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Objective:To discuss clinical effect of addition and subtraction therapy of Ditantang combined with Taohong Siwutang to cerebral infarction and syndrome of phlegm and blood stasis blocking collaterals during early recovery， and to study protection to brain nerve. Method:One hundred and fifty-two patients were randomly divided into control group （76 cases） and observation group （76 cases） by random number table， 71 patients in control group completed the therapy （5 patients were falling off， missing visit or eliminated）， and 70 patients in observation group completed the therapy. Both groups' patients got comprehensive rehabilitation measures. Patients in control group got Zhongfeng Huichun pills， 1.5 g/time， 3 times/day. Patients in observation group got addition and subtraction therapy of Ditantang combined with Taohong Siwutang in the morning and at night， 1 dose/day. The treatment was continued for 12 weeks. Before and after treatment， scores of degree of neurological deficit， Barthel （BI） index， Fugl-Meyer scale （FMA）， modified Rankin scale （MRS） and syndrome of phlegm and blood stasis blocking collaterals were graded. And levels of malondialdehyde （MDA）， glutathione peroxidase （GSH-Px）， superoxide dismutase （SOD）， advanced oxidation protein products （AOPP）， vascular endothelial growth factor （VEGF）， brain-derived neurotrophic factor （BDNF） and neuron specific enolase （NSE）. And cerebral hemodynamics were detected， and peak flow velocity （VS）， vascular resistance index （RI）， pulsatility index （PI） and cerebrovascular reserve function （CVR） were recorded. Safety was evaluated. Result:After the 6th week and 12th week of treatment， scores of degree of neurological deficit， BI， FMA， MRS， syndrome of phlegm and blood stasis blocking collaterals， AOPP， MDA， NSE， RI and PI were lower than those in control group （P<0.01）， levels of SOD， GSH-Px， BDNF， VEGF， Vs and CVR were higher than those in control group （P<0.01）. The clinical effect was better than which in control group （Z=2.109， P<0.05）. Besides， there was no adverse reaction caused by Ditantang combined with Taohong Siwutang. Conclusion:Ditantang combined with Taohong Siwutang can ameliarate the hemodynamics， reduce the lipid peroxidation damage， regulate the neurovascular repair factor， so it can promote the repair of nerve tissue and function， clinically reduce the degree of nerve function defect， improve the ability of daily life and exercise when it used to cerebral infarction and syndrome of phlegm and blood stasis blocking collaterals during early recovery， and it is good for clinical effect and safe using.
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Taohong Siwutang， originating from Fuke Bingjian by CHAI Dehua in the Qing Dynasty， has been included in the first batch of the 100 classical prescriptions published by the National Administration of Traditional Chinese Medicine（TCM）. Taohong Siwutang is composed of six Chinese medicinals， namely the wine-washed Angelicae Sinensis Radix， wine-washed Rehmanniae Recens Radix， wine-washed Carthami Flos， wine-processed Paeoniae Alba Radix， Persicae Semen undergoing peel-off process in hot water， and Chuanxiong Rhizoma， possessing the effects of nourishing blood， promoting blood circulation， and removing blood stasis， and it is mainly applicable to patients with blood deficiency and stasis syndrome. The textual research on the key information of classical prescriptions and the summarization of their ancient and modern applications are conducive to learning about the research status and confirming the subsequent research direction， thus better guiding the preparation of substance benchmarks and the in-depth exploration of preparations. By exploring the sources and historic evolution of Taohong Siwutang and each Chinese medicinal， this paper uncovered the prescription composition， origin of each Chinese medicinal， processing method， and prescription dose. The review of its clinical applications showed that the application scope in modern times has been extended and expanded in contrast to that recorded in ancient books. As revealed by the clinical application literature， it has been mainly employed for treating gynecological diseases such as dysmenorrhea and irregular menstruation， orthopedic diseases like fracture， dermatological diseases such as chloasma， and internal diseases such as coronary heart disease， all of which were differentiated into the blood deficiency and stasis syndrome. It could be seen that Taohong Siwutang had great clinical application value. This review of the ancient and modern literature concerned with Taohong Siwutang and the analysis and determination of its key information are expected to provide a reference for the rational clinical application and further research of Taohong Siwutang.
