基于循证的中药药性判别数据挖掘方法评价

目的:通过循证方法分析评价数据挖掘方法在中药性效中的应用效果。方法:通过检索万方、知网、维普数据库中的相关文献,按研究需求对文献进行筛选,并使用STATA 15.0对提取的资料进行分析。结果:共搜集文献2 064篇,最终纳入有效文献3篇,含6种数据挖掘方法,共进行8组比较。其中"支持向量机"和"回归判别分析"预测效果比较,总预测准确率为(OR=1.74,95%CI [1.13,2.68]);其中两组比较存在异质性;剩余5组无统计学意义。结论:"支持向量机"在中药药性判别中的预测效果优于"回归判别分析";其他比较组的方法的比较结果均无明显优势,需更多高质量的研究证实。

Treatment of abdominal compartment syndrome in severe acute pancreatitis patients with traditional Chinese medicine

AIM: To investigate the therapeutic effect of traditional Chinese traditional medicines Da Cheng Qi Decoction (Timely-Purging and Yin-Preserving Decoction) and Glauber's salt combined with conservative measures on abdominal compartment syndrome (ACS) in severe acute pancreatitis (SAP) patients. METHODS: Eighty consecutive SAP patients, admitted for routine non-operative conservative treatment, were randomly divided into study group and control group (40 patients in each group). Patients in the study group received Da Cheng Qi Decoction enema for 2 h and external use of Glauber's salt, once a day for 7 d. Patients in the control group received normal saline (NS) enema. Routine non-operative conservative treatments included non-per os nutrition (NPON), gastrointestinal decompression, life support, total parenteral nutrition (TPN), continuous peripancreatic vascular pharmaceutical infusion and drug therapy. Intra-cystic pressure (ICP) of the two groups was measured during treatment. The effectiveness and outcomes of treatment were observed and APACHE Ⅱ scores were applied in analysis. RESULTS: On days 4 and 5 of treatment, the ICP was lower in the study group than in the control group(P < 0.05). On days 3-5 of treatment, acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) scores for the study and control groups were significantly different (P < 0.05). Both the effectiveness and outcome of the treatment with Da Cheng Qi Decoction on abdominalgia, burbulence relief time, ascites quantity, cyst formation rate and hospitalization time were quite different between the two groups (P < 0.05). The mortality rate for the two groups had no significant difference. CONCLUSION: Da Cheng Qi Decoction enema and external use of Glauber's salt combined with routine non-operative conservative treatment can decrease the intra-abdominal pressure (IAP) of SAP patients and have preventive and therapeutic effects on abdominal compartment syndrome of SAP.

Chinese herbal medicine for treatment of dislipidemia

Prevalence of dislipidemia is increasing rapidly in China and there has been a growing interest in Chinese herbal medicine for the treatment of hyperlipidemia both inside and outside China. In this article, lipids regulating effects of 9 herbs or their extracts and 5 herbal formulae which have been published in English-language literature are reviewed. Although evidence from animals and humans consistently supports the therapeutic activities of these Chinese herbal medicines, few multi-center large-scale clinical trials have been conducted to confirm the efficacy and evaluate their safety.

Systematic review of Chinese herbal medicine for functional constipation

Constipation is a common gastrointestinal complaint in clinical practice, affecting an estimated 27% of the population. Many patients are disappointed by current conventional treatments and, therefore, seek help from complementary and alternative medicine （CAM）. Traditional Chinese medicine, is the most important part of CAM and has been practiced for treating diseases and promoting the health of humans for thousands of years, and has become a popular alternative choice. Although there are many Chinese herbal medicine （CHM interventions available, and some have been verified b＇ clinical trials, their efficacy and safety are still questioned by both patients and health care providers worldwide. The purposes of this review are, first, to appraise the qualities of individual study designs in the new Cochrane approach. Second, the benefits of individual CHM interventions or individual types of CHM intervention for the treatment of functional constipation are analyzed. Finally, valid and comprehensive conclusions are drawn, if applicable, in order to make clinical recommendations.

Early metabolism evaluation making traditional Chinese medicine effective and safe therapeutics

Increasing attention is being paid to the scientific evaluation of traditional Chinese medicine （TCM）. As many TCMs are capable of biotransformation in the gastrointestinal tract, attention to biotransforrnation of TCM in the gastrointestinal tract may lead to discovery of the active components and active mechanisms. In this article, we review reports that host metabolic enzymes and intestinal bacteria may be responsible for the metabolism of TCM. Good understanding of the in vivo course of TCM will help us to know how to conduct metabolism evaluation of TCM by using in vitro human-derived system. This evaluation system will create new views on TCM as effective and safe therapeutic agents.

