2023 Vol. 39, No. 4

Display Method:
Exploration of the Complex Pathogenic Transformation Characteristics of Type 2 Diabetes Mellitus with Thyroid Nodules Comorbidity
CHEN Xiao-ying, ZHOU Jing-wen, LI Tian-ci, LU Zi-yu, YE Fang
2023, 39(4): 301-305. doi: 10.14148/j.issn.1672-0482.2023.0301
Abstract:
The comorbidity of type 2 diabetes mellitus(T2DM) with thyroid nodules(TN) is discussed, and the theoretical implications of the compound pathogenesis of phlegm, constraint, stasis and heat are explored. The study introduces the pathogenesis evolution of T2DM and TN in Chinese medicine, and discusses the evolutional characteristics of the compound pathogenesis of T2DM combined with TN. The pathological factors center around phlegm and stasis, which are compounded with constraint, dampness, dryness, heat, etc. The corresponding location of the disease is mainly in the liver and kidney, and is also closely related to the heart, spleen, and lung. The nature of the disease is based on yin deficiency. From the modern biological point of view, the evolution of the compound pathogenesis of T2DM combined with TN is presented as follows. Firstly, insulin resistance is related to the production of phlegm, dampness, and stasis. Secondly, glucolipid metabolism is related to the formation and transformation of phlegm, dampness, and stasis. Thirdly, the formation of chronic inflammation is related to the pathological state of deficiency-excess complex. Thus, the combination of reductionist biomedicine and the holistic view of Chinese medicine is expected to provide new ideas for the modernization of the homotherapy for heteropathy in Chinese medicine.
Exploration on the Relationship between Jia-Wood Descending and Qi Movement of Internal Organs
FENG Shi-yao, ZHANG Feng-cong
2023, 39(4): 306-311. doi: 10.14148/j.issn.1672-0482.2023.0306
Abstract:
Based on the theory of the qi movement of internal organs, Huang Yuan-yu pointed out that the "jia-wood descending" of the gallbladder is closely related to the qi movement of the internal organs within the body. The gallbladder belongs to jia-wood, which promotes qi movement throughout the body by transforming qi into xiang-fire. Therefore, the physiological functions of the lung, kidney, heart, liver, stomach, and bladder are all closely related to jia-wood descending of the gallbladder and xiang-fire lurking. Pathologically, if jia-wood does not descend, it will affect the stomach, resulting in the upward movement of the stomach qi. Besides, if xiang-fire of the gallbladder disturbs the heart fire, it will cause agitation. If the movements of jia-wood and xiang-fire are against the lung, it will cause cough and nasal sinusitis. If xiang-fire is not hidden in the kidney, it will lead to the loss of warmth of kidney water and the extinction of kidney qi. If the gallbladder qi does not descend, it will easily cause the depression of liver-wood, constraining liver qi and producing wind. Thus, in terms of treatment, jia-wood descending and xiang-fire lurking are the main treatment methods for the counterflow of qi based on the gallbladder theory of internal organs. The theory of jia-wood descending can complement and enrich the qi-movement and restraint theory, provide a new interpretation of the "Inner Canon" that "all eleven organs depend on the gallbladder", and also provide new ideas and references for clinical application.
