1.Clinical Efficacy and Mechanism of Bupi Qingfei Prescription in Treating Stable Bronchiectasis
Zi YANG ; Guangsen LI ; Bing WANG ; Bo XU ; Jianxin WANG ; Sheng CAO ; Xinyan CHEN ; Xia SHI ; Qing MIAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(2):162-169
ObjectiveTo explore the clinical efficacy and mechanism of Bupi Qingfei prescription (BPQF) in treating stable bronchiectasis in the patients with syndromes of lung-spleen Qi deficiency and phlegm-heat accumulation in the lungs. MethodsA randomized, double-blind, placebo-controlled trial was conducted. Patients were randomized into BPQF and placebo control (PC) groups. On the basis of conventional Western medicine treatment, the BPQF granules and placebo were respectively administered at 10 g each time, twice a day, for a course of 24 weeks. The TCM symptom scores, Quality of Life Questionnaire for Bronchiectasis (QOL-B) scores, lung function indicators, T lymphocyte subsets, level of inflammatory factors in the sputum, level of neutrophil elastase (NE) in the sputum, and occurrence of adverse reactions were observed before and after treatment in the two groups. ResultsA total of 64 patients completed the study, encompassing 32 in the BPQF group and 32 in the PC group. After treatment, the BPQF group showed decreased TCM symptom scores (P<0.01), increased QOL-B scores (P<0.01), and declined levels of tumor necrosis factor (TNF)-α and NE (P<0.05, P<0.01). The PC group showed decreased TCM symptom (except spleen deficiency) scores (P<0.01), increased the QOL-B health cognition and respiratory symptom domain scores (P<0.05, P<0.01), and a declined TNF-α level (P<0.01). Moreover, the BPQF group had lower TCM symptom (except chest tightness) scores (P<0.05, P<0.01), higher QOL-B (except treatment burden) scores (P<0.05, P<0.01), and lower levels of interleukin-6 and TNF-α (P<0.05) than the PC group. Neither group showed serious adverse reactions during the treatment process. ConclusionBPQF can ameliorate the clinical symptoms of stable bronchiectasis patients who have lung-spleen Qi deficiency or phlegm-heat accumulation in the lungs by regulating the immune balance and inhibiting airway inflammatory responses.
2.Mechanisms of Salvianolic Acid B in Inhibiting Epithelial-mesenchymal Transition in Non-small Cell Lung Cancer by Downregulating PAICS Expression
Bo XU ; Jixian ZHANG ; Linling HU ; Bo JIANG ; Shasha YUAN ; Yiling FAN ; Zhishen RUAN ; Yihan YU ; Qing MIAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(10):23-33
ObjectiveTo investigate the molecular mechanisms by which salvianolic acid B (SalB) inhibits epithelial-mesenchymal transition (EMT) in non-small cell lung cancer (NSCLC) by downregulating phosphoribosylaminoimidazole carboxylase and phosphoribosylaminoimidazole succinocarboxamide synthetase (PAICS) expression. MethodsNSCLC A549 cells and normal bronchial epithelial cells (bronchial epithelium transformed with Ad12-SV40 2B, BEAS-2B) were used as models. Cell viability was assessed using the cell counting kit-8 (CCK-8) assay after treatment with SalB (0, 50, 100, 200, 300, 400, 500 μmol·L-1 for 24 or 48 h to determine effective and safe intervention concentrations. Cell proliferation, cell cycle distribution, and apoptosis were evaluated by 5-ethynyl-2′-deoxyuridine (EdU) staining and flow cytometry, respectively. Wound healing and Transwell invasion assays were performed to assess cell migration and invasion. RNA sequencing combined with bioinformatic analysis was conducted to identify differentially expressed genes and functional enrichment. Molecular docking was used to predict the binding ability between SalB and PAICS, and the cellular thermal shift assay (CETSA) was performed to evaluate the effect of SalB on the thermal stability of the PAICS protein. Western blot (WB) was used to detect the effects of SalB on PAICS and EMT-related proteins (E-cadherin, N-cadherin, Vimentin, Snail, and Slug). A functional rescue assay was conducted by PAICS overexpression via plasmid transfection. ResultsCompared with the control group, SalB inhibited A549 cell viability in a dose-dependent manner (P<0.05), and the effective concentrations (≤300 μmol·L-1) showed no significant cytotoxicity in BEAS-2B cells. Within this concentration range, SalB significantly inhibited A549 cell proliferation, migration, and invasion, and induced G0/G1 phase arrest and apoptosis (P<0.05). Transcriptomic analysis showed that SalB significantly downregulated PAICS expression, and its functions were enriched in cell proliferation and EMT. Bioinformatic analysis indicated that PAICS is highly expressed in lung adenocarcinoma and is associated with poor prognosis (P<0.01). Molecular docking showed that SalB has strong binding ability to PAICS (binding energy -9.1 kcal·mol-1. CETSA results showed that SalB significantly increased the thermal stability of the PAICS protein (P<0.05). WB results showed that, compared with the control group, SalB dose-dependently