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Gastric cancer is one of the malignancies with high incidence in the world. Xiangsha Liu Junzitang，a common prescription for the prevention and treatment of gastric cancer，has the effects of moving Qi to relieve pain，drying dampness， and invigorating the spleen. It is especially indicated for gastric cancer of the spleen and stomach qi deficiency syndrome. Based on the databases such as CNKI，Wanfang Data，and PubMed，the clinical efficacy and experimental studies of Xiangsha Liu Junzitang for the prevention and treatment of gastric cancer were summarized and sorted out，and the mechanism of Xiangsha Liu Junzitang for the prevention and treatment of gastric cancer was elaborated in order to provide useful references for the clinical and basic research on Xiangsha Liu Junzitang in the field of gastric cancer in the future. In clinical practice，Xiangsha Liu Junzitang can treat gastric precancerous lesions，increase the body immunity of patients with gastric cancer，improve the symptoms of spleen and stomach weakness after gastric cancer surgery，and reduce the adverse reactions of the digestive tract after chemotherapy for gastric cancer. Its clinical efficacy is superior to that of western medicine alone whether it is combined with western medicine or used alone. In the experimental research，Xiangsha Liu Junzitang has the effects of regulating inflammatory factors，inhibiting the proliferation of gastric cancer cells，promoting the apoptosis of gastric cancer cells，and improving the activity of pepsin. Modern pharmacological research has shown that Xiangsha Liu Junzitang can conduct a comprehensive intervention with multiple components and multiple targets. The main components of a single drug contained include saponins，polysaccharides，lactones，volatile oils，organic acids，and others， with the effects of protecting gastric mucosa，regulating endocrine，and promoting apoptosis of epithelial cells in gastric mucosal dysplasia，reflecting the advantages and values of traditional Chinese medicine in the prevention and treatment of gastric cancer.
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Esophageal cancer is a type of upper gastrointestinal malignant tumor with a high degree of malignancy， strong invasion ability， and poor prognosis， which belongs to the category of "dysphagia" in traditional Chinese medicine （TCM）. In addition to tumor resistance， Chinese herbal prescription plays a role in sensitization. In light of information in literature， the syndrome elements of esophageal cancer include Qi stagnation， phlegm， Qi deficiency， blood stasis， and Yin deficiency. After clinical differentiation， the syndromes of esophageal cancer are divided into phlegm and Qi obstruction， Qi and Yin deficiency， fluid deficiency and heat accumulation， Qi deficiency and phlegm dampness， combined phlegm and heat， combined phlegm and stasis， combined heat toxin and stasis， healthy Qi deficiency and toxin accumulation， et al. Dabanxiatang， Qigesan， Xuanfu Daizhetang， Liujunzitang， Shashen Maidongtang， and Tongyoutang are the common clinical prescriptions， where Qigesan， Liu Junzitang， and Tongyoutang have been proved by in vitro and in vivo experiments to exert anti-esophageal cancer effect by directly inhibiting tumor cell proliferation， promoting apoptosis， affecting tumor microenvironment， regulating cell energy metabolism， and inhibiting angiogenesis. In addition， an increasing number of studies have been conducted on anti-esophageal cancer effect of Chinese herbal prescription by targeting non-coding single-stranded microRNA. The specific mechanisms of Da Banxiatang， Shenzhe Peiqitang， Xiao Xianxiongtang， Renshen Banxiatang， and Liushenwan have been scarcely reported despite good clinical efficacy. Wuzhuyu Tang and Tongguansan recorded in ancient books have been rarely applied in modern times. Therefore， the present study reviewed the special drugs and prescriptions mentioned in ancient TCM classics， the commonly used Chinese herbal prescriptions in modern clinical practice， and experimental research progress， to promote treatment methods of Chinese herbal prescriptions against esophageal cancer.
