Objective:To evaluate the effectiveness and safety of seven oral Chinese patent medicines(CPMs)as adjuvant therapy for cancer-related anemia(CRA)by network meta-analysis(NMA).Methods:A literature search to obtain rand...Objective:To evaluate the effectiveness and safety of seven oral Chinese patent medicines(CPMs)as adjuvant therapy for cancer-related anemia(CRA)by network meta-analysis(NMA).Methods:A literature search to obtain randomized controlled trials(RCTs)of seven oral CPMs in the adjuvant treatment of CRA was conducted in multiple databases from the inception to April 2022.The RevMan5.3 and R 4.1.1 software were used for NMA.Results:We ultimately included 29 RCTs with 2140 patients.Traditional meta-analysis showed that Fufang E'jiao syrup(FFEJS),Shengxuebao mixture(SXBM),Shengxuening tablets(SXNT),Jianpi Shengxue granules(JPSXG),and Yixuesheng capsule(YXSC)combined with basic Western treatment(BWT)could improve the hemoglobin(HGB)level.JPSXG combined with BWT could improve the red blood cell(RBC).FFEJS combined with BWT improved the Karnofsky performance status(KPS).NMA showed that FFEJS,JPSXG,SXBM,and SXNT plus BWT improved HGB better than Shengxue tablets(SXT)plus BWT,with top three ranking results being JPSXG plus BWT>SXNT plus BWT>FFEJS plus BWT.FFEJS plus BWT,JPSXG plus BWT,SXBM plus BWT,SXNT plus BWT,and SXT plus BWT improved RBC better than BWT,with top three ranking results being SXNT plus BWT>JPSXG plus BWT>FFEJS plus BWT.In terms of the KPS score,compared with SXT plus BWT,FFEJS,JPSXG,SXBM,SXNT,and Yizhong Shengxue capsule(YZSXC)plus BWT had higher KPS,with top three ranking results being SXBM plus BWT>JPSXG plus BWT>FFEJS plus BWT.Conclusions:Our NMA demonstrated that seven oral CPMs used as adjuvant treatment of CRA had a definite clinical effect.JPSXG not only increases the levels of HGB and RBC to enhance the clinical effect but also improves patients'quality of life.More accurate conclusions need to be verified by more high-quality RCTs.展开更多
Objective:To systematically evaluate the clinical efficacy of oral Chinese patent medicine combined with sacubitril/valsartan in treating chronic heart failure(CHF).Methods:CNKI,CSPD,CCD,CBM,PubMed,Web of Science,Coch...Objective:To systematically evaluate the clinical efficacy of oral Chinese patent medicine combined with sacubitril/valsartan in treating chronic heart failure(CHF).Methods:CNKI,CSPD,CCD,CBM,PubMed,Web of Science,Cochrane Library and EMbase were retrieved to screen out randomized controlled trials Chinese patent medicine and Western medicine in treating CHF.Manual retrieval was also applied as a supplement.The Cochrane Reviewers Handbook 5.1.0 was used to evaluate the bias risk of the included studies and RevMan 5.4 software was used for Meta-analysis.Results:A total of 1301 patients enrolled in the 13 RCTs were included.According to the results of Meta-analysis,a combination of oral Chinese patent medicine and sacubitril/valsartan could further improve total effectiveness rate(RR=1.23,95%CI[1.16,1.30],P<0.001),increase 6 minutes’walk distance(MD=53.04,95%CI[33.43,72.64],P<0.001),improve left ventricular ejection fraction(MD=6.67,95%CI[5.15,8.19],P<0.001)and stroke volume(MD=7.56,95%CI[3.94,11.18],P<0.001),reduce left ventricular end-diastolic dimension(MD=-3.68,95%CI[-4.57,-2.78],P<0.001)and N terminal pro B type natriuretic peptide(MD=-434.08,95%CI[-518.95,-349.22],P<0.001)and no statistically significant difference in drug safety was found between the sacubitril/valsartan-only group and the combined treatment group(RR=0.73,95%CI[0.32,1.65],P=0.45).Conclusion:It’s indicated that a combination of traditional Chinese patent medicine and sacubitril/valsartan had a good clinical efficacy in the treatment of CHF,which had certain guiding significance for clinical practice.展开更多
Objective To explore the rules and characteristics of the adverse drug reactions(ADRs)of three Chinese patent medicines and three herbal formulas for the treatment of COVID-19,and to provide a reference for clinical s...Objective To explore the rules and characteristics of the adverse drug reactions(ADRs)of three Chinese patent medicines and three herbal formulas for the treatment of COVID-19,and to provide a reference for clinical safe medication.Methods The cases and ADR reports of the three Chinese patent medicines and three herbal formulas in PubMed,Web of Science,Springer Link,CNKI,Wanfang and VIP database were retrieved from December 2019 to May 2021.Then we extracted and analyzed the effective information included in the literature.Results and Conclusion According to the pre-developed retrieval plan,a total of 136 documents were obtained,and a total of 6 documents met the inclusion criteria finally.553 patients used three Chinese patent medicines and three herbal formulas,and there were 133 cases of adverse reactions.The adverse reactions of patients taking the three Chinese patent medicines and three herbal formulas can all be explained under the theory of traditional Chinese medicine,and the adverse reactions can be eliminated by adding or subtracting the flavor of the medicine or stopping the medicine.展开更多
BACKGROUND Glioblastoma is the most common type of brain tumor and is invariably fatal,with a mean survival time of 8-15 mo for recently diagnosed tumors,and a 5-year survival rate of only 7.2%.The standard treatment ...BACKGROUND Glioblastoma is the most common type of brain tumor and is invariably fatal,with a mean survival time of 8-15 mo for recently diagnosed tumors,and a 5-year survival rate of only 7.2%.The standard treatment for newly diagnosed glioblastoma includes surgery followed by concurrent chemoradiotherapy and further adjuvant temozolomide.However,the prognosis remains poor and longterm survival is rare.This report aimed to demonstrate a new therapeutic strategy for the treatment of glioblastoma.CASE SUMMARY A patient was referred to the Department of Neurosurgery with an intracranial space-occupying lesion with a maximum diameter of approximately 5 cm.The tumor was compressing functional areas,and the patient accordingly underwent partial resection and concurrent chemoradiotherapy.The imaging and pathological findings were consistent with a diagnosis of glioblastoma with oligodendroglioma differentiation(World Health Organization IV).The patient was finally diagnosed with glioblastoma.However,the patient discontinued treatment due to intolerable side effects,and was prescribed Kangliu pill(KLP)7.5 g three times/d,which he has continued to date.Significant shrinkage of the tumor(maximum diameter reduced from about 3.5 to about 2 cm)was found after 3 mo of KLP therapy,and the tumor was further reduced to about 1 cm after 3 years.The patient’s symptoms of headache,limb weakness,and left hemiplegia were relieved,with no side effects.CONCLUSION KLP has been a successful intervention for glioblastoma, and the current caseindicates that traditional Chinese medicine may offer effective alternativetherapies for glioblastoma.展开更多
Stable angina pectoris is a common condition that affects a wide group of patients with coronary artery diseases.A number of Chinese patent drugs based on classic herbal formulations are available for angina managemen...Stable angina pectoris is a common condition that affects a wide group of patients with coronary artery diseases.A number of Chinese patent drugs based on classic herbal formulations are available for angina management.A network meta-analysis is proposed to assess the relative efficacy and safety of commonly used drugs for stable angina and generate a clinically meaningful ranking for each important outcome.We composed a list of 24 widely-used oral blood-quickening Chinese patent drugs from literature review and expert consultation.Three English and five Chinese electronic databases will be searched up to July 2021 for randomised clinical trials comparing between drugs on the list or with nitrates or placebo for stable angina.Unpublished data or grey literature will be sought through trial registries and correspondence to the report authors.Two reviewers independently screen literature,extract data and assess clinical and methodological features of included studies.The WinBUGS software will be used to perform network meta-analysis and the Stata 13.0 software to generate graphic demonstrations of the results.Primary outcomes are the incidence of cardiovascular events and changes in angina frequency,duration and intensity.We will use the surface under the cumulative ranking curve and the mean value for the numeric presentation of efficacy and safety ranking probabilities of multiple treatments.Heterogeneity and inconsistency will be assessed using appropriate statistical tests,and subgroup analysis and network meta-regression will be resorted when necessary.The quality of evidence for each outcome will be graded with the web-based GRADEpro GDT.展开更多
