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Expert consensus on the clinical application of Xuanfei Baidu granule 宣肺百度颗粒临床应用专家共识
Pub Date : 2023-01-12 DOI: 10.1097/HM9.0000000000000052
Qingquan Liu, Hongchung Zhang, Chengxiang Wang, Q. Miao, Fengwen Yang, Yuhong Huang, Wenke Zheng
Xuanfei Baidu granule is an effective prescription for COVID-19, which is modified from classical famous prescriptions. In order to further standardize clinician’s rational use of Xuanfei Baidu granule, enhance clinical efficacy, improve rational medication level, and let it play a more significant role, the frontline clinical experts are invited for discussion on the major functions, usage, adverse reactions, and considerations of Xuanfei Baidu granule to form the consensus. The consensus is that: Xuanfei Baidu granule has the efficacy of promoting the lung and resolving dampness, clearing heat and removing pathogeneses, purging the lung and depoisoning; it can be used for the treatment of patients with mild, moderate, and heavy COVID-19 and other common upper respiratory tract infectious diseases such as influenza; acute tracheitis and bronchitis and community-acquired lower respiratory tract infectious diseases all belong to damp-toxin constraint in the lungs, Xuanfei Baidu granule can relieve cough, expectoration, and other symptoms caused by an acute exacerbation of the chronic obstructive pulmonary disease, with definite clinical efficacy and good safety. According to the principles of evidence-based medicine, this expert consensus will be updated regularly.
宣肺百度颗粒是由经典名方改良而成的新型冠状病毒肺炎有效方剂。为进一步规范临床医师对宣肺百度颗粒的合理使用,增强临床疗效,提高合理用药水平,让其发挥更显著的作用,诚邀一线临床专家就宣肺百度颗粒的主要作用、使用方法、不良反应、注意事项等进行研讨,形成共识。共识是:宣肺百度颗粒具有润肺化湿、清热祛病、清肺解毒的功效;可用于治疗轻、中、重度新冠肺炎患者及流感等常见上呼吸道传染病;急性气管炎、支气管炎、社区获得性下呼吸道感染性疾病均属于肺湿毒约束,宣肺百度颗粒可缓解慢性阻塞性肺疾病急性加重引起的咳嗽、咳痰等症状,临床疗效明确,安全性好。根据循证医学的原则,这一专家共识将定期更新。
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引用次数: 1
Effects of acupuncture on angiogenesis-associated factor expression in ischemic brain tissue following cerebral infarction in rats 针刺对大鼠脑梗死后缺血脑组织血管生成相关因子表达的影响
Pub Date : 2023-01-12 DOI: 10.1097/HM9.0000000000000054
Yajie Sun, Jing Li, Rainer Georgi, Bernhard Kolberg, Lihong Yang
Background: We aimed to investigate changes into the levels of angiogenesis-associated factors following cerebral infarction and acupuncture intervention and reveal the underlying molecular mechanisms involved in promoting angiogenesis. Methods: Model rats with middle cerebral artery occlusion (MCAO) were randomized into electroacupuncture (EA), model control (MC), and blank control (control) groups. Changes in the degree of neurological impairment following cerebral infarction and angiogenesis in the ischemic center and peripheral area were observed using immunofluorescence double-labeling. Reverse transcription-polymerase chain reaction (RT-PCR) and western blotting were used to detect changes in the Ang-1, Ang-2, PDGF-B, and bFGF levels. Moreover, the effects of EA intervention were evaluated. Results: The neurological severity score of each phase in the EA group was lower than that into the simultaneous phase in the MC group. The proliferation of vascular endothelial cells in the EA group was higher than that in the MC group at 12 hours to 7 days. The Ang-1 and Ang-2 mRNA and protein levels in the EA group were significantly higher than those in the MC group. PDGF-B levels in the EA group were significantly higher than those in the MC group at 3 to 6 hours and 3 to 12 days, and protein levels were high at 6 hours and 3 to 12 days. bFGF mRNA levels at 24 hours to 12 days and bFGF protein at 3 to 12 days were significantly elevated in the EA group than those in the MC group. Conclusions: EA at Shui Gou(DU 26) significantly improved the neurological symptoms of MCAO rats, promoted vascular endothelial cell proliferative activity around the infarct area, significantly advanced the time of proliferation of vascular endothelial cells, and upregulated the expression of angiogenesis-related factors, thereby promoting angiogenesis. Thus, EA may significantly improve the prognosis of cerebral infarction. Graphical abstract: http://links.lww.com/AHM/A43.
