AIM To explore the pharmacokinetics and pharmacodynamics of Da-Cheng-Qi decoction (DCQD) in the liver of rats with severe acute pancreatitis (SAP) based on an herbal recipe tissue pharmacology hypothesis. METHODS Heal...AIM To explore the pharmacokinetics and pharmacodynamics of Da-Cheng-Qi decoction (DCQD) in the liver of rats with severe acute pancreatitis (SAP) based on an herbal recipe tissue pharmacology hypothesis. METHODS Healthy male Sprague-Dawley rats were randomly divided into a sham operation group (SOG); a model group (MG); and low-, median- and high-dose treatment groups (LDG, MDG, and HDG, respectively). Different dosages (6, 12 and 24 g/kg for the LDG, MDG, and HDG, respectively) of DCQD were administered to the rats with SAP. The tissue concentrations of aloeemodin, rhein, emodin, chrysophanol, honokiol, rheo chrysophanol, magnolol, hesperidin, naringenin and naringin in the liver of the treated rats were detected by high-performance liquid chromatography tandem mass spectrometry. Alanine transaminase (ALT) and aspartate transaminase (AST) in serum, inflammatory mediators in the liver and pathological scores were evaluated. RESULTS The major components of DCQD were detected in the liver, and their concentrations increased dose-dependently. The high dose of DCQD showed a maximal effect in ameliorating the pathological damages, decreasing the pro-inflammatory mediators tumor necrosis factor-a and interleukin (IL)-6 and increasing anti-inflammatory mediators IL-4 and IL-10 in the liver. The pathological scores in the pancreas for the MG were significantly higher than those for the SOG (P < 0.05). DCQD could reduce the pathological scores in the pancreas and liver of the rats with SAP, especially in the HDG. Compared to the SOG, the ALT and AST levels in serum were higher in the MG (P < 0.05), while there was no statistical difference in the MG and HDG. CONCLUSION DCQD could alleviate liver damage by altering the inflammatory response in rats with SAP based on the liver distribution of its components.展开更多
Background Intra-abdominal hypertension （IAH） is a recognized prognostic marker for severity of severe acute pancreatitis （SAP） and has a strong impact on the clinical course of SAP. Previous studies indicate that...Background Intra-abdominal hypertension （IAH） is a recognized prognostic marker for severity of severe acute pancreatitis （SAP） and has a strong impact on the clinical course of SAP. Previous studies indicate that a Da-Cheng-Qi Decoction （DCQD） is beneficial in the treatment of SAP. The purpose of this study was to evaluate the effect of modified DCQD on IAH in patients with SAP. Methods Between January 2008 and December 2008, 42 patients from the West China Hospital were randomized into either the DCQD or control group （n=21 in each group）. Mortality, intra-abdominal pressure （lAP）, Acute Physiology and Chronic Health Evaluation II （APACHE II） score, C-reactive protein （CRP）, oxygenation index, Balthazar CT score, rate of renal failure, decompression rate, intensive care unit （ICU） transfer rate, and length of hospital stay （LOS） were compared between the two groups. Results Compared to the control group, the modified DCQD treatment significantly decreased lAP （P 〈0.05） and APACHE II （P 〈0.05） scores on days 4-8, CRP on day 8 （P 〈0.01）, renal failure rate （P 〈0.05）, and LOS （P 〈0.05）. The oxygenation index was significantly improved in the DCQD group compared with the control group （P 〈0.05）. No significant differences in the Balthazar CT score, shock rate, ICU transfer rate, or mortality occurred between the two groups. Conclusions The modified DCQD can effectively relieve IAH and decrease LOS for patients with SAP. Larger clinical trials are needed to confirm these findings.展开更多
