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ObjectiveTo explore the possible mechanism of Yupingfeng Granules (玉屏风散) in preventing and treating chronic obstructive pulmonary disease (COPD) from the perspective of “lung-gut axis”. MethodsThirty-two male Wistar rats were randomly divided into normal group,model group, roxithromycin group and Yupingfeng Granules group, with 8 rats in each group. Except for the normal group, the rat model of COPD was prepared by intratracheal instillation of lipopolysaccharide (LPS) combined with smoking for 12 weeks. Since the fifth week of modeling,the roxithromycin group and the Yupingfeng Granules group were given 31.5 mg/(kg·d) and 1.575 g/(kg·d) of corresponding drugs respectively by gavage,and normal group and model group were given 10 ml/(kg·d) physiolo-gical saline. Sample was collected 24 hours after the last administration. The pathological changes of lung tissue were observed using HE staining; Ultrahigh performance liquid chromatography quadrupole time of flight mass spectrometry (UHPLC-QTOFMS) was used to detect the differential metabolites in alveolar lavage fluid (BALF) in all groups but roxithromycin group;16S rDNA sequencing technology was used to detect the changes of intestinal flora, and the association analysis was conducted between the differential metabolites and the differential flora. ResultsCompared with the normal group, the model group showed an increase in goblet cells in the small bronchial wall, disappearance of the smooth muscle layer of the bronchial wall, and infiltration of inflammatory cells; compared with the model group, roxithromycin group showed slight alveolar interstital edema, and obviously reduced inflammatory cell, while no obvious alveolar interstital edema was observed in the Yupingfeng Granules group, showing a small amout of inflammatory cell infiltration. The results of the BALF differential metabolite screening showed that compared with the normal group, 12 substances were upregulated and 19 substances were downregulated in the model group; compared with the model group, 37 substances in the Yupingfeng Granules group were upregulated and 43 substances were downregulated KEGG analysis yielded a total of 2 metabolic pathways, glycerophospholipid metabolism, and unsaturated fatty acid biosynthetic metabolism; compared with the model group, choline, acetylcholine, glycerol-3-phosphate, glycerophosphate choline, palmitic acid, and arachidonic acid showed an upward trend, while stearic acid and docosahexaenoic acid showed a downward trend in Yupingfeng Granules group (P<0.05). The results of the intestinal flora showed that, there are 80 different species between the normal group and the model group, and 65 different species between the model group and Yupingfeng Granules group. Among the top 5 species with relative abundance levels,compared with the model group, the level of Prevotella_9,Ruminococcaceae_UCG-005,Ruminiclostridium_6 increase,and Lactobacillus,Bacteroides decrease(P<0.05).The results of the correlation analysis showed that, in the normal and model groups, arachidonic acid was negatively correlated with Oribacterium(r=-0.753,P<0.01); in the Yupingfeng Granules group and model group, stearic acid and Bacteroides(r=0.788), Mycobacterium(r=0.826),[Eubacterium]_Ruminantium_Group(r=0.770) was positively correlated(P<0.01), Arachidic acid was negatively correlated with Roseiarcus(r=-0.779), glycerol-3-phosphate was negatively correlated with Desulfovibrio(r=-0.758), Arachidonic acid was negatively correlated with Oribacterium(r=-0.753), and Palmitic acid was negatively correlated with Pseudolabs(r=-0.750,P<0.01). ConclusionYupingfeng Granules can affect the metabolism of BALF and the flora structure of intestinal microorganisms, and regulating the balance of “lung-gut axis” may be one of the mechanisms of Yupingfeng Granules in treatment of COPD.