Clinical Study of Curative Effect of Bikangfu Nasal Tamponade on Acute Rhinosinusitis
YUAN Yan-hong, WEI Rui, CHEN Lu-lu, WANG Jun-jie, CAI Ji-tang
2023, 39(4): 312-318. doi: 10.14148/j.issn.1672-0482.2023.0312
Abstract:
  OBJECTIVE  To observe the effects of Bikangfu nasal tamponade on acute rhinosinusitis, inflammatory factors, inflammation-related proteins and neuropeptides in serum and nasal secretions.  METHODS  144 cases were randomly divided into the control group and observation group (n=72). On the basis of conventional treatment the control group was given mometasone furoate, and the observation group was treated with Bikangfu nasal tamponade. The nasal situation Lund-Kennedy (Lund-Kennedy) and sinus nasal outcome test-20 (SNOT-20) were used, and the nasal airway resistance (NAR) and TCM symptoms were observed before and after treatment. The nasal ciliary clearance function, including mucosal ciliary clearance rate (MCC), mucociliary transport rate (MTR), and saccharin clearance time (SCT), was tested. The inflammatory factors leukotriene C4 (LTC4), interleukin 17 (IL-17), prostaglandin D2 (PGD2), inflammation-related proteins eosinophil cationic protein (ECP), aquaporin-3 (AQP-3), immunoglobulin E (IgE), and neuropeptides substance P (SP), neurokinin A (NKA), neuropeptide Y (NPY) in serum and nasal secretions were detected.  RESULTS  After treatment, the TCM symptoms, Lund-Kennedy score, SNOT-20 score, NAR, SCT, LTC4, IL-17, PGD2, ECP and IgE of the two groups were decreased (P < 0.05, P < 0.01), and MTR, MCC, AQP-3, SP, NKA and NPY of the two groups were increased (P < 0.05, P < 0.01). Moreover, the observation group displayed better therapeutic effects than the control group (P < 0.05, P < 0.01). The clinical total effective rate of TCM in the observation group was significantly higher than that in the control group (P < 0.05).  CONCLUSION  Bikangfu nasal tamponade can remit the clinical symptoms of patients with acute rhinosinusitis, and the mechanism of the action may be related to regulating inflammatory factors, inflammation-related proteins and neuropeptides in serum and nasal secretions.
Electroacupuncture Influences Macrophage M2 Polarization and TLR4 and MyD88 Expression in Myocardial Tissue of Myocardial Ischemia Injury Mice
SHI Jun-jing, YANG Jia-li, MA Nai-qi, JIANG Min-Jiao, PENG Rou, FU Shu-ping, BAI Hua, YU Mei-ling, LU Sheng-feng
2023, 39(4): 319-327. doi: 10.14148/j.issn.1672-0482.2023.0319
Abstract:
  OBJECTIVE  To observe the effect of electroacupuncture on cardiac function and its effect on macrophage polarization, TLR4 and MyD88 expression in the heart of mice with myocardial infarction, and to explore the possible mechanism of electroacupuncture against cardioprotection.  METHODS  27 male C57BL/6J mice were randomly divided into the sham-operated group, model group, and electroacupuncture group, with 9 mice in each group. The myocardial ischemia model was established by ligating the left anterior descending branch of the coronary artery in the model group and electroacupuncture group. In the electroacupuncture group, after successful modeling, the mice were treated with electroacupuncture at the bilateral Neiguan points: 2/15 Hz, dense and sparse waves, 1 mA, 20 min/time, once a day for 7 days. The ejection fraction (EF) and short-axis systolic rate (FS) were calculated by echocardiography; the fibrosis of mice heart was observed by Sirius red staining; the number of neutrophils and macrophages in myocardial tissue and the percentage of macrophages in each phenotype was detected by flow cytometry; the mRNA expression of TNF-α and IL-1β in myocardial tissue were detected by real-time quantitative fluorescence PCR; the protein expression levels of TLR4, MyD88, IL-1β, and IL-17A in myocardial tissues were detected by Western blot.  RESULTS  Compared with the sham-operated group, mice in the model group showed decreased EF and FS values (P < 0.0001), increased collagen volume fraction (P < 0.001), increased numbers of neutrophils and macrophages in cardiac tissues (P < 0.0001, P < 0.001), as well as increased percentage of M1-type macrophages (P < 0.05). The mRNA expression of TNF-α, IL-1β in myocardial tissues expression increased (P < 0.01, P < 0.001); TLR4, MyD88, IL-1β, IL-17A protein expression levels increased (P < 0.05, P < 0.01); compared with the model group, mice in the electroacupuncture group had higher EF and FS values (P < 0.01, P < 0.001), lower collagen volume fraction (P < 0.001), the numbers of neutrophils and macrophages in cardiac tissues decreased (P < 0.0001, P < 0.01), while the percentage of M2-type macrophages increased (P < 0.05), the mRNA expression of TNF-α and IL-1β in myocardial tissues decreased (P < 0.001), and the TLR4, MyD88, IL-1β, IL-17A protein expression levels were decreased (P < 0.05, P < 0.001).  CONCLUSION  Electroacupuncture may achieve myocardial protective effects by reducing the expression of TLR4 and MyD88 in myocardial tissue, promoting the polarization of cardiac macrophages to M2 type after MI, reducing local inflammation, and inhibiting myocardial fibrosis.
