Effectiveness and safety of traditional Chinese medicine for diabetic retinopathy:A systematic review and network meta-analysis of randomized clinical trials

BACKGROUND Diabetic retinopathy(DR)is currently recognized as one of the most serious diabetic microangiopathies and a major cause of adult blindness.Commonly used clinical approaches include etiological control,microvascular improvement,and surgical intervention,but they are ineffective and have many side effects.Oral Chinese medicine(OCM)has been used for thousands of years to treat DR and is still widely used today,but it is unclear which OCM is more effective for DR.AIM To estimate relative effectiveness and safety profiles for different classes of OCMs for DR,and provide rankings of the available OCMs.METHODS The search time frame was from the creation of the database to January 2023.RevMan 5.3 and Stata 14.0 software were used to perform the systematic review and Network meta-analyses(NMA).RESULTS A total of 107 studies and 9710 patients were included,including 4767 cases in the test group and 4973 cases in the control group.Based on previous studies and clinical reports,and combined with the recommendations of Chinese guidelines for the prevention and treatment of DR,9 OCMs were finally included in this study,namely Compound Xueshuantong Capsules,Qiming Granules,Compound Danshen Dripping Pills,Hexue Mingmu Tablets(HXMM),Qiju Dihuang Pills(QJDH),Shuangdan Mingmu Capsules(SDMM),Danggui Buxue Decoction(DGBX),Xuefu Zhuyu Decoction and Buyang Huanwu Decoction.When these nine OCMs were analyzed in combination with conventional western medicine treatment(CT)compared with CT alone,the NMA results showed that HXMM+CT has better intervention effect on the overall efficacy of DR patients,HXMM+CT has better effect on improving patients'visual acuity,SDMM+CT has better effect on inhibiting vascular endothelial growth factor,DGBX+CT has better effect on reducing fundus hemorrhage area,HXMM+CT has better effect on reducing fasting blood glucose,and QJDH+CT has better effect on reducing glycated hemoglobin.When there are not enough clinical indicators for reference,SDMM+CT or HXMM+CT treatments can be chosen because they are effective for more indicators and demonstrate multidimensional efficacy.CONCLUSION This study provides evidence that combining OCMs with CT leads to better outcomes in all aspects of DR compared to using CT alone.Based on the findings,we highly recommend the use of SDMM or HXMM for the treatment of DR.These two OCMs have demonstrated outstanding efficacy across multiple indicators.

Effectiveness and safety of traditional Chinese medicine decoction for diabetic gastroparesis:A network meta-analysis

BACKGROUND Diabetic gastroparesis(DGP)is a prevalent complication of diabetes that impairs people's quality of life and places a significant financial burden on them.The gastrointestinal symptoms of DGP patients can be improved by several Traditional Chinese Medicine(TCM)decoctions that have been shown to be effective in treating the disease.There are still many unanswered questions regarding the identification of appropriate therapeutic agents for the treatment of DGP in clinical practice.AIM To analyze the efficacy of several TCM decoctions in the treatment of DGP using Bayesian network meta-analysis for reference.METHODS PubMed,EMBASE,Cochrane Library,Web of Science,China National Knowledge Infrastructure,The China Biology Medicine DVD,Wanfang,and CQVIP were searched from inception to September 17,2022,to collect randomized controlled trials(RCTs)about TCM decoctions for DGP.Clinical effects and symptom scores were the primary outcomes.Additionally,we assessed motilin(MOT),somatostatin(SS),gastrin(GAS),gastric emptying rate,gastric emptying time,and adverse drug events as secondary outcomes.RESULTS A total of 67 eligible RCTs involving 4790 DGP patients and 7 TCM decoctions were included.The results of network meta-analysis(NMA)and surface under the cumulative ranking curve showed that with western medicine(WM)as a common control,the Banxia Xiexin Decoction(BXXD)+WM was most effective in clinical effects and enhancing early satiety scores;the Simo decoction(SMD)+WM was most effective in improving nausea and vomiting scores and anorexia scores,bloating scores;the Chaishao Liujunzi Decoction(CSLJD)was most effective in MOT,the Zhishi Xiaopi Decoction(ZSXPD)was most effective in SS and upgrading emptying rate;the Jianpi Xiaozhi Decoction was most effective in GAS;the CSLJD+WM was most effective in improving gastric emptying time.CONCLUSION These NMA results suggest that the BXXD+WM and SMD+WM may be one of the potential optimal treatments.Due to various limitations,further large-sample,double-blind,multi-center randomized RCTs are needed.

