Latest Issue
      2020 Year 26 Vol. 6 Issue

        Feature Article

      • Wen-wei LI
        2020, 26(6): 405-411. DOI: 10.1007/s11655-020-3096-5
        Abstract：Parkinson's disease (PD) was first formally described by James Parkinson in 1817, but the shaking of limbs was described in the literature of several ancient civilizations, such as ancient Chinese civilization and ancient Indian civilization. Historically, botanical drugs were used as the main source for the treatment of such kind of disorders. In Western countries, plant extracts also occupied an important place in the earlier medications of PD. With the adventure of synthetic drugs, the role of plant-derived drugs in management of PD has been diminished. Nowadays, there is still no cure for PD, dopaminergic (DA) medication is the treatment of choice, which is just designed to ameliorate symptoms of PD, and long-term use of DA medication will result in reduced efficacy and severe adverse reactions. It is necessary to explore new methods for the treatment of PD. Chinese medicine (CM) developed a holistic and unique theoretical system, and botanical drugs are widely used in practice for more than two millennia. Modern pharmacological studies have proved that Chinese herbs have potential therapeutic effects on PD, such as enhancing neurotrophic activity, clearing protein aggregates, regulating neuroinflammation, etc. All the advances provide us with hope for developing CM as a mainstream medication for treating PD.  
        Keywords：Parkinson's disease;botanical therapeutics;Chinese medicine;neurotrophic activity;protein aggregation;neuroinflammation   
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        Published：2021-08-23

