Effect of Modified Chaihu Shugansan and Its Disassembled Formulas on ACE2- Ang （Ⅰ-Ⅶ）-MasR Axis in Rats with Myocardial Ischemia and Depression / 中国实验方剂学杂志

ObjectiveTo observe the effects of modified Chaihu Shugansan（CHSG） and its disassembled formulas on angiotensin-converting enzyme 2 （ACE2）-angiotensin （Ⅰ-Ⅶ） ［Ang （Ⅰ-Ⅶ）］-mitochondrial assembly receptor （MasR） axis in hyperlipidemic rats with myocardial ischemia and depression， and to explore the underlying mechanism of its prevention and treatment of myocardial ischemia and depression. MethodA total of 108 male SD rats were randomly divided into a normal group， a model group， a modified CHSG group （11.7 g·kg-1）， a Quyu Huatan disassembled formula group （4.05 g·kg-1）， a Shugan Xingqi disassembled formula group （3.15 g·kg-1）， a Jianpi Yangxue disassembled formula group （4.5 g·kg-1）， a fluoxetine group （0.001 8 g·kg-1）， a trimetazidine group （0.005 4 g·kg-1）， and a simvastatin group （0.001 8 g·kg-1）， with 12 rats in each group. The hyperlipidemia model with myocardial ischemia and depression was induced with a high-fat diet combined with injection of isoproterenol （ISO） and chronic unpredictable mild stress （CUMS） in rats in the model group and groups with drug intervention for eight weeks. The rats in each group with drug intervention were treated correspondingly by gavage from the first day of modeling， while those in the normal group and the model group received the same amount of normal saline. The behavioral changes of rats in each group were observed by open field test and forced swimming test. Left ventricular fractional shortening （LVFS） and left ventricular ejection fraction （LVEF） were measured by echocardiography. The serum levels of total cholesterol （TC）， triglyceride （TG）， low-density lipoprotein cholesterol （LDL-C）， and high-density lipoprotein cholesterol （HDL-C） were detected by the enzyme-labeled apparatus. Hematoxylin-eosin （HE） staining was used to observe the histomorphological changes of the heart. The serum levels of angiotensin Ⅱ （AngⅡ）， ACE2， and Ang（Ⅰ-Ⅶ） were detected by enzyme-linked immunosorbent assay （ELISA）. The protein and mRNA expression of ACE2 and MasR in the hippocampus and the heart was detected by real-time quantitative polymerase chain reaction （Real-time PCR） and Western blot. ResultCompared with the normal group， the model group showed reduced movement time， distance， and average speed in the central area of the open field （P<0.01）， prolonged immobility time of rats in the forced swimming test （P<0.01）， decreased LVFS and LVEF （P<0.01）， inflammatory exudation and disorderly arranged fiber in heart tissues， elevated serum levels of TC， LDL-C， AngⅡ， ACE2 and Ang（Ⅰ-Ⅶ）， diminished HDL-C （P<0.01）， dwindled mRNA and protein expression of ACE2 in the hippocampus and the heart and MasR in the hippocampus， and up-regulated mRNA and protein expression of MasR in the heart （P<0.01）. Compared with the model group， the modified CHSG group displayed increased movement time， distance， and average speed in the center area of the open field （P<0.01）， shortened immobility time in the forced swimming test （P<0.01）， increased LVFS and LVEF （P<0.01）， relieved heart injury， reduced serum levels of TC， LDL-C， AngⅡ， ACE2， and Ang（Ⅰ-Ⅶ）， elevated level of HDL-C （P<0.01）， up-regulated mRNA and protein expression of ACE2 in the hippocampus and the heart and MasR in the hippocampus， and down-regulated mRNA and protein expression of MasR in the heart （P<0.01）. Each disassembled formula could improve the above indexes to a certain extent （P<0.05， P<0.01）， but the effect of the whole formula was optimal. ConclusionThe modified CHSG and its disassembled formulas have the effects of resisting depression， improving myocardial injury， and reducing blood lipid. Due to the synergistic effects of stasis-resolving/phlegm-eliminating drugs， liver-smoothing/Qi-moving drugs， and spleen-tonifying/blood-nourishing drugs in the formula， the modified CHSG is superior to each disassembled formula in efficacy. Its mechanism may be related to the activation of the ACE2-Ang （Ⅰ-Ⅶ）-MasR axis.

