1
|
Liu L, Qi YF, Wang M, Chen BX, Zhou QB, Tong WX, Zhang Y. A serum metabolomics study of vascular cognitive impairment patients based on Traditional Chinese medicine syndrome differentiation. Front Mol Biosci 2023; 10:1305439. [PMID: 38116379 PMCID: PMC10728729 DOI: 10.3389/fmolb.2023.1305439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/08/2023] [Indexed: 12/21/2023] Open
Abstract
Objective: Vascular cognitive impairment (VCI) accounts for approximately 50%-70% of all dementia cases and poses a significant burden on existing medical systems. Identifying an optimal strategy for preventing VCI and developing efficient symptomatic treatments remains a significant challenge. Syndrome differentiation represents a fundamental approach for personalized diagnosis and treatment in Traditional Chinese Medicine (TCM) and aligns with the principles of precision medicine. The objective of this study was to elucidate the metabolic characteristics of VCI based on TCM syndrome differentiation, thus providing novel insights into the diagnosis and treatment of VCI. Methods: A 2-year cross-sectional cognitive survey was conducted in four communities in Beijing between September 2020 and November 2022. The syndrome differentiation of participants was based on the Kidney-Yang Deficiency Syndrome Scale (KYDSS), which was originally developed by Delphi expert consultation. The identification of serum metabolites was performed by Ultra performance liquid chromatography (UPLC) analysis coupled with an electrospray ionization quadruple time-of-flight mass spectrometer (ESI-QTOF MS). Multivariate, univariate, and pathway analyses were used to investigate metabolic changes. Logistic regression models were also used to construct metabolite panels that were capable of discerning distinct groups. Phospholipase A2 (PLA2) levels were measured by a commercial ELISA kit. Results: A total of 2,337 residents completed the survey, and the prevalence of VCI was 9.84%. Of the patients with VCI, those with Kidney-Yang deficiency syndrome (VCIS) accounted for 70.87% of cases and exhibited more severe cognitive impairments. A total of 80 participants were included in metabolomics study, including 30 with VCIS, 20 without Kidney-Yang deficiency syndrome (VCINS), and 30 healthy control participants (C). Ultimately, 45 differential metabolites were identified when comparing the VCIS group with group C, 65 differential metabolites between the VCINS group and group C, and 27 differential metabolites between the VCIS group and the VCINS group. The downregulation of phosphatidylethanolamine (PE), and phosphatidylcholine (PC) along with the upregulation of lysophosphatidylethanolamine (LPE), lysophosphatidylcholine (LPC), phosphatidic acid (PA) and phospholipase A2 (PLA2) can be considered as the general metabolic characteristics associated with VCI. Dysfunction of glycerophospholipids, particularly LPEs and PCs, was identified as a key metabolic characteristic of VCIS. In particular Glycerophospho-N-Arachidonoyl Ethanolamine (GP-NArE) was discovered for the first time in VCI patients and is considered to represent a potential biomarker for VCIS. The upregulation of PLA2 expression was implicated in the induction of alterations in glycerophospholipid metabolism in both VCIS and VCINS. Moreover, robust diagnostic models were established based on these metabolites, achieving high AUC values of 0.9322, 0.9550, and 0.9450, respectively. Conclusion: These findings contribute valuable information relating to the intricate relationship between metabolic disorders in VCI, neurodegeneration and vascular/neuroinflammation. Our findings also provide a TCM perspective for the precise diagnosis and treatment of VCI in the context of precision medicine.
