Application of ZHANG Zhongjing，s Jizihuang （Egg Yolk） Prescriptions in Type 2 Diabetes Mellitus based on the Theory of “Yin Restricts Fire” and “Many Different Diseases can be Treated in the Same Way” / 中医杂志

Type 2 diabetes mellitus （T2DM） can be categorized into “xiao ke （消渴）” in traditional Chinese medicine （TCM）. The theory of “yin restricts fire” originates from Inner Canon of Yellow Emperor （《黄帝内经》） which states that “yin essence restricts chief fire”， and the crucial pathogenesis and treatment of xiao ke coincide with this theory. ZHANG Zhongjing，s three prescriptions of Jizizhuang （egg yolk） are Baihe Jizizi Decoction （百合鸡子汤）， Huanglian Ejiao Decoction （黄连阿胶汤） and Painong Powder （排脓散）， which are scattered in different chapters of Treatise on Cold Damage and Miscellaneous Diseases （《伤寒杂病论》）. By analyzing and summarizing the mechanism and characteristics of the three prescriptions， it is found that the three prescriptions are in line with the characteristics of “yin restricts fire” and the pathogenesis of T2DM. These three prescriptions are composed of Jizizhuang and different medicinals. Baihe Jizizi Decoction is composed of Jizizhuang and Baihe （Bulbus Lilii）， and can be used to treat T2DM and mental diseases. Huanglian Ejiao Decoction is composed of Jizihuang， Ejiao （Colla Corii Asini）， Shaoyao （Radix Paeoniae Alba seu Rubra）， Huanglian （Rhizoma Coptidis） and Huangqin （Radix Scutellariae）， which could be used to treat T2DM and cardiorenal system diseases. Painong Powder is composed of Jizizhuang， Shaoyao， Jiegeng （Radix Platycodonis） and Zhishi （Fructus Aurantii Immaturus）， which can be used to treat T2DM and carbuncle. Therefore， based on the theory of “yin restricts fire” and “many different diseases can be treated in the same wa”， this paper propose that the three Jizihuang prescriptions could be used in T2DM， which could provide ideas for clinical treatment.

Huanglian Ejiao Decoction formula syndrome and its application for refractory insomnia / 中国中药杂志

Huanglian Ejiao Decoction,firstly recorded in Treatise on Febrile Diseases,could be used to treat heat-conversion syndrome of Shaoyin. It has been identified that,the indications of Huanglian Ejiao Decoction include:(1)in modern medicine,it can be used to treat insomnia,arrhythmia,oral ulcer,Xiali,blood syndrome and other diseases;(2)in terms of symptoms and signs,it is mainly used for restlessness,ritability,insomnia,extremely difficult to fall asleep,palpitation,atrial premature beat,ventricular premature beat and other arrhythmias,stomach distension and stuffiness,stomach pain,vomiting,abdominal pain,cramps,lower edge,constipation,blush,red lips,easy bleeding,red tongue,thin or no coating,dry tongue surface,or light red tongue,or dark red,thin white tongue coating,and rapid pulse. It has been also identified that,(1)although the original statement of Huanglian Ejiao Decoction is very simple,it can not only be used according to irritability and insomnia;(2)tongue image is not the key to syndrome differentiation of this prescription;(3)the essence of Shaoyin syndrome is not completely heart kidney Yang deficiency,which is closest to shock in modern medicine,including septic shock,hypovolemic shock and cardiogenic shock;(4)the essential difference between Shaoyin cold and heat conversion syndrome of Shaoyin lies in the different types of shock,in which cardiogenic shock is the main cold type,while septic shock is the main heat shock;(5)heat-conversion syndrome of Shaoyin is more common in the late stage of septic shock,and part of it can be seen in the stage of heart failure combined with sympathetic activation;(6)Dioscoreae Rhizoma and Rehmanniae Radix are often used to replace egg yolk;(7)Huanglian Ejiao Decoction takes effect quickly and the course of treatment is short.

Clinical efficacy evaluation and potential mechanism of Huanglian Ejiao Decoction in treatment of type 2 diabetes mellitus by Meta-analysis associated network pharmacology / 中草药

Objective: To evaluate the clinical efficacy of Huanglian Ejiao Decoction and explore its mechanism in the treatment of type 2 diabetes (T2DM) based on Meta-analysis and network pharmacology technology. Methods: Firstly, CNKI, VIP, Wanfang, PubMed, the Cochrane Library, and Web of Science were used to find randomized controlled trials of Huanglian Ejiao Decoction for T2DM until May 2020. The included literatures were evaluated according to the Cochrane risk bias assessment tool, and the Review Manager software was used for quantitative synthesis. The chemical components and its targets of Huanglian Ejiao Decoction were screened based on network pharmacology. Common targets were obtained after taking the intersection with T2DM targets. The bioinformatics technology was used to annotate key pathways, and the potential mechanism of Huanglian Ejiao Decoction was explored in the treatment of T2DM. Results: A total of 15 RCTs were selected which included 1 254 patients. Compared with the conventional treatment of western medicine, Huanglian Ejiao Decoction combined with western medicine had a more satisfactory clinical effect, stronger hypoglycemic and hypolipidemic effect. Through network pharmacology methods, 258 chemical components and 985 targets were obtained from online databases. There were 60 components, 121 targets, and 181 pathways closely related to the treatment of T2DM, mainly involving AGE-RAGE signaling pathway in diabetic complications, HIF-1 signaling pathway, MAPK signaling pathway, insulin resistance, etc. Conclusion According to the existing research, the conventional treatment of western medicine combined with Huanglian Ejiao Decoction can increase the clinical efficacy of T2DM and have better hypoglycemic and hypolipidemic action. T2DM can be cured by improving insulin resistance, reducing inflammation, mitigating oxidative stress and other treatments.