Estrogenic activity of ethyl gallate and its potential use in hormone replacement therapy.

We aimed to compare the estrogenic activities of compounds isolated from Moutan Cortex Radicis (MRC, Paeonia suffruticosa Andrews) and identify their potential use in hormone replacement therapy. We quantified seven marker components (gallic acid, oxypaeoniflorin, paeoniflorin, ethyl gallate, benzoic acid, benzoylpaeoniflorin, and paeonol) in MRC using a high-performance liquid chromatography simultaneous analysis assay. To investigate the estrogenic activity of MRC and the seven marker components, an E-screen assay was conducted using the estrogen receptor (ER)-positive MCF-7 human breast cancer cell line. Among them, ethyl gallate caused cell proliferation in a concentration-dependent manner at concentrations above 25 µM and was clearly suppressed by combination treatment with the ER antagonist ICI 182,780. Therefore, ethyl gallate may be a compound of MRC that can increase the estrogenic effect in ER-positive MCF-7 cells.

Effectiveness analysis of herbal medicine for gastroesophageal reflux disease: A retrospective study.

This study aimed to identify the clinical features of gastroesophageal reflux disease (GERD) in primary clinics and the effectiveness and safety of herbal medicine (HM). Thirty-five patients with gastroesophageal-reflux symptom who visited the 16 Korean medicine (KM) primary clinics from June 2022 to October 2022 were included in the study. We retrospectively analyzed the charts of 35 patients and collected clinical characteristics, HM, and outcome variables such as the numerical rating scale, gastroesophageal reflux disease questionnaire, frequency scale for symptoms of gastroesophageal reflux disease, Euro-Quality Of Life-5 Dimension, and adverse events. Of the 35 patients, 12 (34.3%) were men, and the average age of all patients was 47.0 ±â€…14.3 years. HM was prescribed for all 35 patients; Pinelliae Tuber (n = 31, 88.57%), Zingiberis Rhizoma Recens (n = 30, 85.71%), and Poria Sclerotium (n = 28, 80%) were the most prescribed herbs. All scores including numerical rating scale, frequency scale for symptoms of gastroesophageal reflux disease, gastroesophageal reflux disease questionnaire, and Euro-Quality Of Life-5 Dimension after 30 and 60 days from baselines showed significant improvement, and there were only a few adverse events. This study supports the effectiveness and safety of HM in reducing GERD symptoms in primary Korean medicine clinics. The most frequently used herbs may play significant roles in GERD symptom management.

Acupuncture for patients with Maigne's syndrome: A case series.

RATIONALE: Diagnosing the precise etiology of low back pain (LBP) is crucial for facilitating speedy recovery in patients. Maigne's syndrome (MS), commonly referred to as thoracolumbar junction syndrome, is a condition characterized by pain resulting from nerve entrapment, yet its underlying mechanisms remain poorly understood. This study presents a series of six case reports wherein patients diagnosed with MS received acupuncture treatment. PATIENT CONCERNS: Six individuals with LBP were included in the study, and all were diagnosed with MS. DIAGNOSES: The diagnosis was confirmed in all six patients through pinch-roll and thoracic vertebrae compression tests, indicating the presence of thoracolumbar junction syndrome. INTERVENTIONS: Acupuncture treatment was administered to all patients, primarily targeting the T11-L2 facet joints, with additional acupoints selected based on the specific nerve entrapment of MS including the superior cluneal, subcostal, and iliohypogastric nerves. OUTCOMES: Following acupuncture therapy, all patients reported improvements in their LBP symptoms, while four patients also exhibited amelioration in their thoracic vertebrae compression test results. LESSONS: These findings underscore the significance of promptly diagnosing the underlying cause of LBP and suggest that acupuncture may be an effective approach in alleviating MS-related pain.

Chuna manual therapy for the treatment of anorexia in children: A PRISMA-compliant systematic review and meta-analysis.

