Gastroesophageal reflux disease(GERD)has a high prevalence worldwide.Li et al performed a well-designed study on the efficacy of modified Xiaochaihu decoction(MXD)for GERD,which showed that MXD is an optional therapy ...Gastroesophageal reflux disease(GERD)has a high prevalence worldwide.Li et al performed a well-designed study on the efficacy of modified Xiaochaihu decoction(MXD)for GERD,which showed that MXD is an optional therapy for GERD beyond proton pump inhibitors(PPIs).The herbal granule administration mode minimized the bias from traditional herbal formula in clinical trials.One limitation of that study was that it lacked records of side effects and rescue medication.As a chronic disease with recurrent symptoms,GERD rehabilitation requires prolonged observation of the clinical course with MXD therapy.展开更多
BACKGROUND Gastroesophageal reflux disease(GERD)has a high prevalence worldwide,and its incidence is increasing annually.Modified Xiaochaihu Decoction(MXD)could relieve the symptoms of GERD,but the effects of MXD on G...BACKGROUND Gastroesophageal reflux disease(GERD)has a high prevalence worldwide,and its incidence is increasing annually.Modified Xiaochaihu Decoction(MXD)could relieve the symptoms of GERD,but the effects of MXD on GERD manifestations and relapse prevention need to be further explained.Therefore,we performed a prospective,double-blind,and double-simulation study.AIM To verify the efficacy of MXD for GERD and its effect on esophageal motility.METHODS Using randomization,double-blinding,and a simulation design,288 participants with GERD were randomized to the treatment group and control group and received herbs(MXD)plus omeprazole simulation and omeprazole plus herbs simulation,respectively,for 4 wk.The GERD-Q scale score and esophageal manometry were measured at baseline,after treatment,and at 1 mo and 3 mo follow-up visits when medication was complete to evaluate recurrence indicators.RESULTS The GERD-Q scale score in both groups decreased significantly compared to those before treatment(P<0.01).However,no significant difference was observed between the two groups(P>0.05).Esophageal manometry showed that participants with lower esophageal sphincter pressure reduction and the proportion of ineffective swallowing(more than 50%)improved in both groups from baseline(P<0.01),especially in the treatment group(P<0.05).The percentage of small intermittent contractions,large intermittent contractions,and increased pre-phase contractions in the treatment group significantly improved compared with baseline(P<0.05)but did not improve in the control group(P>0.05).There was no significant difference between the groups after treatment(P>0.05).The percentage of weak esophageal contractility(distal contractile integral<450 mmHg·s·cm),improved in both groups(P<0.01),but no significant difference was observed between the groups after treatment(P>0.05).The relapse rate in the treatment group was lower than that in the control group at the 1 mo(P<0.01)and 3 mo follow-up(P<0.05).CONCLUSION MXD has a similar therapeutic effect to omeprazole in mild-to-moderate GERD.The therapeutic effect may be related to increased pressure in the lower esophageal sphincter and reduced ineffective swallowing.展开更多
Objective:To compare the effectiveness of Xiaochaihu Decoction(XCHD)or the modified XCHD combined with western medicine in the treatment of superficial gastritis.Methods:We collected the studies about XCHD or the modi...Objective:To compare the effectiveness of Xiaochaihu Decoction(XCHD)or the modified XCHD combined with western medicine in the treatment of superficial gastritis.Methods:We collected the studies about XCHD or the modified XCHD combined with western medicine for superficial gastritis in China Biology Medicine(CBM)Database(2010-2018),China National Knowledge Infrastructure(CNKI)Database(2010-2018),VIP Database(2010-2018),Wanfang Database(2010-2018)and the Back Issues Database of Hebei University.The randomized controlled trials(RCTs)were included in this study.The literatures were independently extracted by two researchers and the Cochrane Review Handbook(version 5.1.0)was applied to assess the quality of included trials.Statistical analysis was performed with RevMan(version 5.3).Results:A total of 8 RCTs,including 732 cases,were included finally.Meta-analysis results showed that compared with the western medicine treatment group,XCHD or the modified XCHD combined with western medicine could improve the total effective rate[OR=4.67,95%CI(2.90,7.55),P<0.00001],physiological function[MD=10,95%CI(8.78,11.23),P<0.00001],role physical[MD=13.85,95%CI(11.19,16.51),P<0.00001],physical pain[MD=11.64,95%CI(9.05,14.23),P<0.00001],general health[MD=11.20,95%CI(9.52,12.88),P<0.00001],vitality[MD=13.46,95%CI(12.30,14.62),P<0.00001],social function[MD=19.20,95%CI(17.32,21.09),P<0.00001],affection function[MD=30.3,95%CI(28.99,31.62),P<0.00001],mental health[MD=9.80,95%CI(8.44,11.16),P<0.00001].Conclusion:XCHD or the modified XCHD combined with western medicine in the treatment of superficial gastritis has good performance in clinical efficacy and the improvement of quality of life.However,with several methodology problems existing in the included RCTs,the effectiveness of XCHD or the modified XCHD is still need more high-quality randomized,double-blind,placebo-controlled trials to further confirmed.展开更多
