الملخص
Kampo medicine has been used for patients with pneumophagia to improve deficiency and stagnation of qi. Here, we report a case in which symptoms were alleviated by treating spleen yang deficiency and liver qi stagnation as the main pathogenesis. The patient was a 75-year-old woman. She was diagnosed with atrophic gastritis after a close examination of her gastric discomfort. She took antacids and proton pump inhibitors, but the condition did not improve. Her abdominal distension and belching also appeared and worsened, so she requested Kampo treatment. Since she had interior cold with qi stagnation, we prescribed tokito that is able not only to warm interior cold but also to adjust qi sufficiently. The pathology of pneumophagia is generally considered to be stagnation of qi mainly and concomitant with deficiency of qi. However, for those having interior cold like this case, a medicine that can firmly perform warm supplementation is necessary, and tokito is considered to be a candidate for the condition. Strangled pain is mentioned as the main targeted symptom of tokito, and it is often administered for abdominal or chest pain. Although, in this case, abdominal pain might have occurred if the condition had worsened further, it is important to utilize tokito in the case of qi stagnation and yang deficiency regardless whether patients have pain or not.
الملخص
ObjectiveTo systematically review the existing evidence of Tongxiening（TXN） Granules in the treatment of diarrhea-predominant irritable bowel syndrome （IBS-D） with liver Qi invading spleen syndrome，and evaluate the clinical comprehensive value from the 6+1 dimension，providing references for national medical decision-making，drug clinical application promotion，pharmaceutical services，etc. MethodFollowing the relevant standards of the "Guidelines for the Management of Clinical Evidence and Value Evaluation of Drugs"， a combination of qualitative and quantitative approaches based on evidence-based medicine，questionnaire surveys，pharmacoeconomic evaluation，etc.，was employed. Multi-criteria decision analysis （MCDA） model was employed to comprehensively evaluate the clinical evidence and value of TXN Granules in the treatment of IBS-D with liver Qi invading spleen syndrome from the "6+1" dimensions of effectiveness，safety，economy，innovation，suitability，accessibility， and traditional Chinese medicine （TCM） characteristics Result① Safety： Based on the evaluation of known risks and adequacy of safety evidence， TXN granules were considered to have controllable risks with sufficient safety evidence. ② Effectiveness： Meta-analysis showed that TXN granules combined with probiotics could reduce the intestinal symptom score level of IBS-D patients ［mean difference （MD）=-2.29， 95% confidence interval （CI） （-3.20， -1.38）， P<0.01］， and TXN granules combined with conventional treatments （such as Bifidobacterium triple viable capsules，pinaverium bromide tablets，or trimebutine maleate tablets）effectively improved the comprehensive improvement rate of IBS-D patients ［relative risk （RR）=1.19， 95%CI （1.14，1.25）， P<0.01］. TXN granules significantly improved abdominal pain ［RR=1.99， 95%CI （1.62，2.44）， P < 0.01］ and diarrhea efficacy rate ［RR = 1.56， 95% CI （1.07，2.25）， P<0.05］ in IBS-D patients. TXN granules were comparable to pinaverium bromide tablets in reducing HAMA score ［MD = 0.29， 95% CI （-0.30， 0.88）， P=0.34］， HAMD score ［MD=0.35， 95%CI （-0.31，1.00），P=0.30］， and improving IBS-QOL score ［MD = 0.28， 95%CI （-1.70，2.26）， P=0.78］. Based on the quality of evidence and evidence value assessment of effectiveness， it was considered that there was sufficient evidence of effectiveness for this product. ③ Economy： TXN granules are a national medical insurance category B product. After 5 years of simulation with three kinds of Markov models， it was considered that TXN granules were the advantageous treatment option with stable results and good economy. ④ Innovation： TXN granules adhered to original innovation， conducting research and development from clinical application， product components， and production processes. They have obtained national TCM new drug certificates， first prizes from the China Association of Chinese Medicine for Science and Technology， and excellent awards for Chinese patents， providing sufficient innovative evidence in clinical， corporate， and industrial aspects. ⑤ Suitability： The information service of this drug is comprehensive. The questionnaire survey results showed that this drug was suitable for clinical doctors， nurses， pharmacists， and patients in terms of individual compliance， system， and management across multiple dimensions. The overall assessment showed sufficient evidence of suitability for this product. ⑥ Accessibility： The daily cost of TXN granules accounts for 2.43% of the median disposable daily income of urban residents and 9.26% of rural residents， which is moderate and reasonable compared to similar drugs. There is sufficient evidence of affordability， and it is sold nationwide covering all 31 provinces， municipalities， and autonomous regions， with full accessibility evidence and clear results. TCM characteristics： TXN granules originate from the prescription for treating diarrhea in Danxi's Experiential Therapy. They are derived from classical formulas and have undergone multiple clinical trials involving 5 000 cases since their launch， accumulating a certain amount of human use experience. Based on the principles of evaluating TCM characteristics， TXN granules highlight TCM characteristics. The comprehensive value measured using CSC V2.0 software is 0.83 points based on the results of “6+1” dimensions. ConclusionBased on the evaluation results of TXN granules in various dimensions and the comprehensive evaluation score， it is considered that there is sufficient clinical value evidence for TXN granules in treating IBS-D with liver Qi invading spleen syndrome， which can provide references for clinical decision-making and pharmaceutical management. It is suggested for future research to conduct network Meta-analysis， conduct horizontal comparisons of similar TCM treatments for IBS-D， improve the quality of evidence-based evidence， and fully leverage the clinical value advantages of TXN granules.
