天枢超声中药透入治疗阿片类所致肝郁脾虚型便秘的临床观察（英文）

Objectives:To observe the clinical effect on opioid-induced constipation of liver stagnation and spleen deficiency treated with the ultrasonic penetration of the No.1 constipation herbal formula at Tiānshū(天枢 ST25).Methods:A total of 126 patients that were in compliance with the inclusion criteria were randomized into an acupoint group(41 cases),a Chinese medication group(42 cases) and a western medication group(43 cases).In the acupoint group,the ultrasonic penetration of the No.1 constipation herbal formula at bilateral Tiānshū(天枢 ST25) were given.In the Chinese herbal medication group,the No.1 constipation herbal formula was prescribed for oral administration.In the western medication group,polyethylene glycol electrolyte powder was prescribed for oral administration.The treatment was given once a day,for 14 days totally.Before and after treatment,the constipation symptom score,the score of the patient assessment of constipation quality of life(PAC-QOL),the situation of nitric oxide synthetase(NOS) in serum were observed in each group.The safety indicators in the observation included diarrhea,allergic reaction,liver dysfunction,skin lesions,etc.Results:A total of 122 cases accomplished the trial.The total effective rate was 82.5% in the acupoint group,80.48% in the Chinese medication group and 78.04% in the western medication group.The constipation symptoms were all relieved in the three groups,indicating the statistical significance as compared with those before treatment(P0.01,P 0.05).In the acupoint group and the western medication group,the improvements in the three symptom items,i.e.distention or scurrying pain in the chest,hypochondriac region or the bilateral sides of the abdomen,depression or irritability and poor appetite,were better than the western medication group(P0.01,P 0.05).The improvements in all of the symptoms in the acupoint group were better than the Chinese medication group(all P0.05).The PACQOL score was improved in each group after treatment and it was different significantly in statistics as compared with that before treatment in each group.After treatment,the improvement of PAC-QOL score in the acupoint group and the Chinese medication group was better than that in the western medication group(both P 0.05),and the improvement in the acupoint group was better than the Chinese medication group(P 0.05).As to serum NOS,after treatment,it was different significantly as compared with that before treatment in each group(all P 0.05),the improvement in the acupoint group was better than that of either the Chinese medication group or the western medication group,indicating the statistical significance(both P0.05).The incidence of adverse reaction in the acupoint group was less and different significantly as compared with the western medication group(P0.01),and it was different statistically as compared with the Chinese medication group(P0.05).Conclusion:The ultrasonic penetration of the No.l constipation herbal formula at Tiānshū(天枢 ST25) is effective on opioid-induced constipation of liver stagnation and spleen deficiency.This therapy achieves the significant therapeutic effect and presents the good compliance in treatment.Hence,it deserves to be further promoted in clinical application.     

ACUPUNCTURE RELIEVES PAIN IN REFLEX SYMPATHETIC DYSTROPHY:PITFALLS IN THE ANALYSIS OF RESULTS

Objective: Despite thousands of years of utilizing acupuncture for relief of pain, there is considerable controversy whether acupuncture deserves to be considered an efficacious modality along with medications and operations.Many publications claiming to answer this most important question have inspired more controversy regarding experimental design, designation of adequate controls and avoiding the dreaded placebo effect.Methods: We present a retrospective series of patients all of whom have severe chronic pain of the extremities with the unequivocal diagnosis of reflex sympathetic dystrophy.The patients were included if they had 15 treatments with acupuncture.The patients were treated in a single practice of acupuncture by two of the authors.There was no standardization of treatment given to each patient.The treatments were modified at each session.Objective date collected included the pain level on a 0 to 10 visual analogue scale and other functional data such as range of motion and daily activities.Results: At each treatment time, the acupuncture treatment significantly decreased the pain level from the value before the treatment to the pain level after the acupuncture treatment.Firsttreatment pre-treatment pain level: 7.43±2.15, post treatment 3.86±2.76(P0.0019).Over the course of the initial 15 treatments, the pre-treatment pain level did not significantly decline.Treatment number 15 had an average pain level of 6.5±1.51(P0.40).Conclusions: The treatment with acupuncture unequivocally caused a significant reduction in pain level on each treatment day; however, 15 treatments with acupuncture did not significantly produce a lasting effect.However, reviewing each individual charted data and analyzing the individual patient course gives a more accurate picture of the effect of acupuncture on patients with c omplex pain problems.     

