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.

加味逍遥散通过外泌体miRNA途径发挥抗肝癌作用

背景:在课题组先前研究中发现加味逍遥散具有明显的抗肝癌作用,但具体作用机制不明。目的:基于高通量测序结合生物信息学,探讨加味逍遥散对二乙基亚硝胺慢性诱导的原发性肝癌模型大鼠血浆外泌体miRNA水平的调节作用。方法:将SD大鼠随机分为空白对照组、肝癌模型组、加味逍遥散组。以二乙基亚硝胺持续给药12周诱导肝癌模型,从第17周开始,加味逍遥散组大鼠给予加味逍遥散灌服,每日1次,直至第20周末停药,空白对照组和肝癌模型组大鼠给予等量生理盐水灌胃,通过检测大鼠肝组织的形态结构、肝癌标志物Glypican-3蛋白和血清甲胎蛋白表达验证抗肝癌效应。使用超速离心法分离提取各组大鼠血浆外泌体,利用高通量测序技术筛选出大鼠血浆外泌体中差异表达的miRNA,生物信息学预测加味逍遥散通过肝癌血浆来源外泌体miRNA发挥抗肝癌作用的潜在生物标志物,并进行功能分析。结果与结论:①加味逍遥散对肝癌模型大鼠肝组织的形态结构有显著改善作用,与肝癌模型组相比,加味逍遥散组肝癌标志物Glypican-3蛋白和血清甲胎蛋白的表达均显著降低;②生物信息学分析显示,加味逍遥散组对肝癌模型组上调的miR-223-3p与基因E2F1、NCOA1存在靶向结合位点,并且与肝癌生存率及预后密切相关。由此可见,加味逍遥散对肝癌有治疗作用,可能是通过肝癌血浆来源外泌体miR-223-3p靶向负调控NCOA1/E2F1进而发挥抗肝癌效应。

加味春泽汤调控内质网应激凋亡治疗脊髓损伤大鼠的尿潴留

背景:前期临床观察发现加味春泽汤是临床治疗脊髓损伤后尿潴留的有效方剂。动物实验发现磷脂酰肌醇3激酶/蛋白激酶B(PI3K/Akt)信号通路与膀胱功能障碍程度密切相关。目的:进一步验证加味春泽汤对脊髓损伤后尿潴留大鼠膀胱功能及PI3K/Akt通路的影响。方法:将60只SD雌性大鼠随机分为假手术组、模型组、加味春泽汤低剂量组、加味春泽汤高剂量组、激动剂组。假手术组大鼠暴露脊髓但不切断,其余各组大鼠采用改良后的Hassan Shaker脊髓横断法建立骶髓损伤大鼠模型。造模24 h后,假手术组和模型组大鼠给予等体积生理盐水灌胃,加味春泽汤低、高剂量组大鼠分别给予含有14.4 g/kg和28.8 g/kg的加味春泽汤颗粒剂,等体积灌胃4周,激动剂组大鼠给予PI3K/Akt信号通路激动剂740Y-P腹腔注射0.02 mg/kg治疗。治疗4周后采用尿流动力学检测各组大鼠膀胱最大容量、漏尿点压力、膀胱顺应性,膀胱离体逼尿肌条收缩性检测各组大鼠膀胱最小收缩张力、收缩频率,苏木精-伊红染色观察各组大鼠膀胱病理学改变,ELISA法检测各组大鼠血清中GRP78、CHOP、Caspase-12水平,RT-PCR、Western blot法检测大鼠膀胱组织PI3K、Akt、GRP78、CHOP、Caspase-12 mRNA及蛋白的表达。结果与结论:①与假手术组相比,模型组大鼠膀胱最大容量、膀胱顺应性、最小收缩张力升高(P<0.05),漏尿点压力、膀胱收缩频率降低(P<0.05);血清中GRP78、CHOP、Caspase-12水平升高(P<0.05);膀胱上皮细胞排列紊乱,细胞间存在单核细胞浸润,组织水肿,逼尿肌束萎缩;膀胱组织PI3K、Akt mRNA和蛋白表达降低,GRP78、CHOP、Caspase-12 mRNA和蛋白表达升高(P<0.05)。②与模型组相比,加味春泽汤低、高剂量组及激动剂组干预4周后,大鼠膀胱最大容量、膀胱顺应性、最小收缩张力降低(P<0.05),漏尿点压力、膀胱收缩频率升高(P<0.05);血清中GRP78、CHOP、Caspase-12水平降低(P<0.05);膀胱上皮细胞分布较均匀,排列较整齐,炎细胞浸润较少,逼尿肌束较饱满;膀胱组织PI3K、Akt mRNA和蛋白表达增加,GRP78、CHOP、Caspase-12 mRNA和蛋白表达降低(P<0.05)。加味春泽汤高剂量组优于低剂量组,与激动剂组结果相似。③结果说明,加味春泽汤可以改善脊髓损伤后尿潴留大鼠膀胱功能,其作用机制可能与通过PI3K/Akt信号通路减轻膀胱组织内质网应激的发生,进而减轻凋亡有关。

