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OBJECTIVE To improve the a pplicability of the prescription pre-review system to traditional Chinese medicine （TCM），and improve the quality of prescription review and rational drug use. METHODS The inappropriate pre-review rules of TCM prescription in prescription automatic screening system of our hospital were summarizd ，review rules were revised and the review process was standardized purposefully. The data of prescription review of Chinese patent medicine and TCM decoction pieces were collected from outpatient and emergency department of our hospital in the second quarter of 2020 （before the optimization of review rules ）and the fourth quarter of 2021（after the optimization of review rules ）. The reasonable rate of prescription and effective rate of intervention before and after the optimization of review rules were compared，and unreasonable problems were counted. RESULTS In our hospital ，the pre-review system had poor applicability in reviewing TCM prescriptions. There were some problems ，such as inconsistent or nonstandard names of TCM decoction pieces ，unreasonable dosage range settings，mechanical review of repeated drug use ，excessively strict review of “eighteen incompatible medicaments ”and“nineteen medicaments of mutual restraint ”and lack of safety warnings for special populations. In view of the above problems ，our hospital standardized the name of TCM decoction pieces ，and optimized the review rules such as dose range of TCM decoction pieces ， usage and dosage of Chinese patent medicine ，repeated medication ，drug interaction ，drug taboos for special people ，etc. After the revision of the rules ，the qualification rate of Chinese patent medicine prescriptions increased from 97.38％ to 98.17％（P＞0.05）， and the rate of effective intervention increased from 42.86％ to 79.71％（P＜0.05）；the qualification rate of TCM decoction pieces prescriptions increased from 47.98％ to 79.29％（P＜0.05），and the rate of effective intervention increased from 11.17％ to 29.13％（P＜0.05）. The number of unreasonable problems such as excessive daily dosage of TCM ，excessive dosage range ，drug interaction and drug contraindications for special groups decreased significantly in our hospital （P＜0.05）. There was no statistical significance in the number of unreasonable problems of repeated medication between 2 groups （P＞0.05），but there was a downward trend. T he total number of unreasonable problems had also decreased significantly （P＜0.05）. CONCLUSIONS The optimization measures of review rules in our hospital canimprove the applicability of the review system for TCM prescriptions，and improve the quality of prescription review and the level of rational drug use. However ，review rules of indications and the effectiveness of prescription intervention still needs to be further improved.
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Cephalotaxus is the only genus of Cephalotaxaceae family, and its natural resources are declining due to habitat fragmentation, excessive exploitation and destruction. In many areas of China, folk herbal doctors traditionally use Cephalotaxus plants to treat innominate swollen poison, many of which are cancer. Not only among Han people, but also among minority ethnic groups, Cephalotaxus is used to treat various diseases, e.g., cough, internal bleeding and cancer in Miao medicine, bruises, rheumatism and pain in Yao medicine, and ascariasis, hookworm disease, scrofula in She medicine, etc. Medicinal values of some Cephalotaxus species and compounds are acknowledged officially. However, there is a lack of comprehensive review summarizing the ethnomedicinal knowledge of Cephalotaxus, relevant medicinal phytometabolites and their bioactivities. The research progresses in ethnopharmacology, chemodiversity, and bioactivities of Cephalotaxus medicinal plants are reviewed and commented here. Knowledge gaps are pinpointed and future research directions are suggested. Classic medicinal books, folk medicine books, herbal manuals and ethnomedicinal publications were reviewed for the genus Cephalotaxus (Sanjianshan in Chinese). The relevant data about ethnobotany, phytochemistry, and pharmacology were collected as comprehensively as possible from online databases including Scopus, NCBI PubMed, Bing Scholar, and China National Knowledge Infrastructure (CNKI). "Cephalotaxus", and the respective species name were used as keywords in database search. The obtained articles of the past six decades were collated and analyzed. Four Cephalotaxus species are listed in the official medicinal book in China. They are used as ethnomedicines by many ethnic groups such as Miao, Yao, Dong, She and Han. Inspirations are obtained from traditional applications, and Cephalotaxus phytometabolites are developed into anticancer reagents. Cephalotaxine-type alkaloids, homoerythrina-type alkaloids and homoharringtonine (HHT) are abundant in Cephalotaxus, e.g., C. lanceolata, C. fortunei var. alpina, C. griffithii, and C. hainanensis, etc. New methods of alkaloid analysis and purification are continuously developed and applied. Diterpenoids, sesquiterpenoids, flavonoids, lignans, phenolics, and other components are also identified and isolated in various Cephalotaxus species. Alkaloids such as HHT, terpenoids and other compounds have anticancer activities against multiple types of human cancer. Cephalotaxus extracts and compounds showed anti-inflammatory and antioxidant activities, immunomodulatory activity, antimicrobial activity and nematotoxicity, antihyperglycemic effect, and bone effect, etc. Drug metabolism and pharmacokinetic studies of Cephalotaxus are increasing. We should continue to collect and sort out folk medicinal knowledge of Cephalotaxus and associated organisms, so as to obtain new enlightenment to translate traditional tips into great therapeutic drugs. Transcriptomics, genomics, metabolomics and proteomics studies can contribute massive information for bioactivity and phytochemistry of Cephalotaxus medicinal plants. We should continue to strengthen the application of state-of-the-art technologies in more Cephalotaxus species and for more useful compounds and pharmacological activities.
