The American Journal of Chinese Medicine

Acupuncture treatment has been accepted worldwide. Many clinical trials have been conducted especially in analgesia. The present review includes almost all the important trials since 1970. Among all the pain conditions, postoperative pain, lower back pain, osteoarthritis of the knee and chronic headache are the most popular topics. We found that there are diverse conclusions in each condition; however, most trials agree that acupuncture is an effective therapeutic strategy for analgesia. As with regard to the placebo effect, there is no consensus. In chronic headache treatment, the placebo effect of acupuncture seems to be large. However, in osteoarthritis, the placebo effect is minimal. Another issue is the non-specific physiologic response to piercing the skin. We believe that this effect produces analgesia in some heterogeneous syndrome such as lower back pain. However, this effect is not superior to the specific therapeutic effect of acupuncture based on TCM theory in all the pain conditions reviewed here. We also notice that the design of the sham acupuncture or the placebo has great impact on the result. Rigorous design can minimize the non-specific and placebo effects of acupuncture. Therefore, the real effect of acupuncture can be investigated well. We conclude that acupuncture is a proven treatment for relieving pain. This conclusion is based on specific effects of acupuncture rather than placebo.

Emblica Officinalis (also known as Amla or Indian Gooseberry), a natural, traditional and functional food in Asia, has physiological benefits such as hepato-, cyto- and radio- protection, as well as hypolipidemic effects. In addition, Amla often functions as a potent antioxidant due to the high level of ascorbic acid (ranging from 1,100 to 1,700 mg/100 g of fruit) in its fruit. The aim of this study was to determine whether supplementation with Amla extract could reduce oxidative stress in patients with uremia. The findings show that supplementation with Amla extract for 4 months reduced the plasma oxidative marker, 8-iso-prostaglandin, (M0 vs. M4 = 1415 ± 1234 pg/ml vs. 750 ± 496 pg/ml, p < 0.05) and increased plasma total antioxidant status (TAS) (M0 vs. M4 = 2.32 ± 0.14 mM vs. 2.55 ± 0.24 mM, p < 0.05) in uremic patients. On the other hand, there were no significant differences observed in liver function (GOP and GPT), renal function (creatinine, blood urea nitrogen and uric acid), diabetic index (plasma glucose and adiponectin) and atherogenic index (LDL/HDL ratio, total cholesterol and homocysteine) in patients treated with Amla for 4 months. Our data suggest that Amla supplementation may increase plasma antioxidant power and decrease oxidative stress in uremic patients. However, Amla extract did not influence hepatic or renal function, or diabetic and atherogenic indices in uremic patients.

We aimed to assess the effects of traditional Chinese medicine; marine (MT) and kuhuang (KH), either alone or in combination, on the early graft function of the recipients and overall patient survival rate after liver transplantation (LT) by using diammonium glycyrrhizinate (DG) as a positive control. A total of 151 subjects undergoing LT were included in this prospective study. According to the different regimens given in the first two post-transplant weeks, they were divided into DG group (n = 49), DG + KH group (n = 36), MT group (n = 42) and MT + KH group (n = 24). The graft function in the early post-transplant period and patient survival rate were examined. During the first two post-transplant weeks, there was no significant difference in total bilirubin, alanine transaminase, aspartate transaminase, serum creatinine, and prothrombin time between MT group and DG group. Patient survivals in these two groups were also similar. Compared to DG group, DG + KH group showed a significantly lower total bilirubin value on post-transplant day 5 (3.2 ± 2.1 mg/dL vs. 5.7 ± 5.6 mg/dL, p < 0.01) and day 7 (2.8 ± 1.8 mg/dL vs. 5.8 ± 6.1 mg/dL, p < 0.01), and higher patient survival. There was no significant difference between DG + KH group and MT + KH group. In conclusion, MT provides an alternative to DG after LT. The combination of MT and KH is highly effective in decreasing the total blirubin in the early post-transplant period and improving patient survival.

The objective is to analyze the treatment used in relatively high quality randomized controlled trials to identify any similarities of therapeutic approaches and subsequently present recommendations for a standard acupuncture procedure for the treatment of peripheral facial paralysis (PFP). We searched Chinese and English language literatures through MEDLINE (January 1966 to October 2007), EMbase (January 1980 to October 2007), Chinese Biomedical Database (January 1978 to October 2007) and China National Knowledge Infrastructure (January 1979 to October 2007) for randomized controlled trials. With independent assessment by 2 observers, 33 of 386 originally identified articles were finally included. The extracted information from these articles was focused on the selection of meridians and acupoints, types of stimulation and duration of treatment. On the whole, when treating PFP, the best acupoints options are Dicang (ST4), Xiaguan (ST7), Jiache (ST6), Chengjiang (CV24), Yingxiang (LI20), Quanliao (SI18), Yifeng (TE17), Yangbai (GB14), Sibai (ST2), Fengchi (GB20), Shuigou (GV26), Yuyao (EX-HN4) and Hegu (LI4). Manual stimulation or electro-acupuncture combined with moxibustion is recommended. Moreover, the suggested duration of acupuncture treatment refers to once a day, 10 times for each course, 2 to 5 days as courses interval, and 20 to 40 treatments in total.