背景:我们旨在研究脑梗死和针灸干预后血管生成相关因子水平的变化,揭示促进血管生成的潜在分子机制。方法:将大脑中动脉闭塞(MCAO)模型大鼠随机分为电针组(EA)、模型对照组(MC)和空白对照组(control)。采用免疫荧光双标记法观察脑梗死后神经功能损害程度的变化以及缺血中枢和外周区血管生成的变化。采用逆转录聚合酶链反应(RT-PCR)和western blotting检测Ang-1、Ang-2、PDGF-B和bFGF水平的变化。并对EA干预的效果进行了评价。结果:EA组各期神经系统严重程度评分均低于MC组同期神经系统严重程度评分。12 h ~ 7 d, EA组血管内皮细胞增殖明显高于MC组。EA组的Ang-1和Ang-2 mRNA及蛋白水平显著高于MC组。EA组PDGF-B水平在3 ~ 6小时和3 ~ 12天显著高于MC组,蛋白水平在6小时和3 ~ 12天较高。EA组24 ~ 12 d时bFGF mRNA水平和3 ~ 12 d时bFGF蛋白水平显著高于MC组。结论:水沟EA (du26)可显著改善MCAO大鼠神经系统症状,促进梗死区周围血管内皮细胞增殖活性,显著提前血管内皮细胞增殖时间,上调血管生成相关因子的表达,从而促进血管生成。因此,EA可显著改善脑梗死的预后。图形摘要:http://links.lww.com/AHM/A43。
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引用次数: 2
How to conduct an acupuncture dose–effect relationship study? A discussion based on study methodology 如何进行针灸剂量效应关系研究?基于研究方法的讨论
Pub Date : 2022-12-01 DOI: 10.1097/HM9.0000000000000050
Boxuan Li, Menglong Zhang, Sakhorn Ngaenklangdon, Hailun Jiang, Weiming Zhu, Bifang Zhuo, Chenyang Qin, Yuanhao Lyu, Yuzheng Du, Shizhe Deng, Zhihong Meng
Acupuncture therapy is widely used in the clinic, and its therapeutic effects have been proven by numerous studies. The dose–effect relationship of acupuncture is a fundamental aspect of the acupuncture research system. Recent studies found that different acupuncture dosages altered study results directly, indicating the importance of screening the optimal stimulation dosage. However, the system for studying the acupuncture dose–effect relationship is still in its infancy, and the methodology of the system needs to be improved. This review aimed to define the factors impacting acupuncture “dosage” and “effect,” and to improve the methodological system for research on the dose–effect relationship of acupuncture. By summarizing the current findings of acupuncture dose–effect studies, we discussed the vital acupuncture parameters and methodological problems that influence the relationship between acupuncture dosage and its effects. These factors consist of specific influencing factors (acupoint selection, acupuncture manipulation parameters, de qi response) and nonspecific influencing factors (comparison selection, blinding procedure, patient expectancy). Our perspectives offer suggestions for the design of acupuncture dosage–effect trials. Further studies need to be conducted to establish the methodological system and provide systematic evidence of the acupuncture dose–effect relationship. Graphical abstract: http://links.lww.com/AHM/A37
针灸疗法在临床上被广泛应用,其治疗效果已被大量研究证实。针灸的剂量效应关系是针灸研究体系的一个基本方面。最近的研究发现,不同的针灸剂量直接改变了研究结果,表明筛选最佳刺激剂量的重要性。然而,针灸剂量效应关系的研究体系尚处于起步阶段,研究方法有待完善。本文旨在明确影响针灸“剂量”和“效果”的因素,完善针灸量效关系研究的方法体系。通过总结目前针灸剂量效应研究的发现,我们讨论了影响针灸剂量效应关系的重要针灸参数和方法学问题。这些因素包括特异性影响因素(穴位选择、针刺手法参数、德气反应)和非特异性影响因素(比较选择、盲法程序、患者期望)。我们的观点为针灸剂量效应试验的设计提供了建议。进一步的研究需要建立方法学体系,为针灸的剂量效应关系提供系统的证据。图形摘要:http://links.lww.com/AHM/A37
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引用次数: 0
Identification of key genes and active anti-inflammatory ingredients in Panax medicinal plants by climate-regulated callus culture combined with gene-component-efficacy gray correlation analysis 气候调节愈伤组织培养结合基因-成分-功效灰色关联分析鉴定人参药用植物关键基因和抗炎活性成分
Pub Date : 2022-10-17 DOI: 10.1097/HM9.0000000000000049
Jiao Ai, Yongshen Ren, Long Cheng, Xinqiao Liu, Yan-qiu Li, Majing Jiao, Yingzhou Wang, Xin-Xian Deng, Linlin Chen
