Xiaoqinglong decoction mitigates nasal inflammation and modulates gut microbiota in allergic rhinitis mice.

Introduction: Allergic rhinitis (AR) is a respiratory immune system disorder characterized by dysregulation of immune responses. Within the context of AR, gut microbiota and its metabolites have been identified as contributors to immune modulation. These microorganisms intricately connect the respiratory and gut immune systems, forming what is commonly referred to as the gut-lung axis. Xiaoqinglong Decoction (XQLD), a traditional Chinese herbal remedy, is widely utilized in traditional Chinese medicine for the clinical treatment of AR. In this study, it is hypothesized that the restoration of symbiotic microbiota balance within the gut-lung axis plays a pivotal role in supporting the superior long-term efficacy of XQLD in AR therapy. Therefore, the primary objective of this research is to investigate the impact of XQLD on the composition and functionality of the gut microbiota in a murine model of AR. Methods: An ovalbumin-sensitized mouse model to simulate AR was utilized, the improvement of AR symptoms after medication was investigated, and high-throughput sequencing was employed to analyze the gut microbiota composition. Results: XQLD exhibited substantial therapeutic effects in AR mice, notably characterized by a significant reduction in allergic inflammatory responses, considerable alleviation of nasal symptoms, and the restoration of normal nasal function. Additionally, following XQLD treatment, the disrupted gut microbiota in AR mice displayed a tendency toward restoration, showing significant differences compared to the Western medicine (loratadine) group. Discussion: This results revealed that XQLD may enhance AR allergic inflammatory responses through the regulation of intestinal microbiota dysbiosis in mice, thus influencing the dynamics of the gut-lung axis. The proposal of this mechanism provides a foundation for future research in this area.

Xiaoqinglong decoction improves allergic rhinitis by inhibiting NLRP3-mediated pyroptosis in BALB/C mice.

ETHNOPHARMACOLOGICAL RELEVANCE: Xiaoqinglong decoction (XQLD), first recorded in Shang Han Lun, is a traditional Chinese medicine prescribed for the treatment of allergic rhinitis (AR). XQLD alleviates the clinical symptoms of AR by inhibiting the occurrence of an inflammatory response, but the specific regulatory mechanism remains unclear. AIM OF THE STUDY: NLRP3-mediated pyroptosis is closely related to AR pathogenesis. Hence, this study aimed to explore the potential role of NLRP3-mediated pyroptosis pathway in the AR-associated pharmacological mechanism of XQLD. MATERIALS AND METHODS: BALB/C mice models of AR was established by using ovalbumin (OVA) and aluminum hydroxide sensitization. After intragastric administration of different dosages of XQLD, nasal allergic symptoms were observed. The expression of OVA-sIgE and Th2 inflammatory factors (IL-4, IL-5, and IL-13) in serum was detected by ELISA. The histopathological morphology and expression of inflammatory factors in nasal mucosa along with pyroptosis were investigated. Molecular docking was performed to analyze the binding of representative compounds of XQLD with NLRP3. Activation of the NLRP3 inflammasome was detected by immunofluorescence and western blotting. RESULTS: XQLD significantly improved the nasal allergic symptoms of mice, reduced the degree of goblet cell proliferation, mast cell infiltration, and collagen fiber hyperplasia in nasal mucosa. Meanwhile, it could downregulate the expression of Th2 inflammatory factors (IL-4, IL-5, and IL-13) in serum and nasal mucosa. XQLD significantly reduced the number of GSDMD and TUNEL double-positive cells and IL-1ß and IL-18 expression. Molecular docking confirmed that seven representative compounds of XQLD had good binding properties with NLRP3 and were able to inhibit the activation of the NLRP3 inflammasome. CONCLUSIONS: The representative compounds of XQLD might inhibit pyroptosis in nasal mucosa mediated by the NLRP3 inflammasome to helping the recovery of AR, which provides a new modern pharmacological proof for XQLD to treat AR.

[Metabolomics of nasal lavage fluid in patients with allergic rhinitis treated by Xiaoqinglong Decoction].

