Prognostic significance of identification of traditional Chinese medicine syndromes in colorectal cancer

Background:Traditional Chinese medicine(TCM)syndrome is the basic unit of TCM treatment,which help clinicians assess the disease progression and treatment preoperative of tumor patients.However,the prognostic significance of TCM syndrome is still unclear.This study aims to detect the differences in overall survival between different TCM syndrome and further develop a new nomogram with TCM syndrome for predicting overall survival in colorectal cancer.Methods:A total of 324 patients with colorectal cancer were enrolled and categorized into three groups based on TCM syndrome:deficiency,excess,and deficiency-excess.The prognosis of colorectal cancer patients with different TCM syndromes was evaluated using Kaplan-Meier analysis and Cox regression analysis.Results:The proportion of advanced stage and lymph metastasis in the patients with deficiency syndrome was higher,and the overall survival was shorter than other syndromes.Meanwhile,the TCM syndrome(P<0.001),tumor invasion depth(P<0.001),lymph metastasis(P=0.018),organic metastasis(P=0.005)and tumor node metastasis(TNM)stage(P=0.029)were the independent prognostic factor.Then,a new nomogram with TCM syndrome was established and assessed.324 colorectal cancer patients were randomly divided into training(n=215)and validation cohorts(n=109).A nomogram incorporating preoperative TCM syndrome,gender,age,T,N,and M status was developed,which had good discrimination and calibration.Conclusion:Taken together,our results indicated that TCM syndrome could assess the prognosis of colorectal cancer.The nomogram incorporating TCM syndromes and tumor information is helpful for risk stratification and prognostic predictions in colorectal cancer preoperatively.

A cross-sectional study on traditional Chinese medicine syndromes distribution for chronic atrophic gastritis based on data mining

Background:Chronic atrophic gastritis(CAG)is a common digestive system disease characterized by reduced gastric mucosa inherent glands and often accompanied by intestinal metaplasia and dysplasia.Traditional Chinese medicine believes that syndrome elements dampness and blood stasis are closely related to the occurrence and development of CAG and promote the occurrence of precancerous lesions of gastric cancer.However,there is a lacking of more in-depth and detailed study on the above syndrome elements.This study aimed to made a quantitative description by cross-sectional study on the frequency of key syndrome elements dampness and blood stasis of CAG.Methods:201 CAG patients who met with inclusion criteria were divided into 4 groups including:only dampness group,only blood stasis group,none of dampness and blood stasis group,dampness and blood stasis group according to their four diagnostic information.The severities and levels of patients’clinical symptoms,pathological signs and patient-reported outcome scale used as evaluation indexes were collected.Data mining method of exploratory factor analysis was used for statistics.Results:The results suggested that the frequencies of dampness and blood stasis were reflected in the severity and levels of gastric symptoms,helicobacter pylori infection and the distribution and severity of dysplasia.And blood stasis played a more prominent role in promoting the progression of the CAG to cancer.Conclusion:Our results might provide a quantitative syndrome description for the traditional Chinese medicine differentiation in treating precancerous lesions of gastric cancer and preventing gastric cancer.

Comprehensive effects of traditional Chinese medicine treatment on heart failure and changes in B-type natriuretic peptide levels: A meta-analysis

