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1.
Chinese herbal medicine for diabetic kidney disease: a systematic review and meta-analysis of randomised placebo-controlled trials.
Zhang, L, Yang, L, Shergis, J, Zhang, L, Zhang, AL, Guo, X, Qin, X, Johnson, D, Liu, X, Lu, C, et al
BMJ open. 2019;(4):e025653
Abstract
OBJECTIVES To provide a broad evaluation of the efficacy and safety of oral Chinese herbal medicine (CHM) as an adjunctive treatment for diabetic kidney disease (DKD), including mortality, progression to end-stage kidney disease (ESKD), albuminuria, proteinuria and kidney function. DESIGN A systematic review and meta-analysis. METHODS Randomised controlled trials (RCTs) comparing oral CHM with placebo as an additional intervention to conventional treatments were retrieved from five English (Cochrane Central Register of Controlled Trials, MEDLINE, Embase, Allied and Complementary Medicine Database and Cumulative Index of Nursing and Allied Health Literature) and four Chinese databases (China BioMedical Literature, China National Knowledge Infrastructure, Chonqing VIP and Wanfang) from inception to May 2018. RCTs recruiting adult DKD patients induced by primary diabetes were considered eligible, regardless of the form and ingredients of oral CHM. Mean difference (MD) or standardised mean difference (SMD) was used to analyse continuous variables and RR for dichotomous data. RESULTS From 7255 reports retrieved, 20 eligible studies involving 2719 DKD patients were included. CHM was associated with greater reduction of albuminuria than placebo, regardless of whether renin-angiotensin system (RAS) inhibitors were concurrently administered (SMD -0.56, 95% CI [-1.04 to -0.08], I2=64%, p=0.002) or not (SMD -0.92, 95% CI [-1.35 to -0.51], I2=87%, p<0.0001). When CHM was used as an adjunct to RAS inhibitors, estimated glomerular filtration rate was higher in the CHM than placebo group (MD 6.28 mL/min; 95% CI [2.42 to 10.14], I2=0%, p=0.001). The effects of CHM on progression to ESKD and mortality were uncertain due to low event rates. The reported adverse events in CHM group included digestive disorders, elevated liver enzyme level, infection, anaemia, hypertension and subarachnoid haemorrhage, but the report rates were low and similar to control groups. The favourable results of CHM should be balanced with the limitations of the included studies such as high heterogeneity, short follow-up periods, small numbers of clinical events and older patients with less advanced disease. CONCLUSIONS Based on moderate to low quality evidence, CHM may have beneficial effects on renal function and albuminuria beyond that afforded by conventional treatment in adults with DKD. Further well-conducted, adequately powered trials with representative DKD populations are warranted to confirm the long-term effect of CHM, particularly on clinically relevant outcomes. PROSPERO REGISTRATION NUMBER CRD42015029293.
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2.
Naoxuekang, Xinnaoshutong and Xuesaitong capsules for treating stroke: a protocol for a randomised controlled trial.
Chen, H, Cao, H, Guo, X, Zhao, M, Xia, Q, Chen, B, Zhao, T, Gao, W
BMJ open. 2017;(11):e015983
Abstract
INTRODUCTION After stroke, hemiplegia, dysphasia and facial paralysis can manifest during the convalescent period. Currently, no Chinese patent medicine (CPM) is previously reported to cure each of these symptoms primarily, and thus, there are no relevant instructions for the use of CPM. This study presents a new approach based on comparative effectiveness research to distinguish the curative effects of three CPMs that are often used in stroke convalescence to determine the ideal medicine for the treatment of each symptom. METHODS AND ANALYSIS In this multicentre and double-blind clinical trial, stratified randomisation is used to group the patients according to their primary symptoms (hemiplegia, dysphasia and facial paralysis). Three strata will be enrolled, with 80 eligible participants included in each stratum. Each stratum will be randomly and equally divided into four groups, and each group will receive one of the following treatments: Naoxuekang, Xinnaoshutong (XNST), Xuesaitong (XST) or placebo. This study will include two stages: the initial treatment period (30 days) and a follow-up period (180 days). Three replicates for each data point will be completed during this trial. The first visit will occur on day 0 after enrolment, the second visit on day 30±2 and the third visit on day 210±5. The Delphi technique is adopted to achieve index weighting, which ensures that the evaluation outcome is patient oriented. The weighted index value will be computed as the final measurement index of the outcome. ETHICS AND DISSEMINATION This study has been approved by the Medical Ethics Committee of Tianjin University of Traditional Chinese Medicine (registration number TJUTCM-EC20160007). The results will be offered for publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER This trial was registered with the Chinese Clinical Trial Registry (ChiCTR-IOR-17010397). The date of registration was 11 January 2017.
