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This study aimed to compare the efficacy of Qi-benefiting and blood-activating Chinese patent medicines in the treatment of ischemic stroke with network Meta-analysis. CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, and Cochrane Library were searched from database inception to October 2022 for randomized controlled trial(RCT) on 11 Qi-benefiting and blood-activating Chinese patent medicines in the treatment of ischemic stroke. The risk of bias plot was made by RevMan 5.3, and network Meta-analysis and efficacy ranking were performed by Stata 17. Ninety-two RCTs were included, involving 10 608 patients. According to the network Meta-analysis, in terms of the clinical total effective rate, surface under the cumulative ranking curve(SUCRA) as followed: Qilong Capsules+conventional western medicine>Zhishe Tongluo Capsules+conventional western medicine>Longshengzhi Capsules+conventional western medicine>Naoxintong Capsules+conventional western medicine>Tongsaimai Tablets+conventional western medicine>Naoan Capsules+conventional western medicine>Naoluotong Capsules+conventional western medicine>Xiaoshuan Changrong Capsules+conventional western medicine>Dengzhan Shengmai Capsules+conventional western medicine=Tongxinluo Capsules+conventional western medicine>Naomaitai Capsules+conventional western medicine. In terms of the improvement in National Institute of Health stroke scale(NIHSS) score, SUCRA as followed: Longshengzhi Capsules+conventional western medicine>Naomaitai Capsules+conventional western medicine>Naoxintong Capsules+conventional western medicine>Dengzhan Shengmai Capsules+conventional western medicine>Xiaoshuan Changrong Capsules+conventional western medicine>Naoluotong Capsules+conventional western medi-cine>Tongxinluo Capsules+conventional western medicine>Naoan Capsules+conventional western medicine>Qilong Capsules+conventional western medicine. In terms of safety, the overall adverse reactions/events of Qi-benefiting and blood-activating Chinese patent medicines + conventional western medicine were less than those of the control group. Since Qilong Capsules+conventional western medicine and Zhishe Tongluo Capsules+conventional western medicine were preferred to improve the clinical total effective rate. In the aspect of improving NIHSS score, Longshengzhi Capsules+conventional western medicine and Naomaitai Capsules+conventional western medicine were first options. Due to the lack of direct comparisons between drugs, the overall quality of RCT was not high, so more studies are needed to verify the strength of the evidence.
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Humanos , Cápsulas , Accidente Cerebrovascular Isquémico , Medicina , Metaanálisis en Red , QiRESUMEN
ObjectiveThis study analyzed the outcome indicators in randomized controlled trials (RCTs) on traditional Chinese medicine (TCM) treatment of vertigo, aiming to provide a reference for clinical trial protocol design and the establishment of core indicator sets for vertigo treatment. MethodCNKI, Wanfang, VIP, SinoMed, PubMed, Embase, and Web of Science were searched for the RCTs on TCM treatment of vertigo, and data extraction was conducted. ResultA total of 375 RCTs involving 33 593 patients were included, from which 482 outcome indicators were extracted, with a frequency of 2 715 and an average of seven outcome indicators used for each RCT. In addition, there were some differences in outcome indicators reported by different study groups. According to the functional properties, the reported outcome indicators were classified into nine domains: clinical symptoms and signs, TCM symptom efficacy, physical and chemical examinations, quality of life, mental health, safety events, patients’ satisfaction degree, long-term prognosis, and economic evaluation. The outcome indicators with higher frequency were clinical total effective rate, total TCM symptom score, occurrence of adverse reactions, dizziness handicap inventory (DHI) score, average flow velocity of the basilar artery, incidence of adverse reactions, average flow velocity of the left vertebral artery, average flow velocity of the right vertebral artery, plasma viscosity, and vertigo score. ConclusionThe outcome indicators reported by RCTs of TCM treatment of vertigo mainly have two problems: lack of unified standards and norms and insufficient attention to outcome indicators that can reflect the characteristics of TCM. The construction of the core indicator set for TCM treatment of vertigo should fully highlight the characteristic advantages of TCM and unify the standards and norms for the outcome indicators on this basis, so as to improve the quality of clinical research and the value of secondary research.
