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Zeng M, Wu Z, Liang J, Gong A. Efficacy and safety of sodium hyaluronate combined with celecoxib for knee osteoarthritis: A systematic review and meta-analysis. Asian J Surg 2024; 47:1331-1338. [PMID: 38008631 DOI: 10.1016/j.asjsur.2023.11.077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/27/2023] [Accepted: 11/17/2023] [Indexed: 11/28/2023] Open
Abstract
Due to the large cost of joint replacement for surgical treatment of knee osteoarthritis, there are many complications in elderly patients, and there are many contraindications to surgery, and conservative treatment is still based on drugs. To further evaluate the efficacy and safety of sodium hyaluronate combined with celecoxib for the treatment of osteoarthritis of the knee. In total, 202 studies were screened, with a final selection of 9 RCTs involving 2339 participants; of these, 9 RCTs were included in the final meta-analysis. Treatment group reduces VAS (SMD = -1.61; 95 % CI [-2.25, -0.98]; I2 = 95 %; P < 0.00001) and adverse reactions (OR = 0.45; 95 % CI [0.22,0.94]; I2 = 0 %; P < 0.33); Meanwhile, improving Lysholm knee scores (SMD = 0.19; 95 % CI [-0.06, -0.44]; I2 = 76 %; P = 0.0004) and Clinical efficiency (OR = 0.31; 95 % CI [0.19,0.50]; I2 = 0 %; P < 0.00001). All indicators were superior to the control group. Our primary findings suggest that KOA treatment with celecoxib combined with sodium hyaluronate reduces VAS, while improving Lysholm scores and Clinical efficiency. In addition, we found that celecoxib combined with sodium hyaluronate treatment had fewer adverse effects than the control group, indicating that the combination is safe and effective in the treatment of KOA.
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Affiliation(s)
- Mengjie Zeng
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
| | - Zhiquan Wu
- Department of Rehabilitation Medicine, Sanya Central Hospital, Sanya, PR China.
| | - Jinying Liang
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
| | - Aimin Gong
- Department of Traditional Chinese Medicine, Hainan Medical University, Haikou, PR China.
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Lee JH, Song JY, Park KS, Lee J, Ha IH, Lee YJ. Long-term follow-up of inpatients with meniscus tears who received integrative Korean medicine treatment: A retrospective analysis and follow-up survey. Medicine (Baltimore) 2024; 103:e36917. [PMID: 38335386 PMCID: PMC10860960 DOI: 10.1097/md.0000000000036917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 11/22/2023] [Accepted: 12/19/2023] [Indexed: 02/12/2024] Open
Abstract
Evidence regarding the use of Korean medicine (KM) for the conservative treatment of meniscus tears remains lacking. We aimed to evaluate clinical effectiveness and long-term follow-up outcomes in patients undergoing integrative KM treatment for meniscus tears. We analyzed the electronic medical records (EMRs) of 86 patients with meniscus tears and administered a follow-up survey. Patients treated at 1 of 4 KM hospitals between June 1, 2015, and June 30, 2020, were reviewed. KM treatment comprised herbal medicine, acupuncture, pharmacopuncture, bee venom pharmacopuncture, Chuna therapy, and KM physiotherapy. The primary outcome was the numeric rating scale (NRS) score for knee pain; secondary outcomes were the Western Ontario and McMaster Universities Arthritis Index (WOMAC), EuroQol 5-dimension (EQ-5D) score, range of motion, and patient global impression of change. The NRS for knee pain was reduced by an average of 2.49 (95% confidence interval [CI]: 2.03-2.95) at discharge and 1.97 (95% CI: 2.03-2.95) at follow-up. The WOMAC decreased by an average of 15.52 (95% CI: 10.14-20.89) during hospital stay and 30.72 (95% CI: 24.58-36.87) at follow-up. The EQ-5D score increased by an average of 0.06 (95% CI: -0.14 to 0.02) at discharge and 0.19 (95% CI: -0.29 to -0.09) at follow up. KM treatment effectively reduced knee pain, improved knee joint function, and enhanced the quality of life in patients with a meniscus tear for a relatively long period after treatment.
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Affiliation(s)
- June Haeng Lee
- Jaseng Hospital of Korean Medicine, Gangnam-gu, Seoul, Republic of Korea
| | - Jin Young Song
- Jaseng Hospital of Korean Medicine, Gangnam-gu, Seoul, Republic of Korea
| | - Kyoung Sun Park
- Jaseng Hospital of Korean Medicine, Gangnam-gu, Seoul, Republic of Korea
| | - Jinho Lee
- Jaseng Hospital of Korean Medicine, Gangnam-gu, Seoul, Republic of Korea
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Gangnam-gu, Seoul, Republic of Korea
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Gangnam-gu, Seoul, Republic of Korea
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Xin P, Xu X, Zhang H, Hu Y, Deng C, Sun S, Liu S, Zhou X, Ma H, Li X. Mechanism investigation of Duhuo Jisheng pill against rheumatoid arthritis based on a strategy for the integration of network pharmacology, molecular docking and in vivo experimental verification. PHARMACEUTICAL BIOLOGY 2023; 61:1431-1445. [PMID: 37674371 PMCID: PMC10486301 DOI: 10.1080/13880209.2023.2252854] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 07/04/2023] [Accepted: 08/23/2023] [Indexed: 09/08/2023]
Abstract
CONTEXT Duhuo Jisheng pill (DHJS) is a classic traditional Chinese medicine (TCM) formula for rheumatoid arthritis (RA). The effective components and therapeutic mechanisms of DHJS for treating RA are still unclear. OBJECTIVE To explore the potential mechanism of DHJS against RA by means of network pharmacology and experimental verification. MATERIALS AND METHODS A network pharmacology and molecular docking analysis based on phytochemistry was used to elucidate the mechanism of DHJS against RA. The targets of DHJS anti-RA active ingredient were obtained by searching TCMSP, ETCM and TCMSID. The RA model induced by collagen was established in Wistar rats. The rats in the DHJS group were administered doses of 0.5, 1.0 and 2.0 g/kg for a period of 10 d. The expression of targets was measured with Western blot. RESULTS Network pharmacology analysis showed that the anti-RA effect of DHJS was mediated by targets involved in immunity, inflammation and apoptosis, as well as PI3K-Akt and NF-κB signalling pathways. Of 2.0 g/kg DHJS significantly alleviated the ankle inflammation (IL-6: 62.73 ± 8.39 pg/mL, IL-1β: 50.49 ± 11.47 pg/mL, TNF-α: 16.88 ± 3.05 pg/mL, IL-17A: 12.55 ± 1.87 pg/mL, IL-10: 16.24 ± 3.00 pg/mL), comparing with the model group (IL-6: 92.02 ± 13.25 pg/mL, IL-1β: 71.85 ± 4.12 pg/mL, TNF-α: 25.64 ± 3.69 pg/mL, IL-17A: 22.14 ± 4.56 pg/mL, IL-10: 9.51 ± 3.03 pg/mL) (p < 0.05). Moreover, the protein expression of p-PI3K, p-AKT and p-p65 significantly decreased after DHJS administration. CONCLUSIONS DHJS could alleviate the collagen-induced arthritis (CIA) by the PI3K/AKT/NF-κB signalling pathway.
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Affiliation(s)
- Ping Xin
- College of Pharmacy, Harbin Medical University, Daqing, PR China
| | - Xiaoyun Xu
- College of Pharmacy, Harbin Medical University, Daqing, PR China
| | - Huaxi Zhang
- College of Pharmacy, Harbin Medical University, Daqing, PR China
| | - Yuezhou Hu
- College of Pharmacy, Harbin Medical University, Daqing, PR China
| | - Chengjie Deng
- College of Pharmacy, Harbin Medical University, Daqing, PR China
| | - Shiqin Sun
- Science and Education Department, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing, PR China
| | - Shuang Liu
- College of Pharmacy, Harbin Medical University, Daqing, PR China
| | - Xuegang Zhou
- College of Pharmacy, Harbin Medical University, Daqing, PR China
| | - Hongxing Ma
- Clinical Laboratory Department, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui Branch, Southeast University, Nanjing, PR China
| | - Xiaoliang Li
- Key Laboratory of Tropical Translational Medicine of Ministry of Education, Hainan Provincial Key Laboratory for Research and Development of Tropical Herbs, Haikou Key Laboratory of Li Nationality Medicine, School of Pharmacy, Hainan Medical University, Haikou, PR China
- Key Laboratory of Tropical Cardiovascular Diseases Research of Hainan Province, Cardiovascular Diseases Institute of the First Affiliated Hospital, Hainan Medical University, Haikou, PR China
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Ye QY, Lin Q, Hu XL, Yang YM, Zheng BL, Li T, Zhong WQ, Wang HY, Zhang ZF, Luo BJ, Xiao YW, Wu AL, Li Y, Zou ZL, Li LY, Li XY, Wang PP, Yang L, Zhu XF, Han L, Zhang RH. Efficacy and safety of combined Chinese and Western medicine in the treatment of knee osteoarthritis: a prospective, multicenter cohort study. Front Pharmacol 2023; 14:1176980. [PMID: 37701040 PMCID: PMC10494435 DOI: 10.3389/fphar.2023.1176980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 08/15/2023] [Indexed: 09/14/2023] Open
Abstract
Purpose: To conduct a real-world evaluation of the efficacy and safety of combined Chinese and Western medicine in treating knee osteoarthritis (KOA). Methods: A multicenter, prospective cohort study design was employed, enrolling 450 KOA patients (Kellgren-Lawrence score of 3 or less). The patients were divided into a Western medicine treatment group (WM group) and a combined Western and traditional Chinese medicine treatment group (WM-CM group). A 6-week treatment plan was administered, and follow-up visits occurred at 2 weeks, 4 weeks, and 6 weeks after initiating treatment. The primary outcome indicator was the total Western Ontario and McMaster Universities Arthritis Index (WOMAC) score after 6 weeks of treatment. Secondary outcome indicators included WOMAC subscales for pain, stiffness, and joint function, visual analogue scale (VAS) score, physical component summary (PCS), mental component summary (MCS), and clinical effectiveness. The incidence of drug-related adverse events was used as a safety evaluation indicator. Results: A total of 419 patients were included in the final analysis: 98 in the WM group and 321 in the WM-CM group. The baseline characteristics of the two groups were comparable, except for the incidence of stiffness symptoms and stiffness scores. After 6 weeks of treatment, the WM-CM group exhibited superior results to the WM group in improving the total WOMAC score (24.71 ± 1.38 vs. 16.36 ± 0.62, p < 0.001). The WM-CM group also outperformed the WM group in WOMAC pain and joint function scores, VAS score, PCS score, MCS score, and clinical effectiveness (p < 0.05), which was consistent with the findings of the main evaluation index. Subgroup analysis indicated that the combined Chinese and Western medicine treatment showed more pronounced benefits in patients under 65 years of age and in those with a Kellgren-Lawrence (K-L) classification of 0-I. Throughout the study, no adverse effects were observed in either group. Conclusion: The combination of Chinese and Western medicine demonstrated superiority over Western medicine alone in relieving knee pain symptoms, improving knee function, and enhancing the quality of life for KOA patients with a K-L score of 3 or less. Moreover, the treatment exhibited a good safety profile. Clinical Trial Registration: (https://www.chictr.org.cn/), identifier (ChiCTR1900027175).
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Affiliation(s)
- Qian-Yun Ye
- College of Traditional Chinese Medicine, Jinan University, Guangzhou, China
- First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Qing Lin
- College of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Xue-Ling Hu
- College of Pharmacy, Jinan University, Guangzhou, China
| | - Yu-Mei Yang
- College of Pharmacy, Jinan University, Guangzhou, China
| | - Bao-Lin Zheng
- Department of Nephropathy and Rheumatology, Foshan Hospital of TCM, Foshan, China
| | - Ting Li
- Department of Nephropathy and Rheumatology, Foshan Hospital of TCM, Foshan, China
| | | | - Hao-Yu Wang
- College of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Zhi-Fen Zhang
- College of Pharmacy, Jinan University, Guangzhou, China
| | - Bing-Jie Luo
- College of Pharmacy, Jinan University, Guangzhou, China
| | - Ya-Wen Xiao
- College of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Ai-Ling Wu
- College of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Yan Li
- College of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Zhuo-Ling Zou
- College of Traditional Chinese Medicine, Jinan University, Guangzhou, China
| | - Ling-Yu Li
- College of Pharmacy, Jinan University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Jinan University, Guangzhou, China
- Cancer Research Institution, Jinan University, Guangzhou, China
| | - Xiao-Yun Li
- College of Pharmacy, Jinan University, Guangzhou, China
| | - Pan-Pan Wang
- First Affiliated Hospital of Jinan University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Jinan University, Guangzhou, China
- Cancer Research Institution, Jinan University, Guangzhou, China
| | - Li Yang
- College of Pharmacy, Jinan University, Guangzhou, China
| | - Xiao-Feng Zhu
- College of Traditional Chinese Medicine, Jinan University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Jinan University, Guangzhou, China
| | - Li Han
- First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Rong-Hua Zhang
- College of Pharmacy, Jinan University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Jinan University, Guangzhou, China
- Cancer Research Institution, Jinan University, Guangzhou, China
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Chan KH, Ching JYL, Chan KL, Lau HY, Chu KM, Chan K, Pang HF, Wong LC, Chia CP, Zhang HW, Song T, Leung SB, Ng BFL, Lin ZX. Therapeutic effect of Duhuo Jisheng Decoction add-on Tui-na manipulation on osteoarthritis of knee: a randomized controlled trial. Chin Med 2023; 18:82. [PMID: 37424023 DOI: 10.1186/s13020-023-00737-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 03/17/2023] [Indexed: 07/11/2023] Open
Abstract
BACKGROUND Knee osteoarthritis (KOA) is a common degenerative joint condition that causes disability and pain in the elderly population. The prevalence of KOA among persons aged 63 or above is approximately 30%. Previous studies have reported the positive effects of Tui-na treatment and the Chinese herbal formula Du-Huo-Ji-Sheng Decoction (DHJSD) for KOA treatment. The current study aims to evaluate the add-on therapeutic effect of oral administration of DHJSD on KOA in addition to Tui-na. METHODS We conducted a prospective, randomized, controlled clinical trial. Seventy study subjects with KOA were randomly assigned to the treatment and control groups in a 1:1 ratio. Both two groups received eight sessions of Tui-na manipulation for 4 weeks. The DHJSD was only administered to the study subjects in the treatment group. The primary outcome measure was rated using the WOMAC at the end of treatment (4 weeks). Secondary outcomes were assessed using EQ-5D-5L, a health-related quality of life with 5-level EQ-5D version at end of treatment (week 4) and follow-up (week 8). RESULTS No statistically significant difference was found between two groups on WOMAC scores at the end of treatment. The mean WOMAC Pain subscale score was significantly lower in the treatment group than control group at week 8 follow up (mean difference, MD - 1.8, 95% CI - 3.5 to - 0.02, P = 0.048). The mean WOMAC Stiffness subscale score was significantly lower in the treatment group than in the control group at week 2 (MD 0.74, 95% CI 0.05 to 1.42, P = 0.035) and week 8 follow up (MD 0.95, 95% CI 0.26 to 1.65, P = 0.008). The mean EQ-5D index value was significantly improved in the treatment group than in the control group at week 2 (MD 0.17, 95% CI 0.02 to 0.31, P = 0.022). The analysis of WOMAC scores and EQ-5D-5L in both groups showed statistically significant improvement with time. No significant adverse effect was found during the trial. CONCLUSION DHJSD may have an add-on effect in addition to Tui-na manipulation relieving pain and improving stiffness as well as quality of life (QOL) in patients with KOA. The combined treatment was generally safe and well tolerated. Trial registration The study was registered at the ClinicalTrials.gov (website: https://clinicaltrials.gov/ct2/show/NCT04492670 , registry number: NCT04492670), registered on 30 July 2020.