downregulated PAICS expression, upregulated E-cadherin, and downregulated N-cadherin, Vimentin, Snail, and Slug (P<0.05). Functional rescue experiments showed that, compared with the empty vector group, PAICS overexpression significantly enhanced A549 cell proliferation, migration, and invasion, promoted cell cycle progression, and inhibited apoptosis (P<0.05). Meanwhile, compared with the empty vector + SalB-H group, PAICS overexpression partially reversed the inhibitory effects of SalB on malignant phenotypes and EMT-related proteins (N-cadherin, Vimentin, Snail, and Slug), and downregulated E-cadherin expression (P<0.05,P<0.01), indicating that PAICS is a key functional target mediating the antitumor effects of SalB. ConclusionSalB effectively inhibits EMT progression and cell cycle progression in A549 cells by downregulating PAICS expression, thereby exerting anti-NSCLC effects. This study not only reveals that PAICS is a key functional target through which SalB regulates EMT, but also provides experimental evidence supporting SalB as a potential candidate drug for inhibiting NSCLC metastasis.
3.Eupatilin Inhibits Proliferation, Invasion, and Metastasis of Non-small Cell Lung Cancer via EZH2/H3K27me3 Signaling Pathway
Bo XU ; Yihan YU ; Linling HU ; Bo JIANG ; Yu QI ; Shasha YUAN ; Yiling FAN ; Jixian ZHANG ; Qing MIAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(10):58-69
ObjectiveTo investigate the mechanisms by which eupatilin (Eup) inhibits proliferation, invasion, and metastasis of non-small cell lung cancer (NSCLC) through the enhancer of zeste homolog 2/histone H3 lysine 27 trimethylation (EZH2/H3K27me3) signaling pathway. MethodsIn vivo, a subcutaneous xenograft tumor model was established in nude mice using H1299 cells to evaluate the anti-NSCLC effects of Eup. Immunohistochemistry (IHC-P) was used to detect the expression of proliferation- and invasion/metastasis-related proteins, including proliferating cell nuclear antigen (PCNA), matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9), and vascular endothelial growth factor A (VEGFA). In vitro, cell counting kit-8 (CCK-8) assays were performed to determine the viability of H1299 cells treated with different concentrations of Eup (0-200 μmol·L-1) and to select appropriate concentrations. Colony formation and 5-ethynyl-2′-deoxyuridine (EdU) assays were used to evaluate cell proliferation. Wound healing and invasion assays were conducted to assess cell migration and invasion. Human umbilical vein endothelial cell (HUVEC) angiogenesis assays were used to evaluate the effects of Eup on angiogenesis. Transcriptomic analysis was performed to identify the targets of Eup in H1299 cells and to explore its major functions. Molecular docking and molecular dynamics simulations were conducted to predict the binding affinity and interaction stability between Eup and its target proteins. Western blot was used to detect the effects of Eup on the expression levels of EZH2/H3K27me3 pathway-related proteins and proliferation- and invasion/metastasis-related proteins, including PCNA, MMP-2, MMP-9, and VEGFA. ResultsIn the subcutaneous xenograft model, compared with the model group, Eup treatment dose-dependently inhibited the growth of H1299 xenograft tumors, and the tumor inhibition rate was significantly increased (P<0.05). IHC-P results showed that, compared with the model group, high-dose Eup significantly reduced the expression levels of PCNA, MMP-2, MMP-9, and VEGFA in vivo (P<0.05). In vitro, compared with the control group, Eup inhibited the proliferation, invasion, and metastasis of NSCLC cells in a concentration-dependent manner. Transcriptomic analysis further showed that, compared with the control group, Eup significantly downregulated EZH2 expression, and its functional effects were associated with inhibition of tumor metastasis. Molecular docking and molecular dynamics simulations indicated that Eup exhibited strong binding affinity with EZH2 and stable interactions. Western blot results demonstrated that, compared with the model group, Eup significantly inhibited, in a dose-dependent manner, the expression levels of EZH2, H3K27me3, and proliferation- and invasion/metastasis-related proteins (PCNA, MMP-2, MMP-9, and VEGFA) in both in vivo and in vitro experiments (P<0.05). In vitro, compared with the control group, overexpression of EZH2 via plasmid transfection partially reversed the inhibitory effects of Eup on the expression of key proteins involved in proliferation and invasion/metastasis in H1299 cells. ConclusionEup effectively inhibits the proliferation, migration, and invasion of H1299 cells both in vivo and in vitro. The underlying mechanism may be related to inhibition of the EZH2/H3K27me3 signaling pathway and downregulation of proliferation- and invasion/metastasis-related proteins, including PCNA, MMP-2, MMP-9, and VEGFA. Eup may serve as a potential therapeutic agent for suppressing proliferation and invasion/metastasis in NSCLC.
