Antioxidant properties of proanthocyanidins of Uncaria tomentosa bark decoction: a mechanism for anti-inflammatory activity

Decoctions prepared from the bark of Uncaria tomentosa (cat's claw) are widely used in the traditional Peruvian medicine for the treatment of several diseases, in particular as a potent anti-inflammatory agent. Therefore, the main purpose of this study was to determine if the well-known anti-inflammatory activity of cat's claw decoction was related with its reactivity with the oxidant species generated in the inflammatory process and to establish a relationship between such antioxidant ability and its phenolic composition. We observed that the decoction prepared according to the traditional Peruvian medicine presented a potent radical scavenger activity, as suggested by its high capacity to reduce the free radical diphenylpicrylhydrazyl, and by its reaction with superoxide anion, peroxyl and hydroxyl radicals as well as with the oxidant species, hydrogen peroxide and hypochlorous acid. It also protected membrane lipids against peroxidation induced by the iron/ascorbate system, as evaluated by the formation of thiobarbituric acid-reactive substances (TBARs). The decoction phenolic profile was established by chromatographic analysis (HPLC/DAD and TLC) revealing essentially the presence of proanthocyanidins (oligomeric procyanidins) and phenolic acids, mainly caffeic acid. Thus, our results provide evidence for an antioxidant mechanism underlying the anti-inflammatory activity of cat's claw and support some of the biological effects of proanthocyanidins, more exactly its antioxidant and radical scavenging activities.     

桂枝芍药知母汤联合甲氨蝶呤对类风湿性关节炎患者中医证候评分、血清炎性因子及免疫球蛋白的影响

摘要 目的：探讨桂枝芍药知母汤联合甲氨蝶呤对类风湿性关节炎（RA）患者血清炎性因子、中医证候评分及免疫球蛋白的影响。方法：选取2018年1月~2019年10月期间我院接收的RA患者136例。根据随机数字表法分为对照组（n=68）和研究组（n=68）。对照组给予甲氨蝶呤治疗，研究组在对照组基础上联合桂枝芍药知母汤治疗。比较两组患者的疗效、中医证候评分、血清炎性因子[肿瘤坏死因子-α（TNF-α）、白介素-17（IL-17）、白介素-1β（IL-1β）]水平、风湿四项检查指标[类风湿因子（RF）、C反应蛋白（CRP）、抗链球菌溶血素"O"(ASO)、血沉（ESR）]水平及免疫球蛋白[免疫球蛋白A（IgA）、免疫球蛋白G（IgG）、免疫球蛋白M（IgM）]水平。结果：研究组治疗2个月后的临床总有效率91.18%（62/68）高于对照组的77.94%（53/68）（P<0.05）。两组治疗2个月后关节肿胀程度、关节屈伸不利程度、畏恶风寒、晨僵证候评分均下降，且研究组低于对照组（P<0.05）。两组治疗2个月后血清TNF-α、IL-1β、IL-17水平均下降，且研究组低于对照组（P<0.05）。两组治疗2个月后IgA、IgM、IgG水平均下降，且研究组低于对照组（P<0.05）。两组治疗2个月后RF、ESR、CRP、ASO水平均下降，且研究组低于对照组（P<0.05）。结论：RA患者在甲氨蝶呤的基础上联合桂枝芍药知母汤治疗，可有效降低患者血清炎性因子、风湿四项检查指标、免疫球蛋白水平，改善患者临床症状，疗效显著。     

Shufeng Jiedu,a promising herbal therapy for moderate COVID-19:Antiviral and anti-inflammatory properties,pathways of bioactive compounds,and a clinical real-world pragmatic study

