Latest Issue

    2010 Year 16 Vol. 5 Issue

      OriginalPaper

    • Jia-liang Wang
      2010, 16(5): 387-389. DOI: 10.1007/s11655-010-0532-y
      Keywords:Clinical Effect;Western Medicine;Modern Medicine;Clinical Epidemiology;Consort Statement   
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    • Jin-Ling Tang
      2010, 16(5): 390-391. DOI: 10.1007/s11655-010-0531-z
      Keywords:Chinese Medicine;Artemisinin;Western Medicine;clinical effectiveness;Basic Laboratory Research   
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    • Ji-yao Wang
      2010, 16(5): 392-393. DOI: 10.1007/s11655-010-0533-x
      Keywords:Chinese Medicine;Liver Fibrosis;Western Medicine;Nonrandomized Control Trial;Accepted Index   
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    • Ji-qian Fang,Feng-bin Liu,Zheng-kun Hou
      2010, 16(5): 394-398. DOI: 10.1007/s11655-010-0534-9
      Abstract:A new method for the comparison of the treatment efficacy for specific diseases or conditions between Chinese medicine and Western medicine, which serve the same medical aim but are based on substantially different theoretical systems, was identified. Abiding by the principle of parallel subgroup design of a randomized controlled trial (PSD-RCT), participants were recruited following identical inclusion and exclusion criteria and were randomly allocated into two groups to receive treatment using the respective approaches of Chinese medicine and Western medicine. The Chinese medicine group was divided into subgroups according to the theory of Chinese medicine and the Western medicine group was also divided into subgroups according to the theory of Western medicine. The treatment for each subgroup was well defined in the protocol, including major formulae and principles for individualized modifications. The primary outcome measure was ascertained to be directly related to the patients’ status but independent from both theories of Chinese medicine and Western medicine, while the secondary outcomes were represented by the patient-reported outcomes and some laboratory tests commonly accepted by Chinese medicine and Western medicine. Then, taking functional dyspepsia as an example, the authors explain the framework of the PSD-RCT for efficacy comparisons between Chinese medicine and Western medicine, and recommend that the PSD-RCT can be used to compare treatment efficacy for a specific disease or condition between Chinese medicine and Western medicine, and the comparison among subgroups can provide valuable clues for further studies.  
      Keywords:Chinese Medicine;Western Medicine;parallel subgroup design;randomized controlled trial;syndrome differentiation and treatment;individualized treatment;functional dyspepsia   
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    • Fu-yong Chu,Jie Wang,Kui-wu Yao,Zhi-zhong Li
      2010, 16(5): 399-405. DOI: 10.1007/s11655-010-9999-9
      Abstract:Compared with Shengmai Capsule (生脉胶囊, SM), the study was conducted to evaluate the efficacy and safety of Xuefu Zhuyu Capsule (血府逐瘀胶囊, XFZY) on the symptoms and signs and health-related quality of life (HR-QOL) in the unstable angina (UA) patients with blood-stasis syndrome (BSS) after percutaneous coronary intervention (PCI). A randomized, double-blinded, double-dummy, and placebo-controlled trial was applied. Ninety patients, diagnosed as UA and BSS after successful PCI, were enrolled and equally randomized into three groups, XFZY group, SM group, and placebo group, and administered with the corresponding medications respectively for four weeks. The clinical symptoms and signs (CSS), electrocardiography (ECG), and BSS scores were recorded and compared among groups during and after the treatment. Short-form 36 (SF-36) and Seattle Angina Questionnaire (SAQ) were applied to assess the HR-QOL in each group before and after the treatment. Safety indexes (blood routine and liver and kidney function tests) were also examined at the beginning and after the treatment. Eighty-six patients completed the whole study. After the treatment, the total effective rates of the XFZY group in ameliorating CSS and ECG were 76.7% and 60.0%, respectively, which were obviously higher than those in SM (CSS: 53.3%; ECG: 36.7%) and the placebo (CSS: 43.3%; ECG: 30.0%) groups. After one week’s treatment, BSS scores slightly decreased in each group, but no signifificant differences were found among three groups (P>0.05). After four weeks’ treatment, BSS scores in the XFZY group decreased to a lower level compared with SM (P <0.05) and the placebo (P <0.01) groups. After the treatment, the effificacy of XFZY group in improving body pain (BP), general health (GH), vitality (VT), society functioning (SF), role emotional (RE), angina stability (AS), angina frequency (AF), and treatment satisfaction (TS) were better than those in the placebo group (P <0.05,P <0.01). Meanwhile, the dimensions of BP, GH, SF, AS, AF, and TS were better improved than those in the SM group P <0.05). No obvious adverse reaction was found during and after the treatment except one case in the XFZY group reporting of stomach discomfort. Compared with SM Capsule treatment, a short-term treatment with XFZY Capsule exhibits better effificacy on CSS and BSS scores, and HR-QOL in UA patients with BSS after PCI. However, its long-term effificacy and safety still needs further investigation.  
