Exploring Modern Mechanism of Treating Diabetic Retinopathy and Coronary Heart Disease from Perspective of Blood Stasis Under Viewpoint of Treating Different Diseases with the Same Method / 中国实验方剂学杂志

Diabetic retinopathy（DR） and coronary heart disease（CHD） are both major chronic vascular complications that seriously jeopardize the health of the population and often occur together in clinical practice， it is of great clinical value to actively explore the association between the two in the process of disease development and methods of prevention and treatment of modern medicine and traditional Chinese medicine（TCM）. According to TCM， the heart and eyes physiologically communicate with each other by taking Qi， blood and veins as bridges， blood stasis obstructing collaterals is the common TCM etiology of DR and CHD， whose mechanism involves inflammation， oxidative stress and endothelial dysfunction. Promoting blood circulation and removing blood stasis plays an important role in the same treatment for different diseases and prevention and treatment of comorbidities， possibly by inhibiting the expression of interleukin-1β（IL-1β）， endothelin-1（ET-1） and hypoxia inducible factor-1α/vascular endothelial growth factor（HIF-1α/VEGF）， regulating phosphatidylinositol 3-kinases/protein kinase B/mammalian target of rapamycin（PI3K/Akt/mTOR） pathway， initiating adenosine monophosphate（AMP）-activated protein kinase/silent information regulator 1（AMPK/SIRT1） and nuclear transcription factor erythroid 2-related factor 2/heme oxygenase-1（Nrf2/HO-1） signaling pathways， inhibiting Hippo/Yes-associated protein（Hippo/YAP） signaling pathway， inhibiting mitochondrial permeability transition pore and anti-platelet agglutination for treating DR and CHD， which provides a multi-component， multi-pathway and multi-target selection strategies and ideas for the prevention and treatment of DR and CHD by TCM from a biological perspective. Based on this， subsequent studies should focus on constructing clinically relevant comorbidity models， conducting multicenter prospective studies， and fully utilizing artificial intelligence technology to gain a deeper understanding of the relationship between the two diseases， so as to elucidate the mechanism of promoting blood circulation and removing blood stasis in preventing and treating panvascular diseases.

Efficacy and safety of activating blood circulation and removing blood stasis of Traditional Chinese Medicine for managing renal fibrosis in patients with chronic kidney disease: a systematic review and Meta-analysis.

OBJECTIVE: To evaluate the efficacy and safety of activating blood circulation and removing blood stasis in terms of Traditional Chinese Medicine (TCM) for managing renal fibrosis (RF) in patients with chronic kidney disease (CKD). METHODS: We searched randomized controlled trials (RCTs) from eight databases. RESULTS: Sixteen eligible studies with 1,356 participants were included in this study. Compared to treatment with Western Medicine (WM) alone, the combined treatment with activating blood circulation and removing blood stasis in terms of TCM (ARTCM) and WM to manage RF in patients with CKD significantly ameliorated type Ⅳ collagen (CⅣ) (: 2.17, 95% : 3.01 to 1.34), type Ⅲ procollagen (PCⅢ) (: 1.08, 95% : 1.64 to 0.53), laminin (LN) (: 1.28, 95% : 1.65 to 0.90), transforming growth factor ß 1 (TGFß1) (: 0.65, 95% : 1.18 to 0.12), serum creatinine (Scr) (: 1.36, 95% : 1.85 to 0.87), blood urea nitrogen (BUN) (: 1.51, 95% : 2.59 to 0.43), and 24 h urine protein (24hUpro) (: 1.23; 95% : 1.96 to 0.50). The level of hyaluronic acid (HA) was similar in both types of treatment (: 0.74, 95% : 1.91 to 0.44). The subgroup analysis showed that the duration of 8 weeks might affect the concentration of C-Ⅳ, PC-Ⅲ, and LN (<0.05). The effectiveness of the longer duration to C-Ⅳ, PC-Ⅲ, and LN was not certain. However, the result should be interpreted in care. The safety of the treatment using ARTCM and WM could not be evaluated because a few studies had reported adverse effects. The results of the Metaanalysis were not stable enough. There was publication bias for the reports on Scr ( 0.001), C-Ⅳ ( 0.001), PC-Ⅲ ( 0.026), and LN ( 0.030) and no publication bias for the reports on BUN ( 0.293). The quality of evidence varied from low to very low. CONCLUSIONS: The combined treatment using ARTCM and WM to manage RF in patients with CKD has some advantages over treatment with WM alone. Highquality RCTs need to be conducted for the strong support.