AIM:To investigate the effect of severe acute pan- creatitis(SAP)on pharmacokinetics of Da-Cheng-Qi Decoction(DCQD)components in rats. METHODS:Rats were divided into SAP group and sham-operation group as a control gro...AIM:To investigate the effect of severe acute pan- creatitis(SAP)on pharmacokinetics of Da-Cheng-Qi Decoction(DCQD)components in rats. METHODS:Rats were divided into SAP group and sham-operation group as a control group(n=6). Rhein,chrysophanol,rheochrysidin,magnolol,hesperidin and naringin in DCQD were quantified in rat serum by high performance liquid chromatography tandem mass spectrometry for studying their pharmacokinetics. RESULTS:Early absorption of each DCQD component was tended to degrade in SAP group after treatment with DCQD by gavage.The Cmax(chrysophanol,P= 0.0059;rheochrysidin,P=0.0288;magnolol,P= 0.0487;hesperidin,P=0.0277;naringin,P=0.0023) and AUC(rhein,P=0.0186;chrysophanol,P=0.0013; magnolol,P=0.001;hesperidin,P=0.0081;naringin, P=0.0272)of DCQD component were obviously lower in SAP group than in control group.The T1/2α of chrysophanol and rheochrysidin(P=0.0467 and 0.0005,respectively)and Tmax of chrysophanol and rheochrysidin(P=0.0101 and 0.0037,respectively) lasted longer in SAP group than in control group. CONCLUSION:SAP can significantly impact the ab-sorption of DCQD components in rats and their phar-macokinetic parameters.展开更多
Objective To investigate the effects of Da-Cheng-Qi Decoction(DCQD,大承气汤)combined with Lactobacillus acidophilus(LA)on the recovery of gastrointestinal(GI)function in traumatic brain-injured(TBI)mice.Methods A tota...Objective To investigate the effects of Da-Cheng-Qi Decoction(DCQD,大承气汤)combined with Lactobacillus acidophilus(LA)on the recovery of gastrointestinal(GI)function in traumatic brain-injured(TBI)mice.Methods A total of 150 male C57BL/6 mice were randomly divided into sham-injury,normal saline(NS),DCQD(0.4 mL/day),LA(⩾1×1010 cfu/day LA),DCQD+LA(LA administration at the same dosage after 4 h of feeding DCQD),and½DCQD+LA groups(LA administration at the same dosage after 4 h of feeding½DCQD dose)by a random number table,5–8 mice in each group.The sever TBI model was constructed according to Feeney’s enhanced gravitational forces of free falling.On days 1,3,and 7 post-TBI,plasma diamine oxidase(DAO)and D-lactic acid levels were assessed by enzyme-linked immunosorbent assay(ELISA).Occludin expression in the intestinal epithelium was assessed by Western blot analysis.Transmission electron microscopy(TEM)was used to observe the morphological changes in the network structure of interstitial cells of Cajal(ICC)and change of enteric nervous system-ICC-smooth muscle cell(ENS-ICC-SMC).Immunofluorescence staining was used to detect changes in the network structure of the ICC.Results Compared with the NS group,occludin expression in the DCQD+LA group significantly increased on Day 1,3,and 7 post-TBI(P<0.05 or P<0.01).The concentration of DAO significantly decreased in the LA,DCQD,and DCQD+LA groups on Day 3 and 7,whilst the D-lactate concentrations in the LA and½DCQD+LA groups decreased on Day 1 and 3 post-injury(P<0.05 or P<0.01).The NS group experienced a great damage on the ENS-ICC-SMC network morphology and ICC network structure,and all treatment groups had some improvements,among which the DCQD+LA group presented relatively intact network morphology.Conclusions DCQD combined with LA treatment could effectively repair the intestinal mucosal barrier and improve GI motility in mice after TBI.The combination of DCQD and LA was more effective than their respective monotherapies.展开更多
AIM To identify the optimal oral dosing time of Da-Cheng-Qi decoction(DCQD) in rats with acute pancreatitis(AP) based on the pharmacokinetic and pharmacodynamic parameters.METHODS First, 24 male Sprague-Dawley rats we...AIM To identify the optimal oral dosing time of Da-Cheng-Qi decoction(DCQD) in rats with acute pancreatitis(AP) based on the pharmacokinetic and pharmacodynamic parameters.METHODS First, 24 male Sprague-Dawley rats were divided into a sham-operated group [NG(a)] and three model groups [4 h G(a), 12 h G(a) and 24 h G(a)]. The NG(a) and model groups were administered DCQD(10 g/kg.BW) intragastrically at 4 h, 4 h, 12 h and 24 h, respectively, after AP models induced by 3% sodium taurocholate. Plasma samples were collected from the tails at 10 min, 20 min, 40 min, 1 h, 2 h, 4 h, 8 h, 12 h and 24 h after a single dosing with DCQD. Plasma and pancreatic tissue concentrations of the major components of DCQD were determined by high-performance liquid chromatography tandem mass spectroscopy. The pharmacokinetic parameters and serum amylase