The efficacy and safety of anti-humidification traditional Chinese medicine in the treatment of viral pneumonia: A meta-analysis

Objective A meta-analysis was used to evaluate the efficacy and safety of traditional Chinese medicine(TCM)for dispelling dampness in the treatment of viral pneumonia.Methods The databases of CNKI,CBM,WanFang data,VIP,EMBASE,PubMed,and Cochrane library were searched,and the clinical trials of dispelling dampness TCM in the treatment of viral pneumonia were selected.The retrieval period is from the establishment of the database to December 2022.Stata 17.0 software was used to perform meta-analysis,and review manager 5.3 software was used to assess the risk of bias.Overall efficacy was evaluated by OR,and improvement in major clinical symptoms were evaluated by RR.Results A total of 20 randomized controlled trials were included,with a total of 2136 patients,including 1180 patients in the experimental group and 956 patients in the control group.Meta-analysis showed that TCM for dispelling dampness could significantly improve the efficacy of viral pneumonia patients[OR=2.652,95%CI=(2.187,3.217),Z=9.908,P<0.05];The child with abnormal lung X-rays returned to normal after treatment[RR=4.23,95%CI=(2.42,7.42),Z=5.04,P<0.05];In addition,patients had fewer adverse reactions to dispelling dampness TCM,and the safety of the trial was good.Conclusion This Meta-analysis further clarified the efficacy of TCM for dispelling dampness in the treatment of viral pneumonia by combining clinical data and has suggestive significance for the treatment of novel coronavirus pneumonia.

Ultrasonic Nebulization Extraction Coupled with Gas Chromatography-Mass Spectrometry for Analysis of Volatile Components in Traditional Chinese Patent Medicine

The ultrasonic nebulization extraction（UNE） was developed and applied to the extraction of volatile components from traditional Chinese patent medicine Xiaoyao Pills. Several parameters of ultrasonic nebulization extraction including the sample particle size, solvent volume, extraction time and ultrasonic power were studied and selected. As a result, 2.4 g of sample with particle size of 80 mesh was extracted with 15 mL of n-hexane for 20 min at an ultrasonic power of 35 W. The volatile components were analyzed by gas chromatography-mass spectrometry （GC-MS） under the optimal conditions and 57 compounds were identified. The precision, repeatability and stability of the proposed method were also studied. Compared with ultrasonic-assisted extraction（UAE） and hydrodistillation（HD） extraction, the proposed method is more efficient, faster and easier to be operated at room temperature with smaller sample and energy consumption. It is suggested that the ultrasonic nebulization extraction can be used as a novel alternative method for the extraction of volatile components from traditional Chinese patent medicine.

Clinical Study on External Use of Chinese Medicine in Treating Children with Herpetic Stomatitis

Background: Pediatric herpetic stomatitis is a common pediatric disease, the course of the disease is about 1 - 2 weeks, and it usually occurs in 1 - 3 years old children, due to infection of herpes simplex virus I and onset. Objective: To observe the curative effect of Chinese medicine prescription (Yueshi, Zhongbai, Qingdai, Phelloderma phelloderma and glycyrrhiza) on children with herpetic stomatitis. Methods: 90 patients were divided into 2 groups by random number table method. 45 patients in the observation group were treated with traditional Chinese medicine, and 45 patients in the control group were treated with iodine glycerin. The total effective rate after treatment was compared between the two groups. Results: The total effective rate of the treatment group was 95.55%;the total effective rate of the control group was 71.11%;the total effective rate of the two groups after treatment was compared;the treatment group was significantly better than the control group;the difference was significant (P 0.05). Conclusion: The external use of Chinese medicine in the treatment of pediatric herpetic stomatitis has achieved good results, improving the condition of children, and significantly improving the clinical efficacy.

