Long-term efficacy and safety of Huangqi ()-based Traditional Chinese Medicine in diabetic peripheral neuropathy: a Meta-analysis of randomized controlled trials.

OBJECTIVE: To assess the long-term effectiveness of Huangqi (Radix Astragali Mongolici, HQ)-based Traditional Chinese Medicine (TCM) in the treatment of diabetic peripheral neuropathy (DPN). METHODS: Nine databases were searched to retrieve available randomized controlled trials that compared HQ-based TCM and Western Medicines in the treatment of DPN. The methodological quality of the included studies was assessed using the Cochrane bias risk tool, and RevMan 5.4 was used for data analysis. The effect estimates of interest were risk ratio (RR), mean difference (MD) or standardized mean difference (SMD) with 95% confidence interval (CI). RESULTS: The results from 48 available studies assessing 3759 patients demonstrated that cases administered HQ-based TCM [RR = 1.30, 95% CI (1.21, 1.40), P < 0.000 01] or HQ-based TCM combined with Western Medicines [RR = 1.25, 95% CI (1.19, 1.31), P < 0.000 01] exhibited higher total efficacy rates than individuals who received Western Medicine alone. The results showed that the HQ-based TCM group had decreased Toronto Clinical Scoring System scores [MD =－1.50, 95% CI (－1.83, －1.17), P < 0.000 01], and reduced serum interleukin 6 [SMD = －0.57, 95% CI (－0.87, －0.27), P = 0.0002] and tumor necrosis factors-α levels [SMD = －0.60, 95% CI (－0.95, －0.25), P = 0.0009]. In addition, both HQ-based TCM and HQ-based TCM combined with Western Medicine increased nerve conduction velocity and decreased glycaemia compared with Western Medicine alone. In terms of blood lipids, oxidative stress and adverse drug reactions, there were no significant differences between the HQ-based TCM groups and the Western Medicine control group. CONCLUSION: The current Meta-analysis revealed that HQ-based TCM yields higher efficacy and safety than Western Medicine alone for the treatment of DPN, although further well-designed RCTs are required to validate these findings.

Caracterización de pacientes con enfermedades cerebrovasculares en fase aguda según diagnóstico tradicional chino

Fundamento en la medicina china, los accidentes cerebrovasculares se relacionan con el síndrome de golpe de viento (Zhong Feng), lo cual se corresponde en la medicina occidental con los accidentes cerebrovasculares hemorrágicos e isquémicos. Objetivo caracterizar a los pacientes con accidentes cerebrovasculares en fase aguda según diagnóstico de la medicina china. Métodos estudio descriptivo, de serie de casos (n=40), que incluyó a pacientes atendidos en el periodo marzo-diciembre de 2018 en el Hospital Dr. Gustavo Aldereguía Lima, de Cienfuegos. Se analizaron las variables: edad, sexo, tipo de enfermedad cerebrovascular en fase aguda, gravedad del ataque del golpe de viento, síndrome según órganos y vísceras, y factor patógeno presente. Resultados predominaron los accidentes cerebrovasculares trombóticos, de los cuales 75,0 % se comportaron como golpe de viento graves tipo flácido; y el 81,3 % estuvo asociado al síndrome de insuficiencia de sangre de hígado. Los embólicos: ataques leves en el 33,3 %; y 18,8 % síndrome de insuficiencia de sangre de hígado. Las hemorragias cerebrales intraparenquimatosas: 62,5 % ataque grave tipo tenso; y 71,4 % fuego de hígado. Hemorragia subaracnoidea: 15 % como ataque grave tipo flácido; y 17,6 % síndrome de insuficiencia de Yin de hígado. El factor patógeno más frecuente resultó el viento interno, presente en 90,0 % de los casos. Conclusiones el análisis de los pacientes con accidente cerebrovascular en fase aguda según diagnóstico tradicional chino, mostró que existe relación clínica con el síndrome golpe de viento y de los Zhang fu de la medicina china.

Foundation In Chinese medicine, strokes are related to wind stroke syndrome (Zhong Feng), which corresponds in Western medicine to hemorrhagic and ischemic strokes. Objective to characterize patients with strokes in the acute stage according to Chinese medicine diagnosis. Methods descriptive case series study (n=40), which included patients treated from March to December 2018 at the Dr. Gustavo Aldereguía Lima Hospital, Cienfuegos. The analyzed variables were: age, sex, type of cerebrovascular disease in the acute stage, severity of the wind stroke attack, syndrome according to organs and viscera, and pathogenic factor present. Results thrombotic strokes predominated, of which 75.0% behaved as severe flaccid type wind stroke; and 81.3% were associated with liver blood failure syndrome. Embolics: mild attacks in 33.3%; and 18.8% liver blood failure syndrome. Intraparenchymal cerebral hemorrhages: 62.5% severe tense attack; and 71.4% liver fire. Subarachnoid hemorrhage: 15% as severe flaccid type attack; and 17.6% liver Yin deficiency syndrome. The most frequent pathogenic factor was internal wind, present in 90.0% of cases. Conclusions the analysis of patients with stroke in the acute phase according to traditional Chinese diagnosis showed that there is a clinical relationship with wind stroke syndrome and the Zhang fu of Chinese medicine.

Clinical research progress in Traditional Chinese Medicine in treating wound healing after anal fistula surgery.

In the study of the mechanism of wound healing after anal fistula surgery, how to scientifically and efficiently promote wound healing is of great significance. At present, modern medical treatment of wounds after anal fistula surgery mostly focuses on physical therapy intervention, new wound dressing and packing, and external application of growth factors. However, these therapies have many problems, and there is still no consensus on their clinical use. Traditional Chinese Medicine (TCM) has several methods to promote wound healing, such as oral administration, rubbing, and fumigation, which have a long history and obvious efficacy, but research in this area is relatively scattered and lacks classification and summarizing. Therefore, this paper analyzes and summarizes the existing research on TCM for promotion of wound healing after anal fistula surgery, carries out targeted analyses according to different clinical syndromes and treatment methods, and analyzes the defects in current research and anticipates future research trends in order to provide theoretical support for the advantages of TCM in promoting wound healing after anal fistula surgery.

Effects of Traditional Chinese Medicine on the survival of patients with stage I gastric cancer and high-risk factors: a real-world retrospective study.

OBJECTIVE: To investigate the benefits of Traditional Chinese Medicine (TCM) therapy for improving the survival of patients with stage I gastric cancer (GC) and high-risk factors in a real-world setting. METHODS: The clinical data of patients who were diagnosed with stage I GC from March 1, 2012 to October 31, 2020 were collected. Prognostic analysis was performed to explore the high-risk factors that affected the survival of the patients. A Cox multivariate regression model was used to compare the hazard ratios for the mortality risk of patients, especially those with high-risk factors. Kaplan-Meier survival curve and log-rank test were utilized to assess the survival time. RESULTS: Prognostic analysis demonstrated that female sex, tumor invasion into blood vessels, and Ib stage were independent risk factors. The 1-, 3-, and 5-year survival rates of the TCM group those of the non-TCM group were 100.0% 91.0%, 97.6% 64.5%, and 81.4% 55.5%, respectively. A significant difference in median overall survival (mOS) was found between the two groups (χ = 7.670, = 0.006). Subgroup analysis showed that the mOS of female patients and stage Ib patients in the TCM group were longer than those in the non-TCM group ( ≤ 0.001 and 0.001, respectively). CONCLUSIONS: TCM treatment can improve the survival of patients with stage I GC and high-risk factors.