To analyze the medication rule of Chinese patent medicine compound for constipation by data mining,and to provide reference for the treatment of constipation.Methods:The Chinese patent medicines for constipation in th...To analyze the medication rule of Chinese patent medicine compound for constipation by data mining,and to provide reference for the treatment of constipation.Methods:The Chinese patent medicines for constipation in the Pharmacopoeia of the People’s Republic of China(2020)and Chinese patent medicine prescription database of yaozhi.com(https://db.yaozh.com/chufang)were collected and sorted.The prescriptions and drug composition were input into Excel2010.ategories,nature,flavour and channel tropism of drugs were analyzed by using ancient and modern medical case cloud platform(V2.3.5).The cluster analysis of high-frequency drugs was carried out by SPSS 22.0,and rules of high-frequency drugs were analyzed by Apriori algorithm provided by SPSS modeler 18.0.Results:Two hundred and thirty-six Chinese patent medicine prescriptions that met the requirements were collected,containing 349 Chinese medicines in total,with a total frequency of 2,277.The drugs with frequency≥25 times were high-frequency drugs,with a total of 24 flavours,and the top 5 were Dahuang(Rhei radix et rhizoma),Huangqin(Scutellariae radix),Gancao(Glycyrrhizae radix et rhizoma),Huanglian(Coptidis rhizoma)and Bohe(Menthae haplocalycis herba).The top 3 frequency of efficacy of high-frequency drugs were“Heat-Clearing(remove heat from the body surface and inside)”drugs,“Purgating(to promote excretion of stools)”drugs and“Reinforcing”(to supplement the body’s lack of“Qi,Blood,Yin and Yang”)drugs.The nature of high-frequency drugs were cold,warm and flat.The top 3 flavour of the high frequency drugs were bitter,spicy and sweet.The top 4 channel tropism of high-frequency drugs were“Spleen”,“Stomach”,“Lung”,“Large intestine”.According to the association rule,11 drug pairs were obtained,and the core drug pairs were Zhizi(Gardeniae fructus)-Rhei radix et rhizoma,Huangbo(Phellodendri chinensis cortex)-Rhei radix et rhizoma.Four new methods were obtained based on cluster analysis.Conclusion:Chinese patent medicine has a certain regularity in the treatment of constipation.This paper can provide some references for the clinical treatment of constipation with Chinese medicine.展开更多
The ultrasonic nebulization extraction(UNE) was developed and applied to the extraction of volatile components from traditional Chinese patent medicine Xiaoyao Pills. Several parameters of ultrasonic nebulization extr...The ultrasonic nebulization extraction(UNE) was developed and applied to the extraction of volatile components from traditional Chinese patent medicine Xiaoyao Pills. Several parameters of ultrasonic nebulization extraction including the sample particle size, solvent volume, extraction time and ultrasonic power were studied and selected. As a result, 2.4 g of sample with particle size of 80 mesh was extracted with 15 mL of n-hexane for 20 min at an ultrasonic power of 35 W. The volatile components were analyzed by gas chromatography-mass spectrometry (GC-MS) under the optimal conditions and 57 compounds were identified. The precision, repeatability and stability of the proposed method were also studied. Compared with ultrasonic-assisted extraction(UAE) and hydrodistillation(HD) extraction, the proposed method is more efficient, faster and easier to be operated at room temperature with smaller sample and energy consumption. It is suggested that the ultrasonic nebulization extraction can be used as a novel alternative method for the extraction of volatile components from traditional Chinese patent medicine.展开更多
On July 1, 2019, the website of the National Health Commission of the People’s Republic of China issued the “Notice on printing and distributing the first batch of national key monitoring and rational drugs (chemica...On July 1, 2019, the website of the National Health Commission of the People’s Republic of China issued the “Notice on printing and distributing the first batch of national key monitoring and rational drugs (chemicals and biological products)”(National Health Office Medical Letter [2019] No. 558)[1], where the third article stipulates:“Other types of physicians, after not less than one year of systematically studying Chinese medicine professional knowledge and passing the examination, in accordance with the basic principles of syndrome differentiation, can issue prescriptions for Chinese patent medicine”.展开更多
The MEHECO Traditional Chinese Patent Medicines Import and Export Corporation is a State-owned enterprise under the 2nd Business Department of the China National Medicines and Health products Import and Export Corpora...The MEHECO Traditional Chinese Patent Medicines Import and Export Corporation is a State-owned enterprise under the 2nd Business Department of the China National Medicines and Health products Import and Export Corporation. Established in March 1994, it mainly handles the export of traditional Chinese patent medicines and health products and imports of herbal medicines.展开更多
Processing of traditional Chinese medicine is a traditional pharmaceutical technology in China.The processing technology and methods in different places have their own characteristics.Anguo County,known as Qizhou in a...Processing of traditional Chinese medicine is a traditional pharmaceutical technology in China.The processing technology and methods in different places have their own characteristics.Anguo County,known as Qizhou in ancient times for its well-developed pharmaceutical industry,is known as"millennium medicine capital"and"the world's first pharmaceutical market".It is one of China's famous distribution centers of medicinal materials.Its traditional medicinal material processing and processing technology has high popularity.However,Influenced by inheritance mode and mechanical modernization,A large number of processing techniques of traditional Chinese medicine are in danger of being lost.This article focused on the traditional manufacturing process of Anguo's Chinese patent medicine.Relying on the literature,we collected and organized the Chinese patent medicine of Anguo,analyzed its varieties,sources of prescriptions and processing technology,which improves the understanding of Anguo's traditional Chinese medicine processing technology and its cultural connotation and provides a research basis for its inheritance and development.展开更多
Ji Shen: Dr.Ma Shuangcheng,Director of Institutes for Control of Chinese Traditional Medicines and Ethnic Medicine,National Institutes for Food and Drug Control,is a long-term researcher on the quality standards of Ch...Ji Shen: Dr.Ma Shuangcheng,Director of Institutes for Control of Chinese Traditional Medicines and Ethnic Medicine,National Institutes for Food and Drug Control,is a long-term researcher on the quality standards of Chinese materia medica,Chairman Member of the Risk Assessment of the Pharmacopoeia of People's Republic of China ,and is also the Director Member of the Professional Committee of Drug Risk,China Pharmaceutical Association,and the Director Member of the Directors Committee of Chinese Materia Medica Quality and Safety.He has long been engaged in the control of the quality and safety of Chinese materia medica,and has also been included in the National 10000 Talent Plan.Let's invite Dr.Ma to give a report.Thank you.展开更多
