A systematic study of Erzhu Erchen decoction against damp-heat internalized type 2 diabetes based on data mining and experimental verification

Background:Erzhu Erchen decoction(EZECD),which is based on Erchen decoction and enhanced with Atractylodes lancea and Atractylodes macrocephala,is widely used for the treatment of dampness and heat(The clinical manifestations of Western medicine include thirst,inability to drink more,diarrhea,yellow urine,red tongue,et al.)internalized disease.Nevertheless,the mechanism of EZECD on damp-heat internalized Type 2 diabetes(T2D)remains unknown.We employed data mining,pharmacology databases and experimental verification to study how EZECD treats damp-heat internalized T2D.Methods:The main compounds or genes of EZECD and damp-heat internalized T2D were obtained from the pharmacology databases.Succeeding,the overlapped targets of EZECD and damp-heat internalized T2D were performed by the Gene Ontology,kyoto encyclopedia of genes and genomes analysis.And the compound-disease targets-pathway network were constructed to obtain the hub compound.Moreover,the hub genes and core related pathways were mined with weighted gene co-expression network analysis based on Gene Expression Omnibus database,the capability of hub compound and genes was valid in AutoDock 1.5.7.Furthermore,and violin plot and gene set enrichment analysis were performed to explore the role of hub genes in damp-heat internalized T2D.Finally,the interactions of hub compound and genes were explored using Comparative Toxicogenomics Database and quantitative polymerase chain reaction.Results:First,herb-compounds-genes-disease network illustrated that the hub compound of EZECD for damp-heat internalized T2D could be quercetin.Consistently,the hub genes were CASP8,CCL2,and AHR according to weighted gene co-expression network analysis.Molecular docking showed that quercetin could bind with the hub genes.Further,gene set enrichment analysis and Gene Ontology represented that CASP8,or CCL2,is negatively involved in insulin secretion response to the TNF or lipopolysaccharide process,and AHR or CCL2 positively regulated lipid and atherosclerosis,and/or including NOD-like receptor signaling pathway,and TNF signaling pathway.Ultimately,the quantitative polymerase chain reaction and western blotting analysis showed that quercetin could down-regulated the mRNA and protein experssion of CASP8,CCL2,and AHR.It was consistent with the results in Comparative Toxicogenomics Database databases.Conclusion:These results demonstrated quercetin could inhibit the expression of CASP8,CCL2,AHR in damp-heat internalized T2D,which improves insulin secretion and inhibits lipid and atherosclerosis,as well as/or including NOD-like receptor signaling pathway,and TNF signaling pathway,suggesting that EZECD may be more effective to treat damp-heat internalized T2D.

A Meta-analysis of Dachaihu Decoction combined with western medicine in the treatment of acute pancreatitis with the TCM syndrome of liver qi depression and liver-gallbladder dampness-heat

