1H NMR serum metabolomics and its endogenous network pharmacological analysis of gushudan on kidney-yang-deficiency-syndrome rats

The pharmacodynamics, ¹H NMR metabolomics and endogenous network pharmacology strategy approaches were integrated to investigate the preventive mechanism of Gushudan (GSD) on kidney-yang-deficiency-syndrome (KYDS) rats in this study. Firstly, the KYDS rat model was achieved by hydrocortisone induction, and the efficacy of GSD on KYDS model rats was assessed by the pharmacodynamic indicators. Next, the comprehensive untargeted serum metabolic profile of rats was obtained in ¹H NMR metabolomics study, 29 potential biomarkers closely associated with KYDS were identified, which were mainly involved in carbohydrate metabolism, amino acid metabolism and intestinal flora metabolism. In addition, the potential biomarkers-targets-pathways-disease metabolic network was further investigated for deeper understanding the preventive effects of GSD on KYDS rats and its mechanism, which was further obtained for the important targets related to biomarkers and diseases such as NOS3, PTGS2 and CXCL8, and important metabolic pathways such as glyoxylate and dicarboxylate metabolism, arginine and proline metabolism, and microbial metabolism in diverse environments. Finally, compared with our previous anti-osteoporosis study of GSD, it suggested that some similar metabolic pathways, which would provide some scientific reference of the existence of the kidney-bone axis under the traditional Chinese medicine (TCM) theory of "kidney dominates bone".

[Clinical study on depression differentiated as yang deficiency treated with the combined therapy of ginger-isolated moxibustion and western medicine]

OBJECTIVE

To compare the differences in the clinical efficacy on depression differentiated as yang deficiency between the combined therapy of ginger-isolated moxibustion and escitalopram and the simple application escitalopram.

METHODS

Eighty patients of depression differentiated as yang deficiency were randomized into an observation group and a control group, 40 cases in each one. In the control group, escitalopram was prescribed for oral administration, 10 mg a day, after each breakfast. In the observation group, on the basis of the treatment as the control group, the ginger-isolated moxibustion was supplemented at Dazhui (GV 14) and bilateral back-shu points of five zang organs[Xinshu (BL 15), Ganshu (BL 18), Pishu (BL 20), Feishu (BL 13) and Shenshu (BL 23)]. Moxibustion was used 5 times a week. Twenty times of moxibustion were taken as one session and totally 3 sessions were required (totally 84 days). After 3 sessions of treatment, the concentration of serum 5-hydroxytryptamine (5-HT) before and after treatment and clinical efficacy were observed in the two groups. After 3 sessions of treatment, escitalopram was taken continuously, 10 mg a day for 9 months in the two groups and the recurrent rate was observed in a half year after discontinuity of medication in the two groups.

RESULTS

The total effective rate was 97.5% (39/40) in the observation group and was 92.5% (37/40) in the control group. The total effective rate was similar between the two groups (both P>0.05). The curative and remarkably effective rate was 82.5% (33/40) in the observation group, better than 62.5% (25/40) in the control group (P<0.05). The serum 5-HT after treatment was increased as compared with that before treatment in the patients of the two groups (both P<0.05), but the diffe-rence was not significant statistically between the two groups (P>0.05). The recurrent rate of depression was 7.7% (3/39) in the observation group, lower than 27.0% (10/37) in the control group (P<0.05).

CONCLUSIONS

The combined therapy of ginger-isolated moxibustion and escitalopram achieves the better curative and remarkably effective rate as compared with the simple western medicine and it significantly reduces the recurrence of depression.

Mahuang-Xixin-Fuzi decoction reduces the infection of influenza A virus in Kidney-Yang deficiency syndrome mice

ETHNOPHARMACOLOGICAL RELEVANCE

Mahuang-Xixin-Fuzi Decoction (MXF) as a famous formula for the treatment of colds, fever, nasal congestion and headache with elder people, has always been widely used in traditional Chinese medicine. The present study is aimed at investigating the treatment effect of MXF on Kidney-Yang deficiency syndrome in mice simultaneously infected with H1N1 virus.

MATERIALS AND METHODS

We employed the Kidney-Yang deficiency mouse model to investigate the effect of MXF against influenza A virus (A/FM/1/47, H1N1). Mice were infected with the virus after fifteen days Kidney-Yang deficiency syndrome was established (intraperitoneal injection of estradiol benzoate), while MXF was orally administrated with 1.2-4.7g/kg/d for 6 consecutive days after inoculation. Body weight, rectal temperature, morbidity, and mortality were recorded daily. Histopathologic changes, antioxidant activity of SOD and MDA were detected. Moreover, levels of inflammatory cytokines including IL-6, IL-10, MCP-1, TNF-α were measured in the sera of mice.

RESULTS

We found that the extract of MXF at dosages of 2.3-4.7g/kg could effectively diminish mortality rate, ameliorate lung edema and inflammation. Administration of MXF decoction significantly depressed the expression of IL-6, MCP-1 and TNF-α, and markedly increased expression of IL-10 in serum. Simultaneously, the extract was also found to reduce MDA and increase SOD in the lung tissue of mice.

CONCLUSION

These data support the notion that the extract of MXF could treat Kidney-Yang deficiency syndrome in mice simultaneously infected with influenza A virus by reducing inflammation and increasing antioxidant activities.

[Study on Serum Metabolite Profiling in Pi-deficiency Rats Based on LC-MS Technique]

OBJECTIVE

To explore metabolite profiling changes in serum of rats with pi-qi deficiency syndrome (PQDS) and pi-yang deficiency syndrome (PYDS) based on liquid chromatograph-mass spectrometer (LC-MS) technique, and to explore the essence of Pi-deficiency syndrome (PDS) from small molecule metabolite level.

METHODS

Totally 21 male SD rats of SPF grade were randomly divided into three groups, the normal control group, the PQDS group, and the PYDS group, 7 in each group. Rats in the PQDS group overate for 1 day and fasted for 2 days. They drank freely and then swam to be exhausted in water at 35 degrees C - 37 degrees C for 15 successive days. The PYDS model was established by the same method for PQDS rats plus drenching 20% Folium sennae water extract (2 mL/100 g), once in the morning and once in the evening for one successive week. After modeling, models were evaluated according to rat general state, changes in body weight and rectal temperature. Serum metabonomic profiles were detected using LC-MS technique. Difference in inter-group metabolite spectrograms was analyzed using orthogonal partial least squares discriminant analysis (OPLS-DA). Potential biomarkers related to syndrome types in rat serum were selected via the parameter of variable importance in the projection (VIP).

RESULTS

The weight of rats in the PQDS group and the PYDS group decreased more significantly after modeling. The difference in prepost weight was statistically significant from that of the normal control group (P < 0.01). It was more obviously lowered in the PYDS group than in the PQDS group (P < 0.05). Compared with the normal control group, the rectal temperature of rats in the PYDS group and the PQDS group decreased (P < 0.05, P < 0.01). It decresed more in the PYDS group than in the PQDS group (P < 0.05, P < 0.01). Compared with the normal control group, levels of PC(19:0)/PE(22:0), PC(17:0)/PE(20:0), capric acid, oleic acid, stearic acid, succinic acid, fumaric acid, malic acid, glucose increased; arachidonic acid, linolenic acid, lauric acid, androsterone, 4-heptanone, dihydroxyacetonephosphate (DHAP) (6:0), and uridine decreased in the PYDS group and the PQDS group. Compared with the PQDS group, levels of PC(22:1), PC (22:6), PE (18:0)/PC (15:0), retinol, and deoxycytidine increased significantly in the PYDS group; PC (18:1), PC(19 :3), PC (20:3), PC (17:0)/PE (20:0), PC (19:1)/PE (22:1), PC (19:0)/PE (22:0), PC (17:1)/PE (20: 1), PC (16:1)/PE (19:1), cholic acid, hippuric acid, furoic acid, undecanedicarboxylic acid, palmitoleic acid, hydroxy stearic acid, eicosatrienoic acid, phenylalanine, tyrosine, glutamic acid, serine, carbamoyl aspartic acid, palmitoyl carnitine, tetradecanoyl carnitine, acetylcarnitine, and linoleylcarnitine decreased more significantly in the PYDS group.

CONCLUSIONS

Comparative contents of various serum metabolites changed significantly in PQDS and PYQS model groups. Some potential small molecular biomarkers related to PDS were preliminarily identified. These results might provide some data reference for exploring scientific connotation and pathological mechanisms of PDS.

