To present the advances of evidence-based medicine and clinical research methodology in integrative oncology,we conducted a literature review of real-world studies of traditional Chinese medicine(TCM)in cancer care an...To present the advances of evidence-based medicine and clinical research methodology in integrative oncology,we conducted a literature review of real-world studies of traditional Chinese medicine(TCM)in cancer care and summarized the available evidence.Pragmatic randomized controlled trials(pRCTs)and clinical registry studies are becoming more popular as they could compensate for the limitations of RCTs.Many RCTs of TCM for cancer treatment as well as systematic reviews have been published.The most investigated therapies are based on acupuncture,Chinese herbal compounds,and Chinese patent medicines.Acupuncture has a significant advantage in relieving cancer-related symptoms.Published studies focus more on improving clinical symptoms and laboratory indicators.However,the patient's quality of life deserves more attention.展开更多
Objective:To provide high-quality clinical evidence of the efficacy of Tibetan medicine Honghua Ruyi(HHRY)pills for endometriosis-associated dysmenorrhea.Methods:This study constitutes a multicenter,randomized,double-...Objective:To provide high-quality clinical evidence of the efficacy of Tibetan medicine Honghua Ruyi(HHRY)pills for endometriosis-associated dysmenorrhea.Methods:This study constitutes a multicenter,randomized,double-blind,placebo-controlled trial encompassing a three-menstrual cycle intervention followed by a three-menstrual cycle follow-up period.A total of 164 eligible females with endometriosis-associated dysmenorrhea were randomly divided into HHRY pills and placebo groups in a 1:1 ratio.The primary outcome included dysmenorrhea symptoms assessed using Visual Analog Scale(VAS)scores and quality of life,whereas the secondary outcome measures included the maximum VAS for non-menstrual pelvic pain,duration of pain episodes(in days),frequency and quantity of the consumption of ibuprofen sustained-release capsules(or other non-steroidal anti-inflammatory drugs),and days off work/study for staff/student due to dysmenorrhea,ovarian cyst,and/or pelvic nodule size.The safety was monitored throughout the treatment period.All the analyses were based on the intention-to-treat principle.For continuous outcomes,simple or multiple linear regressions were used to estimate the differences between the HHRY pills and placebo groups,with categorical data expressed as the number and percentage of occurrences.Differences were compared using the chi-square test or Fisher's exact test.The predefined analysis was adjusted for concomitant treatment,a variable considered to be associated with outcomes but unaffected by treatment allocation.Estimates of treatment effects were reported with 95%confidence intervals.Two-tailed P values≤.05 were considered statistically significant.Conclusion:Positive results from this trial,upon completion would provide robust evidence for the efficacy and safety of HHRY pills in treating dysmenorrhea in patients with endometriosis.展开更多
Influenza is a serious public health problem that endangers the health of the global human population.Traditional Chinese medicine(TCM)is rich in theory and practical experience regarding the treatment of influenza,an...Influenza is a serious public health problem that endangers the health of the global human population.Traditional Chinese medicine(TCM)is rich in theory and practical experience regarding the treatment of influenza,and TCM treatments have shown good curative effects,but there is a dearth of standardized clinical guidance.It is necessary to formulate a clinical practice guide based on evidence-based medicine.To this end,the Specialty Committee of Emergency,China Association of Chinese Medicine(Beijing,China)organized a team of clinical experts,methodological experts,and other multidisciplinary experts to develop a guideline with integrated research methods in the first place of TCM.This guide includes 23 recommendations.The prescription section contains 16 recommendations,including 5 recommendations for mild cases,5 recommendations for severe cases,3 recommendations for critical cases,and 4 recommendations for the recovery period;the portion covering proprietary Chinese medicines forms a total of 7 recommendations.This guide aims to provide the best evidence for clinicians and related practitioners to make decisions about influenza diagnosis and treatment in Chinese medicine.展开更多
Objective:To systematically evaluate the effectiveness and safety of Chinese herbal medicine (CHM) plus nucleotide analogues (NAs) for treating compensated HBV-related cirrhosis,the early stage of cirrhosis.Methods:Pu...Objective:To systematically evaluate the effectiveness and safety of Chinese herbal medicine (CHM) plus nucleotide analogues (NAs) for treating compensated HBV-related cirrhosis,the early stage of cirrhosis.Methods:PubMed,Cochrane library,China Network Knowledge Infrastructure Database (CNKI),Chinese Scientific Journals Database (VIP),Wan Fang Database and Sino-Med Database were searched.Randomized controlled trials (RCTs) and quasi-RCTs comparing NAs and NAs plus CHM therapy on patients with compensated HBV-related cirrhosis were included.Two reviewers independently extracted information and assessed the methodological quality of the trials.Different CHM herbal formulas used in the trials were considered.Primary metaanalysis was conducted when there were at least two trials comparing the same CHM formula.Results:Forty-five trials comprising 3497 participants were included.The quality of most of the trials was moderate or low.Twenty-six herbal formulations were identified.A meta analysis was conducted for compound Biejia Ruangan (FFBJ),Dahuang Zhechong (DHZC),and Fuzheng Huayu (FZHY).The results of the subgroup analysis showed a beneficial effect of FFBJ plus entecavir (ETV),and DHZC plus adefovir dipivoxil (ADV) on hyaluronic acid (HA);FFBJ plus ADV on laminin (LN);and FZHY plus ADV on HA,LN,and precollagen type Ⅲ (PC-Ⅲ).The results from other studies suggested significant benefits of CHM plus NAs compared with NAs alone,except those on albumin (ALB).None of the trials evaluated the quality of life or reported severe adverse events.Conclusions:A positive effect was found for FFBJ plus ETV,DHZC plus ADV,and FZHY plus ADV on HA;FZHY plus ADV and FFBJ plus ADV on LN;and FZHY plus ADV on PCⅢ compared with the effects of NAs used alone.展开更多
Objective:To summarize the use of Chinese herbal medicines (CHM) for the treatment of hand-foot-and-mouth disease (HFMD) in children and to provide high-level evidence for clinical decision-making.Methods:We conducted...Objective:To summarize the use of Chinese herbal medicines (CHM) for the treatment of hand-foot-and-mouth disease (HFMD) in children and to provide high-level evidence for clinical decision-making.Methods:We conducted an overview of systematic reviews (SRs).Two English-language and four Chinese-language electronic databases were searched from inception to March 31,2018.Published SRs and meta-analyses evaluating CHM use in children with HFMD and reporting clinically-relevant outcomes such as time to fever resolution were eligible for inclusion in this overview.Reviews were accepted if the intervention featured CHM with or without other treatment.Two authors evaluated the methodological quality of the included SRs by using ASMTAR and ROBIS.Results:Thirty SRs comprising 90 244 children with HFMD were included in this overview of SRs.All SRs were published in Chinese between 2011 and 2017.All intervention arms received CHM with or without conventional treatment and were compared against control arms receiving no treatment,conventional treatment alone,or placebo.All 30 reviews reported the time to fever resolution and results demonstrated that CHM had a greater benefit in reducing fever compared with controls.Twenty-three reviews reported the time to rash resolution which presented similar results.Fourteen SRs reported the time to oral ulcer healing and CHM demonstrated a significantly reduced time to resolution compared to controls.The quality of the included SRs was low to moderate as assessed by the AMSTAR tool.Conclusion:Published reviews demonstrated potential benefits of CHM in children with HFMD.Overall,the methodological quality of reviews included in this overview of SRs was low and our findings should be interpreted with caution.We would strongly recommend that future SRs be designed and reported rigorously following PRISMA in order to provide more robust evidence on which to base clinical guidance.展开更多
Objective:This study assessed whether Chinese herbal medicine(CHM)combined with probiotics/synbiotics for irritable bowel syndrome-diarrhea(IBS-D)was more effective and safer than probiotics/synbiotics alone.Methods:T...Objective:This study assessed whether Chinese herbal medicine(CHM)combined with probiotics/synbiotics for irritable bowel syndrome-diarrhea(IBS-D)was more effective and safer than probiotics/synbiotics alone.Methods:Ten databases were searched for randomized control trials(RCTs)of IBS-D as diagnosed by Manning or Rome criteria.Trials comparing probiotics and probiotics with CHM were included.The Cochrane risk of bias(ROB)was evaluated for each trial.RevMan 5.3 was used to conduct a meta-analysis.Results:Twenty-six RCTs were included(25 Chinese,1 English),involving 2045 participants.Metaanalysis was conducted on two outcomes:overall symptom improvement and relapse.CHM combined with live Bifidobacterium and Lactobacillus preparations reduced relapse rate(RR 0.28,95%CI 0.15e0.52,3 trials,n?205)compared with probiotics alone.The subgroup analysis showed the benefit of CHM prescriptions based on soothing liver and invigorating spleen(1.28,1.14e1.44,3,244),invigorating spleen and resolving dampness(1.20,1.03e1.41,2,128),or warming and invigorating spleen and kidney formulae(1.27,1.09e1.46,2,210)combined with triple Bifidobacterium preparations than the same probiotics alone which improved overall symptoms for IBS-D.There was unclear bias in almost domains of ROB.Most studies had a high risk of bias due to lack of blinding of investigator and participants,and selective reporting.Conclusions:This study showed that CHM combined with probiotics may reduce relapse rate by 72%,and improve overall symptoms of IBS-D(as diagnosed by Rome II and III)compared to probiotics alone.From the limited subgroup analysis,only soothing liver and invigorating spleen formulae,represented by Tongxie Yaofang,added to triple Bifidobacterium preparations may be superior to the single preparations in terms of overall symptoms.However,due to the poor methodological quality and small sample size of the trials,these findings must be interpreted with caution.展开更多