Objective:To explore the mechanism of Bupleurum on fever by means of network pharmacology,and to provide ideas for further experimental study.Methods:The effective components and targets of Xiaochaihu Decoction and Bu...Objective:To explore the mechanism of Bupleurum on fever by means of network pharmacology,and to provide ideas for further experimental study.Methods:The effective components and targets of Xiaochaihu Decoction and Bupleurum were extracted by searching TCM systematic pharmacology database(TCMSP),and got to the effective components and targets of Xiaochaihu Decoction.By searching GeneCards database,disGeNET database,OMIM database and symmap database to extract the disease target of fever.And the"protein interaction network"was constructed with the protein interaction relationship in HINT database as the background network,and the GO enrichment analysis and KEGG pathway enrichment analysis were carried out on the targets by using R software and DAVID database.Results:726 kinds of effective components of Xiaochaihu Decoction were obtained from TCMSP database,including 215 kinds of effective components of Bupleurum,677 targets of Xiaochaihu Decoction and 516 targets of Bupleurum.A total of 7305 fever-related genes were obtained from the disease database,and 400 key targets of Bupleurum for fever treatment were obtained by mapping drug targets and disease targets GAPDH,AKT1,INS,IL-6 and VEGFA,are the targets with high node connectivity in PPI network.The results of GO enrichment of key targets by R software are cofactor binding and coenzyme binding.KEGG enrichment pathway of key targets involves infection,cancer,immune system diseases and so on.Conclusion:This study preliminarily verified the effect and mechanism of Bupleurum on fever,and provided reference for further study.展开更多
Background:In this investigation,we sought to evaluate the benefits of Xiaochaihu decoction(XCHD)on polyinosinic:polycytidylic acid-induced viral pneumonia in mice and elucidate its mechanisms of action.Method:A viral...Background:In this investigation,we sought to evaluate the benefits of Xiaochaihu decoction(XCHD)on polyinosinic:polycytidylic acid-induced viral pneumonia in mice and elucidate its mechanisms of action.Method:A viral pneumonia model was established in mice using polyinosinic:polycytidylic acid,with mice being intragastrically administered different doses of XCHD.The benefits of XCHD therapy for mice with viral pneumonia were assessed by determining the weight ratio of lung tissue,wet-to-dry,overall protein concentrations,and total cell counts in bronchoalveolar lavage fluid,and hematoxylin and eosin staining of lung tissues.By determining the interleukin-1βlevels,interleukin-6,tumor necrosis factor-alpha,nitric oxide,interleukin-10,and interleukin-4,and the mRNA and protein expression of nitric oxide synthase 2,arginase-1,and macrophage mannose receptor 1 in bronchoalveolar lavage fluid,we assessed consequences of XCHD on macrophage polarization with mice suffering from viral pneumonia.Results:XCHD was found to significantly reduce lung tissue wet-to-dry and the total protein content and total number of cells of bronchoalveolar lavage fluid,while ameliorating pathological modifications to the lung tissues of rodents suffering from viral pneumonia,thereby indicating that this medicinal preparation has a healing impact on model mice with viral pneumonia.In addition,XCHD was found to reduce the magnitudes of interleukin-1β,interleukin-6,tumor necrosis factor-alpha,and nitric oxide and the mRNA and protein manifestation of nitric oxide synthase 2,and promote an increase in the levels of interleukin-10 and interleukin-4 and the mRNA and protein expression of arginase-1 and macrophage mannose receptor 1,thereby indicating that XCHD can favorably mediate polarization of macrophages in mice with viral pneumonia.Conclusion:XCHD has notable therapeutic effects on viral pneumonia in mice,the fundamental workings of action of which may be connected to regulation of macrophage polarization.展开更多
基金Scientific Research Project of Zhejiang TCM Science and Technology Programme,No.2020ZB067,No.2020ZT001,and No.2021ZQ031National Natural Science Foundation of China,No.81503522 and No.82104862.
