1.Traditional Chinese Medicine in Prevention and Treatment of Osteonecrosis of Femoral Head Based on OPG/RANK/RANKL Signaling Pathway: A Review
Xiaoting LIU ; Jianjun LIU ; Wenbo AN ; Yusuo GONG ; Baohua YUAN ; Kang HUANG ; Tongke LIU ; Fuping KANG ; Chenglong LU ; Yalong MA
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(16):274-282
Osteonecrosis of the femoral head (ONFH) is a painful and debilitating disease caused by impaired blood supply to the femoral head and cellular and tissue degeneration, leading to gradual destruction of the bone structure and progressive collapse of the femoral head. The main pathological mechanism of ONFH is the disruption of the balance between bone absorption and the reconstruction of new bone, resulting from microcirculation damage and decreased cellular tissue ability. This imbalance leads to biomechanical changes and accelerates the pathological progression of ONFH. In the early stages, clinical manifestations may not be obvious, mainly presenting as pain or discomfort in the hip or groin area, which can be relieved after rest. In the later stage of the disease, pain intensifies, and limb shortening, lower limb weakness, difficulty walking, or limping may occur. Currently, western medicine commonly uses osteogenic agents, anticoagulants, and artificial joint replacement for treatment, but there are also many issues such as prosthesis loosening and infection. Research has shown that traditional Chinese medicine (TCM) treatment of ONFH takes a holistic approach and employs multi-functional, multi-target, and multi-system Chinese medicine therapies, ensuring the safety and effectiveness of the treatment. The osteoprotegerin (OPG)/receptor activator of nuclear factor-κB (RANK)/RANK ligand (RANKL) signaling pathway plays a crucial role in maintaining the dynamic balance of bone remodeling. TCM treatments utilize this pathway to promote apoptosis of osteoclasts, reduce bone resorption, and accelerate bone formation, thereby playing an important role in the prevention and treatment of ONFH. This paper reviewed the role of OPG/RANK/RANKL signaling pathway and related cytokine expression in ONFH by reviewing relevant literature in China and abroad and research status of Chinese medicinal monomers, Chinese medicinal formulations, and combinations with physical therapy in increasing osteoblast secretion, promoting OPG expression, enhancing cytokine expression levels, and inhibiting osteoclast activity for the prevention and treatment of ONFH. This paper is expected to provide new ideas and directions for TCM in the prevention and treatment of ONFH.
2.Historical Evolution and Modern Clinical Application of Danggui Liuhuangtang
Yanan WU ; Fuping LI ; Ying XU ; Liying KANG ; Jiangxia YANG ; Jianying BAI ; Xiufen ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(9):8-17
Danggui Liuhuangtang is the 47th of the 100 famous classical formulas published by the National Administration of Traditional Chinese Medicine, and is known as the holy medicine for night sweat. By bibliometrics, the authors collected the ancient books on Danggui Liuhuangtang and screened out 269 valid data, involving 156 ancient books of traditional Chinese medicine. The analysis on the historical origin, disease syndromes, pathogenesis, composition, dosage, preparation, usage, and processing of Danggui Liuhuangtang found that this famous classical formula originated from Secret Book of the Orchid Chamber (《兰室秘藏》) written by LI Dongyuan, and is composed of Angelicae Sinensis Radix, Rehmanniae Radix, Rehmanniae Radix Praeparata, Phellodendri Chinensis Cortex, Scutellariae Radix, Coptidis Rhizoma and Astragali Radix. It has the functions of nourishing Yin, reducing fire, consolidating exterior and stopping sweating, and mainly treats night sweat due to Yin deficiency and fire exuberance. In the later generations, disease syndromes are mostly treated based on LI Dongyuan's theory, and have expanded to more than 30 kinds (339 in total), among which night sweat (208) was the most, accounting for 61.36% of the total disease syndromes, followed by spontaneous sweating (38), accounting for 11.21%. Additionally, it was found that Danggui Liuhuangtang was widely used in modern clinical practice for various disease syndromes. Among them, endocrine disease (77, 28.21%) was predominant, followed by gynecological disease (48, 17.58%), and pediatric disease (24, 8.79%). Although Danggui Liuhuangtang treats many disease syndromes, their pathogenesis was always yin deficiency and fire exuberance. Through the systematic excavation of the ancient books on Danggui Liuhuangtang and the analysis of its modern clinical application, this paper probed into the historical evolution and confirmed the key information of the formula, providing detailed literature basis for the research and development application of famous classical formulas.