[Regulatory mechanism of hormones of the pituitary-target gland axes in kidney-Yang deficiency based on a support vector machine model]

OBJECTIVE

To study the development mechanism of kidney-Yang deficiency through the establishment of support vector machine models of relevant hormones of the pituitary-target gland axes in rats with kidney-Yang deficiency syndrome.

METHODS

The kidney-Yang deficiency rat model was created by intramuscular injection of hydrocortisone, and contents of the hormones of the pituitary-thyroid axis: thyroid stimulating hormone (TSH), 3,3',5-triiodothyronine (T3) and thyroxine (T4); hormones of the pituitary-adrenal gland axis: adrenocorticotropic hormone (ACTH) and cortisol (CORT); and hormones of the pituitary-gonadal axis: luteinizing hormone (LH), follicle-stimulating hormone (FSH), and testosterone (T), were determined in the early, middle, and advanced stages. Ten support vector regression (SVR) models of the hormones were established to analyze the mutual relationships among the hormones of the three axes.

RESULTS

The feedback control action of the pituitary-adrenal axis began to lose efficacy from the middle stage of kidney-Yang deficiency. The contents all hormones of the three pituitary-target gland axes decreased in the advanced stage. Relative errors of the jackknife test of the SVR models all were less than 10%.

CONCLUSION

Imbalances in mutual regulation among the hormones of the pituitary-target gland axes, especially loss of effectiveness of the pituitary-adrenal axis, is one pathogenesis of kidney-Yang deficiency. The SVR model can accurately reflect the complicated non-linear relationships among pituitary-target gland axes in rats with of kidney-Yang deficiency.

[Effects of electroacupuncture with branch-foundation acupoint combination on the pituitary-target gland axis in aging rats with yang deficiency]

OBJECTIVE

To observe the effects of electroacupuncture (EA) with branch-foundation acupoint combination on the indices regarding pituitary-target gland axis in aging rats with yang deficiency, so as to explore its regulating mechanism on aging rats with yang deficiency.

METHODS

Forty healthy Sprague-Dawley female rats were randomly divided into a normal control group, a model group, an EA group and an EA control group, 10 rats in each group. Except the normal control group, the rats in the rest 3 groups were all treated with subcutaneous injection of D-galactose for 40 d, followed by intramuscular injection of hydrocortisone for 7 d to establish aging model with yang deficiency. After the successful establishment of model, the EA group was treated with EA at "Guanyuan" (CV 4), "Housanli" (ST 36) and "Baihui "(GV 20) while the EA control group was treated with EA at "Zhongji" (CV 3) "Yinlingquan" (SP 9) and "Yintang" (GV 29); the rats in the normal control group and model group were immobilized and fixed during the same time period. The treatments were given 6 times per week totally for 4 weeks. With radiation immunity analysis method, the 8 biological indices of pituitary-target gland axis, including thyroid-stimulating hormone (TSH), triiodothyronine (T3), tetraiodothyronine-4 (T4), adrenocorticotropic hormone (ACTH), corticosterone (CORT), estradiol (E2), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were detected to observe the changes of their content.

RESULTS

Compared with the normal control group, the serum level of TSH, T3, T4 and E2 were reduced in the model group (P<0.05, P< 0.01) while those of ACTH, CORT, FSH and LH were increased (P<0.05, P<0.01). Compared with the model group, the serum level of TSH, T3, T4 and E2 were increased in the EA group (P<0.05, P<0.01) while those of ACTH, CORT, FSH and LH were significantly reduced (P<0.05, P<0.01). Compared with the EA control group, the content of TSH was increased in the EA group without statistical significance (P>0.05), that of T3, T4 and E2 was increased (all P<0.05) and that of ACTH, CORT, FSH and LH was significantly reduced (all P<0.05).

CONCLUSION

The electroacupuncture with branch-foundation acupoint combination has benign regulating effects on the key hormones of pituitary-target gland axis, which could effectively improve the dysfunction of pituitary-target gland axis that is caused by aging with yang deficiency; the efficacy of electroacupuncture with branch-foundation acupoint combination is superior to that of adjacent control acupoint combination.

Spleen-yang-deficiency patients with polycystic ovary syndrome have higher levels of visfatin

OBJECTIVE

To study serum visfatin levels in women with polycystic ovary syndrome (PCOS) grouped by Traditional Chinese Medicine (TCM) patterns. To study the correlations of serum visfatin levels with homeostatic model assessment insulin resistance (HOMA-IR), fasting plasma glucose (FPG), fasting insulin (FINS), body mass index (BMI), testosterone (T), total cholesterol (TC), and triglycerides (TG).

METHODS

Two hundred and twelve PCOS patients were placed into the following TCM pattern subgroups: Kidney-Yang deficiency (KYD) group, Spleen-Yang deficiency (SYD) group, stagnant Liver-Qi transforming into heat (SLQTH) group, and Kidney-Yin deficiency (KYIND) group. The correlations between serum visfatin levels and HOMA-IR, FPG, FINS, BMI, T, TC, and TG were analyzed.

RESULTS

Of all patients with PCOS, there were 82 in the KYD group (38.6%), 67 in the SYD group (31.6%), 37 in the SLQTH group (17.5%), and 26 in the KYIND group (12.3%). Visfatin levels in all PCOS subgroups were higher than those in the control group (P < 0.01 or P < 0.05). Among these subgroups, the visfatin levels in the SYD group were significantly higher than those in the other three TCM pattern groups (P < 0.05). There were no statistical differences among the remaining three pattern groups. The levels of BMI, FINS, HOMA-IR, T, and TG were significantly higher in all subgroups than those in the control group (P < 0.05). There were no significant differences in FPG and TC between all PCOS subgroups and the control group (P > 0.05). The SYD group had higher levels of FINS and HOMA-IR compared with the KYD, SLQTH, and KYIND groups (P < 0.05). In all subgroups, after controlling for BMI, TG, TC, and age, visfatin was positively correlated with FINS (r = 0.197, P = 0.015) and HOMA-IR (r = 0.173, P = 0.033), and was not correlated with T.

CONCLUSION

KYD and SYD patterns are most common in PCOS patients. Increased visfatin is a common pathophysiologic manifestation in PCOS patients. The SYD group had the highest levels of visfatin, and visfatin was positively correlated with FINS and HOMA-IR.

[Treatment of ulcerative colitis with spleen and kidney yang deficiency by kuijiening plaster: a randomized controlled study]

OBJECTIVE

To explore the clinical efficacy of ulcerative colitis with spleen and kidney yang deficiency by kuijiening plaster and the impacts on IFN-gamma and IL-4 contents, as well as make the comparison with oral medication of sulfasalzine (SASP).

METHODS

Sixty patients of ulcerative colitis with spleen and kidney yang deficiency were randomized into a Kuijiening plaster group, a SASP group and a combined therapy group, 20 cases in each one. In the Kuijiening plaster group, Kuijiening plaster and oral administration of placebo SASP were applied. The plaster was used at Shangjuxu (ST 37), Tianshu (ST 25), Zusanli (ST 36), Mingmen (GV 4) and Guanyuan (CV 4). In the SASP group, was applied Kuijiening plaster placebo at the points and SASP oral administration was adopted. In the combined therapy group, Kuijiening plaster and SASP oral administration were given. The duration of treatment was 60 days. The follow-up visit was 2 months after treatment. The comprehensive efficacy, the efficacy on TCM syndrome and the changes in serum IFN-gamma and IL-4 before and after treatment were compared among the three groups.

RESULTS

The efficacy on TCM syndrome in the Kuijiening plaster was similar to the SASP group [85.0% (17/20) vs 75.0% (15/20), P > 0.05]. The efficacy on TCM syndrome in the Kuijiening plaster group was superior to the western medicine group [80.0% (16/20) vs 60.0% (12/20), P < 0.05]. The total effective rate of the comprehensive efficacy in the combined therapy group was 95.0% (19/20) and that of TCM syndrome efficacy was 90.0% (18/20), which were all superior to the other two groups (all P < 0.05). The differences in serum IFN-gamma and IL-4 were statistically significant before and after treatment in all of the three groups (all P < 0.05). The treatments in the three groups reduced serum IFN-gamma content and increased serum IL-4 content. The results in the Kuijiening plaster group were superior to the SASP group (P < 0.05) and the results in the combined therapy group were superior to the other two groups (all P < 0.05).