Effects of Jiawei Wendan decoction on hippocampal p-CREB protein expression in a rat model of depression

BACKGROUND： Jiawei W＇endan decoction can elevate hippocampal brain-derived neurotrophic factor （BDNF） protein expression in rats with depression. It has been hypothesized that Jiawei Wendan decoction can exhibit antidepressant effects through the hippocampal signal transduction pathway of cyclic adenosine monophosphate response element binding protein （CREB）-BDNF. OBJECTIVE： Using phosphorylated-CREB （p-CREB） as an entry point, the present study was designed to observe intervention effects ofJiawei Wendan decoction compared with fluoxetine. DESIGN, TIME AND SETTING： A randomized, controlled, cellular biology experiment was performed at the Central Laboratory of Guangxi University of Traditional Chinese Medicine, MATERIALS： A total of 40 healthy, male, Sprague-Dawley rats were included in the present study. Rhizoma Acori Talarinowii （Shichangpu）, Flos Albiziae （Hehuanhua）, Rhizoma Pinelliae （Banxia）, Caulis Bambusae in Taeniam （Zhuru）, Fructus Aurantii Immaturus （Zhishi）, Poria （Fuling）, and Radix Bupleuri （Chaihu）, the primary ingredients ofJiawei Wendan decoction, were purchased from First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine. The raw drug was decocted at a concentration of 1.5 g/mL. Fluoxetine capsules were purchased from Shanghai Zhongxi Pharmaceutical Co., Ltd., China. METHODS： Following behavioral testing, 36 rats were selected from the initial 40 rats according to similar behavioral scores, and were randomly divided into 4 groups： model （n = 8）, Jiawei Wendan decoction-treated （n = I 0）, fluoxetine-treated （~ = 10）, and normal control （n = 8）. All rats, except for those in the normal control group, were separately raised in a chronic and unpredictable, mild-stimulation environment for 2 l days to establish a depression model. The Jiawei Wendan decoction-treated and fluoxetine-treated groups were intragastrically administered Jiawei Wendan decoction （12 g/kg/d） and fluoxetine （1.8 mg/kg/d）, respectively. The model and normal control groups received double-distilled water （2 mL/kg/d） once a day for a total of 21 days. MAIN OUTCOME MEASURES： Prior to depression induction and subsequent to administration, memory and degree of depression were measured by open field and tail suspension tests, respectively. At 24 hours after administration, p-CREB expression in the hippocampat CA3 region was analyzed by the immunohistochemical SABC method. RESULTS： Two rats from the Jiawei Wendan decoction-treated group, and one from the fluoxetine-treated group, died of unknown causes. The remaining rats in each group, except for one rat that was randomly selected from the fluoxetine-treated group, were included in the final analysis. Following administration, the model group exhibited significantly decreased numbers of hippocampal p-CREB-positive cells, horizontal and vertical movements, and significantly prolonged duration of immobility in tail-suspension test, compared with the normal control group （P 〈 0.01）. The numbers of p-CREB-positive cells, as well as horizontal and vertical movements, were significantly greater, and the duration of immobility was significantly shorter, in the Jiawei Wendan decoction and fluoxetine groups, compared with the model group （P 〈 0.05-0.01）. There was no significant difference in the above-mentioned three indices between the Jiawei Wendan decoction and fluoxetine groups （P 〉 0.05）. CONCLUSION： Jiawei Wendan decoction increased hippocampal p-CREB expression by influencing the rat hippocampal signal transduction pathway of CREB-BDNF. Jiawei Wendan decoction exhibited antidepressant effects equivalent to fluoxetine.

Clinical Study of Jiawei Huangqi Guizhi Wuwu Decoction (加味黄芪桂枝五物汤) in Preventing and Treating Peripheral Neuro-sensory Toxicity Caused by Oxaliplatin

Objective： To evaluate the efficacy of Jiawei Huangqi Guizhi Wuwu Decoction （加味黄芪桂枝五物汤, JHGWD） in treating neuro-sensory toxicity induced by oxaliplatin. Methods： A randomized controlled self-crossover trial was performed. Thirty-one patients were randomly divided into AB and BA groups. Patients in A cycle belonged to the treated group, who were treated with chemotherapy combined with oxaliplatin plus JHGWD. Patients in B cycle belonged to the control group and were treated with chemotherapy alone. The peripheral neuro-sensory toxicity was observed and analyzed. Results： The main neurotoxicity was cold-induced paresthesia after the use of oxaliplatin, which included hyperaesthesia, chill, anaesthesia in the extremities, electrified sensation, formication, foreign body sensation and pain that might be exacerbated by exposure to cold. Twenty patients （64.5 % ） suffered from neuro-sensory toxicity in the treated group and 27 cases （87.1% ） in the control group. Symptoms were more serious and lasted longer in the control group than those in the treated group （P〈0.01）. Conclusion： JHGWD could prevent and reduce the occurence and intensity of acute peripheral neuro-sensory toxicity caused by oxaliplatin.

