最新刊期
      卷 45 ， 期 2 ， 2022

        Expert Forum

      • Anlong XU
        Vol. 45, Issue 2, Pages: 109-115(2022) DOI: 10.3969/j.issn.1006-2157.2022.02.001
        摘要：The yin and yang theory of traditional Chinese medicine is the philosophical thought of dialectical materialism in ancient China. The yin and Yang theory in traditional Chinese medicine explores the physiological functions and pathological changes in association with structural changes of molecules, cells and tissue/organs in human body based on the ancient Chinese understanding of the natural movement among sun, moon and earth of the universe. Philosophical and scientific thinking of the yin and yang theory is thus proposed in this article based on the comparative analyses of historical development of culture, civilization and medicine between the Chinese and Western medicine. Such a new thinking may serve as a foundation for the integration of traditional Chinese medicine with modern medicine, and might provide the first key to unlocking the treasure house of ancient Chinese civilization.  
        关键词：yin and yang;philosophical connotation;scientific connotation   
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        发布时间：2022-03-08

        Theoretical Studies

      • Bo WANG,Yingying ZHANG,Nian WANG,Qiong LIU,Zhong WANG,Yongyan WANG
        Vol. 45, Issue 2, Pages: 116-119(2022) DOI: 10.3969/j.issn.1006-2157.2022.02.002
        摘要：The research on the mechanism of traditional Chinese medicine (TCM) prescriptions is of great importance to the modernization and internationalization of traditional Chinese medicine. Due to the complexity of TCM prescriptions, the multi-target and multi-channel action mechanism has become a bottleneck in research. Therefore, the search of an appropriate method is the key to current research approaches. Considering the complex network control theory has a great prospect for applications in life sciences, it is possible to identify the driver nodes and classify the components in the network, identifying three different categories of components(critical, common and redundant). It is expected to accurately identify the key targets in prescriptions and reveal the compatibility rules, so as to establish new research models of compatibility of prescriptions, deploy new methods to optimize the composition of prescriptions, and form new ideas to explore the core mechanism of prescriptions, thus providing new strategies for drug development and precision treatment.  
        关键词：traditional Chinese medicine;formula;complex network;control theory;drug target   
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      • Feng YANG,Jianchen HOU,Qianqian LI,Xing FU,Ranran ZHOU,Ran LI,Xiaohua TAO
        Vol. 45, Issue 2, Pages: 120-125(2022) DOI: 10.3969/j.issn.1006-2157.2022.02.003
        摘要：ObjectiveTo construct the theoretical framework of etiology and pathogenesis in Shanghan Lun (Treatise on Cold-induced Diseases) and elucidate the thoughts and characteristics of Zhongjing’s differentiation on etiology and pathogenesis, so as to supplement relevant research and guide the clinical application.MethodsA comprehensive data mining and sorting method was used to screen contents about etiology and pathogenesis in Shanghan Lun with the knowledge element labeling method, and then the data obtained by three-level coding of grounded theory were categorized and analyzed.ResultsThere were 213 "etiology" and 327 "pathogenesis" knowledge elements extracted, and the theoretical framework of etiology and pathogenesis in Shanghan Lun was constructed, including 5 types of etiology: exogenous etiology, mistreatment etiology, pathological product etiology, insect etiology, recurrent etiology and 11 types of pathogenesis: viscera, six meridians, yin and yang, cold and heat, deficiency and excess, qi and blood, exterior and interior, external contraction, nutrient and defense, body fluids, and triple energizers.ConclusionThe theory of etiology and pathogenesis in Shanghan Lun, guided by the unity between heaven and man and the theory of yin and yang, based on the physiological and pathological basis of human meridians, zang-fu organs, qi, blood and body fluids, elucidates the mechanism and law of the occurrence and evolution of the disease, which is not only the key to pattern identification and treatment, but also the basis for prescription and medication.  
