Pharmacological and economical aspects of important species of Cordyceps sensu lato: A review.

Cordyceps is a well-known endo-parasitic fungus commonly used in traditional Chinese medicine for a long time. The demand for Cordyceps is increasing daily because it is commonly used as a nutritional food, medicine, and supplement owing to its natural source. It is very attractive in almost all countries with no side effects. Most Cordyceps species have been studied in China, Bhutan, India, Japan, South Korea, and Nepal. We have discussed the important contents of Cordyceps, dietary source and nutritional value of Cordyceps, multiple pharmacological properties of four important Cordyceps species, Ophiocordyceps sinensis, Cordyceps militaris, Cordyceps cicadae, and Cordyceps tenuipes, along with the economic status of Cordyceps and its benefits in terms of medicine, supplements, and the cosmetics industry. Owing to the high demand and several benefits of Cordyceps, it offers mysterious economic improvements in developed and underdeveloped countries. Therefore, more attention is required to save the endangered species of Cordyceps to fulfil the medicinal and nutritional demands worldwide.

Analysis of factors influencing hospitalization cost of patients with distal radius fractures: an empirical study based on public traditional Chinese medicine hospitals in two cities, China.

BACKGROUND: Distal radius fractures (DRFs) have become a public health problem for all countries, bringing a heavier economic burden of disease globally, with China's disease economic burden being even more acute due to the trend of an aging population. This study aimed to explore the influencing factors of hospitalization cost of patients with DRFs in traditional Chinese medicine (TCMa) hospitals to provide a scientific basis for controlling hospitalization cost. METHODS: With 1306 cases of DRFs patients hospitalized in 15 public TCMa hospitals in two cities of Gansu Province in China from January 2017 to 2022 as the study object, the influencing factors of hospitalization cost were studied in depth gradually through univariate analysis, multiple linear regression, and path model. RESULTS: Hospitalization cost of patients with DRFs is mainly affected by the length of stay, surgery and operation, hospital levels, payment methods of medical insurance, use of TCMa preparations, complications and comorbidities, and clinical pathways. The length of stay is the most critical factor influencing the hospitalization cost, and the longer the length of stay, the higher the hospitalization cost. CONCLUSIONS: TCMa hospitals should actively take advantage of TCMb diagnostic modalities and therapeutic methods to ensure the efficacy of treatment and effectively reduce the length of stay at the same time, to lower hospitalization cost. It is also necessary to further deepen the reform of the medical insurance payment methods and strengthen the construction of the hierarchical diagnosis and treatment system, to make the patients receive reasonable reimbursement for medical expenses, thus effectively alleviating the economic burden of the disease in the patients with DRFs.

Effects of traditional Chinese medicine on outcomes and costs of dementia care: results from a retrospective real-world study.

OBJECTIVES: This study aims to assess the impact of Traditional Chinese Medicine (TCM) on dementia patients, utilizing real-world data. Specifically, it seeks to evaluate how TCM influences clinical outcomes by examining changes in the Clinical Dementia Rating (CDR) and Mini-Mental State Examination (MMSE) scores, as well as its effect on medical expenses over a two-year period. Data from a multi-center research database spanning from 2004 to 2021 will be used to achieve these objectives, addressing the current gap in empirical data concerning intuitive outcomes and cognitive function assessments. METHODS: Propensity score matching was adopted to improve comparability among the intervention and control groups. Due to repeated dependent variable measurements, the generalized estimating equation was used to control for socio-demographic characteristics, regional characteristics, and Western medicine treatments for dementia. RESULTS: After propensity score matching, a total of 441 research subjects were included: 90 in the TCM intervention group and 351 in the non-TCM intervention group. The results of multivariate regression analysis showed that compared with the non-TCM intervention group, the MMSE scores in the TCM intervention group increased by 0.608 points each year. The annual change in CDR scores in the TCM intervention group was 0.702 times that of the non-TCM utilization group. After TCM intervention, annual outpatient expenses increased by US$492.2, hospitalization expenses increased by US$324.3, and total medical expenses increased by US$815.9, compared with the non-intervention group. CONCLUSIONS: TCM interventions significantly decelerate cognitive decline in dementia patients, evidenced by slower reductions in MMSE scores and mitigated increases in CDR scores. However, these benefits are accompanied by increased medical expenses, particularly for outpatient care. Future healthcare strategies should balance the cognitive benefits of TCM with its economic impact, advocating for its inclusion in dementia care protocols.

