Huaiqihuang Granules in Treatment of Chronic Kidney Disease： A Review / 中国实验方剂学杂志

Chronic kidney disease is characterized by renal structural damage and dysfunction （for over three months） caused by various factors. In traditional Chinese medicine， chronic kidney disease can be classified as edema， ischuria， consumptive disease， and anuria and vomiting. The pathogenesis of chronic kidney disease is frequently attributed to the deficiency of lung， spleen and kidney， dampness combined with stasis， and accumulation of turbid toxin. Huaiqihuang granules are a Chinese patent medicine composed of Vanderbylia robiniophila， Lycii Fructus， and Polygonati Rhizoma， with diverse pharmacological effects such as improving immunity and protecting kidney function. It is widely used in the treatment of cancer， chronic kidney disease， and respiratory system diseases. The available studies have demonstrated that Huaiqihuang granules can intervene in the progression of chronic kidney disease via various ways， such as protecting glomerular podocytes， inhibiting the proliferation of glomerular mesangial cells， resisting renal interstitial fibrosis， alleviating renal inflammation and oxidative stress， and regulating renal cell apoptosis and the immune system function. The clinical application of Huaiqihuang granules is based on conventional treatment and has achieved remarkable effects in the treatment of children's nephrotic syndrome， diabetic nephropathy， nephritis of Schonlein-Henoch purpura， IgA nephropathy， and chronic renal failure. Scholars have achieved great progress in the research on the mechanism and the clinical application of Huaiqihuang granules in the treatment of chronic kidney disease. However， the detailed summary of the progress in recent years remains to be carried out. Therefore， this paper reviewed the available studies in this field， aiming to provide a reference for the comprehensive and extensive clinical application of Huaiqihuang granules in the treatment of chronic kidney disease.

The role of Huaiqihuang Granules in the long-term management of bronchial asthma in young children: a multicenter real-world study / 中华实用儿科临床杂志

Objective:To observe the role of Huaiqihuang Granules (HQ) in the long-term management of bronchial asthma in young children, and the effective effect on concomitant rhinitis.Methods:A prospective real-world multicenter study was conducted in children aged 2-5 years with asthma diagnosed in the outpatient department (from April 2016 to March 2019)who received either inhaled corticosteroid (ICS)/leukotriene receptor antagonist (LTRA)(control group); inhaled ICS/LTRA plus HQ(combination group), or HQ alone(HQ group). All patients were followed up at week 4, 8, 12 after treatment. The number of days with asthma symptoms, the frequency of severe asthma attacks, the level of asthma control, and the days with rhinitis symptoms in the last 4 weeks were recorded. Differences before and after treatment, and those among groups after treatment were compared using Kruskal- Wallis H test or Wilcoxon rank-sum test. Results:A total of 2 234 eligible patients were recruited, and 2 147 cases completed followed-up visits, including 477, 1 374 and 296 cases in the control group, combination group, and HQ group, respectively. After the treatment, all 3 groups showed significant declines in the days with asthma symptoms, frequency of severe asthma attack and the days with rhinitis symptoms (all P<0.01), and the rate of well-controlled asthma increased significantly ( P<0.01). It lasted until the end of follow-up. Among groups, patients in the combination group showed significantly less days of asthma symptoms than those of the other 2 group at week 8 and 12[0(0, 0.9) d vs.0(0, 0.3) d, P<0.05; 0(0, 0.1) d vs. 0(0, 1.0) d, P<0.01]. Patients in the combination group and HQ group showed a significantly lower rate of severe asthma attacks than that of the control group at week 12 [0(0, 1), 0(0, 1), 0(0, 2), all P<0.05]. The well-controlled rate of asthma in the combination group was significantly higher than that of the control group and HQ group at week 8 and 12 (89.6% vs. 85.9% vs.82.1%, H=15.28; 90.9% vs. 84.1% vs. 81.8%, χ2=29.32, all P<0.01). Conclusions:HQ can significantly alleviate symptoms of asthma and rhinitis, severe attack of asthma, and increase the control rate of asthma when used as an additional treatment or used alone.