BACKGROUND Liuweiwuling Tablet(LWWL)is a Chinese patent medicine approved for the treatment of chronic inflammation caused by hepatitis B virus(HBV)infection.Previous studies have indicated an anti-HBV effect of LWWL,...BACKGROUND Liuweiwuling Tablet(LWWL)is a Chinese patent medicine approved for the treatment of chronic inflammation caused by hepatitis B virus(HBV)infection.Previous studies have indicated an anti-HBV effect of LWWL,specifically in terms of antigen inhibition,but the underlying mechanism remains unclear.AIM To investigate the potential mechanism of action of LWWL against HBV.METHODS In vitro experiments utilized three HBV-replicating and three non-HBV-replicating cell lines.The in vivo experiment involved a hydrodynamic injectionmediated mouse model with HBV replication.Transcriptomics and metabolomics were used to investigate the underlying mechanisms of action of LWWL.RESULTS In HepG2.1403F cells,LWWL(0.8 mg/mL)exhibited inhibitory effects on HBV DNA,hepatitis B surface antigen and pregenomic RNA(pgRNA)at rates of 51.36%,24.74%and 50.74%,respectively.The inhibition rates of LWWL(0.8mg/mL)on pgRNA/covalently closed circular DNA in HepG2.1403F,HepG2.2.15 and HepG2.A64 cells were 47.78%,39.51%and 46.74%,respectively.Integration of transcriptomics and metabolomics showed that the anti-HBV effect of LWWL was primarily linked to pathways related to apoptosis(PI3K-AKT,CASP8-CASP3 and P53 pathways).Apoptosis flow analysis revealed that the apoptosis rate in the LWWL-treated group was significantly higher than in the control group(CG)among HBV-replicating cell lines,including HepG2.2.15(2.92%±1.01%vs 6.68%±2.04%,P<0.05),HepG2.A64(4.89%±1.28%vs 8.52%±0.50%,P<0.05)and HepG2.1403F(3.76%±1.40%vs 7.57%±1.35%,P<0.05)(CG vs LWWL-treated group).However,there were no significant differences in apoptosis rates between the non-HBV-replicating HepG2 cells(5.04%±0.74%vs 5.51%±1.57%,P>0.05),L02 cells(5.49%±0.80%vs 5.48%±1.01%,P>0.05)and LX2 cells(6.29%±1.54%vs 6.29%±0.88%,P>0.05).TUNEL staining revealed a significantly higher apoptosis rate in the LWWL-treated group than in the CG in the HBVreplicating mouse model,while no noticeable difference in apoptosis rates between the two groups was observed in the non-HBV-replicating mouse model.CONCLUSION Preliminary results suggest that LWWL exerts a potent inhibitory effect on wild-type and drug-resistant HBV,potentially involving selective regulation of apoptosis.These findings offer novel insights into the anti-HBV activities of LWWL and present a novel mechanism for the development of anti-HBV medications.展开更多
Ever since the introduction of Western biomedicine into China, there has been friction between proponents of this new approach, and proponents of the traditional medical practices that had evolved over thousands of ye...Ever since the introduction of Western biomedicine into China, there has been friction between proponents of this new approach, and proponents of the traditional medical practices that had evolved over thousands of years in China. For the most part, this friction has been couched in the unexamined assumption that Western medicine is based on science, while Chinese medicine is not. This article will examine that assumption, which in this author’s opinion is unjustified and incorrect. Having practiced acupuncture for the past 50 years, after receiving my doctoral degrees in medicine and physiology, my thinking on this topic has also evolved over time. I will begin this article with some historical information that bears on the topic under discussion, followed by my personal ideas about how to resolve the confiicts that have arisen.展开更多
Psoriasis is a kind of immune-mediated, chronic, inflammatory skin disease, which is often associated with different degrees of psychological disorders. Specifically, there is a significant correlation between psorias...Psoriasis is a kind of immune-mediated, chronic, inflammatory skin disease, which is often associated with different degrees of psychological disorders. Specifically, there is a significant correlation between psoriasis and depression, and they show the relationships of reciprocal causation and mutual promotion. Psoriasis with depression is more harmful than simple psoriasis, and its prognosis is worse, which brings a huge burden to the family and society and is worthy of clinical attention. Based on the pathogenic factors of western medicine and pathogenesis of traditional Chinese medicine in psoriasis with depression, the paper summarized and elaborated the research progress on the mechanism of traditional Chinese medicine in the treatment of psoriasis with depression, in order to provide new ideas for clinical treatment.展开更多
In 2012, traditional Chinese medicine(TCM) practitioners in Australia became nationally-registered allied health professionals in three categories: acupuncturist, Chinese herbal medicine practitioner, and Chinese herb...In 2012, traditional Chinese medicine(TCM) practitioners in Australia became nationally-registered allied health professionals in three categories: acupuncturist, Chinese herbal medicine practitioner, and Chinese herbal medicine dispenser. Australia was the first Western country to introduce national registration for Chinese medicine, followed by Portugal and, recently, New Zealand. The practice of TCM in Australia can be traced back to the beginning of Chinese immigration to Australia during the Victorian Gold Rush which began in the 1850s. The process which led to national registration commenced in the early 1970s with the establishment of the first acupuncture courses. Decades of gradual development of courses from unaccredited part-time diplomas to accredited bachelor degrees, and the development, by the profession, of national consensus on educational standards were essential elements in the process which led to registration. Professional associations, such as the Australian Acupuncture and Chinese Medicine Association Ltd.(AACMA), also developed a framework of professional selfregulation, including Codes of Ethics, Codes of Conduct, ongoing professional development requirements and Infection Control Guidelines, and provided leadership in the development of the profession. After decades of tribalism and division within the TCM profession, the National Academic Standards Committee brought almost all stakeholders together to reach a consensus on the Australian Guidelines for Traditional Chinese Medicine Education which were published by AACMA in 2001. Professional associations also collaborated on joint submissions to the government in support of registration, which was introduced first in the state of Victoria in 2000, and subsequently became national in 2012. Despite national registration, some barriers still remain, and professional associations continue to lobby the federal government for inclusion in Medicare, chronic disease management scheme, and Veterans Affairs.展开更多
Objective:To summarize the characteristics and evaluate the quality of the methodology and evidence within systematic reviews(SRs)of Chinese herbal medicine(CHM)for Mycoplasma pneumoniae pneumonia(MPP)inchildren.Metho...Objective:To summarize the characteristics and evaluate the quality of the methodology and evidence within systematic reviews(SRs)of Chinese herbal medicine(CHM)for Mycoplasma pneumoniae pneumonia(MPP)inchildren.Methods:SRs of randomized controlled trials were searched using PubMed,the Cochrane Library,Embase,the Chinese National Knowledge Infrastructure Databases(CNKI),the Chinese Scientific Journals Database(VIP),Wanfang,and the SinoMed Database.SRs on the use of CHM alone or in combination with Western medications for MPP in children were included.The study compared the effects of Western medicine alone with those of CHM.The evidence quality using the A Measurement Tool to Assess Systematic Reviews(AMSTAR)2,the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020,and the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)criteria.The primary indicators were the total effective rate,fever subsidence time,and cough disappearance time.The secondary outcomes were pulmonary rale disappearance time,average hospitalization time,lung X-ray infiltrate disappearance time,immunological indices,and inflammatory cytokine levels.Results:Twelve relevant SRs were included;75%(9/12)were assessed as very low quality,and 25%(3/12)Were rated as low quality using the AMSTAR 2 criteria.According to the PRISMA 2020 checklist,the average SR score was 20.3 out of a 27 point maximum.In all SRs,CHM demonstrated improvement in symptoms and signs among children with MPP.The evidence quality using the GRADE criteria ranged from"very low"(>50%)to"moderate"(<5%).The most common downgrading factor was imprecision,followed by publication bias and inconsistency.Conclusion:This overview highlights the limited quality of the methodology and evidence of the included SRs.Although the included studies showed the beneficial effects of CHM on MPP in children,it was difficult to draw firm conclusions owing to methodological flaws.展开更多
