A study on a Chinese herbal medicine preparation to modulate post-injury swelling of the limb: In-vitro and clinical studies

Swelling of the limb is a common sequel and complication after injury or surgery. It will result in significant long term stiffness and loss of function of the limb if not promptly and properly controlled. Conventional treatments of limb edema are insufficient or ineffective for some patients. A formula of Chinese herbal medicine (CHM) has been used for the local control of post-injury swelling with good effects claimed. However, some uncertainties exist in the quality control of herbs and the evidence of efficacy of this formula. Clarifying these uncertainties is necessary for developing it into a treatment option. This study was performed to explore the development of this local treatment as an alternative approach to treat post-injury edema.; This formula composed of 13 kinds of herbs. Tougucao herb was one of them. However, Tougucao herb was a homonym of many herbs and was suggested as a possible enhancer of penetration across some barriers. To clarify the effects of Tougucao herb on penetration across barriers and to establish the best choice of herb among those named Tougucao, in-vitro diffusion experiments using horizontal diffusion cells and eggshells were performed to differentiate the effects of five different Tougucao herbs on penetration across barriers. Results showed that among the five Tougucao herbs tested in our study, the aquatic extractions of Glechoma longituba (Liangiancao) had the highest enhancement ability on the diffusion of the bromophenol blue across the nylon filter paper and porcine parietal peritoneal membrane. Further experiments showed that the aquatic extraction of Glechoma longituba could not enhance the diffusion of the bromophenol blue across the skin or epidermis membrane, but could enhance the diffusion across the dermis membrane or eggshell.; To prove the efficacy of this CHM, the efficacy of the CHM broth in reducing post-injury limb swelling and in improving limb functions were compared with placebo at the same temperature on patients with late post-injury swelling of the hand (20 participants), of the foot (20 participants), or acute post-injury swelling of the hand (10 participants). Result showed the differences between CHM and placebo groups were statistically insignificant in the participants with late post-injury hand and foot swelling, respectively. A significant difference between CHM and placebo groups, with a lesser swelling in the CHM group, was observed on day 10 in the patients with acute post-injury hand swelling; however, the differences of other measurements between CHM and placebo groups were statistically insignificant. (Abstract shortened by UMI.)...