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OBJECTIVE： To systematically evaluate therapeutic efficacy of modified Cangfu daotan decoction （MCDD） combined with chemical medicine versus chemical medicine alone in the treatment of polycystic ovarian syndrome （PCOS）， and to provide evidence-based reference for clinical decision. METHODS： Retrieved from PubMed， Embase， Cochrane Library， CJFD， Wanfang database， VIP and CBM， randomized controlled trials （RCTs） about MCDD combined with chemical medicine [ethynestradiol cycloprogesterone （Diane-35）， clomiphene， metformin] （trial group） versus chemical medicine alone （control group） in the treatment of PCOS were collected. After data extraction and quality evaluation with Cochrane 5.1.0 bias risk evaluation tool and Jadad scale， Meta-analysis was conducted for total response rate， serum hormone level （FSH， LH， LH/FSH， testosterone）， BMI， ovulation rate and physical signs （hirsutism， acne） by using Stata 14.0 software. Trial sequential analysis（TSA）was conducted by using TSA 0.9 software. RESULTS： A total of 20 RCTs were included， involving 1 484 patients. Results of Meta analysis showed that total response rate [RR＝1.13，95％CI （1.02，1.24），P＜0.05]， serum hormone level {FSH [WMD＝－0.59，95％CI（－0.98，－0.20），P＜0.05]，LH [WMD＝－0.95，95％CI（－1.41， －0.52），P＜0.05]，LH/FSH [WMD＝－1.04，95％CI（－1.78，－0.33），P＜0.05]，testosterone [WMD＝－0.93，95％CI（－1.38，－0.28），P＜0.05]}， BMI [SMD＝－1.01，95％CI （－1.76，－0.27），P＜0.05]， ovulation rate [RR＝1.17，95％CI（1.02，1.34），P＜0.05] and physical signs {hirsutism [WMD＝－0.48，95％CI（－0.86， －0.10），P＜0.05]， acne [WMD＝－1.16，95％CI（－1.56，－0.75），P＜0.05]} of trial group were all better than those of control group， with statistical significance. TSA showed that there are reliable evidences for MCDD combined with chemical medicine in the treatment of PCOS. CONCLUSIONS： Versus chemical medicine alone in the treatment of PCOS， MCDD combined with chemical medicine can improve total response rate and ovulation rate， reduce serum hormone levels， BMI and physical signs.
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OBJECTIVE:To investigate the effects of Cangfu daotan decoction combined with Clomiphene citrate capsule on sex hormone level and endometrial receptivity in patients with polycystic ovary syndrome (PCOS) combined infertility. METH-ODS:A total of 116 PCOS patients with infertility in the First Affiliated Hospital of Guiyang College of TCM from Jan. 2014 to Dec. 2014 were divided into observation group and control group according to random number table,with 58 cases in each group. Both groups received hormone regulation therapy since the fifth day of menstruation. Control group was given Clomiphene citrate capsule 50 mg,qd;observation group was additionally given one dose of Cangfu daotan decoction,400 mL after decocted with wa-ter,bid,on the basis of control group. Both groups were treated for 3 cycles of menstruation. The levels of serum sex hormone (E2,LH),endometrial thickness(Em),endometrial spiral arterial pulsatility index(PI)and resistance index(RI)were compared between 2 groups before and after treatment. The ovulation rate and pregnancy rate were compared between 2 groups after 1-year follow-up. RESULTS:Before treatment,there was no statistical significance in E2,LH,Em,PI or RI between 2 groups (P>0.05). After treatment,the levels of E2 and LH as well as Em in 2 groups were increased significantly,while PI and RI were de-creased significantly;the observation group was significantly better than the control group,with statistical significance(P0.05). The pregnancy rate of observation group was 41.38％,which was significantly higher than that of control group (22.41％),with statistical significance (P<0.05). CONCLUSIONS:Cangfu daotan decoction combined with Clomiphene citrate capsule can effectively regulate serum sex hormone levels of PCOS patients with infertility,and improve endometrial receptivity so as to increase pregnancy rate.
