Clinical research report on traditional Chinese patent medicines and traditional Chinese classic famous prescriptions(2022)

Objective:The paper is to comprehensively summarize and analyze the basic situation and methodological quality of clinical randomized controlled trials(RCTs)of traditional Chinese patent medicines and traditional Chinese classic famous prescriptions published in 2022,to provide evidence and reasonable suggestions for the advancement of clinical research and the formulation of policies and guidelines.Methods:The Evidence Database System of clinical evidence-based evaluation of traditional Chinese medicine was searched,and data from China National Knowledge Infrastructure(CNKI),PubMed,and other databases were supplemented.The search duration was from January 1,2022,to December 31,2022.RCTs of traditional Chinese patent medicines and traditional Chinese classic famous prescriptions were included as the source of clinical evidence,and published information,sample size,intervention,control measures,treatment course,methodological quality,and key link report were analyzed and evaluated.Results:A total of 1,464 RCTs of traditional Chinese patent medicines were included,which comprised 667 types of traditional Chinese patent medicines;“traditional Chinese patent medicines+Western medicine vs.Western medicine”was the most widely used intervention and control setting,involving 417 RCTs(28.48%).A total of 245 RCTs of traditional Chinese classic famous prescriptions were included,comprising 55 types of traditional Chinese classic famous prescriptions.“Decoction+conventional treatment vs.conventional treatment”was the most widely used intervention and control setting,with 87 RCTs(35.51%).Published RCTs on traditional Chinese patent medicines and traditional Chinese classic famous prescriptions were limited by the study design and implementation.Most“allocation concealment”and“blinding of patients and personnel”were rated as medium to high risk.There are insufficient reports on key research links such as experimental registration and ethical approval.Conclusions:The number of RCTs on traditional Chinese patent medicines has decreased in 2022,but there has been a slight improvement in the research quality and impact.There are relatively few studies on traditional Chinese classic famous prescriptions.Measures must be taken to improve clinical trial design,implementation,and reporting.Methodological experts should be invited to provide professional technical guidance on the trial design.In the research implementation process,attention should be paid to quality control,particularly the standardization of the randomized execution.

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.

Reflections on Studying Huang Di Nei Jing in the West

Huang Di Nei Jing(《黄帝内经》The Yellow Emperor’s Inner Classic) has been the source text of Chinese medicine knowledge and innovation for over two thousand years. Despite this key relevance, many of its ideas and practices have proven difficult to understand and implement fully into clinical practice. Cultural and language differences can be compounded with these challenges but may also present new opportunities for advancement and insight when studied by researchers outside of the originating culture. This article introduces the method of Classical-Text Archaeology and delves into the author’s two-decade journey of researching this text, with a discussion on cultural differences and issues of medical scholarship.

Reception of Translated Classics of Traditional Chinese Medicine in the Spanish-speaking World:A Survey of Seven Spanish Versions of Huangdi Neijing(The Yellow Emperor’s Inner Classic)

Previous studies on translations of Huangdi Neijing(The Yellow Emperor’s Inner Classic)have focused on English versions;little attention has been given to non-English translations.The present study is the first investigation of the reception of the seven Spanish versions of Huangdi Neijing in terms of three parameters:collection records in libraries worldwide;book reviews and citation counts in international journals;and customer reviews on Amazon.The results revealed four features of Spanish translations and communication of Huangdi Neijing in terms of reception of academia,reception of general readers,the center of translation and communication,and the role of Chinese scholars.These factors demonstrate the marginal status of Spanish translations of traditional Chinese medicine(TCM)classics.The implications are summarized in hopes of promoting the translation and communication of TCM classics in the Spanish-speaking world and to provide insights into the communication of TCM culture in the non-English-speaking world.

The Importance of the Classics in the Transmission of Chinese Medicine to the West

This paper discusses the role of the classical texts(Neijing and Nanjing)in the transmission of Chinese medicine-in particular acupuncture-to the West.This is presented in the following sections:A short historical overview of acupuncture practice in the UK;Philosophy of health and nourishing life(Yang sheng养生);The body as a complex system;Mind-body connections and the future of medicine and the problem of qi(气).

