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 acupuncture for postpartum depression group.

Methods: A total of 84 participants were allocated into the acupuncture (n = 59) and blank control (BC; n = 25) groups. Participants in the acupuncture group received acupuncture therapy twice a week for 16 sessions in total, while participants in the BC group received no medical intervention. The primary outcomes were the response and elimination rates. The secondary outcome measures were the scores of the 17-item Hamilton Depression Rating Scale (HDRS17) and the factor analysis of the HDRS17.

Results: Compared to the BC group, the acupuncture group showed significant improvement in response and elimination rates (both P < 0.05). A significant difference at week 8 was found in the between-group HDRS17 score alterations [RR = －3.04, 95% CI (－5.16, －0.92), P < 0.05]. In addition, the reduction in depression and insomnia in the acupuncture group was greater than that in the BC group [between-group difference, depression: RR =1.20, 95% CI (0.14, 2.26), P < 0.05; insomnia: RR = 0.89, 95% CI (0.16, 1.62), P < 0.05]. There were no severe adverse events in our study.

Conclusion: Acupuncture alleviated the severity of postpartum depressive symptoms compared to the control condition, and no serious adverse events occurred during the treatment.

Objective: To develop a safe and effective green therapy for triple-negative breast cancer, this study combines hydrogen-rich water with acupuncture point injection, and finds that it can prevent tumor growth and minimize cancer metastasis.

Methods: After 21 d of hydrogen rich water injection treatment on 4T1 (mouse breast cancer cells) xenograft mice, in order to systematically identify differentially expressed proteins in tumor samples between the model group and the Zusanli (ST36) group injected with hydrogen rich water at acupoints, with a focus on functional proteins or signaling pathways related to tumor occurrence and development, researchers conducted four-dimensional data independent acquisition (4D-DIA) proteomic analysis on tumor tissues. In order to further investigate the dynamic changes of metabolites after therapeutic intervention, researchers conducted liquid chromatography-tandem mass spectrometry untargeted metabolomics identification and analysis on mouse serum. The results of the joint proteomics-metabolomics analysis were validated using experimental methods such as immunofluorescence, Western blotting, and quantitative reverse transcription polymerase chain reaction detection.

Results: Injecting hydrogen-rich water into acupoints significantly inhibited tumor growth (P < 0.05). 4D-DIA proteomics and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses uncovered pathways such as T helper 1 cell (Th1) and T helper 2 cell (Th2) cell differentiation. The KEGG metabolic pathways identified in the metabolomics analysis included galactose metabolism along with fructose and mannose metabolism. Based on the combined proteomics and metabolomics analysis, the key pathways included the C-type lectin receptor signaling pathway. The major cancer-related differential proteins detected in Th1 and Th2 cell differentiation [interleukin 6 signal transducer, nuclear factor of activated T cells 4, recombinant mitogen activated protein kinase 10 (MAPK10), and MAPK11] were upregulated after the injection of hydrogen-rich water into the Zusanli (ST36) acupoint, whereas Linker for activation of T cells (Lat), signal transducer and activator of transcription 1, and protein kinase C, theta were downregulated.

Conclusion: The injection of hydrogen-rich water into the Zusanli (ST36) acupoint effectively inhibited the hyperplasia of 4T1 BC cells and enhanced their apoptosis, potentially exerting a therapeutic effect through multiple pathways and targeting various sites.

Objective: To explore the mechanism of Wenshen Zhuanggu Fang (, WSZG) against breast cancer bone metastasis from the perspective of macrophage polarization through bioinformatics and experiments.

Methods: Bioinformatics study was used to explore the mechanism underlying the effect of WSZG on breast cancer bone metastasis. Cell viability, migration, invasion and apoptosis assays were performed to detect the influence of WSZG on breast cancer cell MDA-MB-231BO promoted by macrophages. The protein expression level and cytokine content were detected by western blot and enzyme-linked immunosorbent assay kit in vitro. Tumor growth in vivo were performed to evaluate the effects of WSZG on breast cancer bone metastasis. M2/M1 ratio and the maker protein expression were detected by flow cytometry analysis, immun-ohistochemistry and immunofluorescence double staining.

Results: M2 macrophages associated with poor prognosis and may lead to secondary bone metastasis in patients with triple-negative breast cancer. WSZG could treat breast cancer bone metastasis through regulating macrophage polarization by signal transducers and transcription signaling activators (STAT) signaling pathway. WSZG downregulated STAT6, CD206 and Arginase-1, while upregulated STAT1 and Inducible Nitric Oxide Synthase, thus inhibited the M2 macrophage-promoted invasion and migration capabilities of MDA-MB-231BO cells. WSZG treatment suppressed the bone metastasis of breast cancer, and the M2/M1 ratio was reduced by regulating STAT expression in bone metastatic tissue.

