Efficacy of Qingpeng ointment (a Tibetan medicine) for acute gouty arthritis: a multi-center, randomized, double-blind, placebo-controlled trial.

BACKGROUND: This study aims to assess the efficacy and safety of Qingpeng ointment (QPO), a Tibetan medicine for alleviating symptoms in individuals with acute gouty arthritis (AGA). METHODS: This study was a randomized, double-blind, placebo-controlled trial that involved individuals with AGA whose joint pain, as measured on a visual analog scale (VAS) from 0 to 10, was equal to or greater than 3. The participants were randomly assigned to either the QPO or the placebo group and received their respective treatments twice daily for seven consecutive days. In case of intolerable pain, the participants were allowed to use diclofenac sodium sustained-release tablets as a rescue medicine. The primary outcomes measured were joint pain and swelling, while the secondary outcomes included joint mobility, redness, serum uric acid levels, C-reactive protein levels, and the amount of remaining rescue medicine. Any adverse events that occurred during the trial were also recorded. RESULTS: A total of 203 cases were divided into two groups, with balanced baselines: 102 in the QPO group and 101 in the placebo group. For joint pain, differences between the groups were notable in the VAS scores [1.75 (0, 3.00) versus 2.00 (1.00, 3.50); P = 0.038], changes in VAS [5.00 (3.00, 6.00) versus 4.00 (2.00, 6.00); P = 0.036], and disappearance rate [26.47% compared to 15.84%; P = 0.046] after treatment. Concerning joint swelling, significant between-group differences were observed in the VAS scores [1.00 (0, 2.30) versus 2.00 (0.70, 3.00); P = 0.032] and disappearance rate [33.33% compared to 21.78%; P = 0.046] at treatment completion. The QPO group exhibited a statistically significant mobility improvement compared to the placebo group (P = 0.004). No significant differences were found in other secondary outcomes. Five patients, four from the QPO group and one from the other, encountered mild adverse events, primarily skin irritation. All of these cases were resolved after dosage reduction or discontinuation of the medication. CONCLUSIONS: Compared to the placebo, QPO exhibits positive effects on AGA by alleviating pain, reducing swelling, and enhancing joint mobility, without causing significant adverse effects. TRIAL REGISTRATION: ISRCTN34355813. Registered on 25/01/2021.

Efficacy and safety of Tibetan medicine Qingpeng ointment for acute gouty arthritis: protocol for a multi-center, randomized, double-blind, placebo-controlled trial.

BACKGROUND: Acute gouty arthritis (AGA) is an inflammatory arthritis clinically characterized by severe pain, swelling, and restricted movement of joints, which may cause physical disability and decrease quality of life. The use of recommended first-line treatment agents for AGA may be limited by adverse events. There has been a traditional use of alternative therapies for AGA. Tibetan medicine Qingpeng ointment is one of the on-market herbal products used for symptom relief of AGA. Previous clinical studies indicated that Qingpeng ointment can relieve pain, swelling, redness, and dysfunction of joints in patients with AGA. However, there is no rigorous randomized trial to demonstrate its benefit for AGA. In order to evaluate the efficacy and safety of Qingpeng ointment for AGA, we designed a randomized controlled trial. METHODS: This study is designed as a multi-center, randomized, double-blind, placebo-controlled trial. Two hundred and six adults with acute flare of gout, and visual analogue scale (VAS) score of joint pain ≥ 3 points will be recruited. Participants will be randomly assigned to herbal treatment or placebo group at a ratio of 1:1. Qingpeng ointment, or equal placebo ointment, will be applied topically at involved joints twice a day for consecutive 7 days. Patients in both groups would be allowed giving diclofenac sodium sustained-release tablets as rescue therapy when VAS score of joint pain ≥ 7 points during the treatment. The primary outcomes will be joint pain measured by VAS score, and joint swelling measured using width and thickness of affected joints and VAS score. Other outcome measures will be joint mobility, joint redness, C-reactive protein, serum uric acid, and the use of rescue medicine as well as adverse effect. DISCUSSION: To the best of our knowledge, this study is the first multi-center, randomized, double-blind, and placebo-controlled clinical trial to assess the efficacy of Tibetan medicine Qingpeng ointment for AGA. The findings of this study would provide evidence for its use to relieve symptoms of AGA. TRIAL REGISTRATION: ISRCTN ISRCTN34355813 . Registered on 25 January 2021.

