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Chen S, Yu R, Zhao F, Sun L, Yin Y, Zhang G, Chen Q, Shu Q. Network pharmacology and molecular docking to explore the mechanism of a clinical proved recipe for external use of clearing heat and removing dampness in the treatment of immune-related cutaneous adverse events. Medicine (Baltimore) 2024; 103:e37504. [PMID: 38489696 PMCID: PMC10939542 DOI: 10.1097/md.0000000000037504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/04/2023] [Accepted: 02/14/2024] [Indexed: 03/17/2024] Open
Abstract
Immune-related cutaneous adverse events (ircAEs) will undermine the patients' quality of lives, and interrupt the antitumor therapy. A clinical proved recipe for external use of clearing heat and removing dampness (Qing-Re-Li-Shi Formula, hereinafter referred to as "QRLSF") is beneficial to the treatment of ircAEs in clinical practice. Our study will elucidate the mechanism of QRLSF against ircAEs based on network pharmacology and molecular docking. The active components and corresponding targets of QRLSF were collected through traditional Chinese medicine systems pharmacology database. GeneCards, online Mendelian inheritance in man, and pharmacogenomics knowledgebase were used to screen the targets of ircAEs. The intersecting targets between drug and disease were acquired by venn analysis. Cytoscape software was employed to construct "components-targets" network. Search tool for the retrieval of interacting genes/proteins database was applied to establish the protein-protein interaction network and then its core targets were identified. Gene ontology and Kyoto encyclopedia of genes and genomes analysis was performed to predict the mechanism. The molecular docking verification of key targets and related phytomolecules was accomplished by AutoDock Vina software. Thirty-nine intersecting targets related to QRLSF against ircAEs were recognized. The analysis of network clarified 5 core targets (STAT3, RELA, TNF, TP53, and NFKBIA) and 4 key components (quercetin, apigenin, luteolin, and ursolic acid). The activity of QRLSF against ircAEs could be attributed to the regulation of multiple biological effects via multi-pathways (PI3K-Akt pathway, cytokine-cytokine receptor interaction, JAK-STAT pathway, chemokine pathway, Th17 cell differentiation, IL-17 pathway, TNF pathway, and Toll-like receptor pathway). The binding activities were estimated as good level by molecular docking. These discoveries disclosed the multi-component, multi-target, and multi-pathway characteristics of QRLSF against ircAEs, providing a new strategy for such medical problem.
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Affiliation(s)
- Shuyi Chen
- Department of Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
| | - Rui Yu
- The First Clinical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Fangmin Zhao
- The First Clinical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Lin Sun
- The First Clinical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yudan Yin
- The First Clinical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Gaochenxi Zhang
- Department of Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
| | - Qunwei Chen
- Department of Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
| | - Qijin Shu
- Department of Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
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Chen SY, Zhao FM, Yu R, Sun L, Yin YD, Zhang GCX, Yang JY, Shu QJ. Clinical Experience of External Application of Clearing Heat and Removing Dampness in Relieving Grade 2 to 3 Rash Caused by Programed Cell Death Protein 1 (PD-1)/Programed Cell Death Ligand 1 (PD-L1) Inhibitors: A Single-Center Retrospective Study. Integr Cancer Ther 2024; 23:15347354231226108. [PMID: 38240227 PMCID: PMC10799584 DOI: 10.1177/15347354231226108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/05/2023] [Accepted: 12/27/2023] [Indexed: 01/22/2024] Open
Abstract
