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Medicine Nov 2021Epilepsy 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...
Clinical efficacy and safety of removing blood stasis and removing phlegm in the treatment of epilepsy with cognitive impairment: A protocol for systematic review and meta-analysis.
BACKGROUND
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, we intend to evaluate the clinical efficacy and safety of removing stasis and resolving phlegm in the treatment of epilepsy with cognitive impairment.
METHODS
We will search The Cochrane Library, EMbase, Pubmed, Web of Science, Chinese Journal Full-Text Database (CNKI), Wanfang Database, and VIP database. Simultaneously we will retrieval relevant meeting minutes, eligible research reference lists, symposium abstracts, and gray literatures. We will not apply any restrictions to the language and publication date. All randomized controlled trials about the efficacy and safety of removing blood stasis and phlegm in the treatment of epilepsy with cognitive impairment will be included. Two authors will independently carry out. Any objections will be worked out by a third author through consultation. We will use the Revman 5.3 and Stata 13.0 software for data synthesis, sensitivity analysis, meta regression, subgroup analysis, and risk of bias assessment. The grading of recommendations assessment, development, and evaluation standard will be used to evaluate the quality of evidence.
RESULTS
This systematic review will synthesize the data from the present eligible high quality randomized controlled trials to assess whether the treatment of removing blood stasis and phlegm is effective and safety for epilepsy with cognitive impairment from various evaluation aspects including clinical efficacy of epilepsy, EEG improvement rate, MOCA score, QOLIE-31 cognitive function score, traditional Chinese medicine symptom score, incidence of adverse reactions, frequency of seizures of epilepsy, and duration of seizure of epilepsy.
CONCLUSION
The systematic review will provide evidence to assess the efficacy and safety of removing blood stasis and phlegm in the treatment of patients with epilepsy with cognitive impairment.
PROSPERO REGISTRATION NUMBER
CRD42021224893.
Topics: Cognitive Dysfunction; Drugs, Chinese Herbal; Epilepsy; Humans; Medicine, Chinese Traditional; Meta-Analysis as Topic; Research Design; Systematic Reviews as Topic; Treatment Outcome
PubMed: 34964768
DOI: 10.1097/MD.0000000000027929 -
Zhongguo Zhong Yao Za Zhi = Zhongguo... Mar 2023Atherosclerosis(AS) is the key pathological basis of coronary heart disease(CHD), and lipid infiltration is a classical theory to explain the pathological mechanism of...
[Research advances in mechanism of lipid infiltration of coronary heart disease and simultaneous treatment of phlegm and blood stasis based on phlegm-blood stasis correlation theory].
Atherosclerosis(AS) is the key pathological basis of coronary heart disease(CHD), and lipid infiltration is a classical theory to explain the pathological mechanism of AS. The theory highlights that the occurrence and development of AS are closely related to abnormal lipid metabolism, with the essence of the pathological reaction caused by the invasion of lipids into arterial intima from plasma. Phlegm and blood stasis are physiologically homologous and subject to pathological co-existence. Phlegm-blood stasis correlation is the basic theory to explain the pathogenesis characteristics of CHD and has important guiding significance for revealing the mecha-nism of lipid infiltration of CHD. Phlegm is the pathological product of abnormal metabolism of Qi, blood, and body fluid, and a gene-ral summary of a series of abnormally expressed lipid substances. Among them, turbid phlegm invades the heart vessels, gradually accumulates, and condenses to achieve the qualitative change from "invisible pathogen" to "tangible pathogen", which corresponds to the mechanism of lipid migration and deposition in the intima of blood vessels, and is the starting factor of the disease. Blood stasis is the continuous development of phlegm, and it is a result of pathological states such as decreased blood fluidity, increased blood coagulation, and abnormal rheology. The fact that blood stasis caused by phlegm accords with the pathological process of "lipid abnormality-circulatory disturbance" and is the central link of the disease. Phlegm and blood stasis aggravate each other and lead to indissoluble cementation. The phlegm-blood stasis combination serves as common pathogen to trigger the disease, which is the inevitable outcome of the disease. Based on the phlegm-blood stasis correlation theory, the simultaneous treatment of phlegm and blood stasis is established. It is found that this therapy can simultaneously regulate blood lipid, reduce blood viscosity, and improve blood circulation, which can fundamentally cut off the biological material basis of the reciprocal transformation between phlegm and blood stasis, thus exerting a significant curative effect.