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3.
Ziziphus spinosa seeds for insomnia: A review of chemistry and psychopharmacology.
Shergis, JL, Ni, X, Sarris, J, Zhang, AL, Guo, X, Xue, CC, Lu, C, Hugel, H
Phytomedicine : international journal of phytotherapy and phytopharmacology. 2017;:38-43
Abstract
BACKGROUND In Chinese medicine, Ziziphus jujuba Mill. var. spinosa (Bunge) Hu ex H. F. Chou is widely used for the treatment of insomnia. PURPOSE/SECTIONS This paper summarises the chemistry, psychopharmacology, and compares the pharmaceutical effects of the seeds of Ziziphus jujuba plant, Ziziphus spinosa (ZS) seeds, with benzodiazepines. Whole extracts and constituent compounds have been evaluated in preclinical and clinical studies. CONCLUSIONS ZS secondary metabolites modulate GABAergic activity and the serotonergic system. The actual therapeutic agents require further confirmation/identification so that new insomnia phytomedicines can be discovered.
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4.
Chinese Herbal Medicine for Mild Cognitive Impairment: A Systematic Review and Meta-Analysis of Cognitive Outcomes.
Dong, L, May, BH, Feng, M, Hyde, AJ, Tan, HY, Guo, X, Zhang, AL, Lu, C, Xue, CC
Phytotherapy research : PTR. 2016;(10):1592-1604
Abstract
Mild cognitive impairment (MCI) is a condition that may be prodromal to the development of dementia. There remain, as yet, no approved pharmaceutical interventions for MCI. Chinese herbal medicines (CHMs) have a long history of use for cognitive impairments and some plant ingredients have shown neuroprotective actions in experimental studies. This review assesses the current clinical evidence from controlled clinical trials for the effects of CHMs on cognitive outcomes as measured by Mini-mental state examination (MMSE) or Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog). Fifty one studies (4026 participants) were included. These compared CHM with placebo, supportive care, pharmaceutical treatment or combined CHM with a pharmaceutical in an integrative setting. For the eight randomised controlled trials (RCTs) of comparisons with placebo, MMSE was significantly higher in the CHM groups (MD 1.56 [0.78, 2.34] I2 = 85%, n = 503), similarly for eight RCTs of comparisons with supportive care (MD 1.77 [1.33, 2.21] I2 = 0%, n = 555). Benefits were also evident in comparisons with some pharmaceuticals and with integrative treatment. The small size of most studies and methodological weaknesses mean that these results should be interpreted with caution. Further studies employing rigorous methods are required to investigate the potential benefits of these CHMs for MCI. Copyright © 2016 John Wiley & Sons, Ltd.
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5.
Dang shen [Codonopsis pilosula (Franch.) Nannf] herbal formulae for chronic obstructive pulmonary disease: a systematic review and meta-analysis.
Shergis, JL, Liu, S, Chen, X, Zhang, AL, Guo, X, Lu, C, Xue, CC
Phytotherapy research : PTR. 2015;(2):167-86
Abstract
This systematic review and meta-analysis assessed the efficacy and safety of Dang shen [Codonopsis pilosula (Franch.) Nannf., root] formulae for the treatment of chronic obstructive pulmonary disease (COPD). English and Chinese databases were searched, and 48 randomized controlled trials were included. Dang shen formulae improved lung function forced expiratory volume in 1 s compared with conventional pharmacotherapy (CP) [mean difference (MD) 0.22 L, 95% confidence interval (CI) 0.13-0.31, p < 0.001, I(2) = 5%] and quality of life (St. Georges Respiratory Questionnaire) compared with placebo (MD -7.19, 95% CI -10.82 to -3.56, p < 0.001, I(2) = 0%) and when combined with CP versus CP (MD -9.05, 95% CI -12.72 to -5.38, p < 0.001, I(2) = 89%). Dang shen formulae also increased distance walked in 6 min when combined with CP versus CP alone (MD 51.43 m, 95% CI 30.06-72.80, p < 0.001, I(2) = 27%) and reduced frequency/days with COPD exacerbations. Risk of bias was evaluated using the Cochrane tool. Methodological shortfalls were identified. Adverse events were low and not different between intervention and control groups. Thirty-three events were reported, including gastrointestinal upset, dry mouth, and insomnia. Dang shen formulae appear to improve some aspects of the included COPD outcomes. However, owing to methodological flaws, the current evidence is inadequate to support the routine use of Dang shen formulae outside of Chinese medicine practice. However, these results justify further investigation.
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6.
Medium- and long-term efficacy of ligustrazine plus conventional medication on ischemic stroke: a systematic review and meta-analysis.
