Comprehensive Rehabilitation Therapy of Traditional Chinese Medicine Combined with Modern Rehabilitation Training Improves the Spasticity and Motor Function of Hemiplegia after Stroke

Objective:To analyze the impact of comprehensive rehabilitation therapy of traditional Chinese medicine(TCM)(based on modern rehabilitation training)on the spasticity and motor function in stroke patients with hemiplegia.Methods:Seventy-nine stroke and hemiplegia patients admitted to the hospital from June 2021 to June 2023 were selected and randomly divided into a control group(39 cases)using modern rehabilitation training,and an observation group combined with comprehensive TCM rehabilitation therapy(40 cases),over 1 month.The clinical index data of the two groups were compared.Results:There were differences in the clinical index data between the two groups.The total effective rate after 2 treatment in the observation group(92.50%)was higher than that of the control group(74.36%)(χ^(2)=4.727,P<0.05).All central sensitization inventory(CSI)and stroke quality of life(PRO)scores in both groups were lower after treatment,with the observation group having lower scores as compared to the control group(P<0.05).The scores of FMA(upper limbs,lower limbs),Barthel index scores,and Functional Ambulation Categories(FAC)scores of both groups increased after treatment,with the observation group having higher scores as compared to the control group(P<0.05).Conclusion:Comprehensive TCM rehabilitation therapy had a significant therapeutic effect on patients with hemiplegia after stroke.It improved the patient’s spasticity,limb movement,and walking function.Their daily living abilities and quality of life were also enhanced.

Chinese herbal medicine for the treatment of endocrine therapyrelated osteoporosis among patients with breast cancer:A systematic review and meta-analysis

Objective:To assess the efficacy and safety of combining traditional Chinese medicine(TCM),specifically Chinese herbal medicine(CHM),with Western medicine(WM),compared to WM alone to treat breast cancer endocrine therapy-related osteoporosis(BCET-OP)by meta-analysis.Methods:Thirty-eight randomized controlled trials involving 2170 participants were analyzed.Eight databases were searched for articles published between inception and December 2023.Quality assessment was performed using the Risk of Bias 2 tool.Results:Significant increases were observed in the TCM-WM group in lumbar vertebrae bone mineral density(BMD)(P<.001,mean difference(MD)=0.07,95%confidence interval(CI):0.06 to 0.08),lumbar vertebrae T-score(P=.0005,MD=0.21,95%CI:0.09 to 0.33)and collum femoris BMD(P=.01,MD=0.10,95%CI:0.02 to 0.19).No significant difference was observed between the groups in the collum femoris T-score and estradiol levels.Bone gla-protein levels were significantly increased in the TCM-WM group(P=.0002,MD=0.52,95%CI:0.25 to 0.79).Beta-CrossLaps decreased significantly in the TCM-WM group(P=.0008,MD=−0.10,95%CI:−0.16 to−0.04).No significant difference was observed between the TCM-WM and WM groups in alkaline phosphatase,in procollagen type I N-terminal propeptide,and in the Kupperman index.The visual analog score(VAS)was decreased in the TCM-WM group compared to the WM group(P<.001,MD=−1.40,95%CI:−1.94 to−0.87).No significant difference in adverse events was observed between the two groups.Conclusion:Combining CHM with WM in patients with BCET-OP significantly improved BMD,T-score,and certain bone turnover markers and reduced the VAS score,indicating potential benefits for bone health and related pain.Adverse event analysis revealed no differences between the groups,supporting the feasibility of the combination therapy.However,further research,particularly in diverse populations,is required.

Research Progress in the Treatment of Poststroke Depression with Traditional Chinese Medicine

In recent years,the incidence rate of stroke has increased year by year.Post stroke depres‐sion is one of its main complications,which seriously affects the recovery of physiological functions and quality of life of stroke patients.Traditional Chinese medicine has signifi‐cant therapeutic effects in treating this disease.This article provides a classification and review of traditional Chinese medicine treatment methods for post-stroke depression,and looks forward to the current problems.

