1.Current Situation, Problems and Countermeasures of Experimental Research on Traditional Chinese Medicine Regulating PI3K/Akt Signaling Pathway in Rats with Polycystic Ovary Syndrome
Pengxuan YAN ; Yiqing LIU ; Nanxing XIAN ; Linjing PENG ; Kun LI ; Jingchun ZHANG ; Yukun ZHAO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(1):259-266
Polycystic ovary syndrome(PCOS) and its resulting infertility is one of the common diseases of gynecology and reproductive endocrinology. The phosphatidylinositol 3-kinase/protein kinase B(PI3K/Akt) signaling pathway is relatively well-studied in the development of intervention in PCOS, and the experiments on PCOS in rats conducted by traditional Chinese medicine through this signaling pathway is also the main direction of mechanistic research. In this paper, 20 articles published in academic journals in the past 5 years were selected through the corresponding criteria, and the objective situation and existing problems of the selected research projects were analyzed from five aspects, namely, baseline data, modeling and treatment, grouping, evaluative indexes, and pharmacodynamic indexes. It is found that there were different degrees of problems in each research project, such as the observation indicators of modeling, criteria for judging the success of the model, the treatment period, the calculation of dosage of prescription/active ingredients and specific dosage were not clearly defined, which could easily lead the bias of the results or reduce the validity of experimental data. Based on this, the list of PCOS rat experimental research operations was formed, involving five categories of experimental rats, model construction, study implementation, outcome measures and analysis and report with a total of 21 operation lists, with a view to provide a reference for the subsequent PCOS experiments related to scientific research and helping to form high-quality results.
2.Quantitative analysis on microvasculature in the optic disc area of patients with unilateral branch retinal vein occlusion
Jia SUN ; Jian LIU ; Peng YAN ; Nan LU ; Zhiming SHAN ; Dongni YANG
International Eye Science 2025;25(1):152-156
AIM: To observe the changes of retinal nerve fiber layer(RNFL)thickness and radial peripheral capillary(RPC)density in patients with unilateral branch retinal vein occlusion(BRVO), and further analyze the correlation between RPC density and RNFL thickness.METHODS: Observational study. Totally 37 patients with unilateral BRVO diagnosed at the ophthalmology department of First Hospital of Qinhuangdao from October 2020 to January 2022 were selected, the 37 affected eyes were the unilateral BRVO group, and 37 fellow healthy eyes were the contralateral unaffected group, and 35 healthy individuals(35 right eyes were selected)without ocular diseases during the same period were selected as the normal control group. The best corrected visual acuity, intraocular pressure, anterior segment, fundus and optical coherence tomography angiography(OCTA)were examined in both eyes of all BRVO patients and healthy individuals. The central macular thickness(CMT), the RNFL thickness, and the optic disc-AV crossing distance(DAVD)were measured by built-in software of the OCTA equipment. The optimized U-net algorithm was used to eliminate the large blood vessels, and then the RPC density was calculated. The CMT, RNFL thickness and RPC density were compared among the three groups. And the correlations of the RPC density with the CMT, RNFL thickness, and the DAVD were investigated.RESULTS: Compared with the contralateral unaffected group and the normal control group, the CMT and the RNFL thickness were significantly thickened in the unilateral BRVO group(all P<0.05); there were no statistical differences in the CMT and the RNFL thickness between the contralateral unaffected group and the normal control group(all P>0.05). The RPC density in the unilateral BRVO group increased compared with the contralateral unaffected group and decreased compared with the normal control group, but there was no statistically difference(all P>0.05). However, the RPC density in the contralateral unaffected group decreased compared with the normal control group(P<0.05). The RPC density in the unilateral BRVO group was not correlated with the CMT(P=0.960), but positively correlated with the RNFL thickness(r=0.401, P=0.014)and negatively correlated with the DAVD(r=-0.339, P=0.040).CONCLUSION: The RNFL thickened significantly and the RPC density did not change significantly in the optic disc area of BRVO patients. The RPC density is positively correlated with the RNFL thickness, indicating that the RNFL thickness can be used as a monitoring indicator to analyze and study the damage degree of the RPC density.
