Pub Date : 2024-09-01DOI: 10.1016/j.joim.2024.08.004
Shu-rui Yang , Li Chen , Dan Luo , Ya-yuan Wang , Feng-xia Liang
Obesity, a widespread global health issue, is frequently linked to disrupted lipid metabolism, resulting in excessive accumulation of adipose tissue and associated health complications. Acupuncture, a traditional Chinese medical modality, has exhibited potential as a viable intervention for addressing obesity. The underlying mechanism proposed involves the stimulation of specific acupoints to exert a regulatory influence on hepatic function. The liver has a central role in lipid metabolism, including processes such as lipid synthesis, storage and distribution. Acupuncture is believed to enhance the liver’s efficiency in processing lipids, thereby reducing lipid accumulation and improving metabolic functions. Research indicates that acupuncture can influence the expression of certain genes and proteins involved in lipid metabolism in the liver. This includes upregulating genes that promote lipid breakdown and oxidation, and downregulating those involved in lipid synthesis. Additionally, acupuncture has been shown to improve insulin sensitivity, which is crucial for the regulation of lipid metabolism. Furthermore, the potential anti-inflammatory effects of acupuncture may play a significant role in its efficacy for the treatment of obesity. The presence of chronic inflammation has been strongly associated with metabolic disorders such as obesity. Through its ability to mitigate inflammation, acupuncture can potentially aid in the restoration of lipid metabolism and the reduction of body weight. Moreover, the amelioration of hepatic oxidative stress represents another mechanism by which acupuncture may contribute to the reduction of lipid deposition. Notably, the liver, being the primary site of lipid metabolism, maintains communication with various organs including the brain, adipose tissue, skeletal muscle and intestines. This perspective opens new avenues for the treatment of obesity, emphasizing the importance of holistic approaches in managing complex metabolic disorders.
Please cite this article as: Yang SR, Chen L, Luo D, Wang YY, Liang FX. Unlocking the potential: How acupuncture reshapes the liver-centered lipid metabolism pattern to fight obesity. J Integr Med. 2024; 22(5): 523–532.
肥胖症是全球普遍存在的健康问题,往往与脂质代谢紊乱有关,导致脂肪组织过度堆积,并引发相关的健康并发症。针灸作为一种传统的中医疗法,已显示出作为一种可行的干预措施来解决肥胖问题的潜力。所提出的基本机制包括刺激特定穴位对肝功能产生调节作用。肝脏在脂质代谢中起着核心作用,包括脂质合成、储存和分配等过程。针灸被认为可以提高肝脏处理脂质的效率,从而减少脂质堆积,改善代谢功能。研究表明,针灸可以影响肝脏中参与脂质代谢的某些基因和蛋白质的表达。这包括上调促进脂质分解和氧化的基因,下调参与脂质合成的基因。此外,针灸还能提高胰岛素的敏感性,而胰岛素对脂质代谢的调节至关重要。此外,针灸潜在的抗炎作用也可能在其治疗肥胖症的疗效中发挥重要作用。慢性炎症的存在与肥胖等代谢性疾病密切相关。通过缓解炎症,针灸可能有助于恢复脂质代谢和减轻体重。此外,改善肝脏氧化应激也是针灸有助于减少脂质沉积的另一种机制。值得注意的是,肝脏作为脂质代谢的主要场所,与大脑、脂肪组织、骨骼肌和肠道等多个器官保持着联系。这一观点为肥胖症的治疗开辟了新途径,强调了综合方法在控制复杂代谢紊乱中的重要性。本文引用如前:Yang SR, Chen L, Luo D, Wang YY, Liang FX.释放潜能:针灸如何重塑以肝为中心的脂质代谢模式以对抗肥胖?J Integr Med.2024; Epub ahead of print.
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Pub Date : 2024-09-01DOI: 10.1016/j.joim.2024.08.005
Qiong Zhang , Ying-yi Fan , Xue-qing Wu , Yan-dan Huo , Chun-hui Wang , Shi-bing Liang , Ting Wang , Rong Zhong , Xuan Wang , Bao-yong Lai , Xiao-hua Pei , Jian-ping Liu
<div><h3>Background</h3><div>Moderate to severe breast pain has major effects on the quality of life for patients. Patent Chinese medicines are widely used in the treatment of breast pain due to their stable dosage form and good efficacy.</div></div><div><h3>Objective</h3><div>To evaluate the beneficial effects and safety of Hongjin Xiaojie Capsule (HJXJC), a Chinese patent medicine, for the treatment of cyclical breast pain.</div></div><div><h3>Design, setting, participants and intervention</h3><div>This is a multicenter, single-blind randomized controlled trial conducted in 3 medical centers in China from 2019 to 2021. Patients with moderate to severe cyclic breast pain were randomly divided into the intervention group (who took HJXJC, four capsules per dose, three times a day for 12 weeks) and the control group (waiting for the treatment) in a 1:1 ratio.</div></div><div><h3>Main outcome measures</h3><div>The primary outcome was pain duration, and the patients recorded measurements at baseline and at the end of weeks 4, 8, 12 and 16 on a patient log card.</div></div><div><h3>Results</h3><div>The full analysis set (FAS) population included 298 participants (intervention group, <em>n</em> = 150; control group, <em>n</em> = 148), while the per-protocol analysis set (PPS) included 274 participants. After 12 weeks, the duration of breast pain was significantly shorter in the intervention group (FAS: mean difference, –6.69; 95% CI, –7.58 to –5.80; <em>P</em> < 0.01, <em>vs</em> control. PPS: mean difference, –7.09; 95% CI, –8.01 to –6.16; <em>P</em> < 0.01, <em>vs</em> control). The Short-form McGill Pain Questionnaire (SF-MPQ) scores were significantly lower in the intervention group (FAS: mean difference, –12.55; 95% CI, –13.90 to –11.21; <em>P</em> < 0.01, <em>vs</em> control. PPS: mean difference, –13.07; 95% CI, –14.48 to –11.66; <em>P</em> < 0.01, <em>vs</em> control). The above indicators continued to be significantly different through week 16. Moreover, in the intervention group, breast lumps shrank after 12 weeks and the size of breast lumps was statistically smaller than that in the control group (<em>P</em> < 0.05), whereas the sizes of breast nodules and uterine fibroid showed no statistically significant difference compared with the control group (<em>P</em> > 0.05). At weeks 8 and 12, the dysmenorrhea scores in the intervention group were lower than those in the control group (<em>P</em> < 0.05). No obvious adverse reactions were observed in any group.</div></div><div><h3>Conclusion</h3><div>HJXJC can significantly shorten the duration of breast pain, reduce breast pain, reduce the size of breast lumps, and relieve dysmenorrhea. However, it has no significant effect on the size of breast nodules or uterine fibroid.</div></div><div><h3>Trial registration</h3><div>This trial has been registered at the ISRCTN Registry. Number: ISRCTN44184398.</div></div><div><h3>Please cite this article as</h3><div>Zhang Q, Fan YY, Wu
背景:中重度乳房疼痛对患者的生活质量有很大影响。中成药因其剂型稳定、疗效好而被广泛用于乳房疼痛的治疗:评估中成药红金消结胶囊(HJXJC)治疗周期性乳房疼痛的有效性和安全性:这是一项多中心、单盲随机对照试验,于2019年至2021年在中国的3个医疗中心进行。按1:1的比例将中重度周期性乳房疼痛患者随机分为干预组(服用海正羟江胶囊,每次4粒,每天3次,共12周)和对照组(等待治疗):主要结果是疼痛持续时间,患者在基线和第 4、8、12 和 16 周结束时在患者记录卡上记录测量结果:完整分析集(FAS)包括 298 名参与者(干预组,n = 150;对照组,n = 148),而按方案分析集(PPS)包括 274 名参与者。12 周后,干预组的乳房疼痛持续时间明显缩短(FAS:平均差异,-6.69;95% CI,-7.58 至 -5.80;P 0.05)。在第 8 周和第 12 周,干预组的痛经评分低于对照组(P 结论:干预组的痛经评分低于对照组:HJXJC能明显缩短乳房疼痛的持续时间,减轻乳房疼痛,缩小乳房肿块,缓解痛经。但对乳房结节或子宫肌瘤的大小无明显影响:本试验已在 ISRCTN 注册中心注册。本文引用如前:Zhang Q, Fan YY, Wu XQ, Huo YD, Wang CH, Liang SB, Wang T, Zhong R, Wang X, Lai BY, Pei XH, Liu JP.中成药红金消结胶囊治疗中重度周期性乳房疼痛:单盲随机对照试验。J Integr Med.2024; Epub ahead of print.
