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.

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 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.

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.

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.

Effectiveness and safety of Jiawei Xiaoyao pill(加味逍遥丸)in the treatment of premenstrual syndrome(liver depression,spleen deficiency,and blood-heat syndrome):a multi-center,randomized,placebo-controlled trial

OBJECTIVE:To investigate the effectiveness and safety of Jiawei Xiaoyao pill(加味逍遥丸,JXP)in the treatment of symptoms associated with premenstrual syndrome(PMS).METHODS:A total of 144 regularly menstruating women with PMS were recruited at 8 sites in China from August 2017 to December 2018,and randomized to receive either a JXP or a matching placebo(12 g/d,6 g twice a day)for 3 menstrual cycles.The primary indicator was the reduced Daily Record of Severity of Problems(DRSP)scores in the luteal phase after 3 months of treatment.The safety outcomes included clinical adverse events(AEs),adverse reactions(ARs),changes in vital signs,and laboratory tests.RESULTS:JXP surpassed the placebo in reducing DRSP scores(psychological/somatic dysfunction)in the luteal phase over 3 menstrual cycles of treatment(PFAS=0.002,PPPS=0.001).Additionally,there were no significant differences in the incidence of AEs,severe AEs,withdrawal due to AEs and ARs between the two groups(all P>0.05),and no clinically significant adverse medical events related to the test drug observed.CONCLUSIONS:JXP was superior to the placebo in relieving the symptoms associated with PMS,which signified that JXP may be effective,safe,and welltolerated as an alternative therapy.

Jiawei Xiaoyao San in treatment of anxiety disorder and anxiety:A review

Jiawei Xiaoyao San(JWXYS)has shown excellent clinical efficacy in anxiety disorder,but has not yet attracted widespread attention.The animal experiments,clinical trials and mechanism studies of JWXYS were reviewed in this article,which may provide a reference for developing new anxiolytic drugs based on this prescription.The literature was searched in PubMed and CNKI and the documents written in English or with English abstracts were selected.JWXYS could reduce the anxiety symptoms of patients alone and reduce the adverse reactions when it is used in combination with other drugs in the clinic.In preclinical studies,JWXYS also showed therapeutic effects in reducing anxiety-like behavior.The mechanisms may include improving the hypothalamic–pituitaryadrenal(HPA)axis and hormone disorders,increasing neurotransmitter content,neurogenesis,and regulating the synthesis of related enzymes.This article shows that JWXYS could effectively treat anxiety disorders by regulating the central nervous system.In the future,with the participation of more researchers,it is expected to develop innovative drugs for the treatment of anxiety disorders based on JWXYS.

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。

加味升降散对早期糖尿病肾病患者肾小管功能的影响

目的:观察加味升降散对早期糖尿病肾病(DN)患者肾小管功能的影响及其作用机制。方法:选取2018年3月至2019年10月河北省中医院肾内科门诊及住院部收治的早期DN患者92例作为研究对象,中医辨证属气阴两虚、浊毒郁热证。用简单随机化法分为对照组和观察组,每组46例。对照组给予基础治疗;观察组在基础治疗上加服加味升降散,疗程均为2个月。记录2组患者治疗前后中医证候积分;临床指标:糖化血红蛋白(HbA1c),低密度脂蛋白(LDL),总胆固醇(TC),尿微量白蛋白排泄率(UAER),肾小球滤过率(GFR);肾小管功能标志物:β2-微球蛋白(β2-MG),肝型脂肪酸结合蛋白(L-FABP),α1-微球蛋白(α1-MG);氧化应激指标:NADPH氧化酶4(NOX4),超氧化物歧化酶(SOD),总抗氧化能力(T-AOC)。结果:治疗后,观察组总有效率为92.68%,对照组为81.40%,差异有统计学意义(P<0.05);2组患者中医证候积分、HbA1c、TC、LDL、UAER均较前下降,且观察组下降更为显著(均P<0.05);2组患者治疗前后GFR变化不明显,α1-MG、β2-MG、L-FABP水平均较前降低,且观察组下降更显著(均P<0.05);2组患者NOX4表达受到抑制,T-AOC、SOD水平回升(均P<0.05),观察组患者NOX4表达的下降以及T-AOC、SOD水平的回升更显著(P<0.05);2组患者均未出现不良反应。结论:加味升降散能够改善早期DN患者临床症状,调节氧化-抗氧化失衡,减轻氧化应激,缓解肾小管损伤。

