Textual research on ancient and modern literature and analysis on research hot spots of classical prescription Shenling baizhu powder / 中国药房

OBJECTIVE To provide reference for the clinical application and further research and development of Shenling baizhu powder. METHODS Using the methods of textual research and bibliometrics， the key information such as the composition， dose， processing and usage of Shenling baizhu powder in ancient and modern literature were systematically summarized and sorted out， and the number of publications， keywords， and other contents of modern literature were visually analyzed. RESULTS & CONCLUSIONS Shenling baizhu powder was first collected in Taiping Huimin Hejiju Fang （abbreviated “Jufang”）， the composition of core drugs and most widely used dose ratio in previous generations were the same as those in Jufang， basically focusing on powder making and being taken after mixed with liquid； the dosage was concentrated on 2-3 qian； the function and application of it had been expanded to a certain extent compared with Jufang； its clinical application had gradually extended from internal medicine to surgery， gynecology， pediatrics， ophthalmology， dermatology， etc.， covering all aspects of the disease caused by spleen deficiency in general； the composition mechanism revolved around “strengthening the spleen， replenishing qi and removing dampness”； the recommended prescription drugs were all selected from the corresponding varieties in the pharmacopoeia. Modern research mainly focuses on clinical practice， with traditional Chinese medicine or traditional Chinese and Western medicine combined with this formula as the main modified treatment for various intestinal diseases， diarrhea diseases， and lung diseases. The efficacy and application are the frontier hot spots today， and the mechanism of action has begun to be explored. The usage in the literature and the inclusion in the pharmacopoeia are inconsistent， and further research is needed.

Shenling Baizhu Powder alleviates chronic inflammation to prevent type 2 diabetes of ZDF rats via intestinal flora / 中国中药杂志

This study explored the mechanism of Shenling Baizhu Powder(SLBZP) in the prevention and treatment of type 2 diabetes from the perspective of flora disorder and chronic inflammation. Fifty rats were randomly divided into normal control group, model control group, low-dose SLBZP group, medium-dose SLBZP group, and high-dose SLBZP group, with 10 rats in each group. The rats of 5 weeks old were administrated by gavage with ultrapure water and different doses of SLBZP decoction. The basic indicators such as body weight and blood glucose were monitored every week, and stool and intestinal contents were collected from the rats of 9 weeks old for 16 S rRNA sequencing and metabolomic analysis. An automatic biochemical analyzer was used to measure the serum biochemical indicators, ELISA to measure serum insulin, and chipsets to measure leptin and inflammatory cytokines. The results showed that SLBZP reduced the body weight as well as blood glucose, glycosylated hemoglobin, and lipid levels. In the rats of 9 weeks, the relative abundance of Anaerostipes, Turicibacter, Bilophila, Ochrobactrum, Acinetobacter, and Prevotella decreased significantly in the model control group, which can be increased in the high-dose SLBZP group; the relative abundance of Psychrobacter, Lactobacillus, Roseburia and Staphylococcus significantly increased in the model control group, which can be down-regulated in the high-dose SLBZP group. The differential metabolites of intestinal flora included 4-hydroxyphenylpyruvic acid, phenylpyruvic acid, octanoic acid, 3-indolepropionic acid, oxoglutaric acid, malonic acid, 3-methyl-2-oxovaleric acid, and methylmalonic acid. Moreover, SLBZP significantly lowered the levels of free insulin, insulin resistance and leptin resistance in rats. The variations in the serum levels of interleukin 1β(IL-1β) and monocyte chemoattractant protein-1(MCP-1) showed that SLBZP could alleviate chronic inflammation in rats. In conclusion, SLBZP can regulate intestinal flora and metabolites and relieve chronic inflammation to control obesity and prevent type 2 diabetes.