4.Anti-lung Cancer Mechanisms of Yang-warming Herbs and Formulas: A Review
Bo XU ; Yu QI ; Jixian ZHANG ; Linling HU ; Bo JIANG ; Yilong ZOU ; Cunyu FAN ; Yiling FAN ; Qing MIAO ; Yihan YU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(10):70-79
Lung cancer, particularly non-small cell lung cancer (NSCLC), is the malignant tumor with the highest incidence and mortality in China and worldwide. In 2022, the global number of deaths reached 1.8 million, accounting for 18.7% of all cancer-related deaths, seriously threatening human health and life, and posing a severe challenge for prevention and treatment. Although treatment strategies for lung cancer have been continuously enriched in recent years, and progress has been made in targeted therapy and immunotherapy, long-term survival benefits remain limited due to primary or acquired drug resistance, low immune responsiveness, and chemotherapy-related toxicities. Therefore, there is an urgent need to explore safe and effective adjunctive therapeutic strategies. Traditional Chinese medicine (TCM), with its advantages of holistic regulation and individualized syndrome differentiation, has played an increasingly prominent role in comprehensive cancer treatment. TCM holds that "Yang deficiency leads to accumulation" is a key pathogenesis of tumors. Based on the theory that "Yang transforms Qi, while Yin forms substance", deficiency of Yang Qi results in impaired warming and transformation functions, leading to internal accumulation of Yin-cold. This is closely related to dysregulation of the immune microenvironment, "cold tumor" characteristics, and dysfunction of the neuroendocrine system in modern medicine. Accordingly, the therapeutic strategy of "warming Yang, supporting healthy Qi, and combating cancer" has gained increasing attention. In recent years, commonly used Yang-warming Chinese herbs, including Aconiti Lateralis Radix Praeparata, Zingiberis Rhizoma, Cinnamomi Cortex, Epimedii Folium, and Psoraleae Fructus, as well as their active constituents, have achieved notable progress in anti-lung cancer research by regulating multiple signaling pathways, inducing apoptosis, inhibiting metastasis, and reversing drug resistance. In addition, Yang-warming formulae such as Sini Tang and Yanghe Tang have shown promising effects in alleviating myelosuppression, improving cancer-related fatigue, managing malignant pleural effusion, and relieving cancer pain. These therapies exhibit toxicity-reducing and efficacy-enhancing effects, significantly improving patients' quality of life and survival benefits. To systematically summarize the roles and mechanisms of Yang-warming Chinese herbal medicines and compound formulae in lung cancer, this paper provides a comprehensive review of recent advances, aiming to offer insights for the clinical practice of TCM in the prevention and treatment of lung cancer.