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ObjectiveTo observe the effects of Xiangsha Liu Junzitang （XSLJZ） on gastric emptying rate and expression levels of corticotropin-releasing factor （CRF） and urocortin 2 （UCN2） in rats with functional dyspepsia （FD） due to spleen deficiency. MethodForty-eight 10-day-old male SD rats were randomly divided into the normal group （n=8） and iodoacetamide （IA） group （n=40）， and they separately received 2% sucrose solution and 0.1% sucrose solution containing IA for six successive days. Following the removal of mother rats， the three-week-old IA-treated rats were randomized into five groups， namely the model group， mosapride group， and low-， middle-， and high-dose XSLJZ groups， with eight rats in each group. At the age of six weeks， rats in all groups expert for the normal group were modeled by the modified multiple platform method for 14 d. Afterwards， the ones in normal group and model group were treated with 10 mL·kg-1 distilled water， and those in the treatment groups with 1.6×10-3 g·kg-1 mosapride and 2.8， 5.6， and 11.2 g·kg-1 XSLJZ by gavage， respectively， for 14 d. The grasping ability and gastric emptying rate were determined. The histological changes in gastric antrum were observed by hematoxylin-eosin （HE） staining. The protein and mRNA expression levels of CRF and UCN2 in gastric antrum were detected by Western blot and real-time fluorescent quantitative polymerase chain reaction （Real-time PCR）. ResultNo obvious change or organic lesion was observed in gastric antrum of rats in each group. Compared with the normal group， the model group exhibited lowered gastric emptying rate and grasping ability （P<0.01）， up-regulated CRF protein and mRNA expression in gastric antrum （P<0.01）， and down-regulated UCN2 protein and mRNA expression （P<0.05， P<0.01）. Compared with the model group， XSLJZ at the middle and high doses enhanced the grasping ability and gastric emptying rate （P<0.05， P<0.01） and down-regulated CRF mRNA expression to varying degrees （P<0.05， P<0.01）. XSLJZ at the high dose decreased CRF protein expression （P<0.05） and up-regulated UCN2 protein and mRNA expression （P<0.01）. ConclusionThe mechanism of XSLJZ in invigorating spleen and promoting gastric motility of FD rats may be related to its reduction of CRF and elevation of UCN2 in gastric antrum.
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ObjectiveTo explore the mechanism of Liu Junzitang in preventing and treating muscle atrophy in mice with lung cancer cachexia based on the signal transducer and activator of transcription 3（STAT3）/ubiquitin proteasome pathway in vivo. MethodForty C57BL/6 mice aged six weeks were randomly divided into a blank group， a model group， a Liu Junzitang group， an inhibitor group （stattic group），and a Liu Junzitang + inhibitor group （combination group）， with eight mice in each group. The cachectic muscle atrophy model was induced by subcutaneous inoculation of Lewis lung cancer cell line under the right anterior armpit in mice except those in the blank group. On the 8th day after subcutaneous inoculation， the mice in the corresponding groups received Liu Junzitang （9.56 g·kg-1·d-1） by gavage and intraperitoneal injection of stattic ［25 mg·kg-1·（2 d）-1］. After three weeks of drug intervention， the body weight and gastrocnemius muscle weight were recorded. Hematoxylin-eosin （HE） staining was used to observe the pathological changes and cross-sectional area of gastrocnemius muscle fibers in mice. Western blot was used to detect the expression of phosphorylated-STAT3 （p-STAT3）， STAT3， muscle atrophy F-box （MAFbx）， and muscle RING finger protein 1 （MuRF1） in the gastrocnemius muscle. Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） was used to detect the mRNA expression of STAT3， MAFbx， and MuRF1 in the gastrocnemius muscle. ResultCompared with the blank group， the model group showed lightened body and the gastrocnemius muscle， reduced cross-sectional area of gastrocnemius muscle fibers， and increased protein expression of p-STAT3， STAT3， MAFbx， and MuRF1 and mRNA expression of STAT3， MuRF1， and MAFbx in the gastrocnemius muscle （P<0.05）. Compared with the model group， the Liu Junzitang group showed increased body weight， gastrocnemius muscle weight， and cross-sectional area of gastrocnemius muscle fibers （P<0.05）， and decreased protein expression of p-STAT3， STAT3， MuRF1， MAFbx， and mRNA expression of STAT3 and MAFbx in gastrocnemius muscle （P<0.05）. Compared with the model group， the inhibitor group showed increased body weight and cross-sectional area of gastrocnemius muscle fibers （P<0.05）， and reduced protein expression of p-STAT3， STAT3， MuRF1， MAFbx， and mRNA expression of STAT3 and MAFbx in gastrocnemius muscle （P<0.05）. Compared with the model group， the combination group showed increased body weight and gastrocnemius muscle weight （P<0.05），and decreased protein expression of p-STAT3， STAT3， MuRF1， and mRNA expression of STAT3 and MAFbx in the gastrocnemius muscle （P<0.05）. Compared with the Liu Junzitang group， the stattic group and the combination group showed reduced expression of p-STAT3 protein in the gastrocnemius muscle （P<0.05）. ConclusionLiu Junzitang can prevent and treat muscle atrophy in mice with lung cancer cachexia， and its mechanism may be associated with the protein and mRNA expression related to the STAT3-mediated ubiquitin proteasome pathway.
