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PloS One 2024Phlegm-dampness constitution is a traditional Chinese medicine constitution typically associated with essential hypertension. Previous studies have demonstrated that...
Renin-angiotensin system mechanism underlying the effect of auricular acupuncture on blood pressure in hypertensive patients with phlegm-dampness constitution: Study protocol for a randomized controlled trial.
BACKGROUND
Phlegm-dampness constitution is a traditional Chinese medicine constitution typically associated with essential hypertension. Previous studies have demonstrated that auricular acupuncture effectively decreases blood pressure and adjusts the constitution. However, the mechanism underlying auricular acupuncture's effect is poorly understood.
METHODS
A non-blinded, randomized controlled trial will be undertaken between September 2022 and May 2023. Eighty essential hypertensive patients with a phlegm-dampness constitution will be randomly allocated to one of two groups. The intervention group will receive eight weeks of auricular acupuncture and regular use of antihypertensive drugs, while the control group will only receive antihypertensive drugs. The primary outcome will be any mean differences in office systolic blood pressure. The secondary outcomes investigations will include proteins of the renin-angiotensin system, office blood pressure of different genotypes, and phlegm-dampness constitution scores.
DISCUSSION
By demonstrating how auricular acupuncture affects the renin-angiotensin system, this research will offer significant new information on the mechanism underlying the action of auricular acupuncture in hypertension. Moreover, the results will provide crucial clinical information on the associations between renin-angiotensin system gene polymorphisms and the antihypertensive effects of auricular acupuncture.
TRIAL REGISTRATION
Registered at the chictr.org.
Topics: Humans; Blood Pressure; Acupuncture, Ear; Antihypertensive Agents; Renin-Angiotensin System; Hypertension; Acupuncture Therapy; Treatment Outcome; Randomized Controlled Trials as Topic
PubMed: 38300960
DOI: 10.1371/journal.pone.0294306 -
The Journal of the Egyptian Public... Jan 2024Exposure to dust in textile mills adversely affects workers' health. We collected epidemiological data on textile workers suffering from respiratory diseases and...
BACKGROUND
Exposure to dust in textile mills adversely affects workers' health. We collected epidemiological data on textile workers suffering from respiratory diseases and assessed work absence associated with illnesses in Faisalabad, Pakistan.
METHODS
We recruited 206 workers using multistage sampling from 11 spinning mills in Faisalabad, Pakistan. The data were collected using 2-week health diaries and face-to-face interviews. The data pertains to socio-demographics, occupational exposures, the state of the workers' health, and other attributes. A theoretical framework of the health production function was used to estimate the relationship between cotton dust exposure and respiratory illnesses. We also estimated functional limitations (e.g., work absence) associated with dust exposure. STATA 12 was used to calculate descriptive statistics, an ordered probit for byssinosis, a probit model for chronic cough, and three complementary log-log models for blood phlegm, bronchitis, and asthma to measure dose-response functions. A Tobit model was used to measure the sickness absence function.
RESULTS
We found that cotton dust exposure causes a significant health burden to workers, such as cough (35%), bronchitis (17%), and different grades of byssinosis symptoms (22%). The regression analysis showed that smoking cigarettes and working in dusty sections were the main determinants of respiratory diseases. Dusty work sections also cause illness-related work absences. However, the probability of work absence decreases with the increased use of face masks.
CONCLUSION
The study's findings imply the significance of promoting occupational safety and health culture through training and awareness among workers or implementing the use of safety gadgets. Promulgating appropriate dust standards in textile mills is also a need of the hour.
PubMed: 38282165
DOI: 10.1186/s42506-024-00150-2 -
Respiratory Medicine Case Reports 2024Dupilumab inhibits interleukin-4Rα and suppresses type 2 inflammation. Careful administration of dupilumab is required because it increases the blood eosinophil count...
Dupilumab inhibits interleukin-4Rα and suppresses type 2 inflammation. Careful administration of dupilumab is required because it increases the blood eosinophil count secondary to a decrease in local eosinophil counts, sometimes resulting in eosinophilic complications. We herein report a case of recurrent chronic eosinophilic pneumonia after switching from benralizumab to dupilumab. A 54-year-old man with a history of eosinophilic pneumonia presented to our hospital with symptoms of cough, fever, and phlegm production six months after beginning dupilumab administration for recurrent chronic rhinosinusitis. When using dupilumab, it is essential to carefully monitor patients' eosinophil trends and pulmonary symptoms.
