The effect of Huanglian Jiedu Decoction on inflammatory factors and oxidative stress in patients with acute ischemic stroke

Objective:To study the clinical efficacy of Huanglian Jiedu decoction in treating acute ischemic stroke(AIS)and its effects on inflammatory factors and oxidative stress.Method:A total of 53 patients with AIS were recruited as the study subjects and randomly divided into a control group and a treatment group using a random number table method.The control group consisted of 26 patients and the treatment group consisted of 27 patients.The control group received conventional Western medicine treatment.The control group received routine Western medicine treatment,while the treatment group received Huanglian Jiedu decoction based on the control group,with 14 days as a course of treatment.The effects of Huanglian Jiedu decoction on neurological function and activities of daily living were evaluated using the National Institute of Health stroke scale(NIHSS)and activities of daily living(ADL)scores.The effects of Huanglian Jiedu decoction on inflammatory reactions and oxidative stress were evaluated by detecting interleukin-4(IL-4),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),transforming growth factorβ(TGF-β),total antioxidative capacity(T-AOC),malondialdehyde(MDA),superoxide dismutase(SOD),and catalase(CAT)levels.Results:After treatment with Huanglian Jiedu Decoction,the ALD scores of AIS patients in both groups increased,while the NISHH scores decreased,suggesting that Huanglian Jiedu Decoction has therapeutic effects on AIS patients.It also reduces the levels of serum IL-6,TNF-α,MDA in AIS patients and increases the levels of IL-4,TGF-β,CAT,SOD,T-AOC,suggesting that Huanglian Jiedu decoction can improve the anti-inflammatory and antioxidant abilities of AIS patients.Conclusion:Huanglian Jiedu decoction can help AIS patients recover their neurological function,increase their capacity for self-care in daily life,and strengthen the body’s anti-inflammatory and antioxidant defenses.

Effect of Huanglian Jiedu Decoction on the Behavior of Zebrafish with Alzheimer's Disease

[Objectives]To study the effect of Huanglian Jiedu Decoction on the behavior of zebrafish with Alzheimer's disease caused by AlCl 3.[Methods]Each portion of Huanglian Jiedu Decoction was prepared according to the proportion of Coptis chinensis∶Phellodendron chinense Rupr.∶Scutellaria baicalensis Georgi∶Gardenia jasminoides Ellis=63 g∶42 g∶42 g∶63 g.After that,each portion of Huanglian Jiedu Decoction was soaked in 6.3 L water for 30 min and boiled twice at 100℃.The extracts were combined twice and filtered,then concentrated to 308 g/L and put into refrigerator for later use.Before training,zebrafishes were put into T-maze to adapt for 2 d,and then behavioral training was carried out for 7 d.After video recording,the behavior of zebrafish was analyzed by Smart 3.0,and qualified zebrafishes were selected for follow-up experiments.Then 60 successfully trained zebrafishes were randomly divided into control group,model group,positive group,low-dose group,medium-dose group and high-dose group of Huanglian Jiedu Decoction.Except for the control group,all the other groups were exposed to 100μg/L AlCl 3 for 7 d.After that,video was recorded,and behavioral analysis was carried out with behavioral record and analysis software Smart 3.0.And then the zebrafishes in the other four groups except the model group were treated with Huperzine A(4μg/L)and Huanglian Jiedu Decoction(154,308,616 mg/L)for 6 d,respectively.After that,it was recorded and the behavior of each group was analyzed.[Results]There was a significant difference in the time spent in the left area and the percentage of time in the left area between the control group and the model group(P<0.001).The time spent in the left area and the percentage of time in the left area in the model group and positive group,low,medium and high dose groups of Huanglian Jiedu Decoction decreased significantly(P<0.05,P<0.01,P<0.001).The swimming distance in the left area and the percentage of swimming distance in the left area in the model group were significantly higher than those in the control group(P<0.001).There was a significant difference in swimming distance between model group and positive group,low,medium and high dose groups of Huanglian Jiedu Decoction(P<0.01,P<0.001).In the percentage of swimming distance in the left area,there was a significant difference between the model group and the low and high dose groups of Huanglian Jiedu Decoction(P<0.01,P<0.001).[Conclusions]Huanglian Jiedu Decoction can improve the behavior of zebrafish with Alzheimer's disease.