Object:Traditional Chinese medicine(TCM)has been taught widely in the both Eastern and Western world countries.This study compared the origin,student source,duration,and curriculum design of TCM higher education progr...Object:Traditional Chinese medicine(TCM)has been taught widely in the both Eastern and Western world countries.This study compared the origin,student source,duration,and curriculum design of TCM higher education programs in China and five Western countries.Method:We searched the Internet and the China National Knowledge Infrastructure(CNKI)database to gather relevant information.Result:All the six countries offer acupuncture and/or Chinese herbal medicine programs at universities and/or private schools.However,there are great large differences among them in the education of curriculum and TCM students enrollment and curriculum policies of TCM courses.Conclusions:There are large differences among their curriculum and enrollment policies.This comparison should provide information about the further development of international standards in TCM education.展开更多
BACKGROUND Heat shock proteins(HSPs)are molecular chaperones that play an important role in cellular protection against stress events and have been reported to be overex-pressed in many cancers.The prognostic signific...BACKGROUND Heat shock proteins(HSPs)are molecular chaperones that play an important role in cellular protection against stress events and have been reported to be overex-pressed in many cancers.The prognostic significance of HSPs and their regulatory factors,such as heat shock factor 1(HSF1)and CHIP,are poorly understood.AIM To investigate the relationship between HSP expression and prognosis in esophageal and esophagogastric cancer.METHODS A systematic review was conducted in accordance with PRISMA recommend-ations(PROSPERO:CRD42022370653),on Embase,PubMed,Cochrane,and LILACS.Cohort,case-control,and cross-sectional studies of patients with eso-phagus or esophagogastric cancer were included.HSP-positive patients were compared with HSP-negative,and the endpoints analyzed were lymph node metastasis,tumor depth,distant metastasis,and overall survival(OS).HSPs were stratified according to the HSP family,and the summary risk difference(RD)was calculated using a random-effect model.RESULTS The final selection comprised 27 studies,including esophageal squamous cell carcinoma(21),esophagogastric adenocarcinoma(5),and mixed neoplasms(1).The pooled sample size was 3465 patients.HSP40 and 60 were associated with a higher 3-year OS[HSP40:RD=0.22;95%confidence interval(CI):0.09-0.35;HSP60:RD=0.33;95%CI:0.17-0.50],while HSF1 was associated with a poor 3-year OS(RD=-0.22;95%CI:-0.32 to-0.12).The other HSP families were not associated with long-term survival.HSF1 was associated with a higher probability of lymph node metastasis(RD=-0.16;95%CI:-0.29 to-0.04).HSP40 was associated with a lower probability of lymph node dissemination(RD=0.18;95%CI:0.03-0.33).The expression of other HSP families was not significantly related to tumor depth and lymph node or distant metastasis.CONCLUSION The expression levels of certain families of HSP,such as HSP40 and 60 and HSF1,are associated with long-term survival and lymph node dissemination in patients with esophageal and esophagogastric cancer.展开更多
Objective:To evaluate the efficacy and safety of Jiawei Simiao powder(JWSMP)combined with celecoxib for the treatment of acute gouty arthritis by conducting a meta-analysis of randomized controlled trials(RCTs).Method...Objective:To evaluate the efficacy and safety of Jiawei Simiao powder(JWSMP)combined with celecoxib for the treatment of acute gouty arthritis by conducting a meta-analysis of randomized controlled trials(RCTs).Methods: The Chinese National Knowledge Infrastructure Databases,Chinese Scientific Journal Database,Wanfang,Cochrane Library,EMBASE,PubMed,and Web of Science databases were searched from inception until December 2023.Continuous variables were analyzed using the mean difference(MD)for analysis,and dichotomous variables were used as risk ratios.Data with similar characteristics were pooled for meta-analysis,and heterogeneity was assessed using I2.The Cochrane Handbook was used to assess the risk of bias and quality.RevMan 5.3 software was used to perform the meta-analysis.Results: Thirteen RCTs involving 1007 patients were included in the study.The quality of the included studies was low(unclear randomization processes and insufficient blinding reporting).The group receiving JWSMP combined with celecoxib showed significantly lower levels of serum uric acid(SUA,MD=−66.32,95%confidence interval(CI):−80.97 to−51.67,P<.001),erythrocyte sedimentation rate(ESR,MD=−6.05,95%CI:−8.29 to−3.82,P<.001),C-reactive protein(CRP,MD=−7.39,95%CI:−11.15,−3.63,P<.001),and joint pain score(VAS score,MD=−2.14,95%CI:−2.4 to−1.88,P<.001)compared to celecoxib alone.Additionally,the JWSMP combined group had a higher total effective rate(risk ratio=1.22,95%CI:1.14 to 1.29,P<.001)and fewer adverse compared to celecoxib alone.Conclusions: JWSMP combined with celecoxib is more effective than celecoxib alone in improving the total efficacy rate,alleviating joint pain,and improving SUA,ESR,and CRP levels.JWSMP also reduced the occurrence of adverse events caused by celecoxib.However,the quality of the included studies was low,highlighting the need for further high-quality research with larger sample sizes and robust methodologies,such as double-blind randomization,to confirm these findings.展开更多
Background:Acupuncture protocols are essential as they guide study design and improve the quality of clinical trial,thus preventing avoid research waste.Given the increasing number of publications on acupuncture proto...Background:Acupuncture protocols are essential as they guide study design and improve the quality of clinical trial,thus preventing avoid research waste.Given the increasing number of publications on acupuncture protocols,this study aimed to assess the publications trends of acupuncture protocols over the past two decades and provided an overview for future research directions.Methods:Publications focusing on acupuncture protocols in clinical settings were retrieved and compiled from the Web of Science Core Collection spanning the period from 2004 to 2023.CiteSpace and Microsoft Excel software were used to analyze the relationship of publication with countries,institutions,authors,co-cited author,journals,references,keywords and other literature aspects.Results:This study analyzed 721 articles encompassing acupuncture protocols.A continuous yet fluctuating growth in publications volume were observed from 2004 to 2023.Notably,China stands at the forefront in contributing to acupuncture protocols,publishing 513 papers and demonstrating a high centrality score of 1.07 in cooperative network.Furthermore,China has fostered close collaborations with the USA and South Korea.Beijing University of Chinese Medicine(89),Zhishun Liu(36)and Trials(306)emerged as the top contributors in terms of institution,author,and journal,respectively.However,inter-institutional and author collaboration was relatively weak.Macpherson H was the most frequently cited author.High-frequency keywords included“randomized controlled trials”,“acupuncture”,“management”,“study protocol”,“quality of life”.Analysis of timeline diagram of keywords indicated that“functional dyspepsia”,“stroke”,“electroacupuncture”,and“colorectal cancer”were the research development trends and focus.Conclusion:Clinical acupuncture protocols have experienced robust development over the past two decades,with current research hotspots focusing on disease management and quality of life,which remain key research concerns.Moreover,we advocate for researchers to publish acupuncture protocols,which remain key research concerns.This approach allows for thorough pre-study planning of methodologies and objectives,enhancing scientific rigor through peer review,thereby laying the foundation for conducting high-quality research.展开更多
OBJECTIVE:To summarize the evidence from Traditional Chinese Medicine(TCM)practice in the treatment of acute primary headache and provide clinical practice guidance.METHODS:The guidelines were developed in accordance ...OBJECTIVE:To summarize the evidence from Traditional Chinese Medicine(TCM)practice in the treatment of acute primary headache and provide clinical practice guidance.METHODS:The guidelines were developed in accordance with the World Health Organization guideline development manual.After the establishment of steering committee,panel and the registration and protocol formulation,the evidence on TCM for acute primary headache from published guidelines,clinical evidence,and expert experience and consensus were collected.The grading of recommendations assessment,development and evaluation method was used to grade the evidence and make the recommendations.RESULTS:Based on the available evidence,the guidelines recommended three TCM herbal decoctions,six Chinese patent medicines,and two kinds of external application of Chinese herbal medicines.Diagnostic recommendations based on the expert experience and consensus were also included in the guidelines.CONCLUSION:TCM diagnosis and treatment of decoction,Chinese patent medicine and external application for treating acute primary headache were recommended.We hope these guidelines will be helpful in standardize the TCM acute treatment of primary headache.展开更多
