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Study of osteoporosis treatment principles used historically by ancient physicians in Chinese Medicine

ObjectiveTo review the herbal drugs most often used throughout history for the treatment of osteoporosis; to study their property, flavor and meridian attribution; and to explore their compatibility.MethodsThe “Chinese Medical Classics” (upgrade) CD-ROM was used to retrieve historical prescriptions for the treatment of osteoporosis, and these were collected and sorted. Property, flavor and meridian attribution were determined, and the rules of herbal administration were determined by cluster analysis.ResultsA total of 389 prescriptions were found, involving 238 herbal drugs, with a total frequency of appearance of 4,236. Commonly used medications were Radix Achyranthis Bidentatae, Radix Rehmanniae praeparata, Cortex Cinnamomi, Cortex Eucommiae, Poria, Herba Cistanches, Radix Aconiti lateralis and Radix Angelicae sinensis. The herbs used included five kinds of properties, appearing a total of 2,499 times; the two most common ones were warm and plain. There were seven different drug flavors, occurring 4,151 times; sweet and bitter were the two most common ones. Eight meridian attributions were identified, appearing a total of 6,374 times; Kidney (Shen)-meridian and Liver (Gan)-meridian were the two most common ones. The most common functional categories were yang-tonifying medicinal and blood-tonifying medicinal, and together these accounted for 37.8% of the total. The twenty-eight most commonly used herbal drugs formed 3 prescription clusters: C1: Cortex Eucommiae, Poria, Radix Achyranthis Bidentatae; C2: Cortex Eucommiae, Poria, Radix Achyranthis Bidentatae, Cortex Cinnamomi, Radix Rehmanniae praeparata, Herba Cistanches, Radix Angelicae sinensis, Radix Aconiti lateralis, Semen Cuscutae; C3: Os Tigris, Rhizoma Atractylodes Alba, Radix Moromdae Officinalis, Radix Angelicae pubescentis, Radix Paeoniae Alba, Herba Dendrobii, Rhizoma Alismatis, Fructus Corni, Radix Saposhnikoviae.ConclusionsDeficiency is the primary pathogenetic factor in osteoporosis, along with “stagnation” and lack of flow of water or blood. Clinical treatment of osteoporosis should be based on Kidney, Liver and Spleen (Pi) supplementation, and complemented by diuresis and dissolution of stasis, while paying attention to adjustment of the spirit.

Inflammatory responses of the rat lungs in cold-dryness syndrome in the northwest of China.

OBJECTIVE To examine changes in body weight and the lung inflammation factors interleukin-1beta (IL-1beta), interleukin-8 (IL-8), IL-10 and tumor necrosis factor-alpha (TNF-alpha) in a rat model of cold-dryness syndrome in Northwest (Xinjiang) China to provide a reference for treating chronic obstructive pulmonary disease (COPD) with local peculiarities. METHODS The rat COPD model was established by intratracheal instillation of porcine pancreatic elastase (PPE) in combination with cigarette smoking (CS). The rat model of cold-dryness syndrome of COPD in the northwest of China was set up by intratracheal instillation of PPE in combination with CS and environmental cold-dryness stress. The level of IL-1beta, IL-8, IL-10 and TNF-alpha in bronchoalveolar lavage fluid (BALF) were measured by enzyme-linked immunosorbent assay (ELISA). The data were analyzed using the software SPSS 11.5. RESULTS (1) Body weight was less in the two model groups than that of control group (P < 0.01), PPE plus CS cold-dryness group was less than that of PPE plus CS group (P < 0.01). (2) IL-1beta in BALF significantly increased in PPE plus CS and cold-dryness group than that of control group (P < 0.01). (3) IL-8 and TNF-alpha in BALF significantly increased in PPE plus CS and cold-dryness group and PPE plus CS group than that of control group (P < 0.01). CONCLUSION Body weight in COPD model rats was reduced compared with controls. Cold-dryness may aggravate such a condition lung inflammation in the model was mainly manifested by an increase in IL-1beta, IL-8 and TNF-alpha levels, with no change in IL-10 levels. Cold-dryness may aggravate lung inflammation of COPD.

