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ObjectiveTo observe the effects of the kidney-tonifying and blood-activating prescription on the Wnt/β-catenin signaling pathway and uterine spiral artery remodeling in a mouse model of recurrent miscarriage and to explore its underlying mechanism. MethodA mouse model of normal pregnancy was established by mating CBA/J mice with BALB/c mice. A mouse model of recurrent miscarriage was established by mating CBA/J mice with DBA/2 mice. The modeled mice of recurrent miscarriage were randomized into model， dydrogesterone， and low- and high-dose Chinese medicine groups. The mice in normal pregnancy were used as the control group. Each group consisted of 10 mice， and the drug administration lasted for 14 days. After the treatment， the embryo absorption rate of each group was recorded. Hematoxylin-eosin （HE） staining was employed to observe the pathological morphology of the uterine decidua， and the physiological transformation rate of spiral arteries （SPA） was evaluated. Real-time polymerase chain reaction （Real-time PCR） and Western blot were performed to determine the mRNA and protein levels， respectively， of matrix metalloproteinases （MMP）-2， MMP-9， vascular endothelial growth factor （VEGF）， and Wnt/β-catenin signaling pathway. ResultCompared with the control group， the model group presented increased embryo absorption rate （P<0.05）， decreased physiological transformation rate of uterine SPA （P<0.05）， cellular swelling， degeneration， and disordered arrangement in the uterine decidua tissue， and down-regulated mRNA and protein levels of key factors involved in SPA remodeling （MMP-2， MMP-9， VEGF） and the Wnt/β-catenin signaling pathway （Wnt2， β-catenin， Cyclin D1， c-Myc） （P<0.05）. Compared with the model group， both the low- and high-dose Chinese medicine reduced embryo absorption rate （P<0.05）， increased SPA physiological transformation rate （P<0.05）， improved uterine decidua tissue morphology， and increased decidua vessel count. Furthermore， they up-regulated the mRNA and protein levels of MMP-2， MMP-9， VEGF， and proteins in the Wnt/β-catenin signaling pathway （P<0.05）. ConclusionRecurrent miscarriage is associated with impaired uterine spiral artery remodeling. The kidney-tonifying and blood-activating prescription can promote uterine spiral artery remodeling by activating the Wnt/β-catenin signaling pathway and promoting the expression of VEGF， MMP-2， and MMP-9， thus treating recurrent miscarriage.
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Hypertension and its target organ damage have become a major public health problem. Sexual dysfunction is a new problem in the treatment of modern hypertension. Modern pathophysiological studies have shown that hypertension can lead to sexual dysfunction. In addition, three major hypotensive drugs represented by diuretics can also lead to sexual dysfunction. In traditional Chinese medicine(TCM), hypertension belongs to "vertigo" "headache" "head wind", etc. In the past, the understanding of the TCM pathogenesis of hypertension was mainly from the perspectives of "liver wind" and "Yang hyperactivity". However, based on the in-depth research on ancient and modern literature and medical records and many years of clinical practice, it has been identified that kidney deficiency was the key pathogenesis. Hypertension complicated with sexual dysfunction belongs to the category of kidney deficiency syndrome in TCM, especially the deficiency of kidney Yin. Previous studies by other research groups showed that Yin-enriching and kidney-tonifying method could effectively reduce blood pressure, improve sexual dysfunction, reverse risk factors, and protect target organs. This article systematically discussed the TCM understanding, modern pathophysiological mechanism, and the clinical treatment strategy of kidney-tonifying drugs(single drugs and compounds) in the treatment of hypertension complicated with sexual dysfunction in order to provide a scientific basis for kidney-tonifying method in the treatment of hypertension complicated with sexual dysfunction.
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Humans , Antihypertensive Agents/therapeutic use , Medicine, Chinese Traditional , Hypertension/drug therapy , Blood Pressure , Risk Factors , Drugs, Chinese Herbal/therapeutic useABSTRACT
Alzheimer's disease （AD） is a neurodegenerative disease associated with aging and age-related cognitive decline. It is characterized by insidious onset and progressive development， and has become a major global health and socioeconomic issue. The exact mechanisms underlying AD have not been fully elucidated， and various hypotheses have been proposed by researchers based on different etiologies， including the amyloid β （Aβ） cascade hypothesis， Tau protein hyperphosphorylation hypothesis， mitochondrial dysfunction and oxidative stress hypothesis， and neurotransmitter hypothesis. Therefore， there is an urgent need for comprehensive interventions targeting multiple pathways， links， and targets. Based on traditional Chinese medicine （TCM） theory and modern research findings， kidney-tonifying and anti-aging Chinese medicines have unique advantages of toxicity reduction， long-lasting effects， and treating both the root cause and the symptoms. They have been shown to counteract immune-inflammatory responses， clear reactive oxygen species， exhibit antioxidant properties， inhibit abnormal aggregation of Aβ and Tau proteins， reduce neuronal apoptosis， regulate central neurotransmitters， and modulate gut microbiota in AD. In recent years， stem cell therapy has been explored for the treatment of AD through two strategies： endogenous activation and exogenous transplantation， thereby replenishing and replacing damaged neurons. However， factors such as blood-brain barrier permeability， targeted delivery to the affected area， immune rejection， and cell survival rate can affect the efficacy of stem cell transplantation. Therefore， combining stem cell therapy with medication and other methods can further enhance the effectiveness of stem cell transplantation. Kidney-tonifying and anti-aging Chinese medicines can activate dormant neural stem cells（NSCs） in the body， promote neuroregeneration， and facilitate tissue and organ repair and reconstruction in AD. The combined treatment of these Chinese medicines and stem cell transplantation has shown more significant efficacy compared to either treatment alone. This combination therapy provides a new integration point for the modernization of TCM and offers new ideas and approaches for the prevention and treatment of AD， as well as improving the effectiveness of stem cell transplantation.