Acupuncture may modulate the imbalance of the autonomic nervous system. It is well known that restraint stress delays gastric emptying via inhibiting parasympathetic activity and/or stimulating sympathetic activity in rats. We have previously shown that electroacupuncture (EA) improves delayed gastric emptying induced by restraint stress in rats. To investigate whether the beneficial effect of EA on delayed gastric emptying is associated with its modulatory effects on autonomic nervous activity, we utilized spectral analysis of heart rate variability (HRV). In rats, the power in the low frequency (LF; 0.04–1.0 Hz) and high frequency (HF; 1.0–3 Hz) band of HRV represent sympathetic and parasympathetic activities, respectively. Electrocardiography (ECG)-electrodes were implanted on the subcutaneous tissues of the back. One week after the surgery, ECG was recorded before, during and after the restraint stress loading in a conscious state. EA (10 Hz) was applied at bilateral acupuncture points [ST-36 (lower leg) or BL-21 (back)] during restraint stress loading. In response to restraint stress, heart rate and LF component were increased, suggesting the increased activity of sympathetic tone. EA at ST-36 significantly reduced the elevated heart rate and LF, compared to that of control group. EA at ST-36 also significantly increased HF component after finishing the stress loading. In contrast, EA at BL-21 had no significant effect on the heart rate, LF and HF. It is suggested that EA at ST-36 stimulates parasympathetic activity and inhibits sympathetic activity under the restraint stress in rats.

It has been demonstrated that aqueous extract of Radix Hedysari Prescription and modified Radix Hedysari Prescription could improve the regeneration of injured peripheral nerve. Radix Hedysari is a main component in these two formulas. We hypothesized that Hedysari polysaccharides (HPS), a main active ingredient, could also enhance peripheral nerve regeneration after nerve injury in adult animals. In the present study, we examined the effects of HPS on sciatic nerve regeneration for 6 weeks following clamping in rats (administrated orally of 2 ml HPS liquid daily, 0.25 g/ml). The results showed that HPS was able to enhance sciatic function index (SFI) value, tibial function index (TFI) value, peroneal nerve function index (PFI) value, conduction velocity, and the number of regenerated myelinated nerve fibers, suggesting the potential clinical application of HPS for the treatment of peripheral nerve injury in humans.

In order to investigate the mechanism of the therapeutic effect of puerarin on non-alcoholic fatty liver disease, a non-alcoholic fatty disease male rat model was induced by a high fat diet, all rats were randomly divided into a blank group, model group, simavastatin group and puerarin group. After 4 weeks of drug treatment, the liver was slided to investigate pathological morphology. Elisa was used to measure the total cholesterol (TC), triglyeride (TG) in liver, and leptin content in serum. RT-PCR and Western blotting were employed to detect liver leptin mRNA receptor expression and P-JAK2, P-STAT3 expression levels in the liver respectively. The results showed that puerarin significantly decreased the TG, TC content in liver of the non-alcoholic fatty disease rats, ameliorated steatosis in liver, lowered liver inflammatory reaction, decreased leptin level in serum, and enhanced the expression of leptin receptor mRNA and P-JAK2/P-STAT3 level. All the results demonstrated that puerarin can exhibit therapeutic effect on non-alcoholic fatty liver disease by improving leptin signal transduction through JAK2/STAT3 pathways.

The Chinese herbal medicine Huang Qin (Radix Scutellariae) had been used for restless fetus for hundreds of years in China, however, little attention had been given to the components of the herb, specifically its ability to exert abortion-preventing effects at the maternal fatal interface. The present study was carried out to investigate the protective effects of baicalin and the possible mechanisms on pregnancies. Baicalin (at 10, 20, and 50 mg/kg BW respectively) was gavaged to bromocriptine-treated mice from gestation day (GD) 1 through GD 7. Abortion rates were calculated and the changes of interferon-γ (IFN-γ), interleukin-10 (IL-10) and progesterone were assayed on different gestation days. Results showed that the embryonic death rates were significantly decreased in groups supplemented with 20 or 50 mg/kg BW of baicalin, accompanied with reduced IFN-γ and enhanced progesterone contents. Moreover, the highest levels of IFN-γ appeared on GD 5 both in the control and in baicalin treated groups. It is concluded that baicalin can exert an anti-abortive effect by cutting down the production of IFN-γ and elevating the levels of progesterone in a dose dependent manner and IFN-γ is involved in an inflammatory reaction which is beneficial for a successful implantation.

