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Efficacy of externally applied Chinese herbal drugs in treating psoriasis: a systematic review.

Nuo LI ; Yue-Qing LI ; Hong-Yan LI ; Wei GUO ; Yan-Ping BAI

Chinese journal of integrative medicine.2012;18(3):222-229. doi:10.1007/s11655-012-1004-3

OBJECTIVETo assess the efficacy and safety of external application of Chinese herbal drugs (ex-CHD) in the treatment of psoriasis.

METHODSLiterature regarding randomized clinical trials (RCTs) of psoriasis treatments with ex-CHD, either alone or combined with Western medicine (WM) or physiotherapy, controlled by untreated, placebo or WM treatment were found in electronic databases, including PubMed/MEDLINE, EMBASE, Cochrane Library, Cochrane Central Register of Controlled Trials, China Biology Medicine Disc (CBM), Chinese National Knowledge Infrastructure (CNKI), Wanfang database and VIP database from their inception through July 2011. Study selection, data extraction, quality assessment, and data analyses were conducted according to the Cochrane standards.

RESULTSA total of 10 randomized trials (involving 1,435 patients) were included. Because both test and control drugs used in the RCTs were different from each other, the effects can only be described singly and calculated. Regarding the total effective rate for the treatment of psoriasis, ex-CHD in combination with ultraviolet radiation b (UVB) or narrow band ultraviolet radiation b (NB-UVB), which was reported in 6 trials, was superior to UVB alone. One study reported that ex-CHD and externally applied WM had equivalent effects. In another study, ex-CHD showed better results than placebo. However, another two comparisons of ex-CHD and WM (all in combining with oral WM) showed uncertain outcomes. Nine trials reported adverse reactions. Of these, 7 RCTs included statistical analysis. The results showed that the side-effects that occurred in ex-CHD combined with UVB were less severe than those caused by UVB alone, but the incidence was roughly the same as WM.

CONCLUSIONThe evidence supporting the efficacy of ex-CHD with respect to treating psoriasis is quite limited and must be strengthened by high-quality studies.

Administration, Topical ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; therapeutic use ; Humans ; Phototherapy ; Psoriasis ; drug therapy ; Randomized Controlled Trials as Topic ; Treatment Outcome

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Chinese medicine in the treatment of Behcet's disease's uveitis: a case report.

Wan-Yu ZHOU ; Hong ZHANG ; Zeng-Yuan ZHUANG

Chinese journal of integrative medicine.2012;18(3):219-221. doi:10.1007/s11655-011-0949-y

Adult ; Behcet Syndrome ; complications ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Male ; Uveitis ; complications ; drug therapy

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Clinical effect of sphenopalatine ganglion needling in treating primary trigeminal neuralgia of Liver-yang upsurge syndrome type.

Lan HE ; Xiu-Mei ZHANG

Chinese journal of integrative medicine.2012;18(3):214-218. doi:10.1007/s11655-012-1021-2

OBJECTIVETo observe the efficacy and safety of sphenopalatine ganglion needling in treating patients with primary trigeminal neuralgia (PTN) of Liver (Gan)-yang upsurge syndrome (LYUS) type.

METHODSSixty-five PTN patients of LYUS type were assigned by a random number table to two groups and treated by deep-needling (33 patients, DN group) and superficial-needling (32 patients, SN group), respectively. The main-acupoint used for both groups was Xiaguan (ST7) of affected side, on which needle was deeply inserted to reach spheno-palatine ganglion in the DN group, but was inserted conventionally in the SN group; the auxiliary acupoints used were the local points Cuanzhu (BL2), Sibai (ST2), Chengjiang (CV24) of affected side, as well as the remote points, bilateral Hegu (LI4) and Taichong (LR3). The needling was implemented every other day, with electric stimulation applied to all the punctured acupoints for 30 min, 10 days treatment as one therapeutic course. Each patient received 2 courses of needling with 1 week interval in between. The clinical efficacy, pain control and adverse reaction were evaluated and compared after the treatment.

RESULTSRank-sum test showed that the efficacy in the DN group was significantly better than that in the SN group (Z =2.30, P=0.021); the pain was alleviated in both groups in frequency, intensity and sustained time (evaluated by visual analogue scale) significantly (P<0.01), but deep needling showed a superiority over superficial needling in reducing the frequency and intensity of episode (Z=9.55, Z=5.50, both P=0.00). No adverse reaction occurred during the treatment course of both groups.

