Combination of Shengmai San and Radix puerariae ameliorates depression-like symptoms in diabetic rats at the nexus of PI3K/BDNF/SYN protein expression

Background:Hyperglycemia is a characteristic feature of diabetes that often results in neuropsychological complications such as depression.Diabetic individuals are more vulnerable to experience depression compared to the normal population.Thus,novel treatment approaches are required to reduce depressive symptoms among diabetic individuals.Traditional Chinese medicines(TCMs)such as Shengmai San(SMS)and Radix puerariae(R)are usually widely used to treat ailments such as neurological com-plications since ancient time.Methods:In this study,SMS was combined with R to prepare an R-SMS formulation and screened for their antidepressant activity in diabetic rats.The antidepressant po-tential of the prepared combination was evaluated behaviorally using open field test,novelty-induced hypophagia,and forced swim test in diabetic rats with biochemical and protein expression(PI3K,BDNF[brain-derived neurotrophic factor],and SYN[pr-esynaptic vesicle protein])analysis.Results:Diabetic rats(streptozotocin,45 mg/kg)showed elevated fasting blood glu-cose(FBG)>12 mM with depressive symptoms throughout the study.Treatment with R-SMS(0.5,1.5,and 4.5 g/kg)significantly reverted depressive symptoms in diabetic rats as evinced by significantly(p<0.05)reduced immobility time with an increased tendency to eat food in a novel environment.Treatment with R-SMS also significantly increased the protein expression of PI3K,BDNF,and SYN protein,which play a crucial role in depression.Conclusion:This study showed that R-SMS formulation antagonized depressive symptoms in diabetic rats;thus,this formulation might be studied further to develop as an antidepressant.

Effect of Shengmai Yin on the DNA methylation status of nasopharyngeal carcinoma cell and its radioresistant strains

Shengmai Yin(SMY)is a Chinese herbal decoction that effectively alleviates the side effects of radiotherapy in various cancers and helps achieve radiotherapy’s clinical efficacy.In this study,we explored the interaction mechanism among SMY,DNA methylation,and nasopharyngeal carcinoma(NPC).We identified differences in DNA methylation levels in NPC CNE-2 cells and its radioresistant cells(CNE-2R)using the methylated DNA immunoprecipitation array and found that CNE-2R cells showed genomewide changes in methylation status towards a state of hypomethylation.SMY may restore its original DNA methylation status,and thus,enhance radiosensitivity.Furthermore,we confirmed that the differential gene Tenascin-C(TNC)was overexpressed in CNE-2R cells and that SMY downregulated TNC expression.This downregulation of TNC inhibited NPC cell radiation resistance,migration,and invasion.Furthermore,we found that TNC was hypomethylated in CNE-2R cells and partially restored to a hypermethylated state after SMY intervention.DNA methyltransferases 3 a may be the key protein in DNA methylation of TNC.

Observation on Therapeutic Effects of Shengmai Powder (生脉散)in Treating Acute Viral Myocarditis

Objective: To evaluate the clinical efficacy of Shengmai Powder (SMP, 生脉散) in treating a-cute viral myocarditis objectively. Methods: One hundred and twenty-four patients with acute viral myocarditis were randomized into the treated group (SMG, n = 64) and the control group(CG, n = 60 ). Such myo-cardial nutrient medicine as ATP, CoA , Vit-C, were given to both groups. And to the treated group, 40 ml of Shengmai Injection per day was given intravenously for 2 weeks, which was followed by oral intake of Shengmai granule, one package three times daily for another 2 weeks in total. The same anti-arrhythmia agents were applied to both groups, and no fructose-1, 6-diphosphate (FDP) for either. Semi-quantitative scoring method was adopted to observe such symptoms as chest stuffiness, palpitation and chest pain before treatment and four weeks after treatment. Meanwhile, EGG, dynamic ECG by Holter monitor, left ventricular end-diastolic dimension (LVEDD), left ventricular ejection fraction (LVEF), serum neutralizing antibody of virus Coxsackie B, cardiac troponin I (cTnl) and cardiac troponin T (cTnT) were examined. Results: (1) Compared with the control group, more significant improvement was got in SMG in respects of chest stuffiness, palpitation, chest pain and arrhythmia (P<0.05 or P<0.01). (2) Negative converting rates of cTnl ,cTnT in the two groups were 59.46% vs35.48%, 68.75% vs42.31% respectively ( P<0. 05). (3) LVEDD before and after treatment in SMG was 52. 44 ± 3. 40 mm and 48. 81 ± 2. 23mm respectively, while that in the control group was 52. 31 ± 3. 74 mm and 49. 92 ± 2. 67mm respectively; LVEF before and after treatment in SMG was 60.67 ± 4. 62 % and 65. 02 ± 4. 16 % respectively, while that in the control group was 60.91 ± 4. 26 % and 63. 67 ± 3.17 % . There was obvious improvement in the two parameters in both groups, but the improvement in SMG was superior to that in the control group ( P<0. 05). Conclusion: SMP shows a good effect in improving clinical symptoms and signs, heart function, abnormal ECG and inflammatory injury indexes in patients with acute viral myocarditis.

