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An UPLC-Q-TOF-MS method was employed to characterize and classify the chemical components of the standard decoction of Yiguanjian, a classical famous recipe. Chromatographic separation was performed on an Acquity HSS T3(2.1 mm ×100 mm, 1.8 μm) column with a mobile phase of 0.1% formic acid water-0.1% formic acid acetonitrile using gradient elution. The flow rate was 0.4 mL·min~(-1) and the column temperature was 40 ℃. Mass spectrometry was performed on electrospray ionization source(ESI) with positive and negative ion scanning modes. The potential compounds were identified by comparing the reference compounds, analyzing the mass spectrometry data and matching the published articles on Masslynx 4.1 software and SciFinder database. Finally, a total of 113 compounds, including 11 amino acids, 19 terpenoids, 13 phthalides, 11 steroidal saponins, 10 coumarins, 9 alkaloids, 7 flavonoids, 8 phenylethanoid glycosides, 8 organic acids and 17 other categories were identified. The established method systematically and accurately characterized the chemical components in Yiguanjian, which could provide experimental evidences for the subsequent studies on the pharmacodynamical material basis and quality control of Yiguanjian.
Subject(s)
Chromatography, High Pressure Liquid , Drugs, Chinese Herbal/chemistry , Flavonoids/analysis , Formates , Glycosides/analysis , PrescriptionsABSTRACT
Objective:To observe the clinical efficacy and mechanism of Shugan Bushen Huoxue decoction in the treatment of perimenopausal perio syndrome （PPS） with kidney deficiency， liver depression and blood stasis syndrome. Method:One hundred and twelve patients were randomly divided into control group and observation group according to random number table. Both groups took Remifemin orally， 1 tablet/time， by swallowing in the morning and evening. The patients in control group additionally took Fuke Yangrong capsules， 4 capsules/time， 3 times/day. The patients in observation group additionally took Shugan Bushen Huoxue decoction， 1 dose/day. The course of treatment was 12 weeks in both groups. Before and after treatment， scores were graded for modified Kupperman index （KI）， traditional Chinese medicine （TCM） syndromes， menopausal quality of life scale （MENQOL）， self-rating depression scale （SDS） and self-rating anxiety scale （SAS）. Follicle stimulating hormone （FSH），luteinizing hormone （LH），serum estrogen （E<sub>2</sub>）， 5-hydroxytryptamine （5-HT）， dopamine （DA）， norepinephrine （NE）， 5-hydroxyindole acetic acid （5-HIAA）， endothelin （ET）， and nitric oxide （NO） levels were detected before and after therapy. Result:In the observation group， scores of KI， TCM syndrome， SDS and SAS were lower than those in the control group （<italic>P</italic><0.01）. All dimensions of MENQOL scores in the observation group were lower than those in the control group （<italic>P</italic><0.01）. FSH and LH levels in the observation group were lower than those in the control group， and the E<sub>2</sub> level was higher than that of the control group （<italic>P</italic><0.01）. The levels of 5-HT， 5-HIAA， DA and NE in the observation group were higher than those in the control group （<italic>P</italic><0.01）. The ET level in the observation group was lower than that in the control group， and the NO level was higher than that of the control group （<italic>P</italic><0.01）. In observation group，the clinical efficacy was superior to that in control group （<italic>Z</italic>=2.073<italic>，P</italic><0.05）， and the efficacy of TCM syndromes was also superior to that in control group （<italic>Z</italic>=2.086<italic>，P</italic><0.05）. Conclusion:Shugan Bushen Huoxue decoction in the treatment of PPS in patients with kidney deficiency and liver depression and blood stasis can significantly reduce clinical symptoms， depression and anxiety， regulate the sex hormones， vasomotor factors and monoamine neurotransmitters levels， and improve the quality of life， with obvious clinical efficacy and high safety， so it is worthy of clinical use.