Objective: We aimed to establish a novel strategy for identifying key genes and active anti-inflammatory ingredients in Panax medicinal plants. Methods: First, fresh roots of 2-year-old Panax plants, including P. ginseng C. A. Mey., P. quinquefolium L., P. notoginseng (Burk.) F. H. Chen, P. japonicus C.A.Mey., P. japonicus Mey. var. major (Burk.) C. Y. Wu et K. M. Feng, were selected as explants, and callus formation was induced under three experimental temperatures (17, 24, and 30°C). Second, high-performance liquid chromatography-mass spectrometry was used to analyze the saponin content of the callus. Nitric oxide reduction efficacy was used for “component-efficacy” gray correlation analysis to find the active anti-inflammatory ingredients. Quantitative reverse-transcription polymerase chain reaction (qRT-PCR) was used to determine the inflammatory factors and verify the active ingredients’ anti-inflammatory effects. Finally, qRT-PCR was used to detect the expression of key genes in the callus, and “gene-component” gray correlation analysis was used to examine the relationships between the regulatory pathway of the genes and the components. Results: Among the three experimental temperatures (17, 24, and 30°C), the lowest temperature (17°C) is the most suitable for generating Panax callus. Lower-latitude native Panax notoginseng is more adaptable under high culture temperatures (24°C and 30°C) than other Panax plants. The ginsenoside contents of the callus of P. notoginseng and P. japonicus were the highest under similar climate conditions (17°C). Major anti-inflammatory components were G-Rh1, G-Rb1, G-Rg3, and G-Rh6/Floral-GKa. CYP76A47 contributed to the accumulation of anti-inflammatory components. Conclusions: This study provides a strategy for the gene-component-efficacy correlational study of multi-component, multi-functional, and multi-purpose plants of the same genus. Graphical abstract: http://links.lww.com/AHM/A38
目的:建立西洋参药用植物关键基因及抗炎活性成分鉴定的新策略。方法:首先,用2年生的人参(参C. A. Mey.)新鲜根。,西洋参,三七陈富华,陈家祥,陈家祥。, P. japonicus Mey。变体major(伯克)选择Wu c.y.和Feng k.m.作为外植体,在17、24和30℃三个温度下诱导愈伤组织形成。其次,采用高效液相色谱-质谱法分析愈伤组织中皂苷的含量。利用一氧化氮还原功效进行“成分-功效”灰色关联分析,寻找抗炎活性成分。采用定量反转录聚合酶链反应(qRT-PCR)测定炎症因子,验证活性成分的抗炎作用。最后,采用qRT-PCR检测愈伤组织中关键基因的表达,并采用“基因-成分”灰色关联分析检测基因调控通路与成分之间的关系。结果:在17、24、30℃三个实验温度中,最低温度(17℃)最适合人参愈伤组织的产生。低纬度本地三七在高温(24°C和30°C)下的适应性比其他三七植物强。在相同气候条件下(17℃),三七和粳稻愈伤组织人参皂苷含量最高。主要抗炎成分为G-Rh1、G-Rb1、G-Rg3和G-Rh6/ flora - gka。CYP76A47参与抗炎成分的积累。结论:本研究为同一属植物多成分、多功能、多用途的基因-成分-功效相关性研究提供了一种策略。图形摘要:http://links.lww.com/AHM/A38
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引用次数: 1
Tea as a natural gift for discovering antiviral candidates 茶是发现抗病毒候选药物的天然礼物
Pub Date : 2022-10-06 DOI: 10.1097/HM9.0000000000000048
C. Wang, Zhiying Yang, X. Chai, Yuefei Wang, Weili Wang, M. Zhang
