ABSTRACT
BACKGROUND: Total glucosides of paeony (TGP) is commonly used to treat rheumatoid arthritis (RA) in China. However, clinical practice hasn't been well informed by evidence from appropriately conducted systematic reviews. This PRISMA-compliant systematic review aims at examining the effectiveness and safety of TGP for RA. METHODS: Randomized controlled trials (RCTs) comparing TGP with placebo, no treatment, or disease-modifying antirheumatic drugs (DMARDs) for patients with RA were retrieved by searching seven databases. Primary outcomes included disease improvement and disease remission. Secondary outcomes included adverse effects, pain, health-related quality of life, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). Data extraction and analyses were conducted according to the Cochrane standards. We assessed risk of bias for each included studies and quality of evidence on pre-specified outcomes. RESULTS: Eight studies enrolling 1209 patients with active RA were included in this systematic review. On the basis of traditional DMARD(s), TGP might be beneficial for patients with RA in improvement of American College of Rheumatology (ACR) 20 response rate, ACR 50 response rate, ACR70 response rate, and in reduction of adverse effects, compared with no treatment. The overall methodological quality of included studies and the quality of evidence for each outcome were limited. CONCLUSIONS: Current trials suggested potential benefits of TGP for RA on the basis of traditional DMARD(s). Therefore, TGP may be a good choice for RA as an adjuvant therapy. However, considering the limited methodological quality and strength of evidence, high-quality RCTs are warranted to support the use of TGP for RA.
Subject(s)
Antirheumatic Agents/therapeutic use , Arthritis, Rheumatoid/drug therapy , Glucosides/therapeutic use , Paeonia/chemistry , Phytotherapy , Plant Extracts/therapeutic use , Arthritis, Rheumatoid/blood , Blood Sedimentation , C-Reactive Protein/metabolism , Humans , Plant Extracts/pharmacology , Quality of Life , Remission Induction , Severity of Illness IndexABSTRACT
Objective To observe the effect of Bushen Qiangdu Recipe (BQR) on the entheses ossification histomorphology of articular ligament of DBA/1 mice with spontaneous ankylosing spondylitis (AS) , and to study its mechanism for prevention and treatment of AS. Methods Thirty 12-week old male DBA/1 mice were randomly divided into the model group, the positive drug group, low, medium, high dose BQR groups, 6 in each group. Another 6 C57BLE mice of the same age were recruited as a blank control group. BQR containing 11. 25, 22. 50, 45.00 g/kg crude drugs was respectively adminis- tered to mice in low, medium, high dose BQR groups by gastrogavage, 0. 2 mL for each mouse, once per day. Celecoxib Capsule (0. 2 mL/0. 8 mg for each mouse, once per day) was administered to mice in the positive drug group by gastrogavage. Equal volume of normal saline was administered to mice in the model group and the blank control group by gastrogavage. All mice were fed and intragastically adminis- tered for 12 successive weeks. Body weight, diet, stools, and hair were routinely observed. Signs of ar- thritis were evaluated once per two weeks. Mice were sacrifice, and then general observation of achilles tendon was performed. The achilles tendon tissue was HE stained. Protein expressions of alkaline phos- phatase (ALP) , bone gamma-carboxyglutamic-acid-containing proteins (BGP) , Dickkopfl (DKK1) , and Wnt5a in the achilles tendon were detected using immunohistochemical method. Results Compared with the blank control group, the scoring of arthritis obviously increased in the model group (P <0. 05). But the scoring of arthritis was obviously lower in the 3 BQR groups and the positive drug group than in the model group (P <0. 05). Histopathological results of achilles tendon tissue showed that no infiltration of inflammatory cells or fibroblasts occurred in the normal group. Their histomorphological structures were normal. Cartilage formation and bone formation at various degrees occurred in the model group. Filtration of fibroblast-like cells occurred in inflammatory cells and attachment points. Scattered lymphocyte infiltra- tion was often seen in the achilles tendon tissue of each medicated group. Cartilage formation and bone formation were rarely seen. Compared with the blank control group, the scoring of arthritis increased in the model group (P <0. 05). Compared with the model group, the scoring of arthritis was decreased in the 3 BQR groups and the positive drug group (P <0. 05). Compared with the blank control group, protein expression of DKK1 decreased and protein expression of Wnt5a increased in the model group (P <0. 05). Compared with the model group, protein expression of DKK1 increased and protein expression of Wnt5a decreased in middle and high dose BQR groups (P <0. 05). Conclusion BQR could delay the occur- rence and development of arthritis and ossification in DBA/1 mice of spontaneous AS model possibly by inhibiting classical Wnt pathway.