This study used nasal lavage fluid for metabolomics to explore its feasibility, and applied it to the clinical metabolomics study of Xiaoqinglong Decoction in the treatment of allergic rhinitis(AR), aiming to investigate the molecular mechanism of Xiaoqing-long Decoction in the treatment of AR through differential changes in local nasal metabolism. AR patients were selected as the research subjects, and nasal lavage fluid was collected as the sample. Metabolomics analysis using liquid chromatography-mass spectrometry was performed on normal group, AR group, and Xiaoqinglong Decoction group. The differences in metabolic profiles among the groups were compared using principal component analysis and partial least squares discriminant analysis, and differential metabolites were identified and subjected to corresponding metabolic pathway analysis. The results showed that Xiaoqinglong Decoction significantly improved the symptoms of AR patients. The metabolomics analysis revealed 20 differential metabolites between AR group and Xiaoqinglong Decoction group. The core metabolite with a trending return in comparison to normal group was trimethyladipic acid. The metabolites were involved in multiple pathways, including ß-alanine metabolism, glutathione metabolism, and phenylalanine, tyrosine, and tryptophan biosynthesis. The feasibility of applying nasal lavage fluid in nasal metabolomics was preliminarily demonstrated. Differential metabolites and enriched pathways in the treatment of AR patients with Xiaoqinglong Decoction were identified, indicating that it may improve rhinitis symptoms through the regulation of various metabolites, including antioxidant effects and correction of Th1/Th2 imbalance.

Xiaoqinglong decoction suppresses childhood cough variant asthma and inhibited the body inflammatory response by regulating IL-6/STAT3 signalling pathway.

Xiaoqinglong decoction (XQLD) is widely used clinically in the treatment of childhood cough variant asthma (CVA). However, its potential mechanism is still unknown. In the present study, the authors investigate the biological network and signalling pathway of XQLD in treatment of childhood CVA using network pharmacology-based analysis and experimental validation. By using the Bioinformatics Analysis Tool Molecular Mechanism of Traditional Chinese Medicine (BATMAN-TCM) database, the authors confirmed the correlation between XQLD and asthma, and the authors screened 1338 potential target genes of Mahuang and Guizhi, the most active herbs in XQLD. By overlapping "Childhood asthma-related genes" of DisGeNET database, the authors identified 58 intersecting genes of Childhood asthma and 1338 target genes of Mahuang and Guizhi. The intersecting genes were used to construct the protein-to-protein interaction and performed Gene Ontology (GO) functional and the Kyoto Encyclopedia of Genes and Genomes pathway enrichment analyses. Gene Ontology enrichment analysis demonstrated 359 Biological Process terms, 16 Cellular Component terms, and 26 Molecular Function terms. Meantime, 75 terms of Kyoto Encyclopedia of Genes and Genomes signalling pathway were involved in enrichment analysis. These candidates showed a significant correlation with inflammatory response and positive regulation of tyrosine phosphorylation of STAT protein. In addition, XQLD treatment significantly upregulated serum interferon-γ expression, and downregulated serum interlukin-6 expression of CVA mice. XQLD treatment significantly inhibited phosphorylation of STAT3 in bronchial-lung tissues. Our data suggest that XQLD effectively alleviated bronchial-lung tissue damage in CVA mice and inhibited the body inflammatory response by regulating interlukin-6/STAT3 signalling pathway.

Therapeutic effect of modified Xiaoqinglong Decoction on cough-variant asthma and immunological functioning in children.

OBJECTIVE: To investigate the effect of modified Xiaoqinglong Decoction on cough variant asthma (CVA) and immunological functioning in children. METHODS: In this is retrospective analysis, 122 children with CAV admitted to our hospital from Mar. 2021 to Mar. 2022 were divided into an observation group (n=61) and a control group (n=61) according to treatment methods. The control group received fluticasone propionate inhalation aerosol, and the observation group additionally received Xiaoqinglong Decoction. The therapeutic efficacy in the two groups was compared after 8 weeks of treatment. The comparison indictors included scores of daytime and nighttime cough, pulmonary function, fractional exhaled nitric oxide (FeNO), eosinophil count, inflammatory response (interleukin-4 (IL-4), tumor necrosis factor-α (TNF-α) and macrophage inflammatory protein ((MIP)-1α), immunoglobulin (Ig)) level and adverse reactions. RESULTS: The overall response rate of children with CVA in the observation group was higher than that in the control group (P<0.05). After treatment, the scores of daytime and nighttime cough in the observation group were lower than those in the control group (P<0.05). The Forced Vital Capacity (FVC), peak expiratory flow (PEF) and FEV1 (Forced Expiratory Volume)/FVC of the observation group were higher than those in the control group (P<0.05). The FeNO and eosinophil count in the observation group were lower than those in the control group (P<0.05). The serum IL-4 was higher, while TNF-α and MIP-1α levels were lower in the observation group in the control group (P<0.05). The serum IgA, IgG and IgM levels in the observation group were higher than those in the control group (P<0.05). CONCLUSION: The modified Xiaoqinglong Decoction has a conspicuous effect on children with CVA. It helps to reduce cough symptoms, improve pulmonary function, reduce inflammatory response and improve immunological functioning of children.

HDAC Downregulation of Xiaoqinglong Decoction in the Treatment of Allergic Rhinitis.