{"title":"Hongjin Xiaojie Capsule, a Chinese patent medicine, for treating moderate to severe cyclical breast pain: A single-blind randomized controlled trial","authors":"Qiong Zhang , Ying-yi Fan , Xue-qing Wu , Yan-dan Huo , Chun-hui Wang , Shi-bing Liang , Ting Wang , Rong Zhong , Xuan Wang , Bao-yong Lai , Xiao-hua Pei , Jian-ping Liu","doi":"10.1016/j.joim.2024.08.005","DOIUrl":"10.1016/j.joim.2024.08.005","url":null,"abstract":"<div><h3>Background</h3><div>Moderate to severe breast pain has major effects on the quality of life for patients. Patent Chinese medicines are widely used in the treatment of breast pain due to their stable dosage form and good efficacy.</div></div><div><h3>Objective</h3><div>To evaluate the beneficial effects and safety of Hongjin Xiaojie Capsule (HJXJC), a Chinese patent medicine, for the treatment of cyclical breast pain.</div></div><div><h3>Design, setting, participants and intervention</h3><div>This is a multicenter, single-blind randomized controlled trial conducted in 3 medical centers in China from 2019 to 2021. Patients with moderate to severe cyclic breast pain were randomly divided into the intervention group (who took HJXJC, four capsules per dose, three times a day for 12 weeks) and the control group (waiting for the treatment) in a 1:1 ratio.</div></div><div><h3>Main outcome measures</h3><div>The primary outcome was pain duration, and the patients recorded measurements at baseline and at the end of weeks 4, 8, 12 and 16 on a patient log card.</div></div><div><h3>Results</h3><div>The full analysis set (FAS) population included 298 participants (intervention group, <em>n</em> = 150; control group, <em>n</em> = 148), while the per-protocol analysis set (PPS) included 274 participants. After 12 weeks, the duration of breast pain was significantly shorter in the intervention group (FAS: mean difference, –6.69; 95% CI, –7.58 to –5.80; <em>P</em> < 0.01, <em>vs</em> control. PPS: mean difference, –7.09; 95% CI, –8.01 to –6.16; <em>P</em> < 0.01, <em>vs</em> control). The Short-form McGill Pain Questionnaire (SF-MPQ) scores were significantly lower in the intervention group (FAS: mean difference, –12.55; 95% CI, –13.90 to –11.21; <em>P</em> < 0.01, <em>vs</em> control. PPS: mean difference, –13.07; 95% CI, –14.48 to –11.66; <em>P</em> < 0.01, <em>vs</em> control). The above indicators continued to be significantly different through week 16. Moreover, in the intervention group, breast lumps shrank after 12 weeks and the size of breast lumps was statistically smaller than that in the control group (<em>P</em> < 0.05), whereas the sizes of breast nodules and uterine fibroid showed no statistically significant difference compared with the control group (<em>P</em> > 0.05). At weeks 8 and 12, the dysmenorrhea scores in the intervention group were lower than those in the control group (<em>P</em> < 0.05). No obvious adverse reactions were observed in any group.</div></div><div><h3>Conclusion</h3><div>HJXJC can significantly shorten the duration of breast pain, reduce breast pain, reduce the size of breast lumps, and relieve dysmenorrhea. However, it has no significant effect on the size of breast nodules or uterine fibroid.</div></div><div><h3>Trial registration</h3><div>This trial has been registered at the ISRCTN Registry. Number: ISRCTN44184398.</div></div><div><h3>Please cite this article as</h3><div>Zhang Q, Fan YY, Wu ","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"22 5","pages":"Pages 552-560"},"PeriodicalIF":4.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.joim.2024.07.005
Ji-Yeun Park , Ye-Seul Lee , Hi-Joon Park , Seungmin Kathy Lee , Ji-Won Lee , Song-Yi Kim
Objective
This study investigated the clinical details and usage of Sa-am acupuncture in Korean medicine clinics and explored how practicing Korean medicine doctors (KMDs) think about Sa-am acupuncture.
Methods
We conducted a questionnaire-based survey of KMDs who utilize Sa-am acupuncture in their practice. The study comprehensively investigated issues related to clinical application of Sa-am acupuncture, needling techniques used during treatment, training methods, and directions for its future improvement.
Results
We analyzed 572 responses. An average of 50% of the patients visiting Korean medicine clinics were receiving Sa-am acupuncture. The most prevalent indication for Sa-am acupuncture use was digestive disorders. The patients’ appetite level and digestive function were most frequently used indicators for selecting acupuncture points. Regarding prescription compositions, Jung-Gyuk formulas were more frequently used than Seung-Gyuk formulas. Inserting the needle along the flow of the channel or against the flow of the channel was most popular. The acupuncture style most frequently used in combination with Sa-am acupuncture was Ashi point acupuncture. Strengths of Sa-am acupuncture included its versatility, easy application, and good outcomes. Limitations included the lack of rigorous education and training programs, difficulty in applying the principles for beginners, and insufficient clinical research evidence.