Coronavirus disease (COVID-19) remains rampant worldwide and poses a serious threat to human health. Tea is a medicinal and edible homologous plant that exhibits potential anti-SARS-CoV-2 properties via the prevention of virus entry into host cells, inhibition of virus replication, and enhancement of the innate and cellular immune responses. In this review, the properties of six major types of tea were systematically summarized, including green tea, yellow tea, white tea, oolong tea, black tea, and dark tea. We focused on the primary components of tea exhibiting antiviral activities, which included (–)-epigallocatechin-3-gallate, (–)-gallocatechin gallate, tannic acid, oolonghomobisflavan A, theaflavins, and white-tip silver needle flavonoids. Among them, (–)-epigallocatechin-3-gallate is proposed to be an antiviral compound that interferes with the entire life cycle of SARS-CoV-2 by balancing inflammation and immunity. Thus, this compound can serve as a promising lead structure for the development of SARS-CoV-2 inhibitors. Graphical abstract: http://links.lww.com/AHM/A39.
新型冠状病毒病(COVID-19)在全球范围内肆虐,对人类健康构成严重威胁。茶是一种药用和可食用的同源植物,通过防止病毒进入宿主细胞,抑制病毒复制,增强先天和细胞免疫反应,显示出潜在的抗sars - cov -2特性。本文系统总结了绿茶、黄茶、白茶、乌龙茶、红茶、黑茶等六大茶叶的特性。我们重点研究了茶叶中具有抗病毒活性的主要成分,包括(-)-表没食子儿茶素-3-没食子儿茶素没食子酸酯、(-)-没食子儿茶素没食子酸酯、单宁酸、乌龙茶素A、茶黄素和白尖银针类黄酮。其中,(-)-表没食子儿茶素-3-没食子酸酯被认为是一种通过平衡炎症和免疫来干扰SARS-CoV-2整个生命周期的抗病毒化合物。因此,该化合物可以作为开发SARS-CoV-2抑制剂的有希望的先导结构。图形摘要:http://links.lww.com/AHM/A39。
{"title":"Tea as a natural gift for discovering antiviral candidates","authors":"C. Wang, Zhiying Yang, X. Chai, Yuefei Wang, Weili Wang, M. Zhang","doi":"10.1097/HM9.0000000000000048","DOIUrl":"https://doi.org/10.1097/HM9.0000000000000048","url":null,"abstract":"Coronavirus disease (COVID-19) remains rampant worldwide and poses a serious threat to human health. Tea is a medicinal and edible homologous plant that exhibits potential anti-SARS-CoV-2 properties via the prevention of virus entry into host cells, inhibition of virus replication, and enhancement of the innate and cellular immune responses. In this review, the properties of six major types of tea were systematically summarized, including green tea, yellow tea, white tea, oolong tea, black tea, and dark tea. We focused on the primary components of tea exhibiting antiviral activities, which included (–)-epigallocatechin-3-gallate, (–)-gallocatechin gallate, tannic acid, oolonghomobisflavan A, theaflavins, and white-tip silver needle flavonoids. Among them, (–)-epigallocatechin-3-gallate is proposed to be an antiviral compound that interferes with the entire life cycle of SARS-CoV-2 by balancing inflammation and immunity. Thus, this compound can serve as a promising lead structure for the development of SARS-CoV-2 inhibitors. Graphical abstract: http://links.lww.com/AHM/A39.","PeriodicalId":93856,"journal":{"name":"Acupuncture and herbal medicine","volume":"7 1","pages":"211 - 220"},"PeriodicalIF":0.0,"publicationDate":"2022-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79195803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
The exciting and magical journey of components from compound formulae to where they fight 从复方配方到它们战斗的地方的令人兴奋和神奇的旅程
Pub Date : 2022-10-04 DOI: 10.1097/HM9.0000000000000047
N. Meng, Yun Lyu, Xiaoyu Zhang, X. Chai, Kefeng Li, Yuefei Wang
