南京中医药大学学报

Analysis and Clinical Application of the Top Jiao Pulse

ZHANG Li-li, MIAO Run-yu, LEI Ye, ZHAO Lin-hua, WEI Yu, LI Qing-wei, XIA Bing, CHEN Rui, TONG Xiao-lin

2023, 39(7): 601-605. doi: 10.14148/j.issn.1672-0482.2023.0601

[Abstract](197) [FullText HTML] (34) [PDF 2031KB](47)

Abstract:
Academician Tong Xiaolin divided the human body into top, upper, middle and lower jiao in combination with modern anatomy, and proposed the concept of "top jiao pulse", that is, the pulse at or above the wrist transverse stripe. This paper analyzes the shape, trend, state and clinical application of the "top jiao pulse"; believes that the proposal of the "top jiao pulse" has important clinical application value for the severity and prognosis of diseases in the top jiao area, such as cervical thyroid disease, cervical spondylosis, carotid plaque, cerebrovascular disease, etc; emphasizes that there are both connections and differences between disease pulse diagnosis and state pulse diagnosis. When a disease develops to a certain extent and appears in a state, the disease and state should be mutually involved. The proposal of "top jiao" and "top jiao pulse" is a supplement and improvement to the theory of Cunkou sphygmology, which will greatly enrich the theory of traditional Chinese medicine pulse.

Guiding Theory and Clinical Application Strategy of Acupuncture-Moxibustion and Medicine Combination Therapy

DAI Ran-ran, WANG Xin-jun

2023, 39(7): 606-612. doi: 10.14148/j.issn.1672-0482.2023.0606

[Abstract](174) [FullText HTML] (31) [PDF 1044KB](27)

Abstract:
This article discusses the history and current situation of acupuncture-moxibustion and medicine combination therapy, and believes that the combination therapy has been applied since ancient times, but its direct guiding theory has not been clear. By analyzing the relevant literature in previous dynasties, it is believed that the meridian theory is its direct guiding theory. The clinical application strategy of acupuncture-moxibustion and medicine combination therapy should first follow the treatment principles of early treatment and prevention of changes, syndrome urgency, and adaptation to three conditions. Starting from the location and property characteristics of the disease, the severity of the condition, and the expectation of disease development, different clinical strategies should be adopted based on disease conditions, e.g., the location of the disease in the organs, limbs, or meridians, to achieve the goal of increasing efficacy and/or reducing toxicity. Finally, the role characteristics of acupuncture-moxibustion and medicine therapy in the combination of acupuncture-moxibustion and medicine were analyzed.

Exploring Effects of Irisin on Musculoskeletal Decay Based on Equal Emphasis on Sinews and Bones and Same Treatment for Different Diseases Theories

LIU Yan-dong, DENG Qiang, LI Zhong-feng, PENG Ran-dong, WANG Yu-rong, YANG Zhen-yuan, GUO Tie-feng, LUO Lin-zhao

2023, 39(7): 613-617. doi: 10.14148/j.issn.1672-0482.2023.0613

[Abstract](84) [FullText HTML] (14) [PDF 1021KB](12)

Abstract:
Skeleton and skeletal muscle cross talk with each other through various channels, and together form the largest biological movement tissue of the body, the musculoskeletal system. Irisin is a kind of hormone-like muscle factor mediated by exercise, which has dual functions of simultaneously regulating muscle regeneration and bone homeostasis. Based on the theories of "equal emphasis on sinews and bones" and "same treatment for different diseases ", this study explores the dual therapeutic effects of irisin on musculoskeletal decay lesions from the perspectives of traditional Chinese medicine and Western medicine, in order to provide new directions for basic research and clinical prevention and treatment of muscle and bone comorbidities.

