ABSTRACT
In recent years, the incidence of pulmonary nodules has kept rising. To give full play to the advantages of traditional Chinese medicine (TCM) in the treatment of pulmonary nodules and identify the breakthrough points of integrating TCM with Western medicine, the China Association of Chinese Medicine organized medical experts in TCM and western medicine to carry out in-depth discussion regarding this disease. The discussion encompassed the modern medical advances, TCM theories of etiology and pathogenesis, the role and advantages of TCM in the whole course management of pulmonary nodules, contents and methods of research on pulmonary nodules, and science popularization work, aiming to provide a reference for clinical practice and scientific research. After discussion, the experts concluded that the occurrence of pulmonary nodules was rooted in the deficiency of the lung and spleen and triggered by phlegm dampness, blood stasis, and Qi stagnation. TCM can treat pulmonary nodules by controlling and reducing nodules, improving physical constitution, ameliorating multi-system nodular diseases, reducing anxiety and avoiding excessive diagnosis and treatment, and serving as an alternative for patients who are unwilling or unfit for surgical treatment. At present, the optimal diagnosis and treatment strategy for pulmonary nodules has not been formed, which needs to be further studied from multiple perspectives such as clinical epidemiology, biology, and evidence-based medicine. The primary task of current research is to find out the advantages, effective prescriptions, and target populations and determine the effective outcomes of TCM in the treatment of pulmonary nodules. At the same time, basic research should be carried out to explore the etiology and biological behaviors of pulmonary nodules. The expert consensus on the diagnosis and treatment of pulmonary nodules with integrated TCM and Western medicine needs to be continuously revised to guide clinicians to conduct standardized, scientific, and accurate effective diagnosis and treatment.
ABSTRACT
[Objective]To explore the clinical efficacy of modified Yupingfeng Powder combined with western medicine in the treatment of pregnant women with mild corona virus disease 2019(COVID-19).[Methods]The pregnant women with mild COVID-19 admitted to Shanghai Public Health Clinical Center from April 2022 to June 2022 were divided into treatment group and control group randomly.The control group(52 cases)was treated with western medicine such as Vitamin C,and the treatment group(48 cases)was treated with modified Yupingfeng Powder on the basis of control group.A comparison was made between the two groups in terms of each symptoms scores,incidence of adverse pregnancy outcomes and total effective rate.Besides,the levels of laboratory indicators involving lymphocyte,C reactive protein(CRP),interleukin-2 receptor(IL-2R)and interleukin-6(IL-6)were also be compared.The negative changes of virus nucleic acid and disease outcome were observed in the two groups.[Results]Compared with control group,after treatment cessation,the total symptom score in treatment group significantly decreased(P<0.001),and the total effective rate significantly increased(P<0.01).The levels of inflammatory markers including CRP and IL-6 decreased significantly in treatment group(P<0.001,P<0.01),while the count of lymphocyte increased significantly(P<0.001).Besides,there was no difference in the incidence of adverse pregnancy outcomes between the two groups(P>0.05).[Conclusion]Modified Yupingfeng Powder combined with western medicine can significantly relieve the clinical symptoms of pregnant women with mild COVID-19,while shortening nucleic acid negative conversion time and does not affect the pregnancy outcome,which has certain clinical value and is worthy of clinical application.
ABSTRACT
At present, there is no consensus on the diagnosis, treatment, and management of pulmonary nodules with integrated traditional Chinese and Western Medicine in China. To establish the clinical management strategy of pulmonary nodules with integrated medicine, a consensus was formed after full discussion by the experts from the Cancer Committee of Chinese Association of Integrative Medicine and the Cancer Committee of Beijing Association of Chinese Medicine according to the guidelines for pulmonary nodules issued in recent years and the clinical practice of multiple hospitals in the treatment of cancers with integrated Chinese and Western medicine. This consensus involves the existing clinical management guidelines of pulmonary nodules and the intervention methods of traditional Chinese medicine (TCM). Considering the therapeutic positioning and value of TCM, this consensus standardizes the whole-process management of pulmonary nodules with integrated traditional Chinese and Western medicine, which will help more patients.