Effect of Electroacupuncture on the Immune Balance of Th1/Th2 in Diminished Ovarian Reserve Rats Based on the Preventive Treatment Theory
ZHU Yao-yao, QIN Yan-tong, LI Hong-xiao, YIN Yao-li, LU Ge, SHEN Mei-hong
2023, 39(4): 328-336. doi: 10.14148/j.issn.1672-0482.2023.0328
Abstract:
  OBJECTIVE  To explore the effect of electroacupuncture on ovarian reserve function and Th1/Th2 immune balance in DOR rats based on the preventive treatment theory.  METHODS  A total of 27 female SPF Sprague-Dawley rats with normal estrus cycle were randomly divided into control group, DOR group, and electroacupuncture group, with 9 rats in each group. The DOR group and the electroacupuncture group were treated with intragastric administration of tripterygium glycosides(TGs) tablet suspension at a dose of 50 mg·kg-1·d-1 for 14 days to establish the DOR models. An equal volume of normal saline was given to the control group once a day for 14 days. One hour after intragastric administration, rats in the electroacupuncture group had a daily 10-minute electroacupuncture treatment at bilateral "Shenshu" (BL23) or "Guanyuan" (CV4) and "Zhongwan" (CV12). The two groups of acupoints were alternated every other day. The electroacupuncture parameters were as follows: 2/100 Hz, 1.0 mA. Vaginal smears were obtained every day starting the first day of intervention to monitor the estrus cycle of the rats. After the intervention, HE staining was used to observe the histological morphology of ovaries; the level of estradiol (E2), follicle-stimulating hormone (FSH), interleukin-4 (IL-4) and interferon-γ (IFN-γ) were measured through ELISA kits; the expression of T-bet and GATA3 mRNA was detected by qPCR; the protein levels of T-bet and GATA3 in ovarian tissue were detected by immunohistochemistry and Western blot; the ratio of Th1 and Th2 cells in the spleen was detected by flow cytometry.  RESULTS  Compared with the control group, the number of primordial follicles in the DOR group decreased (P < 0.05), and atretic follicles increased (P < 0.01); both the ovarian index and spleen index were reduced in the DOR group (P < 0.01); serum E2 and IL-4 levels decreased (P < 0.05), while the levels of FSH and IFN-γ increased in the DOR group (P < 0.05); GATA3 protein and mRNA expression lessened (P < 0.05, P < 0.01), while T-bet protein and mRNA expression were upregulated in ovarian tissues (P < 0.05); the T-bet/GATA3 ratio was elevated (P < 0.05); the proportion of Th1 cells as well as Th1/Th2 ratio increased (P < 0.01), and the proportion of Th2 cells decreased (P < 0.05). In comparison with DOR group, the number of primordial follicles in the electroacupuncture group increased notably, which was accompanied by decreased atretic follicles (P < 0.01); the ovarian index and spleen index increased (P < 0.01); the levels of E2 and IL-4 both increased(P < 0.05, P < 0.01), while FSH and IFN-γ concentrations decreased in DOR group (P < 0.01); GATA3 protein and mRNA were expressed higher in ovarian tissues (P < 0.05), while the expression of T-bet protein and mRNA was downregulated (P < 0.05, P < 0.01); the T-bet/GATA3 ratio is reduced (P < 0.01); the proportion of Th1 cells alone with Th1/Th2 ratio decreased (P < 0.05, P < 0.01), and the proportion of Th2 cells was higher than that in DOR group (P < 0.05).  CONCLUSION  Electroacupuncture has a protective effect on ovarian reserve in DOR rats, and its mechanism may be related to the regulation of Th1/Th2 immune balance.
