytokine storm induced by COVID-19 and has the potential to treat COVID-19 by suppressing the COVID-19 signature genes and macrophage polarization.

Mechanism of Gegen Qinlian Decoction in Treating Type 2 Diabetes Mellitus Complicated with NAFLD Based on Network Pharmacology

[Objectives]To explore the mechanism of Gegen Qinlian Decoction in treating type 2 diabetes mellitus(T2DM)complicated with non-alcoholic fatty liver disease(NAFLD)by analyzing the effective components of Gegen Qinlian Decoction.[Methods]TCMSP database was used to analyze the active components of Gegen Qinlian Decoction,and pubchem and Swiss ADME databases were also used to predict drug targets,extract T2DM complicated with NAFLD targets from OMIM and Genecards databases.Venny plot was drawn to obtain intersection targets,and finally Cytoscape was used to make core target maps and drug-target-disease network maps.Using DAVID and Metascape database to analyze the intersection targets,the gene ontology information of Go and KEGG was obtained.Microbial informatics technology was used to visualize GO,and Cytoscape was used to make drug-target-disease network map-enrichment pathway map.[Results]The network pharmacological analysis showed that Gegen Qinlian Decoction acted on the key targets of type 2 diabetes mellitus complicated with non-alcoholic fatty liver disease,such as ALB and ALT1,through many components,and achieved the purpose of treating this disease.The chemical constituents of the drug include formononetin,5-hydroxyisomucronulatol-2,5-2-O-glucoside,cholesteryl laurate,isoliquiritigenin,etc.[Conclusions]This study provides a new idea and theoretical support for future drug research and clinical practice.

Gegen Qinlian decoction enhances immunity and protects intestinal barrier function in colorectal cancer patients via gut microbiota

BACKGROUND We previously showed,using the Traditional Chinese Medicine System Pharmacology Database,that Gegen Qinlian decoction(GQD)had a direct antitumor effect,and was combined with programmed cell death protein(PD)-1 inhibitors to treat microsatellite stable(MSS)tumor-bearing mice.However,the effect of GQD on patients with colorectal cancer(CRC)is not clear.AIM To determine the therapeutic mechanism of GQD in improving immune function,reducing inflammation and protecting intestinal barrier function.METHODS Seventy patients with CRC were included in this study:37 in the control group and 33 in the treatment group.The proportions of CD4+T,CD8+T,natural killer(NK),NKT and T regulatory cells were measured by flow cytometry.Levels of the cytokines tumor necrosis factor(TNF)-α,interferon(IFN)-γ,interleukin(IL)-2,IL-6,IL-10 and serotonin(5-hydroxytryptamine;5-HT)in serum were assessed by enzyme-linked immunosorbent assay(ELISA).The expression of zonula occludens(ZO)-1,occludin,nuclear factor(NF)-κB and TNF-αin tumor and normal tissues was measured by immunohistochemistry.The composition of gut microbiota from patients in the treatment group was assessed using 16S rDNA analysis.RESULTS There were no adverse events in the treatment group.The proportion of CD4+T cells and NKT cells in the post-treatment group was significantly higher than that in the pre-treatment and control groups(P<0.05).The level of TNF-αin the posttreatment group was significantly lower than that in the pre-treatment and control groups(P<0.05).The concentration of 5-HT in the post-treatment group was significantly lower than that in the pre-treatment group(P<0.05).The expression of ZO-1 and occludin in tumor tissues in the treatment group was significantly higher than that in the control group(P<0.05).The expression of ZO-1 in normal tissues of the treatment group was significantly higher than that in the control group(P=0.010).Compared with the control group,expression of NF-κB and TNF-αin tumor tissues of the treatment group was significantly decreased(P<0.05).Compared with the pre-treatment group,GQD decreased the relative abundance of Megamonas and Veillonella.In addition,GQD increased the relative abundance of Bacteroides,Akkermansia and Prevotella.CONCLUSION GQD enhances immunity and protects intestinal barrier function in patients with CRC by regulating the composition of gut microbiota.

