1.Network Meta-analysis of Qi-benefiting and blood-activating Chinese patent medicines against ischemic stroke.
Li-Jian ZHU ; Hao-Ran DU ; Hai-Long LI ; Yu WANG ; Zhen YANG
China Journal of Chinese Materia Medica 2023;48(11):3097-3109
		                        		
		                        			
		                        			This study aimed to compare the efficacy of Qi-benefiting and blood-activating Chinese patent medicines in the treatment of ischemic stroke with network Meta-analysis. CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, and Cochrane Library were searched from database inception to October 2022 for randomized controlled trial(RCT) on 11 Qi-benefiting and blood-activating Chinese patent medicines in the treatment of ischemic stroke. The risk of bias plot was made by RevMan 5.3, and network Meta-analysis and efficacy ranking were performed by Stata 17. Ninety-two RCTs were included, involving 10 608 patients. According to the network Meta-analysis, in terms of the clinical total effective rate, surface under the cumulative ranking curve(SUCRA) as followed: Qilong Capsules+conventional western medicine>Zhishe Tongluo Capsules+conventional western medicine>Longshengzhi Capsules+conventional western medicine>Naoxintong Capsules+conventional western medicine>Tongsaimai Tablets+conventional western medicine>Naoan Capsules+conventional western medicine>Naoluotong Capsules+conventional western medicine>Xiaoshuan Changrong Capsules+conventional western medicine>Dengzhan Shengmai Capsules+conventional western medicine=Tongxinluo Capsules+conventional western medicine>Naomaitai Capsules+conventional western medicine. In terms of the improvement in National Institute of Health stroke scale(NIHSS) score, SUCRA as followed: Longshengzhi Capsules+conventional western medicine>Naomaitai Capsules+conventional western medicine>Naoxintong Capsules+conventional western medicine>Dengzhan Shengmai Capsules+conventional western medicine>Xiaoshuan Changrong Capsules+conventional western medicine>Naoluotong Capsules+conventional western medi-cine>Tongxinluo Capsules+conventional western medicine>Naoan Capsules+conventional western medicine>Qilong Capsules+conventional western medicine. In terms of safety, the overall adverse reactions/events of Qi-benefiting and blood-activating Chinese patent medicines + conventional western medicine were less than those of the control group. Since Qilong Capsules+conventional western medicine and Zhishe Tongluo Capsules+conventional western medicine were preferred to improve the clinical total effective rate. In the aspect of improving NIHSS score, Longshengzhi Capsules+conventional western medicine and Naomaitai Capsules+conventional western medicine were first options. Due to the lack of direct comparisons between drugs, the overall quality of RCT was not high, so more studies are needed to verify the strength of the evidence.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Capsules
		                        			;
		                        		
		                        			Ischemic Stroke
		                        			;
		                        		
		                        			Medicine
		                        			;
		                        		
		                        			Network Meta-Analysis
		                        			;
		                        		
		                        			Qi
		                        			
		                        		
		                        	
2.Mechanism of tonifying Qi by traditional Chinese medicine from mitochondrial dynamics.
Ruo-Yuan GAO ; Jing-Ran GAO ; Hao-Yu ZHAO ; Tian LAN ; Yii-der TSENG
China Journal of Chinese Materia Medica 2023;48(13):3684-3692
		                        		
		                        			
		                        			According to the traditional Chinese medicine(TCM) theory, Qi is the essential component maintaining life. Mitochondria are the cellular organelles that generate energy. Qi exhibits abundant common characteristics in bioenergetics compared with mitochondria which control the cellular energy through fusion and fission. Studies have proven that the qi-tonifying function of Chinese medicinal plants and their components facilitates mitochondrial fusion, therefore enhancing ATP synthesis. These studies provide a framework for deciphering the pharmacological mechanisms of Qi-tonifying herbs. This article introduces the common source and function shared by Qi and mitochondria and the regulatory effects of herbal remedies on energy from mitochondria dynamics. This review aims to interpret the connotation of tonifying qi in TCM theory based on the modern biomedical theory.
		                        		