Anti-tumour effect of Huangqin Decoction on colorectal cancer mice through microbial butyrate mediated PI3K/Akt pathway suppression.

Introduction. Huangqin Decoction (HQD), a Chinese herbal formula, is widely used for various diseases, including colorectal cancer (CRC).Hypothesis/Gap Statement. We proposed that microbial butyrate mediated PI3K/Akt pathway suppression might involve the anti-cancer effect of HQD.Aim. This study aimed to evaluate the potential mechanism of HQD against CRC.Methodology. An azoxymethane plus dextran sulphate sodium induced CRC mouse model was used, and the intestinal flora and faecal short-chain fatty acid changes were detected, respectively, after HQD administration with 16S rRNA sequencing and gas chromatography coupled with mass spectrometry. Disease activity index, colon length and levels of inflammatory cytokines were measured to evaluate the effect of HQD on intestinal inflammation. Tumour size, number and histopathology were assessed to reflect the impact of HQD on tumour burden. Apoptosis and PI3K/Akt pathway activity were measured by TUNEL staining and Western-blotting. In vitro, the effects of sodium butyrate (NaB) on the viability of CRC cell lines were detected by the Cell-counting Kit-8. The apoptotic cells were determined by TUNEL staining. Cell migration and invasion were assessed by wound healing assay and Transwell assay, respectively. Western-blotting and immunofluorescent staining were used to test the activity of PI3K/Akt pathway.Results. Animal study showed that HQD could improve the gut dysbiosis, increase the abundance of Clostridium and the level of faecal butyric acid. Then, we found that HQD could attenuate colitis, reduce tumour burden, promote cell apoptosis and suppress PI3K/Akt pathway activity in CRC mice. In vitro experiment revealed that NaB treatment could inhibit cell growth, migration and invasion in CRC cell lines. Additionally, NaB enhanced cellular apoptosis, and reduced phosphorylated PI3K and Akt expressions. Interestingly, addition of 740Y-P, an agonist of PI3K, reversed the NaB effects on CRC cells.Conclusion. Overall, in this study, we revealed that HQD could induce apoptosis through microbial butyrate mediated PI3K/Akt inhibition and perform anti-CRC activity.

Reveal the mechanisms of prescriptions for liver cancer' treatment based on two illustrious senior TCM physicians.

OBJECTIVE: To explore the core herbs of two illustrious senior Traditional Chinese Medicine (TCM) Physicians for the treatment of liver cancer, and to further clarify the gene targets and pathway mechanisms of liver cancer that the core prescription (CP) may regulate. METHODS: We used the patient information of two illustrious senior TCM physicians from the Affiliated Hospital of Shandong University of Traditional Chinese Medicine and the Affiliated Hospital of Capital Medical University as the database. The CP was analyzed using the community network algorithm. The pathway mechanism was analyzed using network pharmacology method. And the prognostic survival genes were identified using Single factor cox regression analysis. Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine (TCMIP), Herb, Online Mendelian Inheritance in Man (OMIM), Genecards, Kyoto Encyclopedia of Genes and Genomes (KEGG), Genomic Data Commons (GDC), The Cancer Genome Atlas (TCGA), Gephi and R were used to mine CP, building a pathway network diagram. All the analyses were visualized. RESULTS: We found that the CP consistes of Huangqi (), Danshen (), Shuihonghuazi (), Baihuasheshecao (), Banzhilian (), and Ezhu (), which were attributed to the two physicians respectively. The CP played an anti-cancer role through such pathways as signal transduction, energy metabolism, immune system and other pathways, covering a total of 112 pathways and 176 herb-disease-related genes. Fourteen genes have a significant impact on the prognosis and survival of liver cancer. CONCLUSION: Based on the liver cancer cases of two illustrious senior TCM physicians, we obtained the CP through data mining. The CP may mainly exert anti-cancer effects by inhibiting inflammatory response, angiogenesis, and enhancing the body's immune response. We screened out 14 genes in the CP that may be related to the prognosis of liver cancer, and these genes may play an important regulatory role in the prognosis of liver cancer.

Aptidão funcional e qualidade de vida de idosos praticantes de Lian Gong, Tai Chi e Qigong / Aptitud funcional y calidad de vida de adultos mayores que practican Lian Gong, Tai Chi y Qigong / Functional fitness and quality of life of elderly Lian Gong, Tai Chi and Qigong practitioners

Resumo Objetivo Comparar a aptidão funcional e as dimensões da qualidade de vida de idosos participantes e não participantes das práticas orientadas Lian Gong, Tai Chi e Qigong. Métodos Estudo caso-controle, desenvolvido no município de São Paulo - SP, Brasil, com 118 idosos, pareados por sexo e idade: 59 no grupo caso, participantes das práticas corporais, divididos em subgrupos por tempo de adesão:< 24 meses e ≥ 24 meses; e 59 no grupo controle, não participantes das práticas. Para a coleta de dados, aplicaram-se: questionário com variáveis sociodemográficas e de saúde, testes funcionais e o instrumento Medical Outcomes Study 36- Item Short-Form Health Survey (SF36). As análises estatísticas foram realizadas com o programa R versão 3.3.2. Os dados foram inicialmente analisados de forma descritiva e, em seguida, efetuou-se regressão logística univariada e o teste Kruskal Wallis. Os aspectos éticos da pesquisa com seres humanos foram obedecidos. Resultados Verificou-se que, no grupo caso, idosos com tempo de adesão às práticas ≥ 24 meses apresentaram resultado superior no teste funcional de levantar e sentar da cadeira (p=0,006), bem como melhor desempenho nos seguintes domínios da qualidade de vida: dor (p= 0,003), vitalidade (p=0,021), aspectos emocionais (p=0,034) e saúde mental (p=0,020). Conclusão A participação nas práticas corporais, orientadas, Lian Gong, Tai Chi e Qigong pode contribuir para a qualidade de vida e a aptidão funcional de idosos.

Resumen Objetivo Comparar la aptitud funcional y las dimensiones de la calidad de vida de adultos mayores que participan y que no participan en prácticas orientadas Lian Gong, Tai Chi y Qigong. Métodos Estudio caso-control, realizado en el municipio de São Paulo - estado de São Paulo, Brasil, con 118 adultos mayores, pareados por sexo y edad: 59 en el grupo caso, participantes de las prácticas corporales, divididos en subgrupos por tiempo de participación: < 24 meses y ≥ 24 meses; y 59 en el grupo control, no participantes de las prácticas. Para la recopilación de datos, se aplicó un cuestionario con variables sociodemográficas y de salud, pruebas funcionales y el instrumento Medical Outcomes Study 36- Item Short-Form Health Survey (SF36). Los análisis estadísticos se realizaron con el programa R versión 3.3.2. Los datos se analizaron inicialmente de forma descriptiva y, a continuación, se realizó regresión logística univariada y la prueba de Kruskal Wallis. Los aspectos éticos de la investigación con seres humanos fueron cumplidos. Resultados Se verificó que, en el grupo caso, los adultos mayores con tiempo de participación en las prácticas ≥ 24 meses presentaron un resultado superior a la prueba funcional de levantarse y sentarse en la silla (p=0,006), como también un mejor desempeño en los siguientes dominios de calidad de vida: dolor (p= 0,003), vitalidad (p=0,021), aspectos emocionales (p=0,034) y salud mental (p=0,020). Conclusión La participación en las prácticas corporales orientadas Lian Gong, Tai Chi y Qigong puede contribuir para la calidad de vida y para la aptitud funcional de adultos mayores.