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OBJECTIVE：To provide r eference for optimizing the review rules of PASS system and improving rational drug use in our hospital. METHODS ：The prescription review of Calcineurin inhibitor （CNI）was taken as an example. The pharmacists of our hospital collected the inappropriate rules in PASS system in their daily work ，and modified and improved them. Three thousands outpatient prescriptions and inpatient orders containing CNI in the fourth quarter of 2019（before the rule modification ） and the fourth quarter of 2020（after the rule modification ）were randomly selected for our hospital. The warnings ，false positives and false negatives of PASS system review were compared before and after rule modification. RESULTS ：There were some problems in the PASS system of our hospital ，such as too strict judgement on off-label use ，lax review rules ，false positive in the audit of contraindications ，failure to grade warnings according to the severity of drug interactions ，inaccurate judgment of patients ’ liver and kidney function ，lengthy problem description ，incomplete or wrong information in the system database ，lack of effects information of food and traditional Chinese medicine on CNI ，etc. In view of these inappropriate rules ，the pharmacy department of our hospital improved the quality of PASS system review rules through formulating the standardized management process of off-label use ， reasonably enabling the interception function of PASS system ， modifying the false-positive rules of drug contraindications，warning drug interaction by grade ，reviewing in combination with laboratory test reports ，and real-time maintenance of system database information and adding patient education content. The number of warning had decreased from 182 to 105，and the proportion of false-negative and false-positive review results from 25.03％ to 0.43％ after a year of optimization. CONCLUSIONS：The optimization of CNI review rules can enhance the applicability of the PASS system ，facilitate the advance of the prescription pre-review ，and promote clinical rational drug use.
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Objective@#To investigate the effects of the compound preparation Jinghuosu on oligospermia and asthenospermia.@*METHODS@#This multi-centered clinical study included 120 cases of mild to moderate idiopathic oligospermia or asthenospermia, all treated with oral Jinghuosu once a bag, bid, for 3 successive months. Before and at 1, 2 and 3 months after treatment, we detected sperm concentration, total sperm motility, progressive sperm motility and normal sperm morphology of each ejaculate, and recorded whether the patients had any adverse reactions.@*RESULTS@#After 3 months of treatment, all the patients showed obvious improvement in semen parameters, most significantly in sperm concentration, total sperm motility, and the percentages of progressive motile sperm and morphologically normal sperm (P <0.05). No significant adverse reactions were observed during the 3 months of medication.@*CONCLUSIONS@#Jinghuosu has a significant efficacy and no obvious adverse effect in the treatment of mild to moderate oligospermia and asthenospermia.
