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.

Inhibition of N-methyl-N-nitrosourea-induced gastric tumorigenesis by Liuwei Dihuang Pill in db/db mice

AIM To investigate the inhibitory effect of Liuwei Dihuang Pill(LDP) on gastric tumorigenesis induced by N-methyl-N-nitrosourea(MNU) in diabetic mice.METHODS Four-week-old mice were divided into four groups: A, 12 db/m mice treated with MNU and saline, as the non-diabetic control; B, 12 db/db mice treated with MNU and saline, as the diabetic control; C, 12 db/db mice treated with MNU and metformin, as the positive control; and D, 12 db/db mice treated with MNU and LDP. MNU was administrated for 20 wk to induce gastric carcinogenesis. LDP was administrated for 10 wk for improvement of insulin resistance. Body weight and food intake were measured every week. Blood samples were collected for assays of fasting blood glucose, insulin, insulin-like growth factor(IGF)-1, adiponectin and leptin. Stomach tissues were collected for histopathological analysis, immunohistochemical staining of Ki67, quantitative reverse transcriptionpolymerase chain reaction and western blotting. RESULTS The incidence of MNU-induced gastric dysplasia was significantly elevated in diabetic(db/db) mice relative to the control(db/m) mice. The incidence of gastricdysplasia was significantly reduced by LDP with suppression of cell proliferation, as demonstrated by a decrease in Ki67 staining. Hyperglycemia, hyperinsulinemia and serum IGF-1 were inhibited by LDP. Expression of IGF-1 and insulin receptor m RNAs was decreased, phosphorylation of IGF-1 receptor and AKT protein was reduced in the stomach tissues by LDP. In addition, adiponectin was increased and leptin was decreased in the serum by LDP. CONCLUSION LDP decreased risk of gastric dysplasia in type 2 diabetic mice by down-regulation of IGF and insulin activity and correction of adipokines disorders.

Liuwei Dihuang Pill(六味地黄丸)Treats Postmenopausal Osteoporosis with Shen(Kidney) Yin Deficiency via Janus Kinase/Signal Transducer and Activator of Transcription Signal Pathway by Up-regulating Cardiotrophin-Like Cytokine Factor 1 Expression

Objectives： To investigate the mechanism of Liuwei Dihuang Pill （六味地黄丸, LDP） in treating postmenopausal osteoporosis （PMOP） with Shen （Kidney） yin deficiency. Methods： In this study, 205 cases of PMOP were divided into the PMOP Shen-yin deficiency group （Group A）, PMOP Shen-yang deficiency group （Group B）, PMOP without Shen deficiency group （Group C）, and control group （Group N）. Real-time polymerase chain reaction （RT-PCR） and Western blot techniques were used to observe the effects of LDP treatment on the cardiotrophin-like cytokine factor 1 （CLCF1）, ankyrin repeat and SOCS box containing 1 （ASB1）, and proldneticin 2 （PROK2） genes and the Janus kinase/signal transducer and activator of transcription （JAK/STAT） signaling pathway. Results： The mRNA （P〈0.05） and protein （P〈0.01） expression levels of the CLCF1 gone in Group A were significantly lower than the corresponding levels in Group N. After LDP treatment for 3 months, the mRNA expression levels of the CLCF1 gone were obviously up-regulated （P〈0.01）. After 6-month treatment, the expression levels of CLCF1 mRNA and protein were significantly up-regulated （both P〈0.01）, and the average bone density of the top femur had significantly increased （P〈0.05）. In vitro, CLCF1 overexpression resulted in a significant increase in the total protein and phosphorylated protein levels of JAK2 and STAT3. Conclusions： The CLCF1 gone is an important gone associated with PMOP Shen-yin deficiency and the therapeutic effects of LDP may be mediated by up-regulation of CLCF1 gone expression and activation of the JAK/STAT signaling pathway.

Liuwei Dihuang Pills(六味地黄丸) Enhance the Effect of Western Medicine in Treating Type 2 Diabetes:A Meta-Analysis of Randomized Controlled Trials

