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ObjectiveTo investigate the effects and mechanism of Zuogui Jiangtang Tongmai prescription （ZJTP） on human umbilical vein endothelial cells （HUVECs） damaged by high glucose combined with lipopolysaccharide （LPS）. MethodThe survival rate of cells was determined by cell counting kit-8 （CCK-8）， and the level of tumor necrosis factor-α （TNF-α） was determined by enzyme-linked immunosorbent assay （ELISA） to determine the optimal injury concentration and action time of LPS， as well as the optimal action concentration of ZJTP drug-containing serum. HUVECs were divided into a blank control group， a model group， a ZJTP drug-containing serum group， and an SCFA mixed liquid group. ELISA was used to detect the level of endothelin-1 （ET-1）， nitric oxide （NO）， interleukin-1β （IL-1β）， interleukin-6 （IL-6）， and TNF-α. Western blot was performed to detect the protein expression of G protein-coupled receptor43 （GPR43）， β-suppressor protein-2 （β-arrestin-2）， nuclear factor-κB suppressor α （IκBα）， and nuclear factor κB p65 （NF-κB p65）. The nucleation of NF-κB p65 was observed by immunofluorescence staining （IF）. The role of GPR43 in the regulation of inflammatory injury was observed by means of small interfering ribonucleic acid （siRNA）. The cells after intervention were divided into an empty carrier group， a ZJTP drug-containing serum group， a Si-GPR43 group， and a Si-GPR43 + ZJTP drug-containing serum group. The content of IL-1β， IL-6， and TNF-α was detected by ELISA. The protein expression of pathways was detected by Western blot. IF was used to observe the nucleation of NF-κB p65. ResultThe optimal molding condition was 1 mg·L-1 LPS for 24 h. The optimal drug intervention condition was 5% ZJTP drug-containing serum for 24 h. Compared with the blank control group， the content of ET-1 in the model group was significantly increased， and the content of NO was significantly decreased （P<0.01）. The levels of inflammatory factors were significantly increased （P<0.01）. The expressions of GPR43 and IκBα were significantly decreased， while the protein expressions of β-arrestin-2 and NF-κB p65 were significantly increased （P<0.01）. NF-κB p65 protein was transferred from the extranuclear to the intranuclear （P<0.01）. Compared with the model group， the content of ET-1 in the ZJTP drug-containing serum group was decreased， and the content of NO was increased （P<0.05）. The levels of inflammatory factors decreased （P<0.05）. The protein expressions of GPR43 and IκBα were increased， while the expressions of β-arrestin-2 and NF-κB p65 were decreased （P<0.05）. The amount of NF-κB p65 transferred from the intranuclear to the extranuclear decreased （P<0.01）. The mechanism study showed that compared with the Si-GPR43 group， the content of IL-1β， IL-6， and TNF-α were significantly decreased after treatment with ZJTP drug-containing serum （P<0.01）. The protein expressions of GPR43 and IκBα were significantly increased （P<0.01）， while the protein expressions of β-arrestin-2 and NF-κB p65 were significantly decreased （P<0.01）. The amount of NF-κB p65 transferred from the extranuclear to the intranuclear decreased （P<0.01）. ConclusionZJTP has a protective effect on HUVECs with high glucose and LPS-induced inflammatory injury， which may be related to the regulation of GPR43/β-arrestin-2/IκBα/NF-κB pathway.
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ObjectiveTo explore the potential mechanism of Zuogui Jiangtang Tongmai prescription （ZJT） in the treatment of diabetes mellitus complicated with cerebral infarction （DM-CI） in rats based on the short-chain fatty acids （SCFAs）/G protein-coupled receptor 43 （GPR43）/glucagon-like peptide-1 （GLP-1）/GLP-1 receptor （GLP-1R） signaling pathway. MethodSixty SD rats were randomly divided into sham operation group， model group， low- and high-dose ZJT groups （12， 24 g·kg-1）， western medicine group （140 mg·kg-1 pioglitazone metformin tablets + 27 mg·kg-1 enteric-coated aspirin tablets）. Except for the sham operation group， all other groups were fed a high-sugar high-fat diet for 4 weeks and then subjected to intraperitoneal injection of 1% streptozotocin at 35 mg·kg-1 combined with middle cerebral artery occlusion （MCAO） to establish a DM-CI rat model. The corresponding interventions were performed with distilled water， low-dose ZJT， high-dose ZJT， pioglitazone metformin tablets， and enteric-coated aspirin tablets. After surgery， National Institutes of Health Stroke Scale （NIHSS） scoring and triphenyltetrazolium chloride （TTC） staining to measure the rat's cerebral infarct volume were carried out. Random blood glucose levels were measured， and hematoxylin-eosin （HE） staining was used to observe histopathological changes in rat brain tissues. Gas chromatography was employed to detect the content of SCFAs in the cecum contents. Enzyme-linked immunosorbent assay （ELISA） was adopted to measure serum GLP-1 level. Western blot was used to detect the protein expression of GPR43 in rat ileal tissues and GLP-1R in the ischemic brain tissues. ResultCompared with the sham operation group， the model group showed significantly increased NIHSS scores， random blood glucose levels， and cerebral infarct volumes （P<0.01）， and significantly decreased SCFAs content， GLP-1 levels， and GPR43 and GLP-1R protein expression （P<0.01）. Compared with the model group， the high-dose ZJT group and the western medicine group exhibited significantly reduced NIHSS scores， random blood glucose levels， and cerebral infarct volumes （P<0.05， P<0.01）， and significantly increased SCFAs content， GLP-1 levels， and GPR43 and GLP-1R protein expression （P<0.01）. ConclusionZJT can improve glucose metabolism disorder and reduce neurological damage in DM-CI rats， and its mechanism may be related to the increase in SCFAs content and the upregulation of the GPR43/GLP-1/GLP-1R signaling pathway.