3.Serum Metabolomics of Simulated Weightless Rats Treated with Taikong Yangxin Pills
Xiaodi LIU ; Xuemei FAN ; Yiming WANG ; Mengjia YAN ; Yongzhi LI ; Jiaping WANG ; Junlian LIU ; Guoan LUO
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(2):147-153
ObjectiveTo study the effect of Taikong Yangxin Pills on the metabolism of simulated weightless rats based on metabolomics and discuss the metabolism mechanism. MethodsIn the simulated space capsule environment on the ground, the rat model of simulated weightlessness was established by the tail suspension method. Rats were randomly grouped as follows: out-of-capsule control, in-capsule control, model, and high (3.0 g·kg-1) and low (1.5 g·kg-1) doses of Taikong Yangxin Pills, and they were administrated with corresponding drugs by gavage for 28 days. The serum levels of endogenous metabolites in rats were determined by ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF/MS). The obtained data were processed by principal component analysis (PCA) and orthogonal partial least squares-discriminant analysis (OPLS-DA) to screen for differential metabolites and potential biomarkers. MetaboAnalyst 5.0 was used for pathway enrichment analysis to explain the metabolic regulation mechanism of the drug. ResultsCompared with the out-of-capsule control group, the in-capsule control group showed elevated levels of thirteen metabolites, including 14-hydroxyhexadecanoic acid, linoleic acid, and α-linolenic acid (P<0.05), which suggested that the space capsule environment mainly affected the metabolism of α-linolenic acid and linoleic acid in the rats. Compared with the in-capsule control group, the model group showed lowered levels of fourteen metabolites, including 4-imidazolone-5-propionic acid, isocitric acid/citric acid, and L-tyrosine (P<0.05), which were recovered after the treatment with Taikong Yangxin pills (P<0.05). The pathway enrichment analysis revealed that weightlessness induced by tail suspension and drug intervention mainly involved the phenylalanine, tyrosine, and tryptophan biosynthesis, tyrosine metabolism, histidine metabolism, and citric acid cycle. ConclusionThe simulated space capsule environment and simulated weightlessness induced by tail suspension can both affect the metabolism level of rats. Taikong Yangxin pills can ameliorate the metabolic abnormality in the rat model of weightlessness by regulating various amino acids and energy metabolism-related pathways.
4.Effect of Rhei Radix et Rhizoma Before and After Steaming with Wine on Intestinal Flora and Immune Environment in Constipation Model Mice
Yaya BAI ; Rui TIAN ; Yajun SHI ; Chongbo ZHAO ; Jing SUN ; Li ZHANG ; Yonggang YAN ; Yuping TANG ; Qiao ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(2):192-199
ObjectiveTo study on the different therapeutic effects and potential mechanisms of Rhei Radix et Rhizoma(RH) before and after steaming with wine on constipation model mice. MethodsFifty-four male ICR mice were randomly divided into control group, model group, lactulose group(1.5 mg·kg-1), high, medium and low dose groups of RH and RH steaming with wine(PRH)(8, 4, 1 g·kg-1). Except for the control group, the constipation model was replicated by gavage of loperamide hydrochloride(6 mg·kg-1) in the other groups. After 2 weeks of modeling, each administration group was gavaged with the corresponding dose of drug solution, and the control and model groups were given an equal volume of normal saline, 1 time/d for 2 consecutive weeks. After administration, the feces were collected for 16S rRNA sequencing, the levels of gastrin(GAS), motilin(MTL), interleukin-6(IL-6), γ-interferon(IFN-γ) in the colonic tissue were detected by enzyme-linked immunosorbent assay(ELISA), the histopathological changes of colon were observed by hematoxylin-eosin(HE) staining, flow cytometry was used to detect the proportion changes of CD4+, CD8+ and regulatory T cell(Treg) in peripheral blood. ResultsCompared with the control group, the model group showed significantly decrease in fecal number in 24 h, fecal quality and fecal water rate(P<0.01), the colon was seen to have necrotic shedding of mucosal epithelium, localized intestinal glands in the lamina propria were degenerated, necrotic and atrophied, a few lymphocytes were seen to infiltrate in the necrotic area in a scattered manner, the contents of GAS and MTL, the proportions of CD4+, CD8+ and Treg were significantly reduced(P<0.01), the contents of IL-6 and IFN-γ were significantly elevated(P<0.05, P<0.01). Compared with the model group, the fecal number in 24 h, fecal quality and fecal water rate of high-dose groups of RH and PRH were significantly increased(P<0.05, P<0.01), the pathological damage of the colon was alleviated to varying degrees, the contents of GAS, MTL, IL-6 and IFN-γ were significantly regressed(P<0.05, P<0.01), and the proportions of CD4+ and CD8+ were significantly increased(P<0.01), although the proportion of Treg showed an upward trend, there was no significant difference. In addition, the results of intestinal flora showed that the number of amplicon sequence variant(ASV) and Alpha diversity were decreased in the model group compared with the control group, and there was a significant difference in Beta diversity, with a decrease in the relative abundance of Lactobacillus and an increase in the relative abundances of Bacillus and Helicobacter. Compared with the model group, the ASV number and Alpha diversity were increased in the high-dose groups of RH and PRH, and there was a trend of regression of Beta diversity to the control group, the relative abundance of Lactobacillus increased, and the relative abundances of Bacillus and Helicobacter decreased. ConclusionRH and PRH can improve dysbacteriosis, promote immune system activation, inhibit the release of inflammatory factors for enhancing the gastrointestinal function, which may be one of the potential mechanisms of their therapeutic effect on constipation.