Mechanism of traditional Chinese medicine in the treatment of psoriasis with depression:A review

Psoriasis is a kind of immune-mediated, chronic, inflammatory skin disease, which is often associated with different degrees of psychological disorders. Specifically, there is a significant correlation between psoriasis and depression, and they show the relationships of reciprocal causation and mutual promotion. Psoriasis with depression is more harmful than simple psoriasis, and its prognosis is worse, which brings a huge burden to the family and society and is worthy of clinical attention. Based on the pathogenic factors of western medicine and pathogenesis of traditional Chinese medicine in psoriasis with depression, the paper summarized and elaborated the research progress on the mechanism of traditional Chinese medicine in the treatment of psoriasis with depression, in order to provide new ideas for clinical treatment.

Advances in the management of arteriosclerosis of the lower extremity:Integrating Western and Chinese medicine approaches

This editorial provides a commentary on the recent article.The paper reviews current literature and explores innovative treatment strategies for lower extremity arteriosclerosis obliterans(LEASO)through an integrative approach.It highlights the effectiveness of combination therapies that merge traditional Chinese medicine(TCM)with Western medical practices,suggesting that such integrative methods may improve patient compliance and outcomes through personalized care.This paper stresses the importance of rigorous clinical trials to evaluate the efficacy and safety of TCM interventions within LEASO treatment protocols,advocating for evidence-based validation of these combined therapies.Our recommendations emphasize accurate diagnosis,appropriate pharmacological in-terventions,the use of advanced surgical and endovascular techniques,and the inclusion of TCM to address underlying dysfunctions.Additionally,continuous monitoring,patient education,and lifestyle modifications are essential to slow disease progression and achieve optimal patient outcomes.The paper concludes by calling for further research to develop standardized treatment protocols that effectively integrate both Western and Chinese medical approaches in managing LEASO.

Enhancing ulcerative colitis treatment with traditional Chinese medicine

Inflammatory bowel disease,particularly ulcerative colitis(UC),poses significant treatment challenges due to its chronic nature and potential for severe complications.This editorial reviews a recent network meta-analysis that evaluated the efficacy of and highlighted the superior outcomes achieved by combining each of five traditional Chinese medicine(TCM)formulations with mesalazine for the adjuvant treatment of UC.Clinical outcomes included enhanced mucosal healing,improved quality of life,and reduced recurrence rates.Additionally,the combination therapy resulted in a lower incidence of adverse reactions compared with mesalazine monotherapy.Despite these promising results,limitations such as variability in study quality and TCM dosage highlight the need for further highquality,large-sample,multicenter randomized controlled trials.This editorial underscores the potential of TCM in enhancing UC management and calls for more rigorous research to substantiate these findings and refine clinical guidelines.

Research Progress on Prevention and Treatment of Diabetes with Traditional Chinese Medicine Based on Intestinal Flora

In recent years,the World Health Organization has proposed the concept that only intes‐tinal health can lead to longevity.It can be seen that gut microbiota plays an important role in maintaining human health,and gut microbiota has become a hot topic in medical research.With the change of Chinese residents'lifestyle,the incidence rate of diabetes is increasing rapidly.Research shows that the incidence of diabetes is closely related to intestinal flora imbalance.Traditional Chinese medicine can reduce blood sugar and improve clinical symptoms by regulating intestinal flora.Based on the theory of tradi‐tional Chinese medicine,this paper discusses the etiology and pathogenesis of intestinal flora imbalance,and provides a theoretical basis for traditional Chinese medicine to regu‐late intestinal flora to prevent and treat diabetes.Intestinal flora is a complex ecosystem,which plays an important role in maintaining human health.The imbalance of intestinal flora may lead to the occurrence of diabetes.The dynamic balance of gut microbiota is closely related to the kidneys,spleen,liver,and lungs.Traditional Chinese medicine monomer and compound can prevent and cure diabetes by regulating intestinal flora.