		                        		
		                        		
		                        			Medicine, Chinese Traditional
		                        			;
		                        		
		                        			Drugs, Chinese Herbal/pharmacology*
		                        			;
		                        		
		                        			Qi
		                        			;
		                        		
		                        			Mitochondrial Dynamics
		                        			;
		                        		
		                        			Plants, Medicinal
		                        			
		                        		
		                        	
3.Network Meta-analysis of Qi-supplementing and Yin-nourishing Chinese patent medicines in treatment of early diabetic nephropathy.
Wen-Ru WANG ; Xu-Ming ZHANG ; Ji-Xin LI ; Jia-Yi YANG ; Ren-Huan YU ; Yan-Ming XIE
China Journal of Chinese Materia Medica 2023;48(14):3949-3964
		                        		
		                        			
		                        			This study aimed to evaluate the efficacy of Qi-supplementing and Yin-nourishing Chinese patent medicine in the treatment of early diabetic nephropathy(DN) by network Meta-analysis to explore the Chinese patent medicine with optimal efficacy and provide references for preventing renal deterioration and delaying the progression of early DN. Eight databases, including CNKI, Wanfang, VIP, SinoMed, PubMed, EMbase, Cochrane Library, and Web of Science, were searched for clinical randomized controlled trial(RCT) of Qi-supplementing and Yin-nourishing Chinese patent medicines in the treatment of early DN. After the literature mee-ting the inclusion criteria was screened, the quality of the literature was evaluated using the Cochrane risk-of-bias tool, and network Meta-analysis was performed using the BUGSnet package in R 4.2.1. Seventy-two research articles with a sample size of 6 344 cases were included, involving eight Chinese patent medicines and seven outcome indicators. The results of the network Meta-analysis showed that(1)in terms of improving urinary albumin excretion rate(UAER), Chinese patent medicines combined with conventional treatment were superior to conventional treatment, and Qiyao Xiaoke Capsules + conventional treatment was optimal.(2)In terms of reducing serum crea-tinine(Scr), Bailing Capsules + conventional treatment had superior efficacy.(3)In terms of reducing 24-hour urine total protein(24hUTP), Shenyan Kangfu Tablets + conventional treatment and Jinshuibao Capsules + conventional treatment had equivalent efficacy, and Shenyan Kangfu Tablets + conventional treatment was superior.(4)In terms of improving fasting blood glucose(FBG), Shenyan Kangfu Tablets + conventional treatment had superior efficacy.(5)In terms of improving total cholesterol(TC), Qiyao Xiaoke Capsules +conventional treatment had superior efficacy.(6)In terms of reducing triglyceride(TG), Bailing Capsules + conventional treatment had superior efficacy.(7)In terms of safety, the occurrence of adverse reactions was reported in seven interventions, but due to the large clinical heterogeneity, the quantitative analysis could not be performed. Overall, Qi-supplementing and Yin-nourishing Chinese patent medicines combined with conventional treatment were superior to conventional treatment alone in the treatment of early DN. The results showed that Qi-supplementing and Yin-nourishing Chinese patent medicines combined with conventional treatment had good clinical efficacy, and they could significantly reduce renal function indicators such as UAER, Scr, and 24hUTP, and reduce blood sugar and blood lipid, which can provide evidence-based support for the treatment of early DN. However, due to the differences in the quantity and quality of the included research articles, large-sample, multi-center, high-quality studies are still needed for further verification.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Diabetic Nephropathies/drug therapy*
		                        			;
		                        		
		                        			Nonprescription Drugs/therapeutic use*
		                        			;
		                        		
		                        			Qi
		                        			;
		                        		
		                        			Network Meta-Analysis
		                        			;
		                        		
		                        			Capsules
		                        			;
		                        		
		                        			Drugs, Chinese Herbal/therapeutic use*
		                        			;
		                        		
		                        			Tablets
		                        			;
		                        		
		                        			Diabetes Mellitus/drug therapy*
		                        			
		                        		
		                        	
4.Two new sesquiterpenes in Qi-nan Aquilariae Lignum Resinatum.
De-Li CHEN ; Guo-Xu MA ; Hui-Mei LIU ; Can-Hong WANG ; Yang-Yang LIU ; Yun YANG ; Jian-He WEI
China Journal of Chinese Materia Medica 2023;48(23):6403-6407
		                        		