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OBJECTIVE To explore the effects of Yupingfeng granules on the improvement of epithelial barrier function and the inhibition of tumor metastasis by regulating epithelial-mesenchymal transition (EMT). METHODS Thirty C57BL/6 mice were randomly divided into the normal group (distilled water),model group (distilled water) and Yupingfeng granule group (40 g/kg), with 10 mice in each group. The model group and Yupingfeng granule group were inoculated with Lewis lung cancer cells subcutaneously in the right armpit to induce the spontaneous lung metastasis model. After modeling,each group was given water/ relevant medicine intragastrically,once a day,for 15 consecutive days. The effects of Yupingfeng granules on tumor metastasis were investigated by observing or determining the pathomorphology of lung tissue,metastatic lesion count on the surface of the lung, tumor metastatic lesion and the expression of carcinoembryonic antigens. qRT-PCR and Western blot assay were used to detect the mRNA and protein expressions of β-catenin,E-cadherin and vimentin in the lung tissue of mice. RESULTS Compared with the model group,the total number of pulmonary metastases on the surface was decreased significantly in Yupingfeng granule group (P< 0.05),the general morphology of lung tissue was recovered,and the expression of carcinoembryonic antigen in lung tissue was significantly decreased (P<0.05). mRNA and protein expressions of E-cadherin in lung tissue were significantly increased (P< 0.05),while mRNA and protein expressions of vimentin and β-catenin were significantly decreased (P<0.05). CONCLUSIONS Yupingfeng granules can inhibit EMT by regulating the expression of β-catenin,thus improving epithelial barrier function,and inhibiting the ability of tumor cells to invade and metastasize.
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Objective To evaluate the efficacy and safety of modified Yupingfeng granules(MYG)combined with probiotics in the treatment of patients with chronic spontaneous urticaria(CSU).Methods Patients with CSU who attended Guang'anmen Hospital,China Academy of Chinese Medical Sciences from June 2021 to June 2023 were enrolled.According to the random number table method,CUS patients were divided into MYG group(loratadine combined with MYG)and MYGP group[loratadine combined with MYG and probiotics(live combined bacillus subtilis and enterococcus enteric-coated capsules)].The urticaria activity score(UAS7),dermatological life quality index(DLQI)and TCM pattern score were used to evaluate the efficacy.The differential levels of inflammatory factors[serum interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)]and immune factors(peripheral blood CD3+,CD4+,CD8+,CD4+/CD8+ levels),IgE were detected and compared before and after treatment.The treatment efficacy betwenen tow groups and occurrence of adverse reactions during treatment was observed and compared.Three months after the completion of treatment,the recurrence of the two groups was compared.Results A total of 240 patients with CSU were included in the study,including 120 patients in the MYG group and 120 in the MYGP group.After treatment,USA7,DLQI,TCM pattern score,IL-6,TNF-α,CD8+ and IgE in the MYGP group were significantly lower than those in the MYG group,while CD3+,CD4+ and CD4+/CD8+ were significantly higher than those in the MYG group(P<0.05).The total effective rate of CSU patients in the MYGP group was significantly higher than that in the MYG group(P<0.05),while the incidence of adverse reactions and recurrence were significantly lower than those in the MYG group(P<0.05).Conclusion The efficacy of probiotics combined with MYG adjuvant therapy for CSU is significantly better than that of MYG monotherapy adjuvant therapy,which can significantly improve the treatment effect,reduce inflammatory factors,regulate immune function,improve quality of life,reduce the recurrence rate and adverse reaction rate of CSU,and have high safety.
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Objective:To investigate the efficacy of Yupingfeng granule combined with cetirizine in the treatment of allergic rhinitis and its effects on serum inflammatory factor level. Methods:A total of 162 patients with allergic rhinitis admitted to Zhejiang Provincial Hospital of Chinese Medicine from January 2021 to March 2022 were included in this prospective controlled study. They were randomly divided into a control group and an observation group ( n = 81/group). The control group was treated with cetirizine and the observation group was treated with Yupingfeng granule combined with cetirizine. All patients were treated for 4 weeks. Clinical efficacy was compared between the two groups after 4 weeks of treatment. Main symptom score, nasal function indexes (total nasal airway resistance, nasal minimal cross-sectional area, and 0-5 cm nasal cavity volume), levels of inflammatory factors (interleukin-4, interleukin-6, and interleukin-10), and Rhinoconjunctivitis