Clinical Study of Chaihu Shugansan Combined with Abdominal Acupuncture on Depression Caused by Chronic Pain / 中国实验方剂学杂志

Objective:To investigate the clinical effect of Chaihu Shugansan combined with abdominal acupuncture on depression caused by chronic pain，and to explore its mechanism. Method:A total of 97 patients with depression caused by chronic pain were randomly divided into control group （49 cases） and observation group （48 cases）. Patients in both groups received routine western medicine treatment，including necessary psychological intervention and taking paroxetine. Control groupobservation groupcontrol group Patients in control group were treated with Xiaoyaowan，and patients in observation group were treated with Chaihu Shugansan combined with abdominal acupuncture. Both groups were treated for 6 weeks. The levels of serum neurotransmitters，cytokines and Hamilton depression rating scale（HAMD） before and after treatment were compared between two groups<bold>.</bold> Result:There was no significant difference in HAMD scores of the two groups before treatment and the HAMD scores of two groups after treatment were significantly lower than those before treatment （<italic>P</italic><0.05），and the HAMD scores in observation group were significantly lower than those in the control group （<italic>P</italic><0.05）. There was no significant difference in the levels of serum 5-hydroxytryptamine （5-HT），norepinephrine （NE），and brain-derived neurotrophic factor （BDNF） between two groups before treatment. After treatment，the levels of serum 5-HT，NE，and BDNF in two groups were significantly higher than those before treatment （<italic>P</italic><0.05），and the levels in observation group were significantly higher than those in control group （<italic>P</italic><0.05）. There was no significant difference in the levels of serum interleukin-6 （IL-6），interleukin-1<italic>β</italic> （IL-1<italic>β</italic>） and tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>） before treatment. After treatment，the levels of serum IL-6，IL-1<italic>β</italic> and TNF-<italic>α</italic> were significantly lower than those before treatment （<italic>P</italic><0.05），and the levels in observation group were significantly lower than those in control group （<italic>P</italic><0.05）. Conclusion:On the basis of psychological intervention and paroxetine administration，the combination of Chaihu Shugansan and abdominal acupuncture exerts their respective advantages. It treats both symptoms and root causes of depression，relieves the degree of depression，reduces the classification of depression，and regulates the levels of neurotransmitter and cellular inflammatory factors，and inhibits inflammatory response. The clinical effect is significant.

Effect of Modified Chaihu Shugansan on Gallbladder Function and Inflammatory Cytokines Levels in Treatment of Chronic Cholecystitis Cholelithiasis / 中国实验方剂学杂志