BACKGROUND Heart failure(HF),a common cardiovascular condition,is characterized by significant morbidity and mortality.While traditional Chinese medicine(TCM)is often used as a complementary approach in HF management,systematic evalua-tions of its impact on clinical outcomes,TCM syndrome scores,and B-type natriuretic peptide(BNP)levels are lacking.This study fills this gap through a comprehensive analysis of randomized controlled trials(RCTs)focusing on TCM for HF treatment.It encompasses an assessment of methodological quality,a meta-analysis,and an evaluation of evidence quality based on established standards.The results offer crucial insights into the potential advantages and constraints of TCM in HF management.RCTs on TCM for HF treatment published since the establishment of the database were searched in four Chinese and English databases,including China National Knowledge Infrastructure,Wanfang,VIP Information Chinese Science and Technology Journal,and PubMed.Methodological quality was assessed for the included studies with the Cochrane risk-of-bias assessment tool,and the meta-analysis and publication bias assessment was performed with the RevMan5.3 software.Finally,the quality of evidence was rated according to the GRADE criteria.RESULTS A total of 1098 RCTs were initially retrieved.After screening,16 RCTs were finally included in our study,which were published between 2020 and 2023.These RCTs involved 1660 HF patients,including 832 in the TCM group[TCM combined with conventional Western medicine(CMW)treatment]and 828 in the CWM group(CWM treatment).The course of treatments varied from 1 wk to 3 months.TCM syndrome differentiation was analyzed in 11 of the included RCTs.In all included RCTs,outcome indicators included comprehensive clinical outcomes,TCM syndrome scores,and BNP levels.The meta-analysis results showed significant differences between the TCM and CWM groups in terms of comprehensive clinical outcomes[risk ratio=-0.54;95%confidence interval(CI)=-0.61,-0.47;P<0.00001],TCM syndrome scores[weighted mean difference(WMD)=-142.07;95%CI=-147.56,-136.57;P<0.00001],and BNP levels(WMD=-142.07;95%CI=-147.56,-136.57;P<0.00001).According to the GRADE criteria,RCTs where"TCM improves clinical comprehensive outcomes"were rated as low-quality evidence,and RCTs where"TCM reduces TCM syndrome scores"or"TCM decreases BNP levels"were rated as medium-quality evidence.CONCLUSION TCM combined with CWM treatment effectively improves comprehensive clinical outcomes and diminishes TCM syndrome scores and BNP levels in HF patients.Given the low and medium quality of the included RCTs,the application of these results should be cautious.

Serum metabolic profiling of traditional Chinese medicine syndromes in patients with diarrhea-predominant irritable bowel syndrome

Objective:The clinical symptoms of diarrhea-predominant irritable bowel syndrome(IBS-D)can be effectively improved by traditional Chinese medicine(TCM)treatment,based on the usage of specific therapies for different TCM syndromes.However,in the stage of diagnosis,the standard criteria for the classification of TCM syndrome were still deficient.Through serum metabolic profiling,this study aimed to explore potential biomarkers in IBS-D patients with different TCM syndromes,which can assist in diagnosis of the disease.Methods:Serum samples were collected from healthy controls(30 cases),IBS-D patients with LiverStagnation and Spleen-Deficiency syndrome(LSSD,30 cases),Yang Deficiency of Spleen and Kidney syndrome(YDSK,11 cases)and Damp Abundance due to Spleen-Deficiency syndrome(DASD,22 cases).Serum metabolic profiling was conducted by ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry.The potential biomarkers were screened by orthogonal partial least square-discriminate analysis,while metabolic pathways undergoing alterations were identified by pathway enrichment analysis in Metabo Analyst 4.0.Results:Overall,34 potential biomarkers were identified in LSSD group,36 in YDSK group and 31 in DASD group.And the 13 metabolites shared by three groups were determined as the potential biomarkers of IBS-D.Glycerophospholipid metabolism was disturbed significantly in IBS-D patients,which may play a role in IBS-D through inflammation.What’s more,three TCM syndromes have the specific potential biomarkers in glycerophospholipid metabolism.Conclusion:The serum metabolomics revealed that different TCM syndrome types in IBS-D may have different metabolic patterns during disease progression and glycerophospholipid metabolism was one of the pathways,whose metabolism was disturbed differently among three TCM syndromes in IBS-D.Therefore,the specific potential biomarkers in glycerophospholipid metabolism of three TCM syndromes in IBS-D can serve as the objective indicators,which can facilitate the TCM-syndrome objective classification of IBS-D.