OBJECTIVE In China, grade 2 to 3 immune-related rash will probably lead to the interruption of immunotherapy. Corticosteroid (CS) is the main treatment, but not always effective. The external application of clearing heat and removing dampness, which is represented by Qing-Re-Li-Shi Formula (QRLSF), has been used in our hospital to treat immune-related cutaneous adverse events (ircAEs) for the last 5 years. The purpose of this study was to discuss its efficacy and safety in the treatment of grade 2 to 3 rash. METHODS A retrospective study of patients with grade 2 to 3 immune-related rash in our hospital from December 2019 to December 2022 was conducted. These patients received QRLSF treatment. Clinical characteristics, treatment outcome, and health-related quality of life (HrQoL) were analyzed. RESULTS Thirty patients with grade 2 to 3 rash (median onset time: 64.5 days) were included. The skin lesions of 24 cases (80%) returned to grade 1 with a median time of 8 days. The accompanying symptoms were also improved with median time of 3 to 4 days. The addition of antihistamine (AH) drug didn't increase the efficacy of QRLSF (AH + QRLSF: 75.00% vs QRLSF: 83.33%, P = .66). No significant difference was observed in the efficacy of QRLSF treatment regardless of whether patients had previously received CS therapy (untreated population: 88.24% vs treated population: 69.23%, P = .36). During 1-month follow-up, 2 cases (8.33%) underwent relapses. In terms of HrQoL, QRLSF treatment could significantly reduce the median scores of all domains of Skindex-16, including symptoms (39.58 vs 8.33, P < .0001), emotions (58.33 vs 15.48, P < .0001), functioning (46.67 vs 13.33, P < .0001) and composite (52.60 vs 14.06, P < .0001). CONCLUSION External application of clearing heat and removing dampness was proven to be an effective and safe treatment for such patients. In the future, high-quality trials are required to determine its clinical application in the field of ircAEs.
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Affiliation(s)
- Shu-yi Chen
- Department of Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
| | - Fang-min Zhao
- The First Clinical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Rui Yu
- The First Clinical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Lin Sun
- The First Clinical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yu-dan Yin
- The First Clinical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Gao-chen-xi Zhang
- Department of Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
| | - Jia-yao Yang
- The First Clinical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Qi-jin Shu
- Department of Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
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Hwang JH, Choi SH. External Treatment of Pyritum for Musculoskeletal Trauma: a protocol for systematic review. J Pharmacopuncture 2023; 26:192-197. [PMID: 37405110 PMCID: PMC10315878 DOI: 10.3831/kpi.2023.26.2.192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 05/15/2023] [Accepted: 05/19/2023] [Indexed: 07/06/2023] Open
Abstract
Objectives Musculoskeletal trauma is a common type of injury that can result from damage to the muscular or skeletal system and has been recognized as a leading cause of death and disability worldwide. This study aims to analyze the efficacy of Pyritum external treatment for musculoskeletal trauma. Methods Randomized controlled trials evaluating the external treatment effect of Pyritum on various types of musculoskeletal traumatic injuries will be considered and identified in the searches of eight databases from their inception to Feb 2023. There will be no restrictions with respect to the publication status, language, or country. The experimental intervention group will be treated with external application of Pyritum alone or in combination with other therapies, and the comparator intervention group will include all types of control interventions. The primary outcome will be measured as treatment efficacy rate, and secondary outcomes will include pain reduction, pain disappearance time, swelling, joint function, and recovery period. Assessment of the methodological quality of this study will be concluded using the risk of bias assessment recommended by the Cochrane Collaboration. If there are sufficient numbers of studies per group in terms of specific rating scales to compare the treatment effects of Pyrium alone and combined external treatment groups, we will consider subgroup analysis. Results This systematic review will be conducted in compliance with the PRISMA-P statement. Conclusion We will conduct an extensive search on the proposed topic within the available literature and provide systematic evidence for the efficacy and safety of external application of Pyritum for all types of musculoskeletal trauma. The evidence generated will help design interventions for the external use of Pyritum for this patient group.