Objective:To observe the clinical efficacy and influence of modified Chaihu Shugansan combined with ursodeoxycholic acid tablets on inflammatory factors in treatment of chronic cholecystitis cholelithiasis （stagnation of liver and gallbladder Qi）. Method:One hundred and ten patients were randomly divided into control group （60 cases） and observation group （60 cases）. Both groups received lifestyle intervention， and oral ursodeoxycholic acid tablets， 50 mg/time， taken in the morning and evening meals. Patients in control group additionally took Yidanshu capsules orally， 4 capsules/time， 3 times/day. Patients in observation group additionally took modified Chaihu Shugansan orally， 1 dose/day. The treatment courses continued 3 months in both groups. Before and after treatment， traditional Chinese medicine （TCM） symptom scores were graded， the ultrasound status of chronic gallbladder inflammation， gallbladder contraction function and stones was graded， the levels of interleukin-6 （IL-6）， IL-8， tumor necrosis factor-<italic>α</italic> （TNF-<italic>α</italic>） and nuclear transcription factor-<italic>κ</italic>B（NF-<italic>κ</italic>B）Were detected， and safety was evaluated. The efficacy for TCM syndromes， imaging efficacy and the efficacy for eliminating gallbladder stones were compared between the two groups. Result:The efficacy for TCM syndrome， efficacy on color ultrasound for chronic cholecystitis and the efficacy on imaging for cholelithiasis in the observation group were all better than those in the control group（<italic>Z</italic>=2.104<italic>，Z</italic>=2.076，<italic>Z</italic>=2.101，<italic>P</italic><0.05）. The thickness of gallbladder wall and volume of the gallbladder of the observation group were smaller than those of the control group （<italic>P</italic><0.01）， and gallbladder contraction function was higher than that in control group （<italic>P</italic><0.01）. Levels of IL-6， IL-8， TNF-<italic>α</italic> and NF-<italic>κ</italic>B in observation group were lower than those in control group （<italic>P</italic><0.01）. Conclusion:modified Chaihu Shugansan combined with ursodeoxycholic acid in the treatment of chronic cholecystitis and cholelithiasis （liver and gall Qi stagnation） is better than Yidanshu capsule combined with ursodeoxycholic acid sour scheme in terms of clinical efficacy， imaging efficacy， and elimination of gallbladder stones. It can reduce inflammation， and enhance gallbladder contraction， with high safety in clinical use.

Liver with Liver Stagnation and Spleen Deficiency Syndrome and Intestinal Microflora / 中国实验方剂学杂志

Objective:To study the clinical efficacy of Chaihu Shugansan on non-alcoholic fatty liver（NAFLD） patients with liver stagnation and spleen deficiency syndrome and its effect on intestinal flora. Method:The study was a single-center， randomized，single-blind， placebo-controlled clinical study involving 80 patients with NAFLD treated from January 2019 to January 2020 at our hospital. They were divided into two groups （Chaihu Shugansan group，<italic>n</italic>=40） and control group （placebo group，<italic>n</italic>=40）. The two groups of patients were given lifestyle intervention as the basic protocol. The treatment group was orally given Chaihu Shugansan，and the control group was orally given placebo. The drugs were given twice in the morning and evening， 1 dose/time. Patients were followed up for 12 weeks. Before and after treatment，the efficady on liver steatosis was observed by abdominal ultrasound and transient elastography （Fibroscan）， levels of alanine aminotransferase（ALT），aspartate aminotransferase（AST），glutamyl transpeptidase（<italic>γ</italic>-GT），high density lipoprotein cholesterol（HDL-C），low density lipoprotein cholesterol（LDL-C），total cholesterol（TC），triglyceride（TG），interleukin（IL）-6，IL-1<italic>β</italic>，Toll-like receptor-4（TLR-4） in peripheral blood mononuclear cells（PBMCs） and intestinal flora were also detected. Result:There were 37 patients in the treatment group and 35 patients in the control group who finally completed the study protocol. The total effective rate of NAFLD in the treatment group（81.08%，30/37） was higher than that in the control group （68.57%，24/35）（<italic>Z</italic>=2.67，<italic>P</italic><0.05）. The treatment group was superior to the control group in reducing the levels of BMI，ALT，AST，TC，LDL-C，TG，<italic>γ</italic>-GT and increasing the level of HDL-C（<italic>P</italic><0.05）. The levels of pro-inflammatory cytokines（TNF-<italic>α</italic>，IL-1<italic>β</italic> and IL-6），the values of Controlled Attenuation Parameter（CAP），Liver Stiffness Measurement（LSM） and expression of TLR4 were down-regulated in the treatment group （<italic>P</italic><0.01）. In addition，the treatment group showed increase in the abundance of beneficial bacteria （<italic>Bifidobacterium</italic> and <italic>Lactobacillus</italic>） and inhibited the abundance of pathogenic bacteria （<italic>Enterobacter </italic>and<italic> Enterococcus</italic>） in the gut（<italic>P</italic><0.01）. Conclusion:In addition to the lifestyle intervention，Chaihu Shugansan can improve lipid metabolism and liver function，regulate intestinal flora and inhibit the level of inflammatory factors in patients with NAFLD.