5.Mechanism of Ferroptosis in Regulating Chronic Heart Failure and Traditional Chinese Medicine Prevention and Treatment Based on Qi Deficiency and Stagnation: A Review
Ziyang YUAN ; Yan ZHANG ; Wei ZHANG ; Yaqin WANG ; Wenjun MAO ; Guo YANG ; Xuewei WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(2):248-255
Chronic heart failure (CHF) is the final stage of cardiovascular diseases. It is a complex syndrome, with dyspnea and edema as the main clinical manifestations, and it is characterized by complex disease conditions, difficult cure, and high mortality. Ferroptosis, a new type of programmed cell death, is different from other types of programmed cell death. Ferroptosis is iron-dependent, accompanied by lipid peroxide accumulation and mitochondrial shrinkage, becoming a hot research topic. Studies have confirmed that ferroptosis plays a key role in the occurrence and development of CHF. The regulation of ferroptosis may become a potential target for the treatment of CHF in the future. The theory of Qi deficiency and stagnation refers to the pathological state of original Qi deficiency and abnormal transportation and distribution of Qi, blood, and body fluid, which has guiding significance for revealing the pathogenesis evolution of some chronic diseases. We believe that Qi deficiency and stagnation is a summary of the pathogenesis of ferroptosis in CHF. Deficiency of Qi (heart Qi) is the root cause of CHF, and stagnation (phlegm turbidity and blood stasis) is the branch of this disease. The two influence each other in a vicious circle to promote the development of this disease. Traditional Chinese medicine (TCM) plays an important role in the treatment of CHF, improving the prognosis and quality of life of CHF patients. This paper explores the correlation between the theory of Qi deficiency and stagnation and the mechanism of ferroptosis in CHF. Furthermore, this paper reviews the mechanism of Chinese medicines and compound prescriptions in preventing and treating CHF by regulating ferroptosis according to the principles of replenishing Qi and dredging to remove stagnation, aiming to provide new ideas and methods for the treatment of CHF with TCM.
6.Gualou Xiebai Banxiatang in Treatment of Cardiovascular Diseases: A Review
Yalong KANG ; Bo NING ; Juanjuan TAN ; Hongfei QI ; Yan SHI ; Fang GUAN ; Haifang WANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(2):256-267
Cardiovascular diseases (CVD),a group of common diseases in clinical practice,are witnessing a steady rise in both incidence and mortality rates,posing a challenge to public health. Gualou Xiebai Banxiatang,originating from Synopsis of the Golden Chamber (《金匮要略》),was initially used to treat severe cases of chest impediment. The formula consists of Trichosanthis Fructus,Allii Macrostemonis Bulbus,Pinelliae Rhizoma,and Baijiu. It has a wide range of clinical applications,with therapeutic effects including moving Qi to relieve depression,activating Yang to dissipate mass,and expelling phlegm to alleviate chest congestion. In recent years,clinical research has confirmed that Gualou Xiebai Banxiatang,with or without modification,used alone or in combination with Western medicine,has definite effects in the treatment of CVD such as hyperlipidemia,coronary atherosclerotic heart disease,hypertension,heart failure,and arrhythmia. It can alleviate disease symptoms and reduce the risk of re-hospitalization. Basic research indicates that the mechanisms of Gualou Xiebai Banxiatang include improving endothelial functions,exhibiting anti-inflammatory properties,countering oxidative stress,preventing apoptosis,inhibiting ventricular remodeling,regulating mitochondrial functions,improving hemorheology,and modulating autophagy and neurotransmitters. This article reviews relevant articles in recent years with focuses on the compatibility,clinical application,and mechanism of Gualou Xiebai Banxiatang. This review is expected to provide a theoretical basis for the mechanism research and clinical application of this formula in treating CVD and to offer ideas and reference for in-depth research.
