1
|
Polasek D, Santhi N, Alfonso-Miller P, Walshe IH, Haskell-Ramsay CF, Elder GJ. Nutritional interventions in treating menopause-related sleep disturbances: a systematic review. Nutr Rev 2024; 82:1087-1110. [PMID: 37695299 PMCID: PMC11233886 DOI: 10.1093/nutrit/nuad113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023] Open
Abstract
CONTEXT Sleep disturbances are a core symptom of menopause, which refers to the permanent cessation of menstrual periods. Nutritional interventions may alleviate menopause-related sleep disturbances, as studies have shown that certain interventions (eg, tart cherry juice, or tryptophan-rich foods) can improve relevant aspects of sleep. OBJECTIVE The aim of this systematic review was to examine the effect of nutritional interventions for menopause-related sleep disturbances, in order to inform the subsequent development of specific interventional trials and assess their potential as a treatment for menopause-related sleep disturbances. DATA SOURCES Published studies in English were located by searching PubMed and PsycArticles databases (until September 15, 2022). DATA EXTRACTION Following full-text review, a final total of 59 articles were included. The search protocol was performed in accordance with PRISMA guidelines. DATA ANALYSIS A total of 37 studies reported that a nutritional intervention improved some aspect of sleep, and 22 studies observed no benefit. Most (n = 24) studies recruited postmenopausal women, 18 recruited menopausal women, 3 recruited perimenopausal women, and 14 recruited women from multiple groups. The majority of the studies were of low methodological quality. Due to the heterogeneity of the studies, a narrative synthesis without meta-analysis is reported. CONCLUSION Despite the large heterogeneity in the studies and choice of intervention, the majority of the identified studies reported that a nutritional intervention did benefit sleep, and that it is mainly subjective sleep that is improved. More high-quality, adequately powered, randomized controlled trials of the identified nutritional interventions are necessary. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42021262367.
Collapse
Affiliation(s)
- Dominik Polasek
- Northumbria Sleep Research, Northumbria University, Newcastle upon Tyne, UK
| | - Nayantara Santhi
- Northumbria Sleep Research, Northumbria University, Newcastle upon Tyne, UK
| | | | - Ian H Walshe
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle, UK
| | - Crystal F Haskell-Ramsay
- Department of Psychology, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Greg J Elder
- Northumbria Sleep Research, Northumbria University, Newcastle upon Tyne, UK
| |
Collapse
|
2
|
Kang WC, Lee YS, Park K, Kong CH, Jeon M, Kim MS, Jung SY, Choi JH, Ryu JH. Paeonol alleviates postmenopause-induced neuropsychiatric symptoms through the modulation of GPR30 in ovariectomized mice. JOURNAL OF ETHNOPHARMACOLOGY 2024; 327:118063. [PMID: 38493906 DOI: 10.1016/j.jep.2024.118063] [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: 01/26/2024] [Revised: 03/12/2024] [Accepted: 03/14/2024] [Indexed: 03/19/2024]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The Moutan cortex (MC), the root bark of Paeonia suffruticosa Anderws (Paeoniaceae), has been historically employed in traditional herbal medicine for addressing women's ailments by replenishing kidney Yin. AIM OF THE STUDY We aimed to explore if paeonol, an active constituent of MC, could ameliorate neuropsychiatric symptoms, such as anxiety, depression, and cognitive impairments, associated with post-menopausal syndrome (PMS) in an ovariectomized (OVX) mouse model. MATERIALS AND METHODS The experimental design comprised 6 groups, including a sham group, OVX group, paeonol administration groups (3, 10 or 30 mg/kg, p.o.), and an estradiol (E2)-treated positive control group. Behavioral tests including the open field, novel object recognition, Y-maze, elevated plus-maze, splash, and forced swimming tests were conducted. In addition, we investigated the effets of paeonol on the phosphorylated levels of phosphatidylinositol 3-kinase (PI3K), Akt, and mammalian target of rapamycin (mTOR), as well as on the expression levels of G protein-coupled receptor (GPR30) and brain-derived neurotrophic factor (BDNF) in the prefrontal cortex and hippocampus. RESULTS Paeonol treatment (10 and 30 mg/kg, p.o.) effectively reversed the cognitive decline in OVX mice, measured by the novel object recognition and Y-maze tests, similar to that in the positive control group. Additionally, it alleviated anxiety- and depressive-like behaviors, as evaluated by the elevated plus-maze test, splash test, and forced swimming test. Paeonol restored GPR30 expression levels in the prefrontal cortex and hippocampus, mirroring the effects of E2 administration. Furthermore, it reversed the reduced expression levels of the PI3K-Akt-mTOR signaling pathway in the prefrontal cortex and hippocampus and increased BDNF expression in the hippocampus of OVX mice. CONCLUSION This research suggests that paeonol would be beneficial for alleviating PMS-associated cognitive impairment, anxiety and depression.
Collapse
Affiliation(s)
- Woo Chang Kang
- Department of Biomedical and Pharmaceutical Science, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Yong Seung Lee
- Department of Biomedical and Pharmaceutical Science, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Keontae Park
- Department of Biomedical and Pharmaceutical Science, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Chang Hyeon Kong
- Department of Biomedical and Pharmaceutical Science, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Mijin Jeon
- Department of Biomedical and Pharmaceutical Science, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Min Seo Kim
- Department of Biomedical and Pharmaceutical Science, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Seo Yun Jung
- Department of Biomedical and Pharmaceutical Science, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Jung Hye Choi
- Department of Biomedical and Pharmaceutical Science, Kyung Hee University, Seoul, 02447, Republic of Korea; Department of Oriental Pharmaceutical Science, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Jong Hoon Ryu
- Department of Biomedical and Pharmaceutical Science, Kyung Hee University, Seoul, 02447, Republic of Korea; Department of Oriental Pharmaceutical Science, Kyung Hee University, Seoul, 02447, Republic of Korea.
| |
Collapse
|
3
|
Han K, Yoo JE, Kim JE, Kwon O, Kim AR, Park HJ, Jung SY, Kim M, Yang C, Cho JH, Lee JH. Beneficial effect of Gyejibokryeong-hwan on climacteric syndrome with blood stasis pattern: A randomized, double-blinded, placebo-controlled clinical pilot trial. Integr Med Res 2023; 12:100951. [PMID: 37187679 PMCID: PMC10176163 DOI: 10.1016/j.imr.2023.100951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 04/16/2023] [Accepted: 04/19/2023] [Indexed: 05/17/2023] Open
Abstract
Background Gyejibokryeong-hwan (GBH), a herbal mixture that is widely used for climacteric syndrome, is studied for its efficacy; however, no study evaluated the GBH indication, which is a blood-stasis pattern based on traditional Chinese medicine theory. Methods This is a randomized, double-blinded, placebo-controlled clinical pilot trial. Fifty subjects with climacteric syndrome were recruited and randomly assigned to GBH group or placebo group. Subjects were administered GBH or placebo granules for 4 weeks followed by 4 weeks of observation period. For the primary outcome, the Menopause Rating Scale (MRS) was evaluated. For the secondary outcomes, quality of life, degrees of abdominal resistance and tenderness, blood-stasis pattern questionnaire and degree of upward movement of Qi were evaluated. Results After 4-week intervention, the mean change of total MRS score significantly decreased in the GBH group compared to the placebo group (p = 0.037). The quality of life related to physical health (p = 0.008) and blood-stasis pattern (p = 0.018) significantly improved in the GBH group but not in the placebo group. Conclusion Our findings provide evidence of the feasibility of recruiting subjects with GBH indications and show that GBH may have clinical efficacy for the treatment of menopausal symptoms, especially urogenital symptoms, without any significant adverse events. Trial registration Clinical Research Information Service (CRIS identifier: KCT0002170).
