Analysis of Herbal Medicine Prescriptions for Patients in An Academic Korean Medical Hospital:A Cross Sectional Study of Electronic Medical Records(2010–2013)

Objective： To obtain fundamental information for the standardization of herbal medicine in Korea. Methods： We analyzed the herbal medicine prescription data of patients at the Pusan National University Korean Medicine Hospital from March 2010 to February 2013. We used the Dongui-Bogam （Dong Yi Bao Jian） to classify prescribed herbal medicines. Results： The study revealed that the most frequently prescribed herbal medicine was ‘Liuwei Dihuang Pill （LWDHP, 六味地黄丸）＇ which was used for invigorating ‘Shen （Kidndy）-yin＇. ‘LWDHP＇ was most frequently prescribed to male patients aged 50-59, 60-69, 70-79 and 80-89 years, and ‘Xionggui Tiaoxue Decoction （XGTXD, 芎归调血饮）＇ was most frequently prescribed to female patients aged 30-39 and 40-49 years. According to the International Classification of Diseases （ICD） codes,‘Diseases of the musculoskeletal system and connective tissue＇ showed the highest prevalence. ‘LWDHP＇ and ＇XGTXD＇ was the most frequently prescribed in categories 5 and 3, respectively. Based on the percentage of prescriptions for each sex, ‘Ziyin Jianghuo Decoction （滋阴降火汤）＇ was prescribed to mainly male patients, and ‘XGTXD＇ with ‘Guima Geban Decoction （桂麻各半汤）＇ were prescribed to mainly female patients. Conclusion： This study analysis successfully determined the frequency of a variety of herbal medicines, and many restorative herbal medicines were identified and frequently administered.

Simultaneous determination of fourteen components of Gumiganghwal-tang tablet in human plasma by UPLC-ESI-MS/MS and its application to pharmacokinetic study

Gumiganghwal-tang is a traditional herbal medicine widely used for its anti-inflammatory,analgesic,and antipyretic effects.However,the safety and efficacy of its active ingredients based on an in vivo pharmacokinetic(PK)study have yet been investigated.We have established a sensitive and accurate UPLC-ESI-MS/MS method and conducted a PK study on 14 constituents of Gumiganghwal-tang through human plasma analysis.Analytical conditions were optimized according to the physicochemical properties of the 14 compounds to facilitate efficient separation and eliminate overlap or interference between peaks.KINETEX-C18 and Inertsil-C8 columns were used as UPLC stationary phases,and acetonitrile and aqueous formic acid were used as mobile phases.All the analytes were quantified with a triple quadrupole mass spectrometer using electrospray ionization in multiple reaction monitoring mode.The chromatograms of 14 bioactive compounds showed excellent elution and sensitivity,and each peak was selectively separated and quantified without interference with each other or impurities.The established analytical method was based on international guidelines and was successfully used to perform PK studies of 14 herbal ingredients in humans after oral administration with Gumiganghwal-tang tablets.The oral absorption of most active components of Gumiganghwal-tang was relatively rapid and remained considerably long in the body to be quantified in plasma up to 48 h after administration.

A review of rat models of periodontitis treated with natural extracts

Objective:To review treatment methods using natural extracts applied in rat models of periodontitis to establish a direction for the design of future experiments.Methods:An electronic search of PubMed was carried out using the keywords“periodontitis,”“natural”,“extracts”,“herb*”,“plants”and“rats.”Articles were screened against inclusion and exclusion criteria by two independent researchers.Data describing the characteristics of rats,method of periodontitis inducement,extract administration,and outcome measures were extracted and analyzed by more than two authors manually.Results:Of the 864 articles identified,33 studies were included.The use of SpragueeDawley rats(51.2%)and male rats(90.9%)was preferred.The most common experimental methods were ligature placement(72.7%)and oral administration(66.7%).Alveolar bone loss was evaluated mainly by photography(51.5%)and micro-computed tomography(39.4%).Factors related to bone remodeling and inflammatory processes,such as interleukin-1b,tumor necrosis factor-a,receptor activator of nuclear factor-kB,and osteoprotegerin,were also measured.Conclusion:Many diverse experimental periodontitis models have been used.However,few articles observed bone formation,immune responses,antibacterial effects,and toxicity.Future studies to assess natural extracts for the treatment of periodontitis should be robust and well-designed.

Combating Drug Resistance in Colorectal Cancer Using Herbal Medicines

Colorectal cancer(CRC)is one of the most prevalent and lethal cancer types around the world.Most of the CRC patients are treated with chemotherapeutic drugs alone or combined.However,up to 90%of metastatic cancer patients experience the failure of treatment mostly because of the acquired drug resistance,which can be led to multidrug resistance(MDR).In this study,we reviewed the recent literature which studied potential CRC MDR reversal agents among herbal medicines(HMs).Among abundant HMs,6 single herbs,Andrographis paniculata,Salvia miltiorrhiza,Hedyotis diffusa,Sophora flavescens,Curcuma longa,Bufo gargarizans,and 2 formulae,Pien Tze Huang and Zhi Zhen Fang,were found to overcome CRC MDR by two or more different mechanisms,which could be a promising candidate in the development of new drugs for adjuvant CRC chemotherapy.

