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BMJ (Clinical Research Ed.) Nov 2013
Topics: Anti-Bacterial Agents; Bacterial Infections; Cough; Drug Utilization; Humans; Sputum
PubMed: 24246568
DOI: 10.1136/bmj.f6885 -
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 Zhen Jiu = Chinese Acupuncture... Nov 2022To observe the clinical effect of acupuncture combined with decoction for stroke-associated pneumonia (SAP) with phlegm-heat obstructing lung, and explore its possible... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To observe the clinical effect of acupuncture combined with decoction for stroke-associated pneumonia (SAP) with phlegm-heat obstructing lung, and explore its possible mechanism.
METHODS
Ninety-nine patients of SAP with phlegm-heat obstructing lung were randomly divided into a combination group (33 cases, 1 case dropped off), a Chinese medication group (33 cases, 1 case dropped off) and an acupuncture group (33 cases, 1 case dropped off). On the basis of routine basic treatment, the patients in the acupuncture group were treated with acupuncture at Tiantu (CV 22), Feishu (BL 13), Taiyuan (LU 9), Sanyinjiao (SP 6), etc., once a day, with an interval of 1 day after continuous 6-day treatment; the patients in the Chinese medication group were treated with decoction, 1 dose per day; the patients in the combination group were treated with acupuncture combined with decoction. Two weeks were taken as a course of treatment, and two courses of treatment were given. Before and after treatment, the clinical pulmonary infection score (CPIS), inflammatory indexes (neutrophil-to-lymphocyte ratio [NLR], procalcitonin [PCT], C-reactive protein [CRP]), cellular immune function (CD, CD, CD and CD/CD) were compared in the 3 groups. The clearance of pathogenic bacteria after treatment was observed in the 3 groups. The clinical efficacy of each group was evaluated.
RESULTS
After treatment, the CPIS scores, NLR, PCT, CRP and CD in the each group were lower than those before treatment (<0.05), while the levels of CD, CD, CD/CD were higher than those before treatment (<0.05). The above indexes in the combination group were better than those in the acupuncture group and the Chinese medication group (<0.05), and the above indexes in the Chinese medication group were better than those in the acupuncture group (<0.05). There was no significant difference in the clearance rate of pathogenic bacteria among three groups (>0.05). The cured and markedly effective rate was 65.6% (21/32) in the combination group, which was higher than 43.8% (14/32) in the Chinese medication group and 18.8% (6/32) in the acupuncture group (<0.05). The cured and markedly effective rate in the Chinese medication group was higher than that in the acupuncture group (<0.05).
CONCLUSION
Acupuncture combined with decoction could effectively improve the clinical symptoms of SAP patients with phlegm-heat obstructing lung, and the mechanism may be related to enhancing the cellular immune function and reducing the level of inflammatory reaction.
Topics: Humans; Hot Temperature; Drugs, Chinese Herbal; Acupuncture Therapy; Lung; Pneumonia; Stroke; Immunity
PubMed: 36397221
DOI: 10.13703/j.0255-2930.20220208-k0003 -
Journal of Internal Medicine Oct 2006It is well known that pulmonary function is associated with all-cause and cardiovascular (CV) death. Less is known about the association between respiratory symptoms and...
OBJECTIVES
It is well known that pulmonary function is associated with all-cause and cardiovascular (CV) death. Less is known about the association between respiratory symptoms and mortality and whether such an association is independent of physical fitness. In this study, we assessed the association of breathlessness and productive cough with CV and all-cause mortality over 26 years.
DESIGN
Prospective occupational cohort study.
SETTING AND SUBJECTS
In 1972-75, 1999 apparently healthy men aged 40-59 years were recruited to the study from five companies in Oslo, Norway. At study entry clinical, physiological and biochemical parameters including respiratory symptoms, spirometry, and an objective assessment of physical fitness were measured in all subjects, of whom 1,623 had acceptable spirometry. The data was analysed using Cox proportional hazards analysis, adjusting for age, lung function, physical fitness, and other possible confounders, with mortality until 2000.
RESULTS
After 26 years (range 25-27), 615 men (38%) had died, of whom 308 (50%) from CV deaths. In multivariable proportional hazards models, 'having phlegm winter mornings' [hazard ratio (HR) 1.30, P = 0.01], 'breathlessness when hurrying/walking uphill' (HR 1.43, P = 0.005) and combinations of the two symptoms remained significant predictors of all-cause mortality. None of six respiratory symptoms were significant predictors of CV mortality in multivariable models.