Applications of HPLC/MS in the analysis of traditional Chinese medicines

In China, traditional Chinese medicines （TCMs） have been used in clinical applications for thousands of years. The successful hyphenation of high-performance liquid chromatography （HPLC） and mass spectrometry （MS） has been applied widely in TCMs and biological samples analysis. Undoubtedly, HPLC/MS technique has facilitated the understanding of the treatment mechanism of TCMs. We reviewed more than 350 published papers within the last 5 years on HPLC/MS in the analysis of TCMs. The present review focused on the applications of HPLC/MS in the component analysis, metabolites analysis, and pharmacokinetics of TCMs etc. 50% of the literature is related to the component analysis of TCMs, which show that this field is the most popular type of research. In the metabolites analysis, HPLC coupled with electrospray ionization quadrupole time-of-flight tandem mass spectrometry has been demonstrated to be the powerful tool for the characterization of structural features and fragmentation behavior patterns. This paper presented a brief overview of the applications of HPLC/MS in the analysis of TCMs. HPLC/MS in the fingerprint analysis is reviewed elsewhere.

Classic mechanisms and experimental models for the anti-inflammatory effect of traditional Chinese medicine

Inflammation is a common disease involved in the pathogenesis,complications,and sequelae of a large number of related diseases,and therefore considerable research has been directed toward developing anti-inflammatory drugs for the prevention and treatment of these diseases.Traditional Chinese medicine(TCM)has been used to treat inflammatory and related diseases since ancient times.According to the re-view of abundant modern scientific researches,it is suggested that TCM exhibit anti-inflammatory effects at different levels,and via multiple pathways with various targets,and recently a series of in vitro and in vivo anti-inflammatory models have been developed for anti-inflammation research in TCM.Currently,the reported classic mechanisms of TCM and experimental models of its anti-inflammatory effects pro-vide reference points and guidance for further research and development of TCM.Importantly,the research clearly confirms that TCM is now and will continue to be an effective form of treatment for many types of inflammation and inflammation-related diseases.

Application of traditional Chinese medicine in treatment of Helicobacter pylori infection

Helicobacter pylori(H.pylori)has a high rate of infection and antibiotic resistance and poses a serious threat to human life.One of the main strategies to overcome drug resistance is to develop new treatment plans.Traditional Chinese medicine(TCM)that is commonly used to treat many diseases in China can reduce drug resistance and increase the eradication rate of H.pylori.In this paper,we review the research progress on TCM in the treatment of H.pylori infection.The mechanism of action of TCM is reviewed and research and applications of TCM in the treatment of H.pylori are demonstrated.Finally,we discuss problems confronting the use of TCM for the treatment of H.pylori infection and propose possible solutions.In addition,the plans of TCM in H.pylori treatment were also screened:Dampness-heat syndrome in the spleen and stomach,deficiency of spleen and stomach,and cold-heat complicated syndrome,and the effective components therein are studied.The antibacterial effect of TCM is relatively slow;for rapid improvement of the treatment effect of refractory H.pylori gastritis,we provide an appropriate treatment regime combining TCM and Western medicine with immune-regulatory and synergistic antibacterial effects.

Property theory of Chinese materia medica: Clinical pharmacodynamics of traditional Chinese medicine

The property theory of Chinese materia medica is one of the foundations of traditional Chinese medicine.The property of Chinese materia medica(PCMM)is a multi-dimensional expression of the effect of Chinese materia medica(CMM),and it is related to the clinical prescription that fully reflects the clinical effect evaluation of CMM in a holistic,systematic,and scientific way.This paper discusses the source,development,and application of the PCMM by considering not only the five dimensions that constitute the PCMM but also the recognition of the human body and disease as given in traditional Chinese medicine.This paper aims to provide theoretical guidance for the rational use and development of CMM.

