Helico)X
Helico)X botanical ingredients have a strong antibacterial effect on H. pylori infections and a therapeutic effect on the stomach lining. It reduces inflammation and helps heal stomach and duodenal ulcers.*
| Ingredients |
|---|
| Rheum palmatum |
| Heydyotis diffusa |
| Panax notoginseng |
| Salvia miltiorrhiza |
| Magnolia officinalis |
| Pueraria lobata |
| Astragalus membranaceus |
| Coptis chinensis |
| Schizonepeta tenuifolia |
| Paeonia lactiflora |
| Prunus mume fructus |
| Codonopsis pilosula |
| Cinnamomum cassia |
| Boswellia thurifera |
Other Ingredients: Vegetable cellulose (hypromellose); Vegetable Stearic Acid; Microcrystalline Cellulose and Vegetable Magnesium Stearate.
Does Not Contain: Wheat, gluten, soy, milk, eggs, fish, crustacean shellfish, tree nuts, peanuts
Helico)X
60 x 500 mg Capsules
Actions
•Inhibits H. Pylori
•Relieves GERD
•Anti-ulcer
•Anti-inflammatory
Indications
•Helicobacter pylori infection
•Gastritis / Chronic atrophic gastritis
•Gastric ulcer
•Peptic ulcers
•Gastroesophageal reflux
•Bloating
•Nausea
•Lymphoma of the stomach
Suggested Use:
2 capsules after each meal, maximum three, or 6 before sleep.
Caution:
Caution with physical depletion and weakness, chronic fatigue, and watery diarrhoea.
Warning:
Contraindicated in Pregnancy and Lactation and with Warfarin
Helicobacter pylori
H. pylori is a very common infection of the stomach. It may be the most common infection in the world. It is now clear that the infection is directly related to the development of stomach and duodenal ulcers, and it is likely that it may be related to stomach cancer.The symptoms of discomfort, bloating, nausea and perhaps vomiting are possible clues to the presence of Helicobacter pylori, but a urea breath test should be used to confirm.
The person may also have symptoms that suggest ulcers - burning or pain in the upper abdomen, usually occurring about an hour or so after meals or even during the night. The symptoms are often relieved temporarily by using antacids, milk, or OTC medications that reduce stomach acidity. Infestation is common when eating utensils are shared or food is consumed from a common bowl.
H. pylori is a very common infection of the stomach. It may be the most common infection in the world. It is now clear that the infection is directly related to the development of stomach and duodenal ulcers, and it is likely that it may be related to cancers involving the stomach, which may be why stomach cancer is common in the East.
Cause: Helicobacter pylori are a spiral shaped bacterium that lives in the stomach and duodenum. It has a unique way of adapting in the harsh environment of the stomach.
The inside of the stomach is bathed in about half a gallon of gastric juice every day. Gastric juice is composed of digestive enzymes and concentrated hydrochloric acid, which can readily tear apart the toughest food or microorganism. Bacteria, viruses, and yesterday’s steak dinner are all consumed in this deadly bath of chemicals. It used to be thought that the stomach contained no bacteria and was actually sterile, but Helicobacter pylori changed that.The stomach is protected from its own gastric juice by a thick layer of mucus that covers the stomach lining. Helicobacter pylori take advantage of this protection by living in the mucus lining.
Once H. pylori is safely ensconced in the mucus, it is able to fight the stomach acid that does reach it with an enzyme it possesses called urease. Urease converts urea, of which there is an abundant supply in the stomach (from saliva and gastric juices), into bicarbonate and ammonia, which are strong bases. This creates a cloud of acid neutralizing chemicals around the H. pylori, protecting it from the acid in the stomach. The reaction of urea hydrolysis is important for diagnosis of H.pylori by the breath test.
Another defence H. pylori has is that the body's natural defences cannot reach the bacterium in the mucus lining of the stomach. The immune system will respond to an H. pylori infection by sending white cells, killer T cells, and other infection fighting agents. However, these potential H. pylori eradicators cannot reach the infection, because they cannot easily get through stomach lining. They do not go away either, though, and the immune response grows and grows. Polymorphs die, and spill their destructive compounds (superoxide radicals) on stomach lining cells. Extra nutrients are sent to reinforce the white cells, and the H. pylori can feed on this. Within a few days, gastritis and perhaps eventually a peptic ulcer results. It may not be H. pylori itself which causes peptic ulcer, but the inflammation of the stomach lining; i.e. the response to H. pylori.
H. Pylori infection are believed to be transmitted orally. Many researchers think that H. Pylori is transmitted orally by means of faecal matter through the ingestion of waste tainted food or water. In addition, it is possible that H. pylori could be transmitted from the stomach to the mouth through gastro-oesophageal reflux (in which a small amount of the stomach's contents is involuntarily forced up the oesophagus) or belching, common symptoms of gastritis. The bacterium could then be transmitted through oral contact.
DISEASES
Peptic ulcers have two causes. The most common cause is also H. pylori infection of the stomach. We expect stomach ulcers to behave similar to duodenal ulcers so that after killing the H. pylori, they should not recur. Stomach ulcers are more complicated than duodenal ulcers, however, but the effectiveness H.pylori Clear treatment for stomach ulcers appears to be similar to that seen in duodenal ulcers (cure rate 70-90% if H.pylori is eradicated).
Duodenal peptic ulcers occur in the first part of the intestine, one or two inches past the end of the stomach. Most duodenal ulcers occur in patients with H. pylori infection. If duodenal ulcers are treated with antacids or drugs such as Tagamet, Zantac, or Pepcid, they usually come back when the drugs are stopped. Acid reducing drugs are expensive and do not cure the duodenal ulcer problem.
Stomach cancers (gastric adenocarcinomas) are often associated with H.pylori (70-90%). In an extensive review of gastric cancer and H.pylori the Eurogast Study Group determined that presence of H.pylori confers an approximately six-fold risk of gastric cancer, accounting for about half of all gastric cancers. Supposedly, chronic gastritis leads to intestinal metaplasia (atrophic gastritis), which then undergoes malignant change. In the final stage H.pylori may no longer be detected on biopsy but immunologic studies may show evidence of past infection.
Mucosa associated lymphoid tissue (MALT) may undergo malignant change causing a low-grade lymphoma of the stomach. Retrospective biopsy studies show that 90% of such MALT lymphomas are associated with H.pylori. Early reports indicate about a 50% cure for localized MALT after cure of H.pylori.
Many patients experience improved well-being and energy level when H.pylori is treated so consider treatment in Gulf Veterans Syndrome and Chronic Fatigue Syndrome.Lots of people with chronic halitosis respond to treatment for H.pylori. This may be because mouth bacteria, sinus and periodontal disease responds to the H.pylori Clear. It may be that H.pylori is the cause of the halitosis (bad digestion, achlorhydria etc.). In any case, treating H.pylori might be worthwhile.
Therapeutic effect of H.pylori Clear on gastric inflammation and Helicobacter pylori infection.
By Dr Daniel Weber, PhD MSc & Dr James Laporta MBChB(UCT), DMH(SA)
H.pylori Clear is a combination of 6 Chinese medicinal herbs that have been used in clearing helicobacter pylori, chronic atrophic gastritis (CAG), gastric & peptic ulcers, and reflux. This formulation is based on an in depth understanding of traditional Chinese medicine (TCM) principles and the effects of specific herbs on various gastro-intestinal disorders and specific TCM disease states. Research using a TCM formulation, similar in ingredients and dosage to H.pylori Clear, shows therapeutic value in terms of treating gastritis and clearing helicobacter pylori infection. The inhibitory and bacteriostatic effects of the herbal ingredients Huang Lian and Da Huang on Helicobacter Pylori (which is recognized as a causative organism of gastric ulceration or gastritis) were found to be 2.7x and 2.1x more effective than aminobenzylpenicillin in an in vitro study. The effective clinical rate was 97.2% with a gastroscopic examination effective rate of 85.7%. A total curative rate was 31.4% in the treated group, compared to 2.9% in the control group was observed. Most noticeably, the pathological study of H. Pylori clearance was 80%. This study gives plausible reason for therapeutic effect and confirms the anecdotal findings and history of traditional use. Although this trial does not constitute the usual structure of a randomized double blind placebo controlled trial, it provides information on the therapeutic effect of such a formulation. Additionally, H.pylori Clear has significant anecdotal support from practicing medical doctors in South Africa for use of gastric ailments- mostly peptic ulcer disease, gastro-oesophageal reflux disease, and chronic atrophic gastritis (Zhang et al, 1992).
Relation between Helicobacter pylori and pathogenesis of chronic atrophic gastritisand the research of its prevention and treatment
Zhang L, Yang LW, Yang LJ.Chinese Journal of Integrated Traditional and Western Medicine (Zhongguo Zhong Xi Yi Jie He Za Zhi).Heilongjiang Academy of Traditional Chinese Medicine, Harbin. 1992 Sep;12 (9):521-3, 515-6.)
Summary: The total detectable rate of Helicobacter pylori (HP) of 485 patients suffering from gastric diseases was 59.6%. The HP in gastric mucosa of chronic atrophic gastritis (CAG) patients was separated from the cell culture in vitro and transferred successively. The mice were perfused with exsiccate alum, and the rabbits with aspirin to injure their gastric mucosa, then HP was perfused. Result showed that the change of experimental animals was identical with that of CAG patients by means of bacteriological and pathological examination. It revealed that HP was in agreement with Robert Koch's three principles about pathogenic bacteria. According to the bacterial infectious hypothesis of CAG, 53 Chinese medicinal herbs and prescriptions were investigated with bacteriostatic test. Panax notoginseng and Magnolia officinalis were discovered to be sensitive, Prunus mume and Corydalis yanhusuo were moderate sensitive, and Coptis chinensis and Rheum palmatum highly sensitive to HP. Decoction of Clearing up the Heat and Relieving the Blood Stasis and No.2 recipe of Huowei were used to treat 70 CAG patients with Stomach Heat Syndrome. The effective rate of gastroscopic examination was 85.7% that of pathological study was 80%. In comparing with the group of Sanjiu Weitai, there was significant difference between the traditional Chinese medicine treated group and Sanjiu Weitai control group, the former being markedly better.
Key Words: Helicobacter pylori, chronic atrophic gastritis, animal model, bacterial infectious hypothesis, bacteriostatic test by Chinese medicinal herbs, clearing Heat and resolving stagnant Blood, No.2 recipe of Huowei
During April, 1988 to March, 1991, gastric mucosa tissues of 485 subjects were taken during gastroscopic examination. It’s found that the positive rates of Helicobacter pylori (HP) were very high in various gastric diseases through urease test, smear microscopy, bacterial culture and electron microscope observation, and the highest detectable rate was found in chronic atrophic gastritis (CAG). Therefore, the relation between HP and pathogenesis of CAG and its prevention and treatment by Chinese medicinal herbs were widely studied. The summary is reported as follows.
Clinical Research
I. Discussion on the relations between HP and various gastric diseases as well as patterns, and the effects of Chinese medicinal herbs on HP
1. Subjects: Patients with pain or stuffy and uncomfortable feeling in the gastric region as the chief complaints, and diagnosed as superficial gastritis (CSC), chronic atrophic gastritis (CAG) and gastric ulcer (GU) through gastroscopy, 485 cases totally, among which 283 males and 202 females, the ratio of male to female was 1.4:1, the oldest patient was 65 years old, and the youngest 18 years old, patients at the age of 35~45 making up 74% (359/485). All the patients underwent HP detection with above four methods, and the total detectable rate was 59.6% (289/485). Among which, the detectable rate of urease test was 58.7% (179/305), and smear microscopy 47.2% (183/388), bacterial culture 47.0% (101/215) and electron microscope observation 30.7% (35/114). The result was similar to reports at home and abroad.