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Affiliation(s)
- Ji Hye Hwang
- Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Gachon University, Seongnam, Republic of Korea
| | - Su Hyun Choi
- College of Korean Medicine, Gachon University, Seongnam, Republic of Korea
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Abstract
BACKGROUND Congenital muscular torticollis (CMT) is the third most common musculoskeletal disease in children. With no standardized treatment method hence, so it is necessary to find an effective treatment method that can be received comfortably by children. This review assessed the efficacy of an external treatment of herbal medicine (ETHM) with tuina for CMT in children. METHODS This study searched the English, Chinese, and Korean databases (total of 10) until June 7 2022, without any language restrictions. All included studies were randomized clinical trials (RCTs) of ETHM with tuina as an intervention comparted to the same tuina alone according to the inclusion and exclusion criteria. The mean differences (MD), standardized mean differences (SMD), risk ratio (RR) with the 95% confidence interval (CI), and risk of bias (ROBs) were calculated using Review Manager Version 5.4 software. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) rating system was used to assess the quality of evidence. The publication bias was evaluated using a funnel plot, the Egger test, the fail-safe N test, and the Duval and Tweedle's trim and fill method using Review Manager Version 5.4 software, the software R Version 4.1.1 and R studio Version 1.4.1106 program. RESULTS Nineteen RCTs with 1710 patients were included in the meta-analysis. ETHM plus tuina improved the outcomes of the total effective rate (TER) [RR 1.21, 95% CI:1.15 to 1.26, P < .001], sternocleidomastoid (SCM) muscle thickness [MD: -1.82, 95% CI: -2.23 to -1.41, P < .001], cervical rotation range [MD: 13.43, 95% CI: 10.41-16.45, P < .001] and lateral flexion range [MD: 8.50, 95% CI: 6.15-10.85, P < .001], tissue elasticity grade [SMD: -0.46; 95% CI: -0.71 to -0.22, P = .0002], muscle elasticity scores [RR: 1.56; 95% CI: 1.04 to 2.34, P = .03], and clinical symptom and sign scores [SMD: -0.78; 95% CI: -1.09 to -0.47, P < .001]. CONCLUSIONS ETHM plus tuina have a combined effect on CMT children. However, further studies with high-quality clinical trials are needed to obtain more robust clinical evidence.
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Affiliation(s)
- Eunjin Kim
- Department of Pediatrics of Korean Medicine, Korean Medicine Hospital, Dongguk University Bundang Medical Center, Bun-dang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Jungyoon Choi
- Department of Pediatrics of Korean Medicine, Graduate School of Dongguk University, Jung-gu, Seoul, Republic of Korea
| | - Sang Yeon Min
- Department of Pediatrics of Korean Medicine, Korean Medicine Hospital, Dongguk University Ilsan Medical Center, Goyang-si, Gyeonggi-do, Republic of Korea
- * Correspondence: Sang Yeon Min, Department of Pediatrics of Korean Medicine, Korean Medicine Hospital, Dongguk University Ilsan Medical Center, Dongguk-ro 27, Ilsandong-gu, Goyang-si, Gyeonggi-do 10326, Republic of Korea (e-mail: )
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Kim E, Choi J, Min SY. External treatment of herbal medicine with tuina in congenital muscular torticollis: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e29035. [PMID: 35451412 PMCID: PMC8913123 DOI: 10.1097/md.0000000000029035] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND This study is the protocol to evaluate the clinical evidence for external treatments using herbal medicine (ETHM) with tuina as a congenital muscular treatment (CMT) in pediatrics. METHODS Eleven databases will be searched until June 2022, without any language restrictions: four English databases (MEDLINE, Pubmed, EMBASE, and The Cochrane Central Register of Database of Controlled Trials), three Chinese databases (China National Knowledge Infrastructure, Chinese Scientific Journal Database, and Wan Fang Database), and four Korean electronic databases (Oriental Medicine Advanced Searching Integrated System, Korean Studies Information Service System, National Digital Science Links, and Research Information Sharing Service). This review will include randomized clinical trials (RCTs) of ETHM with tuina as an intervention versus the same tuina. All published RCTs for any ETHM for CMT will be included. Non-RCTs, RCT protocol, animal studies, case reports, reviews, and surveys will be excluded. The methodological quality assessment will be performed using the Cochrane risk of bias (ROBs). Review Manager version 5.4. will be used for the data synthesis and quantitative analysis. RESULTS AND DISCUSSIONS The systematic review and meta-analysis will provide evidence for ETHM as a treatment of CMT. The evidence can help clinicians and patients recognize more effective therapeutic and safe inventions. INPLASY REGISTRATION NUMBER INPLASY202210017.