Objective： To perform meta-analyses evaluating the efficacy of adding Liuwei Dihuang Pills （六味地黄丸 LDP） to Western medicine in improving treatment outcomes for type 2 diabetes. Methods： Medline, PubMed, Cochrane Library, and Chinese databases, including the Chinese National Knowledge Infrastructure were searched to identify eligible studies; i.e., if the study involved a randomized clinical trial in which the experimental group combined LDP with Western drugs and the control group used the corresponding Western drugs alone to treat type 2 diabetes. Outcomes were measured in terms of fasting blood glucose （FBG）, postprandial blood glucose （2hPG） and HbAlc level. Efficacy was also measured by using control and response rates. The combined odds ratio （OR）, mean difference （MD）, and 95% confidence intervals （95% CI） were calculated. Results： Studies included in the analysis were less adequate than expected in terms of methodological qualify. A total of 1,609 patients from 18 studies were included. We found that adding LDP can lower patients＇ FBG （MD=0.54 mmol/L, 95% CI [0.15, 0.93], P=0.007）, 2hPG （MD=1.05 mmol/L, 95% CI [0.29, 1.81], P〈0.01） and HbAlc （MD=0.23, 95% CI [0.02, 0.45], P=0.008）. There were also improvements in treatment response rates （OR=3.41, 95% CI [2.38, 4.90], P〈0.01） and control rates （OR=2.47, 95% CI [1.91, 3.20], P〈0.01）. Conclusion： Adding LDP to Western medicine might improve treatment outcomes of diabetes, including FBG, 2hPG, response rates and control rates.

Liuwei Dihuang pill suppresses metastasis by regulating the wnt pathway and disrupting β-catenin/T cell factor interactions in a murine model of triple-negative breast cancer

OBJECTIVE:To investigate if the Liuwei Dihuang pill(LWDHP)can inhibit metastasis to the liver and lungs in mice bearing triple-negative breast cancer(TNBC),and the molecular mechanism underpinning this action.METHODS:Ninety-nine TNBC bearing-mice were distributed randomly to five groups:control(Con),paclitaxel(PTX),low-dose LWDHP(LLP,2.3 g·kg^-1·d^-1),middle-dose LWDHP(MLP,4.6 g·kg^-1·d^-1)and high-dose LWDHP(HLP,9.2 g·kg^-1·d^-1).The LWDHP were administered(p.o.)to the agonal stage.The morphology of BC cells was observed by hematoxylin&eosin staining.Expression of axin-2,β-catenin,T cell factor(TCF),cyclin-D1 and vascular endothelial growth factor(VEGF)was detected by western blotting or immunofluorescence.β-catenin/TCF-1 interaction was measured using a co-immunoprecipitation assay.RESULTS:After LWDHP treatment,metastasis of BC cells to the lungs and liver was inhibited,expression of axin-2 was increased,expression of TCF-1,β-catenin,cyclin-D1 and VEGF was decreased,andβ-catenin/TCF-1 interaction was disrupted.CONCLUSION:The LWDHP could inhibit metastasis of BC cells to the liver and lungs.The molecular mechanism underlying this action may be regulation of protein expression andβ-catenin/TCF-1 interactions in the Wnt pathway.

Contribution of Borneolum syntheticum to the Intervention Effect of Liuwei Dihuang Pill (六味地黄丸) on Experimental Retinal Degeneration

Objective： To observe the contribution of Borneolum syntheticum to the intervention effect of Liuwei Dihuang Pill （六味地黄丸, LDP） on experimental retinal degeneration, and initially investigate the mechanism of Borneolum syntheticum as meridian-lead-in drug. Methods： A total of 180 sodium iodate- induced retinital degeneration rats were randomly divided into three groups, including distilled water group, LDP group, and LDP＋Borneolum syntheticum （LDP＋BS） group. Twenty normal rats were fed regularly without any treatment as normal control. On day 7 and 14 after treatment, histopathological study and transferase-mediated deoxyuridine triphosphate-biotin nick end labeling （TUNEL） test were performed to evaluate the retinopathy. Claudin-5 expression at blood-retina barrier （BRB） was detected by Western blot at different time points from 0.5 to 8 h after gavage. Results： On day 7 and 14 after treatment, the retinal lesion grades were significantly different among the three groups （P〈0.05）. The grade in the LDP＋BS group was significantly less than the LDP and distilled water groups （both P〈0.05）, no significant difference was observed between the LDP and distilled water groups （P〉0.05）. The apoptosis rates in the LDP＋BS group was significantly less than the distilled water and LDP groups （both P〈0.05）, while there was no significant difference between LDP and distilled water groups （P〉0.05）. Expression of claudin-5 in LDP＋BS group was significantly less than the other two groups at 0.5, 1 and 2 h after gavage （P〈0.05）. There was no apparent difference among the three groups at 4 and 8 h after gavage （P〉0.05）. Conclusion： Bomeolum syntheticum could strengthen the effect of LDP on experimental retinal degeneration, indicated that Bomeolum syntheticum might play the role of meridian-lead-in drug in the formula. The mechanism may be due to Bomeolum syntheticum could promote the physiologically openness of blood- retina barrier through transiently affecting the expression of claudin-5.