Effects of Shenling-Baizhu Powder combined with modified Guilu-Erxian Decoction on bone metabolism and inflammation response in osteoporosis patients / 国际中医中药杂志

Objective:To explore the effects of Shenling-Baizhu Powder combined with modified Guilu-Erxian Decoction on bone metabolism and inflammation response in osteoporosis patients. Methods:A total of 82 patients with osteoporosis of spleen-kidney deficiency, meeting the inclusion criteria in the hospital, were enrolled between June 2018 and October 2019. They were divided into observation group and control group by random number table method, 41 in each group. The control group was treated with oral calcium carbonate D3 tablets and alendronate sodium, while the observation group was treated with Shenling-Baizhu Powder combined with modified Guilu-Erxian Decoction on basis of control group. Both groups were treated for 6 months. Before and after treatment, scores of TCM symptoms were conducted. The bone mineral density (BMD) values of lumbar vertebra L 2-4, femoral neck and distal radius1/3 site were detected by dual-energy X-ray BMD analyzer. The levels of serum tartrate-resistant acid phosphatase 5b (TRACP 5b) and type I C-terminal cross linked peptide (CTX-I) were detected by electrochemiluminescence analyzer. The level of bone gla protein (BGP) was detected by radioimmunoassay. The levels of interleukin 6 (IL-6), interleukin 10 (IL-10), tumor necrosis factor α (TNF-α) and C-reactive protein (CRP) were detected by full-automatic biochemical analyzer. The adverse events during treatment were observed. And clinical curative effect was evaluated. Results:The differences in response rate between observation group and control group was statistically significant [95.1% (39/41) vs. 78.0% (32/41); χ2=5.145, P=0.023]. After treatment, scores of clinical symptoms (pain in back and loin, soreness and weakness of waist and knees, limb fatigue, debilitation, dizziness and tinnitus, frequent nocturia, loose stools, poor complexion) in observation group were significantly lower than those in the control group ( t=14.268, 10.732, 20.720, 7.564, 9.055, 15.975, 10.826, 6.552, all Ps<0.001). After treatment, BMD values of lumbar vertebra L 2-4 (0.89 ± 0.06 g/cm 3vs. 0.81 ± 0.04 g/cm 3, t=7.104), femoral neck (0.80 ± 0.08 g/cm 3vs. 0.72 ± 0.06 g/cm 3, t=5.122) and distal radius 1/3 site (0.65 ± 0.12 g/cm 3vs. 0.56 ± 0.14 g/cm 3, t=3.125) in observation group were significantly greater than those in the control group ( P<0.01). After treatment, levels of serum BGP and IL-10 in observation group were significantly higher than those in the control group ( t=3.875, 3.714, P<0.01), while levels of TRACP-5b, CTX-I, IL-6, TNF-α and CRP were significantly lower than those in the control group ( t=3.169, 5.849, 9.412, 4.606, 5.430, all Ps<0.001). Conclusion:Shenling-Baizhu Powder combined with modified Guilu-Erxian Decoction can improve clinical symptoms in patients with primary osteoporosis of spleen-kidney deficiency, increase BMD, regulate bone metabolism, alleviate inflammatory response and improve clinical curative effect.

Hepatic protective effects of Shenling Baizhu powder, a herbal compound, against inflammatory damage via TLR4/NLRP3 signalling pathway in rats with nonalcoholic fatty liver disease / 中西医结合学报

OBJECTIVE@#High-fat diet (HFD) and inflammation are two key contributors to nonalcoholic fatty liver disease (NAFLD). Shenling Baizhu powder (SLBZP), a classical herbal compound, has been successfully used to alleviate NAFLD. However, its specific mechanisms are not fully understood. In this study, we assessed the anti-NAFLD effect of SLBZP in vivo.@*METHODS@#Rats were fed an HFD with or without SLBZP or with probiotics. At the end of week 16, an echo magnetic resonance imaging (EchoMRI) body composition analyser was used to quantitatively analyse body composition; a micro-computed tomography (micro-CT) imaging system was used to evaluate whole body and liver fat; and the Moor full-field laser perfusion imager 2 was used to assess liver microcirculation, after which, all rats were sacrificed. Then, biochemical indicators in the blood and the ultrastructure of rat livers were evaluated. Protein expression related to the liver Toll-like receptor 4 (TLR4)/Nod-like receptor family pyrin domain-containing 3 (NLRP3) signalling pathway was assessed using Western blot analysis. Further, high-throughput screening of 29 related inflammatory factors in liver tissue was performed using a cytokine array.@*RESULTS@#SLBZP supplementation reduced body weight, serum free fatty acid, and insulin resistance index (P < 0.05). It also ameliorated liver microcirculation and ultrastructural abnormalities. EchoMRI and micro-CT quantitative analyses showed that treatment with SLBZP reduced fat mass and visceral fat (P < 0.05 and P < 0.01, respectively). In addition, SLBZP decreased the expression of lipopolysaccharide (LPS)-activated TLR4/NLRP3 signalling pathway-related proteins and altered the expression levels of some inflammatory cytokines in liver tissues.@*CONCLUSION@#SLBZP can inhibit NLRP3 inflammasome activation and interleukin-1β release by suppressing LPS-induced TLR4 expression in rats with HFD-induced NAFLD. Thus, SLBZP may be beneficial for the prevention and treatment of inflammatory damage and associated diseases.

