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Journal of Traditional Chinese Medicine... Aug 2022To investigate the short-term efficacy and safety outcomes following a sequential treatment with clearing heat and eliminating phlegm (CHEP) formula and tonifying Qi and...
Efficacy and safety of a sequential treatment with clearing heat and eliminating phlegm and tonifying and activating blood circulation in treating acute ischemic stroke: study protocol for a randomized controlled trial.
OBJECTIVE
To investigate the short-term efficacy and safety outcomes following a sequential treatment with clearing heat and eliminating phlegm (CHEP) formula and tonifying Qi and activating blood circulation (TQABC) formula in patients with acute ischemic stroke (AIS) within a 72 h time window.
METHODS
In this randomized, multicenter, double-blinded, placebo-controlled trial, 500 participants will be randomly assigned in a ratio of 1∶1 to the CHEP+ TQABC group or control group. In addition to guideline-based standard medical care, participants in the treatment group will receive the CHEP formula for the first 5 consecutive days followed by the TQABC formula for another 10 consecutive days, while those in the control group will receive CHEP formula placebo and TQABC formula placebo consecutively. The primary outcome measure will be the comparison of the change in the National Institutes of Health Stroke Scale score from baseline to 15 days after randomization. The secondary outcome measures will include the scores on the modified Rankin Scale, Barthel Index, Patient-Reported Outcomes, TCM symptom pattern (Zheng-hou) evaluation Scale, and the incidence of in-hospital complications. Safety assessment will include the physical examination, laboratory detection, any adverse events or serious adverse events, and the proportion of any complications during hospitalization.
DISCUSSION
The results of this study will provide objective and scientific data with which to assess the efficacy and safety of a sequential treatment based on "integrating disease and symptom pattern" for patients with AIS.
Topics: Double-Blind Method; Hospitalization; Hot Temperature; Humans; Ischemic Stroke; Multicenter Studies as Topic; Qi; Randomized Controlled Trials as Topic; Stroke; Treatment Outcome
PubMed: 35848977
DOI: 10.19852/j.cnki.jtcm.20220617.003 -
Medicine Sep 2022Epilepsy is a chronic encephalopathy caused by abnormal discharge of neurons in the brain, resulting in brain dysfunction. Cognitive impairment is one of the most common... (Meta-Analysis)
Meta-Analysis
BACKGROUNDS
Epilepsy is a chronic encephalopathy caused by abnormal discharge of neurons in the brain, resulting in brain dysfunction. Cognitive impairment is one of the most common complications of epilepsy. The current treatment of epilepsy in the control of symptoms at the same time cause a lot of side effects, especially the aggravation of cognitive impairment. Many literatures have stated that the efficacy and safety of integrated Traditional Chinese and western medicine in the treatment of epilepsy with cognitive impairment is superior to that of western medicine alone. In this systematic review and meta-analysis, we intend to evaluate the clinical efficacy and safety of removing stasis and resolving phlegm in the treatment of epilepsy with cognitive impairment.
OBJECTIVE
To systematically evaluate the clinical efficacy and safety of removing blood stasis and resolving phlegm in the treatment of epilepsy with cognitive impairment.
METHODS
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed to conduct this systematic review. The Chinese Journal Full Text Database (CNKI), Wanfang Database, CQVIP Database (CQVIP), Cochrane Library, EMbase, and Pubmed were searched by computer, and randomized controlled studies on the efficacy of removing blood stasis and resolving phlegm in the treatment of epilepsy with cognitive disorders were included. Retrieval was carried out until January 2022, and relevant data were extracted for meta-analysis using Rev Man5.3 software.
RESULTS
Fourteen randomized controlled studies with a total of 1198 patients were included, including 601 patients in the control group and 597 patients in the treatment group (experimental group).
RESULTS
Meta-analysis results showed that compared with the treatment of epilepsy with cognitive impairment in the western anti-epileptic drugs group alone, the treatment of epilepsy with cognitive impairment combined with the method of removing blood stasis and resolving phlegm could significantly improve the clinical efficacy of epilepsy (OR = 3.41, 95% CI 2.39-4.88, P < .001). Improved the TCM symptom score (OR = 3.99, 95% CI 1.72-9.26, P < .001). Increased the EEG improvement rate (RR = 1.39, 95% CI 1.05-1.84, P = .02). Improved MOCA score and cognitive function (MD = 3.54, 95% CI 1.68-5.40, P < .001). Improved QOLIE-31 cognitive function score. Improved cognitive function (MD = 7.22, 95% CI 3.35-11.08, P < .001). Improved the incidence of adverse reactions (RR = 0.50, 95% CI 0.33-0.76, P = .001).
