Transcriptomic and metabolomic analysis of the effects of Zhenwu decoction on kidney yang deficiency pattern in chronic kidney disease

Objective:To explore the kidney yang deficiency pattern(KYDP)in a chronic kidney disease(CKD)rat model and the mechanisms underlying the effects of Zhenwu decoction(ZWD)by conducting tran-scriptomic and metabolomic analyses.Methods:Adriamycin(ADR)combined with hydrocortisone(HC)was used to induce CKD with KYDP in rats.ADR was injected into the tail vein twice.HC was injected intramuscularly for 8 weeks.ZWD was administered by gavage for 8 weeks.The general condition was observed,24-h urine protein was detected,serum corticosterone,triiodothyronine,thyroxine,TSH,testosterone,cAMP,and cGMP levels were determined,and pathological analysis was conducted.Transcriptomic and metabolomic analyses were conducted to screen differentially expressed genes(DEGs),differentially expressed metabolites(DEMs),and differentially expressed pathways(DEPs).The core DEMs and DEGs were input to Metab-oanalyst 5.0 to identify the pathways affected by ZWD.Results:In the HC group,KYDP symptoms were observed.Compared with control group,the levels of 24-h urine protein,TSH,and cGMP significantly increased(all P<0.01),and corticosterone,triiodothyronine,thyroxine,and cAMP significantly decreased(all P<0.01)in the HC group.After ZWD intervention,the levels of above-mentioned indicators could be reversed to some extent.Pathological analysis in the HC group revealed kidney lesions.DEGs in the ZWD group were mainly associated with pathways such as nucleotide synthesis and endocrine pathways.In the ZWD group,differences in biosynthesis of unsat-urated fatty acids and butanoate metabolism were observed.The following pathways were significantly affected by ZWD:arachidonic acid metabolism,valine,leucine,and isoleucine biosynthesis,linoleic acid metabolism,and alpha-linolenic acid metabolism.Conclusion:ZWD can be used to treat KYDP in CKD through regulating arachidonic acid metabolism,valine,leucine,and isoleucine biosynthesis,linoleic acid metabolism,and alpha-linolenic acid metabolism.

Observation on Clinical Effects of Tuina plus Hot Compress for Infantile Diarrhea Due to Spleen-kidney Yang Deficiency

Objective: To observe the clinical effects of tuina plus hot compress for infantile diarrhea due to spleen-kidney yang deficiency. Methods: One hundred cases were randomly divided into a treatment group and a control group, 50 cases in each group. The treatment group was treated with tuina plus hot compress. The control group was treated with oral administration of Live Combined Bifidobacterium, Lactobacillus and Enterococcus powder(Bifico). The clinical effects were observed after 5-day intervention. Results: The total effective rate was 94.0% in the treatment group and was 66.0% in the control group. The difference in the total effective rate between the two groups was statistically significant(P<0.05). The clinical effect was better in the treatment group than that in the control group. Conclusion: Tuina plus hot compress for infantile diarrhea due to spleen-kidney yang deficiency can produce a better clinical effect than oral administration of Bifico.

EFFECTS OF MOXIBUSTION ON THE IMMUNITY AND THE CENTRAL NERVOUS TRANSMITTERS IN MICE WITH YANG DEFICIENCY

In the present paper, the effects of moxibustion on the immune organs, on the multiplication reactivity of the splenic lymphocyte and the reactivity to the IL - 2, and on the transmitters in brain tissues of the mice with "yang deficiency" were studied. 30 mice were randomly divided into three groups: the normal group, the peng deficiency control group and the moxibustion treated group. Our study found out that in the mice of yang deficienly, the atrophy of the immunt organs was prevented, the reactivity of the splenocyte and the reactivity to IL - 2 were heightened, the amounts of the DA, NE and E in brain were increased significantly after moxibustion on the Point Shengshu. It can be held that moxibustion may protect the immune organs and regulate the immunity of the mouse with yang deficienly, and the effects may be contributed to the increase of the nervous transmitters in the brain.

