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

ObjectivesTo 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).MethodsA 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.ResultsA 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 (P < 0.01, 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 (P < 0.01, P < 0.05). The improvements in all of the symptoms in the acupoint group were better than the Chinese medication group (all P < 0.05). The PAC-QOL 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 P < 0.05). The incidence of adverse reaction in the acupoint group was less and different significantly as compared with the western medication group (P < 0.01), and it was different statistically as compared with the Chinese medication group (P < 0.05).ConclusionThe ultrasonic penetration of the No.1 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.     

Electro-acupuncture promotes gut motility and alleviates functional constipation by regulating gut microbiota and increasing butyric acid generation in mice

ObjectiveAbnormalities in the gut microbiota and intestinal short-chain fatty acid (SCFA) levels are implicated in the pathogenesis of functional constipation (FC). Electro-acupuncture (EA) has been shown to improve constipation-related symptoms and rebalance the gut microbiota. However, it is currently unknown whether the gut microbiota is a key mechanistic target for EA or how EA promotes gut motility by regulating the gut microbiota and SCFAs. Therefore, we assessed the effects of EA in FC mice and pseudo-germfree (PGF) mice to address these questions.MethodsForty female Kunming mice were randomly separated into a normal control group (n = 8), an FC group (n = 8), an FC + EA group (n = 8), a PGF group (n = 8) and a PGF + EA group (n = 8). The FC group and FC + EA group were treated with diphenoxylate to establish the FC model; the PGF group and PGF + EA group were given an antibiotic cocktail to initiate the PGF model. After maintaining the model for 14 d, mice in the FC + EA and PGF + EA groups received EA stimulation at the ST25 and ST37 acupoints, once a day, 5 times per week, for 2 weeks. Fecal parameters and intestinal transit rate were calculated to assess the efficacy of EA on constipation and gastrointestinal motility. Colonic contents were used to quantify gut microbial diversity using 16S rRNA sequencing, and measure SCFA concentrations using gas chromatography-mass spectrometry.ResultsEA significantly shortened the first black stool defecation time (P < 0.05) and increased the intestinal transit rate (P < 0.01), and fecal pellet number (P < 0.05), wet weight (P < 0.05) and water content (P < 0.01) over 8 h, compared with the FC group, showing that EA promoted gut motility and alleviated constipation. However, EA treatment did not reverse slow-transit colonic motility in PGF mice (P > 0.05), demonstrating that the gut microbiota may play a mechanistic role in the EA treatment of constipation. In addition, EA treatment restored the Firmicutes to Bacteroidetes ratio and significantly increased butyric acid generation in FC mice (P < 0.05), most likely due to the upregulation of Staphylococcaceae microorganisms (P < 0.01).ConclusionEA-mediated resolution of constipation occurs through rebalancing the gut microbiota and promoting butyric acid generation.Please cite this article as: Xu MM, Guo Y, Chen Y, Zhang W, Wang L, Li Y. Electro-acupuncture promotes gut motility and alleviates functional constipation by regulating gut microbiota and increasing butyric acid generation in mice. J Integr Med. 2023; Epub ahead of print.     

Herbal medicine use in Republic of Korea to alleviate side effects of COVID-19 vaccines: A cross-sectional study

ObjectiveCoronavirus disease 2019 (COVID-19) has spread worldwide, and several virus variants have emerged. Vaccines are administered to help prevent the infection. In Republic of Korea, most people take herbal medicine. This study investigated the use of herbal medicine to counter the side effects of COVID-19 vaccines.MethodsThis cross-sectional study was conducted using an online survey. Chi-square tests were used to determine differences in the use of herbal medication according to sociodemographic characteristics. Independent two-sample and paired t-tests were performed to examine the effect and satisfaction of herbal medicine use for countering the side effects of COVID-19 vaccines. One-way analysis of variance was used to determine vaccine-related differences.ResultsA total of 233 and 181 participants received the first and second doses of COVID-19 vaccines, respectively. The majority of herbal medicine users were in their thirties, had a bachelor’s degree, suffered from side effects of vaccination, and received Vaxzevria for their first COVID-19 vaccine dose and Comirnaty for their second dose. The herbal medicine group had a higher satisfaction level of post-vaccination side effects than the non-herbal medicine group (P < 0.0001). The numeric rating scale scores for vaccination side effects were lower among participants who took herbal medication to alleviate those symptoms (P < 0.0001). The most commonly used herbal formula was Shuanghetang.ConclusionA third of participants receiving COVID-19 vaccines used herbal medication to counter the side effects of vaccination. The use of herbal medicine was associated with age, education level, vaccine brand, and whether side effects of vaccination occurred. Herbal medication use was associated with greater satisfaction compared to vaccine recipients not using herbal medication.Please cite this article as: Yoon HC. Herbal medicine use in Republic of Korea to alleviate side effects of COVID-19 vaccines: A cross-sectional study. J Integr Med. 2023; 21(4):361–368.     

