The American Journal of Chinese Medicine

Rhubarb is a common herb used in traditional Chinese medicine. However, few publications exist about its pharmacokinetic profiles in animals or healthy volunteers. Whether retention enema administration of rhubarb extract affects its pharmacokinetics as well as its tolerability is unknown. Therefore, we set out to compare the pharmacokinetic parameters of rhein administered by retention enemas with those of conventional oral dosing of rhubarb extract. Eight healthy male volunteers were enrolled in a prospective crossover study. All subjects received a single dose of rhubarb extract (50 mg·kg^-1) on two separate occasions, once orally, once by a retention enema. Rhein plasma concentration was measured by HPLC. The C_max, AUC_0-∞, AUMC were significantly higher in oral administration than those in retention enema administration (p < 0.05), while V_d of rhein after oral administration of rhubarb extract was significantly lower (p < 0.05) than that after retention enema administration. However, no statistically significant differences between the two treatments were observed for any of the other pharmacokinetic parameters (T_max, t_1/2, MRT_0-∞, CL). Dosage adjustment is advisable for retention enema administration of rhubarb extract in patients.

Bioelectrical impedance analysis (BIA), a device that analyzes the current conduction differences between the fat and water components is widely used for reasons that include convenience of use, non-invasiveness, safety, and low cost. Dual energy X-ray absorptiometry (DXA) allows for the assessment of total body and regional lean and fat tissues and bone mineral content (BMC). The objective of this study was to compare body composition assessments by BIA and DXA before and after a 6-week herbal diet intervention program in 50 pre-menopausal women [mean ± SD: age 30.58 ± 6.15, body mass index (BMI) 31.72 ± 3.78]. Waist-to-hip ratio (WHR) was measured by BIA and anthropometry. Lean body mass (LBM), body fat (BF), BMC and percent body fat (%BF) were measured by BIA and DXA. Highly significant correlations were observed between BIA and DXA measurements for LBM, BF, BMC and %BF (r = 0.73, 0.93, 0.53, 0.79, respectively) before the intervention. Differences between BIA and DXA measurements were observed in LBM, BF, %BF and BMC before intervention (p < 0.01) where WHR by BIA was significantly higher compared to anthropometry before (p < 0.01) and after the intervention (p < 0.01). BIA underestimated LBM by 1.85 kg and overestimated BF by 2.54 kg compared to DXA before the intervention. Although BIA and DXA showed highly significant correlations for LBM, BF, BMC and %BF before the intervention, they did not produce statistically comparable results in pre-menopausal Korean women and therefore should not be used interchangeably when measuring body composition.

This study investigates relationships between diseases and the appearance of the human tongue in terms of quantitative features. The experimental samples are digital tongue images captured from three groups of candidates: one group in normal health, one suffering with appendicitis, and a third suffering with pancreatitis. For the purposes of diagnostic classification, we first extract chromatic and textural measurements from original tongue images. A feature selection procedure then identifies the measures most relevant to the classifications, based on which of the three tongue image categories are clearly separated. This study validates the use of tongue inspection by means of quantitative feature classification in medical diagnosis.

Osteoporosis is a common finding following chronic obstructive pulmonary disease (COPD), but there are few reports on the relationship between bone mineral density (BMD) and the syndrome types described in traditional Chinese medicine (TCM) in patients with COPD. A cross-sectional medical survey was used in this study. Twenty-six male patients with COPD and 26 age-matched male healthy subjects were recruited. The symptom questionnaire survey of TCM was implemented, and thereafter the COPD patients were divided into two subgroups: type of deficiency of the lung and spleen (TDLS) and type of deficiency of the lung, spleen and kidney (TDLSK). BMD of lumbar spine (L2-4), non-dominant femoral neck (Neck), Ward's triangle (Ward's), and great trochanter (Troch) were measured by dual-energy x-ray absorptiometry. In addition, the other bone turnover markers were also examined. The results showed that BMD was much more decreased in TDLSK than that in TDLS patients (p < 0.05), and BMD in the patients of the TDLS subgroup without symptoms of kidney-vacuity has showed the decreased trend from healthy subjects to TDLS patients. Furthermore, there was a higher incidence of osteoporosis in patients with TDLSK compared with that in TDLS (p < 0.05, OR > 2.0). Therefore, the data suggest that: (1) BMD might be a marker more sensitive than the symptom for the diagnosis of kidney-vacuity in COPD patients; (2) the deficiency of kidney would be the key factor of bone mineral loss; and (3) that invigorating the kidney should be performed in the phase of TDLS in COPD patients in advance.

