Systematic Review and Meta-Analysis of Hugan Tablets(护肝片)in the Treatment of Drug-Induced Liver Injury

Objective:To systematically evaluate the efficacy and safety of Hugan Tablets(护肝片)in the treatment of drug-induced liver injury.Methods:Totally seven Chinese and English databases,including CNKI,Wanfang,VIP,CBM,PubMed,EMbase,Web of Science were searched for randomized controlled trials(RCTs)of Hugan Tablets(护肝片)for the treatment of drug-induced liver injury,which were published from the date of establishment to April 20,2019.The meta-analysis software RevMan 5.3 software and Excel were used to build a database into combine and analyze the studies that met the standards and to draw a forest plot.Results:Forty five RCTs were included with 7478 patients.The quality of included studies was uneven.Meta-analysis showed that the outcome index of liver injury rate was divided into seven subgroups.Hugan Tablets(护肝片)were used in the treatment of anti-tuberculosis drugs was superior to the conventional western medicine treatment group(RR=0.27,95%CI[0.22,0.33],P<0.00001).Which was also better than the without Hugan Tablets(护肝片)treatment group(RR=0.32,95%CI[0.20,0.52],P<0.00001).For the role of drug-induced liver injury in the treatment of type 2 diabetes,the Hugan Tablet+conventional treatment group is better than the conventional treatment group(RR=0.16,95%CI[0.03,0.88],P=0.03).The effect of drug-induced liver injury in the treatment of hypertension was superior to the conventional western medicine treatment group(RR=0.07,95%CI[0.03,0.14],P<0.00001).The effect of drug-induced liver injury during the treatment of hyperlipidemia was not statistically significant(RR=0.57,95%CI[0.33,1.00],P=0.05).There was no statistical difference between the two groups in the effect of drug-induced liver injury during the treatment of coronary heart disease(RR=0.09,95%CI[0.01,1.61],P=0.10).There was no significant difference between the two groups in the treatment of cerebral thrombosis for drug-induced liver injury(RR=0.11,95%CI[0.01,2.01],P=0.14).The effect of anti-hyperthyroidism on liver injury was better than that of conventional western medicine treatment group(RR=0.45,95%CI[0.25,0.82],P=0.009).Outcome index of total effective rate was divided into two subgroups.The effect of drug-induced liver injury caused by the type of drug was not mentioned was superior to the conventional western medicine treatment group(RR=0.78,95%CI[0.70,0.88],P<0.0001).There was no significant difference between the two groups in the liver injury caused by antipsychotic drugs(RR=0.97,95%CI[0.81,1.16],P=0.72).Conclusion:When used in the treatment of tuberculosis and psychiatric drug treatment,combineduse of Hugan Tablets(护肝片)can significantly reduce the incidence of drug-induced liver damage,and can significantly improve clinical symptoms caused by liver damage.In the treatment of hypertension,the addition of Hugan Tablets(护肝片)can significantly reduce the incidence of drug-induced liver injury,improving the safety of medication.In the treatment of drug-induced liver injury caused by which drug is not mentioned,Hugan Tablet has a therapeutic effect.Slight adverse reactions were reported,including rash,headache,palpitations,hypoglycemia,flushing,fatigue,nausea,bowel sounds,flatulence,diarrhea,and gastrointestinal discomfort.All studies reported minor adverse reactions that were well tolerated by patients and recovered without treatment after discontinuation.Oral administration of Hugan Tablets(护肝片)has positive effects on druginduced liver injury,but this conclusion still needs further evidences delete.It is necessary to adopt a larger sample,more design,and accord with the international standards to improve the quality of evidence.     

Systematic Evaluation and Meta-analysis on the Efficacy and Safety of Qidongyixin Oral Liquid (芪冬颐心口服液) in the Treatment of Coronary Heart Disease

Objective: To systematically evaluate the efficacy and safety of Qidongyixin Oral Liquid (芪冬颐心口服液) in the treatment of coronary heart disease. Methods: Randomiz...     

Systematic Review and Meta-analysis on the Efficacy and Safety of Tianma Gouteng Granules(天麻钩藤颗粒) in Treatment of Dizziness

Objective: The effectiveness and safety of Tianma Gouteng Granules(天麻钩藤颗粒) in the treatment of dizziness were systematically evaluated. Methods: A randomized controlled trial of Tianma Gouteng Granules for dizziness was screened out by searching CNKI, Wanfang Data, VIP, Sino Med, Cochrane Library, Pub Med, Embase, Web of Science in a systematic way and was based on Handbook 5.1 evaluation criteria and tools and Rev Man 5.3 software for meta-analysis of the final inclusion of the study. Results: ...     