Among 485 subjects, there’re 180 cases of CAG, 289 cases of CSG and 18 cases of GU. Of the three diseases, the HP positive rate in CAG was 66.7% (120/180) which was the highest, and that of CSG was 55% (159/289) which was the lowest. There’s significant difference between the two results (P<0.05). The HP positive rate of GU was 62.5% (10/16) which was in the middle. The detectable rates varied because of different detecting methods. Among the detected subjects, urease test had the highest positive rate, then microscopy examination, and the detectable rate was low in electron microscope observation. The result had some relations with the location where the tissues were obtained.
2. The relations between HP and TCM differentiation of CAG
Criteria of TCM patterns: CAG was differentiated into three patterns according to the Three Categories of Etiologic Factors Theory in TCM. If it’s caused by depressed mode complicated with HP infection or leading to the attack of HP in the stomach, the clinical manifestations will be gastric distending or stuffiness which will affect the chest and hypochondriac regions, frequent belching, vomiting, nausea, stuffy feeling in the throat, vexation, irritation, sign, dark-red tongue body with whitish tongue fur, wiry pulse; and the TCM differentiation is Liver-qi invading the Stomach, qi stagnation and Blood stasis (Type I). If it’s caused by six exogenous factors and internal invading of Damp-Heat, or constitution of excessive Damp and Phlegm-Damp transforming into Heat, the onset will be quick and the manifestations include gastric uneasiness, scorching feeling behind breastbone or in the gastric region, decreased appetite, nausea, vomiting, dry and bitter mouth or bad breath, ulcerated mouth and tongue, dry stools or difficult defecation, dark-red tongue body with yellowish-whitish and greasy tongue fur, wiry and slippery pulse; and this is the type of Damp-Heat in the Spleen and Stomach complicated with Blood stasis (Type II). For patients with weak constitution and weak Spleen and Stomach, or suffering from injured Spleen and Stomach due to improper diet and fatigue, if they’re infected by HP, the manifestations will usually be pale complexion, emaciation, fatigue, lack of energy, poor appetite, aggravated distending after food-intaking, uneasiness relieved by warmth and pressure, loose stools, dark-pale or dark-purplish tongue body or with petechia, whitish or whitish-greasy tongue body, deep, fine and weak pulse; this is the type of Spleen deficiency and excess Dampness, Cold coagulation and Blood stasis (Type III). According to above TCM differentiation, there’re 30 cases were of Type I, 51 cases of Type II and 99 cases of Type III among the 180 cases of CAG. And the HP positive detectable rate of Type II was 78.4% (40/51) which was the highest, then Type III, which was 63.5% (63/99), and the rate was low in Type I, which was 56.7% (17/30). There’s significant difference between Type I and Type II (P<0.01).
3. HP and the ultrastructure of patients’ gastric mucosa We observed 141 patients’ biopsy samples of gastric mucosa under transmission electron microscope, and HP was seen directly in 31 cases, which was distributed dispersively or in group on the surface of epithelial cells and invaded into the glandular cavity through intercellular space. The villi of epithelial cells contacting HP disappeared, with rough surface, incomplete limiting membrane, swollen cells, and invaginated cytoplasm. Intestinal metaplasia appeared and Goblet cells or Paneth cells could be seen. The cells degenerated obviously in areas where bacteria concentrated. There were cytoplasmic mitochondria swelling and vacuolar degeneration, groups of necrotic and exfoliated cells were seen, and cytoskeleton was damaged. Among the 31 cases, there’re 7 smears of electron microscope on which HP was phagocytized or dissolved by cells. Under electron microscope, the changes of epithelial cells and glandular epithelial cells of gastric mucosa were severe in HP positive group, and the most obvious changes included swelling, vacuolar degeneration, necrosis and exfoliation of cells and intercellular substance oedema. Comparing with HP negative group, the difference was significant (P<0.01). The changes of cell nucleus and organ were also more severe than those in HP negative group, but there’s no significant difference (P>0.05). The comparison between 31 cases of HP positive group and 31 cases of HP negative group showed that the incidences of intestinal metaplasia were 48.3% (15/31) in HP positive group and 87.1% (27/31) in HP negative group respectively, and there’s significant difference (P<0.05); on the contrary, the incidence of atypical hyperplasia in HP positive group was 25.8% (8/31) and 1 case in HP negative group making up 3.2% (1/31). The results showed that intestinal metaplasia made against the presence of HP, and the activity of HP could lead to the deterioration of CAG and atypical hyperplasia, which would accelerate cancerization. The clearing of HP in treatment is the key of preventing deterioration and curing CAG.
4. Discussion of the effects of Chinese medicinal herbs on HP
In order to explore that whether Chinese medicinal herbs had bacteriostatic effects on HP, we selected 53 herbs and their different prescriptions commonly used to treat Spleen and Stomach diseases in clinic: the herbs included huang lian, da huang, dan shen, hou po, ku shen, pu gong ying, huang qi, sha shen, wu yao, wu mei, rou gui, ban xia, sheng di, sheng di yu, san qi, mai dong, yin hua, bai he, dang shen, chi shao, xing ren, ru xiang, bai shao, gong ding xiang, gou qi zi, huang qin, su geng, mu xiang, yan hu suo, dang gui, chuan xiong, shan yao, chai hu, lai fu zi, chuan lian zi, lian qiao, gui zhi, fo shou, mo yao, ji nei jin, e zhu, ren shen, tao ren, wu zhu yu, gua lou, yu jin, xiang yuan, cao dou kou, sha ren, shi hu, tu fu ling, san leng and zhu sha. The herbs and prescriptions were soaked for 120 minutes respectively and decocted for 25 minutes at the temperature of 100ºC to get 1:1 decoction (1ml liquid from 1g Chinese medicinal herbs) for use. HP was made into 3×108/ml bacterial suspension and inoculated to cAMP-BAP plate and agar gel diffusion test was done with stainless steel cup plate-diffuse method: it’s cultured for 72 hours at the temperature of 37ºC under the condition of mild oxygen-demand. The yin-nourishing, Heat-clearing, qi-regulating and Blood-activating herbs in the 53 herbs were made into formulas respectively, and they’re Heat-clearing formula (huang lian, da huang, ku shen, gong ding xiang, etc.), yin-nourishing formula (bai shao, gou qi zi, wu mei, bei sha shen, etc.), qi-regulating formula (huang qi, hou po, wu yao, lai fu zi, etc.) and Blood-activating formula (dan shen, e zhu, sheng di yu, yan hu suo, etc.). Taking above 4 formulas as the basic formulas, compound formulas were made up by every two formulas, every three formulas and four formulas respectively. For example, Heat-clearing and Blood-activating formula was a compound formula made up of herbs in Heat-clearing formula and Blood-activating formula. The rest may be deduced by analogy. The test showed that Heat-clearing and Blood-activating formula as well as yin-nourishing and Heat-clearing and Blood-activating formula had inhibitory effects on HP in vitro, other compound formulas had no bacteriostatic effects (see the table below).
Table: Comparison of herbs having obvious bacteriostatic effects
Herb
Name
Inhibition
Zone
Herb
Name
Inhibition
Zone
Herb
Name
Inhibition
Zone
huang lian
41
san qi
20
qou qi zi
14
da huang
32
hou po
20
aminobenzylpenicilin
15
gui zhi
30
dang shen
20
Heat-clearing and Blood-activating formula
18
yan hu suo
25
huang qin
18
yin-nourishing and Heat-clearing formula
––
wu mei
25
sheng di yu
18
Blood-activating formula
13
It could be seen from the table that HP was sensitive to san qi, hou po and dang shen, moderately sensitive to wu mei and yan hu suo, and highly sensitive to huang lian, da huang and gui zhi.
II. Treating results
According to the gastroscope and pathological diagnosis criteria worked out in National Symposium on Diagnosis and Treatment of Chronic Gastritis, and referring to the Diagnosis, Differentiation and Therapeutic Effect Criteria of Integrated Traditional Chinese and Western Medicine for Chronic Gastritis drafted by Committee of Digestive System Diseases of Chinese Institute of Integrated Traditional Chinese and Western medicine, 105 cases of CAG of Stomach Heat type were selected randomly, and their HP were all positive. They’re divided into 35 cases of Heat-clearing and Blood stasis-relieving formula (herb pieces) treated group, 35 cases of No. 2 Recipe of Huowei (Heat-clearing and Blood stasis-relieving formula, powder) treated group (Group II), 35 cases of San Jiu Wei Tai (a commonly used TCM patent drug for gastric problems) control group (Group III). Heat-clearing Blood stasis-relieving formula consisted of the following herbs: huang lian 10g, da huang 5g, bai hua she she cao 20g, san qi 3g, dan shen 15g, hou po 15g, ge gen 15g, ji nei jin 15g, bai shao 25g, wu mei 10g, dang shen 10g, huang qi 15g & gui zhi 5g. All the three groups took the medicine each time before breakfast and after supper, 6 months as a course of treatment.
The total clinical effective rate in Heat-clearing and Blood stasis-relieving formula (herb pieces) group was 97.2%, the effective rate of gastroscopic examination was 85.7%, the effective rate of pathological study was 80% and the curative rate was 31.4%. The results in No.2 Recipe of Huowei treated group were 97.2%, 85.7%, 77.1% and 25.7% respectively; in San Jiu Wei Tai control group, they’re 51.3%, 40%, 34.3% and 2.9% respectively. There’re very significant differences among all indices of two treated groups and the control group.
The negative change rate of Heat-clearing and Blood stasis-relieving formula (herb pieces) group was 82.9% (29/35), and 80% (28/35) in No.2 recipe of Huowei treated group, 20% (7/35) in the control group. The effective rate of blood rheology and nailfold microcirculation of the three groups were 85.5% and 83.9% in Heat-clearing and Blood stasis-relieving formula (herb pieces) group, 85.7% and 80% in No.2 recipe of Huowei treated group and 54.3% and 50.5% in the control group. The effects of the treated groups were better than those of the control group (P<0.01) either in HP clearance or in the improving rate of blood rheology and nailfold microcirculation.
Experimental Research
I. Model test by exciccate alum-HP combination
20 male Kunming mice weighing 22~24g provided by Provincial Animal Experiment Centre were randomly divided into two groups. Mice in model group were perfused with exciccate alum once every day. After consecutive 5 times, HP bacterial suspension were perfused (6×108/ml strain), 0.2ml every 4 days, three times totally. After one night’s fast but free water drinking, the mice were killed on the second day and the specimens of gastric mucosa were taken for bacteriological examination as well as pathological and histological examinations. The control group were perfused with physiological saline of the same amount and killed for examination at the same time. The results showed that in the model group, there’re 10/10 HP positive in urease test, 9/10 HP-positive in HP culture; in the control group, they’re 2/10 and 0/10 respectively (P<0.01). Pathological examination showed that in the model group, 9/10 had decreased gastric mucosa glands, 6/10 had infiltrating lymphocytes and 7/10 had dilated small blood vessels; and in the control group, the results were 1/10, 1/10 and 2/10 respectively (P<0.01).
The results showed that after injuring the gastric mucosa with exciccate alum, the inoculating of HP would lead to CAG’s pathological changes in short time. Indices of bacteriological, pathological and histological examinations were significantly different from those of the control group (P<0.01).
