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Sum CH, Ching J, Zhang H, Loo S, Lo CW, Lai MK, Cheong PK, Yu CL, Lin ZX. Integrated Chinese and western medicine interventions for atopic dermatitis: a systematic review and meta-analysis. Chin Med 2021; 16:101. [PMID: 34629103 PMCID: PMC8504066 DOI: 10.1186/s13020-021-00506-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/17/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Atopic dermatitis (AD) is a chronic relapsing skin disease characterized by recurring episodes of itchiness with skin erythema and surface damages. Chinese medicine (CM) is widely used for the management of AD in China not only by its own, but also used in combination with conventional therapy (integrated Chinese-Western medicine, ICWM). Although many clinical trials on the effectiveness of ICWM on AD have been conducted, however, up to date, no sound evidence has been established on the clinical effectiveness and safety of ICWM for AD. OBJECTIVES To systematically review the currently available clinical evidence on the clinical effectiveness and safety of ICWM for AD. METHODS Randomised and quasi-randomised controlled trials, which investigated ICWM interventions with at least one control group using the same conventional interventions, no treatment or placebo treatment, were included. Four English (CENTRAL, MEDLINE, EMBASE, AMED) and three Chinese (CNKI, CBM, WanFang Med) databases were searched. Risk of bias was assessed according to the Cochrane's tool. Meta-analysis was performed to pool the data. RESULTS From 1473 entries, 55 studies were included, involving 5953 participants aged between 35 days and 67 years old. Duration of treatment ranged from 1 to 24 weeks. Only 2 studies were judged to have low risk of bias, 3 studies had unclear risk of bias, and the other 50 studies were with high risk of bias. ICWM was found to be superior over WM alone in improving clinical severity of AD (measured by EASI, SCORAD), health-related quality of life (measured by CDLQI, DLQI), long term control of AD (recurrence rate), patients/investigator global score (clinical effectiveness rate), and serum IgE level. Adverse events associated with ICWM were found to be comparable with WM alone. CONCLUSION ICWM seems to produce superior treatment response than WM alone in managing AD without increased risk of adverse events. However, the current available evidence remains too weak to make a conclusive decision.
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Affiliation(s)
- Chi Him Sum
- Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China
| | - Jessica Ching
- Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China
| | - Hongwei Zhang
- Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China
| | - Steven Loo
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China
| | - Cho Wing Lo
- Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China
| | - Mei Kwan Lai
- Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China
| | - Pui Kuan Cheong
- Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China
| | - Chau Leung Yu
- Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China
| | - Zhi-Xiu Lin
- Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China.
- School of Chinese Medicine, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, China.
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Therapeutic Effects of Chinese Herbal Formula (PTQX) on NC/Nga Mice with Atopic Dermatitis-Like Skin Lesions. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:8359252. [PMID: 31885666 PMCID: PMC6925805 DOI: 10.1155/2019/8359252] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 08/04/2019] [Indexed: 11/18/2022]
Abstract
Atopic dermatitis (AD), also known as atopic eczema, is a chronic pruritic inflammatory skin disease. The available systemic therapies for atopic dermatitis are inadequate. Objective. This study aimed to evaluate the effects of the Chinese herbal formula Pei Tu Qing Xin (PTQX) on dermatitis severity and ear swelling, immunomodulation, and the infiltration of mast cells in a mouse model of 1-chloro-2,4-dinitrobenzene- (DNCB-) induced AD. Methods. AD-like symptoms were induced by DNCB in NC/Nga mice. Skin lesions, dermatitis, ear swelling, and scratching behaviour were evaluated. Changes in the T-helper type 1 (Th1), Th2, Th17, and regulatory T (Treg) subtypes and immunoregulation in the spleen and lymph nodes were detected by flow cytometry. Results. Histopathological and immunohistochemical analyses demonstrated that PTQX decreased the DNCB-mediated induction of mast cells and infiltration of inflammatory cells in the ear and dorsal skin. PTQX also reduced the DNCB-induced increase in the serum immunoglobulin E level, pruritus, and dermatitis (red, flaky areas) on the dorsal skin. Furthermore, PTQX regulated the balance between the populations of Th1, Th2, Th17, and Treg cells (particularly the latter two) in the lymph nodes. Conclusions. Our results suggest that the Chinese herbal formula PTQX can alleviate symptoms of AD, such as epithelial damage, redness, swelling, and pruritus, and potentially be used to treat this condition.