Lavender and dodder combined herbal syrup versus citalopram in major depressive disorder with anxious distress: A double-blind randomized trial

BackgroundMajor depressive disorder (MDD) accompanied by anxious distress is a chronic and disabling disorder. Its conventional drug therapies often have low patient compliance due to drug-related side effects. In Persian medicine, lavender-dodder syrup is one formula often recommended for such disorders.ObjectiveThis study compares the effects of lavender-dodder syrup to the standard drug, citalopram, for treating MDD with anxious distress.Design, setting, participants and interventionThis six-week, double-blind, randomized, clinical trial was carried out in a psychiatric outpatient clinic. During the six-week intervention period, patients in citalopram group received citalopram tablets 20 mg/d plus 5 mL placebo syrup every 12 h; patients in group B received placebo tablets once daily plus 5 mL of lavender-dodder herbal syrup every 12 h.Main outcome measuresPrimary outcome measures, depression and anxiety, were evaluated using the Hamilton Depression/Anxiety Rating Scales, and were scored at the beginning of the study and at weeks three and six. Secondary outcome measures including response to treatment and remission rates were also compared between the two groups.ResultsFifty-six participants with MDD and anxious distress were randomly assigned to two groups. Mean depression scores significantly decreased in citalopram and herbal groups at weeks three and six (time effect: P < 0.001), although the observed changes were not significantly different between the groups (intervention effect: P = 0.61). Mean anxiety scores were not significantly different between the two groups at week three (P = 0.75). However, at the end of week six, the observed decrease was significantly higher in the herbal syrup group than the citalopram group (intervention effect: P = 0.007).ConclusionThe herbal syrup is an effective and tolerable supplement for treating MDD with anxious distress.Trial registration number: IRCT2016102430459N1 on Iranian Registry of Clinical Trials.     

麻仁软胶囊治疗脑卒中后便秘临床观察

目的观察麻仁软胶囊治疗脑卒中后便秘患者临床疗效。方法将104位脑卒中后便秘患者随机分成治疗组和对照组(n=52),治疗组给予麻仁软胶囊治疗,对照组给予麻仁丸治疗,治疗14 d为1个疗程;比较治疗前后两组患者排便次数及大便性状评分情况。结果治疗2周后,治疗组排便次数明显较对照组增多,大便性状评分较对照组升高,差异均显著(P0.05)。对照组总有效率为69.23%,治疗组总有效率为96.15%,两组比较差异极显著(P0.001)。两组患者治疗过程中均无严重不良反应。结论麻仁软胶囊可以有效缓解脑卒中患者便秘问题,改善生活质量。     

聚乙二醇4000治疗急性心肌梗死支架术后患者便秘的疗效分析

目的评价聚乙二醇4000治疗急性心肌梗死行冠状动脉内支架植入术后患者便秘的疗效。方法 65例冠状动脉内支架植入术后便秘患者随机分为试验组和对照组,分别接受聚乙二醇4000（10g,每日2次）和乳果糖（15mL,每日2次）治疗,疗程3周。观察排便次数和大便性状的变化。结果治疗2周后试验组和对照组的总有效率分别为74.5%、64.7%（P〈0.05）;治疗3周后总有效率分别为91.2%和76.8%,组间比较有统计学意义（P〈0.01）。3周治疗结束后患者大便Bristol分型平均计分为,试验组（4.13±0.41）分,对照组（3.61±0.21）分（P〈0.05）;治疗2周后,试验组大便性状恢复正常者达到62.1%,对照组为44.8%（P〈0.01）,治疗3周后,试验组大便性状恢复正常者达到72.4%,对照组为55.2%（P〈0.01）。两组不良反应的发生率分别为12.9%和21.2%（P〈0.05）,均无严重不良反应发生。结论聚乙二醇4000是治疗冠状动脉内支架植入术后患者便秘的有效、安全药物。     