China Association of Chinese Medicine Paper notice for seminar on clinical application of TCM classic prescriptions and herbs in the treatment of emotional diseases

Hosted by ChinaAssociation of Chinese Medicine,and organized by World Journal of Integrated traditional and western Medicine,seminar on clinical application of TCM classic prescriptions and herbs in the treatment of emotional diseaseis planned to be held in Yichang,Hubei province from June 22nd to 24th.

Clinical application of traditional herbal medicine in five countries and regions: Japan;South Korea;China's Mainland;Hong Kong, China;Taiwan, China

Objective:To study the characteristics of the clinical application of traditional herbal medicine in five countries and regions where traditional medicine(TM)is widely used:Japan;South Korea;China's Mainland;Hong Kong,China;Taiwan,China.And to analyze,from multiple angles,the variations in the methods of TM used in each countries and regions.Methods:Fifty commonly used traditional herbs(TOP50)from classical formulae were selected,and descriptive statistics,correlation analyses,and Friedman test were used to compare methods of clinical application and dosages in the countries and regions of interest based on a retrospective review of randomly-selected medical records.Results:There were significant differences in sequencing TOP50 among the five countries and regions(P<.01).The adherence to the classical formulae,from strong to weak was Japan;China's Mainland;Taiwan,China;Hong Kong,China;South Korea.There were also significant differences in TOP50 dosing regimens(P<.01).Overall dosages of TOP50 from high to low were:China's Mainland;Hong Kong,China;Taiwan,China;South Korea;Japan.Finally,there were significant differences in the dosage intervals(P<.01),with dosage intervals from maximum to minimum as follows:China's Mainland;Taiwan,China;Hong Kong,China;South Korea;Japan.Conclusions:The clinical dosages of traditional herbal medicine used in the China's Mainland are relatively large compared with those prescribed in the other four countries and regions,and the range of dosages in China's Mainland is more flexible.On the other hand,clinical dosages of TOP50 are the lowest in Japan,where the dosage range is also the narrowest,supporting the idea that Doctors of Kampo medicine are highly cautious and are likely to adhere strictly to classical formulae,while Hong Kong,China and Taiwan,China are in the middle.The dosage of TOP50 in South Korea is significantly lower than that used in the China's Mainland;Hong Kong,China and Taiwan,China where the adherence to the classical formulae was the lowest,albeit slightly higher than that in Japan.The methods of clinical application of traditional herbal medicine in the five countries and regions were affected by multiple factors,including history,geography,climate,and culture.

Research on Herb Pairs of Classical Formulae of ZHANG ZhongJing Using Big Data Technology