Objective:To explore the characteristics of Xiao Chai Hu(XCH)decoction in randomized controlled trials(RCTs)using a bibliometric method.Methods:Seven databases including PubMed,Web of Science,Embase,Cochrane library,C...Objective:To explore the characteristics of Xiao Chai Hu(XCH)decoction in randomized controlled trials(RCTs)using a bibliometric method.Methods:Seven databases including PubMed,Web of Science,Embase,Cochrane library,China National Knowledge Infrastructure(CNKI),Chinese Scientific Journal Database(VIP)and Wanfang database were retrieved from inception to May 27,2022.In the study,XCH decoction(or modified)used alone or combined with conventional Western medicine as an intervention measure was included.The basic characteristics,funding support,relevant diseases,intervention methods,and adverse events(AEs)were analyzed.Data analysis was performed using SPSS 26.0 software.Results:A total of 813 RCTs were included,published from 1989 to 2022.There was only one Englishlanguage literature with the recent impact factor of 5.374.There were 147 studies were from Chineselanguage core journals,with the highest impact factor of 2.414.Only 6.15%of the literatures mentioned funding support.96.31%of the included literature reported the statistical significance of using XCH decoction.The diseases treated mainly included chronic hepatitis B(9.35%),cough variant asthma(5.66%),dizziness(5.54%),bile reflux gastritis(4.43%),and fever(4.18%).However,the overall research design of the included literature was poor,and large sample size,multicenter RCTs are needed.The incidence of AEs of XCH decoction alone was 8.86%,which was significantly lower than that of conventional Western medicine treatment.The combination of XCH decoction and conventional Western medicine treatment could reduce the incidence of AEs,and no serious adverse event was reported.Conclusion:Although the included studies show that XCH decoction is widely used,and has good efficacy and few AEs.Due to the low quality of the included RCTs,there may be some bias,and its rational use based on the specific conditions is recommended in clinical practice.展开更多
Background:Primary dysmenorrhea(PD)is the most common complaint associated with menstruation and affects up to three-quarters of women at some stage of their reproductive life.In Chinese medicine,navel therapy,treatme...Background:Primary dysmenorrhea(PD)is the most common complaint associated with menstruation and affects up to three-quarters of women at some stage of their reproductive life.In Chinese medicine,navel therapy,treatment provided at Shenque(CV 8),is used as a treatment option for PD.Objective:To evaluate the effect of navel therapy on pain relief and quality of life in women with PD,compared with Western medicine(WM).Methods:China National Knowledge Infrastructure(CNKI),Chinese Scientific Journal Database(VIP),Sino Med and Wanfang Database,MEDLINE,the Cochrane Library,Embase,Web of Science,and the International Clinical Trial Registry of the U.S.National Institutes of Health were searched from their inceptions to April 1,2021.Randomized controlled trials(RCTs)assessing therapeutic effects of navel therapy on PD were eligible for inclusion.Rev Man 5.4 software was used for data analyses.The certainty of the evidence was assessed using the online GRADEpro tool.Results:Totally 24 RCTs involving 2,614 participants were identified.Interventions applied to acupuncture point CV 8 included:herbal patching,moxibustion or combined navel therapy(using at least 2 types of stimulation).Compared to placebo,there was a significant effect in favor of navel therapy on reducing overall menstrual symptom scores at the end of treatment[mean difference:-0.82,95%confidence interval(CI):-1.00 to-0.64,n=90;1 RCT].As compared with Western medicine,navel therapy had a superior effect on pain intensity as assessed by Visual Analogue Scale at the end of treatment[standardized mean difference(SMD):-0.64,95%CI:-1.22 to-0.06,I^(2)=80%,n=262;3 RCTs];on symptom resolution rate at 3-month follow-up(risk ratio:1.94,95%CI:1.47 to 2.56,n=1527,I^(2)=38%;13 RCTs);and on global menstrual symptoms score at the end of treatment(SMD:-0.67,95%CI:-0.90 to-0.45,I^(2)=63%,n=990;12 RCTs).Subgroup analyses showed either a better or an equivalent effect comparing navel therapy with Western medicine.No major adverse events were reported.The methodological quality of included trials was poor overall.Conclusions:Navel therapy appears to be more effective than Western medicine in decreasing menstrual pain and improving overall symptoms of PD.However,these findings need to be confirmed by well-designed clinical trials with adequate sample size(Systematic review registration at PROSPERO,No.CRD42021240350).展开更多
Background:Patients with colon cancer who receive chemotherapy usually experience various gastrointestinal adverse reactions,including nausea,vomiting,and diarrhea,which make it challenging for them to adhere to treat...Background:Patients with colon cancer who receive chemotherapy usually experience various gastrointestinal adverse reactions,including nausea,vomiting,and diarrhea,which make it challenging for them to adhere to treatment.As an effective traditional Chinese medicine,the Jianpi Bushen formula has been widely used to alleviate the side effects of chemotherapy.Objective:To evaluate the efficacy and safety of Jianpi Bushen formulae for patients who undergo chemotherapy.This statistical analysis plan(SAP)is intended to enhance the transparency and research quality of our randomized controlled trial.Methods:Our study is a multicenter,double-blind,randomized controlled clinical trial.This trial aimed to compare the completion rate of chemotherapy in colon cancer patients who are using and not using Jianpi Bushen formula.To attenuate possible selection bias in the final report,we declared the overall trial design,outcome measures,subgroup analyses,and safety measures.Also,we described the data management and statistical analysis methods in detail.Conclusion:The SAP provides more detailed information than the trial protocol for data management and statistical analysis methods.Further post-hoc analyses can be performed by referring to the SAP,and possible selection bias can be attenuated.展开更多
Objective:To assess the quality of systematic reviews assessing the effects of traditional Chinese exercises on controlling blood indices,anthropometric indices,psychological indices,and quality of life in patients wi...Objective:To assess the quality of systematic reviews assessing the effects of traditional Chinese exercises on controlling blood indices,anthropometric indices,psychological indices,and quality of life in patients with diabetes.Methods:Systematic studies/meta-analyses of intervention with traditional Chinese exercises on diabetes mellitus were searched in the Pub Med,Web of Science,the China National Knowledge Infrastructure Databases(CNKI),Wan Fang Database,and Chinese Scientific Journal Database(VIP).Two researchers independently screened the studies and extracted the data.The methodology and quality of evidence of the included studies were assessed using A Measurement Tool to Assess Systematic Reviews2(AMSTAR-2)and Grading of Recommendations Assessment,Development and Evaluation(GRADE)criteria,respectively.Results:A total of 32 systematic reviews/meta-analyses were included in the present study.Of them,the methodological quality of 4 studies was graded as low,while that of the other 28 was graded as extremely low.The most common quality flaws in key items included a lack of preliminary proposals for systematic reviews,failure to explain the reasons for the inclusion criteria,failure to provide a list of excluded studies and reasons for exclusion,failure to report potential conflicts of interest,and inadequate assessment of publication bias.The quality of evidence for most of the 18 outcomes was subsequently graded as medium or low.Overall,the results of these studies indicated that Tai Chi,health qigong,and other traditional Chinese exercises lowered fasting blood glucose(FBG),2-h postprandial blood glucose(2hPBG),hemoglobin A_(1c)(HbA_(1c)),and body mass index,and relieved anxiety and depression in patients with diabetes.Conclusion:Our findings indicate that the methodological quality of systematic reviews related to traditional Chinese exercises in the diabetic population is generally low,and the quality of evidence is also relatively poor.Therefore,we suggest that the quality of systematic reviews and meta-analyses on traditional Chinese exercises for controlling diabetes mellitus needs to be improved.In the future,researchers should conduct higher-quality clinical studies with reference to the AMSTAR2 checklist and GRADE system.展开更多
Objective:Since December 2019,an outbreak of corona virus disease 2019(COVID-19)occurred in Wuhan,and rapidly spread to almost all parts of China.This was followed by prevention programs recommending Chinese medicine(...Objective:Since December 2019,an outbreak of corona virus disease 2019(COVID-19)occurred in Wuhan,and rapidly spread to almost all parts of China.This was followed by prevention programs recommending Chinese medicine(CM)for the prevention.In order to provide evidenee for CM recommendations,we reviewed ancient classics and human studies.Methods:Historical records on prevention and treatment of infections in CM classics,clinical evidence of CM on the prevention of severe acute respiratory syndrome(SARS)and H1N1 in flue nza,and CM preve ntion programs issued by health authorities in China since the COVID-19 outbreak were retrieved from differe nt databases and websites till 12 February,2020.Research evide nee in eluded data from clinical trials,cohort or other population studies using CM for preventing contagious respiratory virus diseases.Results:The use of CM to prevent epidemics of infectious diseases was traced back to ancient Chinese practice cited in Huangdi's Internal Classic(Huang Di Nei Jing)where preventive effects were recorded.There were 3 studies using CM for prevention of SARS and 4 studies for H1N1 influenza.None of the participants who took CM contracted SARS in the 3 studies.The infection rate of H1N1 in flue nza in the CM group was significantly lower than the non-CM group(relative risk 0.36,95%confidence interval 0.24-0.52;n=4).For prevention of COVID-19,23 provinces in China issued CM programs.The main principles of CM use were to tonify qi to protect from external pathoge ns,disperse wind and discharge heat,and resolve damp ness.The most frequently used herbs in eluded Radix astragali(Huangqi),Radix glycyrrhizae(Gancao),Radix saposhnikoviae(Fangfeng),Rhizoma Atractylodis Macrocephalae(Baizhu),Lonicerae Japonicae Flos(Jinyinhua),and Fructus forsythia(Lianqiao).Conclusions:Based on historical records and human evidenee of SARS and H1N1 influenza prevention,Chinese herbal formula could be an alternative approach for prevention of COVID-19 in high-risk population.Prospective,rigorous population studies are warranted to confirm the potential preventive effect of CM.展开更多
