南京中医药大学学报

Inheritance and Innovation of Luobing Research

LI Hong-rong, WU Yi-ling

2022, 38(12): 1075-1085. doi: 10.14148/j.issn.1672-0482.2022.1075

[Abstract](386) [FullText HTML] (51) [PDF 1852KB](48)

Abstract:
Inheriting essence and keeping integrity and innovation are the fundamental principles for the high-quality development of TCM and its industry in the new era. The theoretical system of Luobing of TCM, with the general outline of " diagnosis and treatment principle of Luobing " and the two wings of "Mailuo theory" and "Qiluo theory", inherits the academic thoughts, theoretical views and clinical experience of successive doctors on Luobing and combines with modern science and technology to construct an innovative theory systematically, which has opened up a new way for the prevention and treatment of major clinical diseases. Guided by the Luobing theory and based on modern basic and clinical research, the clinical effective prescriptions have been transformed into a series of innovative traditional Chinese medicine drugs, and major breakthroughs have been made in the prevention and treatment of viral respiratory infectious diseases, microangiopathy and neuro-endocrine-immune system diseases and anti-aging.

Effectiveness of Traditional Chinese Medicine in Reducing the Positive Rate of COVID-19 Close Contacts: A Large Population Cohort Study

WANG Xiao-xiao, DOU Li, ZOU Chong, WU Yong-jun, WANG Wei, ZHAO Jing-jing, YU Qian, SHEN Zhao-feng, NI Ping-min, ZHANG Wen, LU Ya-wen, XI Zhao-qing, FANG Zhu-yuan

2022, 38(12): 1086-1093. doi: 10.14148/j.issn.1672-0482.2022.1086

[Abstract](400) [FullText HTML] (79) [PDF 1353KB](53)

Abstract:
OBJECTIVE Corona-virus disease 2019 (COVID-19) is an infectious disease caused by SARS-CoV-2 virus. The variant of corona-virus first identified in India, known as Delta, has become the dominant strain in China. Unfortunately, more contagious and unknown variants are coming, leading to a number of close contacts under quarantine. Chinese medicine (TCM) has been recommended to prevention and treatment due to the satisfactory therapeutic effects. However, the effect of TCM to decrease positive rate in close contacts remains unknown. METHODS We conducted an retrospective cohort study in Yangzhou, China to assess the effect of Chinese medicine on decreasing positive rate in close contacts under quarantine. The primary observation outcome was positive rate of Nucleic Acid Amplification Tests (NAATs). The secondary observation outcome was a composite of viral load of positive NAATs, severity levels of confirmed cases (asymptomatic, mild, moderate, or severe), daily body temperature, and levels of close contact (primary or secondary). RESULTS A total of 1 286 subjects were collected, of which 1 016 (79.00%) in TCM group and 270 (21.00%) in control group with 55 participants tested positive. The incidence of the primary outcome, positive rate of NAATs was significantly lower in the Chinese medicine group than in the control group, occurring in male and age≥60 years subjects. Multi-variable logistic regression (excluding NO viral load) indicated that the risk of testing positive was reduced by 0.547 times in TCM group compared to control group. CT value of TCM group was higher than that of control group in all subjects and female subjects, and the result showed statistically significant difference. CONCLUSIONS In our study involving close contacts under quarantine, Chinese medicine resulted in lower positive rate of NAATs and viral load than control.

Analysis of the Formulation Idea of Zhenwu Decoction Based on the Prescription Theory of Fu Xing Jue

SHI Sheng-jie, SHEN Jie

2022, 38(12): 1094-1098. doi: 10.14148/j.issn.1672-0482.2022.1094

[Abstract](246) [FullText HTML] (47) [PDF 1022KB](37)

Abstract:
the prescription theory of Fu Xing Jue is summarized into the system of the figure of Tangye Principle and the system of Erdan-Sishen Decoctions. At the same time, in combination with the content of Fu Xing Jue, the formulation idea of Zhenwu Decoction is explored with its prescription theory. It is found that it contains the application of the thinking of five viscera gasification and the Xiang-number thinking of four gods and four signs. It is expected to provide certain ideas and literature support for the application and research of Zhenwu Decoction and enrich the prescription theory.