It has historically been very difficult to trace the history of the westward transmission of Chinese medicine through the accounts of its protagonists. Many of the early scholars such as Jack Worsley, Dick Van Buren, ...It has historically been very difficult to trace the history of the westward transmission of Chinese medicine through the accounts of its protagonists. Many of the early scholars such as Jack Worsley, Dick Van Buren, and Joe Goodman were reluctant to divulge information about the source of their knowledge, or their professional qualifications. Others, such as John Shen and Hong Yuan-bain were early 20th century immigrants who transmitted highly personalized versions of acupuncture and Chinese medicine to select disciples. Eventually, a new class of scholars appeared, including names such as Ted Kaptchuk, Peter Deadman, Nigel Wiseman, William Morris, Peter Eckman, John Mc Donald, Charles Buck, and the late Giovanni Maciocia who looked for answers back in China, developed translation methodologies and terminology, compiled the main textbooks currently in use at TCM colleges, overcame enormous scholastic adversity, developed courses and pursued the regulation and accreditation of TCM in various countries. This special issue synopsizes the path towards the global acculturation of TCM over the last 50 years, the main protagonists, the enormous accomplishments they have achieved for the profession, their philosophy, their clinical perspectives and visions for the future.展开更多
In Chinese medicine, practitioners assess patients’ complaints, analyze their underlying problems, identify causes and come to a diagnosis, which then directs treatment. What is not obvious and not recorded in a cons...In Chinese medicine, practitioners assess patients’ complaints, analyze their underlying problems, identify causes and come to a diagnosis, which then directs treatment. What is not obvious and not recorded in a consultation is the clinical reasoning process that practitioners use. The research filmed three practitioners in the UK while they conducted a consultation and treatment on new patients. The practitioners and researchers viewed the films and used them as aide-memoirs while the reasoning process throughout was discussed. In order to determine the pattern, practitioners used the four examinations to gather information from the patient in an iterative process;their aesthetic reasoning was highly developed. Through triangulation they checked the information they received against a detailed understanding of the qi-dynamic. They used highly analytical strategies of forward(inductive) and backward(deductive) reasoning against the prototypes of the signs and symptoms that indicate a specific Zheng. This was achieved through an abductive process that linked description with explanation and causal factors with pathological mechanisms. The feedback loop with the patient continued through the consultation and into the treatment. A process of translation and interpretation was needed to turn the patient’s story into the practitioner’s story of qi-dynamics that then directed the treatment. Awareness of our clinical reasoning process will mitigate against biases, improve our diagnoses and treatment choices and support the training of students.展开更多
BACKGROUND Heart failure(HF),a common cardiovascular condition,is characterized by significant morbidity and mortality.While traditional Chinese medicine(TCM)is often used as a complementary approach in HF management,...BACKGROUND Heart failure(HF),a common cardiovascular condition,is characterized by significant morbidity and mortality.While traditional Chinese medicine(TCM)is often used as a complementary approach in HF management,systematic evalua-tions of its impact on clinical outcomes,TCM syndrome scores,and B-type natriuretic peptide(BNP)levels are lacking.This study fills this gap through a comprehensive analysis of randomized controlled trials(RCTs)focusing on TCM for HF treatment.It encompasses an assessment of methodological quality,a meta-analysis,and an evaluation of evidence quality based on established standards.The results offer crucial insights into the potential advantages and constraints of TCM in HF management.RCTs on TCM for HF treatment published since the establishment of the database were searched in four Chinese and English databases,including China National Knowledge Infrastructure,Wanfang,VIP Information Chinese Science and Technology Journal,and PubMed.Methodological quality was assessed for the included studies with the Cochrane risk-of-bias assessment tool,and the meta-analysis and publication bias assessment was performed with the RevMan5.3 software.Finally,the quality of evidence was rated according to the GRADE criteria.RESULTS A total of 1098 RCTs were initially retrieved.After screening,16 RCTs were finally included in our study,which were published between 2020 and 2023.These RCTs involved 1660 HF patients,including 832 in the TCM group[TCM combined with conventional Western medicine(CMW)treatment]and 828 in the CWM group(CWM treatment).The course of treatments varied from 1 wk to 3 months.TCM syndrome differentiation was analyzed in 11 of the included RCTs.In all included RCTs,outcome indicators included comprehensive clinical outcomes,TCM syndrome scores,and BNP levels.The meta-analysis results showed significant differences between the TCM and CWM groups in terms of comprehensive clinical outcomes[risk ratio=-0.54;95%confidence interval(CI)=-0.61,-0.47;P<0.00001],TCM syndrome scores[weighted mean difference(WMD)=-142.07;95%CI=-147.56,-136.57;P<0.00001],and BNP levels(WMD=-142.07;95%CI=-147.56,-136.57;P<0.00001).According to the GRADE criteria,RCTs where"TCM improves clinical comprehensive outcomes"were rated as low-quality evidence,and RCTs where"TCM reduces TCM syndrome scores"or"TCM decreases BNP levels"were rated as medium-quality evidence.CONCLUSION TCM combined with CWM treatment effectively improves comprehensive clinical outcomes and diminishes TCM syndrome scores and BNP levels in HF patients.Given the low and medium quality of the included RCTs,the application of these results should be cautious.展开更多
In recent years,there has not been much progress in developing anxiolytic drugs.Amongst the barriers are the lack of clarity on the pathogenesis of anxiety disorders,low product conversion rates for developing drugs t...In recent years,there has not been much progress in developing anxiolytic drugs.Amongst the barriers are the lack of clarity on the pathogenesis of anxiety disorders,low product conversion rates for developing drugs targeting the receptors,and species variability.Some scientists have focused on natural medicines,especially herbal medicines in traditional Chinese medicine.New drugs with excellent anxiolytic activity are hoped to be found in herbal medicines with anxiolytic effects.This mini-review summarised three Chinese herbal medicines with anxiolytic effects and anxiolytic herbal formulas used in the traditional Chinese medicine clinic.Several key issues that block the development of new anxiolytic drugs are also discussed.We hope to provide some ideas for researching and developing new anxiolytic drugs and studying anxiolytic components in traditional Chinese medicine.展开更多
基金This work was supported by the National Natural Science Foundation of China(82074240)the Capital Health Research and Development of Special(2020-2-4193).
