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Evidence-based Complementary and... 2021Chronic heart failure is the main critical illness and cause of death in the later stages of cardiovascular disease, and it is one of the two major challenges in the... (Review)
Review
A Systematic Review and Meta-Analysis of High-Frequency Prescription of Zhigancao Decoction Combined with Conventional Western Medicine in the Treatment of Chronic Heart Failure.
BACKGROUND
Chronic heart failure is the main critical illness and cause of death in the later stages of cardiovascular disease, and it is one of the two major challenges in the field of cardiovascular research. The clinical application of traditional Chinese medicine in the prevention and treatment of chronic heart failure has been relatively common in China, and the "Expert Consensus on the Diagnosis and Treatment of Chronic Heart Failure with Integrated Traditional Chinese and Western Medicine" has been published in China. Combining the literature in this field, the authors found that Zhigancao Decoction has been used in the treatment of chronic heart failure with more clinical research reports and higher frequency (this article refers to it as a high-frequency prescription for short). However, Zhigancao Decoction was not included in the recommended prescriptions in the "Expert Consensus on the Diagnosis and Treatment of Chronic Heart Failure with Integrated Traditional Chinese and Western Medicine," and there was no relevant systematic review and meta-analysis. For this reason, this article has carried out two parts of work, including systematically organizing the literature in this research field and carrying out systematic review and meta-analysis. This can provide stronger evidence support for Zhigancao Decoction combined with conventional Western medicine in the treatment of chronic heart failure and provide a new option for the improvement and update of the "Expert Consensus on the Diagnosis and Treatment of Chronic Heart Failure with Integrated Traditional Chinese and Western Medicine."
METHODS
This article used the bibliometric method to investigate the research articles on the treatment of chronic heart failure with integrated traditional Chinese and Western medicine and analyzed the high-frequency prescriptions which are used and reported frequently. In addition, we also used manual and computer-aided search methods, the search scope includes CNKI, WANFANG, VIP, SinoMed, Web of Science, PubMed, and Cochrane Library, and the search content is the clinical randomized control of Zhigancao Decoction combined with conventional Western medicine in the treatment of chronic heart failure trials (RCTs). The search period is from the establishment of the database to January 29, 2021. The literature was managed and screened by EndNote software; the quality of the included literature was evaluated according to the modified Jadad scale, and the risk bias was assessed using the Cochrane tool; the results of the included studies were analyzed using the Review Manager 5.3 software; the sources of heterogeneity between the studies were analyzed using Stata16.0 software for sensitivity analysis.
RESULTS
According to the bibliometric analysis, the maximum number of research reports is 553, which are arranged in descending order of 21 prescriptions, including Zhenwu Decoction, Zhigancao, and powder of five drugs containing poria. The second most frequently used prescription is Zhigancao Decoction combined with conventional Western medicine in the treatment of chronic heart failure, but its systematic review and meta-analysis still need further research. A total of 17 clinical randomized controlled trials of Zhigancao Decoction combined with conventional Western medicine in the treatment of chronic heart failure were included in the search, with a total of 1752 subjects. Meta-analysis results show that Zhigancao combined with conventional Western medicine is more effective than conventional Western medicine in the treatment of chronic heart failure. The advantages are the following 5 outcome indicators: total clinical effective rate, left ventricular ejection fraction, left ventricular end-diastolic diameter, B-type natriuretic peptide, and 6-minute walk test.
CONCLUSIONS
There are many prescriptions combined with Western medicine to treat chronic heart failure, among which Zhigancao Decoction is the second most frequently used prescription. There are many original studies on Zhigancao Decoction combined with conventional Western medicine in the treatment of chronic heart failure. The quality of the evaluation research shows that the overall standard is scientific, and a few experimental designs are slightly irregular. Meta-analysis shows that Zhigancao Decoction combined with conventional Western medicine has better therapeutic effects and safety than conventional Western medicine. This shows the characteristics and advantages of integrated Chinese and Western medicine in the treatment of cardiovascular diseases and is worth recommending.
PubMed: 34795787
DOI: 10.1155/2021/7140044 -
Journal of Psychiatry & Neuroscience :... May 2020Rett syndrome (RTT), a debilitating neuropsychiatric disorder that begins in early childhood, is characterized by impairments in the autonomic nervous system that can...
BACKGROUND
Rett syndrome (RTT), a debilitating neuropsychiatric disorder that begins in early childhood, is characterized by impairments in the autonomic nervous system that can lead to sudden unexpected death. This study explores the mechanisms of autonomic dysfunction to identify potential risk factors for sudden death in patients with RTT.
METHODS
Following the Reporting Items for Systematic Review and Meta-Analyses (PRISMA) criteria, we undertook comprehensive systematic reviews using the PubMed, Scopus, Cochrane, PsycINFO, Embase and Web of Science databases.
RESULTS
We identified and critically appraised 39 articles for autonomic dysfunction and 5 for sudden death that satisfied the eligibility criteria. Following thematic analysis, we identified 7 themes: breathing irregularities, abnormal spontaneous brainstem activations, heart rate variability metrics, QTc changes, vagal imbalance, fluctuation in peptides and serotonergic neurotransmission. We grouped these 7 themes into 3 final themes: (A) brainstem modulation of breathing, (B) electrical instability of the cardiovascular system and (C) neurochemical changes contributing to autonomic decline. We described key evidence relating to each theme and identified important areas that could improve the clinical management of patients with RTT.