II. Model test by aspirin-HP combination
15 male big-ear white rabbits weighing 2.0~2.5kg provided by Animal Centre were divided into two groups, 9 in the model group and 6 in the control group. The model group were perfused with 2.5ml aspirin liquid made by ourselves, once every day, for consecutive 5 days. On the sixth day, HP suspension (6×108/ml) were used for gastrogavage, 1ml every time, once every 5 days. 5 days after the last inoculation, the rabbits in both groups were fasted (free water-drinking) for 24 hours and killed at the same time to take out the stomach, and 3 mucosa specimens near pylorus were taken under sterile condition for biochemical and bacteriological examinations. The control group was perfused with physiological saline of the same amount. Results: bacteriological examination of the model group: 9/9 HP positive in urease test, 7/9 HP-positive in HP culture; in the control group, they’re 1/6 and 0/6 respectively (P<0.01). Pathological examination showed that in the model group, 8/9 had decreased glands, 7/9 had infiltrating lymphocytes and 8/9 had dilated small blood vessels; and in the control group, the results were 1/6, 1/6 and 2/6 respectively.
The experimental results showed that on the base of aspirin-induced gastric mucosa injury, the inoculating of HP would result in CAG. The results were significantly different from those of the control group (P<0.01).
Discussion
I According to the clinical and experimental studies, we believed that HP is the pathogenic bacteria of gastric diseases, especially CAG, and it’s a conditional pathogenic bacteria. And the bacterial infectious hypothesis on the pathologic mechanism of CAG was put forward.
II. The main Evils causing CAG are Damp and Heat. TCM differentiation shows that in different phases of the disease, Blood stasis is present in the whole course of CAG. It’s proved by electron microscope that the more the HP there is, the more severe of the changes of Blood stasis and bleeding are. There’re both common and different treatment in TCM differentiation.
III. It’s proved by TCM lingual diagnosis as well as examinations of modern blood rheology and nailfold microcirculation, the change of CAG is positively correlated with the amounts of invaded HP. The blood stasis resulted from it is the basic pathological characteristics of CAG. So the treating principles of clearing Heat, relieving Blood stasis to expel Evils and invigorating qi, nourishing yin to support Vital-qi are put forward. Selecting Da Huang Huang Lian Xie Xin Tang as the basic formula, and referring to the result of HP bacteriostatic test of 53 Chinese medicinal herbs, we applied self-prescribed Heat-clearing and Blood stasis-relieving Formula and new preparation of No.2 Recipe of Huowei in the treatment. As they hit to the pathogeny and pathogenesis of CAG, the therapeutic effect was satisfactory.
Huang Lian/Coptis Chinensis
Modern research showed that Huang Lian had anti-bacterial effect on various bacteria, and the effect was the strongest on shigella dysenteriae, staphylococcus aureus and tubercle bacillus. It also had anti-viral, anti-fungal, anti-toxic and anti-inflammatory effects. Berberine at low dosages could excite isolated heart of cats and dilate coronary artery; at high dosage, it showed inhibitory effect. Berberine could increase the contractility of animal heart in heart failure condition. It could also obviously lower the myocardial oxygen consumption in heart failure, and protect the ischemic cardiac muscle. Berberine had anti-arrhythmic and anti-cancer effect; it could lower the blood pressure and dilate blood vessels. Huang Lian and berberine could both lower the blood sugar, and had significant inhibitory effect on platelet aggregation and ADP release in rabbits. Intravenous injection of berberine to small dogs could excite gastrointestinal smooth muscles. Berberine could stimulate bile secretion, lower serum cholesterol and antagonize stress ulcer.
In clinic, Huang Lian is used to treat bacillary dysentery, arrhythmia, hypertension, scarlet fever, refractory heart failure, chronic pelvic inflammation, epidemic cerebrospinal meningitis, diphtheria, whooping cough, pulmonary TB, pulmonary abscess, infections in oral cavity and face, pharyngitis, acute tonsillitis, atrophic rhinitis, sinusitis, purulent otitis media, erythema multiforme, skin ulcer, eczema, chronic atrophic gastritis, fungal infection in the intestinal tract, peptic ulcer, chronic cholecystitis, burn and Trichomonal vaginitis, etc..
Effects on the smooth muscle
Intravenous injection of berberine to small dogs could excite gastrointestinal smooth muscles (Wen et al, 1998).
Bacillary dysentery
The therapeutic effect of huang lian on bacillary dysentery was quite certain. Usually it could be cured within 5~7 days. The oral dosage: small dosage was 2~3g, large dosage was 8~12g, averagely 6g daily (Wen et al, 1998).
Chronic atrophic gastritis
Supplemented Huang Lian Tang (huang lian 9g, zhi gan cao 6g, gan jiang 9g, gui zhi 9g, dang shen 10g, ban xia 12g, da zao 12 pieces, chai hu 18g, san leng 15g), 1 dose daily. The formula was used to treat 98 cases of chronic atrophic gastritis, and 16 were clinically cured, the total effective rate was 98.97% (Wen et al, 1998).
Peptic ulcer
Berberine 0.4g, qid, 4~6 weeks as a course of treatment. The method was used to treat peptic ulcer and the curative rate was 70%. During the treatment, only mild constipation and bitter taste were reported in very few patients (Wen et al, 1998).
Da Huang/Rheum Palmatum
Modern research showed that the herb had purgative, anti-infectious, anti-inflammatory, anti-tumour and haemostatic effects. It could promote bile secretion, increase non-specific immunity, inhibit the biosynthesis of prostaglandin F, prostaglandin E 2 , prostaglandin D 2 , A 2 and thromboxane, lower serum protein, urinary nitrogen and creatinine. Da Huang could also lower serum cholesterol in rabbits, lower blood pressure and had oestrogen-like effects.
In clinic, this herb is used to treat bleeding of the upper digestive tract, haemoptysis, uterine bleeding, traumatic bleeding, haemorrhoids, nasal bleeding, high fever with constipation, viral hepatitis, peptic ulcer, chronic renal failure, endometriosis, Hyperlipemia, chronic prostatitis and insanity, etc.
Prevention of rhubarb (Da Huang) from antibiotic-associated colitis in critical patients in intensive care unit: a prospective, randomized controlled clinical study
HOU Jie, DENG Chong, GUO Ying-jun, WANG Guo-jun, LIU Ba-yi, CHEN Hua-qiong, LI Ping, CHEN Hou-jun. Zhong Guo Zhong Xi Yi Jie He Ji Jiu Za Zhi. 2009; 16(5): 272-274.
Objective: To observe the prevention of rhubarb from antibiotic-associated colitis (AAC) in critical patients in intensive care unit (ICU). Methods One hundred and eighty critical patients in ICU without colitis and gastrointestinal contra-indieation were ready to receive initial antibiotic therapy, and prospectively and randomly they were divided into treatment group (taking rhubarb orally or by nasal feeding in addition to routine therapy, 91 eases) and control group (only taking routine therapy, 89 cases). The incidence of intestinal flora imbalance was diagnosed by stool smear of Gram stain. The incidence and severity of AAC and the degree of intestinal flora imbalance in 7-to 10-day antibiotic treatment in the two groups were compared. Results The total incidence of AAC was 15.6% (28/180) in which 13.2% (12/91) was in treatment group and 18.0% (16/89) in control group (P>0.05). There were 1 ease of severe AAC and 1 ease of III degree intestinal flora imbalance in treatment group, in contrast, there were 7 severe AAC and 8 III degree intestinal flora imbalance cases in control group (both P<0.05). Conclusion Rhubarb is beneficial to the prevention of AAC in critical patients in ICU; it can decrease the incidence of AAC, especially the severe AAC and III degree intestinal flora imbalance.
Influence of Dahuang Granule Prescription on the Level of Motilin in Plasma and Gastrin in Serumof Patients with Severe Acute Pancreatitis
TIAN Hua, ZHUO Yue, WANG Ye. Zhong Guo Zhong Yi Yao Xin Xi Za Zhi. 2009; 16(8): 12-13.
Objective: To study the influence of Dahuang granule on the level of motilin in plasma and gastrin in serum of patients with severe acute pancreatitis (SAP). Methods Sixty-four patients with SAP were divided into Dahuang granule group (32 cases) and control group (32 cases), treated with Dahuang granule and routine therapy respectively. The level of motilin in plasma and gastrin in serum of the two groups were detected by radioimmunoassay method. Results After treated for one week, the level of motilin in Dahuang granule group was significantly higher than that in the control group (P<0.05), and the level of gastrin was significantly lower than that in the control group (P<0.01). Conclusion Dahuang granule can increase motilin and decrease gastrin of patients with SAP.
Bai Hua She She Cao/Heydyotidis Diffusa
Modern research showed that this herb had anti-tumour, anti-bacterial, sedative, hypnotic and analgesic effects. It could antagonize snake venom and inhibit the production of sperm.
In clinic, this herb is used to treat various tumours, acute hepatitis with jaundice, infantile pneumonia, chronic nephritis, appendicitis, pelvic inflammation, annexitis, gallbladder stone, snakebite and multiple dermatomyositis, etc.
Appendicitis
Fresh bai hua she she cao 30g (or dried one 15g), water decoction, twice daily, the dose could be appropriately reduced in children. For those with severe symptoms, the dose could be increased to 60~90g. All treated 19 cases were cured (Wen et al, 1998).
San Qi/Pseudoginseng
San Qi is a TCM herb to activate Blood, dispel stagnated Blood, invigorate qi, stop bleeding, eliminate swelling and relieve pain.Modern research showed that San Qi could decrease heart beat, increase the blood flow volume in the coronary artery, lower the resistance of coronary artery and had haemostatic effect. . San Qi and its total saponins could lower blood pressure. Total saponins of San Qi had anti-arrhythmic, analgesic and sedative effects; it could also lower platelet aggregation, lower serum cholesterol and slightly increase fasting blood sugar.
In clinic, this herb is used to treat cancer pain, chronic renal failure, prostatic hyperplasia, bleeding due to ulcers, soft tissue injury, ulcerative colonitis, enteritis and migraine, etc.
Effect of Total Saponins of Panax notoginseng on Gastric Mucosal Lesion and Ultrastructure of Gastric Mucosal Parietal Cells of Stress Rats
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DENG Xiang-chao, LI Yan-wu, WANG Ru-jun. Shi Zhen Guo Yi Guo Yao. 2008; 19(9): 2143-2145.
Objective: To observe the effect of total saponins of Panax notoginseng (PNS) on gastric mucosal lesion and uhrastructure of gastric mucosal parietal cells of stress rats. Methods: Water-immersion restraint stress (WRS) was used to induce rat models of stress. Six hours after WRS, the rats were executed to obtain the gastric tissue. The erosion and haemorrhage of gastric mucosa in rats were observed by naked eyes, and then the ulceration index (UI) was calculated. The ultrastructure of gastric mucosal parietal cells in rats was observed under transmission electron microscope. Results: The results observed by naked eyes showed that no lesion was found in the normal group. However, in the model group, the gastric mucosal congestion was obvious, there existed scattered punctiform erosion and bleeding in the glandular stomach, and the UI was 16.83 ± 4.96; compared with the model group, gastric mucosal congestion was reduced and UI decreased in the PNS group and ranitidine group (P<0.01). Under the electron microscope, there were less endocrine tubular villi in the parietal cells of the normal group, showing a static status. However, in the model group, the number of endocrine tubular villi increased, showing an activating status; compared with the model group, the expansion of endocrine tubular villi was not obvious but the number of cytoplasm interior vesicles in parietal cells increased in PNS group, and in ranitidine group, the number of endocrine tubular villi was decreased and the number of vesicular structure was increased. Conclusion: PNS can reduce the stress-induced gastric mucosal lesion, and promote the wall cells of gastric mucosa transforming from the activated status into static status. The protective mechanism of PNS is probably related with the regulation of acid secretion of Parietal cell..