With its long-term empirical clinical practice and increasing number of health benefits reported, Chinese Materia Medica (CMM) is gaining increasing global acceptance. Importantly, the identification of chemical constituents in vitro and exposed forms in vivo is a prerequisite for understanding how CMM formulae prevent and treat diseases. This review systematically summarizes the exciting and magical journey of CMM components from compound formulae to where they fight, the possible structural transformation of CMM components in vitro and in vivo, and their pharmacological contribution. When a decoction is prepared, significant chemical reactions are observed, including degradation and production of polymers and self-assembling supramolecules, leading to the construction of a component library with diverse decoction structures. After ingestion, compounds pass through the intestinal and blood-brain barriers and undergo a more wonderful journey involving the gut microbiota, microbial enzymes, and endogenous drug-metabolizing enzymes (mainly liver enzymes). At this stage, they are modified and assembled into novel and complex compounds, such as newly generated metabolites, conjugates, and self-assembling superamolecules. This review might provide a strategic orientation to explore the active compounds of CMM formulae in vivo.
随着其长期的临床实践和越来越多的健康益处的报道,中药(CMM)正在获得越来越多的全球认可。重要的是,鉴定体外和体内暴露形式的化学成分是了解中药配方如何预防和治疗疾病的先决条件。本文系统地综述了中药成分从复方到作用部位的奇妙历程、中药成分在体内体外可能发生的结构转变及其药理作用。制备汤剂时,观察到显著的化学反应,包括聚合物的降解和产生以及超分子的自组装,从而构建了具有不同汤剂结构的成分库。化合物被摄入后,通过肠道和血脑屏障,经历了一个涉及肠道菌群、微生物酶和内源性药物代谢酶(主要是肝酶)的更加奇妙的旅程。在这个阶段,它们被修饰和组装成新的和复杂的化合物,如新生成的代谢物、偶联物和自组装的超分子。本综述为进一步探索中药复方的体内活性成分提供了战略指导。
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引用次数: 1
Investigating the mechanism of action of Danhong injection and its components against myocardial ischemia–reperfusion injury 探讨丹红注射液及其成分对心肌缺血再灌注损伤的作用机制
Pub Date : 2022-09-27 DOI: 10.1097/HM9.0000000000000040
Peng-Zhen Lei, Charity Ngina Mwangi, Yuanlin Cao, Jingrui Chen, Yuting Huang, Yuefei Wang, Yan Zhu, Guanwei Fan, Miaomiao Jiang
Objective: The surgical treatment of myocardial infarction often causes myocardial ischemia–reperfusion injury (MI/RI). Danhong injection (DHI) has curative effects on coronary heart disease and angina pectoris. However, its therapeutic effects on MI/RI still require further validation. This study aims to investigate the components involved and mechanism of action of DHI against MI/RI. Methods: Primary metabolites (PM) and secondary metabolites (SM) were isolated from DHI. We established a rat model of MI/RI by administering PM, SM, and DHI. Cardiac morphology and functional parameters were evaluated using cardiac ultrasound. The metabolic effects of PM, SM, and DHI in the serum and myocardial tissue on MI/RI were investigated using 1hydrogen-nuclear magnetic resonance. Results: Our study showed that DHI, PM, and SM could improve cardiac function by correcting the dilated cardiac structure, alleviating inflammation by downregulating complement C2 expression, reducing reactive oxygen species (ROS) production by upregulating cyclooxygenase expression, and restoring normal energy supply by inhibiting fatty acid metabolism and stimulating glycometabolism. In addition, DHI and SM could attenuate the calcium overload and trigger an inflammatory response and oxidative stress by downregulating Ca2+/calmodulin-dependent protein kinase II expression. Conclusions: This study suggests that DHI and its components exerts resistance against MI/RI by ameliorating cardiac dysfunction, energy metabolism, and oxidative stress.