Effect of cold-dryness on pulmonary and immunologic function in chronic obstructive pulmonary disease model rats.

OBJECTIVE To study the effects of cold-dryness on pulmonary and immunologic function of peripheral T-lymphocytes in chronic obstructive pulmonary disease (COPD) model rats, and to provide references for the prevention and treatment of cold-dryness COPD in the Xinjiang region. METHODS The COPD model was established with an elastase drip into the trachea combined with smoking. The cold-dryness COPD model was developed by stressing with a cold-dry environment. Success of the model was determined by observation of pathologic lung sections. Rats were sacrificed by exsanguination from the femoral artery and changes of peripheral blood CD4+, CD8+, and CD4+/CD8+ were detected by flow cytometry. Data were analyzed with SAS 11.5 statistical software. RESULTS On the ninetieth day after ending the experiment, Peak expiratory flow in the cold-dryness COPD group was lower than that in the COPD and normal control groups (P < 0.01). The time of inspiration in the cold-dryness COPD group was higher than that in the COPD and normal groups (P < 0.05). Time of expiration (Te) in the cold-dryness COPD group was higher than that in the COPD and normal groups (P < 0.01). 50% tidal volume expiratory flow (EF50) in the cold-dryness COPD group was lower than that in the COPD and normal groups (P < 0.01), and EF50 in the COPD group was lower than that in the normal group (P < 0.05). CD4+ content of peripheral blood in the cold-dryness COPD group was lower than that in the COPD and the normal groups (P < 0.05). CD8+ content in the cold-dryness COPD and COPD groups was higher than that in the normal control group (P < 0.01), and CD8+ content in the cold-dryness COPD group was higher than that in the COPD group (P < 0.01). CD4+/CD8+ in the cold-dryness COPD group and the COPD group was lower than that in the normal control group (P < 0.01), and CD4+/CD8+ in the cold-dryness COPD group was lower than that in the COPD group (P < 0.05). CONCLUSION In the cold-dryness COPD model, CD8+ increased and CD4+/CD8+ decreased. Moreover, cold-dryness may aggravate this state. The effects of cold-dryness on pulmonary function mainly manifested as prolongation of Te and decrease of EF50, which could be one of causes of cold-dryness environment in the northwest of China leading to COPD with region characteristics.

Effect of point application on chronic obstructive pulmonary disease in stationary phase and effects on pulmonary function: A systematic evaluation of randomized controlled trials

OBJECTIVE To evaluate clinical efficacy of point application or adjuvant therapy on chronic obstructive pulmonary disease in stationary phase and effects on pulmonary functions. METHODS Computer retrieved CNKI, VIP, CBM and other databanks and manual operations retrieved correlative literatures to find randomized controlled trials (RCTs) about comparison between point application or adjuvant therapy and no-point-applications for treatment of chronic obstructive pulmonary disease in stationary phase in China. RevMan 5.0 software was used for Meta analysis. RESULTS Among 3481 cases in the inclusive 32 RCTS, 1780 cases were in the test group and 1701 cases in the control group. Meta analysis indicated: 1) clinical efficacy: the groups containing point application therapy all were better than the groups of no-point-application; 2) force vital capacity (FVC): There was no statistically significant difference between the group of point application plus Western Medicine and the Western Medicine group; 3) force expiratory volume 1 (FEV1): The groups containing point application therapy were better than the no-point-application; 4) FEV1%: the groups of point application plus Western Medicine were better than the Western Medicine groups; 5) FEV1/FVC: there was a significant difference between the group of point application plus Chinese drugs and the group of Chinese drug. CONCLUSION Point application can increase clinical efficacy of chronic obstructive pulmonary disease in stationary phase in varying degrees, and different combinations of point application with Chinese drugs or Western Medicines have incomplete same actions in improvement of pulmonary function and therapeutic effect.