PubMed: 38274702
DOI: 10.1016/j.rmcr.2023.101968 -
Frontiers in Medicine 2023The objective of this study was to investigate associations between baseline body constitutions (BCs) in traditional Chinese Medicine (TCM) and all-cause mortality in...
Associations of traditional Chinese medicine body constitution and all-cause mortality in patients with type 2 diabetes mellitus: a prospective cohort study of a Taiwanese medical center.
INTRODUCTION
The objective of this study was to investigate associations between baseline body constitutions (BCs) in traditional Chinese Medicine (TCM) and all-cause mortality in Chinese individuals with type 2 diabetes.
METHODS
A total of 887 individuals with type 2 diabetes who were enrolled in managed care in 2010 were included. These individuals were followed up until 2015, and their mortality status was determined through the use of Taiwan National Death Datasets. At baseline, BC status of participants, including Yin deficiency, Yang deficiency, and phlegm stasis, was assessed using a well-developed Body Constitutions Questionnaire. Hazard ratios (HR) were calculated using a multivariate Cox proportional hazards model.
RESULTS
During 6807.2 person-years of follow-up of 887 participants, with an average follow-up period of 7.7 years, a total of 190 individuals died, resulting in an incidence density of 0.0279 person-years. Yin deficiency was associated with all-cause mortality (HR, 95% CI: 1.39, 1.02-1.90). This study indicates that individuals diagnosed with Yin deficiency in TCM, characterized by symptoms such as thirst, reduced urine volume, hard stool, and hot flushes, had a 39% higher risk of all-cause mortality.
DISCUSSION
The findings may provide information for TCM practitioners on tailoring treatment plans for persons with type 2 diabetes. No conclusive statements can be made on the basis of the preliminary data presented here. Controlled prospective studies are warranted.
PubMed: 38249989
DOI: 10.3389/fmed.2023.1320861 -
Journal of Traditional Chinese Medicine... Feb 2024To evaluate the extent of vascular endothelial dysfunction and preliminary identify serum protein biomarkers associated with obese individuals at risk for cardiovascular...
OBJECTIVE
To evaluate the extent of vascular endothelial dysfunction and preliminary identify serum protein biomarkers associated with obese individuals at risk for cardiovascular disease (CVD).
METHODS
Fifteen obese volunteers with the phlegm-dampness constitution or balanced constitution were recruited for this study respectively. The clinical baseline data was collected, and the vascular endothelial function was evaluated using the EndoPAT. Blood samples were collected for the serum proteome analysis. The differences in the serum protein expression levels between the two groups were detected and the protein interaction network analysis, correlation analysis, receiver operating characteristic (ROC) curve analysis, and random forest model investigation were conducted.
RESULTS
There were no statistical differences found in the baseline data. For vascular endothelial function, the reactive hyperemia index (RHI) of the phlegm-dampness constitution obese group was significantly lower than that of the balanced constitution obese group (1.46 ± 0.30 2.82 ± 0.78, < 0.0001), indicating vascular endothelial dysfunction. There are 66 differentially expressed serum proteins between the two groups. apolipoprotein A2 (ApoA2), angiotensin-converting enzyme 2 (ACE-2), interleukin-33 (IL-33), and forkhead box P3 (FoxP3) showed significant differences and area under curve values of their ROC curves were greater than 0.7 and correlated significantly with RHI.
CONCLUSION
Vascular endothelial dysfunction was present in the phlegm-dampness constitution obese group. Thus, alterations in the expression levels of key serum proteins, including ApoA2, ACE-2, IL-33, and FoxP3 could serve as potential biomarkers in the obese population at risk of CVD.
Topics: Humans; Medicine, Chinese Traditional; Proteome; Interleukin-33; Obesity; Cardiovascular Diseases; Biomarkers; Blood Proteins; Forkhead Transcription Factors
PubMed: 38213254
DOI: 10.19852/j.cnki.jtcm.20231110.005 -
Journal of Traditional Chinese Medicine... Feb 2024To explore the mechanism of the Chinese medicine Cigu Xiaozhi prescription (, CGXZ) in the treatment of the non-alcoholic fatty liver disease (NAFLD) by detoxification...
OBJECTIVE
To explore the mechanism of the Chinese medicine Cigu Xiaozhi prescription (, CGXZ) in the treatment of the non-alcoholic fatty liver disease (NAFLD) by detoxification and phlegm-reducing, the effect of CGXZ prescription on ceramide-mediated lipid apoptosis in Hep G2 cells with NAFLD.
