Study on the Characteristics of Gut Microbiota in Chronic Hepatitis B(CHB)Patients with Damp Heat Syndrome and Liver Depression and Spleen Deficiency Syndrome

Objective:This study was designed to explore the characteristics of gut microbiota in CHB patients with two most common traditional Chinese medicine(TCM)Syndromes—damp heat syndrome and liver depression and spleen deficiency syndrome.Methods:According to the diagnostic criteria of Western medicine,TCM and screening exclusion criteria,65 cases of CHB with damp heat syndrome and 28 cases of CHB with liver depression and spleen deficiency syndrome were finally included in the study.All the basic information was gathered and the fresh fecal samples were collected for 16S rDNA sequencing.16S rDNA of gut microbiota was sequenced using Illumina hiseq 2,500 high-throughput sequencing platform.Based on the optimized sequence,Operational Taxonomic Units(OTU)clustering analysis and taxonomic annotation were carried out.Results:The difference in relative abundance of gut microbiota was significant between damp heat syndrome and liver depression and spleen deficiency syndrome in CHB patients.Cyanobacteria was only found in damp heat syndrome.The relative abundance of Erysipelotrichia and Subdoligranulum were higher in liver depression and spleen deficiency syndrome,while the relative abundance of Rhodospirillales,Alphaproteobacteria and Lachnospira were higher in the damp heat syndrome.LDA Effect Size(LEfSe)analysis showed that Lachnospira,Olsenella and Subdoligranulum had significant difference in species among the two TCM syndromes.Conclusion:The different characteristics of gut microbiota in the two TCM syndromes of CHB patients may play an important role in syndrome formation of TCM,which provides a new field of vision for the accurate diagnosis and treatment of TCM.

Screening the effective components in treating dampness stagnancy due to spleen deficiency syndrome and elucidating the potential mechanism of Poria water extract

Poria is an important medicine for inducing diuresis to drain dampness from the middle energizer.However,the specific effective components and the potential mechanism of Poria remain largely unknown.To identify the effective components and the mechanism of Poria water extract(PWE)to treat dampness stagnancy due to spleen deficiency syndrome(DSSD),a rat model of DSSD was established through weight-loaded forced swimming,intragastric ice-water stimulation,humid living environment,and alternate-day fasting for 21 days.After 14 days of treatment with PWE,the results indicated that PWE increased fecal moisture percentage,urine output,D-xylose level and weight;amylase,albumin,and total protein levels;and the swimming time of rats with DSSD to different extents.Eleven highly related components were screened out using the spectrum-effect relationship and LC-MS.Mechanistic studies revealed that PWE significantly increased the expression of serum motilin(MTL),gastrin(GAS),ADCY5/6,p-PKAα/β/γcat,and phosphorylated cAMP-response element binding protein in the stomach,and AQP3 expression in the colon.Moreover,it decreased the levels of serum ADH,the expression of AQP3 and AQP4 in the stomach,AQP1 and AQP3 in the duodenum,and AQP4 in the colon.PWE induced diuresis to drain dampness in rats with DSSD.Eleven main effective components were identified in PWE.They exerted therapeutic effect by regulating the AC-cAMP-AQP signaling pathway in the stomach,MTL and GAS levels in the serum,AQP1 and AQP3 expression in the duodenum,and AQP3 and AQP4 expression in the colon.

Efficacy of Modified Qufeng Runmian Powder(加减祛风润面散)on Acne Vulgaris with Syndromes of Dampness and Blood Stasis:A Multicenter,Randomized,Double-Blind,Placebo-Controlled Clinical Trial

Objective:To evaluate the efficacy and safety of a Chinese medicine(CM)Modified Qufeng Runmian Powder(加减祛风润面散,MQFRMP)for the treatment of acne vulgaris with CM syndromes of dampness and blood stasis.Methods:In this multicenter,randomized,double-blind,placebo-controlled clinical trial,220 acne vulgaris patients with CM syndrome of dampness and blood stasis were included and randomly assigned using a central area group random design to receive either MQFRMP or the placebo,with 110 cases in each group.MQFRMP or a placebo at 145 g/bag were administered once daily for 4 weeks,respectively.The primary index of efficacy was the effective rate according to the acne severity score(ASS).The secondary indices of efficacy included the changes in the dermatology life quality index(DLQI)score,VISIA scores(spots,pores,brown spots,porphyrins and red areas)and skin assessment(skin p H,sebum amount and hydration)according to a SOFT skin multianalyzer.Results:(1)Follow-up:a total of 204 patients completed the follow-up,with 103 in the treatment group and 101 in the control group.(2)Effective rate:the total effective rate of the treatment group was significantly higher than the control group[83.5%(86/103)vs.31.7%(32/101),P<0.01)]with 95%confidence interval of 39.3%–66.4%.(3)DLQI:DLQI scores were significantly decreased the treatment and control groups(both P<0.01),but the treatment group was more obvious than the placebo group(P<0.01).(4)VISIA scores:the scores of spots,brown spots and red areas in the treatment group decreased compared with baseline(P<0.05).In the control group,the scores of brown spots and pores decreased compared with baseline(P<0.05).The improvement was more obvious in the treatment group than in the control group for all items(P<0.05).(5)Skin assessment:the p H and sebum score in the both groups decreased drastically compared with the baseline(all P<0.01),however,the improvement was more obvious in the treatment group than in the control group(P<0.01).The hydration amount in the two groups showed no statistically significant difference compared with the baseline(both P>0.05).(6)Safety:two cases of mild drug allergy were observed in the treatment group.Conclusion:MQFRMP was effective and safe for the treatment of acne vulgaris with syndromes of dampness and blood stasis.(No.ChiCTR1900020479).

Formulation Mechanism of Mailuo Shutong Pills in the Treatment of Varicocele

Varicocele is a common disease in male urology clinic,mainly manifested as testicular pendent distension discomfort,scrotal moisture,less weak semen and other symptoms.There is no specific drug in clinical treatment of modern medicine and traditional Chinese medicine.Mailuo Shutong Pills was created by TANG Zuxuan,a Chinese medical master,for the treatment of damp and heat stasis type thrombotic superficial phlebitis and other vascular diseases.In clinical application,it was found to have a good clinical effect on the treatment of symptoms caused by varicose vein.This paper analyzed the formulation mechanism of Mailuo Shutong Pills in the treatment of varicocele from the perspective of traditional Chinese and western medicine,and provides theoretical basis for clinical application.