Effect of Total Saponins of Panax notoginseng on oxygen free radicals in serum and gastric mucosa of stress rats
Deng Xiangchao, Li Yanwu, Wang Rujun. Zhong Yao Yao Li Yu Lin Chuang. 2008; 24(3): 41-43.
Objective: To observe the effect of Total Saponins of Panax notoginseng (PNS) on oxygen free radicals (OFR) levels in serum and gastric mucosa of stress rats. Methods: Water-immersion restraint stress (WRS)was used to induce rat models of stress. Thirty-two SD rats were randomized into the normal group, model group, PNS group (66mg/kg), and ranitidine group(12.5mg/kg). The rats were pretreated with corresponding drugs or the same volume of distilled water. After treatment, superoxide dismutase (SOD), malondialdehyde (MDA) and nitric oxide (NO) contents in serum and gastric mucosa of stress rats were detected. Results: Six hours after WRS, the NO content and SOD activity in gastric mucosa were lower, and MDA content was higher in the model group than those in the normal group (P<0.05). After treatment with PNS, NO content in gastric mucosa was increased, MDA decreased (P<0.05) and SOD activity increased (P<0.01). In the serum of the model group, NO content and SOD activity were lower, and MDA content was higher than those in the normal group (P<0.01). After treatment with PNS, serum NO content was increased (P<0.05), but there were no obvious changes of MDA and SOD. Conclusion: WRS can induce the injury of oxygen free radicals in rats. PNS has protective effect on gastric mucosa of stress rats by clearing oxygen free radicals and inhibiting the production of peroxides..
Dan Shen/Salvia Miltiorrhiza
Modern research showed that Dan Shen could increase the blood flow volume in gastric mucosa; inhibit tissue peroxidation, strengthening the anti-oxidant ability of gastric mucosa. Dan Shen could stimulate the mucus secretions of gastric wall, consolidate the barrier of gastric mucosal, effectively block the ischemic and anoxia condition of gastric mucosa induced by ethanol so that prevent deep tissues of gastric mucosa from injury (Wen et al, 1998).
Dan Shen could alleviate the denaturalization and necrosis of renal tubular epithelial cell in glycerin-induced acute renal failure in rats, decrease the cast in lumen, increase blood flow volume in kidneys, improve creatinine clearance rate, and lower urea nitrogen; it also had diuretic effect. It could protect ischemic injury of kidney and protect the kidneys from the injury caused by gentamycin, also prevent the declining of Na-K-ATP enzyme activity of renal cortex. Dan Shen had obvious preventing and protecting effects on renal hemodynamics disturbance induced by c iclosporin A so that there's no obvious declining of glomerular filtration rate and urine volume, and renal blood flow volume increased compared with previous condition.
Water extract of Dan Shen had obvious protecting function on isoproterenol-induced myocardial ischemia in rats. It also had preventing effect on acute myocardial ischemia caused by coronary artery ligation in rats (intraperitoneal injection at the dosage of 5g crude drug/kg). For pulmonary injury caused by deep x-ray in mice, Dan Shen could promote the rehabilitation. But it had no obvious protecting effect on thymus gland.
Dan Shen had inhibitory effect on cervical carcinoma in mice. Water-soluble ingredients of Dan Shen could inhibit carrageen-induced foot oedema in rats.
In clinic, this herb is used to treat viral myocarditis, acute myocardial infarction, diabetes, hepatic-cirrhosis, chronic simple rhinitis, hepatitis, chronic renal failure, nasopharyngeal cancer, infantile allergic purpura, pharyngitis and infantile pneumonia, etc.
Intestinal peroxidize mucosal injury and salvia miltiorrhiza pretreatment at hepatic ischemia and reperfusion
ZHANG Zhi-yong, CHEN Xiao-ping, LU Qi-ping. Lin Chuang Wai Ke Za Zhi. 2009; 17(8): 519-521.
Objective: To study the intestinal mucosal injury and salvia miltiorrhiza pretreatment at hepatic ischemia and reperfusion. Methods: Under the condition of hepatic ischemia for 45 min, SD rats were randomly divided into 4 groups: normal control group (CO), sham-operated group (SO), isehemiareperfusion group (IR), salvia miltiorrhiza pretreatment group(SM), then each group were divided into 5 sub -groups according to different reperfusion times (0 h/3 h/12 h/24 h/72 h). SM group were injected 40 ml/kg saline with 6 g/kg salvia miltiorrhiza from caudal vein 30 min before clamping hepatic pedicle, other groups were injected 40 ml/kg normal saline from caudal vein. While SO group were only dissected their porta hepatis, not clamping hepatic pedicle after laparotomy. The upper jejunal samples at each reperfusion time (0 h/3 h/12 h/24 h/72 h) were taken to process the detection of general pathology, activity of DAO, and the flora shifting of mesenteric lymph nodes. Results: The injury of jejunal mucosal in SM group was less than that of IR group, the activity of DAO and the positive rate of mesentery lymph node bacterial culture were lower than IR group (P<0.05) at different reperfusion time limits after hepatic ischemia for 45 min. Conclusion There is significant congestive injury at intestinal in hepatic ischemia-reperfusion, with an declined of DAO activity, and the positive rate of mesenteric lymph node bacterial culture significantly increased. Salvia miltiorrhiza pretreatment have a protect effect on intestinal injury at hepatic ischemia-reperfusion.
Protective effects of Tanshinone-II A on gastric ulcer induced by stress in rats
Gao Hongyan, Niu Chunyan, Liu Kaige, Wu Fangxiong, Wang Wen, Zhang Qi. Shaan Xi Yi Xue Za Zhi. 2009, (11): 1467-1469.
Objective: To evaluate the protective effects of Tanshinone-II A (TanII A) on gastric ulcer in rats induced stress by. Methods: water immersion and restraint stress (WRS) induced gastric injury was used as the experimental model of acute gastric ulcer. Rats were orally administrated with Tan IIA before stress. 6 hours after WRS, all animals were sacrificed and the stomachs of rats were taken out to examine the ulcer index and observe histologically. The activity of total superoxide dismutase (SOD) and malondialdehyde (MDA) were measured in serum and gastric mucosa. Results: 6 hours of water immersion and restraint stress (WRS) resulted in appearance of acute gastric mucosal lesions. Tan II A significantly decreased the ulcer index and the activity of SOD both in serum and gastric mucosa. Conclusion: Tan IIA has remarkable protective effects on WRS induced gastric ulcer on rats, which is related to inhibiting lipid peroxidation.
Protective effect of Salvia miltiorrhiza on gastric mucosa
ZHOU Qin-hua, WANG Hong-mei. Zhong Guo Xian Dai Yi Xue Za Zhi. 2008; 18(5): 582-585.
Objective: To investigate the protective effect of Salvia miltiorrhiza on gastric mucosa during the development of noise stress ulceration in rat so as to provide theoretical evidence for clinical therapy. Methods: 24 SD rats were divided into three groups randomly: control group, noise group and salvia miltiorrhiza group. Factory noise was used as infliction factor to induce evadable, restless, nervous in rats and stress damage of gastric mucosa model was made. For Salvia miltiorrhiza group Salvia miltiorrhiza was injected through sublingual vein at 0, 4, 12, 19 h respectively. Pathologic changes were observed and ulcer index (U1) was calculated. PH of gastric juice was measured and the content of NO, SOD/MDA in gastric mucosa and serum were measured by spectrophotometer. The activity of succinate dehydrogenase in gastric mitochondria was assessed with 2, 6-dichlorophenolindophenol. Result: Comparing with noise group, UI of Salvia miltiorrhiza group decreased significantly (P<0.01) and pH in gastric juice remarkably raised (P<0.05). It was observed that the levels of NO and MDA in both serum and gastric mucosa decreased (P<0.05) and the activity of SOD also raised. The activity of succinate dehydrogenase in gastric mitochondria significantly increased, too (P<0.01). Conclusion: Salvia miltiorrhiza may protect the gastric mucosa of rat from noise stress by restraining the secretion of gastric acid, ridding oxygen free radical, bating lipid peroxides and increasing the activity of succinate dehydrogenase in gastric mitochondria.
Hou Po/Magnolia Officinalis
Modern research showed that the herb could inhibit bacteria including helicobacter pylori, pneumococcus, staphylococcus aureus and shigella dysenteriae; it also had inhibitory effect on dermal fungi. Hou Po decoction could excite isolated intestinal canals of mice and guinea pigs at low dosages and inhibit at high dosages. It could also excite bronchial smooth muscle of mice.
In clinic, this herb is used to treat psoriasis, adhesive ileus, chronic pharyngitis, and incomplete ileus, etc.
Effect on acute pancreatitis in rats
Hou Po Formula (hou po 10g, yin chen 12g, zhi zi 3g, da huang 1.8g (decocted later)). 0.89g/ml. Gastrogavage of 2ml could reduce the secretion of pancreatic juice and the content of amylopsin in rats with acute pancreatitis caused by deoxysodium cholate (Wen et al, 1998).
Effect on smooth muscle
Hou po decoction could excite isolated intestinal canal of mice and guinea pigs at small dosage, and inhibit the canal at large dosage.
Adhesive ileus
Formula for ileus: hou po, lai fu zi, da huang, 30g each; jiao sheng qu, jiao mai ya, zhi shi, zhi ke, 15g each; mang xiao, ji nei jin, tao ren, xing ren, 10g each. 1 dose every day, taken in 2~4 times through stomach tube, 50~100ml every time. 150 cases were treated on the base of fasting including water, fluid infusion, gastrointestinal decompression, and 146 cases were cured (Wen et al, 1998).
Ge Gen/Pueraria Lobata
Modern research showed this herb could lower blood pressure, dilate coronary artery, lower heartbeat and resistance of blood vessels, and relax isolated ileum of rats and lower sugar. It also had anti-arrhythmic, anti-febrile and oestrogen-like effects.
In clinic, Ge Gen is used to treat angina pectoris due to coronary heart disease, typhoid, paratyphoid, infantile spasmodic cough, soft tissue injury, ischemic cerebral infarction, retinal vein obstruction, fungal enteritis, diabetes, facial paralysis, sudden deafness, cervical spondylopathy, glaucoma, arrhythmia, ringworm of the feet and Hyperlipemia, etc.
Effects of puerarin on constractive activity of small intestine smooth muscle in alcoholism rabbit
SUN Hui TIAN Wei ZHANG Hui LIU Hongxia FAN Qianqian DIAO Huiling. Bin Zhou Yi Xue Yuan Xue Bao. 2009; 32(5): 338-339.
