The American Journal of Chinese Medicine

In this retrospective study, clinical data including clinical manifestations, routine blood tests, chest radiographic imaging from 77 severe cases of SARS treated with integrated Chinese and Western medicine were collected and statistically analyzed. Twenty-nine (37.6%) patients were admitted to the intensive care unit, non-invasive ventilation was used in 40 (51.9%) cases, and invasive ventilatory procedure was performed in eight (10.3%) cases. Seventy (90.9%) patients were clinically cured and seven (9.0%) died. The duration of defervescence was 8.3 ± 5.0 days after admission. In the early stage, normal leucocyte count was seen in 46 (75.4%) of the 61 patients tested, decreased leucocyte count in 13 (21.3%) and elevated leucocyte count in only two (3.2%) cases. A decreased lymphocyte count was also seen in 23 (37.7%) cases of the 61 patients tested on admission, and by day 14, the number of patients with decreased lymphocyte count (1.11 ± 0.66 × 10⁹) increased to 32 (47.7%) in 67 cases examined. Neutral granulocyte count was normal or decreased in 58 (95.0%) patients on admission, but elevated from the 7th day onward and peaked on day 21 in 32 (65.3%) of the 49 cases tested. All of the blood abnormalities returned to normal in the convalescent stage. Twenty-nine (37.6%) of the 77 severe cases of SARS patients demonstrated an extensive lung involvement. In comparison with the non-severe SARS cases, this group of patients showed significantly more pneumonic air-space opacities and ground glass-like changes on the chest radiographs (p < 0.05, χ² test). The role Chinese medicine played in the treatment of SARS was discussed.

The behavioral effects of a standardized extract from Panax ginseng roots (G115), of a standardized extract from Ginkgo biloba leaves (GK501) and of their combination (PHL-00701) (Gincosan®) were examined in experiments on rats with undisturbed memory and on rats with experimentally-impaired memory (by alcohol or by muscarinic- and dopamine-receptor antagonists), using methods for active avoidance (shuttle-box) and passive avoidance (step-down and step-through). On multiple administration G115, GK501 and PHL-00701 exerted favorable effects on learning and memory. These effects varied with the dose and administration schedules, with the rat strain and with the behavioral method. Based on earlier results, we discuss the role of changes in brain biogenic amines induced by the extracts in their mechanism of action. The present results allow for ranking G115, GK501 and their combination PHL-00701 (Gincosan®) among cognition-enhancing (nootropic) drugs.

Lindera strychifolia, a scandent shrub Lauraceous medicinal plant, has been used in Chinese traditional medicine as a palliative and an anti-spasmodic. It also shows cytotoxic effects against several tumor cell lines and inhibits marcromolecule biosynthesis. This study investigated the anti-tumor effects of L. strychifolia extract against lung cancer cells using in vitro and in vivo models. Two human lung cancer cell lines A549 (adenocarcinoma) and SBC-3 (small cell carcinoma), and a non-tumor cell line 3T3-L1 (mice fibroblasts) were subjected to L. strychifolia extract treatment. On lung cancer cells, L. strychifolia induced cell growth inhibition in a dose-dependent manner. Conversely, the extract did not show any significant cytotoxic effect on 3T3-L1 cells. Therefore, the extract is specific for tumor cells. Tumor cells treated with L. strychifolia extract showed typical morphological appearance of apoptosis including nuclei fragmentation and cell condensation. The in vivo effects of L. strychifolia extract were investigated in C57BL/6 mice transplanted with Lewis lung cancer (LL-2) cells, and in BALB/c nude mice transplanted with A549 or SBC-3 human lung cancer cells. Oral administration of L. strychifolia extract prolonged survival time and inhibited tumor growth in a dose-dependent manner by inducing apoptosis in the LL-2 cell mice model. Furthermore, in A549 or SBC-3 cell nude mice models, oral administration of L. strychifolia extract also significantly inhibited tumor growth at the 5.0 mg/ml concentration. These findings suggested that the components of L. strychifolia have anticancer activity and may contribute to clinical applications in the prevention and treatment of lung cancer.

