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Chinese herbal medicine may help in functional recovery in gout patients, while safely controlling serum uric acid level and inflammation severity.
This systematic review evaluated a total of 57 randomized clinical trials on Chinese herbal medicine for gout up to December 2012, involving 4,527 patients. The methodology employed the Cochrane risk of bias tool to assess the quality of these trials and used RevMan 5.2 software to synthesize results. However, the overall quality of these trials was generally poor and none reported on health-related quality of life in patients.
Through the trials evaluated, it was found that Chinese herbal medicine may not be significantly more effective than conventional medicines in terms of pain relief. However, when combined with conventional medicines, herbal medicine may exhibit better effectiveness. In trials that reported relief from function limitations, herbal remedies showed improved efficacy over standard treatments. However, there was no evidence to suggest that herbal medicine could prevent recurrence of gout. In closing, the review noted that 25 trials out of 41 found significance in lowering serum uric acid levels through the use of Chinese herbal medicine. Further, herbal medicine seemed more effective in inflammation relief when compared to conventional therapies. Importantly, data suggested the herbal treatments resulted in fewer side reactions as compared to conventional treatment methods.
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Guizhi Shaoyao Zhimu Decoction was more effective and had fewer adverse reactions compared to the control group in the treatment of gout and the combined use of modified GSZD with other treatments showed decreased levels of C-reactive protein and erythrocyte sedimentation rate.
2022 Pharmacological Research - Modern Chinese Medicine Modified Guizhi Shaoyao Zhimu Decoction in the treatment of gout: A systematic review and meta-analysis Liu H, Chi X, Zhang H, Shi H, Pan J, Wang Y, et al.
Systematic Review Gout Gui Zhi Shao Yao Zhi Mu Decoction
This meta-analysis of 22 randomized controlled trials showed that Guizhi Shaoyao Zhimu Decoction (GSZD) was more effective and had lower adverse reactions compared to the control group for gout, and the combined use of modified GSZD with other treatments showed significant decreases in C-reactive protein and erythrocyte sedimentation rate levels.
Traditional Chinese medicine exhibits fewer side effects while effectively controlling inflammation and serum uric acid in gout patients.
2022 Journal of Pharmacy and Pharmacology Phytochemicals in traditional Chinese medicine can treat gout by regulating intestinal flora through inactivating NLRP3 and inhibiting XOD activity Liu ZQ, Sun X, Liu ZB, Zhang T, Zhang LL, Wu CJ
Gout Intestinal Flora
In the methodology, the research used herbs as a primary resource, focusing on their phytochemicals. The study examined how these phytochemicals exert anti-inflammatory effects by inactivating the NF-κB and NLRP3 inflammasome, as well as lowering uric acid through the inhibition of xanthine oxidase activity and the up-regulation of URAT1 and GLUT9 expressions. Further, the study explored the relation of changes in intestinal flora and gout, with Chinese herbs acting like prebiotics to modify this flora.
In terms of results, the study found an increase in the abundance of certain beneficial bacteria, such as Bifidobacterium, Lactobacillus, Bacteroidetes, and Prevotella, and a decrease in Proteus and the Firmicutes/Bacteroidetes ratio post traditional Chinese medicine treatment. The alterations in the intestinal flora led to changes in its metabolites, which eventually impacted inflammatory signaling pathways, regulating gene expressions and suppressing xanthine oxidase activity. The study also observed the relation between the disruption of the intestinal barrier and the onset of gout.
Turmeric curcuminoids are associated with better pain relief than NSAIDs in knee osteoarthritis.
2021 Complementary Therapies in Medicine The efficacy of high- and low-dose curcumin in knee osteoarthritis: A systematic review and meta-analysis An-Fang Hsiao, Yi-Chieh Lien, I-Shiang Tzeng, Chien-Ting Liu, Sheng-Hsun Chou, Yi-Shiung Horng
Systematic Review Knee Osteoarthritis Turmeric
The meta-analysis results showed that curcuminoids were significantly more effective than comparators regarding visual analogue scale (VAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain scores.
However, no significant difference in pain relief or AEs between the high-dose (daily dose ≥1000 mg or total dose ≥42 gm) and low-dose (daily dose <1000 mg or total dose <42 gm) curcuminoid treatments was observed.
When comparing curcumininoids versus NSAIDs, a significant difference in VAS pain was found. For AE analysis, three of our included studies used NSAIDs as comparators, with all reporting higher AE rates in the NSAID group, though significance was reached in only one study.
Green tea catechins potentially contribute to maintaining joint and skeletal muscle health, mitigating symptoms of osteoarthritis and sarcopenia.
2020 Antioxidants Impacts of Green Tea on Joint and Skeletal Muscle Health: Prospects of Translational Nutrition Luk HY, Appell C, Chyu MC, Chen CH, Wang CY, Yang RS, et al.
Review Article Green Tea Green Tea Catechin Osteoarthritis
The research begins by providing an understanding of osteoarthritis, a degenerative inflammatory disorder of articular cartilage, and sarcopenia, a condition characterized by loss of muscle mass and strength. It explores their prevalence, causes such as excessive inflammation and oxidative stress, mitochondrial dysfunction, and diminished autophagy. It then delves into the role of green tea catechins in joint health, including their influence on inflammatory signaling agents, anabolic mediators, and miRNAs expression.
This leads to a decrease in chondrocyte death and collagen degradation, thereby offering cartilage protection. The investigation also examines the effects of green tea catechins on skeletal muscle health. It highlights their role in maintaining an equilibrium between protein synthesis and degradation, and enhancing the synthesis of mitochondrial energy metabolism.
The review thus suggests a positive impact of green tea catechins on joint and muscle health, helping to maintain favorable muscle homeostasis and reduce muscle atrophy associated with aging. It ends by pointing out the limitations of the current study and proposing future research directions.
DKB114, a mixture of Linn flower extract, effectively reduces serum uric acid level, suggesting its potential as a dietary supplement for hyperuricemia treatment.
2020 Nutrients A 12-Week, Multicenter, Randomized, Double-Blind, Placebo-Controlled Clinical Trial for Evaluation of the Efficacy and Safety of DKB114 on Reduction of Uric Acid in Serum Park YH, Kim DH, Lee JS, Jeong HI, Lee KW, Kang TH
Randomised Controlled Trial Gout Hyperuricemia Uric Acid
The research employed a randomized, double-blind, placebo-controlled clinical trial conducted across a span of 12 weeks. A total of 80 asymptomatic hyperuricemic subjects (serum uric acid level between 7.0-9.0 mg/dL) were selected and equally split into two groups. One group was administered DKB114, the investigational mixture of extracts, while the other group received a placebo.
After six weeks of administration, the levels of serum uric acid were evaluated, revealing no significant difference between the two groups. By the end of the 12th week, however, subjects in the DKB114 group exhibited a noticeably larger decrease in their serum uric acid levels when compared to the placebo group. Additionally, various other health indicators including C-reactive protein and apoprotein B levels showed significant trends favoring DKB114.
Further evaluations during the trial included clinical pathological tests, weight measurements and vital signs, and electrocardiogram tests which confirmed the safety of DKB114. No significant harmful effects or differences were detected in comparison to the placebo group. This concludes the positive impact and safe use of DKB114 for patients with elevated serum uric acid levels.
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