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Posterior circulation ischemia vertigo (PCIV) is vertebrobasilar insufficiency resulting in vertigo. Banxia Baizhu Tianma Decoction (BBTD) is broadly applied to treat PCIV in China, but its efficacy and detailed mechanism remains unclear. Therefore, this study aims to investigate the effects of BBTD on PCIV, and identify important gut microbiota and its derived short-chain fatty acid (SCFA) changes and the detailed mechanism through 16â¯S rRNA sequencing with SCFAs profiling. In this study, the model of PCIV was established by surgical ligation of the right subclavian artery (RSCA) and right common carotid artery (RCCA). We found that BBTD administration effectively reduced the volume of cerebral infarction and improved neurologic functions, reduced neuronal apoptosis and neuroinflammatory. Moreover, BBTD significantly modulated the diversity and composition of the gut microbiota, including increasing the relative abundance of Lactobacillus, Prevotella and Akkermansia and decreasing relative abundances of Lachnospiraceae, Bacteroidetes (S24-7) and Ruminococcaceae. BBTD treatment also increased propionate content. Propionate mediates the the recovery of neurological functions and anti-apoptotic effects of BBTD in PCIV rat. Our findings wish to discover the potential mechanism of BBTD treatment on PCIV and promote its clinical application.
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Medicamentos de Ervas Chinesas , Ácidos Graxos Voláteis , Fezes , Microbioma Gastrointestinal , RNA Ribossômico 16S , Ratos Sprague-Dawley , Vertigem , Animais , Ratos , Microbioma Gastrointestinal/efeitos dos fármacos , Medicamentos de Ervas Chinesas/farmacologia , Medicamentos de Ervas Chinesas/uso terapêutico , Medicamentos de Ervas Chinesas/administração & dosagem , Masculino , RNA Ribossômico 16S/genética , Ácidos Graxos Voláteis/metabolismo , Fezes/microbiologia , Fezes/química , Vertigem/tratamento farmacológico , Modelos Animais de Doenças , Insuficiência Vertebrobasilar/tratamento farmacológico , Apoptose/efeitos dos fármacosRESUMO
ETHNOPHARMACOLOGICAL RELEVANCE: The occurrence and development of atherosclerosis, a common chronic inflammatory vascular disease, are closely related to cardiovascular and cerebrovascular diseases. Banxia Baizhu Tianma Decoction (BBTD) is a representative traditional Chinese medicine formula that resolves phlegm, disperses wind, invigorates the spleen and eliminates dampness and is also a commonly used clinical medication for treating vascular diseases. AIM OF THE STUDY: To explore the pharmacological mechanisms of BBTD in alleviating atherosclerosis, the present study was carried out by conducting an integrative analysis of aortic and perivascular adipose tissue (PVAT) proteomics and metabolomics. MATERIALS AND METHODS: Eight-week-old ApoE-/- mice were randomly divided into the BBTD group and the model group, and nine age-matched C57BL/6J (C57) mice were used as the control group (n = 9). The C57 mice were fed a standard diet, while the ApoE-/- mice were fed a high-fat, high-cholesterol diet for 12 weeks. Mice in the BBTD group were transgastrically administered BBTD at a dose of 17.8 g/kg/day for 8 weeks, while the model group and control group mice received an equivalent volume of saline by gavage. Histomorphology of the aortas and PVAT was assessed by HE staining, oil red O staining, Masson staining, and α-SMA and CD68 immunohistochemical methods. An integrative analysis of aortic proteomics, PVAT proteomics and PVAT metabolomics was conducted to study the pharmacological mechanisms of BBTD. RESULTS: Compared to the model group, mice treated with BBTD had thicker fibrous caps, increased collagen content, less erosion of smooth muscle cells and infiltration of macrophages, as well as a relatively low inflammatory response level, suggesting that BBTD treatment reduced plaque vulnerability. Omics analysis suggested that BBTD treatment demonstrated anti-atherosclerotic effects and increased plaque stability in the aorta by activating the TGF-beta pathway. Simultaneously, BBTD inhibited PVAT inflammation levels (decreased the levels of MCP and IL-6). Proteomics and metabolomics of PVAT suggested that the targets of BBTD included upregulation of the α-linolenic acid metabolic pathway and downregulation of multiple inflammatory pathways, such as the NF-kappa B signalling pathway, primary immunodeficiency and Th17 cell differentiation in PVAT. CONCLUSIONS: BBTD reduces the vulnerability of atherosclerotic plaques and inhibits the inflammatory phenotype of perivascular adipose tissue.
