Medical Orient Express (Nov-Dec 2023)

1. Modified Shou Tai Wan combined with Dydrogesterone in Treating Unexplained Recurrent Spontaneous Abortion due to Kidney Essence Deficiency 

SUMMARY: 90 patients with unexplained recurrent spontaneous abortion (URSA) were randomly divided into the treatment group and control group according to the random number table methods, with 45 subjects in each group. All subject met the diagnostic criteria of URSA according to the “Obstetrics and Gynecology (3rd ed)”, as well as the Traditional Chinese Medicine (TCM) diagnostic criteria of spontaneous abortion due to Kidney essence deficiency according to the “Traditional Chinese Medicine Gynecology”. There was no significant difference in age and gestational age between the treatment and control group, and the two groups were therefore statistically comparable (P>0.05). 

In control group, subjects received oral dydrogesterone tablets, 10 mg 3 times a day until 12 weeks of gestation. In addition to oral dydrogesterone tablets, subjects in the treatment group also received TCM herbal formula Modified Shou Tai Wan (加味壽胎丸, one dose as decocted into 300ml of decoction, 150ml in the morning and evening until 12 week of gestation). The ingredients of Modified Shou Tai Wan included:  E Jiao 10g (阿膠 Colla Corii Asini), Tu Si Zi 15g (菟蕬子 Semen Cuscutae), Sang Ji Sheng 15g (桑寄生 Ramulus Taxilli), and Xu Duan 12g (續斷Dipsacus asperoides). 

In order to assess the clinical efficacy, the following parameters were monitored: TCM syndrome scores (signs and symptoms of Kidney essence deficiency), serum human chorionic gonadotropin (β-HCG) levels, pregnancy success rate, and adverse reactions. The clinical efficacy was considered as:

  1. Cured: clinical signs and symptoms resolved, TCM syndrome scores reduced by ≥ 95% 
  2. Markedly effective: clinical signs and symptoms significantly improved, TCM syndrome scored reduced by 70%-94%; 
  3. Effective: clinical signs and symptoms improved, TCM syndrome score reduced by 30%-69%;
  4. Ineffective: No improvement in signs and symptoms, TCM syndrome score reduced by <30% 

Total effective rate = (number of cured cases + number of markedly effective cases + number of effective cases)/total number of cases × 100%. 

Table 1. Comparison of Clinical Efficacy Between Treatment Group and Control Group [n (%)]

After the treatment, the treatment group showed a more significant reduction in TCM syndrome score and a more significant increase in the serum β-HCG level comparing to the control group (P <0.05). The pregnancy success rate in the treatment group was 91.11%, which was significantly higher than the control group (62.22%) (P<0.05). The total effective rate of treatment group was significantly higher than the control group (88.89% vs. 68.89%) (P <0.05). There was no significant difference in terms of adverse reaction between the two groups. It suggested that Modified Shou Tai Wan combined with dydrogesterone may reduce the clinical signs and symptoms of URSA patients with Kidney essence deficiency in the early stage of pregnancy, improve serum β-HCG levels and pregnancy success rate without additional side effect. 

Liping Chen and Lishan Fang. China’s Naturopathy. 2003. 31 (14): 65-67

2. The Combination of Ear Apex Bloodletting with Levofloxacin Eye Drops may be Beneficial for Children with Blepharitis

Ninety children with blepharitis were selected and divided into control group and treatment group according to the blind sampling method, with 45 cases in each group. All subject met the diagnostic criteria of blepharitis according to the “Chinese Ophthalmology”, as well as the Traditional Chinese Medicine (TCM) diagnosis of “wind-heat lodging in eyelid” according to the “Ophthalmology of Traditional Chinese Medicine”. There was no significant difference in age, gender and course of diseases between the two groups; thus, the two group were statistically comparable (P>0.05).

In control group, subjects were treated with levofloxacin (LVFX) eye drop, 1-2 drops 3-5 times a day for two courses of treatment, with 6 days as a course of treatment. In treatment group, subjects were treated with bloodletting methods on the ear apex in addition to the LVFX eye drop. The bloodletting treatment was performed once a day for 3 days, with 5-6 drops of blood per treatment. 

In both groups, clinical signs and symptoms, diameter of induration, level of pain [visual analogue pain score (VAS)] and adverse reaction were evaluated and compared. The clinical efficacy was considered as:

  1. Markedly Effective: clinical signs and symptom resolved, including erythema, edema, sensation of heat and pain, conjunctival congestion, and others;
  2. Effective: local congestion, erythema, edema, sensation of heat and pain improved, and no tenderness on the induration upon palpation;
  3. Ineffective: no improvement in signs and symptoms, or the signs and symptoms exacerbated
  4. Total effective rate = (number of markedly effective cases + number of effective cases)/total number of cases × 100%.

According to the result, the total effective rate of the treatment group was 97.78%, which was significantly higher than the control group (82.22%) (P<0.05). After 3 days of treatment, both groups showed a significant decrease in the diameter of the induration and VAS score (P<0.05), and the treatment group showed a more significant improvement (P<0.05). There was no statistically significant difference in the total incidence of adverse reactions between the two groups (P>0.05). Therefore, combing ear apex bloodletting with LVFX eye drop may be a safe and effective method in improving the symptoms and pain in children with blepharitis. 

Li Chen, et al. China’s Naturopathy. 2023. 31 (14): 62-64