Electroacupuncture for abdominal pain relief in patients with acute pancreatitis:A three-arm randomized controlled trial

Background: Electroacupuncture(EA) may reduce the severity of acute pancreatitis(AP) and provide additional pain relief in patients with chronic pancreatitis. However, the ability of EA to relieve pain in patients with AP has not been well documented.Objective: This study was undertaken to compare the pain-relieving effects of EA and conventional treatment in patients with AP.Design, setting, participants and interventions: This study was conducted using a randomized, controlled,three-arm, parallel-group and multi-center design. Patients diagnosed with AP were randomly and equally assigned to EA1, EA2 or control groups. All participants received conventional standard-of-care therapy for AP. Local EA alone was administered in EA1, and local plus distal EA was given in EA2.Local EA included two abdominal acupoints, while distal EA included twelve peripheral acupoints. EA groups underwent one session of EA daily for 4 days(days 1–4), or until pain was resolved or discharged.Main outcome measures: The primary outcome measure was the change in the visual analogue scale(VAS;0–100) pain score between baseline and day 5.Results: Eighty-nine participants were randomized into EA1, EA2 and control groups, and 88(EA1, 30;EA2, 29;control, 29) were included in the full-analysis set. VAS score change(median [interquartile range]) on day 5 was(12.3 ± 22.5) in the EA1 group,(10.3 ± 21.5) in the EA2 group, and(8.9 ± 15.2) in the control group. There were not significant differences in the change in VAS score among treatments(P = 0.983). However, time to food intake was significantly shorter in the EA group(EA1 + EA2) than in the control group(median 2.0 days vs 3.0 days), with a hazard ratio of 0.581(P = 0.022;95% CI,0.366–0.924). No significant adverse events occurred.Conclusion: EA treatment did not significantly reduce pain after 4 days of treatment in patients with AP-associated abdominal pain but significantly reduced time to first food intake.

Analgesic efficacy of median nerve stimulation in mice with chemotherapy-induced peripheral neuropathy via modulation of brain-derived neurotrophic factor expression

OBJECTIVE:Chemotherapeutic agents such as docetaxel(DTX)can trigger chemotherapy-induced peripheral neuropathy(CIPN),which is characterized by unbearable pain.This study was designed to investigate the analgesic effect and related neuronal mechanism of low-frequency median nerve stimulation(LFMNS)on DTX-induced tactile hypersensitivity in mice.METHODS:To produce CIPN,DTX was administered intraperitoneally 4 times,once every 2 d,to male ICR mice.LFMNS was performed on the wrist area,and the pain response was measured using von Frey filaments on both hind paws.Western blot and immunofluorescence staining were performed using dorsal root ganglion and spinal cord samples to measure the expression of brainderived neurotrophic factor(BDNF).RESULTS:Repeated LFMNS significantly attenuated the DTX-induced abnormal sensory response and suppressed the enhanced expression of BDNF in the DRG neurons and spinal dorsal area.CONCLUSIONS:LFMNS might be an effective nonpharmaceutical option for treating patients suffering from CIPN via regulating the expression of peripheral and central BDNF.

如何设计高质量针刺临床研究:基于证据的专家共识

本针刺随机对照试验(Randomised controlled trials, RCT)专家共识是基于目前针刺试验面临的最普遍、最关键问题,由临床医生、研究人员、从事针灸和外科的临床试验专家、统计专家、临床流行病学和方法学专家以及患者组成的国际临床研究小组联合制订。该共识将有助于临床试验资助者、注册者以及期刊编辑等评估针刺RCT方案及研究结果的相关性、重要性和质量。

Extracts from Paeonia lactiflora Pallas, Rehmannia Glutinosa var. Purpurea Makino, Perilla Frutescens var. Acuta Kudo may increase the endometrial receptivity through expression of leukemia inhibitory factor and adhesion molecules

OBJECTIVE: To find out the combination of the extracts from Paeonia lactiflora Pallas(PL), Rehmannia Glutinosa var. Purpurea Makino(RG), Perilla Frutescens var. Acuta Kudo(PF) to increase endometrial receptivity.METHODS: Herbal medicines were extracted with boiling water and polysaccharides were removed.We examined the effect of PL, RG, and PF(PRP), a most effective herbal formula deduced from constitutive ingredient herbs of Antai Yin which is composed of PRP, on the leukemia inhibitory factor(LIF) expression and endometrial receptivity.RESULTS: The combination of the extracts from PRP induced the LIF expression in Ishikawa cells and increased the adhesion between Ishikawa and JAr cells. In addition, PRP-induced attachment of JAr cells onto Ishikawa cells and expression of adhesion molecules, ITGAV, ITGB5, CD44 s, and Lselectin, are significantly reduced by knock-down of LIF expression.CONCLUSION: Induced by the combination of the PRP extracts, the adhesion between trophoblast and endometrial cells are mediated by expression of LIF and adhesion molecules. Thus, we suggest the combination of the PRP extracts may be a novel therapy for enhancing embryo implantation rate.

