RESUMO
OBJECTIVE: To evaluate the efficacy and safety of oral traditional Chinese medicine combined with conventional anti-osteoporosis drugs in the treatment of osteoporosis and fractures. METHODS: The database of China national knowledge infrastructure, China Science and Technology Journal Database, Wangfang (WANGFANG DATA), ChineseBioMedicalLiteratureDatabase, PubMed, Embase, and Cochrane Library databases were searched from inception to June 1st, 2023 for randomized controlled trials on oral Chinese medicine combined with conventional anti-osteoporosis drugs for the treatment of osteoporosis and fractures. Quality assessment was performed using the Cochrane Handbook for Systematic Reviews of Interventions version 5.1.0. STATA 15.0 software was used for meta-analysis. Outcome measures included overall response rate, adverse events, T-score, bone mineral density, Oswestry Disability Index score, fracture healing time, and visual analog scale score. RESULTS: A total of 72 studies were included, involving 7847 participants. Different treatment options showed different advantages in the adjuvant treatment of osteoporosis and fractures. The total response rate, complication reduction, Oswestry Disability Index and visual analog scale score reduction, bone mineral density improvement and fracture healing time were all superior to drug therapy alone. The differences were statistically significant, but the improvement in T-score was not significant. CONCLUSION: The combination of oral traditional Chinese medicine and conventional anti-osteoporosis drugs is more effective and safer than Western medicine alone in the treatment of osteoporosis and fractures, which indicated that the treatment of integrated Chinese and western medicine can promote the healing of osteoporosis and fracture. This approach had a promising clinical application prospect. Due to the limitations of included studies, the ranking results should be interpreted with caution. In the next step, we will further conduct subgroup data based on factors, such as conventional Western medicine treatment regimens, whether surgical treatment was performed, fracture locations.
Assuntos
Medicamentos de Ervas Chinesas , Fraturas Ósseas , Osteoporose , Humanos , Medicina Tradicional Chinesa/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Revisões Sistemáticas como Assunto , Osteoporose/complicações , Osteoporose/tratamento farmacológico , Fraturas Ósseas/tratamento farmacológico , Medicamentos de Ervas Chinesas/efeitos adversosRESUMO
Hemolytic triterpenoid saponins, as one of the index components of Lonicerae Flos (LF), are also the main components causing hemolytic risk of LF. In order to evaluate the quality and hemolytic risk of LF crude drugs and preparations, it was a key to establish a method for quantitative analysis of hemolytic triterpenoid saponins in LF. Here, a rapid method for quantitative determining hemolytic triterpenoid saponins had been developed via paper spray mass spectrometry (PS-MS), taking macranthoidin B (MaB), macranthoidin A (MaA) and dipsacoside B (DiB) as three target model compounds, and asperosaponin VI (ASA VI, a structural analogue) was used as internal standard. The sample solution was directly loaded and separated on chromatographic paper, sprayed and ionized by a high positive voltage, and ultimately analyzed by mass spectrometry. All analytes were detected with good linearity, precision, repeatability and accuracy. Compared with traditional high performance liquid chromatography with diode array detection (HPLC-DAD) method, PS-MS method had no significant difference in the semi-quantitative analysis of the actual samples, adding the advantages of shorter analysis time, lower reagent consumption and no-need chromatography separation process. This work provides a new strategy for fast determining hemolytic triterpenoid saponins in LF crude drugs and preparations.
Assuntos
Saponinas , Cromatografia Líquida de Alta Pressão , Lonicera , Espectrometria de Massas , Extratos VegetaisRESUMO
Repeated and intensive gait training can improve muscle strength and movement coordination of patients with neurological or orthopedic impairments. However, conventional physical therapy by a physiotherapist is laborious and expensive. Therefore, this therapy is not accessible for the majority of patients. This paper presents a six-bar linkage mechanism for human gait rehabilitation with a natural ankle trajectory. Firstly, a six-bar linkage mechanism is selected as the original mechanism to construct a gait rehabilitation device. Then the ankle trajectory is formulated as a function of the crank angle. And the rotation angle of the crank is set as a linear function of time. Therefore, constant speed motor is sufficient to control the mechanism. For the dimensional synthesis, the precise point distances of the gait trajectory and the coupler curve are set as objective functions, with the kinematic constraints including in the optimization procedure. To obtain the optimal structure design parameters, a cooperative dual particle swarm optimization algorithm is developed. The results show that the coupler curve matches well with the gait trajectory. The average distance between the 60 precision points is 3.5 mm.