were detected and compared. Second, rats were divided into a sham-operated group [NG(b)] and three treatment groups [4 h G(b), 12 h G(b) and 24 h G(b)] with three corresponding control groups [MG(b)s]. Blood and pancreatic tissues were collected 24 h after a single dosing with DCQD. Serum amylase, inflammatory cytokines and pathological scores of pancreatic tissues were detected and compared.RESULTS The concentrations of emodin, naringin, honokiol, naringenin, aloe-emodin, chrysophanol and rheochrysidin in the 12 h G(a) group were higher than those in the 4 h G(a) group in the pancreatic tissues(P < 0.05). The area under the plasma concentration-time curve from time 0 to the time of the last measurable concentration values(AUC0→t) for rhein, chrysophanol, magnolol and naringin in the 12 h G(a) group were larger than those in the 4 h G(a) or 24 h G(a) groups. The 12 h G(a) group had a higher Cmax than the other two model groups. The IL-10 levels in the 12 h G(b) and 24 h G(b) groups were higher than in the MG(b)s(96.55 ± 7.84 vs 77.46 ± 7.42, 251.22 ± 16.15 vs 99.72 ± 4.7 respectively, P < 0.05), while in the 24 h G(b) group, the IL-10 level was higher than in the other two treatme展开更多
目的探讨大承气汤用于结肠镜检前的肠道清洁效果以及患者接受度。方法临床收集63例肠镜检查患者,随机纳入观察组与对照组,其中观察组31例,在结肠镜检查前1天服用大承气汤3剂,对照组32例,在检查前1天服用磷酸钠盐90 m L,分别观察和记录2...目的探讨大承气汤用于结肠镜检前的肠道清洁效果以及患者接受度。方法临床收集63例肠镜检查患者,随机纳入观察组与对照组,其中观察组31例,在结肠镜检查前1天服用大承气汤3剂,对照组32例,在检查前1天服用磷酸钠盐90 m L,分别观察和记录2组肠道准备情况,并在肠道清洁程度、肠道清洁范围、服药后不良反应及性价比等方面进行对比分析。结果观察组肠道清洁程度及清洁范围与对照组无差异(P>0.05),但观察组服药后不良反应少于对照组(P<0.05)。结论口服大承气汤肠道清洁度符合要求,且不良反应少,患者满意度高,值得临床推广应用。展开更多
Objective: The objective of this study was to investigate the effects of Da-Cheng-Qi decoction (DCQD) on enteroparalysis and levels of the serum inflammatory cytokines C-C motif chemokine ligand 2 (CCL2) and interleuk...Objective: The objective of this study was to investigate the effects of Da-Cheng-Qi decoction (DCQD) on enteroparalysis and levels of the serum inflammatory cytokines C-C motif chemokine ligand 2 (CCL2) and interleukin-8 (IL-8) in patients with severe acute pancreatitis (SAP). Methods: A total of 48 patients diagnosed with SAP who hospitalized in First Affiliated Hospital of Henan Traditional Chinese Medicine University from May 1, 2016 to May 30, 2018 were randomly assigned to the control or treatment groups. Patients in the control group (n = 22) received conventional treatment and those in the treatment group (n = 26) received conventional treatment as well as additional DCQD for 10 days. The duration of abdominal pain and distension, the time when bowel sounds returned to normal, changes in the levels of serum amylase, lipase, C-reactive protein (CRP), CCL2 and IL-8, as well as acute physiology and chronic health evaluation (APACHE)Ⅱ scores of patients on days 1 and 10 were recorded and compared. Results: The duration of abdominal pain and distension, the time when bowel sounds returned to normal, the levels of blood amylase, lipase and CRP, and APACHE Ⅱ scores of patients in the treatment group decreased significantly compared with those of patients in the control group. Though there were no statistical differences in serum CCL2 and IL-8 concentrations on day 1 between patients in these two groups, the levels of serum CCL2 and IL-8 in the treatment group were lower than those in the control group on day 10. Conclusion: DCQD may decrease the levels of CCL2, CRP, and IL-8 in patients with SAP, quickly relieve enteroparalysis, and shorten hospitalization duration.展开更多
Objective:To evaluate the efficacy and safety of topical delivery of modified Da-Cheng-Qi Decoction(加味大承气汤,MDCQD)by low-frequency ultrasound sonophoresis(LFUS)in patients with refractory metastatic malignant bow...Objective:To evaluate the efficacy and safety of topical delivery of modified Da-Cheng-Qi Decoction(加味大承气汤,MDCQD)by low-frequency ultrasound sonophoresis(LFUS)in patients with refractory metastatic malignant bowel obstruction(MBO)using an objective performance criteria(OPC)design.Methods:Fifty patients with refractory metastatic MBO were enrolled in this open-label single-arm clinical trial.Alongside fasting,gastrointestinal decompression,glycerol enema,intravenous nutrition and antisecretory