		                        			
		                        			This study aimed to investigate the chemical constituents of supercritical extract from Qi-nan Aquilariae Lignum Resinatum by silica gel column chromatography, thin-layer chromatography, and semi-preparative high-performance liquid chromatography. One new elemane-type and one new eudesmane-type sesquiterpene compounds were isolated from the extract, and their structures were identified by MS, UV, IR, NMR, and ECD spectroscopic techniques, and named aquqinanol C(1) and aquqinanol D(2). Both compounds are novel compounds. The neuroprotective effect of the compounds on CORT-induced PC12 cell damage was determined in vitro. The results showed that compounds 1 and 2 exhibited a certain protective effect against CORT-induced damage in PC12 cells.
		                        		
		                        		
		                        		
		                        			Rats
		                        			;
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Qi
		                        			;
		                        		
		                        			Sesquiterpenes/pharmacology*
		                        			;
		                        		
		                        			Molecular Structure
		                        			
		                        		
		                        	
5.Effectiveness of Zhenqi Buxue Oral Liquid Combined with Progesterone for Treatment of Oligomenorrhea and Hypomenorrhea with Qi-Blood and Kidney (Shen) Essence Deficiency: A Randomized Controlled Trial.
Jing-Wen GAN ; De-Xin LV ; Jin FU ; Liang-Yan SHI ; Chun-Yan YUAN ; Xiao-Qin ZENG ; Jun LI ; Ai-Jun SUN
Chinese journal of integrative medicine 2023;29(11):963-970
		                        		
		                        			OBJECTIVE:
		                        			To evaluate the effectiveness and safety of Zhenqi Buxue Oral Liquid (ZQ), progesterone capsules, and their combination in treating oligomenorrhea and hypomenorrhea with qi-blood and Kidney (Shen) essence deficiency.
		                        		
		                        			METHODS:
		                        			This was a prospective, randomized, multi-center controlled trial between June 2022 to December 2022. Ninety-six oligomenorrhea and hypomenorrhea patients with qi-blood and Shen essence deficiency were randomly assigned to receive ZQ (ZQ group, 29 cases), progesterone capsules (PG group, 32 cases), or the combined Chinese and Western medicine (COM group, 31 cases) at a ratio of 1:1:1. Patients in the ZQ or PG group took daily 10 mL twice a day of ZQ or 200 mg once a day of progesterone capsules for 10 consecutive days on day 15 of the menstrual cycle respectively, and patients in the COM group received the same ZQ combined with progesterone capsules. The treatment course lasted for 3 months and follow-up was performed at 1 and 3 months after the end of treatment. Primary endpoint was the menstrual Traditional Chinese Medicine Syndrome Scale (TCMSS) scores. Secondary endpoints included pictorial blood loss assessment chart (PBAC) scores, clinical efficacy rate, 36-item Short Form Health Survey (SF-36) scores, sex hormones and thickness of endometrium. Adverse events (AEs) were recorded.
		                        		
		                        			RESULTS:
		                        			TCMSS scores after 1- and 3-month treatment in all groups were significantly lower than those at baseline (P<0.05). Only TCMSS scores after 3-month treatment in the ZQ and COM groups continuously decreased compared with those after 1-month treatment in the same group (P<0.01). TCMSS scores after 3-month treatment in the ZQ and COM groups were significantly lower than those in the PG group (P<0.05, P<0.01). Compared with baseline, PBAC scores in the ZQ and COM groups after 3 months of treatment were also significantly higher (both P<0.01). The total effective rates of TCM syndrome of 3-month treatment were significantly improved in all groups compared with that after 1 month of treatment (P<0.05). The total effective rate of the COM group was the highest in the 3rd month of treatment and significantly higher than that of PG group alone (P<0.05). Compared with baseline, only the SF-36 scores of COM group were significantly improved after 3 months of treatment (P<0.05). No serious adverse reactions were observed after treatment.
		                        		