Collapse
Affiliation(s)
- Kyungsun Han
- Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Jeong-Eun Yoo
- Department of Obstetrics and Gynecology, College of Korean Medicine, Daejeon University, Daejeon, South Korea
- Laon Integrative Medicine Research Center, Daejeon, South Korea
| | - Jung-Eun Kim
- Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Ojin Kwon
- Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Ae-Ran Kim
- Clinical Research Coordinating Team, R&D Strategy Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Hyo-Ju Park
- Clinical Research Coordinating Team, R&D Strategy Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - So-Young Jung
- Clinical Research Coordinating Team, R&D Strategy Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Mikyung Kim
- Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
- Department of Internal Medicine, College of Korean Medicine, Sangji University, Wonju, South Korea
| | - Changsop Yang
- Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Jung-Hyo Cho
- Department of Internal Korean Medicine, College of Korean Medicine, Daejeon University, Daejeon, South Korea
| | - Jun-Hwan Lee
- Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
- Korean Medicine Life Science, University of Science & Technology (UST), Campus of Korea Institute of Oriental Medicine, Daejeon 34054, South Korea
- Corresponding author at: Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon 34054, South Korea.
| |
Collapse
|
4
|
Pandozzi C, Giannetta E, Tarsitano MG. Phytotherapic approach in menopause: light and darkness. Minerva Endocrinol (Torino) 2022; 47:421-436. [PMID: 35420287 DOI: 10.23736/s2724-6507.22.03712-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Menopause is a critical period of the woman life, characterized by a peculiar modification in estrogens concentration and accompanied by different signs and symptoms. To prevent and contrast unfavorable consequences of menopause, different therapeutic approaches could be evaluated. The hormone replacement therapy (HRT) is the most known, but it has several contraindications. The increasing interest in phytotherapy introduces the necessity for endocrinologist involved in menopause to suggest different therapeutic approaches, considering the state of health of patient and the real efficacy of the drugs. We aim to outline the main phytotherapy treatments to choose in menopause. EVIDENCE ACQUISITION This review is based on focused research of the current literature on PubMed and Scopus such as research databases. We selected 4120 papers through these keywords: "MENOPAUSE" AND "phytotherapy," "natural therapy," "phytoterapy drugs." Then, the literature was scanned selecting English papers of last 10 years (last research on October 1, 2021), excluding reviews. Separately, two researchers MGT and CP examined and read 212 full selected papers. We included clinical trials and randomized clinical trials written in English and excluded duplicates, animal studies and studies with lack of group of interest, non-relevant outcomes, inappropriate methodology. Retrospective studies, case reports, case series, original articles, brief communications, and letter to the editor were included in our research. We furthermore completed our research by the examination of every study's bibliography. EVIDENCE SYNTHESIS Phytotherapy involves the use of plants or plant extracts for the treatment of diseases thanks to the activities of their compounds and metabolites. In particular, many of them have an estrogen-like activity and are identified as phytoestrogens, because thanks to their chemical structure are able to bind the estrogen receptors and carry out biological estrogenic or antiestrogenic activities. The supplementing diet with these compounds can ensure an advantage on various aspects of the climacteric syndrome and some of them also have a beneficial impact on cardiovascular risk, bone health and sleep complaint. These substances can be used with safety due to their good tolerability and low rate of side effects. There are no known serious adverse events associated with their consumption, but as a precaution, its use is not recommended during pregnancy and in association with hormonal therapies or in women with hormone responsive cancers. CONCLUSIONS Phytotherapy must be considered an interesting tool in the treatment of signs and symptoms in selected menopause woman.
Collapse
Affiliation(s)
- Carla Pandozzi
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Elisa Giannetta
- Department of Experimental Medicine, Sapienza University, Rome, Italy
| | - Maria G Tarsitano
- Department of Clinical and Surgical Sciences, Magna Græcia University, Catanzaro, Italy
| |
Collapse
|
5
|
Choi Y, Jung IC, Kim JY, Cho SH, Kim Y, Chung SY, Kwak HY, Lee DS, Lee W, Nam IJ, Yang C, Lee MY. Efficacy and safety of Gyejibokryeong-hwan (GBH) in major depressive disorder: study protocol for multicentre randomised controlled trial. Trials 2022; 23:447. [PMID: 35650612 PMCID: PMC9158297 DOI: 10.1186/s13063-022-06339-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 04/23/2022] [Indexed: 11/23/2022] Open
Abstract
Background Gyejibokryeong-hwan (GBH) is an herbal medicine composed of five herbs. It has been widely used to treat gynaecological diseases in traditional East Asian medicine. Recent animal studies suggest antidepressant effects of GBH. In this trial, we explore the efficacy and safety of GBH in patients with major depressive disorder and to identify the optimal dose for the next phase III trial. Methods This trial will enrol 126 patients diagnosed with major depressive disorder and not treated with antidepressants. Participants will be randomised to receive a high or a low dose of GBH or placebo granules. The study drugs will be administered three times a day, for 8 weeks. The 17-item Hamilton Depression Rating Scale (HDRS) will be used to measure the severity of depressive symptoms at weeks 2, 4, 6, 8, and 12. The primary efficacy endpoint is the change from baseline in HDRS-17 total score post-treatment at week 8. Analysis of covariance will be based on the baseline HDRS-17 total score and site as the covariates. Safety assessment will be based on the frequency of adverse events. The severity and causality of the study drug will be assessed. Discussion This study is designed to evaluate the efficacy and safety of GBH granules compared with placebo in patients with major depressive disorder. Trial registration Clinical Research Information Service KCT0004417. Registered on November 1, 2019 (prospective registration)
Collapse
Affiliation(s)
- Yujin Choi
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - In Chul Jung
- Department of Oriental Neuropsychiatry, College of Korean Medicine, Daejeon University, Daejeon, 34520, Republic of Korea
| | - Ju Yeon Kim
- Department of Neuropsychiatry, Daejeon Korean Medicine Hospital of Daejeon University, Daejeon, 35235, Republic of Korea
| | - Seung-Hun Cho
- Department of Neuropsychiatry, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.,Research group of Neuroscience, East-West Medical Research Institute, WHO Collaborating Center, Kyung Hee University, Seoul, Republic of Korea.,Department of Clinical Korean Medicine, Graduated School, Kyung Hee University, Seoul, Republic of Korea
| | - Yunna Kim
- Department of Neuropsychiatry, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea.,Research group of Neuroscience, East-West Medical Research Institute, WHO Collaborating Center, Kyung Hee University, Seoul, Republic of Korea.,Department of Clinical Korean Medicine, Graduated School, Kyung Hee University, Seoul, Republic of Korea
| | - Sun-Yong Chung
- Department of Neuropsychiatry, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Hui-Yong Kwak
- Department of Neuropsychiatry, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Doo Suk Lee
- R&D Center for Innovative Medicines, Helixmith Co., Ltd., Seoul, Republic of Korea
| | - Wonwoo Lee
- R&D Center for Innovative Medicines, Helixmith Co., Ltd., Seoul, Republic of Korea
| | - In-Jeong Nam
- R&D Center for Innovative Medicines, Helixmith Co., Ltd., Seoul, Republic of Korea
| | - Changsop Yang
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea.
| | - Mi Young Lee
- KM Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea.
| |
Collapse
|
6
|
Live-Imaging Analysis of Target Vessels and Nitric Oxide Production Associated with Gosha-Jinki-Gan and Keishi-Bukuryo-Gan: Two Herbal Preparations with Clinically Proven Blood Flow-Improving Effects but with Different Traditional Clinical Indicative Patterns. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:3821345. [PMID: 35600944 PMCID: PMC9117033 DOI: 10.1155/2022/3821345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 03/25/2022] [Accepted: 04/11/2022] [Indexed: 11/18/2022]
Abstract
Gosha-jinki-gan (GJG) and Keishi-bukuryo-gan (KBG) are Kampo traditional herbal prescriptions used for different clinical patterns (sho) that improve blood flow. The pharmacological basis of the therapeutic choice remains unclear, although the clinical reliance of this pattern-based therapy is widely proven. We aimed to investigate their effects on microcirculation and nitric oxide (NO) kinetics using a live-imaging system to provide evidence for this. Live-imaging was performed in murine subcutaneous vessels and rat mesentery. In the subcutaneous vessels, we analyzed the effects of both drugs on the vessel diameter, blood flow velocity, and volume in the arteries, arterioles, and capillaries. In the rat mesentery, we induced the “oketsu” blood stasis using a stack of thin vinylidene chloride films and examined the effect on NO production using a fluorescent diaminofluorescein-2 diacetate. Following dissolution in hot water, 300 mg/kg of both drugs were administered intragastrically via a transesophageal catheter. Live-imaging analysis of subcutaneous blood flow revealed the different effects of GJG and KBG on their target vessels and effect onset. GJG targeted the capillaries and progressively increased the blood flow velocity and rate at 30–120 min after administration. No vasodilation or increased blood flow in the arteries and arterioles occurred. In contrast, KBG increased the diameter of the arterioles and arteries at 30–90 min after administration, and increased blood flow velocity and rate in arteries and arterioles. In a model of oketsu blood stasis in the mesenteric arteries, KBG increased the NO production from the vascular endothelial cells with dilatation of the arteriolar diameter. GJG improved blood flow mainly in the capillaries. Endothelial NO production decreased after GJG administration. The empirical treatment choice between GJG and KBG is based on the difference in target vessels and NO action and provides a pharmacological basis for therapy based on traditional medicine.