Study on Lipid Metabolism Regulated by Polygonum Cuspidatum in the Treatment of Pulmonary Fibrosis Model of Respiratory Syncytial Virus Infection in Mice

CHEN Jia-bin, ZHANG Meng-yao, WANG Dan, HUANG Tong-xing, SHAN Jin-jun, YANG Jun-chao, SONG Kang, LIN Li-li

2023, 39(7): 618-628. doi: 10.14148/j.issn.1672-0482.2023.0618

[Abstract](267) [FullText HTML] (52) [PDF 5055KB](13)

Abstract:
OBJECTIVE To investigate the effects of Polygonum Cuspidatum in the treatment of lung fibrosis mice infected with the respiratory syncytial virus (RSV) in terms of altered lipids and the inflammatory process in the lung. METHODS C57BL/6 mice were given a tracheal drip of 50 μL RSV venom (4×10⁶ PFU·mL^-1) combined with bleomycin (2 mg·mL^-1). The mice were randomly divided into blank group, bleomycin induced pulmonary fibrosis group, RSV infected pulmonary fibrosis group and Polygonum Cuspidatum (4.55 g·kg^-1·d^-1) treatment group. To assess changes in pathological and pro-inflammatory cytokine levels (IL-6, and TNF-α), lung tissues from each group were removed 21 days after modeling. Lipidomics analysis was then completed using UPLC-Q Exactive Orbitrap/MS. RESULTS In comparison to the blank group, the lungs of the bleomycin induced pulmonary fibrosis group and RSV infected pulmonary fibrosis group showed prominent collagen fiber deposition and inflammatory infiltration, and the levels of lung inflammatory factors like IL-6 and TNF-α were noticeably higher (P < 0.05). The lipid metabolism of the RSV infected pulmonary fibrosis group differed significantly from that of the bleomycin induced pulmonary fibrosis group, with abnormal levels of ceramide (Cer), phosphatidylcholine (PC), phosphatidylethanolamine (PE), phosphatidylinositol (PI), acylethanolamine (NAE), sphingomyelin (SM), diglyceride (DG), triglyceride (TG) and fatty acid (FA). The above indexes showed a significant trend of correction after the intervention of Polygonum Cuspidatum (4.55 g·kg^-1·d^-1). CONCLUSION RSV has the potential to accelerate the progression of pulmonary fibrosis. Polygonum Cuspidatum reduces inflammation and collagen deposition in the lung tissue of RSV-infected mice with pulmonary fibrosis by regulating lipid metabolism, and it slows the progression of pulmonary fibrosis in mice.

Huangqi Sijunzi Decoction Restrained Gastric Cancer Proliferation via Regulating the Level of PD1 Ubiquitination on T Cells and Remodeling the Tumor Immune Microenvironment

TAN Qian-ying, XIE Gui-ping, LI Xiang, LIU Lian-fang, WU Guan-nan, WU Xiao-yu, ZHAI Jing

2023, 39(7): 629-636. doi: 10.14148/j.issn.1672-0482.2023.0629

[Abstract](293) [FullText HTML] (53) [PDF 3141KB](23)

Abstract:
OBJECTIVE To evaluate the effects of Huangqi Sijunzi Decoction on tumor proliferation and immune function of MFC gastric cancer bearing mice. METHODS The MFC gastric cancer subcutaneous tumor model of C57BL/6 mouse was established. 24 C57BL/6 mice were divided into control group, model group, low dose Chinese medicine group (6.24 g· kg^-1) and high dose Chinese medicine group (12.48 g· kg^-1), with 6 mice in each group. The body weight and tumor volume of these mice were recorded. Expression levels of IFN-γ, TNF-α, IL-2 and IL-8 in peripheral blood of mice in each group were detected by ELISA. The expression levels of CD4⁺, CD8⁺, and PD1⁺ T cell subsets in the tumor, spleen, and thymus of mice were analyzed by flow cytometry. Detect PD1 ubiquitination levels in mouse tumors. RESULTS Compared with control group, the body weight was increased (P < 0.05), the expression of IFN-γ, TNF-α, IL-2 were decreased (P < 0.001), and the expression of IL-8 was increased in model group (P < 0.05). Compared with model group, the tumor volume of mice in high dose Chinese medicine group was remarkable declined (P < 0.05). The expression levels of IFN-γ, IL-2, TNF-α in mouse peripheral blood increased (P < 0.01, P < 0.001), but the expression level of IL-8 decreased (P < 0.05). The expression of CD4⁺ and CD8⁺ T cell subsets in tumor, spleen, and thymus of mice was increased in high dose Chinese medicine group (P < 0.001). The PD1⁺ T cells were decreased (P < 0.001) with the increase of ubiquitination level (P < 0.01). CONCLUSION Huangqi Sijunzi Decoction can upregulate the expression of CD4⁺and CD8⁺ T cells in MFC tumor bearing mice, regulate the expression level of cytokines in peripheral blood, and promote the downregulation of PD1 expression by increasing the level of intracellular ubiquitination of T cells, thus inhibiting the proliferation of gastric cancer cells.