Mechanism of Danshen-Gegen in treating coronary heart disease based on network pharmacology

OBJECTIVE To explore the mechanism of action of Danshen-Gegen on coronary heart disease.METHODS First using network pharmacology,according to oral bioavailability and drug-like properties,taking Danshen-Gegen as the research object,obtaining its active ingredients and targets in the pharmacological analysis platform of Chinese medicine system,using TTD,DrugBank and Disgenet database to obtain coronary heart disease targets,the active componentcoronary heart disease target network was constructed by CytosCape3.6.1 software,and the target protein interaction network was constructed by String database,Finally,GO and KEGG enrichment analysis was performed on the target in the DAVID database.RESULTS 61 active ingredients were screened from Danshen-Gegen,and 68 targets related to coronary heart disease were selected.GO analysis showed that Danshen-Gegen is involved in many biological processes such as transcription and inflammation of RNA polymeraseⅡpromoter.The target of treating coronary heart disease is mainly concentrated in extracellular space,plasma membrane and nucleus to treat coronary heart disease.The main effects of treatment of coronary heart disease are zinc ion binding,cytokine activity and sequence-specific DNA binding.The results of KEGG analysis showed that the regulation of Danshen-Gegen includes signaling pathways such as HIF-10,PI3K-Akt,TNF and Jak-STAT.CONCLUSION The combination of Danshen-Gegen has 61 active ingredients to play a role in the treatment of coronary heart disease through 68 targets and Jak-STAT,PI3K-Akt and other signaling path⁃ways.The results of this study provide a reference for further study of the pharmacological effects of Danshen-Gegen.

LC-ESI-MS/MS,a modified method for simultaneous quantification of isoflavonoids,flavonoids,alkaloids and saponins in a Chinese herbal preparation Gegen-Qinlian decoction

A sensitive and reliable liquid chromatography-electrospray ionisation-tandem mass spectrometry(LC-ESI-MS/MS)method was established to simultaneously quantitate four categories of compounds(isoflavonoids,flavonoids,alkaloids and saponins)in Gegen-Qinlian decoction(GQD).These compounds were separated by a Shiseido CAPCELL PAK C18 column with a linear gradient consisting of 0.1%(v/v)formic acid in water(A)and 0.1%(v/v)formic acid in acetonitrile(B),and delivered at a flow rate of 0.3 mL/min.All the analytes were determined by electrospray positive ionization tandem mass spectrometry in a multiple reaction monitoring(MRM)mode.Linearity,accuracy,precision,recovery and stability of the method were evaluated with the validation over the range of 4.0-538 5 ng/mL.The proposed method was applied to the analysis of a Chinese herbal preparation GQD successfully.

Determination of Adulteration Dye Auramine O in Gegen Qinlian Tablets by HPLC-MS/MS

[Objectives]This study aimed to establish a method for determination of adulteration dye auramine O in Gegen Qinlian tablets by HPLC-MS/MS.[Methods]The instrument conditions were as follows:column,Agilent Eclipse plus C18(2.1 mm×100 mm,1.8μm);mobile phase,acetonitrile-0.01 mol/L ammonium acetate;gradient elution;flow rate,0.3 mL/min;column temperature,35℃;injection volume,2μL;ion source,electrospray ionization source(ESI);and scanning mode,multiple reaction monitoring(MRM).[Results]Methodological validation shows that auramine O had a good linear relationship in the range of 0.0934-1.869 pg(r=0.9999),and the average recovery rate was 94.38%(RSD=3.60%,n=9).[Conclusions]The method established is accurate,convenient,precise,reproducible,and stable,with good linear relationship,and it can be used determine the content of adulteration dye auramine O in Gegen Qinlian tablets.

Simultaneous Determination of Effective Components of Gegen Qinlian Tablets by HPLC