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Taohong Siwutang is a classical famous formula for promoting blood circulation and removing blood stasis. This paper reviewed the research progress of chemical constituents, pharmacological activities, clinical applications of Taohong Siwutang in recent years. At present, the study on the chemical constituents of different extracts of Taohong Siwutang is systematic. The study of its pharmacological effects mostly includes promoting blood circulation and removing blood stasis, regulating menstruation, promoting fracture healing, and so on. In clinical practice, Taohong Siwutang can be used in the treatment of multi-system and multi-viscera diseases, such as gynecological diseases, internal diseases, orthopedic diseases, dermatological diseases, and the like. Based on this, the quality markers of Taohong Siwutang are predicted and analyzed from the perspectives of quality transmissibility and traceability, ingredient specificity, component validity, component measurability, and formula compatibility environment, which is called five principles of quality marker (Q-marker). According to the analysis, ferulic acid, paeoniflorin, amygdalin, albiflorin, hydroxysafflor yellow A, catalpol and gallic acid can be selected as Q-markers of Taohong Siwutang. Subsequently, these Q-markers can be selected as indicators to conduct whole quality control of Taohong Siwutang and establish a quality traceable system by the quality transmitting of medicinal materials, decoction pieces, intermediates and corresponding objects, so as to provide a reference for the study of the whole process quality control system of Taohong Siwutang.
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Objective:To observe the efficacy of modified Yuquanwan combined with Taohong Siwutang on major cardiovascular risk factors of type 2 diabetes and its effect on inflammatory factors and endothelial function. Method:One hundred and sixty patients were randomly divided into control group (80 cases) and observation group (80 cases) by random number table. The control group was given Tianqi Jiangtang capsule 5 tablets/time,3 times/day. Bothgroups were taken orally. aspirin enteric-coated tablets, 0.1 g/time,1 time/day, insulin for injection or oral antidiabetic, simvastatin tablets, 20 mg/time, 1 time/day, and irbesartan tablets, 150 mg/time, 1 time/day.patients in observation group were added with modified Yuquanwan combined with Taohong Siwutang for 24 weeks, 1 dose/day, and a 48-week follow-up visit were paid. Blood glucose, lipid, blood pressure, fasting plasma glucose (FPG), blood sugar 2 h after meal (2 h PG), glycosylated hemoglobin (HbA1c), systolic (SBP) and diastolic pressure (DBP) were detected for every 8 weeks, and at the 8th, 16th, and 24th week after treatment, up-to-standard HbA1c, LDL-C, SBP, DBP and all of those indexes were recorded, and levels of blood glucose, lipids and blood pressure were compared at different time points. During the treatment and within the 72-week follow-up, cardiovascular events, stroke events, peripheral vascular events and microvascular complications were recorded. And levels of tumor necrosis factor-α (TNF-α), homocysteine (Hcy), interleukin-6 (IL-6), hypersensitive C-reactive protein (hs-CRP), endothelin (ET-1) and nitric oxide (NO) were detected, and at the 8th, 16th and 24th week after treatment, body mass index (BMI) was recorded. Result:At the 24th week after treatment, the compliance rate of HbA1c in observation group was 81.16%（56/69）, which was higher than 64.71%（44/68） in control group (χ2=4.701, P<0.05), and the compliance rate of SBP was 94.2%（65/69）, which was higher than 82.36%（56/68） in control group (χ2=4.662, P<0.05). At the 16th week and 24th week after treatment, the compliance rate of LDL-C were 79.71%（55/69） and 88.41%（61/69）, which were higher than 63.24%（43/68） and 70.59%（48/68） in control group (χ2=4.5642, χ2=5.108, P<0.05). At the 16th week, the comprehensive compliance rate (blood glucose, blood pressure, blood lipid) in observation group was 59.42%（41/49）, which was higher than 41.18% （28/68） in control group (χ2=4.559, P<0.05). At the 24th week, the comprehensive compliance rate in observation group was 69.57% （48/69）, which was higher than 51.47% （36/68） in control group (χ2=4.695, P<0.05). At the 16th week, the compliance rate of BMI was 60.87% （42/69）, which was higher than 39.71% （27/68）in control group (χ2=6.136, P<0.05). At the 24th week, the compliance rate of BMI was 72.46% （50/69）, which was higher than 52.94% （36/68） in control group (χ2=5.585, P<0.05). At the 16th week after treatment, levels of 2 h PG and HbA1cin observation group were lower than those in control group (P<0.05). At the 24th week after treatment, levels of FPG, 2 hPG, HbA1c, SBP and DBP were lower than those in control group (P<0.05). Levels of TNF-α, Hcy, IL-6, hs-CRP and ET-1 were lower than those in control group (P<0.01), while level of NO was higher than that in control group (P<0.01). During 72 weeks of observation period, the rate of adverse vascular events in observation group was 13.04%(9/69), which was lower than 30.88%(21/68) in control group (χ2=5.957, P<0.05). Conclusion:In addition to the conventional western medicine therapy, modified Yuquanwan combined with Taohong Siwutang can further control the main cardiovascular risk factors of patients with T2DM, improve the endothelial function of T2DM patients, inhibit the expression of pro-inflammatory factors, and reduce the incidence of adverse vascular events.
