ABSTRACT
Gout is the second largest metabolic disease in China， which can cause joint tissue damage and a variety of chronic diseases， and seriously affect human life and health. The increase in uric acid caused by disorder of purine metabolism or abnormal uric acid excretion is the biochemical basis of its pathogenesis. Western medical treatment mainly uses anti-inflammatory drugs such as colchicine， non-steroidal anti-inflammatory drugs， and uric acid lowering drugs such as febuxostat and benzbromarone， which have obvious effects， but there are problems such as easy to recurrence after drug withdrawal and more adverse reactions. Traditional Chinese medicine （TCM） has a long history in the treatment of gout， and has the advantages of multi-channel， multi-target， and multi-level symptomatic treatment. It exerts therapeutic effects through lowering uric acid， anti-inflammatory， anti-oxidation， and protecting the kidneys. Its curative effect is obvious and the adverse reaction rate is low. In recent years， there have been many studies on the mechanism of TCM for gout animal models. Based on the review of relevant literature in recent years， this article has systematically sorted out the pathogenesis of gout， the mechanism of TCM for gout and related experimental design. The paper summarized and analyzed the mechanism of TCM in the treatment of gout from the aspects of regulating the level of inflammatory factors， inhibiting oxidation reaction， reducing uric acid and regulating signaling pathway， so as to provide reference for the research and development of drugs for gout.
ABSTRACT
OBJECTIVE@#To observe the therapeutic effect between acupuncture combined with medication and simple medication on migraine and cerebral hemodynamics.@*METHODS@#A total of 120 patients with migraine were randomized into an acupuncture plus medication group (60 cases, 3 cases dropped off) and a medication group (60 cases, 6 cases dropped off). In the medication group, flunarizine hydrochloride capsule was given orally before sleep, 10 mg a day. On the basis of the treatment in the medication group, acupuncture was applied at Sizhukong (TE 23), Shuaigu (GB 8), Taiyang (EX-HN 5), Fengchi (GB 20) and etc. in the acupuncture plus medication group, 30 min each time, once a day. Treatment for 4 weeks was required in both groups. Before and after treatment, the visual analogue scale (VAS) score, indexes of cerebral hemodynamic [blood flow velocity of anterior cerebral artery (ACA), middle cerebral artery (MCA), posterior cerebral artery (PCA), vertebral artery (VA) and basilar artery (BA)] and total TCM syndrome score were observed, and the clinical therapeutic effect and the incidence of the adverse events were evaluated in both groups.@*RESULTS@#Compared before treatment, the VAS scores, the blood flow velocity of ACA, MCA, PCA, VA, BA and the total TCM syndrome scores were decreased in both groups (@*CONCLUSION@#Acupuncture combined with flunarizine hydrochloride capsule can effectively relieve the pain in patients with migraine, reduce the cerebral blood flow velocity, the efficacy is superior to simple flunarizine hydrochloride capsule.
Subject(s)
Humans , Acupuncture Points , Acupuncture Therapy , Hemodynamics , Migraine Disorders/therapy , Pain , Treatment OutcomeABSTRACT
Literatures on pain intervention with transcutaneous electrical acupoint stimulation (TEAS) were collected by searching the databases both in Chinese and English, and summarized to understand the research progress of TEAS effects on pain mediators in recent years. This will provide a more objective and scientific theoretical basis for clinical practice of TEAS to treat pain syndrome, thus promoting the clinical application of TEAS. Our literature analysis indicated that TEAS effectively regulated the release levels of various pain factors such as prostaglandin, 5-hydroxytryptamine, interleukins, substance P and tumor necrosis factor-α to achieve the analgesic effects by affecting the conduction pathways. TEAS is a safe, non-invasive and effective treatment for pain syndrome. However, further research is necessary due to the lack of rigor of the current clinical trial design.
