1
|
Xue K, Wang X, Xiao C, Zhang N, Liu M, Fu J, Cui J. Clinical Efficacy and Safety of a Modified Moxibustion Therapy for Low Back Pain in Lumbar Disc Herniation: A Two-Center, Randomized, Controlled, Non-Inferiority Trial. J Pain Res 2024; 17:1853-1865. [PMID: 38803694 PMCID: PMC11129762 DOI: 10.2147/jpr.s457724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 05/08/2024] [Indexed: 05/29/2024] Open
Abstract
Objective Our pilot study shows that a modified moxibustion therapy called Ma's bamboo-based medicinal moxibustion can alleviate the symptoms of low back pain in lumbar disc herniation (LDH), and has the potential to treat LDH. The aim of this study is to evaluate the efficacy and safety of Ma's bamboo-based medicinal moxibustion for low back pain in LDH. Methods A total of 312 LDH patients with low back pain were randomized to receive Ma's bamboo-based medicinal moxibustion (MBMM) or acupuncture (AT). The primary efficacy measure was the change of Visual Analogue Scale (VAS) on the 14th day compared with that at baseline. The secondary efficacy measures included VAS score, Oswestry disability index (ODI), modified Japanese Orthopaedic Association (M-JOA) score, and the content of β-endorphin (β-EP) and substance-P (SP). The safety measures included the occurrence of adverse events and the changes in laboratory indicators. Results In total, 304 patients were incorporated for the analysis of efficacy, including 96 males and 208 females, aged 21-65 years. There was no statistically significant difference in the change of VAS score between the two groups on the 14th day [mean difference (95% CI) = -2.31 (-2.48, -2.13) and -2.28 (-2.45, -2.11), respectively; p = 0.819]. The VAS, ODI, and M-JOA scores changed after the intervention in both groups (p <0.001), with increased β-EP content (p = 0.014, p = 0.032) and decreased SP content (p <0.001, p = 0.048). The ODI score (p = 0.039) and M-JOA score (p = 0.032) of the MBMM group on the 28th day were lower than those of the AT group. Conclusion The efficacy of Ma's bamboo-based medicinal moxibustion therapy in relieving low back pain of LDH patients is comparable to that of acupuncture, and it has post-effect advantages in improving lumbar dysfunction and daily living ability, which can be used as a safe and effective alternative method for LDH treatment.
Collapse
Affiliation(s)
- Kaiyang Xue
- College of Acupuncture and Massage, Guizhou University of Traditional Chinese Medicine, Guiyang, 550002, People’s Republic of China
| | - Xianzhu Wang
- College of Acupuncture and Massage, Guizhou University of Traditional Chinese Medicine, Guiyang, 550002, People’s Republic of China
| | - Caihong Xiao
- Department of Acupuncture and Moxibustion, No.1 Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, 550001, People’s Republic of China
| | - Ning Zhang
- College of Acupuncture and Massage, Guizhou University of Traditional Chinese Medicine, Guiyang, 550002, People’s Republic of China
| | - Minghui Liu
- Department of Acupuncture and Moxibustion, No.2 Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, 550001, People’s Republic of China
| | - Jing Fu
- College of Acupuncture and Massage, Guizhou University of Traditional Chinese Medicine, Guiyang, 550002, People’s Republic of China
| | - Jin Cui
- College of Acupuncture and Massage, Guizhou University of Traditional Chinese Medicine, Guiyang, 550002, People’s Republic of China
| |
Collapse
|
2
|
Hu Y, Yang R, Liu S, Song Z, Wang H. The Emerging Roles of Nanocarrier Drug Delivery System in Treatment of Intervertebral Disc Degeneration-Current Knowledge, Hot Spots, Challenges and Future Perspectives. Drug Des Devel Ther 2024; 18:1007-1022. [PMID: 38567254 PMCID: PMC10986407 DOI: 10.2147/dddt.s448807] [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] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 03/09/2024] [Indexed: 04/04/2024] Open
Abstract
Low back pain (LBP) is a common condition that has substantial consequences on individuals and society, both socially and economically. The primary contributor to LBP is often identified as intervertebral disc degeneration (IVDD), which worsens and leads to significant spinal problems. The conventional treatment approach for IVDD involves physiotherapy, drug therapy for pain management, and, in severe cases, surgery. However, none of these treatments address the underlying cause of the condition, meaning that they cannot fundamentally reverse IVDD or restore the mechanical function of the spine. Nanotechnology and regenerative medicine have made significant advancements in the field of healthcare, particularly in the area of nanodrug delivery systems (NDDSs). These approaches have demonstrated significant potential in enhancing the efficacy of IVDD treatments by providing benefits such as high biocompatibility, biodegradability, precise drug delivery to targeted areas, prolonged drug release, and improved therapeutic results. The advancements in different NDDSs designed for delivering various genes, cells, proteins and therapeutic drugs have opened up new opportunities for effectively addressing IVDD. This comprehensive review provides a consolidated overview of the recent advancements in the use of NDDSs for the treatment of IVDD. It emphasizes the potential of these systems in overcoming the challenges associated with this condition. Meanwhile, the insights and ideas presented in this review aim to contribute to the advancement of precise IVDD treatment using NDDSs.
Collapse
Affiliation(s)
- Yunxiang Hu
- Department of Orthopedics, Central Hospital of Dalian University of Technology, Dalian City, Liaoning Province, People’s Republic of China
- School of Graduates, Dalian Medical University, Dalian City, Liaoning Province, People’s Republic of China
| | - Rui Yang
- Department of Orthopedics, Central Hospital of Dalian University of Technology, Dalian City, Liaoning Province, People’s Republic of China
- School of Graduates, Dalian Medical University, Dalian City, Liaoning Province, People’s Republic of China
| | - Sanmao Liu
- Department of Orthopedics, Central Hospital of Dalian University of Technology, Dalian City, Liaoning Province, People’s Republic of China
- School of Graduates, Dalian Medical University, Dalian City, Liaoning Province, People’s Republic of China
| | - Zefeng Song
- School of Graduates, Dalian University of Technology, Dalian City, Liaoning Province, People’s Republic of China
| | - Hong Wang
- Department of Orthopedics, Central Hospital of Dalian University of Technology, Dalian City, Liaoning Province, People’s Republic of China
- School of Graduates, Dalian Medical University, Dalian City, Liaoning Province, People’s Republic of China
| |
Collapse
|
3
|
Shah MR, Khan SN, Fatima S, Yao L, Yuan H, Ullah S, Ainuddin J, Zeng C, Zheng Y, Sahar N, Anwar S, Zhu M, Ma C, Kumari K, Wang W, Liu R. A randomized, double-blind, positive-controlled, Phase-II clinical trial to evaluate efficacy and safety of Fuke Qianjin capsule in Pakistani patients with pelvic inflammatory disease. Front Pharmacol 2024; 15:1287321. [PMID: 38584600 PMCID: PMC10995302 DOI: 10.3389/fphar.2024.1287321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 02/27/2024] [Indexed: 04/09/2024] Open
Abstract
Ethnopharmacological relevance: Pelvic inflammatory disease (PID) is a frequently occurring gynecological disorder mainly caused by the inflammation of a woman's upper genital tract. Generally, antibiotics are used for treating PID, but prolonged use poses potential risks of gut bacterial imbalance, bacterial resistance, super bacteria production, and associated adverse reactions. Traditional Chinese medicine (TCM) has shown unique advantages in various ailments and has received widespread clinical research attention. Fuke Qianjin (FUKE) capsule is an approved National Medical Products Administration (NMPA License No. Z20020024) Chinese herbal prescription that has been widely used individually or in combination with other Western medicines for the treatment of various gynecological inflammatory diseases, including chronic cervicitis, endometritis, and chronic PID. Aim: This clinical trial was designed to assess the safety and efficacy of FUKE capsule in mild-to-moderate symptomatic PID patients. Materials and methods: This phase 2, randomized, double-blind, positive controlled clinical trial was conducted in mild-to-moderate symptomatic PID patients at a single center in Pakistan from 21 September 2021 to 11 March 2022. Eligible female participants were randomly assigned to a test and a control group with a ratio of 1:1. The test group subjects received two metronidazole (METRO) tablets and one doxycycline hyclate (DOXY) simulant at a time, twice daily for 14 days, and two Fuke Qianjin (FUKE) capsules, three times a day after a meal for 28 days. Subjects in the control group received two METRO tablets and one DOXY tablet at a time, twice daily for 14 days, and two FUKE simulant capsules, three times a day after meal for 28 days. The primary efficacy outcome was an improvement in pelvic pain symptoms assessed through a visual analog scale (VAS). The secondary outcomes were the improvement in secondary efficacy symptoms like local physical signs, clinical assessment of leucorrhea and cervical secretions through laboratory examination, and improvement in the maximum area of pelvic effusion assessed through gynecological ultrasound after the treatment. The safety outcomes were assessed through vital signs, laboratory tests, electrocardiogram findings, and adverse events/serious adverse events. Results: A total of 198 subjects with active PID were randomly assigned to a test group (n = 99) and a control group (n = 99). The baseline characteristics of the subjects in the two groups were similar. In the intention-to-treat analysis, the primary efficacy was 84.9% for the test group and 71.6% for the control group, with a statistically significant difference (p = 0.0370; 95% CI -0.2568 to -0.0088). The secondary clinical efficacy was 88.4% for the test group and 82.7% for the control group, with no significant difference (p = 0.2977; 95% CI -0.1632 to 0.0501). The improvement in local physical signs was 95.8% for the test group and 76.9% for the control group, with no significant difference (p = 0.0542; 95% CI -0.3697 to -0.0085). The inter-group non-inferiority comparison showed that the upper limit of the 95% CI was less than 0.15 and thus met the non-inferiority requirements of the test group to the control group. The results of clinical signs of leucorrhea and cervical secretions showed that there was no difference in the rate of improvement between the test and control groups, indicating that FUKE was non-inferior to DOXY. A total of 14 adverse events in eight subjects were observed in the trial, with an incidence rate of 4.7%. Four subjects in each group experienced seven adverse events with 4.5% and 4.8% incidence rates of adverse reactions in the test and control groups, with no statistically significant differences (p = 0.2001). No serious adverse events occurred in the trial. Conclusion: The results of this trial indicate that the test drug (Fuke Qianjin capsule) is non-inferior to the control drug (doxycycline hyclate tablet) in treating mild-to-moderate PID patients with comparable efficacy, safety, and tolerability to the control drug. Clinical Trial Registration: www.clinicaltrials.gov, identifier NCT04723069.
Collapse
Affiliation(s)
- Muhammad Raza Shah
- Center for Bioequivalence Studies and Clinical Research, Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
| | - Sehrosh Naz Khan
- Center for Bioequivalence Studies and Clinical Research, Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
| | - Samreen Fatima
- Center for Bioequivalence Studies and Clinical Research, Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
| | - Liangyuan Yao
- Qianjin Research Institute, Zhuzhou Qianjin Pharmaceutical Co., Ltd., Zhuzhou, China
| | - Hongbo Yuan
- Qianjin Research Institute, Zhuzhou Qianjin Pharmaceutical Co., Ltd., Zhuzhou, China
| | - Shafi Ullah
- Center for Bioequivalence Studies and Clinical Research, Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
| | - Jahanara Ainuddin
- Obstetrics and Gynecology Department, Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Changqing Zeng
- Qianjin Research Institute, Zhuzhou Qianjin Pharmaceutical Co., Ltd., Zhuzhou, China
| | - Yiyang Zheng
- Qianjin Research Institute, Zhuzhou Qianjin Pharmaceutical Co., Ltd., Zhuzhou, China
| | | | | | - Meijun Zhu
- Qianjin Research Institute, Zhuzhou Qianjin Pharmaceutical Co., Ltd., Zhuzhou, China
| | - Cun Ma
- Qianjin Research Institute, Zhuzhou Qianjin Pharmaceutical Co., Ltd., Zhuzhou, China
| | | | - Wei Wang
- Center for Bioequivalence Studies and Clinical Research, Dr. Panjwani Center for Molecular Medicine and Drug Research, International Center for Chemical and Biological Sciences, University of Karachi, Karachi, Pakistan
- TCM and Ethnomedicine Innovation & Development International Laboratory, Innovative Materia Medica Research Institute, School of Pharmacy, Hunan University of Chinese Medicine, Changsha, China
| | - Ruihuan Liu
- Qianjin Research Institute, Zhuzhou Qianjin Pharmaceutical Co., Ltd., Zhuzhou, China
| |
Collapse
|
4
|
Qin X, Sun K, Xu W, Gao J, Jiang H, Chen W, Zhang L, Li Z, Li W, Yuan P, Yang K, Tong P, Zhong Y, Zhu X, Wan X, He C, Wang Y, Xu X, Huang Y, Zhang Z, Huang Y, Guo W, Cao J, Feng T, Wang X, Yin Y, Wang H, Sun C, Xiao X, Wei X, Zhu L. An evidence-based guideline on treating lumbar disc herniation with traditional Chinese medicine. J Evid Based Med 2024; 17:187-206. [PMID: 38502879 DOI: 10.1111/jebm.12598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 02/29/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Lumbar disc herniation (LDH), as one of the most common causes of lower back pain, imposes a heavy economic burden on patients and society. Conservative management is the first-line choice for the majority of LDH patients. Traditional Chinese medicine (TCM) is an important part of conservative treatment and has attracted more and more international attention. STUDY DESIGN Evidence-based guideline. METHODS We formed a guideline panel of multidisciplinary experts. The clinical questions were identified on the basis of a systematic literature search and a consensus meeting. We searched the literature for direct evidence on the management of LDH and assessed its certainty-generated recommendations using the grading of recommendations, assessment, development, and evaluation (GRADE) approach. RESULTS The guideline panel made 20 recommendations, which covered the use of Shentong Zhuyu decoction, Shenzhuo decoction, Simiao San decoction, Duhuo Jisheng decoction, Yaobitong capsule, Yaotongning capsule, Osteoking, manual therapy, needle knife, manual acupuncture, electroacupuncture, Chinese exercise techniques (Tai Chi, Baduanjin, or Yijinjing), and integrative medicine, such as combined non-steroidal anti-inflammatory drugs, neural nutrition, and traction. Recommendations were either strong or weak, or in the form of ungraded consensus-based statement. CONCLUSION This is the first LDH treatment guideline for TCM and integrative medicine with a systematic search, synthesis of evidence, and using the GRADE method to rate the quality of evidence. We hope these recommendations can help support healthcare workers caring for LDH patients.
