Buyang Huanwu decoction ameliorates coronary heart disease with Qi deficiency and blood stasis syndrome by reducing CRP and CD40 in rats

Ethnopharmacological relevance

Qi deficiency and blood stasis is traditional Chinese medicine (TCM) syndrome. It leads to many diseases including coronary heart diseases (CHD) and cerebrovascular diseases (CVD). Inflammatory biomarkers and many endothelium-derived vasoactive factors are considered to play pivotal roles in CHD. Buyang Huanwu decoction (BYHWD), a TCM formula, has been recognized as a treatment for CHD with Qi deficiency and blood stasis syndrome and CVD in clinic. The mechanisms of BYHWD effect on CHD with Qi deficiency and blood stasis syndrome are unclear.

Aim of the study

The aim is to investigate whether the effects of BYHWD on CHD with Qi deficiency and blood stasis syndrome in rats are associated with the inhibition of CRP, CD40 and vascular endothelial regulators.

Materials and methods

The treated groups were lavaged with 25.68, 12.84 and 6.42 g/kg BYHWD respectively once a day for 21 days. The level of C-reactive protein (CRP) in serum and the expression of cluster of differentiation 40 (CD40) in the heart and aorta of rats were detected. Moreover, the levels of thromboxaneA₂ (TXA₂) and prostacyclin (PGI₂) in plasma were measured and the levels of inducible nitric oxide synthase (iNOS) and endothelial nitric oxide synthase (eNOS) in serum were detected.

Results

BYHWD (25.68 g/kg) significantly decreased the level of CRP in serum and BYHWD (25.68 and 12.84 g/kg) decreased the expression of CD40 in the heart and aorta (P < 0.01). The results also revealed that BYHWD (25.68 g/kg) inhibited the levels of iNOS in serum and TXA₂ in plasma and increased the levels of eNOS in serum and PGI₂ in plasma (P < 0.01).

Conclusion

The study shows that the ameliorative effects of BYHWD on CHD with Qi deficiency and blood stasis syndrome in rats are associated with the inhibition of CRP and CD40 and the regulation of endothelium-derived vasoactive factors.     

冠心病合并慢性心力衰竭患者心功能状态与脉图时域特征的关联研究＊

目的 通过分析冠心病合并慢性心力衰竭患者脉图时域特征参数，探讨心功能不全状态与脉图特征的相关性，挖掘脉诊的临床诊断价值。方法 采用ZBOX—I型脉象数字化采集分析仪采集脉象样本，将其按照心功能不全状态进行分组，并运用非参数检验的方法比较与分析心功能不全不同分组脉图时域特征参数的组间差异；基于脉图特征参数，运用随机森林模式识别方法建立冠心病合并慢性心力衰竭患者心功能不全状态评估模型。结果 与心功能不全轻度组比较，心功能不全中、重度组h4/h1、t1/T、t1/t4（P < 0.05）显著增大；t4（P < 0.01），t3、t5、T、h5/h1（P < 0.05）显著减小；本实验基于193例样本的脉图时域特征建立了心功能不全状态评估识别模型，其平均识别率为70.93%。结论 冠心病合并慢性心力衰竭患者的脉图时域特征参数组间比较存在显著差异，其参数变化可以反映患者的心功能不全状态，有助心功能不全状态的诊断。     

A quantification model of Traditional Chinese Medicine syndromes in children with idiopathic precocious puberty and early puberty

Objective

To establish a quantification model of Traditional Chinese Medicine (TCM) syndromes by sampling patients undergoing idiopathic precocious puberty (IPP) and early puberty.

Methods

A questionnaire for classifying and quantifying TCM syndromes was designed and administered. All the results were analyzed; the relationship between 3 types of syndrome and 47 symptoms were summated. Meanwhile, the frequency distribution of each symptom or sign was aggregated. Fuzzy mathematics was used to develop a quantification model of TCM syndromes.