文摘Gastroesophageal reflux disease(GERD)has a high prevalence worldwide.Li et al performed a well-designed study on the efficacy of modified Xiaochaihu decoction(MXD)for GERD,which showed that MXD is an optional therapy for GERD beyond proton pump inhibitors(PPIs).The herbal granule administration mode minimized the bias from traditional herbal formula in clinical trials.One limitation of that study was that it lacked records of side effects and rescue medication.As a chronic disease with recurrent symptoms,GERD rehabilitation requires prolonged observation of the clinical course with MXD therapy.
基金Supported by Capital Characteristic Study of Clinical Application,Beijing Municipal Science&Technology Commission,No.Z141107002514176Capital Health Development Research Project,No.2018-2-2231.
文摘BACKGROUND Gastroesophageal reflux disease(GERD)has a high prevalence worldwide,and its incidence is increasing annually.Modified Xiaochaihu Decoction(MXD)could relieve the symptoms of GERD,but the effects of MXD on GERD manifestations and relapse prevention need to be further explained.Therefore,we performed a prospective,double-blind,and double-simulation study.AIM To verify the efficacy of MXD for GERD and its effect on esophageal motility.METHODS Using randomization,double-blinding,and a simulation design,288 participants with GERD were randomized to the treatment group and control group and received herbs(MXD)plus omeprazole simulation and omeprazole plus herbs simulation,respectively,for 4 wk.The GERD-Q scale score and esophageal manometry were measured at baseline,after treatment,and at 1 mo and 3 mo follow-up visits when medication was complete to evaluate recurrence indicators.RESULTS The GERD-Q scale score in both groups decreased significantly compared to those before treatment(P<0.01).However,no significant difference was observed between the two groups(P>0.05).Esophageal manometry showed that participants with lower esophageal sphincter pressure reduction and the proportion of ineffective swallowing(more than 50%)improved in both groups from baseline(P<0.01),especially in the treatment group(P<0.05).The percentage of small intermittent contractions,large intermittent contractions,and increased pre-phase contractions in the treatment group significantly improved compared with baseline(P<0.05)but did not improve in the control group(P>0.05).There was no significant difference between the groups after treatment(P>0.05).The percentage of weak esophageal contractility(distal contractile integral<450 mmHg·s·cm),improved in both groups(P<0.01),but no significant difference was observed between the groups after treatment(P>0.05).The relapse rate in the treatment group was lower than that in the control group at the 1 mo(P<0.01)and 3 mo follow-up(P<0.05).CONCLUSION MXD has a similar therapeutic effect to omeprazole in mild-to-moderate GERD.The therapeutic effect may be related to increased pressure in the lower esophageal sphincter and reduced ineffective swallowing.