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The lateral roots of the Aconitum carmichaelii ("Fuzi") have been used for centuries as a cardiotonic in China. The diterpenoid alkaloid talatisamine (TA) is a major bioactive component of Fuzi, but the identity and bioactivities of the TA metabolites have not been examined in detail. In this study, metabolite profiling of TA was performed in rat heart by UPLC-MS following oral administration. Metabolites were identified by comparing protonated molecules, fragmentation patterns, and chromatographic behaviors with those of standard compounds. Metabolites of TA were then prepared and tested for cardiotonic activity on isolated frog hearts. The metabolite cammaconine, a C19 diterpenoid alkaloid with a hydroxyl group at C-18, exhibited substantial cardiotonic activity during frog heart perfusion. To further investigate the structure-cardiac effect relationships, a series of C19-diterpenoid alkaloids with 18-OH were prepared. Eight tested compounds (5: -12: ) demonstrated measurable cardioactivity, of which compound 5: with an N-methyl group and compound 7: with a methoxy at C-16 showed stronger effects on ventricular contraction than the other compounds. Thus, 18-OH is a critical structural feature determining cardiotonic activity, and efficacy is improved by the presence of N-methyl or methoxy at C-16. Preliminary mechanistic studies suggested that the cardiotonic effect of compound 5: is mediated by enhanced cellular calcium influx. Metabolites of TA with these structural features may be useful therapeutics to prevent heart failure.
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Aconitum , Alcaloides , Diterpenos , Ratas , Animales , Cardiotónicos , Cromatografía Liquida , Espectrometría de Masas en Tándem , Alcaloides/química , Administración Oral , Diterpenos/farmacología , Diterpenos/química , Aconitum/química , Raíces de Plantas/químicaRESUMEN
Paeoniae Radix Alba is the dried root of Paeonia lactiflora, which was first recorded in the Shennong's Classic of Materia Medica and listed as the top grade. It is a common blood-tonifying herb, and its chemical components are mainly monoterpenes and their glycosides, triterpenes, flavonoids and so on. Modern research has demonstrated that Paeoniae Radix Alba has the activities of anti-inflammation, pain easing, liver protection, and anti-oxidation, and thus it is widely used in clinical practice and has broad development prospects. In this paper, the research progress on the chemical composition, pharmacological effects, and quality control of Paeoniae Radix Alba were summarized. On this basis, the Q-markers of Paeoniae Radix Alba were predicted from the aspects of mass transfer and traceability, chemical composition specificity, and availability and measurability of chemical components, which will provide a scientific basis for the quality evaluation of Paeoniae Radix Alba.
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Medicamentos Herbarios Chinos , Medicina Tradicional China , Monoterpenos , Paeonia , Extractos VegetalesRESUMEN
To discuss the advantages and necessity of hidden curriculum construction in the academic experience inheritance of distinguished TCM veteran doctors by analyzing the characteristics of the hidden curriculum and the academic experience inheritance of distinguished TCM veteran doctors, and put forward viewpoints and pathways of promoting academic experience inheritance of distinguished TCM veteran doctors through the construction of hidden curriculumï¼such as optimal design of teaching environmentï¼reasonable planning of teaching content and development of teaching information modelï¼to effectively improve student cultivation quality and achieve the TCM talent cultivation goal which clinical diagnosis and treatment skills and clinical innovation ability are the core.
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Curriculum , Medicina Tradicional China , Humanos , MédicosRESUMEN
To discuss the advantages and necessity of hidden curriculum construction in the academic experience inheritance of distinguished TCM veteran doctors by analyzing the characteristics of the hidden curriculum and the academic experience inheritance of distinguished TCM veteran doctors, and put forward viewpoints and pathways of promoting academic experience inheritance of distinguished TCM veteran doctors through the construction of hidden curriculum,such as optimal design of teaching environment,reasonable planning of teaching content and development of teaching information model,to effectively improve student cultivation quality and achieve the TCM talent cultivation goal which clinical diagnosis and treatment skills and clinical innovation ability are the core.
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Humanos , Curriculum , Medicina Tradicional China , MédicosRESUMEN
Epoxy ether type and isophthalene type saponin are the main saponins of Bupleurum chinense. However,due to the difference of their UV spectrum,there is no quantitative method for simultaneous determination of these two kinds of saponins. In this paper,a dual-wavelength high performance liquid chromatography(HPLC) was developed for simultaneous determination of five saponins in epoxidized ether(saikosaponin a,c,d) and isosorbide type(saikosaponin b1,b2). The mobile phase was eluted with acetonitrile-water(0.1% phosphoric acid) gradient at a column temperature of 30 °C and a flow rate of 1.0 mL·min⁻¹. The detection wavelengths were 208 nm for saikosaponins a,c, and d, and 254 nm for saikosaponins b₁ and b₂. The results showed that the separation of five kinds of saikosaponin was good, with the linear range of 9.70-1 935.00(=0.999 4),8.20-1 380.00(=0.999 3),6.90-1 640.00(=0.999 0),5.25-630.00(=0.999 4), and 5.15-618.00 mg·L⁻¹(=0.999 5), respectively. The average recoveries were 97.70%-100.2% and the RSD was less than 3%(=6). The method is simple,rapid and reproducible. It can be used for the determination of five kinds of saikosaponins in B. chinense.