Topics: Humans; Medicine, Chinese Traditional; Coronary Disease; Mucus; Atherosclerosis; Lipids
PubMed: 37005830
DOI: 10.19540/j.cnki.cjcmm.20221126.502 -
Evidence-based Complementary and... 2021To explore the differences in clinical characteristics and psychoacoustic indexes of various traditional Chinese medicine (TCM) syndromes in patients with idiopathic...
OBJECTIVE
To explore the differences in clinical characteristics and psychoacoustic indexes of various traditional Chinese medicine (TCM) syndromes in patients with idiopathic tinnitus.
METHODS
312 patients with idiopathic tinnitus in our hospital from December 2017 to March 2020 were selected; divided into the wind evil invasion group ( = 61), the liver fire disturbance group ( = 69), the phlegm fire stagnation group ( = 42), the spleen and stomach weakness group ( = 48), and the kidney essence loss group ( = 92) according to the medical syndrome type and the detailed medical history; and clinical characteristics of patients in each group were compared.
RESULTS
The kidney essence loss group's age and course of disease were older and longer than those of other syndrome groups, and the wind evil invasion group's disease course was shorter than the liver fire disturbance, phlegm fire stagnation, and spleen and stomach weakness groups ( < 0.05). The PSQI score of all patients was higher than 7 points, but there was no obvious difference between the groups ( > 0.05). The SAS score of the liver fire disturbance and the phlegm-fire stagnation groups was higher than that of the wind evil invasion, the spleen and stomach weakness, and the kidney essence loss groups, and the SDS score of the spleen and stomach weakness and the kidney essence loss groups was higher than that of the wind evil invasion, the liver fire disturbance, and the phlegm and fire stagnation groups ( < 0.05). The kidney essence loss group's total hearing loss rate (92.39%) was higher than the other syndrome groups, and the wind evil invasion group's total hearing loss rate (8.19%) was lower than the other syndrome groups ( < 0.05); the low to medium frequency tone of tinnitus's rate in the wind evil invasion group, liver fire disturbance group, and phlegm fire stagnation group was higher than the spleen and stomach weakness group and the kidney essence loss group, but the high frequency tone of tinnitus's rate was opposite. The tinnitus loudness in these groups was higher than the spleen and stomach weakness and kidney essence loss group ( < 0.05).
CONCLUSION
In addition to the wind evil invasion type, most tinnitus patients may have different levels of psychological disorders. So, in the treatment of idiopathic tinnitus, in addition to the disease itself, paying more attention to the psychological status of the patient is one better therapeutic method. Besides, clinical characteristics and the psychoacoustic indexes of patients with idiopathic tinnitus have a certain correlation with the TCM syndromes.
PubMed: 34608396
DOI: 10.1155/2021/2446357 -
Iranian Journal of Medical Sciences May 2016Stroke has a huge negative impact on the society and more adversely affect women. There is scarce evidence about any neuroprotective effects of commonly used drug in...
BACKGROUND
Stroke has a huge negative impact on the society and more adversely affect women. There is scarce evidence about any neuroprotective effects of commonly used drug in acute stroke. Bushnell et al. provided a guideline focusing on the risk factors of stroke unique to women, including reproductive factors, metabolic syndrome, obesity, atrial fibrillation, and migraine with aura. The ten variables cited by Avicenna in Canon of Medicine would compensate for the gaps mentioned in this guideline. The prescribed drugs should be selected qualitatively opposite to Mizaj (warm-cold and wet-dry qualities induced by disease state) of the disease and according to ten variables, including the nature of the affected organ, intensity of disease, sex, age, habit, season, place of living, occupation, stamina and physical status.
METHODS
Information related to stroke was searched in Canon of Medicine, which is an outstanding book in traditional Persian medicine written by Avicenna.
