Can external use of Chinese herbal medicine prevent cumulative peripheral neuropathy induced oxaliplatin? : a systematic literature review with meta-analysis

Background. Peripheral neurotoxicity caused by oxaliplatin (OXA) chemotherapy is the main limitation preventing continuation of chemotherapy in patients with gastrointestinal cancer. The purpose of this study was to determine the efficacy of external use of Chinese herbal medicine (CHM) on the incidence of cumulative OXA-induced peripheral neurotoxicity (OIPN). Method. Scientific literature databases were searched to identify controlled clinical trials analyzing CHM in OIPN. Clinical studies that included at least 1 relevant primary outcome were analyzed by 2 independent reviewers. Meta-analysis was performed on the software RevMan 5.3. Results. 700 cancer patients of 9 studies were reported, of whom 352 received external CHM and 348 received warm water baths, conventional medicine, or no intervention as controls. Neurotoxicity incidence (Levi grade ≥ 1) was significantly decreased in CHM group, compared with no intervention (P .05). Conclusion. External use of CHM may be beneficial in preventing the OXA-induced cumulative neurotoxicity. However, given the low quality of the evidence, the results should be interpreted with caution

Effects of electroacupuncture on the correlation between serum and central immunity in AD model animals

Objective. The goal was to investigate the connection between neuroinflammation in the brain and serum inflammatory markers as Alzheimer's disease progressed. We also sought to determine whether electroacupuncture had an effect on inflammatory markers found in blood and other brain regions. Methods. As an animal model for AD, we used senescence-accelerated mouse prone 8 (SAMP8) mice. To examine the effects and probable mechanism of electroacupuncture, we used HE staining, immunofluorescence staining, western blotting, and enzyme-linked immunosorbent assay. Results. Electroacupuncture therapy protected neurons, significantly downregulated the Iba-1 level in the hippocampus (p value was 0.003), frontal lobe cortex (p value was 0.042), and temporal lobe cortex (p value was 0.013) of the AD animal model, all of which had significantly lower levels of IL-6 (p value was 0.001), IL-1β (p value was 0.001), and TNF-α (p value was 0.001) in their serum. Conclusion. The amounts of IL-6, IL-1β, and TNF-α detected in the serum were strongly linked to the levels discovered in the hippocampus and the frontal lobes of the brain, respectively. A better understanding of the electroacupuncture process as well as the course of Alzheimer's disease and the therapeutic benefits of electroacupuncture may be gained by using biomarkers such as serum inflammatory marker biomarkers

The feasibility and effects of Qigong intervention (mind-body exercise) in cancer patients with insomnia : a pilot qualitative study

Background: Up to 80% of cancer patients experience insomnia that significantly affects their quality of life. This pilot qualitative study investigated the feasibility and effects of a 3-week Qigong (mind-body exercise) intervention with a 1-week follow-up in cancer patients experiencing insomnia. Methods: Cancer patients with insomnia who had completed radiotherapy or chemotherapy treatment and/or were at least 8weeks post-cancer-related surgery were recruited. Primary outcomes were feasibility outcomes, which included recruitment, retention, attendance, completion of assessment, adverse events and participant feedback via a questionnaire and focus group/individual interview. Secondary outcomes on insomnia severity and sleep quality were measured using the Insomnia Severity Index (ISI) and the Pittsburgh Sleep Quality Index (PSQI) at baseline, mid, post-intervention and follow-up. Results: Seven participants were recruited and two withdrew from the study. The participant retention rate was 71.4% with an overall attendance rate of more than 84% and participants were able to complete all required assessments. An adverse event relating to the worsening of existing musculoskeletal condition was reported. Qualitative analysis of participant feedback identified 4 emerging themes: (1) experience from Qigong intervention; (2) class preferences; (3) barriers to participation; and (4) recommendation for improvement. Participants reported increased relaxation, improved sleep and energy level, better upper body flexibility and reduced stress. Both ISI and PSQI scores improved significantly (P<.05). Conclusion: This study demonstrated that it is feasible to employ the current clinical trial design using Qigong intervention on insomnia in cancer patients. Preliminary data suggest that the intervention may improve sleep outcomes, however, these findings need to be confirmed by future robust randomized controlled trials

Exploring the safety, effectiveness, and cost-effectiveness of a Chinese patent medicine (Fufang E’jiao syrup) for alleviating cancer-related fatigue : a protocol for a randomized, double-blinded, placebo-controlled, multicenter trial