Discussion on Etiology and Pathogenesis of Cancer Pain Based on Cancer Toxin Theory

WU Yan, LI Wen-ting, SHEN Bo, WANG Zi-hao, WU Mian-hua

2022, 38(12): 1099-1102. doi: 10.14148/j.issn.1672-0482.2022.1099

[Abstract](275) [FullText HTML] (27) [PDF 946KB](21)

Abstract:
"Cancer toxin" is an important factor leading to the occurrence and development of tumors. Cancerous pain is caused by cancer toxin, and the pathological products "phlegm, blood stasis, depression and deficiency" produced in the process of tumor occurrence and development are the main pathological factors of cancerous pain, "cancer toxin" runs through the whole process of cancerous pain. The internal accumulation of cancer toxin and the mutual formation of phlegm and blood stasis are the key to the pathogenesis of cancerous pain. The disease location involves related viscera and meridians. Locally true; detoxification and blood stasis, phlegm and collaterals are the basic treatment methods.

Clinical Efficacy and Mechanism of Yishen Huashi Granules in Treating Diabetic Kidney Disease Based on the "Gut-Kidney Axis" Theory

AI Shan-shan, CUI Tao, ZHOU Le, SHEN Zhen, LI Wei, HAN Cong

2022, 38(12): 1103-1109. doi: 10.14148/j.issn.1672-0482.2022.1103

[Abstract](127) [FullText HTML] (27) [PDF 2135KB](28)

Abstract:
OBJECTIVE To observe the clinical efficacy of Yishen Huashi granules in the treating diabetic kidney disease (DKD), and to explore its mechanism of action on alleviating DKD through the "gut-kidney axis". METHODS A total of 100 patients suffering from DKD with syndrome of excessive dampness caused by spleen deficiency were randomly divided into the treatment and control group, with 50 cases in each group. In the control group, the patients were treated with basic western medicine, while the patient in the treatment group were given Yishen Huashi granules based on the treatment of the control group. After the 8-week treatment course, we observed the changes in both groups, including the traditional Chinese medicine (TCM) syndrome score, urinary albumin creatinine ratio (UACR), fasting blood glucose (FBG), glycosylated hemoglobin (HbA1C), serum creatinine (Scr), blood urea nitrogen (BUN), esti mated glomerular filtration rate (eGFR), albumin (ALB), superoxide dismutase (SOD), interleukin-6 (IL-6), and N-acetyl-β-D-glucosaminidase (NAG). In addition, the fecal samples of 60 patients (30 in each group) were randomly collected to screen the target organisms of the granules by sequencing in the area of 16S rDNA V3 + V4. RESULTS The total effective rate of the treatment group was significantly higher than that of the control group (P < 0.05). The TCM syndrome scores of both groups were significantly improved, but the result of the treatment group was better than that of the control group (P < 0.05, P < 0.01). Besides, the UACR, BUN, HbA1C and IL-6 levels of both groups were significantly reduced than those before treatment (P < 0.05, P < 0.01), but the results of the treatment group was better than those of the control group (P < 0.05, P < 0.01). The levels of SOD and ALB in the treatment group were significantly increased (P < 0.05, P < 0.01) and showed better results than those of the control group (P < 0.05, P < 0.01). Compared with the control group, the diversity and abundance of flora in the treatment group increased, the aggregation degree of flora increased, and the F/B value reduced. Through LEfSe analysis, we found that the dominant genera in the treatment group were Parabacteroides, Bifidobacterium longum, and Lactobacillus mucosae. CONCLUSION Yishen Huashi granules can effectively alleviate the clinical TCM symptoms of DKD patients with syndrome of excessive dampness caused by spleen deficiency. Besides, it can also lower blood glucose, reduce proteinuria, regulate the overall level of oxidative stress and inflammation, and stabilize renal function by affecting the distribution of intestinal flora, which provides a basis for further study of Yishen Huashi granules to assess the occurrence, development, and treatment of DKD through intestinal flora.