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@#【Objective】 To investigate the correlations between intestinal flora, plasma metabolites, and blood stasis syndrome in coronary heart disease (CHD), and the mechanisms of Yangxin Tongmai Formula (养心通脉方, YXTMF) for blood stasis syndrome in CHD rats. 【Methods】 A total of 18 specific pathogen free (SPF) male Sqrague-Dawley (SD) rats were used to establish CHD rat models with blood stasis syndrome, which were then randomized into model, YXTMF, and atorvastatin calcium (AVT) groups, with six rats in each group, and were intervened through gavage for two weeks. Subsequently, additional six rats that received normal diet were included as normal group. The pathological changes in the CHD rat models were identified by hematoxylin-eosin (HE) staining. The electrocardiogram, hemodynamics, and lipid profiles of the rats were detected as well. The untargeted plasma metabolomics of rats were analyzed by liquid chromotography-tandem mass spectrometry (LC-MS/MS), their ileal mucosal flora by 16S rRNA sequencing, and the correlation between the two results were also analyzed. 【Results】 The whole blood viscosity, total cholesterol (TC), and low-density lipoprotein cholesterol (LDL-C) of rats in the model group increased compared with those in the control group (P < 0.05). In the model group, the proliferation of endothelial cells in the coronary artery of rats was damaged, with quite a few vacuolated pathological changes observed. However, the endothelial lesions in the coronary artery of rats were alleviated in the intervention groups (YXTMF and AVT groups). With the use of LC-MS/MS, a total of 33 potential endogenous metabolites were identified in plasma, among which 1-methylhistidine, N-acetylhistamine, progesterone, and deoxycorticosterone were expected to be the differential metabolites in CHD rats with blood stasis syndrome. The 16S rRNA sequencing results showed that improved diversity and abundance of intestinal flora were observed in the YXTMF group. The correlation analysis suggested that Hydrogenophaga, Limnohabitans, and Polaromonas, which were highly related to the formation of blood stasis syndrome in CHD patients, were positively correlated with plasma metabolites such as 5-hydroxyindole, N-acetylhistamine, and progesterone (P < 0.01), but were negatively correlated with plasma metabolites such as L-arginine, homoarginine, and Boc-beta-cyano-L-alanine (P < 0.01). After YXTMF intervention, Lactobacillus, Corynebacterium, and Candidatus Nitrososphaera were positively correlated with plasma metabolites such as Boc-β-cyano-L-alanine, stachydrine, and naringenin (P < 0.05), while negatively correlated with 5-hydroxyindole, N-acetylhistamine, and oleoylethanolamide (P < 0.05). 【Conclusion】 YXTMF could alleviate blood stasis syndrome in CHD rats through improving their plasma metabolisms achieved by regulating the intestinal flora.
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ObjectiveTo observe the clinical efficacy of the Modified Tongmai Anshen Formula （通脉安神方加减， MTAF） in the treatment of stable angina pectoris （SAP） with sleep disorders. MethodsA total of 148 patients suffering from SAP with sleep disorder were included and randomly divided into control group and treatment group， with 74 patients in each group. The control group received conventional western medicine， and the treatment group additionally received MTAF （1 dose per day）， both for 4 weeks. The changes in angina pectoris symptoms， traditional Chinese medicine （TCM） syndromes， sleep quality， quality of life， serological indicators including serum intercellular adhesion molecule-1 （ICAM-1） and vascular cell adhesion molecule-1 （VCAM-1）， brain-derived nerve growth factor （BDNF） and tyrosine kinase receptor B （TrkB） were compared between groups before and after treatment， and the safety was evaluated. ResultsIn the treatment group and the control group， the total effective rates of TCM syndromes（82.43% vs 52.70%）， angina pectoris （79.73% vs 64.86%） and sleep （89.19% vs 68.92%） showing significant difference （P＜0.001）. After treatment， the total TCM syndrome score， primary symptom score， secondary symptom score， and secondary symptoms sleeplessness， restlessness， tiredness and fatigue individual score， angina pectoris score， PSQI total score and each item score were all significantly reduced in both groups， while the SF-36 single item score significantly increased （P＜0.05）. The total TCM syndromes and primary symptom scores， secon-dary symptoms sleeplessness， restlessness， tiredness and fatigue individual score， angina pectoris score， time to fall asleep， sleep quality， hypnotic medication， sleep disturbance， daytime dysfunction score and PSQI total score were significantly lower in the treatment group than those in the control group after treatment （P＜0.05）， while the somatic pain， general health status， social functioning， emotional functioning， mental health， and health change were significantly higher in the treatment group （P＜0.05）. After treatment， ICAM-1 and VCAM-1 level significantly decreased （P＜0.05）， and BDNF and TrkB levels increased （P＜0.05） in the treatment group， while BDNF level significantly decreased in the control group （P＜0.05）. The TrkB level was significantly higher in the treatment group compared to the control group after treatment （P＜0.05）. A total of four adverse events occurred during the treatment， none of which were considered to be related to this study. ConclusionMTAF can significantly improve angina pectoris symptoms， TCM syndromes， sleep quality and quality of life in patients suffering from SAP with sleep disorders， the mechanism of which may be related to the protection of vascular endothelial function and central neurons.
