FENG Xiaoxia , CHEN Chen , QIU Jing , YANG Guang
2024, 30(24):1-9. DOI: 10.13422/j.cnki.syfjx.20241502
Abstract:Objective This study aims to investigate the effect of Huanglian Jiedutang on brain iron metabolism disorders, myelin damage, and aggressive behavior in vascular dementia (VaD) mice by regulating the F-box leucine-rich repeat protein 5 (FBXL5)/iron regulatory protein 2 (IRP2) pathway.Method Sixty C57BL/6J mice were randomly divided into six groups: sham operation group, model group, risperidone group (2 mg·kg-1·d-1), and low-dose, medium-dose, and high-dose groups of Huanglian Jiedutang (0.25, 0.5, 1 g·kg-1·d-1), with 10 mice in each group. The VaD model was established by bilateral carotid artery stenosis (BCAS). Drug intervention was administered for two weeks starting from the seventh week. Behavioral assessments, including the touch escape and resident-intruder tests, were conducted in the ninth week. After the behavioral tests, ventromedial hypothalamus ventrolateral (VMHvl) tissue samples were collected. Western blot was used to detect the expression of myelin-associated glycoprotein (MAG), myelin oligodendrocyte glycoprotein (MOG), myelin basic protein (MBP), 4-hydroxynonenal (4-HNE), glutathione peroxidase 4 (GPX4), transferrin receptor 1 (TFR1), ferritin light chain (Ft-L), ferroportin 1 (FPN1), FBXL5, and IRP2. Immunofluorescence was used to measure MBP fluorescence intensity. Transmission electron microscopy was employed to observe ultrastructural changes in the myelin sheath. Perl's staining was used to detect tissue iron deposition. Malondialdehyde (MDA) and superoxide dismutase (SOD) levels were measured by enzyme linked immunosorbent assay (ELISA).Result Compared to the sham operation group, the model group exhibited a significant increase in biting, aggression, and irritability scores, along with a reduced latency of the attack (P<0.01). The expression levels of MAG, MOG, and MBP, as well as the fluorescent density of MBP, were significantly decreased (P<0.01). Disordered myelin ultrastructure, increased Ft-L and TFR1 expression, decreased FPN1 expression, and elevated iron deposition were observed (P<0.01). Antioxidants GPX4 and SOD were reduced, while 4-HNE and lipid peroxidation product MDA were increased (P<0.01). FBXL5 protein expression decreased, and IRP2 protein expression increased (P<0.01). Compared with the model group, in the middle-dose and high-dose groups of Huanglian Jiedutang and the risperidone group, the number of bites, aggressive behaviors, and irritability scores were reduced (P<0.05, P<0.01), while the latency of the attack increased (P<0.01). In the middle-dose and high-dose groups of Huanglian Jiedutang, the expression levels of MAG, MOG, and MBP, as well as MBP immunofluorescence increased (P<0.01). The ultrastructure was orderly arranged. Ft-L and TFR1 expression decreased; FPN1 expression increased, and iron deposition was reduced (P<0.01). GPX4 and SOD expression levels increased, and 4-HNE and MDA expression levels decreased (P<0.01). FBXL5 protein expression increased, and IRP2 protein expression decreased (P<0.01).Conclusion Huanglian Jiedutang may alleviate brain iron metabolism disorders, myelin damage, and aggressive behavior in VaD mice by regulating FBXL5/IRP2 expression in the VMHvl region.
WANG Xiao , WANG Xiaosu , ZHOU Bingduo , XIONG Guangsu , YU Qi , SUN Ji , ZHOU Yun , JING Yi , ZHU Shengliang , LI Li
2024, 30(24):10-17. DOI: 10.13422/j.cnki.syfjx.20241122
Abstract:Objective To observe the clinical efficacy and safety of Chaihu Shugansan combined with Xuanfu Daizhetang (CHSG-XFDZ) in the management of Barrett's esophagus (BE) with liver-stomach disharmony.Method A randomized, parallel, controlled, double-blind clinical trial was conducted. BE patients who met the inclusion criteria were randomized into an observation group and a control group, with 34 patients in each group. The observation group was treated with CHSG-XFDZ combined with omeprazole capsules, and the control group was treated with CHSG-XFDZ mimetic combined with omeprazole capsules. Both groups were treated for 12 weeks. The traditional Chinese medicine (TCM) symptom scores, response rate, BE lesion area, BE pathological changes, and bile acid profile were taken as the indicators to jointly evaluate the clinical efficacy and safety of the two groups.Result A total of 62 patients who completed the trial were included for statistical analysis, including 32 in the observation group and 30 in the control group. There were no statistically significant differences in baseline demographics or disease characteristics between two groups, which suggested that the two groups were comparable. The total response rate in the observation group was 93.7% (30/32), which was higher than that (60.0%, 18/30) in the control group (χ2=24.766, P<0.05). After treatment, the response rate regarding the pathological changes in the observation group was 62.5% (20/32), which was higher than that (23.3%, 7/30) in the control group (χ2=10.270, P<0.05). The response rate regarding the BE lesion area change in the observation group was 21.9% (7/32), which had no statistically significant difference from that (6.7%, 2/30) in the control group, which indicated that the advantages of the two regimens were not obvious in terms of reducing the area of BE lesions. Compared with the control group after treatment, the observation group regulated the bile acid profile, which pointed out the direction for further exploring the mechanism of CHSG-XFDZ in treating BE. Neither group showcased adverse reactions with clinical significance during the treatment period.Conclusion CHSG-XFDZ outperformed the control group in terms of alleviating TCM symptoms, ameliorating pathological changes, and improving the bile acid profile in the BE patients with liver-stomach disharmony. It demonstrates certain potential in reducing the lesion area. This formula is safe and effective in treating BE patients with liver-stomach disharmony and deserves further clinical research and widespread application.
YU Meishuang , DAI Guoliang , HANG Huaxi , YE Yu , WANG Yiran , SHAO Xuewen , JU Wenzheng
2024, 30(24):18-27. DOI: 10.13422/j.cnki.syfjx.20250567
Abstract:Objective To investigate the pharmacodynamics, pharmacokinetics and brain distribution of seven main components of Jiaotaiwan alone and Jiaotaiwan combined with borneol in lipopolysaccharide(LPS)-induced depression rats.Method Rats were randomly divided into the control group, model group, fluoxetine group(10 mg·kg-1), Jiaotaiwan group(1.5 g·kg-1) and combination group(1.5 g·kg-1 of Jiaotaiwan+0.05 g·kg-1 of borneol), with 8 rats in each group. Except for the control group, the depression model was established by intraperitoneal injection of LPS for 7 consecutive days, and each group was given the corresponding drugs or the same volume of pure water by gavage for 14 consecutive days. The behavioral indicators and levels of serum inflammatory factors[interleukin-1β(IL-1β), IL-6 and tumor necrosis factor-α(TNF-α)] of rats in each group were compared. The morphological changes of hippocampal neurons were observed by hematoxylin-eosin(HE) and Nissl staining. After the behavioral tests of sucrose preference, open field and forced swimming were completed, blood samples were collected from Jiaotaiwan group and combination group at the set time points after gavage, the contents of seven components in plasma were determined by ultra performance liquid chromatography-triple quadrupole tandem mass spectrometry(UPLC-QqQ-MS/MS), and the pharmacokinetic parameters of each component were analyzed by DAS 3.2.2. Brains were rapidly removed on ice after blood collection was completed, and UPLC-QqQ-MS/MS was used to compare the content changes of the 7 components in brain tissue.Result Compared with the control group, rats in the model group showed decreased sucrose preference rate and total distance of open field, prolonged swimming immobility time, and increased expression of inflammatory factors in serum(P<0.01). Compared with the model group, the sucrose preference rate and total distance of open field were increased, and the swimming immobility time was shortened in the rats of each administration group, and the expression of inflammatory factors in serum was decreased in rats from Jiaotaiwan group and combination group(P<0.05, P<0.01). The results of HE and Nissl staining showed that Jiaotaiwan group and combination group had a certain protective effect on hippocampal neurons. The pharmacokinetic results showed that compared with Jiaotaiwan group, the area under the curve(AUC0-t, AUC0-∞), peak concentration(Cmax) and the average steady-state plasma concentration(Cav) of berberine and epiberberine in the combination group were increased(P<0.05, P<0.01), AUC0-t, AUC0-∞, mean residence time(MRT0-∞) and Cav of coptisine were significantly increased(P<0.05, P<0.01), Cmax of jatrorrhizine increased significantly(P<0.05), but the pharmacokinetic changes of the seven alkaloids were consistent. The results of brain tissue distribution showed that compared with Jiaotaiwan group, the contents of jatrorrhizine, epiberberine, coptisine, palmatine and berberine in the brain tissue of combination group were increased(P<0.05, P<0.01), the content of magnoflorine increased and that of berberrubine decreased, but the difference was not statistically significant.Conclusion Jiaotaiwan alone or combined with borneol can improve the depression-like behavior of rats, reduce the levels of serum inflammatory factors, improve the pathological damage of hippocampus, and have antidepressant effect. Compared with Jiaotaiwan alone, the combination of Jiaotaiwan and borneol can increase the exposure of multiple active components of Jiaotaiwan in the plasma and brain tissue of rats, improve its bioavailability, promote its absorption, and improve the brain targeting of the drug, which is more conducive to the antidepressant effect of Jiaotaiwan.
HUANG Xiaoxiao , XIE Zhongli , XIE Mengyue , LI Shengzhen
2024, 30(24):28-35. DOI: 10.13422/j.cnki.syfjx.20241408
Abstract:Objective To investigate the therapeutic effect of Qinggongtang in regulating Glu/GABA metabolic balance and the mechanism of its anxiolytic effect on rat models of anxiety.Method Fifty-four rats were randomly divided into normal, model, diazepam (0.225 mg·kg-1), and low-dose, medium-dose, and high-dose groups of Qinggongtang (5.085, 10.17, 20.34 g·kg-1), with nine rats in each group. Except for the normal group, the other groups were subjected to indeterminate vacutainer stress and chronic restraint stress for 12 days to prepare the anxiety model. On the 3rd day of the stress, 10 days of corresponding drug intervention was started. At the end of the drug treatment, the anxiety level of rats in each group was evaluated by the elevated cross maze experiment (EPM) and the light and dark box experiment (LDB), and the effect of Qinggongtang on the anxiety behavior of rats was preliminarily analyzed. The levels of Glu and GABA in the amygdala tissue of the rats were detected by enzyme linked immunosorbent assay (ELISA), and the changes in the synaptic ultrastructure of the amygdala of the rats in each group were observed by electron microscopy. The mRNA expression of glutamic acid decarboxylase (GAD65 and GAD67), glutamine synthetase (GS), and glutamate transporter-1 (GLT-1) in the amygdala were detected by Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR), and their protein expression was detected by Western blot.Result Compared with those in the normal group, rats in the model group showed an obvious anxiety state and dull yellow and lusterless fur. They were irritable, easy to anger, and preferred to curl up in the corner. The number of times the EPM entered the open arm and the residence time in the open arm were significantly reduced (P<0.01), and the residence time in the open box and the number of times the LDB went through the box were significantly reduced (P<0.01). The content of Glu in the amygdala was increased (P<0.01), and the content of GABA was reduced (P<0.01). The value of Glu/GAB was elevated (P<0.01), and the number of synaptic and pre-synaptic membrane vesicles in the amygdala was decreased. Sparse dense material in the post-synaptic membrane, increased synaptic gap, slightly disrupted internal structure, and decreased mRNA and protein expressions of GAD65, GAD67, GS, and GLT-1 in the amygdala were observed (P<0.01). Compared with those in the model group, rats in the medium-dose and high-dose groups of Qinggongtang and the diazepam group had bright fur, sensitive reactions, and more active behavior. The number of times EPM entered the open arm and the residence time in the open arm increased significantly (P<0.01), and the residence time in the open box and the number of times the LDB went through the box increased significantly (P<0.01). The content of Glu in all-dose groups of Qinggongtang and the diazepam group decreased (P<0.05, P<0.01), while GABA content increased (P<0.05, P<0.01). The value of Glu/GABA decreased (P<0.01), and the internal and external synaptic structure of each groups of Qinggongtang and the diazepam group was more complete. Synapses and vesicles were numerous, and the synaptic gap was more clearly defined. The efficacy of the high-dose group of Qinggongtang and the diazepam group was the best, and the mRNA and protein expressions of GAD65, GAD67, GS, and GLT-1 in the amygdala were increased in the high-dose group of Qinggongtang and diazepam group (P<0.05, P<0.01).Conclusion Qinggongtang can improve synaptic plasticity and affect the expression of GAD65, GAD67, GS, and GLT-1 in the amygdala of rats to regulate Glu/GABA metabolic balance and thus exert anxiolytic effects.
