OBJECTIVE:To investigate the short-term efficacy and safety outcomes following a sequential treatment with clearing heat and eliminating phlegm(CHEP)formula and tonifying Qi and activating blood circulation(TQABC)form...OBJECTIVE:To investigate the short-term efficacy and safety outcomes following a sequential treatment with clearing heat and eliminating phlegm(CHEP)formula and tonifying Qi and activating blood circulation(TQABC)formula in patients with acute ischemic stroke(AIS)within a 72 h time window.METHODS:In this randomized,multicenter,doubleblinded,placebo-controlled trial,500 participants will be randomly assigned in a ratio of 1∶1 to the CHEP+TQABC group or control group.In addition to guidelinebased standard medical care,participants in the treatment group will receive the CHEP formula for the first 5 consecutive days followed by the TQABC formula for another 10 consecutive days,while those in the control group will receive CHEP formula placebo and TQABC formula placebo consecutively.The primary outcome measure will be the comparison of the change in the National Institutes of Health Stroke Scale score from baseline to 15 days after randomization.The secondary outcome measures will include the scores on the modified Rankin Scale,Barthel Index,Patient-Reported Outcomes,TCM symptom pattern(Zheng-hou)evaluation Scale,and the incidence of in-hospital complications.Safety assessment will include the physical examination,laboratory detection,any adverse events or serious adverse events,and the proportion of any complications during hospitalization.DISCUSSION:The results of this study will provide objective and scientific data with which to assess the efficacy and safety of a sequential treatment based on“integrating disease and symptom pattern”for patients with AIS.展开更多
OBJECTIVE: To investigate the effects of tonifying Qi and activating blood circulation(SQABC), a method in Traditional Chinese Medicine(TCM), on end-point events in patients with myocardial infarction(MI) in this retr...OBJECTIVE: To investigate the effects of tonifying Qi and activating blood circulation(SQABC), a method in Traditional Chinese Medicine(TCM), on end-point events in patients with myocardial infarction(MI) in this retrospective cohort study.METHODS: Clinical data were obtained from the medical records of patients with acute MI(AMI),both during hospitalization and follow-up, and included general demographic information(age, gender, and contact information), TCM regimens used,and end-point events.RESULTS: A total of 1596 patients with AMI were enrolled to this study, but data of only 1210 casesare accessible till follow-up. We classified the patients based on the exposure levels of SQABC.When comparing the results between all exposure and non-exposure groups, significant differences were identified, both during hospitalization and follow-ups. During hospitalization, cardiac death(4.40% vs 21.55%, P < 0.05) and cardiac shock(3.04% vs 11.62%, P < 0.05) were significantly lower in the exposure group than the non-exposure group. Similarly, during the follow-up, cardiac death(12.04% vs 20.49%, P < 0.05), acute heart failure(7.27% vs 11.81%, P < 0.05), composite endpoint of reinfarction and stroke(9.11% vs 15.28%,P < 0.05), and rehospitalization due to angina(25.49% vs 34.38%, P < 0.05) were significantly lower in the exposure group than the non-exposure group.CONCLUSION: Our findings suggest that SQABC can significantly benefits the subjects in the management of high-risk AMI in them.展开更多
