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Complementary Therapies in Medicine Apr 2017Niuhuang Jiangya Preparation (NHJYP) is one of the most commonly used traditional Chinese patent medicines for essential hypertension (EH) in China. Our meta-analysis... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Niuhuang Jiangya Preparation (NHJYP) is one of the most commonly used traditional Chinese patent medicines for essential hypertension (EH) in China. Our meta-analysis performed a systematic evaluation on the therapeutic efficacy and safety of NHJYP for EH.
DESIGN
Systematic review and meta-analysis.
METHODS
PubMed, Embase, the Cochrane library, CNKI,VIP, Sinomed, and Wanfang Database were searched up to June 2015. Randomized controlled trials (RCTs) comparing NHJYP or combined with western antihypertensive drugs (WAD) versus WAD were included. Quality of each trial was assessed according to the Cochrane Reviewers' Handbook 5. 1.0. Statistical software (RevMan 5.3) was used for data analysis. The primary outcome was categorical or continuous blood pressure, and the secondary outcome was Traditional Chinese Medicine (TCM) syndrome.
RESULTS
12 RCTs including 1651 cases were identified. The methodological quality of trials was low. Meta-analysis showed that, firstly, NHJYP used alone compared with WAD had no significant effect on BP reduction; however, subgroup analysis was used based on whether apply TCM diagnostic criteria in recruitment. It was suggested that, for population that applied TCM diagnostic criteria, RR=1.35,95% CI:1.17-1.56,P<0.0001; for population that didn't apply TCM diagnostic criteria, RR=0.96,95% CI:0.70-1.33,P=0.81.Reduction in systolic blood pressure (SBP) levels showed similar results. But there was no significant difference in improving diastolic blood pressure (DBP). Secondly, we found that NHJYP plus WAD probably lower BP (RR=1.13,95% CI:1.03-1.24,P=0.01)and improve TCM symptoms than WAD only. And subgroup analysis suggested significant BP reduction effect for population that applied TCM diagnostic. No serious adverse events were reported.
CONCLUSIONS
Our review indicated that NHJYP has some beneficial effects in EH patients with liver-yang hyperactivity and abundant phlegm-heat syndrome. However, the evidence is not reliable enough. To produce definite evidence, more rigorously designed trials are needed.
Topics: Biological Products; Blood Pressure; Drugs, Chinese Herbal; Essential Hypertension; Humans; Hypertension; Medicine, Chinese Traditional; Treatment Outcome
PubMed: 28434477
DOI: 10.1016/j.ctim.2017.02.005 -
Frontiers in Neurology 2022Tic disorders (TDs) are common mental disorders in children and adolescents, and the clinical application of acupuncture for treating TDs is becoming increasingly...
OBJECTIVE
Tic disorders (TDs) are common mental disorders in children and adolescents, and the clinical application of acupuncture for treating TDs is becoming increasingly widespread. However, the criteria for selecting acupoint prescriptions and combinations have not been summarized. Therefore, data mining was used herein to determine the treatment principles and the most effective acupoint selection and compatibility criteria for the treatment of TDs.
METHODS
Clinical studies and observations of the efficacy of acupuncture treatment for TDs were obtained from the PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), Wanfang, VIP, and Chinese Biomedical (CBM) databases. The data on the acupoint prescriptions applied in these studies were collected, and network and association analyses were used to reveal the relationships between acupoints and to identify acupoint combinations. Additionally, the principles of acupuncture for TDs were determined through cluster analysis. Subgroup analysis of acupuncture prescriptions based on specific categorical diagnoses was performed to further assess the selection of acupoints.