METHODS
The experiment was randomly divided into 6 groups: normal control group, model group, CGXZ prescription medicated serum high, medium, and low dose groups, and pioglitazone positive control group. Using 500 μmol/L free fatty acid (FFA) mixture to induce Hep G2 cells to establish NAFLD cell model, respectively, with 2%, 4%, and 6% concentration of CGXZ prescription medicated serum intervention for 24 h. The changes in organelles and lipid droplet accumulation were observed under the electron microscope. Furthermore, TdT-mediated dUTP Nick-End Labeling method was used to assay hepatocyte apoptosis; Biochemical determination of glutamic-pyruvic transaminase, glutamic oxalacetic transaminase, triglycerides, and FFA levels in Hep G2 cells; the content of ceramide was determined by high-performance thin-layer chromatography. Finally, Western Blot and quantitative real-time polymerase chain reaction (qRT-PCR) were used to determine the protein and gene expression levels, such as inducible nitric oxide synthase (iNOS), nuclear factor κB (NF-κB), B cell lymphoma 2 (Bcl-2) and Bcl-2-associated X (Bax).
RESULTS
Under the electron microscope, the cells in the model group showed moderate-to-severe steatosis, and apoptotic bodies could be seen. The model group had greater improvements in the apoptosis rate ( 0.01), and the levels of ceramide C2 and FFA in the cytoplasm ( 0.01) than the normal control group. The protein expressions of NF-κB, iNOS, and Bax were significantly up-regulated ( 0.05), while the Bcl-2 had no significant change ( 0.05). Compared with the model group, the levels of ceramide C2 and FFA ( 0.01), the protein expressions of NF-κB, iNOS, and Bax ( 0.05) in the CGXZ prescription treatment group and pioglitazone positive control group were significantly decreased; Only the Bcl-2 protein was significantly up-regulated in the high-dose Chinese medicine group ( 0.05). The down-regulation of Bax mRNA expression in each Chinese medicine treatment group was significantly better than in the pioglitazone positive control group ( 0.01).
CONCLUSIONS
The CGXZ prescription, formulated with the method of detoxification and phlegm, can inhibit lipoapoptosis in the NAFLD cell model by down-regulating the levels of ceramide C2 and FFA, which may be achieved by regulating ceramide/iNOS/NF-κB signaling pathway.
Topics: Humans; Non-alcoholic Fatty Liver Disease; Liver; NF-kappa B; bcl-2-Associated X Protein; Ceramides; Pioglitazone; Prescriptions
PubMed: 38213240
DOI: 10.19852/j.cnki.jtcm.20231215.002 -
Food & Nutrition Research 2023Bulbus of is a medicinal and edible plant that has the functions of clearing away heat and moisturizing the lungs, resolving phlegm, and relieving coughs. Its ethanol...
BACKGROUND
Bulbus of is a medicinal and edible plant that has the functions of clearing away heat and moisturizing the lungs, resolving phlegm, and relieving coughs. Its ethanol extract has been proven to have a therapeutic effect on lung diseases. Pulmonary fibrosis is a respiratory disease that forms scars in lung tissue, leading to severe respiratory problems. However, the therapeutic effect of total alkaloids of bulbus of (BFC-TA) on pulmonary fibrosis has not been confirmed.
OBJECTIVE
This study aimed to investigate the therapeutic effect of total alkaloids of on pulmonary fibrosis rat model and explore its potential mechanism.
DESIGN
The total alkaloids in the bulbus of were purified using cation exchange resin. The alkaloids contained in the BFC-TA were identified, and the concentration of alkaloids was determined by High Performance Liquid Chromatography-Diode Array Detector-Evaporative Light Scattering Detector (HPLC-DAD-ELSD). Bleomycin (BLM) (5.0 mg/kg) was instilled into the trachea of 60 rats to establish a pulmonary fibrosis model. After 7 days, BFC-TA (34.2, 68.4, and 136.8 mg/kg) was administered continuously for 21 days. During this period, the body weight changes of the rats were measured, the levels of hydroxyproline (HYP) and inflammatory factors were measured in the collected serum, and the histological analysis of the lung tissue was performed by staining technology. Western blotting and quantitative Polymerase Chain Reaction (qPCR) were used to assess the protein and gene composition of inflammation and transforming growth factor-β (TGF-β) signaling pathways.