5.Mechanisms of Salvianolic Acid B in Inhibiting Epithelial-mesenchymal Transition in Non-small Cell Lung Cancer by Downregulating PAICS Expression
Bo XU ; Jixian ZHANG ; Linling HU ; Bo JIANG ; Shasha YUAN ; Yiling FAN ; Zhishen RUAN ; Yihan YU ; Qing MIAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(10):23-33
ObjectiveTo investigate the molecular mechanisms by which salvianolic acid B (SalB) inhibits epithelial-mesenchymal transition (EMT) in non-small cell lung cancer (NSCLC) by downregulating phosphoribosylaminoimidazole carboxylase and phosphoribosylaminoimidazole succinocarboxamide synthetase (PAICS) expression. MethodsNSCLC A549 cells and normal bronchial epithelial cells (bronchial epithelium transformed with Ad12-SV40 2B, BEAS-2B) were used as models. Cell viability was assessed using the cell counting kit-8 (CCK-8) assay after treatment with SalB (0, 50, 100, 200, 300, 400, 500 μmol·L-1 for 24 or 48 h to determine effective and safe intervention concentrations. Cell proliferation, cell cycle distribution, and apoptosis were evaluated by 5-ethynyl-2′-deoxyuridine (EdU) staining and flow cytometry, respectively. Wound healing and Transwell invasion assays were performed to assess cell migration and invasion. RNA sequencing combined with bioinformatic analysis was conducted to identify differentially expressed genes and functional enrichment. Molecular docking was used to predict the binding ability between SalB and PAICS, and the cellular thermal shift assay (CETSA) was performed to evaluate the effect of SalB on the thermal stability of the PAICS protein. Western blot (WB) was used to detect the effects of SalB on PAICS and EMT-related proteins (E-cadherin, N-cadherin, Vimentin, Snail, and Slug). A functional rescue assay was conducted by PAICS overexpression via plasmid transfection. ResultsCompared with the control group, SalB inhibited A549 cell viability in a dose-dependent manner (P<0.05), and the effective concentrations (≤300 μmol·L-1) showed no significant cytotoxicity in BEAS-2B cells. Within this concentration range, SalB significantly inhibited A549 cell proliferation, migration, and invasion, and induced G0/G1 phase arrest and apoptosis (P<0.05). Transcriptomic analysis showed that SalB significantly downregulated PAICS expression, and its functions were enriched in cell proliferation and EMT. Bioinformatic analysis indicated that PAICS is highly expressed in lung adenocarcinoma and is associated with poor prognosis (P<0.01). Molecular docking showed that SalB has strong binding ability to PAICS (binding energy -9.1 kcal·mol-1. CETSA results showed that SalB significantly increased the thermal stability of the PAICS protein (P<0.05). WB results showed that, compared with the control group, SalB dose-dependently downregulated PAICS expression, upregulated E-cadherin, and downregulated N-cadherin, Vimentin, Snail, and Slug (P<0.05). Functional rescue experiments showed that, compared with the empty vector group, PAICS overexpression significantly enhanced A549 cell proliferation, migration, and invasion, promoted cell cycle progression, and inhibited apoptosis (P<0.05). Meanwhile, compared with the empty vector + SalB-H group, PAICS overexpression partially reversed the inhibitory effects of SalB on malignant phenotypes and EMT-related proteins (N-cadherin, Vimentin, Snail, and Slug), and downregulated E-cadherin expression (P<0.05,P<0.01), indicating that PAICS is a key functional target mediating the antitumor effects of SalB. ConclusionSalB effectively inhibits EMT progression and cell cycle progression in A549 cells by downregulating PAICS expression, thereby exerting anti-NSCLC effects. This study not only reveals that PAICS is a key functional target through which SalB regulates EMT, but also provides experimental evidence supporting SalB as a potential candidate drug for inhibiting NSCLC metastasis.
