ABSTRACT
Bullous pemphigoid (BP) can be comorbid with a variety of immune diseases, such as immune skin diseases (psoriasis, vitiligo, alopecia areata and various other immune bullous diseases) , immune digestive diseases (inflammatory bowel disease, primary biliary cirrhosis) , autoimmune thyroid diseases, autoimmune rheumatic diseases (rheumatoid arthritis, dermatomyositis, scleroderma and systemic lupus erythematosus) , immune renal diseases (immune nephropathy, renal allograft rejection) and acquired hemophilia A. The above comorbidities markedly affect the quality of life of and treatment options for patients. This review elaborates on currently reported immune diseases associated with BP and their concomitant mechanisms.
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Objective To observe the effects of Siweiyuganzi prescription on anti-peroxidation and blood lipid levels in experimental rats with hyperlipidemia. Methods Sixty male Sprague-Dawley (SD) rats were divided into normal control group, hyperlipidemia model group, Xuezhikang group, Siweiyuganzi prescription large, medium and small dose group according to the random number table method, with 10 rats in each group. The hyperlipidemia rat model was established by intragastric feeding with high fat emulsion everyday 10 mL·kg-1·d-1; normal saline 10 mL/kg was given to the normal control group, twice a day by intragastric feeding; 3 dosages of Siweiyuganzi suspended fluid 12.8, 6.4, 4.3 g·kg-1·d-1 intragastric administrations were given to Siweiyuganzi prescription large, medium and small dose groups respectively; Xuezhikang suspended fluid 0.3 g·kg-1·d-1 was given to Xuezhikang group intragastrically;the same volume of normal saline was given to hyperlipidemia model group. After 4 weeks, the level changes of blood lipid, serum superoxide dismutase (SOD), malonaldehyde (MDA), hydroxymethylglutaryl Coenzyme A (HMG-CoA) were observed. Results Compared to those in the normal control group, the levels of triglyceride (TG), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), MDA, content and positive expression of HMG-CoA, alanine aminotransferase (ALT) were all higher in hyperlipidemia model group [TG (mmol/L): 6.59±0.72 vs. 4.32±0.36, TC (mmol/L): 7.10±0.25 vs. 5.98±0.40, LDL-C (mmol/L): 4.18±1.30 vs. 2.33±0.35, MDA (μmol/L): 26.05± 5.99 vs. 10.08±1.98, HMG-CoA content (ng/L): 54.60±2.90 vs. 48.73±3.09, HMG-CoA positive expression in liver tissue:(57.80±12.30)% vs. (22.00±4.92)%, ALT (U/L): 106.83±15.75 vs. 81.97±13.18]; SOD and high-density lipoprotein cholesterol (HDL-C) in hyperlipidemia model group were significantly decreased [SOD (kU/L): 295.47±37.51 vs. 345.13±19.76, HDL-C (mmol/L): 2.32±0.49 vs. 4.84±0.45, both P < 0.05]. Compared with the hyperlipidemia model group, the TG, TC, LDL-C, MDA, contents and positive expression of HMG-CoA in each group were significantly reduced, and the SOD and HDL-C were obviously increased, and the changes in the Siweiyuganzi high dose group were more significant than those of the Siweiyuganzi middle-and low-dose groups [TG (mmol/L): 4.70±0.46 vs. 5.40±0.31, 5.70±0.41, TC (mmol/L): 5.80±0.23 vs. 6.14±0.20, 6.56±0.32, LDL-C (mmol/L): 2.56±0.45 vs. 2.93±0.33, 3.28±0.32, HDL-C (mmol/L): 4.58±0.28 vs. 3.89±0.30, 3.59±0.08, SOD (kU/L): 381.45±20.68 vs. 360.60±30.16, 325.49±32.13, MDA (μmol/L): 16.98±5.39 vs. 17.89±5.37, 21.03±6.01, HMG-CoA content (ng/L): 50.58±0.77 vs. 52.16±0.66, 52.90±0.91, HMG-CoA positive expression in liver tissue: (27.90±6.03)% vs. (32.20±7.00)%, (43.00±8.39)%, all P < 0.05]. In the normal control group, there were positive cells scattered in the central vein area and loosely distributed around the portal area in the rat liver; in the hyperlipidemia model group, the positive cells were increased in the central vein area and the cells in relatively great number were seen around the portal area. While the positive cells in Xuezhikang group and in the high, medium and low dose Siweiyuganzi groups were decreased. Conclusion Siweiyuganzi prescription can regulate the levels of blood lipids, prevent and treat the lipid peroxidation caused by hyperlipidemia, and inhibit excessive expression of HMG-CoA in experimental rats with hyperlipidemia.