Quality of Life Questionnaire scores were compared between the two groups before and after 4 weeks of treatment. Results:Total response rate in the observation group was significantly higher than that in the control group [92.59% (75/81) vs. 79.01% (64/81), χ2 = 6.13, P < 0.05]. After 4 weeks of treatment, the scores of nasal congestion, nasal itching, and sneezing in the observation group were (0.63 ± 0.20) points, (0.70 ± 0.21) points, and (0.54 ± 0.17) points, which were significantly lower than (1.07 ± 0.23) points, (1.08 ± 0.24) points, and (0.89 ± 0.22) points in the control group ( t = 12.99, 10.72, 11.33, all P < 0.05). After 4 weeks of treatment, total nasal airway resistance in the observation group was significantly lower than that in the control group [(0.17 ± 0.05) kPa·s -1·L -1vs. (0.26 ± 0.06) kPa·s -1·L -1, t = 10.37, P < 0.05]. Nasal minimal cross-sectional area and 0-5 cm nasal cavity volume in the observation group were (0.94 ± 0.17) cm 2 and (9.74 ± 0.89) cm 3, respectively, which were significantly higher than (0.76 ± 0.10) cm 2 and (8.43 ± 0.78) cm 3 in the control group ( t = 8.21, 9.96, both P < 0.05). After 4 weeks of treatment, serum levels of interleukin-4 and interleukin-6 in the observation group were (67.79 ± 9.94) ng/L and (6.74 ± 1.42) ng/L, respectively, which were significantly lower than (104.31 ± 14.45) ng/L and (10.29 ± 2.56) ng/L in the control group ( t = 18.74, 10.91, both P < 0.05). Serum level of interleukin-10 in the observation group was significantly higher than that in the control group [(17.97 ± 2.54) ng/L vs. (12.48 ± 2.46) ng/L, t = 13.97, P < 0.05]. After 4 weeks of treatment, Rhinoconjunctivitis Quality of Life Questionnaire score in the observation group was significantly lower than that in the control group [(27.43 ± 8.82) points vs. (38.95 ± 7.76) points, t = 8.82, P < 0.05). Conclusion:Yupingfeng granule combined with cetirizine is highly effective on allergic rhinitis. The combined therapy can reduce clinical symptoms and inflammatory reactions, improve nasal function, and thereby improve quality of life.
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To evaluate the effectiveness and safety of Yupingfeng Granules in the treatment of recurrent respiratory tract infection.Six Chinese and English databases were retrieved,namely CNKI,Wan Fang,VIP,CBM,PubMed and Cochrane Library. Randomized controlled trials of Yupingfeng Granules in the treatment of recurrent respiratory tract infection were collected and screened. According to the evaluation criteria and tools of Cochrane,the heterogeneity among the studies was analyzed,and the Meta-analysis was carried out by Rev Man 5.3 software. A total of 16 studies were included in this study,with a total sample size of 1 788 cases,including 901 cases in the experimental group and 887 cases in the control group. Among them,11 intervention measures were Yupingfeng Granules combined with Western medicine routine vs routine Western medicine,and 5 research interventions were Yupingfeng Granules combined with pidomod vs pidomod based on routine therapy. Meta-analysis showed that the total effective rate of Yupingfeng Granules combined with Western medicine in the treatment of recurrent respiratory tract infection was better than that of Western medicine( RR= 1. 27,95%CI[1. 21,1. 34],P<0. 000 01). Based on the routine therapy,the total effective rate of Yupingfeng Granules combined with pidomod in the treatment of recurrent respiratory tract infection was better than that of pidomod( RR = 1. 23,95% CI[1. 13,1. 35],P<0. 000 01). A total of 21 cases of adverse events were reported in this study,including 6 cases in the experimental groups combined with traditional Yupingfeng Granules therapy and conventional Western medicine therapy and 15 in the control group. The adverse events were mainly gastrointestinal reactions,such as fatigue,nausea and diarrhea,which can tolerate or disappear with no impact on treatment. The incidence of adverse events in the two groups was not statistically significant( RR = 0. 44,95% CI[0. 19,1. 03],P = 0. 06). The results showed no significant difference in the incidence of adverse events between the two groups during treatment. Based on the routine therapy,no adverse event was reported in Yupingfeng Granules pidomod vs pidomod,indicating that both groups were safe. The analysis showed that Yupingfeng Granules combined with routine Western medicine therapy or combined with pidomod could increase the level of immunoglobulin and T lymphocytes in children. Based on the existing data and methods,Yupingfeng Granules combined with routine Western medicine therapy for recurrent respiratory tract infection can improve the total effective rate,immune function and body immunity,with no serious adverse reaction. However,because of the low quality of the literatures included in this study,it is still necessary to adopt well-designed large-sample clinical trials in conformity to international standards to improve the quality of evidence.