الملخص
Liver depression and spleen deficiency syndrome is a common syndrome type of ulcerative colitis (UC). Based on the theory of 'collaborative treatment of liver and spleen', TCM shows its effect and less adverse reactions in the treatment of UC with liver depression and spleen deficiency. The internal treatment of TCM based on syndrome differentiation and treatment by stages, as well as the external treatment of TCM based on TCM enema therapy, acupuncture therapy and acupoint application therapy, can relieve symptoms, improve relevant clinical indicators and improve the quality of life of patients. The mechanism studies show that the TCM with the effect of soothing the liver and activating the spleen plays a therapeutic role by regulating signal pathway conduction, regulating intestinal flora, and improving the level of inflammatory factors.
الملخص
Objective:To evaluate the clinical efficacy of Rougan Jianpi therapy combined with Mesalazine enema in the treatment of distal ulcerative colitis (DUC) with Ganyu-Pixu syndrome.Methods:This study is a prospective parallel randomized controlled study. From November 2021 to May 2022, 115 patients with DUC in Changshu Hospital Affiliated to Nanjing University of Chinese Medicine were selected and randomly divided into a control group of 58 patients and a study group of 57 patients. The control group was treated with Mesalazine enema, and the study group was treated with Rougan Jianpi Decoction on the basis of the control group. Both groups were treated for 8 weeks. The severity of the disease was evaluated by using the Modified Mayo Scale, and the clinical and endoscopic efficacy was evaluated based on the changes in the score before and after treatment. TCM syndromes were scored from four aspects: abdominal pain, diarrhea, mucopurulent bloody stool, Rectal tenesmus, and anal burning. The quality of life was evaluated by using the IBD Quality of Life Scale (IBDQ). The serum TNF-αand IL-10 level were detected by using ELISA method. The adverse reactions during treatment were observed and recorded.Results:The total effective rate of the study group was 91.23% (52/57), while that of the control group was 79.31% (46/58). The difference between the two groups was no statistically significant ( Z=1.47, P=0.143). The proportion of patients in the study group who achieved clinical response[40.35% (23/57) vs. 51.72% (30/58)] and clinical relief [59.65% (34/57) vs. 43.11% (25/58)] the total proportion were significantly higher than those in the control group [100.00% (57/57) vs. 94.83% (55/58); Z=1.97, P=0.049]. The proportion of patients with endoscopic response [52.63% (30/57) vs. 56.90% (33/58)] and mucosal healing [33.33% (19/57) vs. 17.24% (10/58)] the total proportion in the study group were significantly higher than those in the control group [85.96% (49/57) vs. 74.14% (43/58); Z=2.23, P=0.026]. after treatment, the IBDQ score [(194.3±15.1) vs. (172.6±18.4), t=6.90] in the study group was significantly higher than that of the control group. After treatment, the patient's TCM symptom score: mucopurulent bloody stool [(1.7±0.8) vs. (2.0±0.6), t=2.03], rectal tenesmus [(1.5±0.6) vs. (1.8±0.6), t=2.32] and anal burning [(1.3±0.6) vs. (1.6±0.7), t=2.38] in the control group were significantly lower than those in the control group ( P<0.05). The level of IL-10 [(53.3±8.0) ng/L vs. (49.0±6.7) ng/L, t=3.10] in the study group after treatment was higher than that of the control group ( P<0.01), and TNF-α [(28.3±7.9)ng/L vs. (36.8±8.1)ng/L, t=3.58] was lower than that of the control group ( P<0.01). There were no significant adverse reactions observed during the treatment in both groups. Conclusion:Method of Rougan Jianpi combined with mesalazine enema can improve the clinical symptoms of DUC patients, improve clinical efficacy, and have good safety.