Objective: To investigate the effects of Puerarin on constractive activity of small intestine smooth muscle of alcoholism rabbit and to explore it’s alleviating alcoholism mechanisms. Methods: The routine experimental method of small intestinal smooth muscle isolated from rabbits were used. We recorded the automatic contracting characteristic and changing law before and after taking drugs. Results: Ethanol decreased the amplitude and frequency of smooth muscle. Compared with ethanol, the amplitude and frequency of smooth muscle were reduced by injected into Puerarin in dose-dependent manner. Conclusion: Puerarin could enhance the inhibitory effects of ethanol on small intestine smooth muscle, so it cannot alleviate alcoholism by the above effects.
| Ingredients |
|---|
| Rheum palmatum |
| Heydyotis diffusa |
| Panax notoginseng |
| Salvia miltiorrhiza |
| Magnolia officinalis |
| Pueraria lobata |
| Astragalus membranaceus |
| Coptis chinensis |
| Schizonepeta tenuifolia |
| Paeonia lactiflora |
| Prunus mume fructus |
| Codonopsis pilosula |
| Cinnamomum cassia |
| Boswellia thurifera |
Other Ingredients: Vegetable cellulose (hypromellose); Vegetable Stearic Acid; Microcrystalline Cellulose and Vegetable Magnesium Stearate.
Does Not Contain: Wheat, gluten, soy, milk, eggs, fish, crustacean shellfish, tree nuts, peanuts
Helico)X
60 x 500 mg Capsules
Actions
•Inhibits H. Pylori
•Relieves GERD
•Anti-ulcer
•Anti-inflammatory
Indications
•Helicobacter pylori infection
•Gastritis / Chronic atrophic gastritis
•Gastric ulcer
•Peptic ulcers
•Gastroesophageal reflux
•Bloating
•Nausea
•Lymphoma of the stomach
Suggested Use:
2 capsules after each meal, maximum three, or 6 before sleep.
Caution:
Caution with physical depletion and weakness, chronic fatigue, and watery diarrhoea.
Warning:
Contraindicated in Pregnancy and Lactation and with Warfarin
Helicobacter pylori
H. pylori is a very common infection of the stomach. It may be the most common infection in the world. It is now clear that the infection is directly related to the development of stomach and duodenal ulcers, and it is likely that it may be related to stomach cancer.The symptoms of discomfort, bloating, nausea and perhaps vomiting are possible clues to the presence of Helicobacter pylori, but a urea breath test should be used to confirm.
The person may also have symptoms that suggest ulcers - burning or pain in the upper abdomen, usually occurring about an hour or so after meals or even during the night. The symptoms are often relieved temporarily by using antacids, milk, or OTC medications that reduce stomach acidity. Infestation is common when eating utensils are shared or food is consumed from a common bowl.
H. pylori is a very common infection of the stomach. It may be the most common infection in the world. It is now clear that the infection is directly related to the development of stomach and duodenal ulcers, and it is likely that it may be related to cancers involving the stomach, which may be why stomach cancer is common in the East.
Cause: Helicobacter pylori are a spiral shaped bacterium that lives in the stomach and duodenum. It has a unique way of adapting in the harsh environment of the stomach.
The inside of the stomach is bathed in about half a gallon of gastric juice every day. Gastric juice is composed of digestive enzymes and concentrated hydrochloric acid, which can readily tear apart the toughest food or microorganism. Bacteria, viruses, and yesterday’s steak dinner are all consumed in this deadly bath of chemicals. It used to be thought that the stomach contained no bacteria and was actually sterile, but Helicobacter pylori changed that.The stomach is protected from its own gastric juice by a thick layer of mucus that covers the stomach lining. Helicobacter pylori take advantage of this protection by living in the mucus lining.
Once H. pylori is safely ensconced in the mucus, it is able to fight the stomach acid that does reach it with an enzyme it possesses called urease. Urease converts urea, of which there is an abundant supply in the stomach (from saliva and gastric juices), into bicarbonate and ammonia, which are strong bases. This creates a cloud of acid neutralizing chemicals around the H. pylori, protecting it from the acid in the stomach. The reaction of urea hydrolysis is important for diagnosis of H.pylori by the breath test.
Another defence H. pylori has is that the body's natural defences cannot reach the bacterium in the mucus lining of the stomach. The immune system will respond to an H. pylori infection by sending white cells, killer T cells, and other infection fighting agents. However, these potential H. pylori eradicators cannot reach the infection, because they cannot easily get through stomach lining. They do not go away either, though, and the immune response grows and grows. Polymorphs die, and spill their destructive compounds (superoxide radicals) on stomach lining cells. Extra nutrients are sent to reinforce the white cells, and the H. pylori can feed on this. Within a few days, gastritis and perhaps eventually a peptic ulcer results. It may not be H. pylori itself which causes peptic ulcer, but the inflammation of the stomach lining; i.e. the response to H. pylori.
H. Pylori infection are believed to be transmitted orally. Many researchers think that H. Pylori is transmitted orally by means of faecal matter through the ingestion of waste tainted food or water. In addition, it is possible that H. pylori could be transmitted from the stomach to the mouth through gastro-oesophageal reflux (in which a small amount of the stomach's contents is involuntarily forced up the oesophagus) or belching, common symptoms of gastritis. The bacterium could then be transmitted through oral contact.
DISEASES
Peptic ulcers have two causes. The most common cause is also H. pylori infection of the stomach. We expect stomach ulcers to behave similar to duodenal ulcers so that after killing the H. pylori, they should not recur. Stomach ulcers are more complicated than duodenal ulcers, however, but the effectiveness H.pylori Clear treatment for stomach ulcers appears to be similar to that seen in duodenal ulcers (cure rate 70-90% if H.pylori is eradicated).
Duodenal peptic ulcers occur in the first part of the intestine, one or two inches past the end of the stomach. Most duodenal ulcers occur in patients with H. pylori infection. If duodenal ulcers are treated with antacids or drugs such as Tagamet, Zantac, or Pepcid, they usually come back when the drugs are stopped. Acid reducing drugs are expensive and do not cure the duodenal ulcer problem.
Stomach cancers (gastric adenocarcinomas) are often associated with H.pylori (70-90%). In an extensive review of gastric cancer and H.pylori the Eurogast Study Group determined that presence of H.pylori confers an approximately six-fold risk of gastric cancer, accounting for about half of all gastric cancers. Supposedly, chronic gastritis leads to intestinal metaplasia (atrophic gastritis), which then undergoes malignant change. In the final stage H.pylori may no longer be detected on biopsy but immunologic studies may show evidence of past infection.
Mucosa associated lymphoid tissue (MALT) may undergo malignant change causing a low-grade lymphoma of the stomach. Retrospective biopsy studies show that 90% of such MALT lymphomas are associated with H.pylori. Early reports indicate about a 50% cure for localized MALT after cure of H.pylori.
Many patients experience improved well-being and energy level when H.pylori is treated so consider treatment in Gulf Veterans Syndrome and Chronic Fatigue Syndrome.Lots of people with chronic halitosis respond to treatment for H.pylori. This may be because mouth bacteria, sinus and periodontal disease responds to the H.pylori Clear. It may be that H.pylori is the cause of the halitosis (bad digestion, achlorhydria etc.). In any case, treating H.pylori might be worthwhile.
Therapeutic effect of H.pylori Clear on gastric inflammation and Helicobacter pylori infection.
By Dr Daniel Weber, PhD MSc & Dr James Laporta MBChB(UCT), DMH(SA)
H.pylori Clear is a combination of 6 Chinese medicinal herbs that have been used in clearing helicobacter pylori, chronic atrophic gastritis (CAG), gastric & peptic ulcers, and reflux. This formulation is based on an in depth understanding of traditional Chinese medicine (TCM) principles and the effects of specific herbs on various gastro-intestinal disorders and specific TCM disease states. Research using a TCM formulation, similar in ingredients and dosage to H.pylori Clear, shows therapeutic value in terms of treating gastritis and clearing helicobacter pylori infection. The inhibitory and bacteriostatic effects of the herbal ingredients Huang Lian and Da Huang on Helicobacter Pylori (which is recognized as a causative organism of gastric ulceration or gastritis) were found to be 2.7x and 2.1x more effective than aminobenzylpenicillin in an in vitro study. The effective clinical rate was 97.2% with a gastroscopic examination effective rate of 85.7%. A total curative rate was 31.4% in the treated group, compared to 2.9% in the control group was observed. Most noticeably, the pathological study of H. Pylori clearance was 80%. This study gives plausible reason for therapeutic effect and confirms the anecdotal findings and history of traditional use. Although this trial does not constitute the usual structure of a randomized double blind placebo controlled trial, it provides information on the therapeutic effect of such a formulation. Additionally, H.pylori Clear has significant anecdotal support from practicing medical doctors in South Africa for use of gastric ailments- mostly peptic ulcer disease, gastro-oesophageal reflux disease, and chronic atrophic gastritis (Zhang et al, 1992).
Relation between Helicobacter pylori and pathogenesis of chronic atrophic gastritisand the research of its prevention and treatment
Zhang L, Yang LW, Yang LJ.Chinese Journal of Integrated Traditional and Western Medicine (Zhongguo Zhong Xi Yi Jie He Za Zhi).Heilongjiang Academy of Traditional Chinese Medicine, Harbin. 1992 Sep;12 (9):521-3, 515-6.)
Summary: The total detectable rate of Helicobacter pylori (HP) of 485 patients suffering from gastric diseases was 59.6%. The HP in gastric mucosa of chronic atrophic gastritis (CAG) patients was separated from the cell culture in vitro and transferred successively. The mice were perfused with exsiccate alum, and the rabbits with aspirin to injure their gastric mucosa, then HP was perfused. Result showed that the change of experimental animals was identical with that of CAG patients by means of bacteriological and pathological examination. It revealed that HP was in agreement with Robert Koch's three principles about pathogenic bacteria. According to the bacterial infectious hypothesis of CAG, 53 Chinese medicinal herbs and prescriptions were investigated with bacteriostatic test. Panax notoginseng and Magnolia officinalis were discovered to be sensitive, Prunus mume and Corydalis yanhusuo were moderate sensitive, and Coptis chinensis and Rheum palmatum highly sensitive to HP. Decoction of Clearing up the Heat and Relieving the Blood Stasis and No.2 recipe of Huowei were used to treat 70 CAG patients with Stomach Heat Syndrome. The effective rate of gastroscopic examination was 85.7% that of pathological study was 80%. In comparing with the group of Sanjiu Weitai, there was significant difference between the traditional Chinese medicine treated group and Sanjiu Weitai control group, the former being markedly better.
Key Words: Helicobacter pylori, chronic atrophic gastritis, animal model, bacterial infectious hypothesis, bacteriostatic test by Chinese medicinal herbs, clearing Heat and resolving stagnant Blood, No.2 recipe of Huowei
During April, 1988 to March, 1991, gastric mucosa tissues of 485 subjects were taken during gastroscopic examination. It’s found that the positive rates of Helicobacter pylori (HP) were very high in various gastric diseases through urease test, smear microscopy, bacterial culture and electron microscope observation, and the highest detectable rate was found in chronic atrophic gastritis (CAG). Therefore, the relation between HP and pathogenesis of CAG and its prevention and treatment by Chinese medicinal herbs were widely studied. The summary is reported as follows.
Clinical Research
I. Discussion on the relations between HP and various gastric diseases as well as patterns, and the effects of Chinese medicinal herbs on HP
1. Subjects: Patients with pain or stuffy and uncomfortable feeling in the gastric region as the chief complaints, and diagnosed as superficial gastritis (CSC), chronic atrophic gastritis (CAG) and gastric ulcer (GU) through gastroscopy, 485 cases totally, among which 283 males and 202 females, the ratio of male to female was 1.4:1, the oldest patient was 65 years old, and the youngest 18 years old, patients at the age of 35~45 making up 74% (359/485). All the patients underwent HP detection with above four methods, and the total detectable rate was 59.6% (289/485). Among which, the detectable rate of urease test was 58.7% (179/305), and smear microscopy 47.2% (183/388), bacterial culture 47.0% (101/215) and electron microscope observation 30.7% (35/114). The result was similar to reports at home and abroad.
