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Background: Using Huanglian Jiedu decoction (HJD) as a model, this study systematically compares the traditionally prepared combined decoction with mixtures of separately decocted components, focusing on differences in chemical composition, material properties, and transcriptomic responses. Methods: To maintain consistency, both the combined HJD decoction and the single-herb mixture were prepared using a standardized method, and their chemical profiles were analyzed by HPLC and UPLC-MS/MS to identify constituent differences. Physical properties were examined through key parameter measurements and phase behavior analysis, and the integration of chemical and physical data identified the components driving the observed material changes. Transcriptome sequencing compared the two decoction types, highlighting differentially expressed genes and the major regulatory pathways involved. Results: HPLC analysis showed a clear redistribution of components between the two decoction methods, with the combined decoction containing higher levels of alkaloids such as coptisine chloride, epiberberine, palmatine chloride, jatrorrhizine hydrochloride, and phellodendrine chloride, while the single decoction mixture had higher levels of berberine hydrochloride and baicalin. In the combined decoction, the berberine hydrochloride content was 37.04 mg/g, and the baicalin content was 15.57 mg/g; in the single decoction, the berberine hydrochloride content was 41.15 mg/g; in the combined decoction, the baicalin content was 40.07 mg/g. UPLC-MS/MS analysis confirmed clear differences between the two decoctions, mainly in flavonoid and alkaloid compositions. The combined decoction contains 110 flavonoid compounds and 67 alkaloid compounds, while the single decoction contains 100 flavonoid compounds and 80 alkaloid compounds. Physical measurements showed that the combined decoction had higher total dissolved solids, conductivity, and salinity, while the single decoction had higher resistivity. The combined decoction had a TDS of 2480 mg/L, σ of 4.95 ms/cm, S of 0.26%, and ρ of 202 Ω·cm; the single decoction had a TDS of 1190 mg/L, σ of 2.37 ms/cm, S of 0.12%, and ρ of 419 Ω·cm. Phase separation analysis indicated that the combined decoction formed a stable nanoscale phase structure, whereas the single decoction remained unstable. Transcriptome sequencing at various concentrations revealed marked differences in gene expression between the two preparations, reflecting their distinct biological activities. Conclusions: Analysis showed clear differences in chemical composition, physical properties, and gene expression in the combined decoction. Taking Huanglian Jiedu decoction as a representative example, we systematically compared the specific differences between combined and single decoction methods, providing a reference basis for subsequent pharmacodynamic evaluation and clinical application.

Background Combined decoction (CD)—boiling multiple herbs together—is a fundamental preparation method in Traditional Asian Medicine. While biological synergies are well documented, chemical interactions during the decoction process itself remain largely unexplored. Understanding these preparation-dependent chemical modifications is crucial for standardizing and modernizing traditional herbal medicines. Methods We developed a systematic analytical framework combining theoretical additive modeling with structural similarity analysis to investigate structure-dependent extraction in CD. Using Palmijihwang-tang as a proof-of-concept model, we used liquid chromatography–quadrupole time-of-flight mass spectrometry (LC-QTOF-MS) to compare chemical profiles of CD with predicted profiles from individual decoctions (ID). We then predicted drug-likeness and bioactivity in silico and validated our findings with cell-based assays. Results CD systematically modified compound extraction based on structural features, selectively enhancing certain structural groups while suppressing others. These distinct extraction patterns correlated with the compounds' physicochemical properties, structural complexity, and predicted therapeutic properties—suggesting an empirically optimized process. Cell-based assays confirmed these chemical alterations lead to measurable biological differences between CD and ID preparations. Conclusions Our findings suggest that CD selectively modifies the chemical composition of herbal formulations through structure-dependent extraction, providing a preliminary chemical basis for better understanding traditional decoction practices. This highlights the critical importance of considering preparation methodology in herbal medicine standardization. Our analytical framework opens new avenues for investigating these CD effects across a wider range of traditional prescriptions. We believe this approach may ultimately contribute to the improved understanding and standardization of this fundamental method in Traditional Asian Medicine.

