Mechanism of Huanglian Wendan Decoction in intervening IGT IR based on liver cell pyroptosis / 中国中药杂志

To investigate the mechanism of Huanglian Wendan Decoction in intervening impaired glucose tolerance( IGT) rat insulin resistance( IR) based on the pyroptosis pathway of liver cells. The IGT rat model was established by high-fat diet( 20 weeks) combined with high temperature,humidity environment and inactive lifestyle. The experiment was divided into blank group,model group,metformin hydrochloride group( positive group)( 0. 05 g·kg~(-1)·d~(-1)) and Huanglian Wendan Decoction group( 7. 8 g·kg~(-1)·d~(-1)). After continuous intragastric administration for 4 weeks,the body weight,body length and abdominal circumferences of all the rats were measured,the Lee' s obesity indexes was calculated,and the levels of fasting plasma glucose( FPG) and 2-hour plasma glucose( 2 hPG) in each group were measured. Serum insulin levels( FINS) and tumour necrosis factor-α( TNF-α) levels were detected by ELISA,and insulin sensitivity index( ISI) and insulin resistance index( IRI) values were calculated. The expressions of cysteinyl aspartate specific proteinase-1( caspase-1),gasdermin D( GSDMD),interleukin-1β( IL-1β) and interleukin-18( IL-18) m RNA and proteins in liver tissues were detected by Real-time PCR and Western blot. Immunofluorescence was used to detect the expressions of caspase-1 and GSDMD protein in liver tissues. Huanglian Wendan Decoction could effectively reduce the weight of model rats,improve abdominal obesity,FINS,IRI and ISI indexes and correct 2 hPG levels. Compared with blank group,TNF-α levels in serum and caspase-1,GSDMD,IL-1β and IL-18 expressions in liver tissue of model control group were increased significantly. Huanglian Wendan Decoction could effectively reduce TNF-α level in serum,regulate the expressions of caspase-1,GSDMD,IL-1β and IL-18 genes and proteins in liver tissues of IGT rats. The above results showed that the occurrence and development of " obesity-IR-abnormal glucose metabolism-type 2 diabetes mellitus" was closely related to inflammatory response and the classical pyroptosis pathway mediated by caspase-1/GSDMD. The mechanism of Huanglian Wendan Decoction in improving IR may be correlated with reduction of the level of inflammatory factors and the alleviation of the state of pyroptosis,and thus reverse the course of IGT.

Mechanism of Huanglian Wendan Decoction in improving impaired glucose tolerance based on skeletal muscle NLRP3/caspase-1/IL-1β, IL-18 pathway / 中国中药杂志

This study investigated the mechanism of improving impaired glucose tolerance(IGT) of rats by Huanglian Wendan Decoction from the perspective of the skeletal muscle Nod-like receptor protein 3(NLRP3)/cysteinyl aspartate specific proteinase-1(caspase-1)/interleukin-1β(IL-1β), interleukin-18(IL-18) pathway. Healthy male SD rats were fed with the diet containing 45% fat for 20 weeks, accompanied by a high-temperature and high-humidity environment and an inactive lifestyle, for the establishment of the IGT rat model. The rats were divided into the blank control group, model control group, metformin hydrochloride group(positive drug group, 0.05 g·kg~(-1)·d~(-1)) and Huanglian Wendan Decoction group(7.8 g·kg~(-1)·d~(-1)). After continuous intragastric administration for 4 weeks, the obesity and glycemic indexes of all the rats were measured. The fasting serum insulin(FINS) level was determined by ELISA, with the insulin sensitivity index(ISI) and insulin resistance index(IRI) calculated. The mRNA and protein expression le-vels of nuclear factor kappaB(NF-κB), NLRP3, caspase-1, IL-1β and IL-18 in skeletal muscle tissue were detected by real-time polymerase chain reaction(PCR), Western blot and immunofluorescence. Compared with the blank control group, the model control group witnessed significantly increased mRNA and protein expression of NF-κB, NLRP3, caspase-1, IL-1β and IL-18. As revealed by the comparison with the model control group, Huanglian Wendan Decoction could effectively regulate the obesity status, reduce body weight, correct the abnormal levels of 2-hour plasma glucose(2 hPG), insulin resistance index(IRI), insulin sensitivity index(ISI), and lower the mRNA and protein expression of NF-κB, NLRP3, caspase-1, IL-1β and IL-18 in the skeletal muscle tissue of IGT rats. Combined with previous studies, the above results showed that the occurrence and development of IGT was closely related to inflammatory response and the classic pyroptosis pathway in skeletal muscle, such as NLRP3/caspase-1/IL-1β, IL-18. It is inferred that the mechanism of Huanglian Wendan Decoction was to alleviate insulin resistance(IR) and then reverse the course of IGT lies in the regulation of the abnormal insulin receptor signaling pathway based on the NLRP3 inflammasome pathway.