Jinping Decoction Prevents Respiratory Syncytial Virus Infection by Improving Respiratory Immunity
XU Si-yan, QIU Xi-rui, YAN Yang-tian, LU Yang, ZHANG Yu-lin, WANG Xian-zheng, JI Jian-jian
2023, 39(4): 337-345. doi: 10.14148/j.issn.1672-0482.2023.0337
Abstract:
  OBJECTIVE  To investigate the immunoregulatory effect of Jinping decoction (JP) on immunocompromised mice and its preventive effect on RSV infection.  METHODS  90 Balb/c mice were randomly divided into control group, model group, pidotimod group (0.3 g·kg-1), JP high dose group (55.2 g·kg-1), middle dose group (27.6 g·kg-1), low dose group (13.8 g·kg-1), 15 mice in each group. The immunocompromised mouse model was constructed by intraperitoneal injection of dexamethasone. After 7 days of intragastric administration with normal saline, pidotimod, high, medium low doses of JP, RSV was infected intranasally. The control group received nasal drops of the same volume of normal saline. The body weight of mice was recorded, and the spleen volume was photographed. Flow cytometry was used to detect the proportion of immune cell subsets: CD4+T, CD8+T, NK and DC in spleen, mesenteric lymph nodes and lung tissues. Lung viral load, expression levels of IFN-β mRNA and ISG15 mRNA were detected by qPCR. HE staining was used to evaluate the pathological changes of lung tissue. Lymphocyte infiltration in bronchoalveolar lavage fluid (BALF), the proportion of activated CD8+T cells (CD8+CD69+T) and memory T cells in lung tissue were detected by flow cytometry.  RESULTS  JP treatment significantly restored the body weight of model mice, and the proportion of CD8+T, NK and DC cells in mesenteric lymph nodes and lung tissue. qPCR results illustrated that compared with the model group, the JP treatment group could reduce the RSV load in the lungs of mice and increase the mRNA expression of IFN-β and ISG15 (P < 0.05, P < 0.01, P < 0.001). Flow cytometry showed that lymphocyte infiltration in lung tissue of mice in the JP treatment group was significantly reduced compared with the model group (P < 0.01). The results of HE staining and flow cytometry revealed that JP could improve the histopathological morphology of lung in mice, promote the activation of CD8+T cells and increase the proportion of central memory T cells (P < 0.01).  CONCLUSION  JP can improve the immunosuppression of model mice, and effectively prevent RSV infection, alleviate the pathological damage of lung inflammation and enhance the immune memory after RSV infection by increasing the antiviral immune response mediated by type Ⅰ interferon and CD8+T cells.
Mechanism of Fangji Huangqi Tang against Nephrotic Syndrome Based on Network Pharmacology and Transcriptomics Methods
WAN Hao-ting, LIU Qing, LIU Lu-yao, XIE Lin-tong, ZHU Hui, LIU Xiao
2023, 39(4): 346-358. doi: 10.14148/j.issn.1672-0482.2023.0346
Abstract:
  OBJECTIVE  To explore the mechanism of Fangji Huangqi Tang (FHT) in the treatment of nephrotic syndrome (NS) based on transcriptomics and network pharmacology.  METHODS  Intersection target genes of network pharmacology and transcriptomics were collected for GO/KEGG functional enrichment analysis. Protein-protein interactions (PPI) were constructed and network topology analysis was performed to identify potential core targets. The pathway-target network map was constructed to identify the key signaling pathways. Finally, real-time quantitative PCR (qPCR), western blot and immunofluorescence staining were used to verify the mRNA and protein expression levels of core targets in kidney tissues of rats.  RESULTS  Seven potential core targets AKT1, AMPK, CPT1B, NF-κB1, P53, TGF-β1 and TLR4 were identified by PPI analysis. The main signaling pathways were AMPK, PI3K-Akt, PPAR, NF-κB, TGF-β, P53, MAPK, JAK-STAT and FoxO. In animal experiments, FHT significantly down-regulated the mRNA and protein expression levels of AKT1, CPT1B, NF-κB1, P53, TGF-β1, TLR4 (P < 0.05), and up-regulated the mRNA and protein expression levels of AMPK (P < 0.05).  CONCLUSION  From the perspective of network pharmacology and transcriptomics, the overall regulation features of multi-component, multi-target and multi-pathway of FHT against NS were preliminaries elaborated, which could provide the basis and reference for subsequent pharmacological research and clinical application of FHT.