Study of the Relationship between Carotid Intima-media Thickness and Traditional Chinese Medicine Syndrome of Dyslipidemia

Objective:The study aimed to explore the relationship between the carotid intima-media thickness (IMT),lipids,high-sensitivity C-reactive protein(hs-CRP),homocysteine(Hcy) and other indices of laboratory and the traditional Chinese medicine(TCM) syndrome of dyslipidemia.Methods:A total of 152 dyslipidemia patients and 8 healthy people(taken as the control group) were recruited.According to the theory of the TCM syndrome,152 dyslipidemia patients were assigned to 4 groups:the stagnation of phlegm(SP) grou...

Characteristics of Traditional Chinese Medicine Syndrome in Patients with Coronary Heart Disease at Different Disease Stages

Coronary atherosclerotic heart disease(CHD)has a high incidence,disability rate,and mortality rate,which severely affect people’s health,work,and life.Based on its clinical manifestations,traditional Chinese medicine(TCM)has classified CHD as“chest impediment”and“heart pain”for the treatment.The course of CHD is protracted,and the pathogenesis is complex and changeable.Moreover,different disease stages have different syndrome characteristics.Thus,this article aimed to summarize the classification and distribution characteristics of the TCM syndrome in various stages of CHD,such as before and after percutaneous coronary intervention therapy,disease progression,age,and complications,to provide references for the TCM clinical diagnosis and treatment of CHD.

Exploring medication rules in Chinese randomized controlled trials of type 2 diabetes based on data mining technology

Background:To systematically summarize and categorize the Chinese herbal medicine in the domestic traditional Chinese medicine(TCM)literature on type 2 diabetes mellitus(T2DM),in this paper,we mine traditional Chinese medicine data for relationships and provide for future practitioners and researchers.Methods:Taking randomized controlled trials on the treatment of T2DM in TCM as the research theme,we searched for full-text literature in three major clinical databases,including CNKI,Wan Fang,and VIP,published between 1990 and 2020.We then conducted frequency statistics,cluster analysis,association rules extraction,and principal component analysis based on a corpus of medical academic words extracted from 1116 research articles.Results:The most frequently used is Astragali Radix,and the most commonly used two-herb combination in T2DM treatment consisted of Coptidis Rhizoma and Moutan Cortex.Moutan Cortex,Alismatis Rhizoma,and Dioscoreae Rhizoma were the most frequently used three-herb combination.We found a“lung”and“liver”and“kidney”model and confirmed the value of classical meridian tropism theory and pattern identification.The treatment is mainly to fill deficiency and clear heat and consider water infiltration,dampness,blood circulation,and silt.Conclusion:This study provides an in-depth perspective on the TCM medication rules for T2DM and offers practitioners and researchers valuable information about the current status and frontier trends of TCM research on T2DM in terms of diagnosis and treatment.

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.

Clinical Research of Zhenwu Decoction Combined with Tingli Dazao Xiefei Decoction in the Treatment of Chronic Heart Failure with Edema Syndrome due to Yang Deficiency

