Research on the development methodology for clinical practice guidelines for organic integration of traditional Chinese medicine and Western medicine

Integrated traditional Chinese medicine(TCM)and Western medicine(WM)is a new medical science grounded in the knowledge bases of both TCM and WM,which then forms a unique modern medical system in China.Integrated TCM and WM has a long history in China,and has made important achievements in the process of clinical diagnosis and treatment.However,the methodological defects in currently published clinical practice guidelines(CPGs)limit its development.The organic integration of TCM and WM is a deeper integration of TCM and WM.To realize the progression of"integration"to"organic integration",a targeted and standardized guideline development methodology is needed.Therefore,the purpose of this study is to establish a standardized development procedure for clinical practice guidelines for the organic integration of TCM and WM to promote the systematic integration of TCM and WM research results into clinical practice guidelines in order to achieve optimal results as the whole is greater than the sum of the parts.

Progress in diagnosis and treatment of small cell lung cancer with integrated traditional Chinese and Western medicine

Lung cancer is one of the most common major diseases that seriously threaten human health,lung cancer includes small cell lung cancer(SCLC)and non-small cell lung cancer(NSCLC).Although patients with SCLC account for about 20%of the total number of patients with lung cancer,the mortality rate is much higher than that of patients with NSCLC.Integrated traditional Chinese and Western medicine has obvious advantages in the treatment of patients with SCLC.According to the relevant literature reports on the treatment of SCLC in recent years,this article will summarize the research progress of integrated traditional Chinese and western medicine in the treatmentof SCLC from the aspects of traditional Chinese medicine(TCM)combined with surgery,chemotherapy,radiotherapy,and molecular targeted therapy.

Clinical distribution and molecular profiling on postoperative colorectal cancer patients with different traditional Chinese medicine syndromes

Background:Traditional Chinese medicine(TCM)syndrome,also named syndrome,are comprehensive and integral analyses of clinical information which helps to guide different individualized treatment prescriptions.Methods:Thirty healthy controls and 80 colorectal cancer(CRC)patients(including 33 Spleen Qi Deficiency syndrome,23 Dampness Heat syndrome,17 Blood Stasis syndrome and 7 other syndrome)were enrolled into this study.Human mRNAs were extracted from peripheral blood mononuclear cells.The gene expression for CRC patients with different TCM syndrome was determined by microarray and qRT-PCR.Results:Spleen Qi Deficiency,Dampness Heat and Blood Stasis were the most common syndromes in CRC patients.There is a significant difference was found in mRNA expression levels(especially for PIK3CA,STAT3,SOX9 and KDM5C)among Spleen Qi Deficiency,Dampness Heat and Blood Stasis syndrome groups.The higher mRNA levels of JNK1,TP53,MLH1,MSH6,PMS2,SOCS3,TCF7L2,FAM123B,PSAP,FBXW7,SALL4 and the lower expression of inflammatory cytokine IL-6 were found in Spleen Qi Deficiency group but not other syndrome types.The higher mRNA levels of KRAS,MUC16,EGFR,GRASP65,PIK3CA,MAPK7,CD24,STAT3,SLC11A1,Bcl-2,TXNDC17 and some inflammatory cytokines(IL-6,IL-23,TNF-a,CXCR4)were found in Dampness Heat group but not other syndrome types.Blood Stasis syndrome showed higher expression of SOX9,MLH1,MSH6,KDM5C,PCDH11X,PSAP and SALL4,and lower mRNA levels of PIK3CA,CD24,STAT3,CXCR4,TXNDC17 and TP53.The CRC patients with Dampness Heat syndrome might have a poor prognosis than other syndrome types.Conclusion:The identification of syndrome conditions had different impacts on CRC prognosis,and which might be related with different mRNA expression levels.Some oncogenes and pro-inflammatory cytokines were highly expressed in Dampness Heat group but not other syndrome types,suggesting that the CRC patients with Dampness Heat syndrome might have a poor prognosis.Our results prelimitarily uncovered the molecular basis of syndrome differences in CRC prognosis,a better understanding for TCM treatment of CRC.

