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2017年, 第15卷, 第2期 刊出日期:2017-03-15
综述
Potential application of the Kampo medicine goshajinkigan for prevention of chemotherapy-induced peripheral neuropathy
Marco Cascella, Maria Rosaria Muzio
Journal of Integrative Medicine. 2017 (2):  77-87.  DOI: 10.1016/S2095-4964(17)60313-3
摘要 ( 1160 )   PDF   收藏
Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most common and severe adverse effects related to cancer treatment. Unfortunately, although several agents and protocols have been proposed, no prophylactic strategies have yet to be proven useful. Therefore, new alternative therapies have been considered for CIPN prevention. Herbal medicine in Japan, called Kampo medicine, is derived from traditional Chinese medicine. Goshajinkigan (GJG) is a Kampo medicine, that is comprised of ten herbs. The aim of this work is to analyse the results of pre-clinical and clinical studies on the potential applications of GJG in CIPN prevention.
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Ayurvedic concept of Shatkriyakala: A traditional knowledge of cancer pathogenesis and therapy
Ashutosh Chauhan, Deepak Kumar Semwal, Satyendra Prasad Mishra, Ruchi Badoni Semwal
Journal of Integrative Medicine. 2017 (2):  88-94.  DOI: 10.1016/S2095-4964(17)60311-X
摘要 ( 1261 )   PDF   收藏
The term Kriyakala refers to the recognition of the stage of a disease's progress, which helps to determine appropriate measure to correct the imbalance in Doshas (biological factors). It is a compound expression, comprised of Kriya and Kala, where Kriya means the choice to treatment (medicine, food and daily-routine) used to improve the disturbance in Doshas, and Kala refers to the stage of progress of a disease. Sushruta, an ancient Indian surgeon, has described the concept of Kriyakala in Varnaprashnadhyaya, an ancient Vedic Sanskrit text, which seeks to explain the incidence of Varnas in terms of Doshic disturbances. Varna, in modern parlance, may be described as an inflammatory process that may lead ulceration and chronic inflammation, promoting all stages of carcinogenesis. Abnormal interactions between Prakriti (genotype) and environmental factors vitiate the Doshas and impair immunity, which can lead to aberrant cell growth and cancer. Moreover, the interaction between vitiated Doshas and weak Dhatus (body tissues) manifests as cancers of a specific organ. Shatkriyakala (six stages of progress of a disease), on the other hand, provides a framework to assess the cancer and its pathogenesis in different stages. According to Ayurvedic concepts, all cancer therapies treat the affected tissues indirectly by eliminating vitiated Doshas, rejuvenating Dhatus and restoring immunity in cancer patients. The present review describes the six stages of Shatkriyakala in detail, with an emphasis on research areas to validate the concept of Shatkriyakala. This traditional knowledge can be utilized with modern technologies to detect predisposition for cancer or diagnose cancer in its early stages.
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系统综述
Effectiveness of co-treatment with traditional Chinese medicine and letrozole for polycystic ovary syndrome: A meta-analysis
Qian-wen Ma, Yong Tan
Journal of Integrative Medicine. 2017 (2):  95-101.  DOI: 10.1016/S2095-4964(17)60320-0
摘要 ( 1328 )   PDF   收藏

Background

Polycystic ovary syndrome (PCOS) is an endocrine disease that affects gynecological health. Treatment of PCOS remains a big challenge for clinicians.

Objective

This meta-analysis was developed to compare the efficacy of co-treatment with traditional Chinese medicine (TCM) and letrozole against letrozole monotherapy in the treatment of PCOS.

Search strategy

Randomized controlled trials (RCTs) were electronically retrieved from PubMed, Cochrane Library, China Biomedical Literature Database, China National Knowledge Infrastructure and Wanfang Data; related papers that were not available electronically were manually checked. All papers were assessed according to the Cochrane Handbook for Systematic Reviews of Interventions and the valid data were analyzed using Revman software (The Cochrane Collaboration, Copenhagen, Denmark).

Inclusion criteria

We included RCTs that compared co-treatment with TCM and letrozole against letrozole monotherapy in women with PCOS, which was defined by anovulation, biochemical or clinical hyperandrogenemia and polycystic ovaries. We included trials from all sources.

Data extraction and analysis

Two independent reviewers extracted data, and evaluated study quality according to the Cochrane Handbook for Systematic Reviews of Interventions criteria for RCT, including issues of patient randomization, blinding and bias.