Exploration of A New Method for Evaluating the Quality of Angelica Sinensis Based on the Determination of Blood Tonic Activity in vitro

LIU Huan-huan, ZHANG Ting, WANG Min, YU Yin-ping, SU Lian-lin, JI De, LU Tu-lin, LI Lin

2022, 38(12): 1110-1115. doi: 10.14148/j.issn.1672-0482.2022.1110

[Abstract](90) [FullText HTML] (18) [PDF 1405KB](6)

Abstract:
OBJECTIVE To develop a biological evaluation method based on the blood tonic activity, combined with the main medicinal effects of Angelica sinensis, to evaluated its internal quality. METHODS Hemin was used as standard substance, the relative content of hemoglobin after added Angelica sinensis to K562 cells was determined by the benzidine staining method and the biological titer was calculated by parallel-line assay. After methodological investigation, the biological titers of different production areas and processing of Angelica sinensis were compared. RESULTS The reliability test of Angelica sinensis showed that the regression items were significantly different (P < 0.01). The RSDs of repeatability and precision were 1.13% and 4.73%, respectively, in the methodological investigation. The blood-enriching titers of its pieces from different origins were in the range of 399.61-8 920.32 U·mg^-1. The rank of blood tonic effects of different processed Angelica sinensis products was raw > soil > wine, and that of different medicinal parts was body > head > tail. CONCLUSION The established biological titer method of blood tonic for Angelica sinensis is stable and reliable. The results of methodological investigation are in accord with the relevant requirements of the "Guidelines for the determination of biological activity of traditional Chinese medicines" in the Chinese Pharmacopoeia (2020 edition). It can be used to evaluate the blood tonic titer of Angelica sinensis from different areas, processing methods and medicinal parts, which provides a new idea for further study on the improving of Angelica sinensis quality control.

Isolation and Purification of Alcohol-Extracted Protein from Eupolyphaga Sinensis Walker and Its in vitro Anti-Hepatocellular Carcinoma and Anti-Hepatic Fibrosis Activities

XIE Jia-yu, DAI Long-chao, WANG Na, LIU Cheng, WANG Ling-chong

2022, 38(12): 1116-1127. doi: 10.14148/j.issn.1672-0482.2022.1116

[Abstract](183) [FullText HTML] (32) [PDF 4691KB](14)

Abstract:
OBJECTIVE In vitro cell experiments were used to evaluate the anti-hepatocarcinoma and anti-hepatic fibrosis activities of the macromolecular proteins isolated from the alcohol extract of Eupolyphaga sinensis Walker, and gradually focused on the effective parts and components. METHODS The protein fractions were recovered from the alcohol extracts of Eupolyphaga sinensis Walker by salting out, and the crude protein products of Eupolyphaga sinensis Walker were divided into three different protein sites EEPA, EEPB and EEPC, according to their molecular weight by ultrafiltration. Based on the activity of inhibiting the proliferation of abnormal liver cells, the best part was screened by cell experiments. Then, a purified protein (PC3-Ⅲ) was isolated from EEPC by DEAE anion chromatography and Sephadex G-100 gel chromatography, and identified by LC-MS/MS. Finally, cell experiments were performed to evaluate the in vitro anti-hepatocarcinoma and anti-hepatic fibrosis activities of EEPC and PC3-Ⅲ. RESULTS Among EEPA, EEPB, and EEPC, the protein site EEPC with the largest molecular weight showed the most potent inhibitory activity against abnormal liver cell proliferation. The molecular weight of PC3-Ⅲ was about 10 kDa. LC-MS/MS identification showed that the coverage rate of PC3-Ⅲ to the homologous protein A0A0M3STY1 reached 35%. The peptide sequences obtained by checking the reference were QYSINFISAR, CNGDSCVCTFR and SNNFR. In vitro experiments suggested that PC3-Ⅲ not only exerted anti-hepatoma by inhibiting tumor cell growth, inducing tumor cell apoptosis, and inhibiting tumor cell migration, but also inhibited the proliferation of activated hepatic stellate cells and delayed the process of liver fibrosis. The efficacy was comparable to that of EEPC. CONCLUSION This study confirms the anti-tumor and anti-liver fibrosis activities of the macromolecular protein of Eupolyphaga sinensis Walker and isolates the homogeneous protein product PC3-Ⅲ, laying a foundation for the advanced understanding of the material basis for the efficacy of Eupolyphaga sinensis Walker and the research and development of related products.

