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Combined application of Chinese and western medicine, precise positioning for clinical efficacy.

China Journal of Chinese Materia Medica.2016;41(24):4479-4482. doi:10.4268/cjcmm20162401

Combined application of Chinese and western medicine is widespread in clinical real world because national policy emphasizes both Chinese medicine and western medicine. The studies on the combined use of Chinese and western medicine, are conducive to clinical precise positioning, promote self positioning of Chinese patent medicines and Chinese medicine enterprises based on suitable application fields, and provide direction for the deepening development of herbal industry. In addition, the studies on clinical evaluation and mechanism of combined use of Chinese and western medicine can provide basis for formulating national health policies and promoting medical resource fairness.

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Research progress on breeding standard of medicinal animals and discussion on several key problems.

Yi-Quan ZHOU ; Xian-You QU ; Guang YANG ; Jun-de LI ; Yan SU ; Ying LI

China Journal of Chinese Materia Medica.2016;41(23):4474-4478. doi:10.4268/cjcmm20162329

Medicinal animal breeding standards is regarded as the law to normalize relevant production that can guarantee the quality of traditional Chinese medicine of animal category. The article summarized the medicinal animal resources in our country and the present condition of medicinal animal breeding standards. It considered the current animal breeding standards system was in adequate, not only the quantity of breeding standards, the standard content and index were also uncomprehensive, which is not conducive to the scientific and orderly development and utilization of medicinal animal resources. The article pointed out that the development of the basic standards, environmental control, feed quality, raising management, inspection and quarantine should be included into the medicinal animal breeding standards, and the medicinal animal breeding standards content framework was introduced. Meanwhile, animal welfare, biological safety and file management should be concerned during the process of research. Hope the article has good reference value to medicinal animal breeding standards establishment and production management.

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Analysis of color regulation of Fluoritum in Chinese Pharmacopoeia based on the coloration mechanism of Fluorite.

Ting HAN ; Zhe JIA ; Hui ZHANG ; Huan LIU ; Yan GAO ; Ying ZHANG ; Qing-Hua LIN ; Shu-Ya XU ; Xin-Fang XU ; Xiang-Ri LI

China Journal of Chinese Materia Medica.2016;41(23):4469-4473. doi:10.4268/cjcmm20162328

The fluoritum is used for gynecology frequently and it's for those diseases: kidney yang deficiency, Gong cold sterility, palpitation due to fright, insomnia and dreaminess and cold cough. It's ruled in Chinese Pharmacopoeia (1985 edition) that the fluoritum originates from fluorite which belongs to fluoride minerals. Its main content is CaF2. The colors are of differents grades with purple or green. In the market, there are large differences in quality and it has various colors. Besides of the ruled color of purple and green, white and yellow are also common colors. By digging into and analysis the relevant research literature of fluorite which belongs to fluoride minerals, colors and coloration mechanism of fluorite are summarized in this paper.Natural fluorite is the mineral which has the most species of colors in nature. The different colors of fluorite are mainly caused by the impurity elements. At present, there are mainly about the coloration mechanism of fluorite: rare earth ions (4fN ions), color center, inclusions, crystalline domains or sub microscopic inclusions. The green of fluorite is produced by 570 nm and 305 nm absorption peaks which are caused by Sm2+ and compensated ions Na+ centers generated color center. The yellow of fluorite is produced by the joining of transition element, resulting in the formation of charge transfer between the crystal ions and the formation of O2-O32- ion molecule.The black of fluorite, mainly was attributed to the existence of a higher degree of evolution of organic matter. In this passage,suggestions for modification of the properties of fluoritum in Chinese Pharmacopoeia are put forward.

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Effects of processing on toxic components of Pinellia Rhizoma and its detoxification mechanism.

Hai-Jian YUAN ; Xiao-Bin JIA ; Wen-Jing YIN ; Hui WANG ; Hong-Juan WANG ; Wei LI

China Journal of Chinese Materia Medica.2016;41(23):4462-4468. doi:10.4268/cjcmm20162327

Pinellia Rhizoma is one of the most commonly used medicinal herbs in clinic, but its toxicity couldn't be ignored. Processing is a detoxification method before the toxic traditional Chinese medicine were given to the patients, and mainly impacted the amount of relevant components in Chinese medicinal herbs (increase or decrease). Although there were still some disputes about the toxic components in Pinelliae Rhizoma (mainly referring to the alkaloid substances), more literatures reported that needle-like calcium oxalate crystals and lectin protein in Pinelliae Rhizoma were the main toxic components, and had a significant effect on inflammation and irritation caused by Pinellia Rhizoma. With the development of research methods and the expansion of research angles, researches for the effect of processing on the detoxification mechanism of Pinelliae Rhizoma have been constantly deepened. The recent reports showed that the detoxification mechanism of the herb was correlated with the dosage of detoxifying components, and the effect of relevant excipients in inhibiting a variety of inflammatory cytokines. However, we shall also pay attention to alum and other processing accessories that could cause new toxicity from residual aluminum, and the impact from processing conditions, origin of Chinese medicinal herbs and their combination with other medicinal herbs on Pinellia Rhizoma's toxicity. This paper describes toxic components, different detoxification methods and relevant detoxification mechanisms in Pinelliae Rhizoma to provide the references for further research and development of the plant.