CONCLUSIONSpheno-palatine ganglion needling is highly effective, safe and reliable for the treatment of PTN.

Acupuncture Therapy ; adverse effects ; Adult ; Aged ; Female ; Ganglia, Parasympathetic ; pathology ; Humans ; Liver ; pathology ; Male ; Middle Aged ; Needles ; adverse effects ; Pain ; complications ; Syndrome ; Treatment Outcome ; Trigeminal Neuralgia ; complications ; therapy

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Oxysophoridine suppresses the growth of hepatocellular carcinoma in mice: in vivo and cDNA microarray studies.

Xiao-Qing YAO ; Yun-Hui ZHANG ; Wei LONG ; Pei-Xun LIU

Chinese journal of integrative medicine.2012;18(3):209-213. doi:10.1007/s11655-012-1001-6

OBJECTIVETo observe the in vivo effects of oxysophoridine on hepatocellular carcinoma in mice and to study the related mechanisms.

METHODSC57BL mice were inoculated with mouse hepatoma H22 cells subcutaneously, then divided into 5 groups (14 per group), and treated with oxysophoridine (50, 100, or 150 mg/kg) or cisplatin (4 mg/kg) for 10 days. Inhibitory rate of tumor, body weight gain, and influence indices on internal organs (liver, spleen and thymus) were evaluated. The differentially expressed genes between the oxysophoridine-treated group, and the control group were analyzed using cDNA microarray and quantitative real-time PCR (qRT-PCR) experiments.

RESULTSCompared with the tumor weight of the control group (2.75±0.66 g), oxysophoridine significantly suppressed hepatocellular carcinoma growth in mice (P <0.01), with 0.82±0.36 g, 0.57±0.22 g, and 1.22±0.67 g for the tumor weight in the low, moderate, and high dose treatment group, respectively. The moderate dose led to the highest inhibitory rate, 79.3%. Observation of body weight gain and influence on three organs showed that compared with cisplatin, oxysophoridine produced fewer side effects in vivo. cDNA microarray and qRT-PCR showed that the most significant differentially expressed genes in the tumor samples of oxysophoridine-treated mice were mostly involved in regulating apoptosis, with the Tnfrsf11b (osteoprotegerin) gene being the most significantly affected.

CONCLUSIONOxysophoridine was a promising compound for developing drugs against hepatocellular carcinoma, and its anti-hepatoma effect was probably related to osteoprotegerin activation.

Alkaloids ; pharmacology ; Animals ; Carcinoma, Hepatocellular ; genetics ; pathology ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Drug Screening Assays, Antitumor ; Gene Expression Regulation, Neoplastic ; drug effects ; Liver Neoplasms, Experimental ; genetics ; pathology ; Mice ; Mice, Inbred C57BL ; Oligonucleotide Array Sequence Analysis ; Organ Specificity ; drug effects ; Real-Time Polymerase Chain Reaction ; Tumor Burden ; drug effects ; Weight Gain ; drug effects

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Carboxymethylpachymaran enhances immunologic function of dendritic cells cultured in two kinds of hepatoma carcinoma cell line's supernatant via nuclear factor κ B/Rel pathway.

Zhuo CHEN ; Bin YU ; Xian-Lin WU ; Cong-Qi DAI ; Guo-Qiang QIAN ; Jian-Zhong YU ; Hai-Bin HE ; Zhi-Xin WANG ; Jun HOU ; Xiao-Yin CHEN

Chinese journal of integrative medicine.2012;18(3):203-208. doi:10.1007/s11655-011-0943-4

OBJECTIVETo study the immunologic function of dendritic cells (DCs) cultured in two kinds of hepatoma cell line's supernatant and the enhancing effects of carboxymethylpachymaran (CMP) on DCs.

METHODSDCs were harvested after stimulation by granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin (IL)-4 from umbilical cord blood using density-gradient centrifugation method. Cultured supernatant of two hepatoma cell lines (HepG2 and HepG2.2.15) were collected for condition medium (CM) according to a volume ratio of supernatant to incomplete RPMI-1640 medium, which was 3:1. CMP was dissolved in incomplete RPMI-1640 medium. Experimental groups were divided according to the culture medium, either CM or with CMP in it. DCs subsets CD83, CD86, CD1a, and d-related human leukocyte antigens (HLA-DR) were analyzed by flow cytometry. The proliferation ability of allogeneic T cells in mixed lymphocyte reaction (MLR) stimulated by DCs was examined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) analysis. IL-12p70, interferon-γ (IFN-γ), and nuclear factor κB (NF-κB) were detected by enzyme-linked immunosorbent assay analysis.