Collapse
|
7
|
The Multiple Pharmacologic Functions and Mechanisms of Action of Guizhi Fuling Formulation. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:6813421. [PMID: 35529925 PMCID: PMC9076289 DOI: 10.1155/2022/6813421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 04/09/2022] [Indexed: 11/17/2022]
Abstract
Objectives Guizhi Fuling Formulation (GZFL), a traditional Chinese medical formulation, consists of Cinnamomi Ramulus, Paeoniae Radix Alba (or Paeoniae Radix Rubra), Moutan Cortex, Persicae Semen, and Poria, with multiple therapeutic functions such as sedation, antitumor activity, anti-inflammation, and neuroprotection. However, its clinical applications remain relatively fragmented, and the underlying mechanisms of GZFL in different diseases are still not very certain. Further research and summary in both application and mechanisms remain to be needed for human health and the best use of GZFL. Therefore, we summarized the multiple pharmacologic effects and possible mechanisms of action of GZFL according to recent 17 years of research. Methods We retrieved four English and two Chinese databases using these keywords (the formulation name or its synonyms) and searched articles written in English from January 2006 up to February 2022. Key Findings. GZFL exhibits multiple pharmacologic advantages in gynecologic diseases and other expanding diseases such as cancer, blood, and vascular disease, renal failure, inflammation, and brain injury. Possibly due to its diverse bioactive components and pharmacologic activities, GZFL could target the multiple signaling pathways involved in regulating blood circulation, inflammatory and immune factors, proliferation, apoptosis, and so on. Conclusion This review suggests that GZFL displays promising therapeutic effects for many kinds of diseases, which have been beyond the scope of the original prescription for gynecologic diseases. In this way, we wish to provide a reference and recommendation for further preclinic and clinic studies.
Collapse
|
8
|
Climacteric symptoms in postoperative patients among endometrial cancer, cervical cancer, and ovarian cancer: a cross-sectional study. Support Care Cancer 2022; 30:6785-6793. [PMID: 35526200 PMCID: PMC9213383 DOI: 10.1007/s00520-022-07117-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 05/03/2022] [Indexed: 11/14/2022]
Abstract
Purpose To date, no studies have assessed climacteric symptoms after hystero-adnexectomy for endometrial, cervical, or ovarian cancer. Thus, this study aimed to compare climacteric symptoms among patients who underwent surgery for these three cancer types. Methods In this cross-sectional study, we interviewed patients who were registered at a menopausal outpatient clinic between January 1999 and July 2016 after undergoing total hysterectomy, intrapelvic only or intrapelvic plus para-aortic lymph node dissection, and bilateral adnexectomy performed via laparotomy as a cancer treatment. Climacteric symptoms were assessed using a patient-reported questionnaire covering core domains with five symptoms only at the initial consultation. Each symptom was graded from 0 (no symptoms) to 3 (severe symptoms). We evaluated the frequency of symptom severity according to the time elapsed since surgery and the cancer type. Results The numbers of patients with endometrial, ovarian, and cervical cancer were 328, 90, and 107, respectively. Overall, climacteric symptoms were more severe in patients with cervical cancer than in those with endometrial or ovarian cancer; symptom severity decreased with increasing time since surgery. However, symptom severity did not decrease significantly over time in patients with cervical cancer even after > 5 years had elapsed since surgery. Conclusion The climacteric symptoms were less severe in patients with endometrial or ovarian cancer with longer time elapsed since surgery but not in those with cervical cancer. Patients with cervical cancer may require more prompt interventions, including symptomatic treatment and longer follow-up period, than those with endometrial or ovarian cancer. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-022-07117-z.
Collapse
|
9
|
Tanaka K, Chiba K, Nara K. A Review on the Mechanism and Application of Keishibukuryogan. Front Nutr 2022; 8:760918. [PMID: 35004802 PMCID: PMC8740291 DOI: 10.3389/fnut.2021.760918] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 11/03/2021] [Indexed: 12/15/2022] Open
Abstract
The concept of "blood stasis" - called yū xiě in Chinese, Oketsu in Japanese - is one of the unique pathophysiology of traditional medicine that originated in China and inherited in Korea and Japan. This concept is related to the multiple aspects of hemodynamic disorders brought on by quantitative and qualitative changes. It theorizes that the quantitative changes of "blood stasis" are related to peripheral circulatory insufficiency. When chronic qualitative changes of "blood stasis" produce stagnant blood that turns into a pathological product, it could cause inflammation and lead to organic changes. Trauma induced hematomas, that are considered to be a quantitative change of blood, are also a form of blood stasis. The basic medicine research on Keishibukuryogan (KBG)-a Japanese name in Traditional Japanese Medicine (Kampo) for one of the most common anti- "blood stasis" prescriptions, also known as gui-zhi-fu-ling-wan (GFW) in Chinese in Traditional Chinese Medicine (TCM)-indicated that the initiation of quantitative changes was closely related to loss of redox balances on endothelial function induced by oxidative stress. The following qualitative changes were related to coagulopathy, hyper viscosity; anti-platelet aggregation, lipid metabolism; a regulation of systemic leptin level and/or lipid metabolism, inflammatory factor; cyclooxygenase-1,2 (COX-1, 2), interleukin-6, 8 tumor necrosis factor-α, macrophage infiltration, hyperplasia, tissue fibrosis and sclerosis caused by transforming growth factor-β1 and fibronectin, the dysfunction of regulated cell deaths, such as, apoptosis, autophagy, ferroptosis and ovarian hormone imbalance. Clinically, KBG was often used for diseases related to Obstetrics and Gynecology, Endocrine Metabolism, Rheumatology and Dermatology. In this review, we give an overview of the mechanism and its current clinical application of KBG through a summary of the basic and clinical research and discuss future perspective.
Collapse
Affiliation(s)
- Koichiro Tanaka
- Department of Traditional Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Koki Chiba
- Department of Traditional Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| | - Kazuhiko Nara
- Department of Traditional Medicine, Faculty of Medicine, Toho University, Tokyo, Japan
| |
Collapse
|
10
|
A Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial to Investigate the Effects of Kamishoyosan, a Traditional Japanese Medicine, on Menopausal Symptoms: The KOSMOS Study. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:8856149. [PMID: 33727945 PMCID: PMC7935592 DOI: 10.1155/2021/8856149] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 12/22/2020] [Accepted: 02/11/2021] [Indexed: 12/24/2022]
Abstract
Objective The KOSMOS study, a multicenter, randomized, double-blind, placebo-controlled trial, investigated the effects and safety of kamishoyosan (TJ-24), a traditional Japanese medicine, in the treatment of climacteric disorder. Methods Japanese women with climacteric disorder were administered a placebo during a 4-week run-in period, after which they were classified as placebo responders (R group) if their score on the modified Questionnaire for the Assessment of Climacteric Symptoms in Japanese Women (m-QACS) with excitability and irritability as the primary outcome improved by ≥ 3 points and as placebo nonresponders (NR group) otherwise. Members of the NR group were randomly allocated to receive either TJ-24 or placebo. After 12 weeks, their m-QACS scores, anxiety and depression, sleep, and overall quality of life (QOL) were compared. Results The TJ-24 and placebo arms in the NR group included 20 patients each. The change in the m-QACS scores of members of the NR group for excitability and irritability at 12 weeks versus baseline was –3.1 ± 1.7 in the TJ-24 arm, a significant decrease, but compared with –2.7 ± 2.2 in the placebo arm, no significant difference was between two arms. However, the proportion of participants whose score improved by ≥3 points was significantly higher in the TJ-24 arm. In the subgroup analysis of premenopausal women, the changes in the score for excitability and irritability were significantly larger in the TJ-24 arm. The incidence of adverse drug reactions or adverse events did not differ between the two arms, and no serious events were reported. Conclusion Although no significant difference was identified for the primary outcome, a significantly higher proportion of patients who received TJ-24 displayed improvement. Its high level of safety and effects on excitability and irritability in premenopausal women suggest that TJ-24 may be a useful treatment.