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。

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。

加味桃红四物汤联合利伐沙班在髋关节置换术后的应用

目的探讨加味桃红四物汤联合利伐沙班在髋关节置换术后应用的效果,旨在评估其对术后血栓预防、炎症因子水平及并发症的影响。方法本研究为随机对照试验,前瞻性选取2019年11月至2023年11月在宝鸡市中医医院行髋关节置换手术的120例患者,采用随机数字表法将患者分为观察组(60例)和对照组(60例)。观察组男30例,女30例;年龄(65.25±10.33)岁;病程(4.72±1.15)年。对照组男28例,女32例;年龄(63.96±10.87)岁;病程(4.68±1.13)年。对照组采用利伐沙班治疗方案,观察组采用加味桃红四物汤与利伐沙班的联合治疗方案。比较两组在治疗前及治疗14 d后的凝血功能指标[血浆凝血酶原时间(PT)、凝血酶时间(TT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)及D-二聚体(D-D)]、血流变学指标(全血粘度、血浆粘度、红细胞比容、红细胞刚性指数及红细胞变形指数)、促炎性细胞因子指标[C反应蛋白(CRP)]、并发症及深静脉血栓(DVT)方面的差异。采用独立样本t检验、配对样本t检验和χ^(2)检验。结果治疗前,两组各项指标比较,差异均无统计学意义(均P>0.05)。治疗14 d后,观察组PT[(15.79±2.33)s]、TT[(19.05±3.12)s]和APTT[(30.21±4.07)s]均长于对照组[(14.01±2.67)s、(15.52±2.79)s、(27.33±3.49)s](均P<0.05);观察组FIB[(3.52±1.08)g/L]和D-D水平[(0.22±0.04)mg/L]均低于对照组[(4.09±1.06)g/L、(0.33±0.06)mg/L](均P<0.05)。治疗14 d后,观察组全血粘度[(4.07±1.28)mPa·S]、血浆粘度[(1.48±0.43)mPa·S]、红细胞比容[(37.56±2.79)%]、红细胞刚性指数(5.47±0.77)均低于对照组[(4.65±0.27)mPa·S、(2.02±0.39)mPa·S、(42.06±2.17)%、(6.23±0.84)](均P<0.05);观察组红细胞变形指数(0.84±0.03)高于对照组(0.74±0.07)(P<0.05)。治疗14 d后,观察组CRP水平[(4.25±1.09)mg/L]低于对照组[(7.97±2.14)mg/L](P<0.05)。治疗后14 d内,观察组并发症总发生率[13.33%(8/60)]和DVT阳性率[6.67%(4/60)]均低于对照组[25.00%(15/60)、20.00%(12/60)](均P<0.05)。结论加味桃红四物汤与利伐沙班的联合应用在预防髋关节或膝关节置换术后DVT的效果显著,能有效改善血流变学参数,抑制血液凝集,降低并发症发生率。

