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Hyperplasia of mammary glands is a benign breast disease with disordered breast structure. Nowadays, the incidence rate of breast hyperplasia in women is increasing year by year, and the etiology is related to the imbalance of estrogen and progesterone in the body. The symptoms include breast pain, breast nodules, or nipple discharge, which can develop into breast cancer in the context of psychological pressure. Therefore, it is timely and effectively necessary for people to treat the symptoms. At present, traditional Chinese medicine(TCM) often treats breast hyperplasia by oral drug, external application, acupuncture, moxibustion, and massage, while western medicine often uses hormone therapy or surgery. TCM can regulate hormone levels to treat breast hyperplasia. Acupuncture, moxibustion, and other methods can stimulate acupoints to reduce breast lumps. However, since TCM is easy to produce hepatorenal toxicity after long-term use and simple external treatment is slow to take effect, rapid and effective treatment is difficult to be achieved. Although western medicine can inhibit the disease, it is easy to produce toxic and side effects if taken for a long time. In addition, surgery can only remove the focus and the recurrence rate is high. Some studies have found that the combination of oral and external use of TCM compounds has a significant effect, with mild toxic and side effects, few adverse reactions, and a low recurrence rate. Based on the relevant literature in recent years, this article reviewed the combination of oral and external treatment of TCM in the treatment of hyperplasia of mammary glands, discussed the effectiveness, clinical evaluation indexes, and mechanism, and pointed out the existing shortcomings to explore a comprehensive therapy worthy of clinical application.
Subject(s)
Female , Humans , Mammary Glands, Human , Medicine, Chinese Traditional , Hyperplasia , Acupuncture Therapy , Breast Neoplasms , Drug-Related Side Effects and Adverse Reactions , EstrogensABSTRACT
In traditional Chinese medicine， it is believed that the spleen is the foundation of acquired nature and the source of Qi and blood. All life activities of a person since birth depend on the water and grain essence transported by spleen and stomach. The liver helps the spleen to strengthen the movement， the liver and spleen cooperate with each other. The liver and the spleen are invigorated， so that the Qi and blood are sufficient. The external energy can nourish the limbs， muscles and fur. The Qi and blood can be supplied to the internal organs， meridians and bones， and the body can be nourished both inside and outside to strengthen the acquired foundation. Emotional dissatisfaction can lead to stagnation of liver Qi， loss of spleen Qi， failure to dredge Qi， and deficiency of spleen Qi， forming the syndrome of liver depression and spleen deficiency. Its clinical manifestations include the symptoms of liver Qi stagnation such as depression， stamina， and chest fullness， as well as symptoms of spleen deficiency such as anorexia， abdominal distension， loose stools. Xiaoyaowan is an effective classic prescription for the treatment of liver stagnation and spleen deficiency syndrome， which is based on the dosage form of Xiaoyaosan in Prescriptions of the Bureau of Taiping People's Welfare Pharmacy. It has the effect of relieving depression， nourishing blood and invigorating spleen. In modern research， it has been found that Xiaoyaowan has good curative effect in the treatment of endocrine diseases， liver diseases， immune diseases， and neurological diseases， etc. It was praised by the famous medical scientist YE Tian-shi in the Qing Dynasty as "the holy medicine for women"， with a wide range of significant curative effects gynecology. Progress has been also made in pharmacological research. In this article， we have searched and consulted the relevant literature reports of Xiaoyaowan in recent years， summarized the key directions of the pharmacological research literature， and proposed deficiencies to provide relevant basis for the in-depth study of Xiaoyao pill in the future.