[Objectives]To establish a HPLC method for the simultaneous determination of 14 characteristic components in Gegen Qinlian tablets and the content of Gegen Qinlian tablets in 11 manufacturers.[Methods]A Inertsil ODS-3(250 mm×4.6 mm,5μm)reversed-phase high performance liquid chromatography column was used with acetonitrile-0.02 mol/L ammonium acetate+0.03%triethylamine solution(adjusted with glacial acetic acid to pH of 4.3)as the mobile phase for gradient elution at a flow rate of 1.0 mL/min.The determination wavelength of 8 components(puerarin,daidzin,liquiritin,baicalin,wogonoside,daidzein,ammonium glycyrrhizinate,baicalein)was 250 nm;the determination wavelength of wogonoside was 280 nm;the determination wavelength of 5 components(epierberine,jatrorrhizine hydrochloride,coptisine,palmatine hydrochloride and berberine hydrochloride)was 346 nm.[Results]There was a good linear relationship between the injection volume of puerarin,daidzin,liquiritin,baicalin,wogonoside,epierberine,jatrorrhizine hydrochloride,coptisine,daidzein,palmatine hydrochloride,ammonium glycyrrhizinate,berberine hydrochloride,baicalein and wogonin and peak area(r>0.9990)in the range of 146.26-5850.24,24.13-965.04,18.45-738.00,79.18-3167.32,9.57-382.80,4.76-190.40,2.57-102.80,13.41-536.40,10.60-424.00,11.33-453.22,12.08-483.20,46.73-1869.25,20.28-811.20,12.11-484.50 ng,respectively;the average recovery rates(n=6)were 2.18%,1.79%,1.81%,1.68%,2.27%,2.13%,1.96%,1.07%,0.93%,0.61%,2.92%,0.77%,2.79%and 0.62%,respectively;the precision,repeatability and stability were good,and the RSD was less than 3%.This method was used to determine 16 batches of Gegen Qinlian tablets produced by 11 enterprises.Wogonoside was not detected in a lot of samples,but 14 components were detected for other enterprises,but the content was different.[Conclusions]The method was accurate and feasible and could be used for the overall quality control of this variety.

Administration of modified Gegen Qinlian decoction for hemorrhagic chronic radiation proctitis: A case report and review of literature

BACKGROUND Hemorrhagic chronic radiation proctitis(CRP) is a common late complication of irradiation of the pelvis and seriously impairs life quality. There is no standard treatment for hemorrhagic CRP. Medical treatment, interventional treatment, and surgery are available, but they are limited in their applications due to nondefinite efficacy or side effects. Chinese herbal medicine(CHM), as a complementary or alternative therapy, may provide another option for hemorrhagic CRP treatment.CASE SUMMARY A 51-year-old woman with cervical cancer received intensity-modulated radiation therapy and brachytherapy with a total dose of 93 Gy fifteen days after hysterectomy and bilateral adnexectomy. She received six additional cycles of chemotherapy with carboplatin and paclitaxel. Nine months after radiotherapy treatment, she mainly complained of 5-6 times diarrhea daily and bloody purulent stools for over 10 d. After colonoscopy examinations, she was diagnosed with hemorrhagic CRP with a giant ulcer. After assessment, she received CHM treatment. The specific regimen was 150 mL of modified Gegen Qinlian decoction(GQD) used as a retention enema for 1 mo, followed by replacement with oral administration of 150 mL of modified GQD three times per day for 5 mo. After the whole treatment, her diarrhea reduced to 1-2 times a day. Her rectal tenesmus and mild pain in lower abdomen disappeared. Both colonoscopy and magnetic resonance imaging confirmed its significant improvement. During treatment,there were no side effects, such as liver and renal function damage.CONCLUSION Modified GQD may be another effective and safe option for hemorrhagic CRP patients with giant ulcers.

Study on the molecular mechanism of Gegen Qinlian decoction in the treatment of influenza based on network pharmacology

Objective:The study shows that Gegen Qinlian decoction(GGQL)is feasible in the treatment of influenza.It is explained from traditional Chinese medicine theory and modern pharmacology,and the formula is tested in vitro.The results show that Gegen Qinlian decoction has a good inhibitory effect on influenza virus.Methods:Search TCMSP database to get the components and targets of GGQL,and construct the compound target network.Then search OMIM database and Disgenet database to obtain influenza genes,and the common genes were obtained by VennDiagram.STRING database was used to construct gene function association network.Finally,David database was used to analyze GO enrichment and pathway enrichment.Results:146 ingredients and 128 targets were obtained,588 genes were obtained.46 common genes were obtained by VennDiagram,and import the common genes into the STRING database and construct the gene function association network,then the network information data was imported into Cytoscape software for topology analysis.Finally,13 enriched GO clusters and 7 enriched pathway clusters were obtained by David database,and construct the targets-GO-pathway network.Conclusion:Network pharmacology of GGQL reveal that the target and the pathway of the drug was closely related to influenza,and the results of this study have been verified with published experimental studies,which shows that GGQL has not only theoretical basis for the treatment of influenza,but also in vitro experiments support this conclusion.