Objective: To provide higher level evidence on the benefits of a Chinese patent medicine (CPM) (Fufang E’jiao Syrup, FFEJS) for alleviating cancer-related fatigue (CRF), this article describes a protocol for a randomized controlled trial. Methods/design: We designed a double-blind, placebo-controlled stratified permuted block randomization clinical trial on CRF among 3 types of cancer in China. Participants will be equally allocated to FFEJS group or placebo group according to the randomization sequence and the hospitals they were enrolled at. Each patient will receive 20 ml of either the study formula FFEJS or a placebo formula, 3 times a day for 6 weeks. The follow-up period will be another 4 weeks for safety evaluation. The primary outcome is the difference in improvement of fatigue as measured with the Revised Piper Fatigue Scale-Chinese Version (RPFS-CV). Secondary outcomes include change in fatigue (measured by routine blood panel and hormones in peripheral blood) and QoL (measured by Edmonton symptom assessment scale and Functional Assessment of Cancer Therapy). Patient safety will be measured by liver, renal or cardiac damage, and the risk of FFEJS having a tumor promotion and progression effect will be monitored throughout this study. Cost-effectiveness will also be evaluated mainly by incremental cost per each quality-adjusted life year gained. Discussion: This article describes the study design of a CPM for CRF in patients with advanced cancer through exploring the effectiveness, safety, and cost-effectiveness of FFEJS. Trial registration: ClinicalTrials.gov, NCT04147312. Registered on 1 Sep 2019

Life-Cycle Consumption: Can Single Agent Models Get it Right?

In the quantitative macro literature, single agent models are heavily used to explain "per-adult equivalent" household data. In this paper, we study differences between consumption predictions from a single agent model and "adult equivalent" consumption predictions from a model where household size evolves deterministically over the life-cycle and affects individual preferences for consumption. Using a theoretical model we prove that, under mild conditions, these predictions are different. In particular, the single household model cannot explain patterns in life-cycle consumption profiles (the so called 'humps'), nor cross sectional inequality in consumption originating from the second model, even after controlling for household size using equivalence scales. Through a quantitative exercise, we then document that differences in predictions can be substantial: total (per-adult equivalent) consumption over the life-cycle can be up to 5% different, depending on the specific parameterization. We find a similar number for total cross sectional inequality

Acupuncture for cancer patients

The use of complementary and alternative medicine (CAM) amongst cancer patients or survivors is high, it was reported that the usage in general population in Australia ranges from 52 to 70% (Biddle, Wilkinson, & Simpson, 2003; MacLennan, Myers, & Taylor, 2006), acupuncture is one of the most commonly used complementary medicine therapies. In the United States, as part of integrative cancer care acupuncture is available for public in a number of cancer centres including Dana‐Farber Cancer Institute in Boston, Memorial Sloan‐Kettering Cancer Center in New York, and M.D. Anderson Cancer Center in Huston (Lu et al., 2009). There are a few conditions for which sound research has demonstrated acupuncture to effective and safe adjunct therapy for cancer care, this includes a variety of symptoms and conditions associated with cancer, for example cancer fatigue; adverse effects of conventional treatments such as chemotherapy‐induced nausea and vomiting are also often treated with acupuncture. Common reasons for use acupuncture reported by patients are for improving physical and emotional well‐being and boosting the immunity functions (Kremser et al., 2008; Molassiotis et al., 2005) Despite the popularity of acupuncture in cancer patients (de Valois, Young, Robinson, McCourt, & Maher, 2010) (Frisk, Kallstrom, Wall, Fredrikson, & Hammar, 2011; Lu et al., 2009), there has been poor communication between patients and medical carers (Lu et al., 2009). Patients and healthcare professionals need more information. This presentation aims to provide overview on use of acupuncture for cancer related conditions with information on the possible mechanisms of its effectiveness. Challenges with its application in the Australian health care contexts are also outlined

Effects of nonpharmacological interventions in chemotherapy-induced peripheral neuropathy : an overview of systematic reviews and meta-analyses