Artificial intelligence for the development and implementation guidelines for traditional Chinese medicine and integrated traditional Chinese and western medicine

The translation and implementation of clinical practice guidelines(CPGs)for Traditional Chinese Medicine(TCM)and Integrated Traditional Chinese and Western medicine is crucial to the adoption of medical science and technology,but the low operability and slow update of integrated traditional Chinese and Western Medicine guidelines,and the lack of integration between guidelines and clinical practice,result in the guidelines not having the desired clinical effects in practice.The application of Artificial Intelligence(AI)to the field of CPGs development aims to shorten the development time,optimize and accelerate the whole process of CPG’s development.This article summarized the current research and application status of AI in development and implementation CPGs for TCM and Integrated Traditional Chinese and Western medicine and proposed the method of Combining real world data and AI technology to enrich for TCM and Integrated Traditional Chinese and Western medicine.

Organic Integration of Traditional Chinese and Western Medicines—Future of Clinical Practice Guidelines of Integrated Traditional Chinese and Western Medicines

The transformation and implementation of clinical practice guidelines for integrated traditional Chinese medicine(TCM)and Western medicine(WM)is crucial to the adoption of medical science and technological findings and is an important way for TCM to be made available to the world.First,clinical practice guidelines(CPGs)of TCM and WM integration in recent years was analyzed to clarify the current situation and problems in the existing guidelines according to the following four perspectives:(1)perspective of TCM and WM integration in guidelines,(2)diagnosis Using integrated TCM and WM,(3)integration of TCM and WM treatment,(4)promoting TCM and WM integration.Secondly,the information and quality evaluation of CPGs for integrated Chinese and Western medicine in 2020–2022 were analyzed to explore the degree and methods of integration of Chinese and Western medicine guidelines.And last this study aimed to lay a foundation for the further establishment of Chinese characteristic,repeatable,and calculable clinical practice guidelines of TCM and WM integration.

Clinical research progress of ischemic heart failure and prospect of traditional Chinese medicine

As one of the most common types of heart failure, the diagnosis and treatment of Ischemic heart failure are the main focus of clinic. In recent years, the studies on biomarkers have provided supports for clinical diagnosis, prognosis evaluation and stratification. The clinical application of new drugs and the development of non-drug treatment methods have brought more choices conventional treatment. At the same time, under the guidance of Traditional Chinese Medicine syndrome differentiation theory, Traditional Chinese Medicine therapy also plays an increasingly important role and shows its broad prospects .

Clinical Effect of Integrated Traditional Chinese and Western Medicine on Diabetic Peripheral Neuropathy

Objective:Patients with diabetic peripheral neuropathy were treated with integrated traditional Chinese and western medicine,and the final results were observed.Methods:70 patients with such symptoms were randomly divided into two groups.The number of people is the same,and the treatment methods are different.The control group uses western medicine,while the observation group uses traditional Chinese medicine to evaluate the treatment effect.Results:After treatment,the effective rate of the observation group was(P<0.05),indicating that the treatment effect was significantly better.Conclusion:Patients with clinical diabetic peripheral neuropathy treated with routine nutrition and nerve repair,and with Chinese medicine,the effect is more satisfactory,and the effect is positive,so as to promote the optimization of their health.

Chemoprophylaxis, diagnosis, treatments, and discharge management of COVID-19: An evidence-based clinical practice guideline(updated version)