文摘Objective:To evaluate the effectiveness and safety of seven oral Chinese patent medicines(CPMs)as adjuvant therapy for cancer-related anemia(CRA)by network meta-analysis(NMA).Methods:A literature search to obtain randomized controlled trials(RCTs)of seven oral CPMs in the adjuvant treatment of CRA was conducted in multiple databases from the inception to April 2022.The RevMan5.3 and R 4.1.1 software were used for NMA.Results:We ultimately included 29 RCTs with 2140 patients.Traditional meta-analysis showed that Fufang E'jiao syrup(FFEJS),Shengxuebao mixture(SXBM),Shengxuening tablets(SXNT),Jianpi Shengxue granules(JPSXG),and Yixuesheng capsule(YXSC)combined with basic Western treatment(BWT)could improve the hemoglobin(HGB)level.JPSXG combined with BWT could improve the red blood cell(RBC).FFEJS combined with BWT improved the Karnofsky performance status(KPS).NMA showed that FFEJS,JPSXG,SXBM,and SXNT plus BWT improved HGB better than Shengxue tablets(SXT)plus BWT,with top three ranking results being JPSXG plus BWT>SXNT plus BWT>FFEJS plus BWT.FFEJS plus BWT,JPSXG plus BWT,SXBM plus BWT,SXNT plus BWT,and SXT plus BWT improved RBC better than BWT,with top three ranking results being SXNT plus BWT>JPSXG plus BWT>FFEJS plus BWT.In terms of the KPS score,compared with SXT plus BWT,FFEJS,JPSXG,SXBM,SXNT,and Yizhong Shengxue capsule(YZSXC)plus BWT had higher KPS,with top three ranking results being SXBM plus BWT>JPSXG plus BWT>FFEJS plus BWT.Conclusions:Our NMA demonstrated that seven oral CPMs used as adjuvant treatment of CRA had a definite clinical effect.JPSXG not only increases the levels of HGB and RBC to enhance the clinical effect but also improves patients'quality of life.More accurate conclusions need to be verified by more high-quality RCTs.
基金National Natural Science Foundation of China (No.81803925)National Key Research and Development Program (No.2017YFC1700102)。
文摘Objective:To systematically evaluate the clinical efficacy of oral Chinese patent medicine combined with sacubitril/valsartan in treating chronic heart failure(CHF).Methods:CNKI,CSPD,CCD,CBM,PubMed,Web of Science,Cochrane Library and EMbase were retrieved to screen out randomized controlled trials Chinese patent medicine and Western medicine in treating CHF.Manual retrieval was also applied as a supplement.The Cochrane Reviewers Handbook 5.1.0 was used to evaluate the bias risk of the included studies and RevMan 5.4 software was used for Meta-analysis.Results:A total of 1301 patients enrolled in the 13 RCTs were included.According to the results of Meta-analysis,a combination of oral Chinese patent medicine and sacubitril/valsartan could further improve total effectiveness rate(RR=1.23,95%CI[1.16,1.30],P<0.001),increase 6 minutes’walk distance(MD=53.04,95%CI[33.43,72.64],P<0.001),improve left ventricular ejection fraction(MD=6.67,95%CI[5.15,8.19],P<0.001)and stroke volume(MD=7.56,95%CI[3.94,11.18],P<0.001),reduce left ventricular end-diastolic dimension(MD=-3.68,95%CI[-4.57,-2.78],P<0.001)and N terminal pro B type natriuretic peptide(MD=-434.08,95%CI[-518.95,-349.22],P<0.001)and no statistically significant difference in drug safety was found between the sacubitril/valsartan-only group and the combined treatment group(RR=0.73,95%CI[0.32,1.65],P=0.45).Conclusion:It’s indicated that a combination of traditional Chinese patent medicine and sacubitril/valsartan had a good clinical efficacy in the treatment of CHF,which had certain guiding significance for clinical practice.
文摘Objective To explore the rules and characteristics of the adverse drug reactions(ADRs)of three Chinese patent medicines and three herbal formulas for the treatment of COVID-19,and to provide a reference for clinical safe medication.Methods The cases and ADR reports of the three Chinese patent medicines and three herbal formulas in PubMed,Web of Science,Springer Link,CNKI,Wanfang and VIP database were retrieved from December 2019 to May 2021.Then we extracted and analyzed the effective information included in the literature.Results and Conclusion According to the pre-developed retrieval plan,a total of 136 documents were obtained,and a total of 6 documents met the inclusion criteria finally.553 patients used three Chinese patent medicines and three herbal formulas,and there were 133 cases of adverse reactions.The adverse reactions of patients taking the three Chinese patent medicines and three herbal formulas can all be explained under the theory of traditional Chinese medicine,and the adverse reactions can be eliminated by adding or subtracting the flavor of the medicine or stopping the medicine.
基金the Foundation for Beijing Science and Technology Development of TCM,No.JJ2016-10the National Traditional Chinese Medicine Innovative Talents Training Project from Beijing Municipal Science and Technology Commission,No.Z171100001717006.
文摘BACKGROUND Glioblastoma is the most common type of brain tumor and is invariably fatal,with a mean survival time of 8-15 mo for recently diagnosed tumors,and a 5-year survival rate of only 7.2%.The standard treatment for newly diagnosed glioblastoma includes surgery followed by concurrent chemoradiotherapy and further adjuvant temozolomide.However,the prognosis remains poor and longterm survival is rare.This report aimed to demonstrate a new therapeutic strategy for the treatment of glioblastoma.CASE SUMMARY A patient was referred to the Department of Neurosurgery with an intracranial space-occupying lesion with a maximum diameter of approximately 5 cm.The tumor was compressing functional areas,and the patient accordingly underwent partial resection and concurrent chemoradiotherapy.The imaging and pathological findings were consistent with a diagnosis of glioblastoma with oligodendroglioma differentiation(World Health Organization IV).The patient was finally diagnosed with glioblastoma.However,the patient discontinued treatment due to intolerable side effects,and was prescribed Kangliu pill(KLP)7.5 g three times/d,which he has continued to date.Significant shrinkage of the tumor(maximum diameter reduced from about 3.5 to about 2 cm)was found after 3 mo of KLP therapy,and the tumor was further reduced to about 1 cm after 3 years.The patient’s symptoms of headache,limb weakness,and left hemiplegia were relieved,with no side effects.CONCLUSION KLP has been a successful intervention for glioblastoma, and the current caseindicates that traditional Chinese medicine may offer effective alternativetherapies for glioblastoma.