Euryale Ferox Petioles and Pedicels Polysaccharide Promoted Cell Apoptosis of Murine Lung Cancer LLC Cells by Inducing Cellular Infiltration of CD4⁺T, CD8⁺T and NK Cells

MIN Yi, ZHANG Xi-yao, XIANG Dong-yang, CHEN Jing, LYU Zhi-yang, SHAN Xin

2023, 39(7): 637-644. doi: 10.14148/j.issn.1672-0482.2023.0637

[Abstract](171) [FullText HTML] (12) [PDF 3914KB](6)

Abstract:
OBJECTIVE Aimed to examine the effect of Euryale ferox petioles and pedicels polysaccharide (EFPP) on LLC cell allograft model of lung cancer. METHODS Forty male C57BL/6 rats were randomly divided into 4 groups (n=10/group), namely control group, EFPP low dose group (100 mg·kg^-1 EFPP), EFPP high dose group (200 mg·kg^-1 EFPP), 5-Fu(20 mg·kg^-15-Fu). Different doses of EFPP were orally administered once daily for fifteen consecutive days, and the positive drug was injected once every 3 days after the ectopic xenograft tumor model was established. Rats in control group received PBS treatment by gavage. All mice were sacrificed on the second day of the last administration. Tumor samples were taken from each group, and the volume and tumor weight were weighed. Hematoxylin and eosin staining, flow cytometry, TUNEL apoptosis staining and Western blot were used to detect the pharmacodynamics of EFPP. RESULTS The data showed that EFPP could inhibit the proliferation of LLC cells in vivo. In addition, EFPP increased the levels of CD3⁺CD4⁺T, CD3⁺CD8⁺T and CD3^-NK1.1⁺cells. At the same time, EFPP up-regulated the expression of proteins related to the Caspase3 apoptosis pathway. CONCLUSION EFPP can promote LLC cell apoptosis by increasing the infiltration of lymphocyte subsets, up-regulating the expression of cleaved-caspase3 and Bax, and down-regulating the expression of Bcl2. This study provided the scientific basis for the anti-tumor application of EFPP and utilization of euryale ferox stem resources.

Study on Effective Components and Mechanism of Astragalus-Zedoary against Ovarian Cancer Based on Network Pharmacology and Molecular Docking

ZU Yue, LIANG Yan, SUN Ruo-lan, ZHAO Fan, BIAN Yong, TANG De-cai, Yin Gang

2023, 39(7): 645-656. doi: 10.14148/j.issn.1672-0482.2023.0645

[Abstract](437) [FullText HTML] (30) [PDF 4814KB](55)