Study on Ningmitai Capsule to Ameliorate Pain Caused by Chronc Prostatitis
LU Shang, WANG Qian, LYU Zhi-gang
2023, 39(4): 359-364. doi: 10.14148/j.issn.1672-0482.2023.0359
Abstract:
  OBJECTIVE  To explore the effect and potential mechanism of Ningmitai (NMT) capsule on pain caused by prostatitis.  METHODS  50 male C57BL/6 mice were randomly divided into 5 groups: control group, model group, NMT low dose group, NMT middle dose group, and NMT high dose group. NMT groups were given 6, 12, 18 g·kg-1 NMT solution, respectively, by gavage after modeling. The control and model groups were intragastrically administered the same amount of normal saline. Behavioral assessment was performed using thermal radiation tail flick test and hot plate test; glial fibrillary acidic protein (GFAP) and tumor necrosis factor-α (TNF-α) contents in prostate in each group were detected by Immunohistochemistry; TNF-α, IL-6 and IL-1β mRNA levels in prostate tissue were measured by qPCR; ELISA technology was applied to determine prostate TNF-α, IL-6 and IL-1β expression; protein levels of p-ERK/ERK, p-JNK/JNK and p-P38MAPK/P38MAPK were detected by Western blot.  RESULTS  Compared with the model group, the pain thresholds of the hot plate and tail flick in NMT low dose, middle dose and high dose groups were significantly increased (P < 0.01, P < 0.001); GFAP and TNF-α contents were significantly decreased (P < 0.05); TNF-α, IL-6 and IL-1β mRNA levels were significantly decreased (P < 0.05, P < 0.01, P < 0.001); expression levels of p-ERK/ERK, p-JNK/JNK and p-P38MAPK/P38MAPK were significantly reduced (P < 0.05, P < 0.01).  CONCLUSION  NMT capsule shows a certain analgesic effect on the pain caused by chronic prostatitis in mice, which is associated with inhibiting inflammatory mediators and deactivating astrocytes.
Effect of Platycodon Grandiflorum Polysaccharide on the Growth and Metabolism of Akkermansia Muciniphila
CHONG Ying, LUO Zi-chen, XU Wei-chen, QIAN Gui-ying, SHAN Jin-jun
2023, 39(4): 365-374. doi: 10.14148/j.issn.1672-0482.2023.0365
Abstract:
  OBJECTIVE  To investigate the effect of Platycodon grandiflorum polysaccharides on regulating the growth and metabolism of Akkermansia muciniphila (A.muciniphila).  METHODS  Platycodon grandiflorum polysaccharides were co-incubated with A.muciniphila in vitro and the growth curve was determined; Use LC-MS/MS to determine the content of short-chain fatty acids(SCFAs); Non-targeted metabolomics and non-targeted lipidomics were performed to study the changes of metabolic profiles in A.muciniphila after Platycodon grandiflorum polysaccharides treatment.  RESULTS  Platycodon grandiflorum polysaccharides could promote the growth of A.muciniphila, and increase the content of short-chain fatty acids in A.muciniphila, especially butyrate. Furthermore, Platycodon grandiflorum polysaccharides also remodeled the metabolic profiles of A.muciniphila, as 9 lipids and 18 other metabolites were regulated.  CONCLUSION  Platycodon grandiflorum polysaccharides can enrich A.muciniphila and regulate its metabolism. This study provides a theoretical basis for harnessing Platycodon grandiflorum polysaccharides as prebiotics of A.muciniphila.
