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Objective:To observe the effects of self-made Qingyuan Shenghua decoction on coagulation dysfunction in patients with sepsis, and to explore its possible mechanism.Methods:Eighty patients with sepsis and coagulation dysfunction admitted to the department of critical care medicine of Chengdu First People's Hospital from March 2018 to April 2020 were enrolled. The patients were divided into control group and observation group according to random number table method, with 40 cases in each group. Patients in both groups received basic treatment for sepsis. On this basis, the observation group was administrated with self-made Qingyuan Shenghua decoction, one dose a day, 100 mL in the morning and 100 mL in the evening; the control group was given the same amount of normal saline. Both groups were treated for 7 days. Prothrombin time (PT), activated partial thromboplastin time (APTT), international normalized ratio (INR), fibrinogen (Fib), D-dimer, platelet count (PLT), white blood cell count (WBC), C-reactive protein (CRP), and procalcitonin (PCT) were measured before and after treatment, and acute physiology and chronic health evaluation Ⅱ (APACHEⅡ) and sequential organ failure assessment (SOFA) were calculated. The length of intensive care unit (ICU) stay, the incidence of multiple organ dysfunction syndrome (MODS) and 28-day mortality was recorded.Results:The indexes of coagulation function and inflammation in the two groups were significantly improved after treatment, the improvement of various indexes in the observation group were better than those in the control group [PT (s): 16.01±1.08 vs. 19.21±1.38, APTT (s): 55.33±15.29 vs. 79.41±12.69, INR: 1.30±0.21 vs. 1.65±0.22, Fib (g/L): 2.87±0.89 vs. 5.44±1.13, D-dimer (mg/L): 2.56±1.67 vs. 6.41±2.42, PLT (×10 9/L): 125.79±18.51 vs. 95.46±18.50, WBC (×10 9/L): 7.50±0.78 vs. 12.75±4.09, CRP (mg/L): 21.27±9.32 vs. 65.44±13.40, PCT (μg/L): 1.15±0.58 vs. 6.31±1.29], and the differences were statistically significant (all P < 0.05). After treatment, APACHEⅡ and SOFA scores in the two groups decreased significantly compared with those before treatment, and the decrease in the observation group were more obvious than those in the control group (APACHEⅡ score: 10.29±1.86 vs. 15.35±2.06, SOFA score: 5.51±1.08 vs. 7.65±1.58, both P < 0.05). The length of ICU stay was shortened in the observation group than that in the control group (days: 12.22±9.48 vs. 20.22±15.35, P < 0.05). The incidence of MODS [35.0% (14/40) vs. 47.5% (19/40)] and the 28-day mortality [45.0% (18/40) vs. 47.5% (19/40)] was lower than that of the control group, but there was no statistical difference (both P > 0.05). Conclusion:Self-made Qingyuan Shenghua decoction can effectively improve the prognosis of patients with coagulation dysfunction and sepsis, and its mechanism may be related to inhibition of inflammatory reaction and improvement of coagulation function.
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The Shenghua Decoction recorded in Fu Qing Zhu's Gynaecology,is a commonly used postpartum prescription,widely used in treating postpartum and gynecological diseases. However,its mechanism of action in treating lower abdominal pain remains unclear. In this paper,network pharmacology was used to explore the mechanism of Shenghua Decoction in the treatment of lower abdomen pain,so as to provide data support for better clinical application of Shenghua Decoction. The drug targets of lower abdominal pain and Shenghua Decoction were retrieved in SymMap. String and Cytoscape were adopted for enrichment analysis to construct the disease-drug-target biological network. Relevant gene search results showed that there were 400 targets in Shenghua Decoction,11 of which coincided with the disease genes of lower abdomen pain. In String analysis,18 gene interactions were obtained. Gene modularizationbased analysis results indicated that one module containing six genes was obtained after modularization processing. Furthermore,there were 170 enrichment results of biological process,2 enrichment results of molecular function and 30 enrichment results of KEGG pathways in String enrichment analysis. Shenghua Decoction may play a role in treating lower abdomen pain through neuro-endocrine-immune,metabolism and other means. Its mechanism may be achieved by accelerating the repair and growth of endometrial tissue cells,improving microcirculation,promoting endometrial cell renewal and inflammation subsidence,and accelerating uterine involution; at the same time,it can regulate the autoimmunity,regulate and control the function of some natural immune cells in the process of antiinfection by using signaling pathway,supplement the vital energy,and induce elimination of pathogens from the body,thereby achieving the effect of treating lower abdomen pain.
