Effectiveness and safety of traditional Chinese medicine decoction for diabetic gastroparesis:A network meta-analysis

BACKGROUND Diabetic gastroparesis(DGP)is a prevalent complication of diabetes that impairs people's quality of life and places a significant financial burden on them.The gastrointestinal symptoms of DGP patients can be improved by several Traditional Chinese Medicine(TCM)decoctions that have been shown to be effective in treating the disease.There are still many unanswered questions regarding the identification of appropriate therapeutic agents for the treatment of DGP in clinical practice.AIM To analyze the efficacy of several TCM decoctions in the treatment of DGP using Bayesian network meta-analysis for reference.METHODS PubMed,EMBASE,Cochrane Library,Web of Science,China National Knowledge Infrastructure,The China Biology Medicine DVD,Wanfang,and CQVIP were searched from inception to September 17,2022,to collect randomized controlled trials(RCTs)about TCM decoctions for DGP.Clinical effects and symptom scores were the primary outcomes.Additionally,we assessed motilin(MOT),somatostatin(SS),gastrin(GAS),gastric emptying rate,gastric emptying time,and adverse drug events as secondary outcomes.RESULTS A total of 67 eligible RCTs involving 4790 DGP patients and 7 TCM decoctions were included.The results of network meta-analysis(NMA)and surface under the cumulative ranking curve showed that with western medicine(WM)as a common control,the Banxia Xiexin Decoction(BXXD)+WM was most effective in clinical effects and enhancing early satiety scores;the Simo decoction(SMD)+WM was most effective in improving nausea and vomiting scores and anorexia scores,bloating scores;the Chaishao Liujunzi Decoction(CSLJD)was most effective in MOT,the Zhishi Xiaopi Decoction(ZSXPD)was most effective in SS and upgrading emptying rate;the Jianpi Xiaozhi Decoction was most effective in GAS;the CSLJD+WM was most effective in improving gastric emptying time.CONCLUSION These NMA results suggest that the BXXD+WM and SMD+WM may be one of the potential optimal treatments.Due to various limitations,further large-sample,double-blind,multi-center randomized RCTs are needed.

Analysis on the formation principle and present situation of nano phase state of multi-component self-assembly of traditional Chinese compound medicine decoction

Traditional Chinese medicine decoction is a complex polydispersed phase system containing real solution,colloid solution,emulsion and suspension.The compound decoction of traditional Chinese medicine has complex components,including saponins,alkaloids,polysaccharides,flavonoids,amino acids and so on,which can be self-assembled to form gels,fibers,micelles,vesicles and so on.The self-assembled nano-phase not only neutralizes the single drug and reduces the toxicity and side effects,but also has its own pharmacological effects,which complement each other to achieve synergistic effect,so as to achieve the role of drug supplement,which is of research significance.The formation principle,solubilization and synergism principle and characterization method of multi-component self-assembly of traditional Chinese medicine compound decoction are discussed in this paper.

Identifying medication regularity of traditional Chinese medicine and potential pharmacological mechanism of Jiedu Sangen decoction in colorectal cancer treatment by data mining and network pharmacology

Objective:Colorectal cancer(CRC)is one of the most common malignancies in the world,and traditional Chinese medicine(TCM)is widely used in its treatment in China.However,the medication rules of TCM for CRC treatment remain unclear.Therefore,data mining combined with network pharmacology was utilized to establish treatment principles and rules.Methods:The CRC cases treated at Zhejiang Provincial Hospital of Chinese Medicine from January 1,2016 to October 31,2021 were analyzed using data mining methods.UPLC-Q/TOF-MS analysis was performed to identify the chemical composition of Jiedu Sangen decoction(JSD).Network pharmacology was used to reveal the therapeutic mechanism of JSD.Results:A total of 312 cases 2,998 prescriptions that met the inclusion criteria used 343 kinds of traditional Chinese medicines.The nature of the herbs used in treatment was mainly warm and mild.The taste was mainly sweet,bitter,and pungent.The meridian tropisms were mainly the spleen meridian,followed by lung and stomach meridians.Tonifying and replenishing herbs were the most frequently used in treatment.High-frequency herbs were classified into 11 categories by cluster analysis,and 42 association rules were obtained by association rule analysis.Combined with complex network analysis,3 core prescriptions for clinical CRC treatment were obtained.Jiedu Sangen decoction contains 64 chemical ingredients,out of which 31 active ingredients were identified,including polydatin,caffeic acid,and glutamic acid,along with 130 potential targets such as AKT1,SRC,and MAPK1.Jiedu Sangen decoction may play a role in regulating inflammation,immunity,metabolism,and hormones in the development of CRC via pathways such as the relaxin signaling pathway,IL-17 signaling pathway,prolactin signaling pathway,and T cell receptor signaling pathway.Conclusions:This study summarizes the treatment and medication principles for clinical CRC treatment,promoting the inheritance and development of the traditional Chinese medical experience.