Results

Eight RCTs, involving a total of 537 patients, were included in the present study. The meta-analysis showed that the cycle ovulation rate, the pregnancy rate and the total effective rate of symptom treatment were higher in treatments combining TCM with letrozole, compared with letrozole monotherapy. Although the rate of luteinizing hormone (LH)/follicle-stimulating hormone (FSH) and the body mass index of the group receiving combined therapy were lower than in letrozole monotherapy, no statistical difference was found in the LH and FSH level between the two groups.

Conclusion

Available evidence showed that co-treatment with TCM and letrozole was more effective than letrozole monotherapy in the treatment of PCOS.

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方法学
Consensus on the integrated traditional Chinese and Western medicine criteria of diagnostic classification in polycystic ovary syndrome (draft)
Jin Yu, Chao-qin Yu, Qi Cao, Li Wang, Wen-jun Wang, Li-rong Zhou, Jing Li, Qiao-hong Qian
Journal of Integrative Medicine. 2017 (2):  102-109.  DOI: 10.1016/S2095-4964(17)60331-5
摘要 ( 1222 )   PDF   收藏
Polycystic ovary syndrome (PCOS) is the most common endocrine and metabolic disorder of women, with complex pathogenesis and heterogeneous manifestations. Professor Jin Yu recently wrote an article entitled “Proposal of Diagnosis and Diagnostic Classification of PCOS in Integrated Traditional Chinese and Western Medicine.” From this, the Obstetrics and Gynecology branches of the Chinese Association of Integrative Medicine and the China Association of Chinese Medicine collaborated with the Gynecology branch of the Chinese Association for Research and Advancement of Chinese Medicine to draft a report on the consensus of criteria for the diagnosis and classification of PCOS in integrated traditional Chinese and Western medicine. The diagnosis for PCOS includes all three features: (1) oligo-ovulation or anovulation; (2) clinical and/or laboratory evidence of hyperandrogenism; (3) PCOS is classified into four types: types Ia, Ib, IIa, and IIb. Syndrome differentiation types for PCOS in traditional Chinese medicine are as follows: Kidney deficiency with phlegm blockage syndrome, Kidney Yin deficiency with phlegm blockage and blood stasis syndrome, and Kidney deficiency with Liver Qi stagnation syndrome.
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A data-driven method for syndrome type identification and classification in traditional Chinese medicine
Nevin Lianwen Zhang, Chen Fu, Teng Fei Liu, Bao-xin Chen, Kin Man Poon, Pei Xian Chen, Yunling Zhang
Journal of Integrative Medicine. 2017 (2):  110-123.  DOI: 10.1016/S2095-4964(17)60328-5
摘要 ( 1304 )   PDF   收藏
The efficacy of traditional Chinese medicine (TCM) treatments for Western medicine (WM) diseases relies heavily on the proper classification of patients into TCM syndrome types. The authors developed a data-driven method for solving the classification problem, where syndrome types were identified and quantified based on statistical patterns detected in unlabeled symptom survey data. The new method is a generalization of latent class analysis (LCA), which has been widely applied in WM research to solve a similar problem, i.e., to identify subtypes of a patient population in the absence of a gold standard. A well-known weakness of LCA is that it makes an unrealistically strong independence assumption. The authors relaxed the assumption by first detecting symptom co-occurrence patterns from survey data and used those statistical patterns instead of the symptoms as features for LCA. This new method consists of six steps: data collection, symptom co-occurrence pattern discovery, statistical pattern interpretation, syndrome identification, syndrome type identification and syndrome type classification. A software package called Lantern has been developed to support the application of the method. The method was illustrated using a data set on vascular mild cognitive impairment.
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临床论著
Effects of bee propolis supplementation on glycemic control, lipid profile and insulin resistance indices in patients with type 2 diabetes: A randomized, double-blind clinical trial
Nazli Samadi, Hassan Mozaffari-Khosravi, Masoud Rahmanian, Mohsen Askarishahi
Journal of Integrative Medicine. 2017 (2):  124-134.  DOI: 10.1016/S2095-4964(17)60315-7
摘要 ( 1351 )   PDF   收藏

Background

 Propolis, a natural resinous substance made by bees from material extracted from plants, flowers and bee's wax, has shown great therapeutic effects and been widely used in food and drug industries. Recently, some researchers have studied the effect of this substance in the treatment of diabetes.

Objective

The purpose of this trial was to determine the effect of bee propolis on glycemic control, serum lipid profile and insulin resistance indices in patients with type 2 diabetes (T2D).