INTRODUCTION: As one of the most common allergic diseases, allergic rhinitis (AR) has attracted wide attention all over the world. More appropriate treatment of AR should be explored thoroughly. In recent years, traditional Chinese medicine has attracted more attention in AR treatment. As a classical Chinese medicine prescription, Xiaoqinglong decoction (XQLD) has been commonly used in treating AR. Even though its therapeutic effect on AR has been clinically confirmed, more molecular mechanism remains to be further investigated. Our research aimed to investigate the therapeutic mechanism of XQLD for AR management. METHODS: The study was evaluated in an ovalbumin sensitized mouse model and liquid chromatography-mass spectrometry was adopted to test the stability of XQLD's effective components. RESULTS: The results confirmed the stability and safety of the effective components of XQLD. XQLD significantly downregulated the expression of HDACs (HDAC1, HDAC3, and HDAC4) and Th2 inflammatory factors (IL4, IL5, and IL13) in AR mice. XQLD and the HDAC inhibitor JNJ-26481585 promoted the expression of epithelial tight junction proteins (claudin-1 and ZO-1) and decreased the expression of mucins (Muc5ac and Muc5b) in the nasal mucosa of AR mice. CONCLUSIONS: In conclusion, our findings present the beneficial effects of XQLD on AR and recovery of the nasal epithelium. We also identify the decreased HDAC as a potential target of XQLD for AR treatment. This study provides an important experimental proof for elucidating the therapeutic mechanism of XQLD.

Effect of physical rehabilitation combined with Xiaoqinglong Decoction on the syndrome of lung and spleen deficiency in children with asthma remission / 西安交通大学学报(医学版)

【Objective】 To investigate the effect of physical therapy combined with traditional Chinese medicine (TCM) in treating the syndrome of lung and spleen qi deficiency in children at asthma remission stage and the effect on serological indicators. 【Methods】 A total of 130 children with asthma in remission treated in our hospital from May 2018 to May 2020 were selected and randomly divided into combination group (n=65) and physical group (n=65). The physical group was treated with physical therapy and Montelukaste sodium chewable tablet, while the combination group was treated with Xiaoqinglong Decoction based on soil preparation and gold generation method. Both groups were treated for three months. The scores of chest tightness (attack), cough, asthma and laryngeal wheezing were compared between the two groups before and after treatment. The average score of TCM syndrome was recorded before treatment (T0), 1, 2 and 3 months after treatment (T1, T2 and T3), and 6 and 9 months after treatment (T4 and T5). Serum levels of interleukin 6 (IL-6), immunoglobulin (IgE) and tumor necrosis factor α(TNF-α) were detected before and after treatment. 【Results】 After treatment, the total effective rate in the combination group (86.15%) was higher than that in the physical group (73.85%) (χ2=4.333, P<0.05). After treatment, the TCM syndrome scores of asthma, laryngeal phlegm were significantly lower in the combination group than in the physical group (P<0.05). The average score of TCM syndrome in T3, T4 and T5 combination group was lower than that in the physical group (t=3.167, 3.317, 4.168, 4.267, P<0.05). After treatment, the levels of IL-6, IgE and TNF-α were decreased (P<0.05), and the levels of IgE and TNF-α in the combination group were lower than those in the physical group (t=12.164, 5.136, P<0.05). 【Conclusion】 Physical therapy combined with Xiaoqinglong Decoction can improve clinical symptoms and regulate immunity of children at asthma remission stage.

Metabolomics of nasal lavage fluid in patients with allergic rhinitis treated by Xiaoqinglong Decoction / 中国中药杂志

This study used nasal lavage fluid for metabolomics to explore its feasibility, and applied it to the clinical metabolomics study of Xiaoqinglong Decoction in the treatment of allergic rhinitis(AR), aiming to investigate the molecular mechanism of Xiaoqing-long Decoction in the treatment of AR through differential changes in local nasal metabolism. AR patients were selected as the research subjects, and nasal lavage fluid was collected as the sample. Metabolomics analysis using liquid chromatography-mass spectrometry was performed on normal group, AR group, and Xiaoqinglong Decoction group. The differences in metabolic profiles among the groups were compared using principal component analysis and partial least squares discriminant analysis, and differential metabolites were identified and subjected to corresponding metabolic pathway analysis. The results showed that Xiaoqinglong Decoction significantly improved the symptoms of AR patients. The metabolomics analysis revealed 20 differential metabolites between AR group and Xiaoqinglong Decoction group. The core metabolite with a trending return in comparison to normal group was trimethyladipic acid. The metabolites were involved in multiple pathways, including β-alanine metabolism, glutathione metabolism, and phenylalanine, tyrosine, and tryptophan biosynthesis. The feasibility of applying nasal lavage fluid in nasal metabolomics was preliminarily demonstrated. Differential metabolites and enriched pathways in the treatment of AR patients with Xiaoqinglong Decoction were identified, indicating that it may improve rhinitis symptoms through the regulation of various metabolites, including antioxidant effects and correction of Th1/Th2 imbalance.