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Child , Humans , Male , Drugs, Chinese Herbal/therapeutic use , Respiratory Tract Infections/drug therapyABSTRACT
Objective To analyze the clinical efficacy of Yupingfeng Granules combined with nutrition support for the treatment of children with hand-foot-mouth disease (HFMD) reinfection. Methods A total of 100 children with reinfection of HFMD were randomly divided into treatment group and control group. The treatment group was given Yupingfeng Granule or oral liquid combined with individualized nutritional support on the basis of routine treatment, while the control group was given routine treatment only. Results There was no significant difference in total effective rate between the treatment group and the control group in 50 children with reinfection of HFMD (P > 0.05). But fever subsided time, rash subsided time, and recovery in treatment group were shorter than those in the control group, the difference was statistically significant (P < 0.05). Conclusion Yupingfeng combined nutrition support has good clinical effects on children with HFMD reinfection.
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OBJECTIVE: To investigate the effects of Yupingfeng granules on immune function and related indexes of children with allergic rhinitis (AR) complicated with bronchial asthma (BA). METHODS: Clinical information of 101 children with AR complicated with BA during Feb. 2014-Sept. 2017 were analyzed retrospectively, and they were divided into control group (47 cases) and observation group (54 cases) according to treatment plan. Control group was given Salmeterol xinafoate and fluticasone propionate powder for inhalation through mouth, one inhalation, twice a day+Mometasone furoate nasal spray 50 μg each nostril. Observation group was additionally given Yupingfeng granules 5 g orally, 3 times a day, for consecutive 2 weeks, drug withdrawal at 2 weeks interval, recycled 3 times. Both groups received treatment for consecutive 3 months. Clinical symptom and sign scores, the levels of T-lymphocyte subgroup (CD4+, CD8+, CD4+/CD8+), IL-4, IFN-γ and IgE before and after treatment, the occurrence of ADR were observed in 2 groups. RESULTS: Before treatment, there was no statistical significance in clinical symptom and sign scores, levels of T-lymphocyte subgroup, serum levels of IL-4, IFN-γ or IgE between 2 groups (P>0. 05). After treatment, clinical symptom and sign scores, CD4+, CD4+/CD8+, serum levels of IL-4 and IgE in 2 groups were all significantly lower than before treatment; observation group was significantly lower than control group. CD8+ and serum levels of IFN-y in 2 groups after treatment were significantly higher than before treatment; observation group was significantly higher than control group, with statistical significance (P<0. 05). There was no statistical significance in the incidence of ADR between 2 groups (P>0. 05). CONCLUSIONS: Yupingfeng granules can effectively improve immune function of children with AR complicated with BA, and relieve clinical symptom without increasing the occurrence of ADR.
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OBJECTIVE:To investigate the improvement effects of andrographolide dripping pills combined with Danxi yup-ingfeng granules on immunologic function of children with allergic rhinitis(AR). METHODS:Two hundred and eight AR children were randomly divided into control group,observation groupⅠ,observation groupⅡ,observation groupⅢ,with 52 cases in each group. Control group was given Loratadine syrup 10 mL,qd;observation groupⅠwas given Danxi yupingfeng granules 15 g,bid+Andrographolide dripping pills 0.6 g,tid;observation groupⅡwas given constant dose of Andrographolide dripping pills;observa-tion groupⅢwas given constant dose of Danxi yupingfeng granules. Four groups were treated for 2 weeks. 2 weeks later,they were given Loratadine syrup orally if the symptom appeared again. The levels of IgE and Th1/Th2 were compared among 4 groups be-fore treatment,1,2 weeks after treatment,3 months after the end of treatment. The children receiving Loratadine syrup orally due to the recurrence of AR 3 months after the end of treatment were observed. RESULTS:Before treatment,there was no statistical significance in serum levels of IgE and Th1/Th2 among groups(P>0.05). One week after treatment,serum levels of IgE and Th1/Th2 were improved significantly,with statistical significance (P0.05). 2 weeks after treatment,serum levels of IgE and Th1/Th2 were improved significantly,and the observation groups were significantly better than the control group,with statistical significance(P0.05). The recurrence rate of ob-servation groupⅠwas significantly lower than that of observation groupⅡ,observation group Ⅲ and control group,with statistical significance(P<0.05). No obvious ADR was found in 4 groups. CONCLUSIONS:Andrographolidume dripping pills combined with Danxi yupingfeng granules can effectively improve immunologic function of AR children and reduce recurrence rate with good safety.