CONCLUSIONS
Phlegm, breathlessness and combinations of them were associated with all-cause mortality, even after adjusting for physical fitness, known CV and other risk factors such as smoking, and lung function. The finding of an association also after adjustment for physical fitness is new. In contrast, none of the six respiratory symptoms individually or in combination were associated with CV mortality in multivariable analysis.
Topics: Adult; Cardiovascular Diseases; Cause of Death; Cough; Dyspnea; Exercise; Humans; Male; Middle Aged; Norway; Occupational Diseases; Physical Fitness; Prospective Studies; Respiration Disorders; Respiratory Function Tests; Risk Factors; Smoking
PubMed: 16961670
DOI: 10.1111/j.1365-2796.2006.01693.x -
Journal of Traditional Chinese Medicine... Mar 2012To investigate plasma samples from neoplasm patients with phlegm-stasis or abnormal Savda syndrome, with NMR spectroscopy, and to analyze their metabolic varieties,...
OBJECTIVE
To investigate plasma samples from neoplasm patients with phlegm-stasis or abnormal Savda syndrome, with NMR spectroscopy, and to analyze their metabolic varieties, characteristics and reciprocity.
METHODS
1H-NMR spectra were analyzed using the orthogonal projection to latent structure with discriminative analysis (OPLS-DA) method with unit variance scaling. The discriminative significance of metabolites was determined by the Pearson's product - moment correlation coefficient.
RESULTS
Compared to the control group, neoplasm patients with phlegm - stasis or abnormal Savda syndrome had low concentrations of leucine, isoleucine, valine, alanine, tyrosine, histidine, citrulline, glycoprotein, glutamine, myo-inositol, scyllo-inositol, creatine, alpha-glucose, alpha-glucose and lactate (P < 0.05), and high concentrations of very low density lipoprotein, low density lipoprotein, unsaturated lipid, formate, acetone, acetate, acetoacetate, pyruvate, beta-hydroxybutyrate, carnitine and malonic acid (P < 0.05), with no significant differences between the phlegm - stasis and abnormal Savda syndrome patients.
CONCLUSIONS
Neoplasm patients with different syndromes have very similar metabolic changes. A series of abnormalities such as immune dysfunction and oxidative - antioxidative imbalance, occur in neoplasm patients with abnormal Savda or phlegm - stasis syndrome.
Topics: Adult; Female; Humans; Magnetic Resonance Spectroscopy; Male; Metabolomics; Neoplasms; Sputum
PubMed: 22594115
DOI: 10.1016/s0254-6272(12)60044-2 -
Medicine Aug 2020Unstable angina pectoris is an acute exacerbation secondary to coronary artery occlusion. In routine clinical treatment, patients with unstable angina pectoris are prone...
INTRODUCTION
Unstable angina pectoris is an acute exacerbation secondary to coronary artery occlusion. In routine clinical treatment, patients with unstable angina pectoris are prone to recurrence or aggravation of symptoms. Based on the traditional Chinese medicine (TCM) theory, phlegm, and blood stasis are one of the main pathological factors of unstable angina pectoris. The treatment of unstable angina pectoris with phlegm-blood stasis syndrome by Gualou Danshen granules (GLDS) has been the focus of many clinical trials. However, there is no evidence to prove the safety or clinical efficacy of GLDS.
METHODS AND ANALYSIS
In this study, we will conduct a 4-week randomized, controlled feasibility study, with participants recruited from Guang'anmen Hospital, Chinese Academy of Traditional Chinese Medicine. Sixty subjects are to be diagnosed as having phlegm-blood stasis syndrome and randomly divided into a treatment group (GLDS) and placebo group in a 1:1 ratio. Result measurements will include therapeutic indicators (Clinical Symptom Rating Scale, Phlegm-Blood Stasis Syndrome Scale, and Seattle Angina Questionnaire) and safety indicators (blood routine, urine routine, electrocardiogram, liver function, and kidney function). The clinical data management system (http://www.tcmcec.net/) will be used to collect and manage data. Quality control will be implemented according to good clinical practice.
DISCUSSION
Previous TCM clinical trials have investigated if adding GLDS to standard routine treatment can improve the therapeutic effect in patients with unstable angina pectoris. This study focuses on the safety and efficacy of GLDS on unstable angina pectoris of phlegm-blood stasis type, in order to obtain relevant clinical evidence.
