Umbilical therapy for promoting transdermal delivery of topical formulations: Enhanced effect and underlying mechanism.

Umbilical paste therapy is a promising method to promote transdermal drug delivery of topical formulations. This work investigated the effect and mechanism of transdermal drug delivery through the umbilical skin. The transdermal permeation studies showed the phenomenon of higher cumulative penetration and faster penetration rates for drug through the umbilical skin compared with non-umbilical skin, namely umbilical pro-permeability. This special transdermal permeability of drugs is influenced by their molecular weight, logP value, ability to form hydrogen bonds, and molecular volume. The underlying mechanism of umbilical pro-permeability was elucidated from unique structure and regulation the effect of drugs on microcirculation in the umbilical skin. Mechanistic studies revealed that this phenomenon was not only associated with the structural and physiological properties of the skin but also to the interactions between drugs and different skin layers. The umbilical pro-permeation is attributed to the thinner stratum corneum layer, differences in stratum corneum lipid composition and keratin structure, and lower levels of intercellular tight junction proteins in the viable epidermis and dermis layer of the skin. Our research indicated that umbilical paste therapy enhanced the transdermal delivery and absorption of drugs by stimulating local blood flow through mast cell activation. Surprisingly, skin temperature modulation and calcitonin gene-related peptide and substance P levels did not appear to significantly affect this process. In conclusion, umbilical drug administration, as a straightforward and non-invasive approach to enhance transdermal drug delivery, presents novel concepts for continued investigation and practical implementation of transdermal drug delivery systems.

Timing umbilical therapy in treatment of neurogenic bladder after spinal cord injury based on midnight-noon and ebb-flow doctrine: a randomized controlled trial. / åŸºäºŽå­åˆæµæ³¨ç†è®ºæ‹©æ—¶è„ç–—æ²»ç–—è„Šé«“æŸä¼¤åŽç¥žç»æºæ€§è†€èƒ±ï¼šéšæœºå¯¹ç §è¯•éªŒ.

OBJECTIVES: To observe the clinical efficacy of timing umbilical therapy for neurogenic bladder after spinal cord injury based on the midnight-noon and ebb-flow doctrine. METHODS: Sixty patients with neurogenic bladder after spinal cord injury were randomly divided into a trial group and a control group, with 30 patients in each group. In the trial group, based on the midnight-noon and ebb-flow doctrine, umbilical therapy was given at the time zone, 15:00 to 17:00. In the control group, umbilical therapy was delivered at any time zones except the period 15:00 to 17:00. The herbal plaster was remained on the umbilicus for 4 h each time, once daily. One course of treatment was composed of 2 weeks and the treatment lasted 4 weeks. Before and after treatment, the urodynamic indexes (maximum urinary flow rate [Qmax], maximum detrusor pressure [Pdet-max], residual urine volume [RUV]), voiding diary (average daily number of voiding, average daily number of leakage, average daily voided volume), neurogenic bladder symptom score (NBSS), the score of urinary symptom distress scale (USDS) and the score of World Health Organization quality of life assessment-BREF (WHOQOL-BREF) were compared between the two groups; and the clinical efficacy of the two groups was assessed. RESULTS: After treatment, Qmax, Pdet-max, the average daily voided volume and the scores of WHOQOL-BREF were increased (P<0.05); and RUV, the average daily number of voiding, the average daily number of leakage, NBSS and the scores of USDS were all reduced (P<0.05) in comparison with those before treatment in the two groups. When compared with those in the control group, Qmax, Pdet-max, the average daily voided volume and the score of WHOQOL-BREF were all higher (P<0.05); and RUV, the average daily number of voiding, the average daily number of leakage, NBSS and the score of USDS were lower (P<0.05) in the trial group. The total effective rate was 96.7% (29/30) in the trial group, higher than that (76.7%, 23/30) in the control group (P<0.05). CONCLUSIONS: Timing umbilical therapy, based on the midnight-noon and ebb-flow doctrine, effectively relieves the symptoms of dysuria and improves the quality of life in patients with neurogenic bladder after spinal cord injury.