RESULTS
Eighty-six trials were identified, and 257 groups of effective prescriptions involving 121 acupoints were extracted. Bai-hui (DU20), Feng-chi (GB20), Tai-chong (LR3), He-gu (LI4), and San-yin-jiao (SP6) were the most regularly used acupoints for treating TDs. The Governor Vessel, gallbladder, and large intestine meridians were more commonly used than other meridians. Moreover, most acupoint sites focused on the head and neck. Network analysis revealed potentially effective acupoint prescriptions for their commonly used acupoints, namely, Bai-hui (DU20), Si-shen-cong (EX-HN1), Feng-chi (GB20), Nei-guan (PC6), Shen-men (HT7), He-gu (LI4), Zu-san-li (ST36), San-yin-jiao (SP6) and Tai-chong (LR3). Association rule mining indicated that potential point combinations that should be prioritized in TD treatment are Bai-hui (DU20), Neiguan (PC6) and Sanyinjiao (SP6). Cluster analysis revealed the treatment principle of "coordinating yin and yang, tonifying qi and blood, dispelling pathogenic wind and eliminating phlegm". The core acupoint prescription of TS treatment comprised He-gu (LI4), Feng-chi (GB20), Tai-chong (LR3), Bai-hui (DU20), Yin-tang (EX-HN3), Si-shen-cong (EX-HN1), San-yin-jiao (SP6), and Nei-guan (PC6). The core group included He-gu (LI4) and Feng-chi (GB20). Proximal points were usually used in TS as an additional method of point selection.
CONCLUSION
Using data mining analysis of published studies, this study provides valuable information regarding the selection of the most effective acupoints and point combinations for clinical acupuncture practice for treating TDs.
PubMed: 35756940
DOI: 10.3389/fneur.2022.894951 -
Thorax Dec 1997A systematic quantitative review of the evidence relating parental smoking to the prevalence of asthma and respiratory symptoms was conducted amongst school age children. (Review)
Review
BACKGROUND
A systematic quantitative review of the evidence relating parental smoking to the prevalence of asthma and respiratory symptoms was conducted amongst school age children.
METHODS
Sixty relevant studies were identified after consideration of 1593 articles selected by electronic search of the Embase and Medline databases using keywords relevant to passive smoking in children. The search was completed in April 1997 and identified 25 studies of asthma, 41 of wheeze, 34 of chronic cough, seven of chronic phlegm and six of breathlessness which were included in a quantitative overview.
RESULTS
The pooled odds ratios for either parent smoking were 1.21 (95% CI 1.10 to 1.34) for asthma, 1.24 (95% CI 1.17 to 1.31) for wheeze, 1.40 (95% CI 1.27 to 1.53) for cough, 1.35 (95% CI 1.13 to 1.62) for phlegm, and 1.31 (95% CI 1.08 to 1.59) for breathlessness. Adjustment for confounding had little effect. Evidence of heterogeneity between studies appeared largely explicable by publication bias with a superfluity of small studies with large odds ratios. However, excluding these had little effect on the pooled odds ratios. The prevalence of all symptoms increased with the number of parents who smoked. While maternal smoking had a greater effect than paternal smoking, the effect of father only was clearly significant.
CONCLUSIONS
The relationship between parental smoking and respiratory symptoms seems very likely to be causal given statistical significance, robustness to adjustment for confounding factors, consistency of the findings in different countries, and evidence of dose response. The raised risk in households where the father, but not the mother, smoked argues for a postnatal effect.
Topics: Adolescent; Asthma; Child; Child, Preschool; Humans; Lung Diseases; Odds Ratio; Parents; Prevalence; Tobacco Smoke Pollution
PubMed: 9516904
DOI: 10.1136/thx.52.12.1081 -
Chest Aug 2020Chronic cough due to chronic bronchitis (CB) causes significant impairment in quality of life, and effective treatment strategies are needed. We conducted a systematic...
BACKGROUND
Chronic cough due to chronic bronchitis (CB) causes significant impairment in quality of life, and effective treatment strategies are needed. We conducted a systematic review on the management of chronic cough due to CB to update the recommendations and suggestions of the American College of Chest Physicians (CHEST) 2006 guideline on this topic.
METHODS
This systematic review asked three questions: (1) What are the clinical features of the history that suggest a patient's cough-phlegm syndrome is due to CB? (2) Can treatment of stable CB improve or eliminate chronic cough? (3) Can therapy that targets chronic cough due to CB prevent or reduce the occurrence of acute CB exacerbations? Studies of adult patients with CB were included and assessed for relevance and quality. Based on the systematic review, guideline suggestions were developed and voted on by using the CHEST organization methodology.