Proteomics analysis of IBS-D with spleen and kidney yang deficiency

Objective:To investigate the molecular mechanism underlying the development of diarrhea-predominant irritable bowel syndrome (IBS-D) with spleen and kidney yang deficiency (SKYD) using a proteomics approach.Methods:Male Sprague-Dawley rats (n =22) were divided into IBS-D (n =12) and normal control (n =10) groups.SKYD was then modeled in IBS-D rats by a combination of acetic acid enema,bondage,rectal dilation,tail stimulation,and Senna gavage.Colon tissue samples were subsequently collected and examined by Q Exactive mass spectrometry to identify differentially expressed proteins between the two groups.Results:The occurrence of SKYD/IBS-D was associated with ribosomal protein S23 (Rps23),protein phosphatase 2 catalytic subunit alpha (Pp2a),and growth factor receptor-bound protein 2 (Grb2),which are involved in the ribosome,neurotrophin signaling,and Janus kinase-signal transducer and activator of transcription (JAK-STAT) signaling pathways.Conclusion:These data suggest that SKYD/IBS-D pathophysiology likely involves inflammation,cell growth,apoptosis,stress granule formation,immune activation,loss of epithelial cell integrity,and visceral hypersensitivity.

Treatment of insomnia by differentiation of yang deficiency syndrome

Insomnia has become one of the common clinical diseases.In recent years,it has been found that patients with insomnia of Yang deficiency type are more and more common,and the trend of rejuvenation gradually appears,which seriously affects the normal progress of people's life,work and study.Clinical treatment through syndrome differentiation,mainly from the heart,spleen,kidney three viscera yang deficiency,on the basis of the warm yang method to add Qianzhen tranquilizing products,and pay attention to multiple organs as diseases,add moisture,blood The qi thing,while not forgetting the psychological counseling,adjusting the body and mind,and achieving a certain clinical effect,can provide ideas for the treatment of this disease.

Preventive and therapeutic effect of long snake moxibustion on psoriasis with yang deficiency and external cold syndrome based on the theory of "treatment of winter disease in summer"

Psoriasis is a chronic inflammatory skin disease with multiple layers of silvery white scales on the surface of erythema papule as the main clinical characteristics,of which yang-deficiency external cold psoriasis is refractory,recurrent and severe in winter and mild in summer,which has a great impact on patients'physical and mental health and quality of life.Traditional Chinese medicine has unique insights in the treatment of psoriasis,both curative effect and safety,have obvious advantages.Based on the concept of"winter disease and summer treatment",long-snake moxibustion gives full play to its functions of warming the kidney,invigorating the marrow,warming the meridians,activating blood circulation and removing blood stasis,so as to restore the deficiency of Yang in patients with psoriasis with external cold syndrome,enhance disease resistance,and prevent psoriasis recurrence or aggravation in winter.Therefore,based on the theory of"winter disease and summer treatment",this paper preliminarily discusses the mechanism of long-snake moxibustion in the prevention and treatment of psoriasis with external cold syndrome of Yang deficiency,and provides new ideas and directions for the prevention and treatment of psoriasis with traditional Chinese medicine.

Clinical observation on efficacy of compound of warming yang, descending turbidity and dredging collaterals in the treatment of diabetic kidney disease with Yin-Yang deficiency and blood stasis syndrome

