Safety and efficacy of Danqipiantan capsule for treatment of stroke： a systematic review

OBJECTIVE： To evaluate the efficacy and safety of Danqipiantan capsule （DPC） for the treatment of stroke. METHODS： PubMed, China Science And Technolo- gy Journal Database, Wanfang Database, Chinese periodicals in the China National Knowledge Infra- structure, and the General Hospital of Tianjin Medi- cal University＇s Library were searched until July 2012. Randomized controlled trials （RCTs） and ob- servational studies that reported the use of DPC for treatment of stroke were selected. RESULTS： Eleven articles that included 12 RCTs, and 2 articles that included 3 observational studies were identified. A total of 2590 patients participat- ed in the studies. We found that there was a signifi-cant statistical difference between DPC treatment groups and the control groups in terms of the effec- tive rate [risk ratio （RR）, 1.14; 95% confidence inter- vals （CI）, 1.04, 1.25; P=0.01], FugI-Meyer Assessment Scale [weighted mean difference （WMD）, 9.77; 95% CI （4.84, 14.70）; P=0.00], Barthel Index [WMD=6.40; 95% CI （3.15, 9.65）], and mean flow velocity [WMD= 5.79; 95% CI （1.64, 9.94）]. There were no significant differences for The National Institutes of Health Stroke Scale [WMD=0.60; 95% CI （ - 1.09, 2.29）], vi- sual field defects [left visual field： WMD= - 203.10; 95% CI （ - 424.41, 18.21）; right visual field： WMD= - 172.60; 95% CI （ - 409.29, 64.09）] or the functional independence measure [WMD= - 7.90; 95% CI （ - 16.64, 0.84）]. Seven articles that included eight RCTs reported the safety of DPC treatment. Two ar- ticles that included three observational studies also reported beneficial effects for DPC. Because the Chinese studies were of poor methodological quali- ty, and most of the sample sizes were small, our analysis was likely affected by bias. CONCLUSION： DPC has a beneficial effect and is relatively safe when used for the treatment of stroke.     

Qingkailing injection for the treatment of acute stroke： a systematic review and Meta-analysis

OBJECTIVE: To evaluate systematically the clinical efficacy and safety of Qingkailing(QKL) injection in the treatment of acute stroke.METHODS: Searches for randomized controlled trials into acute stroke treated with QKL injection were performed in the China National Knowledge Infrastructure Database, China Science and Technology Journal Database, Wan fang Database,Chinese Biomedical Literature Database, PubMed and Cochrane Library, from January 1979 to March2013. Two reviewers independently retrieved the RCTs and extracted the information. The Cochrane risk of bias method was used to assess the quality of the included studies, and a Meta-analysis was conducted with Review Manager 5.2 software.RESULTS: A total of 13 studies with 1110participants were included. The quality of the studies was generally low. The Meta-analysis indicated that the combined use of QKL and Western Medicine was significantly superior to control group therapy in terms of the total effective rate. The relative risk(RR) in the acute cerebral hemorrhage(ACH) sub-group was 1.17 [95%confidence interval(CI)(1.08, 1.26), P=0.0001]. In the acute cerebral infarction(ACI) sub-group, RR was 1.27 [95% CI(1.14, 1.42), P0.0001], and in the ACH and ACI mixed sub-group, RR was 1.34 [95% CI(1.20,1.50),P0.00001]. Additionally, QKL promoted the absorption of hematoma [mean difference(MD)=﹣3.73, 95%CI(﹣4.48, ﹣2.98), P0.000 01],decreased neurological damage in ACI [MD=﹣5.60, 95% CI(﹣8.50, ﹣2.70), P=0.0002] and ACH[MD= ﹣ 4.08, 95% CI( ﹣ 8.00, ﹣ 0.16), P=0.04],promoted the recovery of awareness [RR=1.56, 95%CI(1.09, 2.21), P=0.01] and reduced the whole blood viscosity coefficient [MD=﹣ 0.75, 95% CI( ﹣1.47, ﹣0.03), P=0.04]. There were no adverse drug reactions reported in the included studies.CONCLUSION: Based on this systematic review,QKL combined with conventional therapy was effective compared with control treatment.However, because the articles used in the study were not of high quality, further studies should be conducted into the efficacy and safety of QKL in treating acute stroke.     

