Traditional Chinese medicine prescriptions and herbs for the treatment of hypothyroidism:a narrative review

The increasing prevalence of hypothyroidism,which can cause endocrine dysfunction,abnormal neurological function,and cardiovascular and cerebrovascular injuries,poses serious health problems.Thyroid hormone supplementation constitutes the current main therapeutic method for hypothyroidism,yet it has many limitations and risks and is not suitable for everyone.Therefore,it is necessary to seek alternative and complementary treatment methods.It has been proven in practice that traditional Chinese medicine(TCM)possesses multi-channel comprehensive characteristics for the treatment of hypothyroidism and has more advantages than single thyroid hormone supplementation.Through a comprehensive examination of existing literature about TCM efficacy in addressing hypothyroidism,we have meticulously consolidated the most recent research findings on prescriptions and herbal substances employed in the treatment of this condition.Furthermore,we have explicated their respective functions in the management of hypothyroidism,thereby offering valuable perspectives and recommendations for the prospective utilization of natural remedies in its treatment.

Effects of four traditional Chinese medicinal herbs on plasma level of IL-6 and induced TNF level in burned rats with wound infection

Objective : Effects of the decoction of Coptis chinensis Franch. , Scutellaria baicalensis Georgi , P. chinense schneid and Lonicera japonica Thunb. on burn rats with wound infection were observed. Methods : Fifty-six rats were randomly divided into three groups :sham burn , burn wound infected control(BWIC) and burn wound infected and treatment(BWIT). The plasma was harvested from the experimental rats. Plasma IL-6 activity was measured by using the IL-6-dependent cell line B9. The isolated mono-nuclear cells (MNCs) were induced by LPS and cultured for 24 h. TNF in the culture supernatant was detected by ELISA. Results: Plasma IL-6 levels of BWIC and BWIT were significantly elevated at postburn (PB) 24 and 48h , and IL-6 level of BWIC was significantly higher than that of BWIT at PB 48h (P<0. 01). The induced TNF level of BWIT was significantly higher than that of BWIC at PB 24 and 48 h , and that of sham burn at 24 h(P<0. 01). Conclusion : The results indicate that this decoction could inhibit MNCs releasing from pro-inflammatory cytokines which are believed as an endogenous pyrogen.

Evidence and Potential Antibacterial Mechanism of Chinese Traditional Medicine Compounds for the Development of E. coli

Astragalus membranaceus (huangqi), Allium sativum (garlic), Cinnamomum cassia (cinnamon), and Dolichos lablab L. (white hyacinth bean) are the traditional Chinese herbs that were used in prescriptions in treating diarrhea caused by bacterial infection. These herbs are relatively safe for use and investigation. This study aimed to investigate the effects of Astragalus membranaceus, Allium sativum, Cinnamomum cassia, and Dolichos lablab L. on the metabolism of Escherichia coli (E. coli). The growth rate of E. coli was monitored under the influence of each herb, revealing that Astragalus membranaceus and Allium sativum exhibited significant antibacterial activity, whereas Cinnamomum cassia and Dolichos lablab L. demonstrated moderate inhibitory effects on E. coli growth. Further inhibition zone testing allowed for the evaluation of each herb’s potency and the number of generations required for E. coli to develop resistance. Additionally, the impact of the four herbs on the expression of outer membrane protein A (OmpA) in E. coli was examined by using qPCR. The findings revealed that Astragalus membranaceus acted as a sustainable bactericide by inhibiting the growth and metabolism of E. coli MG1655 through the suppression of OmpA expression. These results suggest that Astragalus membranaceus has potential as a natural antimicrobial agent for treating E. coli infections.

Herbal Traditional Chinese Medicine and suspected liver injury: A prospective study

