Efficacy of Traditional Chinese Medicine for the Management of Constipation: A Systematic Review.

J Altern Complement Med. 2009 Dec 3;

Authors: Lin LW, Fu YT, Dunning T, Zhang AL, Ho TH, Duke M, Lo SK

Abstract Objectives: The aim of this systematic review was to critically appraise published clinical trials designed to assess the effect of Traditional Chinese Medicine (TCM) on the management of constipation. Methods: Databases searched included both English and non-English articles published in the Cochrane library, MEDLINE,((R)) CINAHL, AMED, EMBASE, China National Knowledge Infrastructure (CNKI), and the Chinese Electronic Periodical Services (CEPS). Studies reviewed included randomized controlled trials and controlled clinical trials. Methodological quality was assessed using the modified Jadad scale. Results: One hundred and thirty-seven (137) studies met the inclusion criteria, of which 21 were high-quality trials (n = 2449). Eighteen (18) were Chinese herbal medicine (CHM) and 3 were acupuncture trials. The primary outcome measure was total effective rate. CHM was more effective than conventional medicines in eight trials. Of the 10 remaining CHM trials, 9 compared the study CHM with another CHM and the results were significant in 4 trials. The effective rate was significantly higher in the intervention group than in the placebo group in the last CHM study. One (1) of the three acupuncture trials compared acupuncture with a conventional medicine, one trial with Sennae folium, and one trial with deeper acupuncture on Tianshu (ST 25). The therapeutic effect in the treatment group was more effective than that in the control group in all three studies. Conclusions: TCM interventions appear to be useful to manage constipation. Significant positive results were found in 15 high-quality studies. However, only 21 of the 137 publications identified attained high Jadad scores. There was heterogeneity in diagnostic procedures and interventions among the studies. Outcome indicators were also different. Hence, the results should be interpreted cautiously.

BOTTOM LINE: There are two important points about this article, in addition to the finding that TCM methods may be highly effective for constipation.  The first is that this is called a systematic review or “meta-analysis” of many published studies.  The more high quality published studies there are that say the same thing, or close to the same result, the better the chances that something actually works as advertised.  The second important point is regarding the Jadad scoring system, otherwise known as the Oxford quality scoring system.  This is a widely used tool used by scientists WORLD-WIDE to determine the actual  quality of published clinical trials.  In other words, it is important to ask two questions.  1/ Is there more than one piece of research or evidence that something works? 2/Exactly how good was the research study or studies?

Chinese “herbal” cigarettes are as carcinogenic and addictive as regular cigarettes.

Cancer Epidemiol Biomarkers Prev. 2009 Dec;18(12):3497-501

Authors: Gan Q, Yang J, Yang G, Goniewicz M, Benowitz NL, Glantz SA

OBJECTIVE: To examine the Chinese tobacco industry’s claim that herbal cigarettes are less harmful than regular cigarettes. METHODS: The study design was a cross-sectional survey. One hundred thirty-five herbal cigarette smokers and 143 regular smokers from one city in China completed a questionnaire on smoking behavior and provided a urine sample. The main outcome measures were cotinine and trans-3′-hydroxycotinine in all samples, and polycyclic aromatic hydrocarbon metabolites (PAH; 1-hydroxypyrene, naphthols, hydroxyfluorenes, and hydroxyphnanthrenes) and the tobacco specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-butanol (NNAL) and NNAL-glucuronide in randomly selected 98 samples (47 from the herbal smokers’ group and 51 from the regular smokers’ group). Values were normalized by creatinine to correct for possible variability introduced by dilution or concentration of the urine. RESULTS: Health concern was among the main reasons that smokers switched to herbal cigarettes from regular cigarettes. Smokers reported increased consumption after switching to herbal cigarettes from regular cigarettes. For all the four markers analyzed (cotinine, trans-3′-hydroxycotinine, total NNAL, and total PAHs), we observed no significant difference in the levels (P = 0.169, P = 0.146, P = 0.171, and P = 0.554, respectively) between smokers of herbal cigarettes and smokers of regular cigarettes. Both total NNAL and total PAHs were significantly correlated with cotinine and trans-3′-hydroxycotinine (P < 0.001 for all four correlations). CONCLUSIONS: Our findings showed that herbal cigarettes did not deliver less carcinogens than regular cigarettes. The public needs to be aware of this fact, and the Chinese tobacco industry should avoid misleading the public when promoting herbal cigarettes as safer products. (Cancer Epidemiol Biomarkers Prev 2009;18(12):3497-501].