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OBJECTIVE:To explore the effects of Cangfu daotan decoction on expression of organic anion transporting poly-peptide(oatp4a1)and level of sex hormone in the endometrium and ovary tissues of rats with obesity-type polycystic ovarian syn-drome(PCOS). METHODS:Obesity-type PCOS rat models were established. 50 rats were randomized into a normal control(iso-metric normal saline)group,a model(isometric normal saline)group,a metformin(0.043 g/kg)group and Cangfu daotan decoc-tion high-dose and low-dose [5.68 and 1.42 g(medicinal materials)/kg] groups. The rats were given drugs ig once a day for 14 con-secutive days. The expression of oatp4a1 protein in the endometrium and ovaries of the rats was determined by ECL and Western blot. The levels of luteinizing hormone(LH),follicle stimulating hormone(FSH),testosterone(T)and estradiol(E2)in rat’s se-rum were detected by ELISA. RESULTS:Compared to the normal control group,those in the model group had weaker expression of oatp4a1 protein in the endometrium and ovaries,higher levels of serum LH,LH/FSH and T,lower levels of serum FSH and E2. There were statistical significances(P<0.01). Compared to the model group,those in metformin group,Cangfu daotan decoction high-dose and low-dose group had higher expression of oatp4a1 protein in the endometrium and ovaries,lower levels of LH/FSH and T,higher levels of serum E2;those in metformin group and Cangfu daotan decoction high-dose group had lower levels of serum LH,higher levels of serum FSH. There were statistical significances(P<0.01 or P<0.05). CONCLUSIONS:Cangfu daotan decoc-tion can increase the expression of oatp4a1 in the endometrium and ovaries of obesity-type PCOS model rat,alleviate phlegmy dampness and regulate the level of sex hormone.
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Objective To investigate the effect of Yishen-Daotan decoction on TCM syndrome elements of infertility caused by kidney deficiency and phlegm stagnant type polycystic ovary syndrome.Methods 60 patients of kidney deficiency and phlegm stagnant type polycystic ovarian syndrome infertilities were administrated with modified Yishen-Daotan decoction for 3 months and the changes of TCM syndrome elements,menstrual cycle and serum sex hormone were compared before and after the treatment.Results ① TCM syndrome elements had a statistical changes after the treatment compared with those before the treatment(t=62.79,P＜0.01).②menstrual cycle showed statistical difference after the treatment compared with that before the treatment,(x2=21.64,P＜0.01).③Serum FSH,E2 were increased,while LH,LH/FSH and T were decreased after the treatment,showing a significant difference compared with those before the treatment (t=2.67,P＜0.05).④The total effective rate was 91.67％ and pregnancy rate was 30％.Conclusion Yishen-Daotan decoction significantly improve clinical symptoms in patients with kidney deficiency and phlegm stagnant type PCOS infertility.
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Objective: To investigate the mechanisms of daotan decoction (DTD) in the treatment of atherosclerosis by regulation of expression of intercellular adhesion molecule-1 (ICAM-1) mRNA through function of p38 mitogen activated protein kinase. Methods: DTD was given to SD rats at a dose of 0.9 g·kg-1·d-1 through gavage. Blood samples were obtained via the abdominal aorta of SD rats 10 days after DTD gavage and the serum was separated. Neonatal umbilical cords were used to isolate endothelial cells (HUVEC), and they were subcultured for 1 to 3 generations for use. There were 7 groups in this study: normal cultured HUVEC was blank control group; cultured with 20% DTD was DTD control group; induced with tumor necrosis factor-α (TNF-α) was TNF-α group; cultured with 5% DTD 10% DTD, 20% DTD and then TNF-α, were 5%, 10%, 20% DTD group, respectively; and blocked with SB203580 (p38-specific blocker) was blocking group. The impact of DTD on expression of ICAM-1 mRNA and p38 stimulated by TNF-α in HUVEC were observed with the real-time PCR and Western blot. Results: Circled digit oneThe expression of ICAM-1 mRNA (1.17 ± 0.26) and p38 (0.77 ± 0.19) in the TNF-α group was significantly higher than the blank control and DTD control groups (P < 0.01); Circled digit twoAfter being treated with DTD serum, the expression of ICAM-1 mRNA in the 5%, 10% and 20% DTD group were 0.97 ± 0.15, 0.85 ± 0.17, and 0.73 ± 0.10 respectively, and 0.64 ± 0.19 in SB203580 group, which decreased gradually, and the three DTD groups and SB203580 group had significant difference compared with TNF-α group(P < 0.05). While the expression of p38 in the 5%, 10% and 20% DTD group were 0.69 ± 0.21, 0.59 ± 0.27, 0.47 ± 0.11 respectively, and 0.36 ± 0.09 in the SB203580 group, which also decreased gradually. And there was significant difference in 20% DTD group and SB203580 group compared with TNF-α group(P < 0.01). There was a significant positive correlation between the level of p38 and ICAM-1 mRNA (r = 0.706, P < 0.01). Conclusion: DTD inhibits TNF-stimulated expression of ICAM-1 mRNA through the regulation of p38 expression in HUVEC, which may play a therapeutic role in the treatment of arterial atherosclerosis.