therapy,a 50 g dose of MDCQD(prepared as a hydrogel)was applied through topical delivery at the site of abodminal pain or Tianshu(S 25)using LFUS for 30 min,twice daily for 5 consecutive days.The overall outcomes were the remission of intestinal obstruction,improvement on abdominal pain,abdominal distention,nausea and vomiting scores.Indicators of safety evaluation included liver and renal function as well as blood coagulation indicators.Results:Among 50 patients,5 patients(10%)showed complete remission of intestinal obstruction and 21 patients(42%)showed improvement of intestinal obstruction.The overall remission rate of bowel obstruction was 52%.The results of the symptom score,based on the severity and frequency of the episode,were as follows:26 patients(52%)showed improvment on symptom scores,20 patients(40%)did not respond to treatment,and 4 patients(8%)discontinued treatment due to intolerance.No serious adverse effects or abnormal changes on liver and renal functions or blood coagulation were observed.Conclusion:Topical delivery of MDCQD at 100 g/day using LFUS can improve the treatment response in patients with refractory metastatic MBO.展开更多
Objective Patients and doctors often have questions about the equivalence of traditional and machinery decoctions. In this article, using Da-cheng-qi Decoction（DCQD） as a model of formula, traditional decoction（TD...Objective Patients and doctors often have questions about the equivalence of traditional and machinery decoctions. In this article, using Da-cheng-qi Decoction（DCQD） as a model of formula, traditional decoction（TD）, machinery decoction under high pressure（MDHP）, and machinery decoction under normal pressure（MDNP） were compared. Methods For chemical components, HPLC fingerprints were established and evaluated using AHP combined with CRITIC weighing method; For animals＇ effects, the experiments of small intestinal propulsion were conducted; For clinical effects, a randomized clinical trial（RCT） was designed and performed. Results Although there were some differences between TD and MDNP in chemical ingredients, there was no significant difference in animal experiments and clinical trials（P 〉 0.05）. Conclusion The traditional and machinery decoctions of DCQD could be used bioequivalently.展开更多
基金Supported by National Natural Science Foundation of China,No.81374042,No.81370091 and No.81573857
文摘AIM To explore the pharmacokinetics and pharmacodynamics of Da-Cheng-Qi decoction (DCQD) in the liver of rats with severe acute pancreatitis (SAP) based on an herbal recipe tissue pharmacology hypothesis. METHODS Healthy male Sprague-Dawley rats were randomly divided into a sham operation group (SOG); a model group (MG); and low-, median- and high-dose treatment groups (LDG, MDG, and HDG, respectively). Different dosages (6, 12 and 24 g/kg for the LDG, MDG, and HDG, respectively) of DCQD were administered to the rats with SAP. The tissue concentrations of aloeemodin, rhein, emodin, chrysophanol, honokiol, rheo chrysophanol, magnolol, hesperidin, naringenin and naringin in the liver of the treated rats were detected by high-performance liquid chromatography tandem mass spectrometry. Alanine transaminase (ALT) and aspartate transaminase (AST) in serum, inflammatory mediators in the liver and pathological scores were evaluated. RESULTS The major components of DCQD were detected in the liver, and their concentrations increased dose-dependently. The high dose of DCQD showed a maximal effect in ameliorating the pathological damages, decreasing the pro-inflammatory mediators tumor necrosis factor-a and interleukin (IL)-6 and increasing anti-inflammatory mediators IL-4 and IL-10 in the liver. The pathological scores in the pancreas for the MG were significantly higher than those for the SOG (P < 0.05). DCQD could reduce the pathological scores in the pancreas and liver of the rats with SAP, especially in the HDG. Compared to the SOG, the ALT and AST levels in serum were higher in the MG (P < 0.05), while there was no statistical difference in the MG and HDG. CONCLUSION DCQD could alleviate liver damage by altering the inflammatory response in rats with SAP based on the liver distribution of its components.