Huanglian decoction suppresses the growth of hepatocellular carcinoma cells by reducing CCNB1 expression

BACKGROUND Hepatocellular carcinoma(HCC)is one of the most prevalent cancers in human populations worldwide.Huanglian decoction is one of the most important Chinese medicine formulas,with the potential to treat cancer.AIM To investigate the role and mechanism of Huanglian decoction on HCC cells.METHODS To identify differentially expressed genes(DEGs),we downloaded gene expression profile data from The Cancer Genome Atlas Liver Hepatocellular Carcinoma and Gene Expression Omnibus(GSE45436)databases.We obtained phytochemicals of the four herbs of Huanglian decoction from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform.We also established a regulatory network of DEGs and drug target genes and subsequently analyzed key genes using bioinformatics approaches.Furthermore,we conducted in vitro experiments to explore the effect of Huanglian decoction and to verify the predictions.In particular,the CCNB1 gene was knocked down to verify the primary target of this decoction.Through the identification of the expression levels of key proteins,we determined the primary mechanism of Huanglian decoction in HCC.RESULTS Based on the results of the network pharmacological analysis,we revealed 5 bioactive compounds in Huanglian decoction that act on HCC.In addition,a protein-protein interaction network analysis of the target genes of these five compounds as well as expression and prognosis analyses were performed in tumors.CCNB1 was confirmed to be the primary gene that may be highly expressed in tumors and was significantly associated with a worse prognosis.We also noted that CCNB1 may serve as an independent prognostic indicator in HCC.Moreover,in vitro experiments demonstrated that Huanglian decoction significantly inhibited the growth,migration,and invasiveness of HCC cells and induced cell apoptosis and G2/M phase arrest.Further analysis showed that the decoction may inhibit the growth of HCC cells by downregulating the CCNB1 expression level.After Huanglian decoction treatment,the expression levels of Bax,caspase 3,caspase 9,p21 and p53 in HCC cells were increased,while the expression of CDK1 and CCNB1 was significantly decreased.The p53 signaling pathway was also found to play an important role in this process.CONCLUSION Huanglian decoction has a significant inhibitory effect on HCC cells.CCNB1 is a potential therapeutic target in HCC.Further analysis showed that Huanglian decoction can inhibit HCC cell growth by downregulating the expression of CCNB1 to activate the p53 signaling pathway.

Cerebroprotective effect of Huanglian Jiedu decoction on amyloid protein precursor/presenilin-1 double transgenic mice

Huanglian Jiedu decoction （HLJDD） has been shown to improve cerebral blood flow, and reduce lipid peroxidation damage to the brain and its energy metabolism. The present study was designed to observe the cerebroprotective effect of HL.JDD on an Alzheimer＇s disease rodent model, presenilin-1/amyloid protein precursor double transgenic mice. HLJDD reduced serum interleukin-6 and interleukin-113 levels, decreased [3-amyloid precursor protein gene and senile plaque expression, resisted oxidation, and reduced free radical-induced injury, thereby improving the learning and memory of these mice. Moreover, HLJDD at 433 mg/kg per day exhibited better effects compared with that at 865 or 216 mg/kg per day, and donepezil hydrochloride at 30 mg/kg per day. Thus, these results suggest that HLJDD may have protective effects against Alzheimer＇s disease.

Effect of Huanglian Jiedu decoction on cogni⁃tive dysfunction of zebrafish with Alzheimer disease

OBJECTIVE To investigate the effects of Huanglian Jiedu decoction on cognitive dysfunction of zebrafish with Alzheimer disease.METHODS 126 g of coptis chinensis,84 g of phellorescent phellorescent chinensis,84 g of scutellaria chinensis and 126 g of gardenia chinensis were immersed in 10,8 and 8 times of water for 30 min,and then extracted at 100℃for 2,1.5 and 1.5 h,respectively.The three extracts were coarse filtered and concentrated into 308 g·L-1 and stored in refrigerator for later use.200 zebrafish were selected for behavioral train⁃ing in T-shaped tank for seven days.After that,the behavioral record analysis software Smart 3.0 was used to conduct behavioral analysis.Qualified zebrafish were selected as the blank group.Except for the blank group,zebrafish in the other 5 groups were exposed to AlCl3100μg·L-1 aquaculture water for modeling,and exposed for 6 d.The behavioral record analysis software Smart 3.0 was used to conduct behavioral analysis,and Select the successfully modeled zebraf⁃ish.After that,huperzine A(4μg·L-1)and Huan⁃glian Jiedu decoction of low,medium and high doses(154,308 and 616 mg·L-1)were adminis⁃tered respectively,and exposed for six days.Then,the behavior analysis was conducted again through the behavioral record analysis soft⁃ware Smart 3.0 to select qualified zebrafish.After the training,the brain and gut of zebrafish in each group were collected,and the expression changes of N-cadherin,p-P38/p38MAPK and p-Tau in the brain were detected by Western blot⁃ting and qPCR to show the effect of Huanglian Jiedu decoction on cognitive dysfunction of Zebrafish with Alzheimer disease.RESULTS Western blotting and qPCR results showed that the contents of N-cadherin increased(P<0.05),and the contents of p-P38/p38MAPK and p-Tau decreased(P<0.05)compared with the model group,indicating that Huanglian Jiadu decoction had an effect on the cognitive dysfunction of zebrafish with Alzheimer disease.CONCLU⁃SION Huanglian Jiedu decoction can alleviate cognitive dysfunction of zebrafish model with Alzheimer disease to a certain extent.