An investigation of the influence of intestinal flora in external traditional Chinese medicine therapy

External therapy,which has been used for millennia to treat disease,has now become the newest member of complementary and alternative therapies.A growing number of clinical studies and animal experiments have shown that external therapy exerts a positive effect on the intestinal flora.In this paper,we review the research related to external therapy on various systemic diseases and focus on changes in the intestinal flora.We found that studies on external therapy are dominated by acupuncture and tuina,primarily aimed at the treatment of digestive and neurological diseases.However,the deeper mechanism of regulation of the intestinal flora by external therapy has not yet been experimentally confirmed.

Machine learning models for stroke detection by observing the eye-movement features under five-color visual stimuli in traditional Chinese medicine

Objective:To develop a novel diagnostic modality to identify and diagnose stroke in daily life scenarios for improving the therapeutic effects and prognoses of patients.Methods:In this study,16 stroke patients and 24 age-matched healthy participants as controls were recruited for comparative analysis.Leveraging a portable eye-tracking device and integrating traditional Chinese medicine theory with modern color psychology principles,we recorded the eye movement signals and calculated eye movement features.Meanwhile,the stroke recognition models based on eye movement features were further trained by using random forest(RF),k-nearest neighbors(KNN),decision tree(DT),gradient boosting classifier(GBC),XGBoost,and CatBoost.Results:The stroke group and the healthy group showed significant differences in some eye movement features(P<.05).The models trained based on eye movement characteristics had good performances in recognizing stroke individuals,with accuracies ranging from 77.40%to 88.45%.Under the red stimulus,the eye movement model trained by RF became the best machine learning model with a recall of 84.65%,a precision of 86.48%,a F1 score of 85.47%.Among the six algorithms,RF and CatBoost performed better in classification.Conclusion:This study pioneers the application of traditional Chinese medicine's five-color stimuli to visual observation tasks.On the basis of the combined design,the eye-movement models can accurately identify stroke,and the developed high-performance models may be used in daily life scenarios.

Systematic review and meta-analysis of endometrial thickening during endocrine therapy combined with Chinese herbal medicine intervention after breast cancer surgery

Objective:To systematically evaluate the endometrial thickening and Chinese herbal medicine intervention effects during endocrine therapy following breast cancer surgery.Methods:Computerized searches were performed on CNKI,CBM,Wanfang,VIP,Pub Med,Embase,and Cochrane to gather randomized controlled trials(RCTs)of endometrial thickening combined with Chinese herbal medicine intervention during endocrine therapy after breast cancer surgery.The meta analysis is done using Rev Man 5.4,and the retrieval range is from the database's creation to January 2023.Results:There were 710 patients enrolled in a total of 12 RCTs.The results of Meta-analysis were as follows:combined with Chinese herbal medicine treatment for 3 months of endometrial thickness(MD=-1.12,95%CI[-1.47,0.77],P<0.00001);6 months endometrial thickness(MD=-1.90,95%CI[-2.38,-1.42],P<0.00001);endometrial thickness at 12 months(MD=-2.24,95%CI[-2.96,-1.52],P<0.00001);modified Kupperman score(MD=-10.45,95%CI[-19.10,-1.80],P=0.02);TCM syndrome score(SMD=-1.53,95%CI[-1.84,-1.22],P<0.00001);KPS score(MD=3.75,95%CI[2.81,4.68],P<0.00001);there was no significant difference in CA153,CEA,FSH and E2 between the two groups.Conclusion:After breast cancer surgery,endocrine therapy combined with Chinese herbal medicine can significantly lessen endometrial thickening and enhance patient quality of life.