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ObjectiveTo explore the clinical effect of kidney-tonifying and blood-generating method and qi-promoting and blood-nourishing method combined with western medicine on the treatment of aplastic anemia and the characteristics of blood routine recovery， and to explore a new phased treatment model for aplastic anemia. MethodThis study was based on a prospective， multicenter， double-blind， and randomized controlled clinical trial. Patients with aplastic anemia from 19 centers were analyzed and divided into a kidney-tonifying and blood-generating group and a Qi-promoting and blood-nourishing group， which were treated with traditional Chinese medicine （TCM） combined with western medicine. The clinical effect and the changes in blood routine in each group during treatment were evaluated. ResultDuring the observation period， 375 cases of aplastic anemia were included in two groups， and TCM syndrome differentiation conformed these cases as Qi-deficiency type and both Qi and blood-deficiency type. These cases were randomly divided into two groups， including 184 in the kidney-tonifying and blood-generating group and 191 in the Qi-promoting and blood-nourishing group， being treated by kidney-tonifying and blood-generating granules and Qi-promoting and blood-nourishing granules， respectively， and combined oral androgen and ciclosporin soft capsules. The treatment lasted for six months and was divided into three stages. Visits were conducted from the beginning of the treatment to the end of the first， fourth， and sixth months. The curative effect was evaluated six months later. The total effective rate of the kidney-tonifying and blood-generating group was 86.4% （159/184）， which was significantly better than that of the Qi-promoting and blood-nourishing group ［68.6% （131/191）， P<0.01）］. The results of the percentage quartile of blood cell growth in each stage of the 2 groups were analyzed. The hemoglobin concentration and platelet count of the patients in the kidney-invigorating blood group continued to increase after treatment, and significantly increased in the second and third stages compared with the first stage (P<0.05). The increase of reticulocyte count was most significant in the first stage of treatment (P<0.05). The reticulocyte count in supplementing Qi and nourishing blood group increased significantly in the first and second stages of treatment (P<0.05). The other observation indicators increased at each stage, but there was no statistical difference in the growth rate. The effects of the two groups were compared by stages. In the second stage of treatment, the increase of hemoglobin concentration in the kidney-invigorating blood group was better than that in the supplementing Qi-nourishing blood group (P<0.05). The increase of platelet count and red blood cell count in supplementing Qi and nourishing blood group was greater (P<0.05). In the third stage of treatment, the increase of hemoglobin concentration in the bushen Shengxue group was more significant (P<0.05). ConclusionThe overall effective rate of the kidney-tonifying and blood-generating method in the treatment of aplastic anemia is better than that of the Qi-promoting and blood-nourishing method， with significant effects and safety. This study has proposed a three-stage early treatment mode for aplastic anemia. The first and third stages (0-1, 5-6 months) were mainly treated by invigorating kidney and generating blood. In the second stage of treatment (2-4 months), invigorating kidney and generating blood combined with invigorating Qi and nourishing blood were adopted. It may be closer to the actual clinical treatment response and objective rule changes of aplastic anemia.
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Experimental research on male infertility is critical to the study of the pathogenesis of male infertility and the evaluation of drug therapy. This paper reviewed animal experiments on male infertility in recent years. The experimental models of male infertility mainly include oligoasthenozoospermia （OA），teratozoospermia，azoospermia， and varicocele animal models. The OA animal models are mostly induced by glycosides of Tripterygium wilfordii （GTW）， adenine，hydrocortisone， and radiation，which are mainly chemical means. The animal models of azoospermia were usually constructed by intraperitoneal injection of bissulfonyl alkylating agent busulfan and immersion of scrotum in 43 ℃ water. There are few studies on animal models of teratozoospermia，and the induction methods by GTW and methyl methanesulfonate（MMS） are common. The animal models of varicocele-caused infertility are usually induced by operation. The ligation of the middle division of the left renal vein between the lateral inferior vena cava and the medial spermatic vein has a significant influence on testicular morphology and epididymal sperm quality. Animal experimental studies have shown that classic prescriptions for tonifying the kidney and promoting spermatogenesis represented by Wuzi Yanzongwan and clinical empirical prescriptions by modern research have played a significant role in the treatment of male infertility. The mechanism of tonifying the kidney in the treatment of male infertility mainly focuses on inhibiting spermatogenic cell apoptosis. The kidney-tonifying method can regulate the apoptosis of spermatogenic cells，which provides a new treatment idea and a reliable scientific basis for traditional Chinese medicine in the field of male reproduction.