Recent Advance in Studies on Angelica sinensis

Angelicae Sinensis Radix (ASR) is the root of Angelica sinensis which is a fragrant and perennial herb native to China, Japan, and Korea. In traditional Chinese medicine (TCM), the plant is useful for replenishing and invigorating blood, relieving pain, and moistening the intestines, resulting in its application for the treatment of menstrual disorders, and as an emollient and laxative for chronic constipation of the aged and debilitated. An in-depth review of the literature brings to light a great number of chemical constituents that have been isolated from ASR as well as both preclinical (in vivo and in vitro) and clinical studies, which over the years, have sought to investigate the medicinal relevance of some of these phytoconstituents and/or extract(s) prepared from ASR. The purpose of this review is therefore to present some major pharmacological and pharmacokinetic research findings on some selected phytoconstituents of ASR with emphasis on the current trends in terms of research techniques or design. This review would also provide a wealth of information for users/practitioners of TCM regarding the use of ASR or its products for maximum efficiency and minimal toxicity or side effects.     

CORRELATES OF SYMPTOM RESPONSE TO ACUPUNTURE:THE CASE OF GULF WAR SYNDROME

Background: Gulf War Illness(GWI), or chronic multisymptom illness(CMI), is a complex illness characterized by a diverse clinical presentation that may include fatigue, sleep and mood disturbances, cognitive dysfunction, and musculoskeletal pain.First defined by the Centers for Disease Control and Prevention(CDC) after the first Gulf War(Operation Desert Shield/Storm), it is commonly seen with a highly individualistic presentation, associated with clusters of symptoms and co-morbid medicaldiagnoses.Objective: Our study team recently completed a wait-list controlled RCT project, funded by the Department of Defense(W81 XWH) and with the aim of assessing the effectiveness of acupuncture in the treatment of GWI.Methods: GWI is a complex illness with multiple manifestations thus our treatment plan offered tailored individualized treatments to target the symptoms most important to the subjects(n=104).Our main outcome is the physical component subscale of the Sf-36, but we also included validated measurements to capture changes in specific GWI symptom(such as sleep problems) as well as the patient-centered form, the MYMOP.Measurements were conducted every 2 months for the 6 months of the study.Results: As reported previously, we found improvements at the end of the study that reached statistical and clinical significance; for the higher dose group, scores from time 1(mean score=68.5) to time 4(mean score=75.7) did improve with statistical significance P≤0.003(Student's t).A seven point improvement in this physical component of the Sf-36 was also clinically significant.Conclusion: This report focuses on the correlates and predictors of response, including: expectations for treatment, baseline symptom severity, confidence and satisfaction with treatment, presence of concomitant symptoms.Individualized acupuncture treatments may be an effective therapy for GWI, but as with other conditions, effect sizes may be influenced by subjects' baseline characteristics and constitution.     

Clinical Application of Shenque （CV 8） plus Eight Battle Points for Obesity

In order to observe the therapeutic effect of Eight Battle Points for simple obesity.MethodsIn the treatment of 98 cases of the patients with obesity by the oblique puncture of long needles into Eight Battle Points,the body weight,body weight index (BWI),waist circumference,buttock circumference and fat distribution rate of the patients were measured and assessed respectively before and after the treatments.And the changes of complications of obesity were observed before and after the treatments.ResultsThere were significant differences (P＜0.05) in various indexes of obesity before and after acupuncture treatment.ConclusionAcupuncture by puncturing Shenque(CV 8) plus Eight Battle Points is positive in the treatment of obesity and has a better therapeutic effect for complications of obesity.     

