History of Medicine, Placebo

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History, aims and present structure of psychosomatic medicine in Germany

History, aims and present structure of psychosomatic medicine in Germany

understood by a holistic psychosomatic perspective. The physician ’ s way of acting on patient satisfaction and on treatment outcome consists of three elements: (1) hands on diagnostic examination ( “ be-handeln ” in German), (2) carry through or organize different additional examinations through colleagues and (3) to communicate and understand patient needs ( “ be-nennen ” - give them a name) and explain diagnostic and therapeutic activities. Physicians in specialties like internal medicine are involved in basic internal care. Interactions between physician and patient are part of their treatment. The special knowledge, experiences, and skills in internal medicine, as well as the communication and behavior of a physician, influence this treatment effect. Thus, societies of internal medicine, psychosomatic internal medicine (like JSPIM), and integrative internal and other specialties (like DKPM) and partly DGPM (which has developed a special training (P. Janssen) are involved in basic care and psychosomatic basic care. Psychotherapists implement additionally verbal, suggestive, or hypnotic therapeutic techniques, which is in depression on a group level not more effective than psychopharmacology. The mean effect size (ES) of psychotherapy compared to no treatment (or treatment as usual) was shown in 15 controlled studies of different diseases to have an ES of .80, but placebo compared to no treatment had an ES of .42, in psycho-diagnostic measurements [9]. Placebo research has taught us that behavior, intake of placebo drugs, or bodily handling have a treatment effect in different diseases. These methods are used by GP’s and other specialties less trained in
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The efficacy and safety of Danggui Sayuk Ga Osuyu Saenggang tang on Korean patients with cold hypersensitivity in the hands: study protocol for a pilot, double blind, randomized, placebo controlled, parallel group clinical trial

The efficacy and safety of Danggui Sayuk Ga Osuyu Saenggang tang on Korean patients with cold hypersensitivity in the hands: study protocol for a pilot, double blind, randomized, placebo controlled, parallel group clinical trial

cold and tonify the blood in order to enhance the healing capacity of the body system from cold damage [11]. Nishida et al. [12] found that DSGOST treatment for 8 weeks helped to improve the severity of peripheral coldness and blood flow in female Japanese patients. In our research team, we also found that DSGOST relaxes both the endothelial and vascular smooth muscle cells by inhibiting cold-induced activation of the Ras homolog gene family member A (RhoA) and blocks the endothelin-1-mediated paracrine pathway for the cold response in blood vessels [13]. Although it has a long history of use for CHH, there has been no clinical trial performed to evaluate the potential efficacy of DSGOST in the Korean population. For that reason, through this multicenter, randomized, placebo-controlled trial with participant and investiga- tor blinding, we will examine the feasibility of a full randomized clinical trial of DSGOST on Korean fe- male patients with CHH in order to provide more convincing evidence for the treatment of CHH using herbal medicine.
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Chinese herbal medicine for impaired glucose tolerance: a randomized placebo controlled trial

Chinese herbal medicine for impaired glucose tolerance: a randomized placebo controlled trial

and was defined for the purpose of this study as people diagnosed within the last five years, whose diabetes was diet and exercise controlled and were not on any medication to control their blood glucose levels. Selection criteria were designed to ensure a heterogeneous population. We excluded individuals with conditions or treatments that would interfere with participation or completion of the protocol such as an underlying disease likely to limit life span or increase the risk of the intervention, or that had a confounding effect on the outcomes of the study, such as medication or a disease related to metabolism such as Cushing's syndrome. Baseline characteristics on age, sex, ethnicity, family history of diabetes, history of hypertension, smoking or use of cholesterol lowering or anti-hypertensive medication were collected at enrolment using an interviewer administered questionnaire.
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HISTORY OF INDIAN TRADITIONAL MEDICINE: A MEDICAL INHERITANCE