Objective:To observe the clinical efficacy of compound of owarming yang,descending turbidity and dredging collaterals in the treatment of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome.Methods:Seventy-six patients of diabetic kidney disease with yin-yang deficiency and blood stasis syndrome were randomly divided into observation group and control group,thirty-eight cases in each group.The control group was given conventional western medicine treatment,while the observation group took compound of owarming yang,descending turbidity and dredging collaterals orally on the basis of conventional western medicine treatment.The course of treatment covered for one month.Before and after treatment,we observed the scores of traditional Chinese medicine symptoms,indicators of renal function[serum creatinine(Scr),blood urea nitrogen(BUN),microalbuminuria(MALB)],indicators of glucose metabolism[fasting plasma glucose(FPG),2-hour postprandial blood glucose(2hPG),glycosylated hemoglobin(HbAlc)],indicators of hemorheology[plasma viscosity(PV),platelet aggregation rate(PAR),fibrinogen(FIB)],Cystatin-C(Cys-C),C-reactive protein(CRP)in the two groups.Results:After treatment,the clinical effect of the observation group was significantly better than the control group(P<0.05).The scores of traditional Chinese medicine symptoms,indicators of renal function(Scr、BUN、UAER),indicators of glucose metabolism(FPG、2hPG、HbAlc),indicators of hemorheology(PV、PAR、FIB),Cys-C and CRP in the two groups were decreased significantly compared with those before treatment(P<0.05),and the decrease in the observation group was superior to that in the control group(P<0.05).Conclusion:Compound of warming yang,descending turbidity and dredging collaterals has remarkable efficacy in treating of diabetic kidney disease patients with yin-yang deficiency and blood stasis syndrome by alleviating clinical symptoms,glucose metabolism,renal function and microcirculatory disturbance,and the mechanism related to alleviation of microinflammation.

High Density Lipoprotein Phospholipids as a Marker of Coronary Heart Disease of Shen-Yang Deficiency Syndrome

Objective: To seek a new biochemical index for diagnosis of coronary heart disease (CHD) of shen-Yang deficiency syndrom (CHD-SYD). Methods: Sixty-one patients with CHD were divided into 3 groups according to their TCM Syndrome type, 10 patients in the group without Xin-Qi deficiency (Group A), 25 in the group with Xin-Qi deficiency but without Shen-Yang deficiency (Group B) and 26 in the group both with Xin-Qi deficiency and Shen-Yang deficiency (Group C). Levels of 17-hydroxy-corticoste-roid in urine (urinary 17-OHCS) per 24 hrs, and serum level of high density lipoprotein cholesterol (HDL-C) and high density lipoprotein phospholipid (HDL-PL) in them were determined in synchrostep and compared with those in the control group of 23 healthy aged persons, urinary 17-OHCS per 24 hrs was taken as the diagnostic standard to screen a new index for diagnosis of Shen-Yang deficiency Syndrome, and preliminary appraisal to the index was made. Results: Serum HDL-PL in the CHD-SYD patients( Group C) was 616+157 mg/L, which was obviously lower than that in the patients of Group A and B. With low HDL-PL(<650 mg/L) used as the index to diagnose CHD-SYD, the sensitivity was 73%, the specificity 86% and the accuracy 80%. Conclusion: HDL-PL <650 mg/L could be adopted as an index for CHD-SYD diagnosis, which is simple and practical.

Clinical Research of Zhenwu Decoction Combined with Tingli Dazao Xiefei Decoction in the Treatment of Chronic Heart Failure with Edema Syndrome due to Yang Deficiency

[Objectives]The paper was to investigate the clinical effects of Zhenwu Decoction combined with Tingli Dazao Xiefei Decoction in the treatment of chronic heart failure with edema syndrome due to yang deficiency.[Methods]Eighty patients with chronic heart failure were randomly divided into 2 groups(control group and treatment group),with 40 cases in each group.The patients in the control group were treated with conventional western medicine for 14 d,and the patients in the treatment group were treated with Zhenwu Decoction and Tingli Dazhao Xiefeng Decoction on the basis of the control group for 14 d.The curative effect of traditional Chinese medicine(TCM)syndrome score,left ventricular ejection fraction(LVEF),plasma N-terminal brain natruretic peptide precursor(NT-proBNP)and New York Heart Association(NYHA)functional class were compared between the two groups before and after treatment.Minnesota living with heart failure questionnaire in the principle of Chinese civilization and traditional medicine characteristics(C-MLHF)at admission and 1 month after discharge were compared between the two groups.[Results]After treatment,the total effective rate of TCM syndrome score in the treatment group was 82.50%,and that in the control group was 67.50%.The curative effect of TCM syndrome score in the treatment group was better than that in the control group(P<0.05).After treatment the LVEF in both groups was increased compared with that before treatment,and the NT-proBNP level was decreased compared with that before treatment(P<0.05),and those in the treatment group were better than those in the control group.The total effective rate of cardiac function in the treatment group was 87.50%,and that in the control group was 65.00%.The improvement of cardiac function in the treatment group was better than that in the control group(P<0.05).One month after discharge,C-MLHF scores in both groups were decreased compared with those before treatment,and that in the treatment group was lower than in the control group(P<0.05).[Conclusions]Zhenwu Decoction combined with Tingli Dazao Xiefei Decoction based on traditional western medicine treatment could improve the clinical efficacy,symptoms and quality of life of patients in the treatment of chronic heart failure with edema syndrome due to yang deficiency.

