Clinical efficacy of Kuanxiong aerosol for patients with prehospital chest pain: A randomized controlled trial.

BACKGROUND: Kuanxiong Aerosol (KXA)(CardioVent®), consisting of Asarum sieboldii Miq. oil, Santalum album L. oil, Alpinia officinarum Hance oil, Piper longum L. oil and borneol, seems to relieve the symptoms of chest pain and serve as a supplementary treatment for prehospital chest pain in emergency department. STYLE OF THE STUDY: This randomized controlled trial aimed to determine the clinical effect and safety of KXA for patients with prehospital chest pain. METHODS: A total of 200 patients were recruited from Guangdong Provincial Hospital of Chinese Medicine and randomly divided into KXA group (n = 100) and Nitroglycerin Aerosol (NA) group (n = 100) by SAS 9.2 software. All patients were treated with standardized Western medicine according to the pre-hospital procedure. The experimental group and NA group was additionally treated with KXA and NA respectively. The primary outcome was the relieving time of prehospital chest pain (presented as relief rate) after first-time treatment. The secondary outcomes included the evaluation of chest pain (NRS scores, degree of chest pain, frequency of chest pain after first-time treatment), efficacy in follow-up time (the frequency of average aerosol use, emergency department visits, 120 calls, medical observations and hospitalization at 4 weeks, 8 weeks, 12 weeks), alleviation of chest pain (Seattle angina questionnaire, chest pain occurrence, and degree of chest pain at 12-weeks treatment) and the change of TCM symptoms before and after 12-weeks treatment. In addition, the safety of KXA was also assessed by the occurrence of adverse events. The database was created using Epidata software, and statistical analysis was conducted by SPSS 23.0 software. RESULTS: A total of 194 participants finally completed the trial, the results showed that after first-time treatment, KXA had a higher relief rate (72.2%) of chest pain within 30 min than that of NA group (59.4%, p = 0.038), KXA group had a lower degree of chest pain (p = 0.005), lower NRS score (p = 0.011) and higher reduction of NRS score (p = 0.005) than the NA. In the follow-up period, KXA group decreased the frequency of 120 call better than that of NA group at 4 weeks (p = 0.040), but KXA had a similar efficacy as NA in the improvement on the of frequency of chest pain, aerosol use, emergency department visits, 120 call, medical observation and hospitalization at 4 weeks, 8 weeks and 12 weeks (p>0.05). There also had no difference between the two groups on the occurrence of chest pain, degree of chest pain, physical limitation, angina stability, treatment satisfaction, and disease perception between the two groups at 12 weeks (p>0.05). In addition, KXA and NA both improved the patient's chest pain, but not the TCM symptoms. In terms of safety, KXA showed similar safety as NA in this study. CONCLUSIONS: KXA relieved prehospital chest pain faster than NA and had a better remission effect on the prehospital chest pain than that of the NA group in short-period. In long-period, KXA showed similar efficacy on the improvement of prehospital chest pain as NA. KXA may be a safe and reliable therapy for prehospital chest pain.

[Analysis on regional homogeneity of resting brain during balance acupuncture-induced analgesic effect in migraine patients without aura].

OBJECTIVE: To observe the relationship between the analgesic effect of balance acupuncture and functional changes in brain in patients with migraine without aura. METHODS: A total of 40 cases of migraine without aura were equally randomized into a headache-acupoint group and a sham-acupoint group. When acupuncture given, a filiform needle was inserted into the headache-acupoint (the midpoint of the depression region anterior to the juncture of the first and second metatarsal bones on the dorsum of the foot) or the sham point (the midpoint of the depression region anterior to the juncture site between the 3rd and 4th metatarsal joints of the dorsum of the foot) about 25-40 mm deep and manipulated for a while till the patient experienced feelings of electric shock and numbness, then withdrawn immediately. The treatment was conducted once daily for 4 weeks. The visual analogue scale (VAS) was used to evaluate the severity of pain, and the regional homogeneity (ReHo) analysis of resting state functional magnetic resonance imaging (fMRI) was used to assess changes of the spontaneous brain activity. RESULTS: After acupuncture, the analgesic effect of headache-acupoint was better than that of the sham-acupoint in both intervention stage and the follow-up stage (P< 0.05), and was also stronger in the intervention stage than in the follow-up stage (P<0.05). There was no significant difference in the analgesic effect between the intervention stage and the follow-up stage in the sham-acupoint group (P>0.05). Compared with pre-intervention, 4-weeks' intervention at the headache-acupoint showed an increase of ReHo values in the anterior cingulate gyrus, anterior central gyrus, superior orbital frontal gyrus, insula, inferior lobule, left anterior cingulate gyrus, ventral lateral nucleus and ventral posteromedial nucleus of the thalamus, pontine nucleus, cerebellar tonsils and orbital frontal inferior gyrus of the brain (P<0.05), and a decrease of ReHo values in the right brain bridge, central posterior gyrus, posterior cingulate gyrus, left central anterior gyrus, posterolateral nucleus of thalamus, and hippocampus (P<0.05), separately. In the sham-acupoint group, the ReHo value was increased in the right tongue gyrus, the left anterior lobe, the anterior cingulate gyrus and the lower occipital gyrus of the brain (P<0.05), and reduced in the left ventral posterolateral nucleus of the thalamus, separately (P<0.05). CONCLUSION: Balance acupuncture stimulation of headache acupoint has an analgesic effect in migraine patients without aura, which may be related to its effect in regulating resting state brain function of the limbic-system-dominated multiple brain regions.