Clinical study on the treatment of chronic atrophic gastritis with gastric collateral stasis syndrome by activating blood and removing blood stasis, invigorating the spleen and soothing the liver / 国际中医中药杂志

Objective:To evaluate the clinical effect of treatment of activating blood and removing blood stasis, invigorating the spleen and soothing the liver for the patients with gastric collateral stasis syndrome and chronic atrophic gastritis (CAG).Methods:Randomized controlled trial. A total of 68 CAG patients admitted to the Huairou Hospital of Traditional Chinese Medicine from January 2018 to January 2021 who met the selection criteria were divided into 2 groups according to the random number table method, with 34 in each group. The control group received conventional western medicine treatment, such as inhibition of acid, protecting the gastric mucosa, and the observation group was treated with Traditional Chinese Medicine (TCM) herbal prescription of activating blood and removing blood stasis, invigorating the spleen and soothing the liver. Both groups were treated for 12 weeks. TCM symptom scores were performed before and after treatment. The serum level of pepsinogen Ⅰ(PG Ⅰ), pepsinogen Ⅱ (PGⅡ) were detected by ELISA, and the PG Ⅰ/PG Ⅱ ratio was calculated. Gastroscopic biopsy was performed to observe the changes of intestinal metaplasia of gastric mucosa and glandular atrophy, and to evaluate the clinical efficacy.Results:The total responsive rate was 85.3% (29/34) in the study group and 58.8% (20/34) in the control group. There was significant difference between the two groups ( χ2=9.35, P=0.030). After treatment, the scores of stomachache, fullness of feeling in the observation group were significantly lower than those in the control group ( t=2.97, 3.80, P<0.05). After treatment, the level of serum PG Ⅰ[(76.21 ± 17.35) mg/L vs. (66.8 ± 18.77) mg/L, t=2.15] and PG Ⅰ/PG Ⅱ [(4.67 ± 0.99) vs. (3.90± 1.25), t=2.81] in the study group were significantly higher than those in the control group ( P<0.05), and PG Ⅱ [(16.36 ± 1.85) mg/L vs. (17.42 ± 2.05) mg/L, t=2.24] was significantly lower than that of the control group ( P<0.05). After treatment, intestinal metaplasia and glandular atrophy was significantly more improved or reversed than those in the control group ( χ2=20.67,9.33, P<0.05). Conclusion:The methods of activating blood and removing blood stasis, invigorating the spleen and soothing the liver can reverse the precancerous lesions of patients with gastric collateral stasis syndrome of chronic atrophic gastritis and have a good prognosis.

Effects of TCM compounds for Eliminating phlegm and removing blood stasis on the ultrastructure of atrial myocardium and the oxidative stress in rats with atrial fibrillation / 国际中医中药杂志

Objective:To observe the effects of TCM compounds for eliminating phlegm and removing blood stasis on the ultrastructure of atrial myocardium in atrial fibrillation (AF) rats; To explore its possible mechanism.Methods:Totally 60 male SD rats were divided into blank group (10 rats) and model group (50 rats) according to random number table method. The atrial fibrillation model was established by tail vein injection of ACh-CaCl 2 mixture for 7 consecutive days, and then the rats with successful modeling were divided into model group, verapamil group, TCM compounds high-, medium- and low-dosage groups according to random number table method, with 10 rats in each group. TCM compounds high-, medium- and low-dosage groups were given Chinese herbal decoction 41.25, 20.63, 10.31 g/(kg?d) by gavage, respectively, and the verapamil group was given verapamil solution 25 g/(kg?d). The blank group and the model group were given an equal volume of normal saline by gavage for consecutive 14 days. After 14 consecutive days, electrophysiological recorder was used to measure the duration of atrial fibrillation in each group of rats; the changes of ultrastructure of atrial myocytes in each group were observed under transmission electron microscope; serum ROS, SOD and GSH-Px levels of rats were detected by ELISA. Results:Compared with the model group, the duration of atrial fibrillation in TCM compounds high-, medium- and low-dosage groups and verapamil group decreased ( P<0.05); the ultrastructural damage of atrial myocytes was improved; the content of ROS [(139.20±3.34) ng/ml,(139.00±3.28) ng/ml, (139.25±3.82) ng/ml vs. (155.60±7.32) ng/ml] in TCM compounds high- and medium-dosage groups and verapamil group decreased; the contents of SOD [(2.41±0.26) ng/ml, (2.40±0.12) ng/ml, (2.37±0.06) ng/ml vs.(2.12±0.21) ng/ml] increased ( P<0.05); the content of GSH-Px [(3.61±0.06) ng/ml, (3.60±0.08) ng/ml, (3.47±0.15) ng/ml, (3.51±0.19) ng/ml vs.(3.27±0.12) ng/ml] in TCM compounds high-, medium- and low-dosage groups and verapamil group increased ( P<0.05). Conclusion:TCM compounds for eliminating phlegm and removing blood stasis can shorten the duration of atrial fibrillation in rats, reduce the damage of ultrastructure of atrial myocytes in AF rats, regulate the expressions of serum ROS, SOD and GSH-Px in AF rats, and inhibit oxidative stress, which may be one of its mechanisms of action in the treatment of atrial fibrillation.

Experimental and clinical research progress of traditional Chinese medicine promoting blood circulation and removing blood stasis in treatment of pulmonary hypertension / 中国药理学通报

Pulmonary hypertension(PH)is a type of progressive cardiovascular disease or clinical syndrome. Its pathological mechanism is complex. The existing clinical drugs cannot well inhibit the progression of the disease. Traditional Chinese Medicine(TCM)has unique advantages in the treatment of PH due to its synergistic effect of multiple components and multiple targets. Recent studies have found that the TCM of promoting blood circulation and removing blood stasis can play a significant role in the treatment of PH, such as dilating pulmonary blood vessels, improving endothelial function, and relieving right heart failure. This article briefly summarizes and discusses the therapeutic effect and mechanism of TCM that can promote blood circulation and remove blood stasis in treatment of PH.