Clinical Observation of Jiawei Buzhong Yiqi Decoction in the Treatment of Obese Polycystic Ovarian Syndrome

[Objectives] To observe the clinical efficacy of Jiawei Buzhong Yiqi Decoction in the treatment of polycystic ovarian syndrome(PCOS).[Methods]Obese patients with PCOS were recruited for the study in September 2014-December 2016 from Chinese medicine gynecological clinic in the affiliated hospital of Hubei University of Medicine.All these patients were given one dose of Jiawei Buzhong Yiqi Decoction one time a day for three months.Body mass index(BMI) was measured before and after treatment.Sex hormone levels and ovulation were measured,and the improvement of clinical symptoms was compared before and after treatment.[Results] After treatment,the levels of BMI and serum luteinizing hormone(LH),testosterone(T) were significantly decreased,and the level of serum estradiol(E2) was significantly higher than that before treatment.Ovarian enlargement and polycystic changes,menstrual cycle,menstrual flow and menstrual period were improved in varying degrees.[Conclusions] Jiawei Buzhong Yiqi Decoction has a good clinical effect in the treatment of obese PCOS.

Metabolomics and network pharmacology reveal the mechanism of the Jiawei Yangshen pill in treatment of cyclophosphamide-induced dyszoospermia in mice

Background:The Jiawei Yangshen pill enhances sperm abundance.However,the pharmacological mechanism of action of the Jiawei Yangshen pill remains unclear.This study aimed to explore the therapeutic effect of the Jiawei Yangshen pill in the treatment of dyszoospermia and study the underlying mechanism.Methods:A dyszoospermia model was established by injecting mice with cyclophosphamide(50 mg/kg)consecutively for 7 days.Physiological and pathological indicators of the testis and hormone levels were examined after 4 weeks of treatment.Untargeted metabolomics using high-performance liquid chromatograph-mass spectrometry was performed on testis specimens.Network pharmacology analysis was used to construct an“ingredient-target-disease”interactive network,followed by metabolic pathway enrichment analysis.Western blotting was performed to examine the levels of the related proteins.Results:The Jiawei Yangshen pill significantly increased the testis index,epididymal index,sperm count,and testosterone level,while concurrently decreasing sperm mortality and luteinizing hormone levels.The spermatogenic cells in the Jiawei Yangshen pill-treated mice were well arranged with an increased number.Significantly different metabolites were identified.Western blotting showed that the expression levels of p-anti-adenosine monophosphate-activated protein kinase/anti-adenosine monophosphate-activated protein kinase and p-protein kinase B/protein kinase B were significantly increased after the Jiawei Yangshen pill treatment,whereas the expression levels of transforming growth factor-β1 and nuclear factor kappa B(p65)were remarkably decreased.Conclusion:The Jiawei Yangshen pill significantly improved testicular microcirculatory injury and overall metabolic levels in mice with dyszoospermia.

The therapeutic effect of Jiawei Danshen Decoction on myocardial ischemia-reperfusion injury by inhibiting H_(2)S-mediated autophagy signaling pathway

Objective To investigate the protective effects of Jiawei Danshen Decoction(加味丹参饮,JWDSD)on myocardial ischemia-reperfusion injury(MIRI)via the regulation of serum Hydrogen sulfide(H2S)and cardiac Beclin1,light Chain 3 A/B(LC3 A/B),p62,and autophagy protein5(ATG5).Methods Seventy specific pathogen free(SPF)Sprague-Dawley(SD)rats were randomly assigned to seven groups(n=10 in each group),including normal control,sham operation,MIRI model(model),ischemic preconditioning,Na HS,JWDSD,and JWDSD+CSE inhibitor(JWDSD+PPG)groups,and orally administered the indicated drugs for 14 d.Two hours after the last administration,the left anterior decreased branch of the coronary artery of each rat in model,Na HS,JWDSD,and JWDSD+PPG groups was ligated for 30 min and subsequently reperfused for 90 min to establish the MIRI model,and the rats in the sham operation group were only exposed to the thorax after surgery without coronary ligation.Blood samples were collected to detect H2S levels using an enzyme-linked immunosorbent assay(ELISA).Heart tissues were harvested for histopathological and immunohistochemical examination and quantitative reverse transcription polymerase chain reaction analysis of Beclin1 and ATG5 m RNA expression and Western blot analysis of Beclin1,LC3 A/B,and p62 protein expression.Results(1)The serum H2S content in model group rats was significantly reduced(P<0.01),JWDSD significantly increased the serum H2S content of model group rats(P<0.01),and the CSE inhibitor(PPG)significantly reduced H2S levels in the JWDSD group rats(P<0.01).(2)Compared with the normal control group,the myocardial tissue necrosis and cell destruction occurred in the MIRI model group,and JWDSD could alleviate the myocardial tissue necrosis of model rats,but the ameliorative effect of JWDSD could be reversed by PPG.(3)Beclin1,LC3 A/B,and p62 expression levels in the heart tissues of the model group were significantly increased(P<0.001),whereas decreased by JWDSD(P<0.05,P<0.01,and P<0.001,respectively),and the inhibitory effects of JWDSD on Beclin1,LC3 A/B,and p62 expression were partially reversed by PPG(P<0.01,P<0.05,and P<0.01,respectively).(4)The expression levels of autophagy-related genes Beclin1 and ATG5 were significantly increased in the model group(P<0.001).JWDSD clearly downregulated the expression levels of Beclin1 and ATG5(P<0.05 and P<0.001,respectively),which were reversed by PPG(P<0.001).Conclusion Our experimental data show that JWDSD can exhibit an anti-MIRI role by increasing endogenous H2S generation,and downregulating the expression of Beclin1,LC3 A/B,p62 and ATG5,which are related to inhibiting autophagy signaling.