Clinical Study on Modified Huanglian Wendan Decoction for Treatment of Tic Disorder Children with Syndrome of Wind Stirring Due to Phlegm-heat / 中国中医药信息杂志

Objective To observe the clinical efficacy of modified Huanglian Wendan Decoction for treatment of tic disorder (TD) children with syndrome of wind stirring due to phlegm-heat; To detect its effects on peripheral-blood miR-429 expression. Methods Eighty cases of TD children were randomly divided into treatment group and control group,with 40 cases in each group.In the treatment group,children were treated with modified Huanglian Wendan Decoction, one dosage a day, twice a day, orally. In the control group, TD children were treated with haloperidol, 0.03 mg/(kg?d), orally, according to the symptom to adjust dose, and the maximum amount did not exceed 0.08 mg/(kg?d). 30 d was a treatment course for both groups. The treatment lasted for three courses. Before and after 3 months of clinical observation, the severity of disease was evaluated by TCM syndrome and Yale Global Tic Severity Scale (YGTSS) score. Clinical efficacy and TCM syndrome efficacy were evaluated; the level of miR-429 in peripheral blood was detected; the adverse reactions were observed. Results The total effective rate of clinical efficacy was 82.5% (33/40) in treatment group and 80.0% (32/40) in the control group, without statistical significance (P>0.05); The total effective rate of TCM syndrome efficacy was 92.5% (37/40) in treatment group and 75.0% (30/40) in the control group, with statistical significance (P<0.05). Compared with before treatment, the YGTSS score and TCM syndrome score significantly decreased after treatment (P<0.01), and the TCM syndrome score in the treatment group was much lower than the control group after treatment (P<0.05). Compared with before treatment, miR-429 level in both groups increased obviously after treatment (P<0.01), and the miR-429 level in the treatment group was much higher than the control group after treatment (P<0.05). There were mild constipation (1 cases), diarrhea (2 cases), and anorexia (2 cases) in the treatment group, and obvious lethargy (3 cases) and dizziness (3 cases) in the control group. Conclusion Modified Huanglian Wendan Decoction shows obvious effects for treating TD, and can up-regulate miR-429 of peripheral-blood.

The Curative Effect of Acupuncture Combined with Huanglian Wendan Decoction on the Mild Cognitive Impairment after Stroke / 现代生物医学进展

Objective:To explore the curative effect of acupuncture combined with huanglian wendan decoction on the mild cognitive impairment after stroke.Methods:100 patients with mild cognitive impairment after stroke were enrolled in our hospital from June 2013 to August 2016 and randomly divided into two groups.The control group (n=50) accepted nimodipine,and the study group (n=50)accepted huanglian wendan decoction combined with acupuncture treatment based on the control group.The MMSE and MSSS scores were evaluated and compared,and the improvement of cognitive dysfunction and nervous dysfunction,quality of life were compared and analyzed.Results:After treatment,the MMSE,ADL scores of patients were remarkably decreased compared with those before treatment (P＜0.05),and the decreasing degree of study group was significantly higher than those of the control group (P＜0.05).The MSSS,MBI scores of both groups were significantly increased compared with those before treatment (P＜0.05),and the increasing degree of study group was significantly higher than those of the control group (P＜0.05).The effective rates of improvement in cognitive dysfunction and nervous dysfunction,quality of life of study group were significantly higher than those of the control group (P＜0.05).Conclusions:Huanglian wendan decoction combined with acupuncture treatment was effective for the mild cognitive impairment after stroke and could improve the quality of life.