Clinical study of dynamic changes of T lymphocyte level in children with protracted bacterial bronchitis / 中国实用儿科杂志

OBJECTIVE: To investigate the relationship between pathogenesis of PBB and the T cell subsets disorders and to evaluate the clinical significance of immunomodulatory therapy to the prognosis of PBB and the prevention of recurrent PBB. METHODS: A total of 127 cases of PBB children treated in the Fourth Hospital of Baotou City from May2015 to May 2018 were selected. Blood samples were collected before treatment,and the levels of CD4,CD8 cells and CD4/CD8 in peripheral blood T cell subsets were detected by flow cytometry. All children with PBB(PBB group)were given oral amoxicillin and clavulanate potassium for 2 to 4 weeks. The subjects were divided into Huaiqihuang group(n=66)and non-Huaiqihuang group(n=66). The Huaiqihuang group was given Huaiqihuang granules based on the anti-infective treatment. In addition,healthy children were enrolled as control group(n=39). T cell subsets of the two groups were reexamined 3 months after treatment. By analyzing the cough symptom scores of all children after 2 weeks,4 weeks and 12 weeks of treatment,the rate of cure and improvement and the recurrence rate after 1 year were evaluated.SPSS16.0 software was used for data processing,and the difference was significant if P0.05). In 2 weeks after treatment,the cough symptom scores of the PBB group began to decrease,and the non-Huaiqihuang group decreased more significantly,with statistically significant difference(P0.05). Follow-up showed that the recurrence rate of Huaiqihuang group was lower than that of non-Huaiqihuang group in 1 year after the end of treatment,and the difference between the two groups was statistically significant(P<0.01). CONCLUSION: Children with PBB have T cell subsets disorder,and the treatment of anti-infection combined with Huaiqihuang granules for at least 4 weeks has a positive effect on PBB prognosis and recurrence prevention.

Evaluation on efficacy of Huaiqihuang granules in treatment of children with asthma at non-acute attack stage / 吉林大学学报(医学版)

Objective: To explore the efficacy of Huaiqihuang Granules in the treatment of the children with asthma at non-acute attack stage and its effect on the immune function indexes of body. Methods: A total of 180 children with asthma at non-acute attack stage were divided into Huaiqihuang Granules treatment group (n=92, treated with traditional Chinese medicine Huaiqihuang Granules along with oral montelukast and inhaled corticosteroid, ICS+MK+H group) and routine treatment group (n=88, only given oral montelukast and inhaled corticosteroid, ICS+MK group). The indexes of asthma attack degrees, traditional Chinese medicine (TCM) syndrome indexes, blood immune function indexes and pulmonary function indexes of the children in two groups were detected. Results: There was no difference in the disease degrees of the children between two groups before treatment (P>0. 05). Compared with routine treatment group, the score of acute attack of asthma of the children in Huaihuang Granules treatment group was decreased after treatment (P0. 05). Compared with routine treatment group, the peak expiratory flow (PEF) and the ratio value of forced expiratory volume in the first second /forced vital capacity (FEV1/FVC) of the children in Huaiqihuang Granules treatment group were increased (P0. 05). Conclusion: On the basis of routine treatment, Huaiqihuang Granules can reduce the condition of children with asthma at non-acute attack stage and improve the TCM syndrome and immune function.