Collapse
|
11
|
Arai I. Clinical studies of traditional Japanese herbal medicines (Kampo): Need for evidence by the modern scientific methodology. Integr Med Res 2021; 10:100722. [PMID: 34136346 PMCID: PMC8181179 DOI: 10.1016/j.imr.2021.100722] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 01/23/2023] Open
Abstract
Background Japanese Kampo medicine is a traditional medicine with roots in ancient Chinese medicine. Because traditional physicians had been abolished in Japan, the present mainstream of Kampo treatment is that physicians who learned modern Western medicine prescribe Kampo extract products based on Western medical diagnosis. This situation is different from that in other east Asian countries, and the physicians require scientific clinical evidence. Methods Clinical studies were searched from literature databases, clinical trial registry sites, and “Evidence Reports of Kampo Treatment (EKAT)” published by the Japan Society for Oriental Medicine. Results At the approval of Kampo products, scientific clinical evidence was not required because they have a long-period experience as a decoction. However, in the 1990s, Kampo products became a subject for national reevaluation; double-blind and placebo-controlled clinical trials. At the time, a methodological foundation for conducting clinical assessments of Kampo medicines was established. From 2000 onwards, with the evidence-based medicine era, the field of Kampo medicine also saw many randomized controlled trials, and their evidence was collected and published as EKAT. In the 2010s, post-marketing clinical trials of Kampo products also had to be conducted in this environment due to the need for ethical and scientific assurance. Currently, there are numerous clinical trials of Kampo products being conducted with high-grade trial designs. Conclusion The situation of Kampo clinical studies reflects the unique history and position of Kampo medical system and Kampo products in Japan.
Collapse
Affiliation(s)
- Ichiro Arai
- Department of Pharmaceutical Sciences, Nihon Pharmaceutical University
| |
Collapse
|
12
|
Wang YP, Yu Q. The treatment of menopausal symptoms by traditional Chinese medicine in Asian countries. Climacteric 2020; 24:64-67. [PMID: 33094658 DOI: 10.1080/13697137.2020.1832461] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Menopausal symptoms (or climacteric syndrome) refer to a series of symptoms that occur during the perimenopausal and early postmenopausal period. About 80% of women will have various degrees of menopausal symptoms, and most of them need associated treatment. Asian women are more inclined to choose traditional Chinese medicine (TCM) in terms of therapeutic method, and menopausal hormone therapy has low acceptance because the women have been misinformed about the side effects of hormones. Therefore, TCM is used for menopausal symptoms in women in most Asian countries, including China, Japan, Vietnam, and South Korea. In the basic theory of TCM, the menopause is classified as the Kidney deficiency and imbalance of Yin and Yang; therefore, the treatment methods in either Chinese patent medicine or Chinese herbal medicine are aimed at supplementing the Kidney function and rebalancing Yin and Yang. It is believed that TCM treatment is suitable for patients with mild or moderate menopausal symptoms. The incidence rate of adverse reactions in terms of breast tenderness and irregular vaginal bleeding is lower than that of hormone therapy. However, there are few randomized, double-blind, placebo-controlled studies on TCM treatment of menopausal syndrome. Future studies should be undertaken to confirm its merits.
Collapse
Affiliation(s)
- Y-P Wang
- Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Q Yu
- Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| |
Collapse
|
13
|
Effects of Kamishoyosan, a Traditional Japanese Medicine, on Menopausal Symptoms: A Randomized, Placebo-Controlled, Double-Blind Clinical Trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:9285317. [PMID: 32733592 PMCID: PMC7369656 DOI: 10.1155/2020/9285317] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 05/29/2020] [Accepted: 06/17/2020] [Indexed: 01/01/2023]
Abstract
Objective Kampo medicine, a traditional Japanese medicine, is widely used in Japan, especially in the field of menopause medicine. However, few studies have shown evidence-based effects. This study aimed to confirm the effects of kamishoyosan on menopausal symptoms with a randomized, placebo-controlled, double-blind clinical trial. Methods Subjects were randomly allocated to groups that received either kamishoyosan (n = 101) or a placebo resembling kamishoyosan (n = 104). The primary outcomes were the change in the number of hot flashes, depression scores, improvements of anxiety, quality of life (QOL), and menopausal symptoms before and 4 and 8 weeks after initiation of treatment with the study drug. The secondary outcome was drug safety. Results After 8 weeks, the number of hot flashes decreased after treatment in both groups, but there was no significant difference between the two groups. The changes in SDS scores showed the same results. Moreover, no significant differences were observed between the two groups in assessments with the STAI, SF-36, and JSOG menopausal index. No serious adverse effect was reported. Conclusions This first placebo-controlled double-blind randomized trial with kamishoyosan demonstrated that it was safe and had some effects on climacteric symptoms, but not significant compared with placebo. Some problems, such as placebo effects, in the study of Kampo therapy for menopausal symptoms, were revealed. This trial is registered with the trial registration number. UMIN 000006042.
Collapse
|
14
|
Iliodromiti S, Wang W, Lumsden MA, Hunter MS, Bell R, Mishra G, Hickey M. Variation in menopausal vasomotor symptoms outcomes in clinical trials: a systematic review. BJOG 2019; 127:320-333. [PMID: 31621155 PMCID: PMC6972542 DOI: 10.1111/1471-0528.15990] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND There is substantial variation in how menopausal vasomotor symptoms are reported and measured among intervention studies. This has prevented meaningful comparisons between treatments and limited data synthesis. OBJECTIVES To review systematically the outcome reporting and measures used to assess menopausal vasomotor symptoms from randomised controlled trials of treatments. SEARCH STRATEGY We searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials from inception to May 2018. SELECTION CRITERIA Randomised controlled trials with a primary outcome of menopausal vasomotor symptoms in women and a sample size of at least 20 women per study arm. DATA COLLECTION AND ANALYSIS Data about study characteristics, primary vasomotor-related outcomes and methods of measuring them. MAIN RESULTS The search identified 5591 studies, 214 of which were included. Forty-nine different primary reported outcomes were identified for vasomotor symptoms and 16 different tools had been used to measure these outcomes. The most commonly reported outcomes were frequency (97/214), severity (116/214), and intensity (28/114) of vasomotor symptoms or a composite of these outcomes (68/214). There was little consistency in how the frequency and severity/intensity of vasomotor symptoms were defined. CONCLUSIONS There is substantial variation in how menopausal vasomotor symptoms have been reported and measured in treatment trials. Future studies should include standardised outcome measures which reflect the priorities of patients, clinicians, and researchers. This is most effectively achieved through the development of a Core Outcome Set. This systematic review is the first step towards development of a Core Outcome Set for menopausal vasomotor symptoms. TWEETABLE SUMMARY Menopausal hot flushes and night sweats have been reported in 49 different ways in clinical research. A core outcome set is urgently required.
