RESUMO
BACKGROUND The aim of this study was to assess the efficacy and safety of acupuncture therapy for patients with hypertension. MATERIAL AND METHODS We searched PubMed, Embase, the Cochrane Library, the Chinese Biomedical Literature Database, the Chinese National Knowledge Infrastructure, and the Wan-fang Data Database from inception through 29 April 2017. Randomized controlled trials investigating acupuncture therapy for hypertension were included. Review Manager 5.3 software was used for the data analysis. RESULTS A total of 30 RCTs involving 2107 patients were included. The overall methodological quality of the included studies was low. Pooled results demonstrate that acupuncture plus anti-hypertensive drugs is better than anti-hypertensive drugs alone at reducing systolic and diastolic blood pressure (SBP and DBP). The same result was observed for pooled data from experiments that compared acupuncture plus medication to sham acupuncture plus medication at reducing SBP and DBP. However, studies reveal that using acupuncture alone or anti-hypertensive drugs alone do not differ in the effect on lowering blood pressure. Similarly, acupuncture alone also did not differ from sham acupuncture alone, and electroacupuncture versus anti-hypertensive drugs was not significantly different at reducing SBP and DBP. CONCLUSIONS Our systematic review indicates there is inadequate high quality evidence that acupuncture therapy is useful in treating hypertension, as the exact effect and safety of acupuncture therapy for hypertension is still unclear. Therefore, research with larger sample sizes and higher-quality RCTs is still needed.
Assuntos
Terapia por Acupuntura/efeitos adversos , Hipertensão Essencial/terapia , Anti-Hipertensivos/uso terapêutico , Pressão Sanguínea , Diástole , Eletroacupuntura , Hipertensão Essencial/tratamento farmacológico , Hipertensão Essencial/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Viés de Publicação , Ensaios Clínicos Controlados Aleatórios como Assunto , Relatório de Pesquisa , Sístole , Resultado do TratamentoRESUMO
Dehydroepiandrosterone (DHEA) is an abundant adrenal steroid in serum of humans, and has been reported to have anti-inflammatory, anti-proliferative, and certain immune-regulating properties. Experimental autoimmune neuritis (EAN) is a Th1 cell-mediated animal model of Guillain-Barré syndrome (GBS) in humans. In the present study, DHEA was administered subcutaneously to Lewis rats immunized with bovine peripheral myelin (BPM) in Freund's complete adjuvant. Rats treated with DHEA displayed significant delay in onset, decreased inflammatory cell infiltration in the PNS. Benefit was associated with significant decreases in numbers of IFN-gamma and TNF-alpha expressing cells in the PNS, BPM-stimulated T cell proliferation and IFN-gamma, TNF-alpha-secretion in the spleen cells. Only 2 mg DHEA-treated EAN rats decreased peak clinical score. No significant difference of supernatant IL-10 was found among the treatment and control groups. These results suggest that DHEA can ameliorate the severity of EAN by suppressing the proliferation of autoreactive T cell and expression of pro-inflammatory cytokines.
Assuntos
Adjuvantes Imunológicos/administração & dosagem , Desidroepiandrosterona/administração & dosagem , Neurite Autoimune Experimental/tratamento farmacológico , Análise de Variância , Animais , Bovinos , Proliferação de Células/efeitos dos fármacos , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Ensaio de Imunoadsorção Enzimática/métodos , Feminino , Adjuvante de Freund , Interferon-alfa/metabolismo , Interferon gama/metabolismo , Bainha de Mielina/imunologia , Neurite Autoimune Experimental/etiologia , Neurite Autoimune Experimental/imunologia , Neurite Autoimune Experimental/patologia , Neoplasias do Sistema Nervoso Periférico/metabolismo , Ratos , Ratos Endogâmicos Lew , Linfócitos T/efeitos dos fármacos , Linfócitos T/imunologiaRESUMO
AIM: To explore the effect of dehydroepiandrosterone (DHEA) on cellular immune response in experimental autoimmune neuritis (EAN). METHODS: 21 female Lewis rats were randomly divided into DHEA 0.5 mg treatment groups, 2 mg treatment groups and control group ( n=7). Treatment groups were subcutaneously injected every day with DHEA and the control group with the same level of DHEA dissolvent from day 5 post immunization (p.i) with bovine peripheral myelin (BPM) in Freund's complete adjuvant (CFA). The effects were assessed in terms of of the number of IFN-gamma, TNF-alpha positive cells in sciatic nerve sections, T-cell proliferation and inflammatory cytokines (IFN-gamma, TNF-alpha and IL-10) synthesis by draining lymph node and spleen cells at the height of clinical EAN. RESULTS: Rats treated with DHEA at different doses displayed significant decreases in numbers of IFN-gamma, TNF-alpha expressing cells in the PNS (P<0.05), BPM-stimulated T cell proliferation (P<0.05), IFN-gamma, TNF-alpha secretion in draining lymph node and spleen (P<0.05) compared to control group. No significant difference of supernatant IL-10 was found among the different groups (P<0.05). CONCLUSION: Administration with exogenous DHEA inhabits cellular immune response by suppressing the proliferation of autoreactive T-cell and production of pro-inflammatory cytokines in Lewis rats with EAN.