الملخص
Objective To evaluate the effectiveness and safety of acupuncture in patients with Major Depressive Disorders.Methods Search the database for relevant literature published before April 15,2023.Select randomized controlled trial that meeting the enrollment criteria,evaluate the quality of the literature and classify before meta-analysis systematic evaluation.Results 15 RCTs are included in this study,with a total of 1077 patients.The results showed that acupuncture treatment,compared with antidepressants alone,The score of Hamilton Depression Scale(HAMD)in patients with liver-qi depression disorder[MD=-0.73,95%CI(-1.22,-0.24),P<0.05],the score of TCM Syndrome Scale[MD=-1.89,95%CI(-2.35,-1.44),P<0.001],effective rate[RR=1.09,95%CI(1.03,1.153),P=0.001]and TESS score[MD=-2.76,95%CI(-3.68,-1.85),P<0.001]were statistically significant.Compared with fluoxetine hydrochloride,the effective rate of HAMD scale score was statistically significant[RR=1.07,95%CI(1.01,1.14),P<0.05].Conclusion Compared with antidepressants alone,acupuncture therapy has the advantages for the improvement of HAMD score in patients,the improvement of Traditional Chinese medicine symptoms,and significantly less adverse effects than those in the control group.Through this study,it is considered that acupuncture can be a safe and effective treatment modality.However,due to the quantity and quality of the included literature,the above conclusions still need to be verified by more high-quality clinical trials.
الملخص
By exploring the theory of “the liver is the basis of resistance to fatigue”， it is believed that liver with its physiological function of storing blood and governing the free flow of qi plays an important role in the body's tole-rance to physical fatigue and mental fatigue， and it is also related to the physiological activities of eyes and tendons. The formation of asthenopia is related to the dysfunction of liver， spleen and kidney. The liver plays a key role in the occurrence and development of asthenopia. The deficiency of liver blood and liver dysfunction will cause the abnormal circulation of qi and blood， which leads to the loss of malnutrition of eyes and affects the normal physiological function of eyes. During treatment， we pay attention to nourishing the blood and soothing the liver to nourish the spirit， regulating and tonifying liver qi to stimulate the liver yang， strengthening the spleen and soothing liver to replenish qi and promoting yang， nourishing the liver and kidney to harmonize yin and yang， which are meant to restore the physiological characteristics of liver being yin in form but yang in function， so as to cure asthenopia.
الملخص
Based on WANG Xugao's “thirty methods of treating the liver”， it is believed that the occurrence and development of childhood tic disorders follow the dynamic progression from liver qi disease to liver fire disease and then liver wind disease. The basic pathogenesis of three stages are characterized by binding constraint of liver qi， liver fire hyperactivity， and internal stirring of liver wind. Moreover， liver-blood deficiency and stagnation， and malnutrition of liver yin as the main point in terms of the imbalance of liver qi， blood， yin， and yang should be considered， as well as the imbalance relationship of the five zang organs such as the involvement of other organs and the gradually reach of the other organs. Guided by the principles of “thirty methods of treating the liver”， the treatment of tic disorders in liver qi stage should focus on soothing the liver and rectifying qi， soothing the liver and unblocking the collaterals， using Xiaochaihu Decoction （小柴胡汤） and Sini Powder （四逆散）. The treatment of tic disorders in liver fire stage involves clearing， draining and resolving liver heat， using Longdan Xiegan Decoction （龙胆泻肝汤）， Xieqing Pill （泻青丸）， Danggui Longhui Pill （当归龙荟丸）， and Huagan Decoction （化肝煎）. The treatment of tic disorders in liver wind stage involves extinguishing wind and subduing yang， using Lingjiao Gouteng Decoction （羚角钩藤汤） and Liuwei Dihuang Pill （六味地黄丸）. Throughout the treatment process， attention should be paid to harmonizing the liver's qi， blood， yin， and yang， as well as addressing the pathology of other organs.