Among 485 subjects, there’re 180 cases of CAG, 289 cases of CSG and 18 cases of GU. Of the three diseases, the HP positive rate in CAG was 66.7% (120/180) which was the highest, and that of CSG was 55% (159/289) which was the lowest. There’s significant difference between the two results (P<0.05). The HP positive rate of GU was 62.5% (10/16) which was in the middle. The detectable rates varied because of different detecting methods. Among the detected subjects, urease test had the highest positive rate, then microscopy examination, and the detectable rate was low in electron microscope observation. The result had some relations with the location where the tissues were obtained.
2. The relations between HP and TCM differentiation of CAG
Criteria of TCM patterns: CAG was differentiated into three patterns according to the Three Categories of Etiologic Factors Theory in TCM. If it’s caused by depressed mode complicated with HP infection or leading to the attack of HP in the stomach, the clinical manifestations will be gastric distending or stuffiness which will affect the chest and hypochondriac regions, frequent belching, vomiting, nausea, stuffy feeling in the throat, vexation, irritation, sign, dark-red tongue body with whitish tongue fur, wiry pulse; and the TCM differentiation is Liver-qi invading the Stomach, qi stagnation and Blood stasis (Type I). If it’s caused by six exogenous factors and internal invading of Damp-Heat, or constitution of excessive Damp and Phlegm-Damp transforming into Heat, the onset will be quick and the manifestations include gastric uneasiness, scorching feeling behind breastbone or in the gastric region, decreased appetite, nausea, vomiting, dry and bitter mouth or bad breath, ulcerated mouth and tongue, dry stools or difficult defecation, dark-red tongue body with yellowish-whitish and greasy tongue fur, wiry and slippery pulse; and this is the type of Damp-Heat in the Spleen and Stomach complicated with Blood stasis (Type II). For patients with weak constitution and weak Spleen and Stomach, or suffering from injured Spleen and Stomach due to improper diet and fatigue, if they’re infected by HP, the manifestations will usually be pale complexion, emaciation, fatigue, lack of energy, poor appetite, aggravated distending after food-intaking, uneasiness relieved by warmth and pressure, loose stools, dark-pale or dark-purplish tongue body or with petechia, whitish or whitish-greasy tongue body, deep, fine and weak pulse; this is the type of Spleen deficiency and excess Dampness, Cold coagulation and Blood stasis (Type III). According to above TCM differentiation, there’re 30 cases were of Type I, 51 cases of Type II and 99 cases of Type III among the 180 cases of CAG. And the HP positive detectable rate of Type II was 78.4% (40/51) which was the highest, then Type III, which was 63.5% (63/99), and the rate was low in Type I, which was 56.7% (17/30). There’s significant difference between Type I and Type II (P<0.01).
3. HP and the ultrastructure of patients’ gastric mucosa We observed 141 patients’ biopsy samples of gastric mucosa under transmission electron microscope, and HP was seen directly in 31 cases, which was distributed dispersively or in group on the surface of epithelial cells and invaded into the glandular cavity through intercellular space. The villi of epithelial cells contacting HP disappeared, with rough surface, incomplete limiting membrane, swollen cells, and invaginated cytoplasm. Intestinal metaplasia appeared and Goblet cells or Paneth cells could be seen. The cells degenerated obviously in areas where bacteria concentrated. There were cytoplasmic mitochondria swelling and vacuolar degeneration, groups of necrotic and exfoliated cells were seen, and cytoskeleton was damaged. Among the 31 cases, there’re 7 smears of electron microscope on which HP was phagocytized or dissolved by cells. Under electron microscope, the changes of epithelial cells and glandular epithelial cells of gastric mucosa were severe in HP positive group, and the most obvious changes included swelling, vacuolar degeneration, necrosis and exfoliation of cells and intercellular substance oedema. Comparing with HP negative group, the difference was significant (P<0.01). The changes of cell nucleus and organ were also more severe than those in HP negative group, but there’s no significant difference (P>0.05). The comparison between 31 cases of HP positive group and 31 cases of HP negative group showed that the incidences of intestinal metaplasia were 48.3% (15/31) in HP positive group and 87.1% (27/31) in HP negative group respectively, and there’s significant difference (P<0.05); on the contrary, the incidence of atypical hyperplasia in HP positive group was 25.8% (8/31) and 1 case in HP negative group making up 3.2% (1/31). The results showed that intestinal metaplasia made against the presence of HP, and the activity of HP could lead to the deterioration of CAG and atypical hyperplasia, which would accelerate cancerization. The clearing of HP in treatment is the key of preventing deterioration and curing CAG.
4. Discussion of the effects of Chinese medicinal herbs on HP
In order to explore that whether Chinese medicinal herbs had bacteriostatic effects on HP, we selected 53 herbs and their different prescriptions commonly used to treat Spleen and Stomach diseases in clinic: the herbs included huang lian, da huang, dan shen, hou po, ku shen, pu gong ying, huang qi, sha shen, wu yao, wu mei, rou gui, ban xia, sheng di, sheng di yu, san qi, mai dong, yin hua, bai he, dang shen, chi shao, xing ren, ru xiang, bai shao, gong ding xiang, gou qi zi, huang qin, su geng, mu xiang, yan hu suo, dang gui, chuan xiong, shan yao, chai hu, lai fu zi, chuan lian zi, lian qiao, gui zhi, fo shou, mo yao, ji nei jin, e zhu, ren shen, tao ren, wu zhu yu, gua lou, yu jin, xiang yuan, cao dou kou, sha ren, shi hu, tu fu ling, san leng and zhu sha. The herbs and prescriptions were soaked for 120 minutes respectively and decocted for 25 minutes at the temperature of 100ºC to get 1:1 decoction (1ml liquid from 1g Chinese medicinal herbs) for use. HP was made into 3×108/ml bacterial suspension and inoculated to cAMP-BAP plate and agar gel diffusion test was done with stainless steel cup plate-diffuse method: it’s cultured for 72 hours at the temperature of 37ºC under the condition of mild oxygen-demand. The yin-nourishing, Heat-clearing, qi-regulating and Blood-activating herbs in the 53 herbs were made into formulas respectively, and they’re Heat-clearing formula (huang lian, da huang, ku shen, gong ding xiang, etc.), yin-nourishing formula (bai shao, gou qi zi, wu mei, bei sha shen, etc.), qi-regulating formula (huang qi, hou po, wu yao, lai fu zi, etc.) and Blood-activating formula (dan shen, e zhu, sheng di yu, yan hu suo, etc.). Taking above 4 formulas as the basic formulas, compound formulas were made up by every two formulas, every three formulas and four formulas respectively. For example, Heat-clearing and Blood-activating formula was a compound formula made up of herbs in Heat-clearing formula and Blood-activating formula. The rest may be deduced by analogy. The test showed that Heat-clearing and Blood-activating formula as well as yin-nourishing and Heat-clearing and Blood-activating formula had inhibitory effects on HP in vitro, other compound formulas had no bacteriostatic effects (see the table below).
Table: Comparison of herbs having obvious bacteriostatic effects
Herb
Name
Inhibition
Zone
Herb
Name
Inhibition
Zone
Herb
Name
Inhibition
Zone
huang lian
41
san qi
20
qou qi zi
14
da huang
32
hou po
20
aminobenzylpenicilin
15
gui zhi
30
dang shen
20
Heat-clearing and Blood-activating formula
18
yan hu suo
25
huang qin
18
yin-nourishing and Heat-clearing formula
––
wu mei
25
sheng di yu
18
Blood-activating formula
13
It could be seen from the table that HP was sensitive to san qi, hou po and dang shen, moderately sensitive to wu mei and yan hu suo, and highly sensitive to huang lian, da huang and gui zhi.
II. Treating results
According to the gastroscope and pathological diagnosis criteria worked out in National Symposium on Diagnosis and Treatment of Chronic Gastritis, and referring to the Diagnosis, Differentiation and Therapeutic Effect Criteria of Integrated Traditional Chinese and Western Medicine for Chronic Gastritis drafted by Committee of Digestive System Diseases of Chinese Institute of Integrated Traditional Chinese and Western medicine, 105 cases of CAG of Stomach Heat type were selected randomly, and their HP were all positive. They’re divided into 35 cases of Heat-clearing and Blood stasis-relieving formula (herb pieces) treated group, 35 cases of No. 2 Recipe of Huowei (Heat-clearing and Blood stasis-relieving formula, powder) treated group (Group II), 35 cases of San Jiu Wei Tai (a commonly used TCM patent drug for gastric problems) control group (Group III). Heat-clearing Blood stasis-relieving formula consisted of the following herbs: huang lian 10g, da huang 5g, bai hua she she cao 20g, san qi 3g, dan shen 15g, hou po 15g, ge gen 15g, ji nei jin 15g, bai shao 25g, wu mei 10g, dang shen 10g, huang qi 15g & gui zhi 5g. All the three groups took the medicine each time before breakfast and after supper, 6 months as a course of treatment.
The total clinical effective rate in Heat-clearing and Blood stasis-relieving formula (herb pieces) group was 97.2%, the effective rate of gastroscopic examination was 85.7%, the effective rate of pathological study was 80% and the curative rate was 31.4%. The results in No.2 Recipe of Huowei treated group were 97.2%, 85.7%, 77.1% and 25.7% respectively; in San Jiu Wei Tai control group, they’re 51.3%, 40%, 34.3% and 2.9% respectively. There’re very significant differences among all indices of two treated groups and the control group.
The negative change rate of Heat-clearing and Blood stasis-relieving formula (herb pieces) group was 82.9% (29/35), and 80% (28/35) in No.2 recipe of Huowei treated group, 20% (7/35) in the control group. The effective rate of blood rheology and nailfold microcirculation of the three groups were 85.5% and 83.9% in Heat-clearing and Blood stasis-relieving formula (herb pieces) group, 85.7% and 80% in No.2 recipe of Huowei treated group and 54.3% and 50.5% in the control group. The effects of the treated groups were better than those of the control group (P<0.01) either in HP clearance or in the improving rate of blood rheology and nailfold microcirculation.
Experimental Research
I. Model test by exciccate alum-HP combination
20 male Kunming mice weighing 22~24g provided by Provincial Animal Experiment Centre were randomly divided into two groups. Mice in model group were perfused with exciccate alum once every day. After consecutive 5 times, HP bacterial suspension were perfused (6×108/ml strain), 0.2ml every 4 days, three times totally. After one night’s fast but free water drinking, the mice were killed on the second day and the specimens of gastric mucosa were taken for bacteriological examination as well as pathological and histological examinations. The control group were perfused with physiological saline of the same amount and killed for examination at the same time. The results showed that in the model group, there’re 10/10 HP positive in urease test, 9/10 HP-positive in HP culture; in the control group, they’re 2/10 and 0/10 respectively (P<0.01). Pathological examination showed that in the model group, 9/10 had decreased gastric mucosa glands, 6/10 had infiltrating lymphocytes and 7/10 had dilated small blood vessels; and in the control group, the results were 1/10, 1/10 and 2/10 respectively (P<0.01).
The results showed that after injuring the gastric mucosa with exciccate alum, the inoculating of HP would lead to CAG’s pathological changes in short time. Indices of bacteriological, pathological and histological examinations were significantly different from those of the control group (P<0.01).