ABSTRACT
By combing the application and funding situation of general, young scholar and regional scholar programs from National Natural Science Foundation of China(NSFC) in field of integrated traditional Chinese and western medicine in 2023, this paper summarizes the distribution of supporting units, application and funding hotspots, and the problems of application and funding projects in this discipline, in order to provide a reference for applicants and supporting organizations to understand the hotspot dynamics and reporting requirements of the discipline. In 2023, the discipline of integrated traditional Chinese and western medicine received a total of 2 793 applications, and there were 1 254 applications for general programs, 1 278 applications for young scholar programs, and 261 applications for regional scholar programs. The amounts of project funding obtained by the three were 145, 164 and 35, respectively, and the funding rates were 11.56%, 12.83% and 13.41% in that order. From the situation of obtaining funding, the age distribution of the project leaders who obtained funding for the general, young scholar and regional scholar programs were mainly distributed in the age of 40-46, 30-34, 38-44 years, respectively. Within the supported programs, the Chinese medicine affiliations accounted for 55.52%. With respect to research subjects, the proportion of one single Chinese herbs, or monomers, or extracts accounted for 29.4%, but the proportion of Chinese herb pairs or prescriptions accounted for 47.1%. Research hotspots included ferroptosis, bile acid metabolism, macrophages, mitochondria, microglia, exosomes, intestinal flora, microecology and so on. The current research mainly focused on the common key problems of the advantageous diseases of Chinese and western integrative medicine, but still need to be improved in the basic theories of Chinese and western medicine and multidisciplinary cross-disciplinary research.
ABSTRACT
ObjectiveTo evaluate the effect of antihypertensive and lipid-regulating Chinese patent medicine combined with conventional Western medicine in the treatment of hypertension with dyslipidemia. To carry out the evidence synthesis of clinical research and provide evidence-based evidence support for clinical decision-making. MethodThe databases including China National Knowledge Infrastructure (CNKI),Wanfang Data Knowledge Service Platform (WF),VIP,SinoMed,Embase,PubMed,Web of Science (WOS),and the Cochrane Library were searched for randomized controlled trials (RCT) of all listed Chinese patent medicines in the treatment of hypertension with dyslipidemia from the establishment of the databases to April 15,2023. The literature was screened and extracted,and the risk of bias tool 2.0 (RoB2) was used to assess the quality and risk of bias of the methodology. Revman 5.4.1 software was used to analyze the outcome indicators. Grading of Recommendations Assessment,Development and Evaluation (GRADE) was applied to assess the quality of evidence formed by clinical research data. The inclusion and recommendation of Chinese patent medicines in the National Drug Catalogue for Basic Medical Insurance,Work-related Injury Insurance and Maternity Insurance (2022) and domestic guidelines and consensus were searched to form a bubble chart. ResultA total of 15 studies were included. The evaluation of the methodological quality of each study showed that the risk of bias stemmed from the lack of blinding and allocation concealment,and low sample size. The comprehensive analysis of clinical studies showed that Dengzhan Shengmai capsules combined with rosuvastatin and amlodipine besylate,Yindan Xinnaotong capsules combined with simvastatin and levamlodipine tablets,Xiaoshuan Tongluo capsules combined with nifedipine controlled release tablets and pravastatin sodium tablets,Xinshubao capsules combined with atorvastatin calcium tablets and irbesartan,Wenyading capsules combined with enalapril,and Jiangzhining tablets combined with conventional Western medicines were all superior to conventional Western medicines used in the control group in improving systolic blood pressure (SBP),diastolic blood pressure (DBP),cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDL-C),and high density lipoprotein cholesterol (HDL-C). There was no significant difference in the incidence of adverse reactions between the two groups. The GRADE evaluation of the main outcome indicators showed that the evidence quality of SBP and incidence of adverse reactions was graded as B,that of DBP as C,and that of total TC,TG,LDL-C,and HDL-C as D. The evaluation of Chinese patent medicines covered by medical insurance and recommended by guidelines and consensus showed that Yindan Xinnaotong soft capsules,Dengzhan Shengmai capsules and Xiaoshuan Tongluo capsules belonged to class B drugs of medical insurance,and were recommended for 7,6 and 3 times in the guidelines and consensus,respectively. ConclusionCompared with simple medicine treatment,Chinese patent medicine combined with conventional Western medicine has more advantages in improving blood pressure and blood lipid,and shows higher safety. Among them,Yindan Xinnaotong soft capsules,Dengzhan Shengmai capsules and Xiaoshuan Tongluo capsules have stronger clinical applicability and economy. All the trials included in this article adhered to the principle of randomization and reported the outcome measures. However,the quality of evidence in related clinical studies was low. In terms of trial design,large-sample,multi-center,blinded randomized controlled trials based on the consolidated standards of reporting trials (CONSORT) statement are still needed for comprehensive trial designs and reporting,to further improve the GRADE quality evaluation and guideline formulation under the guidance of evidence-based medicine,so as to provide higher quality evidence-based research evidence for clinical decision-making.