Xuefuzhuyu decoction for hyperlipidemia： a systematic review and Meta-analysis of randomized clinical trails

OBJECTIVE：To evaluate the efficacy and safety of Xuefuzhuyu decoction for hyperlipidemia.METHODS：Randomized clinical trials on hyperlipidemia treated by Xuefuzhuyu decoction,either alone or with Western Medicine,were searched in electronic databases.Databases searched were：MEDLINE,Allied and Complementary Medicine Database,EMBASE,The Cochrane Library 2013（Issue4）,China National Knowledge Infrastructure Database,Chinese Biomedical Literature Database,and Wanfang Database up to 2 May,2013.Study selection,data extraction,quality assessment,and data analysis were conducted according to the Cochranestandards.RESULTS：Six randomized clinical trials involving748 patients（373 patients in the treatment group,375 patients in the control group）were included in the analysis.The studies were of low methodological quality.Meta-analysis indicated that the effect of Xuefuzhuyu decoction on hyperlipidemia was better than that in the control group[n=748,OR=5.07,95%CI（3.40,7.58）,P〈0.01].Weighted mean differencesin total cholesterol,low-densitylipoprotein cholesterol,triglycerides,and high-density lipoprotein cholesterol were﹣0.79,﹣0.74,﹣0.44,0.16,respectively,and Meta-analysis revealed that the treatment group was better than the control group with 95%CI（﹣1.21,﹣0.36）,（﹣0.94,﹣0.55）,（﹣0.77,﹣0.11）,（0.04,0.27）,respectively（all P〈0.05）.Some adverse events in evaluated studies wererecorded.CONCLUSION：Xuefuzhuyu decoction may be effective for treating hyperlipidemia.The studies we analyzed were of low methodological quality,which indicates that the above findings should be considered cautiously.Therefore,more strictly designed large-scale randomized clinical trials are needed to evaluate the efficacy of Xuefuzhuyu decoction in hyperlipidemia.     

Efficacy of Chinese herbal medicine for lumbar disc herniation： a systematic review of randomized controlled trials

OBJECTIVE： This is a review of the effects of Chi- nese herbal medicine （CHM） used alone to treat lumbar disc herniation （LDH）. METHORDS： A literature search of the following electronic databases from their inception to Febru- ary 2013 was conducted： Chinese Biomedical data- bases, Chinese National Knowledge Infrastructure, Wanfang Database, China Science and Technology Journal Database, Cochrane Library, Web of Sci- ence, MEDLINE, and EMBASE. Randomized con- trolled trials where CHM had been used to treat LDH were selected. Data extraction, quality assess- ment, and data analysis were carried out by two in- dependent reviewers. RESULTS： Of the 2415 studies identified, eight with complete data on 1146 patients were selected. The methodological quality was poor in all trials. Five studies reported that CHM was better than WesternMedicine [OR=2.81, 95% CI （1.27, 6.18）; OR=3.34, 95% CI （1.92, 5.79）; 0R=2.22, 95% CI （1.08, 4.57）; OR= 6.67, 95% CI （1.34, 33.28）; and OR=1.94, 95% CI （1.23, 3.06）]. Two studies reported that the clinical outcome was better in CHM groups than in physio- therapy and placebo groups, [OR=3.02, 9.5% CI （1.08, 8.46）; and OR=2.67, 95% CI （1.26, 5.64）, re- spectively], whereas one study reported no differ- ence between CHM and physiotherapy groups. One study reported that CHM resulted in higher Japanese Orthopedic Association scores [MD=7.78, 95% CI （6.67, 8.89）] than in a control group and an- other that participants treated with CHM had lower Visual Analogue Scale scores [MD=- 0.72, 95% CI （ - 0.86, 0.58）] than those in a control group. Three studies reported that the adverse effects of CHM and Western Medicine did not differ signifi- cantly [OR=0.10, 95% CI （0.01, 1.85）; OR=0.19, 95% CI （0.01,4.07）; and OR=O.07, 95% CI （0.00, 1.32）]. CONCLUSION： CHM may be more effective than other interventions for LDH; however, methodologi- cal weaknesses in the studies assessed in this re- view prevent a definitive conclusion. More high-quality large-scale studies are required to clar- ify this matter.     

Case-based learning in education of Traditional Chinese Medicine： a systematic review

OBJECTIVE： To assess the effect of case-based learning（CBL） in the education of Traditional Chinese Medicine（TCM）.METHODS： The studies concerning TCM courses designed with CBL were included by searching the databases of EBSCO, Pubmed, Science Citation Index, China National Knowledge Infrastructure,Chongqing VIP database. The valid data was extracted in accordance with the included criteria.The quality of the studies was assessed with Gemma Flores-Masteo.RESULTS： A total of 22 articles were retrieved that met the selection criteria： one was of high quality;two were of low quality; the rest were categorized as moderate quality. The majority of the studiesdemonstrated the better effect produced by CBL,while a few studies showed no difference, compared with the didactic format. All included studies confirmed the favorable effect on learners＇ attitude,skills and ability.CONCLUSION： CBL showed the desirable results in achieving the goal of learning. Compared to didactic approach, it played a more active role in promoting students＇ competency. Since the quality of the articles on which the study was based was not so high, the findings still need further research to become substantiated     