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Objective:To observe clinical effect on chronic atrophic gastritis （CAG） with deficiency of stomach Yin when modified Shaoyao Gancaotang combined with Yiguanjian used on patients， and to study influence to prognostic risk. Method:One hundred and ten cases patients were randomly divided into control group 54 cases and observation group 56 cases. Two groups got treatment of eradication of <italic>Helicobacter pylori </italic>（Hp）. Patients in control group got Yangweishu capsules， 3 grains/time， 2 times/day. Patients in observation groups when Shaoyao Gancaotang combined with Yiguanjian modified， 1 dose/day. The treatment continued for 16 weeks. Before and after treatment， gastroscope was discussed and operative link for gastritis assessment （OLGA） and operative link on intestinal-metaplasia assessment （OLGIM） were recorded， scores of atrophic degree， intestinal metaplasia degree， Hp infection， chronic inflammatory reaction， activity， endoscopic mucosal signs， dyspepsia symptoms， reported outcome patients reported outcomes （PRO） of patients with gastrointestinal diseases were graded. And to test levels of pepsinogenⅠ （PG Ⅰ），PGⅡ， gastrin-17 （G-17）， cytotoxin associated gene A （CagA） and vacuolar cytotoxin （VacA）. Result:The effect of patients treated in observation group was better than the effect of patients received measures in control group （<italic>Z</italic>=2.068， <italic>P</italic><0.05）. Scores of atrophic degree， intestinal metaplasia degree， chronic inflammatory reaction and activity were lower than the scores of patients received measures in control group （<italic>P</italic><0.01）. Levels of OLGA （<italic>Z</italic>=2.037， <italic>P</italic><0.05） and OLGIM （<italic>Z</italic>=2.014， <italic>P</italic><0.05） of patients treated in observation group were better than the levels of patients received measures in control group. And levels of PGⅠ， G-17 and PG Ⅰ/PGⅡ of patients treated in observation group were higher than the dates of patients received measures in control group （<italic>P</italic><0.01）. Positive rates of CagA and VacA were all lower than the dates in control group （<italic>P</italic><0.05）. And gastroscopic mucosal signs and dyspepsia symptoms and scores of PRO were all lower than dates of patients received measures in control group （<italic>P</italic><0.01）. Conclusion:On the basis of eradicating Hp， treatment of Shaoyao Gancaotang with Yiguanjian modified can relieve the clinical symptoms， improve the quality of life of patients， promote mucosal repair， improve the pathological changes， reduce the degree and scope of gastric mucosal atrophy， which is conducive to delay the progression of lesions and reduce the risk of canceration when it used on CAG. It has good clinical efficacy and was worthy of further study
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By systematically sorting out the ancient medical books and modern clinical literature of Yiguanjian， the historical evolution of this formula， including its source， composition， origin， processing， dosage， preparation and usage， functions and indications， evolution of prescription meaning， is textual so as to clarify the historical evolution and clinical application of Yiguanjian. On the basis of fully considering the actual demand of development of famous classical formula preparation and the usage habit of modern clinical practice， the feasible development suggestions were put forward. Yiguanjian is composed of six herbs， which is derived from Yifang Jiedu (《医方絜度》) . It is an ancient book of traditional Chinese medicine edited by QIAN Min-jie in Qing dynasty. The original medicinal plants and medicinal parts of the formula were basically the same as those recorded in the 2020 edition of Chinese Pharmacopoeia. The raw products should be selected for decoction pieces and processed according to the methods recorded in the 2020 edition of Chinese Pharmacopoeia. The reference dose of the medicine in this formula is set out in Yifang Jiedu. According to dosage of one Qian（钱）=3.73 g， the dosages of Glehniae Radix， Ophiopogonis Radix and Angelicae Sinensis Radix were 5.60 g， the dosages of Lycii Fructus and Rehmanniae Radix were 11.19 g， the dosage of Toosendan Fructus was 7.46 g. These decoction pieces were boiled and warm decoction was taken. According to ancient medical records， the formula always has the effect of nourishing Yin and relieving Qi of liver. It is used to treat syndrome of stagnation of liver-Qi and deficiency of liver-Yin and kidney-Yin， which can be seen with pain in chest， stomach and flank， acerbity and vomiting， dry throat and mouth， red tongue， weak pulse or deficiency of string and hernia. Here， the source， processing and others of Yiguanjian were clarified， providing a literature reference for the development and application of this famous classical formula.