Clinical Study of Qingpeng Ointment Treating Shoulder-hand Syndrome After Cerebral Hemorrhage During the Rehabilitation Period.

BACKGROUND: Shoulder-hand syndrome (SHS) refers to a syndrome causing sudden edema, shoulder pain and limited hand function. Qingpeng ointment, a kind of Tibetan medicine, can reduce swelling, relieve pain, tonify stagnation and clear the meridians, which is consistent with the pathological mechanism of SHS after stroke. Therefore, if clinical trials can be used to explore the effectiveness of Qingpeng ointment for the treatment of poststroke SHS and promote its application in clinical medicine, it may prove the specific significance for the treatment of poststroke SHS poststroke SHS. OBJECTIVE: The aim of the study was to investigate the clinical efficacy and safety of Qingpeng ointment in the treatment of poststroke SHS and to provide an objective basis for a better therapeutic treatment for poststroke SHS. METHODS: A prospective, randomized, controlled study was conducted. This study recruited 120 patients with poststroke SHS who met the inclusion criteria. They were randomized into the treatment group and the control group, with 60 patients allocated to each group. The treatment group received routine medical treatment and rehabilitative care after using the Qingpeng ointment, while the patients in the control group received only routine treatment without the ointment. All patients received clinical assessment with the Visual Analogue Scale (VAS), measurement of the range of motion (ROM) of the upper-limb joints, the Fugl-Meyer Assessment of Upper Extremity (FMA-U) and the Modified Barthel Index Score (MBI) before and after the whole treatment. RESULTS: After 4 weeks of treatment, the VAS scores of both the groups decreased significantly (P ＜0.05), and the difference between the two groups was statistically significant (P < 0.05). No statistical significance was observed for the difference between the treatment group and control group in terms of the FMA-U and MBI scores and the forward bend, backward, outstretch, external rotation and pronation angles after treatment. The increases in the values of VAS, FMA-M and MBI in the treatment group were greater than those in the control group, and the difference was statistically significant (P < 0.05). The increases in the values of the forward bend, outreach and external rotation angles in the treatment group were greater than those in the control group, and the difference was statistically significant (P < 0.05). CONCLUSION: The treatment group showed better results than the control group in terms of the relief of pain symptoms, the improvement of motor function and the improvement of the activities of daily living for patients with shoulder-hand syndrome after cerebral hemorrhage. Qingpeng ointment was found to be effective and safe for treating poststroke SHS.

Clinical efficacy of Qingpeng ointment combined with oral Chinese medicine on plaque psoriasis vulgaris / 中华医学美学美容杂志

Objective To study the efficacy and safety of Qingpeng ointment combined with oral Chinese Medicine in the treatment of plaque psoriasis.Methods By a randomized controlled method,60 patients with plaque psoriasis from December 2016 to October 2017 in Zhengzhou Hospital of Traditional Chinese Medicine were evenly divided into experimental group and control group.In the experimental group,patients were treated by Qingpeng ointment and oral Chinese Medicine,while in the control group,vaseline ointment and oral Chinese Medicine were provided.The period of treatment was 4 weeks.The PASI scores,itching index scores before and after treatment,clinical efficacy and security indices were compared between the two groups.Results The total effective rate was 93.33％ in the experimental group and 70.00％ in the control group,which displayed a statistical difference (P＜0.05).The PASI scores and itching index scores were significantly decreased in both groups after treatment (P＜0.05).The value of itching index in the experimental group was lower than that in the control group after treatment,with a statistical difference (P ＜0.05).No adverse reactions occurred in the patients in the two groups.Conclusions Qingpeng ointment combined with oral Chinese medicine is effective and safe in the treatment of plaque psoriasis.

Study on effect of Traditional Chinese Medicine Jianpi Chushi decoction and ointment on chronic eczema.