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Objective To evaluate the curative effect of Huoxue-Xiaozhi capsule on non-alcoholic fatty liver disease (NAFLD). Methods A total of 100 patients with NAFLD who met the inclusion criteria were divided into 2 groups with 50 patients in each group by random number table method. The treatment group was treated with Huoxue-Xiaozhi capsule, while the control group was treated with Compound Methionine Choline Tablets. Both groups were treated for 8 weeks. The ALT, AST, γ-GT (γ- glutamyltranspeptidase ), ALP (alkaline phosphatase, alkaline phosphate) were detected by automatic blood biochemical analyzer. The serum high sensitivity-C reactive protein (hs-CRP) and Homocysteine (Hcy) were detected by supplementary detection method. The serum IL-18 was detected by ELISA method, and liver imaging was performed before and after treatment. The symptoms and signs were evaluated, and clinical efficacy was evaluated. Results The total effective rate was 90.0％ (45/50) in the treatment group and 74.0％ (37/50) in the control group. The difference between the two groups was statistically significant (Z=-2.328, P=0.020 ). After treatment, the serum hs-CRP (2.4 ± 2.9 mg/L vs. 3.6 ± 2.8 mg/L, t=2.105), Hcy (11.2 ± 5.5 μmol/L vs. 13.9 ± 6.4 μmol/L, t=2.262), IL-18 (690.6 ± 61.3 ng/L vs. 775.4 ± 60.5 ng/L, t=6.962) in the treatment group were significantly lower than those in the control group (P<0.05 or P<0.01). After treatment, the improvement of hypochondriac lump, sallow complexion, dark complexion and hypochondriac dull pain in the treatment group were superior to those in the control group (Z values were -2.563, -2.788, -2.780, -2.220 respectively, all Ps<0.05 ). The Serum ALT, AST,γ-GT and ALP levels were significantly lower than those of the control group (t values were 18.820, 19.811, 10.221 and 3.248 respectively, all Ps<0.001 ). Conclusions The Huoxue-Xiaozhi capsule can improve the liver function and reduce the levels of serum hs-CRP, HCY and IL-18, and its curative effect of NAFLD.
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Objective To observe the clinical therapeutic effect of Xiaozhong Sanjie prescription combined with Huayu powder external application for treatment of patients with nodular goiter (NG) and approach its mechanism. Methods A prospective randomized controlled study was conducted, including 128 patients who were definitely diagnosed as NG and admitted into Affiliated Hospital of Qinghai University from September 2014 to December 2016, and they were divided into a control group and a traditional Chinese medicine (TCM) treatment group by random number table method, 64 cases in each group. The control group received follow up observation; the TCM group was treated by Xiaozhong Sanjie prescription (the ingredients: rhizoma sparganii 15 g, zedoary 10 g, fritillary bulb 15 g, prunella vulgaris 20 g, bupleurum 6 g, dried tangerine 10 g, oyster 20 g, fructus aurantii 10 g, radix glycyrrhizae 5 g) in the mean time combined with Huayu powder (the ingredients: borneol 10 g, prunella vulgaris 20 g, pinellia ternata 15 g, oyster 15 g, radix curcumae 15 g, rhubarb 15 g); the ingredients of the prescription were immersed in water and decocted to form a decoction, a dose 400 mL daily, 200 mL taken orally in the morning and 200 mL in the evening after meal; the powder ingredients were mixed and stirred thoroughly with Chinese rice wine or vinegar (10 mL) to form a paste which was put uniformly flat onto a gauze about 15 cm in length and 1 cm in thickness, roasted by infrared lamp, as the paste temperature was lowered to body temperature, it was attached on the goiter skin of neck, then fixed by bandage before sleep to the next morning, afterwards the paste was removed and nodular skin washed, the length of external application being guaranteed to be over 4 hours a day; in the event when skin red swelling or pruritus occurred, promethazine should be used or the duration of application was shortened. Fifteen days constituted one therapeutic course, and after consecutive 3 courses of treatment, the therapeutic effects in the two groups were observed. Before and after treatment in the two groups, the changes of thyroid nodular size and TCM syndrome score were observed, meanwhile the thyroid functional index levels of serum vascular endothelial growth factor (VEGF), insulin-like growth factor Ⅰ(IGF-Ⅰ) and transforming growth factor-β1 (TGF-β1) were detected by enzyme-linked immunosorbent assay (ELISA). Results After treatment for 45 days, compared with control group, the thyroid nodule in TCM treatment group was significantly shrunken (mm: 8.75±3.41 vs. 15.89±4.51, P < 0.05) , and TCM syndrome score in TCM treatment group was significantly lowered (20.35±4.83 vs. 35.53±6.71, P < 0.05); before and after admission in the two groups, the thyroid function indexes of thyrotropic-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4) were in the normal range, and there were no statistical significant differences between the two groups (all P > 0.05); the levels of serum VEGF, IGF-I were reduced in the TCM treatment group [VEGF (ng/L): 27.52±8.35 vs. 33.08±9.57, IGF-Ⅰ (μg/L): 24.12±6.74 vs. 35.57±11.39], TGF-β1 was increased in the TCM treatment group (ng/L: 363.67±97.83 vs. 225.87±47.71), and the differences were statistically significant (all P < 0.05). Conclusions Xiaozhong Sanjie decoction combined with Huayu powder external application can inhibit the levels of VEGF, IGF-Ⅰ and elevate the TGF-β1 level that possibly the mechanism of the combined therapy to shrink the thyroid nodule size.