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Objective:The phase separation of Baihutang was carried out. The content of mangiferin，new mangiferin，calciumion，glycyrrhizin and ammonium glycyrrhizinate in the solution phase，the nano phase and the precipitated phase of Baihutang were measured，so as to define the effect of nanometer particles of Baihutang on the growth of active components，and explain the mechanisms of Baihutang in potent detoxification and heat removal. Method:The phase separation of Baihutang was performed by high-speed centrifugation and dialysis. The contents of mangiferin，new mangiferin，glycyrrhizin and ammonium glycyrrhizinate in Baihutang were determined by HPLC. Chromatographic column Diamonsil C18 (4.6 mm×250 mm，5 μm) was adopted, with acetonitrile-25 mmol·L-1 potassium dihydrogen phosphate solution as the mobile phase, and eluted in a gradient mode. The detection wavelength was 257 nm，the column temperature was 30 ℃，and the flow rate was 1.0 mL·min-1. EDTA-2Na solution was used to calibrate the calcium concentration in different phase states of Baihutang. Result:1 mL Baihutang nanoparticles contained 483.00 μg new mangiferin，1 068.88 μg mangiferin，219.93 μg glycyrrhizin and 187.10 μg ammonium glycyrrhizin，and the content of new mangiferin and mangiferin accounted for 89.4% and 89.9% respectively in 1 mL Baihutang. The new mangiferin and mangiferin in the nano phase were 230.0 and 23.3 times the true solution，and 8.5 and 14.4 times of the precipitation，respectively. The content of calcium ions in Baihutang in the nano phase was higher，accounting for 86.9% of Baihutang，and the content of calcium ions in Baihutang and Baihutang in the nano phase was higher than that in gypsum group. Conclusion:The content of main components in Baihutang in nanometer phase is significantly higher than that in other phases. The nanoparticles of Baihutang have a solubilizing effect on the main antipyretic components, such as mangiferin，mangiferin and calcium ions as well as the antitoxic components glycyrrhizic acid and glycyrrhizic acid. The mechanism of action of Baihutang is related to the formation of nanoparticles.
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Objective:To investigate the spectrum-effect relationship of effect of material components in Shaoyao Gancaotang on the levels of malondialdehyde (MDA), superoxide dismutase (SOD) and adenosine triphosphatase (ATPase) in brain tissue of epileptic mice, and to reveal the material basis of the antiepileptic effect of Shaoyao Gancaotang. Method:HPLC was used to establish the fingerprint of 15 batches of Shaoyao Gancaotang, the mobile phase was consisted of acetonitrile (A)-0.1% phosphoric acid aqueous solution (B) for gradient elution (0-15 min, 19%A; 15-45 min, 19%A-50%A; 45-46 min, 50%A-90%A; 46-48 min, 90%A), the flow rate was 1.0 mL·min-1, and the detection wavelength was 237 nm. The mouse epilepsy model was induced by penicillin, the protective effect of 15 batches of Shaoyao Gancaotang on MDA, SOD and ATPase levels in brain tissue of epileptic mice was investigated. Grey correlation analysis was used to analyze the correlation between the peak areas of characteristic peaks in the fingerprint of 15 batches of Shaoyao Gancaotang and three pharmacodynamic indexes (the activities of MDA, SOD and ATPase), and the mathematical model of spectrum-effect relationship between different material components and pharmacodynamic indexes was established. Result:Shaoyao Gancaotang could increase the contents of ATPase and SOD and reduce the content of MDA in the brain tissue of epileptic mice, and most of the differences were significant (P<0.05, P<0.01). There were 28 common peaks in the fingerprint of 15 batches of Shaoyao Gancaotang, and 15 of them were characteristic peaks. Grey correlation analysis found that the characteristic peaks contributed to the activities of MDA, SOD and ATPase included peak 2 (albiflorin), peak 3 (paeoniflorin), peak 5 (liquiritin), and so on, the specific ranking was peak 3>peak 6>peak 12>peak 8>peak 2>peak 5>peak 9>peak 4>peak 10>peak 7>peak 13>peak 11>peak 15>peak 1>peak 14. Conclusion:Shaoyao Gancaotang can affect the activities of SOD, MDA and ATPase in brain tissue of epileptic mice by multi-component synergy. Simultaneously, introducing the grey correlation analysis into the correlation evaluation of the spectrum-effect relationship between components and efficacy of Chinese herbal compounds, it can objectively reflect the essence of the synergistic action of multiple components in traditional Chinese medicine (TCM), and it is an effective analysis method for screening and predicting the pharmacodynamic components of TCM.