BACKGROUND: Anorexia in children can cause malnutrition, low immunity, growth retardation, and various secondary infections, resulting in a huge burden on society. In East Asia, Chuna manual therapy has been widely used for the treatment of childhood anorexia. We aimed to comprehensively evaluate the effects of Chuna manual therapy for treating childhood anorexia. METHODS: Twelve databases were comprehensively searched from their inception to September 13, 2022. Only randomized controlled trials assessing Chuna manual therapy for the treatment of childhood anorexia were included. The methodological quality of the included studies was assessed using the Cochrane risk-of-bias tool. The quality of evidence for each main outcome was evaluated using the grading of recommendations assessment, development, and evaluation approach. A meta-analysis was performed, and the pooled data were presented as risk ratios (RRs) with 95% confidence intervals (CIs) for dichotomous outcomes. RESULTS: Twenty-five RCTs involving 2230 participants were included. The meta-analysis showed that Chuna manual therapy had a higher total effective rate (TER) based on anorexia symptoms than that of lysine inositol and vitamin B12 (RR: 1.53, 95% CI: 1.28-1.84), multi-enzyme and multi-vitamin (RR: 1.21, 95% CI: 1.11-1.33), and zinc calcium gluconate (RR: 1.22, 95% CI: 1.06-1.39). There was no significant difference in total effective rate between Chuna manual therapy and zinc gluconate plus lysine. No adverse events associated with Chuna manual therapy were reported. Overall, the included studies had an unclear risk of bias, and the quality of evidence was generally moderate to low. CONCLUSION: Current evidence showed that Chuna manual therapy may be effective and safe for improving anorexia symptoms, especially compared with lysine inositol and vitamin B12, multi-enzyme plus multi-vitamin, and zinc calcium gluconate. However, owing to the low methodological quality of the included studies, more rigorous, high-quality RCTs are required on this topic.

Development of the Korean Medicine Core Outcome Set for Primary Dysmenorrhea (COS-PD-KM) for Herbal Medicine Treatment of Primary Dysmenorrhea in Primary Clinics.

The aim of this study was to develop a Korean medicine (KM) core outcome set (COS) for primary dysmenorrhea to evaluate the effectiveness of herbal medicine (HM) in treating primary dysmenorrhea in patients visiting KM primary clinics. Previously reported outcomes were identified through a literature review to define outcomes and effect modifiers (EMs) for the questionnaire. Experts were invited to conduct modified Delphi consensus exercises, and primary care clinicians were invited to conduct Delphi consensus exercises to evaluate suitability and feasibility. Finally, an additional round of a modified Delphi exercise was conducted with experts to obtain a final agreement on the COS. Seventeen outcomes and 15 EMs were included from a literature review, and one effect modifier was suggested by the experts (Phase 1). In Phase 2, after the modified Delphi consensus exercises by experts, 10 outcomes and 11 EMs were included in the COS. The clinicians all agreed on the feasibility of COS (Phase 3). Finally, 10 outcomes and 6 EMs were included in the COS-PD-KM after the final modified Delphi consensus exercise (Phase 4). The effectiveness of HM used in primary clinics could be evaluated with this COS in patients with primary dysmenorrhea. Further studies that involve more relevant stakeholder groups, such as patient representatives and gynecological experts, are needed.

Development of the Korean Medicine Core Outcome Set for Stroke Sequelae: Herbal Medicine Treatment of Elderly Patients With Stroke Sequelae in Primary Clinics.

Objectives: We developed a Korean medicine core outcome set for stroke sequelae (COS-SS-KM) to evaluate the effectiveness and safety of herbal medicine (HM) for stroke sequelae, especially for elderly stroke patients in primary clinics. Methods: We identified previously reported outcomes from a literature review and defined the list of outcomes and effect modifiers for the core outcome set (COS) questionnaire. Three rounds of modified Delphi consensus exercises with experts were conducted online for suitability assessment, and one round of a modified Delphi consensus exercise with primary clinicians was conducted for feasibility assessment. Results: The review identified 17 outcomes and 16 effect modifiers; moreover, six outcomes and one effect modifier were suggested by the experts. The final COS comprised 8 outcomes and 12 effect modifiers for history taking, and experts listed 13 major symptoms of stroke sequelae for symptom assessment. The clinicians agreed on the feasibility of the COS. Conclusion: This COS will help primary care researchers assess the effectiveness of pharmacotherapy, including HM, for elderly patients with stroke sequelae. Future studies should focus on reflecting the opinions of all stakeholders.