[Migraine without aura treated with balance acupuncture therapy:a randomized controlled trial].

OBJECTIVE: To assess the effect of balance acupuncture for migraine without aura. METHODS: Blind evaluation was conducted. Forty patients with migraine without aura were randomized into an observation group and a control group, 19 cases in each one with 1 patient dropped out respectively. In the observation group, Toutongxue, the middle point was used in the hollow before the 1, 2 metatarsal combination, and in the control group, a sham point was applied in the hollow before the 3, 4 metatarsal combination. The manipulation in the two groups was the same. The treatment was given for 4 weeks, once a day, 5 times a week. The comprehensive score and visual analogue scale (VAS) were used before and after treatment, as well as 4 weeks after treatment. RESULTS: The comprehensive score and VAS score after treatment in the observation group decreased after treatment (both P<0.05), of which the total headache time and attack number for one month were lower than those before treatment (both P<0.05), but at follow-up the VAS score was higher than that after treatment (P<0.05). The above indices in the control group were not significantly different from those before treatment (allP>0.05). All the indices in the observation group after treatment and at follow-up were lower than those in the control group (all P<0.05). The different values for the comprehensive score and VAS score before and after treatment, before treatment and at follow-up in the observation group were better than those in the control group (all P<0.05). The different values after treatment and at follow-up had no significant difference between the two groups (bothP>0.05). CONCLUSIONS: Balance acupuncture at Toutongxue achieves obvious effect for migraine without aura, which can relieve pain.

Protective effect of the polysaccharide from Ophiopogon japonicus on streptozotocin-induced diabetic rats.

The present study was designed to investigate the effect of OJP1, a polysaccharide isolated from the roots of Ophiopogon japonica, on blood lipid metabolism, antioxidant activity, as well as its protective effect on the liver and kidneys in diabetic rats. Results showed that OJP1 significantly reduced the MDA concentration and increased the activity of both GPx and SOD in the serum, liver and kidneys of diabetic rats. Moreover, the values of TG, TC, LDL-C and HDL-C in diabetic rats were significantly reversed by OJP1 treatment. Biochemical and histopathological analyses also showed that OJP1 can alleviate liver and kidneys injury in diabetic rats. The mRNA expression of transforming growth factor-ß1 (TGF-ß1) and connective tissue growth factor (CTGF) in diabetic rats decreased significantly after administration of OJP1. Altogether, these results suggest that OJP1 possess potent antioxidant activity and can protect the liver and kidneys from the injurious effects of diabetes.

The effect of integrated health management model on the satisfaction among Chinese elderly.

The study objective was to investigate the effect of integrated health management model on the satisfaction among Chinese elderly. Using a randomized controlled trial, 600 people who are 60 and over have signed the informed consent in China were randomly assigned into management and control group. The management group received care integrated individual health management with community health management model in the follow-up 6 months. The individual health management included establishing health record, performing health evaluation, giving individual instruction, carrying out telephone consultation and follow-up. The community health management includes lectures on health knowledge, distribution of health education materials and physical fitness exercise kit. Factor analysis, t-test, χ(2)-test and logistic regression models were used. The average satisfaction scores of baseline and final of management or control group were calculated through factor analysis. The management group has shown a significant improvement in satisfaction score, no difference in control group. Logistic regression analysis of influencing factors of the elderly satisfaction showed that the satisfaction score of male, individuals without chronic disease and management group was higher. These results suggest that integrated health management model can improve the elderly satisfaction in China through realizing good communication between the elderly and medical staff in community.