基金supported by the National Natural Science Foundation of China(No.81603495)the Administration of Traditional Chinese Medicine of Tianjin Health Commission(No.2019072).
文摘Stable angina pectoris is a common condition that affects a wide group of patients with coronary artery diseases.A number of Chinese patent drugs based on classic herbal formulations are available for angina management.A network meta-analysis is proposed to assess the relative efficacy and safety of commonly used drugs for stable angina and generate a clinically meaningful ranking for each important outcome.We composed a list of 24 widely-used oral blood-quickening Chinese patent drugs from literature review and expert consultation.Three English and five Chinese electronic databases will be searched up to July 2021 for randomised clinical trials comparing between drugs on the list or with nitrates or placebo for stable angina.Unpublished data or grey literature will be sought through trial registries and correspondence to the report authors.Two reviewers independently screen literature,extract data and assess clinical and methodological features of included studies.The WinBUGS software will be used to perform network meta-analysis and the Stata 13.0 software to generate graphic demonstrations of the results.Primary outcomes are the incidence of cardiovascular events and changes in angina frequency,duration and intensity.We will use the surface under the cumulative ranking curve and the mean value for the numeric presentation of efficacy and safety ranking probabilities of multiple treatments.Heterogeneity and inconsistency will be assessed using appropriate statistical tests,and subgroup analysis and network meta-regression will be resorted when necessary.The quality of evidence for each outcome will be graded with the web-based GRADEpro GDT.
基金This study was supported by the Discipline Innovation Team Construction Project of the Second Affiliated Hospital of Shaanxi University of Chinese Medicine(2020XKTD-A02).
文摘To analyze the medication rule of Chinese patent medicine compound for constipation by data mining,and to provide reference for the treatment of constipation.Methods:The Chinese patent medicines for constipation in the Pharmacopoeia of the People’s Republic of China(2020)and Chinese patent medicine prescription database of yaozhi.com(https://db.yaozh.com/chufang)were collected and sorted.The prescriptions and drug composition were input into Excel2010.ategories,nature,flavour and channel tropism of drugs were analyzed by using ancient and modern medical case cloud platform(V2.3.5).The cluster analysis of high-frequency drugs was carried out by SPSS 22.0,and rules of high-frequency drugs were analyzed by Apriori algorithm provided by SPSS modeler 18.0.Results:Two hundred and thirty-six Chinese patent medicine prescriptions that met the requirements were collected,containing 349 Chinese medicines in total,with a total frequency of 2,277.The drugs with frequency≥25 times were high-frequency drugs,with a total of 24 flavours,and the top 5 were Dahuang(Rhei radix et rhizoma),Huangqin(Scutellariae radix),Gancao(Glycyrrhizae radix et rhizoma),Huanglian(Coptidis rhizoma)and Bohe(Menthae haplocalycis herba).The top 3 frequency of efficacy of high-frequency drugs were“Heat-Clearing(remove heat from the body surface and inside)”drugs,“Purgating(to promote excretion of stools)”drugs and“Reinforcing”(to supplement the body’s lack of“Qi,Blood,Yin and Yang”)drugs.The nature of high-frequency drugs were cold,warm and flat.The top 3 flavour of the high frequency drugs were bitter,spicy and sweet.The top 4 channel tropism of high-frequency drugs were“Spleen”,“Stomach”,“Lung”,“Large intestine”.According to the association rule,11 drug pairs were obtained,and the core drug pairs were Zhizi(Gardeniae fructus)-Rhei radix et rhizoma,Huangbo(Phellodendri chinensis cortex)-Rhei radix et rhizoma.Four new methods were obtained based on cluster analysis.Conclusion:Chinese patent medicine has a certain regularity in the treatment of constipation.This paper can provide some references for the clinical treatment of constipation with Chinese medicine.
基金Supported by the Basic Research Foundation from Jilin University China(No.200903131)
文摘The ultrasonic nebulization extraction(UNE) was developed and applied to the extraction of volatile components from traditional Chinese patent medicine Xiaoyao Pills. Several parameters of ultrasonic nebulization extraction including the sample particle size, solvent volume, extraction time and ultrasonic power were studied and selected. As a result, 2.4 g of sample with particle size of 80 mesh was extracted with 15 mL of n-hexane for 20 min at an ultrasonic power of 35 W. The volatile components were analyzed by gas chromatography-mass spectrometry (GC-MS) under the optimal conditions and 57 compounds were identified. The precision, repeatability and stability of the proposed method were also studied. Compared with ultrasonic-assisted extraction(UAE) and hydrodistillation(HD) extraction, the proposed method is more efficient, faster and easier to be operated at room temperature with smaller sample and energy consumption. It is suggested that the ultrasonic nebulization extraction can be used as a novel alternative method for the extraction of volatile components from traditional Chinese patent medicine.
文摘On July 1, 2019, the website of the National Health Commission of the People’s Republic of China issued the “Notice on printing and distributing the first batch of national key monitoring and rational drugs (chemicals and biological products)”(National Health Office Medical Letter [2019] No. 558)[1], where the third article stipulates:“Other types of physicians, after not less than one year of systematically studying Chinese medicine professional knowledge and passing the examination, in accordance with the basic principles of syndrome differentiation, can issue prescriptions for Chinese patent medicine”.
文摘The MEHECO Traditional Chinese Patent Medicines Import and Export Corporation is a State-owned enterprise under the 2nd Business Department of the China National Medicines and Health products Import and Export Corporation. Established in March 1994, it mainly handles the export of traditional Chinese patent medicines and health products and imports of herbal medicines.
文摘Processing of traditional Chinese medicine is a traditional pharmaceutical technology in China.The processing technology and methods in different places have their own characteristics.Anguo County,known as Qizhou in ancient times for its well-developed pharmaceutical industry,is known as"millennium medicine capital"and"the world's first pharmaceutical market".It is one of China's famous distribution centers of medicinal materials.Its traditional medicinal material processing and processing technology has high popularity.However,Influenced by inheritance mode and mechanical modernization,A large number of processing techniques of traditional Chinese medicine are in danger of being lost.This article focused on the traditional manufacturing process of Anguo's Chinese patent medicine.Relying on the literature,we collected and organized the Chinese patent medicine of Anguo,analyzed its varieties,sources of prescriptions and processing technology,which improves the understanding of Anguo's traditional Chinese medicine processing technology and its cultural connotation and provides a research basis for its inheritance and development.