[Effect of Taohong Siwu Decoction() early intervention on mesenchymal stem cells homing in fracture healing in rats].

OBJECTIVE: To observe the effects of Taohong Siwu Decoction(, THSWD) on the mesenchymal stem cells(MSCs) migration, homing number and cytokine expression in callus during the early process of fracture healing, and to explore the mechanism of THSWD on accelerationg fracture healing by regulating the homing of MSCs in rats. METHODS: A rat model of right femoral shaft open fracture was established. Thirty-two 5-week-old male Sprague-Dawley rats, weighting 110 to 130 g, were divided into control group, low-dose group, medium-dose group and high-dose group by using random number table. Distilled water was given to the control group, and the other groups were given Taohong Siwu Decoction. The rats were gavaged twice a day for 5 consecutive days after surgery. Bone volume/tissue volume(BV/TV) and bone mineral density(BMD) were observed using micro-computed tomography (micro-CT) at 21 days after surgery. At 5 days post-fracture, peripheral blood MSCs from THSWD treated and untreated rats were cultured in vitro. Subsequently, the migration ability of MSCs was observed by cell migration assay. The number of MSCs homing to the callus at the early stage of fracture (5 d) was detected by Immunohistochemistry (IHC). Protein chip was used to detect the expression of cytokines in callus. RESULTS: Micro-CT results showed that BV/TV was higher in the high-dose group than in the medium-dose group (P=0.032), and higher in the medium-dose group than in the low-dose group(P=0.041), with no difference between the control and low-dose group (P=0.651). In addition, there was no difference in BMD between low-dose group and the model group (P=0.671), and lower in the low-dose group than in the medium-dose group(P=0.018), and the medium-dose group was lower than the high-dose group(P=0.008). Cell migration assay showed that THSWD promotes enhanced the migration ability of peripheral blood MSCs. IHC assay revealed that CD45-, CD90+, CD29+ MSCs significantly increased in bone callus after THSWD intervention compared with the control group. Protein chip showed that THSWD promoted the upregulation of CINC-1(×2.91), CINC-3(×1.59), LIX(×1.5), Thymus Chemokine (×2.55), VEGF (×1.22) and the down-regulation of TIMP-1 (×2.98). CONCLUSION: THSWD, a representative formula of "promoting blood circulation and removing blood stasis", can significantly accelerate fracture healing, and its mechanism may be related to enhancing the migration ability of peripheral blood MSCs and up-regulating CINC-1, CINC-3, LIX, Thymus Chemokine, VEGF and down-regulating TIMP-1 in bone callus, which promotes the peripheral blood MSCs homing in the early stage of fracture.

Research Progress in Chinese Medicine Preparations for Promoting Blood Circulation and Removing Blood Stasis for Cirrhotic Patients with Portal Vein Thrombosis Following Splenectomy.

This article presented an overview of the therapeutic effects of Chinese medicine (CM) preparations for promoting blood circulation and removing blood stasis for patients with portal vein thrombosis (PVT) after splenectomy. Based on published clinical researches of CM preparations for PVT after splenectomy in patients with cirrhotic portal hypertension (CPH), this paper evaluated the incidence of PVT, and explored potential active components and mechanisms of CM preparations. Safflower Yellow Injection, Danshen Injection () Danhong Injection (), and Compound Danshen Dropping Pill () achieved good curative effect alone or combined with anticoagulant therapy. In addition, Compound Biejia Ruangan Tablet () and Anluo Huaxian Pill () can also significantly improve the hemodynamic disorders of portal vein system in patients with cirrhosis. Considering the role of CM preparations in ameliorating the incidence of PVT after splenectomy in patients with CPH, we suggested that future research should provide more attention to CM alone or CM combined with anticoagulant for cirrhosis with PVT.

Differences in Protective Effect of Five Formulas for Promoting Blood Circulation and Removing Blood Stasis on Endothelial Cells of New Zealand Rabbits with Heart Blood Stasis Syndrome Through JNK Signaling Pathway / 中国实验方剂学杂志

