Recent Advances in Chinese Herbal Medicine for Cerebral Ischemic Reperfusion Injury

Cerebral ischemic reperfusion injury (CI/RI) is a critical factor that leads to a poor prognosis in patients with ischemic stroke. It is an extremely complicated pathological process that is clinically characterized by high rates of disability and mortality. Current available treatments for CI/RI, including mechanical and drug therapies, are often accompanied by significant side effects. Therefore, it is necessary to discovery new strategies for treating CI/RI. Many studies confirm that Chinese herbal medicine (CHM) was used as a potential drug for treatment of CI/RI with the advantages of abundant resources, good efficacy, and few side effects. In this paper, we investigate the latest drug discoveries and advancements on CI/RI, make an overview of relevant CHM, and systematically summarize the pathophysiology of CI/RI. In addition, the protective effect and mechanism of related CHM, which includes extraction of single CHM and CHM formulation and preparation, are discussed. Moreover, an outline of the limitations of CHM and the challenges we faced are also presented. This review will be helpful for researchers further propelling the advancement of drugs and supplying more knowledge to support the application of previous discoveries in clinical drug applications against CI/RI.

Herbal Medicine for the Treatmentof Viral Infections: A Systemic Review

The term “Antiviral agents” has been defined in very wide terms as substances other than a virus or virus containing vaccine or specific antibody which can build either a protective or therapeutic effect to the direct measurable advantage of the virus infected host. Viruses are simple in form which are very tiny germs. They comprise of genetic material inside of a protein coating. Viruses cause amicable infectious diseases like common cold, flu and warts. They also cause severe diseases such as HIV/AIDS, Ebola, avian influenzas, dengue virus and COVID-19. Viral diseases are very complex and are easily spread. Herbs and herbal medicines were the foremost in treating infections from centuries over the world in every civilization. Modern science has narrowed the importance of herbal medicine in the past two centuries. But, the side effects and new varieties of diseases creating challenges to modern science. So, usage of herbal medicines is again attaining interests these days. Herbal products for different treatments have achieved a lot of popularity in the last couple of decades. Thus, discovering novel antiviral drugs is of extremely important and natural products are an excellent source for such discoveries. There are many herbs which are excellent sources for the antiviral properties to treat viral infections. This review provides the verified data on the herbal substances with antiviral activity, and some of the herbal marketed antiviral agents like CORONIL TABLETS from Patanjali and different companies had made an attempt to treat viral infections in this pandemic situation. Therefore, herbal plants proved to be a major resort for the treatment of diseases and sickness by traditional healers in many societies.

The Efficacy and Safety of Chinese Herbal Medicine in the Treatment of Knee Osteoarthritis: An Updated Systematic Review and Meta-Analysis of 56 Randomized Controlled Trials

Objective. This systematic review and meta-analysis were performed to investigate the efficacy and safety of Chinese herbal medicine (CHM) in the treatment of knee osteoarthritis (KOA). Methods. An electronic search was conducted in eight databases (PubMed, EMBASE, Web of Science, Cochrane Library, Chinese National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese VIP Database, and Wanfang Database) from inception until December 2019. The risk of bias assessment of the included RCTs was evaluated by Cochrane collaboration’s tool. The inclusion criteria were RCTs that investigated the efficacy and safety of CHM in the treatment of KOA, with no restrictions on publication status or language. The exclusion criteria included nonrandomized or quasi-RCTs, no clear KOA diagnostic approach, combined Chinese medicinal herbs with other traditional Chinese medicine treatment modalities, and published using repeated data and missing data. We computed the relative risk (RR) and the standard mean difference (SMD) for dichotomous outcomes and continuous outcomes, respectively. When heterogeneity was detected or there was significant statistical heterogeneity ( P < 0.05 or I 2 > 50 % ), a random-effects model was employed, followed by further subgroup analysis and metaregression estimations to ascertain the origins of heterogeneity. Otherwise, we used a fixed-effects model ( P ≥ 0.05 or I 2 ≤ 50 % ). The primary outcome measures were visual analog score (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lysholm score, and Lequesne index. Secondary outcome measures were the total clinical effective rate and adverse events. The meta-analysis was performed using the Stata 14.0 software. Results. A total of 56 RCTs comprising 5350 patients met the inclusion criteria. This meta-analysis showed that application of CHM as adjuvant therapy or monotherapy for KOA can significantly decrease VAS, WOMAC, and the Lequesne index and improve the Lysholm score as well as the total effective rate. In addition, this treatment has fewer adverse effects, suggesting that CHM is generally safe and well tolerated among patients with KOA. Conclusion. Our study offers supportive evidence that CHM, either adjuvant therapy or monotherapy, reduces the VAS, WOMAC, and Lequesne index and improves the Lysholm score and overall effective rate in patients with KOA. Additionally, CHM was well tolerated and safe in KOA patients. We found frequently used CHMs that might contribute to the formulation of a herbal formula that could be considered for further clinical use. However, given the heterogeneity and limited sample size in this study, larger multicenter and high-quality RCTs are needed to validate the benefits of CHM in the treatment of KOA.