HISTORY OF INDIAN TRADITIONAL MEDICINE: A MEDICAL INHERITANCE

In 2013, the homeopathic pathogenetic pilot test for Hepatitis C (Hep C) nosode experiment has been led by Dr. Shah with the volunteers prepared to compose data in prescribed questionnaires and information were investigated. A fifteen-stage technique was used as a part of the planning of Hep C nosode (Genotype I and III), permitting future preparation of an indistinguishable nosode. 22 volunteers were entered, 15 got Hep C nosode in 30c potency, 7 got a placebo, and once per week for a month. The conclusion was that “an enhanced technique for nosode preparation utilized for a double- blind, randomized placebo-controlled pathogenetic trial of the Hep C nosode produced indications, which may encourage its remedy. The nosode ought to be additionally investigated for the treatment of immunologically mediated illnesses, diseases including Hep C, fibrotic pathology, and chronic inflammatory disorders [60]. Pediatrics published the outcome of a Randomized Controlled Trials treatment in children with the looseness of the bowels in Nicaragua. The treatment group had a statistically significant decrease in duration of looseness of the bowels (p<0.05) and the quantity of stool every day between the two groups after 72 h of treatment (p<0.05) [61]. There are innumerable confirmations which propose the herbals drugs cure the illnesses for many centuries and are affordable, ready-to-use for health-care services. Yet, Western medicine was dominated during the British period despite the strength and public faith in these systems of medicine, after the foundation of 1 st Asian Medical College and Hospital,
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Comparison of veterinary drugs and veterinary homeopathy: part 2

Comparison of veterinary drugs and veterinary homeopathy: part 2

The pharmacological basis of therapeutics is, in virtually every respect, the opposite of homeopathy. In the great majority of cases it is based on increased effect provided by increased dose or concen- tration up to a ceiling, the maximum attainable response. Doses are determined by the application of data on each drug’s pharmacody- namic and pharmacokinetic properties, established on a species basis. Additionally, increasingly recognised is the need sometimes to adapt dose not only for bodyweight but also for disease severity, condition of animal, as well as age and breed differences in pharmacodynamics and pharmacokinetics. Drug-based therapeutics emerged by evolu- tionary processes from Materia Medica, which it has supplanted, and it will continue to evolve with advances in clinical and non-clinical sciences. As reviewed in this article, there are many disadvantages to the use of drug-based products in veterinary medicine. However, their benefits and their side effects are based on principles compatible with modern scientific knowledge. They are subject to rigorous evaluation for quality, safety and efficacy by regulatory authorities (unlike home- opathic remedies; see supplemental material for this article). They have contributed greatly to animal welfare and the relief of suffering. Supplementary material
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The efficacy and safety of herbal medicine BHH10 in postmenopausal women with osteoporosis: study protocol for a phase II, multicenter, randomized, double blinded, placebo controlled clinical trial

The efficacy and safety of herbal medicine BHH10 in postmenopausal women with osteoporosis: study protocol for a phase II, multicenter, randomized, double blinded, placebo controlled clinical trial

According to traditional Korean medicine, kidney dys- function can cause osteoporosis by inhibiting bone metabolism and decreasing the level of estrogen [9]. Herbal medicines targeted at the kidney, such as jasinhwan, are already used to treat osteoporosis [10]. BHH10 is an herbal medicine derived from jasinhwan and consists of the roots of Astragalus membranaceus (Mongolian milkvetch), twigs of Cinnamomum cassia (Chinese cassia or Chinese cinnamon), and the bark of Phellodendron amurense (Amur cork tree). BHH10 has been shown to regulate bone resorption and improve bone mineral density (BMD) without toxic effects in ovariectomized rats [11].
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AN INTRODUCTION TO THE HISTORY OF MEDICINE IN ISLAM AND IRAN

AN INTRODUCTION TO THE HISTORY OF MEDICINE IN ISLAM AND IRAN

basic principles of hygiene such as keeping away from patients with contagious diseases, using private tooth brush and towel, clipping nails, combing, removing superfluous hair from the body, using clean dress, washing away excess perspiration, avoiding gluttony, having meals on time, keeping a Iplanced physiological pattern, dividing hours of the day for working, wor­ shipping, and sleeping, and many other instructions that are among the miracles of Islam. Today after fourteen centuries these instructions that were brought up by an unlettered man from among nomad desert people are still weighty and will hold valid. There is no easier way to make human beings observe hygiene. Furthermore, the respect paid by Messenger of Islam (PBUH) and the holy Imams for physicians and medic­ al instructions set a pattern for the faithful. Art of friendship and encouragement of education in general, and attaching importance to medicine in particular, led to the development of the Islamic medicine as one of the most outstanding branches of the Islamic science and civilization. Physicians and researchers of the Islamic world began to collect and translate the books and medical articles of other nations into Arabic language. In fact, it may also be said that the Islamic medicine is a mixture of Hippocratic and Galenic traditions and Greek medicine, as well as the theories and practical aspects of the Iranian and Indian medi­ cine_
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The History of Colonial Science and Medicine in British India: Centre Periphery Perspective