ABSTRACT
Objective To observe the clinical therapeutic effect of Xiaozhong Sanjie prescription combined with Huayu powder external application for treatment of patients with nodular goiter (NG) and approach its mechanism. Methods A prospective randomized controlled study was conducted, including 128 patients who were definitely diagnosed as NG and admitted into Affiliated Hospital of Qinghai University from September 2014 to December 2016, and they were divided into a control group and a traditional Chinese medicine (TCM) treatment group by random number table method, 64 cases in each group. The control group received follow up observation; the TCM group was treated by Xiaozhong Sanjie prescription (the ingredients: rhizoma sparganii 15 g, zedoary 10 g, fritillary bulb 15 g, prunella vulgaris 20 g, bupleurum 6 g, dried tangerine 10 g, oyster 20 g, fructus aurantii 10 g, radix glycyrrhizae 5 g) in the mean time combined with Huayu powder (the ingredients: borneol 10 g, prunella vulgaris 20 g, pinellia ternata 15 g, oyster 15 g, radix curcumae 15 g, rhubarb 15 g); the ingredients of the prescription were immersed in water and decocted to form a decoction, a dose 400 mL daily, 200 mL taken orally in the morning and 200 mL in the evening after meal; the powder ingredients were mixed and stirred thoroughly with Chinese rice wine or vinegar (10 mL) to form a paste which was put uniformly flat onto a gauze about 15 cm in length and 1 cm in thickness, roasted by infrared lamp, as the paste temperature was lowered to body temperature, it was attached on the goiter skin of neck, then fixed by bandage before sleep to the next morning, afterwards the paste was removed and nodular skin washed, the length of external application being guaranteed to be over 4 hours a day; in the event when skin red swelling or pruritus occurred, promethazine should be used or the duration of application was shortened. Fifteen days constituted one therapeutic course, and after consecutive 3 courses of treatment, the therapeutic effects in the two groups were observed. Before and after treatment in the two groups, the changes of thyroid nodular size and TCM syndrome score were observed, meanwhile the thyroid functional index levels of serum vascular endothelial growth factor (VEGF), insulin-like growth factor Ⅰ(IGF-Ⅰ) and transforming growth factor-β1 (TGF-β1) were detected by enzyme-linked immunosorbent assay (ELISA). Results After treatment for 45 days, compared with control group, the thyroid nodule in TCM treatment group was significantly shrunken (mm: 8.75±3.41 vs. 15.89±4.51, P < 0.05) , and TCM syndrome score in TCM treatment group was significantly lowered (20.35±4.83 vs. 35.53±6.71, P < 0.05); before and after admission in the two groups, the thyroid function indexes of thyrotropic-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4) were in the normal range, and there were no statistical significant differences between the two groups (all P > 0.05); the levels of serum VEGF, IGF-I were reduced in the TCM treatment group [VEGF (ng/L): 27.52±8.35 vs. 33.08±9.57, IGF-Ⅰ (μg/L): 24.12±6.74 vs. 35.57±11.39], TGF-β1 was increased in the TCM treatment group (ng/L: 363.67±97.83 vs. 225.87±47.71), and the differences were statistically significant (all P < 0.05). Conclusions Xiaozhong Sanjie decoction combined with Huayu powder external application can inhibit the levels of VEGF, IGF-Ⅰ and elevate the TGF-β1 level that possibly the mechanism of the combined therapy to shrink the thyroid nodule size.