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ObjectiveTo study the changes of mitochondrial function of ovarian granulosa cells in women of different ages and the effect of Erzhi-Tiangui prescription on in vitro fertilization-embryo transfer （IVF-ET） outcomes for elderly women， so as to verify the connotation of the "Seven-Seven" theory in the Huangdi's Internal Classic （《黄帝内经》）. MethodA total of 150 infertility patients undergoing IVF-ET at the Reproductive and Genetic Center of Integrative Medicine， Affiliated Hospital of Shandong University of Traditional Chinese Medicine were recruited and assigned into "hree-Seven/Four-Seven （30 cases）， Five-Seven （60 cases）， and Six-Seven （60 cases） groups according to the "Seven-Seven" theory. The Five-Seven and Six-Seven groups were further assigned into control and Chinese medicine subgroups using the random number plus envelope method， and the Chinese medicine group was administrated with Erzhi Tiangui prescription from the start day of controlled ovulation stimulation cycle to the trigger day. The IVF outcome was observed， and Western blot was employed to determine the levels of mitofusin 1 （MFN1）， mitofusin 2 （MFN2）， and dynamin-related protein 1 （Drp1） in the ovarian granulosa cells. ResultCompared with the Three-Seven/Four-Seven group， the control subgroups of the Five-Seven and Six-Seven groups showed decreased retrieved oocytes， two pronuclear （2PN） embryos， available embryos， high-quality embryos， clinical pregnancy rate， and live birth rate （P<0.05）. Moreover， the control subgroup of the Six-Seven group showed decreased fresh embryo transfer rate（P<0.05）. Compared with the control subgroup of the Five-Seven group， that of the Six-Seven group showed reduced retrieved oocytes， 2PN embryos， available embryos， high-quality embryos， and clinical pregnancy rate （P<0.05）. The Chinese medicine subgroup had more retrieved oocytes， 2PN oocytes， and available embryos than the control subgroup in the Five-Seven groups （P<0.05）. The Chinese medicine subgroup had more retrieved oocytes， than the control subgroup in the Six-Seven groups （P<0.05）. The control subgroup of the Six-Seven group showed lower expression levels of Mfn1 and Mfn2 and higher level of Drp1 than the control subgroup of the Five-Seven group （P<0.05）， which indicated that the levels of Mfn1 and Mfn2 in ovarian granulosa cells were down-regulated while the expression of Drp1 was up-regulated with aging （P<0.05）. The Chinese medicine subgroup had higher Mfn2 level and lower Drp1 level than the control subgroup in the Five-Seven group （P<0.05）， and the Chinese medicine subgroup had higher Mfn1 and Mfn2 levels and lower Drp1 level than then control subgroup in the Six-Seven group （P<0.05）. ConclusionsThe prognosis of IVF in women after "Five-Seven" became worse with aging， and the mitochondria in ovarian granulosa cells showed decreased fusion ability and increased fission， which verified the connotation of the "Seven-Seven" theory from the mitochondrial function. Erzhi Tiangui prescription can regulate the mitochondrial function of ovarian granulosa cells in elderly women， up-regulate the expression levels of Mfn1 and Mfn2 to promote mitochondrial fusion， and down-regulate the expression of Drp1 to reduce mitochondrial fission， thus alleviating the ovarian hypofunction caused by aging， improve the development potential of oocytes， and improve the IVF outcomes of elderly women. However， this prescription has limited efficacy for the elderly women in the age range of "Six-Seven".