Inhibiting the formation of neutrophil extracellular trapping: a potential mechanism of Chinese medicine in the treatment of ischemic stroke

Ischemic stroke(IS)is the main killer that endangers the health and life of middle-aged and elderly people worldwide.Inflammatory response plays a key regulatory role in the pathogenesis of IS.After cerebral ischemia,leukocytes rapidly accumulate,penetrate blood vessels and infiltrate brain tissue,thereby activating pro-inflammatory factors in the infarct area to exacerbate nerve damage.Neutrophil extracellular traps(NETs)are fibrous mesh structures released by activated neutrophils outside the cell,which can clear pathogens and cell debris,induce inflammatory responses and exacerbate cerebral ischemia-reperfusion(CI/R)injury.Various traditional Chinese medicines and their main components can improve neurological function defects after IS,and inhibit the formation of NETs,which opens up a new direction for the study of traditional Chinese medicines in the prevention and treatment of IS.

Effect of different therapies of Chinese medicine on the expressions of c-Fos and c-Jun proteins in hippocampus of rats with post-stroke depression

BACKGROUND ： c-fos and c-jun, the important immediate early genes （IEG）, are regarded as the markers for the location and function of neuronal activity, as well as the third signal messengers, they couple the stress stimulation and the gene expression in neuron, and hippocampus is involved in the process of signal transmission after stress stimulation induced depression. OBJECTIVE： To observe the therapeutic effects of Bushen Yiqi （tonifying kidney to benefit qi）, Huoxue Huayu （promoting blood circulation to dissipate blood stasis） and Ditan Kaiqiao （eliminating phlegm for resuscitation） on the expressions of c-Fos and c-Jun proteins in hippocampus and spontaneous behaviors of rats with post-stroke depression （PSD）, and compare the results with those of fluoxetine, which is known to have definite effect on depression. DESIGN： A randomized controlled tna SETTING ： Zhejiang College of Traditional Chinese Medicine MATERIALS ： The trial was completed in Zhejiang College of Traditional Chinese Medicine from January to July in 2003. Fifty-six healthy adult Wistar male rats of clean grade, weighing （250±50） g, were randomly divided into 7 groups with 8 rats in each group： control group, model group, forced swimming group, Bushen Yiqi group; Huoxue Huayu, Ditan Kaiqiao group and fluoxetine group. The Bushen Yiqi Tang contained Renshen, Huangqi, Heshouwu, Gouqi, Shudi, etc., crude drugs 1 800 g/L. The Huoxue Huayu Tang contained Danshen, Chuanxiong, Chishao, Yujin, etc., crude drugs 3 600 g/L. The Ditan Kaiqiao Tang contained Banxia, Danxing, Changpu, Yuanzhi, etc., crude drug 1 000 g/b METHODS： ① Except the control group and forced swimming group, rats in the other groups were made into PSD models by deligating the bilateral common carotid artedes permanently. ② Rats in the control group, model group and forced swimming group were intragastncally perfused by saline （3 mL for each time）; those in the Bushen Yiqi group, Huoxue Huayu, Ditan Kaiqiao group and fluoxetine group were intragastncally perfused with Bushen Yiqi Tang （18 g/kg）, Huoxue Huayu Tang （9 g/kg）, Ditan Kaiqiao Tang （9 g/kg） and fluoxetine （2.5 mg/kg） respectively, once a day. ③ At 55 days after model establishment, rats in the forced swimming group were managed according to the Porsolt＇s method. They were placed in water for 15 minutes, and then taken out and dned, no moving-time within 5 minutes was recorded at drying and 24 hours after drying. ④ Measurement of spontaneous behaviors： Except the forced swimming