RESUMO
Objective:To study the effect of combined decoction and single decoction of Houpu Wenzhongtang on rats with deficiency-cold of spleen and stomach from the perspective of metabonomics, to find out the relevant potential biomarkers and metabolic pathways, and to explore the similarities and differences between the combined decoction and single decoction, so as to provide reference for the feasibility analysis of replacing traditional decoction with single dispensing granule of this formula. Method:SD rats were randomly divided into normal group, model group, Houpu Wenzhongtang combined decoction group and simgle decoction group. Rats in the normal group were given distilled water by intragastric administration, rats in the other three groups were given cold vinegar at 4 ℃ in the morning and refined lard in the afternoon for 10 days (the dosage of 10 mL·kg-1). After the model was successfully established, rats in the combined decoction group and the single decoction group were given corresponding decoction with dosage of 1.8 g·kg-1 (according to the amount of crude drugs), once a day for 7 days. Ultra-high liquid chromatography-quadrupole-time-of-flight tandem mass spectrometry (UPLC-Q-TOF-MS) technique was used to analyze the small molecular endogenous metabolites in urine. Orthogonal partial least squares-discriminant analysis (OPLS-DA) and principal component analysis (PCA) were used to compare the changes of differential metabolites among the normal group, model group, Houpu Wenzhongtang combined decoction group and single decoction group, and the differential metabolites were introduced into Kyoto Encyclopedia of Genes and Genomes (KEGG) for metabolic pathway analysis. Result:Compared with the model group, the Houpu Wenzhongtang combined decoction group and single decoction group jointly regulated 13 potential biomarkers, including phosphatidylcholine(PC), lysophosphatidic acid(LysoPA) and cholic acid, etc. They played a role in treating deficiency-cold of spleen and stomach by influencing metabolic pathways such as glycerophospholipid metabolism, glycerolipid metabolism, phosphatidylinositol signaling system and so on. The combined decoction and single decoction of Houpu Wenzhongtang could obviously restore the body weight, motilin and gastrin contents of rats with deficiency-cold of spleen and stomach to normal levels. Conclusion:According to biochemical indexes, there is no obvious difference between combined decoction and single decoction of Houpu Wenzhongtang, but according to metabonomics, the combined decoction may be slightly better than the single decoction. The research shows that it is feasible to replace traditional decoction with single dispensing granule of Houpu Wenzhongtang in clinical application.
RESUMO
Objective To observe the clinical effect of Danggui Sini decoction for treatment of patients with chronic non-atrophic gastritis and spleen-stomach deficiency cold syndrome.Methods A prospective randomized control trial was conducted, including 126 in- and out-patients with chronic non-atrophic gastritis diagnosed by gastroscopy and spleen-stomach deficiency cold syndrome differentiated by traditional Chinese medicine (TCM) method admitted to Chinese Medicine Hospital of Haikou City. They were randomly assigned to an observation group (65 cases) and a control group (61 cases). The patients in observation group were given Danggui Sini decoction with addition or/with subtraction of ingredients according to individual situation (ingredients: angelica 15 g, ramulus cinnamomi 15 g, paeonia 15 g, asari 5 g, glycyrrhizae 10 g, Chinese jujube 12, medulla tetrapanacis 10 g ). The warm 200 mL (one dose) decoction was divided into two parts, one part was taken orally before a meal, twice daily, the therapeutic course was 4 weeks and in one week only 6 doses were applied; while the patients in control group, omeprazole capsules (dissolved in intestine), each time 20 mg, once a day combined with domperidone (bite phenanthroline) 10 mg each time, 3 times a day were given. After 4 weeks of treatment, the clinical efficacy, the total integral of symptoms, the therapeutic effect of TCM symptoms score, the improvement of the therapeutic effect of mucosal histological and changes of the number of patients with the patholoyical changes of mucosa under gastroscopy were observed.Results The total effective rate in the observation group was significantly higher than that in the control group [96.9% (63/65) vs. 86.9% (53/61),P < 0.05]. After treatment, the total integral of symptoms and the integrals of main TCM symptoms after treatment were lower than those before treatment, the degree of decrease in the observation group being more marked (the total integral of symptoms score: 12.36±2.11 vs. 15.94±2.37, epigastric distention integral score: 1.23±0.72 vs. 2.12±0.78, epigastric pain score: 1.18±0.67 vs. 2.25±0.94, thermophilic and like pressure integral score: 1.03±0.46 vs. 1.62±0.79, anorexia: 1.06±0.57 vs. 1.43±0.53, integral of loose stools score: 1.36±0.43 vs. 1.67±0.58, lassitude integral score: 1.24±0.32 vs. 1.65±0.42, allP < 0.05). Under gastroscope, the efficacy of mucosal histological change was significantly higher in observation group than that in control group [90.77% (59/65) vs. 81.97% (50/61),P < 0.05]. After treatment, the numbers of patients with chronic inflammatory cell infiltration (47 cases vs. 54 cases), erythema exudation (28 cases vs. 30 cases), flat erosion (8 cases vs. 15 cases), swelling erosion (5 cases vs. 6 cases), bile reflux (2 cases vs. 3 cases) and positive pylorus spirobacteria (20 cases vs. 29 cases) were significantly lower in the observation group than those in the control group (allP < 0.05).Conclusion The therapeutic effects of Danggui Sini decoction for treatment of patients with chronic non-atrophic gastritis and TCM syndrome of spleen-stomach deficiency-cold are remarkable.