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In the Zone
A Professional Resource in Oriental Medicine |
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Disclaimer: This research information is provided to licensed healthcare practitioners and is based upon third party literature that has been published on medical journals. This newsletter is not associated with the sale of any commercial products. The views and opinions expressed in these research articles are those of the authors and do not necessarily reflect any individuals or the company involved in preparation and publishing of this newsletter. |
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Dear TCMzone Member,
Xiao Yao San is a classical Chinese herbal formula published in 1087 in Imperial Grace Formulary of the Tai Ping Era (Tai Ping Hui Min He Ji Ju Fang). Traditionally, it is used for Liver Qi stagnation with Blood deficiency. Clinically, it is used mostly in depression-related diseases in Chinese medicine. A recent systematic review of 26 randomized clinical trials (involving 1837 patients) of Xiao Yao San revealed its effectiveness on depression (see below).
Jia Wei Xiao Yao San (JWXYS) is a modified version of Xiao Yao San recorded in 1602 in Rules of Conformation and Therapy (Zheng Zhi Zhun Sheng). Recently, it has been studied for its usage in functional dyspepsia (FD), a gastrointestinal disorder that affects an estimated 20% of Americans. One of the conventional treatments of FD is low dose anti-depressant drugs. A randomized clinical trial funded by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) is currently underway to examine the effectiveness and mechanisms of the tricyclic antidepressant amitriptyline and the selective serotonin-reuptake inhibitor (SSRI) escitalopram in functional dyspepsia. Interestingly, many studies already conducted in the Chinese medicine field have shown that JWXYS, a commonly used herbal formula for depression-related disorders, may have beneficial roles in FD. A meta-analysis of multiple clinical trials showed that JWXYS is more effective compared to prokinetic drugs in the treatment of FD. A clinical study of 20 patients with FD indicated that the formula improved the symptoms as well as electrogastrography (EGG). Please read on below for details of the studies. |
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Research Updates
Chinese herbal formula Xiao Yao San for treatment of depression: a systematic review of randomized controlled trials.
Objectives: To assess the beneficial and adverse effects of Xiaoyaosan for depression. Inclusion Criteria: We included randomized clinical trials testing Xiaoyaosan against placebo, antidepressants, or combined with antidepressants against antidepressants alone. Data analyses were conducted according to the Cochrane standards. Results: 26 randomized trials (involving 1837 patients) were included and the methodological quality was evaluated as generally low. The pooled results showed that Xiaoyaosan combined with antidepressants was more effective in comprehensive effect, the score of Hamilton Rating Scale for Depression (HAMD) and the score of Self-Rating Depression Scale (SDS) compared with antidepressants alone. Xiaoyaosan was superior to antidepressants for the score of HAMD. However, Xiaoyaosan was not different from placebo for the score of SDS. There was no adverse effect reported in the trials from Xiaoyaosan. Conclusions: Xiaoyaosan appears to be effective on improving symptoms in patients with depression.
Zhang Y, et al.: Evid Based Complement Alternat Med. 2012;2012:931636.
(http://www.ncbi.nlm.nih.gov/pubmed/21869903)
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Chinese herbal medicine modified xiaoyao san for functional dyspepsia: meta-analysis of randomized controlled trials.
BACKGROUND: To critically assess the evidence of modified xiaoyao san (MXS) for treating functional dyspepsia (FD). METHODS: Systematic literature searches were carried out on the Medline database, CNKI database, Wanfang Data, VIP Information and the Cochrane Library. All randomized clinical trials of MXS for treating FD were included. Weighted means and 95% confidence intervals were calculated and sensitivity analyses were carried out. RESULTS: Thirty-three potentially relevant articles were retrieved for further evaluation. Fourteen were suitable for inclusion in the meta-analysis. There was evidence that MXS compared with prokinetic drugs reduced symptoms (odds ratio 3.26, 95% CI 2.24 to 4. 47). There was evidence that MXS + prokinetic drugs compared with prokinetic drugs reduced symptoms (odds ratio 4.32, 95% CI 2.64 to 7.08). CONCLUSION: MXS appears to be more effective compared to prokinetic drugs in the treatment of FD and no serious side-effects were identified. However, the evidence remains weak due to publication bias and methodological flaws, which may amplify the therapeutic benefit of MXS.
Qin F, et al.: J Gastroenterol Hepatol. 2009 Aug;24(8):1320-5 (http://www.ncbi.nlm.nih.gov/pubmed/19702899)
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Study on the effect of Jia-Wei-Xiao-Yao-San decoction on patients with functional dyspepsia
The effect of Jia-Wei-Xiao-Yao-San (JWXYS) decoction on patients with functional dyspepsia was studied by means of electrogastrography (EGG) and symptoms of dyspepsia were assessed. Twenty patients with functional dyspepsia were selected; before and after internal treatment with JWXYS, the integrated symptoms of the patients were down-regulated from 18.55 +/- 3.24 (before treatment) to 11.65 +/- 2.37 (after treatment) (p < 0.01); electrogastrography showed that all the EGG parameters of the patients were outside the normal range. After treatment with JWXYS, all these indices improved before and after dinner. The results showed that the JWXYS decoction not only improves the symptoms, but also adjusts the abnormal gastric motility and gastric myoelectrical activity of patients with functional dyspepsia.
Qu Y, et al.: Phytother Res. 2010 Feb;24(2):245-8. ( http://www.ncbi.nlm.nih.gov/pubmed/19610028) |
Coming up: TCMzone Lunchtime Webinars on Gastrointestinal and Liver Disorders
by Dr. Haihe Tian, Ph.D., A.P., M.D. (China), Professor
TCM Treatment for Hepatitis C and Related Complications, Nov 2, 2011
12-2pm EST, 2 PDA/CEU's (NCCAOM, FL & CA Board Approved), $25/Session
- 11/2/11: TCM Treatment for Hepatitis C and Related Complications
- 11/9/11: TCM Treatment for Crohn's Disease
- 11/16/11: The Use of Acupuncture and Herbal Medicine in Common Digestive Symptoms
- 11/30/11: The Role of TCM & Acupuncture in Treating Cancer Patients during Chemotherapy
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*The information provided here is for healthcare professional practitioners only. These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.
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