Huaiqihuang Granules () reduce proteinuria by enhancing nephrin expression and regulating necrosis factor κB signaling pathway in adriamycin-induced nephropathy / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the effects of Huaiqihuang Granules (, HQH), a mixture of Chinese herbs including Trametes robiniophila Murr, Fructus Lycii and Polygonatum sibiricum, on adriamycininduced nephropathy (ADRN) in rats and its underlying mechanisms.</p><p><b>METHODS</b>Rats with ADRN were divided into four groups: the sham group, the model group (distilled water), the low-dose HQH-treated (2 g/kg) group, and the high-dose HQH-treated (4 g/kg) group. Body weight and 24-h urinary protein (Upro) were checked every week. After 5-week intervention, at the end of the study, the rats were sacrificed and blood samples were collected for examination of biochemical parameters, including glomerular morphological makers, podocyte shape, cellular apoptosis, expressions of nephrin, inflammatory and apoptosis markers.</p><p><b>RESULTS</b>HQH ameliorated the rat's general status, proteinuria, renal morphological appearance and glomerulosclerosis. The decreased expression of nephrin in ADRN rats was increased by HQH, as well as the impaired podocyte foot process fusion. Cytosolic levels of p65 and inhibitor of nuclear factor κBα (IκBα) were decreased in ADRN rats, and recovered by the treatment of HQH. Consistently, the induced expression of tumor necrosis factor α (TNF-α), phosphorylated nuclear factor κB p65 (p-NFκB p65) and IκBα in ADRN were markedly suppressed by HQH. In addition, induction of Bax, cleaved caspase-3 and cytochrome C in ADRN rats were suppressed by HQH, indicating the amelioration of apoptosis.</p><p><b>CONCLUSION</b>HQH could ameliorate renal impairments in ADRN rats by increasing nephrin expression, inhibiting NF-κB signaling pathway via the down-regulation of p-NF-κB p65 and p-IκBα, and suppression of glomerular and tubular apoptosis.</p>

The effects of ACTH and Huaiqihuang on the treatment of recurrence nephrotic syndrome in children / 天津医药

Objective To observe the effects and safety of adrenocorticotropic hormone (ACTH) combined with Huaiqihuang on frequent relapse nephrotic syndrome (FRNS) in children. Methods Fifty-five child patients with FRNS were divided into control group, which was given glucocorticoid (GC) to maintain the treatment (group A, n=10), Huaiqihuang group (group B, n=17), ACTH group (group C, n=14) and ACTH combined with Huaiqihuang group (combined treatment group, group D, n=14). Continuous treatment was for 12 months. The GC treatment doses, the levels of basal secretion of adrenal cortex and adrenal cortex reserve were recorded at 6-month and 12-month respectively. And the recurrence rate and adverse reactions were observed in four groups. Results After 6-month treatment, the doses of GC were significantly lower in group C and group D than those in group A and group B (P0.05). After treatment for 6 months and 12 months, the recurrence rates of nephrotic syndrome were significantly lower in group C and group D than those of group A and group B (P<0.05). Conclusion The simple application of ACTH and the combination of Huaiqihuang can relieve the inhibition of long-term using GC on hypothalamic pituitary adrenal axis in FRNS patients.

Study of Huaiqihuang particles in treatment of children with bron chialasthma and effect on immune function / 药物评价研究

Objective To investigate Huaiqihuang particles in treatment of children with bron chialasthma and effect on immune function.Methods 100 cases of children with bronchial asthma were randomly divided into control group and treatment group,50cases in each group,all were given routine western medicine treatment,and the treatment group combined with Huaiqihuang particles.The levels of interleukin-4 (IL-4),IL-5 and interferon gamma (IFN-γ),diurnal and nocturnal symptom scores before and after treatment and clinical efficacy and recurrence rate in followed up for 3 months in two groups were compared.Results After treatment,serum IL-4,IL-5 levels of the two groups were significantly decreased,IFN-γ levels were significantly increased in the same group before and after treatment,the difference was statistically significant (P ＜ 0.05).,serum IL-4 and IL-5 levels of treatment group were significantly lower than the control group,IFN-γ levels were significantly higher than the control group,there was statistically significant difference between groups (P ＜ 0.05).After treatment,daytime and nighttime symptom scores of two groups were significantly reduced than before treatment (P ＜ 0.05).And the treatment group was significantly lower than the control group (P ＜ 0.05).The total effective rate of the treatment group (96％) was significantly better than that of the control group (82％) (P ＜ 0.05).The treatment group recurred in 3 cases (6％),and the control group relapsed in 12 cases (24％).The recurrence rate of the treatment group was lower than that of the control group (P ＜ 0.05).Conclusion Huaiqihuang particles can effectively improve the immune function of patients with bron chialasthrna,enhance efficacy and reduce recurrence.