الملخص
Objective:To investigate the clinical efficacy of " Shugan Tiaoshen" needling combined with magnesium valproate sustained-release tablets in the treatment of insomnia in patients with bipolar disorder with liver qi stagnation syndrome. Methods:A total of 186 patients with bipolar disorder and insomnia who were diagnosed and treated at the Third Hospital of Quzhou from December 2020 to January 2022 were included in this study. These patients were randomly divided into a control group and an observation group ( n = 93 per group) using a prospective study method. The control group was orally treated with magnesium valproate sustained-release tablets, while the observation group was treated with " Shugan Tiaoshen" needling combined with magnesium valproate sustained-release tablets. Two groups were treated for 8 weeks. Clinical efficacy, Bech-Rafaelsdn Mania Rating Scale score, Pittsburgh Sleep Quality Index score, and serum interleukin-1β, tumor necrosis factor-alpha, brain-derived neurotrophic factor, and glial derived neurotrophic factor levels were compared between the two groups. The Short-Form 36 Health Survey was used to evaluate quality of life. The adverse reaction was compared between the two groups. Results:The total effective rate in the observation group was 92.47% (86/93), which was significantly higher than 78.49% (73/93) in the control group ( χ2 = 7.32, P = 0.007). After treatment, the Bech-Rafaelsdn Mania Rating Scale score and Pittsburgh Sleep Quality Index score in the observation group were significantly higher than those in the control group [(22.35 ± 5.10) points vs. (30.09 ± 5.42) points, (15.37 ± 4.46) points vs. (20.63 ± 4.09) points, t = -10.03, -8.38, both P < 0.001). After treatment, Wsiconsin card sorting test score, Continuous Performance Task score, and Hopkins Verbal Learning Test-Revised score in the observation group were significantly higher than those in the control group [(49.29 ± 6.85) points vs. (47.48 ± 7.14) points, (3.59 ± 0.66) points vs. (2.81 ± 0.73) points, (26.07 ± 5.13) points vs. (24.64 ± 5.08) points, t = 1.76, 7.64, 1.91, all P < 0.05]. After treatment, serum tumor necrosis factor-alpha and interleukin-1β levels in the observation group were significantly lower than those in the control group [(60.26 ± 10.31) ng/L vs. (79.35 ± 9.82) ng/L, (49.27 ± 8.33) g/L vs. (75.61 ± 9.12) g/L, t = -12.93, -20.56, both P < 0.001]. Brain derived neurotrophic factor and glial derived neurotrophic factor levels in the observation group were significantly lower than those in the control group [(60.08 ± 10.31) μg/L vs. (56.96 ± 11.45) μg/L, (53.09 ± 7.01) ng/L vs. (48.65 ± 8.47) ng/L, t = -11.42, 8.02, both P < 0.001]. After treatment, the quality of life scores in each dimension in the observation group were significantly higher than those in the control group ( t = 4.03-5.37, all P < 0.001). The total incidence of adverse reactions in the observation group was 7.52% (7/93), while that in the control group was 8.60% (8/93), and there was no significant difference in total incidence of adverse reactions between the two groups ( χ2 = 0.07, P = 0.788). Conclusion:" Shugan Tiaoshen" needling combined with magnesium valproate sustained-release tablets has an obvious therapeutic effect on bipolar disorder combined with insomnia in patients with bipolar disorder. The combined therapy can reduce manic symptoms, improve sleep quality and quality of life, down-regulate serum tumor necrosis factor-alpha and interleukin-1β levels, and increase brain-derived neurotrophic factor and glial derived neurotrophic factor levels.
الملخص
Objective:To observe the effects of liver-soothing spirit-regulating acupuncture on the behaviors and expression levels of 5-hydroxytryptamine receptor 1A(5-HT1AR)and 5-hydroxytryptamine receptor 2A(5-HT2AR)in the hippocampus of insomnia rats due to liver Qi stagnation. Methods:Ten of the 70 Wistar rats were randomly selected as the blank group,and the remaining rats were subjected to preparing the insomnia model due to liver Qi stagnation by the chronic tail clamping stimulation combined with intraperitoneal injection of para-chlorophenyl alanine.Fifty successful model rats were randomly divided into a model group,a grasp group,a Western medicine group,an acupuncture group,and a sham acupuncture group,with 10 rats in each group.Rats in the grasp group were grabbed in the same way as those in the acupuncture group.Rats in the Western medicine group were given estazolam solution by intragastric administration.Rats in the acupuncture group received liver-soothing spirit-regulating acupuncture at Baihui(GV20),Neiguan(PC6),Shenmen(HT7),and Taichong(LR3);rats in the sham acupuncture group received acupuncture at 4 non-meridian non-point spots.All groups were treated once a day for 7 d.Pentobarbital sleep test was used to evaluate the sleep latency(SL)and sleep time(ST)of rats in each group after 7 d of intervention;the proportion of the number of entry into the open arms(OE％)and the proportion of the residence time in the open arms(OT％)were monitored by elevated plus maze test(EPMT);the open field test(OFT)was used to