Conclusion: WSZG inhibited breast cancer bone metastasis by adjusting the promoting effect of macrophages on MDA-MB-231BO breast cancer cells and decreasing M2 polarization by downregulating STAT signaling.

Objective: To explore the mechanism of Tonglaga-5 (-5, TLG-5) for the treatment of chronic atrophic gastritis (CAG), based on network pharmacology and metabolomics.

Methods: Forty-eight male Sprague-Dawley rats were randomly divided into six groups (n = 8): control group; model group; teprenone group, and low-, median-, and high- dose TLG-5 groups. The enzyme linked immunosorbent assay (ELISA) was used to measure the expression of pepsinogen Ⅰ (PG Ⅰ), pepsinogen Ⅱ (PG Ⅱ) and gastrin-17 (G-17) in the serum. Hematoxylin and eosin staining were performed to observe the pathological condition. And the network pharmacology was employed to identify the targets and signaling pathways of TLG-5 affecting CAG. Then, the metabolomics approach was applied to explore the specific metabolites and metabolic pathways. Finally, validation was performed using the "metabolite-gene" interaction network, molecular docking and quantitative real-time polymerase chain reaction (qPCR).

Results: High-dose TLG-5 significantly improved the expression of PG Ⅰ, PGR (PG Ⅰ/ PG Ⅱ) and G-17 (P < 0.05) and inhibited the expression of phosphoinositide-3-kinase regulatory subunit 2, AKT serine/threonine kinase (AKT), hypoxia-inducible factor 1-alpha (HIF-1α) (P < 0.05). Further, high-dose TLG-5 reduced the number of glands was reduced, and fibrosis with oedema and ecchymosis appeared at the base. Overlapping TLG-5 and CAG gene targets produced 270 interactive targets. The results of gene ontology and Kyoto encyclopedia of genes and genomes enrichment analyses suggested that TLG-5 could affect CAG through the predominantly cancer and inflammation-related pathways. Pyrimidine metabolism was identified as a significantly differential pathway in the mechanism of TLG-5 for treating CAG.

Conclusions: TLG-5 exerts a therapeutic effect on CAG by regulating β-alanine metabolism, pyrimidine metabolism pathways, and inhibiting the PI3K-AKT signaling pathway and HIF-1 signaling pathways.

Objective: To explore the clinical efficacy and potential mechanisms of Huoxue Jiedu prescription in the treatment of polycythemia vera and provide objective basis for the treatment of polycythemia vera by using network pharmacology, molecular docking technology, and clinical trials.

Methods: First, network pharmacology and molecular docking analysis methods were used to screen the main targets of Huoxue Jiedu prescription in the treatment of polycythemia vera. Patients who were first diagnosed with polycythemia vera in the Hematology Department of Langfang Hospital of Traditional Chinese Medicine from September 2022 to January 2024 were enrolled, and a clinical randomized controlled study was conducted. Sixty patients with primary polycythemia who met the inclusion criteria were randomly divided into the treatment group and the control group, with 30 cases in each group. The control group received oral Western Medicine treatment, whereas the treatment group received oral Western Medicine combined with Huoxue Jiedu prescription treatment, and three courses were observed. The differences in the efficacy of Traditional Chinese and Western Medicine, hematological indicators, coagulation function, and expression of related targets before and after treatment were observed between the two groups. SPSS 26.0 statistical software was used for data analysis, and the treatment results of the two groups were compared to observe their clinical efficacy and mechanisms.

Results: Network pharmacology results identified the phosphatidyqinositol-3 kinase (PI3K-Akt) pathway as an important pathway of Huoxue Jiedu prescription in the treatment of polycythemia veraPV, which was closely related to thrombosis. Clinical trial results showed that Huoxue Jiedu prescription improved efficacy and hematological indicators, reduced patients' coagulation indicators such as D-dimer and fibrinogen, reduced activated partial thromboplastin time and prothrombin time, and decreased the expression of PI3K and Serine/threonine-protein kinase AKT1 (AKT1) mRNA in peripheral blood.

Conclusion: Network pharmacology predicted the corresponding targets of traditional Chinese medicine to a certain extent. Huoxue Jiedu prescription could enhance clinical efficacy, improve hematological indicators, and reduce coagulation indicators through antithrombotic effect by inhibiting the expression of PI3K and AKT1.

Objective: To explore the effect of Chang'an decoction (, CAD) of ameliorating the immune imbalances in ulcerative colitis (UC) by regulating Rab27 in the P53/high mobility group box 1 pathway.

