The effects of modified Guizhi plus Gegen decoction combined with the blade needle therapy on TCM syndromes, cervical curvature and levels of inflammatory factors in patients with cervical spondylotic radiculopathy.

OBJECTIVE: To explore the effect of modified Guizhi plus Gegen decoction combined with the blade needle therapy on traditional Chinese medicine (TCM) syndromes, cervical curvature, and inflammatory factor levels in patients with cervical spondylotic radiculopathy. METHODS: In this retrospective study, 114 patients with cervical spondylotic radiculopathy who visited Pain Clinic, Hangzhou Fuyang Hospital of TCM Orthopedics and Traumatology from January 2020 to December 2022 were selected as the study subjects. According to different treatment methods, these patients were divided into an observation group (n=57, treated with blade needle therapy) and a control group (n=57, treated with modified Guizhi plus Gegen decoction combined with the blade needle therapy). Patients in both groups were treated for 3 courses. The treatment effects, TCM syndrome scores, cervical curvature, hemorheology indexes, inflammatory factors and adverse reactions were analyzed and compared between the two groups. RESULTS: The effective rate of patients in the observation group was 94.74%, which was significantly higher than 82.46% in the control group (P<0.05). After treatment, TCM syndrome scores, hemorheology indexes, and inflammatory factors levels in both of groups were significantly decreased in contrast to before treatment, while the cervical curvature was obviously increased. Compared with the control group, after the treatment, TCM syndrome scores, hemorheology indexes, inflammatory factors levels after treatment in the observation group were obviously lower, while the cervical curvature in the observation group being significantly increased (all P<0.05). No statistical differences were found for the incidence of adverse reactions between two the groups. CONCLUSION: Modified Guizhi plus Gegen decoction combined with the blade needle therapy effectively improved the TCM syndrome scores, restored the curvature of the cervical spine, improved the hemorheology of patients, inhibited the levels of inflammatory factors and it also has few adverse reactions, with a significant treatment effect in patients with cervical spondylotic radiculopathy.

Anti-inflammatory Activity of Gegen Decoction and Its Modulatory Mechanism on the NF-κB and MAPK Signaling Pathways.

Gegen Decoction as anti-inflammatory medicine is used in clinic widespread, however the specific anti-inflammatory molecular mechanism of Gegen Decoction is still unclear. The purpose was to study the anti-inflammatory activity of Gegen Decoction in vivo and to research its anti-inflammatory molecular mechanism. The content of main essential components in Gegen Decoction were determined by HPLC method. The anti-inflammatory activity of Gegen Decoction was confirmed through in vivo animal experiments. Furthermore, RAW 264.7 cells were stimulated by lipopolysaccharides to induce inflammatory reaction, the modulatory effect of Gegen Decoction on the activation process of mitogen-activated protein kinases and nuclear factor-κB signaling pathways was investigated. The content of puerarin was the highest among all the index components. Gegen Decoction inhibited carrageenan-induced paw edema in rats and xylene-induced ear swelling in mice. Gegen Decoction had no obvious toxicity against RAW 264.7 cells at the concentrations of 10-40 mg/mL; significantly inhibited the release of nitric oxide, prostaglandin E2, tumor necrosis factor-α and interleukin-6; down-regulated the high expression of inflammatory proteins inducible nitric oxide synthase and cyclooxygenase-2. It inhibited the phosphorylation of mitogen-activated protein kinases (MAPKs)/extracellular regulated protein kinases (ERK)/c-Jun N-terminal kinase (JNK), the degradation of nuclear factor-κB (NF-κB)/inhibitor of NF-κB-α (IκB-α) and the nuclear translocation of NF-κB/p65 into nucleus. Gegen Decoction exerts significant anti-inflammatory activity, mainly by blocking the activation of both MAPKs and NF-κB pathway.

[Quality value transfer of material benchmark of Guizhi Jia Gegen Decoction].