Molecular targets and mechanisms of Jiawei Jiaotai Pill on diabetic cardiomyopathy based on network pharmacology

BACKGROUND Jiawei Jiaotai Pill is commonly used in clinical practice to reduce apoptosis,increase insulin secretion,and improve blood glucose tolerance.However,its mechanism of action in the treatment of diabetic cardiomyopathy(DCM)remains unclear,hindering research efforts aimed at developing drugs specifically for the treatment of DCM.AIM To explore the pharmacodynamic basis and molecular mechanism of Jiawei Jiaotai Pill in DCM treatment.METHODS We explored various databases and software,including the Traditional Chinese Medicine Systems Pharmacology Database,Uniport,PubChem,GenCards,String,and Cytoscape,to identify the active components and targets of Jiawei Jiaotai Pill,and the disease targets in DCM.Protein-protein interaction network,gene ontology,and Kyoto Encyclopedia of Genes and Genomes analyses were used to determine the mechanism of action of Jiawei Jiaotai Pill in treating DCM.Molecular docking of key active components and core targets was verified using AutoDock software.RESULTS Total 42 active ingredients and 142 potential targets of Jiawei Jiaotai Pill were identified.There were 100 common targets between the DCM and Jiawei Jiaotai Pills.Through this screening process,TNF,IL6,TP53,EGFR,INS,and other important targets were identified.These targets are mainly involved in the positive regulation of the mitogen-activated protein kinase(MAPK)MAPK cascade,response to xenobiotic stimuli,response to hypoxia,positive regulation of gene expression,positive regulation of cell proliferation,negative regulation of the apoptotic process,and other biological processes.It was mainly enriched in the AGE-RAGE signaling pathway in diabetic complications,DCM,PI3K-Akt,interleukin-17,and MAPK signaling pathways.Molecular docking results showed that Jiawei Jiaotai Pill's active ingredients had good docking activity with DCM's core target.CONCLUSION The active components of Jiawei Jiaotai Pill may play a role in the treatment of DCM by reducing oxidative stress,cardiomyocyte apoptosis and fibrosis,and maintaining metabolic homeostasis.

Effects of Jiawei Danggui Buxuetang on miRNA-155 and SOCS1 in renal tissue of DKD rats

Objective:To observe the effect of Jiawei Danggui Buxuetang on the expression of microRNA-155(miR-155)and cytokine signal transduction inhibitor 1(SOCS1)in renal tissue of rats with diabetic nephropathy(DKD),and to explore the mechanism of Jiawei Danggui Buxuetang in the treatment of DKD.Methods:Firty 6-week-old SPF male SD rats were randomly divided into normal group(CON)and model group.The model group was fed with high-sugar and high-fat diet for 6 weeks,and the DKD rat model was established by intraperitoneal injection of streptozotocin(STZ)(35 mg/kg).Then the rats were randomly divided into model group(MOD),low dose group(DBTL),medium dose group(DBTM),high dose group(DBTH)and irbesartan group(IRB).Each group was given intragastric administration for 20 weeks,during which CON group and MOD group were given the same amount of normal saline.Urine samples were collected after administration,and the ratio of urinary Microalbumin to urinary creatinine(UACR)was analyzed by automatic analyzer.The renal changes in each group were observed by hematoxylin-eosin(HE)staining,Masson pine(Masson)trichromatic staining and PASM staining.The expression of miR-155 and SOCS1mRNA in renal tissue of DKD rats was detected by Real-time PCR,and the expression of SOCS1 was detected by Western blotting.Results:By comparison with CON group,UACR value,MIR-155 mRNA expression and SOCS1 mRNA expression in MOD group increased significantly,while SOCS1 mRNA expression decreased significantly compared with MOD group,UACR decreased significantly in IRB group and DBT group,SOCS1 expression increased significantly in DBTM group,DBTH group and IRB group.The expression of MIR-155 decreased significantly in all treatment groups(P<0.05),and the expression of SOCS1 in DBTM group,DBTH group and IRB group increased significantly(P<0.05).Conclusion:Jiawei Danggui Buxuetang can reduce the expression of miR-155 in high glucose and increase the expression of SOCS1 in renal tissue,so as to significantly reduce renal damage and play a role in renal protection.