Collapse
Affiliation(s)
- Li Liu
- Graduate School, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yi-fei Qi
- Institute of Geriatric Medicine, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Min Wang
- Beijing University of Chinese Medicine, Beijing, China
| | - Bao-xin Chen
- Second Department of Encephalopathy, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Qing-bing Zhou
- Institute of Geriatric Medicine, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Wen-xin Tong
- Institute of Geriatric Medicine, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Ying Zhang
- Institute of Geriatric Medicine, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| |
Collapse
|
2
|
Wang L, Li J, Dang Y, Pan R, Niu Y. The Association Between Health-Related Behaviors and Traditional Chinese Medicine Syndromes in Type 2 Diabetes Mellitus Patients. Diabetes Metab Syndr Obes 2023; 16:1977-1985. [PMID: 37408728 PMCID: PMC10319278 DOI: 10.2147/dmso.s409179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 06/23/2023] [Indexed: 07/07/2023] Open
Abstract
Background Traditional Chinese medicine (TCM) has certain advantages in treating diabetes via TCM syndromes differentiation, and health-related behaviors can regulate TCM syndromes. This study aimed to identify the clusters of TCM syndromes in type 2 diabetes mellitus (T2DM) patients and to explore the association between health-related behaviors and those TCM syndromes clusters. Methods This was a cross-sectional study of 1761 T2DM patients from the Ningxia Province. The TCM syndromes (11 TCM syndromes in total) scale was used to collect the syndrome information. Health-related behaviors, including smoking, alcohol use, tea drinking, the intensity of physical activity, sleep quality, and sleep duration, were collected via a face-to-face interview questionnaire. Latent profile analysis was employed to identify clusters of 11 TCM syndromes. Multinomial logistic regression was employed to examine the relationships between health-related behaviors and clusters of TCM syndromes. Results TCM syndromes in T2DM patients were classified into three profiles using latent profile analysis: light, moderate, and heavy. Participants with poor health-related behaviors were more likely to have heavy 1.49 (95% CI: 1.12, 1.99) or moderate 1.75 (95% CI: 1.10, 2.79) profiles than those with good health-related habits. Smokers, tea drinkers, and those with poor sleep quality were more likely to have a moderate profile and heavy profile than a light profile. Compared with heavy physical activity, moderate activity 0.24 (95% CI: 0.07, 0.88) was negatively associated with a heavy profile. Conclusion Results showed that most participants had light or moderate levels of TCM syndromes, and those with poor health-related behaviors were more likely to have heavy or moderate profiles. In the context of precision medicine, these results have important implications for understanding the prevention and treatment of diabetes via changing lifestyles and behaviors to regulate TCM syndromes.
Collapse
Affiliation(s)
- Liqun Wang
- Department of Epidemiology and Statistics, School of Public Health at Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
| | - Jiangping Li
- Department of Epidemiology and Statistics, School of Public Health at Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
| | - Yuqi Dang
- Department of Endocrinology, Yinchuan Hospital of Traditional Chinese Medicine, Yinchuan, Ningxia, People’s Republic of China
| | - Ruiping Pan
- Department of Chinese Medicine, the Second People’s Hospital of Shizuishan, Shizuishan, Ningxia, People’s Republic of China
| | - Yang Niu
- Key Laboratory of the Ningxia Ethnomedicine Modernization, Ministry of Education, Ningxia Medical University, Yinchuan, Ningxia, People’s Republic of China
| |
Collapse
|
3
|
Wen Q, Hong X, He K, Liu B, Li M. Can acupuncture reverse oxidative stress and neuroinflammatory damage in animal models of vascular dementia?: A preclinical systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e33989. [PMID: 37335660 DOI: 10.1097/md.0000000000033989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Vascular dementia is a cognitive dysfunction syndrome caused by cerebral vascular factors such as ischemic stroke and hemorrhagic stroke. The effect of acupuncture on vascular dementia models is ambiguous, and there is controversy about whether acupuncture has a placebo effect. Oxidative stress and inflammation are the most essential mechanisms in preclinical studies of vascular dementia. However, there is no meta-analysis on the mechanism of vascular dementia in animal models. It is necessary to explore the efficacy of acupuncture through Meta-analysis of preclinical studies. METHODS Three major databases, PubMed, Embase and Web of Science (including medline), were searched in English until December 2022.The quality of the including literature was assessed using SYRCLE's risk of bias tool. Review Manager 5.3 was used to statistically summarize the included studies and the statistical effect values were expressed by SMD. The outcomes included: behavioral tests (escape latency, number of crossings), pathological sections (Nissl and TUNEL staining), oxidative stress markers (ROS, MDA, SOD, GSH-PX) and neuroinflammatory factors (TNF-α, IL-1β, IL-6). RESULTS A total of 31 articles were included in this meta-analysis. The results showed that the escape latency, the contents of ROS, MDA, IL-1β, and IL-6 were decreased, and the contents of SOD and Nissl-positive neurons were increased in the acupuncture group as compared with the non-group (P < .05). Compared with the impaired group, the acupuncture group also had the above advantages (P < .05). In addition, the acupuncture group also increased the number of crossings and GSH-PX content, and decreased the expression of TUNEL-positive neurons and TNF-α (P < .05). CONCLUSIONS From behavioral tests to slices and pathological markers in animal models of vascular dementia, it can be proved that acupuncture is effective in targeting oxidative stress and neuroinflammatory damage, and acupuncture is not a placebo effect. Nevertheless, attention needs to be paid to the gap between animal experiments and clinical applications.