Therapeutic Mechanism of Xiaoqinglong Decoction against COVID-19 Based on Network Pharmacology and Molecular Docking Technology.

BACKGROUND: A xiaoqinglong decoction (XQLD) has been proven effective in treating severe coronavirus disease 2019 (COVID-19) cases; however, the mechanism remains unclear. OBJECTIVE: In the current study, we used network pharmacology and molecular docking technology to identify the effective components, potential targets, and biological pathways of XQLD against COVID-19. METHODS: Public databases were searched to determine the putative targets of the active compounds of XQLD and COVID-19-related targets. STRING and Cytoscape were used to establish the protein-protein interaction network and drug component, along with the target-pathway network. The DAVID database was used to enrich the biological functions and signaling pathways. AutoDock Vina was used for virtual docking. RESULTS: We identified 138 active compounds and 259 putative targets of XQLD. Biological network analysis showed that quercetin, beta-sitosterol, kaempferol, stigmasterol, and luteolin may be critical ingredients of XQLD, whereas VEGFA, IL-6, MAPK3, CASP3, STAT3, MAPK1, MAPK8, CASP8, CCL2, and FOS may be candidate drug targets. Enrichment analysis illustrated that XQLD could function by regulating viral defense, inflammatory response, immune response, and apoptosis. Molecular docking results showed a high affinity between the critical ingredients and host cell target proteins. CONCLUSION: This study uncovered the underlying pharmacological mechanism of XQLD against COVID-19. These findings lay a solid foundation for promoting the development of new drugs against severe acute respiratory syndrome coronavirus-2 infection and may contribute to the global fight against the COVID-19 pandemic.

Modified Xiaoqinglong decoction alleviates lipopolysaccharide-induced acute lung injury in mice by regulating arachidonic acid metabolism and exerting anti-apoptotic and anti-inflammatory effects.

Effective therapeutics are not available for acute lung injury (ALI) and acute respiratory distress syndrome. Modified Xiaoqinglong decoction (M-XQL) is reported to effectively treat pneumonia, but the underlying mechanisms are unclear. In this study, the therapeutic effect and mechanism of M-XQL were examined using a lipopolysaccharide (LPS)-induced ALI mouse model. The effects of M-XQL on lung injury, inflammatory responses, and cell apoptosis were analyzed. Additionally, high-throughput sequencing was performed to evaluate the therapeutic mechanism of M-XQL. Pretreatment with M-XQL significantly and dose-dependently mitigated the pathological changes and upregulation of pulmonary, nitric oxide content and cell apoptosis and serum tumor necrosis factor-alpha contents in the LPS-induced ALI mouse model. RNA sequencing analysis revealed that the expression of several arachidonic acid metabolism-associated genes in the LPS + high-dose M-XQL group differed from that in the LPS group. In particular, the Cbr2, Cyp4f18, and Cyp2e1 levels were upregulated, whereas the Alox12, Ptges, and Ptges2 levels were downregulated in the LPS + high-dose M-XQL group. These results suggest that M-XQL exerts therapeutic effects in ALI mice by regulating arachidonic acid metabolism and exerting anti-apoptotic and anti-inflammatory effects. Thus, M-XQL is a potential agent for the clinical treatment of ALI.

Mechanism of Xiaoqinglong Decoction and Qingqi Huatan Pills in improving pathological airway mucus based on nuclear factor-κB/microRNA-494 signaling regulation of mucin 5AC and cystic fibrosis transmembrane conductance regulator / 中华危重病急救医学

