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ObjectiveBased on ultra performance liquid chromatography-mass spectrometry（UPLC-MS） and non-targeted metabolomics technology to discuss the central regulatory effect of Chaishao Liujuntang on chronic atrophic gastritis（CAG） rats with liver-depression and spleen-deficiency， and to look for the correlation between cerebral cortex， hypothalamus and metabolic status of gastric tissues. MethodA CAG rat model with liver-depression and spleen-deficiency was established by chemical induction， hunger and satiety disorders， chronic restraint and tail clamping stimulation， lasting for 16 weeks. Twenty-eight Wistar rats were randomly divided into a blank group of 8 rats and a model group of 20 rats. After the completion of modeling， 4 rats in the model group were taken to observe the pathological changes of gastric mucosa. The remaining model rats were randomly divided into a model group of 8 rats and a Chaishao Liujuntang group of 8 rats. Chaishao Liujuntang group rats were given 5.1 g·kg-1 by gavage， and the remaining rats were given equal volume sterilized water by gavage for 4 weeks. Macroscopic characteristics， behavioral indicators and histopathological changes of the gastric mucosa of rats in each group were observed and compared. UPLC-MS non-targeted metabolomics was used to explore the metabolic regulation effect of Chaishao Liujuntang on the cerebral cortex， hypothalamus and stomach tissues of CAG rats with liver-depression and spleen-deficiency. Pearson correlation coefficient method was used to analyze the correlation between different tissue metabolites. ResultCompared with the model group， the macroscopic characteristics of rats in Chaishao Liujuntang group were improved， such as hair color， mental state and stool properties， and the number of times of crossing and standing in the open field experiment was significantly increased， and the static time of forced swimming was significantly reduced（P<0.01）， and the gastric mucosa atrophy was reduced. The metabolic data from the cerebral cortex of rats in each group identified a total of 3 common potential biomarkers， but not enriched in pathways， 26 common potential biomarkers were identified in the hypothalamus， and the key metabolic pathways involved were mainly enriched in purine metabolism， glycerol phospholipid metabolism， D-glutamine and D-glutamic acid metabolism. Seventeen common potential biomarkers were identified in the stomach， and the key metabolic pathways involved were mainly enriched in thiamine metabolism， valine， leucine and isoleucine biosynthesis， and taurine and taurine metabolism. Correlation analysis of metabolites in different tissues revealed that multiple amino acids and their derivatives mediated metabolic connections between the cerebral cortex， hypothalamus and stomach of rats. ConclusionThe metabolic disorders in the cerebral cortex， hypothalamus and stomach of CAG rats with liver-depression and spleen-deficiency have their own characteristics， mainly manifested by changes in the content of glycerol phospholipids， fatty acids and bile acid metabolites. Moreover， Chaishao Liujuntang may play a central regulatory role in CAG rats with liver-depression and spleen-deficiency by correcting the metabolic disorders of amino acids.
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ObjectiveTo explore the effect of Ganshuang granule on liver fibrosis （S1 and S2） in chronic hepatitis B （CHB） with liver depression spleen deficiency and blood stasis syndrome. MethodA total of 100 patients were classified into the control group （50 in total with 4 lost and 2 rejected， 44 finally included） and observation group （50 in total with 5 lost and 2 rejected， 43 finally included） with the random number table method. Both groups were given oral entecavir tablets （0.5 mg/time， once a day， 12 months）， and oral glutathione tablets was applied depending on the conditions of patients. In addition， the control group took the analog drug of Ganshuang granule （3 g/time， 3 times/day， 12 months） and the observation group received Ganshuang granules （3 g/time， 3 times/day， 12 months）， followed by histological examination of the liver by puncture biopsy. The two groups were compared in terms of inflammatory activity grade and fibrosis stage， as well as liver stiffness measure （LSM）， liver function， hepatitis B virus （HBV） DNA， liver depression and spleen deficiency syndrome score， aspartate aminotransferase （AST）-to-platelet ratio index （APRI）， and fibrosis index based on the four factors （FIB-4）. ResultAfter treatment， liver fibrosis in the observation group was milder than that in the control group （P<0.05） and the inflammatory activity grade in the observation group was lower than that in the control group （P<0.05）. The effective rate in down-regulating inflammatory activity grade in the observation group was 77.78% as compared with the 45.83% in the control group （χ2=5.546， P<0.05）. The effective rate in decreasing the fibrosis stage in the observation group was 59.26%， which was higher than that （16.67%） in the control group （χ2=9.669， P<0.01）. The LSM and score of the liver stagnation and spleen deficiency syndrome in the observation group were lower than those in the control group at the 6th months and 12th months of treatment （P<0.05，P<0.01）. The levels of alanine aminotransferase （ALT）， AST， and alkaline phosphatase （ALP） in the observation group were lower than those in the control group （P<0.01）. The APRI and FIB-4 in the observation group were lower than those in the control group （P<0.01）. ConclusionThe Ganshuang granule combined with entecavir can alleviate inflammation and liver fibrosis， delay and reverse liver fibrosis， protect liver， and improve the traditional Chinese medicine syndrome of liver fibrosis （S1 and S2） in CHB， which is worth of clinical use and further research.
