Current Research Status of Traditional Chinese Medicine External Treatment for Diarrhea Type Irritable Bowel Syndrome

Irritable bowel syndrome(IBS-D)with diarrhea is a common gastrointestinal functional disease in clinical practice,which seriously affects the quality of life of patients.Cur‐rently,Western medicine has poor therapeutic effects,while traditional Chinese medi‐cine has unique advantages in relieving IBS-D symptoms and preventing recurrence.In recent years,especially with external treatment of traditional Chinese medicine,it has become a new treatment direction in clinical practice and has achieved good therapeutic effects.This article will provide a review of recent research on the treatment of IBS-D using traditional Chinese medicine external treatment methods.

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.

Exploring the Application Effect of Flipped Classroom Combined with Problem-Based Learning Teaching Method in Clinical Skills Teaching of Standardized Training for Resident Doctors of Traditional Chinese Medicine

Objective: To explore the application effect of flipped classroom combined with problem-based learning teaching method in clinical skills teaching of standardized training for resident doctors of traditional Chinese Medicine. Methods: The study used the experimental control method. The study lasted from September to November 2022. The subjects of this study were 49 students of standardized training for resident doctors of traditional Chinese Medicine from grades 2020, 2021 and 2022 of Dazhou integrated TCM & Western Medicine Hospital. They were randomly divided into experiment group (25) and control group (24). The experiment group adopted flipped classroom combined with problem-based learning teaching method, and the control group adopted traditional teaching method. The teaching content was 4 basic clinical skill projects, including four diagnoses of traditional Chinese Medicine, cardiopulmonary resuscitation, dressing change procedure, acupuncture and massage. The evaluation method was carried out by comparing the students’ performance and a self-designed questionnaire was used to investigate the students’ evaluation of the teaching method. Results: The test scores of total scores in the experimental group (90.12 ± 5.89) were all higher than those in the control group (81.47 ± 7.96) (t = 4.53, P P Conclusions: The teaching process of the flipped classroom combined with problem-based learning teaching method is conducive to improving the efficiency of classroom teaching, cultivating students’ self-learning ability, and enhancing students’ willingness to learn.

Study on traditional Chinese medicine syndrome of esophageal cancer based on Delphi method

Esophageal cancer is one of the common malignant tumors in humans.Traditional Chinese medicine(TCM)has unique advantages in the treatment of esophageal cancer.However,the TCM syndrome classification of esophageal cancer is not standardized.This Delphi survey aimed to explore the TCM syndrome classification and symptom characteristics of esophageal cancer.Methods:Based on literature research,an expert consultation questionnaire was developed for the study of the TCM syndrome rules of esophageal cancer.Two rounds of questionnaire surveys were conducted among 62 experts across the country.Statistical description and statistical analysis of the mean,coefficient of variation,grade sum,and unimportant percentage of the retrieved data.TCM syndrome rules and diagnostic indicators for esophageal cancer after screening and sorting out the questionnaire items,convening experts to demonstrate.Results:62 valid questionnaires were collected,and the expert positive coefficient was 100%.The Kendall's coefficient of concordance W of the first and second rounds are 0.232 and 0.2334 respectively.In addition,the Kendall's coefficient of concordance W of the second round has been improved compared with the first round,suggesting that experts have a better degree of coordination on the importance of indicators.The common TCM syndromes of esophageal cancer are obtained:"liver-stomach disharmony,phlegm and qi obstruction syndrome","liver and spleen disorders,phlegm accumulating with stagnation syndrome","deficiency of liver and kidney yin,stubborn blood syndrome","deficiency of spleen and kidney yang,stubborn blood syndrome".Conclusion:The TCM syndrome indicators of esophageal cancer has been established.It provides a basis for the standardized research of TCM syndrome diagnosis of esophageal cancer,which is of positive significance for improving the level of clinical diagnosis and treatment.