Different impacts of the zero-markup drug policy on county general and traditional Chinese medicine hospitals: evidence from Shandong province, China.

BACKGROUND: As a key part of the new round of health reform, the zero-markup drug policy (ZMDP) removed the profit margins of drug sales at public health care facilities, and had some effects to the operation of these institutions. This study aims to assess whether the ZMDP has different impacts between county general and traditional Chinese medicine (TCM) hospitals. METHODS: We obtained longitudinal data from all county general and TCM hospitals of Shandong province in 2007-2017. We used difference-in-difference (DID) method to identify the overall and dynamic effects of the ZMDP. RESULTS: On average, after the implementation of the ZMDP, the share of revenue from medicine sales reduced by 16.47 and 10.42%, the revenue from medicine sales reduced by 24.04 and 11.58%, in county general and TCM hospitals, respectively. The gross revenue reduced by 5.07% in county general hospitals. The number of annual outpatient visits reduced by 11.22% in county TCM hospitals. Government subsidies increased by 199.22 and 89.3% in county general and TCM hospitals, respectively. The ZMDP reform was not significantly associated with the revenue and expenditure surplus, the number of annual outpatient visits and the number of annual inpatient visits in county general hospitals, the gross revenue, the revenue and expenditure surplus and the number of annual inpatient visits in county TCM hospitals. In terms of dynamic effects, the share of revenue from medicine sales, revenue from medicine sales, and gross revenue decreased by 20.20, 32.58 and 6.08% respectively, and up to 28.53, 63.89 and 17.94% after adoption, while government subsidies increased by around 170 to 200% in county general hospitals. The number of annual outpatient visits decreased by 9.70% and up to 18.84% in county TCM hospitals. CONCLUSION: The ZMDP achieved its some initial goals of removing the profits from western medicines in county hospitals' revenue without disrupting the normal operation, and had different impacts between county general and TCM hospitals. Meanwhile, some unintended consequences were also recognized through the analysis, such as the decline of the utilization of the TCM.

[Analysis of projects funded by NSFC in field of pharmacology of traditional Chinese medicine in 2019].

The projects which supported by National Natural Science Foundation of China(NSFC) including General Program, Young Scientist Fund, and Fund for Less Developed Regions, in field of pharmacology of traditional Chinese medicine in 2019 were reviewed. Based on these research items, the main contents and characteristics, as well as the main problems from academic and non-academic point of view, were summarized for reference.

[Research on competitiveness of traditional Chinese medicine industry's international trade based on diamond theory].

China has a long history of the international trade of traditional Chinese medicine(TCM).And the export products mainly composed of Chinese herbal medicine and its extracts with Chinese patent herbal medicine and health care products as complementary items.The international trade of TCM faces problems of structural disequilibrium in export products and trade barriers.In this study,we used Michael Porter's diamond model to analyze the international competitiveness of TCM industry.We found that TCM industry in China was rich in production factors and broad in market demands,but lack of the related and supporting industries.In addition,compared with the herbal medicine manufacturers in European,American and Japanese,enterprises in China were weaker in the strategy making,market positioning and industry competing.The development of the international market of herbal medicine,the arrival of the aging society,and the introduced policies of the TCM,provide great opportunities for TCM industry' s development.In order to improve the competitiveness of the TCM industry,we propose to increase the international recognition of TCM by developing clinical study,cope with international trade barrier by strengthen international standardization research,and improve the competitiveness of TCM industry by economies of scale formed by the accumulation of the pharmaceutical industry.

Efficacy, Safety, and Cost of Therapy of the Traditional Chinese Medicine, Catalpol, in Patients Following Surgical Resection for Locally Advanced Colon Cancer.