Objective:To observe the effects of Xiaoqinglong Decoction and Qingqi Huatan Pills on interleukin-1β(IL-1β)-induced mucushypersecretion model of human airway epithelial H292 cellsand related molecules of nuclear factor-κB/microRNA-494 (NF-κB/miR-494) signaling pathway, and to explore the mechanism of the two medicines in improving pathological airway mucus.Methods:Methyl thiazolyl tetrazolium (MTT) colorimetric method was used to detect the effects of different concentrations of Xiaoqinglong Decoction and Qingqi Huatan Pills on the activity of H292 cellsinduced by IL-1β, and the appropriate concentration was selected for subsequent experiments. Cells were randomly divided into blank group, IL-1β model group (5 μg/L IL-1β), NF-κB inhibitor pyrrolidinedithiocarbamate (PDTC) group (5 μg/L IL-1β+100 μmol/L PDTC), Xiaoqinglong Decoction (5 μg/L IL-1β+1 000 mg/L Xiaoqinglong Decoction) and Qingqi Huatan Pill group (5 μg/L IL-1β+1 000 mg/L Qingqi Huatan Pills). 5 μg/L IL-1β was used to induce H292 cells for 24 hours to establish a model of airway epithelial mucus hypersecretion. Enzyme linked immunosorbent assay (ELISA) method was used to detect the levels of mucin 5AC (MUC5AC), tumor necrosis factor-α (TNF-α) and IL-8 and the synthesis of intracellular MUC5AC and cystic fibrosis transmembrane conductance regulator (CFTR). Real-time quantitative polymerase chain reaction (RT-qPCR) was used to detect the expression levels of MUC5AC mRNA, CFTR mRNA, miR-494. Western blotting was used to detect protein expression of key proteins (p65) and NF-κB inhibitors (IκB) in NF-κB signaling pathway.Results:Xiaoqinglong Decoction and Qingqi Huatan Pills with the concentration of 1 000 mg/L were selected for the follow-up experiment. Compared with the blank group, the levels of MUC5AC, TNF-α and IL-8 were significantly increased in the model group, intracellular MUC5AC protein content and mRNA expression were also significantly increased, intracellular CFTR protein content and mRNA expression were significantly decreased, and intracellular p65 protein expression was significantly up-regulated, the expression of IκB protein was significantly down-regulated, and the expression of miR-494 was significantly increased. Compared with the model group, the levels of MUC5AC, TNF-α and IL-8 were significantly reduced in PDTC group, Xiaoqinglong Decoction group and Qingqi Huatan Pill group, intracellular MUC5AC protein content and mRNA expression were also significantly decreased, and intracellular p65 protein expression was significantly down-regulated, and IκB protein expression was significantly up-regulated, miR-494 expression was significantly reduced. Intracellular CFTR protein content and mRNA expression were significantly increased in both PDTC group and Qingqi Huatan Pill group. Compared with the PDTC group, the level of TNF-α in the Xiaoqinglong Decoction group was significantly increased (ng/L: 22.77±3.14 vs. 11.09±3.37, P < 0.05), the content and mRNA expression of CFTR and IκB protein expression was significantly decreased [CFTR protein (ng/L): 97.38±6.62 vs. 227.04±19.48, CFTR mRNA (2 -ΔΔCt): 0.99±0.08 vs. 1.21±0.08, IκB/β-actin: 1.69±0.11 vs. 2.00±0.18, all P < 0.05], the level of TNF-α in Qingqi Huatan Pill group was significantly higher (ng/L: 19.08±3.71 vs. 11.09±3.37, P < 0.05). Compared with Xiaoqinglong Decoction group, the protein content and mRNA expression of CFTR and IκB protein expression in Qingqi Huatan Pill group were significantly increased [CFTR protein (ng/L) : 235.01±22.71 vs. 97.38±6.62, CFTR mRNA(2 -ΔΔCt): 1.32±0.15 vs. 0.99±0.08, IκB/β-actin: 1.94±0.16 vs. 1.69±0.11, all P < 0.05]. Conclusions:The effect of Xiaoqinglong Decoctionin improving the hypersecretion of mucus in the airway epithelium may be related to the inhibition of NF-κB/miR-494 inflammatory signal-mediated MUC5AC hypersecretion, while the effect of Qingqi Huatan Pills may be related to the inhibition of NF-κB/miR-494 inflammatory signal-mediated MUC5AC hypersecretion and CFTR dysfunction. Therefore, the difference in the mechanism of the two treatments of airway pathological mucus is mainly in the regulation of CFTR mRNA and protein.

Study on the effect of Xiaoqinglong decoction on vascular endothelin inpulmonary hypertension rat based on Jiebiaokuoluo method / 中华危重病急救医学