OBJECTIVE: To study the effects of Traditional Chinese Medicine Jianpi Chushi decoction and ointment on chronic eczema. METHODS: DNCB acetone solution was used to sensitize the skin of back and ears of 36 rats in order to establish chronic eczema model. A total of 36 rats were divided into four groups of 9 randomly including oral medicine group, external inunctum group, combination therapy group, and model control group respectively. Besides, the blank group of 4 healthy rats were set. The oral medicine group was given Traditional Chinese Medicine Jianpi Chushi decoction [(Poria cocos, Chinese yam, Cortex dictamni, Zaocys dhumnade, Rhizoma atractylodis, Pericarpium citri reticulatae, Scutellaria baicalensis, Radix Sophorae Flavescentis, Raw Radix Paeoniae Alba, Licorice roots (Northwest Origin)] by gastric infusion (1.6 g/mL·5 mL/d); the external inunctum group was given Qingpeng ointment on the skin, the combination therapy group was given Jianpi Chushi decoction by gastric infusion and Qingpeng ointment combination therapy. The model control group was given normal saline (NS) of the same volume by gastric infusion and vaseline on skin. Continuous administration 15 d and stopped for 3 d. The thickness difference and weight difference of left and right ear of every group were measured and the degree of ear swelling were evaluated. The CD4+ and CD8+ content and the IL-2, IL-4 level of serum were detected, and the inflammatory cells counts of back skin were recorded. RESULTS: After treatment, the degree of ear swelling of oral medicine group, external inunctum group and combination therapy group significant decreased compared with model control group (P < 0.05). The CD4+, CD8+ cell content and IL-2 level of oral medicine group, external inunctum group, combination therapy group and model control group significant decreased compared with blank group, and IL-2 level and the inflammatory cells count increased. After 15 d of treatment, the CD4+, CD8+ cell content and IL-2 level of serum of oral medicine group, external inunctum group and combination therapy group raised and the IL-4 level and the inflammatory cells count had significant decreased compared with model control group, and the effect of combination therapy group was more obvious (P < 0.05). CONCLUSIONS: Qral Jianpi Chushi decoction could treat chronic eczema effectively, and oral Chinese medicine combined with ointment could enhance and speed up the efficacy.

Study on effect of Traditional Chinese Medicine Jianpi Chushi decoction and ointment on chronic eczema

OBJECTIVE@#To study the effects of Traditional Chinese Medicine Jianpi Chushi decoction and ointment on chronic eczema.@*METHODS@#DNCB acetone solution was used to sensitize the skin of back and ears of 36 rats in order to establish chronic eczema model. A total of 36 rats were divided into four groups of 9 randomly including oral medicine group, external inunctum group, combination therapy group, and model control group respectively. Besides, the blank group of 4 healthy rats were set. The oral medicine group was given Traditional Chinese Medicine Jianpi Chushi decoction [(Poria cocos, Chinese yam, Cortex dictamni, Zaocys dhumnade, Rhizoma atractylodis, Pericarpium citri reticulatae, Scutellaria baicalensis, Radix Sophorae Flavescentis, Raw Radix Paeoniae Alba, Licorice roots (Northwest Origin)] by gastric infusion (1.6 g/mL·5 mL/d); the external inunctum group was given Qingpeng ointment on the skin, the combination therapy group was given Jianpi Chushi decoction by gastric infusion and Qingpeng ointment combination therapy. The model control group was given normal saline (NS) of the same volume by gastric infusion and vaseline on skin. Continuous administration 15 d and stopped for 3 d. The thickness difference and weight difference of left and right ear of every group were measured and the degree of ear swelling were evaluated. The CD4+ and CD8+ content and the IL-2, IL-4 level of serum were detected, and the inflammatory cells counts of back skin were recorded.@*RESULTS@#After treatment, the degree of ear swelling of oral medicine group, external inunctum group and combination therapy group significant decreased compared with model control group (P < 0.05). The CD4+, CD8+ cell content and IL-2 level of oral medicine group, external inunctum group, combination therapy group and model control group significant decreased compared with blank group, and IL-2 level and the inflammatory cells count increased. After 15 d of treatment, the CD4+, CD8+ cell content and IL-2 level of serum of oral medicine group, external inunctum group and combination therapy group raised and the IL-4 level and the inflammatory cells count had significant decreased compared with model control group, and the effect of combination therapy group was more obvious (P < 0.05).@*CONCLUSIONS@#Qral Jianpi Chushi decoction could treat chronic eczema effectively, and oral Chinese medicine combined with ointment could enhance and speed up the efficacy.