LIMITATIONS
The heterogeneity of the methods used to assess autonomic function increased the difficulty of making inferences from the different studies.
CONCLUSION
This study identified the important mediators of autonomic dysfunction and sudden death in patients with RTT. We proposed brainstem mechanisms and emphasized risk factors that increase brainstem vulnerability. We discussed clinical management to reduce sudden death and future directions for this vulnerable population.
Topics: Autonomic Nervous System; Autonomic Nervous System Diseases; Brain Stem; Death, Sudden; Humans; Rett Syndrome; Risk Factors
PubMed: 31702122
DOI: 10.1503/jpn.190033 -
Journal of Obstetrics and Gynaecology... Jun 2024Up to 80% of women of reproductive age are thought to experience premenstrual stress, which is characterised by physical, psychological, and behavioural changes. Yoga... (Review)
Review
OBJECTIVE
Up to 80% of women of reproductive age are thought to experience premenstrual stress, which is characterised by physical, psychological, and behavioural changes. Yoga activity lowers harmful inflammatory secretions that provide comfort for premenstrual syndrome (PMS) sufferers.
DATA SOURCES
The following worldwide databases were searched for this systematic review: Scopus, PubMed, Cochrane Library, PEDro, and Google Scholar from inception to August 2022.
STUDY SELECTION
A PICOS framework (Population, Intervention, Comparison, Outcome, and Study Design) was used for searching. Population included those with premenstrual syndrome or premenstrual tension syndromes, intervention included yoga therapy, comparator was with control group, and outcome measures included blood pressure (SBP, DBP) and heart rate (HR).
DATA EXTRACTION AND SYNTHESIS
To evaluate the study, we employed the Methodological Index for Randomised Controlled Trials. Fixed effects meta-analysis and qualitative synthesis were conducted. A total of 14 studies out of 224 were included. The main outcome measures included in this review were SBP, DBP, HR, and Moos Menstrual Distress Questionnaire (MMDQ). For the meta-analysis, 7 studies were considered. 3 studies contributed data of SBP (mean difference (MD) = -0.30; 95% CI: -2.29 to 1.69; heterogenicity (I) = 96%; P = 0.00001) and DBP (MD = -0.25; 95% CI: -0.99 to 0.49; I = 79%; P = 0.009). HR results from 4 studies were included (MD = 0.08; 95% CI: -0.83 to 0.99; I = 89%; P = 0.00001). 3 studies contributed data of MMDQ (MD = 1.50; 95% CI: 0.91 to 2.10; I = 92%; P = 0.00001.
CONCLUSION
Yoga can help people with both medical and psychological conditions including menstrual pain, irregular periods, stress, tension, and anxiety. It has been shown to lessen women's emotional, behavioural, and physical PMS symptoms, which has enhanced their quality of life.
OBJECTIF
Jusqu'à 80 % des femmes en âge de procréer connaîtraient un syndrome prémenstruel (SPM), qui se caractérise par des changements physiques, psychologiques et comportementaux. Les activités de yoga réduisent les sécrétions inflammatoires nocives et soulagent les symptômes du syndrome prémenstruel. SOURCE DES DONNéES: Pour cette revue systématique, des recherches ont été effectuées dans les bases de données mondiales Scopus, PubMed, Cochrane Library, PEDro et Google Scholar pour la période allant de leur création au mois d'août 2022. SéLECTION DES éTUDES: Une méthode PICOS (population, intervention, comparaison, résultat et conception de l'étude) a été utilisée pour la recherche. La population à l'étude incluait les personnes souffrant du syndrome prémenstruel ou d'une tension prémenstruelle, l'intervention incluait la thérapie par le yoga, le comparateur était le groupe témoin, et les critères de jugement comprenaient la pression artérielle (systolique et diastolique) et la fréquence cardiaque. EXTRACTION DES DONNéES ET SYNTHèSE: Pour évaluer l'étude, nous avons utilisé l'indice méthodologique pour les essais cliniques randomisés. Une méta-analyse à effet fixe et une synthèse qualitative ont été réalisées. Au total, 14 des 224 études relevées ont été retenues. Les critères de jugement principaux de cette revue étaient les pressions artérielles systolique et diastolique, la fréquence cardiaque et le questionnaire de détresse menstruelle de Moos. Dans la méta-analyse, 7 études ont été prises en compte. Au total, 3 études avaient des données sur la pression systolique (différence moyenne [DM] = -0,30; IC à 95 % : -2,29 à 1,69; hétérogénéité [I] = 96 %; P = 0,00001) et la pression diastolique (DM = -0,25; IC à 95 % : -0,99 à 0,49; I = 79 %; P = 0,009). Les données de fréquence cardiaque de 4 études ont été incluses (DM = 0,08; IC à 95 % : -0,83 à 0,99; I = 89 %; P = 0,00001). Des données du questionnaire de Moos étaient disponibles pour 3 études (DM = 1,50; IC à 95 % : 0,91 à 2,10; I = 92 %; P = 0,00001).
CONCLUSION
Le yoga peut aider les personnes souffrant de troubles médicaux ou psychologiques, notamment les douleurs menstruelles, les menstruations irrégulières, le stress, les tensions et l'anxiété. Les données montrent que le yoga atténue les symptômes émotionnels, comportementaux et physiques du syndrome prémenstruel chez les femmes, ce qui améliore leur qualité de vie.
PubMed: 38871120
DOI: 10.1016/j.jogc.2024.102579