CONCLUSION
Compared with the treatment of epilepsy with cognitive impairment by western anti-epileptic drugs alone, the treatment of epilepsy with cognitive impairment combined with the method of removing blood stasis and resolving phlegm is superior to the treatment of epilepsy with cognitive impairment by western anti-epileptic drugs alone.
Topics: Cognition Disorders; Cognitive Dysfunction; Epilepsy; Humans; Medicine, Chinese Traditional; Treatment Outcome
PubMed: 36123849
DOI: 10.1097/MD.0000000000030212 -
Food Chemistry Oct 2020Platycodonis Radix, the root of Platycodon grandiflorum (Jacq.) A. DC., is a well-known edible herbal medicine. It is a common vegetable used for the preparation of side... (Review)
Review
Platycodonis Radix, the root of Platycodon grandiflorum (Jacq.) A. DC., is a well-known edible herbal medicine. It is a common vegetable used for the preparation of side dish, kimchi, dessert, and tea. Besides, it has been used to treat respiratory disease including cough, excessive phlegm, and sore throat for a long history. In the past decades, the bioactive components and the pharmacological activities of Platycodonis Radix have been widely investigated. Thereinto, platycodins, the oleanane-type triterpenoid saponins were demonstrated to be the main bioactive components in Platycodonis Radix, and more than 70 platycodins have been identified up to date. This paper mainly reviewed the phytochemistry, pharmacological activities (apophlegmatic, anti-tussive, anti-inflammatory, anti-cancer, anti-obesity, anti-diabetic, immunomodulatory, cardiovascular protective, and hepatoprotective activities, etc.), toxicology and pharmacokinetics of platycodins isolated from Platycodonis Radix, aiming to promote further investigation on therapeutic potential of these platycodins.
Topics: Animals; Humans; Phytotherapy; Platycodon; Saponins
PubMed: 32450486
DOI: 10.1016/j.foodchem.2020.127029 -
Journal of Healthcare Engineering 2022To observe the clinical efficacy of heat clearing phlegm mixture combined with vibration sputum excretion instrument in the treatment of patients with acute exacerbation...
To observe the clinical efficacy of heat clearing phlegm mixture combined with vibration sputum excretion instrument in the treatment of patients with acute exacerbation of COPD with phlegm-heat obstructing lung, 90 patients with acute exacerbation of COPD are selected and divided into three groups, namely, control group, traditional medicine group, and combined group: the control group (conventional western medicine treatment), traditional medicine group (heat clearing and phlegm mixture), and combined group (heat clearing and phlegm mixture + vibratory sputum excretion instrument) with 30 cases each. All the patients in the three groups were given conventional western medicine treatment. On this basis, the traditional medicine group was given the oral administration of the heat-clearing and phlegm-clearing mixture, and the combined group was given the oral administration of the heat-clearing and phlegm-clearing mixture and the vibratory sputum discharge apparatus. Machine learning is used to classify the patients into three groups based on the characteristics of their biomarkers, physical attributes, and medical history. The TCM syndrome score, blood gas analysis, lung function, and inflammatory indexes of the three groups were compared. TCM syndrome scores of the three groups were all lower than before; both the combined group and the TCM group were better than the control group ( < 0.05). Although the improvement degree of the combined group was better than that of the TCM group, the difference was not statistically significant ( > 0.05). TCM syndrome effect is seen to be 96.55% in the combined group, 89.29% in the TCM group, and 63.33% in the control group. Blood gas analysis is also performed; PO2 and PCO2 of the three groups were significantly improved after treatment. The combination group was superior to the traditional medicine group and the control group ( < 0.05), and the traditional medicine group was superior to the control group ( < 0.05). It is concluded that the combination of heat clearing phlegm mixture and vibration sputum excretion instrument can improve TCM syndrome score, CAT score, blood gas analysis, lung function, and inflammatory indicators in patients with acute exacerbation of COPD with phlegm-heat obstructing lung.
Topics: Hot Temperature; Humans; Lung; Medicine, Chinese Traditional; Pulmonary Disease, Chronic Obstructive; Treatment Outcome
PubMed: 35313509
DOI: 10.1155/2022/3962074 -
Zhongguo Zhen Jiu = Chinese Acupuncture... May 2022After reading the article, "": published in , the authors collected the original evidences also for the effect of Fenglong (ST 40) on phlegm disorders by tracing from...