文摘Objective:To compare the effectiveness of Xiaochaihu Decoction(XCHD)or the modified XCHD combined with western medicine in the treatment of superficial gastritis.Methods:We collected the studies about XCHD or the modified XCHD combined with western medicine for superficial gastritis in China Biology Medicine(CBM)Database(2010-2018),China National Knowledge Infrastructure(CNKI)Database(2010-2018),VIP Database(2010-2018),Wanfang Database(2010-2018)and the Back Issues Database of Hebei University.The randomized controlled trials(RCTs)were included in this study.The literatures were independently extracted by two researchers and the Cochrane Review Handbook(version 5.1.0)was applied to assess the quality of included trials.Statistical analysis was performed with RevMan(version 5.3).Results:A total of 8 RCTs,including 732 cases,were included finally.Meta-analysis results showed that compared with the western medicine treatment group,XCHD or the modified XCHD combined with western medicine could improve the total effective rate[OR=4.67,95%CI(2.90,7.55),P<0.00001],physiological function[MD=10,95%CI(8.78,11.23),P<0.00001],role physical[MD=13.85,95%CI(11.19,16.51),P<0.00001],physical pain[MD=11.64,95%CI(9.05,14.23),P<0.00001],general health[MD=11.20,95%CI(9.52,12.88),P<0.00001],vitality[MD=13.46,95%CI(12.30,14.62),P<0.00001],social function[MD=19.20,95%CI(17.32,21.09),P<0.00001],affection function[MD=30.3,95%CI(28.99,31.62),P<0.00001],mental health[MD=9.80,95%CI(8.44,11.16),P<0.00001].Conclusion:XCHD or the modified XCHD combined with western medicine in the treatment of superficial gastritis has good performance in clinical efficacy and the improvement of quality of life.However,with several methodology problems existing in the included RCTs,the effectiveness of XCHD or the modified XCHD is still need more high-quality randomized,double-blind,placebo-controlled trials to further confirmed.
基金National Natural Science Foundation of China(No.81603518)Department of Science and Technology of Shaanxi Province(No.2018ZDXM-SF-008)Xi'an Science and Technology Bureau(No.201805103YX11SF37)。
文摘Objective:To explore the mechanism of Bupleurum on fever by means of network pharmacology,and to provide ideas for further experimental study.Methods:The effective components and targets of Xiaochaihu Decoction and Bupleurum were extracted by searching TCM systematic pharmacology database(TCMSP),and got to the effective components and targets of Xiaochaihu Decoction.By searching GeneCards database,disGeNET database,OMIM database and symmap database to extract the disease target of fever.And the"protein interaction network"was constructed with the protein interaction relationship in HINT database as the background network,and the GO enrichment analysis and KEGG pathway enrichment analysis were carried out on the targets by using R software and DAVID database.Results:726 kinds of effective components of Xiaochaihu Decoction were obtained from TCMSP database,including 215 kinds of effective components of Bupleurum,677 targets of Xiaochaihu Decoction and 516 targets of Bupleurum.A total of 7305 fever-related genes were obtained from the disease database,and 400 key targets of Bupleurum for fever treatment were obtained by mapping drug targets and disease targets GAPDH,AKT1,INS,IL-6 and VEGFA,are the targets with high node connectivity in PPI network.The results of GO enrichment of key targets by R software are cofactor binding and coenzyme binding.KEGG enrichment pathway of key targets involves infection,cancer,immune system diseases and so on.Conclusion:This study preliminarily verified the effect and mechanism of Bupleurum on fever,and provided reference for further study.
基金supported by Jiaxing Science and Technology Bureau,applied basic research(no.2023AD11044)Zhejiang Chinese Medicine University joint project(no.2022FSYYZZ23).