Conclusion
In clinics where Sa-am acupuncture is available, KMDs were providing Sa-am acupuncture to about half of their patients. Practitioners were not using all of the tonification and sedation techniques which may be due to time constraints or simply a lack of necessity. Sa-am acupuncture demonstrated high utility in clinical practice and high satisfaction based on the efficacy and safety. More training programs and high-quality research are needed to help expand the use of Sa-am acupuncture.
Please cite this article as: Park JY, Lee YS, Park HJ, Lee SK, Lee JW, Kim SY. A survey on the real-world clinical utilization of a traditional acupuncture in Republic of Korea: Sa-am acupuncture. J Integr Med. 2024; 22(5): 570–578.
目的:本研究调查了萨阿姆针灸在韩医诊所的临床细节和使用情况,并探讨了执业韩医对萨阿姆针灸的看法:本研究调查了萨姆针灸在韩医诊所的临床细节和使用情况,并探讨了执业韩医(KMDs)对萨姆针灸的看法:我们对使用萨姆针灸的韩医进行了问卷调查。研究全面调查了萨姆针灸的临床应用、治疗过程中使用的针刺技术、培训方法以及未来改进方向等相关问题:我们分析了 572 份回复。平均有 50%到韩医诊所就诊的患者接受了萨阿姆针灸治疗。使用萨姆针灸最普遍的适应症是消化系统疾病。患者的食欲水平和消化功能是最常用的选穴指标。在处方组成方面,正谷方的使用率高于承谷方。顺经或逆经进针最常用。与萨阿姆针法结合使用最多的针法是阿是穴针法。萨阿姆针法的优势在于其多功能性、易于应用和良好的疗效。不足之处包括缺乏严格的教育和培训计划,初学者难以应用其原理,以及临床研究证据不足:结论:在提供萨姆针法的诊所中,韩国医疗团队为大约一半的患者提供了萨姆针法。医生们并没有使用所有的补益和镇静技术,这可能是由于时间限制或仅仅是缺乏必要性。根据疗效和安全性,萨姆针灸在临床实践中表现出很高的实用性和满意度。需要更多的培训计划和高质量的研究来帮助扩大萨姆针灸的应用。本文引用如前:Park JY, Lee YS, Park HJ, Lee SK, Lee JW, Kim SY.大韩民国传统针灸临床应用现状调查:Sa-am针灸。J Integr Med.2024; Epub ahead of print.
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Pub Date : 2024-09-01DOI: 10.1016/j.joim.2024.07.001
Sheng-xing Ma
<div><div>Numerous studies from different international groups have demonstrated that sensations can be propagated along acupuncture channel pathways. The propagated sensation along the channel pathway (PSCP) can be elicited by electroacupuncture (EA), transcutaneous electrical nerve stimulation (TENS), manual acupuncture (MA), and heat applied to distal acupuncture points (acupoints). Nitric oxide (NO) levels were reported to be elevated in the gracile nucleus and skin regions near to the EA sites, with higher levels at acupoints associated with an enhanced expression of NO synthase and transient receptor potential vanilloid type 1. The stimuli, EA, MA, TENS, and heat, have been used to elicit axonal reflexes, which increase local release of NO and neuropeptides such as calcitonin gene related peptide. Furthermore, the sensation of PSCP along the body surface occurs only ipsilaterally to the stimulated acupoints in various human studies, which does not support the involvement of the spinal-thalamic pathway, which would involve cross over transmission of the signals. The gracile nucleus receives ascending input from the sciatic nerve and responds to somatosensory stimulation mainly on the ipsilateral side via the dorsal column pathway. EA at Zusanli (ST36) increases NO release and expression of NO synthase mainly in the ipsilateral side of the gracile nucleus, while the cardiovascular effects and analgesic responses to EA at ST36 are changed by influences of <span>l</span>-arginine-derived NO synthesis in the ipsilateral gracile nucleus in rats. The stimuli-induced release of NOergic molecules and neuropeptides exist high levels in the acupoints, which contain rich neuronal components and blood vessels. Enhanced NOergic molecules at acupoints cause axon reflexes during the stimuli, which elevate cutaneous blood flow. Elevated NOergic molecules and local blood flow may spread over acupoints one after another along the meridian lines differing from nerve pathways following the stimuli to induce PSCP. The same types of stimulation also elicit NO release in the gracile nucleus, which contributes to the somatosensory signal transduction of PSCP through the dorsal medulla-thalamic pathways. Other substances such as serotonin and catecholamines are proposed to mediate responses and certain effects of acupuncture-like stimulation but their mechanisms are poorly-understood. In this review we summarize the current understanding of the neurobiological processes of PSCP research with an emphasis on recent developments of NO mediating stimulation-evoked axon reflexes and somatosensory signal transduction for PSCP perceptions through the dorsal medulla-thalamic pathways.</div><div>Please cite this article as: Ma SX. Stimuli-evoked NOergic molecules and neuropeptides at acupuncture points and gracile nucleus contribute to signal transduction of propagated sensation along the meridian through the dorsal medulla-thalamic pathways. <em>J Integr Med</em>. 2024; 22(
来自不同国际组织的大量研究表明,感觉可以沿着针灸通道传播。电针(EA)、经皮神经电刺激(TENS)、徒手针刺(MA)和热敷远端穴位(穴位)均可引起沿通道通路传播的感觉(PSCP)。一氧化氮(NO)水平在蛛网膜核和靠近电针部位的皮肤区域升高,穴位处的较高水平与一氧化氮合酶和瞬时受体电位类香草素 1 型的表达增强有关。EA、MA、TENS 和热等刺激可引起轴突反射,从而增加局部 NO 和降钙素基因相关肽等神经肽的释放。此外,在各种人体研究中,体表 PSCP 感觉仅发生在受刺激穴位的同侧,这并不支持脊髓-丘脑通路的参与,因为这将涉及信号的交叉传输。蛛网膜核接受坐骨神经的上升输入,主要通过背柱通路对同侧的躯体感觉刺激做出反应。祖桑里(ST36)EA主要增加同侧梭状核的NO释放和NO合成酶的表达,而ST36 EA的心血管效应和镇痛反应则受同侧梭状核精氨酸衍生的NO合成的影响而改变。在含有丰富神经元成分和血管的穴位中,刺激诱导的 NO 能分子和神经肽的释放水平较高。在刺激过程中,穴位处增强的氮能分子会引起轴突反射,从而使皮肤血流量增加。升高的能氧化氮分子和局部血流可沿着刺激后不同于神经通路的经络线路逐个扩散到穴位,从而诱发 PSCP。同样类型的刺激也会引起蛛网膜核释放 NO,从而通过背侧延髓-丘脑通路促进 PSCP 的躯体感觉信号转导。其他物质,如血清素和儿茶酚胺,也被认为可以介导针刺样刺激的反应和某些效应,但其机制还不甚明了。在这篇综述中,我们总结了目前对 PSCP 研究的神经生物学过程的理解,重点是 NO 通过背髓-丘脑通路介导刺激诱发的轴突反射和 PSCP 感知的躯体感觉信号转导的最新进展:Ma SX.穴位和蛛网膜核的刺激诱发NO能分子和神经肽有助于通过背侧延髓-丘脑通路沿经络传播感觉的信号转导。J Integr Med.2024; 22(5):515-522.