Changes of Leucocytic Estrogen Receptor Levelsin Patients with Climacteric Syndrome andthe Therapeutic Effects of LiuweiDihuang Pills (六味地黄丸)

he levels of estrogen receptor (ER) in human peripheral leucocytes in 22 women withclimacteric syndrome were measured by radioligand method. The results were compared with those of 12healthy women of child-bearing age. It was found that the contents of leucocytic ER in patients with cli-macteric syndrome were significantly lower than healthy women of child-bearing age (372±149 vs 1143±255 Rs binding sites/cell). The authors used a Chinese prescription---Liuwei Dihuang Pills (LDP) totreat the patients for 2 months. The levels of leucocytic ER were increased affer treatment. The data indi-cate a decrease of ER Ievels in leucocytes may be involved in the pathogenesis of climacteric syndrome.LDP not only increase plasma estradiol levels , but also increase the leucocytic ER levels. This may be thebasis of the therapeutic effect of LDP on climacteric syndrome.

六味地黄丸治疗早发性卵巢功能不全模型小鼠的分子机制

背景:在临床上,大多数治疗早发性卵巢功能不全的方剂均以六味地黄丸为基础方演变而来,并且取得了较好的疗效。目前对六味地黄丸的实验研究大多为体内动物模型的形态学观察及生理生化指标的检测,而分子机制方面的研究报道较少。目的:探讨六味地黄丸治疗早发性卵巢功能不全的分子作用机制。方法:环磷酰胺120 mg/kg联合白消安12 mg/kg腹腔注射制备早发性卵巢功能不全小鼠模型,然后用六味地黄丸混悬液对早发性卵巢功能不全小鼠进行干预,干预12周采用ELISA法检测小鼠血清中促卵泡刺激素、促黄体生成素、雌激素、抗苗勒氏管激素、8-羟脱氧鸟苷、总抗氧化能力、活性氧水平;苏木精-伊红染色观察小鼠卵巢形态学改变;透射电镜观察小鼠卵泡颗粒细胞超微结构及颗粒细胞线粒体的凋亡情况;免疫组化法检测六味地黄丸对小鼠卵巢颗粒细胞中核受体转录辅激活因子(receptor gamma coactivator-1 alpha,PGC-1α)、线粒体转录因子A(mitochondrialtranscriptionfactorA,TFAM)的表达水平。结果与结论:①与模型组比较,实验组小鼠血清促卵泡刺激素、促黄体生成素、活性氧、8-羟脱氧鸟苷水平降低(P<0.05),雌激素、抗苗勒氏管激素、总抗氧化能力水平升高(P<0.05);②苏木精-伊红染色发现模型组小鼠卵巢组织中闭锁卵泡和黄体较多,个别可见次级卵泡,间质纤维化增生;实验组小鼠卵巢组织可见大量闭锁卵泡,黄体较少,边缘可见原始卵泡,次级卵泡较少,未见明显成熟卵泡;③透射电镜发现实验组小鼠卵巢颗粒细胞内细胞器较完整;④免疫组化结果显示,实验组小鼠卵巢组织PGC-1α的表达水平在第4周稍有升高至第8,12周无明显变化,与模型组有明显差异;实验组小鼠卵巢组织TFAM的表达水平在第4周时短暂升高,然后稍有所下降,但结果均与模型组有明显差异;⑤结果表明,六味地黄丸通过PGC-1α-TFAM-ROS信号通路在一定程度上抑制早发性卵巢功能不全小鼠卵巢颗粒细胞凋亡,从而改善卵巢的内分泌功能,提高机体抗氧化能力,减轻氧化应激损伤程度。

六味地黄丸干预FGF23/Klotho轴对慢性肾衰竭钙磷代谢紊乱模型大鼠的影响

目的:观察六味地黄丸通过成纤维细胞生长因子23(FGF23)/Klotho轴对慢性肾衰竭钙磷代谢紊乱模型大鼠的影响及其干预机制。方法:50只SPF级SD大鼠随机分为假手术组(10只)、手术组(40只),手术组采用5/6肾切除及高磷饮食喂养构建慢性肾衰竭钙磷代谢紊乱大鼠模型,模型复制成功后将30只造模成功大鼠随机分为模型组、骨化三醇组、六味地黄丸组,每组10只。六味地黄丸组、骨化三醇组大鼠分别予六味地黄丸和骨化三醇灌胃,假手术组及模型组大鼠予等体积的蒸馏水灌胃,持续给药8周。HE染色观察肾组织变化,检测大鼠血清钙(Ca^(2+))、磷(P^(3+))、碱性磷酸酶(ALP)、甲状旁腺激素(PTH)、肌酐(Scr)、尿素氮(BUN),免疫组化及Western blotting法检测大鼠肾皮质Klotho、FGF23蛋白的表达。结果:HE染色显示,模型组大鼠肾小球结构紊乱、肾小管扩张,间质有大量炎症细胞浸润;与模型组比较,六味地黄丸组大鼠肾小球轻度增生,肾小管轻度扩张,间质炎症细胞浸润数目减少。模型组大鼠血清Scr、BUN、P^(3+)、PTH、ALP高于假手术组(P<0.01),体质量、血清Ca^(2+)低于假手术组(P<0.01);六味地黄丸组大鼠血清Scr、BUN、P^(3+)、PTH、ALP低于模型组,体质量、血清Ca^(2+)高于模型组(P<0.01)。模型组大鼠肾皮质Klotho蛋白相对表达量低于假手术组(P<0.05),FGF23蛋白相对表达量高于假手术组(P<0.01);六味地黄丸组大鼠肾皮质Klotho蛋白相对表达量高于模型组(P<0.01),FGF23蛋白相对表达量低于模型组(P<0.01)。六味地黄丸组大鼠血Scr、BUN及肾皮质FGF23、Klotho蛋白相对表达量与骨化三醇组比较,差异无统计学意义(P>0.05)。六味地黄丸组大鼠血P^(3+)、Ca^(2+)高于骨化三醇组(P<0.05)。结论:六味地黄丸可能通过调控FGF23/Klotho轴改善慢性肾衰竭钙磷代谢紊乱模型大鼠的肾功能和钙磷代谢。