文摘Background:In this investigation,we sought to evaluate the benefits of Xiaochaihu decoction(XCHD)on polyinosinic:polycytidylic acid-induced viral pneumonia in mice and elucidate its mechanisms of action.Method:A viral pneumonia model was established in mice using polyinosinic:polycytidylic acid,with mice being intragastrically administered different doses of XCHD.The benefits of XCHD therapy for mice with viral pneumonia were assessed by determining the weight ratio of lung tissue,wet-to-dry,overall protein concentrations,and total cell counts in bronchoalveolar lavage fluid,and hematoxylin and eosin staining of lung tissues.By determining the interleukin-1βlevels,interleukin-6,tumor necrosis factor-alpha,nitric oxide,interleukin-10,and interleukin-4,and the mRNA and protein expression of nitric oxide synthase 2,arginase-1,and macrophage mannose receptor 1 in bronchoalveolar lavage fluid,we assessed consequences of XCHD on macrophage polarization with mice suffering from viral pneumonia.Results:XCHD was found to significantly reduce lung tissue wet-to-dry and the total protein content and total number of cells of bronchoalveolar lavage fluid,while ameliorating pathological modifications to the lung tissues of rodents suffering from viral pneumonia,thereby indicating that this medicinal preparation has a healing impact on model mice with viral pneumonia.In addition,XCHD was found to reduce the magnitudes of interleukin-1β,interleukin-6,tumor necrosis factor-alpha,and nitric oxide and the mRNA and protein manifestation of nitric oxide synthase 2,and promote an increase in the levels of interleukin-10 and interleukin-4 and the mRNA and protein expression of arginase-1 and macrophage mannose receptor 1,thereby indicating that XCHD can favorably mediate polarization of macrophages in mice with viral pneumonia.Conclusion:XCHD has notable therapeutic effects on viral pneumonia in mice,the fundamental workings of action of which may be connected to regulation of macrophage polarization.
文摘目的探讨咳喘定穴位贴敷联合小柴胡汤合半夏厚朴汤治疗痰浊阻肺证慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)患者的临床疗效。方法选取2020年9月—2022年10月期间海南医学院第二附属医院收治的痰浊阻肺证COPD患者144例,按随机数字表法分为西药组、中药组、中药联合贴敷组,每组各48例。西药组采取常规西医治疗,中药组在西药基础上采取小柴胡汤合半夏厚朴汤治疗,中药联合贴敷组在常规西医基础上采取咳喘定穴位贴敷及小柴胡汤合半夏厚朴汤。治疗4周后,观察比较3组患者临床疗效、不良反应发生率、疾病复发率及治疗前后中医证候积分、肺功能[第1秒用力呼气容积(Forced expiratory volume for 1 second,FEV_(1))、用力肺活量(Forced vital capacity,FVC)、FEV_(1)/FVC]、康复效果[慢性阻塞性肺疾病评估测试量表(Chronic obstructive Pulmonary Disease Assessment Test Scale,CAT)、呼吸困难程度评分(modified Medical Research Council,mMRC)、6 min步行距离试验(6 min walking distance test,6MWT)]。结果治疗后中药联合贴敷组总有效率93.75%(45/48)高于西药组77.08%(37/48)、中药组79.17%(38/48),差异有统计学意义(P<0.05)。治疗后3组患者中医证候痰多、喘息、咳嗽、倦怠乏力、腹胀纳呆、下肢水肿积分均较治疗前降低,差异有统计学意义(P<0.05),且中药联合贴敷组中医证候痰多、喘息、咳嗽、倦怠乏力、腹胀纳呆、下肢水肿积分均明显低于西药组、中药组,差异有统计学意义(P<0.05)。治疗后3组患者肺功能FEV_(1)、FVC、FEV_(1)/FVC指标均较治疗前升高,差异有统计学意义(P<0.05);且中药联合贴敷组肺功能FEV_(1)、FVC、FEV_(1)/FVC指标明显高于西药组、中药组,差异有统计学意义(P<0.05)。治疗后3组患者康复效果CAT、mMRC评分较治疗前降低,6MWT较治疗前延长,差异有统计学意义(P<0.05);且中药联合贴敷组康复效果CAT、mMRC评分均明显低于西药组、中药组,6MWT明显优于西药组、中药组,差异有统计学意义(P<0.05)。治疗期间,中药联合贴敷组不良反应发生率8.33%(4/48)与西药组6.25%(3/48)、中药组4.17%(2/48)比较,差异无统计学意义(P>0.05)。治疗6个月后中药联合贴敷组疾病复发率4.17%(2/48)低于西药组18.75%(9/48)、中药组16.67(8/48),差异有统计学意义(P<0.05)。结论联合采取咳喘定穴位贴敷及小柴胡汤合半夏厚朴汤治疗痰浊阻肺证COPD效果显著,可有效缓解患者临床症状,改善肺功能及机体运动耐力,利于提升疾病整体干预效果,降低疾病复发率,且具有安全性。