BACKGROUND The aim of this study was to evaluate the efficacy, safety, and cost of treatment of the traditional Chinese herbal medicine, catalpol, in patients following surgical resection for locally advanced colon cancer. MATERIAL AND METHODS The 345 patients who had undergone surgical resection for locally advanced colon adenocarcinoma, were divided into three groups: a placebo-treated group (n=115); patients treated with an intraperitoneal injection of 10 mg/kg catalpol twice a day for 12 weeks (treatment group) (n=115); patients treated with 5 mg/kg intravenous bevacizumab twice a week for 12 weeks (control group) (n=115). Serum levels of carbohydrate antigen 19-9 (CA 19-9), carcinoembryonic antigen (CEA), matrix metalloproteinases-2 (MMP-2), and matrix metalloproteinases-9 (MMP-9) were measured. Patient overall survival (OS), cancer-free survival (CFS), adverse effects, and cost of therapy were evaluated. Statistical analysis included the Wilcoxon rank sum test and Tukey's test for clinicopathological response at 95% confidence interval (CI). RESULTS Patients in the catalpol-treated group had significantly reduced serum levels of CA 19-9 (p=0.0002, q=3.202), CEA (p=0.0002, q=3.007), MMP-2 (p£0.0001, q=6.883), and MMP-9 (p<0.0001, q=3.347). Only non-fatal adverse effects occurred in the catalpol treatment group (p<0.0001, q=5.375). OS and CFS were significantly increased in the catalpol treatment group compared with the placebo group (p<0.0001 q=7.586). The cost of catalpol treatment compared favorably with other treatments (p<0.0001, q=207.17). CONCLUSIONS In this preliminary study, treatment with the Chinese herbal medicine, catalpol, showed benefits in clinical outcome, at low cost, and with no serious complications.

The prevalence, characteristics, and factors associated with purchasing Chinese herbal medicine among adults in Taiwan.

BACKGROUND: The objective of this study was to investigate the prevalence and factors associated with purchasing Chinese herbal medicine (CHM) without a physician's prescription among adults. METHODS: Using data from the 2005 National Health Interview Survey and National Health Insurance, we identified 16,756 individuals aged 20 years and older. Socio-demographic factors, lifestyle, medical services utilization and health behaviors were compared between people with and without a history of purchasing CHM by calculating adjusted odds ratios (ORs) and 95% confidence intervals (CIs) in a multiple logistic regression analysis. RESULTS: The one-month prevalence of purchasing CHM without a physician' prescription was 5.2% in Taiwan. People more likely to purchase CHM included people aged ≥70 years (OR 2.84, 95% CI 2.03-3.99), women (OR 1.28, 95% CI 1.11-1.48), non-indigenous people (OR 2.61, 95% CI 1.29-5.30), and people with an illness not receiving medical care (OR 2.69, 95% CI 2.19-3.31). CONCLUSION: The prevalence of purchasing CHM without a physician's prescription is high in Taiwan and is correlated with factors such as socio-demographics, disease history, and behaviors surrounding the utilization of medical care.

[Study on status of criteria for formulating specification and grade of Chinese medicinal materials based on filed survey in medicine market].

The commodity specification and grade is an important factor affecting the price of Chinese medicinal materials. Specification and grade standard play an important role in transferring quality information in Chinese medicinal market, which is characterized by highly information asymmetry. This paper analyses and expounds six classification methods of commodity specification and grade of Chinese medicinal materials based on the market investigation carried out in the medicine markets in Anguo, Bozhou, Yulin, Chengdu and so on. This study proposes that to formulate the commodity specification and grade standard of Chinese medicinal materials, their efficacy, inspection, purity and beauty should be taken into account orderly.

[Common household traditional Chinese medicines].

With the enhancement in the awareness of self-diagnosis among residents, it's very common for each family to prepare common medicines for unexpected needs. Meanwhile, with the popularization of the traditional Chinese medicine knowledge, the proportion of common traditional Chinese medicines prepared at residents' families is increasingly higher than western medicines year by year. To make it clear, both pre-research and closed questionnaire research were adopted for residents in Chaoyang District, Beijing, excluding residents with a medical background. Based on the results of data, a analysis was made to define the role and influence on the quality of life of residents and give suggestions for relevant departments to improve the traditional Chinese medicine popularization and promote the traditional Chinese medicine market.

