南京中医药大学学报

Interpreting the Connotation and Clinical Expansion Application of Supporting Method from the Perspective of System Theory

LI Ming, GUO Shun, PAN Li-qun

2023, 39(11): 1063-1069. doi: 10.14148/j.issn.1672-0482.2023.1063

[Abstract](223) [FullText HTML] (30) [PDF 1055KB](31)

Abstract:
As one of the modern scientific achievements, system theory can better explain and integrate traditional Chinese medicine (TCM). The article is based on the idea of system theory and combines TCM gasification thinking to deeply analyze the connotation of TCM surgical support method. It is believed that support method is based on the relationship between good and evil, with the organs, meridians, qi and blood as the main body of the system, and aims to restore the body's adaptive regulation ability. It reflects the systematic scientific characteristics of hierarchical evolution, leap, and overall emergence. Taking the treatment of chronic subdural hematoma with support method as an example, the possibility of applying support method thinking to other modern surgical diseases was further explored and validated.

Exploring the Application of Kidney-Tonifying Prescriptions in Cognitive Impairment Based on the Theory of Kidney Generating Marrow and Unblocking Brain Collaterals

LI Xin-ning, SHI Sheng-jie, SHEN Jie, DONG Yu

2023, 39(11): 1070-1075. doi: 10.14148/j.issn.1672-0482.2023.1070

[Abstract](213) [FullText HTML] (36)

Abstract:
This paper systematically expounds the research advance and theoretical connotation of the kidney generating the marrow and unblocking brain collaterals, and points out the relationship between the kidney, marrow and brain in terms of structure and function. The article proposes that brain marrow insufficiency is the key to the onset of cognitive impairment. Kidney deficiency runs through cognitive impairment, and phlegm and blood stasis are important pathological factors. The treatment should mainly focus on tonifying the kidney. Through the kidney-tonifying method, the purposes of nourishing the brain and marrow, strengthening the brain and memory, and helping to eliminate phlegm and remove blood stasis are proposed. Representative prescriptions for tonifying kidney yang and kidney yin are proposed to provide ideas and methods for the clinical prevention and treatment of cognitive impairment and the expansion of its prescription and medication selection.

Effects of Glycyrrhizic Acid on Solubility, Pharmacokinetics and Liver Distribution of Osthole in Rats

YUN Fei, KANG An, SHAN Jin-jun, ZHAO Xiao-li, BI Xiao-lin, DI Liu-qing

2023, 39(11): 1076-1085. doi: 10.14148/j.issn.1672-0482.2023.1076

[Abstract](103) [FullText HTML] (15) [PDF 2317KB](16)

Abstract:
OBJECTIVE To investigate the potential of glycyrrhizic acid (GL) to improve the solubility and bioavailability of osthole (Ost), and to explore the underlying mechanism of the potential solubility and pharmacokinetic interactions. METHODS Male Sprague-Dawley rats were orally given osthole (20 mg·kg^-1) alone or with glycyrrhizic acid (45 mg·kg^-1). Blood and liver samples were collected at specific time points and determined by an LC-MS/MS method. The effect of glycyrrhizic acid on the solubility of osthole, and physical characterizations, including X-ray diffraction (XRD) and Fourier transform infrared (FT-IR) spectroscopy, were performed to reveal the mechanism of the solubilization of GL. In addition, bidirectional transport study using Caco-2 cell monolayer model was employed to study the effects of glycyrrhizic acid and its active metabolite glycyrrhetinic acid (GC) on the absorption of osthole. In incubation studies, rat enterocyte S9 and liver S9 were used to explore the potential effect of GL and GC on the metabolism of osthole. RESULTS The results of pharmacokinetics in rats showed that co-administration of glycyrrhizic acid could significantly increase the AUC of osthole as compared with osthole administered alone. The results of rat liver tissue samples indicated that glycyrrhizic acid increased the distribution of osthol in liver tissue. Solubility study found that glycyrrhizic acid could significantly enhance the solubility of osthole in water due to the decreased crystallinity of osthole and the formation of hydrogen bonding between Ost and GL. Caco-2 cell monolayer model demonstrated that neither GL nor GC could enhance osthole absorption. Further in vitro incubation study revealed that there was little metabolic interaction between osthole and GL or GC in phaseⅠmetabolism. CONCLUSION Increased AUC and liver concentration of osthole are probably due to the increased solubility of osthole by GL. The current study has significant implications for further investigation on the potential combination use of natural solubilizing agent GL and drugs with solubility as the rate-limiting step to absorption from the gastrointestinal tract.