Efficacy and Safety of Longshengzhi Capsules (龙生蛭胶囊) in Treatment of Cerebral Infarction: Systematic Review and Meta-analysis

Objective: To systematically evaluate the efficacy and safety of Longshengzhi Capsules (龙生蛭胶囊) in the treatment of cerebral infarction.Materials and methods: A ...     

Clinical Evaluation on Xiyanping Injection in the Treatment of Bronchopneumonia in Children Based on Meta‑Analysis

Objective: The aim of this study is to evaluate the effectiveness and safety of xiyanping injection (XYPI) in the treatment of children with bronchopneumonia. Methods:Asystematic and comprehensive search was conducted in the domestic and foreign electronic databases CNKI, SinoMed, VIP, WanFang DATA, PubMed, The Cochrane Library, Embase, Web of Science, Clinical?Trials.gov, and the search date ended on May 30, 2019. Inclusion criteria: (1) the types of studies included were randomized controlled trials; (2) the study participants were infants and children with a clear diagnosis of bronchopneumonia, without gender and ethnic restrictions; (3) the intervention test group was XYPI or the control group plus XYPI. The control group was routine treatment (RT) (basic treatment such as fever, cough and asthma, oxygen inhalation, anti?infection, maintaining water, electrolyte balance, etc.) or other Western medicine or RT + other Western medicine treatment. Except for XYPI, the two groups were consistent in intervention measures.According to the Cochrane Handbook, 5.1 evaluation standard and a meta?analysis of the final included studies was performed using RevMan 5.3 software. Results:Atotal of 57 studies were included, with a total sample size of 8454 cases, of which 4255 were in the experimental group and 4199 were in the control group. Meta?analysis results showed that (1) Total effective rate: XYPI group was better than the control group (relative risk [RRRT] = 1.25, 95% confidence interval [CI] [1.15, 1.36], P < 0.00001; RRRT + RBVI = 1.18, 95% CI [1.09, 1.29], P < 0.0001; RR antibiotic = 1.16, 95% CI [1.09, 1.24], P < 0.00001, RRRT + antibiotic = 1.22, 95% CI [1.16, 1.27], P < 0.00001); antipyretic time: XYPI group was better than the control group (mean difference [MDRT] = ?0.97, 95% CI [?1.17, ?0.76], P < 0.00001; MDRT + antibiotic = ?2.28, 95% CI [?2.88, ?1.67], P < 0.00001; MDRT + RBVI = ?1.51, 95% CI [?1.81, ?1.21], P < 0.00001; cough disappearing time: XYPI group was better than the control group (MDRT = ?1.37, 95% CI [?1.74, ?1.00], P < 0.00001; MDRT + antibiotic = ?1.71, 95% CI [?2.04, ?1.37], P < 0.00001; MDRT + RBVI = ?1.51, 95% CI [?2.15, ?0.86], P < 0.00001); disappearance time of lung rales: XYPI group was better than the control group (MDRT = ?1.11, 95% CI [?1.35, ?0.88], P < 0.00001; MDRT + RBVI = ?1.63, 95% CI [?2.23, ?1.03], P < 0.00001). The difference was statistically significant; (2) Of the 57 studies (a total of 8454 cases), 29 studies reported adverse reactions, of which 18 studies did not find adverse reactions, and 11 studies reported adverse reactions such as nausea, vomiting, and rash after medication in both groups. (3) The funnel chart indicated potential publication bias. Conclusion: Based on the existing clinical evidence, XYPI can have a certain effect on the treatment of children with bronchopneumonia, and it is not yet possible to conclude its safety evaluation. Moreover, due to the low quality of the included studies, this evidence is still used with cautious clinically.     

Clinical Research Progress of Dachengqi Decoction (大承气汤) in the Treatment of Intestinal Obstruction

综述大承气汤治疗肠梗阻的研究概况.临床采用大承气汤治疗肠梗阻,多以该方为基础方进行加减,兼补气、行气、活血、滋阴、清热等.大承气汤口服、胃管注入、保留灌肠、直肠滴入、肠梗阻导管等给药方式可单独应用或多种给药方式联用,亦可联合针灸、按摩、外敷等中医特色疗法,以加强临床疗效.     

