1.Immunity-inflammation Mechanism of Viral Pneumonia and Traditional Chinese Medicine Treatment Based on Theory of Healthy Qi and Pathogenic Qi
Zheyu LUAN ; Hanxiao WANG ; Xin PENG ; Yihao ZHANG ; Yunhui LI ; Jihong FENG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(2):239-247
Viral pneumonia is an infectious disease caused by virus invading the lung parenchyma and interstitial tissue and causing lung inflammation, with the incidence rising year by year. Traditional Chinese medicine (TCM) can treat viral pneumonia in a multi-component, multi-target, and holistic manner by targeting the core pathogenesis of pneumonia caused by different respiratory viruses, demonstrating minimal side effects and significant advantages. According to the theory of healthy Qi and pathogenic Qi in TCM, the struggle between healthy Qi and pathogenic Qi and the imbalance between immunity and inflammation run through the entire process of viral pneumonia, and the immunity-inflammation status at different stages of the disease reflects different relationships between healthy Qi and pathogenic Qi. Immune dysfunction leads to the deficiency of healthy Qi, causing viral infections. The struggle between healthy Qi and pathogenic Qi causes immunity-inflammation imbalance, leading to the onset of viral pneumonia. Inflammatory damage causes persistent accumulation of phlegm and stasis, leading to the progression of viral pneumonia. The cytokine storm causes immunodepletion, leading to the excess of pathogenic Qi and diminution of healthy Qi and the deterioration of viral pneumonia. After the recovery from viral pneumonia, there is a long-term imbalance between immunity and micro-inflammation, which results in healthy Qi deficiency and pathogenic Qi lingering. Healthy Qi deficiency and pathogenic Qi excess act as common core causes of pneumonia caused by different respiratory viruses. Clinical treatment should emphasize both replenishing healthy Qi and eliminating pathogenic Qi, helping to restore the balance between healthy Qi and pathogenic Qi as well as between immunity and inflammation, thus promoting the recovery of patients from viral pneumonia. According to the TCM theory of healthy Qi and pathogenic Qi, this article summarizes the immunity-inflammation mechanisms at different stages of viral pneumonia, and explores the application of the method of replenishing healthy Qi and eliminating pathogenic Qi in viral pneumonia. The aim is to probe into the scientific connotation of the TCM theory of healthy Qi and pathogenic Qi in viral pneumonia and provide ideas for the clinical application of the method of replenishing healthy Qi and eliminating pathogenic Qi to assist in the treatment of viral pneumonia.
2.Role of Traditional Chinese Medicine in Regulating Immune Inflammation and Microvascular Damage in Preventing Recurrence of Pneumonia During Recovery Based on Combination of Pathogenic Factors
Xin PENG ; Haotian XU ; Lei LIANG ; Zheyu LUAN ; Hanxiao WANG ; Kun YANG ; Jihong FENG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(9):249-258
Pneumonia is an infectious disease with high morbidity and mortality worldwide, and its damage to the body is not limited to the acute phase. The theory of combination of pathogenic factors emphasizes that the combination of new pathogens and residual pathogens in the body leads to the occurrence of diseases, which generalizes the causes of recurrence during pneumonia recovery. During the recovery stage of pneumonia, pathological changes such as disturbance of immune homeostasis, persistent low-grade inflammation, and microvascular damage continue to affect the body function, impair the health and quality of life of patients, and increase the risk of secondary infection. According to the theory of traditional Chinese medicine (TCM), pneumonia is caused by deficiency, and Qi deficiency and blood stasis is the core pathogenesis in the recovery stage. At this time, the body is not full of healthy qi and still has residual pathogens, and thus it is susceptible to external pathogenic factors that lead to disease recurrence. As an important part of the TCM philosophy of treating disease before its onset, prevention of recurrence after recovery emphasizes the need for aftercare in the recovery stage to prevent disease recurrence. Based on the pathogenesis theory of combination of pathogenic factors and the pathogenesis of Qi deficiency and blood stasis, this paper discusses the effect and connotation of TCM in regulating immune inflammation and microvascular damage in preventing recurrence of pneumonia during the recovery stage, aiming to develop new ideas for effective prevention and treatment of pneumonia at this stage.