Curative Efficacy of Budesonide Combined with Huaiqihuang Granules in Treatment of Asthma and Serum LTD4, NGF and TIMP-1 Levels / 现代生物医学进展

Objective:To study the curative efficacy of budesonide combined with huaiqihuang granules in the treatment of children with asthma and its effects on the serum leukotriene D4(LTD4),nerve growth factor (NGF),tissue inhibitor of metalloproteinase-1 (TIMP-1) levels.Methods:90 cases of children with asthma who were treated from March 2014 to March 2015 in our hospital were selected and divided into the observation group (n=45) and the control group (n=45) according to the random number table.Both groups of children were given bronchial antispasmodic agent,oxygen,antibiotics,glucocorticoid and other conventional treatment after admission,the control group was given budesonide atomization inhalation treatment on the basis of conventional treatment,0.5 mg budesonide were add in 3ml saline for continuous inhalation,twice a day,while the observation group was treated with Huaiqihuang Granules on the basis of the control group,twice a day.After 12 weeks of treatment,the curative effect,disappearance time of wheezing,cough relief,pulmonary rales,wheezing and other symptoms,forced vital capacity (FVC),serum LTD4,NGF,TIMP-1 levels,CD3+,CD4+,CD8+ of both groups were compared.Results:After treatment,the total effective rate of observation group was significantly higher than that of the control group [93.33％(42/45) vs 77.77％(35/45)](P＜0.05);disappearance time of breath,cough,moist rales and wheezes were significantly shorter than those of the control group[(4.32± 1.03)d vs (6.08± 1.24)d,(5.60± 1.12)d vs (7.21± 1.30)d,(3.19± 0.98)d vs (4.98± 1.02)d,(3.25± 1.03)d vs (5.89± 1.35)d](P＜0.05);the FEV1,FEV1/FVC were significantly higher than those of the control group [(92.63± 10.01)L/s vs (78.36± 9.19)L/s,(95.37± 11.72)％ vs (80.19± 10.23)％](P＜0.05);the serum LTD4,NGF,TIMP-1 levels were significantly lower than those of the control group [(7.24± 0.86)ng/mL vs (12.68± 1.01vng/mL,(68.18± 9.01)pg/mL vs (80.78± 10.24)pg/mL,(34.16 ± 5.06)ng/mL vs (49.76 ± 5.47)ng/mL] (P ＜0.05);the CD3+,CD4+ were significantly higher than those of the control group [(66.15± 7.20)％ vs (62.03± 6.85)％,(45.13± 7.90)％ vs (37.42± 7.06)％],CD8+ was significantly lower than that of the control group[(34.16± 5.06)％ vs (49.76± 5.47)％] (P＜0.05).Conclusion:Budesonide combined with Huaiqihuang granules was effective for children with asthma,which could enhance the immune function,improve the lung function,reduce the serum levels of LTD4,NGF,TIMP-1.

Effects of ACTH combined with Huaiqihuang on rat hypothalamic pituitary adrenal axis / 天津医药

Objective To investigate the effects of adrenocorticotropic hormone (ACTH)combined with Huaiqihuang on hypothalamic pituitary adrenal (HPA) in rats. Methods Fifty rats were randomly divided into five groups according to the random number table method:normal control group (group A), prednisone group (group B), Huaiqihuang group (group C), ACTH group (group D) and combined treatment group (group E) with 10 rats in each group. Rats in group B, C, D and E were gavaged by acetic acid prednisone water solution 12.5 mg/(kg · d) for 4 weeks to establish HPA axis suppression model. Group A was given distilled water 10 mL/(kg·d) as control. Rats in group C and E were gavaged with Huaiqihuang 5 g/(kg·d) 30 minutes after intragastric administration of prednisone acetate. At the third week of the experiment, group D and E were subcutaneous injected with ACTH 200 μg/(kg·d). The serum cortisol levels were measured respectively at the start of the ex?periment, 2 weeks and 4 weeks of experiment. Animals were sacrificed at the end of the experiment, and then weights of the pituitary, adrenal glands and the viscera index were calculated. The pathological changes of the pituitary and adrenal glands were observed by HE stainning. Results After 2 weeks, the serum cortisol levels were significantly lower in group B, C, D and E than those of group A (Pgroup D>group C (P<0.05). At the same time, the weights of pituitary and adrenal gland and the viscera in?dex were higher in the three groups than those of B group (P<0.05). The HE staining showed that there were no significant changes in the distal part of the pituitary gland in five groups. The adrenal cortex zona was thinning and the structure was dis?ordered in group B. There were different degrees of hyperplasia in group C, group D, and group E, which was the most obvi?ous in group E. Conclusion ACTH combined with Huaiqihuang can promote adrenal cortex zona hyperplasia and cortisol secretion, which reduces the glucocorticoid induced inhibition of HPA axis in rats.