{"title":"Stimuli-evoked NOergic molecules and neuropeptides at acupuncture points and the gracile nucleus contribute to signal transduction of propagated sensation along the meridian through the dorsal medulla-thalamic pathways","authors":"Sheng-xing Ma","doi":"10.1016/j.joim.2024.07.001","DOIUrl":"10.1016/j.joim.2024.07.001","url":null,"abstract":"<div><div>Numerous studies from different international groups have demonstrated that sensations can be propagated along acupuncture channel pathways. The propagated sensation along the channel pathway (PSCP) can be elicited by electroacupuncture (EA), transcutaneous electrical nerve stimulation (TENS), manual acupuncture (MA), and heat applied to distal acupuncture points (acupoints). Nitric oxide (NO) levels were reported to be elevated in the gracile nucleus and skin regions near to the EA sites, with higher levels at acupoints associated with an enhanced expression of NO synthase and transient receptor potential vanilloid type 1. The stimuli, EA, MA, TENS, and heat, have been used to elicit axonal reflexes, which increase local release of NO and neuropeptides such as calcitonin gene related peptide. Furthermore, the sensation of PSCP along the body surface occurs only ipsilaterally to the stimulated acupoints in various human studies, which does not support the involvement of the spinal-thalamic pathway, which would involve cross over transmission of the signals. The gracile nucleus receives ascending input from the sciatic nerve and responds to somatosensory stimulation mainly on the ipsilateral side via the dorsal column pathway. EA at Zusanli (ST36) increases NO release and expression of NO synthase mainly in the ipsilateral side of the gracile nucleus, while the cardiovascular effects and analgesic responses to EA at ST36 are changed by influences of <span>l</span>-arginine-derived NO synthesis in the ipsilateral gracile nucleus in rats. The stimuli-induced release of NOergic molecules and neuropeptides exist high levels in the acupoints, which contain rich neuronal components and blood vessels. Enhanced NOergic molecules at acupoints cause axon reflexes during the stimuli, which elevate cutaneous blood flow. Elevated NOergic molecules and local blood flow may spread over acupoints one after another along the meridian lines differing from nerve pathways following the stimuli to induce PSCP. The same types of stimulation also elicit NO release in the gracile nucleus, which contributes to the somatosensory signal transduction of PSCP through the dorsal medulla-thalamic pathways. Other substances such as serotonin and catecholamines are proposed to mediate responses and certain effects of acupuncture-like stimulation but their mechanisms are poorly-understood. In this review we summarize the current understanding of the neurobiological processes of PSCP research with an emphasis on recent developments of NO mediating stimulation-evoked axon reflexes and somatosensory signal transduction for PSCP perceptions through the dorsal medulla-thalamic pathways.</div><div>Please cite this article as: Ma SX. Stimuli-evoked NOergic molecules and neuropeptides at acupuncture points and gracile nucleus contribute to signal transduction of propagated sensation along the meridian through the dorsal medulla-thalamic pathways. <em>J Integr Med</em>. 2024; 22(","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"22 5","pages":"Pages 515-522"},"PeriodicalIF":4.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141707187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.joim.2024.07.004
Mijung Yeom , Sora Ahn , Dae-Hyun Hahm , Sun-Young Jang , Se Hoon Jang , Su-Yang Park , Jae-Hwan Jang , Jihan Park , Ju-Young Oh , In-Seon Lee , Kyuseok Kim , Soon-Kyeong Kwon , Hi-Joon Park
Objective
Atopic dermatitis (AD) is a chronic inflammatory skin disease that may be linked to changes in the gut microbiome. Acupuncture has been proven to be effective in reducing AD symptoms without serious adverse events, but its underlying mechanism is not completely understood. The purpose of this study was to investigate whether the potential effect of acupuncture on AD is gut microbiota-dependent.
Methods
AD-like skin lesions were induced by applying MC903 topically to the cheek of the mouse. Acupuncture was done at the Gok-Ji (LI11) acupoints. AD-like symptoms were assessed by lesion scores, scratching behavior, and histopathological changes; intestinal barrier function was measured by fecal output, serum lipopolysaccharide levels, histopathological changes, and mRNA expression of markers involved in intestinal permeability and inflammation. Gut microbiota was profiled using 16S rRNA gene sequencing from fecal samples.
Results
Acupuncture effectively improved chronic itch as well as the AD-like skin lesions with epidermal thickening, and also significantly altered gut microbiota structure as revealed by β-diversity indices and analysis of similarities. These beneficial effects were eliminated by antibiotic depletion of gut microbiota, but were reproduced in gut microbiota-depleted mice that received a fecal microbiota transplant from acupuncture-treated mice. Interestingly, AD mice had intestinal barrier dysfunction as indicated by increased intestinal permeability, atrophy of the mucosal structure (reduced villus height and crypt depth), decreased expression of tight junctions and mucus synthesis genes, and increased expression of inflammatory mediators in the ileum. Acupuncture attenuated these abnormalities, which was gut microbiota-dependent.
Conclusion
Acupuncture ameliorates AD-like phenotypes in a gut microbiota-dependent manner and some of these positive benefits are explained by modulation of the intestinal barrier, providing new perspective for non-pharmacological strategies for modulating gut microbiota to prevent and treat AD.
Please cite this article as: Yeom M, Ahn S, Hahm DH, Jang SY, Jang SH, Park SY, Jang JH, Park J, Oh JY, Lee IS, Kim K, Kwon SK, Park HJ. Acupuncture ameliorates atopic dermatitis by modulating gut barrier function in a gut microbiota-dependent manner in mice. J Integr Med. 2024; 22(5): 600–613.