Collapse
Affiliation(s)
- Xiaokuan Qin
- Department of Spine II, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Kai Sun
- Department of Spine II, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Weiguo Xu
- Department of Orthopaedics, Tianjin Hospital, Tianjin, China
| | - Jinghua Gao
- Department of Spine II, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hong Jiang
- Department of Orthopaedics, Suzhou Hospital of Traditional Chinese Medicine, Suzhou, China
| | - Wei Chen
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Ling Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Zhenhua Li
- Department of Orthopaedics, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, China
| | - Wuyin Li
- Department of Orthopaedics, Luoyang Orthopedic Hospital of Henan Province, Luoyang, China
| | - Puwei Yuan
- Department of Orthopedics, Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang, China
| | - Kexin Yang
- Department of Spine II, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Peijian Tong
- Institute of Orthopaedics and Traumatology, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Yuanming Zhong
- Department of Orthopaedic Spine, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, China
| | - Xiaofeng Zhu
- Department of Chinese Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Xiaoming Wan
- Department of Orthopaedics, The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Chengjian He
- Department of Orthopedics, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
| | - Yanguo Wang
- Department of Massage and Rehabilitation, Second Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Xilin Xu
- Department of Orthopaedics, The Third Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yong Huang
- Department of Orthopedics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zhihai Zhang
- Department of Orthopaedics, Guang'an Men Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yifei Huang
- Department of Spine, The Fourth Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Wei Guo
- TCM Manipulative Orthopaedics Therapy Department Ward, Air Force Medical Center, Beijing, China
| | - Junling Cao
- Department of Pharmacy, Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, China
| | - Tianxiao Feng
- Department of Spine II, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Graduate School, Beijing University of Chinese Medicine, Beijing, China
| | - Xu Wang
- Academic Development Office, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuhui Yin
- Department of Spine II, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hao Wang
- Academic Development Office, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Chuanrui Sun
- Academic Development Office, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiangyu Xiao
- Academic Development Office, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xu Wei
- Academic Development Office, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Liguo Zhu
- Department of Spine II, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| |
Collapse
|
5
|
Li S, Du J, Huang Y, Gao S, Zhao Z, Chang Z, Zhang X, He B. From hyperglycemia to intervertebral disc damage: exploring diabetic-induced disc degeneration. Front Immunol 2024; 15:1355503. [PMID: 38444852 PMCID: PMC10912372 DOI: 10.3389/fimmu.2024.1355503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Accepted: 02/05/2024] [Indexed: 03/07/2024] Open
Abstract
The incidence of lumbar disc herniation has gradually increased in recent years, and most patients have symptoms of low back pain and nerve compression, which brings a heavy burden to patients and society alike. Although the causes of disc herniation are complex, intervertebral disc degeneration (IDD) is considered to be the most common factor. The intervertebral disc (IVD) is composed of the upper and lower cartilage endplates, nucleus pulposus, and annulus fibrosus. Aging, abnormal mechanical stress load, and metabolic disorders can exacerbate the progression of IDD. Among them, high glucose and high-fat diets (HFD) can lead to fat accumulation, abnormal glucose metabolism, and inflammation, which are considered important factors affecting the homeostasis of IDD. Diabetes and advanced glycation end products (AGEs) accumulation- can lead to various adverse effects on the IVD, including cell senescence, apoptosis, pyroptosis, proliferation, and Extracellular matrix (ECM) degradation. While current research provides a fundamental basis for the treatment of high glucose-induced IDD patients. further exploration into the mechanisms of abnormal glucose metabolism affecting IDD and in the development of targeted drugs will provide the foundation for the effective treatment of these patients. We aimed to systematically review studies regarding the effects of hyperglycemia on the progress of IDD.
Collapse
Affiliation(s)
- Shuai Li
- Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Youyidong Road, Xi’an, Shaanxi, China
- Medical College, Yan’an University, Yan’an, Shaanxi, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi’an, Shaanxi, China
| | - Jinpeng Du
- Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Youyidong Road, Xi’an, Shaanxi, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi’an, Shaanxi, China
| | - Yunfei Huang
- Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Youyidong Road, Xi’an, Shaanxi, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi’an, Shaanxi, China
| | - Shenglong Gao
- Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Youyidong Road, Xi’an, Shaanxi, China
- Medical College, Yan’an University, Yan’an, Shaanxi, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi’an, Shaanxi, China
| | - Zhigang Zhao
- Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Youyidong Road, Xi’an, Shaanxi, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi’an, Shaanxi, China
| | - Zhen Chang
- Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Youyidong Road, Xi’an, Shaanxi, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi’an, Shaanxi, China
| | - Xuefang Zhang
- Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Youyidong Road, Xi’an, Shaanxi, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi’an, Shaanxi, China
| | - BaoRong He
- Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Youyidong Road, Xi’an, Shaanxi, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi’an, Shaanxi, China
| |
Collapse
|
6
|
Gao S, Wang C, Qi L, Liang S, Qu X, Liu W, Li N. Bushen Huoxue Formula Inhibits IL-1β-Induced Apoptosis and Extracellular Matrix Degradation in the Nucleus Pulposus Cells and Improves Intervertebral Disc Degeneration in Rats. J Inflamm Res 2024; 17:121-136. [PMID: 38204990 PMCID: PMC10777862 DOI: 10.2147/jir.s431609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 12/27/2023] [Indexed: 01/12/2024] Open
Abstract
Background The method of action of Bushen Formula (BSHXF) in the treatment of intervertebral disc degeneration (IVDD) was uncovered in this work using in vivo and in vitro tests. To clarify the mechanism of action of BSHXF, we validated the rat intervertebral disc degeneration model and the nucleus pulposus cell degeneration model. Methods In an in vivo model of IVDD the study explores the impact of BSHXF on mitochondrial function, pro-inflammatory cytokines, pro-apoptotic factors, and matrix metalloproteinases. Additionally, it evaluates the induced degeneration of nucleus pulposus (NP) cells in an in vitro model stimulated by interleukin-1 β (IL-1β). The study measures the effects of BSHXF on both the inflammatory response and mitochondrial function. Results The MRI results showed that BSHXF reduced intervertebral disc volume reduction and degradation of NP tissue. HE, SO-FG and immunofluorescence further confirmed the protective effect of BSHXF on degenerative intervertebral discs. BSHXF reduced the inflammatory levels of IL-6 IL-1β and TNF-α in degenerative intervertebral disc tissue. Meanwhile, JC-1, mPTP and ROS detection revealed that BSHXF can restore mitochondrial function by regulating the expression of antioxidant proteins, playing a protective role in NP cells. Finally, the WB results showed that BSHXF can alleviate IL-1β mediate the degeneration of NP cells. BSHXF can alleviate NP cell apoptosis by inhibiting the expression of bax, cleaved caspase-3, caspase-3, and cyt-c, and increasing the expression of Bcl-2. Conclusion This study reveals that BSHXF inhibits the development of inflammatory factors, which may play a significant role in intervertebral disc degeneration. This implies that BSHXF is a suitable herbal medication for future research into inflammatory cytokine treatment.
Collapse
Affiliation(s)
- Shang Gao
- The First Clinical Medical College of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, People’s Republic of China
| | - Chenmoji Wang
- The First Clinical Medical College of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, People’s Republic of China
| | - Lijie Qi
- Qilu Hospital of Shandong University, Jinan, Shandong Province, People’s Republic of China
| | - Songlin Liang
- The First Clinical Medical College of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, People’s Republic of China
| | - Xintian Qu
- The First Clinical Medical College of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, People’s Republic of China
| | - Wei Liu
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, People’s Republic of China
| | - Nianhu Li
- Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, People’s Republic of China
| |
Collapse
|
7
|
Wang Z, Li X, Yu P, Zhu Y, Dai F, Ma Z, Shen X, Jiang H, Liu J. Role of Autophagy and Pyroptosis in Intervertebral Disc Degeneration. J Inflamm Res 2024; 17:91-100. [PMID: 38204989 PMCID: PMC10778915 DOI: 10.2147/jir.s434896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 12/28/2023] [Indexed: 01/12/2024] Open
Abstract
Intervertebral disc degeneration is a chronic degenerative disease caused by the interaction of genetic and environmental factors, mainly manifested as lower back pain. At present, the diagnosis of intervertebral disc degeneration mainly relies on imaging. However, early intervertebral disc degeneration is usually insidious, and there is currently a lack of relevant clinical biomarkers that can reliably reflect early disease progression. Pyroptosis is a regulatory form of cell death triggered by the activation of inflammatory bodies and caspase, which can induce the formation of plasma membrane pores and cell swelling or lysis. Previous studies have shown that during the progression of intervertebral disc degeneration, sustained activation of inflammasomes leads to nuclear cell pyroptosis, which can occur in the early stages of intervertebral disc degeneration. Moreover, intervertebral disc nucleus pulposus cells adapt to the external environment through autophagy and maintain cellular homeostasis and studying the mechanism of autophagy in IDD and intervening in its pathological and physiological processes can provide new ideas for the clinical treatment of IDD. This review analyzes the effects of pyroptosis and autophagy on IDD by reviewing relevant literature in recent years, in order to explore the relationship between pyroptosis, autophagy and IDD.
Collapse
Affiliation(s)
- Zhiqiang Wang
- Department of Orthopedic Surgery, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, 215009, People’s Republic of China
| | - Xiaochun Li
- Department of Orthopedic Surgery, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, 215009, People’s Republic of China
| | - Pengfei Yu
- Department of Orthopedic Surgery, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, 215009, People’s Republic of China
| | - Yu Zhu
- Department of Orthopedic Surgery, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, 215009, People’s Republic of China
| | - Feng Dai
- Department of Orthopedic Surgery, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, 215009, People’s Republic of China
| | - Zhijia Ma
- Department of Orthopedic Surgery, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, 215009, People’s Republic of China
| | - Xueqiang Shen
- Department of Orthopedic Surgery, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, 215009, People’s Republic of China
| | - Hong Jiang
- Department of Orthopedic Surgery, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, 215009, People’s Republic of China
| | - Jintao Liu
- Department of Orthopedic Surgery, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, 215009, People’s Republic of China
| |
Collapse
|
8
|
Jin Y, Yin X. Aspergillus terreus spondylodiscitis following acupuncture and acupotomy in an immunocompetent host: case report and literature review. Front Cell Infect Microbiol 2024; 13:1269352. [PMID: 38239504 PMCID: PMC10794653 DOI: 10.3389/fcimb.2023.1269352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 12/14/2023] [Indexed: 01/22/2024] Open
Abstract
Aspergillus terreus is a fungus responsible for various infections in human beings; however, spine involvement is uncommon. Herein, we report a case of A. terreus spondylodiscitis following acupuncture and acupotomy in an immunocompetent Chinese patient. Admission lumbar magnetic resonance imaging (MRI) revealed infection at the L4/5 level without significant vertebral destruction. After unsuccessful symptomatic and anti-tuberculosis treatments, A. terreus was identified through culture, microscopy of isolate, histological examination and VITEK system. Intravenous voriconazole was then given; however, the patient's spinal condition deteriorated rapidly, resulting in evident destruction of the L4/5 vertebral bodies. Surgeries including L4/5 intervertebral disc debridement, spinal canal decompression, posterior lumbar interbody fusion (PLIF) with allogeneic fibula ring fusion cages, and posterior pedicle screw fixation were then performed. Imaging findings at one-month and six-month follow-up suggested that the patient was successfully treated. This case highlighted two important points: firstly, although acupuncture and acupotomy are generally regarded as safe conservative treatments for pain management, they can still lead to complications such as fungal spinal infection. Therefore, vigilance is necessary when considering these treatments; secondly, PLIF with allogeneic fibula ring fusion cages may be beneficial for A. terreus spondylodiscitis patients with spinal instability.
Collapse
Affiliation(s)
| | - Xiang Yin
- Department of Spine Surgery, Daping Hospital, Army Medical University, Chongqing, China
| |
Collapse
|
9
|
Liu Q, Zhang H, Lin F, Chen L, Wang Z. Acupuncture treatment for lumbar disc herniation with scoliosis: A case report. Medicine (Baltimore) 2023; 102:e36684. [PMID: 38206743 PMCID: PMC10754577 DOI: 10.1097/md.0000000000036684] [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: 09/15/2023] [Accepted: 11/27/2023] [Indexed: 01/13/2024] Open
Abstract
INTRODUCTION Lumbar disc herniation (LDH) with scoliosis usually refers to lumbar disc herniation caused by scoliosis, which is a postural compensatory deformity to reduce low back and leg pain, mostly with nonstructural changes. Scoliosis may disappear after the treatment of LDH. PATIENT CONCERNS At present, this kind of scoliosis is mainly treated with medicine and surgery, but all these methods may have some adverse effects. DIAGNOSIS A 24-year-old female patient was admitted to the acupuncture department of our hospital due to unbearable pain caused by LDH. INTERVENTIONS According to the patient condition, the acupuncture treatment plan was adopted by Professor Wang Zhanglian, a famous Chinese medicine practitioner. OUTCOMES After 12 weeks of acupuncture treatment, the patient low back pain was significantly relieved. CONCLUSION This case suggests that acupuncture may be an effective alternative treatment for LDH.
Collapse
Affiliation(s)
- Qing Liu
- The Third College of Clinical Medicine, Zhengjiang Chinese Medical University, Hangzhou, China
| | - Han Zhang
- The Third College of Clinical Medicine, Zhengjiang Chinese Medical University, Hangzhou, China
| | - FangXuan Lin
- The Third College of Clinical Medicine, Zhengjiang Chinese Medical University, Hangzhou, China
| | - LiFang Chen
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - ZhangLian Wang
- Department of Acupuncture and Moxibustion, The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| |
Collapse
|
10
|
Chen D, Lv Z, Wu Y, Hao P, Liu L, Pan B, Shi H, Che Y, Shen B, Du P, Si X, Hu Z, Luan G, Xue M. Estimating surgical probability: Development and validation of a prognostic model for patients with lumbar disc herniation treated with acupuncture. Medicine (Baltimore) 2023; 102:e36425. [PMID: 38050285 PMCID: PMC10695558 DOI: 10.1097/md.0000000000036425] [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: 07/15/2023] [Accepted: 11/10/2023] [Indexed: 12/06/2023] Open
Abstract
Lumbar disc herniation (LDH) is a common cause of pain in the lumbar spine and legs. While acupuncture has become the primary conservative treatment for LDH, some patients experience treatment failure and require surgery, causing substantial concern for clinicians. We developed an effective personalized clinical prediction model to identify the independent risk factors associated with acupuncture failure in patients with LDH. Our model aimed to predict the probability of surgery within 6 months of acupuncture failure in patients with LDH. A total of 738 patients with LDH who underwent acupuncture at 4 Chinese hospitals between January 2019 and October 2021 were selected. The patients were divided into training (n = 496) and validation (n = 242) cohorts. Seven predictive variables, including smoking, Oswestry Disability Index (ODI) score, lower-limb herniation, disc herniation type, lumbar spinal stenosis, lumbar lateral recess stenosis, and acupuncture frequency, were selected as risk factors using least absolute shrinkage and selection operato (LASSO) regression. A prediction model was developed using multivariate logistic regression analysis and a nomogram was constructed. The model exhibited good discrimination, with an area under the ROC curve (AUC) of 0.903 for the development cohort and 0.899 for the validation cohort. The Hosmer-Lemeshow goodness-of-fit test was a good fit for both cohorts (P = .956 for the development cohort; P = .513 for the validation cohort). Decision curve analysis (DCA) demonstrated that the threshold probabilities for the 2 cohorts ranged from > 4% and 5-95%, respectively. Therefore, the prediction model had a good net benefit. The nomogram established in this study, incorporating 7 risk factors, demonstrated a good predictive ability. It could predict acupuncture failure in LDH patients and the risk of surgery within 6 months, enabling physicians to conduct individualized treatment measures.