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Gu SX, Mo X, Zhang AL, Liu J, Coyle ME, Ye S, Wen Z, Cranswick NE, Xue CC, Chen D. A Chinese herbal medicine preparation (Pei Tu Qing Xin) for children with moderate-to-severe atopic eczema: a pilot randomized controlled trial. Br J Dermatol 2018; 179:1404-1405. [PMID: 29981274 DOI: 10.1111/bjd.16988] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Affiliation(s)
- S X Gu
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - X Mo
- Department of Dermatology, Guangdong Provincial Hospital of Chinese Medicine, 111 Dade Road, Guangzhou, Guangdong, 51012, China
| | - A L Zhang
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - J Liu
- Department of Dermatology, Guangdong Provincial Hospital of Chinese Medicine, 111 Dade Road, Guangzhou, Guangdong, 51012, China
| | - M E Coyle
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia
| | - S Ye
- Department of Dermatology, Guangdong Provincial Hospital of Chinese Medicine, 111 Dade Road, Guangzhou, Guangdong, 51012, China
| | - Z Wen
- Key Unit of Methodology in Clinical Research, Guangdong Provincial Hospital of Chinese Medicine, 111 Dade Road, Guangzhou, Guangdong, 51012, China
| | - N E Cranswick
- The Royal Children's Hospital, Murdoch Children's Research Institute, The University of Melbourne, Melbourne, Victoria, Australia
| | - C C Xue
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Victoria, Australia.,The Guangdong Provincial Academy of Chinese Medical Sciences, Guangdong, China
| | - D Chen
- Department of Dermatology, Guangdong Provincial Hospital of Chinese Medicine, 111 Dade Road, Guangzhou, Guangdong, 51012, China.,The Guangdong Provincial Academy of Chinese Medical Sciences, Guangdong, China
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DSGOST inhibits tumor growth by blocking VEGF/VEGFR2-activated angiogenesis. Oncotarget 2017; 7:21775-85. [PMID: 26967562 PMCID: PMC5008322 DOI: 10.18632/oncotarget.7982] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 02/16/2016] [Indexed: 01/11/2023] Open
Abstract
Tumor growth requires a process called angiogenesis, a new blood vessel formation from pre-existing vessels, as newly formed vessels provide tumor cells with oxygen and nutrition. Danggui-Sayuk-Ga-Osuyu-Saenggang-Tang (DSGOST), one of traditional Chinese medicines, has been widely used in treatment of vessel diseases including Raynaud's syndrome in Northeast Asian countries including China, Japan and Korea. Therefore, we hypothesized that DSGOST might inhibit tumor growth by targeting newly formed vessels on the basis of its historical prescription. Here, we demonstrate that DSGOST inhibits tumor growth by inhibiting VEGF-induced angiogenesis. DSGOST inhibited VEGF-induced angiogenic abilities of endothelial cells in vitro and in vivo, which resulted from its inhibition of VEGF/VEGFR2 interaction. Furthermore, DSGOST attenuated pancreatic tumor growth in vivo by reducing angiogenic vessel numbers, while not affecting pancreatic tumor cell viability. Thus, our data conclude that DSGOST inhibits VEGF-induced tumor angiogenesis, suggesting a new indication for DSGOST in treatment of cancer.
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Ma L, Li P, Tang J, Guo Y, Shen C, Chang J, Kerrouche N. Prolonging Time to Flare in Pediatric Atopic Dermatitis: A Randomized, Investigator-Blinded, Controlled, Multicenter Clinical Study of a Ceramide-Containing Moisturizer. Adv Ther 2017; 34:2601-2611. [PMID: 29143926 DOI: 10.1007/s12325-017-0640-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Delaying or preventing flares is important in atopic dermatitis (AD) management. The objective of the study was to evaluate whether using a ceramide-containing moisturizer in addition to a body wash during latent AD can delay flares. METHODS This was a randomized, investigator-blinded, parallel-group, controlled study among Chinese children with a history of mild to moderate AD, within 1 week of successful treatment with a topical corticosteroid. Subjects were randomized to receive moisturizer twice daily and body wash once daily, or body wash alone once daily for 12 weeks. The primary efficacy endpoint was time to flare [necessitating medical therapy and/or Investigator Global Assessment (IGA) > 1 (at least mild AD)]. Other efficacy endpoints were AD characteristics and emollient effects. The patient-reported outcome comprised satisfaction at week 12. The safety endpoint was incidence of undesirable events. RESULTS A total of 64 subjects aged 2-12 years were randomized. Median time to flare was delayed by nearly 2 months for moisturizer/body wash compared to body wash alone (89 vs. 27 days, respectively). A significantly earlier onset of action in terms of fewer flares favoring moisturizer was found at week 4 (31 vs. 59%, respectively, p = 0.022), and after 12 weeks, fewer flares occurred (50 vs. 72%). At week 12 for flare-free subjects, nearly half in both groups had clear IGA, and an emollient effect in terms of less dryness or burning was more marked for moisturizer/body wash. Both products led to high patient satisfaction and were well tolerated. CONCLUSION A regimen incorporating a moisturizer plus body wash delayed AD flares by nearly 2 months compared to body wash alone, and yielded high patient satisfaction. FUNDING Galderma R&D. TRIAL REGISTRATION ClinicalTrials.gov identifier, NCT02589392.
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Affiliation(s)
- Lin Ma
- Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
| | - Ping Li
- Department of Dermatology, Shenzhen Children's Hospital, Shenzhen, Guangdong Province, China
| | - Jianping Tang
- Department of Dermatology, Hunan Children's Hospital, Hunan, China
| | - Yifeng Guo
- Department of Dermatology, XinHua Hospital, Shanghai, China
| | - Chunping Shen
- Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China
| | - Jing Chang
- Department of Dermatology, Hunan Children's Hospital, Hunan, China
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