Objective To analyze various herbal combinations in Treatise on Exogenous Febrile Diseases(Shang Han Lun,《伤寒论》)and Synopsis of Prescriptions of the Golden Chamber(Jin Gui Yao Lve,《金匮要略》),seeking to identify fundamental rules dictating the selection of herbal combinations through probability models and big data technology.Methods A total of 252 formulae were collected from Treatise on Exogenous Febrile Diseases(Shang Han Lun,《伤寒论》)and Synopsis of Prescriptions of the Golden Chamber(Jin Gui Yao Lve,《金匮要略》)by ZHANG Zhong-Jing.Formulae were then preprocessed with all herb names standardized.The concepts of candidate herb pair and candidate herb pair probability were proposed to analyze the rules of combinations in classical formulae based on probability statistics.MapReduce parallel computing framework of distributed big data technology was adopted to analyze large data samples combined with inverted index algorithm.Results The results showed that the core herbs were Glycyrrhizae Radix Rhizoma(Gan Cao,甘草),Cinnamomi Ramulus(Gui Zhi,桂枝),Zingiberis Rhizoma Recens(Sheng Jiang,生姜),Jujubae Fructus(Da Zao,大枣),Paeoniae Radix Alba(Bai Shao,白芍),etc.43 high-frequency pairs co-occurring 10 times or above were extracted,and 35 of these combinations were recognized as traditional herb pairs,such as Cinnamomi Ramulus(Gui Zhi,桂枝)-Glycyrrhizae Radix Rhizoma(Gan Cao,甘草),Zingiberis Rhizoma Recens(Sheng Jiang,生姜)-Jujubae Fructus(Da Zao,大枣),and Cinnamomi Ramulus(Gui Zhi,桂枝)-Ginseng Radix Et Rhizoma(Ren Shen,人参).The other 8 pairs of combinations,such as Paeoniae Radix Alba(Bai Shao,白芍)-Zingiberis Rhizoma Recens(Sheng Jiang,生姜),Paeoniae Radix Alba(Bai Shao,白芍)-Jujubae Fructus(Da Zao,大枣),and Zingiberis Rhizoma Recens(Sheng Jiang,生姜)-Ginseng Radix Et Rhizoma(Ren Shen,人参),were not defined traditionally,but in connection with commonly used herbs.Classical formulae took the core herbs as principles,focusing on tonifying deficiency,strengthening the spleen and the stomach,strengthening the healthy Qi,and eliminating pathogenic factors.The compatibility pattern of properties involved was mainly acrid and sweet,which reflected the compatibility laws of benefiting Qi and tonifying Yang,replenishing Qi and nourishing blood,etc.Conclusions The research of classical formulae provides common understanding of some basic rules that have been adopted to tackle common illnesses/diseases using herbal medicine.The results help to reinforce theoretical understanding and development of traditional Chinese medicine(TCM),and revealing the hidden rules of combination in TCM data.Analyzing wider data samples of various herbal combinations through computation and big data technology can further optimize the use of TCM.

Historical Legacy of Traditional Chinese Medicine Education in Canada:The Case of Henry C.Lu

This article begins with a review of the publications by Dr.Henry C.Lu,a Canadian-Chinese traditional Chinese medicine(TCM)scholar,educator and writer,and founder of a Vancouver-based TCM college.Dr.Lu has translated many TCM classics and written books extensively on TCM education,TCM clinical practice and Mandarin-Chinese grammar.Aside from his widespread prominence as one of the representative English translators of Huangdi Neijing(The Yellow Emperor’s Inner Classic),Dr.Lu is also noted for his pioneering role in the promotion of TCM education in British Columbia,where he lived and worked for more than half of his life.By making references to and drawing lessons from Dr.Lu’s four-decade-long efforts to help TCM gain legal status and to promote wider application of TCM in Canada,this article also puts forth suggestions for overseas TCM education and international TCM standards for building a global community with a shared future.

Research and Analysis on the Origin of the Term“Xinche”in Traditional Chinese Medicine and Its Translation

Translating the terminology of traditional Chinese medicine(Thereafter referred to as TCM)is the core of translating TCM culture.By analyzing the connotation and denotation of the word“Xinche”(心掣)in Huangdi Neijing(Yellow Emperor’s Canon of Medicine),the earliest existing TCM classic,and by comparing different English translations of the term“Xinche,”we hope to provide certain reference for the standardization of TCM terminology and to share some ideas for the translation of TCM classics.

Historical Evolution of Traditional Medicine in Japan

Traditional Japanese Medicine originated from traditional Chinese medicine and was first introduced to Japan directly from the mainland of China or the Korean Peninsula.After its dissemination,integration,adaption,and development in Japan for generations,it had evolved into Kampo medicine with Japanese characteristics and taken a leading role in Japanese medical practice.In history,there appeared successively schools such as Followers of Later Developments in Medicine,Followers of Classic Methods,Integrated School,and School of Textual Research.Alter Meiji Restoration,Kampo medicine experienced a tremendous impact by western medicine.However after World War II,with unremitting endeavors from learned scholars,traditional Japanese medicinje was revived again.

