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Efficacy and safety of oral Panax notoginseng saponins for unstable angina patients: A meta-analysis and systematic review.
Duan, L, Xiong, X, Hu, J, Liu, Y, Wang, J
Phytomedicine : international journal of phytotherapy and phytopharmacology. 2018;:23-33
Abstract
BACKGROUND Panax notoginseng saponins (PNS) is one of the most important active ingredients in Panax notoginseng, which plays an important role against cardiovascular diseases in Traditional Chinese Medicine (TCM). METHODS This review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. We searched the following databases from their inception to February 2017: CENTRAL, MEDLINE, EMBASE Database, WHO ICTRP, CNKI, WANFANG, VIP and SinoMed. All the randomized controlled trials (RCTs) based on PNS in patients with unstable angina (UA) which meet the standard were included. RESULT Seventeen studies were included in this systemic review. The included studies indicated that PNS has promising therapeutic effects on reduction of the primary end point [RR 0.05 (95% CI -0.07, -0.02); P < 0.001], electrocardiography (ECG) [RR 0.32 (95% CI 0.23, 0.46); P < 0.001], the frequency and duration of angina attacks [MD -1.88 (95% CI -2.03, -1.72); P < 0.001], and dosage of nitroglycerin [MD -1.13 (95% CI -1.70, -0.56); P < 0.001] of UA patients. Adverse events were described 9 included RCTs. CONCLUSION Oral PNS could reduce the end point, and improve the ECG, the frequency and duration of angina pectoris, dosage of nitroglycerin and lipids in UA patients. And the results indicated oral PNS is safe up to now. However, we need more multi-centre, large-sample, high-quality RCTs to provide high-quality evidence.
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2.
Effectiveness of Radix astragali and Salvia miltiorrhiza injection in treatment of skeletal muscle injury of aerobics athletes.
Wei, Z, Jinguo, D
Pakistan journal of pharmaceutical sciences. 2018;(4(Special)):1767-1771
Abstract
This paper aims to observe and analyze the effects of Radix astragali and Salvia miltiorrhiza on skeletal muscle injury of aerobics athletes. In this study, 600 cases of aerobics athletes with skeletal muscle injury were randomly divided into experimental group and control group according to different treatment regimens, and the number of cases was the same, each with 300 cases. The control group was given local massage and rehabilitation training. On the basis of the above, Radix astragali and Salvia miltiorrhiza injection was given to the experimental group. The indicators of overall treatment efficiency, improvement of serum SOD level, improvement of serum MDA content, comparison of plasma creatine kinase (CK) and myoglobin (Mb) were observed and compared between the two groups. After implementation of different treatment programs, in comparison of overall treatment efficiency, the experimental group is significantly superior to the control group (P <0.05); in comparison of improvement of serum SOD level, improvement of serum MDA content, the experimental group is superior to the control group(P <0.05). In addition, in comparison of plasma creatine kinase (CK) and myoglobin (Mb) level, the experimental group is significantly superior to the control group(P <0.05). It is very important for aerobics athletes with skeletal muscle injury to take active and effective therapy to recover as soon as possible. The program of Radix astragali and Salvia miltiorrhiza injection has obvious effect, which can promote athletes' skeletal muscle injury repair and improve the overall treatment efficiency, which is worth popularizing in practice.
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3.
Chinese herbal medicines compared with N-acetylcysteine for the treatment of idiopathic pulmonary fibrosis: Protocol for a systematic review.