The History of Colonial Science and Medicine in British India: Centre Periphery Perspective

It is very clear then that scholars are quick to identify the inadequacy in Basalla’s thesis. In this scenario, a good many histories of colonial science and medicine in India come to enquire how the scientific ideas are circulated and raise several new questions. Despite differences between their respective points of view, they all suggest that the interminable story of the diffusion and absorption of modern science and medicine as only a Western cultural import is inadequate. It misses out the multifarious nature of transmission of knowledge between South Asians and Europeans. one of the pioneers in this genre, Deepak Kumar explores the intricate connection between imperialism and science and analyses the process whereby an ‘alien’ system of knowledge, methods and tools have truly become indigenised (Kumar, 1980; 1996; 2000; 2004; 2006). Although, Kumar’s writings lavishly deal with various theories of diffusion and exchange, invoking such names as Basalla, Michael Worboys, Macleod, Sangwan and Krishna, his empirical works often are not geared to the modification or advancement of such theoretical insights (Kumar, 1980, pp. 105-113; 2006, pp. 1-31). Elsewhere, Kumar showed that a number of European physicians visited pre-colonial India and wrote extensively on Indian disease condition and therapeutics. As they failed to develop a comprehensive aetiology of maladies, concluded that Indian diseases were environmentally determined and should be treated by Indian methods. They, however, continued to look at the Indian practices with curiosity and disdain, but regarding use of drugs Europeans and Indians both learned from each other (Kumar, 2001, pp. xvi-xvii; 2010, p. 263; 2011, pp. 236- 237). But during the high noon of colonial rule this type of ‘synergetic’ relationship between the ‘micro-parasites’ and the ‘macro-parasites’ was far
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Testosterone therapy and cardiovascular events among men: a systematic review and meta-analysis of placebo-controlled randomized trials

Testosterone therapy and cardiovascular events among men: a systematic review and meta-analysis of placebo-controlled randomized trials

From a clinical perspective the issue is ensuring that the benefits of testosterone therapy outweigh the potential risks. Almost a decade after the IOM’s report [12] the effi- cacy of testosterone therapy for health outcomes where treatments are not already available remains uncertain. Testosterone compared to placebo could be beneficial for glucose metabolism [65], depression [87,88], sexual dysfunction [26,89], bone density [90] and HIV wasting syndrome [91,92], although whether testosterone is better than established treatments for these conditions has not been clearly established. Cardiovascular disease is com- mon in typical users of testosterone therapy, that is, older men. The 10-year risk of a cardiovascular event for US men aged 65 to 69 years is about 28% [93]. Assuming the increased risk of cardiovascular-related events seen here with testosterone therapy would give a number needed to
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History, concepts and aims of internationally active societies in psychosomatic and behavioural medicine

History, concepts and aims of internationally active societies in psychosomatic and behavioural medicine

The cultural history and cultural background as well as the personal history are important for the develop- ment of psychosomatic medicine in a country [1]. In Europe this name was created 1818 by J. Heinroth in Leipzig, the French philosopher R. Decartes had de- scribed 150 years earlier the differences between body and soul and English physicians had described in this time diseases in a very psychosomatic way. Since cen- turies the Asian culture focused on different bio- logical, psychological, environmental and ethical aspects of a life in harmony and for an attempt to harmonise human beings. The American way of life in psychosomatic medicine developed from psycho- analytical roots to targeted, effective and cognitive structured research activities and became a pacemaker for research activities in behavioural and psycho- somatic medicine. This research paradigm seems to push back other cultural and personal experiences in the field. So it is interesting to compare these tradi- tions and scopes of psychosomatic medicine in differ- ent countries: Paper 5 and 6 of this series presents this American way of structural thinking, comprehen- sive research hypotheses and managing successful good research projects. Paper 2 presents the Japanese ideas of psychosomatic harmonization in an individual with the surrounding of family, society and environ- ment under an ethical aspect. Impressive is the effort, which was made to organize successfully psycho- somatic structures in Japan. Paper 4 described the historical development of psychosomatic medicine in Germany and the concept of different psychothera- peutic interventions on all levels of health care. All these papers are written from members within a soci- ety which has members, website and a members only
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Epidemics and History: Disease, Power and Imperialism