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Affiliation(s)
- Eunjin Kim
- Department of Pediatrics of Korean Medicine, Korean Medicine Hospital, Dongguk University Bundang Medical Center, Republic of Korea
| | - Jungyoon Choi
- Department of Pediatrics of Korean Medicine, Graduate School of Dongguk University, Republic of Korea
| | - Sang Yeon Min
- Department of Pediatrics of Korean Medicine, Graduate School of Dongguk University, Republic of Korea
- Department of Pediatrics of Korean Medicine, Korean Medicine Hospital, Dongguk University Ilsan Medical Center, Republic of Korea
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Luo H, Chen Y, Zhang Y, Wang Y, Deng H, Yao D. External treatment of traditional Chinese medicine for radiation enteritis: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e26014. [PMID: 34032719 PMCID: PMC8154505 DOI: 10.1097/md.0000000000026014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 04/30/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Radiation enteritis (RE) is a common complication that often occurs after radiotherapy for abdominal and pelvic malignancies. RE could influence patients' quality of life seriously and it is difficult to cure by conventional treatments. A lot of studies have revealed that the external treatment of traditional Chinese medicine (TCM) for RE is a safe and economical approach, but there is no relevant systematic review. The present study performed a systematic review and meta-analysis to compare TCM external treatment and conventional treatment for RE to evaluate the effectiveness and safety of external treatment of traditional Chinese medicine in the treatment of RE. METHODS Cochrane Library, PubMed, Embase, China National Knowledge Infrastructure (CNKI), Wan-Fang database, VIP Chinese Science and Technique Journals Database, and the Chinese Biomedical Literature Database (CBM) were searched. The time of publication was limited from inception to April, 2021. Two reviewers independently searched for the selected articles and extract the data. The RevMan V.5.3 statistical software (Cochrane Collaboration) and Stata V.16.0 software were used to conduct the meta-analysis. RESULTS We will show the results of this study in a peer-reviewed journal. CONCLUSION This meta-analysis will provide reliable evidence for external treatment of TCM in the treatment of RE. INPLASY REGISTRATION NUMBER INPLASY202140120.
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Affiliation(s)
- Hui Luo
- Clinical Medical College, Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Yanling Chen
- The First Clinical College, Guangzhou University of Chinese Medicine, Guangzhou
| | - Yian Zhang
- The First Clinical College, Guangzhou University of Chinese Medicine, Guangzhou
| | - Yufei Wang
- The First Clinical College, Guangzhou University of Chinese Medicine, Guangzhou
| | - Hualan Deng
- Clinical Medical College, Chengdu University of Traditional Chinese Medicine, Chengdu
| | - Dejiao Yao
- The Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Peng Y, Lu B, Li L, Pan Y, Ye Q, He M, Chen W, Yang X. External treatment of traditional Chinese medicine for myasthenia gravis: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e25475. [PMID: 33847654 PMCID: PMC8051982 DOI: 10.1097/md.0000000000025475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 03/18/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Myasthenia gravis (MG) is an archetypal autoimmune disorder. The conventional treatments for this disease are drugs, plasma exchange, surgical, and so on. However, this disease is difficult to cure. A mass of studies revealed that the external treatment of traditional Chinese medicine (TCM) for MG is a safe and economical approach. The present study conducted a meta-analysis to compare TCM external treatment combined with modern medicine with modern medicine for MG, in order to determine which TCM external treatment intervention has the best relative efficacy, safety, and provide the best evidence for clinical practice. METHODS PubMed, Cochrane Library, EMBASE, Web of Science, Springer, China National Knowledge Infrastructure (CNKI), Wan-fang database, VIP Chinese Science and Technique Journals Database, the Chinese Bio Medical Database (CBM), and Baidu Scholar were searched. The time of publication was limited from inception to February 28, 2021. Two reviewers independently searched for the selected articles and extract the data. The RevMan V.5.3 statistical software (Cochrane Collaboration) and Stata V.16.0 software were used to conduct the meta-analysis. RESULTS The results of the systematic review and meta-analysis will be published in a peer-reviewed journal. CONCLUSION The present study provides a protocol that can be used in the systematic review and meta-analysis, with the intent to inform professionals on the external treatment of TCM for MG. These would lead to investigations on the use of the most external treatment of TCM for MG. TRIAL REGISTRATION NUMBER INPLASY202110083.
