OBJECTIVETo study the therapeutic efficacy and adverse reaction of total glucosides of paeony (TGP, extracted from Paeonia lactiflora Pall.) in patients with systemic lupus erythematosus (SLE).

METHODSClinical data of patients with SLE were analyzed. Those who orally took TGP continuously for five years or more were taken as TGP1 group (29 cases). Those who orally took TGP continuously or intermittently for more than one year but less than five years were taken as TGP2 group (47 cases). Twenty patients matched with the TGP1 group and the TGP2 group in age, affected duration, urine protein, and SLE disease activity index (SLEDAI) were selected as the control group. The average daily dose of prednisone, total cyclophosphamide (CTX) dose, urine protein, SLEDAI score, recurrent case, and episodes of infection were compared among the three groups after five-year treatment.

RESULTSThe average daily dose of prednisone, total CTX dose, and SLEDAI score were obviously lower in the TGP1 group than in the control group (P<0.01). The average daily dose of prednisone, total CTX dose, and SLEDAI score were obviously lower in the TGP1 group than in the TGP2 group, Significant difference was shown (P <0. 05). The average daily dose of prednisone and total CTX dose were lower in the TGP2 group than in the control group (P<0.05, P<0.01). There was no statistical difference in the urine protein among the three groups. As for the recurrence, one case occurred in the TGP1 group, nine in the TGP2 group, and seven in the control group. As for episodes of infection, there were three cases in the TGP1 group, seventeen in the TGP2 group, and eighteen in the control group during the five years. No adverse reaction correlated to TGP was found in the three groups.

CONCLUSIONSTGP had definite therapeutic efficacy in treatment of patients with SLE. It could reduce the average daily dose of prednisone and the total CTX dose, lower the recurrent cases and episodes of infection, especially for the medication of more than five years.

Adult ; Female ; Glucosides ; therapeutic use ; Humans ; Lupus Erythematosus, Systemic ; drug therapy ; Paeonia ; chemistry ; Phytotherapy ; Treatment Outcome

Diabetic Nephropathies ; drug therapy ; Glucosides ; pharmacology ; therapeutic use ; Humans ; Paeonia ; chemistry ; Phytotherapy

OBJECTIVE: To study the clinical effect and mechanism of total glucosides of paeony (TGP) in the adjuvant therapy for children with Henoch-Schönlein purpura nephritis (HSPN). METHODS: Sixty-four HSPN children with moderate proteinuria were divided into a TGP treatment group ( RESULTS: Compared with the healthy children before treatment, the children with HSPN had higher proportion of Tfh cells and expression levels of IL-21 and IL-4 ( CONCLUSIONS TGP has a marked clinical effect in the treatment of HSPN and can reduce the inflammatory response of the kidney and exert a protective effect on the kidney by inhibiting the proliferation of Tfh cells and downregulating the expression of IL-21 and IL-4 in plasma.
Child ; Glucosides/therapeutic use* ; Humans ; Nephritis ; Paeonia ; Prospective Studies ; Purpura, Schoenlein-Henoch/drug therapy*

OBJECTIVETo evaluate the efficacy and adverse reaction of total glucosides of paeony (TGP) combined with sulfasalazine (SSZ) in the treatment of ankylosing spondylitis (AS).

METHODSSixty-seven AS patients were randomly assigned to 2 groups: the treatment group (34 cases) treated with TGP and SSZ, the control group (33 cases) with methotrexate (MTX) and SSZ. Changes of clinical efficacy related indexes including lumber pain index, morning stiffness time, peripheral joint pain index, thoracic expansion, Schober test, Bath AS disease active index (BASDAI), Bath AS functional index (BASFI), the levels of erythrocyte sedimentation (ESR) and C-reactive protein (CRP), and X-ray of sacroiliac joint were observed.