monitor the numbers of standing upright,horizontal cross-grid,and fecal grains in rats.The expression levels of 5-HT1AR and 5-HT2AR in rat hippocampus were detected by Western blotting. Results:The body mass gain,ST,OE％,OT％,upright standing times,horizontal cross-grid times,and the 5-HT1AR expression level in the hippocampus were significantly decreased(P<0.01),while the SL and 5-HT2AR expression level in the hippocampus were significantly increased(P<0.01)in the model group compared with the blank group.After intervention,the body mass,ST,OT％,OE％,upright standing times,horizontal cross-grid times,and hippocampal 5-HT1AR expression level were significantly increased(P<0.01 or P<0.05),while the SL and hippocampal 5-HT2AR expression level were significantly decreased(P<0.01 or P<0.05)in the acupuncture group and the Western medicine group compared with the grasp group.Compared with the Western medicine group,OT％,SL,and hippocampal 5-HT1AR expression level were significantly increased in the acupuncture group(P<0.05).The body mass,OT％,OE％,ST,upright standing times,horizontal cross-grid times,and the 5-HT1AR expression level in the hippocampus were significantly increased(P<0.01),while the SL and 5-HT2AR expression level in the hippocampus were significantly decreased(P<0.01)in the acupuncture group compared with the sham acupuncture group. Conclusion:Liver-soothing spirit-regulating acupuncture can not only improve sleep but also improve the abnormal behaviors and mood of insomnia rats due to liver Qi stagnation,and the improvement effect on abnormal mood is better than that of Western medicine.The mechanism may be related to the regulation of 5-HT1AR and 5-HT2AR
الملخص
@#Objective To investigate the underlying mechanism of the compound Bugansan Decoction (补肝散, BGSD) in intervening learning and memory in D-galactose (D-gal)-induced aging rats. @*Methods@#A total of 40 rats were randomly assigned to four groups: control, model, BGSD [14.06 g/(kg·d)], and piracetam [0.4 g/(kg·d)] groups, with 10 rats in each group. D-gal [400 mg/(kg·d)] was injected intraperitoneally to establish the aging rat model. The rats' body weight, water intake, food intake, and gripping strength were recorded each week. The eightarm maze and step-down test were used to measure the rats' capacity for learning and memory. Liver, thymus, spleen, and brain tissues were weighed to calculate the corresponding organ indices; serum malondialdehyde (MDA) content and superoxide dismutase (SOD) activity were measured. Hematoxylin and eosin (HE) staining was adopted to observe the pathological changes of the hippocampus; enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6, and IL-1β in the hippocampus. Real-time quantitative polymerase chain reaction (RT-qPCR) was used to detect the expression of receptors for advanced glycation end products (RAGE), nuclear factor-κB (NF-κB), TNF-α, IL-6, and IL-1β mRNA in the hippocampus. Western blot (WB) was employed to detect the expression levels of advanced glycation end products (AGEs), RAGE, and NF-κB protein in the hippocampus. @*Results@#In D-gal-induced aging rats, BGSD significantly increased food intake, water intake, body weight, gripping strength, and organ indices (P < 0.05), and significantly decreased working memory error (WME), reference memory error (RME), and total memory errors (TE) in an eight-arm maze (P < 0.05). In the step-down test, step-down latency was prolonged and the frequency of errors dropped (P < 0.05). Additionally, BGSD could lessen the harm done to hippocampus neurons, increase serum SOD activity, lower MDA levels, and down-regulate the expression levels of the pro-inflammatory molecules TNF-α, IL-6, and IL-1β (P < 0.05). Further findings showed that BGSD significantly decreased hippocampal AGEs, RAGE, and NF-κB expression (P < 0.05). @*Conclusion@#By blocking the AGEs/RAGE/NF-κB signaling pathway, BGSD may regulate the neuroinflammatory damage in D-gal-induced aging rats, and thus improve learning and memory.
الملخص
Bipolar disorder （BD） is considered to be mainly related to qi， phlegm， fire and deficiency. Binding constraint of liver qi is the initial cause， while phlegm and qi interact obstruction as well as phlegm and fire interact binding is the key pathogenesis of the transformation between depression and mania， and deficiency of both qi and yin is the main reason of the protracted course of disease. In clinical practice， BD is divided into binding constraint of liver qi pattern， phlegm and qi interact obstruction pattern， phlegm and fire interact binding pattern， and deficiency of both qi and yin pattern， which can be treated with Jinyu Shugan Powder （金玉疏肝散）， Kaiyu Wendan Decoction （开郁温胆汤）， Qingxin Huatan Decoction （清心化痰汤）， and Baihe Shengmai Beverage （百合生脉饮） in their modifications respectively； moreover， Guanye Jinsitao （Herba Hyperici Perforati） is usually used to rectify qi， relieve phlegm and clear heat. It is also suggested to put focus on the prevention and treatment of qi， phlegm and heat simultaneously， and modify the medicinals flexibly in accordance with the pathogenesis evolution and the abnormal exuberance.