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BACKGROUND: A large number of clinical research data show that acupoint injection has the advantages of good therapeutic effect and few adverse reactions in the treatment of knee osteoarthritis, but there is a lack of related multicenter and large-sample clinical trial. OBJECTIVE: To evaluate the effect of acupoint injection on the pain improvement and joint function in patients with knee osteoarthritis by meta-analysis. METHODS: CNKI, Wanfang, VIP, CBM, PubMed, Embase and Cochrane Library databases were searched for the randomized controlled trials concerning the acupoint injection for treating knee osteoarthritis published before May 2019. The observation group was acupoint injection or acupoint injection combined with other treatments. The control group was the treatments different from acupoint injection. The language was either in Chinese or English. After screening, the data included in the study were extracted by Review Manager 5.3 software for meta-analysis. RESULTS AND CONCLUSION: (1) Sixteen randomized controlled trials were included, involving 1 287 patients (648 cases in the observation group, and 639 cases in the control group). (2) Meta-analysis results showed that the overall effective rate, cure rate, Lysholm score and Japanese Orthopaedic Association scores in the observation group were significantly higher than those in the control group [OR=3.23, 95%CI (2.19, 4.76), Z=5.91, P < 0.000 01; OR=1.86, 95%CI (1.35, 2.58), Z=3.74, P=0.000 2; MD=7.87, 95%CI (2.66, 13.08), Z=2.96, P=0.003; MD=9.16, 95%CI (4.18, 14.13), Z=3.61, P=0.000 3]. The Visual Analogue Scale score, WOMAC score, Lequesne index score, and the incidence of adverse reactions between two groups showed no significant difference [MD=-1.11, 95%CI (-2.29, 0.07), Z=1.84, P=0.07; MD=-7.56, 95%CI (-17.26, 2.14), Z=1.53, P=0.13; MD=-0.46, 95%C I(-1.62, 0.71), Z=0.77, P=0.44; OR=1.31, 95%CI (0.31, 5.57), Z=0.37, P=0.71]. (3) These results indicate that the efficacy of acupoint injection for treating knee osteoarthritis is accurate. Because the literature quality included in the study is not high and bias may exist, more high-quality randomized controlled trials are still needed to verify the conclusions.
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OBJECTIVE: To investigate the clinical effect of thunder-fire moxibustion combined with electroacupuncture in the treatment of cold-dampness knee osteoarthritis. METHODS: A total of 72 patients with cold-dampness knee osteoarthritis were randomly divided into observation group and control group according to the random numbers generated by computer software, with 36 patients in each group. For the observation group, electroacupuncture was performed at the main acupoints of Dubi (ST35), Neixiyan (EX-LE4), Zusanli (ST36), Yanglingquan (GB34), Yinlingquan (SP9), Xuehai (SP10), Liangqiu (ST34), and Heding (EX-LE2) once a day, with a needle retaining time of 30 min, and thunder-fire moxibustion was performed at Shenque (CV8) and Guanyuan (CV4) in the form of suspended moxibustion once a day, with 30 min each time. The patients in the control group were given oral administration of diclofenac sodium double-release enteric-coated capsules, 75 mg each time, once a day, and Fugui Gutong capsules, 6 capsules a time and 3 times a day. Each course of treatment was 14 days, and both groups were treated for 2 courses, with an interval of 2 days between the two courses. Visual Analogue Scale (VAS) score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, and Lequesne index were observed before the treatment, immediately after the treatment, and at 4 months after the treatment, and the outcome of traditional Chinese medicine (TCM) syndrome was compared between the two groups after treatment. RESULTS: Both groups had significant reductions in VAS score, WOMAC score, and Lequesne index immediately and at 4 months after the treatment (P<0.05). Compared with the control group, the observation group had significant reductions in VAS score, Lequesne index, and WOMAC score (scores of pain, function and total score) immediately and at 4 months after the treatment (P<0.05). The effective rate was 97.1% (34/35) in the observation group, and was 78.8% (26/33) in the control group. The effective rate of the observation group was obviously higher than that of the control group (P<0.05). CONCLUSION: Thunder-fire moxibustion combined with electroacupuncture has a better, more durable clinical effect and fewer adverse reactions than the drugs in the treatment of cold-dampness knee osteoarthritis.