ABSTRACT
Huaihuasan， first recorded in Puji Benshifang by XU Shu-wei from the Southern Song dynasty， consists of four herbs， namely Sophorae Flos （fried）， Platycladi Cacumen （smashed with pestle and baked）， Schizonepetae Spica， and Aurantii Fructus （cut into pieces after the removal of pulp and then fried yellow with wheat bran）. At present， Huaihuasan and its modified formulas vary in clinical usages and dosages， and the resulting outcomes have been investigated. However， there are few reviews uncovering its historical evolution. On this basis， this review systematically combed and verified the historical evolution， dose conversion between ancient and modern times， efficacy， and indications of Huaihuasan， as well as the origin and processing of the contained herbs. The findings have demonstrated that Huaihuasan is composed of four herbs， with the original plants and medicinal parts basically the same as those recorded in the 2020 edition of Chinese Pharmacopoeia. Sophorae Flos refers to the dried flower and bud of Sophora japonica in family Leguminosae， Platycladi Cacumen the dried branch and leaf of Platycladus orientalis in family Cupressaceae， Schizonepetae Spica the dried flower spike of Schizonepeta tenuifolia in family Labiatae， and Aurantii Fructus the dried immature fruit of Citrus aurantium in family Rutaceae or its cultivated varieties. On account of the efficacy in clearing intestine， stopping bleeding， dispersing wind， and moving Qi， Huaihuasan has been mainly used to treat intestinal diseases such as bloody defecation and perianal abscess. In modern clinical practice， it is mainly applicable to patients with hematochezia and bleeding due to internal hemorrhoid， ulcerative colitis， or anal fissure. It was suggested that the raw medicinal materials should be decocted and processed according to the methods described in the 2020 edition of Chinese Pharmacopoeia. Following the conversion formula of one Qian=4 g， this paper determined the dosages of Sophorae Flos （fried）， Platycladi Cacumen （smashed with pestle and baked）， Schizonepetae Spica， and Aurantii Fructus （cut into pieces after the removal of pulp and then fried yellow with wheat bran） all to be 2 g， with the total dosage being 8 g. Such comprehensive analysis based on ancient books and modern literature has provided a more scientific reference for the clinical application， research， and development of this classical formula.
ABSTRACT
Objective::To observe effect of addition and subtraction therapy of Huaihuasan combined with Taohuatang to ulcerative colitis with cold-heat complicated syndrome at active stage, and to study regulation effect to immune function and inflammatory response. Method::One hundred and twelve patients were randomly divided into control group and observation group by random number table. Patients with light and middle symptoms in control group got mesalazine slow release tablets, 1.0 g/time, 3 times/days, patients with severe symptoms or whose symptoms were not changed after getting for 4 weeks in control group got prednisone acetate tablets, 0.75 mg·kg-1·d-1 for 3 times. Based on the treatment in control group, patients in observation group added Huaihuasan combined with Taohuatang, 1 dose/day. The course of treatment was 4 weeks. At remission period, mesalazine slow release tablets were used for maintain long-term maintenance therapy, 0.5 g/times, 3 times/days. Scores of disease activities were graded by improvement mayo, and clinical remission and clinical efficacy were recorded, scores of cold-heat complicated syndrome, mucous membrane under enteroscopy and histology of mucosa belongs to Geboes were graded. And levels of tumor necrosis factor-α(TNF-α) in peripheral blood, interleukin-8 (IL-8), IL-10, T lymphocyte subsets (CD4+, CD8+), and adverse reactions, 6 months' follow-up and recurrence were also be recorded. Result::Therapeutic effect of traditional Chinese medicine syndromes were analyzed by rank sum test, which in observation group was better than that in control group (Z=1.915, P<0.05). Clinical effect in observation group was 98.04%(50/51) higher than 84.00%(42/50) in control group, clinical remission rate was 94.12%(48/51) higher than 78.00%(39/50) in control group, and mucosal healing rate was 96.08%(49/51) higher than 82.00%(41/50) in control group (P<0.05). Scores of mayo, cold-heat complicated syndrome, colonic mucosa and index scores of Geboes were all lower than those in control group (P<0.01). And levels of TNF-α, IL-8 and CD8+ were lower than those in control group (P<0.01), and levels of IL-10, CD4+ and CD4+ /CD8+ were higher than those in control group (P<0.01). Recurrence rate during 6 months in observation group was 10.42%(5/48) lower than 30.77%(12/39) in control group (χ2=5.669, P<0.05), as for adverse reactions, there was no significant difference between two groups. Conclusion::Huaihuasan combined with Taohuatang can induce UC to remission period, inhibit the activity of disease, alleviate clinical symptoms, regulate immune function and expression of inflammatory factors, alleviate inflammatory reaction, promote intestinal mucosal healing, and can maintain clinical remission and reduce recurrence. The clinical efficacy is superior to that of 5-ASA/glucocorticoid in Western medicine.
ABSTRACT
Objective:To observe the effects of addition and subtraction therapy of Danggui Shaoyaosan combined with Huaihuasan on ulcerative colitis (UC) with syndrome of dampness-heat in large intestine during active stage, and the effects on brain-gut petide neurotransmitter and inflammatory cytokines. Method:A total of 130 cases were included and randomly divided into control group and observation group, 65 cases in each group. In the control group, the patients received oral administration of mesalazine enteric-coated tablets, 1.0 g/time and 3 times/days. Severe patients received prednisone acetate tablets (0.75 mg·kg-1·d-1) in several times by oral administration. Based on the treatment in control group, patients in observation group also received addition and subtraction therapy of Danggui Shaoyaosan combined with Huaihuasan, 1 dose/day. Both groups were treated for 4 weeks. Symptom scores, Mayo scores, colonic mucosa scores and Inflammatory Bowel Disease Questionnaire (IBDQ) scores were assessed before and after treatment. Patients in remission stage were followed up for 6 months to record the recurrence. Before and after treatment, vasoactive intestinal peptide (VIP), substance P (SP), somatostatin (SS), interleukin-1 (IL-1), IL-6, IL-4 and IL-10 were detected. Result:After 4 weeks of treatment, the clinical remission rate was 93.22%in the observation group, better than 80.7%in the control group (χ2=4.035,PPPPχ2=4.509,PPPPPPConclusion:On the basis of conventional western medicine treatment, addition and subtraction therapy of Danggui Shaoyaosan combined with Huaihuasan in the treatment of UC (dampness-heat in large intestine) during active stage can control the disease activity in a short term, promote restoration of the colonic mucosa. And delay the recurrence in a long term, reduce the recurrence rate, regulate ghrelin neurotransmitters and pro-and anti-inflammatory cytokines levels.