        关键词：Shanghan Lun;etiology;pathogenesis;knowledge element labeling;grounded theory   
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      • Yu ZHANG,Chunhua Jia
        Vol. 45, Issue 2, Pages: 126-129(2022) DOI: 10.3969/j.issn.1006-2157.2022.02.004
        摘要：Fujin (taoist magic figures) therapy can effect a cure through rituals, sounds, pictures or even thoughts. It embodies our ancestors’ thinking process of exploring and changing the world. This paper integrates multimodal metaphor, metaphor, and symbolism with medicine to explain the rituals, procedures, incantations, and the combination of medicinals in fujin therapy recorded in Shengji Zonglu (General Records of Holy Universal Relief) to proride an objective interpretation of the therapy. The therapy is based on "similarity law" . It takes metaphor thought as treatment. Despite the application of medicinals according to the symptoms, it is "belief" that plays the leading role.  
        关键词：taoist magic figures;General Records of Holy Universal Relief;multimodal metaphor;metaphor;symbolism   
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      • Yi LI,Bo PANG,Fudong LIU,Xiaochen JIANG,Baojin HUA
        Vol. 45, Issue 2, Pages: 130-134(2022) DOI: 10.3969/j.issn.1006-2157.2022.02.005
        摘要：The six chapters from the 33rd chapter (about "bentun" ) to the 38th chapter (about accumulation) in the Zengbu Neijing Shiyi Fanglun (Discussion on the Supplement of Huangdi Neijing) discuss the accumulation pattern of the five zang organs represented by "feiqi (liver amassment)" , "fuliang (heart amassment)" , "piqi (spleen amassment)" "xiben (lung amassment)" and "bentun (kidney amassment)" . Accumulation-gathering pattern, mostly related to the thoracic and abdominal tumors in modern clinical diseases caused by the retention of pathogenic qi, is a miscellaneous disease of viscera with prolonged stagnation of qi and blood. In this study the causes of accumulation-gathering, the symptoms and patterns of the five zang organs are analyzed based on the articles and the main formula and medicines cited in the book, along with comments on the treatment.  
        关键词：accumulation-gathering;tumor;Zengbu Neijing Shiyi Fanglun;accumulation pattern of the five zang organs;diffusion therapy   
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      • Xiaomin CHEN,Jian ZHANG,Yanbing DING,Jinwen TU
        Vol. 45, Issue 2, Pages: 135-139(2022) DOI: 10.3969/j.issn.1006-2157.2022.02.006
        摘要：Toxin damaging the brain collaterals and toxin damaging the vessels and collaterals are important modern interpretations of the occurrence and development of stroke. The theory that "toxins can destroy the physique and damage the brain collaterals" also plays an important role in the pathogenesis of symptomatic cerebral artery stenosis. This paper explains the disease occurrence from healthy qi deficiency, analyzes the influence of fire toxin, turbid toxin and other toxin damages on cerebral vascular stenosis, as well as the pathological development from "collateral deficiency" to "collateral stagnation" and further to "collateral damage" . It was concluded that "collateral deficiency and toxin damage" is the core pathogenesis of symptomatic intracranial atherosclerotic stenosis (symptomatic cerebral artery stenosis). Parallel treatment of strengthening the deficiency, eliminating toxins, and dredging collaterals should be applied at specific stages. Invigorating qi and eliminating toxins should be distinguished from clearing heat and eliminating toxins. Besides, stage-tailored treatment should also be emphasized, which may provide reference for clinical treatment of the disease.  