BackgroundShufeng Jiedu capsules (SFJDC), a patented herbal drug composed of eight medicinal plants, is used for the treatment of different viral respiratory tract infectious diseases. Based on its antiviral, anti-inflammatory and immunoregulatory activity in acute lung injury, SFJDC might be a promising candidate for the treatment of COVID-19.PurposeTo evaluate the antiviral and anti-inflammatory properties and to discover the mechanism of action of SFJDC as a potential drug for the treatment of COVID-19. Furthermore, the study should determine the clinical effectiveness of SFJDC for the treatment of COVID-19.DesignWe analyzed the antiviral and anti-inflammatory effects of SFJDC in a HCoV-229E mouse model on lung index, virus load in the lung, the release of cytokines, and on T- and B-lymphocytes. The mechanism of action was further investigated by network analysis. Additionally, we investigated data from a clinical pragmatic real-world study for patients with confirmed COVID-19, to evaluate the clinical effect of SFJDC and to determine the best time to start the treatment.ResultsSFJDC significantly reduced the virus load in the lung of HCoV-229E mice (from 1109.29 ± 696.75 to 0 ± 0 copies/ml), decreased inflammatory factors IL-6, IL-10, TNF-α, and IFN-γ in the lung, and increased the amount of CD4⁺ and CD8⁺ cells in the blood compared to the model group. Network analysis revealed that SFJDC reduces the activity of NFκB via several signaling pathways. Quercetin, wogonin, and polydatin bind directly to the main protease (M^pro) of SARS-CoV-2.Clinical data showed that SFJDC, added to standard antiviral therapy (AVD), significantly reduced the clinical recovery time of COVID-19 and fatigue (from 3.55 ± 4.09 to 1.19 ± 2.28 days) as well as cough (from 5.67 ± 5.64 to 3.47 ± 3.75) days compared to AVD alone. SFJDC therapy was significantly more effective when used within the first 8 days after the onset of symptoms.ConclusionSFJDC might be a promising drug for the treatment of COVID-19, but large-scale randomized, double-blinded, placebo-controlled clinical trials are needed to complement the real-world evidence. It might be beneficial to start SFJDC treatment as early as possible in suspected cases of COVID-19.     

五子参药汤治疗COPD稳定期肺脾两虚、痰浊内蕴证的临床观察

目的:本文旨在推广高才达主任医师治疗慢性阻塞性肺病稳定期的临床经验,以及观察五子参药汤治疗慢性阻塞性肺疾病稳定期属肺脾两虚、痰浊内蕴症的临床疗效。方法:随机选取我院慢性阻塞性肺疾病(稳定期)患者90例分为对照组(n=45)和治疗组(n=45),对照组吸入沙美特罗替卡松粉气雾剂进行治疗,治疗组在对照组基础上加服五子参药汤,两组疗程均为12 w。对比两组治疗前后临床症状、肺功能、慢阻肺患者自我评估测试(CAT量表)、改良版英国医学研究委员会呼吸问卷(m MRC)量表及治疗后6个月内因COPD急性加重的再次住院次数。结果:治疗组的有效率优于对照组(91.11%vs 82.45%,P<0.05);治疗后,两组第1秒用力呼气容积(FEV1)、FEV1占预计值百分比(FEV1%)和FEV1/FVC较治疗前均有增加,且治疗组高于对照组(P<0.05);两组m MRC量表、CAT量表评分较治疗前均有下降,且治疗组低于对照组(P<0.05)。结论:五子参药汤可有效治疗肺脾两虚、痰浊内蕴型稳定期慢性阻塞性肺疾病,值得临床推广。     