目的:心肌梗死手术治疗常引起心肌缺血再灌注损伤(MI/RI)。丹红注射液对冠心病、心绞痛有一定的治疗作用。然而,其治疗MI/RI的效果仍需进一步验证。本研究旨在探讨DHI对MI/RI的作用机制。方法:从DHI中分离初级代谢物(PM)和次级代谢物(SM)。我们通过给药PM、SM和DHI建立大鼠MI/RI模型。采用心脏超声检查心脏形态及功能参数。采用氢核磁共振技术研究血清和心肌组织中PM、SM和DHI对心肌梗死/心肌梗死的代谢影响。结果:我们的研究表明,DHI、PM和SM可以通过纠正扩张的心脏结构改善心功能,通过下调补体C2表达减轻炎症,通过上调环加氧酶表达减少活性氧(ROS)的产生,通过抑制脂肪酸代谢和刺激糖代谢恢复正常的能量供应。此外,DHI和SM可以通过下调Ca2+/钙调素依赖性蛋白激酶II的表达来减轻钙超载,引发炎症反应和氧化应激。结论:本研究提示DHI及其组分通过改善心功能障碍、能量代谢和氧化应激对心肌梗死/心肌梗死有抵抗作用。
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引用次数: 2
YINDARA-4 relieves visceral hypersensitivity in irritable bowel syndrome rats via regulation of gut microbiota and serotonin levels YINDARA-4通过调节肠道微生物群和血清素水平减轻肠易激综合征大鼠内脏过敏
Pub Date : 2022-09-27 DOI: 10.1097/HM9.0000000000000042
Yaqin Ling, Ling Ding, Zhi-Mou Tian, Lingpeng Pei, E. Wu
Objective: The present study aims to evaluate the in vivo efficacy of YINDARA-4 in improving the symptoms of irritable bowel syndrome (IBS) in a rat model and investigate the impact of YINDARA-4 on potential targets of IBS management, such as the serotonin level in intestinal tissues and the structure and composition of the gut microbiota. Methods: We developed an IBS rat model by combining stress from maternal separation, acetic acid administration, and restraint. We administered YINDARA-4 water extract to the IBS rat model for 10 consecutive days. The fecal water content, visceral sensitivity, gut microbiota, and serotonin levels in the colonic tissue were then analyzed and compared between the control group, IBS model group, and YINDARA-4–treated groups. Results: Treatment with YINDARA-4 reversed visceral hypersensitivity in a dose-dependent manner in the experimental rat model of IBS. The relief of visceral hypersensitivity upon treatment with YINDARA-4 involved regulation of the gut microbiota structure and composition, and normalization of elevated serotonin levels in the colon. The decrease in colonic serotonin levels with YINDARA-4 treatment might be associated with a reduction in the abundance of Helicobacter and enrichment of Butyricimonas. Conclusions: Treatment with YINDARA-4 was beneficial against visceral hypersensitivity in a rat model of IBS. The improved symptoms exhibited in IBS rats were associated with favorably altered gut microbiota and normalization of serotonin levels in the colon.