ABSTRACT
ObjectiveTo investigate the predictive indicators of early efficacy of Bushen Shengxue prescription combined with western medicine in the treatment of aplastic anemia, and provide prognosis indicators for the treatment of aplastic anemia (AA) with kidney-tonifying therapy in traditional Chinese medicine (TCM) combined with western medicine. MethodA total of 126 patients treated by Bushen Shengxue prescription combined with western medicine in 19 hospitals including Xiyuan Hospital of the China Academy of Chinese Medical Sciences from September 2018 to March 2021 were selected for a retrospective study. The therapy was proven to be effective after six months of treatment. According to the efficacy after 4 months of treatment, the patients were assigned into a 4-month effective group and a 4-month ineffective group. The age, sex, disease severity (including severe aplastic anemia and non-severe aplastic anemia), course of disease, degree of bone marrow nucleated cell proliferation, baseline hemogram levels [including white blood cell count (WBC), absolute neutrophil count (ANC), hemoglobin (HGB), platelets (PLT), and reticulocytes (RET)], T lymphocytes subsets, and the expression levels of T-box transcription factor (T-bet) and GATA-binding protein-3 (GATA-3) were compared between the two groups before treatment. ResultThe proportions of patients within the age ranges of [20, 40) and [60, 80) were higher in the 4-month effective group (P<0.05). The sex, disease severity, course of disease, and comorbidities had no significant differences between the two groups. The 4-month effective group had higher baseline levels of HGB, WBC, ANC, and PLT than the 4-month ineffective group (P<0.05), and there was no significant difference in the RET level between the two groups before treatment. Binary Logistic regression analysis showed that the PLT level before treatment was an independent factor affecting the onset time, while other indicators did not affect the onset time. The receiver operating characteristic (ROC) curve was established to analyze the value of PLT level before treatment for predicting the onset time, and the area under the curve was 0.691. With the critical value of 40.5×109/L, the sensitivity and specificity of the prediction that the therapy will take effect within 4 months were 0.569 and 0.893, respectively. The two groups of patients were graded according to age {(14, 20), [20, 40), [40, 60), and [60, 80)} and PLT level before treatment (PLT<40×109/L, PLT≥40×109/L). The proportion of the patients with PLT≥40×109/L before treatment in the 4-month effective group was significantly higher than that in the 4-month ineffective group (P<0.05). The degree of bone marrow nucleated cell proliferation before treatment had no significant difference between the two groups. The level of total T lymphocytes in the 4-month effective patients was lower than that in the 4-month ineffective patients before treatment (P<0.05). The levels of Th1 cells, Th2 cells, CD4+ T cells, and CD8+ T cells showed no significant differences between the two groups before treatment. The T-bet expression level in the 4-month effective group was higher than that in the 4-month ineffective group before treatment (P<0.05), while the expression level of GATA-3 showed no significant difference between the two groups before treatment. ConclusionBushen Shengxue prescription combined with western medicine will achieve faster effect for the patients within the age ranges of [20, 40) or [40, 60), with higher levels of HGB, WBC, ANC, and PLT (especially those with PLT≥40×109/L), lower level of total T lymphocytes, or higher T-bet expression level before treatment.
ABSTRACT
Cardiometabolic disease (CMD) is a clinical syndrome in which there is a causal relationship between metabolic abnormalities and cardiovascular damage. The incidence and mortality rates of CMD remain high despite the use of potent pharmacologic interventions and clinical therapeutic approaches. There is an urgent need for effective evidence-based comprehensive management measures to improve patients' lifespan and quality of life. From the concept of "nourishing through food" proposed in the Huangdi's Internal Classic (Huang Di Nei Jing) to the widespread application of modern dietary patterns such as dietary restriction, plant-based diets, and Jiangnan cuisine, dietary regulation plays a significant role in preventing diseases, early treatment of existing diseases, and recovery. This article systematically reviewed the traditional Chinese medicine (TCM) theory related to dietary patterns, elucidated the cutting-edge evidence and mechanisms of modern dietary patterns like dietary restriction in preventing and treating CMD, and explored the strategy of integrating TCM theory with dietary patterns, aiming to establish a new food-nutrition-medicine approach that combines traditional Chinese and western medicine and provide novel insights and directions for the clinical management of CMD.
