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Adult-onset Still's disease (AOSD) is a rare but clinically well-known, polygenic, and systemic autoinflammatory disease, which is characterized by spiking fever, evanescent skin rash, arthralgia, and sore throat. The application of non-steroidal anti-inflammatory drugs and glucocorticoids, which are first-line therapies of AOSD, is limited due to their side effects such as liver injury or disorder of blood glucose. Therefore, patients who suffer from systemic diseases in China prefer to seek help from Chinese herbal medicine (CHM), which is an important part of complementary and alternative medicine. In this case, we report a 28-year-old male badminton coach presenting with a 15-day history of fever and skin rash, accompanied by sore throat, fatigue, myalgia and chills. Additionally, hepatosplenomegaly, multiple lymphadenopathies, aminotransferase abnormality, and elevated inflammatory factor levels were observed during hospitalization. Infectious diseases, solid tumors, hematological diseases, and common autoimmune diseases were excluded. Not benefitting from antibiotic therapy, the patient was finally diagnosed with AOSD, after a careful examination, then showed rapid remission after a six-week treatment with CHM granules based on Xiaochaihu Decoction and Yinqiao Powder. After stopping the treatment, there was no relapse within a 15-month follow-up period. To the best of our knowledge, this is the first well-documented case of this successful treatment. The present case report suggests that CHM is a reliable choice for complementary and alternative therapy for AOSD, but confirming the utility of CHM for AOSD requires further support from prospective studies.
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AIM:To investigate the molecular mechanism of Xijiao Dihuang decoction combined with Yinqiao powder (XDY) in treating viral pneumonia, and the effects of XDY on TNF-α-induced permeability in pulmonary microvascular endothelial cells (PMVEC) and the role of PKC-SSeCKS pathway involved.METHODS:The electric conductivity method was used to detect transendothelial electrical resistance (TER) of primarily cultured PMVEC on Transwell chamber at different time points to determine the permeability of PMVEC.After pretreatment for 24 h, the activity of PKC, TER, and the expression of SSeCKS at mRNA and protein levels were detected.Laser scanning confocal microscopy was used to observe the location of SSeCKS and construction of F-actin in PMVEC.RESULTS:The permeability of PMVECs induced by TNF-α reached the peak at 24 h.Compared with control group, the TER in TNF-α group was decreased, and the activity of PKC was increased.Compared with TNF-α group, the activity of PKC in TNF-α with PKC inhibitor group and TNF-α with XDY group was decreased, while the TER was increased, without difference from control group.Compared with control group, the mRNA expression of SSeCKS and phospho-SSeCKS was increased in PMVEC of TNF-α group, but decreased in TNF-α with XDY group compared with TNF-α group.In control group, F-actin was mainly located around the nucleus and at cytoplasmic borders of PMVEC, forming the dense peripheral bundle, and SSeCKS was evenly scattered in the cell.In TNF-α group, the dense peripheral bundle of F-actin surrounding the cells almost disappeared, and SSeCKS was concentrated around the nucleus.Compared with TNF-α group, the distribution and the structure of F-actin and SSeCKS nearly returned to normal in TNF-α with XDY group.CONCLUSION:XDY inhibits the activation of PKC signaling pathway in PMVEC caused by TNF-α to reduce the mRNA expression of SSeCKS and the phosphorylation of SSeCKS, thus preventing the deformation of endothelial cells and reducing the permeability of PMVEC.
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Objective To compare the efficacy difference of Green Forsythiae Fructus and Ripe Forsythiae Fructusby using Lianqiao powder and Yinqiao powder in the classic formula; To provide experimental evidence for the guidance of one for dual-use of the Forsythiae Fructus. Methods The guinea pig sore model was made with Staphylococcus aureus. 40 guinea pigs were randomly divided into blank group, model group, Lianqiao powder Green Forsythiae Fructus group and Lianqiao powder Ripe Forsythiae Fructus group. The blank group and the model group were fed with normal saline, while Lianqiao powder Green Forsythiae Fructus group and Lianqiao powder Ripe Forsythiae Fructus group were treated with 1.2 g raw medicine/kg liquid Lianqiao powder Green Forsythiae Fructus and Lianqiao powder Ripe Forsythiae Fructus for 7 d. The symptom score, blood and pathological changes of guinea pig soreness were observed. The model of acute lung injury was induced by 10% LPS aerosol inhalation. 40 rats were randomly divided into blank group, model group, Yinqiao powder Green Forsythiae Fructus group and Yinqiao powder Ripe Forsythiae Fructus group. The blank group and the model group were fed with normal saline, while Yinqiao powder Green Forsythiae Fructus group and Yinqiao powder Ripe Forsythiae Fructus group were treated with 4 g raw medicine/kg liquid Yinqiao powder Green Forsythiae Fructus and Yinqiao powder Ripe Forsythiae Fructus for 10 d. The levels of IL-6, TNF-α and IL-1β in the lung lavage fluid were detected. Results The effect of Lianqiao powder Green Forsythiae Fructus on the wound healing of guinea pig sore wound was faster than that of Lianqiao powder Ripe Forsythiae Fructus, but there was no significant difference between Lianqiao powder Green Forsythiae Fructus group and Lianqiao powder Ripe Forsythiae Fructus group in inhibiting the secretion and pathological changes of guinea pig sore wound. The levels of IL-6, TNF-α and IL-1β in Yinqiao powder Green Forsythiae Fructus group was lower than that in Yinqiao powder Green Forsythiae Fructus group, without statistical significance. Conclusion It is verified that there is efficacy differences between Green Forsythiae Fructus and Ripe Forsythiae Fructus in the different Chinese herbal compound.