Backgroud:To evaluate the clinical efficacy and safety of Dachaihu Decoction in the treatment of acute pancreatitis(AP)with the traditional Chinese medicine(TCM)syndrome of liver qi depression and liver-gallbladder dampness-heat.Methods:We searched randomized controlled trials of Dachaihu Decoction in the treatment of AP with the TCM syndrome of liver qi depression and liver-gallbladder dampness-heat from databases in CNKI,WanFang,VIP,Embase,PubMed,and Cochrane Library(from established to August 2019).All the retrieved documents were imported into the Noteexpress software for screening and management,and the included documents were evaluated for quality and data extracted.Statistical analysis was performed with RevMan(version 5.3).Results:A total of 132 articles were retrieved and 8 studies were included to analysis,including 679 patients.Quality evaluation of included studies suggested that the quality of the literatures is generally not high.Meta-analysis showed that the total clinical effective rate of AP was higher in the treatment group than in the control group[OR=5.00,95%CI(2.86,8.73)],and the difference was statistically significant(P<0.00001).The patient's abdominal pain relief time[MD=-0.57,95%CI(-0.86,-0.27),P=0.0002],bloating relief time[MD=-0.71,95%CI(-1.05,-0.37),P=0.04],time of serum amylase returning to normal[MD=-1.00,95%CI(-1.60,-0.40),P=0.001]and time of urinary amylase returning to normal[MD=-1.62,95%CI(-2.88,-0.37),P=0.01]all lower than the control group.But there was no statistically significant difference between the treatment group and the control group at the first defecation time[MD=-0.86,95%CI(-1.75,-0.03),P=0.06].The patient's serum TNF-a levels on the 3rd[MD=-28.53,95%CI(-49.57,-7.49),P=0.008]and 7th day[MD=-26.13,95%CI(-49.76,-2.50),P=0.03]in the treatment group were statistically lower in the treatment group than in the control group.Similarly,the patient's serum IL-6 levels on the 3rd[MD=-6.62,95%CI(-12.49,-0.75),P=0.03]and 7th day[MD=-11.98,95%CI(-22.25,-1.71),P=0.02]were also statistically lower in the treatment group than in the control group.No serious complications or adverse reactions were observed.Conclusion:Dachaihu Decoction combined with western medicine in the treatment of AP with the TCM syndrome of liver qi depression and liver-gallbladder dampness-heat can improve clinical efficacy compared with western medicine alone.In addition,the combination therapy method is safe and can be used for syndrome differentiation of AP patients in the clinic.

Effect of the Haoqinqingdan decoction on damp-heat syndrome in rats with influenza viral pneumonia

Objective: To investigate the effect of Chinese medicine prescription-Haoqinqingdan decoction on damp-heat syndrome in rats with influenza viral pneumonia and its influence on the immune function. Methods: A total of 48 Wistar rats were randomly divided into the normal control group, the damp-heat syndrome model group, the Haoqinqingdan decoction group (high, medium and low dose group) and the ribavirin group. The body temperature and weight of rats in each group were recorded after modeling. After treatment for 6 d, the concentration of T lymphocyte subgroup (CD3+ CD4+ , CD3+ CD8+ ) was determined by flow cytometry. The OD value of IFN毭/IL-4 was detected by double-antibody sandwich ELISA method, and its concentration was acquired through conversion. Results: After modeling, the temperature and weight of rats in each modeling group showed the increasing trend ( P<0.01). From the second day of treatment, there was significant difference in the body mass between groups, and the rat weight of the control group was higher than in the modeling group ( P<0.05 or 0.01). With the advances of treatment, only the temperature in the medium and high dose Haoqinqingdan decoction groups declined significantly ( P<0.05). After treatment, the CD4+ /CD8+ ratio of the damp-heat syndrome model group decreased more significantly compared with the control group. Elevated CD3+ CD8+ percentages and declined CD4+ /CD8+ ratios can be observed in the low dose group and ribavirin group ( P<0.05). Moreover, the CD3+ CD4+ percentage of ribavirin group was lower than in the control group ( P<0.05). After treatment, the IFN-毭 and IFN-毭/ IL-4 levels in the peripheral blood of rats in the dampheat syndrome group were obviously higher than in the control group ( P<0.05). Conclusions: Compared with ribavirin, the high dose Haoqinqingdan decoction can improve the ratio of T lymphocyte subgroup and Th1/Th2 cell balance more effectively.

Screening of Traditional Chinese Medicine Prescription for Treating Damp-heat Diarrhea of Piglets

[Objective] The paper was to explore the therapeutic effect of traditional Chinese medicine on damp-heat diarrhea of piglets in summer.[Method] Three prescriptions were developed with a dozen of traditional Chinese medicines,and in vitro antibacterial test against swine standard Escherichia coli [O149：K91,K88 ac（C83907）] was conducted.Moreover,106 natural cases of diarrhea piglets caused by coinfection of damp-heat and E.coli through clinical and laboratory diagnosis were then treated.[Result] The oral liquids prepared by three traditional Chinese medicine prescriptions had certain antibacterial effect on standard pathogenic E.coli.Prescription 2 presented the strongest inhibitory effects on swine E.coli in vitro,with the MIC of 31.25 mg/m L.It had better therapeutic effect,and the effective rate reached 94.74%.[Conclusion] The prescription 2 mainly consisted of Coptis chinensis and Prunus mume might be effective in treatment of piglet diarrhea caused by damp heat and E.coli in clinic.

