Comments on serious anaphylaxis caused by nine Chinese herbal injections used to treat common colds and upper respiratory tract infections

Reports describing severe allergic shock and fatality following treatment of a common cold or upper respiratory tract infection (URTI) with a Chinese herbal injection were collected. Our analysis of the risks associated with this treatment suggested that the potential risk of serious, or even lethal, anaphylaxis should preclude its use in treating common colds and URTIs. In light of our findings herein, we propose the following five suggestions for improving the clinical safety of delivering Chinese herbal injections as medical treatments. First, Chinese herbal injections should not be delivered in the clinic to treat patients in accordance with Bian zheng lun zhi (broad-spectrum application based on holistic Traditional Chinese Medicine (TCM) theory and methodology), but rather they should be administered to target specific indicated disease processes. Second, Chinese herbal injection indications should be based on the results of double-blind randomized controlled clinical trials. Third, Chinese herbal injections should be used only in cases involving severe disease or to rescue patients in critical condition; they should not be used to treat mild, relatively innocuous diseases, such as common colds and upper respiratory tract infections, given the risk of doing harm. Fourth, Chinese herbal injection formulas should include materials from only a single or a small number of plant sources in known quantities. Fifth, more studies examining the toxicology and allergenic potential of Chinese herbal injections are needed.     

Transcatheter arterial chemoembolization combined with or without Chinese herbal therapy for hepatocellular carcinoma: meta-analysis

Objective: Chinese herbal therapy is sometimes used in conjunction with transcatheter arterial chemoembolization (TACE) for the treatment of hepatocellular carcinoma (HCC) in Asian countries. This study aims to systemically review the efficacy of Chinese herbal therapy in HCC patients receiving TACE. Methods: Meta-analysis was performed for clinical trials comparing Chinese herbal therapy versus no Chinese herbal therapy given to HCC patients receiving TACE. Publications in 10 electronic databases were extensively searched. Results/conclusion: Chinese herbal therapy was associated with a significant rise in the number of patients with survival > 1-year, 2-year and 3-year, as well as a significant rise in the number of patients who reported complete or partial response and non-deterioration performance status. Chinese herbal therapy also showed significant efficacies in the increase of T cells and natural killer cells, whereas a significant lower blood α-fetoprotein concentration was reported. There were a significant increase in white blood cell count, a significant lower risk in patients with nausea and vomiting, and a significant rise in patients with increased body weight when Chinese herbal therapy was given. The evidence from this review supports the use of Chinese herbal therapy to enhance the efficacy of TACE in HCC patients. However, owing to limited data and heterogeneity of the included studies, further trials are required.     

中药治疗海洛因依赖急性戒断症状的Meta分析

目的:系统评价中药治疗海洛因依赖急性戒断症状的有效性与安全性。方法:计算机检索多种中英文数据库,收集中、西药(α2-肾上腺素受体激动剂或阿片受体激动剂)对比研究海洛因脱毒的随机对照实验(RCT)。采用Jadad量表对纳入研究进行质量评价,并采用RevM an软件以固定效应和随机效应模型进行M eta分析。评价指标包括:戒断症状评分、焦虑评分及不良反应发生率。结果:共纳入21个实验(共2949位受试者)。结果显示:对于戒断症状的缓解,在疗程的d4-10(d8除外),中药组优于α2-受体激动剂组,在疗程的前3 d,两者无显著性差异。与阿片受体激动剂相比,在疗程前3 d,中药略显逊色,但在疗程d4-9,两者疗效相当。对于焦虑的缓解,中药组与阿片受体激动剂组相比无显著性差异,但与α2-受体激动剂组相比,中药在疗程后期显示出优越性。另外,在某些不良反应(疲乏、眩晕)发生率上,中药组也显著低于α2-受体激动剂组(阿片受体激动剂组数据不足,未分析)。结论:现有数据表明,中药是海洛因依赖脱毒有效而安全的治疗方法。但对于中药特定方剂的特定疗效还需要有进一步的研究。     