Abstract Objective To compare functional fitness and quality of life dimensions of elderly participants and non-participants of Lian Gong, Tai Chi and Qigong guided practices. Methods This is a case-control study, carried out in the city of São Paulo, SP, Brazil, with 118 elderly people, matched by sex and age: 59 in the case group, participants in body practices, divided into subgroups by time of compliance: < 24 months and ≥ 24 months; and 59 in the control group, non-participants in body practices. For data collection, the following were applied: a questionnaire with sociodemographic and health variables, functional tests and the Medical Outcomes Study 36- Item Short-Form Health Survey (SF-36). Statistical analyzes were performed using R version 3.3.2. The data were initially analyzed in a descriptive way and, then, a univariate logistic regression and the Kruskal Wallis test were performed. The ethical aspects of research with human beings were obeyed. Results It was found that, in the case group, elderly people with a time of compliance with practices ≥ 24 months showed a superior result in the functional 30-second chair stand test (p=0.006), as well as better performance in the following quality of life domains: bodily pain (p=0.003); vitality (p=0.021); role emotional (p=0.034); and mental health (p=0.020). Conclusion Participation in guided body practices, Lian Gong, Tai Chi and Qigong, can contribute to elderly people's quality of life and functional fitness.

Efficacy of integrated Traditional Chinese Medicine and anti-retroviral therapy on immunological nonresponse in patients with human immunodeficiency virus/acquired immunodeficiency syndrome: a Meta-analysis of randomized controlled trial.

OBJECTIVE: To explore the efficacy of integrating Traditional Chinese Medicine (TCM) and anti-retroviral therapy (ART), a customized combination of different classes of medications which was also called cock-tail treatment, on the immunological nonresponse (INR) in people living with human immunodeficiency virus (HIV) (PLWH). METHODS: Relevant literature in databases such as China National Knowledge Infrastructure Database (CNKI), Wanfang Digital Journal, Chinese Medical Journal Database (CMJD), Chinese Biomedical Literature Database (CBM), PubMed, Cochrane, and Embase was reviewed by two independent investigators. Data were extracted from the studies according to the eligible criteria and analyzed using Review Manager 5.3. RESULTS: Nine randomized controlled trials (RCTs) with 1078 patients were analyzed. Our analyses showed that CD4 T cell counts in the treatment group improved compared with that in the control group [mean difference (MD) = 13.51, 95% confidence interval (CI): 7.42-19.60, P < 0.0001]. There was no significant difference between the treated and control groups after 3 months (MD = 25.31, 95% CI: ?2.78 to 53.41, P = 0.08). However, after 6 and 12 months, the response of the treatment group was superior to the control group (MD = 27.45, 95% CI: 7.09-47.81, P = 0.008 and MD = 27.34, 95% CI: 6.31-48.37, P = 0.01, respectively). The clinical efficacy of the treatment group was also higher than that of the control group (RR = 1.75, 95% CI: 1.16-2.65, P = 0.007). However, CD45RO and CD45RA T cell counts did not differ significantly between the two groups (MD = 12.37, 95% CI: ?6.71 to 31.45, P = 0.20 and MD = 5.67, 95% CI: ?3.00 to14.35, P = 0.20, respectively). CONCLUSION: The combined treatment strategy of integrated TCM and Western Medicine promotes long-term reconstitution of the immune system and thus, is beneficial and has potential use for improving INR in PLWH. However, large-scale RCTs are required to provide evidence for optimal intervention strategies.

Human body's health function improvement by various whole-body sports exercises / Melhoria da função de saúde do corpo humano por meio de vários exercícios esportivos de corpo inteiro / Mejora de la función de salud del cuerpo humano mediante varios ejercicios deportivos para todo el cuerpo

ABSTRACT Introduction Studies have shown that physical exercise is beneficial to people's overall physical and mental health, but few research reports on the effects of different physical exercises on people's human health. Object The paper explores the difference in human health function between people who adhere to traditional health sports and those who rarely exercise and provide a scientific basis for applying and promoting traditional health sports in TCM "prevention of disease". Methods The paper surveyed 526 people who regularly participate in physical exercises and rarely exercise. The exercise items are divided into Tai Chi/Tai Chi sword group, Health Qigong Baduanjin group, Health Qigong Wuqinxi group, and Health Qigong Yijin group. Warp group, walking/jogging group. Results There are differences in the mental indicators of the people in different exercise groups. The overall average percentage levels of and NK cells in each exercise group and the tiny exercise group are different, and the difference is statistically significant (P<0.05). Conclusions Persisting in physical exercise is beneficial to the balance of health and function of the population. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução Estudos têm demonstrado que o exercício físico é benéfico para a saúde física e mental geral das pessoas, mas existem poucos relatos de pesquisas sobre os efeitos dos diferentes exercícios físicos na saúde humana. Objetivo o documento explora a diferença na função da saúde humana entre pessoas que aderem aos esportes tradicionais de saúde e aqueles que raramente se exercitam e fornece uma base científica para a aplicação e promoção dos esportes tradicionais de saúde na "prevenção de doenças" da medicina tradicional chinesa. Métodos O artigo pesquisou 526 pessoas que praticam exercícios físicos regularmente e raramente praticam exercícios. Os itens de exercícios são divididos em grupo de espada Tai Chi/Tai Chi, grupo de saúde Qigong Baduanjin, grupo de saúde Qigong Wuqinxi e grupo de saúde Qigong Yijin, Grupo Wrap e grupo de caminhada/corrida. Resultados Existem diferenças nos indicadores mentais de pessoas em diferentes grupos de exercícios. Os níveis percentuais médios gerais de células NK e em cada grupo de exercícios e no pequeno grupo de exercícios são diferentes, e a diferença é estatisticamente significativa (P <0,05). Conclusão A persistência na prática de exercícios físicos é benéfica para o equilíbrio da saúde e o funcionamento da população. Nível de evidência II; Estudos terapêuticos: investigação dos resultados do tratamento.

RESUMEN Introducción Los estudios han demostrado que el ejercicio físico es beneficioso para la salud física y mental general de las personas, pero hay pocos informes de investigación sobre los efectos de diferentes ejercicios físicos en la salud humana de las personas. Objeto El documento explora la diferencia en la función de la salud humana entre las personas que se adhieren a los deportes de salud tradicionales y las que rara vez hacen ejercicio y proporciona una base científica para aplicar y promover los deportes de salud tradicionales en la "prevención de enfermedades" de la medicina tradicional china. Métodos El artículo encuestó a 526 personas que participan regularmente en ejercicios físicos y rara vez hacen ejercicio. Los elementos de ejercicio se dividen en grupo de espada de Tai Chi/Tai Chi, grupo de salud Qigong Baduanjin, grupo de salud Qigong Wuqinxi y grupo de salud Qigong Yijin. Grupo Wrap, grupo de caminar/trotar. Resultados Hay diferencias en los indicadores mentales de las personas en diferentes grupos de ejercicio. Los niveles de porcentaje promedio general de células NK y en cada grupo de ejercicio y el pequeño grupo de ejercicio son diferentes, y la diferencia es estadísticamente significativa (P <0.05). Conclusión La persistencia en el ejercicio físico es beneficiosa para el equilibrio de la salud y el funcionamiento de la población. Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.