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Objective:To evaluate the clinical efficacy of modified Sini Powder combined with acupoint application in the treatment of liver depression and spleen deficiency syndrome of diarrhea irritable bowel syndrome(IBS-D). Methods:A total of 104 IBS-D patients with liver depression and spleen deficiency syndrome in our hospital from October 2018 to December 2020 were randomly divided into two groups according to the random number table method, 52 in each group. Both groups took montmorillonite powder orally first. On this basis, the control group was treated with pivirium bromide tablets, and the study group was treated with Modified Sini Powder combined with acupoint application. Both groups were treated for 4 weeks. TCM symptom scores were performed before and after treatment. The levels of serum IL-6, IL-8 and TNF-α were detected by ELISA. The recovery time of stool characteristics, the disappearance time of abdominal pain and the recovery time of stool times were observed and recorded, and the clinical curative effect was evaluated. Results:The total effective rate was 92.3% (48/52) in the observation group and 75.0% (39/52) in the control group, there was significant difference between the two groups ( χ2=5.696, P=0.017). After treatment, the scores of abdominal pain, diarrhea, stool frequency, irritability, mental fatigue and hypochondriac pain in the observation group were significantly lower than those in the control group ( t values were 15.492, 16.827, 13.419, 10.831, 14.736,12.437, respectively, all Ps<0.001), and the levels of serum IL-6, IL-8 and TNF-α were significantly lower than those in the control group ( t values were 16.390, 21.528 and 18.734, respectively, all Ps<0.001). The recovery time of stool characteristics [(3.79 ± 0.63) d vs. (4.84 ± 0.79) d, t=7.493], the disappearance time of abdominal pain [(2.63 ± 0.32) d vs. (3.91 ± 0.37) d, t=18.869], and the recovery time of stool times [(3.26 ± 0.57) d vs. (4.19 ± 0.68) d, t=7.558] in the observation group were significantly shorter than those in the control group ( P<0.01). Conclusion:Modified Sini Powder combined with acupoint application can improve the clinical symptoms of IBS-D patients with liver depression and spleen deficiency syndrome, reduce the level of serum inflammatory cytokines and improve the curative effect.
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Objective::To observe the effect of modified Banxia Xiexintang on depression during perimenopause, in order to study itseffecton 5-hydroxytryptamine (5-HT) and proinflammatory factors. Method::One hundred and thirty-nine patients were randomly divided into control group (69 cases) and observation group (70 cases) by random number table.Patients in control group got tibolone tablets, 2.5 mg/time, 1 time/day, and paroxetine hydrochloride tablets, 20 mg/time, 1 time/day.In addition to the therapy in control group, patients in observation group were added with modified Banxia Xiexintang, 1 dose/day.The course of treatment was 8 weeks.And before and after treatment, Hamilton depression scale for-17 items (HAMD-17), Zung's self-rating depression scale (SDS), hamilton anxiety scale (HAMA), improvement Kupperman(KI), liver depression and spleen deficiency syndrome, menopause-specific quality of life questionnaire (MENQOL) and treatment emergent symptom scale (TESS) were scored, and levels of 5-HT, rain-derived neurotrophic factor (BDNF), interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) were detected. Result::After treatment, scores of HAMD-17 and SDS in observation group were lower than those in control group (P<0.01). And the effect on trea depression in observation group was better than that in control group (Z=2.074, P<0.05). The degree of depression in observation group was ligher than that in control group (Z=2.157, P<0.05). And scores of HAMA, KI and liver depression and spleen deficiency syndrome were lower than those in control group (P<0.01). The severity of perimenopausal syndrome was ligher than that in control group (Z=2.046, P<0.05). And scores of vasomotor symptoms and psychological symptoms of MENQOL scale and the total scores were lower than those in control group (P<0.05). Levels of 5-HT and BDNF were higher than those in control group (P<0.01), while levels of IL-1β, TNF-α and TESS were lower than those in control group (P<0.01). Conclusion::In addition to theroutine western medicine, modified Banxia Xiexintang can alleviate the severity of depression, release the symptoms of depression, anxiety and perimenopausal syudrome(PMS), improve the quality of life, inhibit pro-inflammatory factors, and enhance the expressions of 5-HT and BDNF, with no adverse event.