In this ex vivo study, the inhibitory activity of hypocrellin A (HA), a perylene quinonoid pigment isolated from the Chinese medicinal fungus Hypocrella bambuase, on protein kinase C (PKC) enzyme activity in insulin target tissues of obese Zucker rats was assessed. Pre-incubation with HA for 30 minutes significantly inhibited the activity of partially purified PKC enzyme from liver and soleus skeletal muscle in a dose-dependent manner (IC₅₀=0.07 and 0.26 μg/ml, respectively). HA produced a greater inhibitory effect in enzyme prepared from the liver than enzyme prepared from soleus muscle. Since total PKC activity in these two insulin target tissues is the net result of several different isoforms of PKC, and PKC-θ is a major isoform expressed in the soleus skeletal muscle, the present data suggest that the naturally occurring compound, HA, may selectively inhibit certain PKC isoforms other than PKC-θ. Further investigations are required to determine which PKC isoforms are most susceptible to HA and whether changes in PKC signaling during treatment with HA can reverse abnormalities of glucose and lipid metabolism in insulin resistant and diabetic states.

To examine the effectiveness of the herbal medicine prescription, Shu-Jing-Huo-Xue-Tang (SJHXT), for pain relief, we performed a study using rats with adjuvant arthritis (AA). After injecting the adjuvant, AA rats were maintained for 6 months as a chronic pain model. Starting at 6 months, SJHXT was administered for 12 weeks. We measured the tail skin temperature and locomotor activity of rats using thermography and a metabolism measuring system, respectively, before and after 12 weeks of SJHXT administration. Normal rats were used as controls. Before SJHXT administration, the tail surface temperature and locomotor activity were significantly lower in the AA rats than in the control rats. The tail skin temperature and locomotor activity of SJHXT-treated AA rats were significantly higher than those of the control rats. These findings suggest that the pain relief effects of SJHXT may be primarily due to increased blood circulation.

A type of polycystic ovary resembling some aspects of human polycystic ovarian syndrome (PCOS) can be induced in the rat with a single injection of long-acting estradiol valerate. Among several theories behind the development of polycystic ovaries (PCO), the involvement of the sympathetic nervous system draws much attention, and herbal medicine is known to relieve the abnormal symptoms of PCO. Two herbal formulas, Changbudodam-Tang (cang fu dao tan tang) and Yongdamsagan-Tang (long dan xie gan tang), were used in the present study. The administration of herbal medicine was done every other day for 60 days. The morphological changes of ovaries from herbal medicine treatment were compared to those from an oil-treated control group and an estradiol valerate-injected group. This study also examined the possible hypothesis of neurogenic participation in terms of nerve growth factor (NGF) in the pathology of ovarian dysfunction. The nerve growth factor was analyzed in the central nervous system and ovaries by immunohistochemistry. The main findings of the present study were: (1) PCO were fully developed in rats with a single intramuscular injection of estradiol valerate, (2) PCO resulted in the expression of NGF in the ovaries and the brain tissues, and (3) herbal medicine administration significantly decreased the elevated NGF staining in the ovaries without affecting the brain tissues significantly.

In an effort to find new antiviral agents from natural products, hot water extracts of eight traditionally used medicinal plants in Taiwan were investigated in vitro for their activities against adenoviruses (ADV) and herpes simplex viruses (HSV). Results demonstrated that all extracts exhibited antiviral activity with different degrees of potency. Only two extracts were active in suppressing both HSV and ADV infections. Three extracts inhibited only ADV infection whereas one extract blocked only HSV infection. These results suggested that the aforementioned medicinal plants merit further investigation.

The antioxidative activities of 12 medicinal plants and the compounds isolated from them were investigated using the thiocyanate method to evaluate inhibitory effects on lipid peroxidation in the linoleic acid system. The peroxide levels gradually increased during incubation in the presence of linoleic acid over 3 days, and most of the plants inhibited lipid peroxidation. In particular, of the plants tested, Cudrania tricuspidata, Zanthoxylum piperitum, Houttuynia cordata and Ulmus parvifolia reduced lipid peroxidation more effectively as lipid peroxidation progressed, resulting in inhibition of about 80% relative to the control value by the 3rd day of incubation. In addition, the polyphenols isolated from the plants also showed marked and dose-dependent inhibitory effects on lipid peroxidation. The compounds with the strongest activities were 3,4-dihydroxylbenzoic acid, quercetin, the quercetin glycosides quercetin-3-O-β-D-galactoside, quercetin-3-O-α-L-rhamnoside, quercetin-3-O-β-D-glucoside and quercetin-3-O-rutinose, catechin, gallic acid, methyl gallate and rosamultin isolated from Zanthoxylum piperitum, Houttuynia cordata, Rosa rugosa and Cedrela sinensis. Moreover, quercetin glycosides showed stronger activity than quercetin, suggesting that glycosylation increases the antioxidative activity of quercetin. Our results indicate that the medicinal plants and their polyphenols show promise as therapeutic agents for various disorders involving free radical reactions.

