Regulating and tonifying spleen and kidney traditional Chinese medicine in the treatment of chronic uric acid nephropathy: A systematic review

Objective:To systematically evaluate the efficacy and safety of traditional Chinese medicine for regulating spleen and kidney.Methods:We developed a search strategy and then retrieved the database including CNKI,Wanfang data knowledge service platform,VIP journals resource integration service platform,PubMed,Embasefor randomized controlled trial of regulating spleen and kidney traditional Chinese medicine compared with conventional western medicine in the treatment of chronic uric acid nephropathy.The search deadline was set to June 30,2020.For the included literature,we applied the cochrane collaboration network risk bias assessment tool to evaluate the methodological quality,and evaluated the level of evidence according to GRADE standards.Quantitative data was analyzed by RevMan5.3 software,and trial sequential analysis method was used to analyze its efficiency.Results:A total of 709 cases in 10 articles were included.Compared with the control group,the related traditional Chinese medicine group improved the effective rate[RR=1.45,95%CI(1.32,1.58)],reduced the level of UA[MD=-36.24,95%CI(-41.03,-31.45)],BUN[SMD=-1.27,95%CI(-1.47,-1.07)]and SCR[MD=-36.33,95%CI(-55.79,-16.87),P=0.0003],the difference between the two groups was statistically significant(P<0.05).There was no evidence that a significant adverse reaction occurred.The results of TSA analysis showed that the Chinese medicine group had definite evidence for improving the efficiency.According to the GRADE evaluation criteria,the efficiency,UA,BUN and SCR outcome indicators were extremely low-quality evidence.Conclusions:Traditional Chinese medicine for regulating spleen and kidney in the treatment of chronic uric acid nephropathy improved efficiency,reduced the level of UA,BUN,SCR.Meanwhile,the therapy was proved to be safe.Nevertheless,the conclusions need further high-quality evidence to support.

Professor Fengjie He’s Experience in Treating Polycystic Ovary Syndrome of Kidney Asthenia and Liver Depression

Polycystic ovary syndrome is a common reproductive endocrine metabolic disease in clinic.Professor Fengjie He has accumulated rich clinical experience in the process of diagnosis and treatment of the disease.He believes that the key to the pathogenesis of the disease is the dysfunction of the reproductive axis of“kidney-Tiangui-Chongren-uterus,”which is based on kidney deficiency and involves the liver and spleen.Clinically,patients with kidney deficiency and liver depression are common.The treatment takes tonifying the kidney and regulating the menstrual cycle as the main method,and the clinical effect is very effective.

Effectiveness of tonifying-kidney and regulating-liver therapy on diminished ovarian reserve: a systematic review and Meta-analysis of randomized controlled trials

OBJECTIVE: To evaluate the effectiveness of the Traditional Chinese Medicine tonifying-kidney and regulating-liver therapy on diminished ovarian reserve(DOR).METHODS: The literature was comprehensively searched up to August 2019 using four Chinese and three English electronic databases to extract randomized clinical trials(RCTs) comparing Traditional Chinese Medicine tonifying-kidney and regulating-liver prescriptions(combined with hormone therapy or not) with Western Medicine. Data quality evaluation was conducted using the Cochrane risk of bias tool. Meta-analysis was conducted using Revman 5.3 software with effect estimates presented as mean difference(MD), risk ratio(RR), and95% confidence interval(CI).RESULTS: A total of nine RCTs with 512 participants were extracted and eligible for Meta-analysis.There were no significant differences between Chinese medicine and Western Medicine on basal serum follicle-stimulating hormone(FSH) level(MD0.11, 95% CI-0.52 to 0.74, 392 participants, seven trials), anti-Müllerian hormone level(MD 0.48, 95%CI-0.62 to 1.58, 95 participants, two trials), and the FSH and luteinizing hormone ratio(MD 0.01,95% CI-0.95 to 0.96, 115 participants, two trials).Chinese medicine was more effective at improving Traditional Chinese Medicine symptom scores(TCMSS)(MD-2.39, 95% CI-3.83 to-0.94, 160 participants, three trials), effective rate of TCMSS(RR1.18, 95% CI 1.02 to 1.36, 160 participants, three trials), antral follicle count(AFC)(MD 0.55, 95% CI 0.05 to 1.04, 155 participants, three trials), and FSH levels at 3 months post-treatment(MD-4.77, 95% CI-6.09 to-3.45, 137 participants, two trials).CONCLUSION: Compared with Western Medicine,tonifying-kidney and regulating-liver therapy is more effective at relieving symptoms and improving AFC and FSH at 3 months post-treatment.