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Humans , Male , Asthenozoospermia , Drug Therapy , Drugs, Chinese Herbal , Therapeutic Uses , Oligospermia , Drug Therapy , Semen , Physiology , Sperm Count , Sperm MotilityABSTRACT
Cynanchum is one of the most important genera in Asclepiadaceae family, which has long been known for its therapeutic effects. In this genus, 16 species are of high medicinal value. The extracts of the root and/or rhizome parts have been applied in traditional Chinese medicines (TCM) for the prevention and treatment of various illnesses for centuries. C21 steroids, as the typical constituents of Cynanchum species, possess a variety of structures and pharmacological activities. This review summarizes the comprehensive information on phytochemistry and pharmacology of C21 steroid constituents from Cynanchum plants, based on reports published between 2007 and 2015. Our aim is to provide a rationale for their therapeutic application, and to discuss the future trends in research and development of these compounds. A total of 172 newly identified compounds are reviewed according to their structural classifications. Their in vitro and in vivo pharmacological studies are also reviewed and discussed, focusing on antitumor, antidepressant, antifungal, antitaging, Na(+)/K(+)-ATPase inhibitory, appetite suppressing and antiviral activities. Future research efforts should concentrate on in vitro and in vivo biological studies and structure activity relationship of various C21 steroid constituents.
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Animals , Humans , Cynanchum , Chemistry , Molecular Structure , Plant Extracts , Chemistry , Pharmacology , Steroids , Chemistry , PharmacologyABSTRACT
<p><b>OBJECTIVE</b>To evaluate the efficacy of Fuzhenghuayu capsule for the prevention of oesophageal variceal bleeding in patients with liver cirrhosis.</p><p><b>METHODS</b>A multicentre randomized placebo-controlled trial was conducted. A total of 181 liver cirrhosis patients were enrolled in the study and randomly assigned to different groups according to the level of oesophageal variceal bleeding. Patients with light oesophageal varices received Fuzhenghuayu capsule or a placebo. Patients with medium to heavy oesophageal varices received either Fuzhenghuayu capsule alone, Fuzhenghuayu capsule plus propranolol, or propranolol plus a placebo. Patients with a history of oesophageal variceal bleeding received either Fuzhenghuayu capsule plus propranolol, propranolol alone, or a placebo. For all patients, the treatment lasted 2 years. The primary end point of the study was oesophageal variceal bleeding. The secondary end points were liver cancer, death by any cause, and liver transplantation. Risk of bleeding and survival were statistically assessed.</p><p><b>RESULTS</b>The median follow-up time was 50 months. The patients with small oesophageal varices who were treated with Fuzhenghuayu capsule showed a significantly higher cumulative probability of bleeding than their counterparts treated with the placebo (3.4% vs. 23.7%, x² = 4.829, P =0.028). The patients with medium to heavy oesophageal varices and no history of oesophageal variceal bleeding who were treated with Fuzhenghuayu capsule plus propranolol showed a remarkably higher cumulative probability of bleeding than their counterparts treated with propranolol alone (15.2% vs. 43.6%, x² =6.166, P =0.013). There were no significant differences between the patients treated with Fuzhenghuayu capsule alone and those treated with propranolol alone (P =0.147) or the patients treated with Fuzhenghuayu capsule plus propranolol and those treated with Fuzhenghuayu capsule alone (P =0.147). The patients with history of oesophageal variceal bleeding who were treated with Fuzhenghuayu capsule showed significantly higher cumulative probability of bleeding and median time of bleeding than their counterparts treated with propranolol alone (44.0% vs. 24.2% and 40.00 ± 17.92 months vs. 7.00 ± 2.35 months; x² = 4.433, P =0.035). There were no significant differences in the cumulative probability of liver cancer and survival among all of the groups.</p><p><b>CONCLUSION</b>Fuzhenghuayu capsule can decrease the cumulative probability of bleeding in cirrhotic patients with light oesophageal varices. For cirrhosis patients with a history of oesophageal variceal bleeding, the combination of Fuzhenghuayu capsule plus propranolol can decrease the cumulative probability of bleeding with median or heavy varices.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Double-Blind Method , Drugs, Chinese Herbal , Therapeutic Uses , Esophageal and Gastric Varices , Gastrointestinal Hemorrhage , Liver Cirrhosis , Drug Therapy , Phytotherapy , Prospective Studies , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To explore the efficacy differences in early intervention of different acupuncture and moxibustion methods on gastrocnemius fatigue in rats induced by electrical stimulation.