Recent Medline Abstracts on Herbs

[Guest guest]

This recent posting from Phil is pretty interesting... I'm not sure if it's 3

practitioners

or 3 pairs as it seems to say. Basically all disagreed with the diagnosis.

Fortunately,

the formulas matched their own diagnosis.

Of course, the study wasn't designed to study results. I'm wondering how they

got the

practitioners. If you were to randomly choose them, would agreement be higher

than

going to one " school " ?

doug

 

 

DESIGN: A prospective survey. SETTING:

> General Clinical Research Center, University of Maryland Hospital

> System, Baltimore, MD. PATIENTS: Rheumatoid arthritis patients.

> PRACTITIONERS: Licensed acupuncturists with a minimum of 5

> years licensure and education in Chinese herbs. METHODS: Three

> TCM practitioners examined the same 39 RA patients separately,

> following the traditional " Four Diagnostic Methods. " Patients filled

> out a questionnaire to serve as the data for the " Inquiry "

> component. They then underwent a physical examination, including

> the tongue and pulse, conducted by each of the practitioners.

> Based upon the examination results, each practitioner provided

> both a TCM diagnosis and a herbal prescription. These

> diagnoses/prescriptions were then examined with respect to the

> rate of agreement among the 3 practitioners. RESULTS: The

> average agreement with respect to the TCM diagnoses among the

> 3 pairs of TCM practitioners was 28.2% (25.6 to 33.3% with

> kappas ranging from 0.23 to 0.30). The degree to which the herbal

> prescriptions agreed with textbook recommended practice of each

> TCM diagnosis was 93.2% (range = 87.2 to 100%). CONCLUSION:

> The total agreement on TCM diagnosis on RA patients among 3

> TCM practitioners was low. When less stringent, but theoretically

> justifiable, criteria were employed, greater consensus was obtained

> among the 3 practitioners. The correspondence between the TCM

> diagnosis and the herbal formula prescribed for that diagnosis was

> high, although there was little agreement among the 3 practitioners

> with respect to the herbal formulas prescribed for individual

> patients. PMID: 14727501 [PubMed - in process]

>

[Guest guest]

, " " wrote:

> This recent posting from Phil is pretty interesting... I'm not sure if it's 3

practitioners

> or 3 pairs as it seems to say. Basically all disagreed with the diagnosis.

Fortunately,

> the formulas matched their own diagnosis.

> Of course, the study wasn't designed to study results. I'm wondering how

they got the

> practitioners. If you were to randomly choose them, would agreement be

higher than

> going to one " school " ?

> doug

>

 

I would like to see the entire article so we could pick apart the dx and rx.

anyone have access to a copy. a major medical school might have the journal

in its stacks.

 

if one group said blood stasis

 

another hot bi

 

another yin xu fire

 

all could be right and all their formulas might have some degree of

effectiveness at relieving inflammation and pain.

 

this would perhaps be similar to treating the same disease, say depression,

with different WM therapies, MAO inhibitors, SSRI's and electroconvulsion,

all of which operate by different physiological mechanisms and all have been

proven to work.

 

[Guest guest]

Poking around Pubmed I found the citation that Phil found and then clicked on

" related articles " and found a number of similar studies that used several

acupuncturists with one patient or diagnosis.

 

and just for the record, for any budding medical historians, this reference to a

Chinese language article. sounds very interesting...

 

doug

 

_____________

 

Zhonghua Yi Shi Za Zhi. 2002 Apr; 32(2): 67-72.

Related Articles,

 

 

[General introduction to Examining Committee for Physician of traditional

Chinese

medicine (TCM) in the 1940s]

 

[Article in Chinese]

 

Zhang Z.

 

China Academy of Traditional , Beijing 100700.