The curative effect of traditional chinese medicine compounded medications in relieving racewalking fatigue / O efeito curativo dos medicamentos manipulados da medicina chinesa tradicional para aliviar a fadiga da marcha atlética / Observación del efecto curativo del compuesto de medicina tradicional china para aliviar la fatiga de la carrera

ABSTRACT Racewalking fatigue is a kind of fatigue symptom after a period of racewalking, which may lead to limb weakness, mental fatigue, muscle fatigue and other phenomena. If we do not timely adjust the stretching and effective treatment after exercise, it is very easy to produce sports injury and seriously affect the athletes' physical function. In order to effectively alleviate the fatigue of racewalking, this study focused on the traditional Chinese medicine (TCM) compounded medication, analyzed the mechanism of action and medicinal effectiveness of the TCM compound, and carried out control experiment on 80 male ICR mice. The mice in the experimental group were given sedentary training and racewalking training in groups. The results showed that the two groups of ICR mice, after racewalking training, had exercise fatigue symptoms and a large amount of serum lactic acid and other substances, while mice in group D treated by gavage of traditional Chinese medicine compounded medication had the symptoms of exercise fatigue, but the contents of blood urea nitrogen and lactic acid were decreased, the gastrocnemius muscle fibers were evenly arranged, the transverse lines were neat, and a rebound of protein expression. This shows that Chinese medicine compound can play a significant role in relieving racewalking fatigue.

RESUMO A fadiga causada pela marcha atlética é um tipo de sintoma que acomete os atletas após um período de prática do exercício, que pode ocasionar fraqueza dos membros, fadiga mental, fadiga muscular e outros fenômenos. Na ausência de alongamento e tratamento eficaz após o exercício, as lesões causadas pelo esporte podem afetar seriamente a função física dos atletas. A fim de aliviar de maneira eficaz a fadiga causada pela marcha atlética, o presente estudo se concentrou nos medicamentos manipulados na medicina tradicional chinesa (MTC), analisou o mecanismo de ação e eficácia medicinal dos medicamentos da MTC, e realizou experimentos de controle em 80 camundongos do tipo ICR masculinos. Os camundongos do grupo experimental receberam treinamento sedentário e treinamento de corrida em grupo. Os resultados mostraram que os dois grupos de camundongos ICR, após treino de marcha atlética, apresentavam sintomas de fadiga, e grande quantidade de ácido láctico sérico, além de outras substâncias, enquanto os camundongos do grupo D tratados com gavagem do medicamento manipulado tiveram sintomas de fadiga, mas com redução do teor sanguíneo de ureia e ácido láctico, fibras musculares gastrocnêmias uniformemente arranjadas, linhas transversais regulares, e efeito rebote da expressão proteica. Isto mostra que os medicamentos manipulados da medicina chinesa podem desempenhar um papel significativo no alívio da fadiga causada pela marcha atlética.

RESUMEN La fatiga causada por la marcha atlética es un tipo de síntoma que afecta los atletas después de un período de práctica del ejercicio, que puede ocasionar debilidad de los miembros, fatiga mental, fatiga muscular y otros fenómenos. En ausencia de elongación y tratamiento eficaz después del ejercicio, las lesiones causadas por el deporte pueden afectar seriamente la función física de los atletas. A fin de aliviar de manera eficaz la fatiga causada por la marcha atlética, el presente estudio se concentró en los medicamentos manipulados en la medicina tradicional china (MTC), analizó el mecanismo de acción y eficacia medicinal de los medicamentos da MTC, y realizó experimentos de control en 80 ratones del tipo ICR masculinos. Los ratones del grupo experimental recibieron entrenamiento sedentario y entrenamiento de carrera en grupo. Los resultados mostraron que los dos grupos de ratones ICR, después de entrenamiento de marcha atlética, presentaban síntomas de fatiga, y gran cantidad de ácido láctico sérico, además de otras sustancias, mientras que los ratones del grupo D tratados con gavaje del medicamento manipulado tuvieron síntomas de fatiga, pero con reducción del tenor sanguíneo de urea y ácido láctico, fibras musculares del gastrocnemio uniformemente arregladas, líneas transversales regulares, y efecto rebote de la expresión proteica. Esto muestra que los medicamentos manipulados de la medicina china pueden desempeñar un papel significativo en el alivio de la fatiga causada por la marcha atlética.

Efficacy and mechanism of traditional chinese medicine gel in sports-related soft tissue injury / Eficácia e mecanismo do tradicional gel da medicina chinesa em lesões desportivas de tecidos moles / Eficacia y mecanismo del gel de medicina tradicional china en lesiones deportivas de tejidos blandos

ABSTRACT Soft tissue injury is the most common disease in orthopedics, and it is also the most easily neglected disease in sports. Without timely and effective treatment, it is easy to develop into malignant strain and seriously affect life and sports. In view of this, the aim of this study is to analyze the effect and mechanism of traditional Chinese medicine gel in treating such injuries in the light of the characteristics of sports-related soft tissue injury. The right gastrocnemius muscle injury was simulated in 36 adult male rats. Chinese medicine gel and tincture were used to treat it. The contents of interleukin, alanine aminotransferase, blood urea nitrogen and prostaglandin E2 in the blood of rats under different courses of treatment were analyzed to explore recovery in four rats. The results showed that the levels of interleukin and prostaglandin E2 in the blood of rats treated with drugs were significantly lower than those in the control group (p<0.05), indicating that both drugs have obvious therapeutic effects on soft tissue injury. The content of interleukin in the blood of the Chinese medicine gel group was slightly lower than that of the tincture group, indicating that the Chinese medicine gel could affect the recovery of soft tissue injury by affecting leukocyte interleukin. This result is helpful in the treatment of soft tissue injury in sports and to further improve the therapeutic effect of traditional Chinese medicine gel.

RESUMO A lesão dos tecidos moles é a doença mais comum na ortopedia, e é também a doença mais facilmente negligenciada nos esportes. Sem tratamento ágil e eficaz, facilmente evolui para luxações malignas, afetando seriamente a vida e a prática de esportes. Em vista disso, o objetivo deste estudo é analisar o efeito e o mecanismo do gel da medicina tradicional chinesa no tratamento de tais lesões, com base nas características da lesão dos tecidos moles relacionada à prática esportiva. Estimulou-se lesão do músculo gastrocnêmio direito em 36 ratos adultos. O gel e a tintura chinesa foram usados para o tratamento. Foram analisados os conteúdos de interleucina, alanina aminotransferase, ureia sanguínea azoto e prostaglandina E2 no sangue dos ratos sob diferentes tratamentos, de modo a explorar a recuperação de quatro ratos. Os resultados mostraram que os níveis de interleucina e prostaglandina E2 no sangue dos ratos tratados com medicamentos eram significativamente inferiores aos do grupo controle (p<0.05), indicando que ambos os fármacos têm efeitos terapêuticos óbvios sobre lesões dos tecidos moles. O teor de interleucina no sangue do grupo gel chinês medicinal mostrou-se ligeiramente inferior ao do grupo tintura, indicando que o gel medicinal chinês pode afetar a recuperação da lesão nos tecidos moles, afetando o leucócito interleucina. Este resultado é útil para o tratamento de lesões dos tecidos moles relacionadas à prática esportiva e para melhorar ainda mais o efeito terapêutico do gel da medicina chinesa tradicional.