[Objectives]The paper was to investigate the clinical effects of Zhenwu Decoction combined with Tingli Dazao Xiefei Decoction in the treatment of chronic heart failure with edema syndrome due to yang deficiency.[Methods]Eighty patients with chronic heart failure were randomly divided into 2 groups(control group and treatment group),with 40 cases in each group.The patients in the control group were treated with conventional western medicine for 14 d,and the patients in the treatment group were treated with Zhenwu Decoction and Tingli Dazhao Xiefeng Decoction on the basis of the control group for 14 d.The curative effect of traditional Chinese medicine(TCM)syndrome score,left ventricular ejection fraction(LVEF),plasma N-terminal brain natruretic peptide precursor(NT-proBNP)and New York Heart Association(NYHA)functional class were compared between the two groups before and after treatment.Minnesota living with heart failure questionnaire in the principle of Chinese civilization and traditional medicine characteristics(C-MLHF)at admission and 1 month after discharge were compared between the two groups.[Results]After treatment,the total effective rate of TCM syndrome score in the treatment group was 82.50%,and that in the control group was 67.50%.The curative effect of TCM syndrome score in the treatment group was better than that in the control group(P<0.05).After treatment the LVEF in both groups was increased compared with that before treatment,and the NT-proBNP level was decreased compared with that before treatment(P<0.05),and those in the treatment group were better than those in the control group.The total effective rate of cardiac function in the treatment group was 87.50%,and that in the control group was 65.00%.The improvement of cardiac function in the treatment group was better than that in the control group(P<0.05).One month after discharge,C-MLHF scores in both groups were decreased compared with those before treatment,and that in the treatment group was lower than in the control group(P<0.05).[Conclusions]Zhenwu Decoction combined with Tingli Dazao Xiefei Decoction based on traditional western medicine treatment could improve the clinical efficacy,symptoms and quality of life of patients in the treatment of chronic heart failure with edema syndrome due to yang deficiency.

Summary and correlation analysis of TCM syndromes in 159 elderly patients with acute myeloid leukemia

Objective:To investigate the characteristics of TCM syndromes in elderly patients with acute myeloid leukemia(AML)at the onset,and to analyze the main syndrome types and their correlation with age,percentage of bone marrow blasts,and genetic prognostic stratification.Methods:A retrospective analysis was performed on 159 AML patients aged over 60 years who were diagnosed and treated in our hospital,and the clinical data were collected and analyzed statistically.Results:In 159 elderly AML patients,the main clinical symptoms were fatigue,poor appetite,conscious fever,and various hemorrhages.The main syndromes were Ying(42.01%),Wei(31.25%),Essential(14.81%)and Blood(11.69%);the syndromes are divided into Qi and Yin deficiency(32.70%),Qi and blood deficiency(30.19%),true Yin deficiency(28.03%)and Qi heat and blood(8.81%).The age difference between the two groups was statistically significant(P<0.001),and the multiple comparison results showed that the age of the Qi-blood deficiency group was younger than the true-Yin deficiency group and the Qi-Yin deficiency group;the percentage of bone marrow blasts was statistically significant in the three groups at the initial diagnosis(P<0.05),multiple comparison results showed that the percentage of bone marrow blasts in the true Yin deficiency group was higher than that in the Qi-blood deficiency group and the Qi-Yin deficiency group;the genetic prognostic stratification of the three groups was statistically significant(P<0.05),multiple comparisons.The results showed that the genetic prognosis of the true Yin deficiency group was poorer than that of the Qi and blood deficiency group and the Qi and Yin deficiency group.Conclusion:The most common clinical symptoms of elderly AML patients are fatigue,the disease is located in the bone marrow,and the disease is Ying,Wei,essence,and blood.With the increase in the patient's age,the TCM syndrome types tend to be more insufficiency of true Yin and deficiency of both Qi and Yin,and the prognosis of patients with insufficiency of true Yin is poor.It provides a directional scientific basis for the treatment of senile AML with integrated traditional Chinese and Western medicine.

Traditional Chinese Medicine Clinical Experience of the Treatment for Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a functional bowel disorder that includes abdominal pain or discomfort associated with defecation or a change in bowel habits with features of disordered defecation.This disease lacks morphological changes and biochemical abnormalities to explain the symptoms.