Introduction of Western Medicines into China and Improvement on Decoctions during Modern China

During the late Qing dynasty(1840 A.D.-1912 A.D.),a large quantity of Western medicines entered China,which continuously impacted the traditional Chinese medicine(TCM)market and revealed the shortcomings of Chinese medicines.Some personages in the TCM community followed the trend of learning from the West,and attempted to reform TCM,with the improvement on decoction becoming an important aspect of this effort.Through debates and trials,the improvement on decoction underwent three stages of conceptual evolution:“taking Chinese medicines as the foundation and referring to the dosage forms of Western medicines”,“introducing Western techniques to serve the preparation of decoctions”and“integrating the theories of TCM and Western medicine to improve decoctions”.The study highlights the effective complementarity between modern TCM and Western medicine in the field of pharmacy,and provides valuable experience and support for the reevaluation of the value of TCM in contemporary society.

New treatment for gastroesophageal reflux disease:Traditional Chinese medicine Xiaochaihu decoction

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.

Clinical Comparison and Analysis of Decoction of Traditional Chinese Medicine Combined with Ear Acupoint Application and Simple Artificial Tears in the Treatment of Dry Eye Syndrome

OBJECTIVE: To study the clinical comparison and analysis of decoction of Traditional Chinese Medicine(TCM) combined with ear acupoint application and simple artificial tears in the treatment of dry eye syndrome. METHODS:A total of 62 patients(124 eyes) with dry eye syndrome treated in the Department of Ophthalmology of The 4th People's Hospital of Shenyang from July 2017 to March 2018 were selected and equally divided into 2 groups according to the admission order. The observation group received the combination therapy of TCM decoction and ear acupoint application, while the control group was given the simple artificial tears. The symptom score after 2 weeks, 4 weeks, and 8 weeks as well as the indicators including break-up time(BUT), Schirmer I test(SIT) and fluorescein(FL) were recorded and compared between groups. RESULTS: The symptom scores had no difference before treatment(P > 0.05), and were better in the observation group than those in the control group after treatment(P < 0.05). At 2 weeks, 4 weeks, and 8 weeks after the treatment, the amelioration level of BUT, SIT, and FL indicators in the observation group was better than that of the control group(P < 0.05). CONCLUSION: Compared with the artificial tears treatment method, the TCM decoction combined with ear acupoint application can significantly ameliorate the tear film stability, tear secretion, and reduce ocular surface damage for dry eye patients.

A Systematic Review on Chemical Constituents of Suanzaoren Decoction, a Traditional Chinese Medicine Prescription

Traditional Chinese Medicine prescription Suanzaoren decoction (SZRD) is composed of Ziziphi Spinosae Semen, Chuanxiong Rhizoma, Anemarrhenae rhizoma, Poria and Licorice. It was used to treat central nervous system diseases such as insomnia and anxiety for thousands of years. This paper aims to systematically understand varieties and quantities of compounds and clarify chemical components of SZRD, subsequently to further provide the reference for phytochemistry and pharmacology researches of SZRD. Our results showed that SZRD contained 145 components, including flavonoids, triterpenoids, steroids, coumarins, phthalides, and volatile oils, etc., while five-single herbs contain 1104 components. Only in terms of compound number, there were 80 common components in SZRD and its five herbs, which accounted for 6.8% of total compounds in all 5 herbs and 55.2% of compounds in SZRD. The components of SZRD were not simply the sum of one in every single herb. It is necessary to perform parallel studies among SZRD and its herbs. This review discussed the problems that existed in the chemical research of SZRD and pointed out the direction for its further research.