      Keywords:Xuefu Zhuyu Capsule;Unstable Angina;Percutaneous Coronary Intervention;double-blind;double-dummy   
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    • Wan-yin Wu,Xiao-bing Yang,Hong Deng,Shun-qin Long,Liang-sheng Sun,Wen-feng He,Yu-shu Zhou,Gui-ya Liao,Sai-man Chan,Shi-pu Shan
      2010, 16(5): 406-410. DOI: 10.1007/s11655-010-0535-8
      Abstract:To observe the clinical efficacy and benefit response of extracorporeal high frequency thermotherapy (EHFT) combined with Chinese medicine (CM) in the treatment of patients with advanced nonsmall cell lung cancer. The study adopted a prospective, small sample and randomized controlled method, and the advanced non-small cell lung cancer patients were assigned to two groups according to the table of random digits, one having the treatment of EHFT combined with CM (the treatment group), the other only with CM (the control group). The patients in the treatment group were treated with EHFT one hour once per day, together with CM differentiation decoction, 250 mL orally taken, twice daily for 14 days as one cycle, and 3–4 cycles was performed. The patients in the control group were treated only with CM differentiation decoction using the same dose as the treatment group. The efficacies were evaluated after three to four cycles of treatment. Primary endpoints were disease control rate (DCR) and time to progression (TTP). Secondary endpoints were overall survival time and 1-year survival rate. Sixty-six patients accomplished the study. After the patients underwent different treatments, none of the patients got a complete response or partial response in both groups. In the treatment group, DCR was 72.2%, and 10 had progression of disease (28.8%), while the DCR of the control group was 63.3%, and 11 had progression of disease (36.7%); there was a significant statistical difference (P <0.05), suggesting that the combined regimen had superiority on the DCR. As for long-term efficacy, the median survival time (MST) of the treatment group was 7.5 months, TTP was 5.5 months, and 1-year survival rate was 21.4 %; in the control group, the results were 6.8 months, 4.5 months and 16.6% respectively. There was significant statistical difference on TTP (P <0.05), but no difference on MST or 1-year survival rate. EHFT combined with CM differentiation has better tolerance and short-term efficacy in the treatment of patients with advanced NSCLC.  