目的 特应性皮炎(AD)是一种慢性炎症性皮肤病,可能与肠道微生物组的变化有关。针灸已被证实能有效减轻 AD 症状,且无严重不良反应,但其潜在机制尚不完全清楚。本研究旨在探讨针灸对AD的潜在作用是否依赖于肠道微生物群。方法在小鼠脸颊局部涂抹MC903,诱发AD样皮损。针刺小鼠的谷椎(LI11)穴。AD样症状通过皮损评分、搔抓行为和组织病理学变化进行评估;肠道屏障功能通过粪便排出量、血清脂多糖水平、组织病理学变化以及肠道通透性和炎症相关标记物的mRNA表达进行测量。结果 针灸有效地改善了慢性瘙痒以及表皮增厚的 AD 样皮损,并通过 β 多样性指数和相似性分析显著改变了肠道微生物群结构。抗生素耗尽肠道微生物群后,这些有益作用被消除,但在接受了针灸治疗小鼠粪便微生物群移植的肠道微生物群耗尽小鼠中,这些有益作用得以重现。有趣的是,AD 小鼠肠道屏障功能失调,表现为肠道通透性增加、粘膜结构萎缩(绒毛高度和隐窝深度降低)、紧密连接和粘液合成基因表达减少以及回肠炎症介质表达增加。结论 针灸以肠道微生物群依赖性的方式改善了AD样表型,其中一些积极益处可通过调节肠道屏障来解释,这为调节肠道微生物群预防和治疗AD的非药物策略提供了新的视角:Yeom M, Ahn S, Hahm DH, Jang SY, Jang SH, Park SY, Jang JH, Park J, Oh JY, Lee IS, Kim K, Kwon SK, Park HJ.针灸通过调节小鼠肠道微生物群依赖性肠道屏障功能改善特应性皮炎。J Integr Med.2024; 22(5):600-613.
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Pub Date : 2024-09-01DOI: 10.1016/j.joim.2024.08.001
Yong-guang Fang, Shi-lin Huang, Nan-nan Chen
Introduction
There is currently no standard treatment for relapsed and arsenic trioxide (ATO)-resistant acute promyelocytic leukemia (APL). Here, we report a case series of realgar-indigo naturalis formula (RIF) for the successful treatment of patients with relapsed and ATO-resistant APL.
Case presentation
Two patients in the first relapse and one in the second relapse failed to achieve hematologic complete remission (HCR) when reinduced by ATO; the other five patients progressed to relapse during ATO-based regimens for post-remission therapy. These eight patients received RIF in three doses per day totaling 130 mg/kg (≤ 30 pills) as induction therapy and achieved HCR at a median time of 46.5 days. They received 5 years of post-remission therapy, which consisted of combined chemotherapy followed by RIF. During this period, the patients did not experience renal dysfunction or QT interval prolongation. At the last follow-up, three patients survived without relapse, two patients survived with a second or third relapse and third or fourth remission, and the other three patients relapsed for a third or fourth time and died. The 5-year overall survival and event-free survival rates were 75.0% (95% confidence interval [CI]: 31.5–93.1) and 37.5% (95% CI: 5.6–71.7), respectively.
Conclusion
RIF for induction therapy and RIF combined with chemotherapy for post-remission therapy may represent an effective and safe protocol for the treatment of patients with relapsed and ATO-resistant APL.
Please cite this article as: Fang YG, Huang SL, Chen NN. Realgar-indigo naturalis formula for the treatment of patients with relapsed and arsenic trioxide-resistant acute promyelocytic leukemia: a case series. J Integr Med. 2024; 22(5): 614–620.
{"title":"Realgar-indigo naturalis formula for the treatment of patients with relapsed and arsenic trioxide-resistant acute promyelocytic leukemia: A case series","authors":"Yong-guang Fang, Shi-lin Huang, Nan-nan Chen","doi":"10.1016/j.joim.2024.08.001","DOIUrl":"10.1016/j.joim.2024.08.001","url":null,"abstract":"<div><h3>Introduction</h3><div>There is currently no standard treatment for relapsed and arsenic trioxide (ATO)-resistant acute promyelocytic leukemia (APL). Here, we report a case series of realgar-indigo naturalis formula (RIF) for the successful treatment of patients with relapsed and ATO-resistant APL.</div></div><div><h3>Case presentation</h3><div>Two patients in the first relapse and one in the second relapse failed to achieve hematologic complete remission (HCR) when reinduced by ATO; the other five patients progressed to relapse during ATO-based regimens for post-remission therapy. These eight patients received RIF in three doses per day totaling 130 mg/kg (≤ 30 pills) as induction therapy and achieved HCR at a median time of 46.5 days. They received 5 years of post-remission therapy, which consisted of combined chemotherapy followed by RIF. During this period, the patients did not experience renal dysfunction or QT interval prolongation. At the last follow-up, three patients survived without relapse, two patients survived with a second or third relapse and third or fourth remission, and the other three patients relapsed for a third or fourth time and died. The 5-year overall survival and event-free survival rates were 75.0% (95% confidence interval [CI]: 31.5–93.1) and 37.5% (95% CI: 5.6–71.7), respectively.</div></div><div><h3>Conclusion</h3><div>RIF for induction therapy and RIF combined with chemotherapy for post-remission therapy may represent an effective and safe protocol for the treatment of patients with relapsed and ATO-resistant APL.</div><div>Please cite this article as: Fang YG, Huang SL, Chen NN. Realgar-indigo naturalis formula for the treatment of patients with relapsed and arsenic trioxide-resistant acute promyelocytic leukemia: a case series. <em>J Integr Med</em>. 2024; 22(5): 614–620.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"22 5","pages":"Pages 614-620"},"PeriodicalIF":4.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.joim.2024.06.005
Alexander L. Tournier , Leoni V. Bonamin , Susann Buchheim-Schmidt , Steven Cartwright , Christoph Dombrowsky , Paul Doesburg , Carla Holandino , Maria Olga Kokornaczyk , Everine B. van de Kraats , Jesús Antonio López-Carvallo , Papiya Nandy , José Manuel Mazón-Suástegui , Fateme Mirzajani , Bernard Poitevin , Claudia Scherr , Karin Thieves , Sandra Würtenberger , Stephan Baumgartner
Objective
Pharmacopoeias regulate the manufacture of potentised pharmaceutical preparations used in different branches of complementary and integrative medicine. The physicochemical properties and biological activity of these preparations are often investigated in preclinical research, yet no guidelines for experimental research currently exist in this area. The present PrePoP guidelines aim to provide recommendations to promote high-quality, statistically sound, and reproducible preclinical research on potentised preparations.
Methods
Input was gathered from researchers nominated by the relevant scientific societies using a simplified Delphi consensus approach covering the most relevant aspects of basic research methodology in the field including appropriate controls, sample preparation and handling, and statistics. After three rounds of feedback, a consensus was finally reached on the most important aspects and considerations for conducting high-quality research on potentised preparations.
