The efficacy and safety of traditional Chinese medicine Guilu Erxian Jiao in the treatment of knee osteoarthritis: A systematic review and meta-analysis

ObjectiveA systematic review was conducted to investigate the efficacy of Guilu Erxian Jiao (GEJ) in the treatment of knee osteoarthritis (OA).MethodsWe searched PubMed, MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Chinese Electronic Periodical Services, and ClinicalTrials.gov to identify relevant randomized controlled trials or controlled clinical trials, from the inception of each source to April 20, 2021. Primary outcome included overall efficacy, pain score, and Lequesne index score; secondary outcome included adverse events. Methodological quality was assessed using the Cochrane risk of bias tool (RoB 1.0). The meta-analysis was performed based on a random-effects model due to anticipated clinical heterogeneity. The grading of overall evidence was assessed using the GRADE system. The study protocol was registered on PROSPERO (CRD42021233573).ResultsEight studies were included. Compared to controls, GEJ exhibited superior overall efficacy for treating OA (risk ratio (RR) = 1.20; 95% confidence interval (CI) = 1.06–1.35). Regarding pain score, there was no statistical difference between GEJ and controls (standardized mean difference (SMD) = 0.27; 95% CI = −0.91 – 1.46). No significant difference was found in Lequesne score between GEJ and controls (MD = −0.25; 95% CI = −0.52 – 0.01). No statistical difference in adverse reactions was observed between GEJ and controls (risk difference (RD) = −0.01; 95% CI = −0.05–0.03).ConclusionOur findings suggest that GEJ may have positive effects on overall efficacy in treating OA. However, there is insufficient evidence regarding pain score, Lequesne score, and knee joint function score.     

Traditional Chinese medicine for pressure ulcer: a meta‐analysis

To assess the effect of Traditional Chinese Medicine (TCM) [Chinese herbal medicine ointment (CHMO), acupuncture and moxibustion] on pressure ulcer. In this study, we searched MEDLINE, EMBASE, CENTER, CBM, CNKI, WAN FANG and VIP for articles published from database inception up to 4 April 2011. We included randomised controlled trials (RCTs), which compared the effects of TCM with other interventions. We assessed the methodological quality of these trials using Cochrane risk of bias criteria. Ten of 565 potentially relevant trails that enrolled a total of 893 patients met our inclusion criteria. All the included RCTs only used CHMO intervention, because acupuncture and moxibustion trials failed to meet the inclusive criteria. A meta‐analysis showed beneficial effects of CHMO for pressure ulcer compared with other treatments on the total effective rate [risk ratio (RR): 1·28; 95% confidence interval (CI): 1·20–1·36; P = 0·53; I² = 0%), curative ratio (RR: 2·02; 95% CI: 1·73–2·35; P = 0·11; I² = 37%) and inefficiency rate (RR: 0·16; 95% CI: 0·02–0·80; P = 0·84; I² = 0%). However, the funnel plot indicated that there was publication bias in this study. The evidence that CHMO is effective for pressure ulcer is encouraging, but due to several caveats, not conclusive. Therefore, more rigorous studies seem warranted.     

针灸治疗脊髓损伤后尿潴留的选穴规律探讨

目的：总结近10年间针灸治疗脊髓损伤后尿潴留的选穴规律。方法：采用计算机和手工检索相结合检索近10年国内外用针灸治疗脊髓损伤后尿潴留的文献并进行分析。结果：筛选出合格文献19篇,研究发现针灸治疗脊髓损伤后尿潴留,选取经络以膀胱经、任脉、脾经为主,所选主穴以关元、中极、次、三阴交为最多。结论：以局部解剖结构以及排尿反射神经传导路径为基础采用循经取穴、取用＂特定穴＂及局部取穴是针灸治疗SCI后尿潴留的规律和特点。     

补肾活血方对血管性痴呆大鼠海马神经细胞自噬的影响＊

目的 探究补肾活血方对血管性痴呆（Vascular Dementia， VD）大鼠模型自噬的影响。方法 52周龄SD雄性大鼠50只，随机分为假手术组（Sham组）、模型组（VD组）、模型+补肾活血方组（BSHX组）、模型+雷帕霉素组（Rap组）和模型+3-甲基腺嘌呤组（3-MA组），每组10只大鼠。除Sham组外其余各组采用两血管阻断法（2-VO）建立VD模型。BSHX组中药灌胃治疗28天；自噬干预组于造模前30 min侧脑室给药。运用Morris水迷宫测试各组大鼠的学习记忆能力；通过尼氏染色和透射电子显微镜（Transmission electron microscope，TEM）观察大鼠海马区病理形态及自噬变化；采用蛋白免疫印迹（Western blot）法和反转录实时荧光定量PCR（RT-qPCR）检测大鼠海马Beclin-1、P62以及微管相关蛋白1轻链3（LC3）蛋白及mRNA表达情况。结果 与VD组比较，BSHX组大鼠学习记忆能力显著提升（P<0.05），镜下观察BSHX组和3-MA组的细胞形态及数量均有改善，自噬小体鲜见，Beclin-1以及LC3蛋白和mRNA表达水平显著降低（P<0.05），P62蛋白和mRNA表达水平明显升高（P<0.05）结论 补肾活血方可以降低VD大鼠海马区Beclin-1和LC3蛋白及mRNA的表达，提高P62的表达，通过抑制自噬的发生，减轻对神经细胞的损伤，改善学习记忆能力。     