6.Eupatilin Inhibits Proliferation, Invasion, and Metastasis of Non-small Cell Lung Cancer via EZH2/H3K27me3 Signaling Pathway
Bo XU ; Yihan YU ; Linling HU ; Bo JIANG ; Yu QI ; Shasha YUAN ; Yiling FAN ; Jixian ZHANG ; Qing MIAO
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(10):58-69
ObjectiveTo investigate the mechanisms by which eupatilin (Eup) inhibits proliferation, invasion, and metastasis of non-small cell lung cancer (NSCLC) through the enhancer of zeste homolog 2/histone H3 lysine 27 trimethylation (EZH2/H3K27me3) signaling pathway. MethodsIn vivo, a subcutaneous xenograft tumor model was established in nude mice using H1299 cells to evaluate the anti-NSCLC effects of Eup. Immunohistochemistry (IHC-P) was used to detect the expression of proliferation- and invasion/metastasis-related proteins, including proliferating cell nuclear antigen (PCNA), matrix metalloproteinase-2 (MMP-2), matrix metalloproteinase-9 (MMP-9), and vascular endothelial growth factor A (VEGFA). In vitro, cell counting kit-8 (CCK-8) assays were performed to determine the viability of H1299 cells treated with different concentrations of Eup (0-200 μmol·L-1) and to select appropriate concentrations. Colony formation and 5-ethynyl-2′-deoxyuridine (EdU) assays were used to evaluate cell proliferation. Wound healing and invasion assays were conducted to assess cell migration and invasion. Human umbilical vein endothelial cell (HUVEC) angiogenesis assays were used to evaluate the effects of Eup on angiogenesis. Transcriptomic analysis was performed to identify the targets of Eup in H1299 cells and to explore its major functions. Molecular docking and molecular dynamics simulations were conducted to predict the binding affinity and interaction stability between Eup and its target proteins. Western blot was used to detect the effects of Eup on the expression levels of EZH2/H3K27me3 pathway-related proteins and proliferation- and invasion/metastasis-related proteins, including PCNA, MMP-2, MMP-9, and VEGFA. ResultsIn the subcutaneous xenograft model, compared with the model group, Eup treatment dose-dependently inhibited the growth of H1299 xenograft tumors, and the tumor inhibition rate was significantly increased (P<0.05). IHC-P results showed that, compared with the model group, high-dose Eup significantly reduced the expression levels of PCNA, MMP-2, MMP-9, and VEGFA in vivo (P<0.05). In vitro, compared with the control group, Eup inhibited the proliferation, invasion, and metastasis of NSCLC cells in a concentration-dependent manner. Transcriptomic analysis further showed that, compared with the control group, Eup significantly downregulated EZH2 expression, and its functional effects were associated with inhibition of tumor metastasis. Molecular docking and molecular dynamics simulations indicated that Eup exhibited strong binding affinity with EZH2 and stable interactions. Western blot results demonstrated that, compared with the model group, Eup significantly inhibited, in a dose-dependent manner, the expression levels of EZH2, H3K27me3, and proliferation- and invasion/metastasis-related proteins (PCNA, MMP-2, MMP-9, and VEGFA) in both in vivo and in vitro experiments (P<0.05). In vitro, compared with the control group, overexpression of EZH2 via plasmid transfection partially reversed the inhibitory effects of Eup on the expression of key proteins involved in proliferation and invasion/metastasis in H1299 cells. ConclusionEup effectively inhibits the proliferation, migration, and invasion of H1299 cells both in vivo and in vitro. The underlying mechanism may be related to inhibition of the EZH2/H3K27me3 signaling pathway and downregulation of proliferation- and invasion/metastasis-related proteins, including PCNA, MMP-2, MMP-9, and VEGFA. Eup may serve as a potential therapeutic agent for suppressing proliferation and invasion/metastasis in NSCLC.
7.Anti-lung Cancer Mechanisms of Yang-warming Herbs and Formulas: A Review
Bo XU ; Yu QI ; Jixian ZHANG ; Linling HU ; Bo JIANG ; Yilong ZOU ; Cunyu FAN ; Yiling FAN ; Qing MIAO ; Yihan YU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(10):70-79
Lung cancer, particularly non-small cell lung cancer (NSCLC), is the malignant tumor with the highest incidence and mortality in China and worldwide. In 2022, the global number of deaths reached 1.8 million, accounting for 18.7% of all cancer-related deaths, seriously threatening human health and life, and posing a severe challenge for prevention and treatment. Although treatment strategies for lung cancer have been continuously enriched in recent years, and progress has been made in targeted therapy and immunotherapy, long-term survival benefits remain limited due to primary or acquired drug resistance, low immune responsiveness, and chemotherapy-related toxicities. Therefore, there is an urgent need to explore safe and effective adjunctive therapeutic strategies. Traditional Chinese medicine (TCM), with its advantages of holistic regulation and individualized syndrome differentiation, has played an increasingly prominent role in comprehensive cancer treatment. TCM holds that "Yang deficiency leads to accumulation" is a key pathogenesis of tumors. Based on the theory that "Yang transforms Qi, while Yin forms substance", deficiency of Yang Qi results in impaired warming and transformation functions, leading to internal accumulation of Yin-cold. This is closely related to dysregulation of the immune microenvironment, "cold tumor" characteristics, and dysfunction of the neuroendocrine system in modern medicine. Accordingly, the therapeutic strategy of "warming Yang, supporting healthy Qi, and combating cancer" has gained increasing attention. In recent years, commonly used Yang-warming Chinese herbs, including Aconiti Lateralis Radix Praeparata, Zingiberis Rhizoma, Cinnamomi Cortex, Epimedii Folium, and Psoraleae Fructus, as well as their active constituents, have achieved notable progress in anti-lung cancer research by regulating multiple signaling pathways, inducing apoptosis, inhibiting metastasis, and reversing drug resistance. In addition, Yang-warming formulae such as Sini Tang and Yanghe Tang have shown promising effects in alleviating myelosuppression, improving cancer-related fatigue, managing malignant pleural effusion, and relieving cancer pain. These therapies exhibit toxicity-reducing and efficacy-enhancing effects, significantly improving patients' quality of life and survival benefits. To systematically summarize the roles and mechanisms of Yang-warming Chinese herbal medicines and compound formulae in lung cancer, this paper provides a comprehensive review of recent advances, aiming to offer insights for the clinical practice of TCM in the prevention and treatment of lung cancer.