        关键词：symptomatic cerebral artery stenosis;cerebral infarction;collateral deficiency and toxin damage;etiology and pathogenesis   
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        发布时间：2022-03-08

        Science & Technology Theme

      • Ling ZUO,Jianxin CHEN,Wei WANG,Sijia WANG,Kunlin ZHANG
        Vol. 45, Issue 2, Pages: 140-147(2022) DOI: 10.3969/j.issn.1006-2157.2022.02.007
        摘要：Systematic complexity of TCM syndrome restricts the knowledge of its scientific nature. In order to directly interpret the genetic structure of TCM patterns and the association between patterns and diseases, this study aimed to propose a theoretical and methodological framework for the basic study of "disease-pattern" biology based on TCM informatics and phenomics. Firstly, the theoretical connotation of TCM informatics and phenomics was discussed, and the significance of mutual reference between TCM and phenomics was clarified. Then starting with the relationship between diseases and patterns, the patterns were regarded as a specific series of symptom phenotypes; and the bridge between TCM informatics and phenomics was explored theoretically and methodically. The research potential of this direction was proved by previous research, too. Finally, the research ideas were put forward by taking Sjogren’s syndrome/yin deficiency pattern as an example. A methodological framework based on TCM informatics and phenomics for the basic research of disease-pattern biology was proposed, including determination of pattern phenotype combination, extraction, quantification, and combination of phenotypes, and acquisition, association analysis and result interpretation of genomic data. The framework can demonstrate the specificity of genetic structure in the study of TCM diseases and patterns, and has been preliminarily verified. And interpret the genetic structure of patterns and the association between patterns, symptoms, and diseases, which will help to understand the scientific nature of TCM theory and promote the TCM modernization.  
        关键词：syndrome;Phenotype;phenomics;TCM informatics   
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        发布时间：2022-03-08
      • Yan WANG,Panfei LI,Sumin Hu
        Vol. 45, Issue 2, Pages: 152-156(2022) DOI: 10.3969/j.issn.1006-2157.2022.02.009
        摘要：Based on the theory of "preventive treatment of disease" , and according to the pathogenic characteristics of radiation and the physiological characteristics and functions of intestinal tract, this paper summarized the basic characteristics and pathogenesis of intestinal injury at each stage before and after radiotherapy. The principles of prevention and treatment and the choices of prescriptions in the three stages of "preventing disease before its onset" , "preventing disease from exacerbating" , and "preventing recurrence after recovery" are thus suggested. It could provide guidance for the application of the "preventive treatment of disease" theory in the prevention and treatment of intestinal injury induced by radiotherapy.  
        关键词：preventive treatment of disease;radiotherapy;radiation;radiation induced intestinal injury   
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        Chinese Medicinal Pharmacology

      • Yumei ZHOU,Yanfeng LIU,Mengmeng SHEN,Zhidi SUN,Hanyu ZHENG,Zhibo ZHENG
        Vol. 45, Issue 2, Pages: 157-164(2022) DOI: 10.3969/j.issn.1006-2157.2022.02.010
        摘要：ObjectiveTo investigate the effect of Erbu Zhuyu Gailiang Fang (Modified Formula of Promoting Fertility with Two Tonics, EBZYGLF) on endometrial morphology and oxidative stress related indexes in aged mice.MethodsPregnant mice aged 8~9 months were randomly divided into 6 groups by using random number table(n=8 in each group): aged model group, low-dose (10.89 g/kg), mid-dose (21.78 g/kg) and high-dose (43.56 g/kg) EBZYGLF groups, progynova group (0.3 mg/kg) and aspirin group (15 mg/kg). In addition, 8 pregnant mice aged 6~8 weeks were selected as the childbearing blank group. The morphology of uterus, HE staining of endometrium, pinopodes and embryo implantation were observed. Pinopodes scores, pregnancy rate and average number of embryo implantation sites were calculated. Superoxide dismutase (SOD) in serum and endometrium was measured by using WST-1 method. The content of malondialdehyde (MDA) was measured with colorimetry.ResultsCompared with the control group, the color of uterus in the model group was dark brownish red, with intraluminal blood stasis, thinner endometrium, fewer blood vessels and glands, sparse microvilli, very low pinopodes score (P<0.05), decreased average number of implantation sites (P<0.05), decreased SOD activity in serum and uterus (P<0.05), and increased MDA content in serum and uterus (P<0.05) with satistical significance. Compared with the aged model group, the uterine color, intraluminal blood stasis, endometrial thickness, the number of blood vessels and glands in each treatment group were improved in varying degrees. Pinopodes scores in the low-, mid- and high-dose EBZYGLF groups and the progynova group were increased (P<0.05). The average number of implantation sites and pregnancy rate in the low-, mid- and high-dose EBZYGLF groups were increased (P<0.05), SOD activity in serum increased in high-dose group and aspirin group (P<0.05), SOD activity in uterus increased in low, medium and high-dose groups of EBZYGLF and progynova group (P<0.05), the content of MDA in serum decreased in low-, mid- and high-dose groups of EBZYGLF and progynova group (P<0.05), and the content of MDA in uterus decreased in mid- and high-dose groups of EBZYGLF (P<0.05) with satistical significance.ConclusionEBZYGLF could enrich the expression of microvilli and pinopodes, increase SOD activity, reduce the content of MDA, improve the level of serum and uterine oxidative stress, thus to improve endometrial receptivity, embryo implantation sites and pregnancy rate.  