II. Model test by aspirin-HP combination
15 male big-ear white rabbits weighing 2.0~2.5kg provided by Animal Centre were divided into two groups, 9 in the model group and 6 in the control group. The model group were perfused with 2.5ml aspirin liquid made by ourselves, once every day, for consecutive 5 days. On the sixth day, HP suspension (6×108/ml) were used for gastrogavage, 1ml every time, once every 5 days. 5 days after the last inoculation, the rabbits in both groups were fasted (free water-drinking) for 24 hours and killed at the same time to take out the stomach, and 3 mucosa specimens near pylorus were taken under sterile condition for biochemical and bacteriological examinations. The control group was perfused with physiological saline of the same amount. Results: bacteriological examination of the model group: 9/9 HP positive in urease test, 7/9 HP-positive in HP culture; in the control group, they’re 1/6 and 0/6 respectively (P<0.01). Pathological examination showed that in the model group, 8/9 had decreased glands, 7/9 had infiltrating lymphocytes and 8/9 had dilated small blood vessels; and in the control group, the results were 1/6, 1/6 and 2/6 respectively.
The experimental results showed that on the base of aspirin-induced gastric mucosa injury, the inoculating of HP would result in CAG. The results were significantly different from those of the control group (P<0.01).
Discussion
I According to the clinical and experimental studies, we believed that HP is the pathogenic bacteria of gastric diseases, especially CAG, and it’s a conditional pathogenic bacteria. And the bacterial infectious hypothesis on the pathologic mechanism of CAG was put forward.
II. The main Evils causing CAG are Damp and Heat. TCM differentiation shows that in different phases of the disease, Blood stasis is present in the whole course of CAG. It’s proved by electron microscope that the more the HP there is, the more severe of the changes of Blood stasis and bleeding are. There’re both common and different treatment in TCM differentiation.
III. It’s proved by TCM lingual diagnosis as well as examinations of modern blood rheology and nailfold microcirculation, the change of CAG is positively correlated with the amounts of invaded HP. The blood stasis resulted from it is the basic pathological characteristics of CAG. So the treating principles of clearing Heat, relieving Blood stasis to expel Evils and invigorating qi, nourishing yin to support Vital-qi are put forward. Selecting Da Huang Huang Lian Xie Xin Tang as the basic formula, and referring to the result of HP bacteriostatic test of 53 Chinese medicinal herbs, we applied self-prescribed Heat-clearing and Blood stasis-relieving Formula and new preparation of No.2 Recipe of Huowei in the treatment. As they hit to the pathogeny and pathogenesis of CAG, the therapeutic effect was satisfactory.
Huang Lian/Coptis Chinensis
Modern research showed that Huang Lian had anti-bacterial effect on various bacteria, and the effect was the strongest on shigella dysenteriae, staphylococcus aureus and tubercle bacillus. It also had anti-viral, anti-fungal, anti-toxic and anti-inflammatory effects. Berberine at low dosages could excite isolated heart of cats and dilate coronary artery; at high dosage, it showed inhibitory effect. Berberine could increase the contractility of animal heart in heart failure condition. It could also obviously lower the myocardial oxygen consumption in heart failure, and protect the ischemic cardiac muscle. Berberine had anti-arrhythmic and anti-cancer effect; it could lower the blood pressure and dilate blood vessels. Huang Lian and berberine could both lower the blood sugar, and had significant inhibitory effect on platelet aggregation and ADP release in rabbits. Intravenous injection of berberine to small dogs could excite gastrointestinal smooth muscles. Berberine could stimulate bile secretion, lower serum cholesterol and antagonize stress ulcer.
In clinic, Huang Lian is used to treat bacillary dysentery, arrhythmia, hypertension, scarlet fever, refractory heart failure, chronic pelvic inflammation, epidemic cerebrospinal meningitis, diphtheria, whooping cough, pulmonary TB, pulmonary abscess, infections in oral cavity and face, pharyngitis, acute tonsillitis, atrophic rhinitis, sinusitis, purulent otitis media, erythema multiforme, skin ulcer, eczema, chronic atrophic gastritis, fungal infection in the intestinal tract, peptic ulcer, chronic cholecystitis, burn and Trichomonal vaginitis, etc..
Effects on the smooth muscle
Intravenous injection of berberine to small dogs could excite gastrointestinal smooth muscles (Wen et al, 1998).
Bacillary dysentery
The therapeutic effect of huang lian on bacillary dysentery was quite certain. Usually it could be cured within 5~7 days. The oral dosage: small dosage was 2~3g, large dosage was 8~12g, averagely 6g daily (Wen et al, 1998).
Chronic atrophic gastritis
Supplemented Huang Lian Tang (huang lian 9g, zhi gan cao 6g, gan jiang 9g, gui zhi 9g, dang shen 10g, ban xia 12g, da zao 12 pieces, chai hu 18g, san leng 15g), 1 dose daily. The formula was used to treat 98 cases of chronic atrophic gastritis, and 16 were clinically cured, the total effective rate was 98.97% (Wen et al, 1998).
Peptic ulcer
Berberine 0.4g, qid, 4~6 weeks as a course of treatment. The method was used to treat peptic ulcer and the curative rate was 70%. During the treatment, only mild constipation and bitter taste were reported in very few patients (Wen et al, 1998).
Da Huang/Rheum Palmatum
Modern research showed that the herb had purgative, anti-infectious, anti-inflammatory, anti-tumour and haemostatic effects. It could promote bile secretion, increase non-specific immunity, inhibit the biosynthesis of prostaglandin F, prostaglandin E 2 , prostaglandin D 2 , A 2 and thromboxane, lower serum protein, urinary nitrogen and creatinine. Da Huang could also lower serum cholesterol in rabbits, lower blood pressure and had oestrogen-like effects.
In clinic, this herb is used to treat bleeding of the upper digestive tract, haemoptysis, uterine bleeding, traumatic bleeding, haemorrhoids, nasal bleeding, high fever with constipation, viral hepatitis, peptic ulcer, chronic renal failure, endometriosis, Hyperlipemia, chronic prostatitis and insanity, etc.
Prevention of rhubarb (Da Huang) from antibiotic-associated colitis in critical patients in intensive care unit: a prospective, randomized controlled clinical study
HOU Jie, DENG Chong, GUO Ying-jun, WANG Guo-jun, LIU Ba-yi, CHEN Hua-qiong, LI Ping, CHEN Hou-jun. Zhong Guo Zhong Xi Yi Jie He Ji Jiu Za Zhi. 2009; 16(5): 272-274.
Objective: To observe the prevention of rhubarb from antibiotic-associated colitis (AAC) in critical patients in intensive care unit (ICU). Methods One hundred and eighty critical patients in ICU without colitis and gastrointestinal contra-indieation were ready to receive initial antibiotic therapy, and prospectively and randomly they were divided into treatment group (taking rhubarb orally or by nasal feeding in addition to routine therapy, 91 eases) and control group (only taking routine therapy, 89 cases). The incidence of intestinal flora imbalance was diagnosed by stool smear of Gram stain. The incidence and severity of AAC and the degree of intestinal flora imbalance in 7-to 10-day antibiotic treatment in the two groups were compared. Results The total incidence of AAC was 15.6% (28/180) in which 13.2% (12/91) was in treatment group and 18.0% (16/89) in control group (P>0.05). There were 1 ease of severe AAC and 1 ease of III degree intestinal flora imbalance in treatment group, in contrast, there were 7 severe AAC and 8 III degree intestinal flora imbalance cases in control group (both P<0.05). Conclusion Rhubarb is beneficial to the prevention of AAC in critical patients in ICU; it can decrease the incidence of AAC, especially the severe AAC and III degree intestinal flora imbalance.
Influence of Dahuang Granule Prescription on the Level of Motilin in Plasma and Gastrin in Serumof Patients with Severe Acute Pancreatitis
TIAN Hua, ZHUO Yue, WANG Ye. Zhong Guo Zhong Yi Yao Xin Xi Za Zhi. 2009; 16(8): 12-13.
Objective: To study the influence of Dahuang granule on the level of motilin in plasma and gastrin in serum of patients with severe acute pancreatitis (SAP). Methods Sixty-four patients with SAP were divided into Dahuang granule group (32 cases) and control group (32 cases), treated with Dahuang granule and routine therapy respectively. The level of motilin in plasma and gastrin in serum of the two groups were detected by radioimmunoassay method. Results After treated for one week, the level of motilin in Dahuang granule group was significantly higher than that in the control group (P<0.05), and the level of gastrin was significantly lower than that in the control group (P<0.01). Conclusion Dahuang granule can increase motilin and decrease gastrin of patients with SAP.
Bai Hua She She Cao/Heydyotidis Diffusa
Modern research showed that this herb had anti-tumour, anti-bacterial, sedative, hypnotic and analgesic effects. It could antagonize snake venom and inhibit the production of sperm.
In clinic, this herb is used to treat various tumours, acute hepatitis with jaundice, infantile pneumonia, chronic nephritis, appendicitis, pelvic inflammation, annexitis, gallbladder stone, snakebite and multiple dermatomyositis, etc.
Appendicitis
Fresh bai hua she she cao 30g (or dried one 15g), water decoction, twice daily, the dose could be appropriately reduced in children. For those with severe symptoms, the dose could be increased to 60~90g. All treated 19 cases were cured (Wen et al, 1998).
San Qi/Pseudoginseng
San Qi is a TCM herb to activate Blood, dispel stagnated Blood, invigorate qi, stop bleeding, eliminate swelling and relieve pain.Modern research showed that San Qi could decrease heart beat, increase the blood flow volume in the coronary artery, lower the resistance of coronary artery and had haemostatic effect. . San Qi and its total saponins could lower blood pressure. Total saponins of San Qi had anti-arrhythmic, analgesic and sedative effects; it could also lower platelet aggregation, lower serum cholesterol and slightly increase fasting blood sugar.
In clinic, this herb is used to treat cancer pain, chronic renal failure, prostatic hyperplasia, bleeding due to ulcers, soft tissue injury, ulcerative colonitis, enteritis and migraine, etc.
Effect of Total Saponins of Panax notoginseng on Gastric Mucosal Lesion and Ultrastructure of Gastric Mucosal Parietal Cells of Stress Rats
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DENG Xiang-chao, LI Yan-wu, WANG Ru-jun. Shi Zhen Guo Yi Guo Yao. 2008; 19(9): 2143-2145.
Objective: To observe the effect of total saponins of Panax notoginseng (PNS) on gastric mucosal lesion and uhrastructure of gastric mucosal parietal cells of stress rats. Methods: Water-immersion restraint stress (WRS) was used to induce rat models of stress. Six hours after WRS, the rats were executed to obtain the gastric tissue. The erosion and haemorrhage of gastric mucosa in rats were observed by naked eyes, and then the ulceration index (UI) was calculated. The ultrastructure of gastric mucosal parietal cells in rats was observed under transmission electron microscope. Results: The results observed by naked eyes showed that no lesion was found in the normal group. However, in the model group, the gastric mucosal congestion was obvious, there existed scattered punctiform erosion and bleeding in the glandular stomach, and the UI was 16.83 ± 4.96; compared with the model group, gastric mucosal congestion was reduced and UI decreased in the PNS group and ranitidine group (P<0.01). Under the electron microscope, there were less endocrine tubular villi in the parietal cells of the normal group, showing a static status. However, in the model group, the number of endocrine tubular villi increased, showing an activating status; compared with the model group, the expansion of endocrine tubular villi was not obvious but the number of cytoplasm interior vesicles in parietal cells increased in PNS group, and in ranitidine group, the number of endocrine tubular villi was decreased and the number of vesicular structure was increased. Conclusion: PNS can reduce the stress-induced gastric mucosal lesion, and promote the wall cells of gastric mucosa transforming from the activated status into static status. The protective mechanism of PNS is probably related with the regulation of acid secretion of Parietal cell..