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Female , Humans , Abdominal Pain , Drug Therapy , Drugs, Chinese Herbal , Pharmacology , Gynecology , Signal TransductionABSTRACT
Objective To observe the effects of Qingyuan Shenghua Decoction on cardiovascular indexes and illness severity in sepsis patients after severe bone trauma. Methods Forty-eight sepsis patients after severe bone trauma were randomly divided into control group(22 cases)and treatment group(26 cases). The two groups were given routine treatment of western medicine according to International Guidelines for Management of Severe Sepsis and Septic Shock (2012). Additionally,the treatment group was treated with oral use or intranasal use of Qingyuan Shenghua Decoction, a herbal medicine recipe mainly composed of Radix Astragali, Radix Salviae Miltiorrhizae,Radix Angelicae Sinensis,Radix Paeoniae Rubra,Radix et Rhizoma Rhei,Rhizoma Curcumae, and Flos Carthami. Before and after treatment,we observed the mean arterial pressure(MAP),central venous pressure(CVP), heart rate(HR), arterial blood lactic acid(Lac), central venous blood oxygen saturation (ScvO2),central venous-arterial blood carbon dioxide partial pressure difference (Pcv-aCO2),acute physiology and chronic health evaluation system Ⅱ(APACHE Ⅱ) scores , sequential organ failure assessment (SOFA) scores, and oxygenation index (PaO2/ FiO2) of the two groups. Results With the prolongation of medication time,MAP,CVP,ScvO2,and Pcv-aCO2 of the two groups were increased gradually,and HR and Lac were decreased gradually (P < 0.05 or P < 0.01 compared with those before treatment) . Compared to the control group at the same time period, the treatment group had higher MAP, ScvO2, Pcv-aCO2 and PaO2/FiO2, and had lower HR, Lac, APACHEⅡ scores and SOFA scores 7 days after treatment, the difference being significant(P < 0.05). Conclusion Qingyuan Shenghua Decoction is effective on improving the abnormal hemodynamics and microcirculation, enhancing the efficient utilization of oxygen, protecting the function of multiple viscera,and alleviating the severity of disease in sepsis patients after severe bone trauma.
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Objective To study the effects of modified Shenghua decoction combined with motherwort granules in treatment of postpartum placenta remnants.Methods136 selected patients with postpartum placenta remnants admitted into the hospital from June 2015 to October 2016 were divide into control group (68cases) and research group (68 cases).Control group was given motherwort granules and research group took modified Shenghua decoction on the basis of control group.The changes of endometrial thickness, residual area of placenta, TCM symptom scores, level of human chorionic gonadotropin (β-HCG), survival quality scores, menstruation recovery time, vaginal bleeding duration, cure time, occurrence of adverse reactions of two groups before and after treatment were compared, and efficacy of two groups were evaluated.ResultsAfter treatment, there was statistical difference in the endometrial thickness, residual area of placenta, TCM symptom scores, β-HCG level, survival quality scores, pain scores compared between the two groups (P<0.05);The menstruation recovery time, vaginal bleeding duration, cure time of research group were significantly lower than those of control group (P<0.05);There was statistical difference in the clinical efficacy compared between the two groups (P<0.05);There was no statistical difference in the incidence of adverse reactions between the two groups.ConclusionModified Shenghua decoction soup combined with motherwort granules for treating patients with postpartum placenta remnants can effectively relieve clinical symptoms, increase efficacy, reduce patients' pain, promote their recovery and improve survival quality, which has significant clinical advantages and can be further generalized and applied.
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Objective To observe the effect of modified Fu Qingzhu's Shenghua decoction on uterine involution after repeat cesarean section.Methods Randomized and parallel design was adopted in the study.A total of 112 cases were recruited into an observation group and a control group.56 cases in the observation group were treated with oral Fu Qingzhu's Shenghua decoction for 5 days,while 56 cases in control group were treated without any herbs.The follow-up was 42 days.Duration of lochia,hemoglobin concentration,and abnormalities of uterine ultrasound were observed.Results Duration of lochia rubra (5.1 ± 1.2 d vs.5.8 ± 1.3 d;t=-2.734,P=0.007) and the duration of lochia rubra and lochia serosa in the observation group 25.0 (21.0,29.8) d vs.29.0 (26.0,33.8) d;Z=3.873,P＜0.001) were all lower than the control group.The lochia complete ration in 42 days (94.9％ vs.82.1％,x2=4.264),the average hemoglobin concentration (115.43 ± 10.68 g/L vs.104.29 ± 9.90 g/L,F=4.159) and sum of the three uterine diameters (14.2 ± 1.0 cm vs.14.8 ± 1.3 cm,t=-2.686,P=0.008) in the observation group were all higher than the control group.The incidence of uterine cavity hydrops (3.57％ vs.17.85％,P=0.015) in the observation group was lower than the control group.Conclusion Fu Qingzhu's Shenghua decoction has promotive effects on uterine involution after repeat cesarean section.