中医经典与临床病例结合的教学方式在中医肿瘤科临床教学实践中的应用效果

目的探讨中医经典与临床病例结合的教学方式在中医肿瘤科临床教学实践中的应用效果。方法选择2021年5月至2022年3月每个周期来上海中医药大学附属普陀医院中医肿瘤科学习的108名医师为研究对象,根据教学方法的不同将其分为常规教学组和经典教学组,各54名。以肿瘤常见病症为课程试验对象,常规教学组应用常规内科学教学方式,经典教学组应用中医经典与临床病例结合的教学方式。比较两组的教学效果。结果经典教学组学生的学习主动性、临床思维能力、自主学习能力、小组合作学习能力及探究学习能力评分均高于常规教学组(P<0.05)。经典教学组学生对病症认识、中西医关联理解、方药认识、经典医籍认识、经典医籍兴趣、论文写作启发的熟悉度高于常规教学组(P<0.05);经典教学组教师对教学方法的熟悉度高于常规教学组(P<0.05)。结论中医经典与临床病例结合的教学方式在中医肿瘤科临床教学实践中的应用效果良好。

基于培养学生中医思维目标的经典课程教学方法探讨

中医思维体现和影响着中医人的素质和修养,是成就高水平中医师的一个不可或缺的重要因素。在“健康中国”国家战略方针的指导之下,随着“新医科”的建设与实施,中医思维成为新时代中医学人才必备的关键能力。因此,如何培养和构建中医学生的中医思维能力成为中医药高等教育质量内涵建设的重要课题之一。基于此,文章将从渗透传统文化、“点破”思维方法、重视思维训练三个方面略谈在经典课程教学中的一些粗浅体会,以供同道参考。

基于经典名方开发研究的中医药传承创新型人才培养思路探讨

经典名方是中医药学知识体系的重要组成部分,中医药传承创新型人才的培养是中医药绵延发展的重要基石,两者相互融合。文章从经典名方的内涵解读、研究开发、中医药传承与创新理论内涵的解读、人才培养及两者的融合发展3个方面进行综述,以期采用师承教育、院校教学、科研教学等方式将经典名方的开发研究反哺于教学,为培养中医药传承创新型人才添砖加瓦。

《神农本草经》与《中国药典》2020年版对中药四气五味表述异同分析

目的明确《神农本草经》与现代中药四气五味表述的差异,为进一步指导临床合理用药提供参考。方法以《神农本草经》收载的365种中药为来源进行统计,《中国药典》2020年版和《临床用药须知》(2015版)收录《神农本草经》记载的药物为研究对象,建立数据库,对比分析中药“四气”“五味”的表述差异。结果本研究共统计203种中药,其中中药四气表述完全不相同的有66种,占32.51%;中药五味表述完全不一致的有20种,占9.85%。结论通过对比《中国药典》《临床用药须知》与《神农本草经》中药“四气”“五味”,大部分中药表述一致,表述不一致的中药值得进一步深入研究。

治疗病毒性肺炎的古方配伍特征分析研究

目的利用关联规则算法,探索治疗病毒性肺炎古方中的单味药频次及药物之间配伍特征。方法利用中国中医科学院中医药信息研究所“中医古方数据库”,检索治疗病毒性肺炎相关古方,得到985首方剂,去除与本次检索目的无关方剂,最终纳入749首方剂进行分析。采用Excel 2016建立数据表,并对单味药进行统计、药物配伍、关联规则分析及聚类分析。筛选时间为建库至2023年10月。结果收集方剂中共涉及290味药,筛选出在治疗病毒性肺炎古方中出现频次≥50次的药物,共有43味药,对其中高频单味药进行统计得出:⑴从药性角度分析,温性药18味、出现1773次,寒性药16味、出现1226次,各占药性频次总数的43.33%和29.96%;⑵从药味角度分析,辛味药18味、出现2268次,苦味药22味、出现2013次,甘味药17味、出现1681次,各占药味频次总数的35.55%、31.55%和26.35%;⑶从归经角度分析,归肺经药26味、出现2501次,归脾经药23味、出现2447次,归胃经药18味、出现1587次,归心经药14味、出现1324次,各占归经频次总数的21.45%、20.99%、13.61%和11.36%;⑷从功效角度分析,解表药12味、出现2501次,补虚药7味、出现827次,清热药9味、出现662次,各占功效频次总数的27.59%、20.21%和16.18%。治疗病毒性肺炎古方中药物关联规则结果显示,重要性高的3个药物组合分别为“苦杏仁、石膏、麻黄”“金银花、甘草、连翘”“草果、藿香、厚朴”。结论治疗病毒性肺炎古方中,药物多偏于温辛、寒苦、寒甘等,入肺、脾、胃经,以清热解毒、宣肺透邪为基本治则。

