Improvement effect of Shegan Mahuang Decoction on rats with cold-induced asthma based on TRPV1/NRF-1/mtTFA pathway / 中国中药杂志

This study investigated the therapeutic effect of Shegan Mahuang Decoction(SGMHD) on cold-induced asthma in rats and explored its underlying mechanism. Seventy-two healthy male SD rats of specific pathogen free(SPF) grade were randomly divided into a blank group, a model group, a positive control group(dexamethasone, 0.4 mg·kg~(-1)), and low-, medium-, and high-dose SGMHD groups(3.2, 6.4, and 12.8 g·kg~(-1)). The blank group received saline, while the other groups were sensitized by intraperitoneal injection of ovalbumin(OVA) solution. Subsequently, the rats were placed in a cold chamber adjustable to 0-2 ℃, and OVA solution was ultrasonically nebulized to induce cold-induced asthma in rats. After three weeks of treatment, the general behaviors of rats were observed. Hematoxylin-eosin(HE) staining was used to evaluate pathological changes in lung tissues, periodic acid-Schiff(PAS) staining assessed mucin changes, and Masson staining was performed to examine collagen deposition. Enzyme-linked immunosorbent assay(ELISA) was used to measure the levels of the inflammatory factors interleukin-4(IL-4) and vascular endothelial growth factor(VEGF) in serum and bronchoalveolar lavage fluid(BALF). Real-time quantitative polymerase chain reaction(RT-PCR) was employed to assess the mRNA expression levels of transient receptor potential vanilloid subfamily member 1(TRPV1), nuclear respiratory factor 1(NRF-1), and mitochondrial transcription factor A(mtTFA) in lung tissues. Western blot was used to measure the protein expression levels of TRPV1, NRF-1, and mtTFA in lung tissues. Compared with the blank group, the model group exhibited signs of rapid respiration, increased frequency of defecation with looser stools, and disheveled and dull fur. Pathological results showed significant infiltration of inflammatory cells in lung tissues, narrowing of bronchial lumens, increased mucin secretion, and enhanced collagen deposition in the model group. Additionally, the levels of IL-4 and VEGF in serum and BALF were significantly elevated, and the mRNA and protein expression levels of TRPV1, NRF-1, and mtTFA in lung tissues were significantly increased. Compared with the model group, SGMHD improved the behaviors of rats, alleviated pathological changes in lung tissues, mucin production, and collagen deposition, significantly decreased the levels of IL-4 and VEGF in serum and BALF, and reduced the mRNA expression levels of TRPV1, NRF-1, and mtTFA in lung tissues, with the medium-dose SGMHD group showing the most significant effect. Moreover, the protein expression levels of TRPV1, NRF-1, and mtTFA in lung tissues were also reduced, with the medium-dose SGMHD group exhibiting the most significant effect. In conclusion, this study demonstrates that SGMHD can alleviate airway inflammation and inhibit airway remodeling in cold-induced asthma rats. These effects may be associated with the modulation of the TRPV1/NRF-1/mtTFA signaling pathway.

Research progress of Shegan Mahuang Decoction and predictive analysis on its Q-markers / 中国中药杂志

Shegan Mahuang Decoction has been used in clinical practice for thousands of years, and is a classical formula for treating asthma and other respiratory diseases, with the effects of ventilating lung, dispersing cold, and relieving cough and asthma. This paper summarized the history, clinical application and mechanism of Shegan Mahuang Decoction, and predicted its quality markers(Q-markers) based on the "five principles" of Q-markers. The results suggested that irisflorentin, tectoridin, tectorigenin, irigenin, ephedrine, pseudoephedrine, asarinin, methyleugenol, shionone, epifriedelanol, tussilagone, 6-gingerol, trigonelline, cavidine, schizandrin, and schizandrin B could be used as Q-markers of Shegan Mahuang Decoction, which provided a basis for the quality control and subsequent research and development of Shegan Mahuang Decoction.