The present study was intended to examine the analgesic effect of the 70% methanol extract of Torenia concolor Lindley var. formosana Yamazaki (TC_MeOH) and betulin using models of acetic acid-induced writhing response and formalin test. In addition, we investigated the anti-inflammatory effect of TC_MeOH and betulin using model of λ-carrageenan-induced paw edema. We observed the activities of antioxidant enzymes (SOD, GPx and GR) in the liver and the levels of malondialdehyde (MDA) and nitric oxide (NO) in the edema paw. The results showed that TC_MeOH (1.0 and 2.0 g/kg) and betulin (30 and 90 mg/kg), significantly inhibited the acetic acid-induced writhing response. TC_MeOH (2.0 g/kg) and betulin (30 and 90 mg/kg) significantly inhibited formalin-induced licking time during both the early and late phases. TC_MeOH (0.5, 1.0 and 2.0 g/kg) and betulin (30 and 90 mg/kg) also significantly decreased the paw edema at the 4th hour after λ-carrageenan injection. Furthermore, TC_MeOH and betulin treatment also significantly increased the activities of SOD, GR and GPx in the liver while decreasing the level of MDA in the edema paw. Finally, betulin (30 and 90 mg/kg) also caused considerable reduction of NO level in the edema paw. Taken together, the present results indicated that TC_MeOH and betulin possessed analgesic and anti-inflammatory effects. The anti-inflammatory mechanism of TC_MeOH and betulin may be related to decreasing the levels of MDA and NO in the edema paw by increasing the activities of antioxidant enzymes in the liver.

A traditional Chinese Medicine (TCM) formula, Guo Min Kang (GMK), has been used in clinics in China for allergic diseases, including type I immediate hypersensitivity, a potentially fatal disease, but its modulatory mechanism remains elusive. The aim of this study was to investigate the modulatory mechanisms of GMK in a mouse model of Ag-induced anaphylaxis. Ag (conalbumin) sensitized mice were treated with either PBS (sham) or GMK before (schedule A) or during (schedule B) sensitization, and various anaphylactic parameters were measured following Ag challenge, including symptom score, cutaneous hypersensitivity response, mast cell degranulation, plasma histamine levels and the levels of specific IgE and T-cell responses. Systemic anaphylaxis was investigated in mice immediately following Ag challenge, and the results showed that GMK-treated mice from both treatment schedules A and B showed significantly reduced symptom scores when compared with the sham-treated group. The reduction in symptom score was associated with a significant reduction in the level of Ag-induced cutaneous immediate hypersensitivity. Also, GMK was able to suppress Ag-induced IgE production and T-cell responses, while it spares mitogen (Con A)-induced T-cell response. Further, treatment of mice with GMK abrogated the levels of Ag-induced histamine release and significantly reduced the number of degranulated mast cells. No effect of GMK was observed on the levels of total IgE and plasma histamine in naive mice. These results provide a basis for the modulation effect of GMK and suggest a potential utility of GMK as a prophylactic and therapeutic agent.

We have reported that a 10-herbal traditional formula containing Korean Angelica gigas Nakai (AGN) exerts potent anti-cancer efficacy and identified decursin and decursinol angelate (DA) from AGN as novel anti-androgens. Here, we determined whether AGN would exert in vivo anti-cancer activity and whether decursin or DA could account for its efficacy. The AGN ethanol extract was tested against the growth of mouse Lewis lung cancer (LLC) allograft in syngenic mice or human PC-3 and DU145 prostate cancer xenograft in immunodeficient mice. The pharmacokinetics of decursin and DA were determined. The AGN extract significantly inhibited LLC allograft growth (30 mg/kg) and PC-3 and DU145 xenograft growth (100 mg/kg) without affecting the body weight of the host mice. Biomarker analyses revealed decreased cell proliferation (Ki67, PCNA), decreased angiogenesis (VEGF, microvessel density) and increased apoptosis (TUNEL, cPARP) in treated tumors. Decursin and DA injected intraperitoneally were rapidly hydrolyzed to decursinol. Decursinol and decursin at 50 mg/kg inhibited LLC allograft growth to the same extent, comparable to 30 mg AGN/kg. Therefore the AGN extract possessed significant in vivo anti-cancer activity, but decursin and DA only contributed moderately to that activity, most likely through decursinol.