ObjectiveTo explore the differences in the protective effects of five formulas for promoting blood circulation and removing blood stasis on the aortic endothelial cells of New Zealand rabbits with heart blood stasis syndrome. MethodEighty New Zealand rabbits were randomly divided into a normal group （n=10） and an experimental group （n=70）. The heart blood stasis syndrome model was induced by starvation combined with a high-fat diet and adrenaline in the rabbits of the experimental group. Subsequently， the model rabbits were randomly divided into a model group， a Xuefu Zhuyutang group （3.55 g·kg-1·d-1）， a Taohong Siwutang group （2.66 g·kg-1·d-1）， a Danshenyin group （1.962 g·kg-1·d-1）， a Huoluo Xiaolingdan group （2.80 g·kg-1·d-1）， a Shixiaosan group （0.56 g·kg-1·d-1）， and a c-Jun N-terminal kinase （JNK） inhibitor （SP600125， 5 μg·kg-1）group. The normal group and the model group received the same amount of distilled water. The rabbits in five Chinese medicine groups were treated correspondingly by gavage， and those in the SP600125 group were injected with 0.5 mL of SP600125-dimethyl sulfoxide diluent. After the treatment， the aorta was collected， and terminal deoxynucleotidyl transferase dUTP nick end labeling （TUNEL） assay was used to detect the apoptosis of aortic endothelial cells. The enzyme-linked immunosorbent assay （ELISA） was used to detect serum levels of tumor necrosis factor-α （TNF-α） and interleukin-6 （IL-6）. Western blot was used to detect the protein expression of JNK， phosphorylated JNK （p-JNK）， B-cell lymphoma-2 （Bcl-2）， Bcl-2-associated X protein （Bax）， cysteinyl aspartate-specific protease-9 （Caspase-9）， and cysteinyl aspartate-specific protease-3 （Caspase-3） in aortic tissues. Real-time fluorescence-based quantitative polymerase chain reaction （Real-time PCR） was used to detect the mRNA levels of JNK， Bcl-2， Bax， Caspase-9， and Caspase-3 in aortic tissues. ResultFive formulas could improve the apoptosis of aortic endothelial cells to varying degrees. To be specific， Xuefu Zhuyutang and Taohong Siwutang were optimal in efficacy， followed by Huoluo Xiaolingdan， Shixiaosan， and Danshenyin， and SP600125 was the worst （P<0.05， P<0.01）. Five formulas could reduce the content of TNF-α and IL-6 （P<0.05， P<0.01）， down-regulate the protein expression levels of JNK， p-JNK， Bax， Caspase-9， and Caspase-3 （P<0.05， P<0.01）， decrease the mRNA expression levels of JNK， Bax， Caspase-9， and Caspase-3 （P<0.05， P<0.01）， and up-regulate the protein and mRNA expression levels of Bcl-2 （P<0.05， P<0.01）. ConclusionFive formulas can all reduce the apoptosis of aortic endothelial cells in New Zealand rabbits with heart blood stasis syndrome with different efficacies. It may be related to the different effects of five formulas on the JNK signaling pathway.

Effect of Taohong Siwu Decoction() early intervention on mesenchymal stem cells homing in fracture healing in rats / 中国骨伤

OBJECTIVE@#To observe the effects of Taohong Siwu Decoction(, THSWD) on the mesenchymal stem cells(MSCs) migration, homing number and cytokine expression in callus during the early process of fracture healing, and to explore the mechanism of THSWD on accelerationg fracture healing by regulating the homing of MSCs in rats.@*METHODS@#A rat model of right femoral shaft open fracture was established. Thirty-two 5-week-old male Sprague-Dawley rats, weighting 110 to 130 g, were divided into control group, low-dose group, medium-dose group and high-dose group by using random number table. Distilled water was given to the control group, and the other groups were given Taohong Siwu Decoction. The rats were gavaged twice a day for 5 consecutive days after surgery. Bone volume/tissue volume(BV/TV) and bone mineral density(BMD) were observed using micro-computed tomography (micro-CT) at 21 days after surgery. At 5 days post-fracture, peripheral blood MSCs from THSWD treated and untreated rats were cultured in vitro. Subsequently, the migration ability of MSCs was observed by cell migration assay. The number of MSCs homing to the callus at the early stage of fracture (5 d) was detected by Immunohistochemistry (IHC). Protein chip was used to detect the expression of cytokines in callus.@*RESULTS@#Micro-CT results showed that BV/TV was higher in the high-dose group than in the medium-dose group (P=0.032), and higher in the medium-dose group than in the low-dose group(P=0.041), with no difference between the control and low-dose group (P=0.651). In addition, there was no difference in BMD between low-dose group and the model group (P=0.671), and lower in the low-dose group than in the medium-dose group(P=0.018), and the medium-dose group was lower than the high-dose group(P=0.008). Cell migration assay showed that THSWD promotes enhanced the migration ability of peripheral blood MSCs. IHC assay revealed that CD45-, CD90+, CD29+ MSCs significantly increased in bone callus after THSWD intervention compared with the control group. Protein chip showed that THSWD promoted the upregulation of CINC-1(×2.91), CINC-3(×1.59), LIX(×1.5), Thymus Chemokine (×2.55), VEGF (×1.22) and the down-regulation of TIMP-1 (×2.98).@*CONCLUSION@#THSWD, a representative formula of "promoting blood circulation and removing blood stasis", can significantly accelerate fracture healing, and its mechanism may be related to enhancing the migration ability of peripheral blood MSCs and up-regulating CINC-1, CINC-3, LIX, Thymus Chemokine, VEGF and down-regulating TIMP-1 in bone callus, which promotes the peripheral blood MSCs homing in the early stage of fracture.

Clinical effect of Chinese herbal medicine for removing blood stasis combined with acupuncture on sequelae of cerebral infarction.

OBJECTIVE: To assess the clinical efficacy of Chinese herbal medicine for removing blood stasis combined with acupuncture in the treatment of sequelae of cerebral infarction. METHODS: Ninety patients with cerebral infarction admitted to our hospital from April 2018 to April 2020 were enrolled and equally allocated to an experimental group and a control group. The control group was treated with aspirin, and the experimental group was treated with Chinese herbal medicine for removing blood stasis combined with acupuncture. The recovery of the ability of daily living (ADL), recovery of hemiplegic limb function, blood viscosity, total cholesterol (TC), triglyceride (TG), and quality of life were evaluated. RESULTS: After treatment, the ADL of patients in the two groups witnessed a remarkable recovery, with superior results in the experimental group than the control group (P < 0.05). The hemiplegic limb recovery of the experimental group was observed to be significantly improved when compared with the control group (P < 0.05). Remarkably lower blood viscosity-related indexes of TC and TG of the experimental group compared to the control group were identified (P < 0.05). As to the total remission rate (TRR), the experimental group demonstrated a higher level than the control group (P < 0.05). The scores of quality of life of patients in the experimental group after treatment were evidently higher than those of the control group (P < 0.05). CONCLUSION: Chinese herbal medicine for removing blood stasis combined with acupuncture treatment can better improve the hemiplegic limb function and the quality of life, and reduce blood viscosity of patients with sequelae of cerebral infarction.