"Heterozygous Treatment"Method to Improve the Biased Status of the Damp-Heat Constitution and Symptom Integral:Randomized Controlled Trial

Objective:To observe the clinical effect of"heterozygous treatment"intervening the damp-heat constitution.Method:One hundred and six cases with damp-heat constitution were randomly divided into the observation group and control group,fifty-three cases for each group.Lianpu drink was given to the two groups,and the observation group was treated with scraping,acupuncture,cupping,constitution care and popularization of constitution science for"heterozygous treatment"based on the control group.70 days later,"constitution classification and determination table of traditional Chinese medicine"was used to determine,and statistics was applied to analyze the change of the symptoms of the two groups before and after the intervention.Results:in the observation group,compared to before the intervention,symptoms like dirty and oily complexion,yellow greasy tongue,bitter taste,dullness and scanty dark urine were significantly improved(P<0.05),and improvement of the above symptoms was greater than the control group(P<0.05).Conclusion:There is no significant difference between the two groups(P>0.05).Conclusion:the"heterozygous treatment"method can significantly improve the clinical symptoms of people with damp-heat constitution,with a better role in regulating.

The role of endothelial biomarkers in predicting damp-heat syndrome in diabetic kidney disease

Objective:To explore the role of endothelial biomarkers in predicting damp-heat syndrome in diabetic kidney disease(DKD).Methods:A total of 183 patients with DKD were divided into 3 groups:the early DKD group,established DKD group,and advanced DKD group.All patients were classified according to traditional Chinese medicine(TCM)syndrome type,and clinical indexes were collected for statistical analysis.Results:A total of 183 DKD patients were included in this study.Fibroblast growth factor 23(FGF23),chitinase-3-like protein 1(CHI3L1),endocan,tumor necrosis factor receptor 1(TNFR1),secretory leukocyte protease inhibitor(SLPI),and vascular endothelial growth factor A(VEGF-A)were increased in advanced DKD.FGF23,CHI3L1,endocan,SLPI,and TNFR1 showed a negative correlation with estimated glomerular filtration rate(eGFR),while they had a positive correlation with 24 h urine protein.After adjusting for age,gender,diabetes duration,body mass index(BMI),hemoglobin,glucose,uric acid,24 h urine protein,cholesterol,triglyceride,low-density lipoprotein,and hemoglobin A1c(HbA1c),the multiple regression analysis showed that FGF23,endocan,TNFR1,and SLPI significantly correlated with eGFR.Conclusions:FGF23,endocan,TNFR1,and SLPI are elevated in advanced DKD compared with early stage,and they may take part in the pathogenesis and progression of DKD.Our study provides useful biomarkers for predicting the appearance of damp-heat syndrome,including FGF23,endocan,TNFR1,and SLPI.

Observation on the Therapeutic Effect of Heatclearing and Dampness-eliminating Dredging Collaterals Combined with Papaya Antirheumatic Pills on Treatment of Damp-heat Obstructive Ankylosing Spondylitis

Objective:Therapeutic effect of heatclearing and dampness-eliminating dredging collaterals combined with papaya antirheumatic pills on treatment of damp-heat obstructive ankylosing spondylitis.Methods:A total of 200 patients with ankylosing spondylitis who were treated in our hospital from January 2018 to October 2019 were selected as the research objects and randomly divided into 2 groups,each with 100 patients.The control group was treated with leflunomide+papaya antirheumatic pills,and the observation group was treated with self-drafted recipe of heat-clearing and dampness-eliminating,the curative effect,visual analogue score(VAS),barthel AS function index(BASFI)score,biochemical indicators and adverse reactions between the two groups were compared.Results:After 12 weeks of treatment,the efficacy of the observation group was higher than that of the control group.The pain score,BASFI score,and biochemical index were lower than those of the control group,and the differences were statistically significant(P<0.05);There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Heat-clearing and dampnesseliminating dredging collaterals combined with papaya antirheumatic pills is effective in the treatment of damp-heat obstructive ankylosing spondylitis,which is beneficial to reduce the degree of pain and inflammation of the affected area,helps patients remain active,and improves activities of daily living.

