Clinical intervention effect of Xuefu Zhuyu decoction on chronic heart failure complicated with depression

BACKGROUND The diagnosis and treatment of depression in patients with chronic heart failure(CHF)is challenging,with no ideal treatment at present.AIM To analyze the clinical intervention effect of Xuefu Zhuyu decoction(XFZYD)on CHF complicated with depression.METHODS The study cohort comprised 116 patients with CHF complicated with depression who received treatment from July 2020 to July 2023,of which 55 received Western medicine(control group)and 61 received XFZYD(research group).Data on clinical effectiveness,traditional Chinese medicine(TCM)syndrome score,cardiac function,negative emotions,and serum inflammatory factors,were collected for comparative analyses.RESULTS Compared with the control group,the research group had an evidently higher total effective rate.Furthermore,there were marked reductions in TCM symptom score,left ventricular end-diastolic diameter,left ventricular end-systolic diameter,Self-Rating Depression Scale,Hamilton Depression Scale,high-sensitivity C-reactive protein,monocyte chemoattractant protein-1,and matrix metalloproteinase-9 in the research group after treatment,and these were lower than the corresponding values in the control group.Left ventricular ejection fraction was increased and higher in the research group compared with the control group after treatment.CONCLUSION Our findings conclusively proved that XFZYD was considerably superior to Western medicine for treating CHF complicated with depression because it significantly alleviated patients’symptoms,improved cardiac function,relieved negative emotions,and reduced the levels of serum inflammatory factors.

Analyzing the pharmacological substances and targets of Xuefu Zhuyu decoction in hypertensive vascular endothelial cells

Background:Xuefu Zhuyu decoction(XFZY)could significantly improve the function of hypertensive vascular endothelial cells,but the targets and mechanism are not clear.This study is to analyze the pharmacological substances and targets of Xuefu Zhuyu decoction in hypertensive vascular endothelial cells.Methods:This study used Xuefu Zhuyu decoction to intervene human umbilical vein endothelial cells incubated by hypertensive patients’serum,then detected the function of vascular endothelial cells.The aqueous extract of XFZY was analyzed and validated by liquid chromatography-mass spectrometry technology;Finally,macromolecular docking technology was used to analyze the potential active substances and targets of XFZY in the prevention and treatment of hypertension.Results:Compared with the model group,the XFZY group showed a significant increase in NO expression(P<0.01)and a significant decrease in ET-1 expression(P<0.001);and the expression of BIP,P-JNK,CHOP,and BAX in XFZY group cells was significantly decreased(P<0.001),while the expression of JNK and BCL2 was significantly increased(P<0.001).19 main compounds were identified in XFZY and there were 3 pairs of molecular complexes with high affinity for markers of the endoplasmic reticulum stress,including BIP-Hesperidin complex,BIP-HSYA complex and JNK-Naringin complex.Conclusion:This study analyzed the potential pharmacodynamic substance and targets of Xuefu Zhuyu decoction in improving the function of hypertensive vascular endothelial cells,which could provide a scientific basis for the future molecular mechanism of XFZY in treating hypertension.

Mechanism of the Xuefu Zhuyu decoction in treating diabetes mellitus erectile dysfunction based on the CaSR/Gq-PLC-PKC pathway

Background:To investigate the mechanism of Xuefu Zhuyu decoction in the treatment of diabetes mellitus erectile dysfunction.Methods:Rats with diabetes mellitus erectile dysfunction were developed using streptozocin and randomly assigned into model,low-dose herbal,and high-dose herbal groups.All rats were administered normal saline or the corresponding drugs by oral gavage for 4 weeks.The related indices were detected using enzyme-linked immunosorbent assays,immunohistochemistry,western blotting,and transmission electron microscopy.Results:The levels of lectin-like oxidized low-density protein receptor-1,endothelin-1,NADH oxidase,vascular cell adhesion molecule-1,and intercellular adhesion molecule-1 in the model group were significantly higher than they were in the mock group but lower than they were in the herbal treatment group.The level of nitric oxide was lower in the model group than was in the mock group but higher than the level in the herbal treatment group.The calcium-sensitive receptor,phospho-protein kinase Cδ/protein kinase Cδ,phosphorylated c-Jun amino-terminal kinase/c-Jun amino-terminal kinase,and phospho-P38 mitogen-activated protein kinase/P38 mitogen-activated protein kinase expression levels in the model group were higher than were in the mock group but lower than were in the herbal treatment group.The structures of the Corpus cavernosum penis endothelial cells were significantly improved in the herbal treatment group than they did in the model group.Conclusion:Xuefu Zhuyu decoction can decrease injury to the endothelium,improve vascular endothelial diastolic and contractive function,and inhibit vascular fibrosis in rats with diabetes mellitus erectile dysfunction.This mechanism may be related to the CaSR/Gq-PLC-PKC pathway.