Results

We found that precocious puberty had 3 types of syndrome, including hyperactivity of fire due to Yin deficiency (Syndrome I), depressed liver Qi transforming into fire (Syndrome II), and end retention of damp heat (Syndrome III). In the IPP group, Syndrome I was the most common principal syndrome (100%). Forty-six patients (43.81%) were diagnosed with Syndrome I accompanied by Syndrome II and 11 (10.48%) were diagnosed with Syndrome I accompanied by Syndrome III. In the early puberty group, Syndrome I was also the main syndrome (98.39%). The degrees of most symptoms were mild to moderate. Reddened tongue was the most common tongue manifestation (62.86% prevalence) in the IPP group. The most common pulse manifestations were slippery pulse, thread pulse, and taut pulse. The Asymptotic Normalization Coefficient (ANC) method was used to quantify the TCM syndromes in 167 cases. Diagnostic accuracy rate reached 91%, comparable to expert diagnosis.

Conclusion

We find that there are 3 types of syndrome in the IPP group and in the early puberty group. Syndrome I (hyperactivity of fire due to Yin deficiency) is the main syndrome in the two groups. ANC may be an appropriate for quantification model of TCM syndromes.     

Fatigue severity of patients with idiopathic chronic fatigue compared to healthy subjects

Objective

To analyze the fatigue severity of patients with idiopathic chronic fatigue (ICF) and to compare the severity of this group with that of healthy subjects.

Methods

One hundred and nine ICF patients and 98 healthy subjects were enrolled in this study. Fatigue severity was measured using the Korean-translated Chalder fatigue severity questionnaire. All subjects scored each item on a 10-point scale as a self-rating numeric scale (NRS), and additionally rated their feeling of general fatigue by visual analogue scale (VAS).

Results

The total NRS scores of patients with ICF was 53 ± 15 compared with 25 ± 14 of healthy subjects (2.4 folds for physical symptoms vs. 1.7 folds for mental symptoms respectively). The VAS scores of patients with ICF were 2.7 times as high as those of healthy subjects.

Conclusion

This report is the first to compare the severity of fatigue between ICF patients and healthy subjects. This study contains reference data applicable for the management of this disorder in field of complementary and alternative medicine.     

Biological indicators of sub-optimal health status

Objective

To investigate biological indicators of sub-optimal health status and provide means of objective assessment of sub-optimal health status.

Methods

We set the unified standards for diagnosing a SHS. We tested various laboratory indicators in 407 cases that we selected randomly from 2807 subjects and collected 15 mL of fasting venous blood from each case. We measured serum immunoglobulin A (IgA) and immunoglobulin G (IgG) concentrations, serum beta endorphins (β-EP), cortisol (C), testosterone (T), plasma adrenocorticotropic hormone (ACTH) and serum T lymphocyte subsets CD3+ and CD4+.

Results

Mean serum testosterone concentrations and their ratio to cortisol (C) concentrations were significantly higher in the healthy group than in those with sub-optimal health status (P<0.01). Mean serum CD3+ concentrations were significantly higher in those with sub-optimal health status than in the healthy group (P<0.05).

Conclusion

Decreased serum testosterone/cortisol ratio may be an objective indication of sub-optimal health status. Changes in neuroendocrine and immunological indicators may explain some of the symptoms, including malaise and poor work performance, attributable to persistent or relapsing fatigue in subjects with sub-optimal health status.     

