Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan最新文献

Objective: To evaluate the clinical efficacy and safety of Dongtian Changchun ointment (, DTCO) for the treatment of patients with stable moderate-to-severe chronic obstructive pulmonary disease (COPD).

Methods: This was a multicenter, prospective, open-label, randomized controlled trial. Patients with COPD who met the inclusion and exclusion criteria were randomly divided into a DTCO group and a control group in a 1∶1 ratio. Both groups were treated with Symbicort Turbuhaler (320 μg / 9 μg twice daily) for 48 weeks. The DTCO group was given additional DTCO (15 g twice daily) for the first 12 weeks. Outcome assessments were conducted at five time points: 0, 12, 24, 36, and 48 weeks. Primary outcome measures included frequency and duration of acute exacerbation of COPD (AECOPD). Secondary outcomes included St. George's Breathing Questionnaire, pulmonary function, 6-min walk test, and modified Medical Research Council (mMRC) scores.

Results: A total of 84 patients were randomly divided into the DTCO group (n = 42) and the control group (n = 42). The results showed that in the DTCO group, 23 patients had AECOPD for a total duration of 166 d compared with 31 patients in the control group for a total duration of 307 d. Compared with the control group, the DTCO group showed a significant reduction in the median (interquartile range) frequency and duration of AECOPD (P < 0.05). The incidence of AECOPD significantly reduced in the DTCO group to 0.539 [95% confidence interval (0.347, 0.836), P = 0.006]. In the DTCO group, a significant improvement in forced vital capacity was observed at 12 and 48 weeks (P < 0.05), and a reduction in mMRC was noted at 36 and 48 weeks (P < 0.05). There was no significant difference in the incidence of adverse events between the two groups.

Conclusions: DTCO significantly reduced the frequency and duration of AECOPD in patients with moderate-to-severe COPD, and demonstrated satisfactory safety.

Objective: To examine the effect of Xuanfei Tongqiao acupuncture on nasal inflammation in rats with allergic rhinitis (AR) and its underlying mechanisms, particularly focusing on the role of acupuncture in regulating the methylation of long non-coding RNA growth arrest-specific transcript 5 (lncRNA GAS5).

Methods: Interventions involved acupuncture or short hairpin RNA-GAS5 (sh-GAS5) lentivirus in an ovalbumin-induced AR rat model. Nasal mucosal tissues were collected post-intervention for pathological analysis. Parameters assessed included the proportion of type 2 innate lymphoid cells (ILC2s), the expression of GATA binding protein 3 (GATA3), methyltransferase-like 3 (METTL3), interleukin (IL)-33 proteins, and the expression of METTL3 and lncRNA-GAS5.

Results: Xuanfei Tongqiao acupuncture and/or lentivirus sh-GAS5 significantly alleviated rhinitis symptoms and reduced nasal inflammation in AR rats. This was evidenced by a reduction in inflammatory cells, eosinophils, and cuprocytes in nasal mucosal tissues, along with a decreased proportion of ILC2s. Furthermore, protein levels of GATA3, METTL3, and IL-33, as well as the expression of METTL3 and lncRNA-GAS5, were significantly reduced. These findings suggest that lncRNA-GAS5 and its N6-methyladenosine methylation are key regulators of AR inflammation, with acupuncture exerting a modulatory effect on this pathway.

Conclusions: Xuanfei Tongqiao acupuncture therapy inhibited the METTL3-GAS5-GATA3-IL-33-ILC2 pathway, reducing the inflammatory response and alleviating nasal symptoms in AR rats. These results suggest that Xuanfei Tongqiao acupuncture could serve as a potential alternative therapy for preventing and managing AR associated with inflammation.

Objective: To identify key elements for screening kidney deficiency pattern (KDP) through a systematic review and Delphi methodology to detect high-risk KDP groups.

Methods: We first conducted a systematic review to extract kidney system patterns and then performed four rounds of the Delphi. After the third round, two face-to-face consensus meetings were held to finalize the consensus. The English version of the KDP Screening Questionnaire (KDPScreenQ) was developed through agreement between a bilingual physician and the research team.