Efficacy and safety of Traditional Chinese Medicine for the treatment of acquired immunodeficiency syndrome：a systematic review

OBJECTIVE： To systematically review the efficacy and safety ofTraditional Chinese Medicine（TCM） in- terventions, compared with control interventions（placebo or conventional Western medical thera- py）, in the treatment of acquired immunodeficien- cy syndrome（AIDS）. METHODS： Electronic databases including PubMed, the Cochrane Library, China National Knowledge Infrastructure（CNKI）, and Wanfang Da- ta were searched to identify relevant randomized controlled trials（RCTs） published as of May 2012. Studies were selected according to the specified in- clusion and exclusion criteria and then subjected to methodological quality assessment, data extrac- tion, and meta-analysis according to the Cochrane Handbook for Systematic Reviews of Interventions.RESULTS： Twelve RCTs involving 881 patients with AIDS were included. Methodological quality assess- ment showed that two were high-quality, two were moderate-quality, and eight were low-quality. Me- ta-analysis showed that TCM interventions were as- sociated with significantly reduced plasma viral load compared with placebo [odds ratio OR=2.46, 95% confidence interval CI（1.02, 5.94）; P=0.04]. However, the reductions in plasma viral load signifi- cantly favored conventional Western medical thera- py alone over integrated traditional Chinese and Western medical therapy [OR=0.16, 95% CI（0.05, 0.55）; P=0.004]. Patients receiving TCM interven- tions had significantly higher CD4＋ T lymphocyte counts compared with those on placebo [OR=2.54, 95% CI（1.40, 4.60）; P=0.002]. In addition, TCM inter- ventions were significantly more likely to have im- proved clinical symptoms [OR=2.82, 95% CI（1.85, 4.31）; P0.00001]. TCM interventions conferred a similar risk of adverse events（AEs） compared with control interventions [OR=1.87, 95%CI（0.58, 6.01）; P=0.29]. CONCLUSION： Current evidence suggests that TCM interventions are significantly more effective than placebo in reducing plasma viral load and in- creasing CD4＋ T lymphocyte count in patients with AIDS. When compared with conventional Western medical therapy, TCM interventions were signifi- cantly less effective in reducing plasma viral load, although they were associated with a higher per- centage of patients with improved symptoms. Pa- tients receiving TCM interventions did not seem to be at an increased risk of AEs.     

Effect of Banxiaxiexin Tang on treatment of functional dyspepsia： a Meta-analysis of randomized controlled trials

OBJECTIVE： To evaluate the efficacy of Banxiaxiex- in Tang compared with Western Medicine in the treatment of functional dyspepsia （FD） through Meta-analysis. METHODS： Literature was searched in the following databases： MEDLINE, Excerpta Medica Database, Chinese Medical Current Contents, China Science and Technology Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure. Randomized controlled trials evaluating the efficacy of Banxiaxiexin Tang for the treatment of FD were selected according to certain standards including clear general situation of pa- tients, specific diagnostic criteria, definite clinical outcomes, etc. Articles were evaluated with quality assessment standards in the Cochrane Handbook for Systematic Reviews of Interventions. Meta-analysis was conducted with RevMan 5.0.23 software. RESULTS： Ten articles with a total of 972 patients were included. The comparison of efficacy between Banxiaxiexin Tang and Western Medicine showed a combined effect size [OR=2.75, 95% CI （1.86-4.07）] and combined effect of value ofZ=5.07 （P〈0.000 01 ）, suggesting a significant difference between the groups. CONCLUSION： Banxiaxiexin Tang was more effec- tive than Western Medicine in treating FD.     

Using acupoint-to-acupoint penetrative needling to treat poststroke spastic paralysis： a clinical progress review

OBJECTIVE： To determine the characteristics and advantages of acupoint-to-acupoint penetrative needling（AAPN） treatment for post-stroke spastic paralysis（PSSP） to improve the clinical outcomes of this disease in the future.METHODS： Randomized, controlled trials of PSSP patients receiving AAPN treatment were searched from MEDLINE, EMBASE, and China National Knowledge Infrastructure Database between January 2006 and June 2013. Key words included： clinic or clinical, acupuncture, needling, acupoint-to-acupoint, penetrative or penetration or penetrating,stroke or apoplexy or cerebral infarction or cerebral hemorrhage, spastic paralysis or spasticity or palsy,and hypermyotonia. Language was limited to English and Chinese. Case series reports, review articles, and animal studies were excluded.RESULTS： AAPN showed better clinical results on PSSP than other acupuncture treatments, especially when combined with adjunct therapies such as electroacupuncture, bloodletting, and rehabilitation. The greatest benefit was achieved with rehabilitation combined with penetration from Yang-channel acupoints to Yin-channel acupoints in the upper limbs, and from Yin-channel acupoints to Yang-channel acupoints in the lower limbs with a reinforcing maneuver.CONCLUSION： AAPN is an effective treatment for PSSP, and it can accelerate and enhance functional repair of PSSP patients.     