Effects of Jiawei Buzhong Yiqi Decoction on the Endometrial Receptivity of Rats with Polycystic Ovary Syndrome

[Objectives]The study aims to discuss the effects of Jiawei Buzhong Yiqi Decoction on the endometrial receptivity of rats with polycystic ovarian syndrome(PCOS).[Methods]Adult female SD rats were selected and randomly divided into the model group and control group.In the model group,the PCOS model was established by using the method of Poretsky L.Rats in the control group were given physiological saline intervention at the same time.The successfully modeled rats were randomly divided into the PCOS group and traditional Chinese medicine group.Among them,rats in the Chinese medicine group were given Jiawei Buzhong Yiqi Decoction by gavage;rats in the model group and the control group were given normal saline for 14 d.All rats were killed by anesthesia after the last administration,and serum and uterine specimens were collected.Serum sex hormones(including T,E_(2),and P),glucose and insulin levels were detected;the equivalent diameter and area of endometrial gland and gland cavity,and the endometrial thickness of rats were measured;the expression of endometrial leukemia inhibitory factor(LIF),integrinαvβ3 protein and mRNA was detected by using Elisa and RT-PCR methods.[Results]The serum T,glucose,and insulin levels of rats in the PCOS group were significantly higher than those of the control group and the traditional Chinese medicine group,and there was no significant difference in the above indicators between the control group and the traditional Chinese medicine group;there was no significant difference in the E_(2) and P levels between the three groups.The equivalent diameter and area of endometrial gland and gland cavity,and the endometrial thickness of rats in the PCOS group were lower than those of the control group and the traditional Chinese medicine group;there was no significant difference in the above indicators between the traditional Chinese medicine group and the control group.The expression of LIF,integrinαvβ3 protein and mRNA in the endometrium of rats in various groups was basically the same.The expression of LIF and integrinαvβ3 in the endometrium of rats in the PCOS group was significantly lower than that of the control group and the traditional Chinese medicine group;there was no significant difference in the above indicators between the control group and the traditional Chinese medicine group.[Conclusions]The endometrial receptivity of PCOS rats was decreased;Jiawei Buzhong Yiqi Decoction can improve the endometrial receptivity of PCOS rats by increasing the expression of LIF and integrinαvβ3 in the endometrium.

A network pharmacology analysis on Jiawei Buhuanjin Zhengqi powder against COVID-19 in children

Background:To clarify the effectiveness and potential mechanism of Jiawei Buhuanjin Zhengqi powder(JBZP)for the prevention and treatment of coronavirus disease 2019(COVID-19)in children based on network pharmacology.Methods:The active ingredients and action targets of Jiawei Buhuanjin Zhengqi powder formulas were obtained from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform.Genes related to COVID-19 were found on the GeneCards database.The active ingredients-target network map was constructed by Cytoscape.The action mechanisms of these genes were predicted using a Gene Ontology-based functional enrichment and annotation tool and the Kyoto Encyclopedia of Genes and Genomes.Results:Through Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform,187 eligible compounds and 12,921 targets of Jiawei Buhuanjin Zhengqi powder were identified.A total of 257 genes related to Jiawei Buhuanjin Zhengqi powder and 401 genes related to COVID-19 in children were screened and 59 common target genes were obtained.The network analysis showed that the predicted seven main active components were Quercetin,Luteolin,Wogonin,Kaempferol,Irisolidone,Nobiletin and Licochalcone a.Gene Ontology and the Kyoto Encyclopedia of Genes and Genomes enrichment analysis revealed that key targets were associated with regulating immunological function or glycosylation through the biological processes.Conclusion:The potential mechanisms of Jiawei Buhuanjin Zhengqi powder on COVID-19 in children might be related to anti-inflammatory,virus infection,and immunomodulatory signaling pathway.

加味百合地黄汤对围绝经期抑郁症模型大鼠HPO轴和雌激素受体表达的影响

目的基于下丘脑-垂体-卵巢(hypothalamic-pituitary-ovarian,HPO)轴及雌激素受体(estrogen receptor,ER)探明加味百合地黄汤治疗围绝经期抑郁症的功效及潜在机制。方法将大鼠随机分为正常对照组、模型组、阳性药物组(氟哌噻吨美利曲水溶液1.89 mg/kg)以及加味百合汤高、中、低剂量组(16.2 g/kg、8.1 g/kg、4.05 g/kg),每组10只。除正常对照组外,其他组均采用双侧卵巢摘除联合慢性不可预见性应激建立围绝经期抑郁症大鼠模型。各组给药21 d后采用糖水偏好实验和强迫游泳实验评价大鼠抑郁样行为,酶联免疫吸附法检测血清促性腺激素释放激素(gonadotropin-releasing hormone,GnRH)、卵泡刺激素(follicle-stimulating hormone,FSH)、黄体生成素(luteinizing hormone,LH)、雌二醇(estradiol,E2)含量,HE染色观察下丘脑、垂体、海马等组织病理损伤情况,RT-PCR和Western blot法检测下丘脑、海马组织雌激素受体基因及蛋白的表达。结果与正常对照组比较,模型组大鼠糖水偏好度显著下降(P<0.01),强迫游泳不动时间显著增加(P<0.01),表现出明显抑郁样行为,血清GnRH、FSH、LH含量均显著升高(P<0.01或P<0.05),E2降低(P<0.01),下丘脑、垂体及海马组织受损,雌激素受体表达显著降低(P<0.01);经加味百合地黄汤干预治疗后,模型组大鼠抑郁样行为显著改善(P<0.01或P<0.05),HPO轴亢进状态及海马损伤得以缓解,下丘脑、海马雌激素受体表达均显著增加(P<0.01或P<0.05)。与阳性药物组比较,加味百合地黄汤高剂量组下丘脑雌激素受体基因表达显著增加(P<0.05)。结论加味百合地黄汤通过抑制HPO轴亢进及增加脑内雌激素受体水平,发挥抗围绝经期抑郁症作用。