Design, Setting, Participants and Interventions

This randomized clinical trial involved 66 patients with T2D, which were randomly divided into two groups of intervention (IG) and placebo (PG). IG received 300 mg three times a day for a total of 900 mg/d of propolis pills, while PG received similar pills, lacking propolis, on the same schedule for 12 weeks.

Main Outcome Measures

Fasting blood glucose (FBG), hemoglobin A1c (HbA1c), total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglyceride (TG), serum insulin and insulin resistance indices were the main outcome measures.

Results

The mean change in FBG between the IG ((17.76 ± 27.72) mg/dL decrease) and the PG ((6.48 ± 42.77) mg/dL increase) was significantly different (P = 0.01). Change in mean HbA1c had a similar pattern to FBG. The mean change in TC between the IG ((5.16 ± 43.80) mg/dL increase) and the PG ((28.9 ± 27.4) mg/dL increase) was also significantly different (P = 0.01), showing the protective role of propolis against the increase in TC. The change in mean LDL was similar to mean TC. There was no significant difference in other lipids or insulin resistance indices between the two groups.

Conclusion

Based on this study, the daily intake of 900 mg of bee propolis supplement for 12 weeks results in improvement of glycemic and some serum lipid levels in patients with T2D.

Trial registration

This study is registered on the website of Iranian Ministry of Health (www.irct.ir) with proprietary code of IRCT2014080218659N1.

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实验论著
Therapeutic effect of acupuncture point injection with placental extract in knee osteoarthritis
Kyeong Mee Park, Tae Hwan Cho
Journal of Integrative Medicine. 2017 (2):  135-141.  DOI: 10.1016/S2095-4964(17)60316-9
摘要 ( 1286 )   PDF   收藏

Objective

This study evaluated the effectiveness of acupuncture point injection (API) with placental extract on pain reduction and joint function in patients with knee osteoarthritis (OA).

Methods

Fifty-two patients with knee OA, with an average age of 64, and having a symptom duration of more than 3 months were studied in this report. Placental extract was injected weekly into acupuncture point ST35, BL23, BL24 and BL25 for 5 weeks; 8 mL of placental extract into ST35 on the affected side, and 1 mL of placental extract to BL23, BL24 and BL25 bilaterally.

Results

After a five-week treatment of API with placental extract, pain was substantially decreased in patients of all Kellgren-Lawrence (KL) grades. Improvement of knee joint swelling was also apparent. Decrease of pain and joint swelling improved daily working productive time among patients of all KL grades.

Conclusion

Study results imply that API with placental extract is a potentially useful therapy to control pain and maintain joint functions in knee OA patients.

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The anatomical study of the major signal points of the court-type Thai traditional massage on legs and their effects on blood flow and skin temperature
Yadaridee Viravud, Angkana Apichartvorakit, Pramook Mutirangura, Vasana Plakornkul, Jantima Roongruangchai, Manmas Vannabhum, Tawee Laohapand, Pravit Akarasereenont
Journal of Integrative Medicine. 2017 (2):  142-150.  DOI: 10.1016/S2095-4964(17)60323-6
摘要 ( 1353 )   PDF   收藏

Objective

This study aims to investigate the relationship between major signal points (MaSPs) of the lower extremities used in court-type Thai traditional massage (CTTM) and the corresponding underlying anatomical structures, as well as to determine the short-term changes in blood flow and skin temperature of volunteers experiencing CTTM.

Methods

MaSPs were identified and marked on cadavers before acrylic color was injected. The underlying structures marked with acrylic colors were observed and the anatomical structures were determined. Then, pressure was applied to each MaSP in human volunteers (lateral side of leg and medial side of leg) and blood flow on right dorsalis pedis artery was measured using duplex ultrasound while skin temperature changes were monitored using an infrared themographic camera.

Results

Short-term changes in the blood flow parameters, volume flow and average velocity, compared to baseline (P < 0.05), were observed on MaSP of the lower extremity, ML4. Changes in the peak systolic velocity of the area ML5 were also observed relative to baseline. The skin temperature of two different MaSPs on the lateral side of leg (LL4 and LL5) and four on the medial side of leg (ML2, ML3, ML4 and ML5) was significantly increased (P < 0.05) at 1 min after pressure application.