Objective:To discuss the effect of Xiaoqinglong decoction on vascular endothelin (ET) in rats pulmonary hypertension (PAH) model based on the Jiebiaokuoluo method.Methods:Sixty male SD rats were randomly divided into six groups: control group, PAH model group, positive drug group, and Xiaoqinglong decoction in the high-dose, medium-dose and low-dose groups, 10 rats in each group. The control group did not receive any treatment. The remaining groups were kept in low-pressure oxygen tanks, injections of lipopolysaccharide (LPS) at 200 μL on day 1 and day 14, respectively. The rats were smoked twice a day from day 2 to day 30 (except day 14) at 4 hours intervals. The rats were placed in a low-temperature environment for 1 hour per day, and were put into cold water to swim (for 2 weeks), while the rats were given a cold diet. After modeling, the control group and the PAH model group were given equal volumes of normal saline; the positive drug group was given bosentan (100 mg/kg); Xiaoqinglong decoction 15, 10 and 5 g/kg was given, respectively, in the high, medium and low dose groups; once daily for 30 days. The mean pulmonary artery pressure (mPAP) and right ventricle systolic pressure (RVSP) were then measured with right heart catheterization and the right ventricle hypertrophy index (RVHI) was assessed; ET-1 and nitric oxide (NO) levels were determined by radioimmunoassay.Results:Compared with the control group, the levels of mPAP, RVSP, RVHI and ET-1 were significantly increased in the PAH model group [mPAP (mmHg, 1 mmHg≈0.133 kPa): 33.20±1.04 vs. 13.20±1.03, RVSP (mmHg): 62.40±1.54 vs. 24.20±1.02, RVHI: 42.90±2.51 vs. 25.40±2.01, ET-1 (ng/L): 100.80±20.34 vs. 81.50±13.84, all P < 0.05], while NO levels were significantly decreased (mmol/L: 23.20±1.81 vs. 31.70±1.49, P < 0.05). Compared with the PAH model group, the levels of mPAP, RVSP, RVHI and ET-1 in the positive drug group and high, medium, low dose groups of Xiaoqinglong decoction were significantly decreased [mPAP (mmHg): 25.50±0.84, 26.90±0.74, 27.10±1.19, 29.10±0.75 vs. 33.20±1.04, RVSP (mmHg): 54.40±5.14, 50.10±1.67, 53.10±1.05, 56.60±1.07 vs. 62.40±1.54, RVHI: 41.10±1.19, 31.20±1.67, 31.30±1.89, 40.30±1.88 vs. 42.90±2.51, ET-1 (ng/L): 70.70±7.89, 69.90±2.92, 71.70±4.32, 73.90±5.19 vs. 100.80±20.34, all P < 0.05], while NO levels were significantly increased (mmol/L: 32.50±2.06, 34.70±1.16, 32.70±1.33, 30.10±1.19 vs. 23.20±1.81, all P < 0.05), and with the increased dose of Xiaoqinglong decoction, the change was more obvious, and the effect was better in the high-dose group. Conclusion:Xiaoqinglong decoction can reduce rats PAH by regulating ET-1 and NO levels in a dose-dependent manner.

[Procalcitonin impact analysis, respiratory function and blood gas analysis on Xiaoqinglong decoction combined with non-invasive ventilation in treatment of AECOPD patients].

To observe the effect of Xiaoqinglong decoction combined with noninvasive ventilation on procalcitonin (PCT), blood gas analysis and respiratory functions in acute exacerbation of chronic obstructive pulmonary disease in the elderly (AECOPD), and investigate its correlation and clinical significance. Eighty-four elderly AECOPD patients with respiratory failure in our hospital from January 2015 to October 2017, were randomly divided into control group and observation group, 42 cases in each group. The control group received western medicine combined with noninvasive ventilator therapy, and the patients in observation group additionally received Xiaoqinglong decoction on the basis of the treatment in control group. Both groups were treated for 2 weeks. The clinical effects of two groups were observed and their PCT, blood gas analysis outcomes [arterial oxygen partial pressure (PaO2), arterial partial pressure of carbon dioxide (PaCO2), respiratory function, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC], TCM syndrome score and other indexes and adverse reactions were compared before and after treatment. The total efficiency was 95.24% (40/42) in observation group, higher than 76.19% (32/42) in control group, with statistically significant difference (P<0.05). There were no statistically significant differences in PCT, PaO2, PaCO2, FVC, FEV1/FVC, FEV1, and TCM syndrome scores between two groups before treatment. But after treatment, PCT and PaCO2 levels in the observation group were lower and PaO2, FVC, FEV1/FVC, FEV1 levels was higher than those in the control group (P<0.05); TCM syndrome scores were lower than those in the control group (P<0.05); both groups had no obvious adverse reactions. The results showed that Xiaoqinglong decoction combined with noninvasive ventilator could significantly reduce the procalcitonin level, effectively improve the respiratory function and blood gas analysis indexes, and significantly reduce the clinical symptoms in AECOPD patients, so it is worthy of promotion.

Regulatory Effect of Xiaoqinglong Decoction on Thymic Stromal Lymphopoietin (TSLP) Inflammation Promoter in Mice with Cold Asthma.

Allergic asthma is a complex and chronic inflammatory airway disease. The thymic stromal lymphopoietin (TSLP) signaling pathway plays an important role in asthma. Xiaoqinglong Decoction (XQL) is the first choice to treat cold asthma in clinical settings. In this study, the role of the TSLP pathway in the onset of asthma and the protective mechanism of XQL were investigated. A total of 50 female mice were randomly divided into the following groups: the blank group (A), the model group (B), the XQL group (C), the dexamethasone group (D), and the XQL + dexamethasone group (E). Asthma was induced with ovalbumin, and corresponding drug intervention was carried out for 7 days, after which serum and lung tissue end points were analyzed. Serum interleukin 1ß (IL-1ß), tumor necrosis factor-α (TNF-α), nuclear factor κB (NF-κB), and TSLP levels were higher in group B than in group A (p<0.05). However these levels were lower in group C and D than in group B (p<0.05), and there was no significant difference between groups C and D (p>0.05). Interestingly, these end points were significantly lower in group E than in groups C and D (p<0.05). Regarding pathologic changes, the inflammatory infiltrate in the lungs of groups C, D, and E was lower than that of group B, especially in group E. We conclude that the TSLP pathway plays an important role in the course of asthma, and can be used as an important target for asthma treatment; XQL may play a role in reducing inflammation and relieving asthma by regulating the TSLP signaling pathway.