Abstract:
OBJECTIVE To analyze the active components, key targets and mechanisms of astragalus-zedoary in the treatment of ovarian cancer (OC) by network pharmacology, liquid chromatography-mass spectrometry (LC-MS) and molecular docking. METHODS Through TCMSP, SWISS, Drugbank, DisGeNET and GeneCards database and literature research, combined with the representative component information of astragalus-zedoary decoction quantitatively analyzed by LC-MS, the active components of astragalus-zedoary were obtained and the main anti-OC targets were screened.With the Metascape database, the GO function enrichment and KEGG pathway analyses of the targets were carried out.AutoDock Vina was used for molecular docking on the core components and key targets of astragalus-zedoary and its binding activity. RESULTS By integrating network pharmacology and LC-MS technology, the core active component of astragalus-zedoary for OC treatment were mainly flavonoid in astragalus and curcumin in zedoary.PPI analysis found that its potential key targets are TP53, AKT1, VEGFA, MYC, EGFR, etc.The GO and KEGG enrichment analyses suggested the involvement of protein kinases that regulate signaling pathways, and signaling pathways such as MAPK and HIF-1.Molecular docking results showed that astragalus-zedoary had strong binding activity to the core components and key targets of OC. CONCLUSION The network pharmacology combined with LC-MS and molecular docking technology can rapidly analyze the potential active components of astragalus-zedoary, and preliminarily reveal the relationship between components, targets and pathways.

Analysis of Changes of Sophorae Flos before and after Processing Based on UPLC Fingerprint and Chromatic Value

HUANG Yao, CHEN Qiao-hua, FANG Chao-zuan, DENG Yi-fang, WANG Wen-li, HU Yi, ZHANG Zhi-peng

2023, 39(7): 657-668. doi: 10.14148/j.issn.1672-0482.2023.0657

[Abstract](104) [FullText HTML] (22) [PDF 3281KB](4)

Abstract:
OBJECTIVE To analyze the difference and dynamic change rules of UPLC fingerprint and chromatic value of Sophorae Flos before and after processing, and to provide reference for the identification and processing technology of Sophorae Flos, fried Sophorae Flos, and Sophorae Flos carbonisatus. METHODS The UPLC fingerprint of Sophorae Flos before and after processing was established, and chromatic value was determined by spectrophotometer.The differences of Sophorae Flos, fried Sophorae Flos, and Sophorae Flos carbonisatus were analyzed according to the similarity evaluation, one-way ANOVA, cluster analysis, principal component analysis, orthogonal partial least squares discriminant analysis (OPLS-DA), et al.The dynamic change rule of the fingerprint and chromatic value of Sophorae Flos at different processing time points were also analyzed. RESULTS There were obvious differences in fingerprints and chromatic value before and after processing.15 common peaks were calibrated for Sophorae Flos, 16 for fried Sophorae Flos, and 14 for Sophorae Flos carbonisatus.Peak 2, 3, 8, 9, 10, 11, 14, and 15 were identified as 5-HMF, protocatechuic acid, rutin, isoquercetin, kaempferol-3-O-rutinoside, narcissin, quercetin, and kaempferol, respectively.Peak 1 and peak 2(5-HMF) were the chemical components produced after processing and peak 17 was the component disappeared after processing.There was a significant change in the chromaticity value before and after the processing of Sophorae Flos.The chromaticity values L^*, b^*, E^* of Sophorae Flos carbonisatus were much lower than those of Sophorae Flos and fried Sophorae Flos.The chromaticity value a^* of fried Sophorae Flos was slightly higher than that of Sophorae Flos and Sophorae Flos carbonisatus.It was possible to distinguish samples of Sophorae Flos, fried Sophorae Flos, and Sophorae Flos carbonisatus by the chromaticity value.Cluster analysis and principal component analysis could distinguish Sophorae Flos, fried Sophorae Flos, and Sophorae Flos carbonisatus.The results of orthogonal partial least squares discriminant analysis show that rutin and quercetin were the important components causing the difference between Sophorae Flos and its processed products (VIP>1).Within 46 min of processing of Sophorae Flos, the ratio of peak area/scale sample size/1 000 of peak 1 to peak 16 increased first and then decreased, while peak 17 decreased continuously.Using the color of the slices as an evaluation indicator when the frying temperature was 160℃, the appropriate frying time for fried Sophorae Flos, Sophorae Flos carbonisatus should be 4-6 min and 14-18 min, respectively. CONCLUSION The established UPLC fingerprint and chromatic value determination method can provide reference for the identification and processing technology of Sophorae Flos, fried Sophorae Flos, and Sophorae Flos carbonisatus.