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Aterosclerose , Medicamentos de Ervas Chinesas , Placa Aterosclerótica , Camundongos , Animais , Camundongos Knockout para ApoE , Camundongos Endogâmicos C57BL , Aterosclerose/genética , Placa Aterosclerótica/tratamento farmacológico , Tecido Adiposo/metabolismo , Obesidade , Apolipoproteínas E/genéticaRESUMO
This study aimed to demonstrate the effect of Banxia Baizhu Tianma Decoction(BBTD) on realizing withdrawal of anti-epileptic drugs and explore the relationship between BBTD and the amino acid metabolism by transcriptomic analysis in the rat model of epilepsy induced by lithium chloride-pilocarpine. The rats with epilepsy were divided into a control group(Ctrl), an epilepsy group(Ep), a BBTD & antiepileptic drug integrative group(BADIG), and an antiepileptic drug withdrawal group(ADWG). The Ctrl and Ep were given ultrapure water by gavage for 12 weeks. The BADIG was given BBTD extract and carbamazepine solution by gavage for 12 weeks. The ADWG was given carbamazepine solution and BBTD extract by gavage for the former 6 weeks, and then only given BBTD extract for the latter 6 weeks. The therapeutic effect was evaluated by behavioral observation, electroencephalogram(EEG), and hippocampal neuronal morphological changes. High-throughput sequencing was used to obtain amino acid metabolism-related differen-tial genes in the hippocampus, and the mRNA expression in the hippocampus of each group was verified by real-time quantitative polymerase chain reaction(RT-qPCR). The hub genes were screened out through protein-protein interaction(PPI) network, and Gene Ontology(GO) functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analysis were performed. Two ceRNA networks, namely circRNA-miRNA-mRNA and lncRNA-miRNA-mRNA, were constructed for ADWG vs BADIG. The experimental results showed that compared with those in Ep, rats in ADWG were significantly improved in the behavioral observation, EEG, and hippocampal neuronal impairment. Thirty-four amino acid metabolism-related differential genes were obtained by transcriptomic analysis, and the sequencing results were confirmed by RT-qPCR. Eight hub genes were obtained through PPI network, involving several biological processes, molecular functions, and signal pathways related to amino acid metabolism. Finally, the circRNA-miRNA-mRNA ternary transcription network of 17 circRNA, 5 miRNA, and 2 mRNA, and a lncRNA-miRNA-mRNA ternary network of 10 lncRNA, 5 miRNA, and 2 mRNA were constructed in ADWG vs BADIG. In conclusion, BBTD can effectively achieve the withdrawal of antiepileptic drugs, which may be related to the transcriptomic regulation of amino acid metabolism.