7.Traditional Chinese Medicine Treats Sepsis by Regulating PI3K/Akt Pathway: A Review
Zhu LIU ; Jiawei WANG ; Jing YAN ; Jinchan PENG ; Mingyao XU ; Liqun LI ; Sheng XIE
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(2):314-322
Sepsis is a systemic inflammatory response syndrome caused by the invasion of pathogenic microorganisms such as bacteria. In addition to the manifestations of systemic inflammatory response syndrome and primary infection lesions, critical cases often have manifestations of organ hypoperfusion. The morbidity and mortality of sepsis have remained high in recent years, which seriously affect the quality of life of the patients. The pathogenesis of sepsis is complicated, in which uncontrollable inflammation is a key mechanism. The phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway plays a key role in mediating inflammation in sepsis. The available therapies of sepsis mainly include resuscitation, anti-infection, vasoactive drugs, intensive insulin therapy, and organ support, which show limited effects of reducing the mortality. Therefore, finding new therapeutic drugs is a key problem to be solved in the clinical treatment of sepsis. In recent years, studies have shown that traditional Chinese medicine (TCM) can regulate the PI3K/Akt pathway via multiple pathways, multiple effects, and multiple targets to inhibit inflammation and curb the occurrence and development of sepsis, which has gradually become a hot spot in the prevention and treatment of sepsis. Moreover, studies have suggested that TCM has unique advantages in the treatment of sepsis. TCM can regulate the PI3K/Akt signaling pathway to inhibit inflammation, reduce oxidative stress, and control apoptosis in the prevention and treatment of sepsis. Despite the research progress, a systematic review remains to be performed regarding the TCM treatment of sepsis by regulating the PI3K/Akt signaling pathway. After reviewing relevant papers published in recent years, this study systematically summarizes the relationship between PI3K/Akt pathway and sepsis and the role of TCM in the treatment of sepsis, aiming to provide new ideas for the potential treatment of sepsis and the development of new drugs.
8.Cyclocarya paliurus Polysaccharide Inhibits Benign Prostatic Hyperplasia by Reducing 5α-Reductase 2
Qinhui DAI ; Mengxia YAN ; Chen WANG ; Chenjun SHEN ; Chenying JIANG ; Bo YANG ; Huajun ZHAO ; Zhihui ZHU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(3):107-114
ObjectiveTo investigate the effect and mechanism of polysaccharide in water extract of Cyclocarya paliurus (CPWP) in inhibiting benign prostatic hyperplasia (BPH). MethodsCPWP was obtained by heating reflux, aqueous extraction, alcohol precipitation, and freeze drying. The chemical composition and structural properties of CPWP were analyzed by high performance liquid chromatography with 1-pheny-3-methyl-5-pyrazolone pre-column derivatization and infrared spectroscopy. Male SD rats were randomly assigned into control, model, finasteride (ig 5 mg·kg-1), and low-, medium-, and high-dose (ig 50, 75, 100 mg·kg-1) CPWP groups, with 8 rats in each group. The BPH model was established by subcutaneously injecting propionate testosterone in castrated rats. The rats in the drug intervention groups were administrated with corresponding drugs, and those in the control group were administrated with an equal volume of normal saline each day. After 30 consecutive days, the rats were sacrificed, and the prostate tissue was separated and weighed. The effects of drug interventions on the body weight, prostate wet weight, and prostate index of rats were examined. The prostate tissue was stained with hematoxylin-eosin (HE) for observation of pathological changes. Enzyme-linked immunosorbent assay was employed to measure the level of dihydrotestosterone (DHT), and immunohistochemical staining was used to detect the expression of steroid 5 alpha-reductase 2 (SRD5A2) and Ki67 in the prostate tissue. ResultsCPWP was identified as a saccharide, with characteristic absorption peaks of saccharides. CPWP showed the total sugar content of 44.15% and molecular weight within the range of 5.5-78.8 kDa, being composed of mannose, rhamnose, galacturonic acid, glucose, galactose, xylose, and arabinose. Compared with the control group, the model group had significantly increased prostate wet weight and prostate index (P<0.01), thick and tall prostate epithelial cells, increased internal wrinkles, papillary expansion into the cavity, an elevation in DHT level in the serum, and up-regulated expression of SRD5A2 and Ki67 in the prostate tissue (P<0.05, P<0.01). Compared with the model group, both the finasteride and CPWP groups showed decreases in prostate wet weight and prostate index (P<0.05, P<0.01), thinned prostate epithelial cells, with only a small portion of internal wrinkles and papillary expansion into the cavity, shortened papillary protrusions, lowered DHT level in the serum, and down-regulated expression of SRD5A2 and Ki67 in the prostate tissue (P<0.01). Moreover, CPWP exerted effects in a dose-dependent manner. ConclusionCPWP inhibits BPH by regulating the expression of SRD5A2.