The novel severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is the cause of a rapidly spreading illness,coronavirus disease 2019(COVID-19),affecting more than seventeen million people around the world.Diagnosis and treatment guidelines for clinicians caring for patients are needed.In the early stage,we have issued"A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus(2019-nCoV)infected pneumonia(standard version)";now there are many direct evidences emerged and may change some of previous recommendations and it is ripe for develop an evidence-based guideline.We formed a working group of clinical experts and methodologists.The steering group members proposed 29 questions that are relevant to the management of COVID-19 covering the following areas:chemoprophylaxis,diagnosis,treatments,and discharge management.We searched the literature for direct evidence on the management of COVID-19,and assessed its certainty generated recommendations using the Grading of Recommendations,Assessment,Development and Evaluation(GRADE)approach.Recommendations were either strong or weak,or in the form of ungraded consensus-based statement.Finally,we issued 34 statements.Among them,6 were strong recommendations for,14 were weak recommendations for,3 were weak recommendations against and 11 were ungraded consensus-based statement.They covered topics of chemoprophylaxis(including agents and Traditional Chinese Medicine(TCM)agents),diagnosis(including clinical manifestations,reverse transcription-polymerase chain reaction(RT-PCR),respiratory tract specimens,IgM and IgG antibody tests,chest computed tomography,chest X-ray,and CT features of asymptomatic infections),treatments(including lopinavirritonavir,umifenovir,favipiravir,interferon,remdesivir,combination of antiviral drugs,hydroxychloroquine/chloroquine,interleukin-6 inhibitors,interleukin-1 inhibitors,glucocorticoid,qingfei paidu decoction,lianhua qingwen granules/capsules,convalescent plasma,lung transplantation,invasive or noninvasive ventilation,and extracorporeal membrane oxygenation(ECMO)),and discharge management(including discharge criteria and management plan in patients whose RT-PCR retesting shows SARS-CoV-2 positive after discharge).We also created two figures of these recommendations for the implementation purpose.We hope these recommendations can help support healthcare workers caring for COVID-19 patients.

Clinical Research progress of traditional Chinese medicine in treating esophageal cancer

Esophageal cancer is one of the most common malignant tumors in the world. In recent years, the incidence and mortality of esophageal cancer have increased year by year, which has seriously threatened human health. Surgery, chemotherapy and radiotherapy, as the primary treatments of Western medicine, have achieved specific results in the clinic, but each has its limitations, this is mainly related to their side effects. The diversified treatment methods of traditional Chinese medicine have visible clinical effects, especially in terms of reducing toxicity and increasing efficiency. This present review reviews the research progress of esophageal cancer in terms of traditional Chinese medicine treatment, including the application of Chinese medicine extract, Chinese herbal compound, Chinese patent medicine and TCM external treatment in clinical practice, may provide valuable information for the adjuvant treatment of esophageal cancer with traditional Chinese medicine.

Application of external treatment of traditional Chinese medicine in the treatment of cancer-related fatigue

External treatment of traditional Chinese medicine(TCM),also known as external treatment of internal diseases,has many advantages,such as simple,easy to operate,cost-effective and so on.Therefore,external treatment of TCM is favored by the majority of medical workers.By consulting the domestic literature reports on the treatment of cancer-related fatigue(CRF),it is found that the external treatment of TCM has a significant effect on the intervention of CRF,and has a good effect on reducing fatigue,improving the quality of life and prolonging the survival time.The purpose of this paper is to summarize the application of several external treatments in this disease,and to provide a variety of references for clinical treatment of CRF.

Understanding of Traditional Chinese Medicine and Western Medicine on Swimming Shoulder

Swimming shoulder refers to shoulder pain syndrome which is caused by repeated impinges on shoulder joints among swimmers.It is one of the most common causes of shoulder pain among swimmers with high incidence.Swimming shoulder can affect the systematization of swimmers’training and the improvement of their training level and performance,which is a difficult problem for many swimmers,coaches,medical staff and sports medical doctors.Therefore,attention should be paid to the treatment of swimming shoulder in daily diagnosis and treatment.

An Expert Consensus of Integrated Chinese and Western Medicine Treatment on Lung Cancer

Lung cancer is a malignant tumor of the lung originating from the bronchial mucosa,glands or alveolar epithelium.With the population aging and environmental pollution getting increasingly severe,lung cancer has become the malignant tumor with the highest incidence and mortality rate in China,seriously endangering people’s life and health.However,there is no standardized guideline for the integrated Chinese and Western medicine treatment of lung cancer in China.In order to standardize and improve integrated Chinese and Western medicine diagnosis and treatment of lung cancer in China,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,together with oncologists from the Sun Yat-sen University Cancer Center,compiled this consensus under the coordination of the Medical Policy Department of the National Administration of Traditional Chinese Medicine,taking into account the main results of the pilot project of Chinese and Western Medicine Clinical Collaboration for Major Difficult Diseases(lung cancer).