Xuefu Zhuyu decoction improves neurological dysfunction by increasing synapsin expression after traumatic brain injury

Xuefu Zhuyu decoction has been used for treating traumatic brain injury and improving post-traumatic dysfunction, but its mechanism of action needs further investigation. This study established rat models of traumatic brain injury by controlled cortical impact. Rat models were intragastrically administered 9 and 18 g/kg Xuefu Zhuyu decoction once a day for 14 or 21 days. Changes in neurological function were assessed by modified neurological severity scores and the Morris water maze. Immunohistochemistry, western blot assay, and re- verse-transcription polymerase chain reaction were used to analyze synapsin protein and mRNA expression at the injury site of rats. Our results showed that Xuefu Zhuyu decoction visibly improved neurological function of rats with traumatic brain injury. These changes were accompanied by increased expression of synaptophysin, synapsin I, and postsynaptic density protein-95 protein and mRNA in a dose-de- pendent manner. These findings indicate that Xuefu Zhuyu decoction increases synapsin expression and improves neurological deficits alder traumatic brain injury.

The mechanism of Xuefu Zhuyu decoction in treating erectile dysfunction based on Arrowsmith tool

Arrowsmith,a literature retrieval tool,was used to explore the theoretical pharmacological mechanism of action of Xuefu Zhuyu decoction and its single herb against erectile dysfunction.Cytoscape 3.6.1 software was used to analyze the correlation between the components of Xuefu Zhuyu decoction and the identified mechanism of action.Different herbs in Xuefu Zhuyu decoction may play a therapeutic role by regulating iNOS,COX-2,mTOR,Wnt,AMPK,Nrf2,TLR4,CYP2D6,BDNF,MAPK,Akt,STAT3,PI3K,ERK1,P38MAPK,JNK,VEGF,and other targets.The treatment of erectile dysfunction with Xuefu Zhuyu decoction embodied the multicomponent,multitarget,and multipathway.The Arrowsmith tool retrieval and analysis provided a scientific basis for further elucidation of the mechanism of Xuefu Zhuyu decoction against erectile dysfunction.

The Efficacy of Banxia Baizhu Tianma Decoction(半夏白术天麻汤)Combined with Xuefu Zhuyu Decoction(血府逐瘀汤)for Essential Hypertension and the Effects on Endothelial Function:A Systematic Review and Meta-analysis

Objective:Banxia Baizhu Tianma Decoction(半夏白术天麻汤,BBTD)combined with Xuefu Zhuyu Decoction(血府逐瘀汤,XFZYD)is widely used to treat essential hypertension in China,but its efficacy remains largely unexplored.We systemically summarized relevant evidence from randomized controlled trials(RCTs)to assess the therapeutic efficacy of BBTD+XFZYD.Methods:This review retrieved 6 databases like Pubmed,Cochrane Library,Embase,CNKI,et al.RCTs of BBTD+XFZYD plus conventional Western drugs(experimental group)and conventional Western drugs alone(control group)for hypertension was collected from the database establishment to August 5,2020.And the outcomes included clinical total effective rate,systolic blood pressure(SBP),diastolic blood pressure(DBP),nitric oxide(NO)and endothelin-1(ET-1).All studies’risk of bias were assessed by the Cochrane Collaboration tool 5.1.0.The data was statistically analyzed by RevMan5.3 Software.Results:Six studies with 608 participants were identified.About duration of treatment,4 studies were 1 month,2 studies were 2 months.The quality presented a high risk of bias.The experimental group showed that clinical total effective rate of the 1-month and 2-month was higher(P<0.00001),the systolic pressure was significantly lower(P<0.05),the NO increased(P<0.00001),and the ET-1 decreased(P<0.00001)compared with the conventional Western drugs used alone.However,DBP was significantly lower(P<0.05)at 2 months of treatment.Conclusion:BBTD+XFZYD plus conventional Western drugs might reduce blood pressure,improve clinical efficacy,repair endothelial function,but still need high-quality RCTs to better assess the outcomes.

