Efficacy of Modified Guiling Ganluyin Combined with Colchicine in Treatment of Gouty Arthritis with Damp-heat Accumulation / 中国实验方剂学杂志

Objective:To explore the clinical efficacy of modified Guiling Ganluyin combined with colchicine in treatment of gouty arthritis(GA) damp-heat accumulation. Method:A total of 210 cases of GA were randomly divided into traditional Chinese medicine(TCM) group(70 cases), western medicine group (70 cases), and integrated traditional Chinese and western medicine group(70 cases) according to the digital table method. The patients in TCM group were treated with modified Guiling Ganluyin, the patients in western medicine group were treated with colchicine, and the patients in integrated traditional Chinese and western medicine group received modified Guiling Ganluyin + colchicine, with a treatment course of 30 d in all groups. The clinical symptoms before and after the treatment [joint pain visual analogue scale(VAS), patient global appraise(PGA), number rating scale for pain(NRS)], inflammatory cytokines in serum and joint fluid [tumor necrosis factor-alpha(TNF-α), interleukin-1β(IL-1β), uric acid(UA)], hemorheology index [whole blood high cut viscosity(HCV), whole blood low cut viscosity(LCV), whole blood reductive viscosity(RV)]in 3 groups were observed. The total effective rate and the adverse reactions were compared. Result:Six cases fell off during the study period. The total effective rate in integrated traditional Chinese and western medicine group was 97.1%（67/69）, which higher than 80.8%(55/68) in TCM group (χ2=8.153, P<0.05) and 79.1%(53/67) in western medicine group (χ2=8.735, P<0.05）. Compared with TCM group and western medicine group, the clinical symptoms VAS and NRS scores in integrated traditional Chinese and western medicine group were significantly lower(P<0.05), while the PGA scores were significantly higher(P<0.05). TNF-α, IL-1β and UA in serum and articular fluid in integrated traditional Chinese and western medicine group were significantly decreased(P<0.05). HCV, LCV and RV were significantly decreased in integrated traditional Chinese and western medicine group(P<0.05). Compared with the traditional Chinese and western medicine group, the incidence of adverse reactions was higher in the western medicine group (χ2=5.538,P<0.05) and lower in the Chinese medicine group (χ2=6.273，P<0.05). Conclusion:Modified Guiling Ganluyin combined with colchicine has the effects in enhancing effect and reducing toxicity, and could improve the clinical symptoms of GA patients with damp-heat accumulation, with a low incidence of adverse reactions.

Clinical Efficacy of Flavored Sanxitang Combined with Celecoxib in Treatment of Gonarthromeningitis Cased by Dampness and Cold / 中国实验方剂学杂志

Objective::To observe the clinical efficacy of flavored Sanxitang combined with celecoxib in treating gonarthromeningitis caused by dampness and cold. Method::Totally 120 case were randomly divided into the control group and the treatment group, with 60 cases in each group. The control group was given celecoxib, and the treatment group was treated with flavored sanxitang combined with celecoxib for 30 d. The visual analogue scale (VAS), American knee association knee function scale (AKS), arthritis impact scale (AIMS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were observed before and after treatment. The circumferential diameter, articular cavity effusion and synovial hyperplasia thickness were measured. The serum tumor necrosis factor-α(TNF-α), matrix metalloproteinase (MMP)-3, serum interleukin-1 (IL-1) and erythrocyte sedimentation rate (ESR) were detected. The effective rate and adverse reactions were observed in two groups. Result::The total effective rate in treatment group was 94.8% (55/58), which was higher than 80.7% (46/57) in control group (P<0.05). Compared with before treatment, VAS, AIMS, WOMAC, knee circumference, articular cavity effusion and synovial hyperplasia thickness were significantly reduced in two groups (P<0.05), while the AKS score was significantly increased (P<0.05). Compared with after treatment, VAS, AIMS, WOMAC, knee circumference, articular cavity effusion and synovial hyperplasia thickness were significantly reduced in observation group (P<0.05), whereas the AKS score was significantly increased (P<0.05). TNF-α, MMP-3, IL-1 and ESR in two groups were significantly lower than those group before treatment (P<0.05). After treatment, TNF-α, MMP-3, IL-1 and ESR levels in observation group were significantly reduced compared with those in control group (P<0.05). The incidence rate of adverse reactions in treatment group was 5.89% (4/58), which was lower than 22.81% (13/57) in control group (P<0.05). Conclusion::Flavored Sanxitang combined with celecoxib could alleviate the clinical symptoms of gonarthromeningitis caused by dampness and cold, with a low incidence of adverse reactions.