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Affiliation(s)
- Kin Ho Chan
- Yan Oi Tong-The Chinese University of Hong Kong Chinese Medicine Clinic Cum Training and Research Centre (Tuen Mun District), Hong Kong SAR, China
| | - Jessica Y L Ching
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
| | - Kam Leung Chan
- Hong Kong Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
| | - Hoi Yi Lau
- Yan Oi Tong-The Chinese University of Hong Kong Chinese Medicine Clinic Cum Training and Research Centre (Tuen Mun District), Hong Kong SAR, China
| | - Ka Man Chu
- Yan Oi Tong-The Chinese University of Hong Kong Chinese Medicine Clinic Cum Training and Research Centre (Tuen Mun District), Hong Kong SAR, China
| | - Kenny Chan
- Yan Oi Tong-The University of Hong Kong Chinese Medicine Clinic Cum Training and Research Centre (Islands District), Hong Kong SAR, China
| | - Hon Fai Pang
- Yan Oi Tong-The University of Hong Kong Chinese Medicine Clinic Cum Training and Research Centre (Islands District), Hong Kong SAR, China
| | - Lok Chi Wong
- Yan Oi Tong-The Chinese University of Hong Kong Chinese Medicine Clinic Cum Training and Research Centre (Tuen Mun District), Hong Kong SAR, China
| | - Chon Pin Chia
- Hong Kong Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
| | - Hong Wei Zhang
- Hong Kong Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
| | - Tianhe Song
- Hong Kong Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
| | - Sin Bond Leung
- Hong Kong Institute of Integrative Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China
| | | | - Zhi-Xiu Lin
- Yan Oi Tong-The Chinese University of Hong Kong Chinese Medicine Clinic Cum Training and Research Centre (Tuen Mun District), Hong Kong SAR, China.
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China.
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Zheng S, Zhou B, Yang L, Hou A, Zhang J, Yu H, Kuang H, Jiang H, Yang L. System pharmacology analysis to decipher the effect and mechanism of active ingredients combination from Duhuo Jisheng decoction on osteoarthritis in rats. JOURNAL OF ETHNOPHARMACOLOGY 2023:116679. [PMID: 37257711 DOI: 10.1016/j.jep.2023.116679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/18/2023] [Accepted: 05/21/2023] [Indexed: 06/02/2023]
Abstract
ETHNOPHARMACOLOGY RELEVANCE Duhuo Jisheng decoction is a traditional Chinese formula that has been widely used in clinical practice to treat osteoarthritis, which has the effects of removing invaded cold and dampness, relieving joint pain. However, it is difficult to determine the effective substances and mechanisms due to assorted herbs and components, and further research is needed. AIM OF THE STUDY This study was designed to explore and verify the mechanism and targets of DHJSD in the treatment of OA via network analysis and experiments. METHOD In this study, the active ingredients of DHJSD were qualitatively analyzed by UPLC-QDA. Network analysis was used to identify common targets and pathways. Next, we explored the therapeutic mechanism of DHJSD through a rat model of knee osteoarthritis. HE staining was used to judge the establishment of the animal model. ELISA and Western blotting were used to verify the expression of key pathway proteins. CONCLUSION In this study, seventeen chemical constituents in DHJSD were identified. According to the network analysis, we obtained the potential associated pathways of action. Then, molecular docking and SPR experiments showed that the sixteen identified components had high binding energies to IL-6. HE staining showed that the high-dose group of DHJSD had an obvious therapeutic effect on model rats. Compared with the model group, the levels of IL-1β, TNF-α, IL-6, MMP3, MMP13, ADAMTS4 and ADAMTS5 in serum and the expression of STAT3 and p-STAT3 protein in administration groups were significantly decreased. This result indicated that the IL-6/STAT3 signaling pathway was one of the important pathways regulated by DHJSD to improve OA.
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Affiliation(s)
- Senwang Zheng
- Key Laboratory of Chinese Materia Medica, Heilongjiang University of Chinese Medicine, Ministry of Education, Harbin, 150040, PR China
| | - Bo Zhou
- Key Laboratory of Chinese Materia Medica, Heilongjiang University of Chinese Medicine, Ministry of Education, Harbin, 150040, PR China
| | - Lin Yang
- Key Laboratory of Chinese Materia Medica, Heilongjiang University of Chinese Medicine, Ministry of Education, Harbin, 150040, PR China; Higher College, Jiangxi University of Traditional Chinese Medicine, NanChang, 330000, PR China
| | - Ajiao Hou
- Key Laboratory of Chinese Materia Medica, Heilongjiang University of Chinese Medicine, Ministry of Education, Harbin, 150040, PR China
| | - Jiaxu Zhang
- Key Laboratory of Chinese Materia Medica, Heilongjiang University of Chinese Medicine, Ministry of Education, Harbin, 150040, PR China
| | - Huan Yu
- Key Laboratory of Chinese Materia Medica, Heilongjiang University of Chinese Medicine, Ministry of Education, Harbin, 150040, PR China
| | - Haixue Kuang
- Key Laboratory of Chinese Materia Medica, Heilongjiang University of Chinese Medicine, Ministry of Education, Harbin, 150040, PR China
| | - Hai Jiang
- Key Laboratory of Chinese Materia Medica, Heilongjiang University of Chinese Medicine, Ministry of Education, Harbin, 150040, PR China.
| | - Liu Yang
- Key Laboratory of Chinese Materia Medica, Heilongjiang University of Chinese Medicine, Ministry of Education, Harbin, 150040, PR China.
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Wan R, Ji Y, Fan Y, Yang C, Yang H, Gou X, Zhang X, Liu W. Efficacy and safety of Duhuo Jisheng decoction combined with Western medicine in the treatment of ankylosing spondylitis: A systematic review and meta-analysis. Complement Ther Clin Pract 2023; 51:101739. [PMID: 36809734 DOI: 10.1016/j.ctcp.2023.101739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 02/03/2023] [Accepted: 02/15/2023] [Indexed: 02/19/2023]
Abstract
BACKGROUND and purpose: The effects of Duhuo Jisheng Decoction (DJD) on ankylosing spondylitis (AS) remain controversial. This study aimed to assess the efficacy and safety of DJD combined with Western medicine in treating AS. METHODS A total of nine databases were searched from the establishment of the databases to August 13th, 2021, for randomized controlled trials (RCTs) concerning the use of DJD combined with Western medicine to treat AS. Review Manager was used for the meta-analysis of the retrieved data. The risk of bias was evaluated using the revised Cochrane risk of bias tool for RCTs. RESULTS The results indicated that the combinational use of DJD and Western medicine resulted in significantly higher outcomes in terms of effective rate (RR = 1.40, 95% CI: 1.30, 1.51); thoracic mobility (MD = 0.32, 95% CI: 0.21, 0.43); morning stiffness time (SMD = -0.38, 95% CI: 0.61, -0.14); BASDAI (MD = -0.84, 95% CI: 1.57, -0.10); VAS for pain [spinal (MD = -2.76, 95% CI: 3.10, -2.42); peripheral joint (MD = -0.84, 95% CI: 1.16, -0.53)]; CRP (MD = -3.75, 95% CI: 6.36, -1.14); ESR: (MD = -4.80, 95% CI: 7.63, -1.97); and adverse reactions (RR = 0.50, 95% CI: 0.38, 0.66) in comparison to the Western medicine alone in treating AS. CONCLUSION Compared to the use of Western medicine, DJD combined with Western medicine improves the effective rate, functional scores, and symptoms of AS patients, with a reduced rate of adverse reactions.
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Affiliation(s)
- Renhong Wan
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China; National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, China; Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Yue Ji
- Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Yihua Fan
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610075, Sichuan Province, China
| | - Chen Yang
- Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Hong Yang
- The Second People' s Hospital of Pingwu County, Mianyang, 621000, Sichuan Province, China
| | - Xiaoping Gou
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China; National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, China
| | - Xinyuan Zhang
- Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China
| | - Wei Liu
- First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300193, China; National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, China.
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A Network Pharmacology-Based Study of Potential Targets of Angelicae Pubescentis-Herba Taxilli Compound for the Treatment of Osteoarthritis. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:4286168. [PMID: 36619785 PMCID: PMC9814887 DOI: 10.1155/2022/4286168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/28/2022] [Accepted: 12/09/2022] [Indexed: 12/30/2022]
Abstract
Objective Using network pharmacology and molecular docking, we explored the mechanism of Angelicae Pubescentis- (AP-) Herba Taxilli (HT) in the treatment of osteoarthritis (OA). Methods We selected Traditional Chinese Medicine Systems Pharmacology platform (TCMSP) to filtrate the practical components and targets of AP-HT. The disease targets of "osteoarthritis (OA)" were collected by GeneCards, DrugBank, TTD, OMIM, and PharmGKB databases, and the component-target interaction network was established by Cytoscape 3.9.1. Then, we set the protein-protein interaction (PPI) network by the STRING platform and visualized by Cytoscape 3.9.1. We also conducted Gene Ontology (GO) analysis and Kyoto Encyclopedia of Gene and Genome (KEGG) pathway enrichment analysis via the bioinformatics platform. Finally, we performed molecular docking using PyMOL 2.3.0 and AutoDock Vina software. Results 11 potential compounds were selected, and 1007 OA disease targets were collected. Ninety-four main targets of the AP-HT compound in the treatment of OA have been defined. PPI network demonstrated that JUN, RELA, TNF, IL6, MAPK1, TP53, AKT1, FOS, IL10, and MYC might serve as the critical targets of AP-HT for the treatment of OA. Moreover, membrane raft, membrane microdomain, cellular response to chemical stress, and cytokine receptor binding may play essential roles in the treatment of OA via GO analysis. The main functional pathways involved in these critical targets include fluid shear stress and atherosclerosis, lipid and atherosclerosis, IL-17 signaling pathway, age-range signaling pathway in diabetic composites, and TNF signaling pathway via KEGG analysis. The results of molecular docking showed that the critical ingredients of AP-HT had an excellent affinity to related nuclear genes.
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Tseng SH, Lee CJ, Chen SH, Chen CH, Tsai PW, Hsieh MS, Chu JS, Wang CC. Cinnamic aldehyde, an anti-inflammatory component in Du-Huo-Ji-Sheng-Tang, ameliorates arthritis in II collagenase and monosodium iodoacetate induced osteoarthritis rat models. J Tradit Complement Med 2022; 13:51-61. [PMID: 36685080 PMCID: PMC9845653 DOI: 10.1016/j.jtcme.2022.10.003] [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: 12/24/2021] [Revised: 10/05/2022] [Accepted: 10/08/2022] [Indexed: 11/05/2022] Open
Abstract
Background and aim Du-Huo-Ji-Sheng-Tang (DHJST) is a Chinese herbal formula used for arthralgia and arthritis treatment clinically. This study aims to evaluate the joint-protecting efficacy of DHJST and to identify the active constituents as the evaluation marker. Experimental procedure DHJST can be categorized into three recipes: Blood-tonifying-herbs Si-Wu-Tang (SWT), Wind-dampness-dispelling-herbs (WDH) and Qi-tonifying-herbs (TH). All formulas were used to explore the joint-protecting efficacies. Results and conclusion s: Firstly, DHJST could decrease the arthritis progression in the monosodium-iodoacetate-induced rat and cure arthritis in the type II collagenase-induced rat. Further, in lipopolysaccharide-stimulated RAW 264.7 cells, DHJST, TH and Cinnamomum cassia (CC), an ingredient in TH, were the most potent nitric oxide (NO) and prostaglandin E2 (PGE2) inhibitors. The major components, cinnamic aldehyde, showed the strongest NO and PGE2 inhibition. Up-regulated inducible NO synthase (iNOS) and cyclooxygenase-2 were inhibited by DHJST, TH, CC, and cinnamic aldehyde. In interleukin-1β-stimulated primary chondrocytes, upregulated iNOS was inhibited by DHJST, TH, Cinnamomum cassia, and cinnamic aldehyde. Upregulated matrix metalloprotease-13 was only inhibited by DHJST and TH and Eucommia ulmoides (EU) extract. Results suggest that DHJST presented joint-protective and cure arthritis effects. TH presented equal joint-protective effects as DHJST. The major anti-inflammatory ingredient in TH was Cinnamomum cassia in TH. And cinnamic aldehyde was the potent anti-inflammatory active compound in Cinnamomum cassia. Therefore, this study may facilitate the modern use of DHJST with TH as a simplified version but equally effective anti-osteoarthritic agents with cinnamic aldehyde as a quality control marker of DHJST and TH in osteoarthritis prevention or treatment.
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Affiliation(s)
- Sung-Hui Tseng
- Traditional Herbal Medicine Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chia-Jung Lee
- Traditional Herbal Medicine Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- PhD Program in Clinical Drug Development of Herbal Medicine, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Pharmacognosy Science, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Shih-Han Chen
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Chao-Hsin Chen
- Pharmaceutical and Biotechnology Management, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Po-Wei Tsai
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Department of Medical Science Industry, College of Health Science, Chang Jung Christian University, Tainan, Taiwan
| | - Ming-Shium Hsieh
- Orthopedics Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- En Chu Kong Hospital, New Taipei City, Taiwan
| | - Jan-Show Chu
- School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ching-Chiung Wang
- Traditional Herbal Medicine Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- PhD Program in Clinical Drug Development of Herbal Medicine, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Graduate Institute of Pharmacognosy Science, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Pharmaceutical and Biotechnology Management, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
- Orthopedics Research Center, Taipei Medical University Hospital, Taipei, Taiwan
- Corresponding author. School of Pharmacy, College of Pharmacy, Taipei Medical University 250 Wu-Hsing Street, Taipei, 11031, Taiwan.
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Chondroprotective Effects of Gubitong Recipe via Inhibiting Excessive Mitophagy of Chondrocytes. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:8922021. [PMID: 35958905 PMCID: PMC9359826 DOI: 10.1155/2022/8922021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 06/15/2022] [Accepted: 07/02/2022] [Indexed: 11/29/2022]
Abstract
Objective Osteoarthritis (OA) is the most common degenerative joint disorder and a leading cause of disability. A previous randomized controlled trial has shown that Gubitong (GBT) recipe can improve OA-related symptoms and articular function without noticeable side effects. However, the underlying mechanisms remain unclear. This study aims to explore the therapeutic mechanisms of the GBT recipe for OA through in vivo and in vitro experiments. Methods Rats of the OA model were established by Hulth surgery and intervened with the GBT recipe and then were subjected to pathological assessment of the cartilage. Matrix metalloproteinase 13 (MMP-13) expression in cartilage tissues was assessed by immunohistochemical staining. Chondrocytes were isolated from sucking rats and stimulated with LPS to establish an in vitro model. After intervened by water extraction of the GBT recipe, the fluorescent signal of Mtphagy Dye and mitochondrial membrane potential (Δψm) were detected to determine the states of mitophagy and mitochondrial dynamics of chondrocytes in vitro, respectively. Western blot test was used to detect levels of proteins related to catabolism of the cartilage matrix, mitophagy, and PI3K/AKT pathway. Results In in vivo experiments, the GBT recipe can effectively inhibit the cartilage degeneration of chondrocytes in OA rats, as well as markedly suppress the expression of MMP-13. In vitro experiments on LPS-induced chondrocytes exhibited increase in mitochondrial depolarization and excessive mitophagy, and the GBT recipe can alleviate these changes. LPS-stimulated chondrocytes showed increases in MMP-13, PINK1, and Parkin in cell lysates and LC3II/LC3I ratio in the mitochondrial fraction, and the GBT recipe can inhibit these increases in a dose-dependent manner. Moreover, the GBT recipe can attenuate the abnormal activation of PI3K/AKT pathway induced by LPS. Conclusion The GBT recipe exhibits chondroprotective effects through inhibiting excessive mitophagy of chondrocytes, which may be associated with its inhibitory effect on the abnormal activation of PI3K/AKT pathway.