针灸联合六味地黄丸序贯治疗肾精亏虚型早发性卵巢功能不全临床观察

目的探究针灸联合六味地黄丸序贯治疗对肾精亏虚型早发性卵巢功能不全(POI)的临床效果。方法将63例POI患者纳入试验,于月经期、经后期口服六味地黄丸,排卵期、经前期行灸法序贯治疗,针刺治疗贯穿后三期,隔日1次,每周治疗3次;连续治疗3个月经周期。观察序贯治疗对患者促卵泡生成激素(FSH)、促黄体生成素(LH)、雌二醇(E2)水平及中医证候积分的影响。结果治疗3个月后,患者E2增高,FSH、LH均降低,中医证候得到有效改善(P<0.05)。结论采用针灸联合六味地黄丸序贯治疗肾精亏虚型POI,能较好地改善性激素水平及临床症状,且具有良好安全性。

基于PI3K/Akt/mTOR信号通路、性激素、骨代谢探究知柏地黄丸联合治疗女性特发性性早熟的效果及机制

目的探讨联合知柏地黄丸对女性特发性性早熟(CPP)患儿性激素、骨代谢及PI3K/Akt/mTOR信号通路的影响。方法选取2022年1月—2022年12月收治的60例CPP患儿,随机数字表法分为西药组、联合组2组,均30例。西药组给予注射用曲普瑞林治疗,联合组在西药组基础上联合知柏地黄丸治疗。比较2组临床疗效、安全性,以及治疗前后子宫体积、卵巢体积、卵泡直径、性激素水平[促黄体生成素(LH)、LH/促卵泡激素(FSH)、雌二醇(E_(2))]、骨代谢指标[骨钙素、骨碱性磷酸酶(BALP)、Ⅰ型前胶原氨基端肽(PⅠNP)、骨密度、β-胶原降解产物(β-CTX)]、PI3K/Akt/mTOR信号通路相关蛋白表达。结果联合组总有效率96.67%(29/30)高于西药组70.00%(21/30)(P<0.05)。联合组治疗后子宫体积、卵巢体积、卵泡直径均低于西药组(P<0.05);联合组治疗后血清LH、LH/FSH、E_(2)、骨钙素、BALP、PⅠNP水平低于西药组,骨密度高于西药组(P<0.05)。2组治疗后血清β-CTX水平比较无显著差异(P>0.05)。联合组治疗后PI3K、Akt、mTOR蛋白表达水平低于西药组(P<0.05)。联合组不良反应总发生率与西药组比较无显著差异(P>0.05)。结论注射用曲普瑞林联合知柏地黄丸能降低CPP患儿性激素水平,改善骨代谢相关因子的表达,抑制PI3K/Akt/mTOR信号通路活性,从而改善患儿症状。研究结果表明该方案临床疗效确切,且具有一定安全性。

六味地黄丸联合大黄液治疗慢性牙周炎的效果分析

目的:分析六味地黄丸联合大黄液治疗慢性牙周炎的效果及对牙龈指数(GI)、探针深度(PD)的影响。方法:选取2021年1月-2022年1月广州市胸科医院诊治的慢性牙周炎患者86例作为研究对象,按照随机数字表法分为对照组和联合组,各43例。两组患者均采用常规治疗,对照组在此基础上局部应用大黄液治疗,联合组在对照组基础上给予六味地黄丸治疗。比较两组临床疗效、中医证候积分、牙周健康指标和炎性因子水平。结果:联合组临床疗效总有效率高于对照组,差异有统计学意义(P=0.044)。治疗后,两组牙齿松动、肢体沉重、牙龈红肿、胸闷口苦、反复咽痛评分均下降,且联合组低于对照组,差异有统计学意义(P<0.05);治疗后,两组GI和PD均下降,联合组低于对照组,差异有统计学意义(P<0.05);治疗后,两组C反应蛋白、肿瘤坏死因子-α和白细胞介素-1β水平均下降,且联合组低于对照组,差异有统计学意义(P<0.05)。结论:六味地黄丸联合大黄液治疗慢性牙周炎的临床效果显著,可有效改善患者中医证候积分和牙周健康指标,降低炎性因子水平。

