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

Objective: To summarize the clinical efficacy characteristics of Suhuang Zhike capsule and evaluate the incidence of adverse reactions in its broad clinical application.

Methods: This was a multicenter, prospective, single-arm, open-label phase IV clinical trial. A total of 1100 patients diagnosed with cough variant asthma (CVA) and the Traditional Chinese Medicine (TCM) syndrome of wind evil invading the lung and lung Qi failing to propagate were planned for recruitment. Participants received Suhuang Zhike capsule orally, three capsules per dose, taken three times daily, for a treatment duration of 14 d. The primary outcome was the change in cough symptom scores from baseline to week 2. Cough severity was assessed twice daily. Additional evaluations included the rate and time of cough disappearance or basic disappearance rate, as well as the time of cough relief. TCM symptom scores were recorded at baseline and on days 7 and 14 of treatment. Safety assessments included monitoring for adverse events and conducting laboratory tests.

Results: A total of 1033 patients with CVA from 40 hospitals across China were enrolled in the study. Of these, 1026 patients received the study medication and were included in the safety analysis. Fifty-four patients withdrew from the study, resulting in a drop-out rate of 5.23%. Treatment with Suhuang Zhike capsules significantly reduced cough symptom scores and improved cough-related symptoms in patients with CVA. The overall rate of cough disappearance or basic disappearance increased over the course of treatment, reaching 67.21% after 14 d. The median time of cough relief was 3 d, while the median time to cough disappearance or basic disappearance was 11 d. Additionally, the treatment led to reductions in TCM symptom scores and improvements in accompanying symptoms such as throat itching, expectoration, and shortness of breath. In terms of safety, no serious adverse events were reported. The incidence of related adverse events (AEs) was 2.24% (23 cases, 30 events). The incidence of adverse reactions listed in the drug's instructions was 2.14%. Other related AEs not listed in the drug's instructions occurred in 0.39% of patients and included dizziness (0.19%), headache (0.10%), pruritus (0.10%), and palpitation (0.10%).

Conclusion: Suhuang Zhike capsules demonstrated good efficacy and safety for the treatment of CVA. These findings offer valuable clinical evidence to support their broader application in routine clinical practice.

Objective: To investigate the effect of pestle needle therapy (PNT) on the posterior cervical muscle (PCM) in a rabbit model of cervical spondylosis (CS) and explore the underlying mechanisms.

Methods: Rabbits were divided into control, CS models I and II (CS1 and CS2), electroacupuncture (EA), PNT I and II (PN1 and PN2), activator (AVT), and PNT combined with activator (C-AVT) groups. A long-term neck immobilization technique was used to establish a rabbit model of CS. Following completion of modeling, the EA group received electroacupuncture intervention, whereas the CS1, CS2, and C-AVT groups received PNT intervention. The AVT and C-AVT groups received local 740 Y-P injections into the PCM daily. The inflammatory injury to PCM was evaluated based on pain threshold, morphological changes, and interleukin (IL)-1β, IL-6, and tumor necrosis factor (TNF)-α levels. PCM fibrosis was evaluated by measuring the positive area (PA) of collagen fibrils (CFs) and collagen type 1 alpha 1 (Col1α1) using Masson's and immunohistochemical staining. Terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling assay and transmission electron microscopy were used to identify apoptotic cells and assess autophagy, respectively. Western blotting was used to determine B-cell lymphoma-2 (Bcl-2), Bcl-2 associated X protein (Bax), cysteine aspartate-specific protease (caspase)-3, sequestosome-1 (P62), microtubule-associated protein light chain 3 (LC3-I/II), phosphatidylinositol 3-kinase (PI3K), protein kinase B (AKT), and mammalian target of rapamycin (mTOR) levels. Real-time quantitative polymerase chain reaction was used to determine mRNA expression levels of PI3K, AKT, mTOR, autophagy protein (ATG), and ATG7.

Results: PNT alleviated PCM cell degeneration and necrosis, inhibited inflammatory cell infiltration, decreased IL-1β, IL-6, and TNF-α levels, and decreased the PA of CFs and Col1α1. In the PN1 group, cell apoptosis in the PCM decreased, autophagy increased, Bcl-2 and LC3-II/I levels increased, Bax, Caspase-3, and P62 levels decreased, and the mRNA expression of ATG5 and ATG7 increased. PNT inhibits protein and mRNA expression of PI3K, AKT, and mTOR. Finally, the trend in the results of the rescue experiment was consistent with previous results.