Efficacy and safety of the decoction of nourishing marrow and raising energy in terms of Traditional Chinese Medicine in patients with vascular dementia:a randomized controlled trial

OBJECTIVE: To explore the efficacy and safety of the decoction of nourishing marrow and raising energy in terms of Traditional Chinese Medicine(TCM) in patients with vascular dementia.METHODS: Totally 86 patients with vascular dementia patients hospitalized from September 2010 to January 2015 were recruited and randomly divided into two groups: control group and observation group. Patients in control group received the conventional treatment, whereas patients in another group were treated with the therapy of nourishing marrow and raising energy according to the theory of TCM. Blesse dementia scale scores were measured before and after the treatment for both groups and adverse effect was documented as well.RESULTS: After treatment, Blesse dementia scale scores reduced in both groups, and the difference in score reduction between the two groups was significant(P<0.05). The rate of adverse events was significantly lower in observation group than in control group(P<0.05).CONCLUSION: Our results demonstrate that the decoction of nourishing marrow and raising energy was an effective and safe alternative to vascular dementia in human subjects.

Treatment of abdominal compartment syndrome in severe acute pancreatitis patients with traditional Chinese medicine

AIM: To investigate the therapeutic effect of traditional Chinese traditional medicines Da Cheng Qi Decoction (Timely-Purging and Yin-Preserving Decoction) and Glauber's salt combined with conservative measures on abdominal compartment syndrome (ACS) in severe acute pancreatitis (SAP) patients. METHODS: Eighty consecutive SAP patients, admitted for routine non-operative conservative treatment, were randomly divided into study group and control group (40 patients in each group). Patients in the study group received Da Cheng Qi Decoction enema for 2 h and external use of Glauber's salt, once a day for 7 d. Patients in the control group received normal saline (NS) enema. Routine non-operative conservative treatments included non-per os nutrition (NPON), gastrointestinal decompression, life support, total parenteral nutrition (TPN), continuous peripancreatic vascular pharmaceutical infusion and drug therapy. Intra-cystic pressure (ICP) of the two groups was measured during treatment. The effectiveness and outcomes of treatment were observed and APACHE Ⅱ scores were applied in analysis. RESULTS: On days 4 and 5 of treatment, the ICP was lower in the study group than in the control group(P < 0.05). On days 3-5 of treatment, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores for the study and control groups were significantly different (P < 0.05). Both the effectiveness and outcome of the treatment with Da Cheng Qi Decoction on abdominalgia, burbulence relief time, ascites quantity, cyst formation rate and hospitalization time were quite different between the two groups (P < 0.05). The mortality rate for the two groups had no significant difference. CONCLUSION: Da Cheng Qi Decoction enema and external use of Glauber's salt combined with routine non-operative conservative treatment can decrease the intra-abdominal pressure (IAP) of SAP patients and have preventive and therapeutic effects on abdominal compartment syndrome of SAP.

Evaluation of Clinical Efficacy on Acute Pancreatitis Treated with Combination of Traditional Chinese and Western Medicine: A Meta-Analysis

Objective: Meta-analysis was conducted to assess whether combination of traditional Chinese and western medicine could enhance clinical outcomes compared to single western medicine in the treatment of acute pancreatitis (AP). Methods: This systematic review will include prospective and retrospective comparative studies in all languages and evaluate the clinical efficacy of integrated traditional Chinese and western medicine versus single western medicine in treatment AP. Animal studies will not be considered. Published articles were acquired from Jan. 2001 to Dec. 2017 by a comprehensive search in Chinese National Knowledge Infrastructure database (CNKI), Chinese WANFANG database. Exclusion criteria were non-comparative studies, hybrid treatment. The main points include clinical efficacy;carefully evaluating and reviewing the literature and filtering the literature according to inclusion criteria and exclusion criteria. Statistical analyses were performed using software Review Manager (Version 5.0). Publication biases of main results were examined by Stata 12.0. Results: 1262 cases of 1342 cases were effective and the effective rate reaches 94.04% in the group of integrated traditional Chinese and western medicine, while 949 cases of 1223 cases were effective and its effective rate can be up to 77.60% in the group of single western medicine (P > 0.05%, I2 = 0%, Odds Ratio (OR) = 4.98, 95% CI = 3. 79 - 6.54, P Conclusion: These results suggest that the therapeutic effects of integrated traditional Chinese and Western medicine on AP are better in treatment of AP than that of western medicine alone.

