Post-stroke dysphagia treated with four-step acupuncture therapy for opening orifices and benefiting throat combined with neuromuscular electrical stimulation: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical efficacy on post-stroke dysphagia treated with four-step acupuncture therapy for opening orifices and benefiting throat combined with neuromuscular electrical stimulation.@*METHODS@#Sixty patients with post-stroke dysphagia were randomly divided into an observation group and a control group, with 30 cases in each group. The neuromuscular electrical stimulation was adopted in the control group. Besides the treatment as the control group, in the observation group, the four-step acupuncture therapy for opening orifices and benefiting throat was supplemented. Step 1: the three areas of scalp acupuncture on the affected side were stimulated. Step 2: pricking method was operated on the posterior pharyngeal wall. Step 3: bleeding technique was operated at Jinjin (EX-HN 12) and Yuye (EX-HN 13). Step 4: deep insertion of needle was operated at three-pharynx points. The needles were retained for 30 min at the three areas of scalp acupuncture and the three-pharynx points. The intervention of each group was delivered once daily, 6 times a week, at the interval of 1 day. One course of treatment was 1 week and 4 successive courses were required. The rating of Kubota water swallow test, the score of standardized swallowing assessment (SSA) and the rating of Rosenbek penetration- aspiration scale (PAS) were observed before and after treatment in patients of the two groups. The incidence of clinical complications and clinical efficacy were compared between the two groups.@*RESULTS@#Compared with those before treatment, the rating of Kubota water swallow test, the scores of SSA and the rating of PAS of patients in the two groups were decreased after treatment (P<0.01), and the values of the observation group were lower than those of the control group after treatment (P<0.05). The incidence of clinical complications in the observation group was 13.3% (4/30), lower than 36.7% (11/30) in the control group (P<0.05). The total effective rate in the observation group was 93.3% (28/30), which was better than 70.0% (21/30) in the control group (P<0.05).@*CONCLUSION@#The four-step acupuncture therapy for opening orifices and benefiting throat combined with neuromuscular electrical stimulation can improve the swallowing function of patients with post-stroke dysphagia and reduce the incidence of clinical complications.

Re-evaluation of systematic reviews of acupuncture and moxibustion for childhood autism / 中国针灸

OBJECTIVE@#To re-evaluate the systematic review/Meta-analysis of acupuncture and moxibustion for childhood autism (CA), aiming to provide decision-making basis for clinical diagnosis and treatment.@*METHODS@#The systematic review and/or Meta-analysis of acupuncture and moxibustion for CA were searched in PubMed, EMbase, Cochrane Library, SinoMed, CNKI and Wanfang databases. The retrieval time was from the database establishment to May 5th, 2022. PRISMA (preferred reporting items for systematic reviews and Meta-analyses) was used to evaluate the report quality, and AMSTAR 2 (a measurement tool to assess systematic reviews 2) was used to evaluate the methodological quality, bubble map was used to construct the evidence map and GRADE was used to evaluate the quality of evidence.@*RESULTS@#A total of 9 systematic reviews were included. The PRISMA scores ranged from 13 to 26. The report quality was low, and there was a serious lack in the aspects of program and registration, search, other analysis and funding. The main problems in methodology included not making prespecified protocol, incomplete retrieval strategy, not providing a list of excluded literatures, and incomplete explanation on heterogeneity analysis and bias risk. The evidence map showed that 6 conclusions were valid, 2 conclusions were possible valid and 1 conclusion was uncertain valid. The overall quality of evidence was low, and the main factors leading to the downgrade were limitations, followed by inconsistency, imprecision and publication bias.@*CONCLUSION@#Acupuncture and moxibustion has a certain effect for CA, but the quality of reporting, methodology and evidence in included literature need to be improved. It is suggested to perform high-quality and standardized research in the future to provide evidence-based basis.

Biomarkers and inflammatory characteristics for microcosmic syndrome differentiation of cold-phlegm syndrome and heat-phlegm syndrome in patients with bronchial asthma / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the biomarkers and inflammatory characteristics for microcosmic syndrome differentiation of cold-phlegm syndrome (CPS) and heat-phlegm syndrome (HPS) in patients with bronchial asthma.</p><p><b>METHODS</b>Patients with bronchial asthma of chronic persistent condition were distributed into three groups according syndrome differentiation, the CPS group (27 patients), the HPS group (32 patients) and the non-cold/heat-phlegm syndrome group (NP group, 31 patients), besides, a control group was setup with 33 healthy persons. Percentages of neutrophils and eosinophils (NEU, EOS) in sputum sample (collected by induction) and peripheral blood were counted; and levels of interleukin-8, -5, and -4 (IL-8, IL-5 and IL-4), interferon-gamma (IFN-gamma), leukotriene B4 (LT-B4), eosinophil cationic protein (ECP), and C-reactive protein (CRP) in sputum supernatant and serum were determined by enzyme-linked immunosorbent assay.</p><p><b>RESULTS</b>Percentage of NEU in sputum of HPS group was higher than that in the other three groups (P < 0.05); while percentages of EOS in serum and sputum of CPS group were higher than that in the other three groups (all P < 0.01). Level of ECP (a parameter closely associated with EOS) also was high in the CPS group, but IL-8 (a parameter closely associated with NEU) showed no significant difference in various groups (P > 0.05). Moreover, the CPS group showed a higher serum IL-4 (P < 0.05) but a lower IFN-gamma/IL-4 level as compared with those in the NP group (P < 0.01).</p><p><b>CONCLUSION</b>Phlegm, which is considered by Chinese medicine as an inveterate root of asthma, might be closely related with the inflammation in modern medicine. The inflammatory characteristics of asthma in patients with CPS partially present as increase of EOS, possibly show Th2 dominant trend, similar to that presented in eosinophilic asthma. Asthma with HPS embodies increase of NEU in respiratory tract. EOS and ECP might be the important markers for microcosmic syndrome differentiation of CPS, and NEU might be that for HPS.</p>

