Points - Recent Research
Acupuncture for Breathlessness in Advanced Diseases: A Systematic Review and Meta-Analysis
Effect of Mild Moxibustion on Intestinal Microbiota and NLRP6 Inflammasome Signaling in Rats with Post-Inflammatory Irritable Bowel Syndrome
Comparative Pharmacokinetic Study of the Components in Alpinia Oxyphylla Miq.-Schisandra Chinensis (Turcz.) Baill. Herb Pair and its Single Herb Between Normal and Alzheimer's Disease Rats by UPLC-MS/MS

Acupuncture for Breathlessness in Advanced Diseases: A Systematic Review and Meta-Analysis

von Trott P1, et al.

Abstract
CONTEXT: Non-pharmacological approaches are effective strategies for difficult to palliate breathlessness. Whilst acupuncture is effective for dyspnoea in early-stage COPD, little is known about its effects in patients with advanced (non-)malignant diseases.
OBJECTIVES: To identify and examine the evidence of acupuncture on breathlessness in advanced malignant and non-malignant diseases.
METHODS: Systematic literature review of randomised controlled trials of acupuncture and acupressure searched in five databases. Included were adult participants with at least 25% having advanced diseases such as cancer or COPD with severe breathlessness. Primary outcome was severity of dyspnoea on visual analogue or Borg scale. Secondary outcomes included quality of life, function and acceptability. Data were pooled using a random effects model of standardised mean differences.
RESULTS: 12 studies with 597 patients (347 COPD, 190 advanced cancer) were included. For breathlessness severity significant differences were obtained in a meta-analysis (10 studies with 480 patients; SMD= -1.77 (95% CI -3.05,-0.49; p=0.007; I2= 90%)) and in a subgroup analysis of using sham acupuncture control groups and a treatment duration of at least three weeks (6 studies with 302 patients; SMD= -2.53 (95% CI -4.07,-0.99; p=0.001; I2 =91%)). Exercise tolerance (6MWT) improved significantly in the acupuncture group (6 studies with 287 patients; SMD=0.93 (95% CI 0.27,1.59; p=0.006; I2= 85%)). In four of six studies quality of life improved in the acupuncture group.
CONCLUSION: Acupuncture improved breathlessness severity in patients with advanced diseases. The methodological heterogeneity, low power and potential morphine-sparing effects of acupuncture as add-on should be further addressed in future trials.

J Pain Symptom Manage. 2019 Sep 17. pii: S0885-3924(19)30527-5. doi: 10.1016/j.jpainsymman.2019.09.007. [Epub ahead of print]

Source: PubMed

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Effect of Mild Moxibustion on Intestinal Microbiota and NLRP6 Inflammasome Signaling in Rats with Post-Inflammatory Irritable Bowel Syndrome

Bao CH1, et al.