Results
We present a series of recommendations on a range of topics including experimental controls, system stability, blinding and randomisation, environmental influences, and procedures for the preparation of potentised samples and controls, and we address some specific challenges of this research field.
Conclusion
This expert consensus process resulted in a robust set of methodological guidelines for research on potentised preparations and provides a valuable framework that will inform and improve the quality of subsequent research in this emerging field.
Please cite this article as
Tournier AL, Bonamin LV, Buchheim-Schmidt S, Cartwright S, Dombrowsky C, Doesburg P, Holandino C, Kokornaczyk MO, van de Kraats EB, López-Carvallo JA, Nandy P, Mazón-Suástegui JM, Mirzajani F, Poitevin B, Scherr C, Thieves K, Würtenberger S, Baumgartner S. Scientific guidelines for preclinical research on potentised preparations manufactured according to current pharmacopoeias—the PrePoP guidelines. J Integr Med. 2024; 22(5): 533–544.
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Pub Date : 2024-09-01DOI: 10.1016/j.joim.2024.07.003
Hui-zhi Zhu , Cheng-yi Li , Liang-ji Liu , Jia-bing Tong , Zhi-hui Lan , Shu-guang Tian , Qiao Li , Xiang-li Tong , Ji-feng Wu , Zhen-gang Zhu , Su-yun Li , Jian-sheng Li
<div><h3>Background</h3><div>Chronic obstructive pulmonary disease (COPD), a common respiratory disease, can be effectively treated by traditional Chinese medicine (TCM). Qingfei Huatan, a TCM formula, has been reported to effectively alleviate the clinical symptoms of COPD patients. However, there is a lack of multi-centre, randomised, double-blind, controlled clinical trials documenting the clinical efficacy and safety of this formula in the treatment of acute exacerbation of COPD (AECOPD).</div></div><div><h3>Objective</h3><div>This study evaluated the efficacy and safety of Qingfei Huatan formula in the treatment of AECOPD, thereby providing high-quality clinical evidence.</div></div><div><h3>Design, setting, participants and interventions</h3><div>A total of 276 patients with AECOPD were included in this multi-centre, randomised, double-blind, placebo-controlled trial and were randomised into treatment and control groups at a ratio of 1:1. Patients in the treatment and control groups took Qingfei Huatan granules or simulated Qingfei Huatan granules twice a day, for 14 days, in addition to Western medicine treatment. All patients were followed up for 3 months.</div></div><div><h3>Main outcome measures</h3><div>The primary outcome was time taken to symptom stabilisation. The secondary outcomes included duration of antibiotic use, clinical symptom and sign score, TCM syndrome score, dyspnoea score, and quality of life (QOL) score. Meanwhile, the safety of the formula was assessed through routine urine and stool tests, electrocardiograms, liver and kidney function tests, and the observation of adverse events throughout the trial.</div></div><div><h3>Results</h3><div>The time taken for effective stabilisation (<em>P</em> < 0.05) and obvious stabilisation (<em>P</em> < 0.01), and the duration of antibiotic use (<em>P</em> < 0.05) were significantly shorter in the treatment group than in the control group. On days 6, 9, 12 and 14 of treatment, clinical symptom and sign score decreased in both groups, particularly in the treatment group (<em>P</em> < 0.01). On days 9, 12 and 14 of treatment, the TCM syndrome scores of both groups were reduced (<em>P</em> < 0.01), with more significant reductions in the treatment group. At 3 months after the end of treatment, the treatment group continued to have lower clinical symptom and sign score and TCM syndrome score than the control group (<em>P</em> < 0.01). On days 6, 9, 12 and 14 of treatment, dyspnoea and QOL scores were markedly reduced in the two groups (<em>P</em> < 0.05 and <em>P</em> < 0.01, respectively), especially in the treatment group. At 3 months after the end of treatment, dyspnoea and QOL scores were lower in the treatment group than those in the control group (<em>P</em> < 0.01). No serious adverse events were observed in either group.</div></div><div><h3>Conclusion</h3><div>The Qingfei Huatan formula can effectively shorten the duration of AECOPD and antibiotic use
背景 慢性阻塞性肺疾病(COPD)是一种常见的呼吸系统疾病,中医药可有效治疗该病。据报道,中药配方清热化痰汤能有效缓解慢性阻塞性肺疾病患者的临床症状。然而,目前尚缺乏多中心、随机、双盲、对照临床试验记录该方剂在治疗慢性阻塞性肺疾病急性加重期(AECOPD)中的临床疗效和安全性。本研究评估了清热化痰方在治疗慢性阻塞性肺疾病急性加重期中的疗效和安全性,从而提供高质量的临床证据。这项多中心、随机、双盲、安慰剂对照试验共纳入了276名AECOPD患者,并按1:1的比例随机分为治疗组和对照组。治疗组和对照组患者在接受西药治疗的同时,服用清瘟化毒颗粒或模拟清瘟化毒颗粒,每天两次,共14天。主要结果测量主要结果是症状稳定所需时间。次要结果包括抗生素使用时间、临床症状和体征评分、中医综合征评分、呼吸困难评分和生活质量(QOL)评分。同时,在整个试验过程中,通过尿液和粪便常规检查、心电图、肝功能和肾功能检查以及不良事件观察来评估配方的安全性。在治疗的第 6、9、12 和 14 天,两组的临床症状和体征评分均有所下降,尤其是治疗组(P < 0.01)。在治疗的第 9、12 和 14 天,两组的中医综合征评分均有所下降(P < 0.01),其中治疗组的下降更为显著。治疗结束后 3 个月,治疗组的临床症状和体征评分及中医证候评分仍低于对照组(P < 0.01)。在治疗的第 6、9、12 和 14 天,两组患者的呼吸困难和 QOL 评分明显降低(分别为 P < 0.05 和 P < 0.01),尤其是治疗组。治疗结束 3 个月后,治疗组的呼吸困难和 QOL 评分低于对照组(P <0.01)。结论清热化痰方能有效缩短 AECOPD 病程和抗生素使用时间,显著缓解 AECOPD 患者的临床症状,提高 QOL,且安全性良好。这些结果表明,该配方可作为 AECOPD 患者的辅助治疗:该方案已在中国临床试验注册中心注册(ChiCTR1900026576):Zhu HZ, Li CY, Liu LJ, Tong JB, Lan ZH, Tian SG, Li Q, Tong XL, Wu JF, Zhu ZG, Li SY, Li JS.清瘟化浊方治疗慢性阻塞性肺疾病急性加重期的有效性和安全性:多中心、随机、双盲、安慰剂对照试验。J Integr Med.2024; 22(5):561-569.