Discussion on the Quality Evaluation Method of Traditional Chinese Medicine Compound Preparations

As an important representative of the modernization of the Chinese medicine industry,traditional Chinese medicine(TCM)compound preparations are an indispensable part of the development of TCM.The complex ingredients and unclear action mechanism of TCM compound preparations restrict the development of TCM.In line with this problem,the modern TCM research has made extensive remarkable achievements.From the single indicator in the past to multiple indicator,the research on the combination of TCM fingerprints and pharmacodynamics also has made great progress.The introduction of quality evaluation methods such as the"quantitative analysis of multi-components by a single marker","dose-effect"indicator,"Bioactive Equivalent Combinatorial Components"(BECCs)and TCM quality markers have brought new ideas for quality control of TCM compound preparations.

Construction of Complex Intervention in Traditional Chinese Medicine (TCM): A Preliminary Methodological Study Based on Text Mining and Interviewing Method

Aim: To explore and analyze the feasibility of establishing a program of complex intervention in Traditional Chinese Medicine (TCM) based on Text Mining and Interviewing method. Methods: According to MRC, Constructing the program of complex intervention in TCM by Text Mining and Interviewing method should include 4 steps: 1) establishment of interview framework via normalization of extraction of ancient documents and Effectiveness of collection of modern periodical literatures;2) materialization of interview outline based on Focus Group Interview;3) rudimentary construction of complex intervention program based on Semi-structured Interview;4) evaluation of curative effect of complex intervention. Conclusions: It is feasible and significative to establish a program of complex intervention in TCM based on Text Mining and Interviewing method.

Analysis on the medication and methods of ancient traditional Chinese medicine in the prevention of plague

Background:To analyze the medication and methods of ancient traditional Chinese medicine for the prevention of plague and seasonal pathogen in order to reduce the spread of infectious diseases such as flu and protect the susceptible people.Methods:Search the medication and the methods for preventing plague and seasonal pathogen in the Chinese Medical Code,classify and summarize the methods,perform frequency analysis and efficacy cluster analysis on Chinese medicines of involved medicines.Results:The methods of preventing ancient plague were as follows:burning and fumigating Chinese medicines,medicating nostrils,wearing bags filled with Chinese medicines,oral Chinese medicines and applying medicines to skin.The 3 main ways for drugs to work were external medication,nostril inhalation,and internal absorption.The Chinese medicines for preventing plague are mostly warm in nature and pungent in flavour,belonging to the spleen,stomach,liver,lung meridian.The 3 categories of drugs obtained by cluster analysis are C1:drugs for facilitating lung,relieving exterior and dissipating cold,such as Cangzhu(Atractylodis rhizoma)-Qianghuo(Notopterygh rhizoma et radix)-Xixin(Asari radix et rhizoma)-Baizhi(Angelicae dahuricae radix)-Fangfeng(Saposhnikoviae radix)-Zaojiao(Gleditsiae sinensis fructus);C2:drugs for promoting blood circulation and removing blood stasis,such as Xionghuang(Realgar)-Zhusha(Cinnabaris)-Dahuang(Rhei radix rhizoma)-Chuanxiong(Chuanxiong rhizoma)-Jiegeng(Platycodonis radix);C3:drugs for replenishing Qi(it is the most basic element that constitutes human body and maintains life activities in traditional Chinese medicine)and tonifying the spleen,such as Gancao(Glycyrrhizae radix et rhizoma)-Dazao(Jujubae fructus)-Ganjiang(Zingiberis rhizoma)-Rougui(Cinnamomi cortex)-Gansong(Nardostachyos radix et rhizoma)-Chenpi(Citri reticulatae pericarpium)-Baizhu(Atractylodis macrocephalae rhizoma).Conclusion:Through analysis the medication and methods of ancient traditional Chinese medicine for the prevention of plague,we can provide reference for modern research from the original plague prevention methods,and make an important contribution to the use of traditional Chinese medicine in the prevention and treatment of epidemic infectious diseases in modern clinic.

General Situation of Traditional Chinese Medicine Identification Methods

Traditional Chinese medicines are the material basis for the treatment of diseases under theoretical direction, as well as the raw materials of traditional Chinese medicine decoction pieces and Chinese patent medicines. The quality of traditional Chinese medicine directly influences clinical efficacy. Therefore, the identification of traditional Chinese medicine is the responsibility of medicinal workers. The identification method develops from observation, tasting, smelling and listening to firing method and testing with water, and the construction of fingerprints of traditional Chinese medicines and molecular biological techniques. The development and evolution of traditional Chinese medicine identification methods was reviewed in this paper.