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MicroRNAs , RNA Longo não Codificante , Ratos , Animais , RNA Circular/genética , Transcriptoma , RNA Longo não Codificante/genética , Anticonvulsivantes , MicroRNAs/genética , RNA Mensageiro , Carbamazepina , Aminoácidos , Redes Reguladoras de GenesRESUMO
The alterations of serum biological endogenous chemicals in rats with phlegm dampness accumulation syndrome of prehypertension (PHT) were interfered by Banxia Baizhu Tianma decoction (BBT), and the metabolic regulatory pathway of BBT was clarified using serum metabonomics analysis. To replicate the rat model of prehypertension phlegm dampness syndrome, blood pressure, behavioral markers, and serum biochemical markers of rats were collected. BBT's effectiveness in controlling blood pressure and blood lipids was assessed, and changes in endogenous small molecules in rat serum were determined using UPLC-Q-Orbitrap MS metabolic analysis. The results showed that BBT could regulate 9 metabolites, including arachidonic acid, cholic acid, glycodeoxycholic acid, N-adenosyltyrosine, arginine, lysophosphatidylethanolamine (20:0/0:00), lysophospholipid (P-18:0), lysophospholipid (18:0), lysophospholipid (22:5(7Z,10Z,13Z,16Z,19Z)). MetaboAnalyst was used to analyze the metabolic pathway. There were 7 metabolic pathways closely related to the change of blood pressure in rats, among which arachidonic acid metabolic pathway was the most critical. The metabolism difference foreign body in the model rats tends to return to the normal level, which provides a research basis for the mechanism of BBT from the perspective of metabonomics. This study was approved by the Experimental Animal Welfare Ethics Review Committee of Shandong University of Traditional Chinese Medicine (approval number: SDUTCM20211103001).
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This study aimed to demonstrate the effect of Banxia Baizhu Tianma Decoction(BBTD) on realizing withdrawal of anti-epileptic drugs and explore the relationship between BBTD and the amino acid metabolism by transcriptomic analysis in the rat model of epilepsy induced by lithium chloride-pilocarpine. The rats with epilepsy were divided into a control group(Ctrl), an epilepsy group(Ep), a BBTD & antiepileptic drug integrative group(BADIG), and an antiepileptic drug withdrawal group(ADWG). The Ctrl and Ep were given ultrapure water by gavage for 12 weeks. The BADIG was given BBTD extract and carbamazepine solution by gavage for 12 weeks. The ADWG was given carbamazepine solution and BBTD extract by gavage for the former 6 weeks, and then only given BBTD extract for the latter 6 weeks. The therapeutic effect was evaluated by behavioral observation, electroencephalogram(EEG), and hippocampal neuronal morphological changes. High-throughput sequencing was used to obtain amino acid metabolism-related differen-tial genes in the hippocampus, and the mRNA expression in the hippocampus of each group was verified by real-time quantitative polymerase chain reaction(RT-qPCR). The hub genes were screened out through protein-protein interaction(PPI) network, and Gene Ontology(GO) functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analysis were performed. Two ceRNA networks, namely circRNA-miRNA-mRNA and lncRNA-miRNA-mRNA, were constructed for ADWG vs BADIG. The experimental results showed that compared with those in Ep, rats in ADWG were significantly improved in the behavioral observation, EEG, and hippocampal neuronal impairment. Thirty-four amino acid metabolism-related differential genes were obtained by transcriptomic analysis, and the sequencing results were confirmed by RT-qPCR. Eight hub genes were obtained through PPI network, involving several biological processes, molecular functions, and signal pathways related to amino acid metabolism. Finally, the circRNA-miRNA-mRNA ternary transcription network of 17 circRNA, 5 miRNA, and 2 mRNA, and a lncRNA-miRNA-mRNA ternary network of 10 lncRNA, 5 miRNA, and 2 mRNA were constructed in ADWG vs BADIG. In conclusion, BBTD can effectively achieve the withdrawal of antiepileptic drugs, which may be related to the transcriptomic regulation of amino acid metabolism.