Effect of curcumin on rats/mice with diabetic nephropathy： a systematic review and Meta-analysis of randomized controlled trials

OBJECTIVE： To assess the renal protective effects of curcumin administration ondiabetic rats/mice.METHODS： Databases were searched electronically and conference papers searched manually for search terms to find relevant studies. Articles were assessed independently by two reviewers. Review Manager 5.1 was used fordata analysis.RESULTS： Fourteen randomized controlled experiments were included. Meta-analysis demonstrated that blood sugar levels and kidney weight to body weight ratios in the model group were higher than those in the normal group, and the curcumin group had significantly lower mesangial area to glomerular area ratios compared with the model group, and also lower levels of urinary protein,blood urea nitrogen and serum creatinine.CONCLUSION： Curcumin shows protective effects on the kidneys of rats/mice with diabetes.     

Clinical curative effect of electric acupuncture on acute cerebral in- farction： a randomized controlled multicenter trial

OBJECTIVE： To examine whether electric acupuncture can improve the daily life of patients with ischemic cerebral apoplexy at acute stage.METHODS： A stratified-block randomized controlled multicenter trial was designed for this study.Totally 340 patients with acute ischemic cerebral apoplexy were randomly divided into an electric acupuncture group and a control group. In the electric acupuncture group, 170 patients were treated with electric acupuncture and routine therapy, and170 patients in the control group with routine therapy alone. Major indexes for judging curative effect were Barthel index at 3- and 6- months follow-up visits and number of re-hospitalized patients. Mi-nor indexes for judging curative effect were change in the score for nervous dysfunction at 4and 12 weeks follow-up visits and number of patients persisting in rehabilitation treatment with acupuncture during follow-up visit.RESULTS： Baseline data at the time of case selection between the two groups were similar. The odds ratio（OR） was 0.92, and the 95% confidence interval（CI） was 0.49-1.73 in disabled rate and 0.73 and 0.51-1.05 in the number of re-hospitalized patients in the electric acupuncture group at 6-month follow up visit compared with the control group.There was no difference in the score for nervous dysfunction at the end of 12-week follow-up visit between the two groups. The score for nervous dysfunction at the end of 4-week treatment in the electric acupuncture group was significantly higher than that in the control group（P〈0.05）. The number of patients discharged from hospital who persisted in rehabilitation treatment with acupuncture in the acupuncture group was significantly higher than that in the control group.CONCLUSION： Using electric acupuncture to treat patients with acute ischemic cerebral apoplexy can effectively improve the nervous dysfunction scores after 4-week treatment and their ability to deal with daily life after 6-month follow-up visit. Systematic treatment with acupuncture may also reduc     

Comparison of clinical effectiveness of acupuncture and a Western drug on allergic rhinitis： study protocol for a randomized controlled trial

OBJECTIVE： To compare the efficacy of an acu- puncture regimen for persistent allergic rhinitis （PER）, aimed at improving a patient＇s mind or Shen in Traditional Chinese Medicine, to that of a sec- ond-generation H-receptor antagonist, cetirizine hydrochloride. METHODS： This multicenter, randomized, con- trolled clinical trial on PER will be conducted at three institutions in China. The total study period will be 9 weeks. After a 1-week preparatory screen- ing period, 240 eligible participants with PER willbe randomized to receive acupuncture or pharma- cotherapy （1： 1） for 4 weeks with a 4-week fol- low-up. The primary outcome will be changes in 7-day average total nasal symptom score. Second- ary outcome measures include rhinoconjunctivitis quality of life questionnaire score and total non-na- sal symptom score. RESULTS： The presence and seriousness of psycho- logical and emotional impairments should be con- sidered in therapeutic programs for allergic rhinitis. No clinical trial for treating allergic rhinitis via acu- puncture regulation of psychological and emotion- al activities has been reported. CONCLUSION： The findings of the trial will allow us to determine the effects of the mind （Shen）-regula- tion treatment approach. We will also be able to confirm if the effects of acupuncture are equivalent to those of the conventional drug cetirizine hydro- chloride.