Antipyretic and toxin-eliminating traditional Chinese herbs are believed to possess antiviral activity. In this study, we screened extracts of 22 herbs for activity against enterovirus 71 (EV71). We found that only extracts of Houttuynia cordata Thunb. could neutralize EV71-induced cytopathic effects in Vero cells. The 50% inhibitory concentration of H. cordata extract for EV71 was 125.92 ± 27.84 μg/ml. Antiviral screening of herb extracts was also conducted on 3 genotypes of EV71, coxsackievirus A16 and echovirus 9. H. cordata extract had the highest activity against genotype A of EV71. A plaque reduction assay showed that H. cordata extract significantly reduced plaque formation. Viral protein expression, viral RNA synthesis and virus-induced caspase 3 activation were inhibited in the presence of H. cordata extract, suggesting that it affected apoptotic processes in EV71-infected Vero cells by inhibiting viral replication. The antiviral activity of H. cordata extract was greater in cells pretreated with extract than those treated after infection. We conclude that H. cordata extract has antiviral activity, and it offers a potential to develop a new anti-EV71 agent.

We studied the estrogenic activity and cellular effect of wild yam extract in MCF-7 human breast cancer cells. The extract increased the activity of the progesterone receptor and pS2 genes at the mRNA levels in human breast cancer MCF-7 cells, although the effects were not as prominent as those of 17β-estradiol (E₂). Western blot analysis showed that the level of estrogen receptor α protein was down-regulated after treatment with E₂ or wild yam extract. Wild yam extract also inhibited proliferation of MCF-7 cells. These data indicate that wild yam extract acts as a weak phytoestrogen and protects against proliferation in human breast carcinoma MCF-7 cells.

Hepatocellular carcinoma is a type of tumor highly resistant to available chemotherapeutic agents. The treatment of hepatocellular carcinoma remains a challenge that needs new approaches in the future. In a previous study, we demonstrated that the chloroform fraction (CHCl₃-F) from Z. jujuba has anticancer activity in human liver cancer cells (HepG2), and that combining CHCl₃-F with green tea extracts (GTE) results in enhanced effects of anticancer activity in the cells. To further understand the mechanism of the anticancer activity of combining CHCl₃-F and GTE in HepG2 cells, we investigated whether the addition of a mixture of CHCl₃-F and GTE would affect the expression of APRIL (a proliferation-inducing ligand), which was expressed in HepG2 cells from 4 hours of incubation in vitro. We have shown that CHCl₃-F and GTE enhanced anti-cancer activity by reducing the expression of APRIL. We speculate that the CHCl₃-F and GTE mixture might provide a lead to a new drug design to treat hepatocellular carcinoma in the future.

We evaluated the in vivo anti-inflammatory and analgesic activities of orally administered paeonol in mice, and also investigated the anti-inflammatory activity of paeonol in a cell line. Paeonol significantly reduced the edema induced by arachidonic acid in rats. The analgesic effects were assayed using 2 different models, i.e., by acetic acid-induced writhing response and by formalin induced licking and biting time. Moreover, we examined the effects of paeonol on the release of inflammatory mediators such as NO, PGE₂ and IL-6. Our results demonstrated that paeonol inhibited LPS induced expression of NO, PGE₂ and IL-6. Paeonol prevented LPS induced iNOS, COX-2 and ERK activation. Therefore, paeonol appears to have potential as a treatment for inflammatory disease and analgesic.

Phellodendron amurense Rupr. bark extracts were examined for antioxidant activity, antimicrobial activity and antiviral activity on herpes simplex virus type 1 (HSV-1). Ethanol extract showed higher content of both total phenolic and flavonoid than aqueous extract. In DPPH (2, 2-diphenyl-1-picrylhydrazyl) assay, the concentration providing 50% inhibition (IC₅₀) values were 6.73 ± 0.87 mg/ml and 4.26 ± 0.59 mg/ml for aqueous and ethanol extracts respectively. Ethanol extract had a much higher antimicrobial activity than aqueous extract. Furthermore, the antiviral activity of the ethanol extract on HSV-1 was also tested. The maximum noncytotoxic concentration was 44.12 μg/ml for RC-37 cells. Plaque formation was inhibited by 74±6% when HSV-1 was pretreated with the extract prior to adsorption, whereas pretreatment of the cells with the extract, added during adsorption or after the adsorption only exhibited above 10% antiviral effect. This study has to some extent validated the medicinal potential of P. amurense bark.