Network analysis and molecular docking of the mechanism of Shengmai decoction in treating patients with severe novel coronavirus pneumonia

Background:Studies have shown that,Shengmai injection(Shengmai decoction)which has been included in the diagnosis and treatment of coronavirus disease 2019(COVID-19),is effective in the early treatment of patients with severe COVID-19.However,the mechanism of its intervention in severe stage of COVID-19 at molecular level is still unclear.Therefore,it is necessary to further explore the mechanism of Shengmai decoction in the treatment of patients with severe COVID-19 based on network pharmacology.Methods:The Traditional Chinese Medicine Systems Pharmacology,BATMAN,UniProt databases and the published literatures which contain the reported compounds that have therapeutic effects on COVID-19 were used to screen out the active ingredients and targets of Shengmai decoction,and the“drug-active compound-target”network was constructed.The GeneCards database was used to screen out the targets of COVID-19.The protein-protein interaction network map was constructed by mapping two genes,and the network of active ingredients,targets and disease was constructed using Cytoscape software.Thereafter,Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses of the key targets were performed using the Metascape Site Maintenance website and David databases.The Gene Ontology function and Kyoto Encyclopedia of Genes and Genomes pathway enrichment of the mapping targets were analyzed.Results:The active component-target network contained 73 main compounds and 457 targets.The first five main active components(hydroquinone,guanosine,ophiopogon C,ophiopogon B,ophiopogon D)were obtained by topological analysis of 33 common targets.Using the Matthews correlation coefficient algorithm,the key targets included albumin,tumor necrosis factor,and cyclic adenosine response element binding.Compounds in Shengmai decoction were found to have good binding effect and strong interaction with caspase-8,caspase-3,apoptosis regulator Bcl-2,tumor necrosis factor,C-C motif chemokine 3,to inhibit the inflammatory response and improve lung injury.Additionally,31 biological processes were obtained by Gene Ontology enrichment,mainly related to lipopolysaccharide response and cytokine-mediated signal pathways,and 71 biological processes were obtained by Kyoto Encyclopedia of Genes and Genomes enrichment,mainly related to pulmonary tuberculosis,hepatitis B,and mitogen-activated protein kinase signal pathways.Conclusion:Shengmai decoction has multicomponent,multitarget and multichannel characteristics,which can provide an important theoretical basis to treat patients with severe COVID-19.

Shengmai Suppressed Vascular Tension in Umbilical Arteries and Veins of Human and Sheep

Objective—The umbilical cord is a critical pathway between mothers and fetuses, and regulations of umbilical vessel tension are important for fetal growth. Shengmai is an herbal medicine being used in treatments of cardiovascular diseases. However, effects of Shengmai on human blood vessels and related pharmacological mechanisms are unclear. Methods—This study investigated the effects of related mechanisms of Shengmai and its key compounds on human and sheep umbilical arteries and veins using organ bath systems. Key Findings—Shengmai significantly suppressed phenylephrine-stimulated vasoconstriction in umbilical arteries and veins. NG-Nitro-L-arginine Methyl Estercould not change the Shengmai-suppressed vasoconstriction in human and sheep umbilical vessels. Among four key compounds of Shengmai, Ginsenoside Re, Ginsenoside Rb1, Ginsenoside Rg1, and Schisandrin, only Ginsenoside Re showed the significant effect similar to Shengmai’s in the umbilical vessels. In Ca2+-free solution, Ginsenoside Re did not affect vasoconstriction. In addition, caffeine- or phenylephrine-stimulated vasoconstriction were not changed by Ginsenoside Re. Either charybdotoxin or glibenclamide could inhibit Ginsenoside Re-caused inhibition of the stimulated vasoconstriction in both human and sheep umbilical vessels, where 4-aminopyridine did not show the similar inhibitory effect. Conclusion—The results provide new information on Shengmai’s effects and underlying mechanisms in umbilical vessels. Importantly, the information gained offers interesting potential for developing new drugs acting on umbilical cords for fetal medicine.