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Objective:To establish a mathematical model of total statistical moment, information amount and one-time steady-state feeding quantity of HPLC fingerprint of traditional Chinese medicines (TCMs) and their classical prescriptions, and to carry out experimental verification. Method:The total statistical moment principle, Hardy-Weinberg equilibrium principle and one-time steady-state feeding quantity calculation method were used to study the total statistical moment parameters and one-time steady-state feeding quantity of 15 batches of original medicinal materials, decoction pieces and compound preparations of Taohong Siwutang, these original medicinal materials were from three producing areas. Result:In addition to the total first-order moment, RSD of total zero-order moment, total second-order moment, information entropy and information amount of each medicinal material, decoction piece and compound were all greater than 10%. In the case of single original medicinal material, except for Angelicae Sinensis Radix (142.34 kg), the one-time steady-state feeding quantity calculated according to the RSD change of the accumulated information amount of the whole prescription was the largest (59.10 kg), and according to ratio of the whole prescription, one-time steady-state feeding quantity was the largest (958.57 kg). In the case of processed products, the one-time steady-state feeding quantity of the whole prescription was the largest (73.18 kg) except for Carthami Flos processed with wine (83.28 kg), while according to the whole prescription, one-time steady-state feeding quantity of each processed products was the same as that of the original medicinal material. The one-time steady-state feeding quantity of the compound consisted of the original medicinal materials or processed products was often higher than that of the single medicinal material. Conclusion:The components of TCM are controlled by genetic polymorphism, the chromatographic characteristics (types of components) of Chinese medicine is similar and the intensity of action (content of components) is different. The stability of total first-order moment and information entropy indicates that the overall chemical structure of TCM multi-component system has a stable imprinting trend. The one-time steady-state feeding quantities of each medicinal material in Taohong Siwutang and this compound are far greater than the prescription amount, which can provide reference for the industrial production.
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Objective: To observe the clinical efficacy of Jieyu Tongluo decoction on post-stroke depression (PSD) and its regulatory effect on neurotransmitter. Method: One hundred and twenty-five patients with PSD were randomly divided into control group (62 cases) and observation group (63 cases) by random number table. Both groups got psychological support, health education, and sertraline hydrochloride tablets, 25-50 mg/time, 2 times/days. Patients in control group got Shugan Jieyu capsules, 2 grains/time, 2 times/days. Patients in observation group got Jieyu Tongluo decoction, 1 dose/day. And a course of treatment was 6 weeks. Before and after treatment, hamilton depression scale (HAMD-17), patient health questionnaire-9 (PHQ-9), national institutes of health stroke scale (NHISS),traditional Chinese medicine(TCM) syndrome and activity of daily living scale (ADL) were scored. And levels of 5-serotonin (5-HT), norepinephrine (NE), dopamine (DA), brain-derived neurotrophic factor (BDNF), serum S100-β and neuron enolase (NES) were detected. Result: By rank sum test, after treatment, the clinical efficacy of observation group was superior to that in control group (Z=2.384, PPZ=2.266, PZ=2.817, Pβ and neuron enolase (NES) were lower than those in control group (PPConclusion: In addition to psychotherapy and SSRI, Jieyu Tongluo decoction can relieve degree of depression, depressive symptoms and degree of neurologic impairment, increase activities of daily living, regulate neurotransmitter expression, and improve the reparation of cranial nerve tissue, with obvious clinical effects, and is worthy to be used in clinic.