Clinical Effect of Tripterygium Glycosides Combined with Glucocorticoids in the Treatment of Refractory Nephrotic Syndrome Patients: A Systematic Review and Meta‑Analysis

The objective of this study is to evaluate the effectiveness and safety of Tripterygium glycosides combined with glucocorticoids for the treatment of refractory nephrotic syndrome (NS). Computer search of Chinese and English databases, including CNKI, VIP, Wan Fang Database, PubMed, Cochrane Library, Embase, and Sinomed, for randomized controlled trials (RCTs) of Tripterygium glycosides combined with glucocorticoids for refractory NS (RNS) was conducted. Meta?analysis was performed using RevMan5.3. Thirteen RCTs comprising 994 patients were included in the study. Tripterygium glycosides combined with glucocorticoids had a statistical significance on the effective rate (odds ratio [OR] =4.69, 95% confidence interval [CI] 3.29, 6.67, P < 0.00001), 24?h urine protein ( Weighted mean difference (MD) = ?0.57, 95% CI [?0.62, ?0.51], P < 0.00001), serum albumin (MD = 4.77,95% CI [4.30, 5.24], P < 0.00001), total serum protein (MD = 9.45, 95% CI [8.73, 10.17], P < 0.00001), urea nitrogen (MD = ?0.53, 95% CI [?0.90, ?0.17], P = 0.005), and serum creatinine (MD = ?8.45, 95% CI [?15.32, ?1.57], P = 0.02). There was no statisticalsignificance on adverse reactions(OR = 0.68, 95% CI [0.41, 1.12], P = 0.13). Tripterygium glycosides combined with glucocorticoids could improve clinical effective rate, reduce 24?h urine protein, improve serum albumin and total serum protein, and reduce urea nitrogen and serum creatinine levels in patients with RNS. However, the quality of the included literature is poor, and conclusion still needs further verification using larger samples and high?quality randomized, double?blind controlled trials.     

Effectiveness and safety of Jinshuibao capsules(金水宝胶囊)in treatment of residual cardiopulmonary symptoms in convalescent patients of coronavirus disease 2019:a pilot randomized,double-blind,placebo-controlled clinical trial

OBJECTIVE: To evaluate the effectiveness and safety of Jinshuibao capsules(金水宝胶囊), a Traditional Chinese Medicine(TCM), in the treatment of residual cardiopulmonary symptoms in convalescent corona virus disease 2019(COVID-19) patients. METHODS: A total of 200 participants with COVID-19 in convalescence phase were randomly assigned into two groups at a 1:1 ratio in this multicenter randomized,double-blind, placebo-controlled trial. One group received Jinshuibao capsules, and the other received pl...     

Effects of the Huangkui capsule(黄葵胶囊)on chronic kidney disease:a systematic review and Meta-analysis

OBJECTIVE: To collect data and investigate the effects of Huangkui capsule(黄葵胶囊, HKC) on chronic kidney disease(CKD). METHODS: PubM ed, Embase, Cochrane Library, and three Chinese databases(China National Knowledge Infrastructure, Wanfang, and China Science and Technology Journal Database) were searched for articles published until October 2020. Randomized controlled trials(RCTs) of HKCs used for treating CKD were reviewed. Data were organized and analyzed using RevMan 5.3 software. RESULTS: HKC...     

Efficacy of suspended moxibustion stimulating Shenshu(BL23)and Guanyuan(CV4) on the amygdala-HPA axis in rats with kidney-Yang deficiency symptom pattern induced by hydrocortisone

OBJECTIVE: To investigated the effects of suspended moxibustion stimulating Shenshu(BL23) and Guanyuan(CV4) acupoints on the amygdala and HPA axis in our rat model and elucidated the possible molecular mechanisms of moxibustion on kidney-Yang deficiency symptom pattern(KYDS). METHODS: Sixty male Sprague Dawley rats were randomly divided into a control group(n = 12) and an experimental group(n = 48). Rats in the experimental group were given intramuscular injections of hydrocortisone to establish...     

Treatment of leishmaniasis in the Oyapock basin (French Guiana): A K.A.P. survey and analysis of the evolution of phytotherapy knowledge amongst Wayãpi Indians

Ethnopharmacological relevance

Cutaneous leishmaniasis is a neglected disease with a high incidence in French Guiana, mainly in the middle and upper Oyapock basin, where Amerindian and some Brazilian people live. The main goals of this work were (i) to assess the knowledge about leishmaniasis in the different populations of the middle and upper Oyapock basin, (ii) to study the therapeutic strategies adopted by people affected by leishmaniasis and (iii) to document the use of phytotherapeutic remedies for leishmaniasis. Knowledge, attitudes and practices (K.A.P.) related to this disease and its treatments have been studied according to cultural group and geographical settlement. Within the Wayãpi group, the evolution of the knowledge of phytoremedies over the last 20 years has been characterised by literature-based comparisons.