CONCLUSION

Kuijiening plaster is effective in the treatment of ulcerative colitis of spleen and kidney yang deficiency, which is not inferior to that of SASP. The efficacy of kuijiening plaster on relieving TCM syndrome and improving body immunity is much superior to SASP. The effect is much better with SASP combined in the treatment.

[Determination pharmacokinetics parameters of raw and different processed epimediums by pharmacology effect method]

OBJECTIVE

To determine the pharmacokinetics parameters of raw and different processed epimediums with pharmacology effect method.

METHODS

The kidney-yang deficiency model mice induced with hydrocortisone was used and oxidative stress level was taken as index to estimate main pharmacokinetics parameters of raw and different processed epimediums.

RESULTS

After raw and different processed epimediums po. in mice, the main pharmacokinetics parameters were: raw epimedium AUC(0-t) = 184.77 (g/kg) x h, AUC(0-infinity) = 342.30 (g/kg) x h, MRT(0-t) = 5.95 h, MRT (0-infinity) = 28.58 h,Tmax, = 0.75 h, Cmax = 57.67 g/kg; Fried epimedium AUC(0-t) = 208.08 (g/kg) x h, AUC(0-infinity) = 523.95 (g/kg) x h, MRT(0-t) = 5.86 h, MRT(0-infinity) = 22.55h, Tmax = 1 h, Cmax = 62.53 g/kg; Fat-fried epimedium AUC (0-t) = 232.17 (g/kg) x h, AUC(0-infinity) = 629.96 (g/kg) x h, MRT(0-t) = 5.28 h, MRT(0-infinity) = 19.62 h, Tmax = 1.5 h, Cmax = 81.84 g/kg.

CONCLUSION

The differences of Cmax and AUC between processed products and raw products are significant, and the sequence is as follows: fat-fried products > fried products > raw products.

[Effects of Wenshen Huatan Recipe on the renal function and foe blood lipids of patients with early-middle stage chronic renal insufficiency of Pi-Shen yang deficiency]

OBJECTIVE

To study the clinical effectiveness of Wenshen Huatan Recipe (WHR) in treating early-middle stage chronic renal insufficiency (CRI) of Pi-Shen yang deficiency syndrome (PSYDS).

METHODS

Ninety early-middle stage CRI patients of PSYDS were recruited and randomly assigned to the treated group (60 cases) and the control group (30 cases) in the ratio of 2:1. All patients received conventional and symptomatic treatment, but those in the treated group received WHR additionally. The observation was lasted for six months. The total efficacy, the Chinese medicine syndrome integral, and indices of the renal functions [including serum creatinine (SCr), blood urea nitrogen (BUN), creatinine clearance (CCr), serum cystatin C (Cys-C)], blood lipids [total cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), and low density lipoprotein cholesterol (LDL-C)], as well as adverse reactions were observed before and after treatment.

RESULTS

After six months of treatment, the total effective rate in treated group was 70.0% (42/60), which was obviously higher than that in the control group [43.3% (13/30), P < 0.05]. The Chinese medicine symptoms in the treated group were obviously improved, showing statistical difference between the two groups (P < 0.01). Better effects in lowering SCr, BUN, Cys-C, and LDL-C and increasing CCr were obtained in the treated group than in the control group (P < 0.05).

CONCLUSION

WHR could postpone the progression of CRI, improve the lipid metabolism, indicating certain therapeutic efficacy could be obtained in treating early-middle stage CRI from sputum theory.

[Basic pathogenesis of asthenia of healthy energy and blood stasis in liver cirrhosis studied by serum proteomics]

OBJECTIVE

To study the basic pathogenesis of "asthenia of healthy energy and blood stasis" in liver cirrhosis studied by Chinese syndromes and serum proteomics.

METHODS

The information of four methods of examinations and serum samples were collected from 44 cases of male cirrhotic patients and 17 cases of healthy male volunteers. The different syndrome groups were summarized according to syndrome differentiation and frequency analysis using the patient's information of four methods of examinations. The serum proteins were isolated by magnetic beads and detected by matrix-assisted laser desorption ionization time of flight mass spectrometry (MALDI-TOF-MS). The proteins expressed differently between cirrhotic patients of different syndrome types and healthy volunteers were analyzed by statistical analysis software (product of Bruker Corporation ClinProTools 2.1 software). The diagnosis model was established by QC algorithm.

RESULTS

The liver cirrhosis syndrome with the appearance frequency of more than 30% was sequenced from high to low as fatigue, listlessness, spider telangiectasia, liver palms, anorexia, bleeding from the nose, the gum or the subcutaneous tissue, the abdominal distention, shortness of breath while moving, dim facial complexion, pricking pain of the flank, weak waist and knees, dull pain in the flank, burning sensation of five centers, or low fever, hectic fever, and night sweat. The cases belonging to Child-Pugh A in the seventeen patients of the Pi-qi asthenia syndrome group accounted for 64.7%. The cases belonging to Child-Pugh C in the twelve patients of the Gan-Shen yin deficiency syndrome group accounted for 66.7%. The cases belonging to Child-Pugh A were similar to the cases belonging to Child-Pugh C in the fifteen patients of the blood stasis syndrome group, being more than 40%. Such syndromes as spider telangiectasia, liver palms, shortness of breath while moving, burning sensation of five centers, or low fever, hectic fever, and night sweat, varicose vein of the abdominal wall, and edema of lower extremities appeared more frequently in Child-Pugh C than in Child-Pugh A (all P < 0.05). The characteristic protein expression peak with mass-to-charge ratio of 4642.81, 4963.91, 5247.8, 5805.95, 6305.27, and 12447.7 in the Pi-qi asthenia syndrome diagnosis model were chosen. The former five peaks could be found in Child-Pugh A and Child-Pugh C. The protein expression peak with mass-to-charge ratio of 9 290. 3 was the characteristic protein expression peak in the Gan-Shen yin deficiency syndrome diagnosis model. The protein expression peak with mass-to-charge ratio of 9290.06 and 7 768. 29 were down-regulated in the Gan-Shen yin deficiency syndrome group compared with the other two syndromes groups. The protein expression peaks 9290.3 and 7768.29 were included in the diagnosis model of hepatitis B cirrhosis. They did not appear in Child-Pugh A, while they were gradually down-regulated in Child-Pugh B and Child-Pugh C. Of the other seventeen protein expression peaks in patients of the Gan-Shen yin deficiency syndrome, eight expressed in Child-Pugh A. The protein expression peaks 4964.55 and 5806.83 that expressed both in Child-Pugh A and Child-Pugh C constituted the characteristic protein peaks of the hepatitis B cirrhosis blood stasis diagnosis model. The diagnosis model of the Pi-qi asthenia syndrome was established with the sensitivity of 100% and the specificity of 82.35%. The diagnosis model of the Gan-Shen yin deficiency syndrome was established with the sensitivity of 100% and the specificity of 94.12%. The diagnosis model of the blood stasis syndrome was established with the sensitivity of 100% and the specificity of 100%.

CONCLUSIONS

Asthenia of healthy energy and blood stasis was the basic pathogenesis during the whole process of liver cirrhosis. Asthenia of healthy energy covers Pi-qi asthenia and Gan-Shen yin deficiency. Gan-Shen yin deficiency was obvious in the compensation stage of liver cirrhosis, but it has manifested in this stage. So early treatment was necessary.

[Expression of TNF-alpha signaling adapter proteins in peripheral blood mononuclear cells in lupus nephritis patients of different TCM asthenia syndromes]

OBJECTIVE

To investigate the mRNA expressions of the TNF adapter proteins, including TNF receptor-associated death domain protein (TRADD), Fas-associated death domain protein (FADD), receptor-interacting protein 1 (RIP-1) and TNF receptor-associated factor-2 (TRAF-2) in peripheral blood mononuclear cells (PBMCs) of lupus nephritis (LN) patients of various TCM asthenia syndromes. Methods Fifty-one inpatients with LN were differentiated according to TCM syndrome differentiation, 13 cases of yin-deficiency with inner heat syndrome (A); 26 cases of both qi-yin deficiency syndrome (B), 12 cases of Pi-Shen yang-deficiency syndrome (C). Peripheral venous blood samples from the 51 LN patients and 17 healthy subjects were collected to separate PBMCs. The mRNA expressions of TNF adapter molecules (TRADD, FADD, RIP-1 and TRAF-2), as well as Caspase-3 and interleukin-1beta (IL-1beta) were analyzed by quantitative real-time PCR and the differences among them were compared.