Therapeutic Effect of Shaoyao Jiawei Gancao Decoction(芍药加味甘草汤)with Acupoint Application on Chronic Lumbar Muscle Strain and the Recovery of Lumbar Strength

Objective:To study the therapeutic effect of Shaoyao Jiawei Gancao Decoction(芍药加味甘草汤)with acupoint application on chronic lumbar muscle strain and the recovery of lumbar strength.Methods:From August 2018 to August 2019,100 patients with chronic lumbar muscle strain admitted to our hospital were selected and randomly divided into an acupoint application group and a combined group of 50 cases each.The acupoint application group was treated by acupoint application,and the combined group was treated with Shaoyao Jiawei Gancao Decoction(芍药加味甘草汤)based on acupoint application.The indexes scores,VAS scores,ADL scores,ODI scores,lumbar endurance,TCM syndrome scores and the treatment effects of the two groups before and after treatment were statistically analyzed,and TNF-αand TXB2 levels were detected.Results:After treatment,the scores of indexes,VAS,ODI,TCM syndrome,TNF-αand TXB2 in the combined group were lower than those in the acupoint application group,and the ADL score,lumbar endurance and treatment efficiency were higher than those in the acupoint application group,with a statistical difference(P<0.05).Conclusion:Shaoyao Jiawei Gancao Decoction(芍药加味甘草汤)with acupoint application can effectively reduce pain,improve lumbar function,restore lumbar strength,effectively relieve inflammation,with significant effects.

加味普济消毒颗粒内服联合消肿散结膏外敷治疗儿童急性扁桃体炎的临床研究

【目的】评价加味普济消毒颗粒(由金银花、连翘、蒲公英、紫花地丁、荆芥、牛蒡子、皂角刺、赤芍、牡丹皮、芦根等组成)内服联合消肿散结膏(由黄芩、黄连、黄柏、皂角刺等组成)外敷治疗儿童急性扁桃体炎(acute tonsillitis in children,ATC)的临床疗效及对免疫功能与相关炎症指标的影响。【方法】将116例ATC肺胃郁热证患儿随机分为对照组和观察组,每组各58例。对照组给予头孢克肟分散片治疗,观察组给予加味普济消毒颗粒内服联合消肿散结膏外敷治疗,疗程为14 d并随访6个月。观察2组患儿治疗前后中医证候积分、外周血中白细胞计数(WBC)、T淋巴细胞亚群CD3^(+)、CD4^(+)、CD8^(+)和CD4^(+)/CD8^(+)水平及血清肿瘤坏死因子α(TNF-α)、白细胞介素1β(IL-1β)、白细胞介素6(IL-6)、C反应蛋白(CRP)水平的变化情况,比较2组患儿的临床疗效和各项临床症状消失时间,同时监测2组患儿的不良反应发生情况和扁桃体炎复发情况。【结果】(1)研究期间,对照组有8例患儿脱落,观察组无脱落病例,最终对照组50例、观察组58例患儿完成全部疗程的治疗。(2)治疗14 d后,观察组的总有效率为98.28%(57/58),对照组为90.00%(45/50);组间比较(秩和检验),观察组的临床疗效明显优于对照组(P<0.05)。(3)治疗后,观察组患儿的咽痛消失时间、脓点消失时间、退热时间及扁桃体恢复正常时间均较对照组明显缩短(P<0.05)。(4)治疗后,2组患儿的主症积分、次症积分和中医证候总积分均较治疗前明显降低(P<0.05),且观察组的降低幅度均明显优于对照组(P<0.05)。(5)治疗后,2组患儿的T淋巴细胞亚群CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平均较治疗前明显升高(P<0.05),CD8^(+)水平均较治疗前明显降低(P<0.05),且观察组对T淋巴细胞亚群CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平的升高幅度及对CD8^(+)水平的降低幅度均明显优于对照组(P<0.05)。(6)治疗后,2组患儿的WBC、TNF-α、IL-1β、IL-6及CRP水平均较治疗前明显降低(P<0.05),且观察组的降低幅度均明显优于对照组(P<0.05)。(7)治疗期间,2组患儿均未出现皮肤过敏及恶心、呕吐等胃肠道不良反应情况,具有较高的安全性。(8)随访6个月,观察组患儿的扁桃体炎复发率为5.17%(3/58),明显低于对照组的24.00%(12/50),组间比较,差异有统计学意义(χ2=8.330,P<0.05)。【结论】加味普济消毒颗粒内服联合消肿散结膏外敷治疗ATC肺胃郁热证患儿疗效显著,可明显缩短病程,改善临床症状,有效降低扁桃体炎复发率,其机制可能与增强机体免疫功能、抑制炎症反应有关。