Collapse
Affiliation(s)
- Qin Wen
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
- Yuangang Street Community Health Service Center, Guangzhou, China
| | - Xueqin Hong
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Kunze He
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Buping Liu
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Min Li
- Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| |
Collapse
|
4
|
New Algorithm of Traditional Chinese Medicine and Protection of Intangible Cultural Heritage Based on Big Data Deep Learning. BIOMED RESEARCH INTERNATIONAL 2022; 2022:1645204. [PMID: 36277875 PMCID: PMC9584667 DOI: 10.1155/2022/1645204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/14/2022] [Accepted: 09/27/2022] [Indexed: 11/21/2022]
Abstract
Traditional Chinese medicine (TCM) is a summary of the diagnosis and treatment experience formed by the working people in the long-term struggle against diseases, so it is very important to protect the intangible cultural heritage of TCM. How to extract valuable knowledge accurately and conveniently from the massive medical records of TCM is one of the important issues in the current research on the development of TCM. Due to the large amount of data of TCM medical records, many feature attributes, and diverse patterns, the existing classification technology has high computational complexity, low mining efficiency, and poor universality. Therefore, this paper proposed to quantify the medical records of TCM and obtained the main symptoms according to the improved hierarchical clustering feature selection algorithm. This paper also proposed a support vector machine (SVM) classification method using improved particle swarm algorithm to classify TCM information, which not only improves the efficiency and accuracy of TCM information classification but also discovers the potential dialectical and symptom patterns in diagnosis and treatment, so that the intangible cultural heritage protection of TCM can be developed sustainably. This paper showed that the information acquisition accuracy of the improved algorithm was very high. Before the improved algorithm was used, the accuracy of information mining for TCM was 67.90% at the highest and 65.53% at the lowest, but after using the improved algorithm, the accuracy rate of information mining for TCM was 88.02% at the highest and 82.45% at the lowest. It can be seen that using the improved algorithm to mine TCM information can quickly process effective information.
Collapse
|
5
|
Zhao Y, Yang S, Guo Q, Guo Y, Zheng Y, Ji E. Shashen-Maidong Decoction improved chronic intermittent hypoxia-induced cognitive impairment through regulating glutamatergic signaling pathway. JOURNAL OF ETHNOPHARMACOLOGY 2021; 274:114040. [PMID: 33794336 DOI: 10.1016/j.jep.2021.114040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 03/03/2021] [Accepted: 03/13/2021] [Indexed: 06/12/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Obstructive sleep apnea (OSA) is characterized by chronic intermittent hypoxia (CIH), which is associated with cognitive impairment. Previous study suggested CIH exposure could induce similar symptoms and signs to the clinical features of Deficiency of both Qi and Yin Syndrome (DQYS) in Traditional Chinese Medicine (TCM). Shashen-Maidong Decoction (SMD) has been applied clinically for DQYS for hundred years. However, SMD treatment could be beneficial to CIH induced cognitive impairment is still unclear. AIM OF THE STUDY Therefore, the aim of this study was to investigate the effect of SMD treatment on CIH induced cognitive impairment, and to explore the related neuroprotective mechanism. MATERIALS AND METHODS Mice were exposed to CIH for 5 weeks (8 h/day) and were orally treated with either vehicle or SMD (5.265 g/kg/day) 30 min before CIH exposure. Spatial memory was evaluated by Morris Water Maze and Y-Maze test. Synaptic morphology in hippocampus was observed by Golgi-Cox staining and Electron microscope, and NR2B-ERK signaling pathway were detected by western blotting. RESULTS Our results showed that SMD treatment improved performance in either Morris Water Maze or Y-Maze test in mice exposed to CIH, increased spine density and postsynaptic density (PSD) thickness in hippocampus. SMD treatment suppressed the over-activation of NR2B/CaMKII/SynGAP induced by CIH exposure, enhanced ERK/CREB phosphorylation and increased PSD-95 and BDNF expression. CONCLUSION SMD attenuates the CIH-induced cognitive impairment through regulating NR2B-ERK signaling pathway. Additionally, our findings provided that DQYS may be the potential therapeutic target for neurocognitive diseases in patients with OSA.