基金This study was supported by a grant from the National Natural Science Foundation of China （No. 30801457）.
文摘Background Intra-abdominal hypertension （IAH） is a recognized prognostic marker for severity of severe acute pancreatitis （SAP） and has a strong impact on the clinical course of SAP. Previous studies indicate that a Da-Cheng-Qi Decoction （DCQD） is beneficial in the treatment of SAP. The purpose of this study was to evaluate the effect of modified DCQD on IAH in patients with SAP. Methods Between January 2008 and December 2008, 42 patients from the West China Hospital were randomized into either the DCQD or control group （n=21 in each group）. Mortality, intra-abdominal pressure （lAP）, Acute Physiology and Chronic Health Evaluation II （APACHE II） score, C-reactive protein （CRP）, oxygenation index, Balthazar CT score, rate of renal failure, decompression rate, intensive care unit （ICU） transfer rate, and length of hospital stay （LOS） were compared between the two groups. Results Compared to the control group, the modified DCQD treatment significantly decreased lAP （P 〈0.05） and APACHE II （P 〈0.05） scores on days 4-8, CRP on day 8 （P 〈0.01）, renal failure rate （P 〈0.05）, and LOS （P 〈0.05）. The oxygenation index was significantly improved in the DCQD group compared with the control group （P 〈0.05）. No significant differences in the Balthazar CT score, shock rate, ICU transfer rate, or mortality occurred between the two groups. Conclusions The modified DCQD can effectively relieve IAH and decrease LOS for patients with SAP. Larger clinical trials are needed to confirm these findings.
基金Supported by The National Natural Science Foundation of China,No.30400576 and No.30672588
文摘AIM:To investigate the effect of severe acute pan- creatitis(SAP)on pharmacokinetics of Da-Cheng-Qi Decoction(DCQD)components in rats. METHODS:Rats were divided into SAP group and sham-operation group as a control group(n=6). Rhein,chrysophanol,rheochrysidin,magnolol,hesperidin and naringin in DCQD were quantified in rat serum by high performance liquid chromatography tandem mass spectrometry for studying their pharmacokinetics. RESULTS:Early absorption of each DCQD component was tended to degrade in SAP group after treatment with DCQD by gavage.The Cmax(chrysophanol,P= 0.0059;rheochrysidin,P=0.0288;magnolol,P= 0.0487;hesperidin,P=0.0277;naringin,P=0.0023) and AUC(rhein,P=0.0186;chrysophanol,P=0.0013; magnolol,P=0.001;hesperidin,P=0.0081;naringin, P=0.0272)of DCQD component were obviously lower in SAP group than in control group.The T1/2α of chrysophanol and rheochrysidin(P=0.0467 and 0.0005,respectively)and Tmax of chrysophanol and rheochrysidin(P=0.0101 and 0.0037,respectively) lasted longer in SAP group than in control group. CONCLUSION:SAP can significantly impact the ab-sorption of DCQD components in rats and their phar-macokinetic parameters.