冠状动脉粥样硬化性心脏病患者脉图递归定量分析特征与凝血功能关联研究

目的采用典则相关分析法(CCA)分析冠状动脉粥样硬化性心脏病(CHD)患者脉图递归定量分析(RQA)特征与凝血功能的相关性,探寻可反映CHD患者凝血功能的脉图RQA特征参数。方法纳入2018年7月-2019年11月上海中西医结合医院及上海中医药大学附属曙光医院心内科住院CHD患者205例,采用压力脉冲信息分析系统(Smart TCM-Ⅰ)采集脉图,提取脉图RQA特征,检测患者凝血酶原时间(PT)、活化部分凝血酶时间(APTT)、国际标准化比率(INR)及纤维蛋白原(FIB),采用CCA分析脉图RQA特征与凝血四项的相关性。结果 2组变量间的第一对典则变量的相关系数为0.608,超过2组指标间的任一简单相关系数,差异有统计学意义(P<0.05),表明2组变量有一定相关性;脉图RQA特征递归率(RR)和最长竖直/水平线段长度(V_max)在第一对典则变量上的载荷系数分别为0.904、0.816,在第一对典则变量上的交叉载荷系数分别为0.550、0.496;凝血指标APTT、INR、FIB在第一对典则变量上的载荷系数分别为0.792、-0.935、0.828,在第一对典则变量上的交叉载荷系数分别为0.481、-0.568、0.503。结论 APTT、FIB与脉图RQA特征RR、V_max呈正相关,INR与RR、V_max呈负相关,脉图RQA特征(RR、V_max)能在一定程度上反映APTT、INR、FIB水平。     

Distributions of Sasang constitutions and six syndromes in patients with functional dyspepsia and healthy subjects

Objective

To investigated the characteristics of patients with functional dyspepsia (FD) in terms of Sasang constitutional medicine.

Methods

A total of 116 patients with FD were recruited based on diagnosis by gastroscopy and symptomatic measurements. The distributions of Sasang constitutions and six syndromes in terms of TKM theory in the patients was compared with those from 1423 healthy subjects.

Results

The distribution of Sasang constitutions for the patients with FD significantly differed from that for healthy subjects, especially among women; 36.7% vs 45.6% for Taeumin, 28.9% vs 33.9% for Soumin, and 34.4% vs 20.4% for Soyangin. Our results assumed a high prevalence in Soyangin women (around 1.7 folds), and Soumin (45.2%), in particular, had a high prevalence of “deficiency and coldness of spleen and stomach” compared with Taeumin (14.9%) and Soyangin types (15.7%).

Conclusion

This study identified a trend for the frequency of FD and the Sasang constitutions. The findings may provide new ideas for the study of prevention and management of FD.     

Akupunktur – eine neue Option in der Behandlung traumatisierter Bundeswehrsoldaten?

Introduction

Acupuncture as part of Traditional Chinese Medicine offers an option in the treatment of psychiatric disorders in addition to pharmaco- and physiotherapy.

Aims

To gain first results on subjective effects of acupuncture therapy in Bundeswehr soldiers who have suffered psychological trauma.

Methods

In this pilot study 27 psychiatric inpatients of a Bundeswehr hospital received an acupuncture therapy according to a main treatment scheme (with varying additional points) and were evaluated with respect to five psycho-vegetative parameters. Changes were measured with subjective rating scales.

Results

Positive effects on sleep disturbances, restlessness, agitation, nervousness and aggression were reported. Sleep disturbances improved significantly more than the other symptoms (exept restlessness), the effect was depending on treatment duration.

Discussion

Acupuncture appears to be a therapeutic option in the therapy of sleep disturbance and other psycho-vegetative symptoms in traumatized soldiers. Additional controlled studies should be performed.     

Wound healing potential of methanolic extract of Trichosanthes dioica Roxb (fruits) in rats

Aim of the study

The present study provides a scientific evaluation for the wound healing potential of methanolic (MeOH) extract of TDR fruits.

Materials and methods

Excision and incision wounds were inflicted upon three groups of six rats each. Group I was assigned as control (ointment base), Group II was treated with standard silver sulfadiazine (0.01%) cream. Group III was treated with 5% MeOH extract ointment. The parameters observed were percentage of wound contraction, epithelialization period, hydroxyproline content, tensile strength including histopathological studies.

Results

It was noted that the effect produced by the extract ointment showed significant (P < 0.01) healing in both the wound models when compared with control group. All parameters such as wound contraction, epithelialization period, hydroxyproline content, tensile strength and histopathological studies showed significant changes when compared to control.

Conclusion

The result shows that TDR extract ointment demonstrates wound healing potential in both excision and incision models.     

Correlation between tongue manifestations and glucose,total cholesterol,and high-density lipoprotein cholesterol in patients with acute cerebral infarction

Objective

To analyze the association between tongue manifestations and the levels of glucose (GLU), total cholesterol (TCH), and high-density lipoprotein cholesterol (HDL-C) in subjects with acute cerebral infarction.

