Protective effect of Xixin-Ganjiang herb pair for warming the lungs to dissolve phlegm in chronic obstructive pulmonary disease rats based on integrated network pharmacology and metabolomics.

Xixin-Ganjiang herb pair (XGHP) is a classic combination for warming the lungs to dissolve phlegm and is often used to treat a variety of chronic lung diseases; it can treat the syndrome of cold phlegm obstruction of lungs. First, ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was used to examine the composition of XGHP, and network pharmacology was used to predict its potential core targets and signaling pathways in the current study. Second, a rat model of chronic obstructive pulmonary disease (COPD) was established for assessing the anti-COPD activity of XGHP, and metabolomics was used to explore the biomarkers and metabolic pathways. Finally, the sample was validated using molecular docking and Western blotting. The integration of metabolomics and network pharmacology results identified 11 targets, 3 biomarkers, 3 pathways, and 2 metabolic pathways. Western blotting showed that XGHP effectively regulated the expression of core proteins via multiple signaling pathways (downregulation of toll-like receptor 4 [TLR4] and upregulation of serine/threonine-protein kinase 1 [p-AKT1] and nitric oxide synthase 3 [NOS3]). Molecular docking results showed that the 10 potentially active components of XGHP have good affinity with tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), matrix metalloproteinase 9 (MMP-9), TLR4, p-AKT1, and NOS3. Our findings suggest that XGHP may regulate glucolipid metabolism, improve energy supply, and inhibit inflammatory responses (TNF-α, IL-6, and MMP-9) via the PI3K-Akt signaling pathway and HIF-1 signaling pathway in the management of COPD.

[Clinical trials of Xingnao Kaiqiao needling combined with respiratory training for post-stroke dysphagia].

OBJECTIVE: To observe the clinical effect of Xingnao Kaiqiao needling combined with respiratory training on swallowing function, quality of life and throat surface muscle function in patients with post-stroke dysphagia. METHODS: A total of 124 patients with post-stroke dysphagia were randomized into an observation group and a control group, 62 cases in each group. On the basis of conventional western medication treatment, respiratory training was applied in the control group, once daily, 5 times a week for 4 weeks. On the base of the treatment as the control group, Xingnao Kaiqiao needling was applied at Neiguan (PC6), Sanyinjiao (SP6), Fengchi (GB20), Wangu (GB12), Yifeng (SJ17), posterior pharyngeal wall, Shuigou (GV26) and Lianquan (CV23) in the observation group, once daily, 6 times a week for 4 weeks. Before and after treatment, the Kubota water swallowing test (KWST) scale, swallowing function, swallowing-quality of life (SWAL-QOL) scale, maximum amplitude of pharyngeal surface electromyography (sEMG), and complications of dysphagia were observed and recorded. RESULTS: After the treatment, self-comparison showed that the KWST and swallowing function scores were significantly decreased (P<0.05), the SWAL-QOL score and sEMG were notably increased in both groups (P<0.05) in comparison with their own pre-treatment. The KWST and swallowing function scores were obviously lower in the observation group than in the control group (P<0.05), whereas the SWAL-QOL score and sEMG were evidently higher in the observation group than in the control group (P<0.05). The total effective rate of the observation group was 95.16% (59/62), which was higher than 80.65% (50/62) of the control group (P<0.05). The incidence of dysphagia complications in the observation group was 24.19% (15/62), which was lower than 50.00% (31/62) of the control group (P<0.01). CONCLUSION: Xingnao Kaiqiao needling combined with respiratory training in the treatment of post-stroke dysphagia can increase the activity of throat muscles, promote the swallowing function, improve the quality of life, and reduce the incidence of dysphagia related complications.