RESULTS
The search strategy used an assortment of descriptors and assessments to identify studies of chronic cough due to CB.
CONCLUSIONS
The evidence supporting the management of chronic cough due to CB is limited overall and of low quality. This article provides guidance on treatment by presenting suggestions based on the best currently available evidence and identifies gaps in our knowledge and areas for future research.
Topics: Adult; Bronchitis, Chronic; Cough; Humans; Quality of Life; Symptom Flare Up; United States
PubMed: 32105719
DOI: 10.1016/j.chest.2020.02.015 -
Zhongguo Zhong Yao Za Zhi = Zhongguo... Apr 2023Type 2 diabetes mellitus(T2DM), a common chronic metabolic disease, is often accompanied by internal heat syndrome. Heat-clearing prescriptions are widely used to treat...
Type 2 diabetes mellitus(T2DM), a common chronic metabolic disease, is often accompanied by internal heat syndrome. Heat-clearing prescriptions are widely used to treat different heat syndromes of T2DM from the aspects of clearing stagnant heat, excess heat, damp heat, phlegm heat, and heat toxin, demonstrating remarkable effects. The mechanism of blood sugar-lowering agents has always been a hotspot of research. Recently, the basic studies of heat-clearing prescriptions from different perspectives have been increasing year by year. To clarify the mechanisms of heat-clearing prescriptions and find specific mechanisms, we systematically reviewed the basic studies of heat-clearing prescriptions commonly used for the treatment of T2DM in the past decade, intending to provide a reference for related research.
Topics: Humans; Diabetes Mellitus, Type 2; Drugs, Chinese Herbal; Hot Temperature; Medicine, Chinese Traditional; Prescriptions; Syndrome
PubMed: 37282945
DOI: 10.19540/j.cnki.cjcmm.20221128.401 -
Allergy, Asthma & Immunology Research Mar 2016Recent evidence suggests a global burden of chronic cough in general populations. However, the definitions vary greatly among epidemiological studies, and none have been...
PURPOSE
Recent evidence suggests a global burden of chronic cough in general populations. However, the definitions vary greatly among epidemiological studies, and none have been validated for clinical relevance. We aimed to examine previous epidemiological definitions in detail and explore the operational characteristics.
METHODS
A systematic review was conducted for epidemiological surveys that reported the prevalence of chronic cough in general adult populations during the years 1980 to 2013. A literature search was performed on Pubmed and Embase without language restriction. Epidemiological definitions for chronic cough were classified according to their components, such as cutoff duration. Meta-analyses were performed for the male-to-female ratio of chronic cough prevalence to explore operational characteristics of epidemiological definitions.
RESULTS
A total of 70 studies were included in the systematic review. The most common epidemiological definition was identified as 'cough ≥3 months' duration without specification of phlegm (n=50); however, it conflicted with the cutoff duration in current clinical guidelines (cough ≥8 weeks). Meta-analyses were performed for the male-to-female ratio of chronic cough among 28 studies that reported sex-specific prevalence using the most common definition. The pooled male-to-female odds ratio was 1.26 (95% confidence interval 0.92-1.73) with significant heterogeneity (I²=96%, P<0.001), which was in contrast to clinical observations of female predominance from specialist clinics. Subgroup analyses did not reverse the ratio or reduce the heterogeneity.
CONCLUSIONS
This study identified major issues in defining chronic cough in future epidemiological studies. The conflict between epidemiological and clinical diagnostic criteria needs to be resolved. The unexpected difference in the gender predominance between the community and clinics warrants further studies. Clinical validation of the existing definition is required.