Collapse
Affiliation(s)
- S Iliodromiti
- Women's Health Division, Blizard Institute, Queen Mary University London, London, UK.,School of Medicine, University of Glasgow, Glasgow, UK
| | - W Wang
- Department of Obstetrics, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - M A Lumsden
- School of Medicine, University of Glasgow, Glasgow, UK
| | - M S Hunter
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - R Bell
- Women's Health Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - G Mishra
- Faculty of Medicine, School of Public Health, University of Queensland, Brisbane, Australia
| | - M Hickey
- Department of Obstetrics and Gynaecology, University of Melbourne and The Royal Women's Hospital, Victoria, Australia
| |
Collapse
|
15
|
Li M, Hung A, Lenon GB, Yang AWH. Chinese herbal formulae for the treatment of menopausal hot flushes: A systematic review and meta-analysis. PLoS One 2019; 14:e0222383. [PMID: 31536531 PMCID: PMC6752783 DOI: 10.1371/journal.pone.0222383] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 08/28/2019] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES This systematic review aimed to evaluate the therapeutic effects and safety of Chinese herbal medicine (CHM) formulae for managing menopausal hot flushes (MHF). METHODS Seven English and Chinese databases were searched for studies from respective inceptions to February 2019. Randomized controlled trials investigating the clinical effects and safety of CHM formulae on MHF were considered for inclusion. The outcomes of subjective feelings (MHF and quality of life), objective changes (hormones and peripheral blood flow) and safety were analyzed. The most frequently prescribed formulae and herbs were summarized. RESULTS Nineteen randomized clinical trials involving 2469 patients were included. When compared to menopausal hormone therapy, CHM had similar effects to menopausal hormone therapy on total effectiveness rate (OR 1.41, 95% CI 0.84 to 2.35) and total Kupperman index (KI) score (SMD -0.13, 95% CI -0.61 to 0.36), and could significantly reduce vasomotor symptom score (MD -0.43, 95% CI -0.55 to -0.31) and upper-body peripheral blood flow (MD -3.56, 95% CI -5.14 to -1.98 under the jaw, MD -7.10, 95% CI -11.01 to -3.19 in the fingertip). When compared to placebo, CHM could reduce MHF severity (MD -0.70, 95% CI-1.00 to -0.40) and improve total KI score (MD -12.61, 95% CI -15.21 to -10.01). However, no statistically significant changes to hormone levels were detected. Most commonly seen adverse events were mild gastrointestinal tract reactions. The most popularly studied formula was Kun Tai capsule and the most frequently prescribed herb was Bai shao (Paeoniae Radix Alba, Paeonia lactiflora Pall.). More than 50% included studies had low risks of bias in the domains of selection, performance, attrition and reporting. CONCLUSIONS This review indicated that CHM formulae were safe to be applied in MHF females and able to improve MHF-related symptom scores as well as the peripheral blood flow. Further studies should focus on specific formulae.
Collapse
Affiliation(s)
- Mingdi Li
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Andrew Hung
- School of Science, RMIT University, Melbourne, Victoria, Australia
| | - George Binh Lenon
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| | - Angela Wei Hong Yang
- School of Health and Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia
| |
Collapse
|
16
|
Mahdavian M, Mirzaii Najmabadi K, Hosseinzadeh H, Mirzaeian S, Badiee Aval S, Esmaeeli H. Effect of the Mixed Herbal Medicines Extract (Fennel, Chamomile, and Saffron) on Menopause Syndrome: a Randomized Controlled Clinical Trial. J Caring Sci 2019; 8:181-189. [PMID: 31598511 PMCID: PMC6778311 DOI: 10.15171/jcs.2019.026] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 08/25/2018] [Indexed: 01/10/2023] Open
Abstract
Introduction: Menopause is the transition from the reproductive phase of a woman to the non-reproductive. It may impair quality of life. The study aims to determine the effectiveness of mixed herbal medicines on menopause symptoms Methods: A randomized, triple-blind, clinical trial and placebo-controlled study on 120 peri-menopausal women aged 45-65 years for 12 weeks. All participants took herbal extracts drops orally daily and randomly allocated into four groups: placebo (C), A (250 mg chamomile, 30 mg fennel, 15 mg saffron), B (1000 mg, 120 mg, 60 mg), and D (500 mg, 60 mg, 30 mg). Primary outcome was the mean change in scores of the menopause rating scale that evaluates 11 symptoms. Results: The median (IQR) physical score significantly reduced from 8.5(4) to 2(3), in psych score reduced from 12(4) to 2 (2) and in urogenital score reduced from 6.5(3) to 3(2) in group B. In group D physical score decreased from 12(6) to 8(4), in psychological score reduced from12 (3) to 8(4) and urogenital score reduced from 7.5 (3) to 8(3) at week 12. No significant differences in group A and C. With comparison the scores of physical, psych and urogenital domain of MRS questionnaire in 1th ,6th and 12th, no significant difference within group A and C were seen, but statistically significant difference was within group B (p<0.001) and D (p<0.001) in all weeks. The effect size was 0.92. Conclusion: A 12 weeks extracts treatment, there were significant improvement in physical, psychological and urogenital domains in group B.
Collapse
Affiliation(s)
- Mitra Mahdavian
- Department of Midwifery, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Khadijeh Mirzaii Najmabadi
- Department of Midwifery, Faculty of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Hosseinzadeh
- Department of pharmacology, Faculty of pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sara Mirzaeian
- Women's Health Research Center, Faculty of Medicine Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shapour Badiee Aval
- Department of Acupuncture, Faculty of Traditional Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Habibollah Esmaeeli
- Department of pharmacology, Faculty of pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
| |
Collapse
|
17
|
Li M, Hung A, Li H, Yang AWH. A Classic Herbal Formula Guizhi Fuling Wan for Menopausal Hot Flushes: From Experimental Findings to Clinical Applications. Biomedicines 2019; 7:biomedicines7030060. [PMID: 31426588 PMCID: PMC6783937 DOI: 10.3390/biomedicines7030060] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Revised: 08/10/2019] [Accepted: 08/15/2019] [Indexed: 12/15/2022] Open
Abstract
A classic herbal formula Guizhi Fuling Wan (GFW) has been used for managing menopausal hot flushes (MHFs), but the evidence across different study types has not been systematically summarized. This project investigated the clinical effects, phytochemistry, pharmacodynamics, and potential mechanisms of actions of GFW on the causative target proteins potentially driving MHFs. Twenty English and Chinese databases were searched for relevant clinical and experimental studies. A total of 12,988 studies were identified, of which 46 were included. Seven clinical studies demonstrated GFW had no statistically significant changes in the frequency and severity of MHFs; however, it could improve peripheral blood flow in the fingertips, jaw, and toes. Thirty-five studies on phytochemistry identified 169 chemical compounds of GFW. Four experimental studies revealed GFW's therapeutic effects (e.g., normalize calcitonin gene-related peptide [CGRP] level) and potential target protein/cytokine (estrogen receptor beta [ESR2] with genetic variation, CGRP receptor, and interleukin-8) on MHFs. Therapeutic effects across different study types were inconsistent, possibly due to the dose difference and genotype variety of ESR2 in the human population. Further clinical and experimental studies, as well as biochemical investigation on the mechanisms of actions of GFW, are recommended.
Collapse
Affiliation(s)
- Mingdi Li
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC 3083, Australia
| | - Andrew Hung
- School of Science, RMIT University, Melbourne, VIC 3001, Australia
| | - Hong Li
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC 3083, Australia
| | - Angela Wei Hong Yang
- School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC 3083, Australia.
| |
Collapse
|
18
|
Minenko IA, Berihanova RR, Shakhmatova SA. Effect of the mixed herbal medicines extracts on menopausal symptoms: A randomized clinical trial study. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2019. [DOI: 10.29333/ejgm/109435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
19
|
Shim JM. The coordination of plural logics of action and its consequences: Evidence from plural medical systems. PLoS One 2017; 12:e0189841. [PMID: 29253867 PMCID: PMC5734740 DOI: 10.1371/journal.pone.0189841] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 12/04/2017] [Indexed: 01/26/2023] Open
Abstract
Drawing on the theory of social action in organizational and institutional sociology, this paper examines the behavioral consequences of plural logics of action. It addresses the question based on the empirical case of plural medical systems that are composed of both biomedicine and alternative medicine. Applying mixed methods of a cross-national panel data analysis and a content analysis of medical journal articles, it finds that plural systems affect health outcomes negatively when tensions between biomedicine and alternative medicine are unaddressed. In contrast, plural systems produce tangible health benefits when biomedicine and alternative medicine are coordinated through government policies or by health care organizations/professionals. This paper proposes plurality coordination as an important mechanism that modifies the behavioral consequences of plural logics. This proposition contributes to providing theoretical answers to the sociological puzzle that plural logics of action produce inconsistent behavioral consequences.