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OBJECTIVE To systematically review the efficacy and safety of kidney -tonifying Chinese patent medicine combined with phosphodiesterase type 5（PDE5）inhibitors in the treatment of erectile dysfunction （ED），and to provide evidence - based reference for clinical medication . METHODS Retrieved from PubMed ，Embase，Cochrane Library ，Web of Science ，VIP， China Biomedical Literature Database ，CNKI and Wanfang database ，randomized controlled trials （RCTs）of kidney -tonifying Chinese patent medicine combined with PDE 5 inhibitors（trial group ）versus PDE 5 inhibitors or kidney -tonifying Chinese patent medicine alone （control group ）were collected . The search period was from the establishment of the database to February 15，2022. After literature screening and data extraction ，the risk of bias assessment tool recommended in Cochrane System Reviewer ’s Handbook 6.1.0 was used to evaluate the quality of the included literature ；Stata 16.0 software was used for network meta -analysis； and the funnel plot was used for publication bias analysis . RESULTS A total of 23 RCTs were included ，with a total of 2 417 patients， involving 8 kinds of Chinese patent medicines ， including Congrong yishen granule ，Canrong zhutian capsule ， Compound xuanju capsule ， Huanshao capsule ， Shanhaidan granule， Shengjing capsule ， Shisanwei ziyin zhuangyang capsule，Shugan yiyang capsule . The results of network meta analysis showed that in terms of total effective rate ，Compound xuanju capsule combined with PDE 5 inhibitor，Shengjing capsule combined with PDE 5 inhibitor，Shugan yiyang capsule combined with PDE 5 inhibitor had higher total effective rate ；in terms of international index of erectile function 5，the scores of Compound xuanju capsule combined with PDE 5 inhibitor，Congrong yishen granule combined with PDE 5 inhibitor，and Canrong zhutian capsule combined with PDE 5 inhibitor were higher ；in terms of safety ，the incidence of adverse drug reactions caused by Huanshao capsule ，Shanhaidan granule and Shugan yiyang capsule were lower . CONCLUSIONS Kidney-tonifying Chinese patent medicine combined with PDE 5 inhibitor can improve the erectile function of ED patients and reduce the occurrence of adverse drug reactions . In terms of efficacy and safety ，Compound xuanju capsule combined with PDE 5 inhibitor is the best .
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Objective:As the problem of global aging intensifies，postmenopausal osteoporosis （PMOP） has become a global health problem among females. At present，the commonly used biological agents have been proved not suitable for long-term use due to multiple adverse reactions. Several Meta-analyses have confirmed the good safety and effectiveness of kidney-tonifying method against PMOP，but its therapeutic mechanism remains unclear. The purpose of this Meta-analysis was to evaluate the effect of kidney-tonifying method on osteoclastogenesis inhibitory factor（OPG）/receptor activator of nuclear transcription factor （NF）-<italic>κ</italic>B （RANK）/receptor activator of NF-<italic>κ</italic>B ligand （RANKL） signaling pathway in PMOP animal model，so as to provide an experimental basis for the treatment of PMOP with kidney-tonifying method. Method:The related articles were retrieved from PubMed，Ovid Medline，Embase，China National Knowledge Infrastructure （CNKI），Chongqing Weipu Database for Chinese Technical Periodicals （VIP），and Wanfang Data Knowledge Service Platform with the retrieval time set from their inception to January 2020. The quality of each included article was evaluated using the SYRCLE's risk of bias tool. Then RevMan 5.3 was utilized for Meta-analysis according to the Cochrane systematic review methodology. Result:Thirty-two studies involving 619 rats were included. The quality score of these studies ranged from 3 to 5 points. The results of the Meta-analysis indicated obvious advantages of kidney-tonifying method in increasing bone mineral density （BMD）［standardized mean difference （SMD）=2.01，95% confidence interval（CI）=1.50-2.52，<italic>P</italic><0.000 01］），serum OPG level （SMD=3.33，95% CI=2.59-4.07，<italic>P</italic><0.000 01），and OPG mRNA expression （SMD=11.81，95% CI=7.49-16.13，<italic>P</italic><0.000 01），promoting OPG protein production （SMD=4.95，95% CI=3.09-6.81，<italic>P</italic><0.000 01），reducing serum RANKL（SMD=-4.88，95% CI=-6.01--3.75，<italic>P</italic><0.000 01） and RANK levels （SMD=-7.30，95% CI=-9.53--5.07，<italic>P</italic><0.000 01），and down-regulating RANKL （SMD=-6.22，95%CI=-8.95--3.49，<italic>P</italic><0.000 01） and RANK mRNA （SMD=-3.18，95% CI=-6.19--0.18，<italic>P</italic><0.05） expression and RANKL protein expression in bone tissue （SMD=-3.99，95% CI=-5.47--2.50，<italic>P</italic><0.000 01）. Conclusion:The kidney-tonifying method has been proved to possess potential advantages in regulating the balance of OPG/RANK/RANKL signaling pathway in PMOP animal model. Nevertheless，more large-sample sized，properly designed，and high-quality animal experiments are still needed for further verification.
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Pelvic inflammatory disease(PID) has become one of the leading causes of female infertility, with an increasing incidence in recent years. Modern medicine believes that risk factors of PID will affect the formation of eggs and embryo implantation, especially on the encounter of gametes, fertilization, and transport of fertilized eggs to the uterine cavity. Therapies for infertility due to PID include medication, sonographic hydrotubation, surgery, and assisted reproductive technology. Professor Ma Kun believes that the disease is located in the uterus with appendages with the main pathogenesis of kidney deficiency and blood stasis. Blood stasis is the pathological basis, and kidney deficiency is the fundamental pathogenesis, which exhibits deficiency-excess in complexity. Kidney deficiency will cause blood stasis over time, while blood stasis will aggravate kidney deficiency in turn, making PID-induced infertility refractory. In clinical practice, basic therapies follow the principles of kidney-tonifying and blood-activating, removing blood stasis, dredging collaterals, and coordinating thoroughfare and conception vessels. The oral administration of Chinese medicine combined with enema, external application, and external washing displays better efficacy in improving the pelvic microenvironment and increasing the pregnancy rate and pregnancy success rate in the treatment of PID-induced infertility.