Molecular Identification of Magnoliae Flos and Its Relatives Based on DNA Barcoding

ZHANG Xin-yi, QIU Yu-xuan, HU Yang, TIAN Rong, ZHAO Mian, YAN Hui, WANG Xia-chang, HU Li-hong

2023, 39(11): 1086-1094. doi: 10.14148/j.issn.1672-0482.2023.1086

[Abstract](112) [FullText HTML] (6) [PDF 3154KB](10)

Abstract:
OBJECTIVE To identify Magnoliae Flos and its related species using DNA barcoding technology, so as to establish a rapid, accurate and convenient method for identification of Magnoliae Flos. METHODS Genomic DNA of 21 Magnoliae Flos and their related species were extracted, and ITS, ITS2, psbA-trnH, matK and rbcL gene sequences were amplified and sequenced. MEGA7.0 software was used for sequence comparison, and the intraspecific and interspecific genetic distance was calculated based on Kimura-2-Parameter (K2P) model to evaluate Barcoding gap, and the NJ phylogenetic trees were constructed to react identification results. RESULTS Among the 5 primers, psbA-trnH and matK could normally amplify the target gene, and the success rate of them was higher than 98%, while the success rate of rbcL sequencing was 38.1% only. The matK sequence had the highest number of variation sites, and psbA-trnH had the most prominent species discriminatory on Barcoding gap analysis relative to matK and rbcL. The NJ phylogenetic tree showed that psbA-trnH+matK barcode sequence could accurately identify 9 varieties, and distinguish Magnoliae Flos and its relatives. In addition, we applied it to the molecular identification of Magnolia grafting rootstocks for the first time. CONCLUSION The sequence combination of psbA-trnH+matK can realize the accurate identification of Magnoliae Flos, and can be applied to the rapid identification of Magnolia grafting rootstocks.

Based on HMGB1/NF-κB Signal Pathway to Explore Inhibitory Effect of Wenjing Tongluo Decoction on IL-1β-Induced Inflammation in Primary Chondrocytes in Mice

XU Qi, ZHANG Hong-rong, XU Wei-min, QIAN Jia-jia, HUANG Gui-cheng

2023, 39(11): 1095-1101. doi: 10.14148/j.issn.1672-0482.2023.1095

[Abstract](171) [FullText HTML] (20) [PDF 2753KB](27)

Abstract:
OBJECTIVE To observe the effect of Wenjing Tongluo Decoction on IL-1β-induced inflammation of articular chondrocytes and explore its mechanism. METHODS Primary chondrocytes were extracted from knee cartilage of mice and identified by toluidine blue staining. The chondrocyte inflammation model was induced by IL-1β. Lentiviral RNAi-HMGB1 was transfected into chondrocytes to interfere the expression of HMGB1. Then the cells were intervened with different concentrations of Wenjing Tongluo Decoction containing serum. Western Blot was used to analyze the protein expression of HMGB1 and NF-κB signaling pathway. The expression of HMGB1, NF-κB1, NF-κB2 mRNA was detected by qPCR. ELISA was applied to detect the expression of inflammatory factors IL-6, PGE-2 and TNF-α in cell supernatants. RESULTS Compared with normal cultured cells, the expression of HMGB1 increased significantly (P < 0.01) in the IL-1β-induced chondrocyte inflammatory model, and the relative expression of p-IκBα/IκBα and p-P65/P65 proteins and the expression of NF-κB1 and NF-κB2 mRNA were increased (P < 0.01). Compared with the model group, lentiviral RNAi-HMGB1 transfection could significantly downregulate the expression of HMGB1 (P < 0.01), and inhibit the upregulation of the relative expression of p-IκBα/IκBα (P < 0.01) and p-P65/P65 protein and NF-κB1 and NF-κB2 mRNA expression (P < 0.05). Compared with the model group, different concentrations of Wenjing Tongluo Decoction showed inhibitory effects on HMGB1 and NF-κB signaling pathways, demonstrated by the decrease in the protein expression of HMGB1, p-IκBα/IκBα and p-P65/P65 (P < 0.05). CONCLUSION Wenjing Tongluo Decoction can improve IL-1β-induced chondrocyte inflammation, and its mechanism may be related to inhibition of HMGB1-mediated activation of NF-κB signaling pathway.