TRIAL REGISTRATION
This study is approved by the Ethics Committee of Guang'anmen Hospital of the China Academy of Chinese Medical Sciences (no. 2019-187-KY-02) and is registered with chictr.org (registration number ChiCTR2000031780).
Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Angina, Unstable; Double-Blind Method; Drugs, Chinese Herbal; Medicine, Chinese Traditional; Salvia miltiorrhiza; Feasibility Studies; Randomized Controlled Trials as Topic
PubMed: 32872012
DOI: 10.1097/MD.0000000000021593 -
Zhongguo Zhen Jiu = Chinese Acupuncture... Sep 2022To observe the clinical effect of chicken-claw needling at Xiaguan (ST 7) combined with intradermal needling on negative emotion in primary trigeminal neuralgia (PTN) of... (Randomized Controlled Trial)
Randomized Controlled Trial
[Chicken-claw needling at Xiaguan (ST 7) combined with intradermal needling on negative emotions in primary trigeminal neuralgia of phlegm obstruction and blood stasis: a randomized controlled trial].
OBJECTIVE
To observe the clinical effect of chicken-claw needling at Xiaguan (ST 7) combined with intradermal needling on negative emotion in primary trigeminal neuralgia (PTN) of phlegm obstruction and blood stasis.
METHODS
Sixty cases of patients with PTN of phlegm obstruction and blood stasis were randomly divided into an observation group and a control group, 30 cases in each group. The observation group was treated with chicken-claw needling at Xiaguan (ST 7) combined with intradermal needling (acupoints Sibai [ST 2], Yuyao [EX-HN 4], Hegu [LI 4], Taichong [LR 3] and auricular points Xin [CO], Shenmen [TF], Pizhixia [AT], etc.), once a day, 6 d as a course of treatment, rest 1 d between courses, a total of 2 courses of treatment; and the control group was given oral carbamazepine tablets for 13 days. Before and after treatment, the pain visual analogue scale (VAS), TCM syndromes, self-rating anxiety scale (SAS) scores and the contents of serum neurotransmitter (β-endorphin [β-EP], substance P [SP] and 5-hydroxytryptamine [5-HT]) were compared, and the clinical efficacy was evaluated.
RESULTS
After treatment, the VAS, SAS, TCM syndrome scores and the contents of serum SP in the two groups were lower than those before treatment (<0.05), and the above indexes in the observation group was lower than those in the control group (<0.05). The contents of serum β-EP and 5-HT in the two groups were higher than those before treatment (<0.05), and the above indexes in the observation group were higher than those in the control group (<0.05). The total effective rate in the observation group was 93.3% (28/30), which was higher than 83.3% (25/30) in the control group (<0.05).
CONCLUSION
Chicken-claw needling at Xiaguan (ST 7) combined with intradermal needling can relieve pain symptoms and negative emotions in patients with primary trigeminal neuralgia of phlegm obstruction and blood stasis, which may be related to the regulation of serum neurotransmitter levels.
Topics: Acupuncture Points; Acupuncture Therapy; Emotions; Humans; Pain; Serotonin; Syndrome; Treatment Outcome; Trigeminal Neuralgia
PubMed: 36075595
DOI: 10.13703/j.0255-2930.20220314-0004 -
Zhongguo Zhong Yao Za Zhi = Zhongguo... Oct 2023Depression syndromes(anxiety and depression), as typical psychological disorders, often coexist with and mutually influence coronary heart disease(CHD). They constitute...
[Syndrome differentiation and treatment of coronary heart disease combined with anxiety and depression from stages of phlegm, blood stasis, and toxic pathogen based on theory of "coexistence of diseases and depression syndromes"].
Depression syndromes(anxiety and depression), as typical psychological disorders, often coexist with and mutually influence coronary heart disease(CHD). They constitute a psycho-cardiology disease involving both the blood vessels of the heart and the spirit of the heart. Based on the theory of "coexistence of diseases and depression syndromes", it was proposed that CHD and depression syndromes coexisted independently and were causally related. The factors of depression syndromes go through the entire course of CHD and have different causal relationships at different stages, leading to a pathogenic process of "depression causing disease" or "disease causing depression". In the chronic latent period, phlegm predominates, with depression leading to the production of phlegm. Phlegm accumulation and Qi stagnation initiate a mutual damage process of psycho-cardiology, marking the onset of the disease. In the pathological development period, blood stasis becomes predominant. Depression leads to blood stasis, which further obstructs Qi circulation, accelerating disease progression. In the acute attack period, toxicity becomes crucial. Depression transforms into toxicity, damaging Qi and blood, disturbing the balance of the mind, and inducing a sudden and severe exacerbation of the disease. Based on this, the approach of treating phlegm and depression together, treating blood stasis and depression together, and treating toxicity and depression together by stages was established. Research has found that this approach can simultaneously improve organic damage and emotional disorders, and also has a regulating effect on micro-level syndrome indicators, achieving harmonization of psycho-cardiology in the treatment.