BOTTOM LINE: If you light something up and then inhale it, it isn’t good for you! Basically when you burn ANYTHING, carcinogens are released.  Some tobaccos or herbs may have more or less concentration  of a carcinogen or carcinogens, but they ALL contain them.   If you want to optimize your health don’t smoke ANYTHING!

Gedunin, a novel natural substance, inhibits ovarian cancer cell proliferation.

Int J Gynecol Cancer. 2009 Dec;19(9):1564-9

Authors: Kamath SG, Chen N, Xiong Y, Wenham R, Apte S, Humphrey M, Cragun J, Lancaster JM

The discovery of more active therapeutic compounds is essential if the outcome for patients with advanced-stage epithelial ovarian cancer is to be improved. Gedunin, an extract of the neem tree, has been used as a natural remedy for centuries in Asia. Recently, gedunin has been shown to have potential in vitro antineoplastic properties; however, its effect on ovarian cancer cells is unknown. We evaluated the in vitro effect of gedunin on SKOV3, OVCAR4, and OVCAR8 ovarian cancer cell lines proliferation, alone and in the presence of cisplatin. Furthermore, we analyzed in vitro gedunin sensitivity data, integrated with genome-wide expression data from 54 cancer cell lines in an effort to identify genes and molecular pathways that underlie the mechanism of gedunin action. In vitro treatment of ovarian cancer cell lines with gedunin alone produced up to an 80% decrease in cell proliferation (P < 0.01) and, combining gedunin with cisplatin, demonstrated up to a 47% (P < 0.01) decrease in cell proliferation compared with cisplatin treatment alone. Bioinformatic analysis of integrated gedunin sensitivity and gene expression data identified 52 genes to be associated with gedunin sensitivity. These genes are involved in molecular functions related to cell cycle control, carcinogenesis, lipid metabolism, and molecular transportation. We conclude that gedunin has in vitro activity against ovarian cancer cells and, further, may enhance the antiproliferative effect of cisplatin. The molecular determinants of in vitro gedunin response are complex and may include modulation of cell survival and apoptosis pathways.

BOTTOM LINE: Gedunin is a “tetranortriterpenoid” isolated from the Indian neem tree (Azadirachta indica),  and has shown anticancer activity recently against several cancer cell lines in the lab.  In this case, the study shows that it may be effective against ovarian cancer and help one of the main ovarian cancer chemotherapy drugs (cisplatin) work better.  Remember, the main drug we use against ovarian cancer today (Taxol) was derived from a ewe tree.  Another, currently being studied, is from a sea squirt.  So, no question that the anti-cancer war is not just a synthetic pharmaceutical battle.  In fact, the anti cancer war is right in the middle of many natural substances that potentially will help us win this “war”.  The difference is that the “natural” front is attacking BOTH the anticancer cell attack strategy and strengthening the body from which cancer cells need to be driven from…….or prevented from gaining a foothold in the first place.

Successful treatment with Yokukansan for behavioral and psychological symptoms of Parkinsonian dementia.

Prog Neuropsychopharmacol Biol Psychiatry. 2009 Nov 27;

Authors: Kawanabe T, Yoritaka A, Shimura H, Oizumi H, Tanaka S, Hattori N

OBJECTIVE: To evaluate the efficacy and safety of Yokukansan, a traditional Chinese herbal medicine, for treating of behavioral and psychological symptoms of dementia (BPSD) in patients with Parkinson disease (PD;n=7) and those with PD with dementia (PDD;n=7). BACKGROUND: BPSD are often seen in patients with senile dementia and have serious deleterious effects on the lives of patients and caregivers. Recent studies indicate that the traditional Chinese herbal medicine Yokukansan may be safe and beneficial for the treatment of BPSD patients. METHODS: We treated 7 PD and 7 PDD patients for 4weeks with Yokukansan and observed them without Yokukansan for 4weeks. Changes in behavioral and psychological symptoms were evaluated every 4weeks according to the Neuropsychiatric Inventory (NPI) scale. RESULTS: Significant improvements in behavioral and psychological symptoms, particularly in the incidence and duration of hallucinations, were observed in most PD and PDD patients after 4weeks of Yokukansan treatment. No significant changes were observed in the laboratory tests, cognitive function, activities of daily living, or parkinsonism. CONCLUSION: Our results suggest that Yokukansan improves BPSD in both PD and PDD patients without worsening their cognitive function, ability to perform activities of daily living, or parkinsonism.