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Objective:This study aims to investigate the clinical efficacy of Modified Xiangsha Liu Junzitang in the treatment of diabetic gastroparesis （DGP） and its influence on gastrointestinal hormones and oxidative stress. Method:In this study， 128 patients were randomly divided into control group （64 cases） and observation group （64 cases） . Patients in two groups took domperidone tablets orally 30 minutes before meals， 10 mg/time， 3 times/day. Patients in control group took Shenling Baizhusan San， 6 g/time， twice a day. Patients in observation group were prescribed addition and subtraction therapy of Modified Xiangsha Liu Junzitang， 1 dose/day. The course of treatment for both groups was 4 weeks. Before and after treatment， scores of gastroparesis cardinal symptom index （GCSI）， and gastric emptying test and electrogastrogram were noted. Before the treatment， scores of traditional Chinese medicine （TCM） syndrome and health survey summary were graded（SF-36）. The levels of gastrin （GAS）， motilin （MTL）， vasoactive intestinal peptide （VIP）， somatostatin （SS）， superoxide dismutase （SOD）， reactive oxygen species （ROS） and malondialdehyde （MDA） were measured before and after treatment. And adverse reactions during treatment were recorded. Result:The scores of postprandial abdominal distension/early satiety， nausea and vomiting， abdominal distention and the total scores of GCSI in the observation group were lower than those in control group （<italic>P</italic><0.01）. The gastric emptying rate in observation group was higher than that in control group （<italic>P</italic><0.01）， and the score of TCM syndromes was lower than that of control group （<italic>P</italic><0.01）. The scores of SF-36 in observation group were higher than those in control group （<italic>P</italic><0.01）. The frequency of gastric electricity and gastric electric vibration before and after the meal in observation group were higher than that in control group （<italic>P</italic><0.01）. The levels of GAS， MTL， VIP， ROS and MDA in observation group were lower than those in control group （<italic>P</italic><0.01）， while the levels of SS and SOD were higher than that of control group （<italic>P</italic><0.01）. The total effective rate in observation group was 93.75% （60/64）， which was higher than 79.69% （51/64） （<italic>χ</italic><sup>2</sup>=5.494， <italic>P</italic><0.05） in control group （<italic>P</italic><0.01）. And no adverse reactions were found in the clinical observation. Conclusion:Modified Xiangsha Liu Junzitang combined with prokinetic drugs in the treatment of DGP patients can reduce the clinical symptoms of DGP， enhance gastrointestinal motility， improve the gastric emptying rate， improve the quality of life， regulate the level of gastrointestinal hormones， and reduce the damage of autonomic nerve caused by oxidative stress， with good comprehensive clinical effect and safety in application.