RESUMEN La lesión de los tejidos blandos es la enfermedad más común en la ortopedia, y es también la enfermedad más fácilmente descuidada en los deportes. Sin tratamiento ágil y eficaz, fácilmente evolucionan a luxaciones malignas, afectando seriamente la vida y la práctica de deportes. En vista de eso, el objetivo de este estudio es analizar el efecto y el mecanismo del gel de la medicina tradicional china en el tratamiento de tales lesiones, con base en las características de la lesión de los tejidos blandos relacionada a la práctica deportiva. Se estimuló lesión del músculo gastrocnemio derecho en 36 ratones adultos. El gel y la tintura china fueron usados para el tratamiento. Fueron analizados los contenidos de interleucina, alanina aminotransferasa, urea sanguínea, nitrógeno y prostaglandina E2 en la sangre de los ratones bajo diferentes tratamientos, de modo de explorar la recuperación de cuatro ratones. Los resultados mostraron que los niveles de interleucina y prostaglandina E2 en la sangre de los ratones tratados con medicamentos eran significativamente inferiores a los del grupo control (p<0.05), indicando que ambos fármacos tienen efectos terapéuticos obvios sobre lesiones de los tejidos blandos. El tenor de interleucina en la sangre del grupo gel chino medicinal se mostró ligeramente inferior al del grupo tintura, indicando que el gel medicinal chino puede afectar la recuperación de la lesión en los tejidos blandos, afectando el leucocito interleucina. Este resultado es útil para el tratamiento de lesiones de los tejidos blandos relacionadas a la práctica deportiva y para mejorar aún más el efecto terapéutico del gel de la medicina china tradicional.

Effect of Chahuang ointment on prevention of phlebitis from peripherally inserted central catheter: randomized clinical trial / Efeito da pomada Chahuang na prevenção de flebite de cateter central inserido perifericamente: ensaio clínico randomizado / Efecto de la pomada de Chahuang en la prevención de la flebitis por catéter central insertado periféricamente: ensayo clínico aleatorizado

ABSTRACT Objective: To assess the effect of Chahuang ointment, a Chinese herbal ointment, on the prevention of phlebitis in patients with peripherally inserted central catheters. Method: This was a multicenter randomized controlled trial, with 171 eligible patients randomly assigned into one of three groups: the Chahuang ointment group, the Mucopolysaccharide Polysulfate cream group, and the control group. The degrees of vein injuries at 72 hours after peripherally inserted central catheter insertion were the primary outcome. Secondary outcomes were the vascular wall thickness, tissue edema and microthrombus evaluated by Color Doppler Flow Imaging, the vascular endothelial growth factor, and endothelin-1 (ET-1) expression in vivo. Results: Compared with the control group, the Chahuang ointment group showed significantly lower incidence of postoperative phlebitis, tissue edema, and microthrombus at 72 hours after peripherally inserted central catheter insertion (all P<0.01). The VEGF and ET-1 expression were significantly inhibited in the Chahuang ointment group after 3 days of treatment (both P<0.01). There were no statistical differences in the degree of vein injuries, microthrombus, or tissue edema between the Chahuang ointment and mucopolysaccharide polysulfate groups (all P>0.05). Conclusion: Chahuang ointment was shown to provide effective prevention and protection against phlebitis after peripherally inserted central catheter insertion.

RESUMO Objetivo: Avaliar o efeito da pomada Chahuang, uma pomada à base de ervas chinesas, na prevenção de flebite em pacientes com cateter central de inserção periférica. Método: Este foi um estudo multicêntrico randomizado controlado, com 171 pacientes elegíveis aleatoriamente designados em um de três grupos: o grupo de pomada Chahuang, o grupo de creme de polissulfato de mucopolissacarídeo e o grupo de controle. Os graus de lesões das veias em 72 horas após a inserção do cateter central perifericamente inserido foram o resultado primário. Os desfechos secundários foram a espessura da parede vascular, edema tecidual e microtrombos avaliados por Color Doppler Flow Imaging, o fator de crescimento endotelial vascular e a expressão da endotelina-1 (ET-1) in vivo. Resultados: Comparado com o grupo controle, o grupo de pomada Chahuang apresentou incidência significativamente menor de flebite pós-operatória, edema de tecido e microtrombos 72 horas após a inserção do cateter central inserido perifericamente (todos P <0,01). A expressão de VEGF e ET-1 foi significativamente inibida no grupo de pomada Chahuang após 3 dias de tratamento (ambos P <0,01). Não houve diferenças estatísticas no grau de lesões das veias, microtrombos ou edema de tecido entre os grupos de pomada de Chahuang e polissulfato de mucopolissacarídeo (todos P> 0,05). Conclusão: A pomada Chahuang demonstrou fornecer prevenção e proteção eficazes contra flebite após a inserção do cateter central perifericamente inserido.

RESUMEN Objetivo: Evaluar el efecto de la pomada Chahuang, una pomada herbal china, sobre la prevención de la flebitis en pacientes con catéteres centrales insertados periféricamente. Método: Este fue un ensayo controlado aleatorio multicéntrico, con 171 pacientes elegibles asignados al azar en uno de tres grupos: el grupo de ungüento Chahuang, el grupo de crema de polisulfato de mucopolisacárido y el grupo de control. Los grados de lesiones de las venas a las 72 horas después de la inserción del catéter central insertado periféricamente fueron el resultado primario. Los resultados secundarios fueron el grosor de la pared vascular, el edema tisular y el microtrombo evaluados por imágenes de flujo con Doppler en color, el factor de crecimiento endotelial vascular y la expresión de endotelina-1 (ET-1) in vivo. Resultados: En comparación con el grupo de control, el grupo de ungüento Chahuang mostró una incidencia significativamente menor de flebitis posoperatoria, edema tisular y microtrombos a las 72 horas después de la inserción del catéter central insertado periféricamente (todos P <0,01). La expresión de VEGF y ET-1 se inhibió significativamente en el grupo de pomada de Chahuang después de 3 días de tratamiento (ambos P <0,01). No hubo diferencias estadísticas en el grado de lesiones venosas, microtrombos o edema tisular entre los grupos de pomada de Chahuang y polisulfato de mucopolisacárido (todos P> 0,05). Conclusión: Se demostró que la pomada de Chahuang proporciona una prevención y protección eficaces contra la flebitis después de la inserción de un catéter central insertado periféricamente.

Eletrodiagnóstico e perfil energético com o Ryodoraku em medicina tradicional chinesa: revisão integrativa / Eletrodiagnostic and energy profile with Ryodoraku in chinese traditional medicine: integrative review / Eletrodiagnóstico y perfil energético con el Ryodoraku en medicina tradicional china: revisión integrativa

Objective: To synthesize the evidence in the literature on the applicability of the Ryodoraku system in the energy diagnosis based on the precepts of Traditional Chinese Medicine. Method: integrative review, carried out by independent reviewers in databases. Results: we found 324 studies. After exclusion, eight were analyzed, with a predominance of descriptive studies. There was agreement about the 24 points selected for the application of Ryodoraku; however, there is disagreement as to their location. Conclusions: Ryodoraku still does not present consistent evidence on its use, limiting the evaluation of its applicability

Objetivo: Sintetizar as evidências disponíveis na literatura sobre a aplicabilidade do sistema Ryodoraku no diagnóstico energético baseado nos preceitos da Medicina Tradicional Chinesa. Método: revisão integrativa, realizada por revisores independentes em bases de dados. Resultados: encontrou-se 324 estudos. Após exclusões, oito foram analisados, com predomínio de estudos descritivos. Houve concordância acerca dos 24 pontos selecionados para a aplicação do Ryodoraku; entretanto, há divergência quanto à localização dos mesmos. Conclusões: o Ryodoraku ainda não apresenta evidências consistentes sobre sua utilização, limitando a avaliação de sua aplicabilidade.