补阳还五汤联合强力定眩片对后循环缺血性眩晕患者眩晕症状、氧化应激及血流指标的影响

目的:探讨补阳还五汤联合强力定眩片对后循环缺血(PCI)性眩晕患者眩晕症状、氧化应激及血流指标的影响。方法:选取中国中医科学院西苑医院于2018年12月~2019年12月间接收的80例PCI性眩晕患者,采用信封法将患者随机分为对照组(n=40,常规西医治疗)和研究组(n=40,常规西医基础上增加补阳还五汤联合强力定眩片治疗),比较两组患者临床疗效、眩晕症状、氧化应激及血流指标,记录两组治疗期间不良反应发生情况。结果:治疗2个疗程后,研究组的总有效率高于对照组(P<0.05)。两组患者治疗2个疗程后眩晕障碍量表(DHI)评分、超氧化物歧化酶(SOD)、一氧化氮(NO)水平、椎动脉平均血流速度、基底动脉平均血流速度均升高,且研究组高于对照组(P<0.05);两组丙二醛(MDA)水平、全血黏度、血浆黏度、红细胞压积均降低,且研究组低于对照组(P<0.05)。两组不良反应发生率比较无差异(P>0.05)。结论:补阳还五汤联合强力定眩片治疗PCI性眩晕患者,可改善患者眩晕症状及血流状况,降低机体氧化应激程度,疗效确切,且用药安全性较好。     

血府逐瘀汤对糖尿病视网膜病变患者视神经形态结构的影响

摘要 目的：探讨血府逐瘀汤对糖尿病视网膜病变患者视神经形态结构的影响。方法：2017年11月~2019年12月选择在本院就诊的糖尿病视网膜病变患者76例,根据随机信封抽签原则把患者分为观察组与对照组各38例。对照组给予康柏西普治疗,观察组在对照组治疗的基础上给予血府逐瘀汤治疗,两组都治疗观察2个月,记录视神经形态结构变化情况。结果：治疗后观察组的总有效率为97.37 %,显著高于对照组的78.95 %(P<0.05)。两组治疗后行空腹血糖(fasting blood glucose,FBG)与餐后2 h血糖(2 h postprandial blood glucose,2hPG),值都低于治疗前,观察组低于对照组(P<0.05)。两组治疗前的视盘周围视网膜神经纤维层(Retinal nerve fiber layer,RNFL)厚度在上象限、下象限、颞象限、鼻象限上对比无差异(P>0.05),两组治疗后各个象限的RNFL厚度均显著下降(P<0.05),且观察组各个象限的RNFL厚度均低于对照组(P<0.05)。观察组治疗后的红细胞聚集指数与纤维蛋白原低于治疗前,也低于对照组(P<0.05),对照组治疗前后对比无差异(P>0.05)。结论：血府逐瘀汤在糖尿病视网膜病变患者中的应用能改善视神经形态结构,促进降低血糖,改善患者的血液流变学状况,从而提高治疗效果。     

RP-HPLC 法测定酸枣仁汤中甘草苷的含量

目的:建立测定酸枣仁汤中甘草苷含量的反相高效液相色谱分析方法。方法:色谱柱:WatersC18(250nm×4.6mm,5μm);流动相:乙腈-0.1%磷酸水溶液,梯度洗脱;流速:1.0ml/min,检测波长:276nm。结果:芒果苷在0.093μg-0.744μg范围内与峰面积线性关系良好(r=0.9999),平均加样回收率为98.04%,RSD为0.41%。结论:本方法简便、准确、可靠、重复性好,可作为酸枣仁汤中甘草苷的含量测定方法。     

