Patient-reported Outcomes (PROs): An Approach to Evaluate Treatment Efficacy of Chinese Medicine or Integrative Medicine

Chinese medicine (CM) has been an experience based practice over the past three thousand years. The safety and efficacy of CM has been practised through experience, rather than nowadays’ modern scientific measurements. In this way, the development of CM has not been keeping pace with the advance in science and technology and the progress in orthodox medicine. In order to meet the requirements of modern science and technology, an evidence based approach must be adopted. Reassurance is needed to convince people for safety and efficacy of CM and give confidence to the evidence based demands ——“Tradition is confirmed by Modern Science” (1) .

Clinical Controlled Study of Integrative Chinese and Western Medicine in Treating 49 Cases of SARS

Objective: To evaluate the efficacy of integrative Chinese and western medicine (ICWM) in treating severe acute respiratory syndrome (SARS) patients. Methods: Through parallel control design, 49 SARS patients were observed. Used as control, there were in the western medicine (WM) group 29 patients, who were treated with Ribavirin, Levofloxacin, Thymopentin, Azithromycin, methylprednisolone, etc. , on the basis of 'Recommended Protocol for Infectious Atypical Pneumonia' (abbreviated as 'Recommended Protocol') issueed by Ministry of Health. As the treated group, there were in the ICWM 20 cases. The protocol for treatment of SARS in 'Special Science and Technological Action to Prevent and Treat SARS' (abbreviated as 'Special S-T Action'), issued by Ministry of Science and Technology, together with the same WM as those for the control group. Results: (1) Time from the disease onset to the symptom improvement were 5.10±2. 83 days and 7. 62±2. 27 days in ICWM and WM group respectively, P<0.05; (2) As to corticosteroid (CS) amount and days before reducing dosage, 2 groups showed no significant difference, P>0. 05;(3) There was no significant difference in the time from disease onset to the body temperature normalization and the total amount of CS and the duration of using CS before reducing it to 80 mg between the ICWM group and the WM group; (4) The days and amounts for use CS after reducing between the ICWM group and the WM group were significantly different (P<0. 05). Conclusion: There were obvious advantages in ICWM to treat SARS, compared with that of WM alone, especially in improving the clinical symptoms, promoting the recovery of immune function, promoting the absorption of pulmonary inflammation and reducing the dosage and duration of CS treatment.

Current Status of Traditional Chinese and Western Medicine Treatment of Diabetic Peripheral Vascular Disease

Diabetic peripheral vascular disease(PVD)is one of the common chronic complications of diabetes.The main clinical manifestations of PVD are numbness and coldness of the limbs,resting pain,intermittent claudication,and other symptoms.The combined treatment involving Chinese and Western medicine for PVD has various clinical methods and definite curative effects.It is worthy of in-depth clinical research and application.

Diagnosis and treatment of an elderly patient with 2019-nCoV pneumonia and acute exacerbation of chronic obstructive pulmonary disease in Gansu Province:A case report

BACKGROUND In December 2019,the first patient with 2019-novel coronavirus(2019-nCoV)was reported in Wuhan,China,and the disease spread rapidly across the country and surrounding countries within 2 mo.As of February 29,2020,a total of 91 confirmed cases had been reported in Gansu Province.This case report of the diagnosis and treatment of an elderly patient with 2019-nCoV pneumonia complicated by acute exacerbation of chronic obstructive pulmonary disease in Gansu Province aims to provide a better reference for the treatment of patients in the future.CASE SUMMARY The patient,a 94-year-old female,lived in Maiji District of Tianshui,Gansu Province,China.On January 30,2020,she was admitted to the Fourth People’s Hospital of Tianshui after 9 d of close contact with a patient with 2019-nCoV pneumonia.She was subsequently admitted to Gansu Provincial Hospital of Traditional Chinese Medicine for isolation and transferred to Tianshui Gansu Provincial Hospital of Infectious Diseases on February 3,2020 for treatment.Upon initial examination,her body temperature was 36.7°C,pulse was 80,breathing was 20,and blood pressure was 130/80 mmHg.She was conscious with normal development and normal nutrition.The pharynx was not red,and bilateral tonsils were not red and swollen.The lungs sounded slightly coarse with no dry or wet rales.The first symptoms were cough and fatigue on 2 February.The patient was hospitalized for 12 d.After active treatment,she was discharged on February 14 with a good prognosis.CONCLUSION A history of exposure to the affected area or patient is a major cause of 2019-nCoV infection,and population clustering is a high risk factor for transmission.Patients may not necessarily have respiratory system symptoms as the only clinical manifestation but may also have concomitant or first onset digestive symptoms.Attention should be paid to the prevention and treatment of multiple organ dysfunction syndrome.Nucleic acid testing is extremely important and needs to be repeated several times.Laboratory and auxiliary examination indicators during the first week of admission are extremely important.It is feasible to carry out dynamic and continuous index monitoring,which can predict and guide the prevention and treatment of multiple organ dysfunction and the prognosis of the disease.