        关键词：Erbu Zhuyu Gailiang Fang;aged mice;morphology;endometrial receptivity;oxidative stress   
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      • Jing LIU,Jianglin XU,Xiaolu SHI,Lu LIU,Sinai LI,Haifeng CUI,Yanchao HUANG,Qian WU,Jie WAN,Kun ZHOU,Xiaoyun CUI,Yan LI,Jinjin LU,Dong LI,Qun GAO,Wenhao JIA,Mingjie SUN,Qian LIN
        Vol. 45, Issue 2, Pages: 165-175(2022) DOI: 10.3969/j.issn.1006-2157.2022.02.011
        摘要：ObjectiveTo explore the efficacy of nourishing qi (NouQ) and activating blood (ActB) herbal combination at different ratios on diastolic heart failure (DHF) rats by targeting calcium homeastasis.MethodsDHF rats were induced by abdominal aortic constriction and grouped into NouQ (AM+ CP), NouQ vs ActB=1∶1 (AM+ CP vs SM+ PP=1∶1), or NouQ vs ActB=2∶1 (AM+ CP vs SM+ PP=2∶1). Heart function, hemodynamics, cardiomyocytic shortening and calcium transient were measured after 4/12 weeks of treatment. CaMKⅡ, protein kinase A (PKA) and their responding phosphorylation proteins PLB T17 and PLB S16 were examined by using Western blot assay.ResultsAlthough all NouQ + ActB groups showed improvements on diastolic function (lower end-diastolic left ventricular pressure (LVEDP) at resting status; shorter time to 50% relaxation of cardiomyocytes) and systolic function (shorter time to 50% contraction of cardiomyocytes), only NouQ vs ActB=2∶1 group decreased E/e ratio, LVEDP under exercise stress and reversed LV remodeling (lower LV anterior wall thickness and LV posterior wall thickness). At cellular level, all treatment groups showed shorter time to 50% contraction, shorter time to 50% relaxation, shorter time to 50% Ca2+ release and reduction of CaMKⅡ expression; all NouQ + ActB treatment groups illustrated additional effects on inhibiting PKA overexpression, but only 2∶1 group illustrated shorter time to 50% Ca2+ uptake and reversed hypo-phosphorylation of PLB S16.ConclusionThe combination of NouQ herbs (AM+ CP) and ActB herbs (SM+ PP) at a ratio of 2∶1 have a better therapeutic effect than that of a ratio of 1∶1 and NouQ herbs on DHF, and this effect may work through regulating Ca2+ handling.  
        关键词：diastolic heart failure;yiqihuoxue formula;calcium homeostasis   
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      • Jie GAO,Meizhi LIU,Junhui Qiu,Dusang SUN,Wenjun SHA,Tao LEI
        Vol. 45, Issue 2, Pages: 176-183(2022) DOI: 10.3969/j.issn.1006-2157.2022.02.012
        摘要：ObjectiveTo observe the effects of resveratrol (RSV) on proliferation, migration and tube formation of human umbilical vein endothelial cells (HUVECs) in the context of high glucose.MethodsWell-cultured HUVECs in vitro were randomly divided into six groups: blank group, mannitol 30 mmol/L group, model group, low-dose, mid-dose and high-dose RSV groups. The model group was induced by using 30 mmol/L D-glucose. The low-dose, mid-dose and high-dose RSV groups were established through intervention by administering 20 μmol/L, 40 μmol/L, 60 μmol/L RSV respectively for 24 hours. Cell proliferation, migration and tube formation were detected by using Cell Counting Kit-8(CCK-8), Transwell chamber, wound healing and Matrigel assay respectively.ResultsThe cell proliferation rate, migration number, wound healing rate and lumen branch number in model group were significantly higher than those in blank group and mannitol group (P<0.05). Compared with model group, after intervention with RSV, the ability of cell proliferation, migration and tube formation were significantly decreased. The cell proliferation rate, migration number, wound healing rate and lumen branch number were significantly decreased in a dose-dependent manner (P<0.05). When RSV concentration was 60 μmol/L, the proliferation rate, migration number, wound healing rate and lumen branch number were significantly lower than those in model group, blank group and mannitol group. The differences were statistically significant (P<0.05).ConclusionRSV could inhibit the proliferation, migration and lumen formation of HUVEC cells in high glucose conditions, suggesting that it could protect HUVEC cells from injury induced by high glucose and inhibit pathological angiogenesis.  