 

Established in 1944, the Examining Committee for Physician was the outcome of

struggle of TCM physicians seeking for survival in the Republic of China. The

committee comprised persons from the selecting committee of government and the

TCM committee of Health Office. Its functions were examining the qualification

of

practitioners of TCM who applied, according to the qualified conditions of TCM

physician decided by Examine Office, and sent out the certification to qualified

TCM

physicians for the eligibility of practising; laid down and mastered detailed

rules of

the eligible conditions of TCM physician; laid down the principles and applied

interview; participated in the operation of TCM examination and made relevant

decisions and suggestions; measured and managed concrete problems in examining

process, etc.

 

Publication Types:

Historical Article

[Guest guest]

Recent Medline Abstracts on Herbs

 

Altern Ther Health Med. 2004 Jan-Feb; 10(1): 44-50. | Ayurveda for

diabetes mellitus: a review of the biomedical literature. | Elder C.

Oregon Health and Science University, USA. | Diabetes mellitus is

a condition that is extremely serious from both clinical and public

health standpoints. The traditional healthcare system of India,

Ayurveda, offers a balanced and holistic multi-modality approach to

treating this disorder. Many Ayurvedic modalities have been

subjected to empirical scientific evaluation, but most such research

has been done in India, receiving little attention in North America.

This paper offers a review of the English language literature related

to Ayurveda and diabetes care, encompassing herbs, diet, yoga,

and meditation as modalities that are accessible and acceptable to

Western clinicians and patients. There is a considerable amount of

data from both animal and human trials suggesting efficacy of

Ayurvedic interventions in managing diabetes. However, the

reported human trials generally fall short of contemporary

methodological standards. More research is needed in the area of

Ayurvedic treatment of diabetes, assessing both whole practice

and individual modalities. PMID: 14727499 [PubMed - in process]

 

Chem Res Toxicol. 2004 Jan; 17(1): 55-62. | Cytotoxic Action of

Juglone and Plumbagin: A Mechanistic Study Using HaCaT

Keratinocytes. | Inbaraj JJ, Chignell CF. Laboratory of

Pharmacology & Chemistry, NIEHS, Research Triangle Park, North

Carolina 27709. | Juglone (5-hydroxy-1,4-naphthoquinone) and

plumbagin (5-hydroxy-3-methyl-1,4-naphthoquinone) are yellow

pigments found in black walnut (Juglans regia). Herbal preparations

derived from black walnut have been used as hair dyes and skin

colorants in addition to being applied topically for the treatment of

acne, inflammatory diseases, ringworm, and fungal, bacterial, or

viral infections. We have studied the cytotoxicity of these quinones

to HaCaT keratinocytes. Exposure to juglone or plumbagin (1-20

microM) resulted in a concentration-dependent decrease in cell

viability. The cytotoxicity of these quinones is due to two different

mechanisms, namely, redox cycling and reaction with glutathione

(GSH). Redox cycling results in the generation of the

corresponding semiquinone radicals, which were detected by

electron paramagnetic resonance. Incubation of keratinocytes with

the quinones generated hydrogen peroxide (H(2)O(2)) and resulted

in the oxidation of GSH to GSSG. Depletion of GSH by buthionine

sulfoximine enhanced semiquinone radical production, increased

H(2)O(2) generation, and produced greater cytotoxicity, suggesting

that GSH plays an important protective role. Both quinones

decreased the intracellular levels of GSH. However, plumbagin

stoichiometrically converted GSH to GSSG, indicating that redox

cycling is its main metabolic pathway. In contrast, much of the

GSH lost during juglone exposure, especially at the higher

concentrations (10 and 20 microM), did not appear as GSSG,

suggesting that the cytotoxicity of this quinone may also involve

nucleophilic addition to GSH. Our findings indicate that topical

preparations containing juglone and plumbagin should be used with

care as their use may damage the skin. However, it is probable

that the antifungal, antiviral, and antibacterial properties of these

quinones are the result of redox cycling. PMID: 14727919 [PubMed

- in process]

 

