ABSTRACT
OBJECTIVE: Suanzaoren decoction (SZRD) in Traditional Chinese Medicine is a common prescription for chronic insomnia. This study systematically and accurately evaluated the safety and efficacy of SZRD in the treatment of chronic insomnia, thus providing a reference for its clinical application. MATERIALS AND METHODS: From the establishment of the corresponding database until May 2022, we systematically queried EMbase, PubMed, Cochrane Library, Web of Science, CNKI, VIP, and Wanfang Database. Randomized control trials (RCTs) were included in this study, and the results that qualified for inclusion were screened and cross-checked by two researchers. After the relevant data were extracted, a meta-analysis was performed using RevMan 5.3 software. RESULTS: A total of 1,311 patients with chronic insomnia from 12 RCTs were enrolled in the meta-analysis, showing that the use of SZRD alone or in combination was superior to the control group in improving the clinical effective rate (RR=1.22, 95%CI [1.16, 1.29], p<0.00001), reducing the recurrence rate (RR=0.47, 95%CI [0.28, 0.80], p=0.005), and lowering the Pittsburgh Sleep Quality Index (PSQI) scores (MDSZRD+WM=-3.35,95%CI [-5.22, -1.47], p<0.00001); (MDSZRD=-1.94, 95%CI [-3.80, -0.07], p = 0.04). SZRD also could reduce the adverse effects rate (RR=0.30, 95% CI [0.22, 0.40], p<0.00001). CONCLUSIONS: It was therefore concluded that SZRD alone or in combination with Western medicine can increase the clinical effective rate, reduce the recurrence rate, improve the quality of life of chronic insomnia patients, and decrease the incidence of adverse effects. However, studies included in this analysis varied in quality, and more large-sample, high-quality, multi-center RCTs are still needed to verify the above conclusions.
Subject(s)
Drug-Related Side Effects and Adverse Reactions , Sleep Initiation and Maintenance Disorders , Humans , Sleep Initiation and Maintenance Disorders/drug therapy , Medicine, Chinese Traditional , Databases, Factual , Randomized Controlled Trials as TopicABSTRACT
The noradrenergic neurotoxin DSP4 was injected intrathecally into the lumbar spinal subarachnoid space of the rat. After 10 days, dose-response curves for tail-flick inhibition were determined for both intraperitoneal and intraventricular injections of morphine. In rats pretreated with DSP4, the analgesic effect of morphine given either intraventricularly or intraperitoneally was significantly attenuated. The noradrenaline and 5-hydroxytryptamine contents in the brain-stem and the spinal cord were also measured. Intrathecal DSP4 depleted noradrenaline in the spinal cord but not in the brain-stem. Neither brain-stem or spinal cord 5-hydroxytryptamine was affected by DSP4.
Subject(s)
Amines/pharmacology , Analgesics, Opioid , Benzylamines/pharmacology , Morphine/pharmacology , Norepinephrine/metabolism , Spinal Cord/metabolism , Animals , Benzylamines/administration & dosage , Brain Stem/metabolism , Drug Interactions , Injections, Intraventricular , Injections, Spinal , Pain/physiopathology , Rats , Reaction Time/drug effects , Sensory Thresholds/drug effects , Serotonin/pharmacologyABSTRACT
Reserpine antagonized systemic morphine analgesia as measured by tail-flick latency but the antagonism was surmountable by increasing the morphine dose. Reserpine had no effect on the intrathecal morphine analgesia while the analgesic action of intraventricular morphine was practically eliminated by reserpine.
