TCM Syndrome Score Research Articles

Procalcitonin impact analysis, respiratory function and blood gas analysis on Xiaoqinglong decoction combined with non-invasive ventilation in treatment of AECOPD patients

To observe the effect of Xiaoqinglong decoction combined with noninvasive ventilation on procalcitonin (PCT), blood gas analysis and respiratory functions in acute exacerbation of chronic obstructive pulmonary disease in the elderly (AECOPD), and investigate its correlation and clinical significance. Eighty-four elderly AECOPD patients with respiratory failure in our hospital from January 2015 to October 2017, were randomly divided into control group and observation group, 42 cases in each group. The control group received western medicine combined with noninvasive ventilator therapy, and the patients in observation group additionally received Xiaoqinglong decoction on the basis of the treatment in control group. Both groups were treated for 2 weeks. The clinical effects of two groups were observed and their PCT, blood gas analysis outcomes [arterial oxygen partial pressure (PaO₂), arterial partial pressure of carbon dioxide (PaCO₂), respiratory function, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC], TCM syndrome score and other indexes and adverse reactions were compared before and after treatment. The total efficiency was 95.24% (40/42) in observation group, higher than 76.19% (32/42) in control group, with statistically significant difference (P<0.05). There were no statistically significant differences in PCT, PaO₂, PaCO₂, FVC, FEV1/FVC, FEV1, and TCM syndrome scores between two groups before treatment. But after treatment, PCT and PaCO₂ levels in the observation group were lower and PaO₂, FVC, FEV1/FVC, FEV1 levels was higher than those in the control group (P<0.05); TCM syndrome scores were lower than those in the control group (P<0.05); both groups had no obvious adverse reactions. The results showed that Xiaoqinglong decoction combined with noninvasive ventilator could significantly reduce the procalcitonin level, effectively improve the respiratory function and blood gas analysis indexes, and significantly reduce the clinical symptoms in AECOPD patients, so it is worthy of promotion.

Clinical effect of Shenqi-Tongmai decoction in stable angina pectoris patients with Qi-deficiency-blood-stasis syndrome and the influence on levels of serum associated adhesion factors

Objective To investigate the effect of Shenqi-Tongmai decoction in Stable Angina pectoris Patients with Qi-deficiency-blood-stasis syndrome and the influence on serum associated adhesion factors. Methods A total of 110 patients with stable angina pectoris treated in the department of cardiology of traditional Chinese medicine hospital of Xinle city from Feb. 2015 to Feb. 2017 were divided into 2 groups according to the number random table method, with 55 in each group. All the patients were given the standardized treatment with western medicine, and the treatment group were aditionally treated with the Shenqi-Tongmai decoction. All the patients were treated for a course of 4 weeks. The TCM syndrome score, Seattle angina questionnaire (SAQ) score, electrocardiographic examination index and serum soluble intercellular adhesion molecule 1 (sICAM-1), soluble vascular cell adhesion molecule 1 (sVCAM-1) level of the two groups before and after treatment were compared, and the clinical curative effect of the two groups was compared. Results The TCM syndrome score (7.1 ± 2.2 vs. 11.4 ± 3.0, t=8.590), serum sICAM-1 (227.69 ± 42.81 ng/ml vs. 275.33 ± 48.62 ng/ml, t=5.454) level, serum sVCAM-1 (272.04 ± 39.87 ng/ml vs. 296.58 ± 42.60 ng/ml, t=3.127) level and lead ecg ST segment down number (2.7 ± 0.6 vs. 3.2 ± 0.6, t=4.067), T wave of low lead numbers (1.7 ± 0.3 vs. 2.1 ± 0.3, t=6.807), numbers of T wave inversion lead (1.7 ± 0.3 vs. 2.1 ± 0.2, t=9.908) of the treatment group were significantly lower than those of the control group (P<0.01). The SAQ scores (76.8 ± 10.5 vs. 67.4 ± 10.1, t=4.805) was higher than that of the control group (P<0.01). The curative effect of angina pectoris and electrocardiogram of the treatment group were 91.0% (50/55) and 92.7% (51/55), and the control group were 76.4% (42/55) and 78.2% (43/55). The difference was statistically significant between the two groups (χ2=4.251, 4.681, P<0.05). Conclusions Traditional Chinese medicine Shenqi-Tongmai decoction can effectively improve the SAQ scores and TCM syndrome score and electrocardiogram examination index, improve the clinical curative effect in the treatment of Stable Angina pectoris based on the western medicine (Qi-deficiency-blood-stasis syndrome) and its mechanism may be related to improving of the serum levels of sICAM 1, sVCAM 1. Key words: Angina, stable; Qi-deficiency blood stasis; Shenqi-Tongmai decoction; Soluble intercellular adhesion molecule-1; Soluble vascular cell adhesion molecule-1