Collapse
Affiliation(s)
- Jae-Mahn Shim
- Department of Sociology, Korea University, Seoul, Korea
- * E-mail:
| |
Collapse
|
20
|
Bae KH, Lee Y, Park KH, Yoon Y, Mun S, Lee S. Perception of cold and heat pattern identification in diseases: a survey of Korean medicine doctors. Integr Med Res 2017; 6:26-32. [PMID: 28462141 PMCID: PMC5395675 DOI: 10.1016/j.imr.2016.10.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 09/19/2016] [Accepted: 10/29/2016] [Indexed: 11/09/2022] Open
Abstract
Background This study aimed to investigate the extent to which Korean Medicine doctors consider cold and heat pattern identification when prescribing herbal treatment for a disease. Methods A survey was sent by e-mail to 15,841 members of the Association of Korean Medicine for whom member information was registered. Of these, 699 (4.4%) members participated in the survey. The survey included questions regarding the frequency of use of cold and heat pattern identification in deciding a herbal treatment prescription, the diseases for which cold and heat pattern identification-related herbal treatment was most efficacious, the type of herbal treatment prescribed, and the duration of the treatment. Results Of the 699 respondents, 591 (84.5%) reported that they considered cold and heat when prescribing herbal treatment. The diseases for which consideration of cold and heat patterns was effective were, in order, menopausal disorder (124, 18.3%), chronic rhinitis (98, 14.5%), dyspepsia (94, 13.9%), hwa-byung (92, 13.6%), diarrhea (83, 12.3%), dysmenorrhea (61, 9.0%), headache (59, 8.7%), inflammation in the digestive tract (58, 8.6%), coldness in hands and feet (58, 8.6%), and atopic dermatitis (55, 8.1%). The typical treatment duration differed widely for different diseases: atopic dermatitis was most frequently treated for >2 months (38, 34.5%), whereas diarrhea was most frequently treated for ≤ 10 days (73, 43.6%). Conclusion These findings indicate that cold and heat pattern identification is a useful tool employed by Korean Medicine doctors. This study may provide a basis for clinical research investigating the effect of pattern identification-based treatment of diseases.
Collapse
Affiliation(s)
- Kwang-Ho Bae
- Mibyeong Research Center, Korea Institute of Oriental Medicine, Yuseong-gu, Daejeon, Korea
| | - Youngseop Lee
- Mibyeong Research Center, Korea Institute of Oriental Medicine, Yuseong-gu, Daejeon, Korea
| | - Ki-Hyun Park
- Mibyeong Research Center, Korea Institute of Oriental Medicine, Yuseong-gu, Daejeon, Korea
| | - Youngheum Yoon
- Mibyeong Research Center, Korea Institute of Oriental Medicine, Yuseong-gu, Daejeon, Korea
| | - Sujeong Mun
- Mibyeong Research Center, Korea Institute of Oriental Medicine, Yuseong-gu, Daejeon, Korea
| | - Siwoo Lee
- Mibyeong Research Center, Korea Institute of Oriental Medicine, Yuseong-gu, Daejeon, Korea
| |
Collapse
|
21
|
Kim JE, Cho J, Kwon O, Kim AR, Park HJ, Jung SY, Kim JH, Kim M, Lee HY, Lee JH. Effect of Guizhifulingwan (Keishibukuryogan) on climacteric syndrome: study protocol for a randomized controlled pilot trial. Trials 2017; 18:135. [PMID: 28327172 PMCID: PMC5361822 DOI: 10.1186/s13063-017-1877-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 03/03/2017] [Indexed: 11/28/2022] Open
Abstract
Background The aim of this study is to explore the efficacy of Guizhifulingwan (GFW) in the treatment of climacteric syndrome in women. Methods/design This is a single-center, randomized, placebo-controlled, parallel-group design pilot trial. Fifty participants with climacteric syndrome will be randomly allocated to the GFW or placebo group in a 1:1 ratio. The participants will be administered GFW or placebo granules three times a day for 4 weeks and will be followed up for a further 4 weeks. The primary outcome is the mean change in menopause rating scale score at 5 weeks after randomization. Secondary outcomes include the World Health Organization quality of life-BREF scores, degrees of upward movement of qi and lower abdominal resistance and tenderness, blood stasis pattern questionnaire scores, and results of blood tests including assays for lipid profile, high sensitivity C-reactive protein, follicle-stimulating hormone, and estradiol. The feasibility outcomes include recruitment and completion rates and adherence to medication. Discussion The results of this study will provide basic data for the design of a large-scale clinical trial for evaluating the efficacy of GFW in the treatment of climacteric syndrome in women. Trial registration Clinical Research Information Service (CRIS), Republic of Korea, KCT0002040. Registered on 5 September 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1877-8) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Jung-Eun Kim
- Clinical Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, 34054, Republic of Korea
| | - Junghyo Cho
- Department of Internal Korean Medicine, Daejeon Oriental Hospital of Daejeon University, 176-9, Daeheung-ro, Jung-gu, Daejeon, 34929, Republic of Korea
| | - Ojin Kwon
- Clinical Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, 34054, Republic of Korea
| | - Ae-Ran Kim
- Clinical Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, 34054, Republic of Korea
| | - Hyo-Ju Park
- Clinical Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, 34054, Republic of Korea
| | - So-Young Jung
- Clinical Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, 34054, Republic of Korea
| | - Joo-Hee Kim
- Clinical Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, 34054, Republic of Korea
| | - Mikyung Kim
- Clinical Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, 34054, Republic of Korea
| | - Hye-Yoon Lee
- Clinical Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, 34054, Republic of Korea
| | - Jun-Hwan Lee
- Clinical Research Division, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, 34054, Republic of Korea. .,University of Science & Technology (UST), Korean Medicine Life Science, Daejeon, 34054, Republic of Korea.
| |
Collapse
|
22
|
Tonob D, Melby MK. Broadening our perspectives on complementary and alternative medicine for menopause: A narrative review. Maturitas 2017; 99:79-85. [PMID: 28364873 DOI: 10.1016/j.maturitas.2017.01.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 01/26/2017] [Indexed: 12/20/2022]
Abstract
Complementary and alternative medicine (CAM) is widely used for menopause, although not all women disclose use to their healthcare providers. This narrative review aims to expand providers' understanding of cross-cultural approaches to treating and managing menopause by providing an overarching framework and perspective on CAM treatments. Increased provider understanding and awareness may improve not only provider-patient communication but also effectiveness of treatments. The distinction between illness (what patients suffer) and disease (what physicians treat) highlights the gap between what patients seek and doctors provide, and may help clarify why many women seek CAM at menopause. For example, CAM is often sought by women for whom biomedicine has been unsuccessful or inaccessible. We review the relevance to menopause of three CAM categories: natural products, mind-body practices including meditation, and other complementary health approaches including traditional Chinese medicine (TCM) and Japanese Kampo. Assessing the effectiveness of CAM is challenging because of the individualized nature of illness patterns and associated treatments, which complicate the design of randomized controlled trials. Because many women seek CAM due to inefficacy of biomedical treatments, or cultural or economic marginalization, biomedical practitioners who make an effort to learn about CAM and ask patients about their CAM use or interest may dramatically improve the patient-provider relationship and rapport, as well as harnessing the 'meaning response' (Moerman, 2002) imbued in the clinical encounter. By working with women to integrate their CAM-related health-seeking behaviors and treatments, providers may also boost the efficacy of their own biomedical treatments.
