Zhong xi yi jie he xue bao = Journal of Chinese integrative medicine最新文献

Objective: The study was carried out in order to evaluate the prevalence of burnout in physiotherapists, and to assess whether "White Ball" Qigong exercises may be effective in burnout. This was aimed to provide preliminary data for the preparation and development of a larger study.

Methods: Physiotherapists completed a demographic questionnaire and the Maslach Burnout Inventory (MBI) questionnaire. For the intervention and the control groups, the authors selected those physiotherapists with the highest levels of burnout on the most important subscale. The intervention group (eight physiotherapists) performed a specific qigong intervention as developed by the Heidelberg School of Chinese Medicine; the control group consisted of eight physiotherapists on a waiting list. At the end of a three-week period of treatment or waiting list, both groups repeated the MBI for the comparison of results.

Results: Of 106 physiotherapists (36 males and 70 females) assessed by the MBI, Emotional Exhaustion subscale was seen in 52 (49.1%), Depersonalization subscale in 36 (33.9%), and Burnout in the Personal Accomplishment subscale in 33 (31.2%), of whom 4 (3.8%) suffered to a severe degree and 29 (27.4%) moderately. Within the study group qigong lowered the mean values of Emotional Exhaustion subscale from 38.0 to 31.4, whereas in the control group the values rose from 33.9 to 37.9. The differences between the two groups were statistically significant (P=0.023). Qigong lowered the mean value of Depersonalization subscale from 10.8 to 6.8. In controls the value rose from 7.3 to 10.6. The difference between the two groups was statistically significant (P=0.013). The mean values of Personal Accomplishment subscale decreased in both groups: from 35.4 to 33.9 in the intervention group, and from 37.5 to 37.1 in the control group. The difference between the two groups was not statistically significant.

Conclusion: The effects of "White Ball" Qigong on burnout symptoms are measurable by the MBI. The results are compatible with the thesis that this type of qigong is an effective tool for the self-management of burnout. It is easy to integrate into a daily routine as it takes only 2×5 min per day. On the basis of this evaluation, a study design can now be developed on a larger scale with appropriate blinding, follow-up testing and adequate controls.

Background: Total knee replacement surgery is commonly used in end-stage diseases of the knee. It is important for improving surgical efficacy and patient satisfaction by promoting early rehabilitation of patients and improving knee function.

Objective: To observe the effects of early application of Tuina treatment on quadriceps surface electromyography (EMG) in patients with rheumatoid arthritis having undergone total knee arthroplasty.

Design, setting, participants and intervention: The study was performed at the Orthopedic Department of Huashan Hospital, Fudan University, and the Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine from June 2010 to September 2011. A total of 66 patients with rheumatoid arthritis who had undergone total knee replacement surgery were randomly divided into control group and observation group, 33 cases in each. The patients in the control group were administered with continuous passive training (CPM), and the patients in the observation group were treated with CPM combined with Tuina, from prior surgery to four weeks post-surgery.

Main outcome measures: The knee function was evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire at baseline and 4 weeks after the surgery. Quadriceps surface EMG was also detected at the same time points.

Results: After 4 weeks of Tuina and comprehensive rehabilitation intervention, the WOMAC questionnaire score of the observation group was decreased compared with the control group (P<0.01); median frequency and integrated electromyography of the rectus femoris and vastus medialis muscles, which were recorded by EMG, in the observation group were higher than those in the control group (P<0.01).

Conclusion: Tuina can improve the recovery of patients who have undergone total knee replacement by increasing quadriceps EMG.

Objective: To explore the effects of exercise and Danzhi Jiangtang Capsule (DJC), a compound traditional herbal medicine, on the JNK signaling pathway in pancreatic tissues of diabetic rats and to investigate the possible mechanisms of exercise and DJC in treating diabetes.

Methods: Seventy-eight male Wistar rats were injected with low dose of streptozotocin and fed a high-fat diet to establish a diabetic model in rats. Then 60 diabetic rats were divided into diabetes group, exercise group, DJC group and exercise combined with DJC group. Another twelve rats were used as normal control. After eight months of treatment, the expression levels of phosphor-c-Jun N-terminal kinase (p-JNK), pancreatic and duodenal homeobox-1 (PDX-1), and insulin protein in pancreatic tissues from rats were detected by immunohistochemical method and Western blotting.

Results: In pancreatic tissues of diabetes group, the expression level of p-JNK protein was significantly higher than that in the normal group (P<0.01), and the expression levels of PDX-1 and insulin protein were significantly decreased (P<0.01). After administration of exercise and DJC, the expression level of p-JNK protein in pancreatic tissues of the diabetes group was decreased significantly, while the expression levels of PDX-1 and insulin protein were increased significantly (P<0.05 or P<0.01).