Effectiveness of Shengmai Injection on angina pectoris based on real-world propensity score method

Objective:Shengmai injection is a commonly used traditional Chinese medicine for the treatment of angina pectoris.However,there is still a lack of high-quality clinical research evidence for the treatment effect of Shengmai injection for angina pectoris.Real-world studies based on large samples can provide Shengmai injection.Researches on the treatment of angina pectoris with Shengmai injection provide important evidence.Methods:This article is based on the information collected by the hospital information system(HIS)database of 22 tertiary A general hospitals for all patients who used Shengmai injection and those who did not use Shengmai injection.The propensity scoring method was used to evaluate the possible existence of the research data.The confounding factors are controlled.Through the general Logistic regression analysis method,the propensity score weighted Logistic regression analysis method and the propensity score weighted Logistic regression analysis method with covariates,the therapeutic effect of Shengmai injection on angina pectoris was explored.Results:Three kinds of logistic regression analysis showed that there were statistical differences in the treatment effect of Shengmai injection on angina pectoris in the group without Shengmai injection.Propensity score weighted logistic regression analysis with covariates balanced the effect of multiple confounding factors.Using real-world data to construct a retrospective cohort study confirmed the clinical effectiveness of Shengmai injection in the treatment of angina pectoris,and at the same time confirmed the wide application of Shengmai injection in angina pectoris complicated with multiple organ failure.Conclusion:Shengmai injection is effective in the treatment of angina pectoris.The weighted method of propensity score removes confounding factors,which improves the reliability of real-world research results.

Optimal scheme of Shengmai Injection in the treatment of angina pectoris of coronary heart disease based on Louvain algorithm: A real world study

Objective:To explore the optimal scheme of Shengmai Injection combined with other drugs for clinical doctors.Methods:Based on the large-scale data warehouse established by the institute of Clinical Basic Medicine,Chinese Academy of Traditional Chinese Medicine,the hospital information system of 22 large-scale tertiary hospitals in China was collected and 1751 patients with angina pectoris who were treated with Shengmai Injection were selected.Louvain algorithm and complex network analysis are used to build the model to summarize the rule of Shengmai Injection in the treatment of angina pectoris of coronary heart disease.Results:On the basis of Shengmai Injection,according to the symptom treatment of angina pectoris of coronary heart disease,nitrates or Suxiao Jiuxin Pill was used to dilate coronary artery;for the treatment of risk factors of angina pectoris,a combination of"insulin+acarbose+bisoprolol+nifedipine+captopril+estazolam"was used to control blood glucose and blood pressure;"Ganmao Qingre Granule+levofloxacin"to treat upper respiratory tract infection and other medication regimens were used as well.For the complications of angina pectoris of coronary heart disease,"furosemide+spironolactone+potassium chloride+magnesium sulfate"was used to reduce edema and“isosorbide nitrate+metoprolol+Shenmai injection+Wenxin Granule"was used to improve symptom of heart failure of qi and yin deficiency type.Conclusion:The therapeutic regimen of Shengmai Injection combined with traditional chinese medicine and western medicine is basically consistent with the current guidelines,but more clinical studies are still needed to explore more effective combination therapy.

Effects of Dengzhan Shengmai Capsule combined with antiplatelet drug and statin therapy on platelet function, inflammatory response and lipid metabolism in patients with unstable angina pectoris

