Establishment and Evaluation of Animal Model of Acute Myocardial Infarction with Syndrome of Qi and Yin Deficiency / 中国实验方剂学杂志

ObjectiveTo explore the establishment and evaluation methods of the rat model of acute myocardial infarction （AMI） in coronary heart disease with the syndrome of Qi and Yin deficiency by sleep deprivation （SD） combined with isoproterenol （ISO） and preliminarily explore its biological basis. MethodForty SD rats were assigned into normal （no treatment）， SD （treatment in modified multi-platform water environment for 96 h）， ISO （subcutaneous injection of ISO at 100 mg·kg-1 once every other day for a total of 2 times）， and SD+ISO （injection of 100 mg·kg-1 ISO after SD for 72 h and 96 h） groups. The cardiac function was detected by small animal echocardiography. The serum levels of creatine kinase （CK）， creatine kinase isoenzyme （CK-MB）， lactate dehydrogenase （LDH）， and cardiac troponin T （cTnT） were measured by biochemical methods. The pathological changes of the myocardial tissue were observed by hematoxylin-eosin staining. The general state， body weight， grip strength， body temperature， behaviors in open field test， serum levels of cyclic adenosine monophosphate （cAMP）， cyclic guanosine monophosphate （cGMP）， cAMP/cGMP ratio， red （R）， green （G）， blue （B） values of the tongue surface， and pulse amplitude were observed and measured to evaluate the modeling results. Enzyme-linked immunosorbent assay was employed to determine the serum levels of interleukin-18 （IL-18）， tumor necrosis factor-α （TNF-α）， superoxide dismutase （SOD）， malondialdehyde （MDA）， corticotropin-releasing factor （CRF）， adrenocorticotropic hormone （ACTH）， triiodothyronine （T3）， tetraiodothyronine （T4）， cluster of differentiation 4 （CD4）， and cluster of differentiation 8 （CD8）. ResultIn terms of disease indicators， the ISO and SD+ISO groups had lower cardiac function indicators than the normal group （P<0.01）. The levels of CK， CM-MB， LDH and cTnT elevated in each model group compared with the normal group （P<0.01）. The pathological changes of myocardial tissue were obvious in the ISO and SD+ISO groups. In terms of syndrome indicators， compared with the normal group， the SD and SD+ISO groups showed decreased body weight at each time point （P<0.01）， and the ISO group showed decreased body weight at the time points of 48 h and 72 h （P<0.05， P<0.01）. The paw temperature and rectal temperature increased in the SD group （P<0.01）. The model groups showed weakened grasp strength， lowered R， G， and B values of the tongue surface （P<0.01）， prolonged immobility time （P<0.01）， reduced total distance and number of entering the central area （P<0.01）， decreased average speed （P<0.05， P<0.01）， and increased cAMP and cGMP （P<0.05， P<0.01）. The cAMP/cGMP ratio was increased in the SD+ISO group （P<0.01）， and the pulse amplitude was decreased in the SD and SD+ISO groups （P<0.01）. In terms of serological indicators，compared with the normal group， the levels of IL-18， TNF-α， SOD and MDA were significantly increased in the ISO and SD+ISO groups （P<0.01）， the CRF， ACTH， CORT， T3， T4， CD4 and CD8 in the model groups were increased （P<0.05， P<0.01）. ConclusionSleep deprivation for 96 h combined with high-dose ISO can successfully establish a rat model of acute myocardial infarction in coronary heart disease with the syndrome of Qi and Yin deficiency. The model evaluation system can be built with disease indicators of western medicine， histopathological indicators， macroscopic indicators of traditional Chinese medicine， and serological indicators.