		                        			CONCLUSIONS
		                        			The combination of ZQ and PG, or ZQ only had better effects on reducing TCMSS scores compared with PG, and COM showed the higher total effective rate compared with monotherapy. Besides, COM could effectively improve menstrual blood loss and quality of life. ZQ combined with PG may be an effective and safe option for oligomenorrhea and hypomenorrhea patients with qi-blood and Shen essence deficiency.
		                        		
		                        		
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Progesterone/therapeutic use*
		                        			;
		                        		
		                        			Qi
		                        			;
		                        		
		                        			Oligomenorrhea/drug therapy*
		                        			;
		                        		
		                        			Quality of Life
		                        			;
		                        		
		                        			Prospective Studies
		                        			;
		                        		
		                        			Medicine, Chinese Traditional
		                        			;
		                        		
		                        			Drugs, Chinese Herbal/adverse effects*
		                        			;
		                        		
		                        			Capsules
		                        			;
		                        		
		                        			Kidney
		                        			
		                        		
		                        	
6.Fascia and defensive qi: construction of body view in classical acupuncture theory.
Chinese Acupuncture & Moxibustion 2023;43(8):871-875
		                        		
		                        			
		                        			Influenced by the concept of "qi-void" in Taoist philosophy during the Qin and Han dynasties, the early acupuncture theory attaches the importance to the "fascial (muscular) interstices" distributed widely in the human body. The defensive qi runs through everywhere in these interstices that is easily invaded by the pathogenic wind and cold, and bi syndrome of jingjin (muscle region of meridian) is involved. Besides, fascial (muscular) interstices are the places for the delivery of relaxing needling and joint needling. Fascial tissue is a crucial structure to produce deqi, while, the function of defensive qi is tightly connected to the autonomic nerve in modern medicine, both of which actually belong to the different expressions of patients' body feeling. Medical scholars at early era, in reference with "fascia" and "defensive qi ", has summarized and refined their clinical practice experience. Thereby, the concepts of "arrival of qi " and "fascial (muscular) interstices" are extended, which constructs the peripheral framework of core concepts in acupuncture theoretic system, e.g. meridians and acupoints, and becomes an important component of the body view in classic acupuncture theory.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Qi
		                        			;
		                        		
		                        			Acupuncture Therapy
		                        			;
		                        		
		                        			Meridians
		                        			;
		                        		
		                        			Acupuncture
		                        			;
		                        		
		                        			Acupuncture Points
		                        			
		                        		
		                        	
7.Clinical thinking of acupuncture for snoring based on "disharmony qi leads to restlessness".
Yu-Qiang SONG ; Yuan-Bo FU ; San-Feng SUN ; Jie SUN ; Lin-Bo SHEN ; Yu-Zhuo ZHANG
Chinese Acupuncture & Moxibustion 2023;43(8):951-954
		                        		
		                        			
		                        			This study summarizes the clinical thinking of acupuncture for snoring based on "disharmony qi leads to restlessness". According to the pathological characteristics of qi stagnation and blood stasis, phlegm dampness and internal obstruction in snoring patients, combined with the etiology, pathogenesis and location of the disease, the innovative viewpoint of "disharmony qi leads to restlessness" is proposed. It is believed that the key to snoring treatment lies in "regulating qi ". In clinical practice, acupuncture can directly regulate the qi of the disease's location, regulate the qi of the organs and viscera, and regulate the qi of the meridians to achieve overall regulation of the body's internal and external qi, smooth circulation of qi and blood, and ultimately achieve the therapeutic goal of harmonizing qi, stopping snoring, and improving sleep quality.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Qi
		                        			;
		                        		
		                        			Snoring/therapy*
		                        			;
		                        		
		                        			Psychomotor Agitation
		                        			;
		                        		
		                        			Acupuncture Therapy
		                        			;
		                        		
		                        			Meridians
		                        			
		                        		
		                        	
8.Not Available.
Chinese Acupuncture & Moxibustion 2023;43(12):1433-1434
9.Bloodletting at auricular dorsal vein combined with auricular point sticking for menstrual migraine of qi stagnation and blood stasis and its effect on serum levels of E2 and 5-HT.
Rui LI ; Yan LU ; Meng-Meng WANG ; Dian-Hui YANG
Chinese Acupuncture & Moxibustion 2023;43(4):427-431
		                        		
		                        			OBJECTIVE:
		                        			To observe the clinical effect of bloodletting at auricular dorsal vein combined with auricular point sticking on menstrual migraine (MM) of qi stagnation and blood stasis, and explore its possible mechanism.
		                        		