Collapse
Affiliation(s)
- Yang Zhao
- Department of Physiology, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, People's Republic of China
| | - Shengchang Yang
- Department of Physiology, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, People's Republic of China; Hebei Technology Innovation Center of TCM Formula Preparations, Shijiazhuang, Hebei, People's Republic of China
| | - Qiuhong Guo
- Hebei Technology Innovation Center of TCM Formula Preparations, Shijiazhuang, Hebei, People's Republic of China
| | - Yajing Guo
- Scientific Research Center, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, People's Republic of China
| | - Yuying Zheng
- Department of Physiology, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, People's Republic of China
| | - Ensheng Ji
- Department of Physiology, Hebei University of Chinese Medicine, Shijiazhuang, Hebei, People's Republic of China; Hebei Technology Innovation Center of TCM Formula Preparations, Shijiazhuang, Hebei, People's Republic of China.
| |
Collapse
|
6
|
Deng X, Teng J, Nong X, Yu B, Tang L, Liang J, Zou Z, Liu Q, Zhou L, Li Q, Zhao L. Characteristics of TCM Constitution and Related Biomarkers for Mild Cognitive Impairment. Neuropsychiatr Dis Treat 2021; 17:1115-1124. [PMID: 33907404 PMCID: PMC8068505 DOI: 10.2147/ndt.s290692] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 03/22/2021] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION The incidence of Alzheimer's disease is on the rise, early detection of cognitive impairment of the elderly is very important. In traditional Chinese medicine, constitution is related to the susceptibility of the human body to diseases. Based on the theory of constitution of traditional Chinese medicine (TCM), the human population can be classified into 9 constitutions. However, little is known about the characteristics of medical constitution and related biomarkers in subjects with mild cognitive impairment (MCI). METHODS We measured the TCM Constitution of 214 subjects by using the Constitution in Chinese Medicine Questionnaire (CCMQ). MMSE and MoCA were used to assess cognitive function. The subjects were divided into mild cognitive impairment group (MCI, n = 152) and normal control group (NC, n = 62). The levels of serum Hcy and serum/urine 8-iso-PGF 2α were determined. RESULTS 1) It was found that there was a significant difference in constitution types between MCI and NC. There were significant differences in MMSE and MoCA score, serum Hcy and serum/urine 8-iso-PGF 2a levels between the two groups. 2) In logistic regression analysis, the variables with statistical significance were TCM Constitution of Yang-Deficient, Phlegm-Dampness, Blood-Stasis and abnormal increase of Hcy (OR>1). 3) The MoCA scores had a positive correlation with the MMSE. A statistically significant inverse association was found between serum Hcy, blood and urine 8-iso-PGF 2a and scores of cognitive assessment in MCI. CONCLUSION Constitution types (Yang-Deficient, Phlegm-Dampness and Blood-Stasis) and abnormal serum Hcy elevation can be used as risk factors for MCI. MoCA scores can serve to detect MCI at early stage. Serum/urine 8-iso-PGF 2α has a certain relationship with MCI. Higher levels of serum/urine 8-iso-PGF 2α are more likely to be associated with MCI risk.