Interpretation of Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia(Trial Version 7)

On March 3,2020,the National Health Commission and the National Administration of Traditional Chinese Medicine of China jointly promulgated the Notice on Printing and Distributing the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia(Trial Version 7).The content has been revised and supplemented on the basis of the Version 6,including etiological characteristics and pathological changes in lung,heart,kidney,spleen,liver,gallbladder,esophagus,stomach and intestinal mucosal epithelium.In particular,the diagnosis and treatment methods of traditional Chinese medicine are supplemented.It provides an evidence-based diagnosis and treatment protocol for the treatment and recovery of suspected and confirmed cases of novel coronavirus pneumonia with traditional Chinese medicine and Western medicine.

Guidelines for diagnosis and treatment of hepatic fibrosis with integrated traditional Chinese and Western medicine(2019 edition)

In 2006, the Hepatology Committee of Chinese Association of Integrative Medicine issued the "Guidelines for the Prevention and Treatment of Liver Fibrosis with Integrated Traditional Chinese and Western Medicine." In recent years, the fields of Chinese medicine, Western medicine, and integrative medicine have made rapid advances in basic and clinical research into chronic liver disease, and accumulated new evidence for the prevention and treatment of hepatic fibrosis. Therefore, in order to meet clinical needs, liver disease experts of integrated traditional Chinese and Western medicine were united to revise the previous guidelines in order to help physicians make correct and reasonable decisions in the diagnosis and treatment of hepatic fibrosis.

Traditional Chinese Medicine Syndromes Distribution in Colorectal Cancer and its Association with Western Medicine Treatment and Clinical Laboratory Indicators

Objective:The objective of the study is to explore the traditional Chinese medicine (TCM) syndrome distribution in colorectal cancer (CRC) and its correlation with treatment methods and clinical laboratory indicators.Materials and Methods: Using the CRC cases report form of TCM,760 CRC patients with TCM four diagnosis information,western medicine treatment information and clinical laboratory indicators were collected,and TCM syndromes distribution in CRC were summarized.The correlation between TCM syndrome type and western medicine treatments,clinical laboratory indicators such as liver and kidney function,immune function,and tumor biomarkers was analyzed. Results:In 760 cases of CRC, Spleen deficiency syndrome (SDS, 25%),liver and kidney Yin deficiency syndrome (LKYDS, 13%), LKYDS-SDS,12%,spleen deficient Qi stagnation syndrome (SDQSS, 10%),and damp heat syndrome (DHS, 9%) were more common TCM syndrome types.LKYDS, SDS,LKYDS-SDS,and SDQSS were significantly distributed under different treatment methods (P < 0.001).There was no statistically significant difference in the distribution of immune fUnction and cytokine among the five TCM syndromes (P > 0.05),but there was statistically significant difference in the distribution of blood routine,liver and kidney function, and tumor biomarkers (P < 0.05). Conclusion: LKYDS,SDS,LKYDS-SDS, SDQSS,and DHS were the first five TCM syndromes in CRC.There were the significant correlations between the distribution of TCM syndrome and the clinical laboratory indicators,and the distribution of TCM syndromes was affected by surgery, radiotherapy,and chemotherapy.

Traditional Chinese medicines for non-small cell lung cancer: Therapies and mechanisms

The most common subtype of lung cancer is non-small cell lung cancer(NSCLC), which has a poor prognosis and seriously threatens the health of human beings. The multidisciplinary comprehensive treatment model has gradually become the mainstream of NSCLC treatment. Traditional Chinese medicine(TCM) can be used effectively either as an adjunctive therapy or alone throughout the NSCLC therapy,which has a significant impact on survival, quality of life, and reduction of toxicity. Therefore, this paper reviewed the theoretical basis, the latest clinical application, and combined treatment mechanisms in order to explore the advantage stage of TCM treatment and the synergistic therapeutic mechanisms.