Conclusion: PNT inhibited apoptosis and promoted autophagy of PCM cells in CS rabbits and alleviated inflammation and fibrosis injury of PCM by inhibiting the PI3K/AKT/mTOR pathway.

Objective: To evaluate the clinical outcome of Traditional Chinese Medicine (TCM) syndrome differentiation combined with hysteroscopic treatment for uterine incision defect after cesarean section [previous cesarean scar defect (PCSD)] after cesarean section.

Methods: This is a single-center retrospective study. A total of 120 PCSD patients were enrolled from February 2022 to February 2023 and divided into two groups according to different treatment methods, the TCM group (n = 60) and the control group (n = 60). The control group was treated with hysteroscopy, and the TCM group combined TCM syndrome differentiation with hysteroscopy. Clinical outcome included menstrual scores, menstrual days, TCM symptom scores and intrauterine pregnancy recurrence rate was analyzed in two groups.

Results: The total response rate of the TCM group was significantly higher than that of the control group (P < 0.05); after treatment, the menstrual scores, menstrual days and TCM symptoms of the two groups were decreased, and the menstrual scores, menstrual days and TCM symptoms of the TCM group were all lower than that of the control group (P < 0.05); the recurrence rate of the TCM group was significantly lower than that of the control group (P < 0.05). Follow-up results showed higher healing of incisional scar diverticulum in the TCM group than in the control group (P < 0.05). The duration of menstruation before and after treatment, and the TCM group was better than the control group (P < 0.05).

Conclusion: TCM syndrome differentiation combined with hysteroscopy presented favorable outcome on the prolonged menstrual period of PCSD, which could significantly improve the recovery of menstruation, relief the symptoms of TCM, reduce the recurrence rate and accelerate wound healing.

Objective: To evaluate the clinical efficacy and safety of Tuomin Zhiti decoction (, TZD) in the short-term treatment of seasonal allergic rhinitis (SAR).

Methods: This study is a randomized, double-blind placebo-controlled, and single-center clinical trial. In April 2021, during the spring pollen season in Beijing, 94 SAR patients aged 19-60 years were randomized (1:1 ratio) to receive two weeks of TZD or placebo. The primary outcomes were the change of Total Nasal Symptom Score (TNSS) and Total Ocular Symptom Score (TOSS) from baseline to the end of treatment. Secondary outcomes were the changed score of the mini Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ), Rescue Medication Score (RMS), and Patient Global Impression of Change (PGIC). All adverse events were recorded and evaluated by two senior physicians.

Results: TZD significantly reduced both the total nasal symptom scores and total ocular symptom scores compared to scores at baseline, while the placebo group showed an increasing trajectory in both symptom scores. Compared to the placebo group, the TZD group also showed a greater improvement in the quality of life, scores of RMS, nasal and eye symptoms scores after TZD treatment (P < 0.001). Most notably, at the end of treatment, the proportion of remission measured by PGIC was significantly higher in the TZD group (82.97%) compared with the placebo group (47.72%, P < 0.001).

Conclusion: This study suggested that two weeks of TZD is an effective and safe treatment for SAR patients and spring pollen allergy, TZD could significantly improve the nasal and eye symptoms and improve the quality of life of patients.

Objective: To uncover the biological foundation of the prevailing TCM syndrome in individuals with Esophageal squamous cell carcinoma (ESCC), Zhengxu Xieshi (ZXXS), which is characterized by a deficiency in vital Qi and an excess in evil Qi.

Methods: We investigated shifts in vital Qi by quantifying systemic metabolic changes in the peripheral blood. Serum metabolomic profiling was conducted on the ESCC cohort 1 along with a matched healthy control cohort. Additionally, we assessed changes in evil Qi by examining metabolic perturbations in ESCC tissues. This analysis involved metabolomic and proteomic surveys of ESCC tissues and paired normal adjacent tissues as controls in an independent ESCC cohort 2.

Results: Serum metabolomic profiling highlighted the prevalent downregulation of differentially expressed metabolites in patient sera, in contrast to the upregulation observed in ESCC tissues, compared to their respective controls. Remarkably, the group of differential metabolites in the ESCC tissues was predominantly composed of amino acids. Thus, we focused on amino acid metabolism. Our integrative analysis showed the downregulation of a significant majority of disturbed amino acids in patient sera relative to the upregulation of an overwhelming proportion of perturbed amino acids within ESCC tissues. Enrichment analysis of these amino acids revealed seven metabolic pathways that contribute to the metabolism of antioxidants, energy intermediates, and biosynthetic precursors. Interestingly, these pathways displayed attenuation in patient sera but augmentation in ESCC tissues. Similarly, the proteomic data confirmed the activation of these pathways in ESCC tissues.