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Liver depression and spleen deficiency syndrome are common clinical syndromes of Traditional Chinese Medicine. In recent years, great progress has been made in the study of diagnostic criteria of liver depression and spleen deficiency syndrome. This paper discusses the current domestic research on the diagnostic criteria of liver depression and spleen deficiency syndrome from the aspects of textbooks, diagnostic criteria of teaching reference, guidelines, standardized diagnostic criteria, criteria derived from clinical investigation, and criteria derived from literature analysis.
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Liver depression and spleen deficiency syndrome is common in clinical practice. It has both the symptoms of uncomfortable liver depression and poor digestion of spleen deficiency. The brain-gut peptide not only regulates the gastrointestinal tract, but also participates in the regulation of mood, which is consistent with the mechanism of liver depression and spleen deficiency syndrome. At present, there are more than 10 brain-gut peptides discovered. This paper reviews several of these brain-gut peptides that are most closely related to liver depression and spleen deficiency syndrome to explore the relationship between brain-gut peptides and liver depression and spleen deficiency.
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Objective To test red cells of bone marrow and hematopoietic cells of rats with liver depression and spleen deficiency syndrome in different time period;To discuss the change rules in the blood system. Methods Rat models with liver depression and spleen deficiency syndrome were made by composite method of anger by restraint stress, clipping tails, over fatigue, and abnormal diet. The hemogram, red cells of bone marrow, marrow nucleated red blood cells, stem cell factor, and erythropoietin of male rats in normal group and model group were detected at 2nd, 6th and 9th weeks. Results Compared with normal group, hematokrit and metarubricyte in model group of 2 weeks was higher in the model group (P<0.05);erythropoietin in model group of 6 weeks decreased (P<0.01);red cell counts, red protein level, hemoglobin, hematokrit, and erythropoietin in model group of 9 weeks were lower (P<0.05);red cell counts, hemoglobin, hematokrit, prorubricyte, metarubricyte, and erythropoietin in model group of 6 and 9 weeks were significantly lower than those in model group of 2 weeks (P<0.05, P<0.01). The number of marrow nucleated red blood cells in model group of 2 weeks decreased (P<0.05). Stem cell factor showed no significant difference. Conclusion The rats with liver depression and spleen deficiency syndrome can increase the number of red blood cells in a short time when they suffer from stress stimulation, so that they can fight the damage factors. But long-term stress stimulation will lead the rats to anemia, which may be associated with the reduction of erythropoietin.
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Objective To observe the clinical efficacy of Simotang oral liquid combined with compound glutamine enteric capsules in the treatment of diarrhea-predominant irritable bowel syndrome (IBS-D) belonging to liver depression and spleen deficiency pattern, and to explore its possible mechanism. Methods Sixty patients were randomly divided into two groups. The treatment goup (30 cases) took Simotang oral liquid and compound glutamine enteric capsules, the control group took Cerekinon and Medilac-S. The treatment course was 4 weeks. Clinical symptoms, 5-hydroxytryptamine (5-HT) and substance P (SP) of both groups were evaluated respectively before and after treatment. Recurrence rate and adverse reactions were recorded. Results The total effective rate after treating 1, 2, 4 weeks between the two groups had no significant difference (P>0.05). Four weeks later, in the treatment group, total score of the symptoms, abdominal distension and defecation urgency were apparently lower than that of control group (P0.05). Obvious side effects were not found in the two groups. Conclusion Simotang oral liquid combined with compound glutamine enteric capsules has evident therapeutic effect on IBS-D of liver depression and spleen deficiency pattern, especially good at releasing abdominal distension and defecation urgency. The mechanism may be related with decreasing the levels of 5-HT and SP.