After reading the article, "": published in , the authors collected the original evidences also for the effect of Fenglong (ST 40) on phlegm disorders by tracing from 9 ancient books of acupuncture and moxibustion, explored the standardized expressions of its indications and analyzed the changes of its indications. In that article, it was viewed that the effect of Fenglong (ST 40) started to be generalized in treatment of phlegm disorders since the Ming Dynasty. On contrary, we believes that Fenglong (ST 40) works on strengthening the spleen and resolving dampness for the disorders caused by the broad meaning of "phlegm/damp". Based on it, since the Ming Dynasty, the effect of Fenglong (ST 40) is extended specifically for the disorders caused by the visible sputum from the lung, the narrowing mean of "phlegm". Hence, if "Fenglong (ST 40) for phlegm" is considered as an academic point of view, it needs an adequate evidences to expound and prove.
Topics: Acupuncture; Acupuncture Points; Acupuncture Therapy; Moxibustion; Mucus
PubMed: 35543950
DOI: 10.13703/j.0255-2930.20210520-0007 -
Mini Reviews in Medicinal Chemistry 2020Flavonoids are an important class of phytopharmaceuticals in plants. Naringin (naringenin- 7-O-rhamnoglucoside) is a flavanone glycoside isolated from folk herbal... (Review)
Review
Flavonoids are an important class of phytopharmaceuticals in plants. Naringin (naringenin- 7-O-rhamnoglucoside) is a flavanone glycoside isolated from folk herbal medicine Exocarpium Citri grandis (called Huajuhong in Chinese). Massive experimental works have been performed on naringin describing its phytochemical, pharmacokinetic, and bioactive properties. Naringin was found to possess multiple pharmacological activities in relieving inflammation, diabetes, neurodegeneration, cardiovascular disorders, and metabolic syndrome. Recently, it has been approved as a potential antitussive and expectorant for clinical trials. However, the pharmacokinetic aspects of naringin and its therapeutic potentials in respiratory diseases have not been comprehensively reviewed. The present review provides highlights of naringin with respect to its absorption, distribution, metabolism, excretion and its therapeutic effects on cough, phlegm, and pulmonary inflammation. This review would be helpful for the interpretation of pharmacokinetics and pharmacodynamics of naringin in clinical trials.
Topics: Animals; Flavanones; Humans; Respiration Disorders
PubMed: 32134369
DOI: 10.2174/1389557519666191009162641 -
BMJ Open Respiratory Research Jun 2023Emerging evidence in both developed and developing countries indicate that occupational health hazards and diseases among construction workers constitute a significant...
BACKGROUND
Emerging evidence in both developed and developing countries indicate that occupational health hazards and diseases among construction workers constitute a significant public health challenge. While occupational health hazards and conditions in the construction sector are diverse, a burgeoning body of knowledge is emerging about respiratory health hazards and diseases. Yet, there is a notable gap in the existing literature in terms of comprehensive syntheses of the available evidence on this topic. In light of this research gap, this study systematically reviewed the global evidence on occupational health hazards and related respiratory health conditions among construction workers.
METHODS
Using meta-aggregation, guided by the Condition (respiratory health conditions), Context (construction industry) and Population (construction workers) (CoCoPop) framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, literature searches were conducted on Scopus, PubMed, Web of Science and Google Scholar for relevant studies on respiratory health conditions affecting construction workers. Four eligibility criteria were used in scrutinising studies for inclusion. The quality of the included studies was assessed based on Joanna Briggs Institute's Critical Appraisal tool, while the reporting of the results was guided by the Synthesis Without Meta-analysis guidelines.
RESULTS
From an initial pool of 256 studies from the various databases, 25 studies published between 2012 and October 2022 were identified as meeting the inclusion criteria. In all, 16 respiratory health conditions were identified, with cough (ie, dry and with phlegm), dyspnoea/breathlessness and asthma emerging as the top three respiratory conditions among construction workers. The study identified six overarching themes of hazards that are associated with respiratory health conditions among construction workers. These hazards include exposure to dust, respirable crystalline silica, fumes, vapours, asbestos fibres and gases. Smoking and extended period of exposure to the respiratory hazard were found to increase the risk of contracting respiratory diseases.