Background MicroRNAs (miRNAs) play vital roles in acute inflammatory and antiviral responses during influenza A virus (IAV) infection. The Xijiao Dihuang decoction combined with Yinqiao powder (XDY) is applied to remedy viral pneumonia in China and its therapeutic efficacy in pneumonic mice challenged with IAV was demonstrated; however, the underlying mechanisms remain elusive. Thus, this study aimed to explore the miRNA-mRNA profiles in the lungs of IAV-infected mice and investigate the therapeutic mechanisms of XDY involving miRNAs and associated pathways. Methods We detected the cellular miRNA contents in the lungs of mice treated with XDY (23 g/kg/d) for A/FM/1/47 (H1N1) (FM1) infection at 4 days postinoculation (dpi) and 7 dpi. MiRNA and mRNA high-throughput sequencing analyses, and miRNA and mRNA qRT-PCR analyses were used to detect and verify the relevant miRNAs and mRNAs. Conjoint analysis, GO enrichment analysis, and KEGG database analysis were applied to identify the miRNA-mRNA regulatory relationships. Results The quantities of differentially expressed miRNAs and mRNAs were upregulated over time. The data showed that 104 miRNAs and 3485 mRNAs were differentially expressed after challenge with FM1 on day 4, while 191 miRNAs and 6126 mRNAs were differentially expressed on day 7. The GO enrichment analysis and KEGG database data showed that the differentially expressed miRNAs and mRNAs were mainly enriched in JNK activity, MAPK phosphatase activity, and the TLR, Jak-STAT and TNF signalling pathways after treatment of FM1 infection with XDY. Generally, the expression trends of differentially expressed miRNAs and mRNAs based on the qRT-PCR results exhibited good consistency with the results of the high-throughput sequencing analysis. Conclusions MiRNAs and mRNAs were differentially expressed during FM1 infection. The therapeutic mechanisms of XDY in FM1-infected mice, might be related to regulating antiviral immunity and ameliorating excessive inflammatory responses by modulating the expression of dysregulated miRNAs and mRNAs involved in the ERK/JNK-AP-1, and IFN-β/STAT signalling pathways.

Significant progress is made in the treatment of metastatic colorectal cancer (mCRC) patients, however, therapeutic options remain limited for patients with mCRC. In recent years, traditional Chinese medicine (TCM) has gained significant attention. Among these, Huangqin Houpo decoction has demonstrated efficacy in mCRC treatment. Despite its promise, the active ingredients and mechanisms underlying its anticancer effects remain unclear. Using integrative pharmacological approaches, six compounds are identified as the primary active ingredients in Huangqin Houpo decoction. Among them, honokiol (H), magnolol (M), and baicalin (B) are found to exhibit a synergistic anticancer effect on CRC. The HMB combination significantly outperforms mono‐ or bi‐agent treatments in reducing tumor growth. Furthermore, the anticancer efficacy of the HMB combination surpasses that of medium‐ and high‐dose Huangqin Houpo decoction and the FOLFOX regimen. Notably, HMB is comparable in efficacy to the FOLFIRI regimen. Most importantly, HMB is shown to enhance the sensitivity of CRC cells to anti‐PD‐1 immunotherapy in vivo. Mechanistic studies reveal that the HMB combination exerts its synergistic anticancer effects and enhances anti‐PD‐1 immunotherapy by inducing GSDME‐dependent pyroptosis. Our study will hopefully provide a potential therapeutic strategy for mCRC patients in the future. [Correction added on 25 February 2025, after first online publication: FOLFOIRI is changed to FOLFIRI.] In this study, Honokiol (H)‐magnolol (M)‐baicalin (B) is identified as the primary active ingredients of Huangqin Houpo decoction. The HMB combination not only possesses potent synergistic anticancer activity, but also enhances the effectiveness of anti‐PD‐1 immunotherapy by inducing GSDME‐dependent pyroptosis in CRC cells.

