ABSTRACT
Stroke is a destructive cerebrovascular event caused by the interruption of cerebral blood flow caused by the blockage or rupture of cerebral vessels， which is easy to cause physical disability and multiple functional injuries. The mortality rate of stroke patients in China occupies the first place in the world. How to effectively treat stroke is one of the urgent health problems to be solved. In the clinic， academician WANG Yong-yan observed that 60% of stroke patients with heat-phlegm and sthenic-Fu syndrome. Most of the patients with heat-phlegm and sthenic-Fu syndrome are characterized by stagnation of stool， bad breath and dry pharynx， and so on， After clinical practice， Xinglou Chengqi decoction （XLCQD） was established to treat stroke patients with heat-phlegm and sthenic-Fu syndrome. XLCQD is one of the representative prescriptions for removing phlegm to relax bowels， which is composed of Rhei Radix et Rhizoma， Natrii Sulfas， Trichosanthis Fructus and Arisaema Cum Bile by the ratio of 5∶5∶15∶3. At present， the research on XLCQD is mainly focused on clinical observation and pharmacological mechanism， while the basic research of its pharmacodynamic substance is relatively weak. This paper intends to sort out the chemical composition and pharmacological mechanism of XLCQD， in order to provide the basis for the chemical component identification， drug target prediction and material basis screening of this compound in the later stage. In addition， through the case analysis of XLCQD and modified XLCQD in the treatment of stroke， its rules of clinical application were summarized， in order to provide reference for the clinical application of this compound.
ABSTRACT
Objective To study the effects of Baihu Rensen decoction combined with Fufang Xiebai capsules for treatment of patients with severe pneumonia accompanied by heat-phlegm and sthenic-fu syndrome.Methods A prospective study was conducted; 266 severe pneumonia cases with heat-phlegm and sthenic-fu syndrome admitted into the Department of Respiratory Diseases in Kunshan Hospital Affiliated to Jiangsu University from January 2012 to December 2013 were selected. The patients were randomly divided into a integrated traditional Chinese and western medicine group (136 cases) and a western medicine treatment group (130 cases). Both groups were given basic conventional western medicine according to the disease situation. The integrated traditional Chinese medicine (TCM) was additionally given Baihu Rensen decoction combined with 350 mg of Fufang Xiebai capsules, 3 times a day, 4 grain each time, 7 days constituting a course of treatment. The rate of body temperature descent, the degree of improvement in clinical TCM symptoms, peripheral white blood cell (WBC) count, neutrophil percentage and the situation of endogenous pyrogen production in the two groups were compared.Results After treatment, the body temperature, TCM symptom scores, WBC count and neutrophil percentage were lower than those before treatment, 3 days after treatment these data reached their valley values, and the decrease in level was more significant in the combination group [body temperature (℃): 36.5±0.0 vs. 37.0±0.0, TCM symptom scores: 1.7±0.2 vs. 6.1±0.7, WBC (×109/L): 7.1±0.3 vs. 8.3±0.5, neutrophil percentage: 0.64±0.02 vs. 0.76±0.23, allP < 0.05]. Interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), interferon (IFN-α, IFN-γ), and interleukin-6 (IL-6) level in western medicine (WM) group was respectively marked 1, the levels of IL-1β, TNF-α, IFN-α, IFN-γ, and IL-6 in combination group after treatment for 6 hours were significantly lower than those of WM group, and reached the valley at 12 hours (the relative expression value of each of the above indexes in combination group to each of those in WM group was 0.37, 0.16, 0.21, 0.27 and 0.15 respectively), and had a mild rebound at 24 hours.Conclusion By the addition of Baihu Rensen decoction combined with Fufang Xiebai capsules on conventional basic medicine for treatment of severe pneumonia patients with heat-phlegm and sthenic-fu syndrome, the therapeutic effect is much better.