Conclusion: This study presents a new perspective on the prevalence of ZXXS syndrome in patients with ESCC, contextualized within the realm of metabolic reprogramming. Specifically, diminished amino acid metabolism in the circulating blood corresponds to a deficiency in vital Qi. Conversely, hyperactive amino acid metabolism in ESCC tissues signifies an augmentation of local evil Qi. These findings hold potential to enrich the current medical framework and offer a deeper understanding of ESCC management by integrating the principles of ZXXS syndrome.

Objective: To investigate the effects of gut microbes regulation of the trimethylamine (TMA)/flavin containing monooxygenase 3 (FMO3)/trimethylamine N-oxide (TMAO) pathway on platelet aggregation in acute coronary syndrome (ACS) rats and the intervention of Huayu Qutan formula.

Methods: The ACS rats with syndrome of phlegm and blood stasis rats were established. Platelet, platelet aggregation, platelet activation markers and TMA/FMO3/ TMAO pathway were detected. Metagenomics technology was employed to analyze the characteristics of the gut microbiota.

Results: Huayu Qutan formula and gut microbes could inhibit high platelet reactivity and regulate the TMA/ FMO3/TMAO pathway. The dominant bacteria in ACS rats including but not limited to the major phyla, Firmicutes, Bacteroidetes, Actinobacteria, and Proteobacteria, also including some low abundance phyla, Fusobacteria, Verrucomicrobia, Spirochaetes, and Deferribacteres. The dominant bacteria in the Huayu Qutan formula group were Synergistetes, Deferribacteres, Deferribacteraceae, Faecalibacterium and Mucispirillum. In the Huayu Qutan formula combined with fecal bacteria enema group, the dominant bacteria were Verrucomicrobia, Verrucomicrobiae, Akkermansia and Verrucomicrobium. These gut microbiota were correlated with pathways such as Riboflavin metabolism and Arachidonic acid metabolism.

Conclusion: Huayu Qutan formula may prevent ACS by modulating gut microbes Synergistetes, Faecalibacterium and Allobaculum, regulating the iron metabolism of Deferribacteres, and driving the TMA/FMO3/TMAO pathway to regulate gut microbiota function, and improving platelet aggregation. Akkermansia may serve as a promising probiotic, which could drive TMA/FMO3/ TMAO pathway to regulate Arachidonic acid metabolism to improve platelet aggregation. The findings of this study provide a theoretical basis for the theory of "the heart is connected with the small intestine".

Objective: To explore the therapeutic potential of the Dujieqing (DJQ) decoction for multiple myeloma (MM) and elucidate its mechanism of action.

Methods: RPMI8226 cells were treated with DJQ-containing serum (DJQ-CS) and a Wnt/β-catenin pathway inhibitor, XAV-939. Cell counting kit-8 assay was used to examine cell viability, and flow cytometry was performed to examine apoptosis. Real-time polymerase chain reaction and Western blotting were used to evaluate the Wnt/β-catenin pathway family members in the cells. Subsequently, the RPMI8226 cells were subcutaneously injected into the left flank of none obesity disease and server combined immune-deficiency mice to replicate the xenograft tumor mouse models, which were treated with the DJQ decoction for 14 d. Hematoxylin and eosin staining was used to examine the pathological changes of the liver and kidney tissues, and to detect xenograft tumors. Wnt/β-catenin pathway family members were evaluated via Western blotting.

Results: DJQ-CS significantly reduced the mRNA and protein expression levels of β-catenin, c-myc, cyclin D1, and lymphoid enhancer binding factor 1 (LEF1) while inhibiting the proliferation of RPMI8226 cells and inducing their apoptosis. Similar results were observed when the Wnt/β-catenin pathway was suppressed by inhibitors. Moreover, in the mouse model of xenograft tumors, DJQ decoction not only reduced the tumor volume but also inhibited the protein levels of β-catenin, c-myc, cyclin D1, and LEF1. The histopathology of the mice also showed increased apoptosis in tumor tissues, while the DJQ decoction treatment did not cause any pathological damage to the kidneys or liver.

Conclusion: Our results indicate that the DJQ decoction suppresses tumor progression by inhibiting the Wnt/β-catenin pathway, offering a promising treatment approach for MM.