目的总结益气活血类方治疗心力衰竭临床研究的热点演变及研究不足,并且预测发展趋势。方法检索中国知网和Web of Science数据库(CNKI)建库至2022年11月1日期间有关益气活血类方治疗心力衰竭的相关临床研究文献,借助CiteSpace 6.1R4软件...目的总结益气活血类方治疗心力衰竭临床研究的热点演变及研究不足,并且预测发展趋势。方法检索中国知网和Web of Science数据库(CNKI)建库至2022年11月1日期间有关益气活血类方治疗心力衰竭的相关临床研究文献,借助CiteSpace 6.1R4软件来完成文献研究作者、机构、关键词等可视化研究分析。结果1988—2022年有关益气活血类方治疗心力衰竭的文章整体呈波动上升趋势。发文最多的作者为张艳,辽宁中医药大学(含附属医院)、北京中医药大学(含附属医院)等机构的发文数量较多。根据高频关键词可知研究热点主要集中于证型(气虚血瘀等)、治法(益气活血、活血利水、益气温阳等)、疗效评价标准(心功能、生活质量、脑钠肽等)、合并疾病(冠心病等)。关键词突变、时间线图综合分析显示,益气活血类方治疗心力衰竭的治疗方式、评价标准都呈现多元化趋势。文献横向分析提示,目前临床报告规范仍存在较大的提升空间,疗效评价指标描述存在偏于主观等问题。结论益气活血类方治疗心力衰竭的相关临床研究领域,不同研究机构、团队间的合作仍需进一步加强,以便开展多中心大样本的高质量研究;心力衰竭的证型、治法、疗效评价标准以及合并疾病是目前的研究热点,但在临床报告规范方面仍有待完善,建议制定客观、科学的诊疗标准及报告规范,进一步探索中医或中西医结合治疗心力衰竭的临床优势。展开更多
目的对益气活血类方药联合羟苯磺酸钙治疗非增殖期糖尿病视网膜病变(NPDR)的疗效进行Meta分析。方法检索PubMed、Embase、Web of Science、The Cochrane Library、中国知网、万方和维普数据库报道的益气活血类方药联合羟苯磺酸钙治疗NPD...目的对益气活血类方药联合羟苯磺酸钙治疗非增殖期糖尿病视网膜病变(NPDR)的疗效进行Meta分析。方法检索PubMed、Embase、Web of Science、The Cochrane Library、中国知网、万方和维普数据库报道的益气活血类方药联合羟苯磺酸钙治疗NPDR的相关文献,检索时间为建库至2022年10月31日。采用Cochrane系统评价手册对纳入文献进行质量评估,RevMan 5.3对纳入文献的临床指标进行Meta分析。结果共纳入19篇文献,共计1,598例患者,其中联合治疗组791例,对照组807例。与对照组比较,联合治疗组的总有效率[RR=1.290,95%CI(1.230,1.360),Z=9.970,P=0.000]、视力[MD=0.110,95%CI(0.080,0.140),Z=8.090,P=0.000]、黄斑中心凹厚度[MD=-19.710,95%CI(-29.790,-9.670),Z=3.840,P=0.000)]、中医证候评分[SMD=-1.200,95%CI(-1.800,-0.600),Z=3.900,P=0.000)]、血清血管内皮生长因子[MD=-16.970,95%CI(-22.020,-11.910),Z=6.580,P=0.000]、全血高切黏度[MD=-0.440,95%CI(-0.740,-0.130),Z=2.820,P=0.005]、全血低切黏度[MD=-0.870,95%CI(-1.130,-0.610),Z=6.590,P=0.000]均有改善,差异有统计学意义,且未见严重不良反应。结论益气活血类方药联合羟苯磺酸钙治疗NPDR疗效显著,能提高患者总有效率,改善视力。展开更多
Cerebral ischemia-reperfusion injury(CIRI) refers to a pathological phenomenon that aggravates the injury after the restoration of blood perfusion and oxygen supply to the cerebral ischemia-induced tissues and organs,...Cerebral ischemia-reperfusion injury(CIRI) refers to a pathological phenomenon that aggravates the injury after the restoration of blood perfusion and oxygen supply to the cerebral ischemia-induced tissues and organs, with a relatively high incidence. The traditional Chinese medicine(TCM) believes that Qi deficiency and blood stasis are the cause of CIRI. Therefore, Chinese medicine for tonifying Qi and activating blood is regarded as an important choice for the treatment of CIRI. In recent years, it has been found that many Chinese herbal medical ingredients and compound Chinese medicine(CCM) have significant anti-CIRI effects, and their mechanisms of action mainly include improving brain blood supply, neuroprotection, regulating signal pathways such as TLR4/HO-1/Bcl-2, protecting mitochondrial function, regulating related protein levels, and regulating oxidative molecule levels. This article summarizes and introduces the pharmacological mechanisms of Tonifying-Qi and activating-blood Chinese medicine and CCM which have the function of anti-CIRI. Our goal is to provide effective reference for further researches on the cerebral protection of related TCMs or compounds and their clinical application.展开更多
目的比较加入益气温阳、活血利水法的中医治疗与常规西药治疗慢性心力衰竭的临床疗效,为临床决策提供依据。方法采用Cochrane系统评价方法,计算机检索Medline、中国知网、万方数据库、维普期刊库、中国生物医学文献数据库中加入益气温...目的比较加入益气温阳、活血利水法的中医治疗与常规西药治疗慢性心力衰竭的临床疗效,为临床决策提供依据。方法采用Cochrane系统评价方法,计算机检索Medline、中国知网、万方数据库、维普期刊库、中国生物医学文献数据库中加入益气温阳、活血利水法的中医治疗慢性心力衰竭的随机对照试验(RCT)或半随机对照试验,采用Jadad评分量表评价纳入文献的质量,采用Rev Man 5.2软件进行Meta分析。比较加入益气温阳、活血利水法的中医治疗组(治疗组)与常规西药治疗组(对照组)的显效率、有效率、无效率及治疗前、后左室射血分数(LVEF)的水平。结果共6篇文献符合纳入标准,包括751例患者,其中治疗组376例、对照组375例。Meta分析结果显示,治疗组与对照组显效率和无效率间差异有统计学意义〔OR=2.03,95%CI(1.50,2.73),P<0.01;OR=0.26,95%CI(0.16,0.40),P<0.01〕,治疗组与对照组有效率间差异无统计学意义〔OR=1.05,95%CI(0.78,1.41),P=0.74〕。治疗组与对照组充血性心力衰竭患者治疗前LVEF间差异无统计学意义〔WMD=-0.17,95%CI(-1.10,0.77),P=0.72〕,治疗后差异有统计学意义〔WMD=10.87,95%CI(9.44,12.30),P<0.01〕。结论根据目前的文献结果,加入益气温阳、活血利水法的中医治疗心力衰竭是有效的,能提高显效率和LVEF,降低无效率,值得临床推广,但仍需多中心、大样本量、随访时间长的RCT以佐证。展开更多