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Ratos , Animais , RNA Circular/genética , Transcriptoma , RNA Longo não Codificante/genética , Anticonvulsivantes , MicroRNAs/genética , RNA Mensageiro , Carbamazepina , Aminoácidos , Redes Reguladoras de GenesRESUMO
Hypertension is a major cardiovascular risk factor, which seriously affects the quality of life of patients. Banxia Baizhu Tianma Decoction (BXD) is a Chinese herbal formula that is widely used to treat hypertension in China. This study aimed to evaluate the efficacy and potential mechanism of BXD for hypertension by meta-analysis and network pharmacology. Meta-analysis was performed to explore the efficacy and safety of BXD combined with conventional treatment for hypertension. Network pharmacology was used to explore the molecular mechanism of BXD in antihypertension. A total of 23 studies involving 2,041 patients were included. Meta-analysis indicated that compared with conventional treatment, combined BXD treatment was beneficial to improve clinical efficacy rate, blood pressure, blood lipids, homocysteine, endothelial function, inflammation, and traditional Chinese medicine symptom score. In addition, meta-analysis indicated that BXD is safe and has no obvious adverse reactions. Network pharmacology showed that the antihypertensive targets of BXD may be AKT1, NOS3, ACE, and PPARG. The antihypertensive active ingredients of BXD may be naringenin, poricoic acid C, eburicoic acid, and licochalcone B. Due to the poor methodological quality of the Chinese studies and the small sample size of most, the analysis of this study may have been affected by bias. Therefore, the efficacy and safety of BXD for hypertension still need to be further verified by high-quality clinical studies. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42022353666.
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Banxia Baizhu Tianma decoction (BBTD), a six-herb Chinese medicine formula first described approximately 1732 AD, is commonly prescribed for Hypertension with Phlegm-dampness Stagnation (HPDS) as an adjuvant therapy in China. Obesity is an important risk factor for the increasing prevalence of hypertension year by year in China. In Traditional Chinese medicine, obesity is often differentiated as the syndrome of excessive phlegm-dampness.Vascular endothelial cell injury plays an important role in the development and occurrence of HPDS. In this study, the protective effects of 18 batches of BBTD samples from different origins on HUVEC cells were evaluated, including antioxidant and anti-inflammatory activities. Ultrahigh performance liquid chromatography (UPLC) was used to establish fingerprints, and combined with pharmacodynamic indexes, the protective components of BBTD on endothelial cells were analyzed. Antioxidant and anti-inflammatory activities were evaluated by ROS and Hs-CRP models, respectively. Hierarchical cluster analysis (HCA) and Bivariate correlation analysis (BCA) were used to investigate the potential correlation between chemical components and endothelial cell protection. The results indicated that BBTD could reduce ROS and hs-CRP levels in HUVEC cells, and the pharmacological activities in 18 batches of BBTD samples were significantly different. The results of BCA indicated that Gastrodin, Liquiritin, Hesperidin, Isoliquiritin, Hesperetin, and Isoliquiritigenin might be the active constituents to activate ROS and suppress hs-CRP as determined by spectrum-effect relationships. The antioxidant and anti-inflammatory activities of the 6 components at different concentration were verified, and the results showed that all of them had good antioxidant and anti-inflammatory activities in a concentration-dependent manner. This study showed that activity determination and spectral correlation can be used to search for active substances in Chinese medicine formula and provide data support for quality control of Traditional Chinese medicine (TCM).