Methods

Hospitalized patients with first unilateral cerebral infarction in the Neurological Department of Xuanwu Hospital were included and the correlation between tongue fur color, fur nature, and the levels of GLU, TCH, HDL-C were analyzed.

Results

HDL level in the thin fur group was higher than that in the thick fur group (P=0.02). The difference in the levels of GLU, TCH, and HDL-C among the groups was significant (P<0.05), classified in terms of slippery, moist, and dry fur. Further comparison between the groups by Student-Newman-Keuls test showed that GLU level in the dry fur group was the highest. Moreover, the TCH level in the slippery fur group was higher than the other two groups.

Conclusion

A correlation between tongue manifestations and GLU, TCH, HDL-C was identified in the patients with acute cerebral infarction.     

Evaluation of the protective effect of Rhei Radix et Rhizoma against α-naphthylisothiocyanate induced liver injury based on metabolic profile of bile acids

Ethnopharmacological relevance

To evaluate the hepatoprotective effect of the root and rhizome of Rhubarb (Rhei Radix et Rhizoma) against α-naphthylisothiocyanate (ANIT)-induced liver injury using metabolic profile of bile acids (BAs) along with biochemical parameters and histological alterations.

Materials and methods

Ultra-performance liquid chromatography coupled with quadrupole mass spectrometry (UPLC-MS) was applied to determinate the concentration of BAs, which was followed by multivariate statistical analysis of Principal Component Analysis (PCA) and Partial Least Squares Discriminate Analysis (PLS-DA).

Results

Based on PCA results, three groups (Vehicle group, ANIT group and RhO+ANIT group) were clearly distinguished. Tauro-cholic acid (TCA), tauro-hyodesoxycholic acid (THDCA), glyco-cholic acid (GCA), and glyco-chenodeoxycholic acid (GCDCA) were proved to be the most important markers corresponding to ANIT-induced liver injury and protection provided by Rhubarb, which is further confirmed by PLS-DA. A correlation was found between the foregoing BAs and biochemical parameters including serum aspartate aminotransferase (ALT) and aspartate aminotransferase (AST), which confirmed that TCA, THDAC, GCA, and GCDCA could be considered as sensitive biomarkers.

Conclusion

The variance of the BAs contents can be used to evaluate ANIT-induced hepatotoxicity caused by ANIT and protective effects of Rhubarb. It also lays the foundation for the further research on the mechanisms of cholestasis as well as the therapeutic effect of Rhubarb.     

Essential oil of Perilla frutescens-induced change in hippocampal expression of brain-derived neurotrophic factor in chronic unpredictable mild stress in mice

Ethnopharmacological relevance

Perilla frutescens (Perilla leaf), a traditional Chinese medicinal herb, has been used for centuries to treat various conditions including depression. A previous study of the authors demonstrated that essential oil of Perilla frutescens (EOPF) attenuated the depressive-like behavior in mice.

Aim of the study

This study was undertaken to explore the dynamic change of behaviors and brain-derived neurotrophic factor (BDNF) expression induced by chronic unpredictable mild stress (CUMS), and improved by EOPF.

Materials and methods

Four separate CUMS experimental groups (1-week, 2-week, 3-week and 4-week treatment) were treated with EOPF (3 mg/kg and 6 mg/kg, p.o.) or fluoxetine (20 mg/kg, p.o.), followed by sucrose preference, locomotor activity, immobility and hippocampal BDNF measurement.

Results

EOPF, as well as fluoxetine, restored the CUMS-induced decreased sucrose preference and increased immobility time, without affecting body weight gain and locomotor activity. Furthermore, CUMS (3 or 4-week) produced a reduction in both BDNF mRNA and protein expression in the hippocampus, which were ameliorated by EOPF (4-week) and fluoxetine (3 or 4-week) treatment.

Conclusion

These results presented here show that BDNF is expressed depending on length of CUMS procedure and EOPF administration. And this study might contribute to the underlying reason for the slow onset of antidepressant activity in clinic.     