The purpose of this study was to investigate the differences in bio-potential in the stomach meridians of 20 normal healthy control subjects (NHC) and 20 patients with gastric disease (PGD). We measured changes in potential between ST-39 and ST-37 on the stomach meridian in response to invasive insertion of a needle at ST-36. The response patterns of NHC were regular in both the left and right meridians, whereas the response patterns of PGD were irregular. The potential of the NHC was significantly higher than that of the PGD group. The potential values in the left and right meridians of NHC were the same. However, the potential in the right meridian was significantly higher than that in the left meridian of PGD (p < 0.001). This study indicates that there may be changes in Qi or in the electrical properties of meridians according to health status, reflected in the regularity of the response to acupuncture or in the level of potential along meridians. Therefore, it may be possible to make a diagnosis from the state of a meridian by comparing levels of potential difference and its regularity.

Acupuncture as a therapeutic intervention is widely practiced in the treatment of many functional disorders including alcohol abuse. In the present study, the effects of acupuncture on alcohol withdrawal syndrome (AWS) and Fos-like immunoreactivity (FLI) in the striatum and the nucleus accumbens (NAC) of rats were investigated. During 3 days of cessation following chronic administration of ethanol (3 g/kg, i.p. for 3 weeks), rats showed a significant increase in AWS, such as hypermotility, tail rigidity, grooming and tremor, and an increase in FLI in the dopamine terminal areas of the brain. Treatment with acupuncture at zusanli (ST36) or sanyinjiao (SP6) during the withdrawal period inhibited both AWS and FLI of rats undergoing ethanol injection. These results suggest that acupuncture may be useful in the treatment of alcoholism by modulating post-synaptic neural activation in the striatum and NAC.

This paper describes the methods and theories of patient-reported outcomes, in particular to the health-related quality of life recently applied in Chinese medicine research. It begins with an investigation of the reasons for a patient-reported outcomes measure for Chinese medicine and the development of a new health-related quality of life instrument based on Chinese culture and Chinese medicine. Discussions on the importance and application of patient-reported outcomes as well as the relationship between quality of life and Chinese medicine are at the focus of this paper. Through a description of the Chinese Quality of Life Instrument and its development, the present work demonstrates an evidence-based approach using patient-reported outcomes or health-related quality of life measures to evaluate treatment efficacy of Chinese medicine, and thereby build a bridge for the integration of Chinese medicine into mainstream health care.

Since we all belong to the Kingdom Animalia, it is not surprising that animals in general benefit from the healing art of acupuncture that helps humans. Consequently, any proposed mechanism of Qi and acupuncture for humans based on animal physiology is probably applicable to animals as well, yet none is capable of explaining most of the complicated physiological effects observed. Not much attention was paid to the effects of Qi and acupuncture on plants (Kingdom Plantae) and on enoki mushrooms (Kingdom Fungi) by the TCM community, probably because they cannot be explained in terms of neurochemistry or connective tissue structures. However, our transmission and birdcage model is in principle applicable across Kingdom boundaries, because it is based on physical properties underlying the biological structure, thus its explanatory power is not restricted by categories of biology. We estimate several possible parameters of the birdcage model for animals and plants and give a possible interpretation for the sound fertilization phenomenon.