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Objective To explore the clinical effect of corticosteroids combined with Chinese medicine sequential therapy of Guishao Dihuang pill and Yupingfeng granules on children nephrotic syndrome (NS) with yin deficiency of liver and kidney.Methods Fifty patients (the loss of children during the course of treatment were not included in the statistical analysis) with definitely diagnosed NS accompanied by yin deficiency of the liver and kidney admitted to the First Affiliated Hospital of Gannan Medical University from January 2012 to June 2016 were enrolled,and they were divided into control group and observation group by random number table,25 cases in each group.Conventional treatment of western medicine and long-term treatment of corticosteroids were given to the two groups.In addition,sequential therapy of Guishao Dihuang pills and Yupingfeng granules was given to the observation group on the bases of conventional treatment.The changes of platelet aggregation rate (PAT),cholesterol,cortisol,T cell subsets CD3,CD4,CD4/CD8 were observed before and after treatment for 8 weeks and 6 months,then the clinical efficacy and infection,etc.complications were compared between the two groups.Results There were no statistical significant differences in cholesterol,cortisol and curative effect compared between the two groups before treatment and after treatment for 8 weeks and 6 months (all P > 0.05).Mter treatment for 8 weeks and 6 months,the PAT,cholesterol,cortisol of two groups were significantly decreased compared with those before treatment,while CD3,CD4 were obviously higher than those before treatment,and the degrees of changes of PAT,CD3,CD4 in the observation group were more remarkable than those of the control group [PAT:treatment after 8 weeks was (63.01 ± 6.99)% vs.(66.62 ± 4.65)%,treatment after 6 months was (51.42 ± 7.74)% vs.(57.01 ± 6.77)%,CD3:treatment after 8 weeks was 0.56 ± 0.06 vs.0.52± 0.06,treatment after 6 months was 0.61 ± 0.05 vs.0.58 ± 0.03,CD4:treatment after 8 weeks was 0.33 ± 0.06 vs.0.30 ± 0.05,treatment after 6 months was 0.39 ± 0.05 vs.0.33 ± 0.06,all P < 0.05].CD4/CD8 ratio was significantly higher in observation group after treatment for 8 weeks and 6 months than those before therapy (1.68 ± 0.76,1.82 ± 0.95 vs.1.16 ± 0.67,both P < 0.05);the number of patients with infection in observation group was obviously lower than that of the control group (86 cases vs.175 cases,P < 0.05).Conclusions The therapeutic effect of corticosteroids combined with Chinese medicine sequential therapy of Guishao Dihuang pills and Yupingfeng granules for treatment of children NS with yin deficiency of the liver and kidney is better than that of using western medicine therapy alone,as the combined sequential therapy has good effects on reduction of infection,anti-thrombosis and elevation of immunity.
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ObjectiveTo evaluate clinical efficacy ofYupingfeng Granules combined with western medicine for children with recurrent respiratory tract infection (RRTI).Methods CNKI, VIP, WANFANG DATA, SinoMed, PubMed, Embase, and Cochrane Library were searched for the randomized controlled trials (RCTs) that investigated the clinical and immune effects ofYupingfeng Granules in children with RRTI from inception to October 2015. Two researchers independently screened studies according to the inclusion and exclusion criteria, extracted data and evaluated the methodological quality of included studies. Then Meta analysis was performed through the software RevMan 5.3.Results A total of 8 articles involving 550 patients were included. The results of Meta analysis showed effective rate ofYupingfeng Granules combined with western medicine for children with RRTI [OR=4.16, 95%CI (2.49, 6.95),P0.05). ConclusionYupingfeng Granules combined with western medicine can improve effective rate, antibody level and T-cell level in the treatment of children with RRTI. The overall clinical efficacy is better than single western medicine treatment. However, RCTs with large samples, multiple centers and high quality are needed for further verification.