Influence of electroacupuncture therapy of tonifying the kidney and regulating governor vessel on Aβ related degradation enzymes in the hippocampus of a rat model of Alzheimer's disease induced by Aβ_(1-42)

Objective： To explore influence of electroacupuncture（EA） therapy of tonifying the kidney and regulating governor vessel on amyloid beta（Aβ） related degradation enzymes in the hippocampus of a rat model of Alzheimer＇s disease（AD） induced by Aβ（1-42）.Methods： Forty Wistar male rats were randomly divided into 4 groups： a normal group, a sham operation group, a model group and an EA group, 10 rats in each one. The rats in normal group were normally fed. The rats in sham operation group were bilaterally injected in the hippocampus with 5 μL of saline and they were normally fed after the injection. The rats in the model group and the EA group were bilaterally injected in the hippocampus with 5 μL of Aβ（1-42） on each side. Rats in the EA group received EA of 5 Hz continuous wave at the ＂Bǎihuì（百会 GV20）＂ and bilateral ＂Shènshū（肾俞 BL23）＂ for a duration of 15 min per time every day and continuously for 15 days. After 15 days, the hippocampal expression levels of insulin degrading enzyme（IDE）, lipoprotein（LPL）, transthyretin（TTR）, apolipoprotein E（APoE）,a2 macroglobulin（a2 M） and Aβ（1-42） of the 4 groups were tested by Western blot.Results： Compared with the sham operation group, the expression levels of IDE, LPL, TTR, APoE and a2 M in the hippocampus were significantly lower（P〈 0.05, P〈 0.01） and the expression of Aβ（1-42） was significantly higher（P〈 0.01） in the model group. Compared with the model group, the expression levels of IDE, LPL, TTR,APoE and a2 M in the hippocampus of these rats were significantly lower（P〈 0.05,P〈 0.01）, the expression of Aβ（1-42） was significantly higher（P〈 0.01） in the EA group.Conclusion： EA therapy of tonifying the kidney and regulating governor vessel can enhance the expression of IDE, LPL, TTR, APoE, and a2 M in the hippocampus of AD rats injected by Aβ（1-42）, and may consequently promote the degradation of aβ（1-42） to help improve the pathological manifestations of AD and therefore delay its progression.

One Case of Professor ZHAO Jun's Effective Intervention in Children's Height After Menstrual Onsets

A clinical case of Professor ZHAO Jun's intervention in children's height after menstrual onsets is introduced in this paper,and she believes that regulating spleen and kidney should be paid attention to children in the middle and late stages of puberty.In clinical practice,Pericarpium Citri Reticulatae,Rhizoma Pinelliae and Poria in Erchen Decoction(二陈汤)are used to remove dampness and resolve phlegm,as well as to regulate Qi(气)and invigorate spleen.Fructus Ligustri Lucidi and Herba Ecliptae in Erzhi Pills(二至丸)are applied to invigorate liver and kidney,as well as to regulate Thoroughfare and Conception Channels,so as to achieve the effect of Yin(阴)and Yang(阳)coordination.It has significant efficacy.

Microenvironment of Liver Regeneration in Liver Cancer

The occurrence and development of liver cancer are essentially the most serious outcomes of uncontrolled liver regeneration. The progression of liver cancer is inevitably related to the abnormal microenvironment of liver regeneration. The deterioration observed in the microenvironment of liver regeneration is a necessary condition for the occurrence, development and metastasis of cancer. Therefore, the use of a technique to prevent and treat liver cancer via changes in the microenvironment of liver regeneration is a novel strategy. This strategy would be an effective way to delay, prevent or even reverse cancer occurrence, development and metastasis through an improvement in the liver regeneration microenvironment along with the integrated regulation of multiple components, targets, levels, channels and time sequences. In addition, the treatment of ＂tonifying Shen（Kidney） to regulate liver regeneration and repair by affecting stem cells and their microenvironment＂ can regulate ＂the dynamic imbalance between the normal liver regeneration and the abnormal liver regeneration＂; this would improve the microenvironment of liver regeneration, which is also a mechanism by which liver cancer may be prevented or treated.