Improvement Effect and Mechanism of Shenling Baizhu Powder on IBS-D Model Mice with Anxiety Based on Intestinal Microecology / 中国药房

OBJECTIVE：To study the improvement effect of Shenling baizhu p owder on irritable bowel syndrome with diarrhea（IBS-D）model mice with anxiety ，and to elucidate its mechanism from the point of view of intestinal microecology. METHODS：C57 BL/6 mice were randomly divided into blank control group ，model group ，Shenling baizhu powder group （3.6 g/kg），with 8 mice in each group. Except for blank control group ，IBS-D model with anxiety was established in model group and Shenling baizhu powder group by giving corticosterone subcutaneously combined with intragastric administration of Folium Sennae decoction and chronic restraint treatment. After modeling ， blank control group and model group were given intragastric administration of normal saline ，and Shenling baizhu powder group was given relevant medicine intragastrically ，for consecutive 4 weeks. After last medication ，loose stools rate ，diarrhea index ，body weight ，sugar water preference percentage ，the times of crosssing open field center area and minimum pain threshold as well as the levels of BDNF in hippocampal tissue and 5-HT in serum were detected in each group. The cecal contents of mice in each group were extracted for microbial DNA extraction and sequencing； the abundance and diversity of intestinal microorganisms were analyzed by Alpha and Beta diversity analysis. RESULTS ： Compared with blank control group ，body weight ，sugar water preference percentage ，the times of crossing open field center area and minimum pain threshold as well as the levels of BDNF in hippocampal tissue ，relative abundance of Firmicutes phylum microorganism in intestine ， relative abundance of Lachnospiraceae_NK4A136_group genus microorganism were decreased significantly （P＜0.05）；loose stools rate，diarrhea index ，serum level of 5-HT，relative abundance of Verrucomicrobia phylum microorganism and relative abundance of Ackermann phylum microorganism were increased significantly （P＜0.05），and there were great differences in the types of intestinal microorganisms. Compared with model group ，body weight ，sugar water preference percentage ，the times of crossing open field center area ，minimum pain threshold ，BDNF level of hippocampus ，relative abundance of Firmicutes phylum microorganism，relative abundance of Lachnospiraceae_NK4A136_group genus microorganism were increased significantly （P＜ 0.05 or P＜0.01）；loose stools rate ，diarrhea index ，serum level of 5-HT，relative abundance of Verrucomicrobia phylum microorganism and relative abundance of Ackermann phylum microorganism were decreased significantly （P＜0.05），and and there were great differences in the types of intestinal microorganisms. CONCLUSION ：Shenling baizhu powder can improve the diarrhea and anxiety behavior of IBS-D model mice with anxiety ，increase the level of BDNF in hippocampus and decrease serum level of 5-HT. Its mechanism may be related to decreasing relative abundance of Verrucomicrobia phylum microorganism and Ackermann phylum microorganism ，increasing the relative abundance of Firmicutes phylum and Lachnospiraceae_NK4A136_group genus microorganism.