Mechanisms of Huanglian Jiedu Decoction in treating coronary heart disease and type 2 diabetes mellitus based on network pharmacology

Objective:To explore the common mechanism of Huanglian Jiedu Decoction in treating coronary heart disease and type 2 diabetes by network pharmacology.Methods:All chemical components and targets of the four drugs in Huanglian Jiedu Decoction were retrieved through TCMSP,and the genes were standardized through Uniprot database.Acquire disease targets related to coronary heart disease and diabetes in OMIM and GeneCards databases.The network diagram of"drug-component-target-disease"is constructed by using the software of cytopscape 3.7.2,the PPI network diagram of protein interaction is constructed by using STRING database,and the network diagram of"drug-disease"core target is constructed by using the software of cytopscape 3.7.2.DAVID's online database platform was used to analyze GO biological process and KEGG pathway enrichment of common targets of Huanglian Jiedu Decoction in treating coronary heart disease and type 2 diabetes.Results:103 active ingredients of Huanglian Jiedu Decoction were retrieved,including 140 acting targets,5342 coronary heart disease targets,114 diabetes targets,and 14 common intersection targets of drugs and diseases,involving AR,PPARG,TNF,IL6,CCL2,VEGFA,PON1,etc.The GO biological process analysis results in 98 biological processes,10 cell components and 10 molecular functions.Among them are positive regulation of gene expression,positive regulation of nitric oxide biosynthesis process,Extracellular space,cytokine activity,steroid hormone receptor activity and other biological processes;The enrichment analysis of KEGG pathway yielded 20 signal pathways(P≤0.05).It mainly involves Malaria,cancer in cancer,HIF-1 signaling pathway,TNF signaling pathway,NOD-like receptor signaling pathway,PI3K-Akt signaling pathway,etc.Conclusion:Huanglian Jiedu Decoction"treats different diseases at the same time"coronary heart disease and type 2 diabetes have the characteristics of multiple components,multiple targets and multiple pathways,which provide theoretical basis for Huanglian Jiedu Decoction to treat coronary heart disease and type 2 diabetes in clinic,but the key targets and pathways of Huanglian Jiedu Decoction to treat diseases still need further experimental verification.

Proteomics analysis of Huanglian Wendan decoction drug-containing serum on insulin resistance in 3T3-L1 cell

Objective:To explore possible mechanisms of Huanglian Wendan decoction drug-containing serum to improve insulin resistance.Method: 3T3-L1 fibroblasts were divided into control group, model group and TCM group. 3T3-L1 fibroblasts in model group and TCM group were induced to differentiation, and the 3T3-L1 adipocyte model of insulin resistance was constructed. The control group and model group were given normal serum stimulation, while the TCM group is treated with drug-containing serum. Finally, proceed bioinformatics analysis of the acquired differential expression protein by using TMT marking, liquid chromatography-mass (LC-MS) spectrometry, GO analysis and KEGG pathway analysis.Results:4982 proteins are identified in three groups of samples in this experiment, 4238 of them contain quantitative information. 210 up-regulate and 399 down-regulate proteins exist in model group and control group;221 up-regulate and 98 down-regulate ones are identified in TCM group and control group;310 up-regulate and 142 down-regulate proteins come to light with TCM group and control group. The result shows that the differentially expressed proteins were mainly distributed in s GO terms, such as DNA replication, nucleoplasm and protein binding of TCM group and control group. KEGG pathway enrichment analysis shows that, differentially expressed up-regulate proteins were enriched in 10 pathways, for instance DNA replication, cell cycle and mismatch repair, etc. Besides, differentially expressed down-regulate proteins were enriched in 25 pathways, enriched pathways are peroxisome, fatty acid degradation and metabolism process, etc.Conclusion: It is clear that Huanglian Wendan decoction drug-containing serum could improve insulin resistance by multi-targeting, multi-pathway synergy, and overall regulation.