RESULTS
A hemorrhagic stroke is the result of increasing sanguine humor in the body. Sanguine has warm-wet quality, and should be treated with food and drugs that quench the abundance of blood in the body. An acute episode of ischemic stroke is due to the abundance of phlegm that causes a blockage in the cerebral vessels. Phlegm has cold-wet quality and treatment should be started with compound medicines that either solve the phlegm or eject it from the body.
CONCLUSION
Avicenna has cited in Canon of Medicine that women have cold and wet temperament compared to men. For this reason, they are more prone to accumulation of phlegm in their body organs including the liver, joints and vessels, and consequently in the risk of fatty liver, degenerative joint disease, atherosclerosis, and stroke especially the ischemic one. This is in accordance with epidemiological studies that showed higher rate of ischemic stroke in women rather than hemorrhagic one.
PubMed: 27840525
DOI: No ID Found -
Current Drug Metabolism 2022Platycodonis Radix (Jiegeng), the dried root of Platycodon grandiflorum, is a traditional herb used as both medicine and food. Its clinical application for the treatment... (Review)
Review
Platycodonis Radix (Jiegeng), the dried root of Platycodon grandiflorum, is a traditional herb used as both medicine and food. Its clinical application for the treatment of cough, phlegm, sore throat, pulmonary and respiratory diseases has been thousands of years in China. Platycodin D is the main active ingredient in Platycodonis Radix, which belongs to the family of pentacyclic triterpenoid saponins because it contains an oleanolane type aglycone linked with double sugar chains. Modern pharmacology has demonstrated that Platycodin D displays various biological activities, such as analgesics, expectoration and cough suppression, promoting weight loss, anti-tumor and immune regulation, suggesting that Platycodin D has the potential to be a drug candidate and an interesting target as a natural product for clinical research. In this review, the distribution and biotransformation, pharmacological effects, metabolic mechanism and safety evaluation of Platycodin D are summarized to lay the foundation for further studies.
Topics: Biotransformation; Cough; Humans; Saponins; Triterpenes
PubMed: 35114917
DOI: 10.2174/1389200223666220202090137 -
PloS One 2021This study determined the association between respiratory symptoms and death from respiratory causes over a period of 45 years. In four cohorts of random samples of...
This study determined the association between respiratory symptoms and death from respiratory causes over a period of 45 years. In four cohorts of random samples of Norwegian populations with 103,881 participants, 43,731 persons had died per 31 December 2016. In total, 5,949 (14%) had died from respiratory diseases; 2,442 (41%) from lung cancer, 1,717 (29%) chronic obstructive pulmonary disease (COPD), 1,348 (23%) pneumonia, 119 (2%) asthma, 147 (2%) interstitial lung disease and 176 (3%) other pulmonary diseases. Compared with persons without respiratory symptoms the multivariable adjusted hazard ratio (HR) for lung cancer deaths increased with score of breathlessness on effort and cough and phlegm, being 2.6 (95% CI 2.1-3.2) for breathlessness score 3 and 2.1 (95% CI 1.7-2.5) for cough and phlegm score 5. The HR of COPD death was 6.4 (95% CI 5.4-7.7) for breathlessness score 3 and 3.0 (2.4-3.6) for cough and phlegm score 5. Attacks of breathlessness and wheeze score 2 had a HR of 1.6 (1.4-1.9) for COPD death. The risk of pneumonia deaths increased also with higher breathlessness on effort score, but not with higher cough and phlegm score, except for score 2 with HR 1.5 (1.2-1.8). In this study with >2.4 million person-years at risk, a positive association was observed between scores of respiratory symptoms and deaths due to COPD and lung cancer. Respiratory symptoms are thus important risk factors, which should be followed thoroughly by health care practitioners for the benefit of public health.
Topics: Adolescent; Adult; Asthma; Cohort Studies; Cough; Dyspnea; Female; Forced Expiratory Volume; Humans; Lung Diseases; Lung Neoplasms; Male; Middle Aged; Norway; Pulmonary Disease, Chronic Obstructive; Respiration Disorders; Respiratory Sounds; Risk Factors; Young Adult
PubMed: 34807953
DOI: 10.1371/journal.pone.0260416 -
Zhongguo Zhen Jiu = Chinese Acupuncture... Sep 2021From the perspective of academic history, the background and evolution of "Fenglong (ST 40) for phlegm" were systematically summarized. As a result, it was found that in...
