-
Journal of Ethnopharmacology Dec 2023Wendan Decoction (WDD) is one of the classic traditional Chinese prescriptions that has been used in the treatment of type 2 diabetes mellitus (T2DM), metabolic...
ETHNOPHARMACOLOGICAL RELEVANCE
Wendan Decoction (WDD) is one of the classic traditional Chinese prescriptions that has been used in the treatment of type 2 diabetes mellitus (T2DM), metabolic syndrome, obstructive sleep apnea-hypopnea syndrome (OSAHS) and so on. The therapeutic effects and mechanism of WDD remain to be explored, especially from the perspective of metabolomics, oxidative stress and inflammation.
AIM OF THE STUDY
To investigate the therapeutic and metabolic regulatory effects and the underlying mechanism of WDD in OSAHS with T2DM patients.
MATERIALS AND METHODS
All included patients were from Rudong Hospital of Traditional Chinese Medicine, Nantong, Jiangsu Province, China. Both groups received lifestyle interventions; at the same time, all of them were administered metformin (1500 mg/day) and dapagliflozin (10 mg/day), and the treatment group was administered WDD orally. All patients were treated for two months. Before and after treatment, the changes in clinical symptoms and signs of the two groups of patients were evaluated, and the detection indicators such as body mass index (BMI), apnea-hypopnea index (AHI), lowest arterial oxygen saturation (LSaO), Epworth sleepiness scale (ESS), percentage of total sleep time with oxygen saturation <90% (TST90), fasting plasma glucose (FPG), 2-h post-load glucose(2h-PG), fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR),hemoglobin A1c (HbA1c), blood lipid levels, as well as the adverse reactions and compliance of the patients were observed and detection of serum metabolites in patients to screen out specific biomarkers. The serum metabolic profile of WDD in OSAHS with T2DM patients was explored using ultra-high-performance liquid chromatography-quadrupole/electrostatic field orbitrap high-resolution mass spectrometry (UPLC-Q Orbitrap HRMS).
RESULTS
After treatment with WDD for 8 weeks, biochemical indicators, including BMI, FPG, 2h-PG, blood lipid, FINS, HbA1c, AHI, ESS, LSaO, TST90, and HOMA-IR, were significantly improved. Serum metabolomic analysis showed that metabolites were differentially expressed before and after WDD-treated patients. Metabolomics results revealed that WDD regulated the biomarkers, such as DL-arginine, guaiacol sulfate, azelaic acid, phloroglucinol, uracil, L-tyrosine, cascarillin, Cortisol and L-alpha-lysophosphatidylcholine. Pathway enrichment analysis showed that the metabolites were associated with oxidative stress and inflammation.
CONCLUSION
The study based on clinical research and metabolomics indicated that WDD can improve OSAHS with T2DM through multiple targets and pathways, and it may be a useful alternative therapy for the treatment of OSAHS with T2DM patients.
Topics: Humans; Diabetes Mellitus, Type 2; Glycated Hemoglobin; Sleep Apnea, Obstructive; Treatment Outcome; Inflammation; Metabolomics
PubMed: 37311503
DOI: 10.1016/j.jep.2023.116775 -
Electronic Physician Apr 2018, known as Kafesheh (Persian) and safflower (English) is vastly utilized in Traditional Medicine for various medical conditions, namely dysmenorrhea, amenorrhea,... (Review)
Review
BACKGROUND
, known as Kafesheh (Persian) and safflower (English) is vastly utilized in Traditional Medicine for various medical conditions, namely dysmenorrhea, amenorrhea, postpartum abdominal pain and mass, trauma and pain of joints. It is largely used for flavoring and coloring purposes among the local population. Recent reviews have addressed the uses of the plant in various ethnomedical systems.
OBJECTIVE
This review was an update to provide a summary on the botanical features, uses in Iranian folklore and modern medical applications of safflower.
METHODS
A main database containing important early published texts written in Persian, together with electronic papers was established on ethnopharmacology and modern pharmacology of C. tinctorius. Literature review was performed on the years from 1937 to 2016 in Web of Science, PubMed, Scientific Information Database, Google Scholar, and Scopus for the terms "Kafesheh", "safflower", "Carthamus tinctorius", and so forth.
RESULTS
Safflower is an indispensable element of Iranian folklore medicine, with a variety of applications due to laxative effects. Also, it was recommended as treatment for rheumatism and paralysis, vitiligo and black spots, psoriasis, mouth ulcers, phlegm humor, poisoning, numb limbs, melancholy humor, and the like. According to the modern pharmacological and clinical examinations, safflower provides promising opportunities for the amelioration of myocardial ischemia, coagulation, thrombosis, inflammation, toxicity, cancer, and so forth. However, there have been some reports on its undesirable effects on male and female fertility. Most of these beneficial therapeutic effects were correlated to hydroxysafflor yellow A.
