Experience of Treating Bronchiectasis by Using Mahuang Shengma Decoction （麻黄升麻汤） / 中医杂志

This paper summarized the experience in treating bronchiectasis with Mahuang Shengma Decoction （麻黄升麻汤）. The pathogenesis of bronchiectasis is “lung-spleen qi deficiency” as the root， and “phlegm-heat obstructing the lung” as the branch. The key point of treatment is to improve the internal environment of phlegm， heat， and deficiency. According to clinical experience， Mahuang Shengma Decoction is good at raising the yang qi to dissipate fire， clearing the upper and warming the lower， which is in accord with the pathogenesis of bronchiectasis. In clinical practice， Mahuang Shengma Decoction is usually used as the basic formula， and the heat-clearing medicinals and center-warming medicinals of the formula will be adjusted according to the abnormal exuberance of heat or cold of the pathogenesis； and the formula can also be modified in accordance with the symptoms. At the same time， importance should be attached to the application of Mahuang （Herba Ephedrae）， and its dosage should be flexibly adjusted according to the constraint degree of the pathogenic qi， so as to expel the constraint fire， bank up earth to generate metal， regulate heat and cold simultaneously， and treat both the root and the branch.

Prognosis and Treatment of Systemic Lupus Erythematosus Based on Yin-Yang Toxin Theory / 中医杂志

This paper explored the relationship between systemic lupus erythematosus （SLE） and yin-yang toxins based on the discussion of yin-yang toxin in Synopsis of the Golden Chamber （《金匮要略》）， and found that the two are similar in symptoms， and there is a potential relationship between adverse prognosis factors； and the idea that early treatment of SLE can improve prognosis is in accordance with the opinion in traditional Chinese medicine claiming that yin-yang toxin should be diagnosed and treated as soon as possible. Therefore， it is proposed to take yin-yang as general and toxin pathogen as key to explain the pathogenesis， use yin-yang toxin theory for guidance， discuss on the treatment of SLE around the pathological elements including “toxin， heat， stasis”， and take into account of the kidney essence. Accordingly， Shengma Biejia Decoction （升麻鳖甲汤） is recommended as the basic formula with modifications in accordance with different syndromes in staged treatment， providing reference for the clinical diagnosis and treatment of SLE.

Multiple components of Mahuang Shengma Decoction on prevention and treatment of acute lung injury based on RAGE/NF-κB signaling pathway / 中国中药杂志

To investigate the potential molecular markers and drug-compound-target mechanism of Mahuang Shengma Decoction(MHSM) in the intervention of acute lung injury(ALI) by network pharmacology and experimental verification. Databases such as TCMSP, TCMIO, and STITCH were used to predict the possible targets of MHSM components and OMIM and Gene Cards were employed to obtain ALI targets. The common differentially expressed genes(DEGs) were therefore obtained. The network diagram of DEGs of MHSM intervention in ALI was constructed by Cytoscape 3. 8. 0, followed by Gene Ontology(GO) and Kyoto Encyclopedia of Genes and Genomes(KEGG) enrichment analyses of target genes. The ALI model was induced by abdominal injection of lipopolysaccharide(LPS) in mice. Bronchoalveolar lavage fluid(BALF) was collected for the detection of inflammatory factors. Pathological sectioning and RT-PCR experiments were performed to verify the therapeutic efficacy of MHSM on ALI. A total of 494 common targets of MHSM and ALI were obtained. Among the top 20 key active compounds of MHSM, 14 from Ephedrae Herba were found to be reacted with pivotal genes of ALI [such as tumor necrosis factor(TNF), tumor protein 53(TP53), interleukin 6(IL6), Toll-like receptor 4(TLR4), and nuclear factor-κB(NF-κB)/p65(RELA)], causing an uncontrolled inflammatory response with activated cascade amplification. Pathway analysis revealed that the mechanism of MHSM in the treatment of ALI mainly involved AGE-RAGE, cancer pathways, PI3 K-AKT signaling pathway, and NF-κB signaling pathway. The findings demonstrated that MHSM could dwindle the content of s RAGE, IL-6, and TNF-α in the BALF of ALI mice, relieve the infiltration of inflammatory cells in the lungs, inhibit alveolar wall thickening, reduce the acute inflammation-induced pulmonary congestion and hemorrhage, and counteract transcriptional activities of Ager-RAGE and NF-κB p65. MHSM could also synergically act on the target DEGs of ALI and alleviate pulmonary pathological injury and inflammatory response, which might be achieved by inhibiting the expression of the key gene Ager-RAGE in RAGE/NF-κB signaling pathway and downstream signal NF-κB p65.