Materials and methods

A total of 144 questionnaires were administered in all the villages of the upper Oyapock and Camopi basins. Correspondence analyses were used for multivariate analysis. Plant species were identified at the Cayenne Herbarium (CAY).

Results

The biomedical concept of leishmaniasis correlates well with the Teko and Wayãpi concepts of kalasapa and kalasapau. Although the vector of this disease was not correctly identified, the most commonly cited aetiology (74.5%) was vector-borne, and related epidemiological schemes correlate well with the one encountered in French Guiana.Theoretically and practically, health centres were the most commonly used resource for diagnostic in instances of leishmaniasis infection (65.9%), independently of the patient's cultural group, along with the use of pharmaceutical drugs (85.3%). Pharmaceuticals were commonly utilised despite the frequent (51.5%) use of phytotherapeutic remedies, alone or in combination with drugs. The most cited medicinal plant species for the treatment of leishmaniasis included Eleutherine bulbosa (Mill.) Urb. (Iridaceae, cited 14 times), Euterpe oleracea Mart. (Arecaceae, 9), Cecropia obtusa Trecul (Cecropiaceae, 8), Jatropha curcas L. (Euphorbiaceae, 7), Ceiba pentandra (L.) Gaertn. (Bombacaceae, 6) and Carica papaya L. (Caricaceae, 6).Multiple correspondence analyses demonstrated that the species used in leishmaniasis remedies are more prone to vary by the user's place of residence than by their cultural origin, which indicates that exchange of knowledge about leishmaniasis remedies has occurred across different cultural groups.Literature-based comparisons between the remedies for leishmaniasis used by the Wayãpi during the 1980s showed a striking evolution, both in terms of diversity of species and number of plants used. The large number of species shared with other Guianese groups argues for intercultural exchange and may explain the majority (57.1%) of the newly used species highlighted in our study.

Conclusions

Leishmaniasis is a well-known disease in the studied area. Phytotherapeutic treatments are still in use, although they are not the main source of remedies, and should undergo pharmacological studies to evaluate their potential therapeutic value.     

Effect of Zhihuang Ulcer Mixture(知黄溃疡合剂)on Wound Healing and MCP-1/CCR2/NF-κB Pathway in Rats with Recurrent Oral Mucosal Ulcer

目的:探讨知黄溃疡合剂对复发性口腔黏膜溃疡模型大鼠创面修复的作用及对单核细胞趋化蛋白-1(MCP-1)/趋化因子受体-2(CCR2)/核因子-κB(NF-κB)通路的影响.方法:55只SD大鼠随机选取10只作为对照组,其余45只大鼠建立复发性口腔黏膜溃疡大鼠模型,40只造模成功大鼠随机分为模型组、左旋咪唑组、知黄溃疡合剂低剂量组、知黄溃疡合剂高剂量组,每组10只.左旋咪唑组、知黄溃疡合剂低剂量组、知黄溃疡合剂高剂量组按10 mL/kg灌胃给药,对照组和模型组大鼠则予以等体积生理盐水灌胃,连续给药20d.观察大鼠口腔溃疡情况变化;ELISA法测定大鼠溃疡黏膜组织中炎症因子水平;流式细胞仪检测大鼠外周血T淋巴细胞亚群;HE染色观察大鼠口腔黏膜组织病理;Western blotting测定大鼠溃疡黏膜组织中MCP-1、CCR2、NF-κB、p-NF-κB p65蛋白表达水平.结果:模型组、知黄溃疡合剂低剂量组、知黄溃疡合剂高剂量组、左旋咪唑组大鼠溃疡数目依次减少,溃疡评分依次降低,γ干扰素(IFN-γ)、白细胞介素17(IL-17)依次降低,CD4+、CD4+/CD8+依次升高,CD8+依次降低(P＜0.05).模型组大鼠口腔黏膜组织破溃,可见大量空泡变性,大量炎症细胞浸润;左旋咪唑组、知黄溃疡合剂高剂量组明显改善,知黄溃疡合剂低剂量组有所改善.模型组、知黄溃疡合剂低剂量组、知黄溃疡合剂高剂量组、左旋咪唑组大鼠溃疡黏膜组织中MCP-1、CCR2蛋白相对表达量及p-NF-κB p65/NF-κB依次降低(P＜0.05).结论:知黄溃疡合剂可能通过抑制MCP-1/CCR2/NF-κB通路,发挥对复发性口腔黏膜溃疡大鼠创面的修复作用.