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Objective To explore the effects of Tongfu Huayu Daotan Decoction (通化阏导痰汤)on the serum concentration of S-100β protein, neuron-specific enolase(NSE) and Prognosis in patients with severe craniocerebral injury.Methods Sixty patients with severe craniocerebral injury were randomly divided into a a'eatment group and a control group.The treated group was treated with Tongfu Huayu Daotan Decoction plus conventional treatments including dehydration,antibiotics, organ functional support, nerve nutrition, prevention of complication, etc.; the control group was treated with conventional treatments alone. The concentration of serum S-100β protein and neuron-specific enolase(NSE) in plasma at admission and at24, 36, 72huors, and 5, 7 days after treatment were determined respectively; the Glasgow outcome scale (GOS)and neurological deficits scoring at 2weeks and 4weeks after hospitalization were compared to observe the efficacy of the patients. Results The concentration of serum S-100β protein and neuron-specific enolase (NSE) in plasma at previous treatment and at 24, 36 hours after the treatment had no statistical difference in the two groups(P＞0.05 ), The concentration of serum S-100β protein and neuron-specific enolase (NSE) in plasma at 72huors, 5 and 7 days after the treatment in the Tongfu Huayu Daotan Decoction group were lower than those in the control group, the differences being significant (P＜0.01). The Glasgow outcome scale (GOS) and neurological deficits scoring at 2weeks and 4weeks after the treatment in the Tongfu Huayu Daotan Decoction group were significantly nigher than those in the control group, the differences being significant (P＜0.01) .Conclusion Tongfu Huayu Daotan Decoction can alleviate the plasma concentrations of S-100β protein and neuron-specific enolase (NSE) in patients with severe craniocerebral injury and markedly improve the clinical therapeutic effects. Combined Tongfu Huayu Daotan Decoction and western medicine can significantly reduce mortality and improve the Glasgow outcome scale (GOS), neurological deficits scoring and therapeutic effect.
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Objective To study the intervention of Daotan Decoction to the expression of ICAM-1 in cerebrovascular endothelial cells. Methods Cerebrovascular endothelial cells were cultured to observed the influence of ICAM-1 expression,which was induced by TNF-?,by the way of immunocytochemistry methods. Results Compared with control group,the expression of ICAM-1 in model group was time-dependent (P
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Objective To observe the Influence of Daotan decoction on nonalcoholic steatohepatitis (NASH) in Rats, and its relative mechanisms was analyzed. Methods The rat nonalcoholic steatohepatitis model was induced by high fat diet. The rats of therapeutic groups were treated with small, middle and high dose Daotan decoction respectively. Their general condition, liver index, and the fat change and inflammation of liver were observed. The serum ALT、triglyceride(TG), total cholesterol(TCH), low density lipoprotein(HCL-C), high density lipoprotein(LDL-C)were determined respectively. Results The liver index of therapeutic groups were markedly reduced respectively compared with those of model group(P0.05). The liver inflammation in therapeutic groups were improved better those in model group(P