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Type 2 diabetes mellitus(T2DM), a common chronic metabolic disease, is often accompanied by internal heat syndrome. Heat-clearing prescriptions are widely used to treat different heat syndromes of T2DM from the aspects of clearing stagnant heat, excess heat, damp heat, phlegm heat, and heat toxin, demonstrating remarkable effects. The mechanism of blood sugar-lowering agents has always been a hotspot of research. Recently, the basic studies of heat-clearing prescriptions from different perspectives have been increasing year by year. To clarify the mechanisms of heat-clearing prescriptions and find specific mechanisms, we systematically reviewed the basic studies of heat-clearing prescriptions commonly used for the treatment of T2DM in the past decade, intending to provide a reference for related research.
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Humans , Diabetes Mellitus, Type 2/drug therapy , Drugs, Chinese Herbal/therapeutic use , Hot Temperature , Medicine, Chinese Traditional , Prescriptions , SyndromeABSTRACT
Dachaihu Decoction is a classical Chinese herbal prescription that is effective in harmonizing lesser yang and purging internal accumulated heat. At present, it has been widely used in clinical practice, and the resulting outcomes are satisfactory. However, its quality indicators and action mechanism are still not clear. Therefore, this paper explored the efficacy markers of Dachaihu Decoction and its action mechanism based on literature mining, molecular biology, and network pharmacology, so as to better control its quality and ensure its clinical efficacy. The efficacy markers of Dachaihu Decoction were predicted and analyzed according to the "five principles" for Q-markers of Chinese herbs. Then the anti-inflammatory activity of the efficacy markers of Dachaihu Decoction was evaluated with Griess reagent after the establishment of RAW264.7 cell inflammation model in vitro with lipopolysaccharide(LPS). The potential targets of efficacy markers were predicted by Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP), ChEMBL, and SwissTargetPrediction, followed by the construction of the protein-protein interaction(PPI) network of the efficacy markers of Dachaihu Decoction. Topological, GO, and KEGG enrichment analysis was carried out to construct the "key target-signaling pathway-biological process" network, thus elucidating the action mechanism of the efficacy markers of Dachaihu Decoction. Saikosaponin B_2, baicalin, baicalein, wogonoside, neohesperidin, naringin, hesperidin, and paeoniflorin were considered as the potential efficacy markers of Dachaihu Decoction. The anti-inflammatory activity evaluation showed that the potential efficacy markers effectively inhibited the release of NO, exhibiting good anti-inflammatory activities. As demonstrated by network pharmacology, the efficacy markers of Dachaihu Decoction regulated the inflammatory response by acting on MAPK and NF-κB signaling pathways, the carbohydrate metabolism by HIF-1 and PI3 K-AKT signaling pathways, and the lipid metabolism by AMPK and PI3 K-AKT signaling pathways. This study discovered the efficacy markers of Dachaihu Decoction based on literature mining combined with molecular biological experiments and explored its action mechanism at the molecular level based on network pharmacology, which would provide reference for the quality control of Dachaihu Decoction and scientific basis for its clinical application.
Subject(s)
Biomarkers , Drugs, Chinese Herbal/pharmacology , Medicine, Chinese Traditional , Molecular Docking Simulation , Proto-Oncogene Proteins c-akt , Signal TransductionABSTRACT
Objective: To study the effective components and mechanism of action of Dachaihu Decoction (DCHD) in the treatment of pancreatitis (syndrome of liver depression and qi stagnation). Methods: The PPI network and the multi-dimensional relationship network of “Chinese material medica prescription active ingredient key target” of DCHD in the treatment of pancreatitis with stagnation of liver qi. Based on network pharmacology, the software such as Cytoscape 3.6.0 was firstly used to construct the PPI interaction network of key targets in the Chinese material medica with the effect of soothing liver and regulating qi (“Shugan Liqi” in Chinese) and DCHD “Chinese material medica prescription-effective components-key target” multi-dimensional network for the treatment of pancreatitis, and then treat the two networks as an intersection to obtain the network of DCHD for the treatment of pancreatitis (syndrome of liver depression and qi stagnation) “Chinese material medica prescription-effective components-key target”, and finally analyzed with relevant software. Results: A total of 59 key targets for Shugan Liqi were obtained such as AKT1, VEGFA, and PRSS1; A total of 83 main active ingredients such as quercetin, kaempferol and baicalein were collected from DCHD. The treatment of pancreatitis (syndrome of liver depression and qi stagnation) involved 18 targets of Ganyu Qizhi such as PTGS2, DPP4, PRSS1, and 30 related biological processes and signaling pathways such as extracellular matrix degeadation, IL-17 signaling pathway, and AGE-RAGE signaling pathway in diabetic complications. Conclusion: The multi-component and multi-target in DCHD are the basis for its efficacy. It is worthwhile to deeply think about the use of network pharmacology in the context of syndrome research.