        Original Article

      • Shi-ya CHEN,Shao-jian XIAO,You-ning LIN,Xi-yu LI,Qian XU,Sha-sha YANG,Lian-hong HUANG,Jing CAI
        2020, 26(6): 412-419. DOI: 10.1007/s11655-020-3080-0
        Abstract：Objective:To evaluate the clinical efficacy and safety of Congrong Shujing Granules (苁蓉舒痉颗粒, CSGs) in treating patients with Parkinson's disease (PD) and Chinese medicine (CM) syndrome of Shen (Kidney) essence deficiency, and to investigate the potential mechanism involving efficacy through a transcriptome sequencing approach.Methods:Eligible PD patients with syndrome of Shen essence deficiency were randomly assigned to a treatment group or a control group by a random number table, and were treated with CSGs combined with Western medicine (WM), or placebo combined with WM, respectively. Both courses of treatment lasted for 12 weeks. The Unified Parkinson's Disease Rating Scale (UPDRS) score, the PD Question-39 (PDQ-39) score, CM Syndrome Scale score, and drug usage of all patients were evaluated before and after treatment. Safety was evaluated by clinical laboratory tests and electrocardiographs. Blood samples from 6 patients in each group were collected before and after the trial and used for transcriptomic analysis by gene ontology analysis and Kyoto Encyclopedia of Genes and Genomes pathway analysis. Differentially expressed genes were validated using reverse transcription-polymerase chain reaction.Results:A total of 86 PD patients were selected from the Third Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine between January 2017 and December 2017. Finally, 72 patients completed the trial, including 35 in the treatment group and 37 in the control group. When compared with the control group after treatment, patients in the treatment group showed significant decreases in UPDRS sub-Ⅱ score, PDQ-39 score, CM syndrome score, and Levodopa equivalent dose (P<0.05). During the treatment course, no significant changes were observed in safety indicators between the two groups (P>0.05). A possible mechanism of clinical efficacy was proposed that involved regulating cell metabolism-related processes and ribosome-related pathways. Treatment with CSGs had shown to affect relevant gene loci for PD, including AIDA, ANKRD36BP2, BCL2A1, BCL2L11, FTH1P2, GCH1, HPRT1, NFE2L2, RMRP, RPS7, TGFBR1, WIPF2, and COX7B.Conclusions:CSGs combined with WM can be used to treat PD patients with CM syndrome of Shen essence deficiency with a good safety. The possible mechanism of action and relevant gene loci were proposed. (Registration No. ChiCTR-IOR-16008394)  
        Keywords：Congrong Shujing Granules;Parkinson's disease;randomized controlled trial;RNA-sequencing;transcriptomics;Chinese medicine   
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        Published：2021-08-23
      • Ming-zhe HU,Zi-yi ZHOU,Zhong-yu ZHOU,Hui LU,Min GAO,Long-min LIU,Hai-qing SONG,An-ji LIN,Qing-ming WU,Hong-fei ZHOU,Lei LI,Xia WANG,Ye-feng CAI
        2020, 26(6): 420-427. DOI: 10.1007/s11655-020-3094-7
        Abstract：Objective:To assess the effect and safety of Hydroxysafflor Yellow A for Injection (HSYAI) in treating patients with acute ischemic stroke (AIS) and blood stasis syndrome (BSS).Methods:A multicenter, randomized, double-blind, multiple-dose, active-controlled phase Ⅱ trial was conducted at 9 centers in China from July 2013 to September 2015. Patients with moderate or severe AIS and BSS were randomly assigned to low-, medium-, high-dose HSYAI groups (25, 50 and 70 mg/d HSYAI by intravenous infusion, respectively), and a control group (Dengzhan Xixin Injection (灯盏细辛注射液, DZXXI) 30 mL/d by intravenous infusion), for 14 consecutive days. The primary outcome was the Modified Rankin Scale (mRS) score ≤1 at days 90 after treatment. The secondary outcomes included the National Institute of Health Stroke Scale (NIHSS) score ≤1, Barthel Index (BI) score ≥95, and BSS score reduced ≥30% from baseline at days 14, 30, 60, and 90 after treatment. The safety outcomes included any adverse events during 90 days after treatment.Results:Of the 266 patients included in the effectiveness analysis, 66, 67, 65 and 68 cases were in the low-, medium-, and high-dose HSYAI and control groups, respectively. The proportions of patients in the medium- and high-dose HSYAI groups with mRS score ≤1 at days 90 after treatment were significantly larger than the control group (P<0.05). The incidences of favorable outcomes of NIHSS and BI at days 90 after treatment as well as satisfactory improvement of BSS at days 30 and 60 after treatment in the medium- and high-dose HSYAI groups were all significantly higher than the control group (P<0.05). No significant difference was reported among the 4 groups in any specific adverse events (P>0.05).Conclusions:HSYAI was safe and well-tolerated at all doses for treating AIS patients with BSS. The medium (50 mg/d) or high dose (75 mg/d) might be the optimal dose for a phase Ⅲ trial. (Registration No. ChiCTR-2000029608)  
        Keywords：Hydroxysafflor yellow A;acute ischemic stroke;randomized controlled trial;blood stasis syndrome;Chinese medicine   
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        Published：2021-08-23
      • Hong-zhi SHI,Quan-chun FAN,Gui-e BAI,Jian-yi GAO,Jun-lian LIU,Tao MI,Shuang ZHAO,Yu LIU,Li-guo GUO,Dong XU,Yong-zhi LI,Kai-xian CHEN
        2020, 26(6): 428-433. DOI: 10.1007/s11655-019-3074-y
        Abstract：Objective:To summarize and elucidate the characteristics and evolvement of Chinese medicine (CM) patterns reflecting the physical and mental conditions of participants in the Mars 500 long-term closed environment.Methods:The DS01-T Digital TCM Four-Diagnostic Instrument and CM Inquiring Diagnostic Questionnaire were used to collect information from 6 participants in the Mars 500 International Joint Research Project, through diagnostic methods of observation, palpation and inquiry according to CM theory. During the 520 days of the experiment, data collection was performed 37 times; a total of over 400 digital images of tongues and facial complexion and over 20,000 data were collected. These data were then analyzed by a team of experts in CM, statistics, and data mining.Results:The CM pattern evolvement of participants in the long-term closed environment followed some common trends. Qi deficiency was the main CM pattern observed, with individual features depending on constitutional differences [manifested in varying degrees of accompanying patterns of Gan (Liver) qi stagnation, Pi (Spleen) deficiency, dampness encumbering, or yin deficiency].Conclusion:The research has verified the effectiveness of CM syndrome differentiation based on the four diagnostic methods, which should serve as a solid foundation for observation, monitoring, and intervention in regard to the health conditions of astronauts in long-term space flights in the future.  