Establishment of grading model of knee osteoarthritis based on clinical research system

The factors influencing the grade of knee osteoarthritis were screened by ordered Logistic regression analysis. The classification model of knee osteoarthritis was established, which provided tool for the evaluation of clinical classification of knee osteoarthritis. A total of 753 cases of knee osteoarthritis from Wangjing Hospital, China Academy of Chinese Medical Sciences were treated with single factor and multivariate Logistic regression analysis from September 18, 2014 to April 26, 2016. The model formula was constructed and evaluated. In this study, it was found that 13 factors associated with knee osteoarthritis grading. Old age, obesity, long course of disease, recurrence, lower limb deformity, quadriceps muscle atrophy, WOMAC index, TCM syndrome score, VAS score and grading degree were positively correlated. One knee pain, limited pain range, knee activity and grading degree were negatively correlated. The knee osteoarthritis grading model was constructed and the evaluation test was effective(Training set AUC=0.860, test set AUC=0.879). In this study, a classification model of knee osteoarthritis was established which has a good ability to predict the classification of knee osteoarthritis under preliminary evaluation.

Clinical study on acupuncture Wangshi Wuzangshu combined Geshu in the treatment of liver qi stagnation type of femaleclimacteric depression

Objective To evaluate the clinical effect of acupuncture Wangshi Wuzangshu combined Geshu in the treatment of liver qi stagnation type of femaleclimacteric depression (CD). Methods A total of 82 cases of liver qi stagnation type CD patients were divided into observation group and control group with 41 cases in each group. The control group was treated with fluoxetine hydrochloride (Baiyoujie), and the observation group was treated with acupuncture Wangshi Wuzangshu combined Geshu. Patients were treated for 6 weeks. The Hamilton Depression Scale (HAMD) scores, score reduction rate, changes of TCM syndrome scores, and clinical effect were observed and compared. Results The total effective rate of the observation group was 97.6% (40/41), and the control group was 82.9% (34/41). The difference between the 2 groups was statistically significant (χ2=4.986, P=0.026). After treatment, the HAMD score (7.7 ± 4.3 vs. 10.2 ± 4.4, t=2.551) of the observation group was significantly lower than the control group, and the reduction rate of HAMD (55.1% ± 13.3% vs. 41.5% ± 15.2%, t=4.327) was significantly higher than that of control group (P<0.01). The TCM syndrome score (2.5 ± 1.8 vs. 3.7 ± 2.3, t=2.692) was significantly lower than the control group (P<0.01). Conclusions Acupuncture Wangshi Wuzangshu combined Geshu can improve the clinical effect of liver qi stagnation in female CD patients, and improve the symptoms and emotional state. Key words: Depression; Climacteric; Acupuncture; Point BL17(Geshu); Wuzangshu; Comparative effectiveness research

Mitochondrial factor and cell cytokines associate with TCM syndrome scale in vascular dementia patients.

Mitochondrial factor and cell cytokines play important roles in the incidence of vascular dementia (VD), but their correlations with inflammatory and mitochondrial factors and the role of both in the kidney essence deficiency pattern and phlegm turbidity blocking orifice pattern are not clear. This study was aimed at studying the correlations between the serum mitochondrial factor and cell cytokines with TCM Syndrome Scale in vascular dementia. According to the inclusion criteria we collected 108 vascular dementia patients which were divided into the kidney essence deficiency pattern and phlegm turbidity blocking orifice pattern based on the TCM Syndrome Scale. We measured serum tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-18 (IL-18) concentration using an enzyme-linked immunosorbent assay (ELISA) and serum malondialdelyde (MDA) and superoxide dismutase (SOD) was quantified according to instructions of kits from the 108 patients (45 in kidney essence deficiency pattern, 63 in phlegm turbidity blocking orifice pattern). The scale scores were assessed using TCM Syndrome Scale, MMSE, Hachinski, Barthel, BBS, CDR. There was a significant difference on the scores of CDR and the factors of the memory, judgment, social affairs, personal care, family and hobbies among the two groups, The means of kidney essence deficiency group was higher than that of phlegm turbidity blocking orifice pattern group. IL-18 and SOD in the phlegm turbidity blocking orifice group was higher than those in the kidney essence deficiency pattern; IL-6 in phlegm turbidity blocking orifice pattern group was lower than that in the kidney essence deficiency pattern. By logistic regression analysis, we demonstrated that high concentration of IL-6, TNF-α, and MDA were associated with increased TCM syndrome scores in two groups, while IL-6, IL-18, TNF-α, SOD were associated with decreased MMSE, Barthel. Our study support the notion that IL-6 plays a more important role in the integral of kidney essence deficiency pattern, IL-18 is a more important factor in phlegm turbidity blocking orifice pattern. The results can be used as the theoretical basis of traditional Chinese Medicine prescription and pharmacological research in future, through decrease in IL-6 lever and increase in SOD in integral kidney essence deficiency pattern, and IL-18 as the main anti inflammation index in phlegm turbidity blocking orifice pattern.