Objective This study was performed to investigate the effect of acupuncture combined with Buyang Huanwu decoction in patients with ischemic stroke. Methods In total, 115 patients with ischemic stroke were recruited and divided into 3 groups. The control group received normal treatment, the acupuncture group received additional acupuncture treatment, and the combined group received additional acupuncture combined with Buyang Huanwu decoction treatment. The National Institutes of Health Stroke Scale (NIHSS) and Chinese Stroke Scale (CSS) were used to evaluate the stroke condition, and the Barthel index (BI) was used to measure life quality. Blood lipids and recurrence were also analyzed. Results The CSS and NIHSS scores were significantly lower in the acupuncture group and combined group than in the control group; however, the BI score was significantly higher in the acupuncture group and combined group. Similarly, the levels of cholesterol, triglycerides, and low-density lipoprotein were all significantly increased, while the level of high-density lipoprotein showed no significant difference in all groups. The recurrence rate was significantly lower in the combined group than in the other two groups. Conclusion Acupuncture combined with Buyang Huanwu decoction could improve the clinical outcomes and reduce the recurrence rates in patients with ischemic stroke.

Background Patients with advanced non-small cell lung cancer (NSCLC) harboring mutations of the epidermal growth factor receptor ( EGFR ) gene respond well to the EGFR tyrosine kinase inhibitor (TKI) gefitinib. Chinese herbal medicine (CHM) has been used as a complementary therapy for cancer for decades in China. CHM was proved to be effective in improving the quality of life (QOL) and reducing the toxicity associated with chemotherapy in patients with NSCLC. The purpose of the present trial is to determine whether CHM ( Fuzheng Kang’ai decoction (FZKA), a CHM formula) combined with gefitinib results in longer progression-free survival with less toxicity than gefitinib alone. Methods/Design This is a randomized, placebo-controlled, double-blind trial. This trial is designed to determine if CHM (FZKA) combined with gefitinib results in longer progression-free survival with less toxicity than gefitinib alone. A total of 70 NSCLC patients with EGFR mutations will be randomly assigned to treatment group (gefitinib plus FZKA granules) or control group (gefitinib plus placebo). The primary endpoint is progression-free survival. Secondary endpoints are: (1) overall survival; (2) disease control rate; (3) QOL, measured with the questionnaire of Functional Assessment of Cancer Therapy-lung (FACT-L 4.0) and Lung Cancer Symptom Scale and (4) safety. Discussion In previous clinical practice, we found that CHM (FZKA) could improve the therapeutic efficacy of gefitinib. This study will provide objective evidence to evaluate the efficiency of CHM combined with gefitinib in NSCLC patients with EGFR mutations, and may provide a novel regimen for patients with NSCLC. Trial registration Chinese Clinical Trial Registry ( www.chictr.org ): ChiCTR-IOR-14005679 , registered 17 December 2014.

Pneumonia is one of the most serious infectious diseases for elderly people who have impaired organ functions and are more susceptible to infection. Elderly patients having pneumonia often need long-term hospitalization, leading to declined quality of life, and increase of financial burden to the society and their family. Therefore, studies on novel therapeutic strategies and the clinical prognosis of the pneumonia patients are imperative. In the present study, we found that the Chinese herbal medicine Fu Zheng decoction had great immunomodulatory effects during the recovery period of elderly pneumonia patients. Patients treated with combined treatment of Fu Zheng decoction and antibiotic had a faster decline of temperature and a more significant decrease of C reactive protein and inflammatory factors level, and it is easier for them to cough off phlegm, compared with the antibiotic only treatment. Furthermore, the inflammation absorption and the reduction of NK-cell proportion as well as the inflammatory factors were more remarkable in the patients taken Fu Zheng decoction. Especially, the Fu Zheng decoction treatment could decrease the duration of antibiotic treatment, which may help reduce the side effects of antibiotics. Our study also found that MyD88 might play a role in the immunomodulatory effect of Fu Zheng decoction. Our study provides novel insight for the further development of intravenous injection of Chinese materia medica preparation on the regulation of immune function.