CONCLUSION
More attention should be drawn to the lack of a thorough phytochemical investigation. The potential implications of safflower based on Persian traditional medicine, such as the treatment of rheumatism and paralysis, vitiligo and black spots, psoriasis, mouth ulcers, phlegm humor, poisoning, numb limbs, and melancholy humor warrant further consideration.
PubMed: 29881530
DOI: 10.19082/6672 -
Evidence-based Complementary and... 2015Phlegm is one of the most common patterns of coronary artery disease (CAD) in Chinese medicine. Our research was aimed at investigating the association between phlegm... (Review)
Review
Phlegm is one of the most common patterns of coronary artery disease (CAD) in Chinese medicine. Our research was aimed at investigating the association between phlegm syndrome of CAD and coronary angiography (CAG) by meta-analysis. According to inclusion criteria, a total of 30 studies involving 5,055 CAD patients were included. The meta-analysis showed that phlegm syndrome patients were prone to multivessel disease (28 studies, OR = 1.53, 95% CI, 1.24 to 1.88, P < 0.01) and higher Gensini score (2 studies, OR = 5.90, 95% CI, 1.86 to 9.94, P = 0.004), but not obviously relevant to severe stenosis (≥75%) of coronary arteries (13 studies, OR = 1.20, 95% CI, 0.63 to 2.27, P = 0.57). We concluded that the coronary arteries lesions of CAD patients with phlegm syndrome were more severe than those with nonphlegm syndromes. Phlegm syndrome should, therefore, be regarded as a dangerous pattern of CAD with worse prognosis.
PubMed: 26180535
DOI: 10.1155/2015/751743 -
Molecules (Basel, Switzerland) Jul 2020Cough and phlegm frequently occur in respiratory diseases like upper respiratory tract infections, acute bronchitis, and chronic obstructive pulmonary diseases. To...
Cough and phlegm frequently occur in respiratory diseases like upper respiratory tract infections, acute bronchitis, and chronic obstructive pulmonary diseases. To relieve these symptoms and diseases, various ingredients are being used despite the debates on their clinical efficacy. We aimed to investigate the effects of the extract CKD-497, composed of Atractylodis Rhizoma Alba and Fructus Schisandrae, in relieving cough and facilitating expectoration of phlegm. CKD-497 was found to inhibit inflammatory mediators such as interleukin-8 (IL-8) and tumor necrosis factor α (TNF-α) in lipopolysaccharide (LPS)-treated mouse macrophages and transient receptor potential cation channel 1 (TRPV-1)-overexpressed human bronchial epithelial cells stimulated by capsaicin. CKD-497 decreased the viscosity of the mucin solution. During in vivo experiments, CKD-497 reduced coughing numbers and increased expectoration of phlegm via mucociliary clearance enhancement. Collectively, these data suggest that CKD-497 possesses potential for cough and phlegm expectoration treatment.
Topics: Animals; Atractylodes; Bronchi; Cells, Cultured; Cough; Expectorants; Guinea Pigs; Humans; Inflammation; Inflammation Mediators; Lipopolysaccharides; Mucociliary Clearance; Plant Extracts; Schisandra; Sputum
PubMed: 32635583
DOI: 10.3390/molecules25133064 -
Journal of Ethnopharmacology May 2024Kai Xin San (KXS), first proposed by Sun Simiao during the Tang Dynasty, has been utilized to treat dementia by tonifying qi and dispersing phlegm.
Exploring the anti-ferroptosis mechanism of Kai-Xin-San against Alzheimer's disease through integrating network pharmacology, bioinformatics, and experimental validation strategy in vivo and in vitro.
ETHNOPHARMACOLOGICAL RELEVANCE
Kai Xin San (KXS), first proposed by Sun Simiao during the Tang Dynasty, has been utilized to treat dementia by tonifying qi and dispersing phlegm.
AIM OF THE STUDY
This study aimed to elucidate the mechanism by which KXS exerts its therapeutic effects on Alzheimer's disease (AD) by targeting ferroptosis, using a combination of network pharmacology, bioinformatics, and experimental validation strategies.
MATERIALS AND METHODS
The active target sites and the further potential mechanisms of KXS in protecting against AD were investigated through molecular docking, molecular dynamics simulation, and network pharmacology, and combined with the validation of animal experiments.
RESULTS
Computational and experimental findings provide the first indication that KXS significantly improves learning and memory defects and inhibits neuronal ferroptosis by repairing mitochondria damage and upregulating the protein expression of ferroptosis suppressor protein 1 (FSP1) in vivo APP/PS1 mice AD model. According to bioinformatics analysis, the mechanism by which KXS inhibits ferroptosis may involve SIRT1. KXS notably upregulated the mRNA and protein expression of SIRT1 in both vivo APP/PS1 mice and in vitro APP-overexpressed HT22 cells. Additionally, KXS inhibited ferroptosis induced by APP-overexpression in HT22 cells through activating the SIRT1-FSP1 signal pathway.