[Research model on commodity specification standard of radix Chinese materia medica].

As an important part of the market commodity circulation, the standard grade of Chinese traditional medicine commodity is very important to restrict the market order and guarantee the quality of the medicinal material. The State Council issuing the "protection and development of Chinese herbal medicine (2015-2020)" also make clear that the important task of improving the circulation of Chinese herbal medicine industry norms and the commodity specification standard of common traditional Chinese medicinal materials. However, as a large class of Chinese herbal medicines, the standard grade of the radix is more confused in the market circulation, and lack of a more reasonable study model in the development of the standard. Thus, this paper summarizes the research background, present situation and problems, and several key points of the commodity specification and grade standard in radix herbs. Then, the research model is introduced as an example of Pseudostellariae Radix, so as to provide technical support and reference for formulating commodity specifications and grades standard in other radix traditional Chinese medicinal materials.

[Qualitative characteristics and classification study on commodity specification and grade standard of Panax notoginseng].

Through the markets investigations and literature surveying, this paper investigates and analyzes the qualitative characteristics and commodity condition of Panax notoginseng. And the samples collected from market and origin were analyzed in order to revise the commodity specification and grade standard of P. notoginseng combined with production practice. In this paper, the authors divide the P. notoginseng into 4 commodity specification which are root (including Cunqi and Dongqi ), Rhizome and rootlet according to different parts and harvest time. And the root were divided into 8 grade which are 20, 30, 40, 60, 80, 120, countless and substandard. The density and internal components between the different commodity specification and grade of P. notoginseng were also compared. As well as the effect of different producing area, cultivation years and harvesting time on the commodity specification and grade of P. notoginseng were researched. On this basis, we revise and improve the commodity specification and grade standard of P. notoginseng. Moreover, we suggest the quality control indexes of P. notoginseng should be developed according to the different medicinal part and commodity specification in CHP. In order to guide the standardized production of traditional Chinese medicine and ensure the quality of medicinal materials, the cultivation years and density of each medicinal materials should also be indicated in CHP.

[Correspondence analysis between traditional commercial specifications and quantitative quality indices of Notopterygii Rhizoma et Radix].

This paper aims to explore a comprehensive assessment method combined traditional Chinese medicinal material specifications with quantitative quality indicators. Seventy-six samples of Notopterygii Rhizoma et Radix were collected on market and at producing areas. Traditional commercial specifications were described and assigned, and 10 chemical components and volatile oils were determined for each sample. Cluster analysis, Fisher discriminant analysis and correspondence analysis were used to establish the relationship between the traditional qualitative commercial specifications and quantitative chemical indices for comprehensive evaluating quality of medicinal materials, and quantitative classification of commercial grade and quality grade. A herb quality index (HQI) including traditional commercial specifications and chemical components for quantitative grade classification were established, and corresponding discriminant function were figured out for precise determination of quality grade and sub-grade of Notopterygii Rhizoma et Radix. The result showed that notopterol, isoimperatorin and volatile oil were the major components for determination of chemical quality, and their dividing values were specified for every grade and sub-grade of the commercial materials of Notopterygii Rhizoma et Radix. According to the result, essential relationship between traditional medicinal indicators, qualitative commercial specifications, and quantitative chemical composition indicators can be examined by K-mean cluster, Fisher discriminant analysis and correspondence analysis, which provide a new method for comprehensive quantitative evaluation of traditional Chinese medicine quality integrated traditional commodity specifications and quantitative modern chemical index.

[Formation and evolution of commodity specification and grade of traditional Chinese medicine].