ABSTRACT
ObjectiveTo explore the predictive factors for the efficacy of Yiqi Yangxue prescription combined with western medicine in treating aplastic anemia (AA) in non-elderly adults, so as to provide a reference for predicting the prognosis of this therapy. MethodA retrospective study was conducted with the clinical data of non-elderly adult AA patients who visited 19 hospitals including Xiyuan Hospital of the China Academy of Chinese Medical Sciences from September 2018 to March 2021 and were treated with Yiqi Yangxue Prescription combined with western medicine. According to the efficacy evaluation results at the 6th month of treatment, the patients were assigned into effective and ineffective groups. The two groups were compared in terms of the gender, age, disease classification [non-severe aplastic anemia (NSAA)/severe aplastic anemia (SAA)], course of disease, family history, complications, history of drug allergy, baseline blood routine examination [hemoglobin (HGB), white blood cell (WBC), neutrophil (ANC), platelet (PLT), and reticulocyte (Ret)], T lymphocyte subsets, degree of proliferation of nucleated cells in bone marrow, and expression of T-bet and GATA-3. ResultA total of 101 non-elderly adult AA patients were enrolled in this study, including 81 in the effective group and 20 in the ineffective group. The effective group had a higher proportion of the patients without a history of drug allergy than the ineffective group (P<0.05). The body height, body weight, gender, age, disease classification, course of disease, family history, and complications showed no significant differences between two groups. The effective group had higher levels of ANC and PLT before treatment (P<0.05) and higher proportion of patients with ANC≥1.6×109/L and PLT≥25×109/L (P<0.05, P<0.01) than the ineffective group. The baseline levels of WBC, HGB, and Ret showed no significant statistical differences between two groups. The levels of CD3+HLA-DR+T cells in the effective group before treatment was higher than that in the ineffective group (P<0.05). The levels of CD3+CD19-T cells, CD4+T cells, CD8+T cells, Th1 cells, Th2 cells, and CD3+CD25+T cells showed no significant statistical differences between two groups before treatment. The proportion of patients with active bone marrow nucleated cells proliferation in the effective group before treatment were significantly higher than that in the ineffective group, while the proportion of patients with reduced or extremely reduced proliferation were significantly lower than that in the ineffective group (P<0.05). The expression levels of T-bet and GATA-3 genes had no significant differences between two groups before treatment. The multivariate binary logistic regression analysis showed that the ANC level before treatment and history of drug allergy were independent influencing factors for efficacy (P<0.05, P<0.01), while other indicators were not influencing factors for efficacy. The receiver operating characteristic (ROC) curve was applied to analyze the predictive value of the ANC level before treatment in the treatment of AA in non-elderly adults with Yiqi Yangxue prescription combined with western medicine. The area under the curve was 0.679 (P<0.05), with the critical value of 1.595×109/L, the sensitivity of 0.42, and the specificity of 0.95. ConclusionThe history of drug allergy, pre-treatment ANC, PLT, CD3+HLA-DR+ T cell levels, and proliferation of nucleated cells in bone marrow before treatment are predictive factors for the efficacy of Yiqi Yangxue prescription combined with western medicine in treating AA in non-elderly adults. This therapy tends to be more effective for the patients with no history of drug allergy, higher ANC and PLT levels before treatment, especially those with ANC≥1.6×109/L, PLT≥25×109/L, and higher CD3+ HLA-DR+T cell levels and the more active proliferation of nucleated cells in bone marrow before treatment.
ABSTRACT
Objective:To investigate the application effect of the blended teaching model of "intelligent teaching" and "wisdom learning" in the practice teaching of integrated traditional Chinese and Western medicine in internal medicine.Methods:According to the principle of randomization, 54 interns in Class 1 of integrated traditional Chinese and Western medicine in the grade of 2019 were selected as control group and received traditional teaching, and 56 interns in Class 2 were selected as observation group and received blended teaching with "intelligent teaching" and "wisdom learning". After 6 months of internship, the two groups were compared in terms of the scores of theoretical assessment (basic theoretical knowledge and professional theoretical knowledge), clinical practice ability [Leicester Assessment Package (LAP)], and degree of satisfaction with teaching. SPSS 17.0 was used to perform the t-test and the chi-square test. Results:At the end of internship, compared with the control group, the observation group had significantly higher score of basic theoretical knowledge (41.53±3.42 vs. 38.71±3.38, P<0.05), score of professional theoretical knowledge (39.49±3.14 vs. 37.85±3.07, P<0.05), LAP score (84.32±6.65 vs. 78.46±6.17, P<0.05), and degree of satisfaction with teaching ( P<0.05). Conclusion:For interns majoring in integrated traditional Chinese and Western medicine, the blended teaching model of "intelligent teaching" and "wisdom learning" can strengthen their mastery of theoretical knowledge, enhance their clinical practice ability, and improve their degree of satisfaction with teaching.