EVALUATION ON THE THERAPEUTIC EFFECT OF DEEP PUNCTURE OF TIANSHU (ST 25) FOR SLOW TRANSIT CONSTIPATION

Slowtransit constipation(STC),also called as“colonic inertia”,is thought to have a pri mary defectslower than normal movement of contents fromtheproxi mal to the distal colon and rectum.It belongs todysfunctional constipation and is mainly manifestedbylumpy or hard stools and decrease in the desire ofdefecation,someti mes,with concurrent abdominalpain and discomfort,etc.It constitutes about15%ofthe constipation patients[1]andis arefractory disease.The therapeutic effects of current remedies…     

Complementary and alternative medicine in European countries legislative framework

Complementary and alternative medicine(CAM)is a set of different diagnostic and therapeutic procedures,as well as the use of natural products for the treatment of patients,derived from previously known traditional methods and enriched with modern scientific knowledge.The present article reviews the available data regarding the use of CAM and the legislation behind it in European countries.The use of CAM is recorded in Europe as a whole and varies between 1070%of the population of individual European countries.At least 300,000 registered CAM providers have been identified in the European Union(EU),of which slightly more than half includes non-medical practitioners.The most practiced discipline is acupuncture,followed by homeopathy.CAM regulation and legislation in Europe is not precisely defined and is constantly striving to find a common approach.Since legal frameworks for CAM are not defined,each European country has its own regulations and legislation.In order to define universal legislation for CAM,the EU created the CAMbrella project,a project of the EU designed to find a unique system that would include the treatment of CAM in Europe.According to the data from CAMbrella,from 39 countries in the EU,17 have general CAM legislations.The status of CAM in Europe is characterized by enormous heterogeneity in all aspects,including terminology,methods,prevalence and ultimately,legal status,regulations and legislation.     

Introduction to Mr. ZHANG Ren＇s Experience in Treating Eye Diseases by Extraordinary Acupoints

Mr. ZHANG Ren is an expert at clinical practice and an accomplished scholar in Chinese medical theory, and has a set of unique experience in the treatment of eye diseases by acupuncture. In clinical practice, he particularly focuses on the new acupoints, extraordinary acupoints as well as the arrival of Deqi.     

Meta‑analysis of Clinical Efficacy of Traditional Chinese Medicine in the Treatment of Aplastic Anemia

Background: The “Diagnosis and Treatment Guidelines for Chinese Medicine Internal Common Diseases” issued by the Chinese Institute of traditional Chinese medicine (TCM) offers many methods for the treatment of aplastic anemia (AA). However, there is a lack of corresponding evidence. Objective: The study aimed to evaluate the clinical efficacy of TCM in the treatment of AA, and provide evidence for the development of guidelines for the diagnosis and treatment of AA using TCM. Methods: Data of randomized or semi?randomized control trials of AA treatments with TCM were retrieved, and the selected literature was scored using the Jadad scale. The data were extracted, and RevMan 5.2.6 software was used for the meta?analysis. Results: Two studies on the treatment of AA using Liuwei Dihuang pills combined with compound Zaofan pill were included. The results of the meta?analysis showed that there were no statistically significant differences in the efficacy between Liuwei Dihuang pills combined with compound Zaofan pill and androgen in the treatment of AA (P = 0.65). However, there were less adverse reactions, including liver damage and the hirsutism of women, with the former than the latter (P < 0.05). Other studies on the treatment of AA with TCM did not include reports from clinical trials. Conclusion: TCM had a certain curative effect when used to treat AA. However, the quality of the literature is generally low, and the sample size is small, which makes the validation of the results poor. Further high?quality studies are needed to provide high?level evidence.     

The Clinical Experiences of Dr. CAI Gan in Treating Chronic Constipation

Prof. CAI Gan （蔡淦） is an academic leader in TCM treatment of the spleen and stomach disease. He insisted that liver depression, spleen deficiency and poor nourishment of the intestines are the core of pathogenesis for chronic constipation. Therefore he often treats the disease by strengthening the spleen, relieving the depressed liver, nourishing yin and moistening the intestines. Meanwhile he attaches great importance to syndrome differentiation and comprehensive regulation good therapeutic effects and treatment. As a result, are often achieved. The authors summarized his ways for treating chronic constipation with the following 10 methods, which are introduced below.     