Acupuncture lowering blood pressure for secondary prevention of stroke: a study protocol for a multicenter randomized controlled trial

BackgroundStroke is the prime cause of morbidity and mortality in the general population, and hypertension will increase the recurrence and mortality of stroke. We report a protocol of a pragmatic randomized controlled trial (RCT) using blood pressure (BP)-lowering acupuncture add-on treatment to treat patients with hypertension and stroke.MethodsThis is a large-scale, multicenter, subject-, assessor- and analyst-blinded, pragmatic RCT. A total of 480 patients with hypertension and ischemic stroke will be randomly assigned to two groups: an experimental group and a control group. The experimental group will receive “HuoXueSanFeng” acupuncture combined with one antihypertensive medication in addition to routine ischemic stroke treatment. The control group will only receive one antihypertensive medication and basic treatments for ischemic stroke. HuoXueSanFeng acupuncture will be given for six sessions weekly for the first 6 weeks and three times weekly for the next 6 weeks. A 9-month follow-up will, thereafter, be conducted. Antihypertensive medication will be adjusted based on BP levels. The primary outcome will be the recurrence of stroke. The secondary outcomes including 24-h ambulatory BP, the TCM syndrome score, the Short Form 36-item Health Survey (SF-36), the National Institute of Health Stroke Scale (NIHSS), as well as the Barthel Index (BI) scale will be assessed at baseline, 6 weeks and 12 weeks post initiating treatments; cardiac ultrasound, carotid artery ultrasound, transcranial Doppler, and lower extremity ultrasound will be evaluated at baseline and 12 weeks after treatment. The safety of acupuncture will also be assessed.DiscussionWe aim to determine the clinical effects of controlling BP for secondary prevention of stroke with acupuncture add-on treatment.Trial registrationClinicalTrials.gov, ID: NCT02967484. Registered on 13 February 2017; last updated on 27 June 2017.

Clinical study of Zhenwu decoction combined with Linggui-Zhugan decoction combined with western medicine in the treatment of senile heart failure

Objective To observe the clinical effect of Zhenwu decoction combined with Linggui-Zhugan decoction on senile patients with heart failure. Methods A total of 123 patients with heart failure who met the inclusion criteria were randomly divided into 3 groups by random number table method, each group of 41 cases. The patients in the control group were treated with routine western medicine, Zhenwu decoction group was treated with Zhenwu decoction on the basis of the control group treatment, and the combined decoction group was treated with Zhenwu and Linggui-Zhugan decoction on the basis of the control group. The treatment last 4 weeks as 1 course, 2 courses in total. The TCM syndrome score, left ventricular ejection fraction, brain natriuretic peptide level, nt-probnp level and TGF-β1 level were observed, and the clinical effect was evaluated. Results After 8 weeks treatment, Palpitation (0.68 ± 0.53 vs. 0.79 ± 0.64, 1.12 ± 0.70, F=7.207), chest distress (0.66 ± 0.52 vs. 0.79 ± 0.60, 1.36 ± 0.70, F=6.367), edema (0.32 ± 0.31 vs. 0.43 ± 0.41, 0.52 ± 0.37, F=7.054), wheezing (0.62 ± 0.55 vs. 0.82 ± 0.69, 0.88 ± 0.68, F=6.634), fatigue (0.73 ± 0.47 vs. 0.94 ± 0.62, 1.49 ± 0.58, F=5.832), spontaneous sweat (0.46 ± 0.39 vs. 0.89 ± 0.62, 0.99 ± 0.79, F=7.207), insomnia (0.42 ± 0.39 vs. 0.74 ± 0.50, 0.79 ± 0.58, F=6.672) in the combination group were significantly lowere than those in the other two groups (P<0.05). The TGF-β1 (102.75 ± 15.79 ng/L vs. 121.57 ± 19.25 ng/L, 184.35 ± 23.74 ng/L, F=160.776) in the combination group was significantly lowere than that in the other two groups (P<0.01). The total effective rate was 81.8% (27/33) in the combination group, 78.1% (25/32) in the Zhenwu group, and 62.16% (23/37) in the control group. The the difference of total effective rates among three groups were statistically significant (χ2=7.089, P=0.037 ). Conclusions The Zhenwu decoction and Linggui-Zhugan decoction combined with the routine therapy can improve the symptoms and signs of elderly patients with heart failure, and reduce the serum TGF-1 level. Key words: Heart failure; Zhen Wu Tang; Ling Gui Zhu Gan Tang; Clinical study

Clinical efficacy of Jiawei Dihuang decoction combined with valsartan in treatment of early diabetic nephropathy