HUANG Aoqing , WANG Wenli , LIU Ying , WANG Hai ping , ZHU Chunyan , LIN Na
2024, 30(24):36-46. DOI: 10.13422/j.cnki.syfjx.20241743
Abstract:Objective To clarify the pharmacodynamic characteristics and neuroinflammatory mechanisms of Ruyi Zhenbaowan (RYZBW) in treating nociceptive hypersensitivity and central sensitisation of spinal cord in the mouse model of central post-stroke pain (CPSP).Method SPF-grade male ICR mice of 8 weeks old were assigned into the sham operation (Sham), model (CPSP), low-, medium-, and high-dose (0.303, 0.607 1.214 g·kg-1) RYZBW (RYZBW-L, RYZBW-M, and RYZBW-H, respectively), and pregabalin (PGB, 0.046 g·kg-1, positive control) groups. The rat model of CPSP was established by injection of type Ⅳ collagenase into the ventral posterior lateral nucleus of the thalamus on day 1. Rats were administrated with corresponding drugs or normal saline (Sham and CPSP groups) by gavage from day 14 to day 17. The mechanical pain sensitivity test was performed on days 0, 3, 4, 7, 10, 14, 17. On day 18, the L5 segment of spinal cord was collected for the detection of inflammatory cytokines by immunoinflammatory microarray, CXC chemokine ligand 16 (CXCL16) by enzyme-linked immunosorbent assay, and calcitonin gene-related peptide (cGRP) by immunohistochemistry. In addition, fluorescence dual-labeling was employed to determine the expression levels of CXCL16, the dendritic cell marker CD11c, the macrophage marker CD68, the microglia marker TMEM119, the endothelial cell markers CD31 and CXCR6, and the T cell marker CD3.Result Compared with the Sham group, the mechanical pain threshold of the CPSP group was significantly lower than that of the Sham group from day 3 to day 17, with stable hyperalgesia symptoms. On the 7th day, the mechanical pain threshold of the PGB group was significantly higher than that of the CPSP group, with significant analgesic effect (P<0.01). On days 10-17, the mechanical pain threshold of the RYZBW-H group was significantly higher than that of the CPSP group, showing a stable analgesic effect (P<0.05). On the 17th day, the analgesic effect of RYZBW was dose-effect correlated (R2=0.303 7). From day 4 to day 17, the mechanical pain threshold of RYZBW-H group was positively correlated with time (R2=0.111 5). The above results suggested that the analgesia of RYZBW was time-dependent. On the 17 th day, the expression of central sensitization marker cGRP in the spinal dorsal horn of CPSP mice was significantly increased compared with the Sham group (P<0.05), and RYZBW down-regulated it in a dose-dependent manner (R2=0.500 8), suggesting that RYZBW significantly inhibited the central sensitization of the spinal cord caused by CPSP. The results of spinal cord inflammation chip on the 17th day showed that compared with CPSP group, RYZBW-H group inhibited CXCL16 expression (P<0.01).The results of ELISA based on independent repeated samples showed that RYZBW inhibited the expression of CXCL16 protein in spinal cord in a dose-dependent manner (R2=0.250 4). The results of immunofluorescence double labeling showed that compared with Sham group, the expression of CXCL16 in CD11c positive dendritic cells in CPSP group increased, and the number of CD68 positive cells increased (P<0.05). Compared with CPSP group, RYZBW down-regulated it: the expression of CXCL16 in CD31 positive endothelial cells, CD68 positive macrophages and TMEM119 positive microglia increased, and the number and cell body area of TMEM119 positive microglia increased significantly (P<0.05). The number of CD3 positive T cells (P<0.05) and the expression of CXCR6 in CD3 positive T cells were increased. RYZBW inhibited the activation of endothelial cells and macrophages in a dose-dependent manner, and reduced the infiltration of microglia and T cells (R2=0.691 4, R2=0.551 5, R2=0.653 2, R2=0.180 6, R2=0.287 5, R2=0.298 6,R2=0.511 6).Conclusion RYZBW can effectively alleviate nociceptive hypersensitivity and central sensitisation of the spinal cord in CPSP mice by regulating CXCL16-CXCR-6, inhibiting the infiltration and activation of microglia and macrophages, and the activation of dendritic cells, endothelial cells, and T cells.
WANG Wenli , ZHANG Guoxin , LIU Ying , LIN Na , ZHU Chunyan , LIN Ya
2024, 30(24):47-56. DOI: 10.13422/j.cnki.syfjx.20240644
Abstract:Objective To evaluate the intervention effect of Ruyi Zhenbaowan (RYZBW) on secondary brain injury and central pain in mice with hemorrhagic stroke and to explore its pharmacological mechanism of repairing the neurovascular unit from the perspective of neuroinflammation.Method A mouse model of central post-stroke pain (CPSP) was established by microinjecting type Ⅳ collagenase into the ventroposterior thalamic nucleus. The day of model establishment was recorded as D1, and the mice were divided into Sham operation group (Sham), model group (CPSP), low (RYZBW-L), medium (RYZBW-M), and high (RYZBW-H) dose groups of RYZBW, and positive drug pregabalin (PGB) group. On the 4th day (D4) after model establishment, gavage administration was performed twice daily. The Sham and CPSP groups received an equal volume of normal saline, while the RYZBW-L, RYZBW-M, and RYZBW-H groups received RYZBW at 1.214, 1.821, 2.428 g·kg-1, respectively, and the PGB group received PGB at 0.046 g·kg-1. Mechanical hyperalgesia was assessed before model establishment (D0), on the 3rd day (D3), and after the first gavage on D4. Nerve damage was evaluated after the second gavage on D1 and D4. On D4, peripheral blood was collected for routine blood tests, and the thalamus was collected for immune-inflammation microarray analysis. In independent samples, quantitative analysis was performed on the localization of immune-inflammatory factors, receptors, and cells via immunofluorescence staining, enzyme-linked immunosorbent assay (ELISA), and Western blot analysis.Result Compared with the Sham group, CPSP mice showed significant secondary nerve injury, central pain after stroke (P<0.05,P<0.01), increased red blood cell distribution width (RDW) in peripheral blood (P<0.05), and decreased hemoglobin (HGB) concentration (P<0.05). Immune-inflammation microarray analysis showed that CC chemokine ligand 2 (CCL2) in the CPSP thalamus was significantly increased compared to the Sham group (P<0.01), while CX3C chemokine ligand 1 (CX3CL1) was significantly decreased (P<0.05). These results were confirmed by ELISA and immunofluorescence staining. Western blot analysis indicated that the protein expression of CX3CR1, the receptor for CX3CL1, was significantly decreased in the CPSP group compared to the Sham group (P<0.01). Immunofluorescence staining revealed that the number of Ly6C+CX3CR1+ non-classical monocytes in the CPSP group did not change significantly, while the number of classical monocytes (CX3CR1-Ly6C+) significantly increased (P<0.01). The expression of CX3CR1 in microglia was significantly increased in the CPSP group (P<0.01). Compared with the CPSP group, RYZBW improved neurological deficits (R2=0.367 9) and central pain symptoms (R2=0.501 9) in a dose-dependent manner. RYZBW-H significantly improved peripheral blood RDW and HGB (P<0.05). Immune-inflammation microarray analysis and ELISA results showed that RYZBW-H significantly inhibited CCL2 expression (P<0.01) and increased CX3CL1 expression (P<0.05). Western blot results indicated that the protein expression of CX3CR1 in the RYZBW-L and RYZBW-H groups was significantly increased (P<0.05). Immunofluorescence staining demonstrated that RYZBW increased the overall expression of CX3CR1 in a dose-dependent manner (R2=0.619 6), inhibited the expression of CX3CR1 on microglia, and decreased both the number (R2=0.494 5) and soma area (R2=0.571 7) of microglia compared with the CPSP group. Additionally, RYZBW increased the infiltration of CX3CR1+Ly6C+ non-classical monocytes in a dose-dependent manner (R2=0.635 3) and effectively inhibited the infiltration of Ly6C+CX3CR1- classical monocytes (R2=0.483 6).Conclusion RYZBW can effectively alleviate secondary injury and central pain in CPSP mice, and its mechanism involves regulating the CX3CL1-CX3CR1 ligand-receptor interaction, inhibiting microglial infiltration and activation, promoting non-classical monocyte infiltration for vascular repair, and suppressing the infiltration of classical monocytes for inflammatory phagocytosis.
SUN Chunquan , XIE Yanming , GAO Jinghua , CHEN Weiheng , WANG Lianxin , WANG Shangquan , TIAN Xiangdong , XU Zujian , ZHENG Yuxin , ZHOU Mingwang , LI Chungen , XU Zhanwang , GUO Jiayi , DU Shuangqing , CHEN Qigang , JI Quan , BAI Zhiqiang , XIAO Jing , QI Wanli , YANG Weiyi , ZHANG Jingxiao
2024, 30(24):57-67. DOI: 10.13422/j.cnki.syfjx.20241693
Abstract:Objective This study aimed to evaluate the clinical efficacy of Ruyi Zhenbaowan(RYZBW)in the treatment of initial and early knee osteoarthritis (KOA) through a prospective multicenter,randomized,double-blind,and placebo-parallel controlled trial.Method From October 13th, 2021 to December 25th, 2021, 240 KOA subjects meeting the acceptance criteria were enrolled in 15 sub-centers including Wangjing Hospital, Chinese Academy of Chinese Medical Sciences, and they were randomly divided into observation group and control group, with 120 cases in each group. The intervention measures for the observation group were RYZBW + health education, and the intervention measures for the control group were RYZBW placebo + health education. The intervention period in both groups was four weeks, and they were followed up for four weeks after the intervention. The primary outcome measure was the total score of Western Ontario and McMaster University Osteoarthritis Index score (WOMAC score), and the secondary outcome measures were the response rate of visual scale (VAS) pain score, WOMAC sub item scores (joint pain, joint stiffness, and joint function), quality of life (SF-12) score, and traditional Chinese medicine (TCM) syndrome score.Result (1) Efficacy evaluation. The marginal model results showed that the observation group was better than the control group in improving the WOMAC total score and WOMAC pain score in the treatment of KOA with RYZBW, and the difference was statistically significant (P<0.05). There was no significant difference between the two groups in improving VAS score response rate, WOMAC function score, WOMAC stiffness score, SF12-PCS (quality of life-physical health) score, SF12-MCS (quality of life-mental health) score, and TCM syndrome score. (2) Subgroup analysis. ① In terms of VAS score response rate, the response rate of the observation group was higher than that of the control group for subjects with baseline VAS score of (4, 5], and the difference was statistically significant (P<0.05). ② In terms of TCM syndrome score, for subjects aged [56, 60] and [61, 65], the decrease in total TCM syndrome score in the observation group was better than that in the control group, and the difference was statistically significant (P<0.05).Conclusion Tibetan medicine RYZBW has good clinical efficacy in improving WOMAC total score, VAS score response rate, WOMAC pain score, WOMAC function score, and TCM syndrome score for patients with initial and early KOA, which can fill the lack of Tibetan medicine RYZBW in the treatment of KOA and make a demonstration study for the inheritance and development of ethnic medicine.