Cardiovasc Toxicol. 2003; 3(4): 331-9. | Grape seed

proanthocyanidins induce pro-oxidant toxicity in cardiomyocytes. |

Shao ZH, Vanden Hoek TL, Xie J, Wojcik K, Chan KC, Li CQ,

Hamann K, Qin Y, Schumacker PT, Becker LB, Yuan CS. Tang

Center for Herbal Medicine Research, Emergency Resuscitation

Research Center, and Department of Medicine, Pritzker School of

Medicine, University of Chicago, Chicago, IL, USA. | Grape seed

proanthocyanidin extract (GSPE), a polyphenolic compound with

antioxidant properties, may protect against cardiac ischemia and

reperfusion injury. However, its potential toxicity at higher doses is

unknown. The authors tested the effects of GSPE on reactive

oxygen species (ROS) generation, cell survival, lactate

dehydrogenase (LDH) release, and caspase- 3 activity using chick

cardiomyocytes incubated with GSPE at 5, 10, 50, 100, or 500

micrograms/mL in medium for 8 h. Exposure to increasing

concentrations of GSPE (100 or 500 micrograms/mL) resulted in

an increase in ROS generation and cell death as measured by

propidium iodide uptake and LDH release. Caspase-3 activity was

significantly increased fourfold in cells exposed to GSPE 500

micrograms/ mL compared to controls; this was abolished by the

selective caspase-3 inhibitor Ac-Asp-Gln-Thr-Asp-H (50 microM),

which also significantly reduced the cell death resulting from GSPE

(500 micrograms/mL). The antioxidant N-acetylcysteine (NAC, 100

microM) reduced cell death induced by GSPE (500

micrograms/mL) but failed to attenuate caspase-3 activation.

Collectively, the authors conclude that higher doses of GSPE could

cause apoptotic cell injury via effector caspase-3 activation and

subsequent induction of ROS generation. Consumers may take

higher doses of dietary supplements in the belief that natural herbs

have no major side effects. This study demonstrates that dosages

of GSPE should be optimized to avoid potential harmful pro-oxidant

effects. PMID: 14734830 [PubMed - in process]

 

Toxicol Sci. 2004 Jan 21 [Epub ahead of print] | In Vitro Toxicity of

Kava Alkaloid, Pipermethystine, in HepG2 Cells as Compared to

Kavalactones. | Nerurkar PV, Dragull K, Tang CS. Department of

Molecular Biosciences and Bioengineering, College of Tropical

Agriculture and Human Resources, University of Hawaii at Manoa,

Honolulu, HI 96822. | Kava herbal supplements have been recently

associated with acute hepatotoxicity, leading to the ban of kava

products in approximately a dozen countries around the world. It is

suspected that some alkaloids from aerial kava may have

contributed to the problem. Traditionally, Pacific Islanders employ

primarily the underground parts of the shrub to prepare the kava

beverage. However, some kava herbal supplements may contain

ingredients from aerial stem peelings. The aim of this project was

to test the in vitro effects of a major kava alkaloid, pipermethystine

(PM) found mostly in leaves and stem peelings and kavalactones

such as 7,8-dihydromethysticin (DHM), desmethoxyyangonin

(DMY) that are abundant in the roots. Exposure of human

hepatoma cells, HepG2, to 100 micro M of PM caused 90% loss in

cell viability within 24 h, while 50 micro M caused 65% cell death.

Similar concentrations of kavalactones did not affect cell viability up

to 8 days of treatment. Mechanistic studies indicate that in

contrast to kavalactones, PM significantly decreased cellular ATP

levels, mitochondrial membrane potential and induced apoptosis as

measured by the release of caspase-3 after 24 h of treatment.