One hundred patients with early diabetic nephropathy were randomly divided into control group and study group with 50 cases in each group. All patients received conventional antidiabetic therapy with valsartan tablets 80mg, q. d; patients in study group were given additional TCM Jiawen Dihuang decoction. TCM syndrome scores, relevant biochemical testing and renal function changes were evaluated before and after treatment in two groups. After 8 weeks of treatment, the results showed than the TCM scores in both groups were significantly reduced (study group: 18.9±1.6 vs. 7.2±5.1, control group 18.8±1.5 vs. 10.3±6.2. both P<0.05); the improvement rate of TCM syndrome in study group was significantly higher than that of control group (90% vs. 68%, χ2=5.3, P<0.05) ; and the improvement of relevant biochemical index and renal function in study group was more marked than that in control group. The study indicates that the integrated TCM and Western medicine can enhance the efficacy in treatment of early diabetic hephropathy. Key words: Early diabetic nephropathy; Valsartan Tablets; insulin; TCM therapy; clinical effect

Effect and postoperative reactions of acupoint catgut embedding for prediabetes

To observe the effect and safety of acupoint catgut embedding for prediabetes. Eighty-six patients with prediabetes were randomly assigned into an observation group and a control group, 43 cases in each one. Diabetes health education was applied in the two groups. Catgut embedding was used at bilateral Pishu (BL 20), Weiwanxiashu (EX-B 3), Ganshu (BL 18), Shenshu (BL 23), and Zusanli (ST 36) in the observation group, once every 15 days for 6 times. The type and number of postoperative reactions of the last time had been recorded since the second embedding, and the situation of the last postoperative reactions was observed 15 days after treatment. Total cholesterol (TC), triglyceride (TG), fasting plasma glucose (FPG), 2 hours postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c), empty stomach insulin (Ins) and TCM syndrome score were tested before and after treatment as well as 6 months after treatment. The clinical efficacy was evaluated. After treatment, the levels of TC, TG, FPG, 2hPG, HbA1c of the observation group were lower than those before treatment and those of the control group (all P<0.05). The Ins changed little after treatment and was not significantly different from that of the control group (both P>0.05). All the above indices had no significant difference at follow-up compared with those before treatment (all P>0.05). After treatment, the TCM syndrome score in the observation group was lower than that before treatment and that in the control group (both P<0.05). The TCM syndrome score at follow-up was better than that before treatment in the observation group (P<0.05). The total effective rate of the observation group was 76.7% (33/43) after treatment, which was superior to 30.2% (13/43) of the control group (P<0.05). The rates at follow-up was 37.2% (16/43) in the observation group and was 25.6% (11/43) in the control group (P>0.05). 18 postoperative reactions occurred 168 times totally after embedding, which could be divided into 5 categories, including 75 times (44.6%) of dietary inhibition, 41 times (24.4%) of abnormal feeling, 23 times (13.7%) of local discomfort, 21 times (12.5%) of general malaise, and 8 times (4.8%) of other symptoms. The postoperative peak responses were after the second and third operations. 3-month catgut embedding can improve some of the indices of prediabetes, but long-term healthy living habits need to be kept. There exist various postoperative reactions after embedding without blocking the treatment.

Clinical effects of Wenxin formula on stable coronary heart disease angina

Objective To observe the clinical effect and safety of Wenxin formula in the treatment of stable coronary heart disease angina patients with Syndrome of Yang deficiency with stagnation of the Blood and retention of Phlegm (SYBP). Methods A total of 65 stable coronary heart disease angina patients with SYBP were randomly assigned to the trial group and the control group (34 in the trial group and 31 in the control group). The trial group was treated with Wenxin formula, while the control group was treated with atorvastatin. The treatment lasted 4 weeks. The therapeutic effects on angina, reduction of Nitroglycerin, changes of electrocardiogram (ECG) and TCM syndrome score were observed before and after treatment. Results After treatment, the trial group had a similar effect with the control group in the aspects of the therapeutic effects on angina, reduction of Nitroglycerin and the ECG change. There was no statistical difference between the two groups (P>0.05). The changes of TCM syndrome score in the trial group was superior to the control group (P<0.05). The total effective rates of the trial group and the control group were 88.2% and 74.2%. The significant efficiency of the treatment group (29.41%) was significantly superior to the control group (9.68%) (P<0.05). No adverse reaction occurred during the therapeutic course. Conclusions The Wenxin formula was safe and effective in the treatment of stable coronary heart disease angina patients with SYBP. Key words: Angina, stable; Wenxin formula; Syndrome of Yang deficiency with stagnation of the Blood and retention of Phlegm; Clinical study