Eunkyosan for the common cold: A PRISMA-compliment systematic review of randomised, controlled trials.

BACKGROUND: Eunkyosan (EKS), also known as the Yinqiaosan formula, is widely applied for the common cold in East Asia. Many clinical trials have reported the efficacy and safety of the EKS formula for the treatment of the common cold. OBJECTIVES: This study aimed to assess the clinical evidence for and against the use of EKS formula as a treatment for the common cold. DATA SOURCES: The following databases were searched from inception to the present: MEDINLE, EMBASE, CENTRAL, AMED CINAHL for English articles; OASIS, the Korean Traditional Knowledge Portal, the Korean Studies Information Service System, KoreaMed, the Korean Medical Database and DBPIA); and 3 Chinese databases, including CNKI (i.e., the China Academic Journal, the China Doctoral Dissertations and Master's Theses Full-text Database, the China Proceedings of Conference Full-Text Database and the Century Journal Project), Wanfang and VIP. In addition, we searched a Japanese database and conduct non-electronic searches of conference proceedings. STUDY ELIGIBILITY CRITERIA: Prospective randomised controlled trials (RCTs) evaluating the effectiveness of EKS for the common cold were included in this review. PARTICIPANTS: All types of common colds were eligible for inclusion. Participants who had both the common cold and other conditions were excluded. There were no restrictions based on other factors, such as age, sex, or symptom severity. INTERVENTIONS: Studies that evaluated any type of formulation (ie, decoction, tablet, pill, powder) of EKS were eligible for inclusion. STUDY APPRAISAL AND SYNTHESIS METHODS: Differences between intervention and control groups were assessed. Mean differences with 95% confidence intervals (CIs) were used to measure the effects of treatment for continuous data. METHODS AND ANALYSIS: Fourteen databases were searched in March 2018. We included RCTs examining EKS decoctions for any type of common cold. All RCTs of decoctions or modified decoctions were included. The methodological qualities of the RCTs were assessed using the Cochrane Collaboration tool for assessing risk of bias; confidence in the cumulative evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) instrument. RESULTS: A total of 315 potentially relevant studies were identified, and 4 RCTs met our inclusion criteria. Four RCTs tested the effects of EKS on the common cold, and all RCTs showed that EKS was superior regarding the treatment effect. LIMITATIONS: All RCTs were conducted in China, and the generalisation of these results to other countries might be limited. Most trials did not use internationally recognised reliability and validity outcome measurements. Moreover, the result of the response rate can be distorted by the practitioner. Future trials in compliance with international standards in the evaluation of treatment effects may resolve this issue. CONCLUSION: Our systemic review and meta-analysis provides suggestive evidence of the superiority of EKS over other therapies for treating the common cold. The level of evidence is low because of the high risk of bias. IMPLICATIONS OF KEY FINDINGS: The results of this systematic review and meta-analysis provide suggestive evidence of the superiority of EKS alone or combined with conventional drugs. REGISTRATION NUMBER: CRD42018087694.

Eunkyosan for treatment of the common cold: A protocol for the systematic review of controlled trials.

INTRODUCTION: Eunkyosan (EKS) is widely used for common colds in East Asian countries. Many clinical trials assessing the efficacy and safety of EKS formula for the treatment of common colds have been reported. This review will assess the clinical evidence for and against the use of EKS formula as a treatment for common colds. METHODS AND ANALYSIS: Fourteen databases will be searched from inception until March 2018. We will include randomized controlled trials (RCTs) assessing EKS decoctions for any type of common cold. All RCTs of decoctions or modified decoctions will be included. The methodological qualities of the RCTs will be assessed using the Cochrane Collaboration tool for assessing risk of bias, while confidence in the cumulative evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) instrument. ETHICS AND DISSEMINATION: This systematic review will be published in a peer-reviewed journal and will also be disseminated electronically and in print. The review will be updated to inform and guide healthcare practices.Registration number: CRD42018087694.