A total of 15 batches of the substance reference of Guizhi Jia Gegen Decoction(GZGGD) were prepared and the characteristic fingerprints of them were established. Furthermore, the similarity of the fingerprints and peak attributes were explored. The extraction rate, and the content and the transfer rate ranges of the index components, puerarin, paeoniflorin, liquiritin, and ammonium glycyrrhizate were determined for the analysis of the quality value transfer. The result demonstrated that the fingerprints of the 15 batches of the samples showed high similarity(>0.99). A total of 15 characteristic peaks were identified from the fingerprints, with 10 for Puerariae Lobatae Radix, 1 for Cinnamomi Ramulus, 2 for Paeoniae Radix Alba, and 2 for Glycyrrhizae Radix et Rhizoma. The content of puerarin was 11.05-18.35 mg·g~(-1) and the average transfer rate was 21.27%-39.49%. The corresponding figures were 7.95-10.90 mg·g~(-1) and 23.28%-43.23% for paeoniflorin, 3.25-4.95 mg·g~(-1) and 32.31%-61.27% for ammonium glycyrrhizate, and 3.65-5.80 mg·g~(-1) and 14.57%-27.05% for liquiritin. The extraction rate of the 15 batches of samples was in the range of 16.85%-21.78%. In this paper, the quality value transfer of the substance reference of GZGGD was analyzed based on characteristic fingerprint, content of index components, and the extraction rate. This study is expected to lay a basis for the quality control and further development of GZGGD.

Quality value transfer of material benchmark of Guizhi Jia Gegen Decoction / 中国中药杂志

A total of 15 batches of the substance reference of Guizhi Jia Gegen Decoction(GZGGD) were prepared and the characteristic fingerprints of them were established. Furthermore, the similarity of the fingerprints and peak attributes were explored. The extraction rate, and the content and the transfer rate ranges of the index components, puerarin, paeoniflorin, liquiritin, and ammonium glycyrrhizate were determined for the analysis of the quality value transfer. The result demonstrated that the fingerprints of the 15 batches of the samples showed high similarity(>0.99). A total of 15 characteristic peaks were identified from the fingerprints, with 10 for Puerariae Lobatae Radix, 1 for Cinnamomi Ramulus, 2 for Paeoniae Radix Alba, and 2 for Glycyrrhizae Radix et Rhizoma. The content of puerarin was 11.05-18.35 mg·g~(-1) and the average transfer rate was 21.27%-39.49%. The corresponding figures were 7.95-10.90 mg·g~(-1) and 23.28%-43.23% for paeoniflorin, 3.25-4.95 mg·g~(-1) and 32.31%-61.27% for ammonium glycyrrhizate, and 3.65-5.80 mg·g~(-1) and 14.57%-27.05% for liquiritin. The extraction rate of the 15 batches of samples was in the range of 16.85%-21.78%. In this paper, the quality value transfer of the substance reference of GZGGD was analyzed based on characteristic fingerprint, content of index components, and the extraction rate. This study is expected to lay a basis for the quality control and further development of GZGGD.

[Analysis on ingredients and metabolites of Gegen Decoction absorbed into blood based on UHPLC-Q-TOF-MS].

This study analyzed the plasma components of Gegen Decoction(GGD) by ultra-high-performance liquid chromatography-quadrupole-time of flight mass spectrometry(UHPLC-Q-TOF-MS), which is expected to serve as a reference for exploring the pharmacodynamic substances of GGD. Female Wistar rats were given(ig) GGD and then plasma samples were collected and analyzed by UHPLC-Q-TOF-MS. The results showed that 42 chemical components were identified: 25 prototypes(14 from Puerariae Lobatae Radix, 6 from Glycyrrhizae Radix et Rhizoma, 3 from Paeoniae Radix Alba, and 2 from Ephedrae Herba) and 17 metabolites(from isoflavonoids in Puerariae Lobatae Radix and Glycyrrhizae Radix et Rhizoma). UHPLC-Q-TOF-MS was employed to achieve rapid analysis of plasma components of GGD, laying a basis for elucidating the therapeutic material basis and mechanism of GGD.

[Role of Puerariae Lobatae Radix in Gegen Decoction for treatment of primary dysmenorrhea].