Clinical Efficacy of Qimai Qinlou Prescription in Treating Elderly Community-acquired Pneumonia （Non-severe） with Qi and Yin Deficiency and Phlegm-heat Obstructing Lung Syndrome / 中国实验方剂学杂志

ObjectiveTo evaluate the clinical efficacy of Qimai Qinlou prescription in the treatment of elderly community-acquired pneumonia （CAP） （non-severe） with Qi and Yin deficiency and phlegm-heat obstructing lung syndrome and its impact on immune-inflammatory factors. MethodA total of 120 eligible patients were randomly divided into an observation group （60 cases） and a control group （60 cases）. Both groups received intravenous cefoxitin sodium. In addition， the observation group received oral Qimai Qinlou prescription， while the control group received an oral placebo simulating Qimai Qinlou prescription. The treatment course was 14 days. The disappearance time of major clinical symptoms and signs was recorded. Traditional Chinese medicine （TCM） syndrome scores and the Clinical Research Outcome （CAP-CRO） scale scores for pneumonia of the two groups were compared. Chest computed tomography （CT） scans were performed， and peripheral blood levels of procalcitonin （PCT）， interleukin-6 （IL-6）， serum amyloid A （SAA）， high-sensitivity C-reactive protein （hs-CRP）， CD4+， CD8+， and CD4+/CD8+ were measured. The conversion rate to severe condition during hospitalization， readmission rate within 30 days after discharge， and safety evaluation were recorded. ResultAfter treatment， the observation group showed significantly shorter time of fever， cough， expectoration， and disappearance time of lung moist rales than the control group （P<0.01）. The TCM syndrome scores， CAP-CRO scores in all dimensions， and total scores in both groups were significantly reduced as compared with those before treatment （P<0.01）. After treatment， the observation group had a more significant reduction than the control group （P<0.01）. The levels of PCT， IL-6， SAA， and hs-CRP in both groups were significantly reduced as compared with those before treatment （P<0.01）. After treatment， the observation group showed a more significant reduction than the control group （P<0.01）. There was no statistically significant difference in the changes of CD4+， CD8+， and CD4+/CD8+ in the control group before and after treatment. However， in the observation group， CD4+ and CD4+/CD8+ levels significantly increased （P<0.01）， while CD8+ level significantly decreased （P<0.01） after treatment. After treatment， CD4+ and CD4+/CD8+ in the observation group significantly increased （P<0.01）， and CD8+ significantly decreased as compared with those in the control group （P<0.01）. At 7， 10， and 14 days after treatment， the curative rates in the observation group were 53.33% （32/60）， 85.00% （51/60）， and 91.67% （55/60）， respectively， which were higher than 31.67% （19/60）， 61.67% （37/60）， and 68.33% （41/60） in the control group （χ2=5.763， 8.352， 10.208， P<0.05）. After treatment， the total effective rate of CT scanning in the observation group was 93.33% （56/60）， higher than 80.00% （48/60） in the control group （χ2=4.615， P<0.05）. The conversion rate to severe condition during hospitalization in the observation group was 3.33% （2/60）， lower than 15.00% （9/60） in the control group （χ2=4.904， P<0.05）. The readmission rate within 30 days after discharge in the observation group was 8.33% （5/60）， lower than 23.33% （14/60） in the control group （χ2=5.065， P<0.05）. No serious adverse drug reactions were observed in either group during the treatment period. ConclusionQimai Qinlou prescription can enhance immune function， alleviate inflammatory reactions， significantly relieve clinical symptoms， shorten the duration of the disease， improve the curative rate and CT scanning efficacy， prevent disease progression， reduce the readmission rate in the short term， and is clinically safe for the treatment of elderly patients with non-severe CAP with Qi and Yin deficiency and phlegm-heat obstructing lung syndrome. It is worthy of further research and application.

Expert consensus on ShenqiJiangtang Granule in clinical application of type2 diabetes / 中草药

ShenqiJiangtang Granule is composed of Panax ginseng, Astragali Radix and other valuable Chinese herbal medicines and extract, which has the effect of replenishing qi and nourishing yin, nourishing spleen and kidney, and it is also widely used in the treatment of type 2 diabetes and complications. After more than 20 years of clinical application, abundant research data have been accumulated. In order to accurately locate the clinical position and promote the rational use of drugs, a project was established by the Chinese Society of Traditional Chinese Medicine and experts organized by the Diabetes Branch to compile this consensus. This consensus defines the application of ShenqiJiangtang Granule in the clinical treatment of prediabetes, type 2 diabetes and its complications. It is suitable for clinicians at all levels of hospitals and grass-roots medical and health institutions across the country (traditional Chinese medicine, Western medicine, integrated traditional Chinese and Western medicine).