The active ingredients of Huanglian Jiedu Decoction in treating COVID- 19 based on network pharmacology, molecular docking and molecular dynamics simulation

Objective:To explore the active ingredients of Huanglian Jiedu Decoction(HLJD)for the treatment of COVID-19 and to further verify the combination mode.Methods:The TCMSP database was used to search for HLJD active ingredients and targets.COVID-19 targets were collected from GeneCards,DisGeNET and OMIM databases.Material-active-ingredients-targets(gene)network and targets protein-protein interaction network were constructed using Cytoscape 3.8.0 and the STRING database.GO functional enrichment analysis and KEGG pathway enrichment analysis of core targets were performed using R software.Cytoscape 3.8.0 was used to build“compound-targets-pathways”to predict HLJD mechanisms,and active ingredients were used as ligands to molecularly dock with SARS-CoV-23CL hydrolase,Spike glycoprotein and ACE2.The binding energy was calculated by molecular dynamics simulations and molecular mechanics Poisson-Boltzmann surface area method,and intermolecular interactions and the contribution of each residue to the binding free energy were analyzed.Results:Four medicinal materials,66 compounds and 219 targets were identified.It is found that the Protein-Protein Interaction core network contained 35 HLJD key targets proteins for COVID-19 treatment.705 GO functional enrichment entries(P<0.05)were produced;while KEGG pathway enrichment analysis identified 142 pathways(P<0.05)involving the Tumor Necrosis Factor signaling pathway and Interleukin-17 signaling pathway,etc.The binding energies of Kihadanin A,Palmidin A,Obacunone and Hispidone are much smaller than those of the currently reported clinical drugs with anti-SARS-CoV-2 drugs.The results of the binding energy indicate that van der Waals force is the main driving force for enzyme-substrate combination,whereas the electrostatic interaction and non-polar solvents contribute less.Conclusion:The“multi-component-multi-targets-multi-pathway”synergy of HLJD,which binds to SARSCoV-23CL hydrolase,Spike glycoprotein and ACE2,can act on targets Heat Shock Protein 90 Alpha Family Class A Member 1,Adrenoceptor Beta 2,Checkpoint Kinase 1,Peroxisome Proliferator-Activated Receptor Gamma and Mitogen-activated protein kinase 14 to regulate multiple signal pathways,and it may have a therapeutic effect on COVID-19.

黄连解毒汤通过抑制NLRP3炎性小体改善Tau/APP/PS1转基因AD小鼠神经元损伤的机制研究

目的 探讨黄连解毒汤对Tau/APP/PS1转基因阿尔茨海默病(Alzheimer's disease,AD)小鼠神经元损伤的影响及机制。方法 将Tau/APP/PS1转基因AD小鼠随机分成模型组和黄连解毒汤低、中、高剂量组,每组10只。选取10只相同月龄的雄性C57BL/6J小鼠作为对照组。药物干预4周后,ELISA法检测小鼠海马组织炎症因子及AD相关病理标志物可溶性淀粉酶前体蛋白α(soluble amyloid precursor protein α,s APPα)、β-淀粉样蛋白(amyloid β-protein,Aβ)40、Aβ42和磷酸化Tau蛋白(phosphorylated tau protein,p-Tau)的水平,免疫荧光双标法检测海马Nod样受体蛋白3(nod-like receptor protein 3,NLRP3)炎性小体和小胶质细胞特异性标志物离子钙结合衔接分子1(ionized calcium binding adapter molecule 1,Iba1)的表达,Western blot检测小鼠海马NLRP3炎性小体信号通路活化情况。结果 与对照组比较,模型组小鼠海马中NLRP3、凋亡相关斑点样蛋白(apoptosis-associated speck-like protein containing CARD,ASC)、含半胱氨酸的天冬氨酸蛋白水解酶(cysteinyl aspartate specific proteinase,Caspase)-1和Iba1表达明显增加(P<0.05),炎症因子白细胞介素(interleukin,IL)-1β、IL-18、肿瘤坏死因子(tumor necrosis factor,TNF)-α水平上升(P<0.05),Aβ40、Aβ42和p-Tau水平及p-Tau/Tau值均升高(P<0.05),s APPα水平下降(P<0.05)。与模型组比较,不同剂量黄连解毒汤治疗组小鼠海马中s APPα水平上升(P<0.05),Aβ40、Aβ42及Tau蛋白磷酸化水平均明显下降(P<0.05),IL-1β、IL-18、TNF-α水平降低(P<0.05),NLRP3、ASC、Caspase-1和Iba1表达减少(P<0.05)。结论 黄连解毒汤可能通过下调AD小鼠海马NLRP3炎性小体信号通路活性,抑制小胶质细胞活化,降低Aβ、p-Tau等神经元毒性病理产物的水平,从而改善海马神经元损伤。