Diagnosis and Management of Infected or Suspected Patients with Covid-19 a Study of 48 Cases in the UK

Covid-19 is a pandemic infective disease, which has been erupting throughout the whole world from 2020 to 2021. There have been at the time of reviewing more than a hundred million cases (102,399,513) of infection, and more than 2 million deaths (2,217,005) in more than 200 countries; this information is taken from the Covid-19 daily situation report issued on 1st Feb 2021 by WHO. The pandemic was also declared as an outbreak of Public Health Emergency of International Concern on 30th Jan 2020 by WHO. No effective treatment model has yet been confirmed by conventional western medicine, but some herbal treatments used in China can be recognized as having positive results in Covid-19 cases. This pandemic disaster has been severely damaging to quality of life, disturbing social communication, economic development and the progress of humanity. Successful results were first reported from temporary hospitals (Fangcang Hospitals set up in arenas and exhibition spaces) in Wuhan, China, where more than 90% of patients treated with Chinese herbal medicine were prevented by transferring from the minor or milder stages of the disease to the severe or critical stage. In all of them the positive PCR became negative; herbs were involved in the rescue and treatment of severe and critical cases in ICU’s in hospitals as well. It was an important factor in how Covid-19 was controlled so quickly in China. The author recruited both confirmed and suspected Covid-19 patients through social media (WeChat, WhatsApp, Internet, message etc.) as a volunteer TCM consultant from March 2020, during the first Lockdown phase in UK. It was quickly realized that the appearance of the tongue provides special and significant information for identifying whether Covid-19 is present and shows its severity, from a TCM perspective, as the degree and type of dampness accumulated within the body. Herbal prescriptions were sent by post for patients’ treatment according to their clinical findings, virus exposure history and tongue information (from photos). Similar positive effects were found as in China, and treatment reports and results are summarized here. The author believes there are many herbal medicines that can be effective in controlling the Sars-Cov-2 virus, and that prescribing the appropriate formula to match each individual case is the key point for TCM control of Covid-19. Chinese herbal medicine is the most effective current treatment method that can prevent cases in the minor and ordinary stages from progressing to the severe or critical stage, and so can play a significant role in the decrease and cure of Covid-19.

Efficacy and safety of herbal medicines external application with Tuina in congenital muscular torticollis : A systematic review and meta-analysis protocol

Review question / Objective: By 3 to 4 months of age, infants can keep their necks upright and look into both eyes horizontally. But infants with CMT have a wry neck also known as a twisted neck. Complementary therapies have been commonly used to treat CMT, such as tuina, acupuncture, herbal medicine. Among them, external application of herbal medicine is non-surgical and non-invasive inventions so it can be used widely in East Asia. This review aims to evaluate any form of external application of herbal medicines in CMT, such as cream, oil, extract, form of patch, etc. Information sources: We will electronically search the following database 4 English databases(MEDLINE, PubMed, EMBASE, the Cochrane Central Register of Controlled Trials), 3 Chinese databases(China National Knowledge Infrastructure(CNKI), Chinese Scientific Journal Database(VIP), Wan Fang Database), 4 Korean medical databases(Oriental Medicine Advanced Searching Integrated System(OASIS), Korean Studies Information Service System(KISS), National Digital Science Links(NDSL), Research Information Sharing Service(RISS)) from their founding date to June 2022, without any language restrictions.

Surgical Treatment of Iatrogenic Low Variety Anal Stenosis with Diamond Flap Anoplasty – A Prospective Study

Background: Anal stenosis results from loss of anoderm with subsequent fibrosis and scarring of underlying tissue. The condition represents a technical challenge in terms of surgical management. It is a serious complication of anorectal surgery, most commonly seen after surgical haemorrhoidectomy. However, stenosis can also occur after perianal circumferential burn due to application of herbal medicine by village doctors. Objective: This study was conducted to see the outcome of diamond-flap anoplasty for the treatment of moderate to severe anal stenosis. Patients and interventions: Unilateral diamond flaps anoplasty was performed for moderate to severe anal stenosis. Final anal calibre of 25 to 26 mm was targeted. The demographic characteristics, causes of anal stenosis, number of previous surgeries, anal stenosis severity, postoperative complications and the time of return to work were recorded. Results: From July 2012 to January 2017, 18 patients (12 males, 67% and 6 female patients, 33%) with a mean age of 34 years (range, 25-52) were treated. 15 of the patients had a history of previous haemorrhoidectomy and 3 had circumferential perianal chemical burn due to application of herbal medicine by village doctors. Five patients (28%) had moderate anal stenosis and 13 (72%) had severe anal stenosis. Preoperative, intraoperative, and 12-month postoperative anal calibration values were 9 ± 3 mm (range, 5-15), 25 ± 0.75 mm (range, 24- 26), and 25 ± 1 mm (range, 23-27). The clinical success rate was 98.9%. No severe postoperative complications were observed. Conclusion: Diamond-flap anoplasty is a highly successful method for the treatment of anal stenosis caused by previous haemorrhoidectomy and perianal circumferential chemical burn by herbal medicine. J Shaheed Suhrawardy Med Coll 2020; 12(2): 67-71