Objective: To study the effects of Dengzhan Shengmai Capsule combined with antiplatelet drug and statin therapy on platelet function, inflammatory response and lipid metabolism in patients with unstable angina pectoris. Methods: A total of 96 patients who were diagnosed with unstable angina pectoris for the first time in Beijing Shunyi District Hospital of Traditional Chinese Medicine between February 2015 and January 2018 were chosen and randomly divided into two groups, the observation group received Dengzhan Shengmai Capsule combined with antiplatelet drug and statin therapy, and the control group only accepted antiplatelet drug and statin therapy. Platelet function parameters, inflammatory response parameters and lipid metabolism parameters were determined before treatment and after 2 months of treatment. Results: Compared with those of same group before treatment, PAF, P-selectin, PDGF, E-selectin, Gal-3, TNF-α, IFN-γ, LDL-C, PCSK9, Chemerin and Visfatin contents in serum as well as C3aR and C5aR contents in peripheral blood platelets of both groups of patients were decreasing whereas sFGL2, TGF-β1, APN and Vaspin contents in serum were increasing after treatment, and PAF, P-selectin, PDGF, E-selectin, Gal-3, TNF-α, IFN-γ, LDL-C, PCSK9, Chemerin and Visfatin contents in serum as well as C3aR and C5aR contents in peripheral blood platelets of observation group after treatment were lower than those of control group whereas sFGL2, TGF-β1, APN and Vaspin contents in serum were higher than those of control group. Conclusion: Dengzhan Shengmai Capsule combined with antiplatelet drug and statin therapy for unstable angina pectoris can more effectively inhibit the platelet aggregation and improve the inflammatory response and lipid metabolism.

Effects of Supplemented Shengmai San (SMS) on Blood Biochemistry and HSP72 Expression in Peripheral Blood of Flying-saucer Athletes before and after High Temperature Training

Objective:The purpose of this paper is to study the effects of supplemented Shengmai San on the expression of heat shock protein 72(HSP72)and blood biochemistry in peripheral blood of flying-saucer athletes before and after high temperature training,so as to provide experimental basis for enhancing thermal endurance and preventing heat disease of flying-saucer athletes with anti-heat disease drugs.Methods:24 flying-saucer athletes from Zhejiang province were selected and divided into two groups,including control group and traditional Chinese medicine group with 12 people in each group.Among them,those who did not drink supplemented Shengmai San were in the control group,while those who drank it were in the traditional Chinese medicine group.During summer training,high temperature training task was carried out for 2 weeks.Flying-saucer athletes in traditional Chinese medicine group were given supplemented Shengmai San before training every morning and afternoon.Peripheral venous blood of each group was extracted before experiment and 2 weeks later and lymphocyte HSP72 content,blood routine and biochemical indexes were determined respectively.Results:Before the experiment,there were no abnormal phenomenon blood routine,biochemical test value and HSP72 expression in the control group and the traditional Chinese medicine group.After comparison,there was no significant difference(P>0.05).After the high temperature training,the expression of HSP72 in the Chinese medicine group was significantly higher than that before the training and control group(P<0.05).There were significant differences in white blood cell count before and after the experiment(P<0.05).Conclusion:Taking supplemented Shengmai San can significantly increase expression of HSP72 in up-regulation of flying saucer athletes after thermal stimulation,thus enhancing thermal tolerance and preventing thermal diseases.

Shenxian Shengmai Oral Liquid for treatment of slow arrhythmia： a randomized controlled trial

缓慢性心律失常是临床上比较常见的疾病,在中老年人群中有着较高的发病率.已经有多项临床研究表明,参仙升脉口服液可以缓解改善缓慢性心律失常患者的临床症状.本试验纳入60名缓慢性心律失常的受试者,按照2：1随机分配到试验组（参仙升脉口服液）和对照组（参仙升脉口服液模拟剂）中.该临床试验是一项先导性试验,比较参仙升脉口服液治疗慢性心律失常的疗效,初步明确参仙升脉口服液对缓慢性心律失常患者的安全性及有效性.

Effects of Shengmai Yin(生脉饮)on pulmonary and cardiac function in coronavirus disease 2019 convalescent patients with cardiopulmonary symptoms:a randomized,double blind,multicenter control trial

OBJECTIVE:To evaluate the efficacy and safety of Shengmai Yin(生脉饮,SMY)on visual analogue scale(VAS)for cardiopulmonary symptoms in coronavirus disease 2019(COVID-19)convalescent patients.METHODS:In this randomized,double blind and multicenter controlled trial,a total of 200 COVID-19 convalescent patients who with cardiopulmonary symptoms were enrolled from three medical centers in Hubei,China.These patients were randomized divided into trial group and the control group,100 patients in each one,SMY and its placebo were applied to respectively,for two weeks.VAS of clinical symptoms included shortness of breath,hidrosis,chest distress,palpitation,and dry cough was performed at 0,1,2 weeks.Decrease in VAS of 30%or more was defined as effective,and a reduction in VAS of 0 was defined as curative.RESULTS:A total of 192 completed the study.The VAS of TCM symptoms showed there was no difference in baseline between the two groups.The VAS in both groups was down-regulated,and there was no significant difference in VAS and cure rates at the first and second week between the two groups.There was no significant difference in breath,hidrosis,palpitation,and dry cough between the two groups but SMY treatment for two weeks has remarkable therapeutic effects in chest distress than placebo.CONCLUSIONS:SMY could effectively ameliorate the symptoms of chest distress,and improve the quality of life of the COVID-19 convalescent patients.