Construction of nursing standard of integrated traditional Chinese and Western medicine for patients with COVID‑19 (mild and common) in Beijing based on Delphi method

Objective:The objective of this study is to establish a nursing standard of integrated traditional Chinese and Western medicine for patients with COVID‑19(mild and common)in Beijing,to provide reference for clinical nursing of patients with COVID‑19(mild and common).Methods:Through online communication meeting with nurses who are in the frontline of anti‑epidemic,clinical investigation,literature research,and expert demonstration meeting are carried out to prepare the draft of the standard,and the Delphi method is applied to determine the standard of integrated traditional Chinese and Western medicine care for patients with COVID‑19(mild and common)in Beijing.Results:The nursing standard of integrated traditional Chinese and Western medicine for patients with COVID‑19(mild and common)was established,which included 5 first‑level indicators,14 second-level indicators and 60 third‑level indicators.After two rounds of Delphi method,the positive coefficients of experts were 96%and 83%,the authoritative coefficients of experts were 0.89 and 0.91,and the Kendall’s coefficient of concordance(W)of experts were 0.12,0.09,0.10,0.13(P<0.05)and 0.44,0.43,0.37,0.39(P<0.05).Conclusion:The standard of integrated traditional Chinese and Western medicine nursing for patients with COVID‑19(mild and common)in Beijing constructed by the Delphi method is scientific and practical,which provides a reference for clinical application of integrated traditional Chinese and Western medicine nursing to fight against COVID‑19 infection.

Safety Research in Traditional Chinese Medicine: Methods, Applications, and Outlook

Traditional Chinese medicine (TCM) is a medical system that has collected and summarized abundant clinical experience over its long history of more than 2000 years. However, the frequent occurrence of TCM-induced adverse reactions has hindered the modernization and internationalization of TCM, while attracting increasing attention from around the world. Unlike chemical drugs and biological agents, the difficulties involved in research on the toxicity and safety of TCM mainly include the complexity of its components and the unpredictability of drug–body interactions. Much of TCM, which has overall therapeutic effects, has the typical mechanisms of multiple components, multiple pathways, and multiple targets. While considering the gradualness and unpredictability of TCM toxicity, the ambiguity of toxicants and safe dosage, and individual differences during long-term TCM administration, we have systematically established key techniques for the toxicity assessment of TCM. These techniques mainly include TCM toxicity discovery in an early phase, based on a combination of drug toxicology genomics and metabolomics;methods to identify dose–toxicity relationships in TCM;and integrated techniques for the exploration of TCM interactions, such as fast-screening tests based on drug-metabolizing enzymes and receptor pathways. In particular, we have developed a new technical system for TCM safety evaluation using molecular toxicology, which has been validated well in research on TCM compatibility contraindication, quality control, and allergen discovery. The application of this key technical platform is introduced here in detail. This application includes model organisms, toxicant biomarkers, a magnetic suspension technique, and the application of network toxicology and computational toxicology in research on the toxicity of Fructus toosendan, Semen cassiae, Polygonum multiflorum, and Fructus psoraleae.

Research progress of data mining in the treatment of hypertension by traditional Chinese medicine

With the gradual development of data mining technology,more and more data mining software emerges as the times require,and the data mining methods are diversified,which provides a strong support in the study of the treatment of hypertension by traditional Chinese medicine.This research systematically introduces the advantages,disadvantages and application examples of data mining software such as SPSS,TCM inheritance support platform,TCM clinical research information sharing system and data mining methods such as cluster analysis,bayesian network,system evaluation.It is expected to enhance the practical application of data mining in the study of prevention,diagnosis and medication rule of TCM treatment of hypertension,and provide reference for the development of new software and new technology.