RESULTSThe proliferation of lymphocytes and secreting level of IL-12 and expression of phenotype of DCs cultured in two kinds of CM were lower than those of normal group (P <0.01). Compared with the normal group, groups treated with CMP showed a higher expression level of DCs subsets, lymphocyte reproductive activity, as well as IL-12 and IFN-γ secretion levels. Groups treated with CMP also demonstrated higher levels of DCs phenotype expression and IL-12 and IFN-γ secretion in supernatant of MLR and higher lymphocyte reproductive activity compared with CM group (P <0.05). Compared with the normal group, the expression level of NF-κB in DCs nuclear was higher in CMP groups but lower in two CM groups (P <0.05). After CMP was added, the NF-κB expression levels of two CM groups were increased compared with levels before CMP was added (P <0.05). However, there was no significant difference between the two CM groups (P >0.05).

CONCLUSIONSTwo kinds of hepatoma cell line's supernatant can inhibit the immunologic function of DCs. This suppressive effect may be related to the inhibition of NF-κB/Rel pathway. CMP may up-regulate the DCs function by activating the NF-κB/Rel pathway.

Carcinoma, Hepatocellular ; pathology ; ultrastructure ; Cell Line, Tumor ; Cell Shape ; Dendritic Cells ; drug effects ; immunology ; Glucans ; pharmacology ; Humans ; Immunophenotyping ; Interferon-gamma ; metabolism ; Interleukin-12 ; metabolism ; Liver Neoplasms ; pathology ; ultrastructure ; Lymphocyte Culture Test, Mixed ; Signal Transduction ; drug effects ; Subcellular Fractions ; drug effects ; Transcription Factor RelA ; metabolism

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Total saponin from root of Actinidia valvata Dunn prevents the metastasis of human hepatocellular carcinoma cells.

Guo-Yin ZHENG ; Hai-Liang XIN ; Bai LI ; Yan-Feng XU ; Ting-Jiao YI ; Chang-Quan LING

Chinese journal of integrative medicine.2012;18(3):197-202. doi:10.1007/s11655-012-1055-5

OBJECTIVETo extract the active component from the root of Actinidia valvata Dunn and to investigate the effects on hepatocellular carcinoma (HCC) cells in vitro.

METHODSTotal saponin was extracted from the root of A. valvata (TSAVD). HCC cells, such as BEL-7402, HepG2, PLC, SMMC-7721, MHCC-97-H, and MHCC-97-L, were treated with TSAVD in 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenytetrazolium bromide (MTT) assay. BEL-7402 and MHCC-97-H cells were also treated respectively with TSAVD at different concentrations for 24 h in wound healing and adhesion assays, and the effects of TSAVD on BEL-7402 and MHCC-97-H cells mobility and adhesion abilities were observed. Meanwhile, the effects of TSAVD on invasion and migration of BEL-7402 and MHCC-97-H cells were also investigated by transwell chamber in invasion and migration assays.

RESULTSTSAVD at 1.5 mg/mL inhibited BEL-7402 cell proliferation with inhibition ratios (IRs) of 61.08%, 74.12%, 84.55% at 24, 48, and 72 h, respectively. Meanwhile, TSAVD inhibited MHCC-97-H proliferation in a concentration-dependent manner from 1.5 to 0.5 mg/mL, with the IR of 36% at 1.5 mg/mL at 24 h. For SMMC-7721, PLC, and HepG2, the IR was lower than 30% at 1.5 mg/mL at 24 h. In the wound healing assay, mobility abilities of BEL-7402 and MHCC-97-H cells in TSAVD treated groups were significantly weaker than those of the control group. After pretreatment for 24 h with TSAVD, adhesion abilities were reduced in both MHCC-97-H and BEL-7402 cells, with IRs of 48.50%±4.86% and 49.85%±5.25% at 200 μg/mL. The IRs of MHCC-97-H and BEL-7402 cells in the migration assay were 49.13%±2.91% and 79.37%±0.09% at 200 μg/mL. In the invasion assay, IRs were 69.78%±4.88% and 82.48%±0.25% at 200 μg/mL.