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Affiliation(s)
- Yuxuan Peng
- Chengdu Eighth People's Hospital (Geriatric Hospital of Chengdu Medical College)
| | - Bibo Lu
- Chengdu Eighth People's Hospital (Geriatric Hospital of Chengdu Medical College)
| | - Lu Li
- Chengdu Eighth People's Hospital (Geriatric Hospital of Chengdu Medical College)
| | - Yuting Pan
- Chengdu Eighth People's Hospital (Geriatric Hospital of Chengdu Medical College)
| | - Qing Ye
- Chengdu Eighth People's Hospital (Geriatric Hospital of Chengdu Medical College)
| | - Min He
- Chengdu Eighth People's Hospital (Geriatric Hospital of Chengdu Medical College)
| | - Weiyin Chen
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xueping Yang
- Chengdu Eighth People's Hospital (Geriatric Hospital of Chengdu Medical College)
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Liu PZ, Shi XG, Zuo XM, Lai R, Zhao Z, Yang ZR, Liu JL. A clinical study on the treatment of granulomatous lobular mastitis by the external application of the internal pus-expelling decoction and operation. Ann Palliat Med 2020; 9:2631-2641. [PMID: 32921065 DOI: 10.21037/apm-19-684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 04/07/2020] [Indexed: 11/06/2022]
Abstract
BACKGROUND The objective of this study was to evaluate the clinical efficacy of the external application of internal expulsion pus-expelling decoction (IEPED) combined with surgery in the treatment of granulomatous lobular mastitis (GLM). METHODS A total of 110 patients in our hospital with sepsis GLM were randomly divided into two groups: treatment group (n=60, the wound was treated with IEPED) and control group (n=50, the wound was not treated with IEPED). We assessed the recurrence, contra lateral breast form, and aesthetic evaluation of the patients in the two groups. RESULTS The total effective rates in the patients in the treatment group and the control group were 90% and 68%, respectively, after the preoperative pretreatment and before radical surgery (P<0.05). After 10 days of receiving the debridement treatment, the two groups were compared in term of physical signs scores and the difference was statistically significant (P<0.05). Within one year of the regular follow-up after treatment, 0 case recurred in the treatment group and 1 case recurred in the control group (P>0.05). In the treatment group, 30 cases showed excellent results in the aesthetic evaluation of breast appearance, 18 cases were good, and the overall excellent and good rate was up to 80%. In the control group, 12 cases showed excellent results and 16 cases showed good results, with the overall excellent and good rate reaching 56% (P<0.05). CONCLUSIONS In patients with abscess debridement of GLM, the external application of IEPED can significantly reduce the primary lesion of patients with abscess GLM, reduce the surgical resection area, and maximize the preservation of the patients' breast appearance.