AIM To analyze liver tests before and following treatment with herbal Traditional Chinese Medicine(TCM) in order to evaluate the frequency of newly detected liver injury.METHODS Patients with normal values of alanine aminotransferase(ALT) as a diagnostic marker for ruling out pre-existing liver disease were enrolled in a prospective study of a safety program carried out at the First German Hospital of TCM from 1994 to 2015. All patients received herbal products, and their ALT values were reassessed 1-3 d prior to discharge. To verify or exclude causality for suspected TCM herbs, the Roussel Uclaf Causality Assessment Method(RUCAM) was used.RESULTS This report presents for the first time liver injury data derived from a prospective, hospital-based and largescale study of 21470 patients who had no liver disease prior to treatment with herbal TCM. Among these, ALT ranged from 1 × to < 5 × upper limit normal(ULN) in 844 patients(3.93%) and suggested mild or moderate liver adaptive abnormalities. However, 26 patients(0.12%) experienced higher ALT values of ≥ 5 × ULN(300.0 ± 172.9 U/L, mean ± SD). Causality for TCM herbs was RUCAM-based probable in 8/26 patients, possible in 16/26, and excluded in 2/26 cases. Bupleuri radix and Scutellariae radix were the two TCM herbs most commonly implicated. CONCLUSION In 26(0.12%) of 21470 patients treated with herbal TCM, liver injury with ALT values of ≥ 5 × ULN was found, which normalized shortly following treatment cessation, also substantiating causality.

Herb-herb interaction in traditional Chinese medicine：a review of pharmacokinetics-based interaction in Herb-Pairs

"Herb-Pairs",also known as pair drugs,refers to a prescription consisted of two relatively fixed traditional Chinese medicine,is the most basic,most simple and most common form of medication prescription in traditional Chinese medicine compound compatibility.It is not a random combination of two herbs,nor is the simple accumulation of efficacy,but the simple and delicate experience of ancient Chinese medicine practitioners.As a bridge between single drug and prescriptions,it is the embodiment of the regular and dialectical connotation.Therefore,research on Herb-Pairs has always been the most basic and most important entry point for compound compatibility studies.However,the interaction between herbs and herbs is an effect with a downside as well as benefits.The beneficial herb-herb interaction in Herb-Pairs include mutual promotion,mutual enhancement,mutual restraint between two drugs and counteract toxicity of another drug.And the harmful herb-herb interaction in Herb-Pairs includes mutual inhibition and antagonism.Al of these interactions areby means of affecting the metabolism of components to play a therapeutic effect.Using the pharmacokinetic-pharmacodynamic(PK-PD)binding model,the combination of drug metabolism and pharmacodynamics can further elucidate the influence on effect caused by drug concentration and metabolism,which can help elucidate the mechanism of drug action.Consequently,in this review,the herb-herb interactions in terms of pharmacokinetic were summarized to elucidate rule of TCM compatibility.

Study on Biotransformation of Traditional Chinese Herbal Medicines Complex

A newly designed enzymolysis-fermentation combined method to dramatically enhance the actives level and skin benefits of traditional Chinese herbs (TCHs) was developed, biotransformation process under optimal reaction conditions can significantly transform molecular structures and obtained fermentation extracts can deliver better skin benefits on anti-aging, hydration and whitening. Analytical results showed that the ginsenoside Rg3, total sugar, polyphenols and flavonoids in fermented extract were 2~4 times higher than unfermented extract. In-vitro tests including DPPH radical scavenging activity, tyrosinase inhibition, cells proliferation and Hyaluronan-CD44 activity, have showed significant enhancement of efficacy, inhibition rate on DPPH antioxidation as example achieved over 60% improvement, which makes traditional Chinese herbs application more feasible. It is inferred that this study potentially enables the herbs to deliver required bioefficacy in cosmetic application.

Traditional Chinese medicine for prevention and treatment of hepatocarcinoma: From bench to bedside

Traditional Chinese medicine(TCM) has played a positive role in the management of hepatocarcinoma. Hepatocarcinoma patients may present Qi-stagnation, damp-heat, blood stasis, Qi-deficiency, Yin-deficiency and other TCM syndromes(Zheng). Modern treatments such as surgery, transarterial chemoembolization(TACE) and high intensity focus ultrasound treatment would influence the manifestation of TCM syndromes. Herbs with traditional efficacy of tonifying Qi, blood and Yin, soothing liver-Qi stagnation, clearing heat and detoxifying and dissolving stasis, have been demonstrated to be potent to prevent hepatocarcinogenesis. TCM has been widely used in all aspects of integrative therapy in hepatocarcinoma, including surgical resection, liver transplantation, TACE, local ablative therapies and even as monotherapy for middle-advanced stage hepatocarcinoma. Clinical practices have confirmed that TCM is effective to alleviate clinical symptoms, improve quality of life and immune function, prevent recurrence and metastasis, delay tumor progression, and prolong survival time in hepatocarcinoma patients. The effective mechanism of TCM against hepatocarcinoma is related to inducing apoptosis, autophagy, anoikis and cell senescence, arresting cell cycle, regulating immune function, inhibiting metastasis and angiogenesis, reversing drug resistance and enhancing effects of chemotherapy. Along with the progress of research in this field, TCM will contribute more to the prevention and treatment of hepatocarcinoma.