9.Analysis of Quality Uniformity of Hengzhi Kechuan Capsules Based on HPLC-DAD-CAD
Qian MA ; An LIU ; Qingxia XU ; Cong GUO ; Jun ZHANG ; Maoqing WANG ; Xiaodi KOU ; Yan LIU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(3):168-174
ObjectiveTo establish the fingerprints of 15 batches of Hengzhi Kechuan capsules, to quantitatively analyze 10 index components, and to evaluate the quality uniformity of samples from different batches. MethodsThe fingerprints and quantitative analysis of Hengzhi Kechuan capsules were established by a combination method of high performance liquid chromatography coupled with diode array detector and charged aerosol detector(HPLC-DAD-CAD), adenosine, guanosine, vanillic acid, safflomin A, agarotetrol, naringin, hesperidin, militarine, ginsenoside Rb1, and glycyrrhizic acid were selected as quality attribute indexes. A total of 15 batches of Hengzhi Kechuan capsules from 2022 to 2024(3 boxes per batch) were qualitatively and quantitatively analyzed, and the quality uniformity level of the manufacturers was characterized by parameters of intra-batch consistency(PA) and inter-batch consistency(PB). The homogeneity and difference of quality attribute indexes of samples from different years were analyzed by heatmap clustering analysis. ResultsHPLC fingerprints and quantitative method of Hengzhi Kechuan capsules were established, and the methods could be used for qualitative and quantitative analysis of this preparation, which was found to be stable and reliable by method validation. The similarity of fingerprints of 15 batches of samples was 0.887-0.975, a total of 13 common peaks were calibrated, and 10 common peaks were designated, all of which were quality attribute index components. The results of quantitative analysis showed that the contents of the above 10 ingredients in the samples were 0.038-0.078, 0.115-0.251, 0.007-0.018, 0.291-0.673, 0.122-0.257, 0.887-1.905, 1.841-3.364, 1.412-2.450, 2.207-3.112, 0.650-1.161, respectively. And the contents of ginsenoside Rb1 and glycyrrhizic acid met the limit requirements in the 2020 edition of Chinese Pharmacopoeia. For the samples from 15 batches, the PA values of the 10 index components were all <10%, indicating good intra-batch homogeneity, and the PB values ranged from 33.86% to 92.97%, suggesting that the inter-batch homogeneity was poor. Heatmap clustering analysis showed that the samples from different years were clustered into separate categories, and adenosine, guanosine, safflomin A, naringin, hesperidin and agarotetrol were the main differential components. ConclusionThe intra-annual quality uniformity of Hengzhi Kechuan capsules is good and the inter-annual quality uniformity is insufficient, which may be related to the quality difference of Pinellinae Rhizoma Praeparatum, Carthami Flos, Citri Sarcodactylis Fructus, Citri Reticulatae Pericarpium, Aquilariae Lignum Resinatum, Citri Fructus, etc. In this study, the fingerprint and multi-indicator determination method of Hengzhi Kechuan capsules was established, which can be used for more accurate and efficient quality control and standardization enhancement.