Antiviral Effects of Compound Traditional Chinese Medicine on Newcastle Disease Virus

[Objective] To investigate the mechanism of compound traditional Chinese medicine （TCM） on Newcastle disease virus （NDV） and to provide a scientific basis for the reasonable usage of antiviral drugs in clinic. [Method] The compound TCM was composed of Hedyotis diffusa, Lonicera japonica Thunb, Radix astragali and Glycyrrhiza uralensis. Different dilutions of fluid extract were prepared. Its antiviral effects on NDV were observed through three inoculation ways, first, inoculation with the medicine and NDV mixture which had been incubated at 37 ℃; second, incubating chicken embryo fibroblasts （CEF） with the medicine followed by inoculation with NDV; third, inoculation with N DV followed by incubating CEF with the medicine. The A,= was determined by M]-r [ 3-（4,5-dimethylthiazol-2-yl）-2,5-diphenyltetrazolium bromide） ~ method. Therapeutic indexes were used to evaluate the antiviral effects. [ Result] The minimum effective concentration of the compound TCM which acted through the three ways was 1.0 × 2^-10 1.0 × 2^-8 and 1.0 × 2^-7 g/ml, respectively. The antiviral effects of the compound TCM were the best through inoculation with the incubated medicine and NDV mixture, followed by the second method and the third method. [ Conclusion] The compound TCM can not only kill NDV directly in vitro but also inhibit viral propagation.

Mathematical Reasoning of Treatment Principle Based on “Yin Yang Wu Xing” Theory in Traditional Chinese Medicine

By using mathematical reasoning, this paper demonstrates the treatment principle: “Virtual disease is to fill his mother but real disease is to rush down his son” and “Strong inhibition of the same time, support the weak” based on “Yin Yang Wu Xing” Theory in Traditional Chinese Medicine (TCM). We defined two kinds of opposite relations and one kind of equivalence relation, introduced the concept of steady multilateral systems with two non-compatibility relations, and discussed its energy properties. Later based on the treatment of TCM and treated the healthy body as a steady multilateral system, it has been proved that the treatment principle is true. The kernel of this paper is the existence and reasoning of the non-compatibility relations in steady multilateral systems, and it accords with the oriental thinking model.

Comparative study on the anti-tuberculous effect and mechanism of the traditional Chinese medicines NiuBeiXiao He extract and JieHeWan

Background:The traditional Chinese medicine NiuBeiXiaoHe(NBXH)extract and Chinese medicine preparation JieHeWan(JHW)exhibit anti-tuberculosis(TB)effects.The anti-TB effect of NBXH was compared with that of JHW to elucidate the mechanism of action of NBXH.Methods:BALB/c mice aged 6-8 weeks were randomly divided into a normal control group,TB model group,JHW treatment group,and NBXH treatment group.After 3 and 13 weeks of treatment,the therapeutic effect in each group was evaluated by comparing lung histopathology,lung and liver colony counts,the number of spots representing effector T cells secreting IFN-γin an enzyme-linked immunospot assay(ELISPOT),and the levels of Th1,Th2,and Th17 cytokines,which were measured by a cytometric bead array(CBA).Mouse RNA samples were subjected to transcriptome sequencing.Results:After 13 weeks of treatment,the mean histopathological lesion area of the NBXH group was significantly smaller than that of the TB model group(P<0.05).Compared with those in the TB model group,the lung colony counts in the JHW and NBXH groups were significantly decreased(P<0.05),and the IL-2 and IL-4 levels in the NBXH group were significantly increased(P<0.05).NBXH partly restored significant changes in gene expression caused by Mycobacterium tuberculosis(M.tuberculosis)infection.According to GO and KEGG analyses,the changes in biological process(BP),cell composition(CC)and molecular function(MF)terms and in signaling pathways caused by NBXH and JHW treatment were not completely consistent,but they were mainly related to the immune response and inflammatory response in the mouse TB model.Conclusions:NBXH had therapeutic effects similar to those of JHW in improving lung histopathology,reducing lung colony counts,and regulating the levels of cytokines.NBXH restored significant changes in gene expression and repaired cell damage caused by M.tuberculosis infection by regulating immune-related pathways,which clarified the mechanism of action of NBXH.