      Keywords:non-small cell lung cancer;extracorporeal high frequency thermotherapy;Chinese medicine differentiation;efficacy   
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    • Yong-qi Dou,Ming-hui Yang,Zheng-mao Wei,Chun Xiao,Xu-hui Yang
      2010, 16(5): 411-416. DOI: 10.1007/s11655-010-9998-x
      Abstract:To evaluate the efficacy of compound Dixiong Decoction (地芎汤, a Chinese herbal decoction) on early prevention of radiation pneumonitis. Forty-six patients with non-small cell lung cancer who were planning to receive radiotherapy were randomly assigned to the treatment group treated with the compound Dixiong Decoction and the control group treated with a commonly used herbal decoction which has the effects of supplementing qi and nourishing yin, clearing heat and detoxifying at the time of radiotherapy. Primary measure was the incidence of radiation pneumonitis after radiotherapy. Secondary outcomes included Watters clinical radiographic physiologic (CRP) dyspnea score, the Radiation Therapy Oncology Group (RTOG) grading score, Karnofsky Performance Status (KPS) score, and the application of corticosteroids. The incidence of radiation pneumonitis in the treatment group was 10.0%, while that in the control group was 26.3% (P=0.0032). The Watters CRP dyspnea score and RTOG grading score in the treatment group were significantly =lower than those in the control group (P<0.05). The KPS score in the treatment group was significantly higher than that in the control group (P<0.01). The dosage of corticosteroids was smaller with a shorter duration of therapy in the treatment group than that in the control group. The early application of the Chinese herbal decoction compound Dixiong Decoction can decrease the incidence of radiation pneumonitis, reduce the injury of the lung, and improve the life quality of the patients.  
      Keywords:radiation pneumonitis;complementary and alternative medicine;Chinese Herbal Medicine;clinical trial   
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    • Yong-gang Xu,Rou Ma,Xiao-hong Yang,Xu-dong Tang,Shu-zhen Sun
      2010, 16(5): 417-421. DOI: 10.1007/s11655-010-0536-7
      Abstract:To analyze the changes in peripheral natural killer T-cells (NKT) and gammadelta T-cells (γ δ T-cell) in patients with minimal residual leukemia (MRL) before and after being treated with Yiqi Bushen Granule (益气补肾颗粒, YBG) in order to determine their significance in prognosis of the disease. Granule (益气补肾颗粒, YBG) in order to determine their significance in prognosis of the disease. Before and after treatment, the changes in 36 patients (16 males and 20 females) receiving long-term (more than 3 months) YBG therapy were analyzed using multi-parameter flow cytometry, with 34 healthy persons (19 males and 15 females) acting as controls. males and 15 females) acting as controls. The absolute value and percentage of NKT cells and γ δ T-cells were all significantly raised after treatment, for NKT cells, 0.52%±0.39% to 0.83%±0.66% and 7.25±7.77 cells cell/μL to 12.86±11.99 cell/μL, for γ δ T-cells, 6.08%±3.03% to 7.24%±2.78% and 83.97±48.09 cell/μL 110.53±54.12 cell/μL, respectively (P<0.05 or P<0.01). YBG could regulate the immune function and elevate the amount of NKT cells and γ δ T-cells, thus to kill or suppress the residual leukemic cell in the body, which might be one of the mechanisms of YBG in prolonging the disease-free survival in MRL patients.  
      Keywords:minimal residual leukemia;Yiqi Bushen Granule;natural killer T-cell;gamma-delta T-cell   
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    • Qing-hui Qi,Yi Li,Chen-hui Yao,Guo-gang Liang,Hui-shu Guo
      2010, 16(5): 422-429. DOI: 10.1007/s11655-010-0539-4
      Abstract:To observe the effects of Dachengqi Decoction (大承气汤, DCQD) on morphological changes in the network of enteric nerve-interstitial cells of Cajal (ICCs)-smooth muscle cells (SMC) of enteric deep muscular plexuses (DMP) in the rats with multiple organ dysfunction syndrome (MODS). One hundred Wistar rats of both sexes weighing 200 to 250 g were randomly divided into the control group, MODS group, and DCQD group. The morphologic changes of enteric nerve-ICC-SMC network in the DMP of intestine was observed using c-Kit and vesicular acetylcholine transporter/neuronal nitric oxide synthase immunohistochemical double-staining with whole-mount preparation technique, confocal laser scanning microscopy, and electron microscopy. Compared with the control group, the distribution and densities of cholinergic/nitrergic nerves and ICC in the DMP (ICC-DMP) of intestine in the MODS group were significantly decreased (P<0.01), and the network of cholinergic nerve-ICC-SMC was disrupted; and the ultrastructural features of ICC-DMP, enteric nerve, and SMC were severely damaged. After treatment with DCQD, the damage in the network of enteric nerve-ICC-SMC was significantly recovered. Compared with the MODS group, the distribution and densities of cholinergic/nitrergic nerves and ICC-DMP in the DCQD group were significantly increased (P<0.01); and the ultrastructural features of ICC-DMP, enteric nerve, smooth muscle cells were significantly recovered. DCQD can improve the gastrointestinal motility in MODS. The mechanism may be related to the effect of repairing the damages in the network of enteric nerve-ICC-SMC.  
