ABSTRACT
Introduction. Intradialytic hypotension (IDH) is a common complication during hemodialysis which may increase mortality risks. Low dose of Korean red ginseng (KRG) has been reported to increase blood pressure. Whether KRG can improve hemodynamic stability during hemodialysis has not been examined. Methods. The 8-week study consisted of two phases: observation phase and active treatment phase. According to prehemodialysis blood pressure (BP), 38 patients with IDH were divided into group A (BP ≥ 140/90 mmHg, n = 18) and group B (BP < 140/90 mmHg, n = 20). Patients were instructed to chew 3.5 gm KRG slices at each hemodialysis session during the 4-week treatment phase. Blood pressure changes, number of sessions disturbed by symptomatic IDH, plasma levels of vasoconstrictors, blood biochemistry, and adverse effects were recorded. Results. KRG significantly reduced the degree of blood pressure drop during hemodialysis (P < 0.05) and the frequency of symptomatic IDH (P < 0.05). More activation of vasoconstrictors (endothelin-1 and angiotensin II) during hemodialysis was found. The postdialytic levels of endothelin-1 and angiotensin II increased significantly (P < 0.01). Conclusion. Chewing KRG renders IDH patients better resistance to acute BP reduction during hemodialysis via activation of vasoconstrictors. Our results suggest that KRG could be an adjuvant treatment for IDH.
ABSTRACT
BACKGROUND: Perennial allergic rhinitis (AR) is a common health problem with a high prevalence rate of 43.6% in Taiwan. In our previous study, a mixed formula of Chinese herbs consisted of Xin-yi-san, Xiao-ging-long-tang, and Xiang-sha-liu-jun-zi-tang, exerted diverse immunomodulatory effects in the treatment of patients with perennial allergic rhinitis. OBJECTIVE: The aim of the present study was to determine whether Xin-yi-san (XYS) alone is effective in the treatment of AR and tried to explore its molecular mechanism of anti-allergic activity. METHODS: In a randomized double-blind study, 108 patients with AR received either XYS or a placebo for 3 months. The effectiveness of XYS was evaluated by nasal symptoms, nasal airflow resistance, nostril dissection area, and serum titer of specific IgE antibodies against house dust mite allergens. In addition, the production of T helper (Th) 1 (represented by interferon-gamma) and Th2 [represented by interleukin (IL)-4, IL-10, and IL-13] cytokines, the proinflammatory cytokine IL-8, soluble intercellular adhesion molecule (sICAM), and arachidonate metabolites prostagladin E(2) (PGE(2)) and leukotriene C(4) (LTC(4)) by polymorphonuclear neutrophils (PMNs) were compared before and after treatment between the two groups. RESULTS: XYS attenuated nasal symptoms (sneezing and rhinorrhea) and nasal congestion through reduction of nasal airflow resistance and increase in nostril dissection areas. We also found that XYS exerted diverse immunomodulatory effects, including suppression of serum IgE levels and increased production of IL-10, sICAM-1, and IL-8 compared to placebo group. However, XYS treatment did not affect the release of PGE(2) and LTC(4) from PMNs. CONCLUSIONS: This study originally provides the evidence that Xin-yi-san alone is an effective herb in the treatment of perennial allergic rhinitis.