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OBJECTIVE:To observe therapeutic efficacy of adjunctive treatment of Shenghua decoction for abortion in the ear-ly pregnancy. METHODS:228 patients with abortion in the early pregnancy collected from our hospital were randomly divided into control group and observation group with 114 cases in each group. Control group was given mifepristone 25 mg,bid,and addition-al misoprostol 600 μg on the forth day,qd,for 4 days. Observation group was additionally given misoprostol orally on the forth day,2 h later,Shenghua decoction,bid,for consecutive 7 days. The rate of abortion,bleeding time,amount of bleeding,normal activity time after abortion,and the incidence of ADR were observed in 2 groups. RESULTS:The rate of abortion in observation group was 96.5%,which was higher than that of control group (85.1%),with statistical significance (P<0.05). The bleeding time,amount of bleeding and normal activity time of observation group were significantly lower or shorter then those of control group,with statistical significance (P<0.05). The incidence of ADR in observation group was significantly lower than control group,with statistical significance(P<0.05). CONCLUSIONS:The adjunctive treatment of Shenghua decoction have good effect on abortion in the early pregnancy with less ADR.
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Objective To observe the curative effect of modified Shenghua Decoction on promoting uterine instauration after cesarean section. Methods A total of 300 parturient cases receiving cesarean section were evenly randomized into observation group and control group. After cesarean section, patients of observation group were given modified Shenghua Decoction orally, and those of the control group were given intramuscular injection of oxytocin. The observation indexes included uterine retraction, the amount of lochia, and ultrasound examination for uterine instauration. Results (1) In the observation group, uterine contraction 72, 120 h after cesarean section was better than that of the control group, and the difference was statistically significant ( P0.05). Forty-two days after cesarean section, the sum of the three uterine diameters in the ob-servation group significantly differed from that of the control group (P<0.05). (4) Forty-two days after cesarean section, the incidence of uterine cavity effusion was 6.67%in the observation group, and was 17.33% in the con-trol group, the difference being statistically significant (P<0.05). Conclusion The modified Shenghua Decoction has certain curative effect on promoting uterine instauration after cesarean section.
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Shenghua decoction made by FU Qing-zhu is a famous formula aimed at syndrome of coagulation cold due to blood deficiency,static blood obstruction.The mechanism of disease is definite when this formula is applied.But the extensive use of Shenghua decoction,especially some potent preparation of it following childbirth without according to TCM principle based on differentiation of syndromes is a manifestation of highlighting formula and underestimating theory,which is useless and harmful.It should be emphasized.So the Shenghua decoction should be used under the direction of basic theory of TCM,through precise syndrome differentiation,according to the principle of "looking to and not being besieged by postpartum ".We should not follow blindly the method of treatment of "warming and resolving stasis" on the postpartum disease.It is important that Shenghua decoction should be used on the basis of syndrome differentiation.
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Objective To study the pharmacokinetics of ferulic acid (FA) in plasma of the healthy female volunteers after oral administration of Shenghua decoction.Methods Using p-hydroxybenzaldehyde as the internal standard, the plasma concentration of FA was determined by RP-HPLC. Plasma samples were extracted and treated with boiling water and 3P97 programme was used to calculate the pharmacokinetic parameters. Results The main pharmacokinetic parameters of FA were as follows: T1/2?=18.72 min ,T1/2?=79.21 min,T1/2 Ka=11.19 min,AUC=18004.87 ?g?min?L-1,CL=0.17L?min-1?kg-1,Cmax=206.30 ?g?L-1, Tpeak=22.78 min.Conclusion After oral administration of Shenghua decoction, FA could be absorbed and eliminated rapidly and pharmacokinetics of FA conforms to a two-compartment open model.
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AIM: To study the effects of Shenghua Decoction on the expression of adhesion molecules in vascular endothelial cells (VECs) of blood-stasis rats. METHODS: The expression of VCAM-1, ICAM-1, PECAM-1, iNOS and their corresponding mRNA in VECs were assayed by immunohistochemistry, image analysis and RT-PCR under the function of different Shenghua Decoction doses (high, middle, low). RESULTS: Immunohistochemistry and image analysis indicated: the expression of VCAM-1, ICAM-1, PECAM-1 and iNOS were higher in the model group than in the control group, Shenghua Decoction could decrease the expression of VCAM-1, ICAM-1, PECAM-1 and iNOS in the model group, moreover as the dose decreased, the expression of these molecules increase, it was of dose-effect relation. CONCLUSION: Shenghua Decoction can downregulate the expression of adhesion molecules in vascular endothelial cells of blood-stasis rats, and the dose-effect relation is obvious.