中医辨证加熏洗治疗小腿湿疹临床疗效分析

目的 :探讨中药治疗小腿湿疹的临床疗效。方法 :根据中医理论 ,按辨证分型加局部熏洗治疗小腿湿疹 60例 ,并与抗组胺类药物对照观察 30例。均按 2wk为一疗程 ,共观察 2个疗程。结果 :治疗组的总有效率为 86.7% ,优于对照组 (5 3.3% )。两组比较 ,差异有显著的统计学意义 (P <0 .0 1)。结论 :中医辨证用药 ,内外兼治 ,是治疗小腿湿疹的有效方法 ,在治疗湿疹方面也有一定的优势。     

中草药提取物治疗糖尿病溃疡的研究进展

皮肤溃疡是糖尿病最常见的并发症,糖尿病溃疡患者死亡率远高于无溃疡糖尿病患者。近年来,中草药因具有多成分、多靶点、多通路协同的治疗效应而受到广泛关注。临床实践证明,中草药能有效促进糖尿病创面愈合,并展现出良好的安全性。为系统评价中草药对糖尿病溃疡的治疗效应,笔者通过检索文献,回顾和总结了15种中草药提取物促进糖尿病创面愈合的作用机制,并基于传统中医药理论进行分类讨论,以期为糖尿病溃疡的精准治疗及新药研发提供参考。     

儿童湿疹/特应性皮炎药物临床试验评价指标的研究进展

湿疹是儿科临床常见的皮肤病,特应性皮炎是其中最常见的一种.《儿童湿疹/特应性皮炎中药临床试验设计与评价技术指南》已正式发布,其中提到湿疹/特应性皮炎临床试验的核心指标集,包括客观体征、主观症状、生活质量和长期控制4个核心领域,并参考核心指标集所述,制定了疗效评价指标.综述国内外湿疹/特应性皮炎临床试验中关于上述4个核心...     

中药保留灌肠治疗慢性肾衰竭的 Meta分析

目的：系统评价中药保留灌肠治疗慢性肾衰竭的疗效。方法电子检索中国期刊全文数据库、中国生物医学文献数据库、维普数据库、万方数据库,并加以人工检索,全面收集中药保留灌肠治疗慢性肾衰竭的随机对照临床试验,检索时间截止于2015年3月10日,对符合标准的文献用RevMan5．3进行Meta分析。结果共纳入13个随机对照研究,合计1130例患者。 Meta分析结果显示,中药保留灌肠联合西医治疗组治疗慢性肾衰竭的显效率优于单纯西医对照组（ RR＝2．02,95％ CI：1．66～2．45,P＜0．00001）;治疗组总有效率亦优于对照组（RR＝1．48,95％CI：1．37～1．61,P＜0．00001）;中药保留灌肠组较对照组降低血肌酐更为明显（WMD＝－50．99,95％CI：－69．26～－32．72,P＜0．00001）;中药保留灌肠组较对照组显著改善尿素氮水平（WMD＝－3．70,95％CI：－5．06～－2．34,P＜0．00001）。结论中药保留灌肠联合西医治疗慢性肾衰竭,疗效确切,值得临床推广应用。     

中医药治疗高血压病临床研究

目的：观察自拟中药方穴位敷贴和涌泉穴按压治疗原发性高血压病的降压效果及安全性。方法：选择2014年1月—2015年1月中心门诊高血压患者150例,分为干预组、对照组Ⅰ和对照组Ⅱ,每组50例。三组在不改变原降压药的基础上,干预组同时增加自拟中药方穴位敷贴加涌泉穴按压,对照组Ⅰ仅增加自拟中药方穴位敷贴,对照组Ⅱ仅增加涌泉穴按压。观察三组降压效果、中医临床症候和安全性,观察时间为1年。结果：三组治疗后血压较治疗前均有所改善,患者临床症状也都有不同程度减轻,干预组较对照组疗效更加显著。结论：自拟中药方穴位敷贴和涌泉穴按压治疗高血压病都具有确切的疗效,且二者联合应用效果更显著。以上三组在治疗过程中均未发生不良反应,安全性好。     

Treatment of asthma and food allergy with herbal interventions from traditional chinese medicine