Acupuncture Treating Dystrophy Based on pH <br/>—Mathematical Reasoning of Treatment Principle Based on Yin Yang Wu Xing Theory in Traditional Chinese Medicine (III)

Theory of both Zangxiang (藏象) and Jingluo (经络) is useful in understanding disease. By using mathematical reasoning based on Yin Yang Wu Xing Theory in Traditional Chinese Medicine (TCM), this paper demonstrates the treatment principle: “Searching for a root cause of disease in cure, treatment of both the root-cause and symptoms at the same time” (治病求本, 标本兼治). It means that for a human body, there is the mathematical structure of both Zangxiang and Jingluo as her/his second physiological system. It can be used to determine both the root-cause and symptoms of the sick organ by using both Zangxiang and Jingluo. In general, for the human blood pH value, the normal range of theory is [7.34539, 7.45461] nearly to [7.35, 7.45], and the center is 7.4. The first or second transfer law of a human body’s energies changes according to the different blood pH values whether in the normal range or not. Human disease treatment should protect and maintain the balance of two incompatibility relations: the loving relationship and the killing relationship. As an application, acupuncture is used to treat limb-girdle muscular dystrophy.

Effect of Traditional Chinese Medicine inImproving Hot Flashes Symptom ofBreast Cancer

Breast cancer (BC) is the most common malignant tumor in women. Around 50% of BC receptor-positive patients are hormone-dependent cases, and it is necessary for them to use endocrine after operation. Through inhibition of estrogen level

Exploration on Clinical Effect of Traditional Chinese Medicine Rehabilitation to Treat Cervicalspondylotic Radiculopathy

The purpose of this paper is to study the clinical effect of using traditional Chinese medicine rehabilitation model to treat patientswith cervicalspondylotic radiculopathy.Choosing 84 patients with cervicalspondylotic radiculopathy, who used to be treated in our hospital,anddividing them into control group and treatment group by the way of random grouping,each group has 42 patients.The control group was treatedwith conventional therapy, and the treatment group was treated with rehabilitation therapy of traditional Chinese medicine.The time of symptomdisappearance of cervical spondylopathy of patients and total time of the implementation of treatment plan of the treatment group are shorterthan that of the control group,the difference between groups is remarkable（P〈0.05）;Only 2 adverse reactions occurred during the treatmentperiod,and only 4 patients relapsed within 3 months after treatment,this is significantly less than the 9 patients and 15 patients of the controlgroup,the difference is remarkable（P〈0.05）;The improvement range of clinical symptom score before and after treatment is greater than thatof the control group,difference between groups is remarkable（P〈0.05）;Total effective rate of treatment of cervicalspondylotic radiculopathyreaches 90.5%,which is higher than that of the control group（69.0%）,the difference is remarkable（P〈0.05）.Adopting traditional Chinese medicinerehabilitation model to treat patients with cervicalspondylotic radiculopathy can improve symptoms in a short period of time,reduce adversereactions,reduce the possibility of recurrence after treatment.

The application of traditional Chinese medicinesynthetic effect criteria in the late stage lung cancer

Objective To inspect the correlation of synthetic effect criteria to sensitivity,reliability of late stage lung cancer curative effect verdict and median survival time. Method Using size change of tumor,symptom change related to tumor,Karnofsky score,body weight etc.as synthetic effect criteria and instituting clinical synthetic effect criteria,to assess the curative effect of late stage lung cancer patients who received different treatment in department of tumor of Xiyuan Hospital between March 1997 and March 2000, to analysis medium survival time, and being compared with RR of tumor.Result 52 patients entered this experiment, in which 42 patients were assessable (follow-up), 13 patients were effective(30.95%),17 were patients stable(40.48%),12 patients deteriorated (28.57%).The result of tumor objective remission rate: CR is 0,PR is 16.67%(7 patients),NC is 64.29%(27 patients) and PD is 19.05% (8 patients).There was apparent difference between two effect criteria(P< 0.05).The mean survival time of this group is (9.3±1.6)months,median survival time is 10.5 months(2～28months),survival rate of one year is 33.33%(14 patients).In the patients who live longer than median survival time, most of them survive associated with tumor existence who are in NC of tumor objective remission rate, but also in the effective column of synthetic effect criteria. Compared with tumor objective remission rate,the synthetic effect criteria have more apparent correlation to survival time. Conclusion In the assessment of late stage lung cancer,synthetic effect criteria has better sensitivity and reliability,and emphasize survival quality,at same time it reflect the reaction of tumor and host to treatment,it reflect prognosis of tumor preferably and have better correlation to the survival time. It can be used as clinical effect criteria of late stage lung cancer after further consummation.