group, the spontaneous behaviors and activities （including horizontal and vertical movements） of rats were observed with the Open-Field method at 28, 42 and 56 days after administration in the other groups. ⑤ The expressions of c-Fos and coJun proteins in hippocampus were determined with the immunohistochemical method, the relative sectional area ratio and average objective gray value of c-Fos and c-Jun positive cells in hip- pocampus were measured with the computerized image analytical system. MAIN OUTCOME MEASURES： The spontaneous behaviors of rats, the relative sectional area ratio and average objective gray value of c-Fos and c-Jun positive cells in hippocampus were observed. RESULTS： Of the 56 rats, 1 died in the forced swimming group, and finally 55 rats were involved in the analysis of results. ① Results of spontaneous activities： At 28 days, the times of crossing movements were obviously fewer in the model group and fluoxetine group [（69.00±37.01）, （98.11 ±36.68） times/3 minutes] than in the control group [（128.44±16.85） times/3 minutes, P 〈 0.01, 0.05], but those in the Bushen Yiqi group, Huoxue Quyu group and Ditan Kaiqiao group had no obvious differences as compared with those in the control group （P 〉 0.05）. At 42 and 56 days, the times of crossing movements were obviously more in the Bushen Yiqi group, Huoxue Quyu group and Ditan Kaiqiao group [（106.44±31.24）, （117.20±23.95）, （134.80±28.18）, （136.36±40.95） times/3 minutes; （117.33±35.91）, （129.60 ±23.78）, （131.90 ±26.81）, （136.09±28.34） times/3 minutes] than in the model group [（64.00±17.51）, （72.86±20.68） times/3 minutes, P 〈 0.01]. The times of rearing movements had no obvious differences among the groups for the three times （P 〉 0.05）. ② The no moving-time within 5 minutes 24 hours after drying was obviously longer than that at drying in the forced swimming group. ③ The average objective gray values of c-Fos positive cells were not obviously different in the Bushen Yiqi group and Ditan Kaiqiao group from the control group （P 〉 0.05）, but lower in the model group than in the control group （69.84±9.82, 75.78±5.89, P 〈 0.01）, and higher in the forced swimming group than in the control group （85.97±10.99, P 〈 0.01）; all higher in the fluoxetine group, Bushen Yiqi group, Huoxue Quyu group and Ditan Kaiqiao group than in the model group （81.27±10.73, 74.04±8.34, 83.29±9.89, 70.14±4.92, P 〈 0.05-0.01）. The average objective gray values of c-Jun positive cells were obviously lower in the Bushen Yiqi group than in the control group （68.11 ±6.89, 79.58±5.86, P 〈 0.01）, but all higher in the other groups than in the control group （84.68±7.15, 81.34 ±8.36, 97.51±10.55, 85.68±9.25, 86.19±10.98, P 〈 0.05-0.01）; Those were obviously higher in the fluoxetine group, Huoxue Quyu group and Ditan Kaiqiao group than in the model group （P 〈 0.05-0.01 ）, lower in the Bushen Yiqi group than in the model group （P 〈 0.05）, all obviously lower in the Bushen Yiqi group, Huoxue Quyu group and Ditan Kaiqiao group than in the fluoxetine group （P 〈 0.01）. The relative sectional area ratios of c-Fos and c-Jun positive cells had no obvious differences among the groups （P 〉 0.05）. CONCLUSION ： The methods of Bushen Yiqi, Huoxue Quyu and Ditan Kaiqiao can effectively treat PSD in rats, and the results were equivalent with those of fluoxetine, the actions of the above-mentioned drugs may correlated with their regulation to c-Fos and c-Jun expressions in hippocampus. PSD animal models can be successfully established by both permanent deligation of bilateral common carotid arteries and forced swimming, and the models induced by the former has similar basic cerebrovascular lesions as human stroke in clinic.