Identification of prototype compounds and their metabolites in rats’ serum from Xuefu Zhuyu Decoction by UPLC-Q-TOF/MS

Objective: As a classic prescription in traditional Chinese medicine, Xuefu Zhuyu Decoction(XFZYD) has been widely used in the clinical treatment of cardiovascular and cerebrovascular diseases. In order to unveil the potentially effective compounds, a rapid ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF/MS) method was established to identify prototype compounds and their metabolites from XFZYD in rats’ serum.Methods: The serum from rats after intragastric administration of XFZYD aqueous extract was analyzed by UPLC-Q-TOF/MS method. The prototype compounds and their metabolites were identified by comparison with the reference standards and tentatively characterized by comprehensively analyzing the retention time, MS data, characteristic MS fragmentation pattern and retrieving literatures.Results: A total of 175 compounds(24 prototype compounds and 151 metabolites) were identified and tentatively characterized. The metabolic pathways of prototype compounds in vivo were also summarized, including glucuronidation, hydrolyzation, sulfation, demethylation, and hydroxylation, and so on.Conclusion: In this study, a UPLC-Q-TOF/MS technique was developed to analyze prototype compounds and their metabolites from XFZYD in serum, which would provide the evidence for further studying the effective compounds of XFZYD.

A Microarray Analysis of Angiogenesis Modulation Effect of Xuefu Zhuyu Decoction (血府逐瘀汤) on Endothelial Cells

Objective： To study the angiogenesis modulation mechanism of Xuefu Zhuyu Decoction （血府逐瘀汤） on the endothelial cell line ECV304. Methods： ECV304 cells were treated with 2.5% Xuefu Zhuyu Decoction- containing serum （XFZYD-CS） for 24 h, 48 h or 72 h. Thiazolyl blue tetrazolium bromide （MTT）, fluorescence activating cell sorter （FACS）, migration, adhesion and in vitro tube formation assays were conducted to confirm an angiogenesis effect of XFZYD at 3 time points. An analysis of angiogenesis regulator profiles was performed at 3 times with real-time polymerase chain reaction （RT-PCR） superarray. Results： At 48 h, XFZYD-CS induced ECV304 significantly improved cell viability, number in S phase, migration, adhesion and tube formation. At 24 h and 72 h, only cell migration was elevated. Microarray results showed that the expression of 27 angiogenesis-related genes was changed. Conclusion： XFZYD-CS treatment induced angiogenesis on ECV304 cells with significant cellcular changes occurring at 48 h and genetic changes as early as 24 h.

In Vitro Angiogenesis Effect of Xuefu Zhuyu Decoction(血府逐瘀汤)and Vascular Endothelial Growth Factor:A Comparison Study

Objective： To compare the angiogenesis behaviors of vascular endothelial growth factor（VEGF） and Chinese medicine Xuefu Zhuyu Decoction（血府逐瘀汤,XZD） treatments.Methods： Human microvascular endothelial cells（HMEC-1） were treated with various concentrations of either XZD-containing serum（XZD-CS） or VEGF for 24,48,and 72 h,respectively.Cell viability,proliferation,migration,adhesion,and in vitro tube formation assays were used to assess their angiogenic effects.Results： VEGF promoted all cellular phases involved in angiogenesis including cell viability,proliferation,migration,adhesion,and tube formation（P〈0.05 or P〈0.01）.Unlike the continuous promotion effects of VEGF at the above stages,XZD inhibited cell viability and proliferation（P〈0.05 or P〈0.01） and only promoted tube formation in the early phase of angiogenesis（P〈0.01）.Conclusions： These two medications promote different angiogenesis behaviors,which might be an important reason for their distinct therapeutic profile in clinical usage.

The Effect of Xuefu Zhuyu Decoction(血府逐瘀汤) on in vitro Endothelial Progenitor Cell Tube Formation

Objective： To observe the effect of Xuefu Zhuyu Decoction （血府逐瘀汤）-containing serum （XFZYD-CS） on endothelial progenitor cell （EPC） tube formation in vitro. Methods： Mononuclear cells from rat bone marrow were prepared in a Ficoll density gradient centrifuge. EPCs were separated by the differential attachment method, and observed with inverted microscope for the effect of XFZYD-CS on EPC tube formation. Results： After one day, EPCs exposed to the serum containing 5%, 10% and 15% XFZYD-CS formed typical tubes or vessel networks. The tube formation time was two days ahead of the control group and the size of most tubes in the serum groups was smaller than in the control group. Conclusion： XFZYD-CS could induce EPC angiogenesis and hasten tube formation, especially in capillary vessels. The study provides experimental evidence for the plausibility of Xuefu Zhuyu Decoction in the treatment of ischemic diseases.