文摘Ji Shen: Dr.Ma Shuangcheng,Director of Institutes for Control of Chinese Traditional Medicines and Ethnic Medicine,National Institutes for Food and Drug Control,is a long-term researcher on the quality standards of Chinese materia medica,Chairman Member of the Risk Assessment of the Pharmacopoeia of People's Republic of China ,and is also the Director Member of the Professional Committee of Drug Risk,China Pharmaceutical Association,and the Director Member of the Directors Committee of Chinese Materia Medica Quality and Safety.He has long been engaged in the control of the quality and safety of Chinese materia medica,and has also been included in the National 10000 Talent Plan.Let's invite Dr.Ma to give a report.Thank you.
基金Supported by National Natural Science Foundation of China,No.81930110The National Funded Postdoctoral Researcher Program of China,No.GZC20232406+2 种基金Henan Province Traditional Chinese Medicine Science Research Project,No.2023ZY3040Henan Province Medical Science and Technology Research Plan Joint Construction Project,No.LHGJ20230233National Key Research and Development Program of China,No.2022YFC2303103.
文摘BACKGROUND Liuweiwuling Tablet(LWWL)is a Chinese patent medicine approved for the treatment of chronic inflammation caused by hepatitis B virus(HBV)infection.Previous studies have indicated an anti-HBV effect of LWWL,specifically in terms of antigen inhibition,but the underlying mechanism remains unclear.AIM To investigate the potential mechanism of action of LWWL against HBV.METHODS In vitro experiments utilized three HBV-replicating and three non-HBV-replicating cell lines.The in vivo experiment involved a hydrodynamic injectionmediated mouse model with HBV replication.Transcriptomics and metabolomics were used to investigate the underlying mechanisms of action of LWWL.RESULTS In HepG2.1403F cells,LWWL(0.8 mg/mL)exhibited inhibitory effects on HBV DNA,hepatitis B surface antigen and pregenomic RNA(pgRNA)at rates of 51.36%,24.74%and 50.74%,respectively.The inhibition rates of LWWL(0.8mg/mL)on pgRNA/covalently closed circular DNA in HepG2.1403F,HepG2.2.15 and HepG2.A64 cells were 47.78%,39.51%and 46.74%,respectively.Integration of transcriptomics and metabolomics showed that the anti-HBV effect of LWWL was primarily linked to pathways related to apoptosis(PI3K-AKT,CASP8-CASP3 and P53 pathways).Apoptosis flow analysis revealed that the apoptosis rate in the LWWL-treated group was significantly higher than in the control group(CG)among HBV-replicating cell lines,including HepG2.2.15(2.92%±1.01%vs 6.68%±2.04%,P<0.05),HepG2.A64(4.89%±1.28%vs 8.52%±0.50%,P<0.05)and HepG2.1403F(3.76%±1.40%vs 7.57%±1.35%,P<0.05)(CG vs LWWL-treated group).However,there were no significant differences in apoptosis rates between the non-HBV-replicating HepG2 cells(5.04%±0.74%vs 5.51%±1.57%,P>0.05),L02 cells(5.49%±0.80%vs 5.48%±1.01%,P>0.05)and LX2 cells(6.29%±1.54%vs 6.29%±0.88%,P>0.05).TUNEL staining revealed a significantly higher apoptosis rate in the LWWL-treated group than in the CG in the HBVreplicating mouse model,while no noticeable difference in apoptosis rates between the two groups was observed in the non-HBV-replicating mouse model.CONCLUSION Preliminary results suggest that LWWL exerts a potent inhibitory effect on wild-type and drug-resistant HBV,potentially involving selective regulation of apoptosis.These findings offer novel insights into the anti-HBV activities of LWWL and present a novel mechanism for the development of anti-HBV medications.
文摘Ever since the introduction of Western biomedicine into China, there has been friction between proponents of this new approach, and proponents of the traditional medical practices that had evolved over thousands of years in China. For the most part, this friction has been couched in the unexamined assumption that Western medicine is based on science, while Chinese medicine is not. This article will examine that assumption, which in this author’s opinion is unjustified and incorrect. Having practiced acupuncture for the past 50 years, after receiving my doctoral degrees in medicine and physiology, my thinking on this topic has also evolved over time. I will begin this article with some historical information that bears on the topic under discussion, followed by my personal ideas about how to resolve the confiicts that have arisen.
基金National Natural Science Foundation of China(No.81973846)Heilongjiang Province Traditional Chinese Medicine Research Fund Projec(No.t ZHY2022-132)。
文摘Psoriasis is a kind of immune-mediated, chronic, inflammatory skin disease, which is often associated with different degrees of psychological disorders. Specifically, there is a significant correlation between psoriasis and depression, and they show the relationships of reciprocal causation and mutual promotion. Psoriasis with depression is more harmful than simple psoriasis, and its prognosis is worse, which brings a huge burden to the family and society and is worthy of clinical attention. Based on the pathogenic factors of western medicine and pathogenesis of traditional Chinese medicine in psoriasis with depression, the paper summarized and elaborated the research progress on the mechanism of traditional Chinese medicine in the treatment of psoriasis with depression, in order to provide new ideas for clinical treatment.
文摘In 2012, traditional Chinese medicine(TCM) practitioners in Australia became nationally-registered allied health professionals in three categories: acupuncturist, Chinese herbal medicine practitioner, and Chinese herbal medicine dispenser. Australia was the first Western country to introduce national registration for Chinese medicine, followed by Portugal and, recently, New Zealand. The practice of TCM in Australia can be traced back to the beginning of Chinese immigration to Australia during the Victorian Gold Rush which began in the 1850s. The process which led to national registration commenced in the early 1970s with the establishment of the first acupuncture courses. Decades of gradual development of courses from unaccredited part-time diplomas to accredited bachelor degrees, and the development, by the profession, of national consensus on educational standards were essential elements in the process which led to registration. Professional associations, such as the Australian Acupuncture and Chinese Medicine Association Ltd.(AACMA), also developed a framework of professional selfregulation, including Codes of Ethics, Codes of Conduct, ongoing professional development requirements and Infection Control Guidelines, and provided leadership in the development of the profession. After decades of tribalism and division within the TCM profession, the National Academic Standards Committee brought almost all stakeholders together to reach a consensus on the Australian Guidelines for Traditional Chinese Medicine Education which were published by AACMA in 2001. Professional associations also collaborated on joint submissions to the government in support of registration, which was introduced first in the state of Victoria in 2000, and subsequently became national in 2012. Despite national registration, some barriers still remain, and professional associations continue to lobby the federal government for inclusion in Medicare, chronic disease management scheme, and Veterans Affairs.
基金supported by the Evidence-based Capacity Building Project of Traditional Chinese medicine of the National Administration of Traditional Chinese Medicine(60102)the Fundamental Research Funds for the Central Public Welfare Research Institutes(49425).