RESULTSThe clinical efficacy indexes were significantly improved after treatment in the two groups (P < 0.05). Except that the improvement of lumber pain index and peripheral joint pain index was better in the treatment group than that in the control group (P < 0.05), no significant difference was found in the other indexes between the two groups. The occurrence of adverse reation was less in the treatment group than in the control group (P < 0.05).

CONCLUSIONTGP treatment combined with SSZ shows favorable effect on AS with less and milder adverse reaction.

Adolescent ; Adult ; Antirheumatic Agents ; therapeutic use ; Drug Therapy, Combination ; Female ; Glucosides ; therapeutic use ; Humans ; Male ; Paeonia ; chemistry ; Spondylitis, Ankylosing ; drug therapy ; Sulfasalazine ; therapeutic use

OBJECTIVETo observe the clinical efficacy of methotrexate (MTX) combined with total glucosides of Peony (TGP) on rheumatoid arthritis (RA).

METHODSSixty-one RA patients were divided into 2 groups, 30 patients in the MTX group were only administered orally with MTX, while 31 patients in the combined treated group were treated with MTX plus TGP, the therapeutic course for both groups was 3 months.

RESULTSThe total effective rate was 90%, 94%, 100% in the MTX plus TGP group, and 87%, 90%, 94% in the MTX group at 4, 8 and 12 weeks after treatment respectively, comparison of the therapeutic effect between the two groups showed insignificant difference (P > 0.05). The erythrocyte sedimentation rate (ESR) and the level of C-reactive protein were significantly decreased in both groups, but the decrement in the MTX plus TGP group was more than those in the MTX group.

CONCLUSIONMTX plus TGP treatment is characterized by quick initiating, with stable clinical efficacy, few side effects and high compliance, it is more suitable for aged RA patients.

Adult ; Aged ; Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Arthritis, Rheumatoid ; drug therapy ; Drug Therapy, Combination ; Female ; Glucosides ; therapeutic use ; Humans ; Immunosuppressive Agents ; therapeutic use ; Male ; Methotrexate ; therapeutic use ; Middle Aged ; Paeonia ; chemistry ; Phytotherapy

OBJECTIVETo observe the effect of Compound Fructus Arctii Mixture (FAM, consisted of Fructus Arctii and ethanol extract of Radix Astragalus membranaceus) in treating diabetic nephropathy.

METHODSUsing FAM to treat 31 patients with diabetic nephropathy and controlled by 23 patients treated with Losartan, the therapeutic course was 3 months for both groups, changes of clinical symptoms, blood glucose, lipid metabolism and urinary albumin were observed and compared.

RESULTSThe total effective rate in the treated group was 80.6% while in the control group 65.2%. The symptoms, urinary protein and albumin as well as lipid metabolism in the treated group all significantly improved after treatment (P<0.05), but in the control group improvement only showed in urinary albumin level (P<0.05).

CONCLUSIONFAM has the effects of reducing urinary protein in 24 hrs, lowering urinary albumin, improving blood glucose after meal and lipid metabolism.

Adult ; Albuminuria ; drug therapy ; Astragalus membranaceus ; Diabetic Nephropathies ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; chemistry ; therapeutic use ; Female ; Furans ; therapeutic use ; Glucosides ; therapeutic use ; Humans ; Losartan ; therapeutic use ; Male ; Middle Aged ; Phytotherapy

BACKGROUNDGastrodin, as one of the major components extracted from the Chinese herb Gastrodia elata Bl., has many biologic effects, one of which is anti-apoptosis. Apoptosis is considered to be one of the pathogenetic mechanisms in steroid-induced osteonecrosis of the femoral head (ONFH). Therefore, we performed this study to investigate whether gastrodin has the potential to prevent steroid-induced ONFH.