马晓燕撷经典方剂治疗内科杂病经验浅谈

郁证的主要临床表现为情绪抑郁不宁、心胸满闷、胸部以及胁肋部胀痛,或有善哭易怒,亦或咽中如有炙脔等不适。相当于现代医学中的神经衰弱、癔症及焦虑症等。常因喜怒忧思,郁滞不舒,而导致肝疏泄功能失职,脾脏失其健运之功,心失其养,脏腑、气血、阴阳功能紊乱;而消渴常因禀赋不足亦或是饮食不节等因素导致阴津亏损,燥热偏盛,而出现“三多一少”的症状,即多饮、多尿、多食以及形体消瘦,相当于现代医学的“糖尿病”。马教授投身于对于郁证和消渴的证候及治疗的研究,熟读经典、精求古训,并且在长期的诊疗疾病过程中,对于使用经典方剂加减化裁辨治郁证和消渴等内科杂病积累了丰富的临床经验。现撷马教授以经典方剂治疗郁证和消渴等内科杂病的经验作总结与探析。其临床疗效确切。

温经汤对大鼠子宫内膜异位症SPARC介导的上皮-间质转化的影响

目的探讨温经汤对子宫内膜异位症(EMT)大鼠模型富含半胱氨酸的酸性分泌蛋白(SPARC)介导的上皮-间质转化的影响。方法采用手术自体移植子宫内膜块法建立EMT大鼠模型,将建模成功的40只大鼠随机分为模型组(给予质量分数为0.9%的氯化钠溶液10 mL/kg)、孕三烯酮组(给予孕三烯酮溶液0.5 mg/kg)以及温经汤低、中、高剂量组(分别给予温经汤免煎颗粒剂8.19 g/kg、16.38 g/kg、32.76 g/kg),每组各8只,另取7只未手术大鼠作为正常对照组(给予质量分数为0.9%的氯化钠溶液10 mL/kg)。所有大鼠均连续灌胃给药3周后进行取材。腹主动脉取血,采用酶联免疫吸附试验(ELISA)法检测血清中SPARC水平。电子游标卡尺测量异位病灶体积,计算生长抑制率。取下异位病灶组织(正常对照组取下双侧子宫组织)采用免疫组织化学法检测内膜组织中SPARC、锌指转录因子(Snail)、E-钙黏蛋白(E-cadherin)和波形蛋白(Vimentin)的表达,采用Western blot法和RT-qPCR法测定内膜组织中上述因子的蛋白和mRNA相对表达量。结果各治疗组异位病灶的生长抑制率与模型组比较差异均有统计学意义(P<0.05)。与正常对照组比较,模型组血清中SPARC水平显著升高(P<0.05),各治疗组血清中SPARC水平均明显低于模型组(P<0.05)。模型组异位内膜中SPARC、Snail、Vimentin呈高表达,E-cadherin呈低表达,经温经汤治疗后,异位内膜中SPARC、Snail、Vimentin的阳性表达减少,E-cadherin的阳性表达增加。温经汤中、高剂量组和孕三烯酮组异位内膜中SPARC、Snail、Vimentin的蛋白相对表达量均明显低于模型组(P<0.05),E-cadherin的蛋白相对表达量显著高于模型组(P<0.05)。温经汤高剂量组和孕三烯酮组异位内膜中Snail、Vimentin mRNA相对表达量均较模型组显著降低(P<0.05),E-cadherin mRNA相对表达量明显高于模型组(P<0.05)。结论温经汤可以降低EMT大鼠模型血清中SPARC水平,下调异位内膜中SPARC、Snail、Vimentin蛋白和mRNA表达,升高异位内膜中E-cadherin蛋白和mRNA表达,通过调控SPARC介导的上皮-间质转化,从而抑制异位内膜病灶的生长。