Ni, X, Ni, X, Liu, S, Guo, X
Journal of traditional Chinese medicine = Chung i tsa chih ying wen pan. 2013;(6):715-20
Abstract
OBJECTIVE To evaluate the medium- to long-term efficacy of ligustrazine plus conventional medicine treating ischemic stroke. METHODS Randomized controlled trials (RCTs) testing ligustrazine in the treatment of acute ischemic stroke were retrieved from Cochrane Library, PubMed, Excerpta Medica Database, Chinese Medical Journal Database, Chinese Biomedical Database, China National Knowledge Infrastructure Database, and Chinese Clinical Trial Register, and then identified by the inclusive and exclusive criteria. The quality of trials was assessed with the Cochrane Handbook 5.1, a risk of bias assessment tool. RevMan 5.1 was used for meta-analysis. RESULTS Three RCTs involving 643 patients were included. Compared to conventional medicine treatment alone, ligustrazine plus conventional medicine treatment showed significant difference in reduction of stroke recurrence either at the end of 1-year follow-up [RR = 0.42, 95% CI (0.18, 0.94), P < 0.05] or 3-years observation [RR = 0.48, 95% CI (0.27, 0.83), P < 0.05]. The ligustrazine group also showed higher survival rate [RR =1.67, 95% II (1.02, 0.2.71), P <0.05] and significantly better effective rate [R R= 1.28, 95% II (1.10, 1.50), P <0.05] than that of the control group at the end of 1 year visit. Only one trial conducted safety assessment and no adverse events were reported. The methodological quality of all the trials included was generally poor. CONCLUSION The findings provided evidence that the combination of ligustrazine and conventional medication was medium- and long-term beneficial to the patients suffering ischemic stroke. But more RCTs of high quality are needed to further prove the efficacy and safety of using ligustrazine for ischemic stroke.
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7.
[Clinical observation on effect of intra-articular injection of sodium hyaluronate accompanied with external application of sanhua ointment for knee osteoarthritis].
Xu, P, Guo, X, Jin, WZ, Yao, J, Zhang, Y, Cai, Q
Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi = Chinese journal of integrated traditional and Western medicine. 2005;(7):620-2
Abstract
OBJECTIVE To observe clinical efficacy of intra-articular injection of Sodium hyaluronate (SH) accompanied with external application of Sanhua ointment (SHO) for knee osteoarthritis. METHODS One hundred and twelve patients with osteoarthritis were randomly divided into two groups, Group I was treated with SH and Group II was treated with SH plus SHO. The entire condition of knee joint in the two groups were compared before and after treatment according to Lysholm's function scoring. RESULTS The functional score in the two groups at the 2nd week, 5th week, 3rd month and end of 1st year of the treatment course were significantly higher than that before treatment (P < 0.05), and the scores continuously increased within the first 3 months of treatment. Comparison of scores between the two groups showed that scores in Group II was significantly higher than those in Group I at the corresponding period. The total effective rate after 1 year treatment in Group lI was higher than that in Group II (81.5% vs 96.6%, P < 0.05). In Group II , the initial time of symptom improving was earlier and the adverse effect disappeared more quickly than those in Group I markedly. CONCLUSION The efficacy of combined therapy of intra-articular injection of SH and SHO for knee osteoarthritis was superior to that of intra-articular injection of SH only.
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8.
[Clinical observation on treatment of aplastic anemia patients by zaizhang decoction combined with Western medicine].
Guo, X, Zhang, M, Zhang, YX
Zhongguo Zhong xi yi jie he za zhi Zhongguo Zhongxiyi jiehe zazhi = Chinese journal of integrated traditional and Western medicine. 2003;(10):730-2
Abstract
OBJECTIVE To study the effect of Composite Zaizhang decoction (ZZD) on immune function of chronic aplastic anemia (CAA) patients. METHODS To determine the levels of T-lymphocyte subset, serum tumor necrosis factor (TNF-alpha) and interleukin-2 (IL-2) in CAA patients before and after treatment, and to analyse the regulation of their changes comparatively with the group treated with conventional treatment and a normal control group. RESULTS Before treatment, CD4 was lower, CD8 higher, CD4/CD8 ratio also lower, TNF-alpha and IL-2 were higher in the ZZD treated group than those in the normal control group, with significant difference (P < 0.05), but after ZZD treatment, these indexes were all inversely changed, as compared with those before treatment and with those in the control group, the difference was significant (P < 0.05). CONCLUSION ZZD might relieve the hemopoietic inhibition so as to promote the recovery of hemopoietic function through improving the T-lymphocyte subset and reducing the release of hemopoietic negative ragulatory factors such as TNF-alpha and IL-2 etc.