METHODSAll 18 male adult Wistar rats were divided equally into three groups: the steroid group, the gastrodin+steroid group, and the control group. Osteonecrosis was induced by low-dose lipopolysaccharide and subsequent high-dose methylprednisolone. Histomorphometric method was used to determine the incidence of osteonecrosis. Terminal deoxynucleotidyl transferase-mediated dUTP nick end-labeling (TUNEL) assay was performed to detect apoptotic index of osteocytes and osteoblasts. Real-time PCR and Western blotting were performed to detect mRNA and protein expression of Bax, Bcl-2, and Caspase-3. Fisher's exact probability test and one-way analysis of variance (ANOVA) with Turkey's post hoc test were used to examine significant differences between groups.

RESULTSThe incidence of osteonecrosis in the gastrodin+steroid group (16.7%) was significantly lower than that in the steroid group (83.3%). According to TUNEL assay, the apoptotic indices in the steroid group, the gastrodin+steroid group, and the control group were 91.1%, 27.1%, and 5.4%, respectively, and the differences were significant between groups. Compared with the control group and the gastrodin+steroid group, the mRNA and protein expression levels of Bax and Caspase-3 were significantly higher in the steroid group, but the Bcl-2 mRNA and protein expression levels were significantly lower.

CONCLUSIONGastrodin could prevent steroid-induced ONFH by anti-apoptosis.

Animals ; Apoptosis ; drug effects ; Benzyl Alcohols ; therapeutic use ; Femur Head Necrosis ; drug therapy ; prevention & control ; Glucosides ; therapeutic use ; Lipopolysaccharides ; pharmacology ; Male ; Rats ; Rats, Wistar ; Steroids ; pharmacology

OBJECTIVETo investigate the efficacy and adverse reaction of total glucosides of paeony (TGP) in treating patients with non-systemic involved Sjögren syndrom (NSI-SS).

METHODSRetrospective study was conducted on 27 patients with NSI-SS who received TGP treatment for over two years as the TGP group, and 20 patients received hydroxychloroquine sulfate (HCQs) for over two years in the HCQs group for positive control. Salivary flow, Schirmer's test and serum gamma-globulin at different time points, i.e. before treatment, and at the end of 1st, 3rd, 6th, 12th and 24th month respectively, were compared between groups, and adverse reactions associated with TGP and HCQ were also observed.

RESULTSIn the TGP group, saliva secretion was significantly increased and serum gamma-globulin decreased significantly from the 6th month (P <0.01), Schirmer's test improved significantly after 12 months (P< 0.01). While in the HCQs group serum gamma-globulin was significantly decreased from the 3rd month (P <0.01), saliva secretion and Schirmer's test improved significantly after six months (P<0.01). However, the 3 indexes determined at the end of the 3rd month were insignificantly different from those before treatment. Mild diarrhea occurred in 4 cases in the TGP group, they were improved two weeks later, but one case with severe diarrhea was dropped. While in the HCQs group, 2 patients were dropped, one for the raising of alanine aminotransferase at the 6th month and the other for decreased vision at the 9th month.

CONCLUSIONEfficacy of TGP is equivalent to that of HCQs in treating NSI-SS, but with higher safety and the effect initiating time being about 6 - 12 months.

Adult ; Female ; Glucosides ; therapeutic use ; Humans ; Male ; Middle Aged ; Paeonia ; chemistry ; Phytotherapy ; Prednisone ; therapeutic use ; Retrospective Studies ; Sjogren's Syndrome ; classification ; drug therapy