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Female , Humans , Pregnancy , Infertility, Female/etiology , Kidney , Medicine, Chinese Traditional , Pelvic Inflammatory Disease/drug therapy , Pregnancy RateABSTRACT
In the context of the new era, paying attention to maternal and child health and advocating prenatal and postnatal care can effectively improve the quality of the birth population. Traditional Chinese medicine has a long history of prenatal and postnatal healthcare with rich content, which is the theoretical basis of modern related services. With the social development and the improvement of people's awareness of prenatal and postnatal healthcare, people have gradually shifted the focus of prenatal and postnatal healthcare to the peri-pregnancy stage at present, namely that couples of childbearing age are guided to prepare for pregnancy under the premise of solving their basic diseases. Infertility is a common and refractory disease for women of childbearing age. Ovulation disorder is one of its common pathological mechanisms. Traditional Chinese medicine believes that kidney deficiency is the main cause and pa-thogenesis of anovulation infertility and blood stasis is an important factor throughout the disease course. In clinical practice, therapies for invigorating kidney and activating blood are safe and reliable to treat anovulatory infertility mainly by adjusting the hypothalamus-pituitary-ovarian axis, improving ovarian function, uterine environment and gamete quality and increasing endometrial volume. Under the guidance of the thought of prenatal and postnatal healthcare, the authors tried to explore the effect of therapies for kidney-tonifying and blood-activating in the treatment of anovulatory infertility in eugenics, with the purpose of providing ideas and basis for subsequent relevant clinical studies and contributing to prenatal and postnatal healthcare services.
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Child , Female , Humans , Pregnancy , Anovulation , Eugenics , Infertility, Female/drug therapy , Kidney , Medicine, Chinese Traditional , OvulationABSTRACT
Objective:To study the effect of the kidney-tonifying recipes on mouse syndrome and adrenal function induced by low-dose hydrocortisone reduction and discontinuation. Method:The 48 male ICR mice were randomly divided into normal control group, hydrocortisone group, Liuwei Dihuangtang group and Guifu Dihuangtang group, with 12 rats in each group. Each group was given 1.32 mg·kg-1·d-1 hydrocortisone for 28 days, and half a dose for 7 days, and the administration was discontinued 14 days before modeling. In the reduction and discontinuation phase, 12.5 g·kg-1·d-1 Liuwei Dihuangtang and 13.5 g·kg-1·d-1 Guifu Dihuangtang were simultaneously administered to the corresponding group for 21 d. On the 28th and 49th day of the experiment, the characteristic information of mice was detected by the experimental methodology of syndrome differentiation and treatment in mice (holding power, body surface infrared temperature). The mice were sacrificed on the 50th day of the experiment, the spleen and thymus were separated, and the spleen and thymus index were calculated, serum corticosterone content is measured by enzyme-linked immunosorbent assay (ELISA), the total RNA of the adrenal gland was extracted, and the expressions of Star, cholesterol-side-chain cleavage enzyme (Cyp11a1), Cyp21a1, Cyp11b1, low-density lipoprotein receptor (Ldlr), scavenger receptor class B type I (Scarb1/SRB1), Hmgcr, acyl-CoA-cholesterol acyltransferase-1 (Acat1), hormone sensitive lipase (Lipe/HSL), insulin-inducible gene 1 (Insig1) and sterol regulatory element binding transcription factor 2 (Srebf2) were detected by Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR). Western blot was used to detect the expressions of LDLR, SRB1, CYP11A1 and cytochrome P450 family 21 subfamily A member 2 (CYP21A2) in adrenal gland. Result:Compared with the normal control group, the body weight and the body mean infrared temperature of the model group were significantly decreased after 28 days of continuous administration (P<0.01). After the administration of the drug, the mice in the model group showed a significant decrease in the grip strength (P<0.05), a significant increase in the thymus index (P<0.01), a significant decrease in the serum corticosterone content (P<0.05). Expressions of adrenal Cyp21a1 and Hmgcr genes decreased (P<0.05, P<0.01), Lipe and Acat1 gene expressions increased significantly (P<0.01), adrenal CYP11A1, SRBI protein expressions decreased significantly, and LDLR protein expression increased. Compared with the model group, the body weight of Guifu Dihuangtang group decreased significantly after 21 days of treatment with traditional Chinese medicine (P<0.01), the spleen index of Liuwei Dihuangtang group decreased significantly (P<0.01), expressions of Cyp11a1, Cyp21a1, Acat1 and Lipe genes in Guifu Dihuangtang group were significantly increased (P<0.05, P<0.01), expressions of Ldlr and Scarb1 genes were significantly decreased (P<0.05), and expressions of Ldlr, Acat1 and Lipe genes in Liuwei Dihuangtang group were significantly decreased (P<0.05, P<0.01), and expressions of CYP11A1 and SRBI proteins in Liuwei Dihuangtang and Guifu Dihuangtang increased. Conclusion:Guifu Dihuangtang can promote the recovery of adrenal function in mice with drug-induced deficiency syndrome by correcting expression of adrenal cortex synthase.