Study on Efficacy Evaluation of Qili Huanshao Formula in Ameliorating Sex Hormone Disturbance and Oxidative Damage in Testicular of D-Galactose-Induced Subacute Aging Mice

LI Meng-ting, ZHENG Hui-li, ZHU Zi-qiang, XU Pan, GUO Sheng, QIAN Da-wei, ZHU Yue, DUAN Jin-ao

2023, 39(11): 1102-1112. doi: 10.14148/j.issn.1672-0482.2023.1102

[Abstract](78) [FullText HTML] (9) [PDF 3360KB](12)

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OBJECTIVE To evaluate the effect and mechanism of Qili Huanshao Formula (QLHSF) in ameliorating sex hormone disturbance and oxidative damage in testicular tissues of D-galactose-induced subacute aging mice. METHODS 105 male mice were randomly divided into the normal group, model group, low, medium and high doses of QLHSF group, vitamin E (VE) group and Jin Gui Shen Qi Wan (JGSQW) group. The subacute senescence model was established by continuous intraperitoneal injection of D-galactose (D-gal) and treated by intragastric administration, as well. The testicular histopathological damage was detected by HE staining. The levels of relevant sex hormones in serum were detected by ELISA. The expression of oxidative stress factors was detected by related kits. The apoptotic cells in testicular tissue were detected by TUNEL assay, and the expressions of oxidative stress and apoptotic related proteins in the testicular tissues of mice were detected by Western blot. RESULTS Compared to the aging model mice, all dose groups of QLHSF could obviously improve testicular tissue pathological damage. The levels of T, E₂ and GnRH levels were increased, while LH and FSH were decreased in serum (P < 0.01). Meanwhile, the SOD activity (P < 0.01) and the levels of GSH (P < 0.01) were increased, while MDA levels (P < 0.01) were decreased in serum and testicular tissues. The medium dose group of QLHSF significantly inhibited testicular cell apoptosis (P < 0.01), increased the expression of Nrf2, HO-1 protein and Bcl-2/Bax ratio(P < 0.05), and down-regulated the expressions of Cleaved-Caspase-3/Caspase-3, Cleaved-Caspase-9/Caspase-9 apoptotic protein in the testis of mice (P < 0.05). CONCLUSION QLHSF can effectively improve sex hormone disturbance and protect testicular tissue in aging mice, and the mechanism of action might be related to the inhibition of oxidative stress-induced apoptosis in testicular tissues. The study will provide reference and lay the foundation for the clinical application and functional anti-aging product development of Lycium barbarum and its formulations.

Network Pharmacology Analysis and Experimental Verification of Isoliquiritigenin for the Treatment of Diabetic Encephalopathy

FU Chuan-jun, TAO Jia-sheng, YANG Liang, LIAO Li-xiu, TAN Xin-xin, LI Zhong-zheng, LI Xian-hui

2023, 39(11): 1113-1121. doi: 10.14148/j.issn.1672-0482.2023.1113

[Abstract](104) [FullText HTML] (13) [PDF 4795KB](17)

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OBJECTIVE This study aims to elucidate the mechanism of action of Isoliquiritigenin (ILG) in the treatment of Diabetic Encephalopathy (DE) based on network pharmacological analysis and in-vitro experiments. METHODS The potential targets of ILG were predicted using the HERB database and SwissTargetPrediction database. DE-associated disease targets were obtained from GeneCards, OMIM, and PharmGkb, and the intersecting targets between ILG and DE were identified using the Venny software. A PPI network was constructed using the STRING database, and core targets were screened out using Cytoscape software. GO function and KEGG pathway enrichment analyses were undertaken using R 4.0.3, followed by validation via molecular docking techniques and in vitro experiments. RESULTS 65 intersecting targets between ILG and DE were identified in this study. Topological analysis yielded eight core targets namely, EGFR, ESR1, PTGS2, PPARG, GSK3β, CDK2, PIK3R1, and F3. GO function and KEGG pathway enrichment analyses revealed that ILG antagonizes DE through several biological processes which impact numerous cellular components and molecular functions such as response to lipopolysaccharides, protein phosphorylation, protein kinase activity, and serine/threonine/tyrosine kinase activity. Pathways implicated included the PI3K-Akt signaling pathway, protein polysaccharide signaling pathway in cancer, and endocrine resistance pathway. The molecular docking results showed that all eight core targets had a good binding with ILG, especially with GSK3β, with a binding energy of -7.22 kcal·mol^-1. In vitro experiments indicated that ILG could improve high glucose-induced cell damage and activate the PI3K/AKT/GSK3β signaling pathway. CONCLUSION ILG is likely to exert its effects on GSK3β to regulate the PI3K/AKT/GSK3β signaling pathway, thereby alleviating DE.