Meta analysis and trial sequential analysis of Shegan Mahuang Decoction in treating acute attack of bronchial asthma / 中草药

Objective: To evaluate the efficacy and safety of Shegan Mahuang Decoction in the treatment of acute attack of bronchial asthma, and provide the support of evidence-based medicine for clinical treatment of bronchial asthma. Methods: The databases such as CNKI and PubMed were searched by computer, and RCT meeting the inclusion criteria was extracted. Cochrane 5.1.0 bias risk assessment tool was used to evaluate the quality of included literatures, and Stata14.0 was used for Meta analysis. The outcome indicators included effective rate, pulmonary function (FEV1 / FVC and / or FEV1%), TCM symptoms score and adverse reactions. Finally, TSA 0.9 was used for trial sequential analysis. Results: A total of 20 articles were included in the study. The effective rate [RR = 1.18, 95% CI (1.14, 1.23), P = 0.00] in the trial group was significantly better than that in the control group. Subgroup analysis showed that the effective rate in the trial group with a course of treatment≤7 d[RR = 1.17, 95% CI (1.11, 1.24), P = 0.00] and 7-15 d[RR = 1.17, 95% CI (1.10, 1.24), P = 0.00] was significantly better than that in the control group. According to funnel chart and Begg's test, there was no published bias. The trial sequential analysis showed that the evidence of the effect was reliable. FEV1/FVC, the indexes of pulmonary function test, in the trial group were [SMD=1.17, 95%CI (0.44,1.90), P = 0.00] was significantly better than the control group, and FEV1% [SMD = 1.38, 95% CI (0.24, 2.52), P = 0.018] was also significantly better than the control group. The TCM syndrome score [WMD = -2.79, 95% CI (-3.39, -2.18), P = 0.00] in the trial group was significantly lower than the control group. The indicators of pulmonary function and TCM syndrome score were not reversed after sensitivity analysis, and the results were relatively stable. Serious adverse reactions were not reported in all studies. Conclusion Shegan Mahuang Decoction combined with conventional western medicine has more advantages in the treatment of acute attack of bronchial asthma than conventional western medicine alone. However, due to the limitations of this study, depth evaluation of its efficacy and safety needs more high quality RCTs in the future.

A clinical observation on therapeutic effect of traditional Chinese medicine granules made by formula of ;Shegan Mahuang decoction for treatment of patients with asthma / 中国中西医结合急救杂志

Objective To observe the therapeutic effect of traditional Chinese medicine(TCM)granules made by the formula of Shegan Mahuang decoction for treatment of patients with asthma. Methods A prospective study was conducted,51 cases of light to moderate asthma(cold type)patients were randomly divided into treatment group (25 cases)and control group(26 cases). Conventional symptomatic treatments were of the same in two groups. The patients in control group were given salbutamol aerosol inhalation,100μg each time,4 times per day;based on the treatment of the control group,additionally the above mentioned TCM granules dissolved in water was administered orally 1 dose/day taken twice once in the morning and another once in the evening in treatment group. The therapeutic course was 12 weeks in both groups. Before and after treatment,the asthma control test(ACT)score,forced expiratory volume in 1 second(FEV1)and peak expiratory flow(PEF)were observed. The therapeutic effect,adverse reaction and compliance were evaluated. Results The number of patients with asthma completely controlled in the treatment group was significantly higher than that in the control group(16 cases vs. 9 cases,χ2=4.82,P=0.028). In the patients of two groups,FEV1,PEF and ACT scores were significantly improved after treatment,and in the treatment group,they were obviously higher than those in control group〔FEV1(L):2.67±0.46 vs. 2.32±0.47,PEF(L/min):327.6±49.4 vs. 273.1±42.8,ACT score:22.8±2.0 vs. 21.1±2.6,all P<0.05〕. After treatment,FEV1%predicted value was increased in the treatment group but decreased in control group,there was significantly statistical difference〔(0.68±0.07)% vs.(0.80±0.11)%,P<0.05〕,no significant adverse reaction was found,compliance was good. Conclusion TCM granules made by formula of Shegan Mahuang decoction can improve the clinical symptoms, pulmonary function and control level in patients with asthma,so it is an effective medicine for the control of asthma.

Effect of Shema Zhichuan Liquid on Cyclic Nucleotide in Lung Tissue of Rat Models with Asthma / 广州中医药大学学报

Objective To explore the mechanism of Shema Zhichuan Liquid (SZL) for asthma. Methods Forty rats were allocated to normal control group (Group A), model group (Group B),western medicine group (Group C) and SZL group (Group D). Radioimmunoassay was used to observe the levels of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) and the ratio of cAMP/cGMP.Results After treatment, cAMP level and cAMP/cGMP ratio were increased and cGMP level decereased in Group C and Group D as compared with Group B (P