CONCLUSIONS
Collectively, our findings suggest that KXS may inhibit neuronal ferroptosis through activating the SIRT1/FSP1 signaling pathway. This study reveals the scientific basis and underlying modern theory of replenishing qi and eliminating phlegm, which involves the inhibition of ferroptosis. Moreover, it highlights the potential application of SIRT1 or FSP1 activators in the treatment of AD and other ferroptosis-related diseases.
Topics: Mice; Animals; Alzheimer Disease; Sirtuin 1; Ferroptosis; Molecular Docking Simulation; Network Pharmacology; Computational Biology; Drugs, Chinese Herbal
PubMed: 38360383
DOI: 10.1016/j.jep.2024.117915 -
Asian Cardiovascular & Thoracic Annals Jan 2019Chondrosarcoma is a cancer of cartilage cells, and despite being a common primary bone tumor, tracheal chondrosarcoma is rare with only 18 cases reported in the...
Chondrosarcoma is a cancer of cartilage cells, and despite being a common primary bone tumor, tracheal chondrosarcoma is rare with only 18 cases reported in the literature prior to mid-2016. A 60-year-old gentleman presented with progressively increasing cough, severe stridor, and production of phlegm for approximately 2 years. On admission to our tertiary care hospital, he developed complete obstructive apnea within an hour, and was intubated. A tracheal biopsy was performed, followed by resection. Histopathology confirmed chondrosarcoma of the trachea. The patient tolerated the procedure very well and is currently symptom-free on follow-up, with no signs of recurrence.
Topics: Airway Obstruction; Biopsy; Chondrosarcoma; Humans; Male; Middle Aged; Tracheal Neoplasms; Tracheal Stenosis; Treatment Outcome
PubMed: 29860896
DOI: 10.1177/0218492318778484 -
Evidence-based Complementary and... 2022To explore the clinical effect of acupoint application on the outcome of fertilization-embryo transfer (IVF-ET) in patients with polycystic ovary syndrome (PCOS) of the...
OBJECTIVE
To explore the clinical effect of acupoint application on the outcome of fertilization-embryo transfer (IVF-ET) in patients with polycystic ovary syndrome (PCOS) of the phlegm-dampness type and elucidate its possible mechanism of action from the perspective of follicular fluid metabolomics.
METHODS
A total of 90 patients undergoing IVF-ET due to infertility were selected and divided into three groups: the treatment group (PCOS with acupoint application, = 30), the control group (PCOS without acupoint application, = 30), and the normal group (non-PCOS, = 30). All patients received a gonadotropin-releasing hormone agonist (GnRH-a) long protocol for controlled ovarian hyperstimulation (COH). Among them, the treatment group was also given the acupoint application from the day of pituitary downregulation to the day of the human chorionic gonadotrophin (hCG) trigger. Ultrahigh-performance liquid chromatography connected with quadrupole time-of-flight mass spectrometry (UHPLC-MS) was adopted for untargeted metabolomic analysis of follicular fluid collected from the three groups of patients on the day of oocyte pick-up (OPU). The significantly differential metabolites were screened using univariate and multivariate statistical analysis, and the related metabolic pathways were identified by the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis.
RESULTS
Metabolomic analysis showed that the treatment group's follicular fluid samples were aggregated with the normal group and separated from the control group. A total of 34 significantly differential metabolites were found in the follicular fluid of patients with phlegm-dampness PCOS and normal people. With the intervention of acupoint application, seven metabolites (pseudouridine, phenol, 2-oxoadipic acid, 9R,10S-EpOME, DL-lactate, nicotinamide, and DL-indole-3-lactic acid) were all downregulated, mainly involving the pathways of pyruvate metabolism, nicotinate and nicotinamide metabolism, protein digestion and absorption, biosynthesis of amino acids, and pyrimidine metabolism.
CONCLUSIONS
Acupoint application can effectively improve the clinical symptoms and the outcome of IVF-ET treatment in patients with PCOS of the phlegm-dampness type, and its mechanism of action may be related to the regulation of the pathways of pyruvate metabolism, nicotinate and nicotinamide metabolism, protein digestion and absorption, biosynthesis of amino acids, and pyrimidine metabolism.
PubMed: 36276871
DOI: 10.1155/2022/9568417 -
Chronic Obstructive Pulmonary Diseases... Jan 2020Cough and phlegm are common symptoms of chronic obstructive pulmonary disease (COPD) and may significantly affect quality of life. This study assessed the burden of...
RATIONALE
Cough and phlegm are common symptoms of chronic obstructive pulmonary disease (COPD) and may significantly affect quality of life. This study assessed the burden of cough and phlegm on clinical outcomes and quality of life among people with a self-reported physician diagnosis of COPD.