3.Historical Evolution and Modern Clinical Application of Shengyang Yiweitang
Xiaowen WANG ; Jianying BAI ; Di LU ; Ruiju FAN ; Xiufen ZHANG ; Guizhen YANG ; Zhaojuan XU ; Fuping LI ; Liying KANG
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(19):173-184
Shengyang Yiweitang is one of the first 100 classical prescriptions published by the National Administration of Traditional Chinese Medicine. It originated from the Clarifying Doubts about Damage from Internal and External Causes by physician LI Dongyuan of Jin dynasty, and is composed of Astragali Radix, Ginseng Radix et Rhizoma, Glycyrrhizae Radix et Rhizoma, Atractylodis Macrocephalae Rhizoma, Poria, Pinelliae Rhizoma, Citri Reticulatae Pericarpium, Angelicae Pubescentis Radix, Saposhnikoviae Radix, Notopterygii Rhizoma et Radix, Bupleuri Radix, Paeoniae Radix Alba, Alismatis Rhizoma, and Coptidis Rhizoma. With the effects of replenishing Qi, promoting Yang, clearing heat and removing dampness, Shengyang Yiweitang is used to treat spleen-stomach weakness and dampness-heat accumulation syndrome. Using bibliometrics, the authors systematically sorted out the source,composition, dosage, preparation, efficacy, indications, principle of composition, origin and processing of drugs,and modern clinical application of the prescription, and explored its history and key information. Additionally, it was found that Shengyang Yiweitang was widely used in modern clinical practice and was suitable for multisystem diseases, of which digestive system (264) was the most common, accounting for 41.71%, followed by urogenital system (57, 9.00%) and nervous system (48, 7.58%). Although the treatment scope was wide, the pathogenesis of the diseases in traditional Chinese medicine belongs to "spleen-stomach weakness", which fully reflected Li's academic thought of "internal injury of spleen and stomach leads to various diseases". The key information of Shengyang Yiweitang was determined by summarizing the relevant ancient books and modern literature, so as to provide accurate reference for its rational clinical application and further research and development.
4.Ancient Literature on Qingweisan and Its Modern Clinical Application
Fuping LI ; Lixian FEI ; Xiaowen WANG ; Liying KANG ; Di LU ; Suwen QI ; Ruiju FAN ; Jiangxia YANG ; Jianying BAI ; Xiufen ZHANG ; Huili RONG
Chinese Journal of Experimental Traditional Medical Formulae 2022;28(22):47-57
Qingweisan is one of the classical prescriptions commonly used in the treatment of oral diseases. By means of Bibliometrics, the authors collected the ancient books on Qingweisan and sifted out 411 valid data, involving 116 classics of traditional Chinese medicine. The historical origin, drug composition, indications, principle of composition, dosage,and preparation of Qingweisan were statistically analyzed, and it was found that the prescription originated from the Treatise on Spleen and Stomach(《脾胃论》) by LI Dongyuan and is composed of Rehmanniae Radix, Angelica Sinensis, Cortex Moutan, Coptidis Rhizoma and Cimicifugae Rhizoma, with the functions of clearing stomach, purging fire, cooling blood and dispersing depression. And Qingweisan was mainly used to treat toothache, headache, and preference for cold and aversion to heat caused by "excessive heat in yang brightness meridian". There were 352 indications recorded, most of which followed LI Dongyuan's theory and the expanded indications reached 70 kinds. Specifically, toothache (132) was the most, accounting for 22.49% of the total indications, followed by headache (60, 10.22%). In addition, Qingweisan was widely used in modern clinical practice for multiple system diseases, among which oral system (197) was dominant, accounting for 72.69%, followed by skin system (28, 10.33%) and digestive system (27, 9.96%). Although the indications were wide, the pathogenesis always belonged to "upward attack of stomach fire". Through the excavation and statistical analysis of the ancient books on Qingweisan and its modern clinical application, the authors aimed to provide a more scientific reference for the research and application of classical famous prescriptions.