Neuroprotective Effect and Mechanism of Astragalus Injection on Acute Spinal Cord Injury in Rats

FENG Tao, LYU Yehua, WANG Sheng, HUANG Wei, MI Daguo

2022, 38(12): 1128-1136. doi: 10.14148/j.issn.1672-0482.2022.1128

[Abstract](162) [FullText HTML] (27) [PDF 3671KB](14)

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OBJECTIVE To explore the neuroprotective function of Astragalus injection on acute spinal cord injury (SCI) in rats and its mechanism based on apoptosis signaling pathway. METHODS 40 healthy male SD rats were randomly divided into sham operation group, SCI group, Astragalus injection low dose group (1 mL · kg^-1), Astragalus injection medium dose group (2 mL · kg^-1) and Astragalus injection high dose group (4 mL · kg^-1). A modified heavy object method was used to construct an acute SCI rat model. The locomotor function of rats was evaluated according to BBB method and Rivlin inclined board test. Hematoxylin-eosin (HE) staining was used to detect the pathological changes of spinal cord tissue. Nissl staining method was used to detect the degree of spinal cord neuronal cell damage. High-throughput transcriptome sequencing to analyze differentially expressed genes. The qPCR method verified the expression level of gene transcription. TUNEL kit was used to detect the apoptosis of spinal cord cells in each group. The expression levels of key proteins in the apoptosis pathway was detected by Western blot. RESULTS The results of BBB score and Rivlin plate test indicated that rats in the model group showed obvious motor dysfunction compared with the sham group. HE staining showed severe pathological changes in spinal cord tissue in the model group. Lighter Nissl staining showed severe neuronal cell damage in the model group. Compared with the sham group, 4 597 genes were differentially expressed in the spinal cord of the model group. The expressions of Fas, TRAIL, Caspase-3, Caspase-8, Caspase-9 and Bax proteins were significantly up-regulated (P < 0.01). Moreover, the protein expressions of Fas apoptosis inhibitor FAIM and anti-apoptotic factor Bcl-2 was significantly reduced (P < 0.01). Compared with the model group, the BBB score and the degree of Rivlin in the Astragalus injection group significantly increased and the degree of tissue lesions becomes smaller (P < 0.05, P < 0.01). As the dose of Astragalus injection increased, the degree of Nissl staining becomes deeper. The injury and apoptosis of spinal cord nerve cells in the Astragalus injection high dose group significantly alleviated (P < 0.01). Compared with the model group, the expressions of FAIM and TRAIL mRNA were significantly expressed in the high-dose Astragalus injection group (P < 0.01), the expressions of Fas, TRAIL, Caspase-3, Caspase-8, Caspase-9 and Bax protein in Astragalus injection groups were inhibited in a dose-dependent manner (P < 0.05, P < 0.01), the protein expressions of FAIM and Bcl-2 were up-regulated (P < 0.01). CONCLUSION Astragalus injection may inhibit the expressions of Fas and TRAIL proteins, thereby regulate the programmed apoptosis of neuronal cells, exert a neuroprotective effect on SCI, improve the degree of SCI, and accelerate the later neuromotor function recovery of obstacles.