A comparative study of Salvia miltiorrhiza Radix & Rhizoma raw material and granule products using chromatographic analysis and antioxidant activity

ObjectiveGranules of herbal extracts are a popular medicinal preparation consumed in traditional Chinese medicine clinical practice. However, their quality and efficacy evaluation are lacking. This study aimed to compare the quality and anti-oxidant activity of Dan Shen (Salvia miltiorrhiza Radix & Rhizoma) granule extracts with their herbal extracts.MethodsChromatographic method was used to determine the content of 7 marker compounds in the water extracts of the herb compared to that of 12 granule extracts. Agglomerative hierarchical clustering (AHC) and principal component analysis (PCA) distinguished the herbal and granule extracts based on the content of the marker compounds. The antioxidant activities of herbal and granule extracts were evaluated by 2, 2′-azino-bis (3-ethylbenz-thiazoline-6-sulfonic acid) (ABTS), organic chemical compound 2,2-diphenyl-1-picrylhydrazyl (DPPH) and ferric ion reducing antioxidant power (FRAP) assays.ResultsThe herbal extracts group showed significantly higher contents of salvianolic acid B, sodium danshensu and cryptotanshinone compared with that of the granule group. This corresponded to significantly higher ABTS, DPPH and FRAP (P < .05) activities of the herbal extracts. The AHC and PCA analysis distinguished granule extracts from most herbal extracts predominantly by the content of salvianolic acid B.ConclusionThe results confirm the need for the assessment of granule products so that healthcare practitioners and consumers are better informed of their quality and efficacy.     

Chinese herbal medicine for COVID-19: Current evidence with systematic review and meta-analysis

BackgroundThere is currently no drug or therapy that cures COVID-19, a highly contagious and life-threatening disease.ObjectiveThis systematic review and meta-analysis summarized contemporary studies that report the use of Chinese herbal medicine (CHM) to treat COVID-19.Search strategySix electronic databases (PubMed/MEDLINE, Cochrane Library, ScienceDirect, Google Scholar, Wanfang Data and China National Knowledge Infrastructure) were searched from their beginning to May 15, 2020 with the following search terms: traditional Chinese medicine, Chinese medicine, Chinese herbal medicine, COVID-19, new coronavirus pneumonia, SARS-CoV-2, and randomized controlled trial.Inclusion criteriaRandomized controlled trials (RCTs) from peer-reviewed journals and non-reviewed publications were included. Further, included RCTs had a control group that was given standard care (SC; such as conventional Western medicine treatments or routine medical care), and a treatment group that was given SC plus CHM.Data extraction and analysisTwo evaluators screened and collected literature independently; information on participants, study design, interventions, follow-up and adverse events were extracted, and risk of bias was assessed. The primary outcomes included scores that represented changes in symptoms and signs over the course of treatment. Secondary outcomes included the level of inflammatory markers, improvement of pneumonia confirmed by computed tomography (CT), and adverse events. Dichotomous data were expressed as risk ratio or hazard ratio with 95% confidence interval (CI); where time-to-event analysis was used, outcomes were expressed as odds ratio with 95% CI. Continuous data were expressed as difference in means (MD) with 95% CI, and standardized mean difference (SMD) was used when different outcome scales were pooled.ResultsSeven original studies, comprising a total of 732 adults, were included in this meta-analysis. Compared to SC alone, CHM plus SC had a superior effect on the change of symptom and sign score (−1.30 by SMD, 95% CI [−2.43, −0.16]; 3 studies; n = 261, P = 0.03), on inflammatory marker C-reactive protein (CRP, mg/L; −11.82 by MD, 95% CI [−17.95, −5.69]; 5 studies; n = 325, P = 0.0002), on number of patients with improved lung CT scans (1.34 by risk ratio, 95% CI [1.19, 1.51]; 4 studies; n = 489, P < 0.00001). No significant adverse events were recorded in the included RCTs.ConclusionCurrent evidence shows that CHM, as an adjunct treatment with standard care, helps to improve treatment outcomes in COVID-19 cases.     