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ETHNOPHARMACOLOGICAL RELEVANCE: Banxia Baizhu Tianma decoction (BBTD) is a classical representative prescription for expelling phlegm, extinguishing wind, strengthening the spleen and dissipating excessive fluid in traditional Chinese medicine (TCM). According to both TCM theory and about 300 years of clinical practice, BBTD is especially suitable for hypertensive patients of abdominal obesity and lacking physical activity. AIM OF THE STUDY: The present study tried to interpret the pharmacology of the ancient formula of BBTD. Herein, we focused on the plasma metabonomics of BBTD and evaluated the effect and targets of BBTD on endothelial protective effect. METHODS: Obesity-related hypertensive mice were induced by high-fat diet for 20 weeks. BBTD (17.8 g/kg) was administered intragastrically for 8 weeks, and telmisartan group (12.5 mg/kg) was used as positive drug. Body weight, blood pressure, triglyceride and cholesterol were recorded to evaluate the efficacy of BBTD in vivo. Lipid deposition in aortic roots was assessed by oil red O staining, while morphology of aortas was observed by HE staining. Ultra performance liquid chromatography/tandem mass spectrometry (UPLC-MS/MS) was performed to study the plasma non-targeted metabonomics. According to the data of metabonomics, human aortic endothelial cells (HAECs) were treated by oxidized low-density lipoprotein (ox-LDL, 50 µg/mL) with/without BBTD (2, 1 or 0.5 mg/mL). Apoptosis rate (Annexin V-FITC/PI), migration (Transwell), cytoskeleton (Phalloidin) and density of VE-cadherin (Immunofluorescence staining) were used to investigate the effect of BBTD in vitro. Transcriptome sequencing was performed (2 mg/mL BBTD vs ox-LDL) to screen the possible targets of BBTD in endothelial protection against ox-LDL. RESULTS: BBTD effectively reduced the body weight and total cholesterol, and decreased 12.1 mmHg in SBP and 10.5 mmHg in DBP of obesity-related hypertensive mice (P < 0.05). BBTD attenuated lipid deposition in arterial roots and improved the morphology of aortas in vivo. Plasma metabolite profiles identified 94 differential metabolites and suggested BBTD mainly affected glycerophospholipids and fatty acyls. Bioinformatics analysis indicated sphingolipid metabolism and fluid shear stress and atherosclerosis were main pathways. Therefore, we focused on endothelial protective effect of BBTD against ox-LDL. In vitro, BBTD demonstrated endothelial protective effects, decreasing apoptosis rate, improving cell migration in dose-dependent manner and maintaining cell morphology. Transcriptome sequencing identified 251 downregulated and 603 upregulated mRNAs after 24h-BBTD treatment, which reversed 51.8% change in mRNAs (393 DE mRNAs) induced by ox-LDL. Bioinformatics analysis supported the potential of BBTD in hypertension and suggested that BBTD improved endothelial cells by targeting mainly on p53 and PPAR signaling pathways. CONCLUSIONS: BBTD attenuates obesity-related hypertension by regulating metabolism of glycerophospholipids and endothelial protection.
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Medicamentos de Ervas Chinesas/farmacologia , Hipertensão/tratamento farmacológico , Metabolômica , Obesidade/prevenção & controle , Animais , Aorta/citologia , Aorta/efeitos dos fármacos , Apoptose/efeitos dos fármacos , Células Cultivadas , Dieta Hiperlipídica , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Medicamentos de Ervas Chinesas/administração & dosagem , Células Endoteliais/efeitos dos fármacos , Células Endoteliais/metabolismo , Humanos , Hipertensão/complicações , Hipertensão/metabolismo , Lipoproteínas LDL/administração & dosagem , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Obesidade/etiologia , Obesidade/metabolismoRESUMO
Objective: The extraction process optimization method of chemometrics combined with information entropy weight was established and applied to the water extraction process optimization of Banxia Baizhu Tianma Decoction (BBTD), in order to fully ensure the effectiveness and quality consistency of classical prescription. Methods: Taking BBTD as the model drug, the fingerprint was established by HPLC method. The common peak area was analyzed by principal component analysis (PCA), the total factor score of PCA, the similarity of fingerprint and the yield of dry paste were used as evaluation indexes. L9(34) orthogonal design was used to investigate the effects of adding water, soaking time and boiling time on the extraction effect, and the Objective: weight of each index was determined by information entropy weighting method. The technological parameters of water extraction were optimized. Results: Twenty-six common peaks and seven compounds were identified by the similarity evaluation system of chromatographic fingerprints of traditional Chinese medicine. According to the results of comprehensive score, the optimum extraction process of the preparation was determined to be 12 times the amount of water, decoction twice, 1 hour each time. The average comprehensive score of the three batches of verification was 0.418 0 with RSD of 3.32%. Conclusion: The optimized process has high extraction rate, good stability and repeatability, and is suitable for the industrial production of BBTD.