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Bupleurum , Química , Cromatografía Líquida de Alta Presión , Medicamentos Herbarios Chinos , Química , Ácido Oleanólico , Raíces de Plantas , Química , SaponinasRESUMEN
Moutan Cortex is an important traditional Chinese medicine, "Fengdan Pi" was known as Dao-di herbs from the root bark of Paeonia suffruticosa cv. Feng Dan for its extracted various active components. However, the genetic basis for their activity is virtually unknown. The transcriptome of the root bark from "Fengdan" was sequenced using the Illumina HiSeq 4000 sequencing platform. The clean reads were then de novo assembled into 72 997 unigenes. Among them, the number of unigenes which could been annotated by dataset Nr and GO was 41 139 and 34 592. The 20 016 unigenes could been annotated by KEGG dataset, which were involved in 5 major categories, 34 middle categories, and 352 metabolism pathways. The number of unigenes which were mapped to the phenylpropanoid biosynthesis pathway, terpenoid backbone biosynthesis pathway, terpenoid biosynthesis pathway, alkaloid biosynthesis pathway, and flavonoid biosynthesis pathway was 214, 104, 152, 55 and 36 respectively, suggesting that they are involves in these pathways of pharmaceutically important. Furthermore, there also showed remarkable differences in groups which enrichment ratio of the different expressed gene compared. In addition, a total of 9 939 SSRs were identified from the sequence of 72 997 unigenes. This study not only provides many valuable basal data which was important gene in the synthesis pathway of secondary metabolites with gene searching, but also has important significance to find molecular marker in germplasm for breeding and improvement.
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Objective To explore the clinical effect of acupuncture combined with Chinese Medicine in the treatment of ischemic stroke patients with Qi deficiency and blood stasis restoring stage. Methods 180 patients with ischemic stroke in recovery period of Qi deficiency and blood stasis were divided into control group and study group, 90 cases in each group. The control group received conventional rehabilitation therapy, the study group on the basis of routine rehabilitation therapy combined with traditional Chinese medicine and acupuncture. Recorded the change of nerve function pre-treament and after continuous treatment for 1 month. Results There was no significant difference in neurological function between the two groups before treatment. After treatment, the NIHSS scale scores of the two groups were significantly lower than pre-treatment (P<0.05). After treatment, the improvement effect of nerve function in the study group was better than control group (P<0.05). Conclusion The traditional Chinese medicine and acupuncture on the basis of routine rehabilitation therapy in treating patients ischemic stroke in recovery period of Qi deficiency and blood stasis can get ideal clinical effect.
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Objective To explore the clinical effect of acupuncture combined with Chinese Medicine in the treatment of ischemic stroke patients with Qi deficiency and blood stasis restoring stage. Methods 180 patients with ischemic stroke in recovery period of Qi deficiency and blood stasis were divided into control group and study group, 90 cases in each group. The control group received conventional rehabilitation therapy, the study group on the basis of routine rehabilitation therapy combined with traditional Chinese medicine and acupuncture. Recorded the change of nerve function pre-treament and after continuous treatment for 1 month. Results There was no significant difference in neurological function between the two groups before treatment. After treatment, the NIHSS scale scores of the two groups were significantly lower than pre-treatment (P<0.05). After treatment, the improvement effect of nerve function in the study group was better than control group (P<0.05). Conclusion The traditional Chinese medicine and acupuncture on the basis of routine rehabilitation therapy in treating patients ischemic stroke in recovery period of Qi deficiency and blood stasis can get ideal clinical effect.
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This study aims to investigate the oxidative stress and hepatocellular injury induced by Cr(3+) in chicken. Different doses of CrCl3 solutions (50% LD50 , 25% LD50 , and 12.5% LD50) and equivalent water were orally administered to chicken. Chicken liver samples were measured for the activities of antioxidant enzymes, the contents of glutathione, total antioxidant capacity (T-AOC), malondialdehyde (MDA), and hydrogen peroxide to indirectly evaluate the oxidative stress in chicken liver. Results indicated that the oral administration of Cr(3+) at high dose significantly increased (P < 0.05) the MDA levels after 28 days of exposure, with decreased T-AOC, glutathione, and antioxidant enzymes activities. Low and medium doses groups show that T-AOC, glutathione, and antioxidant enzymes activities increased after 14 days, then decreased gradually, but low and medium groups higher than control group, only high group lower than control group finally. These statistics and histopathological analysis suggest that high dose and long-term exposure of Cr(3+) induce oxidative stress and hepatocellular injury.