Shenling Baizhu Powder () Ameliorates Pi (Spleen)-Deficiency-Induced Functional Diarrhea in Rats / 中国结合医学杂志

OBJECTIVE@#To explore the mechanism of Pi (Spleen)-deficiency-induced functional diarrhea (FD) model rats treated by Shenling Baizhu Powder (, SBP).@*METHODS@#Thirty male Sprague-Dawley rats were randomly divided into 5 groups including control, model, low-, medium-, and high-dose SBP groups (SBPLDG, SBPMDG, SBPHDG), 6 rats in each group, respectively. Pi-deficiency-induced FD rats model was developed through Radix et Rhizoma Rhei gavage for 7 days. After modeling, the rats were treated with 3 doses of SBP [0.93, 1.86, and 3.72 g/(kg·d)], and the rats in the control and model groups were given pure water for 7 days. The diarrhea index was calculated. On the 7th and 14th days, the traveled distance of rat was measured by the open field test. Serum D-xylose content was determined by the phloroglucinol method and interleukin (IL)-10 and IL-17 levels were measured using an enzyme-linked immunosorbent assay kit. The content of Treg cells was determined by flow cytometry.@*RESULTS@#Compared with the control group, the diarrhea index and IL-17 level in the model group were significantly higher and the total exercise distance and D-xylose content significantly decreased (P>0.05). The expression of IL-10 in the SBPHDG group was significantly up-regulated, and serum D-xylose level and Treg cells increased significantly compared with the model group (P>0.05).@*CONCLUSION@#High-dose SBP exhibited ameliorating effects against Pi-deficiency induced FD, which might be attributed to its modulations on intestinal absorption function as well as adaptive immunity in mesenteric lymph nodes of rat.

Comparative Study on Mobilization of Endogenous MSCs in Treatment of Ulcerative Colitis Rats by Shenling Baizhu Powder and Tongxie Yaofang Decoction / 中国中医药信息杂志

Objective To compare mobilization effects of endogeneous MSCs in the treatment of ulcerative colitis rats by Shenling Baizhu Powder and Tongxie Yaofang Decoction. Methods Twenty SD male rats were randomly divided into blank group, model group, Shenling Baizhu Powder group and Tongxie Yaofang Decoction group. TNBS/ethanol method was used to build the ulcerative colitis model. Administration groups were given Shenling Baizhu Powder and Tongxie Yaofang Decoction for gavage and model group and blank group were given normal saline for gavage. After gavage, MSCs from peripheral blood and bone marrow were extracted for primary culture. MSCs of bone marrow and peripheral blood were detected by flow cytometry. Results MSCs from bone marrow showed: Compared with the blank group, the percentage of positive cells in the model group decreased (P<0.05); Compared with the model group, the percentage of positive cells in Shenling Baizhu Powder group and Tongxie Yaofang Decoction group increased, and the expression of Shenling Baizhu Powder group was more obvious (P<0.05). MSCs from peripheral blood showed: Compared with the blank group, the percentage of positive cells in the model group increased (P<0.05); Compared with the model group, the percentage of positive cells in Shenling Baizhu Powder group and Tongxie Yaofang Decoction group decreased, and the expression of Shenling Baizhu Powder group was more obvious (P<0.05). Conclusion Shenling Baizhu Powder and Tongxie Yaofang Decoction have the function of promoting the increase of bone marrow-derived MSCs and the reduction of peripheral blood source of MSCs in model rats, and Shenling Baizhu Powder is better than Tongxie Yaofang Decoction.

Comparative Study of Probiotics and Traditional Chinese Medicine Syndrome-differentiation Treatment for Rotavirus Enteritis in Children / 广州中医药大学学报