الملخص
Objective:To explore the mechanism of modified Xiaoyao Powder on inflammatory response of rats with syndrome of stagnation of liver qi and spleen deficiency of experimental autoimmune thyroiditis (EAT) from the perspective of differentiation of microrna 326 (miR326) regulating Th17 cell.Methods:48 rats were randomly divided into normal group (12 rats) and model group (36 rats) respectively and they were immunized twice a week with high iodine water combined with subcutaneous injection of thyroglobulin. From the fifth to eighth weeks, 36 rats were immunized once a week. From the fifth week, the model group with liver depression and spleen deficiency syndrome of Traditional Chinese Medicine was reproduced with chronic restraint stress, excessive fatigue and eating incoherence methods. The modelrats were randomly divided into model group, Xiaoyao Powder group and Jinshuibao group. Rats in Xiaoyao Powder group were gavaged with 13.63 g/(kg·d) Xiaoyao Powder modified granule suspension, and rats in Jinshuibao group were gavaged with 477 mg/(kg·d) Jinshuibao suspension, twice a day, for 8 weeks.The levels of serum FT3, FT4, TSH, TGAb and TPOAb were detected by ELISA; the expression of miR326, IL-17 mRNA, IL-4 mRNA and IFN-γ mRNA were detected by PCR. The expression of Ets-1 protein in thyroid tissue was detected by Wes method, and the proportion of CD4 + IFNγ + T cells, CD4 + IL-4 + T cells and CD4 + IL-17 + T cells were detected by flow cytometry, HE staining was used to detect the pathological manifestations of thyroid tissue in each group. Results:Compared with the model group, the serum TSH [(3 328.88±724.45) pg/ml vs. (1 900.25±203.91) pg/ml] in Xiaoyao Powder group increased ( P<0.01), TGAb [(63.60±9.01) IU/ml vs. (96.19±10.74) IU/ml] and TPOAb [(6.84±1.45) IU/ml vs. (11.62±2.06) IU/ml] decreased ( P<0.01), and the expression of miR326 (3.57±0.57 vs. 7.63±0.90),IL-17 mRNA (6.71±0.97 vs. 13.02±1.18) significantly decreased ( P<0.01), the expression of Ets-1 (0.71±0.40 vs. 0.39±0.02) significantly increased ( P<0.01), the ratio of CD4 +IFN-γ + T cell [(13.10±2.23)% vs. (20.7±2.07)%], CD4 +IL-17 + T cell ratio [(18.90±1.31)% vs. (25.1±1.03)%] significantly decreased ( P<0.01), and thyroid histopathology changed significantly. Conclusion:Modified Xiaoyao Powder could regulate the expression of target protein Ets-1 upward, inhibit the differentiation of Th17 cells and further reduce the expression of IL-17 mRNA by regulating the expression of mir-326 downward in the thyroid tissue of EAT rats, so as to improve the inflammatory response of rats with liver depression and spleen deficiency.
الملخص
Objective: To observe the effects of acupoint sticking therapy of different dosages and durations on the subjective and objective sleep indicators in insomnia patients.Methods: Ninety-six patients with insomnia due to liver-Qi stagnation and spleen deficiency were divided into a high-dosage 7 d group (25 cases), a high-dosage 14 d group (22 cases), a low-dosage 7 d group (21 cases), and a low-dosage 14 d group (28 cases) using the random numbers generated in a stratified and stage-by-stage manner in combination with the visiting sequence. The four groups all received the same acupuncture treatment, but acupoint sticking therapy varied in dosage and duration. Before and after treatment, the actigraphic readings (total time in bed, total sleep time, sleep efficiency, number of wake bouts, length of wakes after asleep, and sleep latency), Pittsburgh sleep quality index (PSQI) score, and symptoms score of traditional Chinese medicine (TCM) were observed. A correlation analysis was conducted among the subjective and objective indicators. Results: The PSQI score was positively correlated with the total time in bed and total sleep time (P<0.05). After treatment, the sleep latency, PSQI scores, and TCM symptoms scores changed significantly in the four groups (P<0.05). The total sleep time and sleep efficiency gained improvements after treatment in the high-dosage 14 d and low-dosage 14 d groups (P<0.05). The high-dosage acupoint sticking groups had longer total sleep time compared with the low-dosage groups of the same treatment duration (P<0.05). After treatment, the length of wakes after asleep, PSQI scores, and TCM symptoms scores were better in the 14 d groups than in the 7 d groups of the same acupoint sticking dosage (P<0.05). Conclusion: Given the same acupuncture treatment, acupoint sticking therapy of different treatment durations produces different effects on the length of wakes after asleep, PSQI score, and TCM symptoms score in insomnia patients, and the 14-day acupoint sticking treatment is superior to the 7-day treatment.
