The American Journal of Chinese Medicine

Ephedra has been commonly used in traditional Chinese medicine (TCM) without significant adverse effects. Ephedra-containing dietary supplements are widely used in the United States to promote weight reduction and energy enhancement. However, there are significant safety concerns regarding the use of ephedra-containing dietary supplements, especially when such use occurs by consumers without medical supervision. This article reviews and contrasts the usage of ephedra as a dietary supplement in the US against an herbal medication in TCM. The potential adverse effects of ephedra-containing dietary supplements are also reviewed.

The present study was designed to investigate the ameliorating effects of Cnidiuim monnieri L. Cusson (CM) and osthole, a constituent of CM, on the spatial performance deficit in scopolamine (SCOP)-treated or ovariectomized (OVA) rats. CM improved the deficit of spatial performance, and reversed the lower plasma estradiol levels caused by SCOP in female rats. In addition, osthole (3 and 10 mg/kg, sc) improved the performance deficit in OVA rats. It (10 and 30 μg/brain, icv) also improved the performance deficit caused by SCOP in intact female rats, and at 30 μg/brain improved the deficit in OVA rats. However, osthole did not alter the latency swum to reach the visible target in SCOP-treated and OVA rats. Accordingly, we suggested that osthole is an active constituent of CM, and possesses ameliorating effects on the spatial performance deficits in SCOP-treated female rats or OVA rats. The action mechanism of the effects of osthole on performance deficits was related to the estrogen-like properties and activating the central cholinergic neuronal system.

It has been shown that Ginkgo biloba Extract (EGb 761) increases peripheral and cerebral blood flow and microcirculation and improves myocardial ischemia reperfusion injury. This study was designed to investigate the effect of EGb 761 on hepatic endothelial cells and hepatic microcirculation. Sixty male Wister rats were divided into normal, carbon tetrachloride (CCl₄) and EGb groups, and were given normal saline, CCl₄ and CCl₄ plus EGb 761, respectively, for 10 weeks. Samples were taken from the medial lobe of the rat livers ten weeks later. Hepatic sinusoidal endothelial cells and other parameters of hepatic microcirculation were observed under transmission electron microscopy (TEM). The amount of malondialdehyde (MDA), endothelin (ET-1), platelet-activating factor (PAF) and nitric oxide (NO) in liver tissue was determined by spectrophotometry and radioimmunoassay, respectively. Compared with the CCl₄ group, aggregation of blood cell or micro thrombosis in hepatic sinusoids, deposition of collagen in hepatic sinusoids and space of Disse, injury of endothelial cells and capillization of hepatic sinusoid was significantly reduced in the EGb group. The amount of MDA, ET-1 and PAF was markedly reduced in the EGb group than in the CCl₄ group, while no significant difference in the amount of NO was observed between the two groups. The results demonstrate that EGb 761 has protective effect on hepatic endothelial cells and hepatic microcirculation in rats with chronic liver injury induced by CCl₄. The mechanisms may involve its inhibition on ET-1, PAF and lipid peroxidation.

A competitive enzyme-linked immunosorbent assay (ELISA) for ginkgolic acids (GAs) was developed using monoclonal antibody (MAb) 9F raised against 6-(13-formylheptyl) salicylic acid covalently coupled to bovine serum albumin (BSA). ELISA, at an effective measuring range of 300 ng/ml–1 μg/ml of GA_15:1, was successful in detecting GAs content in ginkgo leaves and standardized extracts due to the lack of cross-reactivity against various related compounds. The sensitive and simple immunoassay developed in this study was validated to be specific for the quantitative determination of total GAs content in ginkgo crude drugs with no interference from the sample matrix. The analytical recovery of spiked GA_15:1 was 103% in a concentration range between 10 and 40 mg/g dry weight of ginkgo leaves.

The pathogenesis of gentamicin (GM) nephrotoxicity has been shown to involve the generation of oxygen free radicals, and several free radical scavengers have been shown to ameliorate the nephrotoxicity. The seeds and oil of Nigella sativa are reported to possess strong antioxidant properties and was effective against disease and chemically-induced hepatotoxicity and nephrotoxicity. Therefore, in the present work, we have tested whether oral treatment of rats with N. sativa oil (0.5, 1.0 or 2.0 ml/kg/day for 10 days) would ameliorate nephrotoxicity of GM (80 mg/kg/day given intramuscularly and concomitantly with the oil during the last 6 days of treatment). Nephrotoxicity was evaluated histopathologically with a light microscope and by measurement of concentrations of urea, creatinine and total antioxidant status (TAS) in plasma and reduced glutathione (GSH) and TAS in kidney cortex. The results indicated that GM treatment caused moderate proximal tubular damage, significantly increased the concentrations of creatinine and urea, and decreased that of TAS and GSH. Treatment with N. sativa oil produced a dose-dependent amelioration of the biochemical and histological indices of GM nephrotoxicity that was statistically significant at the two higher doses used. Compared to controls, treatment of rats with N. sativa did not cause any overt toxicity, and it increased GSH and TAS concentrations in renal cortex and enhanced growth. The results suggest that N. sativa may be useful in ameliorating signs of GM nephrotoxicity in rats, and pending further experimentation to determine safety and efficacy, may be useful clinically.

