ABSTRACT
Objective:The SD rat model of hyperplasia of mammary gland（HMG） and the ultrahigh-performance liquid chromatography and mass spectrometry (UHPLC-LTQ-Orbitrap MS) technology were used to explore the pharmacological material basis of Shuangjin Sanjie granules (SJSJG) for the treatment on HMG.Method:SD rat models of HMG were administered in groups, and the nipple height and the diameter were measured; the levels of estradiol (E2), progesterone (P) and prolactin (PRL) in serum were detected, pathological examination was conducted for the hyperplasia of breast tissue. Histochemical methods were used to detect the expressions of estrogen receptor α (ERα), androgen receptor (AR), progesterone receptor (PR), tumor necrosis factor-α (TNF-α) proteins. Finally, UHPLC-LTQ-Orbitrap MS technology was used to detect the main chemical constituents of SJSJG, and the pharmacodynamic substance basis was analyzed based on the pharmacological effect.Result:The results of animal experiments showed that compared with the normal group, nipple height and diameter of the model group increased remarkably (P<0.01), serum E2 significantly increased (P<0.01). Pathological examination showed abnormal hyperplasia of breast tissue， expressions of ERα, AR, PR and TNF-α increased， compared with the model group, the nipple height and diameter of the SJSJG group decreased remarkably (P<0.01), serum E2 was decreased significantly (P<0.01)， pathological examination showed weakened abnormal hyperplasia of breast tissue, ERα, AR, PR and TNF-α protein expressions were significant decreased (P<0.01). The results of basic material study showed that 85 chemical components were identified from SJSJG, including 16 alkaloids, 7 flavonoids, 15 terpenes, 9 phenolic acid compounds, 3 coumarin compounds, 10 esters and lactone compounds, 7 fatty acids compounds, 4 amino acids compounds, and 14 other types of ingredients， among them, alkaloids and terpenoids chemical drug substances were closely related.Conclusion:SJSJG can effectively improve the condition of breast hyperplasia, and its medicinal substance basis may include saikosaponin A, Saikosaponin D, verticinone, peimine.
ABSTRACT
Objective To observe the advantages and disadvantages the combination of traditional Chinese medicine and western medicine in community health service centers through cost-effectiveness and cost-utility analysis.Methods Take community common diseases as an example, Knee Osteoarthritis (KOA), Cervical Spondylosis (CS) and Lumbar Disc Herniation (LDH) were used. A total of 200 cases were selected for each disease, and 100 cases in each one group.In the treatment group, the rehabilitation mode was used.In the control group, comprehensive treatment of traditional Chinese medicine was adopted. We analyzed the cost-effectiveness and cost-utility, with VAS as the effect indicator and QALYs as the utility indicator. Results The VAS values of the knee osteoarthritis, cervical spondylosis and lumbar disc herniation in the treatment group were lower than those in the control group after 14 days, 30 days and 6 months (P<0.05) . The QALYs values of them in the treatment group were lower than those in the control group after 14 days, 30 days and 6 months (P<0.05) . The treatment group has a higher increase cost-effectiveness ratio (ICER) . Each get a unit effect can pay 222.56, 297.13 and 1178.59 Yuan less . The treatment group has a higher increase cost-utility ratio (ICUR) . Each get a unit effect can pay 741.86, 3178.60 and 2862.29 Yuan less . Conclusion Community application in rehabilitation mode of integrated traditional Chinese and western medicine can improve the treatment effect, and can reduce the cost of treatment and the loss of QALYs.