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11
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Efficacy of Duhuo Jisheng Decoction for Treating Cold-Dampness Obstruction Syndrome-Type Knee Osteoarthritis: A Pooled Analysis. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2350404. [PMID: 35774274 PMCID: PMC9239816 DOI: 10.1155/2022/2350404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/09/2022] [Indexed: 11/17/2022]
Abstract
Aim. The aim of this study is to provide evidence of the effect of Duhuo Jisheng decoction (DHJSD) on knee osteoarthritis (KOA) of the cold-dampness obstruction syndrome type. Methods. We searched PubMed, Embase, the Cochrane Library, the China National Knowledge Infrastructure, the Wanfang database, and the China Biology Medicine for randomized controlled trials (RCTs) evaluating DHJSD or DHJSD combined with other conventional therapies (DHJSD group) compared to conventional therapy (control group) for cold-dampness obstruction syndrome-type KOA. We calculated the pooled odds ratio (OR), mean difference (MD), and 95% confidence interval (CI) using fixed- or random-effects models. Results. Eleven RCTs, with a total of 895 patients, were included. The results showed that DHJSD could significantly improve the effective rate (
,
2.07 to 4.72,
), reduce both the WOMAC (
,
-16.34 to -7.79,
) and VAS (
,
-1.54 to -0.50,
) scores, and reduce the serum IL-6 (
,
-0.90 to -0.69,
) and TNF-α (
,
-2.77 to -2.21,
) levels during the treatment of cold-dampness obstruction syndrome-type KOA. The subgroup analysis showed that compared with glucosamine sulfate (GS) alone, DHJSD combined with GS significantly improved the effective rate (
,
1.19 to 5.65,
) and reduced the WOMAC (
,
-16.14 to -11.51,
) and VAS (
,
-1.27 to -0.55,
) scores. DHJSD + warm-needle acupuncture (WA) lowered the VAS score more than WA alone. There was no significant difference in the decrease in serum IL-1β between the DHJSD and control groups. Conclusion. This study shows that DHJSD can improve the clinical efficacy and reduce the VAS and WOMAC scores in the treatment of cold-dampness obstruction syndrome-type KOA. Compared with GS or WA alone, the combined application of DHJSD with GS or WA could better reduce both the VAS and WOMAC scores.
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12
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Liang Y, Xu Y, Zhu Y, Ye H, Wang Q, Xu G. Efficacy and Safety of Chinese Herbal Medicine for Knee Osteoarthritis: Systematic Review and Meta-analysis of Randomized Controlled Trials. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2022; 100:154029. [PMID: 35316726 DOI: 10.1016/j.phymed.2022.154029] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 02/09/2022] [Accepted: 02/28/2022] [Indexed: 06/14/2023]
Abstract
PURPOSE This study aims to evaluate the effectiveness and safety of oral Chinese herbal medicine (CHM) in the treatment of knee osteoarthritis (KOA). STUDY DESIGN Systematic review and meta-analysis of randomized controlled trials (RCTs). MATERIALS AND METHODS A computer was used to retrieve all RCTs of CHM in the treatment of KOA from 7 databases (PubMed; Embase; Cochrane Central Register of Controlled Trials; China National Knowledge Infrastructure; Chinese VIP Information Database; Chinese Biomedical Database and Wanfang Med Database) from the establishment to August 2021. The literature was organized using NoteExpress, and literature screening and data extraction were conducted by two researchers independently by the inclusion and exclusion criteria. Quality evaluation was performed using GRADE, and the meta-analysis was performed using RevMan5.4. RESULTS A total of 31 RCTs and 3115 cases are included. The following meta-analysis results are observed: (1) WOMAC: CHM vs. placebo (SMD = -0.87, 95% CI: -1.27 to -0.47, P < 0.0001), CHM vs. Western medicine (SMD = -1.64, 95% CI: -2.09 to -1.19, P < 0.00001), and CHM + Western medicine vs. Western medicine (SMD = -2.17, 95% CI: -3.01 to -1.33, P < 0.00001); (2) VAS: CHM vs. Western medicine (SMD = -1.02, 95% CI: -1.63 to -0.41, P < 0.00001) and CHM + Western medicine vs. Western medicine (SMD = -2.68, 95% CI: -4.36 to -1.00, P < 0.00001); (3) Lequesne severity index: CHM vs. Western medicine (SMD = -0.90, 95% CI: -1.40 to -0.39, P = 0.0005) and CHM + Western medicine vs. Western medicine (SMD = -0.94, 95% CI: -1.36 to -0.52, P < 0.0001); (4) Lysholm knee joint function score: CHM vs. Western medicine (MD = 9.10, 95% CI: 4.20 to 14.01, P = 0.0003), and CHM + Western medicine vs. Western medicine in a single trial (MD = 21.15, 95% CI: 19.71 to 22.59, P < 0.00001); (5) SOD: in a single trial, CHM vs. Western medicine (MD = 1.62, 95% CI: 0.9 to 2.30, P < 0.00001) and CHM + Western medicine vs. Western medicine (MD = 17.08, 95% CI: 10.71 to 23.44, P < 0.00001); (6) TNF-α: CHM vs. Western medicine (SMD = -1.90, 95% CI: -2.04 to -0.14, P = 0.02) and CHM + Western medicine vs. Western medicine (SMD = -2.32, 95% CI: -4.33 to -0.30, P = 0.02); (7) IL-1β: CHM vs. Western medicine (SMD = -1.60, 95% CI: -2.36 to -0.84, P < 0.0001); and (8) IL-6: in a single trial, CHM vs. Western medicine (MD = -0.75, 95% CI: -1.20 to -0.30, P = 0.001) and CHM + Western medicine vs. Western medicine (MD = -3.18, 95% CI: -6.24 to -0.12, P = 0.04). CONCLUSION The efficacy of CHM in the treatment of KOA is superior to those of placebo and Western medicine. At the same time, the combination of CHM + Western medicine is superior to Western medicine alone in the treatment of KOA. However, due to the existence of certain biases in the included studies, and the need for further study on the effective components of Chinese medicine, a positive conclusion on the efficacy of traditional CHM in the treatment of KOA cannot be drawn and needs to be confirmed by high-quality clinical RCTs.
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Affiliation(s)
- Yongqi Liang
- School of Nursing, Nanjing University of CHM, Nanjing, China
| | - Yue Xu
- School of Nursing, Nanjing University of CHM, Nanjing, China
| | - Yuan Zhu
- School of Nursing, Nanjing University of CHM, Nanjing, China
| | - Hui Ye
- School of Nursing, Nanjing University of CHM, Nanjing, China
| | - Qing Wang
- School of Nursing, Nanjing University of CHM, Nanjing, China.
| | - Guihua Xu
- Nanjing University of CHM, Nanjing, China.
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Wang Y, Zhou Z, Chen L, He X, Li H, Huang Y, Pu Y. Efficacy of Duhuo Jisheng Decoction in Treating Ankylosing Spondylitis: Clinical Evidence and Potential Mechanisms. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:3305773. [PMID: 35419071 PMCID: PMC9001112 DOI: 10.1155/2022/3305773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 11/18/2021] [Accepted: 12/09/2021] [Indexed: 11/17/2022]
Abstract
Background Duhuo Jisheng Decoction (DHJSD) is an ancient compound widely used in the treatment of ankylosing spondylitis (AS). However, its efficacy is controversial, and its mechanism of action is not clear enough. Using meta-analysis and network pharmacology, our study evaluated the clinical efficacy of DHJSD in the treatment of AS and explored its mechanisms of action. Methods We searched medical databases, including Embase, PubMed, the China National Knowledge Infrastructure databases, Wanfang, and the Chinese Scientific Journal Database, to identify studies that met the inclusion criteria. RevMan 5.3 software was used for the meta-analysis. The compounds and the potential protein targets of DHJSD were obtained from the Traditional Chinese Medicine Systems Pharmacology (TCMSP) database and analysis platform. AS was treated as a search query in the NCBI, PharmGKB, TTD, DrugBank, and OMIM databases to obtain disease-related genes. The overlapping targets of DHJSD and AS were identified, and then Gene Ontology functional enrichment and Kyoto Encyclopedia of Genes and Genomes enrichment analyses were performed. Cytoscape was employed to construct a drug-compound-target network and a protein-protein interaction (PPI) network. CytoHubba was utilized to select the hub genes. Results A total of 10 studies involving 860 participants were included in the meta-analysis. Compared with the control, DHJSD treatment significantly improved clinical symptoms; reduced the erythrocyte sedimentation rate (ESR), the C-reactive protein (CPR), and interleukin 6 (IL-6) levels; increased the degree of motion of the chest; reduced the visual analog scale (VAS) pain score; reduced Schober's test values; reduced the finger-to-floor distance; reduced the duration of morning stiffness. However, the differences were not statistically significant in the Bath Ankylosing Spondylitis Functional Index scores, the Bath Ankylosing Spondylitis Disease Activity Index scores, the bone Gla-containing protein (BGP) levels, or the bone alkaline phosphatase (BALP) levels. In terms of adverse events, DHJSD treatment of AS reduced the incidence of gastrointestinal events, the incidence of skin events, and the incidence of abnormal liver function; however, there was no statistically significant reduction in the incidence of adverse renal function events. Subgroup analysis showed that in the treatment of AS, the clinical effect of DHJSD for AS was better than that of the controls for both treatment durations, ≤2 months and >2 months. A total of 178 active compounds and 47 related potential targets were identified for DHJSD in the treatment of AS, including four hub genes (CXCL8, PTGS2, VEGFA, and STAT3). The core active ingredients of DHJSD in the treatment of AS were mainly quercetin, kaempferol, licochalcone A, and isorhamnetin. DHJSD treatment of AS-related pathways mainly involved the IL-17 signaling pathway, the TNF signaling pathway, and the rheumatoid arthritis signaling pathway. Conclusion The above results suggest that DHJSD acts on AS through multiple targets, components, and pathways with significant clinical efficacy. Future studies may further explore the active components of DHJSD.
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Affiliation(s)
- Yi Wang
- Department of Orthopedic, Chongqing Jiangbei hospital of Traditional Chinese Medicine, Chongqing 400020, China
- Chongqing Key Laboratory of Traditional Chinese Medicine for Prevention and Cure of Metabolic Diseases, Chongqing Medical University, College of Traditional Chinese Medicine, Chongqing 400016, China
| | - Zhihua Zhou
- Department of Orthopedic, Chongqing Jiangbei hospital of Traditional Chinese Medicine, Chongqing 400020, China
| | - Li Chen
- Department of Orthopedic, Chongqing Jiangbei hospital of Traditional Chinese Medicine, Chongqing 400020, China
| | - Xiangwei He
- Department of Orthopedic, Chongqing Jiangbei hospital of Traditional Chinese Medicine, Chongqing 400020, China
| | - Hui Li
- Department of Orthopedic, Chongqing Jiangbei hospital of Traditional Chinese Medicine, Chongqing 400020, China
| | - Yingru Huang
- Chongqing Key Laboratory of Traditional Chinese Medicine for Prevention and Cure of Metabolic Diseases, Chongqing Medical University, College of Traditional Chinese Medicine, Chongqing 400016, China
| | - Yu Pu
- Department of Orthopedic, Chongqing Jiangbei hospital of Traditional Chinese Medicine, Chongqing 400020, China
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14
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The Efficacy and Safety of Chinese Herbal Medicine in the Treatment of Knee Osteoarthritis: An Updated Systematic Review and Meta-Analysis of 56 Randomized Controlled Trials. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:6887988. [PMID: 35035664 PMCID: PMC8759838 DOI: 10.1155/2022/6887988] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 11/24/2021] [Indexed: 12/14/2022]
Abstract
Objective This systematic review and meta-analysis were performed to investigate the efficacy and safety of Chinese herbal medicine (CHM) in the treatment of knee osteoarthritis (KOA). Methods An electronic search was conducted in eight databases (PubMed, EMBASE, Web of Science, Cochrane Library, Chinese National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese VIP Database, and Wanfang Database) from inception until December 2019. The risk of bias assessment of the included RCTs was evaluated by Cochrane collaboration's tool. The inclusion criteria were RCTs that investigated the efficacy and safety of CHM in the treatment of KOA, with no restrictions on publication status or language. The exclusion criteria included nonrandomized or quasi-RCTs, no clear KOA diagnostic approach, combined Chinese medicinal herbs with other traditional Chinese medicine treatment modalities, and published using repeated data and missing data. We computed the relative risk (RR) and the standard mean difference (SMD) for dichotomous outcomes and continuous outcomes, respectively. When heterogeneity was detected or there was significant statistical heterogeneity (P < 0.05 or I2 > 50%), a random-effects model was employed, followed by further subgroup analysis and metaregression estimations to ascertain the origins of heterogeneity. Otherwise, we used a fixed-effects model (P ≥ 0.05 or I2 ≤ 50%). The primary outcome measures were visual analog score (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lysholm score, and Lequesne index. Secondary outcome measures were the total clinical effective rate and adverse events. The meta-analysis was performed using the Stata 14.0 software. Results A total of 56 RCTs comprising 5350 patients met the inclusion criteria. This meta-analysis showed that application of CHM as adjuvant therapy or monotherapy for KOA can significantly decrease VAS, WOMAC, and the Lequesne index and improve the Lysholm score as well as the total effective rate. In addition, this treatment has fewer adverse effects, suggesting that CHM is generally safe and well tolerated among patients with KOA. Conclusion Our study offers supportive evidence that CHM, either adjuvant therapy or monotherapy, reduces the VAS, WOMAC, and Lequesne index and improves the Lysholm score and overall effective rate in patients with KOA. Additionally, CHM was well tolerated and safe in KOA patients. We found frequently used CHMs that might contribute to the formulation of a herbal formula that could be considered for further clinical use. However, given the heterogeneity and limited sample size in this study, larger multicenter and high-quality RCTs are needed to validate the benefits of CHM in the treatment of KOA.
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15
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Huang CY, Cheng CJ, Chiou WF, Chang WC, Kang YN, Lee MH. Efficacy and safety of Duhuo Jisheng Decoction add-on bisphosphonate medications in patients with osteoporosis: A meta-analysis of randomized controlled trials. JOURNAL OF ETHNOPHARMACOLOGY 2022; 283:114732. [PMID: 34637967 DOI: 10.1016/j.jep.2021.114732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/25/2021] [Accepted: 10/07/2021] [Indexed: 06/13/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Duhuo Jisheng Decoction (DHJSD) is the most frequently prescribed herbal formula for the treatment of osteoporosis. However, efficacy and safety of DHJSD add-on bisphosphonate medications remain unclear. AIM OF THE STUDY The purpose of this study was to reveal efficacy and safety of DHJSD add-on bisphosphonate medications in patients with osteoporosis through a systematic review with meta-analysis of randomized controlled trials (RCTs). METHODS Five important databases were searched for RCTs on this topic, and two authors individually extracted information and data concerning study design, baseline characteristics, efficacy rate, bone mineral density (BMD), pain score, and adverse event. Meta-analysis was done mainly with risk ratio (RR) and standardized mean difference (SMD) for BMD and pain, using random-effects model; while Peto odds ratios (PORs) were used for pooling adverse event rates due to sparse data. Point estimate was reported with 95% confidence intervals (CIs). RESULTS Seventeen RCTs (n = 1526) met eligibility criteria, and were included in this synthesis. Pooled estimates demonstrated that as compared with no DHJSD, DHJSD-B led to significantly higher efficacy rates (RR = 1.25, 95%CI: 1.19-1.31; I2 = 0%), more lumbar BMD (SMD = 0.61, 95%CI: 0.25-0.96; I2 = 20%), lower pain score (SMD = -1.10, 95%CI: 1.40-0.79; I2 = 33%), and lower overall adverse event rates (POR = 0.40; 95%CI: 0.20-0.97; I2 = 27%). CONCLUSION Adding DHJSD on bisphosphonate medications seems to be an effective and safe strategy in treating patients with osteoporosis.