CONCLUSIONS
Our systematic review indicates that construction workers are exposed to hazards and conditions that have adverse effects on their health and well-being. Given the considerable impact that work-related health hazards can have on the health and socioeconomic well-being of construction workers, we suggest that the implementation of a comprehensive occupational health programme is essential. Such a programme would extend beyond the mere provision of personal protective equipment and would incorporate a range of proactive measures aimed at controlling the hazards and mitigating the risk of exposure to the occupational health hazards.
Topics: Humans; Occupational Exposure; Construction Industry; Respiratory Tract Diseases
PubMed: 37364917
DOI: 10.1136/bmjresp-2023-001736 -
Frontiers in Pharmacology 2022This meta-analysis aimed at evaluating the effectiveness and safety of Chinese medicine (TCM), which nourished qi, promoted blood circulation, and expelled phlegm...
Effectiveness and safety of treating carotid atherosclerotic plaques with the method of nourishing qi, promoting blood circulation and expelling phlegm: A systematic review and meta-analysis.
This meta-analysis aimed at evaluating the effectiveness and safety of Chinese medicine (TCM), which nourished qi, promoted blood circulation, and expelled phlegm (YQHXZT), in treating carotid atherosclerosis (CAS) from an immunological perspective. The incidence of CAS has been increasing and tends to be younger. Although western medicine is effective, there are some limitations. TCM has certain advantages over the multichannel and multitarget treatment strategies in slowing down the process of CAS. However, there is no comprehensive review in this field. Nine databases were searched from January, 2012, to September, 2022. After applying the inclusion and exclusion criteria to the RCTs, research quality evaluation and data extraction were conducted, and a meta-analysis of the articles was performed. The GRADE was used to assess the quality of the evidence. Fourteen RCTs involving 1,191 patients were identified. The results indicated that the experimental group was more effective in improving carotid intima-media thickness (CIMT)[SMD = -0.97, 95%CI(-.30,-0.65), < 0.00001], reducing carotid plaque area [SMD = -1.98, 95%CI(-3.06,-0.89), = 0.0003], lowering hs-CRP [SMD = -1.33, 95%CI(-1.59,-1.06), < 0.00001] and LDL-C levels [SMD = -0.60, 95%CI(-0.83,-0.38), < 0.00001]. Moreover, the experimental group was superior to peak systolic blood flow velocity (PSV) [SMD = -0.37, 95%CI(-0.59,-0.16), = 0.0007], clinical efficacy [RR = 1.64, 95% CI (1.39, 1.94), < 0.00001] and plaque area efficacy [RR = 1.36, 95% CI (1.22, 1.52), < 0.0001]. The adverse reactions were not statistically significant in the two groups [RD = -0.01, 95% CI (-0.04.0.01), = 0.17]. The results of grade evaluation suggested that the outcome indicators LDL-C, hs-CRP, plaque area efficacy, PSV, and adverse events were moderate. CIMT, plaque reduction area, and TCM clinical efficacy were low-quality. The combination of YQHXZT can alleviate the process of CAS by inhibiting the thickening of CIMT, reducing plaque area and lowering hs-CRP and LDL-C levels. The mechanism may possibly be related to reducing lipid deposition and inhibiting the inflammatory response. Besides, the combination did not increase the risk of adverse effects. However, more well-designed RCTs are needed in the future. CRD42022360529, https://www.crd.york.ac.uk/prospero/.
PubMed: 36438842
DOI: 10.3389/fphar.2022.1059737 -
Chinese Journal of Integrative Medicine May 2023To derive the Chinese medicine (CM) syndrome classification and subgroup syndrome characteristics of ischemic stroke patients.
OBJECTIVE
To derive the Chinese medicine (CM) syndrome classification and subgroup syndrome characteristics of ischemic stroke patients.
METHODS
By extracting the CM clinical electronic medical records (EMRs) of 7,170 hospitalized patients with ischemic stroke from 2016 to 2018 at Weifang Hospital of Traditional Chinese Medicine, Shandong Province, China, a patient similarity network (PSN) was constructed based on the symptomatic phenotype of the patients. Thereafter the efficient community detection method BGLL was used to identify subgroups of patients. Finally, subgroups with a large number of cases were selected to analyze the specific manifestations of clinical symptoms and CM syndromes in each subgroup.