Effects of Zishen Xieqing Tang on Dopamine Signaling Pathway of Desensitization/Resensitization in Attention Deficit Hyperactivity Disorder Rats' Prefrontal Cortex

SUN Jichao, ZHANG Bixia, LI Weiwei

2022, 38(12): 1137-1142. doi: 10.14148/j.issn.1672-0482.2022.1137

[Abstract](143) [FullText HTML] (46) [PDF 1831KB](9)

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OBJECTIVE To investigate the effects of Zishen Xieqing Tang(ZXT)on attention deficit hyperactivity disorder (ADHD) related behavior and dopamine signaling pathway of desensitization and resensitization in spontaneously hypertensive rats' prefrontal cortex. METHODS 10 Wistar Kyoto rats were set as normal control group. 50 SHR rats were randomly divided into 5 groups including model group, methylphenidate (MPH) group (2 mg·kg^-1by gavage), and high, middle, low dose of ZXT groups(ig ZXT with the crude drug dosage 6.0, 12.1, 24.1 g·kg^-1 respectively). Rats were orally given the drugs twice a day, then, behavior experiment was done to test the ADHD related behavior changes. After 4 weeks of treatment, the prefrontal cortex of rats were collected for further study. Real-time PCR and Western blot were used to test the protein or mRNA expression of GRK-6, β-arrestin2, NCS-1, PP2A and PSD-95 in SHR rats' prefrontal cortex. RESULTS MPH group and ZXT groups could improve the ADHD related behavioral performance of SHR. Statistic difference of β-arrestin2, GRK-6, NCS-1, PSD-95, PP2A and PKA expression were observed among different groups (P < 0.05). Comparing with normal control group, the β-arrestin2, NCS-1, PSD-95 and PP2A expression of SHR rats' prefrontal cortex in model group were much lower (P < 0.05). After treatment with ZXT, comparing the model group, the expression of β-arrestin2, NCS-1, PSD-95 and PP2A in MPH group and every-dosage group of ZXT were much higher in both parts (P < 0.05). At the meanwhile, the expression of GRK-6 was observed on the contrary behavior. CONCLUSION Both MPH and Zishen Xieqing Tang can affect the function of dopamine receptors by regulating desensitization and re-sensitization, thus improve the ADHD related symptom.

Identification of the Chemical Components of Peucedani Radix and in vivo Chemicals Based on UPLC-Q-TOF-MS/MS

JI Chunliang, SU Yan, ZHANG Jinge, SHENG Xiansen, ZHANG Jianrong, SHAN Chenxiao

2022, 38(12): 1143-1155. doi: 10.14148/j.issn.1672-0482.2022.1143

[Abstract](167) [FullText HTML] (518) [PDF 2781KB](44)

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OBJECTIVE To deduce the main chemical components in Peucedani radix and its absorbed prototype components and metabolites in plasma and lung using a UPLC-Q-TOF-MS/MS method. METHODS Thermo Acclaim^TM RSLC 120 C₁₈ column (3.0 mm×100 mm, the particle size is 2.2 μm) was used by using a gradient elution program with 0.1% formic acid water and acetonitrile as mobile phase. Column temperature was set at 35 ℃, the flow rate was 0.3 mL · min^-1 and the injection volume was 5 μL. ElectroSpray Ionization Source (ESI) was selected to collect parent and product mass spectrometric data in positive ion mode. RESULTS The chemical components in Peucedani radix were analyzed and identified according to the accurate mass, retention time, the fragmentation and other information of the compounds, especially, by comparing the reference substances and literature data. A total of 54 chemical constituents were identified in Peucedani radix, including 52 coumarins, 1 terpene and 1 phenolic compound. And a total of 21 prototype components and 26 metabolites were identified in rat plasma. 17 prototype components and 9 metabolites were identified in lung tissue after oral administration of Peucedani radix extract to rats. CONCLUSION This method is rapid, accurate and comprehensive. The analysis results lay a foundation for the quality control of Peucedani radix and the further study of pharmacological material basis.