Explanation of Gegen Qinlian Decoction Syndrome and Its Clinical Application

Gegen Qinlian Decoction is one of the commonly used classical prescriptions,which consists of fourherbs:Gegen(Puerariae Lobatae Radix),Huangqin(Scutellariae Radix),Huanglian(Coptidis Rhizoma),and Zhigancao Glycyrrhizae Radix et Rhizoma Praeparata cum Melle.The clinical application experience of Gegen Qinlian Decoction is as follows:first,according to Zhongjing Zhang's original text,heat distressing the large intestine with unresolved exterior syndrome is theoriginal meaningof Gegen Qinlian Decoction syndrome.In clinical practice,bacillary dysentery,gastrointestinal cold,etc.,belong to simultaneous exterior and interior disease,which are completely consistent with the original meaning of this prescription;second,the clinical digestive system diseases with exuberant heat of the large intestine as the core manifestation cannot be treated merely based on the exterior syndrome;third,due to the interior-exterior relationship between the lung and the large intestine and between the meridians,the use of Gegen(Puerariae Lobatae Radix),Huangqin(Scutellariae Radix),and Huanglian(Coptidis Rhizoma)can make the source of body clear,and the waste qi can be released and thepore can be easily opened,so this prescription can also be used for exogenous fever;fourth,with multidimensional comprehensive understanding of the syndrome,pathogenesis,symptoms and pharmacology,Gegen Qinlian Decoction has also been further applied to the treatment of hypertension,diabetes,etc.

Double-blinded,randomized clinical trial of Gegen Qinlian decoction pinpoints Faecalibacterium as key gut bacteria in alleviating hyperglycemia

Background:Accumulating evidence suggests that metabolic disorders,including type 2 diabetes mellitus(T2DM),can be treated with traditional Chinese medicine formulas,such as the Gegen Qinlian decoction(GQD).This study elucidates the mechanisms by which gut microbes mediate the anti-diabetic effects of GQD.Methods:We conducted a double-blind randomized clinical trial involving 120 untreated participants with T2DM.During the 12-week intervention,anthropometric measurements and diabetic traits were recorded every 4 weeks.Fecal microbiota and serum metabolites were measured before and after the intervention using 16S rDNA sequencing,liquid chromatography-mass spectrometry,and Bio-Plex panels.Results:Anti-diabetic effects were observed in the GQD group in the human trial.Specifically,glycated hemoglobin,fasting plasma glucose,and two-hour postprandial blood glucose levels were significantly lower in the GQD group than in the placebo group.Additionally,Faecalibacterium was significantly enriched in the GQD group,and the short-chain fatty acid levels were higher and the serum inflammation-associated marker levels were lower in the GQD group compared to the placebo group.Moreover,Faecalibacterium abundance negatively correlated with the levels of serum hemoglobin,fasting plasma glucose,and pro-inflammatory cytokines.Finally,the diabetes-alleviating effect of Faecalibacterium was confirmed by oral administration of Faecalibacterium prausnitzi(DSMZ 17677)in T2DMmousemodel.Conclusions:GQD improved type 2 diabetes primarily by modulating the abundance of Faecalibacterium in the gut microbiota,alleviating metabolic disorders and the inflammatory state.

Simultaneous analysis of 12 bioactive constituents in Gegen Qinlian pill by HPLC-DAD