XU Mingzhu , LI Huaiping , MA Zhaochen , LI Tao , LIU Yudong , XIAO Ziqing , ZHANG Chu , CHEN Kedian , MA Weihua , HUANG Feng , LIN Na , ZHANG Yanqiong
2024, 30(24):68-77. DOI: 10.13422/j.cnki.syfjx.20250261
Abstract:Objective To identify the pharmacodynamic material basis of Ruyi Zhenbaowan in relieving neuropathic pain by integrating the calculation of biological network proximity and pharmacokinetic characterization.Method The interaction network of "drug candidate target-related gene of disease" was constructed by Cytoscape 3.8.2, and the average shortest path value of each drug putative target acting on neuropathic pain-related genes in this network was calculated by Pesca 3.8.0 tool so as to evaluate the network proximity between them, and screen prescription candidate targets with strong intervention efficiency and their corresponding potential effect components. After that, plasma and cerebrospinal fluid samples were collected from rats after administration of Ruyi Zhenbaowan at set time points, and the contents of potential effect components in samples was quantified by ultra performance liquid chromatography-quadrupole-ion trap mass spectrometry(UPLC-Q-TRAP/MS), and drug concentration-time curves were plotted, then the pharmacokinetic parameters were calculated by DAS 2.1.1.Result By evaluating the network proximity between candidate targets and neuropathic pain-related genes in the interaction network, a total of 40 putative targets of Ruyi Zhenbaowan with strong intervention effects on neuropathic pain-related genes, such as estrogen receptor 1(ESR1), cyclic adenosine monophosphate(cAMP)-dependent protein kinase catalytic subunit alpha(PRKACA) and protein kinase B1 (Akt1), and 10 corresponding potential effect components, such as glycyrrhizic acid and betulinic acid, were obtained. Pharmacokinetic characterization showed that among the 10 potential effect components, gallic acid, apigenin-7-O-glucuronide, glycyrrhizic acid and apigenin were well absorbed and metabolized in plasma and cerebrospinal fluid, with long onset time and good bioavailability.Conclusion From the perspective of efficacy-target-constituent-pharmacokinetic, this study analyzes the main effective materials of Ruyi Zhenbaowan, such as glycyrrhizic acid, gallic acid, apigenin-7-O-glucuronide and apigenin, which have a high exposure in plasma or cerebrospinal fluid and have a strong intervention effect on neuropathic pain. The related results provide reliable experimental evidences for clarifying the material basis and developing quality standards of Ruyi Zhenbaowan.
CHEN Kedian , MA Zhaochen , CAI Bingbing , LIU Ying , LIU Yudong , LI Tao , XU Mingzhu , WANG Haiping , LIN Na , ZHANG Yanqiong
2024, 30(24):78-84. DOI: 10.13422/j.cnki.syfjx.20241443
Abstract:Objective To identify the chemical constituents of Ruyi Zhenbaowan in vitro and in vivo.Method The chemical constituents of Ruyi Zhenbaowan were identified based on UHPLC-Q Exactive Orbitrap HRMS. A total of 12 male SD rats were randomized into two groups: control (pure water) and Ruyi Zhenbaowan (1.8 g·kg-1). The rats were administrated with the suspension of Ruyi Zhenbaowan or pure water by gavage. After 1.5 h, the plasma and cerebrospinal fluid were collected. Chromatographic separation was performed on a Waters ACQUITY UPLC BEH C18 column (2.1 mm × 150 mm, 1.7 μm) with a mixture of 0.1% formic acid aqueous solution (A) and acetonitrile (B) as the mobile phase. Gradient elution was carried out according to the procedure of 0~15 min,97%~80%A;15~30 min ,80%~60%A;30~40 min,60%~30%A;40~45 min,30%~5%A. The ion source was electrospray ionization, and scan range was m/z 100-1 500. The prototype components and the components in the plasma and cerebrospinal fluid were analyzed qualitatively by scanning in positive and negative ion modes and identified by comparison with the data in published literature and the information of standard substances.Result A total of 126 chemical constituents were identified from the 80% methanol solution of Ruyi Zhenbaowan, and 14 and 7 prototype constituents were detected in the plasma and the cerebrospinal fluid, respectively. In addition, the fragmentation rules of apigenin, apigenin-7-O-glucuronide, galangin, liquiritin, piperine, glycyrrhizic acid, eugenol, gallic acid, and cholic acid were deduced.Conclusion This study achieved rapid multicomponent characterization and identification of Ruyi Zhenbaowan in vitro and in vivo, providing theoretical support for exploring active substances and performing quality control.l.
TIAN Shiqiu , ZUO Zeping , TIAN Yingying , LI Yilin , PEI Hailuan , LIN Zhaozhou , LYU Yingnan , WANG Jianfang , WANG Zhibin
2024, 30(24):85-94. DOI: 10.13422/j.cnki.syfjx.20241404
Abstract:Objective To explore the therapeutic effect and mechanism of the Danhe granules on hypercholesterolemia rats by observing the changes in the efficacy indicators and the levels of proteins related to the cholesterol metabolism pathway in the rats under the intervention of Danhe granules.Method SD rats were randomly assigned to either the blank group or the model group based on their body weight. The blank group had normal chow diets, while the model group was fed high-fat diets for seven weeks. One week after the establishment of the model, the content of the serum total cholesterol (TC) in the model rats was detected. According to the TC value, the model group was further randomly divided into a control group, pravastatin sodium tablet group(4.02 mg·kg-1), Xuezhikang capsule group(0.12 g·kg-1), high-dose, middle-dose, and low-dose groups of Danhe granules(4.536, 2.268, 1.134 g·kg-1). After grouping the model groups, each treatment group received continuous oral gavage for six weeks, with weekly measurements of body weight and food intake (the difference between feed intake and feed surplus). Six weeks later, the levels of serum TC, triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were measured. The liver pathology and lipid droplet distribution were evaluated by hematoxylin-eosin (HE) staining and oil red O staining, with scoring and calculation conducted. Rat liver tissue was collected, and western blot and immunohistochemistry (IHC) were used to detect the expression levels of cholesterol metabolism-related proteins namely phosphorylated adenosine 5'-monophosphate (AMP)-activated protein kinase (p-AMPK), AMPK, 3-hydroxy-3-methyl glutaryl coenzyme A reductase (HMGCR), low-density lipoprotein receptor (LDLR), cholesterol 7α-hydroxylase (CYP7A1), Acyl-coenzyme A: cholesterol acyltransferase 2 (ACAT2), and apolipoprotein B (ApoB) in hypercholesterolemia rats.Result Compared with the blank group, the model group showed a significantly higher level of serum TC (P<0.01). The TG level had no significant change, and the HDL-C level was significantly decreased (P<0.05). The liver index, steatosis score, total score of pathological state, and the positive area ratio of oil red O staining were significantly increased (P<0.01), and the protein expression levels of p-AMPK, p-AMPK/AMPK, LDLR, and CYP7A1 were significantly decreased (P<0.05, P<0.01), while the protein expression levels of AMPK, HMGCR, and ACAT2 were significantly increased (P<0.05, P<0.01). Compared with the model group, the TC level in each dose group of Danhe granules was significantly decreased (P<0.05), and the positive area ratio of oil red O staining in the pravastatin sodium tablet group and medium-dose group of Danhe granules was significantly decreased (P<0.05). In each administration group, the protein expression levels of p-AMPK and p-AMPK/AMPK were significantly increased (P<0.05, P<0.01), and the levels of HMGCR and ACAT2 were significantly decreased (P<0.01). The ApoB level showed a downward trend. The CYP7A1 level in the pravastatin sodium tablet group and each dose group of Danhe granules was significantly increased (P<0.05, P<0.01), and the LDLR level in the pravastatin sodium tablet group, Xuezhikang capsule group, and high-dose and medium-dose groups of Danhe granules was significantly increased (P<0.05, P<0.01).Conclusion Danhe granules can reduce serum TC levels and improve hepatic steatosis. It may activate AMPK, down-regulate the expression of HMGCR, and inhibit cholesterol synthesis. It can also up-regulate the expression of LDLR and CYP7A1, promote cholesterol uptake and excretion, down-regulate the expression of ACAT2 and ApoB, reduce cholesterol absorption and assembly of LDL and other lipoproteins, and thus play a role in the treatment of hypercholesterolemia.
YUAN Yulu , HE Zhanzhan , CHU Ce , TAO Xuguang , YANG Zhen , CHEN Xiangyun , DING Wei , XU Yongqi , ZHANG Yuxin , ZHAO Peizhang , CHEN Wanping , ZHAO Hongxia , WANG Wenlai
2024, 30(24):95-102. DOI: 10.13422/j.cnki.syfjx.20241501
Abstract:Objective To investigate the mechanism and effect of Qingfei Paidu decoction on transient receptor potential vanilloid-1/Transient receptor potential ankyrin1 (TRPV1/TRPA1) based on heat-sensitive channel and inflammatory response.Method According to body weight, 80 8-week-old C57BL/6 mice were randomly divided into the normal group, model group, dexamethasone group (5 mg·kg-1), and low-dose, medium-dose, and high-dose groups of Qingfei Paidu decoction (14.865, 29.73, 59.46 g·kg-1), with 12 mice in each group. In addition to the normal group, the other groups were administered 20 μL (1×10-3 g·kg-1) to each mouse by airway infusion to establish the acute lung injury (ALI) model. In the administration group, the drug was given 1 h after modeling and again after an interval of 24 h. The lung tissue was taken 36 h after modeling. Double lung wet/dry weight ratio(W/D), hematoxylin-eosin (HE) staining, enzyme-linked immunosorbent assay (ELISA), and Western blot were used to observe and detect the pathological changes of lung tissue, expression levels of inflammatory cytokine tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), and expressions of TRPV1 and TRPA1 proteins in heat-sensitive channel, nuclear factor kappa-B (NF-κB), inhibitor of NF-κB (IκBα) in inflammatory pathway, and phosphorylated proteins. The phosphorylated protein/total protein ratio was calculated.Result Compared with that in the normal group, the lung tissue of mice in the model group was seriously damaged, and pulmonary capillary permeability increased. Alveolar capillary congestion and dilation destroyed the complete structure of the alveolar, and the alveolar wall thickened. A large number of inflammatory cells and red blood cells were infiltrated, and pulmonary edema was significantly aggravated. The expressions of TNF-α, IL-6, TRPV1, TRPA1, phosphorylated NF-κB p65/NF-κB p65, and phosphorylated IκBα/IκBα were significantly increased (P<0.01), and the whole lung W/D was significantly increased (P<0.01). Compared with the model group, the dexamethasone group and low-dose, medium-dose, and high-dose groups of Qingfei Paidu decoction could significantly improve pulmonary edema. TNF-α, IL-6, TRPV1, TRPA1, lung tissue NF-κB p65, and IκBα phosphorylated protein/total protein ratio decreased significantly (P<0.05, P<0.01). The whole lung W/D also decreased significantly (P<0.05, P<0.01).Conclusion Qingfei Paidu decoction has anti-inflammatory and protective effects on LPS-ALI mice, which can effectively reduce inflammation, induce diuresis, and alleviate edema. Its mechanism may be related to the regulation of the expression of TRPA1 and TRPV1 and the inhibition of the activation of the NF-κB pathway.