Timing umbilical therapy in treatment of neurogenic bladder after spinal cord injury based on midnight-noon and ebb-flow doctrine: a randomized controlled trial / 中国针灸

OBJECTIVES@#To observe the clinical efficacy of timing umbilical therapy for neurogenic bladder after spinal cord injury based on the midnight-noon and ebb-flow doctrine.@*METHODS@#Sixty patients with neurogenic bladder after spinal cord injury were randomly divided into a trial group and a control group, with 30 patients in each group. In the trial group, based on the midnight-noon and ebb-flow doctrine, umbilical therapy was given at the time zone, 15:00 to 17:00. In the control group, umbilical therapy was delivered at any time zones except the period 15:00 to 17:00. The herbal plaster was remained on the umbilicus for 4 h each time, once daily. One course of treatment was composed of 2 weeks and the treatment lasted 4 weeks. Before and after treatment, the urodynamic indexes (maximum urinary flow rate [Qmax], maximum detrusor pressure [Pdet-max], residual urine volume [RUV]), voiding diary (average daily number of voiding, average daily number of leakage, average daily voided volume), neurogenic bladder symptom score (NBSS), the score of urinary symptom distress scale (USDS) and the score of World Health Organization quality of life assessment-BREF (WHOQOL-BREF) were compared between the two groups; and the clinical efficacy of the two groups was assessed.@*RESULTS@#After treatment, Qmax, Pdet-max, the average daily voided volume and the scores of WHOQOL-BREF were increased (P<0.05); and RUV, the average daily number of voiding, the average daily number of leakage, NBSS and the scores of USDS were all reduced (P<0.05) in comparison with those before treatment in the two groups. When compared with those in the control group, Qmax, Pdet-max, the average daily voided volume and the score of WHOQOL-BREF were all higher (P<0.05); and RUV, the average daily number of voiding, the average daily number of leakage, NBSS and the score of USDS were lower (P<0.05) in the trial group. The total effective rate was 96.7% (29/30) in the trial group, higher than that (76.7%, 23/30) in the control group (P<0.05).@*CONCLUSIONS@#Timing umbilical therapy, based on the midnight-noon and ebb-flow doctrine, effectively relieves the symptoms of dysuria and improves the quality of life in patients with neurogenic bladder after spinal cord injury.

[Umbilical therapy combined with moxibustion for autumn diarrhea in children].

OBJECTIVE: To observe the efficacy differences between moxibustion combined with umbilical therapy and oral administration of montmorillonite powder (smecta) on diarrhea symptoms in children of different ages. METHODS: A total of 120 children were randomly divided into an observation group and a control group, 60 cases in each group. In the observation group, the children aged under 3 years old were treated with moxibustion at Shenque (CV 8), Zhongwan (CV 12) and Tianshu (ST 25), and each acupoint was treated for less than 3 min, and the total treatment duration was no more than 10 min; the children aged between 3 to 7 years old were treated with moxibustion at Shenque (CV 8), Zhongwan (CV 12), Tianshu (ST 25), Guanyuan (CV 4), Zusanli (ST 36), Pishu (BL 20), Shenshu (BL 23) and Dachangshu (BL 25), each acupoint was treated for less than 3 min, and the total treatment duration was no more than 20 min. After moxibustion, traditional Chinese medicine patch (clove, cinnamon, rhizoma zingiberis, fructus evodiae, hawthorn, rhizoma atractylodis) was applied at Shenque (CV 8). For the children under 1 year old, the medical bag with 30 g powder was heated to 50 ℃ and used for about 30 min; for children over 1 year old, 2-5 g powder was mixed with vinegar and used for 4-8 h each time. The treatment was given once a day, three times as a course of treatment, and a total of one course of treatment was given. The children in the control group were treated with oral administration of montmorillonite powder, 3 g per day for children under 1 year old, 3-6 g per day for children aged 1-2 years old and 6-9 g per day for children over 2 years old. The montmorillonite powder was taken three times a day for 3 days. The diarrhea symptom scores before and after treatment were observed and the clinical efficacy was evaluated. From the first treatment, the recovery cases and recovery time in the two groups were recorded, the recovery cases and recovery time in acute and chronic stages were compared between different age groups. The recurrence was observed 3 months after treatment. RESULTS: Compared before treatment, the diarrhea symptom score after treatment was decreased in the observation group (P<0.05), while there was no significant difference before and after treatment in the control group (P>0.05). After treatment, the score of diarrhea symptoms in the observation group was lower than that in the control group (P<0.05). The total effective rate was 95.0% (57/60) in the observation group, which was superior to 76.7% (46/60) in the control group (P<0.05). The recovery cases of acute stage aged ≤ 1 year old and 5-7 years old, and chronic stage of different age stages in the observation group was insignificantly higher than that in the control group (P>0.05). The recovery time of different age stages and average recovery time in the observation group were shorter than those in the control group (P<0.05). The recovery time of children in acute stage>1 year old and ≤5 years old and average recovery time in the observation group were shorter than those in the control group (P<0.05), while the average recovery time of children in chronic stage in the observation group was shorter than that in the control group (P<0.05). Three months after treatment, the recurrence rate was 0% (0/36) in acute phase and 4.8% (1/21) in chronic phase in the observation group, which were superior to 9.7% (3/31) in acute phase and 46.7% (7/15) in chronic phase in the control group (P<0.05). CONCLUSION: The umbilical therapy combined with moxibustion could improve the symptoms of diarrhea and shorten the recovery time in children of different ages with autumn diarrhea, which have better efficacy than montmorillonite powder.