Collapse
Affiliation(s)
- Dunia Tonob
- Department of Anthropology, University of Delaware, USA
| | - Melissa K Melby
- Department of Anthropology, University of Delaware, USA; College of Health Sciences, University of Delaware, USA.
| |
Collapse
|
23
|
Abstract
BACKGROUND Chinese herbal medicine (CHM) usage is expected to increase as women suffering from menopausal symptoms are seeking alternative therapy due to concerns from the adverse effects (AEs) associated with hormone therapy (HT). Scientific evidence for their effectiveness and safety is needed. OBJECTIVES To evaluate the effectiveness and safety of CHM in the treatment of menopausal symptoms. SEARCH METHODS We searched the Gynaecology and Fertility Group's Specialised Register of controlled trials, Cochrane Central Register of Controlled Trials (CENTRAL; 2015, Issue 3), MEDLINE, Embase, CINAHL, AMED, and PsycINFO (from inception to March 2015). Others included Current Control Trials, Citation Indexes, conference abstracts in the ISI Web of Knowledge, LILACS database, PubMed, OpenSIGLE database, and China National Knowledge Infrastructure database (CNKI, 1999 to 2015). Other resources included reference lists of articles as well as direct contact with authors. SELECTION CRITERIA Randomised controlled trials (RCTs) comparing the effectiveness of CHM with placebo, HT, pharmaceutical drugs, acupuncture, or another CHM formula in women over 18 years of age, and suffering from menopausal symptoms. DATA COLLECTION AND ANALYSIS Two review authors independently assessed 864 studies for eligibility. Data extractions were performed by them with disagreements resolved through group discussion and clarification of data or direct contact with the study authors. Data analyses were performed in accordance with Cochrane Collaboration guidelines. MAIN RESULTS We included 22 RCTs (2902 women). Participants were from different ethnic backgrounds with the majority of Chinese origin.When CHM was compared with placebo (eight RCTs), there was little or no evidence of a difference between the groups for the following pooled outcomes: hot flushes per day (MD 0.00, 95% CI -0.88 to 0.89; 2 trials, 199 women; moderate quality evidence); hot flushes per day assessed by an overall hot flush score in which a difference of one point equates to one mild hot flush per day (MD -0.81 points, 95% CI -2.08 to 0.45; 3 RCTs, 263 women; low quality evidence); and overall vasomotor symptoms per month measured by the Menopause-Specific Quality of Life questionnaire (MENQOL, scale 0 to 6) (MD -0.42 points; 95% CI -1.52 to 0.68; 3 RCTs, 256 women; low quality evidence).In addition, results from individual studies suggested there was no evidence of a difference between the groups for daily hot flushes assessed by severity (MD -0.70 points, 95% CI -1.00, -0.40; 1 RCT, 108 women; moderate quality evidence); or overall monthly hot flushes scores (MD -2.80 points, 95% CI -8.93 to 3.33; 1 RCT, 84 women; very low quality evidence); or overall daily night sweats scores (MD 0.07 points, 95% CI -0.19 to 0.33, 1 RCT, 64 women; low quality evidence); or overall monthly night sweats scores (MD 1.30 points, 95% CI -1.76 to 4.36, 1 RCT, 84 women; very low quality evidence). However one study using the Kupperman Index reported that overall monthly vasomotor symptom scores were lower in the CHM group (MD -4.79 points, 95% CI -5.52 to -4.06; 1 RCT, 69 women; low quality evidence).When CHM was compared with hormone therapy (HT) (10 RCTs), only two RCTs reported monthly vasomotor symptoms using MENQOL. It was uncertain whether CHM reduces vasomotor symptoms (MD 0.47 points, 95% CI -0.50 to 1.44; 2 RCTs, 127 women; very low quality evidence).Adverse effects were not fully reported in the included studies. Adverse events reported by women taking CHM included mild diarrhoea, breast tenderness, gastric discomfort and an unpleasant taste. Effects were inconclusive because of imprecise estimates of effects: CHM versus placebo (RR 1.51; 95% CI 0.69 to 3.33; 7 trials, 705 women; I² = 40%); CHM versus HT (RR 0.96; 95% CI 0.66 to 1.39; 2 RCTs, 864 women; I² = 0%); and CHM versus specific conventional medications (such as Fluoxetine and Estazolam) (RR 0.20; 95% CI 0.03 to 1.17; 2 RCTs, 139 women; I² = 61%). AUTHORS' CONCLUSIONS We found insufficient evidence that Chinese herbal medicines were any more or less effective than placebo or HT for the relief of vasomotor symptoms. Effects on safety were inconclusive. The quality of the evidence ranged from very low to moderate; there is a need for well-designed randomised controlled studies.
Collapse
Affiliation(s)
- Xiaoshu Zhu
- Western Sydney UniversityNational Institute of Complementary Medicine (NICM)Locked Bag 1797PenrithSydneyNew South WalesAustralia2751
| | - Yuklan Liew
- Herbal Medicines Research and Education Centre, Sydney UniversityMilperra Family Medicine CentreSydneyNSWAustralia
| | - Zhao Lan Liu
- Beijing University of Chinese MedicineCentre for Evidence‐Based Chinese Medicine11 Bei San Huan Dong Lu, Chaoyang DistrictBeijingChina100029
| | | |
Collapse
|
24
|
Abstract
OBJECTIVE Insomnia both as a symptom and as part of chronic insomnia disorder is quite common in menopause. Comorbid conditions, such as restless legs syndrome and obstructive sleep apnea, occur with high prevalence among perimenopausal women with insomnia. Insomnia in this population group is associated with adverse health outcomes, and there are no clear standards on how to treat it. METHODS Based on extensive literature search, 76 articles were identified. Two authors independently graded evidence according to the Oxford Centre for Evidence-Based Medicine Levels of Evidence. RESULTS Evaluation and treatment of other comorbid sleep disorders are recommended, as is cognitive-behavioral therapy for insomnia. Hormone therapy, eszopiclone, escitalopram, gabapentin, isoflavones, valerian, exercise, and hypnosis are suggested. Zolpidem, quiteiapine XL, citalopram, mirtazapine followed by long-acting melatonin, ramelteon, Pycnogenol, Phyto-Female Complex, yoga, and massage may be considered. Kampo formulas are not recommended. Acupuncture may not be suggested, and cognitive-behavioral therapy that is not tailored for insomnia probably should not be considered. CONCLUSIONS Although a variety of interventions are shown to be helpful in improving sleep in menopause, there is a need for well-designed head-to-head trials with uniform outcome measures.
Collapse
|
25
|
Shim JM. The influence of social context on the treatment outcomes of complementary and alternative medicine: the case of acupuncture and herbal medicine in Japan and the U.S. Global Health 2015; 11:17. [PMID: 25907272 PMCID: PMC4415294 DOI: 10.1186/s12992-015-0103-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Accepted: 04/01/2015] [Indexed: 11/23/2022] Open
Abstract
Background Complementary and alternative medicine (CAM), such as acupuncture and herbal medicine, is popular in many countries. Yet, treatment outcomes of CAM are found to vary significantly between medical trials in different social environments. This paper addresses how the social organization of medicine affects medical treatment outcomes. In particular, it examines the extent to which two popular complementary and alternative medicine (CAM) interventions (acupuncture and herbal medicine) are coordinated with biomedicine and how coordination characteristics are related to the treatment outcomes of the two CAM interventions. Methods This paper conducts an archival analysis of the institutional settings of the CAM interventions in Japan and the U.S. It also conducts a systematic content analysis of the treatment outcomes in 246 acupuncture reports and 528 herbal medicine reports that are conducted in Japan or the U.S. and registered in the Cochrane Library’s Central Register of Controlled Trials (CENTRAL), and 716 acupuncture reports and 3,485 herbal medicine reports that are from Japan or the U.S. and listed in MEDLINE. It examines the association between the treatment outcomes of the two interventions and the geographical location of the reports; it also explores how the institutional settings of the interventions are related to the treatment outcomes. Results Japanese herbal medicine is integrated into the national medical system the most and American herbal medicine the least; American acupuncture and Japanese acupuncture fall in the middle. Treatment outcomes are the most favorable for Japanese herbal medicine and the least favorable for American herbal medicine. The outcomes of American acupuncture and Japanese acupuncture fall in the middle. Conclusions The co-utilization of CAM with biomedicine can produce difficulties due to tensions between CAM and biomedicine. These difficulties and subsequent CAM treatment outcomes vary, depending on how CAM is institutionalized in relation to biomedicine in the national medical system. Coordinated CAM interventions are more likely to be effective and synergic with biomedicine, when compared to uncoordinated ones.