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BACKGROUND: Guided bone regeneration technology, as a most widely used method for repairing bone defects, has been extensively used in the field of stomatology. However, there are few reports on the guided bone regeneration technology in long bone defects. OBJECTIVE: To explore the effects of guided bone regeneration combined with kidney-tonifying therapy on the repair of femoral bone defects in rats, and investigate its osteogenic efficacy and underlying mechanism. METHODS: Thirty-six Sprague-Dawley rats were randomly divided into six groups: blank group, guided bone regeneration group, high-, moderate-, and low-dose kidney-tonifying groups, and ossotide tablets group. The femur bone defect model of rats was established, and was treated by guided bone regeneration except for blank group. Bio-Gide collagen membrane combined with autologous bone was implanted by guided bone regeneration. The kidney-tonifying groups were given 0.216, 0.108 and 0.054 g/(kg•d) Qianggu capsule via gavage for 8 weeks. The ossotide tablets group was given 0.58 mg/(kg•d) ossotide tablets via gavage for 8 weeks. At 12 weeks after surgery, the osteogenesis was evaluated by X-ray examination, hematoxylin-eosin staining and Masson staining of bone tissue. The mRNA expression levels of alkaline phosphatase, Runx-2, vascular endothelial growth factor and bone morphogenetic protein-2 in bone tissues were detected by quantitative real-time RT-PCR. RESULTS AND CONCLUSION: Results of X-ray examination and hematoxylin-eosin staining and Masson staining of bone tissue showed that the scores of Lane Sandhu and Huddleston in each group were significantly higher than those in the blank group (P < 0.001). The scores in the high-and moderate-dose kidney-tonifying groups were significantly higher than those in the guided bone regeneration group (P < 0.01). RT-PCR results showed that the mRNA expression levels of alkaline phosphatase, Runx-2, vascular endothelial growth factor and bone morphogenetic protein-2 in bone tissue in the high-and moderate-dose kidney-tonifying groups were significantly higher than those in the blank group (P < 0.01), and were superior to the guided bone regeneration group (P < 0.05). In summary, guided bone regeneration combined with kidney-tonifying can significantly promote the repair of femoral bone defects, reduce bone absorption and improve osteogenic efficacy in rats. The mechanism of promoting bone regeneration and angiogenesis may be by up-regulating the expression of related osteogenic factors and angiogenic factors in the environment where the membrane barrier creates a dominant growth of bone tissue.
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Infertility with diminished ovarian reserve(DOR) is a major problem in the field of reproductive health and it has attracted great attention worldwidely.Function deficiency of the kidney is one of the fundamental pathogenesis for DOR.Traditional Chinese medicines(TCMs) have a long history with rich experience for the treatment of infertility.Some TCMs are very effective in the treatment of kidney deficiency for infertility with DOR.The integrated TCMs and western medicine,and combination of disease differentiation and syndrome differentiation may help for diagnosis and treatment of infertility with DOR.We adopt the concept of unified treatment for special disease,and the methods and principle of treatment can be used.Therefore,we adopt the TCM concept of kidney-tonifying,blood-nourishing,liver-dispersing and spleen-invigorating.The TCMs kidney-tonifying formulae are added and subtracted.TCMs can regulate the reproductive function via multiple systems for simultaneous conditioning of follicular development and ovulation.At the same time,a hypothesis of " simultaneous conditioning of follicular development and ovulation" was proposed.Two-stage therapy with integrated TCMs and western medicine has been used,mainly for increasing the number of eggs,and improving follicle quality.The goal is to achieve simultaneous conditioning of follicular development and ovulation and ultimately for effective treatment of infertility with DOR.
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Objective: To observe the clinical efficacy of kidney tonifying and essence strengthening method in delaying physiological vascular aging. Method: Sixty-two subjects who completed the study were randomly divided into experimental group (31 cases) and control group (31 cases) with the matching research method. The experimental group was treated with kidney tonifying and essence strengthening recipe orally for 24 weeks, while the control group was not interfered with traditional Chinese medicine (TCM). Score of TCM syndrome in kidney deficiency syndrome, pulse wave velocity, intima-media thickness, plasma homocysteine level and serum superoxide dismutase level were evaluated before and after treatment. Result: Compared with before treatment period, the score of TCM syndrome in kidney deficiency syndrome, pulse wave velocity and plasma homocystenine level decreased, while the serum superoxide dismutase level increased in the experimental group after treatment (PPPPPConclusion: The kidney tonifying and essence strengthening method may delay the aging of physiological blood vessels caused by aging.