Oplopanax elatus（Nakai） Nakai： chemistry,traditional use and pharmacology

Oplopanax elatus（Nakai） Nakai, a member of the ancient angiosperm plant family Araliaceae, is used for the treatment of different disorders in the medicine systems of China, Russia, and Korea, and was designated in Russia as a classical adaptogen. Despite extensive studies of classical adaptogens, there are comparatively few reports concerning the chemical composition and pharmacological effects of O. elatus in English. The plant is a potential source of saponins, flavonoids, anthraquinones, terpenes, and other active compounds. Experimental studies and clinical applications have indicated that O. elatus possesses a number of pharmacological activities, including adaptogenic, anti-convulsant, anti-diabetic, anti-fungal, anti-inflammatory, anti-oxidant, blood pressure modulating, and reproductive function effects. In this review, the chemistry, safety, and therapeutic potential of O. elatus are summarized and highlighted to encourage the further development of this plant.     

Antidepressant-like effect of essential oil of Perilla frutescens in a chronic,unpredictable, mild stress-induced depression model mice

Perilla frutescens（Perilla leaf）, a garnishing vegetable in East Asian countries, as well as a plant-based medicine, has been used for centuries to treat various conditions, including depression. Several studies have demonstrated that the essential oil of P. frutescens（EOPF） attenuated the depressive-like behavior in mice. The present study was designed to test the anti-depressant effects of EOPF and the possible mechanisms in an chronic, unpredictable, mild stress（CUMS）-induced mouse model. With the exposure to stressor once daily for five consecutive weeks, EOPF（3, 6, and 9 mg·kg-1） and a positive control drug fluoxetine（20 mg·kg-1） were administered through gastric intubation to mice once daily for three consecutive weeks from the 3rd week. Open-field test, sucrose consumption test, tail suspension test（TST）, and forced swimming test（FST） were used to evaluate the behavioral activity. The contents of 5-hydroxytryptamine（5-HT） and its metabolite, 5-hydroxyindoleacetic acid（5-HIAA）, in mouse hippocampus were determined by HPLC–ECD. Serum interleukin（IL）-1, IL-6, and tumor necrosis factor（TNF）-α levels were evaluated by enzyme-linked immunosorbent assay（ELISA）. The results showed that CUMS significantly decreased the levels of 5-HT and 5-HIAA in the hippocampus, with an increase in plasma IL-6, IL-1β, and TNF-α levels. CUMS also reduced open-field activity, sucrose consumption, as well as increased immobility duration in FST and TST. EOPF administration could effectively reverse the alterations in the concentrations of 5-HT and 5-HIAA; reduce the IL-6, IL-1β, and TNF-α levels. Moreover, EOPF could effectively reverse alterations in immobility duration, sucrose consumption, and open-field activity. However, the effect was not dose-dependent. In conclusion, EOPF administration exhibited significant antidepressant-like effects in mice with CUMS-induced depression. The antidepressant activity of EOPF might be related to the relation between alteration of seroto     

Effect of Zhuyeshigao granule on tumor necrosis factor-a and inter- leukins serum protein levels in rats with radiation esophagitis