OBJECTIVE:To assess the effectiveness and safety of Traditional Chinese Medicine(TCM) treatment of non-acute bronchial asthma complicated by gastroesophageal reflux.METHODS:We searched databases from MEDLINE,Cochrane ...OBJECTIVE:To assess the effectiveness and safety of Traditional Chinese Medicine(TCM) treatment of non-acute bronchial asthma complicated by gastroesophageal reflux.METHODS:We searched databases from MEDLINE,Cochrane Library,CNKI,VIP,CBM,Wanfang Data,and TCM Database Systems.All randomized,controlled trials(RTCs) of TCM treatment of non-acute asthma complicated by gastroesophageal reflux were included.Data were independently collected by two reviewers.The standards for assessing quality described in the Cochrane Handbook for Systematic Reviews of Interventions were used to evaluate articles.Meta-analyses were conducted using RevMan 5.0.17 software.Heterogeneity was assessed,and a corresponding effects model was used to merge and analyze results.Indexes used to evalu-ate curative effects were:clinical efficacy,symptom scores,pulmonary function values,and adverse incidents.Effectiveness was indicated using risk ratio(RR) or mean difference(MD),and 95% confidence intervals(CIs) were calculated.RESULTS:Six RCTs were included,involving 304 patients with non-acute asthma complicated by gastroesophageal reflux.The treatment groups received Chinese drugs alone or TCM combined with standard Western medical treatment,and the control groups received standard Western medical treatment alone.Standard Western medical treatment included anti-inflammatory drugs and bronchodilators for asthma,and drugs to promote gastric peristalsis and inhibit gastric acid production for gastroesophageal reflux.Methodological quality was low in all six RCTs.Two RCTs showed that clinical efficacy was higher in the treatment group than in the control group(RR:1.43,95%CI:1.10 to 1.87 vs RR:1.51,95% CI:1.09 to 2.08).One RCT showed that the asthma score was lowered more effectively in the treatment group than in the control group(MD:-1.10,95% CI:-2.04 to-0.16).Two RCTs showed that the gastroesophageal reflux score was reduced more effectively in the treatment group than in the control group(RR:-3.70,95% CI:-4.30 to 3.10 vs RR:-5.30,95% CI:-6.32 to-4.28).One RCT showed that some pulmonary function values were improved more effectively in the treatment group than in the control group(P< 0.05).No differences were seen in the various indexes between groups in the other RCTs.No adverse reactions,dropout rates,or follow-up rates were reported in any of the RCTs.CONCLUSIONS:The clinical symptoms ofnon-acute asthma complicated by gastroesophageal reflux can be improved by some Chinese drugs.Curative effects can be increased by combining the use of TCM with Western medicine.Because of the small quantity and low quality of research reported to date,it is necessary to conduct further RCTs to confirm these results.The results of this systematic review indicate that the quality of future clinical trials should be improved by including larger patient numbers,correctly randomizing patients into study groups,using blinding methods to measure and assess outcomes,and using accepted indexes to evaluate curative effects.展开更多
Objective:To provide evidence on the efficacy and safety of Chinese herbal medicine(CHM)as interventions for systemic lupus erythematosus(SLE).Methods:Seven electronic databases,including the Cochrane Library,Chinese ...Objective:To provide evidence on the efficacy and safety of Chinese herbal medicine(CHM)as interventions for systemic lupus erythematosus(SLE).Methods:Seven electronic databases,including the Cochrane Library,Chinese National Knowledge Infrastructure(CNKI),Chinese Scientific Journal Database(VIP),Chinese Biomedical Literature Service System(SinoMed),Wanfang,Embase,and PubMed,were comprehensively searched,from their inception to August 16,2020,for all randomized controlled trials(RCTs)that focused on CHM used alone or in combination with conventional medicine for SLE.Outcomes were SLE activity index(SLEDAI),traditional Chinese medicine symptom/syndrome score(TCMSS),dosage of glucocorticoids,main serological testing,and incidence of adverse events.Data were extracted and pooled using Review Manager 5.3 software.Results:A total of 13 RCTs enrolling 856 participants met our inclusion criteria.Meta-analyses showed that,compared to placebo,CHM had statistically significant effect on reducing SLEDAI score(MD=-1.74,95%Cl:-2.29 to-1.18),diminishing TCMSS(SMD=-0.89,95%Cl:-1.16 to-0.62),decreasing dosage of glucocorticoids(MD=-2.41 mg/d,95%Cl:-3.34 to-1.48),lowering erythrocyte sedimentation rate(MD=-4.78 mm/h,95%Cl:-8.86 to-0.71),and increasing serum complement C4 level(MD=0.03 mg/dL,95%Cl:0.00 to 0.06).No significant difference was found between CHM and placebo on adverse events.Conclusions:CHM provided significant beneficial effect on controlling disease activity and reducing dose of glucocorticoids used among SLE patients.Future advanced designed RCTs for CHM treating moderate to severe SLE with multicenter and longer follow-up are urgently needed.展开更多
The objectives of this study are to conduct a comprehensive literature search and bibliometric analysis to identify the breadth and volume of pharmacological and clinical studies on pine pollen(Pinus pollen)and to ide...The objectives of this study are to conduct a comprehensive literature search and bibliometric analysis to identify the breadth and volume of pharmacological and clinical studies on pine pollen(Pinus pollen)and to identify the potential effects and the use of pine pollen.Three Chinese electronic databases and two English electronic databases were searched for pharmacological and clinical studies on pine pollen.Data were extracted and analyzed and included publication year,authors,study type,pharmacological research topics or clinical diseases/conditions,usage and type of preparation,authors’conclusions,and adverse effects.Of 239 publications identified,180 were pharmacological studies,37 were clinical trials,and 22 were reviews.Numbers of publications increased particularly from 2004 onward.The top 10 most frequent topics in pharmacological studies were immune regulation,antisenility,antioxidation,liver protection,inhibiting prostate hyperplasia,inhibiting tumor cell proliferation,lowering blood glucose,lowering blood lipids,antifatigue,and improving intestinal function.The top 10 most frequent clinical diseases treated or where pine pollen was used as an adjuvant were bedsores,diaper dermatitis,hyperlipidemia,oral mucositis,eczema,hyperplasia of prostate,hypertension,prostatitis,type 2 diabetes mellitus,and radiodermatitis.Eight trials reported no adverse events associated with pine pollen,one reported mild gastrointestinal reactions,but symptoms disappeared without special management.There have been an increasing number of publications on pine pollen during the past 20 years.Pharmacological studies have shown many potential benefits,and clinical studies have indicated some positive effects when it is either used as a single herb or as an adjuvant to treat disease.Its use as a topical agent,especially for skin diseases,was notable.展开更多
Background:As a traditional treatment method,cupping therapy is widely used in Asian countries.This overview of systematic reviews (SRs) investigated the effectiveness and safety of cupping therapy through an evidence...Background:As a traditional treatment method,cupping therapy is widely used in Asian countries.This overview of systematic reviews (SRs) investigated the effectiveness and safety of cupping therapy through an evidence-based approach.Methods:SRs that assessed the effectiveness of cupping therapy for any type of disease were searched through 6 electronic databases.Target diseases,cupping methods,numbers and types of included studies,quality of included trials,main results (including meta-analysis re sults),and authors' conclusions of SRs were extracted.The Assessment of Multiple Systematic Reviews measurement was used to evaluate methodologic quality of the SRs.Results Eight SRs met the inclusion criteria and effectiveness and safety of cupping therapy for 11 diseases were assessed.All included SRs were of good methodologic quality.However,quality of trials included in the SRs was generally poor.Meta-analysis was performed in 4 studies.Results:showed cupping therapy (alone or combined with other interventions) was better than medications (or other interventions alone) for herpes zoster,acne,facial paralysis,low back pain,or cervical spondylosis.One review reported adverse events,including hematoma,increased pain and tingling following cupping treatment.Conclusions:Cupping therapy may be beneficial for pain-related conditions,acne,and facial paralysis.However,a firm conclusion could not be drawn due to the insufficient number of included reviews and the low quality of the original studies.展开更多
基金This study was supported by the Key Project of the National Natural Science Foundation of China(81830115).