The effects of Buyang Huanwu decoction combined with Western medicine in diabetic foot treatment:a systematic review and meta-analysis

Objective:Systematically evaluate the effect of Buyang Huanwu decoction(BHD)combined with Western medicine(WM)in treating diabetic foot(DF).Methods:Randomized controlled trials that examined the effects of BHD on DF were collected from various databases,including CBM,PubMed,EMBASE,Web of Science,CNKI,Wanfang,and Weipu.Two researchers evaluated the quality of the literature and extracted relevant data,which was then analyzed using RevMan 5.3 for meta-analysis.The analysis was carried out in accordance with the 2020 PRISMA checklist.Results:The study analyzed 19 articles involving 1284 patients.According to the meta-analysis,BHD combined with WM improved clinical efficacy and reduced traditional Chinese medicine syndrome scores,glycosylated hemoglobin,and fibrinogen levels in DF patients.Although the BHD combined with WM showed a trend towards reducing wound area,the difference was not significant.Additionally,the incidence of adverse reactions did not show a significant decrease with BHD combined with WM.Conclusion:The findings of the study indicated that the use of BHD combined with WM yielded better therapeutic outcomes than WM alone,supporting the recommendation of using BHD with WM for DF treatment.This approach is suggested for further clinical application and promotion.

Shao Yao Decoction exerts a protective effect on ulcerative colitis by inhibiting inflammation mediated by hypercoagulability

Background:Shaoyao decoction(SYD)has been found widespread clinical use in treating ulcerative colitis(UC).However,the mechanism underlying SYD impact on UC remains elusive.Materials and methods:We preliminarily evaluated the therapeutic effect of SYD intervention in a dextran sulfate sodium-induced UC mouse model by analyzing the body weight change,disease activity index score,colon length,and HE staining results of colon tissue in each group of mice.Subsequently,we determined pro-inflammatory cytokines level and blood coagulation markers in the colon tissues of mice in each group to evaluate the effect of SYD intervention on colonic inflammatory response and coagulation function in UC mice.Results:Our findings emphasize the significant therapeutic effect of SYD on UC,including slowed down body weight loss,reduced disease activity index score,increased colon length,and reduced inflammatory infiltration in colon tissue.Moreover,SYD intervention significantly downregulated the levels of pro-inflammatory cytokines IL-1β,IL-6,and IL-17A in the colon.Furthermore,SYD intervention reversed the coagulation-related indicators such as prothrombin time,fibrinogen,P-selectin,D-dimer,and platelet glycomembrane protein IIb/IIIa.Conclusion:Our results elucidate the substantial therapeutic impact of SYD on UC mice.Importantly,the therapeutic mechanism of SYD in addressing UC potentially involves the inhibiting of inflammatory response mediated by hypercoagulability.

May Traditional Chinese Medicine Reduce the Risk of Developing Rheumatoid Arthritis?An One-armed Prospective Study

