Duhuo Jisheng Tang for treating osteoarthritis of the knee: a prospective clinical observation

Abstract

BackgroundLittle scientific evidence supports the efficacy of herbal medicines in the treatment of degenerative arthritis of the knee. The purpose of this study is to evaluate both the efficacy and safety of a finished Chinese herbal preparation Duhuo Jisheng Tang (DJT) in reducing symptoms of degenerative osteoarthritis of the knee.MethodsA prospective follow-up study was carried out in two hospitals in Taipei between April and October 2005. Sixty-eight osteoarthritis patients, with symptoms diagnosed by radiologists, received DJT at a rate of 2.5 g, twice daily for four weeks. Baseline scores were measured on the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, followed by further measures at the end of weeks 1, 2 and 4. The World Health Organization Quality of Life (WHOQOL) assessment was undertaken as a secondary outcome, with pattern identification questionnaires being adopted. Regression models were constructed to explore the score differences between the baseline and at weeks 2 and 4 by various determinants including age, gender, body mass index (BMI), severity at baseline, use of rescue medication, aversion to cold and flaccidity of the lower back and knees.ResultsAmong the 68 participants, there were statistically significant reductions in the WOMAC index scores for pain, stiffness and physical functioning in the second and fourth weeks, with effects first appearing during week 2. By week 4, the mean WOMAC index scores had fallen from 22.2 (± 19.2) to 16.1 (± 16.2) for pain, from 28.1 (± 24.9) to 18.5 (± 20.3) for stiffness, and from 22.6 (± 18.0) to 18.2 (± 17.8) for physical functioning, while the global score for pain under the visual analogue scale (VAS) was reduced from 38.7 (± 21.5) to 27.8 (± 19.8).ConclusionIn the treatment of degenerative osteoarthritis of the knee, a 4-week therapy with the Chinese herbal preparation DJT reduced pain and stiffness and improved physical functioning, but it was less effective in treating flaccidity and aversion to cold.

Duhuo Jisheng Decoction-containing serum promotes proliferation of interleukin-1β-induced chondrocytes through the p16-cyclin D1/CDK4-Rb pathway

“…Duhuo Jisheng Decoction (DHJSD), initially documented in the book Bei Ji Qian Jin Yao Fang (20), is composed of the following ingredients: Angelica pubescens; Saposhnikovia divaricata; L igust icu m chu a n xiong; Achyra nthes bidenta ta; L o ra n t h u s p a ra s i t i c u s; G e n t i a n a m a c rop h yll a; Eucommia ulmoides; Angelicae sinensis; Poria cocos; Codonopsis pilosula; radix Rehmannia preparata; radix Paeoniae alba; Asarum sieboldii; Glycyrrhiza uralensis; and Cinnamomum cassia. It has been widely used for treating OA (21), and a previous study indicated that DHJSD contains drug-and lead-like compounds with potential synergy and polypharmacology against OA (22). An in vivo study demonstrated that treatment with DHJSD promotes the progression of chondrocytes from G 1 to S phase (23), and this may be one of the mechanisms underlying its use in OA.…”

Frequencies and prescription patterns of traditional Chinese medicine use among elderly patients in Taiwan: A population-based study

“…This formula was used to treat a combination of symptoms, such as stiffness, flaccidity, pain, and aversion to cold of the knee. The outcome of a 4-week prospective clinical research study has demonstrated the effectiveness of this formula in relieving stiffness and pain in the knee joint and improving physical function in osteoarthritis patients (Lai et al, 2007). An experimental study showed that Du-Huo-Ji-Sheng-Tang could regulate the expression of the vascular endothelial growth factor mRNA and hypoxia-inducible factor -1α mRNA and inhibit chondrocyte apoptosis in an animal model (Chen et al, 2011a).…”

Prescription pattern of traditional Chinese medicine for climacteric women in Taiwan

“…Based on an ancient TCM book, these symptoms signify disharmony caused by 'Wind', 'Cold' and 'Dampness' and can be improved by Du-huo-jisheng-tang 12 . In fact, we have conducted a 4week outcome research, which demonstrated its effectiveness in reducing pain and stiffness of the knee joint and improving physical function for osteoarthritis 13 . Future research is still needed to provide more evidence for the safety and efficacy of these medications.…”