        关键词：resveratrol;high glucose;human umbilical vein endothelial cells;angiogenesis   
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      • Xiao YANG,Ji LUO,Yongmin LI,Jiaqin LIU,Xiaoning TAN,Yuan LYU,Rongli MA,Yilan JIANG
        Vol. 45, Issue 2, Pages: 184-192(2022) DOI: 10.3969/j.issn.1006-2157.2022.02.013
        摘要：ObjectiveTo study the effect of MIF in colon cancer exosomes on TGF-β1 expression in liver Kupffer cells and the intervention effect of Jianpi Xiaoai Fang (Spleen-invigorating Cancer-eliminating Formula, JPXAF) at cellular level.MethodsLiver Kupffer cells were treated with exosomes of colon cancer cells; and TGF-β1 mRNA expression in liver Kupffer cells was detected by using RT-PCR. After the MIF gene expression of CT26 cells was knocked down with siRNA interference technique, the exosomes were used in the treatment of Kupffer cells; and the TGF-β1 expression level of Kupffer cells was evaluated with RT-PCR and ELISA. The expressions of MIF in CT26 cells and their exosomes were measured with RT-PCR and WB after intervention with serum containing low-, mid- and high-dose JPXAF; and TGF-β1 expression in Kupffer cells was measured by using RT-PCR and ELISA after CT26 cell exosomes were treated with serum containing JPXAF.ResultsTGF-β1 mRNA expression in mouse Kupffer cells was increased after CT26 exosome intervention (P<0.05). After knockdown of MIF gene expression in CT26 cells, the up-regulation of exosomes on TGF-β1 in Kupffer cells was weakened (P<0.05). 20% of the serum containing JPXAF decreased the expressions of MIF in CT26 cells and their exosomes (P<0.05), and reduced the up-regulation of CT26 exosomes on TGF-β1 expressions in Kupffer cells (P<0.05).ConclusionExosomes of colon cancer cells could up-regulate TGF-β1 expression in liver Kupffer cells by MIF. The serum containing JPXAF could reduce the expression of TGF-β1 in liver Kupffer cells by inhibiting the expression of MIF in exosomes of colon cancer cells.  