Feature of airway inflammation in asthmatic rats complicated with chronic obstructive pulmonary disease and effect of Chinese herbs for reinforcing Shen and supplementing qi on it / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the airway inflammatory change in asthmatic rats complicated with chronic obstructive pulmonary disease (COPD) and to assess the intervention effects of Chinese herbs for reinforcing Shen and supplementing qi (CH) on it.</p><p><b>METHODS</b>Eighty-four Norway rats were randomized into 7 groups, the normal control group (A), the COPD model group (B), the asthma model group (C), the combined COPD and the asthma model group (D), and the three CH treated groups (E, F and G, combined model rats administered by low-, moderate- and high- dose CH, respectively), 12 rats in each group. Changes of symptoms, pathologic changes of the lung tissue, airway reactivity, and serum levels of interleukin-4, interleukin-6, interleukin-8 (IL-4, IL-6, and IL-8) and interferon-gamma (IFN-gamma) in rats were observed.</p><p><b>RESULTS</b>Symptoms were alleviated in the three CH treated groups. Similar pathological features were shown in group B and D, showing inflammatory cell, mainly lymphocyte, infiltration in bronchial and lung tissues, with cilia denudation, partial alveolar wall rupture, alveolar cavity expansion, and accompanied with evident eosinophilic infiltration. These inflammatory exudation in group E-G was alleviated, while in group C, it developed showing a trend similar to that in group D. Airway resistance raised along with the concentration of Mch used. In group D, the serum level of IL-4 was higher than that in group B, and level of INF-gamma was lower than that in group A, B and C (all P <0.05). CH showed a lowering effect on serum levels of IL-4 and -8, and a dose-dependent rising effect on IFN-gamma.</p><p><b>CONCLUSIONS</b>IL- 4 significantly increased and INF-gamma decreased in rat model of combined COPD and asthma, its mechanism is similar to that of Th1/Th2 imbalance in asthma. Chinese herbs for reinforcing Shen and supplementing qi could improve the symptoms and inhibit the airway inflammation in the combined COPD and asthma model rats, its mechanism might be related with the alleviation of TH1/TH2 imbalance.</p>

Determination of glycyrrhizic acid in different decoctions of sanaotang by HPLC and comparison with antifugal effects in vitro / 中国中药杂志

<p><b>OBJECTIVE</b>To investigate the contents of glycyrrhizic acid in hejian decoction (mixed the traditional Chinese herbs together, then boiling them with water) and the fenjian decoction (boiling the single traditional Chinese herb with water separately, then mixed the abstracts) of Sanaotang (composed of Ephedra sinica, Prunus armeniaca and Glycyrrhiza uralensis) and to compare with their anti-bacterial activities in vitro.</p><p><b>METHOD</b>A HPLC method was established with a Agilent Zorbax SB-C18 column (4. 6 mm x 250 mm, 5 microm), a mobile phase of acetonitrile-0.2% acetic acid solution (35:65), a flow rate of 1 mL x min(-1) and a detection wavelength of 254 nmn in order to determine the contents of glycyrrhizic acid minimal bacterial inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) antagonized the common bacteria in different decoctions were rieasured in vitro by employing dilution method.</p><p><b>RESULT</b>The average content of glycyrrhizic acid of the hejian decoction was higher than that of the fenjian decoction. The hejian decoction could display the inhibitory bactericidal activity to Aeruginosus bacillus, but the fenjian decoction could not. And to Staphylococcus aureus, the inhibitory bactericidal activity the hejian decoction was slightly stronger than that of the fenjian decoction.</p><p><b>CONCLUSION</b>Comparing with that of the fenjian decoction, the content of glycyrrhizic acid of the hejian decoction was higher and the anti-bacterial activities was stronger.</p>

Measurement of baicalin contents by HPLC / 中国中药杂志

<p><b>OBJECTIVE</b>To compare the contents of baicalin in the raw medical material and the different prepared medical materials of Scutellaria baicalensis.</p><p><b>METHOD</b>The contents of baicalin were determined by HPLC. Chromatographic conditions included Hypersil C18 column and the mobile phase consisting of a mixture of methanol-0.04% phosphoric acid (46:54). Baicalin was detected at 280 nm. The standard curve was linear in the range of 0.0280-4.6700 micrograms with correlation coefficient 1.0000. The average recovery of baicalin was 101.22% with RSD = 2.54% (n = 5).</p><p><b>RESULT</b>The contents of baicalin were 6.80% in raw material, 6.00% and 6.73% in the different prepared medical materials of S. baicalensis respectively.</p><p><b>CONCLUSION</b>The two different kinds of preparing methods can be used to the raw material of S. baicalensis.</p>