Journal of Traditional Chinese Medicine最新文献

OBJECTIVE

To critically appraise the methodological quality of clinical practice guidelines for headache produced over the last two decades, including those covering specific interventions using Traditional Chinese Medicine.

METHODS

The guidelines on headache disorders were obtained by searching a number of databases, including PubMed, EMBASE, Web of Science, Chinese Biomedical Literature Database, China National Knowledge Infrastructure Database, China Science and Technology Journal Database, and Wanfang database, three guideline-related databases [Guideline-International Network, National Guideline Clearinghouse, and Medlive], and the records of organizations that develop guidelines. The publication date was limited to the period from January 1996 to June 2015. The search terms “headache”, “headache disorders”, “cephalalgia”, “migraine”, “tension-type headache”, “practice guideline”, “consensus “, “statement”, “regulation”, and “recommendation” were used in the “MeSH” and “Free-text” fields. The guidelines were independently appraised by four researchers using the Appraisal of Guidelines for Research and Evaluation II instrument.

RESULTS

A total of 23 guidelines published between 1998 and 2014 were reviewed. The overall consistency of the four appraisers was good [interclass correlation coefficient 0.84; 95% confidence interval (CI) 0.82–0.86]. The mean (standard deviation) scores for scope and purpose, stakeholder involvement, rigor of development, clarity of presentation, applicability, and editorial independence were 52.1 (18.0), 39.5 (17.1), 33.4 (21.0), 49.8 (21.9), 23.8 (19.3), and 24.2 (23.7). Only two guidelines were recommended, 12 were recommended with modification, and nine were not recommended.

CONCLUSION

Physical Traditional Chinese Medicine therapies were recommended to treat headache. The overall quality of headache guidelines was low in China, but evidence-based guidelines are gradually becoming mainstream. Guideline developers should carefully consider, in particular, three domains: rigor of development, applicability, and editorial independence.

OBJECTIVE

To investigate the effect of Banxia Xiexin decoction (BXD) on Helicobacter pylori (Hp)-related peptic ulcers (PUs) and the possible mechanism underlying BXD actions via the transforming growth factor-β/small mothers against decapentaplegic (TGF-β/Smad) signaling pathway.

METHODS

PU patients with cold-heat complex syndrome were randomly assigned to groups that received Chinese or Western medicines with 20 patients in each group. Serum was collected after 7 d of treatment. The healthy group included 20 individuals. Gastric mucosal epithelial cell line GES-1 was cultured in vitro and randomly divided into the following seven groups: control, model, healthy, Western Medicine, prior treatment, low dosage, and high dosage. After 72 h of treatment with the corresponding serum, the mRNA and protein expression levels of TGF-β1, Smad3, and Smad7 were measured by reverse transcription quantitative polymerase chain reaction and western blotting, respectively.

RESULTS

The mRNA expression levels of TGF-β1 and Smad3 in GES-1 cells were increased after Hp introduction, and these increased levels were reduced by the BXD-containing serum. The protein levels of p-Smad3, but not TGF-β1 or Smad3, were significantly increased in Hp-treated GES-1 cells, and treatment with the BXD-containing serum markedly decreased the protein levels. Smad7 expression was significantly enhanced following treatment with the BXD-containing serum at transcriptional and protein levels in a dose-dependent manner.

CONCLUSION

BXD regulates the TGF-β/Smad signaling pathway by inhibiting the expression of TGF-β1 and Smad3, and increasing the expression of Smad7.

OBJECTIVE

To determine whether patients with post-stroke hemiplegia could benefit from long-term treatment with scalp cluster (SC) acupuncture combined with electrical stimulation (ES) and to evaluate the feasibility of this treatment to improve motor and living abilities.

METHODS

Twenty patients were enrolled and divided into two groups: SC acupuncture and SC acupuncture with ES (SC and SC + ES, respectively). All participants also received rehabilitation training. All participants were blindly evaluated using the Fugl-Meyer assessment scale for motor ability, the modified Barthel Index for living ability, and a scale for the degree of neurological deficits. Outcome was assessed at three points before randomized grouping, at the beginning or treatment, and after 4 weeks of treatment.

RESULTS

Following 4 weeks treatment, all the patients exhibited significant improvements in aspects of motor ability, living ability, and the severity of neurological deficits. The experimental group (SC + ES) scored higher on the Fugl-Meyer assessment scale (68 ± 12) and the modified Barthel Index (49 ± 9) than the control (SC) group (50 ± 13, 36 ± 13, respectively).

CONCLUSION

When patients with post-stroke hemiplegia are treated using SC acupuncture with ES, motor and living ability can improve more than if they were treated with SC acupuncture alone.

OBJECTIVE

To evaluate the effect of heat stimulation via scar-producing moxibustion at the acupoints Zusanli (ST 36) and Feishu (BL 13) on the neutrophil-to-lymphocyte ratio (NLR) and quality of life in patients with non-small-cell lung cancer (NSCLC).