基金Supported by the National Key Research and Development Program of China(Evidence-based Evaluation of TCM Key Syndrome Differentiation and Treatment for Acute Ischemic Stroke,No.2018YFC1705002)
文摘OBJECTIVE:To investigate the short-term efficacy and safety outcomes following a sequential treatment with clearing heat and eliminating phlegm(CHEP)formula and tonifying Qi and activating blood circulation(TQABC)formula in patients with acute ischemic stroke(AIS)within a 72 h time window.METHODS:In this randomized,multicenter,doubleblinded,placebo-controlled trial,500 participants will be randomly assigned in a ratio of 1∶1 to the CHEP+TQABC group or control group.In addition to guidelinebased standard medical care,participants in the treatment group will receive the CHEP formula for the first 5 consecutive days followed by the TQABC formula for another 10 consecutive days,while those in the control group will receive CHEP formula placebo and TQABC formula placebo consecutively.The primary outcome measure will be the comparison of the change in the National Institutes of Health Stroke Scale score from baseline to 15 days after randomization.The secondary outcome measures will include the scores on the modified Rankin Scale,Barthel Index,Patient-Reported Outcomes,TCM symptom pattern(Zheng-hou)evaluation Scale,and the incidence of in-hospital complications.Safety assessment will include the physical examination,laboratory detection,any adverse events or serious adverse events,and the proportion of any complications during hospitalization.DISCUSSION:The results of this study will provide objective and scientific data with which to assess the efficacy and safety of a sequential treatment based on“integrating disease and symptom pattern”for patients with AIS.
基金Supported by National Natural Science Foundation-funded Project:the Method of Establishing End Point Index Based on Principal Component Analysis Combined with Frequency Statistics for Evaluating TCM Efficacy(No.81373827)
文摘OBJECTIVE: To investigate the effects of tonifying Qi and activating blood circulation(SQABC), a method in Traditional Chinese Medicine(TCM), on end-point events in patients with myocardial infarction(MI) in this retrospective cohort study.METHODS: Clinical data were obtained from the medical records of patients with acute MI(AMI),both during hospitalization and follow-up, and included general demographic information(age, gender, and contact information), TCM regimens used,and end-point events.RESULTS: A total of 1596 patients with AMI were enrolled to this study, but data of only 1210 casesare accessible till follow-up. We classified the patients based on the exposure levels of SQABC.When comparing the results between all exposure and non-exposure groups, significant differences were identified, both during hospitalization and follow-ups. During hospitalization, cardiac death(4.40% vs 21.55%, P < 0.05) and cardiac shock(3.04% vs 11.62%, P < 0.05) were significantly lower in the exposure group than the non-exposure group. Similarly, during the follow-up, cardiac death(12.04% vs 20.49%, P < 0.05), acute heart failure(7.27% vs 11.81%, P < 0.05), composite endpoint of reinfarction and stroke(9.11% vs 15.28%,P < 0.05), and rehospitalization due to angina(25.49% vs 34.38%, P < 0.05) were significantly lower in the exposure group than the non-exposure group.CONCLUSION: Our findings suggest that SQABC can significantly benefits the subjects in the management of high-risk AMI in them.
