RESUMO
Objective To observe the effect of spleen-warming and kidney-tonifying therapy on Toll-like receptor 4 (TLR4) signaling pathway of cerebral infarction sequelae patients. Methods A total of 60 cerebral infarction sequelae patients with spleen and kidney(yang) deficiency were divided into control group and treatment group, 30 cases in each group. The two groups were given function rehabilitation training following by the theory of modern rehabilitation medicine, and additionally the treatment group was treated with spleen-warming and kidney-tonifying herbs orally. The treatment period for the two groups averaged 3 months. Before and after treatment, the scores of traditional Chinese medicine (TCM) symptoms and signs, peripheral blood TLR4 mRNA expression level, and the inflammation-related factors in the two groups were observed, and the observation parameters were compared with 30 healthy volunteers. Meanwhile, the changes of modern rehabilitation evaluation indexes were also evaluated before and after treatment. Results (1) After treatment, the Fugl-Meyer scores for motor function and Modified Barthel Index(MBI) scores for activities of daily living in the treatment group were obviously increased(P 0.05). (2) After treatment, the predominant symptoms and signs of hemiplegia, facial distortion and dysphasia in the two groups were much improved(P 0.05 compared with those before treatment); the treatment group had obvious effect on the above symptoms and signs, and the effect was superior to that in the control group(P 0.05), and TNF-α level in the control group was decreased but did not arrive to the normal level(P < 0.05); levels of interleukin(IL)-1β, IL-6 and TLR4 mRNA in the two groups were decreased but did not arrive to the normal(P < 0.01), and the decrease in the treatment group was superior to that in the control group(P < 0.05 or P < 0.01). (4) During the treatment period, no obvious adverse effect was found in the two groups. Conclusion Oral use of spleen -warming and kidney –tonifying Chinese medicine combined with modern rehabilitation therapy is effective for the treatment of the sequelae of cerebral infarction patients by relieving the clinical TCM symptoms, and one of the therapeutic mechanisms is probably related with the TLR4 signaling pathway through regulating the expression of inflammatory factors.
RESUMO
Objective To investigate the clinical efficacy of Bushen Tiaojing Recipe Extract(an extract preparation of Chinese herbal medicine with the actions of tonifying kidney and regulating menstruation) for the treatment of kidney deficiency type of premature ovarian failure (POF),and to observe the effect of the extract formula on sexual hormone levels of POF patients.Methods A total of 75 POF patients were randomly divided into Chinese medicine (CM) decoction group,CM extract group and western medicine (WM) group,25 cases in each group.CM decoction group was treated with the decoction of Bushen Tiaojing Recipe (a decoction recipe for tonifying kidney and regulating menstruation),CM extract group was treated with Bushen Tiaojing Recipe Extract,and WM group was treated with hormone replacement therapy(HRT).Twenty-eight days constituted one treatment course,and the treatment for the 3 groups lasted 3 continuous courses.After treatment,the patients were followed up for 3 months.Clinical efficacy of the 3 groups was evaluated,and clinical symptom scores,the improvement of menstruation and the changes ofsexual hormones ofestrogen(E2),follicle-stimulatinghormone(FSH) and luteinizing hormone (LH) were observed before and after treatment.Results (1) Two cases of each group dropped out,and a total of 69 patients completed the study.(2) The total effective rate of CM decoction group and CM extract group was 73.91％,78.26％ respectively,higher than 52.17％ of WM group (P ＜ 0.05).(3)After treatment,clinical symptoms of CM decoction group and CM extract group were obviously improved (P ＜ 0.05 or P ＜ 0.01 compared with those before treatment),while WM group only had an effect on improving the abnormal menstruation (P ＜ 0.01 compared with that before treatment).CM decoction group and CM extract group had better effect on improving the clinical symptoms than WM group (P ＜ 0.05 or P ＜ 0.01).(4) CM decoction group and CM extract group had higher menstrual improvement rate,shorter menstrual-improvement time and lower recurrence rate than WM group (P ＜0.05).(5) CM decoction group and CM extract group had better effect on increasing serum E2 level and decreasing FSH and LH levels than WM group (P ＜ 0.05 or P ＜ 0.01).(6) The adverse reaction incidence of CM decoction group and CM extract group was all 4.35％,lower than 13.04％ of WM group (P ＜ 0.05).Conclusion Bushen Tiaojing Recipe Extract has high drug concentration,and its effect is stable,mild and lasting,having the advantages of convenience for carrying and medication.The extract exerts certain clinical efficacy for the treatment of POF,and is effective on alleviating clinical symptoms,recovering normal menstruation,regulating serum sexual hormone levels,with lower abnormal menstruation relapse rate and less adverse reaction.