CONCLUSIONSOf all HCC cells, the highest inhibition by TSAVD was seen for BEL-7402 proliferation. TSAVD could restrain adhesion, invasion, mobility, and migration abilities of BEL-7402 and MHCC-97-H cells in vitro.

Actinidia ; chemistry ; Carcinoma, Hepatocellular ; drug therapy ; pathology ; Cell Adhesion ; drug effects ; Cell Line, Tumor ; Cell Movement ; drug effects ; Cell Proliferation ; drug effects ; Drug Screening Assays, Antitumor ; Humans ; Liver Neoplasms ; drug therapy ; pathology ; Neoplasm Invasiveness ; Neoplasm Metastasis ; drug therapy ; prevention & control ; Plant Roots ; chemistry ; Saponins ; pharmacology ; therapeutic use ; Wound Healing ; drug effects

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Influenza early warning model based on Yunqi theory.

Xue-Qin HU ; Gerald QUIRCHMAYR ; Werner WINIWARTER ; Meng CUI

Chinese journal of integrative medicine.2012;18(3):192-196. doi:10.1007/s11655-012-1003-4

OBJECTIVETo establish an early warning model to simulate the outbreak of influenza based on weather conditions and Yunqi theory, an ancient calendar theory of Chinese medicine (CM).

METHODSTianjin, a northeastern city in China, was chosen as the region of research and applied the influenza-like illness attack rate (ILI)% as the baseline and warning line to determine the severity of influenza epidemic. Then, an influenza early warning model was constructed based on the theory of rough set and support vector machines (RS-SVM), and the relationship between influenza and meteorology was explored through analyzing the monitoring data.

RESULTSThe predictive performance of the model was good, which had achieved 81.8% accuracy when grouping the obtained data into three levels that represent no danger, danger of a light epidemic, and danger of a severe epidemic. The test results showed that if the host qi and guest qi were not balanced, this kind of situation was more likely to cause influenza outbreaks.

CONCLUSIONSThe outbreak of influenza closely relates to temperature, humidity, visibility, and wind speed and is consistent with some part of CM doctrine. The result also indicates that there is some reasonable evidence in the Yunqi theory.

China ; epidemiology ; Decision Making ; Epidemiologic Methods ; Humans ; Influenza, Human ; epidemiology ; Medicine, Chinese Traditional ; Models, Biological

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A randomized controlled single-blind clinical trial on 84 outpatients with psoriasis vulgaris by auricular therapy combined with optimized Yinxieling Formula.

Chuan-Jian LU ; Yu XIANG ; Xiu-Li XIE ; Mei-Ling XUAN ; Ze-Hui HE

Chinese journal of integrative medicine.2012;18(3):186-191. doi:10.1007/s11655-012-1020-3

OBJECTIVETo explore the therapeutic effect of auricular therapy combined with optimized Yinxieling Formula on psoriasis vulgaris.

METHODSA randomized controlled single-blind clinical trial on 84 outpatients with psoriasis vulgaris was conducted. The patients were randomized to a treatment group (43 cases treated by auricular therapy combined with optimized Yinxieling Formula) and a control group (41 cases treated by optimized Yinxieling Formula alone) according to a random number generated by SPSS 17.0 software. The treatment duration for both groups was 8 weeks. The therapeutic effect was comprehensively measured by the primary outcome measure [Psoriasis Area and Severity Index (PASI) reduction rate] and the secondary outcome measure [PASI, Visual Analogue Scale (VAS), Dermatology Life Quality Index (DLQI), Self-rating Depression Scale (SDS), and Self-rating Anxiety Scale (SAS)]. The outcomes of both groups were obtained and compared before and after the intervention.

RESULTSThe PASI reduction rate in the treatment group was 74.4% (32/43), which was higher than that in the control group (36.6%, 15/41, P<0.01). The PASI scores decreased in both groups after treatment and was lower in the treatment group compared with the control group P<0.01). With stratified analysis, there were significant differences between the PASI scores in the following subgroups: age 18-30, baseline PASI>10 and stable stage (P<0.05). DLQI decreased in both groups on some categories after treatment, but there were no significant differences between the two groups in SDS, SAS and VAS (P >0.05). No obvious adverse reactions were found in either group.