Herbal Literature Research and Drug Use Investigation of Tibetan Medicine Zuomoxing
YUAN Mao-hua, GAO Bi-xing, TAO Jing, GU Rui, JIANG Gui-hua
2023, 39(4): 375-383. doi: 10.14148/j.issn.1672-0482.2023.0375
Abstract:
  OBJECTIVE  To clarify the origins, medicinal parts, clinical use and market circulation of Tibetan medicine Zuomoxin, and provide a reference for its further research and development.  METHODS  The origins, medicinal parts, and preparations of Zuomoxing were sorted out by adopting TCM literature research; the usage of corresponding origins was derived based on the origin and medicinal condition survey that was conducted with 41 cities and counties, 21 Tibetan hospitals, 13 pharmaceutical factories and pharmaceutical companies, and 6 Tibetan medical experts in the four provinces and regions of Sichuan, Yunnan, Tibet, and Qinghai, as well as the identification results of collected medicinal materials.  RESULTS  Literature research showed that Zuomoxing involved 10 origins, such as xylem heartwood, decoction, leaves, flowers, etc. The survey results suggested that the most widely recognized origin of Zuomoxing was C. changduensis Y. X. Liou, and the second was C. jubata (Pall.) Poir. The red heartwood of C. changduensis Y. X. Liou was primarily used as medicine, with the best quality. The heartwood of C. jubata (Pall.) Poir of other colors was less used and has poor effects. On the market, the most popular medicinal material for Zuomoxing was C. changduensis Y. X. Liou, and a few Tibetan hospitals use C. jubata (Pall.) Poir. This study involved a total of 20 prescription preparations. The commonly used therapeutic effects of Zuomoxing in preparations were mainly to reduce blood pressure, treat polyemia, clear blood heat, and dissipate blood stasis.  CONCLUSION  This study confirmed that the main source of Tibetan medicine Zuomoxing is the red heartwood of C. changduensis Y. X. Liou, which provides a basis for its further development and utilization.
Research Progress on the Mechanism of Traditional Chinese Medicine in the Intervention of Nonalcoholic Steatohepatitis
LIANG Xin-yu, LIN Su-qin, WANG Yi-bin, XU Jing-yi, LIU Ya-meng, XIE Cen
2023, 39(4): 384-392. doi: 10.14148/j.issn.1672-0482.2023.0384
Abstract:
Nonalcoholic fatty liver disease (NAFLD) is a metabolic syndrome that has become a public health problem of general concern. Nonalcoholic steatohepatitis (NASH) is a progressive NAFLD lesion resulting from the interaction of multiple risk factors with multiorgan involvement. Due to the complex underlying pathophysiologic mechanisms that contribute to the development and progression of NASH, there are no approved drugs to control the progression of the disease. Based on traditional Chinese medicine(TCM) theory, NAFLD belongs to the category of "Ganpi", and was divided into 4 syndrom types: liver stagnation and spleen deficiency, internal obstruction of phlegm and dampness, obstruction of dampness and heat, and interaction of phlegm and blood stasis. Chinese medicine can effectively intervene and treat different clinical types of NASH with its unique theoretical system and treatment strategy. With the continuous development of modern pharmacology and molecular biology, more and more studies have shown that TCM compound formula and active monomers can improve NASH through various mechanisms, which promotes the application of TCM. This review focuses on the mechanisms related to the improvement of NASH by TCM from the perspectives of compound formula and active monomers, in order to provide a theoretical and experimental research basis for the rational and effective treatment of NASH.
Application and Institutional Supervision of Gene Editing for Germplasm Innovation of Medicinal Plant Resources
XIE Zhen-ni, LAO Jia, ZHONG Can, HE Wei, ZHANG Shui-han, JIN Jian
2023, 39(4): 393-400. doi: 10.14148/j.issn.1672-0482.2023.0393
Abstract:
Medicinal plant resources are an important part of Traditional Chinese Medicine, gene editing technology can realize site-specific targeted mutation of genome and innovation of medicinal plants germplasm without introducing other genes. CRISPR gene editing technology, the widely used gene editing technology in recent years, has been investigated and applied in medicinal plants resources, and a corresponding gene editing system has been constructed in Citrus sinensis, Dendrobium officinale, Opium poppy, Salvia miltiorrhiza, Rehmannia glutinosa, Panax ginseng, Ganoderma lucidum, Flammulina filiformis, Shiraia bambusicola, Cordyceps militaris, etc. Research on active components and content regulation of key genes, phenotypic traits, and quality improvement research of key genes, has been carried out in medicinal plants resources. China, the United States, Japan, Brazil, Australia, and other countries have successively issued corresponding regulatory policies for gene editing germplasm innovation, which promotes its industrialization. This paper proposes to further advance the basic research of gene editing germplasm innovation of medicinal plants resources, strengthen the research on drug equivalence after gene editing of germplasm, launch popular science publicity and establish a scientific supervision system.