{"title":"Efficacy and safety of Qingfei Huatan formula in the treatment of acute exacerbation of chronic obstructive pulmonary disease: A multi-centre, randomised, double-blind, placebo-controlled trial","authors":"Hui-zhi Zhu , Cheng-yi Li , Liang-ji Liu , Jia-bing Tong , Zhi-hui Lan , Shu-guang Tian , Qiao Li , Xiang-li Tong , Ji-feng Wu , Zhen-gang Zhu , Su-yun Li , Jian-sheng Li","doi":"10.1016/j.joim.2024.07.003","DOIUrl":"10.1016/j.joim.2024.07.003","url":null,"abstract":"<div><h3>Background</h3><div>Chronic obstructive pulmonary disease (COPD), a common respiratory disease, can be effectively treated by traditional Chinese medicine (TCM). Qingfei Huatan, a TCM formula, has been reported to effectively alleviate the clinical symptoms of COPD patients. However, there is a lack of multi-centre, randomised, double-blind, controlled clinical trials documenting the clinical efficacy and safety of this formula in the treatment of acute exacerbation of COPD (AECOPD).</div></div><div><h3>Objective</h3><div>This study evaluated the efficacy and safety of Qingfei Huatan formula in the treatment of AECOPD, thereby providing high-quality clinical evidence.</div></div><div><h3>Design, setting, participants and interventions</h3><div>A total of 276 patients with AECOPD were included in this multi-centre, randomised, double-blind, placebo-controlled trial and were randomised into treatment and control groups at a ratio of 1:1. Patients in the treatment and control groups took Qingfei Huatan granules or simulated Qingfei Huatan granules twice a day, for 14 days, in addition to Western medicine treatment. All patients were followed up for 3 months.</div></div><div><h3>Main outcome measures</h3><div>The primary outcome was time taken to symptom stabilisation. The secondary outcomes included duration of antibiotic use, clinical symptom and sign score, TCM syndrome score, dyspnoea score, and quality of life (QOL) score. Meanwhile, the safety of the formula was assessed through routine urine and stool tests, electrocardiograms, liver and kidney function tests, and the observation of adverse events throughout the trial.</div></div><div><h3>Results</h3><div>The time taken for effective stabilisation (<em>P</em> < 0.05) and obvious stabilisation (<em>P</em> < 0.01), and the duration of antibiotic use (<em>P</em> < 0.05) were significantly shorter in the treatment group than in the control group. On days 6, 9, 12 and 14 of treatment, clinical symptom and sign score decreased in both groups, particularly in the treatment group (<em>P</em> < 0.01). On days 9, 12 and 14 of treatment, the TCM syndrome scores of both groups were reduced (<em>P</em> < 0.01), with more significant reductions in the treatment group. At 3 months after the end of treatment, the treatment group continued to have lower clinical symptom and sign score and TCM syndrome score than the control group (<em>P</em> < 0.01). On days 6, 9, 12 and 14 of treatment, dyspnoea and QOL scores were markedly reduced in the two groups (<em>P</em> < 0.05 and <em>P</em> < 0.01, respectively), especially in the treatment group. At 3 months after the end of treatment, dyspnoea and QOL scores were lower in the treatment group than those in the control group (<em>P</em> < 0.01). No serious adverse events were observed in either group.</div></div><div><h3>Conclusion</h3><div>The Qingfei Huatan formula can effectively shorten the duration of AECOPD and antibiotic use","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"22 5","pages":"Pages 561-569"},"PeriodicalIF":4.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141695550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-01DOI: 10.1016/j.joim.2024.07.002
Yu Zhang , Xiao-bo Zhu , Yang Zhao , Gui-yun Cui , Wen-tao Li , Can-xing Yuan , Jian-ping Huang , Ying Wan , Na Wu , Lu Song , Jia-hao Zhao , Yan Liang , Chuan-ying Xu , Mei-juan Liu , Chen Gao , Xin-xin Chen , Zhen-guo Liu
Background
Patients with Parkinson’s disease (PD) undergoing long-term levodopa therapy are prone to develop levodopa-induced dyskinesia (LID). Amantadine is the main drug recommended for the treatment of LID by current guidelines, but it is far from meeting clinical needs. Tianqi Pingchan Granule (TPG), a compound Chinese herbal medicine, has been developed to relieve symptom of LID.
Objective
This randomized controlled trial evaluated the efficacy and safety of the combination of TPG and amantadine for LID.
Design, setting, participants and interventions
This is a randomized double-blind placebo-controlled trial, conducted from January 2020 to August 2021 at 6 sites in Jiangsu, Zhejiang and Shanghai, China. One hundred PD patients with ≥ 0.5 h of LID were randomly assigned to either the TPG plus amantadine group (TPG group) or the placebo plus amantadine group (placebo group), and treated for a period of 12 weeks. To ensure unbiased results, all study participants, investigators and sponsors were unaware of group allocations. Additionally, the data analysts remained blinded until the analysis was finalized.
Main outcome measures
The primary outcome was assessed using the Unified Dyskinesia Rating Scale (UDysRS) (Range 0–104). The key secondary end point was improvement of motor and non-motor symptoms. Safety analyses included all enrolled patients.
Results
One hundred patients were enrolled and randomized into the two treatment groups. The changes in UDysRS at week 12 were –11.02 for the TPG group and –4.19 for the placebo group (treatment difference –6.83 [–10.53 to –3.12]; P = 0.0004). Adverse events were reported for 2 of 50 patients (4.0%) in each of the groups.
Conclusion
This study indicated that a 12-week treatment of amantadine plus TPG effectively reduced UDysRS scores and was well tolerated, demonstrating the efficacy and safety of TPG for the treatment of LID in PD.
Zhang Y, Zhu XB, Zhao Y, Cui GY, Li WT, Yuan CX, Huang JP, Wan Y, Wu N, Song L, Zhao JH, Liang Y, Xu CY, Liu MJ, Gao C, Chen XX, Liu ZG. Efficacy and safety of Tianqi Pingchan Granule, a compound Chinese herbal medicine, for levodopa-induced dyskinesia in Parkinson’s disease: A randomized double-blind placebo-controlled trial. J Integr Med. 2024; 22(5): 545–551.