Effect of Shengmai Yin on Epithelial-Mesenchymal Transition of Nasopharyngeal Carcinoma Radioresistant Cells

Objective: To investigate the mechanism by which Chinese medicine Shengmai Yin(SMY)reverses epithelial-mesenchymal transition(EMT) through lipocalin-2(LCN2) in nasopharyngeal carcinoma(NPC)cells CNE-2R. Methods: Morphological changes in EMT in CNE-2R cells were observed under a microscope,and the expressions of EMT markers were detected using quantitative real-time PCR(RT-q PCR) and Western blot assays. Through the Gene Expression Omnibus dataset and text mining, LCN2 was found to be highly related to radiation resistance and EMT in NPC. The expressions of LCN2 and EMT markers following SMY treatment(50 and 100 μg/m L) were detected by RT-q PCR and Western blot assays in vitro. Cell proliferation,migration, and invasion abilities were measured using colony formation, wound healing, and transwell invasion assays, respectively. The inhibitory effect of SMY in vivo was determined by observing a zebrafish xenograft model with a fluorescent label. Results: The CNE-2R cells showed EMT transition and high expression of LCN2,and the use of SMY(5, 10 and 20 μg/mL) reduced the expression of LCN2 and reversed the EMT in the CNE-2R cells. Compared to that of the CNE-2R group, the proliferation, migration, and invasion abilities of SMY high-concentration group were weakened(P<0.05). Moreover, SMY mediated tumor growth and metastasis in a dose-dependent manner in a zebrafish xenograft model, which was consistent with the in vitro results.Conclusions: SMY can reverse the EMT process of CNE-2R cells, which may be related to its inhibition of LCN2expression. Therefore, LCN2 may be a potential diagnostic marker and therapeutic target in patients with NPC.

冠心生脉丸质量标准提升

目的提升冠心生脉丸质量标准。方法TLC法定性鉴别人参和三七,分析采用硅胶G薄层板,以三氯甲烷-甲醇-水(13∶7∶2)10℃以下放置的下层溶液为展开剂,10%硫酸乙醇溶液为显色剂。HPLC法测定人参皂苷Rg1、人参皂苷Re、人参皂苷Rb1、人参皂苷Rd的含量,分析采用Thermo Accucore-C18色谱柱(4.6 mm×150 mm,2.6μm);流动相乙腈-水,梯度洗脱;体积流量0.8 mL/min;柱温20℃;检测波长203 nm。结果TLC斑点清晰,阴性无干扰。4种成分在各自范围内线性关系良好(R^(2)≥0.9999),平均加样回收率91.21%~106.86%,RSD 0.68%~1.43%。结论该方法专属性、重复性良好,可为冠心生脉丸质量控制提供参考。

基于网络药理学和生物信息学探讨生脉饮(党参方)治疗慢性心力衰竭的作用机制

目的:运用网络药理学和生物信息学方法,探究生脉饮(党参方)治疗慢性心力衰竭(CHF)的活性成分、作用靶点和分子通路,阐明生脉饮(党参方)治疗CHF的分子机制。方法:借助中药系统药理学数据库与分析平台(TCMSP)以及BATMAN-TCM平台获取生脉饮(党参方)有效活性成分及化合物潜在靶点,检索GeneCards、治疗靶点数据库(TTD)、DrugBank、DisGeNET数据库,筛选CHF相关靶点;将化合物与疾病交集靶点通过STRING数据库构建蛋白相互作用(PPI)网络图,采用Cytoscape软件获得生脉饮(党参方)作用于CHF的关键化合物和核心靶点,使用R语言软件包进行基因本体(GO)生物学过程分析和京都基因与基因组百科全书(KEGG)通路分析并可视化,在基因表达综合数据库(GEO)下载CHF基因表达芯片,经过R语言软件包处理后验证核心靶点基因差异表达情况,最后,使用Autodock软件将有效成分和核心靶点进行分子对接再次验证,并将结果可视化展示。结果:共筛选得到35个有效化学成分、120个潜在靶点,获得菠菜甾醇、11-羟基兰金断肠草碱、α菠菜甾醇、邻苯二甲酸二异辛酯、黄豆黄素、去氧哈林通碱等有效成分,丝氨酸/苏氨酸激酶(AKT1)、非受体酪氨酸激酶(SRC)、表皮生长因子受体(EGFR)等核心靶点,关键通路包括氧化应激、酪氨酸磷酸化修饰、磷脂酰肌醇-3激酶/蛋白激酶B(PI3K/AKT)等。GEO芯片验证结果显示核心靶点在健康组与疾病组之间差异表达明显。分子对接结果显示生脉饮(党参方)关键有效成分与核心靶点整体结合较好。结论:生脉饮(党参方)可能通过AKT1、SRC、EGFR、热休克蛋白(HSP90AA1)、前列腺素内过氧化物合酶2(PTGS2)、基质金属蛋白酶9(MMP-9)等多靶点和PI3K/AKT信号通路改善心肌重塑、抑制细胞凋亡、调节雌激素、抗脂质及动脉粥样硬化等作用改善CHF。