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Banxia-Baizhu-Tianma decoction (BBTD) is a compound formulae of traditional Chinese medicine (TCM), which has been clinically used for treatments of neural vertigo, hypertension and epilepsy with a long history. In this study, with an ultra-fast liquid chromatography coupled with quadrupole time of flight mass spectrometry (UFLC-Q-TOF-MS) method, a total of 88 components in BBTD were identified by the accurate masses and fragmentation pathways including 19 flavonoids, 8 lactones, 12 triterpenoids, 10 phenolics, 14 amino acids, 13 nucleobases and nucleosides, 7 organic acids, and 5 other compounds. In addition, under the same chromatographic conditions, we developed an ultra-fast liquid chromatography coupled with quadrupole linear ion trap mass spectrometry (UFLC-Q-TRAP-MS) method to simultaneously quantify 20 bioactive components in multiple-reaction monitoring (MRM) mode. The assay method was validated in terms of linearity, precision, repeatability, recovery and was successfully applied for determination of 12 batches of BBTD. We hope that this study work would help to reveal the chemical profiling and provide a valuable and reliable approach for quality evaluation and even efficacy material basis study of BBTD.
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Cromatografia Líquida de Alta Pressão , Medicamentos de Ervas Chinesas/farmacologia , Espectrometria de Massas em Tandem , Aminoácidos/análise , Flavonoides/análise , Lactonas/análise , Nucleosídeos/análise , Nucleotídeos/análise , Fenol/análise , Reprodutibilidade dos Testes , Triterpenos/análiseRESUMO
Objective: To identify the quality markers (Q-marker) for Baizhu Tianma Decoction from different batches based on multivariate statistical analysis. Methods: The fingerprint data of 18 batches of Banxia Baizhu Tianma Decoction were processed by the Similarity Evaluation System of Chromatographic Fingerprints of Traditional Chinese Medicine (2012A Edition). SPSS 20.0 was used for cluster analysis and principal component analysis (PCA). According to PCA results, cluster analysis was carried out to screen out the markers that might affect the quality difference of Banxia Baizhu Tianma Decoction and determine its content in the samples. Results: A total of 12 chromatographic peaks were selected as common peaks of fingerprint, and the similarity of 18 batches of samples was greater than 0.900, which indicated that each batch had good consistency. Eighteen batches of samples were clustered into three groups by cluster analysis. Five marker peaks were screened out from PCA results. Two of them were identified as gastrodin and naringin. The five marker peaks were further clustered and the results were basically the same as before. There was a certain correlation between the comprehensive score of principal components and the determination results of gastrodin and naringin in 18 batches of samples. Conclusion: Through multivariate statistical analysis, the Q-markers that may affect the difference of Banxia Baizhu Tianma Decoction were better identified, which can lay the foundation for the comprehensive quality control of Banxia Baizhu Tianma Decoction and its compound preparations, and provide reference for the further study of the correlation between the different components and pharmacodynamics of Banxia Baizhu Tianma Decoction.
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Objective To lay the foundation for studying the possible pathogenesis of epilepsy and the anti-epileptic mechanism of Banxia Baizhu Tianma Decoction through the bioinformatic analysis of target gene prediction and signal pathway of miRNA-146a-5p in hippocampus of epileptic rats. Methods Lithium-pilocarpine was used to induce seizures in rat models. The experiment rats were randomly divided into normal control group, model group, Banxia Baizhu Tianma Decoction group, with 20 rats in each group. The method of miRNA expression profiling was used to observe the miRNA differential expression of hippocampus neuron cell of rats. The expression level of miRNA-146a-5p was detected by real-time quantitative PCR. MiRDB was used for target gene prediction of miRNA-146a-5p, and miRTarBase and DAVID were used for enrichment analysis on the GO function and KEGG signaling pathway. Results The attack times and grades of the rats in Banxia Baizhu Tianma Decoction group were significantly lower than those in the model group from behavioral observation. MiRNA microarray analysis showed that the expression level of miRNA-146a-5p in model group was 2.107 times normal control group (P<0.05), and the expression level decreased to 1.377 times after treatment with Banxia Baizhu Tianma Decoction (P<0.05). The results of RT-PCR was consistent with that of miRNA microarray, with statistical significance (P<0.05). MiRNA-146a-5p target gene prediction results had 140 target genes by GO, and there were 14 annotation information of biological process (P<0.05), 9 annotation information of cellular component (P<0.05), 11 annotation information of molecular function (P<0.05). Enrichment analysis of KEGG biological pathway showed that 140 target genes of miRNA-146a-5p were enriched in EB virus infection signal pathway and thyroid hormone signaling pathway (P<0.05). Conclusion miRNA-146a-5p is closely related to the inflammatory reaction after epilepsy, and Banxia Baizhu Tianma Decoction can control epilepsy possibly by controlling the inflammatory reaction after epilepsy.