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Objective:To evaluate the clinical effect of Guanxin Tongmai plaster combined with conventional western medicine in the treatment of phlegm and blood stasis syndrome of coronary heart disease and angina pectoris.Methods:A total of 60 patients in the Department of Cardiology of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine (TCM) from February to August 2020 who met the inclusion criteria were randomly divided into two groups with 30 in each group. Both groups were treated with conventional western medicine. On this basis, Guanxin Tongmai plaster was applied at the acupoints in the treatment group and placebo plaster was applied in the control group. TCM syndrome score was performed before and after treatment, angina score was evaluated from three aspects of angina attack frequency, duration and pain degree, and blood lipid TG, TC, LDL-C and HDL-C were detected by enzyme quantitative method. The blood homocysteine (Hcy) was detected by enzyme circulation method, the ECG and the nitroglycerin reduction rate were recorded, and the safety index was detected according to the ECG changes.Results:In the treatment period, 2 patients in the treatment group fell off, 3 in the control group. A total of 28 patients in the treatment group and 27 in the control group were analyzed. The total effective rate of ECG efficacy in the treatment group was 67.9% (19/28) and the control group was 48.1% (13/27). There was significant difference between the two groups ( χ2=4.46, P=0.040). After treatment, the TCM syndrome score and angina score in the treatment group were significantly lower than those in the control group ( t values were 9.12 and 4.45, P values were 0.004 and 0.042, respectively). The reduction rate of nitroglycerin in the treatment group was 82.1% (23/28) and 55.6% (15/27) in the control group. There was significant difference between the two groups ( χ 2=4.72, P=0.030). After treatment, the plasma TG, TC, LDL-C in the treatment group were significantly lower than those in the control group ( t values were 4.17, 6.57 and 6.52, P<0.05 or P<0.01), the level of HDL-C was significantly higher than that of the control group ( t=7.07, P=0.010), and the level of plasma Hcy was significantly lower than that in the control group ( t=6.70, P=0.012). There was no significant difference in liver, kidney and coagulation function between the two groups. Conclusion:Guanxin Tongmai plaster combined with conventional western medicine can improve the clinical symptoms of patients with coronary heart disease and angina pectoris, reduce the level of blood lipid and Hcy, and improve the clinical curative effect.
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Objective:To evaluate the clinical efficacy of Yiqi-Tongmai Decoction on isolated coronary muscle bridge angina patients with qi deficiency and blood stasis syndrome. Methods:A total of 64 patients with isolated coronary artery muscular bridge angina pectoris with qi deficiency and blood stasis syndrome in Beijing Hospital of Traditional Chinese Medicine affiliated to Capital Medical University from April 2016 to January 2020 who met the inclusion criteria were divided into 2 groups by random number table method, with 32 patients in each group. The control group took diltiazem hydrochloride tablets orally, and the treatment group took Yiqi-Tongmai Decoction on the basis of the control group. Both groups were treated for 8 weeks. The TCM syndrome scores were observed before and after treatment, and Seattle Angina Questionnaire was assessed for patient's quality of life and functional status. The exercise ECG test was observed before and after treatment, and the cause of angina pectoris need to be recorded, including the movement time and plate movement caused by time of ST segment in electrocardiogram (ecg) and dynamic evolution. Results:The total effective rate of angina pectoris was 84.38% (27/32) in the treatment group, and 53.13% (17/32) in the control group, and the difference between the two groups was statistically significant ( χ2=8.09, P<0.05). After treatment, the degree of physical activity limitation (69.24 ± 14.21 vs. 59.42 ± 11.71, Z=-2.61), stable state of angina (82.25 ± 21.24 vs. 69.11 ± 19.52, Z=2.64), angina (80.24 ± 18.31 vs. 69.11 ± 15.54, Z=2.63), treatment satisfaction (86.16 ± 19.23 vs. 61.19 ± 17.35, Z=2.22), degree of disease cognition (74.41 ± 21.13 vs. 60.43 ± 19.42, Z=2.40) scores in the treatment group were significantly higher than those in the control group ( P<0.05). In the treatment group, the time of exercise-induced angina pectoris [(476.15 ± 62.15)s vs. (399.38 ± 78.42)s, Z=-2.08], the time of ST segment descending 1 mm after exercise [(394.54 ± 75.61)s vs. (309.64 ± 81.62)s, Z=-2.40] in the treatment group were significantly longer than those in the control group ( P<0.05). The total effective rate of TCM syndrome was 93.8% (30/32) in the treatment group and 65.6% (21/32) in the control group, and the difference was statistically significant ( χ2=7.96, P<0.05). The TCM syndrome scores of the treatment group (25.15 ± 6.15 vs. 36.38 ± 10.42, Z=-2.56) in the treatment group were significantly lower than that of the control group ( P<0.05). There were no obvious adverse reactions in both groups during treatment. Conclusion:Yiqi-Tongmai Decoction can improve the clinical symptoms of isolated coronary artery muscle bridge angina pectoris with qi deficiency and blood stasis syndrome, reduce the onset of angina pectoris, delay the time of exercise induced angina pectoris, and improve the clinical efficacy.