This study aimed to explore the characteristic role of Puerariae Lobatae Radix(PLR) in Gegen Decoction for the treatment of primary dysmenorrhea(PD). Estrogen(E_2) was combined with oxytocin to establish a mouse model of PD. The mice were randomly divided into a normal group, a model group, a Gegen Decoction group, a PLR-free Gegen Decoction group, a PLR group, and a positive drug group(ibuprofen). Writhing response times and writhing incubation of mice in each group were tested by behavio-ral assessment, and the serum levels of prostaglandin F_(2α)(PGF_(2α)), prostaglandin E_2(PGE_2), E_2, and progesterone(PROG) were detected by ELISA kits. Western blot method was adopted to detect cyclooxygenase-2(COX-2) and estrogen receptor alpha(ER_α) expression levels in uterine tissues. Doppler ultrasound was employed to detect changes in uterine artery blood flow in mice, including peak systolic blood flow velocity(maximum velocity), end-diastolic velocity(minimum velocity), peak systolic blood flow velocity/end-diastolic velocity(S/D), pulsatility index(PI), and resistive index(RI). Histopathological changes in the uterus were detected by HE staining. Based on the oxytocin-induced isolated uterine contraction model, the effects of Gegen Decoction, PLR-free Gegen Decoction, and PLR on the amplitude, frequency, and activity of isolated uterine contraction were compared to investigate the role of PLR in Gegen Decoction for the treatment of PD. The results showed that compared with the Gegen Decoction group, the PLR-free Gegen Decoction improved the indicators of PD except for E_2 content, ER_α expression, and uterine artery blood flow. PLR could significantly down-regulate the serum content of E_2 and the protein expression of uterine ER_α, and improve the uterine artery blood flow. The data suggested that PLR, as the sovereign drug of Gegen Decoction, might function in Gegen Decoction for the treatment of PD by mediating E_(2 )and improving the uterine artery blood flow.

Analysis on ingredients and metabolites of Gegen Decoction absorbed into blood based on UHPLC-Q-TOF-MS / 中国中药杂志

This study analyzed the plasma components of Gegen Decoction(GGD) by ultra-high-performance liquid chromatography-quadrupole-time of flight mass spectrometry(UHPLC-Q-TOF-MS), which is expected to serve as a reference for exploring the pharmacodynamic substances of GGD. Female Wistar rats were given(ig) GGD and then plasma samples were collected and analyzed by UHPLC-Q-TOF-MS. The results showed that 42 chemical components were identified: 25 prototypes(14 from Puerariae Lobatae Radix, 6 from Glycyrrhizae Radix et Rhizoma, 3 from Paeoniae Radix Alba, and 2 from Ephedrae Herba) and 17 metabolites(from isoflavonoids in Puerariae Lobatae Radix and Glycyrrhizae Radix et Rhizoma). UHPLC-Q-TOF-MS was employed to achieve rapid analysis of plasma components of GGD, laying a basis for elucidating the therapeutic material basis and mechanism of GGD.

Role of Puerariae Lobatae Radix in Gegen Decoction for treatment of primary dysmenorrhea / 中国中药杂志

This study aimed to explore the characteristic role of Puerariae Lobatae Radix(PLR) in Gegen Decoction for the treatment of primary dysmenorrhea(PD). Estrogen(E_2) was combined with oxytocin to establish a mouse model of PD. The mice were randomly divided into a normal group, a model group, a Gegen Decoction group, a PLR-free Gegen Decoction group, a PLR group, and a positive drug group(ibuprofen). Writhing response times and writhing incubation of mice in each group were tested by behavio-ral assessment, and the serum levels of prostaglandin F_(2α)(PGF_(2α)), prostaglandin E_2(PGE_2), E_2, and progesterone(PROG) were detected by ELISA kits. Western blot method was adopted to detect cyclooxygenase-2(COX-2) and estrogen receptor alpha(ER_α) expression levels in uterine tissues. Doppler ultrasound was employed to detect changes in uterine artery blood flow in mice, including peak systolic blood flow velocity(maximum velocity), end-diastolic velocity(minimum velocity), peak systolic blood flow velocity/end-diastolic velocity(S/D), pulsatility index(PI), and resistive index(RI). Histopathological changes in the uterus were detected by HE staining. Based on the oxytocin-induced isolated uterine contraction model, the effects of Gegen Decoction, PLR-free Gegen Decoction, and PLR on the amplitude, frequency, and activity of isolated uterine contraction were compared to investigate the role of PLR in Gegen Decoction for the treatment of PD. The results showed that compared with the Gegen Decoction group, the PLR-free Gegen Decoction improved the indicators of PD except for E_2 content, ER_α expression, and uterine artery blood flow. PLR could significantly down-regulate the serum content of E_2 and the protein expression of uterine ER_α, and improve the uterine artery blood flow. The data suggested that PLR, as the sovereign drug of Gegen Decoction, might function in Gegen Decoction for the treatment of PD by mediating E_(2 )and improving the uterine artery blood flow.