Radix Adenophorae (Shashen), a traditional Chinese medicine commonly used as an antitussive and expectorant, is derived from roots of Adenophora stricta Miq. and Adenophora tetraphylla (Thunb.) Fisch. Twelve species and varieties of Adenophora and Glehnia, however, could act as substitutes or adulterants of Radix Adenophorae on the commercial markets in South East Asia, and roots of Adenophora hunanensis Nannf. and Glihnia littoralis F. Schmidt ex Miq. are the most common examples. The authentic identification of dried roots of A. stricta and A. tetraphylla, however, is difficult on the basis of appearance and morphology. A molecular genetic approach was developed here to identify the species of Radix Adenophorae. The 5S-rRNA spacer domains (~250 bp) were amplified by the polymerase chain reaction (PCR) from genomic DNAs isolated from A. stricta, A. tetraphylla, A. hunanensis and G. littoralis, and subsequently, the nucleotide sequences were determined. Diversity in DNA sequence and restriction enzyme mapping among various species were found in their 5S-rRNA spacer domains, which could serve as markers for authentic identification of Radix Adenophorae.

Medicinal herbs have a long history of use in the practice of traditional Chinese medicine and a substantial body of evidence has, over recent decades, demonstrated a range of important pharmacological properties. Western biomedical researchers are examining not only the efficacy of the traditional herbal products but, through the use of a range of bioassays and analytical techniques, are developing improved methods to isolate and characterize active components. This review briefly describes the different extraction methodologies used in the preparation of herbal extracts and reviews the utility of chromatography-mass spectrometry for the analysis of their active components. In particular, applications of gas or liquid chromatography with mass spectrometry for the isolation and characterization of active components of ginseng are critically assessed. The analysis of toxic substances from herb extracts with mass spectrometric techniques is also discussed along with the potential for mass spectrometric methods to investigate the proteomics of herbal extracts.

Acupuncture has been widely used as a treatment for various conditions like headache and stroke, especially in Asian countries such as Korea and China. But few scientific investigations have been carried out. The aim of the present study is to investigate the effect of acupuncture on the production of inflammatory cytokines in patients with chronic headache (CH). Patients with CH were treated with acupuncture during the acute stage. Clinical signs of CH disappeared markedly after three months of treatment with acupuncture. Peripheral blood mononuclear cells obtained from a normal group and those from the patients with CH, before and after treatment with acupuncture, were cultured for 24 hours in the presence or absence of lipopolysaccharide (LPS). The amount of interleukin (IL)-1β, IL-6 and tumor necrosis factor-α (TNF-α) in LPS culture supernatant was significantly increased in the patients with CH compared to the healthy control group (p < 0.05). But those cytokines came down toward the levels of the healthy group (p < 0.05) after treatment with acupuncture, although the levels still remained elevated. Plasma cytokine levels were analyzed to evaluate any change due to acupuncture treatment. There was little difference in the levels of IL-1β or IL-6 due to the treatment with acupuncture in the patients with CH, but significantly reduced plasma levels of TNF-α were observed. These data suggest that acupuncture treatment has an inhibitory effect on pro-inflammatory cytokine production in patients with CH.

It has been reported by Stein et al. that the immune system and peripheral opioid receptors are involved in the control of pain accompanying inflammation. Electroacupuncture (EA) is used to relieve various kinds of pain. However, little is known about the effect of electroacupuncture analgesia (EAA) during hyperalgesia elicited by inflammation. The aim of the present study was to compare (1) the individual variation of EAA, (2) the durability of EAA, and (3) the effect of naloxone on EAA between normal rats and rats subjected to acute inflammatory pain. Carrageenan was subcutaneously administered by intraplantar (i.pl.) injection of the left hind paw to induce a nociceptive response. Nociceptive thresholds were measured using the paw pressure threshold (PPT). Rats received EA at 3 Hz in the left anterior tibial muscles for 1 hour after carrageenan injection. Naloxone was administered by intraperitoneal (i.p.) or i.pl. injection just before EA. EAA was elicited in 15 of 29 normal rats. These rats were divided into responders and non-responders. EAA in the responder group was almost completely antagonized by i.p. injection of naloxone. In contrast, in all the rats with carrageenan-induced inflammation, EAA was elicited, lasted for at least 24 hours after carrageenan injection, and was dose-dependently antagonized by i.pl. injection, but not significantly by i.p. injection of naloxone. It seems likely that the EAA in the rats with carrageenan-induced inflammation differs from that in normal rats, and these findings suggest that peripheral opioid receptors are involved in EAA during inflammatory conditions.

