Clinical application and mechanism research progress of Wuling Powder in the treatment of brain edema / 国际中医中药杂志

Brain edema belongs to the category of "stroke" and "true headache", while Traditional Chinese Medicine mostly understands its core disease mechanisms from the perspectives of stasis, deficiency, and heat, and mostly treats the disease by using warming yang to induce diuresis and eliminating stasis to remove water. Wuling Powder has been lauded as the "first party to typhoid and relieving diuresis", which is used to cure clearing damp and promoting diuresis and warming yang and transforming qi, and has been clinically used in the treatment of brain edema caused by various causes such as head trauma, intracerebral hemorrhage, cerebral infarction, and intracranial space occupying, all with remarkable efficacy. Wuling Powder improves cellular energy supply, scavenges excess oxygen radicals and calcium ions in brain tissue, and reduces the damage to brain tissue caused by vascular inflammatory factors and regulates aquaporins and vascular endothelial growth factor, thereby achieving therapeutic effects.

Wu Ling San' protective effect on blood retinal barrier in diabetic rats / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the therapeutic effects and mechanisms of Wu Ling San on retinopathy in diabetic rats.<p>METHODS: The rats with hyperglycemia were divided into five groups: model group, Wu Ling San high dose group, low dose group, positive control group and normal groups each group of ten. After oral administration for 12wk, the expression of ICAM-1 and CRP in the serum of rats were measured by ELISA. After HE staining, retinal structure was observed under the light microscope. Blood retinal vascular barrier permeability was measured by Evans blue. The vascular endothelial growth factor(VEGF)expression of retinal tissue were observed by immunohistochemistry<p>RESULTS: Compared with the normal group, the expression of CRP, ICAM-1 and the EB content in diabetic group were increased. The contents of CRP and ICAM-1 and EB permeability in Wu Ling San high dose group were lower than low dose group and positive control group(all <i>P</i><0.05). There are retinal ganglion cell layer disorder, retinal edema, and positive VEGF immunohistochemistry expression in the diabetic group. Wu Ling San high dose group can improve retinal structure and reduce retinal edema. <p>CONCLUSION: Wu Ling San can effectively reduce the expression of inflammatory cytokine, VEGF and retina edema in diabetic retinopathy rats, and also can improve the retinal microvascular in order to protect diabetic retinopathy.

A clinical study of Mahuang-Fuzi-Xixin decoction and Wuling powder combined with routine western medicine therapy for chronic renal disease stage 3 / 国际中医中药杂志

Objective To evaluate the efficacy of Mahuang-Fuzi-Xixin decoction and Wuling powder combined with routine western medicine therapy for chronic kidney disease (CKD) stage 3.Methods A total of 65 patients with CKD stage 3 were recruited and randomized into a treatment group (32 cases) and a control group (33 cases).On the basis of the same routine western medicine therapy,the patients in the treatment group was treated with Mahuang-Fuzi-Xixin decoction and Wuling powder,while those in the control group was treated with ketosteril.All patients were treated for one month.Renal function was evaluated by serum creatinine,urea nitrogen and uric acid before and after treatment.The therapeutic effect was compared between the two group.Results The serum ereatinine after treatment in the treatment group was significantly decreased than that in the control group (387.52 ± 92.13 mol/L vs.502.78 ± 117.35 mol/L;t=4.395,P＜0.01).The total effective rate in the treatment group was significantly higher than that in the control group (87.5％ vs.42.4％;X2=12.533,P＜0.01).In respects of syndrome improvements,tiredness/weakness (90.6％ vs.48.5％,x2=11.637),waist soreness/leg weakness (90.0％ vs.35.5％;x2=17.040,P＜0.01),anorexia and tympanites (93.3％ vs.37.9％;x2=17.802,P＜0.01),loose stool (93.1％ vs.25.8％;x2=25.219,P＜0.01),anasarca (84.6％ vs.41.7％;x2=8.214,P＜0.01),pale and teeth-printed tongue (76.7％ vs.26.7％;x2=13.081,P＜0.01) in the treatment group were significantly better than those in the control group.Conclusions Mahuang-Fuzi-Xixin decoction and Wuling powder combined with routine western medicine therapy can improve the renal function and syndromes in patients with CKD stage 3.

Wu-Ling-San formula prophylaxis against recurrent calcium oxalate nephrolithiasis - a prospective randomized controlled trial.

Wu-Ling-San (WLS) formula has been proved to prevent calcium oxalate nephrolithiasis both in vitro and in vivo. This is the first prospective, randomized and placebo-controlled clinical trial of WLS in calcium oxalate nephrolithiasis prevention. All patients who enrolled were asked to drink enough fluid to urinate at least 2 L daily during the study period. A 24-hour urine collection was performed to establish the baseline levels of multiple urinary parameters before taking the medicine. The patients were randomized and divided into two groups. The medication group took 2 gm WLS formula three times daily for 1 month. The control group took 2 gm placebo three times daily for 1 month. A 24-hour urine collection was performed to evaluate multiple urinary and serum parameters from all patients during the study period. A total of 39 patients were enrolled and 28 patients completed the study. Fourteen patients were allocated to WLS group and 14 patients to placebo group. After treatment, the mean urine output level increased to 2796.4 ± 525.7 ml/day (percentage of change, 13.9 %) in the WLS formula group. With placebo therapy, the mean decreased slightly to 2521.4 ± 762.7ml/day (percentage of change, -5.7 %). The percentage of change was significantly different between the two groups (independent t-test, P=0.02). No patient complained of side effects, such as fatigue, dizziness, musculoskeletal symptoms, or gastrointestinal disturbance. WLS formula is a promising adjunct to surgical and medical management of kidney stones. Active therapy with WLS formula has a positive effect on diuresis without leading to electrolyte imbalance.