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Objective:To explore the regulatory effect of modified Liu Junzitang on the immune function， nutritional status and intestinal microecology in advanced gastric cancer patients with syndrome of deficiency of Qi and blood. Method:The 86 advanced gastric cancer patients with syndrome of deficiency of Qi and blood were randomly divided into control group and observation group according to their admission numbers， with 43 cases in each group. The control group was given Yiqi Yangxue oral liquid on the basis of basic treatment while the observation group was given modified Liu Junzitang. After 4 weeks， compare the clinical efficacy of two groups of patients， traditional Chinese medicine （TCM） syndrome score， gastrointestinal function recovery， adverse reaction and quality of life， immune function， T cell subsets CD3<sup>+</sup>， CD4<sup>+</sup>， CD8<sup>+</sup>， C<sub>3</sub> and C<sub>4</sub> levels， immunoglobulin A （IgA）， immunoglobulin G （IgG）， immunoglobulin M （IgM）， nutritional status： albumin （propagated）， prealbumin （PA）， serum total protein （TP） and hemoglobin （Hb） content changes， the intestinal micro ecology： <italic>Bifidobacterium</italic>， <italic>Lactobacillus</italic>， <italic>Enterococcus aureus</italic>， <italic>Escherichia coli</italic> content changes. Result:The total effective rate of the observation group was 95.35% （41/43）， which was significantly higher than 79.07% （34/43） of the control group （<italic>χ<sup>2</sup></italic>=5.108，<italic>P</italic><0.05）， after treatment， the TCM syndromes such as dizziness， pale complexion， palpitation， shortness of breath and fatigue in the observation group were significantly lower than those in the control group （<italic>P</italic><0.05）， the bowel sound recovery， exhaust and defecation time of the observation group were significantly lower than those of the control group （<italic>P</italic><0.05）， the quality of life scores in the observation group， such as the nature-to-human correspondence， form and spirit integration， specific modules， functional areas， and overall health score， were significantly higher than those in control group （<italic>P</italic><0.05）， the CD3<sup>+</sup>， CD4<sup>+</sup>， CD4<sup>+</sup>/CD8<sup>+</sup>， C<sub>3</sub>， C<sub>4</sub>， IgA， immune function indexes such as IgG and IgM were significantly higher than those of the control group， and the CD8<sup>+</sup> level was lower than which of control group （<italic>P</italic><0.05）， the nutritional status levels such as Alb， PA， TP and Hb in the observation group were significantly higher than those of the control group （<italic>P</italic><0.05）， <italic>Bifidobacterium</italic>， <italic>Lactobacillus</italic>， and <italic>E. faecalis </italic>in the observation group were higher than those in the control group， and <italic>E. coli</italic> was lower than the control group （<italic>P</italic><0.05）， the adverse reaction rate of the observation group was 11.63% （5/43） and the control group was 16.28% （7/43） ， and there was no statistical difference between two groups. Conclusion:Modified Liu Junzitang has a good clinical effect on advanced gastric cancer patients with syndrome of deficiency of Qi and blood. It can improve TCM syndromes and gastrointestinal function， improve quality of life， and its mechanism is related to improving immune function， enhancing nutritional status， and improving intestinal microecology， and it has good safety.
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Objective:To observe the relationship between serum homocysteine (Hcy), nitric oxide (NO), high-sensitivity C-reactive protein (hs-CRP) as well as the number and degree of coronary lesions, and the effect of Liu Junzitang combined with Erchentang on Hcy, NO, hs-CRP in patients with coronary heart disease (CHD), so as to explore the protector effect of Liu Junzitang combined with Erchentang on CHD patients. Method:A total of 76 inpatients with phlegm turbidity and internal resistance (CHD) from the Cardiovascular Department of Jiangxi University of Traditional Chinese Medicine（TCM） from November 2016 to April 2019 were selected to analyze the relationship between Hcy, NO, hs-CRP as well as the number and degree of coronary lesions. By lottery, the 76 patients were randomly divided into observation group and control group, with 38 patients in each group. Patients in the control group were given conventional therapy, while patients in the observation group were given Liu Junzitang combined with Erchentang in addition to conventional therapy. The experimental period was 3 months. TCM symptom scores of the two groups before and after administration were evaluated. Hcy, NO, hs-CRP, triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and total cholesterol (TC), apolipoprotein A1 (Apo A1), apolipoprotein B (Apo B), N-terminal B-type natriuretic peptide (NT-proBNP), left ventricular ejection fraction (LVEF) indicators of the two groups were measured before and after administration. Result:The levels of Hcy and hs-CRP were positively correlated with the number and degree of coronary lesions. The level of NO was negatively correlated with the number and degree of coronary lesions. TCM symptom scores were different between the two groups after treatment. Compared with the control group, the TCM symptom score in the observation group was decreased more significantly (P<0.05). The two groups could reduce Hcy, hs-CRP and increase in NO to a certain extent (P<0.05). Compared with the control group, the observation group showed reduction in Hcy, hs-CRP and increase in NO more significantly (P<0.05). After treatment in both groups, TG, LDL, TC, Apo A1, Apo B and HDL were reduced (P<0.05) compared with before treatment. Compared with the control group, the observation group showed decrease in TG, LDL, TC, Apo A1, Apo B and increase in HDL more significantly (P<0.05). Both groups could increase LVEF and decrease NT-proBNP after treatment (P<0.05). Compared with the control group, the observation group increased LVEF and decreased NT-proBNP more significantly (P<0.05). Conclusion:The levels of Hcy and hs-CRP were positively correlated with coronary lesions, while the level of NO was negatively correlated with coronary lesions. Modified Liu Junzitang and Erchentang may be correlated with inhibition of Hcy, hs-CRP and CHD and increase of patient's NO level, thereby reducing the patient's blood lipids, improving the patient's heart function, and improving the patient's clinical symptoms.