Acupuncture Treating Heart Disease Based on Eight Palaces or Eight Veins <br/>—Mathematical Reasoning of Treatment Principle Based on Yin Yang Wu Xing Theory in Traditional Chinese Medicine (IV)

Theory of eight palaces (八宫) or eight veins (八脉) is useful in understanding the basic sick subsystems that may be to fall ills as the root-cause. By using mathematical reasoning based on Yin Yang Wu Xing Theory in Traditional Chinese Medicine (TCM), this paper demonstrates the treatment principle: “Even if all changed, it is hard to change one’s nature” (江山易改, 本性难移). The eight palaces or eight veins can be used to diagnose basic sick subsystems that may be to fall ills as the root-cause. The first or second transfer law of human body energies of the eight palaces or eight veins according to the different blood pH values of a human body whether in the normal range or not, respectively, assuming that the range of blood pH value is divided into four parts from small to large. Both second and third are for a healthy human body. Both the root-cause and symptoms come from the first transfer law of human body energies. And both first and fourth are for an unhealthy human body. Both the root-cause and symptoms come from the second transfer law of human body energies. A disease treatment should protect and maintain the balance of two incompatibility relations: the loving relationship and the killing relationship. As an application, acupuncture is used to treat atrial premature beats as a congenital heart disease.

Mathematical Reasoning of Treatment Principle Based on “Yin Yang Wu Xing” Theory in Traditional Chinese Medicine (II)

By using mathematical reasoning, this paper demonstrates the treatment principle: “Do not treat a disease after it has occurred. But treat the disease before it will occur” (不治已病治未病) based on “Yin Yang Wu Xing” Theory in Traditional Chinese Medicine (TCM). We defined generalized relations and reasoning, introduced the concept of generalized steady multilateral systems, and discussed its energy properties. Later based on the treatment of TCM and treated the healthy body as a steady multilateral system, it has been proved that the treatment principle above is true. The kernel of this paper is the existence and reasoning of the non-compatibility relations in steady multilateral systems, and it accords with the oriental thinking model.

Application of Traditional Chinese Medicine in Treating COVID-19

Traditional Chinese medicine(TCM)has been applied to the treatment of the novel coronavirus(COVID-19).In the epidemic,COVID-19 patients were treated through integrated TCM and Western medicine.The effect was remarkable,especially in the treatment of mild COVID-19 cases.This paper introduces several TCM treatments to COVID-19,put forward by both domestic and foreign scholars.

In vitro study on the antiviral activity of 9 extracts of traditional Chinese herbal medicine against the human respiratory syncytial virus

Objective:To study the in vitro virucidal activity of 9 extracts of traditional Chinese herbal medicine(the water extracts of Evodia lepta,Clausena lansium,Clerodendrum cyrtophyllum,Callicarpa nudiflora,Nauclea officinalis and Elaeagnus gonyanthes,the alcohol extracts of Nauclea officinalis,Elaeagnus gonyanthes and Zanthoxylumarmatum)on human respiratory syncytial virus(HRSV).Methods:The cytotoxic effect of the extracts on cells was evaluated by a cell viability assay using the CCK-8 method,a concentration of the extracts with cell viability greater than 50%was selected for the follow-up anti-HRSV effect assay,the 50%effective concentration(EC50)was assessed by an in vitro cell infection model.Results:The EC50s of the water extract from Clerodendrum cyrtophyllum,Callicarpa nudiflora and Elaeagnus gonyanthes were 0.05 mg/mL,0.03 mg/mL and 0.05 mg/mL,and the therapeutic index(TI)of them were 18.60,21.67 and 56.80 respectively.Conclusion:The water extracts of Clerodendrum cyrtophyllum,Callicarpa nudiflora and Elaeagnus gonyanthes possess the activity of anti-HRSV virus.