Strategies and Methods for the Treatment of Diabetic Neuropathy Using Integrative Chinese and Western Medicine

Diabetic neuropathy （DN） is the most common metabolic neuropathy in clinics, not only in diabetes patients （〉60%）, but also in pre-diabetic （8%） and normal persons （5%）^（1）. Its pathogenesis has not been fully understood up to now. It is generally believed that it is related to the increase in glycation endoproducts （AGEs） caused by hyperglycemia,

Successful Treatment with Integrated Chinese and Western Medicine for Severe Overdose of Amlodipine:A Case Report

Introduction Amlodipine is a dihydropyridine calcium channel blocker （CCB） that inhibits calcium influx into cardiac, vascular smooth muscle cells, and pancreatic beta cells, leading to dilation of arteries and arterioles and reduction in insulin secretion. Oral administration of amlodipine is absorbed slowly but almost completely, with a hiah oral bioavailabilitv up to 60%-80%.

中西药结合对猪弓形虫病的疗效研究

[ Objective] To evaluate the efficacy of integrated Chinese herbs and western medicine on the treatment of swine toxoplasmosis, in order to increase cure rate and lower recurrence rate. [ Method] Pigs artificially infected by Toxoplasma gondii were treated with compound suffonamide and a self-designed Chinese herbs formula, and the quantities of toxoplasma in ascites were determined. Animal regression experiment was per- formed after mice were inoculated with pathological samples of the pigs infected with toxoplasma. After treatment with integrated Chinese herbs and western medicine, the clinical manifestations of pigs were observed and the level of circulating antigen （CAg） in sera was detected. Curative effect indexes of integrated Chinese herbs and western medicine-treated group were compared with that of Chinese herbs-treated group, western medi- cine-treated group and positive control group. [ Result] All the toxoplasma trophozoites were killed by integrated and westem medicine. Regression expedment results showed that toxoplasma appeared only in one mouse that was inoculated with brain of pig. The treated pigs had nonsignificant clinical symptoms; the peak of serum CAg was lower than that of the positive control group and CAg turned negative faster than that of Chinese herbs-treated group, westem medicine-treated group, and positive control group. [ Conclusion] The integrated Chinese herbs and western medicine has good effect on the treatment of swine toxoplasmosis.

Oral Administration and External Application of Chinese Drugs Combined with Micro-invasive Operation for the Treatment of Varicose Ulcers in the Lower Extremities

Objective:To evaluate the clinical therapeutic effects of oral administration and external application of Chinese drugs combined with micro-invasive surgery for the treatment of varicose ulcers in the lower extremities(ecthyma).Methods:A total of 152 patients(163 limbs) suffering from varicose ulcers on the lower limbs were assigned to two groups according to the patients willingness.The 102 cases(109 limbs) in the treatment group underwent the method of endovenous microwave closure of communicating veins ...

Different Survival Benefits of Chinese Medicine for Pancreatic Cancer:How to Choose?

Objective：To assess the efficacy of Chinese medicine（CM） on patients with pancreatic cancer（PC） in a retrospective population-based study.Methods：Between January 1,2013,and August 30,2016,according to whether received Western medicine treatment,the patients were included into either integrative medicine（IM） group or CM group.All enrolled patients were orally administrated with Gexia Zhuyu Decoction（膈下逐瘀汤） or Liujun Ermu Decoction（六君二母汤） by syndrome differentiation,twice a day,last for at least 2 months.The primary end point was overall survival（OS）.Results：A total of 174 patients with PC were enrolled in this study.In stage Ⅰ/Ⅱ,the median OS was 20.5 months in the IM group [95% confidence interval（CI）,12.499 to 28.501] and 11.17 months in the CM group（95% CI,5.160 to 17.180,P=0.015）.The 1-and 2-year survival rates for the two groups were 47.0%,40.0% and 21.0%,21.0%,respectively.In stage Ⅲ/Ⅳ,median OS was 13.53 months（95% CI,8.665 to 18.395） in the IM group versus 6.4 months（95% CI,0.00 to 15.682） in the CM group,respectively（P=0.32）.The 1-and 2-year survival rate for the IM and CM groups were 27.0%,7.0% and 20.0%,2.0%,respectively.Conclusions：Intervention of CM contributes to the different survival benefits for PC in different stages.Multimodality treatment might be a promising strategy for PC patients in early stage.While,in advanced stage,CM might be an alternative candidate for PC patients.

Clinical Observations on 206 Cases with Lower Limb Deep Venous Thrombosis Treated by Integrated Traditional Chinese and Western Medicine

Objective: To study the pathogenetic mechanism of integrated traditional Chinese and Western medicine in treating lower limb deep venous thrombosis (DVT). Methods: Thrombosis test in vitro of 206 cases with lower limb DVT was measured. All of them were treated by integrated traditional Chinese and Western medicine. Results: The indexes of thrombosis test in vitro of patients were much higher than those of normal subjects (P < 0. 001 ). The relevent indexes were different in type distribution according to differentiation of symptoms and signs (P < 0. 01 - 0. 001 ) and between pre-treatment and post-treatment (P < 0. 001 ). It showed that hypercoagulability of blood occurred even after DVT took place. Changes of indexes, when after treatment they got lower along with improvement in the state of illness, might be objective parameters for Syndrome Differentiation in traditional Chinese medicine. Conclusions: The therapy of traditional Chinese and Western medicine has good efficacy for DVT.