Prevalence of asthma and allergy has increased over the past 2-3 decades in Westernized countries. Despite increased understanding of the pathogenesis of asthma and allergic diseases, control of severe asthma is still difficult. Asthma is also associated with a high prevalence of anxiety, particularly in adolescents. There is no effective treatment for food allergy. Food allergy is often associated with severe and recalcitrant eczema. Novel approaches for treatment of asthma and food allergy and comorbid conditions are urgently needed. Traditional Chinese medicine, used in Asia for centuries, is beginning to play a role in Western healthcare. There is increasing scientific evidence supporting the use of traditional Chinese medicine for asthma treatment. Since 2005, several controlled clinical studies of "antiasthma" herbal remedies have been published. Among the herbal medicines, antiasthma herbal medicine intervention is the only antiasthma traditional Chinese medicine product that is a Food and Drug Administration investigational new drug that has entered clinical trials in the United States. Research into the effects and mechanisms of action of antiasthma herbal medicine intervention in animal models is actively being pursued. Research on traditional Chinese medicine herbal medicines for treating food allergy is rare. The herbal intervention Food Allergy Herbal Formula-2 is the only Food and Drug Administration botanical investigational new drug under investigation as a multiple food allergy therapy. This review article discusses promising traditional Chinese medicine interventions for asthma, food allergy, and comorbid conditions, and explores their possible mechanisms of action.     

Herb–drug interactions: Review and assessment of report reliability

AIMS: The aim of this systematic review was to assess the published clinical evidence on interactions between herbal and conventional drugs. METHODS: Four electronic databases were searched for case reports, case series or clinical trials of such interactions. The data were extracted and validated using a scoring system for interaction probability. RESULTS: One hundred and eight cases of suspected interactions were found. 68.5% were classified as 'unable to be evaluated', 13% as 'well-documented' and 18.5% as 'possible' interactions. Warfarin was the most common drug (18 cases) and St John's wort the most common herb (54 cases) involved. CONCLUSION: Herb-drug interactions undoubtedly do occur and may put individuals at risk. However our present knowledge is incomplete and more research is urgently needed.     

近5年中医药治疗小儿湿疹研究进展

参阅近5年相关文献,总结小儿湿疹的常见证型,归纳中医药内、外治法在小儿湿疹治疗中的应用情况,分析其治疗特色及潜在优势,拓展临床治疗思路,为今后小儿湿疹的临床诊疗提供借鉴。     

中药治疗150例湿疹的临床观察

目的：根据湿疹的不同类型采用中药治疗,观察中药治疗湿疹的临床疗效。方法：收集2007年8月-2010年8月来本院就诊的150例湿疹患者,按临床表现及皮损特点分为六型治疗。结果：治愈128例,占85．3％,好转14例,占9-3％,无效8例,占5．3％,总有效率达94．7％。结论：湿疹是皮肤科的常见病,缠绵难愈,中药辨证治疗效果显著,值得推广。     

中药开拓欧盟植物药市场的机会与威胁分析

目的:帮助我国中药企业加深对欧盟植物药市场的了解,推动中药国际化。方法:在认识欧盟植物药市场的市场容量、细分市场、消费方式和发展趋势等的基础上,分析中药开拓欧盟植物药市场所面临的机会与威胁。结果与结论:中药开拓欧盟植物药市场,机会与威胁并存,但总的来说机会大于威胁。我国企业应加大对欧盟植物药市场的开拓力度。     

穴位注射联合中药外洗治疗手部湿疹的疗效观察

目的 探讨穴位注射醋酸曲安奈德注射液加利多卡因联合中药外洗治疗手部湿疹的疗效.方法 将108例手部湿疹患者随机分为对照组和治疗组各54例.对照组采用穴位注射醋酸曲安奈德注射液1 ml加2％利多卡因1 ml的混合液,分别对双手合谷穴注射,每3周1次,6周1个疗程;治疗组在对照组的基础上加用中药浸泡患部20～30 min,2次/d,6周1个疗程.2个疗程后对两组疗效进行比较.结果 治疗组治疗后EASI评分下降比对照组明显（P＜0.05）.治疗组和对照组有效率分别为96.3％和79.63％,两组比较差异有统计学意义（P＜0.05）.结论 穴位注射醋酸曲安奈德注射液加2％利多卡因联合中药洗剂治疗手部湿疹是安全有效的,值得推广应用.     