Effectiveness and safety of auriculotherapy for breastfeeding: a systematic review

OBJECTIVE:To summarize and critically evaluate the evidence pertaining to the effectiveness and safety of auriculotherapy for breastfeeding.METHODS:We performed a systematic search of10 databases from their inception dates to May 15,2017.Randomized controlled trials evaluating the effectiveness and safety of auriculotherapy for breastfeeding were included.Risk of bias was assessed using the Cochrane risk of bias tool.RESULTS:This review included 31 randomized controlled trials with 5389 participants.Owing to the obvious clinical or statistical heterogeneity,a Meta-analysis was not conducted.Twenty-nine studies compared auriculotherapy plus routine care with routine care alone.No consistent adjunctive effect of auriculotherapy was observed in increasing the volume of milk production(9 studies showed significant results in favor of auriculotherapy and 5 did not)and serum prolactin level(7 studies showed significant results in favor of auriculotherapy and 2 did not),and in facilitating the initiation of milk secretion(10 studies showed significant results in favor of auriculotherapy and 7 did not).Two studies compared auriculotherapy with no treatment.Auriculotherapy as a monotherapy showed significant effects in increasing serum prolactin level and facilitating the onset of milk secretion;however,it was limited and inconclusive because only two studies were included in this comparison.The subgroup analysis of women who underwent cesarean delivery showed inconsistent results with respect to all outcomes.No serious adverse events were reported with the use of auriculotherapy.The methodological quality of the included studies was generally poor.CONCLUSION:Although some studies showed positive results,no definite conclusion about the effectiveness and safety of auriculotherapy for breastfeeding could be drawn,owing to the low methodological quality of the included studies and the heterogeneity among trials.Large-scale,well-designed studies are warranted on this topic.

A manual acupuncture treatment attenuates common cold and its symptoms: a case series report from South Korea

OBJECTIVE: To investigate beneficial effects of manual acupuncture on common cold periods and its symptoms depended on the difference onset time of common cold, within 36 h or over than that. To prove effects of manual acupuncture on common cold, a retrospective chart review was conducted.METHODS: Chart data for patients with commoncold who were treated with only manual acupuncture with fulfilling Jackson scales and satisfaction at the end of each treatment were collected via multi-centers of Oriental hospitals,Oriental medicine clinics and covalent hospital in South Korea. Totally 187 patients were divided into two groups, Group Ⅰ(115 patients, within 36 h)and Group Ⅱ(72 patients, onset time of cold over than 36 h). Finally 120 patients were observed until entire resolution of cold symptoms.RESULTS: GroupⅠ showed significant decreases themediandurationsofcompletelyrecovery(3 days;95% CI 3.0-4.0) as compared with Group Ⅱ(6 days;95% CI 4.0-7.0, P < 0.001). The manual acupuncture beneficially worked for reduction rate of common cold symptoms by 50% after initial treatment,decreased cold symptoms, and reduced cold duration.CONCLUSION: Manual acupuncture beneficially affected common cold and its symptoms.Moreover it is more susceptibility on the early time of onset cold.

Safety of acupotomy in a real-world setting:A prospective pilot and feasibility study

Objective:Acupotomy is a modern acupuncture method that includes modern surgical methods.Since acupotomy is relatively more invasive than filiform acupuncture treatment,it is important to establish the safety profile of this practice.To justify further large-scale prospective observational studies,this preliminary study was performed to assess the feasibility of the approach and investigate the safety profile and factors potentially associated with adverse events(AEs).Methods:This was a prospective pilot study that assessed the feasibility of a large-scale forthcoming safety study on acupotomy treatment in a real-world setting.The feasibility(call response rate,dropout rate,response rate for each variable and recruitment per month)and safety profile(incidence,type,severity and causality of AEs,and factors potentially associated with AEs)were measured.Results:A total of 28 participants joined the study from January to May 2018.A follow-up assessment was achieved in 258(1185 treatment points)out of 261 sessions(1214 treatment points).The response rate via telephone on the day after treatment was 87.3%.There were 8 systemic AEs in all the sessions(8/258;3.11%)and 27 local AEs on the total points treated(27/1185;2.28%).Severe AEs did not occur.Total AE and local AE occurrence were associated with blade width and the number of needle stimulations per treatment point.Conclusion:The findings suggest that it could be feasible to analyze the safety of acupotomy in a realworld setting.Moreover,the primary data on some relevant AEs could be determined.We are planning large-scale prospective studies based on these findings.Trial registration:Clinical Research Information Service(CRIS)KCT0002849(https://cris.nih.go.kr/cris/search/detailSearch.do/11487).