ABSTRACT
The theory of Zang Xiang is the core of the theory of traditional Chinese medicine,and its content mostly comes from the comparison of images.Among them,the liver Zang of"main drainage"and"main blood storage"involves many systems such as nerve,digestion,circulation,hematopoiesis,reproduction and so on.It is difficult to find the corresponding anatomical organs or tissues in western medicine.The author analyzes and believes that the collection of the functional system of the liver system of traditional Chinese medicine,compares the physiological function and pathological changes of the liver system with the histamine receptor distributed in multiple systems of the whole body,as well as the main symptoms and adverse reactions of the drugs regulating the histamine receptor,and believes that the functional system composed of histamine receptors may carry the important functions of the liver system of traditional Chinese medicine.
ABSTRACT
Objective:To verify the clinical efficacy and safety of Qufeng Tongxuan method in treating low- and moderate-volume intracerebral hemorrhage at acute stage.Methods:A prospective, multicenter, randomized, double-blind, placebo-controlled study was performed; patients with low- and moderate-volume intracerebral hemorrhage at the basal ganglia and/or thalamus accepted treatment in 16 hospitals from September 2019 to April 2022 were enrolled. These patients were divided into experimental and control groups with a block randomized method by SAS software. Patients in control group were given conventional western medicine treatment; those in experimental group accepted Qufeng Tongxuan method (sequential therapy of Shexiang Huayu Xingnao granules and Zhilong Huoxue Tongyu granules) besides conventional western medicine treatment. NIHSS was used to assess neurological function before treatment and on 7 th, 14 th, 30 th, and 90 th d of treatment. Prognoses of these patients were assessed by modified Rankin scale (mRS) before treatment and on 180 th d of treatment. Brain CT was performed before treatment and on 7 th and 14 th d of treatment to calculate the hematoma volume. Before treatment and on 14 th d of treatment, changes of coagulation function, liver and kidney functions of the 2 groups were compared. Adverse reactions during treatment in the 2 groups were recorded. Results:No significant differences in NIHSS scores were noted between the 2 groups before treatment, on 7 th, 14 th, and 30 th d of treatment ( P>0.05); NIHSS scores in experimental group on 90 th d of treatment were signficantly lower than those in control group ( P<0.05); NIHSS scores in experimental group decreased gradually before treatment and on 7 th, 14 th, 30 th and 90 th d of treatment, with statistical significances ( P<0.05). No significant differences in mRS scores were noted between the 2 groups before treatment ( P>0.05); mRS scores in experimental group on 180 th d of treatment were signfciantly lower than those in control group ( P<0.05). No significant difference in hematoma volume was noted between the 2 groups before treatment and on 7 th and 14 th d of treatment ( P>0.05); both groups had gradually decreased hematoma volumes before treatment and on 7 th and 14 th d of treatment, respectively, with significant differences ( P<0.05); the volume difference of hematoma between 14 th d of treatment and before treatment in experimental group (6.42[4.10, 11.73]) was significantly higher than that in control group (4.00[1.25, 10.58], P<0.05). No significant differences in liver and kidney function indexes or coagulation function indexes were noted between the 2 groups before treatment and on 14 th d of treatment ( P>0.05). Adverse reaction incidence was 9.52% ( n=12) in experimental group and 10.34% ( n=12) in control group, without statistical difference ( P>0.05). Conclusion:Under premise of conventional western medicine treatment, Qufeng Tongxuan method can promote hematoma absorption and improve neurological deficit symptoms in low- and moderate-volume intracerebral hemorrhage at acute stage, without obvious adverse reactions.