OBJECTIVE： To investigate the effects of Zhuyesh- igao granule （ZSG） on tumor necrosis factor-a （TNF-a）, interleukin-1 （IL-1）, IL-2, IL-6, and IL-8 in rats with radiation esophagitis. METHODS： Fifty Wistar rats were randomly divid- ed into five groups （10 rats in each group）： con- trol （without radiation）, saline-treated, and low, medium, and high-dose ISG-treated groups. Rats were given normal saline （10 mL/kg） or 1.15, 2.3, or 4.6 g/kg ZSG by intragastric administration once a day for 7 days. A rat model of radiation esophagi- tis was established by local irradiation of Co60 （490.25 cGy/min, totaling 30 Gy）. The administra- tion of ZSG was continued for another 7 days and on the 7th day post-irradiation, inferior vena cavablood was collected. The serum was separated, and TNF-a, IL-1, IL-2, 11_-6, and IL-8 protein levels were determined. RESULTS： Inflammatory response factors were found in the serum of each group. However, levels in ZSG-treated groups were significantly lower than in the saline-treated group （P〈0.05）. CONCLUSION： ZSG may prevent the development of radiation esophagitis, perhaps by inhibiting the generation and release of the inflammatory re- sponse factors TNF-a, IL-1, IL-2, IL-6, and IL-8.     

叶景华运用滋肾通关丸治疗泌尿系统疾病经验

介绍叶景华运用滋肾通关丸治疗泌尿系统疾病的经验，并附验案5则。     

中药膏方治疗疑难杂症验案4则

所谓膏方又称膏滋方，具有治病纠偏，滋补强身等多种作用。时下在江南一带时兴冬令以膏方进补，实际上是中药传统剂型的丸、散、膏、丹、汤、酒、露、锭八种剂型之一。由于服用方便、疗效显著，在一年四季均可服用，尤其是针对一些需长期服药的慢性病或疑难顽症，更适合以膏方来调治。现代家庭多具备冰箱冷藏的条件，这为膏剂的收藏提供了方便。因此，更可以提倡以膏方剂型来治疗诸多慢性疾病。笔者常不拘季节以膏方为主，根据辨证施治原则来治疗某些疑难病症，现撷取4则医案，以飨读者，不当之处，请多赐教为盼。     

Efficacy of Saam acupuncture treatment on improvement of immune cell numbers in cancer patients： a pilot study

OBJECTIVE： To collect preliminary data on the effects of Saam acupuncture with regard to the immunity in cancer patients.METHODS： Ten cancer patients were analyzed for improvements in immunity. Acupuncture was applied at the 5 acupuncture points, Jingqu（LU 8）, Zutonggu（BL 66）, Yanggu（SI 5）, Yangchi（TE 4）, and Zhongwan（CV 12） for 2 weeks with 4 sessions. We assessed the effect of Korean Saam acupuncture on the immune system in cancer patients by measuring particular blood cell subsets, including CD3 ＋,CD4＋, CD8＋, CD19＋, and CD56＋ cells, as well as total white blood cell count, absolute neutrophil count, and fatigue score. The measurement was performed before and after acupuncture and at a 2-week follow-up.RESULTS： There was a statistically significant increase in the number of CD3＋（P=0.023） and CD8＋ cells（P〈0.001） and T-cell subsets, as well as a decrease in the fatigue severity scale（FSS） score（P=0.001） after Saam acupuncture using the 5 acupoints.CONCLUSION： Acupuncture may improve the immune system by increasing the counts of a few immune cells and relieve fatigue in cancer patients by decreasing FSS scores. Although this was a non-controlled study, it constitutes preliminary research investigating the potential effects of Saam acupuncture in increasing the counts of several immune cells in cancer patients.     

Polysaccharides from Tricholoma matsutake and Lentinus edodes enhance 5-fluorouracil-mediated H22 cell growth inhibition