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Objective: To observe the clinical efficacy of addition and subtraction therapy of Taohong Siwutang combined with Chaihu Shugansan to unstable angina pectoris with type A behavior pattern (Qi stagnation and blood stasis syndrome), and investigate its effects on proinflammatory factors and serotonin (5-HT). Method: One hundred twenty-four patients were randomly divided into control group (60 cases) and observation group(64 cases) by random number table. Patients in control group got Aspirin enteric-coated tablets, 100 mg/time, 1 time/day. Tigrillo tablets, 90 mg/time, 2 times/days. Metoprolol tartrate tablets, 50 mg/time, 2 times/days. Simvastatin tablets, 10 mg/time, 1 time/day. Nitroglycerin tablets, 0.5 mg/time. Based on the treatment in control group, patients in observation group also received addition and subtraction therapy of Taohong Siwutang combined with Chaihu Shugansan, 1 dose/day. The treatment course was 8 weeks in both groups. Number of attacks, duration, degree of pain and usage of nitroglycerin were recorded for every week. Before and after treatment, electrocardiogram was also recorded. And levels of triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), hypersensitive C-reactive protein and 5-HT were detected. In addition, scores of Seattle Angina Scale (SAQ) and Qi stagnation and blood stasis syndrome were graded. Result: In the rank sum test, the curative effect in electrocardiogram of observation group was better than that of control group (Z=1.965, PPPPα and 5-HT in observation group were lower than those in control group (PPConclusion: On the basis of conventional western medicine, addition and subtraction therapy of Taohong Siwutang combined with Chaihu Shugansan can further control angina attack, relieve clinical symptoms, improve quality of life, regulate lipid metabolism, and can inhibit expression of proinflammatory factors and 5-HT, so it can play a role in stabilizing the disease.
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Renal fibrosis is a common pathological change in the later stages of all kidney diseases. It is a multi-cytokine, multi-signal pathway, multi-factor driven chronic kidney disease. It includes renal interstitial fibrosis, tubular sclerosis and glomerular sclerosis, which eventually leads to chronic renal failure. From health through injury to loss of function, the disease process is closely related to the degree of deterioration of renal function and the prognosis of chronic kidney disease. There is no effective western medicine for the treatment of renal fibrosis. Professor HE Liqun from Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine has summarized the Kangxianling decoction through decades of long-term practical experience. It has the effects in strengthening the spleen and replenishing Qi, clearing away dampness and heat, promoting blood circulation and removing phlegm, and strengthening turbidity. It is composed of Salviae Miltiorrhizae Radix et Rhizoma 15 g, Persicae Semen 12 g, Angelicae Sinensis Radix 12 g, Achyranthis Bidentatae Radix 9 g, Rhei Radix et Rhizoma 15 g. Kangxianling can affect the synthesis and secretion of cytokines and inflammatory factors by expanding blood vessels, and can improve renal tubular fibrosis. It has a good multi-channel, multi-target and multi-directional protective effect on renal function. It also can delay the progress of chronic renal fibrosis by significantly alleviating such symptoms as fatigue and edema in patients with chronic renal fibrosis, and reducing serum creatinine, urea nitrogen and urine protein. In this paper, 5/6 nephrectomy, ischemia reperfusion injury, adriamycin-induced nephropathy, unilateral ureteral obstruction and other different modeling methods are listed. The mechanism of Kangxianling decoction in antagonizing renal fibrosis is discussed and summarized, which further provided new ideas and directions for future clinical and scientific research.