ZHANG Qiman , GAO Yanhua , WU Wenjie , YANG Wei , LIU Chen , LI Shuting , CAI Bingjie , YANG Jialin , ZHANG Ying , MA Jing , LI Shaojing
2024, 30(24):103-113. DOI: 10.13422/j.cnki.syfjx.20250967
Abstract:Objective To investigate the mechanism of neferine(Nef) in promoting vascular regeneration against cerebral ischemia through modulation of mitochondrial calcium uniporter(MCU) ion channel.Method Taking the area of subintestinal vessels in microvascular deficiency zebrafish as an index, the vascular regenerative efficacy of Nef was evaluated, and the median effective concentration(EC50) was calculated. Rats were randomly divided into a sham operation group, a model group, a positive drug group(butylphthalide, 6 mg·kg-1), and Nef low, medium, and high dose groups(0.125, 0.625, 3.125 μg·kg-1). Except for the sham operation group, the middle cerebral artery occlusion(MCAO) model was established in other groups. After modeling, the groups were administered the corresponding dose of drugs by gavage, while the sham operation and model groups received equal volumes of saline, once a day for 7 consecutive days. Neurobehavioral scores were assessed for each group of rats, and the infarct rate of ischemic brain tissue was calculated by 2,3,5-triphenyltetrazolium chloride(TTC) staining. The regional cerebral blood flow(rCBF) of each group was measured using a speckle contrast imaging. Immunofluorescence and Western blot were conducted to detect the expression of vascular endothelial growth factor(VEGF), platelet endothelial cell adhesion molecule-1(CD31), and hypoxia-inducible factor-1α(HIF-1α) proteins in each group. Human umbilical vein endothelial cells(HUVECs) were divided into the normal group, model group, positive drug group(astragaloside Ⅳ, 10 μmol·L-1), and Nef group (32 nmol·L-1). In the verification of mitochondrial protection of Nef and its mechanism in promoting vascular regeneration, the spermine(MCU agonist) and Nef+spermine group were added. HUVECs model of oxygen-glucose deprivation(OGD) was established in all groups except the normal group, the cell viability was assessed using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide(MTT) assay, and cell migration ability was evaluated through scratch and tube formation assays. Fluorescent probes(Rhod-2 AM, Fluo-3 AM, JC-1, Calcein AM) and a cellular energy metabolism analyzer were used to analyze the mitochondrial protective effects of Nef. Molecular docking was performed to predict the binding ability of Nef with MCU and HIF-1α, and Western blot was used to detect the effects of Nef on the protein expressions of MCU, B-cell lymphoma-2 associated X protein(Bax), Caspase-3 and HIF-1α in the OGD model HUVECs.Result The results of vascular regeneration in microvascular deficiency zebrafish showed that compared to the normal group, the area of subintestinal vessels in the model group significantly decreased(P<0.01). Compared to the model group, different concentrations of Nef could significantly increase the area of subintestinal vessels(P<0.01), with the maximum tolerated concentration of 10.24 μmol·L-1 and the EC50 of 0.23 μmol·L-1. Anti-cerebral ischemia results on MCAO rats showed that compared to the sham operation group, the model group had a significant decrease in rCBF and a significant increase in infarct rate, while CD31 expression significantly decreased(P<0.01), and VEGF and HIF-1α protein expressions significantly increased(P<0.05). Compared to the model group, the treated groups showed significant increases in rCBF, significant reductions in infarct volume, and significant increases in CD31, VEGF, and HIF-1α protein expression(P<0.01). Cell experiment results showed that compared to the normal group, the model group had decreased cell viability and migration ability, increased intracellular Ca2+ and mitochondrial Ca2+ levels, reduced mitochondrial permeability transition pore(MPTP) opening, and decreased mitochondrial energy metabolism capability, with increased expressions of MCU, Bax, Caspase-3 and HIF-1α proteins(P<0.05, P<0.01). Compared to the model group, the Nef group showed increased cell viability and migration ability, decreased intracellular Ca2+ and mitochondrial Ca2+ levels, increased MPTP opening, enhanced mitochondrial energy metabolism capability, decreased expressions of MCU, Bax and Caspase-3 proteins, and increased HIF-1α protein expression(P<0.05, P<0.01).Conclusion Nef can stabilize mitochondrial membrane potential and inhibit mitochondrial apoptosis. By down-regulating the expression of MCU, it suppresses the activation of intracellular Bax and Caspase-3 while activating the HIF-1α signaling pathway, enhancing the expression of VEGF and CD31, thereby promoting vascular regeneration to treat ischemic brain injury.
LYU Chong , QIAO Xianhua , GAO Juanjuan , TIAN Fei , ZHOU Kuilong , WANG Chengcheng , WANG Jiepeng
2024, 30(24):114-120. DOI: 10.13422/j.cnki.syfjx.20240937
Abstract:Objective To investigate the effect of shikosin (SHI) on psoriasis (PSO) and explore the underlying mechanism via the cyclic guanosine monophosphate-adenosine monophosphate synthase (cGAS)/stimulator of interferon genes (STING) signaling pathway.Method HaCaT cells were classified into normal culture(Control), a mixture of five proinflammatory cytokines(M5), low-, medium-, and high-dose SHI (L-SHI, M-SHI, and H-SHI, respectively), and SHI+ADU-S100 groups. The cells in the M5 group were stimulated with 10 μg·L-1 interleukin (IL)-1α, IL-17, IL-22, tumor necrosis factor (TNF)-α, and oncostatin M (OSM) for 48 h. The cells in the L-SHI, M-SHI, and H-SHI groups were treated with 0.1, 1, 10 μmol·L-1 SHI, respectively, on the basis of the treatment in the M5 group. The cells in the SHI+ADU-S100 group were treated with 10 μmol·L-1 STING activator ADU-S100 on the basis of the treatment in the H-SHI group. The methyl thiazolyl tetrazolium (MTT) assay and colony formation assay were employed to examine the effect of SHI on the proliferation of HaCaT cells. The wound healing assay was employed to examine the effect of SHI on the migration of HaCaT cells. Flow cytometry was employed to detect the effect of SHI on the apoptosis of HaCaT cells. Enzyme-linked immunosorbent assay was employed to measure the levels of IL-1β, IL-6, IL-15, IL-23, and interferon-γ (IFN-γ) in HaCaT cells. Western blot was employed to determine the protein levels of cGAS and STING in HaCaT cells.Result Compared with Control group, the M5 group showed decreased survival rate, colony formation, and would healing rate of HaCaT cells, increased apoptosis rate, elevated levels of IL-1β, IL-6, IL-15, IL-23, and IFN-γ, and up-regulated protein levels of cGAS and STING (P<0.01). Compared with the M5 group, the L-SHI, M-SHI, and H-SHI groups showed increased survival rate, cell colony formation, and wound healing rate, decreased apoptosis rate, lowered levels of IL-1β, IL-6, IL-15, IL-23, and IFN-γ, and down-regulated protein levels of cGAS and STING (P<0.01). Compared with the H-SHI group, the SHI+ADU-S100 group showed decreased survival rate, cell colony formation, and wound healing rate, increased apoptosis rate, risen levels of IL-1β, IL-6, IL-15, IL-23, and IFN-γ, and up-regulated protein levels of cGAS and STING (P<0.01).Conclusion SHI can inhibit the inflammation in the cell model of PSO by inhibiting the cGAS/STING signaling pathway.
MA Chengjun , YAN Fengzhe , YANG Lixia , LIANG Yonglin , ZHU Xiangdong , AN Dong , GAO Yankui
2024, 30(24):121-130. DOI: 10.13422/j.cnki.syfjx.20240723
Abstract:Objective To explore the effects and mechanisms of modified Dahuang Huanglian Xiexintang on hepatic oxidative stress injury in type 2 diabetes mellitus (T2DM) rats based on the nuclear factor erythroid 2 related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) axis.Method Six ZDF (fa/+) rats were as assigned to the blank group, and 30 ZDF (fa/fa) rats were used to induce the T2DM model by feeding a high-fat diet. After successful modeling, the rats were randomly divided into the model group, metformin group (0.18 g·kg-1), and low, medium, and high dose groups of modified Dahuang Huanglian Xiexintang (0.54, 1.08, 2.16 g·kg-1), with six rats in each group. After 12 weeks of drug intervention, the body mass, liver mass, fasting blood glucose (FBG), and oral glucose tolerance test (OGTT) levels were measured. Serum total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) levels were detected using an automatic biochemical analyzer. The pathological changes of liver tissue were observed by hematoxylin-eosin (HE) staining. Enzyme-linked immunosorbent assay (ELISA) was used to detect the activity of superoxide dismutase (SOD), reactive oxygen species (ROS), glutathione peroxidase (GSH-Px), and the level of malondialdehyde (MDA) in liver tissues. Immunohistochemistry was used to detect the expression of Nrf2 in the liver. Real time quantitative polymerase chain reaction (Real-time PCR) and Western blot were used to detect the mRNA and protein expression levels of Nrf2 and HO-1 in liver tissues.Result Compared with the normal group, the model group showed a significant increase in body mass, liver mass, and liver index (P<0.01). Compared with the model group, the metformin group and the medium and high dose groups of modified Dahuang Huanglian Xiexintang showed a significant decrease in body weight, liver mass, and liver index (P<0.01). Compared with the normal group, the model group showed significantly increased TC, TG, and LDL levels (P<0.01), and significantly decreased HDL levels (P<0.01). Compared with the model group, the metformin group and all doses of modified Dahuang Huanglian Xiexintang showed significantly reduced TC levels (P<0.01), and significantly reduced TG levels (P<0.05). The medium and high dose groups of modified Dahuang Huanglian Xiexintang showed significantly reduced LDL levels (P<0.05). The metformin group and all doses of modified Dahuang Huanglian Xiexintang showed significantly increased HDL levels (P<0.05). Compared with the normal group, the model group showed significantly increased ALT and AST activities (P<0.01). Compared with the model group, all doses of modified Dahuang Huanglian Xiexintang and the metformin group showed significantly reduced ALT activities (P<0.05) and significantly reduced AST activities (P<0.01). Compared with normal group, the model group showed significantly increased FBG at all time points (P<0.01). Compared with the model group, the metformin group and all doses of modified Dahuang Huanglian Xiexintang showed significantly reduced FBG at 8, 10, 12 weeks. The OGTT results showed that compared with the normal group, the model group had significantly increased blood glucose at all time points (P<0.01). Compared with the model group, the metformin group showed significantly reduced blood glucose at all time points (P<0.01), and the medium and high dose groups of modified Dahuang Huanglian Xiexintang showed significantly reduced blood glucose at 90, 120 min (P<0.01). HE pathology showed clear and regular liver cell structure in the normal group, while the model group showed disordered liver cell structure with visible fat vacuoles and a large number of deformed necrotic cells. The liver tissue structure improved in the metformin group and all doses of modified Dahuang Huanglian Xiexintang, with fewer necrotic cells. Compared with the normal group, the model group showed significantly reduced SOD and GSH-Px levels (P<0.01), and significantly increased ROS and MDA levels (P<0.01). Compared with the model group, the metformin group and all doses of modified Dahuang Huanglian Xiexintang showed significantly increased SOD and GSH-Px levels (P<0.01), and significantly reduced MDA levels (P<0.01). The medium and high dose groups of modified Dahuang Huanglian Xiexintang showed significantly reduced ROS levels (P<0.05). Compared with the normal group, the model group showed significantly reduced Nrf2 and HO-1 mRNA expression levels (P<0.01). Compared with the model group, the metformin group and the medium and high dose groups of modified Dahuang Huanglian Xiexintang showed significantly increased Nrf2 and HO-1 mRNA expression levels (P<0.05). Immunohistochemistry showed that compared with the normal group, the model group had significantly reduced positive expression of Nrf2 and HO-1 (P<0.05). Compared with the model group, the metformin group and all doses of modified Dahuang Huanglian Xiexintang showed increased positive expression of Nrf2 and HO-1, with a significant increase in brown-yellow granules around the cell nucleus (P<0.05). Western blot results showed that compared with the normal group, the model group had significantly reduced protein expression of Nrf2 and HO-1 (P<0.01). Compared with the model group, the metformin group and all doses of modified Dahuang Huanglian Xiexintang showed significantly increased protein expression of Nrf2 and HO-1 (P<0.01).Conclusion Modified Dahuang Huanglian Xiexintang can significantly improve the general condition and pathological changes of liver tissues in T2DM model rats. This improvement is likely achieved through ameliorating hepatic oxidative stress injury via regulating the Nrf2/HO-1 axis.