Traditional Chinese Medicinal Syndromes and Treatment in Colorectal Cancer

Colorectal cancer remains the third most common malignancy worldwide. According to the principles of Traditional Chinese Medicine (TCM), colorectal cancer is related to spleen-deficiency, damp-heat, and toxicity accumulation. Traditional Chinese medicine has been confirmed to effectively reduce toxic side effects and enhance curative effects of chemotherapy, palliate clinical syndrome, prevent recurrence and metastasis, improve quality of life and immune function, and prolong survival time in colorectal cancer. However, TCM theoretical and syndrome differentiation study has lagged far behind due to progression of therapy model in colorectal cancer. As a type of drug treatment, there are some common biological basis between chemotherapy, targeted therapy and anti-cancer herb therapy in colorectal cancer, such as apoptosis, cell senescence and autophagy. There are growing needs to explore the effect mechanism and compatibility of anti-cancer herbs, to further enhance the efficacy of TCM treatment in colorectal cancer.

Determination of vanadium in food and traditional Chinese medicine by graphite furnace atomic absorption spectroscopy

Various experimental conditions were described for the vanadium determinationby graphite furnace atomic absorption spectroscopy (GFAAS). The experiments showed that whenatomization took place under the conditions where the combination of a pyrolytic coating graphitetube and fast raising temperature were used and the temperature was stable, the signal peak shapescould be improved, the sensitivity was enhanced, and the memory effect was removed. The vanadium infood and traditional Chinese medicinal herbs can be accurately determined using the standard curvemethod.

Applicability of Zipfs Law in Traditional Chinese Medicine Prescriptions

Objective Traditional Chinese medicine(TCM)prescriptions have been used to cure diseases in China for thousands of years,in which many TCM herbs have no definite common quantity.Some key TCM herbs are commonly used and thus deserve in-depth investigations based on a more acceptable classification method.This study analyzes whether TCM prescriptions follow Zipf's law and attempts to obtain the thresholds of key TCM herbs based on the application of Zipfs law;Methods A total of 84,418 TCM prescriptions were collected and standardized.We tested whether Zipf's law and Zipfs distribution fit the Chinese herb distributions.A linear fitting experiment was performed to verify the relationship between the frequency distribution and frequency of TCM herbs.Results The distribution of TCM herbs in TCM prescriptions conformed to Zipf's law.Accordingly,the thresholds were obtained for the key TCM herbs.Conclusion The distribution of TCM herbs in TCM prescriptions follows Zipfs law.

Determination of components in traditional Chinese medicines associated with promoting or inhibiting urinary stone formation

Objective:To measure oxalate,calcium,and sodium contents of traditional Chinese medicines(TCMs)that are commonly used to prevent and dissolve urinary stones to exclude the possibility that long-term use of such medicines promotes stone formation.The second objective was to measure citrate,potassium,and magnesium contents in the same medicines to provide possible clues about the mechanisms of prevention and dissolution of urinary stones by TCMs.Methods:Ten of the most commonly-used TCMs for preventing and dissolving urinary stones were chosen and subjected to ion chromatography(IC)to measure water-soluble and total oxalate and citrate contents.Inductively coupled plasma atomic emission spectrometry(ICPAES)was used to measure calcium,potassium,magnesium,and sodium contents in a water extract and in digestion liquid.Results:Average contents of water-soluble oxalate,calcium,and sodium in the water extract were 41.92,84.32,and 22.82 mg/100 g,respectively,far below the normal dietary intake of adults in China.The average contents of citrate and magnesium in water extracts were 268.99 and 66.65 mg/100 g,respectively,below the recommended intake for adults.These ion contents are therefore insufficient to inhibit the formation of urinary stones.The average content of potassium in the water extract was 867.71 mg/100 g,which was relatively abundant,so taking the prescription used in this experimental protocol can increase the body’s potassium content to some extent.Conclusions:Long-term use of TCMs would not increase the risk of urinary stone formation.The potassium content in TCMs is high,which is one possible reason for the prevention of urinary stones by TCMs.