Introduction: Chemotherapy-induced peripheral neuropathy (CIPN) is one of the prevalent and disabling side effects of cancer treatment. However, management strategies for CIPN currently remain elusive, with treatment restricted to neuropathic pain medications, supportive care, and chemotherapy dosing adjustments. This overview explores evidence on the potential benefits and safety of nonpharmacological interventions in preventing and treating CIPN in cancer patients. Methods: Seven databases were searched for systematic reviews of randomized controlled trials (RCTs). The methodological quality of the selected reviews was assessed by AMSTAR 2, and the quality of evidence was judged by GRADE. Twenty-eight systematic reviews were considered eligible for this review. Results: It was found that nonpharmacological interventions (acupuncture, exercise, herbal medicine, nutritional supplements) provided potential benefits for patients with CIPN. Furthermore, Chinese herbal medicine, administered orally or externally, significantly prevented and/or relieved the incidence and severity of CIPN in comparison to control groups (no additional treatment, placebo, and conventional western medicine). However, the quality of evidence and strength of recommendations were compromised by the inconsistencies and imprecision of included studies. The main concerns regarding the quality of systematic reviews included the lack of sufficiently rigorous a priori protocols, and the lack of protocol registration adopted in the included studies. Conclusions: Though looking across reviews, Chinese herbal medicine appear generally effective in CIPN, uncertainty remains about the effects of many other nonpharmacological interventions. The evidence on what works was particularly compromised by reporting and methodological limitations, which requires further investigation to be more certain of their effects

Building up integrative approaches in cancer care with Chinese medicine in Australia

This abstract reports on building up integrative approaches in cancer care in Australia with Chinese medicine. Cancer is a common disease worldwide; it affects 1 in 2 Australians in their lifetime by the age of 85 and it is a leading cause of death in Australia. Although the life expectancy for many patients has been increasing because of improvements in early diagnosis and treatment, in turn, this has led to specific problems encountered by patients who experience adverse effects from conventional treatments and long-term cancer survivors for relapse and metastasis. Many turn to complementary and alternative medicine (CAM) including Chinese medicine (CM) for answers. Attempts with integrative oncology approaches have been made in many countries; this includes government funded medical schemes allowing access of acupuncture and herbal medicine in public hospitals in China; and acupuncture is made available for public access in prestigious medical oncology centres in America. Despite there has been tremendous public interest in and use of CM; acceptance from the medical professionals and access for patients to quality service with integrative care in Australia is limited. This research initiative aims to explore an integrated model of health-care provision in effective cancer care in Australia through conducting various research activities and projects. Under this research theme, the goal of research activities is to establish formal dialogues between medical oncologists in Australia and integrative oncologists in China. The purposes of research projects are to investigate potential effectiveness and safety of CM for managing treatment related side effects; and to understand the perceptions of patients and CM practitioners who treat cancer patients in Australia

Chinese herbal medicine for menopausal symptoms (Review)

Background: Menopause usually takes place when a woman is around 51 years of age. Women can experience symptoms such as hot flushes, sweats, poor sleep, joint pains, anxiousness, dry skin and vagina when the organs which produce female hormones slow down. Usually hormone therapy (HT) is prescribed to reduce the symptoms. Due to concerns on long term use of HT resulting in adverse effects, women have been looking for alternative treatments to relieve their symptoms. Chinese herbal medicines (CHM) is one of the popular choices. Although CHM has been used for a very long time clinically, its effectiveness and long-term safety remained unanswered from a scientific perspective. Study characteristics: This review examined 22 randomised clinical trials where 2902 women took part in the studies; 1499 in the CHM group and 1403 in the control group which might include a placebo (non-active compound made to look, taste and smell the same as the study compound) or a drug or HT or another CHM formula (different from the one being tested). Most of the studies had a trial period for 12 weeks. The data are current to March 2015. Key results: We found insufficient evidence that CHM were any more or less effective than placebo or HT for the relief of vasomotor symptoms. Adverse effects were not well reported, some women taking CHM reported mild diarrhoea, breast tenderness, gastric discomfort and an unpleasant taste. Effects on safety were inconclusive

Chinese herbal medicine for opioid induced constipation in cancer patients : protocol for a systematic review

Background: Opioid induced constipation (OIC) is a symptom that is commonly encountered in cancer pain management. Chinese herbal medicine (CHM) has been widely used to improve OIC in China. Many clinical trials indicate that CHM could improve OIC. In this systematic review, we aim to evaluate the effectiveness and safety of CHM for OIC in cancer patients. Methods: We will search the following electronic databases for randomized controlled trials to evaluate the effectiveness and safety of CHM for OIC in cancer patients: Central, Embase, Mediline, Cinahl and China National Knowledge Infrastructure. Each database will be searched from inception to June 2018. The entire process will include study selection, data extraction, risk of bias assessment and meta-analyses. Results: This proposed study will evaluate the effectiveness and safety of CHM for OIC. The outcomes will include change in bowel movements, quality of life and adverse events. Conclusions: This proposed systematic review will evaluate the existing evidence on the effectiveness and safety of CHM for OIC in cancer patients. Dissemination and ethics: The results of this review will be disseminated through peer-reviewed publication. Because all of the data used in this systematic review and meta-analysis has been published, this review does not require ethical approval. Furthermore, all data will be analyzed anonymously during the review process