RESULTS
Nine main components (Peimisine, Imperialine-3-β-D-glucoside, Yibeinoside A, Imperialine, Peiminine, Isopeimine, Hupehenine, Delavinone, Ebeiedinone) were determined by HPLC-DAD-ELSD, and the contents of Peimisine, Imperialine-3-β-D-glucoside and Imperialine were determined. BFC-TA (34.2, 68.4, and 136.8 mg/kg) reduced the levels of pro-inflammatory factors, increased the levels of anti-inflammatory factors, dose-dependently improved the morphology of lung tissue. And during epithelial-mesenchymal transition process, BFC-TA dose-dependently reduced the expression of E-cadherin, dose-dependently increased the expression of Fibronectin. In addition, Western blot analysis and qPCR results showed that inhibiting NF-κB and TGF-β-related signaling pathways effectively slowed down the occurrence of BLM-induced pulmonary fibrosis in rats. And the therapeutic effect of BFC-TA (136.8 mg/kg) is better than that of pirfenidon (PFD) (150 mg/kg).
CONCLUSION
BFC-TA effectively alleviates the progression of the BLM-induced pulmonary fibrosis rat model by regulating the inflammatory response in the lungs and the expression of the TGF-β signaling pathway.
PubMed: 38187805
DOI: 10.29219/fnr.v67.10292 -
BMC Pulmonary Medicine Jan 2024Exposure to wood dust can cause respiratory symptoms, like cough, phlegm, breathlessness, and chest pain, reduce lung function.
BACKGROUND
Exposure to wood dust can cause respiratory symptoms, like cough, phlegm, breathlessness, and chest pain, reduce lung function.
OBJECTIVE
The objective of the study was to assess the prevalence of respiratory symptoms and associated factors among woodwork workers in Bahir-Dar city, Ethiopia.
METHODS
A comparative cross-sectional study was employed among 229 exposed and 228 unexposed groups. Participants for the study were selected using simple random sampling technique. The chronic respiratory symptoms were assessed using a questionnaire adopted from the American Thoracic Society. The data was entered using Epi-Data version 4.6 and export to SPSS version 22 for analysis. Poisson regression, Multivariate linear regression and multivariable logistic regression analysis were used to identify factors associated with woodworkers, general population and in pooled analysis.
RESULT
The prevalence of having at least one chronic respiratory symptom was higher among exposed group (59.4%) than unexposed group (18.0%) with PR = 3.03(95%CI: 2.45, 4.45). In woodworker; Not taking health and safety training(5.15,95%(CI:1.93-13.76),primary educational(3.85,95%,CI:(1.1,13.47), not using Mask(6.38, 95%CI:(2.69-15.76) & number of families(3.05,95%,CI:1.04-9.028), In general population; Number of family members(2.75, 95%CI:1.1-7.19)& lower monthly income (3.3, 95%CI: (1.49-7.4), and In pooled analysis; wood dust exposure status 14.36 95%, CI:(7.6-27.00),primary education(2.93,95%CI:1.24-6.92), number of families(3.46,95%CI:1.8-6.64), lower monthly income(2.13,95%CI:1.19-3.81), & smoking (6.65, 95%CI:1.19-36.9) were associated with respiratory symptom.
CONCLUSION
Prevalence of respiratory symptoms was higher among exposed group than unexposed group. Reduced wood dust exposure status, Provision of occupational safety and health training, use of respiratory protective devices is recommended to reduce respiratory symptoms among woodwork workers.
Topics: Humans; Cross-Sectional Studies; Prevalence; Ethiopia; Occupational Diseases; Occupational Exposure; Dust
PubMed: 38166969
DOI: 10.1186/s12890-023-02812-x -
Journal of Ethnopharmacology Apr 2024Many researchers have adopted resolving phlegm and unblocking fu-organs (RPUF) therapy for acute ischemic stroke (AIS) patients and yielded beneficial results in terms... (Meta-Analysis)
Meta-Analysis Review
ETHNOPHARMACOLOGICAL RELEVANCE
Many researchers have adopted resolving phlegm and unblocking fu-organs (RPUF) therapy for acute ischemic stroke (AIS) patients and yielded beneficial results in terms of clinical symptoms. However, there has been no systematically pooled analysis of RPUF therapy for AIS to date. Therefore, a well-designed systematic review and meta-analysis is necessary.
AIM
This systematic review aims to determine the efficacy and safety of traditional Chinese medicine (TCM) therapy for resolving phlegm and unblocking fu-organs (RPUF) for the treatment of acute ischemic stroke (AIS).