These observations suggest that PM, rather than kavalactones, is

capable of causing cell death, probably in part by disrupting

mitochondrial function. Thus, PM may contribute to rare but severe

hepatotoxic reactions to kava. PMID: 14737001 [PubMed - as

supplied by publisher]

 

Cancer Chemother Pharmacol. 2004 Jan 17 [Epub ahead of print] |

Interactions of a herbal combination that inhibits growth of prostate

cancer cells. | Chung VQ, Tattersall M, Cheung HT. Harvard

Medical School, Unit 105, 111 Gainsborough, MA 02115, Boston,

USA. | PURPOSE. PC SPES is an eight-component herbal

product marketed for the treatment of prostate cancer. The

manufacturer of PC SPES claims that the herbal combination is a

synergistic blend, but the purported synergy has never been

tested. We examined the interaction in cell culture of these eight

individual herbal components by the use of an isobologram.

METHODS. US patent no. 5,665,393 (1997) for PC SPES was

acquired, and each of the eight herbal components described was

acquired, properly identified, and extracted by 95% ethanol. The

extracts were tested for cytotoxicity to PC 3 human prostate

cancer cells in culture by the MTT (3-[4,5-dimethythiazol-2-yl]-2,5-

diphenyltetrazolium bromide) assay. Seven combinations of herbal

extracts were made, varying in the proportion of the most cytotoxic

herbal extract, that of Panax notoginseng. The interactions of P.

notoginseng with the other seven herbs were evaluated through the

use of an isobologram. RESULTS. In all seven herbal

combinations, P. notoginseng was found to be antagonistic with

the other seven herbal components in the cytotoxicity assay ( P

values: 0.09, 0.12, 0.12, 0.33, 0.45, 0.56, and 0.76).

CONCLUSIONS. The interaction between the most cytotoxic

herbal component of a widely used herbal product and the other

seven components was antagonistic. Herbal combinations are no

different from traditional combination pharmacotherapy. If herbal

combinations are able to achieve antagonism, then theoretically

they can achieve synergism if combined properly. PMID: 14730387

[PubMed - as supplied by publisher]

 

Planta Med. 2003 Nov; 69(11): 1057-9. | Tanshinone IIA from Salvia

miltiorrhiza inhibits inducible nitric oxide synthase expression and

production of TNF-alpha, IL-1beta and IL-6 in activated RAW 264.7

cells. | Jang SI, Jeong SI, Kim KJ, Kim HJ, Yu HH, Park R, Kim

HM, You YO. Department of Oral Microbiology, School of

Dentistry, Wonkwang University, Iksan, Chonbuk, South Korea. |

The inhibitory effects of tanshinone IIA, a diterpene isolated from

Salvia miltiorrhiza root, on the production of nitric oxide (NO),

interleukin-1beta (IL-1beta), interleukin-6 (IL-6) and tumor necrosis

factor-alpha (TNF-alpha), and the expression of inducible nitric

oxide synthase (iNOS) were investigated in activated RAW 264.7

cells. This compound markedly inhibited the production of NO, IL-

1beta and TNF-alpha, and suppressed the expression of iNOS in a

dose-dependent manner. These results suggest that the traditional

use of S. miltiorrhiza as an anti-inflammatory herbal medicine may

be explained, in part, by the inhibition of NO, IL-1beta, IL-6 and

TNF-alpha production, and expression of iNOS. PMID: 14735448

[PubMed - in process]

 

Altern Ther Health Med. 2004 Jan-Feb; 10(1): 58-63. | The

variability of TCM pattern diagnosis and herbal prescription on

rheumatoid arthritis patients. | Zhang GG, Lee WL, Lao L, Bausell

B, Berman B, Handwerger B. Center For Integrative Medicine,

School of Medicine, University of Maryland, Baltimore, USA. |

CONTEXT: The consistency of diagnosis made among Traditional

(TCM) practitioners and the relationship between

TCM diagnosis and Chinese herbal prescription have not been

adequately examined. OBJECTIVE: To investigate the degree of

consistency with which TCM diagnoses and herbal prescriptions

can be made by practitioners examining rheumatoid arthritis (RA)

patients. To survey TCM diagnostic patterns and to examine the

correlation between herbal prescriptions and these diagnoses for a

sample of RA patients. DESIGN: A prospective survey. SETTING:

General Clinical Research Center, University of Maryland Hospital

System, Baltimore, MD. PATIENTS: Rheumatoid arthritis patients.