3.Thoughts of Syndrome Differentiation and Treatment and Effect Mechanism of Haoqin Qingdantang in Treating Viral Pneumonia Based on Theory of Treating Different Diseases with Same Therapy
Xin PENG ; Haotian XU ; Lei LIANG ; Zheyu LUAN ; Hanxiao WANG ; Yihao ZHANG ; Kun YANG ; Jihong FENG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(8):209-217
The principle of treating different diseases with the same therapy is the essence of syndrome differentiation and treatment in traditional Chinese medicine (TCM). It means that when the same pathogenic changes or the same symptoms appear in the development of different diseases, the same principles or methods can be used for treatment. Due to the complexity and high variability of viral pathogenicity, the precise and effective treatment of different types of viral pneumonia (VP) has always been a research focus and difficulty in modern medicine. VP belongs to the category of external-contraction febrile disease, warm disease, and epidemic in TCM. Haoqin Qingdantang (HQQDD) is a representative formula for clearing heat and dispelling dampness in warm diseases, and its intervention in VP caused by various viral infections has significant effects. This study, guided by the theory of treating different diseases with the same therapy, links the related studies on using HQQDD to treat different types of VP and finds that influenza virus pneumonia (IVP), severe acute respiratory syndrome (SARS), and COVID-19 all have a common pathogenic mechanism of dampness-heat at different stages of respective diseases. When these diseases are dominated by damp-heat factors, the use of HQQDD yields remarkable therapeutic effects. Modern pharmacological studies have confirmed that HQQDD can inhibit virus replication, reduce fever reactions, inhibit the expression of inflammatory mediators, and regulate immune balance. Moreover, the sovereign medicine in this formula has excellent antiviral activity, and the formula reflects rich scientific connotations of treating VP. According to the theory of treating different diseases with the same therapy and based on the effective treatment practice and modern pharmacological research of HQQDD for different types of VP, this paper mines the underlying TCM theory of treatment with the same therapy, explores the syndrome differentiation and treatment strategy and effect mechanism of this formula for different types of VP, and analyzes the treatment mechanism and characteristics, with the aim of providing evidence and reference for the clinical application and modern research of HQQDD.
4.Connotation of Traditional Chinese Medicine in Treatment of Chronic Obstructive Pulmonary Disease by Regulating Gut Microbiota Based on "Lung and Large Intestine Being Interior-exterior Related"
Hanxiao WANG ; Zheyu LUAN ; Jihong FENG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(3):169-177
Chronic obstructive pulmonary disease (COPD) is a heterogeneous lung condition characterized by persistent and often progressive airflow obstruction, including airway abnormalities (e.g., bronchitis and bronchiolitis) and chronic respiratory symptoms (e.g., dyspnea, cough, and expectoration). It is one of the leading causes of death worldwide. According to the theory of traditional Chinese medicine (TCM), the lung and large intestine are interior-exterior related. Therefore, COPD can be treated from both the lung and intestine by the methods of tonifying and invigorating lung, spleen, and kidney, dispelling phlegm, and expelling stasis. Gut microbiota plays a key role in human immunity, nerve, and metabolism and may act on COPD by affecting the structures and functions of lung and intestine tissue and regulating lung inflammation and immunity. TCM can restore the balance of gut microbiota, which is conducive to the recovery from COPD. For example, the treatment method of tonifying lung and invigorating kidney can regulate gut microbiota, alleviate pulmonary and intestinal injuries, and improve lung immunity. The treatment methods of dispelling phlegm and expelling stasis can regulate gut microbiota and reduce pulmonary inflammation. According to the TCM theory of lung and large intestine being interior-exterior related, this review elaborates on the connotation of TCM in the treatment of COPD by regulating gut microbiota, aiming to provide new ideas for the clinical treatment of COPD via gut microbiota.