Clinical Study of Traditional Chinese Medicine Combined with Hormone Non-Tailing Therapy in the Treatment of Children with Refractory Nephrotic Syndrome

NI Jin-yu, ZHANG Meng-meng, REN Xiang-ge, ZHANG Qiu-yue, LI Bing, YANG Meng, ZHANG Jian, ZHAI Wen-sheng

2023, 39(7): 669-676. doi: 10.14148/j.issn.1672-0482.2023.0669

[Abstract](111) [FullText HTML] (18) [PDF 1081KB](8)

Abstract:
OBJECTIVE To evaluate the clinical efficacy of traditional Chinese medicine combined with hormone non-tailing therapy in the treatment of children with refractory nephrotic syndrome (RNS). METHODS A total of 122 children with RNS who were treated in the hospital from June 2019 to June 2022 were divided into an observation group and a control group according to the random number table method, with 60 cases in the observation group and 62 cases in the control group.The control group was given prednisone tablets combined with tacrolimus treatment, of which prednisone tablets were treated with tailing therapy.On the basis of the control group, the observation group was additionally treated with traditional Chinese medicine (sequential syndrome differentiation of Yiqi Huayu Qingre Decoction), among which the prednisone tablets were treated with non-tailing therapy.To compare the total cumulative amount of hormones, hormone side effects, total effective rate and recurrence rate after 52 weeks of treatment.The changes of 24 h urine protein quantification (24 h UTP), plasma albumin (ALB), and blood lipids[total cholesterol (TC) and triglyceride (TG)]before treatment and after 4 weeks, 12 weeks and 24 weeks of treatment were compared.The changes of liver and kidney function, i.e., alanine aminotransferase (ALT), aspartate aminotransferase (AST), blood urea nitrogen (BUN), and serum creatinine (SCr) before treatment and after 24 weeks of treatment were compared.Observe the changes in the scores of the Chinese medicine life quality evaluation scale in children with refractory nephropathy before treatment and after 24 weeks of treatment. RESULTS After 4 weeks, 12 weeks and 24 weeks of treatment, 24 h UTP, ALB, TC and TG in the two groups were improved compared with those before treatment, and the improvement in the observation group was more obvious (P < 0.05, P < 0.01).There was no significant change in ALT, AST, BUN and SCr in the two groups before and after 24 weeks of treatment (P>0.05).After 24 weeks of treatment, the scores of TCM syndromes in the two groups were significantly decreased (P < 0.05, P < 0.01), and the total scores of TCM quality of life scale were significantly increased (P < 0.01), and the observation group was better than the control group (P < 0.05, P < 0.01).After 52 weeks of treatment, the total cumulative amount of hormones in the observation group was lower than that in the control group (P < 0.01), and the side effects of hormones were less than those in the control group (P < 0.01).The total effective rate was higher than that of the control group (P < 0.05), and the recurrence rate was lower than that of the control group (P < 0.05). CONCLUSION Traditional Chinese medicine combined with hormone non-tailing therapy is effective in the treatment of children with RNS.It can increase plasma albumin, reduce the urine protein, and blood lipids, and improve the life quality of RNS children.

Clinical Study on Ginger Moxibustion Combined with Adalimumab to Improve Anxiety and Life Quality in Patients with Crohn's Disease at Mild and Moderate Active Stages

LI Ying, JIAO Ya-yun, MI Zi-shuo, PEI Li-xia, YU Xiao-yao, CHEN Hao

2023, 39(7): 677-682. doi: 10.14148/j.issn.1672-0482.2023.0677

[Abstract](193) [FullText HTML] (16) [PDF 1018KB](13)