ABSTRACT
ObjectiveTo systematically evaluate the efficacy and safety of integrated traditional Chinese and western medicine in the treatment of chronic liver failure(CLF). MethodSeveral databases was searched from the establishment date of these databases to January, 2023, including China National Knowledge Infrastructure(CNKI), WanFang Data Knowledge Service Platform(WanFang), China Biomedical Literature Database(CBM), VIP Chinese Science and Technology Journal Database(VIP), Cochrane Library, Embase and PubMed. The randomized controlled trial(RCT) conforming to the treatment of CLF with integrated traditional Chinese and western medicine were screened and included, the control group was treated with basic western medicine, and the test group was treated with traditional Chinese medicine on the basis of western medicine. Then, the Cochrane risk bias assessment tool was used to evaluate the quality of the included literature, and Meta analysis was performed by RevMan 5.3 software. ResultEleven literatures with a total of 1 110 patients were included, and Meta analysis showed that the integrated traditional Chinese and western medicine was better than western medicine alone in the treatment of patients with CLF in improving the overall effective rate[relative risk(RR)=1.36, 95% confidence interval(CI) (1.27, 1.46), P<0.000 01], reducing the mortality[RR=0.35, 95% CI(0.23, 0.53), P<0.000 01)], reducing alanine aminotransferase(ALT) level[mean difference(MD)=-38.73, 95% CI(-54.59, -22.87), P<0.000 01], reducing the aspartate aminotransferase(AST) level[MD=-58.16, 95% CI(-83.45, -32.79), P<0.000 01] and reducing the total bilirubin(TBil) level[MD=-69.21, 95% CI(-94.15, -30.53), P<0.000 01], promoting serum albumin(ALB) level[MD=3.24, 95% CI(0.82, 5.66), P=0.009] and prothrombin activity(PTA) level[MD=5.44, 95% CI(3.38, 7.50), P<0.000 01], and improving the traditional Chinese medicine(TCM) symptom score[MD=-4.28, 95% CI(-8.39, -0.17), P=0.04]. ConclusionThe treatment of CLF with integrated traditional Chinese and western medicine has good clinical efficacy and safety. However, due to the limitations of the quality and quantity of the included literature, the above conclusions still need to be verified by larger scale of high-quality RCT, which is worthy of further expansion of the study.
ABSTRACT
Liver transplant patients require lifelong immunotherapy, and if they are infected by SARS-Cov-2, their immune function will face double whammy. This report described the integrated approach of traditional Chinese and western medicine in the treatment of a liver transplant patient with severe COVID-19. The treatment was involved with western medicine such as antiviral, immunosuppressive, focusing on maintaining immune balance. Traditional Chinese medicine was given based on the differentiation of syndromes, targeting at the core pathogenesis and using methods such as promoting qi circulation, clearing heat and resolving dampness, draining lung and relieving panting. Following the treatment, the patient exhibited notable improvement in clinical symptoms and liver function, leading to the effective cessation of disease progression and a shortened recovery period.
ABSTRACT
Colorectal cancer is one of the common malignant tumors with high morbidity, and changes in lifestyle, dietary structure and environment in China in recent decades have been associated with an increase in the incidence of colorectal cancer. A large number of studies have shown that traditional Chinese medicine(TCM) can be used as a complementary and alternative treatment for colorectal cancer after conventional western medicine treatment. TCM physicians have accumulated a lot of clinical experience in the treatment of patients with stage Ⅰ-Ⅲ colorectal cancer, and have proved that TCM has unique efficacy, but there is still a lack of relevant clinical practice guidelines to standardize and guide the diagnosis and treatment of TCM. Based on this, according to the guideline development process of the World Health Organization Handbook for Guideline Development and the Clinical Evidence Grading Criteria on TCM Based on Evidence Body, under the framework of relevant laws, regulations and technical guidance documents, combined with the evidence of relevant domestic and foreign clinical research in recent years for evidence grading and opinion recommendation, and then the Guidelines for TCM Intervention After Conventional Western Medicine Treatment for Stage Ⅰ-Ⅲ Colorectal Cancer were developed by expert consensus. This guideline introduces the etiology, pathogenesis, syndrome differentiation and treatment of TCM intervention for colorectal cancer, which can provide guiding opinions for TCM clinicians and clinicians of integrated traditional Chinese and western medicine engaged in the prevention and treatment of colorectal cancer.