目的:本研究旨在评价YINDARA-4在改善肠易激综合征(IBS)大鼠模型中的体内疗效,并探讨YINDARA-4对肠组织血清素水平和肠道菌群结构组成等IBS治疗的潜在靶点的影响。方法:采用分离应激、醋酸应激和约束应激相结合的方法建立IBS大鼠模型。我们给IBS大鼠模型连续10天给予YINDARA-4水提物。然后分析比较对照组、IBS模型组和yindara -4治疗组大鼠粪便含水量、内脏敏感性、肠道微生物群和结肠组织血清素水平。结果:在IBS实验大鼠模型中,YINDARA-4以剂量依赖的方式逆转内脏超敏反应。使用YINDARA-4治疗后内脏过敏的缓解涉及调节肠道微生物群的结构和组成,以及使结肠中升高的血清素水平正常化。经YINDARA-4治疗后结肠血清素水平的降低可能与幽门螺杆菌丰度的降低和丁酸单胞菌的富集有关。结论:YINDARA-4对肠易激综合征模型大鼠内脏超敏反应有利。肠易激综合征大鼠症状的改善与肠道菌群的良好改变和结肠血清素水平的正常化有关。
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引用次数: 2
Extracellular vesicle–based drug delivery system boosts phytochemicals’ therapeutic effect for neurodegenerative diseases 细胞外囊泡给药系统提高植物化学物质对神经退行性疾病的治疗效果
Pub Date : 2022-09-27 DOI: 10.1097/HM9.0000000000000039
Zhenzhu Zhu, Liuyue Liao, Hongzhi Qiao
Neurodegenerative diseases (NDs) are a major threat to the elderly, and efficient therapy is rarely available. A group of phytochemicals has been shown to ameliorate NDs; however, poor stability, low bioavailability, and reduced drug accumulation in brain tissue limit their application in NDs. Therefore, a targeted drug delivery system is a feasible treatment strategy for NDs. Extracellular vesicles (EVs) possess many favorable bioactivities and are excellent carriers for targeting brain tissue. This review summarizes EVs as novel phytochemical carriers in ND therapy. First, we discuss the current challenges of ND therapy and the therapeutic effects of phytochemicals for NDs. Second, we highlight the ability of EVs to cross the blood-brain barrier and act as drug carriers to enhance the therapeutic efficacy of drugs for NDs. Finally, encapsulation strategies for phytochemicals in EVs are particularly reviewed, as they are critical for obtaining high loading efficacy and stable drug delivery systems. This review provides new insights into EV-based drug delivery systems for improving the therapeutic effect of phytochemicals for ND treatment. Therefore, the release rate and pharmacokinetics of phytochemicals should be well controlled to ensure the therapeutic efficacy of phytochemical-loaded EVs in the brain.