Background The modified Si-Jun-Zi Decoction (SJZ), a Chinese medicine formula, is clinically used against multiple malignancies including colorectal cancer (CRC). This study aims to evaluate the effect of modified SJZ on CRC liver metastasis and identify the therapeutic mechanisms. Methods Human CRC cells with GFP fluorescence were transplanted into Balb/c nude mice spleens. Modified SJZ, 5-fluorouracil or the combined treatment was given for 3 weeks. CRC liver metastasis was measured by fluorescence imaging and plasma cytokines were analyzed. Furthermore, the effects of administration time and doses for the modified SJZ were investigated in nude mice. Results Modified SJZ could increase the survival rate and reduce CRC liver metastasis in the nude mice model. Plasma GM-CSF level was elevated. Three weeks of treatment with the modified SJZ at the full dose (45 g/kg) could significantly increase the number of macrophages but not neutrophils in the spleen. Conclusions These results indicate that modified SJZ can inhibit CRC liver metastasis by activating the innate immune system, providing a complementary and alternative therapy for CRC.

Lung cancer is the most common type among all malignant tumors, bringing huge pain and mood disorders to patients suffering from it. This study aims to evaluate the effect of the Feiji Decoction for soothing the liver combined with psychotherapy for depression and anxiety on patients with primary lung cancer. It also aims to further explore the relationship between depression and anxiety. A total of 118 patients with primary non-small cell lung cancer were randomly divided into two groups. The combined therapy group consisted of 57 patients who were treated with Feiji Decoction for soothing the liver and psychotherapy combined with chemotherapy. The control group consisted of 61 patients who were treated with chemotherapy only. Both groups were observed for two treatment courses. The Zung Self-reported Depression Scales (SDS) and Zung Self-reported Anxiety Scales (SAS) were used to assess the patients' psychology status in both groups before and after treatment scales. After treatment, the depression and anxi

Introduction: Shaofu Zhuyu Decoction (SZD) is a traditional Chinese herbal formula commonly used for gynecological disorders involving “blood stasis” and lower abdominal pain. Although applied clinically for endometriosis, evidence regarding its efficacy and safety remains fragmented. This systematic review and meta-analysis aimed to evaluate the clinical efficacy and safety of SZD combined with conventional medication (CM) for the treatment of endometriosis. Methods: Databases including PubMed, EMBASE, CNKI, and Web of Science were searched from inception to May 2024 for randomized controlled trials (RCTs) comparing SZD + CM versus CM alone. Risk of bias was assessed using the risk of bias 2.0 tool. The primary outcome was total effective rate (TER); secondary outcomes included serum CA-125 levels, pain scores (VAS), recurrence rate, and adverse events. Results: Eleven RCTs (n = 1186 patients) were included. Meta-analysis showed that SZD plus CM significantly improved TER compared to CM alone (OR 1.15; 95% CI: 1.09–1.22; p < 0.00001). Reductions in CA-125 levels (OR −1.57; 95% CI: −2.18 to −0.95; p < 0.00001) and pain (VAS) scores (OR −4.90; 95% CI: −6.82 to −2.98; p < 0.00001) were also significant. Three studies reported lower recurrence in the SZD group. Adverse events were generally mild and comparable between groups. Conclusions: SZD combined with CM appears more effective than CM alone in improving endometriosis symptoms, reducing biochemical markers, and decreasing pain intensity, with acceptable safety. However, the findings are limited by methodological heterogeneity and geographic concentration of studies. Rigorous multicenter trials are warranted to support integration of SZD into global endometriosis care.