Analysis of novel coronavirus pneumonia treatment with Chinese herbal compound

Objective: To analyze the prescription law of TCM compound in the treatment of new coronavirus pneumonia, and provides reference for the clinical treatment of new coronavirus pneumonia. Methods: Collected Collected 24 novel coronavirus pneumonia related diagnostic and therapeutic plans issued by the National Health Council and the Chinese medicine authority from January 26, 2020 to March 8th ,the filtered solution involved in the formula, establishing database of traditional Chinese medicine compound prescription for the treatment of new crown pneumonia, the frequency of using frequency analysis methods of analysis and clustering analysis and association rules analysis to sort out data mining analysis of traditional Chinese medicine compound. Results: In this study, a total of 159 TCM compounds were included in the treatment of new crown pneumonia from the country and 23 provinces, municipalities and autonomous regions, involving 189 TCM compounds. A total of 62 high-frequency traditional Chinese medicines (frequency ≥ 11) were obtained, mainly including licorice, almond, ephedra, gypsum, Poria cocos, Huoxiang, etc The drug types are mainly heat-clearing drugs, vacuous drugs, moisture-curing drugs, and surfactant drugs. The main effect of the medicine was warm, cold, lukewarm and flat, the main effect of the medicine was bitter and bitter, and the main effect of the medicine was the lung, stomach and spleen. Cluster analysis results according to the performance of traditional Chinese medicine treatment of new crown pneumonia high frequency drugs into 7 classes;Association rule analysis results in 29 common drug pairs. Conclusion: In the treatment of pneumonia caused by new coronavirus infection with traditional Chinese medicine, the following characteristics are presented: the number of times of supplementing qi and Yin is more than that of attacking evil and maintaining health;The method of dispersing and solving the attack of wet, beneficial, wet, permeable and wet medicine fully embodies a variety of ways to drive away evil;In terms of drugs, heat-clearing drugs, deficiency drugs, dampness drugs and surface drugs are the main ones, highlighting that the basic treatment method is to dissolve dampness and detoxify, and replenish qi and Yin. In summary, this study can provide reference for guiding clinical drug use and developing new drugs.

Traditional Chinese Medicine Pattern Classification and Herbal Medicine for COVID-19: A Comparative Study of Data from Different Sources

Background: Traditional Chinese medicine(TCM) plays a crucial role in the prevention and control of coronavirus disease 2019(COVID-19). Objective: The study aimed to reveal the distribution characteristics of COVID-19 TCM syndrome types and syndrome elements and the law of TCM treatment and medication. Methods: The TCM diagnosis and treatment protocol for COVID-19 and clinical research data were obtained through network retrieval, and Revman 5.3 and SPSS 23.0 were employed to analyze the composition of TCM syndromes and the situation of TCMs in meta and frequency. Results: The top three TCM syndromes of COVID-19 included damp-heat accumulation in the lung pattern, damp abundance due to spleen deficiency, and epidemic toxin invading the lung pattern, while the syndrome elements were dampness, heat, and toxin. Gypsum fibrosum, Pogostemonis herba, and Armeniacae semen were identified as the commonly used drugs. Different syndrome elements were identified at lung disease location: Forsythiae fructus, Glycyrrhizae radix, and Armeniacae semen can be used for “wind;” Glycyrrhizae radix, Armeniacae semen, and Scutellariae radix can be used for “Heat;” Armeniacae semen, Sheng Gypsum fibrosum, and Ephedrae herba can be used for “Toxin;” Ephedrae herba, Armeniacae semen, and Atractylodis rhizome can be used for “Damp;” Magnoliae officinalis Cortex, Ephedrae herba, and Zingiberis Rhizoma recens can be used for “cold;” and Armeniacae semen, Gypsum fibrosum, Ephedrae herba, and Lepidii/Descurainiae semen can be used for “epidemic.” Conclusion: The establishment of a treatment scheme based on the classification of disease syndrome elements should be considered for sudden infectious diseases, such as COVID-19. Pogostemonis herba, Armeniacae semen, Gypsum fibrosum, and Glycyrrhizae radix should be considered as effective drugs from TCM for the treatment of COVID-19.