参仙升脉口服液中挥发性成分及无机元素研究

目的:利用挥发性物质的定性鉴别和无机元素的定量分析,探究参仙升脉口服液的化学物质基础。方法:采用顶空气相色谱-质谱联用(HS-GC-MS)分析技术,通过质谱信息,搜索美国国家标准与技术研究院(NIST)数据库,并结合相关文献资料,对参仙升脉口服液中的挥发性化学成分进行快速辨识;并利用电感耦合等离子体质谱(ICP-MS)分析技术对参仙升脉口服液中的21种无机元素进行定量分析。结果:从参仙升脉口服液中共检测到29个挥发性成分,这些成分主要归属于组方药材细辛,相对含量较高的成分有11个,占所鉴定挥发性成分总量的82.64%。无机元素定量分析结果显示,参仙升脉口服液中含有丰富的人体必需常量元素Na、Mg和K,以及较高水平的Fe、Zn、Mn微量元素;重金属及有害元素Cd、Pb、As、Hg、Cu的含量均符合相关限度要求。结论:阐明了参仙升脉口服液中的挥发性化学物质基础和无机元素的种类及含量,为其药效物质基础的研究和质量控制提供了依据。

生脉散合杏苏二陈方辅助西医基础治疗气阴两虚兼痰浊证急性加重期慢性阻塞性肺疾病患者的临床观察

目的 探讨生脉散合杏苏二陈方辅助西医基础治疗气阴两虚兼痰浊证急性加重期慢性阻塞性肺疾病(Acute exacerbation of chronic obstructive pulmonary disease,AECOPD)患者的临床疗效。方法 选取2020年3月—2022年3月期间六安市中医院收治的气阴两虚兼痰浊AECOPD患者80例,按照随机数字表法分为对照组和研究组,每组各40例。对照组采用常规西医基础疗法,研究组在对照组基础上联合生脉散合杏苏二陈汤。治疗1个月后,观察比较两组患者临床疗效,治疗前后中医证候评分、动脉血气指标[血氧饱和度(Oxygen saturation,SaO_(2))、动脉血氧分压(Partial pressure of oxygen,PaO_(2))、动脉血二氧化碳分压(Arterial carbon dioxide partial pressure,PaO_(2))]、炎症相关指标[白细胞介素-6(Interleukin-6,IL-6)、C反应蛋白(C-reactive protein,CRP)、降钙素原(Procalcitonin,PCT)]及肺通气功能相关指标[第1秒用力呼气容积(Forced expiratory volume in one second,FEV_(1))、用力肺活量(Forced Vital Capacity,FVC)、一秒率(Forced expiratory volume in one second/Forced Vital Capacity,FEV_(1)/FVC)]表达水平。结果 治疗后两组患者咳嗽、咳痰、喘息、发热、食欲下降、大便干结评分均较治疗前降低,差异有统计学意义(P<0.05);且研究组咳嗽、咳痰、喘息、发热、食欲下降、大便干结评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者SaO_(2)、PaO_(2)指标均较治疗前升高,PaCO_(2)指标均较治疗前降低,差异有统计学意义(P<0.05);且研究组SaO_(2)、PaO_(2)指标均较对照组明显升高,PaCO_(2)指标较对照组明显降低,差异有统计学意义(P<0.05)。治疗后两组患者炎症指标IL-6、CRP、PCT表达水平均较治疗前降低,差异有统计学意义(P<0.05);且研究组炎症指标IL-6、CRP、PCT表达水平均较对照组明显降低,差异有统计学意义(P<0.05)。治疗后两组患者FEV_(1)、FVC、FEV_(1)/FVC值均较治疗前明显升高,差异有统计学意义(P<0.05);且研究组FEV_(1)、FVC、FEV_(1)/FVC值均明显高于对照组,差异有统计学意义(P<0.05)。治疗后研究组临床总有效率92.50%(37/40)明显高于对照组75.00%(30/40),差异有统计学意义(P<0.05)。结论 生脉散合杏苏二陈汤通过改善气阴两虚兼痰浊证AECOPD患者的肺通气功能,同时还可调节机体免疫炎症反应,从而提高整体治疗效果。