RESULTS
Seven main subgroups of patients with specific symptom characteristics were identified, including M3, M2, M1, M5, M0, M29 and M4. M3 and M0 subgroups had prominent posterior circulatory symptoms, while M3 was associated with autonomic disorders, and M4 manifested as anxiety; M2 and M4 had motor and motor coordination disorders; M1 had sensory disorders; M5 had more obvious lung infections; M29 had a disorder of consciousness. The specificity of CM syndromes of each subgroup was as follows. M3, M2, M1, M0, M29 and M4 all had the same syndrome as wind phlegm pattern; M3 and M0 both showed hyperactivity of Gan (Liver) yang pattern; M2 and M29 had similar syndromes, which corresponded to intertwined phlegm and blood stasis pattern and phlegm-stasis obstructing meridians pattern, respectively. The manifestations of CM syndromes often appeared in a combination of 2 or more syndrome elements. The most common combination of these 7 subgroups was wind-phlegm. The 7 subgroups of CM syndrome elements were specifically manifested as pathogenic wind, pathogenic phlegm, and deficiency pathogens.
CONCLUSIONS
There were 7 main symptom similarity-based subgroups in ischemic stroke patients, and their specific characteristics were obvious. The main syndromes were wind phlegm pattern and hyperactivity of Gan yang pattern.
Topics: Humans; Syndrome; Ischemic Stroke; Medicine, Chinese Traditional; Liver; Phenotype
PubMed: 35723812
DOI: 10.1007/s11655-022-3571-2 -
Journal of Ethnopharmacology Jun 2022Qingkailing (QKL), Reduning (RDN), Xiyanping (XYP), Tanreqing (TRQ) and Yuxingcao (YXC) injections are all phlegm-heat clearing Chinese medicine (CM) injections composed... (Meta-Analysis)
Meta-Analysis Review
ETHNOPHARMACOLOGICAL RELEVANCE
Qingkailing (QKL), Reduning (RDN), Xiyanping (XYP), Tanreqing (TRQ) and Yuxingcao (YXC) injections are all phlegm-heat clearing Chinese medicine (CM) injections composed of the extract from traditional CM materials. Evidence from clinical studies and animal experiments indicates that the above CM injections are effective supplementary therapy for acute exacerbation chronic obstructive pulmonary disease (AECOPD), and clinicians are faced with a difficult choice on the optimal phlegm-heat clearing CM injection for AECOPD.
AIM OF THE STUDY
This systematic review and Bayesian network meta-analysis aimed to evaluate the comparative effectiveness of five commonly used phlegm-heat clearing CM injections for COPD.
MATERIALS AND METHODS
A pairwise and network meta-analyses were performed to assess the effectiveness of QKL, RDN, TRQ, XYP and YXC on AECOPD. Randomized controlled trials (RCTs) were identified by searching English and Chinese databases. The primary outcome was lung function (forced expiration volume [FEV1] and forced vital capacity [FVC]), blood gas analysis index was secondary outcome measure. Winbugs and Stata 15.0 software were used for data analysis.
RESULTS
A total of 57 RCTs were included. The pairwise analyses showed that each of the injections combined with routine treatment were superior to routine treatment alone [FEV1: QKL, MD 0.20, 95% CI (0.06, 0.35); RDN, MD 0.24, 95% CI (0.08, 0.40); TRQ, MD 0.24, 95% CI (0.19, 0.29); XYP, MD 0.26, 95% CI (0.20, 0.32); YXC MD 0.73, 95% CI (0.06, 1.41)]. The network meta-analysis provided the following rank of lung function improvement: FEV1: YXC > TRQ > XYP > RDN > QKL; FVC: YXC > TRQ > QKL > RDN > XYP. RDN and YXC ranked highest in blood gas analysis index. RDN was the highest ranked injection for effectiveness, followed by QKL, TRQ, XYP, then YXC. Most of the injections appeared safe, with severe adverse events rarely reported.
CONCLUSION
This study suggests that YXC and TRQ are the most effective therapies in treating AECOPD patients. RDN and YXC are more effective in the alleviation of clinical symptoms. Given that the safety of YXC is controversial, TRQ and RDN may be preferable as phlegm-heat clearing CM injections in the adjuvant treatment of AECOPD.
Topics: Animals; Drugs, Chinese Herbal; Forced Expiratory Volume; Hot Temperature; Humans; Medicine, Chinese Traditional; Network Meta-Analysis; Pulmonary Disease, Chronic Obstructive
PubMed: 35124185
DOI: 10.1016/j.jep.2022.115043