ABSTRACT
In recent years, the incidence of colorectal cancer has been rising in China, and with the promotion of early screening and early diagnosis, most colorectal cancers are able to achieve long-term survival through timely diagnosis and treatment. Nevertheless, 30%-70% of patients with early to mid-stage colorectal cancer after radical surgery still have psychological problems such as anxiety, depression, and fear of recurrence and metastasis, and they hope to seek help from traditional Chinese medicine(TCM) treatment. In order to further standardize the integrated traditional Chinese and western medicine psychological rehabilitation interventions of stage Ⅰ-Ⅲ colorectal cancer after radical surgery, and to improve the diagnosis and treatment level, under the support of the pilot project of clinical collaboration between Chinese and western medicine for major and difficult diseases of National Administration of TCM, experts in oncology, integrated Chinese and western medicine, psychology, surgery, nursing, evidence-based medicine and other disciplines from 10 units nationwide participated in the work, led by Xiyuan Hospital,China Academy of Chinese Medical Sciences and Beijing Cancer Hospital. Based on the methodology and process of guideline development of the World Health Organization Handbook for Guideline Development and the Regulations for Group Standards of China Association of Chinese Medicine, the Guidelines for Psychological Rehabilitation Intervention Combined Integrated Traditional Chinese and Western Medicine After Radical Surgery for Early and Middle Stage Colorectal Cancer have been developed according to the current best evidence, extensive consultation with clinical experts and following the situation of current clinical practice. The guideline provides the psychological characteristics, the needs and willingness to accept psychological rehabilitation, the interventions for psychological rehabilitation, evaluation of efficacy, follow-up review, educational guidance and others of patients with stage Ⅰ-Ⅲ colorectal cancer after radical surgery. It can provide guidance for TCM(integrated Chinese and western medicine) clinicians and psychologists engaged in the psychological rehabilitation of integrated Chinese and western medicine oncology, especially for doctors in primary medical institutions.
ABSTRACT
Colorectal cancer is one of the most common malignant tumors of digestive tract. In 2020, 1.93 million new cases of colorectal cancer were diagnosed globally, ranking third in the global incidence spectrum, and 930 000 new deaths were reported, ranking second in the global cause of death spectrum. Meanwhile, the medical cost of metastatic colorectal cancer is the highest among all stages. A large number of studies have demonstrated that traditional Chinese medicine(TCM) treatment can bring clinical benefits to patients with metastatic colorectal cancer with unique efficacy. In order to further standardize the TCM diagnosis and treatment for metastatic colorectal cancer and improve the level of TCM diagnosis and treatment, Xiyuan Hospital, China Academy of Chinese Medical Sciences, together with other relevant units in China, according to the guideline development process of the World Health Organization Handbook for Guideline Development and the relevant requirements of the Clinical Evidence Grading Criteria on TCM Based on Evidence Body, the Regulations for Group Standards of China Association of Chinese Medicine and others, combined with the characteristics of TCM diagnosis and treatment and the actual situation in China, the Guidelines for TCM Diagnosis and Treatment of Metastatic Colorectal Cancer was developed in accordance with the Catalogue of TCM Diagnosis and Treatment Plans for 105 Diseases in 24 Specialties issued by Department of Medical Administration of National Administration of TCM.
ABSTRACT
Hyperuricemic nephropathy (HN), a secondary renal damage common in clinical practice, is characterized by early concealing and continuous progression. The understanding of HN in traditional Chinese medicine (TCM) is from a macroscopic perspective. According to the TCM theory, HN is caused by the combination of external pathogens and internal injuries, with the main pathogenesis being root deficiency combined with superficial excess and deficiency-excess in complexity. In western medicine, the understanding of HN is from the microscopic perspective, which holds that the occurrence of HN is the result of inflammation, oxidative stress, renin-angiotensin-aldosterone system (RAAS) activation, and metabolic abnormalities. The TCM syndromes of HN include internal dampness and heat, obstruction in dampness and turbidity, deficiency of spleen and kidney, and deficiency of kidney yin. Accordingly, the prescriptions should clear heat and dampness, remove dampness and turbidity, tonify spleen and kidney, and nourish kidney yin, respectively. In addition to TCM prescriptions, single herbal medicines and their extracts, Chinese patent medicines, and external applications of Chinese medicines have played a significant role in the treatment of HN, promoting the application of TCM in the treatment of HN. Moreover, the integrated traditional Chinese and western medicine has also played a role in the treatment of HN, enriching the treatment schemes of HN. Different from common kidney diseases such as acute and chronic glomerulonephritis and nephrotic syndrome, HN with particularity should be carefully differentiated in clinical practice. This article systematically summarizes the research progress in the treatment of traditional Chinese medicine and integrated traditional Chinese and western medicine on hyperuricemic nephropathy with TCM and integrated traditional Chinese and western medicine, aiming to enrich the system and theory of HN treatment and further guide the clinical practice.
