ABSTRACT
ObjectiveTo explore the mechanism of Danggui Niantongtang （DGNTT） against adjuvant-induced arthritis （AA） in rats with wind-dampness-heat arthralgia （FSR） based on the variation of intestinal flora. MethodA total of 60 SD rats were randomized into normal （control） group， FSR group， low-， medium-， and high-dose DGNTT （5.67， 11.34， 22.68 g·kg-1） groups， and methotrexate （MTX） group （1.35 mg·kg-1）， with 10 rats in each group. The rats， except the control group， were injected with Mtb adjuvant and then exposed to artificial climatic chamber （hot and humid with wind） for 64 h for modeling. The rats were treated with water， DGNTT or MTX for 28 days from the day of injection. Arthritis index （AI） of rats was measured and paw volume was determined with a volume meter. The morphology of synovial tissues of the knees was observed based on hematoxylin-eosin （HE） staining and the changes of intestinal flora were analyzed based on 16S rRNA sequencing. ResultDGNTT can alleviate the hyperplasia of synovial tissue and inflammation of AA rats with FSR and inhibit the formation of pannus. The results of 16S rRNA sequencing showed that the relative abundance of Firmicutes， Lactobacillus， Prevotella 9， and Alloprevotella decreased （P<0.05， P<0.01） and the relative abundance of Bacteroidetes and Bacteroides increased （P<0.01） in FSR group compared those in the control group. Compared with the FSR group， all DGNTT groups and MTX group had high relative abundance of Lactobacillus （P<0.05， P<0.01） and low relative abundance of Bacteroidetes （P<0.01） and medium-dose and high-dose DGNTT groups and MTX group showed high abundance of Firmicutes， Prevotella 9， and Alloprevotella and low abundance of Bacteroides （P<0.05， P<0.01）. Spearman's correlation analysis suggested that the abundance of Bacteroides and Helicobacter was in positive correlation with AI （P<0.05）， while the abundance of Prevotella 9 and Candidatus Saccharimonas was in negative correlation with AI （P<0.01， P<0.05）. There was a negative correlation between the abundance of Prevotella 9 and paw volume （P<0.01）， and the abundance of Ruminococcaceae NK4A214 group， Christensenellaceae R-7 group， and Bacteroides was in negative correlation with spleen index （P<0.05）. The abundance of Prevotella 9 was in negative correlation with spleen index （P<0.01）. ConclusionDGNTT is effective for arthritis with FSR， as it can regulate the composition of intestinal flora in AA rats by increasing the abundance of probiotics and inhibiting the growth of pathogenic bacteria. The mechanism is the likelihood that it improves intestinal immune metabolism to ensure intestinal homeostasis.
ABSTRACT
ObjectiveTo explore the mechanism of Danggui Niantongtang （DGNT） against adjuvant arthritis （AA） rats with wind-dampness-heat arthralgia by quantitative proteomics. MethodSixty SD rats were randomly divided into normal group， model group， angelica came pain soup low， medium and high dose group and methotrexate （MTX） group， each group of 10， only the rat tail root subcutaneously inactivated mycobacterium tuberculosis （Mtb） of adjuvant to build model of AA， artificial climate box intervention 16 d rheumatic fever bi syndrome model is set up， building the day began to drug intervention， The intervention lasted for 28 days. The proteins of synovial tissues in experimental rats were extracted. The differential proteins in the medium-dose DGNT group and the model group were detected and analyzed by 4D label-free quantification （4D-LFQ） proteomics. The differentially expressed proteins associated with mitochondrial pathway apoptosis were verified by immunohistochemistry and Western blot. ResultA total of 4 756 proteins were identified from rat synovial tissues， of which 4 234 proteins contained quantitative information. There were 814 differential proteins between the model group and the DGNT group. As revealed by Gene Ontology （GO） and Kyoto Encyclopedia of Gene and Genome （KEGG） enrichment analyses， DGNT had an effect on the synovial proteome of AA rats with wind-dampness-heat arthralgia， and the differential proteins were enriched in the regulation of the immune system， response to acute inflammation， and apoptosis regulation. As demonstrated by the results of immunohistochemistry and Western blot， compared with the model group， the DGNT groups and the MTX group showed increased protein expression of B-cell lymphoma 2 （Bcl-2）-associated X protein （Bax） and cytochrome C （Cyt C）（P<0.05， P<0.01）， reduced Bcl-2 level （P<0.05， P<0.01）， elevated level of cleaved cysteinyl aspartate-specific protease 9 （Caspase-9）/Caspase-9 （P<0.01）， and decreased level of phosphorylated protein kinase B （p-Akt）/Akt（P<0.05， P<0.01）. ConclusionDGNT involved multiple targets in the treatment of AA with wind-dampness-heat arthralgia and it may exert its effect in the prevention and treatment by regulating the Akt/Bax/Bcl-2 pathway and promoting the cell apoptosis in the mitochondrial pathway.
ABSTRACT
The patient was an 84-year-old woman living in a nursing home. Her chief complaint was difficulty in moving her body due to extreme pain. She could not lie down especially in a supine position because of severe unidentified somatic pain from left side of lower chest to flank. According to her family, she had been taking 2-3 L of water daily at her nursing home to avoid dehydration even in the wintertime. Therefore she urinated frequently, but she also had constipation for several days. Since NSAIDs had been not effective, byakujutsubushito was administered from the first day of her hospitalization. Accordingly, her constipation improved and her pain quickly faded away. We inferred that her pain resulted from “fluid disturbance” caused by massive intake of water in the wintertime in Aizu region. We believe that byakujutsubushito is a useful Kampo medicine for the treatment of pain resulting from “wind-dampness” along with keishibushito and kanzobushito.
ABSTRACT
We report on a case of Hailey-Hailey disease successfully treated with Sokeikakketsuto. This case was a 70-year-old woman. Her mother, grandmother and elder sister had the same symptoms. From 2004 August, she noticed erythematous exudative lesions with itching on both sides of her inguinal area. By September, she was diagnosed with Hailey-Hailey disease histologically. We treated using a topical corticosteroid at first. This had little effect, so we considered treatment using Kampo medicines. We diagnosed a kidney Yin-deficiency from a fissure of her tongue, thirstiness, numbness in the region below the umbilicus and night sweat, thus and selected Rokumigan. We then diagnosed deficiency of Qi from her general malaise, so chose Hochuekkito. The pathology of Hailey-Hailey disease exists mainly in the epidermis which covers most of the body's surface area. And this indicates the presence of pathogenic wind factor. We considered the presence of dampness as a disease-inducing factor because of her exudation, and the presence of the heat from her erythema. So we also selected Eppikajutsuto as an anti wind-wetness-heat drug. Her general condition was very much improved with these administrations, but her skin lesions improved very little. So we stopped Eppikajutsuto, and Sokeikakketsuto administration was started instead. After this change of drug, her skin lesions were improved remarkably.
ABSTRACT
We did Oriental medical treatment to intractable atopic dermatitis patients. The number of cases is twenty. We divided them into two groups, namely the group of the combined treatment of acupuncture and “Toeki” (internal remedy), the “Toeki” treatment group, and compared the effective rates of the two. The combined treatment of acupuncture and “Toeki” is effective in seven cases out of eirht, and the effective rate is 88%, while the “Toeki” treatment is effective in eight out of twelve, and the effective rate is 67%. We think that both of the combined treatment of acupuncture and “Toeki” and “Toeki” treatment are both effective, but that the former is more effective than the latter.