Integrated Chinese and Western medicine in the treatment of a patient with podocyte infolding glomerulopathy:A case report

BACKGROUND Podocyte infolding glomerulopathy(PIG)is a newly described and rare glomerular disease.To date,only approximately 40 cases have been reported globally.CASE SUMMARY A 26-year-old female patient presented to our hospital with a complaint of intermittent edema of both lower limbs over the past 2 years.The patient was diagnosed with PIG.She was prescribed corticosteroid therapy in other hospitals during the initial stage,to which she had responded poorly and had developed femoral head necrosis.Therefore,we administered immunosuppressants,reninangiotensin system inhibitors,combined with traditional Chinese medicine.The patient was followed for 1 year,during which her clinical condition improved.CONCLUSION Integrated Chinese and Western medicine may be effective for PIG treatment,which requires active intervention to improve prognosis.

Integration of Chinese herbal medicines and exercise for insomnia:a systematic review and meta-analysis

Background:As a disease,insomnia is often ignored by the general public.Insomnia,which not directly fatal,may be equivalent to chronic suicide if it is not paid attention to.However,there are many theories on how to treat insomnia,and researchers have been searching for a cure.Chinese herbal medicine(CHM)and exercise therapy(ET)are relatively effective,and have been used since ancient times to treat insomnia.This study aimed to examine the effect of CHM combined with ET(CHM-ET)on patients with insomnia.Methods:We searched eight electronic databases including PubMed,Web of Science,EMBASE,the Cochrane Library,the China National Knowledge Infrastructure(CNKI),the China Biology Medicine disc(CBMdisc),the China Science and Technology Journal Database(VIP),the Wanfang Database to find randomized controlled trials(RCTs)evaluating CHM-ET in the treatment of insomnia patients up to September 13,2022.Two researchers read and screened the publications to extract data.We used the pittsburgh sleep quality index(PSQI)as the evaluation indicators for each study,and the other was the total effective rate(TER).The Cochrane risk-of-bias assessment tool was used to assess the risk of bias of the included literature.The level of evidence for this result was assessed by GARDE method.The meta-analysis was performed using STATA 14 software and RevMan 5.3.The research method was registered with PROSPERO(CRD42022350926).Results:We included fourteen randomized controlled trials,which including a total of 1,126 participants.Compared with the control group,the experimental group showed significantly improvements in sleep effect as reflected by the reduced PSQI score[mean difference(MD)=-2.47,95%confidence interval(CI)(-3.15,-1.78),I^(2)=92%]with low quality of evidence,and increased TER[risk ratio(RR)=1.23,95%CI(1.14,1.33),I^(2)=40%]with moderate quality of evidence.Compared with hypnotic drugs,CHM-ET significantly reduced the PSQI score[mean difference(MD)=-3.18,95%CI(-5.48,-0.89),I^(2)=73%]with low quality of evidence.The PSQI of CHM-ET significantly decreased compared with single CHM[mean difference(MD)=-3.04,95%CI(-5.84,-0.25),I^(2)=98%]with low quality of evidence,and ET[mean difference(MD)=-2.44,95%CI(-2.87,-2.02),I^(2)=0%]with moderate quality of evidence.No serious adverse reactions were observed.Conclusion:This review suggested that CHM-ET may be an effective treatment for insomnia.However,given the limited quality of the studies and methodologies included in the trials,further rigorous randomized controlled trials are needed for more accurate results.

Therapeutic potential of natural compounds from Chinese medicine in acute and subacute phases of ischemic stroke

Stroke is one of the leading causes of death and disability in adults worldwide,resulting in huge social and financial burdens.Extracts from herbs,especially those used in Chinese medicine,have emerged as new pharmaceuticals for stroke treatment.Here we review the evidence from preclinical studies investigating neuroprotective properties of Chinese medicinal compounds through their application in acute and subacute phases of ischemic stroke,and highlight potential mechanisms underlying their therapeutic effects.It is noteworthy that many herbal compounds have been shown to target multiple mechanisms and in combinations may exert synergistic effects on signaling pathways,thereby attenuating multiple aspects of ischemic pathology.We conclude the paper with a general discussion of the prospects for novel natural compound-based regimens against stroke.

Traditional Chinese Medicine as a Treatment for Rheumatoid Arthritis:From Empirical Practice to Evidence-Based Therapy