Epidemics and History: Disease, Power and Imperialism

approaches and interests signalled by the coming of the 'social history of medicine'. How 'new' the social history of medicine actually was is debatable, but there can be no doubting the proliferation of work on topics such as patients, non- orthodox practitioners, madness, and healing and disease outside of Western cultures. Also, previously well-worked seams, such as the development of the medical profession and medical science, have been the subject of new studies and major revisions. A characteristic of much of the new work, following from its attempt to set medicine in its specific social context and its reaction to older universal histories, has been its relatively narrow focus in time and place. There are many recent studies of doctor-patient relations as revealed in casebooks or diaries, of alternative healers in particular towns, of individual asylums, and of health and medicine in specific regions or countries. A popular theme in this vein has been the history of epidemics, which has allowed historians to focus on a particular place and time, and to explore the social context of disease and medicine at a moment of social crisis. In turn, this approach has spawned a relatively new genre of the history of disease, where medical historians consider a disease over a longer period, weaving changes in understanding and management with epidemiological and cultural history. The emphasis in the new social history of medicine has very much been on the 'social' in medicine and how the wider 'society' impacts upon medicine. There have been fewer studies of the 'impact' of
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Possible contribution of quantum-like correlations to the placebo effect: consequences on blind trials

Possible contribution of quantum-like correlations to the placebo effect: consequences on blind trials

In 2013, I proposed a slight modification of trial design in order to increase the chance to observe a difference between outcomes in double-blind placebo-controlled randomized trials of homeopathy medicines. This suggestion was not an encourage- ment for the practice of homeopathy, but an attempt to understand the persisting suc- cess of this alternative medicine in the absence of a rational basis. Based on the hypothesis that quantum-like correlations were responsible for “ successful ” open-label homeopathy clinical trials, it was proposed to replace the centralized assessment of effi- cacy in blind trials (generally done by statisticians) with a local assessment (by physi- cians) [23]. Thieves et al. recently challenged this hypothesis and reported experiments in a plant model (wheat germination) that compared a homeopathy medicine and a pla- cebo both in local and centralized blind designs [24]. The results were in favor of the initial hypothesis since a significant difference of plant growth was observed between homeopathy medicine and placebo with local assessment while there was no significant difference with centralized assessment. The interaction test for local vs. centralized blind designs was statistically significant (p = 0.003). If we consider all samples (includ- ing homeopathy medicine) as plain placebos that differ only by their labels, these re- sults are in favor of the present hypothetical modeling. These results should be also an encouragement for physicians to implement the same local blind design in clinical trials comparing a placebo with homeopathy medicine (i.e. a second placebo) in order to test in vivo the hypothesis of quantum-like correlations as depicted in Fig. 5.
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A standardized transcutaneous electric acupoint stimulation for relieving tobacco urges in dependent smokers

A standardized transcutaneous electric acupoint stimulation for relieving tobacco urges in dependent smokers

Concerning the criteria of choosing the four acupoints, the Hegu point is known to be the most powerful point to produce an analgesic e ff ect via the increase of release of opioid peptides, which are released in the CNS [19], whereas Neiguan, a strategic point of the pericardial meridian is known to produce a calming or anxiolytic e ff ect according to traditional Chinese medicine. When EA or TEAS is used instead of manual needling, it is advisable to use the close-by point to complete an electric circuit rather than to use the point in the opposite extremity, thereby letting the current pass through the cardiac region. Repeated use of acupuncture is needed for most of the therapeutic interventions. In the treatment of heroin addiction with TEAS, it was used three times a day in the first 5 days of drug abstinence, followed by twice a day for the following 5 days, and ending with once a day for the rest of the detoxification period of 15 days [22]. From a clinical point of view, repeated use seems to be necessary for e ff ective symptom control. However, too frequent a use, for example, 4–6 times a day, will unavoidably lead to the development of tolerance [34]. Therefore, a three- times-a-day schedule was used in the present study.
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Clinical role of brexpiprazole in depression and schizophrenia