Clinical Efficacy of Modified Chaihu Shugansan Combined with Xuanfu Daizhetang on Depression of Patients of Patients with Gastroesophageal Reflux Disease / 中国实验方剂学杂志

Objective:To observe the clinical efficacy modified Chaihu Shugansan combined with Xuanfu Daizhetang on anxiety and depression of patients with gastroesophageal reflux disease （GERD） and Qi stagnation and phlegm obstruction syndromes in clinic and the effect on neuropeptide factor and pro-inflammatory factor. Method:Patients 200 cases were divided into control group and observation group. Patients in control group got omeprazole enteric-coated tablets， 20 mg/time， 1 time/day， flupentixol and melitracen tablets， 1 tablet/time， 2 times/day， and Dalitong granules， 1 bag/time， 3 times/day. In addition to omeprazole enteric-coated tablets in control group， patients in observation group were also added with syndrome differentiation-based treatment of modified Chaihu Shugansan combined with Xuanfu Daizhetang， 1 dose/day. The treatment lasted for 8 weeks. Before and after treatment， scores of acid regurgitation， heartburn， poststernal pain， syndrome of Qi stagnation and phlegm obstruction， gastroesophageal reflux disease questionnaire （GerdQ）， Hamilton anxiety Scale-14 （HAMA-14） and Hamilton depression scale-17 （HAMD-17） were scored； And upper gastrointestinal endoscopy， levels of peripheral vasoactive intestinal peptide （VIP）， 5-hydroxytryptamine （5-HT）， tumor necrosis factor-<italic>α </italic>（TNF-<italic>α</italic>）， interleukin-1 （IL-1）， IL-6 were detected. All the patients （GerdQ<8） got follow-up for 16 weeks， and the recurrence and safety were recorded. Result:After treatment， scores of GerdQ， endoscope， main symptoms and syndrome of Qi stagnation and phlegm obstruction on observation group were lower than those in control group （<italic>P</italic><0.01）， and scores of HAMA-14 and HAMD-17 decreased in both groups （<italic>P</italic><0.01）， but with no statistically significant difference in both groups. The comprehensive efficacy of main symptoms in observation group was better than that in control group （<italic>Z</italic>=2.076， <italic>P</italic><0.05）. The curative effect of traditional Chinese medicine （TCM） syndrome in observation group was superior to that in control group （<italic>Z</italic>=2.151， <italic>P</italic><0.01）. The effect of endoscope was better than that in control group （<italic>Z</italic>=2.103， <italic>P</italic><0.05）. And levels of VIP， 5-HT， TNF-<italic>α</italic>， IL-1 and IL-6 in observation group were lower than those in control group. During the 16-week follow-up， the recurrence rate in observation group was 19.23% （15/78）， which was lower than 35.38% （23/65） in control group （<inline-formula><alternatives><mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML" id="M2"><mml:msup><mml:mrow><mml:mi>χ</mml:mi></mml:mrow><mml:mrow><mml:mn mathvariant="normal">2</mml:mn></mml:mrow></mml:msup></mml:math><graphic specific-use="big" xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="alternativeImage/EF9122E2-D647-4d34-AB25-83CBA259DE55-M002.jpg"><?fx-imagestate width="3.30199981" height="3.64066648"?></graphic><graphic specific-use="small" xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="alternativeImage/EF9122E2-D647-4d34-AB25-83CBA259DE55-M002c.jpg"><?fx-imagestate width="3.30199981" height="3.64066648"?></graphic></alternatives></inline-formula>=4.741， <italic>P</italic><0.05）. The average recurrence time of the observation group was lower than that of the control group（<italic>P</italic><0.01）. Conclusion:Modified Chaihu Shugansan combined with Xuanfu Daizhetang can significantly improve the main symptoms and TCM syndromes， relieve depression， anxiety and other adverse emotions， promote the healing of gastroesophageal mucosa， reduce the recurrence rate and delay the recurrence time among patients with GERD and Qi stagnation and phlegm obstruction syndromes. The mechanism of action may be related to the expression of neuropeptide factor and the inhibition of pro-inflammatory factor.