Methods: The functions and important signaling pathways of the Rab27- and UC-related genes were analyzed viathe use of microarray data from the gene expression omnibus database, gene ontology database, Kyoto encyclopedia of genes and genomes database and gene set enrichment analysis. Dextran sulfate sodium salt-induced colitis mouse model was used to verify the bioinformatics results. Colon length, body weight, and disease activity index were measured. Hematoxylin and eosin staining was applied to validate the histopathology. Tight junction proteins were detected by immunohistochemistry. The proportions of T helper 17 cells (Th17) and regulatory T cells (Treg) in mesenteric lymph nodes were measured viaflow cytometry. Proinflammatory cytokines like interleukin (IL) 17 (IL-17), IL-21 and IL-22 and anti-inflammatory cytokines like transforming growth factor β and IL-10 in the serum and colon of mice were detected by enzyme-linked immunosorbent assay and quantitative real-time polymerase chain reaction, respectively. The expression levels of high mobility group box 1 (HMGB1), P53 and phospho- P53 (P-P53) in colonic tissues were detected by immunofluorescence and Western blotting.

Results: Bioinformatics analysis revealed that compared with normal tissues, the expression of Rab27 was significantly increased in UC tissues. Receiver operating characteristic curve showed that Rab27 has the potential to be used as a biomarker for the diagnosis of disease activity. Enrichment analysis showed that UC and Rab27 were mainly associated with small molecule transport, nutrient metabolism, transmembrane transport and the downstream pathway of P53. According to animal experiments, the expression of Rab27 was increased in UC tissues, which aggravated the colonic pathological damage, activated the expression of HMGB1, and also leaded to the imbalance of Th17 and Treg cells. After CAD intervention, Rab27 overexpression, weight loss, colon shortening, and pathological damage were substantial reduced, the expression of tight junction proteins, zona occludens 1 and Occludin were increased. The effect of CAD at high-dose was more obvious. In addition, CAD upgraded the number of Treg cells and the production of TGF-β and IL-10, while decreasing the number of Th17 cells and the expression of inflammatory cytokines (IL-17, IL-21, and IL-22). Moreover, colon inflammation was alleviated by CAD, as indicated by the regulation of HMGB1 and P-P53 expression.

Conclusion: The expression of Rab27, HMGB1 and P-P53 could be decreased by CAD, and the balance of Th17 and Treg cells as well as their related cytokines could be regulated by CAD.

Primary liver cancer (PLC) is the third major cause of cancer related death, which seriously affects the survival period and quality of life of patients. However, there is currently no evidence to prove which treatment method is most effective. Traditional Chinese Medicine (TCM) has shown certain advantages in the treatment of PLC, especially in the side effects of Western Medicine. Therefore, we designed a clinical trial protocol for the treatment of PLC using TCM granules. Our purpose is to explore the efficacy and safety of Yangxiao Fukang granule (YXFKG, ) in the treatment of stage III hepatitis B related PLC. A total of 216 patients from three hospitals in Henan Province will be enrolled and randomly divided into a trial group and a control group in a 1∶1 ratio. The trial group will be treated with conventional western medicine plus YXFKG, while the control group will receive conventional western medicine plus a placebo for YXFKG. All patients will receive a daily dose of either YXFKG or a placebo for six months, followed by a six-month follow-up period. The main observation outcome includes 1-year survival rate, while secondary outcomes include conversion rate to remission, objective response rate, progression free survival, overall survival, quality of life score, and TCM clinical symptom score. Blood routine, urine routine, stool routine, electrocardiogram, liver and kidney function, coagulation function test, and D-dimer are safety indicators. Collect data before treatment and during the 3rd, 6th, 9th, and 12th months of treatment, and conduct statistical analysis. This study will preliminarily verify the effectiveness and safety of YXFKG in the treatment of stage III hepatitis B related PLC, which may provide a new choice for clinical treatment of PLC.

Objective: To explore the active compounds and the mechanism of Shenfu decoction (, SFD) against ischemic stroke (IS) through network pharmacology and animal experiments.

Methods: SFD components were retrieved from the Traditional Chinese Medicine (TCM) database. The Online Mendelian Inheritance in Man (OMIM), Comparative Toxicogenomics Database (CTD) and Therapeutic Target Database (TTD) database were used to retrieve the IS-related disease targets. The herb-compound-target network was built by Cytoscape 3.7.1 software. The core targets were obtained using protein-protein interaction (PPI) network. The core targets of SFD were further analyzed through Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG). We then performed molecular docking between the hub proteins and key active compounds. Finally, we conducted animal experiments to verify the regulation of SFD on apoptosis following IS.