Traditional Chinese medicine compounds for the treatment of functional dyspepsia:an updated meta-analysis of randomized,double-blind,placebo-controlled trials

Objective To evaluate the efficacy and safety of traditional Chinese medicine(TCM)compounds for the treatment of functional dyspepsia(FD).Methods The Pub Med,Embase,Cochrane Library,Web of Science,Chinese Biomedical Database(CBM),Wanfang Data,China National Knowledge Infrastructure(CNKI),and China Science and Technology Journal Database(VIP)were searched to collect randomized,double-blind,and placebo-controlled trials of FD treated with TCM compounds.The search duration was from the establishment of the database to March 2,2021.After two researchers independently screened the literature,extracted the data,and evaluated the bias risk included in the study,they used Rev Man 5.4 software for meta-analysis.Results A total of 23 clinical trials were included,including 2898 patients.Meta-analysis showed that the overall remission rate of FD treated with TCM compounds was significantly higher than that of placebo(73.8%vs.46.2%)[RR=1.50,95%CI(1.29,1.76),P<0.00001].Among the single symptoms,TCM compounds were superior to the placebo in improving epigastric pain[MD=﹣0.99,95%CI(﹣1.37,﹣0.61),P<0.00001],epigastric burning sensation[MD=﹣0.32,95%CI(﹣0.59,﹣0.05),P=0.02],postprandial fullness discomfort[MD=﹣1.59,95%CI(﹣1.96,﹣1.21),P<0.00001],and early satiety symptoms[MD=﹣0.93,95%CI(﹣1.32,﹣0.54),P<0.00001].Compared with the placebo,TCM compounds treatment can obviously improve TCM syndrome in patients with FD[MD=﹣5.58,95%CI(﹣7.55,﹣3.61),P<0.00001],gastric emptying rate[MD=12.22,95%CI(8.90,15.55),P<0.00001],and helped to improve patients’quality of life[MD=11.27,95%CI(0.10,22.43),P=0.05].No severe adverse events were reported between the two groups[RR=1.34,95%CI(0.91,1.96),P=0.14].Conclusion Our results showed that TCM compounds treatment could significantly alleviate FD symptoms,improve gastric emptying in FD patients,and help to improve their quality of life.No severe adverse reactions have been reported in clinical applications.Due to the limitation of the quantity and quality of the included studies,the above conclusions need to be verified by more high-quality studies.

Study of Linearization of Hill Dose-Effect Curve with Metabolic Velocity Instead of Drug Concentration

Objective To explore the velocity-effect relationship in order to the establish linearization of effect on an equation with regard to the consistency of the Hill dose-effect expression with the metabolic kinetics of receptors.Methods The linear velocity-effect expression was obtained by solving multivariant differential equation groups,which were established to compare the coincidences and basic relations between the Hill dose-effect and metabolic kinetic Michaelis-Menten equation for receptors.The validation test was conducted with acetylcholine,adrenaline,and their mixture as model drugs.Results The linear velocity-effect modelling was represented in vivo or in vitro,for single and multidrug systems.Pharmacodynamic parameters,especially suitable for multicomponent CMM formulas,could be determined and calculated for single or multicomponent formulas at high saturating or low linear concentration for receptors.The validation test showed that the pharmacodynamic parameters of acetylcholine were:k,2.675×10^-3s^-1;ka,5.786×10^-9s^-1;km,2.500×10^-7s^-1;α,4.619×10^9张s·mg^-1;E0,13张(P<0.01)and those of adrenaline were:k,1.415×10^-3s^-1;ka,5.846×10^-9s^-1;km,2.300×10^-7s^-1;α,-1.627×10^9张s·m g^-1;E0,9.2张(P<0.01).For the mixture of the two components,the values were:α,1.375×1010张s·m g^-1;-6.150×10^9张s m g^-1for acetylcholine and adrenaline,respectively,and E0was7.08张in both,with the other parameters unchanged(P<0.01).Conclusion The velocity-effect equation can linearize the Hill dose-effect relationship,which can be applied to study the pharmacodynamics and availability of CMM formulations in vivo and in vitro.