Identification of protein targets for the antidepressant effects of Kai-Xin-San in Chinese medicine using isobaric tags for relative and absolute quantitation

Kai-Xin-San consists of Ginseng Radix, Polygalae Radix, Acori Tatarinowii Rhizoma, and Poria at a ratio of 3:3:2:2. Kai-Xin-San has been widely used for the treatment of emotional disorders in China. However, no studies have identified the key proteins implicated in response to Kai-Xin-San treatment. In this study, rat models of chronic mild stress were established using different stress methods over 28 days. After 14 days of stress stimulation, rats received daily intragastric administrations of 600 mg/kg Kai-Xin-San. The sucrose preference test was used to determine depression-like behavior in rats, while isobaric tags were used for relative and absolute quantitation-based proteomics to identify altered proteins following Kai-Xin-San treatment. Kai-Xin-San treatment for 2 weeks noticeably improved depression-like behaviors in rats with chronic mild stress. We identified 33 differentially expressed proteins: 7 were upregulated and 26 were downregulated. Functional analysis showed that these differentially expressed proteins participate in synaptic plasticity, neurodevelopment, and neurogenesis. Our results indicate that Kai-Xin-San has an important role in regulating the key node proteins in the synaptic signaling network, and are helpful to better understand the mechanism of the antidepressive effects of Kai-Xin-San and to provide objective theoretical support for its clinical application. The study was approved by the Ethics Committee for Animal Research from the Chinese PLA General Hospital(approval No. X5-2016-07) on March 5, 2016.

A Review of Traditional Chinese Medicine for the Treatment of Depression

Depression is a common mental illness with symptoms such as loss of interest.At present,It is mainly treated with antidepressants,which are effective in a short time,but it is highly addictive and has a high probability of adverse reactions.Traditional Chinese medicine(TCM)treatment of depression has the advantages of high feasibility,good tolerance,obvious effect,and small side effects.In addition,TCM has great potential for the treatment of depression with the overall concept of the unity of nature and man as its guiding ideology and rich clinical experience.This review mainly expounds on the research progress of TCM treatment of depression from two aspects of TCM non-drug therapy and TCM drug therapy,to provide a reference for clinical treatment of depression.

Progress on Therapy of Infertility by Integrated Traditional Chinese and Western Medicine

Infertility is one of the difficult complicated diseases. Many couples suffer from it. The pathogenesis is very complicated. The imbalance or lesson of any link of the reproductive system can cause infertility. This paper summarizes the treatment of female infertility by integrated Traditional Chinese Medicine (TCM) and Western Medicine (WM) which can not only improve the ovulation rate and pregnancy rate, but also decrease the complications. The effects are better than that by TCM or WM only. Therefore, the coupling method is worth to be used widely in clinical practice.

A Skopos Theory-based Study of Translation Principles of Traditional Chinese Medicine Decoctions

English translations of Traditional Chinese medicine(TCM)terms and prescriptions need standardizing to minimize ambiguity as the popularity of TCM spreads globally.Herein an evaluation guide for translation of TCM decoctions in English into diverse social,cultural and medical systems,is proffered which integrates Skopos theory and Li Zhaoguo’s principles of English translation(conciseness of lexical composition,information accuracy,and similarity in lexical composition).Based on a case study of the traditional herbal medicine Mahuang Xingren Gancao Shigao Tang,direct translation methods with concise lexical composition are determined to most clearly convey the sophisticated and verbose original TCM prescription.

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.

Research of Quality Standards for Stachydrine Hydrochloride in Chinese Medicine TJF Granule

A high-performance liquid chromatographic method was applied to the determination of stachydrine hydrochloride concentration in TJF granule (Chinese name: Tiao-Jing-Fang), using a mobile phase of methanol-acetonitrile (50:50, v/v) by the Agilent Kromasi NH2 column (250 mm × 4.6 mm, 5 μm, S/N: 22N25110). Detection wavelength was 201 nm. The result revealed good linearity of stachydrine hydrochloride and was obtained within the range of 0.20 - 1.98 μg/mL (R = 0.9995). The average recovery was 97.01%;the relative standard deviation (RSD) was 0.19%. To the best of our knowledge, this is the first report dedicated to the determination of stachydrine hydrochloride by the evaporative light scattering detector-high-performance liquid chromatographic (ELSD-HPLC) method.