From the perspective of academic history, the background and evolution of "Fenglong (ST 40) for phlegm" were systematically summarized. As a result, it was found that in the early period, Fenglong (ST 40) was used for "tangible phlegm" of respiratory tract, but in the later generations, due to the comprehensive effects of various factors, the phlegm treated by Fenglong (ST 40) was generalized. In modern clinical practice of acupuncture and moxibustion, Fenglong (ST 40) is widely used for phlegm-related diseases. In addition, the knowledge content represented by "Fenglong (ST 40) for phlegm" showed evolution and change in academic heritage of previous dynasties. It is necessary for modern acupuncture researchers to systematically sort out, test and discriminate the habitual knowledge in combination with the background of traditional Chinese medicine, so as to promote the contemporary inheritance and application of traditional acupuncture theory and knowledge.
Topics: Acupuncture Points; Acupuncture Therapy; Moxibustion; Mucus; Respiratory System
PubMed: 34491655
DOI: 10.13703/j.0255-2930.20210104-k0001 -
Thorax Nov 2014This study aimed to assess associations of outdoor air pollution on prevalence of chronic bronchitis symptoms in adults in five cohort studies (Asthma-E3N, ECRHS, NSHD,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
This study aimed to assess associations of outdoor air pollution on prevalence of chronic bronchitis symptoms in adults in five cohort studies (Asthma-E3N, ECRHS, NSHD, SALIA, SAPALDIA) participating in the European Study of Cohorts for Air Pollution Effects (ESCAPE) project.
METHODS
Annual average particulate matter (PM(10), PM(2.5), PM(absorbance), PM(coarse)), NO(2), nitrogen oxides (NO(x)) and road traffic measures modelled from ESCAPE measurement campaigns 2008-2011 were assigned to home address at most recent assessments (1998-2011). Symptoms examined were chronic bronchitis (cough and phlegm for ≥3 months of the year for ≥2 years), chronic cough (with/without phlegm) and chronic phlegm (with/without cough). Cohort-specific cross-sectional multivariable logistic regression analyses were conducted using common confounder sets (age, sex, smoking, interview season, education), followed by meta-analysis.
RESULTS
15 279 and 10 537 participants respectively were included in the main NO(2) and PM analyses at assessments in 1998-2011. Overall, there were no statistically significant associations with any air pollutant or traffic exposure. Sensitivity analyses including in asthmatics only, females only or using back-extrapolated NO(2) and PM10 for assessments in 1985-2002 (ECRHS, NSHD, SALIA, SAPALDIA) did not alter conclusions. In never-smokers, all associations were positive, but reached statistical significance only for chronic phlegm with PM(coarse) OR 1.31 (1.05 to 1.64) per 5 µg/m(3) increase and PM(10) with similar effect size. Sensitivity analyses of older cohorts showed increased risk of chronic cough with PM(2.5abs) (black carbon) exposures.
CONCLUSIONS
Results do not show consistent associations between chronic bronchitis symptoms and current traffic-related air pollution in adult European populations.
Topics: Air Pollution; Bronchitis, Chronic; Cohort Studies; Cross-Sectional Studies; Environmental Monitoring; Global Health; Humans; Incidence; Risk Factors
PubMed: 25112730
DOI: 10.1136/thoraxjnl-2013-204352 -
The Journal of International Medical... Aug 2020This study aimed to evaluate the effect of clearing heat and resolving phlegm for acute exacerbation of chronic obstructive pulmonary disease with the syndrome of...
OBJECTIVE
This study aimed to evaluate the effect of clearing heat and resolving phlegm for acute exacerbation of chronic obstructive pulmonary disease with the syndrome of phlegm-heat obstruction of the lung.
METHODS
This was a real-world retrospective cohort study of inpatients at our institution from 1 January 2015 to 31 December 2017. The patients were divided into two groups according to whether they received oral traditional Chinese medicine (TCM) for clearing heat and resolving phlegm or routine treatment (controls). Efficacy and safety indicators were analyzed. Propensity score matching was used to control for confounding factors.