文摘To present the advances of evidence-based medicine and clinical research methodology in integrative oncology,we conducted a literature review of real-world studies of traditional Chinese medicine(TCM)in cancer care and summarized the available evidence.Pragmatic randomized controlled trials(pRCTs)and clinical registry studies are becoming more popular as they could compensate for the limitations of RCTs.Many RCTs of TCM for cancer treatment as well as systematic reviews have been published.The most investigated therapies are based on acupuncture,Chinese herbal compounds,and Chinese patent medicines.Acupuncture has a significant advantage in relieving cancer-related symptoms.Published studies focus more on improving clinical symptoms and laboratory indicators.However,the patient's quality of life deserves more attention.
基金supported by the National Natural Science Foundation of China(81830115).
文摘Objective:To provide high-quality clinical evidence of the efficacy of Tibetan medicine Honghua Ruyi(HHRY)pills for endometriosis-associated dysmenorrhea.Methods:This study constitutes a multicenter,randomized,double-blind,placebo-controlled trial encompassing a three-menstrual cycle intervention followed by a three-menstrual cycle follow-up period.A total of 164 eligible females with endometriosis-associated dysmenorrhea were randomly divided into HHRY pills and placebo groups in a 1:1 ratio.The primary outcome included dysmenorrhea symptoms assessed using Visual Analog Scale(VAS)scores and quality of life,whereas the secondary outcome measures included the maximum VAS for non-menstrual pelvic pain,duration of pain episodes(in days),frequency and quantity of the consumption of ibuprofen sustained-release capsules(or other non-steroidal anti-inflammatory drugs),and days off work/study for staff/student due to dysmenorrhea,ovarian cyst,and/or pelvic nodule size.The safety was monitored throughout the treatment period.All the analyses were based on the intention-to-treat principle.For continuous outcomes,simple or multiple linear regressions were used to estimate the differences between the HHRY pills and placebo groups,with categorical data expressed as the number and percentage of occurrences.Differences were compared using the chi-square test or Fisher's exact test.The predefined analysis was adjusted for concomitant treatment,a variable considered to be associated with outcomes but unaffected by treatment allocation.Estimates of treatment effects were reported with 95%confidence intervals.Two-tailed P values≤.05 were considered statistically significant.Conclusion:Positive results from this trial,upon completion would provide robust evidence for the efficacy and safety of HHRY pills in treating dysmenorrhea in patients with endometriosis.
基金funded by the National Key Research and Development Program of China(2020YFC0861000)the National Science and Technology Major Project of the National Health Commission(2017ZX10305501).
文摘Influenza is a serious public health problem that endangers the health of the global human population.Traditional Chinese medicine(TCM)is rich in theory and practical experience regarding the treatment of influenza,and TCM treatments have shown good curative effects,but there is a dearth of standardized clinical guidance.It is necessary to formulate a clinical practice guide based on evidence-based medicine.To this end,the Specialty Committee of Emergency,China Association of Chinese Medicine(Beijing,China)organized a team of clinical experts,methodological experts,and other multidisciplinary experts to develop a guideline with integrated research methods in the first place of TCM.This guide includes 23 recommendations.The prescription section contains 16 recommendations,including 5 recommendations for mild cases,5 recommendations for severe cases,3 recommendations for critical cases,and 4 recommendations for the recovery period;the portion covering proprietary Chinese medicines forms a total of 7 recommendations.This guide aims to provide the best evidence for clinicians and related practitioners to make decisions about influenza diagnosis and treatment in Chinese medicine.
基金The current work was partially supported by the National Basic Research Program of China(973 Program,no.2011CB505105)We thank Guoyan Yang from National Institute of Complementary Medicine,University of Western Medicine for her suggestions in data synthesis.
文摘Objective:To systematically evaluate the effectiveness and safety of Chinese herbal medicine (CHM) plus nucleotide analogues (NAs) for treating compensated HBV-related cirrhosis,the early stage of cirrhosis.Methods:PubMed,Cochrane library,China Network Knowledge Infrastructure Database (CNKI),Chinese Scientific Journals Database (VIP),Wan Fang Database and Sino-Med Database were searched.Randomized controlled trials (RCTs) and quasi-RCTs comparing NAs and NAs plus CHM therapy on patients with compensated HBV-related cirrhosis were included.Two reviewers independently extracted information and assessed the methodological quality of the trials.Different CHM herbal formulas used in the trials were considered.Primary metaanalysis was conducted when there were at least two trials comparing the same CHM formula.Results:Forty-five trials comprising 3497 participants were included.The quality of most of the trials was moderate or low.Twenty-six herbal formulations were identified.A meta analysis was conducted for compound Biejia Ruangan (FFBJ),Dahuang Zhechong (DHZC),and Fuzheng Huayu (FZHY).The results of the subgroup analysis showed a beneficial effect of FFBJ plus entecavir (ETV),and DHZC plus adefovir dipivoxil (ADV) on hyaluronic acid (HA);FFBJ plus ADV on laminin (LN);and FZHY plus ADV on HA,LN,and precollagen type Ⅲ (PC-Ⅲ).The results from other studies suggested significant benefits of CHM plus NAs compared with NAs alone,except those on albumin (ALB).None of the trials evaluated the quality of life or reported severe adverse events.Conclusions:A positive effect was found for FFBJ plus ETV,DHZC plus ADV,and FZHY plus ADV on HA;FZHY plus ADV and FFBJ plus ADV on LN;and FZHY plus ADV on PCⅢ compared with the effects of NAs used alone.
基金This study was supported by The National Natural Science Foundation of China(81673828)Capacity Building in Evidence-based Chinese Medicine and Internationalization Project(1000061020008).
文摘Objective:To summarize the use of Chinese herbal medicines (CHM) for the treatment of hand-foot-and-mouth disease (HFMD) in children and to provide high-level evidence for clinical decision-making.Methods:We conducted an overview of systematic reviews (SRs).Two English-language and four Chinese-language electronic databases were searched from inception to March 31,2018.Published SRs and meta-analyses evaluating CHM use in children with HFMD and reporting clinically-relevant outcomes such as time to fever resolution were eligible for inclusion in this overview.Reviews were accepted if the intervention featured CHM with or without other treatment.Two authors evaluated the methodological quality of the included SRs by using ASMTAR and ROBIS.Results:Thirty SRs comprising 90 244 children with HFMD were included in this overview of SRs.All SRs were published in Chinese between 2011 and 2017.All intervention arms received CHM with or without conventional treatment and were compared against control arms receiving no treatment,conventional treatment alone,or placebo.All 30 reviews reported the time to fever resolution and results demonstrated that CHM had a greater benefit in reducing fever compared with controls.Twenty-three reviews reported the time to rash resolution which presented similar results.Fourteen SRs reported the time to oral ulcer healing and CHM demonstrated a significantly reduced time to resolution compared to controls.The quality of the included SRs was low to moderate as assessed by the AMSTAR tool.Conclusion:Published reviews demonstrated potential benefits of CHM in children with HFMD.Overall,the methodological quality of reviews included in this overview of SRs was low and our findings should be interpreted with caution.We would strongly recommend that future SRs be designed and reported rigorously following PRISMA in order to provide more robust evidence on which to base clinical guidance.
基金This study was supported by the key program of the National Natural Science Foundation of China(No.81830115)Prof.Nicola Robinson(Visiting Professor of Beijing University of Chinese Medicine)is funded by Overseas Expertise Project,Ministry of Education of China(MS200800090).
文摘Objective:This study assessed whether Chinese herbal medicine(CHM)combined with probiotics/synbiotics for irritable bowel syndrome-diarrhea(IBS-D)was more effective and safer than probiotics/synbiotics alone.Methods:Ten databases were searched for randomized control trials(RCTs)of IBS-D as diagnosed by Manning or Rome criteria.Trials comparing probiotics and probiotics with CHM were included.The Cochrane risk of bias(ROB)was evaluated for each trial.RevMan 5.3 was used to conduct a meta-analysis.Results:Twenty-six RCTs were included(25 Chinese,1 English),involving 2045 participants.Metaanalysis was conducted on two outcomes:overall symptom improvement and relapse.CHM combined with live Bifidobacterium and Lactobacillus preparations reduced relapse rate(RR 0.28,95%CI 0.15e0.52,3 trials,n?205)compared with probiotics alone.The subgroup analysis showed the benefit of CHM prescriptions based on soothing liver and invigorating spleen(1.28,1.14e1.44,3,244),invigorating spleen and resolving dampness(1.20,1.03e1.41,2,128),or warming and invigorating spleen and kidney formulae(1.27,1.09e1.46,2,210)combined with triple Bifidobacterium preparations than the same probiotics alone which improved overall symptoms for IBS-D.There was unclear bias in almost domains of ROB.Most studies had a high risk of bias due to lack of blinding of investigator and participants,and selective reporting.Conclusions:This study showed that CHM combined with probiotics may reduce relapse rate by 72%,and improve overall symptoms of IBS-D(as diagnosed by Rome II and III)compared to probiotics alone.From the limited subgroup analysis,only soothing liver and invigorating spleen formulae,represented by Tongxie Yaofang,added to triple Bifidobacterium preparations may be superior to the single preparations in terms of overall symptoms.However,due to the poor methodological quality and small sample size of the trials,these findings must be interpreted with caution.