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ObjectiveTo explore the effect and mechanism of Zuogui Jiangtang Tongmai prescription （ZGJTTMP） on astrocytes （ASs） injured by advanced glycation end products（AGEs） combined with oxygen-glucose deprivation （OGD）. MethodCell counting kit-8 （CCK-8） was used to determine the optimal concentration of AGEs and the action time of OGD， and the optimal blood concentration of ZGJTTMP was selected for follow-up experiments. ASs were divided into normal group， model group （AGEs + OGD）， ZGJTTMP group， an adenosine 5'-monophosphate-activated protein kinase （AMPK） inhibitor （Compound C） group， AMPK activator （AICAR） group， and combination group （ZGJTTMP + AICAR）. The morphological changes in ASs in each group were observed under an inverted microscope. The cell survival rate in each group was detected by CCK-8. The content of interleukin-1β（IL-1β）， interleukin-6（IL-6）， and tumor necrosis factor-α（TNF-α） was detected by enzyme-linked immunosorbent assay （ELISA）. The number of autophagosomes in each group was counted under an electron microscope. The expression of microtubule-associated protein light chain 3 （LC3） was observed by immunofluorescence. The protein expression of LC3， p62， p-AMPK， AMPK， p-mammalian target of rapamycin （mTOR）， mTOR， p-UNC-51 like kinase 1 （ULK1）， and ULK1 was detected by Western blot. ResultAccording to the results of cell survival rate， 200 mg·L-1 AGEs and OGD for 6 h were selected as the optimal modeling conditions for the model group， and 5% was selected as the optimal blood concentration of ZGJTTMP. Under the inverted microscope， the cells were severely damaged after modeling， but the cell injury in the ZGJTTMP group and the Compound C group was significantly improved. As revealed by ELISA results， the content of IL-1β， IL-6， and TNF-α in the model group increased （P<0.01）， and the content of inflammatory factors in the ZGJTTMP group and the Compound C group decreased （P<0.01）. Under the electron microscope， the number of autophagosomes in the model group increased significantly. The immunofluorescence results showed that the expression area of LC3 increased in the model group （P<0.01）， and the ZGJTTMP group and the Compound C group showed decreased number of autophagosomes and reduced expression area of LC3 （P<0.01）. As demonstrated by the results of Western blot， compared with the normal group， the model group showed increased expression of LC3Ⅱ/LC3Ⅰ and p-AMPK/AMPK （P<0.01） and decreased p62， p-mTOR/mTOR， and p-ULK1/ULK1 （P<0.01）. Compared with the model group， the ZGJTTMP group and the Compound C group showed decreased expression of LC3Ⅱ/LC3Ⅰ and p-AMPK/AMPK （P<0.01） and increased p62， p-mTOR/mTOR， and p-ULK1/ULK1 （P<0.01）. ConclusionZGJTTMP possesses a protective effect on ASs with inflammatory injury by AGEs combined with OGD， which may be achieved by inhibiting the activation of the AMPK/mTOR/ULK1 pathway related to autophagy， thus inhibiting the overexpression of autophagy.
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ObjectiveTo explore the regulatory effect of Quyu Huatan Tongmai prescription on intestinal mircoflora of hyperlipidemia golden hamster and scientific evidence for the compatibility. MethodSyrian golden hamsters were randomized into normal， model， prescription， stasis-dispelling （Quyu）， phlegm-dissolving （Huatan）， and detoxification （Jiedu） groups， with 8 in each group. Hyperlipidemia in golden hamsters was induced by high-fat diet （4 weeks）. Then hamsters in the Quyu group （1.11 g·kg-1）， Huatan group （0.39 g·kg-1）， Jiedu group （0.07 g·kg-1）， and prescription group （1.42 g·kg-1） were given （ig） corresponding drugs and those in the normal group and the model group received （ig） distilled water of equivalent volume， once a day for 6 weeks. Serum lipids were determined， and hematoxylin-eosin （HE） staining was used to observe the pathological morphology of the liver. Feces were collected for 16S rRNA gene high-throughput sequencing of intestinal flora. ResultCompared with normal group， the model group demonstrated increase in body weight （P<0.05， P<0.01） and blood lipids （P<0.01）， decrease in intestinal flora diversity （P<0.05， P<0.01）， and variation of the relative abundance of intestinal flora at phylum， family， and genus levels （P<0.05， P<0.01）. Compared with the model group， Quyu Huatan Tongmai prescription controlled the body weight change， reduced the serum triglyceride （TG）， total cholesterol （TC）， and low density lipoprotein cholesterol/high density lipoprotein cholesterol ratio （LDL-C/HDL-C） （P<0.05， P<0.01）， improved the structure of intestinal flora， decreased the ratio of Firmicutes to Bacteroides （P<0.01）， raised the abundance of Bacteroidaceae， Porphyromonadaceae， Rikenellaceae， and Pasteurella （P<0.05， P<0.01）， and lowered the relative abundance of Coriobacterium （P<0.05） in hyperlipidemia golden hamsters. All the split prescriptions improved blood lipids and intestinal flora of the hamsters and particularly， the lipids-lowering effect of the Jiedu group and the regulation of flora in the Huatan group were closer to those of the prescription group. ConclusionQuyu Huatan Tongmai prescription and the split prescriptions all alleviated the hyperlipidemia of golden hamsters to different degrees possibly by regulating intestinal flora structure and improving intestinal microecology. The effect of the prescription group was most significant， and coming in second was the Huatan group. This study also provides scientific evidence for the effect of Quyu Huatan Tongmai prescription.