Effect of Shengmai Injection (生脉注射液) on Vascular Endothelial and Heart Functions in Patients with Coronary Heart Disease Complicated with Diabetes Mellitus

Objective： To study the effect of Shengmai injection （生脉注射液, SMI） on vascular endothelial and heart functions in coronary heart disease patients complicated with diabetes mellitus （CHD-DM）. Methods： One hundred and twenty patients with CHD-DM, their diagnosis confirmed by coronary arteriography, were equally randomized into a control group treated with conventional treatment and a treated group treated with conventional treatment plus SMI. The changes in blood levels of nitric oxide （NO）, endothelin-1 （ET-1） and angiotensin Ⅱ （Ang Ⅱ）, as well as endothelium-dependent vascular dilating function and heart function in the patients were observed before treatment and after the 3-week treatment. Results： After being treated with SMI for 3 weeks, in the treated group, blood level of NO was raised significantly from 69.8±33.1 μmol/L to 120.1±50.8μmol/L, and ET-1 was lowered from 70.1±32.1 ng/L to 46.2±21.3 ng/L, respectively （P〈0.01）; that of Ang Ⅱ was lowered from 81.3±24.3 ng/L to 50.2±27.3 ng/L （P〈0.01）; brachial arterial post-congestion blood flow increasing rate was raised from 389.4±26.3% to 459.3±27.8% （P〈0.01）; and the improvement in heart function as seen through the ejection fraction （EF） was increased from 44±5% to 68±6% （P〈0.01）, all the changes being more significant than those in the control group （all P〈0.01）. Conclusion： SMI can improve not only the endothelial function in CHD-DM patients, but also heart contraction significantly.

Effect of Shengmai Injection(生脉注射液) on Cardiac Function and Inflammatory Reaction in Patients with Acute Coronary Syndrome

Objective： To confirm the effect of Shengmai Injection （生脉注射液, SMI） in improving cardiac function in patients with acute coronary syndrome （ACS） and to explore its influence on inflammatory reaction in patients. Methods： Ninety ACS patients were randomized into two groups, the control group treated with conventional therapy and the SMI group treated with SMI. The patients＇ cardiac function was noted and the content of high sensitive C-reactive protein （hs-CRP） in venous blood was measured before treatment and 1 week and 3 weeks after treatment, so as to observe and compare their changes between the two groups. Results： The cardiac output, stroke volume and ejection fraction in the SMI group after 3 weeks of treatment were all higher than those in the control group （P〈0.05）. The serum content of hs-CRP was reduced in both groups （P〈0.05）, but the reduction in the SMI group was more significant than that in the control group （P〈0.05）. Conclusion： SMI could improve the cardiac function and further inhibit the inflammatory reaction in patients with ACS.