Functional changes of airway epithelial cells and mitochondria in rat models of asthenic lung and phlegm blocking combined with cough variant asthma

The aim of this study was to investigated the functional changes of airway epithelial cells and mitochondria in rat models of asthenic lung and phlegm blocking combined with cough variant asthma (CVA). Sixteen Sprague-Dawley rats were randomly divided into two groups: Control and model group, with 8 rats in each group. On the basis of the CVA rat model induced and sensitized by ovalbumin and aluminum hydroxide, the rat models with asthenic lung and phlegm blocking combined with CVA were established via smoking stimulation. The rats in the control group were injected with equivalent normal saline. All rats were sacrificed after the model was successfully prepared. The lung histopathological sections of the two groups of rats were observed, and respiratory control ratio (RCR) of mitochondria and membrane potential changes were compared. The results showed that the rats in the model group had tracheal structure abnormities, epithelial cell damages, cilia structure defects, capillary injection, alveolar exudates, and inflammatory cells compared to those in the control group. RCR of mitochondria and membrane potential of rats in the model group were significantly lower than those of rats in the control group (P<0.05). Damaged lung tissue and decreased mitochondrial activity and membrane potential are detected in the rat models of asthenic lung and phlegm blocking combined with CVA.

Effects of Modified Zhisou Powder on Airway Mucus Production in Chronic Obstructive Pulmonary Disease Model Rats with Cold-Dryness Syndrome

Objective. In China, the Chinese medicine formula modified zhisou powder (MZP) is commonly used to treat COPD with cold-dryness syndrome (CDSCOPD) to relieve cough and sputum. However, the underlying mechanisms of MZP on treating CDSCOPD remain to be elucidated. Methods. COPD and CDSCOPD rat models were established; MZP was given to CDSCOPD rats in the last 7 days of the 97-day model establishment. Then the rats were subjected to lung function measurement. Pathological changes in lungs were observed through paraffin section and H&E staining. The mRNA and protein levels of AQP1, 4, and 5 and Muc5AC and Muc5B in lung were determined by quantitative RT-PCR and western blotting. NE levels was determined by ELISA. Results. The impaired lung functions were observed in rats exposed to cigarette smoke. Among all parameters evaluating lung functions, only tidal volume demonstrates a further decrease in CDSCOPD when compared with COPD, indicating further impaired pulmonary ventilation functions upon cold-dryness stimulation. The intervention of MZP effectively improved lung functions parameters, prevented the inflammations, and eliminated the increases of AQP4 and 5 and the decrease of Muc5AC in lung. Conclusion. MZP probably improves pulmonary functions in CDSCOPD through inhibiting lung inflammation, increasing expressions of AQPs, and decreasing Muc5AC expression in lung.

Effect of Abnormal Savda Munziq, a Traditional Uighur Herbal Medicine, on Pulmonary Function and Aquaporins of COPD Rat Model with Abnormal Savda Syndrome

Objective To investigate the effect of abnormal savda munziq (ASM) on the pulmonary function and expression of lung-specific aquaporins in the rat model of chronic obstructive pulmonary disease with abnormal savda syndrome (ASSCOPD). Methods Eighty male rats were randomized into ASSCOPD, COPD, and control groups. ASSCOPD was further categorized into ASM and non-ASM groups. COPD model was established by combining fumigation with airway instillation of elastase; ASSCOPD model was developed based on COPD by induction with dry cold diet, cold dry environment, and plantar electric stimulation. ASM was administered twice daily. The pulmonary function was evaluated based on respiration. The mRNA and protein levels of AQPs were estimated by real-time PCR and Western blot, respectively. Results MV, TV, the mRNA level of AQP5, and the protein expression of AQP1, AQP4, and AQP5 were increased in ASMCOPD compared to ASSCOPD. Conclusion The pulmonary function was impaired in ASSCOPD group; the expression of AQP1, AQP4, and AQP5 was decreased at protein and mRNA levels in ASSCOPD group. ASM can improve the pulmonary function in ASSCOPD for MV and TV. ASM could elevate the protein expression of AQP1, AQP4, and AQP5 and the mRNA level of AQP5 in lung tissue.