        Keywords：Mars 500;long-term closed environment;health condition;syndrome differentiation;Chinese medicine   
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        Published：2021-08-23
      • Xiao-juan REN,Guan-ying WANG,Xing-ping ZHANG,Qing-quan WANG,Zhi-peng PENG
        2020, 26(6): 434-441. DOI: 10.1007/s11655-020-3087-6
        Abstract：Objective:To study the sedative and hypnotic effects and underlying mechanisms of Polygala tenuifolia (PT) on treating aged insomnia rats.Methods:Sixty Sprague-Dawley male rats were divided into 6 groups by a random number table, including control group, model group, diazepam group (0.92 mg/kg), as well as PT low-, medium- and high-dose groups (0.0875, 0.175, 0.35 g/kg, respectively), 10 rats in each group. Aged insomnia rat model was established with subcutaneous injection of D-galactose for 42 days and then intraperitoneal injection of para-chlorophenylalanine for 3 days. PT and diazepam were respectively given to aged insomnia rats by intragastric administration for 7 days after model establishment. Then the rats were investigated by body weight, Morris water maze test, pentobarbital test, enzyme-linked immunosorbent assay, and transcriptome sequencing.Results:Compared with the model group, PT increased the body weight, improved memory ability, and prolonged pentobarbital-induced sleep time of aged insomnia rats (P<0.01 or P<0.05). The medium dose of PT also increased the neurotransmitter levels of 5-hydroxytryptamine (5-HT) and gamma-aminobutyric acid (GABA), and decreased the level of Glu in the hippocampus of aged insomnia rats (P<0.05 or P<0.01). Twenty-four differentially expressed genes (DEGs) were overlapped among model group, medium-dose PT group, and diazepam group in transcriptome analysis. Fuom and Pcp2 were down-regulated by the treatment of medium-dose PT (P<0.01 or P<0.05). The metabolic pathways of PT were relatively less than diazepam (91 vs. 104).Conclusions:The sedative and hypnotic effects of PT in aged insomnia rats might be related to neuro, metabolism pathways, especially through GABAergic signaling pathway. It provided more effective herb choice for the treatment of senile insomnia.  
        Keywords：Polygala tenuifolia;Chinese medicine;aged insomnia;sedative and hypnotic effects;molecular mechanism   
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        Published：2021-08-23
      • Meng-qian CHEN,Kui-wu YAO,Zhang-jing LIU,Xiao-xiao FENG,Ye XIAO
        2020, 26(6): 442-447. DOI: 10.1007/s11655-019-3076-9
        Abstract：Objective:To observe the changes of ischemic myocardial cells apoptosis in rats following intervention with Xuefu Zhuyu Oral Liquid (血府逐瘀口服液, XFZY), as well as changes of protein expression of silent information regulator 1 (SIRT1) and SIRT1 pathway-related genes.Methods:H9c2 rat myocardial cells were divided into 6 groups: control group, oxygen glucose deprivation (OGD) group, SIRT1 siRNA group, OGD+SIRT1 siRNA group, OGD+XFZY group, and OGD+SIRT1 siRNA+XFZY group. Quantitative fluorescent polymerase chain reaction (PCR) and Western blot were used to detect the concentration variations of SIRT1 and its pathway-related genes and corresponding protein expression after XFZY intervention and SIRT1 transfection.Results:Compared with the control group, the mRNA and protein expressions of SIRT1 were decreased obviously, while the mRNA and protein levels of P53, forkhead box protein O1 (FoxO1), FoxO3, FoxO4 and nuclear factor kappa B (NF-κB) were increased in the OGD group, SIRT1 siRNA group, and OGD+SIRT1 siRNA group (P<0.01). Compared with the OGD group and OGD+SIRT1 siRNA group, the treatment of XFZY inhibited the decline in SIRT1 mRNA and protein expressions (P<0.01), and down-regulated the mRNA and protein levels of P53, FoxO1, FoxO3, FoxO4 and NF-κB, respectively (P<0.05 or P<0.01).Conclusion:XFZY could prevent myocardial cells apoptosis probably by increasing the mRNA and protein expressions of SIRT1 and inhibiting the mRNA and protein expressions of P53, NF-κB, FoxO1, FoxO3 and FoxO4.  
        Keywords：ischemic heart disease;silent information regulator 1;myocardial cell apoptosis;Xuefu Zhuyu Oral Liquid;Chinese medicine   
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        Published：2021-08-23
      • Zhang-cheng LIANG,Wei-xin LI,Zhi-gang HE,Xiao-zi LIN,Xiang-yun REN,Xiao-jie LIN
        2020, 26(6): 448-454. DOI: 10.1007/s11655-019-3072-0
        Abstract：Objective:To reveal the effect of foods with different natures on cold or hot syndrome and gastrointestinal bacterial community structure in mice.Methods:Forty-five 6-week-old male ICR Kunming mice of clean grade were divided into 5 groups, 9 per group, including the control (CK), hot nature herb medicine (HM), Hong Qu glutinous rice wine (RW), tea rice wine (TW), and cold nature herb medicine (CM) groups. Distilled water or corresponding herbs were administered to mice (0.01 mL/g body weight) in the 5 groups by gastric infusion respectively, once daily for 28 d. Appearance, behavior, and serum biochemical indicators, including 5-hydroxytryptamine (5-HT), thyroid stimulating hormone (TSH), noradrenaline (NE), cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP), the hot nature index, as well as the gastrointestinal bacterial community structure were analyzed in all groups after treatment.Results:After supplementation for 28 d, CM and TW mice showed different degrees of cold syndrome, and HM and RW mice showed different degrees of hot syndrome. Compared with the HM and RW mice, the TSH, NE, cAMP levels and hot nature indices in the CM and TW mice were significantly decreased and 5-HT and cGMP levels were significantly increased (P<0.05). There was no obvious change in appearance or behavior in CK mice. Results of clustering analysis showed that the gastrointestinal bacterial community structures were highly similar in TW and CM mice as well as in RW and HM mice, and that they were from the same branch, respectively, when the distance was 0.02. The key microbes associated with cold syndrome were Lachnospiraceae uncultured, Lactococcus, etc., and the key microbes associated with hot syndrome were S24-7 norank, Ruminococcaceae uncultured, etc.Conclusion:The interventions with different nature foods could change cold or hot syndrome in mice, leading to changes in gastrointestinal bacterial community structure.  
        Keywords：gastrointestinal bacterial community structure;different natural foods;cold or hot syndrome;Hong Qu glutinous rice wine;key microbe   
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        Published：2021-08-23