Effect of Chaihu Shugansan on Mitochondrial Function and Mitophagy in Gastric Tissue of Rats with Functional Dyspepsia / 中国实验方剂学杂志

Objective:To observe the effects of Chaihu Shugansan on gastric motility and mitochondrial function and mitophagy in rats with functional dyspepsia （FD） and to preliminarily reveal its mechanism in preventing and treating FD. Method:Thirty-two SD rats of SPF grade were randomly divided into the normal group， model group， Chaihu Shugansan （4.8 g·kg^-1） group， and domperidone group （4.5 mg·kg^-1） after one week of adaptive feeding， with eight rats in each group. Rats in all groups except for the normal group were exposed to modified tail-clamping stimulation for inducing FD. Four weeks later， the semi-solid nutritive medium was used to observe the gastric emptying rate of FD rats， and the serum citrate synthase （CS）， motilin （MTL）， and gastrin （GAS） were detected by enzyme-linked immunosorbent assay （ELISA）. The pathological changes in gastric tissue were observed by hematoxylin-eosin （HE） staining， the mitochondrial characteristics by transmission electron microscopy， and the expression of microtubule-associated protein light chain 3 （LC3） and voltage-dependent anion-selective channel 1 （VDAC1） by immunofluorescence co-localization. The mitochondria were extracted from fresh gastric tissue for measuring the reactive oxygen species （ROS）， malondialdehyde （MDA）， and superoxide dismutase （SOD） levels using the biochemical kits. The mitochondrial LC3， yeast Atg6 homologous（Beclin1）， and p62 protein expression was assayed by Western blot. Result:Compared with the normal group， the model group exhibited significantly reduced gastric emptying rate （<italic>P</italic><0.01） and serum CS， MTL， and GAS levels （<italic>P</italic><0.01）. HE staining showed no pathological changes like erosion or ulcer in the gastric tissue of rats in each group. However， the mitochondria in the gastric tissue were observed swollen and dilated under the transmission electron microscope， and vacuolar lesions appeared. The co-expression of LC3 with VDAC1 increased significantly （<italic>P</italic><0.01）. The mitochondrial ROS and MDA levels were elevated significantly （<italic>P</italic><0.01）， while SOD content was significantly reduced （<italic>P</italic><0.01）. The protein expression levels of LC3 and Beclin1 were significantly up-regulated （<italic>P</italic><0.05， <italic>P</italic><0.01）， whereas p62 protein expression was down-regulated significantly （<italic>P</italic><0.01）. Compared with the model group， Chaihu Shugansan and domperidone elevated the gastric emptying rate （<italic>P</italic><0.05） and serum CS， MTL， and GAS levels （<italic>P</italic><0.05， <italic>P</italic><0.01）. It was observed under the transmission electron microscope that the mitochondrial nuclear membrane of the gastric tissue was intact， with clear structure and high density of mitochondrial cristae， and mitochondrial fission and fusion were observed in some parts. The co-localization area of LC3 and VDAC1 was significantly reduced （<italic>P</italic><0.01）. The mitochondrial ROS and MDA levels declined significantly （<italic>P</italic><0.05， <italic>P</italic><0.01）， whereas SOD level rose （<italic>P</italic><0.05）. The protein expression levels of LC3 and Beclin1 were significantly down-regulated （<italic>P</italic><0.05， <italic>P</italic><0.01）， while that of p62 was obviously up-regulated （<italic>P</italic><0.01）. Conclusion:The mechanism of Chaihu Shugansan in preventing and treating FD may be related to the improvement of mitochondrial function and the inhibition of mitophagy in gastric tissue.