AN Dong , LIANG Yonglin , GAO Yankui , YAN Fengzhe , ZHAO Sichen , LIU Zhongtang , MA Chengjun , ZHU Xiangdong
2024, 30(24):131-140. DOI: 10.13422/j.cnki.syfjx.20240722
Abstract:Objective To observe the effect of modified Dahuang Huanglian Xiexintang on mitochondrial autophagy and browning of visceral adipose tissue in obese type 2 diabetes mellitus (T2DM) model ZDF rats.Method Forty ZDF rats were induced with a high-fat diet to establish an obese T2DM model. The rats were randomly divided into five groups: Model group, metformin group (0.18 g·kg-1), and high, medium, and low dose groups of modified Dahuang Huanglian Xiexintang (2.16, 1.08, 0.54 g·kg-1), with eight rats in each group. Additionally, eight ZDF (fa/+) rats were assigned to the normal group. All groups received an intragastric volume of 10 mL·kg-1, with the model and normal groups receiving the same volume of purified water once daily for 12 weeks. Fasting blood glucose (FBG) was regularly measured. After 12 weeks of intervention, the body weight, epididymal fat weight, and serum levels of glucose (GLU), glycated serum protein (GSP), triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were measured. Hematoxylin-eosin (HE) staining was used to observe pathological changes in epididymal fat tissue. Transmission electron microscopy (TEM) was employed to observe mitochondrial autophagy in adipocytes. Real-time PCR was used to detect the mRNA expression of hypoxia-inducible factor-1α (HIF-1α), Bcl-2/adenovirus E1B 19 kDa interacting protein 3 (BNIP3), microtubule-associated protein 1 light chain 3B (LC3B), p62/SQSTM1, uncoupling protein 1 (UCP1), iodothyronine deiodinase 2 (Dio2), and PR domain containing 16 (Prdm16) in epididymal fat. Western blot was used to detect the protein expression of HIF-1α, BNIP3, LC3B, p62, and UCP1 in epididymal fat.Result Compared with the normal group, the model group showed pathological changes in epididymal fat, with adipocyte mitochondrial condensation and numerous autophagosomes indicating mitochondrial autophagy. The model group also exhibited significantly increased body weight, epididymal fat weight, FBG, GLU, GSP, TC, TG, and LDL-C levels (P<0.01), significantly decreased HDL-C levels (P<0.01), significantly elevated mRNA and protein expression of HIF-1α, BNIP3, and LC3B (P<0.01), significantly reduced mRNA and protein expression of p62 and UCP1 (P<0.01), and significantly reduced mRNA expression of Dio2 and Prdm16 (P<0.01). Compared with the model group, all intervention groups showed varying degrees of improvement in epididymal fat pathology. The metformin group and high-dose modified Dahuang Huanglian Xiexintang group displayed intact mitochondrial morphology, clear cristae, uniform matrix, and few autophagosomes and autophagosomes in the adipocyte cytoplasm. The metformin group and high- and medium-dose groups of modified Dahuang Huanglian Xiexintang showed significantly reduced body weight and epididymal fat weight (P<0.01). The epididymal fat index was reduced in all intervention groups (P<0.05), and FBG was lowered in all intervention groups (P<0.01).Serum GSP, GLU, TG, and LDL-C levels were reduced in the metformin group and the high- and medium-dose groups of modified Dahuang Huanglian Xiexintang (P<0.05, P<0.01). The serum TC level was significantly reduced in the metformin group and high-dose group of modified Dahuang Huanglian Xiexintang (P<0.01), and HDL-C levels were significantly increased in all intervention groups (P<0.05, P<0.01). The mRNA and protein expression of HIF-1α, BNIP3, and LC3B were significantly reduced, and UCP1 protein expression was significantly increased in the metformin group and high- and medium-dose groups of modified Dahuang Huanglian Xiexintang (P<0.05, P<0.01). The mRNA and protein expression of p62, Dio2, and Prdm16 were significantly increased in the metformin group and high-dose group of modified Dahuang Huanglian Xiexintang (P<0.05, P<0.01).Conclusion Modified Dahuang Huanglian Xiexintang may inhibit mitochondrial autophagy and promote the browning of visceral adipose tissue through the HIF-1α/BNIP3/LC3B pathway, thereby improving glucose and lipid metabolism in obese T2DM rats.
AN Dong , ZHAI Yanhui , GAO Yankui , LIU Rong , ZHOU Qi , ZHU Xiangdong , LIANG Yonglin
2024, 30(24):141-151. DOI: 10.13422/j.cnki.syfjx.20242323
Abstract:Type 2 diabetes mellitus (T2DM) is based on insulin resistance (IR) and insulin secretion deficiency, with the specific mechanisms still unclear. Current research involves mechanisms such as glycolipid toxicity, inflammatory response, oxidative stress damage, and mitochondrial dysfunction. Modern traditional Chinese medicine (TCM) scholars have named it "blood glucose collateral disease" based on the clinical characteristics and natural progression of T2DM. This condition is primarily manifested as abnormal blood sugar levels in the early stages, and as the disease progresses, it gradually causes widespread damage to the body's veins and collaterals, ultimately leading to lesions in vessels and collaterals. Among these, "spleen heat" (obesity type) is the most common clinical type of T2DM. The concept of "internal heat-induced elimination" runs through both the onset and complications of T2DM, with internal heat being a key factor in its pathogenesis. The clinical application of Dahuang Huanglian Xiexintang and its modifications has achieved significant therapeutic effects. This paper reviews the origins and treatment characteristics of Dahuang Huanglian Xiexintang, along with clinical application research and experimental studies related to T2DM treatment, involving mechanisms for regulating glucose and lipid metabolism disorders, improving IR, modulating inflammatory responses, combating oxidative stress damage, regulating autophagy-related signaling pathways, modulating intestinal flora, inhibiting pyroptosis, and alleviating endoplasmic reticulum stress, with the purpose to provide direction for further research on the prevention and treatment of T2DM and its related complications, to offer reference for developing Dahuang Huanglian Xiexintang as a rapid hypoglycemic Chinese patent medicine for obese T2DM, and to better guide the clinical promotion of this drug.
QIN Zhan , MO Mei , HE Chaoba , GENG Liguo , WANG Bin , WANG Jisheng , LI Kecheng , HUANG Nianwen , HONG Zhiming , YUAN Shaoying , ZHANG Xiaoxiao
2024, 30(24):152-158. DOI: 10.13422/j.cnki.syfjx.20242392
Abstract:Chronic prostatitis is a common and frequently occurring disease in male clinics. Due to the diverse symptoms, complex etiology, unclear mechanisms, and recurrent episodes of chronic prostatitis, Western medicine often faces the challenge of limited treatment options and unsatisfactory outcomes. In order to fully leverage the unique advantages of traditional Chinese medicine (TCM) in the treatment of chronic prostatitis, the China Association of Chinese Medicine organized a discussion among experts from the fields of TCM urology, Western urology, and related pharmacy. The experts focused on the advancements in the understanding of chronic prostatitis in modern medicine, various theories on the etiology, pathogenesis, and treatment of chronic prostatitis in TCM, entry points from interdisciplinary fields, the role and advantages of TCM in the comprehensive management of chronic prostatitis, and research into mechanisms related to chronic prostatitis. After discussions, the experts concluded that chronic prostatitis is one of the diseases where TCM has a distinct advantage. TCM can effectively improve the clinical syndromes of chronic prostatitis, including urinary issues, social psychology, organ specificity, infection, nervous system problems, pain and discomfort, sexual dysfunction, etc., and can enhance the quality of life. For patients with chronic prostatitis who cannot tolerate or may not accept the adverse effects of Western medicine, as well as for those with non-inflammatory chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), those with pain as the primary symptom, those with urinary tract symptoms, those with coexisting anxiety and depression, and those with abnormal semen liquefaction, TCM-based treatment can be the main approach. Currently, the optimal diagnosis and treatment strategy for chronic prostatitis has not yet been established, and further research from perspectives such as clinical epidemiology, evidence-based medicine, and molecular biology is needed. Both TCM and Western medicine should integrate their respective strengths, clarify the role and advantages of TCM interventions based on mutual reference, and improve the diagnosis and treatment standards for chronic prostatitis in China.
WANG Guojun , ZHANG Shimin , JIN Jiao , LIU Ning , LIN Hai , SHI Fudong , CHEN Chun , FENG Yadi
2024, 30(24):159-166. DOI: 10.13422/j.cnki.syfjx.20241744
Abstract:Objective To observe the therapeutic effects of Qishao Huoxue prescription on patients with lumbar disc herniation due to Qi stagnation and blood stasis and the effects of this prescription on hemorheological parameters and serum levels of inflammatory mediators.Method A total of 86 patients with lumbar disc herniation due to Qi stagnation and blood stasis treated in the Wangjing Hospital of China Academy of Chinese Medical Sciences from January 2023 to February 2024 were selected and assigned according to the random number table into observation and control groups (n=43). Patients in both groups received lumbar traction treatment. In addition, the observation group was orally treated with Qishao Huoxue prescription and the control group with celebrex for 3 weeks. The visual analogue scale (VAS) score, Oswestry disabilitiy index (ODI) score, 12-item Short-Form Survey (SF-12) score, traditional Chinese medicine (TCM) symptom score, hemorheological parameters [whole blood high shear viscosity, middle shear viscosity, low shear viscosity, plasma viscosity (PV), and fibrinogen (FIB)], and the serum levels of inflammatory mediators [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-1β (IL-1β), and transforming growth factor-β1 (TGF-β1)] were determined before and after treatment. In addition, the clinical efficacy and adverse reactions were observed and compared between the two groups.Result After treatment, both groups showed declined VAS, ODI, and TCM symptom scores (P<0.05), increased SF-12 physical component summary (PCS) and mental component summary (MCS) scores (P<0.05). After treatment, the whole blood high shear viscosity, middle shear viscosity, low shear viscosity, PV, and FIB decreased in the observation group (P<0.05), while they did not show significant variations in the control group. After treatment, both groups of patients showed reductions in TNF-α, IL-6, and IL-1β levels and an elevation in the TGF-β1 level (P<0.05). Compared with the control group after treatment, the observation group showed decreases in VAS, ODI, TCM symptom scores and main symptom scores (P<0.05), no significant differences in the secondary symptom scores, increased PCS and MCS scores (P<0.05). The observation group outperformed the control group in terms of recovering whole blood high shear viscosity, middle shear viscosity, low shear viscosity, PV, FIB, TNF-α, IL-6, IL-1β, and TGF-β1 (P<0.05). The total response rate in the observation group was 97.5% (40/41), which was higher than that (88.1%, 37/42) in the control group (P<0.05). No serious adverse reaction was observed in the two groups during the observation period. One case in the observation group showed subcutaneous bruising on the lower limbs, which gradually disappeared after withdrawal.Conclusion Qishao Huoxue prescription demonstrated definite effect in treating lumbar disc herniation due to qi stagnation and blood stasis by recovering hemorheological parameters and inhibiting the expression of inflammatory mediators in the serum without inducing adverse reactions. It is worth applying in clinical practice.