METHODS
Eight databases were searched to identify eligible randomized controlled trials (RCTs) involving RPUF therapy for AIS. The primary outcome included the modified Rankin Scale (mRS), and the secondary outcomes were the National Institute of Health Stroke Scale (NIHSS), the Neurological Deficit Score (NDS), Barthel Index (BI), Fugel-Meyer assessment (FMA), and the Glasgow Coma Scale (GCS). The Cochrane Handbook for Systematic Reviews of Interventions was used to assess risk of bias. The quantitative synthesis was analyzed using RevMan 5.3 and Stata 14.0 software.
RESULTS
The systematic review and meta-analysis comprised 61 RCTs with a total of 6056 participants. RPUF prescriptions combined with usual care were superior to usual care alone in individuals with AIS, as evidenced by decreased mRS (MD=-0.34; 95%CI [-0.65, -0.03]; P=0.03), NIHSS (MD=-3.38; 95%CI [-4.07, -2.68]; P<0.00001), and NDS (MD=-3.65; 95%CI [-4.07, -3.24]; P<0.00001), as well as improved BI (MD=10.4; 95%CI [8.21, 12.59]; P<0.00001), FMA (MD=20.41; 95%CI [17.40, 23.41]; P<0.00001), and GCS (MD=3.08; 95%CI [1.95, 4.20]; P<0.00001). No significant difference was observed in the incidence of adverse effects between the RPUF therapy group and the usual care group.
CONCLUSION
RPUF therapy appears to be an effective and safe approach for treating AIS; it could decrease mRS, NIHSS, and NDS while improving BI, FMA, and GCS. However, the methodological quality of the included RCTs was far from sufficient, and further high-quality, well-designed RCTs with long-term follow-up are still required.
Topics: Humans; Ischemic Stroke; Medicine, Chinese Traditional; Randomized Controlled Trials as Topic; Treatment Outcome
PubMed: 38160868
DOI: 10.1016/j.jep.2023.117660 -
Biomedicine & Pharmacotherapy =... Jan 2024Hyperlipidaemia is described as "excessive phlegm" and "blood stasis" in the classic theory of traditional Chinese medicine. Exocarpium Citri Grandis has the effect of...
Selection and evaluation of quality markers for the regulation of PXR-CYP3A4/FXR-LXRα by Exocarpium Citri Grandis for the treatment of hyperlipidaemia with dispelling blood stasis and removing phlegm.
Hyperlipidaemia is described as "excessive phlegm" and "blood stasis" in the classic theory of traditional Chinese medicine. Exocarpium Citri Grandis has the effect of dispelling blood stasis and removing phlegm, which can better meet the treatment needs of this disease. However, there is still a lack of focus and depth in the study of the chemical composition of this medicine, and the correlation between the study of relevant medicinal substances and the efficacy of dispelling stasis and removing phlegm is insufficient. To address this issue, this study was carried out to validate the overall efficacy and identify and determine the chemical composition of Exocarpium Citri Grandis. The regulatory mechanism of the PXR-CYP3A4/FXR-LXRα pathway and its active ingredients were screened, and a pharmacokinetic study of active ingredients was performed. The obtained multidimensional data were statistically analysed and comprehensively evaluated. The quality marker of Exocarpium Citri Grandis in the treatment of hyperlipidaemia based on the PXR-CYP3A4/FXR-LXRα mechanism to exert the efficacy of dispelling blood stasis and removing phlegm was finally determined. Based on the above experiments, we identified 27 compounds from the ethanol extract of Exocarpium Citri Grandis. Among them, naringenin, meranzin hydrate, apigenin, caffeic acid phenethyl ester, anacardiin, hesperidin and naringin can significantly regulate all or part of the targets in the PXR-CYP3A4/FXR-LXRα pathway. It also has suitable content and pharmacokinetic characteristics in vivo. In conclusion, this study established quality markers to characterize the efficacy of Exocarpium Citri Grandis in dispelling blood stasis and removing phlegm, which provides a scientific basis for the targeted evaluation of the hypolipidaemic activity of this medicinal plant.
Topics: Cytochrome P-450 CYP3A; Hyperlipidemias; Drugs, Chinese Herbal; Plants, Medicinal; Hesperidin; Medicine, Chinese Traditional
PubMed: 38157640
DOI: 10.1016/j.biopha.2023.116089