Traditional Chinese medicine: potential approaches from modern dynamical complexity theories.

Despite the widespread use of traditional Chinese medicine (TCM) in clinical settings, proving its effectiveness via scientific trials is still a challenge. TCM views the human body as a complex dynamical system, and focuses on the balance of the human body, both internally and with its external environment. Such fundamental concepts require investigations using system-level quantification approaches, which are beyond conventional reductionism. Only methods that quantify dynamical complexity can bring new insights into the evaluation of TCM. In a previous article, we briefly introduced the potential value of Multiscale Entropy (MSE) analysis in TCM. This article aims to explain the existing challenges in TCM quantification, to introduce the consistency of dynamical complexity theories and TCM theories, and to inspire future system-level research on health and disease.

Publication analysis on insomnia: how much has been done in the past two decades?

Insomnia has been a rising public concern in recent years. As one example of a multidisciplinary topic, the theme of insomnia research has gradually shifted over time; however, there is very little quantitative characterization of the research trends in insomnia. The current study aims to quantitatively analyze trends in insomnia publications for the past 20 years. We retrospectively analyzed insomnia-related publications retrieved from PubMed and Google Scholar between 1994 and from a number of different perspectives. We investigated the major areas of research focus for insomnia, journal characteristics, as well as trends in clinical management and treatment modalities. The resulting 5841 publications presented an exponential growth trend over the past two decades, with mean annual growth rates at nearly 10% for each publication type. Analysis of major research focuses indicated that depression, hypnotics and sedatives, questionnaires, and polysomnography are the most common topics at present. Furthermore, we found that while studies on drug therapy and adverse effects decreased in the most recent five years, the greatest expansion of insomnia publications were in the areas of cognitive behavioral therapy for insomnia (CBT-I) and alternative therapies. Collectively, insomnia publications present a continuous trend of increase. While sedative and hypnotic drugs dominated the treatment of insomnia, non-pharmacological therapies may have great potential for advancement in future years. Future research effort is warranted for novel tools and clinical trials, especially on insomnia treatments with inadequate evidence or not-yet-clear efficacy and side effects.

Applications of dynamical complexity theory in traditional Chinese medicine.

Traditional Chinese medicine (TCM) has been gradually accepted by the world. Despite its widespread use in clinical settings, a major challenge in TCM is to study it scientifically. This difficulty arises from the fact that TCM views human body as a complex dynamical system, and focuses on the balance of the human body, both internally and with its external environment. As a result, conventional tools that are based on reductionist approach are not adequate. Methods that can quantify the dynamics of complex integrative systems may bring new insights and utilities about the clinical practice and evaluation of efficacy of TCM. The dynamical complexity theory recently proposed and its computational algorithm, Multiscale Entropy (MSE) analysis, are consistent with TCM concepts. This new system level analysis has been successfully applied to many health and disease related topics in medicine. We believe that there could be many promising applications of this dynamical complexity concept in TCM. In this article, we propose some promising applications and research areas that TCM practitioners and researchers can pursue.

Efficacy and safety of Wuling capsule, a single herbal formula, in Chinese subjects with insomnia: a multicenter, randomized, double-blind, placebo-controlled trial.

ETHNOPHARMACOLOGICAL RELEVANCE: Wuling Capsule is a single herbal formula from mycelia of precious Xylaria nigripes (Kl.) Sacc and its pharmacological function have a tranquilizing effect on the central nervous system. The aim of the study to evaluate the efficacy and safety of Wuling capsule in treatment of insomnia. MATERIALS AND METHODS: We performed a multicenter, randomized, double-blind, placebo-controlled study. The participants received either placebo (n=92) or Wuling capsule (n=94) for 4 weeks and a follow-up period for 2 weeks. RESULTS: Compared between pre-treatment and post-treatment, the global Pittsburgh sleep quality index (PSQI) scores in both Wuling capsule group and placebo group improved significantly (P<0.01). However, there was no significant difference between Wuling capsule group and placebo group (P>0.05). Scores of clinical global impressions scale (CGI-I) at each week in Wuling capsule group was similar to those in placebo group (P>0.05). Compared between pre-treatment and post-treatment, scores of the four components of world health organization on quality of life brief scale (WHOQOL-BREF) in both Wuling capsule group and placebo group improved significantly (P<0.01). However, there were no difference between the two groups (P>0.05). The rate of adverse events was 10.10% in Wuling group, and 6.73% in placebo group (P>0.05). CONCLUSIONS: Wuling capsule can improve insomnia when compared with pre-treatment for 4 weeks and be a well tolerated by all the patients at the 6 weeks of study period. However, there are no significant in the results of the variables tested when compared with placebo control. Further additional rigorous randomized clinical trials are still required.

[Contrast study of acupuncture anesthesia and local anesthesia: their effects on the blood pressure and the heart rate in chronic rhinitis patients accompanied inferior turbinate hypertrophy in low temperature radiofrequency ablation].