Clinical efficacy and safety of Guipi decoction combined with escitalopram oxalate tablets in patients with depression

BACKGROUND Depression is a widespread mental health condition that requires effective treatment.In the treatment of depression,traditional Chinese medicine(TCM)offers obvious advantages,fewer adverse reactions,and a lower recurrence rate.AIM To evaluate the clinical benefits of Guipi decoction combined with escitalopram oxalate tablets for individuals with depression.METHODS In total,80 patients diagnosed as having depression were enrolled in the study and divided into either an experimental group or a control group.All of the patients were orally administered escitalopram oxalate tablets.Additionally,the experimental group received Jiajian Guipi decoction and reduced Governor vessel fumigation over 4 wk.TCM syndrome scores,Hamilton depression rating scale(HAM-D)scores,self-rating depression scale(SDS)scores,and Pittsburgh sleep quality index scores were measured for the two groups and compared before and after the treatment.The two groups were monitored for any adverse reactions.RESULTS After 4 wk of treatment,both groups exhibited a significant reduction in TCM syndrome scores compared with their pre-treatment scores(P<0.05).However,the experimental group exhibited significantly lower TCM syndrome scores than the control group(P<0.05).Similarly,the post-treatment SDS and HAM-D-24 scores were significantly lower in both groups than the pre-treatment scores(P<0.05),with the experimental group exhibiting lower scores than the control group(P<0.05).The total treatment efficiency was significantly better in the experimental group(97.14%)than in the control group(77.78%)(P<0.05).Furthermore,after 4 wk of treatment,the Pittsburgh sleep quality index scores for both groups were significantly lower than those before the treatment(P<0.05),with the experimental group exhibiting lower scores than the control group(P<0.05).The incidence of adverse reactions was significantly lower in the experimental group than in the control group(P<0.05).CONCLUSION The combination of Guipi decoction and escitalopram oxalate tablets was found to be an effective and safe treatment for depression.This combination could reduce TCM syndrome scores,improve depressive symptoms,and enhance sleep quality.

Clinical Study of Acupoint Application of Jiezi Fangxiao Ointment Combined with Pingchuan Prescription in the Treatment of Pediatric Asthma

[Objectives]To study the clinical effect of Acupoint Application of Jiezi Fangxiao Ointment combined with Pingchuan Prescription in the treatment of pediatric asthma.[Methods]A total of 40 children with asthma admitted to the First Affiliated Hospital of Heilongjiang University of Chinese Medicine from July 2017 to September 2018 were selected as the research subjects,and divided into control group and observation group according to random classification method,with 20 cases in each group.Among which the control group was given routine symptomatic treatment,the observation group was treated with Acupoint Application of Jiezi Fangxiao Ointment combined with Pingchuan Prescription on the basis of the control group.After 4 weeks of continuous treatment,the clinical efficacy was observed and the changes of traditional Chinese medicine symptom scores,forced expiratory volume in the first second(FEV1),maximum expiratory flow(PEF),forced vital capacity(FVC),peripheral blood eosinophils(EOS)and interleukin-17(IL-17)were compared between the two groups before and after treatment.[Results]After treatment,the traditional Chinese medicine(TCM)scores such as asthma,cough,expectoration,chest tightness,dyspnea and wheezing sound of lungs in the two groups were significantly improved,and the improvement in the observation group was superior to that in the control group.The difference was statistically significant(P<0.05).FEV1,PEF and FVC in the two groups were significantly improved after treatment,and the improvement in the observation group was superior to that in the control group.The difference was statistically significant(P<0.05);after treatment,the levels of EOS and IL-17 decreased in both groups,and the improvement in the observation group was superior to that in the control group,the difference was statistically significant(P<0.05).[Conclusions]The clinical effects of Acupoint Application of Jiezi Fangxiao Ointment combined with Pingchuan Prescription in the treatment of infantile asthma were obvious,which can significantly improve the TCM symptoms scores,pulmonary function and immune function of patients.

Evaluation on Quality of Life and Analysis on Its Correlation with TCM Syndromes in Patients of Chronic Hepatitis B

Objective:To evaluate the quality of life(QOL) in patients with chronic hepatitis B(CHB) and analyze its correlation with traditional Chinese medicine(TCM) syndrome types.Methods:With cross-sectional investigation adopted,the QOL of 335 CHB patients was studied by the World Health Organization Quality of Life BREF Questionnaire(WHOQOL-BREF) and the chronic liver disease questionnaire(CLDQ).The results was compared with that of 30 healthy persons.Results:The QOL of the patients with chronic hepatitis B wa...