Guo, J, Li, B, Li, W, Pan, Y, Wang, Z, Wu, Y, Wang, F
Medicine. 2018;(44):e13077
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Abstract
BACKGROUND Idiopathic pulmonary fibrosis (IPF) is a major public health problem worldwide. There is no curative treatment for IPF except lung transplantation. Chinese herbal medicines (CHMs) are widely used in the treatment of IPF in China. However, their effectiveness and safety are still obscure and deserve further investigation. The aim of the study was to assess the efficacy and safety of CHMs in treating IPF compared with N-acetylcysteine (NAC). METHODS This review summarizes and meta-analyzes randomized controlled trials (RCTs) of CHMs for the treatment of IPF. RCTs compare either CHMs alone or in combination with NAC or conventional medicine treatment (CMT) vs NAC alone or in combination with CMT have been included. The following electronic databases have been searched: PubMed, Cochrane Library, Embase, CNKI, CBM, VIP, and WANFANG DATA. The methodologic quality of RCTs has been assessed using the Cochrane risk assessment tool. All trials included are analyzed according to the criteria of the Cochrane Handbook. Review Manager 5.3, R-3.5.1 software, and GRADE pro GDT web solution are used for data synthesis and analysis. RESULTS This review evaluates the effects of CHMs on acute exacerbation, mortality, the quality of life, 6-minute walking test distance, lung function (total lung capacity, diffusing capacity of the lungs for carbon monoxide, and forced vital capacity), partial pressure of oxygen in blood (PaO2), and safety in patients with IPF. CONCLUSION This review provides clear evidence to assess the effectiveness and safety of CHMs for IPF.
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Comparison of Aspirin and Naoxintong Capsule () with Adjusted-Dose Warfarin in Elderly Patients with High-Risk of Non-Valvular Atrial Fibrillation and Genetic Variants of Vitamin K Epoxide Reductase.
Wang, H, Zhou, XK, Zheng, LF, Wu, XY, Chen, H
Chinese journal of integrative medicine. 2018;(4):247-253
Abstract
OBJECTIVE To compared the therapeutic effect of a Chinese patent medicine Naoxintong Capsule (, NXT) and aspirin with adjusted-dose warfarin in Chinese elderly patients (over 65 years) with nonvalvular atrial fibrillation (NVAF) and genetic variants of vitamin K epoxide reductase (VKORC1), who are at high-risk of thromboembolism. METHODS A total of 151 patients, with NVAF and AA genotype of VKORC1-1639 (a sensitive genotype to warfarin) and a CHA2DS2-VASc clinical risk score of 2 or above, were chosen for this study. Patients were randomized into two groups and orally treated with a combination of aspirin (100 mg/day) and NXT (1.6 g thrice a day) or adjusted-dose warfarin [international normalized ratio 2.0-3.0). The primary end points including ischemic stroke and death as well as the secondary end points including hemorrhage events were followed up for at least 1 year. RESULTS Baseline clinical data and the rates of primary end points were similar between groups. However, the rate of serious bleeding (secondary event) in the combination therapy group was lower than that in the adjusted-dose warfarin group (0% vs. 7.9%, odds ratio: 0.921, 95% confidence interval: 0.862-0.984, P=0.028). CONCLUSIONS Aspirin combined with NXT and warfarin displayed comparable rates of primary end point including ischemic stroke and all-cause death during the 1-year follow-up. However, as compared with warfarin, the combination therapy reduced the rate of serious bleeding. Therefore, aspirin combined with NXT might provide an alternative pharmacotherapy in preventing ischemic stroke for elderly patients with NAVF who cannot tolerate warfarin. (No. ChiCTR-TRC-13003596).
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5.
Oriental Herbal Medicine for Neurological Disorders in Children: An Overview of Systematic Reviews.
Lee, B, Kwon, CY, Chang, GT
The American journal of Chinese medicine. 2018;(8):1701-1726
Abstract
Oriental herbal medicine (OHM) has been widely used in pediatric neurological disorders and has attracted attention as a safe and effective treatment. We aim to summarize and evaluate the evidence for OHM in pediatric neurological disorders for evidence-based decision-making. Without language restrictions, up-to-date research data were obtained from nine electronic databases. Systematic reviews (SRs) assessing the efficacy of OHM for pediatric neurological disorders were included. The methodological quality of each review was assessed using the AMSTAR instrument. The quality of evidence for the main findings was evaluated using the GRADE approach. Sixteen SRs comprising 169 randomized controlled trials with 19,542 participants were included. In epilepsy (six SRs, n=5,341 ), OHM as an adjunctive or alternative therapy to antiepileptic drugs showed higher clinical symptom improvements than did antiepileptic drugs alone. The Activities of Daily Living scale score was significantly higher in children with cerebral palsy (one SR, n=508 ) when OHM was added to rehabilitation. There were inconsistent results for tic disorder (four SRs, n=9,870 ) and enuresis (two SRs, n=1,995 ) and unclear results for attention deficit hyperactivity disorder (two SRs, n=1,261 ) and autism spectrum disorder (one SR, n=567 ). Eleven SRs reported adverse events, but no fatal adverse reaction was reported. The methodological quality of the included reviews was medium-to-high. The overall quality of evidence ranged from "very low" to "moderate." In conclusion, the efficacy of OHM is promising for some pediatric neurological disorders such as epilepsy and cerebral palsy. However, more high-quality evidence is needed to make clinical recommendations on OHM use.
