Effect of compound preparation Tongqiao Jiannao capsules on neural cell apoptosis and Bcl-2 and Bax protein levels in a rat model of brain ischemia/reperfusion injury

BACKGROUND：Pharmacological studies have demonstrated that compound preparation Tongqiao Jiannao capsules composed of Zexie, Baizhu, Honghua, Danshen, and Shexiang can supplement qi, activate blood circulation, relieve blood stasis, induce resuscitation for alleviating pain, relieve pain, and dilate blood vessels. OBJECTIVE： To observe the effects of Tongqiao Jiannao capsules on the levels of the anti-apoptotic protein Bcl-2 and the proapoptotic protein Bax, and verify the mechanism of action. DESIGN, TIME AND SETTING： Randomized, controlled animal experiment, performed in the Laboratory of Biochemistry and Molecular Biology, Shanxi Medical University between June 2001 and December 2002. MATERIALS： The right middle cerebral arteries of 24 healthy adult Sprague Dawley rats were occluded by the suture method. The primary Chinese herbal medicinal ingredients of Tongqiao Jiannao capsules are Zexie, Baizhu, Honghua, Danshen, and Shexiang, which were purchased from Shanxi Provincial Medicinal Material Company, China, and prepared into condensed granules in the Room for Chinese Herbal Medicine Preparation, Second Hospital, Shanxi Medical University. Bcl-2 and Bax immunohistochemical staining kits, a 3,3-diaminobenzidine（DAB） kit, and an in situ apoptosis detection kit were purchased from Wuhan Boster Bioengineering Co., Ltd., China. METHODS： Twenty-four rats were randomly and evenly divided into three groups： （1） sham-operated rats in which sutures were inserted and immediately pulled out; （2） Tongqiao Jiannao capsule-treated rats that were intragastrically administered 6.5 g/kg/d Tongqiao Jiannao capsule preparation for seven successive days prior to middle cerebral artery occlusion （MCAO）; and （3） MCAO rats without any other treatments. MAIN OUTCOME MEASURES： The levels of neural cell apoptosis and Bcl-2 and Bax proteins at 24 hours post-surgery. RESULTS： In the MCAO group, the numbers of apoptotic cells and Bax-positive cells were significantly increased, while the numbers of Bcl-2-positive cells were slightly decreased compared with the sham-operated group. Bcl-2- and Bax-positive cells and apoptotic cells were primarily distributed in the ischemic penumbra. In the Tongqiao Jiannao capsule-treated group, neuronal apoptosis was inhibited, and the number of Bcl-2-positive cells was significantly increased （P 〈 0.01）, while the number of Bax-positive cells was significantly decreased （P 〈 0.01）, compared with the MCAO group. CONCLUSION： Tongqiao Jiannao capsules elevated Bcl-2 expression, lowered Bax expression, and inhibited cellular apoptosis during the process of cerebral ischemia/reperfusion injury.

Clinical Experience in Treatment of Alzheimer’s Disease with Jiannao Yizhi Formula (健脑益智方) and Routine Western Medicine

Objective:To investigate the long-term therapeutic effects of the Chinese medicine Jiannao Yizhi Formula(健脑益智方,JYF)in the treatment of Alzheimer’s disease(AD).Methods:Sixty mild-to-moderate AD participants were recruited and randomly allocated to the treatment(30 with JYF)and the control groups(30 with donepezil)for 6 months with the random numbers.The primary outcomes were scores of Alzheimer’s Disease Rating Scale-Cognitive(ADAS-Cog)and Chinese Medicine Symptom Scale(CM-SS).The secondary outcomes were scores of Mini Mental State Examination(MMSE),Montreal Cognitive Assessment(MoCA),and Activities of Daily Living(ADL).Safety assessments were conducted at baseline and the 6 th month of treatment.Serum levels of acetylcholine(Ach),amyloid-β protein 42(Aβ42),and the microtubule-associated protein tau(Tau)were also determined by enzyme-liked immunosorbent assay.Results:Fifty-one participants were included in the final analyses(JYF n=27;donepezil n=24).Compared with baseline,both JYF and donepezil increased the MoCA and MMSE scores and decreased the ADAS-Cog and CM-SS scores(P<0.05 or P<0.01).Both drugs increased the serum levels of Ach and decreased the serum levels of Aβ42 and Tau(all P<0.05).There was no significant difference in these variables between the two groups,which showed that JYF was not inferior to donepezil.No obviously significant changes were observed in the ADL.No severe adverse events were observed in both groups.Conclusion:The effect and safety of JYF for the treatment of AD were not inferior to those of donepezil.

Clinical Research on Comprehensive Treatment of Senile Vascular Dementia

Objective:To observe the curative effect of combined Chinese medicine,acupuncture and rehabilitation therapy on vascular dementia(VD),and to compare the Western medicine piracetam.Methods:Total 134 VD patients screened in reference to the standard for VD diagnosis in DSM-IV were randomly divided into a Chinese medicine plus rehabilitation group(32 cases),a Chinese medicine plus acupuncture group(33 cases),a Chinese medicine and acupuncture plus rehabilitation group(37 cases) and a Western medicine piracetam group(32 cases).Mini Mental State Examination(MMSE) and Bless Behavior Scale(BBS) were used to assess changes in intelligence disorder before treatment and after 12-week treatment.Results:BBS score,living ability and daily habit were enhanced after treatment in all groups.Cognitive function and behavioral ability were improved with similar total curative effects in all the 4 groups.Directional ability and short-term memory ability were significantly enhanced after treatment(P<0.05) in both the Chinese medicine plus rehabilitation group and the Chinese medicine plus acupuncture group groups.Living ability was significantly improved after treatment in the Chinese medicine and acupuncture plus rehabilitation group(P<0.01).However,no obvious difference was shown before and after treatment in the piracetam group.Conclusion:The improvement of living ability in the comprehensive treatment group is better than that in the other groups.Chinese medicine and acupuncture plus rehabilitation treatment can improve intelligence and living ability of senile VD patients.