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Bencao literature investigation of Polygonum multiflorum (Heshouwu).

Li LIANG ; Jin-Sheng ZHENG ; Zhong-Zhen ZHAO

China Journal of Chinese Materia Medica.2016;41(23):4456-4461. doi:10.4268/cjcmm20162326

Heshouwu, derived from the root of Polygonum multiflorum (=Fallopia multiflora), is widely used in the Chinese medicine market as a traditional tonic. The emergence of heshouwu material with a human shape reflects a pursuit of its supplementing effects. However, reports of Heshouwu toxicity have repeatedly surfaced in recent years, attracting widespread concern. To clarify the situation surrounding the safety and efficacy of Heshouwu, this research utilizes a systematic review of the text and illustrations in historical bencao (materia medica) literature to investigate the origin, botanical characteristics, actions and processing of Heshouwu, as well as the origin and historical evolution of Baishouwu ("white Heshouwu").

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Endangered situation and conservation strategy of Tibetan medicine in Qinghai-Tibet Plateau.

Cai-Yun ZHAO ; Huan LIU ; Jin-Song SU ; Xuan-Hao LI ; Min-Ru JIA ; Yi ZHANG ; Jing ZHANG

China Journal of Chinese Materia Medica.2016;41(23):4451-4455. doi:10.4268/cjcmm20162325

With the rapid development of Tibetan medicine industry, the study on plateau medicinal plants' endangered status is not enough, measures to protect is weak and the plateau ecological environment' inherent vulnerability, resulted in the shortage of Tibetan medicinal resources and affect the sustainable development . According to the existing endangered information of Tibetan medicine resources, how to formulate feasible protection plan, is an urgent problem of the rational development and utilization of Tibetan medicine resources to be solved. To find out the endangered Tibetan medicines in Qinghai Tibet Plateau, the Grade division method of Chinese Rare and Endangered Plants was applied, the endangered species were sorted out, which divided into class one (threatened) eleven species, class two (rare) twenty-one species, and class three (fading) forty-two species,a total of seventy-four species.In addition to national protection list in "Chinese rare and endangered plants". It's proposed to increase the endangered Tibetan medicinal species. Finally, according to the endangered status of the resources,from the survey of endangered Tibetan medicinal species regularly, the germplasm repository establishment of endangered Tibetan medicine, in situ conservation, artificial cultivation research and renew the idea, reasonable development and utilization, a total of 5 aspects to discussed the protection strategy, to provide a scientific basis for the protection and sustainable utilization of Tibetan medicine resources in Qinghai-Tibet Plateau.

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Analysis of Diemailing Kudiezi injection use in real world in 7 189 patients with cerebral infarction.

Xing LIAO ; Yin ZHANG ; Yan-Ming XIE ; Yan LIU ; Dan-Hui YI ; Yi-Li ZHANG ; Feng CHEN

China Journal of Chinese Materia Medica.2016;41(23):4442-4450. doi:10.4268/cjcmm20162324

This is a study based on hospital intensive monitoring to explore medication use of Diemailing Kudiezi injection(one Chinese herbal medicine injection) in real word in the patients with cerebral infarction. The active monitoring model was adopted and hospital intensive monitoring on safety of 7 189 cases of patients with cerebral infarction was conducted to obtain the drug use information of Diemailing injection. The results were analyzed by using statistical description and association rule method. The statistical description and association rule analysis were conducted based on patients' basic demographic characteristics, use of Diemailing injection and combined use of drugs. Sixty-two percent(4 437/7 189) of the patients were from traditional Chinese medicine hospitals as compared with 39%(2 752/7 189) from western medicine hospitals; 84%(6 003/7 189) of the patients were from tertiary hospitals as compared with 16%(1 186/7 189) from second-class hospitals. The hospitals were mostly located in north China. Drug related indicators such as a single dripping speed, stash time after allocating transfusion, duration of injection, and injecting room temperature were not noted in instruction manual. It was also found that there were off label use in the practice, for instance, non-intravenous infusion, >14 d treatment course, use of non-designated solvent, and a single dose>40 mL or<10 mL. Analysis of association rules showed that only Edaravone among the most frequent combined drugs was listed in the current guideline in China, and the other three most frequent combined drugs deproteinized calf blood extractive injection, Cinepazide Maleate injection and Alprostadil injection were used with little evidence. Diemailing＋Aspirin＋Alprostadil was the most common combined use in our study, but the recommended clopidogrel＋Aspirin was not found in this study. The drug use situation of Diemailing injection in the real world was obtained by data analysis on large size samples, providing basic reference information for clinicians and researchers. However, efficacy was not concerned in this study, so efficacy-related information could not be explained.

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Analysis on pharmacokinetics-pharmacodynamics correlation of effective ingredients of Qing'e wan.

