Therapeutic effects of Buzhong Yiqi decoction in patients with spleen and stomach qi deficiency after routine surgery and chemotherapy for colorectal cancer

BACKGROUND According to the theory of traditional Chinese medicine(TCM),the spleen and stomach are the basis of acquired nature and the source of qi and blood biochemistry.After surgery and chemotherapy,patients with colorectal cancer often develop spleen and stomach qi deficiency syndrome,leading to decreased immune function.Buzhong Yiqi decoction,a classic TCM prescription,has the effect of tonifying middle-jiao and invigorating qi,boosting Yang,and suppressing immune-related inflammation.Moreover,it is widely used in the treatment of spleen and stomach qi deficiency syndrome.AIM To investigate the effect of Buzhong Yiqi decoction on spleen and stomach qi deficiency in patients with colorectal cancer.METHODS One hundred patients with colorectal cancer who underwent preoperative chemotherapy and laparoscopy at The First TCM Hospital of Changde from January 2022 to October 2023 were retrospectively analyzed.The patients were divided equally into control and observation groups.Both groups underwent conventional rehabilitation surgery,and the observation group was supplemented with Buzhong Yiqi decoction.SPSS 26.0 was used for statistical analyses.Theχ2 test was used for univariate analysis;independent sample t-tests were used in all cases.RESULTS No significant differences were observed preoperatively in the general characteristics of the two groups.Fourteen days post-surgery,the abdominal distension,emaciation,loose stool,loss of appetite,and vomiting scores were significantly lower in the observation group than in the control group(P<0.05).Immune function and interleukin(IL)-10 levels in the observation group were significantly higher than those of the control group,whereas IL-6,tumor necrosis factor-α,and C-reactive protein levels,tumor biological indexes,and adverse reactions in the observation group were significantly lower than those of the control group(P<0.05).One month after surgery,the patients’quality of life in the observation group was significantly higher than that of the patients in the control group(P<0.05).CONCLUSION Buzhong Yiqi decoction can regulate inflammatory responses and metabolic processes by enhancing immune function,thereby promoting overall immune nutrition and restoring the body’s balance.

Effect of Buzhong Yiqi Decoction (补中益气汤) on Murine Liver Damage Induced by Food Allergy

Objective: To investigate the effect of Buzhong Yiqi decoction (补中益气汤, BZYQD) on liver damage induced by food allergy in mice. Methods: Nc/Jic strain mice with high levels of serum IgE were sensitized by ovalbumin (OVA), and then divided into two groups and respectively treated with BZYQD (treated group) or normal saline (model group). Samples of serum, liver tissues and small intestine were collected two weeks later, and another group of non-sensitized mice was set as the normal group. The levels of serum alanine aminotransferase (ALT) were measured with spectrophotometry. The liver tissue and small intestine were stained with hematoxylin and eosin (HE) for pathologic analysis. The liver samples were also subjected to analysis of CD4-T helper cell and cytokine (interleukin-4, IL-4, interleukin-6, IL-6) expression with immunohistochemical (avidin-biotin complex, ABC) method. Results: Serum ALT levels decreased and obvious pathologic improvements were seen in the mice treated with BZYQD. And compared with the model mice, the number of positive cells of IL-4, IL-6 and CD4 cell decreased significantly in those treated with BZYQD. Conclusion: BZYQD can effectively decrease the production of cytokines associated with allergic reaction in the liver of mice thus effective in treating liver damage caused by food allergy.

Analysis of mechanism of Buzhong Yiqi Decoction in treating senile functional constipation via network pharmacology

Objective:To explore the molecular mechanism of buzhong yiqi decoction in the treatment of senile functional constipation based on network pharmacology.Methods:Chemical compositions and selected targets related to the eight traditional Chinese medicine herbs were searched through the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP).Through GeneCards database and OMIM database,disease targets of senile functional constipation were searched.R language was used to screen the common targets between drugs and disease,and then the interaction network diagram of the targets was constructed by String.Cytoscape3.7.0 was applied to construct the traditional Chinese medicines-chemical compositions-disease targets network.GO enrichment analysis and KEGG enrichment analysis of the targets were based on DAVID.Results:Five main chemical compositions including quercetin,kaempferol,nobiletin,naringenin and formononetin were screened,and five key targets including PTGS2,ESR1,AR,NOS2 and PPARG were identified.622 GO functional entries and 125 pathways were yielded by gene enrichment analysis.Conclusion:Buzhong yiqi decoction may play the role of anti-inflammatory and anti-oxidation through multi-component,multi-target and multi-channel,so as to improve senile functional constipation.

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.

Combined Treatment with Bojungikgi-tang(Buzhong Yiqi Decoction)and Riluzole Attenuates Cell Death in TDP-43-Expressing Cells