Collapse
Affiliation(s)
- Jae-Mahn Shim
- Department of Sociology, University of Seoul, 163 Seoulsiripdae-ro, Dongdaemun-gu, Seoul, 130-743, Korea.
| |
Collapse
|
26
|
Identification of a predictive biomarker for the beneficial effect of keishibukuryogan, a kampo (Japanese traditional) medicine, on patients with climacteric syndrome. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 2014:962109. [PMID: 24639885 PMCID: PMC3930128 DOI: 10.1155/2014/962109] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Revised: 11/05/2013] [Accepted: 11/27/2013] [Indexed: 12/24/2022]
Abstract
Keishibukuryogan (KBG; Guizhi-Fuling-Wan in Chinese) is one of the Kampo (Japanese traditional) medicines used to treat patients with climacteric syndrome. KBG can be used by patients who cannot undergo hormone replacement therapy due to a history of breast cancer. We evaluated whether cytosine-adenine (CA) repeat polymorphism of the estrogen receptor β gene can be a predictor of the beneficial effect of KBG on climacteric syndrome. We also investigated the relationship between CA repeat polymorphism, the patients' profiles, and the therapeutic effect. We found that CA was an SS, SL, or LL genotype according to the number of repeats. We studied 39 consecutive patients with climacteric disorders who took KBG for 12 weeks. The diagnosis of climacteric disorders was made on the basis of the Kupperman index. KBG significantly improved the patients' climacteric symptoms (i.e., vasomotor symptoms in the patients with the LL genotype and melancholia in the patients with the SL genotype). No relationship between the patients' profiles and CA repeat polymorphism was recognized. CA repeat polymorphism could thus be a potential biomarker to predict the efficacy of KBG in climacteric syndrome, and its use will help to reduce the cost of treating this syndrome by focusing the administration of KBG on those most likely to benefit from it.
Collapse
|
27
|
Prescription of kampo drugs in the Japanese health care insurance program. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 2013:576973. [PMID: 24550992 PMCID: PMC3914391 DOI: 10.1155/2013/576973] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/29/2013] [Revised: 09/25/2013] [Accepted: 10/08/2013] [Indexed: 12/24/2022]
Abstract
Kampo medicine or traditional Japanese medicine has been used under Japan's National Health Insurance scheme for 46 years. Recent research has shown that more than 80% of physicians use Kampo in daily practice. However, the use of Kampo from the patient perspective has received scant attention. To assess the current use of Kampo drugs in the National Health Insurance Program, we analysed a total of 67,113,579 health care claim records, which had been collected by Japan's Ministry of Health, Labour and Welfare in 2009. We found that Kampo drugs were prescribed for 1.34% of all patients. Among these, 92.2% simultaneously received biomedical drugs. Shakuyakukanzoto was the most frequently prescribed Kampo drug. The usage of frequently prescribed Kampo drugs differed between the youth and the elderly, males and females, and inpatients and outpatients. Kampo medicine has been employed in a wide variety of conditions, but the prescription rate was highest for disorders associated with pregnancy, childbirth, and the puerperium (4.08%). Although the adoption of Kampo medicine by physicians is large in a variety of diseases, the prescription rate of Kampo drugs is very limited.
Collapse
|
28
|
Xu LW, Jia M, Salchow R, Kentsch M, Cui XJ, Deng HY, Sun ZJ, Kluwe L. Efficacy and side effects of chinese herbal medicine for menopausal symptoms: a critical review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2013; 2012:568106. [PMID: 23365599 PMCID: PMC3551256 DOI: 10.1155/2012/568106] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Accepted: 10/03/2012] [Indexed: 11/17/2022]
Abstract
This study evaluates 23 (9 Chinese and 14 non-Chinese) randomized controlled trials for efficacy and side effects of Chinese herbal medicine on menopausal symptoms. Menopause was diagnosed according to western medicine criteria in all studies while seven Chinese studies and one non-Chinese study further stratified the participants using traditional Chinese medical diagnosis "Zheng differentiation." Efficacy was reported by all 9 Chinese and 9/14 non-Chinese papers. Side effects and adverse events were generally mild and infrequent. Only ten severe adverse events were reported, two with possible association with the therapy. CHM did not increase the endometrial thickness, a common side effect of hormone therapy. None of the studies investigated long-term side effects. Critical analysis revealed that (1) high-quality studies on efficacy of Chinese herbal medicine for menopausal syndrome are rare and have the drawback of lacking traditional Chinese medicine diagnosis (Zheng-differentiation). (2) Chinese herbal medicine may be effective for at least some menopausal symptoms while side effects are likely less than hormone therapy. (3) All these findings need to be confirmed in further well-designed comprehensive studies meeting the standard of evidence-based medicine and including Zheng-differentiation of traditional Chinese medicine.
Collapse
Affiliation(s)
- Lian-Wei Xu
- Gynecology Department, Yueyang Integrated Traditional Chinese Medicine and Western Medicine Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
- HanseMerkur Traditional Chinese Medicine Centre, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Man Jia
- Gynecology Department, Yueyang Integrated Traditional Chinese Medicine and Western Medicine Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Roland Salchow
- HanseMerkur Traditional Chinese Medicine Centre, University Medical Centre Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Michael Kentsch
- Department of Internal Medicine, University Teaching Hospital Itzehoe, 25524 Itzehoe, Germany
| | - Xue-Jun Cui
- Clinical Evaluation Centre, Longhua Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
| | - Hong-Yong Deng
- Technology Information Centre, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Zhuo-Jun Sun
- Gynecology Department, Shuguang Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai 200021, China
| | - Lan Kluwe
- Laboratory for Research and Diagnostics, Departments of Maxillofacial Surgery and Neurology, University Medical Center Hamburg-Eppendorf, Martinistraβe 52, 20246 Hamburg, Germany
| |
Collapse
|
29
|
Lu AP, Bian ZX, Chen KJ. Bridging the traditional Chinese medicine pattern classification and biomedical disease diagnosis with systems biology. Chin J Integr Med 2012; 18:883-90. [PMID: 23238995 DOI: 10.1007/s11655-012-1290-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Indexed: 12/20/2022]
Abstract
Being the unique core of traditional Chinese medicine (TCM), pattern classification exerts a direct effect on the efficacy and safety of herbal interventions. In this article, the authors integrated the pattern classification and disease diagnosis with many approaches from systems biology. Integration of pattern classification with biomedical diagnosis by systems biology is not only a new direction of personalized medicine development, but also provides a new drug development model. In the further study, the pattern classifications of major diseases will be the focus of research.
Collapse
Affiliation(s)
- Ai-ping Lu
- School of Chinese Medicine, Hong Kong Baptist University, Kowloon, Hong Kong, China.
| | | | | |
Collapse
|
30
|
Guttuso T. Effective and clinically meaningful non-hormonal hot flash therapies. Maturitas 2012; 72:6-12. [PMID: 22377187 DOI: 10.1016/j.maturitas.2012.01.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Revised: 01/30/2012] [Accepted: 01/31/2012] [Indexed: 11/19/2022]
Abstract
Although many non-hormonal compounds have shown statistically significant benefit over placebo in hot flash randomized controlled trials (RCTs), these studies have varied considerably in basic methodology making it challenging to deduce which compounds have the greatest potential to provide clinically meaningful benefit. This review used evidence-based methodology closely mirroring the FDA and EMEA guidelines as a template to identify "well-designed" RCTs from which effective and clinically meaningful non-hormonal hot flash therapies could be identified. In addition, pertinent safety information was reviewed. Out of 3548 MEDLINE citations and abstracts, 51 well-designed hot flash RCTs were identified. From these trials, gabapentin, oxybutynin ER, desvenlafaxine, soy-derived isoflavones and black cohosh each showed a clinically meaningful treatment effect in at least 1 RCT. Among these 5 compounds, only gabapentin demonstrated consistent and statistically significant benefit over placebo in all of its well-designed RCTs. Desvenlafaxine, soy-derived isoflavones, and black cohosh demonstrated statistically significant benefit over placebo in 75%, 21%, and 17% of the well-designed RCTs for each compound, respectively. There was only 1 well-designed RCT using oxybutynin ER, which showed it to have a robust and clinically meaningful benefit. In terms of safety, there have been cardiovascular risks associated with desvenlafaxine use in postmenopausal women with hot flashes. The use of anticonvulsants, in general, has been associated with an absolute 0.21% increase in suicidal thoughts and behavior. Further research is needed with several of these nonhormonal compounds to replicate these findings and to also directly compare their efficacy and tolerability with those of hormone replacement therapy.
Collapse
Affiliation(s)
- Thomas Guttuso
- University at Buffalo, Buffalo, NY 14214, United States.
| |
Collapse
|