8.Expert Consensus on Clinical Application of Qinbaohong Zhike Oral Liquid in Treatment of Acute Bronchitis and Acute Attack of Chronic Bronchitis
Jian LIU ; Hongchun ZHANG ; Chengxiang WANG ; Hongsheng CUI ; Xia CUI ; Shunan ZHANG ; Daowen YANG ; Cuiling FENG ; Yubo GUO ; Zengtao SUN ; Huiyong ZHANG ; Guangxi LI ; Qing MIAO ; Sumei WANG ; Liqing SHI ; Hongjun YANG ; Ting LIU ; Fangbo ZHANG ; Sheng CHEN ; Wei CHEN ; Hai WANG ; Lin LIN ; Nini QU ; Lei WU ; Dengshan WU ; Yafeng LIU ; Wenyan ZHANG ; Yueying ZHANG ; Yongfen FAN
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(4):182-188
The Expert Consensus on Clinical Application of Qinbaohong Zhike Oral Liquid in Treatment of Acute Bronchitis and Acute Attack of Chronic Bronchitis (GS/CACM 337-2023) was released by the China Association of Chinese Medicine on December 13th, 2023. This expert consensus was developed by experts in methodology, pharmacy, and Chinese medicine in strict accordance with the development requirements of the China Association of Chinese Medicine (CACM) and based on the latest medical evidence and the clinical medication experience of well-known experts in the fields of respiratory medicine (pulmonary diseases) and pediatrics. This expert consensus defines the application of Qinbaohong Zhike oral liquid in the treatment of cough and excessive sputum caused by phlegm-heat obstructing lung, acute bronchitis, and acute attack of chronic bronchitis from the aspects of applicable populations, efficacy evaluation, usage, dosage, drug combination, and safety. It is expected to guide the rational drug use in medical and health institutions, give full play to the unique value of Qinbaohong Zhike oral liquid, and vigorously promote the inheritance and innovation of Chinese patent medicines.
9.Sufei Pingchuan Formula (肃肺平喘方) for the Treatment of Bronchiectasis Patients Combined with Airflow Limitation of Phlegm-Heat Obstructing the Lung and Lung-Spleen Qi Deficiency Syndrome: A Randomised Controlled Trial
Shasha YUAN ; Haiyan ZHANG ; Xia SHI ; Bing WANG ; Xiaodong CONG ; Qing MIAO
Journal of Traditional Chinese Medicine 2025;66(6):581-587
ObjectiveTo evaluate the effectiveness and safety of Sufei Pingchuan Formula (肃肺平喘方) in the treatment of bronchiectasis with airflow limitation, phlegm-heat obstructing the lung, and lung-spleen qi deficiency syndrome. MethodsA randomized, double-blind, placebo-controlled trial was conducted. A total of 72 patients with stable bronchiectasis with airflow limitation of phlegm-heat obstructing the lung and lung-spleen qi deficiency syndrome were randomly divided into treatment group and control group, with 36 cases in each group. On the basis of regular inhalation of tiotropium bromide inhalation spray, the treatment group was given Sufei Pingchuan Formula granules, and the control group was given Sufei Pingchuan Formula granule simulant. The course of treatment in both groups was 12 weeks. The pulmonary function of both groups before and after treatment was observed, specifically focusing on forced expiratory volume in one second (FEV1); the modified British Medical Research Council (mMRC) dyspnea scale, 24-hour sputum volume, COPD assessment test (CAT), and traditional Chinese medicine (TCM) syndrome scores were assessed before treatment and after 4, 8, and 12 weeks of treatment; acute exacerbations were recorded at weeks 4, 8, and 12; additionally, changes in routine blood tests, urinalysis, liver and kidney function, and adverse events were monitored before and after treatment. ResultsAfter treatment, 4 patients in the treatment group and 6 in the control group dropped out. After 12 weeks of treatment, FEV1 increased in both groups compared to pre-treatment levels (P<0.05), but the difference between groups was not statistically significant (P>0.05). Compared to before treatment, the treatment group showed a reduction in mMRC scores after 12 weeks (P<0.05) and a decrease in 24-hour sputum volume, CAT scores, and TCM