Subject(s)
Drugs, Chinese Herbal , Wnt Signaling Pathway , Animals , Drugs, Chinese Herbal/pharmacology , Male , Mice , Mice, Inbred DBA , Rats, Sprague-Dawley , Wnt Signaling Pathway/drug effectsABSTRACT
INTRODUCTION: Total glucosides of paeony (TGP) is a natural plant extract, which is widely used in China for treating rheumatoid arthritis (RA). Many relevant randomised controlled trials (RCTs) of TGP for RA are available, but they have not been systematically reviewed. This systematic review aims to examine the effectiveness and safety of TGP in patients with RA. METHODS AND ANALYSES: We will search for RCTs of TGP in the treatment of RA, performed up until February 2016, in PubMed, Embase, Cochrane Central Register of Controlled Trials, and four Chinese databases (Chinese Biomedical Database, China National Knowledge Infrastructure, Wanfang Database and Chinese Scientific Journal Database). Trial registers and reference lists of retrieved articles will also be searched to identify potential articles. RCTs comparing TGP with placebo, no treatment, or disease-modifying antirheumatic drugs for patients with RA will be retrieved. The primary outcomes will be disease improvement and disease remission. The secondary outcomes will be surrogate outcomes, symptoms, adverse effects, and quality of life. Two reviewers will independently extract data on participants, interventions, comparisons, outcomes, etc. The methodological quality of each included study will be evaluated using the Cochrane risk of bias tool, and the strength of evidence on prespecified outcomes will be assessed in accordance with the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Review Manager 5.3 software will be used for data analyses. Meta-analyses will be performed if the data are sufficiently homogeneous, both statistically and clinically. Possible publication bias will also be checked using funnel plots once the number of included studies is sufficient. ETHICS AND DISSEMINATION: Ethics approval is not required, as this study will not involve patients. The results of this study will be submitted to a peer-reviewed journal for publication, to inform both clinical practice and further research. TRIAL REGISTRATION NUMBER: CRD42015026345.
Subject(s)
Antirheumatic Agents/pharmacology , Arthritis, Rheumatoid/drug therapy , Drugs, Chinese Herbal/pharmacology , Glucosides/blood , Paeonia/chemistry , Arthritis, Rheumatoid/blood , China , Clinical Protocols , Humans , Patient Safety , Phytotherapy , Randomized Controlled Trials as Topic , Systematic Reviews as TopicABSTRACT
OBJECTIVE: To evaluate the short-term efficacy and safety of Bushen Shuji Granule (BSG) in treating ankylosing spondylitis (AS) patients. METHODS: A prospective randomized controlled clinical trial was carried out in 62 active stage AS patients with Shen deficiency Du-channel cold syndrome (SDDCS), who were randomly assigned to the BSG group (treated with BSG) and the control group (treated with Celecoxib Capsule). Twelve weeks consisted of one therapeutic course. Therapeutic effects were evaluated by ASAS20 and ASAS40 (set by Assessments in Ankylosing Spondylitis working group) , BASDA150, Chinese medical (CM) syndrome efficacy evaluation standards. BASDAI, the Bath Ankylosing Spondylitis Functional Index (BASFI), the Bath AS Metrology Index (BASMI), scores for spine pain, scores for pain at night, patient global assessment (PGA) , erythrocyte sedimentation rate (ESR) , and C reactive protein (CRP) were observed before and after treatment. RESULTS: After three-month treatment by BSG, ASAS20 standard rate was 63. 33% (19/30 cases) in the BSG group and 66.67% (20/30 cases) in the control group with no significant difference between the two groups (χ2 = 0.073, P > 0.05). The efficacy for CM syndromes was 70.00% (21/30 cases) in the BSG group, higher than that in the control group [40.00% (12/30 cases), χ2 = 5.455, P < 0.05]. Scores for CM syndromes, BASDAI, night pain index, spinal pain index, PGA, CRP were improved in the BSG group (P < 0.05, P < 0.01). The incidence of adverse events in the BSG group was lower than that of the control group. CONCLUSION: BSG based on Shen supplementing, Du-channel strengthening, blood activating, and channels dredging method had good short-term clinical efficacy and safety in treating AS.