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Affiliation(s)
- Chung-Yu Huang
- PhD Program in Clinical Drug Development of Herbal Medicine, College of Pharmacy, Taipei Medical University, Taipei, 11031, Taiwan; Department of Traditional Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, 11696, Taiwan.
| | - Ciao-Jhih Cheng
- Department of Traditional Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, 11696, Taiwan; School of Post-Baccalaureate Chinese Medicine, Tzu Chi University, Hualien, 97004, Taiwan.
| | - Wen-Fei Chiou
- PhD Program in Clinical Drug Development of Herbal Medicine, College of Pharmacy, Taipei Medical University, Taipei, 11031, Taiwan; National Research Institute of Chinese Medicine, Ministry of Health and Welfare, Taipei, 112, Taiwan.
| | - Wei-Chiao Chang
- PhD Program in Clinical Drug Development of Herbal Medicine, College of Pharmacy, Taipei Medical University, Taipei, 11031, Taiwan; Department of Clinical Pharmacy, School of Pharmacy, Taipei Medical University, Taipei, Taiwan; Master Program for Clinical Pharmacogenomics and Pharmacoproteomics, School of Pharmacy, Taipei Medical University, Taipei, Taiwan.
| | - Yi-No Kang
- Evidence-Based Medicine Center, Wan Fang Hospital, Taipei Medical University, Taipei, 11696, Taiwan; Research Center of Big Data and Meta-analysis, Wan Fang Hospital, Taipei Medical University, Taipei, 11696, Taiwan; Cochrane Taiwan, Taipei Medical University, Taipei, 11031, Taiwan; Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, 10055, Taiwan.
| | - Mei-Hsien Lee
- PhD Program in Clinical Drug Development of Herbal Medicine, College of Pharmacy, Taipei Medical University, Taipei, 11031, Taiwan; Graduate Institute of Pharmacognosy, College of Pharmacy, Taipei Medical University, Taipei, 11031, Taiwan; Center for Reproductive Medicine and Sciences, Taipei Medical University Hospital, Taipei, 11031, Taiwan.
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16
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Liu L, Xu L, Wang S, Wang L, Wang X, Xu H, Li X, Ye H. Confirmation of inhibitingTLR4/MyD88/NF-κB Signalling Pathway by Duhuo Jisheng Decoction on Osteoarthritis: A Network Pharmacology Approach-Integrated Experimental Study. Front Pharmacol 2022; 12:784822. [PMID: 35140604 PMCID: PMC8818874 DOI: 10.3389/fphar.2021.784822] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 12/28/2021] [Indexed: 12/26/2022] Open
Abstract
This study was conducted to identify whether the TLR4/MyD88/NF-κB signalling pathway plays a vital role in osteoarthritis (OA) treatment with Duhuo Jisheng Decoction (DHJSD) on the basis of a network pharmacology approach (NPA)-integrated experiment. Two experiments were conducted as follow: NPA for DHJSD using six OA-related gene series and the key pathway was screened out using NPA. NPA identified a vital role for the TLR4/MyD88/NF-κB signalling pathway in OA treatment with DHJSD, the conventional western blot analysis and qPCR confirmed it. Furthermore, changes of miR-146a-5p and miR-34a-5p in the cellular models were recovered by DHJSD administration, which synergistically contributed to OA therapy. The toll-like receptor signalling pathway and the NF-κB signalling pathway were meaningfully enriched by the miRNA-regulated gene pathways. This study identified and confirmed the TLR4/MyD88/NF-κB signalling pathway is an essential inflammatory signalling pathway in the DHJSD underlying OA treatment. The results provide a basis for further evaluation of the regulatory mechanism of the drug’s efficacy in treating OA.
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Affiliation(s)
- Linglong Liu
- College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Limei Xu
- College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Shengjie Wang
- College of Pharmacy Science, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Lili Wang
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fuzhou, China
| | - Xiaoning Wang
- College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Huifeng Xu
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fuzhou, China
| | - Xihai Li
- College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fuzhou, China
- *Correspondence: Xihai Li,
| | - Hongzhi Ye
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Fujian Key Laboratory of Integrative Medicine on Geriatrics, Fuzhou, China
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Liu W, Xu D, Qi Q, Li J, Ou L. Chinese herbal medicine Xianling Gubao capsule for knee osteoarthritis: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e28634. [PMID: 35060547 PMCID: PMC8772681 DOI: 10.1097/md.0000000000028634] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 01/04/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Knee osteoarthritis (KOA) is the most prevalent degenerative joint disease among populations over 60 years old, and is the most common cause of musculoskeletal pain and disability worldwide. Xianling Gubao capsule (XLGBC), a Chinese patent medicine, is widely used for treatment of osteoporosis. Meanwhile, according to the theory of homotherapy for heteropathy, XLGBC is increasingly applied in the clinical practice of KOA. However, no systematic review has found that XLGBC is as effective in treatment of KOA as it is in treatment of osteoporosis. Therefore, we will conduct a systematic review of XLGBC in KOA treatments. METHODS All randomized controlled trials assessing the validity of XLGBC therapy for KOA will be retrieved from the following seven databases, including the Cochrane Library, PubMed, EMBASE, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wan Fang Database, and Chinese Scientific Journal Database. The primary outcome measures are the visual analogue scale pain score, and a comprehensive evaluation including the Western Ontario and McMaster Universities Arthritis Index scores, Lysholm scores, and Bristol scores. And the secondary outcome measures include cure rate and adverse events. The procedure such as retrieval and selection of literature, data extraction, evaluation of risk of bias, and assessment of reporting bias will be executed by 2 reviewers independently. The data synthesis for meta-analysis will be conducted by Review Manager 5.4 software. RESULTS A high-quality evidence of XLGBC for the treatment of KOA will be generated from the aspects of safety and efficacy. CONCLUSION This systematic review will provide evidence to help us confirm the clinical efficacy of XLGBC in the treatment of KOA. OSF REGISTRATION NUMBER Registration DOI 10.17605/OSF.IO/QD5SY.
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Affiliation(s)
- Wang Liu
- The Second Affiliated Hospital of Guizhou University of Chinese Medicine, Guiyang 550003, China
| | - Daoqing Xu
- The Graduate School, Guizhou University of Chinese Medicine, Guiyang, 550003, China
| | - Qi Qi
- The Graduate School, Guizhou University of Chinese Medicine, Guiyang, 550003, China
| | - Jingjing Li
- The Graduate School, Guizhou University of Chinese Medicine, Guiyang, 550003, China
| | - Liang Ou
- The Second Affiliated Hospital of Guizhou University of Chinese Medicine, Guiyang 550003, China
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Zheng H, Zhang D, Zhu Y, Wang Q. Effect of Tai Chi exercise on lower limb function and balance ability in patients with knee osteoarthritis: A protocol of a randomized controlled trial. Medicine (Baltimore) 2021; 100:e27647. [PMID: 34797287 PMCID: PMC8601362 DOI: 10.1097/md.0000000000027647] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 10/14/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Knee osteoarthritis (KOA) is a chronic degenerative joint disease commonly occurring in middle-aged and elderly people. The main clinical manifestations are joint pain, limited activity, and decreased muscle strength resulting in decreased motor control ability. Exercise therapy is an effective method to enhance muscle strength of lower limbs, while China's traditional skill Tai Chi (TC) is a combination of activity and inertia, internal and external exercise therapy. In recent years, scholars at home and abroad have found that regular TC can effectively improve patients' lower limb function and balance ability. The purpose of this study is to explore the effects of TC on lower limb function and balance ability in patients with KOA. METHODS This is a prospective randomized controlled clinical trial. One hundred forty-six cases of KOA patients will be randomly divided into experimental group and control group according to 1:1 ratio, 73 cases in each group, the control group: sodium hyaluronate; experimental group: TC added on the basis of the control group. Both groups will receive standard treatment for 5 weeks and will be followed up for 3 months. Observation indicators include: the western Ontario and McMaster universities osteoarthritis index; hospital for special surgery knee score; balance stability index, liver and kidney function, adverse reaction rate, etc. SPSS 23.0 software will be used for data analysis. DISCUSSION This study will evaluate the effects of TC on lower limb function and balance ability of patients with KOA. The results of this trial will provide a clinical basis for the selection of exercise therapy for patients with KOA.
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Affiliation(s)
- Haoyun Zheng
- Beijing Hospital of Traditional Chinese Medicine, Beijing, China
| | - Dong Zhang
- Dongfang Hospital Beijing University of Chinese Medicine, Beijing, China
| | - Yonggang Zhu
- Beijing Hospital of Traditional Chinese Medicine, Beijing, China
| | - Qingfu Wang
- Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China
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Cho YM, Hui KK, Perng WT, Wang YH, Wei JCC. Chinese herbal medicine might be associated with a lower rate of joint replacement in patients with osteoarthritis: A 12-year population-based matched cohort analysis. JOURNAL OF ETHNOPHARMACOLOGY 2021; 280:114419. [PMID: 34284084 DOI: 10.1016/j.jep.2021.114419] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 06/21/2021] [Accepted: 07/12/2021] [Indexed: 06/13/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE To determine whether adjuvant Chinese herbal medicine (CHM) treatment is associated with the risk of joint replacement in osteoarthritis (OA) patients. MATERIALS AND METHODS This retrospective study used a population-based national health insurance (NHI) database from 2000 to 2012 in Taiwan. A total of 125,023 newly diagnosed OA patients were selected from one million beneficiaries of longitudinal health insurance database. Based on applying ten selected frequently used CHM formulas for OA, patients were divided into CHM user and non-CHM user. One-CHM to four-non-CHM user were propensity score matched with age, gender, monthly income, urbanization, comorbidities, Nonsteroidal anti-inflammatory drugs (NSAIDs) and index year were adjusted to reduce selection bias and confounding. Cox regression model was used for comparing the hazard ratios (HR) for the risk of joint replacement and Kaplan-Meier curve for the proportion of joint replacement. RESULTS OA patients who were female, younger (20-60 years), higher income and lived in urbanization location were found to preferred using CHM. Younger CHM users had a lower adjusted HR (0.63) of the risk of joint replacement (95% confidence interval (CI) = 0.42-0.94). Compared to non-CHM user, HR among CHM users (≥225 days annually) is 0.48 (95% CI = 0.31-0.76). The proportion of joint replacement in younger non-CHM user began to rise notably with time (log-rank test, p = 0.026). However, this benefit by CHM did not apply to older (over 60 years) OA patients. CONCLUSION This study suggested that adjuvant CHM might be associated with a lower rate of joint replacement in OA patients. CHM therapy might be considered in OA patients to reduce the need of joint replacement.
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Affiliation(s)
- Yu-Min Cho
- Center for East West Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, USA; Tzu Chi Medical Foundation, Alhambra, CA, USA.
| | - Ka-Kit Hui
- Center for East West Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, USA.
| | - Wuu-Tsun Perng
- Department of Recreational Sport & Health Promotion, National Pingtung University of Science and Technology, Pingtung, Taiwan.
| | - Yu-Hsun Wang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan.
| | - James Cheng-Chung Wei
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan; Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.
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Traditional Chinese Medicine for Postoperative Care following Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:9993651. [PMID: 34594394 PMCID: PMC8478569 DOI: 10.1155/2021/9993651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 08/19/2021] [Indexed: 11/17/2022]
Abstract
Objectives This review verifies the clinical effects of traditional Chinese medicine (TCM) combined with conventional rehabilitation after anterior cruciate ligament reconstruction (ACLR). Methods MEDLINE/PubMed, EMBASE, CENTRAL, JMAS, CNKI, and seven Korean databases were searched using predetermined strategies. The risk of bias was assessed using Cochrane Collaboration's tool and a meta-analysis was conducted accordingly. Results Nineteen randomized controlled trials involving 1283 participants were included in this systematic review and meta-analysis. The TCM treatment group showed more significant improvements in pain (MD −0.74, 95% CI [−0.93, −0.54]; I2 = 89%), range of motion (ROM) (SMD 1.19, 95% CI [0.78, 1.59]; I2 = 78%), and knee swelling (SMD −1.72, 95% CI [−2.38, −1.07]; I2 = 76%). The Lysholm score of the TCM treatment group significantly improved (MD 5.62, 95% CI [3.93, 7.32]; I2 = 84%) relative to the control group. The IKDC subjective score (MD 3.40, 95% CI [−0.61, 7.41]; I2 = 97%) and the hospital for special surgery (HSS) score did not improve initially (MD 6.79, 95% CI [−1.27, 14.86]; I2 = 97%) but did so during the subgroup analysis. TCM showed a long-term effect on the IKDC subjective score (MD −0.51, 95% CI [−1.69, 0.67]; I2 = 30%). A longer treatment period of 12 weeks showed more improvement (MD 5.96, 95% CI [0.69, 11.22]; I2 95%). Conclusion TCM can be used as an adjuvant therapy to conventional rehabilitation for relieving pain, improving ROM and oedema, and facilitating better function of the knee joint after ACLR. However, this recommendation should be cautiously applied in clinical practice owing to the low quality of the included studies.
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Wu J, Li W, Ye B, Yao Y. The efficacy and safety of Xianling Gubao capsules in the treatment of knee osteoarthritis: A protocol for a randomized, double-blind, controlled trial. Medicine (Baltimore) 2021; 100:e27086. [PMID: 34516497 PMCID: PMC8428714 DOI: 10.1097/md.0000000000027086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 08/12/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Knee osteoarthritis (KOA) is a chronic degenerative joint disease, which is the most common type of osteoarthritis. The clinical manifestations are pain, swelling, and dysfunction of the knee joint, which seriously reduces the quality of life of patients and causes a huge social burden. At present, western medicine mainly focuses on symptomatic treatment, such as anti-inflammatory and pain relief, joint cavity injection, joint replacement, etc. The curative effect has certain limitations. Xianling Gubao capsule has some advantages in the treatment of KOA, but it lacks high-quality clinical research to verify it. Therefore, the purpose of this study is to evaluate the efficacy and safety of Xianling Gubao capsule in the treatment of KOA. METHODS A randomized, double-blind, double-simulation, parallel controlled trial design was used to study the efficacy and safety of Xianling Gubao capsules in the treatment of KOA. The patients were randomly divided into a treatment group and the control group according to 1:1. The treatment group: Xianling Gubao capsule + glucosamine hydrochloride capsule simulation agent treatment; the control group: glucosamine hydrochloride capsule + Xianling Gubao capsule simulation agent treatment. Both groups received standard treatment for 8 weeks and followed up for 30 days. And at the same time, pay attention to its efficacy and safety indicators. Observation indicators include: the western Ontario and McMaster universities osteoarthritis index, hospital for special surgery knee score, liver and kidney function, adverse reactions, etc. Data analysis was performed using SPSS 25.0 software. DISCUSSION This study will evaluate the efficacy and safety of Xianling Gubao capsule in the treatment of KOA. The results of this experiment will provide evidence support for Xianling Gubao capsule in the treatment of KOA. TRIAL REGISTRATION OSF Registration number: DOI 10.17605/OSF.IO/ERM9C.
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Yang L, Wu BY, Ma L, Li ZD, Xiong H. Comparative efficacy and safety of Chinese herbal medicine for knee osteoarthritis: A protocol for systematic review and network meta-analysis. Medicine (Baltimore) 2021; 100:e26671. [PMID: 34398031 PMCID: PMC8294919 DOI: 10.1097/md.0000000000026671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Knee osteoarthritis (OA) is a major public health concern causing chronic disability as well as a substantial burden on health care and the economy. However, effective treatments for knee OA were still not available. Numerous clinical studies have suggested that Chinese herbal medicine (CHM) seems to be clinically effective in treating knee OA. Thus, this study aims to evaluate the efficacy and safety of CHM in the treatment of knee OA through a systematic review and network meta-analysis. METHODS A comprehensive search will be performed in PubMed, Cochrane Library, Embase, Web of Science, China National Knowledge Infrastructure, VIP Database, Wanfang Database, Chinese Biomedical Database, and 3 clinical trials registration websites, from the database inception to May 2021. Randomized controlled trials meeting the eligible criteria based on the PICOS framework will be included. All studies fulfilling the eligible criteria will be assessed for risk of bias using the Cochrane Collaboration's tool. The primary outcome will be the visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index, and total effective rate. The secondary outcome is the incidence of adverse events. Data analysis will be performed using Stata, Addis, and WinBUGS. DISCUSSION This study will provide a reliable evidence to assess effectiveness and safety of CHM for knee OA, which may provide guidance for clinical practice. SYSTEMATIC REVIEW REGISTRATION This study protocol has been registered on INPLASY202160060.