YANG Hang , PENG Yehui , YANG Wei , WANG Jiaheng , ZHAO Zhiwei , XU Wenyuan , LI Yuxin , ZHU Yan , LIU Lihong
2024, 30(24):167-173. DOI: 10.13422/j.cnki.syfjx.20241165
Abstract:Objective In order to improve the recognition accuracy of named entities in medical record texts and realize the effective mining and utilization of medical record knowledge, a Bert-Radical-Lexicon(BRL) neural network model is constructed to recognize medical record entities with respect to the characteristics of medical record texts.Method We selected 408 medical records related to hypertension from the the Complete Library of Famous Medical Records of Chinese Dynasties and constructed a dataset consisting of 1 672 medical records by manually labeling. Then, we randomly divided the dataset into three subsets, including the training set(1 004 cases), the testing set (334 cases) and the validation set(334 cases). Based on this dataset, we built a BRL model that fused various text features of medical records, as well as its variants BRL-B, BRL-L and BRL-R, and a baseline model Base for experiments. During the model training phase, we trained the above models using the training set to reduce the risk of overfitting. We continuously monitored the performance of each model on the validation set during training and saved the model with the best performance. Finally, we evaluated the performance of these models on the testing set.Result Compared with other models, the BRL model had the best performance in the medical records named entity recognition task, with an overall recognition precision of 90.09%, a recall of 90.61%, and the harmonic mean of the precision and recall(F1) of 90.35% for eight types of entities, including disease, symptom, tongue manifestation, pulse condition, syndrome, method of treatment, prescription and traditional Chinese medicine(TCM). Compared with the Base model, the BRL model improved the overall F1 value of entity recognition by 5.22%, and the F1 value of pulse condition entity increased by 6.92%, which was the largest increase.Conclusion By incorporating a variety of medical record text features in the embedding layer, the BRL neural network model has stronger named entity recognition ability, and thus extracts more accurate and reliable TCM clinical information.
MENG Lingbang , YU Huan , WU Xiaoying , GUO Yijing , QU Fei , GONG Qianfeng
2024, 30(24):174-182. DOI: 10.13422/j.cnki.syfjx.20250768
Abstract:Objective To systematically compare the chemical compositional differences between Puerariae Thomsonii stem base(PTSB) and Puerariae Thomsonii Radix(PTR), and to explore the potential hepatoprotective effects of PTSB by liver metabolomics.Method Ultra performance liquid chromatography-quadrupole-time-of-flight mass spectrometry(UPLC-Q-TOF-MS/MS) was used to analyze the chemical compositions of PTSB and PTR. Twenty Kunming mice aged 6-8 weeks, half male and half female, were randomly divided into the blank group(sterile water) and PTSB group(1.95 g·kg-1), with 10 mice in each group, and the drug was administered by gavage for 14 d, and the body mass was weighed once a day. After the last administration, mice were anesthetized, organs such as heart, liver, spleen, lungs and kidneys were collected, and the organ index was calculated. Enzyme-linked immunosorbent assay(ELISA) was used to measure the levels of aspartate aminotransferase(AST), alanine aminotransferase(ALT), total cholesterol(TC) and triglyceride(TG) in the serum of mice from each group, the morphological changes of heart, liver, spleen, lung and kidney tissues were observed by hematoxylin-eosin(HE) staining, and the regulation of PTSB for the hepatic metabolic profiles of mice was analyzed by UPLC-Q-TOF-MS/MS, then the differential metabolites between the blank group and PTSB group were designated, and the metabolic pathways was enriched by Kyoto Encyclopedia of Genes and Genomes(KEGG).Result A total of 19 common chemical constituents were identified from PTSB and PTR, all of which were the main pharmacodynamic substances of PTR. The pharmacodynamic results showed that PTSB could control the growth of body mass of mice and reduce the contents of TC, TG, ALT and AST in serum of mice. HE staining observations and organ indexes showed that there was no significant effect of PTSB on all major organs at the highest clinically equivalent dose. A total of 38 differential metabolites were identified by metabolomics, of which 35 were up-regulated and 3 were down-regulated. These differential metabolites were mainly compounds such as amino acids, fatty acids, vitamins, steroids, nucleosides, pyrimidines and alkaloids. Three key metabolic pathways, including tyrosine metabolism, vitamin B6 metabolism and tryptophan metabolism, were screened by metabolic pathway analysis.Conclusion PTSB has a similar chemical composition to that of PTR, and it may regulate the metabolism of amino acids and vitamins through the flavonoids and isoflavonoids, thus exerting a potential hepatoprotective effect. This study provides an experimental reference for the clinical application and product development of PTSB.
REN Cuijiao , DING Yangfei , LI Jingji , LI Shuaishuai , LI Pengfei , ZHANG Wei , ZHAO Hongsu , XU Fengqing , JIN Chuanshan , LIU Junling
2024, 30(24):183-189. DOI: 10.13422/j.cnki.syfjx.20241264
Abstract:Objective Ultra performance liquid chromatography-quadrupole-electrostatic field orbitrap high resolution mass spectrometry(UPLC-Q-Exactive Orbitrap MS) was used to analyze the differences in chemical components between raw products and wine-processed products of Polygonatum cyrtonema rhizome.Method UPLC-Q-Exactive Orbitrap MS was used to analyze the chemical compositions of P. cyrtonema rhizome before and after processing, and the effective response ions were extracted after raw data processing, and the differential compounds before and after processing were screened combined with multivariate statistical analysis and according to the conditions of variable importance in the projection(VIP) value>1, P<0.05, fold change(FC)>2 or FC<0.5, based on the retention time, quasi-molecular ions, fragment ions and other information, the components were identified in combination with the control products and the literature, and the significant difference compounds were identified by clustering thermal analysis and relative quantitative analyzed, in order to clarify the change rule of the main components in P. cyrtonema rhizome before and after processing.Result A total of 72 differential constituents between raw products and wine-processed products were identified, including 15 alkaloids, 12 organic acids, 12 amino acids, 6 flavonoids, 4 saccharides and 23 others. There were a total of 18 significantly different components, among which 13 compounds, including L-malic acid, lactic acid and 9,12,13-trihydroxy-10-octadecenoic acid, showed an increasing trend in content after wine processing, 5 compounds such as trans-3-indoleacrylic acid, L-arginine, D-tryptophan, showed a decreasing trend after processing.Conclusion The chemical components of P. cyrtonema rhizome are significantly different before and after processing, mainly organic acids, saccharides, amino acids, flavonoids and alkaloids, which can lay the foundation for the in-depth study of the processing mechanism of Polygonati Rhizoma.
LIANG Lyuyuan , ZHANG Jinyan , CAO Jialei , WAN Hejia , HUANG Tongyi , GENG Mengmeng , WEI Bingqi , MA Bingxiang , HE Yajing
2024, 30(24):190-197. DOI: 10.13422/j.cnki.syfjx.20240317
Abstract:This paper discussed the historic evolution of Juanbitang and similar decoctions, clarified the historic development of Yangshi Juanbitang and Chengshi Juanbitang, and probed into the key information of the meaning, original plants, processing methods, and modern dosage and usage of Chengshi Juanbitang. A total of 267 pieces of relevant information were collected from ancient traditional Chinese medicine (TCM) books, among which 53 pieces of effective data were included in this study. The results showed that both Chenshi Juanbitang and Yangshi Juanbitang were originated from Duhuo Jishengtang recoded in the Important Prescriptions Worth a Thousand Gold for Emergency (Bei Ji Qian Jin Yao Fang). According to the standard of "1 qian roughly equals 3.73 g" in the measurement system of the Qing Dynasty, we suggest Chenshi Juanbitang is composed of 3.73 g Notopterygii Rhizoma et Radix, 3.73 g Angelicae Pubescentis Radix, 3.73 g Gentianae Macrophyllae Radix, 11.19 g Angelicae Sinensis Radix, 11.19 g Mori Ramulus, 2.61 g Chuanxiong Rhizoma, 1.87 g Cinnamomi Cortex, 1.87 g stir-fried Glycyrrhizae Radix et Rhizoma, 7.46 g Piperis Kadsurae Caulis, 2.98 g Olibanum, and 2.98 g Aucklandiae Radix, which should be decocted with 600 mL water to reach a volume of 300 mL. The decoction should be taken 3 times a day before meals. Juanbitang, a classical formula specialized for treating impediment diseases, has the effects of dispelling wind, removing dryness, and alleviating impediment to relieve pain. It can be used for treating vexing pain in body, spasm of nape and back, and heaviness in waists and legs. Modern studies have shown that Juanbitang can be used for treating rheumatoid arthritis, knee osteoarthritis, and periarthritis of shoulder. The above results served as a reference for the future development of Juanbitang.
GUO Zhidan , LIANG Lyuyuan , CAO Jialei , CHEN Jinyu , LYU Xinghang , JIN Xuancui , SUN Yifan , CHANG Yujie , LI Yihan , WEI Bingqi , ZHOU Zheng , MA Bingxiang
2024, 30(24):198-207. DOI: 10.13422/j.cnki.syfjx.20241019
Abstract:Zhigancao Tang (also known as Fumaitang) is a classic formula for treating "intermittent pulse and palpitations" and is widely used in clinical practice. Sanjia Fumaitang, included in the Catalogue of Ancient Classical Formulas (First Batch) published by the National Administration of Traditional Chinese Medicine of China in 2018, is derived from this formula. This paper employed bibliometric methods to comprehensively investigate and summarize the historical evolution, drug composition, herb origins and preparation, prescription meanings, and ancient and modern applications of Zhigancao Tang, analyzed the composition and usage of Zhigancao Tang, and discussed the reasons and applications of the "Fumaitang" variants created by Wu Jutong. A total of 47 valid pieces of data from 38 ancient texts were included. Results showe that Zhigancao Tang originates from the Treatise on Cold Damage (Shang Han Lun), and the name "Fumaitang" is also recorded in the formula's description. Converted to modern measurements from the Han dynasty system, the recommended preparation for Zhigancao Tang includes 55.2 g of fried Glycyrrhizae Radix et Rhizoma, 41.4 g of Cinnamomi Ramulus, 27.6 g of Ginseng Radix et Rhizoma, 220 g of fresh Rehmannia glutinosa, 27.6 g of Asini Corii Colla, 53 g of Ophiopogonis Radix, 45 g of Cannabis Fructus, and 90 g of Jujubae Fructus. All herbs should be decocted with 1 400 mL of yellow rice wine and 1 600 mL of water until 600 mL. Once the Asini Corii Colla is fully dissolved, the decoction should be taken warm at a dosage of 200 mL, three times a day. Zhigancao Tang is effective for replenishing Qi, warming Yang, nourishing Yin, and nourishing blood and is primarily used to treat “intermittent pulse and palpitations” caused by deficiencies in heart Yin and Yang, as well as malnutrition of the heart meridian and conditions like lung atrophy. Modern applications mainly focus on cardiovascular and cerebrovascular diseases, including arrhythmias, coronary heart disease, and premature ventricular contractions. The findings from this research provide a reference for the further development of Zhigancao Tang.