Abstract
BACKGROUND: About one-third of refractory irritable bowel syndrome (IBS) cases are caused by gastrointestinal (GI) infection/inflammation, known as post-infectious/post-inflammatory IBS (PI-IBS). Although it is known that intestinal microbiota and host NOD-like receptor family pyrin domain containing 6 (NLRP6) inflammsome signaling are closely related to PI-IBS and moxibustion has a therapeutic effect on PI-IBS, whether moxibustion regulates the intestinal flora and host NLRP6 events in PI-IBS remains unclear.
AIM: To examine the regulatory effect of moxibustion on intestinal microbiota and host NLRP6 inflammatory signaling in PI-IBS.
METHODS: Sprague-Dawley rats were divided into a normal control group, a model control group, a mild moxibustion group, and a sham mild moxibustion group. PI-IBS rats in the mild moxibustion group were treated with moxibusiton at bilateral Tianshu (ST 25) and Zusanli (ST36) for 7 consecutive days for 10 min each time. The sham group rats were given the same treatment as the mild moxibustion group except the moxa stick was not ignited. Abdominal withdrawal reflex (AWR) score was measured to assess the visceral sensitivity, and colon histopathology and ultrastructure, colonic myeloperoxidase (MPO) activity, and serum C-reactive protein (CRP) level were measured to evaluate low-grade colonic inflammation in rats. The relative abundance of selected intestinal bacteria in rat feces was detected by 16S rDNA PCR and the NLRP6 inflammsome signaling in the colon was detected by immunofluorescence, qRT-PCR, and Western blot.
RESULTS: The AWR score was significantly decreased and the low-grade intestinal inflammation reflected by serum CRP and colonic MPO levels was inhibited in the mild moxibustion group compared with the sham group. Mild moxibustion remarkably increased the relative DNA abundances of Lactobacillus, Bifidobacterium, and Faecalibacterium prausnitzii but decreased that of Escherichia coli in the gut of PI-IBS rats. Additionally, mild moxibustion induced mRNA and protein expression of intestine lectin 1 but inhibited the expression of IL-1β, IL-18, and resistance-like molecule β by promoting the NLRP6 and reducing the mRNA and protein expression of apoptosis-associated speck-like protein containing CARD (ASC) and cysteinyl-aspartate-specific proteinase 1 (Caspase-1). The relative DNA abundances of Lactobacillus, Bifidobacteria, Faecalibacterium prausnitzii, and Escherichia coli in each group were correlated with the mRNA and protein expression of NLRP6, ASC, and Caspase-1 in the colon.
CONCLUSION: These findings indicated that mild moxibustion can relieve low-grade GI inflammation and alleviate visceral hypersensitivity in PI-IBS by regulating intestinal microbes and controlling NLRP6 inflammasome signaling.

World J Gastroenterol.2019 Aug 28;25(32):4696-4714. doi: 10.3748/wjg.v25.i32.4696.

Source: PubMed

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Comparative Pharmacokinetic Study of the Components in Alpinia Oxyphylla Miq.-Schisandra Chinensis (Turcz.) Baill. Herb Pair and its Single Herb Between Normal and Alzheimer's Disease Rats by UPLC-MS/MS

Qi Y1, et al.

Abstract
Alzheimer's disease (AD) is a neurodegenerative disease that seriously affects daily life. Schisandra chinensis (Turcz.) Baill. Fructus (SCF) and Alpinia oxyphylla Miq. Fructus (AOF) have been regarded as classical herbs for dementia since ancient times. Alpinia oxyphylla Miq.-Schisandra chinensis (Turcz.) Baill. herb pair (ASHP) is the compatible form of the two herbs. Ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was established for the simultaneous determination of protocatechuic acid, chrysin, schisandrin, gomisin A, gomisin B, nootkatone, deoxyschizandrin, schisandrin B and schisandrin C in rat plasma. The pharmacokinetic differences of the above nine active components in normal rats and AD model rats after oral administration of SCF, AOF, and ASHP ethanol extracts were investigated. Chloramphenicol and bifendate were used as the internal standards. Extraction of plasma sample was by liquid-liquid extraction with ethyl acetate. A SBC18 column (2.1 mm  100 mm, 1.8 μm) was used in this experiment at a flow rate of 0.3 mL/min at 30 C with linear gradient elution using acetonitrile and water containing 0.1% formic acid. This study showed ASHP can improve the absorption of protocatechuic acid, chrysin, schisandrin, gomisin B, nootkatone, deoxyschizandrin, schisandrin B and schisandrin C in vivo and slow down part of these components' elimination. In addition, compared with normal rats, the pharmacokinetic parameters changed significantly in AD model rats' plasma after oral administration of ASHP. Hence, these may be the pharmacokinetic mechanism of ASHP, in addition to serving as a potential agent in the treatment of AD.

J Pharm Biomed Anal. 2019 Sep 12;177:112874. doi: 10.1016/j.jpba.2019.112874. [Epub ahead of print]

Source: PubMed

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