Objetivo: Sintetizar las evidencias de la literatura sobre la aplicabilidad del sistema Ryodoraku en el diagnóstico energético basado en los preceptos de la Medicina Tradicional China. Método: revisión integrativa, realizada por revisores independientes en bases de datos. Resultados: se han encontrado 324 estudios. Después de exclusiones, ocho fueron analizados, con predominio de estudios descriptivos. Hubo concordancia sobre los 24 puntos seleccionados para la aplicación del Ryodoraku; sin embargo, hay divergencia en cuanto a la localización de los mismos. Conclusión: el Ryodoraku todavía no presenta evidencias consistentes sobre su utilización, limitando la evaluación de su aplicabilidad

Effectiveness and safety of traditional Chinese medical therapy for cancer-related fatigue: a systematic review and Meta-analysis of randomized controlled trials.

OBJECTIVE: To assess the effectiveness and safety of traditional Chinese medical therapy for cancer-related fatigue. METHODS: We systematically searched eight electronic databases up to June 2017 for randomized clinical trials of traditional Chinese medical therapy for cancer-related fatigue. Two authors independently extracted data and assessed the risk bias of the included trials using the Cochrane Handbook. Data were analyzed by RevMan 5.2 software. RESULTS: A total of 23 trials involving 1832 participants identified with cancer-related fatigue were included. Twenty trials reported a beneficial effect of traditional Chinese medical therapy on cancer-related fatigue. On pooling the data from Chinese herbal medicine therapy and acupuncture or moxibustion therapy, respectively, significant differences were found between experimental groups and control groups. Fatigue improvement rates showed significant differences between traditional Chinese medical therapy and control groups [odds ratio (OR), 7.62; 95% confidence interval (CI), 3.75-15.49; P < 0.000 01; and OR, 3.78; 95% CI, 2.29-6.23; P < 0.000 01). Fatigue change scores also showed significant differences between the two groups (mean difference, -0.91; 95% CI, -0.16 to -0.65; P < 0.000 01). Eleven trials demonstrated that traditional Chinese medical therapy improved the quality of life of cancer patients. No severe adverse effects occurred in traditional Chinese medical therapy groups. CONCLUSION: Meta-analysis showed that Chinese medical therapy seems to be effective and safe in the treatment of cancer-related fatigue.

Clinical research linking Traditional Chinese Medicine constitution types with diseases: a literature review of 1639 observational studies.

OBJECTIVE: To analyze clinical studies on correlations between Traditional Chinese Medicine (TCM) body constitution types and diseases published in the past 10 years, and to provide an evidence base to support the use of such correlations for health maintenance and disease prevention. METHODS: We searched five databases for the period April 2009 to December 2019: China National Knowledge Infrastructure Database, Wanfang Database, China Science and Technology Journal Database, PubMed and Embase. Three types of observational studies on correlation between constitution types and diseases were included: cross-sectional, case-control and cohort studies. Descriptive statistical methods were employed for data analysis. RESULTS: A total of 1639 clinical studies were identified: 1452 (88.59%) cross-sectional studies, 115 (7.02%) case-control studies and 72 (4.39%) cohort studies covering 30 regions of China and five other countries (Malaysia, South Korea, Singapore, Thailand and France). The collection of studies comprised 19 disease categories and 333 different diseases. The 10 most commonly studied diseases were hypertension, diabetes, stroke, coronary atherosclerotic heart disease (CAHD), sleep disorders, neoplasm of the breast, dysmenorrhea, fatty liver disease, chronic viral hepatitis B and dyslipidemia. We found high distributions for each biased constitution type in different patient populations as follows: Qi-deficiency constitution in stroke, diabetes, chronic obstructive pulmonary disease, acquired immunodeficiency syndrome and hypertension; Yang-deficiency constitution in female infertility, osteoporosis, irritable bowel syndrome, gonarthrosis and dysmenorrhea; Yin-deficiency constitution in hypertension, diabetes, constipation, female climacteric states and osteoporosis; phlegm- dampness constitution in hypertension, stroke, fatty liver disease, diabetes and metabolic syndrome; damp-heat constitution in acne, chronic gastritis, chronic viral hepatitis B, human papillomavirus infection and hyperuricemia; blood-stasis constitution in CAHD, endometriosis and stroke; Qi-stagnation constitution in hyperplasia and neoplasms of the breast, insomnia, depression and thyroid nodules; and inherited-special constitution in asthma and allergic rhinitis. CONCLUSION: Eight biased TCM constitutions were closely related to specific diseases, and could be used to guide individualized prevention and treatment. More rigorously designed studies are recommended to further verify the constitution-disease relationship.

Chinese herbal medicines for prevention and treatment of colorectal cancer: From molecular mechanisms to potential clinical applications.

Worldwide, colorectal cancer (CRC) is one of the most common malignant tumors, leading to immense social and economic burdens. Currently, the main treatments for CRC include surgery, chemotherapy, radiotherapy and immunotherapy. Despite advances in the diagnosis and treatment of CRC, the prognosis for CRC patients remains poor. Furthermore, the occurrence of side effects and toxicities severely limits the clinical use of these therapies. Therefore, alternative medications with high efficacy but few side effects are needed. An increasing number of modern pharmacological studies and clinical trials have supported the effectiveness of Chinese herbal medicines (CHMs) for the prevention and treatment of CRC. CHMs may be able to effectively reduce the risk of CRC, alleviate the adverse reactions caused by chemotherapy, and prolong the survival time of patients with advanced CRC. Studies of molecular mechanisms have provided deeper insight into the roles of molecules from CHMs in treating CRC. This paper summarizes the current understanding of the use of CHMs for the prevention and treatment of CRC, the main molecular mechanisms involved in these processes, the role of CHMs in modulating chemotherapy-induced adverse reactions, and CHM's potential role in epigenetic regulation of CRC. The current study provides beneficial information on the use of CHMs for the prevention and treatment of CRC in the clinic, and suggests novel directions for new drug discovery against CRC.

Effects of four types of integrated Chinese and Western medicines for the treatment of COVID-19 in China: a network meta-analysis

SUMMARY OBJECTIVE Various integrated Chinese and Western medicines might be beneficial for the treatment of Coronavirus disease 2019 (COVID-19). This study aims to evaluate the efficacy of lung computed tomography (CT) of four integrated Chinese and Western medicines in the treatment of COVID-19 using network meta-analysis (NMA). METHODS Multiple databases were consulted to find randomized controlled trials of four different types of integrated Chinese and Western medicines for the treatment of COVID-19. NMA was conducted on the data using Stata (13.0) software. The odds ratio (OR) was calculated. The studies included in this paper were divided into a control group (Western medicine) and an observation group (one of four integrated Chinese and Western medicines). RESULTS 5 eligible publications were identified. A total of 598 cases were included in the study, and the results showed that the four types of integrated Chinese and Western medicines (symptomatic and supportive care with Qingfei Touxie Fuzheng, Lianhua Qingke, and Xuebijing) were significantly superior (P < 0.05) to symptomatic and supportive care alone, except for symptomatic and supportive care with Lianhua Qingwen. The combination of symptomatic and supportive care with Lianhua Qingke had the highest probability of being the most clinically efficacious intervention, with a surface under the cumulative ranking (SUCRA) curve of 85.7. CONCLUSIONS A combination of symptomatic and supportive care with Lianhua Qingke is the best option among the four integrated Chinese and Western medicines considered for the treatment of COVID-19.