ABSTRACT
Traditional Chinese medicine (TCM) has played an important role in the prevention and treatment of Coronavirus disease 2019 (COVID-19) epidemic in China. The integration of Chinese and Western medicine is an important feature of Chinese COVID-19 prevention and treatment. According to a series of evidence-based studies, TCM can reduce the infection rate of severe acute respiratory syndrome coronavirus 2 in high-risk groups. For patients with mild and moderate forms of COVID-19, TCM can relieve the related signs and symptoms, shorten the period of nucleic-acid negative conversion, and reduce conversion rate to the severe form of the disease. For COVID-19 patients with severe and critical illnesses, TCM can improve inflammatory indicators and blood oxygen saturation, shorten the hospital stay, and reduce the mortality rate. During recovery, TCM can improve patients' symptoms, promote organ function recovery, boost the quality of patients' life, and reduce the nucleic-acid repositive conversion rate. A series of mechanism research studies revealed that capability of TCM to treat COVID-19 through antiviral and anti-inflammatory effects, immune regulation, and protection of organ function via a multicomponent, multitarget, and multipathway approach.
Subject(s)
Humans , COVID-19 , Medicine, Chinese Traditional , Drugs, Chinese Herbal/therapeutic use , SARS-CoV-2 , EpidemicsABSTRACT
Reperfusion injury occurs after return of spontaneous circulation (ROSC) in patients with cardiac arrest (CA), which leads to multiple organ dysfunction, called post-cardiac arrest syndrome (PCAS). PCAS is closely related to the prognosis of CA patients, and is an independent risk factor of survival. Integrated traditional Chinese and Western medicine diagnosis and treatment is critical for improving prognosis of PCAS. In order to guide and standardize integrated traditional Chinese and Western medicine diagnosis and treatment in PCAS among clinicians, nurses and research personnel in China, the Emergency Medicine Professional Committee of the Chinese Society of Integrated Chinese and Western Medicine has established an expert group to determine 14 clinical issues related to the diagnosis and treatment of PCAS with integrated traditional Chinese and Western medicine through clinical survey. The working group formulates a search strategy for each clinical issue according to the PICO principle. Chinese and English literature were searched from CNKI, Wanfang, VIP, SinoMed, PubMed, Embase, and Cochrane Library. The grade of recommendations assessment, development and evaluation (GRADE) were used to form the level of evidence and recommendation. When the literature evidence was insufficient, the recommendations and level of recommendation were formed after expert discussion. Combined with the aspects of generalizability, suitability, and resource utilization, the expert consensus developed 28 recommendations around the 14 aspects of three stages of PCAS, including early circulation, respiratory support and reversible cause relief, mid-term neuroprotection, improvement of coagulation, prevention and treatment of infection, kidney and gastrointestinal protection and blood sugar control, post rehabilitation treatment, providing references for the integrated traditional Chinese and Western medicine of the diagnosis and treatment for PCAS.
ABSTRACT
SUMMARY OBJECTIVE: This study aimed at the oral health problems of elderly patients with diabetes. A training course of integrated traditional Chinese and Western medicine was constructed, helping patients improve their oral health quality of life. METHODS: A randomized controlled prospective experimental study was conducted. A total of 190 elderly patients were divided randomly into an observation group and a control group with 95 cases in each. The control group received regular health education, while the observation group was based on the control group to implement the integrated experiential learning of traditional Chinese and Western medicine in small groups. The oral health knowledge, attitude, behavior, and blood glucose control status along with the oral health quality of life of the two groups were compared before the intervention and at 3-month postintervention. RESULTS: Three months after the intervention, the fasting blood glucose control and the 2-h postprandial blood glucose/glycosylated hemoglobin levels in the observation group were significantly better than in the control group, and the difference was statistically significant (p<0.05). The oral health quality of life in the observation group was significantly better than in the control group, and the difference was statistically significant (p<0.05). CONCLUSION: The small-group experiential learning model of integrated Chinese and Western medicine can promote the transformation of knowledge-beliefs-behaviors in elderly patients with diabetes, which is conducive to controlling blood sugar levels and improving the quality of oral health.