Optimization of vinegar-steaming process for Wuweizi (Fructus Schisandrae Chinensis) with response surface method

Objective

To optimize the vinegar-steaming process of Wuweizi (Fructus Schisandrae Chinensis) using the response surface method (RSM) based on the Box-Behnken design.

Methods

A regression model was constructed with the response variables, the content of Deoxyschizandrin, and the three explanatory factors: length of steaming time, the quantity of vinegar and length of moistening time to evaluate the effects on the processing of Wuweizi (Fructus Schisandrae Chinensis).

Results

There was a linear relationship between the content of Deoxyschizandrin and the three explanatory factors. When the steaming time was 5.49 h, with 2.365 g of vinegar added and a moistening time of 4.13 h, the content of Deoxyschizandrin reached the maximum predicted value of 0.1076%, and under the conditions the average content of Deoxyschizandrin was 0.1058%.

Conclusion

The correlation coefficient of the nonlinear mathematical model was relatively high and the model matched the data well, potentially providing a method for the study of the steaming process.     

The anti-obesity effect of Ephedra sinica through modulation of gut microbiota in obese Korean women

Ethnopharmacological relevance

Ephedra sinica (Ma Huang) has been used in traditional Chinese medicine for more than 5000 years for treatment of various conditions, including modern-day obesity. Ephedra has been used as a supplement for weight loss and its effects have been reported. The current study investigated the influence of ephedra on the composition of gut microbiota, and its correlation with weight loss.

Materials and methods

Clinical data of subjects were measured at pre- and post-intake of ephedra (4 g of water extract, roughly equivalent of 24 g of crude herb), and analysis of the alteration of gut microbiota was performed simultaneously using 16S rRNA gene based pyrosequencing.

Results

Body weight (BW), body mass index (BMI), and body fat percentage of subjects were reduced after intake (p<0.05). In correlation analysis, Subdoligranulum, Oscillibacter, and Akkermansia showed an association with changes of BW and BMI (p<0.05). However, the alteration of gut microbiota varied by indigenous microbiota of each subject, and the dissimilarity between microbiota of subjects at pre- and post-intake were different.

Conclusions

The influences of gut microbiota are unique according to indigenous microbiota and differences in individual sensitivity to ephedra. Alteration of gut microbiota by ephedra intake showed correlation with loss of BW and BMI.     

Therapeutic effects of acupuncture for neurogenic dysphagia--a randomized controlled trial

Objective

To evaluate the therapeutic effects and long-term efficacy of acupuncture for neurogenic dysphagia.

Methods

Subjects with neurogenic dysphagia undergoing routine swallowing management were randomized to receive either 20 sessions of true acupuncture (experimental group) or sham acupuncture (control group 1) for approximately one and a half months. A third group (control group 2) comprised of non-randomized subjects with neurogenic dysphagia who received routine care were recruited from separate wards. The outcomes were assessed by the Royal Brisbane Hospital Outcome Measure for Swallowing (RBHOMS), as well as by the consistencies of ingested food and fluid.

Results

A total of 87 subjects (experimental group, n= 20; control group 1, n=19; control group 2, n=48) were recruited into the trial. The average RBHOMS score showed a greater improvement in the experimental group and in control group 1 than in control group 2. The average levels of food and fluid consistencies displayed greater improvement in the experimental group than in the two control groups.

Conclusions

This study demonstrates that acupuncture may have therapeutic effects and long-term efficacy for neurogenic dysphagia. However, due to an insufficient sample size and the lack of follow-up for control group 2, multi-centre trials employing a larger sample size may be required to draw concrete conclusions.     

Electroacupuncture for Sciatica: A Literature Trawl using the Clinical Studies Database at www.electroacupunctureknowledge.com

Background

This article introduces the electroacupuncture (EA) clinical studies database at www.electroacupunctureknowledge.com and demonstrates how it can be used in conjunction with other available literature to develop a treatment protocol for a common condition such as sciatica.