中药砭石热熨治疗帕金森病气虚便秘的疗效观察＊

目的 观察中药砭石热熨治疗帕金森病气虚秘患者的临床疗效。方法 将90例帕金森病气虚便秘患者随机分为中药砭石热熨组，砭石热熨组和对照组，每组各30例，治疗2周。3组患者治疗前、后运用Wexner便秘评分、Bristol粪便性状评分、便秘患者生活质量量表（PAC-QOL）评分进行结果评定。结果 中药砭石热熨组Wexner便秘评分、Bristol粪便性状评分（BSS）、便秘患者生活质量量表（PAC-QOL）评分均优于砭石热熨组和麻仁丸组，差异有统计学意义（P<0.05），中药砭石热熨组的总有效率（96.67%），显著高于砭石热熨组（86.67%）和麻仁丸组（83.33%）。结论 中药砭石热熨治疗帕金森病气虚便秘的临床疗效显著，可有效改善帕金森患者的便秘症状，帮助患者建立规律排便，提高患者生活质量。     

通腑调神针法治疗便秘型肠易激综合征:随机对照试验（英文）

目的:观察通腑调神针法对便秘型肠易激综合征(const ipat ion-predominant irritable bowel syndrome,IBS-C)患者的便秘、焦虑、抑郁症状及血清神经肽Y (NPY)含量的影响。方法:将42例IBS-C患者随机分为通腑调神针刺组(针刺组)和枸橼酸莫沙必利药物组(药物组),每组21例。治疗过程中,药物组剔除1例,实际观察20例,针刺组实际观察21例。观察两组患者治疗前、治疗后、随访时(治疗后1个月)的便秘量表(CCS)评分、焦虑自评量表(SAS)评分和抑郁自评量表(SDS)评分,并比较两组患者治疗前、治疗后血清NPY含量变化。结果:(1)CCS总评分:治疗后,针刺组和药物组的CCS总评分分别为(4.76±2.10)分和(5.60±1.88)分,均低于各自本组治疗前,差异有统计学意义(both P<0.05),而针刺组和药物组比较,差异无统计学意义(P>0.05)。随访时,针刺组和药物组的CCS总评分分别为(4.19±1.69)分和(6.35±2.06)分,药物组高于本组治疗后(P<0.05),而针刺组和药物组比较,差异无统计...     

Chinese herbal medicine for chronic heart failure: a multicenter,randomized, double-blind,placebo-controlled trial