The selected traditional chinese medicinal formulas for treating diabetic nephropathy: perspective of modern science.

With the increasing patients and limited therapeutic options, diabetic nephropathy (DN) is a long-term complication of diabetic mellitus. The precise mechanism of DN is not yet fully understood and the effective blockade of the progression of nephropathy remains a therapeutic challenge. Application of traditional Chinese medicine (TCM) for diabetes and its related complications has received increasing attention due to its wide availability, low side effects, and proven therapeutic mechanisms and benefits. In the current review, we mainly focus on the recent laboratory studies of the TCM formulas including Wu-Ling-San (Poria Five Powder; Wǔ Líng Sǎn), Danggui-Buxue-Tang (Tangkuei and Astragalus Decoction; Dang Gui Bǔ Xuè Tang), and Danggui-Shaoyao-San (Tangkuei and Paeonia Formula; Dang Gui Sháo Yào Sǎn), conducted by the Committee on Chinese Medicine and Pharmacy at the Department of Health of Taiwan Government, in the amelioration of DN. These selected TCM formulas have anti-diabetic properties, with antihyperglycemic activity accompanied by amelioration of advanced glycation end product-mediated renal damage in streptozotocin-induced diabetic rats. However, the renoprotective effects of the selected TCM formulas did not correlate with suppressing renal renin-angiotensin system hyperactivity in diabetic rats. These TCM formulas also have the capacity to ameliorate the defective antioxidative defense system, leading to modulation of the oxidative stress, thereby resulting in downregulation of nuclear factor-kB as well as transforming growth factor-ß1 and, consequently, attenuation of extracellular matrix components such as fibronectin or type IV collagen expression in diabetic renal cortex tissue. More detailed mechanistic researches and long-term clinical evaluations, as well as evaluation of safety of the selected TCM formulas are needed for their future applications in DN therapy.

Anti-diabetic effect of Wen-pi-tang-Hab-Wu-ling-san extract in streptozotocin-induced diabetic rats.

OBJECTIVES: Wen-pi-tang-Hab-Wu-ling-san (WHW) is an oriental herbal prescription formulated using 14 herbs and has been used to cure chronic renal failure in Korean oriental medicine. In this study, we investigated the anti-diabetic effect of WHW in the streptozotocin-induced diabetic rats. MATERIALS AND METHODS: Diabetes was induced by streptozotocin (STZ, 60 mg/kg, i.p.) in rats. WHW extract (100 mg/kg) was orally dosed once a day for four weeks. The results were compared with standard antidiabetic drug, glibenclamide (3 mg/kg, p.o). RESULTS: Significant decrease in body weight and insulin levels and increase in blood glucose, triglycerides, urea nitrogen (BUN), and creatinine were detected in STZ-induced diabetic rats with disruption and disappearance of pancreatic and kidney cells and decrease in insulin producing beta cells. However, these diabetic changes were significantly inhibited by treatment with WHW extract. In the oral glucose tolerance test, the extract produced a significant decrease in glycemia 60 minutes after the glucose pulse. CONCLUSIONS: Based on these results, we suggest that WHW extract has favorable effects in protecting the STZ-induced hyperglycemia, renal damage, and beta-cell damage in rats.

Differences between the Effects of Sho-saiko-to, Gorei-san and Toki-shakuyaku-san on the Sphincter of Oddi. An intraoperative cholangiomanometric study / 日本東洋医学雑誌

Female patients suffering from gallbladder stone disease were administered Sho-saiko-to (Xiao-Chai-Hu-Tang), Gorei-san (Wu-Ling-San) or Toki-shakuyaku-san (Dang-Gui-Shao-Yao-San) preoperatively, and were examined by cholangiomanometry during operation. Perfusion pressure was significantly elevated, when Sho-saiko-to or Gorei-san were administered, meaning that the pressure threshold of the sphincter of Oddi for volume load in the bile duct was lowered. This phenomenon tended to be more obvious in Gorei-san group, and will prevent duodenal fluid from transpapillary reflux. Parameters concerning the declining curve (T_1/2, T_1/4, T_1/5) showed a significantly rapid relaxation of the sphincter of Oddi only in Sho-saiko-to group, which will result in a prevention of stasis of bile. These modulating functions of Sho-saiko-to and Gorei-san for the sphincter of Oddi would be one of the main reasons why these formulas are used for hypochondriac fullness and distress or excessively accumulated intestinal fluid. Toki-shakuyaku-san showed no such effects on the sphincter of Oddi.