Clinical Observation on Modified Huqianwan in Treatment of Rheumatoid Arthritis Liver-kidney Yin Deficiency Syndrome / 中国实验方剂学杂志

Objective: To explore the clinical efficacy and safety of modified Huqianwan in treatment of rheumatoid arthritis (RA) liver-kidney Yin deficiency syndrome, and investigate its possible mechanism. Method: A total of 184 patients with RA liver-kidney Yin deficiency syndrome were randomly divided into Chinese medicine group (62 cases), western medicine group (57 cases) and integrated Chinese and western medicine group (65 cases) according to the digital table method. The patients in Chinese medicine group were treated with Huqianwan; the patients in western medicine group were treated with methotrexate tablets and leflunomide tablets; and the patients in integrated Chinese and western medicine group received Huqianwan+methotrexate tablets and leflunomide tablets,with a treatment course of 12 weeks in all groups. The pain visual analog scale (VAS), swelling and tenderness scores of 28 joints (DAS28), average hands grip strength, morning stiffness time and liver-kidney Yin deficiency syndrome differentiation of traditional Chinese medicine (TCM) syndrome score were compared between groups before and after treatment. The changes of erythrocyte sedimentation rate (ESR), C reactive protein (CRP), immunoglobulin (Ig) G, tumor necrosis factor-alpha (TNF-α) and rheumatoid factor (RF) were detected in all groups after treatment. Clinical efficacy, and incidence of adverse reactions such as gastrointestinal response, liver injury, leukopenia, serum glutamate oxaloacetic aminotransferase (GOT) and platelet (PLT) level changes were compared between the groups, so as to investigate the efficiency and safety of the different medicines. Result: After 12 weeks of treatment, the total clinical effective rate was 79.0%, 80.7%, and 92.3% respectively in Chinese medicine group, western medicine group, and integrated Chinese and western medicine group; the integrated Chinese and western medicine group was significantly better than the Chinese medicine group and western medicine group (PPPPConclusion: The efficacy in treating RA liver and kidney Yin deficiency syndrome shows no significant difference between modified Huqianwan and methotrexate tablets+leflunomide tablets. In the treatment of RA liver and kidney Yin deficiency syndrome, Huqianwan has fewer adverse reactions. Huqianwan combined with methotrexate tablets+leflunomide tablets is superior to that in methotrexate tablets+leflunomide tablets in treatment of RA liver-kidney Yin deficiency syndrome.

Effect of processing excipient suet oil on formation and absorption of baohuoside Ⅰ-bile salt self-assembled micelles / 中国中药杂志

The fried method with suet oil,which can strengthen the effect of Epimedium in warming kidney and enhancing Yang,has been widely used in the processing of Epimedium in traditional Chinese medicine. Based on the formation mechanism of Epimedium flavonoids self-assembled micelles in vivo,the synergistic mechanism of processing excipient suet oil was investigated in this paper from the perspective of pharmaceutics. Baohuoside Ⅰ,as representative component of processed Epimedium,was selected as model drug.Average size and zeta potential were measured and the morphology of micelles was observed under transmission electron microscopy. Caco-2 monolayer cell model,rat intestinal perfusion model and in vivo serum drug concentration method were established to investigate the effect of suet oil on the formation and absorption of the baohuosideⅠ bile salt self-assembled micelles. Baohuoside Ⅰ can form selfassembled micelles under the action of sodium deoxycholate. While,adding suet oil into the baohuoside Ⅰ-bile salt micelles( BSDOC) can make it form a more stable system with a smaller average size,higher Zeta potential,lower polydispersity index( PDI) value,significantly improved encapsulation efficiency and drug loading,indicating that suet oil could significantly improve the micelle formation in vivo. In addition,the permeability coefficient of baohuoside Ⅰ in Caco-2 monolayer cells and the four intestinal organs( duodenum,jejunum,ileum and colon) was increased and the oral bioavailability was also improved after adding the suet oil to BS-DOC.All the results demonstrated that the suet oil can promote the formation and absorption of baohuoside Ⅰ self-assembled micelles,so as to enhance its synergistic effects.