中医经典实践技能实训教学模式探索

中医经典著作是中医学思想精华的集中呈现和整体学术发展的基石。在教学实践中针对首都医科大学中医学专业本科生经典教学过程中存在的问题,开设了中医经典实践技能实训创新课程,通过构建虚拟仿真平台、运用PBL教学、模拟标准患者诊疗等,线上线下多种教学方法并举开展教学,旨在培养学生中医思维,提高学生临床辨证综合能力、拓展临床思路。

仙方活命饮治疗囊性中性粒细胞性肉芽肿性乳腺炎热毒证的临床疗效及机制探讨

目的观察仙方活命饮对囊性中性粒细胞性肉芽肿性乳腺炎(CNGM)热毒证患者的临床疗效及潜在作用机制。方法将72例CNGM热毒证患者随机分为对照组与试验组,每组各36例;试验组予仙方活命饮口服治疗,对照组予左氧氟沙星口服治疗,两组疗程均为14 d。观察比较疾病活动指数、疾病活动度、肿块大小、疼痛数字分级评分法(NRS)评分、炎症指标的变化。免疫荧光法检测乳腺组织内中性粒细胞胞外诱捕网(NETs)标志物瓜氨酸化组蛋白H3(CitH3)、髄过氧化物酶(MPO)含量的变化。结果①试验过程中,对照组脱落2例,试验组剔除1例、脱落2例,最终完成试验者67例,其中对照组34例、试验组33例。完成14d药物治疗后进一步接受手术治疗者共40例,其中对照组22例、试验组18例,每组随机选取5例纳入NETs形成相关指标机制分析。②局部症状活动指数,治疗前后组内比较,对照组疼痛活动指数降低(P<0.05),脓肿活动指数升高(P<0.05);试验组肿块、疼痛、红热活动指数均降低(P<0.05)。组间治疗后比较,试验组肿块、疼痛、红热活动指数低于对照组(P<0.05)。③全身症状活动指数,治疗前后组内比较,对照组发热活动指数降低(P<0.05),试验组发热、其他相关炎症症状活动指数降低(P<0.05)。组间治疗后比较,两组各项全身症状活动指数比较,差异无统计学意义(P>0.05)。④疾病活动指数,治疗前后组内比较,对照组全身症状活动指数、疾病活动指数下降(P<0.05),试验组局部、全身症状活动指数及疾病活动指数均下降(P<0.05)。组间治疗后比较,试验组局部症状活动指数、疾病活动指数低于对照组(P<0.05)。⑤治疗后,两组高活动度例数减少、低活动度及中活动度例数增多,其中试验组高活动度比例从78.8%下降到36.4%;两组疾病活动度分布情况比较,试验组优于对照组(P<0.05)。⑥治疗后,试验组肿块变小(P<0.05),对照组肿块大小无明显变化(P>0.05);两组疼痛NRS评分均降低(P<0.05),且试验组低于对照组(P<0.05)。⑦治疗前后组内比较,试验组红细胞沉降率水平降低(P<0.05),对照组白细胞、中性粒细胞水平降低(P<0.05);组间治疗后比较,两组各项炎症指标比较,差异无统计学意义(P>0.05)。⑧治疗后,两组CitH3的光密度(IOD)、面密度(AD)值均下降(P<0.05),且试验组低于对照组(P<0.05);试验组MPO的IOD、AD值下降(P<0.05),且试验组低于对照组(P<0.05)。结论仙方活命饮能改善CNGM热毒证患者乳房局部炎症症状,降低疾病活动度,在局部症状改善方面疗效优于左氧氟沙星,在全身症状改善方面疗效与左氧氟沙星相当;其可能通过清除乳腺炎症组织中过量产生的NETs发挥疗效。