الملخص
We had a female patient who had stagnation of qi and recovered not only by adjusting qi but also by warming interior cold. A 67-year-old woman visited our clinic for generalized anxiety disorder and whole body overstrain on the basis of domestic problems. She had taken anxiolytic, which brought about some relief. She also suffered from uterine cancer, and had operation of uterine resection. After operation, she took radiation therapy, which caused ileus. Although she took daikenchuto, ileus sometimes recurred. At first, we diagnosed her condition as stagnation of liver qi and deficiency of liver blood according to Kampo medical findings, and prescribed yokukansankachimpihange. However, she felt little effectiveness. We focused on her condition as spleen-stomach deficiency cold, and switched to anchusan, which gradually improved her symptom and led to discontinuation of daikenchuto and anxiolytic. She continued to take it for 7 years, and gradually reduced. She stopped taking medication 2 years later, and has had no recurrence ever since. It suggests that anchusan was effective in warming her latent severe interior cold. We should consider anchusan as a therapeutic candidate for stagnation of qi and interior cold, although it is well known Kampo medicine that is suitable for stomach pain.
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We have reported cases of idiopathic sensorineural hearing loss treated with Japanese Kampo medicine in the past, but they all exhibited deficiency pattern. This time, we experienced cases of idiopathic sensorineural hearing loss, which exhibited medium pattern and excess pattern. Case 1 is a 57-year-old man. He had a chief complaint of ringing and hearing loss in his right ear from 3 days ago and was diagnosed with right idiopathic sensorineural hearing loss Grade3b. He exhibited medium pattern with liver qi depression and blood stasis, and was administered shosaikoto and keishibukuryogan. He was cured after 2 weeks. Case 2 is a 48-year-old man. He had a chief complaint of hearing loss in his right ear and dizziness from 2 days ago and was diagnosed with right idiopathic sensorineural hearing loss Grade4a. He exhibited excess pattern with liver qi depression and blood stasis, and was administered daisaikoto and tokakujokito for 1 week. After that, we switched tokakujokito to keishibukuryogan and continued treatment, but there remained a slight difference in hearing around the treble part, and it stopped at a remarkable recovery.
الملخص
We report a case of a 74-year-old woman who suffered from uncomfortable heat under her right shoulder blade and felt anxiety about general fatigue that had been worsening mainly in the summer. She visited our Kampo clinic because of insufficient effect of various types of drug that had been prescribed by 3 doctors for about a year. We made the diagnosis of somatic symptom disorder and suggested Kampo therapy with decoction. We thought this might be caused by liver qi depression, blood deficiency, and blood stasis because he had symptoms of dry skin, cold of feet, deeply located fine pulse, pale and purple tongue with yellow thick fur, fullness in the chest and hypochondrium. Therefore we administered keppuchikuoto modified formula. Her symptom improved within about a month after taking this formulation. There was no recurrence of the physical symptom and fatigue in the summer during taking medicine for about 20 months. Evidence-based treatment in somatic symptom disorder has not been established and some cases are resistant to treatments in modern Western medicine. Kampo medicine may be useful and hopeful.
الملخص
In this study, according to TCM theory of "liver qi stagnation forming fire", emotional stress mice model was employed to evaluate the protective effects of Qingre Xiaoyanning on herpes simplex virus type 1 (HSV-1) induced reactivation. The animal experimental protocol has been reviewed and approved by Laboratory Animal Ethics Committee of Jinan University, in compliance with the Institutional Animal Care Guidelines. BALB/c mice were divided into six groups, including mock group, HSV-1 latency group, HSV-1 reactivation group (HSV-1 latency + stress), low (0.658 g·kg-1·day-1) and high dose (1.316 g·kg-1·day-1) of Qingre Xiaoyanning groups and positive control group (acyclovir, 0.206 g·kg-1·day-1). Except for the normal group and HSV-1 latency group, all mice in other groups received a daily 12-h restraint stress for 4 days. After 7-day treatment of drugs, body weight and recurrent eye infections of mice were recorded. Brain tissues were harvested to monitor HSV-1 antigen distribution by immunohistochemical staining and detect virus titer by plaque assay. In the meantime, the mRNA and protein levels of infected cell polypeptide (ICP27) and glycoprotein B (gB) in the brain tissues were detected by RT-PCR and Western blot, respectively. The level of 4-hydroxynonenal (4-HNE) and expressions of ferroptosis-related proteins were measured by Western blot. The evaluation of malondialdehyde (MDA) content in the brain tissues was conducted by MDA assay commercial kit. The results showed that Qingre Xiaoyanning significantly retarded the decline of body weight of mice induced by HSV-1 reactivation, reduced the activation rate of HSV-1 and recurrent eye infections, declined virus titer of HSV-1, down-regulated gene and protein expressions of ICP27 and gB, and hindered the distribution of HSV-1 antigen in the brain of mice. Meanwhile, Qingre Xiaoyanning also decreased the protein expression of ferroptosis-related proteins, including DMT1, TFR1 and ALOX15 in the brain tissue of HSV-1 reactivated mice. The levels of lipid peroxidation products, 4-HNE and MDA, were also reduced by Qingre Xiaoyanning treatment. All the above results indicate that Qingre Xiaoyanning significantly inhibited HSV-1 reactivation by restraint stress, which might be related to the regulation of ferroptosis. Our findings provide a theoretical basis for the application of "clearing liver-fire" TCM on treatmenting HSV-1 reactivation-related symptoms.