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OBJECTIVES: Banxia Baizhu Tianma Decoction (BBTD) is widely used to treat vertebrobasilar insufficiency vertigo (VBIV) in China, but its efficacy remains largely unexplored. We systemically summarized relevant evidence from randomized controlled trials (RCTs) to assess the therapeutic effect of BBTD. METHODS: Seven electronic databases were searched for relevant electronic studies published before July 2016. We evaluated RCTs that compared BBTD, anti-vertigo drugs and a combination of BBTD and anti-vertigo drugs. We performed a meta-analysis in accordance with the Cochrane Collaboration criteria. The outcomes were clinical efficacy (CE), blood flow velocity of the vertebrobasilar artery by transcranial Doppler (TCD), and adverse effects. RESULTS: Twenty-seven studies with a total of 2796 patients were identified. Compared with anti-vertigo drugs, BBTD showed slight effects on CE (n=350; RR, 1.09; 95% CI, 1.01-1.18; p=0.03; I2=0%); however, BBTD plus anti-vertigo drugs (BPAD) significantly improved the clinical efficacy (n=2446; RR, 1.20; 95% CI, 1.16-1.24; p<0.00001; I2=0%) and accelerated the blood flow velocity of the left vertebral artery (LVA) (n=1444; WMD, 5.21cm/s; 95% CI, 3.72-6.70cm/s; p<0.00001; I2=91%), the blood flow velocity of the right vertebral artery (RVA) (n=1444; WMD, 5.45cm/s; 95% CI, 4.02-6.88cm/s; p<0.00001; I2=89%), and the blood flow velocity of the basilar artery (BA) (n=1872; WMD, 5.20cm/s; 95% CI, 3.86-6.54cm/s; p<0.00001; I2=90%). Adverse effects were mentioned in six studies. CONCLUSIONS: The current evidence indicates that BPAD is effective for the treatment of VBIV, but the efficacy and safety of BBTD is uncertain because of the limited number of trials and low methodological quality. Hence, high-quality and adequately powered RCTs are warranted.
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Medicamentos de Ervas Chinesas/uso terapêutico , Insuficiência Vertebrobasilar/tratamento farmacológico , Vertigem/tratamento farmacológico , Medicamentos de Ervas Chinesas/efeitos adversos , Humanos , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Objective To decompose and reformulate Banxia Baizhu Tianma Decoction (BBT) in order to optimize its ratio for vasodilatory effect. The fingerprints of these six component herbs were also studied via Tri-step FTIR analysis. Methods The herbal components of BBT were extracted separately with different solvents, such as 95% ethanol, 50% ethanol, and distilled water. The vasodilatory effect of the extracts was studied using the in vitro pre-contracted aortic ring model. Among these extracts, the water extracts of Pinellia ternata [PT(W)] and Citri reticulatae [CR(W)], 50% ethanol extracts of Gastrodia elata [GE(50)] and Glycyrrhiza uralensis [GU(50)], and 95% ethanol extracts of Atractylodes macrocephala [AM(E)], and Poria cocos [PC(E)] were selected for the orthogonal stimulus-response compatibility group study due to their high effectiveness in vasodilation. Results The best combination ratio (G2) was GE(50), GU(50), AM(E), PC(E), CR(W), and PT(W) at EC0, EC5, EC5, EC5, EC5, and EC5, with EC50 of (0.06 ± 0.01) mg/mL. Comparison between the vasodilatory effects of extracts derived from G2 and BBT were also studied. From the results, the 50% ethanol extract following G2 ratio was found to be most potent extract with the highest vasodilatory effect compared with other extracts derived from G2 or BBT, with EC50 of (0.05 ± 0.005) mg/mL. Conclusion The optimum ratio and appropriate extraction method for the new BBT formulae are obtained. G2 is determined as the best formulae with the highest potency in producing the vasodilatory effect on isolated rat aortic rings. The results obtained suggest that 50% ethanol is found to be the best solvent to extract the vasoactive compounds of G2 in order to exhibit the highest efficacy of vasodilatory effect.