Mechanism of flavonoid components in Astragali Radix in inhibiting tumor growth and immunoregulation in C57BL/6 tumor bearing mice based on "invigorating Qi for consolidation of exterior" / 中国中药杂志

Traditional Chinese medicine believes that the occurrence and development of tumors is related to the body's Qi deficiency. " Invigorating Qi for consolidation of exterior" has became an effective way to treat tumors by traditional Chinese medicine. This study is based on the " invigorating Qi for consolidation of exterior" to explore the effect of flavonoid components in Qi-invigorating herbs Astragali Radix( AR) on the growth and immune function of mouse Lewis lung cancer xenografts,and further explore its mechanism of action. In the present study,high performance liquid chromatography was performed to analyze the flavonoid components in AR.The Lewis lung cancer model of C57 BL/6 mice was constructed,and the tumor volume of mice was determined by Visual Sonics Vevo2100 high frequency color ultrasound. The levels of IL~(-1)7 and RORγt in serum and tumor tissues were detected by ELISA and immunohistochemistry. The expression of IRE~(-1)/XBP~(-1) pathway-related proteins in tumor tissues was detected by Western blot. The results revealed that treatment of 5 and 10 g·kg~(-1)·d~(-1) of flavonoid components in AR significantly inhibited tumor growth of C57 BL/6 tumorbearing mice. The inhibition rates at the dose of 5 and 10 g·kg~(-1)·d~(-1) of flavonoid components in AR were( 29. 5±4. 4) % and( 43. 4±5. 2) %,respectively. The expression of IL~(-1)7 and RORγt in serum and tumor tissues of Lewis lung cancer mice were decreased,and the spleen index and thymus index were significantly enhanced by the flavonoid components in AR. Flavonoid components in AR could decrease the expression of X-box binding protein 1( XBP1),inositol-requiring enzyme( IRE1) and glucose regulated protein 78 k D( GRP78),and increase the expression of C/EBP homologous protein( CHOP),and the high-dose group is better,suggesting that the anti-lung cancer effect of flavonoid components in AR is related to the regulation of XBP1 mediated ERs. This study provides new evidence that the flavonoid components in AR could inhibit the tumor growth of C57 BL/6 tumor-bearing mice by regulating the body's immune function through " invigorating Qi for consolidation of exterior".

Effect of perioperative modified rehabilitation training exercise in patients undergoing permanent pace-maker implantation and prognosis analysis / 心血管康复医学杂志

Objective:To explore effect of perioperative modified rehabilitation training exercise in patients undergo-ing permanent pacemaker implantation and their prognosis.Methods:A total of 123 patients undergoing permanent pacemaker implantation were enrolled.According their hospitalization time,they were randomly divided into reha-bilitation training group(n=63)and modified rehabilitation training group(n=60).Postoperative 4d incision pain score, training time standard-reaching rate and action specification within one week after surgery were compared between two groups.On third month after surgery,incidence rate of surgical side shoulder pain was followed up,DASH simplified sco-ring table was used to assess daily living capacity and patient satisfaction etc.,and results were statistically analyzed.Re-sults:After permanent pacemaker implantation,compared with rehabilitation training group,there were significant reduc-tions in incidence rates of venous thrombosis(6.35% vs.0%),surgical shoulder pain(17.5% vs.5.0%)and DASH score [(17.05 ± 4.48)scores vs.(14.02 ± 3.85)scores,P<0.05 or <0.01],and significant rise in patient satisfaction(85.7%vs.96.6%),training time standard-reaching rate(28.5% vs.76.7%)and action specification rate(33.3% vs.68.3%) in modified rehabilitation training group,P<0.05 or <0.01. Conclusion:Perioperative modified rehabilitation training exercise can increase effect for rehabilitation training,reduce incidence of complications and improve daily living capacity in patients undergoing permanent pacemaker implantation.