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Zhou Y, Wang W, Tian K, Huang H, Jia M. Efficacy and safety of Biqi capsule in the treatment of knee osteoarthritis: A protocol of a randomized controlled trial. Medicine (Baltimore) 2021; 100:e25476. [PMID: 33879680 PMCID: PMC8078235 DOI: 10.1097/md.0000000000025476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 03/18/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Knee osteoarthritis (KOA) is a chronic and degenerative bone and joint disease, with KOA, cartilage degeneration, destruction and subchondral bone remodeling as the main pathological features. Its clinical symptoms are knee pain, swelling, limited activity, and long course of disease can cause joint deformities. At present, the early treatment of Western medicine is mainly the use of nonsteroidal drugs for anti-inflammation and removing pain, but because the efficacy of these drugs is unstable, the disease is easy to repeat after treatment, and the clinical effect is not good. Although Biqi capsule has advantages in the treatment of KOA, there is a lack of standard clinical studies to verify it, so the purpose of this randomized controlled study is to evaluate the efficacy and safety of Biqi capsule in the treatment of KOA. METHODS This is a prospective randomized controlled trial to study the efficacy and safety of Biqi capsule in the treatment of KOA. The patients were randomly divided into a treatment group and a control group according to 1:1. Among them, treatment group: Biqi capsule combined with diclofenac sodium sustained release tablets; Control group: Diclofenac sodium sustained-release tablets alone. Both groups were treated with standard treatment for 2 weeks and were followed up for 30 days to pay attention to the efficacy and safety indexes. Observation indicators included: the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Hospital for Special Surgery Knee Score (HSS), liver and kidney function, adverse reactions, and so on. SPSS 25.0 software is used for data analysis. DISCUSSION This study will evaluate the efficacy and safety of Biqi capsule in the treatment of KOA, and the results of this experiment will provide a clinical basis for Biqi capsule in the treatment of KOA. TRIAL REGISTRATION OSF Registration number: DOI 10.17605/OSF.IO/6HB9D.
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Affiliation(s)
| | - WenGang Wang
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
| | - Ke Tian
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
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Exploring the Pharmacological Mechanism of Duhuo Jisheng Decoction in Treating Osteoporosis Based on Network Pharmacology. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:5510290. [PMID: 33880122 PMCID: PMC8046540 DOI: 10.1155/2021/5510290] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/21/2021] [Accepted: 03/25/2021] [Indexed: 12/14/2022]
Abstract
Objective The purpose of this work is to study the mechanism of action of Duhuo Jisheng Decoction (DHJSD) in the treatment of osteoporosis based on the methods of bioinformatics and network pharmacology. Methods In this study, the active compounds of each medicinal ingredient of DHJSD and their corresponding targets were obtained from TCMSP database. Osteoporosis was treated as search query in GeneCards, MalaCards, DisGeNET, Therapeutic Target Database (TTD), Comparative Toxicogenomics Database (CTD), and OMIM databases to obtain disease-related genes. The overlapping targets of DHJSD and osteoporosis were identified, and then GO and KEGG enrichment analysis were performed. Cytoscape was employed to construct DHJSD-compounds-target genes-osteoporosis network and protein-protein interaction (PPI) network. CytoHubba was utilized to select the hub genes. The activities of binding of hub genes and key components were confirmed by molecular docking. Results 174 active compounds and their 205 related potential targets were identified in DHJSD for the treatment of osteoporosis, including 10 hub genes (AKT1, ALB, IL6, MAPK3, VEGFA, JUN, CASP3, EGFR, MYC, and EGF). Pathway enrichment analysis of target proteins indicated that osteoclast differentiation, AGE-RAGE signaling pathway in diabetic complications, Wnt signaling pathway, MAPK signaling pathway, PI3K-Akt signaling pathway, JAK-STAT signaling pathway, calcium signaling pathway, and TNF signaling pathway were the specifically major pathways regulated by DHJSD against osteoporosis. Further verification based on molecular docking results showed that the small molecule compounds (Quercetin, Kaempferol, Beta-sitosterol, Beta-carotene, and Formononetin) contained in DHJSD generally have excellent binding affinity to the macromolecular target proteins encoded by the top 10 genes. Conclusion This study reveals the characteristics of multi-component, multi-target, and multi-pathway of DHJSD against osteoporosis and provides novel insights for verifying the mechanism of DHJSD in the treatment of osteoporosis.
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25
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Zhang X, Chen X, Wang L, He C, Shi Z, Fu Q, Xu W, Zhang S, Hu S. Review of the Efficacy and Mechanisms of Traditional Chinese Medicines as a Therapeutic Option for Ionizing Radiation Induced Damage. Front Pharmacol 2021; 12:617559. [PMID: 33658941 PMCID: PMC7917257 DOI: 10.3389/fphar.2021.617559] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 01/11/2021] [Indexed: 12/16/2022] Open
Abstract
Ionizing radiation damage refers to acute, delayed, or chronic tissue damage associated with ionizing radiation. Specific or effective therapeutic options for systemic injuries induced by ionizing radiation have not been developed. Studies have shown that Chinese herbal Medicine or Chinese Herbal Prescription exhibit preventive properties against radiation damage. These medicines inhibit tissue injuries and promote repair with very minimal side effects. This study reviews traditional Chinese herbal medicines and prescriptions with radiation protective effects as well as their mechanisms of action. The information obtained will guide the development of alternative radioprotectants.
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Affiliation(s)
- Xiaomeng Zhang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xiaoying Chen
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Lei Wang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Changhao He
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Zhongyu Shi
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Qian Fu
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Wenhui Xu
- Beijing Academy of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Shujing Zhang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Sumin Hu
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
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26
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Tang H, Hosein A, Mattioli-Belmonte M. Traditional Chinese Medicine and orthopedic biomaterials: Host of opportunities from herbal extracts. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 120:111760. [PMID: 33545901 DOI: 10.1016/j.msec.2020.111760] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/13/2020] [Accepted: 11/24/2020] [Indexed: 12/15/2022]
Abstract
The role of Traditional Chinese Medicine (TCM), especially herbs or herbal extracts, in treating diseases has received increasing attention. This review focuses on the use of herbal extracts as signaling molecules and functional materials in the field of orthopedics, biomaterial science and bone tissue engineering strategies. A literature review using both Chinese and English references on herbs and herbal extracts based on TCM theory used in orthopedics and biomaterial science was performed. We discuss the efficacy of herbs, the active extracts from these herbs, the combination of herbal extracts and biomaterials and, finally, the application of herbal extracts to the biomaterials specific to orthopedics. Only a few studies have confirmed the feasibility of applying herbal extracts to biomaterials to improve the role of biomaterials and/or optimize drug delivery and release in orthopedics. In this context, this review reveals a new and promising direction for herbal extracts, where the use of herbal extracts based on TCM systemic treatment, can change the limited modern medicine view of biomaterials as "only for local treatment" when considering its efficacy.
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Affiliation(s)
- Huijuan Tang
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy; First College of Clinical Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Andrell Hosein
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Monica Mattioli-Belmonte
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy.
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Xiao W, Sun W, Lian H, Shen J. Integrated Network and Experimental Pharmacology for Deciphering the Medicinal Substances and Multiple Mechanisms of Duhuo Jisheng Decoction in Osteoarthritis Therapy. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2020; 2020:7275057. [PMID: 33204290 PMCID: PMC7657680 DOI: 10.1155/2020/7275057] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 09/16/2020] [Accepted: 10/21/2020] [Indexed: 12/23/2022]
Abstract
Osteoarthritis (OA) is currently the most common joint disorder worldwide. In last decades, herbal remedies have achieved a significant advancement in the treatment of OA. Duhuo Jisheng Decoction (DHJS), an herbal formula consisting of 15 medicinal herbs, has a long-time practice in OA therapy in China. However, its therapeutic mechanisms have not been comprehensively elucidated. In the present work, integrated network and experimental pharmacology were performed for investigating the therapeutic substances and mechanisms of DHJS. Based on network analysis, the contribution of each herb to OA therapy was evaluated. Furthermore, a series of potential targets and signaling pathways were enriched, which could be involved in the therapeutic effects and mechanisms of DHJS. Further experimental results indicated that DHJS attenuated TNFα, IL-6, MMP-1, MMP-9, MMP-13, and ADAMTs-5 expression, inhibited NF-κB and p38 MAPK signaling pathway, activated AMPK-SIRT1 signaling pathway, and suppressed chondrocyte apoptosis, which synergistically contributed to OA therapy. Our work demonstrated that DHJS could be very promising for OA therapy through synergistically acting on multitargets and multipathways.
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Affiliation(s)
- Wenyu Xiao
- Department of Orthopaedics, Shanghai Tenth People's Hospital Chongming Branch, School of Medicine, Tongji University, Shanghai 202157, China
| | - Weibing Sun
- Department of Orthopaedics, Shanghai Tenth People's Hospital Chongming Branch, School of Medicine, Tongji University, Shanghai 202157, China
| | - Hui Lian
- Department of Orthopaedics, Shanghai Tenth People's Hospital Chongming Branch, School of Medicine, Tongji University, Shanghai 202157, China
| | - Juexin Shen
- Department of Orthopaedics, Shanghai Tenth People's Hospital Chongming Branch, School of Medicine, Tongji University, Shanghai 202157, China
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Luo Y, Wang CZ, Sawadogo R, Tan T, Yuan CS. Effects of Herbal Medicines on Pain Management. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2020; 48:1-16. [PMID: 32054304 DOI: 10.1142/s0192415x20500019] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Pain is an unpleasant sensory and emotional experience in many diseases and is often caused by intense or damaging stimuli. Pain negatively affects the quality of life and increases high health expenditures. Drugs with analgesic properties are commonly used to relieve pain, but these Western medications could be overwhelmed by side effects including tolerance and addiction. Herbal medicines may provide alternative measures for pain management. In this review paper, after introduction of Chinese medicine theory and treatment modality, emphasis is placed on the application of Chinese herbs and herbal formulations in pain management. Three of the most commonly used herbs, i.e., Corydalis yanhusuo, Ligusticum chuanxiong, and Aconitum carmichaeli, are reviewed. Subsequently, using this ancient medical remedy, Chinese herbal formulation in treating common medical conditions associated with pain, such as headache/migraine, chest pain, abdominal pain, low back pain, neuropathic pain, osteoarthritis, and cancer pain, is presented. Chinese herbal medicines could be considered as a complementary and integrative approach in the modern armamentarium in combating pain.
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Affiliation(s)
- Yun Luo
- Key Laboratory of Modern Preparation of Traditional Chinese Medicine, Ministry of Education, Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, P. R. China.,Tang Center for Herbal Medicine Research, Pritzker School of Medicine, University of Chicago, Chicago, Illinois 60637, USA.,Department of Anesthesia and Critical Care, Pritzker School of Medicine, University of Chicago, Chicago, Illinois 60637, USA
| | - Chong-Zhi Wang
- Tang Center for Herbal Medicine Research, Pritzker School of Medicine, University of Chicago, Chicago, Illinois 60637, USA.,Department of Anesthesia and Critical Care, Pritzker School of Medicine, University of Chicago, Chicago, Illinois 60637, USA
| | - Richard Sawadogo
- Tang Center for Herbal Medicine Research, Pritzker School of Medicine, University of Chicago, Chicago, Illinois 60637, USA.,Department of Anesthesia and Critical Care, Pritzker School of Medicine, University of Chicago, Chicago, Illinois 60637, USA.,Institute for Health Science Research, 03 BP 7192 Ouagadougou 03, Burkina Faso
| | - Ting Tan
- Key Laboratory of Modern Preparation of Traditional Chinese Medicine, Ministry of Education, Jiangxi University of Traditional Chinese Medicine, Nanchang 330004, P. R. China
| | - Chun-Su Yuan
- Tang Center for Herbal Medicine Research, Pritzker School of Medicine, University of Chicago, Chicago, Illinois 60637, USA.,Department of Anesthesia and Critical Care, Pritzker School of Medicine, University of Chicago, Chicago, Illinois 60637, USA.,Committee on Clinical Pharmacology and Pharmacogenomics, Pritzker School of Medicine, University of Chicago, Chicago, Illinois 60637, USA
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Efficacy and Safety of Modified Duhuo Jisheng Decoction in the Treatment of Lumbar Disc Herniation: A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020; 2020:2381462. [PMID: 32714400 PMCID: PMC7355353 DOI: 10.1155/2020/2381462] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 06/14/2020] [Accepted: 06/16/2020] [Indexed: 02/06/2023]
Abstract
Objective Lumbar disc herniation (LDH) is based on the degenerative changes of the intervertebral disc. Many drugs are used to treat and prevent LDH, including Western medicine and Chinese medicine. Duhuo Jisheng Decoction (DHJSD) is one of the most classic Chinese medicine prescriptions. The purpose of our meta-analysis is to evaluate the efficacy and safety of modified DHJSD in the treatment of LDH. Methods We searched multiple databases including PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI) databases, Wanfang Database, and Chinese Scientific Journal Database (VIP) to identify studies that met the inclusion criteria. This meta-analysis was registered at INPLASY with reference number ID: INPLASY202060053. Results Fourteen randomized controlled trials (RCTs) were identified, including 1560 patients. This meta-analysis showed that the total effective rate and cure rate of modified DHJSD are higher than those of diclofenac sodium enteric-coated tablets (total effective rate: RR = 1.18, 95% CI: 1.12 to 1.25, P < 0.0001, I2 = 0%; cure rate: RR = 1.60, 95% CI: 1.30 to 1.97, P < 0.00001, I2 = 2%), diclofenac sodium enteric-coated tablets plus ibuprofen and indomethacin (total effective rate: RR = 1.23, 95% CI: 1.11 to 1.37, P=0.0001, I2 = 0%; cure rate: RR = 1.58, 95% CI: 1.22 to 2.04, P=0.0005, I2 = 0%), and diclofenac sodium sustained-release capsule (total effective rate: RR = 1.49, 95% CI: 1.27 to 1.74, P < 0.00001, I2 = 0%; cure rate: RR = 10.07, 95% CI: 3.29 to 30.88, P < 0.00001, I2 = 5%). Modified DHJSD was also better than Western medicine (MD = −1.56, 95% CI: −2.42 to −0.70, P=0.0004, I2 = 74%) in terms of visual analogue scale (VAS) scores. Three RCTs showed no adverse events in the modified DHJSD group, but adverse events existed in the Western medicine group. Conclusion This meta-analysis showed that modified DHJSD had a more favorable effect on the treatment of LDH than Western medicine, and there were no obvious adverse events. More high-quality RCTs are needed to complement existing conclusions.