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Add-on therapy with traditional Chinese medicine: An efficacious approach for lipid metabolism disorders.
Zhang, Y, Kishi, H, Kobayashi, S
Pharmacological research. 2018;:200-211
Abstract
Add-on therapy with traditional Chinese medicine (TCM) has been extensively researched in the intractable diseases, such as asthma, cancer, and Alzheimer's disease. As an entirely new concept, add-on therapy of TCM has been also used to prevent and treat hyperlipidemia via lowering cholesterol level. However, the efficacy of add-on therapy with TCM for mediating lipid metabolism disorders remains controversial. In this review, we summarize and provide strong evidence that add-on therapy of TCM as a novel approach is efficacious and safe for hyperlipidemia associated diseases based on the mediation of lipid metabolism disorders.
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[Ferroptosis pathway and its intervention regulated by Chinese materia medica].
Xu, WH, Li, CH, Jiang, TL
Zhongguo Zhong yao za zhi = Zhongguo zhongyao zazhi = China journal of Chinese materia medica. 2018;(20):4019-4026
Abstract
Ferroptosis is a new form of regulated cell death which is different from apoptosis, necrosis and autophagy, and results from iron-dependent lipidperoxide accumulation. Now, it is found that ferroptosis is involved in multiple physiological and pathological processes, such as cancer, arteriosclerosis, neurodegenerative diseases, diabetes, antiviral immune response, acute renal failure, hepatic and heart ischemia/reperfusion injury. On the one hand, it could be found the appropriate drugs to promote ferroptosis to clear cancer cells and virus infected cells, etc. On the other hand, we could inhibit ferroptosis to protect healthy cells. China has a wealth of traditional Chinese medicine resources. Chinese medicine contains a variety of active ingredients that regulate ferroptosis. Here, this paper reported the research of ferroptosis pathway, targets of its inducers and inhibitors that have been discovered, and the regulatory effects of the discovered Chinese herbs and its active ingredients on ferroptosis to help clinical and scientific research.
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Herbal medicine (Bojungikki-tang) for allergic rhinitis: A protocol for a systematic review of controlled trials.
Lee, JA, Jang, S, Jun, JH, Lee, MS, Lee, E, Kim, N, Lee, DH
Medicine. 2018;(3):e9551
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Abstract
BACKGROUND Bojungikki-tang, a herbal medicine for strengthening the digestive system, has been widely used in East Asian countries since the Yuan Dynasty in China. Moreover, Bojungikki-tang has reportedly exhibited anti-allergy effects in many clinical trials. This systematic review will assess the effectiveness and safety of Bojungikki-tang for allergic rhinitis (AR). METHODS AND ANALYSIS Eleven databases, including Asian databases, will be searched for studies conducted through October 2017. We will include randomized controlled trials (RCTs) assessing Bojungikki-tang for AR. The risk of bias will be evaluated using the Cochrane risk of bias assessment tool, and confidence in the cumulative evidence will be evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) instrument. ETHICS AND DISSEMINATION This systematic review will be published in a peer-reviewed journal and will also be disseminated electronically and in print. The review will be updated to inform and guide health care practices. REGISTRATION The protocol for this systematic review has been registered in PROSPERO (https://www.crd.york.ac.uk/PROSPERO) under number CRD42017068993.
