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Analysis on the rules of prescriptions for ischemic stroke based on the traditional Chinese medicine inheritance auxiliary system
Jing-Na Zhou, Zi-Qi Jing, Xin-Zhe Zhao, Guo-Wei Zhang
7Drug Combination Therapy    2019, 1 (2): 65-74.   https://doi.org/10.12032/DCT201902004
Abstract PDF (445KB)  

In China, traditional Chinese medicine is widely used in the treatment of ischemic stroke, but its prescription rules needs to be further studied. This paper uses the traditional Chinese medicine inheritance auxiliary system (a software) to analyze the composition rules of a large number of prescriptions for the treatment of ischemic stroke, and discusses the clinical rationality of the new prescriptions. We found that the prescriptions for the treatment of ischemic stroke are mainly composed by herbs for promoting blood circulation and removing blood stasis, dredging collaterals and tonifying deficiency, and some of the new prescriptions are also in line with this characteristic. This paper can provide reference for clinical prescription in the treatment of ischemic stroke and the development of related new drugs.

Analysis on formula principles for “head wind” disease based on apriori and clustering algorithm
Ji-Wei Lin, Dong-Cai Wang, Hai-Bin Wu, Yang-Hui Gu, Xiao-Rong Song, Bo-Min Cheng, Jia-Hui Wang, Ming-Zhen Xu
7Drug Combination Therapy    2019, 1 (2): 56-64.   https://doi.org/10.12032/DCT201902001
Abstract PDF (568KB)  
Objective: To explore the formula principles for “head wind” disease by data-mining and provide reference for the treatment of “head wind” disease. Methods: Prescriptions for headache from “Dictionary of Traditional Chinese Medicine Prescriptions” were collected, sorted and entered into the “Traditional Chinese Medicine Inheritance System” (V2.5) to analyze the composition principles by the methods of revised mutual information, complex system entropy cluster and unsupervised hierarchical cluster. Results: The herbs with high usage frequency in these prescriptions for “head wind” disease included Chuan-xiong, Bai-zhi, Xi-xin, Fang-feng, Gan-cao, Shi-Gao and Qiang-Huo. Three new prescriptions were obtained based on the composition principles and rules. The first new prescription is composed of Quan-xie, Xiong-huang, Jiang-can, Zhi-chuan-wu and Di-long. The second new prescription is composed of Du-huo, Rou-gui, Ku-shen; Fang-feng, Gao-ben, Qiang-huo. The third new prescription is composed of Fu-zi, Sheng-chuan-wu, Tian-nan-xing, Chuan-xiong, Bai-zhi, Shi-gao. Conclusion: We found that the most of herbs used to treat the “head wind” disease are warm and spicy, mainly belong to diaphoretic herbs, wind-expelling herbs, and dampness-dispelling herbs. In addition, the new prescriptions for infertility mainly focus on eliminating evil, with the characteristics of “eliminating phlegm and turbid”, “dredging the channels and collaterals”, “expelling wind-evil” and “promoting blood circulation”.
Dissecting the underlying pharmaceutical mechanism of traditional Chinese medicine Wenxin Keli acting on atrial fibrillation through network pharmacology
Xian-Jun Wu, Xin-Bin Zhou, Chen Chen, Wei Mao
7Drug Combination Therapy    2019, 1 (3): 117-133.   https://doi.org/10.12032/DCT201903003
Abstract PDF (1072KB)  

As a well-known Chinese medicine prescription, Wenxin Keli (WXKL) has been widely used in the treatment of many arrhythmias including atrial fibrillation and has achieved significant clinical effects, but the specific mechanism of its treatment of atrial fibrillation remains unclear. This study used a network pharmacology approach to reveal the potential molecular mechanisms of WXKL in the treatment of atrial fibrillation. It involves oral bioavailability screening of ingredients, drug-likeness evaluation, compound target fishing, H-C-T network and C-T-P network construction and analysis. Through the network pharmacology-based research strategy, the complex system of WXKL was analyzed. It was found that 14 representative compounds of WXKL, 30 protein targets and 12 related signaling pathways help us systematically understand the underlying mechanism of WXKL's anti-atrial fibrillation effects.