Clinical Efficacy on Chaihu Shugansan Combined with Saccharomyces boulardii in Treatment of Functional Dyspepsia in Children / 中国实验方剂学杂志

Objective:To explore the clinical efficacy of Chaihu Shugansan combined with saccharomyces boulardii in treating functional dyspepsia (FD) in children and the effect on serum cytokines and gastrointestinal hormones expression. Method:Totally 120 cases were divided into control group (60 cases) and observation group (60 cases)．The control group was treated with Duopanlitong Pian 0.3 mg·kg-1, po， tid， and Saccharomyces boulardii 0.25 g，po，bid. The observation group was treated with Chaihu Shugansan, po，qd， and saccharomyces boulardii 0.25 g，po，bid. Four weeks was a course of treatment．The changes of serum Gastric Hunger Hormone and cytokines, Hamilton depression scale (HAMD) score, symptoms improvement time and clinical effect in the two groups were observed. And the recurrence rate was observed after 6 months follow-up. Result:The total effective rate was compared between control group (76.67%，46/60) and observation group (96.15%，57/60)，with significant differences (P<0.01). After treatment, serum tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in both groups were decreased, while serum levels of ghrelin of both group were increased. However，the decreasing range and the increasing range of observation group were statistically obvious than those of control group (P<0.01). HAMD score and disappearance time of clinical symptoms in observation group was significantly different from those in control group (P<0.01). In adverse reactions during treatment, the control group was inferior to the observation group (P<0.05). After the 6-month follow-up, the recurrence rate in observation group was lower than that in control group (P<0.01). Conclusion:Chaihu Shugansan combined with Saccharomyces boulardii was effective in treatment of FD in children, with a low recurrence rate and good compliance. The mechanism may be related to the effective regulation of brain-intestinal axis, balance of intestinal flora, inhibition of inflammatory reaction, regulation of cytokines and gastrointestinal hormone levels.

Mechanism of Chaihu Shugansan on Syndrome of Liver Stagnation / 中国实验方剂学杂志

Chaihu Shugansan is a representative prescription for soothing the liver and relieving depression in traditional Chinese medicine(TCM). Chaihu Shugansan is from Jingyue Quanshu.Chaihu Shugansan has been widely used in clinic since Ming dynasty because of its exact curative effect.Chaihu Shugansan has the effect in soothing the liver and relieving depression through multiple components, multiple ways and multiple targets.At present, the mechanism of Chaihu Shugansan has been interpreted based on its multiple effect on neurotransmitters, cytokines, neuronal injury signal pathways, neuroendocrine, oxidative stress and so on.This paper summarizes the progress of clinical studies on source, pharmacology of single herbs and effective components of Chaihu Shugansan, in aspects of cardiovascular system, neuropsychiatric system, digestive system, reproduction-related systems, analyses and summarizes relevant literatures of Chaihu Shugansan published in recent years, and discusses about current development and shortcomings of Chaihu Shugansan, so as to provide ideas for the studies in the future.Beneficial explorations will be conducted in large-sample-size, standardized, clinical and experimental mutual verification.In proteomics research technology, network pharmacology, supramolecular theory of TCM and other fields, Chaihu Shugansan and liver depression syndrome will be organically connected from the microscopic perspective.And comprehensive studies will be conduct to TCM, metabonomics, proteomics, genomics and other disciplines, in order to clarify Chaihu Shugansan prescriptions, syndromes, therapeutics and its mechanism.

Effect of Method of Relieving Depression and Resolving Phlegm on Expression of IRS-1 and IRS-2 in Liver Tissues of Rats with Polycystic Ovary Syndrome / 中国实验方剂学杂志