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Objective: To observe the changes of dysfunctional high density lipoprotein cholesterol (dyHDL) and the intervention effect of Xiangsha Liu Junzitang in rats with spleen deficiency and hyperlipidemia, and reveal the effect and mechanism of Xiangsha Liu Junzitang on dyHDL in rats with spleen-deficiency hyperlipidemia. Method: Seventy-five SPF SD rats were randomly divided into normal group, high fat group, spleen deficiency and high fat group, Xiangsha Liu Junzitang low and high dose groups (5.67, 11.34 g·kg-1). In the spleen deficiency and high fat group, as well as Xiangsha Liu Junzitang low and high dose groups, composite method of improper diet and exhaustive swimming was used for 15 days for modeling. After modeling for 15 days, normal group was fed with basic diet, while the high-fat group, spleen-deficiency and high-fat group, the Xiangsha Liu Junzitang low and high dose groups were fed with high-fat diet. After 12 weeks, the Xiangsha Liu Junzitang low dose and high dose groups received corresponding dosage of drugs, while normal group, high fat group and spleen deficiency high fat group received corresponding volume of normal saline. After 4 weeks, the contents of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol cholesterol (LDL-C), and high density lipoprotein cholesterol(HDL-C)were detected by automatic biochemistry analyzer, while D-xylose excretion rate was measured by phloroglucinol method. The morphological changes of liver cells were observed by hematoxylin eosin (HE) staining. The level of PON1, apoA1 and SAA in plasma were detected by enzyme-linked immunosorbent assay (ELISA). Paraoxonase 1(PON1), apolipoprotein A1 (apoA1) and serum amyloid protein A (SAA) gene expression in rats liver were detected by Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR). Result: As compared with normal group, the serum TC, TG, and LDL-C levels were significantly increased in the high-fat group and spleen-deficiency high-fat group (PPPPPPD-xylose excretion rate was significantly decreased in the spleen-deficiency and high-fat group (PPPPPPPPConclusion: The lipid disorder in hyperlipidemia rats was aggravated by the spleen deficiency, but was corrected after intervention with Xiangsha Liu Junzitang. and its mechanism may be related to the regulation of the expression of dyHDL-related genes and protein.
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The effects of four Kampo medicines, Ninjin-to, Hange-shashin-to, Rikkunshi-to and Sho-hange-ka-bukuryo-to, were investigated in a rat model of postoperative ileus. The postoperative ileus model was made by incising the abdomen and exposing the small intestine and caecum for five minutes under ether anesthesia. The gastrointestinal transit was estimated by the migration of a charcoal marker. In contrast to the animals anesthetized only, the gastrointestinal transit was markedly decreased in control animals. First, we studied the gastrointestinal prokinetic drugs (cisapride, mosapride and metoclopramide), the anti-inflammatory drug indomethacin, and the Kampo medicine Dai-kenchu-to in this model. They significantly increased the transit as compared with the control. Using the same method, Rikkunshi-to and Sho-hange-ka-bukuryo-to were demon-strated to be almost inactive. However, Ninjin-to and Hange-shashin-to not only significantly improved the gastrointestinal mobility compared to the control, but also showed stronger effects than those of Dai-kenchu-to. These results suggest that in addition to Dai-kenchu-to, Ninjin-to and Hange-shashin-to are also effective Kampo medicines for postoperative ileus.