        关键词：colon cancer;liver metastasis;exosomes;macrophage migration inhibitory factor;traditional Chinese medicine;rats   
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      • Wenxiong ZHU,Yifeng YUAN,Tao PENG,Xi ZHANG,Tao LIU,Bo LI,Qihua CHEN
        Vol. 45, Issue 2, Pages: 193-200(2022) DOI: 10.3969/j.issn.1006-2157.2022.02.014
        摘要：ObjectiveTo observe on intervention of TFF/Wnt signaling pathway on benign prostatic hyperplasia (BPH) with Yiqi Huoxue Xiaozheng Fang (Qi-replenishing, Blood-activating and Aggregation-resolving Formula, YQHXXZF), and explore its mechanism of action.MethodsTwelve healthy adult male SD rats were taken as the blank control group, and 60 castrated rats were randomly divided into model control group, Longbishu group (1.687 5 g/kg), low-dose (10.625 g/kg), mid-dose (21.250 g/kg) and high-dose (42.50 g/kg) YQHXXZF groups. The model was made by subcutaneous injection of testosterone propionate, and the blank control group and model control group were gavage with distilled water, and each treatment group was given intragastric gavage with the corresponding drug solution. After 30 days, the rats were sacrificed to remove the prostate. The wet weight, volume and index of the rats’ prostate in each group were measured. The prostate tissue was observed by using HE staining. The expression of TFF2, Wnt4 and Wnt6 mRNA was detected by using QRT-PCR.ResultsBoth YQHXXZF and Longbishu capsule reduced the wet weight, volume and index of prostate in BPH model rats to varying degrees. The curative effect of high-dose YQHXXZF was better than Longbishu capsule. YQHXXZF at three doses reduced the wet weight, volume and index of prostate, which showed a certain positive correlation and dose-dependent effect. In terms of pathological changes of the prostate tissue in the BPH model rats, the effects of the high-dose group of YQHXXZF and the Longbishu group were the most significant groups. Both YQHXXZF and Longbishu Capsules reduced the acinar area and interstitial area of the prostate. The Longbishu capsule had the same effect as the middle-dose YQHXXZF. As the dose increased, the area of acinar and interstitium decreased accordingly. TFF2, Wnt4, and Wnt6 were significantly increased in the model control group, while decreased to varying degrees in each treatment group. The effect of YQHXXZF in the mid-dose and high-dose groups was stronger than that of the Longbishu group, and the effect of reducing the expression levels of TFF2 and Wnt4 increased with the dose.ConclusionThis study found that YQHXXZF may reduce the acinar area and interstitial area of the prostate, improve the pathological changes of the prostate tissue, and play a role in treating BPH. The mechanism of its efficacy may be closely related to the intervention of the TFF/Wnt signaling pathway and the down-regulation of the expression of TFF2, Wnt4, and Wnt6.  
        关键词：Yiqi Huoxue Xiaozheng Fang (Qi-replenishing, Blood-activating and Aggregation-resolving Formula);TFF;Wnt;benign prostatic hyperplasia;rats   
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        Clinical Studies

      • Jinchen GUO,Jian Liu,Xiaojun ZHANG,Qiao ZHOU,Dan HUANG
        Vol. 45, Issue 2, Pages: 201-207(2022) DOI: 10.3969/j.issn.1006-2157.2022.02.015
        摘要：ObjectiveTo study the effects of Huangqin Qingre Chubi (Scutellaria Heat-clearing Impediment-eliminating, HQC) Capsule on oxidative stress immune inflammation in patients with Rheumatoid Arthritis (RA) by regulating Peroxisome Proliferator-activated Receptor -γ (PPAR-γ)/CD36/ Manganese Superoxide Dismutase (MnSOD) axis, and to explore its anti-oxidation, anti-inflammatory and anti-immune mechanism.Methods60 RA patients hospitalized in Department of Rheumatology, the First Affiliated Hospital of Anhui University of Chinese Medicine from December 2018 to December 2020 were randomly divided into control group and experimental group(n=30 in each group). The control group received conventional anti-symptomatic treatment alone, while the experimental group was additionally treated with HQC Capsule. The course of treatment was 8 weeks. The joint and systemic symptoms of RA patients before and after treatment were evaluated. Laboratory parameters such as Erythrocyte Sedimentation Rate (ESR), Rheumatoid Factor (RF), Anti-cyclic Citrullinated Peptide Antibody (CCP-AB) and C-reactive Protein (CRP) were measured. Serum levels of Tumor Necrosis Factor-α (TNF-α), Interleukin-10 (IL-10), Lipid Peroxide (LPO), Malondialdehyde (MDA), Superoxide Dismutase (SOD) and Total Antioxidant Capacity (TAOC) were detected by using ELISA. The level of CD36 in monocytes was measured with FCM. The expression of PPAR-γ and MnSOD protein was detected by using Western blot assay.ResultsThe total effective rates of experimental group