Background:Rheumatoid arthritis(RA)is a worldwide public health problem.Intervention and prevention before the onset of rheumatic diseases is a new direction in current research.Objective:The aim of this study was to evaluate the potential and feasibility of traditional Chinese medicine(TCM)in the prevention of RA.Methods:This was a single-armed prospective clinical trial.All participants were recruited from a single center in Guangdong,China.Adults who were tested positive for anti-cyclic citrullinated peptide antibody(anti-CCP)and/or rheumatoid factor(RF),had no synovitis and never been treated with disease-modifying anti-rheumatic drugs(DMARDs),were enrolled to take the Huayu-Qiangshen-Tongbi(HQT)decoction orally twice daily,200 mL each time for 24 weeks.Primary outcome was the proportion of patients who met 2010 ACR(American College of Rheumatology)/EULAR(European League Against Rheumatism)classification criteria of RA during observation.Secondary outcomes included levels of anti-CCP,RF,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),assessment of signs and symptoms,and radiographic progression by magnetic resonance imaging(MRI).Results:19 individuals were enrolled in the study,4 of which withdrew because of the epidemic of COVID-19.During the observation period,3 individuals(20%)developed RA and they had longer morning stiffness(P=0.009)and more obvious synovial enhancement in MRI(P=0.041)at baseline when compared with those who did not develop RA.After 24 weeks of intervention,there were improvements in 28-swollen joint count(SJC28)(P=0.046),Visual Analog Scale(VAS)(P=0.019),Patient’s Global Assessment(PtGA)(P=0.019)and Physician’s Global Assessment(PGA)(P=0.031),but no statistical significance was observed in the levels of anti-CCP,RF,ESR,CRP,morning stiffness,28-tender joint count(TJC28),Health Assessment Questionnaire(HAQ)and magnetic resonance imaging(MRI)analysis(P>0.05).Conclusion:The HQT formula is safe and could improve joint symptoms and signs in these at-risk individuals,but it remains to be investigated in futher study to see if it might potentially reduce the risk of developing RA.Besides,for individuals at high risk to develop RA,morning stiffness and synovial enhancement in MRI might be predictive factors and warning signs.

Clinical Effect of Yinma Zhisou Decoction Combined with Western Medicine in the Treatment of Acute COPD(Stagnation of PhlegmDampness in Lung)

[Objectives]To explore the effectiveness and safety of Yinma Zhisou Decoction in the treatment of AECOPD with phlegm-heat obstructing lung syndrome,and observe the symptoms of Yinma Zhisou decoction in the treatment of AECOPD patients with phlegm-heat stagnation lung syndrome improvement,inflammatory indicators,lung function,blood gas analysis,etc.[Methods]A total of 92 cases who met the inclusion criteria and exclusion criteria were included in the study according to 1∶1 were randomly divided into treatment group and control group,control group with conventional Western medicine treatment,the treatment group on the basis of control group with Yinma Zhisou decoction treatment,a course of 10 d.The changes in TCM syndrome score,arterial blood gas analysis,pulmonary function,serum inflammatory indicator,mMRC score,and the CAT scores between the two groups after treatment were observed.All collected data were statistically analyzed with SPSS 26.0.[Results](i)Comparison of the curative effect between the two groups.After treatment,the total effective rate of the treatment group was 93.5%,which was higher than that of the control group(76.1%,P<0.05).The curative effect of the treatment group was better than that of the control group(P<0.05).(ii)Comparison of single TCM symptom scores.After treatment,the single TCM symptom scores of the two groups were lower than before(P<0.05),but the improvement of wheezing,cough,phlegm and chest pain in the treatment group was better than that in the control group(P<0.05).There was no significant difference in the improvement of wheezing sound(P>0.05),but there was a trend of difference.(iii)Comparison of mMRC score and CAT score between the two groups.After treatment,the mMRC score and CAT score of the two groups were significantly improved(P<0.05),and the difference was statistically significant.(iv)Comparison of blood gas analysis indicators between the two groups.Intra-group comparison after treatment:PaOof the control group and the treatment group after treatment was significantly improved compared with that before treatment(P<0.05),and the difference was statistically significant.Comparison between the two groups after treatment:PaOand PaCOof the two groups after treatment(P>0.05),and the difference was not statistically significant.It indicated that Yinma Zhisou decoction had more advantages in improving hypoxia.(v)Comparison of pulmonary function between the two groups.After treatment,the FEV1/FVC of the treatment group and the control group was significantly different(P<0.05),and there was a statistical difference(P<0.05).(vi)Comparison of inflammatory indicators between the two groups.Intra-group comparison after treatment:the inflammatory indicators WBC,CRP and PCT in the control group and the treatment group were significantly lower than before treatment(P<0.05),and the differences were statistically significant.It indicated that Yinma Zhisou decoction could effectively control inflammation and reduce inflammation reaction.[Conclusions]Compared with the control group,Yinma Zhisou decoction has obvious advantages in improving cough,expectoration and wheezing,and can significantly improve the total effective rate.Compared with Western medicine alone,Yinma Zhisou decoction can significantly improve patients’hypoxia,reduce mMRC and CAT scores,improve body activity tolerance,improve airway symptoms,and significantly reduce WBC,CRP,PCT and other serum inflammatory indicators.It can be seen that Yinma Zhisou decoction combined with Western medicine treatment is obviously better than simple Western medicine treatment,the curative effect is better,and the safety is better,and there are no serious adverse reactions in the course of the trial.