Chinese Herbal Medicines for Promoting Blood Circulation and Removing Blood Stasis for Preventing Deep Venous Thrombosis after Total Hip Arthroplasty: A Systematic Review and Meta-Analysis.

AIM AND OBJECTIVE: To evaluate the efficacy and safety of Chinese herbal medicines for promoting blood circulation and removing blood stasis (PBCRBSM) for preventing deep venous thrombosis (DVT) after total hip arthroplasty (THA). MATERIALS AND METHODS: The databases were searched for studies comparing the preventive abilities of PBCRBSM and Western medicine, such as low molecular weight heparin (LMWH), rivaroxaban, and aspirin, as well as for randomized controlled trials on DVT after THA. Data were analyzed using RevMan 5.3 software. RESULTS: A total of 3254 randomized controlled trials were included, including 1630 cases in the experimental group and 1624 cases in the control group. Meta-analysis showed that compared with Western medicine, PBCRBSM reduced the incidence of DVT (OR=0.38, 95% CI [0.30, 0.48], P < 0.001); prolonged activated partial thromboplastin time (APTT) (SMD=0.44, 95% CI [0.35, 0.53], P < 0.001); reduced D-dimer (SMD=-0.75, 95% CI [-0.84,-0.65], P < 0.001), FIB (SMD=-0.61, 95% CI [-0.72, -0.50], P < 0.001), blood viscosity (P<0.01), circumference difference in lower extremities (P<0.01), venous blood flow velocity (SMD=0.97, 95% CI [0.77, 1.16], P < 0.001), and drainage volume (SMD=-1.53, 95% CI [-1.71, -1.35], P < 0.001); and reduced adverse reactions (OR = 0.32, 95% CI [0.19, 0.56], P < 0.001). There was no significant difference in prolonging prothrombin time (PT) between traditional Chinese medicine and Western medicine (SMD = 0.07, 95% CI [-0.0.01). 3, 0.16], P > 0.05. CONCLUSION: PBCRBSM is an effective method for preventing DVT after THA and has fewer adverse effects.

Relationship Between Syndrome Elements and Therapy of Ischemic Stroke Based on Scale Hierarchy and Principal Component Analysis / 中国实验方剂学杂志

Objective:To study the distribution of ischemic stroke treatment with data mining technology and evaluate its clinical efficacy. Method:China National Knowledge Infrastructure Database（CNKI），China Science and Technology Reader's Digest Database（VIP），Wanfang Data，Chinese Biomedical Literature Database（Sino Med）were retrieved from January 1978 to December 2018. The clinical observation and study literatures on the treatment of ischemic stroke with the combination of traditional Chinese medicine and Western medicine were retrieved in the four databases. After standardized and hierarchical collection and processing of all syndromes，treatment methods，prescriptions and other information in the literatures，a database of syndrome elements and treatment of ischemic stroke was established. Syndrome factors and treatment methods were analyzed by scale evaluation and hierarchical classification methods. Kendall's tau-b correlation analysis，principal component analysis and other statistical methods were used to describe the correlation and distribution of syndrome factors and treatment methods of ischemic stroke. Result:The results of heterogeneity analysis showed that the included literatures were homogeneous and could be combined with subsequent statistics. A total of 450 syndromes and treatment methods were included in this study，and 1 287 single syndrome elements and 1 562 single treatment methods were obtained after unified and standardized splitting. Besides the corresponding syndrome elements and treatment methods，phlegm-dampness-invigorating Qi（-0.52） and Qi deficiency-invigorating Qi（-0.56） were also highly correlated. The study team represented the importance of syndrome and treatment elements with class Ⅰ，Ⅱ，Ⅲ from high to low. Qi deficiency，blood stasis and fire heat，phlegm，viscera excess were class Ⅰ syndrome elements；Yin deficiency，endogenous wind were class Ⅱ syndrome elements；Yin deficiency and Yang deficiency were class Ⅲ syndrome elements；Removing phlegm dampness，clearing heat，clearing the hollow viscera and extinguishing wind，promoting blood circulation to remove blood stasis，tonifying Qi were class Ⅰ treatment of ischemic stroke，and removing phlegm dampness，clearing heat，clearing the hollow viscera were more likely to appear simultaneously； and extinguishing wind，activating blood circulation and removing blood stasis，and benefiting Qi were more likely to appear simultaneously. Nourishing Yin and regulating Qi were class Ⅱ therapies of ischemic stroke，which were highly correlated and often appear simultaneously. Inducing resuscitation，tonifying Yang and dredging collaterals were class Ⅲ，Ⅳ，Ⅴ therapies. Conclusion:Qi deficiency，blood stasis，phlegm dampness，fire heat and viscera excess were the main syndromes of ischemic stroke，while Qi deficiency and blood stasis，phlegm heat and viscera excess were the main syndromes. Eliminating phlegm and dampness，clearing heat，clearing the hollow viscera，promoting blood circulation and removing blood stasis，extinguishing wind and benefiting Qi were the main therapies for the treatment of ischemic stroke. In clinical treatment for ischemic stroke，the therapies for relieving phlegm and dampness，clearing heat and relieving organs are often used in combination，and the therapies for promoting blood circulation and removing blood stasis were often used in combination with the therapies for invigorating Qi and extinguishing wind for the synergistic effect.