Results: There were 221 corresponding targets and 25 components related to Chinese medicine throughout the compound-target network. The core targets of SFD in the treatment of IS was tumor protein P53 (Tp53), mitogen-activated protein kinase 3 (MAPK3), MAPK1, heat shock proteins 90AA1 and alpha serine/threonine-protein kinase1. There were 221 GO items in GO function enrichment analysis and 106 signaling pathways in KEGG, mainly including negative regulation of the apoptosis process, vascular endothelial growth factor signaling pathways, NOD-like receptor signaling pathway, etc. Among them, Tp53, MAPK3, and MAPK1 were docked with small molecule compounds. Through animal research, we confirmed the effect of SFD on apoptosis following stroke.

Conclusion: This study demonstrates that SFD can treat IS through multiple targets and pathways, and provides new perspectives for exploring the core targets and mechanisms of SFD against IS.

Objective: To explore the effect of Traditional Chinese Medicine (TCM) constitution on cognitive impairment (CI) in patients with cerebral small vessel disease (CSVD) and its underlying neuroimaging mechanism and to provide countermeasures for health management of CSVD patients.

Methods: A total of 241 CSVD patients were recruited from the Department of Neurology. All subjects underwent head magnetic resonance imaging (MRI), Chinese Medicine Questionnaire (CCMQ) and cognitive function examination. The CSVD patients were divided according to the Montreal Cognitive Assessment (MoCA) score into a normal cognitive group (73 cases) and a CI group (168 cases). Logistic regression was used to analyse the risk constitution of CSVD-CI and to construct a risk prediction model. 3DT1 MRI images and FreeSurfer 6.0 software (Athinoula A. Martinos, Boston, MA, USA) were used to further explore the involvement of hippocampal subregion volume in patients with at-risk constitution and its correlation with cognitive function.

Results: Logistic regression analysis showed that Yang-deficiency constitution (YADC) (P = 0.020), older age (P = 0.008) and hypertension (P = 0.011) were risk factors for CSVD-CI but that balanced constitution (P = 0.003) and education (P < 0.001) were protective factors. A receiver operating characteristic curve (ROC) was drawn, and the area under the curve was 0.820. Further comparison of overall hippocampal and 12 hippocampal subregion volumes between YADC and non-YADC patients revealed decreased total volume of the left and right hippocampus, bilateral subiculum, presubiculum, molecular layer and right fimbria in the YADC group (P < 0.05/13, 13 is the number of hypothesis tests). Moreover, in the YADC group, the cognitive function of CSVD patients correlated positively with the overall volume of the left hippocampus (r = 0.304, P < 0.05) and the molecular layer volume of the left hippocampus (r = 0.288, P < 0.05).

Conclusion: CSVD patients with YADC are more prone towards developing CI, and asymmetric atrophy of the hippocampus might be the underlying neuroimaging mechanism. In particular, the volume of the left whole hippocampus and the left hippocampal molecular layer correlated significantly with general cognitive function.

Objective: To compare the therapeutic effects of nine acupuncture-related therapies (acupuncture, scrapping therapy, catgut embedding, blood-letting, electro-acupuncture, warm acupuncture, cupping, moxibustion, and needle knife) in the treatment of nonspecific low back pain (NLBP), providing evidence-based medical support for clinical treatment.

Methods: Randomized controlled trials evaluating various acupuncture therapies for NLBP were screened from the China National Knowledge Infrastructure Database, Wanfang Database, China Science and Technology Journal Database, PubMed, Web of Science, Chinese Biomedical Literature Database, Embase, and the Cochrane Library. Methodological quality was assessed using the Cochrane 5.1.0 risk of bias assessment tool, and the data were analyzed using STATA 15.1.

Results: This study included 19 randomized controlled trials involving 1356 participants and assessing pain using the visual analog scale (VAS), improvement in dysfunction using the oswestry disability index (ODI), and the effective rate. Blood-letting [surface under the cumulative ranking curve (SUCRA) = 81.4] exhibited a significant clinical effect in relieving NLBP in studies with the VAS score as the outcome indicator, followed by cupping (SUCRA = 70.4) and moxibustion (SUCRA = 58.5). Scrapping therapy (SUCRA = 77.7) had the most significant effect on improving NLBP-related functional impairment, followed by moxibustion (SUCRA = 59.8), and then bloodletting (SUCRA = 58.2). The effective rates of warm acupuncture (SUCRA = 78.0), scrapping therapy (SUCRA = 77.2) and blood-letting (SUCRA = 58.6) were better than those of acupuncture (SUCRA = 12.0), especially for cold and wet NLBP. These findings demonstrate the importance of syndrome differentiation during clinical decision making when determining diagnosis and treatment.

Conclusion: Blood-letting was the most effective treatment for relieving pain, and scrapping therapy was the most effective treatment for improving dysfunction. Warm acupuncture was the preferred treatment for cold and wet NLBP. However, further high-quality clinical studies are needed for validation.