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To establish a method for the determination of chemical specific chromatograms and five components in Yinqiao powder decoction, and provide basis for elucidating the scientific connotation of ″taking in when the fragrance volatilized fiercely″. Yinqiao powder decoctions with different decocting times were prepared to study the changes of chemical components during decocting process. Specific chromatograms and contents of chlorogenic acid, phillyrin, arctiin, liquiritin and glycyrrhizin were determined by high performance liquid chromatography. According to the results, the similarities of Yinqiao powder decoctions with different decocting times were high, which indicated that their chemical compositions were similar. The dissolutions of the five components in Yinqiao powder reached more than 39.7% of 2 hour maximum dissolution amounts (MDA) after 20 minutes of soaking, more than 69.5% of MDA when boiling, more than 79.1% of MDA at the 5th minute after boiling, and more than 85.7% of MDA at the 10th minute after boiling. The concentrations of five components were not increasing obviously after 15 minutes of boiling (RSD<4.3%). The fragrance volatilized fiercely at about the 5th minute after boiling, which indicated that the contents of volatile components in Yinqiao powder decoctions were high, but it became weak after boiling for 15 minutes, which indicated that the contents of volatile components in Yinqiao powder decoctions were low. The results showed that the contents of five components in Yinqiao powder decoctions were heavily influenced by the decocting time. When boiling for about 5 minutes, the fragrance volatilized fiercely, both the contents of volatile components and non-volatile components were high. It is suggested that the traditional decocting method has a certain scientific basis.
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To establish a method for the determination of three volatile components: menthone, menthol and pulegone in Yinqiao powder (YQP) decoction, explore the change rules of volatile components in decocting process, and provide evidence for elucidating the scientific connotation of its traditional decocting method "taking when the fragrance is volatilized fiercely". YQP decoctions with different decocting time were prepared, and GC-MS was used to qualitatively analyze the volatile components and determine the contents of menthone, menthol and pulegone in decoctions. Then the effects of different decocting time on contents of volatile components were investigated. The results showed that the volatile components in YQP decoctions mainly come from Menthae Haplocalycis Herba, Schizonepetae Herba and Forsythiae Fructus. With the extension of decocting time, the concentrations of all the above 3 volatile components in Yinqiao powder decoction were first increased and then decreased. When soaking for 30 minutes, as well as boiling for 0, 5, 10, 15, 20, 30, 40, 50, 60 minutes, the concentrations of menthone in YQP decoction were 0.058, 0.268, 0.216, 0.073, 0.065, 0.048, 0.048, 0.041, 0.038, 0.034 mg•L ⁻¹; the concentrations of menthol were 0.965, 2.847, 3.633, 2.420, 1.539, 1.189, 1.273, 1.188, 0.905, 0.663 mg•L ⁻¹; the concentrations of pulegone were 0.355, 0.522, 0.598, 0.477, 0.374, 0.374, 0.339, 0.355, 0.248, 0.251 mg•L ⁻¹; and the total concentrations were 1.377, 3.637, 4.446, 2.970, 1.979, 1.611, 1.660, 1.583, 1.191, 0.947 mg•L ⁻¹, respectively. The results showed that the contents of menthone, menthol and pulegone in YQP decoctions were heavily influenced by the decocting time. The fragrance was volatilized fiercely at about 5 minutes after boiling, with larger concentrations of the above three volatile components in decoction; the fragrance got weak after 15 minutes of boiling, the concentrations of menthone, menthol and pulegone in YQP decoctions were significantly decreased, indicating that the traditional decocting method "taking when the fragrance is volatilized fiercely" has some scientific foundation.