As an important reference index to evaluate the quality of Chinese medicinal materials, the commodity specification and grade of traditional Chinese medicine has an effect on the medicinal material's price, can promote "high quality and high price" of the traditional Chinese medicine, prompt market transactions more convenient and standard, and has a great significance to the development of the whole traditional Chinese medicine industry. The formation of traditional Chinese medicine specifications and grades experienced a long historical development process. In order to provide the reference for modification of the product specifications and grades standards and management of traditional Chinese medicine products, the author consulted a large number of materia medica books and related references, sorted and analyzed the historical development process. The author divided the formation and development process into four stages, including germination stage before the Southern and Northern Dynasties, development stage of Tang and Song Dynasty, mature period of the Ming and Qing Dynasties and the inheritance development stage since the foundation of the People's Republic. The author believes that the clinical curative effect is the driving force to promote the development of commodity specifications and grades. In addition, the national pharmaceutical policy, international status, the level of science and technology also influence the development of commodity specifications and grades in some extents. Finally, the author provides three piece of suggestions for the modification of the product specifications and grades standards, according to the historical development rule.

Use of Chinese medicine correlates negatively with the consumption of conventional medicine and medical cost in patients with uterine fibroids: a population-based retrospective cohort study in Taiwan.

BACKGROUND: Chinese medicine is commonly used and covered by health insurance to treat symptoms of uterine fibroids in Taiwan. This retrospective cohort study compared the consumption of conventional western medicine and medical cost between Chinese medicine (CM) users and nonusers among patients with uterine fibroids. METHODS: We extracted 44,122 patients diagnosed with uterine fibrosis between 1996 and 2010 from the National Health Insurance reimbursement database, which is a population-based database released by a government-run health insurance system. Multivariate linear regression models were used to find association between using Chinese medicine and the consumption of conventional medicine, and between using Chinese medicine and medical cost. RESULTS: The total fibroid-related conventional western medicine consumed by CM users was less than that by nonusers (ß = -10.49, P < 0.0001). Three categories of conventional medicines, including antianemics (-3.50 days/year/patient, P < 0.0001), hemostatics (- 1.89 days/year/patient, P < 0.0001), and hormone-related agents (-3.13 days/year/patient, P < 0.0001), were used less in patients who were CM users. Moreover, although using CM increased 16.9 USD per patient in CM users annually (P < 0.0001), the total annual medical cost for treating fibroid was 5610 USD less in CM users than in nonusers (P < 0.0001). CONCLUSIONS: Our results suggested that CM reduced the consumption of conventional medicine, and might be a potential therapeutic substitute for conventional western medicines to treat uterine fibroids with low cost.

[Brief introduction of research methods of commodity specification and grade of Chinese medicinal materials].

The commodity specification and grade of Chinese medicinal materials is a measure of the quality of traditional Chinese medicines (TCMs), which directly impacts on the safety and effectiveness of clinical medicines. It is an urgent problem to establish a set of standards which can both interpret the scientific connotation of the commodity specification and grade of Chinese medicinal materials and play a significant role on clinical medicines as well as markets. This paper reviews the research methods of the commodity specification and grade of Chinese medicinal materials such as sensory evaluation, chemical assessment, biological evaluation, and cited the applications of various methods for the classification of TCMs. It provides technical support for establishing standards of the commodity specification and grade of Chinese medicinal materials, and also constructs scientific basis for clinical rational drug use.

[Systematic economic assessment and quality evaluation for traditional Chinese medicines].

To learn about the economic studies on traditional Chinese medicines in domestic literatures, in order to analyze the current economic assessment of traditional Chinese medicines and explore the existing problems. Efforts were made to search CNKI, VIP, Wanfang database and CBM by computer and include all literatures about economic assessment of traditional Chinese medicines published on professional domestic journals in the systematic assessment and quality evaluation. Finally, 50 articles were included in the study, and the systematic assessment and quality evaluation were made for them in terms of titles, year, authors' identity, expense source, disease type, study perspective, study design type, study target, study target source, time limit, cost calculation, effect indicator, analytical technique and sensitivity analysis. The finally quality score was 0.74, which is very low. The results of the study showed insufficient studies on economics of traditional Chinese medicines, short study duration and simple evaluation methods, which will be solved through unremitting efforts in the future.