Efficacy and safety of umbilical therapy with the traditional Chinese medicine formulation Lishui Xiaogu cataplasm for cirrhotic ascites: protocol for a randomized controlled trial.

BACKGROUND: Ascites is one of the most common complications of cirrhosis. Umbilical therapy with traditional Chinese medicines has been increasingly prescribed to treat cirrhotic ascites. However, high-quality evidence from clinical trials supporting such application of traditional Chinese medicines remains limited. Therefore, we designed a clinical trial to evaluate the efficacy and safety of umbilical therapy with the Lishui Xiaogu cataplasm formulation applied to treat cirrhotic ascites. METHODS/DESIGN: This ongoing study is a double-blind, randomized, parallel, placebo-controlled trial. A total of 82 patients will be recruited and randomly assigned to either a treatment group or a placebo group, in a 1:1 ratio. The treatment group will receive umbilical therapy with the Lishui Xiaogu cataplasm plus red light irradiation along with conventional treatment; the placebo group will receive umbilical therapy with a placebo cataplasm plus red light irradiation along with conventional treatment. Interventions for both groups will be administered once daily for up to 10 days, with a 30-day follow-up after the last treatment. The primary efficacy measurement will be ascites depth. Secondary efficacy measurements will include abdominal perimeter, weight, urine volume, the symptomatic score of traditional Chinese medicine, and the Chronic Liver Disease Questionnaire. Adverse events will also be reported. DISCUSSION: This randomized trial will be the first rigorous study designed to evaluate the efficacy and safety of umbilical therapy with Lishui Xiaogu cataplasm applied for cirrhotic ascites. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR-INR-16007686 . Registered on 1 January 2016.

Umbilical therapy combined with moxibustion for autumn diarrhea in children / 中国针灸

OBJECTIVE@#To observe the efficacy differences between moxibustion combined with umbilical therapy and oral administration of montmorillonite powder (smecta) on diarrhea symptoms in children of different ages.@*METHODS@#A total of 120 children were randomly divided into an observation group and a control group, 60 cases in each group. In the observation group, the children aged under 3 years old were treated with moxibustion at Shenque (CV 8), Zhongwan (CV 12) and Tianshu (ST 25), and each acupoint was treated for less than 3 min, and the total treatment duration was no more than 10 min; the children aged between 3 to 7 years old were treated with moxibustion at Shenque (CV 8), Zhongwan (CV 12), Tianshu (ST 25), Guanyuan (CV 4), Zusanli (ST 36), Pishu (BL 20), Shenshu (BL 23) and Dachangshu (BL 25), each acupoint was treated for less than 3 min, and the total treatment duration was no more than 20 min. After moxibustion, traditional Chinese medicine patch (clove, cinnamon, rhizoma zingiberis, fructus evodiae, hawthorn, rhizoma atractylodis) was applied at Shenque (CV 8). For the children under 1 year old, the medical bag with 30 g powder was heated to 50 ℃ and used for about 30 min; for children over 1 year old, 2-5 g powder was mixed with vinegar and used for 4-8 h each time. The treatment was given once a day, three times as a course of treatment, and a total of one course of treatment was given. The children in the control group were treated with oral administration of montmorillonite powder, 3 g per day for children under 1 year old, 3-6 g per day for children aged 1-2 years old and 6-9 g per day for children over 2 years old. The montmorillonite powder was taken three times a day for 3 days. The diarrhea symptom scores before and after treatment were observed and the clinical efficacy was evaluated. From the first treatment, the recovery cases and recovery time in the two groups were recorded, the recovery cases and recovery time in acute and chronic stages were compared between different age groups. The recurrence was observed 3 months after treatment.@*RESULTS@#Compared before treatment, the diarrhea symptom score after treatment was decreased in the observation group (0.05). After treatment, the score of diarrhea symptoms in the observation group was lower than that in the control group (0.05). The recovery time of different age stages and average recovery time in the observation group were shorter than those in the control group (1 year old and ≤5 years old and average recovery time in the observation group were shorter than those in the control group (<0.05), while the average recovery time of children in chronic stage in the observation group was shorter than that in the control group (<0.05). Three months after treatment, the recurrence rate was 0% (0/36) in acute phase and 4.8% (1/21) in chronic phase in the observation group, which were superior to 9.7% (3/31) in acute phase and 46.7% (7/15) in chronic phase in the control group (<0.05).@*CONCLUSION@#The umbilical therapy combined with moxibustion could improve the symptoms of diarrhea and shorten the recovery time in children of different ages with autumn diarrhea, which have better efficacy than montmorillonite powder.