Protective effects of Huanglian Wendan Decoction aganist cognitive deficits and neuronal damages in rats with diabetic encephalopathy by inhibiting the release of inflammatory cytokines and repairing insulin signaling pathway in hippocampus / 中国天然药物

Huanglian Wendan decoction (HLWDD) has been used for the treatment of symptom of "Re", one of major causes in diabetes and metabolic disorders, according to the theory of traditional Chinese medicine. The present study aimed at investigating the cerebral protective effects of HLWDD on diabetic encephalopathy (DE), one of the major diabetic complications. The effects of HLWDD and metformin were analyzed in the streptozocin (STZ) + high-glucose-fat (HGF) diet-induced DE rats by gastric intubation. In the present study, the effects of HLWDD on cognition deficits were investigated after 30-day intervention at two daily dose levels (3 and 6 g·kg). To explore the potential mechanisms underlying the effects of HLWDD, we detected the alterations of neuronal damages, inflammatory cytokines, and impaired insulin signaling pathway in hippocampus of the DE rats. Based on our results from the present study, we concluded that the protective effects of HLWDD against the cognitive deficits and neuronal damages through inhibiting the release of inflammatory cytokines and repairing insulin signaling pathway in hippocampus of the DE rats.

Clinical Observation of 112 Cases Phlegm-fire Syndrome Insomnia Patients Treated by Modified Huanglian Wendan Decoction / 浙江中医药大学学报

[Objective]Observe the clinical curative effect of phlegm-fire syndrome insomnia treated by Modified Huanglian Wendan Decoction.[Method] Col ect 208 cases phlegm-fire syndrome insomnia patients in the clinic which were randomly divided into two groups. 112 cases in the treating group were treated by Modified Huanglian Wendan Decoction, and 96 patients in the control group were given lmg estazolam.30d as a course, and observe the clinical curative effect after the course, including total effective rate, PSQI,TCM syndrome score and side-effect, etc. [Results]The total effective rate of phlegm-fire syndrome insomnia patients treated by Modified Huanglian Wendan Decoction was 91.96%, and the control group was 77.08%, there was significant difference between two groups. There were significant differences between two groups in PSQI ,TCM syndrome score and adverse reaction, too, it suggests that the treatment group is better than the control group.[Conclusion]The Modified Huanglian Wendan Decoction has a definite curative effect on phlegm-fire syndrome insomnia, and with little adverse reaction.

Clinical Observation of Stable Coronary Heart Disease Treated by Huanglian Wendan Decoction and Danshen Decoction Combined with Western Medicine: 30 Cases Report / 中国康复理论与实践

@#ObjectiveTo observe the effect of Huanglian Wendan decoction and Danshen decoction combined with Wester medicineon stable coronary heart disease.Methods60 patients with angina or myocardial infarction were randomly divided into the control group and treatment group with 30 cases in each group. The patients of the control group were treated with routine medicine and those of the treatment group were added with traditional Chinese medicine (TCM) Huanglian Wendan decoction combined with Danshen decoction. The changes of angina, symptoms and signs of TCM, electrocardiogram (ECG), low density lipoprotein cholesterol (LDL-C) and high sensitive C-reactive protein (HS-CRP) of all patients were observed before and after treatment.ResultsAfter treatment, the frequency and duration of angina, dose of notroglycerine of patients in two groups were significantly different from those before treatment (P<0.01 ), but there was no significant difference between two groups (P>0.05). The symptoms such as chest discomfort and palpitation of patients of two groups improved after treatment (P<0.05～0.01), but the treatment group improved more obviously than the control group (P<0.05). The total effective rate showed by ECG were 53.3% in the control group and 73.3 % in the treatment group, there was no significant difference between two groups. HS-CRP and LDL-C of all patients decreased after treatment (P<0.01), but the treatment group was lower than the control group (P<0.05).Conclusion Huanglian Wendan decoction combined with Danshen decoction can relief clinical symptoms of stable coronary heart disease, which may be related with lipid decrease and inflammation reduction.