Application time-point and effect observation of fire needling therapy in IVF-ET

To observe the effects of the intervention with fire needling therapy on the uterine microenvironment at the specific time points of menstrual cycle and evaluate the effects on the assisted reproduction. Sixty-eight patients of in vitro fertilization and embryo transplantation (IVF-ET) were randomized into an observation group (35 cases) and a control group (33 cases). The patients in the two groups all received post-IVF-ET corpus luteum support of the microstimulation scheme in the Clinical Reproduction Center of Jiangsu People's Hospital. In the control group, the regular sequential therapy of acupuncture was used. In the observation group, on the basis of the treatment as the control group, the intervention of fire needling therapy was applied after ovulation (the 1st time point, on the 1st day after ovulation) and at the end of premenstrual stage (the 2nd time point, 3 days before the menstruation). At the 1st time point, Shenshu (BL 23), Mingmen (GV 4) and Yaoyangguan (GV 3) were selected and at the 2nd time point, Shenshu (BL 23) and Ciliao (BL 32) were selected. The acupoints were stimulated from up to down and from the left to the right. The changes in TCM syndrome during the preparation, the endometrial thickness and types on the day of transplantation, the biochemical pregnant rate after transplantation and clinical pregnant rate were observed and compared in the patients of the two groups. After treatment, TCM syndrome scores were all reduced in the two groups (both P<0.05). In the observation group, the biochemical pregnant rate and clinical pregnant rate were slightly higher than those in the control group, without significant difference in comparison (both P>0.05). In the observation group, the endo-metrial thickness on the day of transplantation was higher than that in the control group (P<0.05). After treatment, the differences in TCM syndrome score and endometrial type were not significant statistically between the two groups (all P>0.05). The intervention of fire needling therapy at the specific time points of menstrual cycle relieves menstrual symptoms and increases endometrial thickness so as to assist embryo implantation in the patients of infertility.

Warm acupuncture for chronic atrophic gastritis with spleen-stomach deficiency cold

To observe the clinical effect of warm acupuncture at Zhongwan(CV 12) for chronic atrophic gastritis(CAG) with spleen-stomach deficiency cold by the comparison with conventional acupuncture. Sixty-two patients were randomly assigned into a warm acupuncture group and a conventional acupuncture group,31 cases in each one. The acupoints in the two groups were Zhongwan(CV 12),Zusanli(ST 36),Neiguan(PC 6),Gongsun(SP 4),Qihai(CV 6),Pishu(BL 20) and Weishu(BL 21). Warm acupuncture was intervened at Zhongwan(CV 12) in the warm acupuncture group. Twirling reinforcing was applied at Zhongwan(CV 12) in the conventional acupuncture group. All the treatment was given for 3 courses continuously,5 days as one course,once a day. TCM syndrome score and symptom rating scale were observed before and after treatment in the two groups,and the effects were compared. The total effective rate was 93.5%(29/31) in the warm acupuncture group,which was better than 87.0%(27/31) in the conventional acupuncture group(P<0.05). The TCM syndrome score and symptom rating score were improved in the two groups after treatment(P<0.01, P<0.05),with more apparent improvement in the warm acupuncture group(P<0.01,P<0.05). Warm acupuncture at Zhongwan(CV 12) can improve gastrointestinal discomfort,which is better than twirling reinforcing at Zhongwan(CV 12) for CAG with spleen-stomach deficiency cold.

Efficacy of acupuncture-moxibustion periodic therapy on follicular maldevelopment differentiated as spleen and kidney yang deficiency

To observe the clinical efficacy of acupuncture and moxibustion periodic therapy on folli-cular maldevelopment differentiated as spleen and kidney yang deficiency. Sixty patients of follicular maldevelopment differentiated as spleen and kidney yang deficiency were randomized as an observation group and a control group, 30 cases in each one. The conventional acupuncture-moxibustion therapy was used in the control group and the acupuncture-moxibustion periodic therapy was applied to the observation group. In the control group, the acupoints were selected in terms of spleen and kidney yang deficiency, such as Guanyuan (CV 4), Qihai (CV 6), Zusanli (ST 36), Sanyinjiao (SP 6), Taixi (KI 3), Xuehai (SP 10) and Zigong (EX-CA 1). In the observation group, the acupoints were selected in terms of the physiological characteristics of follicular phase, ovulatory phase, luteal phase and menstrual phase. The main acupoints were Zusanli (ST 36), Sanyinjiao (SP 6), Taixi (KI 3) and Xuehai (SP 10). The acupoints for benefiting kidney yin were added in the follicular phase, such as Guanyuan (CV 4) and Dahe (KI 12), etc. The acupoints for regulating qi and activating blood circulation were added in the ovulatory phase, such as Hegu (LI 4) and Taichong (LR 3), etc. The moxibustion was added for tonifying kidney yang in the luteal phase, such as Qihai (CV 6) and Guanyuan (CV 4). The treatment was discontinued during the menstrual phase in the two groups. In the rest phases, acupuncture and moxibustion were given once every two days, 30 min each time. The overall efficacy, basal body temperature (BBT), follicular development, the average endometrial thickness and morphology as well as TCM syndrome score of spleen and kidney yang deficiency were observed in the patients after 3-month menstrual periods. The adverse reactions were recorded in the two groups. In the observation group, one case gave up the treatment due to the personal reason and another one stopped the treatment due to suffering from another kind of disease. 28 cases were included totally. In the control group, 3 cases were dropped out since attempting to receive in vitro fertilization-embryo transfer (IVF-ET) and 27 cases were finally included. The total effective rate was 92.9% (26/28) in the observation group, better than 85.2% (23/27) in the control group (P<0.05). Except the endometrial morphology in the control group, after treatment, BBT, follicular development, the average endometrial thickness and morphology as well as TCM syndrome score were all improved apparently after treatment in the two groups (all P<0.05). The improvements in follicular development, endometrial morphology and TCM syndrome score in the observation group were more obvious as compared with those in the control group (all P<0.05). The incidence of the adverse reaction was 7.1% (2/28) in the observation group and was 3.7% (1/27) in the control group, indicating mild adverse reaction that could be relieved naturally. The treatment with acupuncture and moxibustion achieves the significant efficacy on follicular maldevelopment differentiated as spleen and kidney yang deficiency. Compared with conventional acupuncture-moxibustion therapy, the periodic therapy of acupuncture and moxibustion achieves the much better clinical efficacy.