Brief Analysis of Treatment of Postpartum Body Pain by Professor Zhang Xiaofeng from the Viewpoint of “Liver Vital Deficiency and Yang Stagnation”

Postpartum body pain is a common gynecological disease in clinical setting.Its symptoms are complex and is difficult to treat.It is often treated in many ways but with poor results,which bring great pain to patients and their families.Professor Zhang Xiaofeng can effectively improve clinical treatment of this disease from the point of view of“liver vital deficiency and yang stagnation”.This paper mainly introduces the professional experience of Professor Zhang Xiaofeng in treating postpartum body pain.A clinical case was attached for reference as proof.

Observation of tongue picture and tongue and nailbed microcirculation before and after blood dialysis in 125 uremic patients with deficiency of kidney-yang

using a WZD—1 microcirculation microscope,we observed the tongue tipand nail-bed microcirculation of uremic patients with deficiency of kidney-yangbefore and after blood dialysis.The results showed that the pathological basis ofuremia with deficiency of kidney-yang may be microcirculation disturbance,in-crease of metabolites and water retention.The effusion from capillary loops intongue tip may be one of the pathogenetic factors of a swollen and jaggedtongue.The flow rate of blood in capillary loops in the nail-bed was apparentlyabnormal and markedly improved after blood dialysis.The weighted integral ofnail-bed microcirculation decreased from moderately abnormal (4.99±1.52) toapproximately normal (1.98±0.97) (P【0.01).Microcirculation seems to be a sensi-tive criterion for reflecting the pathologic changes of uremia with deficiency ofkidney-yang.

Discuss ion on the Correlation Between Yang Deficiency&Cold-dampness and Malignant Tumors Based on"Diseases producing the liquid that is clear and chill all result from coldness"

Tumor is defined as a kind of chronic diseases by the World Health Organization.The integrative traditional Chinese and western medicine works well on the treatment of tumors,even in advanced patients or patients with recurring and metastatic tumor.However,the pathogenic mechanism of tumors is still unclear.Therefore,based on the 19 th pathogenesis in Yellow Emperor's Internal Class that"Diseases producing the liquid that is clear and chill all result from coldness",the paper explore s the etiology pathogenesis of malignant tumors,and the correlation between which and tumor recurrence and metastasis,and also discusses the rules for the treatment of tumors at various stages with great method of warming yang for dispelling cold.

A Study on the Law of Birth and Formation of Yang-Deficiency Constitution Based on the Theory of Five Movement and Six Qi

Objective:To explore the law of birth and yang deficiency constitution based on the theory of five movements and six qi,as well as to provide a new way to better realize the prevention of yang deficiency constitution.Methods:The data of TCM quality table and luck data were collected via questionnaires.According to the data of from the TCM quality table,the respondents were divided into yang deficiency constitution group and non-yang deficiency group.According to the luck data,the distributions of gestational age were compared between the two groups.Results:A total of 175 questionnaires were collected,of which 89 were non-yang deficiency constitution and 86 were yang deficiency constitution.The proportion of Ding year(15.1%)in the yang deficiency group was significantly higher than that in non-yang deficiency group(5.6%),in which the difference was statistically significant(P<0.05).Conclusion:The possibility of yang deficiency constitution is higher.

Clinical Research into Ke Min Yin for Treatment of Persistent Allergic Rhinitis in Patients with Qi Deficiency and Blood Stasis

Persistent allergic rhinitis (PAR) is one of the common diseases at ear-nose-throat department. From August 1998 to May 2001, we randomly selected 60 cases of PAR with qi deficiency and blood stasis for a clinical observation. 30 patients in the treatment group were treated with Ke Min Yin (克敏饮), a herbal medicine, to supplement qi, expel wind, nourish blood and promote blood circulation; and the other 30 cases in the control group were treated with cetrine. Through systematic observation and statistical processing, the clinical research is summarized and reported in the following.