中药治疗女童性早熟的临床效果

目的:分析中药治疗女童性早熟的临床效果。方法:选择2020年3月—2023年9月在江西省妇幼保健院接受体检的乳房早发育的80例女童为研究对象,以诊断结果为依据分为A组、B组。诊断为不完全性性早熟的43例患儿为A组,以随机数字表法分为两组,观察A组21例,对照A组22例。诊断为特发性中枢性性早熟的37例患儿为B组,以随机数字表法分为2组,观察B组18例,对照B组19例。对照A组和对照B组选择知柏地黄丸治疗,观察A组和观察B组在知柏地黄丸治疗的基础上加用大补阴丸治疗。比较临床效果,乳房、子宫、卵巢大小,骨龄指数及不良反应发生率。结果:观察A组总有效率高于对照A组,观察B组总有效率高于对照B组,差异均有统计学意义(P<0.05)。与治疗前相比,四组治疗后乳核直径均缩短,子宫容积、卵巢容积均较治疗前减少,且观察A组均优于对照A组,观察B组均优于对照B组,差异均有统计学意义(P<0.05)。观察A组、观察B组骨龄指数均低于治疗前(P<0.05);对照A组、对照B组骨龄指数与治疗前比较,差异均无统计学意义(P>0.05);治疗后,观察A组低于对照A组,观察B组低于对照B组,差异均有统计学意义(P<0.05)。对照A组与观察A组不良反应发生率相比,对照B组与观察B组相比,差异均无统计学意义(P>0.05)。结论:相比较知柏地黄丸,大补阴丸联合知柏地黄丸治疗不完全性性早熟和特发性中枢性性早熟女童的效果更佳,能够显著改善患儿的体征,抑制早熟症状,延缓骨骼成熟,应用价值较高。

基于网络药理学和分子对接探讨六味地黄丸异病同治老年性聋和阿尔茨海默病的作用机制

目的借助网络药理学和分子对接的方法探讨六味地黄丸异病同治老年性聋和阿尔茨海默病(AD)的共同分子机制,并采用细胞实验进行验证。方法利用中药系统药理学数据库与分析平台(TCMSP)、成分靶点数据库(SwissADME)获取六味地黄丸有效成分,并结合基因和化学物质相互作用预测数据库(STITCH)获取作用靶点。利用人类基因综合数据库(Genecard)、人类疾病相关基因与突变位点信息数据库(DisGeNET)获取老年性聋和AD靶点。使用Cytoscape 3.7.1软件构建“中药-成分-靶点-疾病”网络,借助蛋白互作网络分析数据库(STRING)构建蛋白-蛋白相互作用(PPI)网络,获取核心靶点。利用富集分析数据平台(Metascape)对共有靶点进行基因本体(GO)和京都基因与基因组百科全书(KEGG)富集分析。采用AutoDock Vina 1.1.2软件对核心靶点与相关成分进行分子对接。采用过氧化氢(H2O2)致PC12细胞氧化损伤模型,观察六味地黄丸的作用。采用细胞计数(CCK-8)法观察细胞存活率,活性氧(ROS)检测试剂盒检测ROS水平,酶联免疫吸附测定(ELISA)法检测肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平,Western blot法检测基质金属蛋白酶-9(MMP-9)、蛋白激酶B(AKT)、磷酸化-蛋白激酶B(p-AKT)蛋白表达。结果共获得六味地黄丸有效成分86种,主要来自薯蓣皂素、视黄醇、丹皮酚、软脂酸等化合物,六味地黄丸防治老年性聋和AD共有靶点49个,核心靶点为AKT1、TNF、IL-6、MMP-9等。GO分析表明这些共有靶点主要参与对氧化应激的反应、对脂多糖的反应等生物进程。KEGG通路分析显示,共有靶点主要涉及缺氧诱导因子-1(HIF-1)、核因子-κB(NF-κB)等信号通路。分子对接结果显示,TNF-α、IL-6、AKT1、MMP-9与相关成分均存在结合可能。细胞实验结果发现,六味地黄丸含药血清可以增强细胞存活率,降低细胞ROS、TNF-α、IL-6水平,增加MMP-9蛋白表达水平,降低p-AKT蛋白表达水平。结论六味地黄丸异病同治老年性聋和AD具有物质基础,其共同的分子机制,可能是通过薯蓣皂素、视黄醇、丹皮酚等多种成分,作用于AKT、TNF-α、IL-6、MMP-9等核心靶点,抑制炎症反应和氧化应激,减少神经元死亡。