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Objective To observe the effect ofYinqiao Powder on the mouse models with upper respiratory trace mucosal immunity dysfunction infected with influenza virus A, and explore mechanism of action.Methods The mouse models of upper respiratory trace mucosal immunity dysfunction induced by cold stimulation with the influenza A/PR/8/34 (H1N1) virus through the nasal cavity were established. The mice were randomly divided into normal group, model group, positive medicine (Ribavirin) group, andYinqiao Powder group. All administration groups received gavage with relevant medicine, and then mortality, the life prolonging rate, average survival time and the lung index of each group were observed.Results Compared with the model group, the mortalities in positive medicine group andYinqiao Powder group decreased significantly (P<0.05,P<0.01), with longer survival time. The lung indexes in positive medicine group andYinqiao Powder group decreased significantly (P<0.05,P<0.01), and the inhibition ratios of lung index were 35.5% and 24.6%, respectively.ConclusionYinqiao Powder can realize the protective effects on upper respiratory infection through upregulating the mucosal immunity of the upper respiratory tract of mouse models.
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Objective To justify the clinical use of traditional Chinese materia medica (TCMM) in the treatment of influenza.Methods The literature on treatment of influenza published before December 31, 2013 was searched in MEDLINE, EMBASE, CBMdisk, Chinese National Knowledge Infrastructure (CNKI) and Wanfang Database.Results A total of 7 randomized controlled trials were identified and reviewed. Based on the meta-analysis, Yinqiao Powder prescription had similar effect to oseltamivir in defervescence [WMD=5.66, 95%CI (-32.02, 43.35), P=0.77] and viral shed-ding [WMD=-6.21, 95%CI (-84.19, 71.76), P=0.88], and Lianhuaqingwen also had similar effect in viral shed-ding [WMD=-0.24, 95%CI (-4.79, 4.31), P=0.92] but was more effective in defervescence [WMD=-4.65, 95%CI (-8.91, -0.38), P=0.03].Conclusion TCMM has a potential positive effect in the treatment of influenza.
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Objective To observe the clinical efficacy of Oseltamivir combined with Chinese medicine for the treatment of influenza. Methods One hundred and ninety-seven cases confirmed as influenza were randomly divided into treatment group ( N=101) and control group ( N=96) . Both groups were given conventional symptomatic and supportive treatment. Additionally, the treatment group received Oseltamivir and Chinese medicine based on syndrome differentiation, and the control group was given Oseltamivir orally. The treatment lasted 5 days. The clinical outcomes included incidence of flu symptoms, time for body temperature decreasing to the normal and time for the relief of all symptoms in both groups. Results ( 1) The total effective rate of the treatment group was 98.0%, superior to 91.7%of the control group (P<0.05) . (2) The treatment group had an effect on sub-siding fever and relieving symptoms more quickly than the control group, the differences being significant (P<0.05 or P<0.01) . ( 3) The treatment group could relieve flu symp toms of sore throat, muscular soreness, cough, nasal obstruction and discharging more effectively, and the differences were significant compared with the control group (P<0.05) . Conclusion The overall effect of Oseltamivir combined with Chinese medicine is better than Oseltamivir alone, showing the advantages of subsiding fever in a relatively short period of time and relieving flu symptoms more effectively.
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OBJECTIVE: To establish a method for the determination of chlorogenic acid, phillyrin, arctiin, liquiritin and glycyrrhizin in Yinqiao Powder. METHODS: High performance liquid chromatography was performed on a Kromasil C18 column (4.6 mm × 250 mm, 5 μm) at 30°C. The mobile phase was acetonitrile -0.4% phosphoric acid solution with gradient elution. The flow rate was 1.0 mL · min-1 and the detection wavelength was set at 230 nm. RESULTS: Chlorogenic acid, phillyrin, arctiin, liquiritin and glycyrrhizin had good liner relationship in the ranges of 0.0394-0.788, 0.0205-0.410, 0.068-1.36, 0.0348-0.697 and 0.0376-0.752 μg, respectively. The correlation coefficients were all more than 0.9996. The average recoveries were 101.3% (RSD=1.5%), 99.5% (RSD=1.2%), 98.7% (RSD=1.9%), 96.7% (RSD=2.3%) and 98.2% (RSD=2.0%), respectively. CONCLUSION: This method is convenient, rapid, accurate, reliable and has good reproducibility, which can be used for the determination of chlorogenic acid, phillyrin, arctiin, liquiritin and glycyrrhizin in Yinqiao Powder. This study provides scientific basis for the quality evaluation of Yinqiao Powder and preparations of the same kind.
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Objective To compare the four kinds of Yinqiao Powder prepared by archaic decoction,Japan standard decoction,medical institution decoction and decoction combined archaic with modern technology,select the best method and provide the important theory basis for standardization of decoction technics of diaphoretic recipes.Methods The major contents of traditional Chinese medicine were determined by HPLC and used as the evaluating indicator as well as the ratio of dry extraction.Results The method of archaic decoction got the highest synthetic scores,and the validating experimental result was stable.Conclusion The preparation method of archaic decoction could be used as the reference standard for preparation technology of Yinqiao Powder,in order to further standardize the preparation of the standard decoction of diaphoretic recipes.