Effect of Qingjin Huatan Decoction on transferrin and Iron regulatory protein in COPD rats

Objective:To explore the mechanism of Qingjin Huatan Decoction in regulating iron metabolism by regulating inflammatory factors in the inflammatory environment of chronic obstructive pulmonary disease.Methods:The COPD model was prepared by tracheal drops of lipopolysaccharide(LPS)combined with smoke.40 rats were randomly divided into normal group,COPD group,roxithromycin western medicine group and Qingjin Huatan Decoction traditional Chinese medicine group(n=10).Post-molding drug administration intervention,Qingjin Huatan Decoction Chinese medicine group was given 14.62 g/kg(Qingjin Huatan Decoction),roxithromycin western medicine group was given 0.01575 g/kg(roxithromycin),COPD group and normal group were given normal saline 10 mL/kg,twice a day.The expressions of Hepcidin,IL-1β,IL-10 and TGF-β1 in serum of rats in each group were detected by ELISA.WesternBlot and qRT-PCR were used to detect the expression of TF and IREB2 protein and mRNA in lung tissues of each group.Results:Compared with the normal group,the contents of serum Hepcidin and IL-10 in COPD group were significantly decreased(P<0.01),while the contents of serum IL-1βand TGF-β1 were significantly increased(P<0.01,P<0.05).Compared with COPD group,the contents of serum Hepcidin and IL-10 were significantly increased in the two drug groups(P<0.01),while the contents of serum IL-1βand TGF-β1 were significantly decreased in the two drug groups(P<0.05).Compared with normal group,TF mRNA and protein expression in COPD group were increased(P<0.01),while IREB2 mRNA and protein expression were decreased(P<0.01).Compared with COPD group,TF mRNA and protein expressions in lung tissues of the two-drug group were decreased(P<0.01,P<0.05),while IREB2 mRNA and protein expressions were increased(P<0.01).Conclusion:Iron metabolism is related to inflammation.Qingjin Huatan Decoction can regulate iron metabolism in inflammatory environment to treat COPD.

Clinical efficacy and safety of Guipi decoction combined with escitalopram oxalate tablets in patients with depression

BACKGROUND Depression is a widespread mental health condition that requires effective treatment.In the treatment of depression,traditional Chinese medicine(TCM)offers obvious advantages,fewer adverse reactions,and a lower recurrence rate.AIM To evaluate the clinical benefits of Guipi decoction combined with escitalopram oxalate tablets for individuals with depression.METHODS In total,80 patients diagnosed as having depression were enrolled in the study and divided into either an experimental group or a control group.All of the patients were orally administered escitalopram oxalate tablets.Additionally,the experimental group received Jiajian Guipi decoction and reduced Governor vessel fumigation over 4 wk.TCM syndrome scores,Hamilton depression rating scale(HAM-D)scores,self-rating depression scale(SDS)scores,and Pittsburgh sleep quality index scores were measured for the two groups and compared before and after the treatment.The two groups were monitored for any adverse reactions.RESULTS After 4 wk of treatment,both groups exhibited a significant reduction in TCM syndrome scores compared with their pre-treatment scores(P<0.05).However,the experimental group exhibited significantly lower TCM syndrome scores than the control group(P<0.05).Similarly,the post-treatment SDS and HAM-D-24 scores were significantly lower in both groups than the pre-treatment scores(P<0.05),with the experimental group exhibiting lower scores than the control group(P<0.05).The total treatment efficiency was significantly better in the experimental group(97.14%)than in the control group(77.78%)(P<0.05).Furthermore,after 4 wk of treatment,the Pittsburgh sleep quality index scores for both groups were significantly lower than those before the treatment(P<0.05),with the experimental group exhibiting lower scores than the control group(P<0.05).The incidence of adverse reactions was significantly lower in the experimental group than in the control group(P<0.05).CONCLUSION The combination of Guipi decoction and escitalopram oxalate tablets was found to be an effective and safe treatment for depression.This combination could reduce TCM syndrome scores,improve depressive symptoms,and enhance sleep quality.