5.Pathogenesis of Airway Mucus Hypersecretion in Chronic Obstructive Pulmonary Disease and Intervention of Traditional Chinese Medicine: A Review
Xin PENG ; Jian LIU ; Zheyu LUAN ; Jihong FENG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(4):228-239
Chronic obstructive pulmonary disease (COPD) is one of the most common chronic diseases of the respiratory system in the clinic. The disease has a long course and is difficult to cure, which seriously threatens human health. Airway mucus hypersecretion (AMH) is an independent risk factor for COPD and has a significant impact on the development and prognosis of the disease. The review finds that the abnormal proliferation of goblet cells and the excessive secretion of mucin are the direct causes of AMH. The pathogenesis of AMH may be closely related to the inhalation of heterogeneous particles, airway inflammation, the imbalance of mucin/water salt ratio, and the regulation of related signaling pathways. Traditional Chinese medicine (TCM) believes that AMH of COPD belongs to the category of lung distension with phlegm-fluid retention syndrome, and the disease is mainly treated from phlegm on the basis of lung distension. This article summarizes the relevant research in the field of TCM in recent years and finds that the single TCM that effectively intervened AMH of COPD is mainly phlegm-resolving TCM, and the main active ingredients of TCM are flavonoids, terpenoids, phenols, and alkaloids. The main TCM compounds are mainly designed to remove heat-phlegm, warmly resolve cold-phlegm, dry dampness to eliminate phlegm, invigorate Qi, promote blood circulation and dispel phlegm, and invigorate lung, spleen, and kidney. Its mechanism of action may be direct inhibition or indirect inhibition of airway epithelial goblet cell metaplasia and mucin expression by inhibiting airway inflammation, regulating aquaporins to correct the imbalance of mucin/water salt ratio, and regulating signaling pathways, so as to reduce mucus oversecretion in COPD. However, there are still some problems. For example, the research mainly focuses on TCM compounds instead of the single TCM or its effective components. The research on the mechanism of action is not thorough enough, and the research results are not interoperable. The clinical transformation rate of basic research is insufficient. This article systematically reviews the research status of AMH in the treatment of COPD with TCM and puts forward some thoughts on the existing problems, so as to provide a reference for clinical rational medication and in-depth research.
6.GC-MS Analysis of Total Volatile Oil from Branches and Leaves of Four Rhododendron Species Under Supercritical CO2 Extraction
Dan FENG ; Zhenjie LUAN ; Ruolan LONG ; Peipei LI ; Xi LUO ; Jing SUN
Chinese Journal of Modern Applied Pharmacy 2024;41(13):1742-1749
OBJECTIVE
To clarify the components of volatile oil in branches and leaves of Rhododendron anthopogonoides, Rhododendron capitatum, Rhododendron thymifolium and Rhododendron przewalskii.
METHODS
The total volatile oil in leaves and branches of these plants were obtained by supercritical CO2 extraction. After that, the chemical composition of the total volatile oil was analyzed and identified by GC-MS, and the contents of different parts and varieties were compared.
RESULTS
The results showed that the highest oil yield of leaves was Rhododendron thymifolium(6.97%), and the highest oil yield of branches was Rhododendron anthopogonoides(20.53%). Thirty-five, eighty, fifty-eight and forty compounds were detected in the branch oil of Rhododendron anthopogonoides, Rhododendron capitatum, Rhododendron thymifolium and Rhododendron przewalskii respectively, among which Rhododendron capitatum was rich in compounds. Forty-eight, fifty-seven, sixty-two and fifty compounds were detected in the leaf oil, among which the compounds of Rhododendron anthopogonoides were the richest. Among the detected components, squalene(34.92%, 26.90%) was the highest content in the branches and leaves of Rhododendron anthopogonoides. 1-Eicosanol(26.79%) was the highest content in the branch oil of Rhododendron capitatum, and octadecyl acetate(42.32%) was the highest content in the leaf oil. The highest content of bisabola-3,10-diene-2-one(34.66%, 28.20%) was found in the branches and leaves of Rhododendron thymifolium, and 15-oxoETE(38.20%, 40.40%) was the highest content in the branches and leaves of Rhododendron przewalskii. The results showed that the contents of oil in branches and leaves of Rhododendron capitatum were quite different in different parts. In the comparison of different varieties, the compounds with the highest content of four rhododendrons were all different.
CONCLUSION
According to the difference of the content of active components of different rhododendrons and parts, the appropriate species and parts for purposeful development and utilization should be selected. The research results can provide scientific basis for rational development and utilization of Rhododendron resources.