Objective To examine the effect of combined treatment with Bojungikgi-tang(BJIGT,Buzhong Yiqi Decoction)and riluzole(RZ)in transactive response DNA-binding protein 43(TDP-43)stress granule(SG)cells,a amyotrophic lateral sclerosis(ALS)cell line using transcriptomic and molecular techniques.Methods TDP-43 SG cells were pretreated with BJIGT(100µg/mL),RZ(50µmol/L),and combined BJIGT(100µg/mL)/RZ(50µmol/L)for 6 h before treatment with lipopolysaccharide(LPS,200µmol/L).Cell viability assay was performed to elucidate cell toxicity in TDP-43 SC cells using a cell-counting kit-8(CCK8)assay kit.The expression levels of cell death-related proteins,including Bax,caspase 1,cleaved caspase 3 and DJ1 in TDP-43 SG cells were examined by Western blot analysis.The autophagy-related proteins,including pmTOR/mTOR,LC3b,P62,ATG7 and Bcl-2-associated athanogene 3(Bag3)were investigated using immunofluorescence and immunoblotting assays.Results Cell viability assay and Western blot analysis showed that combined treatment with BJIGT and RZ suppressed LPS-induced cell death and expression of cell death-related proteins,including Bax,caspase 1,and DJ1(P<0.05 or P<0.01).Immunofluorescence and immunoblotting assays showed that combined treatment with BJIGT and RZ reduced LPS-induced formation of TDP-43 aggregates and regulated autophagy-related protein levels,including p62,light chain 3b,Bag3,and ATG7,in TDP-43-expressing cells(P<0.05 or P<0.01).Conclusion The combined treatment of BJIGT and RZ might reduce inflammation and regulate autophagy dysfunction in TDP-43-induced ALS.

Clinical efficacy of Buzhong Yiqi decoction(补中益气汤)in the treatment of hospital-acquired pneumonia with multi-drug resistant bacteria:a prospective,randomized,multicenter controlled trial

OBJECTIVE:To evaluate the efficacy and safety of Buzhong Yiqi decoction(补中益气汤,BZYQ)in the treatment of hospital-acquired pneumonia(HAP)with multi-drug-resistant bacteria(MDRB).METHODS:This 28-day study was conducted at 5 clinical centers in Shanghai.The eligible patients were randomly assigned(1∶1)into the intervention group(BZYQ plus conventional Western Medicine therapy)and control group(conventional Western Medicine therapy).The primary outcomes were the clinical response,clinical pulmonary infection score(CPIS),and microbiologic response.The secondary outcomes were the 28-day allcause mortality(ACM),Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ)score,ventilator weaning rate,length of mechanical ventilation(MV),length of hospital stay,and changes of infection indicators.RESULTS:Altogether 83 subjects in the intervention group and 85 subjects in the control group were analyzed.The clinical success rate(48.2%)and the pathogen eradication rate(59.0%)of the intervention group were all better than those of the control group(32.9%and 38.9%,respectively)with statistically significant differences(P<0.05).The CPIS score of the intervention group(8.9±1.7)was lower than that of the control group(9.6±2.5)(P<0.05).The length of MV in the intervention group[(13.7±6.4)d]was significantly shorter than that of the control group[(17.2±7.2)d](P<0.05).The 28-day ACM of the intervention group(13.33%)was lower than that of the control group(21.2%)with no statistically significant difference(P>0.05).The differences between two groups in ventilator weaning rate,length of hospital stay,and APACHEⅡscore were not statistically significant(P>0.05).The intervention group displayed decreases in white blood cell count,C-reactive protein,neutrophil percentage,and procalcitonin at day 28 compared with baseline(P<0.05).No serious adverse events occurred in either group during the 28-day follow-up.CONCLUSION:BZYQ may be an effective therapeutic option for the management of HAP with MDRB.

Efficacy of Buzhong Yiqi decoction(补中益气汤)on benign prostatic hyperplasia and its possible mechanism

OBJECTIVE:To explored the mechanism of Buzhong Yigi decoction(补中益气汤 BZYQD) in inhibiting prostatic cell proliferation effect.METHODS:The compounds of BZYQD consisted with eight herbs were searched in TCMSP databases and the putative targets of BZYQD were collected in Drugbank database.Then,“Benign prostatic hyperplasia”(BPH) was used to find the targets based on the Gene Cards,Online Mendelian Inheritance in Man(OMIM) and Therapeutic Target Database(TTD) databases,and they were further used to collect further collect the intersection targets between BZYQD and BPH by counter-selection.Next,Herb-Compound-Target-Disease network was constructed by Cytoscape software and protein interaction network was built by Search tool for recurring instances of neighbouring genes(STRING) database.Gene Ontology(GO) enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment were analyzed by Database for Annotation,Visualization and Integrated Discovery(DAVID) database to predict the mechanism of the intersection targets.Mitogen activated protein kinase 8(MAPK8),interleukin 6(IL-6) and quercetin were chosen to perform molecular docking.Then 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-Htetrazolium bromide(MTT) assay was to detect the via bility of BPH-1(BPH epithelial cell line) by treated with quercetin at the concentrations of 15,30,60,120 μM for 12,24,48,72 h.The production of IL-6,tumor necrosis factor-α(TNF-α),IL-1β and were m RNA expression detected by enzyme-linked immunosorbent assay kit and quantitative real-time polymerase chain reaction.Western blot was used to detect the expression of phospho-p38 mitogen-activated protein kinase(p-P38) and matrix metalloprotein-9(MMP-9).RESULTS:A total 151 chemical ingredients of 8 herbs and 1756 targets in BZYQD,105 common targets of BZYQD and BPH which mainly involving with MAPK8,IL-6,and so on.GO enrichment analysis got 352 GO entries(P < 0.05) which included 208 entries of biological process,64 entries of cell component and 80 entries of molecular function.KEGG pathway Enrichment analyses got 20 significant pathways which mainly involved with MAPK signaling way.MTT assay indicated quercetin inhibited the viability of BPH-1 cells by time-and dosedependent manner.Quercetin decreased the IL-6,TNF-α and IL-1β production and m RNA expression,and the expression of p-P38 and MMP-9 were also obviously reduced after treated with quercetin.CONCLUSIONS:BZYQD inhibited BPH through suppressing inflammatory response which might involving with regulating the MAPK signaling way.