Mechanism study of the effect of Ningxue Shengban decoction on regulating the ratio of Treg/Th17 cells and downstream inflammatory factors in immune thrombocytopenia model mice

Background:To explore the role and mechanism of T cell imbalance in the process of immune thrombocytopenic purpura(ITP)and the efficacy of the Ningxue Shengban decoction in treating this disease.Methods:Passive immune ITP mouse model was established by injecting CD41 monoclonal antibody into BALB/c mice.The mice were divided into different groups for intervention and drug administration for 9 days.The therapeutic effects(blood cell count,bone marrow morphology)were observed.The changes in the number and proportion of regulatory T/Th17 cells in each group,as well as the expression of key transcription proteins and genes(Foxp3,RORγt)in mouse spleen,and the secretion of related inflammatory factors(interleukin-17,TGF-β,interleukin-21,interleukin-10)in serum were detected.Results:Ningxue Shengban decoction significantly increased the peripheral blood platelet count in ITP mice,improved bone marrow morphology,restored the imbalance of regulatory T/Th17 ratio,and exerted a positive regulatory effect on target proteins and downstream inflammatory factor secretion.Conclusion:Ningxue Shengban decoction may exert its therapeutic effect in treating ITP by regulating T cells and exerting immune regulatory function.

双侧卵巢切除大鼠下丘脑⁃垂体的转录组学特征及二仙汤的调节效应

目的利用RNA测序技术研究围绝经期综合征模型大鼠下丘脑-垂体的转录组学特征及二仙汤的作用。方法以大鼠双侧卵巢切除术模拟围绝经期综合征雌激素骤然下降状态。48只雌性SD大鼠,随机取假手术组12只,其余36只大鼠双侧卵巢切除术后再随机分为双侧卵巢切除组、17β-雌二醇组、二仙汤组,每组12只。大鼠双侧卵巢切除术后第7天,17β-雌二醇组灌胃17β-雌二醇(0.1 mg·kg^(-1)·d^(-1)),二仙汤组灌胃二仙汤提取液(8 g·kg^(-1)·d^(-1)),每日灌胃1次,持续6周;假手术组与双侧卵巢切除组均灌胃等量的灭菌水。采用酶联免疫吸附测定(ELISA)法检测血清雌二醇(E2)、促性腺激素释放激素(GnRH)与β-内啡肽(β-EP)含量。采用mRNA转录组测序技术检测下丘脑与垂体,根据FPKM值与edgeR算法筛选组间差异表达基因,进行基因本体(GO)与京都基因与基因组百科全书(KEGG)富集分析,并以实时荧光定量逆转录聚合酶链式反应(RT-qPCR)法验证下丘脑雌激素受体α(Esr1)与线粒体编码的NADH脱氢酶亚基4(Mt-nd4)、垂体钙/钙调素依赖性蛋白激酶Ⅱα(Camk2a)与甲状腺激素受体α(Thra)共4个差异表达基因。结果①与假手术组比较,双侧卵巢切除组大鼠血清E2与β-EP显著下降(P<0.05);与双侧卵巢切除组比较,二仙汤组E2与β-EP水平显著升高(P<0.05)。②大鼠下丘脑与垂体可检测基因数量均为30957个。③与假手术组比较,双侧卵巢切除大鼠下丘脑上调基因135个、下调基因348个,垂体上调基因409个、下调基因82个。与双侧卵巢切除组比较,17β-雌二醇治疗后大鼠下丘脑上调基因126个、下调基因225个,垂体上调基因93个、下调基因273个;二仙汤治疗后大鼠下丘脑上调基因91个、下调基因92个,垂体上调基因390个、下调基因376个。④GO分析表明,下丘脑与垂体差异表达基因富集于细胞过程、生物学调控、代谢过程等。⑤KEGG呈现了下丘脑与垂体的差异表达基因富集前30个信号通路,其中二仙汤调节尼古丁成瘾、氮代谢、突触囊泡循环等信号通路。⑥RT-qPCR所验证的二仙汤显著调节的Esr1、Mt-nd4、Camk2a基因表达变化与转录测序结果一致。结论双侧卵巢切除大鼠下丘脑与垂体的神经内分泌系统处于紊乱状态,17β-雌二醇侧重于调节下丘脑基因,二仙汤对垂体调节更广、更深。