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As the epitome of the modern regenerative medicine, stem cells were proposed in the basic sense no more than 200 years ago. However, the concept of "stem cells" existed long before the modern medical description. The hypothesis that all things, including our sentient body, were generated from a small origin was shared between Western and Chinese people. The ancient Chinese philosophers considered Jing (also known as essence) as the origin of life. In Chinese medicine (CM), Jing is mainly stored in Kidney (Shen) and the so-called Shen-Jing (Kidney essence). Here, we propose that Shen-Jing is the CM term used to express the meaning of "origin and regeneration". This theoretical discovery has at least two applications. First, the actions underlying causing Shen-Jing deficiency, such as excess sexual intercourse, chronic diseases, and aging, might damage the function of stem cells. Second, a large number of Chinese herbs with Shen-Jing-nourishing efficacy had been proven to affect stem cell proliferation and differentiation. Therefore, if Shen-Jing in CM is equivalent with stem cells in regenerative medicine, higher effective modulators for regulating stem-cell behaviors from Kidney-tonifying herbs would be expected.
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Humans , Drugs, Chinese Herbal , Pharmacology , Kidney , Medicine, Chinese Traditional , Regenerative Medicine , Stem CellsABSTRACT
The treatment effect and signaling pathway regulation effects of kidney-tonifying traditional Chinese medicine on osteoporosis have been widely studied, but there is no systematic summary currently. This review comprehensively collected and analyzed the traditional Chinese medicines on the treatment and signaling pathway regulation of osteoporosis in recent ten years, such as Epimedii Folium, Drynariae Rhizoma, Cnidii Fructus, Eucommiae Cortex, Psoraleae Fructus and Dipsaci Radix. Based on the existing findings, the following conclusions were obtained: ①kidney-tonifying traditional Chinese medicine treated osteoporosis mainly through BMP-Smads, Wnt/-catenin, MAPK, PI3K/AKT signaling pathway to promote osteoblast bone formation and through OPG/RANKL/ RANK, estrogen, CTSK signaling pathway to inhibit osteoclasts of bone resorption. Epimedii Folium, Drynariae Rhizoma, Cnidii Fructus and Psoraleae Fructus up-regulated the expression of key proteins and genes of BMP-Smads and Wnt/-catenin signaling pathways to promote bone formation. Epimedii Folium, Drynariae Rhizoma, Cnidii Fructus, Eucommiae Cortex, Psoraleae Fructus and Dipsaci Radix inhibited the bone resorption by mediating the OPG/RANKL/RANK signaling pathway. ②Kidney-tonifying traditional Chinese medicine prevented and treated osteoporosis through a variety of ways: icariin in Epimedii Folium, naringin in Drynariae Rhizoma, osthole in Cnidii Fructus and psoralen in Psoraleae Fructus can regulate BMP-Smads, Wnt/-catenin signaling pathway to promote bone formation, but also activate OPG/RANKL/RANK, CTSK and other signaling pathways to inhibit bone resorption. ③The crosstalk of the signaling pathways and the animal experiments of the traditional Chinese medicine on the prevention and treatment of osteoporosis as well as their multi-target mechanism and comprehensive regulation need further clarification.
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Animals , Humans , Drugs, Chinese Herbal , Therapeutic Uses , Medicine, Chinese Traditional , Osteoporosis , Drug Therapy , Signal TransductionABSTRACT
Objective:To compare the clinical effects and improvement of serum hormone levels of kidney tonifying and blood circulation recipe and mirena in the treatment of perimenopasual dysfunctional uterine bleeding.Methods:92 cases of perimenopausal patients with dysfunctional uterine bleeding in our hospital from July 2013 to November 2016 were selected and divided into group A and group B with 46 cases in each group.Group A was orally administered with kidney tonifying and blood circulation recipe,and group B was administered with mirena.Both groups were treated for 3 periods.The efficacy and incidences of adverse effect in two groups were observed.The levels of serum hormones and hemoglobin (Hb),and endometial thickness (ET) were detected in two groups.The indices of serum hormone included follicle-stimulating hormone (FSH),luteinizing hormone (LH),progestone (P) and estradiol (E2).Results:No significant difference was found in the total effective rate between two groups (P＞0.05).After treatment,the levels of serum FSH,LH,E2 and P as well as ET and Hb in both groups were all significantly lower than those before treatment (P＜0.01),and the levels of serum FSH,LH,E2 and P as well as ET of group B were significantly lower than those of group A (P＜0.01),no significant difference in the Hb level between two groups (P＞0.05).The incidence of adverse reactions of group B (15.22％) was significantly higher than that of group A(0％) (P＜0.01).Conclusions:The kidney tonifying and blood circulation recipe had similar effect as mirena in the treatment of perimenopasual dysfunctional uterine bleeding,while mirena had strong improving effect in serum hormone level and ET,kidney tonifying and blood circulation recipe had higher security.