A review and comment on the current situation of 2019 novel coronavirus prevention by traditional Chinese medicine

Objective:To provide some valuable research ideas for the prevention of 2019-nCoV through reviewing and commenting the Chinese herbs in existing prevention programs of TCM.Methods:Firstly,searching the prevention and treatment programs for 2019-nCoV issued before January 29,2020.There are only three sources that can be selected in,including national and provincial health commissions,research and clinical institutes of TCM and national famous TCM doctors.Secondly,from the collections of all prevention and treatment programs,we sorted out prevention parts within Chinese herbs or patent drugs.Thirdly,we divided these TCM prevention programs into three categories and the classification is based on the two aspects of Zhengqi and pathogenic factors.Results:We classified the herbs into three parts:dispelling pathogenic factors mainly,tonifying Zhengqi with dispelling pathogenic factors and syndrome differentiation according to the two most important aspects,Zhengqi and pathogenic factors in TCM prevention theory.Reviewing the above three parts according to TCM theories and introducing some modern pharmacological researches of these herbs.Some matters needing attention were pointed out in clinical application of traditional Chinese herbs.Comments and perspectives:We made the comments on shortcomings of the present situation and look forward to what can be done later from three aspects:collection of clinical data,clinical controlled study and modern pharmacological research.

Research progress on the regulation of androgen receptor signaling pathway in the treatment of prostate cancer by traditional Chinese medicine monomers

The prevalence of prostate cancer in males worldwide is increasing every year.Androgen and androgen receptor drive the development of prostate cancer and are important targets for the treatment of prostate cancer.A growing number of reports indicate that the traditional Chinese medicine has a clear advantage in the prevention and treatment of prostate cancer.This article provides an overview of the in vitro and in vivo studies of different traditional Chinese medicine monomers acting on the androgen receptor-signaling pathway in prostate cancer.

A brief overview of traditional Chinese medicine prescription powered by artificial intelligence

Traditional Chinese medicine prescription is one of the treasures of traditional Chinese medicine(TCM).There are tens of thousands TCM prescriptions accumulated in the past thousands of years,corresponding to different diseases,symptoms and therapeutic goals.The correspondences are so complicated that there is an urgent need to leverage new technologies such as artificial intelligence(AI)to analyze,understand and utilize them effectively.In this paper,we present a brief overview of this direction,where current research progress on TCM prescription powered by AI is summarized.Our summarization focuses on three aspects,TCM prescription mining that aims at understanding the TCM prescription,TCM prescription or herb knowledge base construction that aims at extracting knowledge to support the TCM prescription-related study,and TCM prescription discovery that aims at utilizing AI technologies to further energize TCM.It is encouraging to see that steady progress in this direction has been made recently.Besides,a toy experiment on image-based TCM herb recognition by using convolutional neural networks is also conducted.It basically verifies that it is promising to use AI technologies to address challenging tasks in TCM.We also point out several research topics that could be cooperatively performed by researchers from the two disciplines.

Research Progress of Traditional Chinese Medicine in the Treatment of Carotid Atherosclerosis

Carotid atherosclerosis is a partial manifestation of arteriosclerosis of organism.In recent years,its incidence rate is increasing year by year.Traditional Chinese medicine(TCM)has a broad prospect in the clinical development of CAS treatment by holism concept and the principle of treatment based on syndrome differentiation.This paper reviews the etiology,pathogenesis,TCM dialectics and TCM treatment of carotid atherosclerosis,in order to provide theoretical guidance for TCM treatment of CAS patients.

The role of autophagy in the treatment of osteoporosis by Chinese medicines(natural)

Osteoporosis is one of the common orthopaedic diseases,characterised by increased bone fragility due to reduced bone mass and microstructural degeneration,posing a great threat to patients’quality of life and safety.In recent years,Chinese medicine(natural)has had a unique advantage in the treatment of osteoporosis and has shown good efficacy.Autophagy is an inherent cellular survival mechanism for the removal and recycling of damaged proteins and organelles and plays an important role in maintaining the stability of the intracellular environment and organ function.Therefore,this article aims to provide a comprehensive review of these Chinese medicines(natural)for the treatment of osteoporosis through autophagy.They have been intensively studied and reported to have effects such as promoting osteogenesis and anti-bone resorption.The Chinese medicines include plants such as Cistanche deserticola,Epimedium,Curculigo orchioides Gaertn,Achyranthes bidentata Blume,Leonurus japonicus Houtt,Ginseng,Chuanxiong Rhizome,Eucommia ulmoides,Morindae Officinalis Radix,Curcuma longa,Polygoni Cuspidati Rhizoma et Radix,Anemarrhena asphodeloides Bunge,Salvia miltiorrhiza Bge and Pueraria Lobata,thus providing evidence for the use of alternative herbal therapies for the effective treatment of osteoporosis.