Clinical Study of Modified Chaihu Guizhi Decoction in Treating Stable Angina Pectoris of Coronary Heart Disease with Anxiety/Depression of Qi Stagnation and Blood Stasis Type

HUANGFU Hai-quan, HUANG Hui-chun, YU Hai-rui, SHANG Xiao-ming, LIAO Wei-qian

2023, 39(11): 1122-1128. doi: 10.14148/j.issn.1672-0482.2023.1122

[Abstract](143) [FullText HTML] (15) [PDF 1073KB](30)

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OBJECTIVE To observe the clinical efficacy of modified Chaihu Guizhi Decoction in treating stable angina pectoris with anxiety/depression in patients with coronary heart disease of qi stagnation and blood stasis type. METHODS 60 patients with stable angina pectoris and anxiety/depression caused by qi stagnation and blood stasis type of coronary heart disease were included in the study. They were randomly divided into a control group (n=30) and a treatment group (n=30). Both groups of patients received health education, psychological counseling, and routine treatment for coronary heart disease angina pectoris. The control group received droperidol melitracin tablets in addition to basic treatment, while the treatment group received modified Chaihu Guizhi Decoction in addition to basic treatment for 4 weeks. The efficacy of traditional Chinese medicine (TCM) syndrome, total score of traditional Chinese medicine syndrome, angina symptom score, electrocardiogram treadmill exercise test, nitroglycerin withdrawal rate, self-rating anxiety scale (SAS), self-rating depression scale (SDS), and Seattle angina questionnaire (SAQ) scores between the two groups of patients were compared before and after treatment. At the same time, peripheral blood lipids and IL-6 levels were measured. RESULTS After treatment, the TCM syndrome score, angina symptom score, SAS, SDS score of both groups of patients decreased (P < 0.01), and the scores of various dimensions of SAQ increased (P < 0.01). The occurrence time of ST segment depression of 1mm in treadmill exercise test was prolonged, the occurrence time of angina was prolonged, and the recovery time of ST segment was shortened (P < 0.01), and TC, TG, LDL-C, IL-6 were significantly reduced (P < 0.05, P < 0.01). Moreover, the treatment group was superior to the control group in improving TCM syndrome scores, angina symptom scores, SAS, SDS scores, PL and TS scores in SAQ, apparent effective rate of TCM syndrome, nitroglycerin cessation rate, blood lipids (TC, LDL-C), and serum IL-6 (P < 0.05, P < 0.01). CONCLUSION Modified Chaihu Guizhi Decoction can significantly improve the clinical symptoms, anxiety and depression status of patients with stable angina pectoris and anxiety/depression of qi stagnation and blood stasis type of coronary heart disease, improve quality of life, reduce blood lipids and IL-6 levels.

The Efficacy of Xingnao Kaiqiao Acupuncture Combined with Modified Shaoyao Decoction in The Treatment of Limb Spasm in Patients with Post-Stroke

LU Jun-wei, WANG Yun, ZHOU Miao, REN Meng-lei, WANG Fang, YU Li

2023, 39(11): 1129-1133. doi: 10.14148/j.issn.1672-0482.2023.1129

[Abstract](96) [FullText HTML] (21) [PDF 1014KB](18)

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OBJECTIVE To observe the efficacy of Xingnao Kaiqiao acupuncture combined with modified Shaoyao decoction in the treatment of post-stroke limb spasm. METHODS 70 patients with post-stroke limb spasticity who met the inclusion criteria were selected and divided into an observation group and a control group with 35 cases each using the random number table method. The control group received routine rehabilitation training and modified Shaoyao decoction, while the observation group was treated with Xingnao Kaiqiao acupuncture on the basis of the treatment of the control group. The course of treatment was 8 weeks for both groups. The traditional Chinese medicine (TCM) syndrome scores, clinical efficacy, clinical spasm index (CSI), simple Fugl-Meyer assessment (FMA), modified Barthel index (MBI) in the two groups of patients before and after treatment were observed. RESULTS After treatment, the TCM syndrome scores of both groups decreased significantly (P < 0.05, P < 0.01), and the observation group was better than the control group (P < 0.05, P < 0.01); the curative effect in the observation group was better than that in the control group (P < 0.05); the FMA and MBI scores of both groups increased significantly (P < 0.01), and the CSI score decreased significantly (P < 0.05), the observation group was better than the control group (P < 0.05, P < 0.01). No obvious adverse reactions occurred in either group during the treatment period. CONCLUSION Xingnao Kaiqiao acupuncture combined with Jiawei Shaoyao decoction can improve the patients' limb spasticity, limb activity function and clinical symptoms, and improve the patients' daily living ability.