Study on the medication regularity of Traditional Chinese Medicine on treating diabetic lower extremity arterial disease based on data mining / 国际中医中药杂志

Objective:To explore the medication regularity of Traditional Chinese Medicine (TCM) for diabetic lower extremity arterial disease (DLEAD) based on data mining.Methods:Search for the clinical literature of treating DLEAD in recent 20 years from China Academic Journal Database (Wanfang Data), China National Knowledge Resources Database (CNKI), China Biomedical Literature Service System (SinoMed) and Chinese Science and Technology Journal Database (Chongqing VIP) dated. The frequency analysis, cluster analysis and association analysis for TCM were carried out respectively through Excel 2019, SPSS 25 and SPSS Modeler 18.Results:There are altogher 175 papers mentioning 201 prescriptions and 186 herbs, among which the top 5 herbs that are used frequently are Astragali Radix, Angelicae Sinensis Radix, Chuanxiong Rhizoma, Achyranthis Bidentatae Radix, Carthami Flos. The taste are mainly sweet and the nature is warm, with liver meridian as the most important maridian. The herbs for activating blood circulation and removing blood stasis are frequently used, followed by Qi tonic and blood tonic herbs. Association Rule Analysis suggested that Astragali Radix, Angelicae Sinensis Radix, Chuanxiong Rhizoma are the herbs that are frequently combined together. Conclusions:The medication for treating DLEAD mainly focuses on promoting blood circulation and removing blood stasis and tonifing Qi and blood. At the same time, the treatment should focus on dispelling wind and dispersing cold, warming yang and unblocking collaterals, resolving phlegm and removing dampness, nourishing yin and clearing heat based on different syndromes. Astragali Radix, Angelicae Sinensis Radix, Chuanxiong Rhizoma were the core herbs. It can be combined with Achyranthis Bidentatae Radix, Pheretma, Paeoniae Radix Rubra, Salviae miltiorrhizae Radix et Rhizoma, Peach Kernel, Carthami Flos to improve the curative effect.

[Study on efficacy markers of Salviae Miltiorrhizae Radix et Rhizoma for promoting blood circulation and remving blood stasis based on systematic traditional Chinese medicine].

Traditional Chinese medicine for promoting blood circulation and removing blood stasis has been widely used in clinical practice. However, due to the diversity of the composition of traditional Chinese medicine and the complexity of its interaction with human body, it is difficult to apply traditional quality control ingredients to characterize its overall efficacy. Systematic traditional Chinese medicine is an effective method for studying the efficacy of traditional Chinese medicine, embodying the dialectical unity of holism and reductionism. Salviae Miltiorrhizae Radix et Rhizoma is a common traditional Chinese medicine for promoting blood circulation and removing blood stasis. In this study, we constructed a multi-dimensional network of "efficacy-pharmacological efficacy-targets-components" based on systematic traditional Chinese medicine, and discussed the discovery of the efficacy markers of Salviae Miltiorrhizae Radix et Rhizoma for promoting blood circulation and removing blood stasis. Firstly, based on the Chinese medicine efficacy-pharmacology database, the most relevant pharmacological actions(boundary) for promoting blood circulation and removing blood stasis(function) were obtained, and the target sets(structure) of the corresponding pharmacological action were obtained by the DrugBank database. Then, STRING database was used to construct protein-protein interaction network(relationship) of targets related to promoting blood circulation and removing stasis, and key targets(elements) in the network were selected by evaluating topological parameters of targets. Finally, the potential efficacy markers of Salviae Miltiorrhizae Radix et Rhizoma were predicted by molecular docking based on the key targets of promoting blood circulation and removing blood stasis. The results demonstrated that salvianolic acid B, salvianolic acid A, tanshinone Ⅱ_A and tanshinone Ⅰ were the potential markers of Salviae Miltiorrhizae Radix et Rhizoma on promoting blood circulation and removing blood stasis. Salvianolic acid B, salvianolic acid A, tanshinone Ⅱ_A had been reported to have anti-platelet aggregation, anti-thrombotic, cardiovascular protection and some other pharmacological functions. Based on systematic traditional Chinese medicine, we have preliminarily predicted the efficacy markers of Salviae Miltiorrhizae Radix et Rhizoma in promoting blood circulation and removing blood stasis in this study, providing a research method for the discovery of efficacy markers and a reference for the overall quality control of traditional Chinese medicine.