Conclusion

This study established the clear correlation between the location of MaSP, as defined in CTTM, and the underlying anatomical structures. The effect of massage can stimulate skin blood flow because results showed increased skin temperature and blood flow characteristics. While these results were statistically significant, they may not be clinically relevant, as the present study focused on the immediate physiological effect of manipulation, rather than treatment effects. Thus, this study will serve as baseline data for further clinical studies in CTTM.

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Evidence against the participation of a pharmacokinetic interaction in the protective effect of single-dose curcumin against gastrointestinal damage induced by indomethacin in rats
Liliana Zazueta-Beltrán, Lorena Medina-Aymerich, Nadia Estela Díaz-Triste, Aracely Evangelina Chávez-Piña, Gilberto Castañeda-Hernández, Leticia Cruz-Antonio
Journal of Integrative Medicine. 2017 (2):  151-157.  DOI: 10.1016/S2095-4964(17)60324-8
摘要 ( 1072 )   PDF   收藏

Objective

To determine the role of a pharmacokinetic interaction in the protective effect of curcumin against the gastric damage induced by indomethacin administration as such or as its prodrug acemetacin.

Methods

Wistar rats orally received single dose of indomethacin (30 mg/kg) with and without curcumin (30 mg/kg); gastric injury was evaluated by determining the total damaged area. Additional groups of rats received an oral single dose of indomethacin (30 mg/kg) or its prodrug acemetacin (34.86 mg/kg) in the presence or absence of curcumin (30 mg/kg). Indomethacin and acemetacin concentrations in plasma from blood draws were determined by high-performance liquid chromatography. Plasma concentration-against-time curves were constructed, and bioavailability parameters, maximal concentration (Cmax) and area under the curve to the last sampling time (AUC0-t) were estimated.

Results

Concomitant administration of indomethacin and curcumin resulted in a significantly reduced gastric damage compared to indomethacin alone. However, co-administration of curcumin did not produce any significant alteration in the bioavailability parameters of indomethacin and acemetacin after administration of either the active compound or the prodrug.

Conclusion

Curcumin exhibits a protective effect against indomethacin-induced gastric damage, but does not produce a reduction of the bioavailability of this nonsteroidal anti-inflammatory drug, indomethacin. Data thus suggest that a pharmacokinetic mechanism of action is not involved in curcumin gastroprotection.

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Antidiarrheal activity of hexane extract of Citrus limon peel in an experimental animal model
Olasupo Stephen Adeniyi, James Omale, Samuel Chukwuma Omeje, Victoria Ojimaojo Edino
Journal of Integrative Medicine. 2017 (2):  158-164.  DOI: 10.1016/S2095-4964(17)60327-3
摘要 ( 1253 )   PDF   收藏

Objective

Acute diarrhea is one of the major illnesses that cause death in children, despite clinical interventions and the use of oral rehydration therapy. Thus, there is need to discover other effective, affordable and accessible treatments for this disease. Therefore, this study was carried out to investigate the effects of hexane extract of Citrus limon peel (HECLP) on castor oil-induced diarrhea in rats.

Methods

Diarrhea was induced in male albino Wistar rats weighing 100-150 g. The antidiarrheal activity of HECLP at different oral dosages (5, 10 and 20 mg/kg) was investigated by counting the number of wet fecal pellets. Animals were further treated with propranolol, prazosin, nifedipine and atropine to assess the effects of receptor blockers on the activities of the extract. The effects of HECLP on castor oil-induced enteropooling and the intestinal transit time of activated charcoal were also evaluated.

Results

Each of the 3 doses of C. limon significantly reduced (P < 0.05) the number of wet fecal pellets produced by animals, with 20 mg/kg HECLP producing the highest percentage inhibition (34.2%). Wet fecal pellet inhibition by the standard drug loperamide (3 mg/kg p.o.) was 68.4% relative to the negative control. Blockage of β adrenergic receptors by propanolol abolished the antidiarrheal effects of HECLP. Intestinal fluid accumulation was inhibited by 68.7% and 78.5% by 20 mg/kg HECLP and loperamide respectively. Furthermore, 20 mg/kg HECLP significantly (P < 0.05) reduced the percentage intestinal transit time (21.4% ± 1.42%), relative to the control (34.2% ± 4.29%); atropine (5 mg/kg, intraperitoneal injection) significantly (P < 0.001) reduced the percentage intestinal transit time to 11.2% ± 0.85%.

Conclusion

These results suggest that C. limon peel possesses antidiarrheal effects through antisecretory and antimotility mechanisms that act through the β adrenergic system.

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