Effect of Shenqi Compound Recipe on Intestinal Microecology of Patients with Qi and Yin Deficiency and Blood Stasis Syndrome Newly Diagnosed Type 2 Diabetes Mellitus / 中国实验方剂学杂志

Objective: To observe the effect of Shenqi compound recipe on glucose and lipid metabolism in patients with Qi and Yin deficiency and blood stasis syndrome newly diagnosed type 2 diabetes mellitus (T2DM), and its intervention effect on intestinal microecology and serum proinflammatory factors. Method: The 106 eligible patients were divided into the observation group (54 cases) and the control group (52 cases) by random number table method. Another 40 healthy volunteers in physical examination center of the hospital during the same period were enrolled as health control group. On the basis of Guidelines for the Prevention and Treatment of Type 2 Diabetes in China(2013 edition), control group was provided lifestyle interventions, such as reasonable diet, weight control, moderate exercise, salt restriction, tobacco control, alcohol restriction and psychological balance. In addition to the therapy of the control group, the observation group was given Shengi compound for oral administration, 2 times/days. Both groups were treated for 8 weeks. The fasting blood glucose (FBG), postprandial 2 h blood glucose (PBG), glycosylated hemoglobin (HbA1c), homeostasis model assessment-insulin resistance index (HOMA-IR), total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) before and after treatment were evaluated. The structure and quantity of intestinal flora before and after treatment were detected. The traditional Chinese medicine(TCM)symptom was scored. The levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), IL-8, and tumor necrosis factor-α (TNF-α) were measured before and after treatment. Result: FBG, PBG, HbA1c and HOMA-IR levels in observation group were lower than those in control group (PPPPβ, IL-6, IL-8 and TNF-α levels in observation group were lower than those in control group (PZ=2.134, PConclusion: Shenqi compound can regulate blood glucose and blood lipid in patients with newly diagnosed T2DM (Qi and Yin deficiency and blood stasis syndrome), improve IR, intestinal microecology imbalance, and reduce non-specific inflammatory response, with a good clinical efficacy on intestinal microecology of patients with Qi and Yin deficiency and blood stasis syndrome newly diagnosed type 2 diabetes mellitus.

Xerophthalmia of and deficiency treated with needling technique / 中国针灸

<p><b>OBJECTIVE</b>To explore the differences in the clinical therapeutic effects on xerophthalmia of and deficiency between the needling technique (the combined reinforcing technique to induce warm sensation) and the reinforcing needing technique achieved by rotating needle.</p><p><b>METHODS</b>A total of 54 patients of xerophthalmia were randomized into an observation group (28 cases) and a control group (26 cases). In both of the groups, the main acupoints included Cuanzu (BL 2), Sizhukong (TE 23), Taiyang (EX-HN 5) and Fengchi (GB 20); the combined acupoints were Danzhong (CV 17), Sanyinjiao (SP 6), Taixi (KI 3) and Taichong (LR 3). In the observation group, the needling technique was used and in the control group, the reinforcing needing technique achieved by rotating needle was adopted. The treatment was given once every day. 10 treatments made one course and 2 courses were required. Before and after treatment, the score of eye symptoms, tear secretion and the breakup time of tear film were observed in the two groups. The clinical therapeutic effects were compared between the two groups after treatment and in 4-week follow-up after treatment separately.</p><p><b>RESULTS</b>After treatment, the total effective rate was 92.9% (26/28) in the observation group and was 80.8% (21/26) in the control group, without significant difference in comparison (>0.05). In 4-week follow-up after treatment, the total effective rate was 85.7% (24/28) in the observation group and was 61.5% (16/26) in the control group, indicating the significant difference in comparison (<0.05). After treatment, the differences were significant in the score of eye symptoms, tear secretion and the breakup time of tear film as compared with those before treatment in the two groups (all <0.01). After treatment, the improvements of the score of eye symptoms, tear secretion and the breakup time of tear film in the observation group were better remarkably than those in the control group, indicating the significant differences (all <0.05).</p><p><b>CONCLUSION</b>The needling technique achieves the significant therapeutic effects on xerophthalmia of and deficiency and the recurrence rate of the disease is low.</p>

Therapeutic Efficacy of Xiaoke Formula in the Treatment of Type 2 Diabetes Mellitus with Qi and Yin Deficiency:A Meta-analysis / 中国药房