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Objective To observe the clinical efficacy of modified Dachaihu Decoction on the treatment of constipation in hemodialysis patients. Methods Totally 60 hemodialysis patients were divided into treatment group and control group through random number table method, with 30 cases in each group. Both groups received Western basic treatment. The treatment group was given modified Dachaihu Decoction on the basis of Western medicine treatment,one dosage 100 mL per day,morning and evening after dinner,orally.The control group received Maren Runchang Pills, one pill each time, twice a day, orally. The treatment cycle for both groups was one month. The clinical efficacy, constipation symptoms, incidence of hypotension during dialysis, incidence of muscle spasm and Kt/V were compared between the two groups. Results The total effective rate was 93.33% (28/30) in the treatment group and 66.67% (20/30) in the control group. The treatment group was significantly better than the control group (P<0.05). Compared with before treatment, the number of defecation per week increased after treatment in both groups, and the squatting time decreased; Comparing the two groups after treatment, the number of defecation per week and squatting time in the treatment group were significantly better than those in the control group (P<0.05). Compared with before treatment, the incidence of hypotension rate in the treatment groups of dialysis were significantly reduced (P<0.05); After treatment, the incidence of hypotension in the treatment group was significantly lower than those in the control group (P<0.05). Compared with before treatment, Kt/V in both groups increased significantly (P<0.05); After treatment, the improvement of Kt/V in the treatment group was significantly better than that in the control group(P<0.05).Conclusion Modified Dachaihu Decoction can effectively improve the symptoms of hemodialysis patients with constipation and improve the dialysis adequacy.
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Objective To observe the clinical efficacy of Dachaihu decoction in treatment of stroke-associated pneumonia (SAP) in the elderly patients with excess-heat syndrome and acute ischemic stroke (AIS). Methods One hundred elderly patients with excess-heat syndrome and SAP admitted to the Department of Neurology of Tianjin Nankai Hospital from August 2015 to September 2016 were enrolled, and they were divided into a control group and an observation group according to the random number table, 50 cases in each group. Both groups were given conventional neurological treatment, while the observation group additionally received Dachaihu decoction (the ingredients of the decoction: bupleurum 15 g, scutellariae 10 g, pinellia 10 g, fructus aurantii immaturus 15 g, radix paeoniae alba 10 g, rhubarb 5 g, ginger 10 g, jujube 2), and according to the individual's symptoms and signs, the above ingredients can be added and/or subtracted, 1 dose per day, divided into two parts, 1 part taken in the morning and 1 part in the evening orally, 14 days as a therapeutic course. The body temperature recovery time, the duration of antibiotic treatment, the changes of Clinical Pulmonary Infection Score (CPIS) and National Institutes of Health Stroke Scale (NIHSS) score before and after treatment of the two groups were observed and the therapeutic effects in the two groups were evaluated. Results The body temperature recovery time (days: 6.56±2.70 vs. 8.08±3.23) and the duration of antibiotic treatment (days: 8.78±2.80 vs. 10.02±2.90) in the observation group were significantly shorter than those in the control group (both P ＜ 0.05); with the prolongation of treatment, after treatment, the CPIS and NIHSS score were decreased significantly in both groups, reaching the lowest levels on the 14th day, and the degrees of score descent in observation group were more significant than those of the control group (CPIS score: 0.68±0.59 vs. 1.12±0.96, NIHSS score: 6.38±2.31 vs. 7.44±2.74, both P ＜ 0.05); the total effective rate in the observation group was significantly higher than that in the control group [92% (46/50) vs. 76% (38/50), P ＜ 0.05]. Conclusion The therapeutic effect of Dachaihu decoction used for treatment of SAP in elderly patients with excess-heat syndrome is favorably effective and safe.
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[ ABSTRACT] AIM:To investigate the combined effect of octreotide and Dachaihu decoction on the treatment of severe acute pancreatitis (SAP).METHODS:Wistar rats (n=50) were randomly divided into sham group, SAP group, octreotide group, Dachaihu decoction group and combination group.The quantity of ascites was measured.The levels of amylase, alanine aminotransferase and creatinine in the serum were examined.The morphological changes of the pancreatic tissues were observed by HE staining.The activation of NF-κB and IκBαexpression were determined by Western blot.The mRNA expression with ICAM-1 and IL-1 was detected by qPCR.RESULTS: Combined treatment with octreotide and Dachaihu decoction effectively reduced the quantity of ascites and the levels of amylase, alanine aminotransferase and creat-inine in the serum in SAP rats.Moreover, combined treatment significantly inhibited SAP-induced activation of NF-κB and decrease in IκBαprotein expression, accompanied by a decrease in ICAM-1 and IL-1 mRNA expression.CONCLU-SION:Combination of octreotide with Dachaihu decoction effectively attenuates SAP by inhibiting NF-κB signaling pathway and ICAM-1 and IL-1 expression.
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ObjectiveTo observe effect of Dachaihu decoction on plasma inflammatory cytokines of acute pancreatitis patients.Methods186 cases of acute pancreatitis were randomly recruited into TCM group and control group.The control group was given routine treatment.On the basis of the control group,the TCM group was given Dachaihu decoction for enema additionally,twice daily,7 days.Then plasma inflammatory cytokines level was tested in both groups.ResultsTCM group had lower levels of TNF-α [ (42.18 ± 20.57) mg/L、(22.06± 10.73) mg/L,(9.88 ±4.62)mg/L],IL-1β[ (0.28 ±0.11) μg/L,(0.19±0.02) μg/L,(0.18 ±0.06)μg/L],and IL-6[(87.90±49.41)ng/L,(16.59±10.24) ng/L,(14.96±11.42) ng/L] at 2/5/7 days than the control group.There were statistical difference (P＜0.05).ConclusionEnema with Dachaihu decoction was effective on reducing plasma inflammatory cytokines level.It was probably the key to cure acute pancreatitis.