基于BDNF/TrkB/CREB通路研究六味地黄丸对丙戊酸钠诱导的孤独症谱系障碍模型仔鼠的作用机制

目的基于脑源性神经营养因子(brain-derived neurotrophic factor,BDNF)/酪氨酸激酶受体B(tyrosine kinase receptor B,TrkB)/cAMP反应元件结合蛋白(cAMP response element binding protein,CREB)通路,探讨六味地黄丸对丙戊酸钠(sodium valproate,VPA)诱导的孤独症谱系障碍(autism spectrum disorder,ASD)仔鼠的作用机制。方法将13只SD孕鼠随机分为两组,其中10只孕鼠在第12.5天时腹腔注射VPA溶液(600 mg·kg^(-1))为VPA组,另外3只孕鼠注射等体积生理盐水为对照组。第21天对两组雄性仔鼠开展行为学检测,筛选出符合ASD疾病模型的仔鼠30只,随机分为模型组(等体积生理盐水),维生素D组(1480 IU·kg^(-1)),六味地黄丸高(3 g·kg^(-1))、中(1.5 g·kg^(-1))、低(0.75 g·kg^(-1))剂量组,每组6只。正常雄性仔鼠6只,设为空白组(等体积生理盐水)。各组仔鼠连续灌胃14 d,1次/d,给药后再次开展行为学检测。尼氏染色观察各组仔鼠海马组织神经元形态学变化,比色法检测各组仔鼠海马组织中谷氨酸(glutamic acid,GLU)、γ-氨基丁酸(gamma-aminobutyric acid,GABA)含量;qRT-PCR检测各组仔鼠海马组织中BDNF、TrkB、CREB mRNA相对表达。结果与对照组比较,VPA组仔鼠体质量、身长、尾长更小(P<0.05)。与空白组比较,模型组社交障碍症状明显(P<0.01),焦虑障碍症状明显(P<0.01),重复刻板行为增多(P<0.05或P<0.01),海马神经元结构损伤,GLU升高(P<0.01)、GABA下降(P<0.01),BDNF、TrkB、CREB mRNA表达降低(P<0.05或P<0.01);与模型组比较,维生素D组及六味地黄丸中、低剂量组仔鼠社交能力增强(P<0.05或P<0.01),焦虑障碍减轻(P<0.05或P<0.01),重复刻板行为减少(P<0.01或P<0.05),海马神经元结构明显复原,GLU下降(P<0.01),BDNF、TrkB、CREB mRNA表达增加(P<0.05或P<0.01),六味地黄丸中、低剂量组GABA上升(P<0.05或P<0.01)。结论六味地黄丸能显著改善VPA诱导的ASD仔鼠行为表现,增强海马组织神经元的再生与修复,其机制可能与平衡GLU、GABA水平,上调仔鼠海马组织中BDNF/TrkB/CREB的表达有关。