OBJECTIVE:To systematically evaluate therapeutic efficacy of Xiaoke formula in the treatment of type 2 diabetes mellitus (T2DM) with Qi and Yin deficiency,and to provide evidence-based reference in clinic. METHODS:Retrieved from PubMed,Embase,Cochrane Library,CBM and CNKI,randomized controlled trials(RCTs)about modified Xiaoke formula(trial group) with Qi and Yin deficiency versus Metformin tablet or insulin(control group) in the treatment of T2DM were included. After literature screening and data extraction,the qualities of included studies were evaluated by modified Jadad scoring scale. Meta-analysis was performed by using Rev Man 5.3 statistical software. RESULTS:Totally 18 RCTs were included,involving 2 065 patients. Meta-analysis showed that response rate of trial group [OR＝2.89,95%CI(2.16,3.86),P＜0.001] was significantly higher than that of control group,while fasting blood glucose [SMD＝－0.72,95%CI(－0.96,－0.47),P＜0.001],2 h postprandial blood glucose [SMD＝ －0.72,95%CI(－0.96,－0.47),P＜0.001],glycosylated hemoglobin [MD＝－0.65,95%CI (－0.88,－0.42),P＜0.001] and TCM syndrome score [MD＝－5.77,95%CI(－7.46,－4.08),P＜0.001] were significantly lower than control group. Totally 18 RCTs were included,involving 18 formula and 66 ingredients. The sum of use frequency of various medicinal materials was 218. Trichosanthes,Coptis chinensis,Ophiopogon japonicus and so on were used most frequently. CONCLUSIONS:Xiaoke formula shows significant therapeutic efficacy for T2DM with Qi and Yin deficiency,and reduces related index levels and TCM syndrome score effectively.

Evaluation criteria of animal model of coronary heart disease with qi and yin deficiency syndrome based on clinical literature / 中草药

Coronary heart disease (CHD) is a disease with high incidence which is threat to human health. CHD belongs to the chest pain, palpitations, etc in traditional Chinese medicine (TCM). Nowadays the research on TCM syndrome type of coronary artery disease animal model gradually becomes hot topics in the study of traditional Chinese medicine. Through the comprehensive retrieval and analysis of the related literatures of TCM syndromes of CHD, it is found that qi and yin deficiency syndrome is the main type of syndrome of CHD. This article takes CHD qi and yin deficiency syndrome as the research object, through the strict inclusion and exclusion criteria and retrieval system, all the literatures related to clinical trials of CHD qi and yin deficiency syndrome were collected. Through the analysis on literatures of clinical evaluation, the evaluation indexes of CHD qi and yin deficiency syndrome animal model are explored, and aims to build evaluation standard for CHD qi and yin deficiency syndrome animal model.

The Study of Relationship between Material Bases of Early Diabetic Nephropathy as Deficiency of both Qi and Yin and Obstruction of Collat-erals and AGE-RAGE / 浙江中医药大学学报

Objective] To investigate the relationship between the AGE-RAGE and Qi and Yin deficiency and blood stasis of pathogenesis in diabetic nephropathy(DN).[Methods] The model was established by intravenous injection low-dose streptozotocin(STZ, 30 mg·kg-1) after having the high fat/high glucose diets for one month. And then that were divided into DN group, Tangshenfang low, medium, high groups, Valsartan group. Fasting blood-glucose (FBG) and Creatinine clearance(Ccr) were monitored. The morphological changes of renal tissue were examined under microscopy on sections stained with PAS. The RAGE mRNA and protein expression were determined by Real-time PCR and Western blot respectively;the urine album(U-alb) and content of AGE in serum were determined by ELISA. [Results] The model group rats acted obviously as deficiency of both Qi and Yin and obstruction of collaterals. compared with normal group, FBG, urinary albumin excretion rate and the content of AGE, RAGE expression were markedly increased; Ccr was markedly decreased in DN model group;blood viscosity and whole blood reduction viscosity were increased. FBG, Urinary albumin excretion rate and the content of AGE, RAGE expression were markedly decreased, Ccr was markedly increased by the intervention of Tangshenfang and valsartan. Blood viscosity and whole blood reduction viscosity were decreased; it was obviously and positively correlated between AGE with RAGE expression and U-alb, excretion rate and negatively correlated with the Ccr, r value was-0.456. [Conclusion] The early DN model rats were in the pathogenesis of Qi and Yin deficiency and blood stasis. And the AGE-RAGE may have close relationship with the pathogenesis of Qi and Yin deficiency and blood stasis.