</p><p><b>METHODS</b>Fifty male SD rats were randomly divided into a control group, a model group, a hand acupuncture group, an electroacupuncture group and a moxibustion group, 10 rats in each group. Electrical stimulation of the sciatic nerve was given in the control group and gastrocnemius fatigue test was induced by electrical stimulation of the sciatic nerve in the model group after anesthesia without other treatment, but just take 6 times interval stimulation in the control group. The hand acupuncture group, the electroacupuncture group and the moxibustion group were treated with the corresponding acupoints stimulation method respectively for 20 min before gastrocnemius fatigue test, and Dazhui (GV 14) and Zusanli (ST 36) were selected. Immediately after gastrocnemius fatigue test, three or four gastrocnemius tissues at the same site on the right side were quickly taken for making specimen for transmission electron microscope (TEM). The changes of skeletal muscle ultrastructure of myofibrils, mitochondria, sarcoplasmic reticulum, glycogen particles were observed under TEM.</p><p><b>RESULTS</b>(1) Muscle fibers disorder, partial mitochondrial vacuolization and glycogen particles smaller were shown in the model group. (2) No abnormalities were shown in the hand acupuncture group and the moxibustion group with mitochondrial morphology and number, which better than that in the model group, and glycogen particles increased. (3) Abnormal changes in morphology were shown in the electroacupuncture group with part of the muscle fibers derangement, Z line malalignment and a few mitochondria vacuolization.</p><p><b>CONCLUSION</b>Hand acupuncture, electroacupuncture and moxibustion have the different effects on ultrastructure of gastrocoemius in rats. Acupuncture and moxibustion have shown good effects on the prevention and treatment of exercise-induced skeletal muscle cell and organelle damage and delaying exercise-induced fatigue.</p>
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Animals , Male , Rats , Acupuncture Points , Acupuncture Therapy , Glycogen , Metabolism , Mitochondria , Metabolism , Moxibustion , Muscle, Skeletal , Metabolism , Rats, Sprague-DawleyABSTRACT
The genus Fritillaria is a botanical source for various pharmaceutically active components, which have been commonly used in traditional Chinese medicine for thousands of years. Increasing interest in Fritillaria medicinal resources has led to additional discoveries of steroidal alkaloids, saponins, terpenoids, glycosides and many other compounds in various Fritillaria species, and to investigations on their chemotaxonomy, molecular phylogeny and pharmacology. In continuation of studies on Fritillaria pharmacophylogeny, the phytochemistry, chemotaxonomy, molecular biology and phylogeny of Fritillaria and their relevance to drug efficacy is reviewed. Literature searching is used to characterize the global scientific effort in the flexible technologies being applied. The interrelationship within Chinese Bei Mu species and between Chinese species, and species distributed outside of China, is clarified by the molecular phylogenetic inferences based on nuclear and chloroplast DNA sequences. The incongruence between chemotaxonomy and molecular phylogeny is revealed and discussed. It is essential to study more species for both the sustainable utilization of Fritillaria medicinal resources and for finding novel compounds with potential clinical utility. Systems biology and omics technologies will play an increasingly important role in future pharmaceutical research involving the bioactive compounds of Fritillaria.
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Animals , Humans , China , Drugs, Chinese Herbal , Chemistry , Pharmacology , Fritillaria , Chemistry , Classification , Molecular Structure , Phylogeny , Plants, Medicinal , Chemistry , ClassificationABSTRACT
The current situation of courses on diagnosis and treatment with acupuncture both domestically and internationally were analyzed in this article. It explored the methods of enhancing the dialectical thinking method in clinic through specific cases, and proposed suggestions for editions of the textbooks and examination papers on acupuncture education. It is held that the effect of courses on acupuncture diagnosis and treatment may directly influence the ability of student on application of acupuncture in disease prevention and treatment. Acupuncture education abroad is featured with flexibility and practicability. However, attention attached on theory is not enough. Oppositely, domestic courses focus more on theoretical study, but neglect the hands-on ability. Although certain result has been achieved by various forms of the domestic education reform, it still needs to be further perfected.