The Analogical Reasoning to Xiaoqinglong Decoction Replacing Ephedra with Daphninae / 世界科学技术-中医药现代化

"If slight diarrhoea, replacing Ephedra with Daphninae"under the article 40 of Treatise on Febrile Diseasesis is controversial. There are two different opions in all physicians, one explaination it is in line with Zhang Zhongjing but without the evidence about"replacing Ephedra with Daphninae"; the other is that Daphninae is too strong to apply in diarrhoea. According to the analysis on Treatise on Febrile and Miscellaneous Diseases, the slight diarrhoea is the phenomenon of Vital qi exorcism. The reason why replacing Ephedra owing to exogenous evil disappearance, the construction of Daphninae Pinellia ternate and Paeony is to expell the water on the leaving way. And we draw a conclusion that the function of Paeony in Xiaoqinglong decoction is inclined to be expelling Water Qi.

Clinical Study on Modified Xiaoqinglong Decoction with Bladder Meridian Ginger Treatment for Acute Exacerbation of Chronic Obstructive Pulmonary Disease of External Cold and Internal Fluid / 中国中医药信息杂志

Objective To analyze the clinical efficacy of modified Xiaoqinglong Decoction with bladder ginger treatment in treating acute exacerbation of chronic obstructive pulmonary disease (AECOPD) of external cold and internal fluid. Methods Totally 150 cases of AECOPD were divided into Western medicine group, integrated traditional Chinese and Western medicine group, and observation group, with 50 cases in each group. Western medicine group received routine treatment, such as controlled oxygen therapy, anti-infection, triple inhalation, relieve spasm and asthma, cough and phlegm, correct water and electrolyte balance. On the basis of routine treatment, integrated traditional Chinese and Western medicine group received modified Xiaoqinglong Decoction, one dosage per day, twice a day, orally. On the basis of integrated traditional Chinese and Western medicine group, observation group received scraping the bladder at the back of the Bladder Meridian of Foot-Taiyang, putting 20–30 g fresh mashed ginger, for 15–20 min. All treatment lasted for 14 d. TCM symptom scores, the main symptoms of remission time and lung function before and after treatment in the three groups were compared. Results The differences in main symptoms scores (cough, expectoration, wheezing, shortness of breath) and total scores of the observation group were higher than Western medicine group and integrated traditional Chinese and Western medicine group (P<0.05). The main symptoms remission time of the observation group was much shorter than Western medicine group and integrated traditional Chinese and Western medicine group (P<0.05). Compared with before treatment, the FEV1,FEV1/FVC and MMEF of the three groups after treatment showed an upward trend (P<0.05). The FEV1, FEV1/FVC and MMEF in observation group were significantly higher than Western medicine group and integrated traditional Chinese and Western medicine group (P<0.05). Conclusion Modified Xiaoqinglong Decoction combined with bladder ginger for the treatment of AECOPD of external cold and internal fluid has definite curative effect, and can significantly improve TCM symptoms and pulmonary function.

Effect of Xiaoqinglong Decoction on the expression of TSLP in airway epithelial cells of asthmatic model mice / 重庆医学

Objective To study the effect of Xiaoqinglong Decoction on the expression of TSLP in airway epithelial cells of asthmatic model mice.Methods Thirty healthy female BALB/C mice were divided into the blank control group,asthma model group and Xiaoqinglong Decoction group,10 cases in each group.The each group adopted corresponding intervention measures. Then the bronchial and lung tissues were taken.The expression level of bronchial TSLP was detected by immunofluorescence,and the expression level of TSLP mRNA and protein in lung tissue was detected by qRT-PCR and Western Blot.Results The mouse bronchial epithelial cell membrane TSLP staining was strongly positive in the asthma model group,which was weakly positive in the Xiaoqinglong Decoction group and negative in the blank control group.Compared with the asthma model group,mice lung tissue TSLP mRNA expression level in the Xiaoqinglong Decoction group and blank control group was decreased(P<0.05),the Xiaoqin-glong Decoction group was slightly higher than the blank control group,but the inter-group difference was not statistically signifi-cant(P>0.05).The expression level of lung tissue TSLP protein in the Xiaoqinglong Decoction group and blank control group was lower than that in the asthma model group(P<0.05),the Xiaoqinglong Decoction group was slightly higher than the blank control group,but the inter-group difference was not statistically significant(P>0.05).Conclusion Xiaoqinglong decoction has obvious inhibiting effect on the expression of TSLP in airway epithelial cells of asthmatic model mice.