7.Therapeutic effects of enalapril maleate on doxorubicin-induced heart failure in rats
Shu-Yan HUANG ; Yu-Ling LUAN ; Ying ZHANG ; Jun-Feng QIAN ; Zong-Jun LIU
The Chinese Journal of Clinical Pharmacology 2024;40(4):569-573
Objective To investigate the therapeutic effects and mechanism of enalapril maleate tablet on doxorubicin-induced heart failure rats based on mitogen-activated protein kinase(MAPK)signaling pathway.Methods Eleven of the 40 male SD rats were randomly selected as the normal group(equivalent to 0.9%NaCl),and the remaining 29 were prepared with intraperitoneal injection of 3 mg·kg-1·w-1 doxorubicin to prepare heart failure model.After successful modeling,they were randomly divided into model group(n=15 cases)and experimental group(n=14 cases).Experimental group was given 1.8 mg·kg-1·d-1 enalapril maleate suspension for gavage;normal and model groups were given the same amount of 0.9%NaCl by gavage.After 8 weeks,the rats were subjected to cardiac ultrasound,the left ventricular ejection fractions(LVEF)of each group were recorded,the serum myocardial injury index level was detected by enzyme-linked immunosorbent assay,and the expression levels of mRNA and protein related to the MAPK signaling pathway were detected by real-time quantitative polymerase chain reaction and Western blot.Results The LVEF values of control,model and experimental groups were(77.85±3.34%)%,(41.39±2.87%)%and(60.10±6.53%)%;serum brain natriuretic peptide contents were(219.30±10.59),(333.90±61.19)and(260.00±16.10)pg·mL-1;the relative expression levels of Mapk8ip2 were 1.00±0.01,2.60±0.12 and 2.00±0.08;the relative expression levels of Mapk8ip3 were 1.00±0.00,6.77±1.04 and 3.66±0.54;the relative expression levels of Mapk1 were 1.00±0.00,4.40±0.14 and 2.71±0.24;the relative expression levels of Mapk3 were 1.00±0.01,7.83±0.34 and 2.71±0.24;the relative expression levels of P38-MAPK were 1.00±0.05,1.14±0.02 and 1.02±0.03;the relative expression levels of extracellular regulated protein kinase 1/2 protein were 1.00±0.07,1.49±0.03 and 1.16±0.10;the relative expression levels of c-Jun N-terminal kinase 1/2 protein were 1.00±0.03,1.65±0.19 and 1.14±0.01,respectively.Compared with the model group,the differences of above indexes in the normal and experimental groups were statistically significant(all P<0.01).Conclusion Enalapril maleate tablets have therapeutic effects on rats with heart failure,and the mechanism may be achieved by regulating the MAPK signaling pathway.
8.Role of Supplementing Qi and Activating Blood in Preventing Relapse After Recovery of Community-acquired Pneumonia with Syndrome of Lung Deficiency and Collateral Stasis
Hanxiao WANG ; Zheyu LUAN ; Jihong FENG
Chinese Journal of Experimental Traditional Medical Formulae 2024;30(14):232-239
Community-acquired pneumonia (CAP) is a respiratory infection which takes a long time to fully recover after clinical symptoms are alleviated in the short term. It affects the physical health and quality of life of the patients in the long term and can occur repeatedly, which is related to inflammation, immunity, and the coagulation function. Lung Qi deficiency and collateral stasis are the key pathogenesis of CAP at the recovery stage. The development of CAP is accompanied by the decreased production and the increased consumption of Qi, which results in lung Qi deficiency. At the same time, heat pathogen forces the blood to move improperly, which depletes Qi and damages fluid, resulting in lung collateral stasis. Lung Qi deficiency and collateral stasis are causal and influence each other. The patients at the recovery stage of CAP generally present deficient lung Qi and healthy Qi, impaired immune function, and weakened defense function. However, pathogenic Qi, coagulation function changes, and thrombosis exist, and some coagulation factors are associated with the prognosis of CAP. The Chinese medicines for tonifying lung and supplementing Qi can help replenish healthy Qi, consolidate the body foundation, and regulate the inflammation. The Chinese medicines for activating blood and resolving stasis can dredge the lung collaterals, clear the pathogenic Qi, improve the microvascular circulation, and inhibit the inflammatory response. The Chinese medicines for supplementing Qi and activating blood can replenish healthy Qi and dispel pathogen to regulate immunity, inhibit inflammation, and alleviate the clinical symptoms, thus promoting the recovery from pneumonia. From lung Qi deficiency and collateral stasis, this paper summarizes the application and explains the scientific connotation of supplementing Qi and activating blood in preventing relapse after recovery of CAP, providing ideas for using this method to assist in preventing relapse after recovery of CAP.
