ABSTRACT
Objective To analyze the improved the effects of prevention and treatment by integrated tradition Chinese and Western medicine on TCM constitutions and relevant indexes of community diabetic patients; To provide a reference for the comprehensive prevention and treatment of community diabetes.Methods By using cluster sampling method, 700 patients with diabetes aged 45 to 65 in healthcare service center in Minhang District in Shanghai were chosen randomly and divided into intervention group and control group, with 350 cases in each group. The control group used information platform, and was treated with standardized management and treatment of diabetes. On the basis of the treatment of the control group, the intervention group was identified TCM constitutions once a month, developed personalized community diabetes prevention and treatment of TCM norms, and gave guidance and intervention for health preserving and disease prevention for a year. The TCM constitution improvement was observed. Diabetic symptoms grading scale and anxiety self-rating scale, depression self-rating scale were assessed, and the complications were observed.Results Before intervention: TCM constitution of yin-yang harmony (51.43％) > yin asthenia (18.29％) > qi asthenia (11.71％) > yang asthenia (9.71％) > damp-heat (1.57％). After intervention: TCM constitution of yin-yang harmony (63.71％) > yin asthenia (8.71％) > qi asthenia (6.57％), yang asthenia (6.29％) > damp-heat (1.71％). There was difference in constitutions of yin-yang harmony, yang asthenia, and damp-heat before and after and through intervention and group interaction (P<0.05). There was statistical significance in diabetes symptoms curative effect index between the two groups (P=0.021). There was statistical significance in ophthalmoscopy results before and after and through intervention and group interaction (P=0.002).Conclusion The prevention and treatment by intervention of integrated traditional Chinese and Western medicine can improve the TCM constitutions of diabetic patients in community and influence the symptoms of diabetes.
ABSTRACT
<p><b>BACKGROUND</b>Roughly focused extracorporeal shock waves therapy (ESWT) is characterized by a wide focal area, a large therapy zone, easy positioning, and less pain during treatment. The purpose of this study was to investigate the effects of roughly focused ESWT on the expression of osteoprotegerin (OPG) and bone morphogenetic protein-2 (BMP-2) in osteoporotic fractures in rats.</p><p><b>METHODS</b>Seventy-two female Sprague-Dawley (SD) rats, 3 months old, were divided into sham-operated group (n = 6) and an ovariectomized (OVX) group (n = 66). Sixty OVX SD rats were used as a model of double proximal tibial osteotomy and inner fixation. The osteotomy site in the left tibia was treated with roughly focused ESWT once at an energy density of 0.26 mJ/mm2, 60 doses/min, and 2000 pact quantities. The contralateral right tibia was left untreated and served as a control. Expression of OPG and BMP-2 in the callus of the osteoporotic fracture area was assessed using immunohistochemistry, real-time polymerase chain reaction (PCR), and Western blotting analysis.</p><p><b>RESULTS</b>Bone mineral density (BMD) at the proximal tibia, femur, and L5 spine was significantly reduced after ovariectomy. BMD of proximal tibia was 12.9% less in the OVX group than that in the sham-operated group. Meanwhile, bilateral oophorectomy resulted in a lower trabecular bone volume fraction (BV/TV) in the proximal tibia of the sham-OVX animals. Three months after bilateral oophorectomy, BV/TV was 14.29% of baseline BV/TV in OVX legs versus 45.91% in the sham-OVX legs (P < 0.001). These data showed that the SD rats became a suitable model of osteoporosis, 3 months after they were OVX. Immunohistochemical analysis showed higher levels of BMP-2 and OPG expression in the treatment group than those in the control group. Compared with the contralateral controls, decreased expression of OPG and BMP-2 at 3 days after roughly focused ESWT, followed by a later increase at 7 days, was indicated by real-time PCR and Western blotting analysis. The OPG messenger RNA (mRNA) expression levels peaked at 6 weeks after the shock wave treatment, paired with a much earlier (at 4 weeks) increase of BMP-2, and declined close to normal at 8 weeks.</p><p><b>CONCLUSIONS</b>Roughly focused ESWT may promote the expression of OPG and BMP-2 in the osteoporotic fracture area in rats. BMP-2 and OPG may act synergistically and may lead to a significant enhancement of bone formation and remodeling.</p>