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Meige syndrome is one of the rare Diseases of neurology. It is a part of the group of segmental cranial dystonia, which affects more than two cranial muscle groups. Especially, blepharospasm is associated with another cranial dystonia. Currently, the etiology and pathogenesis of this disorder are not well-understood. Based on the theory of collaterals and the relationship between collateral disease and five zang organs,we try to classify the disease into the category of collateral disease, and hold that the mechasnism of disease is not only linked to brain, but also the five zang organs. The disorder of qi and blood leads to the "deficiency of qi and blood", "phlegm-damp" and "stagnant blood" in collateral. These pathological changes cause the deficiency of both qi and blood in brain marrow and tendon.We think that "unblocking and regulating the collterals"is the general program. Adjusting the five zang organs to heel the brain is the key point of the treatment. What's more, we create Tongmai Heluo Decoction to regulate qi and blood of the collateral. This decoction is composed of Huangqi Jianzhong Decoction with some herbal medicine for tonifying qi and activating blood. By adjusting the middle energizer, the qi and the qi movement of five zang organs are well regulated. We use this decoction effectively on refractory Meige syndrome.
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@#AIM: To explore the clinical value of oral administration of Tongmai Tangyanming Capsule after 23-gauge(23G)pars plana vitrectomy(PPV)in patients with proliferative diabetic retinopathy(PDR).<p>METHODS: This prospective study included 98 patients(109 eyes)with PDR admitted to the hospital between February 2018 and October 2019. The patients were randomly divided into control group(49 cases, 54 eyes, 23G PPV)and observation group(49 cases, 55 eyes, oral administration of Tongmai Tangyanming Capsule, 750 mg/time, 3 times/d, for 12wk). The best corrected visual acuity(BCVA), intraocular pressure, visual field sensitivity and central macular thickness(CMT)were measured before and 12wk after surgery. Changes in insulin-like growth factor-1(IGF-1)and vascular endothelial growth factor(VEGF)were determined, and insulin resistance index(HOMA-IR)was calculated. The surgical complications and recurrence rate during 12wk of follow-up were observed.<p>RESULTS: At 12wk after surgery, the BCVA(LogMAR)and visual field sensitivity of the two groups were improved(<i>P</i><0.001), and CMT was decreased(<i>P</i><0.001), but there was no significant change in intraocular pressure(<i>P</i>>0.05). Meanwhile, the BCVA and visual field sensitivity of the observation group were higher than those of the control group(<i>P</i><0.05), and CMT was smaller than that of the control group(<i>P</i><0.05). At 12wk after surgery, serum IGF-1, VEGF and HOMA-IR were decreased in the two groups(<i>P</i><0.001), and these indicators in the observation group were lower than those in the control group(<i>P</i><0.001). The incidence of complications and recurrence rate were similar in the two groups(<i>P</i> >0.05).<p>CONCLUSION: Oral administration of Tongmai Tangyanming Capsule after 23G PPV can better promote postoperative visual recovery, improve visual sensitivity, reduce insulin resistance and lower the levels of IGF-1 and VEGF, inhibit retinal neovascularization and proliferation, and reduce the risk of recurrence.
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Objective:To evaluate the efficacy of Tongmai-Huaban Decoction combined with conventional western medicine in the treatment of patients with coronary heart disease, and to explore the effects on unstable plaque formation and oxidative stress response. Methods:A total of 120 patients with coronary heart disease in Jiangsu Traditional Chinese Medicine Hospital from March 2020 to March 2021 were randomly divided into two groups by random number table method, with 60 in each group.The control group was treated with aspirin and atorvastatin, and the treatment group was treated with Tongmai-huaban Decoction on the basis of the control group. Both groups were treated for 3 months. The Carotid plaque area and carotid intima-media thickness (cIMT) were measured by color Doppler, the serum MDA and SOD were detected by electrochemiluminescence, the lipid peroxidation (LPO) was detected by double antibody sandwich method, the TNF-α and IL-6 levels were measured by ELISA, and the level of CRP was measured by immunoturbidimetry. The adverse reactions of the two groups were observed, and the clinical efficacy was evaluated. Results:The total effective rate was 91.7% (55/60) in the treatment group and 76.7% (46/60) in the control group, and the difference between the two groups was statistically significant ( χ2=5.016, P=0.024). After treatment, the carotid plaque area [(0.51 ± 0.13) cm 2vs. (0.65 ± 0.16) cm 2, t=5.416] and cIMT [(1.89 ± 0.41) mm vs. (2.11 ± 0.52) mm, t=2.650] in the treatment group were significantly less than those in the control group ( P<0.05); LPO [(3.31 ± 0.83) μmol/L vs. (4.18 ± 1.04) μmol/L, t=5.215], MDA [(2.94 ± 0.77) μmol/L vs. (3.79 ± 0.95) μmol/L, t=5.543] levels were significantly lower than those in the control group ( P<0.05); the level of SOD [(86.56 ± 22.73) U/L vs. (78.79 ± 19.07) U/L, t=2.085] was significantly higher than that of the control group ( P<0.05); the levels of TNF-α, CRP and IL-6 in the treatment group were significantly lower than those in the control group ( t values were 2.557, 6.781 and 6.014, respectively, P<0.05 or P<0.01). The incidence of adverse reactions was 8.3% (5/60) in the treatment group and 10.0% (6/60) in the control group, where there was no significant difference between the two groups ( χ2=0.100, P=0.751). Conclusion:Tongmai-Huaban Decoction combined with conventional western medicine can improve the clinical symptoms of patients with coronary heart disease and reduce plaque instability, inflammatory cytokine level and oxidative stress response.
