Efficacy and safety of Chinese herbal medicine for pneumonia convalescence in children: A systematic review and meta-analysis

Lipid-lowering effect of Danshen, Fufang Danshen, Shuxuening and Shuxuetong injections: A Systematic Review and Meta-Analysis of Controlled Clinical Trials

Danshen, Fufang Danshen, Shuxuening and Shuxuetong injections, four traditional Chinese medicine prescriptions, have been widely explored regarding their lipid-lowering property, but the findings were inconsistent and inconclusive. This meta-analysis was to clarify the lipid-lowering effect of the four injections. PubMed, Scopus, Embase, Web of Science, Google Scholar, Cochrane Library and CNKI databases were searched, and data including age, sex, ethnicity, disease type, dose, duration, sample size and blood lipids were extracted from each eligible study. The alterations in lipids from pre- to post-treatment were calculated and compared between control and treatment groups, and standardized mean differences (SMDs) with 95% confidence intervals (CIs) were used to assess the lipid-lowering effect of the injections. Twenty-eight studies (2,624 subjects), 31 studies (3,023 subjects), 17 studies (1,507 subjects) and 54 studies (4,435 subjects) were respectively identified for Danshen, Fufang Danshen, Shuxuening and Shuxuetong injections. All of the four injections could effectively and significantly reduce serum levels of triglycerides (p < 0.001 for all), total cholesterol (p < 0.001 for all) and low-density lipoprotein cholesterol (p < 0.001 for all), and elevate high-density lipoprotein cholesterol level (p ≤ 0.02 for all). Shuxuening injection had the strongest lipid-lowering effect with almost twice that of the other three injections. Danshen, Fufang Danshen and Shuxuening injections showed a good lipid-lowering effect on patients with heart disease, while Shuxuetong injection displayed a powerful lipid-lowering effect among diabetic patients. Unfortunately, all of these injections had a poor lipid-lowering effect in patients with renal disease. The meta-analysis demonstrates that Danshen, Fufang Danshen, Shuxuening and Shuxuetong injections all can effectively reduce blood lipids. Among them, Shuxuening injection has the strongest lipid-lowering effect with almost twice that of the other three injections. In terms of reducing blood lipid levels, Danshen, Fufang Danshen and Shuxuening injections are suitable for patients with cardiovascular disease, Shuxuetong injection is suitable for patients with diabetes, but none of them is suitable for patients with renal disease.

Effect of Fu Zheng Jie Du Formula on outcomes in patients with severe pneumonia receiving prone ventilation: a retrospective cohort study

Background

The effect of combining prone ventilation with traditional Chinese medicine on severe pneumonia remains unclear.

Objective

To evaluate the effect of Fu Zheng Jie Du Formula (FZJDF) combined with prone ventilation on clinical outcomes in patients with severe pneumonia.

Methods

This single-center retrospective cohort study included 188 severe pneumonia patients admitted to the ICU from January 2022 to December 2023. Patients were divided into an FZJD group (receiving FZJDF for 7 days plus prone ventilation) and a non-FZJD group (prone ventilation only). Propensity score matching (PSM) was performed to balance baseline characteristics. The primary outcome was the change in PaO2/FiO2 ratio after treatment. Secondary outcomes included 28-day mortality, duration of mechanical ventilation, length of ICU stay, PaCO2, lactic acid levels, APACHE II score, SOFA score, Chinese Medicine Score, inflammatory markers, and time to symptom resolution.

Results

After PSM, 32 patients were included in each group. Compared to the non-FZJD group, the FZJD group showed significantly higher PaO2/FiO2 ratios, lower PaCO2, and lower lactic acid levels after treatment (p < 0.05 for all). The FZJD group also had significantly lower APACHE II scores, SOFA scores, Chinese Medicine Scores, and levels of WBC, PCT, hs-CRP, and IL-6 (p < 0.05 for all). Time to symptom resolution, including duration of mechanical ventilation, length of ICU stay, time to fever resolution, time to cough resolution, and time to resolution of pulmonary rales, was significantly shorter in the FZJD group (p < 0.05 for all). There was no significant difference in 28-day mortality between the two groups.

Conclusion

FZJDF as an adjuvant therapy to prone ventilation can improve oxygenation and other clinical outcomes in severe pneumonia patients. Prospective studies are warranted to validate these findings.

Epigallocatechin-3-Gallate attenuates lipopolysacharide-induced pneumonia via modification of inflammation, oxidative stress, apoptosis, and autophagy

BACKGROUND

Pneumonia, the acute inflammation of lung tissue, is multi-factorial in etiology. Hence, continuous studies are conducted to determine the mechanisms involved in the progression of the disease and subsequently suggest effective treatment. The present study attempted to evaluate the effects of Epigallocatechin-3-Gallate (EGCG), an herbal antioxidant, on inflammation, oxidative stress, apoptosis, and autophagy in a rat pneumonia model.

METHODS

Forty male Wistar rats, 5 months old and 250-290 g were divided into four groups including control, EGCG, experimental pneumonia (i/p LPS injection, 1 mg/kg), and experimental pneumonia treated with EGCG (i/p, 15 mg/kg, 1 h before and 3 h after LPS instillation). Total cell number in the bronchoalveolar lavage fluid, inflammation (TNF-a, Il-6, IL-1β, and NO), oxidative stress (Nrf2, HO-1, SOD, CAT, GSH, GPX, MDA, and TAC), apoptosis (BCL-2, BAX, CASP-3 and CASP-9), and autophagy (mTOR, LC3, BECN1) were evaluated.

RESULTS

The findings demonstrated that EGCG suppresses the LPS-induced activation of inflammatory pathways by a significant reduction of inflammatory markers (p-value < 0.001). In addition, the upregulation of BCL-2 and downregulation of BAX and caspases revealed that EGCG suppressed LPS-induced apoptosis. Furthermore, ECGC suppressed oxidative injury while promoting autophagy in rats with pneumonia (p-value < 0.05).

CONCLUSION

The current study revealed that EGCG could suppress inflammation, oxidative stress, apoptosis, and promote autophagy in experimental pneumonia models of rats suggesting promising therapeutical properties of this compound to be used in pneumonia management.