Efficacy of Pidan Jianqing decoction in treatment of type 2 diabetes with spleen deficiency and damp-heat syndrome

Introduction:This study aimed to assess the clinical efficacy of Pidan Jianqing decoction in the treatment of type 2 diabetes.Methods:A total of 72 patients with type 2 diabetes differentiated as spleen deficiency with damp-heat syndrome were randomly assigned to a treatment group(n=35)or control group(n=32).Patients in the control group received diet and exercise guidance and medication in the form of 0.5 g metformin hydrochloride tablets,while patients in the treatment group received Pidan Jianqing decoction in addition to the treatment given to the control group.Efficacy was evaluated after 8 weeks of treatment.Results:Efficacy was 91.4%in the treatment group versus 68.8%in the control group,which was a statistically significant difference(P<0.05).Significant group differences were also noted in the number of patients with improvement in symptoms such as dry mouth and polydipsia,frequency of urination and polyuria,abdominal distention and loss of appetite,fatigue and weakness,and sticky stools(all P<0.05),with greater improvement in the treatment group compared to the control group.The fasting blood glucose(FBG)and 2 h postprandial blood glucose levels significantly improved in both groups after treatment(P<0.05);however,there was no significant difference in glycated hemoglobin levels before and after treatment in both groups.Conclusion:Pidan Jianqing decoction can lower blood glucose levels and improve symptoms in patients with type 2 diabetes.

Clinical Efficacy of Western Medicine Combined with Chinese Medicine for Pelvic Inflammatory Disease(Damp-Heat and Stasis Type)

Objective:This study was undertaken to evaluate the clinical efficacy of Western medicine combined with Chinese medicine for pelvic inflammatory disease(damp-heat and stasis type).Methods:Seventy-four patients who were diagnosed with pelvic inflammatory disease(damp-heat and stasis type)by our hospital during July 2021 to July 2022 were randomized into two groups:the participants in the control group received conventional Western medicine treatment,and the participants in the study group received Western medicine combined with Chinese medicine.Results:After treatment,the total effectiveness of the control group(72.98%)was significantly lower than that of the study group(94.59%),(P<0.05);the whole blood viscosity high cut,whole blood viscosity low cut,fibrinogen and plasma viscosity of the control group were all lower than those of the study group(P<0.05);the levels of CRP,IL-6,and TNF-αin the control group were higher and IL-2 levels in the control group were lower than those in the study group(P<0.05).Conclusion:Western medicine combined with Chinese medicine is more effective in curing damp-heat and stasis-type pelvic inflammatory disease by improving the blood rheological indexes and lowering the level of inflammatory factors.

Effective Common Chinese Herbal Medicines Used in Treating Chronic Cholecystitis with Liver-Gallbladder Dampness-Heat Syndrome: A Review of Clinical Studies in the Past 10 Years

The objective of the study is to identify the effective common Chinese herbal medicines used in treating chronic cholecystitis with liver-gallbladder dampness-heat syndrome(CCLGDHS) through reviewing relevant clinical studies published in the past 10 years. Data were collected from Science Direct and Chinese National Knowledge Infrastructure. Data screening was carried out for the abstracts and full texts of the data. The top 15 Chinese herbal medicines with the highest occurring frequency were selected, statistically analyzed, and classified by their medicinal properties, actions, and indications according to the Chinese Pharmacopoeia 2015 edition. The top 15 effective common Chinese herbal medicines comprise Chai Hu, Huang Qin, Jin Qian Cao, Bai Shao, Yin Chen, Yu Jin, Chuan Lian Zi, Yan Hu Suo, Zhi Shi, Ban Xia, Bai Zhu, Pu Gong Ying, Gan Cao, Zhi Zi, and Qing Pi. The predominant natures were cold, cool, and warm. This combination can clear stagnant heat, warm Yang, and regulate Qi dynamics. In addition, bitter, pungent, and sweet were the predominant flavors. They can clear dampness-heat, regulate Qi dynamics to relieve cramps and pain, as well as tonify the deficiency. Along with entering the liver and gallbladder meridians, these herbal medicines also entered the spleen, stomach, and lung meridians to prevent potential disease transmission. The combinatorial medicinal actions of the effective common Chinese herbal medicine highlight the importance of the holistic concept of traditional Chinese medicine when treating CCLGDHS. In addition, the inclusion of activating blood to promote blood circulation, relieving cramps and alleviating pain, and tonifying the spleen and stomach represents a new finding in the treatment principle for CCLGDHS.