Clinical role of brexpiprazole in depression and schizophrenia

properties of brexpiprazole suggest a more tolerable side effect profile with regard to akathisia, extrapyramidal dysfunction, and sedation. While no head-to-head data are currently available, double-blind placebo-controlled studies show favorable results, with the number needed to treat (NNT) vs placebo of 6–15 for response in acute schizophrenia treatment and 4 for main- tenance. NNT is 12 for response and 17–31 for remission vs placebo in major depression. In schizophrenia trials, treatment-emergent adverse effects (TEAEs) and discontinuation rates due to TEAEs were lower in treatment groups vs placebo (7.1%–9.2% vs 14.7%, respectively). Meanwhile, discontinuation rates due to TEAEs in depression studies were higher in treatment groups vs placebo (1.3%–3.5% vs 0–1.4%, respectively) and appeared dose dependent. Rates of akathisia are lower compared to those with aripiprazole and cariprazine, weight gain is more prominent than with aripiprazole, cariprazine, or ziprasidone, and sedation is less than with arip- iprazole but more than with cariprazine. Brexpiprazole target dosing is 2–4 mg in schizophrenia and 2 mg in depression augmentation. Dose adjustments should be considered in hepatic or renal dysfunction and/or in poor cytochrome P450 2D6 metabolizers. While brexpiprazole represents an exciting second entry for D 2 partial agonists with positive studies thus far, direct head-to-head comparisons will shed more light on the efficacy and side effect profile of brexpiprazole. Keywords: serotonin–dopamine activity modulator, antipsychotic, partial agonist, psychopharmacology
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The key role of Shenyan Kangfu tablets, a Chinese patent medicine for diabetic nephropathy: study protocol for a randomized, double blind and placebo controlled clinical trial

The key role of Shenyan Kangfu tablets, a Chinese patent medicine for diabetic nephropathy: study protocol for a randomized, double blind and placebo controlled clinical trial

estimated 34.7 percent of people diagnosed with diabetes have renal complications and a further 50 percent die of renal failure. Hence, identification of alternative treatments for these patients should be given priority. The Shenyan Kangfu tablet (SYKFT) is a new formulation of an existing and widely acclaimed Chinese herbal tea for treating qi-yin deficiency syndrome. Because a considerable portion of DN patients presenting with symptoms of swelling, fatigue and weak limbs would be diagnosed with qi-yin deficiency syndrome according to the traditional Chinese medicine (TCM) diagnostic criteria, we hypothesize that SYKFT may represent a complementary drug for DN patients with the corresponding syndrome. In view of this, we have designed a trial to assess the efficacy and safety of SYKFT for patients with diabetic nephropathy exhibiting signs of qi and yin deficiency.
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Oral granulated Chinese herbal medicine (YXBCM01) plus topical calcipotriol for psoriasis vulgaris: study protocol for a double blind, randomized placebo controlled trial

Oral granulated Chinese herbal medicine (YXBCM01) plus topical calcipotriol for psoriasis vulgaris: study protocol for a double blind, randomized placebo controlled trial

The topical drug calcipotriol 0.005% (50 μg/g) cream (30 g tubes) will be administered as standard care. Calci- potriol is a vitamin D3 derivative, which decreases prolif- eration and induces the differentiation of keratinocytes. It has a strong immunomodulating effect, reducing the level of pro-inflammatory cytokines [37,38]. It is a moderate-action first-line therapy drug, with a low risk of side effects and proven efficacy; it is commonly used and treatment guidelines recommend it for mild to moderate psoriasis [39]. The calcipotriol cream will be administered daily, for 12 weeks, to affected body sur- face areas according to American Academy of Dermatol- ogy guidelines (1% surface area coverage = 0.5 fingertip units), or until the complete clearance of lesions [15]. The maximum dose will not exceed 100 g per week, ac- cording to consumer medicine information for the prod- uct (calcipotriol). The calcipotriol dosage can be reduced from its initial dose at the participants’ discretion and as their symptoms reduce, but should meet dosage recom- mendations for the severity of the plaques. In addition, in case of intolerable itch, antihistamine (cetirizine hydrochloride tablets 10 mg) will be provided to all par- ticipant groups as rescue therapy.
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From Experimental Science to Clinical Medicine- A Historical Overview of Important Milestones in the Evolution of Organ Transplantation