Abstract:
OBJECTIVE To observe the effect of ginger moxibustion combined with Adalimumab on the mood and life quality of patients with anxiety and Crohn's disease at mild and moderate active stages. METHODS 60 patients with anxiety and Crohn's disease at mild and moderate active stages who met the inclusion criteria were selected and randomly divided into the treatment group and control group with 30 cases each.The control group was given a standardized treatment of Adalimumab, and the treatment group was treated with ginger moxibustion on the basis of the control group.The course of treatment was 12 weeks.Observe the changes in TCM syndrome score and clinical efficacy, anxiety relief response rate, Crohn's disease activity index (CDAI) score, Inflammatory bowel disease quality of life (IBDQ) score, and safety indicators of the two groups of patients before and after treatment. RESULTS After treatment, the TCM syndrome scores of both groups were significantly reduced (P < 0.05, P < 0.01), and the treatment group was superior to the control group (P < 0.05, P < 0.01);the clinical efficacy and anxiety relief response rate of the treatment group were better than those of the control group (P < 0.05);the IBDQ scores of both groups were significantly increased (P < 0.05, P < 0.01), and the treatment group was better than the control group (P < 0.05);the CDAI scores of both groups significantly decreased (P < 0.05, P < 0.01), and the treatment group was better than the control group (P < 0.05, P < 0.01). CONCLUSION Ginger moxibustion combined with Adalimumab can improve the anxiety and life quality of patients with Crohn's disease at mild and moderate active stages.

Research on the Historical Origin and Clinical Application of Zhishi Xiebai Guizhi Decoction

CHEN Zhi-qiang, ZHANG Yi-lin, CHEN Ren-shou

2023, 39(7): 683-692. doi: 10.14148/j.issn.1672-0482.2023.0683

[Abstract](229) [FullText HTML] (51) [PDF 1152KB](31)

Abstract:
Zhishi Xiebai Guizhi Decoction (ZXGD) is one of the first hundred classic prescriptions published by the National Administration of Traditional Chinese Medicine. A systematic review was conducted on the historical origin, development, understanding, and clinical application of this formula. ZXGD is scattered in the works of medical experts during the Jin and Tang dynasties, but there is a confusion in the name and composition of the prescription. From the Wei and Jin dynasties to the Tang and Song dynasties, the understanding and application of ZXGD mainly focused on discussing the two pathogens of wind and cold; during the Jin and Yuan dynasties, there was a breakthrough in the argument towards internal causes of chest pain; after the Ming and Qing dynasties, the understanding and application of this decoction were mostly based on the theory of qi inversion disorder. Since modern times, the application of ZXGD has expanded to 17 diseases, involving multiple systemic diseases such as the circulatory system, digestive system, and respiratory system diseases. The main treatment is angina in circulatory system diseases, followed by myocardial infarction and myocardial ischemia.

Research on the Interaction Between Autoimmune Diseases and Gut Microbiota and Regulation of Chinese Herbal Medicines

LIU Pan-ru, GUO Xi, TANG Yi-zhao, WANG Hai-dan, GUO Yun-ke, YIN Ai-ling, LI Yong-ming, ZHOU Wei

2023, 39(7): 693-700. doi: 10.14148/j.issn.1672-0482.2023.0693

[Abstract](848) [FullText HTML] (127) [PDF 1616KB](55)

Abstract:
Autoimmune diseases are characterized as the destruction of self-tolerance, abnormal activation of immune cells, production of autoantibodies and the release of large amounts of inflammatory factors, which in turn result in multisystem damage. The gut microbiota balance is closely related to the host health.Dysbiosis of gut microbiota has been identified in relation to many autoimmune diseases, including rheumatoid arthritis ulcerative colitis and autoimmune thyroiditis, etc. There has strong relationship between Chinese herbal medicine and its ability to alter the composition of the gut microbiota, and many studies has been proved that Chinese herbal medicine has therapeutic effect by reshaping the intestinal micro-ecological structure. In this review, we aim to investigate how gut microbiota affects the occurrence and development of autoimmune diseases, and to correlate the effects of Chinese herbal medicine on the regulation of gut microbiota with its effectiveness in disease prevention and treatment, with a view to providing a certain reference basis for the clinical application and pharmacological research of Chinese herbal medicine.

2023 Vol. 39, No. 7

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