Results: A systematic review identified 35 studies that predominantly focused on KDP, KDP-Yin, and KDP-Yang. Twenty-two common symptoms were reported in five or more studies. A panel of ten experts, including specialists in internal medicine and diagnostics, participated in all four rounds of the Delphi process. The final KDPScreenQ comprises 20 key elements. Key elements for KDP include lassitude; weakness, and pain in the lumbar region and knee joints (four items); reduced libido or sexual dysfunction; tinnitus or deafness; urinary incontinence (two items); thinning and loss of hair; forgetfulness; loose teeth and weak gums. Key elements for KDP-Yin include heat sensation in the palms and feet; a sensation of heat and tightness in the chest (particularly in the afternoon); night sweats; and dry mouth. Key elements for KDP-Yang include aversion to cold; edema; early morning diarrhea; and loose stools.

Conclusion: The KDPScreenQ is a fundamental tool for standardizing KDP differentiation, serving both to screen patients with KDP and to track their long-term prognosis. This questionnaire will next be used in a prospective observational study to determine cut-off values.

Objective: To investigate the therapeutic effects of Huai'er (Trametes) on psoriasis by identifying specific molecular targets and pathways involved in regulating keratinocyte behavior and immune responses.

Methods: Cellular experiments were conducted using human keratinocyte cell line (HaCaT) keratinocytes to evaluate the effects of Huai'er (Trametes) on cell proliferation, migration, and inflammatory factor expression. Additionally, an imiquimod (IMQ)-induced psoriasis-like mouse model was established to assess the therapeutic efficacy of Huai'er (Trametes) in vivo. Network pharmacology and transcriptomic analyses were performed to identify potential targets and pathways.

Results: Huai'er (Trametes) significantly inhibited HaCaT keratinocyte proliferation and migration in vitro, as evidenced by reduced 5-ethynyl-2'-deoxyuridine incorporation and wound healing rates. In the IMQ-induced psoriasis-like mouse model, Huai'er (Trametes) treatment reduced erythema, scaling, and dermal infiltration of inflammatory cells, demonstrating its efficacy in alleviating psoriasis symptoms. Network pharmacology and transcriptomic analyses identified signal transducer and activator of transcription 1 (STAT1) as a central target modulated by Huai'er (Trametes). This regulation was associated with decreased expression of pro-inflammatory cytokines, including interleukin-17A and tumor necrosis factor alpha, both in vitro and in vivo.

Conclusion: This study demonstrates that Huai'er (Trametes) exerts therapeutic effects on psoriasis by modulating STAT1, thereby inhibiting keratinocyte proliferation and inflammatory responses. The findings provide a foundation for further research into the potential of Huai'er (Trametes) as a treatment for psoriasis.

Objective: To access the effectuveness of four different types of Chinese traditional Qigong exercises in the management of cervical spondylosis.

Methods: Observational studies published up to July 2024 were searched in online databases: China National Knowledge Infrastructure Database, Wanfang, China Science and Technology Journal Database, SinoMed, PubMed, Cochrane Library, Embase, and Web of Science). The quality of the included randomized controlled trial (RCT) was evaluated using the Cochrane risk-of-bias tool. A total of 623 studies were retrieved, of which 44 were considered eligible. Four kinds of Chinese traditional Qigong exercises were involved, including Tai Chi, Baduanjin, Yijinjing and Wuqinxi.

Results: In the treatment of cervical spondylosis, Baduanjin, Yijinjing, Tai Chi, Wuqinxi plus standard of care (SOC) were more effective than SOC in improving the comprehensive curative effect, reducing the index of neck disability index, visual analogue scale and Yasuhisa Tanaka Cervial Spine Assessment Questionnaire.

Conclusion: Chinese traditional Qigong exercises are recommended as a treatment option for cervical spondylosis.

Objective: To elucidate the possible mechanism of Jiawei Erzhi pill (, JWEZP) in the treatment of atherosclerosis (AS).