From Experimental Science to Clinical Medicine- A Historical Overview of Important Milestones in the Evolution of Organ Transplantation

of total body irradiation such as infections and malignancy [20]. Development of antileukemic drugs promised a more refined method of suppressing the immune system. Pharmacologic immune suppression with prednisone was first tested on a female kidney recipient in 1960. The patient died after 5 months [21]. Immunosuppression with either azathioprine or 6-mercaptopurine also yielded poor survival rate with only one of the ten transplant recipients surviving to six months post-transplant [22,23]. The transplant revolution was halted until the early 1960s when Thomas Starzl at the University of Colorado demonstrated that high doses of prednisone with azathioprine could reverse graft rejection and even induce tolerance in the host [24]. Soon after Starzl overcame the genetic compatibility barrier, experimental renal transplants became clinical medicine although complications of lymphocyte depletion remained a problem [25]. A decade later, Borel & Stähelin discovered cyclosporine which was effective in immunosuppression but exhibited little cytotoxicity [26] and till date, combined with Starzl’s “cocktail”, this drug offers least harmful immune suppression [8].
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QUESTIONING COMMON USES OF ALTERNATIVE MEDICINES

QUESTIONING COMMON USES OF ALTERNATIVE MEDICINES

www.wjpr.net Vol 3, Issue 10, 2014. 604 demonstrable scientific experience (definition of American Medical Association)." [1] These traditional or alternative medicines include Homeopathy, Reflexology, Anthroposophical medicine, Orgone therapy, Naturopathy, Aromatherapy, Biochemical Breathing therapy (Pranayam), Ayurveda, Magnet therapy, Music therapy, Chiropractic, etc. "These all cults have common features (1) Absence of scientific thinking (2) Naive acceptance of hypotheses (3) Uncritical acceptance of causation and assumption that if recovery follows treatment, it is due to the treatment and close attention to the personal feeling." [1] Important alternative systems of medicine, popular in India, are Homeopathy, Ayurveda, Yoga (Pranayam), Tantra-Mantra, worship, religious act and exorcism.
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Effect of traditional Chinese medicine on outcomes in patients with mild/moderate chronic obstructive pulmonary disease: study protocol for a randomized placebo controlled trial

Effect of traditional Chinese medicine on outcomes in patients with mild/moderate chronic obstructive pulmonary disease: study protocol for a randomized placebo controlled trial

Traditional Chinese medicine (TCM), as a system of medicine, has been a form of health care in China and its neighboring countries for several thousand years. Some TCM therapy, such as Tanreqing injections, has been reported to be of some benefit to COPD patients, and could improve the Chinese medical signs and symp- toms in patients with AECOPD, reducing airway inflam- mation and airway mucus hypersecretion [17,18]. Others improve lung function and relieve airway inflammation in patients with stable COPD [19].

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Aspirin plus Pseudoephedrine (Aspirin Complex) for the Treatment of Symptoms of Upper Respiratory Tract Infection

Aspirin plus Pseudoephedrine (Aspirin Complex) for the Treatment of Symptoms of Upper Respiratory Tract Infection

In order to address requirements of the European Health Authority EMA stated in the guideline for fixed medicinal combination products [5], study 3 compared the combination with the individual active ingredients. This study had two primary objectives: relief of nasal congestion of the combination vs. ASA alone and relief of sore throat of the combination vs. PSE alone. The study did not meet its two primary objectives and failed to demonstrate a statistically sig- nificant superiority of ASA plus SE vs. ASA in nasal congestion and of ASA plus PSE vs. PSE in sore throat. Also comparisons with placebo (ASA plus PSE vs. placebo, ASA vs. placebo, PSE vs. placebo) did not reveal statistically significant differences [27]. This suggests that the study may have lacked assay sensitivity; variability has to be taken into consideration because this study was done in 79 centers in 4 countries and the duration of symptoms at baseline was longer than 96 hours. This is different from studies 1 and 2 which were done in 2 centers each and the duration of symptoms at baseline was 24 hours. The subsequent study 4 also investigated the combination in comparison to its individual active ingredients. This study was done is a single center, using patients having symp- toms no longer than 72 hours and using an objective measurement of nasal con- gestion (measurement of nasal airflow resistance by posterior rhinomanometry) and categorical congestion scales. Pain was assessed for the combination of sore throat pain and/or headache using categorical pain intensity and pain relief scales [10]. The study showed statistically significant differences between ASA plus PSE vs. ASA for the endpoint nasal congestion (Figure 3) and between ASA plus PSE vs. PSE for the endpoint pain (Figure 4). Furthermore comparisons of ASA vs. PSE for pain and PSE vs. ASA for nasal congestion showed statistically significant differences. All active treatments differed from placebo for the respec- tive endpoints [10]. Results of the objective measurement of nasal decongestion
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