基于TLR4/NF-κB/NLRP3信号通路探讨黄连解毒汤对冠状动脉性心脏病小鼠心肌保护作用

目的 研究基于Toll样受体4(TLR4)/核转录因子-κB(NF-κB)/NOD样受体蛋白3(NLRP3)信号通路探讨黄连解毒汤对冠状动脉粥样硬化性心脏病(CHD)小鼠心肌保护作用。方法 50只6周的雄性SD小鼠中取10只作正常对照组,其余小鼠给予高脂饮食建立CHD模型。采用随机数字表法将40只模型小鼠分为模型组、黄连解毒汤低、中、高剂量组,每组各10只。黄连解毒汤低、中、高剂量组每日分别以10、20、40 g/kg剂量进行灌胃,每日1次,持续6周;正常组、模型组每日给予等量蒸馏水灌胃。干预后采用生化法检测各组总胆固醇、甘油三酯、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)水平,酶联免疫吸附试验检测超氧化物歧化酶(SOD)、丙二醛、内皮素水平;采用苏木精-伊红染色法观察小鼠心肌细胞病理形态,蛋白质印迹法检测心肌组织中TLR4、NF-κB、NLRP3的表达。比较各组小鼠血脂、心肌组织中抗氧化相关指标和TLR4、NF-κB、NLRP3的表达。结果 模型组、黄连解毒汤低、中、高剂量组血脂水平均高于对照组,差异均有统计学意义(P<0.05);黄连解毒汤低剂量组与模型组血脂水平比较,差异无统计学意义(P>0.05);黄连解毒汤中、高剂量组总胆固醇、甘油三酯、LDL水平均低于模型组,HDL水平高于模型组,差异均有统计学意义(P<0.05)。模型组、黄连解毒汤低、中、高剂量组心肌组织中SOD水平均低于对照组,丙二醛、内皮素水平均高于对照组,差异均有统计学意义(P<0.05);黄连解毒汤低、中、高剂量组SOD水平均高于模型组,丙二醛、内皮素水平均低于模型组,差异均有统计学意义(P<0.05)。对照组心肌纤维排列整齐,横纹清晰且细胞完整,无细胞肿胀、炎症浸润等;模型组心肌纤维排列紊乱,结构发生异常,有严重细胞肿胀、炎症浸润;黄连解毒汤低、中、高剂量组未见心肌纤维断裂,黄连解毒汤中、高剂量组细胞肿胀和炎症浸润情况优于黄连解毒汤低剂量组,黄连解毒汤高剂量组优于黄连解毒汤中剂量组。模型组、黄连解毒汤中、高剂量组TLR4、NF-κB、NLRP3蛋白表达量均高于对照组,差异均有统计学意义(P<0.05);黄连解毒汤低、中、高剂量组TLR4、NF-κB、NLRP3蛋白表达量均低于模型组,差异均有统计学意义(P<0.05)。且黄连解毒汤各剂量组中以上指标变化呈剂量依赖性。结论 黄连解毒汤能降低CHD小鼠血脂水平,保护心肌细胞,其能够通过下调组织TLR4、NF-κB、NLRP3蛋白表达以调节血脂水平并改善心肌功能,且黄连解毒汤的效果随着剂量的增加而增强。

黄连解毒汤对ApoE^(-/-)小鼠动脉粥样硬化炎症及主动脉斑块稳定性作用的机制研究

目的观察黄连解毒汤对ApoE^(-/-)小鼠主动脉粥样硬化炎症及斑块稳定性的影响,探讨黄连解毒汤治疗主动脉斑块稳定性的作用机制。方法将36只ApoE^(-/-)小鼠随机分为空白组,模型组,黄连解毒汤低、中、高剂量组,阿托伐他汀组,每组6只。模型组及给药组ApoE^(-/-)小鼠给予高脂饮食构建主动脉粥样硬化模型8周后,黄连解毒汤低、中、高剂量组小鼠分别按10、20、40 g/(kg·d)剂量给予黄连解毒汤;阿托伐他汀组小鼠按10 mg/(kg·d)剂量给予阿托伐他汀;空白组、模型组给予等量的蒸馏水。每日灌胃1次,共8周。第16周末采集标本,采用苏木精—伊红染色观察各组小鼠主动脉内膜的组织形态;半自动生化分析仪检测各组小鼠血清总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、低密度脂蛋白—胆固醇(low density lipoprotein-cholesterol,LDL-C)及高密度脂蛋白—胆固醇(high density lipoprotein-cholesterol,HDL-C)水平;采用ELISA法检测各组白细胞介素-1β(interleukin-1β,IL-1β)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、白细胞介素-10(interleukin-10,IL-10)含量;组织学特殊病理染色技术测定斑块内巨噬细胞含量、α-平滑肌肌动蛋白(α-smooth muscle actin,α-SMA)细胞含量、斑块内胶原纤维含量及斑块内脂质含量,从而计算斑块不稳定指数(vulnerability index,VI)。结果黄连解毒汤能明显改善小鼠主动脉管壁的病理变化。与空白组比较,模型组小鼠血清TC、TG、LDL-C水平均显著上升(P<0.05),HDL-C水平显著下降(P<0.05);IL-1β、IL-6、TNF-α含量均显著增加(P<0.05),IL-10含量显著减少(P<0.05);VI显著增加(P<0.05)。与模型组比较,黄连解毒汤中、高剂量组小鼠血清TG、TC、LDL-C水平均显著下降(P<0.05),HDL-C水平显著上升(P<0.05);IL-1β、IL-6、TNF-α含量均显著减少(P<0.05),IL-10含量显著增加(P<0.05);各给药组小鼠主动脉内膜斑块VI均显著减少(P<0.05)。黄连解毒汤高剂量组改善上述指标的效果与阿托伐他汀组相当(P>0.05)。结论黄连解毒汤对动脉粥样硬化ApoE^(-/-)小鼠主动脉血管内炎症反应及斑块稳定性具有一定的改善作用,且呈剂量依赖性,其机制可能与降低血脂水平、缓解炎症损伤有关。