Methods: The chemical constituents of JWEZP were identified using ultra-performance liquid chromatography-mass spectrometry. A high-fat diet (HFD) was used to establish AS models in ApoE^-/- mice. The ApoE^-/- mice were randomly divided into the Model (normal saline), Simvastatin (normal saline), Low-dose JWEZP, Medium-dose JWEZP and High-dose JWEZP groups (n = 15), and C57BL/6 mice on a normal diet were used as the control group. Mice were treated with JWEZP at different doses (3.9, 7.8, 15.6 g·kg?¹·d?¹) or with simvastatin (2.6 mg·kg?¹·d?¹) for ten weeks. The inhibitory effects of JWEZP on AS were assessed by measuring serum lipid levels and changes in atherosclerotic plaques, lipid peroxidation and ferroptosis. Common targets and key regulatory pathways of JWEZP-mediated inhibition of ferroptosis were predicted using network pharmacology and verified using real-time quantitative polymerase chain reaction (RT-qPCR) and Western blotting.

Results: We identified 46 active compounds in JWEZP. Mice in the JWEZP group had lower body weights and serum cholesterol levels compared to HFD mice. The results of Hematoxylin-Eosin and Oil Red O staining showed that JWEZP alleviated AS. Masson staining showed that JWEZP improved the stability of atherosclerotic plaques. In addition, JWEZP-treated mice had lower levels of reactive oxygen species (ROS) in thoracic aortic tissue according to ROS fluorescence staining. The ELISA results showed that JWEZP decreased the levels of iron, lipid peroxide, malondialdehyde and nicotinamide adenine dinucleotide phosphate and increased the levels of glutathione (GSH) and GSH-PX in the thoracic aortic tissues of mice. The expression of glutathione peroxidase 4 in the thoracic aorta of mice in the JWEZP group was upregulated in the results of the immunofluorescence assay. Network pharmacology results indicated that the action mechanisms of JWEZP-mediated inhibition of ferroptosis were closely related to the p53, mitogen-activated protein kinase (MAPK), and phosphatidylinositol 3-kinase (PI3K)/ protein kinase B (Akt) signaling pathways. RT-qPCR and Western blotting results demonstrated that JWEZP inhibited the p53 and MAPK pathways, and activated the PI3K/Akt pathway to regulate ferroptosis.

Conclusion: JWEZP improved AS by inhibiting ferroptosis. The study provides a scientific basis for further research and validation of JWEZP as a potential therapeutic for AS.

Objective: To investigate the hypoglycemic mechanism of modified Gegen Qinlian decoction (，MGQD) by examining its regulation of cholesterol transporter expression and DNA methylation, specifically the low-density lipoprotein receptor (LDLR) and scavenger receptor class B type 1 (SR-B1), in epididymal white adipose tissue (eWAT) and inguinal white adipose tissue (iWAT) of rats with type 2 diabetes mellitus (T2DM).

Methods: The control group (CON) consisted of ten Sprague-Dawley (SD) rats fed a standard chow diet, while 80 SD rats were fed a high-fat diet and administered streptozotocin intraperitoneally to induce diabetes. The diabetic rats were randomly assigned to four groups: T2DM, metformin (MET, 200 mg/kg), low-dose MGQD (MGQDL, 5 g/kg), and high-dose MGQD (MGQDH, 10 g/kg), and received treatment via gavage for 14 weeks. Western blot (WB), quantitative real-time polymerase chain reaction (qPCR), and bisulfite sequencing PCR (BSP) were used to analyze protein levels, mRNA expression, and DNA methylation of Ldlr (gene encoding LDLR) and Srb1(gene encoding SR-B1).

Results: MGQD and metformin treatment significantly reduced blood glucose levels, restored LDLR and SR-B1 protein levels in eWAT, and effectively regulated the mRNA expression and non-cytosine-p-guanine (non-CpG) methylation of Srb1 in eWAT. A significant negative correlation was observed between the methylation of Srb1 in eWAT and its mRNA expression. However, MGQD and metformin had no significant effect on the protein levels, mRNA expression, or DNA methylation of Ldlr and Srb1 in iWAT.

