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Treatment of allergic rhinitis using a Chinese herbal formula Shi-Bi-Lin (SBL): animal study, in vitro study and clinical trial. / CUHK electronic theses & dissertations collectionJanuary 2005 (has links)
Conclusions. SBL showed its efficacy in treating the animal model of allergic rhinitis. Its mechanisms may be related to its suppressive action on PCA reaction, the production of TXB2 and the expression of eNOS, as well as its modulation of cytokines, including IL-4, IL-6, IL-8, GM-CSF and TNF-alpha, release from mast cells. The clinical trial showed that SBL had more beneficial action on the quality of life, in comparison to the placebo, in the domains of RE and BP. Some symptoms evaluations of PAR patients, including GF, NB and SF were more markedly improved in the SBL group when compared with the placebo group. Furthermore, the use of SBL, with the study dose and treatment period, was safe. However, the accurate efficacy and mechanisms of SBL are largely unknown and need further investigation. (Abstract shortened by UMI.) / Introduction. Although great progress in treatment of allergic rhinitis have made in recent years, remarkably increasing prevalence and cost in epidemiology studies strongly suggest the difficulties in the management of allergic rhinitis. Shi-Bi-Lin (SBL) is a formula modified from the traditional Chinese herbal formula Cang-Er-Zi-San (CEZS) and a classic European formula SinupretRTM. CEZS has been used for the treatment of allergic rhinitis for several centuries in East Asia communities, and SinupretRTM has been used in treating paranasal sinusitis and rhinitis widely in Europe for decades. However, its therapeutic mechanisms remain unclear. We examined the efficacy and the possible mechanism of SBL in an animal model of allergic rhinitis and in cell culture study using Human Mast Cell Line (HMC-1) and Peripheral Blood Mononuclear Cells (PBMC). In addition, a clinical trial was conducted to examine its clinical efficacy and safety. / Results. In the animal study, SBL showed a potent effect in relieving the symptoms of nasal obstruction, sneezing and nasal scratching (P<0.05 or P<0.01), but had no convincing effect in decreasing the nasal discharge (P>0.05). In PCA test, IgG1 increased in a modest manner in the SBL-treated group when compared with the sham group (P<0.05 or P<0.01). Eosinophil infiltration and the expression of eNOS in nasal mucosa, but not iNOS, were obviously lower in the SBL treated group (P<0.05 or P<0.01) in comparison to the sham group. The levels of thromboxane B (TXB)2 in the nasal lavage fluid, but not histamine and peptide leukotrienes (p-LTs), showed significantly lower than that of the sham group (P<0.05). In vitro study showed that SBL modulated the cytokines, including interleukin (IL)-4, IL-6, IL-8, Granulocyte/Macrophage Colony-Stimulating Factor (GM-CSF) and tumor necrosis factor (TNF)-alpha, release from human mast cell line (HMC-1). However, the mRNA expressions of these cytokines were not significantly altered. As the controls, dexamethasone, desloratadine and budesonide had more potently inhibitory effects on cytokines release from HMC-1. The component herbs generally had stimulatory effects on the cytokine release from HMC-1 and variable effects on PBMC. In the clinical trial, a total of 84 patients were recruited in the clinical trial and 77 of them completed the trial. Although no significant differences of each domain between the SBL and placebo groups were detected, findings supported the efficacy of SBL were obtained. / by Zhao Yu. / "July 2005." / Advisers: C. A. Van Hasselt; Ping-Chung Leung; Kong-Sang Woo. / Source: Dissertation Abstracts International, Volume: 67-01, Section: B, page: 0172. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references. / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstract in English and Chinese. / School code: 1307.
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