Neuroprotective mechanism of Kai Xin San: upregulation of hippocampal insulin-degrading enzyme protein expression and acceleration of amyloid-beta degradation

Kai Xin San is a Chinese herbal formula composed of Radix Ginseng, Poria, Radix Polygalae and Acorus Tatarinowii Rhizome. It has been used in China for many years for treating amnesia. Kai Xin San ameliorates amyloid-β （Aβ） induced cognitive dysfunction and is neuroprotective in vivo, but its precise mechanism remains unclear. Expression of insulin-degrading enzyme （IDE）, which degrades Aβ, is strongly correlated with cognitive function. Here, we injected rats with exogenous Aβ42 （200 μM, 5 μL） into the hippocampus and subsequently administered Kai Xin San （0.54 or 1.08 g/kg/d） intragastrically for 21 consecutive days. Hematoxylin eosin and Nissl staining revealed that Kai Xin San protected neurons against Aβ-induced damage. Furthermore, enzyme linked immunosorbent assay, western blot and polymerase chain reaction results showed that Kai Xin San decreased Aβ42 protein levels and increased expression of IDE protein, but not mRNA, in the hippocampus. Our findings reveal that Kai Xin San facilitates hippocampal Aβ degradation and increases IDE expression, which leads, at least in part, to the alleviation of hippocampal neuron injury in rats.

Effect of Sinai San decoction on the development of non-alcoholic steatohepatitis in rats

AIM: To explore the effect of Sinai san decoction on the development of non-alcoholic steatohepatitis induced by CCL4 combined with a fat-rich diet in rats.METHODS: Twenty-seven Sprague-Dawley rats were divided into three groups randomly: control group (n = 9),model group (n = 9) and treatment group (n = 9). The rats of model group and treatment group were given small dosage of CCL4 combined with a fat-rich diet, andthose of control group were given normal diet. After four weeks of fat-rich diet feeding, the rats of treatment group were given Sinai san decoction. The serum levels of aminotransferase and lipid were measured, and the pathology of livers was observed by HE staining after the rats were sacrificed at eight weeks.RESULTS: The rats' livers presented the pathology of steatosis and inflammation with higher serum levels of ALT and AST in the model group. In the treatment group the serum ALT and AST levels decreased significantly and were close to the control group. The hepatic inflammation scores also decreased markedly, but were still higher than those of control group. And the degree of hepatocyte steatosis was similar to that of model group.CONCLUSION: Sinai san decoction may ameliorate the hepatic inflammation of rats with steatohepatitis induced by small dosage of CCL4 combined with a fat-rich diet,but does not prevent the development of hepatocyte steatosis.

Analysis of fibronectin, fibronectin receptor and interleukin 1 in patients with cirrhosis treated by Yanggan Jieyu decoction

AIM To investigate the adjusting effects of the Yanggan Jieyu (YGJY, nourishing the liver and alleviate mental depression) decoction on the plasma concentration of fibronectin (FN), fibronectin receptor (FNR), tumor necrosis factor alpha (TNF α) and the activity of interleukin 1 (IL 1) in patients with cirrhosis. METHODS Thirty four cases of cirrhosis (in decompensation) were divided into YGJY decotion treated group and control group treated by routine method. FN, FNR and TNF α were measured with ELESA and expressed as mg/L (FN, FNR) and ng/L (TNF α), and IL 1 was measured by mice thymocyte proliferation using β scintillation counter and expressed as cpm. RESULTS In YGJY decoction treated group, before treatment, FN was 247 9±97 2, FNR 5 6±2 7, TNF α 83 9±7 1 and IL 1 was 2760 8±813 6, and after treatment. FN was 298 3±93 2 ( P <0 01), FNR 4 3±2 3 ( P <0 05, TNF α 93 6±12 0 ( P <0 05) and IL 1 was 1922 3±847 0 ( P <0 05). The FN and TNF α plasma level after treatment increased remarkably, while FNR and IL 1 decreased obviously. In the control group before treatment, FN was 248 8±101 9, FNR 5 5±1 9, TNF α 126 1±48 1 and IL 1 was 2540 6±603 2, and after treatment was 241 6±77 1 ( P >0 05), FNR 5 4±1 2 ( P >0 05), TNF α 100 6±15 5 ( P >0 05) and IL 1 was 2360 6±860 0 ( P >0 05), the plasma levels of FN, TNF α, FNR and IL 1 did not change signifiantly. CONCLUSION YGJY decoction could prevent the process of the hepatic fibrosis by readjusting the plasma levels of FN, FNR, TNF α and IL 1 mediating acivities in cirrhosis, which is of clinical significance.