ObjectiveThe purpose of this study was to assess the efficacy and safety of Chinese herbal medicine (CHM) in the treatment of chronic heart failure (CHF) patients according to syndrome differentiation.MethodsIn this multicenter, randomized, double-blind, placebo-controlled clinical trial, a total of 220 CHF patients were assigned to receive CHM or placebo granules without decoction according to syndrome differentiation in addition to their standard western treatment for 4 weeks. The change in the left ventricular ejection fraction (LVEF) was the primary outcome, and the changes in the TCM syndrome scores (TCM-SS) and New York Heart Association functional classification (NYHA-FC) were the secondary outcomes.ResultsAfter 4 weeks of treatment, the mean changes in the LVEF (13.1 ± 9.78 vs. 7.34 ± 7.40, P < 0.001) and the TCM syndrome scores (−34.2 ± 24.6 vs. −23.5 ± 25.2, P = 0.002) were better in the CHM group than in the placebo group. After two weeks of treatment, the mean changes in the LVEF (9.26 ± 7.83 vs. 4.72 ± 5.60, P < 0.001) and the TCM syndrome scores (−23.5 ± 18.6 vs. −14.0 ± 15.9, P < 0.001) were better in the CHM group than in the placebo group. In addition, repeated-measures analysis of variance (ANOVA) indicated significant time course effects of CHM versus placebo in the LVEF and TCM syndrome cores (P < 0.001 for all). The distention of the jugular vein (P = 0.021), expectoration (P = 0.044), abdominal distention (P = 0.004), and rib pain (P = 0.005) were significantly less in the CHM group than in the placebo group after two weeks of treatment. Fatigue (P = 0.001), less gas and lazy words (P = 0.001), dizziness (P = 0.003), gasping for breath (P = 0.027), abdominal distention (P = 0.011), nausea (P = 0.001) and emesis (P = 0.012) were significantly less in the CHM group than in the placebo group after treatment for four weeks. After four weeks of treatment, the change in the NYHA functional classification in the CHM group was better than that in the placebo group (P < 0.001). There was one death in the placebo group, and one patient in the CHM group experienced atrial fibrillation.ConclusionCHM treatment according to syndrome differentiation effectively improved the LVEF, TCM-SS, and NYHA-FC in patients with CHF and also appeared to be safe. Thus, CHM treatment could be used as an adjuvant therapy in the treatment of CHF (Clinical trial registration: NCT01939236).     

中药复方联合TAM对MCF-7乳腺癌细胞周期及CyclinD1、Bcl-2、Bax表达的影响

目的观察中药复方联合三苯氧胺(TAM)对MCF-7乳腺癌细胞周期及细胞周期素Dl(Cyclin D1)、Bcl-2、Bax表达的影响。方法将造模成功的裸鼠随机分为模型组、三苯氧胺(TAM)组、乳结合组(乳岩宁方+TAM)和益结合组(益气养阴方+TAM)。连续给药21 d后脱颈处死裸鼠,完整剥离出瘤体,切开标本取材。采用流式细胞仪(FCM)检测乳腺癌细胞周期的分布,Western blotting法检测瘤组织中Bax、Bcl-2、Cyclin D1蛋白表达。结果各用药组G0/G1期细胞的比例增多,S期比例明显减少,与模型组比较差异有统计学意义(P0.01);但是乳结合组与益结合组分别对比G0/G1期、S期的细胞比例均无统计学差异(P0.05)。各用药组均可下调Bcl-2及Cyclin D1蛋白的表达,上调Bax蛋白的表达,降低Bcl-2/Bax的比值,与模型组相比差异有统计学意义(P0.01);两个结合组与TAM组比较,差异有统计学意义(P0.01);乳结合组与益结合组之间比较,差异无统计学意义(P0.05)。结论中药复方联合TAM通过阻滞细胞周期进程、下调细胞周期相关蛋白Cyclin D1、抑制Bcl-2的表达、促进Bax的表达来抑制MCF-7乳腺癌细胞增殖,同时中药复方对TAM有协同作用。     

Hypercholesterolemia treated with medicinal pad-separated moxibustion: A randomized clinical trial隔药饼灸治疗高胆固醇血症-随机临床试验