The efficacy of Xuefu Zhuyu prescription for diabetic encephalopathy: A meta-analysis of randomized controlled trials

Objective:To evaluate the safety and effectiveness of Xuefu Zhuyu Decoction in treating diabetic encephalopathy.Methods:Computer search and manual search of Pub Med,Web of Science,The Cochrane Library,CNKI,WF,VIP and CBM from January 2000 to April 2020 on the treatment of diabetic encephalopathy with Xuefu Zhuyu Decoction In randomized controlled clinical trials,select documents that meet the criteria for analysis using Rev Man 5.3 software.Results:A total of 11 articles and 838 patients were included in the study.Metaanalysis showed that Xuefu Zhuyu Decoction was effective(OR=3.71,95%CI[2.42,5.70],P<0.00001),and the patient’s neurological deficit score(MD=-4.52,95%CI[-5.10,-3.94],P<0.00001),fasting blood glucose(MD=-1.05,95%CI[-1.51,-0.59],P<0.00001),2 hours postprandial blood glucose(MD=-1.31,95%CI[-1.94,-0.69],P<0.00001),glycated hemoglobin(MD=-0.94,95%CI[-1.15,-0.72],P<0.00001),TCM symptom score(MD=-2.44,95%CI[-3.82,-1.06],P=0.0005<0.01),vitality score(MD=12.79,95%CI[8.79,16.79],P<0.00001),the improvement effect is obvious Better than conventional Western medicine treatment.Conclusion:Xuefu Zhuyu Decoction can improve the clinical efficiency of patients with diabetic encephalopathy,reduce brain damage,reduce blood sugar and glycated hemoglobin levels,and has good safety.However,the quality of some of the included literatures is low,and the number of clinical cases is small,which may affect the authenticity of the Meta analysis results.Still need to be further verified by clinical randomized controlled trials with high-quality large samples.

针刺联合血府逐瘀汤治疗睫状视网膜动脉阻塞1例

The report presented a case of cilioretinal artery occlusion. A 22-year-old woman, with a complain of reduced visual acuity of the right eye for 4 days, presented with blurred vision and inferior visual field defect at the time of visit. Acupuncture combined with herbal medication of Xuefu Zhuyu Decoction was applied for the patient. Main acupoints included Jingming (BL1), Qiuhou (EX-HN7), Sizhukong (TE23), Yuyao (EX-HN3), Sibai (ST2), Fengchi (GB20), Hegu (LI4), Guangming (GB37) and Taichong (LR3). The needles were remained for 30 min in each session, which was given once daily for 10 days. The modified Xuefu Zhuyu Decoction (Semen Juglandis [10 g], Flos Carthami [10 g], Rhizoma Chuanxiong [10 g], Radix Paeoniae Rubra [10 g], Radix Rehmanniae [15 g], Radix Angelicae Sinensis [10 g], Radix Bupleuri [10 g], Fructus Aurantii [5 g], Radix et Rhizoma Glycyrrhizae Praeparata cum Melle [6 g], Fructus Crataegi [20 g], Endothelium Corneum Gigeriae Galli [10 g], Scorpio [5 g], Herba Leonuri [15 g], Radix Astragali [35 g] and Ramulus Cinnamomi [10 g]) was applied one dose daily for 7 days. After 7 days of treatment, the visual acuity of the patient was increased from 0.04 to 0.6 in the right eye with spectacles, the retinal fundus edema disappeared and the inferior vision field defect relieved. With acupuncture treatment for another 10 days, it was observed that the visual acuity of the patient's right eye was improved and the inferior vision field defect reduced. There was no symptom recurrence and the visual acuities in both eyes of the patient were 1.0 with spectacles till the latest follow-up. This therapy provided a new idea and approach to treat cilioretinal artery occlusion.

Chinese Medicines and Bioactive Compounds for the Treatment of Stroke

Stroke is an important cause of mortality and morbidity worldwide but effective therapeutic strategy for the prevention of brain injury in patients with cerebral ischemia is lacking. Although tissue plasminogen activator has been used to treat stroke patients, this therapeutic strategy is confronted with ill side effects and is limited to patients within 3 h of a stroke. Due to the complexity of the events and the disappointing results from single agent trials, the combination of thrombolytic therapy and effective neural protection therapy may be an alternative strategy for patients with cerebral ischemia. Chinese medicine （CM） is the most widely practiced form of herbalism worldwide, as it is a sophisticated system of medical theory and practice that is specifically different from Western medicine. Most traditional therapeutic formulations consist of a combination of several drugs. The combination of multiple drugs is thought to maximize therapeutic efficacy by facilitating synergistic actionsand preventing possible adverse effects while at the same time marking at multiple targets. CM has been labeled in ancient medicine systems as a treatment for various diseases associated with stroke. This review summarizes various CMs, bioactive compounds and their effects on cerebral ischemia.