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Liver cirrhosis caused by the repeated action of one or more causes is a pathological stage characterized by diffuse fibrosis of the liver parenchyma， formation of false lobules and regenerative nodules， portal hypertension which caused by abnormal blood vessels inside and outside the liver. The progression of cirrhosis to decompensation is characterized by severe liver damage， with ascites， gastroesophageal varices bleeding， hepatic encephalopathy and other complications， and most of the treatments are symptomatic， with high mortality and poor prognosis. At present， the traditional Chinese medicine treatment of decompensated cirrhosis can not only effectively improve liver function， but also significantly improve the 5-year survival rate of patients， which suggests that Chinese medicine has potential advantages in preventing and treating end-stage liver disease， and promoting liver cirrhosis tissue reconstruction. Modern Chinese medicine doctors believe that liver cirrhosis is mainly caused by Qi Yin deficiency （liver， spleen， kidney），internal invasion of damp-heat epidemic toxin， and collateral stasis. Deficiency of liver and kidney Yin is a common symptom of decompensated cirrhosis. Yiguanjian， one of Kidney-Nourishing and Liver-Replenishing decoction in traditional Chinese medicine ， is the representative prescription for modern clinical treatment of chronic liver disease with "deficiency of liver and kidney Yin" syndrome. Yiguanjian， created by WEI Yu-zhen （WEI Zhi-xiu）in the Qing Dynasty， Contained in "Xu Ming Yi Lei An ". Clinical studies show that Yiguanjian can effectively improve liver function in patients with liver cirrhosis， promote ascites resolution， and reduce the occurrence of hepatic encephalopathy and other related complications. Experimental research has suggested that Yiguanjian has the characteristics of multi-path， multi-level， and multi-target comprehensive regulation. The mechanism of prevention and treatment of liver cirrhosis may be mainly related to anti-oxidative stress， improving liver inflammation， improving liver cell biosynthesis， inhibiting hepatic stellate cell activation， reducing collagen deposition， improving sinusoidal vascularization and promoting liver cell regeneration. This paper reviews the progress of clinical and experimental research of Yiguanjian in the treatment of liver cirrhosis in the past 5 years， to provide some references for the clinical application and in-depth study of Yiguanjian.
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The aim of this paper was to observe the function of bone marrow mesenchymal stem cell (BMSC) transplantation in process of liver injury induced by carbon tetrachloride (CCl₄) and the intervention effect of Yiguanjian (YGJ), a compound of Chinese herbal medicine. Wistar rats were randomly divided into five groups: normal group, model group, cell transplantation (CT) group, YGJ group and cell transplantation plus Yiguanjian (CTY) group. Liver injury was induced through subcutaneous injection with CCl₄ at a dose of 3 mL·kg⁻¹ body weight for 4 weeks, twice a week. They were injected for a total of 9 times. After the first injection with CCl₄, rats in the CT group and CTY group were injected with the third-generation BMSCs at dose 1×10⁶ (suspended in 1 mL saline solution) via tail vein. Rats in the YGJ and CTY groups were also intragastrically administered with Yiguanjian once a day. Rat serum ALT and AST activities were increased significantly on the second day after injection with CCl₄, while BMSC transplantation and Yiguanjian decreased their activities. After 4 weeks of injection with CCl₄, serum ALT, AST and -GT activities, and serum TNF- and IL-6 expressions were increased, while TBIL were decreased in model rats compared with normal rats. Meanwhile, liver cells edema, plasmatic loose, and numerous lipid droplets were observed in rats of the model group. BMSC transplantation aggravated liver injury compared with model rats, which was manifested by decreasing SOD activity, increased MDA, TG, TNF- and IL-6 levels, and aggravated necrosis level of hepatocytes, fusion of lipid droplets, and collagen deposition in liver tissue. Yiguanjian decreased liver injury induced by CCl₄ alone and CCl₄ plus BMSC transplantation. SRY gene hybridization method was used to detect the positive SRY expressions in heart, liver, spleen, lung and kidney, especially in liver, while Yiguangjian decreased liver SRY expression. Wnt and -catenin showed high expressions in rats of normal group, which were decreased significantly in rats of models group, while Yiguanjian increased their expressions. In conclusion, BMSC transplantation could exacerbate liver injury, while Yiguanjian could protect liver injury induced by CCl₄ and BMSC transplantation, which was related to decreasing the homing of BMSCs to liver and up-regulating Wnt/-catenin signaling pathway.