Effect of traditional Chinese medicine formula GeGen decoction on primary dysmenorrhea: A randomized controlled trial study.

ETHNOPHARMACOLOGICAL RELEVANCE: GeGen Decoction, a well-known Chinese herbal formula, is widely used in China and other Asian countries to treat gynecological diseases, including primary dysmenorrhea. Pharmacological studies have confirmed that GeGen Decoction is able to inhibit spasmodic contractions of the uterus in vivo and in vitro. AIM OF THE STUDY: The objective of this study is to examine the efficacy and safety of GeGen Decoction on primary dysmenorrheic patients. METHODS: This was a randomized, double-blinded, placebo-controlled trial. GeGen Decoction or placebo was administered a week before the expected start of each cycle for three consecutive menstrual periods. Between-group differences in pain intensity were detected by visual analogue scale (VAS). In addition, serum levels of arginine vasopressin (AVP) and estrogen (E) were examined by enzyme-linked immunosorbent assay. Metabolomic analysis was further used to evaluate the influence of GeGen Decoction on the metabolomics of primary dysmenorrheic patients. RESULTS: A total of 71 primary dysmenorrheic women were recruited and 30 participants met the criteria were randomized into GeGen Decoction or placebo group. After three consecutive menstrual cycles' treatments, the VAS score of the GeGen Decoction group was significantly lower than that of the placebo group. Both serum levels of AVP and E decreased after GeGen Decoction administration, while the placebo seemed to have little effect on either of the index. Moreover, after GeGen Decoction treatment, seven important metabolites were identified by metabolomic analysis compared to the placebo group. No abnormalities in blood biochemical and routine physical examination pre and post GeGen Decoction intervention were observed. CONCLUSIONS: GeGen Decoction can remarkably relieve the severity of menstrual pain without obvious adverse effects. Its therapeutic effect on primary dysmenorrhea might be related to the regulation of pituitary hypothalamic ovarian hormones, and interfering with the metabolic change.

[Exploration on method and strategy of Gegen decoction from its novel application in primary dysmenorrhea].

Many classical prescriptions still have superior clinical values nowadays, and their modern studies also have far-reaching scientific research demonstration values. Gegen decoction, a representative prescription for common cold due to wind-cold, can treat primary dysmenorrhea due to cold and dampness, characterized by continuous administration without recurrence. It is not only in accordance with the principle of homotherapy for heteropathy, but also demonstrates the unique feature of traditional Chinese medicine of relieving the primary and secondary symptoms simultaneously. This article aimed to discuss the method and strategy of Gegen decoction study based on the discovery of its novel application in treatment of primary dysmenorrhea and previous research progress of our group. It was assumed that modern medicine and biology studies, as well as chemical research based on biological activity should be used for reference. Principal active ingredients (groups) in Gegen decoction could be accurately and effectively identified, and its possible mechanism in treatment of primary dysmenorrhea could be eventually elucidated as well. Simultaneously, the theoretical and clinical advantages of traditional Chinese medicine were explored in this paper, focusing on the compatibility characteristics of Gegen decoction. The research hypothesis showed the necessity of following the characteristics and advantages of traditional Chinese medicine in the modern research and reflected the importance of basic research based on the clinical efficacy, expecting to provide some ideas and methods for reference for further modern studies of classical prescriptions.