Collapse
Affiliation(s)
- Di Chen
- Nanjing University of Chinese Medicine, Nanjing, China
- Department of Tui Na, the First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Zimeng Lv
- Department of Tui Na, the First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Yicheng Wu
- Department of Tui Na, the First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Panfu Hao
- Acupuncture Rehabilitation Department, the Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Liu Liu
- Department of Tui Na, the First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Bin Pan
- Department of Tui Na, the First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Haiping Shi
- Department of Tui Na, the First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Youlu Che
- Department of Tui Na, the First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Bo Shen
- Department of Rehabilitation Medicine, Anhui NO.2 Provincial People’s Hospital, Hefei, China
| | - Peng Du
- Department of Tui Na, Anhui Provincial Hospital of Integrated Chinese and Western Medicine, Hefei, China
| | - Xiaohua Si
- Department of Tui Na, the First Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, China
| | - Zhongling Hu
- Acupuncture Rehabilitation Department, Traditional Chinese Hospital of Luan, Luan, China
| | - Guorui Luan
- Department of Tui Na, Anhui Provincial Hospital of Integrated Chinese and Western Medicine, Hefei, China
| | - Mingxin Xue
- The First Clinical Medical College of Nanjing University of Chinese Medicine, Nanjing, China
| |
Collapse
|
11
|
Zhang W, Wang G, Xie R, Zhan J, Zhu L, Wan C, Xie H, Cai C, Du Y. Traditional Chinese exercises on pain and disability in middle-aged and elderly patients with lumbar disc herniation: a systematic review and meta-analysis of randomized controlled trials. Front Med (Lausanne) 2023; 10:1265040. [PMID: 38020108 PMCID: PMC10663407 DOI: 10.3389/fmed.2023.1265040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Background Traditional Chinese exercises (TCEs) have played a significant role in treating various diseases. However, there is limited research assessing the efficacy of TCEs in treating Lumbar disc herniation (LDH). This study aimed to systematically evaluate the effects of four commonly used TCEs (Baduanjin, Yijinjing, Taichi, and Wuqinxi) on pain and disability in elderly patients with LDH. Objectives To assess the quality of relevant randomized controlled trials (RCTs) to provide evidence support for the treatment of LDH. Methods RCTs were identified through eight databases. Meta-analysis and trial sequence analysis (TSA) were conducted using RevMan 5.4, Stata 17.0, and TSA 0.9. Results A total of 22 RCTs, involving 1931 patients, were included in the analysis. TCEs exhibited a superior effectiveness in treating LDH compared to the control group. However, the TSA analysis suggested the possibility of false positives, indicating the need for more high-quality RCT evidence. Nevertheless, TCEs showed reliable results in significantly improving the VAS score and JOA score of LDH patients. Conclusion Current evidence indicates that the four TCEs have advantages in treating LDH in middle-aged and elderly individuals. However, considering the limitations of this study, we need to exercise caution in drawing conclusions, and further research is required to validate these findings. Systematic Review Registration http://www.crd.york.ac.uk/PROSPERO, identifier [CRD42023431633].
Collapse
Affiliation(s)
- Weiye Zhang
- Third Department of Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Gewen Wang
- Third Department of Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Rong Xie
- Third Department of Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Jiawen Zhan
- Third Department of Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Beijing Key Laboratory of Bone Setting Technology of Traditional Chinese Medicine, Beijing, China
| | - Liguo Zhu
- Third Department of Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- Beijing Key Laboratory of Bone Setting Technology of Traditional Chinese Medicine, Beijing, China
- Second Department of Spine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Chunyou Wan
- Department of Orthopedics, Tianjin Hospital, Tianjin, China
| | - Hualong Xie
- Third Department of Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Chuhao Cai
- Third Department of Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuxuan Du
- Third Department of Sports Medicine, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| |
Collapse
|
12
|
Zhang L, Gao J, Li Z, Liu J, Zhang C, Liu J, Dong H, Mei W. Astragaloside IV relieves IL-1β-induced human nucleus pulposus cells degeneration through modulating PI3K/Akt signaling pathway. Medicine (Baltimore) 2023; 102:e34815. [PMID: 37603510 PMCID: PMC10443759 DOI: 10.1097/md.0000000000034815] [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: 05/06/2023] [Accepted: 07/27/2023] [Indexed: 08/23/2023] Open
Abstract
BACKGROUND Intervertebral disc degeneration (IDD) is a multifactorial disease that is associated with nucleus pulposus (NP) apoptosis and extracellular matrix (ECM) degeneration and inflammation. Astragaloside IV (AS IV) has antioxidant, free radical scavenging, anti-inflammatory and anti-apoptosis effects. This study was to investigate whether AS IV could inhibit IL-1β-mediated apoptosis of HNP cells and its possible signal transduction pathway. METHODS Human nucleus pulposus cells (HNPCs) were stimulated with AS IV or LY294002 (PI3K inhibitor), followed by exposure to IL-1β for 24 hours. CCK8, TUNEL analysis and flow cytometry, ELISA and Western blotting were used to analyze the effects of AS IV on cell proliferation, apoptosis, inflammation, ECM and PI3K/Akt pathway signaling path-related proteins in IL-1β-induced HNPCs. RESULTS Compared with IL-1β-induced HNPCs, AS IV could improve the proliferation activity and the expressions of Collagen II, Aggrecan and Bcl-2 proteins, inhibit the apoptosis rate, inflammation and Bax and cleaved caspase-3 protein expression, and increase the activity of PI3K/Akt pathway. LY294002 attenuated the protective effect of AS IV against IL-1β-induced HNPCs degeneration. CONCLUSION AS IV can inhibit IL-1β-induced HNPCs apoptosis inflammation and ECM degeneration by activating PI3K/Akt signaling pathway, which can be an effective drug to reduce disc degeneration.
Collapse
Affiliation(s)
- Lu Zhang
- Orthopedics, The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People's Hospital), Zhengzhou, Henan, China
| | - Junsheng Gao
- Orthopedics, The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People's Hospital), Zhengzhou, Henan, China
| | - Zhentao Li
- Orthopedics, The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People's Hospital), Zhengzhou, Henan, China
| | - Jun Liu
- Orthopedics, The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People's Hospital), Zhengzhou, Henan, China
| | - Chong Zhang
- Orthopedics, The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People's Hospital), Zhengzhou, Henan, China
| | - Jie Liu
- Orthopedics, The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People's Hospital), Zhengzhou, Henan, China
| | - Hui Dong
- Orthopedics, The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People's Hospital), Zhengzhou, Henan, China
| | - Wei Mei
- Orthopedics, The Fifth Clinical Medical College of Henan University of Chinese Medicine (Zhengzhou People's Hospital), Zhengzhou, Henan, China
| |
Collapse
|
13
|
Ruan L, Lei J, Yuan Y, Li H, Yang H, Wang J, Zhang Q. MIR31HG, a potential lncRNA in human cancers and non-cancers. Front Genet 2023; 14:1145454. [PMID: 37636269 PMCID: PMC10449471 DOI: 10.3389/fgene.2023.1145454] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 07/31/2023] [Indexed: 08/29/2023] Open
Abstract
Long non-coding RNAs have recently attracted considerable attention due to their aberrant expression in human diseases. LncMIR31HG is a novel lncRNA that is abnormally expressed in multiple diseases and implicated in various stages of disease progression. A large proportion of recent studies have indicated that MIR31HG has biological functions by triggering various signalling pathways in the pathogenesis of human diseases, especially cancers. More importantly, the abnormal expression of MIR31HG makes it a potential biomarker in diagnosis and prognosis, as well as a promising target for treatments. This review aims to systematically summarize the gene polymorphism, expression profiles, biological roles, underlying mechanisms, and clinical applications of MIR31HG in human diseases.
Collapse
Affiliation(s)
- Luxi Ruan
- Department of Oncology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jing Lei
- Department of Oncology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yihang Yuan
- Department of Oncology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Huizi Li
- Department of Oncology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hui Yang
- Department of Oncology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jinyan Wang
- Department of Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Quanan Zhang
- Department of Oncology, The Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing, Jiangsu, China
| |
Collapse
|
14
|
Zhou D, Song C, Mei Y, Cheng K, Liu F, Cai W, Gao S, Wang Z, Liu Z. A review of Duhuo Jisheng decoction mechanisms in intervertebral disc degeneration in vitro and animal studies. J Orthop Surg Res 2023; 18:436. [PMID: 37322524 DOI: 10.1186/s13018-023-03869-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/21/2023] [Indexed: 06/17/2023] Open
Abstract
Intervertebral disc degeneration (IVDD) has become a serious public health problem, placing a heavy burden on society and the healthcare system. Its pathogenesis is not completely clear and may be closely related to mechanical damage, inflammatory factors, oxidative stress and death of nucleus pulposus cells (NPCs). The treatment of IVDD mainly includes conservative treatment and surgery. Conservative treatment is based on hormonal and anti-inflammatory drugs and massage techniques, which can relieve the pain symptoms to a certain extent, but cannot solve the problem from the root cause. Surgical treatment is mainly by removing the herniated nucleus pulposus, but it is more traumatic for IVDD patients, expensive and not suitable for all patients. Therefore, it is extremely important to clarify the pathogenesis of IVDD, to find an effective and convenient treatment and to further elaborate its mechanism of action. The effectiveness of traditional Chinese medicine in the treatment of IVDD has been well demonstrated in clinical medical research. We have been working on the Chinese herbal formula Duhuo Jisheng Decoction, which is a common formula for the treatment of degenerative disc disease. Not only does it have significant clinical effects, but it also has few adverse effects. At present, we found that its mechanism of action mainly involves regulation of inflammatory factors, reduction of apoptosis and pyroptosis of NPCs, inhibition of extracellular matrix degradation, improvement of intestinal flora, etc. However, a few relevant articles have yet comprehensively and systematically summarized the mechanisms by which they exert their effect. Therefore, this paper will comprehensively and systematically explain on it. This is of great clinical significance and social value for elucidating the pathogenesis of IVDD and improving the symptoms of patients, and will provide a theoretical basis and scientific basis for the treatment of IVDD with traditional Chinese medicine.
Collapse
Affiliation(s)
- Daqian Zhou
- Department of Orthopedics, The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou, 646000, Sichuan Province, China
| | - Chao Song
- Department of Orthopedics, The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou, 646000, Sichuan Province, China
| | - Yongliang Mei
- Department of Orthopedics, The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou, 646000, Sichuan Province, China
| | - Kang Cheng
- Department of Orthopedics, The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou, 646000, Sichuan Province, China
| | - Fei Liu
- Department of Orthopedics, The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou, 646000, Sichuan Province, China
| | - Weiye Cai
- Department of Orthopedics, The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou, 646000, Sichuan Province, China
| | - Silong Gao
- Department of Orthopedics, The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou, 646000, Sichuan Province, China
| | - Zhenlong Wang
- Department of Orthopedics, The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou, 646000, Sichuan Province, China.
| | - Zongchao Liu
- Department of Orthopedics, The Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou, 646000, Sichuan Province, China.
- Luzhou Longmatan District People's Hospital, Luzhou, Sichuan Province, China.
| |
Collapse
|
15
|
Wang CA, Zhao HF, Ju J, Kong L, Sun CJ, Zheng YK, Zhang F, Hou GJ, Guo CC, Cao SN, Wang DD, Shi B. Reabsorption of intervertebral disc prolapse after conservative treatment with traditional Chinese medicine: A case report. World J Clin Cases 2023; 11:2308-2314. [PMID: 37122521 PMCID: PMC10131025 DOI: 10.12998/wjcc.v11.i10.2308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 02/16/2023] [Accepted: 03/09/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Conservative treatments have been reported to diminish or resolve clinical symptoms of lumbar intervertebral disc herniation (LIDH) within a few weeks.
CASE SUMMARY Computed tomography and magnetic resonance imaging (MRI) of the lumbar region of a 25-year-old male diagnosed with LIDH showed prolapse of the L5/S2 disc. The disc extended 1.0 cm beyond the vertebral edge and hung along the posterior vertebral edge. The patient elected a conservative treatment regimen that included traditional Chinese medicine (TCM), acupuncture, and massage. During a follow-up period of more than 12 mo, good improvement in pain was reported without complications. MRI of the lumbar region after 12 mo showed obvious reabsorption of the herniation.
CONCLUSION A conservative treatment regimen of TCM, acupuncture, and massage promoted reabsorption of a prolapsed disc.