Objective: To explore the mechanism of Danggui Buxue decoction (, DBD) for the treatment of gastric ulcer (GU), based on network pharmacology and in vivo experiments.

Methods: A network pharmacology strategy was used to predict the main components, candidate targets, and potential signaling pathways. Then, molecular docking was performed to further investigate the interactions and binding affinities between the main components and primary targets. Finally, a mouse model of ethanol-induced gastric ulcers was established to confirm the efficacy and potential therapeutic benefits of DBD, and candidate targets were finally identified.

Results: A total of 22 active components and 220 target genes were found to be associated with DBD. In addition, 343 GU-related target genes and 57 target genes specific to DBD treatment of GU were identified. The Gene Ontology functional enrichment analysis revealed 510 entries for biological processes, 36 entries for cell composition, and 69 entries for molecular functions. In the pathway enrichment analysis, 143 signaling pathways were identified. Additionally, the molecular docking results revealed that the main active components of DBD exhibited a strong binding capacity with key proteins, including tumor necrosis factor, AKT serine/threonine kinase 1, interleukin-6, vascular endothelial growth factor, and interleukin-1 Beta. Among these, quercetin, kaempferol, formononetin, isorhamnetin, and beta-sitosterol displayed the strongest binding affinities for these key proteins. in vivo experiments showed that DBD pretreatment effectively protected gastric mucosa, and the benefits might be attributed to the downregulation of above key proteins.

Conclusions: Based on network pharmacology analysis and in vivo experiments, we conclude that DBD leads to the protection and healing of the gastric mucosa by targeting genes and pathways, thus effectively countering the development and progression of GU.

Objective: To evaluate the effect of Yiqi Liangxue Shengji prescription (, YQLXSJ) on cardiac function and outcomes in acute myocardial infarction (AMI) patients with myocardial ischemia-reperfusion injury (MIRI) and to determine its clinical efficacy.

Methods: This prospective, randomized, double-blind, placebo-controlled trial enrolled hospitalized patients with AMI who underwent percutaneous coronary intervention and experienced MIRI either intraoperatively or postoperatively. Participants were randomly allocated to the treatment group, which received YQLXSJ, or the control group, which received a placebo, concurrent with standard Western Medicine therapy. The intervention period lasted 8 weeks. The primary outcome measure was left ventricular ejection fraction (LVEF), determined by echocardiography. Secondary outcomes included N-terminal pro brain natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) levels, left ventricular internal diameter, major adverse cardiovascular events (MACE), angina pectoris scores, and Chinese medicine evidence scores.

Results: Following 8 weeks of intervention, the treatment group demonstrated a significant increase in LVEF and a marked reduction in NT-proBNP when compared to the control group. There was also a significant decrease in peak cTnI levels, Chinese medicine evidence scores, and angina pectoris scores. The control group's left ventricular end-systolic diameter (LVESD) significantly increased compared to baseline after 8 weeks (P < 0.05), whereas the treatment group's LVESD showed no significant change from baseline (P > 0.05). Although the treatment group showed a downward trend in MACE incidence compared to the control group, this difference was not statistically significant (P > 0.05).

Conclusions: This study demonstrated that the addition of YQLXSJ to standard therapy can improve cardiac function and alleviate clinical symptoms in AMI patients with MIRI, and also showed a potential to mitigate the incidence of MACE. Furthermore, YQLXSJ displayed a favorable safety profile in clinical application.

Objective: To investigate the effects of Jiawei Huangqi Guizhi decoction on chronic atrophic gastritis (CAG) in rats and its modulation of the phosphatidylinositol 3-kinase/protein kinase B/ mechanistic target of rapamycin complex 2 (PI3K/Akt/ mTORC2) signaling pathway.

Methods: CAG was induced in rats and treated with high-, medium-, or low-dose Jiawei Huangqi Guizhi decoction. Gastric histopathology was observed by hematoxylin and eosin staining. Serum levels of gastrin, PI3K, Akt, and mTORC2 were detected by enzyme-linked immunosorbent assay. Gene and protein expression levels were analyzed by reverse transcription polymerase chain reaction and western blot.

Results: The decoction alleviated gastric mucosal injury, reduced inflammation, and restored epithelial structure. It regulated PI3K, Akt, and mTORC2 expression at both mRNA and protein levels.

Conclusion: Jiawei Huangqi Guizhi decoction may prevent CAG progression by improving gastric tissue and modulating the PI3K/Akt/mTORC2 signaling pathway.