清营生脉汤激活Akt信号通路保护H9c2心肌细胞缺氧复氧损伤的作用研究

目的研究清营生脉汤含药血清对缺氧复氧诱导H9c2心肌细胞损伤的保护机制。方法本研究采用H9c2心肌细胞缺氧/复氧(H/R)方法模拟心肌缺血再灌注损伤(MIRI)细胞模型,细胞实验分组为:空白血清对照组、模型组、含药血清低剂量组、含药血清中剂量组、含药血清高剂量组。应用CCK-8法测定心肌细胞活性,流式细胞术检测细胞凋亡率,ELISA法检测超氧化物歧化酶(SOD)、乳酸脱氢酶(LDH)、丙二醛(MDA)、肌酸激酶同工酶(CK-MB)水平,Western blotting法检测细胞内磷脂酰肌醇3-激酶(PI3K)、蛋白激酶B(Akt)及p-Akt的蛋白表达。结果与对照组相比,模型组细胞存活率显著降低、凋亡率显著升高、细胞内SOD水平显著降低,LDH、MDA、CK-MB水平显著升高(P<0.01);与模型组相比,含药血清低、中、高剂量组细胞的存活率显著升高、凋亡率显著降低、细胞内SOD水平显著升高,LDH、MDA、CK-MB水平显著降低(P<0.01);与对照组相比,模型组细胞中p-Akt蛋白表达水平显著降低(P<0.01),p-Akt/Akt比值降低(P<0.05);与模型组相比,含药血清高剂量组细胞内p-Akt蛋白表达量显著升高(P<0.01),p-Akt/Akt比值明显升高(P<0.05)。结论清营生脉汤含药血清能够提高缺氧复氧心肌细胞的活性,降低细胞凋亡率,升高SOD水平,降低LDH、MDA、CK-MB水平,提高细胞抗氧化能力,且可能通过促进Akt磷酸化降低缺氧复氧诱导的H9c2心肌细胞损伤程度。

复方生脉成骨胶囊修复激素性股骨头坏死的作用机制

背景:复方生脉成骨胶囊治疗早期激素性股骨头坏死的疗效佳,但具体治疗机制尚不完全明确。目的:观察复方生脉成骨胶囊干预对激素性股骨头坏死大鼠骨组织中岩藻糖基转移酶8、成骨基因及Wnt/β-catenin信号通路蛋白表达的影响。方法:取60只雄性SD大鼠,采用随机数字表法分为空白组、模型组、中药低剂量组、中药中剂量组及中药高剂量组,每组12只。模型组和中药低、中、高剂量组通过皮下注射咪喹莫特(每2周一次,共2次)与臀肌注射甲强龙(1次/周,共4次)的方法建立激素性股骨头坏死模型,末次造模给药后第2天,中药低、中、高剂量组分别灌胃给予1.89,3.78,7.56 g/(kg·d)的复方生脉成骨胶囊溶液,模型组灌胃给予等量生理盐水,连续给药8周。给药结束后,分别进行股骨头micro-CT扫描、组织学染色、压缩实验、RT-qPCR及Western blot检测。结果与结论:①micro-CT扫描显示,与空白组比较,模型组大鼠骨小梁体积分数、骨小梁数量及骨小梁厚度减少(P<0.05),骨小梁离散度增加(P<0.05);与模型组比较,中药低、中、高剂量组骨小梁体积分数、骨小梁数量及骨小梁厚度增加(P<0.05),骨小梁离散度减少(P<0.05),且呈剂量依赖性。②苏木精-伊红染色显示,与模型组比较,中药低、中、高剂量组空骨陷窝率减少(P<0.05),且呈剂量依赖性;免疫组化染色显示,与空白组比较,模型组岩藻糖基转移酶8、Runx2、骨形态发生蛋白2的蛋白表达降低(P<0.05);与模型组比较,中药低、中、高剂量组岩藻糖基转移酶8、Runx2、骨形态发生蛋白2的蛋白表达升高(P<0.05),且呈剂量依赖性。③压缩实验显示,与模型组相比,中药低、中、高剂量组股骨头最大载荷及弹性模量升高(P<0.05),且呈剂量依赖性;④RT-qPCR及Western blot检测显示,与空白组相比,模型组岩藻糖基转移酶8、Runx2、碱性磷酸酶、骨钙素、成骨细胞特异性转录因子及骨形态发生蛋白2的mRNA与蛋白表达降低(P<0.05);与模型组相比,中药低、中、高剂量组上述指标的mRNA与蛋白表达升高(P<0.05),且呈剂量依赖性。与空白组比较,模型组Wnt2、低密度脂蛋白受体相关蛋白5及β-连环蛋白的mRNA与蛋白表达降低(P<0.05),糖原合成酶激酶3β的mRNA与蛋白表达升高(P<0.05);与模型组比较,中药低、中、高剂量组Wnt2、低密度脂蛋白受体相关蛋白5及β-连环蛋白的mRNA与蛋白表达升高(P<0.05),糖原合成酶激酶3β的mRNA与蛋白表达降低(P<0.05),且呈剂量依赖性。⑤结果表明,复方生脉成骨胶囊治疗激素性股骨头坏死的机制可能是通过上调岩藻糖基转移酶8表达来激活Wnt/β-catenin信号通路,促进骨形成。