METHODS

Seventy patients with NSCLC were randomly assigned into two groups: group A received scar-producing moxibustion at the acupoints Zusanli (ST 36) and Feishu (BL 13) every day for 6 weeks, while group B received no intervention (control group). Outcome measures were the NLR and the scores from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). The NLR and the EORTC QLQ-C30 were assessed at baseline and at the end of 6 weeks.

RESULTS

Five participants dropped out, leaving a final total of 65 participants who completed the trial. Groups A and B had a similar mean NLR at baseline. After the treatment course, the NLR in group A was significantly lower than that in group B (P < 0.001). Compared with group B, the EORTC QLQ-C30 scores in group A were significantly greater in terms of global health status or quality of life (P < 0.001) and function (P < 0.05), and significantly lower in terms of symptoms (P < 0.05).

CONCLUSION

The present study suggests that performing scar-producing moxibustion by heat-stimulating the acupoints Zusanli (ST 36) and Feishu (BL 13) effectively decreases the NLR and improves the quality of life in patients with NSCLC.

OBJECTIVE

To undertake a systematic review and network meta-analysis (NMA) to compare the effectiveness among the different regimens of Salvia miltiorrhiza injection classes (SMICs) for unstable angina pectoris (UAP) treatment.

METHODS

A systematic retrieval was conducted in several literature databases to identify randomized controlled trials focusing on the different regimens of SMICs for UAP treatment until January 2016. The quality assessment was accomplished according to the Cochrane risk of bias tool. Pair-wise meta-analyses were carried out by RevMan 5.3. A random-effects model of NMA was used to compare the different regimens of SMICs with regard to efficacy by STATA 13.0.

RESULTS

A total of 111 studies involving 10 500 patients were included in the NMA. The methodological quality of included studies was not high. Current evidence shows that salvianolate (SI) is the optimal treatment for UAP in improving the total efficacy against UAP. Guanxingning (GXN) is the optimal treatment for UAP for improving the total effectiveness of electrocardiography.

CONCLUSION

SMICs have advantages in preventing cardiovascular events. GXN, SI, and Danhong had the greatest probability of being the best treatment in the total efficacy against UAP and for improving the total effectiveness of electrocardiography.

OBJECTIVE

To systematically evaluate the effect of conventional medical treatment plus Qigong exercise on type 2 diabetes mellitus (T2DM) in Chinese patients.

METHODS

A literature search was conducted in PubMed, Medline, Embase, China National Knowledge Infrastructure Database, Wanfang and China Science and Technology Journal Database until on January 2017. In this Meta-analysis, enrolled were the studies, including experimental group (with conventional medical treatment plus Qigong therapy) and control group (with conventional medical treatment plus diet control or other exercises). Then, the standardized mean differences (SMDs) of fasting blood-glucose (FBG), 2-hplasmaglucose (2hPG), hemoglobinAlc (HbAlc), triglyceride (TG), total cholesterol (TC), high-density lipoprotein (HDL) and low density lipoprotein (LDL), as well as their 95% confidence interval (CIs) were calculated to evaluate the effect of Qigong on patients with T2DM by RevMan 5.2 and Stata 11.0 software.

RESULTS

Totally 834 cases of T2DM from 11 studies were included in this review. The pooled SMDs with its 95% CIs of FBG, 2hPG, HbAlc, TG, TC, HDL and LDL were – 0.70 (– 0.93, – 0.47), – 0.66 (– 1.11, – 0.21), – 0.73 (– 0.96, – 0.50), – 1.05 (– 1.67, – 0.43), – 0.42 (– 1.12, 0.28), 0.69 (0.19, 1.19), and – 0.26 (– 0.69, 0.18), respectively. The pooled data showed significantly difference between Qigong and the levels of FBG, 2hPG, HbA1c, TG, and HDL in patients with T2DM (P < 0.05).

CONCLUSION

Combining with conventional medical treatment, Qigong exercise might have significant effect on T2DM in Chinese patients.

OBJECTIVE

To investigate the involvement of growth arrest specific 5 (GAS5), a long non-coding RNA, in the anti-hepatic fibrosis process induced by Dahuang Zhechong pill (DHZCP) in rats.

METHODS

Thirty adult rats were divided into three groups, including a control group, a CCl₄-induced fibrosis group and a DHZCP-treated fibrosis group. Hematoxylin-eosin and Masson staining were used for histopathological study. Serum enzymes, cytokines and cell proliferation were assayed using commercially available kits. A GAS5 lenti-virus vector was constructed to further investigate the role of GAS5 in the anti-hepatic fibrosis effect of DHZCP in rats.

RESULTS

Our results revealed that the proliferation of hepatic stellate cells cultured in serum derived from rats treated with DHZCP was significantly decreased, compared with cells treated with serum from the untreated rats. DHZCP alleviated the CCl₄-induced hepatic fibrosis. Additionally, DHZCP can restore the expression of GAS5, which was significantly decreased in the CCl₄-induced group, and markedly suppress the expression of p-p38 and p-Erk induced by CCl_4, but not p-Jnk. Cell proliferation was significantly arrested when cells overexpressed GAS5. Thus, DHZCP can inhibit the expression of p-p38 and p-Erk, while GAS5 can only inhibit the expression of p-Erk.