Clinicopathological features and expression of regulatory mechanism of the Wnt signaling pathway in colorectal sessile serrated adenomas/polyps with different syndrome types

BACKGROUND Colorectal cancer(CRC)is the third most common cancer worldwide,with the fourth highest mortality among all cancers.Reportedly,in addition to adenomas,serrated polyps,which account for 15%-30%of CRCs,can also develop into CRCs through the serrated pathway.Sessile serrated adenomas/polyps(SSAs/Ps),a type of serrated polyps,are easily misdiagnosed during endoscopy.AIM To observe the difference in the Wnt signaling pathway expression in SSAs/Ps patients with different syndrome types.METHODS From January 2021 to December 2021,patients with SSAs/Ps were recruited from the Endoscopy Room of Shanghai Traditional Chinese Medicine-Integrated Hospital,affiliated with Shanghai University of Traditional Chinese Medicine.Thirty cases each of large intestine damp-heat(Da-Chang-Shi-Re,DCSR)syndrome and spleen-stomach weakness(Pi-Wei-Xu-Ruo)syndrome were reported.Baseline comparison of the general data,typical tongue coating,colonoscopy findings,and hematoxylin and eosin findings was performed in each group.The expression of the Wnt pathway-related proteins,namelyβ-catenin,adenomatous polyposis coli,and mutated in colorectal cancer,were analyzed using immunohistochemistry.RESULTS Significant differences were observed with respect to the SSAs/Ps size between the two groups of patients with different syndrome types(P=0.001).The other aspects did not differ between the two groups.The Wnt signaling pathway was activated in patients with SSAs/Ps belonging to both groups,which was manifested asβ-catenin protein translocation into the nucleus.However,SSAs/Ps patients with DCSR syndrome had more nucleation,higherβ-catenin expression,and negative regulatory factor(adenomatous polyposis coli and mutated in colorectal cancer)expression(P<0.0001)than SSA/P patients with Pi-Wei-Xu-Ruo syndrome.In addition,the SSA/P size was linearly correlated with the related protein expression.CONCLUSION Patients with DCSR syndrome had a more obvious Wnt signaling pathway activation and a higher risk of carcinogenesis.A high-quality colonoscopic diagnosis was essential.The thorough assessment of clinical diseases can be improved by combining the diseases of Western medicine with the syndromes of traditional Chinese medicine.

Treatment of male infertility from damp heat physique

Male infertility is a common and frequently-occurring disease in andrology clinics.Its pathogenesis and clinical symptoms are complex and changeable.The treatment of traditional Chinese medicine is mostly based on dialectical treatment.Modern physicians headed by Professor Wang Qi respected the theory of physique,combined body differentiation,disease differentiation and syndrome differentiation,and put forward a new diagnosis and treatment concept of"quality differentiation and treatment".Big clinical data has confirmed that there is a correlation between Damp-Heat(Etiological terms.It refers to a disease.The combination of heat and dampness.)physique and male infertility.In order to improve the therapeutic effect of male infertility due to Damp-Heat,through the differentiation and treatment of male infertility and the analysis of the theory of Damp-Heat physique,combined with the investigation and research results of Damp-Heat physique and modern doctors’experience in the treatment of male infertility from the perspective of Damp-Heat In summary,it is concluded that correcting the formation and development of Damp-Heat physique clinically has important clinical basis and therapeutic advantages for the prevention and treatment of male infertility.