Objective To investigate the therapeutic effect of probiotics and traditional Chinese medicine syndrome-differentiation treatment for children rotavirus enteritis. Methods One hundred and twenty cases of children with rotavirus enteritis were randomly divided into Chinese medicine group, probiotics group and control group,40 cases in each group. The 3 groups were given conventional treatment such as proper feeding, prevention of dehydration and correction of dehydration. Additionally, Chinese Medicine group was separately given modified Gegen Qinlian Decoction for patients with damp-heat syndrome, modified Huoxiang Zhengqi Decoction for patients with wind-cold syndrome, modified Baohe Pills for patients impaired by overeating, modified Shenling Baizhu Powder for patients with spleen deficiency syndrome;probiotics group received Probiotic Bifidobacterium Triple Viable Enteric Capsules;the control group was given oral use of Smecta. Daily defecation frequency and stool characteristics were recorded,and the clinical efficacy was analyzed on treatment day 3 and 5. Results(1)After treatment for 3 days,the total effective rate of the 3 groups arrived to 100%,the difference being insignificant between the 3 groups (P > 0.05);after treatment for 3 days, Chinese medicine group had higher markedly effective rate than probiotics group and control group,the difference being significant (P < 0.05). (2) After treatment for 3 and 5 days,the defecation frequency of the 3 groups was much reduced as compared with that before treatment (P < 0.05), and the improvement of defecation frequency in Chinese medicine group was superior to that in probiotic group and control group, the difference being significant (P <0.05). (3)The mean course of disease in Chinese medicine group was shorter than that in probiotic group and control group,the difference being significant (P < 0.05). Conclusion Traditional Chinese medicine syndrome-differentiation treatment exerts certain effect for the treatment of rotavirus enteritis, and can quickly reduce defection frequency and shorten the course of disease.

Meta-analysis of Shenling Baizhu Powder Combined with Aminosalicylic Acid Preparation in the Treatment of Ulcerative Colitis / 中国药房

OBJECTIVE:To evaluate clinical efficacy of Shenling baizhu powder combined with aminosalicylic acid in the treatment of ulcerative colitis (UC),and to provide evidence-based reference in clinic.METHODS:Retrieved from PubMed,Cochrane library,CJFD,VIP,Wanfang database and CBM,randomized controlled trials (RCTs) about Shenling baizhu powder combined with aminosalicylic acid preparations (trial group) vs.aminosalicylic acid preparations alone (control group) in the treatment of UC were collected.Meta-analysis was performed by using Rev Man 5.2 statistical software afder data extraction and quality evaluation with Cochrane systematic evaluator manual 5.1.0.RESULTS:A total of 14 RCTs were included,involving 1 177 patients.Meta-analysis showed that total response rate of trial group was significantly higher than that of control group [OR=3.40,95％ CI (2.44,4.74),P＜0.001],while Sutherland DAI score [MD=-1.31,95％ CI (-2.07,-0.56),P＜0.001],the levels of TNF-α [SMD=-1.90,95％CI(-2.90,-0.90),P＜0.001],IL-17[MD=-85.18,95％CI(-100.51,-69.85),P＜0.001] and IL-23 [MD=-113.27,95％CI(-132.34,-94.21),P＜0.001] in trial groups were significantly lower than control group,with statistical significance.CONCLUSIONS:Therapeutic efficacy of Shenling baizhu powder combined with aminosalicylic acid preparation is better than aminosalicylic acid preparation alone in the treatment of UC,and can significantly reduce Suthedand DAI and the levels of serum cytokines.

Meta-analysis of Shenling Baizhu Powder Combined with Western Medicine in Treating Ulcerative Colitis / 广州中医药大学学报

Objective To make a Meta-analysis of the effectiveness and safety of Shenling Baizhu Powder (SBP) for the treatment of ulcerative colitis(UC),thus to provide evidence for the clinical treatment of ulcerative colitis.Methods Randomized controlled trials (RCTs) of SBP combined with western medicine vs western medicine in treating ulcerative colitis were included.The quality of RCTs was assessed by the Cochrane scale.A Meta-analysis was performed for the clinical efficacy,improvement of disease activity index (DAI) levels of the included trials.Results A total of 19 RCTs were included,involving 1498 cases.The results of Metaanalysis showed that compared with the western medicine group,the combined risk ratio(RR) of clinical efficacy in the SBP combined group was 1.55,95％ confidence interval (CI) being (1.39,1.72).The subgroup analysis based on control medicine showed that the combined RR of combined use of sulfasalazine or mesalazine/Olsalazine was 1.46,1.59 [95％CI (1.19,1.77) vs 95％CI (1.40,1.80)].The subgroup analysis based on different treatment courses showed that the combined RR of 1-30 days,31-60 days,61-90 days was 1.42,1.69,1.47 [95％CI (1.18,1.70) vs 95％CI (1.44,1.97) vs 95％CI (1.15,1.88)] respectively.The differences were significant (P ＜ 0.05).(2) The differences of the two groups on the improvement of DAI and inflammatory factors levels of interlekin-17(IL-17),IL-23,tumor necrosis factor alpha(TNF-α),C-reactive protein(CRP) were statistically significant(P ＜ 0.05).(3)The sensitivity analysis of the primary outcomes showed a higher homogeneity in the literatures and the funnel plot analysis showed no evidence of publication bias.Conclusion Compared with western medicine,SBP combined with western medicine has better clinical efficacy for the treatment of UC,and the combined use of mesalazine/Olsalazine medicated for 30-60 days is more effective on improving DAI and inflammatory factors levels.However,for the low quality of the included literatures and insufficient experimental design,the conclusion needs more evidence from large sample-size randomized double-blind controlled trials.