9.Comparison of effectiveness,safety,and economy of generic and original levetiracetam concentrated solution for injection:a real-world study
Yingnan FENG ; Xianzhe DONG ; Jing PENG ; Ke WANG ; Zhizhou WANG ; Jiajie LUAN ; Lan ZHANG ; Xiaolin YUE
Chinese Journal of Pharmacoepidemiology 2024;33(2):152-157
Objective To evaluate the effectiveness,safety and economy of the clinical application of levetiracetam(LEV)concentrated solution for injection generic drug and the original drug in the national centralized volume-based procurement.Methods The information of inpatients using original LEV concentrated solution for injection in the Xuanwu Hospital of Capital Medical University(original drug group)and inpatients using generic LEV concentrated solution for injection in the First Affiliated Hospital of Wannan Medical College(generic drug group)was retrospectively analyzed after the implementation of the procurement policy(from November 2021 to March 2022).To compare the effectiveness,safety and economy of the two in the prevention and treatment of epilepsy.Results In the original drug group and the generic drug group,18 and 17 patients were enrolled in the treatment of epilepsy respectively,the effective rates were 50.00%and 58.82%,the incidence of adverse reactions were both 0%,and the median daily cost was 255.00(255.00,510.00)yuan and 131.78(131.78,131.78)yuan.After propensity score matching,both the original drug group and the generic drug group had 76 patients each received preventive medication,the effective rates were 97.37%and 100%(P>0.05),and the incidence of adverse reactions were both 0%.The median daily fee for the original the generic drug group was 170.00(170.00,170.00)yuan and 131.78(131.78,131.78)yuan,there were significant difference(P<0.01).Conclusion The clinical effect of generic and original LEV concentrated solution for injection in preventing epilepsy is basically the same,the clinical safety are equivalent,the generic has better economy than the original.The effective rate of the treatment of epilepsy is similar,while the sample size needs to be further expanded to verify the results.
10.Effect of anterior cingulate cortex-nucleus accumbens GABAergic cir-cuit on irritable bowel syndrome in mice and its underlying mechanisms
Ruixiao GUO ; Shengli GAO ; Xufei FENG ; Hua LIU ; Xing MING ; Jinqiu SUN ; Xinchi LUAN ; Zhenyu LIU ; Weiyi LIU ; Feifei GUO
Chinese Journal of Pathophysiology 2024;40(5):815-826
AIM:To investigate the effects of the γ-aminobutyric acid(GABAergic)neural pathway from the anterior cingulate cortex(ACC)to the nucleus accumbens(NAc)on the regulation of irritable bowel syndrome(IBS)and its underlying mechanisms in mice.METHODS:(1)A C57BL/6J mice model of IBS was established by using chronic acute combing stress(CACS).The mice were divided into a normal group and an IBS group(n=8).The presence of IBS-like symptoms was determined through behavioural tests,an intestinal motility test and abdominal withdrawal reflex scores.(2)Fluorescence gold(FG)retrograde tracing and immunohistochemistry were used to investigate the ACC-NAc GABAergic neural pathway and to examine the activation of GABA in the ACC in IBS mice(n=8).(3)A total of 1.5 μL of normal saline(NS),GABAA receptor antagonist bicuculline(BIC)or agonist isoguvacine hydrochloride(Isog)was ad-ministered via a preburied catheter into the NAc of mice in IBS and normal groups.The mice were randomly divided into three groups(n=8):NS group,BIC group and Isog group.IBS-like symptoms were assessed.(4)The mice were prein-jected with AAV2/9-mDlx-iCre-WPRE-pA in the ACC and AAV2/2Retro Plus-hSyn-DIO-hM3D(Gq)-eGFP-WPRE-pA in the NAc and subsequently divided into four groups(n=8):NS(intraperitoneal injection)+NS(NAc microinjection)group,NS+BIC group,clozapine N-oxide(CNO)+NS group and CNO+BIC group.The mice who received AAV2/2Retro-hSyn-DIO-hM4D(Gi)-EGFP-WPRE-pA in the NAc were randomly divided into three groups(n=8):NS+NS group,NS+BIC group and CNO+NS group.Enzyme-linked immunosorbent assay(ELISA)was employed to estimate the expression levels of histamine and 5-hydroxytryptamine(5-HT)in colon tissue,and the effects of GABAergic neural pathways from ACC to NAc on IBS were studied.RESULTS:CACS induced IBS-like symptoms in mice.The results of FG retrograde tracing combined with fluorescence immunohistochemistry showed that GABA neurons of ACC could project to NAc.The injection of BIC in the NAc was found to significantly reduce anxiety-like behaviours,diarrheal symptoms and visceral hy-persensitivity in the IBS mice(P<0.05).Chemogenetic inhibition of the ACC-NAc GABAergic neurons ameliorated IBS-like symptoms in mice(P<0.05).CONCLUSION:The GABAergic pathway of ACC-NAc might be involved in the regu-lation of IBS in mice,which may be related to the release of histamine and 5-HT in colon tissue.


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