syndrome scores at weeks 4, 8, and 12 (P<0.05). In the control group, 24-hour sputum volume decreased after 12 weeks (P<0.05), and TCM syndrome scores decreased at weeks 8 and 12 (P<0.05). Compared to the control group, the treatment group showed a greater reduction in mMRC scores at week 12 (P<0.05), a decrease in 24-hour sputum volume and TCM syndrome scores at weeks 4, 8, and 12 (P<0.05), and lower CAT scores at weeks 8 and 12 (P<0.05). The frequency and number of acute exacerbations in the treatment group were significantly lower than those in the control group at week 12 (P<0.05). No severe adverse events occurred in either group. ConclusionSufei Pingchuan Formula can improve the pulmonary function FEV1, the severity of dyspnea, reduce 24-hour sputum volume and frequent acute exacerbations, and improve the quality of life in patients with bronchiectasis and airflow limitation, with good safety.
10.Determination method of clopidogrel and its metabolites in rat plasma and its pharmacokinetic study
Huan YI ; Lan MIAO ; Changying REN ; Li LIN ; Mingqian SUN ; Qing PENG ; Ying ZHANG ; Jianxun LIU
China Pharmacy 2025;36(13):1599-1603
OBJECTIVE To establish a method for determining the contents of clopidogrel (CLP), clopidogrel carboxylate (CLP-C), clopidogrel acyl-β-D-glucuronide (CLP-G) and contents of clopidogrel active metabolite (CAM) in rat plasma, and to investigate their in vivo pharmacokinetic characteristics. METHODS The Shisedo CAPCELL ADME column was used with a mobile phase consisting of water and acetonitrile (both containing 0.1% formic acid) in a gradient elution. The flow rate was 0.4 mL/min, and the column temperature was maintained at 20 ℃. The injection volume was 2 μL. The analysis was performed in positive ion mode using electrospray ionization with multiple reaction monitoring. The ion pairs for quantitative analysis were m/z 322.1→211.9 (for CLP), m/z 308.1→197.9 (for CLP-C), m/z 322.1→154.8 (for CLP-G), m/z 504.1→154.9 [for racemic CAM derivative (CAMD)]. Six rats were administered a single intragastric dose of CLP (10 mg/kg). Blood samples were collected before medication and at 0.08, 0.33, 0.66, 1, 2, 4, 6, 10, 23 and 35 hours after medication. The established method was used to detect the serum contents of various components in rats. Pharmacokinetic parameters were then calculated using WinNonlin 6.1 software. RESULTS The linear ranges for CLP, CLP-C and CAMD were 0.08-20.00, 205.00-8 000.00, and 0.04-25.00 ng/mL, respectively (r≥0.990). The relative standard deviations for both intra-day and inter-day precision tests were all less than 15%, and the relative errors for accuracy ranged from -11.68% to 14.40%. The coefficients of variation for the matrix factors were all less than 15%, meeting the requirements for bioanalytical method validation. The results of the pharmacokinetic study revealed that, following a single intagastric administration of CLP in rats, the exposure to the parent CLP in plasma was extremely low. Both the area under the drug concentration-time curve (AUC0-35 h) and the peak concentration of the parent CLP were lower than those of its metabolites. The AUC0-35 h of the active metabolite CAM was approximately 43 times that of CLP, though it had a shorter half-life (2.53 h). The inactive metabolite CLP-C exhibited the highest exposure level, but it reached its peak concentration the latest and was eliminated slowly. The AUC0-35 h of CLP-G was about four times that of CAM, and its half-life was similar to that of CLP-C. CONCLUSIONS This study successfully established an liquid chromatography-tandem mass spectrometry method for the determination of CLP and its three metabolites, and revealed their pharmacokinetic characteristics in rats. Specifically, the parent drug CLP was rapidly eliminated, while the inactive metabolites CLP-C and CLP-G exhibited long half-lives, and active metabolite CAM displayed a transient exposure pattern.

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