		                        			METHODS:
		                        			A total of 102 cases of MM with qi stagnation and blood stasis were randomly divided into an observation group (51 cases, 3 cases dropped off) and a control group (51 cases, 2 cases dropped off). The patients in the observation group were treated with bloodletting at auricular dorsal vein combined with auricular point sticking. The bloodletting was performed at vein at upper 1/3 of the dorsalis near the ear helix; the auricular point sticking was performed at Pizhixia (AT4), Neifenmi (CO18), Jiaogan (AH6a), Nie (AT2), Zhen (AT3), Shenmen (TF4) and Yidan (CO11). The auricular points of both ears were alternate used. From 7 days before the onset of menstruation, bloodletting at auricular dorsal vein was given once every 7 days, 3 times were taken as a course of treatment, and 1 course of treatment was given; the auricular point sticking was given once every 3 days, and 6 times of treatment were given. The patients in the control group were treated with oral administration of flunarizine hydrochloride capsules. From 7 days before the onset of menstruation, flunarizine hydrochloride was given 2 capsules per time, once a day for 3 weeks. The menstrual headache index and visual analogue scale (VAS) score of the two groups were observed before treatment, one menstrual cycle into treatment and the first and the second menstrual cycle after treatment; the migraine-specific quality of life questionnaire (MSQ) score and the serum levels of estradiol (E2) and 5-hydroxytryptamine (5-HT) were compared before treatment and one menstrual cycle into treatment; the clinical efficacy was evaluated at one menstrual cycle into treatment.
		                        		
		                        			RESULTS:
		                        			Compared before treatment, the menstrual headache index and VAS scores were reduced at one menstrual cycle into treatment and the first and second menstrual cycle after treatment in the two groups (P<0.05), and those in the observation group were lower than the control group (P<0.05). Compared before treatment, the MSQ scores and the serum levels of E2 and 5-HT in the two groups were increased at one menstrual cycle into treatment (P<0.05), and those in the observation group were higher than the control group (P<0.05). The total effective rate was 95.8% (46/48) in the observation group, which was higher than 73.5% (36/49) in the control group (P<0.05).
		                        		
		                        			CONCLUSION
		                        			Bloodletting at auricular dorsal vein combined with auricular point sticking could relieve headache intensity, improve the quality of life in patients with MM of qi stagnation and blood stasis, which may be achieved by raising the serum levels of E2 and 5-HT to improve the level of hormone in the body.
		                        		
		                        		
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Acupuncture, Ear
		                        			;
		                        		
		                        			Bloodletting
		                        			;
		                        		
		                        			Serotonin
		                        			;
		                        		
		                        			Capsules
		                        			;
		                        		
		                        			Flunarizine
		                        			;
		                        		
		                        			Qi
		                        			;
		                        		
		                        			Quality of Life
		                        			;
		                        		
		                        			Migraine Disorders/drug therapy*
		                        			;
		                        		
		                        			Headache/therapy*
		                        			;
		                        		
		                        			Treatment Outcome
		                        			;
		                        		
		                        			Acupuncture Points
		                        			
		                        		
		                        	
10.Cervical spondylosis of nerve root type with qi stagnation and blood stasis treated with warming needle with different lengths of moxa stick: a randomized controlled trial.
Dun-Po SUN ; Jie FU ; Juan TENG ; Qian HUANG ; Chuan-Dong ZHANG ; Xu-Zhu GAO
Chinese Acupuncture & Moxibustion 2023;43(6):647-653
		                        		
		                        			OBJECTIVE:
		                        			To compare the clinical efficacy on cervical spondylosis of nerve root type with qi stagnation and blood stasis treated with warming needle with different lengths of moxa stick.
		                        		