Procalcitonin impact analysis, respiratory function and blood gas analysis on Xiaoqinglong decoction combined with non-invasive ventilation in treatment of AECOPD patients / 中国中药杂志

To observe the effect of Xiaoqinglong decoction combined with noninvasive ventilation on procalcitonin (PCT), blood gas analysis and respiratory functions in acute exacerbation of chronic obstructive pulmonary disease in the elderly (AECOPD), and investigate its correlation and clinical significance. Eighty-four elderly AECOPD patients with respiratory failure in our hospital from January 2015 to October 2017, were randomly divided into control group and observation group, 42 cases in each group. The control group received western medicine combined with noninvasive ventilator therapy, and the patients in observation group additionally received Xiaoqinglong decoction on the basis of the treatment in control group. Both groups were treated for 2 weeks. The clinical effects of two groups were observed and their PCT, blood gas analysis outcomes [arterial oxygen partial pressure (PaO₂), arterial partial pressure of carbon dioxide (PaCO₂), respiratory function, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC], TCM syndrome score and other indexes and adverse reactions were compared before and after treatment. The total efficiency was 95.24% (40/42) in observation group, higher than 76.19% (32/42) in control group, with statistically significant difference (<0.05). There were no statistically significant differences in PCT, PaO₂, PaCO₂, FVC, FEV1/FVC, FEV1, and TCM syndrome scores between two groups before treatment. But after treatment, PCT and PaCO₂ levels in the observation group were lower and PaO₂, FVC, FEV1/FVC, FEV1 levels was higher than those in the control group (<0.05); TCM syndrome scores were lower than those in the control group (<0.05); both groups had no obvious adverse reactions. The results showed that Xiaoqinglong decoction combined with noninvasive ventilator could significantly reduce the procalcitonin level, effectively improve the respiratory function and blood gas analysis indexes, and significantly reduce the clinical symptoms in AECOPD patients, so it is worthy of promotion.

A Clinical Trial of Xu's Xiaoqinglong Decoction's Effect on Children's Pneumonia with Syndrome of Phlegm Blocking in the Lung / 世界科学技术-中医药现代化

Objective:To observe the clinical effect of Xu's Liu Wei Xiaoqinglong Decoction on children's pneumonia with the syndrome of phlegm blocking in the lung.Method:86 cases were randomly divided into 2 groups,43 cases in each.Treatment group was treated by Liuwei Xiaoqinglong Decoction (granules),Control group was treated by San Ao Decoction (granules),both taken orally,twice per day,for 7 days.The clinical effects and syndrome integrals improvement were observed.Result:The total effective rate of the treatment group was 95.34％ and it was 81.39％ in the control group,the difference between the 2 groups was statistically significant (P＜0.05).And the syndrome improvement of the treatment group was also significantly better than that of the control group.The disappearing time of major symtoms was statistically significantly shorter than that of the control group (P＜0.05).Conclusion:Xu's Liu Wei Xiaoqinglong Decoction has certain effect on children's pneumonia with the syndrome of phlegm blocking in the lung and it should be applied in patient with simple syndrome of phlegm blocking in the lung,or in early stage of phlegm blocking in the lung,compared with cases with syndrome of phlegm blocking in the lung accompanied by spleen deficiency.

Discussion on Character of Xiaoqinglong Decoction Based on HPLC Fingerprints of Single Herb and Herb-pair / 世界科学技术-中医药现代化

Xiaoqinglong decoction,first recorded by Zhang Zhongjing in traditional Chinese medicine (TCM) classic text Shang Han Lun (Treatise on Cold Damage Diseases),has eight herbal components including Herb Ephedrae (Mahuang),Radix Paeoniae Alba (Shaoyao),Radix Asari (Xixin),Rhizoma Zingiberis (Ganjiang),Glycyrrhiza Uralensis (Gancao),Ramulus Cinnamomi (Cuizhi),Rhizoma Pinelliae (Banxia) and Fructus Schisandrae (Wuweizi).Fingerprints of HPLC for single herb and herb-pair including Mahuang-Gancao,Mahuang-Guizhi,Shaoyao-Guizhi,Shaoyao-Gancao,Wuweizi-Xixin were analyzed.Based on the HPLC of single herb and herbal pair,we discussed the character of the Xiaoqinglong decoction and explored the scientific connotation of the compatibility of medicines in prescription.