and control group were 90.0% and 83.3% respectively, and the clinical efficacy of experimental group was better than that of control group (P<0.05). Compared with those before treatment, the scores of systemic symptoms of the experimental group all decreased significantly (P<0.05 or P<0.01). After treatment, the experimental group performed better in the improvement of morning joint stiffness, reduced appetite, lack of qi, no desire to speak, joint heaviness and abdominal distension after eating and loose stools (P<0.05 or P<0.01). RF, CRP, ESR, TNF-α and MDA in the two groups both decreased significantly after treatment while the expressions of IL-10, CD36, PPAR-γ and MnSOD increased significantly; and the expressions of SOD and TAOC in the experimental group increased while LPO decreased significantly (P<0.05 or P<0.01). After treatment, the experimental group also had a better outcome than control group in reducing ESR and increasing the expressions of IL-10, SOD, CD36, PPAR-γ and MnSOD (P<0.05 or P<0.01).ConclusionHQC may regulate oxidative stress and inflammatory immune response, and improve the clinical symptoms of RA via regulating PPAR-γ/CD36/MnSOD axis,  
        关键词：rheumatoid arthritis;oxidative stress;immune inflammation;PPAR-γ;CD36;MnSOD;Huangqin Qingre Chubi Capsule   
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      • Xiaoqing WU,Lei CHANG,Wenping LU
        Vol. 45, Issue 2, Pages: 208-216(2022) DOI: 10.3969/j.issn.1006-2157.2022.02.016
        摘要：ObjectiveTo observe the effects of Yiqi Huoxue Jiedu Fang (Qi-Benefiting, Blood-Activating, and Toxin-Eliminating Formula, YQHXJDF) on progression-free survival (PSF), quality of life and pattern changes of traditional Chinese medicine (TCM) in the treatment of platinum-resistant ovarian cancer, and its mechanism through regulating IL-6 level and macrophage phenotype.MethodsA randomized controlled trial was conducted in 75 patients with platinum-resistant ovarian cancer with qi deficiency and blood stasis pattern. Both groups received standardized treatment of western medicine, on the basis of which the control group was given Chinese patent medicine-Xihuang Jiedu Jiaonang (Toxin-Eliminating Capsule with American Ginseng and Cow Bezoar, XHJDJN) orally, while the treatment group, YQHXJDF. The intervention was finished with end of the study or progression of the disease followed by death. The peripheral blood of the participants was collected, and the levels of IL-6 and M2 in macrophage percentage were detected at enrollment and 2 months after intervention with Pearson coefficient analysis. There was follow-up once every 2 months to evaluate the quality of life (QoL)and the changes of TCM pattern scores. Cox regression analysis was conducted to identify PFS risk factors.ResultsThere was no statistically significant difference in TCM pattern scores, age, stage, M2 macrophage percentage and IL-6 level between the two groups. The median progression-free survival (mPFS) of the treatment group was 6 months [95% confidence interval (CI), 4.77-7.23] , and the mPFS of the control group was 5 months (95% CI, 3.06-6.94). There was significant difference between the two groups. QoL and TCM pattern score were improved in both groups with no satistical significance between two groups. When IL-6 is lower than 5.5 ng/L, IL-6 level was negatively correlated with M2 macrophage percentage. IL-6 in the treatment group was increased after treatment, but there was no statistically significant difference in the control group before and after treatment; when IL-6 is higher than 5.5 ng/L, the level of IL-6 was positively correlated with M2 macrophage percentage, and the levels of IL-6 in both groups were decreased after treatment. The quality of life in the treatment group was better after intervention than that before intervention. There was no statistically significant difference in the control group before and after treatment. Besides, the quality of life in the treatment group was better than that in the control group. The number of chemotherapy lines and M2 macrophage percentage were risk factors of PFS.ConclusionYQHXJDF could prolong the PFS of patients with advanced platinum-resistant ovarian cancer, improve the quality of life and TCM patterns. It could also improve the level of IL-6 to a certain extent and thus improve immune function. When IL-6 is too high, both YQHXJDF and XHJDJN can reduce the level of IL-6 in peripheral blood and alleviate immunosuppression. The changes of macrophage phenotype seems to influence the PFS.  
        关键词：traditional Chinese medicine;ovarian cancer;platinum resistance;macrophage phenotype;randomized control trial   
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        发布时间：2022-03-08
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