从胆论治失眠研究概况

现今社会,失眠的发病率正逐年递增,已成为临床上的常见病、多发病,严重危害了人们的身心健康,因此如何有效地防治失眠备受医学界关注。中医药治疗失眠,从整体观念出发,辨证分型,个体化治疗,用药安全,疗效稳定,相较西药颇受患者推崇。文章结合中医理论,从胆为少阳之枢、胆主决断、喜静谧、十一脏取决于胆、胆与三焦的关系等理论出发,突出胆腑在睡眠中的关键作用。参考历代相关文献记载,将胆病不寐分为胆寒证、胆火证、胆郁痰扰证、胆虚证4个证型进行辨证。并结合现代药理实验研究,将黄连温胆汤作用于失眠的相关机制进行归纳,认为其多与抑制失眠患者的炎症介质血清水平、方药成分中含有类黄酮化合物两方面关系密切。其方药多被现代医家所应用,临床疗效突出,颇受推崇。故作者认为从胆腑论治失眠不失为一种佳法,使“阴平阳秘,精神乃治”,以期更好地指导临床实践。

基于网络药理学与分子对接探讨黄连解毒汤治疗白念珠菌感染的作用机制

目的运用网络药理学与分子对接探讨黄连解毒汤治疗白念珠菌感染的作用机制,为临床应用和基础研究提供理论依据。方法运用TCMSP和BATMAN-TCM数据库检索黄连解毒汤的有效成分及作用靶点,通过GeneCards、OMIM、PharmGkb、TTD、DrugBank数据库收集疾病相关靶点。运用Cytoscape 3.8.0软件构建“活性成分-靶点”网络,借助STRING平台构建交集蛋白互作网络,并使用Cytoscape对网络进行拓扑分析,获取核心靶点,通过R语言进行GO富集分析和KEGG通路富集分析,最后将主要活性成分与核心靶点进行分子对接验证。结果黄连解毒汤治疗白念珠菌感染的活性成分有槲皮素、山柰酚、汉黄芩素、黄芩新素等,核心靶点为HIF1A、MMP9、AKT1、FN1、PTGS2、IFNG、IL1B、STAT1、CASP8。富集得到IL-17信号通路、Th17细胞分化、Toll样受体信号通路等,主要通过调节炎症反应和细胞免疫等生物过程发挥治疗作用。分子对接结果表明,主要活性成分与核心靶点具有较强的结合能。结论黄连解毒汤能通过多成分-多靶点-多途径共同治疗白念珠菌感染,为临床应用及基础研究提供理论基础和参考依据。

大黄黄连泻心汤抑制NLRP3炎症小体活性对急性胃溃疡的保护作用及机制研究

[目的]研究不同浸渍条件下大黄黄连泻心汤抑制NOD样受体热蛋白结构域相关蛋白3(NLRP3)炎症小体活性对急性胃溃疡小鼠的保护作用,探讨其作用机制并筛选最佳浸渍条件。[方法]对小鼠进行无水乙醇灌胃以建立急性胃溃疡模型,并给予不同浸提条件下的大黄黄连泻心汤进行实验,同时选用MCC950抑制剂作为阳性药。对各组小鼠进行胃组织苏木精-伊红(HE)染色,观察胃组织病理变化;统计溃疡指数(UI);用酸碱度(pH)试纸测试胃液pH值;检测胃液胃蛋白酶活性(PA);采用酶联免疫吸附(ELISA)法检测血清中白细胞介素1β(IL-1β)和白介素18(IL-18)的水平;采用蛋白免疫印迹法(Western blot)检测药物组小鼠胃组织中NLRP3、半胱氨酸蛋白酶-1(caspase-1)的蛋白表达。[结果]与空白组相比,模型组小鼠胃组织出现明显的溃疡病变,各项指标异常。与模型组相比,药物组可降低乙醇诱导下急性胃溃疡模型小鼠的溃疡指数(P<0.05或P<0.01),抑制胃酸的分泌(P<0.05),抑制胃蛋白酶活性(P<0.01);各药物组中促炎细胞因子IL-1β、IL-18的表达明显降低(P<0.01);通过各药物组灰度值/对照模型组蛋白灰度值的比较,表明药物组能够降低NLRP3、Caspase-1蛋白表达(P<0.01或P<0.05)。最后,对不同浸渍条件下大黄黄连泻心汤的药效进行综合评分,结果表明E(85℃、15 min)组评分最高。[结论]大黄黄连泻心汤对无水乙醇灌胃诱导的急性胃溃疡小鼠有保护作用,其机制可能与抑制NLRP3炎症小体活性有关。通过各药物组抑制NLRP3炎症小体的表达差异,得出85℃、15 min的最佳浸渍条件。