CONCLUSIONThe therapeutic effect of auricular therapy combined with Optimized Yinxieling Formula was superior to Optimized Yinxieling Formula alone with no obvious adverse reaction.

Acupuncture, Ear ; Adult ; Anxiety ; complications ; Combined Modality Therapy ; Depression ; complications ; Drugs, Chinese Herbal ; adverse effects ; therapeutic use ; Female ; Humans ; Male ; Outpatients ; Pain Measurement ; Psoriasis ; complications ; drug therapy ; Quality of Life ; Severity of Illness Index ; Single-Blind Method

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Application of the dermatology life quality index in clinical trials of biologics for psoriasis.

Mohammad Khurshid Azam BASRA ; Sadath HUSSAIN

Chinese journal of integrative medicine.2012;18(3):179-185. doi:10.1007/s11655-012-1007-0

The significance of patient-reported outcomes (PROs) is increasingly being acknowledged and quality of life (QOL) has become an integral element of the assessment of overall burden of disease. Psoriasis has been known for its major impact on patients' QOL and various generic, dermatology-specific and psoriasis-specific self-administered psychometric instruments have been used over the years to assess the QOL of psoriasis patients. However, the Dermatology Life Quality Index (DLQI) is the most widely used QOL measure among these measures in psoriasis-related clinical trials. A number of topical and systemic treatments have been used in the management of psoriasis and lately biologics have emerged as a new and promising treatment modality for difficult-to-treat psoriasis. The evidence on the efficacy of these agents has been growing dramatically with QOL being used as one of the primary outcome measures in many clinical trials. The aim of this paper is to give an overview of the use of the DLQI as an outcome measure for assessing the QOL impact of biologics on psoriasis patients. Furthermore, the efficacy of five commonly used biologics has been compared in terms of their ability to improve the QOL assessed by the DLQI. This review has revealed that there is a variation in the efficacy of various biologics in terms of QOL improvement with the mean reduction in the DLQI scores being highest for ustekinumab 90 mg (mean DLQI score reduction=9.5), followed by infliximab (8.5), etanercept 50 mg, twice a week (7.7), adalimumab (6.3), and alefacept (4.0).
Biological Products ; therapeutic use ; Clinical Trials as Topic ; Dermatologic Agents ; therapeutic use ; Dermatology ; Humans ; Psoriasis ; drug therapy ; Quality of Life

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Oral herbal medicines for psoriasis: a review of clinical studies.

Brian H MAY ; Anthony L ZHANG ; Wenyu ZHOU ; Chuan-Jian LU ; Shiqiang DENG ; Charlie C L XUE

Chinese journal of integrative medicine.2012;18(3):172-178. doi:10.1007/s11655-012-1008-z

Various forms of complementary and alternative medicine are used in psoriasis. Among these, herbal medicines are frequently used as systemic and/or topical interventions either as a replacement for or in conjunction with conventional methods. The benefit of such use is unclear. This review is to provide an up-to-date review and discussion of the clinical evidence for the main kinds of herbal therapies for psoriasis. Searches of the biomedical databases PubMed (including MEDLINE), EMBASE and CINAHL were conducted in December 2011 which identified 32 clinical studies, all published in English. Twenty of these primarily tested topical herbal medicines and were thus excluded. The 12 studies that evaluated systemic use of herbal medicines were included in the review. Four were case series studies and the other 8 were controlled trials. In terms of interventions, 4 studies tested the systemic use of plant oils combined with marine oils and 8 studies tested multi-ingredient herbal formulations. The clinical evidence for plant and animal derived fatty acids is inconclusive and any benefit appears to be small. For the multi-herb formulations, benefits of oral herbal medicines were shown in several studies, however, a number of these studies are not controlled trials, a diversity of interventions are tested and there are methodological issues in the controlled studies. In conclusion, there is promising evidence in a number of the studies of multi-herb formulations. However, well-designed, adequately powered studies with proper control interventions are needed to further determine the benefits of these formulations. In addition, syndrome differentiation should be incorporated into trial design to ensure effective translation of findings from these studies into Chinese medicine clinical practice.
Administration, Oral ; Clinical Trials as Topic ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Humans ; Plant Oils ; therapeutic use ; Psoriasis ; drug therapy

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