Case report: Treating postpartum SUI with acupuncture and Chinese herbal medicine

Background:Stress urinary incontinence(SUI),is the most common type of urinary incontinence affecting women.SUI has a significant impact on psychosocial functioning and quality of life.Biomedical treatments,such as surgery,often result in post-operative complications.In China,traditional Chinese medicine tends to be the treatment of choice for SUI.Case presentation:We present a 35-year-old patient who developed SUI following forceps delivery and was treated successfully with acupuncture and Chinese herbs.Traditional Chinese diagnosis,including channel and acupoint palpation revealed the patient had a syndrome pattern of liver/kidney deficiency,disordered bladder qi transformation,all of which lead to enuresis.Acupuncture,both body and scalp needling,were performed.Herbs were prescribed adjunctively.Conclusion:Traditional Chinese medicine modalities may be considered for treatment of SUI based on appropriate syndrome pattern assessment.

Aknowledge-guided and traditional Chinese medicine informed approach for herb recommendation

Traditional Chinese medicine(TCM)is an interesting research topic in China’s thousands of years of history.With the recent advances in artificial intelligence technology,some researchers have started to focus on learning the TCM prescriptions in a data-driven manner.This involves appropriately recommending a set of herbs based on patients’symptoms.Most existing herb recommendation models disregard TCM domain knowledge,for example,the interactions between symptoms and herbs and the TCM-informed observations(i.e.,TCM formulation of prescriptions).In this paper,we propose a knowledge-guided and TCM-informed approach for herb recommendation.The knowledge used includes path interactions and co-occurrence relationships among symptoms and herbs from a knowledge graph generated from TCM literature and prescriptions.The aforementioned knowledge is used to obtain the discriminative feature vectors of symptoms and herbs via a graph attention network.To increase the ability of herb prediction for the given symptoms,we introduce TCM-informed observations in the prediction layer.We apply our proposed model on a TCM prescription dataset,demonstrating significant improvements over state-of-the-art herb recommendation methods.

Research ideas and strategies on the dose-effect relationship of traditional Chinese medicine prescriptions and herbs

We discuss here the complexity of the doses of traditional Chinese medicine(TCM) prescriptions and herbs from different viewpoints,including the heterogeneity of drug quality,the flexibility of prescriptions,and the diversity of drug effects.Then,the corresponding research ideas and strategies are proposed.We can reveal the actual situation of clinical doses based on in-depth "real-world study" of the safety and effectiveness of TCM prescriptions,create an analytical method for dose-effect relationships in accordance with the features of TCM,and reveal the correlated regular nature of the effectiveness and dosage of TCM prescriptions and herbs.

Antiviral effect of Chinese medicine jiaweisinisan in hepatitis B virus transgenic mice

AIM： To study the antiviral effect of Chinese medicine jiaweisinisan （JWSNS） on hepatitis B virus （HBV） infection in transgenic mice （TGM）. METHODS： Twenty two 6-8 wk old HBV TGM in the third generation were divided into TGM control group and TGM treated group randomly. The normal control group included ten normal BC 57L/6 mice at the same age. The mice in treated group were administrated with JWSNS at the concentration of 4 g/mL and the dosage of 50 g/kg per d for 30 d, while the mice in TGM control group and normal control group were administrated with normal saline at the same dosage and the same time. Polymerase chain reaction （PCR） was used to assess the contents of HBV DNA in serum of HBV TGM before and after treatments, whereas blot hybridization was utilized to measure the contents of HBV DNA in the liver of both HBV TGM and normal BC 57L/6 mice. RESULTS： The levels of serum HBV DNA in TGM treated group were remarkably decreased after the treatment of JWSNS （7.662±0.78 vs 5.22±3.14, P〈0.05）, while there was no obvious change after administration of normal saline in TGM control group （7.125±4.26 vs 8.932 ± 5.12, P〉 0.05）. The OD values of HBV DNA in the livers of the mice in TGM treated group were significantly lower than those of TGM control group （0.274±0.096 vs 0.432 ± 0.119, P 〈 0.01）. CONCLUSION： JWSNS exerts suppressive effects on HBV DNA in the serum and liver of TGM.