RESULTS

(1) As compared with the healthy subjects, expression of TRADD mRNA in patients of syndrome A, B and C was lowered to 0.54, 0.32, and 0.38-fold, respectively (P < 0.05, P < 0.01), showing insignificant difference among the three syndromes; (2) FADD mRNA lowered to 0.79, 0.62, and 0.72-fold respectively, only with significance shown in syndrome B (P < 0.05); (3) RIP-1 mRNA lowered to 0.79, 0.50, and 0.60-fold respectively with significance shown in syndrome B and C (P < 0.01, P < 0.05), and insignificant difference was shown among the three syndromes; (4) TRAF-2 lowered to 0.70, 0.52, and 0.50-fold respectively (P < 0.01, P < 0.01, P = 0.07), significance shown in syndrome B and C (P < 0.01), but with insignificant difference among the three; (5) Caspase-3 elevated in all patients of the three syndromes (all P < 0.01); (6) IL-1beta in syndrome A was apparently lower ed to the normal range and also lower than that in the other two syndromes (both P < 0.05).

CONCLUSIONS

Expressions of TRADD, FADD, RIP-1 and TRAF-2 mRNA decreased in all the patients of various TCM asthenia syndromes, the decrement in patients of syndrome B and C was lesser than that in syndrome A. These abnormal low expressions of signal proteins might be the substantial bases for asthenia syndromes of LN patients, and the apoptotic signal mediated by them may involve in the formation of asthenia syndrome in LN.

[Construction of the male rat model of adenine-induced infertility with kidney-yang deficiency]

OBJECTIVE

To investigate the time- and dose-related reproductive toxicity of adenine in male Wistar rats.

METHODS

Adenine was dissolved with Arabian sol at the proportion of 1:10 and different adenine solutions were prepared at the concentration of 0, 50, 100, 150 and 200 mg/ml. Seventy-five male Wistar rats were equally assigned to 5 dose groups and received intragastric administration of the adenine solution at 1 ml/(100 g x d). Five from each group were sacrificed every 10, 20 and 30 days, their sperm quality and body and genital weight measured, pathological examinations conducted, sex hormone changes detected by radioimmunoassay, and analyses made on the time- and dose-related reproductive toxicity of adenine.

RESULTS

With the increase in the time and dose of adenine administration, signs of kidney-yang deficiency gradually appeared in all the dose groups on the third day; and statistically significant changes were observed in sperm concentration and motility, and serum testosterone and luteinizing hormone levels in the 100 mg/(100 g x d) group (P < 0.05 or P < 0.01) by the 10th day. The same changes were observed in 50 mg/(100 g x d) group by the 20th day. Different degrees of pathological changes were noted in a time and dose-dependent manner in all the dose groups, suggestive of a progressive reduction of the reproductive function with the increase of time and dose of adenine administration.

CONCLUSION

For the construction of the male rat model of adenine-induced infertility with kidney-yang deficiency, the best dose is 50-100 mg/(100 g x d) and the best administration time is 10-20 consecutive days intragastrically.

[Establishment and analysis of serum two-dimensional gel electrophoresis profiles of myasthenia gravis patients with spleen and kidney deficiency syndrome]

OBJECTIVE

The purpose of this study was to establish two-dimensional gel electrophoresis (2-DE) profiles of serum of myasthenia gravis patients, and to identify the differential proteomic expressions between normal persons and myasthenia gravis patients with spleen and kidney deficiency syndrome.

METHODS

Samples of serum protein were extracted by repeated freeze-thaw method and separated by two-dimensional electrophoresis. Differential proteomic expressions between the myasthenia gravis patients and the normal control persons were identified by two-dimensional polyacrylamide gel electrophoresis, silver staining, image-master 2-DE software analysis, peptide mass fingerprinting based on matrix assisted laser desorption/ionization time of flight mass spectrometry (MALDI-TOF-MS), BioWorks and NCBI software database searching.

RESULTS

The two-dimensional polyacrylamide gel electrophoresis profiles of serum proteins were successfully established by 2-DE. Twenty-one of the significant differential proteins were selected and identified by MALDI-TOF-MS. Eight of them were finally identified.

CONCLUSIONS

The 2-DE profiles of serum proteins were established and the differential proteomic expressions were identified by proteome technique in our study. This can be an experimental basis for further research of the pathogenesis and treatment of myasthenia gravis.

[Effect of Tongguan capsule on post-intervention patients of coronary heart disease with qi-deficiency and blood stasis syndrome]

OBJECTIVE

To observe the effect of Tongguan Capsule (TGC), a Chinese herbal preparation for supplementing qi and activating blood circulation, in patients after percutaneous coronary intervention (PCI) with qi-deficiency and blood stasis syndrome.

METHODS

One hundred patients after successful PCI operation were assigned to two groups, 50 in each group. Western routine therapy with anti-thrombosis and anti-coagulant agents were applied in all patients before, during and after operation, while to the patients in the treated group, TGC was given additionally. The therapeutic course for both groups was one month. The efficacy was evaluated by observing the effect on angina pectoris, main TCM syndromes and scores of qi-deficiency syndrome and blood stasis syndrome at 3 time points (the day before, 3 days and 30 days after operation).

RESULTS

The total effective rate in relieving angina pectoris was 96.0% (48/50) in the treated group and 92.0% (46/50) in the control group, showing insignificant difference between them (P > 0.05). The score of qi-deficiency in both groups raised 3 days after PCI as compared with that before PCI, but showed no statistical significance (P > 0.05); 30 days after PCI, it increased in the control group, as compared with that before PCI (P < 0.05). The score of blood stasis syndrome significantly lowered at the 3rd and the 30th day after PCI in both groups as compared with before PCI, showing statistical significance (P < 0.05); while in comparing the value at the 3rd day with that at the 30th day, the difference showed significance in the treated group but not in the control group (P < 0.05); and comparison between the two groups at the 30th day showed it was much lower in the treated group (P < 0.05).

CONCLUSION

TGC could significantly improve the clinical symptoms of qi-deficiency and blood stasis syndrome in patients after PCI.

Correlation between syndromes of posthepatitic cirrhosis and biological parameters: a report of 355 cases

OBJECTIVE

To investigate the pathological factors of syndrome pathomechanism through studying the correlation between syndromes of posthepatitic cirrhosis and biological parameters.

METHODS

Clinical information of three hundred and fifty-five patients with posthepatitic cirrhosis was collected and the database was established. Parameters with statistical significance were analyzed with multi-factor regression analysis to investigate the main influencing factors of the syndromes of posthepatitic cirrhosis.

RESULTS

Formulae of six syndromes, including syndrome of yin deficiency of liver and kidney, syndrome of damp heat, syndrome of stagnated heat smoldering, syndrome of yang deficiency of spleen and kidney, syndrome of stagnation of liver qi and spleen deficiency and syndrome of blood stasis due to qi deficiency, were established with stepwise regression analysis.

CONCLUSIONS

One of the pathophysiological bases of syndrome of blood stasis due to qi deficiency in cirrhosis is synthetic dysfunction of hepatocytes. The pathophysiological basis of syndrome of damp heat is inflammatory injury, which is also syndrome of stagnated heat smoldering in cirrhosis patients. The relationship between syndrome of yin deficiency of liver and kidney and stasis and damp heat may be the pathophysiological basis of the posthepatitic cirrhosis..

[Recent pharmacological study on sanshengwan decoction]

OBJECTIVE

To investigate the pharmacological function of Sanshengwan decoction with modern medical and rheological techniques, and also to discuss the differences between injury blood stasis syndrome and yang deficiency blood stasis syndrome.

METHOD

Animal model for injury blood stasis syndrome was found by bruise; Animal model for yang deficiency blood stasis syndrome was done by exhausting the animals in a - 15 degrees C freezer for 4 hours.

RESULT

Blood fibrinogen content, platelet aggregation and blood coagulation time were significantly increased, plasma viscosity and blood coagulation slope was significantly decreased in injury blood stasis syndrome group. Blood fibrinogen content, platelet aggregation and blood coagulation time were dropped markedly. Blood coagulation slope was raised noticeably in yang deficiency blood stasis syndrome group. Sanshengwan decoction behaved very good effects on removing blood stasis on both of the two kinds of animal models.