甲氨喋呤联合加味活络效灵丹治疗类风湿关节炎40例临床观察

目的:观察甲氨蝶呤联合加味活络效灵丹治疗类风湿关节炎的临床疗效。方法:选取80例活动期瘀血痹阻型类风湿关节炎,随机分为对照组和观察组,每组40例,对照组予甲氨蝶呤治疗;观察组在对照组基础上予加味活络效灵丹治疗,两组均持续治疗12周,观察两组治疗前后中医证候积分、视觉模拟评分(VAS)、疾病活动度评分(DAS28)、简化疾病活动指数(SDAI),比较两组治疗前后红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)、25羟维生素D[25(OH)D]、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、关节超声中关节腔积液、滑膜增生、滑膜血流分级及不良反应。结果:治疗后,两组的中医证候积分、VAS、DAS28、SDAI评分均改善,且观察组优于对照组(P<0.05)。治疗后,两组的ESR、CRP、RF、IL-6、TNF-α水平均降低,25(OH) D水平升高,且观察组优于对照组(P<0.05),治疗后,两组关节超声中关节积液、滑膜血流及滑膜增生均有所改善,且观察组优于对照组(P<0.05)。观察组的总有效率高于对照组(P<0.05)。结论:采用甲氨蝶呤联合加味活络效灵丹治疗活动期类风湿关节炎的临床疗效确切,可有效缓解患者中医证候及临床症状,可减轻机体炎性反应,改善关节病变,疗效优于单用甲氨蝶呤治疗,可明显提高患者的生活质量,且安全性较高。

加味消癥方对慢性肾衰竭大鼠肾纤维化的保护作用及对肾小管上皮细胞TGF-β_(1)/Smad3信号通路的影响

目的:探讨加味消癥方对慢性肾衰竭大鼠肾纤维化的保护作用及对肾小管上皮细胞TGF-β_(1)/Smad3信号通路的作用影响。方法:观察加味消癥方对慢性肾衰竭大鼠的血肌酐、尿素氮、24 h尿蛋白定量、肾脏病理及肾组织中FN1、Col-Ⅰ、Col-Ⅲ表达水平的影响;观察加味消癥方对TGF-β_(1)诱导肾小管细胞损伤中TGF-β_(1)、Smad3、LC3、Beclin1及P62蛋白表达的影响。结果:与模型组相比,加味消癥方高剂量组的Scr水平及加味消癥各组和缬沙坦组的24 h尿蛋白水平显著降低(P<0.05,P<0.01);实时荧光定量PCR法检测提示加味消癥方高剂量组的FN1、Col-ⅠmRNA相对表达量、加味消癥方中剂量组和缬沙坦组的Col-ⅢmRNA相对表达量、高剂量组和缬沙坦组的TGF-β_(1)mRNA相对表达量以及高、中、低剂量组和缬沙坦组的Smad3 mRNA相对表达量均较模型组显著降低(P<0.05,P<0.01);Western Blot法检测提示加味消癥方高、中剂量组和缬沙坦组的FN蛋白表达量、加味消癥方高剂量组的Col-Ⅰ蛋白表达量、加味消癥方高、低剂量组和缬沙坦组的Col-Ⅲ蛋白表达量以及高、中剂量组的Beclin1蛋白表达量均较模型组显著降低(P<0.05,P<0.01);Masson染色观察加味消癥方高剂量组的肾间质纤维化程度显著减轻(P<0.01)。此外,该组的48 h/72 h细胞存活率显著升高(P<0.01)。结论:加味消癥方可有效提升细胞存活率,改善肾间质纤维化程度保护肾功能,可能是通过TGF-β_(1)/Smad3通路调控自噬水平,下调FN1、Col-Ⅰ、Col-Ⅲ水平实现的。

加味寿胎贴脐片释药动力学与药效学研究

本研究旨在通过体外透皮试验考察加味寿胎贴脐片的透皮效果,以大鼠先兆性流产模型的流产率、脏器指数、胚胎个数和血清激素水平为评价指标,进一步确定其疗效,以期为临床治疗先兆性流产提供疗效显著且使用方便的新制剂。试验采用Franz扩散池法进行体外透皮试验,考察贴脐片中金丝桃苷、槲皮素、大黄素和川续断皂苷Ⅵ的透皮吸收情况,以评价经皮渗透效果。建立大鼠先兆性流产模型,动物随机分为4组,即空白组、空白贴脐片对照组(只含辅料,不含药)、阳性组及加味寿胎贴脐片组,以流产率、脏器指数、胚胎个数、雌二醇(E2)、孕酮(P)、人绒毛膜促性腺激素(β-HCG)、前列腺素(PGF-2α)水平考察加味寿胎贴脐片对模型动物先兆性流产的影响。结果表明,加味寿胎贴脐片中4种指标成分24h累计透过量为142.68μg/cm^(2)、3.44μg/cm^(2)、3.78μg/cm^(2)、718.77μg/cm^(2),累计透过速率分别为0.0497μg/(cm^(2)·h)、0.0485μg/(cm^(2)·h)、0.0544μg/(cm^(2)·h)、0.045μg/(cm^(2)·h)。4种指标成分的透过率规律均符合一级动力学方程。金丝桃苷透过百分率为23.9%、槲皮素透过百分率为17.6%、大黄素透过百分率为27.7%、川续断皂苷Ⅵ透过百分率为27.1%。药效学试验结果显示,与空白贴脐片对照组相比,各给药组大鼠血清中E2、P、β-HCG的含量均有上调,PGF-2α的含量均有下调,贴脐片组在治疗先兆流产的作用上疗效显著,保胎效果更优。加味寿胎贴脐片具有体外经皮渗透的特性,对大鼠先兆性流产的治疗具有一定的改善作用,说明该制剂具有一定的临床开发价值。