ObjectiveTo assess the effect of medicinal pad-separated moxibustion for reducing low-density lipoprotein cholesterol (LDL-C) in the patients with hypercholesterolemia.DesignClinical randomized controlled trial with blinding for outcome assessors and statisticians.SettingDepartment of Acupuncture-Moxibustion and Tuina, Department of Physical examination of the First Affiliated Hospital of Hunan University of Chinese Medicine and three community health centers adjacent to the Hospital and University, from July 2015 to December 2017.Patients60 patients with hypercholesterolemia (elevated LDL-C).InterventionsThe therapeutic lifestyle change (TLC) was provided in both groups.In the experiment group, medicinal pad-separated moxibustion was applied using two groups of acupoints (Group No.1: Jùquē [巨阙CV14], Tiānshū [天枢ST25] and Fēnglóng [丰隆ST40]). Group No.2: Xīnshū [心俞BL15], Gānshū [肝俞BL18] and Píshū [脾俞BL20]) alternatively for 3–5 times a week. In the control group, Simvastatin tablets were administered orally by the patients in accordance with instructions in the medication guides (10 mg/d).Main outcome measuresChange of LDL-C after 12 weeks of treatment compared with the baseline.ResultsAfter 12 weeks of treatment, LDL-C was reduced in both the medicinal pad-separated moxibustion group and the simvastatin group compared with that at baseline (both P < 0.05). The difference on change of LDL-C was not significant between groups (P > 0.05). At week 4 of follow-up, LDL-C was reduced compared with that at baseline in the medicinal pad-moxibustion group (P < 0.05), and the difference on change of LDL-C was significant between groups (P < 0.05). At week 12 of follow-up, the difference on change of LDL-C was not significant when compared with the baseline in each group (both P > 0.05) and between groups (P > 0.05). In comparison with values before treatment, the values of triglyceride (TC) and triacylglycerol(TG) were reduced in both groups (all P < 0.05), while value of high-density lipoprotein cholesterol (HDL-C) was increased in the medicinal pad-separated moxibustion group after 12 weeks of treatment (P < 0.05). The change of TG and HDL-C values were significantly different between groups (both P < 0.05). At week 4 of follow-up, values of TC and TG were lower (both P < 0.05) and HDL-C was higher (P < 0.05) when compared with that at baseline in the medicinal pad-separated moxibustion group; and value of TC was lower and HDL-C higher in the medicinal pad-separated moxibustion group compared with that in the simvastatin group (both P < 0.05). At week 12 of follow-up, compared with that at baseline, all blood lipid outcomes were not significantly different either within (P > 0.05) or between groups (P > 0.05).ConclusionMedicinal pad-separated moxibustion could reduce LDL-C and increase HDL-C in patients with hypercholesterolemia. However, these results need to be further verified by study with large sample size.Trial registrationClinicaltrials.gov NCT02269046.     

Laser acupuncture combined with auricular acupressure improves low-back pain and quality of life in nurses: A randomized controlled trial

BackgroundLow-back pain (LBP) in nurses is a major health concern that affects their quality of life and ability to work, with consequences for their economic status.ObjectiveThis study evaluates the effect of low-level laser acupuncture combined with auricular acupressure (LAA) on pain intensity, pain interference and quality of life in nurses with LBP.Design, setting, participants and interventionsThis randomized controlled trial recruited a convenience sample of hospital-based nurses from one teaching hospital in Taiwan, China. Participants were randomly assigned to the LAA group (n = 38) receiving low-level laser acupuncture and auricular acupressure for 4 weeks, and the control group (n = 38) receiving only sham laser acupuncture treatment without laser energy output.Main outcome measuresData were collected for the primary pain outcome using the Short Form of the Brief Pain Inventory, while the secondary outcome, quality of life, was evaluated using the Roland-Morris Disability Questionnaire. Both primary and secondary outcomes were scored before the intervention, and after 2-week and 4-week intervention. The rate of LBP recurrence was evaluated at the 4th week and 8th week after the end of intervention.ResultsAfter controlling for prior pain, the result of linear mixed model analysis showed trends in significant between-group differences in the level of current pain occurring in week 4 (P < 0.001), worst pain in week 2 (P < 0.001) and week 4 (P < 0.001), least pain in week 2 (P = 0.032) and week 4 (P < 0.001), pain interference in week 2 (P = 0.009) and week 4 (P < 0.001), and in the life dysfunction in week 2 (P < 0.001) and week 4 (P < 0.001). Recurrence rates of LBP at the 4th and 8th weeks after the end of intervention were 0% and 36.89% in the LAA group, and 69.44% and 36.11% in the control group.ConclusionThis study shows that 4-week LAA intervention reduced pain intensity and pain interference, and improved quality of life for hospital-based nurses with LBP. These effects were maintained continuously for at least 4 weeks after the intervention. The nonpharmacological intervention, LAA, may be another efficacious, feasible, noninvasive, analgesic intervention for LBP.Trial registrationThis study is registered at Clinicaltrials.gov (registration number NCT04423445).     