基金the Innovative Research Team of Beijing University of Chinese Medicine(2011-CXTD-09)partially supported by the“Capacity Building Project for TCM Clinical Researchers”(Grant No.:201207007)from the State Administration of TCM in China.
文摘Object:Traditional Chinese medicine(TCM)has been taught widely in the both Eastern and Western world countries.This study compared the origin,student source,duration,and curriculum design of TCM higher education programs in China and five Western countries.Method:We searched the Internet and the China National Knowledge Infrastructure(CNKI)database to gather relevant information.Result:All the six countries offer acupuncture and/or Chinese herbal medicine programs at universities and/or private schools.However,there are great large differences among them in the education of curriculum and TCM students enrollment and curriculum policies of TCM courses.Conclusions:There are large differences among their curriculum and enrollment policies.This comparison should provide information about the further development of international standards in TCM education.
文摘BACKGROUND Heat shock proteins(HSPs)are molecular chaperones that play an important role in cellular protection against stress events and have been reported to be overex-pressed in many cancers.The prognostic significance of HSPs and their regulatory factors,such as heat shock factor 1(HSF1)and CHIP,are poorly understood.AIM To investigate the relationship between HSP expression and prognosis in esophageal and esophagogastric cancer.METHODS A systematic review was conducted in accordance with PRISMA recommend-ations(PROSPERO:CRD42022370653),on Embase,PubMed,Cochrane,and LILACS.Cohort,case-control,and cross-sectional studies of patients with eso-phagus or esophagogastric cancer were included.HSP-positive patients were compared with HSP-negative,and the endpoints analyzed were lymph node metastasis,tumor depth,distant metastasis,and overall survival(OS).HSPs were stratified according to the HSP family,and the summary risk difference(RD)was calculated using a random-effect model.RESULTS The final selection comprised 27 studies,including esophageal squamous cell carcinoma(21),esophagogastric adenocarcinoma(5),and mixed neoplasms(1).The pooled sample size was 3465 patients.HSP40 and 60 were associated with a higher 3-year OS[HSP40:RD=0.22;95%confidence interval(CI):0.09-0.35;HSP60:RD=0.33;95%CI:0.17-0.50],while HSF1 was associated with a poor 3-year OS(RD=-0.22;95%CI:-0.32 to-0.12).The other HSP families were not associated with long-term survival.HSF1 was associated with a higher probability of lymph node metastasis(RD=-0.16;95%CI:-0.29 to-0.04).HSP40 was associated with a lower probability of lymph node dissemination(RD=0.18;95%CI:0.03-0.33).The expression of other HSP families was not significantly related to tumor depth and lymph node or distant metastasis.CONCLUSION The expression levels of certain families of HSP,such as HSP40 and 60 and HSF1,are associated with long-term survival and lymph node dissemination in patients with esophageal and esophagogastric cancer.
基金supported by the National Administration of Traditional Chinese Medicine Young Qi Huang Scholars support project.
文摘Objective:To evaluate the efficacy and safety of Jiawei Simiao powder(JWSMP)combined with celecoxib for the treatment of acute gouty arthritis by conducting a meta-analysis of randomized controlled trials(RCTs).Methods: The Chinese National Knowledge Infrastructure Databases,Chinese Scientific Journal Database,Wanfang,Cochrane Library,EMBASE,PubMed,and Web of Science databases were searched from inception until December 2023.Continuous variables were analyzed using the mean difference(MD)for analysis,and dichotomous variables were used as risk ratios.Data with similar characteristics were pooled for meta-analysis,and heterogeneity was assessed using I2.The Cochrane Handbook was used to assess the risk of bias and quality.RevMan 5.3 software was used to perform the meta-analysis.Results: Thirteen RCTs involving 1007 patients were included in the study.The quality of the included studies was low(unclear randomization processes and insufficient blinding reporting).The group receiving JWSMP combined with celecoxib showed significantly lower levels of serum uric acid(SUA,MD=−66.32,95%confidence interval(CI):−80.97 to−51.67,P<.001),erythrocyte sedimentation rate(ESR,MD=−6.05,95%CI:−8.29 to−3.82,P<.001),C-reactive protein(CRP,MD=−7.39,95%CI:−11.15,−3.63,P<.001),and joint pain score(VAS score,MD=−2.14,95%CI:−2.4 to−1.88,P<.001)compared to celecoxib alone.Additionally,the JWSMP combined group had a higher total effective rate(risk ratio=1.22,95%CI:1.14 to 1.29,P<.001)and fewer adverse compared to celecoxib alone.Conclusions: JWSMP combined with celecoxib is more effective than celecoxib alone in improving the total efficacy rate,alleviating joint pain,and improving SUA,ESR,and CRP levels.JWSMP also reduced the occurrence of adverse events caused by celecoxib.However,the quality of the included studies was low,highlighting the need for further high-quality research with larger sample sizes and robust methodologies,such as double-blind randomization,to confirm these findings.
基金supported by the Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine(ZYYCXTD-C-202006)the High-level traditional Chinese medicine key subject construction project of National Administration of Traditional Chinese Medicine--Evidence-based Traditional Chinese Medicine(ZYYZDXK-2023249).
文摘Background:Acupuncture protocols are essential as they guide study design and improve the quality of clinical trial,thus preventing avoid research waste.Given the increasing number of publications on acupuncture protocols,this study aimed to assess the publications trends of acupuncture protocols over the past two decades and provided an overview for future research directions.Methods:Publications focusing on acupuncture protocols in clinical settings were retrieved and compiled from the Web of Science Core Collection spanning the period from 2004 to 2023.CiteSpace and Microsoft Excel software were used to analyze the relationship of publication with countries,institutions,authors,co-cited author,journals,references,keywords and other literature aspects.Results:This study analyzed 721 articles encompassing acupuncture protocols.A continuous yet fluctuating growth in publications volume were observed from 2004 to 2023.Notably,China stands at the forefront in contributing to acupuncture protocols,publishing 513 papers and demonstrating a high centrality score of 1.07 in cooperative network.Furthermore,China has fostered close collaborations with the USA and South Korea.Beijing University of Chinese Medicine(89),Zhishun Liu(36)and Trials(306)emerged as the top contributors in terms of institution,author,and journal,respectively.However,inter-institutional and author collaboration was relatively weak.Macpherson H was the most frequently cited author.High-frequency keywords included“randomized controlled trials”,“acupuncture”,“management”,“study protocol”,“quality of life”.Analysis of timeline diagram of keywords indicated that“functional dyspepsia”,“stroke”,“electroacupuncture”,and“colorectal cancer”were the research development trends and focus.Conclusion:Clinical acupuncture protocols have experienced robust development over the past two decades,with current research hotspots focusing on disease management and quality of life,which remain key research concerns.Moreover,we advocate for researchers to publish acupuncture protocols,which remain key research concerns.This approach allows for thorough pre-study planning of methodologies and objectives,enhancing scientific rigor through peer review,thereby laying the foundation for conducting high-quality research.
基金National Key Research and Development Program of China:Research on the Development and Evaluation of International Standards of Traditional Chinese Medicine(No.2019YFC1712000)。
文摘OBJECTIVE:To summarize the evidence from Traditional Chinese Medicine(TCM)practice in the treatment of acute primary headache and provide clinical practice guidance.METHODS:The guidelines were developed in accordance with the World Health Organization guideline development manual.After the establishment of steering committee,panel and the registration and protocol formulation,the evidence on TCM for acute primary headache from published guidelines,clinical evidence,and expert experience and consensus were collected.The grading of recommendations assessment,development and evaluation method was used to grade the evidence and make the recommendations.RESULTS:Based on the available evidence,the guidelines recommended three TCM herbal decoctions,six Chinese patent medicines,and two kinds of external application of Chinese herbal medicines.Diagnostic recommendations based on the expert experience and consensus were also included in the guidelines.CONCLUSION:TCM diagnosis and treatment of decoction,Chinese patent medicine and external application for treating acute primary headache were recommended.We hope these guidelines will be helpful in standardize the TCM acute treatment of primary headache.
基金supported by a Project of National Administration of Traditional Chinese Medicine(TB2021011)“Excellence Program”of the Beijing University of Chinese Medicine.
