[Clinical observation of acupoint application of Chinese herbal medicine in preventing postoperative nausea and vomiting after orthopaedic surgery under general anesthesia]

OBJECTIVE

To explore clinical effect of acupoint application of Chinese herbal medicine in preventing postoperative nausea and vomiting after orthopaedic surgery under general anesthesia.

METHODS

From January 2018 to December 2019, 168 patients who met inclusion criteria and were underwent selective spine surgery, were double-blind divided into two groups according to central random system, 84 patients in each group. In control group, there were 39 males and 45 females aged from 30 to 65 years old with an average of (53.83±9.17) years old, 37 patients were classified to typeⅠand 47 patients were typeⅡ according to American Society of Anesthesiologists (ASA) grading. In experiment group, there were 39 males and 45 females aged from 30 to 65 years old with an average of (54.08±9.00) years old; 32 patients were classified to typeⅠand 52 patients were typeⅡ according to ASA grading. Both of two groups were obtained acupoint application before anesthesia induction, and acupoint application were put on Zhongwan (CV 12) and bilateral Neiguan (PC 6) for 6 h, changed after 24 h, last for 2 d. The drug prescription of plasters in experimental group was consist of Rhizome Pinelliae Preparata, Ginger and Clove. The plasters in control group was consistent with drug plasters in experimental group in appearance and smell to the greatest extent. The ingredients were flour and excipients with 10% of experimental drug concentration. Incidence of nausea vomiting, visual analogue scale (VAS) of narusea degree at 24 h and 24 to 48 h after operation between two groups were compared, SF- 12 simple quality of life score before operation, 24 and 48 h after operation were also compared by using R3.6.1 Rstudio software by the third-party.

RESULTS

There were no statistical differences in incidence of nausea vomiting, VAS of narusea degree at 24 h after operation (P>0.05), while there were no differences in incidence of nausea vomiting, VAS of narusea degree at 24 to 48 h after operation (P>0.05) . There were no statistical differences in SF-12 before operation, 24 and 48 h after opertaion (P>0.05).

CONCLUSION

The curative effect of acupoint application of traditional Chinese medicine on the prevention and treatment of postoperative nausea and vomiting is not obvious.

Preventive and therapeutic effectiveness of Sanfu acupoint herbal patching for chronic obstructive pulmonary disease at stable stages: a systematic review and Meta-analysis

OBJECTIVE

To evaluate the preventive and therapeutic effects of Sanfu acupoint herbal patching (SAHP) in adjuvant treatment in patients with stable chronic obstructive pulmonary disease (COPD).

METHODS

We had searched eight electronic databases and six major trial registries from their inception to July 2017 for randomized controlled trials (RCTs). We utilized RevMan 5.3 to evaluate the methodological quality and to perform data analyses.

RESULTS

A total of 28 RCTs involving 1615 records were included in the descriptive analysis, and 25 RCTs were performed for Meta-analysis. Lung function such as forced vital capacity rate of one second FEV1/predicted%, forced vital capacity (FVC) % found no significant difference. The results of Meta-analysis showed that SAHP plus conventional therapy (CT) in the treatment of stable COPD were better than CT, in second sessions' data of FEV1, in third sessions' data of FEV1/FVC, in three sessions' data of SGRQ, in third session's data of Modified Medical Research Council and 6MWT. The symptoms of SAHP's adverse reactions seem to be mild and the incidence of that seems to be low. Descriptive analysis shows that SAHP with CT seems to improve clinical effective rate and had a certain preventive effect on acute exacerbation of COPD, which the curative effect may be better with the increase of treatment course.

CONCLUSION

SAHP with CT appears to be more effective than CT or CT plus placebo only on improving the quality of life, but the effect on lung function is not obvious. Improve clinical effective rate and preventive effect is uncertainty. SAHP with CT may be used in any Grade to safely treat patients with stable COPD. The more exactly clinical effect still needs to be proved by more high-quality, large sampling, multilingual RCTs.

Altered metabolites in guinea pigs with allergic asthma after acupoint sticking therapy: New insights from a metabolomics approach

BACKGROUND

Clinical evidence gathered in Chinese communities suggested that acupoint sticking therapy could be an alternative treatment for asthma-related diseases. However, its underlying mechanism is still poorly understood.

AIM/HYPOTHESIS

In this study, we aimed to investigate the mechanism of the anti-inflammatory effect of acupoint sticking application with 'Treatment of Winter Disease in Summer' (TWDS) prescription by using metabolomics.

METHODS

Allergic asthma in guinea pig was sensitized and challenged by ovalbumin (OVA). Histopathological evaluation of the lung tissue was performed by hematoxylin and eosin (H&E) staining and Masson's trichrome staining. The levels of Th2 cytokine and IgE level in serum were measured using enzyme-linked immunoassay (ELISA). The mRNA expression levels of IL-4, IL-5, IL-13 and orosomucoid-like 3 (ORMDL3) were measured using quantitative reverse transcription polymerase chain reaction (RT-qPCR). Proteins of NF-κB signaling pathway were measured using western blot. The serum metabolomics profiles were obtained by using ultra-performance liquid chromatography combined with electrospray ionization quadrupole time-of-flight mass spectrometry (UPLC-ESI-QTOF-MS).

RESULTS

The overall results confirmed that AST with TWDS prescription had a significant protective effect against OVA-induced allergic asthma in guinea pig. This treatment not only attenuated airway inflammation and collagen deposition in the airway, but also decreased the levels of IL-4, IL-5, IL-13 and IgE in serum. In addition, metabolomics results indicated that metabolisms of phospholipid, sphingolipid, purine, amino acid and level of epinephrine were restored back to the normal control level. Moreover, results of the gene expression of ORMDL3 in lung tissues indicated that AST using TWDS could alter the sphingolipid metabolism. Further western blotting analysis also showed that its anti-inflammatory mechanism was by decreasing the phosphorylation of p65 and IκB.

CONCLUSION

The study demonstrated that metabolomics provides a better understanding of the actions of TWDS acupoint sticking therapy on OVA-induced allergic asthma.