Collapse
Affiliation(s)
- Cong-An Wang
- Postdoctoral Mobile Station of Shandong University of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong Province, China
- Bone Biomechanics Engineering Laboratory of Shandong Province, Neck-Shoulder and Lumbocrural Pain Hospital of Shandong First Medical University, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250014, Shandong Province, China
| | - Hong-Fei Zhao
- School of Acupuncture-Tuina, Shandong University of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong Province, China
| | - Jing Ju
- Weihai Hospital of Traditional Chinese Medicine, Weihai 264200, Shandong Province, China
| | - Li Kong
- Department of Intensive Care Medicine, The Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250011, Shandong Province, China
| | - Cheng-Jiao Sun
- Huantai County Hospital of Traditional Chinese Medicine, Zibo 256400, Shandong Province, China
| | - Yue-Kun Zheng
- Bone Biomechanics Engineering Laboratory of Shandong Province, Neck-Shoulder and Lumbocrural Pain Hospital of Shandong First Medical University, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250014, Shandong Province, China
| | - Feng Zhang
- Bone Biomechanics Engineering Laboratory of Shandong Province, Neck-Shoulder and Lumbocrural Pain Hospital of Shandong First Medical University, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250014, Shandong Province, China
| | - Guang-Jian Hou
- Shandong University of Traditional Chinese Medicine, School of Acupuncture-Tuina, Jinan 250014, Shandong Province, China
| | - Chen-Chen Guo
- Bone Biomechanics Engineering Laboratory of Shandong Province, Neck-Shoulder and Lumbocrural Pain Hospital of Shandong First Medical University, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250014, Shandong Province, China
| | - Sheng-Nan Cao
- Bone Biomechanics Engineering Laboratory of Shandong Province, Neck-Shoulder and Lumbocrural Pain Hospital of Shandong First Medical University, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan 250014, Shandong Province, China
| | - Dan-Dan Wang
- Shandong First Medical University and Shandong Academy of Medical Sciences, Neck-Shoulder and Lumbocrural Pain Hospital, Shandong Medicinal Biotechnology Center, Jinan 250062, Shandong Province, China
| | - Bin Shi
- Shandong First Medical University and Shandong Academy of Medical Sciences, Neck-Shoulder and Lumbocrural Pain Hospital, Shandong Medicinal Biotechnology Center, Jinan 250062, Shandong Province, China
| |
Collapse
|
16
|
Kim T, Kim H, Shin WC, Cho JH, Song MY, Chung WS. Multiple traditional Chinese medicinal approaches in collaboration with conservative conventional medicine for lumbar herniated intervertebral discs: A systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e33353. [PMID: 36961145 PMCID: PMC10036008 DOI: 10.1097/md.0000000000033353] [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: 10/30/2022] [Accepted: 03/03/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND This review aimed to verify the clinical effects of traditional Chinese medicine in collaboration with conservative conventional medicine for lumbar herniated intervertebral discs (LHIVD). METHODS The CENTRAL, EMBASE, MEDLINE/PubMed, JMAS, CNKI, and seven Korean databases were searched using pre-planned strategies. The risk of bias was assessed using the Cochrane Collaboration tool and a meta-analysis was conducted accordingly. RESULTS Twenty-eight randomized controlled trials (RCTs) were included in this systematic review and meta-analysis. All RCTs included 2746 participants. The experimental group showed more significant improvements in VAS (Mean differences (MD) -1.61, 95% Confidence Intervals (CI) [-2.44, -0.79]; I2 = 98%), Oswestry Disability Index (ODI) (MD -8.52, 95% CI [-11.71, -5.34]; I2 = 96%), and Japanese Orthopaedic Association (JOA) scores (MD 4.83, 95% CI [3.49, 6.17]; I2 = 85%) than the control group. However, the difference in the incidence of adverse events between the experimental and control groups was not significant (Relative Risk (RR) 0.05, 95% CI [0.23, 1.10]; I2 = 46%). CONCLUSION Traditional Chinese medicine in collaboration with conservative conventional medicine can be used to relieve pain and facilitate better function of the lumbar spine in lumbar herniated intervertebral disc cases. However, this conclusion should be applied with caution in clinical practice owing to the low quality of the included studies.
Collapse
Affiliation(s)
- Taeoh Kim
- Department of Clinical Korean Medicine Graduate School, Kyung Hee University, Seoul, Korea
- Department of Korean Medicine Rehabilitation, Kyung Hee University Medical Center, Seoul, Korea
| | - Hyungsuk Kim
- Department of Clinical Korean Medicine Graduate School, Kyung Hee University, Seoul, Korea
- Department of Korean Medicine Rehabilitation, Kyung Hee University Medical Center, Seoul, Korea
| | - Woo-Chul Shin
- Department of Clinical Korean Medicine Graduate School, Kyung Hee University, Seoul, Korea
- Department of Korean Medicine Rehabilitation, Kyung Hee University Medical Center, Seoul, Korea
| | - Jae-Heung Cho
- Department of Clinical Korean Medicine Graduate School, Kyung Hee University, Seoul, Korea
- Department of Korean Medicine Rehabilitation, Kyung Hee University Medical Center, Seoul, Korea
| | - Mi-Yeon Song
- Department of Clinical Korean Medicine Graduate School, Kyung Hee University, Seoul, Korea
- Department of Korean Medicine Rehabilitation, Kyung Hee University Medical Center, Seoul, Korea
| | - Won-Seok Chung
- Department of Clinical Korean Medicine Graduate School, Kyung Hee University, Seoul, Korea
- Department of Korean Medicine Rehabilitation, Kyung Hee University Medical Center, Seoul, Korea
| |
Collapse
|
17
|
Chang H, Xu J, Li X, Zhao R, Wang M, Ding W. Association between anemia and lumbar disc degeneration in patients with low back pain: an observational retrospective study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023:10.1007/s00586-023-07652-1. [PMID: 36939888 DOI: 10.1007/s00586-023-07652-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 03/02/2023] [Accepted: 03/10/2023] [Indexed: 03/21/2023]
Abstract
OBJECTIVE The goal of this study was to evaluate the possible associations between anemia and morphologic features of lumbar disc degeneration (LDD) in subjects with low back pain. MATERIALS AND METHODS A total of 131 patients with normocytic or microcytic anemia (mean age 41.0 ± 6.4 yrs, BMI: 24.8 ± 3.3 kg/m2, 12.2% men) and a matched control group of 131 patients without anemia (mean age 41.0 ± 6.4 yrs, BMI: 24.9 ± 3.1 kg/m2, 12.2% men) were evaluated for LDD according to the Pfirrmann scoring system. The primary outcome was the difference of radiological features of LDD between two groups. The second outcome was the correlation between the hemoglobin (Hb) value and disc degeneration (DD). Statistical associations were assessed by Student's t-test, Chi-square test, and Spearman correlation. RESULTS Anemic patients had a significantly higher number of degenerated discs than non-anemic patients in the level of L2/3 and L3/4 (p < 0.05). We also found that the severe DD occurred more frequently in the level of L2/3, L3/4 and L5/S1 among anemic patients (p < 0.05). In addition, we noticed that the incidence of multilevel LDD happened much more frequently in patients with anemia (p < 0.05). The Hb value showed a borderline negative correlation with the total score of DD (p = 0.056). CONCLUSION The results suggested that patients with anemia, and those without are radiologically different with varying patterns of DD. Patients with back pain and anemia were more likely to have extensive and severe DD. Although relevant mechanisms are not yet well understood, this study improved our understandings of the pathophysiology for LDD.
Collapse
Affiliation(s)
- Hengrui Chang
- Department of Spinal Surgery, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China
- Hebei Medical University, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Jiaxin Xu
- Department of Spinal Surgery, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Xiangyu Li
- Hebei Medical University, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Ruoyu Zhao
- Hebei Medical University, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Ming Wang
- Department of Imaging, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, People's Republic of China
| | - Wenyuan Ding
- Department of Spinal Surgery, The Third Hospital of Hebei Medical University, No.139 Ziqiang Road, Shijiazhuang, 050051, Hebei, People's Republic of China.
| |
Collapse
|
18
|
Guan C, Gu Y, Cheng Z, Xie F, Yao F. Global trends of traditional Chinese exercises for musculoskeletal disorders treatment research from 2000 to 2022: A bibliometric analysis. Front Neurosci 2023; 17:1096789. [PMID: 36845420 PMCID: PMC9950260 DOI: 10.3389/fnins.2023.1096789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 01/16/2023] [Indexed: 02/12/2023] Open
Abstract
Background Traditional Chinese exercise has been shown to be effective in relieving long-term chronic pain, physical dysfunction, decreased ability to participate in society and decreased quality of life in musculoskeletal diseases. In recent years, there has been a steady increase in publications on the treatment of musculoskeletal disorders by traditional Chinese exercises. The purpose of this study is to review the characteristics and trends of Chinese traditional exercise studies on musculoskeletal diseases published since 2000 through bibliometric analysis, and identify current research hotspots, so as to guide the direction of future research. Methods Publications regarding traditional Chinese exercises for musculoskeletal disorders from 2000 to 2022 were downloaded from the Web of Science Core Collection. VOSviewer 1.6.18 and CiteSpace V software were used for bibliometric analyses. Bibliometric visualization and comparative analysis were conducted for authors, cited authors, journals, co-cited journals, institutions, countries, references, and keywords. Results A total of 432 articles were obtained, with an upward trend over time. The most productive countries and institutions in this field are the USA (183) and Harvard University (70). Evidence-based Complementary and Alternative Medicine (20) was the most prolific journal, Cochrane Database System Review (758) was the most commonly cited journal. Wang Chenchen published the largest number of articles (18). According to high frequency keywords, the hot spot musculoskeletal disorder and the type of traditional Chinese exercise are knee osteoarthritis and Tai Chi. Conclusion This study provides a scientific perspective for the research of traditional Chinese exercises for musculoskeletal disorders and provides valuable information for researchers to discover the current research status, hot spots and new trends of future research.
Collapse
Affiliation(s)
| | | | - Ziji Cheng
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fangfang Xie
- Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | | |
Collapse
|
19
|
Guo L, Li L, Li X, Li L, Zhang L, Zhang H. Efficacy and safety of warm acupuncture combined with Western medicine for sciatica: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2023; 102:e32543. [PMID: 36607877 PMCID: PMC9829287 DOI: 10.1097/md.0000000000032543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND There are more and more clinical studies on the efficacy of warm acupuncture in treating sciatica, but the systematic review of the efficacy of warm acupuncture is still lacking. The objective of this study was to evaluate the efficacy and safety of warm acupuncture combined with conventional Western medicine in the treatment of sciatica. METHODS The review was registered in the PROSPERO database (CRD42022379486) and was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. The following databases will be used to search the existing literature (from inception to January 2023): Web of Science, Embase, Cochrane Library, PubMed, Cumulative Index to Nursing and Allied Health Literature, Wanfang, Allied and Complementary Medicine Database, China Knowledge Network, and SPORT-Discus. Included studies are considered eligible if they met the population, intervention, comparator, outcomes, and study design criteria as follows: Population: patients with newly diagnosed sciatica; Intervention: warm acupuncture combined with conventional Western medicine; Comparator: Western medicine alone; Outcomes: total response rate, pain score and pain threshold, adverse events and recurrence rate. Study design: randomized controlled trials or non-randomized cohort studies. Review Manager (RevMan) V.5.3 will be used to perform statistical analyses and to generate forest plots. RESULTS The review will add to the existing literature by showing compelling evidence and improved guidance in clinic settings.
Collapse
Affiliation(s)
- Lingling Guo
- Osteopathy Department of Integrated Traditional Chinese and Western Medicine, Zibo Central Hospital, Zibo, Shandong, China
| | - Liang Li
- Department of Chinese Medicine, Zibo Central Hospital, Zibo, Shandong, China
| | - Xiuli Li
- Department of Plastic and Cosmetic Surgery, Zibo Central Hospital, Zibo, Shandong, China
| | - Linghan Li
- Osteopathy Department of Integrated Traditional Chinese and Western Medicine, Zibo Central Hospital, Zibo, Shandong, China
| | - Lijin Zhang
- Osteopathy Department of Integrated Traditional Chinese and Western Medicine, Zibo Central Hospital, Zibo, Shandong, China
| | - Haixia Zhang
- Department of Internet, Zibo Central Hospital, Zibo, Shandong, China
| |
Collapse
|
20
|
Zhang J, Zhai X, Wang X, Wang L, Tong H, Xian T, Shao L. The Effect of Thunder-Fire Moxibustion on Lumbar Disc Herniation: Study Protocol for a Randomized Controlled Trial. Front Public Health 2022; 10:930830. [PMID: 35875009 PMCID: PMC9298968 DOI: 10.3389/fpubh.2022.930830] [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: 04/28/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background Lumbar disc herniation (LDH) is a common disease seen in orthopedics; it is caused by nucleus pulposus herniation. Its clinical manifestations are low back pain, radiating pain of the lower limbs, and cauda equina symptoms that seriously affect patients' quality of life. At present, oral analgesics are commonly used in the treatment of LDH; but they can produce gastrointestinal reactions and other side effects. Thunder-fire moxibustion is a method that is widely used in China to treat pain syndromes. This study aimed to design a randomized controlled trial to explore the effectiveness and safety of thunder-fire moxibustion in the treatment of lumbar disc herniation. Methods Ninety patients will be enrolled and randomly divided into one of two groups: the thunder-fire moxibustion group and the acetaminophen group. The thunder-fire moxibustion group will be treated with moxa sticks at BL25, GV3, BL23, and GV4; and after 15 min of local whirling moxibustion, the contralateral acupoints will be treated with moxibustion for 15 min. The study period will include two 10-day courses of treatment, for a total study duration of 20 days. The acetaminophen group participants will take one acetaminophen sustained-release tablet twice a day for the duration of the study period. In contrast, the thunder-fire moxibustion group participants will be treated with thunder-fire moxibustion every other day for 30 min. The primary outcome will be the Japanese Orthopedic Association (JOA) score. Visual analog scale (VAS) and Oswestry Disability Index (ODI) will be used as the secondary outcome measures. Adverse events (AEs) will also be recorded. Assessments will be conducted at baseline, the end of the first and second courses of treatment. Discussion This study will determine whether thunder-fire moxibustion is more effective and safer than acetaminophen in the treatment of patients with LDH. Trial Registration Chinese Clinical Trial Registry (http://www.chictr.org.cn), ChiCTR2000036079.
Collapse
Affiliation(s)
- Jiale Zhang
- Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xu Zhai
- Graduate School, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xue Wang
- Department of Acupuncture and Massage, Nanling Hospital of Traditional Chinese Medicine, Wuhu, China
| | - Liuqing Wang
- Institute for the History and Literature of Traditional Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Hongxuan Tong
- Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing, China
| | - Tiancai Xian
- Genius Tianzhiyuan Group Co., Ltd., Ningbo, China
| | - Lexuan Shao
- Graduate School, China Academy of Chinese Medical Sciences, Beijing, China
| |
Collapse
|
21
|
Bushen Huoxue Formula Modulates Autophagic Flux and Inhibits Apoptosis to Protect Nucleus Pulposus Cells by Restoring the AMPK/SIRT1 Pathway. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8929448. [PMID: 35669720 PMCID: PMC9167005 DOI: 10.1155/2022/8929448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/27/2022] [Accepted: 05/05/2022] [Indexed: 11/26/2022]
Abstract
Background Low back pain (LBP) has the characteristics of chronic and persistence, which is a heavy social burden. Intervertebral disc degeneration (IVDD) is a major cause of LBP. The typical features of IVDD are extracellular matrix (ECM) degradation and nucleus pulposus cell (NP) apoptosis. Bushen Huoxue Formula (BSHXF) has good clinical effects on LBP. However, the mechanism of BSHXF affecting ECM and NP cells is still unclear. Aim of the Study. In this study, the impact of BSHXF on autophagy and apoptosis of NP cells was studied through the AMPK/SIRT1 pathway. Material and Methods. NP cells were extracted through the digestion of collagenase and trypsin, and the components of BSHXF were identified. Cell Counting Kit-8 was applied to detect the impact of BSHXF on NP cells. Mitochondrial function was detected using MitoTracker assay, ATP kit, and SOD kit. Autophagy and apoptosis were detected by RT-qPCR, western blotting, and flow cytometry. Results BSHXF promoted NP cell survival in a concentration-dependent manner, and the elimination of rat serum did not increase cell proliferation; TNF-α accelerated ECM degradation, ROS accumulation, and NP cell apoptosis and decreased autophagic flux. BSHXF restored mitochondrial function and autophagic flux. In addition, AMPK/SIRT1 pathway activation was associated with IVDD. Conclusions BSHXF regulates autophagy and enhances autophagic flux to suppress excessive ROS production and restore mitochondrial function in an AMPK/SIRT1-dependent manner. However, the protection of BSHXF on TNF-α-treated cells was eliminated by 3-MA. Furthermore, the protective impact of BSHXF on ECM degradation and apoptosis induced by TNF-α was restrained by an AMPK inhibitor. Therefore, maintaining the proper autophagy illustrates treatment strategy for IVDD.