辨证运用骨蚀宁Ⅰ号、Ⅱ号对激素性股骨头坏死兔股骨头血管内皮生长因子表达的影响

目的 探讨骨蚀宁Ⅰ号、Ⅱ号治疗激素性股骨头坏死的作用机制,为其临床应用提供理论依据。方法 选取60只家兔,随机抽取6只作为正常组,其余54只用于复制激素性股骨头坏死模型,模型复制成功后随机分为模型组、阳性对照组和治疗组,每组18只。三酰甘油大于1.00 mmol/L判为血瘀证。模型组灌胃生理盐水,阳性对照组灌胃健骨生丸,治疗组辨证给予骨蚀宁Ⅰ号、Ⅱ号（血瘀证用Ⅰ号,肾虚证用Ⅱ号）。于模型复制后4周、8周、12周分批处死家兔,每组6只,光镜下观察股骨头组织形态变化,采用免疫组织化学法检测血管内皮生长因子（vascular endothelial growth factor,VEGF）表达水平。结果 治疗组和阳性对照组骨坏死比模型组减轻,空缺骨陷窝数百分比明显低于模型组（P＜0.05）;模型复制第4周,模型组VEGF灰度值明显低于正常组（P＜0.05）;阳性对照组、治疗组灰度值比模型组显著升高（P＜0.05）;模型复制后8周,模型组灰度值明显高于其他两组（P＜0.05）;模型复制后12周,阳性对照组、治疗组VEGF灰度值明显低于模型组（P＜0.05）,治疗组VEGF灰度值明显低于阳性对照组（P＜0.05）。结论 骨蚀宁Ⅰ号、Ⅱ号通过增强VEGF的表达,促进激素性股骨头坏死的血管形成和骨坏死修复。     

美国外周神经刺激对针灸发展模式的启示

目的:了解外周神经刺激疗法,为针灸研究提供新思路。方法:通过查阅相关文献,简要阐述外周神经刺激疗法,并从探索优势病种、实现精确治疗、转化创新技术三方面着手探讨美国刺激外周神经活动以减轻疾病状况(SPARC)计划对针灸研究的启示。结果:SPARC计划对外周神经刺激疗法投入大量支持和关注,这种疗法通过电刺激局部神经调动人体神经信号传导网络以实现对疾病的调控,与我国传统针灸疗法有相似之处,其作用机制明确、刺激方法先进、刺激部位准确和多领域合作等优势,可为针灸疗法借鉴。结论:针灸疗法应借鉴外周神经刺激疗法,明确优势病种,加强精准治疗,重视治疗工具的创新发展。     

Effect of naringin and naringenin on contractions induced by noradrenaline in rat vas deferens—I. Evidence for postsynaptic alpha-2 adrenergic receptor

• 1.1. Naringin at all doses (2 × 10⁻⁶, 5 × 10⁻⁷, and 1 × 10⁻⁷ M) significantly increased contractions induced by noradrenaline in rat vas deferens but the increments of maximal contraction were not concentration-dependent.
• 2.2. In a medium containing 1 × 10⁻⁶ M yohimbine (a selective blocker of α₂-adrenoceptor) and naringin, the curve constructed with noradrenaline decreased below the control curve.
• 3.3. Naringenin (aglycone of naringin) (2 × 10⁻⁶ and 1 × 10⁻⁷ M) increased the contractile effect of noradrenaline and the maximal effect evoked was related to the maximal dose of naringenin.
• 4.4. The α₂ antagonism produced by yohimbine in the naringenin-noradrenaline association were retained at two doses of naringenin tested and we noticed a similar behaviour when we used clonidine-noradrenaline.

     

优化传统针刺助产处方对孕晚期大鼠宫颈成熟的影响

目的:通过对孕晚期大鼠宫颈成熟相关指标的实验研究,从分子生物学角度探讨优化的传统针刺助产处方对宫颈成熟的影响机制.方法:将20只初孕Wistar大鼠随机分为电针组和模型对照组各10只,10只同批次非孕雌鼠作为空白对照组.电针组于妊娠20 d时以优化的传统针刺助产处方(先电针“合谷”20 min,再加刺“三阴交”5 min,选用疏密波2 Hz/50 Hz)为干预方法,模型对照组及空白对照组不予针刺.3组均采用酶联免疫吸附试验方法对宫颈组织基质金属蛋白酶9(MMP-9)及白介素8(IL-8)进行检测.结果:与空白对照组比较,模型对照组MMP-9及IL-8含量显著升高(均P＜0.01);与模型对照组比较,电针组MMP-9及IL-8含量显著升高(P≤0.05).结论:优化的传统针刺助产处方通过提高晚孕大鼠宫颈组织MMP-9、IL-8的含量,参与并介导宫颈成熟,从分子生物学层面阐明了针刺促宫颈成熟的作用机制.     

电针环跳穴对腰椎间盘突出症坐骨神经损伤修复的实验研究

目的:观察电针环跳穴对腰椎间盘突出症(LIDP)家兔坐骨神经(SN)潜伏期和神经传导速度的影响,揭示电针环跳穴对LIDP家兔的损伤修复机制。方法:40只家兔随机分为空白组、模型组、环跳组和非穴组,采用自制的LIDP动物病理模型造模器建立家兔LIDP病理模型,用BL-410电生理系统测定家兔SN潜伏期和神经传导速度(NCV)。结果:各组治疗前后SN潜伏期和神经传导速度比较,环跳组治疗后SN的潜伏期显著低于治疗前(P0.01),而神经传导速度却显著高于治疗前(P0.01)。各组治疗前后SN潜伏期和神经传导速度差值组间比较,环跳组SN潜伏期和神经传导速度差值均显著高于空白组、模型组与非穴组(P0.01)。结论:电针环跳穴可使腰椎间盘突出症家兔SN的潜伏期缩短,神经传导速度有所增快。