态靶辨证在胃肠实热型糖尿病合并高脂血症中的应用:基于大黄黄连泻心汤加红曲、生山楂

糖尿病是一种临床常见病,合并症很多,其中合并高脂血症较为常见。糖尿病合并高脂血症属中医“消渴”合并“痰证”“浊证”“瘀证”等范畴。仝小林院士基于多年临床研究把糖尿病的发展过程分为郁、热、虚、损4个阶段,胃肠实热为“热”阶段的常见证型,临床症状多见脘腹胀满、口干、口渴、口臭、大便秘结、舌红、苔黄燥、脉沉实等。此类患者以热为态,治疗需清热通腑以调态,主方选用大黄黄连泻心汤;若合并高脂血症,以痰浊为靶,用红曲、生山楂化浊降脂以打靶。针对胃肠实热型糖尿病合并高脂血症,运用态靶辨证既能调患者实热之态,又可对痰浊症状精准打靶。

大黄黄连泻心汤联合针刺治疗肥胖2型糖尿病患者的临床研究

目的 观察大黄黄连泻心汤联合“土郁夺之”针刺法治疗肥胖2型糖尿病患者的临床疗效。方法 选择2021年9月至2023年2月于广西壮族自治区江滨医院就诊的肥胖2型糖尿病患者112例,根据随机数字表法分为观察组与对照组,根据纳入排除标准,最终每组54例患者。2组均给予西药常规治疗,对照组给予“土郁夺之”针刺法治疗,观察组在对照组基础上给予大黄黄连泻心汤治疗。观察2组治疗前后临床疗效、中医证候评分、血糖(空腹血糖、餐后2 h血糖、糖化血红蛋白)水平、肥胖指标(体质量指数、内脏脂肪面积、腰臀比)、血脂(总胆固醇、甘油三酯、低密度脂蛋白胆固醇)水平、血清脂肪因子(血清脂联素、血清瘦素、神经肽Y)水平及不良反应发生情况。结果 治疗后观察组总有效率为92.59%,显著高于对照组的79.63%(P<0.05)。治疗后2组中医证候评分、血糖、血脂、肥胖指标、血清瘦素、神经肽Y水平均较治疗前降低,且观察组低于对照组,2组治疗后血清脂联素水平较治疗前升高,且观察组高于对照组,差异均有统计学意义(P<0.05)。2组治疗过程中均未出现低血糖等严重不良反应。结论 大黄黄连泻心汤联合“土郁夺之”针刺法治疗肥胖2型糖尿病患者临床疗效显著。

黄连温胆汤治疗卒中后抑郁症的前瞻性随机对照研究

目的探讨卒中后抑郁症患者采用黄连温胆汤治疗的临床效果及对认知功能和生活质量的影响。方法选取80例2019年5月—2022年5月医院收治的卒中后抑郁患者作为研究对象,根据随机数字表法将其分为观察组(40例)和对照组(40例)。对照组予以常规对症治疗,观察组则在此基础上联合黄连温胆汤加味内服治疗。两组患者均连续治疗8周。比较两组患者治疗后的临床疗效,治疗前后的汉密尔顿抑郁量表(Hamilton depression scale,HAMD)、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)、匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、简易精神状态检查(mini-mental state examination,MMSE)、美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)、不良反应量表(treatment emergent symptom scale,TESS)、改良Barthel指数(modified Barthel index,MBI)、生活质量评分、血清去甲肾上腺素(norepinephrine,NE)、多巴胺(dopamine,DA)、5-羟色胺(5-hydroxytryptamine,5-HT)水平。结果治疗后观察组临床总有效率高于对照组;与治疗前比较,治疗后两组HAMD、HAMA、PSQI、NIHSS、TESS评分均降低,且观察组低于对照组;两组MMSE、MBI、生活质量各维度评分、血清NE、DA、5-HT水平均逐渐升高,且组间进行比较,观察组更高,差异有统计学意义(P<0.05)。结论黄连温胆汤应用于卒中后抑郁症患者的治疗中可有效缓解患者的焦虑、抑郁症状,提升睡眠质量,明显减轻神经功能和认知功能的损伤,有效促进神经递质水平的调节,使患者生活质量和日常生活活动能力明显提升,疗效显著且安全性高。