Collapse
Affiliation(s)
- Xiangming Deng
- Department of Acupuncture and Moxibustion, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, 530023, People’s Republic of China
| | - Jinlong Teng
- Department of Acupuncture and Moxibustion, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, 530023, People’s Republic of China
| | - Xiucheng Nong
- Department of Acupuncture and Moxibustion, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, 530023, People’s Republic of China
| | - Bihan Yu
- Department of Acupuncture and Moxibustion, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, 530023, People’s Republic of China
| | - Liying Tang
- The Xinhu Outpatient Clinic of the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530021, People’s Republic of China
| | - Jinsong Liang
- Department of Clinical Laboratory of the First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, 530023, People’s Republic of China
| | - Zhuocheng Zou
- Department of Acupuncture and Moxibustion, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, 530023, People’s Republic of China
| | - Qiang Liu
- The Xinhu Outpatient Clinic of the People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530021, People’s Republic of China
| | - Lu Zhou
- Medical Examination Center of the First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, 530023, People’s Republic of China
| | - Qirong Li
- Renai Branch of the First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, 530023, People’s Republic of China
| | - Lihua Zhao
- Department of Acupuncture and Moxibustion, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, 530023, People’s Republic of China
| |
Collapse
|
7
|
Won J, Lee BH, Jung WM, Chae Y, Lee H. Herbal medicine for inflammatory bowel diseases: development of pattern identification algorithms by retrospective analysis of case series data. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2020.101114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
8
|
Qingxin Kaiqiao Recipe Improves Cognitive Performance, Inhibits Apoptosis, and Reduces Pathological Deposits in APP/PS1 Double Transgenic Mice via the PI3K/Akt Pathway. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:3019674. [PMID: 32419798 PMCID: PMC7204341 DOI: 10.1155/2020/3019674] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 03/27/2020] [Accepted: 04/13/2020] [Indexed: 12/17/2022]
Abstract
The traditional Chinese medicine of Qingxin Kaiqiao Recipe (QKR) is effective in the treatment of Alzheimer's disease (AD). This study aims to investigate whether QKR improves the cognitive ability and takes neuroprotective effect on APP/PS1 double transgenic mice via the PI3K/Akt pathway. APP/PS1 double transgenic mice were randomly divided into a model, donepezil-treated, or QKR-treated group (L-QKR: 4.75 mg/kg/d, M-QKR: 9.5 mg/kg/d, and H-QKR: 19 mg/kg/d, respectively). Wild-type C57/BL6J mice were used as the control group. Morris water maze (MWM) was used to test the ability of spatial navigation and memorization; terminal deoxynucleotidyl transferase-mediated dUTP nick end-labelling (TUNEL) assay was applied to test the apoptosis; amyloid protein granule deposition was detected via Methenamine silver staining; Western blot (WB) analysis, immunohistochemistry, and RT-PCR were applied to measure the expression of Aβ and corresponding indicators of the PI3K/Akt pathway. Compared with the model group, QKR significantly relieved the cognitive impairment, reduced the deposition of senile plaques, decreased the expression of GSK-3α and Aβ, and increased the expression of p-PI3K, p-Akt, and IDE. In addition, the number of TUNEL-positive cells decreased after treatment using QKR. The current study proved that QKR, especially at the high dose tested, exerted a protective effect on improving learning and memory, inhibiting apoptosis, and reducing the process of pathological degeneration in the hippocampus of AD mice.