基于网络药理学结合动物实验探究六味地黄丸治疗孤独症谱系障碍的作用机制

目的采用网络药理学、分子对接技术结合动物实验探究六味地黄丸治疗孤独症谱系障碍(autism spectrum disorder,ASD)的潜在作用机制。方法通过TCMSP数据库获取六味地黄丸的有效活性成分及对应的靶基因信息,通过GeneCards、OMIM、DrugBank数据库获取ASD疾病靶基因;将上述靶基因用韦恩图取交集后再用STRING数据库构建关键靶点PPI网络;用Metascape数据库对关键靶点进行GO功能和KEGG信号通路富集分析;用Autodock软件对核心靶点及六味地黄丸有效成分进行分子对接。动物实验验证:选用8只SPF级SD孕鼠,随机分为空白孕鼠组(1只)及模型孕鼠组(7只),采用腹腔注射丙戊酸钠(valproate,VPA)造模。筛选符合ASD疾病模型的30只雄性仔鼠,随机分为模型对照组,维生素D组和中药高、中、低剂量组;同样筛选出空白仔鼠,为空白组,每组6只。中药低、中、高剂量组分别予六味地黄丸悬浮液0.75、1.5、3 g/kg灌胃;维生素D组予维生素D滴剂1480 IU/kg灌胃;模型组、空白组予等量生理盐水灌胃。均干预1次/d,连续干预2周。采用三箱社交实验、旷场实验评估大鼠社交情况;ELISA检测各组仔鼠海马体糖原合成酶激酶3β(glycogen synthase kinase 3β,GSK3β)、β-连环蛋白(β-Catenin)水平;Western blot检测各组仔鼠海马体中β-Catenin、髓细胞增生原癌基因(cellular myelocytomatosis oncogene,c-Myc)、细胞周期蛋白D1(cell cycle protein D1,Cyclin D1)蛋白表达水平。结果从六味地黄丸中筛选共得到74个活性成分及205个药物靶基因,3903个ASD疾病靶基因,127个关键靶点及蛋白激酶Bα(protein kinase Bα,Akt1)、白细胞介素-6(interleukin-6,IL-6)、白细胞介素-1(interleukin-1,IL-1)、肿瘤坏死因(tumor necrosis factor,TNF)等核心靶点。GO功能富集显示主要作用于有机氮原化合物的细胞反应、突触后膜、突触后神经递质受体活动等,KEGG通路富集显示调控TNF、核因子κB(nuclear factor-κB,NF-κB)、Wnt等信号通路。分子对接结果显示,六味地黄丸中的有效成分可与核心蛋白Akt1结构稳定。动物实验结果显示,在社交能力测试阶段,模型组、维生素D组及中药低、中、高剂量组仔鼠接触陌生鼠1的时间均短于空白组(P<0.05);给药2周后,维生素D组及中药低、中、高剂量组接触陌生鼠1的时间延长(P<0.05)。在社交新颖性测试阶段,模型组、维生素D组和中药低、中、高剂量组仔鼠接触陌生鼠2的时间短于较空白组(P<0.05);给药2周后,维生素D组及中药低、中、高剂量组接触陌生鼠2的时间延长(P<0.05)。矿场实验结果提示,治疗后,中药低、中剂量组活动总路程及中央区域活动路程均增加(P<0.05),维生素D组、中药高剂量组活动总路程增加(P<0.05)。与模型组比较,维生素D组及中药低、中、高剂量组GSK-3β水平升高(P<0.05),β-Catenin水平降低(P<0.05),β-Catenin、c-Myc蛋白表达减少(P<0.05);中药低剂量组Cyclin D1蛋白表达减少(P<0.05)。结论六味地黄丸可有效调控Wnt信号通路,改善VPA诱导的ASD仔鼠社交行为、焦虑状态。

六味地黄丸介导RAGE抑制MMP-2/MMP-9对Aβ_(1-40)损伤bEnd.3细胞紧密连接蛋白的影响

目的探讨六味地黄丸对β淀粉样蛋白1-40(Aβ_(1-40))损伤的小鼠脑微血管内皮细胞(bEnd.3)的保护作用及其机制。方法采用CCK8法检测Aβ_(1-40)和六味地黄丸含药血清(MSLDP)对细胞活性的影响,筛选合适的作用浓度。将bEnd.3细胞分为对照组、Aβ_(1-40)组、MSLDP+Aβ_(1-40)组和MSLDP组,采用Western blot检测低密度脂蛋白相关蛋白1(LRP1)、晚期糖基化终末产物受体(RAGE)、基质金属蛋白酶2(MMP-2)、MMP-9、闭锁小带蛋白-1(ZO-1)、脑源性神经营养因子(BDNF)蛋白表达,免疫荧光检测LRP1、RAGE、ZO-1表达;再将bEnd.3细胞分为对照组、Aβ_(1-40)组、FPS-ZM1(RAGE抑制剂)+Aβ_(1-40)组和FPS-ZM1+Aβ_(1-40)+MSLDP组,Western blot检测RAGE、MMP-9、MMP-2、ZO-1蛋白表达。结果Aβ_(1-40)呈剂量依赖性降低bEnd.3细胞活性(P<0.01),MSLDP对Aβ_(1-40)损伤的细胞活性具有保护作用(P<0.05,P<0.01),因此选择10μmol/L Aβ_(1-40)和10%MSLDP进行后续实验。与对照组比较,Aβ_(1-40)组RAGE、MMP-2、MMP-9蛋白表达升高(P<0.01),LRP1、ZO-1、BDNF蛋白表达降低(P<0.05,P<0.01),并且LRP1、ZO-1荧光强度降低(P<0.01),RAGE荧光增强(P<0.01);与Aβ_(1-40)组比较,MSLDP组RAGE、MMP-2、MMP-9蛋白表达和RAGE荧光强度降低(P<0.05,P<0.01),而LRP1、ZO-1、BDNF蛋白表达和LRP1、ZO-1荧光强度升高(P<0.05,P<0.01)。与Aβ_(1-40)组比较,Aβ_(1-40)+FPS-ZM1组MMP-2、MMP9、RAGE蛋白表达降低(P<0.05,P<0.01),ZO-1蛋白表达升高(P<0.05);Aβ_(1-40)+FPS-ZM1+MSLDP组MMP-2、MMP9、RAGE蛋白表达降低(P<0.01),ZO-1蛋白表达升高(P<0.01),FPS-ZM1和MSLDP联合使用的效果更佳。结论六味地黄丸能够保护Aβ_(1-40)损伤的脑微血管内皮的细胞紧密连接,减轻血脑屏障障碍,保护神经血管单元防治阿尔茨海默病,可能通过调节RAGE途径抑制MMP-2/MMP-9途径实现。