Clinical Factors Affecting Platelet Growth in the Treatment of Aplastic Anemia by Tonifying Kidney and Generating Blood

Objective:To investigate the influence of kidney-tonifying and blood-generating method on platelet(PLT)growth in the treatment of aplastic anemia(AA)and analyze the characteristics of the clinical factors affecting PLT growth.We enrolled patients treated from September 2018to March 2021 in the China Academy of Traditional Chinese Medicine(TCM)Xiyuan Hospital,China Academy of TCM hospital gate 19sub-center.We enrolled 128 AA patients,for whom the inclusion criteria were:treatment is given priority to with kidney and heart's-blood method,on the basis of western medicine treatment for kidney fill party avoid Fried instant particles,stay for 3 months for a period of treatment,taking two consecutive period of treatment,changes in the PLT were observed,and the clinical characteristics of AA patients,such as PLT growth and recovery from baseline value,were analyzed.Materials and Methods:A total of 128 AA patients from 19 branches of Xiyuan Hospital,China Academy of Chinese Medical Sciences and Guang'anmen Hospital,China Academy of Chinese Medical Sciences treated from September 2018 to March 2021 were enrolled.The treatment was based on the kidney-tonifying and blood-generating method and lasted for 3 months as a course of treatment.The changes in the number of PLT in patients were observed,and the clinical characteristics of AA affecting PLT growth and recovery from baseline value were analyzed.Results:After 6 months of treatment following the kidney-tonifying and blood-generating method,PLT increased from the baseline values in 75 cases,including 21 cases of AA with normal PLT recovery and 54 cases of AA without normal PLT recovery.There were 53 cases of AA in whom PLT did not increase from the baseline.Analysis of the general data showed that patients with lower Karnofsky Performance Status(KPS)score were more likely to experience PLT growth or even return to normal after therapy(P<0.05).The results of routine blood analysis showed that when hemoglobin(HGB)was≥60 g/L and the reticulocyte(RET)proportion was≥0.3%before treatment,PLTs were more likely to increase,even returning to normal in some patients(P<0.05).Analysis of bone puncture results before treatment showed that when the proliferation of nucleated cells was low or extremely low in bone puncture examination,with the proportion of granulocytes<40%,and the proportion of erythroid cells<20%,the treatment method was more effective at increasing PLT count(P<0.05).Analysis of the chromosome karyotype results before treatment showed that when the chromosome karyotype was normal,PLTs were more likely to increase or even return to normal after treatment(P<0.05).Analysis of T-lymphocyte subsets before treatment showed that when CD3+human leukocyte antigen(HLA)-DR+proportion was≥30%,PLTs were more likely to increase or even return to normal(P<0.05).Conclusions:AA patients with a low KPS score,higher HGB≥60 g/L,RET proportion≥0.3%,low or extremely low proliferation of nucleated cells,granulocytes proportion<40%,erythroid proportion<20%,normal chromosome karyotype,CD3+HLA-DR+≥30%,should be treated with a kidney-tonifying and blood-generating method.Such patients are more likely to show PLT growth and the values may even return to normal.

Shenyi Capsule(参一胶囊) plus Chemotherapy versus Chemotherapy for Non-Small Cell Lung Cancer:A Systematic Review of Overlapping Meta-Analyses

Objective：To assist decision-makers interpret and choose among conflicting meta-analyses,as well as to offer treatment recommendations based on current best evidence by performing a systematic review of overlapping meta-analyses regarding Shenyi Capsule（参一胶囊,SC） plus chemotherapy versus chemotherapy of non-small cell lung cancer（NSCLC）.Methods：A literature search was conducted to select systematic reviews comparing SC plus chemotherapy with chemotherapy for NSCLC.Meta-analyses only composed of randomized controlled trials（RCTs） met the inclusion criteria.Two authors individually estimated the quality of meta-analysis and extracted data.The Jadad decision algorithm was applied to guarantee which meta-analysis provided the best original evidence.Results：A total of 5 meta-analyses were included.All the studies composed of RCTs or quasi-RCTs and were regarded as level-Ⅱ evidence.The scores of the Assessment of Multiple Systematic Reviews ranged from 3 to 6（median 4）.A high-quality meta-analysis with more RCTs was chosen,which suggested that SC plus chemotherapy could increase incidence of short-term efficacy,improve the quality of life and survival rate in comparison to chemotherapy.However,there was no statistically significant difference between SC plus chemotherapy and chemotherapy regarding chemotherapy-induced side effect,such as liver and kidney function obstacle,leukopenia,hemoglobin decrement and gastrointestinal adverse reaction.Conclusions：Based on the best available evidence,treatment effect of SC plus chemotherapy was better than chemotherapy and did not increase side effects.Therefore,SC plus chemotherapy may be superior to chemotherapy for treating NSCLC.However,due to some limitations,SC plus chemotherapy should be cautiously considered,and further high-quality meta-analyses are needed.