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ObjectiveTo explore the therapeutic mechanism of Bushen Huoxue prescription from the perspective of bone metabolism by observing the clinical efficacy of this prescription in treating femoral head necrosis （ONFH， syndrome of liver and kidney deficiency） and its influences on bone metabolism indexes： N-terminal propeptide （PINP） and β-collagen degradation product （β-CTX）. MethodSixty-six ONFH patients with the syndrome of liver and kidney deficiency in Zhengzhou Traditional Chinese Medicine Hospital of Orthopedics from December 2021 to September 2022 were selected. The patients were randomized into an experimental group and a control group by the parallel control method， with 33 patients in each group. The experimental group received Bushen Huoxue prescription orally， while the control group received Xianlinggubao Capsules orally， with a treatment cycle of 6 months. The visual analogue scale （VAS） score， Harris score， Association Research Circulation Osseous （ARCO） staging， imaging changes， quantitative scores of TCM symptoms， and serum levels of PINP and β-CTX were determined before and after treatment. The occurrence of adverse events and reactions was recorded. ResultThe total response rate in the experimental group was 83.87% （26/31）， which was higher than that （68.75%， 22/32） in the control group （Z=-2.096， P<0.05）. After treatment， the single and total scores of TCM symptoms， VAS score， and β-CTX level decreased in the two groups （P<0.05）. Moreover， the decreases in the scores of hip pain， lower limb mobility， soreness of waist and knees， and lower limb flaccidity， total score of TCM symptoms， VAS score， and β-CTX level in the experimental were larger than those in the control group （P<0.05）. After treatment， the imaging results showed no significant improvement in the two groups. The Harris score and PINP level in both groups increased after treatment （P<0.05）， and the increases were more obvious in the experimental group than in the control group （P<0.05）. No serious adverse event or adverse reaction appeared during the observation period. ConclusionBushen Huoxue prescription can relieve pain and TCM symptoms and improve the hip joint function in treating ONFH patients with the syndrome of liver and kidney deficiency. It can inhibit the development of ONFH， increase PINP， and decrease β-CTX. No obvious side effect appears during the clinical observation period， which shows that Bushen Huoxue prescription has good safety.
ABSTRACT
The etiology and pathogenesis of patients with hypertension are lower deficiency and upper excess. The deficiency below the etiology comes first, and then leads to upper excess. Lower deficiency is manifested by the yin deficiency of liver and kidney. The clinical symptoms are lumbar and knee weakness, or low back pain, or lower limb weakness, or systemic fatigue, or dry throat. In fact, it is mostly manifested as excess of liver yang, manifesting Qi inversion symptoms of high blood pressure, dizziness, dry throat, or bitter mouth, or headache, or tinnitus and deafness, or palpitations, or chest pain, or gastroesophageal reflux, or heartburn acid reflux, which are also named like hyperactivity of liver yang, liver yang heat, liver defencing spleen, or spleen deficiency leading to phlegm. Deficiency of liver and kidney leads to yin failing to restrain yang, resulting in hyperactivity of liver yang, spleen deficiency generating phlegm, and phlegm blocking orifices. Hypertension is due to deficiency of liver and kidney, and its sign is hyperactivity of liver yang. Therefore, lower deficiency and upper excess process and guides the treatment and prevention of hypertension. In the treatment, with the principle of lower deficiency and upper excess, we can nourish liver and kidney Yin to defence liver Yang for hypertension.
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ObjectiveTo observe the clinical efficacy of Gandou Fumu granules （GDFM） in the treatment of Wilson disease （WD） with liver-kidney deficiency and phlegm-blood stasis. MethodNinety WD patients in The First Affiliated Hospital of Anhui University of Chinese Medicine were randomly divided into a control group （45 cases） and a treatment group （45 cases）. All patients were treated with sodium 2，3-dimercaptopropane-1-sulfonate （DMPS）， while those in the treatment group received additional GDFM. All patients were treated for four courses （32 days）. The traditional Chinese medicine （TCM） syndrome scores，clinical effective rate，24 h urinary copper，ceruloplasmin （CER），tumor necrosis factor-α（TNF-α），interleukin-1β（IL-1β），interleukin-6 （IL-6），superoxide dismutase （SOD），glutathione peroxidase （GSH-Px） and malondialdehyde （MDA） levels of the two groups before and after treatment were observed. ResultAfter treatment， the TCM syndrome scores of the two groups decreased （P<0.01），and the score of TCM syndrome in the treatment group was lower than that of the control group （P<0.01）. The total effective rate of the treatment group was 82.22% （37/45）， higher than 57.78% （26/45） of the control group （χ2=6.402，P<0.05）. There was no significant difference in CER before and after treatment in both groups. The post-treatment 24 hour urinary copper increased （P<0.01）， which was higher in the treatment group than that in the control group （P<0.05）. The TNF-α，IL-1β， and IL-6 levels were significantly reduced in both groups after treatment（P<0.01），and the above indicators in the treatment group were significantly lower than those in the control group （P<0.01）. After treatment，the SOD level increased and the MDA level decreased in the control group （P<0.01）， while no significant difference in GSH-Px level was observed. The SOD and GSH-Px levels increased and the MDA level decreased in the treatment group （P<0.01）. After treatment， SOD and GSH-Px levels of the treatment group were higher than those in the control group， while the MDA level was lower than that in the control group（P<0.05，P<0.01）. ConclusionGDFM can improve the TCM syndrome score and clinical efficacy，enhance the copper removing effect，and inhibit the inflammatory response and antioxidative stress in the treatment of WD with liver and kidney deficiency and phlegm-blood stasis.
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Objective To evaluate the clinical efficacy ofDuhuo Jisheng Decoction in treating liver and kidney deficiency syndrome of knee osteoarthritis (KOA) by ultrasound.Methods A total of 120 cases of KOA patients with liver and kidney deficiency syndrome were randomly divided into two groups (each contains 60 cases). Control group took hydrochloric acid glucosamine capsules, while treatment group tookDuhuo Jisheng Decoction additionally for 8 weeks. ESR, CRP, WOMAC, joint swelling scores, and TCM syndrome scores of the two groups were determined, and the sonographic characteristics of knee-joint effusion in patellar fabricius, synovial membrane, cartilage and bone erosions were compared before and after treatment.Results There were significant differences in ESR, CRP, WOMAC, joint swelling scores, and TCM syndrome scores between before and after treatment in both groups (P<0.05,P<0.01). The knee-joint synovial membrane got thinner after therapy in osteoarthritis patients, and the effusion in knee-joint also decreased. The vessel flow signals in knee-joint synovial membrane of osteoarthritis decreased after drug therapy (P<0.05,P<0.01).ConclusionDuhuo Jisheng Decoction can improve clinical efficacy of KOA with liver and kidney deficiency syndrome. Ultrasound can clearly observe the changes of effusion in patellar fabricius, and synovial membrane, and can provide good imaging assessment for the drug therapy for KOA patients.
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Objective To evaluate the therapeutic effect of Xifeng Dingchan Pill (Pill for stopping wind and tremor) on Parkinson's disease (PD).Methods Sixty PD patients were randomized into a treatment and a control group. The treatment group (30 cases) was given madopar and Xifeng Dingchan Pill and the control group (30 cases) was administered madopar only. The effect Xifeng Dingchan Pill was evaluated according to the changes of Webster score and PD symptom factor score.Results The total effective rate of the treatment group was 76.67%, higher than 53.33% in the control group (P