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Affiliation(s)
- Peng-Zhou Liu
- Beijing University of Chinese Medicine, Beijing, China
| | - Xiao-Guang Shi
- Department of Galactophore Dongzhimen Hospital of Beijing University of Chinese Medicine, Beijing, China.
| | - Xi-Meng Zuo
- Beijing University of Chinese Medicine, Beijing, China
| | - Rui Lai
- Beijing University of Chinese Medicine, Beijing, China
| | - Ze Zhao
- Beijing University of Chinese Medicine, Beijing, China
| | - Zhen-Rui Yang
- Beijing University of Chinese Medicine, Beijing, China
| | - Jie-Li Liu
- Beijing University of Chinese Medicine, Beijing, China
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Xie H, Cao L. [External therapy of Traditional Chinese Medicine for allergic rhinitis]. Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2017; 31:13-17. [PMID: 29774677 DOI: 10.13201/j.issn.1001-1781.2017.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Indexed: 06/08/2023]
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Feize W, Meng L, Yanni L, Yuan L, Liqun J, Tong L, Guowang Y, Huijuan C, Donggui W, Zhiqiang C, Lei Z. A Randomized Controlled Study to Observe the Efficacy of External Treatment With a Traditional Chinese Medicine Herbal Ointment on Malignant Plural Effusion: Outcome Report and Design Review. Integr Cancer Ther 2016; 16:473-478. [PMID: 27431570 PMCID: PMC5739134 DOI: 10.1177/1534735416660193] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background. Malignant pleural effusion (MPE) is a common complication in most malignancies. Despite its frequent occurrence, current knowledge of MPE remains limited and the effect of the management is still unsatisfying. Traditional Chinese medicine (TCM) external treatment has unique advantages, such as quicker efficacy and fewer side effects. Objective. To observe the effects and safety of Kang’ai Xiaoshui ointment (TCM herbal ointment) in MPE. Design. This was a placebo-controlled double-blinded randomized study. A total of 80 patients were enrolled, of which 72 were randomized to receive Kang’ai Xiaoshui ointment or placebo at an allocation ratio of 1:1. Kang’ai Xiaoshui ointment or placebo was applied on the thorax wall for 8 hours daily. The intervention lasted 2 weeks. Kang’ai Xiaoshui ointment consisted of Astragalus membranaces (黄芪), Semen pharbitidis (牵牛子), Cassia twig (桂枝), Pericarpium arecae (大腹皮), Curcuma zedoary (莪术), Borneol (冰片), and other substances. In both groups, diuresis and drainages were used as needed. Outcomes covered the quantity of pleural effusion evaluation, TCM Symptom Scale, Karnofsky Performance Scale, and safety indicators such as routine blood test, blood biochemistry test, and response table of skin irritation. Results. Of 72 patients randomized to receive Kang’ai Xiaoshui ointment or placebo along with symptomatic treatment, the response rate was documented as 42.4% for the treatment group and 25.0% for the placebo group (P = .138). As for the TCM symptom scale, the treatment group showed improvement in chest distress (P = .003), fullness and distention (P = .042), shortness of breath (P < .001), no statistical significance in palpitation (P = .237), and pain (P = .063), whereas the placebo group did not show statistical significance in any of the 5 symptoms. Major adverse events related to the treatment, mainly skin irritation, were distributed equally. Conclusions. Kang’ai Xiaoshui ointment showed a potential of reducing MPE, and it could alleviate symptoms of dyspnea. Thus, it may be appropriate as a supplementary intervention for MPE. There were some flaws in the study design. A larger scale and better designed trial is advocated.
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Affiliation(s)
- Wu Feize
- 1 Beijing University of Chinese Medicine, Beijing, China.,2 China-Japan Friendship Hospital, Beijing, China
| | - Liu Meng
- 2 China-Japan Friendship Hospital, Beijing, China
| | - Lou Yanni
- 2 China-Japan Friendship Hospital, Beijing, China
| | - Li Yuan
- 2 China-Japan Friendship Hospital, Beijing, China
| | - Jia Liqun
- 2 China-Japan Friendship Hospital, Beijing, China
| | - Li Tong
- 3 Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China
| | - Yang Guowang
- 4 Beijing Hospital of Traditional Chinese Medicine, Beijing, China
| | - Cui Huijuan
- 2 China-Japan Friendship Hospital, Beijing, China
| | - Wan Donggui
- 2 China-Japan Friendship Hospital, Beijing, China
| | | | - Zheng Lei
- 1 Beijing University of Chinese Medicine, Beijing, China
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