Study on effect of Traditional Chinese Medicine Jianpi Chushi decoction and ointment on chronic eczema

Objective To study the effects of Traditional Chinese Medicine Jianpi Chushi decoction and ointment on chronic eczema. Methods DNCB acetone solution was used to sensitize the skin of back and ears of 36 rats in order to establish chronic eczema model. A total of 36 rats were divided into four groups of 9 randomly including oral medicine group, external inunctum group, combination therapy group, and model control group respectively. Besides, the blank group of 4 healthy rats were set. The oral medicine group was given Traditional Chinese Medicine Jianpi Chushi decoction [(Poria cocos, Chinese yam, Cortex dictamni, Zaocys dhumnade, Rhizoma atractylodis, Pericarpium citri reticulatae, Scutellaria baicalensis, Radix Sophorae Flavescentis, Raw Radix Paeoniae Alba, Licorice roots (Northwest Origin)] by gastric infusion (1.6 g/mL·5 mL/d); the external inunctum group was given Qingpeng ointment on the skin, the combination therapy group was given Jianpi Chushi decoction by gastric infusion and Qingpeng ointment combination therapy. The model control group was given normal saline (NS) of the same volume by gastric infusion and vaseline on skin. Continuous administration 15 d and stopped for 3 d. The thickness difference and weight difference of left and right ear of every group were measured and the degree of ear swelling were evaluated. The CD4+ and CD8+ content and the IL-2, IL-4 level of serum were detected, and the inflammatory cells counts of back skin were recorded. Results After treatment, the degree of ear swelling of oral medicine group, external inunctum group and combination therapy group significant decreased compared with model control group (P < 0.05). The CD4+, CD8+ cell content and IL-2 level of oral medicine group, external inunctum group, combination therapy group and model control group significant decreased compared with blank group, and IL-2 level and the inflammatory cells count increased. After 15 d of treatment, the CD4+, CD8+ cell content and IL-2 level of serum of oral medicine group, external inunctum group and combination therapy group raised and the IL-4 level and the inflammatory cells count had significant decreased compared with model control group, and the effect of combination therapy group was more obvious (P < 0.05). Conclusions Qral Jianpi Chushi decoction could treat chronic eczema effectively, and oral Chinese medicine combined with ointment could enhance and speed up the efficacy.

Topical application of a Chinese medicine, Qingpeng ointment, ameliorates 2, 4-dinitrofluorobenzene-induced allergic contact dermatitis in BALB/c mice.

BACKGROUND: Qingpeng ointment (QP) is a traditional Chinese medicine which has been used for treatment of eczema in China. However, the mechanisms of its anti-inflammatory activities are not known. OBJECTIVES: To assess the anti-inflammatory effects of QP using a mouse model of allergic contact dermatitis, compare the effects with mometasone furoate cream (MF), and to relate the effects to modulation of inflammatory cytokines. METHODS: Persistent dermatitis was induced in BALB/c mice using dinitrofluorobenzene. Topical treatment, including the vehicle of QP, 50%, 75%, 100% QP in vehicle, and MF was applied for 14 days. Dermatitis was evaluated macroscopically and microscopically at day 8 and day 15 after treatment. The levels of IL1B, IL2, TNFA, IFNG in both sera and skin tissue were detected with Enzyme-Linked Immunosorbent Assay (ELISA). RESULTS: Significant reductions of skin inflammation in mice skin were observed after treatment with QP and MF, but not with the vehicle of QP. Similar to MF, QP also suppressed the expression of IL1B, IL2, TNFA and IFNG. CONCLUSION: This study demonstrates that QP inhibits allergic contact dermatitis in mice, similar to MF. QP suppresses the expression of Th1 cytokines in both sera and skin tissue, by which it may exert its anti-inflammatory effects.

Effect of Qingpeng ointment on experimental atopic dermatitis in mice and its possible mechanisms / 中华皮肤科杂志