Collapse
|
22
|
Cyanidin attenuates the high hydrostatic pressure-induced degradation of cellular matrix of nucleus pulposus cell via blocking the Wnt/β-catenin signaling. Tissue Cell 2022; 76:101798. [DOI: 10.1016/j.tice.2022.101798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/29/2022] [Accepted: 04/08/2022] [Indexed: 11/20/2022]
|
23
|
Yaobishu Regulates Inflammatory, Metabolic, Autophagic, and Apoptosis Pathways to Attenuate Lumbar Disc Herniation. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:3861380. [PMID: 35615578 PMCID: PMC9125431 DOI: 10.1155/2022/3861380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 02/18/2022] [Accepted: 04/16/2022] [Indexed: 12/03/2022]
Abstract
Objective Here, we aimed to explore the main mechanism of Yaobishu (YBS) in lumbar disc herniation (LDH). Methods and Results Eighteen compounds that might act on LDH were obtained through a combination of network pharmacology prediction and identification by high-performance liquid chromatography-mass spectrometry. The key compounds were palmitic acid and trans-4-hydroxy-3-methoxycinnamate (cinnamate). KEGG analysis demonstrated that palmitic acid target genes mainly regulate the PPAR signaling pathway, Ras signaling pathway, and fatty acid metabolism. Cinnamate target genes were primarily involved in chemical carcinogenesis-receptor activation, lipid and atherosclerosis, the HIF-1 signaling pathway, and nitrogen metabolism. The rat LDH model was constructed using autologous nucleus pulposus tissue implantation. Differential expression gene (DEGs) related to metabolism (CDKN1A and UHRF1), inflammation (S100A9 and SOCS3), autophagy (DCN and LEPR), and apoptosis (CTSW and BCL2A1) in dorsal root ganglion (DRG) tissues of the control and LDH groups was evaluated by RNA-Seq. TNF-α stimulated DRG neuronal cells were used to establish an in vitro LDH model. YBS, palmitic acid, and cinnamate reduced the expression of substance P, CGRP, S100A9, CTSW, and cleaved caspase-3, while enhancing the expression of CDKN1A, UHRF1, PCNA, Ki67, SOCS3, DCN, LEPR, and BCL2A1, as well as telomerase activity. Pearson's correlation analysis confirmed that DCN was positively correlated with BCL2A1, indicating that autophagy might be negatively correlated with apoptosis in LDH. YBS, palmitic acid, and cinnamate reduced the Siegal neurological score and serum IL-1β and IL-18 levels, while increasing changes in the hind paw mechanical withdrawal threshold. The RNA-Seq results further showed that YBS downregulated S100A9 and CTSW expression, while upregulating SOCS3, CDKN1A, UHRF1, DCN, LEPR, and BCL2A1 expression. Conclusion YBS and its compounds, palmitic acid, and cinnamate, attenuated LDH by regulating the inflammatory, metabolic, autophagic, and apoptotic pathways. Our results might improve the theoretical and experimental basis for clinical applications of LDH disease treatment.
Collapse
|
24
|
Zhou Y, Yang M. Clinical Effect of the Treatment of Lumbar Intervertebral Disc Protrusion. Appl Bionics Biomech 2022; 2022:6803124. [PMID: 35528534 PMCID: PMC9076308 DOI: 10.1155/2022/6803124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/02/2022] [Accepted: 04/12/2022] [Indexed: 11/26/2022] Open
Abstract
Compared with traditional acupuncture, it is urgently needed for more effective method for the disease to serve the clinical treatment. This paper combines acupuncture and massage to treat lumbar intervertebral disc protrusion, uses a controlled trial to study the clinical effects of acupuncture combined with massage for the treatment of lumbar intervertebral disc protrusion, combines mathematical statistics to test the data, and compares and analyzes the statistical object parameters. Through experimental research, it is known that in the treatment of lumbar intervertebral disc protrusion, in order to obtain a faster and better effect, traditional acupuncture treatment should be combined with massage therapy. On the basis of fully eliminating the pathological factors, the intervertebral disc is reset by mechanical treatment, which makes the patient more likely to heal. Therefore, it is a comprehensive treatment plan that is worth adopting.
Collapse
Affiliation(s)
- Yehui Zhou
- Wuhan No.4 Hospital, WuHan 430000, China
| | - Ming Yang
- Wuhan No.4 Hospital, WuHan 430000, China
| |
Collapse
|
25
|
Yu G, Yang W, Zhang J, Zhang Q, Zhou J, Hong Y, Luo J, Shi Q, Yang Z, Zhang K, Tu H. Application of a nomogram to radiomics labels in the treatment prediction scheme for lumbar disc herniation. BMC Med Imaging 2022; 22:51. [PMID: 35305577 PMCID: PMC8934490 DOI: 10.1186/s12880-022-00778-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 03/09/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Objective
To investigate and verify the efficiency and effectiveness of a nomogram based on radiomics labels in predicting the treatment of lumbar disc herniation (LDH).
Methods
By reviewing medical records that were analysed over the past three years, clinical and imaging data of 200 lumbar disc patients at the Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine were obtained. The collected cases were randomly divided into a training group (n = 140) and a testing group (n = 60) at a ratio of 7:3. Two radiologists with experience in reading orthopaedics images independently segmented the ROIs. The whole intervertebral disc with the most obvious protrusion in the sagittal plane T2WI lumbar MRI as a mask (ROI) is sketched. The LASSO (Least Absolute Shrinkage And Selection Operator) algorithm was used to filter the features after extracting the radiomics features. The multivariate logistic regression model was used to construct a quantitative imaging Rad‑Score for the selected features with nonzero coefficients. The radiomics labels and nomogram were evaluated using the receiver operating characteristic curve (ROC) and the area under the curve (AUC). The calibration curve was used to evaluate the consistency between the nomogram prediction and the actual treatment plan. The DCA decision curve was used to evaluate the clinical applicability of the nomogram.
Result
Following feature extraction, 11 radiomics features were used to construct the radiomics label for predicting the treatment plan of LDH. A nomogram was then constructed. The AUC was 0.93 (95% CI: 0.90–0.97), with a sensitivity of 89%, a specificity of 91%, a positive predictive value of 92.7%, a negative predictive value of 89.4%, and an accuracy of 91%. The calibration curve showed that there was good consistency between the prediction and the actual observation. The DCA decision curve analysis showed that the nomogram of the imaging group has great potential for clinical application when the risk threshold is between 5 and 72%.
Conclusion
A nomogram based on radiomics labels has good predictive value for the treatment of LDH and can be used as a reference for clinical decision-making.
Collapse
|
26
|
Yang L, Li Z, Ouyang Y. Taurine attenuates ER stress‑associated apoptosis and catabolism in nucleus pulposus cells. Mol Med Rep 2022; 25:172. [PMID: 35315493 PMCID: PMC8971911 DOI: 10.3892/mmr.2022.12688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 02/10/2022] [Indexed: 11/20/2022] Open
Abstract
Nucleus pulposus (NP) apoptosis and subsequent excessive degradation of the extracellular matrix (ECM) are key pathological characteristics of intervertebral disc degeneration (IDD). The present study aims to examine the signaling processes underlying the effects of taurine on IDD, with specific focus on endoplasmic reticulum (ER) stress-mediated apoptosis and ECM degradation, in NP cells. To clarify the role of taurine in IDD, NP cells were treated with various concentrations of taurine and IL-1β or thapsigargin (TG). Cell Counting Kit-8, western blotting, TUNEL, immunofluorescence assays and reverse transcription-quantitative PCR were applied to measure cell viability, the expression of ER stress-associated proteins (GRP78, CHOP and caspase-12), apoptosis and the levels of metabolic factors associated with ECM (MMP-1, 3, 9, ADAMTS-4, 5 and collagen II), respectively. Taurine was found to attenuate ER stress and prevent apoptosis in NP cells induced by IL-1β treatment. Additionally, taurine significantly decreased the expression of ER stress-activated glucose regulatory protein 78, C/EBP homologous protein and caspase-12. TUNEL results revealed that taurine decreased the number of apoptotic TG-treated NP cells. TG-treated NP cells also exhibited characteristics of increased ECM degradation, supported by observations of increased MMP-1, MMP-3, MMP-9 and A disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS)-4 and ADAMTS-5 expression in addition to decreased collagen-II expression. However, taurine treatment significantly reversed all indicators of excessive ECM catabolism aforementioned. These data suggest that taurine can mediate protection against apoptosis and ECM degradation in NP cells by inhibiting ER stress, implicating therapeutic potential for the treatment of IDD.
Collapse
Affiliation(s)
- Liuxie Yang
- Department of Orthopedics, Shanghai Jing'an District Zhabei Central Hospital, Shanghai 200040, P.R. China
| | - Zhenhuan Li
- Department of Orthopedics, Shanghai Jing'an District Zhabei Central Hospital, Shanghai 200040, P.R. China
| | - Yueping Ouyang
- Department of Orthopedics, Shanghai Changzheng Hospital, Second Military Medical University, Shanghai 200003, P.R. China
| |
Collapse
|
27
|
Tan J, Li Z, Liu L, Liu H, Xue J. IL‐17 in intervertebral disc degeneration: mechanistic insights and therapeutic implications. Cell Biol Int 2022; 46:535-547. [PMID: 35066966 DOI: 10.1002/cbin.11767] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 12/28/2021] [Accepted: 01/04/2022] [Indexed: 11/11/2022]
Affiliation(s)
- Jing‐Hua Tan
- The First Affiliated Hospital, Department of Spine Surgery, Hengyang Medical School, University of South ChinaHengyangHunan421001China
| | - Ze‐Peng Li
- The First Affiliated Hospital, Department of Spine Surgery, Hengyang Medical School, University of South ChinaHengyangHunan421001China
| | - Lu‐Lu Liu
- The First Affiliated Hospital, Department of Spine Surgery, Hengyang Medical School, University of South ChinaHengyangHunan421001China
| | - Hao Liu
- The First Affiliated Hospital, Department of Spine Surgery, Hengyang Medical School, University of South ChinaHengyangHunan421001China
| | - Jing‐Bo Xue
- The First Affiliated Hospital, Department of Spine Surgery, Hengyang Medical School, University of South ChinaHengyangHunan421001China
| |
Collapse
|
28
|
Zhang B, Shi H, Cao S, Xie L, Ren P, Wang J, Shi B. Revealing the magic of acupuncture based on biological mechanisms: A literature review. Biosci Trends 2022; 16:73-90. [PMID: 35153276 DOI: 10.5582/bst.2022.01039] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Bo Zhang
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Haojun Shi
- Second Clinical Medical College, Henan University of Traditional Chinese Medicine, Zhengzhou, China
| | - Shengnan Cao
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Liangyu Xie
- Department of Traditional Chinese Medicine Orthopedics, Neck-Shoulder and Lumbocrural Pain Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Pengcheng Ren
- Department of Traditional Chinese Medicine Orthopedics, Neck-Shoulder and Lumbocrural Pain Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Jianmin Wang
- School of Acupuncture and Tuina, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Bin Shi
- Department of Traditional Chinese Medicine Orthopedics, Neck-Shoulder and Lumbocrural Pain Hospital Affiliated to Shandong First Medical University, Jinan, China
| |
Collapse
|
29
|
Lee HS, Lee IH, Kang K, Jung M, Yang SG, Kwon TW, Lee DY. Network Pharmacological Dissection of the Mechanisms of Eucommiae Cortex-Achyranthis Radix Combination for Intervertebral Disc Herniation Treatment. Nat Prod Commun 2021. [DOI: 10.1177/1934578x211055024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Eucommiae cortex (EC) and Achyranthis radix (AR) are herbal medicines widely used in combination for the treatment of intervertebral disc herniation (IDH). The mechanisms of action of the herbal combination have not been understood from integrative and comprehensive points of view. By adopting network pharmacological methodology, we aimed to investigate the pharmacological properties of the EC-AR combination as a therapeutic agent for IDH at a systematic molecular level. Using the pharmacokinetic information for the chemical ingredients of the EC-AR combination obtained from the comprehensive herbal drug-associated databases, we determined its 31 bioactive ingredients and 68 IDH-related therapeutic targets. By analyzing their enrichment for biological functions, we observed that the targets of the EC-AR combination were associated with the regulation of angiogenesis; cytokine and chemokine activity; oxidative and inflammatory stress responses; extracellular matrix organization; immune response; and cellular processes such as proliferation, apoptosis, autophagy, differentiation, migration, and activation. Pathway enrichment investigation revealed that the EC-AR combination may target IDH-pathology-associated signaling pathways, such as those of cellular senescence and chemokine, neurotrophin, TNF, MAPK, toll-like receptor, and VEGF signaling, to exhibit its therapeutic effects. Collectively, these data provide mechanistic insights into the pharmacological activity of herbal medicines for the treatment of musculoskeletal diseases such as IDH.