Objective::To observe the effect of Erchentang, Chaihu Shugansan, Erchentang+ Chaihu Shugansan and metformin on insulin receptor substrate-1(IRS-1)and insulin receptor substrate-2(IRS-2)mRNA and protein expression in liver tissues of model rats with polycystic ovary syndrome(PCOS), and to explore the biological mechanism of relieving depression and resolving phlegm to improve insulin resistance of polycystic ovary syndrome. Method::A model of polycystic ovary syndrome was replicated in rats by subcutaneous injection of dehydroepiandrosterone(DHEA) under the neck and back.The control group was the normal group, The model rats were divided into model group, Erchentang group(9.135 g·kg-1), Chaihu Shugansan group(6.615 g·kg-1), Erchentang+ Chaihu Shugansan group (Hefang group, 9.135 g·kg-1+ 6.615 g·kg-1), and metformin group(0.158 mg·kg-1). The corresponding drugs were given by intragastric administration once a day for 4 weeks. The ovarian and liver tissues of rats were isolated, and serum testosterone(T)and estradiol(E2)hormone levels in each group were detected by enzyme-linked immunosorbent assay(ELISA), the histopathological changes of ovary in each group were detected by hematoxylin-eosin (HE) staining, IRS-1 and IRS-2 mRNA and protein expression levels in rat liver tissues were detected by quantitative real-time fluorescence PCR(Real-time PCR)and Western blot. Result::Compared with normal group, the serum T and E2 level of model group were significantly decreased (P<0.01), the histology of ovary showed a large number of saccate dilated follicles, thin granular cell layer and rare corpus luteum, IRS-1, IRS-2 mRNA and protein levels in liver tissues decreased significantly (P<0.01). Compared with model group, the serum T and E2 level of each group significantly decreased (P<0.01), histopathology of ovarian tissue showed that the number of saccular dilated follicles decreased, and the granulosa cell layer thickened, showing follicles of all levels, IRS-1, IRS-2 mRNA and protein expression were significantly increased in Erchentang group(P<0.05, P<0.01), IRS-1 mRNA and protein expression were significantly increased in Chaihu Shugansan group(P<0.01), IRS-2 mRNA and protein expression were on the rise, IRS-1 mRNA and protein expression and IRS-2 mRNA expression were significantly increased in the Hefang group (P<0.05), while IRS-2 mRNA was on the rise, IRS-1 protein and IRS-2 mRNA and protein expression were significantly increased in metformin group (P<0.01), while IRS-1 mRNA showed an upward trend. Conclusion::Erchentang improved the insulin resistance of PCOS model rats more significantly than Chaihu Shugansan, and its mechanism may be related to IRS-1, IRS-2 mRNA and protein expression levels of key signaling molecules regulating insulin signal transduction pathway.

Clinical Observation of Addition and Subtraction Therapy of Taohong Siwutang Combined with Chaihu Shugansan to Unstable Angina Pectoris with Type A Behavior Pattern / 中国实验方剂学杂志

Objective: To observe the clinical efficacy of addition and subtraction therapy of Taohong Siwutang combined with Chaihu Shugansan to unstable angina pectoris with type A behavior pattern (Qi stagnation and blood stasis syndrome), and investigate its effects on proinflammatory factors and serotonin (5-HT). Method: One hundred twenty-four patients were randomly divided into control group (60 cases) and observation group(64 cases) by random number table. Patients in control group got Aspirin enteric-coated tablets, 100 mg/time, 1 time/day. Tigrillo tablets, 90 mg/time, 2 times/days. Metoprolol tartrate tablets, 50 mg/time, 2 times/days. Simvastatin tablets, 10 mg/time, 1 time/day. Nitroglycerin tablets, 0.5 mg/time. Based on the treatment in control group, patients in observation group also received addition and subtraction therapy of Taohong Siwutang combined with Chaihu Shugansan, 1 dose/day. The treatment course was 8 weeks in both groups. Number of attacks, duration, degree of pain and usage of nitroglycerin were recorded for every week. Before and after treatment, electrocardiogram was also recorded. And levels of triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α), hypersensitive C-reactive protein and 5-HT were detected. In addition, scores of Seattle Angina Scale (SAQ) and Qi stagnation and blood stasis syndrome were graded. Result: In the rank sum test, the curative effect in electrocardiogram of observation group was better than that of control group (Z=1.965, PPPPα and 5-HT in observation group were lower than those in control group (PPConclusion: On the basis of conventional western medicine, addition and subtraction therapy of Taohong Siwutang combined with Chaihu Shugansan can further control angina attack, relieve clinical symptoms, improve quality of life, regulate lipid metabolism, and can inhibit expression of proinflammatory factors and 5-HT, so it can play a role in stabilizing the disease.