Empirical Prescriptions Used in Treatment of Epigastralgia due to Blood Stasis of Deficiency Type

Epigastralgia,a commonly-seen symptom inchronic gastritis or gastric ulcer,and usually causesinjury of the vital-qi and thereby deficiency of thehuman body due to its chronicity.The deficiency isdivided into deficiency of yin,yang,qi,and blood.Asis said in A Guide to Clinical Practice with MedicalRecords(临证指南医案),illnesses at the early stageaffect channels which dominate qi while at the latestage collaterals which dominate blood,and

Twenty-seven Cases of Spleen-Q/Deficiency Syndrome Treated by Heat-Producing Needling at Zusanli

The spleen-qi deficiency syndrome can beinduced by many factors.It is generally characterizedby a decreased food-intake,abdominal distention,watery or loose stool,general lassitude,pale tongueproper,and weak pulse.In recent years when workingin the Mediterranean TCM Center in Malta,the authorhad treated 27 such cases by applying the heat-

基于“动则生阳”理论探讨鸢尾素与慢性心力衰竭心阳虚证本质的联系

慢性心力衰竭(chronic heart failure, CHF)是各种原因导致的心脏疾病终末阶段,心阳不足是导致CHF恶化的关键病因。鸢尾素是一种肌动蛋白糖基化蛋白激素,是纤维连接蛋白Ⅲ型结构域5(fibronectin typeⅢdomain containing 5, FNDC5)的多肽切割产物,同时也是一种依赖于过氧化物酶体增殖物激活受体γ共激活物-1α(peroxisome proliferator-activated receptor γ coactivator-1α, PGC-1α)的肌细胞因子。在肌肉运动时,PGC-1α通过刺激FNDC5表达,增加鸢尾素释放并介导运动相关的效应。在这一过程中产生的鸢尾素可以增加线粒体产能和脂肪褐变产热,促进葡萄糖代谢和脂肪酸氧化。“动则生阳”理论源于《易经》,其指出“动”是化生阴阳万物的起源。对于CHF心阳虚证患者,运动可振奋其心阳,促进人体气血通畅,改善CHF症状,促进疾病向愈。“动则生阳”的本质可能是运动改善了CHF心阳虚证患者的“气虚”和“寒象”状态,可能与机体运动时产生的鸢尾素调控了能量代谢及线粒体产能有关。因此,推测缺乏鸢尾素可能是CHF心阳虚证的生物学内涵。

参杞强精颗粒对慢性疲劳综合征脾肾阳虚证大鼠免疫调节作用研究

目的:探讨参杞强精颗粒对慢性疲劳综合征(CFS)脾肾阳虚证模型大鼠的影响以及免疫调节作用。方法:将50只无特定病原体(SPF)级健康雄性斯泼累格·多雷(SD)大鼠随机分为正常对照组,模型对照组,参杞强精颗粒高剂量组、中剂量组、低剂量组,采用游泳力竭实验造成大鼠体力疲劳,慢性束缚应激造成大鼠心理疲劳,同时给予番泻叶煎煮液灌胃造成脾肾阳虚证候,构建CFS脾肾阳虚证大鼠模型,造模成功后分别按照各组剂量灌胃,连续给药21 d后,测定各组大鼠的胸腺和脾脏指数,酶联免疫吸附试验(ELISA)检测血清免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、免疫球蛋白A(IgA)浓度以及细胞因子白细胞介素2(IL-2)、白细胞介素6(IL-6)和γ干扰素(IFN-γ)含量,MTT法检测脾脏T、B淋巴细胞增殖能力,流式细胞法检测各组大鼠外周血T淋巴细胞亚群分布情况。结果:行为学结果显示,模型大鼠的体质量增长缓慢,精神萎靡,摄食水量减少,活动减少,便质稀软,力竭游泳时间减少,悬尾静止时间增加。药物干预后,与模型组比较,各给药组大鼠精神状态、体质量、摄食水量均显著改善,力竭游泳时间增加、悬尾静止时间减少(P<0.01或P<0.05);参杞强精颗粒各剂量组能显著提升大鼠胸腺和脾脏指数,提高IgG、Ig M、IgA浓度和IL-2、IL-6、IFN-γ的含量,显著提高脾脏T、B淋巴细胞增殖能力,也能提高CD3+、CD4+T淋巴细胞百分率和CD4+/CD8+T比值,降低CD8+T淋巴细胞百分率,差异有统计学意义(P<0.01或P<0.05)。结论:参杞强精颗粒能显著改善慢性疲劳综合征脾肾阳虚证大鼠免疫功能,缓解疲劳症状,且具有很好的免疫调节作用。