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Objective:To prepare Lycii Fructus polysaccharide buccal tablets and investigate its immunomodulatory effect. Method:Taking the appearance, taste, hardness and disintegration time of the tablets as comprehensive evaluation index, based on single factor tests, central composite design-response surface methodology was adopted to optimize the prescription of Lycii Fructus polysaccharide buccal tablets with mass ratio of dextrin to mannitol, mass ratio of cyclamate to malic acid and dosage of sodium carboxymethyl starch (CMS-Na) as factors. Kunming mice were randomly divided into 5 groups, namely the Lycii Fructus polysaccharide buccal tablets low (100 mg·kg-1·d-1), medium (200 mg·kg-1·d-1) and high (300 mg·kg-1·d-1) dose groups, the normal group (0.9% normal saline, 300 mg·kg-1·d-1) and the positive medicine group (Cinengsu group, 300 mg·kg-1·d-1). The immunomodulatory effect of the buccal tablets were investigated by calculating immune organ index, monocyte-macrophage phagocytic index, serum hemolysin antibody level, and the voix pedis thickness difference of delayed hypersensitivity (DTH) of mice. Result:Optimal prescription for the buccal tablets was 80% of Lycii Fructus extract, 11.5% of dextrin-mannitol (1.2:1), 1% of cyclamate-malic acid (1:1), 0.5% of cream essence, 6.5% of CMS-Na, 0.5% of magnesium stearate, and appropriate amount of 80% ethanol. Under the optimal condition, the hardness of the buccal tablets was 11.83 kg, its disintegration time was 13.21 min, both of which were in line with the relevant provisions of the 2015 edition of Chinese Pharmacopoeia, and the buccal tablets had good appearance and taste. Compared with the normal group, medium and high dose groups of Lycii Fructus polysaccharide buccal tablets significantly increased thymus index, spleen index and phagocytic index of mice (PPPPPConclusion:The formulation process of the buccal tablets optimized by central composite design-response surface methodology is stable and feasible, and Lycii Fructus polysaccharide buccal tablets can improve the immune regulation function of normal mice, and this study can provide experimental basis for the development, utilization and clinical application of Lycii Fructus and Lycii Fructus polysaccharides.
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Objective To optimize the prescription and preparation technology of brucine nanostructured lipid carriers (B-NLC). Methods The method of "the solvent emulsification ultrasound" was used to prepare B-NLC. The prescription and preparation was optimized using a single factor method combined with central composite design-response surface methodology (CCD-RSM). Results The resultant B-NLC was transparent liquid with light blue opalescence. The optimal conditions were that the dosage of drugs was 1.28 mg, the mass concentration of poloxamer 188 was 1.08%, and the ratio of solid lipid to liquid lipid was 1.45:1. The obtained NLC showed the average particle size of (136.89 ± 4.23) nm with a polydispersity index of 0.289 ± 0.005 and a zeta potential of (-34.46 ± 0.31) mV. The entrapment efficiency was calculated to be (68.98 ± 2.06)%, and the drug loading content was (1.90 ± 0.06)%. Conclusion B-NLC prepared by solvent emulsification ultrasound had a high entrapment efficiency and a narrow particle size distribution. The method was easy and simple and can be used to optimize the prescription and preparation of B-NLC, which provides a foundation for the further in vivo research of brucine.
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Objective To investigate the uptake mechanism of HepG2.2.15 cells to the nanoparticles co-loaded with syringopicroside and hydroxytyrosol (SH-NPs). Methods The nanoparticles were prepared by using a nanoprecipitation method with mPEG-PLGA as nano-carrier co-loaded with syringopicroside and hydroxytyrosol. The uptake mechanism of HepG2.2.15 cells to SH-NPs was studied by fluorescence microscopy and flow cytometry using fluoresceineisothiocyanate (FITC) as a fluorescent marker. Results With colchicine as the inhibitor, the incubation time ranged from 0.5 to 24 h, the percentage of positive cells increased from 1.9% to 56.4%; When the drug concentration was 125, 250 μg/mL and 500 μg/mL, the positive cell percentages were 4.9%, 3.4% and 3.9%. With chloroquine as the inhibitor; the incubation time ranged from 0.5 to 24 h, the percentage of positive cells increased from 7.4% to 55.4%; When the drug concentration was 125, 250 and 500 μg/mL, the percentage of positive cells was 19.5%, 22.5% and 27.6%. Conclusion Colchicine and chloroquine have an inhibitory effect on HepG2.2.15 cells uptake, and the uptake of SH-NPs in HepG2.2.15 cells was positively correlated with drug concentration and incubation time. It can be concluded that the uptake mechanism of HepG2.2.15 cells to SH-NPs was nonspecific adsorption endocytosis.