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[Meta-analysis on efficacy and safety of combination therapy of Aconitum and Western medicine in treatment of rheumatoid arthritis].
Zhang, XM, Zhang, B, Li, F, Tian, ZP
Zhongguo Zhong yao za zhi = Zhongguo zhongyao zazhi = China journal of Chinese materia medica. 2018;(2):227-233
Abstract
To analyze the efficacy and safety of the combination therapy of Aconitum and Western medicine in the treatment of rheumatoid arthritis (RA) by Meta-analysis, and provide evidence for its clinic application for RA. The random clinical trials (RCTs) regarding the combination therapy for treating RA were retrieved in the database of China National Knowledge Infrastructure database, China Science and Technology Journal database, WanFang, Chinese Biomedical Medical Database, PubMed, and Cochrane Library up to July 2017. According to the given inclusion criteria, 8 RCTs involving 659 participants were included, and the included RCTs could be further divided into three subgroups according to the herb type, which were Aconiti Radix (Chuanwu) subgroup (6RCTs), Aconiti Kusnezoffii Radix (Caowu) subgroup (1RCT), and Chuanwu-Caowu subgroup (1RCT). The Meta-analysis results indicated that as compared with Western medicine, the combined use of Aconitum and Western medicine, no matter Chuanwu, Caowu or Chuanwu-Caowu subgroups, could improve the total effective rate of RA (6RCTs, RR=1.19, 95%CI [1.10, 1.28], P<0.000 01), (1 RCT, RR=1.43, 95%CI [1.18, 1.73], P=0.000 2), (1 RCT, RR=1.27, 95%CI [1.02, 1.58], P=0.03) respectively. The combined use of Aconitum and Western medicine was also effective on the number of joint swelling, duration of morning stiffness, patients' handgrip, and the erythrocyte sedimentation rate, C-reactive protein and rheumatoid factor. However, its action was not significant on joint tenderness. And also, in the included RCTs, there were 34 cases of adverse drug reactions/events (ADR/ADE) in the Chuanwu subgroup, while 86 cases in the Western medicine control group. The ADR/ADE incidence was even more lower in Chuanwu-Caowu subgroup, but no difference between Caowu subgroup and Western medicine group. Based on the included RCTs, the combined use of Aconitum and Western medicine could achieve more satisfying efficacy and lower ADRs incidence for RA as compared with Western medicine alone. However, due to the limitation in the not-high quality of included RCTs and the lack of large-scale multi-center research, the results still need to be further validated in the clinic application.
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Patient characteristics associated with treatment response in patients receiving salvianolate injection for stable angina.
Qi, Y, Yu, C, Tang, L, Li, S, Sun, X
Journal of evidence-based medicine. 2018;(2):83-88
Abstract
OBJECTIVE To explore patient characteristics associated with treatment response in patients receiving salvianolate injection for stable angina. METHODS An analysis was conducted of data from a multicenter, phase IV clinical trial undertaken in China that enrolled 2150 patients hospitalized for stable angina from 50 hospitals. The treatment outcomes were changes of angina severity and nitroglycerin use between baseline and the last day of treatment. We used logistic regression models to explore patient characteristics associated with the treatment response. RESULTS Patients who were overweight or obese (ORa 1.20, 95% CI 1.01 to 1.44), present with hypertension (ORa 1.23, 95% CI 1.01 to 1.49), experienced with 3 or more episodes of angina per week (ORa 1.77, 95% CI 1.44 to 2.17), or concomitantly using antiplatelet agents (ORa 1.44, 95% CI 1.17 to 1.78) were associated with better treatment response defined with the change of angina severity. Those of overweight or obesity (ORa 1.57, 95% CI 1.17 to 2.12) or concomitantly using calcium antagonists (ORa 2.38, 95% CI 1.39 to 4.08) fared better treatment response according to discontinuation or reduction of nitroglycerin use. CONCLUSIONS Patients diagnosed with stable angina and receiving salvianolate injection might fare better treatment response if they were overweight or obese, experienced with hypertension, three or more episodes of angina per week, or concomitantly using antiplatelet agents and calcium antagonists.