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Objective: To observe the effect of serum-containing Qingxin Tongmai decoction(QXTMD) on the apoptosis rate of mouse mononuclear macrophage cell line RAW264.7 induced by Acetylated low density lipoprotein (ac-LDL) and the expressions of type A scavenger receptor(SR-A), B-cell lymphoma-2(Bcl-2), Bcl-2-associated X protein(Bax), inositol-requiring enzyme 1α(IRE1α), exploring the possible mechanism of QXTMD in the treatment of atherosclerosis.Method: Eight New Zealand rabbits were randomly divided into the atorvastatin group (2.6 g·kg-1) low, medium and high-dose QXTMD groups (3.33, 6.66, 13.32 mg·kg-1). After 7 days of gavage, the carotid blood was collected to prepare drug-containing serum. The RAW264.7 cell line was stimulated with 2.5%, 5%, 10%, and 20% drug-containing serum culture for 6, 12, and 24 h, respectively. The cell proliferation rate was observed by cell counting kit-8 (CCK-8) method. The RAW264.7 cell line was cultured in vitro and divided into blank group, model group, atorvastatin group, and low, medium and high-dose QXTMY groups. The cells in blank group were cultured with bovine serum albumin(BSA). The model group was stimulated with BSA+50 mg·L-1 ac-LDL for 24 h. The other groups were stimulated with BSA+50 mg·L-1 ac-LDL+10% drug-containing serum for 24 h. The apoptosis rate and SR-A expression of RAW264.7 cells were detected by flow cytometry. The expressions of Bcl-2, Bax and IRE1α protein were detected by Western blot.Result: Compared with the blank group, the model group could increase the apoptosis rate of RAW264.7 cells (PPPPα (PPPPPConclusion: QXTMD can reduce the apoptosis rate of macrophages. The mechanism of atherosclerosis may be related to the expressions of Bax, IREα, SR-A and anti-apoptotic protein Bcl-2.
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To systematically review the efficacy and safety of Tongmai Yangxin Pills in treatment for angina pectoris of coronary heart disease. CNKI, WanFang, VIP, SinoMed, PubMed, EMbase and the Cochrane Library databases were retrieved online to collect randomized controlled trials(RCTs) of Tongmai Yangxin Pills for angina pectoris of coronary heart disease since the establishment to November 2018. Two investigators screened out literatures independently, extracted data and assessed the risk of bias of included studies. The risk assessment of included references was made according to criteria recommended by Cochrane Handbook 5.3. Meta-analysis was then performed by RevMan 5.3 software. A total of 9 RCTs were included. The results of Meta-analysis showed that compared with the single application of chemotherapy, the combined administration with Tongmai Yangxin Pills and Western medicine could significantly improve the clinical efficacy of angina(RR=1.22, 95%CI[1.13, 1.31]), the improvement rate of electrocardiogram(RR=1.31, 95%CI[1.21, 1.42]), and the clinical efficacy of traditional Chinese medicine(TCM) syndrome(RR=1.17, 95%CI[1.02, 1.35]). Only one study reported adverse events, while 5 studies reported no adverse event. According to current evidences, in the treatment of angina pectoris of coronary heart disease, Tongmai Yangxin Pills has a better clinical efficacy in the treatment of angina pectoris of coronary heart disease in terms of the improvement rate of electrocardiogram and the clinical efficacy of TCM syndrome. Due to the limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.
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Humans , Angina Pectoris , Drug Therapy , Coronary Disease , Drug Therapy , Drugs, Chinese Herbal , Therapeutic Uses , Electrocardiography , Medicine, Chinese Traditional , Randomized Controlled Trials as TopicABSTRACT
Objective To improve the quality standard of Taohong Tongmai granule.Methods TLC was used to make qualitative identification of Paeoniae Radix Rubra,Rehmanniae Radix,Glycyrrhizae Radix;The effective components of the main walnut kernel were identified by HPLC;and HPLC was used to do quantitative determination of Paeoniflorin,the determination was performed on Agilent HC-C18(250mm×4.6mm,5μm)column with mobile phase consisted of Acetonitrile-water(13:87) at the flow rate of 1.0 ml/min,the column temperature was 30 ℃ and the detection wavelength was set at 230 nm.Results These TLC spots were fairly clear,and the blank test showed no interference;The paeoniflorin at the range of 1·79-57.28 μg/ml was linear with peak area(r= 0.999 9),its average recovery rate was 99.99% and RSD was 2.05%(n= 9). Conclusion The quality standard of Taohong Tongmai granule had been improved,identification method was better reproduc-ibility,the determination method of paeoniflorin content had enhanced the controllability of product quality.