基金Supported by The General Project of Traditional Chinese Medici ne Tech no logical Projects for the Health Bureau of Chongqing(No.2012-2-91)。
文摘Objective To investigate the effects of Da-Cheng-Qi Decoction(DCQD,大承气汤)combined with Lactobacillus acidophilus(LA)on the recovery of gastrointestinal(GI)function in traumatic brain-injured(TBI)mice.Methods A total of 150 male C57BL/6 mice were randomly divided into sham-injury,normal saline(NS),DCQD(0.4 mL/day),LA(⩾1×1010 cfu/day LA),DCQD+LA(LA administration at the same dosage after 4 h of feeding DCQD),and½DCQD+LA groups(LA administration at the same dosage after 4 h of feeding½DCQD dose)by a random number table,5–8 mice in each group.The sever TBI model was constructed according to Feeney’s enhanced gravitational forces of free falling.On days 1,3,and 7 post-TBI,plasma diamine oxidase(DAO)and D-lactic acid levels were assessed by enzyme-linked immunosorbent assay(ELISA).Occludin expression in the intestinal epithelium was assessed by Western blot analysis.Transmission electron microscopy(TEM)was used to observe the morphological changes in the network structure of interstitial cells of Cajal(ICC)and change of enteric nervous system-ICC-smooth muscle cell(ENS-ICC-SMC).Immunofluorescence staining was used to detect changes in the network structure of the ICC.Results Compared with the NS group,occludin expression in the DCQD+LA group significantly increased on Day 1,3,and 7 post-TBI(P<0.05 or P<0.01).The concentration of DAO significantly decreased in the LA,DCQD,and DCQD+LA groups on Day 3 and 7,whilst the D-lactate concentrations in the LA and½DCQD+LA groups decreased on Day 1 and 3 post-injury(P<0.05 or P<0.01).The NS group experienced a great damage on the ENS-ICC-SMC network morphology and ICC network structure,and all treatment groups had some improvements,among which the DCQD+LA group presented relatively intact network morphology.Conclusions DCQD combined with LA treatment could effectively repair the intestinal mucosal barrier and improve GI motility in mice after TBI.The combination of DCQD and LA was more effective than their respective monotherapies.
基金Supported by the National Natural Science Foundation of China,No.81374042,No.81370091 and No.81603480
文摘AIM To identify the optimal oral dosing time of Da-Cheng-Qi decoction(DCQD) in rats with acute pancreatitis(AP) based on the pharmacokinetic and pharmacodynamic parameters.METHODS First, 24 male Sprague-Dawley rats were divided into a sham-operated group [NG(a)] and three model groups [4 h G(a), 12 h G(a) and 24 h G(a)]. The NG(a) and model groups were administered DCQD(10 g/kg.BW) intragastrically at 4 h, 4 h, 12 h and 24 h, respectively, after AP models induced by 3% sodium taurocholate. Plasma samples were collected from the tails at 10 min, 20 min, 40 min, 1 h, 2 h, 4 h, 8 h, 12 h and 24 h after a single dosing with DCQD. Plasma and pancreatic tissue concentrations of the major components of DCQD were determined by high-performance liquid chromatography tandem mass spectroscopy. The pharmacokinetic parameters and serum amylase were detected and compared. Second, rats were divided into a sham-operated group [NG(b)] and three treatment groups [4 h G(b), 12 h G(b) and 24 h G(b)] with three corresponding control groups [MG(b)s]. Blood and pancreatic tissues were collected 24 h after a single dosing with DCQD. Serum amylase, inflammatory cytokines and pathological scores of pancreatic tissues were detected and compared.RESULTS The concentrations of emodin, naringin, honokiol, naringenin, aloe-emodin, chrysophanol and rheochrysidin in the 12 h G(a) group were higher than those in the 4 h G(a) group in the pancreatic tissues(P < 0.05). The area under the plasma concentration-time curve from time 0 to the time of the last measurable concentration values(AUC0→t) for rhein, chrysophanol, magnolol and naringin in the 12 h G(a) group were larger than those in the 4 h G(a) or 24 h G(a) groups. The 12 h G(a) group had a higher Cmax than the other two model groups. The IL-10 levels in the 12 h G(b) and 24 h G(b) groups were higher than in the MG(b)s(96.55 ± 7.84 vs 77.46 ± 7.42, 251.22 ± 16.15 vs 99.72 ± 4.7 respectively, P < 0.05), while in the 24 h G(b) group, the IL-10 level was higher than in the other two treatme
文摘目的探讨大承气汤用于结肠镜检前的肠道清洁效果以及患者接受度。方法临床收集63例肠镜检查患者,随机纳入观察组与对照组,其中观察组31例,在结肠镜检查前1天服用大承气汤3剂,对照组32例,在检查前1天服用磷酸钠盐90 m L,分别观察和记录2组肠道准备情况,并在肠道清洁程度、肠道清洁范围、服药后不良反应及性价比等方面进行对比分析。结果观察组肠道清洁程度及清洁范围与对照组无差异(P>0.05),但观察组服药后不良反应少于对照组(P<0.05)。结论口服大承气汤肠道清洁度符合要求,且不良反应少,患者满意度高,值得临床推广应用。