The influence of the aqueous crude extract of Glycine tomentella root (Leguminosae) on lipid metabolism was investigated in hyperlipidemic hamsters. It was found that the administration of the G. tomentella extract (GTE) leads to a decrease of high serum cholesterol and triglyceride levels induced by high-fat diet. The GTE also increased serum high-density lipoprotein (HDL) cholesterol and decreased serum low-density lipoprotein (LDL) cholesterol. The reduction of serum triglyceride levels was accompanied by a significant decrease in the hepatic triglyceride content, while the cholesterol content was not changed. The results indicate that GTE is definitely an anti-hyperlipidemic agent, at least, in animals.

Spirodela polyrhixa Schleid has been used in folk medicine to treat inflammatory diseases. Since nitric oxide (NO) is one of the major inflammatory parameters, we studied the effect of aqueous extracts of Spirodela polyrhixa (AESP) on NO production in lipopolysaccharide (LPS)-stimulated mouse peritoneal macrophages. AESP inhibited the secretion of NO in macrophages, without affecting cell viability. The protein level of inducible nitric oxide synthase (iNOS) in peritoneal macrophages was also decreased by AESP. Transient transfection assay of reporter plasmid and gel shift assay indicated that AESP blocked the activation of nuclear factor-kappa B (NF-κB), which was considered to be a potential transcription factor for iNOS expression. AESP also blocked the phosphorylation and degradation of inhibitory protein I kappa B-alpha (IκB-α). These results suggest that AESP could exert its anti-inflammatory actions by suppressing the synthesis of NO through inhibition of NF-κB activity.

Ginseng is one of the most widely used Chinese herbal medicines. In this report, the relatively short-term effect of ginseng extract on the immunoglobulin production and cytokine production was studied. The ginseng extract was prepared by boiling the ground ginseng root in 50% ethanol. The specific pathogen-free mice were intraperitoneally (i.p.) injected with various doses of ginseng extract for 3 consecutive days. The results indicated that the serum levels of immunoglobulin (Ig)M, IgG and IgA were significantly elevated after the mice were i.p. injected with 4 g/kg/day of ginseng extract. Under in vitro condition, the lipopolysaccharide (LPS)-stimulated spleen cells showed a dose-dependent increase in secretion of IgM, IgG and IgA. However, at a higher dosage (4 g/kg/day), the amount of IgA secretion began to decline. The serum level of interleukin (IL)-2, interferon (IFN)-γ [T-helper (Th)1-type cytokines] and IL-4 and IL-10 (Th2-type cytokines) were significantly elevated after the mice were i.p. injected with 2 g/kg/day or higher doses of ginseng extract. The amount of cytokine secretion by concanavalin A (Con A)-stimulated spleen cells was also significantly enhanced after the mice were i.p. injected with 0.4 g/kg/day or higher dose of ginseng extracted. To further confirm the results from enzyme-linked immunosorbent assay (ELISA), the spleen cells were cultured for 36 hours in the presence of 1 μg/ml of Con A. Total mRNA was isolated and assayed for mRNA expression using reverse transcriptase-polymerase chain reaction (RT-PCR). The results revealed that expression of IL-2 and IFN-γ mRNA were dose-dependently enhanced by the ethanol extract of ginseng. The levels of IL-4 and IL-10 mRNA expression were also elevated in the spleen cells of ginseng-treated mice in comparison with that of the control group. In addition, we observed that the concentrations of IgG1, IgG2a and IgG2b in culture supernatants of spleen cells were dose-dependently increased by in vivo treatment of ginseng extract, suggesting that both Th1- and Th2-type cytokines were involved in IgG production. Our observation in this study demonstrated that the Chinese herbal drug ginseng was able to regulate antibody production by augmenting Th1- (IL-2, IFN-γ) and Th2-type (IL-4, IL-10) cytokine production.