الملخص
OBJECTIVE@#To observe the efficacy of acupuncture combined with @*METHODS@#A total of 180 children with cerebral palsy were randomly divided into a combined group (60 cases, 2 cases dropped off), an acupuncture group (60 cases, 4 cases dropped off) and a Chinese medication group (60 cases, 5 cases dropped off). On the basis of conventional treatment, the children in the combined group were treated with acupuncture [Baihui (GV 20), Sishencong (EX-HN 1), Shenting (GV 24), Benshen (GB 13), 30 min each time, twice a day] and @*RESULTS@#The total effective rate was 91.4% (53/58) in the combined group, which was higher than 80.4% (45/56) in the acupuncture group and 78.2% (43/55) in the Chinese medication group (@*CONCLUSION@#Acupuncture combined with
الموضوعات
Child , Humans , Acupuncture Points , Acupuncture Therapy , Cerebral Palsy/drug therapy , Powders , Treatment Outcomeالملخص
Objective: To observe the clinical efficacy of acupuncture plus medicine in treating laryngopharyngeal reflux due to liver-qi stagnation and spleen deficiency. Methods: A total of 70 patients were divided into a control group and an observation group by the random number table method, with 35 cases in each group. Both groups were treated with conventional medications, and the observation group was treated with additional acupuncture therapy. The reflux symptom index (RSI) and reflux finding score (RFS) were evaluated. Esophageal motility indicators such as lower esophageal sphincter pressure (LESP) and upper esophageal sphincter pressure (UESP), and salivary pepsin level were measured. The clinical efficacy was also compared. Results: The total effective rate of the observation group was higher than that of the control group (P<0.05). After treatment, the RSI and RFS scores in both groups decreased significantly (all P<0.05), and the RSI and RFS scores in the observation group were significantly lower than those in the control group (both P<0.05). There were no significant changes in the LESP and UESP in the control group (both P>0.05), while LESP and UESP in the observation group increased significantly (both P<0.05), and higher than those in the control group (both P<0.05). The salivary pepsin levels in both groups decreased (both P<0.05), and the salivary pepsin level in the observation group was significantly lower than that in the control group (P<0.05). Conclusion: Acupuncture plus medicine can improve symptoms and signs in patients with laryngopharyngeal reflux due to liver-qi stagnation and spleen deficiency, and regulate esophageal motility and salivary pepsin level. Its efficacy is more significant compared with medicine alone.
الملخص
Objective: To observe the efficacy of acupoint sticking with Jianpi Tongjing Zhitong ointment in the treatment of functional dyspepsia due to liver-qi stagnation and spleen deficiency and its effect on serum 5-hydroxytryptamine (5-HT) and ghrelin contents. Methods: One hundred patients with functional dyspepsia due to liver-qi stagnation and spleen deficiency were divided into a treatment group and a control group by the random number table method, with 50 cases in each group. The treatment group received acupoint sticking with Jianpi Tongjing Zhitong ointment and the control group was treated with mosapride citrate orally. Patients were treated for 4 weeks as a course. The therapeutic efficacy was compared after one-course treatment and the differences in gastric emptying rate, and serum 5-HT and ghrelin contents between groups were compared before and after treatment. Results: The total effective rate was 79.6％ in the control group and 89.4％ in the treatment group, showing significantly different between groups (P<0.05). After treatment, the gastric emptying rate and serum ghrelin content of the two groups increased significantly, and the serum 5-HT content decreased significantly, the intra-group differences were significant (all P<0.01). After treatment, the gastric emptying rate and serum ghrelin content were significantly higher in the treatment group than those in the control group, while the serum 5-HT was significant lower in the treatment group, the inter-group differences were significant (all P<0.05). A negative correlation (r=-0.59) was observed between serum 5-HT content and gastric emptying rate, and a positive correlation (r=0.64) was observed between serum ghrelin content and gastric emptying rate, showing statistical significance (all P<0.01). Conclusion: Acupoint sticking with Jianpi Tongjing Zhitong ointment has a remarkable clinical efficacy in treating patients with functional dyspepsia due to liver-qi stagnation and spleen deficiency and is able to influence the secretion of serum 5-HT and ghrelin. Improving the gastrointestinal motility through the regulation of related brain-gut peptides is suggested as an underlying mechanism for this therapy.