TCM Classification and Determination Standards for Children's Constitution

Drafting Group of "TCM Classification and Determination Criteria for Children's Constitution (Formulation)" by China Association of Chinese Medicine, ZHAO Xia, LI Min

2023, 39(11): 1134-1142. doi: 10.14148/j.issn.1672-0482.2023.1134

[Abstract](480) [FullText HTML] (70) [PDF 1068KB](102)

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Based on the completion of literature search and evaluation and the formation of literature summary, the "TCM Classification and Determination Standards for Children's Constitution (Formulation)" was developed through three rounds of expert questionnaires, expert validation sessions, cross-sectional surveys, and public opinion solicitation. The standards propose the scope of application, normative references, terms and definitions, age stratification, classifications of children's constitution, characteristics of children's constitution, and the determination of children's constitution of TCM. The purpose of this standard is to provide a standardized and objective reference for the clinical practice.

Textual Research of Pediatric Classic Famous Prescription of Yigong Powder Based on Ancient and Modern Literature

WANG Jia-hao, XUE Hao, CHEN Ren-shou

2023, 39(11): 1143-1154. doi: 10.14148/j.issn.1672-0482.2023.1143

[Abstract](187) [FullText HTML] (32) [PDF 1156KB](33)

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Yigong powder is one of the classic famous prescriptions published in the Catalogue of Ancient Classical Famous Prescriptions (the Second Batch of Pediatrics). Through systematically collating textual research and analyzing ancient literatures and clinical literatures on Yigong decoction, the key issues of prescription origin, composition, drug base, processing method, usage and dosage, efficacy and indications of Yigong powder were summarized, providing literature data support for the development and clinical application of the classic pediatric prescription of Yigong powder. According to the analysis and research, Yigong powder comes from Qian Yi's Key to Diagnosis and Treatment of Children's Diseases and is consisted of ginseng, poria cocos, atractylodes, tangerine peel and licorice, with ginger and jujube being used as guiding medicine. The medicinal base follows the 2020 edition of Chinese Pharmacopoeia. Ginseng, poria cocos, and orange peel are used as raw products, atractylodes is used as bran fried atractylodes, licorice is used as processed licorice. Children should be differentiated from adults in terms of drug dosage. The dosage for children is 1.4— 1.7 g each for ginseng, poria cocos, atractylodes, tangerine peel and licorice, and the dosage for adults is 5.6 g— 6.8 g each. The method of making and taking medicine is to file drugs down, take 300 mL water, add ginger and jujube and fry to 210 mL, take warm medicine before meals and adjust the frequency according to the actual situation. The ancient prescription was often used in children anorexia, diarrhea and other diseases. After the innovation of later generations of doctors, it is also used for digestive system diseases, recurrent respiratory tract infections in children, allergic rhinitis and so on.

Research Progress of Chinese Medicine in Regulating Autophagy-Related Pathways Against Lung Cancer

LUO Cheng, YE Yuan-hang, TU Jin-wen, KE Jia

2023, 39(11): 1155-1164. doi: 10.14148/j.issn.1672-0482.2023.1155

[Abstract](208) [FullText HTML] (24) [PDF 1257KB](21)

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As a malignant tumor with high incidence and mortality worldwide, lung cancer seriously threatens the life and health of human beings. At present, clinical treatment of lung cancer is mainly based on surgery combined with radiotherapy and chemotherapy and other comprehensive treatments, which can control the progression of lung cancer to a certain extent, but there are still problems such as low survival rate and poor quality of life. Autophagy is a complex intracellular self degradation mechanism. The occurrence of autophagy is closely related to autophagy-related gene proteins and signal pathways. Research shows that reasonable regulation of signal pathway can interfere with autophagy leading to lung cancer cell death and inhibit tumor growth. In recent years, the regulation of autophagy-related signaling pathways in Chinese medicine against lung cancer has become a hot spot in the field of oncology research. Therefore, this paper compares and summarizes the research on the regulation of autophagy-related signaling pathways in Chinese medicine against lung cancer in recent years, in order to provide a reference basis for the development of new drugs and clinical application of Chinese medicine against lung cancer.

2023 Vol. 39, No. 11

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