四物汤在卵巢衰老大鼠骨骼肌中的雌激素样作用机制研究

摘要 目的：探讨四物汤通过胰岛素样生长因子-1（Insulin-ike growth factors-1，IGF-1）/磷脂酰肌醇3-激酶（PI3K）/蛋白激酶B（AKT）/雷帕霉素靶蛋白（Mammalian target of rapamycin，mTOR）mTOR信号通路发挥对4-乙烯基环己烯二环氧化合物（4-Vinylcyclohexene Diepoxide，VCD）诱导的卵巢衰老大鼠骨骼肌的保护作用及其分子机制。方法：选用28日龄雌性F-344大鼠，随机选取6只作为空白对照组，剩余大鼠连续腹腔注射VCD溶液（160 mg/kg/d）20天，每天阴道涂片检测动情周期，连续观察12 d无角化细胞或仅有少量角化细胞即符合"卵巢衰老"表现，经动情周期筛选出24只造模成功的大鼠，分为模型组（Model）、阳性（戊酸雌二醇，E₂）对照组、四物汤高剂量（SWT-H）组和四物汤低剂量（SWT-L）组，每组6只，灌胃持续3周后取材。取大鼠骨骼肌组织进行HE染色观察病理组织结构；MASSON染色骨骼肌纤维形态变化；RT-PCR检测骨骼肌组织中各基因的mRNA水平。结果：与空白组比较，模型组骨骼肌肌纤维排列疏松，分布不均且有断点，胞浆不均，细胞核增多，出现增生的结缔组织，胶原纤维逐渐增多且肌纤维间距变宽；与模型组相比，E₂组、SWT-H组与SWT-L组肌纤维排列相对整齐，胞浆较为均匀。肌肉形态较规则，纤维间距缩短，胶原纤维减少。RT-PCR结果显示，与空白组相比，模型组IGF-1、PI3K、AKT、mTOR基因的mRNA表达量明显下调，E₂组、SWT-H组与SWT-L组的IGF-1、PI3K、mTOR的表达明显上升，SWT-H组AKT表达无明显变化，无统计学意义，SWT-L组AKT表达相对降低。与模型组相比，E₂组、SWT-H组与SWT-L组的IGF-1、AKT、mTOR的表达明显增加，且具有剂量依赖性，PI3K表达增加，但无明显剂量依赖性。结论：四物汤可以明显改善VCD诱导的卵巢衰老大鼠的肌肉减少情况，其机制可能是通过IGF-1-PI3K-AKT-mTOR信号通路来发挥其抑制肌肉流失的作用。     

合欢解郁汤联合草酸艾司西酞普兰片治疗老年抑郁症患者疗效及对hs-CRP影响

摘要 目的：探究合欢解郁汤联合草酸艾司西酞普兰片在治疗老年抑郁症患者中的疗效,并分析治疗对患者超敏C反应蛋白（hs-CRP）水平的影响。方法：选择2021年2月至2022年1月在我院接受治疗的80例老年抑郁症患者为研究对象,将其均分为实验组与对照组（各40例）,对照组患者接受常规草酸艾司西酞普兰片治疗,实验组患者在对照组基础上加用合欢解郁汤治疗,对比两组患者治疗效果,治疗前后汉密尔顿抑郁量表（HAMD）、匹兹堡睡眠质量指数（PSQI）、自杀意念自评量表（SIOSS）、白细胞介素-6（IL-6）、hs-CRP水平,并记录对比两组患者治疗中不良反应发生率。结果：（1）实验组患者治疗有效率为97.50 %,对照组为85.00 %,两组比较差异明显（P<0.05）;（2）治疗前两组患者HAMD及PSQI评分差异不大,治疗后实验组患者上述量表评分均低于对照组（P<0.05）;（3）治疗前两组患者SIOSS量表各维度评分差异不大（P>0.05）,治疗后实验组患者绝望因子、乐观因子、睡眠因子和掩饰因子得分均低于对照组（P<0.05）;（4）治疗前两组患者IL-6和hs-CRP水平差异不大（P>0.05）,治疗后实验组IL-6和hs-CRP水平均低于对照组（P<0.05）;（5）两组患者不良反应发生率差异不大（P>0.05）。结论：合欢解郁汤联合草酸艾司西酞普兰片对老年抑郁症具有较好疗效,能改善抑郁症状,降低其自杀风险以及炎症因子水平,同时治疗安全性较高。     

补阳还五汤对脑缺血再灌注损伤大鼠神经元凋亡的影响

目的:研究补阳还五汤对脑缺血再灌注损伤大鼠神经元凋亡的影响。方法:利用末端标记法,泱l定补阳还五汤干预后,脑缺血再灌注损伤大鼠脑组织中神经元的凋亡情况。结果:补阳还五汤能明显降低神经元凋亡百分率,减轻病理损害。结论:补阳还五汤可显著抑制由缺血再灌注诱导的脑神经元凋亡,从而起到一定程度的神经保护作用。