RESUMO OBJETIVO Vários medicamentos chineses e ocidentais integrados podem ser benéficos para o tratamento da COVID-19. O objetivo deste estudo é avaliar a eficácia da tomografia computadorizada (TC) de pulmão de quatro medicamentos chineses e ocidentais integrados para o tratamento da COVID-19 usando uma meta-análise em rede (NMA). MÉTODOS Vários bancos de dados foram consultados para encontrar ensaios clínicos randomizados de quatro tipos diferentes de medicamentos chineses e ocidentais integrados para o tratamento da COVID-19. A NMA foi realizada nos dados usando o software Stata (13.0). O odds ratio (OR) foi calculado. Os estudos incluídos neste artigo foram divididos em um grupo de controle (medicina ocidental) e um grupo de observação (um dos quatro medicamentos chineses e ocidentais integrados). RESULTADOS 5 publicações elegíveis foram identificadas. Um total de 598 casos foram incluídos no estudo, e os resultados mostraram que os quatro tipos de medicamentos chineses e ocidentais integrados (tratamento sintomático e de suporte com Qingfei Touxie Fuzheng, Lianhua Qingke e Xuebijing) foram significativamente superiores (P <0,05) a somente cuidados sintomáticos e de suporte, exceto cuidados sintomáticos e de suporte com Lianhua Qingwen. A combinação de cuidados sintomáticos e de suporte com Lianhua Qingke teve a maior probabilidade de ser a intervenção clinicamente mais eficaz, com uma superfície abaixo da curva de classificação cumulativa (SUCRA) de 85,7. CONCLUSÕES Uma combinação de tratamento sintomático e de suporte com Lianhua Qingke é a melhor opção entre os quatro medicamentos integrados chineses e ocidentais considerados para o tratamento de COVID-19.

Paris polyphylla ethanol extract induces G2/M arrest and suppresses migration and invasion in bladder cancer.

BACKGROUND: Paris polyphylla is a traditional Chinese medicinal herb with multiple antitumor activities, but the role of P. polyphylla in bladder cancer (BC) is under investigation. This study aims to examine the antitumor activities of P. polyphylla ethanol extract (PPE) on BC cells and elucidate the underlying mechanisms. METHODS: Viable cells were counted using the trypan blue exclusion assay. The cell cycle was analyzed using flow cytometry, and scratch wound-healing and transwell assays were used to evaluate cell migration and invasion abilities, respectively. The protein expression levels were determined by western blotting. A xenograft model was used to assess the in vivo inhibitory effect of PPE on BC tumor growth. RESULTS: Our results showed that PPE inhibited the growth of BC cells in vivo and in vitro. Mechanistically, PPE regulated the levels of cell cycle-associated proteins, with PPE-induced G2/M phase arrest occurring through cyclin-dependent kinase inhibitor 1 (CDKN1A) accumulation and cyclin B1 (CCNB1)/cyclin-dependent kinase 1 (CDK1) inhibition. BC tumor growth was also inhibited by PPE treatment. Moreover, the migration and invasion abilities of J82 cells were suppressed through modulating epithelial-mesenchymal transition (EMT) regulatory factors with upregulation of cadherin-1 (CDH1) and downregulation of cadherin-2 (CDH2), snail family transcriptional repressor 2 (SNAI2), and twist family bHLH transcription factor 1 (TWIST1). CONCLUSIONS: PPE inhibited cell growth, induced G2/M arrest, and suppressed the migration and invasion of J82 cells. BC tumor growth in vivo was also inhibited by PPE. Our results lay the foundation for further studies on the antitumor mechanisms of PPE.

Efetividade do fitoterápico chinês Gan Mai Da Zao para melhoria do estresse crônico na equipe de enfermagem oncológica: ensaio clínico randomizado / Effectiveness of Chinese herbal medicine Gan Mai Da Zao to improve chronic strss in the oncology nursing team: randomizes clinical trial

Introdução: A equipe de enfermagem oncológica é uma população com alto risco de desenvolver estresse crônico, pois lidam com uma enfermidade de alta complexidade e mortalidade, intensificando a carga emocional sofrida no trabalho. Quando persistente, o estresse pode promover uma série de consequências deletérias, dentre elas distúrbios de sono e transtornos de ansiedade e depressão que em parte podem ser explicadas por alterações nos níveis de cortisol (quantificado na saliva) e melatonina (estimada também pela excreção do seu subproduto 6- sulfatoximelatonina/ 6SMEL na urina). Investigar terapias de fácil aplicação e que podem ser administradas de forma contínua, podem trazer benefícios para saúde desses profissionais que possuem pouco tempo para cuidar de si.Objetivo: Avaliar a efetividade da fitoterapia chinesa para a melhoria dos níveis de estresse ocupacional, ansiedade, depressão e qualidade do sono em profissionais de enfermagem oncológica. Método: Ensaio clínico controlado randomizado duplo-cego com dois grupos fitoterapia/ Gan Mai Da Zao (GMDZ - G1) e placebo (G2). 187 profissionais de enfermagem de hospital público de oncologia de São Paulo, responderam ao questionário sociodemográfico e a Lista de Sintomas de Stress de Vasconcelos (LSS); 100 profissionais com médio e alto estresse foram randomizadas nos grupos G1 e G2 e mais 10 pessoas sem estresse pelo LSS foram avaliadas apenas no início do estudo e alocadas no grupo controle (G3) que serviu como referência de \"indivíduos saudáveis\" da população da enfermagem oncológica. A escala de coping ocupacional (ECO) e o inventário de sintomas de stress da LIpp (ISSL) foram utilizados para caracterização da amostra e a avaliação foi feita pela escala de estresse no trabalho (EET), pelo índice de qualidade de sono de Pittsburgh (PSQI), pela escala de ansiedade e depressão hospitalar (HADS) e dosagens de cortisol e 6-sulfatoximelatonina aplicadas início e final da intervenção. Os níveis energéticos dos meridianos foram avaliados pelo Ryodoraku apenas nos grupos GMDZ e placebo também em dois momentos. A intervenção teve duração de 4 semanas com dose de 2 cápsulas do fitoterápico ou placebo (excipientes farmacêuticos) a cada 12 horas para ambos os grupos. Foi feita a análise descritiva, teste de Correlação de Pearson e modelo de efeitos mistos para avaliar o resultado da intervenção com nível de significância de =0,05 no software R. Resultados: O GMDZ foi superior ao placebo na redução dos níveis de estresse (p=0,007), no estresse no trabalho (p=0,03); na melhora dos sintomas de depressão (p=0,03) e na regulação dos níveis de cortisol e energéticos dos meridianos. Não houve diferença na qualidade do sono (p=0,259); na ansiedade (0,139) e nos níveis de 6SMEL (p=0,573). Conclusão: O Gan Mai Da Zao foi eficaz na redução dos níveis de estresse crônico, estresse no trabalho, para melhora de sintomas depressivos e equilíbrio do cortisol e energético dos meridianos da enfermagem oncológica, demostrando que a fitoterapia chinesa pode auxiliar na promoção de bem-estar físico e mental desses profissionais.