CONCLUSION

Though hemorheological index and experimental data in the two kinds of animal models were behaved statistically significance, but the experimental representative indexes were obviously difference. Sanshengwan the tipical herbal medicine for eliminating blood stasis syndrome showed significantly effects on both of the two kinds of animal models, but the effects on injury blood stasis syndrome group was better than the other animal model's.

[Clinical efficacy and T-lymphocyte subset, serum interferon-gamma (IFN-gamma), tumor necrosis factor-alpha (TNF-alpha), interleukin-2(IL-2) levels on treatment of chronic aplastic anemia patients by shenfu injection combined with stanozol and cyclosporin A]

OBJECTIVE

To observe the effect of Shenfu injection (SFI) and influence on T-lymphocyte subset, serum level of interferon-gamma(IFN-gamma), tumor necrosis factor-alpha(TNF-alpha), interleukin-2(IL-2) in patients with chronic aplastic anemia (CAA) based on treating with stanozol and cyclosporin A.

METHOD

60 patients with CAA were randomly divided into two groups, 30 patients in the SFI group were treated with SFI (100 mL which contains Ginsenoside 0.8 mg x mL(-1) and aconitine 1.8 microg x mL(-1) by adding it in 500 mL of 5% glucose every day) plus stanozol and cyclosporin A and 30 patients in the control group treated with slanozol and cyclosporin A alone for 2 months. The clinical efficacy was observed. The change of T-lymphocyte subset analyzed by flow cytometry and the levels of serum IFN-gamma, TNF-alpha, IL-2 measured with ELISA method were also observed before and after treatment.

RESULT

After treatment, the total effective rate of the SFI group was higher than that in the control group, but it did not showing significant difference. The CD4/CD8 levels were significantly increased (1.76+/-0.49, P< 0.01) and CD8 levels were significantly lowered (22.57+/-6.30, P < 0.01) in the SFI group after treatment. Serum levels of lFN-gamma, TNF-alpha and IL-2 were lower in both groups, and the level of TNF-alpha and IL-2 in the SFI group (0.710+/-0.213) ng x L(-1) and (0.639+/-0.247) ng x L(-1) was significantly lowered than that in the control group (P < 0.05, P < 0.01).

CONCLUSION

SFI might believe the hemopoietic inhibition so as to promote the recovery of hemopoietic function through improving the T-lymphocyte subset and reducing the release of hemopoietic negative regulatory factors such as IFN-gamma, TNF-alpha and IL-2.

[Study on relationship between TCM Syndrome types (Xin-qi and Xin-yang deficiency) and contents of cytokines (tumor necrosis factor-alpha and interleukins) in patients with congestive heart failure]

OBJECTIVE

To explore the relationship between TCM Syndromes types, Xin-qi deficiency (XQD) and Xin-yang deficiency (XYD), and contents of cytokines, including tumor necrosis factor alpha (TNF-alpha), interleukin-6 (IL-6), IL-1beta and IL-10 in patients with congestive heart failure (CHF).

METHODS

Sixty-seven CHF in-patients with Xin-qi deficiency or Xin-yang deficiency syndrome were enrolled, their NYHA (New York Heart Association) cardiac function was assessed, ejection fraction (EF) and E peak/A peak (E/A) ratio were determined by Doppler ultrasonic echocardiograph, and serum TNF-alpha, II-6, IL-1beta and IL-10 were measured by double antibody sandwich ELISA assay.

RESULTS

The cardiac function grading in patients of XQD was mostly of I and II grade, while that in patients of XYD was mostly of III and IV grade (by Ridit analysis, P<0.01). The E/A and EF values were higher in patients of XQD than those in patients of XYD (P<0.01). Levels of TNF-alpha, IL-6 and IL-1beta were higher and IL-10 was lower in patients of XYD than those in patients of XQD (P<0.05 or P<0.01) respectively.

CONCLUSION

TNF-alpha, IL-6, IL-1beta and IL-10 probably play an important role in the development process of XQD to XYD, and could be taken as the microcosmic indexes for differentiation of the two syndromes.

[Relationship of plasma endotoxin level with TCM deficiency/excess syndrome and grading/staging of pathologic change of liver in patients with chronic hepatitis]

OBJECTIVE

To explore the relationship of plasma endotoxin level with TCM deficiency/excess Syndrome and the grading/staging of pathologic change of liver in patients with chronic hepatitis B (CHB).

METHODS

Plasma level of endotoxin (ET) was determined using chromogenic limulus amebocyte lysate (LAL) assay in 75 patients with chronic hepatitis B (30 of excess dominance, 45 of deficiency dominance) and also in 15 healthy subjects for control. Moreover, pathological examination on liver biopsy of 20 patients was conducted.

RESULTS

(1) ET level increased in all CHB patients, and the increment was higher in patients of excess dominance than that in patients of deficiency dominance, showing significant difference (P < 0.01). (2) Correlation between ET level and liver pathological grading/staging was shown in CHB patients.

CONCLUSION

Plasma level of ET could be taken as one of the criteria of TCM microcosmic diagnosis in differentiating deficiency/excess syndrome. (2) Endotoxemia plays an important role in pathologic process of liver injury.

[Effect of fuzheng jianpi recipe on content of trace element and immune function in children with spleen deficiency anorexia]

OBJECTIVE

To evaluate the efficacy and prospect of Fuzheng Jianpi Recipe (FZJPR) in treating children's Spleen deficiency anorexia (CSDA) by means of observing its effect on trace element content and immune function.

METHODS

One hundred and thirty cases of CSDA were treated with FZJPR, one dose per day in decoction, orally taken, 30 days for one therapeutic course. Levels of T-lymphocyte subsets, IL-2R, immunoglobulin and trace elements were determined before and after treatment, and compared with those in the control group consisted of 60 healthy children.

RESULTS

In the treated group, abnormal figures were shown in T-lymphocyte subsets, especially in lowering of CD3 and CD4 count before treatment, and IgG content was reduced also. After treatment, CD3, CD4, CD4/CD8 ratio as well as IgG and IgA were improved significantly (P < 0.01), IL-2R percentage approached normal. Moreover, the levels of Zn and Fe changed significantly (P < 0.01).

CONCLUSION

FZJPR could improve the trace elements content and immune function in CSDA children, so it is effective in treating CSDA.

[Exploration on essence of spleen-kidney deficiency in middle-aged patients]

OBJECTIVE

To explore the essence of Spleen-Kidney Deficiency in middle-aged patients.

METHODS

Investigation was carried out in 773 cases of 50-69 years old to assay 34 parameters in them, including blood lipid, oxidation and anti-oxidation related substance, sex hormone, liver and renal function, immune function, blood routine, blood pressure and lung vital capacity, etc.

RESULTS

Spleen Deficiency Syndrome is closely related with lipid metabolism disorder; Kidney-Qi Deficiency Syndrome is closely related with hypoimmune function; Kidney-Yin Deficiency Syndrome is closely related with lipid metabolism disorder and hypertension, and Kidney Yang Deficiency is closely related with weakness of anti-oxidation capacity, hypoimmunity, the internal environment disorder of sex hormone and aging, manifested as multiple functions abating.

CONCLUSION

Spleen Deficiency, Kidney-Qi Deficiency and Kidney Yang Deficiency are different layers of a gradually developed and aggravated pathological process, but Kidney-Yin Deficiency could not be listed into this layer.

[Clinical study on relationship of CD62p, CD63 and TSP to the qi-stagnation induced blood-stasis syndrome and qi-deficiency induced blood-stasis syndrome in aged patients]

OBJECTIVE

To observe the relationship of platelet activation to the Qi-stagnation induced blood-stasis (QSBS) or Qi-deficiency induced blood-stasis (QDBS) syndrome.

METHODS

Expressions of platelet activating molecules, including alpha-granule membrane glycoprotein (CD62p), lysosomal integral membrane protein (CD63) and thrombospondin (TSP), in patients with QSBS and QDBS were determined quantitatively with flow-cytometry and specific monoclonal antibody against activated platelet. And platelet aggregation was tested simultaneously.

RESULTS

CD62p, CD63 and TSP expressions in Blood-Stasis patients, both QSBS and QDBS, were higher than those in the normal control significantly (all P < 0.01); all the three expressions were higher in QSBS group than those in QDBS group (all P < 0.01), Positive correlation was shown between CD62p and CD63 (r = 0.740, P < 0.01), CD62p and TSP (r = 0.744, P < 0.01), TSP and CD63 (r = 0.635, P < 0.01), and between CD62p and ADP induced platelet aggregation (r = 0.715, P < 0.01).