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Zhang L, Shi X, Huang Z, Mao J, Mei W, Ding L, Zhang L, Xing R, Wang P. Network Pharmacology Approach to Uncover the Mechanism Governing the Effect of Radix Achyranthis Bidentatae on Osteoarthritis. BMC Complement Med Ther 2020; 20:121. [PMID: 32316966 PMCID: PMC7171799 DOI: 10.1186/s12906-020-02909-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 03/31/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND This study used a network pharmacology approach to elucidate the molecular mechanism governing the effect of Radix Achyranthis Bidentatae (RAB) on osteoarthritis (OA). METHODS Based on oral bioavailability and drug-likeness, the main active components of RAB were screened via the Traditional Chinese Medicine Systems Pharmacology platform. The GeneCard, OMIM, PharmGkb, Therapeutic Targets database, and DrugBank database were used to establish a database of osteoarthritis targets. The interactive active network map of "ingredient-target" was constructed with Cytoscape software (Version 3.7.1). The protein-protein interaction network was constructed with the STRING database, and the related protein interaction relationship was analysed. GO biological function analysis and KEGG enrichment analysis for core targets were performed. Finally, docking of the active components with the core target was carried out. RESULTS Sixteen active components of RAB were obtained, and 63 potential targets for OA were identified. Network analysis results indicate that these targets are primarily involved in regulating biological processes, such as cell metabolism, apoptosis, and cell proliferation. Pathways involved in the treatment of osteoarthritis include virus-related signalling pathways, apoptosis signalling pathways, IL-17 signalling pathways, and PI3K/AKT signalling pathways. CONCLUSION RAB has the characteristics of being multi-system, multi-component and multi-target. Possible mechanisms of action for RAB include regulating the immune and inflammatory responses, reducing chondrocyte apoptosis, and protecting the joint synovial membrane and cartilage to control disease development. The active ingredients in RAB, such as sterols and flavonoids, exhibit strong potential as candidate drugs for the treatment of osteoarthritis.
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Affiliation(s)
- Laigen Zhang
- Department of Orthopaedics and Traumatology, The First Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Provincial Hospital of Traditional Chinese Medicine, No 155, Hanzhong Road, Nanjing, 210029 Jiangsu Province China
| | - Xiaoqing Shi
- Department of Orthopaedics and Traumatology, The First Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Provincial Hospital of Traditional Chinese Medicine, No 155, Hanzhong Road, Nanjing, 210029 Jiangsu Province China
| | - Zhengquan Huang
- Department of Orthopaedics and Traumatology, The First Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Provincial Hospital of Traditional Chinese Medicine, No 155, Hanzhong Road, Nanjing, 210029 Jiangsu Province China
| | - Jun Mao
- Department of Orthopaedics and Traumatology, The First Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Provincial Hospital of Traditional Chinese Medicine, No 155, Hanzhong Road, Nanjing, 210029 Jiangsu Province China
| | - Wei Mei
- Department of Orthopaedics and Traumatology, The First Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Provincial Hospital of Traditional Chinese Medicine, No 155, Hanzhong Road, Nanjing, 210029 Jiangsu Province China
| | - Liang Ding
- Department of Orthopaedics and Traumatology, The First Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Provincial Hospital of Traditional Chinese Medicine, No 155, Hanzhong Road, Nanjing, 210029 Jiangsu Province China
| | - Li Zhang
- Department of Orthopaedics and Traumatology, The First Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Provincial Hospital of Traditional Chinese Medicine, No 155, Hanzhong Road, Nanjing, 210029 Jiangsu Province China
| | - Runlin Xing
- Department of Orthopaedics and Traumatology, The First Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Provincial Hospital of Traditional Chinese Medicine, No 155, Hanzhong Road, Nanjing, 210029 Jiangsu Province China
| | - Peimin Wang
- Department of Orthopaedics and Traumatology, The First Affiliated Hospital of Nanjing University of Chinese Medicine, Jiangsu Provincial Hospital of Traditional Chinese Medicine, No 155, Hanzhong Road, Nanjing, 210029 Jiangsu Province China
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Liu W, Jin S, Huang M, Li Y, Wang Z, Wang P, Zhao X, Xia P, Feng J. Duhuo jisheng decoction suppresses matrix degradation and apoptosis in human nucleus pulposus cells and ameliorates disc degeneration in a rat model. JOURNAL OF ETHNOPHARMACOLOGY 2020; 250:112494. [PMID: 31874213 DOI: 10.1016/j.jep.2019.112494] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 12/05/2019] [Accepted: 12/19/2019] [Indexed: 06/10/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The lower back pain (LBP) caused by intervertebral disc (IVD) degeneration brings a heavy burden to society. A classic treatment method of Chinese medicine, fangji-duhuo jisheng decoction (DHJSD), has been effective in the clinical treatment of LBP, although the underlying mechanism remains unknown. AIM OF THE STUDY In this work, the main objective was to study the effects of DHJSD on in vitro IVD degeneration of human nucleus pulposus (NP) cells after pressure treatment and on an in vivo interrupted IVD degeneration rat model. MATERIALS AND METHODS The effects of DHJSD on the viability of NP cells were detected using Cell Counting Kit-8. RT-qPCR, western blotting, TUNEL assay, transmission electron microscopy, and immunofluorescence staining were performed to explore the molecular mechanism underlying protection against compression-induced matrix degradation and apoptosis in NP cells by DHJSD. Furthermore, the effects of DHJSD on IVD degeneration in a rat IDD model were also determined. RESULTS We found that DHJSD increased the viability of NP cells in a concentration- and time-dependent manner. Furthermore, DHJSD significantly reduced compression-induced NP matrix degeneration and apoptosis, activated autophagy, and inhibited the p38/MAPK signaling pathway in NP cells subjected to compression. Autophagy inhibitor 3-MA and p38/MAPK signaling pathway activator anisomycin reversed the beneficial effects of DHJSD in NP cells, indicating that DHJSD protects against IVD degeneration by autophagy activation and P38/MAPK signaling pathway inhibition. Furthermore, DHJSD treatment effectively delayed IVD degeneration in a puncture-induced IDD rat model. CONCLUSIONS DHJSD prevents compression-induced matrix degradation and cell apoptosis through regulating autophagy and the P38/MAPK signaling pathway. The mechanism underlying the effects of DHSJD elucidated in this study provides a new direction for LBP treatment.
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Affiliation(s)
- Wei Liu
- Department of Orthopaedics, First Hospital of Wuhan, Wuhan, 430022, China
| | - Shuwen Jin
- College of Acupuncture of Orthopedics, Hubei University of Chinese Medicine, Wuhan, 430061, China
| | - Mi Huang
- Department of Orthopaedics, First Hospital of Wuhan, Wuhan, 430022, China
| | - Yanli Li
- College of Acupuncture of Orthopedics, Hubei University of Chinese Medicine, Wuhan, 430061, China
| | - ZhiWei Wang
- Department of Orthopaedics, First Hospital of Wuhan, Wuhan, 430022, China
| | - Peng Wang
- College of Acupuncture of Orthopedics, Hubei University of Chinese Medicine, Wuhan, 430061, China
| | - Xiaolong Zhao
- Department of Orthopaedics, First Hospital of Wuhan, Wuhan, 430022, China
| | - Ping Xia
- Department of Orthopaedics, First Hospital of Wuhan, Wuhan, 430022, China.
| | - Jing Feng
- Department of Orthopaedics, First Hospital of Wuhan, Wuhan, 430022, China.
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Ahmad N, Ansari MY, Haqqi TM. Role of iNOS in osteoarthritis: Pathological and therapeutic aspects. J Cell Physiol 2020; 235:6366-6376. [PMID: 32017079 DOI: 10.1002/jcp.29607] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 01/22/2020] [Indexed: 01/15/2023]
Abstract
Accumulating evidence suggests that inflammation has a key role in the pathogenesis of osteoarthritis (OA). Nitric oxide (NO) has been established as one of the major inflammatory mediators in OA and drives many pathological changes during the development and progression of OA. Excessive production of NO in chondrocytes promotes cartilage destruction and cellular injury. The synthesis of NO in chondrocytes is catalyzed by inducible NO synthase (iNOS), which is thereby an attractive therapeutic target for the treatment of OA. A number of direct and indirect iNOS inhibitors, bioactive compounds, and plant-derived small molecules have been shown to exhibit chondroprotective effects by suppressing the expression of iNOS. Many of these iNOS inhibitors hold promise for the development of new, disease-modifying therapies for OA; however, attempts to demonstrate their success in clinical trials are not yet successful. Many plant extracts and plant-derived small molecules have also shown promise in animal models of OA, though further studies are needed in human clinical trials to confirm their therapeutic potential. In this review, we discuss the role of iNOS in OA pathology and the effects of various iNOS inhibitors in OA.
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Affiliation(s)
- Nashrah Ahmad
- School of Biomedical Sciences, Kent State University, Kent, Ohio.,Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown, Ohio
| | - Mohammad Y Ansari
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown, Ohio
| | - Tariq M Haqqi
- Department of Anatomy and Neurobiology, Northeast Ohio Medical University, Rootstown, Ohio
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Sun K, Huang F, Qi B, Yin H, Tang B, Yang B, Chen L, Zhuang M, Wei X, Zhu L. A systematic review and meta-analysis for Chinese herbal medicine Duhuo Jisheng decoction in treatment of lumbar disc herniation: A protocol for a systematic review. Medicine (Baltimore) 2020; 99:e19310. [PMID: 32118755 PMCID: PMC7478537 DOI: 10.1097/md.0000000000019310] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 01/27/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Lumbar disc herniation (LDH) is 1 of the most common diseases in orthopedics, which seriously affects people's daily life and brings a heavy burden on society and families. Chinese herbal medicine has been used in clinical practice for a long time and Duhuo Jisheng Decoction (DHJSD) is believed to help alleviate the symptoms of LDH. This systematic review aims to collect evidences from randomized clinical trials and evaluate the efficacy of DHJSD on LDH in order to provide a reference for clinicians and researchers. METHODS We will comprehensively search the 8 electronic databases until December 2019 to identify related randomized controlled trials, including 4 foreign databases (PubMed, MEDLINE, EMBASE, Cochrane Library) and 4 Chinese databases (China National Knowledge Infrastructure Database, VIP Database, Wanfang Database and China Biology Medicine disc). The data of the World Health Organization International Clinical Trial Registry Platform and the Chinese Clinical Trial Registry also will be searched. The primary outcomes are Japanese Orthopaedic Association scores and visual analog scale scores. The risk of bias will be assessed using the Cochrane Collaboration tool. RevMan (V.5.3) software will be used for meta-analysis. RESULTS This study will report the results of DHJSD for the treatment of LDH from the literature screening, the basic information of the included studies, the risk of bias of the included studies, treatment effects, safety, and so on. CONCLUSION This systematic review will evaluate the effectiveness and safety of DHJSD for the treatment of LDH and provide the latest evidence for its clinical application. ETHICS AND DISSEMINATION This is a literature-based study, therefore it does not require ethical approval. PROSPERO REGISTRATION NUMBER CRD42019147302.
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Affiliation(s)
- Kai Sun
- Department of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences
| | - Fasen Huang
- The Third Affiliated Hospital of Beijing University of Chinese Medicine
| | - Baoyu Qi
- Department of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences
| | - He Yin
- Department of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences
| | - Bin Tang
- Department of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences
| | - Bowen Yang
- Department of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences
| | - Lin Chen
- Department of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences
| | - Minghui Zhuang
- Department of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences
| | - Xu Wei
- Office of Academic Research, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Liguo Zhu
- Department of Spine, Wangjing Hospital of China Academy of Chinese Medical Sciences
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Chen W, Wang J, Hua Z, Zhang Y. Du Huo Ji Sheng Tang relieves knee osteoarthritis via suppressing NLRP3/NF-κB inflammatory signals in rats. EUR J INFLAMM 2020. [DOI: 10.1177/2058739220942627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Knee osteoarthritis (KOA) is a common chronic disease in the elderly and leads to a high rate of disability. Du Huo Ji Sheng Tang (DHJST), a Chinese traditional medicinal formula, is a classic prescription for the treatment of KOA. Here, we investigated whether DHJST could inhibit inflammation and treat KOA through suppressing NLRP3/nuclear factor (NF)-κB inflammatory signals in rats. The serum levels of interleukin (IL)-1β, IL-6, IL-10, tumor necrosis factor (TNF)-α, NLRP3, ASC, Caspase-1, p-NF-κB-P65, and p-IκBa were detected in healthy adults and patients with KOA before and after treatment. Sprague Dawley (SD) rats were divided into normal group, model group, diclofenac sodium group (5 mg/kg), DHJST high-dose group (1 g/kg), and DHJST low-dose group (0.5 g/kg). The right hind knee joint of the rats, except normal group, was injected with 4% papain (0.25 mL/kg) once every 7 days for three times. All rats were treated for 3 weeks. The swelling volume of right hind paw; five classification of inflammatory cells in synovial fluid; pathological changes of the knee-joint synovial membrane and cartilage; levels of IL-1β, IL-6, and TNF-α in serum and knee-joint synovial fluid; and the expressions of NLRP3/NF-κB inflammatory signals in the knee-joint synovial membrane were detected. The serum levels of IL-1β, IL-6, IL-10, TNF-α, NLRP3, ASC, Caspase-1, p-NF-κB-P65, and p-IκBa in KOA patients treated with DHJST were significantly decreased. The KOA rats treated with DHJST showed significant decreases in swelling volume of right hind paws; the percentage of leukocyte, lymphocyte, neutrophil, and eosinophils in synovial fluid; the levels of IL-1β, IL-6, and TNF-α in serum and knee-joint synovial fluid; and the expressions of NLRP3 ASC, Caspase-1, IL-1β, p-NF-κB-P65, and p-IκBa in the knee-joint synovial membrane, and showed an alleviation in pathological changes of the knee-joint synovial membrane and cartilage. Our data provide the first evidence that DHJST relieves KOA via suppressing NLRP3/NF-κB inflammatory signals in rats
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Affiliation(s)
- Wenjin Chen
- Department of Orthopedics, Wuxi Affiliated Hospital of Nanjing University of Chinese Medicine, Wuxi, China
| | - Jianwei Wang
- Department of Orthopedics, Wuxi Affiliated Hospital of Nanjing University of Chinese Medicine, Wuxi, China
| | - Zhen Hua
- Department of Orthopedics, Wuxi Affiliated Hospital of Nanjing University of Chinese Medicine, Wuxi, China
| | - Yafeng Zhang
- Department of Orthopedics, Wuxi Affiliated Hospital of Nanjing University of Chinese Medicine, Wuxi, China
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Alfieri FM, Barros MCC, Carvalho KCD, Toral I, Silva CFD, Vargas e Silva NCDO. Geotherapy combined with kinesiotherapy is efficient in reducing pain in patients with osteoarthritis. J Bodyw Mov Ther 2020; 24:77-81. [DOI: 10.1016/j.jbmt.2019.05.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 05/24/2019] [Indexed: 11/28/2022]
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Are Kidney-Tonifying and Blood-Activating Medicinal Herbs Better than NSAIDs for Knee Osteoarthritis? A Systematic Review and Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:9094515. [PMID: 31885673 PMCID: PMC6899304 DOI: 10.1155/2019/9094515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 09/19/2019] [Accepted: 09/25/2019] [Indexed: 01/12/2023]
Abstract
Objective To compare the efficacy and safety of kidney-tonifying and blood-activating medicinal herbs (KTBAMs) and nonsteroidal anti-inflammatory drugs (NSAIDs) in the treatment of knee osteoarthritis (KOA). Methods Randomized controlled trials (RCTs) from online databases that compared the efficacy of KTBAMs and NSAIDs in the treatment of KOA were retrieved. The main outcomes included the evaluation of functional outcomes, pain, and adverse effects. The Cochrane risk-of-bias (ROB) tool was used to assess methodological quality. Results A total of 38 RCTs (3994 participants) were included in our meta-analysis. We found that KTBAMs had a significantly higher total effective rate (P < 0.00001, risk ratio (RR) = 1.08, confidence interval (CI) = 1.05 to 1.11, I2 = 4%) and a lower gastrointestinal adverse reaction rate (P < 0.00001, RR = 0.36, CI = 0.24 to 0.53, I2 = 33%) than NSAIDs. KTBAMs showed greater improvements in the Knee Society Scale (KSS) scores (mean difference (MD) = 7.17, 95% CI 0.71 to 13.64, P=0.03). Regarding the visual analog scale (VAS) scores, WOMAC scores, and Lequence scores, there were no significant differences between the KTBAM group and the NSAID group. The GRADE quality level of this systematic review indicated that the very low-quality evidence showed that KTBAMs had a higher total effective rate, while the moderate-quality evidence showed that the adverse reactions of KTBAMs were lower and the KSS scores were higher. Low-quality evidence showed no significant differences in improving VAS scores, WOMAC scores, or Lequence scores. Conclusion KTBAMs were superior to NSAIDs in terms of a higher total effective rate, a lower adverse reaction rate, and a higher KSS score. There were no significant differences between KTBAMs and NSAIDs in improving VAS scores, WOMAC scores, and Lequence scores of patients with KOA. Therefore, KTBAMs may be an alternative effective method for treating KOA. However, high-quality, well-designed RCTs with long-term follow-up are still required.