六味地黄丸的现代药理学研究进展及在生殖医学的应用

目的归纳近些年来六味地黄丸的现代药理学研究及其在生殖医学中的应用。方法查阅文献,总结分析。结果六味地黄丸是滋补肝肾的经典方剂,现代药理研究显示,其有增强免疫功能、增强生殖功能、延缓衰老及抗肿瘤、降血糖、降血压、降血脂等作用,对生殖系统、泌尿系统、呼吸系统、内分泌系统及心血管系统有明显作用。结论六味地黄丸治疗男女生殖疾病有独到的优势,应重视其在生殖医学中的应用。

杞菊地黄丸联合施图伦治疗肝肾不足型近视萎缩性黄斑病变临床研究

目的观察杞菊地黄丸联合施图伦治疗肝肾不足型近视萎缩性黄斑病变(MAM)患者的临床疗效。方法选择2021年1月—2022年12月于山东中医药大学附属眼科医院眼底外科门诊就诊的60例肝肾不足型MAM患者为研究对象,采用随机数字表法分为对照组和治疗组各30例(30只眼)。对照组给予施图伦点患眼,治疗组在施图伦点眼基础上口服杞菊地黄丸,2组疗程均为30 d。比较2组患者治疗前后中医证候评分和相关眼参数(裸眼及最佳矫正视力、等效球镜度、光敏感度、视野平均缺损、黄斑中心凹视网膜厚度、黄斑中心凹下脉络膜厚度),并比较2组不同近视性黄斑病变(MMD)分级[弥漫性脉络膜视网膜萎缩(C2级)、斑片状脉络膜视网膜萎缩(C3级)、黄斑萎缩(C4级)]患者相关眼参数。结果治疗后,2组中医证候积分均较治疗前明显降低(P均<0.05),且治疗组明显低于对照组(P<0.05)。治疗后,2组裸眼及最佳矫正视力与治疗前比较及组间比较差异均无统计学意义(P均>0.05),但治疗组C2级患者裸眼及最佳矫正视力均明显高于治疗前及对照组(P均<0.05);治疗组总体光敏感度明显高于治疗前及对照组(P均<0.05),其中C2和C3级患者(其中C2级疗效最佳)光敏感度明显高于治疗前及同级对照组(P均<0.05);2组等效球镜度、黄斑中心凹视网膜厚度、黄斑中心凹下脉络膜厚度与治疗前比较及组间比较差异均无统计学意义(P均>0.05),且不同分级患者比较差异均无统计学意义(P均>0.05)。结论杞菊地黄丸联合施图伦治疗肝肾不足型MAM患者疗效确切,可有效改善患者中医证候和光敏感度,有效提高病变早期(C2级)患者的裸眼及最佳矫正视力。

六味地黄丸通过干预缝隙连接通讯功能调控树突状细胞抗原交叉提呈能力研究

【目的】探讨六味地黄丸是否通过提高缝隙连接通讯功能(GJIC)增强树突状细胞(DC)抗原交叉提呈能力,并对其机制进行相关探索。【方法】采用Western Blot实验、免疫荧光法观察六味地黄丸含药血清对黑色素瘤细胞(B16)缝隙连接蛋白43(Cx43)表达及膜定位的影响;采用钙黄绿素(Ca-AM)/DiI荧光示踪实验观察六味地黄丸含药血清对B16细胞GJIC功能的影响;采用流式细胞术观察GJIC在六味地黄丸含药血清增强DC抗原提呈能力中的作用;采用碘化丙啶(PI)/Hoechst染色实验观察CD8+T淋巴细胞的免疫杀伤效果。【结果】Western Blot及免疫荧光实验结果显示,六味地黄丸含药血清上调Cx43表达;荧光示踪实验证明,六味地黄丸含药血清显著增强B16细胞GJIC功能;流式细胞术分析表明,六味地黄丸含药血清增强DC抗原提呈能力;PI/Hoechst染色结果显示,六味地黄丸含药血清干预B16-OVA后CD8+T细胞的免疫杀伤效果更加显著。【结论】六味地黄丸通过上调黑色素瘤细胞Cx43表达,改善GJIC功能,进而增强DC的交叉提呈能力,从而激活更强的CD8+T细胞免疫杀伤反应。