Effect of protein intervention on amino acid metabolism spectrum of Qi and Yin deficiency type 2 diabetic rats / 中国中药杂志

To study the effect of plant protein and animal protein on amino acid metabolism spectrum of Qi and Yin deficiency type 2 diabetic rats. 110 male SD rats were randomly divided into blank group (n=10), diabetic model group (n=20), disease-symptoms group (n=80). The rats of blank group received ordinary feeding, while other groups were fed with high sugar and fat diets. During the whole process of feeding, rats of disease-symptoms group were given with Qingpi-Fuzi (15.75 g•kg⁻¹) once a day through oral administration. Five weeks later, the rats were given with a low dose of STZ (40 mg•kg⁻¹) by intraperitoneal injection to establish experimental diabetic models. Then the models were randomly divided into disease-symptoms group 1 (Qi and Yin deficiency diabetic group, 15.75 g•kg⁻¹), disease-symptoms group 2 (plant protein group, 0.5 g•kg⁻¹), disease-symptoms group 3 (animal protein group, 0.5 g•kg⁻¹), disease-symptoms group 4 (berberine group, 0.1 g•kg⁻¹). The drugs were given for 4 weeks by gavage administration. After 4 weeks of protein intervention, the abdominal aortic blood was collected and serum was isolated to analyze its free amino acid by using AQC pre-column derivatization HPLC and fluorescence detector. Four weeks after the protein intervention, plant protein, animal protein and berberine had no obvious effect on body weight and blood sugar in type 2 diabetic rats. As compared with animal protein group, histidine and proline（P<0.01）, serine, glycine, threonine, alanine, tyrosine, valine, methionine, bright+isoleucine, phenylalanine and lysine（P<0.05）changed a lot in rats serum of plant protein group.The results showed that gavage administration of protein would produce effects on amino acid metabolism of Qi and Yin deficiency type 2 diabetic SD rats. Symbolic differential compounds could be found through metabonomics technology, providing experimental basis for early warning of type 2 diabetes and diagnosis of Qi and Yin deficiency syndrome.

Effect of Yuquan Pill on blood glucose fluctuation of diabetes mellitus patients receiving insulin therapy with deficiency type of qi and yin / 中草药

Objective: To observe the effect of Yuquan Pill on the blood glucose fluctuation of diabetic patients receiving insulin therapy with the deficiency type of qi and yin. Methods: One hundred and six patients in Nanjing city hospital of traditional Chinese medicine from January 2012 to August 2014, with the diabetes mellitus in the view of Western medicine and with deficiency of both qi and yin diagnosis standard according to the theory of traditional Chinese medicine (TCM), were selected and randomly divided into treatment group and control group. The original insulin therapy of all subjects continues. The patients in treatment group were given Yuquan Pill, once daily. The patients in control group were not treated by Chinese materia medica, but kept corresponding follow-up. The course of treatment was 28 d. These indicators were to assess at the beginning and end of the research, including the mean blood glucose level (MBG), duration below low limit (DBLL), standard deviation of blood glucose (SDBG), largest amplitude glycemic excursions (LAGE), mean amplitude of glycemic excursions (MAGE), and means of daily differencies (MODD). Results: In the treatment group, dry mouth and throat, fatigue, eat easy to hunger, shortness of breath, sweating, palpitation, cardiac heat, syndrome integral treatment of insomnia, and tongue were improved significantly compared with before the treatment (P < 0.05); The two groups after treatment, TCM syndromes of throat dry, feverish feeling in palms and soles, sweating, palpitations, insomnia, and tongue coating were better improved significantly in the treatment than those in the control group (P < 0.05). The MAGE of the patients in the treatment group decreased after the treatment compared with those before treatment (P < 0.05). The MAGE level was decreased apparently compared with the control group. Conclusion: This study shows that the fluctuation of blood glucose levels in diabetic patients receiving insulin therapy with the deficiency type of qi and yin can be improved by the treatment of Yuquan Pill.