National Medical Master Zhang Qi's Experience in Differentiating and Treating Hepatorenal Syndrome

CHEN Ming, YAN Xiaoming, PAN Yang

2022, 38(12): 1156-1159. doi: 10.14148/j.issn.1672-0482.2022.1156

[Abstract](112) [FullText HTML] (13) [PDF 950KB](32)

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Through summarizing the experience of professor Zhang Qi, a master of Chinese medicine, in the treatment of hepatorenal syndrome(HRS), it is concluded that HRS is a disease of deficiency at the root and excess at the symptoms, which is closely related to the dysfunction of liver, spleen and kidney. In other words, the weakened body resistance, qi stagnation, blood stasis, damp heat, and pathogenic toxins are the key to the disease mechanism. Thus, we should differentiate the deficient and excess causes of the disease to set the treating priorities right. Besides, we should closely follow the mechanism of the disease to treat it in stages. For example, in the early stage, we should dredge the liver and regulate the qi, and strengthen the spleen and stomach; in the middle stage, we should warm the yang and strengthen the spleen, and promote the qi and water movement; in the late stage, we should treat the liver, spleen, and kidneys together, and combine the elimination and supplementation methods at the same time.

Professor Jin Shi's Experience in Treating Rheumatoid Arthritis with A Secondary Osteoporosis by Benefiting the Kidney and Unblocking the Collaterals

YANG Fan, CAO Jing

2022, 38(12): 1160-1163. doi: 10.14148/j.issn.1672-0482.2022.1160

[Abstract](184) [FullText HTML] (27) [PDF 948KB](21)

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Rheumatoid arthritis is a common chronic systemic immune disease. Professor Jin Shi believes that the disease begins with congenital deficiency of kidney essence. After the long course of the disease, the lack of production and transformation source of qi and blood can lead to the poor qi movement and blood circulation. As the condition gets worse, it will breed pathogenic phlegm and stasis. Besides, excessive drug use and physical disability can also exacerbate the disease, which is deficiency in root and excess in manifestation. Bones and collaterals are the delicate structures for running qi and blood, which are often weakened by qi- and blood-deficiency. In addition, they are easily paralyzed by pathogenic phlegm and stasis. The disfunction of bones and collaterals can lead to bone marrow malnutrition, further resulting in bone withering and marrow reduction, and thus leading to osteoporosis. Professor Jin Shi took the deficiency of kidney essence, combined with paralysis and obstruction of bone and collaterals as the core pathogenesis of rheumatoid arthritis with a secondary osteoporosis. Therefore, when the treatment method of benefiting kidney and unblocking the collaterals is applied clinically, a better therapeutic effect can be achieved.

Several Key Questions about Rational Use of Toxic Chinese Medicine Based on Clinical Thinking

CHEN Renshou

2022, 38(12): 1164-1169. doi: 10.14148/j.issn.1672-0482.2022.1164

[Abstract](139) [FullText HTML] (32) [PDF 990KB](12)

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From the clinical perspectives, toxic side effects occur after using toxic Chinese medicine. There are multiple reasons, such as lack of attention towards toxicity of Chinese medicine, ignorance of detoxification and controlling knowledge, excessive and long-term use of toxic Chinese medicine, improper use of medicinal materials and processed products, inconsistency between tradition and its usage and dosage, inadequate medical advice after diagnosis and etc. Therefore, it is suggested that Chinese medical practitioners should pay attention to the toxicity and toxic side effects of traditional Chinese medicine; master the theory and methods of controlling and detoxification. They should also select the correct medicinal materials, processed products, dosage forms and medication methods; understand the contemporary toxicological knowledge, and pay attention to the key problems such as the damage to the body caused by taking multiple drugs, so as to use toxic traditional Chinese medicine safely and reasonably.

Review on the Ancient Chinese Medical Books and Literature Study Based on Knowledge Element

WANG Fenglan

2022, 38(12): 1170-1174. doi: 10.14148/j.issn.1672-0482.2022.1170

[Abstract](199) [FullText HTML] (128) [PDF 999KB](15)

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Knowledge representation of ancient Chinese medical books based on knowledge elements is a method for organizing and mining the knowledge of ancient Chinese medical books by combining knowledge elements and metadata theory. The current situation, problems, and significance of ancient Chinese medical books study based on knowledge elements are reviewed, and it is concluded that knowledge element theory and technology-based ancient Chinese medical books study is a supplement and development of traditional literature organization and study. Thus, it is an important development direction of ancient Chinese medical books organization and literature study in the future.

2022 Vol. 38, No. 12

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