黄连解毒汤在重度颅脑损伤合并肺部感染中的护理效果

目的分析黄连解毒汤在重度颅脑损伤合并肺部感染循证护理中的护理效果。方法2021年1月至2022年12月,选取重度颅脑损伤合并肺部感染患者60例,按随机数字表法分为对照组(30例,行循证护理)和研究组(30例,行黄连解毒汤联合循证护理),比较两组肺部感染治愈情况、肺功能指标水平、生活质量评分、住院时间、住院费用及护理满意度。结果研究组感染治愈总有效率、各项生活质量评分、护理满意度均高于对照组(均P<0.05)。研究组FEV1和FVC水平均高于对照组(均P<0.05),两组FEV1/FVC比较无差异(P>0.05)。与对照组比较,研究组住院时间更短,住院费用更低(均P<0.05)。结论黄连解毒汤应用在重度颅脑损伤合并肺部感染循证护理中,可有效提高肺部感染治愈率、生活质量、患者满意度,缩短住院时间,减少住院费用。

基于网络药理学方法与分子对接技术探讨黄连解毒汤治疗类风湿关节炎的作用机制

目的:基于网络药理学方法和分子对接技术探讨黄连解毒汤治疗类风湿关节炎(RA)可能的作用靶点及相关机制。方法:通过TCMSP平台收集黄连解毒汤的活性成分和靶点,从GeneCards和DisGeNET数据库中检索RA疾病靶点,将疾病靶点与黄连解毒汤活性成分靶点取交集,获得黄连解毒汤治疗RA的潜在作用靶点。应用Cytoscape3.9.1软件构建中药-活性成分-疾病靶点可视化网络,分析网络节点度值以筛选关键活性成分。通过蛋白质-蛋白质相互作用(PPI)网络分析得到黄连解毒汤治疗RA的关键蛋白靶点,利用DAVID数据库对黄连解毒汤治疗RA的潜在靶点进行GO功能分析及KEGG通路富集分析,预测其作用机制。最后,借助AutoDockTools1.5.6软件进行分子对接,分析活性成分与关键蛋白靶点的相互作用关系。结果:共收集黄连解毒汤活性成分85个,对应治疗RA的潜在靶点114个。PPI网络分析显示,TP53蛋白(TP53)、肿瘤坏死因子(TNF)、白细胞介素-6(IL-6)等为黄连解毒汤治疗RA的关键靶点;GO功能分析显示,黄连解毒汤治疗RA的机制涉及基因表达的正向调控等680个生物过程、细胞外空间等60个细胞组分、酶结合位点等128个分子功能;KEGG通路富集分析显示,黄连解毒汤活性成分主要通过AGE/RAGE、TNF、TLRs及PI3K-Akt等信号通路来对抗RA;分子对接显示,黄连解毒汤主要的有效活性成分与关键靶点分子TP53、TNF、IL-6能够自发结合。结论:黄连解毒汤通过多成分、多靶点及多通路发挥其治疗RA的作用。

虎符铜砭刮痧联合黄连阿胶汤加减治疗阴虚火旺型焦虑性失眠的临床研究

目的 分析虎符铜砭刮痧联合黄连阿胶汤加减治疗阴虚火旺型焦虑性失眠的临床研究。方法 选择2020年8月-2022年12月收诊的80例阴虚火旺型焦虑性失眠患者,采用随机数字法将患者分成3组,即刮痧组(n=26,虎符铜砭刮痧治疗)、中药组(n=26,黄连阿胶汤加减治疗)、联合治疗组(n=28,虎符铜砭刮痧联合黄连阿胶汤加减治疗),对比3组患者治疗效果、睡眠质量[匹兹堡睡眠质量指数(PSQI)]、睡眠进程[多导睡眠监测(PSG)睡眠进程指数]、神经递质情况[去甲肾上腺素(NE)、多巴胺(DA)、5-羟色胺(5-HT)]、中医证候积分。结果 联合治疗组总有效率(92.86%)显著高于刮痧组(65.38%)、中药组(69.23%)(P <0.05);与治疗前比较,治疗后3组患者PSQI总分及其各因子评分均呈现下降趋势,其中联合治疗组各评分均低于刮痧组、中药组(P <0.05);治疗后联合治疗组觉醒次数、睡眠潜伏期、觉醒时间、快速眼球运动睡眠、潜伏期明显低于刮痧组、中药组,而联合治疗组睡眠效率明显高于刮痧组、中药组(P <0.05);治疗后3组NE、DA明显下降,5-HT显著升高,其中联合治疗组指标变化程度最大(P <0.05);3组治疗后中医证候积分显著降低,其中联合治疗组评分下降幅度最大(P <0.05)。结论 虎符铜砭刮痧联合黄连阿胶汤加减治疗对阴虚火旺型焦虑性失眠患者的临床疗效显著,可有效改善其睡眠质量,值得推广。