Clinical Observation on General Anxiety Disorder Treated by Acupuncture plus Herbal Medicine

目的观察疏肝理气、清心除烦中药结合针刺治疗广泛性焦虑症的疗效.方法治疗组用针刺结合中药治疗40例,对照组采用口服多虑平治疗38例,治疗前、中、后均作焦虑自评量表(SAS)、副反应量表(TESS)评定.结果治疗组与对照组总有效率分别为82.5%和84.2%,两组治疗前后SAS组内比较差异有统计学意义(P＜0.01),两组间痊愈显效率、总有效率及SAS评分比较无差异(P＞0.05),但副反应对照组显著高于治疗组(P＜0.01).结论针刺结合中药治疗广泛性焦虑症疗效确切,且毒副反应轻微.     

Hewei Jiangni granule alleviates visceral hypersensitivity in a rat model of non-erosive reflux disease via transient receptor potential channel signaling

ObjectiveTo uncover the underlying mechanism of Hewei Jiangni granule (HWJNG) on non-erosive reflux disease (NERD) treatment by examining histological changes, gastrointestinal neurochemicals release and visceral hypersensitivity-related receptor expression in NERD model rats.MethodsA NERD rat model was established via a combination of basal sensitization and acid perfusion. HWJNG treatments at different doses were then administered. Pathological changes to tissues, mast cell (MC) activation, serum levels of esophageal visceral hypersensitivity-related neurochemicals, and transient receptor potential (TRP) receptor mRNA and protein levels were investigated.ResultsCompared with the control group, the expression of tryptase in MCs, the changes of intercellular space, and the serum levels of substance P (SP), calcitonin gene-related peptides (CGRP) and proteinase-activated receptor 2 (PAR2) increased in the model group (all P < .05). The expression of TRP vanilloid 1 (Trpv1) mRNA decreased in esophagus and dorsal root ganglia (DRG) of the model group (P = .030 & P = .013), and the expression of TRP melastatin channel subfamily member 8 (Trpm8) mRNA decreased in the esophagus of model group (P < .01). The level of esophageal TRPV1 protein increased in the model group (P < .01) and the level of TRPM8 protein decreased in esophagus and DRG of the model group (both P < .05). Compared with the model group, the serum levels of SP, CGRP, and PAR2 in the medium-dose HWJNG group showed significant decreases (all P < .05). The expression of Trpv1 mRNA in esophagus and DRG of the HWJNG groups and the Omeprazole group remarkably decreased (all P < .05), as was the expression of Trpm8 mRNA in esophagus of the HWJNG groups (all P < .05).ConclusionHWJNG alleviated visceral hypersensitivity in NERD model rats by regulating TRP-mediated signaling. Our results indicate that HWJNG has potential as a therapeutic agent for NERD.     

通便颗粒调节慢传输型便秘大鼠结肠水通道蛋白3,水通道蛋白8表达的研究

目的: 观察通便颗粒对慢传输型便秘(STC)大鼠结肠水通道蛋白3(AQP3),水通道蛋白8(AQP8)的影响,阐明其治疗慢传输型便秘的作用机制. 方法: 选取健康SD大鼠60只,随机选取10只大鼠作为正常组,剩余50只大鼠采用复方苯乙哌啶法诱导慢传输型便秘大鼠动物模型,造模组大鼠随机分为模型组、通便颗粒低、中、高剂量组(9.3,18.7,37.3 g·kg^-1)、聚乙二醇散剂组(2.1 g·kg^-1),给药组ig给予相应剂量,正常组和模型组给予同体积生理盐水,连续给药30 d.记录大鼠体质量、24 h大便质量,运用炭墨灌胃法检测大鼠肠道传输功能,并运用免疫组织化学技术检测结肠AQP3,AQP8的分布、表达及相对含量. 结果: 与正常组比较,大鼠24 h大便质量降低,肠管炭墨推进率降低,AQP3,AQP8的表达增加,均具有统计学差异(P<0.05);给予药物干预后,与模型组相比,治疗组各组大鼠24 h大便质量均有所增加,差异明显(P<0.05);通便颗粒中、高剂量组、聚乙二醇散剂组肠管炭墨推进率明显增加,差异有统计学意义(P<0.05);免疫组化结果显示通便颗粒中、高剂量组和聚乙二醇散剂组能不同程度减少AQP3,AQP8的表达,以通便颗粒高剂量组最为明显(P<0.05). 结论: 通便颗粒具有明显改善便秘大鼠的排便功能,可能通过下调AQP3,AQP8的表达从而调节水分的吸收和分泌来治疗STC.     