KONG Yamin , LIANG Lyuyuan , CAO Jialei , WANG Xuan , CHEN Liyuan , WEI Bingqi , CHANG Yujie , LI Yihan , XI Leying , MA Bingxiang , SHI Wenli
2024, 30(24):208-214. DOI: 10.13422/j.cnki.syfjx.20240614
Abstract:Tingli Dazao Xiefeitang is a classic formula for treating lung abscesses and thoracic fluid retention, recognized throughout history and included in the Catalogue of Ancient Classic Formulas (Second Batch). This article employs bibliometric methods to investigate and analyze the source, origin, and key information of Tingli Dazao Xiefeitang, providing a theoretical basis for the development and application of this renowned formula. The results show that Tingli Dazao Xiefeitang first appears in Synopsis of the Golden Chamber (Jin Kui Yao Lue), where three clinical applications are recorded. The original text clearly states that this formula is used to treat lung abscesses and thoracic fluid retention, with symptoms such as inability to lie down due to wheezing, chest and rib fullness, facial edema, inability to rest due to thoracic fluid retention, and cough inversion. This aligns with findings from ancient application research. In later generations, the methods proposed by ZHANG Zhongjing were predominantly used for medication and formulation. Modern applications of Tingli Dazao Xiefeitang focus primarily on the respiratory system, with pleural effusion being the most common condition. For the preparation and decoction, a single dose of 5 g of Descurainiae Semen Lepidii Semen (dried and mature seeds of Lepidium apetalum) processed as stir-fried seeds and 36 g of Jujubae Fructus (dried and mature fruit of Ziziphus jujuba) prepared as raw materials were recommended. Then 600 mL of water was added and Jujubae Fructus was first boiled until the volume reduced to 400 mL. After filtering out the residue, the supernatant was retained and mixed with stir-fried Descurainiae Semen Lepidii Semen, followed by boiling to 200 mL, which should be consumed all at once. This research provides a theoretical basis for the development and application of this formula.
WANG Yizhen , LIANG Lyuyuan , CAO Jialei , LIU Yihang , MA Rongze , ZHANG Zhengshao , TANG Jing , WEI Bingqi , HUANG Chongyi , WAN Hejia , MA Bingxiang , SHI Wenli
2024, 30(24):215-223. DOI: 10.13422/j.cnki.syfjx.20240817
Abstract:Jinlingzi San is a formula frequently used in treating pain syndrome, first recorded in the Collection of Writings on the Mechanism of Disease, Suitability of Qi, and the Safeguarding of Life as Discussed in the 'Basic Questions' written by LIU Wansu in the Jin Dynasty. Jinlingzi San is composed of 2 Chinese medicinals Toosendan Fructus and Corydalis Rhizoma with a concise composition and exact clinical efficacy, having been included in the Catalogue of Ancient Classical Formulas (Second Batch: Han Chinese Medicine). The formula name, historic evolution, medicine origins, composition, dosage, decocting methods, and ancient and modern clinical application were sorted out and analyzed with the bibliometric method. A total of 209 pieces of information were collected from ancient books and literature. After screening, 49 pieces of effective data involving 45 ancient books were included. Results showed that the name of Jinlingzi San was first recorded in Secret Formulas of the Yang Family written by Yang Tan in the Southern Song Dynasty and developed into 3 other versions of the decoction. The Jinlingzi San included in the Collection of Writings on the Mechanism of Disease, Suitability of Qi, and the Safeguarding of Life as Discussed in the 'Basic Questions' written by LIU Wansu invariably plays a dominant role. As for the 3 other versions, although they have the same name of Jinlingzi San, their composition and indications are different from those of the original formula, which were therefore viewed as prescriptions based on Jinlingzi San and also included in the research. The medicine origins and processing of Jinlingzi San are suggested: Toosendan Fructus is the dry mature fruit of Melia toosendan of Meliaceae, and the crude is used after cleansing without putamen. Corydalis Rhizoma is the dry tuber of Corydalis yanhusuo of Papaveraceae, which is used after impurity removal, cleaning, and drying. Depending on the conversion from the measurement system in the Jin Dynasty to modern measurement, it is suggested that Toosendan Fructus and Corydalis Rhizoma (41.3 g each) are ground into fine powder, and one dose includes 12.39 g of the powder, which should be taken with an appropriate amount of wine. If wine is not suitable for the patient, the decoction can also be taken with warm water. Jinlingzi San has the effects of soothing the liver, discharging heat, and activating blood to stop pain. As recorded in ancient books, Jinlingzi San is specialized in treating heart pain caused by reversal heat, chest and abdominal pain, hypochondriac pain, jaundice, hernia, and other diseases. Modern studies have shown that modified Jinlingzi San can be used in treating diseases involving the digestive system, the integumentary system, the gynecological system, the reproductive system, and other systems and has wide clinical application in treating epigastric pain, herpes zoster, dysmenorrhea, and other diseases. This study has made clear the key information of Jinlingzi San by textual research of ancient books and literature in the hope of providing a theoretical reference for the clinical application, set prescriptions, and new drug development.
HAN Yanping , ZHANG Yiyi , YANG Mengyuan , LI Raorao , YAO Li , SUN Zhaoxiang , MA Zhuo , GAO Huimin , ZHANG Wei
2024, 30(24):224-232. DOI: 10.13422/j.cnki.syfjx.20241217
Abstract:Gualou Niubangtang is a classic formula for eliminating swelling and dispersing lumps, commonly used in the clinical treatment of breast diseases in traditional Chinese medicine (TCM). This paper employed bibliometric methods to collect and organize 12 pieces of data from ancient texts related to Gualou Niubangtang, ultimately screening 10 valid references from 10 ancient Chinese medical books. Information regarding the prescription origin, main indications, formulation principles, drug composition, dosages, preparation methods, and decoction techniques was systematically verified. The results indicate that Gualou Niubangtang originates from the Orthodox Manual of External Medicine (Wai Ke Zheng Zong) by Chen Shigong in the Ming Dynasty. The formula consists of 12 Chinese medicines, including Citri Reticulatae Pericarpium, Arctii Fructus, Gardeniae Fructus, Lonicerae Japonicae Flos, Glycyrrhizae Radix et Rhizoma, Trichosanthis Semen, Scutellariae Radix, Trichosanthis Radix, Forsythiae Fructus, Gleditsiae Spina, Bupleuri Radix, and Citri Reticulatae Pericarpium Viridm. In terms of drug origins, the dominant radical for Trichosanthis Semen and Trichosanthis Radix is Trichosanthes kirilowii, and the historical dominant radical for Glycyrrhizae Radix et Rhizoma is Glycyrrhiza uralensis. The nine medicines, Citri Reticulatae Pericarpium, Arctii Fructus, Gardeniae Fructus, Lonicerae Japonicae Flos, Scutellariae Radix, Forsythiae Fructus, Gleditsiae Spina, Bupleuri Radix, and Citri Reticulatae Pericarpium Viridm, are consistent with the 2020 edition of the Chinese Pharmacopoeia. The preparation methods involve frying Arctii Fructus, removing the heart from Forsythiae Fructus, while the remaining 10 medicines are used raw. The efficacy includes clearing heat, removing toxins, reducing swelling, and dispersing lumps. Clinically, it is used to treat conditions such as breast carbuncles, breast gangrene, and knot-like swellings and pain. The dosage, converted to modern standards, includes 3.73 g of Trichosanthis Semen, 3.73 g of Trichosanthis Radix, 3.73 g of Arctii Fructus, 3.73 g of Scutellariae Radix, 3.73 g of Gardeniae Fructus, 3.73 g of Forsythiae Fructus, 3.73 g of Gleditsiae Spina, 3.73 g of Lonicerae Japonicae Flos, 3.73 g of Glycyrrhizae Radix et Rhizoma, 3.73 g of Citri Reticulatae Pericarpium, 1.85 g of Citri Reticulatae Pericarpium Viridm, and 1.85 g of Bupleuri Radix. The preparation is in the form of a decoction, with the 12 medicines added to 400 mL of water and decocted until 160 mL. The liquid is then mixed with 200 mL of yellow wine and taken before meals three times a day. Through the excavation and organization of ancient literature regarding Gualou Niubangtang, key information has been identified to provide a scientific basis for its clinical application and further development.
MENG Lichong , LIAN Kun , LI Xinchun , LU Cong , HU Zhixi
2024, 30(24):233-242. DOI: 10.13422/j.cnki.syfjx.20250494
Abstract:Chronic heart failure (CHF) and diabetes mellitus (DM) comorbidity presents a myriad of symptoms and a complex pathogenesis, making the traditional diagnostic and treatment model of "using disease to treat syndrome" often inadequate in clinical practice. The concept of "syndrome-based treatment of disease" is rooted in the core thinking of traditional Chinese medicine (TCM) syndrome differentiation and treatment, emphasizing the importance of syndrome as the guiding principle. This approach categorizes various diseases according to their corresponding syndrome categories for exploration, adhering to the principle of starting from the syndrome and addressing the disease thereafter, which highlights the advantages of TCM holistic view and syndrome differentiation and treatment. The pathogenesis of CHF is characterized by deficiency of both Qi and Yin, along with blood stasis, affecting organs such as the lung, spleen, and kidney, which in turn impacts the distribution and metabolism of body fluids. Dysfunction in body fluid regulation leads to stagnation, resulting in pathological products like phlegm and turbidity, which exacerbates syndromes of Yin deficiency and excessive heat. As the conditions of Yin deficiency and dryness-heat intensify, and as body fluid depletion continues, the patient's DM symptoms worsen, contributing to or aggravating the comorbidity. Following the diagnostic approach of "syndrome-based treatment of disease", TCM diagnosis and treatment of CHF and DM comorbidity should focus on the core pathogenesis of "deficient Qi retention". This study categorized CHF and DM comorbidity into four stages: A (comorbid risk period), B (precomorbid period), C (intermediate stage of comorbidity), and D (advanced comorbidity), proposing corresponding TCM syndrome types for each stage. In terms of treatment, adhering to the principle of "tonifying deficiency and relieving stagnation", the specific methods included invigorating Qi and strengthening the body, nourishing Yin and generating body fluids, activating blood circulation and Qi, and promoting diuresis and removing toxins. This study reviewed recent research progress on Chinese medicine compound prescriptions for CHF combined with DM, aiming to achieve precise treatment for both diseases and provide a scientific basis for the application of TCM in the prevention and treatment of CHF and DM comorbidity.
SONG Xiaohui , ZHANG Huamin , GUO Zhuang , YIN Jiyao , LIU Menghan , ZHANG Juan , NIU Qikai , WANG Junwen
2024, 30(24):243-249. DOI: 10.13422/j.cnki.syfjx.20240299
Abstract:Objective To support intelligent clinical decision-making in traditional Chinese medicine(TCM), this study utilized ontology and knowledge graph construction techniques to achieve the IT application of clinical practice guidelines.Method Based on the principles of findability, accessibility, interoperability, and reusability (FAIR principles), this study employed ontology techniques to construct an ontology for TCM clinical practice guidelines and built a knowledge graph using coronary heart disease as an example. Based on the Checklist for Reporting Practice Guidelines in Traditional Chinese Medicine and Recommendation Grading in TCM Clinical Guidelines/Consensus (T/CAS 530—2021),the ontology of TCM clinical practice guidelines was constructed using the seven-step ontology construction method. On this basis,the TCM diagnosis and treatment data from the Guidelines for the Diagnosis and Treatment of Stable Angina Pectoris in Coronary Heart Disease were stored in Neo4j in the form of triples through knowledge extraction,integration,and storage.Result The information in the clinical practice guidelines was divided into three categories: onset and prevention information, diagnosis information, and treatment information, and the TCM clinical practice guideline ontology was constructed. A total of 27 concepts related to TCM clinical diagnosis and treatment and 14 data attributes were obtained, and 12 conceptual relationships including hierarchical relationships and object attributes were established. By taking coronary heart disease as an example and the TCM clinical practice guideline ontology as the model layer, the knowledge map of TCM diagnosis and treatment guidelines for stable angina pectoris in coronary heart disease with 276 nodes and 336 relationships was constructed, realizing the visual display and query of the guideline content.Conclusion The ontology of TCM clinical practice guidelines and the knowledge graph of stable angina pectoris in coronary heart disease constructed by combining the seven-step ontology construction method and Neo4j graph database technology are efficient and flexible,providing an intelligent TCM diagnosis and treatment scheme and promoting the standardization and objectification of TCM diagnosis and treatment.