Rheumatoid arthritis(RA)is a common autoimmune condition with an elusive etiology.Conventional and biological disease-modifying drugs sometimes fail or produce only partial responses.Traditional Chinese medicine(TCM)has long been used in China as a treatment for RA and is achieving everincreasing acceptance worldwide.TCM treatments are traditionally guided by the theory of treatment based on TCM syndrome differentiation;however,they remain a matter of empirical practice relying on TCM theories and doctors’own experience,which places severe restrictions on worldwide TCM application.Nevertheless,TCM is a treasure trove for drug discovery,particularly as a treatment for complicated human conditions.The discoveries of artemisinin as a treatment for malaria and of TCM–arsenic trioxide(As2O3)combination therapy as a treatment for acute promyelocytic leukemia(APL)are excellent examples of the great value of TCM.Regarding RA treatments,many Chinese medicinal herbs and their formulas,extracts,ingredients,and even single compounds have been used in clinical applications.Several Chinese proprietary medicines(CPMs)derived from TCM formulas or herbal bioactive components,such as the controlled-release ZhengQingFengTongNing(ZQFTN)Tablets,Tripterygium Glycoside Tablets,and Total Glucosides of Peony(TGP)Capsules,have been included in the National Health Insurance Directory of China,and show comparable therapeutic efficacies to those of western chemical drugs with fewer side effects.As TCM research has advanced,particularly in the use of multidisciplinary technologies,the scientific foundations and characteristics of the use of TCM to treat RA have been revealed,and the quality of TCM treatments have been increasingly enhanced.However,TCM generally lacks sufficient clinical and laboratory data to be consistent with international standards for quality,safety,and efficacy in order to support its application worldwide.Therefore,intensive basic and clinical studies on TCM are required.In particular,investigations that use cutting-edge technologies in analytical chemistry,biology,and biomedical sciences,and the development of randomized clinical trials(RCTs)and personalized pragmatic randomized controlled trials(PPRCTs)are necessary.Researchers should also collaborate to advance TCM from empirical practice to evidence-based therapy,thus consistently promoting TCM development and globalization in a vital,beneficial,and contributable manner.

Assessment and Explorations on the Mechanism of Neuroprotection of Patients in Ischemic Stroke by Traditional Chinese Medicine

ischemic stroke is a common clinical emergency, with thrombolysis and neuroprotection as its cardinal treatment, and nowadays the latter is more and more stressed by stroke researchers. On the basis of pathophysiology and ischemic cascade of ischemic stroke, we now try to analyze the conceivable mechanism of intervention by tradition Chinese medicine （TCM） and hopefully provide experience for experimental and clinical research in the future.

Efficacy of Yiqiyangxin Chinese medicine compound combined with cognitive therapy in the treatment of generalized anxiety disorders

Objective:To observe the clinical efficacy of Yiqiyangxin Chinese medicine compound combined with cognitive therapy on generalized anxiety disorders.Methods:A total of 202 generalized anxiety disorders patients were randomly allocated to a control condition(Paroxetine combined with cognitive therapy) or a treatment condition(Yiqiyangxin Chinese medicine compound combined with cognitive therapy).Subsequently,scores of Hamilton Anxiety Scale(HAMA), Zung Self-rating Anxiety Scale(SAS) and blood routine,urine routine,liver function,renal function,electrocardiogram were detected before treatment,3 months,6 months after treatment and 6 months after medicine withdrawal,respectively.Results:HAMA and SAS scores were significantly reduced in two groups(P【0.001) after treatment,but the differences in HAMA and SAS scores,apparent effect and effectiveness were not significant(P】0.05).HAMA and SAS scores were significantly increased in two groups(P【0.05) after medicine withdrawal,and there were significant differences in HAMA and SAS scores,recurrent disease and adverse reaction(P【0.001). The incidence of recurrent disease and adverse reaction in treatment group was low.Both two groups showed no apparent abnormality in blood routine,urine routine,liver and renal function, and electrocardiogram.Conclusions:Yiqiyangxin Chinese medicine compound combined with cognitive therapy can significantly reduce the recurrence after medicine withdrawal and is effective on generalized anxiety disorders.Furthermore,the incidence of adverse reactions is low. The treatment program is worthy clinic application in the further.