Curcumin in The Treatment of in Animals Myocardial ischemia reperfusion: A Systematic review and Meta-analysis
Qian He, Bin Meng, Hong-Yun Hu, Gao-Jian Zhuang, Qun Tang, Xu Zhu
92Medical Data Mining    2019, 2 (2): 66-75.   https://doi.org/10.12032/mdm2018019
Abstract PDF (2923KB)  
Objective: The protective effects of curcumin on myocardial ischemia-reperfusion were systematically evaluated by analyzing the related literatures of curcumin and myocardial ischemia-reperfusion. Methods: The computer was searched for Wanfang, VIP, China National Knowledge Infrastructure(CNKI), SinoMed, and Pubmed database to find animal experiments on curcumin treatment of myocardial ischemia-reperfusion.The retrieval time is from the establishment of the database to November 2018. Two researchers independently screened the literature based on inclusion and exclusion criteria, extracted the data, and assessed the risk of bias in the included studies. Meta analysis was performed using RevMan 5.3 software. Results: Finally, 9 studies were included for analysis. Meta-analysis showed that the curcumin group can reduce LDH and MDA levels compared with the ischemiar-reperfusion group  (LDH: SMD=-4.75, 95% CI [-6.56, -2.94], P < 0.01, MDA: SMD=-2.27, 95% CI [-3.07, -1.47], P < 0.01), the difference was statistically significant (P<0.01). In the subgroup analysis of different doses of curcumin, different doses of curcumin (0.8, 10, 12.5, 20, 25, 30, 50 mg) were able to reduce LDH content compared with the ischemia-reperfusion group, and the differences were statistically significant. Different doses of curcumin (5,10,20,30,40mg) can reduce MDA content, and the difference is statistically significant; curcumin (0.8mg) group has no statistically significant effect on MDA content (SMD = -0.54, 95% CI [-1.35, 0.28], P = 0.20). The relationship between the content of MDA and the dose of curcumin showed that compared with the curcumin (20 mg) group, the curcumin (40 mg) group could better reduce the MDA content, and the difference was statistically significant (P=0.03). Conclusion: Curcumin can reduce the content of LDH and MDA in myocardial ischemia-reperfusion,  and has a protective effect on myocardium. Moreover,  the ability to reduce the damage is related to the dose of curcumin. However, the sample of the included studies is limited, and this conclusion requires more high-quality experiments to verify.
Acupuncture preconditioning protects against myocardial ischemia/reperfusion injury mediated apoptosis through miR-214/NCX1 activation: a hypothesis
Hai-Long Fan, Yu-Lan Ren, Li-Zhen Yang, Fei Wu
1Traditional Medicine Research    2019, 4 (4): 178-183.   https://doi.org/10.12032/TMR20190306109
Abstract HTML PDF (397KB)  

Highlights

This review provides evidences for the recommendation of acupuncture preconditioning at Neiguan (PC6) point in coronary heart disease patients as a non-pharmacological therapeutic method to activate the miR-214/NCX1 pathway.

Traditionality

The concept of acupuncture preconditioning is described in the ancient book of Fan Wang Fang (Eastern Jin Dynasty of China). It refers to the application of acupuncture before the occurrence of disease or when the disease is relatively mild. According to the record of the ancient book of Huang Di Nei Jing (Qin Han Period of China, 475 B.C.-221 B.C.), acupuncture at Neiguan (PC6) point can prevent and treat angina pectoris in coronary heart disease (CHD). The WHO also recommends acupuncture as one of the alternative and complementary therapies for the prevention and treatment of angina pectoris in CHD.

Abstract

Early reperfusion of ischemic cardiac tissue is usually the best option to improve clinical outcome of angina pectoris, especially of acute myocardial infarction. However, myocardial reperfusion may cause an abnormal increase of intracellular Ca2+-mediated cardiomyocyte death and consequent loss of cardiac function, which is referred to myocardial ischemia/reperfusion (I/R) injury. Recently, the microRNA-214 (miR-214)/Na+/Ca2+ exchanger (NCX) 1 co-expression is a key factor in cellular protection against myocardial apoptosis for myocardial I/R injury. Once activated, miR-214/NCX1 axis can inhibit several Ca2+ downstream signaling effectors that mediate cell death simultaneously. Studies have shown that acupuncture preconditioning has a protective effect on myocardial I/R injury, but its mechanism deserves further research. It has been proved that acupuncture preconditioning for ischemic myocardium successfully inhibit multiple Ca2+ handling related microRNAs that mediate cell death pathways, and miR-214 is one of its targets. In terms of clinical practice, coronary heart disease (CHD) patients benefit a lot from this intervention. However, there is barely no study correlating acupuncture preconditioning to the miR-214/NCX1 co-expression in patients with CHD. This review aims to discuss whether there is some evidence to justify a recommendation of acupuncture preconditioning in CHD patients as a non-pharmacological therapeutic method to activate the miR-214/NCX1 co-expression network model.