Effect of Salivary Antimicrobial Factors on Microbial Composition of Tongue Coating in Patients with Coronary Heart Disease with Phlegm-Stasis Syndrome

Objective: Phlegm-stasis syndrome is one of the most common traditional Chinese medicine(TCM) syndromes and found in 59% of patients with coronary heart disease(CHD) in routine TCM clinical practice in China. One of the diagnostic criteria of phlegm-stasis syndrome is its characteristic white-greasy and thin tongue coating. We have previously reported that different types of tongue coating have different microbiome characteristics that can be used as diagnostic markers. However, the microbial characteristics of tongue coating of CHD patients with phlegm-stasis syndrome, including coating feature and underlying reason of formation, have rarely been reported. Herein, we examined the characteristic microbiome of tongue coating, and discussed the cause of tongue coating formation via salivary proteins in patients with phlegm-stasis syndrome. Methods: We examined white-greasy and thin tongue coatings obtained from 10 patients with CHD having phlegm-stasis syndrome(n = 10), and compared with those of patients with almost no coating – patients with Qi-Yin deficiency syndrome(n = 10) – and healthy controls(n = 10). 16S r RNA sequencing of tongue coating microbiome and isobaric tags for relative and absolute quantitation(i TRAQ)-based quantitative analysis of salivary proteins were used to detect tongue coating and salivary protein separately. Salivary levels of s Ig A, lysozyme, and amylase were detected by ELISA. Results: We identified Candidatus_Saccharimonas and Candidate_division_TM7_norank as the prominent members of tongue coating in patients with CHD having phlegm-stasis syndrome. Salivary proteins involved in biological processes, pentose phosphate pathway, and complement and coagulation cascades were among the differentially expressed proteins identified in patients with CHD having phlegm-stasis syndrome on i TRAQ analysis. Moreover, the formation of microbiota in tongue coating was associated with salivary s Ig A, lysozyme, and saliva flow rate. Conclusions: We explored the characteristics of microbial composition of tongue coating patients with CHD having phlegm-stasis syndrome and identified correlations between salivary proteins and microbiome formation, providing a theoretical and mechanistic basis for tongue coating formation.

Tongue diagnosis based on hue-saturation value color space: controlled study of tongue appearance in patients treated with percutaneous coronary intervention for coronary heart disease

Objective To analyze the characteristics of tongue imaging color parameters in patients treated with percutaneous coronary intervention(PCI)and non-PCI for coronary atherosclerotic heart disease(CHD),and to observethe effects of PCI on the tongue images of patients as a basis for the clinical diagnosis and treatment of patientswith CHD.Methods This study used a retrospective cross-sectional survey to analyze tongue photographs and medicalhistory information from 204 patients with CHD between November 2018 and July 2020.Tongue images ofeach subject were obtained using the Z-BOX Series traditional Chinese medicine(TCM)intelligent diagnosisinstruments,the SMX System 2.0 was used to transform the image data into parameters in the HSV color space,and finally the parameters of the tongue image between patients in the PCI-treated and non-PCI-treated groupsfor CHD were analyzed.Results Among the 204 patients,112 were in the non-PCI treatment group(38 men and 74 women;average age of(68.76±9.49)years),92 were in the PCI treatment group(66 men and 26 women;average age of(66.02±10.22)years).In the PCI treatment group,the H values of the middle and tip of the tongue and the overall coating of thetongue were lower(P<0.05),while the V values of the middle,tip,both sides of the tongue,the whole tongueand the overall coating of the tongue were higher(P<0.05).Conclusion The color parameters of the tongue image could reflect the physical state of patients treated withPCI,which may provide a basis for the clinical diagnosis and treatment of patients with CHD.