Efficacy of Loulu Shengma Tang Combined with Azithromycin in Treating Children with Mycoplasma Pneumonia with Obstruction of Lung by Pathogenic Heat and Its Effect on Treg and Foxp3 mRNA / 中国实验方剂学杂志

Objective:To investigate the clinical efficacy of Loulu Shengma Tang combined with azithromycin in the treatment of pediatric mycoplasma pneumoniae pneumonia（MPP） with obstruction of lung by pathogenic heat， and its effect on inflammatory factors， treg and Foxp3 mRNA. Method:Totally 274 children with MPP were divided into observation group （137 cases） and control group （137 cases）. Observation group was treated with Loulu Shengma Tang combined with azithromycin dry suspension， while control group was treated with azithromycin dry suspension alone. The changes of traditional Chinese medicine（TCM） syndrome score of pathogenic-heat obstruction in the lung， serum inflammatory cytokines ［interleukin-6 （IL-6），interleukin-10 （IL-10），tumor necrosis factor-α （TNF-α），C-reactive protein （CRP）］， CD4+CD25+Treg， CD4+Foxp3+Treg and Foxp3 mRNA expressions were observed after treatment. The clinical efficacy and the incidence of adverse reactions were compared between two groups. Result:The total effective rate of observation group was 94.16%（129/137） after treatment， which was significantly higher than 77.37% （106/137）of observation group （P<0.05）. The disappearance times of cough， lung rale， fever and lung shadow in observation group were shorter than that in control group （P<0.05）. After treatment， TCM syndrome score of pathogenic-heat obstruction in lung was significantly higher than those in control group （P<0.05）， serum IL-6， IL-10， TNF-α and CRP levels in observation group were significantly lower than those in control group （P<0.05， P<0.01）， while CD4+CD25+Treg， CD4+Foxp3+Treg and Foxp3 mRNA expressions were significantly higher than those in control group （P<0.05）. The incidence of adverse reactions in observation group was 7/137 （5.11%）， which was significantly lower than 16/137 （11.68%） in control group. Conclusion:The clinical efficacy of Loulu Shengma Tang combined with azithromycin dry suspension in the treatment of pediatric MPP and its effect on serum inflammatory factors （IL-6， IL-10， TNF-α， CRP）， regulatory T cells and Foxp3 mRNA expressions were better than those of azithromycin dry suspension alone. The incidence of adverse reactions of Loulu Shengma Tang was lower than that of azithromycin dry suspension alone.

Clinical Efficacy of Yang Warming, Stasis Dissipating and Detoxifying Method on Sepsis-induced Myocardial Dysfunction / 中国实验方剂学杂志

Objective:To observe clinical efficacy of Shengma Biejia Tang combined with Shenfutang on sepsis-induced myocardial dysfunction (SIMD) and study the controlling effect on inflammatory reaction. Method:Eighty-eight patients with SIMD were randomly divided into control group (44 cases) and observation group (44 cases) by random number table. Patients in control group received the early bundle therapy of sepsis, including fluid resuscitation, anti-infection treatment and vasoactive drugs. In addition to the therapy of control group, patients in observation were also given Shengma Biejia Tang combined with Shenfutang, 1 dose/day. And a course of treatment was 7 days. Before and after treatment, levels of troponin (cTnI), creatine kinase isoenzyme (CK-MB), N terminal brain natriuretic precursor (NT-proBNP), calcitonin (PCT), hypersensitivity C reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), interleukins-6 (IL-6) and blood lactic acid (LAC) were detected. And color Doppler ultrasound examination of the heart was performed to record left ventricular ejection fraction (LVEF), blood flow velocity of early mitral valve diastole and ratio of blood flow velocity at atrial systolic peak (E/A) and stroke volume (SV). And lactate clearance rate (LCR) was calculated. And sequential (sepsis-related) organ failure assessment (SOFA), acute physiology and chronic health (APACHEⅡ) and traditional Chinese medicine(TCM)syndromes were scored. Result:After treatment, levels of cTnI, NT-ProBNP, CK-MB, Hs-CRP, IL-6, PCT, TNF-α and LAC in observation group were lower than those in control group (PPPConclusion:In addition to the integrated western medicine, Shengma Biejia Tang combined with Shenfutang can control inflammatory reaction, relieve myocardial inhibition and myocardial damage, and protect and improve heart function, and alleviate the symptoms.

