RESUMO
Six dimensional syndrome differentiation theory， put forward by professor GU Xiao-hong at Beijing University of Chinese Medicine based on her theoretical teaching and clinical experience， emphasizes that the syndrome differentiation should be carried out from six dimensions including etiology， disease location， disease stage， disease condition， pathology， and disease nature， which is conducive to clinical thinking training and formation of traditional Chinese medicine （TCM）. The differentiation and treatment of Baihutang syndrome frequently seen in cold damage and warm disease still need to be explored. Guided by the six dimensional syndrome differentiation theory coupled with diverse viewpoints of cold damage and warm disease schools， this paper summarized and reinterpreted the understandings and thoughts of GU Xiao-hong and YU He， warm disease specialists of two generations. Considering the lung-stomach dysfunction caused by the internal invasion of exogenous pathogens， Baihutang syndrome was staged into Qi aspect. In this stage， exuberant pathogens and sufficient healthy Qi allowed the prevailing of internal heat and the consumption of body fluid， manifested as high fever， profuse sweating， thirst， and the pulse corresponding to interior excess and heat syndrome. This paper also pointed out that the Baihutang syndrome involved both lung and stomach， and the adoption of Baihutang contributed to preventing tu from restricting shui in the case of extreme excess of Yang brightness and protecting the kidney Yin. As revealed by the dynamic analysis of prognosis of Baihutang syndrome based on the six dimensional syndrome differentiation theory， even though the Baihutang syndrome could be present in both cold damage and warm disease， the specific disease stage， transmission and change， condition， prognosis， pathology， and medication differed. On this basis， a series of prescriptions have been modified from Baihutang， which has expanded the application scope of Baihutang and enriched its research value， thus better promoting its clinical application.
RESUMO
Objective:To study the effect of Baihutang on blood glucose， blood lipid metabolism and vascular remodeling in type 2 diabetic rats and its regulation on insulin receptor substrate-1（IRS-1）/ phosphatidylinositol-3 kinase（PI3K）/ protein kinase B（Akt） signal pathway. Method:The 90 rats were randomly divided into normal group， model group， Baihutang low， middle and high dose groups and metformin group， with 15 rats in each group. Except for normal group， the other rats were injected intraperitoneally with streptozotocin to establish the model of type 2 diabetes. The rats in the low， middle and high dose groups were given Baihutang formula granules of 5， 10， 20 g·kg-1 respectively according to their body weight. The positive control group was given metformin （100 mg·kg-1） by intragastric administration， while those in the control group and model group were given the same amount of normal saline once a day for 12 weeks. The levels of fasting blood glucose， glycosylated hemoglobin， serum tumor necrosis factor-α（TNF-α）， interleukin-6（IL-6）， interleukin-1 β（IL-1β）， total cholesterol（TC）， triglyceride（TG） and low-density lipoprotein cholesterol（LDL-C） were measured after administration. The levels of sterol regulatory element binding protein 1C （SREBP1C）， acetyl CoA carboxylase （ACC）， fatty acid synthase gene （FASN） and carnitine palmitoyl transferase 1A （CPT1A）， acylcoa oxidase 1（ACOX1）， recombinant human acylcoa dehydrogenase （ACADM） mRNA in liver of rats were detected by Real-time fluorescence quantitative polymerase chain reaction（Real-time PCR）， Western blot was used to detect the protein levels of IRS-1， PI3K and Akt in liver of rats. Hematoxylin-eosin（HE） staining was used for histopathological examination of rat thoracic aortic vessels. The migration ability of vascular smooth muscle cells in rat thoracic aorta was detected by scratch test. Result:Compared with the normal group， the fasting blood glucose， glycosylated hemoglobin， serum TNF-α， IL-6，IL-1β， TC，TG and LDL-C levels， liver lipid synthesis gene mRNA level and vascular smooth muscle cell migration ability of thoracic aorta in model group were significantly higher than those in normal group （P<0.05）， while fatty acid oxidation gene mRNA level and IRS-1，PI3K，Akt protein level in liver were significantly decreased in model group （P<0.05）. The vascular wall thickness of thoracic aorta increased significantly in rats （P<0.05）. Compared with model group， the levels of fasting blood glucose， glycosylated hemoglobin， serum TNF-α，IL-6， IL-1β， TC， TG and LDL-C， the level of lipid synthesis gene mRNA in liver and the migration ability of vascular smooth muscle cells in thoracic aorta of rats in all Baihutang groups were significantly lower than those in model group （P<0.05）. The mRNA level of fatty acid oxidation gene and the protein levels of IRS-1， PI3K and Akt in liver were significantly increased（P<0.05）， and the histopathology of thoracic aorta was significantly improved and the vascular wall thickness decreased significantly（P<0.05）. Conclusion:Baihutang can reduce the levels of blood glucose， blood lipid and serum inflammatory factors in type 2 diabetic rats， regulate the expression of genes related to lipid metabolism in liver， and improve the histopathology and vascular remodeling of thoracic aorta. The mechanism may be related to the regulation of IRS-1/PI3K/Akt signal pathway.
RESUMO
Objective:The phase separation of Baihutang was carried out. The content of mangiferin，new mangiferin，calciumion，glycyrrhizin and ammonium glycyrrhizinate in the solution phase，the nano phase and the precipitated phase of Baihutang were measured，so as to define the effect of nanometer particles of Baihutang on the growth of active components，and explain the mechanisms of Baihutang in potent detoxification and heat removal. Method:The phase separation of Baihutang was performed by high-speed centrifugation and dialysis. The contents of mangiferin，new mangiferin，glycyrrhizin and ammonium glycyrrhizinate in Baihutang were determined by HPLC. Chromatographic column Diamonsil C18 (4.6 mm×250 mm，5 μm) was adopted, with acetonitrile-25 mmol·L-1 potassium dihydrogen phosphate solution as the mobile phase, and eluted in a gradient mode. The detection wavelength was 257 nm，the column temperature was 30 ℃，and the flow rate was 1.0 mL·min-1. EDTA-2Na solution was used to calibrate the calcium concentration in different phase states of Baihutang. Result:1 mL Baihutang nanoparticles contained 483.00 μg new mangiferin，1 068.88 μg mangiferin，219.93 μg glycyrrhizin and 187.10 μg ammonium glycyrrhizin，and the content of new mangiferin and mangiferin accounted for 89.4% and 89.9% respectively in 1 mL Baihutang. The new mangiferin and mangiferin in the nano phase were 230.0 and 23.3 times the true solution，and 8.5 and 14.4 times of the precipitation，respectively. The content of calcium ions in Baihutang in the nano phase was higher，accounting for 86.9% of Baihutang，and the content of calcium ions in Baihutang and Baihutang in the nano phase was higher than that in gypsum group. Conclusion:The content of main components in Baihutang in nanometer phase is significantly higher than that in other phases. The nanoparticles of Baihutang have a solubilizing effect on the main antipyretic components, such as mangiferin，mangiferin and calcium ions as well as the antitoxic components glycyrrhizic acid and glycyrrhizic acid. The mechanism of action of Baihutang is related to the formation of nanoparticles.