Traditional Chinese medicine for gouty arthritis

Abstract

Background: Gouty arthritis (GA) is a chronic disease caused by monosodium urate crystal deposition. Repeated attacks of arthritis may lead to the deposition of urate to form gout stone, resulting in joint deformity and joint damage. Although GA is not fatal, it causes low work productivity and low quality of life. Western drug, such as febuxostat, colchicine, allopurinol, often cannot get satisfying curative effect, and may even lead to serious side effects, such as exfoliative dermatitis or uremia. However, the therapeutic effect of Traditional Chinese medicine is very satisfactory. The treatment effect of simiao powder, a Chinese patent medicine, combined with acupuncture was widely used on treatment of GA. Although it has been widely used in clinical practice, its relative effectiveness and safety have not been confirmed. Therefore, this study will use meta-analysis to verify the efficacy and safety of simiao powder combined with acupuncture in the treatment of GA. Methods: All randomized controlled trial of simiao powder combined with acupuncture for the treatment of RA from their inception 29 October, 2020 will be searched form the China National Knowledge Infrastructure, Wanfang Database, Chinese Science and Technology Periodical Database, Chinese Biomedical Literature Database, Pubmed, Embase, Web of Science, and the Cochrane library. Two authors will independently select studies, extract data based on pre-designed inclusion and exclusion criteria. Methodological quality assessment and risk of bias will be assessed using Cochrane bias risk tool. All data analysis will be conducted using Revman5.3, WinBUGS 1.4.3, and Stata14.2 software. Results: We will compare the different outcome indicators of various studies to provide a synthesis of the efficacy and safety of Simiao powder combined with acupuncture for GA patients. The main outcome measures included efficacy, remission rate (no drug symptoms), recurrence rate, clinical absolute score and relative score. Secondary outcome measures included related adverse reactions and uric acid concentration. Conclusion: The findings of the study will provide helpful evidence for the efficacy and safety of simiao powder combined with acupuncture in the treatment of GA. Registration number: This study protocol have been funded through a protocol registry. The registry number is INPLASY2020110028

Exploring effect of herbal monomers in treating gouty arthritis based on nuclear factor-kappa B signaling: A review

“…Compared with the current main treatment drugs for GA, Chinese medicine monomers are gradually being favored by clinicians and patients because of their extremely mild side effects and good efficacy. [99,100] Overall, NF-κB and its related targets have become a research hotspot in GA. Canonical NF-κB is activated by a variety of stimuli, has rapid transcription but short-lived activity, and can regulate the expression of various pro-inflammatory genes. [101] As a key mediator of the inflammatory response, NF-κB has been regarded as an important therapeutic target for the treatment of inflammatory diseases.…”

“…Compared with the current main treatment drugs for GA, Chinese medicine monomers are gradually being favored by clinicians and patients because of their extremely mild side effects and good efficacy. [ 99 , 100 ]…”

Anti-inflammation is an important way that Qingre-Huazhuo-Jiangsuan recipe treats acute gouty arthritis

“…The most widely used TCM treatments for GA are acupuncture and the Chinese herbal medicine Si-Miao-San ( Chi et al, 2020 ; Pu et al, 2021 ). Acupuncture is based on the theory of meridians, while SMS is a combination of four herbs that have been used to treat GA for over 1,000 years ( Chi et al, 2020 ; Pu et al, 2021 ), SMS can significantly improve the symptoms of acute arthritis in gout patients, and its curative effect is not lower than colchicine, with small side effects ( Chi et al, 2020 ; Pu et al, 2021 ). SMS is effective in the treatment of GA through anti-inflammation and lowering urate ( Chi et al, 2020 ; Pu et al, 2021 ).…”

“…Acupuncture is based on the theory of meridians, while SMS is a combination of four herbs that have been used to treat GA for over 1,000 years ( Chi et al, 2020 ; Pu et al, 2021 ), SMS can significantly improve the symptoms of acute arthritis in gout patients, and its curative effect is not lower than colchicine, with small side effects ( Chi et al, 2020 ; Pu et al, 2021 ). SMS is effective in the treatment of GA through anti-inflammation and lowering urate ( Chi et al, 2020 ; Pu et al, 2021 ). Acupuncture treatment for GA involves the ing spleen, to the unifying kidney, dissipating dampness, resolving blood stasis, clearing away heat, and removing toxins ( Chi et al, 2020 ; Pu et al, 2021 ).…”

“…SMS is effective in the treatment of GA through anti-inflammation and lowering urate ( Chi et al, 2020 ; Pu et al, 2021 ). Acupuncture treatment for GA involves the ing spleen, to the unifying kidney, dissipating dampness, resolving blood stasis, clearing away heat, and removing toxins ( Chi et al, 2020 ; Pu et al, 2021 ). Qingre-Huazhuo-Jiangsuan Recipe (QHJR), one of the TCM prescriptions, is prepared based on the classic TCM prescription Si-Miao-San that can be empirically adopted for treating GA during the clinical practice of TCM ( Fan et al, 2010 ).…”