Conclusion: Exercise and DJC effectively protect isletβ-cell function in diabetic rats, which might be due to a decreased JNK signaling pathway.

Background: Vascular dementia (VaD) is the second common subtype of dementia after Alzheimer's disease. However, there is still a lack of medication that demonstrates clinically relevant symptomatic improvement. Static blood obstructing the brain is the main Chinese medicine syndrome of VaD.

Objective: To evaluate the effects of Chinese medicine for promoting blood circulation and removing blood stasis in patients with mild to moderate VaD.

Design, setting, participants and interventions: In this 12-week randomized, double-blind, parallel-controlled trial, a total of 48 patients with mild to moderate VaD were enrolled between March 2009 and December 2010. All the patients entered a two-week placebo run-in period followed by a 12-week treatment with Chinese medicine for promoting blood circulation and removing blood stasis (n=24) or placebo (n=24), respectively. The placebo tablets have the identical taste and appearance as the Chinese medicine tablets.

Main outcome measures: The primary outcome measure was the Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog); the secondary outcome measures included the Activities of Daily Living (ADL) and the Mini-Mental State Examination (MMSE).

Results: The Chinese medicine group showed a slight deterioration of 0.25 points and the placebo group showed a deterioration of 2.35 points from baseline by the ADAS-cog, and there was a significant difference between the two groups (P=0.027). The ADL and the MMSE showed no significant difference from baseline in both groups. Adverse events were rare in both groups.

Conclusion: The Chinese medicine for promoting blood circulation and removing blood stasis may improve cognition and it is safe and well tolerated.

Objective: To explore the intervention effects of Xiaopi Pill (XPW), a compound traditional Chinese herbal medicine, on the development progress of dimethylnitrosamine (DMN)-induced liver fibrosis in rats.

Methods: Liver fibrosis model was established by intraperitoneal injection of 0.5% DMN 2 mL/kg thrice a week for 4 weeks. Rats were divided into control group given saline and treatment group given XPW during the 3rd week of DMN injections. Rats were sacrificed at the end of the experiment, and then liver histological changes, liver function and mRNA expression of the liver fibrosis-associated markers were observed.

Results: (1) At the end of the 2nd and 4th weeks of DMN injection, serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and alkaline phosphatase (ALP) increased significantly in rats (P<0.01 or P<0.05); content of total bilirubin (TBil) increased significantly compared with the normal group until the end of the 4th week (P<0.05); compared with the model group after 4 weeks of DMN injection, the serum levels of ALT, AST, ALP and TBil were decreased remarkably in the XPW-treated group (P<0.01 or P<0.05). (2) The hepatic inflammation and collagen deposition in hepatic tissues increased by different degrees in experimental rats. Parts of pathological changes in the rat liver were found at the end of the 4th week, including a complete round structure of false flocculus round, meantime, the hydroxyproline content of hepatic tissue was increased significantly at the end of the 2nd and 4th weeks (P<0.05). Compared with the 4-week model group, the hepatic inflammation, collagen deposition and hydroxyproline content in hepatic tissues were alleviated dramatically (P<0.05). (3) Compared with the normal and 2nd week groups, protein expression of alpha-smooth muscle actin (α-SMA) was gradually increased, and that of the 4th week group were aggrandized significantly (P<0.01). Compared with the normal group, the mRNA expression of α-SMA, transforming growth factor-β1 (TGF-β1), tissue inhibitor of metalloproteinase-1 (TIMP-1), and heme oxygenase-1 (HO-1) was gradually increased. Further changes in above-mentioned abnormalities were found in the model rats at the end of the 4th week (P<0.01); while compared to the 4th week group, protein and mRNA levels of α-SMA and mRNA levels of TGF-β1, TIMP-1, and HO-1 were decreased significantly in the XPW group (P<0.01 or P<0.05).

Conclusion: Progressive DMN-induced liver fibrosis in rats can be suppressed by XPW; the mechanism may be associated with inhibition of the activated hepatic stellate cells.

Objective: To establish a quantitative estimate model for diagnosing traditional Chinese medicine (TCM) syndromes of patients with osteoporosis.

Methods: Symptoms and signs of osteoporosis and methodology related to syndrome research were collected by reviewing medical literature. The symptoms and sighs were quantitatively classified into three, two or one category according to a 100-mm visual analog scale. Fuzzy comprehensive evaluation model of TCM qualitative syndromes was performed based on analytic hierarchy process. Then "Hall for Workshop of Metasynthetic Engineering" expert symposium was held on subjects of syndrome quantification method and weight of evaluation indices in different levels for developing the analysis model of common syndromes. For clinical verification, the created models were applied to patients with osteoporosis for discriminating syndromes. Syndrome of each patient was also identified by 8 experts major in integrative medicine treating osteoporosis for comparing the coincidence rate using a self-made clinical questionnaire.