围手术期应用益气养阴方提高肺癌患者术后生活质量的临床研究

目的：观察非小细胞肺癌患者围手术期应用益气养阴方对患者术后生活质量的影响。方法：选择46例气阴两虚证非小细胞肺癌患者，随机分为两组(对照组和治疗组)，对照组按术后常规治疗，治疗组在对照组治疗的基础上于围手术期加用益气养阴中药治疗，分别记录治疗前后的体重、KPS评分与中医证候评分，进行比较研究，应用SPSS 18.0统计软件包进行统计分析。结果：在治疗结束后，治疗组与对照组相比，在中医证候评分、体重、KPS评分方面具有显著性差异(P < 0.05)。结论：在非小细胞肺癌患者围手术期应用益气养阴方，可明显改善患者的术后体重、KPS评分、中医证候评分，有利于提高患者的术后生活质量。 Objective: TO observe the effect of perioperative management of Qi-replenishing and Yin-nou- rishing prescription of immunologic function in the patients with nonsmall-cell lung cancer. Me-thods: Forty-six patients with nonsmall-cell lung cancer in qi-yin deficiency type. The 46 cases with lung cancer were randomly divided into 2 groups (control group and treatment group). Conventional therapy following operation was carried out on the patients in control group, while perioperative management of Qi-replenishing and Yin-nourishing prescription was added to the patients in treatment group. The body weight, KPS scores and TCM syndrome scores were recorded. All the data were analyzed with the software package of statistics SPSS 18.0. Results: In treatment group, the body weight, KPS scores and TCM syndromes were increased obviously (P < 0.05). Conclusion: The perioperative management of Qi-replenishing and Yin-nourishing prescription may improve body weight, KPS scores and TCM syndrome scores to improve the quality of life.

Clinical observation of post-infectious cough differentiated as wind-cold retention in the lung treated with scraping therapy and xuanfei zhisou decoction

To compare the difference in the therapeutic effect on post-infectious cough differentiated as wind-cold retention in the lung between the combined therapy of scraping and xuanfei zhisou decoction and the simple application of xuanfei zhisou decoction. Eighty patients were randomized into a combined therapy group and a Chinese herbal medicine group, 40 cases in each one. In the Chinese herbal medicine group, the oral administration of xuanfei zhisou decoction was used. The main ingredients included roasted herba ephedrae, amygdalus communis vas, rhizoma zingiberis recens, platycodon grandiflorum, flos farfarae, pinellia temata, radix stemonae, herba periliae, etc., one dose a day, twice a day. In the combined therapy group, on the basis of the treatment as the Chinese herbal medicine group, scraping therapy was added and applied to the bladder meridian of foot-taiyang, the lung meridian of hand-taiyin, the conception vessel and the governor vessel, focusing on Tiantu (CV 22), Baihui (GV 20), Dazhui (GV 14), Feishu (BL 13), Fengmen (BL 12), Taiyuan (LU 9), Lieque (LU 7) and Fengchi (GB 20), once a week and one-week treatment as one session. Totally, the continuous two sessions were required in the two groups. The cough symptom score, cough remission time, relapse, TCM syndrome score, the score of Leicester cough questionnaire (LCQ), SP concentration in the supernatant of the induced sputum before and after treatment as well as clinical efficacy were observed in the two groups. The cough symptom score, TCM symptom score and SP concentration in the supernatant of the induced sputum were all apparently reduced after treatment in the patients of the two groups (all P<0.01). The scores in the combined therapy group were reduced in the higher amplitude as compared with those in the Chinese herbal medicine group (all P<0.01). The total effective rate was 95.0% (38/40) in the combined therapy group, better than 87.5% (35/40) in the Chinese herbal medicine group (P<0.05). Regarding the cough remission time and relapse rate, the results in the combined therapy group were better than those in the Chinese herbal medicine group[(5.3±1.2) d vs (7.4±1.5) d, P<0.01; 0% (0/19) vs 62.5% (5/8), P<0.01]. The scoreo of LCQ was all apparently improved in the patients of the two groups (both P<0.01), and the score in the combined therapy group was higher than that in the Chinese herbal medicine group (P<0.01). Scraping therapy combined with xuanfei zhisou decoction and the simple application of xuanfei zhisou decoction all relieve the symptoms of post-infectious cough and improves the living quality. The therapeutic effects of the combined therapy are superior to the oral administration of xuanfei zhisou decoction.