In this study, a novel and simple high performance liquid chromatography with diode array detection （HPLC-DAD） method for the simultaneous qualitative and quantitative determination of 12 bioactive components in Gegen Qinlian pill was developed. The separation was performed on a Kromasil C18 column （250 mm×4.6 ram, 5.0 μm） by gradient elution with acetonitrile and 0.02 mol/L ammonium acetate （containing 0.3% triethylamine, and adjusted pH to 4.3 using 1% glacial acetic acid） as the mobile phase at a flow rate of 0.7 mL/min. Three different detection wavelengths （250, 280, 346 nm） were set at the maximum UV absorption wavelengths of these components. Twelve components （puerarin, daidzin, baicalin, wogonoside, liquiritin, berberine, palmatine, jatrorrhizine, glycyrrhizin, baicalein, wogonin and daidzein） were identified and determined using the developed method. All calibration curves showed good linear regression （r〉0.9995） within tested ranges. The injection precision, intra-day precisions and analysis repeatability were evaluated with the RSD values, which were no more than 0.97%, 1.69% and 1.71%, respectively. The recoveries were ranged from 97.4% to 100.2% with RSD values less than 1.87%. This readily available, low-cost and reliable HPLC-DAD method would improve the quality control of Gegen Qinlian pill.

Antidiabetic Effects of Gegen Qinlian Decoction via the Gut Microbiota Are Attributable to Its Key Ingredient Berberine

Gegen Qinlian Decoction(GQD),a traditional Chinese medicine(TCM)formula,has long been used for the treatment of common metabolic diseases,including type 2 diabetes mellitus.However,the main limitation of its wider application is ingredient complexity of this formula.Thus,it is critically important to identify the major active ingredients of GQD and to illustrate mechanisms underlying its action.Here,we compared the effects of GQD and berberine,a hypothetical key active pharmaceutical ingredient of GQD,on a diabetic rat model by comprehensive analyses of gut microbiota,short-chain fatty acids,proinflammatory cytokines,and ileum transcriptomics.Our results show that berberine and GQD had similar effects on lowering blood glucose levels,modulating gut microbiota,inducing ileal gene expression,as well as relieving systemic and local inflammation.As expected,both berberine and GQD treatment significantly altered the overall gut microbiota structure and enriched many butyrate-producing bacteria,including Faecalibacterium and Roseburia,thereby attenuating intestinal inflammation and lowering glucose.Levels of short-chain fatty acids in rat feces were also significantly elevated after treatment with berberine or GQD.Moreover,concentration of serum proinflammatory cytokines and expression of immune-related genes,including Nfkb1,Stat1,and Ifnrg1,in pancreatic islets were significantly reduced after treatment.Our study demonstrates that the main effects of GQD can be attributed to berberine via modulating gut microbiota.The strategy employed would facilitate further standardization and widespread application of TCM in many diseases.

Clinical Observations on the Dose-effect Relationship of Gegen Qin Lian Decoction (葛根芩连汤) on 54 Out-patients with Type 2 Diabetes

Objective: To observe the therapeutic effect of different dosages of Gegen Qin Lian Decoction (葛根芩连汤) on type 2 diabetic patients. Methods: Fifty-four type 2 diabetic patients from low dosage group (20 cases), medium dosage group (19 cases) and high dosage group (15 cases) were treated with different dosage of Gegen Qin Lian Decoction for 12 weeks. Fasting blood-glucose (FBG), postprandial blood sugar (PBG) and Hemoglobin A1c (HbAlc) were determined before and after treatment. Results: With the increase of dosage, the overall effective rate of glycaemic control increased, and FBG, PBG, HbAlc decreased. The overall effective rate of blood glucose control of high dosage, medium dosage and low dosage group were 80%, 47%, 30% respectively, and there were significant differences between high dosage group and low dosage group. The decrease of FBG, PBG and HbAlc of high dosage showed significant differences from low dosage too. These data was analyzed by trend χ2 test and covariance analysis. Conclusion: The result indicated that different dosage of Gegen Qin Lian Decoction has dose-effect relationship in reducing HbAlc and FBG.

Effect of Puerarin on the Pharmacokinetics of Baicalin in Gegen Qinlian Decoction (葛根芩连汤) in Mice