Effect of Shenling Baizhu Powder and Moxibustion on Serum Brain-gut Peptide in Patients with Irritable Bowel Syndrome / 中国中医药信息杂志

Objective To explore the effect of Shenling Baizhu Powder and moxibustion on serum brain-gut peptide in patients with diarrhea predominant irritable bowel syndrome (D-IBS). Methods Sixty D-IBS cases were randomly divided into two groups, 30 cases in the treatment group were given Shenling Baizhu Powder and moxibustion therapy, and 30 patients in the control group were given loperamide hydrochloride capsule. Treatment for the two groups lasted for 4 weeks. Clinical symptoms and serum brain gut peptide (5-HT, VIP and SP) levels of two groups were observed before and after treatment, clinical efficacy were evaluated. Results Markedly effective rate of the treatment group was 66.7% (20/30), better than 33.3% (10/30) in the control group (P0.05), with statistical significance (P<0.01). Conclusion Clinical efficacy of Shenling Baizhu Powder and moxibustion in treating D-IBS is better than that of loperamide hydrochloride capsule, and can significantly improve clinical symptoms and regulate serum brain-gut peptides levels.

Therapeutic Effect of Shenling Baizhu Powder Combined with Erchentang in Treatment of Senile Pneumonia and Influence on Procalcitonin / 中国中医药信息杂志

Objective To observe the efficacy of Shenling Baizhu powder combined with Erchentang in treatment of senile pneumonia, and its influence on serum procalcitonin. Methods With randomized controlled trial, 100 patients were randomly divided into two groups. The control group (49 cases) was treated by routine western medicine, and the treatment group (51 cases) was treated by Shenling Baizhu powder combined with Erchentang additionally. The treatment course was 1 week, and the therapeutic effect was observed after two courses. The improvement time of clinical symptoms and signs, and the change of serum procalcitonin were detected. Results Clinical efficacy of the two groups had no significant difference (P>0.05). The improvement time of signs and symptoms in treatment group was better than that in control group (P<0.05). The serum procalcitonin improved in treatment group was better than that in control group (P<0.05). Conclusion Shenling Baizhu powder combined with Erchentang has obvious anti-infection effect, and can improve symptoms and signs of senile pneumonia rapidly.

Determination of Camphor, Borneol and Bornyl Acetate in Shenling Baizhu Powder by Gas Chromatography / 中国中医药信息杂志

Objective To establish a GC method for simultaneous determine of camphor, borneol and bornyl acetate in Shenling Baizhu Powder. Methods Capillary column was used with 100% methyl polysiloxane as stationary phase. The temperature-programmed was as follows:starting temperature of 60 ℃, 5 ℃/min, rose to 130 ℃, kept for 5 minutes, followed by 20 ℃/min up to 230 ℃, and kept for 5 minutes. Results The average recovery rate of camphor was 99.87%, RSD was 1.3%, and good linear relationship was showed in the range of 0.003 77-0.150 8 μg (r=0.999 9). The average recovery of borneol was 100.71%, RSD was 2.1%, and good linear relationship was showed in the range of 0.002 411-0.096 4 μg (r=0.999 9). The average recovery rate of bornyl acetate was 101.95%, RSD was 1.3%, and good linear relationship was showed in the range of 0.003 02-0.121 1 μg (r=0.999 9). Conclusion The method is simple, reliable, accurate, and can effectively control the quality of Amomi Fructus in Shenling Baizhu Powder.