CONCLUSION

Platelet activation was involved in the pathogenesis and development of Blood-Stasis Syndrome, especially closely related with the QSBS Syndrome.

[Qi deficiency and blood stasis and circulatory renin-angiotensin system as well as plasminogen activator inhibitor activity in rats with cardiac qi deficiency syndrome]

OBJECTIVE

To explore the relationship between cardiac Qi deficiency Syndrome and effect of circulatory renin-angiotensin system (RAS) and endogenous fibrinolytic system in rats with heart failure (HF).

METHODS

Plasma RAS levels and plasminogen activator inhibitor (PAI-1) activity were measured in 2 groups of rats: the sham-operated group (Group A) and the HF with Heart Qi deficiency Syndrome model group (Group B) established by making arteriovenous fistula. Using radioimmunoassay and chromatography, plasma renin activity (PRA) and angiotensin II (Ang II) levels and PAI-I activity were determined before, immediately after and 30 days after the surgical operation respectively.

RESULTS

After the operation was completed in Group B the left ventricular dysfunction revealed, left ventricular systolic pressure decreased and end diastolic pressure increased (P < 0.05), PRA and Ang II level and PAI-1 activity increased significantly, as compared with those in Group A and before modeling (P < 0.05). With cardiac function improved, the plasma PRA, Ang II level and PAI-1 activity lowered in Group B comparing with those immediately after modeling (P < 0.05).

CONCLUSION

The activation of RAS is associated with the endogenous fibrinolyticim balance, and play an important role in endogenous fibrinolytic system dysfunction in HF with Heart Qi deficiency Syndrome and Qi deficiency-blood stasis, which was helpful to explain that cause of hypercoagulant state in HF patients and increase the risk of suffering from embolism-thrombotic diseases, and might be the pathogenetic basis of Heart Qi deficiency induced Qi deficiency-blood stasis.

[Effect of yimai jiangya extract on plasma neuropeptide Y level in patients of senile hypertension with qi-deficiency and blood stasis syndrome]

OBJECTIVE

To observe the effect of Yimai Jiangya extract (YMJYE) on plasma neuropeptide Y (NPY) level in patients of senile hypertension at stage II with Qi-Deficiency and blood stasis Syndrome (QDBSS).

METHODS

Sixty-eight patients were randomly divided into two groups, 36 patients in the treated group treated with YMJYE and 32 patients in the control group treated with captopine. Radioimmunoassay was used to examine the level of plasma NPY before and after treatment in the two groups.

RESULTS

Before treatment, plasma NPY level was significantly higher in both groups than that in the old healthy persons (P < 0.01), it lowered significantly after treatment and the decrement was more obvious in the treated group in comparing with that in the control group (P < 0.01). Blood pressure was significantly lowered in both groups after treatment (P < 0.01) but with no significant difference between them.

CONCLUSION

Plasma NPY level was increased in patients of senile hypertension with QDBSS. YMJYE had good effect in lowering plasma NPY level and reducing blood pressure. It is presumed that the NPY lowering effect of YMJYE might be one of its mechanisms in lowering blood pressure.

[Effects of Chinese herbs xianzhen tablet on the deformability of erythrocyte in non-insulin-dependent diabetes mellitus patients with deficiency of both qi and yin and deficiency of kidney with blood stasis]

OBJECTIVE

To explore the effects of Xianzhen Tablet (XZT) on the hemorheology of type 2 diabetes (NIDDM) on the basis of previous studies in XZT, that have indicated its ability to deplete fasting blood glucose, to reduce the injury of free radical to the body, to improve the Na(+)-K(+)-ATPase in the erythrocyte membrane of NIDDM.

METHODS

Erythrocyte deformability and aggregation were studied with Ektacytometer in a total of 60 type 2 diabetes who were randomly divided into two groups. One was ZXT treated group, another was placebo group.

RESULTS

(1) The erythrocyte deformability of type 2 diabetes was lower than that in normal subjects (P < 0.001), but the erythrocyte aggregation increased abnormally than that of health people (P < 0.001). The correlation test indicated there were negative correlation with plasma fibronogen and positive correlation with blood cholesterol (P < 0.05). (2) The erythrocyte deformability in the ZXT treated group with 30 patients improved after 8 weeks treatment (P < 0.01), with the decreased fasting blood glucose and plasma fibrinogen (P < 0.05). Compared with placebo group, there was significant statistical difference (P < 0.01).

CONCLUSIONS

XZT could improve the erythrocyte deformability in the type 2 diabetes.

[Effects of coumarins from cnidium monnieri on the function of pituitary-adrenocortical axis in kidney yang deficiency rats]

OBJECTIVE

To observe the effect of Cnidium monnieri in Kidney Yang Deficiency rats.

METHODS

Rats were injected intraperitoneally with hydrocortisone acetate to replicate the animal model of Kidney Yang Deficiency. Osthol, total-coumarins (TCR) from the fruit of Cnidium monnieri and positive control drug (PCD) were administered orally to model rats. The plasma levels of corticosterone (B), adrenocorticotropic hormone (ACTH), renin (PRA), angiotensin-II (AT-II) and aldosterone (ALD) were determined by radioimmunoassay.

RESULTS

Compared with those in normal rats, the levels of B and ACTH in the plasma of model rats lowered significantly (P < 0.01), the levels of B and ACTH of treatment groups were higher than those of model group, while the levels of PRA, AT-II and ALD had no significant difference (P > 0.05).

CONCLUSION

The osthol, TCR have the effects in protecting and strengthening the function of pituitary-adrenocortex axis.

[Effect of osthol and total coumarins of fructus cnidii on thyroid hormone and thyrotropic hormone in kidney-yang deficiency rats]

Osthol and total coumarins of Fructus Cnidii were given to the model of Kidney-Yang Deficiency rats induced by hydrocortison acetate injection, the changes of serum concentration of thyroxine T3, reverse T3 (rT3), T4 and thyroid stimulating hormone (TSH) were observed. Results showed that in comparison with normal rats, all of the criteria mentioned above were lowered significantly (P < 0.01) in model rats. After treatment, the criteria observed were all increased significantly (P < 0.01 or P < 0.05). It was suggested that the osthol and total coumarins of Fructus Cnidii could elevate the pituitary-thyroid axis function of Kidney-Yang Deficiency rats.

[Study on relation of kidney-deficiency with hearing damage and serum trace elements in patients with chronic nephropathy]

The hearing and serum trace element of 73 cases of chronic nephropathy were measured. Results showed that the incidence of hearing damage in high frequency was 68.5% with a mean hypoacusis of 35.1 +/- 6.1 dB, while in 55 patients of Kidney Deficiency type, the incidence of hearing damage in high frequency was 83.6%, it was significantly higher than that in patients without Kidney Deficiency. The serum levels of trace elements (iron and zinc) in patients with Kidney Deficiency were lower than that of normal level and in patients without Kidney Deficiency, and the decrease of serum iron was directly proportional to the degree of hearing damage. There were close relationship between the Kidney Deficiency with the hearing damage as well as the serum levels of iron and zinc.

[Diphasic regulatory effect of lishen injection on sex hormones in senile female patients with coronary heart disease of kidney deficiency type]

Effects of Lishen injection on serum estradiol (E2), testosterone (T) and the E2/T ratio in 30 cases of postmenopausal patients with coronary heart disease and of Kidney Deficiency type were observed. Results showed that: (1) Serum E2 and the E2/T ratio were lower (P < 0.01) in the group of Kidney-Yin Deficiency type and higher (P < 0.01) in the group of Kidney-Yang Deficiency type as compared with normal control. (2) After treatment with Lishen injection the levels of serum E2 and the E2/T ratio were elevated in the former (P < 0.01) and lowered in the later (P < 0.01). Both were approaching to normal level (P > 0.05). (3) The levels of T in both groups were unaffected (P > 0.05) before and after treatment. These results suggested the imbalance of Kidney-Yin and Kidney-Yang is related to the disturbance of sex hormones and Lishen injection could not only regulate the Kidney-Yin and Kidney-Yang, improve the symptoms of Kidney Deficiency, but also could convert the abnormal change of sex hormone, it has a good diphasic regulatory effect on E2, and is beneficial on balance of sex hormones of both sex in the inner environment of human body.