文摘Objective:To explore the characteristics of Xiao Chai Hu(XCH)decoction in randomized controlled trials(RCTs)using a bibliometric method.Methods:Seven databases including PubMed,Web of Science,Embase,Cochrane library,China National Knowledge Infrastructure(CNKI),Chinese Scientific Journal Database(VIP)and Wanfang database were retrieved from inception to May 27,2022.In the study,XCH decoction(or modified)used alone or combined with conventional Western medicine as an intervention measure was included.The basic characteristics,funding support,relevant diseases,intervention methods,and adverse events(AEs)were analyzed.Data analysis was performed using SPSS 26.0 software.Results:A total of 813 RCTs were included,published from 1989 to 2022.There was only one Englishlanguage literature with the recent impact factor of 5.374.There were 147 studies were from Chineselanguage core journals,with the highest impact factor of 2.414.Only 6.15%of the literatures mentioned funding support.96.31%of the included literature reported the statistical significance of using XCH decoction.The diseases treated mainly included chronic hepatitis B(9.35%),cough variant asthma(5.66%),dizziness(5.54%),bile reflux gastritis(4.43%),and fever(4.18%).However,the overall research design of the included literature was poor,and large sample size,multicenter RCTs are needed.The incidence of AEs of XCH decoction alone was 8.86%,which was significantly lower than that of conventional Western medicine treatment.The combination of XCH decoction and conventional Western medicine treatment could reduce the incidence of AEs,and no serious adverse event was reported.Conclusion:Although the included studies show that XCH decoction is widely used,and has good efficacy and few AEs.Due to the low quality of the included RCTs,there may be some bias,and its rational use based on the specific conditions is recommended in clinical practice.
基金Supported by Innovation Team and Talents Cultivation Program of National Administration of Traditional Chinese Medicine(No.ZYYCXTD-C-202006)Longitudinal Development Funding of Beijing University of Chinese Medicine(No.2021-ZXFZJJ-016)+1 种基金the National Institute for Health Research(No.SPCR-143)Shanxi Provincial Health Commission Project(No.2020050)。
文摘Background:Primary dysmenorrhea(PD)is the most common complaint associated with menstruation and affects up to three-quarters of women at some stage of their reproductive life.In Chinese medicine,navel therapy,treatment provided at Shenque(CV 8),is used as a treatment option for PD.Objective:To evaluate the effect of navel therapy on pain relief and quality of life in women with PD,compared with Western medicine(WM).Methods:China National Knowledge Infrastructure(CNKI),Chinese Scientific Journal Database(VIP),Sino Med and Wanfang Database,MEDLINE,the Cochrane Library,Embase,Web of Science,and the International Clinical Trial Registry of the U.S.National Institutes of Health were searched from their inceptions to April 1,2021.Randomized controlled trials(RCTs)assessing therapeutic effects of navel therapy on PD were eligible for inclusion.Rev Man 5.4 software was used for data analyses.The certainty of the evidence was assessed using the online GRADEpro tool.Results:Totally 24 RCTs involving 2,614 participants were identified.Interventions applied to acupuncture point CV 8 included:herbal patching,moxibustion or combined navel therapy(using at least 2 types of stimulation).Compared to placebo,there was a significant effect in favor of navel therapy on reducing overall menstrual symptom scores at the end of treatment[mean difference:-0.82,95%confidence interval(CI):-1.00 to-0.64,n=90;1 RCT].As compared with Western medicine,navel therapy had a superior effect on pain intensity as assessed by Visual Analogue Scale at the end of treatment[standardized mean difference(SMD):-0.64,95%CI:-1.22 to-0.06,I^(2)=80%,n=262;3 RCTs];on symptom resolution rate at 3-month follow-up(risk ratio:1.94,95%CI:1.47 to 2.56,n=1527,I^(2)=38%;13 RCTs);and on global menstrual symptoms score at the end of treatment(SMD:-0.67,95%CI:-0.90 to-0.45,I^(2)=63%,n=990;12 RCTs).Subgroup analyses showed either a better or an equivalent effect comparing navel therapy with Western medicine.No major adverse events were reported.The methodological quality of included trials was poor overall.Conclusions:Navel therapy appears to be more effective than Western medicine in decreasing menstrual pain and improving overall symptoms of PD.However,these findings need to be confirmed by well-designed clinical trials with adequate sample size(Systematic review registration at PROSPERO,No.CRD42021240350).
基金funded by the Key R&D project of the Ministry of Science and Technology,China(2017YFC1700604).
文摘Background:Patients with colon cancer who receive chemotherapy usually experience various gastrointestinal adverse reactions,including nausea,vomiting,and diarrhea,which make it challenging for them to adhere to treatment.As an effective traditional Chinese medicine,the Jianpi Bushen formula has been widely used to alleviate the side effects of chemotherapy.Objective:To evaluate the efficacy and safety of Jianpi Bushen formulae for patients who undergo chemotherapy.This statistical analysis plan(SAP)is intended to enhance the transparency and research quality of our randomized controlled trial.Methods:Our study is a multicenter,double-blind,randomized controlled clinical trial.This trial aimed to compare the completion rate of chemotherapy in colon cancer patients who are using and not using Jianpi Bushen formula.To attenuate possible selection bias in the final report,we declared the overall trial design,outcome measures,subgroup analyses,and safety measures.Also,we described the data management and statistical analysis methods in detail.Conclusion:The SAP provides more detailed information than the trial protocol for data management and statistical analysis methods.Further post-hoc analyses can be performed by referring to the SAP,and possible selection bias can be attenuated.
基金supported by the Fundamental Research Funds for the Central Universities(2022-JYB-JBZR-026)the National Natural Science Foundation of China(81873211)。
文摘Objective:To assess the quality of systematic reviews assessing the effects of traditional Chinese exercises on controlling blood indices,anthropometric indices,psychological indices,and quality of life in patients with diabetes.Methods:Systematic studies/meta-analyses of intervention with traditional Chinese exercises on diabetes mellitus were searched in the Pub Med,Web of Science,the China National Knowledge Infrastructure Databases(CNKI),Wan Fang Database,and Chinese Scientific Journal Database(VIP).Two researchers independently screened the studies and extracted the data.The methodology and quality of evidence of the included studies were assessed using A Measurement Tool to Assess Systematic Reviews2(AMSTAR-2)and Grading of Recommendations Assessment,Development and Evaluation(GRADE)criteria,respectively.Results:A total of 32 systematic reviews/meta-analyses were included in the present study.Of them,the methodological quality of 4 studies was graded as low,while that of the other 28 was graded as extremely low.The most common quality flaws in key items included a lack of preliminary proposals for systematic reviews,failure to explain the reasons for the inclusion criteria,failure to provide a list of excluded studies and reasons for exclusion,failure to report potential conflicts of interest,and inadequate assessment of publication bias.The quality of evidence for most of the 18 outcomes was subsequently graded as medium or low.Overall,the results of these studies indicated that Tai Chi,health qigong,and other traditional Chinese exercises lowered fasting blood glucose(FBG),2-h postprandial blood glucose(2hPBG),hemoglobin A_(1c)(HbA_(1c)),and body mass index,and relieved anxiety and depression in patients with diabetes.Conclusion:Our findings indicate that the methodological quality of systematic reviews related to traditional Chinese exercises in the diabetic population is generally low,and the quality of evidence is also relatively poor.Therefore,we suggest that the quality of systematic reviews and meta-analyses on traditional Chinese exercises for controlling diabetes mellitus needs to be improved.In the future,researchers should conduct higher-quality clinical studies with reference to the AMSTAR2 checklist and GRADE system.
基金Supported by the National Natural Science Foundation of China(No.81830115),ChinaProf.Nicola Robinson(visiting professor of Beijing University of Chinese Medicine)is supported by the Overseas Expertise Project,Ministry of Education of China(No.MS20080009)。
文摘Objective:Since December 2019,an outbreak of corona virus disease 2019(COVID-19)occurred in Wuhan,and rapidly spread to almost all parts of China.This was followed by prevention programs recommending Chinese medicine(CM)for the prevention.In order to provide evidenee for CM recommendations,we reviewed ancient classics and human studies.Methods:Historical records on prevention and treatment of infections in CM classics,clinical evidence of CM on the prevention of severe acute respiratory syndrome(SARS)and H1N1 in flue nza,and CM preve ntion programs issued by health authorities in China since the COVID-19 outbreak were retrieved from differe nt databases and websites till 12 February,2020.Research evide nee in eluded data from clinical trials,cohort or other population studies using CM for preventing contagious respiratory virus diseases.Results:The use of CM to prevent epidemics of infectious diseases was traced back to ancient Chinese practice cited in Huangdi's Internal Classic(Huang Di Nei Jing)where preventive effects were recorded.There were 3 studies using CM for prevention of SARS and 4 studies for H1N1 influenza.None of the participants who took CM contracted SARS in the 3 studies.The infection rate of H1N1 in flue nza in the CM group was significantly lower than the non-CM group(relative risk 0.36,95%confidence interval 0.24-0.52;n=4).For prevention of COVID-19,23 provinces in China issued CM programs.The main principles of CM use were to tonify qi to protect from external pathoge ns,disperse wind and discharge heat,and resolve damp ness.The most frequently used herbs in eluded Radix astragali(Huangqi),Radix glycyrrhizae(Gancao),Radix saposhnikoviae(Fangfeng),Rhizoma Atractylodis Macrocephalae(Baizhu),Lonicerae Japonicae Flos(Jinyinhua),and Fructus forsythia(Lianqiao).Conclusions:Based on historical records and human evidenee of SARS and H1N1 influenza prevention,Chinese herbal formula could be an alternative approach for prevention of COVID-19 in high-risk population.Prospective,rigorous population studies are warranted to confirm the potential preventive effect of CM.