Research Progress of Different Components of Traditional Chinese Medicine in Treatment of Blood Stasis Syndrome / 中国实验方剂学杂志

To a certain extent, put forward the concept of " component of traditional Chinese medicine (TCM)" simplifies the complexity of multi-component and multi-target of TCM, which provides a possibility for the clarification of the material basis of the efficacy of TCM, and also provides a new direction for promoting the modernization and industrialization of TCM, promots the high quality development of TCM. The correlation between prescription and disease syndrome has made rapid progress, both basic research and clinical application are fruitful. However, the correlation between components and disease syndrome still needs to be further studied. The syndrome of blood stasis is a common syndrome of TCM science, and it is more common in various diseases, especially cardiovascular and cerebrovascular diseases, kidney disease, diabetes and hyperlipoidemia. A large number of studies have shown that some specific components contained in TCM or TCM compound can improve the related indexes of patients or experimental animal model with blood stasis syndrome. It is manifested in reducing blood viscosity, inhibiting platelet activation and adhesion aggregation, changing erythrocyte deformability index, inhibiting thrombosis and so on. Blood stasis is not only the pathogenic factor of many diseases, but also the pathological product of many kinds of diseases, which involves a wide range of diseases. Therefore, this study will study the progress of different components of TCM in the prevention and treatment of blood stasis syndrome, focusing on saponins, flavonoids, organic acids, polysaccharides, alkaloids and other active components in improving hemorheological abnormalities, hypercoagulability, platelet activation and adhesion aggregation, thrombosis. Based on the thought of component-disease syndrome, this paper searches the relevant literature in recent 20 years, classifies and summarizes the achievements of different components in the prevention and treatment of blood stasis syndrome, and hopes to provide some ideas for the further study of the pharmacological action of TCM components, the study of compatibility of TCM components and the research of TCM components.

Research progress on chemical constituents and pharmacological effects of Salvia miltiorrhiza / 中草药

Salvia miltiorrhiza is a commonly used Chinese materia medica for promoting blood circulation and removing blood stasis. It has a wide range of pharmacological effects and is mainly used for the treatment of irregular menstruation, palpitation, insomnia and various cardiovascular diseases, particularly angina pectoris and myocardial infarction. The chemical constituents of S. miltiorrhiza are the important material basis for its pharmacological effects. This paper reviews the research progress of the chemical constituents and pharmacological effects of S. miltiorrhiza. The research status and research direction of S. miltiorrhiza are analysed, which will provide a reference for its further research and development.

Clinical observation on treatment of androgen deficiency syndrome after endocrine therapy for advanced prostate cancer by "Jianpi Lishi Huayu Method" / 中草药

Objective: To observe the improvement of androgen deficiency syndrome after endocrine therapy by "Jianpi Lishi Huayu Method" for advanced prostate cancer and its clinical effect. Methods: A total of 60 patients with advanced prostate cancer were randomly divided into observation group (30 cases) and control group (30 cases). The control group was treated with intermittent endocrine therapy (androgen blocking). The treatment group was treated with "Jianpi Lishi Huayu Decoction" on the basis of the control group. The end point of the study was the time to develop castration-resistant prostate cancer. ISS scale scores, disease progression-free survival, PSA, serum testosterone, I-PSS and TCM clinical symptom scores were compared between the two groups. Results: The median progression-free survival time of the patients in the observation group was 23 months, and there was no significant difference between the two groups. After treatment, the total ISS score, physical symptoms score, vasomotor symptoms score and psychosocial symptoms score in the observation group were significantly lower than those before treatment, and lower than those in the control group (P < 0.05). After treatment, the effective rate of ISS score in the observation group (73.33%) was significantly higher than that in the control group (16.67%); The PSA level in both groups decreased significantly after treatment, and the PSA level in the observation group (2.13 ± 0.58) ng/mL was better than that in the control group (5.30 ± 1.40) ng/mL (P < 0.05); There was no significant difference in serum testosterone between the two groups after treatment. After treatment, the I-PSS score and TCM clinical symptom score of the observation group and the control group were improved, and the observation group was better than the control group (P < 0.05). After treatment, the effective rate of the I-PSS score of the observation group (96.67%) and the improvement rate of TCM clinical symptom score (76.67%) were better than those of the control group (73.33%, 26.67%). Conclusion: On one hand, "invigorating spleen, draining dampness and removing blood stasis" method combined with endocrine therapy can prolong the time for hormone-dependent prostate cancer to develop into castrated resistant prostate cancer, improve clinical efficacy, reduce the level of tumor markers, stabilize the level of testosterone, and improve some androgen deficiency syndrome after endocrine therapy, especially in ovariectomized resistant prostate cancer. It has obvious advantages in improving physical symptoms, vasomotor symptoms and psycho-psychological symptoms. It can obviously alleviate adverse reactions after endocrine therapy. On the other hand, it can better improve clinical symptoms, reduce I-PSS scores and TCM clinical symptoms scores, improve the quality of life of patients, and give full play to the role of reducing TCM toxicity and increasing synergism efficiency.