        Acupuncture Research

      • Bin-yan YU,Yan-ping WANG,Hong-cai SHANG,Li-ying WANG,Yi-jia WAN,Chen ZHAO,Li-hua XUAN
        2020, 26(6): 455-461. DOI: 10.1007/s11655-020-3081-z
        Abstract：Objective:To compare the clinical effects of thick-needle therapy (TNT) and acupuncture therapy (AT) on patients with Bell's palsy (BP) at the recovery stage.Methods:A total of 146 eligible participants from 3 hospitals in China were randomized into the TNT group (73 cases) and the AT group (73 cases) using a central randomization. Both groups received Western medicine thrice a day for 4 weeks. Moreover, patients in the TNT group received subcutaneous insertion of a thick needle into Shendao (GV 11) acupoint, while patients in the AT group received AT at acupoints of Cuanzhu (BL 2), Yangbai (GB 14), Dicang (ST 4), Xiaguan (ST 7), Jiache (ST 6), Yingxiang (LI 20) and Hegu (LI 4), 4 times a week, for 4 weeks. Both groups received 2 follow-up visits, which were arranged at 1 month and 3 months after treatment, respectively. The primary outcome measure was House-Brackmann Facial Nerve Grading System (HBFNGS) grade. And the clinical recovery rates of both groups were evaluated according to the HBFNGS grades after treatment. The secondary outcome measures included the facial disability index (FDI) and electroneurogram (EnoG). The adverse events were observed and recorded in both groups.Results:Three cases withdrew from the trial, 2 in the TNT group and 1 in the AT group. There was no significant difference in the clinical recovery rates between the TNT and AT groups after 4-week treatment [40.85% (29/71) vs. 34.72% (25/72), P>0.05]. At the 2nd follow-up visit, more patients in the TNT group showed reduced HBFNGS grades than those in the AT group (P<0.01). No significant difference was observed between the two groups in FDI score, EnoG latency and maximum amplitude ratio at all time points (all P>0.05).Conclusion:The clinical effect of TNT was equivalent to that of AT in patients with BP at recovery stage, while the post-treatment effect of TNT was superior to that of AT. (Registration No. ChiCTR-INR-16008409)  
        Keywords：Bell's palsy;acupuncture;thick-needle therapy;randomized controlled trial;Chinese medicine   
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        Published：2021-08-23