背景长期接受左旋多巴治疗的帕金森病(PD)患者容易出现左旋多巴诱发的运动障碍(LID)。金刚烷胺是目前指南推荐的治疗 LID 的主要药物,但远远不能满足临床需要。这项随机对照试验评估了天芪平消颗粒和金刚烷胺联合治疗LID的有效性和安全性。设计、地点、参与者和干预措施这是一项随机双盲安慰剂对照试验,于2020年1月至2021年8月在中国江苏、浙江和上海的6个地点进行。100名LID≥0.5 h的帕金森病患者被随机分配到TPG加金刚烷胺组(TPG组)或安慰剂加金刚烷胺组(安慰剂组),接受为期12周的治疗。为确保结果无偏见,所有研究参与者、调查人员和赞助商都不知道组别分配情况。主要结果测量主要结果采用统一运动障碍评定量表(UDysRS)(范围 0-104)进行评估。主要次要终点是运动和非运动症状的改善。安全性分析包括所有入组患者。第12周时,TPG组的UDysRS变化为-11.02,安慰剂组为-4.19(治疗差异为-6.83 [-10.53 to -3.12];P = 0.0004)。结论本研究表明,金刚烷胺加TPG治疗12周可有效降低UDysRS评分,且耐受性良好,证明了TPG治疗PD患者LID的有效性和安全性:试验注册:ClinicalTrials.gov identifier:本文引用地址:Zhang Y, Zhu XB, Zhao Y, Cui GY, Li WT, Yuan CX, Huang JP, Wan Y, Wu N, Song L, Zhao JH, Liang Y, Xu CY, Liu MJ, Gao C, Chen XX, Liu ZG.复方中药天芪平消颗粒治疗左旋多巴所致帕金森病运动障碍的有效性和安全性:随机双盲安慰剂对照试验。J Integr Med.2024; 22(5):545-551.
{"title":"Efficacy and safety of Tianqi Pingchan Granule, a compound Chinese herbal medicine, for levodopa-induced dyskinesia in Parkinson’s disease: A randomized double-blind placebo-controlled trial","authors":"Yu Zhang , Xiao-bo Zhu , Yang Zhao , Gui-yun Cui , Wen-tao Li , Can-xing Yuan , Jian-ping Huang , Ying Wan , Na Wu , Lu Song , Jia-hao Zhao , Yan Liang , Chuan-ying Xu , Mei-juan Liu , Chen Gao , Xin-xin Chen , Zhen-guo Liu","doi":"10.1016/j.joim.2024.07.002","DOIUrl":"10.1016/j.joim.2024.07.002","url":null,"abstract":"<div><h3>Background</h3><div>Patients with Parkinson’s disease (PD) undergoing long-term levodopa therapy are prone to develop levodopa-induced dyskinesia (LID). Amantadine is the main drug recommended for the treatment of LID by current guidelines, but it is far from meeting clinical needs. Tianqi Pingchan Granule (TPG), a compound Chinese herbal medicine, has been developed to relieve symptom of LID.</div></div><div><h3>Objective</h3><div>This randomized controlled trial evaluated the efficacy and safety of the combination of TPG and amantadine for LID.</div></div><div><h3>Design, setting, participants and interventions</h3><div>This is a randomized double-blind placebo-controlled trial, conducted from January 2020 to August 2021 at 6 sites in Jiangsu, Zhejiang and Shanghai, China. One hundred PD patients with ≥ 0.5 h of LID were randomly assigned to either the TPG plus amantadine group (TPG group) or the placebo plus amantadine group (placebo group), and treated for a period of 12 weeks. To ensure unbiased results, all study participants, investigators and sponsors were unaware of group allocations. Additionally, the data analysts remained blinded until the analysis was finalized.</div></div><div><h3>Main outcome measures</h3><div>The primary outcome was assessed using the Unified Dyskinesia Rating Scale (UDysRS) (Range 0–104). The key secondary end point was improvement of motor and non-motor symptoms. Safety analyses included all enrolled patients.</div></div><div><h3>Results</h3><div>One hundred patients were enrolled and randomized into the two treatment groups. The changes in UDysRS at week 12 were –11.02 for the TPG group and –4.19 for the placebo group (treatment difference –6.83 [–10.53 to –3.12]; <em>P</em> = 0.0004). Adverse events were reported for 2 of 50 patients (4.0%) in each of the groups.</div></div><div><h3>Conclusion</h3><div>This study indicated that a 12-week treatment of amantadine plus TPG effectively reduced UDysRS scores and was well tolerated, demonstrating the efficacy and safety of TPG for the treatment of LID in PD.</div><div>Trial registration: <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> identifier: NCT04173832.</div></div><div><h3>Please cite this article as</h3><div>Zhang Y, Zhu XB, Zhao Y, Cui GY, Li WT, Yuan CX, Huang JP, Wan Y, Wu N, Song L, Zhao JH, Liang Y, Xu CY, Liu MJ, Gao C, Chen XX, Liu ZG. Efficacy and safety of Tianqi Pingchan Granule, a compound Chinese herbal medicine, for levodopa-induced dyskinesia in Parkinson’s disease: A randomized double-blind placebo-controlled trial. <em>J Integr Med</em>. 2024; 22(5): 545–551.</div></div>","PeriodicalId":48599,"journal":{"name":"Journal of Integrative Medicine-Jim","volume":"22 5","pages":"Pages 545-551"},"PeriodicalIF":4.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141710122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1016/j.joim.2024.04.005
Phytosomes (phytophospholipid complex) are dosage forms that have recently been introduced to increase the stability and therapeutic effect of herbal medicine. Currently, bioactive herbs and the phytochemicals they contain are considered to be the best remedies for chronic diseases. One promising approach to increase the efficacy of plant-based therapies is to improve the stability and bioavailability of their bio-active ingredients. Phytosomes employ phospholipids as their active ingredients, and use their amphiphilic properties to solubilize and protect herbal extracts. The unique properties of phospholipids in drug delivery and their use in herbal medicines to improve bioavailability results in significantly enhanced health benefits. The introduction of phytosome nanotechnology can alter and revolutionize the current state of drug delivery. The goal of this review is to explain the application of phytosomes, their future prospects in drug delivery, and their advantages over conventional formulations.
Please cite this article as: Chauhan D, Yadav PK, Sultana N, Agarwal A, Verma S, Chourasia MK, Gayen JR. Advancements in nanotechnology for the delivery of phytochemicals. J Integr Med. 2024; 22(4): 385–398.
植物载体(植物磷脂复合物)是最近推出的一种剂型,可提高草药的稳定性和治疗效果。目前,生物活性草药及其所含的植物化学物质被认为是治疗慢性疾病的最佳疗法。提高植物疗法疗效的一个可行方法是提高其生物活性成分的稳定性和生物利用率。植物载体采用磷脂作为其活性成分,并利用其两亲特性来溶解和保护草药提取物。磷脂在给药方面具有独特的特性,在草药中使用磷脂可提高生物利用率,从而显著增强保健功效。植物胶体纳米技术的引入可以改变和革新当前的给药方式。本综述旨在解释植物体的应用、其在给药方面的未来前景以及与传统制剂相比的优势:Chauhan D, Yadav PK, Sultana N, Agarwal A, Verma S, Chourasia MK, Gayen JR.纳米技术在植物化学物质递送方面的进展。J Integr Med.2024; 22(4):385-398.
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