Objective： To study the pharmacokinetics of puerarin（PUE） in Gegen Qinlian Decoction（葛根芩连汤, GQD）, and the effects of PUE dosage variations on the pharmacokinetics of baicalin（BAL） in mice. Methods： GQD is composed of the concentrated granules of four Chinese herbs. Three dosages with different levels of PUE, including GQD, GQD co-administered with PUE, and GQD co-administration with two times the amount of PUE, were used to research the pharmacokinetics of PUE and BAL in mice. The indirect competitive enzyme-linked immunosorbent assay（ic ELISA） methods based on an anti PUE-monoclonal antibody（MAb） and BAL-MAb were employed to determine the concentration of PUE and BAL in mice blood. Results： After the co-administration of GQD with PUE, the area under the curves（AUC0-14 h） of PUE increased 2.8 times compared with GQD. At the dose of GQD co-administration at two times that of PUE, the AUC0-14 h of PUE was almost equal to that of GQD co-administration of PUE, showing non-linear pharmacokinetics. The AUC0-48 h of BAL showed a good dose-related increase of PUE（r=0.993） in the range from 100 to 300 mg/kg, indicating that PUE dramatically affects the absorption of BAL in mice. There was no significant difference in the other pharmacokinetic parameters, such as the first time of maximum concentration（Tmax）, the second Tmax, or the mean residence time. Conclusions： The ic ELISA methods were successfully applied to pharmacokinetic studies of PUE and BAL in GQD in mice. The dosage variability of PUE of the main ingredient in GQD affects its own pharmacokinetic characteristics and the absorption characteristics of BAL.

Comprehensive Metabolic Profiling of Modified Gegen Qinlian Decoction by Ultra-high-Performance Liquid Chromatography-Diode Array Detection-Q-Exactive-Orbitrap-Electrospray Ionization-Mass Spectrometry/Mass Spectrometry and Application of High-Performance

Objective:Gegen Qinlian decoction(GQD)is a classical traditional Chinese medicine formulation which has been used for almost 2000 years.At Guang'anmen Hospital,Beijing,a modified GQD version(m GQD)with seven instead of four herbal ingredients has been applied to treat Type 2 diabetes.Quality control is a crucial prerequisite for the therapeutic application of herbal medicines.For the identification of products derived from classical GQD,the Chinese Pharmacopeia requires the analysis of only three marker compounds.Because m GQD is a more complex mixture containing seven herbs and hundreds of constituents,the pharmacopoeia method for GQD is inadequate.Materials and Methods:A more comprehensive characterization of the formula's constituents has been developed using ultra-high-performance liquid chromatography-diode array detection(UHPLC-DAD)-Q-Exactive-mass spectrometry(MS)in electrospray ionization positive and negative mode.Moreover,a new method for the fingerprint analysis of m GQD via high-performance thin-layer chromatography(HPTLC)has been established.Results:Altogether,91 compounds have been assigned to their originating plants and 84 substances were identified either by comparison with authentic references or with data from the literature.The HPTLC method is based on the application of two different mobile phases and is able to detect both lipophilic and hydrophilic constituents of m GQD.Conclusions:The modified GQD was extensively characterized by UHPLC combined with DAD and Q-Exactive Orbitrap high-resolution MS detection,leading to the assignment and identification of compounds present in the decoction.In addition,a new method for the fingerprint analysis of the m GQD using HPTLC was established,which allows fast and simple identification of the herbal ingredients in the mixture.

基于免疫调节探讨葛根汤颗粒治疗小鼠病毒性肺炎的作用机制

目的研究葛根汤颗粒对甲型流感病毒(influenza A virus,IAV)致小鼠病毒性肺炎模型的药效评价及免疫调节作用。方法ICR小鼠,13~15 g,分为正常对照组、模型对照组,磷酸奥司他韦阳性药对照组及葛根汤颗粒高、中、低剂量组(6.6、3.3、1.7 g-1·kg^(-1)·d^(-1)),每组10只,采用IAV(FM1株)病毒液感染建立小鼠病毒性肺炎模型,同时给予相关药物治疗。观察各组小鼠肺指数及肺指数抑制率,RT-PCR法检测肺组织核酸,ELISA法检测小鼠肺组织因子白介素-6(IL-6)、白介素-10(IL-10)、肿瘤坏死因子TNF-α;同时采用IAV(FM1株)病毒液滴鼻感染小鼠,造成死亡保护模型,观察小鼠感染后2周内的死亡情况,计算小鼠的死亡率、死亡保护率、平均存活天数和生命延长率。结果葛根汤颗粒中剂量组肺指数及肺组织病毒载量显著降低(P<0.01),肺指数抑制率为50.73%;葛根汤颗粒高、中剂量组肺组织炎性因子IL-10含量显著降低(P<0.01)、葛根汤颗粒中、低剂量组肺组织炎性因子TNF-α含量显著降低(P<0.01);葛根汤颗粒3个剂量组肺组织炎性因子IL-6含量显著降低(P<0.01);模型组小鼠死亡率90%,平均存活天数9.45 d,葛根汤颗粒3个剂量组小鼠死亡率显著降低、平均存活天数显著延长,生命延长率显著提高(P<0.01)。结论葛根汤颗粒可通过调节模型小鼠免疫炎性因子水平达到改善病毒性肺炎小鼠免疫功能的作用,同时可显著降低模型小鼠肺指数和肺组织病毒载量,从而减轻模型小鼠的肺部炎性损伤;对模型小鼠有死亡保护作用。