RESULTS
Among 488 patients, 164 (82 pairs) were successfully matched. The changes in neutrophils (%) and C-reactive protein levels were more significant in the TCM group than in the control group. The duration of fever was significantly shorter in the TCM group than in the control group.
CONCLUSIONS
The therapy of clearing heat and resolving phlegm might effectively control the inflammatory reaction of acute exacerbation of chronic obstructive pulmonary disease in patients with the syndrome of phlegm-heat obstruction of the lung, especially for those with fever. Nevertheless, large-scale and prospective studies are required to provide a higher quality of evidence.
Topics: Drugs, Chinese Herbal; Hot Temperature; Humans; Lung; Medicine, Chinese Traditional; Prospective Studies; Pulmonary Disease, Chronic Obstructive; Retrospective Studies
PubMed: 32814490
DOI: 10.1177/0300060520945502 -
Journal of Ethnopharmacology Dec 2023Wendan Decoction (WDD) is one of the classic traditional Chinese prescriptions that has been used in the treatment of type 2 diabetes mellitus (T2DM), metabolic...
ETHNOPHARMACOLOGICAL RELEVANCE
Wendan Decoction (WDD) is one of the classic traditional Chinese prescriptions that has been used in the treatment of type 2 diabetes mellitus (T2DM), metabolic syndrome, obstructive sleep apnea-hypopnea syndrome (OSAHS) and so on. The therapeutic effects and mechanism of WDD remain to be explored, especially from the perspective of metabolomics, oxidative stress and inflammation.
AIM OF THE STUDY
To investigate the therapeutic and metabolic regulatory effects and the underlying mechanism of WDD in OSAHS with T2DM patients.
MATERIALS AND METHODS
All included patients were from Rudong Hospital of Traditional Chinese Medicine, Nantong, Jiangsu Province, China. Both groups received lifestyle interventions; at the same time, all of them were administered metformin (1500 mg/day) and dapagliflozin (10 mg/day), and the treatment group was administered WDD orally. All patients were treated for two months. Before and after treatment, the changes in clinical symptoms and signs of the two groups of patients were evaluated, and the detection indicators such as body mass index (BMI), apnea-hypopnea index (AHI), lowest arterial oxygen saturation (LSaO), Epworth sleepiness scale (ESS), percentage of total sleep time with oxygen saturation <90% (TST90), fasting plasma glucose (FPG), 2-h post-load glucose(2h-PG), fasting insulin (FINS), homeostasis model assessment of insulin resistance (HOMA-IR),hemoglobin A1c (HbA1c), blood lipid levels, as well as the adverse reactions and compliance of the patients were observed and detection of serum metabolites in patients to screen out specific biomarkers. The serum metabolic profile of WDD in OSAHS with T2DM patients was explored using ultra-high-performance liquid chromatography-quadrupole/electrostatic field orbitrap high-resolution mass spectrometry (UPLC-Q Orbitrap HRMS).
RESULTS
After treatment with WDD for 8 weeks, biochemical indicators, including BMI, FPG, 2h-PG, blood lipid, FINS, HbA1c, AHI, ESS, LSaO, TST90, and HOMA-IR, were significantly improved. Serum metabolomic analysis showed that metabolites were differentially expressed before and after WDD-treated patients. Metabolomics results revealed that WDD regulated the biomarkers, such as DL-arginine, guaiacol sulfate, azelaic acid, phloroglucinol, uracil, L-tyrosine, cascarillin, Cortisol and L-alpha-lysophosphatidylcholine. Pathway enrichment analysis showed that the metabolites were associated with oxidative stress and inflammation.
CONCLUSION
The study based on clinical research and metabolomics indicated that WDD can improve OSAHS with T2DM through multiple targets and pathways, and it may be a useful alternative therapy for the treatment of OSAHS with T2DM patients.
Topics: Humans; Diabetes Mellitus, Type 2; Glycated Hemoglobin; Sleep Apnea, Obstructive; Treatment Outcome; Inflammation; Metabolomics
PubMed: 37311503
DOI: 10.1016/j.jep.2023.116775