文摘Objective: The objective of this study was to investigate the effects of Da-Cheng-Qi decoction (DCQD) on enteroparalysis and levels of the serum inflammatory cytokines C-C motif chemokine ligand 2 (CCL2) and interleukin-8 (IL-8) in patients with severe acute pancreatitis (SAP). Methods: A total of 48 patients diagnosed with SAP who hospitalized in First Affiliated Hospital of Henan Traditional Chinese Medicine University from May 1, 2016 to May 30, 2018 were randomly assigned to the control or treatment groups. Patients in the control group (n = 22) received conventional treatment and those in the treatment group (n = 26) received conventional treatment as well as additional DCQD for 10 days. The duration of abdominal pain and distension, the time when bowel sounds returned to normal, changes in the levels of serum amylase, lipase, C-reactive protein (CRP), CCL2 and IL-8, as well as acute physiology and chronic health evaluation (APACHE)Ⅱ scores of patients on days 1 and 10 were recorded and compared. Results: The duration of abdominal pain and distension, the time when bowel sounds returned to normal, the levels of blood amylase, lipase and CRP, and APACHE Ⅱ scores of patients in the treatment group decreased significantly compared with those of patients in the control group. Though there were no statistical differences in serum CCL2 and IL-8 concentrations on day 1 between patients in these two groups, the levels of serum CCL2 and IL-8 in the treatment group were lower than those in the control group on day 10. Conclusion: DCQD may decrease the levels of CCL2, CRP, and IL-8 in patients with SAP, quickly relieve enteroparalysis, and shorten hospitalization duration.
基金Supported by the Beijing Hope Run Special Fund of Cancer Foundation of China(No.LC2014B18)。
文摘Objective:To evaluate the efficacy and safety of topical delivery of modified Da-Cheng-Qi Decoction(加味大承气汤,MDCQD)by low-frequency ultrasound sonophoresis(LFUS)in patients with refractory metastatic malignant bowel obstruction(MBO)using an objective performance criteria(OPC)design.Methods:Fifty patients with refractory metastatic MBO were enrolled in this open-label single-arm clinical trial.Alongside fasting,gastrointestinal decompression,glycerol enema,intravenous nutrition and antisecretory therapy,a 50 g dose of MDCQD(prepared as a hydrogel)was applied through topical delivery at the site of abodminal pain or Tianshu(S 25)using LFUS for 30 min,twice daily for 5 consecutive days.The overall outcomes were the remission of intestinal obstruction,improvement on abdominal pain,abdominal distention,nausea and vomiting scores.Indicators of safety evaluation included liver and renal function as well as blood coagulation indicators.Results:Among 50 patients,5 patients(10%)showed complete remission of intestinal obstruction and 21 patients(42%)showed improvement of intestinal obstruction.The overall remission rate of bowel obstruction was 52%.The results of the symptom score,based on the severity and frequency of the episode,were as follows:26 patients(52%)showed improvment on symptom scores,20 patients(40%)did not respond to treatment,and 4 patients(8%)discontinued treatment due to intolerance.No serious adverse effects or abnormal changes on liver and renal functions or blood coagulation were observed.Conclusion:Topical delivery of MDCQD at 100 g/day using LFUS can improve the treatment response in patients with refractory metastatic MBO.
基金Longhua Medical Project(LYTD-14)National special research foundation of TCM(No.201007010)
文摘Objective Patients and doctors often have questions about the equivalence of traditional and machinery decoctions. In this article, using Da-cheng-qi Decoction（DCQD） as a model of formula, traditional decoction（TD）, machinery decoction under high pressure（MDHP）, and machinery decoction under normal pressure（MDNP） were compared. Methods For chemical components, HPLC fingerprints were established and evaluated using AHP combined with CRITIC weighing method; For animals＇ effects, the experiments of small intestinal propulsion were conducted; For clinical effects, a randomized clinical trial（RCT） was designed and performed. Results Although there were some differences between TD and MDNP in chemical ingredients, there was no significant difference in animal experiments and clinical trials（P 〉 0.05）. Conclusion The traditional and machinery decoctions of DCQD could be used bioequivalently.