The observation of single-agent gemcitabine maintenance therapy in patients with metastatic breast cancer

Objective:The aim of the study was to evaluate the efficacy and tolerability of single-agent gemcitabine in the maintenance treatment of histologically confirmed metastatic breast cancer cases.Methods:The 45 patients carried efficacious chemotherapy were divided into maintenance therapy group(n=23) and control group(n=22) according to the different treatment methods.Patients in the maintenance therapy group received gemcitabine therapy until 6 cycles,disease progression or adverse effect intolerance.Within the control group,the patients were given best supportive care.Follow-up was made until disease progression,death or 2 years.The short-term clinical efficacy and adverse effects,progression-free survival(PFS) and median survival of recurrence(MSR) of these two groups were compared and analyzed.Results:Compared with the control group,the experiment group had higher response rate(RR;73.9% vs 31.8%;P<0.05),and significantly progress of median PFS(13.1 vs 9.6 months;P<0.05).However,the progression of MSR had no statistically difference with the control group(23.3 vs 21.1 months;P>0.05).Most of the treatment-related adverse events were mild,and the most common adverse event was hematologic toxicity.The 3 cases occurred grades 3–4 neutropenia and 3 cases occurred grades 3–4 thrombocytopenia.The 1 patient stopped treatment because of grade 3 allergic reaction,and 4 patients required dose reduction for grade 4 adverse events.Other adverse effects were grades 1–2,and all were recovered after symptomatic treatment.There was no significant side effect which threatened the life.Conclusion:In the extension maintenance treatment,gemcitabine can consolidate the therapeutic effect in advance and significantly prolong median PFS of metastatic breast cancer patients.In conclusion,gemcitabine monotherapy with a favorable safety profile is an effective maintenance treatment in metastatic breast cancer patients.

Evaluation of Insecticidal Properties of Some Medicinal Herbs on the Confused Flour Beetle Tribolium confusum （Tenebrionidae： Coleoptera）

Five concentrations effects of nine herb powders against the confused flour beetle T. confusum have been studied under controlled conditions. The insecticidal effects of using powders on the egg, larval, pupal and adult stages of the insect showed that some of which （e.g., Foeniculum capillaceum and Anethum graveolens） have certain effects on the different stages of the studied insect even at the lowest concentrations. The mentioned herb powders showed very high mortality for egg stage reached 96.6% and 93.3% respectively at the lowest concentration and 100% at the highest concentration for both powders. Other powdered herbs showed prolonged effect of durations for larval stage. For example, Acorus calamus prolonged this duration to 34.2 days, at the first concentration while it was 25.4 days for control treatment. At the second concentration it was 53 and 41.5 days for An. gr. and Pimpinella anisum respectively, also Matricaria chamomilla showed similar effect at the 4th and 5th concentrations. Comparing with high numbers of progeny for the control treatment, also some powdered herbs showed high effect on respiration of the adults. The quantity of oxygen consumed by untreated beetles during the time of experiment （90 min） was so high than that of beetles treated with Ac. caL, Artemisia absinthium and AL sat. Moreover the internal systems of both sex males and females have been affected, ducts showing different changes when studied anatomically giving small size of ovarioles, deformed of accessory glands, swollen of stink glands with liquid oil. Majority of those males showed small testis. Most of the mentioned effects were happened as results of the powders of A c. cal., Al. sat., and Ma. ch., also the powders of F. cap., and A. abs., decrease the sizes of the testis, and accessory glands.

Pharmacodynamic comparison of two different source plants of Murrayae Folium et Cacumen

A comparison of the pharmacodynamic effects of two source plants of Murrayae Folium et Cacumen(MFC),Murraya exotica L.and Murraya paniculata(L.)Jack,was performed in order to supply reference for its multi-source rationality and interchangeability in clinical practice.According to the traditional efficacy of MFC,the effects of promoting Qi,relieving pain,promoting blood circulation and removing blood stasis were systematically evaluated by the models of writhing response in mice,foot swelling in rats,gastric emptying and small intestine propulsion in mice,and acute blood stasis in rats,respectively.The results showed that both M.exotica and M.paniculata could significantly inhibit the writhing reaction induced by acetic acid in mice and the paw swelling induced by carrageenan in rats,reduce IL-6,TNF-αand PGE2 levels in plasma of paw-swelling rats and increase gastric empty rate and intestinal propulsive rate.The above-mentioned effects were dose-dependent,and there was no significant difference between M.exotica and M.paniculata at the same doses.Therefore,M.exotica and M.paniculata had the similar anti-inflammatory,analgesic and gastrointestinal motility promotion effects,which provided a support for the pharmacodynamic equivalence of the multi-source plants of MFC.