基于Caspase-3/Bcl-2/Bax信号通路探究加味旋覆代赭汤治疗食管癌前病变的作用机制

目的:探究加味旋覆代赭汤对食管癌前病变大鼠Caspase-3/Bcl-2/Bax信号通路的调控作用机制。方法:将48只雄性SD大鼠随机分为4组,空白组、模型组、中药组、西药组,每组各12只。除空白组外均采用复合造模法制作食管癌前病变大鼠模型,造模成功后,分别进行药物灌胃干预,空白组、模型组用生理盐水灌胃,中药组和西药组分别给予加味旋覆代赭汤、西药(雷贝拉唑+莫沙必利)灌胃,给药8周取材。利用光学显微镜观察食管上皮组织的形态学变化;分别应用蛋白质印迹法(Western-blot)及聚合酶链式反应(PCR)检测食管上皮组织Caspase-3、Bcl-2及Bax的表达水平。结果:与空白组比较,模型组大鼠食管上皮病理积分升高(P<0.01);与模型组比较,中药组、西药组大鼠食管上皮病理积分均降低(P<0.01)。PCR及Western-blot检测结果显示,与空白组比较,模型组大鼠Caspase-3、Bax mRNA、蛋白表达均降低(P<0.01);与模型组比较,中药、西药组大鼠Caspase-3、Bax mRNA、蛋白表达均增高(P<0.05)。与空白组比较,模型组大鼠食管组织中Bcl-2 m RNA及蛋白表达水平均升高(P<0.05);与模型组比较,中药组和西药组Bcl-2 mRNA及蛋白表达水平均降低(P<0.05)。结论:加味旋覆代赭汤可能通过下调Bcl-2/Bax比值,增加线粒体外膜通透性,释放凋亡因子,激活Caspase-3,使病变组织发生凋亡,扭转食管上皮异型增生,从而起到治疗食管癌前病变的作用。

加味左金丸治疗肝胃郁热型功能性消化不良临床疗效及对相关激素水平的影响

目的观察加味左金丸治疗肝胃郁热型功能性消化不良的临床疗效及对相关激素水平的影响。方法研究纳入南京市中西医结合医院脾胃病科门诊治疗的120例肝胃郁热型功能性消化不良患者(2021年1月—2023年1月),将患者以随机数字表法分为对照组(60例)与治疗组(60例),给予对照组患者多潘立酮片治疗,给予治疗组患者多潘立酮片结合加味左金丸治疗,各组患者临床数据观察:临床治疗效果、治疗前后中医证候(上腹痛、餐后饱胀、上腹烧灼感、嗳气等)积分变化、上腹痛、餐后饱胀、上腹烧灼感、嗳气等证候改善时间、治疗前后患者胃泌素与胃动素水平变化、血清白介素-6(interleukin 6,IL-6)及肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)水平变化、尼平消化不良指数(nephrology dialysis transplantation, NDT)及生活质量量表(short form 36 questionnaire, SF-36)评分变化、不良反应。结果治疗组患者治疗总有效率比对照组高[95.00%(57/60)vs 83.33%(50/60)](P<0.05);治疗组患者上腹痛、餐后饱胀、上腹烧灼感、嗳气等证候改善时间均短于对照组患者(P<0.05);治疗前各组患者中医证候(上腹痛、餐后饱胀、上腹烧灼感、嗳气等)积分、胃泌素与胃动素水平、IL-6及TNF-α水平、NDT及SF-36评分比较(P>0.05),治疗后各组患者中医证候(上腹痛、餐后饱胀、上腹烧灼感、嗳气等)积分、胃泌素与胃动素水平、IL-6及TNF-α水平、NDT及SF-36评分均改善,治疗组患者治疗后中医证候(上腹痛、餐后饱胀、上腹烧灼感、嗳气等)积分、胃泌素与胃动素水平、IL-6及TNF-α水平、NDT及SF-36评分均优于对照组(P<0.05);治疗组患者不良反应与对照组不良反应均较少(P>0.05)。结论加味左金丸治疗肝胃郁热型功能性消化不良的临床疗效显著,可较好改善患者胃肠功能,促进患者更快恢复健康,且患者生活质量提升,治疗不良反应少,安全可靠。