This research investigated the anti-hypertension effect of the traditional Chinese medicine (TCM) Ju-Ling-Tang (JLT) on an animal model of hypertension induced by unilateral renal artery ligation. In the study of anti-hypertension effects, 60 minutes after oral administration with NG tube feeding of 240 mg/kg JLT, a significant decrease in blood pressure (p < 0.05) was observed and sustained till 120 minutes. In the group given 50 mg/kg α-methyldopa orally, the effect was obvious 90 minutes after medication (p < 0.01), and lasted until 240 minutes. In terms of organ pathology, a significant reduction in the extent of induced glomerular sclerosis was observed in rats given 240 mg/kg JLT compared with the control. From these results, we infer that JLT has a beneficial anti-hypertensive effect on renal hypertension.

Gap junction communication between astrocytes plays an important role in the brain. The purpose of this study was to investigate the effects of Gingko biloba extract (GBE) on the changes of connexin 43 (Cx43) mRNA and protein expression levels of rat cortex and hippocampus induced by ischemia-reperfusion and astrocyte gap junction intercellular communication (GJIC) induced by hypoxia-reoxygenation. After 2 hours of middle cerebral artery occlusion (MCAO) followed by 24 hours of reperfusion, there was obvious neurological deficit in rats. Cx43 mRNA and protein expression levels of rat cortex and hippocampus in the ischemia hemisphere were decreased significantly. When GBE at doses of 50 and 100 mg/kg body weight was administrated by p.o. daily for 7 days, the neurological deficit was improved, and lower Cx43 mRNA and protein expression levels induced by ischemia-reperfusion were recovered to normal. The i.p. injection of nimodipine (0.7 mg/kg weight body) also showed improvement on neurological deficit and Cx43 expression levels. Astrocyte GJIC was measured by the fluorescence recovery after photobleaching (FRAP). Hypoxia-reoxygenation induced a significant decrease in GJIC. Pretreatment with GBE (100 mg/l) and nimodipine (1.6 mg/l) significantly prevented the hypoxia-reoxygenation inhibition of GJIC. These results suggest that GBE could exert its neuroprotective effects by improvement of Cx43 expression and GJIC induced by hypoxia/ischemia-reoxygenation/ reperfusion injury.

A rapid and simple high-performance liquid chromatographic method for determination of berberine in rat thalamus was described in this study. Thalamus samples were pretreated by protein precipitation with methanol and acetonitrile. Berberine was determined using a Hypersil C₁₈ column with an isocratic mobile phase of acetonitrile — 0.05 M potassium dihydrogen phosphate (containing 0.5% triethylamine, pH 3.0) (30:70 v/v) and with UV detection at 265 nm. The lower limit of quantification for berberine in thalamus was 24 ng/ml, and the lowest concentration of berberine determined in rat thalamus samples was 47.5 ng/ml at 48 hours. The calibration curve for berberine was linear (r² = 0.9994) over the concentration range 24–6000 ng/ml. At this concentration range, the overall recoveries (91.20%–93.24%) for berberine were determined and the accuracy of the intra- and inter-day assays from rat thalamus were less than 6% RSD. Following intravenous administration of 10.2 mg/kg of Coptidis Rhizoma (CR) extract containing 3 mg/kg berberine into rats, the thalamus level of berberine increased rapidly (t_1/2α = 1.93 hours), peaked at 2.48 hours with a concentration of 271 ng/g, and had a slow elimination rate (t_1/2β = 14.6 hours), which suggested that berberine might directly act on certain regions of the thalamus, have pharmacological effects on some cerebral dysfunctions, and be an active ingredient of Huang Lian Jie Du Tang for the treatment of cerebral disease.