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Lima MVV, Freire ADO, Sousa ELF, Vale AAM, Lopes AJO, Vasconcelos CC, Lima-Aragão MVV, Serra HO, Liberio RNMG, dos Santos APSDA, Silva GEB, da Rocha CQ, Moreira Lima FCV, Cartágenes MDSDS, Garcia JBS. Therapeutic Use of Scoparia dulcis Reduces the Progression of Experimental Osteoarthritis. Molecules 2019; 24:molecules24193474. [PMID: 31557835 PMCID: PMC6803828 DOI: 10.3390/molecules24193474] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/07/2019] [Accepted: 09/10/2019] [Indexed: 11/20/2022] Open
Abstract
Pain is recognized as one of the main symptoms in knee osteoarthritis and is the main reason why patients seek medical attention. Scoparia dulcis has been popularly used to relieve discomfort caused by various painful conditions. The objective of the study is to evaluate the analgesic and anti-inflammatory effect of the crude extract of S. dulcis, in an experimental model of osteoarthritis. The experiment was performed with Wistar rats divided into 4 groups with 5 animals each: healthy, saline, crude extract, and meloxicam groups. Knee osteoarthritis was induced by intra-articular injection of sodium mono-iodoacetate. First, clinical parameters of pain were assessed at days 0, 5, 10, 15, and 20 after induction. Second, the potential cyclooxygenase inhibition was evaluated, and the cytokines of the synovial fluid were quantified. An in silico test and Molecular Docking tests were performed. A histopathological evaluation was made on articular cartilage with safranin O staining. The results showed that a 15-day treatment with crude extract reduced edema, spontaneous pain, peripheral nociceptive activity, and proinflammatory cytokines in the synovial fluid. The highest inhibition of cyclooxygenase 2 in the crude extract occurred at 50 µg/mL. The crude extract of S. dulcis presents therapeutic potential for the treatment of osteoarthritis due to its anti-inflammatory and anti-nociceptive action.
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Affiliation(s)
- Marcus Vinícius Viégas Lima
- Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão, São Luís 65080-805, Brazil; (A.d.O.F.); (E.L.F.S.); (A.A.M.V.); (A.J.O.L.); (C.C.V.); (R.N.M.G.L.); (A.P.S.d.A.d.S.); (G.E.B.S.)
- Universidade Ceuma, São Luís 65075-120, Brazil
- Correspondence: (M.V.V.L.); (M.d.S.d.S.C.); (J.B.S.G.); Tel.: +55-(98)-3272-9527 (M.V.V.L.)
| | - Abner de Oliveira Freire
- Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão, São Luís 65080-805, Brazil; (A.d.O.F.); (E.L.F.S.); (A.A.M.V.); (A.J.O.L.); (C.C.V.); (R.N.M.G.L.); (A.P.S.d.A.d.S.); (G.E.B.S.)
| | - Emerson Lucas Frazão Sousa
- Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão, São Luís 65080-805, Brazil; (A.d.O.F.); (E.L.F.S.); (A.A.M.V.); (A.J.O.L.); (C.C.V.); (R.N.M.G.L.); (A.P.S.d.A.d.S.); (G.E.B.S.)
| | - André Alvares Marques Vale
- Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão, São Luís 65080-805, Brazil; (A.d.O.F.); (E.L.F.S.); (A.A.M.V.); (A.J.O.L.); (C.C.V.); (R.N.M.G.L.); (A.P.S.d.A.d.S.); (G.E.B.S.)
| | - Alberto Jorge Oliveira Lopes
- Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão, São Luís 65080-805, Brazil; (A.d.O.F.); (E.L.F.S.); (A.A.M.V.); (A.J.O.L.); (C.C.V.); (R.N.M.G.L.); (A.P.S.d.A.d.S.); (G.E.B.S.)
- Universidade Federal do Maranhão, Coordenação de Ciências Naturais, Campus Bacabal, São Luís 65080-80, Brazil
| | - Cleydlenne Costa Vasconcelos
- Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão, São Luís 65080-805, Brazil; (A.d.O.F.); (E.L.F.S.); (A.A.M.V.); (A.J.O.L.); (C.C.V.); (R.N.M.G.L.); (A.P.S.d.A.d.S.); (G.E.B.S.)
| | - Mônica Virginia Viégas Lima-Aragão
- Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão, São Luís 65080-805, Brazil; (A.d.O.F.); (E.L.F.S.); (A.A.M.V.); (A.J.O.L.); (C.C.V.); (R.N.M.G.L.); (A.P.S.d.A.d.S.); (G.E.B.S.)
| | | | - Rosane Nassar Meireles Guerra Liberio
- Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão, São Luís 65080-805, Brazil; (A.d.O.F.); (E.L.F.S.); (A.A.M.V.); (A.J.O.L.); (C.C.V.); (R.N.M.G.L.); (A.P.S.d.A.d.S.); (G.E.B.S.)
| | - Ana Paula Silva de Azevedo dos Santos
- Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão, São Luís 65080-805, Brazil; (A.d.O.F.); (E.L.F.S.); (A.A.M.V.); (A.J.O.L.); (C.C.V.); (R.N.M.G.L.); (A.P.S.d.A.d.S.); (G.E.B.S.)
| | - Gyl Eanes Barros Silva
- Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão, São Luís 65080-805, Brazil; (A.d.O.F.); (E.L.F.S.); (A.A.M.V.); (A.J.O.L.); (C.C.V.); (R.N.M.G.L.); (A.P.S.d.A.d.S.); (G.E.B.S.)
- Hospital Universitário Presidente Dutra, São Luís 65020-070, Brazil;
| | | | | | - Maria do Socorro de Sousa Cartágenes
- Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão, São Luís 65080-805, Brazil; (A.d.O.F.); (E.L.F.S.); (A.A.M.V.); (A.J.O.L.); (C.C.V.); (R.N.M.G.L.); (A.P.S.d.A.d.S.); (G.E.B.S.)
- Correspondence: (M.V.V.L.); (M.d.S.d.S.C.); (J.B.S.G.); Tel.: +55-(98)-3272-9527 (M.V.V.L.)
| | - João Batista Santos Garcia
- Centro de Ciências Biológicas e da Saúde, Universidade Federal do Maranhão, São Luís 65080-805, Brazil; (A.d.O.F.); (E.L.F.S.); (A.A.M.V.); (A.J.O.L.); (C.C.V.); (R.N.M.G.L.); (A.P.S.d.A.d.S.); (G.E.B.S.)
- Correspondence: (M.V.V.L.); (M.d.S.d.S.C.); (J.B.S.G.); Tel.: +55-(98)-3272-9527 (M.V.V.L.)
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Ai D, Yu F. LncRNA DNM3OS promotes proliferation and inhibits apoptosis through modulating IGF1 expression by sponging MiR-126 in CHON-001 cells. Diagn Pathol 2019; 14:106. [PMID: 31526393 PMCID: PMC6747757 DOI: 10.1186/s13000-019-0877-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 08/23/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND As a degenerative disease, osteoarthritis (OA) greatly affects aged population. The human chondrocyte cell line CHON-001, derived from normal human articular cartilage, has been widely used in vitro in osteoarthritis models. In order to better understand the underlying mechanism of OA pathogenesis, this study was conducted to explore the effects of LncRNA dynamin 3 opposite strand (DNM3OS) on CHON-001 cells. METHODS The expression levels of and correlation between DNM3OS and miR-126 that derived from OA and non-OA tissues were determined by quantitative real time (qRT)-PCR and Spearman's correlation analysis. Cell viability, clone, migration, invasion and apoptosis were respectively determined by cell counting kit-8, colony formation, wound healing assay, transwell and flow cytometry. The target genes were predicted by starbase V2 and targetscan 7.2 and confirmed by luciferase reporter assay. The expressions of apoptosis-related factors were detected by Western blot. RESULTS The expression of DNM3OS was down-regulated in OA patients. Functional assays demonstrated that ectopic expression of DNM3OS promoted the proliferation and inhibited apoptosis of CHON-001 cells, and that knocking down DNM3OS suppressed cell proliferation and induced apoptosis. Mechanistic investigation revealed that DNM3OS physically bound to the promoter of miR-126 and suppressed miR-126 expression. Decreased expression of DNM3OS was negatively correlated with miR-126 in OA patients. Furthermore, the effects of siDNM3OS on inhibiting cell proliferation and promoting apoptosis were partially reversed by miR-126 inhibitor. Meanwhile, type insulin-like growth factor-1 (IGF1) was identified as a target gene for miR-126 and was negatively associated with the miR-126 expression. Overexpressed IGF1 restored the effects of miR-126 mimic in suppressing cell proliferation and promoting apoptosis. CONCLUSION Our results showed that DNM3OS could affect the CHON-001 cell proliferation and apoptosis by regulating IGF1 by sponging miR-126.
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Affiliation(s)
- Di Ai
- Department of Joint Surgery, Beijing Shijitan Hospital, CMU, No. 10 Tieyi Road, Yangfangdian, Haidian District, Beijing, 100038 China
| | - Fang Yu
- Department of Joint Surgery, Beijing Shijitan Hospital, CMU, No. 10 Tieyi Road, Yangfangdian, Haidian District, Beijing, 100038 China
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Lo PC, Lin FC, Tsai YC, Lin SK. Traditional Chinese medicine therapy reduces the risk of total knee replacement in patients with knee osteoarthritis. Medicine (Baltimore) 2019; 98:e15964. [PMID: 31169724 PMCID: PMC6571282 DOI: 10.1097/md.0000000000015964] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Knee osteoarthritis is a degenerative disease occurring in elderly people worldwide. For severe knee osteoarthritis, total knee replacement is the final treatment option. Traditional Chinese medicine (TCM) is popular in Taiwan and has been shown to exert therapeutic effects on knee osteoarthritis. We investigated the long-term clinical effects of TCM for reducing the need for total knee replacement risk in patients with knee osteoarthritis.We used the National Health Insurance Research Database to conduct a retrospective study of patients with knee osteoarthritis between 1997 and 2003 in Taiwan. Data from the date of diagnosis of knee osteoarthritis to total knee replacement were assessed using the Cox regression proportional hazards model, and the Kaplan-Meier survival curve was used to determine the association between total knee replacement risk and TCM use.A total of 34,231 patients with knee osteoarthritis, who were diagnosed by orthopedic or rehabilitation physicians between 1997 and 2003 were included. Patients were categorized into 2 groups: 26,257 (76.7%) were TCM users and 7974 (23.3%) were TCM non-users. The mean follow-up period was 9.26 years. Multivariate regression demonstrated that using TCM may decrease the need for total knee replacement in patients with knee osteoarthritis (adjusted hazards ratio [aHR] = 0.69, 95% confidence interval [95% CI]: 0.64-0.77) compared with TCM non-users. A relationship between longer TCM use and reduced total knee replacement use was observed, especially in patients who used TCM for ≥120 days (aHR = 0.49, 95% CI: 0.42-0.56).The results of this study suggested that TCM is associated with a reduced risk of total knee replacement in patients with knee osteoarthritis, with enhanced benefits from longer durations of TCM use.
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Affiliation(s)
- Pei-Chia Lo
- Institute of Traditional Medicine, School of Medicine, National Yang-Ming University
| | | | - Yao-Chien Tsai
- Department of Chinese Medicine, Taipei City Hospital, Renai Branch
| | - Shun-Ku Lin
- Department of Chinese Medicine, Taipei City Hospital, Renai Branch
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
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Lai CY, Chiang JH, Lin JG, Yen HR, Tu CH, Chen YH. Chinese herbal medicine reduced the risk of stroke in patients with Parkinson's disease: A population-based retrospective cohort study from Taiwan. PLoS One 2018; 13:e0203473. [PMID: 30192890 PMCID: PMC6128574 DOI: 10.1371/journal.pone.0203473] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 08/21/2018] [Indexed: 12/16/2022] Open
Abstract
Parkinson’s disease (PD) is associated with a significantly increased risk of stroke. Traditional Chinese medicine (TCM) has long been used in Asia to treat stroke, but there are no large-scale clinical data to confirm its efficacy in protecting PD patients against stroke. Herein, we analyzed a cohort of 1,000,000 records from Taiwan’s National Health Insurance Research Database for the period 1997–2011, and identified 1,882 patients with new-onset PD. We matched 290 patients who received Chinese herbal medicine (CHM) by age, sex, year of CHM prescription, and year of PD diagnosis with 290 patients who did not use CHM as control. Both cohorts were followed until the end of 2013 for the incidence of new-onset stroke. In a multivariable Cox proportional hazard model adjusted for potential comorbidities, the incidence of stroke was lower among PD patients using CHM compared with non-CHM users (11.10 per 100 person-years vs 23.15 per 100 person-years; Hazard ratio: 0.56; 95% confidence interval: 0.44 to 0.72). The probability curve generated from our follow-up data showed that PD patients receiving CHM treatment had a decreased risk of stroke compared with those not receiving CHM treatment (P <0.001). The analysis on the prescription pattern of CHM revealed that Danshen is the most common single herb and Ma Zi Ren Wan is the most common herbal formula. Although the analysis are limited by a lack of analytic information regarding lifestyle patterns, biochemical profiles, and levels of PD severity in database, this population-based study suggest that CHM may be an complementary therapy to reduce the risk of stroke in PD patients.
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Affiliation(s)
- Ching-Yuan Lai
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Emergency Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Jen-Huan Chiang
- Health Data Management Office, China Medical University Hospital, Taichung, Taiwan
- School of Medicine, China Medical University, Taichung, Taiwan
| | - Jaung-Geng Lin
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
- Research Center for Traditional Chinese Medicine, Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Hung-Rong Yen
- School of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
- Chinese Medicine Research Center, China Medical University, Taichung, Taiwan
| | - Cheng-Hao Tu
- Chinese Medicine Research Center, China Medical University, Taichung, Taiwan
- Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan
- * E-mail: (YHC); (CHT)
| | - Yi-Hung Chen
- Chinese Medicine Research Center, China Medical University, Taichung, Taiwan
- Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan
- Department of Photonics and Communication Engineering, Asia University, Taichung, Taiwan
- * E-mail: (YHC); (CHT)
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Liu ZC, Wang ZL, Huang CY, Fu ZJ, Liu Y, Wei ZC, Liu SG, Ma C, Shen JL, Duan DD. Duhuo Jisheng Decoction inhibits SDF-1-induced inflammation and matrix degradation in human degenerative nucleus pulposus cells in vitro through the CXCR4/NF-κB pathway. Acta Pharmacol Sin 2018; 39:912-922. [PMID: 29795361 DOI: 10.1038/aps.2018.36] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 04/23/2018] [Indexed: 12/14/2022] Open
Abstract
Lower back pain (LBP) is the most common disease in orthopedic clinics world-wide. A classic Fangji of traditional Chinese medicine, Duhuo Jisheng Decoction (DHJSD), has been proven clinically effective for LBP but its therapeutic mechanisms remain unclear. We hypothesized that DHJSD might relieve LBP through inhibiting the exaggerated proinflammatory cytokines and extracellular matrix (ECM) degradation. Thus, we studied the effects of DHJSD on stromal cell-derived factor-1 (SDF-1)-induced inflammation and ECM degradation in human nucleus pulposus cells (hNPCs). The primary hNPCs were isolated from either degenerated human intervertebral disc (HID) of LBP patients or normal HID of lumbar vertebral fracture patients, and cultured in vitro. The cells were treated with SDF-1 (10 ng/mL) and subsequently with different concentrations (100-500 μg/mL) of DHJSD for 24 h, respectively. We found that application of DHJSD significantly antagonized the SDF-1-induced production of proinflammatory cytokines and reduction of aggrecan and type II collagen in the hNPCs. DHJSD also markedly reduced the SDF-1-induced increase of CXCR4 and p-p65 and inhibited the nuclear translocation of p65 in the hNPCs. DHJSD, CXCR4-siRNA, and NF-κB inhibitor (BAY11-7082) caused the same inhibition of exaggerated proinflammatory cytokines in the SDF-1-treated hNPCs. These results provided compelling evidence that DHJSD may inhibit the generation of proinflammatory mediators and ECM degradation of HID through an orchestrated targeting at multiple molecules in the SDF-1/CXCR4/NF-κB pathway, thus offered novel mechanistic insights into the clinical effectiveness of DHJSD on LBP.