Shenxian Shengmai Oral Liquid for treatment of slow arrhythmia: a randomized controlled trial
Li Jing, Zhao Chen, Chen Jing, Xing Yan-Wei, Qian Ke, Liu Zhi, Zhai Jing-Bo, Shi Yang
TMR Modern Herbal Medicine    2018, 1 (2): 51-56.   https://doi.org/10.12032/TMRmhm2017A12
Abstract HTML PDF (352KB)  

Background:Slow arrhythmia, a common clinical condition, has a higher incidence in the elderly population. Shenxian Shengmai Oral Liquid has been shown to improve the symptoms of patients with slow arrhythmia in many clinical studies and systematic reviews. Sixty participants with slow arrhythmia will be randomized to treatment group (Shenxian Shengmai Oral Liquid) and control group (Shenxian Shengmai Oral Liquid Placebo) in a 2:1 ratio. This clinical trial is a pilot study to compare the effects of Shenxian Shengmai Oral Liquid and the control groups; to analyze the effect of Shenxian Shengmai Oral Liquid for slow arrhythmia.

Highlights

1.This is the clinical trial plan of oral liquid of Chinese medicine for the treatment of slow arrhythmia.2.This study is a pilot study. Sixty patients with slow arrhythmia were randomly divided into observation group (40 cases) and control group (20 cases) to explore the safety and effectiveness of Shenxian Shengmai Oral Liquid.3.The study will be a randomized, double-blind, placebo-controlled clinical trial.

Chinese medicine in the treatment of intracranial vascular stenosis in 1 case
Wu Di, Dai Wei-Ying
TMR Modern Herbal Medicine    2018, 1 (2): 67-73.   https://doi.org/10.12032/TMRmhm2017C10
Abstract HTML PDF (477KB)  

Intracranial vascular stenosis is closely related to transient ischemic attack (TIA) and cerebral infarction, early prevention and treatment of intracranial vascular stenosis can prevent cerebral infarction and improve the prognosis of stroke. Western medicine employs interventional surgery or vasodilator, antiplatelet drugs, lipid lowering drugs, plaque-stabilizing agents and other drugs for treating intracranial vascular stenosis. No corresponding disease name with “intracranial vascular stenosis” is found in Chinese medicine literature. Based on the characteristics of syndromes, symptoms and diseases, “intracranial vascular stenosis” is summarized as weakened body resistance and prevailed pathogenic factors, phlegm with blood stasis and “obstruction (Bi) syndrome” in the brain. The self-made Chinese herbal “Naomaitong” prescription treating for bilateral middle cerebral artery stenosis in 1 case got satisfactory efficacy by transcranial doppler (TCD) and computed tomography angiography (CTA) examination.

Highlight

“Intracranial vascular stenosis” has no corresponding name in Chinese medicine literature. The writer summarized it as vessel impediment which location was in the brain with weakened body resistance and pathogenic stagnation, phlegm with blood stasis, based on the characteristics of its symptoms, syndromes and disease. The present study suggested the self-made Chinese herb “Naomaitong” prescription treating for bilateral middle cerebral artery stenosis can get satisfactory effect in clinic.

Various models of atrial fibrillation induced by acetylcholine and its application in the field of traditional Chinese medicine
Zhang Qin, Wang Ping, Wu Lin
TMR Modern Herbal Medicine    2018, 1 (2): 111-117.   https://doi.org/10.12032/TMRmhm2017B21
Abstract HTML PDF (345KB)  

Atrial fibrillation is of public health importance and profoundly increases morbidity, mortality and health-related expenditures. Morbidities include the increased risks of cardiovascular outcomes such as heart failure and stroke, and the deleterious effects on quality of life, functional status and cognition. Our purpose is to understand the molecular mechanism of atrial fibrillation, a model under pathological conditions should be established. Acetylcholine, a neurotransmitter in the vagus nerve, has been established with numerous atrial fibrillation models. We will discuss the established model of atrial fibrillation which induced by acetylcholine, aiming to seek a model which are more close to the clinical condition. The underlying mechanisms will be discussed in order to observe the mechanism of antiarrhythmic drugs.

Highlight

Acetylcholine as a neurotransmitter of the vagus nerve which plays an important role in the occurrence and maintenance of atrial fibrillation, is important in basic researches. The acetylcholine is another novel candidate target for atrial-specific drug therapy. The constitutively active form of this current increased in human atrial fibrillation and pharmacological inhibition might be of therapeutic value.