Topics: Humans; Medicine, Chinese Traditional; Depression; Coronary Disease; Mucus; Syndrome; Anxiety
PubMed: 38114161
DOI: 10.19540/j.cnki.cjcmm.20230627.501 -
The Indian Journal of Medical Research Jul 2011Chronic cough and chronic phlegm are important indicators of respiratory morbidity, accelerated lung function decline, increased hospitalization and mortality. This...
BACKGROUND & OBJECTIVES
Chronic cough and chronic phlegm are important indicators of respiratory morbidity, accelerated lung function decline, increased hospitalization and mortality. This study was planned to estimate the prevalence of chronic cough and phlegm in the absence of dyspneoa and wheezing and to study its associated factors in a representative population of Mysore district.
METHODS
A cross-sectional survey was planned in a representative population of Mysore taluk. Eight villages were randomly selected based on the list of villages from census 2001. Trained field workers using the Burden of Obstructive Diseases questionnaire carried out a house-to-house survey.
RESULTS
A total of 4333 adult subjects were enrolled in the study with 2333 males and 2000 females. The prevalence of chronic cough in the community was 2.5 per cent and that of chronic phlegm was 1.2 per cent. A significant association was observed between chronic cough and age, gender, occupation and smoking and chronic phlegm with age, gender, occupation, indoor animals and smoking. A multivariate analysis confirmed independent association of age, occupation and smoking for chronic cough and age and smoking for chronic phlegm. On sub-group analysis of males, heavy smokers had higher prevalence of chronic cough and chronic phlegm as compared to light smokers and non smokers.
INTERPRETATION & CONCLUSIONS
The prevalence of chronic cough was 2.5 per cent and chronic phlegm was 1.2 per cent in the general population in Mysore which is lower than that observed in other studies. Heavy smoking was an important preventable risk factor identified in this study and efforts towards smoking cessation are crucial to achieve good respiratory health in the community.
Topics: Adult; Age Factors; Aged; Chronic Disease; Cough; Female; Humans; India; Male; Middle Aged; Prevalence; Sex Factors; Smoking; Surveys and Questionnaires
PubMed: 21808140
DOI: No ID Found -
Journal of Proteome Research Jan 2024Heart failure (HF), a complex clinical syndrome, has become a global burden on health and economics around the world. Phlegm-blood stasis syndrome, one of the...
Heart failure (HF), a complex clinical syndrome, has become a global burden on health and economics around the world. Phlegm-blood stasis syndrome, one of the Traditional Chinese Medicine (TCM) syndrome differentiation, is the core pathogenesis dynamically throughout the occurrence, development, and prognosis of HF. Biomarkers having high sensitivity and specificity are highly demanded to facilitate the accurate differentiation of HF patients with phlegm-blood stasis syndrome. In the present study, serum samples were collected from 20 healthy controls and 40 HF patients (20 with and 20 without phlegm-blood stasis syndrome). We implemented data-independent acquisition mass spectrometry (DIA-MS) for discovery and parallel reaction monitoring (PRM) for validation of biomarkers for heart failure with phlegm-blood stasis syndrome. A total of 84 different proteins were found in the HF with phlegm-blood stasis syndrome (HF-TY) group compared with healthy controls. 37 candidate proteins were selected for the PRM assay, and five validated proteins with high sensitivity and specificity, including insulin-like growth factor-binding protein 4 (IGFBP4), β-2-microglobulin (B2M), dystroglycan (DAG1), immunoglobulin J chain (JCHAIN), and kallikrein B1 (KLKB1), were considered potential biomarkers for heart failure patients with phlegm-blood stasis syndrome. Newly identified biomarkers might provide insights into the diagnosis and treatment of HF with TCM syndrome differentiation.
Topics: Humans; Proteomics; Medicine, Chinese Traditional; Biomarkers; Heart Failure; Syndrome
PubMed: 38048169
DOI: 10.1021/acs.jproteome.3c00537