Identification and differentiation of major components in three different "Sheng-ma" crude drug species by UPLC/Q-TOF-MS

Cimicifugae Rhizoma (Sheng ma) is a Ranunculaceae herb belonging to a composite family and well known in China. has been widely used in traditional Chinese medicine. Thecontains three varieties ((Turcz.),L. andKom.) which have been used clinically as "Sheng-ma". However, the chemical constituents of three components of "Sheng-ma" have never been documented. In this study, a rapid method for the analysis of the main components of "Sheng-ma" was developed using ultra-high performance liquid chromatography with quadrupole-time-of-flight mass spectrometry (UPLC/Q-TOF-MS). The present study reveals the major common and distinct chemical constituents of,andand also reports principal component and statistical analyses of these results. The components were identified by comparing the retention time, accurate mass, mass spectrometric fragmentation characteristic ions and matching empirical molecular formula with that of the published compounds. A total of 32 common components and 8 markers for different "Sheng-ma" components were identified. These findings provide an important basis for the further study and clinical utilities of the three "Sheng-ma" varieties.

Simultaneous Determination of Baicalin, Paeoniflorin and Puerarin in Shengma Huangqin Granules by RP-HPLC / 中国药师

Objective:To develop a RP-HPLC method for simultaneously determining the contents of baicalin,paeoniflorin and pu-erarin in Shengma Huangqin granules. Methods:Three active compounds were chromatographically separated on a Kromasil C18 column (150 mm ×4.6 mm,5 μm) using the isocratic mobile phase composed of acetonitrile-0.1%H3PO4( 20∶80) coupled with changed flow rate and detection wavelength:1-12 min:1. 0 ml·min-1 ,230nm;12. 01-20. 0 min:1. 5 ml·min-1 ,278nm. The temperature of column was 30℃,and the injection volume was 20μl. Results:The linear range of baicalin, paeoniflorin and puerarin was 10-160,30-480 μg·ml-1and 20-320 μg·ml-1 with average recovery of 100. 17%(RSD=1. 29%),100. 14%(RSD=0. 47%) and 100. 68%(RSD=1. 81%),respectively. Conclusion: The method is convenient,accurate and reproducible for the determination of baicalin , paeoniflorin and puerarin in Shengma Huangqin granules.

Experimental Study on Anti-tumor Prescription Screening and Therapeutic Effects of Shengma Combined with Zao Jiao-ci / 中国中医药信息杂志

Objective To screen the anti-tumor prescription (Shengzao Fang) of Shengma (Rhizoma Cimicifugae) combined with Zao Jiao-ci (Spina Gleditsiae), and evaluate its anti-tumor effects. Methods The lung metastatic model of 4T1 breast cancer and the 4T1 subcutaneous transplanted model were established, both models of mice were randomly divided into model group, Shengma group, Zao Jiao-ci group, Shengzao Fang first group, Shengzao Fang second group and Shengzao Fang third group, 10 mice for each group. The proportion of Shengzao Fang was ascertained by their anti-tumor effects. MTT assay was used to investigate the effects of Shengzao Fang on 4T1 breast cancer. The concentration of type 1 collagen (Col-Ⅰ), platelet-activating factor (PAF), tissue inhibitor of metalloproteinase 1 (TIMP-1), tyrosine kinase receptor A (TrkA) and tyrosine kinase receptor B (TrkB) in serum from tumor-bearing mice was tested by enzyme-linked immunosorbent assay (ELISA). The effects of Shengzao Fang on matrix metalloproteinase (MMPs) was examined by Gelatin matrix method. Results Compared with the model group, the prescription of Shengma∶Zao Jiao-Ci=2∶1 significantly suppressed lung metastasis of 4T1 breast cancer, showing fewer lung nodes, lower lung metastasis rate and highest tumor inhibitory rate to 4T1 subcutaneous transplanted model. Although the concentration of serum Col-Ⅰ, PAF, TIMP-1, TrkA and TrkB was decreased in all treated group, the prescription of Shengma∶Zao Jiao-ci=2∶1 had the strongest activity, and its inhibitory effect on the expression of MMP-2 and MMP-9 was strongest, too. Conclusion The prescriptions of Shengma combined with Zao Jiao-ci had different antitumor activity, the strongest activity was exhibited when shengma∶Zao Jiao-ci was 2∶1, suggesting that 2∶1 was optimization for Shengma combined with Zao Jiao-ci.