Effect of splitting combination of different components of Zhilong Huoxue Tongyu Capsule on vascular remodeling in hypertension
Liao Hui-ling, Ma Qian, Fu Ling
TMR Modern Herbal Medicine    2018, 1 (3): 164-170.   https://doi.org/10.12032/TMRmhm2017A24
Abstract HTML PDF (605KB)  

Objective: To observe the effects of the components of Zhilong Huoxue Tongyu Capsule (ZLHXTY) on the expression of NF-κB-P65 and ICAM-1 in blood vessels of rats, and to explore the effect and mechanism of ZLHXTY and its ingredients on vascular remodeling in hypertension. Methods: A rat model of renal hypertension was established by narrowing the left renal artery in the operation group. The corresponding drugs were given once a day respectively. The Normal group, Sham-operation group and Model group were administered with the same volume of normal saline. After 4 weeks of gavage, the thoracic aorta of rat was taken, followed by fixation, embedding, sectioning and HE staining, and NF-κB -p65 was detected by immunohistochemistry. Results: 1. The effect of drugs on the expression of NF-κB in thoracic aorta of hypertensive rats (immunohistochemistry): A small amount of NF-κB protein was expressed in the Normal group and the Sham-operate group. The NF-κB expression in the Model group was significantly increased, and the electron microscope image showed that the brown-yellow granule was distributed in the vascular smooth muscle of the membrane. After treatment, the expression of NF-κB in the Captopril group and the Whole prescription group was significantly reduced compared with the Model group, while the protein expression in other groups was decreased compared with the Model group. The protein expression of captopril group was decreased compared with that of the Whole prescription group. Compared with Promoting blood circulation for removing blood stasis group, the expression of NF-κB in Benefiting qi group was significantly decreased and was similar to that in Warming meridian group. Conclusion: The vascular remodeling mechanism of ZLHXTY on renal hypertension rats may be related to its effects on lowering blood pressure, antioxidant stress and anti-inflammation. After the compatibility of formula produced a significant synergistic effect, and its compatibility after embodies multiple targets for treatment of advantages of traditional Chinese medicine.

Highlights

By observing the effect of each component of Zhilong Huoxue Tongyu Capsule (ZLHXTY) on the expression of blood vessel NF-κB -P65 and ICAM-1 in rats, to explore the effect of ZLHXTY and its ingredients on vascular remodeling in hypertension and its mechanism. The experimental results indicate that different components of ZLHXTY exert therapeutic effects on vascular remodeling in hypertensive rats from different aspects. Huangqi (Radix Astragali seu Hedysari) plays an important role in lowering blood pressure. The combination of Guizhi (Ramulus Cinnamomi) and Daxueteng (Caulis Sargentodoxae) has a significant effect on the expression of NF- induced B protein. Shuizhi (Hirudo) and compatibility of Dilong (Lumbricus) can lower blood pressure, the NF-κB protein expression. The synergistic effects of the combination of various components are significant, which reflects the therapeutic advantages of multiple targets of traditional Chinese medicine.

Evidence-based optimization of integrated traditional Chinese and Western medicine therapies for prevention and treatment of coronary heart disease: design and implementation
Jiang Yin, Zhang Xiao-Yu, Tian Gui-Hua, Zhang Li-Jing, Zhang Ming-Xue, Wan Hai-Tong, Ye Min, He Rong-Rong, Sun Xin, Shang Hong-Cai
TMR Modern Herbal Medicine    2018, 1 (3): 124-126.   https://doi.org/10.12032/TMRmhm2017B28
Abstract HTML PDF (254KB)  

As a chronic disease that seriously endangers public health, the number of coronary heart disease (CHD) patients in China has increased in recent years. There is great potentiality to integrate traditional Chinese and Western medicine therapies to prevent and treat CHD in clinical practice. However, most of the current integrated therapies still lack sufficient high-quality evidence, and the key links in how to apply are unclear. It is urgent to optimize them through evidence-based research to further improve the effectiveness. Therefore, we propose strategies to conduct evidence-based optimization of integrated traditional Chinese and Western medicine therapies in prevention and treatment of progressive cardiovascular diseases. These are integrated clinical trial design, attention to the key links of taking effect, combination of clinical and basic research. Based on the strategies, we started the national key research and development project "Evidence-based optimization research of TCM therapies in prevention and treatment of CHD (angina pectoris - myocardial infarction - heart failure)", which is expected to be a new paradigm in the field.

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