Methods

A comprehensive search strategy was developed and raw material (studies) gathered from personal collections, bibliographic databases, and hand-searching runs of periodicals held in specialist libraries. Data was extracted from these according to a defined protocol. The resulting database concentrates on treatment with EA and other nontraditional forms of acupuncture. Studies located on back pain and sciatica were analysed for the acupoints and treatment parameters used (other data types recorded included study type, numbers and subgroups of subjects, endpoint measures used, and outcome).

Results

So far, data have been entered from well over 8000 studies originally published in Chinese, Russian, Ukrainian, English and other Western and Eastern European languages, by 23 different individuals, including acupuncture practitioners and students, researchers and translators. Of these studies, 206 were on sciatica (or low back pain with sciatica), 34 being RCTs and 43 CTs. When using EA, the traditional pattern of using local and distal points along BL and GB channels has been retained, with EA applied locally or distally, or both. Most used points were BL-23 shenshu, huatuojiaji and ashi points locally, with distal points on the BL, GB (or ST) channels. Most used parameters for EA were LF or DD stimulation ‘to tolerance’ for around 25 minutes, and strong but comfortable HF or intermittent stimulation for 30 minutes or more for TEAS/TENS.

Conclusions

The database at www.electroacupunctureknowledge.com can provide information that is useful for developing baseline clinical or experimental protocols, as in the current example of sciatica. The challenge now is to obtain funding so that the database can be refined and updated, with better definition of the resulting protocols.     

Effects of peony glycosides on mice exposed to chronic unpredictable stress: Further evidence for antidepressant-like activity

Ethnopharmacology relevance

Peony, the processed root of Paeonia lactiflora Pall. (Ranunculaceae), is a component herb of many traditional formulae for the treatment of depression-like disorders.

Aim of the study

The present study aimed to investigate whether the total glycosides of peony (TGP) could prevent depression induced by chronic stress.

Materials and methods

Mice were subjected to an experimental setting of chronic unpredictable stress (CUS). The effect of TGP treatment on CUS-induced depression was examined by measuring behavioral and neurochemical parameters of depression and the antioxidant status of brain tissue.

Results

CUS-induced depression, as indicated by a significant increase in immobility time in the tail suspension test, was associated with increases in the activities of monoamine oxidases, depletion of reduced glutathione, and an increase in malondialdehyde level, in mice brains. TGP treatment alleviated the extent of CUS-induced depression and the associated impairment of antioxidant status in the mouse brain.

Conclusion

The results suggest that TGP alleviates depression induced by chronic unpredictable stress. The antidepressant-like activity of TGP is probably mediated by inhibition of monoamine oxidases and the attenuation of oxidative stress in mouse brain.     

A novel dihydroxy gymnemic triacetate isolated from Gymnema sylvestre possessing normoglycemic and hypolipidemic activity on STZ-induced diabetic rats

Aim of the study

Gymnema sylvestre (Asclepiadaceae) is emerging as a potential treatment for the management of diabetes. The leaves are used in herbal medicine preparations. The present study was carried out to isolate and identify the putative antidiabetic compound based on bioassay-guided fractionation.

Materials and methods

An active compound dihydroxy gymnemic triacetate has been isolated from Gymnema sylvestre acetone extract and its optimum dose has been determined and patented. An optimum dose of dihydroxy gymnemic triacetate (20 mg/kg body weight) was orally administered for 45 days to streptozotocin diabetic rats for the assessment of plasma glucose, insulin, glycated hemoglobin (HbA1c), tissue glycogen, lipid parameters such as triglycerides, total cholesterol, LDL-cholesterol, HDL-cholesterol and activities of hepatic marker enzymes, such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and acid phosphatase (ACP) in normal and streptozotocin diabetic rats.

Results

Dihydroxy gymnemic triacetate at 20 mg dose produced significant effects on all biochemical parameters studied compared to diabetic control group.

Conclusions

These results indicate that dihydroxy gymnemic triacetate, the compound from Gymnema sylvestre, possessed hypoglycemic and hypolipidemic activity in long-term treatment and hence it could be used as a drug for treating diabetes.