METHODS
Patient-reported data from the COPD Foundation's Patient-Powered Research Network (COPD PPRN) were utilized. Cough and phlegm severity and frequency were assessed by responses to questions on the COPD Assessment Test (CAT) and categorized into none/low, moderate and severe. Quality of life domains were evaluated using the Patient-Reported Outcome Measurement Information System (PROMIS-29). Associations between cough and phlegm levels and PROMIS-29 domains were examined using multivariate analysis of variance (MANOVA).
RESULTS
The 5286 participants were average age 64.4 years (SD=11.4), 87.9% white, 60.4% female, 51.2% married, and 42.2% with caregivers. Approximately three-fourths of the participants had moderate or severe cough or phlegm levels. Respondents with moderate and high cough or phlegm had significantly worse dyspnea (<0.0001), more exacerbations in the previous one year (<0.0001), worse physical and social functioning, and more symptoms of anxiety and depression on PROMIS-29 compared to those with no/low cough and phlegm.
CONCLUSIONS
In this group of people with COPD, higher levels of cough and phlegm are associated with worse clinical and quality of life outcomes.
PubMed: 31999902
DOI: 10.15326/jcopdf.7.1.2019.0146 -
Bulletin of the History of Medicine 2023Phlegm figures as a major cause and consequence of disease in late imperial Chinese medicine. Curiously, however, when we go back to the classics, the very notion of...
Phlegm figures as a major cause and consequence of disease in late imperial Chinese medicine. Curiously, however, when we go back to the classics, the very notion of phlegm is entirely absent. The rise of phlegm is one of the fundamental transformations in the history of Chinese medicine. This article suggests that the little-known Yuan dynasty treatise On the Art of Nourishing Life (1338), which is notable for extending Chinese phlegm theory in unprecedented ways, was pivotal for this transformation. Noting a strong resemblance of the innovations of this treatise with Galenic medical theories, this article argues that they were inspired by an encounter with the Galenic medical tradition. It submits that these novel ideas radically altered preexisting Chinese understandings of the body's materiality and the nature of disease, and calls for closer attention to the transcultural movements of theories and concepts in the historiography of Chinese and global medicine.
Topics: Medicine, Chinese Traditional; Historiography
PubMed: 38588245
DOI: 10.1353/bhm.2023.a905729 -
Chinese Journal of Integrative Medicine Jun 2022To delineate the onset and recurrence characteristics of noncardiogenic ischemic stroke patients in China.
OBJECTIVE
To delineate the onset and recurrence characteristics of noncardiogenic ischemic stroke patients in China.
METHODS
A prospective, multicenter and registry study was carried out in 2,558 patients at 7 representative clinical sub-centers during November 3, 2016 to February 17, 2019. A questionnaire was used to collect information of patients regarding CM syndromes and constitutions and associated risk factors. Additionally, stroke recurrence was defined as a primary outcome indicator.
RESULTS
A total of 327 (12.78 %) patients endured recurrence events, 1,681 (65.72%) were men, and the average age was 63.33 ± 9.45 years. Totally 1,741 (68.06%) patients suffered first-ever ischemic stroke, 1,772 (69.27%) patients reported to have hypertension, and 1,640 (64.11%) of them reported dyslipidemia, 1,595 (62.35%) patients exhibited small-artery occlusion by The Trial of Org 10172 in Acute Stroke Treatment (TOAST) classification. Specifically, 1,271 (49.69%) patients were considered as qi-deficient constitution, and 1,227 (47.97%) patients were determined as stagnant blood constitution. There were 1,303 (50.94%) patients diagnosed as blood stasis syndrome, 1,280 (50.04%) patients exhibited phlegm and dampness syndrome and 1,012 (39.56%) patients demonstrated qi deficiency syndrome. And 1,033 (40.38%) patients declared intracranial artery stenosis, and 478 (18.69%) patients reported carotid artery stenosis. The plaque in 1,508 (41.36%) patients were of mixed. Particularly, 41.09% of them demonstrated abnormal levels of glycated hemoglobin levels.
CONCLUSIONS
Recurrence in minor and small-artery stroke cannot be ignored. Hypertension, dyslipidemia, abnormal HbA1c, intracranial artery stenosis and carotid plaque were more common in stroke patients. Particularly, phlegm-dampness and blood stasis syndromes, as well as qi deficiency and blood stasis constitutions, were still the main manifestations of stroke. (Trial registration at ClinicalTrials.gov No. NCT03174535).
Topics: Aged; Constriction, Pathologic; Female; Hospitals; Humans; Hypertension; Ischemic Stroke; Male; Medicine, Chinese Traditional; Middle Aged; Prospective Studies; Stroke; Syndrome
PubMed: 35258782
DOI: 10.1007/s11655-022-3306-4