This paper was aimed to investigate the effect of gastrodin( GAS) on hippocampal neurogenesis after cerebral was chemic and to explore its mechanism of action related to NO. The cerebral ischemia model of C57 BL/6 mice was established by bilateral common carotid artery occlusion. The pathological changes in hippocampal CA1 region and the cognitive function of mice were assessed by HE staining and Morris water maze test,respectively. The count of Brd U/Neu N positive cells in dentate gyrus was detected by immunofluorescence assay. The NOS activity and the NO content were determined by colorimetric and nitrate reduction methods,respectively.The level of c GMP was measured by ELISA kit,and the PKG protein expression was tested by Western blot. On postoperative day 8,the hippocampal CA1 pyramidal neurons of mice showed irregular structure,with obvious nuclear pyknosis,loose cell arrangement and obvious decrease in the number of neurons. On postoperative day 29,the spatial learning ability and memory were decreased. These results indicated cerebral ischemia in mice. Meanwhile,the Brd U/Neu N positive cells were increased significantly in ischemic mice,indicating that neurogenesis occurred in hippocampus after cerebral ischemia. Treatment with different doses of gastrodin( 50 and 100 mg·kg-1) significantly ameliorated the pathological damages in the CA1 region,improved the ability of learning and memory,and promoted hippocampal neurogenesis. At the same time,both the NOS activity and the NO concentration were decreased in model group,but the c GMP level was increased,and the PKG protein expression was up-regulated. Gastrodin administration activated the NOS activity,promoted NO production,further increased c GMP level and up-regulated PKG protein expression. These results suggested that gastrodin can promote hippocampal neurogenesis after cerebral ischemia and improve cognitive function in mice,which may be related to the activation of NO-cGMP-PKG signaling pathway.
Animals ; Benzyl Alcohols/therapeutic use* ; Brain Ischemia/drug therapy* ; CA1 Region, Hippocampal/drug effects* ; Cognition ; Glucosides/therapeutic use* ; Mice ; Mice, Inbred C57BL ; Neurogenesis ; Signal Transduction

The efficacy of gastrodin as a Chinese herbal medicine extract in the treatment of tension-type headache has been confirmed. This paper systematically reviewed the efficacy and safety of gastrodin in the treatment of tension-type headache, aiming to provide a new choice for the treatment of this disease. In this study, four Chinese databases, four English databases and two trial registries were searched from the date of establishment to September 2020. The related randomized controlled trials(RCTs) were screened out according to the predetermined criteria. The bias risk assessment tool developed by Cochrane collaboration was used to evaluate the quality of the reports. RevMan 5.4.1 was used for Meta-analysis, and GRADE system for the evidence-based evaluation on the quality of outcome indicators. A total of 177 articles were retrieved and 8 articles were finally included for analysis, with a total sample size of 1 091 cases, which included 565 cases in the treatment group and 526 cases in the control group. The overall quality of included stu-dies was not high. The results of Meta-analysis are as follows:(1)In terms of headache frequency, gastrodin group was better than wes-tern medicine group(MD=-2.90, 95%CI[-3.76,-2.03], P<0.000 01).(2)In terms of number of abnormal blood vessels in TCD, gastrodin group was better than western medicine group(MD=-88.96, 95%CI[-102.36,-75.55], P<0.000 01).(3)In terms of effective rate, gastrodin group was better than western medicine group(RR=1.47, 95%CI[1.29, 1.68], P<0.000 01). The results of subgroup analysis are as follows:(1)Effective rate based on age, for the patients upper age limit 40-46 years old, gastro-din group was better than western medicine group(RR=1.69, 95%CI[1.50, 1.90], P<0.000 01); for the patients upper age limit 55-60 years old, gastrodin group was better than western medicine group(RR=1.27, 95%CI[1.16, 1.38], P<0.000 01).(2)Effective rate based on dosage form, both the gastrodin capsules and injection groups were better than western medicine group(RR_(capsules)=1.42, 95%CI[1.08, 1.88], P=0.01; RR_(injection)=1.50, 95%CI[1.26, 1.77], P<0.000 01). GRADE evaluation showed that the above outcomes had low quality of evidence. Only one article detailed the occurrence of adverse reactions and thus the present study cannot make a positive conclusion on the safety of gastrodin in the treatment of tension-type headache. The small number and low quality of the included reports affected the reliability of the results. In the future, more high-quality randomized controlled trails are needed to improve the evaluation on the efficacy and safety of gastrodin in the treatment of tension-type headache.
Adult ; Benzyl Alcohols/therapeutic use* ; Drugs, Chinese Herbal/adverse effects* ; Glucosides ; Humans ; Middle Aged ; Reproducibility of Results ; Tension-Type Headache