Huaiqihuang granule in adjuvant treatment of childhood asthma:a randomized controlled,multicenter study / 国际儿科学杂志

Objective To observe the clinical efficacy and safety of GINA regimen and GINA regimen combined with oral Huaiqihuang granule in the treatment of children with bronchial asthma.Methods A ran-domized,single blind,multicenter,parallel controlled clinical trial wascarried out.A total of 1 128 patients with bronchial asthma in children were randomized into two groups.The observation group were treated with GINA regimen combined with oral Huaiqihuang granule.The GINA regimen treatment group was treated by GINA reg-imen.Clinical assessment and C-ACT scores was observed in first month,third month,sixth month after treat-ment.Clinical assessment included the times of upper respiratory tract infection occurrence,bronchitis and pneu-monia,asthmatic attacks,application of emergency medicine,hospitalizations due to asthmatic.Drug adverse effect in the two groups was compared.Results The times of upper respiratory tract infection,bronchitis and pneumonia,asthmatic was significantly decreased(P 0.05).Conclusion The treatment of bronchial asthma in children with GINA regimen combined with oral Huaiqihuang granule can significantly reduce the incidence of respiratory infections and the number of asthmatic attacks dramatically and safely improve clinical curative effect,asthma control.

Observation on efficacy of Huaiqihuang Granule in treatment of nephrotic syndrome in children / 中草药

Objective: To investigate the efficacy of Huaiqihuang Granule in children with primary nephrotic syndrome. Methods: There were 112 cases (78 male and 34 female, at the age of 1.3-13.5 years old) in the ward of Renal Department of Internal Medicine in Affiliated Children's Hospital, School of Medicine, Zhejiang University during July 1st, 2009 to June 30th, 2010, who were initially treated and sensitive to glucocorticoid. They were enrolled in the study randomly and were divided into two groups under the similar condition: group A (54 cases in treatment group with Huaiqihuang Granule) and group B (58 cases in control group with hormone instead of Huaiqihuang Granules). We observed the duration of proteinuria turned into negative, the frequency of recurrence, the frequency of respiratory tract infection, and the changing of cytokines after the treatments. On the admission and six months after the onset of disease, the IL-2, -4, -6, and -10, TNF, and IFN-γ of some patient children were determined. Results: The duration of proteinuia being negative was 5-22 d (average 12.6 d) in the group A and 5-24 d (average 14.1 d) in the group B. After one year's follow-up, nine cases suffered recurrence in group A (16.67%), while 20 cases in group B (34.48%). There was statistically significant difference with P < 0.05. Among 38 cases who were suffered respiratory tract infection frequently in group A, the times of infection were significantly reduced in 32 cases, the reduction rate was 84.21%, while it was 47.50% in group B (P < 0.01). All the recurrence patients were associated with infection. The level of IL-2 was low during disease, after recovery, it increased faster in group A than in group B (P < 0.05). IFN-γ was elevated at the onset in both groups, after recovery it dropped down to normal in group A, and decreased under the normal level in group B. The TNF, IL-6, and -10 showed no significant deference between the two groups. Conclusion: Huaiqihuang Granule can reduce the relapse rate of nephrotic syndrome in children according to its influence to cellular immune function.