[Clinical and experimental study on inhibitory effect of sanhuang mixture on platelet aggregation]

Sanhuang mixture (Xinmai capsule) is composed of Astragalus membranaceus, Coptis chinensis and Scutellaria baicalensis. It could inhibit platelet aggregation (PAG) induced by ADP in rats or by ADP and ADR in vivo. Patients with high PAG took Xinmai capsule for 4 weeks, the effective rate was 88.7%, which was same as the efficacy of aspirin 50 mg/day. In Syndrome Differentiation of TCM, the effective rate was the highest (92.3%) in the Syndrome of Qi Deficiency-Blood Stasis, and the lowest (72.7%) in the Syndrome of Stasis Phlegm and combined together.

[Effects of Sichuan herba Epimedii on the concentration of plasma middle molecular substances and sulfhydryl group of "yang-deficiency" model animal]

The effects of tonifying the kidney and strengthening the "Yang" produced by the extracts of Chinese herbs Epimedium wushanense and E. pubescens were studied in this paper. The results showed that both two herbs could decrease the concentration of plasma middle molecular substances and increase the concentration of plasma sulfhydryl group of "Yang-deficiency" model mice, thus suggesting that the above-said tonifying and strengthening effects of Herba Epimedii may result from its effects on middle molecular substances and sulfhydryl group, so as to strengthen the body resistance and eliminate the invading pathogenic factors.

[Preliminary study on pathophysiology of liver-qi deficiency syndrome]

The authors advocate a program for diagnosing Liver-Qi Deficiency Syndrome (LQDS) based on the TCM theory and clinical practice. Through investigation, LQDS was found to be widely existed as latent period or as external manifestation, which occupied 18.85% in Qi Deficiency Syndrome. The subjects were divided into four groups including normal group, Spleen-Qi Deficiency Syndrome (SQDS) group, LQDS with Liver diseases (LD) and LQDS with non-Liver diseases (NLD) group. In order to explore the essence, the simultaneous determinations were done on lactate dehydrogenase (LDH) and its isoenzyme, dopamine beta-hydroxylase (D beta H), trace element Zn and Cu, and other serological indexes such as GPT, TP, Alb, A/G, etc. The results were, the content of LDH and trace element Zn in both LQDS-NLD and SQDS were significantly lower than that of normal group. D beta H reflecting sympathetic nerve function in LQDS-NLD was significantly higher than that of both normal and SQDS group; comparing LQDS-LD and LQDS-NLD group, the content of GPT, LDH, LDH5 and trace element Cu in former was significantly higher than that of the latter, but the content of TP, Alb, A/G, D beta H and Zn in former was remarkably lower than that of the latter. In order to avoid confusion, in studying this syndrome, one should distinguish LD and NLD.

[The effect of Baji Zibugao on the serum levels of endocrines in thyroidectomized (yang deficiency) rabbits]

In order to study the effect of Baji Zibugao (BJZBG, a medicinal plaster mainly consisting of Radix Morindae Officinalis) on the endocrine functions of hypothyroid rabbits, we determined the serum levels of thyroxine (T4), triiodothyronine (T3), cAMP, cGMP and corticosterone in three groups of rabbits: total thyroidectomized and untreated (group I), total thyroidectomized and treated with BJZBG (group II) and controls (group III). The results showed: (1) The serum level of T4 in group I and II after operation was significantly lower than that before operation (P < 0.005), and the serum level of T3 in group I was also lower than that before operation (P < 0.02), but the change of T3 in group II after operation was not significant (P > 0.05); (2) The serum cAMP level in group I after operation decreased and the cGMP level increased (P < 0.025), but the changes of cAMP and cGMP level in group II after operation were not significant (P > 0.05), (3) The change of serum corticosterone level in group I or II after operation was not remarkable (P > 0.05).

[Changes in serum free amino acid level in patients with spleen deficiency syndrome]

Eighteen kinds of serum free amino acid (SFAA) were measured in 32 patients with Spleen-Deficiency (SD) Syndrome. Several obvious changes were noticed as compared with 20 healthy adults: (1) The levels of total FAA, essential amino acids and free branched-chain amino acids of SD group were significantly lower than that of the control group (P < 0.01); (2) Total FAA, essential amino acids and branched-chain amino acids were all positively correlated to D-xylose absorptivity, serum protein and immune function. The above results suggested that the decrease of various SFAA level might be related to malabsorption in patients with SD. It is possible that the decrease of serum protein and immune function was due to the lowering of SFAA.

[Relationship between syndrome differentiation and blood total fibrinolytic activity, superoxide dismutase and albumin in nephrosis syndrome]

Relationship between the Syndrome Differentiation and total fibrinolytic activity (TFA), superoxide dismutase (SOD), serum albumin (Alb) was observed in 118 pediatric patients with nephrosis syndrome. The results suggested that there was significant difference between Damp-Heat type and Spleen Deficiency type in terms of blood TFA, SOD and serum Alb. Very significant positive correlation was found between serum Alb and TFA, P < 0.01. The level of TFA in pediatric patients with edema was significantly lower than that in normal children, the more the degree of edema, the more the level of TFA activity. It was shown that there would be possibility to find intrinsic connection between Syndrome Differentiation and laboratory findings.

[Comparison on the kidney nourishing and yang strengthening functions of three different species of herba Cistanches]

Oral administration of water extraction of three kinds of herba cistanches can increase the weight of young mice, prolong the duration of swimming and promote anoxia tolerance in mice. These water decoctions can also increase the body weight, the activities of SOD in serum and the lifespan of "Yang insufficient" model mice induced by administration of hydrocortisone acetate.

[Pharmacokinetic characteristics of tetramethylpyrazine and study on hemorheology in rat model of spleen deficiency syndrome]

In this experiment, the essence of Spleen Deficiency Syndrome (SDS) was explored with the rat model of SDS using tetramethylpyrazine (TMP). 120 Wistar rats were divided into two groups, 60 each for control and test group, they were treated with normal saline and reserpine respectively. The hemorheological parameters were also studied in 6 each of both groups. The pharmacokinetic properties were investigated in the remaining control group and test group.

RESULTS

(1) Two-compartment open model of the control group was turned into that of one-compartment in test group; (2) The SDS model significantly affected the absorption and distribution of TMP in rats. AUC was much higher and serum concentration of TMP increased significantly than that of control. Hemorheological parameters (viscosity of whole blood, fibrinogen, etc.) increased significantly (P < 0.05-0.01), it demonstrated that the SDS model was in a state of Blood Stasis. It might be one of the pharmacokinetic mechanisms of TMP in the SDS model of rats.

[Relation between traditional Chinese medicinal syndrome differentiation and blood platelet function in 310 cases of blood stasis]

310 patients (153 male, 157 female) of Blood Stasis were divided into various groups by Syndrome Differentiation of TCM and 35 healthy subjects were taken as control. The relationship of TCM Syndrome and function of blood platelet were studied with blood platelet counting, its volume, adherence and aggregation, plasma thromboxane B2 (TXB2) and 6-keto-prostaglandin F1 alpha(6k-PGF1 alpha) as indices of observation. The results were: (1) Blood platelet aggregation of Blood Stasis patients was higher than that in control (P > 0.001). (2) There were some differences of platelet aggregation among different TCM Syndromes. Platelet aggregation of Blood Stasis patients with Qi Deficiency was higher than that with other Syndromes significantly, and the aggregating rate in those patients was higher than that in control (P < 0.05). (3) The platelet aggregation and TXB2 of patient with Heart Qi Deficiency were significantly higher than those of the control (P < 0.05, P < 0.001), and they were also higher than of other groups of blood stasis patient with Spleen, Lung or Kidney Qi Deficiency.

[Changes in serum zinc level of periodontitis with kidney deficiency]

The study is to explore the possible relationship between the level of trace element zinc in serum and periodontitis with Kidney deficiency. The level of serum zinc in 40 cases of periodontitis and in 19 normal controls was examined by atomic absorption spectrum analysis. The results indicated that there was only a descending trend of serum zinc in periodontitis group as compared with normal group. But further analysis revealed that according to the severity of periodontitis and the theory of Syndrome differentiation in TCM, it showed that the drop of serum zinc had not only a negative correlation with the severity of periodontitis, but also was co-related to whether there was Kidney deficiency or not. Serum zinc of periodontitis with Kidney Deficiency group was significantly lower than that of normal control group as well as the group of periodontitis without Kidney deficiency (P < 0.05). The data suggested that the decline of serum zinc level is closely related to the occurring and development of periodontitis with Kidney Deficiency.

