ABSTRACT
Objective:To observe the clinical efficacy of the modified Buzhong Yiqitang combined with Erxian decoction in treating stress urinary incontinence （SUI） of perimenopausal women due to spleen and kidney Qi deficiency. Method:One hundred and six patients were randomly divided into a control group （52 cases） and an observation group（54 cases）. Patients in both groups received lifestyle intervention and pelvic floor muscle training （PFMT）. On this basis， patients in the observation group were further treated with the modified Buzhong Yiqitang combined with Erxian decoction， 1 bag/day， while those in the control group were provided with Suoquan pills， 6 g/time， 2 times/day， for eight weeks. Following the international consultation on incontinence questionnaire-short form （ICIQ-SF） scoring before and after treatment， the urodynamic parameters such as maximum urinary flow rate （Q<sub>max</sub>）， maximum urethral closure pressure （MUCP）， residual urine volume （RUV）， abdominal pressure leakage point pressure （ALPP）， and bladder capacity （BC） were measured. The number of incontinence episodes per 24 h， the degree of urinary incontinence， the amount of 1 h urine leakage， and the spleen and kidney Qi deficiency syndrome score were recorded before and after treatment. The levels of estradiol （E<sub>2</sub>）， follicle stimulating hormone （FSH）， pituitary adenylate cyclase activating peptide （PACAP）， and vasoactive intestinal peptide （VIP） were measured before and after treatment. Result:The ICIQ-SF sub-scores of the urinary incontinence frequency， severity， and impact on quality of life as well as the total score in the observation group were all lower than those in the control group （<italic>P</italic><0.01）. Q<sub>max</sub>， MUCP， ALPP and BC in the observation group were elevated in contrast to those in control group （<italic>P</italic><0.01）， while the RUV declined （<italic>P</italic><0.01）. Compared with the control group， the observation group exhibited a decreased number of incontinence episodes per 24 h， milder degree of urinary incontinence， reduced amount of 1 h urine leakage， and lower spleen and kidney Qi deficiency syndrome score （<italic>P</italic><0.01）. The E<sub>2</sub>， PACAP， and VIP in the observation group were up-regulated as compared with those in the control group （<italic>P</italic><0.01）， whereas the FSH was down-regulated （<italic>P</italic><0.01）. The cure and effective rates of the observation group were （29/50） 58.00% and （47/50）94.00%， respectively， significantly better than （18/48）37.50% and （38/48）79.17% of the control group （<italic>χ</italic><sup>2</sup>=4.124， <italic>χ</italic><sup>2</sup>=4.683， <italic>P</italic><0.05）. Conclusion:On the basis of the lifestyle intervention and PFMT， the modified Buzhong Yiqitang combined with Erxian decoction obviously alleviates urinary incontinence， adjusts sex hormones， PACAP and VIP， ameliorates urodynamic parameters， and enhances the quality of life of patients with SUI due to spleen and kidney Qi deficiency. The resulting cure and effective rates are superior to those of the positive control.
ABSTRACT
Objective::To investigate the effect of Wenshen Zhuyang Tiaozhou method on sex hormones, insulin and ovulation in polycystic ovary syndrome (PCOS) patients with kidney-Yang deficiency syndrome based on phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway. Method::Totally 60 PCOS patients with kidney-Yang deficiency syndrome treated at the First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine from February 2017 to July 2018 were selected and divided into observation group and control group according to the random number table method, with 30 cases in each group. The control group was orally treated with ethinylestradiol and cycloproterone acetate tablets, in addition to this therapy, the observation group also received Wenshen Zhuyang Tiaozhou method. Both groups were followed up after three months of treatment. Sex hormone levels, fasting plasma glucose (FPG) and fasting insulin (FINS) levels were measured in all patients. Homeostasis model assessment-insulin resistance(HOMA-IR) was calculated by homeostasis model assessment method, and the expression levels of Akt and p-Akt proteins in endometrium were detected by Western blot. Result::After treatment, the levels of FSH and LH in both groups decreased, and the level of E2 sex hormone increased (P<0.05). After treatment, the levels of FSH and LH in observation group were lower than those in control group, whereas the level of E2 sex hormone was higher than that in control group (P<0.05). After treatment, the levels of FPG and FINS in two groups were significantly lower (P<0.05), while the levels of FPG and FINS in observation group were significantly lower than those in control group (P<0.05). After treatment, the ovarian volume and the number of sinusoidal oocytes in two groups decreased significantly, while the endometrial thickness increased (P<0.05). After treatment, the ovarian volume and the number of sinusoidal oocytes in observation group were significantly lower than those in control group, and the endometrial thickness was significantly lower than that in observation group (P<0.05). After treatment, the ovarian volume and the number of sinusoidal oocytes in observation group were significantly lower than those in control group, and the endometrial thickness was larger than that of control group (P<0.05). After treatment, the Akt and p-Akt proteins in the endometrium of observation group and control group were significantly decreased, while the Akt and p-Akt proteins in the endometrium of observation group were significantly lower than those of control group (P<0.05). Conclusion::Wenshen Zhuyang Tiaozhou method can effectively ameliorate the sex hormone level, regulate insulin and promote the recovery of ovarian function in PCOS patients with kidney-Yang deficiency syndrome. This may be related to the blocking of the phosphorylation of Akt and the inhibition of the activation of PI3K/Akt signaling pathway.
ABSTRACT
<p><b>OBJECTIVE</b>To compare the advantages and disadvantages between exercise challenge test (ECT) and methacholine challenge test (MCT) in the measurement of airway hyperresponsiveness (AHR), in order to identify a better and safer method to measure AHR.</p><p><b>METHODS</b>Forty-seven children with controlled asthma after regular treatment were enrolled. ECT and MCT were performed for each child successively, and sensitivity was obtained through comparison with the golden standard (PD20). The occurrence of bronchospasm symptoms during the two tests was recorded.</p><p><b>RESULTS</b>Taking PD20 as the gold standard, in children with moderate or severe AHR, the sensitivity of MCT (61%) for the measurement of AHR was significantly higher than that of ECT (9%) (P<0.05). The consistency between MCT results and PD20 was relatively high (κ=0.614), while the consistency between ECT results and PD20 was relatively low (κ=0.006). However, in the MCT, the incidence of bronchospasm symptoms was high and positively correlated with the incidence of cough and chest distress (P<0.05).</p><p><b>CONCLUSIONS</b>MCT has a higher sensitivity for the measurement of AHR, but has a higher incidence of adverse events, compared with ECT in children with controlled asthma after regular treatment.</p>