文摘Objective:To summarize the characteristics and evaluate the quality of the methodology and evidence within systematic reviews(SRs)of Chinese herbal medicine(CHM)for Mycoplasma pneumoniae pneumonia(MPP)inchildren.Methods:SRs of randomized controlled trials were searched using PubMed,the Cochrane Library,Embase,the Chinese National Knowledge Infrastructure Databases(CNKI),the Chinese Scientific Journals Database(VIP),Wanfang,and the SinoMed Database.SRs on the use of CHM alone or in combination with Western medications for MPP in children were included.The study compared the effects of Western medicine alone with those of CHM.The evidence quality using the A Measurement Tool to Assess Systematic Reviews(AMSTAR)2,the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020,and the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)criteria.The primary indicators were the total effective rate,fever subsidence time,and cough disappearance time.The secondary outcomes were pulmonary rale disappearance time,average hospitalization time,lung X-ray infiltrate disappearance time,immunological indices,and inflammatory cytokine levels.Results:Twelve relevant SRs were included;75%(9/12)were assessed as very low quality,and 25%(3/12)Were rated as low quality using the AMSTAR 2 criteria.According to the PRISMA 2020 checklist,the average SR score was 20.3 out of a 27 point maximum.In all SRs,CHM demonstrated improvement in symptoms and signs among children with MPP.The evidence quality using the GRADE criteria ranged from"very low"(>50%)to"moderate"(<5%).The most common downgrading factor was imprecision,followed by publication bias and inconsistency.Conclusion:This overview highlights the limited quality of the methodology and evidence of the included SRs.Although the included studies showed the beneficial effects of CHM on MPP in children,it was difficult to draw firm conclusions owing to methodological flaws.
文摘It has historically been very difficult to trace the history of the westward transmission of Chinese medicine through the accounts of its protagonists. Many of the early scholars such as Jack Worsley, Dick Van Buren, and Joe Goodman were reluctant to divulge information about the source of their knowledge, or their professional qualifications. Others, such as John Shen and Hong Yuan-bain were early 20th century immigrants who transmitted highly personalized versions of acupuncture and Chinese medicine to select disciples. Eventually, a new class of scholars appeared, including names such as Ted Kaptchuk, Peter Deadman, Nigel Wiseman, William Morris, Peter Eckman, John Mc Donald, Charles Buck, and the late Giovanni Maciocia who looked for answers back in China, developed translation methodologies and terminology, compiled the main textbooks currently in use at TCM colleges, overcame enormous scholastic adversity, developed courses and pursued the regulation and accreditation of TCM in various countries. This special issue synopsizes the path towards the global acculturation of TCM over the last 50 years, the main protagonists, the enormous accomplishments they have achieved for the profession, their philosophy, their clinical perspectives and visions for the future.
基金This research was self-funded as part of an Education Doctorate at the Institute of Education,University College London.
文摘In Chinese medicine, practitioners assess patients’ complaints, analyze their underlying problems, identify causes and come to a diagnosis, which then directs treatment. What is not obvious and not recorded in a consultation is the clinical reasoning process that practitioners use. The research filmed three practitioners in the UK while they conducted a consultation and treatment on new patients. The practitioners and researchers viewed the films and used them as aide-memoirs while the reasoning process throughout was discussed. In order to determine the pattern, practitioners used the four examinations to gather information from the patient in an iterative process;their aesthetic reasoning was highly developed. Through triangulation they checked the information they received against a detailed understanding of the qi-dynamic. They used highly analytical strategies of forward(inductive) and backward(deductive) reasoning against the prototypes of the signs and symptoms that indicate a specific Zheng. This was achieved through an abductive process that linked description with explanation and causal factors with pathological mechanisms. The feedback loop with the patient continued through the consultation and into the treatment. A process of translation and interpretation was needed to turn the patient’s story into the practitioner’s story of qi-dynamics that then directed the treatment. Awareness of our clinical reasoning process will mitigate against biases, improve our diagnoses and treatment choices and support the training of students.
文摘BACKGROUND Heart failure(HF),a common cardiovascular condition,is characterized by significant morbidity and mortality.While traditional Chinese medicine(TCM)is often used as a complementary approach in HF management,systematic evalua-tions of its impact on clinical outcomes,TCM syndrome scores,and B-type natriuretic peptide(BNP)levels are lacking.This study fills this gap through a comprehensive analysis of randomized controlled trials(RCTs)focusing on TCM for HF treatment.It encompasses an assessment of methodological quality,a meta-analysis,and an evaluation of evidence quality based on established standards.The results offer crucial insights into the potential advantages and constraints of TCM in HF management.RCTs on TCM for HF treatment published since the establishment of the database were searched in four Chinese and English databases,including China National Knowledge Infrastructure,Wanfang,VIP Information Chinese Science and Technology Journal,and PubMed.Methodological quality was assessed for the included studies with the Cochrane risk-of-bias assessment tool,and the meta-analysis and publication bias assessment was performed with the RevMan5.3 software.Finally,the quality of evidence was rated according to the GRADE criteria.RESULTS A total of 1098 RCTs were initially retrieved.After screening,16 RCTs were finally included in our study,which were published between 2020 and 2023.These RCTs involved 1660 HF patients,including 832 in the TCM group[TCM combined with conventional Western medicine(CMW)treatment]and 828 in the CWM group(CWM treatment).The course of treatments varied from 1 wk to 3 months.TCM syndrome differentiation was analyzed in 11 of the included RCTs.In all included RCTs,outcome indicators included comprehensive clinical outcomes,TCM syndrome scores,and BNP levels.The meta-analysis results showed significant differences between the TCM and CWM groups in terms of comprehensive clinical outcomes[risk ratio=-0.54;95%confidence interval(CI)=-0.61,-0.47;P<0.00001],TCM syndrome scores[weighted mean difference(WMD)=-142.07;95%CI=-147.56,-136.57;P<0.00001],and BNP levels(WMD=-142.07;95%CI=-147.56,-136.57;P<0.00001).According to the GRADE criteria,RCTs where"TCM improves clinical comprehensive outcomes"were rated as low-quality evidence,and RCTs where"TCM reduces TCM syndrome scores"or"TCM decreases BNP levels"were rated as medium-quality evidence.CONCLUSION TCM combined with CWM treatment effectively improves comprehensive clinical outcomes and diminishes TCM syndrome scores and BNP levels in HF patients.Given the low and medium quality of the included RCTs,the application of these results should be cautious.
文摘In recent years,there has not been much progress in developing anxiolytic drugs.Amongst the barriers are the lack of clarity on the pathogenesis of anxiety disorders,low product conversion rates for developing drugs targeting the receptors,and species variability.Some scientists have focused on natural medicines,especially herbal medicines in traditional Chinese medicine.New drugs with excellent anxiolytic activity are hoped to be found in herbal medicines with anxiolytic effects.This mini-review summarised three Chinese herbal medicines with anxiolytic effects and anxiolytic herbal formulas used in the traditional Chinese medicine clinic.Several key issues that block the development of new anxiolytic drugs are also discussed.We hope to provide some ideas for researching and developing new anxiolytic drugs and studying anxiolytic components in traditional Chinese medicine.
