1. Chaihu Shugan Powder Combined with Zusanli (ST-36) Acupuncture May Help in Patients with Acute Pancreatitis
SUMMARY: 80 patients diagnosed with acute pancreatitis were divided into the treatment group and control group according to the random number table method, with 40 subjects in each group. All subjects met the diagnostic criteria of mild acute pancreatitis or moderately severe acute pancreatitis according to the “Classification of Acute Pancreatitis – 2012: Revision of the Atlanta Classification and Definitions by International Consensus”, as well as the diagnostic criteria of Liver Qi Stagnation according to the “Expert Consensus on TCM Diagnosis and Treatment of Acute Pancreatitis (2017)”. There was no significant difference in age, gender and the Acute Physiology and Chronic Health Evaluation II (APACHE Ⅱ) between the treatment group and control group, and the two groups were therefore statistically comparable (P>0.05).
In control group, subjects received routine treatment for acute pancreatitis, including fasting, fluid resuscitation, gastric acid and pancreatic enzyme inhibition, enteral nutrition, water and electrolyte balance, rehydration, oral administration of raw rhubarb, external application of Glauber’s salt, and other treatment when necessary (eg. continuous gastrointestinal decompression, infection control, parenteral nutrition, etc.)
In addition to the routine treatment, subjects in treatment group also received Chaihu Shugan Powder (柴胡疏肝散), 1 dose three times a day for 5 days, as well as acupuncture treatment on Zusanli (ST-36 足三里), 30 minutes once a day for 5 days. The ingredients of Chaihu Shugan Powder included: Chai Hu 12g (柴胡 Bupleurum chinense), Chen Pi 12g (陳皮 Pericarpium Citri Reticulatae), Bai Shao 9g (白芍 Radix Paeoniae Alba), Zhi Ke 9g (枳殼 Fructus Aurantii), Chuan Xiong 9g (川芎 Rhizoma Ligustici Chuanxiong), Xiang Fu 9g (香附 Rhizoma Cyperi), and Zhi Gan Cao 3g (炙甘草 Radix Glycyrrhizae Preparata).
In order to assess the efficacy and safety of the treatment, the following parameters were monitored in both groups before and after treatment: serum amylase, serum lipase, inflammatory factors [tumor necrosis factor-α (TNF-α), white blood cell (WBC) count, neutrophil percentage (NE%), C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-1β (IL-1β)] and immune indicators (CD3+, CD4+, CD8+, CD4+/ CD8+), and vital signs (respiratory rate, heart rate, blood pressure, oxygen saturation).
According to the result, the levels of serum amylase and serum lipase decreased in both groups after the treatment (P<0.05), and the treatment group showed a more significant decrease compared to the control group (P<0.05). After the treatment, the levels of serum TNF-α, WBC count, NE%, CRP, IL-6, IL-8 and IL-1β significantly decreased in both groups (P<0.05), and the levels of serum TNF-α, CRP, IL-8 and IL-1β in the treatment group showed a more significant decrease compared to the control group (P<0.05). The serum levels of CD3+, CD4+, CD8+ and CD4+/CD8+ increased in both groups after the treatment (P<0.05), but the levels of CD3+ and CD4+ in the treatment group were significantly higher than the control group (P<0.05). The result of this study suggests that Chaihu Shugan Powder combined with Zusanli (ST-36) acupuncture treatment and routine medical treatment may benefit patients with acute pancreatitis.
Wei Wei Lu, et al. Shanghai J Tradit Chin Med. 2023. 57 (6): 80-83.
2. Combination of Acupuncture and Routine Medical Treatment in Treating Primary Sjogren’s Syndrome of Yin Deficiency and Blood Dryness Type
SUMMARY: 52 patients diagnosed with primary Sjogren’s syndrome of Yin Deficiency and Blood Dryness type were divided into the treatment group and control group by random number table methods, with 26 patients in each group. All subjects met the diagnostic criteria of primary Sjogren’s syndrome according to the “American-European Consensus Group (AECG, 2002 edition)”, as well as the diagnostic criteria of “Dryness Bi (燥痺)” (Yin Deficiency and Blood Dryness type) according to the “Practical TCM Rheumatology”. There was no significant difference in terms of gender, age and course of disease, and the two groups were therefore statistically comparable (P > 0.05).
In the control group, subjects were prescribed oral hydroxychloroquine sulfate tablets, 0.2 g twice a day (morning and evening) for 12 weeks. In treatment group, subjects received acupuncture treatment in addition to the oral hydroxychloroquine sulfate tablets. The acupuncture protocol was as follows: KI-6 (Zhaohai 照海), KI-7 (Fuliu 復溜), SP-6 (Sanyinjiao 三陰交), SP-10 (Xuehai 血海), ST-36 (Zusanli 足三里), LI-4 (Hegu 合谷), and LR-2 (Xingjian 行間). For subjects with dry mouth, M-HN-20 (Yuyu, Jinjin 金津 玉液) and CV-23 (Lianquan 廉泉) were added; for subjects with dry eyes, M-HN-9 (Taiyang 太陽), BL-1 (Jingming 睛明), and ST-2 (Sibai 四白) were added; for dry nose, LI-20 (Yingxiang 迎香) was added. For KI-6, KI-7, SP-6 and ST-36, reinforcing method was used; for LI-20, even reinforcing-reducing method was used; for M-HN-20 and CV-23, pricking method was used; for the rest of acupuncture points, reducing method was used. Acupuncture treatment was done twice a week, 30 minutes each session, and the total course of treatment was 12 weeks.
To evaluate the efficacy of the treatment, the following parameters were monitored: TCM syndrome score (TCMSS) according to the “Guiding Principles for Clinical Research of New Drugs of Traditional Chinese Medicine”, EULAR SS Patient Reported Index (ESSPRI), Visual Analogue Scale (VAS), saliva flow rate, tear flow rate, main laboratory indicators [erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Rheumatoid Factor (RF)], blood routine, liver function, kidney function, and urine routine. A subject was considered as:
① Cured: main signs & symptoms (dry mouth and dry eyes) resolved, and the main laboratory indicators (ESR) return to normal or close to normal;
② Markedly Effective: main signs & symptoms and ESR improved by ≥ 75%;
③ Effective: main signs & symptoms and ESR improved by ≥ 30% but < 75%;
④ Ineffective: main signs & symptoms improved by < 30%, and the main laboratory indicators (ESR) did not improve.
According to the result, the total effective rate of the treatment group was significantly higher than the control group (P<0.05). After the treatment, TCM syndrome scores and ESSPRI scores decreased, tear flow rate and saliva flow rate increased, the main laboratory indicators decreased in both groups, but the treatment group showed a more significant improvement compared to the control group (P<0.05). No significant adverse reaction was observed in both groups. This indicates that combining acupuncture with routine medical treatment may be effective and safe in treating primary Sjogren’s Syndrome of Yin Deficiency and Blood Dryness type.
Chao Wang, et al. Clinical Journal of Chinese Medicine 2023. 15 (16): 82-86