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Objective To study whether the effects of bone mineral density by a kidney-tonifying herbal fufang treatment in senile osteoporosis mice (P6) is by the mechanism of improving the expression level of GH mRNA and IGF-1 mRNA. Methods The experimental points four groups as following:SAMR1 mice which feed saline lavage,SAMP6 divid as saline lavage group,subcutaneous injection of rhGH group and a kidney-tonifying herbal fufang treatment group. All intervention is one time everyday. After 3 months and 6 months intervention,we measure the BMD and the expression level of the GH mRNA and of IGF-1 mRNA. Results After 3 months intervention,the BMD of R1 group and the Kidney group were higher than the P6 blank group;but there is no difference in BMD between RhGH group and the P6 blank group. The effect of GH mRNA and IGF-1 mRNA expression levels:the R1 group,rhGH and kidney group were higher than the P6 blank group. After six months intervention,the BMD of the rhGH group and kidney group are higher than the P6 blank group. GH mRNA and IGF-1 mRNA expression levels:GH group and kidney group are higher than the P6 blank group. The expression level of GH mRNA and IGF-1 mRNA in four groups has positive correlation. After six months intervention ,we found the positive correlation between the expression level of GH mRNA and IGF-1 mRNA and each part of the whole body BMD. Conclusion A kidney-tonifying herbal fufang can improve the bone mineral density of P6,and its mechanism may be related to improve expression level of GH mRNA and IGF-1 mRNA.
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Objective To observe the effect of spleen-warming and kidney-tonifying therapy on Toll-like receptor 4 (TLR4) signaling pathway of cerebral infarction sequelae patients. Methods A total of 60 cerebral infarction sequelae patients with spleen and kidney(yang) deficiency were divided into control group and treatment group, 30 cases in each group. The two groups were given function rehabilitation training following by the theory of modern rehabilitation medicine, and additionally the treatment group was treated with spleen-warming and kidney-tonifying herbs orally. The treatment period for the two groups averaged 3 months. Before and after treatment, the scores of traditional Chinese medicine (TCM) symptoms and signs, peripheral blood TLR4 mRNA expression level, and the inflammation-related factors in the two groups were observed, and the observation parameters were compared with 30 healthy volunteers. Meanwhile, the changes of modern rehabilitation evaluation indexes were also evaluated before and after treatment. Results (1) After treatment, the Fugl-Meyer scores for motor function and Modified Barthel Index(MBI) scores for activities of daily living in the treatment group were obviously increased(P 0.05). (2) After treatment, the predominant symptoms and signs of hemiplegia, facial distortion and dysphasia in the two groups were much improved(P 0.05 compared with those before treatment); the treatment group had obvious effect on the above symptoms and signs, and the effect was superior to that in the control group(P 0.05), and TNF-α level in the control group was decreased but did not arrive to the normal level(P < 0.05); levels of interleukin(IL)-1β, IL-6 and TLR4 mRNA in the two groups were decreased but did not arrive to the normal(P < 0.01), and the decrease in the treatment group was superior to that in the control group(P < 0.05 or P < 0.01). (4) During the treatment period, no obvious adverse effect was found in the two groups. Conclusion Oral use of spleen -warming and kidney –tonifying Chinese medicine combined with modern rehabilitation therapy is effective for the treatment of the sequelae of cerebral infarction patients by relieving the clinical TCM symptoms, and one of the therapeutic mechanisms is probably related with the TLR4 signaling pathway through regulating the expression of inflammatory factors.
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The treatment and signaling pathway regulation effects of kidney- tonifying traditional Chinese medicine on osteoporosis have been widely studied, but without a systematic summary currently. This review comprehensively collected and analyzed the traditional Chinese medicine on the treatment and signaling pathway regulation of osteoporosis in recent ten years, such as Epimedium, Drynariae Rhizoma, Cnidium, Eucommia, Psoralen and Dipsacus. Based on the existing findings, we concluded the following conclusions: (1) kidney-tonifying traditional Chinese medicine treats osteoporosis mainly through BMP-Smads, Wnt/β-catenin, MAPK, PI3K/AKT signaling pathway to promote osteoblast bone formation and through OPG/RANKL/RANK, estrogen, CTSK signaling pathway to inhibit osteo?clasts of bone resorption. ① Epimedium, Drynariae Rhizoma, Cnidium and Psoralen up-regulate the key proteins and genes of BMP-Smads and Wnt/β-catenin signaling pathways to promote bone formation.② Epimedium, Drynariae Rhizoma, Cnidium, Eucommia, Psoralen, Dipsacusinhibit the bone resorption by mediating the OPG/RANKL/RANK signaling pathway. (2) Kidney-tonifying traditional Chinese medicine prevent and treat osteoporosis through a variety of ways: Icariin, Naringin, Osthol, Psoralen can regulate BMP-Smads, Wnt/β-catenin signaling pathway to promote bone formation, but also activate OPG/RANKL/RANK, CTSK and other signaling pathway to inhibit bone resorption. (3) The crosstalk of the signaling pathways and the animal experiments of the traditional Chinese medicine on the prevention and treatment of osteoporosis as well as their multi-target mechanism and comprehensive regulation need further clarification.