Introduction: The oncology nursing team is a population at high risk of developing chronic stress, because they need to cope with a complex illness with high mortality, increasing the emotional exaustion in workplace. When persistent stress can promote a series of harmful consequences, among these sleep disorders and anxiety and depression disorders. This disorders are possible explained by changes in the levels of salivary cortisol and melatonin by 6-sulfatoximelatonin/ aMT6s in urine).Investigating therapies that are easy to apply and that can be administered continuously can bring health benefits to those professionals who have little time to take care of themselves. Objective: To assess the effect of Chinese herbal medicine to improve levels of occupational stress, anxiety, depression. and sleep quality in oncology nursing professionals. Method: Randomized controlled double blind clinical trial with two groups: Gan Mai Da Zao (GMDZ - G1) and placebo (G2). 187 volunteers from a municipal hospital of São Paulo, answering the sociodemographic questionnaire and the Vasconcelos Stress Symptoms List (LSS); 100 professionals with medium and high stress were randomized in groups G1 and G2 and another 10 people without stress by the LSS were evaluated only at the beginning of the study and allocated to the control group (G3), which served as a reference for \"heathy people\" in the population oncology nursing. For sample characterization, the occupational coping scale (ECO) and the LIpp stress symptom inventory (ISSL) was applied and he other evaluations were made by the following instruments: Pittsburgh sleep quality index (PSQI); hospital anxiety and depression scale (HADS) and work stress scale (EET). Cortisol and aMT6s were also are evaluated in a private laboratory as well as energy levels of the meridians by Ryodoraku in two moments (before and after) for GMDZ and placebo gropus.The intervention occured in 4 weeks with a dose of 2 GMDZ or placebo capsules (pharmaceutical excipients) every 12 hours for both groups. A descriptive analysis, Pearson\'s correlation test and mixed effects model were performed for evaluation or outcome of the intervention with a significance level of = 0.05 in the R software. Results: GMDZ was superior than placebo in reducing stress levels (p = 0.007), in occupational stress (p = 0.03); in the improvement of depression symptoms (p = 0.03) and in cortisol and meridians energy regulation. There was no difference in sleep quality (p = 0.259); anxiety (0.139) and aMT6s levels (p = 0.573). Conclusion: Gan Mai Da Zao was effective in reducing the levels of chronic stress, stress at work, for improving depressive symptoms and balancing the cortisol and energy of the oncology nursing meridians, demonstrating that Chinese herbal medicine can help in promoting well-being physical and mental health of these professionals.

Inventário de rastreamento de diagnósticos de medicina tradicional chinesa aplicados ao estresse crônico: construção e validação de conteúdo / Inventory for tracking diagnosis of Traditional Chinese Medicine applied to chronic stress: construction and content validation

Introdução: Os estudos ocidentais mostram que o estresse crônico é um dos principais contribuintes para a progressão das doenças crônicas, dentre elas, o diabetes mellitus e as doenças cardiovasculares, elevando o risco da mortalidade experimentado por algumas profissões estressantes. Na medicina chinesa não foram ainda estabelecidos os Diagnósticos de Medicina Tradicional Chinesa (MTC) para o estresse crônico e desenvolver um instrumento de rastreamento pode auxiliar na determinação de condições que são tratáveis prematuramente, antes da instalação de uma doença. Objetivo: Construção e validação de conteúdo de um Inventário para Rastreamento de Diagnósticos de MTC aplicados ao estresse crônico. Método: Trata- se de um estudo de trajetória metodológica. Na primeira etapa, um banco de dados de 805 participantes com níveis de estresse médio, alto e altíssimo, segundo a Lista de Sintomas de Estresse (LSS) de Vasconcellos, foi submetido à uma análise fatorial exploratória (AFE) para obtenção dos principais sintomas, aos quais foram associados possíveis Diagnósticos de MTC. Estes foram avaliados por um Comitê de sete juízes e validados os sintomas e diagnósticos de MTC pelo Índice de Validade de Conteúdo (IVC). Na segunda etapa, aos sintomas da LSS foram acrescidos de outros diagnósticos da MTC pela literatura, para a construção do Inventário e submetidos a um Comitê de cinco juízes que validaram os sintomas pela razão de validade de conteúdo (Content Validity Ratio), segundo critérios de clareza, representatividade e pertinência. Resultados: A AFE resultou em 15 principais fatores, correspondente a 57,3% da variância dos itens. Ao realizar teste de Confiabilidade (Alfa de Cronbach) para cada um dos fatores, sete foram considerados confiáveis. A partir destes fatores, três principais domínios foram associados: Deficiência geral (Qi, Yin, Yang, Xue); Distúrbio de Shen e Desarmonia do Fígado. Trinta e sete sintomas da LSS, relacionados aos três fatores, foram submetidos ao Comitê que validaram em três rodadas de avaliação 18 diagnósticos de MTC. Na segunda etapa, foi construído o Inventário com 55 itens (sinais e sintomas) gerais, mais cinco somente para mulheres e mais dois só para homens, totalizando 62 itens, que foram validados pelo Comitê. O CVR-Content Validity Ratio relativo a cada item obteve razão igual a um, que representa 100% de validade. Para reconhecimento dos diagnósticos de MTC, a partir da aplicação do Inventário, foi adaptado um quadro sinóptico com base na literatura de MTC, dos principais diagnósticos e sinais e sintomas relacionados. Conclusão: O Inventário construído tem no total 55 itens, dos quais 38 são sintomas físicos e 17 emocionais e cinco sintomas somente para mulheres e dois somente para os homens. Estes determinam 18 diagnósticos de MTC, que são em sua maioria relacionados a Deficiências, Distúrbios de Shen e de Fígado. Contribuições: O Inventário poderá contribuir na prática clínica como um instrumento para detecção de diagnósticos de MTC em indivíduos com estresse crônico e diferentes morbidades, como auxiliar para estudantes iniciantes e profissionais de MTC, podendo ser utilizado pela Enfermagem e por todas as profissões da saúde, que tem a acupuntura e práticas associadas como especialidades.

Introduction: Western studies show that chronic stress is one of the major contributors to the progression of chronic diseases, including diabetes mellitus and cardiovascular diseases, increasing the risk of mortality experienced by some stressful professions. In Chinese medicine, the Diagnostics of Traditional Chinese Medicine (TCM) for chronic stress have not yet been established and developing a screening instrument can assist in determining conditions that are treatable prematurely, before the onset of a disease. Objective: Construction and content validation of an Inventory for Tracking TCM Diagnostics applied to chronic stress. Method: This is a methodological study. In the first stage, a database of 805 participants with medium, high and very high stress levels, according to the Vasconcellos Stress Symptoms List (SSL), was subjected to an exploratory factor analysis (EFA) to obtain the main symptoms, to which possible TCM diagnoses have been associated. These were evaluated by a Committee of seven judges and the TCM symptoms and diagnoses were validated by the Content Validity Index (CVI). In the second stage, to the symptoms of the SSL, other diagnoses of TCM were added by the literature, for the construction of the Inventory and submitted to a Committee of five judges who validated the symptoms by the content validity ratio (Content Validity Ratio), according to criteria of clarity, representativeness and pertinence. Results: EFA resulted in 15 main factors, corresponding to 57.3% of the items\' variance. When performing the Reliability test (Cronbach\'s alpha) for each of the factors, seven were considered reliable. From these factors, three main domains were associated: General deficiency (Qi, Yin, Yang, Xue); Shen\'s and Liver Disorder. Thirty-seven symptoms of SSL, related to the three factors, were submitted to the Committee that validated 18 diagnoses of TCM in three evaluation rounds. In the second stage, the Inventory was built with 55 general items (signs and symptoms), five more only for women and two more only for men, totaling 62 items, which were validated by the Committee. The CVR-Content Validity Ratio for each item obtained a ratio equal to one, which represents 100% agreement. To recognize the diagnoses of TCM, from the application of the Inventory, a synoptic table was adapted based on the TCM literature, of the main diagnoses and related signs and symptoms. Conclusion: The Inventory built has a total of 55 items, of which 38 are physical and 17 emotional symptoms and five symptoms for women only and two for men only. These determine 18 diagnoses of TCM, which are mostly related to Deficiencies, Shen and Liver Disorders. Contributions: The Inventory can contribute to clinical practice as an instrument for detecting TCM diagnoses in individuals with chronic stress and different morbidity, as an aid for beginning students and TCM professionals, and can be used by Nursing and by all health professions, that have acupuncture and associated practices as specialties.