OBJECTIVE： Few studies have investigated the ef- fects produced by combinations of polysaccharides and chemotherapeutic drugs in cancer treatment. We hypothesized that a combination of polysaccha- rides （COP） from Lentinus edodes and Tricholoma matsutake would improve the efficacy of 5-fluoro- uracil （5-FU）-mediated inhibition of H22 cell growth. METHODS： Mice were injected H22 cells and then treated with either 5-FU, polysaccharides from Tri- choloma matsutake （PTM）, polysaccharides from Lentinus edodes （PL）, PTM ＋ PL, 5-FU ＋ PTM, 5-FU ＋ PL, or 5-FU ＋ COR The tumor weight and volume, and splenic CD4 ＋ and CD8 ＋ T cell frequencies, were determined. Additionally, splenic natural killer （NK） cell and cytotoxic T lymphocyte （CTL） activities were assessed and the serum levels of tumor necro- sis factor-a （TNF-a）, Interleukin-2 （IL-2）, and Interfer- on-y （IFN-y） were measured. RESULTS： Compared with mice from the control,5-FU, PL, PTM, PTM ＋ PL, 5-FU ＋ PL, and 5-FU ＋ PTM groups, mice treated with 5-FU ＋ COP showed： （a） significantly reduced tumor weight and volume （P〈 0.05）, （b） significantly higher serum levels of TNF-α, IL-2, and IFN-y （P〈0.05）, （c） significantly increased CD4＋ and CD8＋ 1 cell frequencies in the spleen （P〈 0.05）, and （d） significantly increased splenic NK cell and CTL activities （P〈0.05）. The tumor weight and volume in mice treated with 5-FU＋PL or 5-FU＋PTM were significantly reduced compared with mice treated with 5-FU alone （P〈0.05）. Serum levels of TNF-α, 11.-2, and IFN-y, frequencies of CD4 ＋ and CD8＋ T cells in the spleen, and splenic NK and CTL activities were also significantly increased in mice treated with 5-FU＋PL or 5-FU＋PTM compared with mice treated with 5-FU alone （P〈0.05）. CONCLUSION： Polysaccharides from Lentinus edodes and Tricholoma matsutake could enhance the efficacy of 5-FU-mediated H22 cell growth inhi- bition.     

Roles of Chinese medicine bioactive ingredients in the regulation of cellular function of endothelial progenitor cells

To improve the function of endothelial progenitor cells （EPCs） is one of the goals in Chinese traditional therapy to treat various cardio-celebrovascular diseases. In the past decades, scholars in the field of traditional Chinese medicine （TCM） have found fifteen active compounds to regulate the function of EPC. These metabolites are extracted from thirteen, plant-based Chinese medicine, with majority of them as potent reductive or oxidative hydrophilic molecules containing phenyl groups. These active compounds either enhance the mobilization of EPC, or inhibit their apoptosis through different signaling pathways. In this review, the molecular structure, biophysical properties, and the plant sources of these active ingredients and their regulatory effects on the function of EPC are summarized, aiming to reveal the modem basis of Chinese medicine for promoting blood circulation and removing blood stasis at the progenitor cell level.     

刘公望运用经方治疗放化疗不良反应验案2则

恶性肿瘤的致死率甚高，源自上皮组织者称为癌，源自间叶非上皮组织者称为肉瘤，二者均病情凶险，预后恶劣。目前肿瘤的治疗有外科手术治疗、放射治疗及化学治疗。在放化疗过程中往往发生毒副作用，导致患者的抵抗力下降，严重时可影响治疗的继续进行。刘公望教授巧用经方治疗放化疗后引起的毒副反应，收效良好。现举医案2则，以飨读者。     

Effect of pulsatile perfusion during cardiopulmonary bypass in terms of radial artery sphygmogram

OBJECTIVE： To investigate a quantitative method for using radial artery pulse waveforms to assess the effect of pulsatile flow during cardiopulmonary bypass（CPB）.METHODS： A total of 34 adults with heart disease who underwent open-heart surgery between April2010 and January 2011 were randomized into a pulsatile perfusion group（n=17） and a non-pulsatile perfusion group（n=17）. Radial arterial pulse waveforms of pulsatile and non-pulsatile perfusion patients were observed and compared before and during CPB.RESULTS： No pulse waveform could be detected at patients＇ radial artery in both groups when the aorta was cross-clamped. Pulse waveforms could be detected at pulsatile perfusion patients＇ radial artery, but could not be detected at non-pulsatile perfusion patients＇ radial artery during CPB. Additionally, patients＇ pulse waveforms during pulsatile perfusion were lower than those before the operation.CONCLUSION： Our findings indicate that radial artery sphygmogram can be used as a valid indicator to evaluate the effectiveness of pulsatile perfusion during CPB.