Clinical effect of Qiqin decoction combined with lamivudine for the patients with hepatitis B and TCM syndrome of liver stagnation and spleen deficiency and damp heat

Objective To discuss the effect of Qiqin decoction combined with lamivudine for the patients with hepatitis B and the TCM syndrome of liver stagnation and spleen deficiency and damp heat. Methods A total of 70 patients with chronic hepatitis B were divided into two groups by random number table method, 35 patients in each group. The patients in the control group were treated with lamivudine, and the patients in the observation group used lamivudine combined with Qiqin decoction. The HBV-DNA was detected by fluorescence quantitative PCR, and the levels of serum ALT and AST were detected by full automatic biochemical analyzer. The TCM syndrome score of two groups were compared, and the drug resistance in the treatment process was recorded, and the clinical effect rate was evaluated. Results After treatment, the HBV-DNA negative rate of observation group was 77.1% (27/35), and the control group was 54.3% (19/35). There were statistically significant difference of the negative rate of HBV-DNA between two groups (χ2=4.136, P=0.041). The drug resistance rate of the observation group was 11.4% (4/35), and the control group was 31.4% (11/35). There were statistically significant difference of the drug resistance rate between two groups (χ2=4.297, P=0.043). After treatment, the serum ALT (29.1 ± 13.2 U/L vs. 121.8 ± 50.2 U/L, t=5.982), the AST (28.5 ± 10.9 U/L vs. 98.3 ± 46.1 U/L, t=8.263), the TCM syndrome scores (4.8 ± 3.1 vs. 11.5 ± 7.9, t=5.982) in the observation group were significantly lower than those in the control group (P<0.01). The total effect rate of observation group was 88.6% (31/35), and the control group was 57.2% (20/35). There was significant difference between two groups (χ2=4.248, P=0.003). Conclusions The Qiqin decoction combined with lamivudine could reduce the levels of HBV-DNA, serum ALT levels and AST levels of patients with chronic hepatitis B, and improve the clinical efficacy. Key words: Hepatitis B, chronic; Syndrome differentiation classification; Liver-Qi stagnation and spleen deficiency; Dampness-heat; Qiqin decoction; Lamivudine; Clinical study

Clinical study on addition treatment of liver-kidney yin deficiency and postmenopausal osteoporosis with Liuwei Dihuang pill