[Effects of total coumarins, essential oil and water extracts of Cnidium monnieri on plasma prostaglandin and cyclic nucleotide in the rats of kidney-yang insufficiency]

Effects of total coumarins, essential oil and water extracts of Cnidium monnieri on plasma prostaglandin (PGE2 and PGF2 alpha) and cyclic nucleotide levels in rats of Kidney-Yang insufficiency were studied. 55 rats were divided randomly into 5 groups, Group I was administered orally with saline (normal group), group II was injected with intraperitonally hydrocortison acetate to induce Kidney-Yang insufficiency (control group), group III, group IV and group V (experimental groups) were injected with hydrocortison acetate, the same as group II, and administered orally with the total coumarins, essential oil and water extracts of Fructus Cnidii respectively. The levels of plasma PGE2, PG2 alpha and plasma cAMP, cGMP were measured. In group II, in comparing with those of group I, the levels of plasma PGE2, and PGF2 alpha decreased significantly (P < 0.01), and the value of cAMP/cGMP also lowered obviously (P < 0.01) due to the significant reduction of cAMP and insignificant change of cGMP. In group III and group V, the above-mentioned indices changed significantly (P < 0.01 or 0.05) compared with those of group II, and after treatment it normalized basically in comparing with those of group I. In group IV, those indices didn't change regularly and apparently as group III and group V did, compared with group II, and could not normalize satisfactorily. It is suggested that the coumarins in the fruit of Cnidium monnieri are probably the effective ingredients to invigorate Kidney and strengthen Yang, while the efficacy of essential oil remained unconfirmed.

[Clinical study in treating qi-deficiency and blood-stasis syndrome of angina pectoris with qi xue granule]

55 cases of Qi-deficiency and Blood-Stasis syndrome of coronary heart disease (CHD) and angina pectoris (AP) were divided randomly into two groups. Qi Xue granule (QXG) was administered to 30 cases of treated group, while compound Salvia tablet (CST) was administered to 25 cases of control group. Besides, both group were also given one placebo tablet or granule so as to eliminate the patient's psychological effects.

RESULTS

(1) Effects on clinical symptoms: Total effective rate for AP: 90% in QXG group, marked effective rate and effective rate for ischemic ECG changes were 30% and 46.6% respectively. All of these were better than that of CST group significantly (P < 0.05). Besides, QXG group could alleviate symptoms including asthenia. (2) Effects on submaximal paddle work load test: QXG group could prolong the capacity of exercise (from 336.2 +/- 34.7 to 437.5 +/- 43.8 seconds, P < 0.05), magnify the work load (from 73 +/- 7.18 to 94 +/- 8.5 W, P < 0.05) and elevate the ST segment (from 0.218 +/- 0.03 to 0.176 +/- 0.03 mV) significantly in comparison with CST group, which had little change only. (3) Effects on plasma TXB2, 6-keto-PGF1 alpha (6 Kp) level and ration of TXB2/6Kp in 10 normal subjects were 165 +/- 12.1 pg/ml, 142.6 +/- 17.4 pg/ml and 1.16 +/- 0.19 pg/ml respectively, while in 36 cases AP were 390.6 +/- 14.3, 106.0 +/- 7.9 and 3.67 +/- 0.85 pg/ml respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

[Correlation analysis between plasma atrial natriuretic peptide and cardiac function in blood deficiency syndrome]

The function of ANP in the cardiovascular regulation is very similar with the TCM theory of "the Heart governs blood circulation". Using the method of cardiac impedance to check cardiac output and the method of radioimmunoassay (RIA) to check plasma ANP, the result showed that in the status of Blood Deficiency Syndrome, cardiac function was impaired, there were reduced kinemia and stroke volume, as well as markedly raised plasma ANP and peripheral resistance. The above-mentioned indexes were significantly different from those of normal group (P < 0.01). Using multivariate regression analysis, cardiac output was negatively correlated with the plasma ANP (P < 0.05). 23 cases with Blood Deficiency Syndrome showed normal hemoglobin, but an evidently changed cardiac output and plasma ANP were closely related with the level of the Blood Deficiency. Both parameters might serve as the objective basis to reflect the level of Blood Deficiency to facilitate the clinical diagnosis of the patient.

[Determination of blood hormone levels in patients with "spleen deficiency" syndrome after major operations]

The character of "Spleen Deficiency" (SD) Syndrome was evaluated by determination of the blood levels of various gastroenteropancreatic hormones and thyroid hormone. Patients of SD group were diagnosed clinically by Syndrome Differentiation, and those of the normal group were volunteer blood donors. RIA was used to determine all the hormones except T3RUR.

RESULTS

TT3, FT3 of the SD group were very significantly lower than that of normal group (P less than 0.001). The levels of rT3 in SD group were significantly higher than normal control (P less than 0.05). For TT4, T3RUR and FT4, there were no significant differences between the two groups. Among the gastroenteropancreatic hormones, gastrin in the SD group was significantly lower than that of the normal group (P less than 0.01), motilin was very significantly higher (P less than 0.002). The value of pp was similar in the two groups, under physiological conditions, however, in adults the hormone tended to increase with age. Since the average age of patients in the SD group was 54.9, and that of the normal group was 38.5, remarkably lower values were seen in the SD group. Other hormones such as VIP, SST, glucagon and insulin were of no significant difference between the two groups. The result showed that thyroid hormone and some of gastroenteric hormones in the blood of patients with SD after major operations were quite different from normal, and was common to patients with general SD Syndrome, with low T3 syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)

[Plasma cortisol concentration and blood leukocyte content of glucocorticoid receptors in patients with deficiency-cold vs deficiency-heat syndromes]

Plasma cortisol concentration and blood leukocyte content of glucocorticoid receptors (GCR) were assayed in 20 patients with deficiency syndromes, 10 cold in property (deficiency-cold), the other 10 hot in property (deficiency-heat), and also in 10 healthy individuals as normal control for the purpose of investigating the nature of cold and heat syndromes. As a result, the cases of deficiency-cold syndrome (DCS) had a normal concentration of plasma cortisol but a lowered content of GCR in leukocytes when compared with the normal control (P less than 0.05); the cases of deficiency-heat syndrome (DHS) had a higher concentration of plasma cortisol than the normal control (P less than 0.05) and a slightly higher content of GCR in leukocytes. It was concluded that the DCS is characterized by diminished biological effects of adrenocortical activity, while the DHS, by augmented biological effects of adrenocortical activity.

[Changes in superoxide dismutases and serum Zn, Cu in senile patients with yang deficiency]

This article reports on the respective determinations, which employ RIA and AAS, of superoxide dismutases (SOD-I) and serum Zn, Cu from 40 cases of senile patients with Yang deficiency. The results, which 994 +/- 125 ng/mg Hb, 63.6 +/- 12.1 micrograms%, 72.6 +/- 10.7 micrograms% respectively, were all significantly lower than the normal subjects and senile subjects (P less than 0.01), and showed that serum Zn was positively interrelated with SOD-I (r = 0.34). Integrating SOD-I and the function of serum Zn, Cu in senile especially the relations between Zn, Cu and SOD-I, the authors have made a preliminary probe into the mechanism of senile Yang deficiency's occurrence.

[Exploring the substantial basis of the features yinxu huowang in girls with precocious puberty]

Differential diagnosis to 75 girls with true precocious puberty was made using method of TCM. It was observed that each girl had Yinxu Huowang (intense internal heat due to deficiency of vital essence) to a certain extent, these features were very remarkable in most of them. To explore the substantial basis of the features, the functions of hypothalamic-pituitary-ovarian axis were determined. The results showed that the levels of serum FSH, LH, E2 in the girls rise significantly than those in normal girls of the same age, and LHRH stimulating test displays characteristic changes of excessive activity. Treated with TCM of Ziyin Xiehuo, (nourish vital essence reducing intense internal heat) and remitted, the levels of serum FSH, LH, E2 descend significantly, the volume of uterus and ovary reduce markedly, secondary sexual characteristics retrogress evidently, while the features of intense internal heat due to deficiency of vital essence mitigate obviously. According to the above mentioned, the authors consider that the hypothalamic-pituitary-ovarian axis starting beforehand and being hyperfunction are likely to be the substantial basis of the features--that deficiency of Shen Yin, (vital essence) accompanied with intense Fire of the Vital Gate--of the girls with true precocious puberty.