Ling LIU ; Ze-Bin WENG ; Heng WANG ; Xing-Yu ZHU ; Zhi-Peng CHEN ; Li WU ; Wei-Dong LI

China Journal of Chinese Materia Medica.2016;41(23):4436-4441. doi:10.4268/cjcmm20162323

To study the pharmacokinetics of three active ingredients in Qing'e wan, namely geniposidic acid, psoralen and isopsoralen, in rats, in order to investigate their correlation in the anti-osteoporotic effect. The rats were taken blood from their eye sockets at different time points after being orally administered with raw and salt-processed Qing'e wan. Geniposidic acid, psoralen and isopsoralen in rats plasma were determined by means of UHPLC-MS/MS to draw the concentration-time curve. The proliferation rate of osteoblasts was taken as the pharmacodynamic index, and determined by MTT method to draw effect-time curve. In comparison between the effect-time curve and the concentration-time curve, the blood concentrations of geniposidic acid and psoralen were close to the peak when the cell proliferation rate reached its peak, indicating a good correlation between them. The peak blood concentration of isopsoralen was slightly lagging behind the peak of efficacy. According to the correlation analysis after fitting the effect-time curve and the concentration-time curve, salt-processed Qing'e wan had a better correlation than the raw one. The above experimental results showed that the effect-time curve and the concentration-time curve of geniposidic acid and psoralen had a good correlation, and the correlation of salt-processed Qing'e wan was better than the raw one.

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Meta-analysis of Yinzhihuang oral liquid in treatment of intrahepatic cholestasis of pregnancy.

Jing-Jing YAN ; Xiao-Ping XIA ; Na BU

China Journal of Chinese Materia Medica.2016;41(23):4428-4435. doi:10.4268/cjcmm20162322

To systematically review the clinical efficacy and safety of Yinzhihuang oral liquid in the treatment of intrahepatic cholestasis of pregnancy(ICP). Literatures published by June 2016 were searched in databases, such as Medline, Pubmed, Cochrane Library, China National Knowledge Infrastructure(CNKI), Chinese Scientific Journals Full-text Database(VIP), Chinese biomedical literature database(CBM), and Wanfang Database. Randomized controlled trials(RCT) of Yinzhihuang oral liquid were collected according to the inclusion criteria, and the methodological quality of selected literatures was evaluated. The Meta-analysis was conducted by using RevMan 5.3 software. A total of 7 RCTs involving 711 patients were included. The results of Meta-analysis showed that, compared with control group, Yinzhihuang oral liquid significantly alleviated pruritus symptoms[MD=－0.68, 95%CI(－0.95,－041), P<0.000 01], reduced blood biochemical indexes including TBA[MD=－7.23, 95%CI (－10.88,－3.58), P=0.000 1], TB[MD=－1.90, 95%CI(－3.09,－0.70), P=0.002], ALT[MD=－39.08, 95%CI (－56.46,－21.70), P<0.000 1], and CG [MD=－0.71, 95%CI(－0.89,－0.52), P<0.000 01]. In the respect of pregnancy outcome, Yinzhihuang oral liquid can distinctly improve birth weight [MD=430.03, 95%CI (219.28, 640.78), P<0.000 1]. However, there was no significant difference in cesarean section rate [OR=0.93, 95%CI (0.36, 2.36), P=0.87], preterm birth rates [OR=0.63, 95%CI (0.28, 1.42), P=0.26], and neonatal asphyxia rate [OR=0.50, 95%CI (0.18, 1.43), P=0.20]. Yinzhihuang oral liquid showed better efficiency and slighter adverse reaction. However, more rigorously designed, double-blind, randomized controlled trials with large sample size and high quality are required to provide further evidences.

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Hepatotoxicity of emodin based on UGT1A1 enzyme-mediated bilirubin in liver microsomes.

Qi WANG ; Zhong DAI ; Yu-Jie ZHANG ; Shuang-Cheng MA

China Journal of Chinese Materia Medica.2016;41(23):4424-4427. doi:10.4268/cjcmm20162321

To study the hepatotoxicity of emodin based on bilirubin metabolism mediated by glucuronidation of UGT1A1 enzyme. In this study, three different incubation systems were established by using RLM, HLM, and rUGT1A1, with bilirubin as the substrate. Different concentrations of bilirubin and emodin were added in the incubation systems. The double reciprocal Michaelis equation was drawn based on the total amount of bilirubin glucuronidation. The apparent inhibition constant Ki was then calculated with the slope curve to predict the hepatotoxicity. The results indicated that emodin had a significant inhibition to the UGT1A1 enzyme in all of the three systems, with Ki=5.400±0.956(P<0.05) in HLM system, Ki =10.020±0.611(P<0.05) in RLM system, Ki=4.850±0.528(P<0.05) in rUGT1A1 system. Meanwhile, emodin had no significant difference between rat and human in terms of inhibition of UGT1A1 enzyme. Emodin had a potential risk of the hepatotoxicity by inhibiting the UGT1A1 enzyme activity. And the method established in this study provides a new thought and new method to evaluate hepatotoxicity and safety of traditional Chinese medicines.

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