In China, the ethylacetate extract of the herb Tripterygium wilfordii Hook f (TWEE), containing the major active ingredient triptolide, is often used with favorable effect on rheumatoid arthritis patients, in alternation with the use of prednisone. The mechanism of this therapeutic effect, however, has not been completely delineated. In this study, we studied how TWEE and prednisone affect the pituitary and adrenal glands in rats. Thirty normal male Sprague-Dawley rats (ten per group) were randomly assigned to receive: (1) TWEE (25 mg/kg, twice a day), (2) prednisone (2 mg/kg, twice a day), or (3) vehicle (control) (0.5% sodium carboxymethyl cellulose 1 ml, twice a day), orally for 30 days. Pituitary and trunk blood were collected on day 31. Adrenocorticotropic hormone (ACTH) expression in the pituitary gland was assessed morphologically by immunohistochemical techniques. Plasma ACTH concentrations and serum corticosterone concentrations were quantitatively measured by radioimmunoassay. We found that TWEE significantly increased plasma ACTH concentration and serum corticosterone concentration and dramatically increased the number of ACTH-positive cells in the pituitary. Our findings indicate that TWEE can promote the synthesis and secretion of ACTH cells — in the pars distalis of the rat pituitary gland and the production of corticosterone in the zone fasciculata of the adrenal cortex. Our results indicate that TWEE has a cortical hormone-like function and can promote adrenal cortex function by activating the hypothalamus-pituitary-adrenal axis.

The anti-allergic effects of a 70% ethanol extract from Selaginella tamariscina herb (EST) were evaluated in this study. EST given at the doses of 500 and 1000 mg/kg can inhibit mouse systemic anaphylactic shock induced by compound 48/80 in a dose-dependent manner. It can also dose-dependently block rat homologous passive cutaneous anaphylaxis and skin reactions caused by exogenous histamine and serotonin with a significant difference observed at the dose of 1000 mg/kg. In addition, EST can reduce histamine release from rat peritoneal mast cells triggered by compound 48/80 and an antigen in vitro. When incubated with rat mast cells, the extract (200 μg/ml) can significantly elevate the intracellular cAMP levels. The finding suggests that EST inhibits mast cell-dependent, immediate allergic reactions. Its effects appear to be mediated by reducing the release of vasoactive amines such as histamine from mast cells via stabilizing the cell membrane and weakening the inflammatory action of these amines. Based on these results, Selaginella tamariscina and one of its active components flavonoids may be useful as potential remedies for allergic rhinitis and other allergy-related diseases.

Cardiac actions of the constituents of Sinomeni Caulis et Rhizome (SCR) and Mokuboi-to, a traditional herbal drug, were investigated. In voltage-clamp experiments, sinomenine (1 mM) and tetrandrine (100 μM) inhibited the ionic currents concentration-dependently. The constituents affected the action potential configurations. In multicellular preparations, SCR (1 mg/ml) decreased the maximum rate of depolarization. Tetrandrine (30 μM) and sinomenine (300 μM) also had similar effects, but magnoflorine (1 mM) had less or no effect. Dysrhythmias were abolished under Ca²⁺ overload conditions by sinomenine. These results indicate that at even acute administrations, these drugs exert the active electropharmacological actions and cardioprotections.

Acute p.o. administration of 99.5% ethanol (0.1 ml) to fasted mice produced heart toxicity. Pretreatment with p.o. administration of tetramethylpyrazine (TMP) could prevent such toxicity effectively and dose-dependently. The maximal antioxidative effect against 99.5% ethanol-induced heart toxicity could be observed at 1 hour after TMP administration. In order to further investigate the heart protective mechanism of TMP, both lipid peroxidation level in vivo and superoxide scavenging activity were conducted. TMP exhibited a dose-dependently anti-lipid peroxidation effect in mice heart homogenate, and results indicated that 99.5% ethanol-induced intoxicated mice hearts have higher malonic dialdehyde (MDA) levels compared with those in TMP administrated mice hearts. These results suggest that the potentially heart protective mechanism of TMP could be contributed, at least in part, to its prominent anti-lipid peroxidation and anti-free radical formation effects, hence it could protect the heart from lipid peroxidation-induced heart toxicity.