基于PTEN与JAK对PI3K/Akt信号通路的影响探讨加味小蓟饮子治疗急性放射性膀胱炎的作用机制

目的:探讨加味小蓟饮子治疗急性放射性膀胱炎的作用机制。方法:50只ICR小鼠随机分为空白组12只和造模组38只。采用X射线辐照仪造模,造模后随机取2只小鼠处死鉴定模型是否成功。将剩余造模组小鼠随机分为模型组、小蓟饮子组和加味小蓟饮子组各12只。空白组、模型组、小蓟饮子组、加味小蓟饮子组分别予0.9%氯化钠、0.9%氯化钠、小蓟饮子药液,加味小蓟饮子药液灌胃处理,每日1次,连续7 d。末次灌胃后24 h处死取材,酶联免疫吸附实验(ELISA)法检测血清超氧化物歧化酶(SOD)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)、总抗氧化能力(T-AOC)含量。Western Blot法检测小鼠膀胱丝氨酸/苏氨酸激酶(AKT)、E钙粘着蛋白(E-Cadherin)、内皮素-1(ET-1)、JAK激酶(JAK)、核转录因子红系2相关因子2(Nrf2)、磷脂酰肌醇3-激酶(PI3K)、人第10号染色体缺失的磷酸酶(PTEN)、Smad蛋白2(Smad2)、Smad蛋白3(Smad3)、转化生长因子β1(TGF-β1)、尿斑蛋白3(Upk3)、血管内皮生长因子(VEGF)蛋白相对表达水平;实时荧光免疫定量-聚合酶链式反应法(RT-PCR)法检测小鼠膀胱微RNA-21(MicroRNA-21,miR-21)、PTEN、JAK、PI3K、AKT、Nrf2信使核糖核酸(mRNA)相对表达水平。结果:相较模型组,加味小蓟饮子组小鼠体内SOD、GSH-Px、T-AOC、AKT、E-Cadherin、JAK、Nrf2、PI3K、Upk3含量升高(P<0.05),MDA、ET-1、PTEN、Smad2、Smad3、TGF-β1、VEGF含量下降(P<0.05);与模型组和小蓟饮子组比较,加味小蓟饮子miR-21 mRNA表达升高(P<0.05)。结论:加味小蓟饮子组可能通过上调miR-21表达,同调PTEN、JAK蛋白以激活下游PI3K/AKT/Nrf2信号通路治疗急性放射性膀胱炎。

加味玉屏风散治疗气虚毒瘀型晚期肝癌的临床研究

目的观察加味玉屏风散治疗气虚毒瘀型晚期肝癌的临床疗效及对患者血清胸腺基质淋巴细胞生成素(TSLP)水平的影响。方法采用随机双盲法将120例气虚毒瘀型晚期肝癌患者分为加味玉屏风散组、玉屏风散组和安慰剂组各40例,3组患者均给予放疗、化疗、介入或靶向治疗等常规治疗,加味玉屏风散组加服加味玉屏风散颗粒,玉屏风散组加服玉屏风散颗粒,安慰剂组加服安慰剂,疗程均为2个月。治疗前后观察3组患者Karnofsky功能状态评分(KPS评分)、中医证候积分、瘤体大小及血清TSLP水平变化情况,并将肿瘤大小变化与TSLP变化进行相关性分析。结果治疗后,玉屏风散组及加味玉屏风散KPS评分均显著提高(P<0.05,P<0.01),中医证候总积分显著降低(P<0.01),同时明显延缓肿瘤的生长(P<0.05,P<0.01),显著降低血清中TSLP水平(P<0.05,P<0.01)。此外,肿瘤大小变化与TSLP变化呈轻度正相关(P<0.05)。在改善瘤体大小方面,加味玉屏风散组疗效优于玉屏风散组(P<0.05)。治疗期间,3组患者均未见明显不良反应。结论加味玉屏风散联合常规治疗可显著延缓气虚毒瘀型晚期肝癌患者的肿瘤生长,改善患者中医症状同时显著提高患者生存质量,其疗效机制可能为通过降低患者血清TSLP表达,改善机体免疫状态有关。

加味强壮散对白羽肉鸡血清抗氧化及免疫功能的影响

研究加味强壮散对白羽肉鸡的抗氧化功能和免疫球蛋白及脏器组织形态结构的影响,为加味强壮散用于白羽肉鸡健康养殖提供依据。选取88只健康、体重相近的1日龄白羽肉鸡,雌雄各半,随机分成4组,包括1个空白对照组(饲喂基础饲粮)和3个试验组(分别在基础饲粮中添加0.2%、0.4%、0.8%的加味强壮散),连续饲养42 d。与对照组相比,饲粮添加0.8%加味强壮散能显著提高血清总抗氧化能力、谷胱甘肽过氧化物酶活力(P<0.05),显著降低血清中丙二醛含量(P<0.05),能显著提高血清免疫球蛋白IgA和IgM的含量(P<0.05);组织形态学观察发现加味强壮散可促进免疫器官发育。在饲粮中添加不同比例的加味强壮散可提高白羽肉鸡的抗氧化功能,增加免疫球蛋白含量,促进免疫器官发育,其中以0.8%的添加量效果最佳。