      Keywords:Dachengqi decoction;Multiple Organ Dysfunction Syndrome;interstitial cells of Cajal;enteric nerve smooth muscle cells   
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    • Hong-jin Wu,An-ruo Zou,Fang Xie,Yi-mei Du,Yu Cao,Yu-na Liu,Ji-yuan Yang,Xin-min Li
      2010, 16(5): 430-434. DOI: 10.1007/s11655-010-9997-y
      Abstract:To observe the effect of matrine on human ether à go-go related gene (HERG) potassium channels expressed in Chinese hamster ovary (CHO) cells and investigate whether HERG channel is a new target of the pharmacological effect of matrine on arrhythmia and tumor HERG channel potassium current in CHO cell was recorded using whole-cell patch-clamp technique, and the influence of matrine on the current was explored. Matrine inhibited HERG potassium current in a dose-dependent manner, and the 50% inhibitory concentration (IC IC50) was 411±23 μmol/L. Matrine had no significant effect on the activation kinetics, and mainly blocked HERG channels in their closed state. The blocking effect of matrine on HERG channels might be one of the mechanisms against arrythmias and tumors. Unlike most other blockers exerting blocking effect at the intracellular sites by entering the cell with the opening of HERG channel, matrine blocked HERG channels at the extracellular sites.  
      Keywords:Matrine;patch-clamp technique;human ether à go-go related gene;potassium channel;Chinese hamster ovary cell   
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    • Da-zhi Sun,Da-wei Ju,Jin He,Ye Lu,Feng Wu,Chang Li,Pin-kang Wei
      2010, 16(5): 435-441. DOI: 10.1007/s11655-010-0537-6
      Abstract:To explore a method of extracting tumor interstitial fluid (TIF) which is similar to muddy phlegm in Chinese medicine (CM), interleukin-8 (IL-8) in concentration was taken as the representative of the content of TIF, analyzed in the extracted TIF and the original tumor tissue, and examined to see whether TIF has an interfering effect on tumor recurrence. Tumor tissue was ground, centrifuged, and filtered for intercellular substances. Tumor-bearing Kunming S180 mice were raised for 21 days and then the tumors were removed to observe the influence of intervention with TIF, normal saline (NS) and a blank control on tumor recurrence. The content of IL-8 in the filtered and unfiltered tumor tissue was not significantly different (P>0.05). Postoperative tumor recurrence in TIF intervention group was significantly higher than that in the NS intervention and control groups (60%, 12/20 vs. 20%, 4/20. vs. 15%, 3/20, χ2 =11.058, P<0.01). Tumor cells grew vigorously and infiltrated to muscular tissue in TIF intervention group. Large numbers of tumor cells were seen necrotic in the NS intervention group, and small numbers of tumor cells were seen necrotic in the blank control group. TIF can be effectively extracted by the means described. It does not contain tumor cells, but its contents such as IL-8 may stimulate tumor cell growth and promote postoperative tumor recurrence, which provided preliminary experimental basis for hypothesis of “tumor-phlegm microenvironment”.  