Exploration on method and strategy of Gegen decoction from its novel application in primary dysmenorrhea / 中国中药杂志

Many classical prescriptions still have superior clinical values nowadays, and their modern studies also have far-reaching scientific research demonstration values. Gegen decoction, a representative prescription for common cold due to wind-cold, can treat primary dysmenorrhea due to cold and dampness, characterized by continuous administration without recurrence. It is not only in accordance with the principle of homotherapy for heteropathy, but also demonstrates the unique feature of traditional Chinese medicine of relieving the primary and secondary symptoms simultaneously. This article aimed to discuss the method and strategy of Gegen decoction study based on the discovery of its novel application in treatment of primary dysmenorrhea and previous research progress of our group. It was assumed that modern medicine and biology studies, as well as chemical research based on biological activity should be used for reference. Principal active ingredients (groups) in Gegen decoction could be accurately and effectively identified, and its possible mechanism in treatment of primary dysmenorrhea could be eventually elucidated as well. Simultaneously, the theoretical and clinical advantages of traditional Chinese medicine were explored in this paper, focusing on the compatibility characteristics of Gegen decoction. The research hypothesis showed the necessity of following the characteristics and advantages of traditional Chinese medicine in the modern research and reflected the importance of basic research based on the clinical efficacy, expecting to provide some ideas and methods for reference for further modern studies of classical prescriptions.

Study on the effect of Huangqi-Gegen decoction and Peiyuan-Guben powder on autoimmune myasthenia gravis rats / 国际中医中药杂志

Objective Experimental model of experimental autoimmune Myasthenia Gravis (EAMG) were established to explore the effect of Zini-Huangqi-Gegen decoction and Peiyuan-Guben powder on EAMG rats model.Methods Experimental animals were randomly divided into the control group (n=10) and the model group (n=30).The model rats were induced by murine AChR-α97-116 peptide immunostaining for EAMG rats model.After the first immunization,the general condictions and body weight of rats were observed,and the Lennon score was used to evaluate the rats.The second immunization was performed on the 1 1th day after the first immunization.On the 15th day after the first immunization,the rats were randomly divided into the model group(n=8),Huangqi-Gegen decoction and Peiyuan-Guben powder group (abbreviated Huangpei group,n=8) and Prednisone group (n=8) according to the Lennon score.Huangpi group rats were treated with Huangqi-Gegen decoction (21.5 g/kg) combined with Peiyuan-Guben powder (0.8 g/kg),prednisone group with 0.005 4 g/kg prednisone aqueous solution,the control group and the model group oral volume of distilled water.The rats were administered with a body weight of 10 ml/kg once a day for a total of 56 days.At the 70th day after the first immunization,serum was extracted from the rats.The Anti-AChR-α97-116 IgG and its subtype in serum were detected by ELISA.The IL-4,IL-10,IL-17 in serum were detected by ELISA.Results Compared with the model group,the weight of the rats in the Huangpei group and the prednisone group significantly increased after the 28th day of the first immunization (P＜0.05).After the 36nd day of the first immunization,the Lennon score of the Huangpei group significantly decreased (P＜0.05).At the end of the administration,the amplitude of EMG amplitude attenuation (41.83％ ± 7.45％ vs.67.76％ ± 4.32％) in the Huangpei group significantly decreased (P＜0.05),and the serum IgG (1.15 ± 0.07 vs.1.24 ± 0.08),IgG1 (0.17 ± 0.01 vs.0.25 ± 0.03),IL-4 (16.54 ± 1.66 pg/ml vs.25.64 ± 1.74 pg/ml),IL-10 (113.65 ± 12.87 pg/ml vs.121.54 ± 10.44 pg/ml),IL-17 (43.58 ± 3.54 pg/ml vs.65.76 ± 3.59 pg/ml) in the rat serum significantly decreased (P＜0.05).Conclusions Huangqi-Gegen decoction and Peiyuan-Guben powder can increase the body weight of rats,decrease the concentration of AChR-Ab in serum,the concentrations of IL-4,IL-10 and IL-17 in serum,and effectively improve the symptoms of EAMG rats.