The aim of this study was to investigate the effect of electrical stimulation on activator protein-1 (AP-1) in recombinant liver cells. In order to elucidate the molecular effects of electrical stimulation on cells, AP-1 expression was detected by a luciferase assay. The parameters used were taken from clinical electroacupuncture (EA) therapy as follows: biphasic rectangular symmetrical pulses (frequency: 2, 10 and 100 Hz; pulse width: 50, 80, 130 and 250 μsec; intensity: 1, 2, 5 and 10 mA; time: 5, 10, 20 and 30 minutes). S (10% fetal bovine serum in medium), SF (serum free medium) and 12-O-tetradecanoylphorbol-13-acetate (TPA) treatment represented the experimental, negative and positive groups, respectively. We found that electrical stimulation with 10 Hz, a pulse width of 130 μsec, and a duration of 30 minutes gave a significant increase in AP-1 activity. In contrast, the intensity of the stimulation had no significant effect on AP-1 activity. In conclusion, our data suggest that electrical stimulation with an appropriate frequency, duration and pulse width could cause an increase in AP-1 activity in cells.

Rashīd ad-Dīn gives a summary of what he found in Arabic and Chinese medical literature concerning the topic Heat.

Acupuncture is based on the theory of channels, which serve as pathways for energy (Qi). On the course of the channels, acupuncture points are described, and by stimulation of these points, therapeutic effects may be achieved. This system is very complex and both channels and acupuncture points are anatomically invisible. Unlike in Western medicine, scientists fail to trace both the origin and the progress of acupuncture theory. Having developed in its full form not later than the 2nd century BC, it never underwent fundamental change. On the other hand, it has become a part of modern Western medicine as an effective therapy and the existence of acupuncture points, specified thousands of years ago, has been demonstrated by modern science. It is hardly probable that acupuncture theory, although dating back to ancient times, could have originated in primitive civilization. The origin of the energy channel theory does not fit into the traditional developmental scheme. The existence of the theory cannot be explained other than by its being a product of a highly developed civilization.

The occurrence of many congenital syndromes has long been an enigma. Clinically, the phenotype of any given genetic defect usually varies to some extent, whilst, pathogenetically, features within each syndrome are probably interconnected, albeit by largely unknown mechanisms. Through its unique theories such as the Jing-Mai (variously translated as the Channels, Vessels or Meridians), Zang-Fu (the Yin and Yang internal organs) and Wu-Xing (translated as the Five-Phase Correspondence or Five-Element theory), traditional Chinese medicine (TCM) seems to have comprehensively summarized the makeup of the human phenotypes. By combining the above TCM theories with modern medical knowledge, the intrinsic mechanisms between various aspects of the phenotypic makeup of the human individual, i.e. the Human Phenome, may be deduced. Analysis of congenital syndromes in light of the Human Phenome seems to suggest that various genetic defects may cause diseases in a similar fashion; i.e. primarily with structural abnormalities distributed along the four Jing-Mai connected with the Kidneys (midline defects) as well as "Marrow" aberrations (anomalies of hematology/immunology, endocrine, central nervous system and the bones). The derived Human Phenome may thereby enable a better understanding of such conditions and provide a model for the study of multigenic traits. On the other hand, blind spots of clinical observation and unknown aspects of human nature, e.g. circuits formed by the Jing-Mai, symmetries of the Jing-Mai and Zang-Fu, and correspondences between body physiques, spiritual factors and the external world may also be deduced. The TCM-based Human Phenome may thereby offer a fresh view for genotype-phenotype correlations, insights into gene-development mechanisms, as well as potential directions for the development of new treatments.

The Chungpyesagan-tang was developed for one of four human constitutional types in Korea. In order to test the effectiveness and efficacy, randomized controlled trials and placebo controlled trials, respectively are required. The safety question should be answered through control studies within the same constitutional population.