LIU Fangqi , LIU Mengyu , ZHENG Danping , LI An , CHEN Xue , ZHANG Gezhi , WEI Dongfeng , YANG Wei , BAI Weixuan , LI Yong
2024, 30(24):250-256. DOI: 10.13422/j.cnki.syfjx.20250593
Abstract:Guidance implementation acts as a bridge between theory and practice,enabling the rapid expansion of their impact and application. This study demonstratively evaluated emergency health systems guidance documents (HSG),represented by the COVID-19 emergency HSG,based on the item implementability of the Appraisal of Guidelines for Research and Evaluation-Health Systems (AGREE-HS),aiming to explore the characteristics of implementability in emergency HSG. The evaluation results indicated that the COVID-19 emergency HSG had a low mean score in implementability,which ranked just above the item participants. Criterion 2 (costs and resource considerations for implementing the recommendations) received the highest mean score of 4.29,while criterion 9 (systematic evaluation of implementation) received the lowest mean score of 1.34. The emergency HSG formulated by the World Health Organization(WHO) and those formulated by various countries showed no difference (P=0.114) in criterion 1 (barriers and facilitators to implementation) but had differences (P<0.05) regarding the average item scores and the scores of the remaining criteria. The WHO standard HSG had high overall scores and had differences (P<0.05) in both the mean item scores and the scores of the nine criteria when compared with the emergency HSG. The global/national HSG showed differences in scores of criterion 1 (barriers and facilitators to implementation) compared with the both clinically relevant HSG and material support HSG (P<0.05). Emergency HSG prioritized considerations of implementation costs,resources,and flexibility in terms of implementability,while de-emphasizing aspects such as stakeholder opinions,dissemination strategies,and evaluation of HSG. This may be attributed to the context in which emergency HSG are formulated,given the inherent flexibility and variability of emergency health events. The developers should comprehensively consider the needs and characteristics related to the implementability of emergency HSG during the formulation process.
ZHAO Guozhen , ZONG Xingyu , ZHAO Xueyao , LI Huizhen , ZHOU Feng , ZENG Xuanling , LIN Jiahao , LIANG Ning , ZHANG Haili , CHE Qianzi , LIU Bin , SHI Nannan
2024, 30(24):257-261. DOI: 10.13422/j.cnki.syfjx.20250396
Abstract:The classification of traditional Chinese medicine (TCM) syndromes is one of the core technical elements in the industry standard of Specification of Diagnosis and Therapeutic Effect Evaluation of Diseases and Syndromes in TCM. In the past,when clinical standards for TCM were formulated,the determination of TCM syndrome classification relied heavily on textbooks and expert experience,lacking systematic research. This approach thus failed to reflect the advancement and scientificity of the standards,thereby affecting their implementation and application. This article reviewed the presentation forms and technical methods of TCM syndrome classification,including the two-tier syndrome classification model with primary and secondary symptoms,as well as the application of modern literature research,ancient literature research,Delphi method,in-depth expert interviews,consensus conferences,and real-world research. When syndrome classification standards are developed,it is necessary to build upon modern literature research,adopt a mixed approach combining qualitative research and quantitative analysis results,and reach expert consensus through consensus conferences. Through systematic research,the scientificity,applicability,and coordination of TCM syndrome classification standards can be enhanced,providing guidance for the standardization of TCM.
YUAN Ziyang , ZHANG Yan , ZHANG Wei , WANG Yaqin , MAO Wenjun , YANG Guo , WANG Xuewei
2024, 30(24):262-271. DOI: 10.13422/j.cnki.syfjx.20241998
Abstract:Heart failure is a group of complex clinical syndromes that represent the final stage of cardiovascular disease development, characterized by an extremely high mortality rate. However, due to the complexity of the pathological mechanisms, an effective treatment method has not yet been found. Mitochondria are among the most critical organelles in cells, playing an essential role in energy supply and widely participating in various life activities, such as the regulation of oxidative stress and apoptosis. The normal functioning of mitochondria is crucial for maintaining the body's normal life activities. In recent years, studies have found that mitochondrial dysfunction is associated with the occurrence and progression of various diseases, particularly closely related to the onset of heart failure. An imbalance in mitochondrial homeostasis is a key factor in cardiomyocyte death and the onset of heart failure. Mitochondrial autophagy, as a means of regulating mitochondrial homeostasis, is significant for the prevention and treatment of heart failure. Traditional Chinese medicine (TCM) therapy is a unique treatment approach in China now widely applied in clinical practice, demonstrating significant efficacy in treating heart failure, with unique advantages. Modern pharmacological research indicates that Chinese medicine monomers and compounds can target and regulate mitochondrial homeostasis in cardiomyocytes, affect mitochondrial autophagy, and protect cardiomyocytes, though the specific mechanisms remain unclear. Therefore, this paper explored the mechanisms of the PTEN-induced putative kinase 1 (PINK1)/Parkin pathway in mitochondrial autophagy and heart failure, reviewed the effects of PINK1/Parkin-mediated mitochondrial autophagy on heart failure, and discussed the therapeutic effects of PINK1/Parkin-mediated mitochondrial autophagy on heart failure in conjunction with TCM. This paper is expected to provide new ideas and methods for the prevention and treatment of heart failure from the perspective of PINK1/Parkin regulation of mitochondrial autophagy.
TANG Yinpei , ZHU Zhengwang , WANG Bing , ZHU Pingsheng
2024, 30(24):272-278. DOI: 10.13422/j.cnki.syfjx.20240826
Abstract:Metabolic-associated fatty liver disease (MAFLD) is a manifestation of multi-system metabolic dysfunction that affects the liver. Its disease spectrum not only includes fatty liver hepatitis, liver fibrosis, cirrhosis, liver malignancies, and other liver diseases but also includes extrahepatic diseases such as type 2 diabetes, atherosclerosis diseases, and chronic kidney disease. It is the most common chronic liver disease worldwide, with a complex pathogenesis and a lack of effective pharmacological treatments. With the improvement of people's living standards and the acceleration of the aging process, the incidence of MAFLD may continue to increase in the future, and its occurrence, development, prevention, and treatment have received widespread attention. Recent studies have shown that abnormal composition and proportion of gut microbiota can affect the changes in gut microbiota-derived metabolites. Metabolic disorders of bile acids and choline can further exacerbate gut microbiota imbalance, leading to a vicious cycle that destroys intestinal barrier function, increases intestinal permeability, and allows lipopolysaccharides, bacteria, viruses, and other substances to enter the liver through the ''gut-liver axis''. This process promotes liver inflammation and lipid deposition. Factors such as gut microbiota shift, regulation of host energy absorption, glucose and lipid metabolism, and inflammatory response interact to participate in the occurrence and development of MAFLD. Traditional Chinese medicine regulates the structure and function of gut microbiota through multiple targets, promoting the growth of beneficial bacteria, inhibiting the formation of harmful bacteria, restoring the balance of gut microbiota, improving intestinal mucosal barrier function, inhibiting liver inflammation and lipid degeneration, and influencing liver metabolism and immune response. This ultimately contributes to the prevention and treatment of MAFLD. This article systematically reviewed the mechanism of traditional Chinese medicine (TCM) treatment of MAFLD targeting gut microbiota through a literature search, aiming to provide ideas and references for TCM treatment of MAFLD.
CAO Yuqing , GUO Yang , SHANG Xiyu , JIA Zihan , XIONG Yibai , CHEN Renbo , ZHANG Lei , TONG Lin , ZHANG Huamin , MA Yan
2024, 30(24):279-288. DOI: 10.13422/j.cnki.syfjx.20240739
Abstract:Cinnamomi Ramulus and Alismatis Rhizoma are commonly used in the treatment of external-contraction diseases. Cinnamomi Ramulus is pungent, sweet, and warm, with the effects of ventilating lung and dispersing cold, warming Yang and transforming Qi, and promoting water and liquid flow from Taiyang meridian to remove dampness. Alismatis Rhizoma is sweet and cold, with the effects of draining dampness and promoting urination, regulating the waterway, removing water retention in lung, and promoting urination to remove dampness and heat. Herbal pairs are extracted from the accumulated experience of medical practitioners over the ages in the use of medicines and have been proved by clinical application to be composed of simple and effective combinations for specific diseases. The herb pair Cinnamomi Ramulus-Alismatis Rhizoma is an important part in ancient classic formulas such as Wulingsan. Both herbs play a role in draining dampness and promoting urination, warming Yang and transforming Qi, being a representative herb pair used for treating external-contraction exterior syndrome and water retention inside. The review of ancient medical publications revealed that there were a large number of compound formulas containing Cinnamomi Ramulus-Alismatis Rhizoma for dispersing cold and removing dampness, which were widely used for thousands of years in clinical practice. Modern pharmacological studies have shown that the active pharmacological components of Cinnamomi Ramulus (cinnamaldehyde and cinnamic acid) and Alismatis Rhizoma (alisol A and 23-acetate alisol B) have anti-inflammatory, antiviral, and immunoregulatory effects and high safety. Qingfei Paidu decoction containing this herbal pair played an important role in fighting against COVID-19. Despite the extensive pharmacological studies on Cinnamomi Ramulus and Alismatis Rhizoma, few studies have been carried out regarding this herb pair. This paper summarizes the traditional Chinese medicine knowledge about Cinnamomi Ramulus and Alismatis Rhizoma in the treatment of external-contraction diseases and summarizes the chemical composition, pharmacological effects, toxicology and other aspects of the two herbs before and after compatibility, aiming to provide a reference for further research and clinical application.
2024, 30(24):289-298. DOI: 10.13422/j.cnki.syfjx.20240627
Abstract:Hominis Placenta (HP), also known as "Baoyi (placenta)'', is derived from the placenta of healthy parturient women and has a medicinal history in China spanning over a thousand years. HP is typically used in its processed or dried form according to traditional Chinese medicine (TCM). TCM theory attributes HP with the abilities to warm the kidney and replenish essence, and benefit Qi and nourish blood. This article reviewed studies on HP from various databases and identified that over 79 compounds have been isolated and identified from HP, including various amino acids, proteins, lipids, multifunctional active factors, as well as common inorganic and organic compounds. Research has shown that aqueous extracts of HP possess numerous pharmacological activities, including immunomodulation, hormone-like effects, anti-tumor, anti-fibrosis, anti-inflammatory, anti-allergy, and anti-infection properties. Clinically, HP has been widely used in treating a range of diseases affecting multiple body systems, including the human locomotor system, nervous system, circulatory system, respiratory system, digestive system, urinary system, and reproductive system. As a Chinese medicine with a long history of use, HP has garnered increasing attention in modern medical research and holds promise for contributing significantly to human health. With the continuous advancement of science and technology, research into the pharmacological activities of HP is expected to become more in-depth, uncovering its potential medical value more effectively.
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