Collapse
Affiliation(s)
- Ho-Sung Lee
- The Fore, 87 Ogeum-ro, Songpa-gu, Seoul 05542, Republic of Korea
- Forest Hospital, 129 Ogeum-ro, Songpa-gu, Seoul 05549, Republic of Korea
| | - In-Hee Lee
- The Fore, 87 Ogeum-ro, Songpa-gu, Seoul 05542, Republic of Korea
| | - Kyungrae Kang
- Forest Hospital, 129 Ogeum-ro, Songpa-gu, Seoul 05549, Republic of Korea
| | - Minho Jung
- Forest Hospital, 129 Ogeum-ro, Songpa-gu, Seoul 05549, Republic of Korea
| | - Seung Gu Yang
- Kyunghee Naro Hospital, 67, Dolma-ro, Bundang-gu, Seongnam 13586, Republic of Korea
| | - Tae-Wook Kwon
- Forest Hospital, 129 Ogeum-ro, Songpa-gu, Seoul 05549, Republic of Korea
| | - Dae-Yeon Lee
- The Fore, 87 Ogeum-ro, Songpa-gu, Seoul 05542, Republic of Korea
- Forest Hospital, 129 Ogeum-ro, Songpa-gu, Seoul 05549, Republic of Korea
| |
Collapse
|
30
|
Tang K, Su W, Huang C, Wu Y, Wu X, Lu H. Notoginsenoside R1 suppresses inflammatory response and the pyroptosis of nucleus pulposus cells via inactivating NF-κB/NLRP3 pathways. Int Immunopharmacol 2021; 101:107866. [PMID: 34588155 DOI: 10.1016/j.intimp.2021.107866] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/27/2021] [Accepted: 06/06/2021] [Indexed: 11/28/2022]
Abstract
Intervertebral disc degeneration (IVDD) is the main cause of low back pain. Notoginsenoside R1 (NR1) is widely applied in the treatment of bone disorders, including IVDD. The present study aimed to investigate the effects of NR1 on the development of IVDD and the potential mechanisms. AF puncture was performed to establish IVDD rat model. Histology changes were analyzed by hematoxylin and eosin (H&E) staining. mRNA expressions were determined using qRT-PCR. Protein expressions were detected with western blot. Cellular functions were detected by MTT, EdU, flow cytometry, and TUNEL assays. The results showed that NR1 suppressed AF puncture induced IVDD, restored intervertebral disc (IVD) function, and suppressed mechanical hyperalgesia and thermal hyperalgesia. Moreover, NR1 promoted the release of extracellular matrix (ECM) in vivo and in vitro, and decreased the mRNA expressions of proinflammation cytokines. Additionally, NR1 inactivated NF-κB/NLRP3 pathways, improved cellular functions of nucleus pulposus cells (NPCs), and suppressed cell pyroptosis, which was reversed by NLRP3 activation. Taken together, NR1 may protect against IVDD via suppressing NF-κB/NLRP3 pathways. This may provide a novel therapy for IVDD.
Collapse
Affiliation(s)
- Kai Tang
- Department of Spinal Surgery, Longyan First Hospital Affiliated to Fujian Medical University, Longyan, Fujian Province 364000, China
| | - Wanhan Su
- Department of Spinal Surgery, Longyan First Hospital Affiliated to Fujian Medical University, Longyan, Fujian Province 364000, China
| | - Chunhui Huang
- Department of Spinal Surgery, Longyan First Hospital Affiliated to Fujian Medical University, Longyan, Fujian Province 364000, China
| | - Yiqi Wu
- Department of Spinal Surgery, Longyan First Hospital Affiliated to Fujian Medical University, Longyan, Fujian Province 364000, China
| | - Xiuming Wu
- Department of Spinal Surgery, Longyan First Hospital Affiliated to Fujian Medical University, Longyan, Fujian Province 364000, China
| | - Haichuan Lu
- Department of Spinal Surgery, Longyan First Hospital Affiliated to Fujian Medical University, Longyan, Fujian Province 364000, China.
| |
Collapse
|
31
|
Shen L, Ji C, Lin J, Yang H. Construction of Vertebral Body Tracking Algorithm Based on Dynamic Imaging Parameter Measurement and Its Application in the Treatment of Lumbar Instability. JOURNAL OF MEDICAL IMAGING AND HEALTH INFORMATICS 2021. [DOI: 10.1166/jmihi.2021.3534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Static imaging measurements could not truly reflect the dynamic panorama of the lumbar movement process, and the abnormal activities between the lumbar vertebrae and their dynamic balance could not be observed, resulting in difficulties in the mechanism analysis of lumbar instability
and the efficacy evaluation of manipulation therapy. Therefore, this paper constructed a vertebral tracking algorithm based on dynamic imaging parameter measurement through imaging parameter measurement and calculation. According to the imaging data obtained by vertebral body tracking algorithm,
the corresponding statistical methods were used to compare the functional scores before and after manipulation and the changes of imaging data, so as to evaluate the therapeutic effect of manipulation on lumbar instability. Through the clinical observation and imaging analysis of 15 patients
with lumbar instability before and after manipulation treatment, it is verified that the vertebra tracking algorithm is effective in the vertebra tracking and plays a positive role in the treatment of lumbar instability.
Collapse
Affiliation(s)
- Lanjuan Shen
- The First People's Hospital of Hangzhou City, Zhejiang Province, Hangzhou 310006, Zhejiang, China
| | - Cheng Ji
- The First People's Hospital of Hangzhou City, Zhejiang Province, Hangzhou 310006, Zhejiang, China
| | - Jian Lin
- Xiaoshan, Hangzhou City, Zhejiang Province Hospital, Hangzhou 311201, Zhejiang, China
| | - Hongping Yang
- The First People's Hospital of Hangzhou City, Zhejiang Province, Hangzhou 310006, Zhejiang, China
| |
Collapse
|
32
|
Ji QH, Xue Y, Qiao XF, Shi L, Liu SC. Study on the effect of percutaneous intervertebral foraminoscopic discectomy in the treatment of lumbar disc herniation. Medicine (Baltimore) 2021; 100:e25345. [PMID: 34106586 PMCID: PMC8133092 DOI: 10.1097/md.0000000000025345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/10/2021] [Indexed: 11/27/2022] Open
Abstract
This study explored the effect of percutaneous intervertebral foraminoscopic discectomy (PIFD) in the treatment of lumbar disc herniation (LDH).This retrospective study collected a total of 88 patient cases for inclusion. Epidemiological and clinical data of patients with LDH at the First Affiliated Hospital of Jiamusi University between May 2017 and January 2020 were retrospectively analyzed. Of those, 44 patients received PIFD and were allocated to an intervention group. The other 44 patients administrated fenestration discectomy (FD), and were assigned to a control group. We compared surgery time (minute), incision length (cm), duration of hospital stay after surgery (day), pain intensity (as checked by Visual Analogue Scale (VAS), health-related quality of life (as examined by Oswestry Disability Index, ODI), and complications between 2 groups.There were not significant differences in surgery time (minute) (P = .56), VAS (P = .33) and ODI (P = .46) after surgery between 2 groups. However, there were significant differences in incision size (cm) (P < .01) and length of hospital stay (day) (P < .01) after surgery between 2 groups. When compared before the surgery, patients in both groups had significant improvements in VAS (P < .01) and ODI (P < .01) after the surgery. Moreover, both groups had similar safety profiles (P > .05).The findings of this study showed that both PIFD and FD benefit patients with LDH. However, PIFD can benefit patients more than FD in the incision size and duration of hospital stay after surgery.
Collapse
Affiliation(s)
| | - Yu Xue
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Jiamusi University, Jiamusi, China
| | | | - Lei Shi
- First Ward of Orthopedics Department
| | | |
Collapse
|
33
|
Zhong X, Liu J, Wang Y, Zhang L, Zhang H. Which of the acupuncture treatment regimen for lumbar disc herniation is more effective and safer: A protocol for systematic review and network meta-analysis. Medicine (Baltimore) 2021; 100:e25199. [PMID: 33761703 PMCID: PMC9281967 DOI: 10.1097/md.0000000000025199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Lumbar disc herniation (LDH) is the most common cause of low back pain and severely affects people's quality of life and ability to work. Although many clinical trials and medical reports conducted over the years have shown that acupuncture treatments are effective for LDH, the comparative effectiveness of these different acupuncture therapies is still unclear. This protocol of a network meta-analysis was designed to compare the effects and safety of acupuncture treatment regimens on LDH using both direct and indirect evidence. METHODS AND ANALYSIS This protocol is reported according to the 2015 PRISMA-P and PRISMA guidelines for acupuncture. Eight databases and two platforms will be searched for articles published from their establishment to 1 December 2020 with medical subject heading terms and keywords. Three reviewers will verify the eligible randomized controlled trials independently. NoteExpress (3.2.0) software will be utilized to manage the literature. The overall quality of evidence will be evaluated by Confidence In Network Meta-Analysis (CINeMA). Additionally, we will conduct a meta-analysis of the effectiveness, recurrence rate, and symptom score of acupuncture in treating LDH using Review Manager (RevManV.5.4.1) and R4.0.2 software (The R Foundation for Statistical Computing). RESULTS The results of the study will be published in journals or relevant conferences. CONCLUSION This proposed systematic review will evaluate the comparative efficacy and safety of various acupuncture methods and combination protocols for LDH.
Collapse
Affiliation(s)
| | - Jiaxin Liu
- Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou
| | - Yanping Wang
- Evidence-based Medicine Research Centre, Jiangxi University of Traditional Chinese Medicine, Jiangxi, China
| | | | | |
Collapse
|
34
|
Byun DY, Kim H, Han SH, Kim KW, Lee JH, Chung WS, Song MY, Cho JH. Pharmacopuncture for lumbar herniated intervertebral disc: A systematic review and meta-analysis. Complement Ther Clin Pract 2021; 43:101369. [PMID: 33765550 DOI: 10.1016/j.ctcp.2021.101369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 02/16/2021] [Accepted: 03/13/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The purpose of this systematic review was to evaluate the effectiveness of pharmacopuncture treatment for lumbar herniated intervertebral disc (LHIVD). METHODS Databases including Korean and Chinese ones were searched to identify all randomized controlled trials (RCTs) that evaluated the effect of pharmacopuncture on LHIVD. Outcome measurements included pain scale and functional index of the lower back and lower limb. The risk of bias of studies was assessed using Cochrane's Risk of Bias tool, and a meta-analysis was conducted. RESULTS Sixteen studies were included in the systematic review, and the quality assessment showed equivocal results. The meta-analysis revealed that pharmacopuncture has a significant effect on pain relief and functional status compared to the control intervention.
Collapse
Affiliation(s)
- Da-Young Byun
- Department of Rehabilitation Medicine of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Hyungsuk Kim
- Department of Rehabilitation Medicine of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Si-Hoon Han
- Department of Rehabilitation of Korean Medicine, College of Korean Medicine, Dae-Jeon University, Daejeon 34520, Republic of Korea
| | - Koh-Woon Kim
- Department of Rehabilitation Medicine of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Jun-Hwan Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon 34520, Republic of Korea
| | - Won-Seok Chung
- Department of Rehabilitation Medicine of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Mi-Yeon Song
- Department of Rehabilitation Medicine of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Jae-Heung Cho
- Department of Rehabilitation Medicine of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea.
| |
Collapse
|
35
|
Zhang Y, Tan W, Wu M, Sun J, Cao W, Zhou CS, Wu Y. Characterization and cytocompatibility of 3D porous biomimetic scaffold derived from rabbit nucleus pulposus tissue in vitro. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2021; 32:8. [PMID: 33471211 PMCID: PMC7817588 DOI: 10.1007/s10856-020-06480-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 12/18/2020] [Indexed: 05/13/2023]
Abstract
Intervertebral disc (IVD) degeneration is one of the most important causes of lower back pain. Tissue engineering provides a new method for the experimental treatment of degenerative disc diseases. This study aims to develop a natural, acellular, 3D interconnected porous scaffold derived from the extracellular matrix (ECM) of nucleus pulposus. The nucleus pulposus (NP) was decellularized by sequential detergent-nuclease methods, including physical crushing, freeze-drying and cross-linking. These 3D porous scaffolds were fabricated with a high porosity of (81.28 ± 4.10)%, an ideal pore size with appropriate mechanical properties. Rabbit bone marrow mesenchymal stem cells (rBMSCs) were seeded and cultured on the scaffolds. And the mechanical tests showed the compressive elastic modulus of the scaffolds cultured for 4 weeks reached 0.12 MPa, which was better than that of the scaffolds cultured for 2 weeks (0.07 MPa) and that of the control group (0.04 MPa). Scanning electron microscopy (SEM), histological assays, molecular biology assays revealed that the scaffolds could provide an appropriate microstructure and environment for the adhesion, proliferation, migration and secretion of seeded cells in vitro. As assays like histology, immunohistochemistry and the real-time qRT-PCR showed, NP-like tissues were preliminarily formed. In conclusion, the 3D porous scaffold derived from NP ECM is a potential biomaterial for the regeneration of NP tissues. A natural, acellular, 3D interconnected porous scaffold derived from the extracellular matrix (ECM) of nucleus pulposus was developed by sequential detergent-nuclease and freeze-drying method, which can reduce the damage of protein activity to the minimum. It is very similar to the composition and internal environment of the natural nucleus pulposus, because it derived from the natural nucleus pulposus. Scanning electron microscopy (SEM), histological assays, molecular biology assays revealed that the scaffolds could provide an appropriate microstructure and environment for the adhesion, proliferation, migration, and secretion of seeded cells in vitro.
Collapse
Affiliation(s)
- Yu Zhang
- Department of Orthopaedics, General Hospital of Southern Theatre Command of PLA, Guangzhou, 510010, Guangdong, PR China
| | - Wei Tan
- Department of Spinal Orthopedics, Huizhou Third People's Hospital, Guangzhou Medical University, Huizhou, 516002, Guangdong, PR China
- Department of Spine Surgery, The Third Xiangya Hospital of Central South University, Changsha, 410013, Hunan, PR China
| | - Mingxin Wu
- Department of Spinal Orthopedics, Huizhou Third People's Hospital, Guangzhou Medical University, Huizhou, 516002, Guangdong, PR China
| | - Jin Sun
- Department of Spinal Orthopedics, Huizhou Third People's Hospital, Guangzhou Medical University, Huizhou, 516002, Guangdong, PR China.
| | - Wei Cao
- Department of Spinal Orthopedics, The first people's hospital of Huaihua, Huaihua, 418000, Hunan, PR China
| | - Chu-Song Zhou
- Department of Orthopaedics, Zhu-Jiang Hospital of Southern Medical University (First Military Medical University), Guangzhou, 510282, Guangdong, PR China.
| | - You Wu
- Department of Orthopaedics, General Hospital of Southern Theatre Command of PLA, Guangzhou, 510010, Guangdong, PR China
| |
Collapse
|
36
|
Miao Z, Tong Z, Ye J, Leng S, Wang M, Hu A, Zhang J, Dai X, Liang J, Geng Y, Chen L, Ye B, Dong Y. Tuina for lumbar disc herniation: A protocol for systematic review and meta analysis. Medicine (Baltimore) 2021; 100:e24203. [PMID: 33429811 PMCID: PMC7793356 DOI: 10.1097/md.0000000000024203] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/15/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Lumbar disc herniation (LDH) is an important factor of causing leg pain and numbness. As a secondary discipline of Traditional Chinese Medicine, tuina is widely used for the treatment of LDH in China even in other nations while its clinical value is not acknowledged universally. So, we focus on this article aims to evaluate its efficacy and safety of LDH. METHODS Electronic databases involving Cochrane Library, PubMed, Web of Science, EMBASE, China Science and Technology Journal, China National Knowledge Infrastructure, Wanfang and Chinese Biomedical Literature Database will be pertained with appropriate search strategy. And RevMan V.5.3.5 software will be conducted as the assessment tool for bias risk, data synthesis, subgroup analysis as well as meta-analyses. RESULTS This systematic review will provide a high-quality synthesis of current evidence of tuina for LDH. CONCLUSION This protocol will determine whether Tuina is an effective and safe treatment method for LDH.