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AIM To investigate the effects of Tongmai Decoction on PLT,PAgR,D-D and TEG in elderly patients with intertrochanteric fracture in perioperative period.METHODS One hundred and fifteen recruited patient subjects were randomly divided into two groups.Fifty-seven cases in the control group were treated with Low Molecular Weight Heparins Calcium Injection,and 58 cases in the treatment group were intervened with both Low Molecular Weight Heparins Calcium Injection and Tongmai Decoction.The preoperative and postoperative dynamic changes of PLT,PAgR,D-D and TEG (R value,K value,alpha angle,MA),and adverse drug reactions in the two groups were detected 1,3,7 d prior to,and after the treatments,respectively.RESULTS No statistically significant difference between the two groups' PLT,PAgR and D-D contents were observed before the operation (P ＞ 0.05).The levels of PLT,PAgR and D-D in both groups increased one day after the operation with similar change degree (P ＞ 0.05).On the 3rd and 7th days after the surgery,the PLT,PAgR and D-D contents in the two groups began to drop,and the decline in the treatment group was more significant (P ＜ 0.05).No significantly different TEG (R value,K value,alpha angle,MA) between the two groups was noticed before the operation (P ＞ 0.05).Patients of both groups displayed their R value,K value decrease,and alpha Angle,MA increase (P ＞ 0.05) one day after the operation with similar change degree.Their R value,K value increased,and alpha angle,MA decreased,and as well as the statistically significant change between the two groups were discovered on the 3rd and 7th postoperative days (P ＜ 0.05).CONCLUSION Tongmai Decoction can effectively reduce blood hypercoagulability and prevent deep venous thrombosis in terms of PLT,PAgR,D-D and TEG (R value,K value,alpha angle,MA) improvement in elderly patients with intertrochanteric fracture in perioperative period.
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Objective: To study the effect of 60Co-γ ray irradiation on the contents of danshensu,protocatechuic aldehyde,puerarin and salviamolic acid B in Tongmai granules by HPLC. Methods: An Agilent ZORBAX Eclipse XDB C18(2) column (250 mm × 4. 6 mm,5 μm) was adopted and the wavelength of UV detection was 280 nm at the flow rate of 1. 0 ml·min-1. The mobile phase consisted of 0. 1% phosphoric acid (B) and acetonitrile (A) with gradient elution, and the column temperature was 35℃. Tongmai granules were irradiated by 60Co-γ ray respectively at 0, 2, 5,10 and kGy,the contents of the active ingredients were compared before and after the irradiation. Results: The linear range of danshensu,protocatechuic aldehyde,puerarin and salviamolic acid B was 0. 098-4. 925 μg, 0. 028-1. 411 μg, 0. 378-18. 882 μg and 0. 218-10. 888 μg, respectively. The average recovery was 99. 8% , 97. 7% , 99. 9% and 99. 9% , respectively. When the radiation dose was not more than 2 kGy, the contents of the five components did not change significantly (P>0. 05). After 5 kGy radiation, the contents of protocatechuic aldehyde and salviamolic acid B were signifi-cantly different (P <0. 05). Conclusion: The dose of 60Co ray should be controlled not more than 2 kGy, and the sterilization method is safe and effective for Tongmai granules.
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Objective To investigate the effect of Shenqi-Tongmai decoction in Stable Angina pectoris Patients with Qi-deficiency-blood-stasis syndrome and the influence on serum associated adhesion factors. Methods A total of 110 patients with stable angina pectoris treated in the department of cardiology of traditional Chinese medicine hospital of Xinle city from Feb. 2015 to Feb. 2017 were divided into 2 groups according to the number random table method, with 55 in each group. All the patients were given the standardized treatment with western medicine, and the treatment group were aditionally treated with the Shenqi-Tongmai decoction. All the patients were treated for a course of 4 weeks. The TCM syndrome score, Seattle angina questionnaire (SAQ) score, electrocardiographic examination index and serum soluble intercellular adhesion molecule 1 (sICAM-1), soluble vascular cell adhesion molecule 1 (sVCAM-1) level of the two groups before and after treatment were compared, and the clinical curative effect of the two groups was compared. Results The TCM syndrome score (7.1 ± 2.2 vs. 11.4 ± 3.0, t=8.590), serum sICAM-1 (227.69 ± 42.81 ng/ml vs. 275.33 ± 48.62 ng/ml, t=5.454) level, serum sVCAM-1 (272.04 ± 39.87 ng/ml vs. 296.58 ± 42.60 ng/ml, t=3.127) level and lead ecg ST segment down number (2.7 ± 0.6 vs. 3.2 ± 0.6, t=4.067), T wave of low lead numbers (1.7 ± 0.3 vs. 2.1 ± 0.3, t=6.807), numbers of T wave inversion lead (1.7 ± 0.3 vs. 2.1 ± 0.2, t=9.908) of the treatment group were significantly lower than those of the control group (P<0.01). The SAQ scores (76.8 ± 10.5 vs. 67.4 ± 10.1, t=4.805) was higher than that of the control group (P<0.01). The curative effect of angina pectoris and electrocardiogram of the treatment group were 91.0% (50/55) and 92.7%(51/55), and the control group were 76.4% (42/55) and 78.2% (43/55). The difference was statistically significant between the two groups (χ2=4.251, 4.681, P<0.05). Conclusions Traditional Chinese medicine Shenqi-Tongmai decoction can effectively improve the SAQ scores and TCM syndrome score and electrocardiogram examination index, improve the clinical curative effect in the treatment of Stable Angina pectoris based on the western medicine (Qi-deficiency-blood-stasis syndrome) and its mechanism may be related to improving of the serum levels of sICAM 1, sVCAM 1.