[The ancient clinical application of umbilical therapy for retention of urine].

By collecting relevant ancient literature, with retention of urine, umbilical therapy and Shenque (CV 8) as key words, various umbilical therapies for retention of urine from the Song dynasty to Qing dynasty were retrieved and summarized. The results indicated rich knowledge of umbilical therapy was recorded in ancient literature (the Song dynasty to the Qing dynasty), including 9 kinds of therapies e.g. sticking umbilical method, ironing umbilical method, pasting umbilical method, smearing umbilical method, filling umbilical method, sealing umbilical method, covering umbilical method, dripping umbilical method and bundling umbilical method. Moreover, the detailed methods were briefly explained. It is hoped to provide reference for modern application of umbilical therapy for retention of urine.

The ancient clinical application of umbilical therapy for retention of urine / 中国针灸

By collecting relevant ancient literature, with retention of urine, umbilical therapy and Shenque (CV 8) as key words, various umbilical therapies for retention of urine from thedynasty todynasty were retrieved and summarized. The results indicated rich knowledge of umbilical therapy was recorded in ancient literature (thedynasty to thedynasty), including 9 kinds of therapies e.g. sticking umbilical method, ironing umbilical method, pasting umbilical method, smearing umbilical method, filling umbilical method, sealing umbilical method, covering umbilical method, dripping umbilical method and bundling umbilical method. Moreover, the detailed methods were briefly explained. It is hoped to provide reference for modern application of umbilical therapy for retention of urine.

"Therapeutic Observations of""Wen Yang Zhu Shui Formulae""Combined with Moxa Salt Packets in the Treatment of Malignant Ascites" / 浙江中医药大学学报

[Objective] To observe the clinical effect ofWen Yang Zhu Shui Formulaecombined with moxa salt packets in the treatment of malignant ascites. [Methods] 61 patients were randomly divided into an observation group(n=31) and a control group(n=30). The patients in the control group were treated with western medicine, while patients in the observation group, based on the treatment of control group, were treated with Wen Yang Zhu Shui Formulaecombined with moxa salt packets for one time a day for two weeks. The effective rates for malignant ascites and Karnofsky performance score(KPS) were compared in the two groups. [Results] The effective rate for malignant ascites in the observation group(80.64%) was higher than that in the control group (53.33%), P<0.05. The observation group showed significantly higher score of KPS than patients of the control group( P<0.05). [Conclusion]Wen Yang Zhu Shui Formulaecombined with moxa salt packets can effectively reduce the malignant ascites.

Effects of Umbilical Therapy by Rheum palmatum Combined with Early Colon Irrigation on the Quality of Life in Elderly Patients with Colon Stoma / 中国药房

OBJECTIVE:To explore the effects of umbilical therapy by Rheum plamatum combined with early colonic irriga-tion on the quality of life in elderly patients with colon stoma. METHODS:80 patients underwent radical resection of abdominoperi-neal rectal carcinoma were randomly divided into control group and observation,with 40 cases in each group. Control group was given early colonic irrigation;observation group was additionally given umbilical therapy by R. plamatum. Treatment course of 2 groups lasted for one month,and both were followed up for 6 months after treatment. The quality by life in 2 groups was evaluated by using QLQ-C30,and therapy costs were calculated before and after treatment. RESULTS:Compared with before treatment, function score and total health score of 2 groups improved significantly in 1,3,6 months after treatment,while symptom score and single item score decreased significantly,with statistical significance(P<0.05). In 1,3,6 months after treatment,role func-tion,social function,cognitive function,emotional function and total health score of observation group were significantly higher than those of control group,and insomnia and pain score were significantly lower than control group,with statistical significance (P<0.05). 3 and 6 months after treatment,diarrhea and economic difficulty score of observation group were significantly lower than those of control group,with statistical significance(P<0.05). 1 months after treatment,loss of appetite score of observation group were significantly lower than those of control group,with statistical significance (P<0.05). 6 months after treatment, fa-tigue,nausea and vomiting score of observation group were significantly lower than those of control group,with statistical signifi-cance (P<0.05). 6 months after treatment,nursing cost,drug cost and total cost of observation group were significantly lower than those of control group,with statistical significance(P<0.05). CONCLUSIONS:The umbilical therapy by R. plamatum com-bined with early colonic irrigation can improve the quality of life in elderly patients with colon stoma significantly and reduce treat-ment cost.