Traditional Chinese medicine ointment combined with tuina therapy in treatment of pain and swelling after total knee arthroplasty

BACKGROUND The most effective treatment for knee joint pain is total knee arthroplasty(TKA),but the risk of pain and swelling in patients after surgery is high.Ice application,ankle pump exercise and non-steroidal anti-inflammatory painkillers are the primary clinical treatments after surgery.However,long-term use of nonsteroidal anti-inflammatory pain relievers can easily cause gastrointestinal damage.Traditional Chinese medicine(TCM)ointments and tuina therapy integrate TCM and manipulation,which effectively promotes the penetration of TCM into the skin lesions,improves local blood circulation and inflammatory reaction and has good long-term effects on patients.AIM To evaluate the efficacy of TCM ointment combined with tuina therapy in the treatment of pain and swelling after TKA.METHODS The randomized controlled clinical trial enrolled 80 patients who underwent TKA via the same procedure.The patients were randomly divided among the treatment group(n=40)and the control group(n=40).The control group was given an analgesia pump in addition to oral painkillers as the postoperative intervention.The treatment group received TCM ointment with tuina therapy in addition to the analgesia pump and oral painkillers in the postoperative period.The following variables were recorded 3 d before surgery and 3 d,7 d and 14 d after surgery:Visual analogue scale(VAS)score;skin temperature;circumferences at 15 cm above and below the patella;maximum active knee flexion angle;and the knee injury and Osteoarthritis Outcome score(KOOS).RESULTS After treatment,VAS was significantly lower in the treatment group than the control group at 7 d(t=7.536,P<0.001)and 14 d(t=8.563,P<0.001).The skin temperature of participants in the treatment group was significantly lower than that in the control group at 7 d(t=2.968,P=0.004)and 14 d(t=4.423,P<0.001).The circumference values of the two positions in the treatment group were lower than those in the control group at 7 d[t=2.315,P=0.023(above);t=2.121,P=0.037(below)]and 14 d[t=2.374,P=0.020(above);t=2.095,P=0.039(below)].After 14 d of treatment,the maximum active knee flexion angle and KOOS of the two groups were significantly improved but were significantly higher in the treatment group(P<0.05 for both).CONCLUSION TCM ointment and tuina therapy have significant advantages over standard care in the treatment of pain and swelling after TKA.This additional treatment may improve knee function but additional studies are needed to confirm our observations.

Methodological exploration on the construction of a traditional Chinese medicine nursing expert consensus based on evidence--taking stroke as an example

Objective: To explore the methodology of the evidence-based expert consensus formulation process of traditional Chinese medicine(TCM) nursing taking stroke as an example.Methods: First, preliminary and comprehensive presentation of all stroke-related symptoms and corresponding TCM nursing techniques involved were revealed through bibliometric analysis. Then, selection of stroke symptoms and TCM nursing techniques for inclusion in the consensus was performed using an expert consultation method. Next, we determined the search strategy for a precise evidence search;conducted an evaluation of evidence quality and the grade of the evidence;and completed evidence extraction, evidence analysis, and evidence synthesis based on the included symptoms and TCM nursing techniques. The Delphi method was then applied to determine the strength of each recommendation and the choice of nursing care points by referring to the Grading of Recommendations, Assessment, Development, and Evaluations grid. Finally, we conducted an external expert validation of the Delphi results to form an expert consensus guideline.Results: Through the bibliometric analysis, 22 stroke symptoms and 18 TCM nursing techniques were identified in the literature. Then, after expert consultation, 22 symptoms and 111 pairs of symptoms combined with TCM nursing techniques were selected for the evidence search. Evidence integration yielded 10 stroke symptoms corresponding to 29 bodies of evidence;these 10 symptoms were retained through the Delphi consultation, and recommendation strength results for 26 recommendations were obtained. A total of 9 symptoms were further retained for expert external validation to form 24 recommendations, with a recommendation process score range of 7.64-9.99 points and a more scientific and standardized recommendation-formation process.Conclusion: Owing to the current limited conditions of evidence-based resources for TCM nursing, the present consensus-building process represents only a preliminary exploration of an evidence-based expert consensus for TCM nursing to provide a reference for a more scientific and standardized methodology.