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Objective To investigate the clinical efficacy and effects of Tongmai Powder external application on serum inflammatory cytokines levels in patients with chemotherapeutic phlebitis. Methods Totally 60 patients with chemotherapeutic phlebitis were randomly divided into observation group and control group by order of inclusion, with 30 cases in each group. The observation group was treated with Tongmai Powder. The Tongmai Powder was evenly applied to the gauze. The thickness was 0.5–1 cm. The area was slightly larger than the lesion. The gauze was applied externally to the lesion and fixed with tape. The control group was given magnesium sulfate, twice a day for not less than 2 hours. 3 d was one treatment course for both groups, for successive three courses. Clinical efficacy and VAS of both groups were observed. The levels of TNF-α, IL-4, IL-8 and IL-10 before and after treatment in the two groups were compared. Results The total effective rate was 96.67％ (29/30) in the observation group and 83.33％ (25/30) in the control group. The observation group was significantly better than the control group (P=0.007). Compared with before treatment, the VAS of the two groups were significantly lower. The serum levels of TNF-α and IL-8 in the observation group decreased significantly, and the levels of IL-4 and IL-10 increased significantly (P＜0.05). After treatment, the VAS was lower in the observation group than in the control group (P＜0.05), the levels of TNF-α and IL-8 were lower in the observation group (P＜0.05) and the IL-4 and IL-10 levels were higher than the control group (P＜0.05). Conclusion Tongmai Powder external application can effectively treat chemotherapeutic phlebitis, which mechanism may be related to regulating the balance of inflammatory cytokines.
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The aim of the present study is to evaluate the vasodilation effects of Tongmai Yangxin Pills (TMYX) on rat mesenteric artery as well as its mechanism of action. The relaxation effects of TMYX extracts with different concentrations were determined on isolated rat mesenteric artery in normal condition as well as pretreating by phenylephrine and KCl. Vascular relaxation effects of TMTX were also determined in mesenteric artery preincubated with L-ANME and indomethacin or in endothelium denuded mesenteric artery. Moreover, effects of TMYX by 50 mg·L⁻¹ on NO secretion and the phosphorylation of eNOS in a cellular model of human umbilical vein endothelial cell (HUVEC) pretreated with or without L-NAME were also observed. The experimental results showed that TMYX has no obvious effect on vasodilation of arteries in normal or KCl pretreated condition, while it can dose-dependently relax the rat mesenteric artery with intact endothelium stimulated with phenylephrine at a maximal diastolic rate of (64.71±10.03)%. After preincubating with L-NAME for 15 min or removal of mesenteric artery endothelium, the maximal diastolic rate was decreased to (35.77±8.93)% and (25.85±10.84)% respectively. However, preincubating with indomethacin had no inhibitory effect on TMYX induced vascular relaxation. Meanwhile, TMYX at 50 mg·L⁻¹ could increase the expression of P-eNOS and the secretion of NO in HUVEC. L-NAME significantly inhibited NO release and phosphorylation of eNOS induced by TMYX. The results suggested TMYX exerted endothelium-dependent relaxation effects against PE-induced contractions of isolated rat mesenteric artery through NO-cGMP signaling pathway.
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Animals , Humans , Rats , Endothelium, Vascular , Mesenteric Arteries , VasodilationABSTRACT
Objective: To observe the intervening effects of Tongmai Yangxin Pills on miniature pigs with syndrome of deficiency of both qi and yin in later stage of myocardial ischemia reperfusion injury. Methods: A total of 24 miniature pigs were randomly divided into the sham-operated group, the model group (syndrome of deficiency of both qi and yin in myocardial ischemia), the Shengmai Capsules group (0.14 g/kg), and Tongmai Yangxin Pills groups (0.36 g/kg) with six pigs in each group. Except for the sham-operated group, the left anterior descending artery in other groups had been occluded for 30 min by inflation balloons and arterial reperfusion injury was acquires by withdraw balloons. After the operation, the groups were administered with drugs for four weeks. The parameters of noninvasive hemodynamics were measured at the end of study. The tongue color was recorded by digital camera. The tongue and pulse manifestation of the miniature pigs were evaluated according to the symptom-graded scoring method. The size of myocardial ischemia and infarction was analyzed by Evens and TTC staining. Results: Compared with the sham-operated group, the area of myocardial ischemia and necrosis in the model group increased significantly. The noninvasive hemodynamics showed a reduction in cardia coutput (CO) and stroke volume (SV), an augment in systemic vascular resistance (SVR) and left cardiac woke (LCW) of the model group compared with the sham-operated group. Moreover, the scores of tongue and pulse manifestation were also significantly increased in the model group with abnormal color of tongue (P < 0.05, 0.01). Compared with the model group, Shengmai Capsules and Tongmai Yangxin Pills reduced the area of myocardial ischemia and infarction, increased the values of CO and SV, decreased the scores of tongue and pulse manifestation and improved tongue color (P < 0.05, 0.01). In addition, Tongmai Yangxin Pills also reduced SVR (P<0.01). Conclusion: The syndrome of deficiency of both qi and yin in mini pigs could be partly manifested in later stage of myocardial ischemia reperfusion injury. Tongmai Yangxin Pills can improve tongue and pulse signs, protect myocardial tissue, and recover abnormal hemodynamics, which can establish foundation for the further clinical application.