参芪益心汤治疗心力衰竭合并利尿剂抵抗患者的临床疗效及对其心功能、NT-proBNP水平的影响

目的 探讨参芪益心汤加减治疗心力衰竭合并利尿剂抵抗患者的疗效。方法 选取2021年12月—2022年12月期间黑龙江中医药大学附属第一医院收治的心力衰竭合并利尿剂抵抗患者100例作为研究对象,按照随机数字表法分为对照组和试验组,每组各50例。对照组予常规治疗,试验组在对照组基础上加用参芪益心汤,两周为1个疗程,两组患者均治疗4周。观察比较两组患者治疗前后心功能指标[左心室舒张末期内径(Left ventricular end-diastolic diameter,LVDD)、左房内径(Left atrial diameter,LAD),计算左室射血分数(Left ventricular ejection fraction,LVEF)]、血清指标[N端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)、肌钙蛋白T(Cardiac troponin T,CTnT)、肌酸磷化脢同功脢(Creatine kinase isoenzyme,Ck-MB)]、中医证候积分,比较两组患者临床疗效及不良反应。结果 治疗后两组患者心功能LVDD、LAD水平均较治疗前降低,LVEF水平均较治疗前升高,差异有统计学意义(P<0.05);且试验组LVDD、LAD水平均明显低于对照组,LVEF水平明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者NT-proBNP、CTnT、Ck-MB水平均较治疗前降低,差异有统计学意义(P<0.05);且试验组NT-proBNP、CTnT、Ck-MB水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者心悸、气短、气喘、胸闷评分均较治疗前降低,差异有统计学意义(P>0.05);且试验组心悸、气短、气喘、胸闷评分均明显低于对照组,差异有统计学意义(P<0.05)。治疗后试验组总有效率96.00%(48/50)高于对照组72.00%(36/50),差异有统计学意义(P<0.05)。治疗期间,两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论 应用参芪益心汤能够显著改善心功能,缓解临床症状,疗效显著,值得临床应用。

不同剂量附子水煎液对慢性心力衰竭小鼠的干预作用

目的:探讨不同剂量附子水煎液对慢性心力衰竭(CHF)小鼠的影响。方法:将53只C57/6J小鼠雄性随机分为对照组、模型组、附子水煎液低剂量组、附子水煎液中剂量组、附子水煎液高剂量组,用盐酸阿霉素(Dox)腹腔注射诱导CHF小鼠模型,药物干预给予不同浓度(0.2、0.6、2 mg/kg)的附子水煎液进行灌胃治疗,1次/d,连续干预30 d,统计小鼠生存率和一般指标,评价小鼠心脏功能,观察心肌组织病理形态学的变化,检测血清中脑钠肽(BNP)和心肌肌钙蛋白I(cTnI)的含量,检测心钠尿肽(ANP)和BNP的mRNA表达水平,检测活化的天冬氨酸特异性半胱氨酸蛋白酶(Cleaved-caspase3)和凋亡蛋白Bax(Bax)的表达情况。结果:与模型组比较,不同剂量附子水煎液组小鼠心脏功能均得到改善(P<0.05),且高剂量附子水煎剂组改善最为显著,具体表现为心肌组织横截面积增大,血清BNP和cTnI的含量降低(P<0.05),BNP的mRNA表达水平和Cleaved-caspase3及Bax蛋白表达水平明显降低(P<0.05)。结论:附子水煎液能剂量依赖性地抑制心肌细胞凋亡,减轻小鼠心功能及其病理结构的改变,进而改善Dox诱导的CHF。