PRACTITIONERS: Licensed acupuncturists with a minimum of 5

years licensure and education in Chinese herbs. METHODS: Three

TCM practitioners examined the same 39 RA patients separately,

following the traditional " Four Diagnostic Methods. " Patients filled

out a questionnaire to serve as the data for the " Inquiry "

component. They then underwent a physical examination, including

the tongue and pulse, conducted by each of the practitioners.

Based upon the examination results, each practitioner provided

both a TCM diagnosis and a herbal prescription. These

diagnoses/prescriptions were then examined with respect to the

rate of agreement among the 3 practitioners. RESULTS: The

average agreement with respect to the TCM diagnoses among the

3 pairs of TCM practitioners was 28.2% (25.6 to 33.3% with

kappas ranging from 0.23 to 0.30). The degree to which the herbal

prescriptions agreed with textbook recommended practice of each

TCM diagnosis was 93.2% (range = 87.2 to 100%). CONCLUSION:

The total agreement on TCM diagnosis on RA patients among 3

TCM practitioners was low. When less stringent, but theoretically

justifiable, criteria were employed, greater consensus was obtained

among the 3 practitioners. The correspondence between the TCM

diagnosis and the herbal formula prescribed for that diagnosis was

high, although there was little agreement among the 3 practitioners

with respect to the herbal formulas prescribed for individual

patients. PMID: 14727501 [PubMed - in process]

 

Life Sci. 2004 Feb 6; 74(12): 1503-11. | Tissue specific expression

and immunohistochemical localization of glutathione S-transferase

in streptozotocin induced diabetic rats: Modulation by Momordica

charantia (karela) extract. | Raza H, Ahmed I, John A. Department

of Biochemistry, Faculty of Medicine and Health Sciences, UAE

University, P.O. Box 17666, Al Ain, United Arab Emirates | In

streptozotocin (STZ)-induced diabetes, destruction of pancreatic

beta-cell causes an acute shortage of insulin. Increased oxidative

stress is believed to be one of the main factors in the etiology and

complications of diabetes. In this study we have reported

hyperglycemia and glutathione-associated oxidative stress in rats

one week after treatment with STZ. In our previous studies, we have

reported oxidative stress-related changes in xenobiotic metabolism

in tissues from STZ-induced chronic diabetic rats. Here, we

demonstrate by immunohistochemistry, that glutathione S-

transferase (GST) isoenzymes are differentially expressed in the

liver, kidney and testis of diabetic rats. The distribution of GST

isoenzymes was found to be tissue- and regio-specific. In addition,

we have also shown that treatment with an extract of Momordica

charantia (karela), an antidiabetic herb, modulates GST expression

in diabetic rats and reverts them to the normal distribution as seen

in the tissues of control rats. These results suggest that

glutathione metabolism and GST distribution in the tissues of

diabetic rats may play an important role in the etiology, pathology

and prevention of diabetes. PMID: 14729399 [PubMed - in process]

 

 

 

 

 

Best regards,

 

Email: <

 

WORK : Teagasc Research Management, Sandymount Ave., Dublin 4, Ireland

Mobile: 353-; [in the Republic: 0]

 

HOME : 1 Esker Lawns, Lucan, Dublin, Ireland

Tel : 353-; [in the Republic: 0]

WWW : http://homepage.eircom.net/~progers/searchap.htm

[Guest guest]

Looking for a practitioner in

 

Providence Rhode Island about 1 hour south of Boston, Mass.

 

for a patient suffering from Polycythemia Vera.

 

Treatment must include herbal medicine, preferrably raw herbs.

 

Thank you.

 

Simon Becker