Collapse
Affiliation(s)
- Zuoxiong Miao
- School of Acupuncture-Tuina and Rehabilitation, Yunnan University of Chinese Medicine, Kunming
| | - Zhenglan Tong
- School of Acupuncture-Tuina and Rehabilitation, Yunnan University of Chinese Medicine, Kunming
| | - Jinfei Ye
- The first Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shihan Leng
- School of Acupuncture-Tuina and Rehabilitation, Yunnan University of Chinese Medicine, Kunming
| | - Min Wang
- School of Acupuncture-Tuina and Rehabilitation, Yunnan University of Chinese Medicine, Kunming
| | - Anli Hu
- School of Acupuncture-Tuina and Rehabilitation, Yunnan University of Chinese Medicine, Kunming
| | - Jingyu Zhang
- School of Acupuncture-Tuina and Rehabilitation, Yunnan University of Chinese Medicine, Kunming
| | - Xingze Dai
- Clinical Medical college, Yunnan University of Chinese Medicine
| | - Jiarong Liang
- School of Acupuncture-Tuina and Rehabilitation, Yunnan University of Chinese Medicine, Kunming
| | - Yunlong Geng
- School of Acupuncture-Tuina and Rehabilitation, Yunnan University of Chinese Medicine, Kunming
| | - Liang Chen
- School of Acupuncture-Tuina and Rehabilitation, Yunnan University of Chinese Medicine, Kunming
| | - Bin Ye
- Yunnan St.John's Hospital
| | - Youkang Dong
- The first Affiliated Hospital, Yunnan University of Chinese Medicine/Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, China
| |
Collapse
|
37
|
Wang M, Zheng B, Wu C, Yi S. The efficacy and safety of fire needle for the treatment of lumbar disc herniation: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e23751. [PMID: 33327365 PMCID: PMC7738131 DOI: 10.1097/md.0000000000023751] [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: 11/03/2020] [Accepted: 11/18/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND A very large acceleration in clinical studies on the efficacy of fire needle to treat lumbar disc herniation (LDH) are increasing, while studies on the assessment of its efficacy are still lacking. Therefore, this study will demonstrate the efficacy of fire needle in the treatment of LDH combining with the meta-analysis. METHODS The studies on randomized controlled trials (RCTs) will be searched at the databases of China National Knowledge Infrastructure (CNKI), WANFANG database (Chinese Medicine Premier), Chinese Scientific Journal Database (VIP), Chinese Biomedical Literature database (CBM), PubMed, EMBASE, and Cochrane Library from their inception to May 1, 2020. RESULTS This authentic and multi-dimensional study will shed light on the referable information for the treatment of LDH with fire needle. CONCLUSION This study will evaluate the efficacy of fire needle in the treatment of LDH. REGISTRATION PROSPERO (registration number CRD42020158596).
Collapse
Affiliation(s)
- Meiyuan Wang
- Chongqing Traditional Chinese Medicine Hospital Rehabilitation Department, Chongqing
| | - Beisi Zheng
- Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Cunshu Wu
- Clinical Medical College of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Shixiong Yi
- Chongqing Traditional Chinese Medicine Hospital Rehabilitation Department, Chongqing
| |
Collapse
|
38
|
Dai F, Dai YX, Jiang H, Yu PF, Liu JT. Non-surgical treatment with XSHHD for ruptured lumbar disc herniation: a 3-year prospective observational study. BMC Musculoskelet Disord 2020; 21:690. [PMID: 33076896 PMCID: PMC7574183 DOI: 10.1186/s12891-020-03723-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 10/15/2020] [Indexed: 12/02/2022] Open
Abstract
Background Lumbar disc herniation (LDH) is mainly caused by annular fiber disruption with a discrete leakage of nucleus pulposus pressing on a nerve, resulting in back pain and radiating pain. Most patients with LDH can be treated conservatively, but there are many different conservative treatments. Furthermore, most previous studies did not evaluate the long-term efficacy of these treatments and the prognosis. Therefore, an effective and safe therapeutic strategy is lacking for patients with LDH. In this study, we evaluated Xiao Sui Hua He decoction (XSHHD) in the treatment of LDH. Methods This was a rigorous prospective observational 3-year follow-up study. We recruited 69 participants with ruptured lumbar disc herniation (RLDH) between February 2014 and February 2016. Patients took XSHHD orally twice a day for 6 months. The primary outcome measurements were visual analogue scale (VAS) pain score, Oswestry disability index (ODI) and straight leg raising test (SLRT). The secondary outcome measurements was nucleus pulposus protrusion volume on magnetic resonance imaging (MRI). Clinical outcomes were measured at baseline (Visit 1), and at 3, 6, 12, and 36 months (Visit 2, 3, 4, and 5, respectively).. Results Sixty-three patients were followed-up for 3 years after treatment. SLRT and ODI after non-surgical treatment improved significantly compared with baseline (P < .001). There were no statistically significant differences at 6 months vs 36 months for SLRT and ODI. VAS scores (leg, back) after 3 years of treatment were statistically significantly different compared with baseline (P < .001; Z = − 6.93, − 6.637). The baseline protrusion volume was 2018.61 ± 601.16 mm3, and the volume decreased significantly to 996.51 ± 387.42 mm3 at 36 months (t = 12.863; P < .001). The volume of protrusion resorption rate (VPRR) at 36 months was 47.24 ± 23.99%, with significant resorption in 23 cases, partial resorption in 23 cases, no resorption in 15 cases, and increased volume in 2 cases. Conclusions This study showed that non-surgical treatment with XSHHD was effective, and the study clarified the natural outcomes in LDH.
Collapse
Affiliation(s)
- Feng Dai
- Department of Orthopedics, Suzhou TCM Hospital affiliated to Nanjing University of Traditional Chinese Medicine, Suzhou, 215009, Jiangsu Province, China
| | - Yu Xiang Dai
- Department of Orthopedics, Suzhou TCM Hospital affiliated to Nanjing University of Traditional Chinese Medicine, Suzhou, 215009, Jiangsu Province, China
| | - Hong Jiang
- Department of Orthopedics, Suzhou TCM Hospital affiliated to Nanjing University of Traditional Chinese Medicine, Suzhou, 215009, Jiangsu Province, China
| | - Peng Fei Yu
- Department of Orthopedics, Suzhou TCM Hospital affiliated to Nanjing University of Traditional Chinese Medicine, Suzhou, 215009, Jiangsu Province, China
| | - Jin Tao Liu
- Department of Orthopedics, Suzhou TCM Hospital affiliated to Nanjing University of Traditional Chinese Medicine, Suzhou, 215009, Jiangsu Province, China.
| |
Collapse
|
39
|
Liu Y, Yu Y, Dai H, Fei A. Efficacy of Shufeng Jiedu Capsules in the treatment of sepsis: A prospective, randomized, placebo-controlled trial. Eur J Integr Med 2020. [DOI: 10.1016/j.eujim.2020.101172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
40
|
Biomechanical Comparison of Lumbar Fixed-Point Oblique Pulling Manipulation and Traditional Oblique Pulling Manipulation in Treating Lumbar Intervertebral Disk Protrusion. J Manipulative Physiol Ther 2020; 43:446-456. [DOI: 10.1016/j.jmpt.2019.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 05/07/2019] [Accepted: 10/10/2019] [Indexed: 11/22/2022]
|
41
|
Jeong JK, Kim E, Yoon KS, Jeon JH, Kim YI, Lee H, Kwon O, Jung SY, Lee JH, Yang C, Kang JH, Han CH. Acupotomy versus Manual Acupuncture for the Treatment of Back and/or Leg Pain in Patients with Lumbar Disc Herniation: A Multicenter, Randomized, Controlled, Assessor-Blinded Clinical Trial. J Pain Res 2020; 13:677-687. [PMID: 32280270 PMCID: PMC7131997 DOI: 10.2147/jpr.s234761] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 03/07/2020] [Indexed: 12/29/2022] Open
Abstract
Background Acupotomy, which involves the addition of a scalpel function to the conventional acupuncture treatment, has recently been applied as a conservative treatment method for lumbar disc herniation (LDH). This study investigated the effectiveness and safety of acupotomy, compared to manual acupuncture, for the treatment of patients with LDH. Methods A total of 146 patients diagnosed with LDH were randomly assigned to either the acupotomy group or the manual acupuncture group at a 1:1 ratio. Participants in both groups received four sessions of each intervention over 2 weeks. Outcome assessments based on the visual analog scale (VAS), Roland Morris Disability Questionnaire (RMDQ), Modified-Modified Schober Test (MMST), EuroQol Five Dimensions (EQ-5D), clinically important difference (CID), and patient global impression of change (PGIC) were conducted at baseline and at 2, 4, and 6 weeks post-randomization. Results The acupotomy group showed significant improvement in VAS and MMST at 2, 4, and 6 weeks than did the manual acupuncture group. RMDQ was significantly different between the two groups at 2 and 6 weeks. In EQ-5D, there was no significant difference between the two groups. The proportion of patients with ≥15 mm decrease on the VAS (minimal CID) was significantly higher in the acupotomy group at weeks 2 and 4. Better improvement in the PGIC at week 4 was also observed in the acupotomy group. Post-intervention muscle pain was reported, but there was no serious adverse event related to interventions. Conclusion In this study, four sessions of acupotomy treatment were found to be effective in improving the pain intensity and range of motion of the lumbar region in patients with LDH. Despite post-treatment muscle pain, acupotomy treatment can be considered a preferred treatment method over manual acupuncture. Trial Registration This trial has been registered 24 April 2018 in Clinical Research Information Service of South Korea (CRIS-KCT0002824).
Collapse
Affiliation(s)
- Jeong Kyo Jeong
- Department of Acupuncture and Moxibustion Medicine, Daejeon University Dunsan Korean Medicine Hospital, Daejeon, Republic of Korea
| | - Eunseok Kim
- Department of Acupuncture and Moxibustion Medicine, Daejeon University Dunsan Korean Medicine Hospital, Daejeon, Republic of Korea
| | - Kwang Sik Yoon
- Department of Acupuncture and Moxibustion Medicine, Daejeon University Cheonan Korean Medicine Hospital, Cheonan, Republic of Korea
| | - Ju Hyun Jeon
- Department of Acupuncture and Moxibustion Medicine, Daejeon University Dunsan Korean Medicine Hospital, Daejeon, Republic of Korea
| | - Young Il Kim
- Department of Acupuncture and Moxibustion Medicine, Daejeon University Dunsan Korean Medicine Hospital, Daejeon, Republic of Korea
| | - Hyun Lee
- Department of Acupuncture and Moxibustion Medicine, Daejeon University Cheonan Korean Medicine Hospital, Cheonan, Republic of Korea
| | - Ojin Kwon
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - So-Young Jung
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Jun-Hwan Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea.,Korean Medicine Life Science, University of Science and Technology (UST), Campus of Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Changsop Yang
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Jae Hui Kang
- Department of Acupuncture and Moxibustion Medicine, Daejeon University Cheonan Korean Medicine Hospital, Cheonan, Republic of Korea
| | - Chang-Hyun Han
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea.,Korean Medicine Life Science, University of Science and Technology (UST), Campus of Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| |
Collapse
|
42
|
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.
Collapse
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.
| |
Collapse
|
43
|
Ji Y, Li X, Wang Z, Xiao W, He Z, Xiong Z, Zhao L. Extraction optimization of accelerated solvent extraction for eight active compounds from Yaobitong capsule using response surface methodology: Comparison with ultrasonic and reflux extraction. J Chromatogr A 2020; 1620:460984. [PMID: 32102737 DOI: 10.1016/j.chroma.2020.460984] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 01/23/2020] [Accepted: 02/17/2020] [Indexed: 12/27/2022]
Abstract
This work described the development of a novel method for simultaneous extraction of eight active compounds (including catechin, albiflorin, paeoniflorin, ferulic acid, ginsenoside Rg1, tetrahydropalmatine, ginsenoside Rb1 and osthole) from Yaobitong capsule by accelerated solvent extraction (ASE). Response surface methodology (RSM) with desirability functions was employed to optimize the extraction conditions yielding the optimal conditions of ASE (extraction time 8 min, extraction temperature 80 °C, extraction solvent 70% methanol and flushing volume 100%). A high-performance liquid chromatography coupled with a diode array detector (HPLC-DAD) method was developed and validated for simultaneous quantification of the eight compounds in Yaobitong capsule. The values of correlation coefficient (R) were satisfactory between 0.9992 and 0.9999 over the linear concentration range of 0.5-1000 μg mL-1. It was found that the limits of detection (LODs) and the limits of quantification (LOQs) for the eight active compounds were 0.10-2.90 μg•mL-1 and 0.30-9.40 μg•mL-1, respectively. The recoveries of the eight main active compounds in Yaobitong capsule were in the range of 93.31%-106.22%. And the contents of the analytes extracted by ASE under the optimal conditions were compared to traditional solvent extraction methods, such as ultrasonic and reflux extraction. The results indicated that the ASE method proved to be more suitable for the extract of active compounds in Yaobitong capsule, which could obtain higher extraction efficiency. At last, the proposed method was applied to analyze ten batches of actual samples, which provided high extraction efficiency and had wide potential application in the analysis of traditional Chinese medicines.