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Humans , Acupuncture , Education , Education, Medical , Medicine, Chinese TraditionalABSTRACT
A new phenolic glycoside was isolated from the spikes of Prunella vulgaris. Its structure was elucidated as gentisic acid 5-O-beta-D-(6'-salicylyl)-glucopyranoside by spectroscopic evidence and chemical analysis.
Subject(s)
Glucosides , Chemistry , Glycosides , Chemistry , Molecular Structure , Phenols , Chemistry , Plants, Medicinal , Chemistry , Prunella , ChemistryABSTRACT
<p><b>OBJECTIVE</b>To study the effect of acupuncture on skeletal muscle endurance in rats as a pre-games assistant training.</p><p><b>METHODS</b>Thirty male SD rats were randomly divided into 3 groups: control, model and acupuncture group. Acupuncture group was treated at "Dazhui" (GV 14), "Housanli" (ST 36) by twisting mild reinforcing-reducing method for 20 min, no interventions were added on control and model group. Muscle strength was detected in three groups under anaesthetic (after model established in model group, after model established and treated in acupuncture group). Averaged change percentage of mean skeletal muscle endurance (P(m)) and averaged maximum percentage of skeletal muscle endurance (P(max)) were evaluated.</p><p><b>RESULTS</b>(1) 10P(m) in model group decreased more than acupuncture group statistically (P < 0.05); 20P(m), 30P(m) and 40P(m) in model group decreased significantly compared to those in control group and acupuncture group (P < 0.05, P < 0.01). (2) Changes of 10P(max) in acupuncture group was much less than in model group (P < 0.05); changes of 20P(max), 30P(max), 40P(max) and 50P(max) decreased more in model group than in acupuncture group and control group (P < 0.01, P < 0.05).</p><p><b>CONCLUSION</b>As an assistant training method, acupuncture can postpone descending point of muscle strength endurance to delay sport fatigue.</p>
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Animals , Humans , Male , Rats , Acupuncture Therapy , Kinetics , Models, Animal , Muscle, Skeletal , Chemistry , Physiology , Physical Endurance , Random Allocation , Rats, Sprague-DawleyABSTRACT
To analyze the acupuncture treatment for impotence in 130 kinds of classical medical books by computer,and summarize the rules of acupuncture for this disease.The results showed that selection of acupoints along the meridians,selection of acupoints by boay parts,selection ofacupoints by pattern identification are the laws ofacupuncture for this disease.
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<p><b>OBJECTIVE</b>To study the chemical constituents of Prunella vulgaris.</p><p><b>METHOD</b>To separate the constituents of P. vulgaris by using various kinds of chromatography and identify their structures on the basis of spectral analysis.</p><p><b>RESULT</b>Seven compounds were isolated from the spikes of P. vulgaris. Their structures were established as autantiamide acetate (1), rhein (2), tanshinone I (3), danshensu (4), stigmast-7, 22-dien-3-one (5), 3, 4, alpha-trihydroxy-methyl phenylpropionate (6), butyl rosmarinate (7).</p><p><b>CONCLUSION</b>Compounds 1-4 were isolated from this genus for the first time.</p>
Subject(s)
Amides , Chemistry , Anthraquinones , Chemistry , Chromatography, High Pressure Liquid , Abietanes , Flowers , Chemistry , Lactates , Chemistry , Magnetic Resonance Spectroscopy , Phenanthrenes , Chemistry , Plants, Medicinal , Chemistry , Prunella , ChemistryABSTRACT
Statistical analysis was made through computer on the information of insomnia treated by acupuncture in 93 ancient medical books. Statistical results showed that 65 acupoints were used in ancient times, up to 108 times in frequency. The common acupoints are as follows:Gongsun (SP 4), Danshu (BL 19), Yinbai (SP 1), Qihai (CV 6), Tianfu (LU 3), Sanyinjiao (SP 6),Yinlingquan (SP 9), Feishu (BL 13), Yemen (TE 2), Guanyuan (CV 4), Yinjiao (GV 28) et al.The common meridians are Bladder Meridian, Spleen Meridian, Conception Vessel, Stomach Meridian, et al.