		                        			METHODS:
		                        			Six hundred patients with cervical spondylosis of nerve root type with qi stagnation and blood stasis were randomly divided into 4 groups: a 4 cm length group (150 cases, 5 cases dropped off, 2 cases suspended), a 3 cm length group (150 cases, 6 cases dropped off, 2 cases suspended), a 2 cm length group (150 cases, 6 cases dropped off), and a routine acupuncture group (150 cases, 6 cases dropped off). Warming needle with moxa stick in the length of 4 cm, 3 cm and 2 cm was delivered in the 4 cm length group, the 3 cm length group and the 2 cm length group, respectively. In the routine acupuncture group, simple acupuncture was applied. The acupoints selected in the above groups included Dazhui (GV 14) and bilateral Jiaji (EX-B 2) of C5 and C7, Fengchi (GB 20), Jianzhen (SI 9), Quchi (LI 11), Zhongzhu (TE 3), etc. In each group, the intervention was delivered once daily and 5 times a week. One course of intervention was composed of 2 weeks and 2 courses were required. The TCM syndrome score, the score of clinical assessment scale for cervical spondylosis (CASCS), the score of the brachial plexus traction test of the affected upper limb, F wave occurrence rate and conduction velocity of the ulnar nerve, the median nerve and the radial nerve of the affected upper limb were compared before and after treatment in the patients of each group. The levels of serum inflammatory factors, i.e. interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor α (TNF-α) and hypersensitive C-reactive protein (hs-CRP), were measured before and after treatment in the patients of each group. The clinical cfficacy was evaluated in the 4 groups.
		                        		
		                        			RESULTS:
		                        			After treatment, the results of TCM syndrome evaluation, i.e. the scores of neck pain, activity limitation and upper limb numbness and pain, as well as the total scores; and the scores of brachial plexus traction test were reduced when compared with those before treatment in each group (P<0.01, P<0.05). The scores of subjective symptoms and adaptability, and the total scores of CASCS were elevated in comparison with those before treatment in each group (P<0.01, P<0.05). In the 4 cm length group, compared with the other 3 groups, the scores of neck pain and activity limitation for TCM syndrome evaluation, and its total score were lower (P<0.05, P<0.01); and the scores of subjective symptoms and adaptability, and the total score of CASCS were higher (P<0.05, P<0.01). The score of the brachial plexus traction test in the 4 cm length group was lower than that of the routine acupuncture group (P<0.05). After treatment, F wave occurrence rates and conduction velocity of median nerve and radial nerve were increased when compared with those before treatment in each group (P<0.05, P<0.01). F wave occurrence rate and conduction velocity of the radial nerve in the 4 cm length group were higher than those of the other 3 groups (P<0.05), and those of the median nerve were higher when compared with the routine acupuncture group (P<0.05). After treatment, the levels of serum IL-1β, IL-6 and TNF-α were all reduced when compared with those before treatment in each group (P<0.01, P<0.05); the level of serum IL-6 in the 4 cm length group was lower than those of the other 3 groups and serum level of TNF-α was lower compared with that in the routine acupuncture group (P<0.05). The total effective rate of the 4 cm length group was 78.3% (112/143), which was higher when compared with the 3 cm length group (67.6%, 96/142), the 2 cm length group (65.3%, 94/144) and the routine acupuncture group (53.5%, 77/144), respectively (P<0.05).
		                        		
		                        			CONCLUSION
		                        			Warming needle with moxa stick of 4 cm in length effectively relieves the clinical symptoms of cervical spondylosis of nerve root type with qi stagnation and blood stasis, improves the nerve function of the upper limbs, and reduces the inflammatory responses caused by nerve compression. The clinical efficacy of this therapy with moxa stick of 4 cm in length is superior to the warming needle with moxa sticks of 3 cm and 2 cm, as well as the routine acupuncture.
		                        		
		                        		
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Interleukin-6
		                        			;
		                        		
		                        			Neck Pain
		                        			;
		                        		
		                        			Qi
		                        			;
		                        		
		                        			Tumor Necrosis Factor-alpha
		                        			;
		                        		
		                        			Spondylosis/therapy*
		                        			
		                        		
		                        	
            
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