OBJECTIVE: To compare the effects of acupuncture anesthesia (AA) and local anesthesia (LA) on the blood pressure (BP) and the heart rate (HR) in chronic rhinitis patients accompanied inferior turbinate hypertrophy in low temperature radiofrequency ablation (RFA). METHODS: Totally 61 chronic rhinitis patients accompanied inferior turbinate hypertrophy were randomly assigned to the AA group (31 cases) and the control group (30 cases). All patients received RFA respectively under AA and RA. Their heart rate (HR), systolic pressure (SP), diastolic pressure (DP), and mean pressure (MP) were recorded and compared at 10 minutes after their entry into the operating room, immediately before surgery, intraoperation, and 5 min after operation. RESULTS: When compared with the control group at the same time points, the SP, DP, MP, and HR all decreased at intraoperation and 5 min after operation in the AA group. There was statistical difference in the SP on the right side at the 2nd melting point and the HR on the left side at the 2nd melting point between the two groups (P < 0.05). Compared with the same group at 10 min after entry into the operating room, the SP on the right side at the 1st melting point, the SP, DP, and MP on the right side at the 2nd melting point, the SP, DP, and MP on the left side at the 1st melting point, and the SP on the left side at the 2nd melting point all obviously increased with statistical difference (P < 0.05, P < 0.01). When compared with the same group at 10 min after entry into the operating room and immediately before surgery, there was no statistical difference in the SP, DP, MP, or HR of the AA group at intraoperation and 5 min after operation (P > 0.05). When compared with the same group at 10 min after entry into the operating room and immediately before surgery, there was no statistical difference in HR of the control group at intraoperation and 5 min after operation (P > 0.05). CONCLUSION: Patients undergoing AA had less fluctuation of the BP and the HR, indicating AA had better analgesic effects.

[Clinical study on intervention of spleen-restoring decoction integrating with dormancy hygiene education on subhealthy insomnia of deficiency of both heart and spleen pattern].

OBJECTIVE: To appraise the clinical efficacy, safety and compliance of the intervention of spleen-restoring decoction combined with dormancy hygiene education and the intervention of spleen-restoring decoction alone on sub-healthy insomnia of deficiency of both the heart and spleen pattern. METHOD: Study design took multi-centers, blind and randomized control trial, 107 participants with sub-healthy insomnia of deficiency of both the heart and spleen pattern were assigned to A group (52 cases) which was treated with the intervention of spleen-restoring decoction combined with dormancy hygiene education and B group (55 cases) which was treated with the intervention of spleen-restoring decoction single, compared by efficacy, PSQI score, CGI score, WHOQOL-BREF score and security. RESULT: The efficacy of two group was 79.58%. There was no significant different between them. The PSQI scores before treatment was (11.80 +/- 2.08) and which afer treatment was (6.78 +/- 2.84) of A group. The PSQI scores before treatment was (11.61 +/- 2.00) and which afer treatment was (6.73 +/- 2.27) of B group. There was significant difference in PSQI scores both A group and B group after treatment (P < 0.01); the results of CGI score and WHOQOL-BREF score before and after measurement showed the same as PSQI. There were no significant difference between two groups in all scores after treatment and there was no interaction between time pots and treatment factors . Withdrawal reaction analysis: comparing CGI after withdraw 2 weeks and at the end of treatment course, there was no significant difference between two groups. The same result was in comparison among groups. CONCLUSION: Both the intervention of spleen-restoring decoction integrating with dormancy hygiene education and spleen-restoring decoction had obvious clinical efficacy on treating subhealthy insomnia of deficiency of both the heart and spleen pattern, and had high compliance and safety. The intervention of spleen-restoring decoction integrating with dormancy hygiene education showed no better clinical efficacy than spleen-restoring decoction did.

[Randomized controlled study on electroacupuncture compound anesthesia in radiofrequency ablation for hypertrophic inferior turbinate].

OBJECTIVE: To explore the feasibility of electroacupuncture compound anesthesia in radiofrequency ablation for hypertrophic inferior turbinate. METHODS: The patients confirmed to the enrolled criteria were randomly divided into an observation group (n = 31) and a control group (n = 30). The observation group was treated with electroacupuncture at Sibai (ST 2), Xiaguan (ST 7), Hegu (LI 4) and Zhigou (TE 6) on the left side and routine local anesthesia on the right side. The control group was treated with routine local anesthesia on the both side. The feelings of pain, circulatory index and operation effect were observed and compared. RESULTS: During radiofrequency ablation, the pain grade of two measurements on the left side and the 2nd measurement on the right in the observation group were all lower than those in the control group (all P<0.05). In the observation group, the pain grades on the left side were lower than that on the right side (P<0.05), and the systolic blood pressure and the heart rate were lower than that in the control group when undergoing the 2nd radiofrequency ablation on the right side and on the left side, respectively (both P<0.05). There was no significant difference in operation effect between the two groups. CONCLUSION: Electroacupuncture compound anesthesia can meet the analgesia requirement of radiofrequency ablation for treatment of hypertrophic inferior turbinate, and would be helpful to prevent cyclic fluctuation during the operation at the same time.