葛根芩连汤加味治疗急性肠炎的临床观察

目的探究葛根芩连汤加味治疗急性肠炎的效果。方法纳入急性肠炎患者共80例,按照随机数字表法分为对照组与观察组各40例。对照组接受奥美拉唑等常规西医治疗,观察组在此基础上加用葛根芩连汤治疗。观察两组疗效,并比较治疗前后中医证候积分、炎症指标[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL6)、超敏C反应蛋白(hs-CRP)、降钙素原(PCT)]、白蛋白、前白蛋白及免疫指标[免疫球蛋白G(IgG)、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)]。结果观察组临床总有效率为95.00%,比对照组的80.00%高(P<0.05)。两组治疗后胃脘疼痛、身热不扬、大便稀溏、恶心呕吐评分比治疗前低,且观察组比对照组低(P<0.05);TNF-α、IL-6、hs-CRP及PCT比治疗前低,且观察组比对照组低(P<0.05);白蛋白、前白蛋白、IgG、IgA及IgM比治疗前高,且观察组比对照组高(P<0.05)。结论中西医结合治疗急性肠炎疗效确切,可明显抑制患者炎症反应,改善其血清白蛋白、前白蛋白水平。

葛根芩连汤加减治疗胃肠湿热型2型糖尿病糖脂代谢紊乱患者的疗效观察

目的探讨葛根芩连汤加减治疗胃肠湿热型2型糖尿病糖脂代谢紊乱患者的临床疗效。方法选取2022年8月—2023年8月期间在保定市中医院就诊的120例糖脂代谢紊乱患者,按随机数字表法分为对照组和观察组,每组各60例。对照组常规采取饮食控制、运动疗法、常规降糖降脂药物治疗,观察组在对照组基础上采用葛根芩连汤加减治疗,8周为1个疗程,共治疗2个疗程。观察比较两组患者临床疗效、不良反应发生情况,治疗前后血糖[空腹血糖(Fasting blood glucose,FBG)、2 h血糖(2 hour postprandial blood glucose,2 h PG)、糖化血红蛋白(Glycosylated hemoglobin,HbA1c)]、血脂[总胆固醇(Total cholestero,TC)、甘油三酯(Triglyceride,TG)、低密度脂蛋白胆固醇(Low density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(High density lipoprotein cholesterol,HDL-C)]、体质量指数(Body mass index,BMI)水平、中医证候积分。结果治疗后两组患者HbA1c、FBG、2 h PG水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组血糖指标明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者TC、TG、LDL-C水平均较治疗前降低,HDL-C水平较治疗前升高,差异有统计学意义(P<0.05);且观察组TC、TG、LDL-C水平明显低于对照组,HDL-C水平明显高于对照组,差异有统计学意义(P<0.05);而两组患者BMI水平均出现轻微变化,但组间比较,差异无统计学意义(P>0.05)。治疗后两组患者中医证候积分均较治疗前降低,差异有统计学意义(P<0.05);且观察组中医证候积分明显低于对照组,差异有统计学意义(P<0.05)。治疗后观察组临床总有效率88.33%(53/60)明显高于对照组73.33%(44/60),差异有统计学意义(P<0.05)。治疗期间,观察组不良反应总发生率8.33%(5/60)与对照组11.67%(7/60)比较,差异无统计学意义(P>0.05)。结论葛根芩连汤加减可有效降低胃肠湿热型2型糖尿病糖脂代谢紊乱患者的血糖、血脂水平,并明显改善症状,且安全性较高,具有良好的临床疗效及应用价值。