Low-level laser acupuncture reduces postoperative pain and morphine consumption in older patients with total knee arthroplasty: A randomized placebo-controlled trial

BackgroundPatients commonly develop postoperative pain after total knee arthroplasty (TKA). Acupuncture-related techniques and low-level laser therapy could be beneficial for pain management for older individuals.ObjectiveTo examine the effect of low-level laser acupuncture (LA) in reducing postoperative pain, pain-related interference in daily life, morphine consumption, and morphine-related side effects in older patients with knee osteoarthritis who underwent TKA.Design, setting, participants and interventionA single-blind randomized placebo-controlled trial was conducted. Patients (N = 82) were recruited and randomly assigned via a computer-generated list to the LA group or a placebo group. The LA group received low-level laser therapy at Sanyinjiao (SP6), Taixi (KI3), Kunlun (BL60), Fengshi (GB31), Futu (ST32) and Neiguan (PC6) after TKA, while the placebo acupuncture group received the same treatment procedure without laser energy output.Main outcome measuresThe primary outcome was postoperative pain intensity, and it was measured at baseline and hours 2, 6, 10, 24, 48 and 72 after TKA. The secondary outcomes, including relative pain, postoperative pain-related interference in daily life and morphine consumption, were measured at hours 24, 48 and 72 after TKA.ResultsGeneralized estimating equations revealed significant between-group differences in pain intensity (P = 0.01), and trend differences in pain intensity for the LA group starting at hours 10 to 72 (P < 0.05) and morphine consumption at hours 48 and 72 (P < 0.05). The changes in pain-related interference in daily life were significant (P < 0.05) at 72 h, with the exception of the parameters for worst pain, mood, and sleep. Nausea and vomiting side effects from morphine had significant between-group differences at hours 10 and 24 (P < 0.05).ConclusionLow-level LA gradually reduced older patients’ postoperative pain intensity and morphine consumption within the first 72 h after their TKA for osteoarthritis. Low-level LA may have benefits as an adjuvant pain management technique for clinical care.Trial registrationClinicalTrials.gov registration number NCT03995446.     

Clinical research on treating fracture of middle and lower 1/3 of tibiofibula by electroacupuncture

ObjectiveTo observe the differences in efficacy on treatment of fractures of the middle and lower 1/3 of the tibiofibula between cribriform splints plus electroacupuncture, warming needle and moxibustion only, and external fixation with traditional splints plus the administration of an herbal formula. Clinical efficacy and the effects on serum bone morphogenic protein ?7 (BMP-7) and endothelin ?1 (ET-1) were both measured.Method600 patients with fractures of the middle and lower 1/3 of the tibiofibula were randomly divided into three groups according to andome number table: splint with electroacupuncture (group A), warm needling moxibustion group (group B) and splint with traditional Chinese medicine herb (Group C). Cribriform splints with electroacupuncture were used in group A, warming needling therapy were adopted in group B, and traditional splints with external fixation were used along with oral administration of musk bone capsules (

) in group C. Clinical results for the three groups were compared, and ELISA method was used to detect the serum BMP-7 and ET-1 of patients in the three groups before and after treatment.ResultsGroup A was better than group B and group C in terms of clinical healing days and delayed healing status (P<0.05). After treatment, group A was also better than the other two groups in the improvement of BMP-7 and ET-1 (P<0.05).ConclusionElectroacupuncture treatment with cribriform splints for fractures of the middle and lower 1/3 of the tibiofibula resulted in significantly shorter clinical healing time, and lower incidence of delayed healing compared to warm needling or splints with a traditional Chinese herbal formula. Its mechanism may be associated with greater regulation of serum BMP-7 and ET-1 through electroacupuncture.