Efficacy of the Chinese herbal medicine Jintiange capsules in the postoperative treatment of osteoporotic vertebral compression fractures: a systematic review and meta-analysis.

Background: In traditional Chinese medicine, Jintiange capsules are frequently used to treat metabolic bone diseases and strengthen bones and tendons. The main component of Jintiange capsules is bionic tiger bone powder. However, the active ingredients and proteins are derived from other animal bones, with chemical profiles similar to that of natural tiger bone. This study aimed to explore the efficacy of Jintiange capsules, a Chinese herbal medicine, in the postoperative treatment of osteoporotic vertebral compression fractures (OVCFs). Methods: In this systematic review, literature was retrieved using PubMed, the Cochrane Library, the Chinese National Knowledge Infrastructure, the Web of Science, the Wanfang Database, the Chinese Biomedical Literature Database, and the Chinese VIP Database from inception to July 2023. The primary outcome measures were the bone mineral density (BMD) and effective rate. The secondary outcome measures were the visual analog pain score (VAS), Oswestry disability index (ODI), Cobb's angle, serum osteocalcin, serum alkaline phosphatase, and adverse events. RevMan 5.4 and STATA 17.0 software were used for data analysis. Results: We enrolled randomized controlled trials (RCTs) focusing on 1,642 patients in the meta-analysis. The meta-analysis illustrated that Jintiange capsules significantly increased the BMD of the lumbar spine (p < 0.00001), femoral neck (p = 0.0005), and whole body (p = 0.01). The subgroup analysis of Jintiange capsules combination therapy showed that the BMD of the lumbar spine and whole body was significantly improved with Jintiange capsules (p < 0.00001). The test for the overall effect showed that Jintiange capsules had a significantly higher effective rate than the control groups (p = 0.003). Additionally, the overall effect test showed that Jintiange capsules decreased the VAS and ODI (p < 0.00001) and Cobb's angle (p = 0.02), and improved serum OC and ALP (p < 0.00001) compared with the controls. Furthermore, the pooled analysis of adverse reactions showed no serious impacts on the treatment of OVCFs. Conclusion: Jintiange capsules demonstrate high safety and efficacy in the treatment of OVCFs, including increasing BMD, the lift effect rate, serum OC levels, and pain relief, decreasing the ODI, serum ALP levels, and adverse events, and improving Cobb's angle. Additional research is required to validate the efficacy of Jintiange capsules for the postoperative treatment of OVCFs.Systematic review registration: https://www.crd.york.ac.uk/PROSPERO.

Network Pharmacological Study on Mechanism of the Therapeutic Effect of Modified Duhuo Jisheng Decoction in Osteoporosis.

Background: Modified Duhuo Jisheng Decoction (MDHJSD) is a traditional Chinese medicine prescription for the treatment of osteoporosis (OP), but its mechanism of action has not yet been clarified. This study aims to explore the mechanism of MDHJSD in OP through a combination of network pharmacology analysis and experimental verification. Methods: The active ingredients and corresponding targets of MDHJSD were acquired from the Traditional Chinese Medicine System Pharmacology (TCMSP) database. OP-related targets were acquired from databases, including Genecards, OMIM, Drugbank, CTD, and PGKB. The key compounds, core targets, major biological processes, and signaling pathways of MDHJSD that improve OP were identified by constructing and analysing the relevant networks. The binding affinities between key compounds and core targets were verified using AutoDock Vina software. A rat model of ovariectomized OP was used for the experimental verification. Results: A total of 100 chemical constituents, 277 targets, and 4734 OP-related targets of MDHJSD were obtained. Subsequently, five core components and eight core targets were identified in the analysis. Pathway enrichment analysis revealed that overlapping targets were significantly enriched in the tumour necrosis factor-alpha (TNF-α) signaling pathway, an inflammation signaling pathway, which contained six of the eight core targets, including TNF-α, interleukin 6 (IL-6), transcription factor AP-1, mitogen-activated protein kinase 3, RAC-alpha serine/threonine-protein kinase, and caspase-3 (CASP3). Molecular docking analysis revealed close binding of the six core targets of the TNF signaling pathway to the core components. The results of experimental study show that MDHJSD can protect bone loss, inhibit the inflammatory response, and downregulate the expression levels of TNF-α, IL-6, and CASP3 in ovariectomized rats. Conclusion: The mechanism of MDHJSD in the treatment of OP may be related to the regulation of the inflammatory response in the bone tissue.

[A study on the time-effect relationship in the treatment of bronchial asthma with medicinal vesiculation therapy].

OBJECTIVE: To compare the therapeutic effects of medicinal vesiculation performed in the dog-days and ordinary-days, as well as "Xin"-days and "Geng"-days in the treatment of bronchial asthma. METHODS: A total of 162 bronchial asthma patients were divided into ordinary-days group (n = 80) and dog-days group (n = 82) according to the time sequence. Plasters made up of Gansui (Radix Euphorbiae Kansui), Baijiezi (Semen Sinapis Albae), Mahuang (Herba Ephedrae), Xixin (Herba Asari), etc. were applied to Feishu (BL 13), Fengmen (BL 12), Dingchuan (EX-B 1), Pishu (BL 20) Shenshu (BL 23), etc. during ordinary days (spring, summer, autumn and winter), dog days (the 1st-, 2nd- and 3rd-10 day periods of the hot season) for each group, once every 10 days and with 3 times being a therapeutic course. After a course of treatment, the curative effect was assessed. Before and 5 days after the treatment, venous blood samples were collected for detecting serum immunoglobulin E (IgE), lymphocyte transformation rate (LTR) and the number of eosinophile granulocytes (Eos) separately. In addition, other 80 asthma patients were treated during "Geng"-days ( (n = 42) and "Xin"-days (n = 38) separately with the same methods mentioned above. RESULTS: After one course of treatment, or the 82 and 80 cases in dog-days group and ordinary-days groups, 35 (43%) and 31(39%) experienced marked improvement in clinical symptoms, 41 (50%) and 37 (46%) had an improvement, 6 (7%) and 12 (15%) failed, with the effective rates being 93% and 85% respectively. After the treatment, serum IgE and Eos count of the two groups decreased significantly (P < 0.01, 0.05), and LTR of the two groups increased evidently (P < 0.01). No significant differences were found between two groups in the therapeutic effect and the 3 biochemical indexes. In other 80 asthma patients, of the 42 and 38 cases in "Geng"-days group and "Xin"-days group, 23 (54.76%) and 17 (44.74%) experienced marked improvement in their symptoms, 17 (40.47%) and 19 (50.00%) had an improvement, 2 (4.76%) and 2 (5.26%) failed, with the effective rates being 95.23% and 94.74% separately. No significant difference was found between two groups in the therapeutic effect (P > 0.05). CONCLUSION: Medicinal vesiculation therapy can effectively improve asthma patients' clinical symptoms, lower serum IgE and Eos count and raise LTR whenever performed in the ordinary days, dog days, "Xin" days or "Geng" days. Thus, this therapy is applicable all year round.