PubMed: 26739408
DOI: 10.4168/aair.2016.8.2.146 -
Recenti Progressi in Medicina Jan 2020In recent years there has been an enormous development in the use of electronic cigarettes (e-cig). In Italy, in the 2019, the users of e-cig are about 900.000. E-cig... (Comparative Study)
Comparative Study
BACKGROUND
In recent years there has been an enormous development in the use of electronic cigarettes (e-cig). In Italy, in the 2019, the users of e-cig are about 900.000. E-cig users tend to overlook the absolute risk of the e-cig product in favor of the relative risk compared to traditional ones. This is also due to the fact that at the moment there are large knowledge gaps on the health effects of using e-cig. Recently reports have emerged regarding serious health adverse effects (AE) related to their use. As of December 2019, the American Centers for Disease Control and Prevention (CDC) reported 2409 cases of lung disease associated with the use of e-cig, and 52 deaths.
AIM
To summarize the available evidence on the health effects of electronic cigarettes.
METHODS
We searched systematic reviews (SR) of the literature published up to September 2019.
RESULTS
The systematic searches led to the identification of 14 SRs (1037 studies included of which 77 provided useful information for this review) that met the inclusion criteria. Given the heterogeneity of the comparisons and of the outcome measures considered, the results are described narratively. Effects on the respiratory system: cough, phlegm, asthma and bronchitis symptoms, cases of chronic bronchitis and COPD have also been reported. Effects on the oropharyngeal system: lesions in the oral cavity, villous black tongue, allergic reactions, endogenous formation of carcinogens, development of oral cancer. Effects on the cardiovascular system: increased heart rate, increased systolic and diastolic pressure. Effects on skin and annexes: squamous and pruritic dermatitis. Any adverse effect: the most frequently reported AEs are cough, dry mouth, shortness of breath, irritation of the mouth and throat and headache. Effects of exposure to e-cig passive smoking: increase in cotinine levels in exposed environments.
CONCLUSIONS
These results, based on evidence from very low to moderate, show a series of possible risks linked to the use of e-cig. However, there is a need for further well-conducted studies with longer follow-up periods to confirm these results.
Topics: Electronic Nicotine Delivery Systems; Humans; Risk; Tobacco Smoke Pollution; Vaping
PubMed: 31992902
DOI: 10.1701/3294.32651 -
Journal of Traditional Chinese Medicine... Feb 2021To evaluate the effectiveness and safety of Xuanbai Chengqi decoction (, XBCQD) plus Western Medicine (WM) in treatment of severe pneumonia with symptom pattern of... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To evaluate the effectiveness and safety of Xuanbai Chengqi decoction (, XBCQD) plus Western Medicine (WM) in treatment of severe pneumonia with symptom pattern of phlegm-heat obstructing lung.
METHODS
Randomized controlled trials (RCTs) investigating the effect of XBCQD on severe pneumonia with symptom pattern of phlegm-heat obstructing lung, were included in this study. Seven electronic databases were searched up to March 2019. Meta-analysis was conducted by Review Manager 5.3 software. Risk ratio (RR) and mean difference (MD) with 95% confidence interval (CI) were used as effect estimation.
RESULTS
Eleven RCTs were included, involving 992 participants. Meta-analysis showed that XBCQD combined with WM achieved better effectiveness than WM alone in terms of total effective rate [RR = 1.23, 95%CI (1.16, 1.30)], clinical pulmonary infection score [CPIS, MD = -2.02, 95%CI (-2.42, -1.63)], acute physiology and chronic health evaluation Ⅱ [APACHEⅡ, MD = -6.81, 95% CI (-8.26, 5.37)], mechanical ventilation time [MD = -101.41, 95%CI (-140.47, -62.34)], and lactic acid content in arterial blood [MD = -2.41, 95%CI (-2.64, -2.18)].
CONCLUSION
XBCQD combined with WM had better benefit than WM alone to the patients of severe pneumonia with the symptom pattern of phlegm-heat obstructing lung. However, due to low quality of the included studies, more rigorously designed studies were required to further evaluate the effectiveness and safety of XBCQD in the treatment of severe pneumonia with symptom pattern of phlegm-heat obstructing lung.
Topics: Drug Therapy, Combination; Drugs, Chinese Herbal; Hot Temperature; Humans; Lung; Mucus; Pneumonia; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 33522193
DOI: 10.19852/j.cnki.jtcm.2021.01.003