文摘目的总结益气活血类方治疗心力衰竭临床研究的热点演变及研究不足,并且预测发展趋势。方法检索中国知网和Web of Science数据库(CNKI)建库至2022年11月1日期间有关益气活血类方治疗心力衰竭的相关临床研究文献,借助CiteSpace 6.1R4软件来完成文献研究作者、机构、关键词等可视化研究分析。结果1988—2022年有关益气活血类方治疗心力衰竭的文章整体呈波动上升趋势。发文最多的作者为张艳,辽宁中医药大学(含附属医院)、北京中医药大学(含附属医院)等机构的发文数量较多。根据高频关键词可知研究热点主要集中于证型(气虚血瘀等)、治法(益气活血、活血利水、益气温阳等)、疗效评价标准(心功能、生活质量、脑钠肽等)、合并疾病(冠心病等)。关键词突变、时间线图综合分析显示,益气活血类方治疗心力衰竭的治疗方式、评价标准都呈现多元化趋势。文献横向分析提示,目前临床报告规范仍存在较大的提升空间,疗效评价指标描述存在偏于主观等问题。结论益气活血类方治疗心力衰竭的相关临床研究领域,不同研究机构、团队间的合作仍需进一步加强,以便开展多中心大样本的高质量研究;心力衰竭的证型、治法、疗效评价标准以及合并疾病是目前的研究热点,但在临床报告规范方面仍有待完善,建议制定客观、科学的诊疗标准及报告规范,进一步探索中医或中西医结合治疗心力衰竭的临床优势。
基金supported by Beijing Key Laboratory of Traditional Chinese Medicine Pharmacologythe National Natural Science Foundation of China (No. 81873041)。
文摘Cerebral ischemia-reperfusion injury(CIRI) refers to a pathological phenomenon that aggravates the injury after the restoration of blood perfusion and oxygen supply to the cerebral ischemia-induced tissues and organs, with a relatively high incidence. The traditional Chinese medicine(TCM) believes that Qi deficiency and blood stasis are the cause of CIRI. Therefore, Chinese medicine for tonifying Qi and activating blood is regarded as an important choice for the treatment of CIRI. In recent years, it has been found that many Chinese herbal medical ingredients and compound Chinese medicine(CCM) have significant anti-CIRI effects, and their mechanisms of action mainly include improving brain blood supply, neuroprotection, regulating signal pathways such as TLR4/HO-1/Bcl-2, protecting mitochondrial function, regulating related protein levels, and regulating oxidative molecule levels. This article summarizes and introduces the pharmacological mechanisms of Tonifying-Qi and activating-blood Chinese medicine and CCM which have the function of anti-CIRI. Our goal is to provide effective reference for further researches on the cerebral protection of related TCMs or compounds and their clinical application.
文摘目的比较加入益气温阳、活血利水法的中医治疗与常规西药治疗慢性心力衰竭的临床疗效,为临床决策提供依据。方法采用Cochrane系统评价方法,计算机检索Medline、中国知网、万方数据库、维普期刊库、中国生物医学文献数据库中加入益气温阳、活血利水法的中医治疗慢性心力衰竭的随机对照试验(RCT)或半随机对照试验,采用Jadad评分量表评价纳入文献的质量,采用Rev Man 5.2软件进行Meta分析。比较加入益气温阳、活血利水法的中医治疗组(治疗组)与常规西药治疗组(对照组)的显效率、有效率、无效率及治疗前、后左室射血分数(LVEF)的水平。结果共6篇文献符合纳入标准,包括751例患者,其中治疗组376例、对照组375例。Meta分析结果显示,治疗组与对照组显效率和无效率间差异有统计学意义〔OR=2.03,95%CI(1.50,2.73),P<0.01;OR=0.26,95%CI(0.16,0.40),P<0.01〕,治疗组与对照组有效率间差异无统计学意义〔OR=1.05,95%CI(0.78,1.41),P=0.74〕。治疗组与对照组充血性心力衰竭患者治疗前LVEF间差异无统计学意义〔WMD=-0.17,95%CI(-1.10,0.77),P=0.72〕,治疗后差异有统计学意义〔WMD=10.87,95%CI(9.44,12.30),P<0.01〕。结论根据目前的文献结果,加入益气温阳、活血利水法的中医治疗心力衰竭是有效的,能提高显效率和LVEF,降低无效率,值得临床推广,但仍需多中心、大样本量、随访时间长的RCT以佐证。