10.Horticultural Therapy Combined with Intradermal Needling for Patients with Generalized Anxiety Disorder of Liver Depression Transforming into Fire Syndrome Under Transcranial Magnetic Stimulation and Psychological Therapy:Clinical Observation of 60 Cases
Wanyun ZHANG ; Jiayi YAN ; Qingyi QIU ; Yumei PENG ; Xiaoling ZHONG ; Jinwen ZHANG ; Rundong TANG ; Miao WU ; Dan HU ; Guang SU
Journal of Traditional Chinese Medicine 2025;66(1):50-58
ObjectiveTo observe the clinical effectiveness of horticultural therapy involving the planting of Chinese medicinal herbs (mint and lily potted plants) combined with intradermal needling therapy for generalized anxiety disorder (GAD) of liver depression transforming into fire syndrome under transcranial magnetic stimulation and basic psychological therapy, and to explore the possible mechanisms of action. MethodsA total of 180 patients with GAD of liver depression transforming into fire syndrome were randomly divided into three groups, horticultural therapy group, intradermal needling group, and horticultural therapy+intradermal needling group, with 60 patients in each. All groups received basic treatment including basic psychological therapy and transcranial magnetic stimulation. The horticultural therapy group received horticultural therapy in addition to the basic treatment; the intradermal needling group received intradermal needling therapy once a week for 8 weeks in addition to the basic treatment; the horticultural therapy+intradermal needling group received both horticultural therapy and intradermal needling therapy, following the same procedures and duration. Hamilton Anxiety Rating Scale (HAMA), Self-Rating Anxiety Scale (SAS), and Pittsburgh Sleep Quality Index (PSQI) scores were assessed at baseline and after 2, 4, 6, and 8 weeks of treatment. Serum levels of adrenocorticotropic hormone (ACTH) and corticosterone (CORT) were measured before treatment and after 8 weeks of treatment. Motor-evoked potential (MEP) baseline levels were recorded before treatment, and MEP amplitude ratios were compared after 1 week and 8 weeks of treatment. Clinical effectiveness and safety were evaluated after 8 weeks of treatment. Pearson correlation analysis was used to examine the relationships between serum ACTH and CORT levels, MEP amplitude, and anxiety. ResultsIn the horticultural therapy group and intradermal needling group, HAMA, SAS and PSQI scores after 4, 6, and 8 weeks treatment were lower than baseline scores (P<0.05). In the horticultural therapy+intradermal needling group, these scores showed a significant decline starting after 2 weeks treatment and continuing through 8 weeks after treatment (P<0.05). The HAMA, SAS, and PSQI scores in the horticultural therapy+intradermal needling group were significantly lower than those in the other two groups after 2, 4, 6, and 8 weeks treatment (P<0.05). After 8 weeks of treatment, serum CORT and ACTH levels in the horticultural therapy+intradermal needling group were significantly lower than baseline levels (P<0.05) and were also lower than those in the horticultural therapy group and intradermal needling group at the same time point (P<0.01). When comparing the level after 8 weeks treatment to that after 1 week treatment, under PAS10 stimulation, the MEP amplitude ratio in the intradermal needling group decreased at 30 minutes, while in the horticultural therapy+intradermal needling group, the MEP amplitude ratio decreased at all time points (P<0.05 or P<0.001); under PAS25 stimulation, the MEP amplitude ratio in the horticultural therapy group increased at 20 minutes, and in the intradermal needle group at 10 minutes (P<0.05). In the horticultural therapy+intradermal needling group, the MEP amplitude ratio increased significantly at all time points after treatment (P<0.001). The cure rate in the horticultural therapy+intradermal needling group (74.14%, 43/58) was significantly higher than that in the horticultural therapy group (30.00%, 18/60) and the intradermal needling group (48.28%, 28/58, P<0.05). Correlation analysis revealed that serum ACTH and CORT levels were positively correlated with HAMA scores (r = 0.488, P<0.01; r = 0.428, P<0.01). Following PAS10 intervention, the MEP amplitude ratio was positively correlated with HAMA scores (r = 0.458, P<0.01), whereas after PAS25 intervention, the MEP amplitude ratio was negatively correlated with HAMA scores (r = -0.562, P<0.01). ConclusionHorticultural therapy combined with intradermal needling treatment, under transcranial magnetic stimulation and basic psychological therapy, demonstrates significant clinical effectiveness in patients with GAD of liver depression transforming into fire syndrome. Its mechanism of action may be related to the regulation of hyperactivation of the hypothalamic-pituitary-adrenal (HPA) axis and the reduction of cortical excitability.

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