Clinical Observation of Gegen Decoction Plus Sini Powder for Treatment of Polycystic Ovarian Syndrome Women with Acne / 广州中医药大学学报

Objective To observe the therapeutic effect of Gegen Decoction plus Sini Powder for polycystic ovarian syndrome(PCOS) women with acne and to explore its possible therapeutic mechanism.Methods Seventy cases of PCOS women with acne aged 18-45 years were randomized into treatment group and control group,35 cases in each group.The treatment group was given Gegen Decoction plus Sini Powder orally and the control group was given Diane-35 orally.The treatment lasted for 12 weeks.After treatment,the skin lesions and symptom scores were observed.The body mass index (BMI),serum dihydrotestosterone (DHT),interleukin-6 (IL-6) and interleukin-8 (IL-8) were detected before and after treatment.Results (1) The markedly effective rate of the treatment group was 80.00％ and that of the control group was 57.14％,the difference being significant between the two groups(P ＜ 0.05).(2) After treatment,the total scores of the symptoms and the scores of each symptom such as sweating,sleeping and physical strength in both groups were decreased(P ＜ 0.01),and the decrease in the treatment group was superior to that in the control group(P ＜ 0.05).(3) The BMI and serum levels of DHT,IL-6 and IL-8 in both groups were significantly decreased after treatment (P ＜ 0.01),and the decrease in the treatment group was superior to that in the control group(P ＜ 0.05).Conclusion Gegen Decoction plus Sini Powder is effective for the treatment of PCOS women with acne,and the mechanism is probably related with the decrease of BMI and serum DHT,IL-6 and IL-8 levels.

Studies on Process Parameters for Purification of Extract Solution of Herb Drugs Composing Huangqi Gegen Decoction Prescription by Ceramic Membrane Ultrafiltration / 广州中医药大学学报

Objective To optimize the process parameters for the purification of the extract solution of Radix Astragali and Radix Puerariae in Huangqi Gegen Decoction prescription by ceramic membrane ultrafiltration. Methods With the extract solution of Radix Astragali and Radix Puerariae (in the proportion of 1 : 2) as the study object, and with solid content, puerarin transfer rate and characteristic peak area as indicators, the membrane pore size, ultrafiltrate temperature and ultrafiltration pressure were selected as the main factors, and single factor test and L9 (34) orthogonal test were used to optimize purification conditions. Results With comprehensive scores as the evaluation index, the optimized conditions for the extract solution were as follows:membrane pore size was 100 nm, ultrafiltration temperature was 35 ℃, and ultrafiltration pressure was 0.18 MPa. The main influence factors of ceramic membrane pore size and ultrafiltration pressure had obvious effects on the refined process(P<0.05).Conclusion The method of purification of the extract solution of Huangqi Gegen Decoction prescription by ceramic membrane ultrafiltration is feasible , and the results will provide reliable experimental evidence for the purification of Chinese herbal medicine extract with ceramic membrane.

Clinical observation on treatment of sympathetic cervical spondylopathy by Jiawei Gegen decation / 中国生化药物杂志

Objective To observe the clinical effect of Jiawei Gegen Decoction on cervical spondylosis of sympathetic.Methods 54 patients with cervical spondylosis from June 2013 to June 2016 were divided into the control group and the study group by odd and even numbers,each 27 cases,the contrel group was treated with Flunarizine Hydrochloride, the study group was treated with Jiawei Gegen decoction,The treatment effect, symptom improvement and adverse reaction rate were evaluated between the two groups.Results Compared with the control group, the treatment effect of the patients in the study group and the improvement of symptoms after treatment were better than the control group,the incidence of adverse reactions was lower in the study group (P <0.05).Conclusion With Jiawei Gegen Decoction for the treatment of sympathetic cervical spondylosis patients, the treatment effect is prominent, at the same time, the symptoms of patients improved better, less adverse reactions, it is worthy of clinical trust.

Therapeutic Observation on Treatment of Infantile Epidemic Parotitis with Chaihu Gegen Decoction / 国际中医中药杂志

Objective To observe the clinical effects of Chaihu Gegen decoction in treating children's epidemic parotitis and to explore its possible mechanism. Methods Sixty five patients were randomly recruited into a control group and a treatment group. The control group was treated with conventional western therapy (CWT) , while the treatment group was treated with CWT plus Chaihu Gegen decoction and external application of Chinese medicine. The therapeutic effects in both groups were observed. Results The body temperature and the improvement time of clinical symptoms were obviously better in treatment group than the control group. The effective rate was 94.29% and 76.67% in the treatment group and the control group respectively. The difference between the two groups was significance (P<0.05). Conclusion It is effective to treat epidemic parotitis with Chaigu Gegen decoction combined with external treatment.