Scutellaria baicalensis (SbE) is a commonly used Chinese herb medicine and grape seed proanthocyanidins is a popular herbal supplement in the United States. Both herbs have been shown to possess potent antioxidant effects. Using an in vitro model to produce the reactive oxygen species (ROS) generation (H₂O₂/FeSO₄ for hydroxyl radicals, xanthine/xanthine oxidase for suproxide), we observed that Scutellaria baicalensis and grape seed proanthocyanidins acted synergistically to scavenge ROS. Our data suggest that a combination of these two herbs can potentially enhance their antioxidant efficacy, allowing lower dosages of each drug to be used. This has the advantage of avoiding possible side effects that may arise when higher doses of a single herb are used in an attempt to achieve a maximum degree of antioxidant activity.

The purpose of this study was to determine the inhibitory action of protocatechuic aldehyde (PCA) on tyrosinase activity. PCA is one of the compounds found in the root of Salvia miltiorrhiza. Our study documented that PCA has a potent inhibitory effect on tyrosinase, which catalyzes the rate-limiting step of melanin biosynthesis. Although melanin biosynthesis has an essential function normally in human skin for defense against ultraviolet light of the sun, its abnormal activity as seen in pigmentation disorder could lead to serious medical problems. Our data showed that PCA, with concentrations ranging from 1×10^-5M to 8×10^-5M, exhibited dose-dependent inhibition of the enzyme activity with 50% of inhibition at 19.92×10^-6M. A further kinetic analysis on PCA inactivation of tyrosinase activity revealed a competitive inhibition of the enzyme at the L-tyrosine binding site. The findings of our present study merit further research on the applicability of PCA as a potential agent for treatment of pigmentation disorder.

Allergic rhinitis is a common health problem usually treated with drug therapy. Some patients experience side effects of drug therapy while others fear the use of drugs. Acupuncture is an interesting alternative to traditional treatment. The few studies evaluating acupuncture indicate a possible clinical effect on allergic rhinitis. This study compared active versus sham acupuncture in 40 consecutive patients with a history of allergic rhinitis and a positive skin test. Patients were randomized and assessed prior to treatment and then reassessed after 12 months. Improvements in symptoms using visual analogue scales, reduction in skin test reactions and levels of specific immunoglobin E (IgE) were used to compare the effect of treatment. For one allergen, mugwort, a greater reduction in levels of specific IgE (p=0.019, 0.039) and skin test reaction (p=0.004) was seen in the group receiving active acupuncture compared to the group receiving sham acupuncture. However, this finding might be an artifact. No differences in clinical symptoms were seen between active versus sham acupuncture, thus the conclusion being that the effect of acupuncture on allergic rhinitis should be further evaluated in larger randomized studies.

The purpose of this study was to investigate the effect of the De-Qi sensations of acupuncture (sourness-distension and distension-numbness) stimulation. Fifty-two healthy medical student volunteers were given acupuncture at the Hoku (LI-4) acupoint as they were resting. During a test that lasted 30 minutes, their skin blood flow was measured at the Quchi (LI-11) acupoint and their palm temperature was measured. Our results indicated that acupuncture increased blood flow when the De-Qi sensation occurred. If the needle was twirled a few minutes thereafter and the De-Qi feeling again occurred, the same blood flow increase was seen again. If the needle was not twirled, but the test person felt soreness, numbness and heat sensation within a few minutes after needle insertion, the same blood flow increase was also seen. After acupuncture, Quchi did not show continuous increase of blood flow as did Hoku. Hoku acupuncture also increased palm temperature suggesting that the blood flow increased from cutaneous vessel vasodilation. In conclusion, when the test person felt the sore and numb De-Qi sensation, there was an increase of blood flow at the acupuncture points. Thus, our results suggest that increased flow may be one of the mechanisms accounting for meridian system responses during acupuncture.

