ABSTRACT
BACKGROUND: Although China has a long history of using acupoints herbal patching (acupoints herbal patching means applying herbal patch on special acupoints to stimulate skin to form blisters, hyperemia, and even suppuration) in Sanfu Days (Sanfu Days are supposed to be the three hottest days in a year which is calculated by the ancient calendar) for the treatment of asthma, there is insufficient evidence to support its effectiveness and safety issues. This study investigated the efficacy and safety of acupoints herbal patching compared with placebo in participants with asthma in clinical remission stage. METHODS: We enrolled participants with asthma in clinical remission stage, above 13 years old and both genders in a randomized, double-blind and placebo-control trial at clinical center, School of Chinese Medicine, The University of Hong Kong to assess the effectiveness and safety of acupoints herbal patching, as compared with placebo, when added to guidelines-based therapy. The trial was conducted for three times (these three times were 19 July, 29 July and 8 August 2010), and the primary outcome was pulmonary function test. Secondary outcome was self-made questionnaire which were designed based on Traditional Chinese Medicine theory and clinical experience summary. RESULTS: Three hundred and twenty three eligible participants were enrolled, they were randomly assigned to acupoints herbal patching group (n = 165), placebo control group (n = 158). There was no significant difference in primary and secondary outcome as compared with placebo group at the end of 3rd treatment and four times follow ups. But sub-analysis of secondary outcome in four times follow ups showed that acupoints herbal patching significantly reduced the proportion of participants who didn't need medical treatment when they had a small rise in asthma-related symptoms increased from 6-15 % at 1st follow up and 0-7 % at 3rd follow up (P < 0.05). It indicated that the proportion of participants who can spontaneous resolution of an asthma attack increased through acupoints herbal patching. In addition, acupoints herbal patching was significantly superior to placebo in reducing the percentage of participants who were susceptibly waken up by asthma symptoms from 27-14 %, and the percentage of participants who had the symptom of running nose and sneezing before onset from 18-8 % at 2nd follow up (P < 0.05). Improvements also occurred with treatment group, it reduced the proportion of participants who were spontaneous sweating at 3rd follow up (P < 0.05). CONCLUSIONS: There was no significant difference between acupoints herbal patching and placebo in pulmonary function test in this study. Self-made questionnaire showed that the lasting effect of acupoints herbal patching was significantly better than placebo in reducing the need for medications to control asthma and the proportion of susceptible symptoms in participants with asthma in clinical remission stage. It showed that the low quality of life caused by asthma-related symptoms was significantly improved through acupoints herbal patching in Sanfu Days. Besides, acupoints herbal patching was as safe as placebo for chronic stable asthma. TRIAL REGISTRATION NUMBER: HKUCTR-1128, Registration date 22 Jul 2010.
ABSTRACT
<p><b>OBJECTIVE</b>To systematically review the clinical practice guidelines (CPGs) for ischemic stroke in Chinese medicine (CM) with the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument.</p><p><b>METHODS</b>CM CPGs for ischemic stroke were searched in 5 online databases and hand-searches in CPGrelated handbooks published from January 1990 to December 2012. The CPGs were categorized into evidence based (EB) guideline, consensus based with no explicit consideration of evidence based (CB-EB) guideline and consensus based (CB) guideline according to the development method. Three reviewers independently appraised the CPGs based on AGREE II instrument, and compared the CPGs' recommendations on CM pattern classification and treatment.</p><p><b>RESULTS</b>Five CM CPGs for ischemic stroke were identified and included. Among them, one CPG was EB guideline, two were CB guidelines and two were CB-EB guidelines. The quality score of the EB guideline was higher than those of the CB-EB and CB guidelines. Five CM patterns in the CPGs were recommended in the EB CPG. The comprehensive protocol of integrative Chinese and Western medicine recommended in the EB CPG was mostly recommended for ischemic stroke in the CPGs. The recommendations varied based on the CM patterns.</p><p><b>CONCLUSION</b>The quality of EB CPG was higher than those of CB and CB-EB CPGs in CM for ischemic stroke and integrative approaches were included in CPGs as major interventions.</p>
Subject(s)
Humans , Biomedical Research , Brain Ischemia , Therapeutics , Health Planning Guidelines , Medicine, Chinese Traditional , Practice Guidelines as Topic , Stroke , TherapeuticsABSTRACT
Background. Tianjiu therapy has established efficacy against chronic asthma with related symptoms or the medication need during asthma attack. This study aimed to explore the optimal duration of Tianjiu therapy for asthma. Methods. This study was a self-comparison-to-the-baseline study, which comparing treatment with Tianjiu therapy for 1 year and 2 years in the same 102 chronic asthma patients. Totally 6 sessions of Tianjiu treatment were provided, 3 sessions in a year as a course of treatment and totally two years treatment. The primary endpoint was the number of asthma related symptoms which frequently appeared in asthma patients and the frequency of bronchodilator used during asthma attack. Results. The frequency of bronchodilator used during asthma attack significantly improved (χ (2) = 46.276, P = 0.000). But the number of asthma related symptoms which frequently appeared in asthma patients added by 1.38 points (95% CI, 0.25 to 2.51), 2.93 ± 0.41 in 1-year group and 4.31 ± 0.41 in the 2-years group (P < 0.05). Conclusions. The effect of 2 years Tianjiu therapy was not as effective as 1 year such treatment for asthma, but the second year Tianjiu therapy was still needed because it has a role to consolidate the curative effect of Tianjiu therapy for asthma.