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[Shaoyangzhugu Formula regulates p19 Arf-p53-p21 Cip1 signaling pathway to ameliorate cartilage degeneration in aged cynomolgus monkeys with knee osteoarthritis]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2018; 38. [PMID: 29643043 PMCID: PMC6744164 DOI: 10.3969/j.issn.1673-4254.2018.03.17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To study the effect of Shaoyangzhugu (SYZG) Formula (a formula consisting of 9 traditional Chinese drugs) in delaying the degeneration of articular cartilage and the role p19Arf-p53-p21Cip1 signaling pathway in mediating this effect. METHOD Thirteen aged cynomolgus monkeys with degenerative knee joints were selected based on X-ray findings, and one of them was randomly selected for pathological observation. The other monkeys were randomized equally into SYZG Formula group (treated with SYZG decoction), ammonia moxime group and saline group. All the monkeys were sacrificed after 8 weeks of treatment with intragastric administration of the drugs or saline. The pathology in the knee joint articular cartilage was observed and the mRNA and protein expressions of p19Arf, p53, and p21Cip1 in the articular cartilage were detected using RT-qPCR and Western blotting. RESULTS The pathological findings of the articular cartilage in old cynomolgus monkeys were consistent with the characteristics of knee osteoarthritis (KOA). Mankin scores of the cynomolgus monkeys were 7.38∓0.52 in SYZG Formula group, 7.88∓0.83 in ammonia moxime group, and 8.38∓0.74 in saline group, showing a significant difference between SYZG Formula group and saline group (P<0.05). The expressions of p19Arf, p53, and p21Cip1 were the lowest in SYZG Formula group and the highest in saline group with significant differences among the 3 groups (P<0.05). CONCLUSION SYZG Formula can delay chondrocyte senescence by regulating p19Arf-p53-p21Cip1 signaling pathway to delay articular cartilage degeneration in aged cynomolgus monkeys.
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周 鑫, 张 磊, 扶 世, 刘 刚, 郭 晓, 易 刚, 刘 洋, 汪 国. [Shaoyangzhugu Formula regulates p19 Arf-p53-p21 Cip1 signaling pathway to ameliorate cartilage degeneration in aged cynomolgus monkeys with knee osteoarthritis]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2018; 38:346-352. [PMID: 29643043 PMCID: PMC6744164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Indexed: 11/05/2023]
Abstract
OBJECTIVE To study the effect of Shaoyangzhugu (SYZG) Formula (a formula consisting of 9 traditional Chinese drugs) in delaying the degeneration of articular cartilage and the role p19Arf-p53-p21Cip1 signaling pathway in mediating this effect. METHOD Thirteen aged cynomolgus monkeys with degenerative knee joints were selected based on X-ray findings, and one of them was randomly selected for pathological observation. The other monkeys were randomized equally into SYZG Formula group (treated with SYZG decoction), ammonia moxime group and saline group. All the monkeys were sacrificed after 8 weeks of treatment with intragastric administration of the drugs or saline. The pathology in the knee joint articular cartilage was observed and the mRNA and protein expressions of p19Arf, p53, and p21Cip1 in the articular cartilage were detected using RT-qPCR and Western blotting. RESULTS The pathological findings of the articular cartilage in old cynomolgus monkeys were consistent with the characteristics of knee osteoarthritis (KOA). Mankin scores of the cynomolgus monkeys were 7.38∓0.52 in SYZG Formula group, 7.88∓0.83 in ammonia moxime group, and 8.38∓0.74 in saline group, showing a significant difference between SYZG Formula group and saline group (P<0.05). The expressions of p19Arf, p53, and p21Cip1 were the lowest in SYZG Formula group and the highest in saline group with significant differences among the 3 groups (P<0.05). CONCLUSION SYZG Formula can delay chondrocyte senescence by regulating p19Arf-p53-p21Cip1 signaling pathway to delay articular cartilage degeneration in aged cynomolgus monkeys.
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Affiliation(s)
- 鑫 周
- 西南医科大学附属中医医院骨科,四川 泸州 646000Department of Orthopedics, Traditional Chinese Medicine Hospital Affiliated to Southwest Medical University, Luzhou 646000, China
- 泸州市院士工作站,四川 泸州 646000Academician Workstation in Luzhou, Luzhou 646000, China
| | - 磊 张
- 西南医科大学附属中医医院骨科,四川 泸州 646000Department of Orthopedics, Traditional Chinese Medicine Hospital Affiliated to Southwest Medical University, Luzhou 646000, China
- 泸州市院士工作站,四川 泸州 646000Academician Workstation in Luzhou, Luzhou 646000, China
- 南方医科大学 中医药学院,广东 广州 510515School of Traditional Chinese Medicine, Southern Medical University, Guangzhou 510515, China
| | - 世杰 扶
- 西南医科大学附属中医医院骨科,四川 泸州 646000Department of Orthopedics, Traditional Chinese Medicine Hospital Affiliated to Southwest Medical University, Luzhou 646000, China
- 泸州市院士工作站,四川 泸州 646000Academician Workstation in Luzhou, Luzhou 646000, China
| | - 刚 刘
- 西南医科大学附属中医医院骨科,四川 泸州 646000Department of Orthopedics, Traditional Chinese Medicine Hospital Affiliated to Southwest Medical University, Luzhou 646000, China
- 泸州市院士工作站,四川 泸州 646000Academician Workstation in Luzhou, Luzhou 646000, China
| | - 晓光 郭
- 西南医科大学附属中医医院骨科,四川 泸州 646000Department of Orthopedics, Traditional Chinese Medicine Hospital Affiliated to Southwest Medical University, Luzhou 646000, China
- 泸州市院士工作站,四川 泸州 646000Academician Workstation in Luzhou, Luzhou 646000, China
| | - 刚 易
- 西南医科大学附属中医医院骨科,四川 泸州 646000Department of Orthopedics, Traditional Chinese Medicine Hospital Affiliated to Southwest Medical University, Luzhou 646000, China
- 泸州市院士工作站,四川 泸州 646000Academician Workstation in Luzhou, Luzhou 646000, China
| | - 洋 刘
- 西南医科大学附属中医医院骨科,四川 泸州 646000Department of Orthopedics, Traditional Chinese Medicine Hospital Affiliated to Southwest Medical University, Luzhou 646000, China
- 泸州市院士工作站,四川 泸州 646000Academician Workstation in Luzhou, Luzhou 646000, China
| | - 国友 汪
- 西南医科大学附属中医医院骨科,四川 泸州 646000Department of Orthopedics, Traditional Chinese Medicine Hospital Affiliated to Southwest Medical University, Luzhou 646000, China
- 泸州市院士工作站,四川 泸州 646000Academician Workstation in Luzhou, Luzhou 646000, China
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Yang M, Jiang L, Wang Q, Chen H, Xu G. Traditional Chinese medicine for knee osteoarthritis: An overview of systematic review. PLoS One 2017; 12:e0189884. [PMID: 29267324 PMCID: PMC5739454 DOI: 10.1371/journal.pone.0189884] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 12/04/2017] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Traditional Chinese medicine (TCM) has been accepted as a complementary therapy for knee osteoarthritis. However, the efficacy and safety of the intervention were still conflicting and uncertain. Meanwhile, the quality of methodology and evidence in the field was unknown. OBJECTIVE To summarize the characteristics and critically evaluate the quality of methodology, as well as the evidence of systematic reviews (SRs) on TCM for knee osteoarthritis. METHODS Five electronic databases were searched from inception to April 2016. The methodological quality of the included studies was assessed by AMSTAR and ROBIS. The quality of the evidence was determined using the GRADE approach. RESULTS Ten SRs were included. The conclusions suggest that TCM provides potential benefits for patients with knee osteoarthritis. These benefits include pain relief, functional improvement, and presence of few adverse events. Limitations of the methodological quality mainly included the lack of a-priori protocol or protocol registration and incomprehensive literature search. A list of excluded studies was also not provided. The overall quality of evidence in the SRs was poor, ranging from "very low" to "low," mainly because of the serious risk of bias of original trials, inconsistencies, and imprecision in the outcomes. CONCLUSIONS TCM generally appears to be effective for knee osteoarthritis treatment. However, the evidence is not robust enough because of the methodological flaws in SRs. Hence, these conclusions on available SRs should be treated with caution for clinical practice.
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Affiliation(s)
- Min Yang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Li Jiang
- Jingjiang College, Jiangsu University, Zhenjiang, Jiangsu, China
| | - Qing Wang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Hao Chen
- The Second Clinical Medical School, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Guihua Xu
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
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Martel J, Ko YF, Ojcius DM, Lu CC, Chang CJ, Lin CS, Lai HC, Young JD. Immunomodulatory Properties of Plants and Mushrooms. Trends Pharmacol Sci 2017; 38:967-981. [DOI: 10.1016/j.tips.2017.07.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 07/24/2017] [Accepted: 07/27/2017] [Indexed: 01/11/2023]
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Chinese Classical Formula Sijunzi Decoction and Chronic Atrophic Gastritis: Evidence for Treatment Approach? EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2017; 2017:9012929. [PMID: 29138645 PMCID: PMC5613649 DOI: 10.1155/2017/9012929] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 07/26/2017] [Indexed: 12/19/2022]
Abstract
Objective This aim is to evaluate the effect of Sijunzi decoction (SJZD) treating chronic atrophic gastritis (CAG). Methods We performed searches in seven databases. The randomized controlled trials (RCTs) comparing SJZD with standard medical care or inactive intervention for CAG were enrolled. Combined therapy of SJZD plus conventional therapies compared with conventional therapies alone was also retrieved. The primary outcome included the incidence of gastric cancer and the improvement of atrophy, intestinal metaplasia, and dysplasia based on the gastroscopy and pathology. The secondary outcomes were Helicobacter pylori clearance rate, quality of life, and adverse event/adverse drug reaction. Results Six RCTs met the inclusion criteria. The research quality was low in the trials. For the overall effect rate, pooled analysis from 4 trials showed that modified SJZD plus conventional medications exhibited a significant improvement (OR = 4.86; 95% CI: 2.80 to 8.44; P < 0.00001) and without significant heterogeneity compared with the conventional medications alone. None reported the adverse effect. Conclusions Modified SJZD combined with conventional western medicines appears to have benefits for CAG. Due to the limited number and methodological flaw, the beneficial and harmful effects of SJZD for CAG could not be identified. More high-quality clinical trials are needed to confirm the results.
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Chen N, Wang J, Mucelli A, Zhang X, Wang C. Electro-Acupuncture is Beneficial for Knee Osteoarthritis: The Evidence from Meta-Analysis of Randomized Controlled Trials. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2017; 45:965-985. [DOI: 10.1142/s0192415x17500513] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Knee osteoarthritis (KOA) is a common chronic degenerative disease of the elderly. Electro-acupuncture (EA) is considered as a beneficial treatment for KOA, but the conclusion is controversial. This systematic review compiled the evidence from 11 randomized controlled trials to objectively assess the effectiveness and safety of EA for KOA. Eight databases including PubMed, Cochrane Library, Clinic trials, Foreign Medical Literature Retrial Service (FMRS), Science Direct, China National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), and Wanfang Data were extensively searched up to 5 July 2016. The outcomes included the evaluation of effectiveness, pain and physical function. Risk of bias was evaluated according to the Cochrane risk of bias tool. Eleven RCTs with 695 participants were included. Meta-analysis indicated that EA was more effective than pharmacological treatment (RR [Formula: see text] 1.14; 95% CI [Formula: see text] 1.01,1.28; [Formula: see text]) and manual acupuncture (RR [Formula: see text] 1.12; 95% CI [Formula: see text] 1.02,1.22; [Formula: see text]). Also, EA had a more significant effect in reducing the pain intensity (SMD [Formula: see text]; 95% CI [Formula: see text]; [Formula: see text]) and improving the physical function in the perspective of WOMAC (MD [Formula: see text]; 95% CI [Formula: see text], 5.56; [Formula: see text]) and LKSS (pharmacological treatment: MD [Formula: see text]; 95% CI [Formula: see text], 6.64; [Formula: see text]). Furthermore, these studies implied that EA should be performed for at least 4 weeks. Conclusively, the results indicate that EA is a great opportunity to remarkably alleviate the pain and improve the physical function of KOA patients with a low risk of adverse reaction. Therefore, more high quality RCTs with rigorous methods of design, measurement and evaluation are needed to confirm the long-term effects of EA for KOA.
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Affiliation(s)
- Na Chen
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing 210023, P. R. China
| | - Jing Wang
- The First Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing 210023, P. R. China
| | - Attilio Mucelli
- School of Economics “Giorgio Fuà”, Polytechnic University of Marche, Ancona 60121, Italy
| | - Xu Zhang
- Jiangsu Collaborative Innovation Center of Traditional, Chinese Medicine Prevention and Treatment of Tumor, Nanjing 210023, P. R. China
| | - Changqing Wang
- School of Health Economics and Management, Nanjing University of Chinese Medicine, Nanjing 210023, P. R. China
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Xu XX, Zhang XH, Diao Y, Huang YX. Achyranthes bidentate saponins protect rat articular chondrocytes against interleukin-1β-induced inflammation and apoptosis in vitro. Kaohsiung J Med Sci 2017; 33:62-68. [DOI: 10.1016/j.kjms.2016.11.004] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Revised: 11/02/2016] [Accepted: 11/16/2016] [Indexed: 12/18/2022] Open
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Li JY, Jia YS, Chai LM, Mu XH, Ma S, Xu L, Wei X. Effects of Chinese herbal formula Erxian decoction for treating osteoporosis: a systematic review. Clin Interv Aging 2017; 12:45-53. [PMID: 28115834 PMCID: PMC5221555 DOI: 10.2147/cia.s117597] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Affiliation(s)
- Jin-Yu Li
- Department of Orthopaedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Yu-Song Jia
- Department of Orthopaedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Li-Min Chai
- Department of Orthopaedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Xiao-Hong Mu
- Department of Orthopaedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Sheng Ma
- Department of Orthopaedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Lin Xu
- Department of Orthopaedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
- Correspondence: Lin Xu, Department of Orthopaedics, Dongzhimen Hospital, Beijing University of Chinese Medicine, No 5 Haiyuncang Street, Dongcheng District, Beijing 100700, People’s Republic of China, Tel +86 10 8401 5571, Email
| | - Xu Wei
- Department of Scientific Research, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
- Xu Wei, Department of Scientific Research, Wangjing Hospital, China Academy of Chinese Medical Sciences, Huajiadi Street, Chaoyang District, Beijing 100102, People’s Republic of China, Tel +86 13 4887 16557, Email
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