To establish the proper analgesic method by electroacupuncture (EA) for bovine surgery, the analgesic effect of dorsal and lumbar acupoints, in addition to the combination with dorsal and lumbar acupoints, were investigated in the present study. Four Korean native cattle (two males and two females) and 24 Holstein-Friesian cattle (all females) were used. The experimental animals were divided into four groups according to used acupoints: dorsal acupoint group (Tian Ping [GV-20] and Bai Hui [GV-5]: 7 heads), lumbar acupoint group (Yap Pang 1 [BL-21], Yao Pang 2 [BL-23], Yao Pang 3 [BL-24] and Yao Pang 4 [BL-25]; 5 heads), dorsal-lumbar acupoint group (Yao Pang 1 [BL-21], Yao Pang 2 [BL-23], Yao Pang 3 [BL-24] and Bai Hui [GV-5]; 8 heads) and control group (non-acupoints, the last intercostals space and the femoral area; 3 heads). The acupoints were stimulated with currents of 2–6 V (30 Hz) in dorsal acupoint group, 0.5–2.0 V (30 Hz) in lumbar acupoint group and 0.3–2.5 V (30 Hz) in dorsal-lumbar acupoint group. Recumbency time was 10 seconds to 1 minute (except one case) and induction time of analgesia was approximately 1 to 6 minutes in dorsal acupoint group. Analgesic effect was systemic, including the extremities in dorsal acupoint group. During the EA, the consciousness was evident and blepharo-reaction was still present under EA in dorsal acupoint group. During the surgery, grades of analgesic effect were 6 excellent (6/7, 87.5%) and 1 good (1/7, 14.3%). In addition, induction time for analgesia was about 10 minutes in both lumbar and dorsal-lumbar acupoint groups. Analgesic areas were found in abdominal areas from the last intercostal spaces to the femoral areas, except lower abdomen in lumbar and lumbar-dorsal acupoint groups. The consciousness was evident and standing position was maintained during EA stimulation in contrast to that of dorsal excellent (1/5, 20.0%), 3 good (3/5, 60.0%) and 1 poor (1/5, 20.0%) in the lumbar acupoint group. Additionally, grades of analgesic effect were 4 excellent (4/8, 50.0%), 3 good (3/8, 37.5%) and 1 poor (1/8, 12.5%). On the other hand, pain was present and analgesia was not accomplished under EA stimulation in control group. In conclusion, analgesia by EA was effective with decreasing order of dorsal acupoint > dorsal-lumbar acupoint > lumbar acupoint among groups. It was considered that dorsal acupoint group might be useful for operation with recumbent position, and lumbar and dorsal-lumbar acupoint groups might be proper for operation with standing position.

The objective of this study was to compare cardiorespiratory responses to exercise among older Qigong participants, Tai Chi Chuan (TCC) practitioners and normal sedentary controls during cycle ergometry. Thirty-six community-dwelling men with a mean age of 59.1±6.6 years participated in this study. Each group (Qigong, TCC and control) included 12 subjects with matched age and body size. The Qigong group practiced Qigong regularly for 2.3±1.5 years; the TCC group practiced Yang TCC for 4.7±2.3 years. Heart rate (HR) responses were measured during the practice of Qigong and TCC. Additionally, breath-by-breath measurement of cardiorespiratory function was performed during the incremental exercise of leg cycling. The mean HR during Qigong and TCC practice was 91±5 bpm and 129±7 bpm, respectively. At the peak exercise and the ventilatory threshold (VeT), TCC group displayed highest oxygen uptake , O₂ pulse and work rate among the three groups. The Qigong group also showed higher oxygen uptake and O₂ pulse than the control group. At the same relative exercise intensity, the Qigong group had the highest tidal volume among the three groups. In conclusion, Qigong and TCC show a beneficial effect to aerobic capacity in older individuals, but TCC displays a better training effect than Qigong due to its higher exercise intensity. However, Qigong can enhance breathing efficiency during exercise due to the training effect of diaphragmatic breathing.

This study aims to determine the relative exercise intensity of classical Yang Tai Chi Chuan (TCC) in different ages and gender. One hundred TCC practitioners (54 men and 46 women) aged 25 to 80 years participated in this investigation. Men and women were separated into three groups: young (25–44 y/o), middle-aged (45–64 y/o) and elderly (65–80 y/o). Heart rate (HR) responses during TCC practice were measured by using electrocardiographic telemetry. An exercise test with breath-by-breath measurements of cardiorespiratory function was also performed for each subject during the incremental exercise of leg cycling. Measurements obtained during the TCC practice and exercise testing were compared to determine the exercise intensity of TCC. While performing TCC, the mean HR of men was 141±12 bpm, 132±9 bpm and 120±10 bpm in the young, middle-aged and elderly groups, respectively. Men practiced TCC with mean HR corresponding to 57.8±3.7%, 56.6±3.4% and 55.1±3.1% of heart rate reserve (HRR) in the three groups. Meanwhile, the mean HR of women was 136±10 bpm, 126±11 bpm and 115±12 bpm in the young, middle-aged and elderly groups, respectively. Women practiced TCC with mean HR corresponding to 52.7±2.8%, 51.5±2.6% and 50.3±2.9% of HRR in the three age groups. The results demonstrate that classical Yang TCC is an exercise with moderate intensity, and its exercise intensity is similar across different ages in each gender. In conclusion, TCC is an aerobic exercise and suitable for participants of different ages and gender to improve their functional capacity.