摘要：
Objective: To observe the clinical efficacy and safety of modi fied Shentong Zhuyu decoction ( 身痛逐瘀汤 ) combinedwith seated position rotation reduction method in the treatment of degenerative lumbar spondylolisthesis of stagnation of Qi and blood stasistype.Methods: From January 2018 to January 2019, 80 patients of degenerative lumabr spondylolisthesis of stagnation of Qi and blood stasistype were randomly divided into the control group and the observation group, with 40 cases in each group. Patients in the control groupwere treated with Celecoxib capsule orally combined with seated position rotation reduction method. Patients in the observation group weretreated with modified Shentong Zhuyu decoction combined with seated position rotation reduction method. The course of treatment was 2weeks. The changes of the total effective rate of treatment, JOA score of low back pain and Visual Analogue Scores (VAS) before and aftertreatment between the two groups were compared. And the incidence of gastrointestinal adverse reactions in two groups was evaluated.Results: ① The total effective rate of clinical treatment was 82.5%(33/40) in the control group, which was significantly lower than thatin the observation group (97.5%)(39/40). The difference between the two groups was significant (P<0.05). ② The JOAscore of the two groups of patients after treatment and during the follow-up period was significantly higher than that before treatment(P<0.05), and the JOA score of the control group was significantly lower than that of the observation group (P<0.05). The Visual AnalogueScores (VAS) of the two groups of patients after treatment and during the follow-up period were signi ficantly lower than those beforetreatment (P<0.05), and the Visual Analogue Scores (VAS) of the observation group was significantly lower than that of the control group(P<0.05). ③ The incidence of gastrointestinal adverse reactions in the control group was significantly higher than that in the observationgroup (P<0.05).Conclusion:The results
作者机构：
[Yu, Xiaoming; Cheng, Yong; Wu, Kemei; Wang, Yan; Wang, Muzou; Zhang, Juntian; Zhu, Chuanjiang; Chu, Shifeng] Chinese Acad Med Sci, Inst Mat Med, Beijing 100050, Peoples R China.;[Yu, Xiaoming; Cheng, Yong; Zhang, Juntian; Wu, Kemei; Wang, Yan; Wang, Muzou; Zhu, Chuanjiang; Chu, Shifeng] Peking Union Med Coll, 1 Xiannongtan St, Beijing 100050, Peoples R China.;[Huang, Huiyong; Chu, Shifeng] Hunan Univ Chinese Med, Collaborat Innovat Ctr Digital Tradit Chinese Med, Key Lab Diagnost Tradit Chinese Med, Changsha 410208, Hunan, Peoples R China.;[Liu, Shaolin] Univ Maryland, Sch Med, Dept Anat & Neurobiol, Baltimore, MD 21201 USA.;[Liu, Shaolin] Univ Maryland, Sch Med, Program Neurosci, Baltimore, MD 21201 USA.
通讯机构：
[Zhang, JT ] P;Peking Union Med Coll, 1 Xiannongtan St, Beijing 100050, Peoples R China.;Chinese Acad Med Sci, Inst Mat Med, Dept Pharmacol, 1 Xiannongtan St, Beijing 100050, Peoples R China.
摘要：
Multi-target drugs, such as the cocktail therapy used for treating AIDS, often show stronger efficacy than single target drugs in treating complicated diseases. This review will focus on clausenamide (clau), a small molecule compound originally isolated from the traditional Chinese herbal medicine, Clausenalansium. The finding of four chiral centers in clau molecules predicted the presence of 16 clau enantiomers, including (-)-dau and (+)-clau. All of the predicted enantiomers have been successfully synthesized via innovative chemical approaches, and pharmacological studies have demonstrated (-)-clau as a eutomer and (+)-clau as a distomer in improving cognitive function in both normal physiological and pathological conditions. Mechanistically, the nootropic effect of (-)-clau is mediated by its multi-target actions, which include mild elevation of intracellular Ca2+ concentrations, modulation of the cholinergic system, regulation of synaptic plasticity, and activation of cellular and molecular signaling pathways involved in learning and memory. Furthermore, (-)-clau suppresses the pathogenesis of Alzheimer's disease by inhibiting multiple etiological processes: (1) beta amyloid protein-induced intracellular Ca2+ overload and apoptosis and (2) tau hyperphosphorylation and neurodegeneration. In conclusion, the nature of the multi-target actions of (-)-clau substantiates it as a promising chiral drug candidate for enhancing human cognition in normal conditions and treating memory impairment in neurodegenerative diseases. (C) 2016 Elsevier Inc. All rights reserved.