基金Supported by a Capital Special Project Grant for Traditional Chinese Medicine and Nursing Research (No. ZM01)
文摘OBJECTIVE:To assess the effectiveness and safety of Traditional Chinese Medicine(TCM) treatment of non-acute bronchial asthma complicated by gastroesophageal reflux.METHODS:We searched databases from MEDLINE,Cochrane Library,CNKI,VIP,CBM,Wanfang Data,and TCM Database Systems.All randomized,controlled trials(RTCs) of TCM treatment of non-acute asthma complicated by gastroesophageal reflux were included.Data were independently collected by two reviewers.The standards for assessing quality described in the Cochrane Handbook for Systematic Reviews of Interventions were used to evaluate articles.Meta-analyses were conducted using RevMan 5.0.17 software.Heterogeneity was assessed,and a corresponding effects model was used to merge and analyze results.Indexes used to evalu-ate curative effects were:clinical efficacy,symptom scores,pulmonary function values,and adverse incidents.Effectiveness was indicated using risk ratio(RR) or mean difference(MD),and 95% confidence intervals(CIs) were calculated.RESULTS:Six RCTs were included,involving 304 patients with non-acute asthma complicated by gastroesophageal reflux.The treatment groups received Chinese drugs alone or TCM combined with standard Western medical treatment,and the control groups received standard Western medical treatment alone.Standard Western medical treatment included anti-inflammatory drugs and bronchodilators for asthma,and drugs to promote gastric peristalsis and inhibit gastric acid production for gastroesophageal reflux.Methodological quality was low in all six RCTs.Two RCTs showed that clinical efficacy was higher in the treatment group than in the control group(RR:1.43,95%CI:1.10 to 1.87 vs RR:1.51,95% CI:1.09 to 2.08).One RCT showed that the asthma score was lowered more effectively in the treatment group than in the control group(MD:-1.10,95% CI:-2.04 to-0.16).Two RCTs showed that the gastroesophageal reflux score was reduced more effectively in the treatment group than in the control group(RR:-3.70,95% CI:-4.30 to 3.10 vs RR:-5.30,95% CI:-6.32 to-4.28).One RCT showed that some pulmonary function values were improved more effectively in the treatment group than in the control group(P< 0.05).No differences were seen in the various indexes between groups in the other RCTs.No adverse reactions,dropout rates,or follow-up rates were reported in any of the RCTs.CONCLUSIONS:The clinical symptoms ofnon-acute asthma complicated by gastroesophageal reflux can be improved by some Chinese drugs.Curative effects can be increased by combining the use of TCM with Western medicine.Because of the small quantity and low quality of research reported to date,it is necessary to conduct further RCTs to confirm these results.The results of this systematic review indicate that the quality of future clinical trials should be improved by including larger patient numbers,correctly randomizing patients into study groups,using blinding methods to measure and assess outcomes,and using accepted indexes to evaluate curative effects.
基金the Key Project of the National Natural Science Foundation of China(No.81830115)WANG Ying was also supported by the China Scholarship Council(No.201606555023)。
文摘Objective:To provide evidence on the efficacy and safety of Chinese herbal medicine(CHM)as interventions for systemic lupus erythematosus(SLE).Methods:Seven electronic databases,including the Cochrane Library,Chinese National Knowledge Infrastructure(CNKI),Chinese Scientific Journal Database(VIP),Chinese Biomedical Literature Service System(SinoMed),Wanfang,Embase,and PubMed,were comprehensively searched,from their inception to August 16,2020,for all randomized controlled trials(RCTs)that focused on CHM used alone or in combination with conventional medicine for SLE.Outcomes were SLE activity index(SLEDAI),traditional Chinese medicine symptom/syndrome score(TCMSS),dosage of glucocorticoids,main serological testing,and incidence of adverse events.Data were extracted and pooled using Review Manager 5.3 software.Results:A total of 13 RCTs enrolling 856 participants met our inclusion criteria.Meta-analyses showed that,compared to placebo,CHM had statistically significant effect on reducing SLEDAI score(MD=-1.74,95%Cl:-2.29 to-1.18),diminishing TCMSS(SMD=-0.89,95%Cl:-1.16 to-0.62),decreasing dosage of glucocorticoids(MD=-2.41 mg/d,95%Cl:-3.34 to-1.48),lowering erythrocyte sedimentation rate(MD=-4.78 mm/h,95%Cl:-8.86 to-0.71),and increasing serum complement C4 level(MD=0.03 mg/dL,95%Cl:0.00 to 0.06).No significant difference was found between CHM and placebo on adverse events.Conclusions:CHM provided significant beneficial effect on controlling disease activity and reducing dose of glucocorticoids used among SLE patients.Future advanced designed RCTs for CHM treating moderate to severe SLE with multicenter and longer follow-up are urgently needed.
基金supported by the fund from Beijing University of Chinese Medicine for the Project on Research and Development of Evidence-Based Medicine of Clinical Scientific Research Capacity and International Development in TCM(No.2016-ZXFZJJ-011,No.1000061020008)partially supported by the NCCIH grant(AT001293 with Sub Award No.020468C)funded by Overseas Expertise Project,Ministry of Education of China(MS20180009)。
文摘The objectives of this study are to conduct a comprehensive literature search and bibliometric analysis to identify the breadth and volume of pharmacological and clinical studies on pine pollen(Pinus pollen)and to identify the potential effects and the use of pine pollen.Three Chinese electronic databases and two English electronic databases were searched for pharmacological and clinical studies on pine pollen.Data were extracted and analyzed and included publication year,authors,study type,pharmacological research topics or clinical diseases/conditions,usage and type of preparation,authors’conclusions,and adverse effects.Of 239 publications identified,180 were pharmacological studies,37 were clinical trials,and 22 were reviews.Numbers of publications increased particularly from 2004 onward.The top 10 most frequent topics in pharmacological studies were immune regulation,antisenility,antioxidation,liver protection,inhibiting prostate hyperplasia,inhibiting tumor cell proliferation,lowering blood glucose,lowering blood lipids,antifatigue,and improving intestinal function.The top 10 most frequent clinical diseases treated or where pine pollen was used as an adjuvant were bedsores,diaper dermatitis,hyperlipidemia,oral mucositis,eczema,hyperplasia of prostate,hypertension,prostatitis,type 2 diabetes mellitus,and radiodermatitis.Eight trials reported no adverse events associated with pine pollen,one reported mild gastrointestinal reactions,but symptoms disappeared without special management.There have been an increasing number of publications on pine pollen during the past 20 years.Pharmacological studies have shown many potential benefits,and clinical studies have indicated some positive effects when it is either used as a single herb or as an adjuvant to treat disease.Its use as a topical agent,especially for skin diseases,was notable.
基金Huijuan Cao,Mei Han,and Jianping Liu are supported by the Research Capacity Establishment Grant(No.2013-ZDXKKF)the Innovative Research Team(No.2011-CXTD-09)from the Beijing University of Chinese Medicine.
文摘Background:As a traditional treatment method,cupping therapy is widely used in Asian countries.This overview of systematic reviews (SRs) investigated the effectiveness and safety of cupping therapy through an evidence-based approach.Methods:SRs that assessed the effectiveness of cupping therapy for any type of disease were searched through 6 electronic databases.Target diseases,cupping methods,numbers and types of included studies,quality of included trials,main results (including meta-analysis re sults),and authors' conclusions of SRs were extracted.The Assessment of Multiple Systematic Reviews measurement was used to evaluate methodologic quality of the SRs.Results Eight SRs met the inclusion criteria and effectiveness and safety of cupping therapy for 11 diseases were assessed.All included SRs were of good methodologic quality.However,quality of trials included in the SRs was generally poor.Meta-analysis was performed in 4 studies.Results:showed cupping therapy (alone or combined with other interventions) was better than medications (or other interventions alone) for herpes zoster,acne,facial paralysis,low back pain,or cervical spondylosis.One review reported adverse events,including hematoma,increased pain and tingling following cupping treatment.Conclusions:Cupping therapy may be beneficial for pain-related conditions,acne,and facial paralysis.However,a firm conclusion could not be drawn due to the insufficient number of included reviews and the low quality of the original studies.