Collapse
|
9
|
Korean Traditional Medicine in Treating Patients with Mild Cognitive Impairment: A Multicenter Prospective Observational Case Series. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:4323989. [PMID: 32184890 PMCID: PMC7060453 DOI: 10.1155/2020/4323989] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 01/28/2020] [Accepted: 01/31/2020] [Indexed: 12/20/2022]
Abstract
In Korea, patients with mild cognitive impairment can choose to receive treatment of Korean medicine, and Korean medicine hospitals provide specialized medical care for the prevention and management of cognitive disorders. The aim of the study is to explore the role of Korean medicine therapy for patients with mild cognitive impairment in a real clinical setting. Fifteen patients with amnestic mild cognitive impairment were enrolled in this prospective observational study in three Korean medicine hospitals. Korean medicine treatments were delivered by experienced professionals and not restricted to standardized treatment. Outcome measures were prospectively planned to examine the Korean-Montreal Cognitive Assessment (K-MoCA), Korean-Mini Mental State Examination (K-MMSE), and other detailed neuropsychological assessment at the baseline and after 12 and 24 weeks of treatment. Korean medicine treatment for MCI treatment in the real-world clinical setting included herbal medicine and acupuncture. The most frequently used herbs in herbal decoctions were Acori Graminei Rhizoma, Polygalae Radix, and Poria Sclerotium Cum Pini Radix. The herbal medicine formulae used in this study were classified into three categories: tonifying Qi (33.3%), tonifying kidney (46.7%), and calming liver (20%) formulae. In the cognitive ability assessment, the K-MoCA score significantly improved after treatment (mean difference 2.6; 95% CI: 1.3 to 3.9, p=0.001). The K-MMSE score slightly increased after treatment; however, the improvement was not statistically significant (mean difference 0.8; 95% CI: −0.5 to 2.0, p=0.195). In detailed neuropsychological assessment, the cognitive domains of executive functions and memory after the treatment were distinctively improved. In this prospective observational case series, we could see the real clinical environments of treating patients with mild cognitive impairment in Korean medicine hospitals. Patients treated with Korean medicine showed improved results in the neuropsychological assessment after 12 and 24 weeks.
Collapse
|
10
|
Xu Z, Zhang S, Huang L, Zhu X, Zhao Q, Zeng Y, Zhou D, Wang D, Kuga H, Kamiya A, Qu M. Altered Resting-State Brain Activities in Drug-Naïve Major Depressive Disorder Assessed by fMRI: Associations With Somatic Symptoms Defined by Yin- Yang Theory of the Traditional Chinese Medicine. Front Psychiatry 2018; 9:195. [PMID: 29867614 PMCID: PMC5962703 DOI: 10.3389/fpsyt.2018.00195] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 04/25/2018] [Indexed: 12/23/2022] Open
Abstract
Identification of biological markers for defining subtypes of major depressive disorder (MDD) is critical for better understanding MDD pathophysiology and finding effective treatment intervention. The "Yin and Yang" theory is a fundamental concept of traditional Chinese Medicine (TCM). The theory differentiates MDD patients into two subtypes, Yin and Yang, based on their somatic symptoms, which had empirically been used for the delivery of effective treatment in East Asia. Nonetheless, neural processes underlying Yin and Yang types in MDD are poorly understood. In this study, we aim to provide physiological evidence using functional magnetic resonance imaging (fMRI) to identify altered resting-state brain activity associated with Yin and Yang types in drug-naïve MDD patients. The Yin type and Yang type MDD patients showed increased amplitude of low-frequency fluctuation (ALFF) in different cortical brain areas in the parietal, temporal, and frontal lobe, compared to matched healthy controls. Differential ALFF is also observed in several cortical areas in frontal lobe and insula between Yin and Yang type group. Of note, although ALFF is increased in the inferior parietal lobe in both Yin and Yang type group, inferior parietal lobe-centered functional connectivity (FC) is increased in Yang type, but is decreased in Ying type, compared with matched healthy controls. These results suggest that differential resting-state brain activity and functional connectivity in Yin and Yang types may contribute to biological measures for better stratification of heterogeneous MDD patients.
Collapse
Affiliation(s)
- Zhexue Xu
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China.,Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Shu Zhang
- Department of Neurology, Fengtai Integrated Chinese and Western Medicine Hospital of Beijing, Beijing, China
| | - Liyuan Huang
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Xiaolei Zhu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Qing Zhao
- School of Applied Psychology and Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Yawei Zeng
- Department of Radiology, People's Liberation Army No.306 Hospital, Beijing, China
| | - Dongfeng Zhou
- Department of Clinical Psychology, Peking University Sixth Hospital, Beijing, China
| | - Di Wang
- Department of Clinical Psychology, Beijing Anding Hospital, Beijing, China
| | - Hironori Kuga
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Atsushi Kamiya
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Miao Qu
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China.,Third Affiliated Hospital, Beijing University of Chinese Medicine, Beijing, China
| |
Collapse
|