Objective To investigate the effect of a topical Tibetan medicine,Qingpeng ointment,on atopic dermatitis in mice and its possible mechanisms.Methods A model of atopic dermatitis was established in 180 7-week-old BALB/c mice by repeatedly applying 100 μl of 0.15％ 2,4-dinitrofluorobenzene (DNFB) to shaved ventral skin and 50 μl of 0.15％ DNFB to shaved dorsal skin.After the establishment of model,the mice were divided into 5 groups,i.e.,model group receiving no treatment,three Qingpeng groups treated with 100％,75％ and 50％ Qingpeng ointment respectively,vehicle control group treated with the vehicle of Qingpeng ointment.Thirty-six mice receiving neither DNFB sensitization nor Qingpeng ointment or vehicle treatment served as the blank control group.The treatment lasted 14 days.On day 8 and 15,serum samples and dorsal skin tissue samples were obtained from these mice.Skin samples underwent the measurement of thickness and weightness,observation of histopathological changes by using hematoxylin and eosin (HE) staining,enumeration of inflammatory cells infiltrating the dermis.Enzyme linked immunosorbent assay (ELISA) was carried out to determine the levels of several cytokines,including interleukin (IL)-2,-4 and-5,interferon (IFN)-γ,tumor necrosis factor (TNF)-α,in the sera and homogenate of the skin samples.Results All the 3 concentrations of Qingpeng ointment significantly inhibited skin inflammation induced by DNFB on day 8 and 15,with a decrease in the degree of edema and number of lymphocytes infiltrating the dermis.Compared with the model mice and vehicle-treated mice,those treated with 100％ and 75％ Qingpeng ointment showed a significantly lower level of IL-4 and IL-5 in both sera and homogenates of skin lesions on day 8 and 15 after the start of treatment (all P ＜0.05).On day 15,a statistical increase was observed in IL-2,IFN-γand TNF-α in sera as well as in IFN-γ and TNF-α in homogenates of skin lesions from mice treated with 100％ Qingpeng ointment compared with the model mice and vehicle control mice (all P ＜ 0.05).Conclusion Qingpeng ointment can inhibit the inflammation in mouse model of atopic dermatitis,likely by modulating the balance between type 1 and type 2 T helper cells.

Inhibitory effect of Qingpeng ointment on experimental irritant contact dermatitis in mice and its possible mechanisms / 中华皮肤科杂志

Objective To investigate the inhibitory effect of Qingpeng ointment,a topical Tibetan medicine,on induced irritant contact dermatitis (ICD) in mice and its possible mechanisms.Methods An ICD model was developed in 180 seven-week-old BALB/c mice by applying sodium dodecyl sulfate (SDS,10％ in distilled water) on shaved backs,and the mice were then equally divided into 5 groups to remain untreated (model control),be treated with 100％,75％,50％ Qingpeng ointment and vehicle of the ointment (vehicle control),respectively,for 11 days.Thirty-six mice receiving no irritation or treatment served as the blank control.At day 8 and 12 after the beginning of treatment,drill biopsy specimens were gained from induced lesions of these mice and subjected to the measurement of skin thickness and weight,observation of histopathological changes with hematoxylin and eosin staining,and calculation of inflammatory cells infiltrating the dermis; blood samples were also obtained,and enzyme linked immunosorbent assay (ELISA) was performed to quantify the expression level of interleukin (IL)-2,tumor necrosis factor (TNF)-α and interferon (IFN)-γ in sera and homogenates of skin lesions.Results Compared with the model control and vehicle control mice,those treated with 100％ Qingpeng ointment showed an attenuated inflammation and swelling,together with a decreased neutrophil skin infiltration.At day 12,the levels of IL-2,TNF-α and IFN-γ were significantly lower in the sera ( (5.55 ± 0.33) vs.(6.41 ± 0.96) and (6.25 ± 0.92) pg/ml,(70.88 ± 1.55 )vs.(76.67 ± 1.14) and (76.95 ± 1.08) pg/ml,(76.99 ± 1.85) vs.(82.20 ± 2.36) and (81.76 ± 3.19) pg/ml,respectively,all P ＜ 0.05) and homogenates of skin lesions ((17.75 ± 0.97) vs.(23.92 ± 0.82) and (23.11 ± 0.82) pg/ml,(66.95 ± 3.58) vs.(70.66 ± 2.68) and (71.17 ± 3.30) pg/ml,(46.85 ± 2.43) vs.(55.14 ± 2.68) and (53.55 ± 3.24) pg/ml.all P ＜ 0.05) in mice treated with 100％ Qingpeng ointment than those in the model control and vehicle control groups.Conclusion The 100％ Qingpeng ointment can suppress the inflammatory response in experimental ICD in mice,with a decrease in the level of IL-2,TNF-α and IFN-γ in sera and skin lesions.