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Objective To study the mechanism of Liangruntongluo Recipe in improving gastrointestinal function on DM rats induced by STZ. Methods Forty male Wistar rats were divided into four groups randomly: group A as model control group,group B as Liangruntongluo group,group C as Cisapride group,and group D as normal control group. There are 10 rats in each group. After the establishment of DM animal model with Wistar rats,the animals were raised for 6 weeks without any hypoglycemic agents. And then medicines were intragastric administrationed for another 6 weeks. In the 12th week motile and cholecystokinin in blood and tissue were tested. Result By the time of the twelfth week,the rats with DM presented the disorder of gastrointestinal hormone. Liangruntongluo Recipe affected the excretion and releasing of hormone in blood,stomach,and duodenum. With a wide target range,effect of Liangruntongluo Recipe is superior to Cisapride. Conclusions Chinese herbal medicine Liangruntongluo recipe has the superiority in improving the obstacle of the gastrointestinal function of diabetes mellitus.
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Systematical and comprehensive statistics, induction and analysis on literature and data of acupuncture and moxibustion treatment of tuberculosis in incunabula are carried out by computer. The results indicate that in treatment of tuberculosis, most select acupoints of the upper back, chest-epigastrium and The Yangming Channel on the leg to promote dispersing function of the lung, strength the spleen and anti-tuberculosis; select acupoints of The Conception Vessel on the lower abdomen and Shenshu (BL 23) and others on the lower back to tonify the kidney and anti-tuberculosis. Clinically, most select moxibustion and acupuncture with reinforcing-reducing manipulation and pricking blood therapy. And referential recipes for clinical treatment are raised.
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Humans , Acupuncture Points , Acupuncture Therapy , Moxibustion , Publications , TuberculosisABSTRACT
The information concerning the treatment of Bi condition in 93 ancient medical books has been statistically analyzed through computer. The results showed that there were a total of 149 items of literature and 102 acupoints (276 times in frequency) in association with Bi condition. The common acupoints are Hegu (LI 4), Zusanli (ST 36), Fengshi (GB 31), diseased foci, Quchi (LI 11), Weizhong (BL 40), Yanglingquan (GB 34), Yangfu (GB 38), et al. The common meridians are Gallbladder Meridian,Bladder Meridian, Large Intestine Meridian, Stomach Meridian, Lung Meridian, Liver Meridian and Triple Energizer Meridian. The common parts are the lateral aspect of leg, arm, and foot, the medial aspect of foot, the lateral aspect of hand, the medial aspect of arm, and head. The common acupuncture techniques and their frequencies are moxibustion (54), needling (9), blood-letting (9), fire needling (2), ironing (2) and compression (1). Statistical analysis on the above information showed in the ancient times in treating Bi condition with acupuncture, selecting acupoints are according to meridian distribution, the body parts and syndrome differentiation.
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The information concerning dormant papule in 93 ancient medical books is statistically computerized and shows that there are totally 29 items of information and 25 acupoints (55 times in frequency) in connection with dormant papule. The commonly used acupoints are Quchi (LI 11), Jianyu (LI 15), Tianjing (TE 10), etc, which are around joints, on the upper body, on the lateral aspect or on the ends of the limbs. The commonly used meridians are Large Intestine Meridian, Pericardium Meridian,Triple Energizer Meridian, and Gallbladder Meridian. The commonly used parts are the lateral aspect of arm, the dorsum of hand, the external aspect of leg, the medial aspect of arm, and the palm.
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Information of the acupuncture treatment ofdepression in 93 ancient books has been made statistics with computer Results showed that Heart Meridian, Pericardium Meridian, Bladder Meridian, Governor Vessel,Conception Vessel, Spleen Meridian and Stomach Meridian have been used frequently; as to areas, the medi al aspect of upper limbs, head and face, medial aspect of legs, upper back, chest and abdomen have been mostly selected; as to treatment methods, needling,moxibustion and blood-letting therapies have been utilized.
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The data concerning the treatment of diarrhea by acupuncture in 62 ancient books are computerized and thus show that the ancient acupuncturists primarily used the acupoints of the conception vessel, stomach meridian, bladder meridian, and the foot yin meridians.As to the location, the acupoints on the abdomen, back,exterior side of leg and the hands and feet are used. The common techniques are moxibustion, hot compression,needling, blood letting, navel application and so on.