Potential Mechanism and Application of Strengthening the Spleen, Clearing Heat and Dampness in Treatment of Gastroesophageal Reflux Disease

Gastroesophageal reflux disease(GERD)is one of refractory digestive disease in clinic characterized by high prevalence,complex and recurrent symptoms.Traditional Chinese medicine(TCM)has a significant effect on the treatment of GERD.Spleen deficiency and damp-heat syndrome becomes one of the main syndrome patterns of GERD adapting with the changes of modern lifestyle.Although the therapy of strengthening the spleen,clearing heat and dampness is widely used in treatment of GERD,further studies still need to be conducted.The article comprehensively analyses the theoretical basis,mechanism and clinical efficacy of the therapy in order to provide more ideas for clinical treatment.

Logistic Regression Analysis of Damp-Heat and Cold Damp Impeding Syndrome of Rheumatoid Arthritis:A Perspective in Chinese Medicine

Objective： To investigate a method for quantitative differential diagnosis of damp-heat and cold-damp impeding syndrome of rheumatoid arthritis （RA） in Chinese medicine （CM）. Methods： Laboratory parameters were collected from 306 patients with RA. The clinical symptoms and laboratory parameters were compared between patients with these two syndromes （158 with RA of damp-heat impeding syndrome, and 148 with RA of cold-damp impeding syndrome）, and a regression equation was established to facilitate discrimination of the two RA syndromes. Results： There were significant differences in disease activity score in 28 joints [DAS28 （4）], erythrocyte sedimentation rate （ESR）, white blood cell count （WBC）, C-reactive protein （CRP）, platelet count （PLT）, albumin （ALB） and globulin （GLB） between the two syndrome of RA （P〈0.05）. Logistic regression analysis showed that the parameters ESR, WBC, CRP, joint pyrexia, joint cold, thirst, sweating, aversion to wind and cold, and cold extremities were statistically useful to discriminate damp-heat from cold-damp impeding syndrome. The regression equation was as follows： P=1/{1＋exp[-（3.0-0.021X1-0.196X2-0.163X3- 1.559X4＋1.504X5-0.927X6-1.039X7＋1.070X8＋1.330X9）]}. The independent variables X1-X9 were ESR, WBC, CRP, hot joint, cold joint, thirst, sweating, aversion to wind and cold, and cold limbs. A P value 〉 0.5 signified cold-damp impeding syndrome, and a P value 〈 0.5 signified damp-heat impeding syndrome. The accuracy was 90.2%. Conclusion： The regression equation may be useful for discriminating damp-heat from cold-damp impeding syndrome of RA.

Objective Tongue Inspection on 142 Liver Cancer Patients with Damp-Heat Syndrome

Objective： To establish the diagnosis evidence of objective tongue inspection for liver cancer （LC） patients with damp-heat syndrome （DHS） by dynamically observing their tongue figures using modern tongue image analytic apparatus, and to explore the effect of intervention on the tongue figures. Methods： Tongue figures were collected from 142 LC patients with DHS by tongue image analytic apparatus. Red （R）, green （G） and blue （B） values were analyzed. The r and g values were calculated requesting r=R/（R＋G＋B）, g=G/（R＋G＋B）, and b=l-r-g, and scored in combination with Chinese medical symptoms scale. The tongue figure and correlated scores were collected from 59 of them 3 days after transcatheter arterial chemoembolization intervention. Results： The range of objective tongue inspection of LC patients with DHS was as follows： as for tongue fur, 0.360〈r〈0.402 and 0.280〈g〈0.322; as for tongue proper, 0.404〈r〈0.470 and 0.243〈g〈0.301. The tongue figures and the average scores of quality of life, DHS, poor appetite, aggravated pain, decreased sleep quality and aggravated fever were obviously changed in the 59 LC patients with DHS after intervention, showing statistical difference when compared with before intervention （P〈0.05 or P〈0.01）. Conclusion： The range of objective tongue inspection of LC patients with DHS could be known by collecting and analyzing objective indicator of tongue figures, thus laying foundation for further studies with analysis of correlation between intervention and Chinese medicine based on tongue figures.