      Keywords:tumor interstitial fluid;muddy phlegm;interleukin-8;tumor recurrence   
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    • Yong Wang,Wen-li Cheng,Yuan-nan Ke,Zhe Cai,Li Chen,Yuan Xi,Pu Wang,Jian Guo,Hong Li,Cong-xin Huang
      2010, 16(5): 442-447. DOI: 10.1007/s11655-010-0545-6
      Abstract:To investigate the effect of Qingre Quyu Granule (清热祛瘀颗粒, QRQYG) on stabilizing vulnerable plaques in apolipoprotein E (ApoE) deficient mice. Seventy-two male ApoE deficient mice were given a high-fat diet from 6 weeks of age. At the 16th week, all the mice were randomized into 3 groups: the QRQYG group, the simvastatin group, and the control group. Sixteen weeks after administration of 0.9 g/kg QRQYG, 3 mg/kg simvastatin or 10 mg/kg sodium chloride per day to the respective groups, the animals were euthanized. The pathological morphologic changes in the vulnerable plaques were evaluated, the matrix metalloprotease-9 (MMP-9) expression was measured by immunohistofluorescence, the soluble intercellular adhesion molecule 1 (ICAM-1) was determined by ELISA, the nuclear factor kappaB (NF-κB) subunit p65 was measured by quantitative RT-PCR, and, finally, thrombospondin-1 (TSP-1) was determined by the immunohistochemical method. The plaque cross-sectional area in the brachiocephalic artery (23.7%, P<0.01), the lipid core of the plaque (43.1%±3.1%), and the number of buried fibrotic caps of the plaque were significantly decreased in the QRQYG group compared to the control group (both P<0.01); furthermore, the thickness of the fibrotic cap of the plaque increased and the intra-plaque hemorrhage of the plaque decreased. The serum soluble ICAM-1 (27.1±5.1 μg/mL), the protein expression of MMP-9 and TSP-1 and the p65 mRNA expression increased in the QRQYG group in comparison with the control group (P<0.05 or P<0.01). QRQYG could stabilize the vulnerable plaque through inhibition of the inflammatory response.  
      Keywords:Vulnerable Plaque;matrix metalloprotease-9;intercellular adhesion molecule-1;nuclear factor kappaB;thrombospondin-1;atherosclerosis   
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    • Xian-qian Li,Shi-he Shao,Gui-lian Fu,Xiao-hong Han,Hong Gao
      2010, 16(5): 448-452. DOI: 10.1007/s11655-010-0538-5
      Abstract:To investigate the mechanism of norcantharidin (NCTD)-induced SMMC-7721 hepatoma cell apoptosis. SMMC-7721 cell growth inhibition was measured by the MTT method. Apoptosis was detected by Annexin V/propidium iodide staining. The mitochondrial membrane potential was measured by flow cytometry. Western blot analysis was used to evaluate the level of cytochrome c, caspase-3, AIF, Bcl-2 and Bax expression. NCTD inhibited SMMC-7721 cell growth in a time- and dose-dependent manner. The cells treated with NCTD showed the loss of mitochondrial membrane potential. The activities of caspase-3, cytochrome c, AIF, and Bax were up-regulated after NCTD treatment at different doses. The expression of Bcl-2 was decreased after treatment with NCTD. NCTD could induce SMMC-7721 cell apoptosis. The activation of the mitochondrial pathway was involved in the process of NCTD-induced SMMC-7721 cell apoptosis.  
      Keywords:norcantharidin;Liver Cancer;apoptosis;mitochondrial pathway   
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    • Min Deng,Xiang-qian Sui,Shi-bing Zhu,Wei Ma,Ying Xu,Zhi-ming Chen
      2010, 16(5): 453-456. DOI: 10.1007/s11655-010-0540-y
      Abstract:To observe the therapeutic efficacy and safety of amiodarone combined with Shenmai Injection (参麦注射液) on atrial fibrillation. A total of 351 patients with atrial fibrillation caused by cardiovascular diseases and idiopathic atrial fibrillation were assigned to amiodarone group (control group, 128 cases) and amiodarone combined with Shenmai Injection group (treatment group, 223 cases). The patients in the control group received intravenous injection of 150 mg amiodarone in 10 min, followed by intravenous drip infusion at 1 mg /min and 6 h later at 0.5 mg /min until 48 h or cardioversion. The patients in the treatment group received the same treatment of amiodarone, while in addition, they received an injection of Shenmai Injection of 100 mL simultaneously. Blood pressure, ventricular rate, and cardioversion were observed. The total efficiency rate was 98% (control group) and 99% (treatment group) (P>0.05). The mean ventricular rate decreased 23% and 31% in the control group and the treatment group, respectively (P<0.05). The mean cardioversion time of the two groups was 570±211 min and 351±123 min, respectively (P<0.05). Only mild side effects were observed in both groups. Compared with amiodarone, amiodarone combined with Shenmai Injection takes effect more quickly with low side effects on the treatment of atrial fibrillation.  