A network pharmacology approach to explore mechanisms of activating blood circulation and removing blood stasis herbs in the treatment of endometriosis / 药学实践杂志

Objective To explore the possible mechanism of activating blood circulation and removing blood stasis herbs in the treatment of endometriosis (EM) with network pharmacology approach. Methods Seven kinds of commonly used activating blood circulation and removing blood stasis herbs, such as: peach kernel, safflower, zeilan, salvia miltiorrhiza, leonuri, radix cyathulae, and wang buliuxing were selected as the research subjects. TCMSP platform, a database of traditional Chinese medicine chemical ingredients, was used to retrieve the effective ingredients of 7 herbs. The targets of the effective ingredients were obtained through the Targets information software. GeneCards database was used to collect EM related target genes. Venn diagram tool was used to obtain the target genes of active ingredients of activating blood circulation and removing blood stasis herbs. Cytoscape 3.6.0 software was used to construct the active ingredient-target-disease network. KEGG database was used to analyze the signal pathways of target gene enrichment. Results A total of 94 active ingredients and 119 targets of 7 herbs were screened. Quercetin, luteolin and kaempferol were the key active components. PTGS2, PTGS1, NCOA2 and NCOA1 were the key targets. The 7 herbs have 20 related KGEE pathways, involving sex hormones, inflammation, apoptosis and angiogenesis. PI3K-Akt signaling pathway, IL-17 signaling pathway, TNF signaling pathway were the main pathways. Conclusion The treatment of EM with activating blood circulation and removing blood stasis herbs has the characteristics of multiple components, multiple targets and multiple pathways, which can relieve the pain, inflammation and menstrual disorders symptoms of EM.

Study on efficacy markers of Salviae Miltiorrhizae Radix et Rhizoma for promoting blood circulation and remving blood stasis based on systematic traditional Chinese medicine / 中国中药杂志

Traditional Chinese medicine for promoting blood circulation and removing blood stasis has been widely used in clinical practice. However, due to the diversity of the composition of traditional Chinese medicine and the complexity of its interaction with human body, it is difficult to apply traditional quality control ingredients to characterize its overall efficacy. Systematic traditional Chinese medicine is an effective method for studying the efficacy of traditional Chinese medicine, embodying the dialectical unity of holism and reductionism. Salviae Miltiorrhizae Radix et Rhizoma is a common traditional Chinese medicine for promoting blood circulation and removing blood stasis. In this study, we constructed a multi-dimensional network of "efficacy-pharmacological efficacy-targets-components" based on systematic traditional Chinese medicine, and discussed the discovery of the efficacy markers of Salviae Miltiorrhizae Radix et Rhizoma for promoting blood circulation and removing blood stasis. Firstly, based on the Chinese medicine efficacy-pharmacology database, the most relevant pharmacological actions(boundary) for promoting blood circulation and removing blood stasis(function) were obtained, and the target sets(structure) of the corresponding pharmacological action were obtained by the DrugBank database. Then, STRING database was used to construct protein-protein interaction network(relationship) of targets related to promoting blood circulation and removing stasis, and key targets(elements) in the network were selected by evaluating topological parameters of targets. Finally, the potential efficacy markers of Salviae Miltiorrhizae Radix et Rhizoma were predicted by molecular docking based on the key targets of promoting blood circulation and removing blood stasis. The results demonstrated that salvianolic acid B, salvianolic acid A, tanshinone Ⅱ_A and tanshinone Ⅰ were the potential markers of Salviae Miltiorrhizae Radix et Rhizoma on promoting blood circulation and removing blood stasis. Salvianolic acid B, salvianolic acid A, tanshinone Ⅱ_A had been reported to have anti-platelet aggregation, anti-thrombotic, cardiovascular protection and some other pharmacological functions. Based on systematic traditional Chinese medicine, we have preliminarily predicted the efficacy markers of Salviae Miltiorrhizae Radix et Rhizoma in promoting blood circulation and removing blood stasis in this study, providing a research method for the discovery of efficacy markers and a reference for the overall quality control of traditional Chinese medicine.

Oral Taodan granules for mild-to-moderate psoriasis vulgaris: protocol for a randomized, double-blind, multicenter clinical trial.

BACKGROUND: Psoriasis is a common chronic inflammatory skin disease with high recurrence rates and increasing incidence. Patients require long-term medication to reduce symptoms and prevent disease progression. Therefore, the development of treatments with high efficiency and low rate of adverse events is of utmost importance. Traditional Chinese medicine (TCM) plays an outstanding role in reducing disease symptoms and improving quality of life. The aim of this trial is to clarify the treatment efficacy, safety, and control of disease recurrence in patients with psoriasis with blood-stasis syndrome treated with Taodan granules (TDKL). METHODS: This trial is a five-center, randomized, double-blind, placebo-controlled study planned to transpire between September 1, 2019, and December 31, 2021. A sample size of 216 participants (108 per group) with mild-to-moderate psoriasis will be randomly assigned to receive TDKL or placebo twice per day, 7 days per week, for 8 weeks. The study duration will be 17 weeks, including a 1-week screening period, 8 weeks of intervention, and another 8 weeks of follow-up. The primary outcomes are improvement in the Psoriasis Area and Severity Index score and recurrence rate after 8 weeks of treatment. Secondary outcomes include body surface area affected and the scores for the Physician Global Assessment, Dermatology Life Quality Index, pain-related quality of life, pain on the visual analogue scale, and TCM syndromes. The number, nature, and severity of adverse events will be carefully recorded. DISCUSSION: The study results will help clarify the safety and efficacy of TDKL as treatment for psoriasis with respect to both disease regression and recurrence rate. We expect that this study will provide high-quality evidence with important public health implications that may alter the approach to psoriasis management in China. TRIAL REGISTRATION: The trial has been registered at ClinicalTrials.gov (ID: NCT03942198).