Objective To study the clinical effects of addition treatment of liver-kidney yin deficiency and postmenopausal osteoporosis with Liuwei Dihuang pill. Methods 120 patients suffering from postmenopausal osteoporosis who were determined to be subject to liver-kidney Yin deficiency by doctors of traditional Chinese medicine when they received treatment at the outpatient clinic of traditional Chinese medicine department of our hospital in the period from February 2010 to june 2013 were divided into three groups: group A,B and C,with the random number table.For group A:provided the honeyed pills made up by supplemented six-ingredient rehmannia pill,and taken two pills per day continuously for six months; For group B:provided 5mg of zoledronic acid injection for intravenous drip infusion;For group C:provided traditional Chinese medicine honeyed pills and zoledronic acid for treatment at the same time; all of the three groups take Calcium carbonate D3 at the same time;The three groups of cases until the 12th month were observed and followed-up. The clinical efficacy of three groups were compared. Results A,C group 3 months after treatment with estradiol levels compared with before treatment, the difference was statistically significant(t=2.54,P=0.05,t=2.07,P=0.06). A group 3 months after treatment,the VAS scores at 6 months respectively(3.75±1.32),(2.06±1.53)points before treatment, and the differences were statistically significant(t=10.18, P=0.00,t=9.26,P=0.00). A group 3 months after treatment,the SF-36 scores at 6 months were(90.82± 12.38),(105.82±9.06)%respectively, compared with that before treatment, the differences were statistically significant(t=8.40,P=0.00,t=5.21,P=0.00).A group 6 months after treatment of lumbar 1-4 bone densitywere (0.85±0.07)g/m2,and before treatment[(0.76±0.07)g/m2]comparison,thedifference was statistically significant(t =7.5 6,P=0.0 0);A group 6 months after treatment of Wards bone density com pared with before treatment, the difference was statistically significant(t=8.07,P=0.00).C group 6 months after treatment of lumbar 1-4 bone density(0.91±0.07)g/m2,and B Group[(0.88±0.05)g/m2]comparison,the difference was statistically significant(t=27.19,P=0.00);C group after treatment,the bone mineral density of Wards area for 6 months were(0.62±0.04)g/m2.The difference was statistically significant(t=26.22,P=0.00), compared with the B group.The TCM syndromes of TCM in the 6 months after treatment in A group were(5.42± 2.13),and the difference was statistically significant(t=13.29,P=0.00),compared with the B Group(10.75 ±4.08).(t=13.29,P=0.00). Compared with B group,the difference was statistically significant(t=26.22,P =0.00).A group after the treatment of TCM syndrome score was 6 months(5.42±2.13),and B Group[(10.75 ±4.08)],the difference was statistically significant(t=13.29,P=0.00). Conclusion The addition of Liuwei Dihuang pill can improve BMD, alleviate the ostealgia and improve life quality of patients suffering from postmenopausal osteoporosis, and has no obvious adverse effects. It can enhance curative effects through using with diphosphonate. Key words: Osteoporosis; Yin deficiency; Bone density; Liuwei dihuang pill

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).

Multicenter randomly controlled trial on acupoint injection therapy with Chinese herbal medicines for oculomotor paralysis

ObjectiveTo evaluate the clinical effect of acupoint injection therapy for paralysis of oculomotor nerve with Chinese herbal medicines. MethodsA total number of 456 patients from 3 centers with paralysis of oculomotor nerve were randomly divided into an acupoint injection group and a control group with 228 cases each. Patients in the acupoint injection group were treated with injection of Chinese herbal medicines to Jīngmíng (▪ BL 1), Yángbái (▪ GB 14), Sìbái (▪ ST 2), Tóngziliáo (▪ GB 1) on the affected side, and Gĕnshū (▪ BL 18) on both sides, Compound Angelica Injection was the main drug, and the corresponding acupoints and other injection drugs were also used according to differentiation of syndrome. Patients in the control group were treated with common western medicine. The treatment was given once a day, 10 times constituted one course with 3 days of interval. After 3 courses, the effect was assessed. TCM syndrome score, eyeball movement degree, the sizes of oculi rimae and pupil of the two groups were recorded before and after treatment. ResultsThe effective rate of acupoint injection group was 91.7% (209/228), and that of the control group was 73.6% (168/228). There was statistical significance in comparing the difference between the two groups (P<0.05). TCM syndrome scores of the two groups after the treatment became less obviously than those before the treatment (P<0.01, P<0.05), the score of acupoint injection group was more reduced than that of the control group (P<0.05). Eyeball movement degree and oculi rimae were enlarged and the pupil reduced in the affected eye in both groups after the treatment (all P<0.05). The musculus rectus medialis for the eyeball movement in the acupoint injection group was more improved than that of the control group, and the oculi rimae was bigger in the acupoint injection group than that in the control group (both P<0.05). ConclusionAcupoint injection therapy with Chinese herbal medicines has assured effect on the treatment of oculomotor paralysis.

Zhen gan xi feng decoction, a traditional chinese herbal formula, for the treatment of essential hypertension: a systematic review of randomized controlled trials.

Objectives. To assess the clinical effectiveness and adverse effects of Zhen Gan Xi Feng Decoction (ZGXFD) for essential hypertension (EH). Methods. Five major electronic databases were searched up to August 2012 to retrieve any potential randomized controlled trials designed to evaluate the clinical effectiveness of ZGXFD for EH reported in any language, with main outcome measure as blood pressure (BP). Results. Six randomized trials were included. Methodological quality of the trials was evaluated as generally low. Four trials compared prescriptions based on ZGXFD with antihypertensive drugs. Meta-analysis showed that ZGXFD was more effective in BP control and TCM syndrome and symptom differentiation (TCM-SSD) scores than antihypertensive drugs. Two trials compared the combination of modified ZGXFD plus antihypertensive drugs with antihypertensive drugs. Meta-analysis showed that there is significant beneficial effect on TCM-SSD scores. However, no significant effect on BP was found. The safety of ZGXFD is still uncertain. Conclusions. ZGXFD appears to be effective in improving blood pressure and hypertension-related symptoms for EH. However, the evidence remains weak due to poor methodological quality of the included studies. More rigorous trials are warranted to support their clinical use.