Subject(s)
Drugs, Chinese Herbal/therapeutic use , Spondylitis, Ankylosing/drug therapy , Asian People , Biomedical Research , Blood Sedimentation , C-Reactive Protein , Humans , Pain , Prospective Studies , SafetyABSTRACT
To resolve the key environmental problems in coal mine areas of environmental phytoremediation, symbiosis of arbuscular mycorrhizal fungi (AMF) and Amorpha fruticosa was investigated. Effects of AMF on the root growth of Amorpha fruticosa and degenerated soil in coal mining subsidence area were studied. Results showed that after 5 months inoculation, AMF improved the shoot and root growth of Amorpha fruticosa. After inoculation with arbuscular mycorrhiza (AM) for 5 months, the inoculation significantly increased root colonization of Amorpha fruticosa. Total glomalin and easily extractable glomalin were increased significantly in the incubated soil. The content of phosphorus and organic matter were increased in the rhizosphere soil. Population of microorganism increased obviously. All the above results show that their ecological effects are significantly improved. AM would promote rhizosphere soil that will help the sustainability of ecological systems in mining area. It is really of great significance to keep the ecological system stability.
Subject(s)
Coal , Fabaceae/microbiology , Mycorrhizae/physiology , Soil Pollutants/analysis , Biodegradation, Environmental , Ecosystem , Fabaceae/growth & development , Fungal Proteins/chemistry , Glycoproteins/chemistry , Mining , Phosphorus , Plant Roots/microbiology , Rhizosphere , Soil/chemistry , Soil Microbiology , SymbiosisABSTRACT
OBJECTIVE: To observe the therapeutic effect of Bushen Qiangdu Recipe (BSQDR) on osteoporosis and bone loss in patients with ankylosing spondylitis (AS). METHODS: Patients with AS were randomly assigned to two groups. The 288 patients in the treatment group received BSQDR (consisting of cibotii rhizoma, antler, prepared rehmannia root, epimedium herb, rhizoma drynariae, teasel root, eucommia bark, pangolin scales, etc., one dose daily, taken in two portions, once in the morning and once in the evening). The 72 patients in the control group received SIDSM and sulfasalazine. The therapeutic course for both was six months. Clinical symptoms, pillow distance from the wall, hand distance from the ground, jaw distance from the handle, chest mobility, Schober test, spinal mobility and other signs of disease activity indices (ESR and CRP) were observed in patients before and after treatment. The bone mineral density (BMD) testing was performed in the lumbar spine, the femur, the forearm, and the heels, etc. Osteocalcin (BGP), calcitonin, parathyroid hormone (PTH), etc. bone metabolic indices were detected. RESULTS: BASFI, BASDAI, the overall assessment, the spinal pain, pillow distance from the wall, hand distance from the ground, jaw distance from the handle, chest mobility, Schober test, spinal mobility, and so on were all improved to some extent when compared with before treatment in the treatment group (P<0.05). The ESR and CRP decreased to various degrees, showing statistical significance when compared with before treatment (P <0.01). BGP increased and PTH decreased, showing statistical difference when compared with before treatment (P<0.05). The BMD in patients' lumbar spine, femoral neck, Ward's triangle, femoral trochanter increased to various degrees. The calcaneal intensity index, blood uric acid (BUA) and SOS values also increased more than before treatment, showing statistical significance (P<0.05). Long-term oral administration of BSQDR was safe, with no obvious adverse reaction. CONCLUSIONS: BSQDR showed significant effect in treatment of AS. It could regulate the bone metabolic level in patients, attenuate the immune inflammatory response, improve the spine and joint activities functions, increase bone formation, reduce bone resorption, thereby, enhancing the BMD, showing significant therapeutic effect on osteoporosis in AS patients.
Subject(s)
Drugs, Chinese Herbal/therapeutic use , Osteoporosis/drug therapy , Phytotherapy , Spondylitis, Ankylosing/drug therapy , Adult , Bone Density , Bone Resorption/drug therapy , Female , Humans , Male , Middle Aged , Osteoporosis/metabolism , Spondylitis, Ankylosing/metabolism , Young AdultABSTRACT
OBJECTIVE: To discuss the efficacy of Qingkailing soft capsules in treating acute fever, and the relationship between symptoms-effect and time effect. METHOD: Qingkailing soft capsules was taken orally, 4 times a day, 1.6 g each time. Shuanghuanglian kou fu liquid was taken as control. 129 patients with acute upper respiratory tract infection were recruited. RESULT: There were 73.34% of patients cured by Qingkailing soft capsules and 43.59% cured by Shuanghuanglian kou fu liquid. The efficacy of the former was better than that of the latter (P < 0.05). The efficacy of Qingkailing soft capsules in treating Fengrexing was better than that in Fenghanxing (P < 0.05). The efficacy of Qingkailing soft capsules in reducing rapid pulse and adding moderate pulse was more remarkable than Shuanghuanglian kou fu liquid (P < 0.05). Taking Qingkailing soft capsules seldom induced mild gastrointestinal disturbance. CONCLUSION: Qingkailing soft capsules showed good result in the treatment of acute upper respiratory tract infection with less adverse effect.