      Keywords:Atrial Fibrillation;amiodarone;Shenmai injection   
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    • Min Ma,He-ning Zhai
      2010, 16(5): 457-463. DOI: 10.1007/s11655-010-9996-z
      Abstract:Mammary hyperplasia (MHP) is the most commonly encountered mammary disease in women at the child-bearing stage. Especially, atypical hyperplasia which belongs to the precancerous category, is the disease for class I prevention of breast cancer. Therefore, advancing the clinical efficacy of MHP treatment is of critical importance. Chinese medicine (CM) and drugs show a peculiar effect in this field; the clinical or experimental researches concerning MHP treatment by CM compounds or patent drugs have been increasing gradually in recent years, but the thinking paths and methods for establishing the MHP animal model are divergent. Particularly, the disease/CM syndrome conjugated model (D/S model) has rarely been studied. For this reason, the pathogenetic mechanism, the establishment of an animal disease model, as well as the thinking paths and methods for establishing the D/S model of MHP are discussed and summarized preliminarily in this paper by the authors. This could provide a new way of thinking and method for creating the MHP model in modern medicine.  
      Keywords:mammary hyperplasia;animal model;thinking path   
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      ReviewPaper

    • Yu Qiu,Hao Xu,Dong-yan Zhao
      2010, 16(5): 466-471. DOI: 10.1007/s11655-010-0549-2
      Abstract:It is a common view that the integration of Chinese medicine (CM) and modern Western medicine is an efficient way to facilitate the development of CM. Integrative medicine is a kind of complex interventions. Scientific therapeutic evaluation plays a crucial role in making integrative medicine universally acknowledged. However, the modern method of clinical study, which is based on the concept of evidence-based medicine, mostly focuses on the population characteristics and single interventional factor. As a result, it is difficult for this method to totally adapt to the clinical features of CM and integrative medicine as complex interventions. One possible way to solve this issue is to improve and integrate with the existing method and to utilize the evaluation model on complex interventions from abroad. As an interdisciplinary technique, data mining involves database technology, artificial intelligence, machine learning, statistics, neural network and some other latest technologies, and has been widely used in the field of CM. Therefore, the application of data mining in the therapeutic evaluation of integrative medicine has broad prospects.  
      Keywords:Integrative Medicine;Chinese Medicine;complex intervention;therapeutic evaluation;data mining   
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    • Fang Yang,Chen Hou
      2010, 16(5): 472-479. DOI: 10.1007/s11655-010-9995-0
      Abstract:In this paper we investigated the mechanisms of Baihu Decoction ((白虎汤, BH) and Baihu with Radix Ginseng (BHG) in treating systemic inflammatory response syndrome (SIRS) and sepsis in humans and animals. By reviewing published data on the effects of BH and BHG and the control of blood glucose in treating SIRS and sepsis, we found that (1) BH and BHG were beneficial in the treatment of SIRS and sepsis in humans and animals; (2) BH and BHG also had great effect in lowering blood glucose level; and (3) the tight control of blood glucose during critical illness substantially improved the outcome. Considering these data together, we hypothesize that one of the major mechanisms of BH and BHG in treating SIRS and sepsis is to lower the blood glucose level. The findings also suggest that the application of BH and BHG can extend to many acute illnesses and injuries, which commonly cause hyperglycemia.  
      Keywords:Baihu Decoction;mechanism;hyperglycemia;critical illness;blood glucose control   
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