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Objective To investigate therapeutic effect of the Banxia-Baizhu-Tianma decoction combined with simvastatin for phlegm and blood stasis obstructing hyperlipidemia. Methods A total of 120 patients with phlegm and blood stasis obstructing hyperlipidemia from Dalian central hospital from June 2010 to December 2013 were divided into 2 groups according to random digits table:60 patients in a control group treated with simvastatin 20 mg/d,and 60 patients in a treatment group treated with Banxia-Baizhu-Tianma decoction on the basis of the control group. After 6 weeks treatments, the clinical efficacy, serum levels of total cholesterol(TC), triglyceride(TG), high density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), high sensitive C reactive protein(hs-CRP),high mobility group protein B1(HMGB1), alanine aminotransferase(ALT), γ-glutamyl transpeptidase(γ-GT), interleukin 8(IL-8)and superoxide dismutase(SOD) were evaluated in both groups. Results The total effective rate was 91.7%(55/60) and 73.3%(44/60) in the treatment group and the control group, respectively, with significant difference (χ2=5.772, P<0.05). After treatment, the serum levels of TC, TG, HDL-C, hs-CRP, HMGB1 in both groups were significantly lower than those before the treatment (in the treatment group t value were 12.355, 5.984, 32.825, 13.806, 14.661 and in the control group t value were 7.553, 2.177, 3.064, 10.281, 9.019, P<0.05 or P<0.01), LDL-C concentration significantly increased (t in the treatment group=3.382, P<0.01;t in the control group =2.388, P<0.05). After the treatment, the serum levels of TC, TG, HDL-C, hs-CRP, and HMGB1 in the treatment group were lower than those in the control group (t value were 7.173, 3.418, 2.377, 3.967, 8.352, P<0.05 or P<0.01);there was no significant difference in LDL-C concentration between the two groups (t=1.630, P=0.106);the levels of ALT, GT, IL-8 and SOD in the treatment group showed significant difference compared with those before the the treatment (t value were 19.053, 9.592, 12.909, 10.377, P<0.01), while in the control group, exceptγ-GT, other parameters showed significant difference after the treatment compared with before the treatment (t value were 2.253, 5.876, 3.266, P<0.05). Compared with the control group, these parameters in the treatment group were significantly different after the treatment(t value were 27.872, 10.244, 6.954, 6.145, P<0.01). Conclusions Banxia-Baizhu-Tianma decoction combined with simvastatin has good lipid-lowering effect. It may significantly lower inflammatory factor levels, reduce inflammation, and enhance antioxidant capacity.
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Objective Comparing the serum fingerprint of four kinds of extract solution from Banxia Baizhu Tianma Decoction.Methods Taking rabbits as experiment animals,collecting blood,and separating serum after drenching semi-bionic enzyme extracting(SBEE) solution.HPLC was used to detect the fingerprints of medicated serum at different blood-collecting time in order to optimize the best blood collecting time,then the serum fingerprints of four kinds of solution collected were compared.Results HPLC showed that when blood collecting time was 2 h,the number and total area of chromatographic peak had the maximum value;SBEE Solution had the the maximum number and total area of chromatographic peak in the four kinds of solution at the best blood collecting time.Conclusion The component content in SBEE medicated serum is higher than that by other method.