Effect of Total Saponins of Panax notoginseng on oxygen free radicals in serum and gastric mucosa of stress rats
Deng Xiangchao, Li Yanwu, Wang Rujun. Zhong Yao Yao Li Yu Lin Chuang. 2008; 24(3): 41-43.
Objective: To observe the effect of Total Saponins of Panax notoginseng (PNS) on oxygen free radicals (OFR) levels in serum and gastric mucosa of stress rats. Methods: Water-immersion restraint stress (WRS)was used to induce rat models of stress. Thirty-two SD rats were randomized into the normal group, model group, PNS group (66mg/kg), and ranitidine group(12.5mg/kg). The rats were pretreated with corresponding drugs or the same volume of distilled water. After treatment, superoxide dismutase (SOD), malondialdehyde (MDA) and nitric oxide (NO) contents in serum and gastric mucosa of stress rats were detected. Results: Six hours after WRS, the NO content and SOD activity in gastric mucosa were lower, and MDA content was higher in the model group than those in the normal group (P<0.05). After treatment with PNS, NO content in gastric mucosa was increased, MDA decreased (P<0.05) and SOD activity increased (P<0.01). In the serum of the model group, NO content and SOD activity were lower, and MDA content was higher than those in the normal group (P<0.01). After treatment with PNS, serum NO content was increased (P<0.05), but there were no obvious changes of MDA and SOD. Conclusion: WRS can induce the injury of oxygen free radicals in rats. PNS has protective effect on gastric mucosa of stress rats by clearing oxygen free radicals and inhibiting the production of peroxides..
Dan Shen/Salvia Miltiorrhiza
Modern research showed that Dan Shen could increase the blood flow volume in gastric mucosa; inhibit tissue peroxidation, strengthening the anti-oxidant ability of gastric mucosa. Dan Shen could stimulate the mucus secretions of gastric wall, consolidate the barrier of gastric mucosal, effectively block the ischemic and anoxia condition of gastric mucosa induced by ethanol so that prevent deep tissues of gastric mucosa from injury (Wen et al, 1998).
Dan Shen could alleviate the denaturalization and necrosis of renal tubular epithelial cell in glycerin-induced acute renal failure in rats, decrease the cast in lumen, increase blood flow volume in kidneys, improve creatinine clearance rate, and lower urea nitrogen; it also had diuretic effect. It could protect ischemic injury of kidney and protect the kidneys from the injury caused by gentamycin, also prevent the declining of Na-K-ATP enzyme activity of renal cortex. Dan Shen had obvious preventing and protecting effects on renal hemodynamics disturbance induced by c iclosporin A so that there's no obvious declining of glomerular filtration rate and urine volume, and renal blood flow volume increased compared with previous condition.
Water extract of Dan Shen had obvious protecting function on isoproterenol-induced myocardial ischemia in rats. It also had preventing effect on acute myocardial ischemia caused by coronary artery ligation in rats (intraperitoneal injection at the dosage of 5g crude drug/kg). For pulmonary injury caused by deep x-ray in mice, Dan Shen could promote the rehabilitation. But it had no obvious protecting effect on thymus gland.
Dan Shen had inhibitory effect on cervical carcinoma in mice. Water-soluble ingredients of Dan Shen could inhibit carrageen-induced foot oedema in rats.
In clinic, this herb is used to treat viral myocarditis, acute myocardial infarction, diabetes, hepatic-cirrhosis, chronic simple rhinitis, hepatitis, chronic renal failure, nasopharyngeal cancer, infantile allergic purpura, pharyngitis and infantile pneumonia, etc.
Intestinal peroxidize mucosal injury and salvia miltiorrhiza pretreatment at hepatic ischemia and reperfusion
ZHANG Zhi-yong, CHEN Xiao-ping, LU Qi-ping. Lin Chuang Wai Ke Za Zhi. 2009; 17(8): 519-521.
Objective: To study the intestinal mucosal injury and salvia miltiorrhiza pretreatment at hepatic ischemia and reperfusion. Methods: Under the condition of hepatic ischemia for 45 min, SD rats were randomly divided into 4 groups: normal control group (CO), sham-operated group (SO), isehemiareperfusion group (IR), salvia miltiorrhiza pretreatment group(SM), then each group were divided into 5 sub -groups according to different reperfusion times (0 h/3 h/12 h/24 h/72 h). SM group were injected 40 ml/kg saline with 6 g/kg salvia miltiorrhiza from caudal vein 30 min before clamping hepatic pedicle, other groups were injected 40 ml/kg normal saline from caudal vein. While SO group were only dissected their porta hepatis, not clamping hepatic pedicle after laparotomy. The upper jejunal samples at each reperfusion time (0 h/3 h/12 h/24 h/72 h) were taken to process the detection of general pathology, activity of DAO, and the flora shifting of mesenteric lymph nodes. Results: The injury of jejunal mucosal in SM group was less than that of IR group, the activity of DAO and the positive rate of mesentery lymph node bacterial culture were lower than IR group (P<0.05) at different reperfusion time limits after hepatic ischemia for 45 min. Conclusion There is significant congestive injury at intestinal in hepatic ischemia-reperfusion, with an declined of DAO activity, and the positive rate of mesenteric lymph node bacterial culture significantly increased. Salvia miltiorrhiza pretreatment have a protect effect on intestinal injury at hepatic ischemia-reperfusion.
Protective effects of Tanshinone-II A on gastric ulcer induced by stress in rats
Gao Hongyan, Niu Chunyan, Liu Kaige, Wu Fangxiong, Wang Wen, Zhang Qi. Shaan Xi Yi Xue Za Zhi. 2009, (11): 1467-1469.
Objective: To evaluate the protective effects of Tanshinone-II A (TanII A) on gastric ulcer in rats induced stress by. Methods: water immersion and restraint stress (WRS) induced gastric injury was used as the experimental model of acute gastric ulcer. Rats were orally administrated with Tan IIA before stress. 6 hours after WRS, all animals were sacrificed and the stomachs of rats were taken out to examine the ulcer index and observe histologically. The activity of total superoxide dismutase (SOD) and malondialdehyde (MDA) were measured in serum and gastric mucosa. Results: 6 hours of water immersion and restraint stress (WRS) resulted in appearance of acute gastric mucosal lesions. Tan II A significantly decreased the ulcer index and the activity of SOD both in serum and gastric mucosa. Conclusion: Tan IIA has remarkable protective effects on WRS induced gastric ulcer on rats, which is related to inhibiting lipid peroxidation.
Protective effect of Salvia miltiorrhiza on gastric mucosa
ZHOU Qin-hua, WANG Hong-mei. Zhong Guo Xian Dai Yi Xue Za Zhi. 2008; 18(5): 582-585.
Objective: To investigate the protective effect of Salvia miltiorrhiza on gastric mucosa during the development of noise stress ulceration in rat so as to provide theoretical evidence for clinical therapy. Methods: 24 SD rats were divided into three groups randomly: control group, noise group and salvia miltiorrhiza group. Factory noise was used as infliction factor to induce evadable, restless, nervous in rats and stress damage of gastric mucosa model was made. For Salvia miltiorrhiza group Salvia miltiorrhiza was injected through sublingual vein at 0, 4, 12, 19 h respectively. Pathologic changes were observed and ulcer index (U1) was calculated. PH of gastric juice was measured and the content of NO, SOD/MDA in gastric mucosa and serum were measured by spectrophotometer. The activity of succinate dehydrogenase in gastric mitochondria was assessed with 2, 6-dichlorophenolindophenol. Result: Comparing with noise group, UI of Salvia miltiorrhiza group decreased significantly (P<0.01) and pH in gastric juice remarkably raised (P<0.05). It was observed that the levels of NO and MDA in both serum and gastric mucosa decreased (P<0.05) and the activity of SOD also raised. The activity of succinate dehydrogenase in gastric mitochondria significantly increased, too (P<0.01). Conclusion: Salvia miltiorrhiza may protect the gastric mucosa of rat from noise stress by restraining the secretion of gastric acid, ridding oxygen free radical, bating lipid peroxides and increasing the activity of succinate dehydrogenase in gastric mitochondria.
Hou Po/Magnolia Officinalis
Modern research showed that the herb could inhibit bacteria including helicobacter pylori, pneumococcus, staphylococcus aureus and shigella dysenteriae; it also had inhibitory effect on dermal fungi. Hou Po decoction could excite isolated intestinal canals of mice and guinea pigs at low dosages and inhibit at high dosages. It could also excite bronchial smooth muscle of mice.
In clinic, this herb is used to treat psoriasis, adhesive ileus, chronic pharyngitis, and incomplete ileus, etc.
Effect on acute pancreatitis in rats
Hou Po Formula (hou po 10g, yin chen 12g, zhi zi 3g, da huang 1.8g (decocted later)). 0.89g/ml. Gastrogavage of 2ml could reduce the secretion of pancreatic juice and the content of amylopsin in rats with acute pancreatitis caused by deoxysodium cholate (Wen et al, 1998).
Effect on smooth muscle
Hou po decoction could excite isolated intestinal canal of mice and guinea pigs at small dosage, and inhibit the canal at large dosage.
Adhesive ileus
Formula for ileus: hou po, lai fu zi, da huang, 30g each; jiao sheng qu, jiao mai ya, zhi shi, zhi ke, 15g each; mang xiao, ji nei jin, tao ren, xing ren, 10g each. 1 dose every day, taken in 2~4 times through stomach tube, 50~100ml every time. 150 cases were treated on the base of fasting including water, fluid infusion, gastrointestinal decompression, and 146 cases were cured (Wen et al, 1998).
Ge Gen/Pueraria Lobata
Modern research showed this herb could lower blood pressure, dilate coronary artery, lower heartbeat and resistance of blood vessels, and relax isolated ileum of rats and lower sugar. It also had anti-arrhythmic, anti-febrile and oestrogen-like effects.
In clinic, Ge Gen is used to treat angina pectoris due to coronary heart disease, typhoid, paratyphoid, infantile spasmodic cough, soft tissue injury, ischemic cerebral infarction, retinal vein obstruction, fungal enteritis, diabetes, facial paralysis, sudden deafness, cervical spondylopathy, glaucoma, arrhythmia, ringworm of the feet and Hyperlipemia, etc.
Effects of puerarin on constractive activity of small intestine smooth muscle in alcoholism rabbit
SUN Hui TIAN Wei ZHANG Hui LIU Hongxia FAN Qianqian DIAO Huiling. Bin Zhou Yi Xue Yuan Xue Bao. 2009; 32(5): 338-339.
Objective: To investigate the effects of Puerarin on constractive activity of small intestine smooth muscle of alcoholism rabbit and to explore it’s alleviating alcoholism mechanisms. Methods: The routine experimental method of small intestinal smooth muscle isolated from rabbits were used. We recorded the automatic contracting characteristic and changing law before and after taking drugs. Results: Ethanol decreased the amplitude and frequency of smooth muscle. Compared with ethanol, the amplitude and frequency of smooth muscle were reduced by injected into Puerarin in dose-dependent manner. Conclusion: Puerarin could enhance the inhibitory effects of ethanol on small intestine smooth muscle, so it cannot alleviate alcoholism by the above effects.