我院门诊中药处方调查与分析

目的:通过对我院中药处方进行分析,了解我院2011年中药处方的临床使用存在的问题.方法:利用我院信息管理系统进行数据统计.对我院中药处方的书写、处方数、用量、药味等情况进行调查分析.结果:我院中药处方存在剂量偏大,药味偏多,剂数也超过《处方管理办法》(试行)规定、重复用药、不写用水量和脚注等问题.结论:必须加强中药处方的管理工作,为临床用药安全和合理用药提供参考.促进临床合理用药,更好地解决看病贵问题.     

我院2004～2006年不育不孕症患者中草药应用分析

目的:探讨我院不育不孕症患者中草药应用的规律性。方法:对我院2004～2006年不育不孕症患者所用58376剂中草药所涉及到的品种、用药频率、用量等,按性别进行统计分析。结果:所用中草药的品种、用药频率及用量都比较稳定;其药性分布结构符合中医药理论的特征。结论:中草药治疗不育不孕症的技术已较为成熟、功效较确切可靠;对中草药的临床应用,应以中医药理论为指导,突出中医药特色。     

2009年解放军总医院糖尿病患者中草药应用分析

目的:通过调查我院糖尿病患者中草药使用情况,寻找用药规律,以期指导临床合理用药.方法:选取2009年全年中医科门诊糖尿病患者553例,口服草药处方共4 980张,对其用药种类数量统计分析.结果:单张处方药味最多在11～ 20味之间,占91.12％,使用最多的前3类中草药分别是补益药、清热药、消食药.结论:我院中医科在对...     

中西药结合治疗复发性生殖器疱疹42例

目的:观察中西药结合治疗复发性生殖器疱疹的临床疗效及复发率。方法:将120例复发性生殖器疱疹患者随机分为3组,中西药结合组给予口服中药自拟方+西药伐昔洛韦胶囊+重组人干扰素治疗;西药组给予伐昔洛韦+重组人干扰素治疗;中药组给予口服中药自拟方治疗。结果:中西药结合组有效率比其他2组高,复发率比其他2组低(均P<0.05)。结论:中西药结合治疗复发性生殖器疱疹,疗效好,复发率低。     

The efficacy of ginseng. A systematic review of randomised clinical trials

Objective: Ginseng is one of the most popular herbal remedies, and a number of health claims are made for it. This systematic review provides an evaluation of the current evidence for or against the efficacy of ginseng root extract. Methods: Searches of the computerised literature databases Medline, Embase, Biosis, CISCOM and the Cochrane Library were performed to retrieve double-blind, randomised, placebo-controlled trials of ginseng root extract for any indication. Manufacturers and experts were contacted to provide additional information. There were no restrictions regarding the language of publication. The outcome and methodological quality of all trials were independently assessed by two reviewers. Results: Sixteen trials met the inclusion criteria and were reviewed. These trials related to physical performance, psychomotor performance and cognitive function, immunmodulation, diabetes mellitus and herpes simplex type-II infections. The evidence found for ginseng root extract is compelling for none of these indications. Conclusion: Based on these data, it is concluded that the efficacy of ginseng root extract is not established beyond reasonable doubt for any of these indications. The widespread use of ginseng as a herbal remedy warrants more rigorous investigations to assess its efficacy and safety. Received: 23 April 1999 / Accepted in revised form: 26 July 1999     

中西医结合治疗腰椎间盘突出症78例疗效观察

目的 探讨中西医结合治疗腰椎间盘突出症的效果.方法 腰椎间盘突出症患者78例,采用山东产DFQ-300型多方位腰椎牵引床牵引,并选用伸筋草等十多味中草药汽蒸后于牵引后次日置药袋于腰部热敷.结果 本组78例中,治愈38例,占48.7%;显效24例,占30.8%,有效11例,占14.1%;无效5例,占6.4%,总有效率达93.6%.结论 多方位腰椎牵引加中草药热敷,中西医结合治疗腰椎间盘突出症疗效显著值得推广.