A Randomized Controlled Study of the Yi Qi Gu Biao Pill in the Treatment of Frequent Exacerbator Phenotype in Chronic Obstructive Pulmonary Disease (Lung and Spleen Qi Deficiency Syndrome)

Objective To evaluate the efficacy and safety of Yi Qi Gu Biao (YQGB) pill in treating frequent exacerbator phenotype in chronic obstructive pulmonary disease (lung and spleen qi deficiency syndrome) (FEPCOPD). Methods This prospective, randomized, double-blind, controlled study assessed 112 cases (64 included) of FEPCOPD treated at the outpatient department in our hospital in January–August 2016. The patients were randomly divided into YQGB and placebo (Pb) and treated for three months. Lung function, CAT, mMRC, and TCM symptom scores (TCMs) were observed. Results Compared with Pb, YQGB showed decreased wheezing symptom scores (WSs) and TCMs at one month and decreased CAT and TCMs at three months. From one to three months, CAT, cough, sputum, WSs, and TCMs in YQGB were lower than pretreatment values. But in Pb, CAT was lower than pretreatment values after one month; CAT, sputum, and TCMs were lower than pretreatment values after two months; CAT, cough, sputum, WSs, and TCMs were lower than pretreatment values after three months. Conclusion Yi Qi Gu Biao pill can improve wheezing, health status, and TCMs in FEPCOPD and also can shorten the durations of cough, sputum, and wheezing. This trial is registered in the Clinical Trials Registry of China: ChiCTR-IOR-15007542 (on 8 December 2015).

Expression of airway mucus-associated proteins in rats with chronic obstructive pulmonary disease with a cold-dryness symptom pattern

OBJECTIVE To reveal the effects on expression of airway mucus-associated proteins in rats with chronic obstructive pulmonary disease (COPD) and a cold-dryness symptom pattern induced by elastase and smoking. METHODS The COPD model was established with an elastase dose into the trachea combined with exposure to smoking; the COPD model cold-dryness symptom pattern was further developed by exposure to a cold, dry environment. After 90 days, pathologic lung sections, inflammatory cytokine levels (measured by enzyme linked immunosorbent assay), mRNA and protein expression of mucus-associated proteins and aquaporins (measured by real-time polymerase chain reaction and western blots) were examined. RESULTS Cytokines interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor-α (TNF-α) in the COPD and the cold-dryness symptom pattern COPD groups were all significantly higher than in controls (each P < 0.01). IL-6 and IL-8 levels were higher in the cold-dryness symptom pattern COPD group than in the COPD group (each P < 0.05). The AQP5 mRNA expression in the cold-dryness symptom pattern COPD and COPD groups was lower than in the control group (P < 0.01), and that in the cold-dryness symptom pattern COPD group was lower than the COPD group (P < 0.05). The expression of MUC5AC and MUC5B mRNAs in the cold-dryness symptom pattern COPD group and COPD group was higher than in the control group (each P < 0.01), and that in the cold-dryness symptom pattern COPD group was higher than the COPD group (P < 0.01, and P < 0.05, respectively). The ratio of MUC5AC mRNA/MUC5B mRNA was COPD group < the cold-dryness symptom pattern COPD group < the control group. AQP4 and AQP5 protein expression in the cold-dryness symptom pattern COPD group was lower than that in the COPD group which was lower again than in the control group. MUC5AC and MUC5B expression in the cold-dryness symptom pattern COPD group was higher than in the COPD group and higher again than in the control group. CONCLUSION Cold-dryness affects the expression of mucus-associated protein mRNA and its corresponding proteins, reducing the secretion of aquaporins and increasing the secretion of mucins. Imbalance in aquaporins and mucins can affect the function of mucus, increasing airway obstruction.