CONCLUSIONS

DHZCP can alleviate hepatic fibrosis by increasing the expression of GAS5 to suppress p-Erk and regulating other factors to inhibit p-p38.

De Qi refers to a series of sensations experienced when acupuncture is performed at acupoints. De Qi comprises needling sensations felt by the patient, and the sensations perceived by the acupuncturist. Classical Traditional Chinese Medicine theory states that De Qi is closely related to curative effect. In modern studies, the main index that researchers have used to evaluate De Qi was the needling sensation reported by the patient. Between 1st Aug and 31st Oct 2014, we conducted an electronic database search of all fields in Chinese and English to select literature assessing acupuncture needle sensations. We then reviewed the methods used within these studies to evaluate De Qi. The methods included simple evaluation, and the use of a De Qi scale/questionnaire. The simple evaluation, a qualitative evaluation, was judged by typical sensations felt by the patient after needling at acupoints, such as soreness, numbness, fullness, and heaviness. This method was easy and practicable, and had been adopted widely by Chinese researchers. In contrast, the De Qi scale/questionnaire, a quantitative evaluation, had multiple compiling methods available for evaluating the intensity of De Qi. The standardization and objectification of the De Qi scale/questionnaire effectively improved the quality of studies on De Qi, thereby these scales/questionnaires have been acknowledged and applied by most researchers. The present review analyzed and compared the scales/questionnaires used to evaluate De Qi; furthermore, we provided suggestions for the development and improvement of these questionnaires through integration with classical De Qi theory.

OBJECTIVE

To investigate the effects of Ningmitai capsule combined with sertraline on patients with premature ejaculation (PE) and an increased anterior-posterior diameter (APD) of the seminal vesicles (SVs).

METHODS

Sixty men with acquired PE were enrolled and randomly divided into two groups. The combined group was treated with Ningmitai capsule and sertraline, while the control group was treated with sertraline alone. Main outcomes were measured using the premature ejaculation diagnostic tool (PEDT), APD of SVs, and Clinical Global Impression of Change questionnaire and compared before and after 3 months of treatment.

RESULTS

Comparing after treatment with before treatment outcomes within each group, the PEDT score was significantly reduced in the combined group (12.1 ± 2.5 vs 8.6 ± 3.2, P < 0.001, respectively) and control group (12.9 ± 2.6 vs 10.3 ±1.6, P < 0.001, respectively). Furthermore, the PEDT score after treatment was significantly lower in the combined compared with control group (8.6 ± 3.2 vs 10.3 ± 1.6, P = 0.011, respectively). The APD of SVs in the combined group was significantly decreased after treatment [(10.8 ± 2.4) vs (12.9 ± 2.2) mm, P = 0.001], while the APD of SVs in the control group was equivalent before and after treatment. The treatment response rate was not significantly higher in the combined compared with control group.

CONCLUSION

These results indicated that the effect of Ningmitai capsule combined with sertraline was better than that of sertraline alone for the treatment of PE patients exhibiting an increased APD of SVs. The therapeutic effect found for the combined treatment may be due to antibacterial and anti-inflammatory activity reported for Ningmitai capsule, and may suggest that seminal vesiculitis is a potential pathophysiological factor in acquired PE.

OBJECTIVE

To observe the effect of stimulating Qihai (CV 6) and bilateral Tianshu (ST 25) with herb-partitioned moxibustion (HPM) in rats with Crohn's disease (CD), and to investigate the possible anti-inflammatory mechanism of HPM.

METHODS

Forty rats were randomly divided into four groups (n = 10 rats per group): normal control (NC), model control (MC), mesalamine (MES), and HPM. The CD rat model was established in the MC, MES, and HPM groups by administering a mixture of trinitrobenzenesulfonic acid and alcohol via enema. The HPM group received HPM on Qihai (CV 6) and bilateral Tianshu (ST 25), while the MES group received intragastric mesalamine. Colonic histomorphological scores, and serum concentrations of tumor necrosis factor α (TNF-α) and interleukin 1β (IL-1β) were assessed to evaluate the effects of HPM on colonic reparation and anti-inflammation. The expressions of Toll-like receptor 4 (TLR-4), nuclear factor κB inhibitor α (IkB-α), IkB kinase α/β (Iκκα/β), and NF-κB p65 were further analyzed to investigate the regulatory effects of the interventions on the TLR4/NF-κB pathway.

RESULTS

CD rats showed inflammatory colonic damage and increased serum concentrations of TNF-α and IL-1β. The expressions of TLR4, IKKα/β, and NF-κB p65 in the colons of CD rats were significantly increased compared with the NC group, while the expression of IκBα (a key negative regulator of NF-κB p65) was decreased. HPM significantly mitigated colonic damage and reduced the serum concentrations of TNF-α and IL-1β. HPM downregulated the expressions of TLR4, IKKα/β, and NF-κB p65 in the colon, and upregulated the expression of IκBα. The effects of HPM in CD rats were similar to those of mesalamine.

CONCLUSION

HPM alleviates colonic inflammation in CD rats. This may be achieved through regulation of TLR4, which induces NF-κB signal transduction.