温肾汤治疗慢性肾功能不全脾肾阳虚证的临床疗效及对肾脏纤维化的影响

目的:探究温肾汤治疗慢性肾功能不全脾肾阳虚证的效果及其对肾脏纤维化的影响。方法:选择符合纳入标准的慢性肾功能不全脾肾阳虚证患者96例,依据随机数字表随机分为对照组和观察组。对照组采用常规西药治疗,观察组在对照组基础上口服温肾汤治疗,2周为1个疗程,两组均治疗2个疗程。比较治疗前后两组患者中医症状评分(畏寒肢冷、面浮肢肿、神疲乏力、食少纳呆、腰膝畏寒和脘腹胀痛)、肾功能相关损伤指标(24 h Pro、BUN、Ccr和GFR)及肾纤维化相关指标(CTGF、CIV、PCⅢ和BMP-7)变化情况及临床疗效。结果:对照组临床总有效率为77.1%(37/48),观察组临床总有效率为91.7%(44/48),差异有统计学意义(P<0.05);治疗后两组患者畏寒肢冷、面浮肢肿、神疲乏力、食少纳呆、腰膝畏寒和脘腹胀痛的中医症状评分均较治疗前显著降低(P<0.05),且观察组改善程度优于对照组(P<0.05);治疗后两组患者24 h Pro、BUN水平均较治疗前显著降低(P<0.05),Ccr、GFR水平显著升高(P<0.05),且观察组改善程度优于对照组(P<0.05);治疗后两组患者CTGF、CIV及PCⅢ水平较治疗前明显降低(P<0.05),BMP-7水平明显升高(P<0.05),且观察组改善程度优于对照组(P<0.05)。结论:温肾汤可以有效改善慢性肾功能不全脾肾阳虚证患者的肾功能,降低蛋白尿,显著抑制肾脏纤维化。

菟丝子盐炙前后对肾阳虚模型大鼠精子活力的影响

本文旨在研究菟丝子盐炙前后对肾阳虚大鼠精子活力的影响。本研究采用肌注氢化可的松的方法建立大鼠肾阳虚模型,分别用菟丝子生品、盐炙品、市售盐菟丝子的水提液以及金匮肾气丸对肾阳虚大鼠灌胃14 d,记录大鼠睾丸、附睾等脏器指数,精子密度及精子活力,观察睾丸组织病理切片,测定血清睾酮(T)水平及睾丸匀浆中酸性磷酸酯酶(ACP)、琥珀酸脱氢酶(SDH)、总超氧化物歧化酶(T-SOD)、谷胱甘肽(GSH)、丙二醛(MDA)水平。结果表明,与模型组比较,菟丝子盐炙品、市售品和生品水提液均可提高模型大鼠的精子活力,降低睾丸、附睾指数,改善生精小管稀少、各级生精细胞的病理症状,盐炙组睾酮、ACP、SDH、T-T-SOD、GSH平均值高于市售组和生品组,MDA低于市售组和生品组。菟丝子生品及盐炙品水提液可通过影响精子生成的酶以及抗氧化应激反应,改善氢化可的松致肾阳虚大鼠的精子活力,其中盐炙品效果更好。本研究初步探讨了盐菟丝子的炮制机理,为炮制的科学性提供了进一步的理论支撑。