Conclusions: MGQD did not significantly affect LDLR and SR-B1 expression or gene methylation in iWAT. However, its hypoglycemic effect may be linked to cholesterol regulation in eWAT. Potential mechanisms include increased LDLR protein levels, which may enhance cholesterol uptake, and increased Srb1 methylation, which may suppress its expression and consequently reduce cholesterol efflux.

Objective: Antibiotics are the main drugs used to treat bacterial infections, which have been extensively utilized across various fields. However, the problem of antimicrobial resistance (AMR) has greatly limited its use, leading to the creation of various superbugs such as Methicillin-resistant Staphylococcus aureus (MRSA), making antibiotics less effective, become a major global public health challenge. MRSA, which is resistant to most β-lactam and cephalosporin antibiotics, poses a significant threat to public health. Combination therapy has shown promise as a strategy to combat multi-drug-resistant bacteria. Chinese medicine also has potential applications in this field. Thus, we tried to find a new approach to overcoming MRSA by combining Chinese herb and penicillin G sodium (PGS).

Methods: The antibacterial activity of Guanghuoxiang (Herba Pogostemonis) samples was investigated by turbidimetry. Then using the checkerboard assay, live/ dead bacterial staining and scanning electron microscopy (SEM) to investigate whether the combination of Guanghuoxiang (Herba Pogostemonis) samples and PGS could improve the sensitivity of MRSA, and metabolomics was used to investigate the underlying mechanisms.

Results: In this study, we find that the Guanghuoxiang (Herba Pogostemonis) samples had good inhibitory effects on MRSA, and showed a synergistic effect when combined with PGS, enhancing the sensitivity of MRSA to PGS. Metabolomics data further revealed that this combination exerts a broader impact on the energy and material metabolism of the bacteria, resulting in improved antibacterial efficacy.

Conclusion: Combining Guanghuoxiang (Herba Pogostemonis) with antibiotics could improve the sensitivity of drug-resistant bacteria, provided a new direction for solving the problem of AMR, and offered a valuable strategy for clinical response to MRSA.

Objective: To investigate the possible mechanisms by which acupuncture improves post-stroke limb spasticity using single-cell sequencing technology.

Methods: Thirty-two rats were randomly assigned to four groups: Control, Sham, Model, and Acupuncture. The middle cerebral artery occlusion (MCAO) model was established, and the acupuncture groups received acupuncture treatment. After treatment, brain morphological changes and the degree of neurological impairment were assessed. The effect of acupuncture on the proportion of brain cell types in the ischemic penumbra of MCAO rats was analyzed using single-cell transcriptomics, and the expression and enrichment of differentially expressed genes were examined. Finally, selected differential genes were validated by Western blot and quantitative real-time polymerase chain reaction.

Results: Triphenyltetrazolium chloride staining showed that the infarct area in MCAO rats was significantly reduced after acupuncture. Garcia scoring, hematoxylin-eosin staining, Nissl staining, and terminal deoxynucleotidyl transferase dUTP nick end labeling demonstrated that acupuncture reduced brain damage. Enzyme-linked immunosorbent assay results showed that acupuncture significantly decreased serum inflammatory factors, including interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α). Single-cell transcriptome analysis revealed marked changes in cell type proportions between the Acupuncture and Model groups. A total of 207 differential genes were identified, including 157 upregulated and 50 downregulated genes. Analysis of macrophage-specific differential genes in the ischemic penumbra showed enrichment in Gene Ontology terms such as Ras protein signal transduction and regulation of GTPase activity, and Kyoto Encyclopedia of Genes and Genomes pathways including lysosome, axon guidance, and mitogen-activated protein kinase signaling. S100a8 and leukocyte specific transcript 1 (LST1) were identified as key differential genes.

Conclusion: These findings suggest that the key differential genes S100a8 and LST1 may alleviate post-stroke limb spasticity by regulating the inflammatory response in the ischemic penumbra.