BOTTOM LINE: This type of a clinical trial is called a crossover study and is not the best evidence, but it is very promising and builds a plausible case for this type of natural therapy. Basically in a crossover trial, each participate gets both treatments being tested so they act like their own “control”.  In this case, the treatment vs no treatment.   They are hard to perform correctly so that the results are truly not due to chance alone.   However, in this case this small study shows something that was previously modeled in rats.  Specifically that this traditional Japanese medicine can improve daily living in patients living with this type of dementia.  It’s a step in the right direction.

Structural characterization of trace stilbene glycosides in Lysidice brevicalyx Wei using liquid chromatography/diode-array detection/electrospray ionization tandem mass spectrometry.

J Chromatogr B Analyt Technol Biomed Life Sci. 2009 Oct 20;

Authors: Hu Y, Qu J, Liu Y, Yu S, Li J, Zhang J, Du D

The mass fragmentation patterns of stilbene glycosides isolated from the genus Lysidice were investigated by negative ion electrospray ionization tandem mass spectrometry, and the influence of collision energy on their fragmentation behavior is discussed. It is found that the presence of the Y(0)(-) and B(0)(-) ions in the MS(2) spectra is characteristic for 1–>6 linked diglycosyl stilbenes, while the Y(0)(-), Y(1)(-), and Z(1)(-) ions are representative ions of 1–>2 linked diglycosyl stilbenes. These results indicate that ESI-MS(n) in the negative ion mode can be used to differentiate 1–>6 and 1–>2 linked diglycosyl stilbenes. Based on the fragmentation rules, 9 new trace constituents were identified or tentatively characterized in a fraction of Lysidice brevicalyx by using HPLC/HRMS and HPLC-DAD/ESI-MS(n). The results of the present study can assist in on-line structural identification of analogous constituents and targeted isolation of novel compounds from crude plant extracts.

BOTTOM LINE: In this case an endangered  plant whose bark has known antioxidant activity was evaluated. It turns out that some constituents of it show antioxidant activity at concentrations of 10⁻⁴ and 10⁻⁵ mol/L.  What does this mean??  It means ULTRA-TINY amounts of it show antioxidant activity, but are limited to SOME of the constituents or parts. The whole plant is not antioxidant.  This goes against some naturopathic holism principles, but otherwise we may find consuming 99% of something does no good (or even harm) and 1% leads to the effect we want.  This highly specific technology will allow us to figure that out. Then it will be up to us what extracts or parts we wish to consume rather than doing it blindly.

Nardostachys jatamansi Protects Against Cerulein-Induced Acute Pancreatitis.

Pancreas. 2009 Nov 23;

Authors: Bae GS, Park HJ, Kim DY, Song JM, Kim TH, Oh HJ, Yun KJ, Park RK, Lee JH, Shin BC, Sim HJ, Hong SP, Song HJ, Park SJ

OBJECTIVES:: Nardostachys jatamansi belonging to the family Valerianaceae has been used as a remedy for stomach and skin ailments in Korea. The effect of N. jatamansi on acute pancreatitis (AP) has not been defined. Therefore, we investigated the effect of N. jatamansi on cerulein-induced AP. METHODS:: In the pretreatment group, N. jatamansi was administered orally to mice at 10 and 20 mg/kg for 5 days, and the mice were intraperitoneally injected with the stable cholecystokinin analogue cerulein hourly for 6 hours. In the posttreatment group, cerulein was injected hourly for 6 hours, and N. jatamansi was administered at the indicated time (1, 3, and 5 hours after the first cerulein injection) and dose (10 and 20 mg/kg) during the cerulein injection. Blood samples were taken 6 hours later to determine the serum amylase, the lipase, and the cytokine levels. The pancreas and the lung were rapidly removed for morphologic examination, myeloperoxidase assay, and real-time reverse transcription polymerase chain reaction. RESULTS:: Nardostachys jatamansi treatment attenuated the AP, as shown by the histological examination results of the pancreas and the lung, reductions in pancreatic edema, neutrophil infiltration, serum amylase and lipase levels, serum cytokine levels, and messenger RNA expressions of inflammatory mediators. CONCLUSIONS:: These results suggest that N. jatamansi attenuates the severity of AP and pancreatitis-associated lung injury.

BOTTOM LINE: In order to test what works in the animal basic science laboratory model, various diseases and conditions are induced or caused by substances.  In this case the substance cerulein induced acute pancreatitis in the animal model so that nardostachys jatamansi could be tested as a remedy. Nardostachys jatamansi is otherwise known as a Himlayan plant by the name of Spikenard. As you can see in the results, via modulation of very complex biochemical processes Spikenard may be useful to test against acute pancreatitis in humans.