Results: Through literature reviewing, symptoms and signs quantification and expert discussing, the authors formed estimate models of essence deficit, qi deficiency, yin deficiency, yang deficiency, and blood stasis. A total of 220 patients with osteoporosis were enrolled and filled the clinical questionnaire. All 8 experts completed and returned the questionnaire (1 760 cases), and 1 545 of them were filled in completely. Experts' opinion on syndrome differentiation was exactly coincidence to estimate model in 611 cases and almost coincidence in 639 cases. The total coincidence rate reached to 94.05%.

Conclusion: The estimate model for syndrome differentiation of osteoporosis has a high-coincidence rate with the fuzzy evaluation from experts, with good rationality and feasibility, and is worthy of promotion in the clinical study.

Objective: In this study, the optical data of tongue color of different syndromes in primary hepatic carcinoma (PHC) were detected by optical spectrum colorimetry, and the chromaticity of tongue color was compared and analyzed. The tongue color characteristics of different syndromes in PHC and the relationship between different syndromes and tongue color were also investigated.

Methods: Tongue color data from 133 eligible PHC patients were collected by optical spectrum colorimetry and the patients were divided into 4 syndrome groups according to their clinical features. The syndrome groups were liver depression and spleen deficiency (LDSD), accumulation of damp-heat (ADH), deficiency of liver and kidney yin (DLKY), and qi stagnation and blood stasis (QSBS). The variation characteristics of chromaticity coordinates, dominant wavelength, excitation purity and the distribution in the International Commission on Illumination (CIE) LAB uniform color space were measured. At the same time, the differences of overall chromatism, clarity, chroma, saturation and hue were also calculated and analyzed.

Results: PHC patients in different syndrome groups exhibited differences in chromaticity coordinates. The dominant wavelength of QSBS was distinctly different from that of the other 3 syndromes. Excitation purity in the syndromes of LDSD, ADH and DLKY showed gradual increases (P<0.01). Different syndromes in the CIE LAB color three-dimensional space showed differences in tongue color distribution areas. The CIE hue-angle value of QSBS was negative, and different from that of the other 3 syndromes (P<0.01). CIE chroma in the syndromes of LDSD, ADH and DLKY showed gradual increases (P<0.01), the same as excitation purity. In the comparison of chromatism, tongue color variations in different syndromes were quantified by human observation.

Conclusion: This study shows that tongue color diagnosis according to the syndrome classifications of traditional Chinese medicine can be quantified with optical spectrum colorimetry technology. Different syndromes in PHC exhibit distinct chromatisms of tongue color through the calculation and analysis of chromaticity parameters of CIE, combined with colorimetric system and CIE LAB color space, and these are consistent with the characteristics of clinical tongue color. Applying optical spectrum colorimetry technology to tongue color differentiation has the potential to serve as a reference point in standardizing traditional Chinese medicine syndrome classification in PHC.

Objective: To investigate the effects of icariin, an effective extract from traditional Chinese medicine Epimedium pubescens with the function of tonifying kidney, in promoting osteogenesis of mesenchymal stem cell line C3H10T1/2, and to explore the underlying mechanism.

Methods: After culture with icariin (0, 10(-7), 10(-6), 10(-5), and 10(-4) mol/L) and osteogenic supplement for 26 d in vitro, osteogenic differentiation of C3H10T1/2 cells was detected by alkaline phosphatase (ALP) assay. The RNA was extracted from cells cultured with 10(-5) mol/L icariin for 2, 8, 24 and 48 hours, and mRNA expressions of p38, p42 and p44 were measured using real-time reverse transcription-polymerase chain reaction (PCR) method. Three main proteins of MAPK signaling pathway (p38, and extracellular signal-regulated protein kinase (ERK), also named p42/44) and c-Jun N-terminal kinase (JNK) and their phospho-products were examined using Western blotting after icariin treatments of 10, 30, 60 and 120 min.

Results: Icariin at a dose of 10(-5) mol/L, when combined with the osteogenic supplement, had the best ability to promote osteogenic differentiation on C3H10T1/2 cells. Based on real-time PCR, the authors found that after two-hour ICA treatment, the gene expression of p38 revealed a significant decline compared with the control group (P<0.01). The levels of p42 and p44 mRNAs were decreased greatly after two-hour ICA treatment, while increased after 48-hour ICA treatment (P<0.05, P<0.01). There was no significant difference at other time points (P>0.05). Phospho-p42 was decreased after 10-minute icariin treatment, while phospho-p38 expression displayed an increase after 10- and 30-minute of treatment with icariin. There was no notable difference in phospho-JNK expression at these four time points.

Conclusion: Icariin promotes differentiation of the mesenchymal stem cells C3H10T1/2 into osteoblasts, and its effect is related to the restraining of ERK expression and activation of p38 expression in the MAPK signaling pathway.