Collapse
Affiliation(s)
- Yinghe Ji
- School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road Shenhe District, Shenyang 110016, China
| | - Xianhui Li
- School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road Shenhe District, Shenyang 110016, China
| | - Zhenzhong Wang
- Jiangsu Kanion Pharmaceutical Co. Ltd., Lianyungang 222002, China
| | - Wei Xiao
- Jiangsu Kanion Pharmaceutical Co. Ltd., Lianyungang 222002, China
| | - Zhonggui He
- School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road Shenhe District, Shenyang 110016, China
| | - Zhili Xiong
- School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road Shenhe District, Shenyang 110016, China
| | - Longshan Zhao
- School of Pharmacy, Shenyang Pharmaceutical University, 103 Wenhua Road Shenhe District, Shenyang 110016, China.
| |
Collapse
|
44
|
Combination of Rehabilitative Therapy with Ultramicronized Palmitoylethanolamide for Chronic Low Back Pain: An Observational Study. Pain Ther 2019; 9:319-326. [PMID: 31863365 PMCID: PMC7203351 DOI: 10.1007/s40122-019-00140-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Indexed: 12/18/2022] Open
Abstract
Introduction Chronic low back pain (LBP) caused by intervertebral disc herniation was reported in the 2010 Global Burden of Disease study to be the main reason for years lived with disability. It causes significant personal, social, and economic burdens. Many of those who suffer from LBP find conventional medical treatments to be unsatisfactory for treating their pain, so they are increasingly resorting to complementary and alternative medicine (CAM) therapies. Given that the population is aging, there is an urgent need to characterize the combinations of complementary therapies that yield the best outcomes and treatments, even for prolonged periods. This observational study aimed to evaluate the effect of ultramicronized palmitoylethanolamide (umPEA) + CAM (daily functional rehabilitation + decontracting massage) therapies on chronic pain in patients suffering from multiple herniated discs in the lumbar spine. Methods Eligible patients received 600 mg of umPEA twice a day in combination with a daily functional rehabilitation session according to the McKenzie Method of Mechanical Diagnosis and Therapy plus a decontracting massage for 20 consecutive days, followed by 600 mg of umPEA once a day for 40 days in addition to standard therapy. Results The results showed that the average pain intensity score, evaluated via the Numeric Rating Scale, progressively decreased during the study period, reaching a value that was not clinically relevant at the end of the observation period. Pain relief was paralleled by improvements in the physical and mental components of quality of life as evaluated with the SF-36 questionnaire as well as in disability for low back pain as evaluated with the Oswestry Disability Questionnaire. Collectively, the results demonstrate that umPEA in combination with CAM therapies could be an important strategy for combating LBP. Conclusions The multiple action of PEA in combination with CAM therapies may represent the multitarget approach needed to tackle the as-yet unsolved problem of chronic pain resistant to conventional therapies.
Collapse
|
45
|
Shen X, Li L, Ma Q, Chen H, Wang J, Lv L, Li Y. Pharmacokinetic study of eight bioactive components following oral administration of Zhiqiao Gancao decoction and observation of its clinical efficacy. Biomed Chromatogr 2019; 34:e4706. [PMID: 31629372 DOI: 10.1002/bmc.4706] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 09/09/2019] [Accepted: 09/17/2019] [Indexed: 01/21/2023]
Affiliation(s)
- Xiaofeng Shen
- Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine Suzhou China
| | - Ling Li
- School of PharmacySecond Military Medical University Shanghai China
| | - Qihan Ma
- Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine Suzhou China
| | - Hua Chen
- Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine Suzhou China
| | - Jiangping Wang
- Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine Suzhou China
| | - Lei Lv
- Department of PharmacyShanghai Eastern Hepatobiliary Surgery Hospital Shanghai China
| | - Yuwei Li
- Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine Suzhou China
| |
Collapse
|
46
|
Wang J, Zhang Y, Liu YM, Yang XC, Chen YY, Wu GJ, He XH, Duan L, Dong Y, Ma RF. Uncovering the protective mechanism of Huoxue Anxin Recipe against coronary heart disease by network analysis and experimental validation. Biomed Pharmacother 2019; 121:109655. [PMID: 31734577 DOI: 10.1016/j.biopha.2019.109655] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 10/21/2019] [Accepted: 11/06/2019] [Indexed: 12/12/2022] Open
Abstract
Coronary heart disease (CHD) is a leading cause of death and disability worldwide. Huoxue Anxin Recipe (HAR) is a novel Chinese Herbal Medicine formula of that has been used to treat CHD for several decades. Our previous study found that HAR had anti-oxidative effects, and could promote myocardial angiogenesis and improve cardiac function following myocardial infarction (MI) in rats. However, the active compounds, potential targets, and biological processes related to HAR have not been systematically investigated. Here, network pharmacology and experimental validation were used to study the protective mechanisms of HAR against CHD. We identified 124 active components, 124 verified targets, and 111 predictive targets. A total of 1192 genes related to CHD were identified by cDNA microarray and database analysis. A total of 47 putative targets of HAR against CHD were identified, including 32 verified targets and 15 predictive targets. ClueGo enrichment analysis identified 49 biological processes involved in the anti-CHD effects of HAR. Among them, the negative regulation of blood coagulation and regulation of collagen biosynthetic process were experimentally validated. After constructing a protein-protein interaction network and clustering with MECODE and ClusterONE, 162 key proteins (from ClueGo and clustering) were used to construct an internal interaction network. Complement C3 (C3), Fibrinogen alpha (FGA), Fibrinogen gamma (FGG), interleukin-6 (IL6), and Apolipoprotein A1 (APOA1) were the top 5 hub proteins identified by cytoHubber analysis. HAR limited the concentrations of C3, FGA, FGG, and IL6 and increased APOA1 levels. The results indicated that HAR could down-regulate blood coagulation, regulate collagen biosynthesis, inhibit peroxidation and inflammation injury, and promote cholesterol efflux. HAR could be a potential source of novel and effective drugs for CHD.
Collapse
Affiliation(s)
- Jie Wang
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Yun Zhang
- Immunology Research Department, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
| | - Yong-Mei Liu
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
| | - Xiao-Chen Yang
- Department of Cardiology & Health Care, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Yin-Ying Chen
- Department of Research Office, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Guang-Jun Wu
- Immunology Research Department, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Xuan-Hui He
- Immunology Research Department, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Lian Duan
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Yan Dong
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| | - Ru-Feng Ma
- Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China
| |
Collapse
|
47
|
Clinical effectiveness and safety of acupotomy: An overview of systematic reviews. Complement Ther Clin Pract 2019; 36:142-152. [DOI: 10.1016/j.ctcp.2019.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 07/03/2019] [Accepted: 07/03/2019] [Indexed: 12/16/2022]
|
48
|
Comparisons of the Effectiveness and Safety of Tuina, Acupuncture, Traction, and Chinese Herbs for Lumbar Disc Herniation: A Systematic Review and Network Meta-Analysis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:6821310. [PMID: 31015852 PMCID: PMC6446119 DOI: 10.1155/2019/6821310] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 02/17/2019] [Accepted: 02/19/2019] [Indexed: 12/20/2022]
Abstract
Background Tuina, acupuncture, traction, and Chinese herbs play an important role in the treatment of lumbar disc herniation. However, the comparative effectiveness and safety of the four commonly utilized treatment modalities are still unclear. Objective To compare the effectiveness and safety of the four interventions for lumbar disc herniation. Methods Randomized controlled trials comparing any two of the four interventions in the treatment of lumbar disc herniation were identified using the following databases: PubMed, the Cochrane Library, Embase, Web of Science, the China National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, and Wanfang data, and network meta-analysis was performed using STATA 14.0. Results One hundred and twenty-one studies involving a total of 13075 patients were included. In all the outcome measurements, traction demonstrated a worst effectiveness, and Tuina and acupuncture demonstrated a best effectiveness, but no significant differences were found between Tuina and acupuncture. Compared with Tuina or acupuncture, Chinese herbs showed a similar effectiveness in Visual Analogue Score and Japanese Orthopedic Association Scores, but an inferior effectiveness in invalid rate and cure rate. Conclusions In the treatment of lumbar disc herniation, Tuina and acupuncture were superior to traction or Chinese herbs, and the effectiveness of traction was the worst. However, considering the limitations of this review, more high-quality trials, especially those comparing Chinese herbs with the other three interventions, should be carried out in the future to further confirm the current findings.
Collapse
|
49
|
Goo B, Kim SJ, Kim EJ, Nam D, Lee HJ, Kim JS, Park YC, Baek YH, Nam SS, Seo BK. Clinical research on the efficacy and safety of Bosinji for low back pain with radiculopathy caused by herniated intervertebral disc of the lumbar spine: A protocol for a multicenter, randomized, controlled equivalence trial. Medicine (Baltimore) 2018; 97:e13684. [PMID: 30558079 PMCID: PMC6320215 DOI: 10.1097/md.0000000000013684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND A lumbar herniated intervertebral disc (LHIVD) is a common problem that usually causes low back pain and radiating pain. The effectiveness of Bosinji, one of the herbal medicines used for low back pain and radiating pain in patient with LHIVD, has been reported in several studies; however, little clinical evidence is available owing to the methodological limitations in previous studies. Hence, the present study aims to establish the clinical evidence regarding the efficacy and safety of Bosinji in improving pain, function, and quality of life in LHIVD patients. METHOD/DESIGN This is a multicenter, open-label, randomized, controlled, and equivalence trial with 2 parallel arms. A total of 74 patients who have low back pain and radiating pain due to LHIVD will be recruited and randomly allocated to the experimental group and control group. The patients in the experimental group and control group will take 2.5 g of Bosinji granule (1.523 g of Bosinji extract) or Loxonin tablet (60 mg of loxoprofen) 3 times a day for 6 weeks. Additionally, both groups will receive the same acupuncture treatment once a week for 6 weeks as a concurrent treatment. Changes in the 100-mm visual analogue scale (VAS) for low back pain after 6 weeks from baseline will be assessed as the primary outcome. Furthermore, the 100-mm VAS for radiating pain, Oswestry disability index (ODI), Roland-Morris disability questionnaire (RMDQ), EuroQol 5 Dimensions 5 Levels (EQ-5D-5L), global perceived effect (GPE), and deficiency syndrome of kidney index (DSKI) will be used to evaluate secondary outcomes. Outcomes will be assessed at baseline and at 3, 6, and 10 weeks after screening. For the safety evaluation, laboratory examinations including complete blood count, liver function test, renal function test, blood coagulation test, inflammation test, and urine analysis will be conducted before and after taking the medications. DISCUSSION The results of this trial will be used to establish clinical evidence regarding the use of Bosinji with acupuncture treatment in the treatment of patients with LHIVD. TRIAL REGISTRATION NUMBER NCT03386149 (clinicaltrials.gov) and KCT0002848 (Clinical Research Information Service of the Republic of Korea).
Collapse
Affiliation(s)
- Bonhyuk Goo
- Department of Acupuncture and Moxibustion, Kyung Hee University Hospital at Gangdong, Seoul
| | - Sung-Jin Kim
- Department of Acupuncture and Moxibustion, Kyung Hee University Hospital at Gangdong, Seoul
| | - Eun-Jung Kim
- Department of Acupuncture and Moxibustion Medicine, College of Oriental Medicine, Dongguk University, Gyeongsangbuk-do
| | - Dongwoo Nam
- Department of Acupuncture and Moxibustion Medicine, College of Korean Medicine, Kyung Hee University, Seoul
| | - Hyun-Jong Lee
- Department of Acupuncture and Moxibustion medicine, College of Korean medicine, Daegu Haany University, Daegu, South Korea
| | - Jae-Soo Kim
- Department of Acupuncture and Moxibustion medicine, College of Korean medicine, Daegu Haany University, Daegu, South Korea
| | - Yeon-Cheol Park
- Department of Acupuncture and Moxibustion, Kyung Hee University Hospital at Gangdong, Seoul
| | - Yong-Hyeon Baek
- Department of Acupuncture and Moxibustion, Kyung Hee University Hospital at Gangdong, Seoul
| | - Sang-Soo Nam
- Department of Acupuncture and Moxibustion, Kyung Hee University Hospital at Gangdong, Seoul
| | - Byung-Kwan Seo
- Department of Acupuncture and Moxibustion, Kyung Hee University Hospital at Gangdong, Seoul
| |
Collapse
|
50
|
Jeong JK, Kim YI, Kim E, Kong HJ, Yoon KS, Jeon JH, Kang JH, Lee H, Kwon O, Jung SY, Han CH. Effectiveness and safety of acupotomy for treating back and/or leg pain in patients with lumbar disc herniation: A study protocol for a multicenter, randomized, controlled, clinical trial. Medicine (Baltimore) 2018; 97:e11951. [PMID: 30142818 PMCID: PMC6112943 DOI: 10.1097/md.0000000000011951] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 07/27/2018] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND As the number of patients suffering from back and/or leg pain due to lumbar disc herniation (LDH) is increasing in Korea, conservative treatments for patients with LDH have been spotlighted. Although several studies have been published on the use of acupotomy for the treatment of such patients, most of them are only case studies. Therefore, the purpose of this study is to compare the effectiveness and safety of acupotomy to those for manual acupuncture for the treatment of patients with LDH. METHODS/DESIGN This study is planned as a multicenter, parallel design, randomized, controlled, clinical study. One hundred forty-six patients diagnosed with LDH will be randomly assigned to either the acupotomy group or the manual acupuncture group at a 1:1 ratio. Participants in both groups will receive a total of 4 interventions over 2 weeks. An effectiveness assessment based on the outcomes on the visual analog scale (VAS), Roland Morris Disability Questionnaire (RMDQ), Modified-Modified Schober Test (MMST), EuroQol Five Dimensions (EQ-5D), and Patient Global Impression of Change (PGIC) will be conducted at baseline and at 2, 4, and 6 weeks postrandomization. The primary outcome will be the mean change in the VAS for back and/or leg pain 4 weeks postrandomization. Adverse events will be recorded at every visit. DISCUSSION The results of this study will provide evidence for the effectiveness and safety of acupotomy treatment for patients with LDH. TRIAL REGISTRATION Clinical Research Information Service of South Korea (CRIS- KCT0002824), April 24, 2018.
Collapse
Affiliation(s)
- Jeong Kyo Jeong
- Department of Acupuncture and Moxibustion Medicine, Daejeon University Dunsan Korean Medicine Hospital, Daejeon
| | - Young Il Kim
- Department of Acupuncture and Moxibustion Medicine, Daejeon University Dunsan Korean Medicine Hospital, Daejeon
| | - Eunseok Kim
- Department of Acupuncture and Moxibustion Medicine, Daejeon University Dunsan Korean Medicine Hospital, Daejeon
| | - Hae Jin Kong
- Department of Acupuncture and Moxibustion Medicine, Daejeon University Cheonan Korean Medicine Hospital, Cheonan
| | - Kwang Sik Yoon
- Department of Acupuncture and Moxibustion Medicine, Daejeon University Cheonan Korean Medicine Hospital, Cheonan
| | - Ju Hyun Jeon
- Department of Acupuncture and Moxibustion Medicine, Daejeon University Dunsan Korean Medicine Hospital, Daejeon
| | - Jae Hui Kang
- Department of Acupuncture and Moxibustion Medicine, Daejeon University Cheonan Korean Medicine Hospital, Cheonan
| | - Hyun Lee
- Department of Acupuncture and Moxibustion Medicine, Daejeon University Cheonan Korean Medicine Hospital, Cheonan
| | - Ojin Kwon
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - So-Young Jung
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Chang-Hyun Han
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| |
Collapse
|