神经退行性疾病(NDs)是老年人的主要威胁,有效的治疗方法很少。一组植物化学物质已被证明可以改善NDs;然而,稳定性差、生物利用度低以及药物在脑组织中的积累减少限制了它们在ndds中的应用。因此,靶向给药系统是一种可行的NDs治疗策略。细胞外囊泡(EVs)具有许多良好的生物活性,是靶向脑组织的优良载体。本文综述了ev作为ND治疗中的新型植物化学载体。首先,我们讨论了目前ND治疗的挑战和植物化学物质对ND的治疗效果。其次,我们强调了ev通过血脑屏障并作为药物载体的能力,以提高药物对NDs的治疗效果。最后,特别回顾了植物化学物质在电动汽车中的包封策略,因为它们对于获得高负载效率和稳定的给药系统至关重要。本文综述了以ev为基础的药物传递系统,为提高植物化学物质治疗ND的疗效提供了新的见解。因此,必须控制好植物化学物质的释放速度和药代动力学,以确保装载植物化学物质的ev在脑内的治疗效果。
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引用次数: 5
Chinese herbal medicine and COVID-19: quality evaluation of clinical guidelines and expert consensus and analysis of key recommendations. 中草药与新冠肺炎:临床指南和专家共识的质量评估和关键建议的分析。
Pub Date : 2022-09-01 Epub Date: 2022-12-08 DOI: 10.1097/HM9.0000000000000043
Qingyong Zheng, Ya Gao, Lu Xiong, Hengyi Huang, Junfen Li, Guoyuan OuYang, Wulayin Saimire, Jingjing Yang, Yu Zhang, Xiaopeng Wang, Xiaofeng Luo

To systematically review the clinical practice guidelines (CPGs) for the treatment of patients with coronavirus disease 2019 (COVID-19) using Chinese herbal medicine (CHM), assess the methodological quality as well as clinical credibility and implementability of specific recommendations, and summarize key recommendations.

Methods: As of April 2022, we conducted a comprehensive search on major electronic databases, guideline websites, academic society websites, and government websites to assess the methodological quality and clinical applicability of the included CPGs using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool and Evaluation-Recommendations EXcellence (AGREE-REX) instructions, respectively.

Results: The search yielded 61 CPGs, which were mostly published in 2020; moreover, 98.4% of the CPGs were published in China. Only five CPGs achieved a high-quality AGREE II rating; further, six CPGs could be directly recommended, with most of the CPGs still showing much room for improvement. CPGs had a low overall score in the AGREE-REX evaluation, with the domains of clinical applicability, values and preferences, and implementability being standardized in 21.80% ± 12.56%, 16.00% ± 11.81%, and 31.33% ± 14.55% of the CPGs, respectively. Five high-quality CPGs mentioned 56 Chinese herbal formulas. Half of the recommendations had moderate or strong evidence level in the GRADE evaluation. The most frequently recommended herbal medicines were Lianhua Qingwen granule/capsule and Jinhua Qinggan granule; however, the strength of recommendation for each prescription varied across CPGs and populations.

Conclusions: The overall quality of current CPGs for COVID-19 for CHM still needs to be improved; moreover, the strength of the evidence remains to be standardized across CPGs.

Graphical abstract: http://links.lww.com/AHM/A34.

系统回顾2019冠状病毒病(新冠肺炎)患者使用中草药(CHM)治疗的临床实践指南(CPGs),评估具体建议的方法学质量、临床可信度和可实施性,并总结关键建议。方法:截至2022年4月,我们在主要电子数据库、指南网站、学术协会网站和政府网站上进行了全面搜索,以使用研究与评估指南评估(AGREE)II工具和评估建议执行(AGREE-REX)说明评估纳入的CPG的方法学质量和临床适用性,分别地结果:搜索产生了61个CPG,大部分发表在2020年;此外,98.4%的CPG是在中国发表的。只有五个CPG获得了高质量的AGREE II评级;此外,可以直接推荐六个CPG,其中大多数CPG仍有很大的改进空间。CPG在AGREE-REX评估中的总体得分较低,临床适用性、价值观和偏好以及可实施性领域的标准化率为21.80% ± 12.56%、16.00% ± 11.81%和31.33% ± 占CPG的14.55%。五个高质量的CPG提到了56个中草药配方。在GRADE评估中,一半的建议具有中等或强烈的证据水平。推荐次数最多的中药为连花清瘟颗粒/胶囊和金华清肝颗粒;然而,每种处方的推荐力度因CPG和人群而异。结论:目前中药新冠肺炎CPG的总体质量仍有待提高;此外,证据的强度仍有待于CPG的标准化。图形摘要:http://links.lww.com/AHM/A34.
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Acupuncture and herbal medicine
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