        Evidence-Based Integrative Medicine

      • Xiang GAO,Hai-yi JIA,Guo-chong CHEN,Cheng-yue LI,Mo HAO
        2020, 26(6): 462-468. DOI: 10.1007/s11655-020-3085-8
        Abstract：Objective:To assess the relationship between yogurt intake and mortality risk from prospective cohort studies.Methods:The PubMed, EMBASE, and Web of Science databases were searched for all records related to yogurt intake and mortality risk [all-cause or cardiovascular disease (CVD) or cancer mortality] before October 1, 2018. The Newcastle-Ottawa Quality Scale was used to estimate the quality of all eligible articles. The results of the highest and lowest categories of yogurt intake in each study were collected and the effect size was pooled using a random effects model. The dose-response analysis was calculated using the generalized least squares trend estimation model.Results:Eight eligible cohort studies were included in this meta-analysis. There were 235,676 participants in the 8 studies, and the number of deaths was 14,831. Compared with the lowest category, the highest category of yogurt intake was not significantly related with allcause mortality [hazard ratio (HR)=0.93; 95% confidence interval (CI): 0.85, 1.01], CVD mortality (HR=0.92; 95% CI: 0.81, 1.03) and cancer mortality (HR=0.97; 95% CI: 0.83, 1.12). These studies were homogenous, since the homogeneity test showed that I2 was 28.7%, 15.1% and 11.8%, respectively. However, yogurt intake ≥200 g/d was significantly associated with a lower all-cause mortality (HR=0.88; 95% CI: 0.80, 0.96) and CVD mortality (HR=0.87; 95% CI: 0.77, 0.99) in the subgroup analysis. The dose-response analysis showed that yogurt intake of 200 g/d was inversely associated with all-cause mortality (P=0.041, HR=0.95, 95% CI: 0.92, 1.00) and CVD mortality (P=0.009, HR=0.92, 95% CI: 0.86, 0.98), and all of which were linear relationship (P>0.05).Conclusions:This review provided the evidence regarding yogurt intake can reduce all-cause and CVD mortality. Although some positive findings were identified, more high-quality cohort studies and randomized controlled trials are warranted on a possible protective effect of yoghurt on health.  
        Keywords：yogurt;mortality;cardiovascular disease;cancer;meta-analysis   
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        Published：2021-08-23

        Academic Exploration

      • En-chang LI
        2020, 26(6): 469-472. DOI: 10.1007/s11655-020-3470-3
        Abstract：MAO Ze-dong's view on traditional Chinese medicine (TCM) can be divided into the scientific view on TCM, the development view on TCM and the future view on TCM. The core of MAO Ze-dong's view on TCM lies in its scientific nature. The basic content of MAO Ze-dong's development view on TCM includes unity of TCM and Western medicine (WM), advocating the multi-angle development of TCM from the height of Chinese national dignity, independence and self-confidence. MAO Ze-dong's future view on TCM is targeted at WM learning from TCM, integrating TCM and WM and establishing new Chinese medicine. The contemporary enlightenment of MAO Ze-dong's view on TCM is to start from reforming the medical education system before establishing new Chinese medicine.  
        Keywords：MAO Ze-dong;view on traditional Chinese medicine (TCM);scientific view on TCM;development view on TCM;future view on TCM;Western medicine learning from TCM   
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        Published：2021-08-23

        Review

      • Yang-yang SONG,Wen-tao XU,Xin-chang ZHANG,Guang-xia NI
        2020, 26(6): 473-480. DOI: 10.1007/s11655-020-3092-9
        Abstract：Alzheimer's disease (AD) is the main type of dementia affecting elderly people. The medicines used for treating AD have limits in their ability to alleviate cognitive and functional decline. Electroacupuncture (EA), an economical alternative and complementary therapeutic measure used in Chinese medicine, has strong clinical applicability, and its treatment effects are more reliable as its stimulation factors can be standardized. EA has been effectively used for ameliorating spatial learning and memory impairment in AD patients and rodent AD models. Here, we summarized the mechanisms of EA on rodent AD models, aiming to provide a theoretical basis for identifying new targets and research directions, and exploring appropriate EA stimulation parameters, then provide a detailed methodology to optimize the effects of EA, ultimately reducing the heavy burden of treating AD patients on families and countries. Our review showed that 8 acupoints were used when treating AD animals; Baihui (GV 20) was the most frequently used. Four mechanisms of EA were studied: (1) protection of cerebral neurons from oxidative stress, apoptosis, neuroinflammation, synaptic plasticity and hormone levels; (2) regulation of metabolism, including glucose metabolism and plasma metabolism; (3) regulation of brainderived neurotrophic factor; and (4) regulation of β-amyloid peptide protein deposition.  
        Keywords：mechanism;electroacupuncture;Alzheimer's disease;Chinese medicine   
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